Manifesto of liberal psychiatry

Psychiatry is the medical discipline that covers the clinical space of mental illness in its various expressions.It takes account of man in his global nature, body and spirit, and his subjectivy, his life and his history, at the heart of his affective and social network

In the interaction of the biological and relational, psychiatry considers a set of complex causalities which are irreducible to only objective, quantifiable parameters. For the same reason, the practice of psychiatrist cannot be satisfied with the usual medical model, to confine itself to established supposed norms, even less to lose itself in certain current scientific trends. It gives priority to return to the patient his freedom to live, to love, and to establish an open and creative relation with the world, registered in the social bond.

The history of French psychiatry for a half-century is characterized by a continuous fight against confinement and exclusion, a persistent desire for disalienation.

The impetus of liberal psychiatry bears witness to the first founder of this dynamic of which it constitutes the one of the major instruments.

The psychiatrist, in his liberal exercise, intervenes precisely with his characteristics of independence, of autonomy, of personal responsibility in deciding on and implementing therapeutic work, of strict confidentiality of the relation. His intervention answers exclusively to the request of the subject who retains at each step his freedom of choice and his bearing, of which the payment for the treatment constitute the one of the guarantees.

The availability, the establishment of the psychiatrist in the city and his accessibility - including economic - facilitate the expansion and the precocity of the demand for care, which also increases the effectiveness of the latter with respect to the risks of decompensation, of loss of autonomy, and of social dysadaptation

The psychiatrist is concerned with what he is as well as with what he kwows; he is trained and continues to train himself in a permanent, freely agreed upon, and organized inter-evaluation and resquestioning.

Confronted with the originality of each situation of suffering in the repeated surprise of the encounter whith the patient, admitting the existence of an unknown always to be deciphered, the psychiatrist must always preserve his capacity for innovation in order to keep himself as close as possible to the reality of each one.

To try to confine him within standardized procedures and intangible models only would compromise seriously the very means of his efficiency.

We, liberal psychiatrists, cannot compromise on what the very quality of our care is based.

Text written on April 10th, 1995.