What are the practical implications of classifying Psychiatry into one of the mentioned categories? Would doing so necessarily bring Psychiatry out of the "crisis' mentioned (is it really in a crisis?). My own Psychiatry colleagues used insights from all the disciplines mentioned. For example, several were involved with the issue of euthanasia and the ethical issues involved (philosophy), issues of anthropology were involved (do forms of mental illness manifest themselves differently in different cultures), and neurology and neuro-psychology (are there underlying specific correlations with present diagnostic categories?). An additional issue is that the boundaries between the disciplines mentioned are not fixed. Further, some areas of medicine have changed to be concerned with enhancing human beings rather than just fixing organic problems, will Psychiatry follow this path in the future? I've probably just muddied the water, but I'm not sure why the question needs to be asked.

A branch of medicine.

While psychology may be considered a part of the humanities and is not really an experimental science, having much in common with philosophy, psychiatry is definitely a branch of medicine since it uses pharmacology and relies on experiments. To practice psychiatry today, you must know much about how the brain works on biological level. I am a neuroscientist myself, and I met lots of psychiatrists on neuroscience conferences, but not a single psychologist.

On everyday level, it is usually considered okay if you need to consult with a psychotherapist because of stress or family problems - you're still considered healthy and sane. But if you are a patient of a psychiatrist and have to take some psychotropic medicines, it's a social stigma and people think of you as a nutcase.

Psychology relies on experiments of behaviors as opposed to psychiatry in our country that relies on the use of psychopharmacology more so than psychology. The latter is a branch of medicine but a psychologist can specialize in Finland in 5 fields:  health psychology,  psychotherapy, school psychology, labor or organization as well as in neuropsychology.  

Psychiatry is the true human medicine; most other parts of medicine are factually veterinary medical science. While I do not see a workable intersection with the humanities, except medical humanities, I think that there is a practical intersection with social science, i.e. in the sense of Wittgenstein that human behavior shows the workings of the soul; in addition, human consciousness manifests itself socially in the collective space or the constructive act of doing.

What are the practical implications of classifying Psychiatry into one of the mentioned categories? Would doing so necessarily bring Psychiatry out of the "crisis' mentioned (is it really in a crisis?). My own Psychiatry colleagues used insights from all the disciplines mentioned. For example, several were involved with the issue of euthanasia and the ethical issues involved (philosophy), issues of anthropology were involved (do forms of mental illness manifest themselves differently in different cultures), and neurology and neuro-psychology (are there underlying specific correlations with present diagnostic categories?). An additional issue is that the boundaries between the disciplines mentioned are not fixed. Further, some areas of medicine have changed to be concerned with enhancing human beings rather than just fixing organic problems, will Psychiatry follow this path in the future? I've probably just muddied the water, but I'm not sure why the question needs to be asked.

Stephen, I am not so sure the humanities can be so easily cordoned off, my background is humanities, literature and performing arts to be precise but I have done some work on psychoanalysis and stream of consciousness technique in literature. I have found psychiatry providing very good material and a good perspective on ranges of human behavior. Techniques from psychiatry and content therefrom have enriched my understanding and analysis of human behavior and relationships.  The paper here takes snippets from psychiatry. 

Article Physical and Psychological Factors in Bessie's A Question of Power

I think psychiatry is best seen as an interdisciplinary branch of medicine that integrates the neurosciences with psychology.

Thank you all for your thoughtful posts on this question.

I will think about your posts and wait for more until I reply in more detail. 

For now, I will limits myself to a few comments: 

1. Ekaterina Chesnokova: Although the vast number of practitioners of psychology around the world are clinical and applied practitioners, academic psychology does consider itself an experimental field, although the standards for experimentation vary across the many sub-disciplines of psychology, from clinical psychology to cognitive psychology and some contentious areas like social psychology where deception in their experiments led to serious ethical concerns. Psychology was my first field of study and I continue to admire and work with many psychologists. Psychology has many of the same issues of identity and crisis as psychiatry but psychiatry's issues are unique. Psychiatry's foundation as the third branch of medicine, after surgery and pharmacy (which we call internal medicine today), makes it part of biomedicine which has all the strengths of the life sciences and the same complexities and more as we are dealing with issues central to human being. 

