Groleger Urban
University Psychiatric Hospital, Studenec 48, SI-1260, Ljubljana, Slovenia.
Psychiatr Danub. 2007 Sep;19(3):206-8.
The "mind-body" dualism has shaped the development of psychiatry. At the very beginning psychiatry was related to the mind and the rest of the medicine to the body. The main reasons for such division were lack of biological evidence for psychiatric disorders and wrong beliefs about demonic origins of "lunacy". But although the development of science offered more than enough biological evidence to understand brain as an organ of origin for psychiatric disorders, the dualism of mind and body remained alive even in the modern classification systems. One of the consequences was another dualism that differ biological (e.g. pharmacotherapy) from psychological therapy (e.g. psychotherapy) as completely different approaches. The purpose of this article is to offer enough evidence to reframe the existing dualisms into a different paradigm. In every illness both mind and body can be affected to a different extent. Which part of an illness is body and which part is mind is often difficult to differentiate even when we compare a person with broken leg with a person with acute stress reaction. For that reason it might be an over-simplification to differentiate sharply between biological and psychological therapies. The evidence show that psychotherapy influences biology of the brain and that pharmacotherapy influences psychological, social and developmental dimensions of the diseased person as well as overall well-being and functionality. In the era where medicine discovered psychology and psychiatry discovered biology, the debates and divisions that steam out of past dualisms should end. Every practising physician regardless of the medical discipline uses in everyday practice both biological and psychological approaches to help the patient successfully.
“身心”二元论塑造了精神病学的发展。最初,精神病学与心智相关,而医学的其他领域与身体相关。造成这种划分的主要原因是缺乏精神疾病的生物学证据,以及对“精神错乱”恶魔起源的错误认知。但是,尽管科学的发展提供了足够多的生物学证据来将大脑理解为精神疾病的起源器官,但身心二元论在现代分类系统中仍然存在。其后果之一是另一种二元论,即将生物治疗(如药物治疗)与心理治疗(如心理疗法)视为完全不同的方法。本文的目的是提供足够的证据,将现有的二元论重新构建为一种不同的范式。在每一种疾病中,身心都可能在不同程度上受到影响。即使我们将腿部骨折的人与急性应激反应的人进行比较,也常常很难区分疾病的哪一部分是身体方面的,哪一部分是心理方面的。因此,将生物治疗和心理治疗截然区分可能过于简单化。证据表明,心理疗法会影响大脑的生物学特性,而药物治疗也会影响患者的心理、社会和发育维度,以及整体幸福感和功能。在医学发现心理学、精神病学发现生物学的时代,源于过去二元论的争论和分歧应该结束。每一位执业医生,无论其医学专业如何,在日常实践中都会同时使用生物和心理方法来成功帮助患者。