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With regard to the report in the December 5 on Dr. James Scully’s view that biological reductionism has contributed to economic reductionism, I would take issue with only one point in an otherwise very timely and logical proposition. Dr. Scully is reported to have stated that psychoanalytic models did nothing to reduce stigma against psychiatric illness and that, indeed, concepts such as "schizo-phrenogenic mother" may have indeed worsened the situation. I would argue that psychoanalytic models were developed with a view to decrease the stigma and succeeded in doing so.
Psychoanalytic theory took root at a time when society was rather discouraged with the prognosis of mental illness. Notions of moral degeneration left little hope for anyone identified as suffering from psychological symptoms not considered acceptable by existing standards.
Neurosis was a harbinger of psychosis, which, in turn, preceded idiocy, barring a generation or two. Of course, any form of "debauchery" was the basis of it all! A focus on insight leading to change even at the risk of blaming the parents and having the patient assume some responsibility, at least, for getting better may have seemed preferable to having no hope at all.
At the risk of telescoping history somewhat, I would submit that concepts such as "schizophrenogenic mother" were probably less stigmatizing than accusations of witchcraft and its consequences!
Dilip Ramchandani, M.D.
Philadelphia, Pa.