Mental health articles

McLemore and Benjamin proposed an interpersonal behavior taxonomy, based on their contention that useful aspects of psychiatric diagnostic schemata are psychosocial and that most diagnoses of ‘‘functional mental disorders’’ are made on the basis of observed interpersonal behavior. Interpersonal is described as what ‘‘one person does, overtly or covertly, in relation to another person who, in some sense, is the object of this behavior’’. McLemore and Benjamin claim that interpersonal taxonomy would be more useful in understanding and treating psychological difficulties and that it may also help to identify constructive factors in human development, thereby enhancing efforts to prevent the appearance of behavior disorders. The concept of interpersonal diagnosis was developed by Timothy Leary in 1957.

This interpersonal system concerned itself with ‘‘the impact one person has or makes with others’’ and allows for the ‘‘interaction of psychological pressures among the different levels of personality.’’ Benjamin  expanded this idea to develop a clinical classification model of social behavior known as the structural analysis of social behavior (SASB). In this circumplex type of analysis, three diamonds are used to express interpersonal, self, and intrapsychic (or introjected other to self) quadrants. Horizontal axes on all three diamonds concern love–hate affiliations, and a vertical axis outlines interdependence with maximum independence at the top. An advantage of this model is that it has been tested with certain types of circumplex analysis, factor analysis, and autocorrelational methods, and fairly high reliabilities have been demonstrated. An interpersonal nosology is emphasized by McLemore and Benjamin to ameliorate the complicated business of how one person (the therapist) is best advised to behave toward another person (the client) to improve the latter’s life (via successful psychotherapy). It allows assessing interpersonal functioning, with an additional provision that interpersonal experiences may be internalized. A more complete discussion and appropriate references can be found in Benjamin. The major assumption of this approach is that personality traits are substrates that cause all normal or abnormal behavior.

Thus, personality (interpersonal interaction) is human psychology, and aberrant behavior reflects an aberrant personality. McLemore and Benjamin agree with Szasz  that only social and interpersonal behavior is diagnosed and classified. The social category is seen as a window through which to view the other domains of human functioning. Other processes that affect or derive from social behavior are critical, and McLemore and Benjamin believe that the ‘‘object of one’s social behavior may be oneself.’’ They further state that social behavior ‘‘regardless of its causes or correlates’’ is more accessible to the psychologists’ (or psychotherapist’s) interventions. There are serious questions about the validity of these assumptions. It is not at all clear that conditions such as tics, stuttering, phobias, compulsive rituals, obesity, and sleep disorders can be viewed as disorders of interpersonal relations or maladaptive styles of interacting. Even though a number of conditions, such as the personality disorders, may reflect aberrant interpersonal interactions, the assumption that all psychopathology is similarly based is certainly open to debate. This assumption is the primary difficulty with this system, although other criticisms have been voiced as well, such as those regarding the use of terms like introjection.

Tags: diagnosis, interpersonal, personality