Chapter 3 Beyond the Ontological Difference: Heidegger, Binswanger, and the Future of Existential Analysis Anthony Vincent Fernandez The "ontological difference"-that is, the difference between being and beings-is a central theme in Martin Heidegger's philosophy. The proper interpretation of this difference is, however, contentious. One of the most famous misinterpretations is found in the work of Ludwig Binswanger, the founder of existential analysis-a fusion of psychoanalysis and phenomenol- ogy. Binswanger adapted Heidegger's philosophy of human existence for his own studies of mental disorder and, in the course of this adaptation, critiqued Heidegger's philosophy. Heidegger, initially supportive of Binswanger's application, later accused him of grossly misunderstanding the ontological difference. According to Heidegger, Binswanger's studies of particular psy- chopathological cases should be taken as ontic (i.e., as a study of concrete beings-in this case, the concrete human being) rather than as ontological (i.e., as a study of the meaning of being-in this case, what it means to be human). Binswanger readily admitted his error but claimed that it was, in the end, a "productive misunderstanding"-a characterization that did little to satisfy Heidegger. In many tellings, this is where the story ends: Binswanger initially mis- understood Heidegger's ontological difference but later admitted his error, corrected his interpretation, and properly characterized the nature of his own psychiatric project. This story, however, presents the disagreement as a quib- ble between two thinkers. It neglects the broader influence of Binswanger's misinterpretation-specifically, how this misinterpretation produced the philosophical foundations of phenomenological psychopathology, or the phenomenological study of mental disorders. In this chapter, I revisit this dispute and explain how Binswanger inspired the philosophical foundations of phenomenological psychopathology. In fol- lowing this thread, I do not deny that Binswanger misunderstood Heidegger's 27 Fernandez, Anthony V. (2018). Beyond the Ontological Difference: Heidegger, Binswanger, and the Future of Existential Analysis. In K. Aho, Ed., Existential Medicine: Essays on Health and Illness, pp. 27–42. New York: Rowman and Littlefield International. 28 Anthony Vincent Fernandez ontological difference. I suggest, instead, that Binswanger's misunderstand- ing of Heidegger points us toward the correct understanding of human existence. However, to achieve this new understanding, we will have to clarify the nature of the ontological difference and resolve the ambiguities in Binswanger's approach. This chapter proceeds in four parts: First, I provide an interpretation of the ontological difference, laying the foundation for subsequent sections. Sec- ond, I use this interpretation to justify Heidegger's critique, and to highlight the ambiguities in Binswanger's approach. Third, I show how Binswanger's application ofHeideggerian phenomenology, despite his misunderstanding of the ontological difference, inspired Michel Foucault's and Maurice Merleau- Ponty's approaches to psychopathology.1 Fourth, I develop a new account of what it means to overcome the ontological difference, and I argue that this manner of overcoming the difference provides the metaphysical foundations that phenomenological psychopathologists require. THE ONTOLOGICAL DIFFERENCE What is the ontological difference? The nature of this difference is not entirely clear in Heidegger's own work and, as a result, has been interpreted in a variety of ways. Before articulating the nature of Heidegger's critique, and Binswanger's apparent error, it will be helpful to make my own interpre- tation of the ontological difference explicit. Ontology is the study of being, or of what it means for something to be what it is. Heidegger contrasts ontology with ontic investigations, which are studies of particular beings, rather than their being. For instance, I might con- sider my coffee mug ontically: It's white, made of ceramic, four inches high, holds eight ounces of liquid, and so on. These are ontic facts about my coffee mug. But, if I wanted to get philosophical (or ontological), I could ask what it means to be a coffee mug: What makes a coffee mug what it is? Which features or qualities must something have in order to be considered a coffee mug at all? Is a coffee mug with a hole in the bottom still a coffee mug? Is a painting of a coffee mug a coffee mug? What about a sculpture of a coffee mug? Rather than asking about ontic facts that pertain to my particular coffee mug, or even ontic facts that pertain to all coffee mugs, these questions aim at determining the being-or, we might say, the essence-of coffee mugs. Of course, Heidegger's concern wasn't to clarify the being of coffee mugs. It was to understand the meaning of being in general, or what it means to be at all. But, in order to properly ask this question, he first had to answer another: What does it mean to be human? According to Heidegger, we need to articu- late the essence of human existence before we can properly inquire into the Beyond the Ontological Difference 29 meaning of being as such. This is because human beings are the ones who ask ontological questions in the first place. Human beings are "pre-ontological," because they already have some vague understanding of what it means to be (Heidegger 1962, 36-37). For our purposes, we can focus exclusively on this ontological question of what it means to be human; how this question differs from ontic questions about human beings gets us to the