Hundert E M
Harvard Medical School, Boston, MA 02115.
Theor Med. 1991 Mar;12(1):7-23. doi: 10.1007/BF02134775.
Epistemology--the study of knowledge--is a philosophical discipline with close ties to psychiatry. When epistemologists address specific questions about how knowledge is actually realized by human beings, their philosophy must be informed by empirical studies of the sort psychiatrists now take up in a variety of forms. As this paper describes, psychiatrists can likewise improve their understanding of human psychology through a deeper appreciation of philosophical analysis in epistemology. The aim of this article is to introduce a unifying framework within which the experience from different approaches to psychiatry--(1) the conceptual schemas of cognitive psychiatry, (2) the mental structures of psychoanalytic psychiatry, (3) the categorical forms of existential psychiatry, and (4) the neural pathways of biological psychiatry--can all be applied productively to the central question of epistemology. By establishing a broad understanding of the problem of knowledge, this new view of epistemology is developed within the idiom of each psychiatric approach. In addressing themselves to a unitary problem, these diverse psychiatric approaches are themselves revealed, not as competing points of view, but as complementary views of a single subject. The result is a new epistemology that can not only bring the insights of psychiatry to philosophy, but can also contribute to the care of patients when psychiatrists bring this broader view to their clinical work.
认识论——对知识的研究——是一门与精神病学联系紧密的哲学学科。当认识论学者探讨关于人类如何实际获取知识的具体问题时，他们的哲学必须以精神病学家目前以各种形式开展的实证研究为依据。正如本文所描述的，精神病学家同样可以通过更深入地理解认识论中的哲学分析来增进对人类心理的理解。本文的目的是引入一个统一的框架，在这个框架内，来自不同精神病学研究方法的经验——（1）认知精神病学的概念模式，（2）精神分析精神病学的心理结构，（3）存在主义精神病学的分类形式，以及（4）生物精神病学的神经通路——都能够有效地应用于认识论的核心问题。通过对知识问题形成广泛的理解，这种新的认识论观点是在每种精神病学研究方法的表述方式中发展起来的。在处理同一个统一的问题时，这些不同的精神病学研究方法并非展现为相互竞争的观点，而是对单一主题的互补观点。其结果是一种新的认识论，它不仅能够将精神病学的见解带给哲学，而且当精神病学家将这种更广阔的视角应用于临床工作时，还能为患者护理做出贡献。
