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Overheard
Psychiatrist A.: "An interesting schizphrenic patient. He loves cigars and when he lights one up the negative symptoms seem to disappear and he glows with pleasure."
Psychiatrist B.: "Perhaps cigar smoking has dopalytic activity.
Psychiatrist C.: (Passing by) "Sometimes a cigar is just a cigar.
Comment: "Some things never change."
—Sacks and Dixon (1989)
EXPLANATIONS AND DESCRIPTIONS, phenomenology and meaning, data and interpretation—each pair reminds us of the specific temporal flux in which we work—of how we look at what is "most real"—of how we grasp our world.
We have seen the rise of a Freudian interpretation of experience that emerged out of initial disbelief, and now we face another powerful shift in how we explain things. The sequence of comments in the epigraph to this brief note actually occurred in a modern hospital. It is amusing insofar as the allusion to a comment by Freud is clear, but something has happened to the explanation that suggests a change in what modern psychiatric training considers to be an adequate explanation of behavior. The comment marks the time of the encounter; it could not easily have occurred before 1985. The explanation in terms of neurotransmission clearly suggests that our younger colleagues are trying to apply what they learn about the substrate of the mind and to use it as an adequate explanation of behavior and mood. It has become commonplace to look for linkages across levels of observation and to hear phrases such as "chemical depression," genetic shyness, family aggregation of generalized anxiety disorders, panic attacks and agoraphobia, Clomipramine-sensitive obsessive-compulsive disorder (or more recently, fluoxitine-sensitive).