heart ofBinswanger's apparent misunderstanding. How does Heidegger approach the distinctive ontology of the human being? fu Being and Time, he aims to discover and describe the basic "struc- tures" of human existence. These are "not just any accidental structures, but essential ones which, in every kind of Being that factical Dasein may possess, persist as determinative for the character of its Being" (Heidegger 1962, 38). By "factical Dasein," he refers to a particular human existence, a human being with a concrete history, situation, and so on. In other words, Heidegger's goal is to discover those structures of human existence that hold across all particu- lar human beings. And these structures must be "determinative"-they must play a central role in what it means to be human. For Heidegger, to be human is to be world-disclosive: Human existence is being-in-the-world. What, then, are these essential structures? They are what Heidegger calls "existentials"-structures that play a role in our existentiality, or transcen- dence and openness toward the world. For example, the existential that Heidegger calls "situatedness" (Befindlichkeit) refers to the fact that we are always situated in the world through some mood or affective attunement. Perhaps you are situated through a mood of joy, while I am situated through a mood of boredom. Neither joy nor boredom is an essential structure, or existential, because they are just one way that a particular subject might be attuned to the world. But no matter which mood we are attuned through, we are always situated and attuned through some mood, so it is the basic struc- ture of situatedness that is essential (F emandez 2017; Heidegger 1962). The particular affective attunement that we are situated in, our mood, is what Heidegger calls a "mode" (Heidegger 1962, 179-182). Modes are the phenomena that belong to some existential, or category, of human existence.2 Moods are the modes of affective situatedness, but each existential has its own set of modes, such as modes of understanding, modes of spatiality, and modes of temporality. In the case of temporality, for instance, I might find myself in the temporal mode of eager anticipation, or the temporal mode of whiling away the time. But the world is always presented to me through some temporal mode, which means that temporality is an essential struc- ture of human existence-that is, an existential. Each existential therefore encompasses a set of phenomena that share the same basic features, and the total set of existentials is the structure of human existence in general-what Heidegger sometimes calls our "categorial structure" (Heidegger 1962, 37). 30 Anthony Vincent Fernandez What does this all have to do with the ontological difference? Existentials are, on Heidegger's account, ontological features of human existence; modes, in contrast, are ontic features of human existence. To provide a complete ontology of what it means to be human, I will need to articulate all of the existentials, all of those structures that are essential to and determinative of human existence in general. But I won't need to provide an account of any particular modes of human existence. Particular modes are accidental, or non- essential, and are therefore not in the purview of ontology. But what if I wanted to understand the experience of a particular individ- ual, say, a person living with severe depression? According to Heidegger, this investigation would be ontic, rather than ontological, because it concerns a particular human being-not the structures that hold across all human beings. Instead of studying the essential structure of affective situatedness, I might investigate the particular mode of affective situatedness that the depressed person finds himself in-that is, his depressed mood. This doesn't mean that existential, or ontological, features of human existence play no role in my ontic investigation. They provide a useful framework for my particular inquiry. If I know that all human beings are affectively situated, and have some spatial and temporal orientation, then I might decide to study the modes of situatedness, spatiality, and temporality in this particular human being. Nevertheless, the ontological and ontic approaches to human existence are fundamentally different projects, with different aims and subject matter- even if they can reciprocally guide and inform each other. With this clari- fication of the ontological difference in hand, we can tum to Binswanger's misunderstanding of this difference, and Heidegger's critique. BINSWANGER'S MISINTERPRETATION Binswanger was one of the first psychiatrists to draw upon twentieth-century phenomenology. He found in Heidegger's work a new way of conceiving the nature of human existence and, thus, a new way of conceiving the nature of disordered or pathological forms of human existence. He developed his own phenomenological approach to psychiatric research and practice, which he called "existential analysis." Heidegger initially supported Binswanger's project, and the two engaged in a long-if not too frequent-correspondence. However, Binswanger's work was not merely an application. He also argued that there were important aspects of human existence that Heidegger neglected. While Heidegger was initially open to these criticisms, he eventually turned on Binswanger with a damning criticism of his own: Binswanger's attempt to supplement and modify Heidegger's project was based on a fundamental Beyond the Ontological Difference 31 misunderstanding of the nature and aims of Heidegger's work, and especially of the ontological difference. For