Introduction

This book about psychiatry and human nature is dualistic. But it is not dualistic in the Cartesian sense of mind and body. Descartes conceptualised the mind and the body as two fundamentally separate and distinct substances or things. The brain for Descartes was a bodily, physical, mechanistic thing and the mind a conceptual, non-mechanistic thing hovering above the brain and somehow interacting with it. Cartesian dualism of the mind and the brain is an impossible metaphysical position for psychiatry.Footnote ¹

Rather, this book is dualistic in the sense that it views psychiatry as attracting two fundamentally different ways of seeing, feeling and conceptualising its object of study. I am going to call them the ‘classic’ and the ‘romantic’ perspectives, but, from the outset, I invite readers to step back from many of the associations that these words may have for them and consider the words in a way which may be unfamiliar initially. In this chapter I will lay out what I mean by these terms in more detail. However, because I would like readers to build a fuller sense of the contrast between ‘classic’ and ‘romantic’ in psychiatry through a consideration of it across examples, I recommend rereading this chapter after you have read the topic-specific chapters, or even skimming some of this chapter now with a view to returning to it later.

There is a natural reaction against dualism of perspectives, namely that differences are a matter of degree and that perspectives mix and integrate. The classic and romantic perspectives do mix, and it is the contention of the book that they must integrate in psychiatry, but the thesis is that their differences need to be better grasped for better integration. This is because it is possible in psychiatry to be committed to either the classic or the romantic perspective, and to be disproportionate in that commitment. It is also possible to be confused or overconfident in mixing the classic and the romantic. This book takes Goethe’s point about these risks seriously (see the quote at the start of the chapter), as well as his suggestion that both the classic and the romantic perspectives need active cultivation rather than lazy assumption.

Clarifying Terms

Historians of ideas and culture keep identifying two clusters of intellectual/emotional characteristics across civilisations. These have been variously termed. The philologist and philosopher Friedrich Nietzsche drew attention to two opposing cultural tendencies within the ancient Greeks – the ‘Apollonian’ and the ‘Dionysian’ – mapping them onto the worship of two deities – Apollo (god of light) and Dionysus (god of wine). The historian and philosopher Isaiah Berlin drew attention to two similar clusters within eighteenth-century European cultural history: the Enlightenment and – running with it, and opposing it – the Counter-Enlightenment. The literary theorist, psychiatrist and writer Iain McGilchrist, studying the human cerebral hemispheres in the light of culture, contrasted the ‘left hemisphere’ and the ‘right hemisphere’ as organic substrates for two fundamentally different takes on the world. Social anthropologists Goodenough and Harris distinguished research that observed and analysed native customs (‘etic’) from research that participated in, and prioritised, the native’s point of view (‘emic’). The mathematician Blaise Pascal distinguished ‘the subtle spirit’ from the ‘geometric spirit’ and thought that ‘the heart has its own order; the intellect has its own, which is by principle and demonstration’ ([Reference Pascal2], fragment 277). In popular culture there is a recurring contrast of ‘science’ and ‘art’, and in ordinary psychology we often cluster and contrast ‘reason’ versus ‘emotion’.

Goethe, summarising the trends within the artistic and intellectual milieu of his day, spoke of the ‘classic’ versus the ‘romantic’ – and occupied both positions himself, in different ways, across his rich career. The distinction arose in his discussions with the physician, playwright and polymath Friedrich Schiller, and was widely referred to in literature and art history thereafter.

These are not precise contrasts but they are recurring ones. They are family resemblances, or broad patterns, useful for our purposes.

For a variety of reasons, I prefer Goethe’s terms to the other contrasts. The main reason is that Goethe was not necessarily locating them in time (his own) or place (the Europe of his day). He saw them as much more perennial poles of human experience and activity, and conceptualised them in the context of his concept of world literature. This is in distinction to Nietzsche’s terms, which are too historically located in ancient Greece to be universal, or Berlin’s terms, which are highly concentrated within quite a short period of European history. Nietzsche’s Apollonian/Dionysian contrast and Berlin’s Enlightenment/Counter-Enlightenment contrast are historically and geographically located (the ‘west’). But the contrast they point to need not be. There are similar contrasts in the ‘east’. For example, in ancient India a preoccupation with (1) logic and epistemology and (2) materialism and scepticism about immortality can be found in the Nyaya school (arising between the sixth and second centuries BCE) and the Charvaka school (circa sixth century BCE), respectively. Both are cultural characteristics that overlap with the Enlightenment in Europe – they are just much more extended or diffuse across time in India.

