Letty wrote: Er, Deb. What's reification?
To reify means to regard or treat (an abstraction) as if it had concrete or material existence.
DSM IV and ICD 10 and such are useful when treated correctly.
Some diagnoses in DSM are likely "illnesses" in the traditional sense, in that there is a physical component.
Many are - and are only meant as - descriptions of commonly presented clusters of behaviour, affect and cognition. Such classification is useful in research and such, and can tell us a lot about TRENDS for outcome, because of the research that has already been done.
But.....
Let me give you an example of my point.
Conduct disorders are well described in DSM IV. They are descriptions of various levels of naughty behaviours of (mainly) boys.
They are useful, in that good research has been able to be done which tells us that a little fella with conduct problems, fitting criteria for Oppositional Defiant Disorder, at age three, is in need of intensive intervention - because if there is no successful intervention then, he is likely to go on to be a very unhappy, naughty adult who causes harm to himself and others, may well end up in prison and has a reasonable chance of getting pretty depressed in adolescence and may top himself.
Of course, ALL little people at three are oppositional and defiant! Good assessment is needed to filter out the normally naughty little munchkins (whose parents may need education and support if they are finding this too challenging!) from the munchkins in real trouble.
But - too often, said munchkin is taken to a doctor - who is no expert in mental health, and looks at the DSM IVR - makes what may be an accurate assessment - and tells parent "Freddy has Oppositional Defiant Disorder".
Munchkins who DO qualify for such a description usually have very troubled families - who feel really bad and to blame for Freddy. But - now? Freddy is ILL! Freddy CAN'T HELP IT! It's not my fault!
Trying to work effectively with a family who now have a child with an ILLNESS - via the means which may work - like family work, work on attachment repair, and assistance with good behavioural management can be hell. "Why do you want to see us? It's nothing to do with us! You are trying to blame me! I want a pill!"
Such families will find a doctor who WILL drug the munchkin.
This is an example of reification at work.