[Recent crisis of psychiatry in the context of modern and postmodern science]

Abstract

Introduction: We have investigated the recent crisis of psychiatry in perspective of the last two centuries of its history. First and longer part of this period belongs to the Modern era. The second part beginning in the sixties of the last century is the Postmodern era, the one we live in today. We have pointed out that the recent crisis has not come by accident but as one of the several changes characterising our transition into the era labelled "Postmodern".

Methods: The crisis of psychiatry was analysed in respect of the development of science and in social context. We focused on psychiatry and science and their interconnectedness in their historical articulations. A way out of the crisis of the current era can be found also with the use of historical methods.

Results: Science is changing both in respect of its quality and its role in our age. Taking into consideration normal and post-normal science, we differentiated two additional generations of science, pro-normal science and perato-scientia, in the most recent history. On the one hand, psychiatry serves as a paradigm for the conceptualisation of contemporary science. On the other hand, as an up-to-date science re-conceptualised partly according to its own paradigm it may find a way out of its own crisis. The many facets of the current crisis were demonstrated by analysing recent developments of the Hungarian health politics. Concerning this topic we adopted the term "economicity" elaborated by us earlier. We found that psychiatry operated by the hegemony of the rules of economicity might become a relay station for selecting patients to be thrown away as human garbage.

Conclusions: This catastrophic outcome may occur if a political system is organized purely by economicity rules without either historical responsibility or local solidarity. However, up-to-date trends of scientificity as shown by pro-normal science and perato-scientia guarantee a radically different course for psychiatry. Following this course, which is consistent with the insight into the common lot of normal and abnormal people, psychiatry should be guided also in the future by the categorical imperative of therapy.