the sake of clarity, we can focus on one example that received consid- erable attention from Heidegger and illustrates Binswanger's general misun- derstanding. One of the central existentials that Heidegger discusses in Being and Time is care (Sorge).3 According to Heidegger, when we take human existence in its totality, or as a whole, we find that it is first and foremost care. This means that the world, and everything within it, is always given to us as meaningful. Even when I say "I don't care," this is a way of caring. What- ever it is that I don't care about is meaningful to me, or makes sense to me, precisely as that which is not worth my time, my consideration, my attention, and so on. Furthermore, Heidegger stresses that care should be understood in an "ontologico-existential manner" (1962, 237). This means that care, as an existential, should be taken as an ontological category that includes an array of ontic modes. As Heidegger says, Care, as a primordial structural totality, lies "before" ["vor"] every factical "atti- tude" and "situation" ofDasein, and it does so existentially a priori; this means that it always lies in them. So this phenomenon by no means expresses a priority of the "practical" attitude over the theoretical. When we ascertain something present-at-hand by merely beholding it, this activity has the character of care just as much as does a "political action" or taking a rest and enjoying oneself. "Theory" and "practice" are possibilities of Being for an entity whose Being must be defined as "care." (Heidegger 1962, 238) In other words, any particular way of taking one's world or environment as meaningful is already grounded in this existential. No matter which attitude or concrete situation we might find ourselves in, that situation is always meaningfully available to us through care. Binswanger was intrigued by Heidegger's notion of care as the human being's openness toward a meaningful world. But, he believed that Hei- degger's notion was incapable of accounting for certain kinds of interpersonal relationships because it neglected the importance of love. He argued that Heidegger provided an account of how we can be with other human beings, mutually directed toward our world, but failed to provide a robust account of what Martin Buber called the "I and thou" relation-that is, a relation in which we are directed toward the other, rather than directed toward our world with the other (Buber 1972). Central to this form of interpersonal directedness is love. Binswanger "believed that true psychotherapy was dependent upon the emergence of a loving relationship between the patient and therapist-a relationship that was always attuned to the affective complexities of interac- tion" (Frie 1999, 249). 32 Anthony Vincent Fernandez As I noted earlier, Heidegger's criticism centered on Binswanger's appar- ent misunderstanding of the ontological difference.4 But what does love have to do with the ontological difference? Heidegger explained his concern with Binswanger's work when he lectured to a group of Swiss psychiatrists at the home of Medard Boss.5 In these lectures, Heidegger disparaged Binswanger's existential analysis: Binswanger's misunderstanding consists not so much of the fact that he wants to supplement "care" with love, but that he does not see that care has an exis- tential, that is, ontological sense. Therefore, the analytic of Da-sein asks for Dasein's basic ontological (existential) constitution [Ve1fassungJ and does not wish to give a mere description of the ontic phenomena of Dasein. (Heidegger 2001a, 1 1 6) As Heidegger argues here, Binswanger's account of love is not problematic in itself. Rather, it reveals a deeper misunderstanding that Heidegger wants to correct. Binswanger thought he needed to supplement care with love because he misunderstood care from the start. Moreover, he misunderstood care because he misunderstood the difference between the ontological and the ontic. He took care as one particular way that human beings can be ori- ented toward their world, and wanted to show that there is another way we are oriented toward our world (and especially toward others) that Heidegger neglected. Heidegger admitted that he didn't develop a robust account of love, but he argued that nothing in his account of care conflicts with an adequate account of love. Care, taken ontologically, refers to the fact that we are always open to a meaningfully articulated world. Our particular mode of meaningful articulation-love included-can change over time, and differ between subjects. But that the world is meaningfully articulated through the existential of care is never in doubt. If Binswanger understood this, then he might have gone forward with his account of love anyway, but he would not have portrayed it as a critique of Heidegger's ontological account of care. Rather, he would have portrayed love as an ontic mode of care-one that Heidegger did not adequately articu- late in his own work. Despite Heidegger's negative response, Binswanger took the criticism well and ultimately admitted his "productive misunder- standing." However, Binswanger's misunderstanding was not as clear-cut as Heidegger makes it out to be. Binswanger did not simply mistake an onto- logical phenomenon for an ontic one. Rather, his entire approach is grounded in an ambiguous relationship between the ontological and the ontic-even if Binswanger himself did not bring this ambiguity to the fore. In some cases, Binswanger seems to present the relationship between his own project and Heidegger's with the utmost clarity. For example, in his Beyond