Enchantment in psychiatric medicine

摘要

Max Weber's 1918 essay "Science as a Vocation" posits that increasing scientific knowledge has contributed to a disenchantment of the natural world. His argument has implications for medicine, an applied science aimed at the improvement of health, including psychiatric medicine. Using Weber's argument, this paper discusses the ambivalent relationship psychiatry has with technology. On one hand, based on the historical roots of the specialty and the influence of psychodynamic psychotherapy, psychiatrists believe themselves to be masters of the invisible space between physicians and their patients. They claim to have the skills and insight that enable them to establish a unique kind of relationship in which communication not only allows them to diagnose, but also to heal through a variety of psychotherapeutic techniques. As a result, many psychiatrists are wary of the introduction of technology into therapeutic setting and the potential for this type of communication to be disrupted or diminished in value, often basing their concern on the ways in which technology has been witnessed to be "disenchanting" in other medical specialties. On the other hand, others see the future practice of psychiatry best guided through whole-hearted embrace of brain-based medical technology, which has been stunted by the complexity of the brain and relative lack of research funding compared to other medical specialties. This discussion within the field is timely, as on the horizon lies the holy grail of technological advancement for psychiatric practice: definitive biomarkers to diagnose mental illness and provide individualized treatments.