Reply to a commentary on “The Psychodynamic Diagnostic Manual Version 2 (PDM-2): Assessing patients for improved clinical practice and research”.

Abstract

We appreciate John Clarkin’s (2014) thoughtful, friendly commentary on the original Psychodynamic Diagnostic Manual (PDM) project and on our hopes and intentions for the second edition of the PDM. As there is very little in his essay with which we disagree, we expand on some of his points. First, his emphasis on the process rather than the product of the PDM fits with our sense of our overall aim; namely, to initiate an open conversation in the psychodynamically oriented community—and beyond that, to the practitioner community in general— about how best to represent individual psychology and psychopathology in the more dimensional, inferential, and contextual ways that the psychoanalytic tradition has valued and found clinically useful over many decades of psychotherapeutic efforts. Stanley Greenspan was explicit in defining the PDM as a work in progress and certainly not as the last word in nosology. When we published the first edition of the PDM, we were hoping for ongoing critical feedback from clinicians and researchers, and despite Greenspan’s untimely death and the consequent loss of his role in mediating all such communications, the contributors to PDM-1 have received many useful critiques from our colleagues that we hope will improve PDM-2. Second, Clarkin’s sense that the project was perhaps too ambitious feels right to us. And yet we have persisted in that ambitious attitude: We could not resist attempting to address a very wide range of diagnostic issues in PDM-2. Such a goal involves continuing communication among numerous experts who often disagree, or who at least come at the work from substantially different angles of vision, and who bring widely varying experiences in theory, research, and practice to the common task. Trying to turn this chorus of discordant voices into something like a choir has been daunting to say the least. And yet,