ABSTRACT
This chapter looks at some basic premises in our thinking in general psychiatry and suggests where a dynamic approach might integrate into the practice of psychiatry. The disease model classifies disorder on the basis of symptom clusters, which assume underlying anatomical and physiological change, and imply that there is a unitary disease process corresponding to the symptoms. The pathology of much mental disturbance is only partly understood. Mental disturbance can be treated at a pharmacological level, at a personal psychological level or at a family or social level. Sometimes treatment includes intervention at all three levels. In each clinical situation we have to decide whether a patient will be best helped by physical intervention (drugs) or psychological intervention, or a combination of both.
