More than 90% of the choices made by our brains may be done unconsciously. When working as psychiatrists we are to a large extent not conscious of the beliefs that are behind our social or moral choices (Lakoff, Reference Lakoff1996). George Lakoff, the eminent cognitive scientist, has given the name ‘frame’ for the structures of our mind, based upon which we organize our world. They shape our goals, our behavioral models and our way to evaluate the consequences of our deeds. In everyday life we are not able to see or hear these structures of our cognitive unconsciousness. The so called common sense is a collection of the thinking produced unconsciously, automatically and effortlessly by these attitudes.

As a cognitive linguist Lakoff (Reference Lakoff2014) sees language as a road to identify those unconscious beliefs that regulate our everyday decisions. Behind our words there is always an unconscious frame of the concepts we are talking about. When we hear a word that belongs to a certain frame of our mind, this frame is immediately activated. When we say to ourself ‘do not think of an elephant’, we are not able not to think of an elephant. The more these unconscious frames of our minds are activated, the stronger they will become. The meaning of these frames of our mind is seen everywhere – in political, social and psychological discussions and decisions.

The task of a psychiatrist is to help people, who suffer from fears, anxiety, delusions, hallucinations, depression, impulsivity, anorexia and bulimia. Psychiatrists are medical doctors and thus using a medical frame, the objects of conditions of psychiatric treatments are called diseases or illnesses (Kendler & Parnas, Reference Kendler and Parnas2008). The concepts ‘disease’ or ‘illness’ are bound to activate the ‘medical’ frame in the minds of the psychiatrists. According to this frame the psychiatric states are essentially brain diseases treated or prevented by psychiatric drugs. The diseases have an ‘onset’ and a ‘course’.

Psychotherapeutically orientated psychiatrists together with psychologists think that their patients are suffering from psychiatric or psychological ‘disorders’, in which case the symptoms or problems are produced by conflicts of mind or modes of thinking of their patients or clients. Hence the treatment is solving of the psychological conflicts or negative circular thinking by psychodynamic or cognitive psychotherapy.

The frame of trauma therapy views symptoms as an expression of suppressed memories of childhood traumas and dissociated states of personality. This frame calls for an emotional re-experience of these painful memories in an emphatic therapeutic relationship. The frames of the couple and family therapies focus on solving the conflicts, problems of individuation or the unrealistic expectations of the couples or family members. The existentially orientated psychiatrist sees the fear of death, the meaning of life or the individual responsibility as a center of the therapeutic work (Yalom, Reference Yalom1980).

There is also a growing trend to see the concepts of ‘disease’, ‘disorder’, ‘conflict’ or ‘traumas’ as anti-therapeutic stigmatic frames of thinking. To counterbalance these negative frames the more positive ‘problem-solving’ therapy has emerged during the last few decades.

The list of the frames of the minds of psychiatrists is, however, almost endless. George Vaillant (Reference Vaillant1977), a psychoanalyst and an eminent epidemiologist, agreed with Adolph Meyer, who did not consider psychiatric disorders as diseases, with the exception of schizophrenia. Vaillant sees most psychiatric symptoms and problems as the patient’s individual ways to adapt to a difficult life situation or to solve a painful internal conflict. Ronald Laing (Reference Laing1960), the Scottish leading figure of the antipsychiatry movement in the sixties considered even schizophrenia as a meaningful reaction to a meaningless world. In the same spirit another famous antipsychiatrist Thomas Szasz (Reference Szasz1960) called entirely into question the concept of the psychiatric illness. In the minds and frames of social psychiatrists much of the symptoms of psychiatric patients reflect the problems of communities and societies.

From the viewpoint of the people suffering from diseases, illnesses, disorders, crises or problems, this mixture of different frames of psychiatry are problematic because each of these frames can be either the best or the worst way to help them. In some cases the combination of two, three or even more frames may bring the best result. Sometimes the best frame in the initial phase of treatment is better changed later in the illness to another frame.

Cecchin et al. (Reference Cecchin, Lane and Ray1994), the celebrated family therapists, have proposed that the impasse of psychiatric treatment is usually the obstinate clinging of the psychiatrist to a therapeutic frame that is contrary to the needs of the patient or family. This danger can be best prevented by the pluralistic treatment philosophy described by David Brendel (Reference Brendel2006). In order to succeed in this approach the psychiatrist has to have several competing psychiatric frames in his mind and an ability for a continuous metaphoric dialogue within his mind (Lakoff, Reference Lakoff and Johnson1983).