Thursday, August 18, 2022

Comments by Audrey Stillerman, MD

Showing 3 of 3 comments.

  • Thanks for sharing your thoughts, Sam. We agree that labels often distract us from what is really going on and can be harmful, both DSM and ICD-10 labels. These labels are not based on science but on a reductionist Western paradigm that carves the brain-body system up into small, independent bits instead of seeing the whole person in context across time and their physiology as a process that can be supported or injured by their experiences including in the healthcare system. We particularly appreciate Bessel van der Kolk’s description of “mental injury”: “Psychiatric diagnoses must be seen as fluid, temporary phenomena that can change rapidly. With this perspective, assigning diagnoses can be a useful map of current mental state but should never be confused with the individual’s rich experience and potential for repair, capacity to develop insight, and ability to learn to behave with calm and strength.”

  • In this context buffer means anything that would protect us/mitigate harm from adversity such as a physically and emotionally safe environment where physiologic needs are met, attached, attuned caregivers, social connections, equality and equity.

  • That’s right, Miranda and we can even go a little further. Before people begin to have symptoms, their experiences (individual, community, structural and historical) have an impact on their brain-body physiology, as a result of a process or processes which occur over time and are often unseen until they manifest as symptoms.