Abstract
This theoretical analysis begins from the premise that the medical specialty of psychiatry is practically and ideologically dominant in relation to psychiatric nursing.To explicate some difficulties with psychiatric nursing from a therapeutic perspective, crucial 19th century European psychiatric epistemological developments are outlined. The article addresses the contemporary problematic of nursing agency in the face of mainstream psychiatry's focus on physical treatments. It is argued that there are intrinsic contradictions for present-day humanistic psychiatric nursing given the theoretical and practical power of the materialist medical model.