[Toward a dialectic concept in psychiatry].

Abstract

It is intended to define dialectics, and then to follow its evolution from its origin in the pre-Socratic philosophy up to its culmination in Hegel. It is then postulated its importance for the better understanding of the vital history, of the endogenous or functional psychoses and of the classical types of personality in its relation with the fundamental psychopathological structures. With respect to the first one, dialectic thinking would allow to understand vital history as the unfolding in time of a consciousness that is being splinted in contradictions of increasing tension up to its resolution in a failure (disease) or in a synthesis that implies a step forward in the maturation, plenitude or wisdom. With respect to the second one, the great psychoses could be seen as dialectic polarities, both within themselves (mania versus depression, type I versus type II of Crow), and of a group with respect of the other (affective diseases versus schizophrenic diseases). What is schizophrenic and what is depressive appear as polar ones both in the previous personality and in the outbreaking situations, both in the symptomatology as in the evolution. In the third place, dialectics would also allow to conceive the most classic types of personality as ordered in polarities (schizoid-depressive, hysterical-obsessive), in which the poles simultaneously attract and repel themselves, so that each one can be seen as a positivity with respect to the other one. The deviation towards a pole of the alternative does not need to be seen as a lack, but as a dynamic displacement of the existence against the other pole of the alternative. Finally, the author proposes a scheme on the interrelation between the mentioned four structures and the more frequent psychiatric syndromes.