The Psychodynamic Diagnostic Manual, 2nd Ed.: Implications for Therapists (Meet the Author Session)

The second edition of the Psychodynamic Diagnostic Manual will be published by Guilford Press in early June, 2017. Vittorio Lingiardi and I edited the manual; Jonathan Shedler and I wrote the opening section on personality... [ view full abstract ]

The second edition of the Psychodynamic Diagnostic Manual will be published by Guilford Press in early June, 2017. Vittorio Lingiardi and I edited the manual; Jonathan Shedler and I wrote the opening section on personality patterns and disorders.

The DSM and ICD systems of psychiatric classification have treated “schizophrenia” as a categorical illness. This conceptualization has led many to assume that the complex combination of symptoms traditionally labeled “schizophrenic” result from a disease of the brain and therefore require only medication and management, not psychotherapy. The emphasis of categorical systems has been on how one either “has” or “does not have” a particular disorder.

The PDM is an alternative diagnostic system that takes a dimensional, inferential, and contextual approach to understanding psychological difficulties. Unlike the DSM and ICD, which were developed with a view to facilitating research and record-keeping, it is intended to be useful primarily to therapists and service-providers. The PDM covers personality differences, functional differences, and symptom patterns in separate sections on infants and toddlers, children, adolescents, adults, and elderly patients. Unlike categorical systems, it conceptualizes psychotic phenomena as on a continuum with normal psychological life. It also gives an in-depth look at the subjective experiences of patients who are given DSM diagnoses of psychotic disorders, as well as at the subjective experiences that may be evoked in those who work therapeutically with them. Although based mostly in psychoanalytic clinical experience and psychodynamically oriented research, the manual is written without psychoanalytic jargon. Pre-publication data suggest that people trained in other theoretical orientations find it user-friendly and clinically useful. I would welcome conversations about the ways in which the PDM diverges from other diagnostic systems and about how it might help clinicians to reduce the suffering of individuals diagnosed with psychotic disorders.