Beruflich Dokumente
Kultur Dokumente
Existential Foundations
of
Medicine and Psychology
by MEDARD B O S S
Gerald Epstein
German
by
Stephen Conway and Anne Cleaves
with an introduction
by Paul J. Stem
NEW Y O R K
JASON ARONSON
LONDON
M
CONTENTS
Copyright
!
1 9 8 3 , 1979 b y M e d a r d Boss
ir
,
Introduction to the English Translation
ix
xxiii
xxv
xxvii
N e w Printing 1 9 8 3
Part I:
T h e Traditional Foundation of Medicine
ISBN: 0-87668-667-6
Chapter
1.
Chapter
2.
19
Chapter
3.
T h e N a t u r a l S c i e n t i f i c V i e w o f P s y c h o l o g y and
Psychosomatics
33
Library o f C o n g r e s s C a t a l o g N u m b e r : 8 4 - 2 8 2 2
vi
EXISTENTIAL FOUNDATIONS
Chapter
4.
Applying T h i s V i e w t o R e g u l a Z i i r c h e r
43
Chapter
5.
T h e Fundamental Conditionality of
P s y c h o l o g y and P s y c h o s o m a t i c s
57
Part II:
An Adequately H u m a n Foundation for Medicine
Chapter
6.
Applying t h e E x i s t e n t i a l O u t l o o k t o S o m e
Aspects of the Test Case
81
85
Chapter
Chapter
8.
A n E x i s t e n t i a l S t u d y o f the B a s i c C o n c e p t s o f
B i o l o g y , P h y s i o l o g y , and P s y c h o l o g y
127
C r i t i c i s m s o f a n E x i s t e n t i a l M e t h o d o f Medical
Investigation
155
T r a n s i t i o n a l Difficulties i n U n d e r s t a n d i n g
Daseinsanalytic Insights
161
Chapter
9.
Chapter 10.
Chapter 11.
167
Chapter 12.
G e n e r a l D a s e i n s a n a l y t i c Etiology and
Pathogenesis
191
C h a p t e r 13.
197
( haptei
A D a s e i n s a n a l y t i c E x a m i n a t i o n of S o m e
Prevailing, C o n c e p t s o f G e n e r a l P a t h o l o g y
241
vii
Part IV:
Suggestions for a Daseinsanalytic T h e r a p y
Preliminary Remarks
249
Chapter 15.
T h e Patient to Be Treated
251
Chapter 16.
257
Chapter 17.
273
Afterword:
T h e F o u n d a t i o n s o f a Ds-sein-Based S o c i a l
P s y c h o l o g y and Social P r e v e n t i v e M e d i c i n e
in M o d e r n Industrial S o c i e t y
285
Index
Part III:
T h e R u d i m e n t s of an Existential G e n e r a l Pathology
it
Contents
299
INTRODUCTION TO THE
ENGLISH TRANSLATION
EXISTENTIAL
FOUNDATIONS
xi
T h o m a s K u h n h a s pointed o u t t h a t n o s c i e n c e , e v e n d u r i n g s e t t l e d
periods of its h i s t o r y is e v e r e n t i r e l y free of t r o u b l e spots ("anomalies")
t h a t r e s i s t a s s i m i l a t i o n b y t h e prevailing paradigm. A s long a s t h e s e
z o n e s of i n t r a c t a b i l i t y a r e f e w , c i r c u m s c r i b e d , and p e r c e i v e d as fairly
p e r i p h e r a l , t h e y pose little t h r e a t t o o r t h o d o x y . Y e t e a c h o n e o f t h e s e
z o n e s can b e c o m e t h e s t a g i n g a r e a for i n v e s t i g a t i o n s t h a t g r a d u a l l y e r o d e
t h e prevailing f r a m e w o r k of m e t a t h e o r y . It will be discarded, h o w e v e r , if
a sizable n u m b e r of s c i e n t i s t s c o m e to feel t h a t t h e i r field is indeed in a
s t a t e o f crisis, t h a t t h e a n o m a l i e s p r e v i o u s l y perceived a s i n c o n s e q u e n t i a l
do in fact m a t t e r . T h e r e m u s t also be a p o t e n t i a l r e p l a c e m e n t w a i t i n g in
t h e w i n g s a n e w p a r a d i g m t h a t solves a n u m b e r o f p r o b l e m s insoluble
u n d e r t h e old d i s p e n s a t i o n .
In t h e field of m e d i c i n e , o n e of t h e p r o b l e m a r e a s h a s b e e n for a long
t i m e t h e r e a l m o f m e n t a l illness. T h e s e illnesses w e r e d i s c o n c e r t i n g for
t h e C a r t e s i a n paradigm i n t h a t t h e y s e e m e d t o b e p r i m a r i l y diseases o f
t h e cogito w i t h o u t definite s o m a t i c locus. T h e medical s t r u c t u r e built upon
t h a t p a r a d i g m had a hard t i m e coping w i t h this n o t i o n of l a r g e l y
d i s e m b o d i e d illness, and its leading n i n e t e e n t h - c e n t u r y s p o k e s m e n used
t h e d i s c o v e r y of t h e syphilitic a n t e c e d e n t s of paresis to p o s t u l a t e t h a t all
m e n t a l illness w a s o f s o m a t i c origin. T h a t " m e n t a l d i s e a s e s are, a t b o t t o m
d i s e a s e s o f t h e b r a i n " h a s b e e n o n e o f t h e m o s t widely a c c e p t e d articles o f
faith o f m o d e r n p s y c h i a t r y . T h e a x i o m a t i c value a t t a c h e d t o this d o g m a
w a s s o s t r o n g t h a t its lack o f empirical s u p p o r t s e e m e d o f m i n o r
c o n s e q u e n c e . I n e v i t a b l y , f u t u r e a d v a n c e s in t h e u n d e r s t a n d i n g of
n e u r o a n a t o m y and n e u r o p h y s i o l o g y would provide the (as y e t ) missing
c l u e s . Even Freud, the r e d i s c o v e r e r o f the p r i m a c y o f psychic factors
xii
EXISTENTIAL
FOUNDATIONS
a m o n g t h e a n t e c e d e n t s o f m a j o r f o r m s o f m e n t a l illness, e m b r a c e d this
s o m a t i c prejudice. A t t i m e s h e s e e m e d t o v i e w e v e n n e u r o s e s a s
u l t i m a t e l y o r g a n i c in n a t u r e and p s y c h o a n a l y s i s as a t e m p o r a r y
e x p e d i e n t to be replaced in t i m e by m o r e direct, s o m a t i c m e t h o d s of
treatment.
xiii
n a t u r a l scientific d o g m a o f a c o n t i n u o u s causal n e x u s b e t w e e n
everything that exists. D o u b t after doubt about Freud's theoretical
m e t a p s y c h o l o g y ' n o w b e g a n t o assail m e . H o w w a s i t t h a t Freud had
e v e n i n v e n t e d t h e label of ' m e t a p s y c h o l o g y , ' t h a t is, a p s y c h o l o g y b e y o n d
p s y c h o l o g y ? ' M e t a ' ? O b v i o u s l y b e c a u s e h e w a s i n t e n t upon o v e r s t e p p i n g
w h a t w a s actually e x p e r i e n c e d and p e r c e i v e d . "
3
xiv
EXISTENTIAL
FOUNDATIONS
t h e r e f r a c t i n g m e d i u m o f i n t r u s i v e e x p l a n a t o r y t h e o r i e s . While t h e s e
c a s e studies b y t h e m s e l v e s offered striking t e s t i m o n y for the t e x t u r a l
r i c h n e s s and c o m p r e h e n s i v e g r a s p yielded b y the D a s e i n s a n a l y t i c
approach, B o s s ' s m o r e g e n e r a l o b s e r v a t i o n s a b o u t t h e p s y c h o p a t h o l o g y
o f s e x w e r e equally a r r e s t i n g . A s s t a r t i n g p o i n t for his e x p l o r a t i o n B o s s
used a description of w h a t he viewed as t h e ideal n o r m of love. To a t t a i n
to t h e dual m o d e of loving e x i s t e n c e w i t h its t r a n s c e n d e n c e of selfa b s o r b e d s i n g u l a r i t y , a c c o r d i n g to B o s s a person m u s t be capable of
m a t u r e s u r r e n d e r o f t h e s e l f and m u s t freely e m b r a c e his spiritual a s well
a s his s e n s u a l p o t e n t i a l i t i e s o f being. T h o s e w h o e x h i b i t m a j o r s e x u a l
p a t h o l o g y a r e , in B o s s ' s v i e w , psychically impaired; trapped in a n a r r o w
a s t r i n g e n t world, t h e y y e t s t r i v e t o a t t a i n , i n t h e face o f g r e a t o u t e r and
i n n e r o b s t a c l e s , as m u c h as t h e y can of love's r i c h n e s s , in t h e only w a y
o p e n t o t h e m : t h e d e v i a n t s e x u a l act. S u c h a c t s , i n o t h e r w o r d s , w e r e s e e n
by Boss as tortured attempts to come to terms with personality defects
t h a t prohibit t h e a c t u a l i z a t i o n o f t h e dual m o d e o f e x i s t e n c e . Y e t e v e n
these impoverished erotic configurations are illuminatedas Boss
d o c u m e n t e d in his case s t u d i e s b y at least part of t h e aura i n t r i n s i c to
fully realized loving t r a n s c e n d e n c e . " T h e o m n i p o t e n c e of love is p e r h a p s
n o w h e r e m o r e e v i d e n t t h a n i n t h e s e , its a b e r r a t i o n s . " Freud's o b s e r v a
tion w a s amply c o n f i r m e d b y B o s s ' s study o f s e x u a l p a t h o l o g y .
4
I n his n e x t b o o k , B o s s e x t e n d e d t h e r e a c h o f D a s e i n s a n a l y s i s t o t h e
r e a l m o f d r e a m s . O n c e m o r e , h e t o o k F r e u d a s his point o f r e f e r e n c e .
F r e u d a c c o m p l i s h e d m u c h i n r e s c u i n g the r e a l m o f d r e a m i n g from the
d i s r e p u t e i n t o w h i c h it had fallen a m o n g his positivistic c o n t e m p o r a r i e s .
V i e w i n g t h e d r e a m as a m a j o r bridge b e t w e e n t h e d o m a i n s of t h e c o n
s c i o u s and the u n c o n s c i o u s , F r e u d w a s able t o s h o w t h a t t h e s e g o s s a m e r
c r e a t i o n s of sleep could be made to yield i m p o r t a n t m e s s a g e s by m e a n s of
p s y c h o a n a l y t i c m a n i p u l a t i o n s . In a s e n s e , F r e u d t h u s r e i n s t a t e d t h e reality
of d r e a m s . Y e t , as B o s s w a s to point o u t , o n l y to a d e g r e e . Freud
c o n t i n u e d t o regard t h e d r e a m from t h e s t a n d p o i n t and w i t h the
c a t e g o r i e s o f t h e w a k i n g s t a t e , w i t h o u t e v e r allowing t h e d r e a m r e a l m t o
c h a l l e n g e t h e claim t o c l e a r - c u t p r e e m i n e n c e o f the w a k i n g world. ( T h e
t h o u g h t t h a t such a c h a l l e n g e w a s possible hardly o c c u r r e d to h i m . )
W h i l e c o n f e r r i n g upon t h e d r e a m t h e s t a t u s o f being " p s y c h o l o g i c a l l y
r e a l , " Freud t o o k it for g r a n t e d t h a t this m e r e l y psychological reality w a s
s u b s t a n t i a l l y less real t h a n the solid reality of w a k i n g .
In his b o o k on d r e a m s B o s s s h o w e d t h a t Freud's a priori a s s u m p t i o n s
a b o u t d r e a m reality's lack o f a u t o n o m y vis-a-vis t h e w a k i n g s t a t e led him
to use p r o c e d u r e s t h a t w e r e needlessly h i g h h a n d e d and forceful in
dealing with d r e a m s . T r e a t i n g the d r e a m as a m a s t e r of deception, Freud
tore aparl its web, f r a g m e n t i n g and shredding it. Impatient with the
xv
s y m b o l i c disguises he i m p u t e d to t h e d r e a m , F r e u d ripped t h e s e s y m b o l i c
m a s k s o f f so e n e r g e t i c a l l y t h a t in t h e p r o c e s s he denuded t h e d r e a m and
r e d u c e d it to an a m o r p h o u s pulp, u n a b l e to resist t h e m o s t a r b i t r a r y
interpretations.
Repudiating such methods, Boss attempted to show that with
p r o c e d u r e s t h a t w e r e less u n g e n t l e and m o r e r e s p e c t f u l o f t h e
p h e n o m e n a disclosing t h e m s e l v e s i n d r e a m s , d r e a m s w o u l d yield t h e i r
m e a n i n g s o f t h e m s e l v e s . T h e d r e a m m e s s a g e s e x p l i c a t e d i n this
seemingly simple-minded m a n n e r , rather than extracted by cunning
F r e u d i a n c r y p t o g r a p h y , are apt to p r o d u c e p r o f o u n d l y illuminating
t h e r a p e u t i c e f f e c t s upon t h e d r e a m e r . T h e p o t e n t i a l impact o f d r e a m s o n
t h e a w a k e n e d d r e a m e r is f u r t h e r s u p p o r t e d by B o s s ' s refusal to
d o w n g r a d e t h e reality o f t h e d r e a m w o r l d i n favor o f w a k i n g reality.
B y taking d r e a m s s e r i o u s l y , i n q u e s t i o n i n g t h e claim o f t h e daylight
w o r l d to be t h e u n c o n t e s t e d a r b i t e r of w h a t is real, by allowing t h e
p h e n o m e n a o f t h e d r e a m w o r l d t o appear u n d i m m e d , w i t h o u t
prejudging t h e m b y t h e c a t e g o r i e s o f a w a k e n e s s , B o s s was i n e l u c t a b l y led
t o s t r u g g l e w i t h s o m e v e r y old m e t a p h y s i c a l riddles: I f t h e d r e a m w o r l d
appears as real to us while we a r e d r e a m i n g as t h e w a k i n g w o r l d does
w h i l e w e a r e a w a k e , w h a t m a k e s u s decide w h i c h i s w h i c h ? H o w can w e
b e s u r e t h a t t h e w o r l d o f o u r a w a k e n e s s i s not j u s t a n o t h e r d r e a m ? A r e
t h e r e c r i t e r i a w h i c h allow u s t o distinguish reliably b e t w e e n w a k i n g and
dreaming?
T h e i n t e r e s t e d r e a d e r m a y w a n t t o p u r s u e t h e s e and similar puzzles b y
reading B o s s ' s b o o k on d r e a m s . W h a t is of p a r t i c u l a r r e l e v a n c e h e r e is
t h a t B o s s w a s able t o s h o w t h a t i n its d r e a m i n g m o d e h u m a n e x i s t e n c e
c o r r e s p o n d s , as o n e r e v i e w e r of t h e b o o k put it, "in its spatiality,
t e m p o r a l i t y , and its e n c o u n t e r w i t h the w o r l d e x a c t l y t o t h e c o n c e p t i o n s
a d v a n c e d by M a r t i n H e i d e g g e r c o n c e p t i o n s t h a t h a v e led us, or could
lead us, to a r e f l e c t i v e r e - a p p r o p r i a t i o n of t h e m o d e s of b e i n g - i n - t h e world."
B o s s ' s b o o k on d r e a m s signified a m a j o r step in t h e p r o c e s s of t h e
" d e s t r u c t i o n o f psychological t h e o r y " ( G u s t a v Bally) t h a t w a s t o clear t h e
g r o u n d for t h e e x i s t e n t i a l i s t paradigm. T a k i n g this p r o c e s s o n e step
f u r t h e r , B o s s n e x t t u r n e d t o t h e d o m a i n o f so-called p s y c h o s o m a t i c
i l l n e s s e s . T h e traditional n o t i o n t h a t t h e s e illnesses w e r e s o m a t i c
d i s o r d e r s of primarily psychic origin would n o t do for B o s s . By positing
the bodily and psychic r e a l m s as equally basic Ausiragsmedien ("media of
a r t i c u l a t i o n " ) o f h u m a n e x i s t e n c e , B o s s bypassed t h e t i m e - w o r n d e b a t e s
a b o u t p s y c h o g e n e s i s vs. s o m a t o g e n e s i s . I n t h e B o s s i a n s c h e m e o f t h i n g s ,
no s o m a t i c e v e n t could c a u s e a psychic o n e or vice v e r s a . S i m i l a r l y , s o m e
l o n g - s t a n d i n g puzzles such as c h o i c e of illness and choice of o r g a n w e r e
r e f o r m u l a t e d ; the s e a r c h for c a u s a t i v e factors in the guise of specific
5
XVI
EXISTENTIAL
FOUNDATIONS
xvii
xviii
EXISTENTIAL
FOUNDATIONS
a n a d e q u a t e u n d e r s t a n d i n g o f t h e o b j e c t t h u s m a n i p u l a t e d . T o b e able t o
describe in g r e a t detail t h e physically a c c e s s i b l e f e a t u r e s of s o m a t i c
p h e n o m e n a and t h e i r p h y s i c o c h e m i c a l a n t e c e d e n t s is n o t the s a m e as
being able t o c o m p r e h e n d t h e i r c o n t e x t o f s i g n i f i c a n c e . S i n c e m o d e r n
medicine has so little to say a b o u t t h e e x i s t e n t i a l m e a n i n g of m o s t
physical illnessin fact, c o n s i d e r s the q u e s t i o n of m e a n i n g as largely
i r r e l e v a n t w e m i g h t be well advised to lend o u r e a r to a d i v e r g e n t
approach, such as B o s s ' s , t h a t views t h e issue of the m e a n i n g of disease as
central.
Far from w a n t i n g to abolish the u s e of n a t u r a l science m e t h o d o l o g y in
m e d i c i n e , B o s s is b e n t on pointing out its l i m i t a t i o n s . T h a t w i t h i n c e r t a i n
limits t h e use of this m e t h o d o l o g y is justifiable and n e c e s s a r y B o s s t a k e s
for g r a n t e d . It is t h e claim of this m e t h o d o l o g y to total dominion o v e r
m e d i c i n e t h a t B o s s c o n t e s t s . T h e first part o f t h e p r e s e n t b o o k
c o n s t i t u t e s in fact a forceful e s s a y on the inability of the n a t u r a l scientific
approach t o gain a c c e s s t o t h e w h o l e reality o f day-to-day h u m a n
e x i s t e n c e . It is only t h e fullest possible a r t i c u l a t i o n of t h i s r e a l m from a
p h e n o m e n o l o g i c a l point o f view, B o s s c o n t e n d s , t h a t can e n s u r e a n
a d e q u a t e u n d e r s t a n d i n g o f t h e h u m a n being i n h e a l t h and i l l n e s s .
7
xix
XX
EXISTENTIAL
FOUNDATIONS
xxi
xxii
EXISTENTIAL
FOUNDATIONS
NOTES
1. D e s c a r t e s did n o t c o n c e i v e of m a n , as La M e t t r i e l a t e r did, as I'homme machine. B u t his
notion
of
l e corps
machine,
the
human
body
as
mechanism,
favored
the
subsequent
Traum
5. Einfhrung
und
in
seme
Auslegung.
(Bern:
Hans
Huber,
1953).
Basil
Books.
IQbil
7. Boss's attempt to define the boundaries of the natural scientific method in medicine has the interesting side
effect o\
eroding
vanishing
point.
the
traditional
dividing
I w o u l d n e v e r h a v e b e e n able t o c o m p l e t e t h e v o l u m e n o w b e f o r e y o u
w i t h o u t t h e help of m a n y o t h e r people. I o w e a special debt of g r a t i t u d e to
a whole generation of students w h o have persistently engaged me in
s c i e n t i f i c and philosophical d i s c u s s i o n s . T h e y f o r c e d m e t o r e e v a l u a t e
c o n t i n u a l l y ideas I had t a k e n o v e r from m y o w n t e a c h e r s , along w i t h
o t h e r s I had arrived at l a t e r on my o w n . By a happy c h a n c e , m a n y of my
t e a c h e r s w e r e o f u n c o m m o n i n t e l l e c t u a l c a l i b e r , t h e m o s t influential
a m o n g them being the physiologist W. R. Hess, the psychiatrists Eugen
B l e u l e r and W a g n e r v o n J a u r e g g , t h e i n t e r n a l specialists W . L o e f f l e r and
C h v o s t e k , and t h e depth p s y c h o l o g i s t s S i g m u n d F r e u d and C a r l J u n g . T o
t h e s e m e n I a m i n d e b t e d n o less t h a n t o m y s t u d e n t s .
B u t a b o v e all, it is t h e p h i l o s o p h e r M a r t i n H e i d e g g e r w h o is
r e s p o n s i b l e for this a t t e m p t to lay out a f o u n d a t i o n f o r m e d i c i n e . It
r e f l e c t s t h e c o u n t l e s s c o n v e r s a t i o n s in w h i c h I w a s privileged to
p a r t i c i p a t e o v e r t w o d e c a d e s o f friendship. F o r t h e past fifteen y e a r s ,
m o r e o v e r , H e i d e g g e r has held t w o o r t h r e e s e m i n a r s e a c h s e m e s t e r for
t h e b e n e f i t o f medical s t u d e n t s , including m i n e . T h e d i s c u s s i o n s c o m i n g
o u t o f t h e s e " Z o l l i k o n S e m i n a r s " also figure significantly i n this w o r k .
M o r e i m p o r t a n t , t h o u g h , i s t h e fact t h a t this w o r k actually evolved under
xxi V
EXISTENTIAL
FOUNDATIONS
Medard Boss
Medard Boss
x xvii
INTRODUCTION
T h e p r i m a r y f u n c t i o n of a study on t h e f o u n d a t i o n of a s c i e n c e is to lay
o u t t h e field o f p h e n o m e n a i n t e n d e d for i n v e s t i g a t i o n . N o less i m p o r t a n t ,
h o w e v e r , i s t h a t t h e w o r k specify t h e p r o p e r t i e s w h i c h t h e s c i e n c e has
a s s i g n e d t o its o b j e c t s o f s t u d y f r o m t h e v e r y s t a r t , and o f t e n w i t h o u t
e x p r e s s d e l i b e r a t i o n . It is as i m p o s s i b l e for a s c i e n c e as for a n y o t h e r
h u m a n e n d e a v o r t o avoid a n t i c i p a t i n g t h e g e n e r a l n a t u r e o f its o b j e c t s o f
study. E v e n a scientific e n t e r p r i s e c a n n o t begin vis-a-vis an i n d e t e r m i
n a t e n o t h i n g n e s s . It can t a k e for its s u b j e c t only s o m e t h i n g it has already
p e r c e i v e d as being s o m e t h i n g . W h e n e v e r we p e r c e i v e s o m e t h i n g as
s o m e t h i n g , w e h a v e already i n t e r p r e t e d its m o d e o f being i n s o m e w a y o r
o t h e r , n o m a t t e r h o w v a g u e this i n t e r p r e t a t i o n m a y b e a t t h e o u t s e t .
Every science is therefore necessarilyand thus alwaysbased on
prescientific premises. T h e s e constitute a fundamental structure that
n o t m e r e l y sets f o r t h i n a d v a n c e w h i c h inquiries a r e p o s s i b l e and w h i c h
are n o t , b u t f u r t h e r m o r e d e t e r m i n e s t h e v e r y c h a r a c t e r o f t h e s c i e n c e
and t h e e x t e n t to w h i c h its r e s u l t s will be significant. It s e t s t h e goals for
t h e s c i e n c e and e s t a b l i s h e s t h e p r o c e d u r e s g u a r a n t e e i n g c o r r e c t practical
application o f t h e o r y .
A n y s c i e n c e t h a t w o u l d be w o r t h y to be called a s c i e n c e is accordingly
obligated to keep its f o u n d a t i o n clear of a m b i g u i t y and a p p r o x i m a t i o n . It
xxviii
EXISTENTIAL FOUNDATIONS
Introduction
xxix
XXX
EXISTENTIAL
FOUNDATIONS
Introduction
xxxi
Part
T h e Traditional Foundation
o f Medicine
Chapter 1
A TEST CASE: REGULA ZRCHER
EXISTENTIAL
FOUNDATIONS
.1
I I i s t r u e that h e r f o r m e r p h y s i c i a n s w e r e n o t u n a w a r e o f possible
p yi h o s o m a t i c r a m i f i c a t i o n s in h e r c a s e . In fact, t h e y had c o n s i d e r e d
e i m u ' . l y the idea o f telling t h e p a t i e n t t h a t t h e r e m i g h t be p s y c h o l o g i c a l
i. | M i I s in her suffering. B u t d u r i n g t h e long y e a r s of t r e a t m e n t , t h e y had
mil
in l i n e d any s y m p t o m s o f h e i g h t e n e d n e r v o u s n e s s o r h y s t e r i c a l
in iei y oi a n y t h i n g else t h a t s u g g e s t e d e m o t i o n a l illness and concluded
thai any suspicion of n e u r o t i c c o m p l i c a t i o n s o u g h t to be discarded.
EXISTENTIAL
FOUNDATIONS
H e n c e t h e y t h o u g h t it u n w i s e to a r o u s e false h o p e s in the p a t i e n t by
s u g g e s t i n g p s y c h o t h e r a p y . In fact, t h e i r c a u t i o n w e n t so far t h a t t h e y did
not even m e n t i o n t h e possibility t o h e r .
To the therapist she chose, Regula Ziircher appeared to be a shy, very
s e n s i t i v e y o u n g w o m a n . H e r figure w a s girllike, t o o thin, b u t full o f
g r a c e ; h e r face w a s beautiful, w i t h delicate, v e r y f e m i n i n e , soft f e a t u r e s .
O n l y for m o m e n t s at a t i m e did s h e dare look up and m e e t t h e e y e s of h e r
t h e r a p i s t . T h e r e s t o f t h e t i m e she s t a r e d a t t h e floor i n f r o n t o f her, s o
t h a t of h e r large, n e a r l y closed e y e s , o n l y t h e lids w i t h t h e i r long dark
l a s h e s could b e s e e n . H e r t w o hands w e r e t w i s t e d t o g e t h e r o n h e r k n e e s
in the folds of an e x q u i s i t e l y tasteful dress.
D u r i n g t h e first i n t e r v i e w , a f t e r m a k i n g a f e w c o n v e n t i o n a l r e m a r k s ,
t h e p a t i e n t fell silent and v e n t u r e d t o say n o t h i n g m o r e o n h e r o w n . S h e
responded to the d o c t o r ' s q u e s t i o n s in a r a t h e r p r o v o c a t i v e , a l m o s t
c o n d e s c e n d i n g , t o n e o f voice.
T h i s i n t e r v i e w was t h e first session of a p s y c h o t h e r a p e u t i c c u r e w h i c h
w a s to last for t h r e e y e a r s and a total of m o r e t h a n six h u n d r e d h o u r s of
analysis. I n the c o u r s e o f t h e s e y e a r s , m a n y details o f R e g u l a Z u r c h e r ' s
life h i s t o r y w e r e disclosed. We r e p r o d u c e h e r e a few w h i c h c o m p l e m e n t
the h i s t o r y and medical findings.
H e r f a t h e r ' s f a t h e r c a m e from an upper-class family. Like all his
b r o t h e r s and s i s t e r s , he had p u r s u e d an a c a d e m i c c o u r s e of study, but his
disposition w a s fiery and b a r e l y c o n t r o l l a b l e ; t h e r e w a s no o n e else like
him in his family. W h i l e he w a s still quite y o u n g , his p a s s i o n a t e n a t u r e led
him to fall head o v e r h e e l s in love w i t h a y o u n g s e r v a n t , a b a n d o n his
studies, and elope w i t h h e r t o a n o t h e r c o u n t r y . H e n e v e r a m o u n t e d t o
m u c h p r o f e s s i o n a l l y and was c o n s i d e r e d the black s h e e p of t h e family.
D i s r e g a r d i n g the e c o n o m i c m i s e r y o f his o w n family, h e f a t h e r e d one
child after a n o t h e r w i t h o u t r e s t r a i n t . U l t i m a t e l y he d e g e n e r a t e d into a
c h r o n i c alcoholic. T h e b u r d e n o f t h e h u g e flock o f children was piled u p
on his wife, w h o , while intellectually limited, w a s s t r o n g - w i l l e d , v e r y
h a r d - w o r k i n g , and kind.
hronic jealousy.
As a m o t h e r , h e r g r e a t e s t c o n c e r n w a s t e a c h i n g h e r d a u g h t e r s
absolute r e s t r a i n t o f t h e i r feelings. S h e c o n s t a n t l y held u p t h e awful
i ample of their f a t h e r as a w a r n i n g . In him, she would say, t h e y could
l e h o w disgusting all m e n are. D i d n ' t t h e i r f a t h e r p r o v e , e v e r y day, t h a t
w o m e n can e x p e c t only i n g r a t i t u d e and b r u t a l i t y from m e n ? O n l y t h e
most si upid girl would be taken in by their s e d u c t i o n s or give t h e m h e r
II
le.t
EXISTENTIAL
FOUNDATIONS
10
EXISTENTIAL
FOUNDATIONS
II
12
EXISTENTIAL
FOUNDATIONS
14
EXISTENTIAL FOUNDATIONS
IS
w o u l d m o v e i n t o in a f e w w e e k s . T h e y pictured it in t h e i r m i n d s in g r e . i I
detail and t h o u g h t a b o u t t h e c o m i n g sun-filled h o u r s t o g e t h e r ,
s w i m m i n g and w a n d e r i n g in o p e n fields.
S o m e t i m e a f t e r this happy v a c a t i o n , h o w e v e r , i t b e c a m e evident that
c i r c u m s t a n c e s would n e v e r allow a p e r m a n e n t b o n d o f m a r r i a g e w i t h h e r
l o v e r . A f t e r t w o y e a r s o f u n t r o u b l e d h a p p i n e s s , t h e m a n left for t h e F a r
East, never to return. T h r e e weeks after the separation, Regula Z r c h e r
b e c a m e u n b e a r a b l y agitated. S e v e r e irritability, s p i t e f u l n e s s , and
i n t o l e r a n c e seized her; ill will o v e r s h a d o w e d h e r w h o l e day. E v e r y t h i n g
she e n c o u n t e r e d u p s e t h e r and g o t i n h e r w a y . E v e n w i t h t h e b e s t o f
i n t e n t i o n s , she could no l o n g e r find e n o u g h t i m e to do h e r daily
h o u s e w o r k . A c o n s t a n t i m p a t i e n c e p u s h e d h e r f r o m o n e thing t o
a n o t h e r . S h e felt b o x e d in, like a p u r e b r e d h o r s e in a n a r r o w stall.
B e c a u s e h e r life had b e e n r e d u c e d so suddenly to t a k i n g c a r e of h e r child
and small a p a r t m e n t , she h e r s e l f spoke of a m e n a c i n g panic, like
claustrophobia.
In this situation of r e n e w e d l o n e l i n e s s and isolation, t h e old u r g e s to
s t a b and t o s t r a n g l e , w h i c h s h e had t h o u g h t g o n e f o r e v e r , r e t u r n e d t o
h e r surprise and h o r r o r . T r y i n g t o e x p a n d h e r s e v e r e l y limited w a y o f
life, s h e looked for an o u t l e t in p r o f e s s i o n a l a r t i s t i c w o r k and also
r e n e w e d social c o n n e c t i o n s w i t h f o r m e r friends and a c q u a i n t a n c e s .
T h e s e d i v e r s i o n s , h o w e v e r , a c c o m p l i s h e d n o t h i n g . N e i t h e r h e r irritabili
t y n o r h e r u r g e s t o stab o r s t r a n g l e disappeared. R e g u l a Z r c h e r longed
for t h e c l o s e n e s s o f t h e m a n s h e loved. H e r l o n g i n g for h i m n e v e r left h e r ,
e v e n during h e r daily r o u t i n e w h e n she m o s t w a n t e d t o b e d i s t r a c t e d .
A t t r i b u t i n g h e r a n i m o s i t y and t e n s e n e s s t o s e x u a l f r u s t r a t i o n , she tried
t o m a s t u r b a t e , hoping t o a c h i e v e s o m e s o r t o f r e l e a s e from h e r
d e s t r u c t i v e u r g e s . B u t she found she w a s c o m p l e t e l y u n a b l e t o satisfy
h e r s e l f this w a y . It w a s n o t at all t h a t feelings of guilt g o t in h e r w a y , but
t h a t m a s t u r b a t i o n simply did n o t put h e r in t o u c h w i t h h e r s e l f , the
w o m a n w h o had k n o w n the flowing feeling of loving a m a n body and
soul, and w h o had g r o w n physically capable of a full f e m a l e o r g a s m in
s e x u a l t o g e t h e r n e s s w i t h a m a n . N o t o n c e did she reach any sexual
e x c i t e m e n t t h r o u g h h e r m a s t u r b a t i o n , let alone o r g a s m .
In h e r despair o v e r this a p p a r e n t l y i n e s c a p a b l e s i t u a t i o n , R e g u l a
Z r c h e r e n t e r e d i n t o a s e x u a l r e l a t i o n s h i p with a n o t h e r m a n . A l t h o u g h
he w a s a pleasant sort, he w a s in no w a y suitable for h e r , e i t h e r physically
or, especially, artistically. S h e had little t r o u b l e a t t a i n i n g a purely
physical o r g a s m w i t h h i m , b u t h e r ability to a b a n d o n h e r s e l f to him
r e m a i n e d o n l y a s h a d o w of w h a t it was w i t h h e r f o r m e r lover. S h e was
c o n s t a n t l y a w a r e o f this m a n ' s distance from h e r o w n spiritual
sensibilities and d i s c r i m i n a t i o n s and of his inability to s h a r e hei
16
EXISTENTIAL
FOUNDATIONS
her
and
the
bed
17
S h e described t h e m o m e n t o f impact t h u s :
S u d d e n l y , a hard, s t r o n g s i d e w a y s b l o w k n o c k e d me o f f balance.
B e f o r e I k n e w w h a t had h a p p e n e d , I w a s lying flat on my back on the
c e m e n t . A m a d d e n i n g pain s t a r t e d up s o m e w h e r e d o w n in my leg. I
didn't k n o w j u s t e x a c t l y w h e r e it w a s at first. It w a s d o w n low and
c a m e f r o m v e r y deep inside. In t h e first m o m e n t s t h e pain w a s like a
ball of h o t , g l o w i n g s t e e l . B u t t h e n it flooded t h r o u g h me w i t h
l i g h t n i n g speed. I b e c a m e n o t h i n g m o r e t h a n o n e e n o r m o u s ripping
pain. I n e a r l y lost my s e n s e s and fell h a l f - u n c o n s c i o u s . I felt m y s e l f sink
c o m p l e t e l y into this pain, b e c o m e lost in it. Luckily, I w a s able to t e a r
m y s e l f o u t of this and pull m y s e l f t o g e t h e r again. O n l y t h e n did it
b e c o m e c l e a r to me t h a t I had p r o b a b l y b r o k e n my s h i n . I c o u l d n ' t m o v e
my leg e v e n a m i l l i m e t e r , or a t e a r i n g pain would s h o o t f r o m my leg
t h r o u g h my w h o l e body. T h e n a first-aid a t t e n d a n t g a v e me a s h o t .
T h e pain shifted t o t h e b a c k g r o u n d . T h e people and t h i n g s a r o u n d m e
also b e c a m e h a z y and distant. I fell asleep and a w a k e d n e x t , f a s t e n e d to
t h e bed by t r a c t i o n a p p a r a t u s , in a r o o m in t h e surgical clinic.
T h e h e a v y pain o f t h e first f e w days e x h a u s t e d h e r c o n s i d e r a b l y . T i m e
dragged, but s o o n she w a s h e r old self again. D u r i n g t h e r e m a i n i n g
w e e k s o f h e r time a s a n invalid s h e w r o t e s h o r t s t o r i e s , w h i c h w e r e
s o u g h t a f t e r by t h e b e s t n e w s p a p e r s . B e s i d e s t h a t , hardly a day w e n t by
w h e n h a l f a dozen friends didn't c o m e to visit h e r . S h e had r e c o v e r e d
totally in t h r e e m o n t h s .
F r o m h e r hospital bed s h e w r o t e a l e t t e r o f a p p r e c i a t i o n t o h e r f o r m e r
t h e r a p i s t , w h o had t r e a t e d h e r t h r o u g h e x i s t e n t i a l a n a l y s i s . In it s h e
r e p e a t e d a richly i n f o r m a t i v e t h o u g h t she had o f t e n e x p r e s s e d , e v e n in
t h e last w e e k s o f h e r t r e a t m e n t .
I am a s t o n i s h e d by t h e c o u r s e of my d e v e l o p m e n t , w h e n I look b a c k at
m y life b e f o r e and a f t e r t h e e x i s t e n t i a l a n a l y t i c t r e a t m e n t . Y o u k n o w
that under the influence of my utterly incompatible parents I was
c o m p l e t e l y a l i e n a t e d from m y s e l f and could lead o n l y a s h a d o w life up
until t h e b e g i n n i n g of my c u r e by y o u . I m y s e l f basically n e v e r had
a n y t h i n g t o d o w i t h t h e small p e r s o n t h a t I w a s t h e n ; t h a t w a s n o t m e
at all. In reality I was first b o r n in t h e e x i s t e n t i a l a n a l y s i s t r e a t m e n t .
A n d so, t o w a r d t h e end o f t h e t r e a t m e n t I t h o u g h t o f m y s e l f m o r e and
m o r e o u t r i g h t as a woman without a past or earlier life.
Chapter 2
THE NATURAL SCIENTIFIC VIEW OF MEDICINE
T h e field o f p h e n o m e n a t o w h i c h m o d e r n n a t u r a l scientific r e s e a r c h
m u s t r e s t r i c t itself w a s precisely o u t l i n e d by its actual founder,
D e s c a r t e s . His s e c o n d L a w o f C o g n i t i o n reads:
It is advisable to a t t e n d o n l y to t h e circle of o b j e c t s for w h i c h o u r
n a t u r a l faculties suffice t o p e r c e i v e w i t h c e r t a i n t y and w i t h o u t d o u b t .
O n l y i n o r g a n i c m a t t e r g r a n t s u s s u c h p e r c e p t i o n ; s o t h o r o u g h l y does i t
satisfy n a t u r a l law t h a t this v e r y s a t i s f a c t i o n c o n t i n u e s today to s e r v e as
the only useful definition for t h e d o m i n a n t n a t u r a l s c i e n c e s .
