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Revista de Psiquiatria do Rio Grande do Sul

Print version ISSN 0101-8108

Rev. psiquiatr. Rio Gd. Sul vol.26 no.2 Porto Alegre May/Aug. 2004 



A conversation with Cláudio Laks Eizirik, first editor of the Journal





Interview given on 25 July 2004 to the editor and members of the Editorial Board (Photo): Antonio Marques da Rosa, Jacó Zaslavsky, Letícia Kipper, Anna Luiza Kauffmann, Julio Chachamovich and Gustavo Schestatsky.

Dr. Cláudio Laks Eizirik was the first editor of the Journal of Psychiatry of Rio Grande do Sul, a fact which makes us very proud at a point in time when the Journal is completing 25 years of existence. He has held such an impressive list of posts in institutions that introductions could be dispensed with, since he has filled many posts at the level of director and manager and has tended innumerable services to psychiatry, psychoanalysis, teaching, research and culture. He is a gifted with great capacity to unite and integrate institutions. He is an editorial or consulting member of the boards of many national and international publications. In addition to be known in our area, both at the national and international levels, he has accrued an extensive quantity of high quality scientific production, publishing articles and books in several languages.

From amongst the many titles and posts held by Eizirik we could cite: Associate Professor at the Department of Psychiatry at UFRGS, Didactic Psychoanalyst of the Sociedade Psicanalítica de Porto Alegre, President elect of the International Psychoanalytic Association, Former President of the Sociedade Psicanalítica de Porto Alegre, Former President of Fepal, Former Head of the Department of Psychiatry at UFRGS, Former Director of the Medical Faculty at UFRGS, Former Coordinator of the Post-Graduate Program in Psychiatry at UFRGS.

Journal of Psychiatry of Rio Grande do Sul (J): In the names of the Editorial Board of the Journal and of the Sociedade de Psiquiatria do RS (SPRS, Brazilian Society for Psychiatry), we would like to thank Cláudio for taking time to talk to us about the Journal which is now completing a quarter of a century and of which he was the first editor.

Firstly, we'd like to ask you to tell us how the Journal originated.

Cláudio Laks Eizirik (C): It is a great satisfaction to be here with you. I was looking at the first and latest issues of the Journal and I realized, with emotion, that what I had proposed in the first editorial has happily come to pass, i.e. the Journal has not failed to be published by its successive directorates for all these years. At a certain point the Sociedade de Psiquiatria do RS, Clínica Pinel and the Centro de Estudos Luís Guedes, joined forces to publish a journal called the Revista de Psiquiatria Dinâmica, on the Editorial Board of which I sat and whose editor was Carlos Gari Faria. Later, Marcelo Blaya, who was director of Clínica Pinel at the time, informed us that Clínica Pinel no longer wished to participate in the journal and that they wished to produce their own. Therefore, after discussions between the various interested parties, that deal came apart.

That was when Hans Ingomar Schreen, president of the SPRS, together with his scientific director, José Ricardo Pinto de Abreu, had the initiative to start a journal for the SPRS and invited me to be editor. I, therefore, invited a series of colleagues to work with me. They were : Antônio Carlos Jardim Pires, Cláudio Maria da Silva Osório, Ivete Enk, José Ricardo Pinto de Abreu, Juarez Guedes Cruz and Maria Lucrécia S. Zavaschi. We became the Editorial Board and we began to plan the Journal.

We set up a Consulting Board with our colleagues: Carlos Gari Faria, David Zimmerman, Hans Ingomar Schreen, Isaac Pechansky, Manuel Albuquerque, Milton Shansis, Odon Cavalcanti Monteiro and Roberto Pinto Ribeiro.

Abstracts in English were written by Cristina Heuser, and our secretary was Dalva dos Anjos, with whom I worked for many years.

In March 1979, it was ready. We took delivery of the Journal from the printers Grafosul, on Rua General Vitorino, on either a Monday or Tuesday morning. Thus was the Journal born. I remember that we had one curious section in this first issue: "Test your knowledge". We also had book reviews.


J: What was the editorial line taken by the SPRS Journal at that time? Was it different from that taken by the Revista de Psiquiatria Dinâmica that had preceded it?

C: The Revista de Psiquiatria Dinâmica was a more focused journal. With the new journal (the SPRS journal) we aimed to be wider-ranging. The idea was to have a journal that could be open to all tendencies and that would give space to all currents in gaucho (adj. pertaining to the state of Rio Grande do Sul) psychiatry of the period.


