Holistic psychiatry without the whole self

Crossley, David

doi:10.1192/pb.bp.111.034397

Cited by 5 publications

(2 citation statements)

References 12 publications

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“…The modern term "holistic psychiatry" is usually described as the "whole self " approach, including mind and body concepts (Wallace, 2008), an increased humanistic aspect in treatment of psychiatric diseases (Linnett, 2006), a systemic (organizational/integrative) view on human behavior (Angyal, 1948) and questioning of our understanding self and identity in a psychiatric context (Crossley, 2012). All of these holistic categories represent the whole-person care approach that is highly desired yet remains hard to reach for biological psychiatry.…”

Section: Milestones In Biopsychiatric Conceptsmentioning

confidence: 99%

Developing translational biological psychiatry: Learning from history to build the future

Demin

Meshalkina

Lakstygal

et al. 2017

BioComm

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Section: Milestones In Biopsychiatric Conceptsmentioning

confidence: 99%

Developing translational biological psychiatry: Learning from history to build the future

Demin

Meshalkina

Lakstygal

et al. 2017

BioComm

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“…David Crossley recently argued that psychiatrists are treating the self but unfortunately evade broader questions about the self. He therefore suggests that psychiatrists use shame as a departure point for understanding the self and psychiatric care because “our task as psychiatrists is in trying to understand the multifaceted implications of hearing our patients say they are not who they want to be” (Crossley, 2012[ 16 ], p. 100). But what is this “self” which terms such as “self-awareness,” “self-evaluation,” and “self-knowledge” presuppose to exist?…”

Section: Introductionmentioning

confidence: 99%

Medicine and mind-body dualism: a reply to mehta′s critique

Joubert¹

2014

Mens Sana Monogr

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Neeta Mehta recently advanced the thesis that medical practice is facing a crisis today. In her paper “Mind-body dualism: a critique from a health perspective” she attributes the crisis to the philosophy of Descartes and set out to understand why this dualism is still alive despite its disavowal from philosophers, health practitioners and lay people. The aim of my reply to her critique is three-fold. First, I draw attention to a more fundamental problem and show that dualism is inescapable—scientifically and commonsensically. I then focus on the self-conscious emotions of shame, guilt and remorse, and argue that the self is not identical with a brain. The third section draws attention to the crisis in psychiatry and stipulates some of the main reasons why this is so. Contrary to Mehta's thesis, the health profession faces a crisis because of physicalism and biological reductionism.

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The role of holistic, patient-centred research

Cooper¹

2012

Psychiatrist

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We strive to provide patient-centred care within the framework of evidence-based medicine, although we try to ascertain that evidence base using structured, standardised processes.Other thinking behind the patient-centred approach has been developed by Fulford, expanding arguments surrounding the concept of disease.2 In his model of the 'balanced or fullfield model of health care' he examines the balance between the objective concept of disease and the subjective concept of illness. In these, he states, there is a tension between the views of the patient (who is subjectively experiencing the feelings and complaints of being ill) and the doctor (who takes the role of the expert in the area of disease, an objective, scientific concept).If we want to emphasise the subjective experience of patients in our work, then I would like to suggest we increase our exposure to the subjective experience in research. Categorising original research articles over two decades from the three highest-profile general psychiatric journals, rated by both journal impact factor and the proportion of psychiatrists reading them 3 (the British Journal of Psychiatry, the American Journal of Psychiatry and Archives of General Psychiatry) showed that their focus is on objective research, with biological or epidemiological domains accounting for 70% of the articles published (n = 5710). When articles were rated using a narrow operational definition of whether their main aim was to study the subjective experience of the patient, 4 only 2% (156 articles) met the criteria. Variables associated with subjective experience research (perhaps unsurprisingly) included psychosocial research topics (odds ratio (OR) = 10.2; 95% CI 7.4-14.2), and qualitative (OR = 34.6; 95% CI 5.74-208.7) and cross-sectional (OR = 4.2; 95% CI 3.1-5.9) research methodologies. It is likely that journals from other disciplines (such as the social sciences and psychology) would have more articles pertaining to the subjective experience of patients, as would psychiatric journals with explicit aims to publish articles relating to ethics and patient-centred care; however, British psychiatrists are less exposed to these than to the journals investigated. 3There is no reason why a subjective, values-based approach cannot sit alongside the objective, factual approach, and conflicts between values-based practice and evidencebased medicine are unnecessary. To be person-centred we must have a strong understanding of the factual evidence for our interventions, but also understand the patient's unique set of values and experiences. Evidence-based medicine promotes the integration of three key elements: best research evidence, clinical expertise and patient values. 5 To do this effectively, patient-centred ethos should be applied when taking into account the illness experience, the person and the context in which the illness presents, to find common ground between both the physician's and the patient's perspective.

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Holistic psychiatry without the whole self

Cited by 5 publications

References 12 publications

Developing translational biological psychiatry: Learning from history to build the future

Developing translational biological psychiatry: Learning from history to build the future

Medicine and mind-body dualism: a reply to mehta′s critique

The role of holistic, patient-centred research

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