Consultation psychiatry

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Consultation psychiatry is a term used by Erwin H. Ackerknecht for neurosis psychiatry . According to the triadic system of psychiatry , this third part of psychiatry relates to a group of patients best suited for talk therapy. The author Walter Bräutigam also called this part of psychiatry “ little psychiatry ”. This is to express the relatively favorable prognosis of these rather mild mental disorders with regard to healing . Bridegroom also speaks of “closeness and connection to normal psychological processes” to characterize this group of diseases.

More detailed definition

Klaus Dörner took up the concept of consultation hour psychiatry in his presentation of the history of psychiatry. Together with the author W. Bräutigam, he comes to the characterization that with the concept of consultation hour psychiatry, the patient's own self-image is in the foreground of the interest, which tries to obtain confirmation in the public discourse. In contrast, Bräutigam emphasizes that the symptoms of endogenous psychoses “ cannot be grasped in general psychological approaches ”. This, however, repeats the social "exclusion of irrationality" formulated by both Ackerknecht and Dörner in this context.

Social question

As it turned out mainly in Germany in the course of the development of psychiatry, consultation hour psychiatry has experienced a great upswing due to the general development towards university psychiatry . The hallmark of this university psychiatry of the 19th century was that the mostly theoretical demands of psychics for the public application of moral standards found an opposite pole here, as mental illness was viewed like any other physical illness and thus did not need special " moral treatment " ostensibly . In the view of psychics, the use of moral treatment did not preclude the use of coercive measures . In this respect, the practiced practice of neurosis psychiatry confirms the critical remark by K. Dörner that economically better off citizens could afford to “have it on their nerves”, while the poor insane were further concentrated in special institutions, cf. the problem of institutional psychiatry . Through the theory of nerves since Georg Ernst Stahl (1659–1734) in Germany and Thomas Willis (1621–1675) in England and the associated neurologization of psychiatry, which also gave rise to the term neurosis, the problem of mental disorders was only partially in Way of outpatient treatment as a problem in consultation psychiatry solved. The majority of the mentally ill are still cared for by the institutional system. If, however, outpatient care for these “seriously ill patients” mainly relates to the administration of medication, the term psychiatry has become questionable as there is little time left to speak. The well-known patients of Freud were also among the financially wealthy circles. B. Sergius Pankejeff (the wolfman), Marie Bonaparte (Princess of Greece) and Bertha Pappenheim (Anna O.). For Klaus Dörner, the most striking evidence for the relativity of the term neurosis and its dependence on political assessment lies in the marked change in terms to which "neurosis" was exposed, especially after the First World War , in connection with the problem of war tremors and the moral standards of evaluation Defense force decomposition.

Historical beginnings of consultation hour psychiatry

England

England was the starting point both in the moral treatment of the mentally ill and in the public discussion about the self-image of mild mental disorders. The novels by Samuel Richardson (1689–1761) can serve as a gauge of this interest of a sensitive public . Well-known medical representative of this time is George Cheyne (1671–1743). The demand he advocated for a withdrawal from the overstimulated everyday world anticipates the thoughts of Jean-Jacques Rousseau (1712–1778). The name of the "English Malady" (English Malady) goes back to Cheyne, which he coined in a positive sense in connection with England's leading position in political and economic terms. This can be seen as the beginning of the self-analysis , as it was later pursued and demanded by Freud. Politics, economics and hysteria were preferred topics in the coffee houses. In these coffeehouses the conversations of the mostly wealthy social classes, who have coined the name of the consultation hour psychiatry, took place.

France

Jean-Jacques Rousseau (1712–1778) is to be regarded as the mastermind of the ideas which, as in England, led to a public preoccupation with mild mental disorders such as hypochondria and melancholy in France. Rousseau is committed to these English models on his 1737 trip to Montpellier , which he described as the "English trip". Montpellier was known as the school of vitalists from 1750 under Théophile de Bordeu . Franz Anton Mesmer (1734–1815) already put these ideas into practice during his time in Vienna. In 1768 he opened a practice in a large baroque villa that was inherited from a rich widow he had married. There he has z. B. listed pieces of music for therapeutic purposes, u. a. there was Bastien und Bastienne by Mozart premiered 1768th Mesmer's treatment practices represent the new theories of nerves determined by the vitalists, which no longer focus on enlightened reason, but on sensitivity and sensibility. In Paris, the new treatment practices are literally revolutionary. A commission formed by the king in 1784 from the leading scientific scholars of his time rejected his treatment methods. Even if the era of clinic psychiatry ended with the revolution, it lived on in Germany and later reappeared in France in a different form.

Germany

In Germany, consultation hour psychiatry was introduced primarily by Wilhelm Griesinger (1817–1868) along with somatism .

Individual evidence

  1. ↑ a b Ackerknecht, Erwin H .: Brief history of psychiatry . Enke, Stuttgart 3 1985, ISBN 3-432-80043-6 ; Page 29
  2. ↑ a b c Bräutigam, Walter : reactions, neuroses, psychopathies . dtv Scientific Series, Georg Thieme, Stuttgart 1 1968; page 1
  3. ↑ a b c d e f g Dörner, Klaus : Citizens and Irre . On the social history and sociology of science in psychiatry. (1969) Fischer Taschenbuch, Bücher des Wissens, Frankfurt / M 1975, ISBN 3-436-02101-6 ; (a) Stw.-overview of the conceptual use of “clinic psychiatry”: pages 39, 129–131, 137, 203 f, 269, 317; (bc) Re. “Self-understanding versus public understanding”: page 39; (d) on Stw. “Change of concept of the» neurosis «and problem of the tremors of war”: page 62 f .; (e) Re. “Development of consultation hour psychiatry in England”: page 39 ff .; (f) on “Consultation psychiatry in France”: pages 125–137; (g) Re. “Consultation psychiatry in Germany”: pages 317, 325
  4. ↑ Jaspers, Karl : Allgemeine Psychopathologie . Springer, Berlin 9 1973, ISBN 3-540-03340-8 , Appendix § 4 Historical on psychopathology as a science. - Institutional and university psychiatry. Page 705 f.
  5. ^ Dörner, Klaus and Ursula Plog: To err is human or textbook of psychiatry / psychotherapy. Psychiatrie-Verlag Rehburg-Loccum 7 1983, ISBN 3-88414-001-9 ; Page 432
  6. ↑ Erdheim, Mario : The social production of unconsciousness. An introduction to the ethno-psychoanalytical process. suhrkamp pocket book science 456, Frankfurt / Main, 2 1988, ISBN 3-518-28065-1 ; Pages 78, 82, 84, 99, 136, 142, 160, 183