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Despite the broad current use of the historically recent Diagnostic and Statistical Manual of Mental Disorders, clinicians concerned with psychodynamics find that manual to be insufficient and misleading, shaping thought—and often, regrettably, general mental health training—on the basis of nineteenth-century descriptive psychiatry. It is as if modern pathophysiological cardiology were to fall back upon primitive descriptions of heart size or pulse rate and pattern to organize present thinking.
Accepting the need for a usable statistical system, a group of German workers labored over several years with the aim of creating a pattern of structured diagnosis that would take account of psychodynamic forces. The results, presented in this volume in a first English translation, assumes that “the user would acknowledge basic psychoanalytic concepts such as the dynamic unconscious, transference 1089 and countertransference, inner conflict, or internalized images of self and objects” (p. xiv). Waiting for that to become the general state of knowledge seems hopeful yet sadly naive.
Also, the task force that developed this operationalized psychodynamic diagnostic system is aware that any such system can be misused to undermine the importance of the uniqueness of every case. Nonetheless, the development of a more psychoanalytically informed statistical system offers a countervailing model potentially useful for influencing future changes in the DSM. This volume represents a contribution in that direction.