Prejudice in diagnostic and therapeutic processes in psychiatry

Il pregiudizio nel processo diagnostico e terapeutico in psichiatria

C. Maggini

Professore Emerito di Psichiatria, Università di Parma


Prejudice (from latin praeiudicium: early judgment that precedes any objective evaluation of facts) is commonly conceived of as a superficial judgment associated with refusing to question its foundation as well as to test its thoroughness and coherence due to uncritical endorsement of a particular point of view or ideological stance. Nevertheless, an alternative definition of this phenomenon sees prejudice as a constitutive element of the normal process of grasping and understanding reality. In fact, the first essential stage of this process implies both reduction and simplification of the vast array of basic information-data to lump them in homogeneous realms on the basis of theoretical assumptions and preconceived ideas. Therefore, prejudice can be conceived of as a modality of grasping and understanding an unknown or ambiguous reality that is carried out in advance, a sort of comprehensive intuitive precognition and pre-apprehension susceptible to further corrections and adjustments throughout subsequent testing. In Psychiatry, diagnostic and therapeutic procedures ought to consider both subjective and paradigm-related prejudices as much relative phenomena as possible and ultimately be able to emend and optimize those kinds of prejudice. Paradigm-related prejudices, in particular, should be seen as more relative phenomena depending on a critical discernment of the flaws and weaknesses of the applied paradigm. Those prejudices which stem from psychiatrist’s insecurities and needs for certainty before clinical complexity are instead the ones to be emended since they are often at risk for triggering an ideological endorsement of a certain paradigm. The prejudices to be optimized include those which have allowed us to be phenomenologists, without being aware of it, in a critical and creative daily exercise of patience and humbleness during patient-doctor encounters. Those prejudices have indeed made us capable of keeping our sensitivity receptive and attentive to listen to our own subjective inner experiences and resonate with them to intimately access our patients’ world.

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