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Northwestern University Law Review,
Summer 1987,
81 Nw. U.L. Rev.
791
Psychiatry as Scientific Humanism:
A Program Inspired by Roberto Unger's
Passion
By J. Allan Hobson, M.D.
I. INTRODUCTION
A funny thing happened on the way to Politics: feeling the need for
nothing less than a new theory of the human personality, Roberto Mangabeira
Unger wrote a book called Passion. This glorious aside -- some 300
pages in length -- is full of the great essayist's wisdom and grace. I read it
with a paradoxical combination of admiration and frustration.
The wide-ranging discourse of Passion culminates in a detailed and
trenchant critique of contemporary psychiatry. Passion's concluding
chapter, "A Program for Late Twentieth-Century Psychiatry," was presented as an
invited address to the American Psychiatric Association in 1980 and published in
the American Journal of Psychiatry in 1982. Unger's Program was
brought to my attention in 1984 by my colleagues in the New Psychiatry Seminar,
a quasi-revolutionary group of Young Turks that was wrestling with the same
issues Unger had so skillfully pinioned.
In his Program, Unger promised that his Passion would provide a sketch
for a new individual psychology that might at once replace the failing
constructs of psychiatry (psychoanalysis) and serve as a building block for the
social assumptions of Politics.
In this Essay, I hope to convey some of my own critical doubts about the
validity and utility of this hybrid agenda and voice some fears that Unger's
vision of reality and his rhetorical style aroused. I also offer here some
ideas, which were inspired by my reading of Passion, for the remaking
of psychiatry.
To sum up my position at the outset, I believe that Unger's overall analysis of
the current problems of psychiatry is correct: Psychoanalysis is out of
gas, and biological psychiatry is not yet up to speed. As a field in
crisis, psychiatry is ripe for change. Into the breach walks Unger with his
Passion. As a means of filling the gap between psychiatry's decadent
psychology and its immature biology, I find Unger's theory of personality both
irresistibly compelling and hopelessly inadequate. In praising Unger's direct
and lucid style, his freedom from technical jargon, his skepticism about
psychiatric pseudoscience, I support Passion's endorsement of a dynamic
model of human possibilities. By enumerating Passion's scientific
inadequacies, I hope to fill a few of the gaps, or at least to outline, more
specifically than Unger has done, a programmatic approach to filling them. Thus,
I hope to remain both friend and ally to Unger in what I take to be a joint
intellectual endeavor.
I begin in part II with a critical overview of the psychological theory in
Passion. I show why I believe that Unger's theory, while substantially true
and eloquently espoused, is not likely to be effective as a humanistic
exhortation to professional psychologists, and why I believe it to be
categorically inadequate as a scientific base for the study of behavior.
In part III, I present my own view of the intellectual agenda that confronts a
New Psychiatry. I develop a much more positive and optimistic appraisal of the
prospects of biology than Unger adopts. I also show that many of the
psychological assumptions of Passion may be evaluated by comparison
with already existing biological data. Some are flatly wrong; many others are
questionable; and all are in need of quantitative measurement. Only in this way
can Unger's psychology advance from a set of slogans to testable hypotheses.
Turning to the need for a new psychology, I articulate in part IV my own Credo
for a scientific humanism that attempts to integrate the broadly humanistic
spirit of Unger's approach with the operationalism of modern science. The goal
of this part is to show that bold propositions such as Unger's need to be
considered as hypotheses seeking verification rather than as a priori truths,
the credibility of which rests upon emotional appeal and vivid articulation.
Feeling as strongly as Unger does about the pressing need for reform, I conclude
in part V with a Manifesto for a New Psychiatry, a call to arms should the
proposed Agenda and Credo fail to be adopted. I confess that two scenarios are
more likely than the one I propose. One is a conservative retrenchmant of both
psychoanalysis and biological psychiatry resulting in a continuing cold war; the
other is a gradual drift toward utilitarianism forced by economic stagnation,
and a resulting vitiation of both scientific and humanistic programs.
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