"Jaspers on the Intersection of Philosophy and Psychiatry" by Leonard H. Ehrlich,1963

Nassir Ghaemi has been involved in mastering the substance and import of Jaspers's work in psychopathology and psychology for many years. His book Concepts of Psychiatry (2003), from which Ghaemi's article to this issue of Philosophy, Psychiatry, & Psychology is excerpted, attests to his insight into the intersection of psychiatry and philosophy, and Jaspers's signal contribution in this regard. Roughly, Jaspers's work can be said to have two aspects to this intersection: first, a critical methodology of psychopathological and psychological research, and, second, philosophical reflections on the question "what is man?"1 Both aspects inform the last edition of General Psychopathology (1963), Jaspers's main work in the relevant field, and the only one fully translated into English. Although Ghaemi discusses both aspects in his book and in the article, he concentrates on the former, on the question of Jaspers's 'philosophy of science'. Working with Jaspers on the intersection of psychiatry and philosophy presents the researcher with considerable problems. Ghaemi is to be credited with achieving success despite the problems. Let me discuss some of these problems.

First, we are dealing with two languages, both of which, but each in its own way, demand precision of thought and of thought elements (e.g., terms). The task of the translator, whether from German to English or vice versa, is unenviable. Thus, the reader who is dependent on the English translation of General Psychopathology by Hoenig and Hamilton faces a handicap, which the translators acknowledge. Writing their "Translators' Preface" in the early 1960s, they not only observe that "modern clinical psychiatry is still largely based on the achievements of continental psychiatrists," but report that they "were not able to get much help from translations of Jaspers's philosophical works" nor from colleagues with orientations that, at that time, predominated in British philosophy departments (Jaspers 1963, vii, viii). Hoenig and Hamilton often inform the reader of these difficulties by means of adding the German original to their translated section titles.

Is Verstehen a Science?
One of the main problems Ghaemi faces in his article is the question of whether verstehende psychology is a science. The insuperable difficulty [End Page 75] lies in that 'Wissenschaft' can only be translated as 'science', but the way these terms are used in their respective languages differs. In recent usage, especially on the part of philosophers of science, 'science' refers to methodical research into inanimate or animate nature. Moreover, philosophers of science of the last century, whether German or English, have tended to regard measurable and mathematizable reality as the standard object of true 'science', as practiced especially in physics. Significantly, they have had little to say about biological fields. And by and large they have discounted thought that is a matter of Verstehen, whether history or verstehende psychology, as cognitively significant areas of science (e.g., see Popper, Hempel).

In German, 'Wissenschaft' refers to any area of critical, methodical inquiry, whether into realms of nature or not. To the English speaker, it may sound strange that in German Wissenschaft includes theology and musicology no less than astronomy and microbiology. (Perhaps it would be more useful to translate the word as 'disciplined inquiry'.) Because of that inclusiveness, Jaspers characterizes Wissenschaft by means of three marks that underlie both the natural sciences and the human studies. Jaspers mention those marks very briefly in General Psychopathology, and Ghaemi refers to them; Jaspers elaborates on them in other works. Ghaemi correctly stresses that the mark of "universal validity" is not to be taken as a pattern to which scientific cognition must conform. Instead, it is an aim of scientific work for it to be accepted as sound and true by anyone capable of following its procedure, and thus functions as a standard against which results of research are measured. To phrase it more concretely: A psychiatric finding has to be capable of being recognized as 'valid' by qualified peers.

Cogency
The mark of "cogency" (German: zwingende Gewissheit, literally "compelling certainty") is also an aim rather than an attribute of scientific cognition. In the natural sciences, what is 'certain' is the explanatory causal rule, nexus, or theory, and the degree of certainty is expressed in terms of probability. In cognition that is or involves interpretive Verstehen, the attainment of certainty is quite problematic. The reason is that what is 'understood' is not there as something that can be observed through a perceptive apparatus, much less measured, experimentally connected, and so on. The 'object' of 'understanding' can be 'understood' in several ways, even in opposite ways, and its interpretation is never at and end.2 Because various interpretations are possible, Verstehen is not a matter of determining degrees of probability. Because conflicting interpretations are equally possible, or more a propos, equally plausible, the determination of certainty with respect to pertinent factual, medical, and behavioral contexts of the case at hand is a matter of demonstrating the plausibility of one, and disproving that of the other. Here is where discussion among, and consultation with peers comes in.

This also points to another aspect of Jaspers's characterization of Verstehen raised to the level of a critically clarified method, namely that it proceeds along a 'hermeneutic circle' (1963, 356f). What is meant is that we never direct our attention to something with a blank mind, but always within a horizon of general dispositions, be they curiosity, prior knowledge, prejudice, or theoretical convictions. As we consider a specific case, we may recognize it as an instance or even a confirmation of a general type, in which case we complete the circle in a simple manner. Although the presence of the horizon of general meaning contexts is as indispensable as it is inevitable, it must not obtrude in the consideration of a case or in the process of research. Hence, the researcher has to suspend any interpretive predispositions much in line with the practice of 'bracketing out' (epochē) practiced by phenomenologists.

