Lorient - Journées Nationales 2001
Profession: psychiatrist
Some professions - psychiatrists ? - became obsolete and must die out. Their remains are shared between, reunification of neuropsychiatry, the general and neurological medicine in charge of the body, neurosciences, psychotropic substances and the psychology, psychoanalytic or not, that would be granted with spirit, psychotherapies, existential and metaphysical uneasiness. Or else: psychiatry should be done and undone by everyone, harrow against the impostor who would make a " job " out of relieving psychic suffering! Denial of a specific psychiatric act.
Successors of asylum clinic, doctors psychiatrists only established themselves as such once they had abandoned in May 1968 their neurological references and their believing that anxieties and psychic sufferings originate in a somatic dysfunction. Psychoanalysis, existential phenomenological requirements revolutionize the conception of the subject by hoisting it to the level of a dynamic psychic structure, a non-neutral one in the development of its destiny which becomes a story, and as such, likely to change, a base for any psycho-therapeutical project.
Child psychiatry and some pedagogical progressivism are triumphant. Possible limits laid down by such a concept as the human nature are criticized and considered a reactionary nonsense.
However, today Changeux can claim that mental, social and cultural objects evolve, certainly to their own advantage, but in accordance with constraints of neuronal organization. François Jacob then announces that genomic findings will not be politically correct, and any kind of humanism will be exploded. Algorithms and the mortification of the living, that is necessary to get them, would be man’s future.
This will be of consequence for the psychiatrist in charge of evaluating his/her patient, once all affects are evacuated. Another expert, socially considered as more expert, will in turn evaluate that psychiatrist according to specifications required by the public opinion regarding a profession performed from now on in a transparent network by various professionals who became inevitable, supporting, competent, efficient, maybe interchangeable interlocutors who are expected to relieve and even eradicate all psychic, and why not social, suffering ?
Neuropsychiatry would enable to build up a specific clinic approach and an ethics supported by medicine. Psychology, analytical or not, would like to be a specific clinic and ethics.
At the dawn of the 21st century, is there a nosography that psychiatry may still rely on? Can the profession of psychiatrist persist in promoting a singular clinic which would justify just as singular a practice? It should be reminded that, classically the clinic is defined as practicing at patient’s bedside. In this way, it collects all characteristic signs from the direct observation of this patient and does not select only those signs that are likely to validate a pre-existing theory, dismissing metaphysics and ideology. "Doctors, free at last from theories and chimeras, agreed to approach the object of their experience, for what it is and with the purity of an unprejudiced gaze" (Foucault).
Is the object of psychiatry the one that we ourselves defined, with our experience or/and the one that the " civilized community " (Freud) assigns to those whose profession is psychiatrist ?