Understanding and Healing

First, I would like to thank Dr. Phillips for his generous words about the potential interest of my work. He speaks about the fact that it is "insightful" and thought-provoking ("it offers us much to think about"). In his comment Dr. Phillips reviews the main moments of the evolution of treatment by words in the Greek world and he focuses on Plato's Dialogue Charmides, whose analysis is the center of my article. He even quotes some parts of the dialogue, which I mention too, although in a different translation. He rightfully underlines the moment in which Socrates tells Charmides: "And the soul ... my dear friend, is cured by means of certain charms, and these charms consist of beautiful words. It is a result of such words that temperance, sophrosyne, arises in the soul, and when the soul acquires and possesses temperance, it is easy to provide health both to the head and to the rest of the body" (643/157). It is extraordinary that already the Greeks of the classic age had full awareness of the importance of psychotherapy not only for mental disorders, but also for those of the body. As a consequence, every medical act must be accompanied by the comprehensive and illuminating words of the physician, even when the malady presents itself as purely somatic.

Dr. Phillips refers then to the value the Greeks gave to the state of the soul which they called sophrosyne, condition of possibility of true health. He offers several words for translating this complex Greek concept, such as temperance, moderation, prudence, and self-control. Perhaps to those definitions could be added the idea of harmony with oneself, with the social environment, with nature and with the gods, which corresponds to what the Greeks understood by "true health." Dr. Phillips proceeds then to review the destiny which this "Greek psychotherapy" has had throughout the centuries and up to the present. He stresses the tremendous revolution of western thought that took place in the seventeenth century and began with Descartes and the English empiricists. This meant, on the one hand, a true advance toward the development of natural sciences, but, on the other—among other things—the omission of that indissoluble body and soul unity, so characteristic of Greek thought, and so fundamental for the comprehension of the human being as a totality. This unity has been widely demonstrated by the new paradigm of sciences, also called ecologic paradigm (Blankenburg, 1989; Merleau-Ponty, 1945; Varela, 1997; Varela et al., 1991; von Weizsäcker, 1939/1997).

In the nineteenth century, psychiatry is divided between a moralist current and a very objectivist one, which only searches the causes of mental disorders in the brain, a psychiatry from which, certainly, every form of psychotherapy was excluded. The inspirator of this second form of psychiatry—which in a way persists until today—was the famous German psychiatrist Wilhelm Griesinger (1845), well known for his principle: "Mental diseases are brain diseases." Treatment with words acquires again all its relevance at the end of the nineteenth century, with Charcot and Freud. Freud's psychoanalysis in a way dominated the psychiatric field during several decades of the twentieth century, until it was practically displaced starting from the 1960s by biological psychiatry. Dr. Phillips is right in complaining about the fact that "the core principles of Greek psychiatry—the requirement of unified body and soul, and the role for temperance/sophrosyne as the goal of treatment—have been left out in contemporary psychiatry." I fully agree with Dr. Phillips's concern. Contemporary psychiatry has become more and more "biological" and impersonal. Psychiatrists limit themselves to "registering" symptoms, in other words, external manifestations devoid of a true bond with the totality of the person, to then establish a diagnosis according to the present models of classification and diagnosis (Diagnostic and Statistical Manual of Mental Disorders and the International Classification of Diseases, 10th edition). These constructs imply or suggest almost always a determined pharmacological treatment. When these "biological" psychiatrists get to considering psychotherapy as an important element of the treatment, they derive the patient to a psychologist, thus generating an...