In this post we'll look back at the reflections of an author as Fernando Hill, whose work we think the most interesting and highly recommend it. The reflection to which we refer to stops on the hermeneutic study of psychosis, which, given the current tyranny of positivist model, provides a breath of fresh air to meet with psychosis and psychotic. Hill is the author of an article entitled News hermeneutics of psychosis, published in 2002 in the journal Freni. Then transcribe an extensive summary of the report, citing mainly his words literally because, obviously, we could not improve at all. Yes, we point out in bold we highlight certain lines.
Hill begins by noting that the word hermeneutic is useful to reclaim the traditional psychiatric theory inspiration that has always found in knowledge of human sciences. Traditional source of our discipline that scientism rampant in recent decades has been neutralized or disguised in a thousand ways. From its origins in the early nineteenth century, psychiatry has been dominated by the confrontation of two current matrix, which favors a psychic or spiritual framework that makes it a medical model, more material and biologist. Both have shared a stage and either allowed to have more or less booming, according to times and places, without actually ever move entirely to its opposite. The psychiatrist, in fact, has always been a divided man bound to a double instruction, medical and humanist. In the long run that first fought for inclusion and then for the maintenance of psychiatry in the field of medical science, there have been times higher prevalence of current spiritual or material, but never, not even during the great turning organismic, 1850 , had reached an exclusive domain thorny and oppressive as the present. Psychiatry, which had always been risky in many humanities fields (ethical, philosophical, aesthetic, historical, literary, linguistic) with which outlined its peculiar identity within medicine, has become, after his last shift biological, uncompromising and isolationist .
Colina goes on to say that it is known that the notions of humanistic study of psychosis can not continue to obtain their main food of phenomenology, whether it merely descriptive or more structural and genetics, as befits the existentialist bias . Hermeneutics, however, represents contemporary philosophical chain extension of phenomenology and existentialism. Hermeneutics, along with Marxism and the analytic philosophy, are the three main streams of twentieth century philosophy, each of which has influenced differently in psychiatric practice. Current Marxist social and ideological criticism, analytic philosophy in the field and behavioral pragmatist, while hermeneutics has emerged as the human wealth of psychiatry. The knowledge from the human sciences turn their attention to the psychosis only near the empowerment discourse of the subject, so that the branches of the language, history and desire, their three vital tips, have become the main ingredients hermeneutics that repeatedly been demanding the attention of psychiatry. It is appropriate to recognize that Freud's work has so shocked the examination of concurrent mental processes in psychosis, there is no way of circumventing influence if it is not restricted to the counter inside our concepts of optics biologist. As Hill says, Freud concentrated, as in any other author, hermeneutical issues that have been nurturing our study. From the analysis, the hermeneutic perspective has fertilized the knowledge of the psychopathology of psychotic.
Psychoanalysis is the main entrance which hermeneutics has entered the domain of mental illness. Foucault, despite his reservations about psychoanalysis, Freud argued that the discipline was the main bridge between the positive sciences and human. However, psychoanalysis, psychological conception and his method, does not exhaust the penetration of hermeneutics in psychiatry. The hermeneutic challenge of this forces us to confront the biological paradigm of illness but also forces us to try to shake off some of the excessive reliance of psychoanalysis, especially when it becomes categorical and prone to interpretation stubborn and intimidating though, as the Hill himself says, this hint of bias is probably quite unfair to discipline Freudian psychoanalysis as it has now become the most eminent subject of psychopathology and where psychiatry will return to find their sources when they awake from their slumber physiological. But within hermeneutics, psychoanalysis, for its ambition, challenge and its interpretive power, represents the risk of psychologism that threatens us from within the family. One might think that under this psychological risk must also enter at the same height all forms of cognitivism and behavioral sciences but in fact they belong firmly in the positive paradigm so not a domestic concern as with psychoanalysis. On the subject behavior, admittedly, not real blood runs . Science behavior can be used for education or rehabilitation of the psychotic, but not for the clinic in the strict sense, which tightens its presence and therapeutic understanding between the science of desire and a word as the proposed offering psychoanalysis. The challenge of hermeneutics in psychiatry lies in its links with psychoanalysis, in the effort to assimilate and integrate without abandoning pass it or exceed it where possible or desirable.
