Sunday, 28 September 2014

'Towards a hermeneutic shift in psychiatry' perspective by Dr Pat Bracken, World Psychiatry, Oct14

'Towards a hermeneutic shift in psychiatry' perspective by Dr Pat Bracken, World Psychiatry 13:3, Oct14


"Psychiatry is currently going through a crisis of confidence (1). Some medical commentators have even questioned the very credibility of the profession (2). There are many indicators of this crisis. For example, leading up to the launch of DSM-5 by the American Psychiatric Association last year, the chairperson of the DSM-IV task force raised serious questions about the validity of the whole DSM process (3), echoing earlier criticisms by the chairperson of the DSM-III (4). It is clear that psychiatry has been a particular target of the marketing strategies of the pharmaceutical industry (5), strategies that have led to the corruption of evidence-based medicine in general (6)."

"One of the major insights of 20th century philosophers such as Wittgenstein, Heidegger andMerleau-Ponty was the realization that meaning is not something that happens inside an individual mind or brain, but instead comes into our lives from the social practices that shape the world around us."

"I do not believe that we will ever be able to explain the meaningful world of human thought, emotion and behaviour reductively, using the “tools of clinical neuroscience”.  This world is simply not located inside the brain. Neuroscience offers us powerful insights, but it will never be able to ground a psychiatry that is focused on interpretation and meaning. Indeed, it is clear that there is a major hermeneutic dimension to neuroscience itself (17). A mature psychiatry will embrace neuroscience but it will also accept that “the neurobiological project in psychiatry finds its limit in the simple and often repeated fact: mental disorders are problems of persons, not of brains. Mental disorders are not problems of brains in labs, but of human beings in time, space, culture, and history.”

Read complete article


Pat Bracken video: "Beyond Reductionism: Towards a Hermeneutic Shift in Psychiatry"

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