Persistent problems of thought, mood, perception, arousal, behavior and relatedness-- problems, that is, that manifest at the higher levels of organized function in the human central nervous system-- have long baffled subjects and observers alike. Is it I, or just my brain? The world, or how I perceive it? Do these feelings, this dream, this idea , these impulses, have meaning, to which I must attend, or are they just the noise of misfiring tissue in my brain, a bad brain day, better ignored or, even better, squelched with anti-symptom pills? Or somehow both? Or neither?

In their more severe forms, such as schizophrenia, autism, and manic-depressive psychosis, these disturbances strike most observers as convincingly organic in nature, accounting for their widespread acceptance as medical disorders in need of a medical approach to treatment. But more than a century's solidly scientific study has failed to uncover any reliable explanation for even the severest of these problems, while clinical experience has revealed frustratingly weak correlations between the phenomenology of symptoms as they present on the one hand, and responses to specific treatments on the other.

There seem to be many causal paths to the same few common clinical presentations; and, to confuse matters further, in many instances, more than one of these paths contribute to the outcome. Clinical depression, for example, often involves an inherited proclivity, an "encourager" in the form of drug or alcohol abuse, and a final precipitant in the guise of a major loss in life. More confusing still, all the symptoms of florid mental illness can arise without organic basis at all, caused and mediated entirely within the domain of the psychological. General psychiatry is the medical subspecialty devoted to the recognition, evaluation, diagnosis and treatment of problems such as these.

Adequate training in the field includes medical school, medical internship and postgraduate residency training in psychiatry. Some practioners will have pursued further studies, as well, such as fellowships in psychopharmacology or advanced psychoanalytic training.

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