"During its period of ascendance, dynamic psychiatry linked itself closely with the discipline of clinical medicine. Indeed, as Horwitz argues, this gave the discipline a prestige of scientific validity that allowed psychiatry to distance itself from other rival discourses in the mental health field (2002a: 58).5 However by the 1960s, the culture in medicine underwent a substantial transformation, adopting a methodology more congruent with classical conceptions of science (Ibid: 58). While practitioners of dynamic psychiatry continued to base their research on particular case histories, medical research began to view case studies as anecdotal and unscientific. According to Starr, medical research moved to a system predicated on specific disease entities that could be precisely defined and subject to scientific analysis. The use of large statistical studies, control groups, and double blind placebo trials of medication became the norm, thereby undermining the scientific legitimacy of the methodology employed by dynamic psychiatry (Starr, 1982). The dynamic system, with its view of manifest symptoms as “clues” or symbols” with variable meanings in determining the underlying causes of psychological distress made it virtually impossible to develop a well defined diagnostic system to be able to conduct large statistical studies with reliably measured disorders along the lines of clinical medicine. . ."
From a Foucaulvian perspective; the shift in psychiatry from identifying psychological/psychiatric issues as Freud, et al described them to what is now considered the medical model. Or rather, how a shift in the dominant discourse has created the increase in diagnosis of social anxiety disorder (implications that the same holds true for other disorders as well).
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