W h i l e t h u s fencing o f f the a r e a w i t h i n w h i c h r e s e a r c h could b e
a u t h o r i t a t i v e , D e s c a r t e s e f f e c t i v e l y p r o m i s e d m a n d o m i n i o n o v e r all
p h e n o m e n a w i t h i n t h e s e limits. T h e n o t i o n o f h u m a n d o m i n a t i o n o f
n a t u r e had appeared long b e f o r e . T h e Bible enjoined m a n t o rule o v e r t h e
e a r t h and r e n d e r i t s u b j e c t t o h i m . D e m o c r i t u s , the a n c i e n t G r e e k
p h i l o s o p h e r , is credited w i t h h a v i n g said t h a t he would r a t h e r find o n e
cause t h a n sit on t h e t h r o n e of P e r s i a . He a p p a r e n t l y realized t h a t a m a n
w h o l e a r n e d t o r e c o g n i z e precisely calculable causal c o n n e c t i o n s would
b e the m i g h t i e r o f t h e t w o , for t h o u g h a n e m p e r o r m i g h t c o m m a n d the
lives and d e a t h s o f s u b j e c t s , h e would not k n o w t h e s o u r c e o f his p o w e r .
20
EXISTENTIAL
FOUNDATIONS
B u t D e s c a r t e s w a s t h e first t o p r o m i s e u n e q u i v o c a l l y t h a t m a n would
indeed b e c o m e "lord and m a s t e r of n a t u r e " if he would o n l y learn h o w to
use t h e n e w c o g n i t i v e m e t h o d o f calculating t h e fixed position o f o b j e c t s .
Physicians h a v e f r o m t i m e i m m e m o r i a l c o n s i d e r e d t h e i r p r i m a r y
o b j e c t i v e to be m a s t e r y o v e r at least t h e diseases of m a n . B e c a u s e it held
o u t this p r o m i s e , t h e y u n h e s i t a t i n g l y adopted t h e i n v e s t i g a t i v e principle
of the c e r t a i n t y of e x a c t m e a s u r i n g calculation, and t r a n s f e r r e d it to t h e i r
o w n o b j e c t of study, diseased m a n . It w a s n o t self-evident t h a t this
t r a n s p l a n t a t i o n o f m e t h o d would produce t h e a s t o u n d i n g s u c c e s s e s o f
m o d e r n m e d i c i n e , for in p u r s u i n g t h e i r task, physicians in fact flagrantly
i g n o r e d D e s c a r t e s ' s w a r n i n g . T h e y applied t h e C a r t e s i a n principle o f
i n v e s t i g a t i o n to an o b j e c t of studydiseased h u m a n b e i n g s w h o can in
no w a y be finally calculated and t h e r e b y fixed. T h e rich yield physicians
have reaped, in spite of t h e i r violation of the limits D e s c a r t e s indicated,
s t e m s f r o m a r a t h e r a s t o n i s h i n g aspect o f h u m a n e x i s t e n c e . S o m e t h i n g
a b o u t this e x i s t e n c e (and this s o m e t h i n g c o n f o r m s w i t h t h e life o f o t h e r
o r g a n i c b e i n g s ) does allow its i n t e r p r e t a t i o n as, simply, an o b j e c t in space.
H u m a n e x i s t e n c e can in fact be i n v e s t i g a t e d as a calculable causal
r e l a t i o n s h i p a m o n g o r g a n i c s t r u c t u r e s , physical and c h e m i c a l p r o c e s s e s
in specific l o c a t i o n s in space.
T h r o u g h p r o c e d u r e s o f n a t u r a l s c i e n c e t h e physical basis o f h u m a n
e x i s t e n c e can be i n t e r p r e t e d and the h u m a n body m a n i p u l a t e d , e v e n to a
t h e r a p e u t i c end. T h i s , t h e n , is the j u s t i f i c a t i o n for applying t h e r e s e a r c h
m e t h o d o f n a t u r a l s c i e n c e t o medical p r a c t i c e . B u t n o m a n i p u l a t i o n , n o
m a t t e r h o w striking, also g u a r a n t e e s t h a t t h e o b j e c t s w h i c h are being
successfully m a n i p u l a t e d are c o m p e t e n t l y u n d e r s t o o d .
K a n t , by this t i m e , had already r e c o g n i z e d t h a t scientific t h o u g h t ,
w h i c h applied only t h e principle of c a u s a l i t y , did n o t suffice to
c o m p r e h e n d living b e i n g s . T h e v e r y simplest b e i n g s , h e tells us, d e m a n d
to be u n d e r s t o o d f r o m a second and teleological p e r s p e c t i v e . E v e n
biological r e s e a r c h e r s placed additional c o n c e p t i o n s alongside t h e purely
causal p e r s p e c t i v e in t h e i r s c i e n c e and in m e d i c i n e . T h e old vitalists, for
i n s t a n c e , t h o u g h t it n e c e s s a r y to posit a u n i q u e life force to a c c o u n t for
the m o s t c o n s p i c u o u s p r o p e r t i e s of living t h i n g s , particularly for the
a s t o u n d i n g m a i n t e n a n c e o f equilibrium b e t w e e n t w o v a r y i n g c h e m o physical p r o c e s s e s , and also for t h e i n c r e a s e of individuals.
B e y o n d this, physicists h a v e r e c e n t l y m a d e b i o l o g i s t s p a r t i c u l a r l y
a w a r e t h a t t h e laws o f physics can l e g i t i m a t e l y d e s c r i b e only e f f e c t s t h a t
t r a v e r s e o n e point and its i m m e d i a t e vicinity and o c c u p y n e i g h b o r i n g
m o m e n t s i n t i m e . L a w s t h a t g o v e r n spatial o r t e m p o r a l e f f e c t s w h i c h
m o v e f r o m a distance t o w a r d a goal, as m u s t be a s s u m e d for living t h i n g s ,
21
We shall t r y t h e s e e x p l a n a t o r y capabilities on a p r o c e s s t h a t m a k e s up
R e g u l a Z u r c h e r ' s e x i s t e n c e after she has r e c o v e r e d . W e c h o o s e this r a t h e r
t h a n a p a t h o l o g i c a l c a s e in point to w o r k from b e c a u s e s i c k n e s s is
invariably n o t h i n g m o r e t h a n deficient h e a l t h i n e s s . O n l y w h e n w e have
22
EXISTENTIAL FOUNDATIONS
23
m a d e u p o f e v e n t s t h a t p r e s e n t t h e m s e l v e s t o e v e r y o b s e r v e r , even a
n a t u r a l scientific i n v e s t i g a t o r , as n o n s o m a t i c s t r u c t u r e s and as p r o c e s s e s
neither material nor energetic in nature.
W h a t d o t h e e x p l a n a t i o n s o f n a t u r a l s c i e n c e say a b o u t p e r c e p t i o n ,
t h i n k i n g , feeling, r e m e m b e r i n g , desire, volition, a c t i o n , and c o n s c i o u s
n e s s ? N a t u r a l scientific m e d i c i n e , and p a r t i c u l a r l y n e u r o l o g y , label
"psychic" anything which is not immediately perceived as somatic, which
is w h a t t h e m o d e r n r e s e a r c h e r is in t h e h a b i t of addressing as the s u m of
m a t e r i a l s t r u c t u r e s and c h e m o p h y s i c a l p r o c e s s e s holding t h e h u m a n
body t o g e t h e r .
T h e psychic a s p e c t i s m o r e n a r r o w l y defined b y o n e leading
neurophysiologistI refer to McLeanas "the non-material attributes
o f t h e ' m i n d . ' " ( T h e t e r m " m i n d " c o r r e s p o n d s t o D e s c a r t e s ' s cogitatw,
w h i c h includes n o t o n l y t h e c o n c e p t o f t h i n k i n g , b u t also t h o s e o f
volition, r e c o g n i t i o n , and opinion.) N o w , " n o n - m a t e r i a l and n o n e n e r g e t i c e n t i t i e s " a r e a s s u c h u n w e i g h a b l e , u n m e a s u r a b l e , and
t h e r e f o r e also u n c a l c u l a b l e . B u t g i v e n its philosophical predisposition,
n a t u r a l s c i e n c e can d o n o t h i n g b u t m e a s u r e and r e c k o n . Faced w i t h this
ticklish s i t u a t i o n , n a t u r a l scientific r e s e a r c h e r s h a v e taken widely
v a r y i n g , e v e n opposing, p o s i t i o n s . M a n y will n o t discuss the psychic at
all, b u t m o s t spend c o n s i d e r a b l e t i m e and e f f o r t t r y i n g to find s o m e w a y
t o bring t h e psychic back i n t o t h e realm o f t h e m e a s u r a b l e , calculable
m a t e r i a l and e n e r g e t i c , o r t h e c y b e r n e t i c , b y a t t e m p t i n g t o derive t h e
psychic e n t i r e l y f r o m t h e s o m a t i c .
2
M c L e a n o p e n s his a t t e m p t b y allowing t h a t e v e r y r e p r e s e n t a t i o n
w h i c h c o m b i n e s t h e p s y c h e w i t h a s o m a is, from scientific s t a n d p o i n t ,
contestable. For the assumption of a closer relationship between the two
c a r r i e s t h e implicit n o t i o n t h a t t h e n o n m a t e r i a l p s y c h e m a y affect the
s u b s t a n c e o f t h e body. M c L e a n holds t h a t this logical i n c o n s i s t e n c y can
be g o t t e n a r o u n d if we will avail o u r s e l v e s of a n e w definition for t h e
"psychic."
In t h e past 1 0 0 y e a r s t h e old G r e e k n o t i o n t h a t t h e " p s y c h e " is capable
of an i n d e p e n d e n t e x i s t e n c e h a s gradually died o u t and the mind h a s
c o m e to be looked upon as i n s e p a r a b l e from a f u n c t i o n i n g o r g a n i c
s y s t e m . C o n s e q u e n t l y , o n e can today pick up a s t a n d a r d d i c t i o n a r y and
find " p s y c h e " defined as " t h e mind, especially c o n s i d e r e d as an o r g a n i c
s y s t e m s e r v i n g t o adjust t h e total o r g a n i s m t o t h e e n v i r o n m e n t . " T h e
definition could h a v e g o n e a s t e p f u r t h e r and s t a t e d t h a t t h e c e n t r a l
n e r v o u s s y s t e m i s r e c o g n i z e d a s being t h e e s s e n t i a l c o m p o n e n t o f the
organic system.
3
24
EXISTENTIAL
FOUNDATIONS
On t h e o n e h a n d is t h e c o m m o n l y held idea t h a t t h e r e is r e p r e s e n t e d in
n e u r a l space and t i m e an i s o m o r p h i c p h a n t o m of the real w o r l d , a
phantom then surmised to be interfaced with some other process of
u n c e r t a i n n a t u r e w h i c h , deriving input from this c o n j u n c t i o n , e v o l v e s
an activity of its o w n w h i c h is r e g a r d e d as a basically m e n t a l or psychic
t h i n g , a s p e r c e p t i o n , c o n s c i o u s n e s s , and t h e o t h e r c o n c o m i t a n t a s p e c t s
o f t h e i n n e r life o f m a n .
On t h e o t h e r hand is t h e set of a s s u m p t i o n s c o m p o s i n g t h e modus
labori o f m a n y n e u r o p h y s i o l o g i s t s , w h i c h m a y b e s u m m a r i z e d u n d e r
t h e t e r m p s y c h o n e u r a l identity. . . . T h a t is, t h a t t h e n e u r a l activity set
in m o t i o n by s e n s o r y stimuli, s u c c e s s i v e l y t r a n s f o r m e d t h r o u g h
successively interconnected populations of neurons, complexed
a g a i n s t s t o r e d i n f o r m a t i o n , c o n t r i b u t i n g t o and c o n d i t i o n e d b y t h o s e
neural locales and activities c o n c e r n e d w i t h set o r a f f e c t t h a t t h e s e
neural activities do t h e m s e l v e s lead to and a r e in fact t h e v e r y e s s e n c e
of t he private e v e n t of p e r c e p t i o n , and, at c h o i c e , its public e x p r e s s i o n
25
in t h e f o r m of a d i s c r i m i n a t i o n , a localization, an e s t i m a t e d m a g n i t u d e ,
or a description of q u a l i t y .
5
2o
EXISTENTIAL FOUNDATIONS
human
such
phenomena
View of Medicine
27
M e a n t i m e , w h e n e v e r p h y s i o l o g y and biology i n t r o d u c e i n f o r m a t i o n
t h e o r y into their bodies o f k n o w l e d g e , t h e y a r e n o t m e r e l y b o r r o w i n g
the c o n c e p t i o n s o f i n o r g a n i c o b j e c t s t h a t t e c h n i c a l scientific t h i n k i n g
provides b u t a r e taking loans from sociology a s well. T h e v e r y n a m e
w a s b o r r o w e d from s o c i o l o g y , for " i n f o r m a t i o n " originally m e a n s t h e
t r a n s m i s s i o n o f a m e s s a g e a m o n g socially o r g a n i z e d people. I n f o r m a
tion i s c o m m u n i c a t i o n , t h e t r a n s m i s s i o n , a m o n g h u m a n b e i n g s , o f
m e a n i n g f u l c o n t e n t w h i c h h a s b e e n revealed t o t h e i n f o r m a n t s b y
s o m e t h i n g e n c o u n t e r e d in t h e i r s h a r e d w o r l d .
W h e n e v e r c o n t e m p o r a r y i n f o r m a t i o n t h e o r y is applied to biology
and p h y s i o l o g y , i n f o r m a t i o n suddenly b e c o m e s a p a r t i c u l a r a r r a n g e
m e n t o f c h e m o p h y s i c a l p r o c e s s e s and s t r u c t u r i n g s w h i c h e n t e r t h e
brain a l o n g w i t h p e r c e p t i o n s and c o m m u n i c a t i o n s , and w h i c h can b e
m e a s u r e d and quantified f r o m the brain m a t t e r . C y b e r n e t i c s
n o w h e r e p r o v e s t h a t this identification is justified, y e t i n f o r m a t i o n as
the m e a s u r a b l y o r d e r e d s y s t e m o f c h e m o e l e c t r i c a l p r o c e s s e s i s
n o n e t h e l e s s c o n s i d e r e d t h e f u n d a m e n t a l i d e n t i t y o f t h e p s y c h i c and
the s o m a t i c .
28
29
FOUNDATIONS
at least t w o p h e n o m e n a w h i c h a r e t h o u g h t of as i n d e p e n d e n t of e.u h
o t h e r . O n l y t h i n g s t h u s divided can c o r r e l a t e , coincide with o n e
a n o t h e r , b e c o u n t e r p a r t s t o o n e a n o t h e r , b e j o i n e d o r coupled. O n c e
a n y s u c h division o f h u m a n e x i s t e n c e h a s b e e n a s s u m e d , t h e r e i s n o
s p e c u l a t i o n t h a t can rejoin t h e p a r t s again t o m a k e t h e unified b e h a v i o r
w h i c h h u m a n e x i s t e n c e c o n s t a n t l y displays. N o o n e p r o c e e d i n g from
this dualistic m o d e o f t h o u g h t h a s m a n a g e d t o say a n y t h i n g
c o m p r e h e n s i b l e a b o u t this p o s t u l a t e d r e l a t i o n s h i p b e t w e e n t h e p s y c h e
and t h e n e r v o u s s y s t e m , m u c h less a b o u t t h e n a t u r e and c o m p o s i t i o n
o f t h e s e supposedly p r e s e n t t h i n g s .
In looking back o v e r o u r e x a m p l e s of n a t u r a l scientific e x p l a n a t i o n s
for h e a l t h y p s y c h e s , we c a n n o t avoid t h e c o n c l u s i o n t h a t n e u r o p h y s i ological h y p o t h e s e s , e v e n w h e n t h e y a r e helped along b y t h e l a t e s t
i n f o r m a t i o n t h e o r i e s , are dead e n d s . N e v e r t h e l e s s , t h e i r o b v i o u s
i n e x p e d i e n c y with r e g a r d to a full u n d e r s t a n d i n g of t h e h e a l t h y
p s y c h i c aspect does n o t a m o u n t to n o t h i n g and is n o t p u r e l y n e g a t i v e .
It is precisely the i n e x p e d i e n c y of this a p p r o a c h t h a t lets us r e c o g n i z e
s o quickly the r e a s o n s b e h i n d t h e i n e x p e d i e n c y . A n d t o d i s c o v e r w h y
n a t u r a l scientific e x p l a n a t i o n s c a n n o t c o h e r e n t l y deduce t h e psychic
f r o m t h e s o m a t i c is also to raise t h e possibility n o t m e r e l y of
c i r c u m v e n t i n g t h e s e e x p l a n a t i o n s but o f g e n u i n e l y t r a n s c e n d i n g
them.
A t first, only t h e n e g a t i v e e m e r g e s w i t h c e r t a i n t y . T h o s e n a t u r a l
scientific h y p o t h e s e s i n t e n t o n explaining t h e psychic a s p e c t o n the
basis o f c h e m o p h y s i c a l o r c y b e r n e t i c s o m a t i c p r o c e s s e s n e v e r t o u c h
t h a t r e a l m w h i c h is t h e actual place of all p e r c e p t i o n , feeling, t h o u g h t ,
m e m o r y , desire, and c o n s c i o u s n e s s , w h e r e e v e r y t h i n g psychic actually
dwells. T h a t realm is d a y - t o - d a y e x i s t e n c e in a w o r l d , w i t h all its
c o m m o n p l a c e , and n o t s o c o m m o n p l a c e , j o y s and s o r r o w s . W e find all
the so-called psychic p h e n o m e n a i n o u r t e s t s u b j e c t ' s e n c o u n t e r w i t h
h e r l o v e r e c h o e d and s u s t a i n e d , w i t h t h e i r m e a n i n g s and c o n t e x t s o f
r e f e r e n c e , i n t h e w o r l d t h e y s h a r e . B u t this w a s possible for t h e m
t w o a c t u a l individual h u m a n b e i n g s b e c a u s e t h e w a y all h u m a n
b e i n g s a r e i n n a t e l y c o n s t i t u t e d as h u m a n beings is c h a r a c t e r i z e d by an
o p e n w o r l d , t h a t is, an ability to p e r c e i v e r e l a t i o n s h i p s in t h e w o r l d . It is
a world, in o t h e r w o r d s , in w h i c h t h i n g s can reveal t h e m s e l v e s as
m e a n i n g f u l . B u t in s u c h a world t h e r e is n o t h i n g at all t h a t s u b m i t s
directly t o m e a s u r e m e n t o r calculation. T h i s i s yet a n o t h e r i n s t a n c e o f
h o w t h e n a t u r a l scientific r e s e a r c h m e t h o d c o m e s up a g a i n s t a s t o n e
wall w h e n i t tries t o d i s c o v e r t h e particular n a t u r e o f h u m a n e x i s t e n c e .
B u t for t h e t h e o r y and p r a c t i c e o f medicine, d e t e r m i n i n g the limits o f
the n a t u r a l scientific r e s e a r c h m e t h o d i s n o t t h e m o s t i m p o r t a n t
30
EXISTENTIAL
FOUNDATIONS
View of Medicine
31
e x i s t i n g as a g e s t u r e . F o r a g e s t u r e , no m a t t e r h o w slight, always
indicates s o m e t h i n g t h a t h a s already b e e n perceived in its particular
significance. N e i t h e r the d i s c e r n i n g r e a l i z a t i o n of m e a n i n g , nor a
g e s t u r e in r e s p o n s e could e v e r o r i g i n a t e in c h e m o p h y s i c a l p r o c e s s e s or
c y b e r n e t i c s t r u c t u r e s . A n d t h u s n e i t h e r biology, a n a t o m y , n o r
p h y s i o l o g y d e s e r v e s to be called a basic s c i e n c e . If this is w h a t they call
t h e m s e l v e s , a r r o g a n c e h a s blinded t h e m t o facts.
B e c a u s e t h e n a t u r a l scientific r e s e a r c h m e t h o d h a s n o t b e e n able t o
b r i n g f o r t h a n a d e q u a t e u n d e r s t a n d i n g o f h u m a n e x i s t e n c e , while
u n l o c k i n g u n d r e a m e d - o f possibilities for t h e medical m a n i p u l a t i o n o f
h u m a n b e i n g s , it has n o t b e e n able to give a n y goal or purpose to
medical practice. As a r e s u l t , its t r a n s g r e s s i o n s b e c o m e i n c r e a s i n g l y
d a n g e r o u s to the survival of h u m a n n a t u r e as its p o t e n t i a l for
t e c h n o l o g i c a l i n t e r v e n t i o n is r e f i n e d to p e r f e c t i o n . W h e n , s o m e t i m e in
the foreseeable future, deliberate intervention in c h r o m o s o m e
s t r u c t u r e m a k e s c o n t r o l l e d b r e e d i n g o f t h e h u m a n race possible, its
scientific c r i t e r i a will give t h e n a t u r a l s c i e n c e o f h u m a n - b r e e d i n g n o
clue a b o u t w h i c h g e n e t i c d i r e c t i o n will be beneficial to m a n and his
w o r l d and w h i c h m o r e apt t o a n n i h i l a t e b o t h .
A d a w n i n g i n s i g h t i n t o t h e l i m i t a t i o n s of the n a t u r a l scientific
r e s e a r c h m e t h o d and t h e d a n g e r s of raising it to an a b s o l u t e in biology
and m e d i c i n e h a s for s o m e t i m e n o w b e e n e n c o u r a g i n g p h y s i c i a n s t o
look for a s o u n d e r basis for m e d i c i n e , a basis m o r e a p p r o p r i a t e to the
illness of h u m a n b e i n g s . A s s u m i n g t h a t t h e y should d i s c o v e r such a
b a s i s , it w o u l d still be illicit to simply discard p r e v i o u s n a t u r a l scientific
a d v a n c e s ; a n e w , m o r e h u m a n f o u n d a t i o n o f m e d i c i n e would k n o w
h o w t o i n t e r p r e t t h e findings o f n a t u r a l scientific r e s e a r c h m o r e
suitably. S c i e n t i s t s h a v e l o o k e d particularly t o p s y c h o l o g y and
p s y c h o s o m a t i c m e d i c i n e for help in e l a b o r a t i n g a m o r e h u m a n
u n d e r s t a n d i n g o f the k n o w n p h e n o m e n a o f h u m a n e x i s t e n c e , with t h e
e x p e c t a t i o n t h a t t h e i r e x p l a n a t o r y capabilities would c o m p l e m e n t
m e d i c i n e ' s s o m a t o l o g i c a p p r o a c h to f o r m a c o m p r e h e n s i v e v i e w p o i n t .
NOTES
1. N.
Mifflin,
W i e n e r , The Human
1949); German
Use of Human
t r a n s l a t i o n : Mensch-Maschine ( 1 9 5 2 ) ,
pp.
(Boston:
Hough tor
94ff.
32
EXISTENTIAL
6. H.
Gehirn
7. H.
Hensel,
Lehrbuch
(Munich:
der
1 9 5 3 ) , pp. 87 a n d
Physiologie.
Allgemeine
Vorgnge,
FOUNDATIONS
3d ed.,
Die
Vorgnge im
153.
Sinnesphysiologie,
Hautsinne,
Geschmack,
Geruch
Chapter 3
34
EXISTENTIAL
FOUNDATIONS
View
35
I t b e c a m e i n c r e a s i n g l y c l e a r t h a t t h e relative and a b s o l u t e n u m b e r o f
t h e s e n e u r o s e s , t h e i n t e n s i t y o f the s u f f e r i n g t h e y e n g e n d e r e d , and t h e
e c o n o m i c d a m a g e for w h i c h t h e y w e r e r e s p o n s i b l e , w e r e s u r p a s s i n g t h e
e f f e c t s o f all t h e primarily o r g a n i c illnesses t a k e n t o g e t h e r . P h y s i c i a n s
w e r e compelled to a c k n o w l e d g e p a t i e n t s ' m e n t a l o r i e n t a t i o n s as a s e c o n d
and d i f f e r e n t a r e a o f r e a l i t y e x i s t i n g a l o n g w i t h t h e s o m a t i c , and t h e y had
t o give this n o n s o m a t i c realm i n d e p e n d e n t scientific c o n s i d e r a t i o n .
W h i l e the n a m i n g o f t h e n e w s c i e n c e s o f medical p s y c h o l o g y and
p s y c h o p a t h o l o g y t o o k i n t o a c c o u n t t h a t all n o n s o m a t i c m a n i f e s t a t i o n s o f
h u m a n e x i s t e n c e w e r e s e e n a s e f f e c t s o r f u n c t i o n s o f the p s y c h e , t h e
n e o l o g i s m " n e u r o s i s " e c h o e s t h e old prejudice t h a t e v e n t h e p s y c h o g e n i c
illnesses c a n , in t h e final analysis, be ascribed to d i s t u r b a n c e s in t h e
n e u r o n s , the physical n e r v e cells and the n e r v e p a t h w a y s .
PSYCHOLOGICAL HYPOTHESES
S i g m u n d F r e u d o p e n e d n e w d i m e n s i o n s t o medicine t h r o u g h his
o b s e r v a t i o n s o f t h e p s y c h i c b e h a v i o r o f his p a t i e n t s , r e c o g n i z i n g t h e
s i g n i f i c a n c e , for t h e g e n e s i s o f m a n y i l l n e s s e s , o f a p a t i e n t ' s c o n c e p t i o n s
of good and evil, of beautiful and ugly, of e n t a n g l i n g guilt and o u t l e t s to
f r e e d o m . B e s i d e s t h i s , F r e u d t a u g h t p h y s i c i a n s t o see the t h e r a p e u t i c
value i n t h e w a y s t h e y dealt w i t h p a t i e n t s . H e pointed t o t h e n e e d f o r
t r e a t i n g p a t i e n t s not j u s t from t h e p r e s c r i b e d position o f d i s t a n c e , w h e r e
t h e y w e r e o r g a n i s m s t h o u g h t o f a s o b j e c t s , and h e m a d e p h y s i c i a n s s e e
t h a t a specifically h u m a n , close, m u t u a l l y e n g a g i n g r e l a t i o n s h i p b e t w e e n
physician and p a t i e n t was in i t s e l f p o w e r f u l l y t h e r a p e u t i c .
N o t least, F r e u d c o n s i d e r e d it i m p o r t a n t to i n t r o d u c e i n t o m e d i c i n e a
r e s e a r c h m e t h o d a t t u n e d t o m e a n i n g , w h i c h would stand beside t h e
n a t u r a l scientific p e r s p e c t i v e t h a t s a w o n l y m e a n i n g - f r e e , causally
c o n n e c t e d r e l a t i o n s h i p s a m o n g q u a n t i t i e s . His first g r e a t w o r k , The
Interpretation of Dreams, b e g a n w i t h t h e bold s e n t e n c e s : "In the following
pages, I shall deliver p r o o f t h a t t h e r e is a p s y c h o l o g i c a l t e c h n i q u e w h i c h
p e r m i t s d r e a m s to be i n t e r p r e t e d and t h a t w h e n this p r o c e d u r e is applied
e v e r y d r e a m t u r n s o u t to be a meaningful p s y c h i c s t r u c t u r e w h i c h can be
fitted i n t o t h e m e n t a l o p e r a t i o n s o f the w a k i n g s t a t e a t specific p o i n t s . "
In all of his s u b s e q u e n t a t t e m p t s to m a s t e r t h e psychic m a n i f e s t a t i o n s
o f h u m a n b e i n g s t h e o r e t i c a l l y , F r e u d held s t e a d f a s t l y t o t h e old
c o n c e p t i o n s of biology and p h y s i o l o g y . J u s t as t h e s e s c i e n c e s had
visualized t h e h u m a n body as a physical o r g a n i s m e x i s t i n g i n d e p e n d e n t l y
and p r e s e n t at a specific point in a p r e e x i s t i n g e m p t y space, so the
nonphysical p h e n o m e n a of h u m a n e x i s t i n g , a w a k e n e d to a n e w reality,
appeared in Freud's p s y c h o a n a l y t i c t h e o r y as e f f e c t s or f u n c t i o n s of a
1
36
EXISTENTIAL
FOUNDATIONS
37
View
38
EXISTENTIAL
FOUNDATIONS
N o w t h e f u n d a m e n t a l illusion a g a i n s t w h i c h w e s e e k t o a s s e r t
o u r s e l v e s c o n s i s t s i n believing t h a t o n e c a n find t r u t h t h r o u g h simple
reflection w i t h o u t stepping out o f his study o r library. T r u t h i s n o t t o
b e gained e x c e p t t h r o u g h d e d u c t i o n b u t b y m e a n s o f precise
a l g o r i t h m s , or t h r o u g h e x p e r i e n c e b u t aided by precise c o n t r o l . It is
View
t h e s e a l g o r i t h m s o r t h e s e c o n t r o l s w h i c h d i s t i n g u i s h t h e s c i e n c e s from
p h i l o s o p h y , and not t h e n a t u r e o f t h e p r o b l e m s a t h a n d .
1 0
40
EXISTENTIAL
FOUNDATIONS
41
W e i s a c k e r , Der Geslalllcreis:
1 9 4 7 ) , p. 177.
3. H. B i n d e r , Die menschlicke Person ( B e r n a n d S t u t t g a r t : 1 9 6 4 ) , p. 4 1 .
EXISTENTIAL
42
FOUNDATIONS
T.
von
Uexkll,
Grundfragen
Rowohlt-Taschenbuchverlag,
1963).
der
psychosomatischen
Medizin
Chapter 4
(Rheinbeck-bei-Hamburg:
PSYCHOLOGICAL HYPOTHESES
44
EXISTENTIAL
FOUNDATIONS
45
T o b e g i n , p s y c h o a n a l y t i c d r e a m t h e o r y would a s s e r t t h a t o u r p a t i e n t ' s
r e c u r r i n g n i g h t t i m e e x p e r i e n c e s o n t h e o c e a n floor w e r e p r o d u c t s o f
endopsychic, hallucinatory dream images. T h e s e manifest dream images
would be f u r t h e r explained as e f f e c t s of a d r e a m c a u s a t i o n or as p r o d u c t s
of a d r e a m m o t o r w h i c h g e n e r a t e d all d r e a m s in o n e and t h e s a m e w a y . In
Freud's view, this is a l w a y s an i n f a n t i l e , i n s t i n c t i v e d e s i r e . W i t h
r e f e r e n c e t o o u r patient's b o x c a r d r e a m , t h e i n f a n t i l e , i n s t i n c t i v e desire
t o r e t u r n t o t h e w o m b would b e held r e s p o n s i b l e for t h e r e a l i z a t i o n o f t h e
d r e a m i m a g e . T h e d r e a m o b j e c t , t h e w o m b , w o u l d b e seen disguised i n
the representation of the dreamed ocean. T h e image of the ocean has
u p s t a g e d t h e o n e actually i n t e n d e d b e c a u s e , to this prudish d r e a m e r , a
w o m b w o u l d p r o b a b l y be t o o indelicate a t h i n g to appear undisguised.
M a s k e d in t h e n e u t r a l i m a g e of an o c e a n , it can appear by duping t h e
dream censor.
T h e r e is a s o m e w h a t d i f f e r e n t d r e a m t h e o r y i n t e r p r e t a t i o n on t h e
s u b j e c t i v e l e v e l w h i c h i s c o m m o n l y c o n t r a s t e d w i t h t h e first type
i n t e r p r e t a t i o n on t h e o b j e c t i v e level. It t o o is f o r e s h a d o w e d in
Interpretation of Dreams b u t w a s n o t fully developed until later by S i l b e r e r ,
M a e d e r , and J u n g . T h e d r e a m t h e o r y o n the s u b j e c t i v e level w o u l d see i n
the d r e a m i m a g e o f t h e o c e a n t h e p a t i e n t ' s o w n individual u n c o n s c i o u s
EXISTENTIAL
17
FOUNDATIONS
r e p r e s e n t e d s y m b o l i c a l l y , or projected o u t w a r d in the f o r m of an i m a g e .
J u n g ' s analysis in p a r t i c u l a r would a s s u m e t h a t the o c e a n s y m b o l i z e d a
collective u n c o n s c i o u s w i t h i n t h e d r e a m e r . T h e o c e a n ' s coldness and t h e
d r e a m e r ' s s e n s e of being lost t h e r e would p r o b a b l y be i n t e r p r e t e d as the
g r a p h i c r e p r e s e n t a t i o n o f h e r poor r e l a t i o n s h i p t o t h e s e levels o f h e r
psyche.
N o w , if we hold t h e s e e x p l a n a t i o n s up to w h a t we actually see
h a p p e n i n g w i t h o u r d r e a m e r , R e g u l a Z r c h e r , and w i t h the w a y she
c o n d u c t s h e r s e l f t o w a r d w h a t is in h e r d r e a m world, we can find little
validity in t h e a s s e r t i o n t h a t all of this is m e r e l y r e p r e s e n t a t i o n or m e r e l y
hallucinated u n r e a l i t y . T h e r e is no e v i d e n c e in t h e s e p h e n o m e n a to
support t h e h y p o t h e s i s t h a t R e g u l a Z r c h e r , while d r e a m i n g , has done
nothing but project mental images of external objects or symbols of
s u b j e c t i v e a s p e c t s o f h e r o w n self.
S t r i c t l y speaking, R e g u l a Z r c h e r did n o t have a dream at all. T h e
d r e a m ' s puzzling p h e n o m e n a are n o t t h i n g s a p e r s o n can have, n o t e v e n in
t h e f o r m o f a n e n d o p s y c h i c s t r u c t u r e . R a t h e r , while s h e was d r e a m i n g
R e g u l a Z r c h e r found h e r s e l f e x i s t i n g in a world, perceiving and
c o n d u c t i n g h e r s e l f t o w a r d t h e p h e n o m e n a o f t h a t d r e a m i n g world j u s t a s
she did t o w a r d h e r w a k i n g world.
F u r t h e r m o r e , i n t h e b o x c a r d r e a m t h e r e w a s n o i n s t i n c t i v e infantile
desire to be f o u n d as c a u s e or m o t i v e . F r e u d h i m s e l f a d m i t t e d t h a t s u c h a
s u p p o s i t i o n w e n t b e y o n d w h a t can b e d e m o n s t r a t e d . F r e u d i a n d r e a m
i n t e r p r e t a t i o n c o n t r a s t s m o s t strikingly w i t h the actuality o f the
p h e n o m e n a t h e m s e l v e s w h e n i t claims t h a t t h e o c e a n o f t h e d r e a m really
m e a n s t h e w o m b . W i t h its icy cold and its t e r r i f y i n g l o n e l i n e s s , this o c e a n
is t h e d i a m e t r i c a l o p p o s i t e of a w o m b , w h i c h is w a r m , safe, n o u r i s h i n g ,
and s h e l t e r i n g .
2
P s y c h o a n a l y t i c d r e a m t h e o r y deals w i t h c o n t r a d i c t i o n b e t w e e n its
e x p l a n a t i o n s and t h e actual p h e n o m e n a b y c o n t r i v i n g t h e o p e r a t i o n o f
u n c o n s c i o u s d r e a m - w o r k w h i c h can t h e n b e said t o employ the trick o f
" r e v e r s a l i n t o t h e o p p o s i t e . " B u t t h e t h e o r y i s hard put t o e x t r a c t f r o m
the actual p h e n o m e n a o f this d r e a m a single p r o o f for t h e e x i s t e n c e o f
such d r e a m - w o r k .
Interpretation of the boxcar dream from the theory of the subjective
l e v e l , too, c a n n o t c o m m a n d e v i d e n c e in its b e h a l f w h e n it would say t h a t
I he ocean r e p r e s e n t s t h e d r e a m e r ' s u n c o n s c i o u s , individual or c o l l e c t i v e .
I his c o n s t r u c t i o n , t o o , m u s t be s e e n in t h e light of a d m i s s i o n s m a d e by
I i e n d and |ung t h e m s e l v e s . B o t h had t o allow t h a t t h e t w o u n c o n s c i o u s
n e s s e s c o u l d n e i t h e r be o b s e r v e d as such n o r d e m o n s t r a t e d t o be actual
e n t i t i e s bul must be i n t e r r e d from the o b s e r v a b l e p h e n o m e n a (which are
already a^sutned t o h e t h e i r effects).
48
EXISTENTIAL F O U N D A T I O N S
h i n d e r i n g h e r t h e m o s t , t h e u r g e s t o s t r a n g l e and s t a b w e r e e n t i r e l y
a b s e n t . M o r e o v e r , t h e a w a r e n e s s t h a t a beloved child is a b u r d e n
s o m e t i m e s is still miles f r o m being a d e a t h w i s h .
P s y c h o a n a l y t i c t h e o r y c o u n t e r s o b j e c t i o n s like t h e s e b y saying t h a t w e
are dealing h e r e w i t h u n c o n s c i o u s , r e p r e s s e d d e s i r e s w i t h d e s i r e s
w h i c h , b e i n g p r e s e n t o n l y i n the u n c o n s c i o u s o f t h e p a t i e n t ' s p s y c h e ,
c a n n o t b e o b s e r v e d directly. B u t t h e t h e o r y n e g l e c t s t o explain t h e n h o w
it can k n o w in t h e first place t h a t such u n c o n s c i o u s d e s i r e s do e x i s t . It
fails also t o m e n t i o n w h a t t h e n a t u r e o f a n u n c o n s c i o u s desire o r i n s t i n c t
is and of w h a t s t u f f it is m a d e . N o r m a l l y , e v e r y act of w i s h i n g i n e v i t a b l y
p r e s u p p o s e s a w a r e n e s s of w h a t is w i s h e d for. H o w t h e n is an
unconscious, unknowing knowledge supposed to be constituted?
T h e same thing happens to the psychoanalytic interpretation of the
knife as phallic s y m b o l , w h i c h is so i m p o r t a n t in all t h e p s y c h o l o g i c a l
explanations. As the patient perceived them, the knives always remained
m e r e l y k n i v e s . N e i t h e r she n o r the p h y s i c i a n - o b s e r v e r w a s e v e r able t o
e s t a b l i s h b e t w e e n t h e k n i v e s and t h e m a l e g e n i t a l s the s o r t o f c o n n e c t i o n
p s y c h o a n a l y t i c t h e o r y has in mind.
