Psychiatry and the irrational: does our scientific world view interfere with the adaptation of psychotics?
Perhaps even more strongly than others in our contemporary Western world, psychiatrists cling to an exceptionally rigid scientific world view. When psychotic patients speak of such matters as their experiences with spirits or of being possessed or of their preoccupations with meaningful coincidences, psychiatrists discount their views as mere psychotic delusions. We suggest that psychiatrists should deal with their patient's attempts at explaining their symptoms by negotiation and compromise, just as any other physician would do when confronted with patient explanations for symptoms which do not coincide with the tenets of scientific medicine. Rather than relegating the psychotic to a meaning-vacuum by dismissing his or her explanations as totally false and non-negotiable, the therapist should help patients find meaning by linking their views and experiences to those of important thinkers within Western cultures. Almost all elements of psychotic thought including beliefs in disembodied spirits, synchronicity (meaningful coincidences), and the possibility of non-material, actions-at-a-distance can be found among respected Western philosophers, psychiatrists, religious leaders and quantum physicists. An example of the world view of a psychotic patient is presented in which a variety of idiosyncratic beliefs are described including convictions of the reality of synchronicity. We demonstrate that highly similar synchronicity beliefs have been entertained by many major Western intellectuals. We contend that on this basis and along with negotiation and compromise, a therapeutic alliance can be established which may provide a measure of symptom relief as well as improvements in rehabilitation potential.
Prince
R H
RH
Department of Psychiatry, McGill University, Montreal, Quebec, Canada.
Reiss
M
M
D003466:Cultural Characteristics; D003702:Delusions / Q000523:psychology; D006801:Humans; D011573:Psychoanalytic Interpretation; D011613:Psychotherapy; D011618:Psychotic Disorders / Q000523:psychology*; D012565:Schizophrenic Psychology; D012917:Social Adjustment; D012938:Social Perception; D014473:Unconscious, Psychology