The grammar of the psychiatric interview. A plea for the second-person mode of understanding

In a recent editorial in this journal, Christoph Mundt argued that the diagnostic interview is part of therapy since ‘the way of asking has an impact on the patient’s self-perception’, and helping patients to ameliorate their self-perception is an essential component and aim of the therapeutic process. The uncoupling of assessment procedures and therapy is an untenable principle in practicing clinical psychiatry: we do not use two separate sets of instruments, one for diagnosing and the other for treating patients, but only one whose scope is to enforce the patient’s intentionality, i.e. his capacity to communicate the feel of his experiences and to make better sense of them. The dispute about the ‘family of instruments’ psychiatrists use or should use for assessment – that is, the debate about the scientific status of psychiatric diagnostic procedures and categories – viewed from this angle largely coincides with the debate about the scientific status of psychotherapeutic approaches.