The discussion about which group, psychologists or psychiatrists, "diagnoses" more accurately is actually a good demonstration of a belief in the medical model.
I think despite extensive training in the biopsychosocial paradigm, people are hamstrung into naming and sometimes treating experiences of dis-ease (sadness, worry, what have you) as more or less permanent states that can be wedged into billable codes. Vs., as an evolving repertoire of (cognitive, interpersonal etc) behaviours, both shaped by and shaping their (social, neural, etc) milieu. Because I’m not sure how that would work on an insurance form, right now.
I feel the NIMH’s tentative
approach to the ‘reduction’ of such “circuits” captures their stability and change, and correctly and clearly identifies them as processes. I’m fine with initially locating them in the brain, and then widening out to more of a mezzo level. The unit of analysis (and ultimate target of intervention) is the individual, who is necessarily bound and most immediately informed by a body. (Vs., ‘society’, which probably causes most of our problems. But from that point of view, the appropriate clinician is the policy-maker.)
Obviously the NIMH paradigm won’t yield a viable alternative to the DSM for a while. Meanwhile, you know, some people are in trouble right now, and there’s nothing to do but be practical about it. Therapy helps enough people to be worthwhile (at a rate somewhat better than chance. Probably not as handily as a smart move to a new city, or loving/being loved well, but the very point is, not everyone can easily do those things).
It is exam time, I am procrastinating.