and I can't say I agree with them all.
I will clarify that when I say brain/mind, I am not referring to a soul/body duality. I am speaking to the reality that, no, we can not state emphatically that empirical manifestations of mind conform with expectations that are an outcome of biotic activity. Studies in neuro-psychology of those with several brain trauma who still retain all mental faculties disproves this for now. How does a human with half a brain still act human? If it is missing components that are necessary for 'mind' then how can it demonstrate those 'mind-aspects' without the biological component? Studies in serotonin receptors shows that there are more of these in the human GI tract than in the brain. So is 'happiness' and well-being in the gut? Are people who are depressed having not a brain chemistry problem but rather a GI tract chemistry problem?
So, it really isn't that cut and dry.
As to empirical evidence from our clients, yes, there are numerous 'scales' for assessing with numbers the states of mental health. The problem again is that human beings are not digital. We are analog. If I have a client who only meets 3 out of the 4 required 'signs or symptoms' of a particular diagnosis, then what? Are they about to manifest it? Have they in the past and now they are overcoming it? No matter how much of a scientist I am, I can not accept that human beings are simply a set of data points to be graphed. With only 3 out of 4 symptoms, that person is still suffering. By following strict guidelines that generalize to such a degree, those individuals don't get treatment. That is one of my chief complaints with the DSM.
You ask is it possible to separate the therapist from the diagnosis. I will state emphatically that no it is not possible from my experience. The consciousness of the observer of any phenomena impacts that observed phenomena whether in gross or subtle ways. Therapy unless it is just a pill given by an MD involves talking which involves relating. Communications theories show us that both members of a communication partnership impact the flow of the communication by how they communicate and what they communicate.
I do agree with your last point. To me a well-trained therapist is always revising a diagnosis. In fact, as I may have shared in another post, really a diagnosis is for the therapist not the patient. It is a way for me to know what protocol or algorithm is needed for one patient versus another. Yet, I must be flexible and not treat every patient with an eating disorder exactly the same, for example. CBT techniques have been shown to be the most empirically successful tool, however, it is still modified in subtle and not so subtle ways for each individual that utilizes it. Furthermore, yes, all forms of cathartic relief are essentially the same. But why does one patient respond to hitting a pillow until they cry whereas another one must process a dream of someone they love hurting in order to have the same emotional response and release? Because no two people are exactly a like.
We may not agree on all points, yet I am pleased with this discussion a great deal. You have given this a great deal of thought. I am curious why?
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