Bracken et al. theorise and speculate about conflicts within
psychiatry whereby "Psychiatry continues to separate mental phenomena from
background contexts." In particular psychiatrists are accused of
regarding social and cultural factors as of secondary importance. I
wonder what has led them to this point of view? It would be interesting
to know the evidence for this amazing conclusion. If someone publishes a
paper dealing exclusively with drug therapy in depression, this by no
means implies that the author does not realise that other factors are
involved in the causation of depression. It simply means that these
factors are not the subject for consideration in this particular paper.
I am a so-called general adult psychiatrist and I have been in
psychiatric practice since 1945. I was always taught to take into account
any factors that may be relevant to the patient's condition ranging from
the exogenous on the one hand to the endogenous on the other hand. One's
only concern was with the effect that these factors had on the patient.
In my experience, in actual practice, the vast majority of clinical
psychiatrists adopt a similar approach in their daily work irrespective of
the labels that may be attached to them in other contexts. As far back as
1927 when D. K. Henderson and R G Gillespie published their Textbook Of
Psychiatry which was dedicated to Adolf Meyer, they quoted Meyer in their
preface, stating that his hypothesis regards mental illness as the
cumulative result of "… unhealthy reactions of the individual mind to its
environment, and seeks to trace in a given case all the factors that go to
the production of these reactions." This was long before so called
"postmodern" psychiatry.
I wonder what is the source of the information gathered by Bracken
and Thomas? My own surmise is that it is gathered from labels and
abstractions that creep into publications as distinct from the daily toil
of the vast majority of clinical psychiatrists.
Yours sincerely
DR MAURICE SILVERMAN
Lately Consultant Psychiatrist
Blackburn, Hyndburn & Ribble Valley Health Authority
Competing interests:
No competing interests
19 April 2001
Maurice Silverman
Lately Consultant Psychiatrist
Blackburn, Hyndburn & Ribble Valley Health Authority
Rapid Response:
Conflicts within psychiatry
Dear Sir
Bracken et al. theorise and speculate about conflicts within
psychiatry whereby "Psychiatry continues to separate mental phenomena from
background contexts." In particular psychiatrists are accused of
regarding social and cultural factors as of secondary importance. I
wonder what has led them to this point of view? It would be interesting
to know the evidence for this amazing conclusion. If someone publishes a
paper dealing exclusively with drug therapy in depression, this by no
means implies that the author does not realise that other factors are
involved in the causation of depression. It simply means that these
factors are not the subject for consideration in this particular paper.
I am a so-called general adult psychiatrist and I have been in
psychiatric practice since 1945. I was always taught to take into account
any factors that may be relevant to the patient's condition ranging from
the exogenous on the one hand to the endogenous on the other hand. One's
only concern was with the effect that these factors had on the patient.
In my experience, in actual practice, the vast majority of clinical
psychiatrists adopt a similar approach in their daily work irrespective of
the labels that may be attached to them in other contexts. As far back as
1927 when D. K. Henderson and R G Gillespie published their Textbook Of
Psychiatry which was dedicated to Adolf Meyer, they quoted Meyer in their
preface, stating that his hypothesis regards mental illness as the
cumulative result of "… unhealthy reactions of the individual mind to its
environment, and seeks to trace in a given case all the factors that go to
the production of these reactions." This was long before so called
"postmodern" psychiatry.
I wonder what is the source of the information gathered by Bracken
and Thomas? My own surmise is that it is gathered from labels and
abstractions that creep into publications as distinct from the daily toil
of the vast majority of clinical psychiatrists.
Yours sincerely
DR MAURICE SILVERMAN
Lately Consultant Psychiatrist
Blackburn, Hyndburn & Ribble Valley Health Authority
Competing interests: No competing interests