J: And, from then till now, over these 25 years, what is your impression of the Journal's evolution?

C: I think there has been a great deal of development of the Journal. I can't evaluate the whole 25 years because I would have to see what each editor had added, something specific, or how each committee went about introducing their changes. There was a point when the "Debate Cycles" began, during Mabilde's stewardship, which became very important. During the management when Sérgio Lewcowikz was editor, for example, the International Board organized and, as a consequence, the quest for listings on indexers during the following years.

At the same time that these improvements were being made, over the years, something that appears very important to me is the fact that the Journal has retained a historical documentary value for our psychiatry. For example, there will be a synthesis of all Psychiatry Symposia in RS in the next issue of the Journal. Major events were also documented in the Journal, such as visits from eminent colleagues like Gavíria, Antonino Ferro, Otto Kernberg, Glenn Gabbard and others. This is in addition to each colleague being invited to write an article for publication.

It was a means, therefore, of recording the scientific happenings of Rio Grande do Sul psychiatry. An historical testament.

It is my impression that this line has been maintained. In that period, 25 years ago, there were few psychiatrists. The basic direction was psychodynamic. There had been no great development in other areas. The areas of psychopharmacology, cognitive-behavioral therapies, research, as neurosciences, all came later. Evidently, the Journal has grown with the introduction of these new disciplines to our area.

The Journal maintains this aggregating spirit, which is a difficult thing to do. It has one characteristic which I think is very important: I believe that it is the only Brazilian psychiatry journal in which there is clear space for psychoanalytic thinking, for dynamic psychotherapy, for the development of this area. I think that this is a differentiating factor, the cohabitation of a number of different areas of scientific thought.

In recent years, for example, one sees more and more research papers, which was something that practically did not exist then. Therefore, the Journal, in addition to being a scientific organ is also a document and is now distributed throughout Brazil.


J: In what ways can research and scientific publications affect the so-called "crisis of psychoanalysis" and, in turn, psychotherapy with a psychoanalytic orientation?

C: I am completing the writing of an interview for a journal called the Revista Latino-Americana de Psicopatologia Fundamental, which is published in São Paulo, and one of the questions goes like this, "Is there evidence that psychoanalysis works as a therapeutic method?" or, to put it another way, should one demand evidence that the methods work?

I believe that one should demand evidence of the efficacy of all methods. In this interview I give the bibliographical reference from 2003 from the International Journal for wide-ranging research into the effectiveness of psychoanalysis in Germany, coordinated by Marianne Leutzinger-Bohleber, and I suggest that people read this paper, which documents very well, among so many others, why psychoanalysis works. I therefore believe that research is very important and that we must publish our results. Including the problems and difficulties involved in performing research in this area. We need a critical evaluation of our clinical work. All this controversy over the efficacy of many treatments changes depending on new studies- for example, meta-analyses and new reviews. Certainty over a given technique can be substituted for the uncertainty of a new series of studies. Thus, research, discussion, systematic investigation, with specific methodology is highly useful to question and/or validate treatment Methods. Both qualitative and quantitative research can help in our dialogue with other disciplines. And also help us to offer tranquility to therapists when they face certain questions on the effectiveness of treatment.

If I prescribe a given treatment, the patient might ask, "On what basis do you say that cognitive-behavioral therapy is suitable for my case?". Or psychoanalysis, or antidepressants. WE must be able to say, "On the basis of my current knowledge and long clinical experience, which tells me that for such a condition such a treatment is indicated". I see research as an important resource for facing this crisis situation in psychoanalysis and psychoanalytic psychotherapies.


J: What is the relationship between scientific publications in psychiatry and psychoanalysis? What do you think of neuroscience?

C: Neuroscience, more specifically neuropsychoanalysis, is a polemic are in many sectors. It appears to me that it could produce highly stimulating scientific advances. As our friend Ricardo Bernardi said, "Psychoanalysis was developed in dialogue with other disciplines and not in isolation, although there have bee periods of greater isolation".

We need to develop dialogue equally with neurosciences and with the humanities, such as with literature, with philosophy, with literary criticism and with history.

My vision is that we must have a double dialogue, on the one hand with neuroscience or with the part labeled "scientific", and, on the other hand, with the humanities. If we went too far in one direction we would run the risk losing the mind, and if we went too far in the other we would run the risk o losing the brain. The challenge is to maintain the balance. Assume the posture of Freud, who was a man of science and a man of the humanities, simultaneously.