Psychiatry claiming membership in the medical sciences. Spurred by fear of psychiatrists to form a lower class of doctors, rigidly ran the organic origin of alienation and asserted its jurisdiction from the beginning expert to identify the ills and certify its authenticity . So, forced from the outset the role of the legal aspects of the profession, which tried to promote itself. Later, when the legal significance of its magnitude lost reports, and had gained the ability to adapt to the medical model, though not without encountering continuing difficulties preventing mental illness simply assimilate to the traditional pathology. Obstacles that apparently seem to have disappeared now when we live a romance of psychiatry Medicine with an intensity almost unknown. Although these loves change, induced by personal interests (identity, resistance subjective intellectual laziness), social (prestige, recognition, ideology) or materials (profits, market pressure), psychiatry has run out of room to breathe. Positivism, pragmatism, empiricism and naturalism and subjugate the choke. Only biological psychiatry is like a wooden iron holding unsound, cut off the interpretation and forces us, without sufficient justification, to the fallacy of abnormal phenomena naturalize more than normal, as if sadness and indolence, grief and reluctance, gain range physiologically by the fact become depressed and inhibition, that is, very sad and very lazy, in great sorrow and great reluctance .
Sitting this framework, Hill said that hermeneutics is the interpretative body of knowledge that lead us to study mental disorders without segregating the subject, preventing forget it and, worse still, that forget the forgotten. The mental condition is inseparable from the problems of the subject and its study requires analogies, legality and which do not correspond entirely to the scientific model, which enables us to not try to be guided only by the ideal of the natural sciences. Knowing also that someone will come soon to say that the distinction between positive and human sciences is over, but without pointing out what is the sense of overcoming. Do not forget that the dogmatic attitude disturbing and Jaspers and denounced as "brain mythology, grand remains active in the" Decade of the Brain "or under the new air of" genetic mythology. " This observation is not to deny the advances of neuroscience, but is resolutely opposed to a conjectural neurology clinical practice aside pending a promising future. The danger of brain mythology expectation is that their findings, usually distant, stop apologizing psychopathological interpretation in the comfort of their plausibility and the imminence of a hypothetical promise. Hermeneutics rebels against this passivity in waiting, allowing the freedom to suspend the biological hypothesis, clinically as something dispensable, where not already established, thus attempting to assert the virtue of modesty the Promethean arrogance science.
Given these considerations, it is time to return to the concept of psychosis in order to appreciate what the conditions are sound, before any psychopathological consideration, that the interpretation we can propose. Since the beginning of the history of the term, which we mentioned briefly in previous lines were at stake, either explicitly or implicitly, that constitute the concept four questions: what is the identity of the symptoms, what causes it, how many there are and psychosis how they differ from the neuroses. And, over time, questions have not changed. As we understood a psychosis deep and serious mental disorders, almost irreversible, we do not know the difference good old generic term for madness. We do not know the exact extent of the disease to functional similarity, since among the most recognized there are disturbing similarities and transitions, but also know its not an organic or whether such support range is causal or not. Differentially examines the neurosis psychosis because they seem far more remote from the disease category and, in principle, more easily understood. So there are four spaces open for Hill relationship: the psychosis and madness, psychosis and illness, from psychosis to herself as to its uniqueness and the multiplicity of psychosis with neurosis.
