Thomas Fuchs, Thiemo Breyer and Christoph Mundt (eds.)Karl Jaspers’ Philosophy and Psychopathology201410.1007/978-1-4614-8878-1_10
© Springer Science+Business Media New York 2014
10. Jaspers on Feelings and Affective States
(1)
Faculty of Psychology, Università degli Studi G. d’Annunzio, Via dei Vestini 31, Chieti, Italy
(2)
Centre for Subjectivity Research, Købmagergade 44-46, 4, 1150 Copenhagen K, Denmark
Abstract
The purpose of this chapter is to examine Jaspers’ analysis of emotions and emotional experience in the General Psychopathology (1997/1959, hereafter GP), to try to make sense of his rather ambivalent attitude towards human emotional life, and finally to discuss if these analyses are helpful for understanding troubled human experience and relevant for contemporary clinical practice. The chapter is divided into six sections. First, we introduce our investigation by asking about the relevance of a Jaspersian psychopathology for contemporary psychiatry. Do we need psychopathology at all? And if so, does Jaspers’ psychopathology still have something to teach us today? And what is the relevance of feelings for psychopathology? We then look at the ambivalent role that feelings and emotional experience play in Jaspers’ psychopathology. The third, and most extensive, section is dedicated to an overview of Jaspers’ treatment of feelings and affective states in the GP. With this overview in place, we then try to articulate his understanding of the role emotions play in mental suffering. We do this by integrating his rather fragmentary descriptions and analyses of emotions into the wider context of a psychopathology of emotional experience. In the fifth section, we will venture an explanation of Jaspers’ ambivalent attitude to emotional experience in terms of his reluctance to formulate a systematic theory of human nature. This explanation will allow us, by way of conclusion, to outline how Jaspers’ peculiar attitude towards emotional experience may (or may not) point in the direction of a person-centred psychopathology of emotions.
Keywords
FeelingsAffective statesPsychopathologySufferingResponsibility10.1 Introduction: Psychopathology, or the Enlightenment in Psychiatry
What is psychopathology? A rather sketchy, but not incorrect, answer is that psychopathology is a logos for pathos, i.e. a discourse about what troubles a person. Psychopathology provides a language to assess and make sense of the phenomena that express the vulnerability of the human person. Among the disturbing experiences that affect a person, emotions play a major role.
According to Jaspers, the founder of this discipline, psychopathology has two major aims. First, it offers ‘clarification, order, formation’ (GP, p. 33/38),1 i.e. concrete descriptions, a suitable terminology, and systematic groupings that allow us to bring order into the chaos of disturbing mental phenomena as recounted by the patient and observed in her or his behaviour. Second, it aims at ‘a psychopathological education’ (GP, p. 44/50), i.e. endowing clinicians with a valid and reliable philosophical background, that is providing a philosophically sound methodology.
Was Jaspers right about the relevance of psychopathology for psychiatry? We are convinced that he was. Since this is not the place to flesh out an argument for that conviction, we will merely list a number of reasons why we agree with Jaspers that psychopathology is an indispensable tool for any psychiatrist:
1.
Psychiatry is a heterogeneous discipline. Its adepts approach the ‘object’ of their discipline from many different angles, as for instance neuroscience, depth psychology, sociology, and philosophy, each of which has its own language, methodology, and practice. Psychiatrists therefore need a common ground and a joint language. To Jaspers, disturbing mental phenomena are the main facts for psychiatry, and psychopathology—whose main focus is on abnormal experiences—is the shared language that allows clinicians with different theoretical backgrounds to understand each other when dealing with mental disorders.
2.
Psychiatry addresses abnormal human subjectivity. Psychopathology attempts to define what is abnormal (rather than taking for granted commonsense views) as well as to grasp what is human in apparently non-human (e.g. irrational or nonsensical) phenomena.
3.
Psychiatry aims at establishing rigorous diagnoses. Psychopathology is still highly useful in a field where the major disorders cannot be neuroscientifically defined as disease entities, but are exclusively syndromes that can be defined according to characterising symptoms such as, notably, abnormal subjective experiences.
4.
Psychiatry is about understanding disturbed human experience, rather than simply diagnosing and classifying it. Psychopathology functions as a bridge between human sciences and clinical sciences, thus providing the basic tools to make sense of mental suffering .
5.
Psychiatry is about caring for troubled human existence, rather than judging, marginalising, punishing, or stigmatising it. Psychopathology connects understanding with caring, and endeavours to establish an epistemological as well as ethical framework for this.
6.