I also prefer Goethe’s terms to the contrasting terms ‘left hemisphere’ and ‘right hemisphere’, ‘etic’ and ‘emic’, ‘science’ and ‘art’, or ‘reason’ and ‘emotion’. ‘Left hemisphere’ and ‘right hemisphere’ as references to a biological organ (literally two brain masses) can distract from the cultural or ideational patterns which are the main family resemblances under consideration. ‘Etic’ and ‘emic’ are limited to ethnographic research distinctions. The contrast between ‘science’ and ‘art’ is too bland or constructed or stereotyped in our culture – it is not nearly as phenomenologically rich as Goethe’s contrast of ‘classic’ and ‘romantic’. The ‘reason’/‘emotion’ contrast is not quite right either – it is too psychological. What is meant by ‘classic’ and ‘romantic’ is not the preserve of one special science. Reservations about these terms is not to imply that the contrasts they point to are without interest (they are of significant interest); it is just to say that I will be using Goethe’s more encompassing starting position and words.

The words ‘classic’ and ‘romantic’, however, do need some clarification as they have come to have inconsistent uses sometimes serving ideological ends. For example, ‘classic’ can refer to the ancient Greek and Roman world. It can also refer to the foundation of a given subject – as in ‘classical mechanics’ or ‘classical psychiatry’ – or to an early period of a nations’ cultural output, as in ‘classical German culture’ (which is actually a reference to romanticism/idealism in the period around the French Revolution in a newly emerging German nation). So, uses of ‘classic’ can mean very different things.

Similarly, there are various and inconsistent uses of the word ‘romantic’. ‘Romantic’ can refer to romantic novels, as in the genre of fiction focused on amorous relationships. It can refer to an eighteenth/nineteenth-century European style of poetry, literature and art. It can refer to ‘romantic science’, which is not about poetry, literature and art but about a way of doing physics, chemistry and biology. It can also refer to nostalgia for the past or to hopes of liberation in the future. So romantic, like classic, can mean different things – it does not necessarily mean falling in love or doing art. Indeed, it can refer to science or even to how to arrange institutions and societies.

This range of uses might make us very sceptical about using the terms ‘classic’ and ‘romantic’ at all. Romantic has been especially difficult to define. Berlin, writing about the roots of romanticism in the western world, simply sidestepped definition:

Despite awareness of the difficulties, scholars repeatedly use the term ‘romantic’, confident that it makes sense to do so. Indeed, as we will see, the resistance to categorise or define is inherent to the romantic perspective itself.

Classic is less difficult to define because the perspective itself holds a positive attitude towards categorisations and definition, including definitions of its own activity. The sense of the word I want is closest to reason, scientific method and intellectual self-examination – terms often associated with the Enlightenment. Yet even here difficulties with definition can be noted. The philosopher Ernst Cassirer, for example, trying to characterise the mind of the Enlightenment, wrote that ‘a “definition” cannot serve as a really unambiguous starting-point, for such a starting-point can only be obtained from experience and observation’ ([Reference Cassirer4], p. 8). Cassirer knew that the Enlightenment was heterogeneous and he wanted to resist the characterisation of it given by romantics as ‘shallow’ ([Reference Cassirer4], p. xvii). He used his study of the Enlightenment to represent a universal human symbolic form of knowledge where reason and science become the primary means of making sense of reality and harmony/balance becomes the main aesthetic tendency ([Reference Cassirer5], part III). Cassirer’s use of the term ‘Enlightenment’ is close to the sense of Goethe’s ‘classic’, which I think is another reason to prefer Goethe’s term.

So, let us start with some working characterisations which we can enrich later with more examples and observations.

Additionally, let both terms have a whole-world and human reference not constrained by epochs or locations whilst appreciating that specific movements have exemplified them in time and place. This whole-world reference is what Goethe had in mind with his world literature. In other words, despite the constraints in the scope of scholarship (e.g. language, primary texts, training, unconscious assumptions) which mean that the reference to ‘world literature’ is necessarily partial and perspectival, let the human world be the primary reference for the terms ‘classic’ and ‘romantic’.Footnote ³ This implies that ‘classic’ is not necessarily western or European, and is not even necessarily modern. It also implies that ‘romantic’ is not necessarily about art, poetry or novels, and it is not necessarily from Germany.

