Is There any Chance for a Biologically-Oriented History Of Psychiatry?

Avant, Vol. XI, No. 1, doi: 10.26913/avant.2020.01.03
published under license CC BY-NC-ND 3.0

Krystyna Bielecka orcid-id
University of Warsaw, Poland
kikab.gazeta.pl @ gmail.com

Published 11 November 2019   Download full text

Abstract: Historia polskiego szaleństwa (History of Polish Madness) by Mira Marcinów is the first book on the history of melancholy in Poland. Nowadays we use a term „depression” instead of „melancholy” so Marcinów’s topic of study somehow corresponds to the concept of depression in modern psychiatry. In the first volume Słońce wśród czarnego nieba: Studium melancholii (The Study of Melancholy: The Sun with the Black Sky), Marcinów presents an original view on the history of the concept of Polish melancholy of the 19th century. It is both a conceptual and fascinating historic work, a large part of which contains a collection of personal case studies, unknown previously to historians of psychiatry, found by Marcinów in diaries or other forgotten notes or records.
In my paper, I want to analyze her claims about the relation between medicine and psychology in Poland of the 19th century that became a leitmotif of the book. Marcinów emphasizes that in the very beginning of psychiatry, all biological and psychological factors underlying psychopathologies (especially, melancholy) were understood as different and strictly separated. It contradicts the fact that psychiatric descriptions and explanations, as one can notice in the records cited, remind us of a mixed-bag of psychological and biological descriptions and explanations rather than a clear-cut distinction between them. My claim is that some of hidden philosophical assumptions that Marcinów slightly gestures toward in her book are responsible for the fact that such division between the mental and the somatic is so common in psychiatric explanations even nowadays (it is worth noticing that the situation in neuroscience is much different). I will then make explicit some of her philosophical assumptions (section 1). Furthermore, I will argue against Marcinów’s assumption that psychology should be considered autonomously from medicine. I will claim that a mixed view on psychopathologies fits very well the historical facts and is much more fruitful. I will then present a draft of an alternative philosophical framework that could rejoin two apparently different perspectives—psychological and medical—in order to explain further why some disordered mental states could have meaning (section 2) This alternative framework, in my opinion, would be useful in a more nuanced understanding of how the notion of melancholy emerged and eventually dissolved. In the last section, I will summarize the main points of the paper.

Keywords:  history of psychiatry; melancholy; biology; medicine; psychology


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