The sense of diagnosis in nosography

Eugenio Borgna

The sense of diagnosis in nosography
In R. Ceglie, ed., "The problem of diagnosis", monographic issue of Psichiatria e Territorio IX, 1 (1992), traslated by Manuela Garuglieri

There is a unique possibility of carrying out a psychiatry that is worthy of its object, i.e. the always obscure and enigmatic human condition. The only possible solution is to use at the same time, that is in a successive way, both the cognitive methods, yet being aware that both methods have their own application rules and their different consequences and practical implications. Such a discourse can seem partly abstract and theoretical: I would say that – as Jaspers and Heidegger have continuously repeated –, at the end, every science justifies itself only when reflection and thinking about what is happening, and about what everyone does, becomes meaningful. If carrying out Psychiatry means to limit himself either to an automatic prescription of drugs or to a social psychiatry more or less wild and anyway unable to reflect upon cultural foundations which – undoubtedly – it owns, it means to transform psychiatry in an amputated science.

Probably Mauz – a German psychiatrist, badly known but able of impressive reflections – was right when he said that psychiatry would be at the end, if it became an exclusively somatologic science. Sure, everybody has his options. Everybody prefers necessarily the lines which are the closest to his own formation, to his own precarious capability of reading reality and detecting these signs, which are not symptoms that reveal themselves and which materialise in every psychotic experience. Anyway it is sure that a Psychiatry, which thoroughly tries to decode the meaning of what is happening in the patient, is a psychiatry that considers essential the analysis of the endless area of patient’s life. Then, there is not any other possibility of knowing what patient feels in his inner life, but listening to him and using the hermeneutic category of identification, of empathy, tied to the studies of Psychopathology, but also of Philosophy by Scheler, Jaspers and Heidegger.

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