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Psychiatry now follows an outdated scientific theory.

Psychiatry has a strong humanistic heritage.

A new guiding theory links humanism and science.

Modern psychiatry finds itself grappling with a dilemma. Its present guiding scientific philosophy or theory seems outdated to many in psychiatry, and they push for the modern systems approach now employed by all sciences except medicine. The impetus for this stems not only from a desire to become more scientific but also to reassert psychiatry’s traditional humanistic orientation.

Humanistic Psychiatry

Medicine itself has a strong humanistic tradition that dates to its origin with Hippocrates in the fifth century BC.1-3 But the advent of modern clinical medicine in the 18th century AD challenged this. Medicine began to view physical diseases as its primary focus, paying less heed to patients’ psychosocial and mental health issues. Reviewed previously, this stems from Descartes and the “mind-body split” theory.2-4

Nevertheless, although accepting the idea that a brain disease caused mental symptoms, groups of general physicians rose to preserve the humanistic tradition.1 The care given to patients in what citizens called “insane asylums” or “lunatic asylums” appalled the doctors. This led them to coalesce over time to form the discipline of psychiatry in the 19th century. Their foremost goal was to provide “moral treatment” to asylum patients and rid the system of egregious practices such as poor control of filth and cessation of punitive practices (prolonged isolation, chain restraints, and corporal punishment, to name a few). Thus, the new psychiatry, alone in medicine, continued the ancient humanistic tradition.1,3,5

Psychiatry’s human orientation flourished and rose to its pinnacle in the first half of the 20th century under the influence of Sigmund Freud and his followers.6 His ideas vastly expanded the human dimensions of psychiatry, its impact continuing yet today. With the monumental discovery of the unconscious and its explanatory influence for human behaviors, psychiatry ensured that patients’ psychological and social features were paramount in diagnosis and treatment. And Freud’s identification of spontaneous free associations as the key to understanding the meaning of patients’ symptoms and actions resonates yet today in the field of patient-centered or person-centered communication.

Unforeseen health problems from the two world wars in the last century further countered the isolated disease focus held by medicine. Droves of soldiers returned home with what we now understand as post-traumatic stress disorder (then called “traumatic war neurosis” or “shell shock”). Clinicians understood soldiers’ anxiety (from war trauma) but were puzzled about the........

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