Introduction: Psychiatry at a Crossroads

Kirmayer, Laurence J.; Lemelson, Robert; Cummings, Constance A.

doi:10.1017/cbo9781139424745.004

Cited by 13 publications

(17 citation statements)

References 127 publications

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“…It differs from anti-psychiatry in some ways and is at least similar in its recognition of the need for change in psychiatry. Kirmayer et al (2015) note how the critical psychiatry literature builds on anti-psychiatry. As they say, ‘This renewed critique emphasises the dehumanisation of care that has come from a narrow, reductionistic medical model and advocates for the central place of the voice and agency of people with lived experience and the key role of community-based interventions aimed at recovery’.…”

Section: Foundations Of Critical Psychiatrymentioning

confidence: 99%

Towards a more relational psychiatry: a critical reflection

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2021

BJPsych advances

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SUMMARY Criticism of the biomedical model of psychiatry that regards mental illness as brain disease has been labelled ‘anti-psychiatry’. Critical psychiatry arises out of so-called anti-psychiatry, but has additional roots in transcultural psychiatry, its alliance with psychiatric user/survivor groups, and the methodological critique of the neuroscientific basis of mental health problems and psychiatric treatment effectiveness. It is not opposed to psychiatry as such and argues for a person-centred shift for practice and research. This article discusses how a more truly biopsychosocial model, which critiques the biomedical model to produce a more relational practice, is needed not only for psychiatry but also for medicine in general.

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Section: Foundations Of Critical Psychiatrymentioning

confidence: 99%

Towards a more relational psychiatry: a critical reflection

Double

2021

BJPsych advances

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“…Psychiatric practice employs multiple ways of knowing that have been characterized as verstehen (understanding), erklären (explaining) and einfühlung (empathic, embodied co-presence/being/knowing) (260). These ways of knowing have different epistemic bases and constraints and are sometimes in tension, conflict or competition.…”

Section: An Ecosocial Systems Approach To Person-centered Clinical Pr...mentioning

confidence: 99%

A cultural-ecosocial systems view for psychiatry

Gómez-Carrillo

Kirmayer

2023

Front. Psychiatry

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While contemporary psychiatry seeks the mechanisms of mental disorders in neurobiology, mental health problems clearly depend on developmental processes of learning and adaptation through ongoing interactions with the social environment. Symptoms or disorders emerge in specific social contexts and involve predicaments that cannot be fully characterized in terms of brain function but require a larger social-ecological view. Causal processes that result in mental health problems can begin anywhere within the extended system of body-person-environment. In particular, individuals’ narrative self-construal, culturally mediated interpretations of symptoms and coping strategies as well as the responses of others in the social world contribute to the mechanisms of mental disorders, illness experience, and recovery. In this paper, we outline the conceptual basis and practical implications of a hierarchical ecosocial systems view for an integrative approach to psychiatric theory and practice. The cultural-ecosocial systems view we propose understands mind, brain and person as situated in the social world and as constituted by cultural and self-reflexive processes. This view can be incorporated into a pragmatic approach to clinical assessment and case formulation that characterizes mechanisms of pathology and identifies targets for intervention.

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“…The closer a medical discipline is to the quantifying, nomothetic natural sciences, the less directly powerful are social or cultural influences on it. Or put another way: if questions about the relationship between the individual and societyfrom material (neuro)biological processes on the one hand to subjective ones such as experience, personal autonomy and responsibility on the otherbelong to the core of a medical discipline (and this is especially the case with psychiatry), then a network of at times conflicting facts, interpretations and values emerges which requires an ongoing, cross-perspective discourse (Campbell et al, 2011;Kirmayer et al, 2015;Zachar 2000). Examples include the controversial debates about the psychiatric concepts of illness, diagnostics, and the justifiability of coercive medical measures for people with a mental illness in urgent need of treatment but who are not ready to accept this (Hoff 2019).…”

Section: Introduction: the "Place" Of Forensic Psychiatry In A Scient...mentioning

confidence: 99%

Psychopathological knowledge and methodically sound diagnostics are core elements of forensic psychiatry

Hoff

2022

Forensic Science International: Mind and Law

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Introduction: Psychiatry at a Crossroads

Cited by 13 publications

References 127 publications

Towards a more relational psychiatry: a critical reflection

Towards a more relational psychiatry: a critical reflection

A cultural-ecosocial systems view for psychiatry

Psychopathological knowledge and methodically sound diagnostics are core elements of forensic psychiatry

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