Allgemeine Psychopathologie

Whereas antipsychiatry left the medical concept of disease and medical institutions intact at the turn of the century, this sector was fiercely called into question in the subsequent reform efforts. The disclosure that an argumentation in terms of pure, exact science was questionable encouraged these reform efforts and cast doubt on the objectivism dominant at that time. However, in the clinical domain, it also led to a profound crisis of legitimation and thus to a crisis in psychiatry’s ethical self-conception. The absence of an integrative perspective comprising clinical theory and practice became obvious. In the future, the basic anthropological preconditions involved in a given clinical situation may serve as a guideline.

Section: Resultsmentioning

confidence: 99%

The Ethical Crisis in Psychiatry: Consequences for a Comprehensive Diagnosis and Therapeutic Practice

Kick¹

1999

“…An often quoted passage of Jaspers' [1] General Psychopathology notes, 'We apply the name ''true delusional ideas'' only to thoses delusional ideas that originate from a primary pathological experience.... In contrast, we call ''delusion-like ideas'' those that are, in some way, understandable by other psychic processes, and that, therefore, may be psychologically traced back to emotions, drives, desires and fears.'…”

Section: Understandable and Nonunderstandable Delusionsmentioning

confidence: 99%

“…We must not, nevertheless, forget the two sides of understanding in psychopathology: the 'static' comprehension focusing on single experiences and the 'genetic' understanding centered on the emergence of one psychic state from another, the flowing into each other of experiences. As Jaspers [1] wrote, the psyche 'moves in a concatenation of experiences, in sudden dialectical transformations'. It so happens that the tool for genetic understanding has upset the criteria used to define nonunderstandability in delusional situations, since it underlines the relationship, only at times graspable, between personality, situations, emotions and delusions.…”

Section: 'Understandable' and 'Nonunderstandable' Is Not A Dichotomymentioning

confidence: 99%

“…At the root of this attitude is the subject's awareness of being the author of his own temporary horizon of truth. This awareness is rooted in the degree of knowledge of the 'ego activity' [1] that can be found in the creation of meanings for oneself and the world. In contrast to delusion, we find an 'objective' prevalence of passivity.…”

Section: Towards a Phenomenological Definition Of Delusionmentioning

confidence: 99%

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Dysphoria: A Key for ‘Understanding’ Delusion?

Ballerini

Ballerini²

2000

The ‘nonunderstandability’ that traditional psychopathology attributes to ‘true’ delusion does not have a clear demarcation line, but, rather, it is a continuum of various delusional experiences. The attention paid to emotional situations and, specifically, to dysphoria, often contributes to making the delusional phenomenon, and, above all, its persistence, more understandable. A positive correlation between productive psychotic symptoms and the dysphoric mood often prevails in delusions with unfavorable prognoses.

“…It is evident that psychiatric diagnosis depends almost exclusively on the experience of the patient, a fact which Jaspers [4] emphasized in his basic work General Psychopathology. Kraus [5] claims, together with Häfner [6], Blankenburg [7] and Tellenbach [8], a 'person-oriented, comprehensive diagnosis which comprises the specific modes of experience and social behavior of the patient and his relation to himself and to the world'.…”

Section: Introductionmentioning

confidence: 99%

Ethics in Psychiatric Diagnosis from a Psychodynamic Perspective

Schmolke¹

1999

The diagnostic evaluation, representing a fundamental activity in psychiatric practice and research, requires a particular ethical responsibility on the part of the clinician. The author proposes the following aspects as being important for a comprehensive and ethically sensitive diagnosis: (a) incorporation of the patient’s subjective perspectives and understanding of his/her disease, (b) consideration of the patient’s quality of life, (c) assessment of the positive aspects of health, (d) awareness of group-dynamic and psychodynamic factors in the diagnostic situation, (e) the clinician’s professional competence, value orientation and personal identity, (f) therapeutic optimism as a basic attitude. The patient’s active involvement is emphasized since he is the real expert as far as his individual, social, religious and ethical needs and values are concerned.