The nature of psychiatry

I’ve mentioned Ivana Marková before (see previous post). She has an interesting article in History of Psychiatry in which she draws from Heidegger to explore the question of what psychiatry is. Psychiatry is a form of interpersonal interaction in which there is a specific reaching out of one Being to another. Through recognition of the other’s mental condition there is a corresponding sense that something should be done about it. She uses the word ‘distress’ for the condition being recognised, which is perhaps not ideal, and she may need to supplement her analysis with one about the nature of mental illness (see eg. previous post). 

As she says, meaning is created through interaction of clinician and person. The construction of distinctions and categories in diagnosis cannot be reified, or even necessarily reduced to brain abnormalities, and should not be viewed as always depicting absolute reality. We should not be surprised if we “struggle to fit clinical presentations into the conventional descriptions”. As she says, 

In the face of a psychiatry that is driven ever more by a neurobiological reductionism in research and by a mechanistic and algorithmic approach to the assessment and management of patients, it is increasingly important to rethink a formulation of psychiatry from within [her emphasis].

As she concludes, authentic engagement is required in the practice of psychiatry (see eg. previous post). Trouble is that modern psychiatry too often avoids it, even labelling it as anti-psychiatry (see another previous post).