Friedmann C T
West J Med. 1978 Aug;129(2):156-9.
Despite the long tradition of psychiatrists practicing psychotherapy, many psychiatric and medical leaders are predicting and urging a reorientation of psychiatry toward the medical model. They would leave psychotherapy to psychologists, social workers and the like. Many social, governmental and institutional factors favor such a change. The marriage of psychiatry and psychotherapy has always been an uneasy one, and the push for divorce may be irresistible. The author cautions that a divorce could be detrimental to medicine by substituting, in the name of "science," a dehumanized, technological psychiatry for the current "moral" treatment. One alternative to divorce is a broader approach to psychiatry, combining biological, neuromedical, socioenvironmental and psychodynamic factors. The divorce, though imminent, should be resisted.
尽管精神科医生进行心理治疗有着悠久的传统,但许多精神科和医学领域的领导者预测并敦促精神医学重新回归医学模式。他们将把心理治疗留给心理学家、社会工作者等。许多社会、政府和机构因素都有利于这种转变。精神医学与心理治疗的结合一直不太和谐,而推动二者分离的力量可能难以阻挡。作者警告说,这种分离可能对医学有害,因为以“科学”之名,会用一种非人性化的、技术性的精神医学取代当前的“道德”治疗。分离的一个替代方案是采用更广泛的精神医学方法,将生物学、神经医学、社会环境和心理动力学因素结合起来。尽管分离迫在眉睫,但应该予以抵制。