Neuropsychiatry as an Integrative Specialty
Neuropsychiatry is the science and art of combining clinical problems best understood as neurological, and problems best viewed as issues of the mind, to various degrees and with varying relative importance. This is the approach we take in the Neuropsychiatry Program at Sheppard Pratt, a program influenced by the rich humanistic tradition of Sheppard Pratt Health System and informed by the latest neuroscience research.
Traditionally, neuropsychiatry has commonly been viewed as placing an across-the-board priority on neural causes and mechanisms of human behavior. However, this is a narrow view of our specialty that ignores developments in the field of neural plasticity* and that reflects our current limitations in translating between brain and mind. In lieu of a pseudo-neurological narrowing down of what is traditionally within the perusal of psychiatry, neuropsychiatry should remain neutral to the unbridgeable tension between brain and mind and, in fact, exploit the tension as a useful dialectic for understanding and managing patients.
Now that neuropsychiatry, appropriately coupled with behavioral neurology, has moved into board certification status, it is crucial that we work to establish a theoretical framework for our field. This framework must be flexible enough to contain clinical complexities but also sound in its foundation on relevant paradigms from the revolution in the neurosciences in the last 25 years. In putting together this framework, we should respect the relative autonomy of brain and mind, and stay reminiscent of the limitations of scientific reductionism. If all else fails, we should resort to the counsel of clinical and empirical wisdom.
*The ability of brain structure, usually synapses, to change with time or in response to external events.