Magazine article USA TODAY

It's Up to You

Magazine article USA TODAY

It's Up to You

Article excerpt

ALFRED ADLER (1870-1937) is one of the great founders of psychotherapy, but often is relegated to a comer with a few remarks about birth order and maybe credit for starting the child guidance movement. He is much more than that, though. The roots of positive psychology can be found in Adler's emphasis on people's effort to interact meaningfully with others and to work towards positive goals. He emphasized that our actions are purposeful; relationships are critical; and that we all are striving, in some way, to overcome difficulties. Adlerians have a very compassionate approach to suffering that emphasizes helping people find their way to living a meaningful life with healthy relationships.

The speakers at the recent Florida Adlerian Society's annual conference discussed the dichotomy in mental health, between pure medical model adherents (all emotional difficulties are biochemical and/or structural problems to be resolved via medical treatment) and the notion that many of the categories of suffering we describe with mental health diagnoses are, in fact, due to problems in living--often relational. This was illustrated in many ways, one of which was the evolution of bereavement as a psychiatric label in psychiatry over the past few decades. The Diagnostic and Statistical Manual of Mental Disorders is the American Psychiatric Association's published list of descriptions of various patterns of symptoms. The intention, back in the early 1980s when DSM-III was published, was to provide a structure for shared dialogue and research for the identified, hypothesized mental disorders. No one pretended that all of these all were identifiable, diagnosable, discrete brain diseases. In those days, bereavement was recognized for up to two years. If a grieving person was still sad, still struggling with aspects of getting back to a (new) normal life, professionals assumed, depending on the relationship, two years was a reasonable time frame. Of course, some losses never heal--but people somehow figure out how to go on, just the same. The point is, no sensible person thought it was pathological to still have some regular bouts of tearfulness a year or more after your most beloved person died.

In 1994, along came DSM-TV. It gave people two months (not two years) to get over it and move on. If not, if the person still was crying, or numb, or having appetite or sleep disturbances ... well, that meant that bereavement was over and the person was diagnosable with a major mental disorder--depression, now sometimes described as a permanent brain disease.

In 2013, DSM-5 was published (note that the change from Roman numerals to integers was done by the APA; it is not a typo on my part). Now, after two weeks of being sad more days than not, plus the other possible symptoms, and the bereaved is diagnosed as mentally ill with depression (according to the APA). There is no exception for bereavement, although it ought to be noted on the chart. One rationale provided during the buildup to the publication of DSM-5 is that this change allows people to have health insurance cover grief counseling. Whether this makes it worthwhile to pathologize normal grief, I leave each reader to consider.

One speaker emphasized the role of personal responsibility in mental health. …

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.