Scudellari P, Valente S, Maldini M, Atti A R, De Ronchi D
Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy.
Clin Ter. 2018 May-Jun;169(3):e135-e139. doi: 10.7417/T.2018.2068.
The uncertainty regarding the scientific status of psychiatry arises from psychiatry's involvement with some unsolved problems, or put in another way, from its enmeshment in certain points of transition of contemporary science. There is, in primis, the unsolved problem of the relationship between the mind and the body and, moreo- ver, the intricate relationship of connection/disjunction among biology, social science, anthropology, philosophy, etc. To speak about what psychopathology can expect from philosophy is, above all, to immerse oneself in a debate about the conditions of possibility of psychiatry as a science. This debate is especially concerned with the models of knowledge that have, until now, been proposed to psychiatry. Those models oscillate between the Dilthey's paradigms of the "Science of Nature" and the "Science of Spirit".
It is certain that psychopathology, as already indicated by Jaspers, is a discipline which is among the most involved regard- ing the use of the two different cognitive strategies. The first strategy concerns the concept of "explanation" and its rigid approach to the objective and ultimate cause of the phenomenon. The second strategy is the "comprehensive" approach. This model, which the hermeneutic thought defines "interpretative", theorizes the provisional character, the subjectiveness and the finiteness of every cognitive project.
The interest of the authors is orientated towards the hermeneutic side (comprehensive-interpretative) of psychiatry, that which deals with the specificity of every clinical history, with the continuity of sense, and with intrinsic narrative intelligibility of every human event, psychopathological or not.
This approach to psychopathology is based on the statement: "a clinical history is a text which must be interpreted". From this perspective, every clinical history should be perceived as a text to decipher but, above all, as a "text" to listen to, in the persevering expectation that it could disclose its particular "project of world". When speaking about psychiatry, we always face a problem which dominates all the others: the unsolved problem of the relation- ship between typicalness and singularity of subjective events. B.B. Mandelbrot, theorist of "fractals", sums this dilemma up clearly. He suggests that the innumerable variety of the configurations of Nature is a challenge to investigate the morphology of that which is "irregu- lar" in order to discover in it, as far as possible, a rule.
精神病学科学地位的不确定性源于其涉及一些尚未解决的问题,或者换句话说,源于它在当代科学某些转型点上的纠结。首先是身心关系这一尚未解决的问题,此外,还有生物学、社会科学、人类学、哲学等之间复杂的联系/脱节关系。谈论精神病理学能从哲学中期待什么,首先是要投身于一场关于精神病学作为一门科学的可能性条件的辩论。这场辩论尤其关注迄今为止向精神病学提出的知识模型。这些模型在狄尔泰的“自然科学”和“精神科学”范式之间摇摆。
正如雅斯贝尔斯已经指出的,精神病理学无疑是一门在使用两种不同认知策略方面涉及最深的学科。第一种策略涉及“解释”概念及其对现象的客观和最终原因的严格方法。第二种策略是“综合”方法。这种被诠释学思想定义为“解释性”的模型,将每个认知项目的临时性、主观性和有限性理论化。
作者们的兴趣倾向于精神病学的诠释学方面(综合 - 解释性),即处理每个临床病史的特殊性、意义的连续性以及每个人类事件(无论是否为精神病理事件)内在的叙事可理解性的方面。
这种精神病理学方法基于这样一种表述:“临床病史是一篇必须被解释的文本”。从这个角度来看,每个临床病史都应被视为一篇有待解读的文本,但最重要的是,应被视为一篇有待倾听的“文本”,始终期待它能揭示其独特的“世界图景”。当谈论精神病学时,我们总是面临一个比其他所有问题都更突出的问题:主观事件的典型性与独特性之间尚未解决的关系问题。“分形”理论家B.B. 曼德勃罗清楚地总结了这一困境。他认为,自然界无数多样的形态构成了一项挑战,即研究“不规则”事物的形态,以便尽可能从中发现规律。