This paper is the second of two to explore historical concepts of causation in psychiatry. Psychogenesis (as opposed to organogenesis) is superficially attractive but ambiguous, as it can apply either to something that is produced by the psyche or alternatively to the effect on the psyche from external factors. The term endogenous may be contrasted to exogenous or reactive, but the meanings of each have become blurred and ambiguous. Difficulty also arises when contrasting the process versus comprehensibility of mental disorders, as the limits of what may be understood are imprecise. A fourth comparison is between temperament and constitution against types of reaction, and again there is a tendency to circularity. Finally, a way forward is suggested using the notion of psychosomatic brain diseases.
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