‘Psyche’ – Spirit as well as Mind?

Abstract

Much has been written about the dangers of Cartesian dichotomy for psychiatry, with its equally perilous errors of ‘mindless’ or ‘brainless’ psychiatry (Eisenberg, 1986), as well as the nonsense of talking about disease as either ‘mental’ or ‘physical’, or with ‘somatic’ or ‘psychological’ symptoms. Kendell (1993) has made this point eloquently; this paper further extends the theme. We psychiatrists complain when our medical colleagues cannot get beyond the physical, even when evidence for psychosocial aetiology is quite blatant, but we may be guilty of an equivalent error in almost totally excluding spiritual considerations from the way we understand our patients. This was alluded to in the address to the Royal College of Psychiatrists by our patron (HRH the Prince of Wales, 1991). We ask patients to which religion they ascribe, but we neglect the much more important question of “what does your religion and your faith mean to you?”