The psychiatrist Heinroth--a critical reflection

Heinroth (1773-1848) belongs to the founders of psychiatry in Germany. He represented an idealistic, spiritualistic psychiatric school that had a strong leaning towards materialist ideas. He believed that mental disturbances were caused by guilt and sin. But, besides these speculations, he also expressed views that led to view psychiatric and psychotherapeutic insights. One of these was his postulated psychogenesis of mental disturbances. His thoughts on the importance of social, biographical and psychosomatic factors also contributed to the development of psychiatry.     

Psychiatry and Psychology in the Writings of L. Ron Hubbard

Objectives: Celebrity followers of the Church of Scientology have recently used their public forum to attack the modern practice of mental health. The practice of Scientology is rooted in the religious writings of its founder, L. Ron Hubbard. This paper will review the religious writings of L Ron Hubbard to understand Scientology’s position on mental health. Method: This paper reviews four of the major religious books written by L Ron Hubbard, in addition to a comprehensive overview of Scientology compiled by Scientology staff. Results: Hubbard’s theory of mind borrowed heavily from the earlier writings of Freud, until Hubbard’s psychological theory extended to include a spiritual existence that goes beyond the material world. The goal of Hubbard’s psychology and religion were to optimize the freedom of the individual, and he viewed psychiatry and psychology as inherently anti-spiritual and opposed to personal freedom and self-realization. Ultimately Hubbard presents a world view of potential nuclear world cataclysm, fueled by the geopolitical climate and mental health theories that dominated the mid 20th century. Conclusions: Hubbard’s writings mirrored the times in which he lived. His views that mental health practices are inherently anti-religious, freedom-inhibiting, and brain damaging do not reflect the modern-day practices of mental health. Dr. McCall is presently Professor and Chairman of the Department of Psychiatry and Behavioral Medicine at the Wake Forest University School of Medicine. He completed his medical degree and post-graduate psychiatric training at Duke University. He completed a Masters degree in Epidemiology from Wake Forest University. He is board certified in general psychiatry, geriatric psychiatry, and sleep disorders medicine. His research interests include depression, electroconvulsive therapy, quality of life, and insomnia. His research has been continuously funded by the National Institute of Mental Health since 1995, and he is author of more than 100 peer-reviewed journal articles. He is Editor of the Journal of ECT, Immediate-Past President of the Association for Convulsive Therapy, and a prior Director of the Board of the American Academy of Sleep Medicine.     

兰恩存在精神病学的心理治疗观

兰恩是20世纪英国著名的存在主义精神病学家,在反对传统精神病学诊疗观的基础上,提出了独特的存在精神病学的心理治疗观。在精神疾病的诊断上,兰恩主张从存在主义——现象学的视角来理解精神疾病,要从一个人的环境或背景中来理解他的行为。在精神疾病的心理治疗上,兰恩强调通过改变患者的生存环境来促进其自我恢复。     

R．D．莱因对传统精神疾病诊疗观的变革

传统的精神疾病诊断以一种经验式的分类手册来诊断精神疾病,而莱因主张从存在主义——现象学的视角来理解精神疾病,认为家庭或社会才是精神疾病的真正来源。在精神疾病的治疗方面,莱因主张通过改变患者的生存环境来促使其进行自我恢复。莱因的思想推动了当代精神病学的变革与发展,具有重要的现实意义。     

Can Ziskin withstand his own criticisms? problems with his model of cross-examination

Ziskin has mounted a concerted attack on the scientific basis of psychology and psychiatry and their ability to provide expertise to the courts. He has assailed both the clinical methods and conclusions rendered by these mental health professionals. To rebut expert testimony, Ziskin has proposed general principles of cross-examination. We discuss the limitations of this model and provide an initial study of its effectiveness.     

A Black and White History of Psychiatry in the United States

Journal of Medical Humanities - Histories of psychiatry in the United States can shed light on current areas of need in mental health research and treatment. Often, however, these histories fail to...     

A Windows program to assist in preparing reports of emergency psychiatry nursing assessments

The Emergency Psychiatry Nursing Assessment Report Framework (EP Nurse) is designed to guide the nurse through the interview-and-reporting process, and to produce a report of the nursing evaluation in emergency psychiatry in 5–10 min. Input includes identifying information, presenting complaints, substance-use history, medical history and vitals, psychiatric medications, treatment history, history of mental illness, last hospitalization, family history of mental illness, nursing diagnosis, and nursing intervention. EP Nurse is intended to be used by licensed nurses familiar with nursing assessment in emergency psychiatry. It is suitable for adult patients.     

