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World J Psychiatr. Nov 19, 2021; 11(11): 915-936
Published online Nov 19, 2021. doi: 10.5498/wjp.v11.i11.915
How does the ‘environment’ come to the person? The ‘ecology of the person’ and addiction
Felix Tretter, Henriette Loeffler-Stastka
Felix Tretter, Bertalanffy Center for the Study of Systems Science, Vienna 1040, Austria
Henriette Loeffler-Stastka, Department of Psychoanalysis and Psychotherapy, Medical University Vienna, Vienna 1090, Austria
Author contributions: Tretter F and Loeffler-Stastka H conceived the topic in iterative discussions; Loeffler-Stastka H contributed the question how comes “the social into the mind” and added the psychoanalytic concepts; Tretter F provided expertise for systems theory, concepts on addiction, and the ecology of the person.
Conflict-of-interest statement: The authors declare no conflict of interest regarding our manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Henriette Loeffler-Stastka, MD, Dean, Professor, Department of Psychoanalysis and Psychotherapy, Medical University Vienna, Währinger Gürtel 18-20, Vienna 1090, Austria. henriette.loeffler-stastka@meduniwien.ac.at
Received: May 1, 2021
Peer-review started: May 1, 2021
First decision: June 17, 2021
Revised: June 30, 2021
Accepted: September 2, 2021
Article in press: September 2, 2021
Published online: November 19, 2021
Processing time: 199 Days and 13 Hours
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.