2. Ivan William Kelly: Yes, psychiatry is in a crisis. There is no consensus on the definition of our field, there is no science of the person, no overarching theory of psychiatry, and no theory of change across all the domains of activity that fall under the rubric of psychiatry. Does asking questions designed to sharpen the focus of our work help? Clearly, I think so, even if the response will ultimately be a kind of pluralism. But before we settle for a simplistic eclectic model, let us think about the fate of the "bio-psycho-social" model that in the words of the chairman of the DSM-IV became "bio-bio-bio." Thanks for being a sceptic about this question - it will make me sharpen my arguments and clarify the stakes. 

3. Stephen I. Ternyik: Your post is quite sophisticated and I particularly like the allusion to Wittgenstein whom I read very carefully and often cite without necessarily agreeing with him (but no matter since he doesn't agree with himself, as in the famous problem of the earlier and later Wittgenstein). Later, I would like to take up your fascinating observation: "human consciousness manifests itself socially in the collective space or the constructive act of doing." I agree with you and this is a reminder than not everything is located in the brain (one of the ideas I am challenging) and as you are suggesting, consciousness resides not solely in the mind but also in the relational and social self.

4. Kirk MacGregor: Yes, psychiatry is interdisciplinary and I do see it as a branch of medicine, as long as we insist on an enlarged view and definition of medicine. But the way in which it is interdisciplinary and how to privilege different sorts of observations and findings is what is at stake. Is it just loosely eclectic? Can we integrate the different approaches in some way? Is pluralism a response? There are people who aren't interested in such questions, but these folks don't see the dangers of pretending that there are not competing ideologies and allegiances along with people jockeying for power and control. Any pretence to a scientific model tends to minimize these questions. 

I'll keep reading your posts and answer to stimulate the exchange here.

Regards, 

Vincenzo

Interesting question and intelligent answers. I see a crisis as a hope.

There seems to be an agreement that the present post-modern crisis is also a challenge. There is a deeper understanding now of human, behavioral, neurobehavioral, medical, and psychiatric science . The crisis is not so much a crisis in the sense of impediment, but is also a challenge, a new light to deepen our understanding of complex human issues confronting the world..It\\The crisis is also a challenge that can be met with understanding as long as we keep in mind " the hermeneutic cycle": which says: I must explain in order to understand, and I must understand in order to explain.

Psychiatry is at the earliest stages of its development, despite more than a hundred-year history of scientific psychiatry. This is a purely medical discipline, about which and for which we do not know much and understand. Modern trends in the development of general medicine, the development of neuroscience, new opportunities for brain and psyche research in general, put it forward as the main medical discipline, which will become possible the philosophy of medicine, the theory of future medicine. This is confirmed by the rather intensive development of the psychosomatic concept in medicine and psychiatry, in particular. The connection and conditioning of many, if not all, somatic diseases by psychological and mental factors also leads me to the idea of the medical roots of psychiatry. Moreover, all I have said also confirms that psychiatry is also social science, because as its main object and subject has a human being - a biological and social being at the same time, the absence of one of these roots denies or excludes the presence of a person as such. Psychiatry has every chance to become synergetic of modern medicine

My playfully serious perspective is that psychiatry is a modernist form of spirituality. It is a "medicine" -- as that term might be understood in other centuries and cultures -- wherein any and all materials, technologies, and procedures available to a skilled provider (i.e., a "medicine person") might be incorporated to assist the healing of, and to promote the wholesome realization of the potentials of, another's mind-and-body.

_______

Having had some additional time to read others' responses in this thread, I'm inclined to offer a further comment. 

Modern-day science, social science, and the humanities all have a history. They're all discourses that have been developed over time, and they're all tied in varying degrees to certain technologies and/or to certain processes for obtaining and determining information.

Put another way, they're all "languages" that are more or less expressly conjoined with tools designed to explore our world and to extend our understanding of it. 

And as a "medicine," psychiatry has the added character of being a discourse-and-practice that's applied to the end of enhancing the quality of lived human experience. 

Implicit to all this is the fact that our discourses - whether they're categorized as "sciences" or as "humanities" - are ultimately tools that we have developed.

