[Formation of new American psychiatrist and the future of psychiatry in the U. S.--A reference for France?].
A Ballad on the future of american psychiatry. Since the publication of Johann Reil's, Rhapsodies About the Application of Psychotherapy to Mental Disturbances (1803), variations upon this theme of extravagant discourse have received enthusiastic welcomes from the ever enlarging psychiatric audience for whom they are performed... Although the soloists change, the basic orchestration continues creating an uncanny sense of déjà entendu. While there as been longstanding recognition of the contributions of biological, psychological and social forces to the etiology of mental illness, actual efforts at a synthesis of their roles have been infrequent. Rather, we have experienced ideological clustering around each with the formation of schools and movements which have tended to over-value their own viewpoint at the expense of the others and to the detriment of progress in psychiatry. The authors describe a periodicity of one to two decades in which one of the schools achieves preeminence over the others, consolidates its position in medical education and with the community at large, comes under fire for failing to provide solutions to the problems of the mentally ill, and finally experiences a decline of its influence and prestige. Since World War II, both psychoanalytic and social and community psychiatry have experienced these vicissitudes, and, as the influence of the latter diminishes, voices are already raised promoting the succession of biological psychiatry of the seat of power. We believe another cycle of hopeful expectance in the quest for psychiatric omniscience and the following period of disillusionment can be avoided. The stunning advances in biological research in the past, and the prospect of even more exciting revelations to come should not lead us to devalue those techniques and institutions which have proved effective, while in pursuit of new approaches. Experience informs us that no one discipline in psychiatry can answer all the questions confronting us, and the time is ripe for a reassessment of the appropriate contributions of each subspecialty to the field as a whole. The authors propose the establishment of fellowships in biological psychiatry to promote this subspecialty, just as fellowships have been created to train child psychiatrists, administrative psychiatrists, etc. We believe such action could insure a more active role for biological psychiatry without repeating the cycle of disruption already described. The outlines of such a fellowship are sketched.
D005602:France; D011570:Psychiatry; D014481:United States
La formation des futurs psychiatres américains et l'avenir de la psychiatrie aux U.S.A. Une référence pour la France?