the Ontological Difference 33 essay "The Existential Analysis School of Thought," he characterizes Hei- degger's philosophy of being-in-the-world as an "ontological thesis" about the "essential condition that determines existence in general" (Binswanger 1958b, 191). Binswanger's existential analysis, in contrast, does not propose an ontological thesis about an essential determining existence, but makes antic statements-that is, statements of factual findings about actu- ally appearing forms and configurations of existence. In this sense, existential analysis is an empirical science, with its own method and particular ideal of exactness, namely with the method and the ideal of exactness of the phenom- enological empirical sciences. ( 1 92) Here, Binswanger suggests that his ontic, or empirical, project in no way challenges Heidegger's ontological project. But some of his other comments are more ambiguous. For example, he later says that Heidegger's account of the structure of existence provides him with a "norm" from which to study deviations. These deviations are, in turn, understood as new "forms," or even new "norms," of being-in-the-world (Binswanger 1958b, 201). This might suggest that he relies on Heidegger's ontological account of human existence as a basic starting point, a frame- work that guides his studies of individual subjects living in concrete situa- tions with particular psychopathological conditions. But it could also mean that the ontological structure itself can deviate or alter in pathological cases. This position would clearly pit his philosophical underpinnings against Hei- degger's, insofar as Heidegger believes that the ontological structure itself cannot change or alter. This ambiguity is reinforced, rather than resolved, in his case studies and analyses. For example, when studying pathologies of temporality in his famous analysis of Ellen West, he says, ''temporality ... has for us an ontological meaning. This must always be kept in mind, even when, in the analysis of a specific human existence, we must limit ourselves to showing what anthropological metamorphoses this ontological meaning goes through" (Binswanger 1958a, 302). We might interpret this in a way that respects the boundaries of the ontological difference. When Binswanger says that the "ontological meaning" of temporality undergoes "anthropological metamor- phoses," he might simply mean that at the anthropological level, the structure of temporality manifests through a variety of ontic modes. However, his con- crete analyses undermine this charitable reading. Providing another example of temporal alterations in the case of Ellen West, he says, the temporalization shows the character of a shortening or shrinking of exis- tence, that is, of the sinking of its rich and flexibly articulated ontological structure to a less articulated level: the unity of the structure falls apart into 34 Anthony Vincent Fernandez its different ex-stasies; the ontological relation of the ex-stasies to each other dissolves; the ex-stasy "future" recedes more and more, the ex-stasy "past" predominates, and coinciding with this the present becomes the mere Now or, at best, a mere time-span. (Binswanger 1958a, 310) Here, he clearly suggests that the ontological structure of temporality has itself undergone some dramatic alteration. In spite of his attempts to draw a line between his ontic investigations of particular psychopathological cases and Heidegger's ontological investigations of human existence as such, this distinction does not hold up in his concrete investigations. This ambiguity is doubtless frustrating to readers seeking a clear and coherent program for the phenomenological study of mental disorders. But, as I show in the following section, this ambiguity is precisely where later French philosophers find the promise of a new way of understanding human existence. EXISTENTIAL ANALYSIS AND THE FOUNDATIONS OF FRENCH PHENOMENOLOGY Foucault and Merleau-Ponty found in Binswanger's existential analysis the seeds of a new philosophical outlook-one that actively challenges the distinction between the ontological and the ontic, or the transcendental and the empirical. Neither fully articulated the nature or implications of this chal- lenge, but I here outline what they took to be the promise of Binswanger's existential analysis. Foucault finds in Binswanger's early work the key to a new way of con- ceiving human existence-a way that takes us beyond the ontological dif- ference. When Foucault was a doctoral student, he was invited to write an introduction to the French translation of Binswanger's 1930 essay, "Dream and Existence." In his introduction, he praises Binswanger's approach: In contemporary anthropology, the approach of Binswanger seems to us to take the royal road. He outflanks the problem of ontology and anthropology by going straight to concrete existence, to its development and its historical content. Thence, by way of an analysis of the structures of existence (Existenz)----of this very existence which bears such and such a name and has traversed such and such a history-he moves continually back and forth between the anthropologi- cal forms and the ontological conditions of existence. ( 1984, 32) Traditionally, ontology and anthropology are distinguished in the following way: Ontology is the study of being; anthropology is the study of human life. However, when we ask what it means to be human, the bounda1y between the disciplines blurs. On Foucault's reading, Binswanger overcomes this Beyond the Ontological Difference 35 traditional distinction by moving between the "anthropological forms" (i.e., the factical modes of human existence) and the "ontological conditions" (i.e., the existentials, or the essential structures of human existence that make experience possible). Foucault says that Binswanger "continually crosses a dividing line that seems so difficult to draw, or rather, he sees it ceaselessly crossed by a concrete existence in which the real limit of Menschsein and Dasein is mani- fested" (1984, 32). Therefore, nothing could be more mistaken than to see in Binswanger's analyses an "appli- cation" of the concept and methods of the philosophy of existence to the "data" of clinical experience. It is a matter, for him, of bringing to light, by returning to the concrete individual, the place where the forms and conditions of existence articulate. Just as anthropology resists any attempt to divide it into philosophy and psychology, so the existential analysis of Binswanger avoids any a priori distinction between ontology and anthropology. One avoids the distinction with- out eliminating it or rendering it impossible: it is relocated at the terminus of an inquiry whose point of departure is characterized not by a line of division, but by an encounter with concrete existence. (32-33) Importantly, Foucault does not claim that Binswanger misunderstands or eliminates the ontological difference-characterized here as the difference between ontology and the ontic science of anthropology. Rather, he claims that Binswanger "avoids the distinction" by placing it at the end of his study rather than at its beginning. But how does a study that begins from concrete existence avoid the distinction between ontology and anthropology? Tradi- tionally, concrete existence stands in the domain of anthropology. The neces- sary conditions for human experience and existence, by contrast, stand in the more abstract domain of ontology. But Foucault believes that Binswanger's distinctive approach merges these disciplines by starting from "the place where the forms and conditions of existence articulate."6 This ''place" can be nothing other than the concrete human being. Foucault seems to suggest that the ontological structures of human existence always inhere in a concrete sub- ject. And if these ontological structures-these "conditions of existence"- are made concrete, it follows that our ontological structures are susceptible to disturbance and disorder. But Foucault never spells this out for us. Following his praise for Binswanger's approach, he says, "[t]o be sure, this encounter [with concrete existence], and no less surely, the status that is finally to be assigned to the ontological conditions, pose problems. But we leave that issue to another time" (Foucault 1984, 33). Regrettably, this time never came. Foucault soon became disillusioned with existential analysis and turned to the poststruc- turalism that we associate with him today. However, Foucault was not the 36 Anthony Vincent Fernandez only philosopher to find the promise of a new philosophical program in Binswanger's existential analysis. fu Phenomenology of Perception, Merleau-Ponty examines a number of psychopathological cases with the intent of revealing the shortcomings of traditional approaches to the study of consciousness, and he defends exis- tential analysis as a viable alternative. He believes that the two dominant approaches-"empiricism" and "intellectualism"-fail to adequately account for the nature of psychopathological experience. According to Merleau- Ponty, an empiricist approach assumes that consciousness is made up of a number of distinct parts: "If consciousness were a sum of psychic facts, then each disturbance should be elective"; that is, each disorder should be capable of altering a single structure of consciousness without disturbing the others (Merleau-Ponty 2012, 138). This approach fails to acknowledge how an alteration in one aspect of consciousness has ramifications throughout the entirety of consciousness. The intellectualist approach, on the other hand, assumes that conscious- ness is complete and unchanging: "If consciousness were a 'representation function' or a pure power of signifying, then it could exist or not exist (and everything else along with), but it could not cease to exist after hav- ing existed, nor could it become ill, that is, it could not be altered" (138).7 According to Merleau-Ponty, if one presumes the necessity and invari- ance of the structures of human existence, then "[t]he empirical variety of consciousness-morbid consciousness, primitive consciousness, infantile consciousness, the consciousness of others-cannot be known or compre- hended. One thing alone is comprehensible, namely, the pure essence of consciousness. None of these other consciousnesses could fail to actualize the Cogito" (126-127). If one presumes necessity and invariance, then one sets strict constraints on how a disorder can be described and explained. Changes in consciousness can only occur at a relatively superficial level; they cannot involve alterations in our fundamental structures. Historically, Merleau-Ponty suggests that this has forced the philosopher or psychologist to devise absurd accounts of the disorder in question; such as the following: "Behind his delusions, obsessions, and lies, the madman knows that he is delirious, that he makes himself obsessive, that he lies, and ultimately that he is not mad, he just thinks he is" (127). According to Merleau-Ponty, the very idea of genuine madness is made incoherent by the metaphysical presump- tion of essential structures. Merleau-Ponty embraces existential analysis as a way to coherently