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The Humanities and Psychiatry: The Rebirth of Mind: Page 2 of 5

The Humanities and Psychiatry: The Rebirth of Mind: Page 2 of 5

In brief, Dr Osheroff was a 42-year-old nephrologist who was admitted to Chestnut Lodge in 1979. At that time, Chestnut Lodge had “played an important role in the modern history of psychiatry in the US. [It was] one of the major centers of theory and clinical practice in intensive individual psychotherapy” based on psychoanalytic therapy.6 Psychotherapy pioneers such as Harry Stack Sullivan and Frieda Fromm-Reichmann served, at various times, as consultants at Chestnut Lodge.

Dr Osheroff had a number of psychosocial stressors, was in his third marriage, and suffered periods of depression and anxiety. He had been treated with TCAs and individual therapy, with moderate improvement; he had difficulty with adhering to treatment. For about 7 months, he was treated at Chestnut Lodge exclusively with psychoanalytically oriented therapy. Dr Osheroff deteriorated significantly, and symptoms of a severe agitated depression developed. His family intervened and had him transferred to Silver Hill Hospital, where he was treated with a TCA and an antipsychotic. He improved and was discharged after approximately 3 months.

The contrast between the approaches of the two hospitals represented the dichotomous thinking prevalent in psychiatry. While Silver Hill focused on Dr Osheroff’s biological depression, Chestnut Lodge focused on long-term change by treating his underlying personality disorder. After his recovery, Dr Osheroff sued Chestnut Lodge, alleging, among other things, negligent diagnosis, negligent treatment, and failure to obtain full informed consent by not disclosing and discussing alternative treatments.7

The two cultures

Surely, the concept of dualism and dichotomous thinking goes back to unknown ages. But about 53 years ago, at the University of Cambridge, a highly respected scholar, C. P. Snow, delivered a lecture that would powerfully capture the tension between 2 types of thought: science and art. His Rede Lecture, “The Two Cultures,” gave open expression to the “gulf of mutual incomprehension” between 2 scholarly approaches that function as pillars of intellectual progress.8The dichotomy was that of scientists against what Snow called the “traditional” community (or literary intellectuals). Snow seemed somewhat disparaging of traditionalists who could readily quote Shakespeare yet remained ignorant of the second law of thermodynamics.

The dichotomy constructed by Snow is a stark one and allows us to more clearly distinguish the 2 types of thought. For example, while the second law of thermodynamics is “specialized knowledge, useful or irrelevant depending on the job,” Shakespeare’s writings are a form of “self-knowledge” in terms of their capacity to “provide a window into the soul of humanity.”9,

Snow was taken to task 2 years later by a member of the traditional community—F. R. Leavis, who was a distinguished English professor and literary critic at Cambridge, and thus one of the elite literati.9 Leavis’s rebuttal, “The Significance of C. P. Snow,” was a withering ad hominem attack. Leavis also suggested the concept of a third realm where important knowledge existed—not in physical reality but in human minds as a collaborative body of work. The practice of medicine has been referred to as both an art and a science. Arguably, it is the medical specialty of psychiatry that bridges this gap rather conspicuously. Psychiatry’s integration of the humanities with science could be considered both its strength and its weakness. Much like other hybrid fields (eg, economics, political science), psychiatry is the quintessential “third culture.”5

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