On psychiatry

December 25, 2019 01:06 am | Updated 01:06 am IST

With reference to the report, “‘Neuroscience can eventually replace psychiatry’,” (Chennai, December 20), I would like to point out that isolating psychiatry from neurosciences is itself a wrong notion. The seat of the mind is the brain. Psychiatry is not all about Freudian theories; needless to say, Freud initially started out as a neurologist. Psychiatry has moved past Freudian and neo-Freudian concepts to a ‘bio-psycho-social model’ proposed by George Engel, which takes into account of biological factors such as genetic makeup, neurophysiological and neurochemical makeup, etc., psychological factors such as a person’s personality, temperament and emotions and social factors such as family and the immediate social environment, socioeconomic status, etc. This approach is holistic and is the basis for a majority of psychiatric disorders. This model also helps a psychiatrist to formulate a treatment plan which may include medications or neuromodulatory treatments, psychotherapy and psychosocial interventions. Hence, reducing psychiatry to just Freudian concepts is regressive (again a Freudian concept), to say the least. I would also like to add that although Freud’s psychoanalytic interpretations do not hold good for all psychiatric disorders, it still holds good for some of them, which cannot be explained better by anything other than psychoanalysis. For example, a dissociative disorder wherein a patient has amnesia which is of psychological origin than neurological, possibly brought on by a traumatic incident cannot be explained better without understanding how bad the psychological trauma was and what it means to that individual. Therefore, I conclude by saying that psychiatry is a science nevertheless, but it is equally an art. The human mind is much complicated than any of us could possibly fathom and none other than a mental health professional could decode it better.

Dr. Subhashini K.R.,

Singaperumal Koil, Tamil Nadu

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