Giống như Eric Kandel, tôi đã đến trường y tế hy vọng sẽ trở thành một nhà phân tâm học. Tôi đã có tiếp xúc đáng kể đến quá trình phân tâm học, kể từ khi tôi là một ứng cử viên tại York New tâm học viện 4 năm (1957-1961) và đã dành 17 năm để đánh giá những tác động dược lý và tâm lý trong bối cảnh dài hạn | CO M ME N TAR FROM METAPSYCHOLOGY TO MOLECULAR BIOLOGY Donald F Klein . Like Eric Kandel I went to medical school hoping to become a psychoanalyst. I have had substantial exposure to the psychoanalytic process since I was a candidate at the New York Psychoanalytic Institute for 4 years 19571961 and spent 17 years evaluating the effects of pharmacotherapy and psychotherapy in the context of the long-term psychoanalytic Hillside Hospital. These years were spent under the indulgent guidance of the director Lew Robbins an open-minded training analyst from the Topeka School. Kandel describes how his brilliant cohort of classmates split some pursued becoming better therapists while others hoping to develop a basic science for psychiatry became immersed in biology. In contrast my career was molded by the advent of clinical psychopharmacology. In the 1950s long before we had a clue to the biology of antipsychotics tricyclic antidepressants monoamine oxidase inhibitors and benzodiazepines the problem of an objective estimate of specific therapeutic benefit had to be addressed. This was largely because the idea that pills could do anything but stun patients into unthinking compliance was the conventional wisdom of the dominant psychoanalytically minded. This need for objective evaluation of specific effects led to the development of comparative placebo-controlled double-blind 107 108 Psychiatry Psychoanalysis and the New Biology of Mind rated randomized clinical trials. During placebo treatment remarkable gains often occurred. These gains were not directly due to the placebo but rather to a factor we had radically underestimated that is many illnesses after having hit bottom which led to entering treatment tend to get better under therapeutic optimistic and caring circumstances. The fact of clinical reconstitution during placebo treatment highlighted the ubiquitous post hoc ergo propter hoc fallacy. Psychotherapy was respected as a powerful tool because it was reported .
