A critical comment on Thomas Fuchs’s Psychiatry as a Relational Medicine
Psicopatologia Fenomenológica Contemporânea September 13, 2025 Peer reviewed DOI: 10.37067/rpfc.v14i1.1243 via DOAJ
Summary
This work critically analyzes Thomas Fuchs's book 'Psychiatrie als Beziehungsmedizin – Ein ökologisches Paradigma', which argues for an ecological-integrative paradigm in psychiatry. The book weaves together philosophy of mind, biology, psychology, and psychiatry, drawing on systemic theory, autopoiesis, enactivism, synergetics, and phenomenology. The analysis defends psychiatry as a medicine of relation, integrating the 5e paradigm with systemic and phenomenological models and the theory of vertical and horizontal causal circularity. This framework understands disorders of embedded subjectivity as disorders of self-understanding and interaction.
Study at a glance
| Design | theoretical or philosophical paper |
|---|---|
| Key finding | Psychiatry can be understood as a medicine of relation through an ecological-integrative paradigm that integrates the 5e paradigm, systemic and phenomenological models, and the theory of causal circularity. |
Abstract
The book Psychiatrie als Beziehungsmedizin – Ein ökologisches Paradigma (Fuchs, 2023) is an essential work in the field of phenomenological psychiatry. Thomas Fuchs manages, in a clear and pedagogical way, to offer the reader an argumentative path that weaves together different domains (philosophy of mind, biology, psychology and psychiatry) and multiple theories (systemic theory, autopoiesis, enactivism, synergetics and phenomenology), showing their coherence in an ecological-integrative paradigm. We propose a critical analysis of the main arguments presented in the book and based on an integrative ecological model, to defend that psychiatry is a medicine of relation. We emphasize the possibility of integrating the 5e paradigm and the systemic and phenomenological model with the theory of causal circularity, vertical and horizontal, which allows us to understand the disorders of embedded subjectivity as disorders of self-understanding and interaction of the person.