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Hermannstraße 154, Berlin, Germany
Abstract
Quite a few authors have dealt with the influence of Karl Jaspers’ work on Husserlian thought. Wiggins and Schwartz (Philos Psychiatr Psychol 4:15–36, 1997) as well as Luft (In S. Rinofner-Kreidl and H. Wiltsche (Eds.), Karl Jaspers’ Allgemeine Psychopathologie Zwischen Wissenschaft, Philosophie Und Praxis, 2008) explore this connection in Jaspers’ General Psychopathology (1997) and beyond. At the same time, relatively little attention has been paid to the contribution Jaspers made to Phenomenological Psychiatry within the fourth edition of his General Psychopathology. This essay unfolds Jaspers’ critique of concepts put forward by von Gebsattel and Straus and of early Phenomenological Psychiatry in general. As it turns out, this critique is an allegation of causalism against explanatory theories of human existence—an existence which for Jaspers can only be understood philosophically. However, Jaspers’ allegation is ambiguous. On the one hand, he accuses early Phenomenological Psychiatry of claiming to be a causalistic theory of human existence, yet on the other, he faults it for not fulfilling the requirements of causalistic theory. This contradiction raises the question as to whether Jaspers’ account of phenomenological theory in psychiatry as causalistic is valid at all. In particular, the phenomenological claims of a more recent thinker in Phenomenological Psychiatry, Arthur Tatossian, criticize reductive and naturalistic approaches to the patient and aim to enable communication with the patient. According to Tatossian’s account, since its outset, the phenomenological movement in psychiatry has therefore been very similar to Jaspers’ own philosophical attempts.
Keywords
AnthropologyPhenomenologyCausalismExistentialismUnderstandingExplanationTranslation: Kelly Mulvaney.
6.1 Introductory Remarks1
In the fourth edition of his General Psychopathology (GP) Karl Jaspers develops a critique of concepts advanced by Viktor E. von Gebsattels and Erwin Straus—thus criticizing two important representatives of the phenomenological movement in psychiatry. It may at first seem peculiar to engage a critique put forward by Karl Jaspers of the phenomenological movement in psychiatry, as it was Karl Jaspers who, with the essay “The phenomenological approach in psychopathology” (1968), and then with the first edition of his General Psychopathology, provided the first systematic introduction of phenomenology into psychopathology. In these works, Jaspers accords phenomenology with the task of empathizing with the psychic life [Seelenleben] of the patient and describing this in clear terms. From such a first-person perspective, singular psychopathological phenomena are intended to be clearly outlined and distinguished from one another—before the question can subsequently be posed as to under which nosological units they could be located (Jaspers 1997, pp. 564). Thus, for Jaspers, phenomenology has a basic function for each psychopathological task. Yet it would be wrong to identify Jaspers as a follower of the phenomenological-psychiatric school. This has to do with changes in phenomenology, which, starting in 1913 emerged as an eidetic science of transcendental consciousness (Husserl 2009). Jaspers’ concept of phenomenology referred to the Husserl in the “Logical Investigations” of 1900, and Jaspers rejected phenomenology in its eidetic-transcendental form (Luft 2008). If we follow Arthur Tatossian, however, it is precisely this latter form of phenomenology, which—contrary to Spiegelberg’s contention—delivered the decisive impulse for the emergence of phenomenological psychiatry (Tatossian 2002; Spiegelberg 1972, p. 96): after Tatossian, phenomenological-psychiatric thought is no longer interested in the psychically actual, as it is found, but rather in the conditions of possibility of this actual—meaning the essence and the essential modifications of factual experience (Tatossian 2002, pp. 21–24). From this perspective, Jaspers’ use of phenomenology solely corresponds to a descriptive psychology of inner life (Tatossian 2002, p. 18; see also Husserl 2009). The actual birth of phenomenological psychiatry is therefore, according to Tatossian, a conference held in 1922 by Eugène Minkowski and Ludwig Binswanger, at which both authors introduced the modified concept of phenomenology into psychiatry (Tatossian 2002, p. 18).
