Is psychiatry more mindful or brainier than it was a decade ago?

Abstract

Academic psychiatry in the USA in the Academic psychiatry in the USA in the decade after the Second World War was decade after the Second World War was dominated by psychoanalytic theory. dominated by psychoanalytic theory. Psychotherapy, most of it psychodynamic Psychotherapy, most of it psychodynamic in orientation, was the principal activity in orientation, was the principal activity of clinicians in office practice. Critics like of clinicians in office practice. Critics like myself who pointed out the lack of empiri-myself who pointed out the lack of empirical validation for the theory or the practice cal validation for the theory or the practice were unavailing (Eisenberg, 1962). were unavailing (Eisenberg, 1962). This is less surprising when considered This is less surprising when considered in context: there were in context: there were no no treatments of treatments of demonstrated effectiveness. Psychiatric demonstrated effectiveness. Psychiatric diagnosis had low interrater reliability.

Depression and Stress: A Biopsychosocial Exploration of Evolved Functions and Mechanisms

“…Indeed, animals with this genotype can do exceptionally well in certain developmental (e.g., high care) contexts but badly in others (e.g., low care; Suomi, 1997). Thus, there is a need to consider genetic effects in social contexts (Cacioppo et al, 2000;Eisenberg, 2000;Gilbert and Miles, 2000) and that the phenotypic possibilities of a given genetic influence for a function are not always predictable (Suomi, 1997 …”

Promotion of Well-Being in Person-Centered Mental Health Care

“…We cannot separate the self or the whole person from their family or culture any more than we can separate a person’s body and mind. Efforts to do so result in “brainless” or “mindless” perspectives, which eventually lead to confusion rather than understanding (16, 17). …”

“…Sometimes these distinctions have been confounded with the belief that neurobiology or nature causes the major categories of illness, whereas psychosocial development or nurture causes personality traits. The dichotomies of nature or nurture, neurobiology or psychosocial development, and category or trait are no longer scientifically tenable perspectives (17). The brain does not have centers for different categories of illness; it is modular, with each module having functions that participate in a variety of integrative processes in combination with other modules to allow purposeful adaptation to internal and external events.…”

Time to abandon the subjective–objective divide?

“…Aware of these dangers, Greenhalgh (1998) has attempted to reconcile the narrative approach with the biomedical one. Likewise, Eisenberg (2000), in his discussion of the tendency of psychiatry to be either mindless or brainless, has argued that a balanced approach should be adopted. Like many others, he concludes that the great challenge for the future is to integrate the neurobiological with the social and psychological.…”