Primary Prevention: A Breakthrough in Sight

We live in the age of prevention. This is the main reason why we are still alive. Man has found many means to prevent hostile natural forces from posing threats to his life, and whenever he builds anything new, from a machine to a toy, he engineers safety devices to prevent breakdown and harm from its use.

Organic medicine has kept pace with scientific progress. Through prevention, it has eradicated bacterial and viral diseases that once caused horrendous epidemics. On the other hand, prevention of diseases of the mind has lagged. Humanity has always been concerned with the immensely destructive effects of these pathological phenomena, a concern second only to the maintenance of life itself. Still, whereas prevention in other fields has passed into the hands of experts, the task of developing healthy thinking and behavior in children remains the concern of religion, the family, the school, and the law. These well-meaning social institutions have not only failed in their assignment but are accused of having caused more severe illnesses than they were supposed to prevent.1 They have, we must say, acknowledged the difficulty of such an enormous task and are looking for whatever help they can get from other disciplines. Some present-day rebels claim that we should get rid of all models of social engineering. This is an understandable expression of despair over past failures, but it cannot be taken seriously. What is really needed is the elimination of the folk model of prevention which was and still is primarily based on moralistic-aversive conditioning. This must be replaced with a scientific model. It is critical that psychiatry assume a leadership role in the development of a scientific model of prevention.

Until recently, psychiatry had preoccupied itself exclusively in the field of treatment. Through the application of the classical medical model, it had attempted to isolate and classify definite clinical entities in the hope of finding a specific treatment for each