Camilo Henríquez
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October 8, 2024
The DSM-5, the Diagnostic and Statistical Manual of Mental Disorders, is a widely used tool in psychology and psychiatry. Its primary function is to provide a common framework for research and classification of mental disorders, facilitating the creation of knowledge and communication among professionals. However, in daily clinical practice, these diagnostic labels do not always rigidly apply to individuals.
In my clinical experience, the patterns described in the DSM-5 don't always strictly apply to people. Humans are not static; they change over time, and their behaviors and thought processes evolve. For example, a person diagnosed with Narcissistic Personality Disorder may exhibit narcissistic behaviors at certain times, but that doesn't mean they are inherently narcissistic forever. Behaviors often respond to specific situations or processes of suffering the person is going through.
As Aaron Beck, founder of Cognitive Behavioral Therapy (CBT), highlighted, people can modify their thinking and behavior patterns by recognizing how their cognitive interpretations influence their emotions and actions. This supports the idea that behaviors are not fixed, but can change when consciously addressed.
It's crucial to understand that labels like "narcissistic" or "obsessive-compulsive" can be helpful for identifying behavioral patterns, but they should not permanently define a person. Often, problematic behaviors arise as defensive mechanisms in response to situations the individual cannot tolerate or process. Each story is unique, and behind every behavior, there are contextual factors we need to understand.
The Mentalization-Based Therapy approach developed by Peter Fonagy emphasizes the importance of helping individuals reflect on their own mental states and those of others. This process can be key in helping people understand and modify their behavior patterns.
Take narcissism, for example. It often represents an aggressive defense strategy. In many cases, people who act narcissistically are not incapable of empathy, but have learned to protect themselves through apparent superiority. These defensive patterns can be identified and changed.
This is where Dialectical Behavior Therapy (DBT), developed by Marsha Linehan, becomes relevant. Linehan reminds us that change is possible when we balance radical acceptance of a person as they are with conscious efforts to modify self-destructive patterns. By understanding the roots of these behaviors, we can help individuals make meaningful changes.
Ultimately, the work in mental health is not about boxing people into diagnostic labels, but about understanding their suffering, their defense mechanisms, and how they have come to be who they are. The DSM-5 is a valuable tool for research and diagnosis, but we must remember that each person is much more than a label. People change, and my role as a therapist is to accompany them in that process of transformation.
John Kabat-Zinn, in his work on mindfulness, teaches us to cultivate greater awareness of the present moment and of ourselves. This can be a crucial element in the process of change, helping people break away from automatic thought patterns and be more present in their lives.
Diagnostic labels can be useful in certain contexts, but it’s essential to remember that people are much more than the behavior patterns they display at any given moment. Accompanying them in their process of change is the true goal of therapeutic work.
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If you're interested in learning more about authors in psychology who explore these ideas, feel free to reach out. I’m here to share resources and discuss how we can better understand mental health from a more human-centered and dynamic perspective. 😊
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