The Classic Perspective (with Prototypes)

Reason, science, balance and harmony have a distinctive kind of coolness and detachment. The phrase ‘Olympian detachment’ captures this quality of removal from the everyday struggles and emotional entanglements of ordinary life to a serene and cool position at the top of a mountain (Mount Olympus).

In art, this Olympian detachment can manifest in attention to form, simplicity and clarity. It will seek harmony, exercise restraint and represent objects in stasis. In science, the detachment manifests in the general rather than the particular, and in impersonal laws or mechanisms. It will be interested in systems of logic and knowledge of facts independent of the subject.

Scientific method is germane to this perspective, though it would be misleading to professionalise the classic perspective. Bertrand Russell [Reference Russell7] identifies the experimental habit of mind as a key feature of the scientific outlook, wherein knowledge of mechanisms proceeds from experiment rather than from tradition. Experimentation to determine how things work or how to make reliable predictions is something we all do to varying extents in our lives. It is important to note, however, how doing this requires a separating from everyday knowledge. If a tool one is familiar with stops working (e.g. a tool one is using to get a job done fails), then one brackets, or detaches from, the tool as a familiar object – one steps back to observe it and one manipulates the tool into unfamiliar states in order to learn more about it so as to return it to a working state. That is the experimental mode of mind.Footnote ⁴

The Arabs, before the ‘scientific revolution’ in Europe, had a strong culture of observation and experimentation (especially in chemistry) and advanced techniques, but Galileo in Italy was more fully a representative of the classic outlook in the sense of Olympian detachment. His experimentation with moving bodies on Earth and his observations of planetary movements yielded laws of motion and mechanistic theories of the Earth’s orbit of the sun which were highly detached from tradition, impersonally conceived and expressed with all the simplicity, clarity and harmony of mathematics. Galileo can be taken as one prototype of the classic perspective. The chemist Peter Atkins, for example, rests virtually all of science on Galileo.Footnote ⁵ However, we have already mentioned parallel traditions in ancient India which emphasised logic and representational knowing, so this Galilean prototype only goes so far. Some concepts upon which science rests (e.g. the concept of zero) were entirely imported into Galileo’s outlook.

The classic perspective is not solely about experimentation. Olympian detachment is also about theory – a word which derives from ‘viewing’ or looking at. Consider the cool position from the top of Mount Olympus: one looks at or theorises everything. But the theorising of everything is not an absorption in the view; rather, it is an enveloping of the view in a concept. This inherently conceptualising mode – the valorising of the idea or the concept – is an important quality of the classic perspective. It was very evident during the Enlightenment. ‘Justice’, ‘Truth’, ‘Number’ – such ideas, brought to the forefront during the Enlightenment, are concepts that are universalising. Theories of everything are possible through conceptualisation. This intensely conceptual quality was not lost on those living through the Enlightenment, such as the eighteenth-century playwright Friedrich Schiller, who wrote that ‘The Enlightenment, which the higher ranks of our age are not wrong in extolling, is merely theoretical culture’ ([Reference Schiller9], p. 125).

The Romantic Perspective (with Prototypes)

Attention to the meaning of phenomena, rather than their causes, is our first step towards understanding the romantic perspective. This takes phenomena to be expressive.

Understood like this, the romantic perspective manifests in simple, immediate observations about human psychology or nature. It also manifests in myth. We see the rage in the person’s face or their entreaty in their outstretched arms. In our engagements with nature we experience that the lake is peaceful or the rain is fierce. Clearly, this perspective is not manifested only in certain periods of human history or culture, and there is something more natural about this perspective in the sense that it is probably our default one as human beings. Indeed, to function it requires sympathetic entanglement with the world rather than ‘Olympian detachment’. Things which are meaningful and expressive are alive, move, are warm or hot and they show spontaneity. We enter the world as entangled human beings (quite literally). That is where we start. Cultures which emphasise the classic mode may tend to view the romantic negatively as ‘primitive’ or ‘atavistic’. But another way to view the situation is that mythic practices like Delphic rituals, African tribal customs, the relaying of Arthurian tales or Norse or Germanic sagas are simply practices emphasising the romantic mode. Modern romantics are oftentimes trying to get back to these practices to fuel this mode.