And while it's not altogether unuseful to ask what "kind" of tool a given field of study and practice constitutes, I think it's deeply productive to also stay mindful of the fact that they are indeed things that human beings have created. And, as such, I find it more useful to ask how, and whether or not, they work - that is, how, and to what degree, they are helpful.

Such a focus on their process and their productiveness is different than a focus on their "essence."  When we're mindful that they are in effect "made up" enterprises which we've created, we remain appreciative that they both come from somewhere and that are designed to take us somewhere.

In this sense, they are not so much starting points as they are vehicles.

It makes all the sense in the world to look to clarify our methods and our epistemological frameworks. But, again, that's what I'd most like to emphasize - psychiatry is not an "essence." It is, instead, a matter of methods and frameworks.

So, to me, when asking how we are to see and view psychiatry, it's less imperative to decide on an essential definition in terms of an "established" field of study. Such "establishments" all have a history; they're contingently constructed and created things. And while for various practical reasons it currently makes sense to, say, offer psychiatric training within medical schools, ultimately it can be more productive not to focus on what psychiatry essentially is than to ask what that which we call psychiatry effectively does.

We of course are not going to get away from putting categorizing names on things (especially when operating within institutionalized, grant-seeking, academic "turfs"). But I find it wholesome and helpful to remind ourselves that we actually name things for our own purposes, and that it is useful to keep our focus directed toward how those purposes can be best served, supported, and furthered.

 Of course psychiatry is a part of medicine  – If for no other reason than that the vast majority of psychiatrists have qualified in medicine and practiced for some time (at least as a Housman) before specialising in psychiatry. Professor Vincenzo Di Nicola, like a select few, practiced first as a psychologist. I think I am right in saying that sometimes a psychologist is appointed as a professor  of psychiatry without any medical degree. Not so Professor Vincenzo Di Nicola, who has multiple qualifications including degrees in medicine and philosophy. His first loyalty however was to psychology and he's degree in philosophy entitles him to ask unanswerable questions!

Samvel points out that 'despite more than 100 year history of scientific psychiatry' it remains hamstrung by its continuing attachment to the ill-defined concept of a Mind and mental illnesses and its failure to research the physicochemistry of these disorders at a molecular level.  Medicine is a discipline and a profession that is judged by its performance (not always good). It has its own philosophy of medicine, like many other scientific disciplines (see Wikipedia) and  one of the roles of medicine is to set limits on what is and what is not illness. It needs to be stressed that not all misbehaviour and deviant thinking is the result of an illness.  This leaves plenty of scope fort other  problems that other disciplines can consider.

 As a very practical discipline medicine pays particular attention to a wide range of life sciences, particularly anatomy, biology, chemistry and physics and pathology. It also has to pay attention to psychosocial issues. The current crisis is perhaps due to the need, that research is now showing, that psychiatry should be seen unequivocally as part of medicine and not half in half out.

Irrespective of the difficult to answer question, the interaction between mental activities and behavior is essential in humans. Consequently, the main function of the mind and behavior is self-regulation. This includes avoiding and remedying material, organic and social disorders, if this is possible. Otherwise, a person has to cope with the disorder. However, crucial causes of severe mental disorders are known: a) Negative stimulation, including negative consequences of one's own behavior, can strongly decrease or increase cortical and emotional/affective arousal. b) Mental processes (judgment, thinking) can significantly enhance the effect of stressful stimulation and can produce extreme arousal even in the absence of stressful stimulation. An extreme state of cortical and emotional/affective arousal in form of hypoactivity or hyperactivity can lead to the loss of self-regulation and self-control. This can be followed by behavior that is suicidal and/or endangers the live of other persons. In this case, a compulsory psychiatric hospitalization is necessary.

The correct diagnosis is “Cortical and affective disorder (CAAD) in form of hypoactivity or hyperactivity”. The correct treatment consists in the pharmacological normalization of the extreme cortical and emotional/affective arousal so that self-regulation becomes available again. When self-regulation is restored, the patient reports on his or her burdening mental states (emotions, imaginations, thoughts). After that, treatment with psychopharmaceuticals or with psychotherapy can be continued. In any case, the diagnosis of a psychosis or a subcategory (schizophrenia, schizoaffective disorder, mania, depression and others) is no longer appropriate in emergency psychiatry and elsewhere.

