A few days of focus on the sorry state of things in the world of mental health treatment and I happily return to Jung. As I was looking for something last night, I found this quote which I had saved several years ago and here we are at an intersection between the mind vs the brain people:
"It is generally assumed in medical circles that the examination of the patient should lead to a diagnosis of his illness, so far as this is possible at all, and that with the establishment of the diagnosis an important decision has been arrived at as regards prognosis and therapy. Psychotherapy forms a startling exception to this rule: the diagnosis is a highly irrelevant affair since, apart from afixing a more or less lucky label to a neurotic condition, nothing is gained by it, at least as regards prognosis and therapy...
The content of a neurosis can never be established by a single examination, or even by several. It manifests itself only in the course of treatment. Hence the paradox that the true psychological diagnosis becomes apparent only at the end." (Collected Works, Vol. 16, pp.86-87)
Jung argues that initially one must make an assessment of whether or not organic brain disease is present and I would add that it is important to assess for psychosis. But given that the vast majority of patients who show up for psychotherapy have already prescreened themselves along those lines so that it is rare for a therapist to see either in a new patient, most of the people we see are what Jung called neurotic. And isn't it interesting that despite the fact that psychiatry discarded neurosis with the DSM III, the term persists in common usage?
How different Jung's perspective is from what dominates today -- a fixation on diagnosis. In fact, if one is not assigned, then there is no third party payment. We may have rather hugely increased the number of potential diagnoses, but to think the process is actually precise or scientific is to labor under serious delusion. Following Jung's path takes patient and therapist to meaning of symptoms in the context of that patient's life.
When I first started out, all the world was divided into 3 parts: psychosis, neurosis, organic brain syndromes. And yes, borderline was in there too along with personality disorders but not as major categories. I can't see that things are better now for having so many more labels.