Re "Thinking Clearly About Personality Disorders" (Nov. 27): From a psychoanalytic perspective, one is always working clinically with the vagaries of personality that lead to patients' difficulties in living, and are often a foundational element of the symptoms of anxiety and depression that many people seek to ameliorate.
Whether or not such personality traits can be easily categorized may have academic importance, or be important to those who look to create diagnoses for insurance reimbursement. But they often have little value in the day-to-day work of the psychotherapy consulting room, where human relations come to bear on human problems in living.
Stefan R. Zicht
New York,
The writer is a clinical psychologist and psychoanalyst.
To the Editor:
As far back as the 1950s, John Bowlby and others documented the roles of relationships, neglect and trauma in generating mental illness. Researchers at McGill University have documented brain changes in adults who suffered trauma and abuse as children, changes that can be communicated to the offspring of these adults. All this work points to attachment between the infant and parent (a function of the limbic brain) as a survival mechanism going back millions of years.
If it is "thinking clearly," the American Psychiatric Association must explain why it ignores a well-documented theory. Possibly the real issues are its bias toward drug treatment, and a bias by insurance companies against the necessary long-term psychotherapy.
Eric Wolf
Denver
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