Metadata →
- Tags: dsm fav psicoterapia psiquiatría
[!summary]In my first week as a psychiatry faculty member, an advanced psychiatry resident—I’ll call her Dr. G—staffed a case with me.
Highlights
id974430289
“Generalized anxiety disorder isn’t the cause of anxiety,” I explained. “That’s just the term we use to describe it.”
id974430396
Diagnoses listed in the DSM—the Diagnostic and Statistical Manual of Mental Disorders, the so-called bible of psychiatry—do not cause anything. They are not things. They are agreed-upon labels—a kind of shorthand—for describing clusters of symptoms. Generalized anxiety disorder means a person has been anxious or worried for six months or longer and it’s bad enough to cause problems—little else. The diagnosis is description, not explanation. Saying anxiety is caused by generalized anxiety disorder makes as much sense as saying “anxiety is caused by anxiety.”
id974430531
Here’s the circular logic: How do we know a patient has depression? Because they have certain symptoms. Why do they have these symptoms? Because they have depression.
id974430586
The DSM was not designed to address causes, only to describe effects.
id974430615
. If we speak of generalized anxiety disorder or major depressive disorder as if they were equivalent to pneumonia or diabetes, we are committing a logical fallacy called a category error. A category error means ascribing a property to something that cannot possess it—like emotion to a rock.
id974430805
We say DSM diagnoses are constructs, not things—then blithely proceed to speak of them as if they were things. Doublethink, anyone?