often defined as the science of pathological behaviour and mental life.
This definition may have seman is acceptability but raises many practical problems that are not immediately apparent but account for much confusion and paradox which continue to trouble psychiatry at every level of practice. This article is an attempt to explore, define and explain some of these difficulties so that areas of confusion are at least recognized ind understood, even if they cannot be resolved easily. Doctors' training and temperament tend towards theoretical and practical formulations that are clearcut, to tangible and relatively certain by scientific parameters. In optimum conditions the doctor is working with problems where the patient's complaint may be dealt with on a technical scientific basis while the doctor at all times retains executive control over problem definition irid problem management—in our own language 'diagnosis' and 'therapy'. When working within this medical model the doctor relies on objectively observable data and the assumption that disease in the patient is due to a fault in the machinery of his body which functions autonomously of the 'whole person' with all his experiences (Zigmond 1977). Such exclusion is due to the fact that phenomena such as thoughts, sensations a nd feelings are not directly accessible to the observer and therefore difficult to include in any scientific formulation. This being so, it becomes necessary to use additional and alternative methods to the medical model in order to place the defined illness in the context of the whole person. Although this may powerfully facilitate understanding and treatment of illness, there is great resistance on the part of most doctors to using alternatives to the medical model. As we shall see, this resistance derives from the doctor's training, temperament and therapeutic dilemma.