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tiresome responsibilities. Assumption of these tasks can be overwhelming and stressful for the newcomer trying to adapt to new roles, The initial allocation of duties can also engender a degree of “sibling rivalry” [5] as some feel overlooked or undervalued. Boundary issues can lead to considerable discomfort: new graduates may find the establishment of peer relationships with senior colleagues difficult. Relationships with friends who remain trainees are often complex as one assumes supervisory roles or acquires information about their performance or practice. Issues of “identity and role confusion” [ 2 ] abound as new Consultants may contemplate altering their image or style to conform with perceived expectations or pressures. The myriad of possible career pathways and opportunities to gain experience in other countries can produce conflict and uncertainty. In an attempt to deal with some of these issues, “The senior trainees and new consultants group” was formed approximately two years ago in Auckland, New Zealand. After completion of the FRANZCP part one examination, trainees are invited to participate in the monthly meetings of this group. It has proven to be a useful forum for the ventilation of dissatisfactions and forproblem solving. In its unity this group has also been effective in dealing with the management of the Area Health Board services in resolving disputes about new employment contracts and conditions of employments. Throughout this period the generally good attendances at meetings and the unequivocal support for the continuation of the group has been a testimony to its success. Unfortunately in recent months a number of members have gone overseas and the number of new graduates has been few. Clearly, for continued success such a group needs to be continually replenished with new recruits. Nevertheless this forum has served the original cohort of members well and we would wholeheartedly recommend that new graduates in other branches and sections of the College contemplate the formation of similar groups. We would be happy to provide any advice in this regard. References I . Mahler M. Pine R. Bergman A. The psychological birth of the human infant. New York: Basic Books, 1975:65-75. 2. Erikson EH. Identity, youth and crisis. London: Faber, 1968. 3. Parkes CM. Bereavement. British Journal of Psychiatry 1985; 146:l 1-17. 4. Minuchin SM. Families and family therapy. London: Tavistock, 1974.

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5. Malan DH. Individual psychotherapy and the science of psychodynamics. London: Butterworth. 1979: I 10-I IS.

Language and complex phenomena Jo1iri Spencer, Nedlurids. Western Austrdiu:

West Australian fellows have patiently listened to Dr McLaren for over a decade and have been involved in considerable polemic and occasional refutation of some of his theories. It is gratifying after all this time to see some of the results of this process in the Journal [I]. Language and its limits, as Dr McLaren would agree, is one of the difficulties we face when trying to explain complex phenomena such as behaviour and the causes of psychiatric disorder. With this limitation in mind, I believe it is relevant to Dr McLaren’s thesis to suggest it is both misleading and inaccurate to use psychiatry as a single noun. Dr McLaren’s conclusion that “psychiatry is a protoscience” is an utterance referred to by philosophers as an existential statement which implies that not only does psychiatry exist, it is also unitary. This is a linguistic trap pointed out by Jean Paul Sartre which we should be aware of in these sorts of discussions. The origins of our temptation to raise questions about existence which no conceivable experience would ever enable us to answer lie in the fact that in our language sentences which express existential propositions and sentences which express attributive propositions may be of the same grammatical form. For instance, the sentences “Schizophrenics exist,” and “Schizophrenics suffer,” both consist of a noun followed by an intransitive verb. and the fact that they both have grammatically the same appearance leads one to assume that they are of the same logical type. It is seen that in the proposition *‘Schizophrenics suffer,” the members of a certain species are credited with a certain attribute and it is sometimes assumed that the same thing is true of such a proposition as “Schizophrenics exist”. If this were actually the case, it would indeed be as legitimate to speculate about the being of schizophrenics as it is to speculate about their suffering but, as Immanuel Kant pointed out, existence is not an attribute, so when we ascribe an attribute to a thing we covertly assert that it exists, so that if existence were in itself an attribute, it would follow that all positive existential propositions were tautologies and all negative existential propositions self-contradictory. This is not the case.

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Assuming that psychiatry has boundaries and therefore exists, the assumption that it is a unitary phenomenon also requires challenging. I believe Dr McLaren is correct in claiming that the theories of psychoanalysis, behaviourism, and now biologism have been found wanting. However, this assertion is only correct if we persist in viewing psychiatry as a unitary concept. Physics and the mathematics are just two of the branches of science which have now accepted the compromise that there are several physics; e.g. Newtonian, quantum and particle, for example. Without this paradigm shift science would have lost even more credibility than it has at present. I would like to propose that, in order to avoid some of the intellectual cul-de-sacs into which our language is leading us, we make a cognitive shift from “branches of psychiatry” to the more categorical concept of the psychiatries. I belive this would help us all with the dilemma that Dr McLaren has so clearly identified for us.

Reference 1. McLaren N. Is mental disease just brain disease’?The limits to

biological psychiatry. Australian and New Zealand Journal of Psychiatry 1992; 26270-276.

Consent and treatment Dr Graham Ridley, Traralgori, Victoria: I found Dr Wallace’s letter (Journal, 1992, 26:33033 1) most interesting. I am familiar with mental health legislation in both the English and Victorian systems, and both of these - in common, I suspect with many other such systems - have the similar problems of being unable to cater for voluntary patients willing to be in hospital but unable to give informed consent to treatment. The analogous situation in mainstream medicine would normally be dealt with either by the doctor acting in good faith, wherever possible in consultation with the patients’ usual carers, or, in more complicated cases, via the Courts. Psychiatric practice is unfortunately subject to much more stringent legal controls and these more frequently than not seem to interfere with, rather than enhance, patients’ rights to the best possible treatment even when they are unable to understand this by virtue of their disorder. ECT is a case in point. Here is a treatment which is not only known to be more rapid in the onset of its

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Language and complex phenomena.

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