The famous English romantic poets (Wordsworth, Coleridge, Shelley, Byron, Keats) were interested in classical Greece not because they were interested in the classic in the sense I am meaning here; they were interested in the feelings of the past and the sentiment of nostalgia gained from contact with ruins and the threads within ancient Greek culture that were in opposition to the ‘Olympian detachment’ of the classic perspective (e.g. the ancient myths, the Bacchic rituals, the lyric poetry). Byron, for example, went to Greece not to honour Socrates or Archimedes but to seek poetry from dwelling in the ruins and fighting (and dying) in a war of independence. ‘Fair Greece! sad relic of departed worth! Immortal, though no more; though fallen, great!’ he wrote ([Reference Byron10], second canto, LXXIII).

Friedrich Schlegel, the German romantic thinker, considered that there were three main events for his famous ‘Jena set’:Footnote ⁶ Fichte’s doctrine of knowledge (‘Wissenschaftslehre’), the French Revolution and Goethe’s novel Wilhelm Meister ([Reference Safranski12], p. 19). Fichte’s Wissenschaftslehre put human self-awareness, or self-consciousness, at the centre of all inquiry. Even those aspects of experience that seem most inanimate and de-linked from human subjectivity Fichte folded into human self-consciousness. ‘Think of yourself and pay attention to how you do this’, Fichte told his students; ‘now think about the wall’. The radical difference between those two things thought or between these two possible objects of awareness (the self or the ‘ich’ and the posited physical wall or ‘non-ich’) was all part of the human’s struggling and striving with intuition, Fichte taught, within a dialectical self-consciousness of the ich and the non-ich. Fichte sought to show a self-consciousness where ‘what is subjective and what is objective are inseparably united within self-consciousness and are absolutely one and the same’ ([Reference Fichte13], p. 113). For Schlegel and his romantic circle, it was this kind of immediate, striving self-consciousness that was, and should be, sought.

The French Revolution was about liberation. It imagined a future free from the chains of the past and the decadence of the existing monarchy and the creaking feudal economic system. Both were experienced as oppressive forces of the status quo which, once released from, would enable equality and solidarity. People in France, and beyond, acted on that image with widespread political activism. For Schlegel and others this kind of activism was central to the romantic perspective.

Goethe’s novel Wilhelm Meister is about character development and becoming. It is often said to be the first ‘Bildungsroman’ or novel about a person’s self-realisation in time. The main character, Wilhelm Meister, passes through despair due to love disappointment, various entanglements with a diverse range of people and places, entourages and fellowships and theatrical performances – in short, horizon expansion through relationships, conversations and strife. Wilhelm Meister was taken to be an exemplar of the romantic life.

Reflecting on these events that fuelled Schlegel’s romantic circle, we gain a sense of the romantic perspective being characteristically about self-awareness and time – primarily in the sense of futurity – and also about activism.

Further Elaborations

The phenomenologist Max Scheler accepted Goethe’s distinction between classic and romantic and sought to elaborate on them in one of his late philosophical works. He lays out contrasting qualities, as summarised in Table 1.1 ([Reference Scheler14], pp. 244–5). Scheler’s main point is that the dichotomy of classic and romantic, in varying degrees of interpenetration, makes up human culture – and that dichotomy makes us inherently multifaceted, and conflicted, as human beings.

The Russian neuropsychologist Alexander Luria also accepted Goethe’s distinction and applied it to scientists’ overall attitude towards their science as well as their personal characteristics. ‘Classic scholars’, he wrote, are ‘those who look upon events in terms of their constituent parts. Step by step they single out important units and elements until they can formulate abstract, general laws. These laws are then seen as the governing agents of the phenomena in the field under study.’ Luria contrasted this with ‘Romantic scholars’, for whom it was crucial to ‘preserve the wealth of living reality … they aspire to a science that retains this richness’ ([Reference Cole, Levitin and Luria15], p. 174).

We can make some additions to Scheler’s scheme using our earlier considerations of the distinction and also from Luria’s remarks (see Table 1.2).

Scheler makes a pertinent, but very brief, remark ([Reference Scheler14], p. 245) that the romantic perspective can be conservative or revolutionary. This feature of romanticism (i.e. its pluripotency with respect to political action) is important to go further into because it helps us gain more insight into the self-awareness and temporality that forms or constitutes the romantic perspective.

The political terms ‘right’ and ‘left’ date back to the French Revolution. They were used to designate physical positions – literally to the left and to the right – relative to the presiding officer of a National Assembly that was tasked to draft a new constitution for France. To the right of the officer were members who supported conservation of traditions and were sympathetic to the nobility and to monarchy. To the left were members who supported revolutionary changes, republicanism and full secularism. The members on the right came to be known as ‘right wing’ in their political orientations and values, and the members on the left came, similarly, to be known as ‘left wing’ [Reference Lukes16, Reference Scruton17].

