DSM Fantasies

A concise essay by Lawrence D. Blum outlining the unacknowledged fantasy foundations of the DSM:

“While the diagnostic categories of DSM-III and DSM-IV (and soon DSM-5) have provided the basis for much useful research, little has been written about how much of the DSM—and how much “evidence-based medicine”—is built on a foundation of fantasy. The DSM itself, unfortunately, does not acknowledge the importance, or existence, of fantasy. If it did, it would be a much more scientifically based, useful resource.”



Moral Injury and PTSD

The theme of the recently concluded 2013 UCIPC Lake Arrowhead conference was “Moral Injury”—a term introduced by Jonathan Shay to refer to the many ways warfare produces not only  “post traumatic stress” reactions, but also profound injuries to the soldier’s sense of personal moral continuity.  Moral injury differs from the traditional fear-based models of war-zone exposure (PTSD), focusing attention on guilt- or shame-based injuries to the self.

The first link connects to a 2012 article in PTSD Research Quarterly, which summarizes the distinction between PTSD and Moral Injury, reviewing several efforts to operationalize the construct in the treatment of returning soldiers:

“Military personnel serving in war are confronted with ethical and moral challenges, most of which are navigated successfully because of effective rules of engagement, training, leadership, and the purposefulness and coherence that arise in cohesive units during and after various challenges. However, even in optimal operational contexts, some combat and operational experiences can inevitably transgress deeply held beliefs that undergird a service member’s humanity. Transgressions can arise from individual acts of commission or omission, the behavior of others, or by bearing witness to intense human suffering or the grotesque aftermath of battle. An act of serious transgression that leads to serious inner conflict because the experience is at odds with core ethical and moral beliefs is called moral injury.” (Read Entire Article Here)

The second link connects to a recent blog post on Moral Injury, which contains an interesting video interview with Jonathan Shay, who discusses the importance of moral injury for understanding the nature of war trauma.

“I really don’t like the term ‘PTSD,’” Department of Veterans Affairs psychiatrist Dr. Jonathan Shay told PBS’ “Religion & Ethics Newsweekly” in 2010. “He says the diagnostic definition of “post-traumatic stress disorder” is a fine description of certain instinctual survival skills that persist into everyday life after a person has been in mortal danger — but the definition doesn’t address the entirety of a person’s injury after the trauma of war. ”I view the persistence into civilian life after battle,” he says, “… as the simple or primary injury.” (Read Entire Article Here)


Freud’s Radical Talking

“Freud’s Radical Talking” by Benjamin Y. Fong—Interesting NY Times essay from last year on the function of speech in the “talking cure”:

“From an outside perspective, the [psychoanalytic] conversation is pointless. And indeed, most of the time it appears to be a waste. But in its disjunction with routine human interaction, it opens a space for our knotted interiors, so used to “having a point,” to slowly unravel. As each piece flakes off, it is examined and seen in relation to other pieces. After a long while, we gain what might be called, to borrow a term from Martin Heidegger, a “free relation” to these parts of ourselves and our world, such that the unmovable density they once comprised becomes pliable and navigable. Some key pieces appear and others vanish, but the puzzle is never complete. The aim of the conversation, however, is not completion, which short of death itself is an illusion, but the ability to change. This change involves neither the victory of the secondary process nor the liberation of the primary process but rather the opening of lines of communication between them.”

Check it out: Read The Whole Story Here


Freud on Translation Podcast

Fascinating London School of Economics (LSE) lecture podcast: “Freud on Translation” by Robert J. C. Young:

“The translations of Freud have been a subject of controversy for many years, but how did Freud himself theorise the role of translation in psychoanalysis? Freud’s own extensive use of the concept of translation can help us to rethink not only the practices of psychoanalysis and of cultural translation but also the possibility of translating “Freud”.

Check it out!  Listen to the Podcast Here