L’épistémologie dans la Société Médico-Psychologique : les grandes modalités et les principaux jalons dans les conceptions psychiatriques de 1852 à nos jours

Abstract

We discuss the major modalities and milestones in psychiatric conceptions from 1852 to the present day. Epistemology in contemporary history has a specificity in its approach, which consists in examining the state of the historical development of science. And the epistemology of the Piaget school particularly helps us to individualize the different phases of the understanding of psychiatry in the evolution of the Medico-Psychological Society. The founding members of our Society represent very diverse disciplines (psychiatry, philosophy, medicine, physiology, administration, etc.) and we distinguish three areas : The major paradigms of 170 years of activity ; The major epistemological approaches; Recent assessments, in the midst of various crises; The major paradigms of 170 years of activity have been particularly well studied by Georges Lanteri-Laura. We differentiate his three main phases: The period of insanity (1791–1854), from Pinel to Boismont, where the spiritualist precursors of the time are present. The period of mental illness (1854–1926) from Falret, Magnan to Auguste Comte. The period of large structures (1926–1977), from the Congress of Geneva-Lausanne, with the presentation in French of Bleuler's conception of schizophrenia, to the death of Henri Ey, with the works of Charcot, Broca, Clérambaud, Régis, Guiraud and the presence of Bergson, Merleau-Ponty, and German phenomenology, to the great work of Henri Ey. And finally, we deal with the period of the classification system (from 1975 to1980), which we include with the previous studies, with the promulgation of the different DSM, and the international classification of mental disorders ICD10. We mention the famous Franco-American meeting of 1978, and the contributions of many members of the Medico-Psychological Society throughout this period. It is important to specify the major epistemological approaches throughout these phases, especially during the last two periods. The relationship between the clinic and epistemology is greatly concerned in two areas in particular: the transformation of concepts, and the dialectic of models (with the very important studies of C.J. Blanc). We delineate the four main approaches: descriptive, explanatory, explicit, and comprehensive approaches. It is at this point that we can consider the very important work of Pierre Marchais. And we can then clearly situate the considerable importance of the comprehensive approach. The contemporary milestones and extensions concern two major dimensions that have been present in the activities of the Medico-Psychological Society for the past thirty to forty years. The modalities of knowledge and epistemology are very much involved in the recent scientific currents of psychiatry (neuro-cognitivism, biochemistry, genetics, etc.) and the importance of understanding disorders and people must be associated with all approaches to explanation. The life sciences are related to epistemology through including objectivity together with the subjective dimensions of the living, because life is, in its essence, a subjective process of self-affection, self-awareness, and identity (G. Canguilhem; M. Henry). The conclusions of this lengthy study over time lead us to highlight two areas: From a general point of view, epistemological approaches to psychiatry always confront us with different conceptions of man, carrying within them various modalities of the meaning of existence. From a particular point of view, in each period considered, we note a certain diversity of paradigms, where psychiatrists consider the psychiatric clinic according to various and complementary epistemological modalities.