Psychogenesis: Conceptual Analysis

According to Berrios, one of the fundamental and unresolved questions in psychiatry is the question of psychogenesis. The issue revolves around whether mental disorders may be the result of complex, interactive, semantically pregnant actions and, thus, psychogenetically caused. The psychogenesis debate has ontological and epistemological consequences but also clinical and organizational derivatives. This chapter deals with the historical epistemology of psychogenesis and explores two main convergences in the contextualization of this construct. The importance of this is not whether a known disease of the brain can “cause” people to behave in strange ways; it is whether every time a person behaves in a strange way the claim can be made that something is wrong with his/her brain. If that is not the case, psychiatry must have the tools to distinguish those mental disorders in which brain representation is causal and primary and the target for treatment, from those in which it is secondary and noncausal, and hence the treatment target lies on the semantic and symbolic network at the origin of that mental disorder.