In his editorial, Fitzgerald ^{Reference Fitzgerald1} rehashes the well-trodden arguments for the reunification of neurology and psychiatry, suggesting the time has finally come. What he fails to address is that the trend in every sphere of medicine is towards further specialisation and not integration. Why psychiatry and neurology should be the exception to the rule goes unanswered.

It is only ever academic psychiatrists, appearing out of touch with clinical practice, who propose that psychiatry has advanced to the point where it is indistinguishable from neurology. On the contrary, despite the calls for psychiatry to become a clinical neuroscience discipline, ^{Reference Insel and Quirion2} psychiatric practice has remained untouched by developments in neuroscience. To be sure, neuroscience is a core basic science for psychiatry. But the claims that psychiatric disorders are simply brain disorders, or that our observations or interventions are not worth a jot if not based in neuroscience, are part of a creeping trend towards neuroessentialism in every sphere of life. ^{Reference Reiner, Iles and Sahakian3} Psychiatrists do not simply deal with brain disorders – to claim otherwise is to impoverish our field. Psychiatry is at its best when embracing a pluralistic approach to the disparate range of problems that fall under our gaze. To neglect insights from the psychological, sociological and anthropological sciences and the narrative approach to formulation does a disservice to our patients. The patient who becomes suicidal after a relationship breakdown and the patient who becomes panic-stricken and housebound after a rape do not have problems that can be made sense of in the same way as the patient with visual hallucinations and bradykinesia, or the patient with impulse control problems after a brain injury. Put simply, even if we accept the claim that psychiatric problems are brain disorders, many problems can be effectively treated without thinking about the brain.

Psychiatrists could certainly benefit from a stronger training in clinical neuroscience and neurology in general, and neuropsychiatry and behavioural neurology in particular. But as Alwyn Lishman said, ‘You have got to have a finger in every pie in psychiatry and be ready to turn your hand to whatever is the most important avenue: an EEG one day, a bit of talking about a dream another day. You just follow your nose. All psychiatrists should be all types of psychiatrist’. ^{Reference Poole4} I could not agree more.