Dancing with the <scp>DSM</scp> – The Reflexive Positioning of Narrative Informed Psychiatric Practice

Simblett, G. J.

doi:10.1002/anzf.1007

Cited by 11 publications

(10 citation statements)

References 13 publications

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“…In this approach to diagnosis, individuals are equated to their diagnostic label and therefore stigmatized or even alienated and dehumanized. To borrow Simblett’s (2013) words, it is possible “to understand DSM as a textual codification of power/knowledge that creates a version of reality, individuality and what is known about the nature of mental illness. But only one possible version” (p. 116).…”

Section: Social Understanding and Methodology In Psychopathology: Fromentioning

confidence: 99%

The intersubjective endeavor of psychopathology research: methodological reflections on a second-person perspective approach

Galbusera

Fellin

2014

Front. Psychol.

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Research in psychopathology may be considered as an intersubjective endeavor mainly concerned with understanding other minds. Thus, the way we conceive of social understanding influences how we do research in psychology in the first place. In this paper, we focus on psychopathology research as a paradigmatic case for this methodological issue, since the relation between the researcher and the object of study is characterized by a major component of “otherness.” We critically review different methodologies in psychopathology research, highlighting their relation to different social cognition theories (the third-, first-, and second-person approaches). Hence we outline the methodological implications arising from each theoretical stance. Firstly, we critically discuss the dominant paradigm in psychopathology research, based on the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2013) and on quantitative methodology, as an example of a third-person methodology. Secondly, we contrast this mainstream view with phenomenological psychopathology which—by rejecting the reductionist view exclusively focused on behavioral symptoms—takes consciousness as its main object of study: it therefore attempts to grasp patients’ first-person experience. But how can we speak about a first-person perspective in psychopathology if the problem at stake is the experience of the other? How is it possible to understand the experience from “within,” if the person who is having this experience is another? By addressing these issues, we critically explore the feasibility and usefulness of a second-person methodology in psychopathology research. Notwithstanding the importance of methodological pluralism, we argue that a second-person perspective should inform the epistemology and methods of research in psychopathology, as it recognizes the fundamental circular and intersubjective construction of knowledge.

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Section: Social Understanding and Methodology In Psychopathology: Fromentioning

confidence: 99%

The intersubjective endeavor of psychopathology research: methodological reflections on a second-person perspective approach

Galbusera

Fellin

2014

Front. Psychol.

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“…There were two editorials in the Journal of Marital and Family Therapy on DSM‐5 (Lebow, ; Wamboldt, ). There was also a special issue of the Australian and New Zealand Journal of Family Therapy on DSM‐5 (volume 34 issue 2) with articles on DSM‐5 and evidence‐based family therapy (Strong and Busch, ), medical family therapy (Nobbs, ), narrative informed practice (Simblett, ), emotional processes (Chambers et al . ), first order change (Denton and Bell, ) and self and society (Epstein et al .…”

Section: Dsm‐5mentioning

confidence: 99%

“…There were two editorials in the Journal of Marital and Family Therapy on DSM-5 (Lebow, 2013a;Wamboldt, 2013). There was also a special issue of the Australian and New Zealand Journal of Family Therapy on DSM-5 (volume 34 issue 2) with articles on DSM-5 and evidence-based family therapy (Strong and Busch, 2013), medical family therapy (Nobbs, 2013), narrative informed practice (Simblett, 2013), emotional processes (Chambers et al 2013), first order change (Denton and Bell, 2013) and self and society (Epstein et al 2013). Two emerging themes from these articles were an acknowledgement of the centrality of the DSM to discourse in the international mental health field, and a continuing dissatisfaction among systemic therapists with the DSM classification system, which conceptualizes problems within an individual framework rather than a systemic one.…”

