Reflections upon "Paradigm Shift" (in Psychiatry)

"Psychiatry beyond the current paradigm" was published more than four years ago. It outlined how professionals consider "mental health difficulties" differently. There was little dissent, but the pace of change is slow. This... [ view full abstract ]

"Psychiatry beyond the current paradigm" was published more than four years ago. It outlined how professionals consider "mental health difficulties" differently. There was little dissent, but the pace of change is slow. This symposium reflects upon two areas where scientific findings point very clearly to the need for conceptual review, and a lesson from history. 

Hugh Middleton: Closer attention to relationship, and an historical parallel. 

Most instances of so-called "serious" mental health problems are associated with developmental relational difficulties. Numerous studies identify associations between other forms of relational disturbance and disabling emotional distress. Nearly a century of psychotherapy research has to conclude that outcome is largely determined by the quality of therapeutic relationship. Social exclusion and stigma are the most disabling consequences of living as someone with a psychiatric diagnosis.

These have powerful implications that are proving difficult to digest. Kuhn's Structure of Scientific Revolutions offers an explanation. The facts speak to greater ontological significance of relationship or interconnections than they are generally afforded. This provide an organising principle not yet widely articulated. For medics, nineteenth century surgeons’ eventual recognition of bacteria’s role in infections offers a parallel.

Tom Stockmann: Critical Psychopharmacology. 

For centuries drugs have been used to alter mental states and dull emotional pain. The current talk will explore the altered mental states produced by prescribed psychiatric drugs and look at the pros and cons of using them in situations in which people are experiencing mental distress or manifesting unusual or disturbing behaviour. It will also examine how the actions of drugs in mental disorders have been misrepresented to reinforce narrow, disease-based models of mental health problems, and how their use might be considered differently. There will be an emphasis on the medications referred to as anti-psychotics, and the increasing focus on the uncertainty surrounding their long-term use.