Who first said those who do not learn from history are doomed to repeat it? 4 Why does history repeat itself in the present?.2 Who said the quote those who fail to learn from history?.1 Who first said those who do not learn from history are doomed to repeat it?.There is profound wisdom to be found in a traditional Maori proverb: “I walk backwards into the future with my eyes fixed on my past”. At a system level, we need to remain constantly vigilant to re-enacting abuses of the past through the use of force and coercion, whether in our hospitals or in society’s treatment of “others”. The past can also help us to learn from our own oversights and errors to become better psychiatrists. The past carries important lessons for our patients who, through therapy, can overcome unhelpful relationships and responses once recurring patterns are elucidated. Santayana was right to warn us of the risks of forgetting our history. The Royal Australian and New Zealand College of Psychiatrists has rightfully drawn attention to the mental health implications of this ongoing violation of ethics and human rights. These policies are reminiscent of the harmful exclusion and marginalisation of Jewish refugees during World War II. Despite clear warnings from the United Nations, Amnesty, and other human rights institutions, Australia continues to treat refugees and asylum seekers harshly with the use of offshore detention in dehumanising conditions. In modern Australia, one of the starkest illustrations of history repeating itself is found in the treatment of refugees and asylum seekers. The Inquiry found that many clinicians opt too readily for coercion and control at the expense of human rights and recovery: a haunting echo of abuses from asylums in our past. Similarly, in New Zealand the Inquiry into Mental Health and Addiction (2018) heard frequent calls for an end to seclusion and restraint. Yet many consumer advocates, including Melbourne-based Indigo Daya, argue that modern psychiatry continues to abuse patients with excessive use of force and chemical and mechanical restraints. We look back in horror on asylums, like Salpêtrière, where patients were shackled in chains prior to Pussin and Pinel’s reforms at the end of the 18th century. The risk of repeating the past occurs at a system level too. (Principle 8 RANZCP Code of Ethics CanMEDs Scholar domain) Improving professional practice requires each of us to remember, and learn from, our past errors and remain engaged in continuing professional development across the course of our clinical careers. Fewer than 5% of doctors received more than 50% of patient complaints, with some doctors receiving multiple complaints about the same pattern of misconduct – whether that be poor communication or violation of sexual boundaries. Research into patient complaints by Bismark et al (2013) shows that past behaviour is the best predictor of future behaviour. In professional practice, learning from the past is important for individual practitioners as well as their patients. The unconscious mind has a profound impact on our behaviour, with childhood experiences leading us to re-enact past relationships and traumas in what has been termed a “repetition compulsion.” According to Freud and his followers, patients can escape their sentence of repeating unhelpful behaviours by delving into the past to reveal and resolve unconscious conflicts. Through his work as a psychoanalyst, Freud came to understand that the human mind resembles an iceberg, with our conscious thoughts reflecting only the small piece of ice above the water while a large body of unconscious urges, memories, and motivation remain hidden beneath the surface. In this essay we explore the importance of learning from the past, at both an individual and a systems level, to avoid stepping into the same traps over and over again.Ī historical milestone in psychiatry was Sigmund Freud’s development of the theory of the unconscious. Over one hundred years on, his warning remains relevant to the profession of psychiatry. Writing in the “Life of Reason”, Santayana warns that, unless we learn from history, we will be destined to repeat it. Yet as any student of history will tell you, some of our most profound learnings can come from the past. In today’s fast paced world, it is easy to always be looking for what is novel and upcoming. Those who cannot remember the past are condemned to repeat it.
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