This book is written in a surprisingly almost casual conversational manner, chock full of useful information combining both theoretical as well as practical examples. They are not afraid to criticize the DSM nor to point out many situations where categories overlap or presentations span a continuum.

Wish I would've found this a long time ago. I also wish this was popular enough to seriously challenge the DSMs American dominance.

It's particularly notable that the PDM includes descriptions of healthy personalities etc and not strictly mental illnesses.

The book is a fruit of an immense work done by many teams of psychoanalysts and psychodynamically minded clinicians in the USA, where the problem of co-existence of psychoanalysis as a recognized clinical practice with its therapeutic efficacy, with the psychiatric (crypto-behaviourist in its theory and pharmacologically oriented in its practice) DSM classification of mental disorders, was born and tense as nowhere else. The psychoanalysts of the entire world should be thankful for their American colleagues for their titanic struggle for the case of psychoanalysis in psychiatry. The American psychoanalysts opted to do not ignore the Zeitgeist -- id est, the growing implication of the third parties (governmental administrations and insurance companies) in the therapeutic process. The book contains the results of thorough reading of the DSM texts, and sensible additions and corrections that the psychoanalytical vistas may introduce in what must be seen as a permanent work in progress, and not at all a trap of pseudo-divine Revelation, as it too often happens to turn in the hands of too many affordability-only minded "third parties".

Finally the psychoanalytic world has produced a diagnostic manual that describes people in a way that is true to life since it incorporates symptoms, inner experiences and the person's strengths and weaknesses. This book at long last puts into black and white the diagnostic map that analysts have used for the past 30 years, though never as an authorized nosology. The result of the long delay is the sad truth that the DSM has had no competition. Wisely the authors--essentially everyone in field of note who has been interested in questions of diagnosis including Kernberg, Wallerstein, McWilliams and Drew Westen -- present the PDM as complementary to the DSM rather than as a replacement since the DSM is unfortunately too firmly entrenched to be dislodged. However the PDM really boils down to an alternative diagnostic system, which corrects the over-simplifications, some of the omissions and a lot of the implicit biological bias of the DSM. In the correcting-omissions-department the PDM restores some traditional personality types that are very common in office practice - like depressive and masochistic - that were left out of the DSM because politically important factions lobbied against their inclusion. The PDM also has restored 'borderline' to its more usual usage as a level of severity. Still, there are suprises in the PDM. Three new "personality types" are introduced, and without full explanation why. These are the the anxious, the dissociative and the somatizing personalities. Usually anxiety, somatization and dissociation are included as symptoms (which the PDM does as well) but here these pathologies are listed as defining personality types. Since no research data is presented to support these additions, the impression is left that one or more members of the Committee prevailed and had to be assuaged in order to hammer out the final compromise document. But what will be most suprising to people who buy this book -- expecting a diagnostic manual -- is that about half of this 800 page book is not a manual at all but a collection of supportive research articles that are not specifically explications of the PDM's diagnostic system. The articles amount to a high level conversation between the analytic researchers and the makers of the DSM, particularly the Axis II committee. It remains to be seen if the audience for this kind of manual - clinicians overwhelmingly - will be put off by so much of the book being devoted to learned articles not obviously related to "The Manual." I myself would have preferred that these pages had been devoted to a fuller explication of the diagnostic system of the PDM (sometimes described too briefly) and with more case examples, since that would help ensure that different readers apply the criteria in the same way (i.e. the reliability issue). Nonetheless the PDM towers over the DSM and no quibble about shortcomings should obscure that fact. The overall schema is more true to life and more clinically on target and the personality types are better described and in fewer words than those of the DSM. Unlike the DSM you won't need a tool kit from Home Depot to fit someone into a diagnostic category.

After taking a seminar in this manual, I purchased it as it offered yet another alternative to the DSM-5. While it mirrors the DSM-IV-TR, it still offers more in depth understanding of some things the DMS will gloss over like the personality disorders, functioning and an array of studies to support the rational for understanding mental illness and part of a functioning continuum. My only regret is that I have yet to figure out a way to introduce it to my clinical work other than helping me better understand and explain diagnosis to my clients. Maybe that's the goal? Great addition to the DSM with an emphasis on the whys.

My feeling is that the DSM has moved too far toward strictly behavioral or external understanding of mental disorders, relies too much on the idea that disorders are discrete categories you are either in or not in, as is too influenced by the pharmaceutical industry. The PDM offers much of the what the DSM lacks:

1. A dimensional way of looking both at personality type and personality health
2. Personality disorder definitions that make sense, avoid unnecessary overlap, and expand upon those in the DSM
3. An understanding that not all mood-related phenomenon are mood disorders, but that some are personality disorders

There are also a variety of very interesting articles on the evidence base for psychoanalytic treatment.