Psychosomatic Medicine 14:10-17 (1952)
© 1952 American Psychosomatic Society

A Critical Analysis of Some Current Concepts in Psychiatry

Implications of a Monistic Mind-Body Concept for Diagnosis, Research, Etiology and Treatment

¹ National Institute of Mental Health, National Institutes of Health, Public Health Service. (Research Branch, U.S. Public Health Service Hospital, Lexington, Kentucky.); Annual meeting of the Kentucky Psychiatric Association, Louisville, Ky., September 25, 1950

Acceptance of a monistic concept of Mind and Body entails the recognition of a number of implications which, at some points, are in conflict with current usage of certain terms in psychiatry. From a monistic standpoint, the terms "psychic," "organic, " "physiologic," "biochemical," etc. denote only different frames of reference which may be used to describe the organism in its environment. One is no more fundamental than any other, and phenomena described in terms of one frame of reference do not cause the phenomena described in any other. Conclusions derived from data in one frame of reference cannot be proved or disproved by comparison with data derived in another frame of reference, since the configuration of variables which these sets of data measure, are different in each case and overlap only to variable extents. It is therefore of utmost importance in psychiatric research to go beyond the determination of psychophysiological correlations and to investigate the "common denominators" which account for the correlations.

Diagnostic terminology in psychiatry should be purely descriptive, and regardless of the frame of reference in which it is expressed, it should not imply anything regarding etiology. When etiologic factors are known, they may be indicated with an adjective indicating whether such are meaningful or not. It should be recognized that "etiology" is always multiple; temporal relations between contributing factors may be indicated by use of such a term as "detonator" or "precipitating" factor.

From the monistic standpoint, treatment in psychiatry must be pragmatic, since the choice of a particular technic bears no relation to the frame of reference in which the condition to be treated is most adequately described. With the application of a multiplicity of technics in many frames of reference to research in psychiatry, new methods of treatment may become available which may be used to alter the organism so that its reactivity to stressful stimuli of any kind will be improved.