Psychiatry and the ‘subjective-objective divide’

In my subjective opinion, one of the most important articles written in the Journal of my College, the Royal College of Psychiatrists, was written by a colleague of mine who has since retired. It saddens me that, in the 15 years that have elapsed since Allan Beveridge asked this question of my profession, that it has so rarely been considered.

As far as I am aware, Psychiatry still teaches the ‘subjective-objective divide’.

In my opinion this “divide” is as fictional, and indeed as monstrous as Jekyll and his Hyde.

It was refreshing then to come across a recent social media exchange on this “divide” and to find the President of my College and one or two other psychiatrists involved in the exchange:

Initial contributor: ” It really beats me how a psychiatrist or a psychologist can say how I ‘objectively’ feel. The presumption of it is breathtaking.”

The full exchange can be read here.

President of the Royal College of Psychiatrists:  “I have always assumed that the ‘objective’ description is based on what the psychiatrist feels about the patient rather than what the patient has said about their feelings. So a patient might say they feel fine while I assess them as sad.”

Contributor: “And it is a loaded term, suggesting psychiatrist opinion is more valid than a person’s expressed feelings. Then often juxtaposed in a way that delegitimises the person’s experienc: i.e Subjectively depressed, objectively euthymic.”

Initial contributor: “That’s fine, but then you should say that it’s your opinion. I find it extraordinary that ‘objective” means something different only for shrinks. How what you ‘feel’ translates into ‘objective’ is well beyond my ken.”

And another contributor: “What I find is that Mental health professionals agree with me and discuss how ‘things are’ sometimes but write something completely different in my notes that doesn’t reflect my views.”

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