Psychiatry yesterday, today, and tomorrow

Abstract

This chapter explores the nature and implications of psychiatric crisis from a critical and innovative perspective, moving beyond the tradition of mainstream psychiatry. The author begins with the clinical observation of the patient in crisis, emphasizing how the severity of the episode is often disproportionate to external events. Psychiatric crisis is portrayed as a radical rupture of ordinary experience, where the individual faces disorientation, agitation, and profound fears, including the terror of losing oneself entirely. The text introduces the concept of the psychiatric crisis (PC) as the basic unit—the foundational building block—of any psychiatric syndrome, highlighting the distinction between positive symptoms (new, intense) and negative symptoms (loss of previous capacities). The author draws attention to the lack of focus, in classical psychiatry, on altered states of consciousness, which are often neglected in both diagnostic assessment and therapeutic approach. A paradigmatic shift is advocated: moving beyond the simple investigation of altered psychic phenomena, towards analyzing the change in the subject’s state of consciousness itself. A brief historical review traces the origins of psychiatry from its attribution to supernatural causes, through the scientific revolution of the Renaissance, to the limitations of phenomenological approaches. The chapter concludes with an opening to the future of the discipline, stressing the need to integrate spiritual and experiential dimensions, outlining the horizons of biological psychiatry, strongly conditioned by information technology and technology, a psychiatry without a soul.