C o n t e m p o r a r y p s y c h o a n a l y t i c t h e o r y would o f c o u r s e b e prepared t o
a m e n d its original s y m b o l i c i n t e r p r e t a t i o n s o m e w h a t . M a n y a n a l y s t s
would no longer reduce the unconscious symbolic content of the knives
to a literal penis. T h e y would p r e f e r to see in t h e s t a b b i n g u r g e t h e
disguised b r e a k t h r o u g h of a g e n e r a l m a l e - a g g r e s s i v e aspect of t h e
p a t i e n t ' s n a t u r e . B u t e v e n this e x p l a n a t i o n does n o t keep t o facts t h a t
could actually b e e x p e r i e n c e d . T h e p a t i e n t ' s c o n s t i t u t i o n h a s a n
u n e q u i v o c a l l y f e m i n i n e s t a m p . S h e n e v e r e x p e r i e n c e d t h e desire to be a
m a n . O n the c o n t r a r y , h e r h a p p i n e s s depended, and still does, o n h e r
being free t o b e a w o m a n . E v e n w h e n s h e w a s o v e r c o m e b y t h e u r g e t o
stab, she n e v e r felt a n y t h i n g m a s c u l i n e a b o u t h e r s e l f . T o t h e m a n y
q u e s t i o n s h e r t h e r a p i s t asked while l o o k i n g for e v i d e n c e o f m a s c u l i n e
t e n d e n c i e s , R e g u l a Z i i r c h e r r e p e a t e d l y r e s p o n d e d b y h e r s e l f asking
w h e t h e r it was senseless to inquire into the gender of the thrashing
a b o u t t h a t h a p p e n e d w h e n a m a n o r w o m a n w a s being t h r o t t l e d .
F o r t h e s e p s y c h o p a t h o l o g i c a l p h e n o m e n a , t h e e x p l a n a t i o n s o f medical
a n t h r o p o l o g y a r e a s crudely i n c o n s i s t e n t a s t h o s e o f p s y c h o a n a l y t i c
t h e o r y . T h e u r g e s t o s t r a n g l e and stab would d o u b t l e s s b e e x p l a i n e d
according to t h e i r t h e o r y of sadism. As this t h e o r y h a s it, all sadism
e x p r e s s e s a s e c r e t inclination to m o v e " f r o m a b o v e to b e l o w , " from
" e l e v a t i o n t o d e g r a d a t i o n , " from " w e a l t h t o p o v e r t y , " from " w h o l e n e s s
t o d i s m e m b e r m e n t , " f r o m " a n i m a t i o n t o a n n i h i l a t i o n , " from " a f f i r m a
tion t o n e g a t i o n , " from " f o r m t o c h a o s , " from " b e i n g t o n o n - b e i n g . "
N o t h i n g w h a t s o e v e r o f t h a t s o r t o f e x i s t e n t i a l m o v e m e n t can b e
3
50
EXISTENTIAL FOUNDATIONS
knife u n e q u i v o c a l l y p e r c e i v e d to be o u t s i d e , at s o m e p a r t i c u l a r spot in h e r
s u r r o u n d i n g s . T h u s , i t w a s n o spell c a s t b y t h e e m e r g e n c e o f a n
endopsychic t h e m e but externally present objects that t h r e a t e n e d to
m a k e R e g u l a Z i i r c h e r a blind slave. A n d it w a s no e n d o p s y c h i c t h e m e
w h i c h m a d e the knife and t h e h a n d s a p p e a r a f t e r a t i m e o n l y as
instruments of murder. R a t h e r , the pathological a t t u n e m e n t to a most
e x t r e m e fear o f s u f f o c a t i o n , w h i c h d o m i n a t e d all h e r r e l a t i o n s h i p s t o t h e
world, w a s r e s p o n s i b l e .
Finally, t h e r e a r e m a n y e x p l a n a t i o n s w h i c h would call R e g u l a
Z i i r c h e r ' s knife h a l l u c i n a t i o n s p s y c h o g e n i c p h e n o m e n a . G e n e t i c e x p l a
n a t i o n s , h o w e v e r , are basically limited to s e e k i n g out m o t i v e s in t h e life
h i s t o r y t h a t u l t i m a t e l y lead t o t h e o u t b r e a k o f s y m p t o m s . A s w e will
discuss in detail l a t e r , this s o r t of e x p l a n a t i o n c o n f u s e s t h e e s t a b l i s h m e n t
o f m o t i v e s and c o n d i t i o n s for t h e m a n i f e s t a t i o n o f p a r t i c u l a r m o d e s o f
human behavior with the understanding of these phenomena t h e m
selves.
PSYCHOSOMATIC HYPOTHESES
52
EXISTENTIAL FOUNDATIONS
53
illnesses. P s y c h o s o m a t i c m e d i c i n e w o u l d n o t b e d e t e r r e d b y t h e fact t h a t
we are no l o n g e r dealing h e r e simply w i t h f u n c t i o n a l d i s t u r b a n c e s , as in
the case o f t h e i n t e s t i n a l s p a s m s , b u t w i t h c h a n g e s i n t i s s u e s t r u c t u r e .
T h e b r e a s t pains, w h i c h had for t h e m o s t part defied all simple h o r m o n e
t r e a t m e n t s , disappeared r e l a t i v e l y quickly during p s y c h o t h e r a p e u t i c
t r e a t m e n t . B u t in spite of this, the pain and r o c k h a r d s w e l l i n g of R e g u l a
Z i i r c h e r ' s b r e a s t s m a y justifiably be a t t r i b u t e d to a h y p e r f u n c t i o n i n g of
her o v a r i e s . P s y c h o s o m a t i c m e d i c i n e h e r e posits simply a periodic
hyperfolliculation, b r o u g h t a b o u t b y p e r s i s t e n t u n c o n s c i o u s e m o t i o n a l
impulses t h a t issue f o r t h f r o m a libidinally o v e r l o a d e d p s y c h e to affect
the s e x u a l o r g a n s .
54
EXISTENTIAL
FOUNDATIONS
55
b e t w e e n t h e s o m a and t h e p s y c h i c e n t i t i e s it p o s i t s . P s y c h o s o m a t i c
thinking d e s c r i b e s t h e r e l a t i o n s h i p b e t w e e n p s y c h e and soma a s
i n t e r a c t i o n , o r a s e x p r e s s i o n o f o n e b y t h e o t h e r . B u t i t n e v e r explains
how a n y such r e l a t i o n s h i p could e x i s t at all b e t w e e n t w o such
heterogeneous things.
I f w e c o n s i d e r h o w , i n aspiring t o c o m p l e t e t h e scientific t h e o r y o f
physical m e d i c i n e , e a c h o f t h e s e p e r s p e c t i v e s t h e p s y c h o l o g i c a l , the
p s y c h o s o m a t i c , and t h e s o m a t o p s y c h i c t r e a t s t h e p h e n o m e n a o f o u r
lest c a s e , we reach a c o n c l u s i o n as u n m i s t a k a b l e as it is striking. T h e i r
e x p l a n a t i o n s for R e g u l a Z i i r c h e r ' s h e a l t h y b e h a v i o r and h e r p a t h o l o g i c a l
s y m p t o m s a s well c o n s i s t e n t l y r e f e r t o psychic e n t i t i e s . T h e s e e n t i t i e s
suffer from o n e o r b o t h o f t h e following s e v e r e flaws: t h e precise n a t u r e
and m o d e of being of s o m e of t h e m is n e v e r specified; and t h e r e is no
e v i d e n c e w h a t s o e v e r t h a t m o s t o f t h e m actually exist.
T h e o n l y q u e s t i o n r e m a i n i n g i s w h e t h e r this o b s e r v a t i o n i s justified
only w i t h r e g a r d t o R e g u l a Z i i r c h e r ' s particular c a s e o r w h e t h e r i t h a s
g e n e r a l and f u n d a m e n t a l validity.
NOTES
1 M. B o s s , DerTraum und seine Auslegung ( B e r n : H a n s H u b e r ,
vergangene Nacht ( B e r n : H a n s H u b e r , 1 9 7 5 ) .
1 9 5 3 ) , a n d Es trumte mir
S. F r e u d , Die Abwehr-Neuropsychosen,
1942), p. 6 3 .
in Gesammelte Werke,
vol. 1. ( L o n d o n : I m a g o , I n c . ,
57
Chapter 5
THE FUNDAMENTAL C O N D I T I O N A L L Y OF
PSYCHOLOGY AND PSYCHOSOMATICS
PSYCHOLOGICAL HYPOTHESES
N o o n e w o u l d dispute t h a t m o s t o f t h e ruling c o n c e p t s i n t h e b r a n c h e s
dl c u r r e n t medical p s y c h o l o g y o r i g i n a t e in F r e u d i a n t h i n k i n g . T h o u g h
Freud r a i s e d t h e h u m a n p s y c h i c a s p e c t o n c e m o r e t o t h e s t a t u s o f a
unique reality, it was characteristic of him that he never thought of
developing a n e w m e t h o d o f r e s e a r c h suited t o t h e p a r t i c u l a r n a t u r e o f
I his r e a l m . As a r e s e a r c h e r w h o w a n t e d to be t a k e n s e r i o u s l y , F r e u d
believed h e w a s d u t y - b o u n d t o f o r c e h u m a n p h e n o m e n a e v e r y last o n e
o l t h e m i n t o t h e old c o n c e p t u a l f r a m e w o r k o f n a t u r a l s c i e n c e . H e
e x p r e s s e d this i n a s t a t e m e n t w h i c h s e t s f o r t h t h e f u n d a m e n t a l i n t e n t o f
his e n t i r e p s y c h o l o g y : " W e a r e w o r k i n g t o w a r d a dynamic p s y c h o l o g y . In
o u r view, p e r c e i v e d p h e n o m e n a m u s t t a k e a s e c o n d place t o a s s u m e d
drives."
1
58
EXISTENTIAL
FOUNDATIONS
The
Fundamental
Conditionality
50
t h e r e b y i g n o r e d t h a t i n h e r e n t l y all such m e t a p s y c h o l o g i c a l c o n c l u s i o n s
beg the question: F r e u d could i n t e r p r e t p h e n o m e n a w h i c h he could
perceive directly as f u n c t i o n s w h i c h implied t h e p r e s e n c e of a psychic
apparatus he could not p e r c e i v e directly o n l y b e c a s s e he had already
a s s u m e d t h e p r e s e n c e o f this a p p a r a t u s . I n t h e p s y c h i c p h e n o m e n a
t h e m s e l v e s t h e r e i s n o t h i n g f o r c i n g u s t o a s s u m e t h a t t h e y are e f f e c t s o f
a n y c a u s e at all.
F r e u d , h o w e v e r , believed t h a t e v e n t h e r e l a t i v e l y simple p h e n o m e n a o f
h u m a n p e r c e p t i o n could n o t b e u n d e r s t o o d w i t h o u t this m e t a p s y c h o l o g i
cal c o n s t r u c t . He had a p e n c h a n t for c o m p a r i n g it to a c a m e r a , n e g l e c t i n g
to c o n s i d e r t h a t a c a m e r a is w o r t h n o t h i n g w i t h o u t a p h o t o g r a p h e r w h o
can see and perceive b e f o r e he e v e r lays h a n d s on it. N o t o n l y does he n o t
need a c a m e r a to see a s u b j e c t as s o m e t h i n g w o r t h p h o t o g r a p h i n g , b u t he
could n e v e r focus his a p p a r a t u s on a p a r t i c u l a r s u b j e c t and c a p t u r e it on
film if he w e r e n o t already a s e e i n g and c o m p r e h e n d i n g b e i n g . F u r t h e r ,
film i t s e l f does n o t see t h e significance of w h a t has b e e n r e p r o d u c e d on it;
only a h u m a n being w h o is already seeing can " s e e " i m a g e s in t h e i r
m e a n i n g f u l n e s s . T h e n o t i o n of a c a m e r a as a c r u t c h to facilitate
u n d e r s t a n d i n g o f t h e h u m a n ability t o perceive i s t h e r e f o r e s u p e r f l u o u s .
In fact, it is b a c k w a r d , t o o , for t h e o p e r a t i o n of a c a m e r a can be
u n d e r s t o o d o n l y o n t h e basis o f t h e h u m a n ability t o see and p e r c e i v e .
B u t e x a c t l y this specifically h u m a n ability to see and perceive as such, is
as i n a c c e s s i b l e to F r e u d i a n m e t a p s y c h o l o g y as it is to t h e m o d e r n
n e u r o p h y s i o l o g i c a l t h e o r i e s o f p e r c e p t i o n a n d for t h e s a m e r e a s o n s .
P s y c h o a n a l y s i s depends o n t h e a s s u m p t i o n o f e n d o p s y c h i c r e p r e s e n t a
tions o f o b j e c t s o f t h e e x t e r n a l w o r l d t o explain t h e h u m a n ability t o
perceive a thing as s o m e t h i n g m e a n i n g f u l . B u t the p r e s e n c e of such
r e p r e s e n t a t i o n s can n e v e r b e a s c e r t a i n e d . T h e y are i n v e n t i o n s . Y e t , even
il t h e y did c o n s t i t u t e t h e mind's initial k n o w l e d g e of t h e e x t e r n a l world,
how would a person ever k n o w thet these were images coming from an
outside w o r l d , or, for t h a t m a t t e r , t h a t t h e r e w a s a n o u t s i d e w o r l d a t all?
O b v i o u s l y , this k n o w l e d g e can c o m e to a p e r s o n t h i s b e a r s c o n s t a n t
r e p e a t i n g o n l y if t h a t p e r s o n ' s s i g h t and p e r c e p t i o n dwell from t h e v e r y
beginning, and b e f o r e a n y s u b s e q u e n t r e p r e s e n t a t i o n s , w i t h t h e w o r l d
outside.
Y e t F r e u d w e n t o n t o i m a g i n e t h a t a p e r s o n gained a c c e s s t o t h e outside
world primarily t h r o u g h an e n e r g y a s s u m e d to be p r e s e n t in t h e p s y c h e
a n d t h r o u g h t h e drives and e m o t i o n s t h a t c a m e from this e n e r g y . H e
believed t h a t t h e s e c a t h e c t e d t h e o b j e c t s o f t h e e x t e r n a l w o r l d . B u t n o
o n e has y e t been able t o establish t h e p r e s e n c e o f the libido, t h e drives, o r
e m o t i o n s in a psyche. E v e n if t h e r e w e r e s u c h t h i n g s , t h e libido would
have to possess sight in o r d e r to direct itself to e x t e r n a l t h i n g s as o b j e c t s
60
EXISTENTIAL
FOUNDATIONS
The
Fundamental
Conditionality
61
p s y c h i c . A s far a s t h e p s y c h i c p h e n o m e n a t h e m s e l v e s a r e c o n c e r n e d ,
t h e r e i s n o r e a s o n w h y t h e y m i g h t n o t b e a b r o k e n s u c c e s s i o n , especially
if this s u c c e s s i o n is t h o u g h t ofas it is in F r e u d ' s t h e o r y a s a m e r e chain
o f c a u s e s and e f f e c t s . B u t F r e u d w o u l d n e v e r h a v e s u c c e e d e d i n applying
t h e n a t u r a l scientific m o d e o f t h o u g h t t o t h e r e a l m o f t h e psychic i f h e
had b e e n forced t o a d m i t t h a t b r o k e n causal c h a i n s w e r e p r e s e n t i n this
r e a l m . S u c h f r a g m e n t a t i o n i s i n c o m p a t i b l e w i t h u n i v e r s a l calculability,
and it is precisely this calculability t h a t is p o s t u l a t e d as a basic a x i o m
applicable to all t r u e b e i n g s by t h e n a t u r a l scientific r e s e a r c h m e t h o d .
W h e n this i s n o l o n g e r t a k e n a s a b s o l u t e and n o l o n g e r u n t h i n k i n g l y
p r e s u p p o s e d a s applying t o all p h e n o m e n a o f h u m a n e x i s t e n c e , t h e
observable "successions of conscious actions" no longer appear in the
least f r a g m e n t a r y .
I t w a s t h e r e f o r e o n l y i n t h e i n t e r e s t s o f t h e scientific r e s e a r c h m e t h o d
t h a t F r e u d h y p o t h e s i z e d a p s y c h i c u n c o n s c i o u s as t h e b o t t o m - m o s t layer,
o r d e e p e s t s y s t e m , o f t h e p s y c h e . O n c e this supposition w a s t h e o r e t i c a l l y
e s t a b l i s h e d , F r e u d w a s free t o a s s u m e , w h e n e v e r i n v e s t i g a t i o n o f a
p h e n o m e n o n could n o t t u r n up a link to c o m p l e t e t h e causal c h a i n he had
i n v e n t e d , t h a t t h e m i s s i n g link w a s t o b e found w i t h i n this u n c o n s c i o u s .
H e sidestepped his scientific d u t y t o d o c u m e n t t h e w o r k i n g p r e s e n c e o f
these endopsychic, unconscious entities by arguing that in the darkness
of t h e u n c o n s c i o u s n o t h i n g could be s e e n in its basic detail.
T h e m o s t i m p o r t a n t c o n t e n t s o f t h e u n c o n s c i o u s , F r e u d held, w e r e
drives, d e s i r e s , t e n d e n c i e s , and r e p r e s e n t a t i o n s w h i c h w e r e i n c o m p a t i b l e
w i t h a p e r s o n ' s s e l f - r e g a r d or m o r a l v i e w s and w h i c h had b e e n r e p r e s s e d
precisely b e c a u s e o f t h e i r i m p o r t a n c e . O n c e m o r e , h o w e v e r , t h e s e w e r e
pure i n v e n t i o n s w h o s e actual p r e s e n c e w a s n o t scientifically c o n f i r m e d .
B e s i d e s , as we pointed o u t in t h e last c h a p t e r , t h e r e is a c o n t r a d i c t i o n
i n h e r e n t i n this m a t t e r s o c e n t r a l t o Freudian t h e o r y . H u m a n desire and
striving c a n n o t e x i s t in a v a c u u m ; t h e y m u s t r e f e r to s o m e t h i n g o t h e r
t h a n t h e m s e l v e s . T h i s m e a n s t h a t e v e r y act of w i s h i n g or striving is aware
o f the m e a n i n g f u l n e s s t h a t m a k e s u p w h a t i s desired o r s t r i v e n for. T h e
n o t i o n of u n c o n s c i o u s desire is an i n h e r e n t c o n t r a d i c t i o n .
C o n s i d e r i n g h o w forcibly F r e u d tried t o fit t h e p h e n o m e n a o f h u m a n
e x i s t e n c e i n t o t h e mold o f n a t u r a l scientific t h o u g h t , i t w a s i n e v i t a b l e
that his o b j e c t s o f s t u d y w o u l d suffer s o m e m u t i l a t i o n . T h i s fate befell
e v e n t h e p h e n o m e n a h e t o o k a s t h e t h e m e o f his first e p o c h - m a k i n g
w o r k , and w h i c h h e h i m s e l f had called t h e " r o y a l r o a d " o f his depth
p s y c h o l o g y : t h e d r e a m . T o m a k e his d r e a m t h e o r y c o n f o r m r e a s o n a b l y t o
the d e m a n d s of t h e n a t u r a l scientific r e s e a r c h m e t h o d , he had to find a
u n i v e r s a l l y valid c a u s a t i o n and e n e r g y for t h e p r o d u c t i o n of d r e a m s . In
62
EXISTENTIAL
FOUNDATIONS
The
Fundamental
Conditionally
03
64
EXISTENTIAL
FOUNDATIONS
The
Fundamental
Conditionally
65
A c c o r d i n g t o t h e m o s t r e c e n t p s y c h o a n a l y t i c t h e o r y , this s t u d e n t o r
t h e p a t i e n t w o u l d begin b y losing his c o n n e c t i o n w i t h t h e p e r t i n e n t
o b j e c t i n t h e e x t e r n a l worldin this case, t h e e x a m i n e r . N e x t this
e x t e r n a l o b j e c t would be replaced by a m e r e r e p r e s e n t a t i o n . A t r u e
neurotic condition is said to arise at this point. T h e e x a m i n i n g p r o f e s s o r , at
h e a r t an a m i a b l e m a n i n t e r e s t e d in a d v a n c i n g t h e c a n d i d a t e , would take
o n t h e a p p e a r a n c e o f a n e n e m y o u t t o d e s t r o y h i m , and this would
a c t i v a t e r e s i s t a n c e t o t h e r e p r e s e n t a t i o n . T h e n would c o m e " o b j e c t - f r e e
psychic a c t i v i t y " during w h i c h h e m i g h t feel n o t h i n g b u t a n x i e t y , for
i n s t a n c e , o r d e s t r u c t i v e u r g e s . T h i s s t a t e would r e s e m b l e psychosis.
U l t i m a t e l y , e v e n the feeling o f a n x i e t y m i g h t go. T h e s t u d e n t would sit
petrified, s h o w i n g signs o f i n c r e a s e d blood p r e s s u r e and c o r o n a r y
activity, in a state of functionally disturbed somatic activity. W h e n a n x i e t y is
believed to o r i g i n a t e like this, it is n o t difficult to i m a g i n e t h e r e s u l t i n g
s t a t e b e c o m i n g p e r m a n e n t i n c e r t a i n c i r c u m s t a n c e s . P e r s o n a l i t y traits
would t h e n c o r r e s p o n d c l o s e l y to t h o s e found in t h e p s y c h o s o m a t i c a l l y ill
p a t i e n t s o f M a r t y e t al.
T h e t r o u b l e h e r e i s t h a t w e h a v e p r o o f a t o u r f i n g e r t i p s t h a t even this
m o s t r e c e n t m o d e l o f n e u r o s i s a i m s v e r y wide o f its m a r k : o b s e r v a b l e
h u m a n reality. It is simply n o t t r u e a n d a n y o n e willing to o b s e r v e
h i m s e l f o r o t h e r s can c o n v i n c e h i m s e l f o f t h i s t h a t s u c h a n e x a m i n e e
would find t h e e x t e r n a l o b j e c t , t h e p r o f e s s o r , replaced by a m e r e
e n d o p s y c h i c r e p r e s e n t a t i o n o f s o m e o n e b e n t o n his d e s t r u c t i o n . O n t h e
c o n t r a r y , an e x a m i n e e would be b o u n d h e a r t and soul to t h e p r o f e s s o r in
I ront of him. He would m e r e l y mistake him, but it is t h e p r o f e s s o r h i m s e l f
w h o w o u l d b e m i s t a k e n for a n e n e m y , n o t s o m e r e p r e s e n t a t i o n o f him i n
I h e s t u d e n t ' s p s y c h e . W e m a y dispense for the m o m e n t w i t h biographical
m a t t e r s t h a t m a k e this kind o f e r r o r inevitable. T h e point i s t h a t while i t
is o n e t h i n g to e n u m e r a t e e v e r y t h i n g in the s t u d e n t ' s life t h a t tends to
limit his perceptual ability, so t h a t o n l y t h e h o s t i l e t e n d e n c i e s of
a u t h o r i t y figures would be perceived, it is a n o t h e r thing a l t o g e t h e r to
66
EXISTENTIAL
FOUNDATIONS
The
Fundamental
Conditionality
07
10
A n y o v e r v i e w o f t h e s t a t e o f m o d e r n p s y c h o l o g y m a k e s i t clear t h a t
even
younger
psychologists,
too,
who
have
abandoned
the
p s y c h o a n a l y t i c b u t n o t t h e n a t u r a l s c i e n t i f i c a p p r o a c h a r e open t o t h e
c h a r g e o f giving t o o little t h o u g h t t o t h e s u p p o s i t i o n s b e h i n d t h e i r
m e t h o d o l o g y and t h e r e f o r e insufficiently r e s p e c t i n g l i m i t a t i o n s w h i c h
t h o s e s u p p o s i t i o n s i m p o s e . F o r if F r e u d seized on t h e n o t i o n of a psychic
u n c o n s c i o u s t o g e t o u t o f p r o v i n g t h e u n p r o v a b l e p a r t s o f his t h e o r y ,
t h e r e a r e p s y c h o l o g i s t s o f a n o t h e r n a t u r a l scientific p e r s u a s i o n t h e s e
days w h o e m p l o y t h e d u b i o u s t e c h n i q u e called b u r y i n g o n e ' s head i n t h e
sand. T h e y a r e t h e n o n m e d i c a l l y t r a i n e d p s y c h o l o g i s t s w h o r e t r e a t i n t o
neurology whenever the phenomena of human behavior present them
w i t h a difficulty. T h e s e p s y c h o l o g i s t s a r e o b v i o u s l y s u b j e c t to t h e s a m e
c r i t i c i s m w e applied e a r l i e r t o r e p r e s e n t a t i v e s o f t h e s o m a t i c t h e o r y o f
t h e p s y c h e . N o m a t t e r h o w n u m e r o u s o r diverse t h e findings o f
n e u r o l o g y m a y b e c o m e , t h e y will n e v e r b e able t o m a k e o n e part o f
human behavior understandable.
M a n y c o n t e m p o r a r y p s y c h o l o g i s t s , o f c o u r s e , u s e n a t u r a l scientific
t e c h n i q u e s o f m e a s u r e m e n t w i t h o u t r e s o r t i n g t o n e u r o l o g y . Y e t all t h e i r
o b j e c t s of i n v e s t i g a t i o n likewise p r e s u p p o s e a h u m a n c a p a c i t y for
perceiving t h e p r e s e n c e s of t h i n g s in t h e i r particular m e a n i n g f u l n e s s and
c o n t e x t o f r e f e r e n c e . B u t a s such, n e i t h e r the p r i m a r y p e r c e p t i o n o f a
p h e n o m e n o n , n o r its m e a n i n g f u l n e s s and c o n t e x t , s u b m i t s t o m e a s u r e
m e n t . C o n s e q u e n t l y , n o scientific p s y c h o l o g y can set forth t h e
c o n d i t i o n s for t h e p h e n o m e n a o f h u m a n b e h a v i o r , w h e t h e r t h e s e
p h e n o m e n a a r e called h u m a n c o n s c i o u s n e s s , p e r c e p t i o n , s e n s a t i o n ,
e x p e r i e n c e and m o t i v a t i o n , o r l e a r n i n g and r e a c t i n g .
Modern "scientific" branches of psychology congratulate themselves
for having " d e m y t h o l o g i z e d " h u m a n b e h a v i o r . B u t , to t a k e a case in
point, i s a n y t h i n g m o r e " m y t h o l o g i c a l " i n this s e n s e t h a n t h e s t a t e m e n t :
11
It is t h e r e f o r e my h y p o t h e s i s t h a t we e x p e r i e n c e c e r t a i n of the
p r o c e s s e s that o c c u r in t h e brain, but n o t o t h e r s . If this h y p o t h e s i s is
68
EXISTENTIAL
FOUNDATIONS
T h e v e r y n a t u r e o f n a t u r a l scientific ( q u a n t i f y i n g ) p s y c h o l o g i e s w h i c h
are not p s y c h o a n a l y t i c a l l y inclined limits t h e i r practical p e r f o r m a n c e to
c o m p a r a t i v e s t a t i s t i c a l a n a l y s e s . F o r t h e m e a n s o f n a t u r a l s c i e n c e can
only c o m p a r e t h e m o s t peripheral t r a i t s o f h u m a n b e h a v i o r w i t h e a c h
o t h e r . O n l y t h o s e t r a i t s can b e m a t h e m a t i c a l l y p r o c e s s e d a d d e d
together or subtracted from one anotherto produce average values.
C o n s e q u e n t l y , the c l o s e r a psychological i n v e s t i g a t i o n aims for t h e
n a t u r a l scientific ideal o f t r u t h , the m o r e e x t e r n a l l y f o r m a l , and
i n t e r n a l l y e m p t y , t h e scientific e l a b o r a t i o n s o f h u m a n b e h a v i o r m u s t
b e c o m e . T h e r e i s n o o t h e r w a y t o e x p r e s s b e h a v i o r statistically. T h i s i s a s
clear i n statistical a n a l y s e s o f t h e b e h a v i o r o f p a r e n t s w h o h a v e
s c h i z o p h r e n i c children as it is, for i n s t a n c e , in m a r k e t i n g a n a l y s e s or
statistical s u r v e y s o f large g r o u p s o r studies o f epidemic diseases d o n e o n
e n t i r e cities and r e g i o n s .
All of t h e s e studies m a y have c o n s i d e r a b l e t h e r a p e u t i c and p r o p h y l a c ti< application. B u t n o n e is likely to p r o m o t e f u n d a m e n t a l u n d e r s t a n d i n g
The
Fundamental
Conditionality
69
of h u m a n n a t u r e . In and of t h e m s e l v e s , q u a n t i f y i n g p s y c h o l o g i e s can do
n o m o r e t h a n locate and m e a s u r e c o n c r e t e p r o c e s s e s and c h a n g e s o f the
psychic aspect. T h e y are n o t equipped even to ask w h a t this psychic aspect
is or w h a t part it plays in m a k i n g a h u m a n life. W h a t is e s s e n t i a l in h u m a n
b e h a v i o r o u r p e r c e p t i o n s , a c t i o n s , and r e s p o n s e s i n t h e face o f d e m a n d s
made b y o t h e r people and w h a t s u r r o u n d s usis f r o m t h e o u t s e t b e y o n d
the p o w e r s of statistical c o m p u t a t i o n . Even F r e u d s p o k e in his practical
writings of greater freedom through psychoanalytic therapy, though
this principal w a s in radical o p p o s i t i o n to his o w n t h e o r y . A n a t u r a l
scientific, d e t e r m i n i s t i c basis for h u m a n freedom is a c o n t r a d i c t i o n in
terms.
S i n c e its inception, G e s t a l t t h e o r y has e m p h a s i z e d t h a t o u r initial
e x p e r i e n c e i s o f unified s t r u c t u r e s o f m e a n i n g f u l " G e s t a l t q u a l i t i e s . " T h e
w h o l e is n o t o n l y greater t h a n t h e sum of its p a r t s b u t also p r e c e d e s its
parts, since the w a y parts a r e p e r c e i v e d depends o n t h e G e s t a l t , t h e
w h o l e . B u t like its p r e d e c e s s o r , G e s t a l t p s y c h o l o g y r e m a i n s fixed o n a n
e n d o p s y c h i c e x p e r i e n c i n g o f s t r u c t u r e s . S t u m p f m e n t i o n s t h e possibility
t h a t u n k n o w n (that is, a s y e t u n k n o w n ) c o n s c i o u s c o n t e n t m a y b e t h e
p r e r e q u i s i t e for unified p e r c e p t i o n . O t h e r G e s t a l t t h e o r e t i c i a n s still
dispute w h e t h e r the e x p l a n a t i o n lies in c h e m o p h y s i c a l p r o c e s s e s and
"shifting force fields" in t h e c e r e b r a l c o r t e x or in u n c o n s c i o u s and
e x t r e m e l y rapid e v e n t s r a t h e r like t h e o b s e r v a b l e e n d o p s y c h i c p r o c e s s e s
of calculating, m a k i n g a j u d g m e n t , or r e a c h i n g a c o n c l u s i o n . For o t h e r
t h e o r i s t s , G e s t a l t f o r m a t i o n t a k e s place "in the p r i m i t i v e m a t e r n a l soil o f
f e e l i n g . " A n d , again, t h e r e i s C o n r a d ' s e n d o p s y c h i c "field o f e x p e r i e n c e "
o n t o w h i c h o b j e c t s o f t h e e x t e r n a l w o r l d are p r o j e c t e d a s i m a g e s , w i t h
c h a n g i n g " e m p h a s i s given t o t h e basic c o n f i g u r a t i o n . "
W e can o n l y r e p e a t t h a t t h e r e i s n o h u m a n e v i d e n c e y e t t o a r g u e for t h e
actual o c c u r r e n c e o f this s o r t o f e n d o p s y c h i c , r e p r e s e n t a t i o n a l " c o n
scious c o n t e x t , " and t h a t t h e s e n o t i o n s are h y p o t h e t i c a l i n v e n t i o n s .
G e s t a l t t h e r a p y h a s n o t c o m e u p w i t h any e x p l a n a t i o n for t h e p i c t u r e i t
offers.
W h a t w e perceive f r o m t h e o u t s e t , r a t h e r , a r e v a r i o u s i n a n i m a t e
o b j e c t s , living c r e a t u r e s , fellow h u m a n b e i n g s , and w h a t e v e r else w e
c o m e u p o n o u t t h e r e i n the w o r l d , w h e r e t h e y address t h e m s e l v e s t o us,
w i t h all t h e i r c o l l e c t i o n s of r e l a t i o n s h i p s and f r a m e s of r e f e r e n c e in t i m e
and space. T h e q u e s t i o n o f h o w precisely o r i m p r e c i s e l y t h e s e t h i n g s
s h o w t h e m s e l v e s to us is of s e c o n d a r y i m p o r t a n c e .
T h e i n n a t e s t r u c t u r e s p r o p o s e d b y c u r r e n t a n i m a l p s y c h o l o o y are
likewise e n d o p s y c h i c o r c e r e b r a l i n n a t u r e and t h e r e f o r e elso e n t i r e l y
h y p o t h e t i c a l . O f c o u r s e , a n i m a l p s y c h o l o g i s t s believe t h a t t h e i r
e x p e r i m e n t s , w h i c h u s e so-called c o n t r o l l e d s i t u a t i o n s , succeed in
70
EXISTENTIAL
FOUNDATIONS
e s t a b l i s h i n g identity b e t w e e n t h e i r o w n a s s u m e d i n t e r n a l s c h e m e s and
t h e actual e v e n t s . B u t a t best, controlled e x p e r i m e n t s can d e m o n s t r a t e
t h e e x t e n t to w h i c h a c r e a t u r e can be deceived by an e x p e r i m e n t e r . T h e y
tell u s n o t h i n g a b o u t t h e e x i s t e n c e o r n o n e x i s t e n c e o f i n n a t e , i n h e r i t e d
s t r u c t u r a l c o n f i g u r a t i o n s within an o r g a n i s m , n o r do t h e y help
illuminate t h e ability to p e r c e i v e a thing as s o m e t h i n g .
W e have s e e n t h a t r e c e n t psychological t h e o r i e s o f layers i n t r o d u c e d
m a n y m e t a p h y s i c a l c o n c e p t s like field of c o n s c i o u s n e s s , s u b j e c t , self,
e x i s t e n c e , and e n t e l e c h y i n t o medicine. T h e m o r e s h a l l o w psychic layers
a r e allowed to s t a n d on t h e i r o w n as primal m e n t a l e n t i t i e s , and t h e i r
g r e a t e s t possible e x t e n s i o n i n t o t h e o r g a n i s m and the deeper psychic
f u n c t i o n s is seen as the end c a u s e of all layer f o r m a t i o n . T h e primal upper
psychic l a y e r s are the place of t h a t h u m a n f r e e d o m and r e s p o n s i b i t i t y
w h i c h n a t u r a l s c i e n c e c a n n o t grasp, and r e s p o n s i b i l i t y and c o n s c i e n c e are
w h a t actually defined self, s u b j e c t , e x i s t e n c e , and e n t e l e c y , in t h e m s e l v e s
and a g a i n s t h i g h e r t h i n g s . But a s far a s w e k n o w , n o n e o f t h e s e t h e o r i e s
o f layers g e t s t h r o u g h t o the q u e s t i o n o f the specific n a t u r e o f psychic
layers, t h o u g h only an a d e q u a t e a n s w e r to this q u e s t i o n can m a k e
r e s p o n s i b i l i t y and c o n s c i e n c e c o m p r e h e n s i b l e . T h e n o t i o n o f a s u p r e m e
e n t e l e c h y is, as a scientific h y p o t h e s i s , p u r e i n f e r e n c e . No d i s c e r n i b l e
p h e n o m e n o n o f h u m a n e x i s t e n c e o f f e r s p r o o f for t h e actual p r e s e n c e o f
any entelechy.
T h e latest t r e a t i s e o f H . E y i s b a s e d n o d o u b t b o r r o w i n g from the
field t h e o r y of m o d e r n p h y s i c s o n t h e n o t i o n of a h u m a n field of
c o n s c i o u s n e s s . Ey himself, h o w e v e r , admits t h a t t h e t e r m , derived from a
m e r e i n f e r e n c e , is n o t h i n g m o r e than a " h y p o t h e t i c a l t r a n s c r i p t i o n " of
c o n s c i o u s n e s s . S e c o n d l y , his definition allows him to d e s c r i b e o n l y t h e
b e h a v i o r and n o t t h e actual n a t u r e of this a s s u m e d field of c o n s c i o u s n e s s .
A n d his description of this field of c o n s c i o u s n e s s as an o r d e r e d s t r u c t u r e
does n o t help us v e r y m u c h ; a rock c r y s t a l is also an o r d e r e d s t r u c t u r e , yet
it can n e v e r p e r c e i v e a t h i n g as s o m e t h i n g t h a t m e a n s this or that.
In trying to define h u m a n c o n s c i o u s n e s s on t h e basis of its ability to
c o n s t r u c t a model w o r l d from v a r i o u s e x p e r i e n c e s and t h e n to a r r a n g e
actual e x p e r i e n c e s to f o r m a field, Ey p u t s this definition u n d e r t h e s a m e
r e s e r v a t i o n s t h a t apply to all h y p o t h e s i s of r e p r e s e n t a t i v e e n d o p s y c h i c
c o n s c i o u s c o n t e n t . F u r t h e r m o r e , the c o n s t r u c t i o n of a model w o r l d
p r e s u m e s prior a w a r e n e s s , a k n o w l e d g e t h a t a t h i n g is s o m e t h i n g in
particular, a p a r t i c u l a r u n d e r s t a n d i n g of t h e w o r l d . Ey's " c o n s c i o u s n e s s , "
in c o n s t r u c t i n g , a r r a n g i n g , and o r d e r i n g e x p e r i e n c e , directs itself to
things w h i c h c a n n o t e x i s t at all if t h e r e is n o t prior a w a r e n e s s .