understand psychopathological existence: "The study of a pathological case has thus allowed us to catch sight of a new mode of analysis-existential analysis-that goes beyond the classical alternatives between empiri- cism and intellectualism, or between explanation and reflection" (138). Beyond the Ontological Difference 37 What Merleau-Ponty finds in Binswanger's existential analysis is an approach that acknowledges both the holistic nature of consciousness and its deep con- tingency. For him, it acknowledges that the human being constitutes her lived, meaningful world. But it also admits that the world itself-our life events, or personal experiences, our history and circumstances-reshapes us at a funda- mental level. However, just how fundamental this level is is left ambiguous in Merleau-Ponty's writings. Like Binswanger, Merleau-Ponty sometimes makes strong claims that seem to undermine the necessity and invariance of our ontological or transcendental structures. But, in his case studies, he often fails to distinguish between those disorders that do not involve alterations in our basic existential structures, and those that can be made sense of only if these basic structures are contingent and variable. BEYOND THE ONTOLOGICAL DIFFERENCE In light of its challenge to the ontological difference, Foucault and Merleau- Ponty found immense promise in Binswanger's existential analysis. But they did not adequately articulate what it means to overcome this difference and thereby failed to adequately articulate the philosophical foundations for the study of human existence. In light of this, I here develop an account of what it means to overcome the ontological difference and show how this account opens up a space for phenomenologists to study psychopathological existence. Remember that Heidegger makes a distinction between the essential struc- tures of human existence, which he calls existentials, and the non-essential ways that these existentials manifest, which he calls modes. Each existential is an ontological category, and this category encompasses a diverse array of ontic modes. It is the category, or categorial structure of human existence, that is essential-not the diverse modes that it encompasses.8 This helps us understand the ontological difference. But how does it help us understand what it means to go beyond the ontological difference? If any- thing, it seems that this way of drawing the distinction makes the difference abundantly clear: Ontological categories are different from the ontic phenom- ena that they encompass. What could it mean to overcome this difference-to complicate or blur this boundary? To overcome the ontological difference, we would have to show that the features of ontological existentials and the features of ontic modes do not differ as much as Heidegger believed. But what are these distinguishing fea- tures? Existentials are necessary and categorial; modes, on the other hand, are contingent and particular. Now, we're hardly going to show that existentials aren't categorial, but we might show that they are contingent-rather than necessary and invariant-features of human existence. 38 Anthony Vincent Fernandez I'll begin with an example of a contingent existential in a psychopathologi- cal condition, and then articulate its implications for overcoming the onto- logical difference. Depression is often characterized as a distinctive mood, or feeling. The depressed person may feel sad, hopeless, or guilty, and this feel- ing shapes how he experiences and understands his world. On a Heideggerian reading, then, depression is a modal disorder-it consists in a particular mode of human existence that discloses the world in a distressing or pathological way. In this case, the basic structure of human existence remains unchanged. The depressed person is still affectively situated in the world, which means that he or she retains the existential of situatedness. A phenomenologist who holds Heideggerian commitments to the ontologi- cal difference would argue that all psychopathological conditions should be understood in this way. Through our ontological investigations, we discover "essential structures" that hold for all factical subjects. Therefore, any altera- tions in human experience and existence can involve only changes in non- essential features, such as the ontic modes of human existence. This outlook clearly accommodates the cases of depression mentioned earlier and might accommodate a wide range of other psychopathological conditions, such as attention deficit hyperactivity disorder (ADHD) and personality disorders. But let's consider some more severe disorders, such as melancholic depres- sion and schizophrenia, to see how well they mesh with these philosophical assumptions. In severe forms of depression, including cases diagnosed as melancholic depression, many people report a general loss of feeling, rather than a kind of feeling. In fact, despite a general association of depression with feel- ings of sadness, despair, and grief, many people diagnosed with depression report an inability to have these feelings-at least to any significant degree. Chase Twichell, for example, recounts one of her childhood experiences of depression: I'm about eight, reading in bed when my mother comes in to tell me that my dog, hit by a car the day before, had died at the vet's. I put my face in my hands, a self-conscious and exaggerated expression of sorrow. My first impulse is to act the part of a grieving child. I am a grieving child, of course, but the real grief is inaccessible to me at that moment. In its place is a calm, numb