The first scenario includes all the problems that suggest about their relationship psychosis with the melancholy old, who is almost the same as referring to the relationship with the general idea of \u200b\u200binsanity. The original medical-philosophical concept of madness was weakening under the paradigm of mental alienation, from Pinel, where the insane, old fool, he was a sick but you could say that even without disease, but the prospect does not languish completely until the triumph of the ideology-P.Falret J. nosological. However, the complete disappearance of the link is impossible to grant because we persist in a variety of irrational behaviors that are not easily reducible to the criteria of disease and yet inextricably intertwined with it in the forms of error, injustice and incontinence. There is bigotry, anger, faith, dogmatic belief, the excessive severity, hesitations circumstantial reality, blind obedience, the conceit, even the vanity of sorrow. The reason and unreason are not mutually exclusive but are intertwined as indivisible. Always need to return to air within the psychosis of the old madness, restoring in this way as suggested by Foucault, a healthy look to the past to get immediate repercussions today. Just stop and think historically, that is, thinking every time recognizing their own perfection and the way psicotizarse to meet again in this with the resonance of distant disease and mellow soul modulations of alienation, and made safe by memory and the study of positivist however.
On the other hand, claim psychosis always a decision regarding your hypothetical organic causation. No study of psychosis may not have to address the importance, causal or not, its biological support, and always analyze symptoms including this perspective problematic. However, the causality is in some sense a corset collapsing psychiatric thought, because the fact that ducks with somatic causation there are at least other three categories that should be taken into account: the genesis , which questions the relative germination of psychosis, that of reason , where we observe the social and historical influences its development, the origin of , which takes us back to that place without language or desire, to that thing itself, which forges psychosis from moving drives disintegration. Cause, origin, cause and origin bend and overlap in a continuous flow is impossible to steer or refer to a single address, as the hegemonic paradigm aims. Psychosis, at last, after all, is the catastrophe of the subject emerged from a combination in unknown proportions, of biological constraints, familiar numbness, pressure gross socio-historical and death drives.
Following the four points previously raised by the author, is the moment to draw the internal borders that separate a psychosis or other unit to establish the principle that binds. Much of psychopathological studies have focused on the endless task, as soon separates rational humoral psychosis, subdivide the rational and paranoid schizophrenic, or allows a reversible traffic to other shapes within a common unit that breaks with the logical model of gender and species, they may be the one and the other at the same time. The stream of studies in this section qualifiers have their accommodation. Of its clinical importance can not be doubted, but they too have produced hypertrophy who have distorted psychopathology. Consider if the emphasis identifier current psychiatric theory, more aware of encrypting the decryption condition that any psychopathology, evoking curiosity in his accentuation paradigm traffic was between the interests of Pinel and Esquirol in the treatment and the His disciples, as Falret, for identification. As quoted by Hill, Buchez in the early nineteenth century, commented jokingly that "Alienists were more or less like the rhetoric: when think they have finished their studies, write a tragedy and rhetorical alienists make a classification."
On the other hand, the psychopathology of psychosis requires the study of differential symptom of neurosis. Whether through the strategy of listing the symptoms and segregate them into primary psychotic character, or analyzing defenses, distress or references to other, no such study possible without comparative look at the core of psychopathology.
Commented
these four points that draw a basic outline of psychosis, it is time to return to the role of hermeneutics in this area, which is summarized in two contributions: the first is economic and can be considered in the payment of concepts, ideas and methods that can enrich our theoretical heritage, aiming to psychiatry may learn from time productions, the other, which is what interests us at this time rests on the task of examining the preconditions that the perspective imposed on any study of psychosis and is based on the analysis of the theoretical principles that support to psychopathology. Since the first appearance the term "hermeneutics" in the seventeenth century, means the science or art of interpretation. And the object of interpretation that hermeneutics offers to psychiatry, in place of sickness, is logically the subject's psychotic. In continuity with the ancient notion of madness and, therefore, with medical and philosophical traditions, hermeneutics rescues us from the circle of the disease, precedes the biographical in nature, and we proposed, under a broader view, attention the psychotic mind and his effort to subjectivity. He is interested in the language of psychotic and linguistics who lives by his background historical, for his role in society either individually or as a group, by the strategies of his desire, rationality and the sublime displays of his spirit, as well as the crisis affecting their own efforts and self-healing to them. All inseparable aspects of the disease but, as opposed to strictly medical model, do not meet both the broad treatment as the treatment with which we try the psychotic. This curious about the mentality and the Treatment common be the first of the records themselves hermeneutic.
