Thursday, August 12, 2004

My relationsship with DSM-IV

I hate it. Just so you know. In my, not many, years of practise I've met perhaps 5 clients that easily fit in the DSM-IV description and that also accept that description, accept the diagnosis and find it true. 5. Let me just say that I've probably met 50 new clients for every year of practise. So the percentage of people in psychatric care for which DSM-IV is a good thing is really really low.
And it doesn't get easier with experience. On the contrary. It gets harder because the more you know, and the more you meet people, the more obvious it is that people are people and diagnosises are NOT people. But for financial reasons every new client needs to be diagnosed in some way according to DSM-IV. Great.
So I read about crisis disorders, and panic disorders and stress reactions ad infinitum and desperately tries to find something that fits my idea of the client aswell as the clients idea of her/himself. And I wonder why it is that the psychiatrists manage to meet a client for 15 minutes and then assess that it's a personality disorder whereas I meet that same someone for 2 hours, it's obvious it's not a personality disorder but rather a non-adaptive crisis, but in the end treatment is decided according to the psychiatrist. Where is my bloody motivation I ask?

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