The principle of complementarity and the relationship between psychiatry and the psychotherapeutic approach
Would not psychiatry become a more internally logical and coherent science if it were to be freed as much as possible from psychotherapeutic language (largely focused on interrelations) and if it were only to employ the language describing characteristics (symptoms) of patients as objects, the language discarding therapists’ (as interaction participants and observers) influence? For it is language that provides the description of patient (as object) properties, characteristics (symptoms, and their correlation with each other, resulting in syndromes) that will remain set, stable, and unchanged. And these properties and characteristics can be examined in terms of the biological mechanisms on which they are based. This may lead to the discovery and development of pharmacological remedies that will treat those unchanging set characteristics and properties, remedies whose effects will not depend on changing circumstances or conditions of patient–therapist interaction. Isn’t that what evidence-based medicine has been striving to achieve in psychiatry, trying to do away with “speculative concepts” embedded in some of its diagnostic formulations? And would not psychotherapy, especially psychoanalysis, benefit were it to be released from psychiatric language and psychiatric diagnostic terms, which are often of little use in psychotherapy, and which may be rather confusing at times? The language and formulations that would suit psychotherapy most are those describing typical patterns of relations built by patients with their environments (including their therapists) — those reflecting potentially evolving patient—therapist relation dynamics. Psychiatry language is often too rigid and static for this aim: It doesn’t reflect the depth of understanding of patients’ experience of their relationship with themselves and with other people that is required for psychotherapy. Should we consider psychotherapy (especially its psychodynamic branch) as its most developed model) and psychiatry as each having its own internal logic, independent, non-overlapping but supplementary theoretical models for describing normal and pathological functioning of the psyche, would that not stimulate a deeper scientific understanding of mental phenomena? Wouldn’t it provide an impetus, playing a role similar to the part of the complementarity principle introduced by Niels Bohr for comprehending quantum physics whereby the electron-as-wave concept is regarded as supplementing that of electron-as-particle and vice-versa? And if we were to use psychotherapeutic (psychodynamic) and psychiatric medical models as two independent coordinate axes to evaluate and examine every patient, wouldn’t that lead to a better and clearer understanding than that produced by attempts to mix psychiatry and psychotherapy into one single system?