Philosophy, Psychiatry, & Psychology

In my view, Nassir Ghaemi is wrong to suggest that Karl Jaspers' applied philosophy could be the basis for a practical pluralistic psychiatry of today: It would be more accurately described as a forerunner of the "eclecticism . . . a vague notion that all methods need to be used, simultaneously, mixed together" that Ghaemi attacked so persuasively in The Concepts of Psychiatry (Ghaemi 2003). As Jaspers himself says, in the passage from General Psychopathology that Ghaemi quotes from in the first part of his article: "no theory or viewpoint is ignored" in this work which more than doubled in size as it went through eight editions over five decades. I challenge any reader who has reached (for example) page 694, and has encountered yet another multiplication of the categories to be considered, into the biological, the (individual) life historical, self-reflective awareness, and the existential, not to feel a certain sense of unease that enlightenment may not even be reached if he or she ever manages to finish the remaining 165 pages, because "These four elements are in reality one and inseparable and are linked in a mutual bond in which diverse modes of Being come to life, in such a way however that they only occupy an understandable position in that midway sphere, which lies between the biological life and Existence itself and sets the bounds for what cannot be understood" (Jaspers 1997, 694). I come to Popper shortly, but at this point I merely suggest that although his few published words on Jaspers include the comment that the books, especially the General psychopathology "contain much of interest," this passage would for Popper fall rather into the category of (quoting Schopenhauer) "empty and hollow verbiage" (Popper 1945).

However, it could be argued that the passage is more philosophical than clinical. Ghaemi points toward a good example of the latter in claiming, as have others (McHugh 1997), that Jaspers "vehemently criticized" psychoanalysis for its [End Page 71] "ossified dogma." Some passages in the General Psychopathology accord with this view, but others do not. For example, listing the types of what we would call life events in order of importance under "psychogenic reactions" (367), Jaspers places "sexuality and eroticism" first, ahead of health, material well-being, relationships, and spirituality. A little later, under "abnormal mechanisms" (382), we read: "Associations that have become mechanical habits turn into despotic and binding ties, into fixations. A normally mobile psychic life . . . is directed by complexes, fetichisms and inescapable images." Again, a passage apparently stating an important role for "repression" in hysteria (404), gives three examples, all involving sexuality, from Pfister, an orthodox Freudian (and an approving reference to Breuer and Freud's Studies in Hysteria follows two pages later). I agree with Ghaemi that "Psychological understanding cannot be used mechanically as a sort of generalized knowledge but a fresh, personal intuition is needed on every occasion" (Jaspers 1997, 313) is primarily aimed at psychoanalysis. But it then follows, from the examples I have given, that Jaspers' general attack is inconsistent: His specific criticisms appear to be against Freud's symbolism, but not Freud's notion of the central importance of sexuality, or the wider concept of unconscious motivation (which even if one takes it to be pre-Freudian, remains a key feature of psychoanalysis).

Returning to philosophy (of science), Jaspers shows himself to be over-eclectic to the point of self-contradiction. On the one hand: "We have, therefore, to make a continual effort to discount the theoretical prejudices ever present in our minds and train ourselves to pure appreciation of the facts" (Jaspers 1997, 17); but on the other, "The investigator, however, is more than a vessel into which knowledge can be poured. He is a living being and as such an indispensable instrument of his own research. The presuppositions without which his enquiry will remain sterile are contained within his own person" (Jaspers 1997, 21). The supposed distinction that Jaspers makes between prejudices (bad, and to be weakened) and presuppositions (good, and to be strengthened) does not convince. He gives the impression of providing...