E x p e r i e n c e is always of s o m e t h i n g specific, of s o m e t h i n g as being
s o m e t h i n g , of s o m e t h i n g we s o m e h o w already h a v e a s e n s e of. Ey
The
Fundamental
71
Conditionally
72
EXISTENTIAL
FOUNDATIONS
s t r i k i n g l y similar t o p s y c h o a n a l y t i c i n t e r p r e t a t i o n s . T h e m o s t a p p a r e n t
similarity i s t h e c o n s t r u c t i o n o f f u n d a m e n t a l opposition a m o n g t h e
d y n a m i c f a c t o r s o f d e s t r u c t i v e a g g r e s s i o n , t h e u r g e t o o r d e r , and e r o t i c
d e v e l o p m e n t . B u t t h e precise n a t u r e of t h e subject as it is v i e w e d by t h e s e
t h e o r i e s r e m a i n s u n c l e a r . Fifteen y e a r s b e f o r e , M a r t i n H e i d e g g e r said o f
t h e field: " A n t h r o p o l o g y i s t h a t i n t e r p r e t a t i o n o f m a n w h i c h k n o w i n g i n
a d v a n c e w h a t m a n basically i s can n e v e r ask w h a t h e is. T h e q u e s t i o n
would b e a n a d m i s s i o n o f s h a k i n e s s and defeat. H o w can a n t h r o p o l o g y b e
e x p e c t e d to ask this q u e s t i o n w h e n its sole t a s k is to s h o r e up t h e selfcertainty of the s u b j e c t ? "
B e c a u s e o f this failing, t h e c o n c r e t e
m a n i f e s t a t i o n s o f h u m a n b e h a v i o r r e m a i n u n c l e a r and inaccessible t o t h e
e x i s t e n t i a l p s y c h o l o g i e s and psychological a n t h r o p o l o g i e s w h i c h , like
p s y c h o a n a l y s i s , w o u l d i l l u m i n a t e dark places w i t h s u p p o s i t i o n s t h a t are
even more obscure.
American ego psychology, always m o r e oriented to the h u m a n
e n v i r o n m e n t , physical and i n t e r p e r s o n a l , t h a n E u r o p e a n p s y c h o l o g i e s ,
claims t h a t from his b e g i n n i n g s m a n lives in an i n t e r p e r s o n a l r e a l m and
e x i s t s primarily i n his i n t e r s u b j e c t i v e r e l a t i o n s and e x c h a n g e s w i t h o t h e r
people. W h i l e t h e s e s t a t e m e n t s r e p r e s e n t a g r e a t a d v a n c e , the
i n t e r s u b j e c t i v e r e l a t e d n e s s of m a n is viewed o n l y as a psychologically
describable p r o p e r t y , an unclarified p s y c h e , b u t n o t as an e s s e n t i a l
d e t e r m i n a n t o f h u m a n n a t u r e itself.
1 5
S i m i l a r ideas a b o u t h u m a n e x i s t e n c e developed i n d e p e n d e n t l y in
E u r o p e , c u l m i n a t i n g in t h e a s s e r t i o n t h a t m a n actually lives in a
" b e t w e e n . " B u b e r ' s " I , " " t h o u , " and ' w e " s c h e m e f o u n d global r e s o n a n c e
i n c o n t e m p o r a r y p s y c h o l o g y . Y e t even i n this " t h e o r y o f d i a l o g u e " t h e
n a t u r e of m a n is n o t e x p l a i n e d clearly e n o u g h to c o n v i n c e us t h a t it is
m a n k i n d as a w h o l e and n o t o n l y t h e t e s t c a s e t h a t can be e x p e r i e n c e d as
a n " I , " " t h o u , " and " w e . " O n e thing o n l y e m e r g e s w i t h c e r t a i n t y t h a t all
of t h e s e p s y c h o l o g i e s of dialogue posit h u m a n b e i n g s as individual
s u b j e c t s i n h e r e n t l y opposed to e a c h o t h e r . A " b e t w e e n " can take place
only a m o n g a t least t w o s e l f - c o n t a i n e d , and s e l f - s u p p o r t i n g , e n t i t i e s . W e
c a n n o t learn f r o m t h e s e t h e o r i e s h o w t h e s e s u b j e c t i v e poles are m a d e s o
t h a t t h e y e n t e r i n t o r e l a t i o n s h i p s o f a n y kind w i t h o n e a n o t h e r
e s s e n t i a l o r i n e s s e n t i a l , direct o r indirect, i n t i m a t e o r r e m o t e .
Because of their inadequate determinations of human nature,
a n t h r o p o l o g i c a l p s y c h o l o g i e s and p s y c h o l o g i e s of dialogue also fail to
establish a s o u n d basis for an a d e q u a t e l y h u m a n m e d i c i n e . I n s t e a d of
clarifying t h e basic n a t u r e o f h u m a n e x i s t e n c e t h e m s e l v e s , b o t h
p s y c h o l o g i e s adopt a f e w traditional W e s t e r n v i e w s of m a n w h i c h h a v e
e m e r g e d in the c o u r s e of h i s t o r y and t h e n u s e t h e s e c o n c e p t i o n s to
support their o w n d e t e r m i n a t i o n s . T h e n a m e s b y which these'
conceptions go"subjectivity," "self," "existence," " I , " "thou," " w e , "
"basic t r u s t , " or "basic d i s t a n c e " m a k e little d i f f e r e n c e .
The
Fundamental
Conditionality
73
T h e s e o b j e c t i o n s n o t w i t h s t a n d i n g , c o n t e m p o r a r y b r a n c h e s o f psy
c h o l o g y and p s y c h o p a t h o l o g y h a v e c o m e a long w a y since Freud's
b e g i n n i n g , h e e x t r e m e l y n a r r o w original f r a m e w o r k f o r m e d b y the
n o t i o n of a primarily a u t o e r o t i c , t o t a l l y n a r c i s s i s t i c p s y c h i c apparatus
w a s exploded long ago. W h i l e t h e m a i n focus w a s for a t i m e t h e various
s t r u c t u r e s and p r o c e s s e s a s s u m e d t o e x i s t w i t h i n t h e individual p s y c h e ,
t h e i n t e r e s t o f p s y c h o l o g i s t s s o o n e x p a n d e d t o include e v e r l a r g e r
c o m p l e x e s o f social r e l a t i o n s h i p s , w h i c h w e r e s e e n m o r e and m o r e a s the
primary phenomena of human existence.
But in the meantime, the phrases current in the most recent theories
" i n t e r s u b j e c t i v e r e l a t i o n s h i p s " and " i n t e r a c t i o n s " a r e n o m o r e t h a n
e x p r e s s i o n s g r o p i n g in t h e dark. T h i s s i t u a t i o n will n o t be r e m e d i e d until
s c i e n c e h a s actually discovered t h e c o n d i t i o n s t h a t m a k e s u c h r e l a t i o n
ships possible.
PSYCHOSOMATIC HYPOTHESES
W e h a v e s h o w n t h a t i n t e r p r e t a t i o n s based o n t h e traditional
f o u n d a t i o n s o f m e d i c i n e could h a n d l e n e i t h e r t h e e x c l u s i v e l y s o m a t i c
m a n i f e s t a t i o n s o f o u r t e s t s u b j e c t , n o r h e r purely psychic b e h a v i o r . T h e y
p a r t i c u l a r l y failed t o c o m e t o t e r m s w i t h R e g u l a Z i i r c h e r ' s p s y c h o s o m a t
ic m a n i f e s t a t i o n s . Y e t p s y c h o s o m a t i c medicine itself s t a n d s helpless
h e r e , and n o t only w i t h r e s p e c t to o u r particular case, as it faces t h e
h e r c u l e a n t a s k o f d i f f e r e n t i a t i n g and c o r r e l a t i n g t w o c o n c e p t s , n e i t h e r o f
w h i c h h a s b e e n a d e q u a t e l y or appropriately elucidated by t h e s c i e n c e of
m e d i c i n e . T h e s e t w o c o n c e p t s are p s y c h e and s o m a .
P s y c h o s o m a t i c m e d i c i n e usually d i s t i n g u i s h e s b e t w e e n t h e t w o b y
saying t h a t t h e s o m a can b e w e i g h e d and m e a s u r e d , w h e r e a s the psychic
aspect is o n l y intuitively p e r c e i v a b l e . In m a k i n g this claim, h o w e v e r ,
p s y c h o s o m a t i c m e d i c i n e h a s o v e r s t e p p e d its b o u n d s as a n a t u r a l s c i e n c e .
In voicing an opinion c o n c e r n i n g t h e e s s e n t i a l c h a r a c t e r of t h e reality of
s o m e actual being, t h e b e i n g n e s s of s o m e being, it is in fact p h i l o s o p h i z
ing, and this is n o t t h e affair of a science. M o r e o v e r , the n o t i o n s of
m e a s u r a b i l i t y and i m m e a s u r a b i l i t y are n o t c r i t e r i a i n t r i n s i c t o the
psychic and s o m a t i c a s p e c t s o f t h e m s e l v e s . T h e fact t h a t s o m e t h i n g i s
m e a s u r a b l e tells u s n o t h i n g a b o u t the n a t u r e o f t h e t h i n g itself;
m e a s u r e m e n t is j u s t a w a y by w h i c h t h e i n v e s t i g a t o r a p p r o a c h e s t h e
object he is investigating. T h e definitions that result from characterizing
the t w o a s p e c t s on such a basis a r e , t h e n , highly s u b j e c t i v e .
W h a t m a t t e r s m o r e , h o w e v e r , is a s e l f - c o n t r a d i c t i o n in w h i c h this
c r i t e r i o n of m e a s u r a b i l i t y e n t a n g l e s p s y c h o s o m a t i c medicine. It is a
f u n d a m e n t a l c o n t r a d i c t i o n t o a t t r i b u t e i m m e a s u r a b i l i t y t o t h e psychic
74
EXISTENTIAL
FOUNDATIONS
aspect w h i l e i n t h e s a m e b r e a t h d e m a n d i n g for p s y c h o s o m a t i c
r e l a t i o n s h i p s p r o o f s t h a t w o u l d c o n v i n c e e v e n a physician schooled in t h e
n a t u r a l scientific o r i e n t a t i o n .
A n a t u r a l scientific proof, if it f u n c t i o n s according to its a x i o m t h a t
e v e r y t h i n g actual is also calculable, m u s t a l w a y s place the m a t t e r s it
i n v e s t i g a t e s i n t o a set of r e l a t i o n s t h a t c o r r e s p o n d to this law, w h i c h can
be m e a s u r e d and e x p r e s s e d in n u m b e r s . B u t the actuality of a
r e l a t i o n s h i p b e t w e e n t w o t h i n g s can be so p r o v e n o n l y if each is
m e a s u r a b l e and q u a n t i f i a b l e . If t h e p s y c h i c e n t i t y is by definition
i m m e a s u r a b l e , it follows t h a t the possibility of a valid, n a t u r a l scientific
p r o o f for a p s y c h o s o m a t i c r e l a t i o n s h i p is precluded. T h e basis for a
calculated p r o o f would have to be e n t i r e l y s o m a t i c in n a t u r e , for o n l y t h e
s o m a t i c aspect of h u m a n being can be m e a s u r e d . A p r o o f b a s e d on o n l y
o n e o f t h e t w o t e r m s o f t h e r e l a t i o n s h i p can affirm n o t h i n g a b o u t t h e
p s y c h o s o m a t i c r e l a t i o n s h i p itself. It leaves t h e psychic aspect a l t o g e t h e r
out of consideration.
T h e d e m a n d for a n a t u r a l scientific (i.e., quantifiable) p r o o f of t h e
p s y c h o s o m a t i c r e l a t i o n s h i p is n o t only f u n d a m e n t a l l y i m p o s s i b l e b u t
w h o l l y unjustified a s well. T h i s d e m a n d g r o w s n o t o u t o f t h e m a t t e r
u n d e r i n v e s t i g a t i o n but c o m e s from the traditional n a t u r a l scientific
r e q u i r e m e n t t h a t all reality be empirically m e a s u r a b l e . B e h i n d this
r e q u i r e m e n t is a d o g m a t h a t puts t r e m e n d o u s r e s t r i c t i o n s on t h e scope of
reality, and, w h a t is m o r e i m p o r t a n t , is n o t itself open to a n y s o r t of
scientific c o n f i r m a t i o n . T h u s , t h e failure of such a poorly founded p r o o f
does n o t p r e c l u d e t h e actual r e l a t e d n e s s o f w h a t i s c o m m o n l y s e p a r a t e d
and given t h e n a m e s " p s y c h i c " and " s o m a t i c . "
T h i s being so, e v e n p s y c h o s o m a t i c m e d i c i n e m u s t u n d e r s t a n d h o w
i m p o r t a n t it is to see t h a t a strictly scientific s e p a r a t i o n a d e q u a t e to each
o f the t w o r e s u l t i n g o b j e c t s o f study would b e possible o n l y a f t e r
bringing to light t h e similarities t h a t n e c e s s i t a t e a s e p a r a t i o n . E v e n t w o
p r o p e r t i e s as e l e m e n t a r y as the r e d n e s s and g r e e n n e s s of a thing can be
distinguished only i f w e h a v e already g r a s p e d t h e significance o f c o l o r .
B o t h red and g r e e n are s u b s u m e d u n d e r t h e c o m m o n c a t e g o r y " c o l o r . "
By c o n t r a s t , " r e d " and " h e a v y " do n o t b e l o n g to a c o m m o n c a t e g o r y , and
t h u s n o t h i n g m e a n i n g f u l can c o m e o u t o f a n a t t e m p t t o distinguish
between them.
Traditional psychosomatic medicine generally construes the one thing
uniting b o t h p s y c h e and s o m a to be t h e u n i f o r m i n t e r a c t i o n w i t h i n a
p s y c h o p h y s i c a l o r g a n i s m . B u t this s o r t o f n o t i o n o b j e c t i f i e s t h e
u n d e r l y i n g h u m a n n a t u r e i n such a n e x t r e m e and i n a p p r o p r i a t e m a n n e r
that not even t h e simplest p s y c h o s o m a t i c p h e n o m e n o n is m a d e
comprehensible.
The
Fundamental
Conditionality
76
EXISTENTIAL
FOUNDATIONS
The
Fundamental
Conditionality
77
78
EXISTENTIAL
FOUNDATIONS
NOTES
1. S.
Freud,
Vorlesungen
zur
Einfhrung
in
die
Psychoanalyse,
in
Gesammelte
Werke,
vol.
II
( L o n d o n : I m a g o , Inc., 1 9 4 0 ) , p. 6 2 .
2. S. F r e u d ,
3. S.
Die Traumdeutung,
Freud,
in
14 ( L o n d o n :
Gesammelte
1 9 4 8 ) , p.
Werke,
vol,
123.
2/3 (London:
1 9 4 2 ) , p.
604).
4 . K . J a s p e r s , Allgemeine Psychopathologie ( B e r l i n : I. S p r i n g e r , 1 9 2 3 ) , p. 2 3 .
5. Freud, op.
at.
(Gesammelte
Werke,
vol. p.
162.
Gesammelte
Werke, vol.
7 (London:
Imago,
1 9 4 1 ) , p.
243ff.
chez
I'enfant;
Le
symbolisme
mconsaent
et
les
schemes
affectives,
3rd
ed.
(Neuchatel:
Delachauxet Nieshe, 1 9 6 4 ) .
10.See
O.
W.
Haseloff,
ed.,
Struktur
und
Dynamik
des
menschlichen
Verhallens.
(Stuttgart,
p.
Heidegger,
103.
Holzwege:
Die Zeil
des
Weltbildes
182.
(Frankfurt-am-Main:
Klostermann,
Part II
An Adequately H u m a n
Foundation for Medicine
Chapter 6
APPLYING THE EXISTENTIAL OUTLOOK TO SOME
ASPECTS OF THE TEST CASE
S e e i n g h e r l o v e r a c r o s s t h e s t r e e t , R e g u l a Z i i r c h e r d a s h e d o v e r and
kissed and h u g g e d h i m a s t h o u g h this w e r e t h e m o s t n a t u r a l t h i n g i n t h e
world. T h e n t h e couple strolled h o m e a r m i n a r m , discussing plans for
I heir c o m i n g v a c a t i o n in t h e C a n a r y Islands on t h e w a y . All in all, this
looks like an u n c o m p l i c a t e d s e q u e n c e of e v e n t s . B u t it is w o r t h asking
what new aspects might turn up if we examined this sequence in a way
t h a t a l l o w e d t h e e v e n t s t o speak for t h e m s e l v e s and kept e x c l u s i v e l y t o
w h a t t h e y r e v e a l e d directly.
A s R e g u l a Z i i r c h e r w a l k e d along t h e main s t r e e t o f h e r t o w n b e f o r e
she ran i n t o h e r lover, h e r a t t e n t i o n w a s f o c u s s e d o n c l o t h e s s h e w a s
going t o b u y for t h e v a c a t i o n . N o t w i t h s t a n d i n g t h e spell t h e s e c l o t h e s
( ast, s h e w a s fully a w a r e of t h e s i d e w a l k on w h i c h s h e walked, of fleeting
g l i m p s e s o f people h u r r y i n g by, o f t h e sign o f park r u l e s s h e had t o s t e p
a r o u n d , and o f d o z e n s o f o t h e r t h i n g s s h e e n c o u n t e r e d . T h o u g h t h e s e
things did n o t h a v e t h e s a m e s o r t o f i m m e d i a t e , f o r e g r o u n d p r e s e n c e a s
the c l o t h e s s h e w a s c o n c e n t r a t i n g o n , t h e y w e r e j u s t a s m u c h t h e r e for
her, helping d e t e r m i n e h e r walk. W i t h o u t perceiving t h e i r p r e s e n c e and
s i g n i f i c a n c e , h o w e v e r p e r i p h e r a l and u n t h e m a t i c this p e r c e i v i n g m a y
h a v e b e e n , s h e w o u l d n e v e r h a v e b e e n able t o find h e r w a y . Y e t i t w a s n o t
only t h e m o m e n t a r i l y p r e s e n t t h i n g s o f h e r world t h a t w e r e t h e r e i n
EXISTENTIAL
82
FOUNDATIONS
t h e i r a p p r o p r i a t e places. H e r walk w a s c o d e t e r m i n e d , s i m u l t a n e o u s l y , b y
e v e r y t h i n g t h a t had e v e r b e e n ; she w o u l d n o t h a v e had t h e n o t i o n t o buy
a n e w w a r d r o b e had s h e n o t r e m a i n e d c o n c e r n e d w i t h h e r old, w o r n - o u t
c l o t h e s . A n d a p p r o a c h i n g h e r from t h e f u t u r e w a s h e r v a c a t i o n . I t w a s
h e r r e l a t i o n t o t h e f u t u r e , a b o v e all, t h a t m o t i v a t e d h e r walk during t h e
present.
A l t h o u g h s h e w a s n o t t h i n k i n g p a r t i c u l a r l y o f h e r l o v e r o n this o u t i n g ,
her relationship to him continued as much more than the mere cerebral
e n g r a m posited by n e u r o p h y s i o l o g y . He had, in fact, n e v e r stopped being
p r e s e n t t o h e r , o u t s i d e , i n t h e w o r l d t h e y b o t h s h a r e d , even w h e n h e had
disappeared f r o m h e r optical field of vision at t h e i r last parting and could
n o l o n g e r s t i m u l a t e h e r r e t i n a l cells. C e r t a i n l y , his p r e s e n c e did n o t
persist in such a w a y t h a t s h e w a s pointedly a w a r e of him e v e r y m o m e n t ,
b u t he r e m a i n e d an i m p o r t a n t c o d e t e r m i n a n t in t h e affairs of h e r life.
Because of this, Regula Ziircher's unexpected sighting of her lover
c a n n o t b e called " r e - c o g n i t i o n . " T h e r e i s n o " r e - " a b o u t t h e m a t t e r , since
h e had n e v e r disappeared from h e r w o r l d . T h o u g h , since t h e y had last
seen e a c h o t h e r , his p r e s e n c e m a y s o m e t i m e s h a v e g r o w n v e r y dim, h e
w a s n o n e t h e l e s s a l w a y s t h e r e . All t h a t c h a n g e d in this physical
e n c o u n t e r w a s t h e m o d e of his p r e s e n c e in h e r w o r l d , in w h i c h a d i s t a n t
p r e s e n c e w a s t r a n s f o r m e d i n t o a n i m m e d i a c y s h e could see and t o u c h .
A n o t h e r p h e n o m e n o n t h a t d e s e r v e s a t t e n t i o n i s t h e feeling t h a t c a m e
with her e n c o u n t e r with her lover. If we restrict ourselves to
d e m o n s t r a b l e , o b j e c t i v e findings, t h e r e can be no talk of a feeling or
e m o t i o n a s a n e n t i t y p r e s e n t w i t h i n t h e p s y c h e . All w e m a y factually
s t a t e is t h a t as a h u m a n r e l a t i o n s h i p R e g u l a Z i i r c h e r ' s e n c o u n t e r w i t h
h e r l o v e r w a s happily disposed. T h e u n e x p e c t e d c h a n c e t o b e close t o h i m
a t o n c e c h a n g e d h e r m o o d o f n e u t r a l i t y t o w a r d t h e world, the
a n o n y m o u s p a s s e r s - b y , and s h o p w i n d o w s , i n t o a m o o d o f h a p p i n e s s .
W h a t b e c a m e a t t u n e d t o h a p p i n e s s w a s n o t j u s t s o m e t h i n g within R e g u l a
Z r c h e r , b u t R e g u l a Z r c h e r h e r s e l f , h e r w h o l e e x i s t e n c e . T h i s happy
h u m o r did n o t o r i g i n a t e w i t h this e n c o u n t e r . T h e p o t e n t i a l for b e i n g
a t t u n e d t o h a p p i n e s s had always b e e n a n i n n a t e part o f h e r e x i s t e n c e , a s
it is of e v e r y h u m a n e x i s t e n c e . T h e physical n e a r n e s s in the e n c o u n t e r
w i t h h e r l o v e r simply allowed h e r to live this p o t e n t i a l .
To an outside observer, the most striking manifestation in her
e n c o u n t e r would h a v e b e e n the m o v e m e n t o f h e r b o d y from o n e side o f
the s t r e e t t o t h e o t h e r . R e g u l a Z r c h e r h e r s e l f , h o w e v e r , did n o t s e n s e
the p r e s e n c e of a body, or of a p s y c h e or psychic drives t h a t seized this
body and impelled it into m o t i o n . W h a t a scientific o b s e r v e r would
i n t e r p r e t as a physical body m o v i n g t h r o u g h space appears, from the
standpoint ol the p h e n o m e n o n itself, as t h e approach of R e g u l a
1
Outlook
83
84
EXISTENTIAL
FOUNDATIONS
Chapter 7
FUNDAMENTAL CHARACTERISTICS OF
HUMAN BEINGS
Preliminary remarks
S i n c e h u m a n beings c a n n o t q u a l i t a t i v e l y p e r c e i v e o r u n d e r s t a n d
e x c e p t i n light o f s o m e p r i o r i n s i g h t s into the m e a n i n g and n a t u r e o f each
thing t h e y p e r c e i v e , w e should n o w direct o u r a t t e n t i o n t o explicating
the f u n d a m e n t a l c h a r a c t e r i s t i c s o f h u m a n being, using e x a m p l e s o f
h e a l t h y p h e n o m e n a from R e g u l a Z i i r c h e r ' s life t o i l l u m i n a t e t h e s e traits.
T h e m o r e strictly o u r d e s c r i p t i o n o f t h e t r a i t s o f h e a l t h y e x i s t e n c e
a d h e r e s t o t h e i r h u m a n c h a r a c t e r , the m o r e solid this e x i s t e n t i a l
f o u n d a t i o n for m e d i c i n e will b e . O u r e x a m i n a t i o n o f t h e s e t r a i t s , t h e n ,
will be a n y t h i n g but a philosophical diversion. It is a c o n s i d e r a t i o n of
e v e r y t h i n g a b o u t t h e actual m o d e o f h u m a n e x i s t e n c e t h a t h a s s o far
been o v e r l o o k e d by, o r b e e n i n a c c e s s i b l e to, the n a t u r a l s c i e n c e s .
L e t us begin by asking in w h a t w a y , and as w h a t , m a n m a n i f e s t s
h i m s e l f . T h e a n s w e r c l o s e s t t o hand h a s long b e e n t h a t m a n ' s e x i s t e n c e i s
such t h a t he is p r e s e n t in a w o r l d , and t h a t m a n ' s p r e s e n c e in this w o r l d is
such t h a t as long as he is h e r e , he is to be found, at any g i v e n t i m e , at s o m e
particular point i n space. T h u s w e are led t o t h e i n f e r e n c e t h a t h u m a n
beings a r e , along w i t h e v e r y t h i n g else that is, s o m e h o w in space and in
time.
T h e first task of m e d i c i n e as a strictly rational s c i e n c e of m a n is to
define precisely p r e s c i e n t i f i c n o t i o n s of " s o m e w h e r e in s p a c e " and
86
EXISTENTIAL FOUNDATIONS
Fundamental
Characteristics of Human
Beings
87
88
EXISTENTIAL
FOUNDATIONS
Fundamental
Characteristics of Human
Beings
89
90
EXISTENTIAL
FOUNDATIONS
In t h e f o r m of p e r c e p t i v e c o n n e c t i o n s w i t h all it e n c o u n t e r s , each
h u m a n e x i s t e n c e spans t h e open spatiality o f its o w n world, s u s t a i n i n g i t
and m a i n t a i n i n g its e c - s t a t i c f r e e d o m . If this w e r e n o t so, n o t h i n g could
e n t e r t h e field of vision of a h u m a n e x i s t e n c e in its actual significance and
shine f o r t h . H u m a n e x i s t e n c e i s c o n t i n u a l l y o p e n t o t h e claim o f each
thing it e n c o u n t e r s , is i n h e r e n t l y o p e n to c o m p r e h e n d i n g t h e possiblity
o f t h e i r b e i n g s o m e t h i n g r a t h e r t h a n n o t h i n g a t all.
A n o t h e r c o n s i d e r a t i o n , no less i m p o r t a n t , is t h a t to e x i s t as a h u m a n
being is to be r e c e p t i v e l y o p e n n o t m e r e l y in a passive or u n s p e a k i n g w a y .
H u m a n e x i s t e n c e i s n o t m e r e l y a n open space i n t o w h i c h o t h e r t h i n g s can
be i n s e r t e d , as f u r n i t u r e is put i n t o an e m p t y r o o m . It is n o t m e r e l y
r e c e p t i v e to t h e e x t e n t t h a t it passively r e c e i v e s and r e c o r d s t h e p r e s e n c e
and m e a n i n g f u l n e s s o f w h a t e v e r a d d r e s s e s it. H u m a n e x i s t e n c e i s
r e s p o n s i v e , able t o r e l a t e i t s e l f t o t h i n g s , a n s w e r t h e m i n p a r t i c u l a r w a y s .
A n y o n e w h o insists t h a t all t h i n g s b e r e g a r d e d a s i n a n i m a t e o b j e c t s
e x i s t i n g in and of t h e m s e l v e s at s o m e specific location in space, w h o
would i n t e r p r e t e v e n h u m a n b e i n g s a s psychic a p p a r a t u s e s a n a l o g o u s t o
the c a m e r a or t h e t e l e s c o p e , will n a t u r a l l y r e m a i n blind to t h e peculiar
n a t u r e o f h u m a n r e c e p t i v e o p e n n e s s t o t h e significance o f w h a t i t
e n c o u n t e r s . Y e t this r e c e p t i v i t y i s t h e o n l y e x p l a n a t i o n for m a n ' s ability
t o b e s i m u l t a n e o u s l y h e r e and t h e r e w i t h w h a t e v e r h e p e r c e i v e s . H u m a n
beings are, as an open, clear r e a l m of p e r c e p t i o n , so e s s e n t i a l l y spatial t h a t
t h e y dwell from t h e b e g i n n i n g with w h a t e v e r is a c c e s s i b l e to p e r c e p t i o n ,
and in a w a y suited to t h e m e a n i n g t h e y p e r c e i v e .
D i s t a n c e s b e t w e e n i n a n i m a t e o b j e c t s can be m e a s u r e d w i t h a s t a n d a r d ,
but an i n h e r e n t l y d i f f e r e n t m e a s u r e applies to d i s t a n c e s in the h u m a n
world. In people, c l o s e n e s s and d i s t a n c e c o n c e r n if and h o w w h a t we
e n c o u n t e r m a t t e r s to us. A friend w h o m a y be t h o u s a n d s of miles apart
from m e , is i n c o m p a r a b l y c l o s e r to me t h a n t h e c o n c r e t e I am w a l k i n g on
right n o w , t h o u g h t h e r e is no physically m e a s u r a b l e d i s t a n c e at all
s e p a r a t i n g it from t h e soles of my s h o e s .
If m a n did n o t e x i s t as a w o r l d - s p a n n i n g r e c e p t i v e r e a l m of p e r c e p t i o n ,
if he w e r e n o t e n g a g e d in this capacity, n o t h i n g at all could e x i s t . " B e i n g , "
i n its traditional u s a g e , m e a n s " p r e s e n c e " and " p e r s i s t e n c e . " T o a c h i e v e
p r e s e n c e , and t h e r e b y being, a n e n t i t y r e q u i r e s s o m e s o r t o f o p e n r e a l m
i n w h i c h p r e s e n c e and p e r s i s t e n c e can take place. T h u s a n o p e n r e a l m o f
p e r c e p t i o n like t h a t of h u m a n e x i s t e n c e is the o n e being t h a t m a k e s being
possible.
T h i n g s can appear in this open r e a l m of p e r c e p t i o n in a wide r a n g e of
locations and p e r s p e c t i v e s . F o r i n s t a n c e , an a p p r o a c h i n g p e r s o n is s e e n
from t h e f r o n t . To the strictly optical field of vision, t h e back of him is not
actually p r e s e n t at all. N o n e t h e l e s s , t h e figure is perceived as the w h o l e
Fundamental
Characteristics of Human
Beings
9I
92
EXISTENTIAL
FOUNDATIONS
Fundamental
Characteristics of Human
Beings
93
94
EXISTENTIAL FOUNDATIONS
Fundamental
Characteristics of Human
Beings
9t>
EXISTENTIAL
FOUNDATIONS
Fundamental
Characteristics
of Human
Beings
97
o b j e c t i v e t i m e , w e hold t o t h e n o t i o n s o f C a r t e s i a n dualism, o f o b j e c t i v i t y
and s u b j e c t i v i t y . B u t in r e s p e c t to t h e s e c o n c e p t s , t h e q u e s t i o n is o p e n
w h e t h e r t h e y can b e a p p r o p r i a t e l y defined b e f o r e t h e n a t u r e o f t i m e has
been adquately illuminated.
W e h a v e already m e n t i o n e d o n e h u m a n r e l a t i o n s h i p t o t i m e t h a t can b e
e x p e r i e n c e d directly. H u m a n b e i n g s can e i t h e r have t i m e or not have t i m e .
N o w w e m u s t ask w h a t m a k e s this r e l a t i o n s h i p t o t i m e possible. I s o u r
b e i n g - i n - t i m e t h e basis o f o u r h a v i n g t i m e , o r i s t h e r e v e r s e t r u e ? W h a t
d o e s b e i n g - i n - t i m e m e a n ? D o w e n e e d t o ask this a t all? N a t u r a l s c i e n c e
m e a s u r e s all n a t u r a l p r o c e s s e s a s t h e y o c c u r i n t i m e , a n d i n o u r e v e r y d a y
t h i n k i n g we find t h a t t h i n g s and e v e n t s o c c u r , p e r s i s t , and perish in t i m e .
N o w , I can say simply t h a t t h e table in f r o n t of me w a s already p r e s e n t
b e f o r e I s e t e y e s on it and will r e m a i n w h e r e it is w h e n I am no l o n g e r
looking a t it. H o w long i t h a s b e e n o r will r e m a i n t h e r e i s o f n o c o n c e r n t o
m e , but t h e fact t h a t it w a s already and will r e m a i n t h e r e m e a n s t h a t it
has p e r s i s t e d during, o r in, t i m e . D o e s o u r indication o f this p e r s i s t e n c e
a d e q u a t e l y define t h e o b j e c t ' s b e i n g - i n - t i m e ? A n d i s t h e b e i n g - i n - t i m e o f
such a t h i n g identical to t h e b e i n g - i n - t i m e of an e x i s t i n g h u m a n b e i n g ? In
e i t h e r c a s e w e m u s t avoid falling i n t o t h e easy e r r o r t h a t time i s s o m e h o w
spatial, s o m e kind of c o n t a i n e r in w h i c h t h i n g s are.
P e r s i s t e n c e is a c h a r a c t e r i s t i c of all o b j e c t s . S o m e p e r s i s t for a long
time, s o m e only for a short time. Do objects need to do anything to
p e r s i s t ? W h e r e is p e r s i s t e n c e to be found in a t h i n g ? W h a t h a p p e n s to an
o b j e c t w h e n t h e r e i s n o l o n g e r a n y o n e n e a r it? D o e s i t c o n t i n u e t o
persist?
A d r i n k i n g g l a s s m a y be b r o k e n w h i l e t h e table is b e i n g c l e a r e d . We a r e
t h e n left w i t h the b r o k e n pieces. I f t h e s e f r a g m e n t s g e t i n t o t h e g a r b a g e ,
t h e y a r e s e p a r a t e d f r o m e a c h o t h e r and are j u s t isolated pieces o f glass.
As glass pieces t h e y c o n t i n u e to p e r s i s t , b u t t h e y no l o n g e r p e r s i s t as a
d r i n k i n g g l a s s . W e realize, t h e n , t h a t t h e d r i n k i n g glass h a s its o w n t i m e
to be a drinking glass. Its t i m e is n o t simply e m p t y p e r s i s t e n c e but a t i m e
for. Its t i m e has to do w i t h its u s e , and its u s e w i t h m a n , w h o h a s t i m e for
t h i n g s . M a n gives t i m e t o t h e g l a s s . A n d , w e m a y ask, i f m a n c e a s e d t o
e x i s t w o u l d t h e r e b e a n y d r i n k i n g g l a s s e s ? T h e a n s w e r is, o f c o u r s e , n o ,
since o n l y m a n can m a n u f a c t u r e d r i n k i n g g l a s s e s . O b j e c t s like t h e g l a s s
e n t e r t i m e b y v i r t u e o f t h e fact t h a t t h e y h a v e b e e n m a d e . W h a t t h e n o f a
m o u n t a i n ? Y e s , it t o o h a s its t i m e , c o n t i n u e s to persist. W a s it in t i m e
already b e f o r e m a n a r r i v e d o n t h e s c e n e ? N o o n e t o d a y w o u l d h e s i t a t e a
m o m e n t i n saying y e s . Y e t e v e n t h e t i m e w e r e f e r t o w h e n w e say " b e f o r e
m a n " is u n e q u i v o c a l l y r e l a t e d to m a n as t h e t i m e w h i c h r e v e a l s itself to
him, t h e h u m a n being, a s long past. T h a t i s w h y w e can n e v e r k n o w w h a t
w a s h e r e w h e n m a n had n o t y e t arrived. W e c a n n o t e v e n decide w h e t h e r
98
EXISTENTIAL
FOUNDATIONS
o r n o t i t i s p r o p e r t o say t h a t t h e Alps w e r e h e r e b e f o r e t h e r e w e r e
h u m a n b e i n g s . S t r i c t l y s p e a k i n g , w e can n e v e r say w h a t was b e f o r e m a n .
G e o l o g i s t s m e a s u r i n g t i m e w i t h t h e a t o m i c clock a r e c o n f i d e n t t h a t
t h e y h a v e b e e n able t o find e r a s o f t i m e c o n t a i n i n g t h i n g s millions o f
y e a r s b e f o r e t h e r e w e r e h u m a n b e i n g s . B u t e v e n t h e a t o m i c clock does
n o t bring u s a n y c l o s e r t o u n d e r s t a n d i n g b e i n g - i n - t h e - w o r l d , b e c a u s e
t h e data it p r o d u c e s a r e also tied to t h e h u m a n b e i n g w h o reads t h e m . It is
t o this h u m a n being t h a t t h e t e s t e d e n t i t i e s appear t o b e o f such and s u c h
an age. W i t h o u t t h e possibility of indicating t i m e to a r e c e p t i v e and
p e r c e i v i n g c r e a t u r e like m a n , all f u n d a m e n t a l w o r d s like " b e i n g , " " i s , "
" w a s , " " h a s b e e n " and "will b e " lose all m e a n i n g . AH p r e s u p p o s e t h e
possibility o f p r e s e n c e e n t e r i n g i n t o a n open r e a l m o f p e r c e p t i o n and
being p e r c e i v e d t h e r e .
I f e v e r y d e t e r m i n a t i o n o f time available from n o n h u m a n e v e n t s and
o b j e c t s is i n e v i t a b l y r e l a t e d to m a n , we will n e v e r g e t past their b e i n g - i n time t o u n d e r s t a n d t h e h u m a n r e l a t i o n s h i p t o t i m e . T h e r e v e r s e i s m o r e
likely, t h a t an a d e q u a t e i n s i g h t i n t o the h u m a n r e l a t i o n s h i p to time will
give us a v i e w of t h e b e i n g - i n - t i m e of i n a n i m a t e o b j e c t s as well.
M a n ' s r e l a t i o n s h i p t o his t i m e i s c e r t a i n l y s o m e t h i n g m o r e t h a n the
w a y in w h i c h a d r i n k i n g g l a s s , for i n s t a n c e , is in t i m e . In o r d e r to see in its
p r o p e r light t h e special w a y in w h i c h time applies to h u m a n b e i n g s , we
m u s t first b r e a k a w a y from o u r o r d i n a r y h a b i t s o f s p e e c h . W e a r e u s e d t o
saying t h a t we a r e in t i m e , and also t h a t we have t i m e . To s t a r t w i t h , this
" i n " should n o t be t a k e n in a n y spatial s e n s e . We a r e n o t in t i m e as s m a l l e r
C h i n e s e ivory balls can b e found inside l a r g e r o n e s . Similarly, w e m u s t
n o t c o n c l u d e t h a t " h a v i n g t i m e " m e a n s t h a t t h e r e i s time o n t h e o n e
h a n d , and on t h e o t h e r a " h a v i n g " t h a t h a s n o t h i n g to do w i t h t h e t i m e
itself. We can h a v e c e r t a i n t h i n g s in this s e n s e a car, a h o u s e , a N o b e l
P r i z e b u t n o t t i m e . W e can also have s u c h t h i n g s a s affect u s directly,
being part of us: I have a b r o k e n a r m , an e a r a c h e , pain, or a w o r r y .
