Most Research in Psychiatry Is Based on Quicksand

This article argues that, epistemologically, much of psychiatric research rests on unstable foundations because it relies on linguistic constructs that become mistaken for objective realities. Psychiatric diagnoses emerge from a complex translation of subjective patient experiences into professional terminology, a process that inevitably simplifies and distorts meaning. When such concepts are turned into presumed disease entities, reification occurs. Abstract human experiences are falsely treated as objective disease entities, which fuels stigma—even within psychiatric practice itself. The authors illustrate these issues through three examples—schizophrenia, Alzheimer’s disease, and suicidality—showing how each of these phenomena is often reduced to rigid categories that obscure personal narratives and contextual factors. As alternatives, they present two examples of research from a more phenomenological point of view, emphasizing the centrality of the therapeutic relationship. One example concerns psychopharmacological research in which the psychiatrist appears to be more relevant to the outcome than the medication, and the other concerns the conceptual model of transactional analysis as presented by Vos and van Rijn. The authors end with some recommendations for research, theory, and practice and warn that the dangers of reification and juggling with jargon must also be kept in mind in a transactional analysis approach.