The second register may seem less convincing, but I understand the nuts is not only to play him more or less successfully to capture the significance of his speech or his actions. The soul of hermeneutics lies, above all, to accept the possibility that the other may be right, but this one is a psychotic alienated. This approach extends the acceptance of a purely rational and reasonable to the mad reasonable condition. Not only rational, therefore, a quality that is difficult to challenge (remember the crazy razonantes), but fair and reasonable thinker. His success is not only the possibility of a sharp wit that often feeds our comments, but his tact and good hand in knowledge of himself, his reason and circumstances . Esquirol complained "that no one has learned to read in the thinking of these patients", cheering and encouraging us to read the soul of the psychotic as if it were a document. For hermeneutics, psychosis is a manuscript original of which is always true that its interpretation . In a way, we can not understand the psychotic better than he does himself. For hermeneutics, rather than a disease psychosis is an extreme experience, a drunken psychotic Dionysian experience having on occasions infernal beauty. In psychosis experience a truth that is not achieved by other means. We need to study the delusional view of hermeneutics and maintain a certain reverence to it. Attitude that does not negate the opposite perspective, the view that the psychotic, despite its well-earned reputation interpreter, including constant interpreter of reality, half of suspicion, half of necessity to provide themselves with respect, it is a little hermeneutic interpreter . Away from hermeneutics as far as it disregards the finitude and contingency of interpretation, acting in his vision as if he had said everything and was in possession of a full linguistic universe. The hermeneutical principle that understanding is always understood otherwise and even an opposite way, falls into disrepute before the psychotic, who clings to an unshakable knowledge that can not get rid minimally desirable alien to endless self-correction. As Gadamer said: "Mal hermeneutics is that you think would have the last word."
From this perspective, us to not only understand the psychotic but understand him. Hermeneutics is the science of dialogue and questions. In its consideration the comprehensive horizon can only be dialogic psychotic, although the psychosis was precisely in a very particular bankruptcy conversation that turns into a lonely logic of propositions, while his conviction, on the other hand, inhibits and prevents the possibility to ask that everything becomes questionable. For this reason, madness can not be foreign to hermeneutics, especially when in his specific proposal for dialogue on the assumption that there is always a misunderstanding constitutive. In fact, in their study gives more weight to the concepts preconceptions, prejudices than the trials, it said no to that. According to Gadamer: "prejudices of the individual are the historical reality of his being in a much greater extent that their judgments." Similarly, adding that what is stated not all, because "that not only becomes expressed in the word you can reach." This program, however, is not betting on a mystical or ineffable silence, but stressed that the study of false agreements and false assumptions can be more important to understand to decipher the actual agreements. Hence the importance of acquiring the disease development of thinking to the study of knowledge, and evidence that psychotic budgets are set in the heart of all understanding.
Finally, hermeneutics reminds us of the moral origin of psychiatry and claims the need to maintain this link in parallel with any natural progress of nature. Psychopathology is ethics. It is a study and practice of accountability. And not only legal responsibility, as he accompanied and encouraged the psychiatric in origin, but the care and self-knowledge that each one is due to oneself. Psychiatry is still a moral discipline, as it was since his birth, besides being a medical specialty. Away with this tone hermeneutic model disease is psychosis reintegrate within the culture. Responds the purpose of restoring psychotic experience the old area of \u200b\u200bunreason and madness. Try placing the psychosis in the same spirit of inclusiveness that guided the medical-philosophical alienism Pinel, which was intended Hippocratic, methodical, thorough and observant but not reductionist. Not be understood in that return to relinquish the current psychiatric canon, nor does it seek to revive the moral treatment or re-apprehend the subject from the theory of the passions that the pioneers of psychiatry inherited from the Hippocratic tradition. Freedom's imposed isolation of moral treatment, as the word has shifted to the role of obedience and strategies of desire for restraint, restraint and moderation of passion. The aim is to aerate the concepts of psychiatry, liberate the ideal tasteless biologist and return to resume treatment of the madman behind the disease.
