Wednesday, January 12, 2022

Reaction against the neo-Kraepelinian approach

Jerome Wakefield has an article in World Psychiatry on the 'credo' of nine propositions of the neo-Kraepelinian movement. One of my articles examined the same nine assumptions from the critical point of view of Adolf Meyer. 

I agree with Wakefield that Robert Spitzer, Chair of the DSM-III taskforce, should not necessarily be seen as a typical neo-Kraepelinian. Spitzer was very clear that, from his point of view, DSM-III was atheoretical (see eg. previous post). I also agree with Wakefield that Spitzer was concerned to counter anti-psychiatric critiques (see eg. another of my articles), particularly the study by Rosenhan (1973) 'On being sane in insane places' (see previous post). The subsequent DSM-5 has of course failed (see eg. previous post).

Where I think Wakefield may have missed a point is that Klerman anticipated a neo-Meyerian revival. He does mention that Klerman noted there was bound to be " a reaction against what will be perceived as the [neo-Kraepelinian] movement’s excesses'. As I said in my 1990 article, this response has been "slow to be formulated". I’ve always argued that critical/relational psychiatry is a neo-Meyerian position in psychiatry (see eg. my talk). 

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