Merger of Psychiatry, Neurology
In the November 21, 2008, issue Stuart Yudofsky, M.D., is quoted as proposing that psychiatry and neurology be “combined into one discipline” and stating that “[i]t would obviate the mind-body dualism that is the source of all stigma against mental illness, and against us [as psychiatrists], and it would reestablish psychiatry as a medical specialty.” Do psychiatrists really believe this combination of historical amnesia and denial of their long record of human rights abuses?
From its origins more than 300 years ago until well into the 20th century, psychiatry and neurology made up a single discipline, called“ mad-doctoring” and “neuropsychiatry.” Consider the following:
1884: Theodor Meynert (1833-1892), neuropsychiatrist: “The reader will find no other definition of 'Psychiatry' in this book but the one given on the title page: Clinical Treatise on Diseases of the Forebrain. The historical term for psychiatry, i.e., 'treatment of the soul,' implies more than we can accomplish, and transcends the bounds of accurate scientific investigation.” | |||||
1889: Carl Wernicke (1848-1905), neuropsychiatrist: “The medical treatment of mental patients begins with the infringement of their personal freedom.” | |||||
Emil Kraepelin (1856-1926), Adolf Meyer (1866-1950), and their colleagues were all neuropsychiatrists, sharing the assumption that mental diseases are brain diseases. | |||||
Inasmuch as psychiatry is taught in all medical schools as a medical specialty, Dr. Yudofsky's reference to “reestablish[ing] psychiatry as a medical specialty” seems redundant, to say the least.
Lastly, Dr. Yudofsky ascribes “the source of all stigma against mental illness” and psychiatrists to “the mind-body dualism.” I disagree. It lies in the psychiatrist's fundamental legal-social mandate and practices—coercion and excuse making (civil commitment and the insanity defense).
