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精神科护理中图像的力量与发现的逻辑

The Power of Images and the Logics of Discovery in Psychiatric Care.

作者信息

Stanghellini Giovanni

机构信息

Department of Health Sciences, University of Florence,50139 Florence, Italy.

Centro de Estudios de Fenomenologia y Psiquiatrías, Diego Portales University, Santiago 8370068, Chile.

出版信息

Brain Sci. 2022 Dec 21;13(1):13. doi: 10.3390/brainsci13010013.

Abstract

This paper, aligned with contemporary thinking in terms of patient-centered care and co-creation of patient care, highlights the limitations of the reductionist approaches to psychiatry, offering an alternative, "emergent" perspective and approach. Assuming that psychopathological phenomena are essentially relational, what kind of epistemological framework and 'logic of discovery' should be adopted? I review two standard methods I call '' and ''. Within the framework, the clinician's main goal is to discover whether a patient showing psychopathological phenomena meets pre-given diagnostic criteria. The process of discovery can be compared to two people assembling a puzzle where the patient has the pieces and the interviewer has the image of the completed design. consists in constructing pathogenetic diagrams that display linear causative relationships between variables connected by an arrow to other nodes. These explanatory narratives include psychodynamic (motivational) and biological (causal) diagrams. I argue for a third approach called 'linking dots', a method of discovery based on the emergent properties of psychopathological phenomena. I build on and develop the approach to images and discovery devised by art historian Aby Warburg in his atlas of images . The visual constellations created by Warburg in the panels of the can be understood as a method to reveal the layers of memory and the web of relationships manifested in them, inviting the viewer to participate in the production of meanings, forging ever new connections between the images. It is the viewer's acts of perception that draw relationships between singularities. I suggest that this method is of enormous significance in the context of today's socio-cultural transformation processes and related forms of psychopathological conditions, which can no longer be comprehended using the categories of existing knowledge systems.

摘要

本文与以患者为中心的护理及共同创造患者护理的当代思维相一致,强调了精神病学还原论方法的局限性,提供了一种替代性的“涌现”视角和方法。假设心理病理现象本质上是关系性的,那么应该采用什么样的认识论框架和“发现逻辑”呢?我回顾了两种我称之为“ ”和“ ”的标准方法。在 框架内,临床医生的主要目标是发现表现出心理病理现象的患者是否符合预先设定的诊断标准。发现过程可以比作两个人拼拼图,患者有拼图碎片,而访谈者有完整设计的图像。 在于构建病因图,这些图展示了由箭头连接到其他节点的变量之间的线性因果关系。这些解释性叙述包括心理动力学(动机)和生物学(因果)图。我主张一种名为“连点”的第三种方法,这是一种基于心理病理现象涌现特性的发现方法。我借鉴并发展了艺术史学家阿比·瓦尔堡在他的图像图谱中设计的图像与发现方法。瓦尔堡在 画板中创建的视觉星座可以被理解为一种揭示记忆层次及其所表现的关系网络的方法,邀请观者参与意义的生成,在图像之间建立新的联系。正是观者的感知行为在奇点之间建立了关系。我认为这种方法在当今社会文化转型过程及相关心理病理状况形式的背景下具有巨大意义,而这些状况已无法用现有知识体系的范畴来理解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11a8/9856504/cff61480bf55/brainsci-13-00013-g001.jpg

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