“Getting to the Bottom of Everyone’s Story”
One of the most sane and wise statements I have read on mental health is an article of the above name by Lisa Pryor, M.D. who writes: “You would be forgiven for thinking that psychiatry is a profession devoted merely to sorting and labeling humans … there is another psychiatry concept that gets less of an airing in public but that could be more helpful for understanding… how any of us can think about mental suffering. This concept is the psychiatric formulation.”
Example:
A straight out and out diagnostic label: Major depressive disorder.
Says Dr. Pryor about the above, “It may not tell you much about a person, but consider a formulation for an individual which might go something like this:
“Forty-six year old single mother of two presents with a three-month history of depressive symptoms including low mood, insomnia and poor appetite (with weight loss). Her condition was precipitated by psycho-social stressors including unstable housing and credit card debt since the breakdown of her marriage 8 months ago. This is on a background of an introverted and passive temperament and a childhood in which her parents encouraged dependency, and this was followed by a marriage in which her husband had complete control of finances. There is a strong family history of depression. Her mother and maternal grandmother were hospitalized for this condition. Protective factors include a strong network of friends and a willingness to engage with therapy.”
“So when something is wrong, we would do well to ask not just what is my diagnosis? But instead, ‘what is my formulation?'”
Source of excerpts:
Pryor, Lisa (March 16-17, 2019). Getting to the bottom of everyone’s story: A “formulation” gathers the biological, psychological, and social factors that led to a mental illness — and offers clues to the way out of suffering. New York Times International Edition.
