Susan
Lanzoni
is an NSF postdoctoral fellow and
research associate at the Center for Philosophy and History of Science
at Boston University. This essay originated from her dissertation,
"Bridging Phenomenology and the Clinic: Ludwig Binswanger's Science of
Subjectivity," completed at the history of science department at
Harvard University. She is presently working on a history of empathy.
An Epistemology of the Clinic: Ludwig Binswanger's
Phenomenology of the Other by Susan Lanzoni
Binswanger's phenomenology of the clinical encounter
stressed the
role of the clinician as the epistemological instrument of perception
and feeling and offered a striking alternative to the
patient-psychiatrist encounter as described by psychoanalysis.
Binswanger's work thus stands in a phenomenological psychotherapeutic
tradition that departs significantly from Freudian psychoanalysis and
that has had profound influence in Central Europe, as well as in
England and the United States8
In the years following World War II, Binswanger's rendering of the
phenomenological vision would inspire Maurice Merleau-Ponty as well as
the young Michel Foucault. 9
As a source of intersubjective and social definitions of mental
disorder, it would also provide philosophical fuel for the
antipsychiatry movement. 10In
formulating a hybrid science melding the domains of philosophy and
psychiatry, Binswanger went further than most in demonstrating the
potential of phenomenology to bridge intellectual and practical worlds:
from European psychiatric asylum practice, to critiques of
psychoanalysis, to philosophical discourse on intersubjectivity.
It is perhaps obvious that a clinical psychiatrist,
especially
the director of a psychiatric asylum, would take an interest in
intersubjectivity as it pertained to the clinical encounter. New
therapeutic practices-suggestion and hypnosis in the late nineteenth
century and psychoanalytic transference in the early twentieth-had
focused attention on the healing possibilities of doctor-patient
contact. For the majority of Binswanger's asylum patients, however, who
suffered from psychotic disturbances such as mania and schizophrenia,
these therapeutic techniques had limited value. For such cases, the
more basic challenge to the practicing psychiatrist was merely to understand
schizophrenic experience, which seemed so unlike the normal, both
cognitively and emotionally. Jaspers, one of the pioneers of
phenomenological psychiatry, found phenomenological methods useful for
understanding individual psychotic symptoms but did not think they
could lead to a comprehensive understanding of psychosis11
Binswanger, in contrast, boldly claimed that phenomenological intuition
and empathy could provide a direct pathway to understanding the
psychotic person holistically.
8.
It is only
recently that
scientific psychologies with debts to phenomenology have become a
research topic for historians of psychology and psychiatry. The classic
work is Spiegelberg's Phenomenology in Psychology and Psychiatry.
See also Max Herzog, Phänomenologische Psychologie: Grundlagen
und Entwicklungen
(Heidelberg, 1992). Mitchell G. Ash chronicles the history of Gestalt
psychology, with particular attention to its phenomenological roots, in
Gestalt Psychology in German Culture, 1890-1967: Holism
and the Quest for Objectivity (Cambridge, 1998). See also Anne
Harrington, Reenchanted Science: Holism in German Culture from
Wilhelm II to Hitler
(Princeton, N.J., 1996), for a discussion of holism and phenomenology
in the work of the neurologist Kurt Goldstein and psychologist Max
Wertheimer. Martin Kusch discusses phenomenology and life-philosophy in
the history of disciplinary disputes between philosophers and
psychologists in Germany in Psychologism: A Case Study in the
Sociology of Philosophical Knowledge (London, 1995). Kusch also
examines the Würzburg school of thought-psychology, which made use
of Husserlian ideas, in Psychological Knowledge: A Social History
and Philosophy
(London, 1999). Katherine Arens explores developments in conceptual
psychology, focusing on Franz Brentano, Dilthey, and Husserl, in Structures
of Knowing: Psychologies of the Nineteenth Century
(Dordrecht, 1989). Louis Sass explores three phenomenological
approaches to schizophrenia in Louis Sass, "Self and World in
Schizophrenia: Three Classic Approaches," Philosophy, Psychiatry,
and Psychology 8 (Dec. 2001): 251 – 70. 9.Binswanger's
first existential essay, "Dream and Existence," was famously introduced
to a French-speaking audience by Michel Foucault in 1954. See Michel
Foucault, "Dream, Imagination, and Existence," in Foucault and
Binswanger, Dream and Existence, ed. Keith Hoeller (1954;
Atlantic Highlands, N.J., 1993). Maurice Merleau-Ponty, Phenomenology
of Perception, trans. Colin Smith (London, 1989) cites Binswanger's
work on hysteria and the body; see p. 160. 10. R. D.
Laing is a major
figure in the antipsychiatry movement (along with Foucault) with strong
connections to existential psychiatry; see R. D. Laing, The Divided
Self: An Existential Study in Sanity and Madness (1959; New York,
1990), pp. 17 – 38. 11. See Karl
Jaspers, Allgemeine Psychopathologie: Für Studierende
ärzte und Psychologen
(1913; Berlin, 1923). In a letter to Jaspers, Binswanger said that
despite his criticism of Jaspers's methods, they were united in the
attempt to turn psychology in the direction of subjectivity; see
Binswanger, letter to Jaspers, 1 Nov. 1922, Binswanger Archive 443/17,
Tübingen University Archive, Tübingen, Germany; hereafter
abbreviated
UAT.