Book Boundary disputes

摘要

It's not easy being a psychiatrist, and I should know because I am one. On the one hand, people come to see us unhappy because their neighbours are vile, lonely because their marriage is without affection, or worried that their child is about to be excluded from school for behaving badly. We sympathise, but after the consultation will inform the general practitioner that there is no evidence of mental disorder, and recommend a social worker, solicitor, marriage guidance counsellor, or some classes in more consistent parenting. Yet, on the other hand, those who think that psychiatry is about more than managing people with well defined disorders, such as psychosis, major depression, or autism, and who devote their careers to demonstrating that mental disorders lie on continuums, and that restricting ourselves to treating just the severe end of the spectrum is rather like a cardiologist announcing she will only deal with malignant hypertension, are often castigated for extending the boundaries of mental health disorders and medicalising the normal.