6.1.1 Psychiatric Historical Dimension of Jaspers’ Critique
Precisely this distinguished use of phenomenology should from now on identify the fault line between the classical German psychiatric school and phenomenological psychiatry : in the classical psychiatric school, from Jaspers to Kurt Schneider and until Gerd Huber, phenomenology was only ever grasped as a descriptive method of subjective experience that served to classify various modes of experience as a basis for psychology and psychopathology. Phenomenological psychiatry, on the other hand, embraced a concept of phenomenology that described this subjective experience in more comprehensive and basic structures. There are many examples of authors of classical German psychiatry distancing themselves from this attempt (Jaspers 1997, p. 55; Schneider 1921, 1976, p. 132; Huber 2005, p. 4). This is the context in which Jaspers’ critique of the first generation of phenomenological psychiatrists in the fourth edition of his General Psychopathology must be seen.
6.1.2 Is There Even a Singular Phenomenological Psychiatry?
The question already suggests that the answer is no. Just as there is no unified concept of phenomenology, there is no unified concept of phenomenological psychiatry . However, here we refer to Tatossian’s hypothesis, which says that despite the differences between and the partial lack of a clear overview of phenomenological-psychiatric works, there are some basic features of this thought that justify the use of the term “phenomenological psychiatry.” As indicated, this corresponds to Tatossian’s concept of phenomenological psychiatry as a psychopathological eidetic science of modified subjective experience (Tatossian 2002, p. 22). In this sense, Tatossian decouples the term essence from its orthodox Husserlian properties: for Tatossian, essence solely implies that the subject’s actual experiences are anchored in basic structures that should be examined by means of phenomenological analysis (Tatossian 2002). He identifies the structures as the condition of possibility for that which is concretely experienced (Tatossian 2002). Tatossian subsumes in this general concept of essence both the concepts of the first generation of phenomenological psychiatrists (including Straus, von Gebsattel, Minkowski, Binswanger, Kunz, and Storch) as well as newer authors (Blankenburg, Kuhlenkampff, Zutt, and Kraus). At the end of this article, Jasper’s critique of Straus and von Gebsattel will give us reason to explicate Tatossian’s concept of essence more closely.
6.1.3 Is Jaspers’ Critique Directed Only at von Gebsattel and Straus or Does It Make a General Claim?
Our examination is complicated by the fact that Jaspers only explicitly develops his critique with reference to some of Viktor E. von Gebsattel’s and Erwin Straus’ essays (Jaspers 1997, pp. 540–546). Moreover, in his critique, Jaspers refers not to “phenomenological psychiatry, ” but rather to the term “constructive-genetic psychopathology” introduced by von Gebsattel (Jaspers 1997, p. 540). However, this should not belie his critique’s claim to generality: first, Jaspers rubricates almost the entire first generation of phenomenological psychiatrists within “constructive-genetic psychopathology” (Jaspers 1997): Ludwig Binswanger, Erwin Straus, Viktor E. von Gebsattel, Alfred Storch, and Hans Kunz (Jaspers 1997), and speaks generally of this “trend of thought in psychopathology” (Jaspers 1997, p. 540). Second, in its applicability, Jaspers’ critique does not intend to deal precisely with the works of Straus and von Gebsattel. Rather, Jaspers sets up general hypotheses and uses the terms of these two authors in their support.
For this reason, we will proceed in this investigation with two steps: first, we will explore Jaspers’ direct confrontation with Straus and von Gebsattel (Sect. 6.3), and then in conclusion (Sect. 6.4) we will evaluate this critique within the broader framework of phenomenological-psychiatric thought in accordance with Jaspers’ claim. Moreover, an assessment based on such a general concept of phenomenological psychiatry is justified by the fact that the structural terms of Jaspers’ critique can be recognized in other authors of classical German psychiatry (Kurt Schneider, Gerd Huber). The basis for this further assessment is Tatossian’s comprehensive determination of phenomenological psychiatry.
6.2 Locating the Critique in General Psychopathology
In order to understand Karl Jaspers’ critique of phenomenological psychiatry , it must first be placed in the broader framework of his General Psychopathology. Thus, our initial task is to explore this critique in the modified context of the fourth edition of General Psychopathology. Subsequently, we will deal briefly with Jaspers’ concept of phenomenology, genetic understanding (Verstehen), explanation (Erklären), his concept of theory, as well as the concept of the Illumination of Existence. From this perspective, his critique of von Gebsattel and Straus can be illustrated.
