Psychiatry is an important branch of modern medical science. It mainly studies the etiology, pathogenesis, symptoms and clinical laws of mental disorders, as well as prevention, diagnosis, treatment and rehabilitation.
The theory and research on psychiatry can be traced back to the middle of the 18th century.
About Freud
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Freud
Freud Sigmund was born into a Jewish family in Austria on May 6, 1856. In 1873, he entered the University of Vienna to study medicine with excellent achievements.From 1883 to 1885, he conducted important research on the brain marrow and served as a lecturer in neurophysiology;The anesthetic effect of cocaine was also found.Under the influence of J. Schalke, his interest shifted from clinical neurology to clinical psychopathology.In 1895, he co wrote Research on Hysteria with Boyle, creatingPsychoanalysis。It is believed that the psychological process suppressed by consciousness is converted into physical symptoms and manifested as hysteria, which can be treated by psychoanalysis.Technically, he abandoned the ancient hypnotism and replaced it with free association, that is, let patients say what they think, so as to discover the hidden cause.After analyzing many cases, he was convinced that sexual problems played an important role in the occurrence of neurosis.It is found that not only parents often have incest impulse, but this impulse is more expressed in children, even in infancy, namely the so-called Oedipus complex.He found the importance of dreams in psychoanalysis and believed that "dreams summarize the psychology of neurosis".As a doctor treating mental diseases, Freud created a theory involving the structure and function of human psychology.His views have been widely used not only in psychiatry, but also in artistic creation, education and political activities.The main arguments of Freud's theory have been revised and developed by later generations.It is recognized that human behavior is not only dominated by sexual desire, but also social economic factors play a role in the formation of personality and cultivation of nature.Although Freud's theory has been criticized repeatedly, this has not damaged his image.His outstanding theories, therapeutic techniques and profound understanding of the hidden part of human psychology have created a new field of psychological research.The theory founded by him fundamentally changed the view on human nature.
The Embarrassment Faced by Psychiatry
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Psychiatry and psychology are two directions in origin, two orientations in methodology, two systems in theoretical construction, and different in academic theory.If they share the same root, it is the spirit of the times at that time.As Murphy said, "The history of psychosis mainly belongs to the history of medicine rather than the history of psychology; however, both medicine and psychology reflect the common root of the development of Western Europe's reason and the rise of modern research spirit.From the time when humans first became aware of 'disease', medicine is an applied profession. Its inevitable stagnation and the lack of attention paid to practical applications by the experimental programs and theoretical assumptions of new psychology will inevitably form a huge gap that has not been completely closed up until today. "
Murphy was keenly aware of the "huge gap" between psychiatry and psychology, but the reasons he said: the stagnation of psychiatry and the lack of attention to practical application of psychology are arguable.
Perhaps the need of society is the most urgent task, or it may be because it is subordinate to medicine. Psychiatry has embarked on the road of application from the beginning, but it cannot be any other way.They concentrate on how to let their poor brothers and sisters get rid of the mental pain as soon as possible.
This is the basic model of psychiatry established by Kleppelin.Within the framework of this basic model, psychiatry clinic has been established, including etiology, pathology, taxonomy, symptomatology, diagnostics, therapeutics, rehabilitation, and prognosis of mental diseases.In the more than 100 years since the era of Kleppelin, the clinical psychiatry has undergone great changes and made great progress. Of course, it is not the "stagnation" as Murphy said, but in terms of the basic methodology and the basic structure of the discipline, it is still the same line with Kleppelin. Today's psychiatrists are all the reincarnated disciples of Kleppelin.
It is precisely because of this real practical spirit and the resulting real practical methods that psychiatrists become real pragmatists and realists.Compared with psychologists, they neither attempt to build a huge theoretical system, but honestly describe the clinical phenomena they observe, and do not make any explanation beyond the phenomenon itself (the nature of the discipline itself makes them unexpectedly become followers of phenomenology, although they cannot be called phenomenologists), nor do profound philosophical thinking,Not even attempt to explore the essence of the mind.Therefore, they will not "go down the steep slope" between "his own standpoint" and "mental fact" as psychologists often do, and they will not have the "psychologist's fallacy" as James said.
But realists have problems with realists.Psychiatrists do not have "psychologists' fallacies", but at least two problems are difficult for them to overcome: one is that the psychiatry system lacks a rigorous logical and speculative theoretical system;The second is that when psychiatrists adhere to the professional norms of "doctors", they often can't help but "borrow" some ideas from psychologists without thinking to embellish themselves, enrich themselves, transform themselves, and make themselves "like" a psychologist.Also unexpectedly, they lost part of themselves.The result is to make oneself wander in“Psychiatrist”Between them and "pathological psychologists", they are neither doctors nor psychologists.
The first problem is most obvious in the diagnosis and classification of mental diseases, which is the most important thing in psychiatry.Without a reasonable diagnosis system and systematic classification, there would be no psychiatry.The reason why we say that Kleppelin has made great contributions to psychiatry is that he has provided a model of classification system for later psychiatrists, although this model is not ideal.
There must be criteria for the diagnosis and classification of diseases.Normally, there can only be one standard, but there are many standards before psychiatrists.
One is the etiology standard, which is considered to be the most ideal standard.There is no doubt that the classification of a disease according to its etiology has fundamental guiding significance for the treatment of diseases.Unfortunately, almost none of the causes of mental illness today are clear, so this standard has to be abandoned.
The second is the standard of symptomatology.It seems not only reasonable but also feasible to classify diseases according to different symptoms of patients and disease diagnosis based on them.Craepelin used this standard when he divided "early-onset dementia" and "manic depressive psychosis".However, the biggest problem in using the criteria of symptomatology is that the manifestations of any kind of mental disease are diverse, and even the same disease often shows a different face.
Since the cause of mental illness is unclear, and psychiatrists have no objective inspection tools to use, the diagnosis depends only on these symptoms.andMental symptomsHowever, there are many differences. Psychiatrists can only understand symptoms by describing them.The problem is obvious. It is conceivable that it is difficult to make an accurate diagnosis of the disease just by relying on it. It is also conceivable that the diagnosis is inconsistent.
