Using a case example, the authors contrast two different approaches to
psychiatric assessment: the medical approach, in which the physician
examines signs and symptoms and compares them with diagnostic criteria for
various disorders, and the narrative approach, in which the clinician tries
to understand symptoms as a part of a meaningful story and as
understandable responses to external conditions. Both approaches make
essential contributions to psychiatry. The current conflict between
biological psychiatry and psychotherapeutic psychiatry can be seen as a
result of reductionist polarization involving these opposite approaches.
The reconciliation of these opposites may be vital for the survival of
general psychiatry as a medical specialty.