If this is finally acknowledged in the psychiatric-psychological practice as well as in the two main nosologies (ICD-10/11 and DSM-5), then there is no crisis of psychiatry.

There have long been tensions in psychiatry, largely between a biomedical model with its attendant categorical diagnoses and presumed organic etiologies, versus meaning-based accounts of mental suffering and dysfunction.  Just as psychoanalysis over-reached as an explanatory model in the mid-20th century, now neurobiology commits the same error.

Nonetheless, I don't see a crisis.  As David Collins writes above, there is little gained by pigeonholing psychiatry.  Our methods are not solely biological, and obviously not solely social science or humanitarian either.  We rely on a variety of tools.

Rather than thinking of this as a loose eclecticism, I find it more useful to see an organizational hierarchy.  Yes, the ultimate substrate of the mind is brain tissue.  Sometimes organic disease in this tissue best accounts for a particular disorder.  No doubt we will learn more about this in the coming years, e.g., about schizophrenia, just as historically we learned that general paresis (tertiary syphilis) and Alzheimer's disease are best thought of as diseases of the body. 

But often such reductionism is a "category error."  Self-defeating attitudes and traumatic relationship histories, for instance, demand explanations and treatments at another level, even if we are all made of organic molecules.  Equating psychiatry with neurobiology is like trying to explain a political movement by describing the role of carbon atoms in the participants.  It's an explanation at a level that isn't useful.

Psychiatry aspires to account for and heal suffering and dysfunction across this hierarchy, from molecules to society.  As such, it uses tools from medicine, neuroscience, psychology, the humanities, and other domains.  Frankly, that's why I like it.

A crisis of psychiatry exists for several reasons: a) No objective or indisputable definition of mental disorder/disease exists. b) Basic diagnostic categories are stigmatizing and ambiguous, especially the concept of psychosis and its subcategories (schizophrenia, schizoaffective disorder, mania, depression and others). c) Knowledge about the etiology of psychoses is poor.

But new knowledge leads to a solution of these problems. The solution of the classification-problem and the stigma-problem of psychopathology is the rejection of the invalid concept of psychosis and the neurobiological definition of a cortical and affective arousal disorder. An extreme state of cortical and emotional/affective arousal in form of hypoactivity or hyperactivity can lead to the loss of self-regulation and self-control. This can be followed by behavior that is suicidal and/or endangers the live of other persons. This is one of the two indisputable definitions of mental disorder. The second indisputable definition of mental disorder is the existence of a burden and the personal need for psychiatric-psychological help. An example is hoarding. The definition of a boundary between reasonable and pathological hoarding is inevitably subjective but the diagnosis is appropriate if a person suffers from this habit and looks for help.

As you can see, the crisis of psychiatry can be easily overcome.

Perhaps psychiatry is in crisis because we are in crisis as psychiatrist...

There is an identity problem in psychiatry and in psychiatrist, because we don't agree about what it is psychiatry and perhaps we don't know well who we are as psychiatrist. Many times we are lost in theories, definitions, etc. We have lost the deep fundament of our knowledge: Philosophy and Anthropology. If we don't know what reality is, or we don't know what we are as persons... How can we understand other people and their suffering?

Another related questions are:

Are we centered in our deep identity? Do we know who we are? Do we know what reality is? Do we know how to manage uncertainty or suffering in our lives? It is necessary before, because each patient confronts us with ourselves and our human limits.

We need to know ourselves better to solve this crisis. Psychiatry crisis it is an humanity and personal crisis in our culture.

Humanity, social learning of self-control or psychiatric-psychological help.

The fundament of knowledge are nonverbal and verbal memory structures in the brain that result from perceptual learning. In the newborn, only the simplest learning process is possible. This is the orienting response (behavioral sensitization) and habituation. Habituation means that simplest memory structures are formed from innate memory elements (for example for phonemes or dots of light). Only then, when memory structures are available, perception and perceptual learning is possible, including the acquisition of language (phonemes, words, sentences). Approximately 18-30 months after birth self-regulation becomes available. This is the increasingly complex coordination of actual states with desired or necessary states by perception, judgment, thinking and behavior according to existing knowledge, ability and the dominant motive (commandment, duty or need). The actual states are material, organic or social stimuli and mental states (emotions, imagery and thoughts). Beneficial to this development are care, love, affection, and rule learning based on interactions with reference persons in the family as well as other forms of social learning.

