Philosophy, Psychiatry, & Psychology

Anyone who doubts Nassir Ghaemi's claim that the major contribution Karl Jaspers made to psychiatry is methodological pluralism just needs to pick up a copy of General Psychopathology and look at the structure of the book. First written in 1913 and running to over 800 pages in its final 1959 edition, it still exercises a peculiar fascination amongst thinking psychiatrists in 2007. It spans a bewildering array of perspectives on the human mind in pathological states. Complex, majestic, and aristocratic, it is a perspectival look at psychiatry at the heyday of Germany's supremacy in the cultural and medical sciences.

Jaspers the psychiatrist sails between the Scylla of high German philosophic thought and the Charybdis of a passionate empirical-mindedness of the kind Jasper's boss—the neuroanatomist Nissl—instilled in him. The tensions are extraordinary and Jaspers seems to revel in them. Scientific methodologies are identified and their results laid out. Jaspers wants to draw everything in and makes no pretence to everything fitting together in one theoretical system. It is also a culling exercise: worldviews built around single methodologies are slain (the worldviews of Wernicke and Freud are examples). Somehow, the complex, plural assembly is held together by the sheer philosophical personality of the author.

I should say that I greatly enjoy reading Nassir Ghaemi's reflections on psychiatry and that Karl Jaspers has always been a sort of hero for me, a figure who turned me toward medicine and psychiatry when I was a philosophy undergraduate.

It is against this background of admiration for Jaspers and appreciation of Nassir Ghaemi's insightful article on him that I want to draw attention to something that I think Jaspers-lovers need to square themselves with. This is the issue that Jaspers' methodological pluralism went hand in hand with a radical exclusion of philosophy from psychopathology. This is perhaps an odd thing to say about Jaspers, who is widely considered to be the philosopher of psychiatry, but I want to argue that it is true and that it leaves Jaspers in a position surprisingly close to instrumentalism, nominalism and relativism. [End Page 67]

This point is not altogether new. The psychiatrist Aubrey Lewis noticed this exclusion of philosophy by Jaspers in a lecture to Royal Institute of Philosophy in 1948.

Of living philosophers, the only one, I think, who has been a psychiatrist of note is Karl Jaspers: and Jaspers, in his well-known book on Psychopathology, writes that though philosophical study has no positive value for the psychopathologist, except in fitting him to meet methodological objections . . . says Jaspers, a philosophical training can be damaging rather than helpful for those who must be alive to fresh points of view in such a field as psychopathology. Evidently Jaspers the psychopathologist has had little help from Jaspers the philosopher.

(Lewis 1967, 164)

The psychiatrist John Cutting has made a similar point about Jaspers in relation to his understanding of schizophrenia.

It is not simply the case that "a new world comes into being and that is all we can say" [Jaspers]. It is that a particular world out of all sorts of possible worlds comes into being. It was his [positivistic] scientific orientation, as Scheler saw with regard to [positivistic] science in general—i.e. that an infinite number of worlds can accommodate the same scientific facts—that condemns him to this view.

(Cutting 2002, 167)

Jaspers loved philosophy, but he did not love philosophers (witness his remarks on Rickert in his philosophical memoir). His real philosophical mentor was the social scientist Max Weber. It was the philosophical personality of Weber that was Jaspers' point of departure. He had limited patience with systematic philosophy or with philosophy construed as knowledge of essences.

To understand how Jaspers excludes philosophy from psychiatry it is important to mention three distinctions Jaspers makes: science, worldview, and philosophy.

Jasper's concept of science is I think more...