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Robert Wallerstein characterizes this volume as
…an effort to present a psychoanalytic nosological conceptualization of the range of personality (character) disorders, of the degrees of mental illness, and of the distinctive psychiatric symptom complexes, that articulates with the standardized DSM (Diagnostic
Page 1105Statistical Manual) of the American Psychiatric Association formulations and that enhances them in a manner that aids in psychodynamic case formulation, in treatment planning and prognostication, and in psychotherapeutic implementation. (pp. 400-1)
Notable is his emphasis on assessment and psychotherapy, that he does not mention research, and that he states that the Psychodynamic diagnostic manual (PDM) is designed to enhance, not confl ict with, DSM. In their introduction to his paper on the history of psychoanalytically based nosologies, the editors add that ‘all classification effort, such as in this volume [is] a creature of its time and place in human history and context’ (p. 385).
The crucial context to PDM is the DSM. In 1980 the American Psychiatric Association revised its previous DSM (from ‘DSM-II’ to ‘DSM-III'), and has since revised it twice (DSM-III-R and DSM-IV). DSM-V is now in preparation. The change from DSM-II to III was fundamental, shifting from a ‘psychodynamic’ [i.e. (Adolph) Meyerian—not Freudian—with conscious but not unconscious psychological processes as central] to a descriptive, phenomenologic symptomatic and syndromic ‘neo-Kraepelinian’ framework. DSM-III's goals of precision, reliability and facilitating communication among empirical researchers were largely achieved. Their cost, the loss of clinical psychodynamic wisdom and of guidelines for psychotherapeutic approaches, is still controversial. Other effects of DSM-III included a shift of focus from patients' life histories to their symptoms, new attention to personality disorders (now diagnosed on ‘axis II') and, most striking, a huge increase of interest in nosology—no one had n