Published semi-annually, the Newsletter of the Society for Humanistic Psychology, Div. 32 of the American Psychological Association, explores the intersections of psychology and the arts, humanities and current events, and it captures the discussions, debates and new ideas taking place in the research, teaching, clinical practice and advocacy applications of humanistic psychology.Co-editors: Andrew Bland and Justin Karter
Since the beginning of our movement, existential-humanistic psychologists (EHPists) have critiqued the limitations of conventional psychiatric diagnosis. Bugental (1965) cautioned against diagnostic labeling that diminishes human existence to a manipulatable object devoid of a person’s essential humanity and individuality. Binswanger (1958) addressed the problem of reductionistic categorization that unnecessarily bifurcates consciousness from the biological organism. And May’s (1967) allegory of the man who was put in a cage suggests a foretelling of EHPists’ efforts toward a peaceful uprising against tyrannical institutional forces that employ psychiatric diagnosis in the interest of upholding conformity to a cultural status quo.
The publication of the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013) was met with resistance from both within and outside the psychiatric community about its scientific merit and its practical utility. Common criticisms included issues involving validity, reliability, etiology, treatment specificity and stigma (Pilgrim, 2014). Whereas historically a return to business as usual is typical in the weeks and months following a new edition of the DSM, during the last decade, EHPists “have taken the initiative to [ongoingly] comment now on how things might improve so that their thoughts may have an impact on the structure of future revision processes or the development of other alternative classifications” (Keeley, 2019, p. 448). Following a 2011 open letter petitioning against the DSM-5 (Kamens et al., 2017) that was endorsed by over 15,000 individuals and over 50 professional organizations (including 15 APA divisions), EHPists’ reform efforts have expanded internationally to include organized discussions about legitimate alternatives to the medical model (see Kinderman et al., 2017; Robbins et al. 2017) and the development of Standards and Guidelines for the Development of Diagnostic Nomenclatures and Alternatives in Mental Health Research and Practice (Kamens et al., 2019).
Arguably as a direct or indirect result of these efforts, articles now appear in mainstream psychology journals on the ethical conflicts associated with diagnosing children (Cartright et al., 2017) and on proposals for diagnostic refinement — ranging from psychometric improvements (Chmielewski et al., 2015; Keeley et al., 2016) and transdiagnostic dimensional modeling (Kotov et al., 2017) to new diagnostic systems centered around identity (Klimstra & Denissen, 2017), trauma (Pilgrim, 2014) and embodied cognition (Nielsen & Ward, 2019), to name just a few. Also, a half-century after Bugental (1965) challenged the “fallacy that diagnosis is basic to treatment,” (p. 15), research by Nakash et al. (2015) noted psychotherapy clients’ preference for inquiry about their personal history and sociocultural background over discussion about their diagnostic symptoms and their tendency to rate working alliances higher when intake interviews are devoted more to the former than the latter.
Meantime, EHPists remain busy identifying next steps. In recent years, special editions of the Journal of Humanistic Psychology have been devoted to debating issues including the controversies of labeling (Bassman, 2019; Chang & Bassman, 2019) and of employing a descriptive diagnostic system (Pavlo et al., 2019; Shahar, 2019), the need for diagnostic alternatives that account for the fuller range of human suffering (Raskin, 2019) and the challenges of developing alternatives that are conducive to therapeutic outcomes (Zalzala et al., 2019) and to implementation in the current managed care system (Cooper, 2019; Russell, 2019).
And now, in February 2020, EHPists have just developed another open letter, which serves as the centerpiece of this issue of the SHP newsletter.
This issue opens with SHP president Drake Spaeth’s commentary on the relatability of the need for diagnostic alternatives and critical psychology in the current zeitgeist (echoing the findings of Nakash et al.’s aforementioned research suggesting that the public is hungry for a change). This is followed by information about and links to the new open letter from SHP’s Task Force for Diagnostic Alternatives regarding reform and revision of diagnostic systems. Then three responses to the open letter are presented by Sami Timimi, Ron Bassman and Kirk Schneider. Next, a personal narrative by Emily Cutler emphasizes effective counselors’ role in normalizing suffering and in encouraging people with disabilities to advocate for themselves. Thereafter, in his Humanitas column, Ed Mendelowitz challenges humanistic psychologists to continue moving beyond the subject-object divide. From there, SHP President-elect Jon Raskin offers a reflection on humanistic psychologists’ need to retain a commitment to openness and humility, even when faced with sometimes-hostile challenges to their core values and beliefs in our current cultural climate. The issue concludes with information about SHP’s annual conference in New Orleans in March 2020, a link to the latest issue of the newsletter of the Psychotherapy and the Arts special interest group (co-sponsored by SHP and Div. 10) and a check-in from The Humanistic Psychologist Editor Scott Churchill.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing.
Bassman, R. (2019). Label jars not people. Journal of Humanistic Psychology, 59(3), 339-345. https://doi.org/10.1177/0022167818777841
Binswanger, L. (1958). The case of Ellen West: An anthropological-clinical study. In R. May, E. Angel, & H. F. Ellenberger (Eds.), Existence: A new dimension in psychiatry and psychology (pp. 237-364). Clarion.
Bugental, J. F. T. (1965). Humanistic psychology: A new breakthrough. In F. T. Severin (Ed.), Humanistic viewpoints in psychology (pp. 6-16). McGraw-Hill.
