Nov. 28, 2023 – In psychoanalysis, little importance was given to diagnosis, unlike the medical tradition. Diagnoses were ‘labels,’ mere shorthand categories for communication. They weren’t ‘real’ and they didn’t represent ‘diseases.’ All psychopathology was about unconscious emotional conflicts, mainly dating to childhood; if the conflicts were normal or mild, they produced ‘neuroses’; if they were severe, they produced ‘psychoses.’ That was the extent of psychoanalytic nosology.
The American Psychiatric Association (APA) organized the first two editions of DSM mainly for administrative purposes. Those who ran mental hospitals needed to label the reasons patients were treated. Since psychoanalytic theory mostly ignored diagnostic labels, DSM terms often were taken from the alternative medical approach to psychiatry, popular in parts of Europe, and associated especially with the research of Emil Kraepelin (circa 1900), and other German and French psychiatrists dating back to Philippe Pinel (circa 1800) . . .
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