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[心理学在医学中的意义]

[The significance of psychology in medicine].

作者信息

Richter H E

出版信息

Psychother Psychosom Med Psychol. 1989 Feb;39(2):51-7.

PMID:2704775
Abstract

It is shown in a retrospective review how the specific political climate twenty years ago helped to establish psychosomatics, psychotherapy and medical psychology as disciplines in their own right. The "reform-minded" trend gave psychotherapy recognition as a treatment method to be acknowledged as cost-refundable under the Federal German health insurance system. Furthermore, it prompted the Federal German government to start an inquiry into the present situation of psychiatry and psychosomatic medicine, whereas research workers at the base developed models of psychosocial working teams and of a renewal of sociopsychiatry. Meanwhile the political "turnabout" in the Federal Republic from a socioliberal to a predominantly conservative line has produced a conservative countercurrent: the medical institutions undergo reinstatement of ancient hierarchies, jobs in the psychosocial sphere are being dramatically axed, psychosomatics is being streamlined as an adapted auxiliary discipline ruled with an iron hand by a dramatically expanding clinical pathology or laboratory medicine and by a concept of "health" that is purely functional. Basing on the case history of a woman suffering from psychogenic sterility the author critically discusses the gap-clearly noticeable although frequently denied-now dividing the individual disciplines and schools of psychological medicine, separating in each case a preferably conformistic branch from a critically engaged one.

摘要

一项回顾性综述表明,二十年前特定的政治气候如何助力心身医学、心理治疗和医学心理学各自成为独立学科。“改革派”趋势使心理治疗被认可为一种治疗方法,并在联邦德国医疗保险体系下被视为可报销费用的治疗方式。此外,它促使联邦德国政府对精神病学和心身医学的现状展开调查,而基层的研究人员则开发了社会心理工作团队模式以及社会精神病学复兴模式。与此同时,联邦共和国从社会自由主义向主要为保守路线的政治“转向”产生了一股保守逆流:医疗机构恢复了古老的等级制度,社会心理领域的工作岗位大幅削减,心身医学被精简为一门适应型辅助学科,由急剧扩张的临床病理学或检验医学以及一种纯粹功能性的“健康”概念严厉掌控。基于一名患有心因性不育症女性的病例史,作者批判性地讨论了如今明显存在(尽管常被否认)的个体学科和心理医学流派之间的差距,在每种情况下都将一个较为因循守旧的分支与一个批判性参与的分支区分开来。

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