The Integrative Nature of Psychiatry
It has been often stated that we human beings live “in two worlds”: a world of biology and physical causes, to which our brain also belongs, and a world of meanings, symbols and interpersonal relationships. Each of these worlds has its own processes and laws, which can be studied separately and have indeed been studied separately for several centuries. On the one hand, there is the domain of neurosciences, in which the brain has frequently been studied as a “biological machine”, isolated from social influences. On the other, there is the domain of social sciences, in which the world of human relationships has usually been explored ignoring brain processes, as if they were totally irrelevant.
Psychiatry, and in general the issue of mental disorders, has been put in the middle by this dualism. Neurobiological and psychosocial views of mental disorders have confronted each other for many decades, not only in the scientific and lay literature, but also in the perception of people with those disorders, who often conceptualize their problems in either essentially biological or essentially psychosocial terms. The specificity of psychiatric expertise and the need for a specific psychopathological language have been often put in question, and psychiatry has recurrently been warned either to become a “clinical neuroscience”, replacing descriptive psychopathology by neurobiological and behavioral measures, because mental disorders are regarded as “brain diseases”, or to adopt a psychosocial paradigm, conceptualizing mental disorders in terms of understandable responses to adverse environmental situations or problematic interpersonal relationships.