How does the ‘environment’ come to the person? The ‘ecology of the person’ and addiction

Abstract

Currently, psychiatry lacks a field that can be called “theoretical psychiatry”, which uses theoretical concepts and explanatory models: The main stream of research is to collect data of all kinds in the hope that the computational Big Data approach will shed a bright light on the black box of mental disorders. Accordingly, the biology-based Research Domain Criteria of the National Institute of Mental Health have been established. However, as philosophical analyses of concepts and methods have shown, several epistemological gaps stand in the way of a consistent multilevel understanding of mental disorders. Also, the implicit ontological problems in the biological reduction of the psychosocial level and in the integration of so-called hard and soft disciplines are mostly left out. As a consequence, a non-reductive psychological theory of mental disorders is sought that also integrates correlating biological and sociological issues. In this context, one example of promising nonreductive psychiatric research is the option of systems/network psychopathology. The possibilities for integrating different psychological perspectives are highlighted for the field of addiction research and treatment, where pragmatic behaviorist approaches dominate over the theory-based practice of psychoanalysis. In comparing the theoretical constructs of these two approaches, the relevance of the concept of “(social) environment” as the wealth of influential sociocultural factors is discussed at levels superior to the interpersonal micro-level, namely the organizational meso- and societal macro level, which is not sufficiently considered in current biopsychiatry. On this basis of argumentation, the usefulness of grounding and framing psychiatry through the field of ecological sciences, especially human ecology, is demonstrated. Finally, to this end, an outline of an ecological model of mental health and illness is presented.

Keywords: Systems/network psychopathology, Theoretical psychiatry, Ecology of the person, Psychoanalytic object relations theory, Addiction, Mind, Resilience

Core Tip: Similar to theoretical medicine, theoretical psychiatry and its engagement with systems/network psychopathology has a research gap, and so we shed light on the question of how the “social”, respectively the environment, manifests itself in the person. Using addiction as an example, we explore systems theoretical and psychoanalytic concepts to provide a framework for understanding the sociocultural, interpersonal, and human ecological factors that impact mental health and illness. This theoretical framework provides a way to understand conceptually and structure computer-collected Big Data. The fact that humans are “situated subjects” implies a broader view of a systemic ecology of the person to guide processes of change in mental health, whether for prevention or treatment.