08/30/2011: The Yale Philosophy and Psychiatry Group, founded and led by third-year Yale Psychiatry resident Elliott Martin, MD, kicks-off another academic year of programming. The group provides a monthly forum to discuss the "bigger questions" that arise in understanding the whole of a patient.
The following article was submitted by Dr. Elliott Martin, third-year Yale Psychiatry resident:
The interface between philosophy and psychiatry received its first major treatment with the publication of Karl Jaspers’ General Psychopathology in 1913. The relationship of philosophy and psychiatry remained an interest of philosophically oriented German and French psychiatrists throughout much of the last century. A resurgence of interest in philosophy and psychiatry occurred in the English-speaking world in the 1960s and ‘70s, stimulated in large part in response to the anti-psychiatry movement initiated, in different ways, by Thomas Szasz in this country, and R.D. Laing in the United Kingdom. Certainly discussion was more broadly based in the pre-biologic era of psychiatry, with psychiatry assuming a more defensive position.
However, with the introduction of widespread psychopharmacology, and the refinement of brain manipulation techniques such as ECT, DBS, VNS, etc., psychiatry has re-established itself, now as a harder ‘science’. Rather than lay philosophic questions to rest, however, the discussion has merely shifted: just how far will ‘science’ go to manipulate the mind to conform better to a perceived ‘normal’. Or, in more familiar terms: the more things change, the more they stay the same.
Historically it has fallen to the philosophers to deal with questions related to the meaning of life: the nature of reality, of consciousness and mind, of ethics and morality, of language and aesthetics. These issues, however, are the vital core of any individual, in any culture, who has ever contemplated his or her place in the cosmos. Before people suffered existential crises they suffered transcendental crises, and from the shaman to the priest to the physician, answers have traditionally been sought from a learned source.
At its own core, psychiatry is concerned with the well-being of the mind. However, with the standardization of psychiatric diagnoses into a ‘statistical manual’, and with the latest redaction nearing completion, the uniqueness of the field’s concern with integrating the biological, psychological, and social realms seems at risk. Psychiatry has always remained apart from other fields of medicine, less by way of its humanity than its sheer humanness, its willingness to do all it can to understand the whole of a patient, its requirement of its practitioners for unmatched empathy and sympathy. But especially with the rise of biological psychiatry and managed care, the nature of what we do – that is, manipulate the very mind – is worth reconsidering, and in a free and safe, dialectical format that welcomes all fields of scholarship.
The Yale Philosophy and Psychiatry Group, we would like to say, was formed less to analyze than to answer these ‘bigger questions’. It is easy enough after all to memorize treatment algorithms, standards of care, and diagnostic criteria. The real challenge to be faced is figuring out just what it is we are trying to do. We provide a forum for real discussion, with monthly seminars led by guest speakers from all over the region. We are an active affiliate of the Association for the Advancement of Philosophy and Psychiatry, and we encourage our members to contribute to the field. Most recently several in our group have contributed to a unique ‘Pluralogue’ led by Allan Frances and one of our faculty mentors here, Jim Phillips, regarding conceptual issues in the forthcoming DSM-5. The piece will be published in the AAPP Bulletin later this year.
Our group is open to all. We meet on the third Tuesday of every month in the large conference room on the first floor of the medical school library from 6:30 to 8:00 PM. We follow the academic calendar, meeting from September through May, with announcements sent out to the Psychiatry, Philosophy, Psychology, and History of Science Departments prior to all sessions. Our opening session this year will take place on September 20th. Our first seminar leader will be Sharlene Walbaum, PhD, professor of psychology at Quinnipiac University. She kicks us off with a seminar titled ‘Work and Lunacy: the Morality of Moral Treatment’. Announcements always precede our speakers, the dates are marked on the departmental calendars, and pizza is always served.