Social learning usually leads to knowledge how to prevent undesired loss of self-regulation and self-control. This includes mental processes that decrease the effects of stressful stimulation and decrease or stop stressing judgments and thinking. An important example is efficient appealing to oneself to calm down. In the case of neglect, however, chronic negative emotions prevail, arousal is increased and a learning deficit in self-control results. This developmental disorder can be counteracted by reference persons who perform missing parental functions in family-like social systems such as preschool playgroups, kindergarten and schools.

Dear Colleagues and Guests, 

I have been following your answers closely and instead of responding in detail to each one, I have been reflecting and will soon post a detailed response. Let me say this: there are already enough responses to warrant my concern of the current state of psychiatry as a crisis. 

When I was a young man and soon to be heading to England to study at the Institute of Psychiatry, a British band called Supertramp recorded an album called, "Crisis? What Crisis?" Some of the answers by my colleagues and in the posts here remind me of that. The cover of Supertramp's album had a man in a colourful lawnchair against the background of the Welsh countryside devastated by strip mining. Après moi, le deluge!

Another Brit and a very brilliant one observed that: 

"The history of psychiatry rewrites itself so often that it almost resembles the self-serving chronicles of a totalitarian and slightly paranoid regime. One-time pioneers are suddenly demoted and deemed to be little more than package tourists.”                                        —J.G. Ballard, "A User's Guide To The Millennium" (1996), p. 152.

The whole point of my work now is not to add to this cacophony or to offer a personal account of psychiatry but to bring meaning and structure to this debate, informed by lengthy training and now many years of working in psychology, medicine, paediatrics and psychiatry, child psychiatry, psychoanalysis and philosophy. Now, one of the problems with contemporary society including at the level of scholars is that people reply to each other in talking points. You cannot finish a sentence before your interlocutor has pegged you into a slot. I can't even write a grocery list or make up my mind what to eat at a restaurant so quickly! My doctoral dissertation is some 500 pages long with almost 900 footnotes - and I feel I just got started!

One reader took the trouble to look at my profile and to read the accompanying documents and his comments reflect that. Thank you! 

Vincenzo Di Nicola

Professor of Psychiatry, University of Montreal

Psychiatry is all three of them in a inclusive approach.  

Dear Colleagues & Friends,

I continue to follow your comments closely and am thinking about them as we come to the final phase of our book, "Psychiatry in Crisis." We may even cite some of your answers!

Most of the answers are compatible with our approach in some form. What's missing in all of them is a principled approach - not just preferences based on what we find congenial but real answers in principle.

Let's get rid of a few pseudo-problems. We are not in crisis because of personal dilemmas - that's interesting and a whole other topic. Some psychiatrists and many psychologists (of my generation at least) have what I call "physics envy," a neurotic disorder akin to Freud's penis envy. Although I have no pretensions whatsoever to being smart enough to contribute to theoretical physics, I read physics quite closely and had detailed dialogues with leading physicists in my youth (Boris Castel at Queen's, Mario Bunge at McGill). I can say flatly that I have no physics envy and having studied medicine and done six months of neurology in paediatrics at McGill associated with the renowned Montreal Neurological Institute, I have no neurology or neuroscience envy whatsoever. I admire and value their contributions but they don't have the answers to psychiatry's crisis. Einstein's interesting but rather vague thoughts about humanity were judged by a brilliant physician-philosopher Karl Jaspers as not being very profound (wise perhaps, but not instructive). Werner Heisenberg's philosophical writings are another matter as they were brilliant and serious reflections on matters of philosophy with import for philosophy of mind.

