Having set the stage for our examination of DSM, we are ready to embark on a journey of both appreciation and criticism into this challenging domain. We are offering a landscape rendering of the world in which DSM operates We begin by stepping back briefly to offer an important distinction between diagnosis and assessment, then describe both the current state and past history of DSM.
From this point, we turn to a second essay that offers the perspectives offered by the “working” professionals in diverse fields of professional psychology. This will be more of an intimate, portrait rendering of DSM. What do these professionals consider the benefits and drawbacks of DSM (and now specifically DSM-V) as those who actually use DSM on a daily basis? We are fortunate to be able to draw on the perspectives of professional psychologists from not only the United States, but also Asia—for DSM indeed is now a powerful internationally-based tool of professional mental health.
Diagnosis versus Assessment
An important distinction must be drawn between processes that are labeled “diagnosis” and those that are labeled “assessment.” While both terms refer to the collection and analysis of information about specific people (or groups of people), diagnoses and assessments are being done for quite different reasons and the results of these two processes look quite different.
Diagnosis
Let’s first look at the term “diagnosis”. In its original meaning, diagnosis has to do with pulling something apart and then putting it back together by providing a determinative classification. We all learned about this process of pulling apart and putting together in our junior high school biology class (and lab) when we cut up a frog (or mouse) and noted the name to be assigned to each of the frog’s parts. This is often a powerful memory that is frequently interwoven with emotions of both fascination and revulsion. If nothing else, we often feel some empathy for the frog that gave up its life for our education. At an even deeper level, the death of the frog and our analysis reminds us that what is taken apart in biology can never be put back together. The “smashed frog” can never again be a live frog. Integrative functions are one-way—this is fundamental to a holistic and emergent perspective on complex, living systems.
