Singh Ajai, Singh Shakuntala
Mens Sana Monogr. 2004 Nov;2(2):5-32.
The uniqueness of Psychiatry as a medical speciality lies in the fact that aside from tackling what it considers as illnesses, it has perchance to comment on and tackle many issues of social relevance as well. Whether this is advisable or not is another matter; but such a process is inevitable due to the inherent nature of the branch and the problems it deals with. Moreover this is at the root of the polarization of psychiatry into opposing psychosocial and biological schools. This gets reflected in their visualization of scope, in definitions and in methodology as well. Whilst healthy criticism of one against the other school is necessary, there should be caution against hasty application of one's frame of reference to an approach that does not intend to follow, or conform to, one's methodology. This should be done within the referential framework of the school critically evaluated, with due consideration for its methods and concepts. Similarly, as at present, there is no evidence to prove one or the other of these approaches as better, aside from personal choice. We can say so even if there is a strong paradigm shift towards the biological at present. A renaissance of scientific psychoanalysis coupled with a perceptive neurobiology which can translate those insights into testable hypotheses holds the greatest promise for psychiatry in the future. This suggests the need for unification of diverse appearing approaches to get a more comprehensive and enlightened worldview. It requires a highly integrative capacity. Just as a physicist thinks simultaneously in terms of particles and waves, a psychiatrist must think of motives, emotions and desires in the same breath as neurobiology, genetics and psychopharmacology. However, the integration must be attempted without destroying the internal cohesiveness of the individual schools. This will give a fair chance for polarization in which a single proper approach in psychiatry could emerge, which may be a conglomerate of diverse appearing approaches of today, or one which supersedes the rest. A synthesis of cognitive psychology and neuroscience offers the greatest promise at present.
精神病学作为一门医学专科的独特之处在于，除了处理它所认为的疾病外，它还可能对许多具有社会相关性的问题进行评论和处理。这是否明智是另一回事；但由于该分支的固有性质及其所处理的问题，这样的过程是不可避免的。此外，这也是精神病学分化为对立的社会心理学派和生物学派的根源。这在它们对范围的设想、定义以及方法中都有所体现。虽然对一个学派与另一个学派进行健康的批评是必要的，但应谨慎避免将自己的参照框架仓促应用于一种不打算遵循或符合自己方法的方法。这应该在经过批判性评估的学派的参照框架内进行，并适当考虑其方法和概念。同样，就目前而言，除了个人选择外，没有证据证明这些方法中的哪一种更好。即使目前存在向生物学方向的强烈范式转变，我们也可以这样说。科学精神分析的复兴，再加上敏锐的神经生物学，能够将这些见解转化为可检验的假设，这对精神病学的未来最具前景。这表明需要统一各种看似不同的方法，以获得更全面、更有启发性的世界观。这需要高度的整合能力。就像物理学家同时从粒子和波的角度思考一样，精神病学家必须在思考动机、情感和欲望的同时，兼顾神经生物学、遗传学和精神药理学。然而，在进行整合时，必须避免破坏各个学派内部的凝聚力。这将为分化提供一个公平的机会，在其中可能会出现一种适用于精神病学的恰当方法，它可能是当今各种看似不同方法的集合体，或者是一种超越其他方法的方法。目前，认知心理学和神经科学的综合最具前景。
