Beyond the Dsmiv Criteria Understanding the Client as Multidimensional

While comparing a highly introverted client against the DSM-IV criteria for schizoid personality disorder, Jenna noticed that the diagnostic criteria focused mainly on the interpersonal perspective. Cognitive style, defense mechanisms, and object representations were not mentioned at all. Her supervisor explained that because the DSM followed the medical model, its diagnostic criteria neglected some personality domains and emphasized others. Together, they decided that a complete understanding of the client would require a broader knowledge base than was represented in the DSM-IV criteria.

defense mechanisms. Such therapists engage their clients through the same domains of personality repeatedly, practicing school-oriented psychotherapy because their education permits nothing more. Even worse, such therapists discover pathology only in those perspectives through which they were trained. As a result, they recruit change processes only from these same domains, making an optimized idiographic therapy impossible. No single school-oriented modality gives therapists access to all the change processes that might be called on to maximize therapeutic efficacy. Synergistic comprehensiveness is the wave of the future in the therapies of the twenty-first century.

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