Psychiatry looks for a way to connect, or at least think together, first-person subjective experience with impersonal brain functioning. As Jaspers saw with admirable clarity, psychopathology is about bridging understanding (Verstehen) and explaining (Erklären) in research as well as in clinical settings.
A century or so after the birth of psychopathology, we can agree that ‘psychopathology is the fundamental professional skill of the psychiatrist’ (Oyebode 2008, p. 3). However, if we still need psychopathology, which psychopathology do we need? (Gross and Huber 1993). We think that there are three kinds of psychopathology, or better, three levels of psychopathological inquiry (Stanghellini 2009):
1.
Descriptive psychopathology: The aim of this level is to systematically order, define, differentiate, and describe specific mental phenomena. These phenomena are thereby rendered accessible and can be described in specific terms. By grouping related phenomena on a purely phenomenological basis, the aim is to avoid any pre-established conceptual scheme or explicit theory about what these phenomena are. This is, of course, an ideal that demands a constant suspension of our ‘natural’ attitudes and pre-conceptions in order to let the phenomena themselves come to expression and, so to say, speak for themselves.
2.
Clinical psychopathology: This is a pragmatic tool for connecting relevant symptoms and diagnostic categories with each other, and thus for restricting the scope of the clinical investigation to those symptoms that are useful to establish a reliable diagnosis. As Kurt Schneider (1967) defined it, it is an instrument for ‘pragmatic diagnostic use’, or the driving belt between the level of symptoms and that of nosographic syndromes (Rossi Monti and Stanghellini 1996).
3.
Structural psychopathology: This must be considered the most ambitious level of psychopathology, namely that of reconstructing the overall meaningful structure of a syndrome. As Georges Lantéri-Laura puts it, ‘instead of the trivialities of semiotics, one puts it [psychopathology] at a level of global understanding […] at a level of synthetic knowledge’ (1985, p. 604). It endeavours to attain to a global level of intelligibility, assuming that the manifold of phenomena of a given mental disorder is a meaningful whole and not just a collection of symptoms.
In the case of emotions, we do need a precise description of emotional experiences, including a sharp and comprehensive characterisation of feelings (such as anger, dysphoria, sadness, shame, jealousy, etc.). We also need to connect given psychopathological syndromes with more or less definite types of emotional experience to enrich our system of classification of mental disorders. Finally, we need an in-depth understanding of the life-worlds that different emotions bring about, and of the meaningful connections between feelings and cognition, perception, action, and values in each of these life-worlds.
10.2 Jaspers’ Ambivalent Attitude to Emotional Experience
To Jaspers, emotional experience 2 is probably the fundamental topic in psychopathology. This can be argued by reading, for instance, his pages on the early stages of acute schizophrenia and delusional mood (Wahnstimmung)—an uncanny atmosphere of unattached feelings. In these pages, an alteration of mood (Stimmung) is at the origin of a deep metamorphosis of world experience:
The environment is somehow different—not to a gross degree—perception is unaltered in itself but there is some change which envelops everything with subtle, pervasive and strangely uncertain light. A living-room which formerly was felt as neutral or friendly now becomes dominated by some indefinable atmosphere [einer undefinierbaren Stimmung]. (GP, p. 98/82)
The following stages of schizophrenia, including perplexity (Ratlosigkeit) and the formation of delusions, are traced back by Jaspers to these uncanny experiences brought about by a change in the mood (Stimmung) of the person. Further, in the chapter dealing with the patient’s attitude to his illness, he explains how these ineffable feelings of change amount to a pre-reflective awareness that something is not right:
At the beginning of a mental illness some persons undergo an uncanny feeling of change [unheimliches Gefühl der Veränderung] (as if they had been bewitched, enchanted, or there may be an increase in sexuality, etc.). All this adds to the awareness [Bewusstsein] of impending madness. It is difficult to say what this awareness really is. It is the outcome of innumerous individual feelings, not a mere judgment [Urteil] but something actually experienced [wirklich erlebt]. (GP, p. 415/345)
Subtle changes in our pre-reflective embodied engagement with the world, a change in existential feelings (Ratcliffe 2008), an uncanny emotional atmosphere, rather than explicit reflective disturbances, are what mark the beginning of psychosis.
