Shirah Vollmer MD

The Musings of Dr. Vollmer

DSM 5: The Retraumatization of Diagnosis

Posted by Dr. Vollmer on May 6, 2013


DSM 5 is being released at the American Psychiatric Association meetings in San Francisco in two weeks. My colleague, Robert Stolorow PhD, sums up the issue.

” Against Descartes and his legacy, the DSM, I am contending that all emotional disturbances are constituted in a context of human interrelatedness. One such traumatizing context is characterized by relentless invalidation of emotional experience, coupled with an objectification of the child as being intrinsically defective. No wonder receiving a DSM diagnosis can so often be retraumatizing!”

6 Responses to “DSM 5: The Retraumatization of Diagnosis”

  1. Jon said

    While Rene Descartes was a great polymath – the genesis of modern philosophy, analytic geometry, and much more – I agree with Dr. Stolorow that his starting in the mid- seventeen century discussion of the mind-body problem is inappropriate technique for the twenty-first century psychoanalyst. To Descartes the mind was separate from the body (and by extension, the brain). Robert Stolorow’s harsh, but probably correct, statement is that, “The DSM is a pseudo-scientific manual for diagnosing sick Cartesian isolated minds. As such, it completely overlooks the exquisite context sensitivity and radical context dependence of human emotional life and of all forms of emotional disturbance.” He goes on to comment what you, Shirah, have already quoted.

    I will comment further in your post that follows this one, which is concerned with the National Institute of Mental Health and its stance on the DMS-5.

  2. Shelly said

    On the one hand, it is a relief to people to know that what they have has a name (i.e. autism, anxiety, bipolar disorder, etc…); on the other hand, by labeling their disease, they receive a stigmatizing label that soon becomes a secret and a source of shame. It’s great that actor’s try to bring these things to the public arena (i.e. Catherine Zeta-Jones and her hospitalization for bipolar disorder, Brittany Spears and mania), but I believe they are simply shoving their fight into people’s faces and are saying, “Here I am…LIVE with it.”

    • Thanks, Shelly. I think the idea is that although diagnosis can bring relief, it can also bring a deeper misunderstanding of the psychodynamics of someone’s pain and traumatic experiences. This is the contradiction or dialectic, in which the psychiatrist is obliged to walk in a way which both gives unique understanding to the individual, while at the same time, conveying that some symptoms overlap with others, such that we have some ideas about how to intervene. My plea is for humility, as a way to navigate these treacherous waters. Thanks again. See also the NYT…

  3. Danny said

    Is this the same Robert Storolow from the Intersubjectivity theory then it’d make sense as to why he would have furor over people being treated like things and categorized using statistics aka DSM and then being medicated..

  4. Danny said

    Ps. How do you pick an icon when posting , or is automatically assigned ?

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