Sunday, 25 November 2007

In Berlin

I’ve just got back from my final conference of 2007: kindly invited by Thomas Fuchs and Martin Heinze to give a paper at the German Psychiatric Association (Deutsche Gesellschaft für Psychiatrie, Psychotherapie und Nervenheilkunde) in Berlin. It was a huge conference with many of the people one would expect (eg Alfred Kraus, Henning Sass) but also my colleague Kwame McKenzie turned out to be in from Toronto and staying in my hotel and the ubiquitous and very hard working Juan Mezzich had been and gone.

Coming from a philosophy background, the strange thing about psychiatry conferences is the different attitude to asking questions. At a philosophy conference, the cut and thrust of the questions after a paper or presentation is the main reason for attending (aside from networking to land one’s next job!). Without that, one might as well wait for the papers to be published and stay at home with decent beer. But at psychiatry conferences, questions are generally merely a polite extra. (I guess this is partly because of differing assumptions about what disciplines the disciplines.)

Thus I was very surprised to be asked a really good question on this occasion. I’d given a presentation arguing that it is a mistake for the WPA to call for an idiographic addition to criteriological diagnosis because no sense can be given to idiographic understanding that marks it off from a contrasting form and the very idea of individualised judgement threatens the validity of diagnosis, broadly construed. (Instead we should follow the more helpful idea that narrative elements be added: these are distinct, normative and not-precluded from possessing validity.) Delightfully I was asked whether my argument turned on neglecting Kant’s idea of reflective, rather than determinate, judgement, which cropped up here the other day. I don’t think it would help because I don’t believe in reflective judgement in Kant’s sense either (and for a related reason to my distrust of idiographic judgement). But I wonder whether a background in philosophy is still a much more common aspect of German psychiatry than it is in the UK. If so, that adds to the recent debate at PEHM about the relationship between the two disciplines.

Very odd to wonder round a city which functions so much like any other affluent European city but where I lacked any grasp of the language. There’s a phrase from Wittgenstein’s Philosophical Investigations which is often, I think, misapplied: If a lion could talk, we could not understand him. This is often used to support the idea that we wouldn’t be able to translate its utterances because its world would be so different from ours. But actually Wittgenstein mentions it in the context of considering being abroad somewhere where one does understand the language but not the people: one doesn’t share the right expectations. What stood out for me in this case was that even not understanding German (yes I’m embarrassed!) how much was understandable, how much is agreed in practice. The systems (in airports and restaurants) are their own translations.