Also, for Jaspers, feelings are fundamental to a person’s well-being and self-understanding. For some persons, it is through a change in feeling and mood that they become aware of their own self; for instance, a basic emotional experience such as suffering (Leiden) is a central component in the various limit-situations . The awareness that something is wrong or simply not as it should be disturbs the person, although he or she may not be able to say what is actually going on. In fact, it is precisely the elusive character of these objectless and cognitively impenetrable feelings (Goldie 2000, pp. 100–111) that is disturbing. Jaspers argues that persons undergoing such experiences often feel an ‘almost inescapable need [Drang] to give some content to such feelings’ (GP, p. 113/95), and goes on to provide a detailed description of how this emotional need can result in a cognitive enactment out of such objectless, but highly comprehensive feelings:
These new and unfamiliar feelings press for some understanding on the part of the person who experiences them. Countless possibilities are contained in them which can be realised only when intuition, imagination, form [Gestalten] and thought [Denken] have created a coherent world. There is therefore always a path which leads from these immense feelings of happiness to recognition [Erkennen]. The experience of blissful feelings starts with a conscious clarity [Klarsehens] without there being no real content to present. The patients delightedly believe that they have grasped the profoundest of meanings. Concepts like timelessness, world, god and death become enormous revelations which when the state have subsided cannot be reproduced or described in any way—they were after all nothing but feelings. (GP, pp. 115/95–97)
Notwithstanding the central place of feelings in Jaspers’ clinical and existential analyses, he does not provide a systematic and coherent theory of human emotions—neither in the GP nor in the minor psychopathological writings, not in Psychologie der Weltanschauungen or in his philosophical works. While he works hard, in the GP, to describe and categorise various feelings and affective states , to account for which categories of abnormal affective states are related to which nosographic symptoms, and to attempt to make sense of the connection between emotions and extra-conscious mechanism s, these efforts remain scattered in several places and amount to a fragmentary picture of human emotional experience . The reader can—so to speak—see the single trees but is not provided with a panoramic view of the whole forest. While he appears to be wary of extensive analysis of individual feelings and affective states, arguing that such an approach would most of the time ‘only end in a vast array of trivialities’ (GP, p. 108/91), he is outright dismissive of the possibility that feelings might teach us something about the cause and origin of mental disorders:
Attempts have been made to let almost all abnormal phenomena derive from feelings [aus Gefühle abgeleitet]. If we use the term ‘feeling’ to denote everything for which common usage permits us to use the word, there is always some truth in this, but then it comes to very little if we go on to derive delusions, for instance, from feelings. Delusions of senselessness, sinfulness, and impoverishment were supposed to arise from a depressive affect in a rationally understandable way [rational verständlich], and it was generally supposed that the depressed patient concluded that there must be something which made him so miserable. People also wanted to explain delusions of persecution by the affect of distrust, delusions of grandeur by euphoric mood [Stimmung], but they did not realise that, though one may understand ordinary mistakes and over-valued ideas in this way, one can never do this with delusions [Wahnideen]. Furthermore, frightening hallucinations in sleep during fever or psychosis have been attributed to some kind of conditioned anxiety, and so on. We can, it is true, find meaningful connections [verständliche Zusammenhänge], and they can teach us something about the relationship of delusional content and previous experiences but nothing at all of how delusions, false perceptions, etc. could have come about in the first place. (GP, pp. 408–409/340)
So though feelings are central to the manifestation and subsequent development of a mental disorder, they are of no help whatsoever when it comes to understanding why or how a person suffers from such a disorder. In other words, Jaspers’ attitude towards the role that emotions play in mental disorder appears to be rather ambivalent.
Now, we believe that explaining this ambivalence is imperative not only for understanding the role emotions play in Jaspers’ psychopathology. It is also a necessary part of an argument for the relevance of Jaspers’ psychopathology in contemporary psychiatry and clinical practice. But before venturing an explanation, we first need to take a careful look at what Jaspers actually has to say about emotions and affective states in the GP.
10.3 Feelings and Affective States in GP: An Overview
Jaspers’ main description and analysis of emotions and emotional experience is limited to two paragraphs in GP, which add up to less than twenty pages. The first is found in Section One, § 5 (pp. 108–117/90–97), in the first chapter of Part One where Jaspers describes the phenomenology of individual features of our mental life. The section is entitled ‘Feelings and Affective States’ and is divided into a ‘Psychological preface’ and a ‘Classification of abnormal affective states ’. The second place is in Section One, (a)-(b) (pp. 367–372/305–310), in the second chapter of Part Two where Jaspers deals with meaningful connections in our mental life in view of extra-conscious mechanism s. This section is entitled ‘Normal Mechanisms’ and of particular relevance here are the first two subdivisions ‘Experiential reactions’ and ‘After-effects of previous experiences’.
