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Kurt Goldstein on autism; exploring a person-centered style of psychiatric thought

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Abstract

Autism research is facing profound difficulties. The lack of clinically valuable translations from the biomedical and neurosciences, the variability and heterogeneity of the diagnostic category, and the lack of control over the ‘autism epidemic,’ are among the most urgent problems facing autism today. Instead of encouraging the prevailing tendency to intensify neurobiological research on the nature of autism, I argue for an exploration of alternative disease concepts. One conceivable alternative framework for understanding disease and those we have come to call autistic, can be found in the work of neurologist Kurt Goldstein (1878–1965). His person-centered approach provides radically new ways to investigate and intervene with the behavior we are accustomed to explain by the elusive entity called autism.

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Notes

  1. Part of this need is motivated by financial rewards; a recent economic analysis estimated the cost of autism was more than that of any other medical or psychiatric condition (Buescher et al. 2014).

  2. See Rosenberg (2002, 2006) and Jutel (2013) for more on the central role of disease entities in the many aspects of modern medicine. For autism in particular, see Verhoeff (2014).

  3. Historical variability of the concept of autism, heterogeneity in symptomatology, the lack of successful translations from bench to bedside (no biomarkers), the expanding boundaries of autism, and an increasingly complex picture of autism’s neurobiology are few of the fundamental problems of current autism research.

  4. Later translated as The organism: A holistic approach to biology derived from pathological data in man.

  5. For Goldstein, this atomistic method “intended to designate any method which uses a dissecting procedure and tries to derive laws from the parts studied” (Goldstein 1963, p. 3).

  6. See e.g., Canguilhem, Knowledge of Life (2008), pp. 113–114 and 129–132 and The Normal and the Pathological (1991), pp. 181–196.

  7. Obviously, Goldstein’s (crypto-) teleological image of man is not unambiguous. For discussions on vitalism and teleology in relation to the work of Goldstein, see Ferrario and Corsi (2013).

  8. These numbers are based on Google Scholar Citations.

  9. Despite the failure to institute a clinical or research program, Goldstein’s work has been important for the emergence and development of humanistic psychology (Noppeney 2001) and it is still well known to specialists in the history and philosophy of disease concepts (see, e.g., Wolfe 2015).

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Authors and Affiliations

  1. Theory and History of Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands

    Berend Verhoeff

  2. Dr. Leo Kannerhuis, Centre for Expertise, Research and Treatment of Autism, Derkinderenstraat 10-18, 1062 DB, Amsterdam, The Netherlands

    Berend Verhoeff

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Correspondence to Berend Verhoeff.

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Verhoeff, B. Kurt Goldstein on autism; exploring a person-centered style of psychiatric thought. HPLS 38, 117–137 (2016). https://doi.org/10.1007/s40656-016-0099-9

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