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Mental Health and Medical Care: Four Cultures and a Single Theme
Published online by Cambridge University Press: 01 July 2024
Extract
We are now slowly re-discovering the conclusion reached by Alfred Grotjahn in his remarkably prescient Soziale Pathologie, namely that “zwischen dem Menschen und der Natur die Kultur steht.“ [1]. In some measure this maxim affects every branch of modern medicine but to none is it more relevant than psychiatry, which is so closely embedded in the social matrix in which the subject is practiced. A comprehensive study of this matrix would have to touch on a number of disciplines, including history, economics, social anthropology and sociology, but for our immediate purpose these multiple influences can be canalized by reference to the available systems of medical care which exist to deliver the two broad types of service offered by contemporary medicine: on the one hand, the specific products of biomedical research—a surgical operation, say, or a new drug—which are impersonal, often expensive and ideally directed at the cure of disease; on the other hand, the “non-specific” psychosocial contribution of medicine, intensely personal and more often directed towards alleviation or support. These two categories do no more than reflect the derivation of modern medicine from its twin sources of science and magic whose respective attributes were etched so sharply by Malinowski: “Science, even as represented by the primitive knowledge of savage man, is based on the normal universal experience of everyday life, experience won in man's struggle with nature for his subsistence and safety, founded on observation, fixed by reason. Magic is based on specific experience of emotional states in which man observes not nature but himself, in which the truth is revealed not by reason but by the play of emotions upon the human organism. Science is founded on the conviction that experience, effort and reason are valid; magic on the belief that hope cannot fail nor desire deceive. The theories of knowledge are dictated by logic, those of magic by the association of ideas under the influence of desire”. [2]
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- Copyright © 1971 Fédération Internationale des Sociétés de Philosophie / International Federation of Philosophical Societies (FISP)
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