The same care must be taken with the editorial policy of a journal, because if it is subjected to a single direction, it too will not be serving the continuous education of its readers and, will not therefore comprehend the current state of science. Our challenge is to keep an open mind to the developments of the many different sectors of psychiatry.


J: What influence can a journal have to incite its readers to write and publish scientific articles?

C: I know, from conversations with many different editors of many journals, that it is sometimes a great problem to obtain quality papers. Nowadays the great majority of journals, including ours, use "Peer Review". To have ones work criticized anonymously, it appears to me, is already a part of the readers' mentality. I understand this as a sign of the vitality and seriousness of a journal.

I think that it is necessary to stimulate people to publish. On the one hand, the Journal has to be respected, and to achieve this, be rigorous in the selection of papers to be published, and on the other hand, it should nurture and send some kind of a report on work received, not the least in order to avoid de-stimulating its readers from writing and sending in their work for publication. It is a dilemma. To the extent that the Journal grows it becomes mort demanding, and so rejects work, which could inhibit contributors.


J: There is relatively little work with a scientific methodology in psychoanalysis journals. Do you believe that such work is being published in journals like ours whose scope includes more lines of study, including psychoanalysis with psychotherapy?

C: Here we have a complex question. There are a number of different types of research, conceptual research, empirical research, case studies. The International Journal of Psychoanalysis, for example, has a research section, but also has a section for theoretical work — shouldn't this, for example, also be a form of conceptual research?

Psychoanalysis has a scope in terms of types of research that is very wide. I think that the psychoanalytic journals give space to research papers. There is space for the publication of all journals.

At the IPA we have two research committees. One deals with conceptual research and the other with empirical. Recently, we had a book edited by Marianne Leutzinger-Bohleber, who I cited a little while ago, which is about research methods in psychoanalysis; very interesting. Overall, I think that this is a field that will be more and more developed.


J: And do you see any difference between research on psychoanalysis and in psychoanalysis?

C: Research into a clinical case can be valid and can be completely useless, depending on what qualities it can bring, just as research performed on the effectiveness of psychoanalytic treatment or on the transmission of given psychoanalytic content during training may or may not be of value. What exists is good and bad research. We need well-built research which brings some type of knowledge and which has solid methodology. I do not agree with a division based on exclusion saying, "It's only research if it's like this", because we would have to say, "Only such a thing is psychoanalysis and only such a thing is psychotherapy". Many different models exist. There are models for training, different practical models and there are applications. We must, therefore, be very careful with such positions that close doors saying, "Only this is science and that is not science". Science is a very big thing, no?

Another issue is that we are at the same time being evaluated by the same criteria as other medical areas, but we are a different area. This, therefore, is a question that many psychiatrists protest about, and many from the area of medicine also, but, in any case, I believe that we need good journals in which work can be published on both psychotherapy and psychoanalysis and which are recognized.

We are subject to a type of dictatorship imposed by financial agencies that establish something very dangerous, which is the number question. One therefore must have "x" papers published, which in a basic area is easy, since from one experiment material for innumerable papers can be taken. In psychoanalytic-oriented psychotherapy and in psychoanalysis, this is not the case. Results come slowly and the methodology is labor-intensive and requires care, which ends up prejudicing psychoanalytic publications. There is already little research and so there is little to quotes, making the index of impact more difficult. One question is pertinent, "How can one measure the real impact of a qualitative study which changes the way we understand a clinical situation and proposes a new manner of interpreting a clinical phenomenon? Could it be just numbers, or do we need to refine and make more sophisticated our assessment processes?


J: Cláudio, what do you think, for example, of electronic publishing?

C: I don't have much experience with it, but it's interesting.


J: From the next issue onwards, the Journal of Psychiatry of Rio Grande do Sul will have two types of publication, one printed in Portuguese and the other, electronic, in English, to be accessed via the SciELO site — our most recent achievement.

C: I think that's a good idea. It will facilitate dialogue with the rest of the world and disseminated scientific knowledge rapidly. Naturally, one should take care with questions of the confidentiality of clinical material.


J: Well Cláudio, our dialogue was most gratifying and we would once more like to thank you for the chance to converse with you about the Journal and to hear your ideas on publications relating to our area of professional activity.

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