Time for psychiatry: schizophrenia as a core issue of the difficulties of psychiatry.

Abstract

Time and space represent the basic coordinates of the system where all human experiences take place. As a necessary consequence of the science of the reality, the vast majority of mechanisms of verbal and written language are oriented to make these experiences communicable within these parameters, which become the limits and the boundaries of human life and of a person’s memory. The value of an individual or of a community is influenced by the relationships of temporal and spatial closeness or distance of similar or opposite, consonant or dissonant, experiences. The concept of ‘value’ itself changes according to these collocations in which the reference point is subject. Therefore, since what is estimated as ‘value’ is qualified and allowed only as an object of human evaluation, this subjectivity involves a wide range of meanings, in both a positive and negative senses. The way in which persons perceive the world is influenced by the way they speak about it, by the image of the world that returns to subjects through their verbal or written representation. For a long time philosophers, anthropologists, linguists, psychologists and psychiatrists have been interested in those aspects; their studies have now reached certain homogeneity, despite the variability of speculative or heuristic perspectives. Most of what people say is directly or indirectly based on the spatial and temporal perception of the situation they are in, and the nature of this inter-relation reveals the meaning of the individual or shared experience. It is very rare that an experience is limited to a single person. He wants to share its understandable characteristics—especially those that are apparently obscure—with those who have similar working, family or daily habits. The search for meaning is a shared activity, since it is realized through communication. The sense or the meaning of an experience can be perceptive, which is connected with the stimuli (i.e. with the facts), and semantic, which is connected with ideas, emotions or their interpretations. To understand the experiences of normal life or of pathological conditions, it is not only necessary to explore how the individual feels, but what he feels and why he feels in that specific way, in that period of life. Traditional psychiatry does not focus on these problems, but rather on facts, such as the external behaviours, rather than on reasons that provide an historical background to the individual experiences. Thus, descriptive psychiatry considers, for example, that ‘neurotic’ thoughts are quite close, although different, to normality, and explains ‘neurotic’ acts—i.e. the symptoms—as an expression of a communicative aim. Following the previous example, the split between neurotic ‘facts’ (the symptoms) and neurotic ‘ideas’ (psychopathology) can be listed as one of the ways to explain the actual crisis in psychiatry. When recent social events forced psychiatry to abandon the purely clinical and psychopathological dimensions, psychiatry reacted with a reductionist simplification. According to this approach, psychiatry considers patients’ behaviours as an expression of their ideas, which implies giving priority to the shape rather than to the meaning. On this basis, psychiatry is at risk of a logic reversal: focusing on the underlying meanings can give the impression of not caring for the mind, but to modify behaviours—thus, psychiatry itself may become an act. If we consider the handbooks on psychiatry published in the last few years or books on specific aspects of ‘normal’ mental functioning (presumed or acceptable from a social perspective) or books on abnormal individual or group functioning, psychiatry has attracted many academics and researchers with different cultural backgrounds.