Review of: Psychobiology and Psychiatry. By Wendell Muncie, M.D. Second edition. (Pp. 620; 70 illustrations. £2 5s.) London: Henry Kimpton. 1948.
British Medical Journal, 9 July 1949, 2: 61
Psychobiology is a school of psychiatry initiated by Dr. Adolf Meyer. Under Meyer's leadership the Henry Phipps Clinic at the Johns Hopkins Hospital became a teaching centre of international repute. Many teachers in key positions in this country studied there under Meyer; whose doctrines have therefore exercised an important influence on British psychiatry.
Psychobiology has three significant aspects : a philosophy, a mode of approach to the patient, and a framework for clinical description. From the philosophical point of view it is monistic, demanding that the individual should be treated as a unity and not in the separate categories of body and mind; and it maintains that the laws of behaviour are distinct from, and of a higher order than, those of physical medicine, as the laws of chemistry are not directly to be derived from the concepts of physics but have a validity of their own. The psychobiological approach to the individual patient is mainly directed to an effort to understand his behaviour as the resultant of past experiences and present circumstances. Mental disorders are conceived as reactions; the approach is biographical, the concepts employed are dynamic. Allowance is made for organic and constitutional factors; but every attempt is made to account for as large a part as possible of the total picture in terms of what is individually rather than generally significant. So it is that such concepts as that of the "endogenous" psychoses come to have little meaning, and even the specific features of organic states tend to become submerged under the emphasis given to the total reaction of the individual.
Standing midway between the classical psychiatry which stems from Kraepelin and the pan-psychic theories developed by the psycho-analysts, psychobiology has been assailed from both sides. From the point of view of the former, its principal weakness is that it leav.es little room for the specific states derived from organic process and hereditary predisposition. The strength it gains in therapy is lost in the fields of diagnosis and prognosis. As the individual patient always remains an individual, features shown in common by groups of patients receive scant attention. It has accordingly proved remarkably sterile in stimulating research, and in this respect cannot be compared with either neo-Kraepelinian psychiatry or psycho-analysis. From the psycho-analytic side it is criticized for the insufficient emphasis it places on the unconscious and for its neglect of free association as a technique of investigation and treatment. In the United States its position has become weaker, and it seems that it will disappear under the rising tide of adherence to the Freudian school. Nevertheless, it has important advantages over both the opposed trends. It has corrected the too static concepts of the older psychiatry, and has especially fructified the study of the neuroses. In this field some of its concepts are indispensable, and it is probably the best available discipline for the student of psychotherapy. Compared with psycho-analysis, it has the great advantages of retaining the medical viewpoint and of being balanced, scientific, and undogmatic. Every student of psychiatry, no matter to what school he is drawn, should read Dr. Muncie's exposition.