Reductive answers such as those provided here that some features of brain resolve psychiatry's crisis or dismiss it are also false starts. Even Eric Kandel, Nobel Prize winning neuroscience researcher who trained in psychiatry and writes beautifully cannot provide the answers. His connections between the brain and aesthetics are a stretch and that's being kind. To use an old metaphor, you cannot understand the music of a phonograph record by analyzing the grooves in the vinyl. The grooves matter because if they are corrupted, they will not play the music faithfully. Anybody my age remembers phonograph records skipping or getting stuck. And there is Neil Young who insists that phonograph records and tube amplifiers - "analog sound" - give a warmer sound and this is confirmed by audio engineers. However, it's one thing to argue that the hardware creates a certain environment (warmer sound, skip-free playing, and so on) and quite another to argue that due to the machinery Leonard Bernstein's interpretation of Gustav Mahler is different than or better than say Claudio Abbado's. To the folks that are reductionists, I offer this musical metaphor: As a psychiatrist, I am listening to the music. Of course, I can consult the score (I had early musical training in violin), I can read the biography of the composer, I can read critiques of the performance, I can read about the audio engineering of the recording, and I can read about the physics of sound and why Neil Young is or isn't right about analog versus digital recording. But that isn't the same as listening to the music! The experience of music can only partially, and in small part, be reduced to or explained by, cognitive neuroscience! And yes, I have read Daniel Levitin's books like "This Is Your Brain on Music."

As a person, I am interested in everything! I love reading Slavoj Zizek and Catherine Malabou and René Girard and I can't get enough of Vittorio Gallese's "mirror neurons" which I call "the machine in the ghost" (upending Gilbert Ryle's famous metaphor of "the ghost in the machine"). But as a psychiatrist, I am listening to the music. That means: talking to people, fostering therapeutic relationships, and together, creating healing environments. If you want to work in a lab or construe abstract theories about Lacanian inventions or René Girard's mimetic theory (one of my favourites), go for it, but that is very far from talking to people and learning how to listen to the music of their lives!

Warmly,

Vincenzo Di Nicola

University of Montreal and The George Washington University

Dear Colleagues & Friends,

Besides the posts here, I have received many personal messages by e-mail. Thank you for your interest.

To further the conversation and exchange, I am adding links to my two-part article at the American Philosophical Association blog online as well as the full text to read and peruse which includes detailed references. A second version has all the hyperlinks that are included in the APA blog online.

https://blog.apaonline.org/2017/11/23/badiou-the-event-and-psychiatry-part-1-trauma-and-event/

https://blog.apaonline.org/2017/11/30/badiou-the-event-and-psychiatry-part-2-psychiatry-of-the-event/

Both parts of my blog include detailed comments along with my responses.

Warmly,

Vincenzo Di Nicola

Univeristé de Montréal & The George Washington University

I've been practicing psycho therapy for the past 30 year before that 15 years as Social Worker

I find most of my clients are disappointed by the very narrow meidcal "what medication do you need" psychatry They mostly thought when they wsaw a psychatrist they could talk about thier problems but can not. They know how psychatry should be praticed

Thank you for your answer, Mike.

It raises important questions. One of them is that in every allied field, from psychology to psychoanalysis, people have emphasized the relationship between the patient and the therapist in some form or other.

On the other hand, others criticize this generic approach and reach for specifics that we may discern as leading to better outcomes. And yet that is only one aspect of the field. Psychiatry is not and should not be, in my view, only psychotherapy. It asks bigger and broader as well deeper and tougher questions than just "pleasing the customer," as D.O. Hebb, my undergraduate professor of psychology at McGill once said. Deeper even than healing, although that is fundamental to clinical work.

These other questions cannot be dismissed. We need an understanding of mind and relations, along with brain and genetics but also the social determinants of health; we need to understand what generates human predicaments and how to think about them; and we need a model of change across the wide spectrum of interventions. Right now, we have no consensus on any of these key questions.

Warm regards,

Vincenzo Di Nicola

University of Montreal &

The George Washington University

One demension you may have left out is spirituality (in the general sence not only religion) As I work in the field of addictions and tauma /PTSD a persons spirituality is very importent in developing a treatment aporoch that will work.

Thank you for your post, Mark Worthen!

