Medical Anthropology in the Work of Karen Horney

Whitehorn (1) has pointed out that quality in medicine is a function of the image the physician holds of human beings. Nevertheless, efforts to portray such an image by physicians are scanty throughout the history of medicine. Of course, in the development of basic notions such as etiology, pathogenesis, and therapeutics, an implicit image of human beings appears in medicine, which lends itself to the elaboration of a medical anthropology, but which is insufficient to guide medical practice. With Whitehorn, we believe that a clear definition of human beings is necessary to truly guide medical praxis and thus to arrive at an anthropological model of medicine which will define human issues such as illness, pain, and death-among many others (2). The above applies even more to psychiatry and particularly to “dynamic psychiatry.” Unlike any other field, here we confront the “total human being,” the concern of anthropology.

Enders (3) classified anthropologies as natural (empirical and philosophical) and theological. The former are in principle akin to psychiatry, and among a variety of them, two are of particular interest, namely naturalistic and personalistic anthropology. While naturalistic views approach the human being as a physico-biological entity, personalistic ones-as the name implies-see in a human being a person, a free and creative being. Unfortunately, both these views are compatible with medicine, and perhaps because of seemingly self-evident needs in medicine, naturalistic views have prevailed; this is true also for psychiatry. That medical praxis, like all human activity, is a function of contrary forces was documented by Schwarz (4). With the name of “antinomic forces,” he classified them in four groups: vocation versus profession, priesthood versus scientific career, personalism versus natural science, and individual versus collective service. We are concerned here with the third dyad.

Physicians do not deal with abstract entities but rather with concrete