Dear Szondians,
Below is an important issue, concerning
DSM V, in a letter from IAAP - International Association for Analytic
Psychology.
Regards,
Giselle Welter - São Paulo/ Brazil
11 May 2010
Dear
Presidents and Individual Members of the IAAP:
I
am writing to let you know that the IAAP has made a submission to the DSM V
Working Group on Personality Disorders. You may know that DSM IV
(Diagnostic and Statistical Manual) is a very influential publication of the
American Psychiatric Association used broadly by psychiatrists, psychologists
and social workers in formulating diagnoses of mental illness and dysfunction
within the community. Its influence is felt beyond the borders of the
USA, and its categorizations of mental illness have an important impact on
patient diagnosis and treatment in many parts of the world.
Recently
John Beebe brought to our attention that the DSM V Working Group, in its
revision of DSM IV, is proposing to include the term ‘introversion’ as one of
the criteria used to designate the category of ‘schizoid withdrawal’, making it
one of the ‘trait domains’ indicative of personality disorder. With
John’s help, we formulated a letter to the Working Group to put forward the
rationale for not using the term ‘introversion’ in this way. This
was forwarded to the Working Group and now appears on the APA website.
The deadline for receiving such communications was 20 April 2010.
The
IAAP’s response, together with this explanatory email, is being posted on the
IAAP’s website in order to to keep you informed about our actions in this
matter. As soon as the results of the Working Group’s deliberations are known,
which may be towards the end of May, I will write again to inform you of the
outcome.
I
would be pleased if the Presidents of Member Groups would circulate this
information to the members of their Societies.
With all my good
wishes
Hester
Solomon
President, IAAP
INTERNATIONAL ASSOCIATION FOR ANALYTICAL PSYCHOLOGY
INTERNATIONALE
GESELLSCHAFT FÜR ANALYTISCHE PSYCHOLOGIE
ASSOCIATION
INTERNATIONALE DE PSYCHOLOGIE ANALYTIQUE
ASSOCIAZIONE
INTERNAZIONALE DI PSICOLOGIA ANALITICA
ASOCIACION INTERNACIONAL
DE PSICOLOGIA ANALITICA
IAAP’s President Secretariat
Hester Solomon, President
e-mail: iaap.president.secretariat@usa.net
12, Kidderpore Gardens
Tel. & fax: 00 39 02 739
5857
London, NW3 7SR, UK
Tel.: 00 44 207 794 7402
e-mail: hester.solomon@blueyonder.co.uk
8 April , 2010
Andrew
E. Skodol, II, M.D.
Research
Professor of Psychiatry
University of Arizona College of Medicine
President,
Sunbelt Collaborative
6340 N. Campbell Avenue, Suite 130
Tucson,
AZ 85718, USA
Dear Dr. Skodol,
I am
writing on behalf of the International Association for Analytical
Psychology to urge that the term introversion
not be used to identify the trait domain
of personality functioning that can become, if
carried to an extreme, a pathological syndrome
of reclusiveness, withdrawal, and affective constriction. Introversion, a
term introduced into psychiatry by C. G. Jung in 1909, has a long and varied
history in personality theory, only a small part of which is captured in
Theodore Millon’s otherwise extremely useful discrimination of the syndromes of
personality disorder. Millon’s book, Disorders of Personality, has led
many American psychiatrists and psychologists to accept the erroneous belief
that introversion was simply the historical antecedent to the contemporary
conception of schizoid personality disorder. Indeed, if one looks on the
DSM-V website for a definition of introversion, one finds this proposed
personality trait domain defined in exclusively negative terms: “Withdrawal from other people, ranging from intimate
relationships to the world at large; restricted affective experience and
expression; limited “hedonic capacity” with trait facets of “social
withdrawal,” “social detachment,” “intimacy avoidance,” “restricted
affectivity,” and “anhedonia”.
This definition is transparently based on the current DSM-IV
diagnostic criteria for Schizoid Personality Disorder, and thus equates
introversion with a pattern that has long been regarded as personality
pathology. Under the proposed new terminology, the pattern
defined as introversion is a trait domain, within a dimensional approach to
diagnosis. While this approach does not insist that a personality
displaying the trait of introversion is ipso facto pathological, unless
the trait dominates the personality to an extreme degree, the clear implication
of the definition is that extraversion is the sole basis of positive
affectivity and healthy relationships with others. We believe this unjustified
conclusion stems from the misuse of “introversion” as a term to represent a
trait domain of detachment from social relationship and one’s own affects.
For many of us, the term “introversion” means the normal and
psychologically essential process of introspection and reflection through which
people define, evaluate, identify, and digest both outer and inner experience.
Encouraging mental health professionals
evaluating personality to write and think about introversion in negative terms
would be analogous to asking internists evaluating patients to view inhaling
with suspicion, because it is a compromise or absence of exhaling.
The
International Association for Analytical Psychology represents approximately
3000 member analysts in 50 Institutes of Jungian Analysis around the world, and
their influence is sufficiently felt through teaching, supervision,
publication, and, of course, clinical work, to bring us in contact with many
mental health practitioners who are working closely in psychotherapy with
patients who happen to be introverted. It
is clear to us that patients who need to connect positively with their inner
lives will suffer if the very word "introversion," which has been a
lifeline to many, becomes stigmatized as it would under the proposed DSM-V
wording.
I
want to thank you for letting us give input as part of your own hard work to
get this right.
Sincerely,
Hester Solomon
President,
IAAP