I have read and was influenced by HS Sullivan, considered one of the neo-Freudians. Like many nuanced and thoughtful thinkers, he has been woefully neglected. Here are a few reasons I appreciate him. First, he values interpersonal relations. This line of thinking in American culture existed but has been shunted aside by mainstream culture, in great part, I believe due to the drift towards scientism and the brain in the human and social sciences, but also because it smacks of socialism to American nationalists and nativists. Actually, I agree with them - it is the foundation of socialism in using relations and community as the starting point for social theorizing, not the abstract, isolated and decontextualized individual à la Ayn Rand.

Second, he values the life of the mind and its psychological processes. This is also in decline. There is a constant and continual reduction of the the psychological in American culture and behaviourism in some form (it's still very much alive) nativism compete to keep the psychological as such in check. So we go from one extreme to the other - there is no mind, it's nature; there is no mind which is a black box, there is only behaviour. This reductive and cyclical denial keeps us off balance from asking properly psychological questions. What are properly psychological questions? I refer you to my favourite American psychologist, William James in his Principles of Psychology (1890), followed by the most startlingly original and counterintuitive pair of psychologists in a long, long time: Daniel Kahneman and Amos Tversky (deceased). Kahneman got the Nobel Prize for his work which he developed with Tversky (after the latter's death) on how we misperceive - that is, how our perceptions are often incorrect!

The major critique of Sullivan came from European psychoanalysts, especially from the Left, who saw his turn along with others to ego psychology a betrayal of Freud towards an accommodation with capitalism that is called Neo-liberalism today.

There are many lost threads in psychiatry's history. Another favourite of mine is Silvano Arieti who had a brilliant approach to schizophrenia that was synthetic and sophisticated. Alas, almost no one every mentions it today!

Regards,

Vincenzo Di Nicola

Université de Montréal &

The George Washington University

I enjoy reading the discussion led by Professor Vincenzo Di Nicola even though I am only a 91-year old classical psychologist

who aspired to combine phenomenology with neuroscience. My concern is that the new generation of psychologists has neglectd

the lesson that Professor Vincenzo Di Nicola is trying to impart to his readers. He is absolutely right in drawing attention to

Sullivan, William James, Husserl, and others. But I fear that this brilliant voice is only heard and understood by classical psychologists

like myself. The fascinating neuroscience has taken the lead in discovery, and it looms like the voice of the future. In my ears of

teaching as well as working at the VA with veterans I was seen by some students and veterans alike as "a wise old man" at best

At worst I may have been seen as "senile" especially when I quoted Husserl and Heidegger saying that our fascination with "knowing"

blinds us to seeing the phenomenon. The phenomon as that which shows itself on the basis of itself is what we experience. Behavior

is an abstraction, but in a scientific sense is also necessary and cannot be neglected.

This is what Professor Vincenzo Di Nicola and his colleagues at the University of Montreal and other colleagues in the US have

been teaching and writing for years. I hope that that their message will persuade the new generation of neuropsychiatrists and neuropsychologists to integrate Hermeneutic phenomenology with neuroscience, and I studied Ricoeur as a good example.

Ricoeur says that we must not be content with what we measure as observable or inferred action, behavior, or cognitions, without

recourse to what does not give give itself intuitively with what limits, according to what horizon, and following what intention,

essence, and signification. I realize that this is an awesome task and only a few can pursue it. But, it is possible to heed what Husserl said:

which I paraphrase as follows: "Without sensibility no object would be given to us, without understanding no object be thought. We

need a hermeneutics of what is given and the sense given in our intuition, and given precisely as it is thought and named. No thought-

intention could fail of its fulfillment, of its last fulfillment. . We need to aspire for the full agreement between the meant and the given as such.

The reader may disregard the last paragraph. I meant to endorse the hopeful message of Prof. Di Nicola not to complicate it. I wish

to apologize for the excess of the last paragraph.

I wish to alert those who follow this discussion that I am a retired VA psychologist, and my current email is [email protected]

There is probably a way to alert the readers to my retirement from the VA but I do not have the skill to do it nor the ability to learn new

information.

Hello,

In my view, psychiatry is an issue which revolves around the social, biological and chemical aspects of one's life. It is a part and parcel of Science and Humanities. You cannot just bereft psychology/ anthropology/ social sciences from Psychiatry and so goes for the neurobiology and chemistry aspects.

It is something which is a share of every domain of a human being!

Best Regards,

Sahar