Hori Arinobu
Department of Psychiatry, Tokyo University Hospital.
Seishin Shinkeigaku Zasshi. 2002;104(7):595-603.
Schools of psychiatric thought are as numerous as they are various, each developed from different sources and presuppositions and each claiming faithful adherents. One inherent difficulty in this profusion of choice lies in discerning whether or not a particular school's presuppositions are valid. To accept one theory is to choose one opinion towards philosophical aporiae--often at the expense of all others. In this paper, issues of scientific philosophy are examined in considering the presuppositions and progress of psychiatric schools. Popper convincingly argued that scientific statements should be "falsifiable." However, because propositions of psychoanalysis or phenomenological psychiatry are closely tied to individual clinical experiences, such statements tend to be exclusive and difficult to check or falsify by other reseachers. They are, in this respect and according to Popper's point of view, necessarily less scientific. Phenomena of the human mind, by its very nature, cannot be observed nor measured directly. Interpretation of the phenomena therefore depends almost entirely upon which theoretical school the researcher has adopted. Biological psychiatry, however, insists that any researcher can objectively measure such phenomenon, and that propositions of biological psychiatry can be connected with those of other branches of natural science. Natural science grandly attempts to comprehensively describe the whole world using one language. This means the researcher is supposedly measuring an object positioned in an ideal and definite position, reached only through infinite steps. Phenomenology is very conscious that the observed object consists at least partly of the observing subject, and so this ideal positioning seems untenable. Phenomenology therefore describes this world from another point of view, different from natural science, and the distinction between measurement of certain systems from inside or outside is important for purposes of explanation and clarification. Although natural science attempts to attain the ideal infinite view, on-going science is naturally limited. In psychiatric practice, we can never rely on one definitive theory; but must rather adopt an appropriate theory to solve an appropriate problem.
精神病学思想流派众多且各不相同,每一种都源自不同的源头和前提假设,且都有忠实的追随者。这种众多选择所带来的一个内在困难在于,要辨别某一特定流派的前提假设是否正确。接受一种理论就意味着对哲学难题选择一种观点——往往是以牺牲其他所有观点为代价。在本文中,我们在考量精神病学流派的前提假设和发展时,审视了科学哲学问题。波普尔令人信服地指出,科学陈述应该是“可证伪的”。然而,由于精神分析或现象学精神病学的命题与个体临床经验紧密相连,这类陈述往往具有排他性,且其他研究者难以进行检验或证伪。从这方面以及根据波普尔的观点来看,它们必然科学性较低。人类思维的现象,就其本质而言,无法直接观察或测量。因此,对这些现象的解释几乎完全取决于研究者所采用的理论流派。然而,生物精神病学坚持认为,任何研究者都能客观地测量这类现象,且生物精神病学的命题能够与自然科学其他分支的命题联系起来。自然科学试图用一种语言全面描述整个世界。这意味着研究者理应测量一个处于理想且确定位置的对象,而这只有通过无限步骤才能实现。现象学非常清楚,被观察对象至少部分由观察主体构成,所以这种理想定位似乎站不住脚。因此,现象学从与自然科学不同的另一个角度来描述这个世界,并且从内部或外部对某些系统进行测量的区分,对于解释和阐明目的而言很重要。尽管自然科学试图获得理想的无限视角,但正在进行的科学自然是有限的。在精神病学实践中,我们绝不能依赖一种确定的理论;而必须采用适当的理论来解决适当的问题。