10.3.1 Previous Classification of Feelings
Jaspers introduces his treatment of feelings (Gefühle) and affective states (Gemütszustände) with a psychological prelude. Here he laments the state of emotion research at the time, which is lacking in clarity compared to research into sensation, perception, ideas, and even research concerning instinctual drive and act of will. In fact, he claims that both the word and the concept of ‘feeling’ remains highly confusing and appears to refer ‘to everything for which we can find no other name’. At the same time, though, he is, as we have seen, sceptical of the trivialities brought about by scrupulous description and analysis of individual feelings, so instead he sets out to provide a synthesis of previous classifications of feelings. This amounts to the following catalogue:
1.
From a Purely Phenomenological Perspective: We have three basic ways of distinguishing feelings: (a) feelings that are an aspect of conscious personality (Persönlichkeitsbewusstsein) and thus defining the self (Ichbestimmtheit) are distinguished from feelings that lend colour to object-awareness (Gegenstandsbewusstsein); (b) distinction by means of opposition, e.g. pleasure and displeasure, tension and relaxation, excitement and calm; (c) feelings without an object (gegenstandslos), i.e. how I feel in a given situation (Zustandsgefühle eines Sichbefindens), are opposed to those directed upon some object.
2.
According to Objects: Feelings of fantasy (Phantasiegefühle), directed upon suppositions, are opposed to serious feelings (Ernstgefühle) directed upon actual objects. Also, feelings of value (Wertgefühle) that are either directed at the feeling person herself or at something extraneous, and can be distinguished as being either affirmative or negative (pride or humbleness, love or hate).
3.
According to Source: This classification is made according to the different layers of our mental life (Seelenleben). Here we find four types of feelings (Scheler 1966): (a) localised feeling sensations, (b) vital feelings involving the whole body, (c) psychic feelings (e.g. sadness, joy), and (d) spiritual feelings (e.g. a state of grace).
4.
According to Significance: The significance of a feeling with regard to life (Leben) or to the purposes of life (Lebenszwecke), i.e. feelings of joy can count as the expression of the promotion of a purpose in life, whereas feelings of distaste can count as expressing a hindrance.
5.
Particular Feelings vs. All-Inclusive Feelings: Particular feelings (partikulare Gefühle) are those directed on specific objects or partial aspects of the whole, whereas in all-inclusive feelings (Totalgefühle), the separate elements are fused into comprehensive affective states (Gefühlszustände), e.g. irritable, ‘feeling of being alive’, etc.
6.
According to Intensity and Duration: Here Jaspers follows what he calls ‘the old and practical’ division: (a) feelings (Gefühle) are the unique and original commotions of the psyche; (b) affects (Affekte) are momentary and complex emotional processes of great intensity with conspicuous bodily accompaniments and sequels; and (c) moods (Stimmungen) characterise the state of mind (Zumutesein) or inner disposition (innere Verfassung) of a person; a mood is a result of prolonged feelings and colour the whole mental life while it lasts.
7.
Feelings vs. Sensations: Feelings (Gefühle) are states of the self (Zustände des Ich) whereas sensations (Empfindungen) are elements in the perception of the environment and of one’s own body (e.g. colour, tonal pitch, temperature). The latter is, furthermore, distinguished according to whether the sensations are object-directed (gegenständlich) or merely express the state of the body (leibzuständlich). In between those extremes, we find sensations that are both object-directed and bodily expressions, i.e. feeling-sensations (Gefühlsempfindungen) in which feelings, affects, and drives constitute a whole as is the case with, for example, hunger, thirst, fatigue, sexual excitation.
10.3.2 Classification of Abnormal Affective States
After this cataloguing of previous classifications of feelings and affective states (leaving the reader rather dissatisfied if not confused), Jaspers goes on to provide a tentative categorisation of abnormal affective states. He starts out by making a fundamental distinction between two kinds: (a) the genetically understandable affective states (genetisch verständliche Gemütszustände), i.e. the abnormally exaggerated and particularly coloured affective states that can nevertheless be understood in view of some previous experiences or situations; and (b) the endogenous affective states that spring from something irreducible in the soul (etwas seelisch Letztes), i.e. affective states that escape our understanding and can be explained only in terms of extra-conscious causes (ausserbewusste Ursachen). He notices that language has enabled us to name many of these all-embracing abnormal affective states (abnorme Gesamtzuständlichkeiten des Gefühls) such as grief, melancholy, cheerfulness, and he concedes that certain typical states can indeed be recognised, for instance, the gloomy mood of depression or the silly, awkward blandness of hebephrenia. Once again, however, instead of examining the nature and phenomenological character of this emotional tonality, he chooses merely to examine the most particular and noteworthy ‘out of the host of trivial affective states’ (GP, p. 110/92). What is most characteristic of this part, though, is his attempt to connect each category of abnormal feeling with nosographic syndromes :
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