Presidential address. Psychiatry today: the human dimensions.
Psychiatry finds itself today at the crossroads where science and humanism intersect. The history of our specialty includes some ignominious aspects, and many that are noble. Fear and loathing toward the depreciated imbecile and lunatic had at first to be overcome, and they were, and a humane and empathetic approach to patients eventuated. More than sympathy was called for--understanding was needed, and the methods of science have led to considerable such understanding: of causes, of syndromes, and of the efficacy of treatments. Effective therapies have permitted the extrapolation of humane treatment, so that many fewer patients require institutional care. Because of our desire to find simple, comprehensive and fully effective cures, and because of the tendency of the human mind to engage in wishful thinking, we have gone too far down several dead-end streets. We thought at one time that intensive, frequent, deep psychotherapy (including psychoanalysis) could correct or cure all ills, and we overprescribed that treatment to the detriment of some of our patients. We have learned that therein lies no panacea. We came to believe that hospitals caused more of the problems than they did in fact cause, and that it should be possible to treat all disorders within the community. As a result, we have disassembled some of our excellent institutions, for which there is still some need. At the same time, we have left too unprotected many of those who still require safe asylum, to their great disadvantage and to our public shame.(ABSTRACT TRUNCATED AT 250 WORDS)
Mount Sinai Hospital, Toronto, Ontario.
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D002170:Canada; D006801:Humans; D001523:Mental Disorders / Q000628:therapy*; D010817:Physician-Patient Relations; D011570:Psychiatry / Q000639:trends*; D011613:Psychotherapy / Q000639:trends; D012017:Referral and Consultation / Q000639:trends