THE SPIRIT OF PSYCHIATRY

By Jon Allen

September 5th, 2013

What better place could there be for the Institute of Spirituality and Health than in the Texas Medical Center? This venerable bastion of scientific medicine and technology has few peers in the entire world of healthcare. Yet the Texas Medical Center must be more than a locus for spectacular innovations; it must be a place for healing, and there is far more to healing than technology alone can offer.

In his article published in the Journal of the American Medical Association in 1975, Walter Menninger pointed to “numerous examples of physicians who are absolutely superb technicians, with all the latest knowledge and skill, but who approach patients in such a cold manner as to prompt doubt and distress.” The role of technology in medicine hardly has waned in the ensuing decades. But Dr. Menninger’s concern was not new; he quoted from a 1927 publication by Francis Peabody, who complained that young doctors “are too ‘scientific’ and do not know how to take care of patients.” He continued, “One of the essential qualities of the clinician is interest in humanity, for the secret of the care of the patient is in caring for the patient.”

One would think that, in the field of medicine, the specialty of psychiatry would be a stronghold for humanism. Yet treatment with medication is gaining popularity over psychotherapy; moreover, within the field of psychotherapy, “evidence-based” therapies with their prescriptive manualized interventions increasingly are dominating practice under the mantle of science. In protest, I have declared myself a practitioner of “plain old therapy.” As in general medicine, biology is in ascendance over humanism; I have dubbed psychiatry’s current enthrallment with neuroscience, “biomania.” I have no doubt that major advances in understanding psychopathology and developing innovative treatments will come from neuroscience. But I believe that humanism should remain the foundation of our therapeutic work; we might aspire to science-informed humanism.

I was heartened to read an article in the 2012 volume of the British Journal of Psychiatry in which the lead author, Pat Bracken, spoke up for mental-health consumers: “many service users did not really value the technical expertise of the professionals. Instead, they were more concerned with the human aspects of their encounters such as being listened to, taken seriously, and treated with dignity, kindness and respect.” Francis Peabody likely would have approved, as Menninger quoted him: “The good physician knows his patients through and through, and his knowledge is bought dearly. Time, sympathy and understanding must be lavishly dispensed, but the reward is to be found in the personal bond which forms the greatest satisfaction of the practice of medicine.”

The Institute of Spirituality and Health makes diverse contributions to the Texas Medical Center, but I think preserving humanism in medicine in general and psychiatry in particular is one of its foremost roles. The annual Psychotherapy and Faith conference exemplifies that role. Spirituality—a search for the sacred, as the Institute’s visiting scholar, Kenneth Pargament, construes it—is one of the defining features of our humanity. Attentiveness to the spiritual dimensions of health and illness keeps our humanity in the forefront of clinical practice. While we are dazzled continually by technological advances, we should never lose sight of the centrality of suffering and healing—the wellspring of spirituality—in our work. What better place could there be for the Institute of Spirituality and Health than in the Texas Medical Center?

 Jon G. Allen, Ph.D., is Senior Staff Psychologist, The Menninger Clinic; Professor of Psychiatry, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine; and a member of the Adjunct Faculty of the Institute of Spirituality and Health