B e f o r e w e can u n d e r s t a n d t h e i n h e r e n t n a t u r e o f " h a v i n g " t i m e , w e
m u s t carefully d i s t i n g u i s h a m o n g t h e v a r i o u s possibilities o f " h a v i n g . "
T h e e x a m p l e o f " h a v i n g a w o r r y " s h o w s m o s t readily t h a t " h a v i n g " can
m e a n far m o r e t h a n j u s t p o s s e s s i n g s o m e t h i n g . I nave a w o r r y . I am
w o r r i e d , or b e t t e r still (to s h o w t h a t it is n o t I w h o c r e a t e t h e w o r r y ) : I am
o v e r c o m e b y w o r r y . H o w does " h a v e " w o r k h e r e ? W e see t h a t w h a t w e
s e e m e d to " h a v e , " t h e w o r r y , w a s in fact n o t " h a d . " It would be m o r e
a p p r o p r i a t e to say t h a t t h e w o r r y has a p e r s o n . It is s o m e m o d e in w h i c h
we find o u r s e l v e s . " H a v e , " as in t h e e x p r e s s i o n " t o h a v e a w o r r y , " r e f e r s
t h e n to a specific m o d e in w h i c h a p e r s o n is, and is e x i s t i n g , at a given
time.
Fundamental
Characteristics of Human
Beings
T h i s dwelling in t h e w o r l d is c h a r a c t e r i z e d by its c o n t a i n i n g a l l
d i f f e r e n t b u t all equally e l e m e n t a r y w h a t is c o m i n g to m a n , w h a t he is
a w a r e o f p r e s e n t l y , and w h a t h a s already b e e n . I n its t h r e e f o l d capacity,
t h e dwelling of h u m a n being holds o u t a t i m e for e a c h t h i n g . It has on
hand t h e " w h e n e v e r , " t h e ' n o w , " and t h e ' t h e n " w h i c h w e use i n o u r
c a l c u l a t i o n s of t i m e . A n d , as h a v i n g a w o r r y actually m e a n s being
w o r r i e d , s o , similarly, h a v i n g t i m e is being e x p e c t a n t of t h e f u t u r e , being
a w a r e o f t h e p r e s e n t , and r e t a i n i n g w h a t h a s passed.
All o f this should d e m o n s t r a t e a t least t h a t w e d o n o t c o m p r e h e n d t h e
p h e n o m e n o n of h a v i n g t i m e for s o m e t h i n g simply by r e f o r m u l a t i n g it to
say t h a t t i m e i s p r e s e n t , w h i c h would sidestep t h e p h e n o m e n o n o f
" h a v i n g . " B u t t i m e or s o m e t h i n g does n o t lie b e f o r e us like s o m e object
w h i c h w e can i g n o r e o r pick up, according t o w h i m . O u r r e l a t i o n s h i p t o
t i m e w h a t e v e r it m a y be at a n y m o m e n t i s t h e basis of o u r dwelling in
the w o r l d . W h e t h e r w e h a v e i t o r n o t , w h e t h e r w e plan o r squander it,
100
EXISTENTIAL
FOUNDATIONS
Human bodyhood
T h e traditional, n a t u r a l scientific f o u n d a t i o n o f m e d i c i n e a s s i g n s t h e
h u m a n b o d y a position of singular p r o m i n e n c e . It is t h e o n l y aspect of t h e
h u m a n c o n s t i t u t i o n w h i c h can b e posited, i n v e s t i g a t e d and m a n i p u l a t e d
as a c h e m o p h y s i c a l or c y b e r n e t i c s t r u c t u r e . B o d y h o o d i t s e l f s u g g e s t s
t h a t it be c o n s i d e r e d as t h o u g h it w e r e a m a t e r i a l o b j e c t , s o m e selfc o n t a i n e d t h i n g p r e s e n t at s o m e specific l o c a t i o n in a p r e e x i s t i n g space.
O n l y w h e n it is defined this w a y is b o d y h o o d a c c e s s i b l e to t h e n a t u r a l
scientific r e s e a r c h m e t h o d , w h i c h t h e n t a k e s this definition as the r e a l i t y
of human existence.
B y positing t h e h u m a n body a s s o m e s e l f - c o n t a i n e d m a t e r i a l t h i n g ,
n a t u r a l s c i e n c e d i s r e g a r d s e v e r y t h i n g t h a t i s specifically h u m a n a b o u t
h u m a n b o d y h o o d . T h e n a t u r a l scientific r e s e a c h m e t h o d t r e a t s t h e body
as it m i g h t t r e a t w o r k s of a r t . G i v e n a collection of P i c a s s o p a i n t i n g s , for
i n s t a n c e , this m e t h o d would see o n l y m a t e r i a l o b j e c t s w h o s e l e n g t h and
b r e a d t h could b e m e a s u r e d , w h o s e w e i g h t could b e d e t e r m i n e d , and
w h o s e s u b s t a n c e could be analyzed c h e m i c a l l y . All t h e r e s u l t i n g data
lumped t o g e t h e r would tell u s n o t h i n g a b o u t w h a t m a k e s t h e s e p a i n t i n g s
w h a t t h e y a r e ; t h e i r c h a r a c t e r a s w o r k s o f art i s n o t e v e n t o u c h e d b y this
approach.
N o r will it suffice to say t h a t s o m e t h i n g else is p r e s e n t in t h e a n i m a t e
body of a h u m a n being, s o m e s u p e r n a t u r a l life f o r c e closed to I he nal ural
scientific r e s e a r c h m e t h o d . S u c h a f o r c e , s e p a r a t e from h u m . i n physical
Fundamental
Characteristics of Human
Beings
102
EXISTENTIAL FOUNDATIONS
o b j e c t s . T h e s e c o n d i s t h e f u n d a m e n t a l dissimilarity o f t h e local
c h a r a c t e r s o f e x i s t i n g h u m a n b e i n g s and i n a n i m a t e o b j e c t s , t h e d i f f e r e n t
w a y s in w h i c h t h e i r l o c a t i o n s at a given t i m e are d e t e r m i n e d .
If h u m a n b o d y h o o d w e r e a physical, m a t e r i a l b o d y , t h e n its b o r d e r s
would b e t h e skin. T h e fact is, h o w e v e r , t h a t n o m a t t e r w h e r e w e are w e
a r e always i n s o m e s o r t o f r e l a t i o n s h i p t o s o m e t h i n g outside o u r skin.
S h o u l d w e t h e n c o n c l u d e t h a t w e a r e c o n s t a n t l y b e y o n d o u r physical
body's b o r d e r s , and n e v e r w h o l l y w i t h i n t h e m ? S u c h a c o n c l u s i o n is
appealing, b u t it is d e c e p t i v e . It w o u l d be a m i s u n d e r s t a n d i n g of t h e
p h e n o m e n o n of b o d y h o o d as well as t h e p h e n o m e n a of Da-sein. We can
n e v e r grasp t h e p h e n o m e n o n of b o d y h o o d if we c o n t i n u e to i m a g i n e it as
a s e l f - c o n t a i n e d physical s t r u c t u r e e x i s t i n g in i t s e l f and of itself, in
isolation from t h e w o r l d . At best, this m i g h t allow us to d e t e r m i n e t h a t
t h e b o r d e r s o f the h u m a n body e x t e n d b e y o n d t h o s e o f t h e physical body
and t h a t , c o n s e q u e n t l y , t h e d i f f e r e n c e b e t w e e n t h e t w o types o f b o r d e r i s
simply q u a n t i t a t i v e . B u t b o d y h o o d and its limits differ from t h o s e of a
physical body n o t q u a n t i t a t i v e l y b u t qualitatively.
It is t h e o r e t i c a l l y possible to i m a g i n e the h u m a n body physically
e x t e n d i n g t o s o m e w i n d o w t h a t p r e s e n t l y f o r m s the b o u n d a r y o f t h e
optical field of my p e r c e p t i o n . In this c a s e , t h e b o r d e r s of the h u m a n b o d y
would coincide w i t h t h e body's physical limits. Y e t t h e v e r y a s s u m p t i o n
of this possibility c l e a r l y reveals t h a t t h e t w o types of b o r d e r s are
fundamentally different.
W h e n I direct s o m e o n e t o w a r d a w i n d o w s i l l w i t h a g e s t u r e of my r i g h t
h a n d , my bodily e x i s t e n c e as a h u m a n being does n o t end at t h e tip of my
index finger. While perceiving the w i n d o w s i l l and m y c o n v e r s a t i o n a l
p a r t n e r w i t h m y e y e s , I e x t e n d m y s e l f bodily far b e y o n d this f i n g e r t i p t o
t h a t windowsill. In fact, bodily I r e a c h o u t e v e n f u r t h e r t h a n this to t o u c h
all the p h e n o m e n a o f m y w o r l d , p r e s e n t o r m e r e l y visualized r e
p r e s e n t e d o n e s , t h o u g h m a n y o f t h e m m i g h t r e m a i n u n t h e m a t i c and
v a g u e in t h e b a c k g r o u n d at this m o m e n t .
N o r is t h e g e s t u r e t o w a r d the w i n d o w s i l l t h e r e s u l t of a t w o - s t a g e
p r o c e s s in w h i c h , initially, my o u t s t r e t c h e d a r m and index f i n g e r
c o n s t i t u t e a s e l f - c o n t a i n e d , m a t e r i a l m e d i u m t h r o u g h w h i c h can be s e n t ,
s e c o n d l y , s o m e flow o f m e n t a l o r e x i s t e n t i a l relating t h a t t r a n s c e n d s the
physical a s p e c t of b o d y h o o d . All my e x p e r i e n c e tells m e , I am i n h e r e n t l y
settled into t h e open space of my world to t h e e x t e n t t h a t I, w i t h
e v e r y t h i n g I am, actually dwell in my perceiving r e l a t i o n s h i p to t h e
windowsill. T o this e c s t a t i c r e l a t i o n s h i p b e l o n g b o t h m y optical
perception o f t h e o b j e c t and, w i t h t h e s a m e i m m e d i a c y , m y g e s t u r e
t o w a r d it. B o t h m a y p e r h a p s b e s t be d e s i g n a t e d as t h e bodying forth of this
existential relationship.
1
ways
ol being in
Fundamental
Characteristics of Human
Beings
103
104
EXISTENTIAL
FOUNDATIONS
Fundamental
Characteristics of Human
Beings
105
106
EXISTENTIAL
FOUNDATIONS
Fundamental
Characteristics
of Human
Beings
107
la
2a
3a
4a
108
EXISTENTIAL
FOUNDATIONS
Fundamental
Characteristics
of Human
Beings
10'
It is n o t o n l y m e d i c i n e t h a t n e e d s to see this p r i m a r y t o g e t h e r n e s s ol
h u m a n beings around the objects of their shared world. Sociology, now
enjoying great popularity, always concerns itselfconsciously or
u n c o n s c i o u s l y w i t h this o n t o l o g i c a l p h e n o m e n a of e x i s t e n c e . In fact,
this p r i m a r y t o g e t h e r n e s s is explicitly t h e sole b a s i s of s o c i o l o g y , and
u n l e s s e a c h m o d e of o n t i c social b e h a v i o r is s e e n in r e l a t i o n to the
p r i m a r y c o e x i s t e n c e o f h u m a n b e i n g , a n y s t a t e m e n t a b o u t sociological
p h e n o m e n a is left h a n g i n g in thin air. T h i s e s s e n t i a l c o e x i s t e n c e is t h e
basis n o t only o f o u r j o i n t u n d e r t a k i n g s w i t h t h e t h i n g s o f o u r world but
of every sort of relationship among human beings themselves, w h e t h e r
t h e y a r e dealing w i t h e a c h o t h e r a s useful o b j e c t s o r e x p r e s s i n g s o m e
f o r m o f love o r h a t e t o w a r d e a c h o t h e r .
2:
3:
Hiddenness.
T h e couple's t h e m a t i c being t o g e t h e r a t t h e i r r e s o r t h o t e l i n t h e
C a n a r y Islands, in t h e f o r m of a p e r c e p t i v e visualization of this
object.
4 , 5 , 6 : T h e lovers' being t o g e t h e r with the sense-perceptible street-car,
buildings, and sidewalk; t h e m o d e of this r a n g e s f r o m a s c a r c e l y
n o t i c e d c o m m o n p e r c e p t i o n t o totally u n t h e m a t i c a w a r e n e s s o f
them.
+++
C r o s s e s i n d i c a t e t h e l o v e r ' s e c - s t a t i c dwelling in t h e w o r l d , in t h e
s e n s e o f a n open and p e r c e p t i v e b e i n g a t w h a t h e e n c o u n t e r s .
C i r c l e s indicate R e g u l a Z i i r c h e r ' s o p e n a n d p e r c e p t i v e b e i n g a t
what she encounters,
ooo
T h e varied t h i c k n e s s e s o f t h e c r o s s e s and circles indicate
m o m e n t a r y variations in the existential closeness of relation
ships to w h a t is p r e s e n t in t h e s h a r e d w o r l d .
110
EXISTENTIAL
FOUNDATIONS
y o u n g w o m a n ' s r e c o v e r y . B u t i n t h e m e a n t i m e h e r r e l a t i o n s h i p t o the
world had b e c o m e free and o p e n e n o u g h to let t h e i n n a t e possibility of a
happy m o o d be realized, and the s e c o n d e n c o u n t e r with t h e y o u n g m a n
ended i n t h e m a n i f e s t a t i o n o f happy a t t u n e m e n t . W h e n e v e r w e s e e
s o m e o n e e n t e r a p a r t i c u l a r m o o d , w h a t we are actually w i t n e s s i n g is o n l y
a r e a t t u n e m e n t of his e x i s t e n c e from an old r e i g n i n g disposition into a
new one.
But i n t h e e s s e n t i a l a t t u n e m e n t o f o u r e x i s t e n c e are r o o t e d n o t o n l y
the manifold p a r t i c u l a r o n t i c m o o d s and dispositions of h a p p i n e s s and
s o r r o w , s o b r i e t y and e q u a n i m i t y , i n d i f f e r e n c e , b o r e d o m and a n x i e t y , but
also o u r e m o t i o n s , o u r feelings and a f f e c t s . Like m o o d s and dispositions,
t h e s e n e v e r appear a s isolated s e l f - c o n t a i n e d e n d o p s y c h i c e n t i t i e s o f t h e
sort that a p e r s o n m i g h t have or p o s s e s s ; t h e y a r e particular m o d e s in
w h i c h h u m a n e x i s t e n t i a l a t t u n e m e n t is fulfilled.
E v e r y a t t u n e m e n t as a t t u n e m e n t is a particular m o d e of t h e p e r c e p t i v e
o p e n n e s s o f o u r e x i s t e n c e . T h e prevailing a t t u n e m e n t i s a t any given
time the c o n d i t i o n o f o u r o p e n n e s s for perceiving and dealing w i t h w h a t
we e n c o u n t e r ; the pitch at w h i c h o u r e x i s t e n c e , as a set of r e l a t i o n s h i p s to
o b j e c t s , o u r s e l v e s and o t h e r people, is v i b r a t i n g . W h a t we call m o o d s ,
feelings, a f f e c t s , e m o t i o n s , and s t a t e s are the c o n c r e t e m o d e s in w h i c h
the possibilities for being o p e n are fulfilled. T h e y are at the s a m e time t h e
m o d e s in w h i c h this p e r c e p t i v e o p e n n e s s can be n a r r o w e d , d i s t o r t e d , or
closed off.
O p e n n e s s , or r e c e p t i v i t y , can e x i s t only in c o n j u n c t i o n w i t h
r e s t r i c t i o n . Each predicates the o t h e r . It can t h e r e f o r e be said t h a t e v e r y
r e s t r i c t i o n is a p a r t i c u l a r privation of o p e n n e s s . W h a t e v e r its m o m e n t a r y
a t t u n e m e n t , t h e o p e n n e s s t h a t i s o u r e x i s t e n c e a l w a y s d e t e r m i n e s a s well
the particular breadth or narrowness, brightness or obscurity of that
existence.
In traditional medical r e s e a r c h , t h e v a r i o u s s h a d i n g s of e x i s t e n c e w e r e
crudely g r o u p e d a s " a f f e c t i v i t y . " T h e d i s t i n c t i o n s a m o n g t h e m w e r e n o t
scientifically m a i n t a i n e d . All t h a t e x i s t s for a p a r t i c u l a r p h e n o m e n o l o g y
of m o o d s , e m o t i o n s and feelings are a f e w t e n t a t i v e s t a t e m e n t s , and in
the f r a m e w o r k o f this g e n e r a l f o u n d a t i o n for m e d i c i n e , w e o u r s e l v e s can
only give a f e w clues c o n c e r n i n g a possible d i f f e r e n t i a t i o n .
A n g e r , for i n s t a n c e , is called an affect. W h e n we say " h a t e , " we r e f e r to
a passion. Y e t both are called feelings. T h i s o v e r l o o k s i m p o r t a n t
d i f f e r e n c e s . A n g e r is not s o m e t h i n g t h a t can be put on or taken o f f at
will. It a s s a u l t s us, falls upon us, a f f e c t s us, its a t t a c k t r a n s p o r t i n g us in
such a way t h a t we are no l o n g e r m a s t e r s of o u r s e l v e s . An agitated
person " t a k e s leave of h i m s e l f " and is t h e n "beside h i m s e l f . " We say, for
i n s t a n c e , that s o m e o n e is beside h i m s e l f w i t h j o y .
Fundamental
Characteristics of Human
Beings
N o w , e v e n i n its c o n c e n t r a t e d a t t u n e m e n t t o love o r h a t e , a n e x i s t e n c e
is o p e n to t h e p e r c e p t i o n of p h e n o m e n a only in limited w a y s . T h u s t h e r e
is blind h a t r e d . People w h o h a t e p a s s i o n a t e l y are no l o n g e r r e s p o n s i v e to
112
EXISTENTIAL
FOUNDATIONS
t h e good side o f w h a t e v e r t h e y h a t e . C o n v e r s e l y , s o m e o n e w h o i s
p a s s i o n a t e l y in love t e n d s to o v e r l o o k ugly a s p e c t s of the beloved p e r s o n
o r t h i n g . T h e m a s k i n g p r o c e s s c o m m o n t o p a s s i o n a t e h a t e and p a s s i o n a t e
love p r e s u m a b l y d e r i v e s f r o m t h e fact t h a t , i n e i t h e r o f t h e s e s t a t e s ,
e x i s t e n c e is c o n c e r n e d w i t h its o w n p o w e r . In h a t r e d , an e x i s t e n c e
e x p e r i e n c e s a n y t h i n g t h a t s t a n d s in t h e w a y of its p o w e r as an
o b s t r u c t i o n to be o v e r r i d e n and d e s t r o y e d . A p a s s i o n a t e l y loving
e x i s t e n c e s e e s in t h e loved o n e t h e p o t e n t i a l for a t o g e t h e r n e s s t h a t
would o f f e r a m u c h g r e a t e r s t o r e of h u m a n possibilities t h a n its o w n
single e x i s t e n c e could e v e r c o m p o s e by itself.
A n o t h e r m a j o r e m o t i o n a l m o d e is a c o m p o s e d , j o y o u s s e r e n i t y . It can
give h u m a n e x i s t e n c e t h e kind of r e c e p t i v i t y t h a t allows it to see in the
b r i g h t e s t light t h e m e a n i n g f u l n e s s and c o n n e c t i o n s o f e v e r y p h e n o m e n
on t h a t r e v e a l s itself. S u c h a s e r e n i t y is a c l e a r n e s s and o p e n n e s s in w h i c h
a h u m a n being is emotionally connected to everything he meets, wanting
n o t to h a v e t h i n g s in his o w n p o w e r b u t c o n t e n t to let t h e m be and
develop on t h e i r o w n . B e c a u s e this c o m p o s e d , j o y o u s s e r e n i t y o p e n s a
h u m a n being t o t h e b r o a d e s t possible r e s p o n s i v e n e s s , i t c o n s t i t u t e s
h a p p i n e s s as well. F o r e v e r y h u m a n e x i s t e n c e is by i t s e l f a t t u n e d to
happiness w h e n e v e r all its i n n a t e p o t e n t i a l w a y s of being stand o p e n to it.
A n e x i s t e n c e free t o e n g a g e i t s e l f i n s u c h a n a t t u n e m e n t can a c c e p t
s e r e n e l y e v e n t h e possibility o f its o w n d e a t h . D e a t h , t h e s u r e s t o f all
realities, r e v e a l s i t s e l f to an e x i s t e n c e so a t t u n e d as a p r o c e s s of being
b r o u g h t b e f o r e a void. To this e x i s t e n c e , t h e void appears no l o n g e r an
e m p t y n o t h i n g n e s s but a void so a b u n d a n t l y rich t h a t all being could
issue f r o m it. In this u n d e r s t a n d i n g s e r e n i t y differs m o s t p r o f o u n d l y
from a n x i e t y , a n o t h e r basic s t a t e o f h u m a n being.
A n x i e t y is t h e a t t u n e m e n t in w h i c h e x i s t e n c e is b o t h o p e n e d up and
r e s t r i c t e d to perceiving t h e possibility of losing its hold on all o t h e r being,
of being t h r o w n back e n t i r e l y upon itself, and c e a s i n g to be, in total
isolation. For i n s t a n c e , e v e n w h e n a m o t h e r fears n o t for h e r o w n life b u t
for h e r child's, s h e i s a n x i o u s a b o u t t h e d e s t r u c t i o n o f h e r s e l f . H e r
e x i s t e n c e is so w r a p p e d up in h e r r e l a t i o n s h i p to h e r child, h e r e x i s t e n c e
m e r g e s s o m u c h i n t o t h e i r being t o g e t h e r , t h a t b r e a k i n g this r e l a t i o n s h i p
would b e t a n t a m o u n t t o d e s t r o y i n g h e r e x i s t e n c e . R e m e m b e r t h a t
e x i s t e n c e c o n s i s t s solely in its possibilities for r e l a t i o n s h i p s .
In c o n t r a s t to s e r e n i t y , a n x i e t y e x p o s e s t h e n e c e s s i t y of d e a t h o n l y as
the possibility o f n o l o n g e r being h e r e , o f perishing i n t o e m p t i n e s s . B u t i n
the very act of e n t e r i n g into its possibilities, e x i s t e n c e e n t e r s d a n g e r , for
e x i s t e n c e e x h a u s t s itself in t h e c o u r s e of e x i s t i n g . T h u s people w h o arc"
m o s t afraid of death a r e t h o s e w h o h a v e t h e g r e a t e s t a n x i e t y about life.
T r a d i t i o n a l p s y c h o l o g y o f t e n m a k e s a d i s t i n c t i o n b e t w e e n realistic,
e x t e i nal a n x i e t y and an u n r e a l i s t i c , i n n e r i n s t i n c t i v e a n x i e t y . A n x i e t y in
Fundamental
Characteristics of Human
Beings
O u r final e x a m p l e o f basic h u m a n s t a t e s i s t h e m o o d o f s o r r o w . S o r r o w
as a p o t e n t i a l w a y of being in h e a l t h y people is n o t to be c o n f u s e d w i t h
pathological f o r m s o f d e p r e s s i o n d i s c o n t e n t , a n n o y a n c e , h o p e l e s s n e s s
and t h e petrified v a r i e t i e s w h i c h will be discussed later on; n e i t h e r is it
e g o c e n t r i c self-pity. E x i s t e n c e is a t t u n e d to t r u e s o r r o w w h e n it
e x p e r i e n c e s a b r e a k or r u p t u r e in its r e l a t i o n s h i p to a c l o s e h u m a n
a c q u a i n t a n c e o r s o m e c h e r i s h e d o b j e c t , b u t t h e o b j e c t o f s o r r o w i s not
lost w i t h this r u p t u r e . I f t h e c a p a c i t y t o b e w i t h t h e o b j e c t o f s o r r o w w e r e
really b r o k e n o r r u p t u r e d t o t h e e x t e n t t h a t t h e r e l a t i o n s h i p was
d e s t r o y e d a l t o g e t h e r this s o r r o w a t loss could n o t arise; t h a t t h i n g would
simply h a v e fallen o u t o f t h e w o r l d and b e e n f o r g o t t e n , w o u l d n o l o n g e r
be t h e r e . " In s o r r o w , h o w e v e r , w h a t is s o r r o w e d for c o m e s close to the
s o r r o w i n g p e r s o n in a p a r t i c u l a r w a y . T h e r u p t u r e perceived in s o r r o w
c o n c e r n s s o m e actual p a r t i c u l a r m o d e o f being w i t h t h e o b j e c t which the
114
EXISTENTIAL
FOUNDATIONS
Fundamental
Characteristics of Human
Beings
c o n t e m p o r a r y n a t u r a l scientific t h e o r i e s o f m e m o r y . M o r e t h a n fifteen
h u n d r e d y e a r s a g o i n t h e W e s t e r n tradition A u g u s t i n e w r o t e i n the t e n t h
b o o k of his Confessions: " a n d I k n o w t h a t t h e y [the s o u n d s t h a t c o m p r i s e
words] a r e b l o w n a w a y w i t h t h e i r r e s o n a n c e s i n t h e w i n d and are n o
m o r e . B u t t h e actual t h i n g s signified b y t h e s e s o u n d s I h a v e n e v e r
g r a s p e d w i t h a n y o f m y physical s e n s e s n o r s e e n t h e m a n y w h e r e out
t h e r e in f r o n t of my mind, and so it is t h e y t h e m s e l v e s , and n o t t h e i r
i m a g e s , t h a t I h a v e p r e s e r v e d in my m e m o r y . "
5
116
EXISTENTIAL
FOUNDATIONS
Fundamental
Characteristics of Human
Beings
B y c o n t r a s t , p s y c h o a n a l y t i c t h e o r y e m p h a t i c a l l y m a i n t a i n s t h a t such
an o c c u r r e n c e is a h i g h l y s i g n i f i c a n t f o r g e t t i n g of t h e u m b r e l l a and of the
possibility of t a k i n g it a l o n g . S u c h p h e n o m e n a are s t a m p e d as i n s t a n c e s
of faulty action (parapraxis) and t h e r e b y m a d e l i k e all f o r g e t t i n g
effects of the repression of an unconscious desire. According to
psychoanalytic theory, my forgetting of the umbrella would have been
c a u s e d by an u n c o n s c i o u s i n t e n t to r e t u r n to see my friend again as s o o n
as possible. By leaving my u m b r e l l a b e h i n d , I w o u l d u n c o n s c i o u s l y h a v e
c r e a t e d an e x c u s e for g o i n g b a c k for a visit right a w a y .
B u t this p s y c h o a n a l y t i c i n t e r p r e t a t i o n is u n c o n v i n c i n g . F o r o n e t h i n g , I
am close e n o u g h to my friend to visit w h e n e v e r I w i s h w i t h o u t a p r e t e x t .
But more important is that from the very beginning the psychoanalytic
a c c o u n t m a k e s n o e f f o r t t o explain t h e f o r g e t t i n g o f m y u m b r e l l a a s
f o r g e t t i n g . I n s t e a d it r e s t s on a h y p o t h e t i c a l a s s u m p t i o n t h a t h a s n o t h i n g
t o d o w i t h t h e p h e n o m e n o n u n d e r i n v e s t i g a t i o n , w h i c h i s t h e leaving
b e h i n d o f m y u m b r e l l a . T h e supposed u n c o n s c i o u s i n t e n t i s p r e s e n t e d
r i g h t from t h e s t a r t as t h e cause w h i c h b r i n g s a b o u t t h e so-called faulty
a c t i o n ; b u t w h a t c a u s e s a p h e n o m e n o n to o c c u r is a n y t h i n g but t h e
p h e n o m e n o n itself, and w h a t d e m a n d s e x p l a n a t i o n i s t h e p h e n o m e n o n
itself.
My forgetting cannot be caused by the repression into an unconscious
of my c o n c e p t i o n of t h e u m b r e l l a . In o r d e r to f o r c e s o m e t h i n g inward, 1
w o u l d need to h a v e it w i t h i n my grasp. Y e t it is c l e a r t h a t w h i l e I am
taking leave of my friend, I am w i t h h i m , n o t w i t h my u m b r e l l a . T h u s I
c a n n o t possibly be o c c u p i e d w i t h a desire to f o r g e t it so I m a y visit him
again. S u c h desire c a n n o t b e o p e r a t i n g a t t h a t m o m e n t , c o n s c i o u s l y o r
u n c o n s c i o u s l y , b e c a u s e my w h o l e being is occupied w i t h my friend and
w i t h t h e topic o f t h e e v e n i n g ' s c o n v e r s a t i o n . H e r e , f o r g e t t i n g i s n o t h i n g
more than the changing of a phenomenon's immediate, thematically
c o n s i d e r e d p r e s e n c e in a h u m a n r e a l m of o p e n n e s s to its n o n i m m e d i a t e
and u n t h e m a t i c p r e s e n c e s o m e w h e r e i n t h e w o r l d .
It is a n o t h e r kind of f o r g e t t i n g w h e n I lose t r a c k of t h e n a m e ol
s o m e o n e I k n o w and c a n n o t c o m e up w i t h it, no m a t t e r h o w hard I try.
H e r e t h e t h i n g i t s e l f (in this c a s e , t h e n a m e ) e s c a p e s m e . B u t w h a t has the
n a m e e s c a p e d f r o m ? E v i d e n t l y f r o m my capacity for a s s o c i a t i n g it with
t h e p e r s o n , w h o m I still r e t a i n . T h i s type of f o r g e t t i n g m a n i f e s t s a
deficiency in my p e r c e p t i v e r e t e n t i v e capacity and, as s u c h , c o n s t i t u t e s a
special f o r m of my o t h e r w i s e i n t a c t r e l a t i o n s h i p to a t h i n g . In this c a s e it
is a deficiency in my ability to r e l a t e m y s e l f to a p e r s o n w i t h such and
such a n a m e .
T h e n a m e , t h o u g h f o r g o t t e n , is n e v e r t h e l e s s still k n o w n to me in a
c e r t a i n s e n s e as s o m e t h i n g t h a t has escaped me, as something, h i d d e n
118
EXISTENTIAL FOUNDATIONS
Fundamental
Characteristics of Human
Beings
120
EXISTENTIAL
FOUNDATIONS
Fundamental
Characteristics of Human
Beings
122
EXISTENTIAL
FOUNDATIONS
p r o p e r p e r s p e c t i v e as e x i s t e n t i a l m o d e s f u n c t i o n i n g as p r e l i m i n a r i e s for
t h e e x t r e m e m o d e of d e a t h . F r o m this p e r s p e c t i v e e x i s t e n c e is not in
danger of having one or the other of the more prominent potentialities
made absolute. At the same time, con-dscious acceptance of mortality as
a n e s s e n t i a l trait o f e x i s t e n c e c o u n t e r b a l a n c e s t h e f e a r s o m e k n o w l e d g e
t h a t each p e r s o n m u s t die a l o n e . T h e p r o c e s s o f b e c o m i n g free for t h e
e x t r e m e p o t e n t i a l i t y o f o n e ' s o w n death also frees a person w i t h r e s p e c t
t o o t h e r s , letting h i m u n d e r s t a n d t h e i r e x i s t e n t i a l possibilities o n the
basis of a solid f o u n d a t i o n .
O b v i o u s l y , a n u n d e r s t a n d i n g o f death a d e q u a t e t o the p h e n o m e n o n o f
m o r t a l i t y is decisively i m p o r t a n t for t h e p h y s i c i a n - p a t i e n t r e l a t i o n s h i p .
D e p e n d i n g on h o w p r o f o u n d this u n d e r s t a n d i n g is in him, a physician
will be c o n c e r n e d o n l y w i t h t h e t r e a t m e n t of a t e r m i n a l case of illness or
w i t h helping o n e in his c a r e die a good d e a t h .
Fundamental
Characteristics of Human
Beings
123
T h e u n q u e s t i o n a b l e e x i s t e n c e o f a f r e e d o m o f will, o f c h o i c e , f o r m s t h e
basis of a h u m a n being's obligation to fulfill his e x i s t e n c e . If h u m a n
b e i n g s w e r e n o t free t o decide w h e t h e r o r not t o take o n and c a r r y out t h e
b e h a v i o r a l possibilities i n h e r e n t in t h e i r e x i s t e n c e s , t h e r e could be no
guilt, h e a l t h y o r p a t h o l o g i c a l , and n o t h e r a p e u t i c r e l e a s e . O f c o u r s e ,
f r e e d o m o f willlike a n y t h i n g h u m a n i s n o t a b s o l u t e . C o n s o n a n t with
t h e overall f i n i t e n e s s of h u m a n e x i s t e n c e , its actual r a n g e is b o u n d e d by
the n u m b e r and v a r i e t y of t h e i n n a t e ways by w h i c h an individual can
r e l a t e h i m s e l f t o w h a t h e e n c o u n t e r s , appropriate t h e s e w a y s a s his o w n ,
and u s e t h e m in f o r m i n g his a u t o n o m o u s e x i s t e n c e . In addition to t h e s e
limits t h e r e a r e a n y n u m b e r o f pathological deficiencies o f f r e e d o m . B u t
it is i m p o r t a n t to r e m e m b e r t h a t e v e n a r e s t r i c t e d f r e e d o m is n o n e t h e l e s s
a f o r m of f r e e d o m . Y e t e v i d e n c e p o i n t i n g to even a v e r y limited sort of
h u m a n f r e e d o m is highly r e p u g n a n t to n a t u r a l scientific r e s e a r c h e r s
w h o s e d e t e r m i n i s m denies a n y kind o f freedom for m a n . I t s e e m s o n l y
fitting, c o n s i d e r i n g t h e decisive i m p o r t a n c e o f h u m a n f r e e d o m t o
m e d i c i n e , t o e x a m i n e critically t h e l e g i t i m a c y o f such denials.
7
124
EXISTENTIAL
FOUNDATIONS
Fundamental
Characteristics of Human
125
Beings
126
EXISTENTIAL
FOUNDATIONS
1 . For t h e s u b s e q u e n t r e a s o n i n g n e e d e d t o i l l u m i n a t e w h a t still r e m a i n s o b s c u r e a b o u t
t i m e , s e e : M. H e i d e g g e r , Zur Sache des Denkens ( T u b i n g e n : N i e m e y e r , 1 9 6 9 ) , p. 1 4 .
2 . T h e w o r d " b o d y h o o d " w a s f i r s t d o c u m e n t e d i n t h e E n g l i s h l a n g u a g e i n 1 6 7 4 and h a s
t h e m e a n i n g , " t h e q u a l i t y o f h a v i n g a b o d y o r o f being body" ( O . E . D . ) . T h i s w o r d i s c o n g r u e n t
w i t h t h e G e r m a n Leib, w h i c h h a s t h e c o n n o t a t i o n o f b o d y a s lived b o d y l i n e s s .
3 . Cf. M . H e i d e g g e r , Nietzsche, v o l . 1 ( P f u l l i n g e n : V e r l a g N e s k e , 1 9 6 1 ) , pp. 5 3 - 6 3 .
4. Cf.
M.
Boss,
Lebensangst,
Schuldgefhle und psychotherapeutische Befrciunt ( B e r n and
S t u t t g a r t : H a n s H u b e r V e r l a g , 1 9 6 2 ) , p . 2 8 f f a n d 3 9 ff.
5 . A u r e l i u s A u g u s t i n u s , Confessiones, 2 d ed. ( M u n i c h : K o s e l - V e r l a g , 1 9 6 0 ) , pp. 5 1 0 - 1 1 .
6. C o m p a r e a l s o : la) W. K e l l e r , Das Problem der Willensfreiheit ( B e r n and M u n i c h : F r a n c k e ,
S c h u l t h e s s & Co., 1 9 6 3 ) and Menschliche Existenz, Willensfreiheit und Schuld ( Z u r i c h : S c h u l t h e s s
& Co., 1 9 6 4 ) . B o t h w o r k s c o n t a i n i m p r e s s i v e i l l u s t r a t i o n s o f t h e f u n d a m e n t a l p o s i t i o n s first
e l a b o r a t e d in H e i d e g g e r ' s Sein und Zeit; lb) M. H e i d e g g e r , Vom Wesen der menschlichen Freiheit.
Unpublished introductory lecture to philosophy, 1 9 3 0 .
7 . All t h a t i s e s s e n t i a l f o r a n e x i s t e n t i a l u n d e r s t a n d i n g o f t h e s t r u c t u r e o f h u m a n g u i l t
and t h e h u m a n conscience c a n b e f o u n d in: M . H e i d e g g e r , " D i e e x i s t e n t i a l - o n t o l o g i s c h e n
F u n d a m e n t e d e r G e w i s s e n s als R u f d e r S o r g e , A n r u f v e r s t e h e n u n d S c h u l d , die e x i s t e n t i a l e
I n t e r p r e t a t i o n d e s G e w i s s e n s u n d die v u l g r e G e w i s s e n s a u s l e g u n g , d e e x i s t e n t i a l e
S t r u k t u r des im G e w i s s e n b e z e u g t e n e i g e n t l i c h e n S e i n k n n e n s , " in Zein und Zeit ( H a l l e :
Niemeyer, 1927), p. 267ff.
8. Cf. M. H e i d e g g e r , Vom Wesen der Wahrheit, 3d e d . ( F r a n k f u r t - a m - M a i n : K l o s t e r m a n ,
1 9 5 4 ) , pp. 1 4 and 1 6 .
9 . T h e p o s s i b i l i t y o f d r e a m i n g a s a n o t h e r E x i s t e n t i a l i s d i s c u s s e d a t l e n g t h in: M . B o s s ,
"Es t r u m t e m i r v e r g a n g e n e N a c h t . . . . " ( B e r n , S t u t t g a r t , W e i n : H a n s H u b e r , 1 9 7 5 ) .
