Resolution of the Polarisation of Ideologies
and Approaches in Psychiatry*
Preface to the Seventh Monograph
Resolution of the Polarisation of Ideologies
and Approaches in Psychiatry
The Consequence - Polarization
Schizm, Eclecticism and Rejection
Resolution, Phase one : Realization
Different Orientation - Different Approach
Resolution, Phase Two : Integration
Integrative Therapeutic Approaches
Some More Integrative Efforts
The Future of Freudian Thought
Particles and Waves, Motives and Genes
Questions that this Monographs Raises
Readers Respond: Prof. N. N.Wig, Prof. A. Venkoba Rao
Like all good neighbours, competing schools of psychiatry
claw at each other. Like all good samaritans, some people try to play arbiters and douse the fires. The tradition of fights
and retaliation is not new to psychiatry, neither is it unique to the branch. Competing schools of thought exist almost everywhere.
And it is tempting to say that the more intellectually robust a field, the greater the controversies and fights in it.
In fact if intellectuals were to come together and not voice
differences, either they are not intellectuals, or they have no opinions.
( Or they may be scared, or silenced for other reasons.)
Of course we must note that while in other fields of thought
there can be controversies, there is one essential difference. They may not be dealing with patients and their lives. And
to that the corollary is that psychiatric controversies should not be carried out at the expense of patient welfare.
Having said that, let us also note that when there are fights,
arbiters become very active. As do advocates, of one or the other approach.
In this monograph we have tried to act the arbiters. Maybe
because it is appropriate. Maybe also because that's the only thing we can do (and do well: atleast that's what we would love
Why not advocates? Well, for one, there are so many already.
For another, we run the risk of doing a poor job of it.
Not that we have necessarily done a good job of being arbiters.
Ajai R. Singh
Shakuntala A. Singh
The uniqueness of psychiatry as a medical speciality lies
in the fact that aside from tackling what it considers as illnessses, it has perchance to comment on and tackle many issues
of social relevance as well. Whether this is advisable or not is another matter; but such a process is inevitable due to the
inherent nature of the branch and the problems it deals with. Moreover this is at the root of the polarisation of psychiatry
into opposing psychosocial and biological schools.This gets reflected in their visualization of scope, in definitions and
in methodology as well. Whilst healthy criticism of one against the other school is necessary, there should be caution against
hasty application of one's frame of reference to an approach that does not intend to follow, or conform to, one's methodology.
This should be done within the referential framework of the school critically evaluated, with due consideration to its methods
and concepts. Similarly, as at present, there is no evidence to prove one or the other of these approaches as better, aside
from personal choice. We can say so even if there is a strong paradigm shift towards the biological at present. A renaissance
of scientific psychoanalysis coupled with a perceptive neurobiology which can translate those insights into testable
hypotheses holds the greatest promise for psychiatry in the future.This suggests the need for unification of diverse
appearing approaches to get a more enlightened world view. It requires a highly integrative capacity. Just as a physicist
thinks simultaneously in terms of particles and waves, a psychiatrist must think of motives, emotions and desires in the same
breath as neurobiology, genetics and psychopharmacology. However, the integration must be attempted without destroying
the internal cohesiveness of the individual schools. This will give a fair chance for polarisation in which a single proper
approach in psychiatry could emerge,which may be a conglomerate of diverse appearing approaches of today, or one which supercedes
the rest. A synthesis of cognitive psychology and neuroscience offers the greatest promise at present.
Resolution of differences, Integration of schools, Polarisation
of approaches, Biological and psychosocial dichotomy, Psychoanalysis and Cognitive Neuroscience, Eclecticism in psychiatry
Mens Sana Monographs(2004-2005),
II : 4-5, November 2004- February 2005, p5-31
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