Edward Shorter`s comment on Jack R. Foucher et al. Wernicke-Kleist-Leonhard phenotypes of endogenous psychoses : a review of their validity
Barry Blackwell’s additional comment
Ned Shorter’s incisive and supportive comment on the WKL nosology is also pessimistic of its evolution in a practical sense due to the need to free Anglo-American DSM nosology from “dominance of the American psychiatric establishment”
This hegemony is not only intellectual but economic, enhanced by the pharmaceutical and insurance industry both of which have garnered vast profits by enabling and capitalizing on the widening gap between psychopharmacology and psychotherapy approaches. (Blackwell 2017 ).
By the early 1990s in America practicing psychiatrists and their training programs not only turned their backs on psychoanalysis but threw out the baby with the bath water, settling for brief (less than 30 minute) “med checks” (Carlat 2010).
Clearly understanding and implementing the WKL nosology is not for the faint of heart or time constrained. Most psychiatrists have adjusted their practice to make a living in that manner, referring psychotherapy to non-medical providers and making do with an Axis 1 biological diagnosis for billing purposes.
For WKL to thrive would also require research support but the ECDEU program is long gone, the NIMH has rejected DSM as a research tool and replaced it with a poorly understood and neglected paradigm. Would industry in the English speaking world be interested in helping define small heterogenous, drug specific WKL populations and would the insurance industry help pay the possibly exorbitant price? Would WKL nosology fit the NIMH paradigm?
So, while WKL ideology is intellectually appealing, pragmatically we seem to be condemned to a passive by-stander role. Perhaps the more hopeful portent is the encroaching synthesis of INHN with the Morra Foundation, traditionally interested in the educational, clinical and research aspects of WKL nosology.
This might require that our website become bilingual (English and Spanish), perhaps even multilingual (French, Chinese and German)? Time will tell.
Blackwell B. Corporate Corruption in the Pharmaceutical Industry (revised). inhn.org.controversies. March 16, 2017.
Carlat DJ. Unhinged. New York, London, Toronto. Sydney Free Press, 2010.
November 5, 2020