kind of consciousness, out of which I can fake the expected responses. (200 1 , 22) Andrew Solomon reports a similar experience: The first thing that goes is happiness. You cannot gain pleasure from anything. That's famously the cardinal symptom of major depression. But soon other emo- tions follow happiness into oblivion: sadness as you know it, the sadness that seemed to have led you here; your sense of humor; your belief in and capacity Beyond the Ontological Difference for love. Your mind is leached until you seem dim-witted even to yourself . . . . You lose the ability to trust anyone, to be touched, to grieve. Eventually, you are simply absent from yourself. (2001 , 1 9) 39 How would a Heideggerian phenomenologist account for such experiences? Which changes in subjectivity would she appeal to in order to make sense of an inability to grieve, to feel, to be affectively touched by the world? If she remains committed to Heidegger's belief that situatedness is an essential structure for human existence, then she would have to redescribe the loss of feeling as a feeling of not feeling. That is, rather than taking reports of not feeling at face value, the Heideggerian phenomenologists would explain these reports away by saying that when someone reports a loss of feeling, he is actually reporting a peculiar feeling of things not mattering, or not having value. Such a feeling might be possible, but the phenomenological psychopa- thologist should not confine herself to such an account in advance. If we put our essentialist assumptions aside, and allow for alterations in the ontological structures themselves, then what kind of account would we be able to offer? How would a phenomenologist make sense of a genuine loss of feeling, without redescribing it as a feeling of not feeling? Some phenomenologists already provide these alternative accounts of depression, although they don't necessarily characterize their accounts as overcoming or challenging the metaphysical presuppositions of the ontological difference. Thomas Fuchs, for instance, argues that melancholic depression involves a loss of bodily resonance-one's lived body loses its affective attunement to others and the world (Fuchs 2013). I, on the other hand, argue that some people diagnosed with severe depression are de-situated-that is, the depressed person loses the capacity to be affectivity situated in and attuned to her world (Fernandez 2014a, 2014b). For our purposes, we don't need to distinguish these views. Both appeal to a general degradation in our ability to be affectively situated in and attuned to our world. And, therefore, both suggest an ontological change in human existence. If one is not affectively situated at all, then we might argue that the ontological category-the exis- tential of situatedness-is lost. An entire category of experiential phenomena has been annihilated from the subject's world. Alternatively, if we allow only for partially diminished affective situatedness, then we might argue that the category itself has been constrained, or altered. The entire category of aff ec- tive phenomena is less intense. Alfred Kraus also characterizes melancholic depression as a loss of moods and feelings: "At its core, the melancholic mood alteration is-paradoxically formulated-rather a lack of mood" (Kraus 2003, 208). However, he also points out that this lack of mood can involve a loss of ipseity, or selfb.ood. Typically, moods situate us in a world. As Heidegger says, we always find 40 Anthony Vincent Fernandez ourselves through a mood, or affective attunement. But, in a melancholic episode, moods are lost, and melancholic depersonalization sets in. The sub- ject feels strangely distinct from himself, as if he cannot be himself. This is different from feeling that he hasn't lived up to his own expectations, or that his character or values have changed over time. The sense of selfhood that is lost in cases of depersonalization is, rather, a condition for having these kinds of experiences. In both the loss of mood and the loss of ipseity we find an ontological alteration-a change in the existential itself-rather than a change from one ontic mode to another. This kind of deep ontological alteration likely occurs in other conditions as well, such as bipolar disorder (Fernandez 2014b), schizophrenia, and some neurological disorders. The phenomenological literature on schizophrenia, for instance, focuses on another disturbance of ipseity. As Louis Sass and Josef Pamas explain, positive symptoms of schizophrenia are "defined by a kind of diminished self-affection-that is, by a loss of the sense of inhabiting one's own actions, thoughts, feelings, impulses, bodily sensations, or perceptions, often to the point of feeling that these are actually in the possession or under the control of some alien force. Along with this diminishment, the very distinction between self and other may disappear" (Sass and Pamas 2003, 431). We might characterize this as a crisis of identity, but it's of a fundamentally different sort from the kind of crisis one might undergo when leaving behind a career, immigrating to a new country, or revealing one's sexual orientation. In these cases, one can only have a crisis of identity because there is a distinct sense of self and other-I left my career, I immigrated, I revealed my sexual orientation. In the case of schizophrenia, by contrast, this distinction between self and other breaks down, producing bizarre experiences of alien control. What we find in these cases are alterations in the ontological structures themselves. In some cases, an entire ontological category