The foundations of critical psychiatry

I’ve mentioned before that the PhD I’ve just started (see previous post) is on ‘The foundations of critical psychiatry’. Critical psychiatry is not new. There are at least three points in the past when its conceptual position has been promoted. These associations are not always well appreciated.

(1) Ernst Von Feuchtersleben (1847) Principles of medical psychology (original German edition, 1845) (eg. see previous post) could be seen as the first attempt to provide an interpretive rather than biomedical account of mental illness. Feuchtersleben has been seen as a 'forgotten psychiatrist' (see article). Following Kant, he recognised that the mind-brain problem is an "enigma, which can never be solved" (p. 16). Despite the success of his book, he was "swimming against the tide" and his "psychosomatic viewpoint made no impact in the second half of the 19th century" (Lesky, 1976; quotes from pp. 154 & 156).

(2) Adolf Meyer's (1866-1950) Psychobiology (eg. see previous post) has the same conceptual understanding of mental illness as critical psychiatry. The problem is that this is not always apparent because of Meyer's tendency to compromise. As I said in my paper, the principles of critical psychiatry "can only be reestablished by a challenge to biomedicine that accepts, as did Meyer, the inherent uncertainty of medicine and psychiatry".

(3) George Engel's (1977) biopsychosocial model (eg. see previous post) was a critique of biomedical dogmatism in the same way as critical psychiatry and proposed a "new medical model". The trouble is that it has tended to be interpreted in an eclectic way and its impact not fully realised (eg. see my review of Nassir Ghaemi's (2009) book The rise and fall of the biopsychosocial model).

Critical psychiatry needs to make more of these and other links with the past. Its conceptual understanding is integral to the history of psychiatry.