Psychopathologie: operationalisiertes Werkzeug oder „Denkstil“?

In recent times, the term psychopathology has been accompanied by a clear ambivalence: positively connoted it stands for a person-centered, method-conscious approach to the mentally ill person. Critical objections, however, identify tendencies towards unreflected medicalization, pathologization and stigmatization in psychopathology. This debate is of particular practical relevance to psychiatric diagnostics as defined by ICD-10/ICD-11 and DSM-5-TR. In the twenty-first century, criticism became more prominent that operationalized diagnostics, which are internationally established but still based on traditional Kraepelinian nosology, could unjustifiably narrow the scientific horizon of psychiatry in view of recent research developments.

Against this background, which is as complex as it is relevant to the practice, this paper is intended as a plea for psychopathological traditions of thought to be recognized as valuable foundations of psychiatry, also in a forensic setting. Far removed from mere historicization or uncritical idealization, psychopathology, irrespective of its empirical-descriptive components, also has the potential in the twenty-first century to express a person-centered attitude, indeed, in the sense of the microbiologist and philosopher of science Ludwik Fleck (1896–1961), a “style of thinking” that is particularly appropriate to psychiatry. An open dialogue with current psychiatric research in the sense of “connectivity” is indispensable for this. In addition to theoretical reflection, the practical relevance of the topic is established by relating to a much-discussed recent decision by the Swiss Federal Supreme Court.