Most Helpful Customer Reviews
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91 of 92 people found the following review helpful:
5.0 out of 5 stars
A Diagnostic Manual With Categories Into Which People Actually Fit, June 16, 2006
Finally the psychoanalytic world has produced a diagnostic manual that describes people in a way that is true to life since it incorporates symptoms, inner experiences and the person's strengths and weaknesses. This book at long last puts into black and white the diagnostic map that analysts have used for the past 30 years, though never as an authorized nosology. The result of the long delay is the sad truth that the DSM has had no competition. Wisely the authors--essentially everyone in field of note who has been interested in questions of diagnosis including Kernberg, Wallerstein, McWilliams and Drew Westen -- present the PDM as complementary to the DSM rather than as a replacement since the DSM is unfortunately too firmly entrenched to be dislodged. However the PDM really boils down to an alternative diagnostic system, which corrects the over-simplifications, some of the omissions and a lot of the implicit biological bias of the DSM. In the correcting-omissions-department the PDM restores some traditional personality types that are very common in office practice - like depressive and masochistic - that were left out of the DSM because politically important factions lobbied against their inclusion. The PDM also has restored 'borderline' to its more usual usage as a level of severity. Still, there are suprises in the PDM. Three new "personality types" are introduced, and without full explanation why. These are the the anxious, the dissociative and the somatizing personalities. Usually anxiety, somatization and dissociation are included as symptoms (which the PDM does as well) but here these pathologies are listed as defining personality types. Since no research data is presented to support these additions, the impression is left that one or more members of the Committee prevailed and had to be assuaged in order to hammer out the final compromise document. But what will be most suprising to people who buy this book -- expecting a diagnostic manual -- is that about half of this 800 page book is not a manual at all but a collection of supportive research articles that are not specifically explications of the PDM's diagnostic system. The articles amount to a high level conversation between the analytic researchers and the makers of the DSM, particularly the Axis II committee. It remains to be seen if the audience for this kind of manual - clinicians overwhelmingly - will be put off by so much of the book being devoted to learned articles not obviously related to "The Manual." I myself would have preferred that these pages had been devoted to a fuller explication of the diagnostic system of the PDM (sometimes described too briefly) and with more case examples, since that would help ensure that different readers apply the criteria in the same way (i.e. the reliability issue). Nonetheless the PDM towers over the DSM and no quibble about shortcomings should obscure that fact. The overall schema is more true to life and more clinically on target and the personality types are better described and in fewer words than those of the DSM. Unlike the DSM you won't need a tool kit from Home Depot to fit someone into a diagnostic category.
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64 of 65 people found the following review helpful:
5.0 out of 5 stars
A Useful and Invaluable Resource for Psychotherapists of Most Clinical Orientations, June 30, 2006
When I first learned about the PDM, I was so intrigued about this much needed and exciting alternative to the DSM that I decided to develop a continuing education online course for psychotherapists, which provides a historical context and a systematized summary of the clinically most relevant part of the new manual. In this process I learned to appreciate that, unlike the DSM or the ICD, which focus exclusively on pathology, the PDM includes descriptions of healthy functional patterns and healthy personality. The new manual insists that personality be evaluated first, and symptoms considered as secondary, because symptoms cannot be understood, assessed, or treated in the absence of an understanding of the personality structure of the person who has the symptoms. While the PDM sees it as important to differentiate "personality disorder" from personality per se, the manual does not present a hard-and-fast dividing line between the two, but suggests a continuum of severity. In contrast to the DSM, the psychodynamic manual considers subjective experiences, typical relationship patterns, and ways of engaging in the therapeutic process in the description of a person's overall functioning. For each personality disorder, clinicians learn what transference and countertransference reactions to expect in the clinical hour and what treatment approach to consider. For many diagnoses the possible psychological roots of the client's problems are mentioned. The manual emphasizes that, depending on their evaluation of a client's location on this severity dimension, therapists need to behave with important differences in emphasis, level of activity, explicitness of boundary-setting, frequency of sessions, and other features of technique. It becomes clear that there is a continuum from exploratory to supportive treatment that correlates roughly with the level-of-organization dimension. I believe that the PDM is a useful and invaluable resource for psychotherapists of most clinical orientations.
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21 of 22 people found the following review helpful:
5.0 out of 5 stars
Forget the DSM! , August 1, 2006
I agree Dunn and Wolz have said it all regarding the PDM. I have only one criticism of this excellent diagnostic volume, that the descriptions of the disorders are too brief. However, its brevity in that regard is instantaneously forgotten when considering it presents mental health from a truly holistic perspective. Any clinician working in the field should have this book!
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