Out of our skulls: How the extended mind thesis can extend psychiatry

The thesis that mental states extend beyond the skull, otherwise known as the extended mind thesis (ExM), has attracted considerable philosophical attention and support. It has also been accused of lacking practical import. At the same time, the field of psychiatry has remained largely unacquainted with ExM, tending to rely instead upon what ExM proponents would consider to be outdated models of the mind. ExM and psychiatry, therefore, have much to offer one another, but the connection between the two has remained largely unexplored. Here, I consider what implications ExM may have for psychiatry and, in so doing, reveal how psychiatry may lend practical import to ExM. First, I detail the possibility of the extension of one mental state relevant to psychiatry. I augment this example by surveying other possibilities for extension in the context of psychiatric diagnoses. I then consider ways in which such extensions might alter psychiatric diagnosis and treatment. Overall, I argue that recognition of the truth of ExM could alter the diagnostic status of certain individuals by correcting both false positives and false negatives, re-conceptualize certain aspects of treatment, help us re-envision psychiatric research, and potentially increase empathy towards those individuals considered to be mentally disordered or mentally different.     

Psychoanalysis as medicine,psychoanalysis as religion

The author explores unfavorable comparisons between psychoanalysts and medical psychiatry, tracing the crisis in the mental health fields created by managed care. This current crisis is traced to an historical identification with the medical profession and a more recent dependence on third-party payments. He suggests reorganizing the profession as a religion or spiritual exercise as a way out of the crisis and as a way of revitalizing its practice.Richard A. Friedman, Ph.D., is a psychoanalyst in private practice in New York City, supervisor at the Psychoanalytic Psychotherapy Study Center, and a faculty member and training analyst at the New York Center for Psychoanalytic Training     

Madness versus badness: the ethical tension between the recovery movement and forensic psychiatry

The mental health recovery movement promotes patient self-determination and opposes coercive psychiatric treatment. While it has made great strides towards these ends, its rhetoric impairs its political efficacy. We illustrate how psychiatry can share recovery values and yet appear to violate them. In certain criminal proceedings, for example, forensic psychiatrists routinely argue that persons with mental illness who have committed crimes are not full moral agents. Such arguments align with the recovery movement’s aim of providing appropriate treatment and services for people with severe mental illness, but contradict its fundamental principle of self-determination. We suggest that this contradiction should be addressed with some urgency, and we recommend a multidisciplinary collaborative effort involving ethics, law, psychiatry, and social policy to address this and other ethical questions that arise as the United States strives to implement recovery-oriented programs.     

The role of mental illness in the European witch hunts of the sixteenth and seventeenth centuries

Historians of psychiatry have propagated the view that the witch hunts of sixteenth and seventeenth-century Europe were primarily a persecution of the mentally ill and that demonological concepts of possession and witchcraft impeded psychiatric progress for centuries. The author reviews the evidence marshaled by these historians and examines additional historical material bearing on the psychopathological view. He concludes that the role of mental disorder in the witch hunts has been overinflated by authors with an interest in promulgating the medical model of abnormal behavior. Furthermore, the psychopathological paradigm is based on an outmoded philosophy of science, which results in historical distortion and paradoxes, and on restriction and selectivity in the choice of evidence.     

Tacit assumptions,countertransference and psychoanalytic technique. Part two: The influence of countertransference on theory and technique

In this article, the author examines bodily symptoms attributed to psychic mediating factors in the light of a psychoanalytic model of affect and sym- bolization. He uses clinical material from a consultation-liaison setting and a psychoanalytic treatment to illustrate how the model might help to understand different bodily symptoms as manifestations of different degrees of failure in the psychic elaboration of affect. On a more personal note, this could be seen as an attempt to understand, using a newly acquired conceptual tool, what went on in his 20 years of experience in the general hospital psychiatry setting.     

