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The Journal of Medicine and Philosophy Feb 1990Psychiatry is rapidly changing. The authors review the history of psychiatry in the United States, its gradual integration into medicine and society, and the dialectic... (Review)
Review
Psychiatry is rapidly changing. The authors review the history of psychiatry in the United States, its gradual integration into medicine and society, and the dialectic between its "biologic" and "mentalist" outlooks. After describing the current state of the profession and its knowledge base, they discuss the likely future of the field: psychiatry's projected mode of practice and economics; its future as a science for understanding human behavior; its expected boundaries with other treatment disciplines; its anticipated relationship with academia and with the community at large; and internal issues for the profession. Unprecedented internal and external pressures on the field are likely to require important reconceptualizations of psychiatry both by its members and by the rest of the American public.
Topics: Forecasting; Humans; Mental Disorders; Physician-Patient Relations; Psychiatry; United States
PubMed: 2187044
DOI: 10.1093/jmp/15.1.5 -
Lancet (London, England) Jun 2012
Topics: Career Choice; Humans; Psychiatry; Students, Medical
PubMed: 22748589
DOI: 10.1016/S0140-6736(12)61067-8 -
Psychiatrische Praxis Jul 2014
Topics: Commitment of Mentally Ill; Europe; Forecasting; Health Services Misuse; History, 19th Century; History, 20th Century; History, 21st Century; Hospitals, Psychiatric; Humans; Psychiatry
PubMed: 24983449
DOI: 10.1055/s-0034-1370079 -
L'Encephale Apr 2016The main hypothesis of this paper is the presence of malaise in psychiatry. The malaise has two sides: on one hand, the end of psychiatry hegemony that dominated the... (Review)
Review
The main hypothesis of this paper is the presence of malaise in psychiatry. The malaise has two sides: on one hand, the end of psychiatry hegemony that dominated the theoretical field of psychiatry until the 1990s. The loss of influence of psychoanalysis is due to its inability to be submitted to any kind of assessment. On the other hand, the supremacy of neurosciences. The idea is not to underestimate the importance of neurosciences but rather to affirm that they occupy the whole theoretical field of psychiatry. This is an unusual situation that is specific to our time. Indeed, this monism has succeeded to an epistemological dualism that has existed throughout the history of psychiatry. In this article, we'll try to draw a history of dualism in psychiatry. Firstly, with Pinel, we find a tension between a metaphysical philosophical pole and a physiological one. Pinel's philosophy has something to do with Condillac's ideology as Pinel applies the analytical method to mental diseases. Under Cabanis's influence, the author of the famous Rapports du physique et du moral de l'homme, this ideology is under pressure with physiologism. As a materialist, he gives an essential part to the brain that distributes pieces of information throughout the body because he thinks that mind influences body. Secondly, dualism lies between the doctrine of localizations defended by Gall and the theory of degeneration elaborated by Magnan. Gall, in Anatomie et physiologie du système nerveux en général, seeks to know how bumps or hollows that are found on the skull are shaped. Gall is for the theory of delocalizations. He is the counterpart of Magnan who wrote a work about Les Dégénérés, that takes its part in the physiological trend with the famous theory of degeneration. For him, degeneration means the imperfect state of a subject whose cerebral functions are in a noticeably imperfect state. Thirdly, with Henry Ey, dualism starts to be less important. Indeed, he tends a monist synthesis with its organodynamic model described in Des idées de Jackson à un modèle organodynamique en psychiatrie. Indeed, he is inspired by the English neurologist Jackson to assert that there are levels of conscience structuring where negative symptomatology appears through its dissolution. Current monism with neuroscience domination sets fundamental epistemological issues. Perhaps neurosciences were setting an impossible task to achieve while following Changeux's intuition. In L'homme neuronal, this latter was developing the idea that to each psychic function, one could associate a neuron. This is a way to go back to Gall who doesn't seem to us to be heuristic. Indeed, let's first introduce the fact that there is no specific cortical area just as the most recent works have shown. Therefore, saying that a cerebral area is correlated to a symptom or a function is no more than relying on parallelism theory. Thus, Bergson, from whom we took the analysis, showed the futility of such a concept and the apporias to which it leads. The research of precise cerebral areas implied in mental diseases, as important as it is, leaves open the question of meaning. The meaning of the disease raises many economic, cultural, psychological and social factors. Thus, we can formulate the hypothesis that psychiatry should be between two complementary poles. First, the pole of neurosciences whose researches are fundamental for research in disease etiology and the development of a new medicine. Second, there is a pole which is more polymorphous and that would deal with the question of meaning. We think that each of these poles should have their own investigation field and their specific methods. We defend the idea that creating subjects such as neuropsychoanalysis is an illusion.
