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Psychiatry and Psychoanalysis: the Hedgehogs

The Letter, Issue 23, Autumn 2001, Pages 1 - 21


Hubert Van Hoorde

Car l'exactitude se distingue de la verite, et la

conjecture n'exclut -pas la rigueur. Jacques Lacan[1]


A century after the appearance of psychoanalysis in the field of the medical clinic and science its position is not easy to define: received with enthusiasm, it is also equally enthusiastically rejected and maliciously misunderstood. To be more precise, in psychiatric circles it is 'good form', often on the basis of an extremely simplistic, not to say caricatured conception of psychoanalysis, to deny its right to exist in the clinical field and to relegate it with well-meaning misunderstanding to the 'general culture' box in which, to the right-minded scholar, literary theories, hermeneutics, philosophy, theology and suchlike belong. Nevertheless, general psychiatry makes eager use of a watered-down version in which a few vaguely recognizable psychoanalytic concepts are to be found and for a number of patients - sometimes as the last remedy - the address of an analyst is dug up out of the drawer. Yet psychiatrists - often the same ones - continue to smilingly cling to the contention that psychoanalysis has been dead and buried for a long time and its only value is as an antique from our general cultural heritage.

This is a two-fold mistake: on the one hand a valuable - if applied conscientiously and with knowledge! - clinical instrument is debased; on the other hand the chance of building the foundations of psychiatry as a clinical science on a (scientific) theoretical basis is being rejected. With regard to the latter, today for the sake of ease only its embedment in the biological substrate, which displays lax reductionism, will be considered.

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