DSM-V

It’s possible that many of the people reading this blog might have no idea what the above letters mean. Part of me envies you a bit. It is basically the mental health bible for diagnosis. While the intention of this tool is good, much harm has been done in the name of diagnosis over the years. The reason there is a V (or 5) is that it has been revised over the years. We must remind ourselves that there used to be diagnoses in the DSM that included homosexuality as an aberration and hysteria (most commonly diagnosed with women). Over the years, the diagnoses have become more and more complex and the length of this manual has grown.

Regarding misdiagnosis, if one looks at the world through a social justice/feminist lens, we see that many wrongs have been committed in the name of science. Many good people’s lives have been destroyed as a result of the manual. Many individuals who suffer from true mental illness have had to wear many labels over the course of their lifetime. As a professional I have been horrified to sit in meetings in which individuals are not described using their name but their diagnosis. There have been comments that would suggest the speaker just jumps to conclusions when the client exhibits behaviour consistent with their diagnosis. Does it partly become a self-fulfilling prophecy? Where does growth and resilience and possibility exist if we just see people within their boxes?

About 17 years ago, I made a conscious choice not to become a clinical social worker because I would be required to use the DSM as part of my practice. I did not want to carry that responsibility and weigh the ethical implications of each diagnosis. Instead, I became a certified traumatic training specialist which was actually more rigourous in comparison and would also allow me to do international trauma work. In hindsight, I am happy with my decision.

Most clients that come to see me don’t care about the specifics of my education or certificates. They want to feel heard and to have a healthy therapeutic relationship. They don’t think about what happens when things go wrong. This week onn my Thrive with Brent Facebook page I posted several articles of professionals caught in a lie or practicing out of their scope or – even worse – jumping to conclusions, making assumptions, and destroying the bond between a parent and child. In some of these cases there was no recourse because there was no licencing college to make a complaint and even when action was necessary, there was no way to enforce such an action. I am proud to be a member of the College of Social Workers who monitor practice and hold our professionals to the highest of standards. And if one of my clients struggles with something I have said or done, I will be accountable to my peers and engage in the work.

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