Friday, March 23, 2012
Plain Views, the online newsletter for Chaplains and other Pastoral Care Givers recently posted an article that was taken from a Blog by Dr. Joanne Cacciatore on the proposed changes to the Diagnostic and Statistical Manual (DSM) of the American Psychological Association that would remove the exclusion of bereavement for a diagnosis of depression. In the previous edition, a person could not be diagnosed with depression if the "symptoms" were the result of grieving. There are a number of reasons that this is problematic and I don't think that I could enumerate them any better than Dr. Cacciatore has. I would recommend that you read her reflections in her blog by clicking the title above or clicking HERE. I am grateful that I work for an organization that understands the mental health diagnoses, but is not bound by them. I am grateful that when the staff of the Pastoral Counseling Centers of Tennessee gathers to reflect on our work with our clients, we are more interested in their story and the circumstances of their lives than making them fit into a diagnostic box or assigning them a label. The DSM helps provide a common language for professionals, insurance companies and others to talk about mental and emotional difficulties, but there is great power in words and labels. It seems that the editors of the DSM go a bit too far when they begin to pathologize existential human experiences. The business of being able to precisely define mental illness is difficult task and one that cannot be taken lightly. As Pastoral Counselors, we seek to understand each individual and his or her situation. We use diagnoses sparingly and seek to understand the issues that are common to humanity - community, alienation, hope, despair, sense of the holy, meaning, and purpose - in each client. As I read the stories of Jesus, I see that he sought to break down the barriers of labels and judgements that people use to marginalize one another. Compassion, understanding, unconditional love are much more useful tools than a good 5 Axis Diagnosis on almost any day. The DSM has it's place and a good clinician should know how to use it, but a good clinician should also know when not to use it also.