Chapter 8
AN EXISTENTIAL STUDY OF THE BASIC CONCEPTS
OF BIOLOGY, PHYSIOLOGY, AND PSYCHOLOGY
128
EXISTENTIAL FOUNDATIONS
129
N e x t t o S a r t r e , M e r l e a u - P o n t y d e s e r v e s r e c o g n i t i o n for his e f f o r t s t o
e s t a b l i s h a basis for h u m a n b o d y h o o d . First, he i m p r o v e d on S a r t r e ' s
t r a n s l a t i o n o f H e i d e g g e r ' s definition for h u m a n b e i n g . B e c a u s e S a r t r e ' s
etre-dans-le-monde implicitly reified h u m a n n a t u r e and r e n d e r e d it m e r e
o b j e c t in s p a c e , M e r l e a u - P o n t y p r e f e r r e d t h e w o r d i n g , ttre-au-monde. He
also set h i m s e l f t h e special t a s k o f t r a n s c e n d i n g t h e C a r t e s i a n dualism
t h a t s e p a r a t e s body and soul. H e h o p e d , b y i n t r o d u c i n g t h e c o n c e p t o f
dwelling, t o solve t h e puzzles o f t h e link b e t w e e n t w o s u c h radically
d i f f e r e n t p h e n o m e n a and " t h e p r o c e s s o f e x c h a n g e c o n s t a n t l y o c c u r r i n g
a m o n g t h e s e t w o and t h e w o r l d a r o u n d t h e m . "
8
mode
EXISTENTIAL
130
FOUNDATIONS
o f h u m a n b e h a v i o r , M e r l e a u - P o n t y allows t h e c o n c e p t o f dwelling t o
r e m a i n a m b i g u o u s and c o m p l i c a t e d . S o m e t i m e s it is t h e soul's " i n h e r
e n c e " i n t h e body; a t o t h e r t i m e s t h e " a r t i c u l a t i o n " o f t h e soul t h r o u g h
t h e body, o r vice v e r s a . T h e n again, h e speaks s o m e t i m e s o f a c o n s t a n t
e x c h a n g e b e t w e e n s o m e t h i n g s e e i n g and s o m e t h i n g visible, s o m e t h i n g
t o u c h i n g and s o m e t h i n g t a n g i b l e . B u t h e does n o t explain h o w w e a r e t o
i m a g i n e this i n h e r e n c e o r this e x c h a n g e b e t w e e n t w o s u c h h e t e r o g e
n e o u s t h i n g s . H e o n l y a s s e r t s t h a t , t h a n k s t o this i n h e r e n c e and
e x c h a n g e , t h e body i s " t h e abode o f t h e soul, and t h e physical eye t h e
w i n d o w i n t h e b o d y t h r o u g h w h i c h t h e soul m a y p e e r o u t . " I n his v i e w ,
t h e body is an o b j e c t , b u t an o b j e c t in w h i c h we d w e l l . C o n s e q u e n t l y ,
t h e spirit n o t o n l y m a k e s u s e o f t h e b o d y b u t actually unfolds i t s e l f
t h r o u g h t h e m e d i u m o f t h e b o d y and m a k e s i t t r a n s c e n d t h e p u r e l y
physical.
D e s p i t e t h e i r v a r i e t y , e a c h o f M e r l e a u - P o n t y ' s d e s c r i p t i o n s o f dwelling
s h o w s t h a t h e h a s n o t t r a n s c e n d e d C a r t e s i a n dualism. His t h i n k i n g i s o n
t h e o n e h a n d a s e l f - s u f f i c i e n t , s u b s t a n t i v e h u m a n soul, and on t h e o t h e r a
physical body. In M e r l e a u - P o n t y ' s s c h e m e , t h e b o d y is m e r e l y physically
t h e r e until it is t r a n s f o r m e d , by t h e soul's dwelling in it, i n t o a living
h u m a n body. B u t t h e r e i s n o t o n e o b s e r v a t i o n t o c o n f i r m t h a t t h e b o d y
e x i s t s initially u n i n h a b i t e d by soul or spirit, m u c h less for a s e c o n d a r y
m e t a m o r p h o s i s of t h e physical o b j e c t - b o d y i n t o a h u m a n s u b j e c t - b o d y , a
t r a n s f o r m a t i o n i n w h i c h s o m e simple physical o b j e c t w o u l d s u d d e n l y
s t a r t t o p e r c e i v e i t s e l f . E v e n M e r l e a u - P o n t y a d m i t s t h a t this alleged
m e t a m o r p h o s i s is i n e x p l i c a b l e .
M e r l e a u - P o n t y ' s r e f l e c t i o n s on the soul's dwelling in the body w e r e
p r e c e d e d b y H e i d e g g e r ' s v e r y d i f f e r e n t n o t i o n o f h u m a n d w e l l i n g , and
we may assume that Merleau-Ponty's introduction to the concept into
French p h e n o m e n o l o g y was not entirely independent of Heidegger's
i n v e s t i g a t i o n s . B u t , a n u n b r i d g e a b l e gap s e p a r a t e s t h e t w o c o n c e p t s .
M e r l e a u - P o n t y ' s c o n c e p t of dwelling e n t a i l s at least a bipolar
r e l a t i o n s h i p b e t w e e n t h e t w o e n t i t i e s , and t h e possibility o f v i e w i n g t h e
e x t e r n a l w o r l d . IN H e i d e g g e r ' s Daseinsanalytik, by c o n t r a s t , dwelling
r e f e r s t o h u m a n e x i s t e n c e ' s d w e l l i n g - i n - t h e - w o r l d . T h i s dwelling i s
totally o t h e r t h a n a m a t e r i a l p r e s e n c e . It is r a t h e r m a n ' s e k - s t a t i c abiding
by, his e x i s t i n g in th o p e n n e s s of a c l e a r e d w o r l d l y r e a l m . T h i s dwelling,
abiding by, e x i s t i n g , is c a r r i e d o u t in t h e c o n c r e t e p e r c e i v i n g and
a n s w e r i n g r e l a t i o n s h i p s t o t h e b e i n g s o f his w o r l d .
9
10
131
It is I, w h o s e f u n d a m e n t a l c h a r a c t e r is t h e w o r l d - s p a n n i n g o p e n n e s s ol
a n ability t o p e r c e i v e s o m e t h i n g a s s o m e t h i n g , w h o a m able t o b e a w a r e
of m y s e l f as being p r e s e n t , and to be in t h e r e l a t i o n s h i p to w h a t I have
p e r c e i v e d . C e r t a i n l y t h e r e a r e p h e n o m e n a o f this h u m a n e x i s t e n c e that
can be i n t e r p r e t e d , t h o u g h i n a d e q u a t e l y , as t h e p h e n o m e n a of a m a t e r i a l
body situated s o m e w h e r e i n space. N e v e r t h e l e s s , o u r u n d e r s t a n d i n g o f
t h e b o d y h o o d o f h u m a n e x i s t e n c e b e c o m e s a d e q u a t e o n l y w h e n this
b o d y h o o d in its e n t i r e l y is s e e n as bodying f o r t h w a y s of b e i n g in relation
to w h a t a h u m a n being e n c o u n t e r s p e r c e p t i v e l y and r e s p o n s i v e l y at any
given m o m e n t .
11
12
13
14
M e r l e a u - P o n t y g o e s a g a i n s t all e x p e r i e n c e s i n c l a i m i n g t h a t t h e h u m a n
b e i n g , by virtue of the fact t h a t it is his body t h a t inexplicably b e g i n s to
see, to r e f l e c t , and to adapt itself to t h e s u r r o u n d i n g space, is a n c h o r e d in
the WOI Id solely t h r o u g h this b o d y . It is n e v e r o n l y my body, as a selfc o n t a i n e d I Inn);. I ha! s e e s , thinks, and adapts to its spatial e n v i r o n m e n t .
1 5
EXISTENTIAL FOUNDATIONS
132
m u l t i t u d e o f w a y s o f p e r c e i v i n g and r e s p o n d i n g . T h e s e m o d e s can b e
scientifically, i.e., o n t i c a l l y , o b s e r v e d and d e s c r i b e d .
In an e x i s t e n t i a l p e r s p e c t i v e , all t h e p h e n o m e n a t h a t h a v e until n o w
been inexplicably m i s i n t e r p r e t e d a s t h e p o s s e s s i o n s , faculties, o r
f u n c t i o n s of a h y p o t h e s i z e d boxlike p s y c h e b e c o m e visible as t h e h i g h l y
various, concrete modes of existing as the world-spanning openness that
is h u m a n Da-sein.
O n c e one has managed to explode the theoretical myths of
p s y c h o l o g i s m and s u b j e c t i v i s m , and h a s s u c c e e d e d in seeing the h o r i z o n
o f t h e D a s e i n s a n a l y t i k v i e w o f h u m a n being, o n e should also h a v e s e e n
t h e a b s u r d i t y of t h e c o m m o n q u e s t i o n of where, after t h e p s y c h e c o n c e p t
h a s d i s a p p e a r e d , t h e possibilities o f perceiving and a c t i n g w h i c h m a k e u p
h u m a n e x i s t e n c e are t o b e f o u n d . T h e form o f t h e q u e r y only s h o w s t h a t
t h e q u e s t i o n e r is still u n a b l e to get out of t h e traditional v i e w in w h i c h
people are n o t h i n g m o r e t h a n e n t i t i e s p r e s e n t a t p a r t i c u l a r l o c a t i o n s
w i t h i n a p r e s u p p o s e d w o r l d space, isolated b o d i e s , w h e t h e r m a t e r i a l or
i m m a t e r i a l , t h a t c o n t a i n m e n t a l faculties, drives, and a s p i r a t i o n s .
O n c e human existence is seen as bearing the spatio-temporal
w o r l d w i d e r e a l m of o p e n n e s s as, itself, a p e r c e p t i v e and a c t i v e l y
r e s p o n s i v e o p e n n e s s , t h e p r o b l e m of location t a k e s on a w h o l l y d i f f e r e n t
aspect. It is t h e n s e l f - e v i d e n t t h a t t h e possibilities for r e l a t e d n e s s b e l o n g
f u n d a m e n t a l l y and i m m e d i a t e l y t o t h e w h o l e r e a l m o f p e r c e p t i v e
o p e n n e s s . T h e y a r e , i n fact, w h a t c o n s t i t u t e h u m a n b e i n g - i n - t h e w o r l d . T h i s o p e n n e s s is t h e primordial spatiality or prespatiality in w h i c h
t h e possibility of a p h e n o m e n o n ' s being located at a n y p o i n t in space is
grounded.
1 6
133
of p s y c h i c life at a g i v e n m o m e n t . We i m a g i n e this c o n s c i o u s n e s s , as it
w e r e , figuratively a s t h e s t a g e o n w h i c h t h e p a r t i c u l a r psychicp h e n o m e n a c o m e and g o , o r a s t h e m e d i u m i n w h i c h t h e y m o v e . "
I t i s n o t h a r d t o see w h y this s t a g e m e t a p h o r c a n n o t b e t a k e n v e r y
far. A s t a g e c a n n o t p e r c e i v e w h a t is b e i n g played on it. W h i l e we speak of
c o n s c i o u s n e s s w e a l w a y s h a v e i n m i n d t h e ability t o b e c o m e c o n s c i o u s o f
things as phenomena of particular meanings.
1 7
134
EXISTENTIAL
FOUNDATIONS
135
a m y s t e r y h o w a s e l f - c o n t a i n e d i n n e r w o r l d l y e n t i t y w h a t e v e r it is
calledwould p e r c e i v e s o m e t h i n g o u t s i d e i t s e l f a s m e a n i n g f u l , the
t r a d i t i o n a l w a y o f s t a t i n g the p r o b l e m o f c o n s c i o u s n e s s can actually best
be served by being b r o u g h t " t o t h e b u r s t i n g p o i n t . " It is n e c e s s a r y to
e x p l o d e the traditional n o t i o n s of an e n c a p s u l a t e d p s y c h e , w i t h its
e n c l o s e d field o f c o n s c i o u s n e s s , t o u n d e r s t a n d h u m a n b e i n g - i n - t h e world, and it should be clear by n o w t h a t to do so is a main goal of this
existential foundation of medicine.
In t h e s u b s e q u e n t d e v e l o p m e n t of his m e t a p s y c h o l o g y , Freud
c o n t i n u e d to use " u n c o n s c i o u s " as a descriptive adjective, bul a l i o
136
EXISTENTIAL
FOUNDATIONS
i n c r e a s i n g l y indulged in an e n t i r e l y novel u s a g e t h a t a m o u n t e d to a
reification o f the original a t t r i b u t e . T h e s e n t e n c e f r o m F r e u d w e cited
a b o v e was followed w i t h : " n o w , h o w e v e r , it [the u n c o n s c i o u s ] m e a n s
more
We apply t h e t e r m ' t h e u n c o n s c i o u s ' to a system w h o s e distinctive
f e a t u r e is t h a t t h e individual p r o c e s s e s c o m p r i s i n g it a r e u n c o n s c i o u s .
This is the most important sense that the expression 'unconscious' has
acquired in p s y c h o a n a l y s i s .
20
T h a t i s h o w , i n F r e u d ' s m e t a p s y c h o l o g y , w h a t had b e e n r e p r e s e n t e d
initially a s m e r e l y the p r o p e r t y o f a n e n d o p s y c h i c p r o c e s s g r e w t o
b e c o m e a n e n t i t y o f its o w n and w a s accorded all m a n n e r o f p r o p e r t i e s
and laws. N o w it w a s said, for i n s t a n c e , t h a t t h e u n c o n s c i o u s e x h i b i t e d a
s o v e r e i g n disdain for t h e laws of logic. A s e c o n d c h a r a c t e r i s t i c F r e u d
a s c r i b e d to this reified u n c o n s c i o u s was t h e peculiar w a y in w h i c h
t h o u g h t p r o c e s s e s t o o k place in it. T h e s e p r i m a r y p r o c e s s e s , in
contradistinction to the secondary processes of conscious thought, were
m a r k e d b y t h e unparalleled fluidity o f its mobile psychic e n e r g y . T h i s
fluidity p e r m i t t e d disparate ideas to c o a l e s c e to a u n i t y and e n a b l e d t h e
f o r c e of m a n y ideas to be shifted, in t h e u n c o n s c i o u s , o n t o a single o n e .
Moreoever, the unconscious, primary thought process showed no
r e s p e c t for t i m e , replacing e x t e r n a l reality w i t h a psychic reality w i t h i n
w h i c h psychic p r o c e s s e s w e r e s u b j e c t e x c l u s i v e l y t o t h e p l e a s u r e
principle.
In c o n t r a s t to a m e r e l y descriptive u s e of t h e w o r d " u n c o n s c i o u s , "
Freud's reified psychic s y s t e m can be called a dynamic u n c o n s c i o u s . F r e u d
a s s u m e d t h a t t h e psychic p r o c e s s e s and ideational c o n t e n t s o f the
u n c o n s c i o u s had b e e n r e p r e s s e d t h e r e t h r o u g h t h e p o w e r o f a p s y c h i c
c e n s o r and w e r e held t h e r e b y the s a m e psychic d y n a m i s m .
21
T h e s e c h a r a c t e r i s t i c s o f the d y n a m i c u n c o n s c i o u s look a s t h o u g h t h e y
w e r e precise d e t e r m i n a t i o n s of a definable o b j e c t . P e r h a p s it was this t h a t
allowed F r e u d , as well as m o s t p s y c h o l o g i s t s and p s y c h o p a t h o l o g i s t s
a f t e r him to f o r g e t quickly t h a t the h y p o t h e s i z e d d y n a m i c u n c o n s c i o u s is
e v e n f u r t h e r from a n a d e q u a t e u n d e r s t a n d i n g o f h u m a n b e i n g s t h a n t h e
e a r l i e r descriptive n o t i o n o f c e r t a i n psychic p r o c e s s e s a s u n c o n s c i o u s .
F r e u d s u b s e q u e n t l y c h a n g e d his opinion o n h o w psychic data b e c a m e
u n c o n s c i o u s , p r e f e r r i n g m o r e and m o r e t h e idea o f libido w i t h d r a w a l t o
t h a t of d e s c e n t i n t o a topically deeper psychic s y s t e m ; but e v e n in its n e w
r o b e s , t h e h y p o t h e s i s of a psychological u n c o n s c i o u s r e m a i n s m i s l e a d i n g
and d i s t o r t s the t r u e p i c t u r e o f h u m a n b e i n g .
In a s h o r t t i m e , F r e u d had so c o m p l e t e l y f o r g o t t e n the purely
h y p o t h e t i c a l n a t u r e o f t h e u n c o n s c i o u s t h a t h e boldly a t t e m p t e d t o p r o v e
I he e x i s t e n c e of t h e s y s t e m he had i n v e n t e d . As a first step, he declared
137
2 3
138
EXISTENTIAL
FOUNDATIONS
explain t h e e x p e r i e n c e o f s u b j e c t s c a r r y i n g o u t p o s t h y p n o t i c s u g g e s
t i o n s . B u t h e s e e s i n e v e r y d a y slips t h e m o s t c o n v i n c i n g e v i d e n c e for a n
unconscious.
N o t o n e o f t h e s e p r o o f s stands u p u n d e r s c r u t i n y . First o f all, t h e
e v e r y d a y o b s e r v a t i o n t h a t a c o n s c i o u s idea can s u d d e n l y be n o t c o n s c i o u s
is far from b e i n g an empirical, d e m o n s t r a b l e pure fact. F r e u d ' s
description is already an i n t e r p r e t a t i o n of h u m a n b e h a v i o r and
i n a d e q u a t e at t h a t . If, at this v e r y m o m e n t , I c o n s c i o u s l y visualize t h e
F r e i b u r g C a t h e d r a l , w h a t h a p p e n s , as we h a v e t a k e n pains to point o u t , is
not the activation of an intrapsychic representation but that the
c a t h e d r a l i t s e l f appears t h e m a t i c a l l y i n t h e p e r c e p t i v e r e a l m o f m y b e i n g in-the-world. T h e r e is no evidence of the endopsychic representation of
t h e c a t h e d r a l , as F r e u d posited. It is only b e c a u s e , for t h e d u r a t i o n of t h e
visualization, I e n t e r ino an open, l u m i n a t i n g r e l a t e d n e s s to t h e c a t h e d r a l
and am, w i t h all t h a t I a m , by t h e c a t h e d r a l , its actual place, t h a t I can in
t h e n e x t i n s t a n t cut off m y specific r e s p o n s e t o t h e c a t h e d r a l , l e t t i n g its
presence retreat into the nonthematic background of the worldo p e n n e s s as w h i c h I am e x i s t i n g and l e t t i n g a n o t h e r thing, or p e r s o n ,
come forward into the center of my perceptive realm.
J u s t as ill suited as p r o o f s for t h e e x i s t e n c e of a p s y c h i c u n c o n s c i o u s a r e
t h e h y p n o s i s e x p e r i m e n t s o f B e r n h e i m , t h e first t o h a v e people p e r f o r m
a c t i o n s h e had s u g g e s t e d t o t h e m e a r l i e r u n d e r h y p n o s i s . T h e s t a t e o f
h y p n o s i s m a y b e defined a s o n e i n w h i c h t h e h y p n o t i z e d h a s c o m e a l m o s t
totally u n d e r t h e spell o f the h y p n o t i s t . O w i n g t o people's f u n d a m e n t a l
being t o g e t h e r in a s h a r e d w o r l d , it is possible for t h e h y p n o t i z e d p e r s o n
to r e n o u n c e his i n d e p e n d e n t s e l f n e s s to s u c h a d e g r e e t h a t h e n c e f o r t h he
can e x i s t o n l y t h r o u g h t h e h y p n o t i s t , dwelling a s o n e w i t h him i n t h e i r
s h a r e d world. T h i s e n a b l e s t h e h y p n o t i s t t o a r b i t r a r i l y c o m m a n d o b j e c t s
to b e c o m e t h e focal point of his s u b j e c t ' s field of vision and to s h a p e t h e
s u b j e c t ' s r e l a t i o n s h i p y t o t h e s e o b j e c t s . T h e h y p n o t i s t can, for i n s t a n c e ,
o r d e r his s u b j e c t to e s t a b l i s h a r e l a t i o n s h i p to a chair so t h a t , fifteen
m i n u t e s a f t e r t h e t r a n c e h a s b e e n b r o k e n , t h e c h a i r will address him a s
s o m e t h i n g t o b e set o n t h e table. B e c a u s e t h e h y p n o t i z e d s u b j e c t h a s
s u r r e n d e r e d his i n d e p e n d e n t s e l f n e s s , it is e a s y for the h y p n o t i s t to
p r e v e n t him f r o m r e c o g n i z i n g t h e origin o f his p o s t h y p n o t i c r e l a t i o n s h i p
t o t h e chair. All o f this m e r e l y s h o w s t h a t t h e s u b j e c t , a f t e r e m e r g i n g
from h y p n o s i s , h a s n o t y e t r e e s t a b l i s h e d h i m s e l f as an i n d e p e n d e n t self.
T h u s the p e r s o n w h o had b e e n h y p n o t i z e d will e x p r e s s i n t h e first p e r s o n
wh.it is actually t h e h y p n o t i s t ' s act of v o l i t i o n : "I will n o w place t h e c h a i r
on the table." In a similar w a y , m a n y people a r e h y p n o t i z e d by tradition
en l>v I l i e a n o n y m o u s " t h e y " of t h e i r c u l t u r e , n o t realizing t h a t t h e i r
t h o u g h t s and a c t i o n s a r e fulfilling n o t t h e i r o w n e x i s t e n t i a l p o t e n t i a l i t i e s
L a s t b u t n o t least, F r e u d w o u l d i n t r o d u c e d r e a m s a s e v i d e n c e o f the
psychic u n c o n s c i o u s . B u t t h e d r e a m i n g Da-sein of a p e r s o n yields to an
i n v e s t i g a t o r t h e n o t i o n of an u n c o n s c i o u s only if he is d e t e r m i n e d at all
c o s t s t o p r o c e e d i n t h e m a n n e r o f n a t u r a l s c i e n c e , e m p l o y i n g purely
h y p o t h e t i c a l c o n c l u s i o n s in o r d e r to t r a c e t h e d r e a m back to a universally
valid c a u s e t h a t does n o t really e x i s t at all.
T h e p a r t i c u l a r h y p o t h e t i c a l c a u s e F r e u d s t e e r e d t o w a r d i n his d r e a m
t h e o r y can be found on page 4 4 2 of The Interpretation of Dreams: " F r o m the
t h e o r y o f h y s t e r i a w e b o r r o w t h e principle t h a t a n o r m a l train o f t h o u g h l
is s u b j e c t e d to a b n o r m a l psychic e l a b o r a t i o n only w h e n it has b e c o m e the
140
EXISTENTIAL FOUNDATIONS
S u m m i n g u p w h a t w e h a v e said, n o t o n e o f t h e p h e n o m e n a o r
a r g u m e n t s F r e u d i n t r o d u c e s to justify his a s s u m p t i o n of a p s y c h i c
u n c o n s c i o u s actually does w h a t it is supposed to do.
All we h a v e said to c o u n t e r Freud's h y p o t h e s i s of an individual
u n c o n s c i o u s applies in kind to t h e collective u n c o n s c i o u s posited in C a r l
J u n g ' s a n a l y t i c p s y c h o l o g y as an a t t e m p t to c o m p l e t e and underpin
Freudian t h e o r y . T h e collective u n c o n s c i o u s d e r i v e s from t h e v e r y s a m e
subjectivistic understanding of man, the very same psychologistic way of
t h i n k i n g . T o g e t h e r w i t h all t h e a r c h e t y p a l i m a g e s , s t r u c t u r e s , and f o r c e s
t h a t i n h a b i t it, t h e collective u n c o n s c i o u s is n o t h i n g m o r e than an
a t t e m p t t o explain t h a t m a n y p h e n o m e n a reveal t h e m s e l v e s i n t h e s a m e
w a y to people w h o a r e widely s e p a r a t e d in space and t i m e . T h i s fact is
i n c o n t e s t a b l e , b u t J u n g ' s interpretation of it r e s t s on t w o faulty
a s s u m p t i o n s . T h e first i s t h a t h u m a n b e i n g s c o n s i s t , aside from t h e i r
bodies, of an i n d e p e n d e n t , stratified p s y c h e . S e c o n d , t h e v e r y n o t i o n of a
collective u n c o n s c i o u s is an i n s t a n c e of r e d u c t i o n i s m , w h e r e b y a given
diversity of p h e n o m e n a is s u b j e c t e d to a logical g e n e r a l i z a t i o n . H e r e ,
p h e n o m e n a t h a t a r e m e r e l y similar in v a r i o u s t i m e s and places lead to t h e
c o n c l u s i o n t h a t t h e r e i s s o m e s t r u c t u r e e x i s t i n g identically within t h e
brains, or p s y c h e s , of all h u m a n b e i n g s . B u t it is m u c h m o r e likely t h a t
t h e y reveal t h e m s e l v e s , by t h e i r v e r y n a t u r e s , in m u c h t h e s a m e w a y
w i t h i n t h e open realm o f h u m a n p e r c e p t i o n , b e c a u s e they t h e m s e l v e s
s h i n e fori h in the s a m e w a y e v e r y w h e r e and at all t i m e s . T h e r e is n o need
141
to s u p p o s e t h a t a collective u n c o n s c i o u s or o t h e r e n d o p s y c h i c e n t i t y
e x i s t s t o give t h e s e p h e n o m e n a similar shapes a f t e r t h e fact.
All n o t i o n s of a p s y c h i c u n c o n s c i o u s t h a t h a v e b e c o m e r o o t e d in
m o d e r n p s y c h o l o g y t u r n o u t t o b e artificial p r o d u c t s o f t h e o r y , false
footholds m a d e to a d v a n c e a p r e c o n c e i v e d and i n a d e q u a t e approach to
h u m a n being. T h e y have n o t h i n g t o d o w i t h t h e actual p h e n o m e n a o f
h u m a n Da-sein and as a r e s u l t actually o b s t r u c t a d e q u a t e i n s i g h t into t h e
n a t u r e o f people.
It is t h e r e f o r e high t i m e t h a t t h e p h r a s e psychic u n c o n s c i o u s w a s
e x p u n g e d from t h e v o c a b u l a r y o f p s y c h o l o g y and p s y c h o p a t h o l o g y . T h i s
c a n n o t be a c h i e v e d m e r e l y by pointing o u t the artificiality, superficiality,
and h a r m f u l n e s s of this h y p o t h e s i z i n g . T h e idea of a psychic u n c o n s c i o u s
would n e v e r h a v e b e e n able to e f f e c t a global t r a n s f o r m a t i o n of the
s c i e n c e s of h u m a n n a t u r e had it n o t at least v a g u e l y indicated t h e
d i m e n s i o n t h a t e n c o m p a s s e s m a n , his w o r l d , and t h e r e l a t i o n s h i p
between them.
N o t e v e n t h e g r e a t p h i l o s o p h e r s i n t h e W e s t e r n m e t a p h y s i c a l tradition
h a v e b e e n able to m a p o u t a s o l u t i o n to this p r o b l e m . P h y s i c i s t s first
realized t h a t no radical s e p a r a t i o n can be m a d e b e t w e e n perceived
p h e n o m e n a and the people w h o p e r c e i v e t h e m , t h a t i n fact t h e o b s e r v e r
and o b s e r v e d belong t o g e t h e r in a m y s t e r i o u s , o b s c u r e r e a l m . T h e
positivistic, s u b j e c t i v i s t i c , o b j e c t i f y i n g a p p r o a c h e s o f c o n t e m p o r a r y
p s y c h o l o g i s t s and p s y c h o p a t h o l o g i s t s limp decades b e h i n d this insight.
W h i l e believing t h e m s e l v e s t o b e p r o g r e s s i v e s c i e n t i s t s , t h e y are actually
still e n g a g e d , as t h e t h e o r e t i c a l physicist W. H e i t l e r c o r r e c t l y r e m i n d s us,
in i m i t a t i n g a d v a n c e s m a d e in physics in t h e nineteenth c e n t u r y .
B u t e v e n t w e n t i e t h - c e n t u r y physicists have b e e n w o r k i n g s o far
without the advantage of a new ontological orientation appropriate to
their findings. F r o m t h e i r o w n c o n c e p t u a l s t a n d p o i n t , i t h a s t h e r e f o r e
been impossible t o grasp t h e e s s e n t i a l c o h e r e n c e o f p e r c e i v e r and
perceived. O n l y by inquiring into being itself, as M a r t i n H e i d e g g e r h a s
been doing n o w for t h e space of a h u m a n lifetime, can we b e g i n e v e n to
g r o p e t o w a r d t h e h e a r t of t h e m a t t e r . We m a k e a b e g i n n i n g in this
f o u n d a t i o n of medicine in t u r n i n g o u r regard a w a y from t h e i n a d e q u a t e
n o t i o n of a psychic u n c o n s c i o u s and t o w a r d w h a t physicians really o u g h t
to keep in v i e w and c o n s i d e r .
S e v e r a l t i m e s already, m e d i c i n e ' s o b j e c t o f study h a s b r o u g h t u s v e r y
close to t h e m a t t e r at h a n d . In discussing g e n u i n e f o r g e t t i n g , for
e x a m p l e , w e spoke o f p h e n o m e n a t h a t had o n c e b e e n t h e m a t i c a l l y
p r e s e n t dropping out of t h e o p e n realm of an individual h u m a n Da-sein or
b e i n g - t h e - t h e r e , e m p h a s i z i n g t h a t this is n o t j u s t a m a t t e r of
e n d o p s y c h i c r e p r e s e n t a t i o n s o f e x t e r n a l - w o r l d o b j e c t s disappearing into
142
EXISTENTIAL
FOUNDATIONS
a different r e g i o n of an e n c a p s u l a t e d p s y c h e . In f o r g e t t i n g , t h e o b j e c t s of
the world t h e m s e l v e s e s c a p e from t h e o p e n realm of a h u m a n e x i s t e n c e .
W h a t is m o r e a n d we will c o m e back to this l a t e r a t any o n e time in
h i s t o r y t h e r e are c e r t a i n p h e n o m e n a t h a t are invisible to all of m a n k i n d .
T h e p r e s e n t age, for i n s t a n c e , is often described as t h a t age in w h i c h
divinity h a s w i t h d r a w n from t h e o p e n realm o f h u m a n e x i s t e n c e and
t h e r e f o r e can no l o n g e r be h e a r d by m a n .
and Psychology
143
dismiss an i n t e r p r e t a t i o n like o u r s as g r o u n d l e s s m y s t i c i s m or p e r n i c i o u s
i r r a t i o n a l i t y , n e g l e c t i n g to c o n s i d e r t h a t t h e i r e s t e e m e d ratio- i t s e l f can be
p r o p e r l y s e e n o n l y in r e l a t i o n to h i d d e n n e s s and t h e o p e n r e a l m released
f r o m h i d d e n n e s s . As long as r e a s o n and t h e r a t i o n a l a r e left as v a g u e as
t h e y a r e n o w , t h e a c c u s a t i o n o f i r r a t i o n a l i t y aimed a t t h e p h e n o m e n o l o g ical a p p r o a c h will r e m a i n h o l l o w . Indeed, if a n y t h i n g d e s e r v e s to be called
i r r a t i o n a l , it is t h e m i n d l e s s r a m p a g e of r a t i o n a l i t y in t h e d e v e l o p m e n t of
t e c h n o l o g y t h a t i s d o m i n a t i n g t h e industrialized w o r l d .
2 8
W e also t o u c h e d o n t h e p r o p e r d i m e n s i o n o f t h e p r o b l e m i n o u r
a t t e m p t t o define t h e f u n d a m e n t a l trait o f h u m a n Da-sein. T h e h u m a n
being e x i s t s as a s p a n n i n g , b e a r i n g , and holding open of a realm of
perception t h a t i s r e s p o n s i v e t o t h e p r e s e n c e o f w h a t e v e r p h e n o m e n a
r e v e a l t h e m s e l v e s in it. T h e condition of such e x i s t e n c e is an open, free,
clear realm in w h i c h t h e h u m a n Da-sein can dwell, spanning and
m a i n t a i n i n g it in its o w n w a y . S u c h a realm is possible only t h e r e , w h e r e
it is released from h i d d e n n e s s and d a r k n e s s . N e i t h e r t h e clearing n o r the
h i d d e n n e s s o r i g i n a t e s in c o n c r e t e t h i n g s , h u m a n b e i n g s , or in t h e p s y c h e .
R a t h e r , this h i d d e n n e s s is the m y s t e r i o u s s o u r c e from w h i c h all t h a t is
c o m e s f o r t h to be. It is t h u s p r e t e m p o r a l , prespatial, and p r e h u m a n . A n d
as it is also p r e l i n g u i s t i c , the w o r d itself t h a t d e s i g n a t e s this primal
p h e n o m e n o n r e p r e s e n t s only a m a k e s h i f t s o l u t i o n f r a u g h t w i t h the
d a n g e r o f being misleading. T h e w o r d " h i d d e n n e s s " m i g h t lead u s t o
believe t h a t this primal p h e n o m e n o n m u s t b e u n d e r s t o o d o n t h e basis o f
w h a t already is. In colloquial u s a g e , " h i d d e n " r e f e r s to s o m e t h i n g t h a t is
already t h e r e w h i c h has m e r e l y b e e n c o v e r e d and s o w i t h d r a w n ,
t e m p o r a r i l y , f r o m view. F o r i n s t a n c e , a m o n u m e n t m a y be hidden by
draperies until t h e m o m e n t o f its dedication, and t h o u g h w e c a n n o t see
t h e m o n u m e n t until t h e c l o t h is r e m o v e d , we a g r e e t h a t it w a s always
t h e r e u n d e r n e a t h in its final form and d i m e n s i o n s . B u t in t h e g r e a t
h i d d e n n e s s t h e r e is no already e x i s t i n g p a r t i c u l a r being.
T h i s d i m e n s i o n has b e e n c o n s i d e r e d for ages b y n o n w e s t e r n t h i n k e r s
as well. T h e y h a v e a l w a y s circled a r o u n d it in t h e w a y of " n e t - n e t , " saying
"it is n o t t h i s , n o t t h a t , n o t
, not
." It is described t h e n as t h a t
w h i c h is totally o t h e r .
R e m a i n i n g mindful o f t h e ineffability o f this d i m e n s i o n , w e m a y i n t h e
f r a m e w o r k of a f u n d a m e n t a l study of m e d i c i n e call it h i d d e n n e s s . If
W e s t e r n t h i n k i n g s o m e d a y i l l u m i n a t e s this h i d d e n n e s s , it will be s e e n as
the origin and s o u r c e of all t h o s e p h e n o m e n a w h i c h p s y c h o l o g y and
p s y c h o p a t h o l o g y h a v e tried in vain to clarify t h r o u g h s u b j e c t i v i s t i c ,
objectifying, reifying t h i n k i n g w h i c h o p e r a t e s w i t h c o n s t r u c t s like
psy( hie u n c o n s c i o u s .
Admittedly, it is no e a s y m a t t e r to c a t c h sight of and t h i n k this
hhl.lrmi.".-. which releases all t h a t is out o f itself. M a n y would try t o
From drive to the human potential for relating specifically to the world
around
T h e p s y c h i c u n c o n s c i o u s is s o m e t i m e s depicted as a r e s e r v o i r of drives,
w h i c h p s y c h o a n a l y t i c t h e o r y holds t o b e t h e u l t i m a t e reality o f psychic
p h e n o m e n a , t h e k e r n e l from w h i c h all o t h e r psychic m a n i f e s t a t i o n s
spring a s p r o d u c t s o f s u b l i m a t i o n o r a s r e a c t i o n f o r m a t i o n s . T h i s c o n c e p t
is prominent in most other contemporary branches of psychology, too,
t h o u g h m o s t n o n p s y c h o a n a l y t i c t h e o r i e s d o n o t follow F r e u d i n m a k i n g
drives an a b s o l u t e .
A n y s t u d y o f t h e e x t e n s i v e l i t e r a t u r e o n drives s h o w s t h a t while i t h a s
g r e a t i m p o r t a n c e for p s y c h o l o g i s t s and p s y c h o p a t h o l o g i s t s t h e r e is only
v e r y s c a n t y i n f o r m a t i o n a b o u t w h a t drive i s supposed t o b e . F r e u d called
drives " m y t h i c a l c r e a t u r e s o f u n k n o w n o r i g i n " and did n o t h e s i t a t e t o
d e s c r i b e his t h e o r y o f drives a s t h e m y t h o l o g y o f p s y c h o a n a l y t i c t h e o r y .
B u t if it is s u r p r i s i n g t h a t a m o d e r n t h e o r y i n t e n t on p r e s e n t i n g i t s e l f as
e x a c t i n g l y scientific is, by its o w n a d m i s s i o n , satisfied w i t h a m y t h o l o g i
cal basis, m o r e striking i s t h e v e r y r e c e n t v i n t a g e o f t h e c o n c e p t .
Trieb ("drive") a r o s e , in fact, m e r e l y as the s u b s t a n t i v e f o r m of the v e r b
triel ten, m e a n i n g "drive" or "drift," and r e f e r r i n g principally to c a t t l e ,
g a m e , o r o c e a n c u r r e n t s . O n l y i n t h e s e v e n t e e n t h c e n t u r y w e r e drives
s p o k e n o f c o n c e r n i n g people. T h e w o r d still did n o t m e a n " i n n e r
c o m p u l s i o n , " but r e f e r r e d to t h e " s t i m u l u s " or "appeal" e x e r t e d on a
person b y s o m e t h i n g o r s o m e o n e from o u t s i d e h i m s e l f . T h e d i c t i o n a r y o f
the B r o t h e r s G r i m m c o n f i r m s this by including a v e r s e of Agrippina,
dating from 1 6 8 5 : " a d u l t e r y r o b s n e c k , b r e a s t s , and belly o f all t h e i r drive
(appeal)." N o t until t h e e i g h t e e n t h c e n t u r y did p s y c h o l o g y begin to
describe Triebe as drives and " p r i m i t i v e , n a t u r a l s t i r r i n g s . " S o o n
afte r w a r d s Triebe found its fullest and m o s t c h a r a c t e r i s t i c d e v e l o p m e n t in
m e c h a n i c s . M a n y t e c h n i c a l t e r m s a r o s e i n c o m b i n a t i o n w i t h it, a m o n g
them Triebrad ("drive-wheel"), Tnebfeder ("mainspring"), Triebstoff ("fuel").
1 low could t h e m e a n i n g of Trieb h a v e evolved in any o t h e r w a y ?
