[Psychopathology - an exhausted mine?]

G Huber
Fortschritte der Neurologie-Psychiatrie 2002, 70 (8): 393-402
Proceeding from the considerations of European psychiatrists that trends in the contemporary psychiatry seem to underestimate or even neglect the psychopathological approach, resulting in a threatening loss of clinical-psychiatric competence, this critical review deals with the reasons and arguments, why our discipline does still need the phenomenological PP for diagnostics and therapy, practice and research. Only the PP under discussion is able to meet the demand of clinical psychiatry to provide a reasonably reliable description of symptoms and syndromes, upon which rational diagnosis and adequate prevention and treatment can be based. The overly objectifying psychiatry of Kraepelin has been overcome by the descriptive-analytic and understanding PP in the direction of Jaspers and Schneider, aiming more at the elucidation of the patients' own inner experiences than at the observation of behaviour and expression. It is shown that important concepts, findings and results of the classical and recent psychiatry could be obtained by means of the PP, developed by representatives of the German speaking clinical psychiatry and psychology. PP has to take the lead previous to all other basic sciences, relevant for our discipline, also because it is not a self-contained theory, but an open approach, based on methodological reflection, showing ways for research. If the maxime "phenomenology is prior to genesis and interpretation" is ignored, or, if this PP is confused with and mistaken for philosophical phenomenology, the results of such a procedure must be doubtful. An intense training and thorough adoption of PP, the "phenomenological attitude" of the physician is urgently demanded as well by German speaking as recently also by anglophone psychiatrists. The substantial influence of the "phenomenological attitude" on psychology and sociology of clinical practice, on the atmosphere of a psychiatric hospital and the style and kind of psychiatric research, due to the fact that the psychopathologist can do practical and scientific work only with the patient and in very close relation with the patient, is also meaningful in order to avoid faulty developments. In this connection the dependence of psychiatry of political and sociological conditions and its susceptibility for ideologies is discussed and illustrated by some pertinent examples of the last decades.

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