Understanding psychopathology

Some texts can provide good examples of psychopathology. The worked example in a later section of this chapter illustrates this. Although there is no substitute for bedside clinical teaching with real patients, literature can provide a method of consolidating knowledge about psychopathology.

Awareness of the self

A work of literature is perceived in different ways according to our differing interests, personalities and varied life experiences. It is inevitable that our past experiences shape the understanding of the text that we are reading. How then, can we use a literary text to aid students' understanding of psychiatry when each student will perceive the piece of work somewhat differently? Rather than limit the use of literature, the varied responses actually illustrate a useful learning point that can be applied to the understanding of psychiatric practice. ICD10 diagnostic classification not withstanding, we each approach patients differently, and more clearly remember or relate to different aspects of their stories. And by discussing these differences in interpretation we can understand more about our roles within the treatment dyad.

Literature can facilitate self-reflection. Works such as Camus' The Plague and Chekhov's 'Ward No. 6' delve into the personal, professional and political lives of a doctor and a psychiatrist. The following excerpt from 'Ward No. 6' illustrates the difficulties faced by a professional:

Having looked the hospital over, [Dr] Ragin concluded that it was an immoral institution, detrimental to its inmates' health in the ultimate degree. The wisest course would be to discharge the patients and close the place down, he felt, but he decided he lacked the willpower to accomplish this on his own . . . Having taken the job, Ragin adopted an attitude of apparent indifference to the irregularities . . . Ragin much admires intellect and integrity but lacks the character and confidence to create a decent, intelligent environment.¹²