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THIS PAPER ADDRESSES THE observation that mental disorders are not fixed entities in the course of time.
Alex Comfort (1983) has written:
The context of psychiatry is existential: problems which perplex or disturb patients, however practical, are set in the context of how they perceive the human situation. So is the substance of psychiatry: how we practice it is bound on our ad hoc model of a world in which the phenomena of "mind" exist, however provisional this may be (p. 393).
Epidemiological and nosological data tend to change at various historical epochs. Neurotic symptoms, styles and fashions are influenced by prevailing socio-cultural models and prescriptions. The spirit of the times, i.e. "the Zeitgeist" seems to have a distinct impact on the overt manifestations of neurotic and some psychotic symptoms. It stands to reason that the forthcoming IVth edition of the APA: Diagnostic Statistical Manual of Mental Disorders will have difficulty keeping in step with changing models of neurosis. There are only fifteen years left of the 20th Century; the dawn of the 21st Century is not far away.
In the meantime, we need to ask ourselves as clinicians how we can modify some of our therapeutic approaches so that they are attuned to contemporary models.
My own interest has become increasingly focused on clinically workable approaches in the face of widely divergent theoretical points of view. Foremost in that respect is the quest for where and how we obtain data with a high therapeutic potential. Such data