Sowerby P
J R Coll Gen Pract. 1977 Oct;27(183):583-9.
Psychoanalytical theories seek to explain human behaviour. I believe that they are not scientific, whereas it appears that Balint thought they were. I suggest instead that they are better regarded as myths and part of an artistic discipline. Whereas most of the problems brought by patients to general practitioners can be understood in scientific terms, others can be understood only in artistic terms.These two terms reflect fundamentally different kinds of problems, and different language must be used to discuss them. Neither the two sets of terms nor the two kinds of problem can be confused without giving rise to error. I argue that Michael Balint came to a false conclusion about the nature of the general practitioner's task, about the way the problems posed by his difficult patients may be identified, and about some of the training doctors should receive.Balint's main contribution remains. He showed us that scientific skills alone are not enough if we are to understand our patients fully. He also showed us how a descriptive science of human behaviour in the consulting room was possible.To these insights must be added new understanding. Popper (1963) has provided us with a clear line of demarcation between science and the rest of our knowledge. This idea suggests that general practitioners should reaffirm the importance to them of the intellectual discipline of science. If they wish their understanding and practice to be comprehensive they must also affirm the importance of the arts. What they must not do is to confuse one with the other.
精神分析理论试图解释人类行为。我认为它们不具有科学性,而巴林特似乎认为它们是科学的。相反,我建议最好将它们视为神话以及艺术学科的一部分。虽然患者向全科医生提出的大多数问题可以从科学角度理解,但其他一些问题只能从艺术角度理解。这两个角度反映了根本不同类型的问题,必须用不同的语言来讨论它们。这两组术语和两种问题都不能混淆,否则会导致错误。我认为迈克尔·巴林特在全科医生任务的本质、识别难缠患者所提出问题的方式以及医生应接受的一些培训等方面得出了错误结论。巴林特的主要贡献依然存在。他向我们表明,如果我们要充分理解患者,仅靠科学技能是不够的。他还向我们展示了如何在诊疗室建立一门关于人类行为的描述性科学。对于这些见解,还必须增添新的理解。波普尔(1963)为我们提供了科学与其他知识之间清晰的分界线。这个观点表明,全科医生应该重申科学知识学科对他们的重要性。如果他们希望自己的理解和实践全面,就还必须肯定艺术的重要性。他们绝不能将两者混淆。