On Psychiatric Diagnostic Categories from the Point of View of Humanistic-Experiential Psychotherapy

Robert Elliott, Professor of Counselling (University of Strathclyde), reflects on psychiatric diagnostic categories in a blog post from his Robert’s EFT Scotland-California Blog:

“… I taught in a clinical psychology doctoral course for almost 30 years, and also taught Abnormal Psychology on many occasions, as well as using different structured psychiatric diagnostic instruments. Like you, I am intimately familiar with the very messy, complicated process of applying psychiatric labels to people in both clinical and research settings. I studied with Ted Sarbin, and have what I consider to be a healthy ambivalence about the larger DSM/ICD enterprise. On the one hand, I’m very aware of and have witnessed the various difficulties with stigmatisation, reification, questionable reliability and validity, conceptual muddiness/overlap, lack of etiological basis, and philosophical disharmony with humanistic-experiential approaches. I also strongly believe that the language we use and the implicit assumptions and metaphors that it contains are important and powerful, for better or worse. I regard language use as an ethical issue.

On the other hand, these categories have their merits and uses:

  1. I’m aware that there are regularities that the diagnostic categories seek to capture; it’s not only or simply a social construction. I’m a dialectical constructivist here: the labels both point to something in the world and are at the same time a social construction of what’s there.
  2. Some clients find acquiring a diagnostic label to be clarifying and validating. I don’t want to deprive them of that, although I don’t mind reminding them that the categories are social constructions cooked up by groups of people as part of a political process.
  3. To progress and disseminate our work we have to be able to communicate with researchers with different philosophical perspectives and lived experiences, including those who exist in an unreflected way within a diagnostic system and psychiatric language that they are attached to and that feels like home to them. They will feel threated and will fight us if we try to take their cherished language from them.
  4. Some labels are more useful, reliable, valid etc than others, or at least less broken or over-simplifying than others; others, I think, pretty much suck and best consigned to the dustbin of history …”

You can read more here.

Any reply would be very welcome


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