The debate is urgent. Most Swedish psychiatrists know, of course, that psychiatry is a medical specialty based on medical science, that we work with mental illness and that these disease processes occur in the brain. Oddly enough, this view is not obvious.An eloquent example of a different view of psychiatry can be found, which contains many articles on “male violence against women”. The articles were submitted by representatives of the health service, the judiciary, Psychiatry, Public Health Perspectives and criminology.
The psychiatric perspective was presented by a psychiatrist and psychoanalyst.
Without comment states that ” … less than 5 percent of women use violence (including convicted rapists!) suffers from any diagnosable pathology.”This would mean that they would be much healthier than in the general population, where the annual incidence of mental illness is estimated to be around 30%.
Fortunately, the criminologist Jan then presents the facts that the psychiatrist should have had as a starting point. As a psychiatrist, I feel embarrassed by the reviewed.
Psychiatrists who do not accept the medical model are usually careful to say that psychiatry is not only a medical science, but also a form of humanism. By humanism is meant sometimes humanism, sometimes humanism in the ethical sense, for which they thus consider themselves a monopolist.
This may sound both far-sighted and favourable to public opinion, but in my opinion it is about dualism, an approach that has not disappeared in the case of Plato or Descartes. According to this view, the domain of psychiatry is the soul, which, by definition, cannot be captured by scientific concepts.
Since the dualistic approach (“sure, the brain is, but…”) goes beyond reality, this field remains open to many alternative psychiatrists. Individual psychiatrists and clinics can work according to their own agenda, have ideologies and cultivate unscientific traditions in a way unthinkable in other medical specialties.
Dualism allows laymen, not just the educated, to consider some kind of understanding of souls in order to have wise things to say about psychiatry. Politicians and officials believe that they understand psychiatry and control it in detail. Dualistic ideology has led to hostility towards diagnosis (see Böhm’s article), in which the line between normal psychology and psychiatry is deliberately blurred. Mental illness is really seen only as “malaise” or experiencing “crises”. In this unlimited dualistic psychiatry a psychiatrist is essential.
However, supporters of dualistic ideology are probably in the minority among psychiatrists, and it is time for the Swedish Psychiatric Association to define a clear and authoritative definition of psychiatry as a medical specialty. Psychiatry is fully within the medical model. Modern psychiatric studies have shown a fairly obvious model of susceptibility to stress, in which the consequence of environmental influence is determined by a set of genes, which in turn depends on the expression of this influence.
There are also no paradigmatic contradictions between the different forms of therapy. The only criterion for good psychiatric treatments is to show that they are effective in the processes of mental illness.
In turn, ideology and unscientific forms of treatment do not belong to psychiatry, as does the treatment of normal psychological reactions. By definition, psychiatry is a powerful and exciting medical specialty of strong clarity.