Two Paradigms, One Person: The Enduring Echo of the Bekhterev–Pavlov Debate in Twenty-First-Century Psychiatry

This article examines the historical and methodological confrontation between Vladimir M. Bekhterev and Ivan P. Pavlov, which has exerted a long-lasting influence on the development of both Russian and international psychiatry. Objective. To demonstrate that the dispute between V.M. Bekhterev and I.P. Pavlov was not a marginal episode in the history of science but a clash between two research strategies that continue to be reproduced in psychiatry when selecting descriptive language, standards of evidence, and levels of clinical intervention. Materials and methods. A historical–methodological analysis of key conceptual oppositions (objectivism vs subjectivity, reductionism vs holism, corticocentrism vs hierarchical brain organisation) was conducted, with reference to typologically analogous scientific debates in other disciplines (Freud–Jung, Einstein–Bohr, Cuvier–Saint-Hilaire), as well as through engagement with contemporary clinical and research contexts.   Results. The Pavlovian trajectory supports standardisation, operationalisation, and biomarker-oriented research, whereas the Bekhterevian framework preserves the phenomenological and social-psychiatric completeness of the clinical case, including subjective experience, subcortical mechanisms, and environmental context. It is demonstrated that a productive resolution in the twenty-first century lies not in choosing one paradigm over the other, but in constructing methodological “bridges” between levels of description. Conclusion. The historical legacy of Bekhterev and Pavlov retains methodological relevance insofar as it enables clinicians to maintain a balance between evidence-based objectification and clinically adequate interpretation   of subjective experience. Contemporary personalised psychiatry therefore requires a dialectical synthesis of both traditions. The continued relevance of this legacy may be further operationalised through scientometric analysis of modern publications that explicitly cite their works or reproduce their methodological approaches.

1. Akimenko MA. V.M. Bekhterev as the Founder of Psychoneurology. Obozrenie psihiatrii i medicinskoj psihologii imeni V.M. Bekhtereva. 2004;1:20-22. (In. Russ.).

2. Aleksandrovskij Yu.A. Istoriya otechestvennoj psihiatrii v 3 t. — M.: GEOTAR-Media, 2013. (In. Russ.).

3. Apchel VYa, Morgoshiia TSh. In memory of Academician Ivan Petrovich Pavlov (on the 170th anniversary of his birth). Vestnik Rossijskoj Voenno medicinskoj akademii. 2019;2(66):273-279. (In. Russ.).

4. Bekhterev V.M. The Subject of Objective Psychology. Vestnik psihologii, kriminal’noj antropologii i gipnotizma. 1904;9:655-658. (In. Russ.).

5. Bekhterev V.M. Ob’ektivnoe izuchenie lichnosti. Vyp. 1. Petrograd; Berlin; M.: Z.I. Grzhebin, 1923. (In. Russ.).

6. Bekhterev V.M. Ob»ektivnaya psihologiya. — M.: Nauka, 1991. (In. Russ.).

7. Neznanov NG, Kotsyubinsky AP, Kotsyubinsky DA. Crisis of natural-scientific and human approaches in psychiatry. Obozrenie psihiatrii i medicinskoj psihologii imeni V.M. Bekhtereva. 2019;(1):8-15. (In Russ.) https://doi.org/10.31363/2313-7053-2019-1-8-15

8. Pavlov I.P. Lekcii o rabote bol’shih polusharij golovnogo mozga. red. i stat’ya «Uchenie I. P. Pavlova o vysshej nervnoj deyatel’nosti» akad. K. M. Bykova. — M.: izd. i 1-ya tip. Izd-va Akad. nauk SSSR, 1949. (In. Russ.).

9. Tukaev RD. Outstanding Russian medical scientists and academicians I.P. Pavlov and V.M. Bekhterev and their contribution to academic and practical advances in hypnosis, hypnotherapy, and psychotherapy in Russia. Vestnik psihoterapii. 2023;85:15 27. (In. Russ.). https://doi.org/10.25016/2782-652X-2023-0-85-15-27

10. Goodkind M, Eickhoff SB, Oathes DJ, Jiang Y, Chang A, Jones-Hagata LB, Ortega BN, Zaiko YV, Roach EL, Korgaonkar MS, Grieve SM, Galatzer Levy I, Fox PT, Etkin A. Identification of a common neurobiological substrate for mental illness. JAMA Psychiatry. 2015;72(4):305-15. https://doi.org/10.1001/jamapsychiatry.2014.2206.

11. Insel T, Cuthbert B, Garvey M, Heinssen R, Pine DS, Quinn K, Sanislow C, Wang P. Research do main criteria (RDoC): toward a new classification framework for research on mental disorders. Am J Psychiatry. 2010;167(7):748-51. https://doi.org/10.1176/appi.ajp.2010.09091379.

12. Kotov R, Krueger RF, Watson D, Achenbach TM, Althoff RR, Bagby RM, Brown TA, Carpenter WT, Caspi A, Clark LA, Eaton NR, Forbes MK, Forbush KT, Goldberg D, Hasin D, Hyman SE, Ivanova MY, Lynam DR, Markon K, Miller JD, Moffitt TE, Morey LC, Mullins-Sweatt SN, Ormel J, Patrick CJ, Regier DA, Rescorla L, Ruggero CJ, Samuel DB, Sellbom M, Simms LJ, Skodol AE, Slade T, South SC, Tackett JL, Waldman ID, Waszczuk MA, Widiger TA, Wright AGC, Zimmerman M. The Hierarchical Taxonomy of Psychopathology (HiTOP): A dimensional alternative to traditional nosologies. J Abnorm Psychol. 2017;126(4):454-477. https://doi.org/10.1037/abn0000258.

13. Northoff G, Heinzel A, de Greck M, Bermpohl F, Dobrowolny H, Panksepp J. Self-referential processing in our brain — a meta-analysis of imaging studies on the self. Neuroimage. 2006;31(1):440-57. https://doi.org/10.1016/j.neuroimage.2005.12.002.

14. Shorter E. A History of Psychiatry: From the Era of the Asylum to the Age of Prozac. New York: John Wiley & Sons. 1997.

15. Todes D.P. Pavlov’s Physiology Factory: Experiment, Interpretation, Laboratory Enterprise. Baltimore: Johns Hopkins University Press. 2001.