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?