Topics: History, 18th Century; History, 19th Century; History, 20th Century; History, 21st Century; Humans; Neurosciences; Psychiatry; Psychoanalysis; Psychoanalytic Theory
PubMed: 26796559
DOI: 10.1016/j.encep.2015.12.011 -
The Lancet. Psychiatry Dec 2019
Topics: Psychiatry
PubMed: 31777346
DOI: 10.1016/S2215-0366(19)30433-X -
The Lancet. Psychiatry Oct 2019
Topics: History, 20th Century; History, 21st Century; Humans; Male; Psychiatry; Switzerland
PubMed: 31544762
DOI: 10.1016/S2215-0366(19)30330-X -
Revue D'epidemiologie Et de Sante... Oct 2014
Topics: Humans; Psychiatry; Referral and Consultation; Suicide, Assisted
PubMed: 25444833
DOI: 10.1016/j.respe.2014.09.003 -
Psychodynamic Psychiatry Jun 2012Over the last 30 years psychiatry and psychoanalysis have moved in substantially divergent directions. Psychiatry has become rich in methodology but conceptually... (Review)
Review
Over the last 30 years psychiatry and psychoanalysis have moved in substantially divergent directions. Psychiatry has become rich in methodology but conceptually limited, with a drift toward biological reductionism. Psychoanalysis has remained relatively limited in methodology, but conceptually rich. The rich methodology of psychiatry has led to major contributions in discovering gene by environment interactions, the importance of early adversity, and to recognition of the serious problem posed by treatment resistance. However, psychiatry's biologically reductionistic conceptual focus interferes with the development of a nuanced clinical perspective based on emerging knowledge that might help more treatment resistant patients become treatment responders. This article argues that recognition of the problem of treatment resistance in psychiatry creates a need for it to reconnect with the conceptual richness of psychoanalysis in order to improve patient care. Psychodynamic psychiatry is defined as the relevant intersection of psychiatry and psychoanalysis where this reconnection can occur. I will suggest selected aspects of psychoanalysis that are especially relevant to psychiatry in improving outcomes in work with treatment resistant patients.
Topics: Adolescent; Adult; Biological Psychiatry; Cognitive Behavioral Therapy; Drug Resistance; Gene-Environment Interaction; Humans; Mental Disorders; Middle Aged; Psychiatry; Psychoanalysis; Psychoanalytic Therapy; Psychotherapy; Transference, Psychology; Treatment Failure; Young Adult
PubMed: 23006116
DOI: 10.1521/pdps.2012.40.2.183 -
The Journal of Medicine and Philosophy Feb 1990Philosophical perspectives are deeply relevant to psychiatric theorization, investigation, and practice. There is no better instance of this than the perennially vexing... (Review)
Review
Philosophical perspectives are deeply relevant to psychiatric theorization, investigation, and practice. There is no better instance of this than the perennially vexing mind-body problem. This essay eschews reductionist, dualist, and identity-theory attempts to resolve this problem, and offers an ontology--"monistic dual-aspect interactionism"--for the biopsychosocial model. The profound clinical, scientific, and moral consequences of positions on the mind-body relation are examined. I prescribe a radically biological cure for psychiatry's--and all medicine's--chronic dogmatism and fragmentation.
Topics: Consciousness; Humans; Neuropsychology; Philosophy, Medical; Psychiatry; Social Environment; Unconscious, Psychology
PubMed: 2187043
DOI: 10.1093/jmp/15.1.41 -
CNS Spectrums Oct 2022
Topics: Humans; Identity Crisis; Psychiatry
PubMed: 33938415
DOI: 10.1017/S109285292100047X