Methodological Consciousness
The key to aiming at universal validity and compelling certainty lies in that science is at heart research; that is, cognition is a doing. This is what is contained in what Jaspers calls 'methodological consciousness': 'method-' indicates a structured procedure; '-logical' means the structure is defined [End Page 76] in relation to specific presuppositions, to the pertinence to the 'object' at hand, and to the limits within which the procedure is operable, such that overstepping these limits would constitute an uncritical shift of perspective on one's 'object', or even a shift of focus on a different 'object'. And 'consciousness' means not simply that that the methodical doing is undertaken deliberately, but that the very doing is a thinking (Jaspers defines surgery as thinking with one's hands), informing the doing with attention to the defined parameters of the method deliberately undertaken.

Pluralism
Ghaemi maintains that "[methodological] pluralism and science are synonymous for Jaspers" (2007, 62), and in particular with reference to the equal pertinence to psychiatry of the methods of causal explanation and Verstehen of meaningful connections. Perhaps 'synonymity' does not quite capture what is meant by Jaspers. The reason is that even if the idea of 'science' were, for example, to be restricted only to 'causal explanation', it would still be a matter of pluralism. The conception of the category of 'cause' is labile and has a checkered history. Just one example: To arrive at the theory of gravitation, natural philosophers had to find a way of departing from the time-honored 'naturally' intuitable contiguity of cause and effect to imagining causation at a distance. And what the physicist means by cause is removed from, say, what the medical diagnostician means by etiology. And something equivalent pertains to the methodology of Verstehen: It will differ among the historian, the literary critic, the police investigator, the psychopathologist, and the psychotherapist. They all 'understand', but each in a different mode.

Thus, pluralism is at one with the methodological nature of the scientific enterprise. What is at play is the implication that Jaspers draws from the circumstance that different 'objects' require different mindsets on the part of the researcher, namely that thought must be critically sovereign.

Phenomena and Factualities
At no place does this sense of methodological pluralism come more clearly into play in General Psychopathology than in Part One, the largest and most elaborate part of the work. Here also the positive and negative interplay is displayed of what, in the respective later parts, are the topics of explanation and Verstehen. To clarify this, one has to point out that in Part One the English reader is confronted with terminological confusion, due in large part to the translators' vain search for knowledgeable consultants.

The heading for Part One is followed by the heading of Chapter I, which in turn is followed by Section One. In the English translation the three titles read as follows:

Part One: Individual Psychic Phenomena Chapter
I: Subjective Phenomena of Morbid Psychic Life (Phenomenology)
Section One: Abnormal Psychic Phenomena

Each of the three titles contains the word 'phenomena', but this same word is used to translate three different terms in the original.

Like all sciences, psychopathological research and diagnosis begins with data. Although the 'object' of the science is the 'psyche'—man's 'soul' and 'spirit'—not all data are strictly 'psychic', but are inferable—by means of Verstehen—through somatic and other material data. This is reflected in the division of this part into four chapters. Whereas the first chapter deals with the various kinds of subjective manifestations of "morbid psychic life," the other three chapters bring in 'objective' data: Chapter II, in dealing with the objective manifestation of psychic life ('performance psychology'), brings in the interplay of 'understandable' subjectivity (psyche) and observable objectivity (soma). At the very beginning of this chapter, Jaspers defines the antagonism between the 'psychological schema of task plus performance' and the 'neurological schema of the reflex arc'. Somatic manifestations as effects and symptoms of psychic life are the subject of Chapter III. And finally, Chapter IV classifies the display and testimony of meaning in expression, behavior, in productions and in works. [End Page 77]

If Part One consisted solely of the subject matter of Chapter I, then "Individual Psychic Phenomena" would be a correct title. But because the other three chapters deal with data that are not simply 'psychic phenomena', Jaspers entitles this part as

Die Einzeltatbestände des Seelenlebens, meaning "Individual Factualities of Psychic Life."

Jaspers speaks here of Tatbestand rather than Tatsache (fact) because the scientist reserves 'fact' for a material occurrence, not for what is indicated by a psychic datum. To accommodate both, Jaspers speaks of Tatbestand, which in the present context is best translated as kind of fact, or factuality. It does not mean 'phenomenon'.

Jaspers refers only to the methodology of Chapter I as 'phenomenology', which in his usage as he explains in the book, is really an aspect of Verstehen, namely "static" Verstehen, i.e., Verstehen of data rather than the connection among data. His title of Chapter I is:

Die subjektiven Erscheinungen des kranken Seelenlebens (Phänomenologie), meaning "Subjective Appearances of Morbid Psychic Life (Phenomenology)."

Accordingly the use of 'phenomena' makes sense and is correct only in the title of the Section One:

Einzelphänomene des abnormen Seelenlebens ("Individual Phenomena of Abnormal Psychic Life")

Philosophy and Psychiatry
A concentration on Part One of General Psychopathology could better illustrate the methodological need for both causal explanation and Verstehen in psychiatric research and practice, than on the juxtaposed Parts Two and Three. The question of methodology is not the only relevance of philosophy to psychiatry. It is of great interest to read Ghaemi's reference to the Parts of General Psychopathology that deal with the intersection of philosophy and psychiatry. These parts take up questions concerning the whole of the human being, mainly from a psychiatric viewpoint in Part Four, and mainly from a philosophical perspective in Part Six. It is fascinating that in Jaspers's elaborate treatise on nosology in Part Four, Ghaemi found his diagnostic psychopathologic schema as remarkably coinciding with a classification now in use in the field. And no study of Jaspers the philosopher-plus-psychopathologist would be complete without regard to Part Six, which was completely new in his last revision of General Psychopathology, the edition that is translated into English. It contains the sententious sentence that has become famous out of its context: "The human being is always more than he knows, or he or anyone else can know about himself.