C-L Psychiatry: History Repeating Itself

As you know, I’ve been reading Don R. Lipsitt’s book, “Foundations of Consultation-Liaison Psychiatry: The Bumpy Road to Specialization.” It’s a fascinating and illuminating history of the specialty.

Not everyone was pleased with the idea of making C-L Psychiatry a subspecialty, as Don points out in Section III: The Process of Specialty Recognition: Prelude to Specialization, in which he quotes those who objected to the “arduous process,” for example:

“Psychosomatic is a relatively new term, but it describes an approach to medicine as old as the art of healing itself. It is not a specialty but rather a point of view which applies to all aspects of medicine and surgery….When the integration [physiology and psychology] is complete, we may not have to use the term, for good medicine will be psychosomatic. (p. 3; emphasis by au.)“–Don R. Lipsitt quoting Weiss and English (1943) in the first textbook on the subject. Again, further down the page,

“Psychosomatic medicine is not a specialty. The proper future of psychosomatic medicine is its disappearance, with replacement by a true holistic or comprehensive medicine. This is a far distant goal. For the present, psychosomatic medicine is necessary, both for purposes of special research and especially for the education of practicing physicians and surgeons as well as younger students.” (pp. 249-250; emphasis by au.)–Don R. Lipsitt quoting Carl Binger (1960), one of the founders of the journal Psychosomatic Medicine.

That’s a refreshing reminder. I think similar statements have been made about motivational interviewing–not really a well-defined psychotherapy itself but, rather, an approach to the style of therapeutic interviewing.

A practical book you can use
A practical book you can use

In his book, Don also mentioned a few other sources of worthwhile reading on the C-L Psychiatry practice itself, including the chapter on consultation process in the book Bob Robinson and I co-edited, “Psychosomatic Medicine: An Intro to C-L Psychiatry.” It was written by Dr. Jeanne Lackamp, who did her residency at Iowa. The other two are “Manual of Psychiatric Consultation” by Nada Stotland MD and Thomas Garrick, MD (published 1990) and “Sigmundoscopy: Medical-Psychiatric Consultation-Liaison: The Bases” by David Robinson, MD (published 1999). I ordered both and have only just received them and skimmed a few pages. Not much has changed. As Don says, “History does indeed have a way of repeating itself.”


And, one of the residents just informed me that a copy of Sigmundoscopy is in the resident’s lounge.

Sigmundoscopy in Book Exchange Resident Library

I wonder who donated it?

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