These terms have extended in their use well beyond the French Revolution and have become used to demarcate general tendencies in political life – namely, the distinction between progressive movements and outlooks that are seeking equalisation of power and those which are traditional and conservative and which recognise hierarchy in authority. Even during periods of history characterised by conservativism (e.g. Europe in the Middle Ages) one can find ‘left wing’ movements in the sense we are using here. Examples include the Peasants’ Revolt in England in 1381 under Wat Tyler and the reformist movement initiated by John Hus in Bohemia in the 1400s. Periods of history characterised by progressive, republican and secular trends can also have within them ‘right wing’ movements. An example from the progressive left era of the Union of Soviet Socialist Republics was the conservative dissent movement seeking traditional values led by Alexander Solzhenitsyn.

The concepts of right and left have been surprisingly enduring and helpful in political theory [Reference Bobbio18, Reference Sowell19], despite the clear existence of mixtures and ‘centrism’ in politics. Polarisation as an extreme political, social and cultural phenomenon becomes quite hard to understand unless right and left are marking out quite basic aspects of our moral and political psychology, as the social psychologist Jonathan Haidt has argued. Haidt supports his arguments with data across cultures showing that the political categories of ‘progressive’ and ‘conservative’ map to different weightings on values [Reference Haidt20]. The emotions linked to those values can be intensified, concretised and manipulated, leading to what is now widely referred to as the ‘culture wars’.

But what are left and right in terms of the romantic perspective? Let us begin with left.

Schlegel held the French Revolution to be quintessentially romantic. A key political thinker of the French Revolution was Jean-Jacques Rousseau. Rousseau held a distinctive view of the self as originally good or innocent. The human being for Rousseau was, in its original, natural form, a being whose desires and values were benign. The society – or the structures or institutions of the society – that we are born into make us uncaring, ignoble, malign or ill. Rousseau’s sense of time or temporality is also distinctive: it takes the past and present as something to escape (life has been traumatic) and it sees the future as liberating (offering possibility and resolution). The image of social utopia is there, beckoning us into the future. There is a fundamentally forward movement to Rosseau’s thinking – it presses into the future, seeks social and political advance and is deeply ‘progressive’ in this sense.

The right also has a preoccupation with the French Revolution. The Anglo-Irish philosopher and politician Edmund Burke lived through it and was fascinated by it. His book Reflections on the Revolution in France [Reference Burke21] has become a core text of conservatism. Burke focused on the ideas of reason and human rights which were held by the revolutionaries, and the new scientific analysis they had of society and how to make it better. He thought this analysis ran roughshod over the feelings and affections which hold people together in social affairs and the organic, living richness of societies which make them meaningful to live in. His romanticism made him sceptical of social engineering and pressed his activism in the opposite direction to that of Rousseau’s:

For Burke, the French Revolution had become a nightmare of new social abstractions force-fitting themselves onto human beings and distorting human relations.

Rousseau’s romantic sense of self and time are instructive to compare with another French thinker who holds a contrasting romantic sensibility: Blaise Pascal. For Pascal, the human being, in its original, natural form, is inherently vain and liable to error,Footnote ⁷ thus society has evolved traditions to tame this vanity and adjust it to the uncertainties it faces. Notice that self-awareness and temporality are distinctive here compared to Rousseau. Trauma is not so much acquired from unreformed social forces as an inescapable starting position for the human being in its natural state (in this sense congenital), and the past and present are thus not something to escape but rather something to reconcile oneself with in a way which is best offered through the loyalty to the longest surviving traditions accrued in historical time. The future does not offer resolution; the possibility of social utopia is deleterious to the task of constructing better adjustment to our ongoing foibles, vanities and experience of uncertainty. The future may offer moments of individual insight which we know from the way insight has featured in the past, but past insights offer the surer ground and so precedent and the appreciation of history are to be preferred over current enthusiasms. Burke thought insights manifested in aesthetic moments in nature (the sublime).

Examples of these contrasting left and right romantic perspectives in human history seem quite plentiful. A few from the western world, across philosophy, psychiatry and law, most familiar to me are worth recording for illustrative purposes, and because of the hypothesis that the contrast is to be found widely in the world once looked for. Table 1.3 shows some examples of individuals – older and more recent – who show romantic perspectives in various degrees of left or right.