I ) e s c a r t e s ' s philosophical division of the world into s u b j e c t and object
and his d i s c o v e r y t h e r e b y of t h e basis for t e c h n o l o g i c a l m a s t e r y o v e r the
144
EXISTENTIAL
FOUNDATIONS
14 5
146
EXISTENTIAL
FOUNDATIONS
w h i c h h e i s a t t h a t m o m e n t t h e m a t i c a l l y a w a r e and h a s m a d e his o w n , s o
b e c o m i n g a self. It is this s e l f t h a t e n d u r e s t h r o u g h t h e life h i s t o r y of a Dasein and w h i c h is a d d r e s s e d w h e n e v e r t h e Da-sein says " I " . Its c o n s t a n c y is
s u c h t h a t t h e Da-sein can at all t i m e s r e t u r n to itself and find its i d e n t i t y in
its dwelling by t h e b e i n g s of its w o r l d , h o w e v e r this dwellingi.e.,
relatedness to the worldchanges in time. By contrast, the constancy of
physical s u b s t a n c e c o n s i s t s of its r e m a i n i n g on h a n d for a g i v e n span of
time. Of itself it has nothing to do with time. T h e constancy of the
p e r s o n ' s selfness appears as this h u m a n self "lives o u t its t i m e " in
c a r r y i n g t o fulfillment its possibilities for r e l a t i n g t o t h e p h e n o m e n a o f
its t e m p o r a l - s p a t i a l w o r l d . T h e identity o r s e l f n e s s h a p p e n s only a s the
e x i s t e n c e ' s "living o u t its t i m e ; " it is j u s t this t h a t c o n s t i t u t e s t h e
primordial t e m p o r a l i t y o f t h e h u m a n s e l f . "
2
My Da-sein a l w a y s i n v o l v e s me as t h e w h o l e c r e a t u r e I am, a b s o r b e d in
t h e m o d e s of b e h a v i o r I am c a r r y i n g o u t at a given m o m e n t . W h i l e
e n g a g e d in my p r e s e n t r e l a t e d n e s s to t h e w o r l d , h o w e v e r , I r e t a i n all
t h o s e w a y s of b e i n g r e l a t e d t h a t I r e m e m b e r h a v i n g c a r r i e d o u t in t h e
past, as well as t h o s e I see as p o t e n t i a l i t i e s for m y s e l f in t h e f u t u r e . W h a t
i s m o s t i m p o r t a n t t o n o t e h e r e i s t h a t n o m a t t e r h o w m a n y t i m e s I say " I "
t h e r e is still no a c t u a l p s y c h i c a g e n c y involved. W h a t is involved is my e c
static b e i n g - i n - t h e - w o r l d to t h e e x t e n t t h a t I h a v e m a d e its p o t e n t i a l i t i e s
m y o w n . " I " r e f e r s t o t h e m o s t c o n c r e t e o f all b e i n g s , t h e Da-sein i n its
having grown as one with the world. By contrast, the psychological egoa g e n c y is an a b s t r a c t i o n par e x c e l l e n c e . It is t h e h y p o s t a t i c r e i f i c a t i o n of
c e r t a i n p h e n o m e n a of t h e u n o b j e c t i f i a b l e Da-sein.
T h e s u p e r e g o - a g e n c y is an equally a b s t r a c t c o n s t r u c t i o n . In p s y c h o l
ogy, t h e s u p e r e g o is e m p l o y e d as a s y n o n y m for t h e c o n s c i e n c e . N o w , a
h u m a n being, as t h e perceiving o p e n b e i n g he is, is e n g a g e d in b e a r i n g
and holding o p e n t h a t i n t o w h i c h w h a t h a s t o b e can s h i n e f o r t h and s o
c o m e i n t o b e i n g . All " s h o u l d ' s " are g r o u n d e d in this e x i s t e n t i a l
e n g a g e m e n t . It is to this t h a t c o n s c i e n c e r e f e r s w h e n e v e r a p e r s o n falls
b e h i n d in fulfilling e s s e n t i a l e x i s t e n t i a l t a s k s . No e n d o p s y c h i c a g e n c y is
involved. W h a t p s y c h o l o g y labels t h e s u p e r e g o is a p a r t i c u l a r m o d e of
h u m a n r e l a t e d n e s s t o t h i n g s for t h e sake o f w h o s e d e v e l o p m e n t h e
e x i s t s , i s t h e r e . T h i s f u n d a m e n t a l a w a r e n e s s c a n , like any p e r c e p t i o n , b e
disguised or d i s t o r t e d . It is often d r o w n e d o u t for children by the
s c r e a m i n g o f s e n s e l e s s p a r e n t s , b u t t h a t does n o t alter i n t h e least t h e
p o t e n t i a l i t y for h a v i n g a c o n s c i e n c e , and e v e n less its c a u s e or s o u r c e are
t h o s e w h o falsify its light. T h e e n g a g e m e n t o f a p e r s o n b y w h a t e v e r h e
e n c o u n t e r s in his w o r l d , and t h e r e s u l t i n g c o n s c i e n t i o u s " s h o u l d " are
b o t h e s s e n t i a l t r a i t s of h u m a n b e i n g . As s u c h , t h e y c a n n o t be c a u s e d at a
later time by m e c h a n i s m s h y p o t h e t i c a l l y i n t r o j e c t e d into the p s y c h e .
T o d e s i g n a t e the third psychic a g e n c y , Freud b o r r o w e d the t e r m "id"
147
from G r o d d e c k . In t h e id b e l o n g t h o s e e n d o p s y c h i c r e p r e s e n t a t i o n s of
e x t e r n a l - w o r l d o b j e c t s , and t h e i r p e r t i n e n t a f f e c t s , w h i c h a p e r s o n ' s selfr e g a r d o r m o r a l feeling r e f u s e s t o r e c o g n i z e a s b e l o n g i n g t o him and
r e p r e s s e s , dynamically o r t o p o g r a p h i c a l l y , i n t o this id. W e h a v e already
pointed o u t t h a t e n d o p s y c h i c , u n c o n s c i o u s r e p r e s e n t a t i o n s and affect
c o n f i g u r a t i o n s are scientifically u n t e n a b l e , and n e e d n o t r e p e a t o u r s e l v e s
here.
T h e i d s h a r e s w i t h t h e older u n c o n s c i o u s its d e s i g n a t i o n a s t h e actual
r e s e r v o i r of t h e drives. B u t drive is an a b s t r a c t i o n t h a t d i s t o r t s ,
artificially i s o l a t e s , and reifies a p a r t i c u l a r h u m a n p o t e n t i a l i t y of relating
to w h a t is in t h e world. W h a t is actually g o i n g on, we said, is w h a t we can
see as a p e r s o n ' s i n v o l u n t a r y s u b m i s s i o n to s o m e t h i n g he e n c o u n t e r s .
I n s e v e r a l s t a t e m e n t s o n t h e id, F r e u d anticipated m u c h o f w h a t J u n g
later a t t r i b u t e d t o t h e c o l l e c t i v e u n c o n s c i o u s , s o o u r c r i t i c i s m o f t h e
collective u n c o n s c i o u s applies equally t o t h e Freudian n o t i o n .
T h e p s y c h o l o g i c a l c o n c e p t o f t h e id, like t h o s e o f t h e e g o and s u p e r e g o ,
t u r n s o u t to be n o t h i n g m o r e t h a n a reified, p e r s o n i f i e d a b s t r a c t i o n .
D e p t h p s y c h o l o g y deduced all t h r e e o f t h e s e a g e n c i e s from p a r t i c u l a r
h u m a n p o t e n t i a l i t i e s o f r e l a t i n g t o the world. I n u s i n g s u c h c o n s t r u c
tions, c o n t e m p o r a r y t h e o r i e s a r e m e r e l y b o r r o w i n g t h e m e t h o d o l o g y o f
lairy t a l e s , w h i c h likewise t e n d t o a b s t r a c t and p e r s o n i f y , r e n d e r i n g the
pleasing b e h a v i o r of adults the a g e n c y of a good fairy and displeasing
b e h a v i o r t h e a g e n c y of a w i c k e d w i t c h . T h i s s o r t of i n t e r p r e t a t i o n is
h a r m l e s s e n o u g h in fairy t a l e s , b u t in p s y c h o l o g y it is h a r m f u l b e c a u s e it
artificially f r a g m e n t s h u m a n b e i n g - i n - t h e - w o r l d . T h e v e r y c h a r a c t e r i s t i c
that d i s t i n g u i s h e s h u m a n Da-sein is t h e unified w a y in w h i c h it e n g a g e s ,
and is a b s o r b e d , in t h e w a y s of r e l a t i n g to w h a t it e n c o u n t e r s . It n e v e r
happens t h a t in a p a r t i c u l a r h u m a n b e h a v i o r only o n e piece of a p e r s o n ' s
being is e n g a g e d , for t h e simple r e a s o n t h a t h u m a n b e i n g - i n - t h e - w o r l d is
b y n a t u r e indivisible. T h i s fact implies, r a t h e r t h a n p r e c l u d e s , the
possibility o f o n e b e h a v i o r being followed, w i t h l i g h t n i n g s u d d e n n e s s
and for a n y n u m b e r o f r e a s o n s , b y a n o t h e r t h a t m a n i f e s t s a n e n t i r e l y
different w a y o f r e l a t i n g t o t h e w o r l d .
All o f this p o i n t s t o t h e n e e d for freeing t h e
ol h u m a n Da-sein from t h e s h a c k l e s of
11 amework. T h e three psychic agencies must
c a t e g o r i e s o f h u m a n b e h a v i n g and relating
a i r . 1 1 acted.
demonstrable phenomena
a distorting conceptual
b e r e t u r n e d t o t h e diverse
from w h i c h t h e y w e r e
148
EXISTENTIAL FOUNDATIONS
149
m e a n i n g f u l i n the c o n t e x t s o f h u m a n e x i s t e n t i a l p h e n o m e n a t o c o n f o r m
t o t h e m e a n i n g l e s s n e s s o f causal c o n n e c t i o n s . I n r e v e r t i n g from a n
h i s t o r i c a l t o a n a t u r a l scientific v i e w o f h u m a n b e i n g s , h e i n e x o r a b l y
m a d e t h e t e r m " m o t i v e " s y n o n y m o u s w i t h t h e idea o f " p s y c h i c c a u s e . "
H e s o o n used t h e t w o t e r m s i n t e r c h a n g e a b l y , a p r a c t i c e t h a t s u r r o u n d e d
his t h e o r y w i t h i m m e n s e t e r m i n o l o g i c a l c o n f u s i o n . T h i s p e r p l e x i t y
spread b e y o n d t h e p s y c h o a n a l y t i c s c h o o l t o infect m o s t o t h e r t h e o r i e s ,
t h o u g h in s o m e it had a r i s e n i n d e p e n d e n t l y . In a n y c a s e , t h e e x t e n t to
w h i c h this c o n f u s i o n o f p s y c h i c c a u s e and m o t i v e t o o k hold i n m o d e r n
p s y c h o l o g y and p s y c h i a t r y i s n o t h i n g t o b e proud of. W h e n e v e n F r e u d n o
l o n g e r d i s t i n g u i s h e d b e t w e e n t h e t w o , o t h e r s f o l l o w e d suit, like
K r e t s c h m e r , w h o w r i t e s : "In r e a l i t y i t i s this w a y : t h e m a n i f e s t a t i o n o f
an a c t i o n is a c c o m p a n i e d by t h e f o r m a t i o n of a m o t i v a t i o n a l c l u s t e r or, to
put it m o r e g e n e r a l l y , a p s y c h i c , causal c l u s t e r . " M c C l e l l a n d , on t h e o t h e r
hand, w r i t e s : " T h e only p a t e n t l y u n a l t e r a b l e a s p e c t o f m o t i v a t i o n i s t h e
n e g a t i v e affective s t a t e c r e a t e d i n t e r n a l l y b y m e t a b o l i s m , and a l w a y s
f u n c t i o n i n g as a motive, m e a n i n g t h a t it is c o n n e c t e d w i t h f u r t h e r
c h a n g e s , positive o r n e g a t i v e . " B u t t h e m o s t i m p r e s s i v e e v i d e n c e o f the
c o n f u s i o n s u r r o u n d i n g m o t i v e and psychic c a u s e i n c o n t e m p o r a r y
p s y c h o l o g y and p s y c h i a t r y is t h e v o l u m i n o u s a n t h o l o g y e n t i t l e d Die
Motivation menschlichen Handelns. In t h e c o u r s e of its 5 0 0 pages, the t w o
t e r m s a r e used i n t e r c h a n g e a b l y , w i t h o u t a n y t h o u g h t being g i v e n t o the
m a t t e r , d o z e n s o f t i m e s and b y a n e x t r e m e l y varied sampling o f w r i t e r s .
N o w h e r e d o e s t h e r e appear a s t r i c t , scientific c o n s i d e r a t i o n of t h e radical
difference between these concepts.
3 0
31
150
EXISTENTIAL FOUNDATIONS
"during," "on the occasion of." It is often forgotten that the meaning of
this w o r d w a s t r a n s f o r m e d to d e s c r i b e a causal r e l a t i o n s h i p as s o m e t h i n g
t h a t p r o d u c e s s o m e t h i n g d i f f e r e n t o u t o f itself. P h y s i c i s t s long a g o
r e d i s c o v e r e d t h a t t h e i r c a u s a l i t y can m e a n n o t h i n g but a description of a
simple t i m e r e l a t i o n s h i p , t h a t t h e causal c o n n e c t i o n s t h e y find in n a t u r e
are no m o r e than records of regularities in the order of temporal
s u c c e s s i o n o f c e r t a i n p h e n o m e n a . T h e e v e n t s a r e not b o u n d t o g e t h e r b y
a n y d i s c e r n i b l e meaning. C o n s e q u e n t l y , causal r e l a t i o n s h i p s do n o t m a k e
us c o m p r e h e n d m e a n i n g . W h a t t h e y yield is i n h e r e n t l y r e s t r i c t e d to t h e
purely t e m p o r a l s t a t e m e n t : " w h e n . . . t h e n . "
in t i m e w i t h r e g u l a r i t y . M o t i v e , t h e r e a s o n b e h i n d a p a r t i c u l a r h u m a n
a c t i o n , should t h e r e f o r e n e v e r be t h o u g h t of as a c a u s e , in t h e strict,
scientific s e n s e o f t h e w o r d . T h e g u s t o f wind t h a t closed t h e w i n d o w a
t r u e c a u s e h a s no f r e e d o m of decision, n o r is it a b l e , or r e q u i r e d , to
perceive in t h e w i n d o w a m e a n i n g f u l n e s s , t h e p o t e n t i a l f o r being closed,
b e f o r e b l o w i n g it shut. C o n s e q u e n t l y , a wind can n e v e r c h o o s e and act.
T h e m o t i v e for my closing t h e w i n d o w , on t h e o t h e r h a n d , is no such blind
c a u s e . E v e r y h u m a n action i s m o t i v a t e d o n a c c o u n t o f s o m e t h i n g
r e c o g n i z e d by t h e person in q u e s t i o n , and this r e c o g n i t i o n is g r o u n d e d in
a p e r s o n ' s being e n g a g e d by s o m e p h e n o m e n o n t h a t a d d r e s s e s h i m .
152
EXISTENTIAL
FOUNDATIONS
J a s p e r s , Allgemeine Psychopathologie ( B e r l i n : S p r i n g e r , 1 9 2 3 ) , p. 9 6 .
153
|0.|2),
(Cologne, Berlin:
K i e p e n h e u e r and
Chapter 9
CRITICISMS OF AN EXISTENTIAL METHOD OF
MEDICAL INVESTIGATION
156
EXISTENTIAL
FOUNDATIONS
scientific c h a r a c t e r o f a n e x i s t e n t i a l f o u n d a t i o n o f m e d i c i n e t o t h e d e g r e e
t h a t it b e c o m e s a triple a c c u s a t i o n . O n c e t h e total calculability of all
t h i n g s is p o s t u l a t e d as a u n i v e r s a l t r u t h , all t h e s t e p s leading up to t h e
triple a c c u s a t i o n s e e m t h o r o u g h l y logical. T h e steps o f this logical a r e
o b v i o u s : (1) C a l c u l a b i l i t y n e c e s s a r i l y p r e s u p p o s e s t h e precise d e t e r m i n a
tion o f a n y t h i n g ; (2) O n l y o b j e c t s c o n c e p t u a l i z e d u n e q u i v o c a l l y can b e
precisely d e t e r m i n e d ; (3) W i t h o u t u n e q u i v o c a l c o n c e p t u a l i z a t i o n , t h e r e
can be no precise calculability; (4) W i t h o u t precise calculability, t h e r e can
be no natural s c i e n c e ; (5) In t h e a b s e n c e of n a t u r a l s c i e n c e , t h e r e is no
s c i e n c e at all.
O u t s i d e t h e c h a r m e d circle o f s u c h i n t e l l e c t u a l fallacies t h e c h a r g e o f
u n s c i e n t i f i c n e s s levelled at D a s e i n s a n a l y s i s falls apart. It is s u p p o r t e d
o n l y b y t h e claim o f n a t u r a l s c i e n c e t h a t n o o t h e r w a y o f t h i n k i n g has the
p o w e r to d e t e r m i n e w h a t is real and w h a t is n o t . T h i s claim is as
u n f o u n d e d as it is a r r o g a n t and c e r t a i n l y does n o t i t s e l f admit of scientific
verification. T h e r e s u l t i s t h a t n o f i r s t - r a t e r e p r e s e n t a t i v e o f t r u e n a t u r a l
s c i e n c e i s e v e n willing t o m a k e this claim a n y m o r e , t h o u g h t h e n u m b e r
o f physicians w h o cling t o i t r e m a i n s high.
T h e second charge, that Daseinsanalysis is hostile to concepts, is on
equally thin ice. It c a n n o t s e r i o u s l y be held t h a t this a p p r o a c h tries to g e t
b y e n t i r e l y w i t h o u t b e n e f i t o f c o n c e p t u a l i z a t i o n . All t h a t can actually b e
c o n t e n d e d i s t h a t this a p p r o a c h , unlike t h a t o f n a t u r a l s c i e n c e , d o e s n o t
set out to c a p t u r e w h a t it studies in e x a c t , u n e q u i v o c a l , quantifiable
c o n c e p t s . B y w h a t r i g h t , w e m a y well ask, can this a c c u s a t i o n declare t h a t
e v e r y t h i n g t h a t is can be d e t e r m i n e d , in e v e r y aspect of its r e a l i t y ,
t h r o u g h e x a c t , c l e a r - c u t m a t h e m a t i c a l f o r m u l a t i o n s ? W h o i s t o say t h a t
t h e r e m i g h t n o t also be a p h e n o m e n a w h o s e v e r y n a t u r e s defy precise,
unequivocal definition? Might not some entity appear whose inherently
c o m p l e x m e a n i n g f u l n e s s c a n n o t be r e d u c e d to a single u n e q u i v o c a l piece
o f i n f o r m a t i o n ? F e a r and a n x i e t y , for i n s t a n c e , a r e n o t s u b j e c t t o e x a c t
m e a s u r e m e n t . It is t r u e t h a t precise, f u n c t i o n a l c o n c e p t u a l i z a t i o n s of
s u c h p h e n o m e n a will f u n c t i o n i n c o m p u t e r s and m a t h e m a t i c a l o p e r a
t i o n s , but it should n e v e r be f o r g o t t e n t h a t this m e t h o d c a p t u r e s o n l y an
insignificant part o f t h e i m m e a s u r a b l e reality o f t h e s e e m o t i o n s . If, o n
the other hand, an existential interpretation of an ambiguous pheno
m e n o n r e n d e r s it in all its a m b i g u i t y , t h e i n t e r p r e t a t i o n h a s p r e s u m a b l y
conceived t h a t p h e n o m e n o n , as it t a k e s place in t h e w o r l d of a h u m a n
e x i s t e n c e , far m o r e c o m p l e t e l y t h a n t h e r e d u c e d definition b a s e d upon
c l e a r - c u t , n a t u r a l scientific c a l c u l a t i o n s . A c c o r d i n g l y , t h e c h a r g e o f
hostility to c o n c e p t s is t u r n e d back upon t h e n a t u r a l scientific critics
t hemselves.
Criticisms
of Medical
Investigation
157
158
EXISTENTIAL
FOUNDATIONS
Criticisms
of Medical
Investigation
159
A g a i n s t t h e b a c k g r o u n d o f t h e s e f a c t s , t h e third o b j e c t i o n , the
a c c u s a t i o n o f lack o f o b j e c t i v i t y i n o u r m e t h o d also b e c o m e s m e a n i n g l e s s
We should r e m e m b e r that objectsin the strictest sense of the word
h a v e e x i s t e d for o n l y 3 0 0 y e a r s . A s w e h a v e said, t h e r e w e r e n o o b j e c t i v e
o b j e c t s , n o r could t h e r e be, b e f o r e D e s c a r t e s e l e v a t e d t h e h u m a n mind a s
res cogitans, to t h e s t a t u s of t h e sole s u b j e c t upon w h i c h all o t h e r b e i n g s
depend for t h e i r being a s o b j e c t s . T h e s e o t h e r b e i n g s w e r e posited a s o b
j e c t e d (Lat.: ohjacere), i.e., t h r o w n a g a i n s t t h e h u m a n faculty of
i m a g i n a t i o n . T h e y w e r e t h e n c o n c e i v e d o f solely a s s o m e t h i n g
r e p r e s e n t e d b y t h e h u m a n s u b j e c t , and this t h e n w a s t h e i r m o d e o f being.
T o a n y o n e i m m e r s e d i n t h e C a r t e s i a n s u b j e c t - o b j e c t division, t h e o n l y
possible a l t e r n a t i v e s e e m s t o b e a n u n f o c u s s e d e m o t i v e e n t h u s i a s m for
experience in which the human observer would come to merge entirely
w i t h w h a t i s o b s e r v e d until b o t h s i n k i n a s o g g y p a s t e . T o c r i t i c s w h o s e e
o n l y this a l t e r n a t i v e , t h e m e r e fact t h a t t h e o r i e n t a t i o n o f d a s e i n s a n a l y s i s
is n o n n a t u r a l scientific is sufficient to classify it as a b r a n d of u n o b j e c t i v e
e n t h u s i a s m for e x p e r i e n c e .
B u t we h a v e already s p o k e n of a third possible r e l a t i o n s h i p to t h e
w o r l d , o n e t h a t is p r i o r to all e x a c t n a t u r a l scientific c o n c e p t u a l i z a t i o n ,
prior t o all e m o t i o n a l e n t h u s i a s t i c e x p e r i e n c e , and t h e f o u n d a t i o n for
b o t h o f t h e s e . I t i s t h e f u n d a m e n t a l r e l a t e d n e s s o f h u m a n being t o w h a t
is, o u r i n h e r e n t worldly r e l a t i o n s h i p o f b e i n g - i n - t h e - w o r l d . W h e n e v e r
w e direct o u r a t t e n t i o n t o this basic trait o f h u m a n e x i s t e n c e , i t r e v e a l s
i t s e l f directly. W e h a v e r e p e a t e d l y described this all-founding r e l a t i o n
ship as a p e r c e p t i v e o p e n n e s s to w h a t e v e r r e v e a l s i t s e l f to h u m a n being.
B e i n g - t h e r e in this w a y , a h u m a n being can allow w h a t e v e r r e v e a l s i t s e l f
to h i m in its c o n t e x t of m e a n i n g and r e f e r e n c e w i t h i n an o p e n vis-a-vis at
its p r o p e r place in his w o r l d and t h e n e n t e r i n t o a free dialogue w i t h it.
T h i s is c e r t a i n l y no o b j e c t - h o s t i l e e n t h u s i a s m for e x p e r i e n c e , since it
o f f e r s a n y unbiased t h i n k e r a c o n s i d e r a b l y s t r i c t e r d i s t i n c t i o n b e t w e e n
t h e h u m a n and n o n h u m a n t h a n t h e old C a r t e s i a n o b j e c t i v i t y , w h i c h i s
actually n o t h i n g b u t s u b j e c t i v i s m carried t o t h e e x t r e m e .
T h e s e c o n d g e n e r a l c a t e g o r y o f o b j e c t i o n s t o t h e Da-sein-based
description o f h u m a n being c o n c e r n s the allegedly allegorical and
a p p a r e n t l y m e r e l y o p e r a t i o n a l d e s c r i p t i o n s of t h e Da-sein. Its v i e w of
h u m a n being as o p e n n e s s to p e r c e p t i o n , as clearing, and as r e s p o n s i v e
ness to what it encounters is often misconstrued as mere analogy. T h e s e
f u n d a m e n t a l d e s c r i p t i o n s a r e simply m i s u n d e r s t o o d a s u n r e a l i s t i c ,
poetic, m y s t i c a l a b s t r a c t i o n s , or as vivid allegorical and m e t a p h o r i c a l
f i g u r e s of s p e e c h , w h i c h should h a v e no place in a scientific (i.e., strict and
s o b e r - t h i n k i n g ) s c i e n c e o f m a n . T h e e x i s t e n t i a l s t a t e m e n t a b o u t clearing,,
w o r l d - o p e n n e s s as the dwelling of the h u m a n being, is often c o n f u s e d
EXISTENTIAL
160
FOUNDATIONS
Chapter 10
TRANSITIONAL DIFFICULTIES IN UNDERSTANDING
DASEINSANALYTIC INSIGHTS
From our attempts to describe the existential traits that are most
significant for m e d i c i n e h a v e c o m e r u d i m e n t s of a Dasefn-based
a n t h r o p o l o g y . B e i n g a first e f f o r t , t h e s e do n o t claim to be c o m p r e h e n
sive, b u t t h e y can s e r v e n e v e r t h e l e s s as a s o u n d basis for t h e a r t of
h e a l i n g . T h e e s s e n c e of h u m a n being is s e e n , in t h e s e r u d i m e n t s , as Dasein, as b e i n g - t h e r e ; or, b e t t e r still, as b e i n g - t h e - t h e r e , w h e r e there r e f e r s
to the whole, open realm of perception that is the essence of human
b e i n g . T h e Da-sein o f all h u m a n b e i n g s t o g e t h e r c o m p r i s e s a n open r e a l m
t h a t a l o n e m a k e s i t possible for t h i n g s t o s h i n e f o r t h and c o m e i n t o being.
W h e n c o n f r o n t e d w i t h t h e t e s t c a s e , t h e Dasem-based a p p r o a c h clearly
d e m o n s t r a t e d its e x c l u s i v e ability t o elucidate t h e individual, c o n c r e t e ,
o b s e r v a b l e p h e n o m e n a of a p a r t i c u l a r h u m a n being as t h e o n t i c
p h e n o m e n a t h e y are. No a p p r o a c h can s u c c e e d h e r e if it is tied to
t r a d i t i o n a l c o n c e p t i o n s o f h u m a n b e i n g s a s physical bodies, o r a s
r e a s o n i n g o r g a n i s m s , or as t h e s u b j e c t h a l f of a s u b j e c t - o b j e c t
relationship, or as the self-actualizing creatures M a r x sees. T h e n u n c
a p p r o p r i a t e Dasein-based v i e w of h u m a n b e i n g s b e g i n s o n l y w h e n I he
long e s t a b l i s h e d cliches a r e a b a n d o n e d in favor of a totally n e w point ol
d e p a r t u r e : t h e simple a s s e n t , r e c e i v i n g . It is m o r e t h a n m e r e e x p e c t a t i o n ,
and it is also v e r y d i f f e r e n t f r o m t h e natural scientific a s s u m p t i o n , whit h
162
EXISTENTIAL
FOUNDATIONS
Transitional
Difficulties
L63
164
EXISTENTIAL
FOUNDATIONS
Part III
e R u d i m e n t s of an Existential
G e n e r a l Pathology
Chapter 11
TESTING AN EXISTENTIAL RESEARCH METHOD
ON SEVERAL PATHOLOGICAL PHENOMENA OF THE
TEST CASE
168
EXISTENTIAL
FOUNDATIONS
M a n y t h e o r e t i c a l h y p o t h e s e s and m a n y u n p r o v e n s u p p o s i t i o n s had t o
b e cleared a w a y b e f o r e t h e d r e a m e r could learn t o s e e the significance o f
her dream world without distortion. S h e was encouraged to abandon her
r e c e n t l y acquired k n o w l e d g e o f t h e w i s h - f u l f i l l m e n t t h e o r y o f t h e
d r e a m , of libidinal and a r c h e t y p a l d r e a m s o u r c e s and d r e a m m o t o r s , as
well a s h e r a c q u a i n t a n c e w i t h t h e o r i e s o f p s y c h i c p r o j e c t i o n , w h i c h
figures in traditional d r e a m i n t e r p r e t a t i o n s on t h e so-called o b j e c t i v e and
subjective levels.
1
L69
Finally, t h e p h e n o m e n o l o g i c a l a p p r o a c h t o t h e s t e r e o t y p i c a l dream
a l l o w e d t h e d r e a m e r t o u n d e r s t a n d t h a t w h a t s h e e x p e r i e n c e d a t night
w a s n o t at all a d r e a m in t h e s e n s e of s o m e t h i n g t h a t can be p o s s e s s e d or
made. R a t h e r , dreaming means being-in-the-world in some particular
w a y for t h e d u r a t i o n o f t h e d r e a m . D r e a m i n g a s well a s w a k i n g , t h e n , she
e x p e r i e n c e d h e r s e l f as an e x i s t i n g h u m a n being e n g a g e d in and dwelling
in her perceptive relationships to things in her world.Only those things
t o w h i c h h e r e x t r e m e l y c o n s t r i c t e d e x i s t e n c e w a s o p e n , h o w e v e r , could
a p p e a r in t h e realm of this e x i s t e n c e and be perceived t h e r e : a cold e m p t y
o c e a n , an icy w i n d , an e m p t y b o x c a r , and she h e r s e l f as a f o r g o t t e n piece
of m e r c h a n d i s e a l o n e in a c o r n e r .
W e appear t o h a v e g l e a n e d e v e r y t h i n g o f i m p o r t a n c e t h a t the
s t e r e o t y p i c a l d r e a m will allow u s t o say a b o u t o u r t e s t s u b j e c t ' s deficient
m o d e o f e x i s t e n c e . A n y t h i n g added a t this point w o u l d b e i n t h e n a t u r e o f
a r b i t r a r y i n v e n t i o n s and p s e u d o s c i e n t i f i c violation o f t h e given facts. A t
first g l a n c e , a n e x i s t e n t i a l i n t e r p r e t a t i o n o f this d r e a m s e e m s poor indeed
a l o n g s i d e c u s t o m a r y d r e a m e x p l i c a t i o n s . B u t it p r o v e d rich e n o u g h in
r e a l i t y to l a u n c h a t h e r a p e u t i c p r o c e d u r e t h a t led to an a s t o n i s h i n g l y
rapid c u r e .
170
EXISTENTIAL FOUNDATIONS
s e p a r a t e m a l e or f e m a l e people. H u m a n being e x p a n d s i n t o a b o u n d l e s s ,
b e a m i n g r e a l m o f light. T h i s i s t h e m o m e n t o f s e x u a l o r g a s m and t h e
peak of a literal e c s t a s y of t h e w h o l e l o v e r and m e , hurling us b e y o n d
o u r s e l v e s . P h y s i c a l b o u n d a r i e s s t o p e x i s t i n g . All t h a t w a s held s e c u r e l y in
its e v e r y d a y c o n t o u r s j u s t a m o m e n t b e f o r e dissolves i n t o an infinite
b r i g h t n e s s . T h e b r e a d t h o f a w o r l d o f love like this has n o r e g a r d for
boundaries."
R e g u l a Z r c h e r s o m e t i m e s c o m p a r e d t h e love e c s t a s y w i t h a m u c h
g e n t l e r t r a n s p o r t , s i n k i n g i n t o deep, d r e a m l e s s sleep. In t h e final
a n a l y s i s , s h e said, this t r a n s p o r t t o o w a s s o m e t h i n g t h a t people n e e d
from t i m e t o t i m e t o r e m a i n h e a l t h y , a s t h e y n e e d t h e e c s t a s i e s o f love.
T h e t w o kinds of t r a n s p o r t a r e related as well in t h a t each can re-place us
i n t o a m o r e e n e r g e t i c and a f f e c t i o n a t e c o e x i s t e n c e w i t h t h e people and
t h i n g s o f o u r e v e r y d a y w o r l d t h a n w e e n j o y e d b e f o r e . N a t u r a l l y , the love
e c s t a s y c a n n o t a c c o m p l i s h this sort o f r e b i r t h i n t o t h e w a k i n g , e v e r y d a y
w o r l d if t h e t r a n s p o r t w i t h a s e x u a l p a r t n e r is c o n f i n e d to a single s t o l e n
m o m e n t . It m u s t be a p r e s e n t w h i c h is s u s t a i n e d by long i n t i m a c y and t h e
e x p e c t a t i o n of a f u t u r e life t o g e t h e r .
R e g u l a Z r c h e r w a s q u i t e d i f f e r e n t during the t i m e s w h e n , e s t r a n g e d
from h e r h u s b a n d , s e p a r a t e d from h e r beloved, s h e g r e w m o r e and m o r e
lonely. T r u e , t h e r e w a s still h e r little d a u g h t e r , w h o m s h e loved
i n t e n s e l y . B u t h a v i n g h e r e n t i r e e x i s t e n c e r e d u c e d t o a single m o t h e r l y
r e l a t i o n s h i p t o h e r child w a s a n u n b e a r a b l e r e s t r i c t i o n for this h i g h l y
gifted and spirited p e r s o n . I t w a s this s t a t e o f e x t r e m e c o n s t r i c t i o n t h a t
paved t h e w a y for t h e i n t r u s i o n o f t h e u r g e s t o s t a b and s t r a n g l e . I n t h e s e
p h a s e s o f h e r life, t h e p a t i e n t felt n e a r s u f f o c a t i o n and s u f f e r e d f r o m
attacks of breathlessness that forced her to t h r o w open every window in
t h e h o u s e , s u m m e r and w i n t e r alike. S h e felt as if s h e w e r e locked in a
prison. S h e b e c a m e i n c r e a s i n g l y r e s t l e s s and u n e a s y . S h e w a s u n a b l e t o
c o n c e n t r a t e o n any o n e activity, b u t w a s driven f r o m o n e t h i n g t o t h e
n e x t . T h e m o s t m i n o r difficulty a n n o y e d h e r n o e n d , p r o v o k i n g fits o f
s c r e a m i n g and o u t b u r s t s o f rage i n w h i c h she w a n t e d t o c r u s h a n y t h i n g
t h a t stood in h e r w a y and h e a v e it t h r o u g h t h e w i n d o w . E v e r y t h i n g
would s e e m to rise up a g a i n s t h e r as a b a r r i e r o b s t r u c t i n g h e r u n f o c u s s e d
urge t o g e t o u t i n t o t h e o p e n .
Y e t in t h e midst of t h e s e periods of s e v e r e f r u s t r a t i o n and ill
humor, Regular Z r c h e r knew m o m e n t s of great happiness. T h e s e
usually happened during t h e e v e n i n g h o u r s , w h e n s h e w a s u n t r o u b l e d
a n d could lose h e r s e l f i n h e r m a t e r n a l m i n i s t r a t i o n s o f h e r child. S h e w a s
happy w a t c h i n g the little girl splashing in t h e b a t h t u b , h e a r i n g h e r s h o u t
foi |oy ( a i i vii')', her to bed a f t e r w a r d s and praying with h e r , she could
enfold the ( hild in her m o t h e r i n g love.
171
W h i l e t h e i n t i m a c y o f this m o t h e r - c h i l d r e l a t i o n s h i p m a d e h e r happy,
this h a p p i n e s s w a s e n t i r e l y d i f f e r e n t f r o m t h a t w h i c h she felt in the
e c s t a s i e s s h e s h a r e d w i t h h e r lover. H a p p i n e s s w i t h t h e child w a s , a s she
h e r s e l f said, i n c o m p a r a b l y m o r e placid b u t also m o r e limited, far from
t r a n s p o r t and s e l f - s u r r e n d e r . I n h e r loving c o n c e r n for h e r child, R e g u l a
Z i i r c h e r had t o c o n t a i n h e r s e l f for t h e sake o f the child, t o a t t e n d o n l y t o
t h e child's w a n t s and n e v e r t h i n k o f h e r s e l f . Still, this d e v o t i o n t o h e r
child w a s a blessing to h e r .
B u t i t w a s precisely t h e isolated m o m e n t s o f deep h a p p i n e s s r e m a i n i n g
t o h e r t h a t called u p t h e i m p u l s e s t o stab and s t r a n g l e m o s t p o w e r f u l l y .
A s i f t h e y c a m e o u t o f t h e c l e a r blue s k y s o w e are t o l d t h e s e
d e s t r u c t i v e u r g e s w o u l d d e s c e n d and t h r e a t e n t o c a r r y h e r a w a y . I n n o
time a t all t h e y would d e s t r o y t h e i n t i m a c y b e t w e e n m o t h e r and
child, from o n e s e c o n d t o t h e n e x t splitting t h e m i n t o p o t e n t i a l m u r d e r e r
and p o t e n t i a l v i c t i m . T h e p a t i e n t h e r s e l f could n o t r u n o u t i n t o t h e hall
fast e n o u g h , w h e r e , h o r r i f i e d a t h e r s e l f , she w o u l d r e s t r a i n t h e
offending right h a n d w i t h t h e left.
I f w e a r e t o u n d e r s t a n d this e x t r e m e l y p a t h o l o g i c a l b e h a v i o r solely o n
t h e basis o f t h e given s i t u a t i o n and t h e p h e n o m e n a lying b e f o r e u s , w e
m u s t first m a k e i t c l e a r t h a t a t n o t i m e could t h e p a t i e n t b e s h o w n t o
e x h i b i t a n u n c o n s c i o u s d e a t h w i s h t o w a r d h e r d a u g h t e r . E v e n during t h e
h o u r s b e f o r e the e p h e m e r a l m o m e n t s o f h a p p i n e s s w i t h t h e d a u g h t e r ,
w h e n a m o o d o f d e s p e r a t e and s u f f o c a t i n g a n x i e t y , o f u n b e a r a b l e
c o n s t r i c t i o n and c o n s t r a i n t r e i g n e d , n o t h i n g o f t h e p a t i e n t ' s e x i s t e n c e
could j u s t i f y s u c h a n a s s u m p t i o n . S h e e x p e r i e n c e d n o death w i s h e i t h e r
during t h e happy m o m e n t s , n o r a f t e r w a r d s , w h e n t h e i m p u l s e s t o s t a b
and s t r a n g l e o v e r c a m e h e r . E v e n w h e n she was a n n o y e d t o t h e b r e a k i n g
point and full o f m a l i c e , s h e n e v e r felt t h e p r e s e n c e o f a n y m a s c u l i n e u r g e
to p e n e t r a t e , to s e e k o u t a f e m a l e being for sacrifice to a m a s c u l i n e desire
to ravish and v i o l a t e . No t r a c e of s u c h a desire was u n c o v e r e d e i t h e r in
the p a t i e n t ' s m o n t h l o n g , m e t i c u l o u s o b s e r v a t i o n o f h e r s e l f o r i n h e r
physician's p r o l o n g e d i n v e s t i g a t i o n .
