Revival of the Need to Listen to each other

Psychiatry is a medical profession that deals with the structural basis of existence, the goal of life and the how of re-channeling suffering of handicapped individuals to live up to their potentialities and aspirations.

Y.T. El-Rakhawy

The relation of culture to psychiatry is not simply like the relation of culture to other branches of medicine. Psychiatry is a medical profession that deals with the structural basis of existence, the goal of life and the how of re-channeling suffering of handicapped individuals to live up to their potentialities and aspirations. Cultural studies in psychiatry should neither be restricted to comparing epidemiological figures of specific disorders in a particular territory nor to delineating some different delusional contents or particular outcome of certain syndromes. Such activities are simply describing superficial differences rather than making use of profound diversities.

To establish synthesis between cultures (transversely) and civilizations (longitudinally), what is needed is to uncover basic structural differences in the how of conceptualization along the way towards complementary synthetic integration between different groups of people sharing common human interest. This lies very deeply in the structural and biological make up of different cultures and individuals.

However, when dealing with the issue of globalization, other related terms worth to be mentioned: globalization, internationalism, totalitarianism and trans-nationalism (up to trans-continental). ‘To Globalize’ means to make worldwide, in scope or application. ‘Internationalism’ refers to what is across nations (two or more). ‘Totalitarianism’ relates to central control (extremely centralized authority),’ trans-nationalism refers to extensions above or beyond nations and ‘ trans-continental’ is what  transcend even continents.

Perhaps it is necessary to identify two types of globalization: authoritarian  globalization, (what mighty authorities are after, becoming a sort of  totalitarianism) and humanistic  globalization aiming at objective synthetic convergence of diversities.  The latter is essentially related to the degree of orientation of cultural differences, hence working through them and converging towards new synthesis.

Culture and civilization are two concepts that have been influenced by globalization. In addition, “culture” is sometimes mixed with “civilization.”  For instance, to consider a specific culture as civilized, it should represent a unique existential stand. The everyday revelation of such stand by most individuals belonging to this culture, the tendency to export/market it all over the world, and the efficient methods and tools to fulfill its goal should be considered in defining ‘civilization’.  Besides, a test of efficacy and a test of time would prove that such stand and tendency are promising something better to human beings, which is apt to propagate worldwide.

In psychiatry, integration of knowledge and experiences could be achieved by respecting the others’ cultures, methodologies, clinical results, observations and their special art of healing. In practice, some hypotheses emerge and need verification by different methodologies. For example, controlled studies (including double blind techniques) could prove to be more illusive than narrating clinical results. The clinical experience does not go parallel with the results of the ‘scientific research.’ Individual variations between psychiatrists are wide enough. The so-called algorithm is becoming more handicapping for creative management of individual patients.  Diagnostic labels are more and more replacing unique individual identification of each patient. Most practitioners emphasize that it is essential to know the state of the disorder than to label it by an agreed upon particular term/label.  It is more important to know the how of the disorder than to know the why of it. It is more useful to know the pathology of the biorhythmic pulsations (periodical, intermittent, remittent) than to know the possible micro-pathology of limited neurotransmitters. It is more important to follow-up by clinical monitoring than by the level. Finally, it is worth to consider the expectation, assimilation and the use of relapse rather than to follow a strict ‘prevention program’ with the risk of aborting affective resonance and creative potentialities.

Y.T. El-Rakhawy

Egypt. J. Psychiat. 25: 1&2 January & July 2002

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