Max Scheler’s insight into the political pluripotency of romanticism suggests that, whilst the romantic perspective has unifying characteristics (see Tables 1.1 and 1.2), it manifests itself differently in self-awareness, temporal awareness and the will to act. But if this view of the romantic is correct – namely, that it is a basic human mode or field of attention which can range from right to left – then we should expect examples of individuals who have moved between left and right politically whilst remaining within the romantic perspective. Have there been examples of left-wing romantics who have become right wing, and vice versa?

Friedrich Schlegel and William Wordsworth were famous romantics who in their early lives were politically left. Both supported the French Revolution and held to forms of activism that were progressive and infused with Rousseauean sentiments. In their later lives they both shifted towards conservatism. Schlegel became religious and Catholic – rather than seeking to usurp social traditions, he emersed himself within them. Wordsworth lost his enthusiasm for the French Revolution and his nature poetry became closer to Burke’s ideal of the sublime:

Victor Hugo was a prototypal romantic who in his early life was conservative in outlook and with age become progressive. He seems to have absorbed his mother’s strong royalist sympathies, and in his twenties his poems celebrated religious sensibilities and medieval themes. Over time, he became secular and progressive in outlook, championing the republic and social progress, especially in relation to poverty. Max Scheler is another example of a person who shifted right to left with age – in his early life he was a Catholic ethicist with quite conservative and nationalistic views. As he aged, he become more progressive and his outlook became panentheistic. Thus, the romantic perspective can express itself differently across a lifespan within the same person.Footnote ⁸

The classic perspective has an inherently apolitical tendency. For example, logic and mathematics (classic ideals) are indifferent to politics. The perspective attaches itself to left or right romanticism – it does their biddings, as it were, and is animated by their ebb and flow.

Goethe’s colleague Schiller realised this tendency, writing that ‘The Enlightenment … is merely theoretical culture, and on the whole shows so little refining influence on sensibility that it rather more helps make a system out of corruption, rendering it incurable’ ([Reference Schiller9], p. 125).Footnote ⁹ Schiller means that, by itself, the Enlightenment (or, more broadly, the classic perspective) could systematise any emotional or moral sensibility and had no inherent motivation to be left or right politically.

However, one thing the classic perspective is able to do which is politically significant is identify/note, hold in check and balance currents of left and right in our self-awareness, our sense of time/temporality and our will to act, at both individual and social levels. We will return to this in Chapter 12.

The Psychiatric Context

Approach to and Pictures of the Classic–Romantic Relationship

So, this book is based on a dualism of the classic and romantic perspectives with an appreciation that the romantic perspective may span from the revolutionary to the conservative (left to right). Its contention is that psychiatry, ultimately, needs to integrate these classic and romantic perspectives – or at least hold them in some kind of modus vivendi because they are fundamental ones. In other words, it is not going to be a matter of the classic disproving the romantic or one achieving a sustained conquest over the other. It is also not likely that culture wars will succeed in sorting psychiatrists into pure perspectival camps with some final victory of one camp because the left–right sensibility within the romantic perspective (in dynamic, often messy and context-dependent mixtures) runs through each person in each camp.

The basic dualism imagined is expressed well in Goethe’s poem ‘Ginkgo Biloba’:

The name of the poem is after the leaf of the Ginkgo tree native to China (see Figure 1.1).Footnote ¹³

Figure 1.1 The bifurcated/dichotomous structure of the ginkgo leaf – Kaempfer ginkgo.

(Sherardian Library of Plant Taxonomy and Oxford University Herbaria)

Goethe’s poem gives a self-consciousness of both ‘double and One’ true to his wide conception of human nature, his acknowledgement of painful divisions and the potentiality for tragedy. But, ultimately, it is a life-affirming approach.

It may also help to represent the dualities pictorially as follows:

The chapters which follow on specific topics in psychiatry and human nature are attuned and informed by these pictures. I hope the pictures are not imposed or forced on the material; rather, I hope that they allow the material to be approached and imagined more deeply. They have evolved through researching and teaching the chapter topics over several years and reflecting upon them in clinical practice. To reiterate: these are not precision definitions of the classic and romantic perspectives, but patterns or family resemblances.

All chapters touch on questions relating to human nature, and in Chapter 12, I will try to bring them together, looking more generally at psychiatry and human nature and making some high-level recommendations for the future of psychiatry. Each chapter can be taken on its own terms, though there is a lot of cross-referencing between chapters too. In this way, a web of meaning for the classic and romantic perspectives in psychiatry and human nature can be built up.