Paris - Journées Nationales 2004
The words of Psychiatry
Semantic shift, revision of the clinic
Though it uses the neuroscientific reference to prove its therapeutical efficiency, our act always makes sense when it questions the inter-subjective relationship, the humanly experienced, and the unconscious horizon. Undoubtedly, our useful wish to produce scientific knowledge requires that we simplify in order to model. Does this necessarily imply that we subscribe to a reductionist Esperanto, thus agreeing to the hegemony of a speech that gives up the pertinence of all others ?
Though social evolution changes the therapeutic demand, the history of psychiatry is in fact closely akin to that of its concepts. The news caricature theoretical confrontations at the risk of wasting the quality of care and discrediting the history of our discipline at the same time. Today psychiatrists fear that their practice may be deskilled and that their nosological tools may lose their meaning. The fashionable clinic, as if it were a social consumerist demand, as well as the quest for lower costs, lead to a targeted, short-term response: "just do it" the commercial says !
In a context of simplifying serialization, our various, contradictory models lose their connexions and float in an empty space where metaphors get lost, for the benefit of a multi utilitarian equipment. Even ethics and deontology are in danger of becoming satellites far away from the daily practice and the Subject, thus for the benefit of a filling answer to the zapping of demands. If one speaks of "depression", according to the common use, is that a syndrome, an illness ? Does this flattened label tell the truth about a personal and social suffering ? Would the tragic of anxiety be then reduced to the ordinary of "stress" ?
Are we not supposed to hear and think so that we can bring relieve ? Could we possibly make a confusion between an automatic prescription, or even a mere "psychology of happiness", and the social, family, medical and psychotherapeutic support provided to a patient … all along ?
If our vocabulary, popularised by media coverage and conceptual slips, forgot all epistemological reference points, we would then share with our patients only a simplified "newspeak", conducive to misunderstandings. Like the rampant de-metaphorization of the world, that is said to have turned transparent, would restrain psychic life to the reality of the body and to a ciphered code, outside bonds, thus outside meaning.
In “1984”, the totalitarian authority commands: "Ignorance is strength " ! With his warning, does Orwell agrees with Freud who thought that " conceding on words means conceding on things" ?
So, what about the words of psychiatry … ?