Psychiatry and Diagnosis

Psychiatrists are medical doctors, and the model for assessing psychological problems in psychiatry is the medical model.  In describing this model, Kandel (1998) argues that all mental processes can be traced to brain function, that essentially mind is a function of brain (also see Ray, 2004). This leads to the idea: change the brain, change the mind.  However, the alternative idea – change the mind, change the brain – also works (cf. Plassman, 2008; Carlat, 2010; Zubieta, et al, 2001). In general psychotropic medications can be very helpful, though they rarely eliminate a psychological problem. Therapy in addition to medication is an excellent approach for addressing problems.

 

The American Psychiatric Association publishes the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2000; hereafter DSM-IV-TR), which is the standard diagnostic tool of the medical model of mental disorders. Constructivism stands as a major alternative to the medical model as a way of looking at or understanding psychological problems. While it may be appropriate to say that a client exhibits behaviors consistent with a particular diagnosis, clients should never be told that they “have” a disorder. Diagnostic labels should be understood more as broad categories of behaviors covered by insurance than as conditions.

 

Dr. Mau is not a physician, he does not provide medical advice, and he generally operates from a Constructivist rather than a medical model perspective. He does work in a team approach with physicians and psychiatrists to address client problems. Clients should follow the medical instructions of their physician or psychiatrist. It can be dangerous to simply stop taking certain medications, and you should never stop taking medication without consulting your physician.

 

Dr. Mau is qualified to provide DSM-IV-TR diagnoses, and will do so when this is necessary for insurance reimbursement. A DSM-IV-TR diagnosis should be understood as a shorthand label for particular behaviors occurring presently and not as a condition of a person. Think about it: “behavior” can be changed – even if it is driven by emotion and seems involuntary, while “conditions” seem difficult to change.

 

For an extended quote on a Constructivist view of mental disorders, click here.


References

 

Theoretical Orientation 

Cognitive Behavior Therapy (CBT)

Person-Centered Therapy and Related Approaches

Psychodynamic Approaches

 

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