The release of the DSM V-TR created more controversy than any previous edition of the DSM. This seminar begins by exploring reasons for this, defining some of the inherent problems that come with parsing a client’s lived experience into di While the DSM-5-TR has highlighted longstanding challenges in fitting lived experience into fixed diagnostic categories, this seminar centers on the Deconstructing Anxiety model as a powerful alternative framework for understanding the anxiety disorders. After a brief review of DSM-5-TR criteria for GAD, Panic Disorder, Social Phobia, OCD, and PTSD, we explore the shared features that point to a single underlying mechanism revealed by Deconstructing Anxiety: the presence of essential “core fears” and the defenses constructed around them. By viewing each anxiety disorder as a distinct variation on this central pattern, clinicians gain a lens that explains both the unity and the nuance in how anxiety manifests across different contexts. Through case studies, we illustrate how this model deepens clinical insight, clarifies the roots of a client’s suffering, and supports more targeted, effective treatment planning. stinct diagnostic categories. Topics such as the “false positive” problem, difficulties distinguishing risk from disorder, the need to include context when making diagnoses, and “fuzzy boundaries” between diagnostic categories will be addressed.
We will then review the DSM V-TR criteria for diagnosing GAD, Panic Disorder, Social Phobia, OCD and PTSD. In doing so, we will highlight common features among these disorders, that we may better understand their underlying mechanism. This mechanism will be elaborated according to the Deconstructing Anxiety model, a new approach to understanding and treating the anxiety disorders. Particular emphasis will be placed on the concept of essential or “core” fears and the defenses we maintain against them, at the root of any kind of anxiety.
The Deconstructing Anxiety perspective, we will propose, makes it possible to appreciate a client’s experience in a more adaptive way, one that lends depth of understanding and accounts for the distinctions between diagnoses. By understanding the basic mechanism underlying each of the anxiety disorders, we may explore their differences as “variations on a theme”, recognizing the unique response each has to factors such as people, objects and circumstances. GAD, for instance, is seen as a “generic” anxiety that is not specific to any particular situation or circumstance. The other anxiety disorders then make more sense as specific forms of GAD, each applied to unique settings. Case studies will be offered to illustrate that this perspective can lend itself to more effective insight into a client, and therefore more effective treatment plans.
Session Highlights
- Come to view the anxiety disorders as ”variations on a single theme”
- Understand the single “core fear” at the root of all anxiety disorders.
- Learn how defensive strategies, meant to protect us from anxiety, actually backfire
- Put these principles into action with the Deconstructing Anxiety exercises
- Discover the ”master key to healing” in the Deconstructing Anxiety model
Todd Pressman, PhD