[Epistemology and history of psychiatry]

This paper has dealt with the history of psychiatry, that is one of the ways in which the epistemology of psychiatry can be elucidated. It has suggested that the philosophical and historical methods are not fundamentally different for they use the same tools to tackle different periods of the narratives of psychiatry. The history of the history of psychiatry has been analyzed in some detail and then something has been said on the conceptual approach as applied to the history of mental symptoms and diseases. The historical needs of the clinician have been emphasized. Conceptual analysis must be mindful of the fact that it is dealing with a complex mixture of narratives which directly and independently relate to the history of the words, concepts and behaviours involved in the construction of a symptom. In this sense, the history of descriptive psychopathology is seen as paying attention both to constructional elements (by accepting that the semantic content of the terms involved may markedly change from period to period, and is socially-dependent) and to the (often biological) invariants that confer continuity to particular forms of peculiar behaviour. In this latter respect, clinical historians entertain a form of naive realism of which (qua medics), they do not need to feel ashamed. Collaboration between professional historians and clinicians could render the conceptual history approach into a fine art. The ensuing body of knowledge not only would provide real historians with solid foundations for their macro-concepts, but also constitute a direct contribution to clinical understanding and patient care. A result like this should be the best remedy for those chronically affected by historiographic pangs.