Cartwright, J., Lasser, J., & Gottlieb, M. C. (2017). To code or not to code? Some ethical conflicts in diagnosing children. Practice Innovations, 2(4), 195-206. https://doi.org/10.1037/pri0000053
Chang, C. R., & Bassman, R. (2019). Psychiatric diagnosis and the power of names. Journal of Humanistic Psychology. Advance online publication. https://doi.org/10.1177/0022167819852786
Chmielewski, M., Clark, L. A., Bagby, R. M., & Watson, D. (2015). Method matters: Understanding diagnostic reliability in DSM-IV and DSM-5. Journal of Abnormal Psychology, 124(3), 764-769. https://doi.org/10.1037/abn0000069
Cooper, R., (2019). Commentary on Jonathan Raskin’s “What might an alternative to the DSM suitable for psychotherapists look like?” Journal of Humanistic Psychology, 59(3), 376-384. https://doi.org/10.1177/0022167818793751
Kamens, S. R., Cosgrove, L., Peters, S. M., Jones, N., Flanagan, E., Longden, E., Schultz, S., Robbins, B. D., Olsen, S., Miller, R., & Lichtenberg, P. (2019). Standards and guidelines for the development of diagnostic nomenclatures and alternatives in mental health research and practice. Journal of Humanistic Psychology, 59(3), 401-427. https://doi.org/10.1177/0022167818763862
Kamens, S. R., Elkins, D. N., & Robbins, B. D. (2017). Open letter to the DSM-5. Journal of Humanistic Psychology, 57(6), 675-687. https://doi.org/10.1177/0022167817698261
Keeley, J. W. (2019). Accounting for social processes in the development of diagnostic classification systems: Commentary on the “Standards and guidelines for the development of diagnostic nomenclatures and alternatives in mental health research and practice.” Journal of Humanistic Psychology, 59(3), 446-452. https://doi.org/10.1177/0022167818788494
Keeley, J. W., Reed, G. M., Roberts, M. C., Evans, S. C., Medina-Mora, M. E., Robles, R., … & Saxena, S. (2016). Developing a science of clinical utility in diagnostic classification systems: Field study strategies for ICD-11 mental and behavioral disorders. American Psychologist, 71(1), 3-16. https://doi.org/10.1037/a0039972
Kinderman, P., Allsopp, K., & Cooke, A. (2017). Responses to the publication of the American Psychiatric Association’s DSM-5. Journal of Humanistic Psychology, 57(6), 625-649. https://doi.org/10.1177/0022167817698262
Klimstra, T. A., & Denissen, J. J. A. (2017). A theoretical framework for the associations between identity and psychopathology. Developmental Psychology, 53(11), 2052-2065. https://doi.org/10.1037/dev0000356
Kotov, R. Krueger, R. F., Watson, D., Achenbach, T., Althoff, R. R., Bagby, R. M., … & Zimmerman, M. (2017). The hierarchical taxonomy of psychopathology (HiTOP): A dimensional alternative to traditional nosologies. Journal of Abnormal Psychology, 126(4), 454-477. https://doi.org/10.1037/abn0000258
May, R. (1967). Psychology and the human dilemma. Van Nostrand.
Nakash, O., Nagar, M., & Kanat-Maymon, Y. (2015). “What should we talk about?” The association between the information exchanged during the mental health intake and the quality of the working alliance. Journal of Counseling Psychology, 62(3), 514-520. https://doi.org/10.1037/cou0000074
Nielsen, K., & Ward, T. (2019). Mental disorder as both natural and normative: Developing the normative dimension of the 3e conceptual framework for psychopathology. Journal of Theoretical and Philosophical Psychology. Advance online publication. https://doi.org/10.1037/teo0000118
Pavlo, A. J., Flanagan, E. H., Leitner, L. M., & Davidson, L. (2019). Can there be a recovery-oriented diagnostic practice? Journal of Humanistic Psychology, 59(3), 319-338. https://doi.org/10.1177/0022167818787609
Pilgrim, D. (2014). Influencing mental health policy and planning: DSM-5 as a disciplinary challenge for psychology. Review of General Psychology, 18(4), 293-301. https://doi.org/10.1037/gpr0000021
Raskin, J. D. (2019). What might an alternative to the DSM suitable for psychotherapists look like? Journal of Humanistic Psychology, 59(3), 368-375. https://doi.org/10.1177/0022167818761919
Robbins, B. D., Kamens, S. R., & Elkins, D. N. (2017). DSM-5 reform efforts by the Society for Humanistic Psychology. Journal of Humanistic Psychology, 57(6), 602-624. https://doi.org/10.1177/0022167817698617
Russell, J. (2019). Developing a common vocabulary: Questions of purpose and priority. Journal of Humanistic Psychology, 59(3), 428-437. https://doi.org/10.1177/0022167818787971
Shahar, G. (2019). The nature of the beast: Commentary on “Can there be a recovery-oriented diagnostic practice?” Journal of Humanistic Psychology, 59(3), 346-355. https://doi.org/10.1177/0022167818777653
Zalzala, A. B., Gagen, E. C., & Lysaker, P. H. (2019). Recovery and personhood in the diagnostic formulation and treatment of serious mental illness: A commentary. Journal of Humanistic Psychology, 59(3), 356-367. https://doi.org/10.1177/0022167818788758
Andrew M. Bland, PhD, is associate professor of psychology at Millersville University in Lancaster County, Penn. He is a licensed psychologist, currently practicing at Samaritan Counseling Center in Lancaster. He serves as treasurer for the Society for Humanistic Psychology. His scholarship provides both qualitative and quantitative support for the practical application of themes and principles from contemporary existential-humanistic psychology in the domains of love and intimate relationships, work and career development, the processes of therapy and education and lifespan development. He is co-editor of The New–Old: Recollections, Reflections and Reconnoiterings of Mike Arons.