Prophylactic psychiatry

The great contributions of Gantt to the problems of prophylactic psychiatry are pointed out. The author reviews his experiences with a 30-year follow-up of a population of 1800 persons. Over the 30 years, there appeared to be a 50% increase of neuroses, which raises great problems for mental health services. The Berlevåg population was offered optimal psychiatric services. Behavior therapy of neuroses and drug treatment of depression may possibly have lowered the prevalence of mental disorders. Psychophysiologic tests were used in the project. It is hoped that such tests may be utilized for early detection and treatment of mental disorders.     

Zukunft der Psychotherapie in der Psychiatrie

The conceptual development of the German mental health system can only be understood against the background of the specific historical development process; therefore, the emigration of psychodynamic psychotherapists during the Third Reich as well as the complicated reintegration of psychotherapy into psychiatry during the postwar period are of particular relevance. The current discussion concerning the relationship of psychiatry and psychotherapy is characterized by the development of new techniques and methods and the concept of modular psychiatry, whereas the traditional complex psychotherapeutic procedures are becoming less important. In the future, the development of clinical and scientific research should focus on psychotherapy in old age as well as adolescence psychotherapy, the combination of psychopharmacological and psychotherapeutic treatment and issues concerning chronic courses as well as resistance to therapy.     

Mindless psychiatry and dubious ethics

Psychiatry all around the world is seen as a specialized branch of medicine. Mental disorders are seen in organic terms and are treated like any other forms of physical disease--with drugs and other forms of organic interventions. This paper argues that the medical model, despite its popularity and continued usage is, to a large extent, unreliable and invalid. Although the present model of psychiatry is in need of an urgent 'paradigm shift', it still continues to exercise immense power and popularity over other approaches to mental illness. The reasons for its popularity and power are analysed and interpreted in historical, scientific, social, economic, and socio-political terms. The practice of psychiatry raises a variety of deep-rooted conceptual and applied issues, particularly those related to the definition and diagnoses of mental illness, treatment procedures, and the ethical practices within psychiatry. It is argued that the need to pathologise every form of mental aberration will be counter-productive in the future. Should this trend remain unchecked it will eventually stifle all forms of scientific, literary, and artistic development.     

Divergences in American psychiatry during the Depression: somatic psychiatry, community mental hygiene, and social reconstruction

The differences between somatic psychiatrists and mental hygienists, already apparent earlier, became much more pronounced during the Depression years, partly as a consequence of their different perspectives on this social crisis. Somatic psychiatrists, emboldened by the apparent success of new medical treatment methods, reasserted the central position of the mental hospital within psychiatry, attempted to improve the discipline's position within medicine, and promoted basic research. Mental hygienists, following the ideal of prevention, proposed far-reaching programs of community mental hygiene to alleviate widespread mental distress. A small group of mental hygienists embraced socialism and advocated measures of radical social reconstruction.     

Psychiatry: The Importance of Understanding Persons While Treating Diagnoses

Modern psychiatry emphasizes chemical, genetic, psychosocial, and similar theoretical biological sciences. While these sciences can explain mental disorders they fail to generate a full understanding of the patient as a person. I argue that psychiatry, to not stereotype persons, must integrate both the important advances in molecular and social sciences needed to diagnose and treat mental illnesses and provide an encounter with the person who is the patient. Standardized forms of diagnostic interviewing now dominate in the psychiatrist–patient relationship. Individualizing forms of inquiry, by contrast, elicit a personal understanding of the patient and her problems and the information necessary to diagnose and treat the patient's mental disorders.

This understanding attitude towards individuals is essential so that psychiatrists avoid falling into over-simplified stereotyping explanations of the persons who are their patients. If psychiatry allows its diagnoses of disordered processes that occur within persons to function as labels for persons, then psychiatry appears scientifically to condone the uses of stereotypes. With an understanding attitude towards patients, psychiatry can better treat mental disorders, while also respecting human diversity.     

Athanasios Koukopoulos (1931–2013)

With the death of Athanasios Koukopoulos last year, psychiatry lost one of its most stimulating and scientifically influential representatives has been lost. His main scientific contributions are in the course of manic depressive illnesses and mixed affective states. Perhaps his most important contribution to modern psychiatry are his studies on the use of antidepressants in bipolar disorder. He was able to show that antidepressants attenuate the beneficial effects of lithium, can trigger mania, and can lead to cycle acceleration and rapid cycling.