Section: Dsm-5mentioning

confidence: 99%

Thematic review of family therapy journals in 2013

Carr¹

2014

Journal of Family Therapy

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In this article the contents of the principal English‐language family therapy journals and key family therapy articles published in other journals in 2013 are reviewed under these headings: models of family therapy, developments in family therapy practice, couple therapy, training, diversity, international developments, research and DSM‐5. Practitioner points Ecosystemic structural family therapy, FFT, MST, MDFT and other traditional systemic approaches, with recent adaptations, may be helpful for an increasing range of populations. Developments in research and practice support the value of father involvement in systemic therapy, conducting family therapy in medical settings and using family therapy to treat adolescent eating disorders. The integration of mindfulness into couple therapy, and new approaches to addressing infidelity are important developments to consider in treating couples.

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“…Part of a post‐structuralist approach to practice, evident in such approaches as narrative therapy (Simblett, ), proceeds from understandings of client concerns that do not fit within a pathologising, decontextualised, or algorithmic approach to naming and addressing client concerns. Instead, problem names, and even the kinds of conversations post‐structuralist therapists discuss with their clients, are more fluid and contextualised than those required for algorithmic adherence to diagnostic interview schedules and manualised intervention protocols.…”

Section: Local Practice Dynamic Nominalism Preferences and Ebpmentioning

confidence: 99%

“…Simblett's () article also looks at the ethical dilemma of working from a different philosophical perspective to the pervasive DSM values that inform the economic foundation of mental health care. However, he argues that very little is written about how to assist practitioners who work in such dilemmas.…”

Section: This Special Issuementioning

confidence: 99%

DSM‐5 and Evidence‐Based Family Therapy?

Strong

Busch

2013

ANZ J of Family Therapy

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The publication of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, (DSM-5) extends a profession and practice-defining direction for family therapy. Warranting and expediting this medicalised direction has been a scientific and administrative coupling of diagnosed symptomatic conditions with evidence-based treatments for addressing those conditions. For systemically or poststructurally oriented family therapists tensions can follow from this direction which we elaborate upon in this article. Specifically, we examine the premises behind this medicalised direction for family therapy, juxtaposing these premises with systemic and post-structural premises of practice. We relate these juxtapositions to tensions family therapists may need to reconcile in their work with families. We close with an overview of this special issue's contributions that pertain to the DSM-5 and family therapy.1 The continuing symptomological and individualistic focus of DSM-5 creates tensions for family therapists who practice from systemic and post-structuralist orientations. 2 A discursive approach enables us to understand how DSM-5 discourse both enables and constrains our understanding of human concerns. 3 DSM-5 does not address relational aspects of practice and creates "linguistic poverty" in limiting understandings of family concerns. 4 Evidence-based practice tied to a medicalised diagnostic classification framework is a seductively algorithmic practice, which reproduces normative, standardised conversations in mapping client concerns to DSM-5based diagnoses. 5 DSM-5-based algorithms of evidence-based practice ignore the importance of context and the ever-changing conversations of human concerns and multiple practices are required to reflect, articulate and work with family concerns effectively.So what is it about the biopolitics of life itself…that provides the spaces within which bioethical authority seems to be required and simultaneously circumscribes the issues to which such ethical concerns appear relevant? (Rose, 2007, p. 31) Welcomed or not, the American Psychiatric Association's (2013) Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) will influence the conversations therapists have with families. In writing about diagnostic language as it relates to relationships, Tom Andersen (1996) long ago wrote that "language is not innocent". The diagnoses of DSM-5 cannot be regarded as neutral scientific discoveries, nor can the expected diagnostic practices accompanying the DSM-5's use be

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Dancing with the DSM – The Reflexive Positioning of Narrative Informed Psychiatric Practice

Cited by 11 publications

References 13 publications

The intersubjective endeavor of psychopathology research: methodological reflections on a second-person perspective approach

The intersubjective endeavor of psychopathology research: methodological reflections on a second-person perspective approach

Thematic review of family therapy journals in 2013

DSM‐5 and Evidence‐Based Family Therapy?

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