of phenomena might be lost. In other cases, the ontological category remains, but all of its ontic modes are altered. All of one's moods, for instance, might have diminished intensity. Or one's ability to distinguish one's own identity and agency from those of others might be compromised. Notably, these alterations can show up to us as distinctly ontological only if we have already distinguished ontologi- cal existentials from their ontic modes. Without this distinction, we wouldn't be able to know when an alteration is truly ontological, or simply ontic. When we fail to draw this distinction, we end up with the ambiguities that we find in Binswanger's existential analysis, as well as Foucault's and Merleau-Ponty's adoptions of this program. These philosophers offer provocative, but ulti- mately ambiguous, characterizations of psychopathological conditions. In order to establish a sound foundation for phenomenological psychopa- thology, we first have to determine what kind of alteration has occurred in the Beyond the Ontological Difference 41 condition in question. And we can determine this only by (a) distinguishing the ontological from the ontic and (b) admitting a deep contingency in the ontological structures themselves. If we haven't distinguished the ontologi- cal from the ontic, then we can't determine at what level an alteration has occurred. And, if we haven't admitted contingency in the ontological struc- tures, then we will look for alterations only at the ontic level. To admit con- tingency in the ontological structures is, in a sense, to particularize them-to admit that they are always instantiated in a concrete human existence and are therefore susceptible to disturbance and disorder. This admission moves us beyond the ontological difference, beyond the distinction between the ontic human being and the ontological structure of human existence in general. To properly understand psychopathological existence, we have to admit that our questions about the particular human being might, at the same time, be ques- tions about what it means to be human. ACKNOWLEDGMENTS I would like to thank Kevin Aho, Francisco Gallegos, and Robin Muller for helpful comments on earlier drafts of this chapter. I would also like to thank the Killam Trusts for providing the time to complete my research on this project. NOTES 1. Foucault is typically characterized as a post-structuralist, rather than as a phenomenologist. However, as I discuss later, Foucault's early work owes much to Binswanger's existential analysis, which is broadly phenomenological in scope and ori- entation. For more on the relation between Binswanger and Foucault, see Smyth (2011 ). 2. In Heidegger scholarship, it is common to stress the distinction between "exis- tentials" and "categories." On Heidegger's account, existentials apply to human exis- tence, and categories apply to nonhuman entities, whether they be physical objects, social events, or even ideas. However, the refusal to refer to existentials as "catego- ries," or "categorial structures," is based on a misunderstanding of Heidegger's dis- tinction. Heidegger doesn't want to confuse existentials with Aristotelian categories, but this doesn't mean that existentials aren't ontological categories or don't function as categories. In fact, throughout his early lectures, Heidegger often referred to the "categorial structures" and "categorial determinants" of human existence (Fernandez 2017; Heidegger 2005, 2008). 3. This existential is unique, insofar as it includes three existentials within it: situ- atedness (Befindlichkeit), understanding (Verstehen), and discourse (Rede). However, for our purposes, we can set this feature of care aside. 42 Anthony Vincent Fernandez 4. Richard Askay' s afterword (200 1) to the Zollikon Seminars provides a detailed analysis of Heidegger' s criticisms. According to Askay, Heidegger leveled five critiques against Binswanger's project. However, I take it that all of these critiques stem from Binswanger's failure to fully understand and acknowledge the ontological difference, so I do not distinguish among these critiques here. 5. For a work that addresses Heidegger' s, Binswanger's, and Boss's approaches to the study of mental disorders, see Kouba (2015). 6. The wording in this sentence is Wlclear, but I take it that Foucault means that the "forms" and "conditions" of human existence are only ever articulated in a con- crete human being. 7. It is important to note that Heidegger's philosophy does not fit neatly under the label of "intellectualism." Some of Merleau-Ponty's critiques of intellectualism are even Heideggerian in character. However, one aspect of this critique-the critique of essentialism, or the belief in necessary and invariant structures of human existence- can be leveled against the philosophical presuppositions of Heidegger's Being and Time. 8. It might be tempting to argue that at least some modes are essential. Take, for example, the centrality of the mode of anxiety (Angst) in Heidegger' s philosophy. Maybe all human beings are open to the possibility of anxiety. Maybe all human beings even experience anxiety at some point in their lives. This still doesn't make anxiety "essential" in Heidegger's sense. Heidegger says that he aims to uncover essential structures that persist "in every kind of Being that factical Dasein may pos- sess" (Heidegger 1962, 38). Therefore, when Heidegger calls something "essential," he means that it holds in all cases. Affective situatedness is essential because we are always affectively situated. 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