6.2.1 The Modified Context of the Fourth Version of General Psychopathology
Jaspers’ GP undergoes significant change throughout the chronic of its editions. Of a total of nine versions, the largest relative differences are to be found between the first (1913) and fourth (1946) edition (for more on the relationship between these two versions, see Kirkbright 2008). This can be traced to multiple causes, which seem to be rooted in Jaspers’ philosophical development. Whereas Jaspers writes the first edition, for the most part, as a psychiatrist with the quasi-philosophical aim of explicating a method specific to psychiatry, his purpose in 1946 (1942) is to place his philosophical standpoint of existential philosophy up against psychiatry as a whole: in simplified terms, Jaspers is primarily a psychiatric, and secondly a philosophical author. The development of his stance toward psychoanalysis and phenomenological psychiatry is grounded in this fact. Whereas this stance can be described as of 1913 as open and affirmative, as Jaspers developed his own philosophical standpoint, this gave way to a position of resignation and critique by 1946. This change is reflected in the structure of the book. While the significant methodical difference in psychopathological practice in 1913 lies between understanding (Verstehen) and explanation (Erklären), the difference stressed in 1946 is one between these two methods and the genuinely Jaspersian view of psychiatry from the focal point of Existential Philosophy . To this end, the book was extended to a sixth part (The human being as a whole) in 1946. This is the first year in which Jaspers added the critique of Straus and von Gebsattel considered in this article, which can be found in the third capital of the third part (The explanatory theories—their meaning and value).
6.2.2 Understanding (Static, Genetic) Explanation, Concept of Theory, and Illumination of Existence
Jaspers is considered the first author who introduced informed, methodical self-reflection to psychiatry (Binswanger 1994, p. 76). The strength of his psychopathology in the first edition lies less in having developed something methodically new than in setting up a methodological order for existing methods and relationships. This methodological conscience can be understood as the norm providing the grounds for Jaspers to call especially phenomenological psychiatry into critique, as it undermines the methodological lines of division he himself draws. These lines of division consist, as generally known, in Jaspers’ distinction between understanding (Verstehen) and explaining (Erklären), as well as in the third dimension of the Illumination of Existence (Existenzerhellung) the latter which he added in the fourth edition. We would like to briefly consider this.
Static Understanding—Jaspers’ Use of Phenomenology
As already mentioned, Jaspers uses phenomenology as a descriptive psychology of a patient’s subjective and conscious ways of experiencing. On the whole this approach results in a static concept of experience: the description of the present condition, rather than how experiences arise from other experiences (see genetic understanding ) and the extraconscious that underlies these experiences (Jaspers 1968, p. 1320 et seq.), matters. The latter in particular is significant for Jaspers’ critique of phenomenological psychiatry . The essential methodical tool for a diagnostician is empathy (Einfühlung): through exploration, analysis of expression, or on the basis of self-assessments, the diagnostician should place oneself in the patient’s way of experiencing, reflexively make this experience an outlook and arrange it in ordered terms (Jaspers 1968, p. 1320). As a histologist describes a preparation under a microscope, one should “account for every psychic phenomenon, every experience met with in our investigation” (Jaspers 1997, p. 56). It is critical for this description that “conventional theories, psychological constructions, interpretations and evaluations must be left aside.” (Jaspers 1997)
Genetic Understanding—Emergence of the Psychic from the Psychic
Contrary to Jaspers’ use of phenomenology as a static description of the conditions of psychic experience, genetic understanding aims to empathetically trace the emergence of one psychic state from another (Jaspers 1997, p. 302 et seq.). Thus, genetic understanding poses the question of the connection between individual psychic phenomena. According to Jaspers, these connections are evident as such and cannot be falsified through empirical research or theories of the unconscious. In this sense, for example, the effect of autumn in promoting suicide is, in understanding, an evident fact—even if this is generally and objectively statistically false (Jaspers 1997, pp. 714–715).
Commonalities of Genetic and Static Understanding
Empathy is typical of both static and genetic understanding , as even genetic understanding is based on a purely conscious level of experience (Jaspers 1997, p. 306). In both cases, Jaspers claims it is possible that things which were heretofore unnoticed can become noticed through understanding. This distinguishes it from the actual unconscious, which he up to now characterizes as extraconscious (Jaspers 1997). Static as well as genetic understanding is compared to mechanisms outside of consciousness (Jaspers 1997).
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