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Horwitz and Wakefield (2007) have released what may prove to be a highly influencial book titled The Loss of Sadness: How Psychiatry Transformed Normal Sorrow Into Depressive Disorder. The title implies that psychiatry transformed sadness into depression. It's an unfortunate catchy title that misleads the uninformed reader. Instead, the book explores in a scholarly way a fundamental principle upon which The Diagnostic and Statistical Manual (DSM) was developed. A review of Horwitz and Wakefield (2007) by Andreea L. Seritan appeared in Am J Psychiatry 164 (11): 1764.
"The central thesis of this book is a persuasive argument that contemporary psychiatry confuses normal sadness with depressive mental disorder because it ignores the relationship between symptoms and the context from which they emerge. Although he remains cautious about the possibility of incorporating situational context into diagnostic criteria, Dr. Spitzer encourages psychiatrists to place this issue on the agenda for the upcoming formulation of DSM-V. The book's title is a reminder of the central role of loss as a potentially severe life stressor leading to depression, as well as of how modern psychiatry is being blindsided into extrapolating most states of sadness into depression.
In the first chapter, "The Concept of Depression," Drs. Horwitz and Wakefield address the move toward using descriptive criteria in diagnosing mental illness. In response to criticisms during the 1960s and 1970s about the lack of reliability of psychiatric diagnoses, DSM-III started using lists of symptoms to establish clear definitions for each disorder. The authors argue that this approach, while greatly increasing diagnostic reliability, has created new validity problems (p. 8). In the definition of major depressive disorder, DSM-III "fails to take into account the context of the symptoms and thus fails to exclude from the disorder category intense sadness, other than in reaction to death of a loved one, that arises from the way human beings naturally respond to major losses" (p. 14).
We only have one life to live. I think we'd all agree that we want to live a happy life, one that has meaning, and fulfills us. We want:
- productive activity that challlenges us, engages our skills and teaches us new ones,
- a life that is enriched by relationships and accomplishments with which we can be proud,
- a life without regrets or worries,
- to live our life fully,
- to maximize our potential,
- to produce a legacy that benefits those that will survive us and we can look back on with pride.
And we want to do all this while feeling healthy and safe.
How many of us succeed? Thats hard to say. We all know people who claim to have a life like this, and we certainly know people who will recount their regrets on request.
You might notice that having it all, all the time, may be impossible. Some of us might conjure up some old sayings like:
- "You can't have your cake and eat it too."
- "You can't always get what you want."
But how to do we make sure we get what we need when we need it most?
I have over 30 years experience providing counseling to a wide variety of adults including many persons with long standing, complex, and difficult problems that haven't responded well to treatment. I have extensive experience with the broadest diversity in treating depression, anxiety, relationship difficulties, recovery from child and/or domestic abuse, crime survivors, including sexual abuse and rape. There are several ways you can work with me.
You can now learn to Live Emotionally Free, Mindfully Aware and Totally Centered! After 30 years of experience providing mental health services, I have discovered six key concepts to a healthy life. Let me show you how to live the kind of life many of us only dream about, a life of passion about what is important. Let me show you the way through Full Impact Living!℠
- I provide counseling at Nuview Psychological Services in Stillwater, MN where I have Saturday hours. I accept most insurances.
- Send me a brief email inquiry and we can negotiate what service might be helpful. You can ensure your email will remain private by using a free secure encrypted account at hushmail.com. Address your email to davemsw[at]4securemail[dot]com or click here for secure email to me. Your confidentiality is ensured by encryption of both the content and Internet links. Or call 763-250-1231, but don't leave a voice mail with confidential information.
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