Understanding the speed of change: Rejoinder for “Seeking clarity for future revisions of the personality disorders in DSM-5”.

Abstract

Presents a rejoinder to comments by Paris (see record 2013-45025-013) and Clark (see record 2013-45025-014) on the original article by Gunderson (see record 2013-45025-012) regarding revisions of personality disorders in the DSM-5. Gunderson begins by commenting that The Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) workgroup (WG) proposal was like a deep interpretation; it may have been essentially right in many respects and, for those who shared its theoretical bias, its bold originality was warmly applauded. Those who authored the proposal ended up defending it and feeling their critics were uninformed. Those who received it felt unheard and disrespected. Gunderson thought he could understand and even agree with the DSM-5 WG's ambitious goals. He remarks that there was much that was foresighted and wise in their proposal. Still, like any deep interpretation, the proposal did not seem to respect the extended time required for alliance building and for working through of the objections from those whose problems the interpretation/proposal was expected to cure. Moreover, he notes, the proposal did not acknowledge the almost certain errors inherent in moving so fast and the almost certain harm those errors would cause their subject.