I just had the pleasure to attend a lecture by Dr. Bruce Perry. It was great, and if his books are as good as his lectures he may be my new hero. The topic was his “neurosequential therapeutics,” which sounds nerdy (and it is) but is much more intuitive and helpful than it is technical. The basic idea is that the developmental stage at which a client was traumatized is an important clue into what kinds of therapeutic activities will be helpful to them, and in what order and priority. Pre-verbal trauma is unlikely to be helped by cognitive therapy, for example.

Anyway, more on that when I get the time to read his books. Another thing I liked about Perry was his attitude towards the DSM, the mental health industry’s diagnostic Bible. Here’s my paraphrase of one of his tangents on the DSM:

The heart is a fairly simple organ. It’s a blood pump. Cardiologists know several hundred ways that the heart can get sick and all of them are diagnosed and named in terms of the physiology of the heart. However, the symptoms that bring the patient in, however, are few–often chest pain and shortness of breath.

The brain, on the other hand, is an extremely complex organ. The DSM lists several hundred psychological symptom clusters which ostensibly represent ways the brain gets sick. But none of them are diagnosed or named based on brain physiology. They are all named based on symptoms: Panic Disorder Without Agoraphobia, Major Depressive Disorder With Postpartum Onset, etc.

If cardiologists followed this protocol, they would have only a few diagnoses, along the lines of Major Chest Pain Disorder With Shortness of Breath, Major Chest Pain Disorder Without Shortness of Breath, etc.