Meaning in Psychiatry: Created or Discovered? | Dr. Dinu Gangure | PS1 Meaning Conference 2002

11 a.m. – 11:50 a.m. Paper Sessions

PS1 Dinu Gangure, M.D., Resident in Psychiatry,
St. Luke's-Roosevelt Hospital, Columbia University, New York

Meaning in Psychiatry: Created or Discovered?

The meaning of a psychiatric act is spread between curing the patient and helping the patient. Many times the road to cure is not the same as the road to help. In the dyad patient-psychiatrist, two meanings develop: the meaning given to the therapeutic encounter by the patient enmeshed in transference, and the meaning given by the psychiatrist enmeshed in countertransference.

The relationship patient-psychiatrist has several parts in it: clinical, financial, boundary confinement, and the relation at the unconscious fantasy level. All of these parts bring in separate meanings that are explored in this paper.

Beginning from the premise that a scientific approach requires validity and of independent testability before meanings are assumed, Californian researchers studied years ago what came to celebrity under the name of “The Rat Race” (a brief description of the experiment is included in this paper). At that time, a major determinant of the behavior of animals exposed to a stressor was acknowledged to be the inside mental representation of the outside environment. For each individual, the very particular way the outside world is mirrored inside determines the rate of success in the attempts to master the environment. For human beings, the internal representation of the world includes aspects like life style, culture, religious belief, modern sexual values, etc. This internal mirroring is the stone that stays at the heart of the mental machine, relating the person to the symbols of the outside world, as they become represented inside.

The interplay of genetic preprogramming, neural connections in the inside world and the perceptual feedback from the outside world determine the discovery, creation and then adjustment of the meanings brought about by the psychiatric act.

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