F u r t h e r , t h e e x i s t e n c e of a d e a t h w i s h t o w a r d t h e child w o u l d hardly be
c o m p a t i b l e w i t h t h e fact t h a t t h e i m p u l s e s to s t a b never a r o s e at t i m e s
w h e n t h e child she w a s c a r i n g for s t o o d m o s t i n h e r w a y and should h a v e
e v o k e d m o s t s t r o n g l y t h e s e c r e t d e s i r e t o d o a w a y w i t h it. W e h a v e even
h e a r d t h a t t h e s e t i m e s o f happy i n t i m a c y b e t w e e n m o t h e r and child,
w h i c h w e r e i n h e r l o v e r ' s a b s e n c e predictably f o l l o w e d b y t h e s t a b b i n g
impulses, w e r e n e v e r s o free o f t h r e a t e n i n g a n x i e t y a s during t h e periods
w h e n s h e could be n e a r an adult l o v e r . It w a s t h e n t h a t c a r i n g for the
child w o u l d o f t e n k e e p h e r f r o m b e i n g c o n s t a n t l y w i t h h e r lover, a s she
172
EXISTENTIAL FOUNDATIONS
173
m e n t t o a n x i e t y , and a f e a r o f s u f f o c a t i o n . T h i s a t t u n e m e n t was s o
p e r v a s i v e t h a t e v e n t h e happy m o o d o f t h e m o t h e r - c h i l d i n t i m a c y was
hard put to c o n c e a l it f o r a s h o r t t i m e .
H o w did it happen, t h o u g h , t h a t just this happy i n t i m a c y b e t w e e n
m o t h e r and child w a s m o s t o f t e n r e s p o n s i b l e for e v o k i n g fresh, p o t e n t
w a v e s o f a n x i e t y and t h e p a n i c k y r e s c u e o p e r a t i o n s t h a t followed t h e m ?
It w a s so b e c a u s e in this i n t i m a c y R e g u l a Z i i r c h e r g e n u i n e l y loved h e r
d a u g h t e r and b e c a u s e this d a u g h t e r was for h e r a n y t h i n g but a n
i n d i f f e r e n t o b j e c t or a c r e a t u r e s h e w i s h e d w o u l d go a w a y . B u t at the
bottom of her existence there wasas we have establisheda constant
feeling of being closed in, w i t h a r e s u l t i n g m o o d of c h o k i n g a n x i e t y , so
t h a t e v e r y t h i n g a r o u n d h e r a p p e a r e d a s prison w a l l s . T h e c l o s e r t h i n g s
c a m e t o h e r , t h e m o r e t h e y t o o k o n the significance o f t h r e a t e n i n g
b a r r i e r s and s t r a n g l i n g c h a i n s . C l o s e s t t o h e r o f all w a s h e r little
d a u g h t e r . W h e n h e r n e a r n e s s t o t h e child a t b a t h and b e d t i m e p r o c e e d e d
to t h e d e e p e s t i n t i m a c y , this v e r y i n t i m a c y had to call f o r t h t h e
c a t a s t r o p h i c c h a n g e f r o m h e r f u n d a m e n t a l a n x i e t y , h e r fear o f
s u f f o c a t i o n . I n this basic a t t u n e m e n t o f e x t r e m e a l a r m , t h e p a t i e n t would
s u d d e n l y perceive h e r g e n u i n e l y beloved child as c h o k i n g , s u f f o c a t i n g ,
and l e t h a l t o h e r o w n e x i s t e n c e , e x a c t l y b e c a u s e t h e child w a s c l o s e s t t o
h e r of all. At Once t h e child b e c a m e s o m e t h i n g to be d e s t r o y e d
i m m e d i a t e l y . A t this m o m e n t s h e s u c c u m b e d s o c o m p l e t e l y t o this
e x p e r i e n c e o f t h e child t h a t t h e e r u p t i o n o f the u r g e s t o s t a b and s t r a n g l e
t h e child can b e c o m p a r e d o n l y t o t h e d e s p e r a t e s t r u g g l e s o f s o m e o n e
w h o is being s t r a n g l e d by a m u r d e r e r .
T h i s i s h o w R e g u l a Z i i r c h e r ' s u r g e s t o s t a b and s t r a n g l e happened.
T h i s is, t h e n , t h e c h a r a c t e r of t h e s e u r g e s as s h e e x p e r i e n c e d it and as it
r e v e a l e d i t s e l f t o the u n p r e j u d i c e d p e r c e p t i o n o f h e r p h y s i c i a n .
W h a t w e h a v e said s o far m a k e s e v i d e n t n o t o n l y w h a t t h e p a t i e n t ' s
p a t h o l o g i c a l c o m p u l s i o n s w e r e not, but also e n a b l e s us to d e s c r i b e t h e i r
n a t u r e in a positive m a n n e r . N o t h i n g we h a v e seen j u s t i f i e s t h e opinion
t h a t t h e s e p h e n o m e n a derive f r o m s o m e hidden d e a t h i n s t i n c t o r death
wish. O n t h e c o n t r a r y , e v e r y t h i n g a r g u e s t h a t t h e y c o r r e s p o n d t o
specific h u m a n m o d e s of r e l a t i n g to w h a t e v e r a p e r s o n e n c o u n t e r s in his
world, and n o t h i n g m o r e . T h e y a r e just t h a t p a r t i c u l a r m o d e o f o u r
patient's ability t o e x i s t . T h e s e u r g e s a r e w h a t h e r blinded e x i s t e n c e , s o
n a r r o w l y a t t u n e d in a l a r m , w a s still o p e n to at a p a r t i c u l a r m o m e n t . H e r
d e f e n s i v e r e l a t i o n s h i p to t h e w o r l d at t h e s e t i m e s is deeply pathological;
it is c h a r a c t e r i z e d by a n e a r l y c o m p l e t e lack of f r e e d o m .
W h a t actually w a s s e e n t o o c c u r i n t h e patient e x p o s e s psychological
p r e s u p p o s i t i o n s and h y p o t h e s e s c o n c e r n i n g an u n c o n s c i o u s death w i s h
o r a n a m b i v a l e n c e b e t w e e n t w o conflicting, q a u s i - c o n s c i o u s endopsychii
174
EXISTENTIAL
FOUNDATIONS
175
176
EXISTENTIAL
FOUNDATIONS
i m m e r s i n g h e r s e l f c o m p l e t e l y in a loving u n i o n w i t h h e r p a r t n e r . S h e
reports that m a n y of the w o m e n she knows, on the other hand, practice
s e x u a l self-denial and e f f o r t l e s s l y r e n o u n c e e r o t i c , s e n s u a l e c s t a s y .
T h e s e friends c o n s i d e r t h e m s e l v e s less s t r o n g l y inclined t o s e n s u a l i t y
and are t h e r e f o r e c o n s t i t u t i o n a l l y alien t o t h e kind o f e c s t a t i c r e l e a s e , t h e
" b e i n g beside o n e s e l f , " o u r t e s t s u b j e c t e x p e r i e n c e d . R e g u l a Z r c h e r
k n o w s o t h e r w o m e n w h o h a v e b e e n happily m a r r i e d t o t h e s a m e m a n for
y e a r s t h o u g h t h e i r s e x u a l i n t i m a c i e s n e v e r end o n a m o r e t h a n
moderately exciting note. In any case, their orgasms never induce the
e c s t a t i c e s c a p e f r o m all limits and c o n f i n e s w h i c h R e g u l a Z r c h e r
e x p e r i e n c e d i n h e r s . R e g u l a Z r c h e r f o u g h t a g a i n s t t h e idea t h a t t h e s e
f u n d a m e n t a l l y d i f f e r e n t w o m e n , w h o m she liked t o call " t h e pillars o f
s o c i e t y , " w e r e s o m e h o w h e a l t h i e r and w o r t h i e r t h a n s h e . I t w a s , and still
is, h e r opinion t h a t t h e s e w o m e n w e r e simply f o r t u n a t e a n d limited
e n o u g h by n a t u r e to be shielded m o r e solidly a g a i n s t perceiving a r e a s of
reality t h a t e x t e n d b e y o n d t h e n a r r o w day t o day.
P e r h a p s we still need to ask if R e g u l a Z r c h e r ' s c o n t i n u e d d e p e n d e n c e
on a physically p r e s e n t l o v e r m i g h t n o t h a v e r e s u l t e d from a failure to
work through her aggressiveness in psychotherapy, to extricate it from
r e p r e s s i o n . In o t h e r w o r d s , w a s t h e i m p u l s e to s t a b simply a c a s e of
i n n a t e a g g r e s s i v e i n s t i n c t s a c c u m u l a t i n g u n d e r inhibition until t h e y had
to erupt? Y e t the patient's entirely openand often very aggressive
b e h a v i o r t o w a r d b o t h h e r f a t h e r and h e r first h u s b a n d e x e m p t s h e r f r o m
categorization as an aggression-inhibited woman. Countless sessions
spent discussing t h e a g g r e s s i v e irritability t h a t plagued h e r during
periods o f f r u s t r a t i o n g a v e h e r n o relief, e v e n w h e n this irritability w a s
c o n s t a n t l y c o n n e c t e d w i t h a t t u n e m e n t s appearing earlier i n h e r life.
Equally u n r e w a r d i n g w e r e allusions t o t h e possibility o f g a i n i n g m o r e
open r e l a t i o n s h i p s t o h e r a t t u n e m e n t s and l e a r n i n g t o relinquish t h e
n e e d for i m m e d i a t e , physical fulfillment o f t h e u r g e s a t t e n d i n g t h e s e
a t t u n e m e n t s . N o n e o f t h e s e u n r e m i t t i n g e f f o r t s t o help t h e p a t i e n t w o r k
t h r o u g h h e r a g g r e s s i v e n e s s kept h e r from being o v e r c o m e b y irritability
w h e n she had to live w i t h o u t a s e x u a l p a r t n e r . S h e r e s p o n d e d to all
q u e s t i o n s in this a r e a by asking in t u r n w h e t h e r t h e a n a l y s t m i g h t n o t
also t h r a s h a b o u t i f h e w e r e being c h o k e d b y s o m e o n e . I f h e a n s w e r e d
yes, he t o o would h a v e to be classified as n e u r o t i c a l l y o b s e s s e d , full of
death i n s t i n c t s , and d e p e n d e n t o n s o m e t h i n g o u t s i d e o f h i m s e l f : t h e
o x y g e n he m u s t b r e a t h all his life from t h e a t m o s p h e r e a r o u n d him.
C o n s e q u e n t l y , t h e h y p o t h e s i s t h a t inhibited, a c c u m u l a t e d a g g r e s s i v e
i i r . t u n K were r e s p o n s i b l e for the patient's impulses to Stab does not
si and up under close s c r u t i n y . B u t p e r h a p s we h a v e been too hasty in also
reje< ting the second c o m m o n t h e o r e t i c a l a s s u m p t i o n 1 rom hei reading
177
o f p s y c h o a n a l y t i c l i t e r a t u r e , t h e p a t i e n t had l e a r n e d t h a t t h e r e m i g h t b e
something homosexual operating in her impulses to stab. Perhaps we
should no l o n g e r r e s t r i c t this h o m o s e x u a l a s p e c t to a p r e c o n c e i v e d
t h e o r e t i c a l c o n s t r u c t like t h a t o f c o r r e s p o n d i n g partial i n s t i n c t s . I f w e
b r o a d e n o u r c o n c e p t i o n o f p h a l l i c - h o m o s e x u a l t e n d e n c i e s t o include
m o r e t h a n j u s t a c o n c r e t e d e s i r e to act using a m o r e or less disguised male
g e n i t a l , w e m i g h t b e able t o s e e t h e p a t i e n t ' s h o m o s e x u a l aspect solely i n
relation to an unconscious, predominantly masculine-active, penetrating
p e r s o n a l i t y . W e m i g h t b e able t o say t h a t w h e n e v e r R e g u l a Z r c h e r did
n o t h a v e a m a n to act as h e r l o v e r , s h e simply a s s u m e d t h e m a s c u l i n e role
h e r s e l f , h e r o t h e r w i s e l a t e n t h o m o s e x u a l i t y o v e r w h e l m i n g h e r and
a c t i v e l y u r g i n g h e r t o s t a b . M i g h t n o t simply m a k i n g h e r fully a w a r e o f
t h e n a t u r e o f h e r p h a l l i c - h o m o s e x u a l a t t i t u d e b e e n o u g h t o free h e r f r o m
t h e i m p u l s e s t h a t afflicted h e r during t i m e s o f l o n e l i n e s s ?
U n f o r t u n a t e l y for t h e t h e o r i e s , t h e p a t i e n t ' s p e r s o n a l e x p e r i e n c e
s t a n d s d i a m e t r i c a l l y o p p o s e d t o s o l u t i o n s o f this kind. E v e n w h i l e c a r r i e d
a w a y b y t h e i m p u l s e s t o stab, she r e m a i n e d totally c o n s c i o u s o f b e i n g
f e m a l e . N o t o n c e did s h e feel t h e least bit m o r e m a s c u l i n e t h a n b e f o r e . T o
all o f t h e a n a l y s t ' s h i n t s i n this d i r e c t i o n she posed t h e s a m e d i s a r m i n g
q u e s t i o n s h e had used b e f o r e a g a i n s t allusions t o t h e p e r s i s t e n c e o f
r e p r e s s e d a g g r e s s i v e i n s t i n c t s . S h e simply asked t h e a n a l y s t i f t h e r e w a s
really a n y s e n s e i n w o r r y i n g a b o u t t h e g e n d e r o r s e x u a l o r i e n t a t i o n o f
s o m e o n e w h o was t h r a s h i n g a b o u t while being s t r a n g l e d . S h e f o u n d his
q u e s t i o n s r e l a t i n g t o t h e phallic, m a s c u l i n e - h o m o s e x u a l aspect o f h e r
impulses t o s t a b h e r d a u g h t e r equally a b s u r d .
T h e p a t i e n t ' s r e l a t i o n s h i p to h e r o w n past provides a first clue to an
u n d e r s t a n d i n g o f w h y she r e m a i n e d s o long i n d a n g e r o f relapsing i n t o
the u r g e t o s t a b . A t t h e c l o s e o f h e r p s y c h i a t r i c t r e a t m e n t , s h e r e p o r t e d
seeing h e r s e l f as a w o m a n a l m o s t e n t i r e l y devoid of a past. A c h i l d h o o d
e n v i r o n m e n t e x t r e m e l y antagonistic to her nature alienated her from
h e r s e l f , f o r c i n g h e r to lead a false, s h a d o w e x i s t e n c e . S h e claimed to h a v e
v e r y little i n c o m m o n w i t h t h e y o u n g p e r s o n she had b e e n t h e n . T h a t
y o u n g girl, s h e insisted, w a s s o m e o n e o t h e r t h a n R e g u l a Z r c h e r , w h o
was n o t e v e n b o r n until she b e g a n p s y c h o a n a l y s i s .
T h e p a t i e n t w a s i n fact e x p r e s s i n g h e r a p p a r e n t lack o f a n y s o u n d
footing in a p e r s o n a l past to w h i c h s h e m i g h t t u r n for s u p p o r t w h e n e v e r
the p r e s e n t w a s n o t e n o u g h f o r h e r . T h i s deficiency helps explain w h y
she so d e s p e r a t e l y needed to be t o g e t h e r physically w i t h a m a l e l o v e r .
I h e r e is little h o p e t h a t she will e v e r r e c o v e r t h e past t h a t p a r e n t a l
discipline p r e v e n t e d h e r from e x p e r i e n c i n g f i r s t h a n d . Still, t h e l o n g e r
she can b e n e f i t from t h e n e w b e g i n n i n g that a d a s e i n s a n a l y t i c t r e a t m e n t
made p o s s i b l e t h e l o n g e r s h e can untold her e x i s t e n c e by c a r r y i n g to
178
EXISTENTIAL
FOUNDATIONS
179
p h e n o m e n o n a r o s e t h a t falls i n t o t h e p s y c h i a t r i c c a t e g o r y o f illusion. T h e
patient b e g a n t o m i s t a k e sparkling facets o f c e r t a i n o b j e c t s for k n i v e s .
A f t e r a time she s a w k n i v e s w h e r e a h e a l t h y p e r s o n w o u l d see n o t even a
h i n t o f a n y t h i n g knifelike i n t h e vicinity. T h e s y m p t o m had passed f r o m
illusion i n t o t r u e h a l l u c i n a t i o n . K n i v e s w e r e s e n s e - p e r c e p t i b l e t o h e r i n
places w h e r e for o t h e r s t h e r e w a s o n l y air. A n d R e g u l a Z i i r c h e r
s u c c u m b e d as well to t h e s e h a l l u c i n a t e d k n i v e s . J u s t like t h e real k n i v e s ,
the h a l l u c i n a t i o n s left h e r n o c h o i c e b u t t o g r a b t h e m and s t a b wildly.
T h e r e i s n o point i n a r g u i n g h e r e w h e t h e r t h e s e p h e n o m e n a should b e
called h y s t e r i c a l o r already s c h i z o p h r e n i c .
T h e phenomenological view attaches great importance, however, to
t h e o b s e r v a t i o n t h a t t h e knife h a l l u c i n a t i o n s c a m e t o t h e p a t i e n t a t t i m e s
w h e n t h e scope o f h e r life w a s a t its m i n i m u m and h e r e x i s t e n t i a l
a t t u n e m e n t t o a n x i e t y and c o n f i n e m e n t a t its m a x i m u m . A l s o , i t had
b e c o m e a p p a r e n t t h a t t h e p a t i e n t ' s m a t u r i n g had b e e n a r r e s t e d at a s t a g e
of helpless, childish d e p e n d e n c e on t h e p a r e n t s . S h e w a s still far f r o m a
selfhood o f significant a u t o n o m y and e n d u r a n c e . I n this s t a t e , h e r
e x i s t e n c e w a s reduced, w h e n e v e r t h e u r g e s o v e r c a m e h e r , a l m o s t
e n t i r e l y to a single r e l a t i o n s h i p c o n s i s t i n g in a v i o l e n t a t t e m p t to t e a r
d o w n b a r r i e r s and b r e a k free o f t h e s u f f o c a t i n g c o n f i n e m e n t o f h e r
world. As long as h e r selfhood w a s so fragile and u n r e s i s t i n g it w a s
inevitable t h a t she fall p r e y t o t h e o n e m o d e o f b e h a v i o r still r e m a i n i n g
o p e n t o h e r : blind, r e f l e x i v e s e l f - d e f e n s e . T h e l o n g e r t h e c o n f i n e m e n t
p e r s i s t e d t h e s m a l l e r and m o r e l o n e l y h e r w o r l d b e c a m e t h e m o r e
c o m p l e t e l y w o u l d she s u r r e n d e r t o this m o d e and b e c o m e a b s o r b e d i n t o
it. W h e n it had r e a c h e d a c e r t a i n i n t e n s i t y , this w a y of c o n n e c t i n g w i t h
the w o r l d gave rise o u t of i t s e l f to h a l l u c i n a t e d t h i n g s t h a t could be used
for d e f e n s e and escape. S h e could s e e and feel t h e m , t h e r e , w h e r e h e a l t h y
h u m a n b e i n g s could see n o t h i n g . S h a r p k n i v e s c o r r e s p o n d e d m o s t
e x a c t l y t o t h e w a y o f b e i n g i n w h i c h s h e e x i s t e d , h e r selfhood totally lost,
outside h e r s e l f . A knife could free h e r from t h e m o s t s t r a n g l i n g ,
c o n f i n i n g m o s t , b e c a u s e it w a s t h e c l o s e s t b o n d of all, t h e child she
loved.
THE PSYCHOSOMATIC AND SOMATOPSYCHIC SYMPTOMS
180
EXISTENTIAL
FOUNDATIONS
T o a k n o w l e d g e a b l e p e r s o n , this n e w r e s p o n s i v e o p e n n e s s t o t h e
y o u n g m a n and h e r fear of his a p p r o a c h w o u l d signify an early
p s y c h o t h e r a p e u t i c s u c c e s s , for b o t h r e a c t i o n s r e v e a l a c e r t a i n b r o a d e n
ing of R e g u l a Z i i r c h e r ' s e x i s t e n c e . S h e w a s n o w a b l e , if o n l y in a r e m o t e
w a y , to perceive a m a n as a m a n ; t h a t is, as a possible p a r t n e r in s e x u a l
love. T h e m a n would o t h e r w i s e n e v e r h a v e affected h e r i n such a n
e x c i t i n g and f r i g h t e n i n g w a y .
O n l y briefly in e a r l y p u b e r t y had s h e e x p e r i e n c e d a similar o p e n i n g and
been able to e n t e r f o r a s h o r t t i m e i n t o r e l a t i o n s h i p s w i t h m a l e p e e r s t h a t
w e r e t a n t a l i z i n g and e r o t i c a l l y tinged. B u t h e r p a r e n t ' s r e p r e s s i v e
m e a s u r e s , applied w i t h r e d o u b l e d e f f o r t , quickly and c o m p l e t e l y buried
all o f t h e p a t i e n t ' s e m e r g i n g possibilities for l o v e . T h u s i t c a m e a b o u t
t h a t , from p u b e r t y until t h e birth o f h e r child, m e n could n o t b e p r e s e n t
i n h e r w o r l d a s w h o l e m e n . All o f t h e m , including h e r h u s b a n d , s e e m e d t o
h e r t o b e m a d e o f i n a n i m a t e m a t t e r from t h e w a i s t d o w n . W h e n e v e r m e n
p r e s s e d h e r w i t h t h e i r u r g e s for s e x u a l c o n t a c t , t h e y s e e m e d like w o o d e n
puppets w i t h o u t s e x u a l o r g a n s .
I n t h e r a p e u t i c s e s s i o n s a f t e r t h e paralysis o f h e r legs, t h e p a t i e n t
b e c a m e m o r e deeply a w a r e t h a n e v e r o f h o w e n s l a v e d she r e m a i n e d t o
her mother's mentality. S h e recognized that her dependent imprison
m e n t w i t h i n this alien life style forced h e r to misidentify m e n as
e x t r e m e l y i n d e c e n t , forbidden, d a n g e r o u s , and sinful c r e a t u r e s . T h u s
she could r e s p o n d t o t h e y o u n g m a n w h o a p p r o a c h e d h e r and called o u t
for h e r t o c r o s s t h e s t r e e t t o h i m o n l y b y holding b a c k and r e t r e a t i n g
f r o m his a t t r a c t i o n . T h e i n s t a n t she c a u g h t s i g h t o f h i m , i n o t h e r w o r d s ,
R e g u l a Z i i r c h e r ' s e n t i r e e x i s t e n c e fell i n t o a c o n t r a d i c t o r y r e l a t i o n s h i p
m a d e u p o f a n u r g e o v e r t o h i m and o n e a w a y from h i m . T o b e
s i m u l t a n e o u s l y d r a w n t o w a r d and also pulled a w a y from s o m e t h i n g
m e a n s t o b e u n a b l e t o m o v e f r o m t h e spot, t o b e paralyzed. O n l y
something that can perceive a meaningful address from a n o t h e r being
anddepending on t h e r e s p o n s e or lack of it to this a d d r e s s e i t h e r be
m o t i v a t e d to m o v e t o w a r d or a w a y f r o m its s o u r c e is in a position to be
paralyzed. A rolling s t o n e t h a t is s u d d e n t l y s t o p p e d c a n n o t be called
paralyzed.
B u t w h y did t h e p a t i e n t ' s s i m u l t a n e o u s a t t r a c t i o n and r e p u l s i o n t a k e
t h e form o f a physical, h y s t e r i c a l p a r a l y s i s ? W h y w e r e t h e y n o t
c o n s i d e r e d freely i n a n o p e n and c o n s c i o u s d e l i b e r a t i o n ? T h e h y s t e r i c a l
paralysis o f t h e legs had t o o c c u r b e c a u s e t h e p a t i e n t was still totally
u n f r e e and d e p e n d e n t i n r e l a t i o n t o b o t h o f t h e s e c o n t r a d i c t o r y m o d e s o f
c o n d u c t t o w a r d t h e y o u n g m a n . S h e had not appropriated t h e s e
possibilities a s h e r o w n ; t h e y w e r e n o t u n d e r h e r c o n t r o l R a t h e r , she w a s
so c o m p l e t e l y ruled by t h e c o n t r a d i c t o r y r e l a t i o n s h i p to the y o u n g man
181
182
EXISTENTIAL FOUNDATIONS
184
EXISTENTIAL FOUNDATIONS
185
186
EXISTENTIAL
FOUNDATIONS
T h e leg f r a c t u r e
T h e leg f r a c t u r e R e g u l a Z i i r c h e r suffered s o m e t i m e a f t e r t h e finish o f
t h e r a p y kept h e r in bed for s e v e r a l w e e k s and, since she w a s in t r a c t i o n ,
literally nailed h e r to it. S h e w a s n o w as u n a b l e to take a step as she had
b e e n i m m e d i a t e l y a f t e r h e r e a r l i e r h y s t e r i c a l paralysis. B u t t h e r e is a
d i f f e r e n c e b e t w e e n t h e f o r m e r paralysis and t h e leg f r a c t u r e . N o o n e
w o u l d b l a m e this f r a c t u r e on a faulty a t t i t u d e on t h e p a t i e n t ' s part, s o m e
n e u r o t i c a c c i d e n t p r o n e n e s s , for i n s t a n c e , t h a t r e s u l t e d in a m i s h a p for
which she was ultimately responsible. T o g e t h e r with a number of other
people, s h e had b e e n r u n d o w n from b e h i n d o n t h e sidewalk b y t h e
a u t o m o b i l e of a t o t a l s t r a n g e r . T h u s h e r f r a c t u r e can be c h a r a c t e r i z e d as
clearly physical in o r i g i n .
It could be said t h a t a f r a c t u r e of t h e tibia p r e v e n t s a p e r s o n f r o m u s i n g
t h e leg as an a m b u l a t o r y tool. B u t did R e g u l a Z i i r c h e r e v e r u s e h e r leg as
such a tool? If she examined what happened w h e n she was hurring across
t h e s t r e e t t o h e r l o v e r , she could n o t h o n e s t l y say t h a t she had used h e r
legs a s i n s t r u m e n t s for t h e purpose o f c r o s s i n g t h e s t r e e t . A s w e h a v e
n o t e d b e f o r e , she did n o t p e r c e i v e h e r s e l f t h e n as a p s y c h e t h a t s o m e h o w
seized t h e body as an i n s t r u m e n t for t r a n s p o r t i n g it a c r o s s t h e s t r e e t .
W h a t actually o c c u r r e d w a s s o m e t h i n g v e r y d i f f e r e n t . F a c t u a l l y
speaking, all t h a t t h e p a t i e n t e x p e r i e n c e d t h e n w a s h e r l o v e r ' s
u n e x p e c t e d e n t r a n c e i n t o h e r field o f vision. S h e i n s t a n t l y r e c o g n i z e d
him a s h e r lover, a t t h e s a m e t i m e felt a t t r a c t e d t o h i m " b o d y " a n d " s o u l , "
and in a c o r r e s p o n d i n g r e s p o n s e to this a t t r a c t i o n h u r r i e d o v e r to h i m as
t h e w h o l e , e x i s t i n g p e r s o n s h e w a s , undivided i n t o s e p a r a t e physical o r
psychic c o m p o n e n t s .
T h i s e x p e r i e n c e d e m o n s t r a t e s clearly h o w directly t h e bodily s p h e r e o f
a h u m a n e x i s t e n c e i n h e r e s in a loving r e l a t i o n s h i p to a n o t h e r h u m a n
being c o e x i s t i n g in a s h a r e d w o r l d , even t h o u g h s o m e part of t h e bodya
leg, for i n s t a n c e m a y also be d e s i g n a t e d as a distinct physical
component.
T h e car accident, n o less t h a n t h e h y s t e r i c a l paralysis, s t r u c k n o t s o m e
m e r e i n s t r u m e n t , and it w a s n o t j u s t a piece of t h e s k e l e t o n t h a t w a s
broken. This something, even as a broken something, belonged to Regula
Z i i r c h e r ' s dwelling in h e r r e l a t i o n s h i p s to t h e w o r l d . In p a r t i c u l a r , h e r leg
c a n n o t be u n d e r s t o o d p r o p e r i y as t h e h u m a n limb it is u n l e s s we see in it
the bodying f o r t h o f t h e possibilities o f a p p r o a c h i n g o r r e t r e a t i n g from
s o m e p r e s e n c e . In b r i e f , t h e c a r e l e s s d r i v e r did n o t simply s h a t t e r a
physical leg w h e n he ran i n t o R e g u l a Z i i r c h e r ; it was a b o v e all h e r
potential for bodily a p p r o a c h i n g o t h e r p h e n o m e n a that was d e s t r o y e d
w h e n h e r b o n e was b r o k e n .
187
188
EXISTENTIAL FOUNDATIONS
Bodily
e x pei
ICI
pains
are
u ed, w e spea
a l w a y s e x p e r i e n c e d as h u r l i n g ,
o l the perception a n d s e n s a t i o n o l
p a i n is
Y e t pain is
Suue
pam
180
a v e r y p a r t i c u l a r s o r t of p e r c e p t i o n , f u n d a m e n t a l l y d i f f e r e n t f r o m all the
o t h e r so-called s e n s e p e r c e p t i o n s . I n o u r discussion o f s i g h t , w e n o t e d
t h a t t h e t h i n g " c a u g h t s i g h t o f " is o b s e r v e d and its s i g n i f i c a n c e perceived,
at its location in t h e o b s e r v e r ' s w o r l d , but t h a t n e i t h e r t h e act of seeing
n o r t h e e y e as t h e involved bodily r e g i o n is part of w h a t is s e e n . W h e n
something is touched or tasted, on the other hand, the hand or tongue
can b e perceived along w i t h t h e o b j e c t itself. R e g u l a Z u r c h e r ' s p e r c e p t i o n
of pain a f t e r h e r leg f r a c t u r e did n o t include t h e a c t u a l c a u s e s of the pain.
I n h e r pain t h e r e w a s n o a w a r e n e s s o f t h e a u t o m o b i l e b u m p e r that had
s p l i n t e r e d h e r leg. W h a t t h e pain told h e r a t first w a s o n l y t h a t h e r
e x i s t e n c e had b e e n hit hard and injured. W h e n s h e tried to stand up, the
pain also let h e r k n o w i n w h a t w a y she had b e e n hit. S h e l e a r n e d t h a t h e r
bodily ability t o s t a n d by, g o t o , o r a w a y f r o m , t h e t h i n g s o f h e r w o r l d had
b e e n t o r n f r o m h e r . T h e special w a y in w h i c h such a r e n d i n g is felt is n o t a
d i s t a n t o b s e r v a t i o n o f s o m e e n t i t y but the p e r c e p t i o n o f already e x i s t i n g
d a m a g e to o n e ' s o w n e x i s t e n c e , a perceiving w h i c h i n v o l v e s t h e Da-sein,
totally and a b s o l u t e l y .
In the hours just after her accident, Regula Ziircher was so absorbed in
t h e pain s h e w a s e x p e r i e n c i n g t h a t h e r e x i s t e n c e , w h i c h until t h e n had
e x t e n d e d i n e x t r e m e l y b r o a d r e l a t i o n s h i p s t o h e r past, p r e s e n t , and
f u t u r e , s h r a n k t o t h e single, p r e s e n t i n t e n t t o k e e p t h e leg still and t h e
h o p e t h a t t h e d o c t o r would a r r i v e as s o o n as possible. All t h a t r e m a i n e d
of h e r past w a s a m e m o r y , at t h e edge of c o n s c i o u s n e s s , of a similar
a c c i d e n t s h e had s u f f e r e d as a y o u n g child.
T h i s d i s c u s s i o n o f t h e p a t i e n t ' s bodily pains c o m p l e t e s t h e e x a m p l e s o f
individual p a t h o l o g y w h i c h w e r e i n t r o d u c e d as a practical t e s t of t h e
e x i s t e n t i a l r e s e a r c h m e t h o d . O u r n e x t t a s k will b e t o e x t r a c t f r o m t h e s e
e x a m p l e s t h e principles implicit in t h e m . Explaining t h e s e principles will
help us t o w a r d a g e n e r a l e x i s t e n t i a l p a t h o l o g y .
NOTES
1. F o r a m o r e d e t a i l e d d i s c u s s i o n o f t h i s , s e e M . B o s s , Der Traum und seine Auslegung ( B e r n e :
H a n s H u b e r , 1 9 5 4 ) a n d M . B o s s , Es trumte mir vergangene Nacht ( B e r n e : H a n s H u b e r , 1 9 7 5 ) .
2 . M . B o s s , Einfuhrung in die psychosomatische Medizin ( B e r n e a n d S t u t t g a r t : H a n s H u b e r ,
1974).
3 . R e f e r a l s o t o t h e e x c e l l e n t s u m m a t i o n a n d c r i t i q u e o f e x i s t i n g n o t i o n s a b o u t pain i n a
w o r k by G . C o n d r a u e n t i t l e d Psychosomatik der Frauenheilkunde ( B e r n a n d S t u t t g a r t : H. H u b e r ,
1 9 6 5 ) , pp. 1 9 9 ff.
Chapter 12
GENERAL DASEINSANALYTIC
ETIOLOGY AND
PATHOGENESIS
I n looking back o v e r t h e p a t h o l o g i c a l p h e n o m e n a o f o u r t e s t c a s e , w e
begin t o s u s p e c t t h a t t h e p a t i e n t m i g h t n e v e r h a v e b e c o m e ill, a t least n o t
i n q u i t e t h e s a m e w a y s , had s h e n o t e n t e r e d t h e w o r l d w i t h h e r o w n
specific i n b o r n p o t e n t i a l i t i e s for b e h a v i n g , and had t h e e v e n t s of h e r life
n o t impelled h e r t o w a r d t h e v e r y e x p e r i e n c e s t h a t a c t u a l l y h a p p e n e d t o
h e r . R e g u l a Z i i r c h e r is n o t an isolated case in this r e s p e c t . W h e r e v e r we
t u r n in t h e r e a l m of p a t h o l o g y , we find a s t r o n g c o n n e c t i o n b e t w e e n
p r e s e n t illness and w h a t h a s c o m e b e f o r e it. T h i s c o n n e c t i o n is described
i n w h a t i s c o m m o n l y called t h e e t i o l o g y , o r p a t h o g e n e s i s , o f h u m a n
illness. F o r t h e m o s t part, h o w e v e r , t h e s e d e s c r i p t i o n s fail t o give
a d e q u a t e and specific c o n s i d e r a t i o n t o t h e s i n g u l a r n a t u r e o f t h e
i m p o r t a n t r e l a t i o n s h i p b e t w e e n a p a t i e n t ' s p r e s e n t c o n d i t i o n and
previous history.
O n e i m p o r t a n t d i s t i n c t i o n in t h i s a r e a h a s already b e e n partly made in
o u r discussion o f t h e u n b r i d g e a b l e g a p b e t w e e n n a t u r a l s c i e n c e ' s concept
o f c a u s e and t h e e x i s t e n t i a l c o n c e p t o f m o t i v a t i o n . F r o m thai d e a l
distinction it follows t h a t we m u s t distinguish s h a r p l y n o w b e t w e e n a
causal and a m o t i v a t i o n a l p a t h o g e n e s i s or e t i o l o g y . Like th:" c a u s e and
e f f e c t s c h e m e , t h e n o t i o n of causal p a t h o g e n e s i s is r o o t e d in thai
philosophical v i e w w h i c h p o s i t s all that e x i s t s as raw material l"i i
192
EXISTENTIAL FOUNDATIONS
General
Daseinsanalytic
Etiology
193
r e p r e s e n t i n g s u b j e c t . T h i s C a r t e s i a n - G a l i l i e a n w o r l d v i e w also s e e s all
real t h i n g s j o i n e d t o g e t h e r i n t o a n i n t e g r a l w o r l d t h r o u g h t h e o p e r a t i o n
of a fixed, precisely calculable c a u s a l i t y . W i t h o u t t h e s e p r e s c i e n t i f i c
s u p p o s i t i o n s , n e i t h e r t h e n a t u r a l scientific principal o f causality i n
g e n e r a l , n o r a n y causal g e n e s i s in p a r t i c u l a r could e v e r h a v e b e e n
thought out.
But this w a y o f t h i n k i n g allowed t h e n o u n s " e t i o l o g y " and " g e n e s i s " t o
a s s u m e m e a n i n g s v e r y distant from t h e i r o r i g i n s . Aitia, the G r e e k w o r d
for " i m p e t u s , " " o c c a s i o n , " and "guilt," n o w c a m e t o m e a n ' c a u s e . " Genesis,
w h i c h had o n c e r e f e r r e d to t h e s o u r c e of an illness, w a s r e i n t e r p r e t e d as a
s e q u e n c e o f c a u s e s and e f f e c t s . F r o m t h e p e r s p e c t i v e o f c o n t e m p o r a r y
medicine, then, both words became near s y n o n y m s .
W i t h i n a g e n e r a l p a t h o l o g y , this c a u s a l - g e n e t i c v i e w can be c o n t r a s t e d
to the D a s e i n s a n a l y t i c , m o t i v a t i o n a l g e n e s i s . A D a s e i n s a n a l y t i c s t u d y of
p a t h o g e n e s i s does n o t aim to t r a c e p h e n o m e n a back to c a u s e s , b u t is
c o n c e r n e d w i t h d i s c o v e r i n g biographical i n c i d e n t s w h i c h t h e n m o t i v a t e d
a h u m a n being to c o n d u c t h i m s e l f in a c e r t a i n w a y and w h i c h still
m o t i v a t e him t o p e r p e t u a t e t h e s e m o d e s . P a t h o g e n i c , b i o g r a p h i c a l
m o t i v a t i n g i n c i d e n t s a r e m o t i v e s w h i c h induce a person to r e s t r i c t , or
partially blind him to, t h e a b u n d a n c e of his i n b o r n possibilities of r e l a t i n g
so t h a t he fulfills o n l y a f e w n e u r o t i c m o d e s of relation to his w o r l d . We
should r e m e m b e r t h a t t h e p a t h o g e n i c m o m e n t s t h e m s e l v e s c a n n o t
produce, c a u s e , o r e f f e c t , t h e s e m o d e s , b e c a u s e all w a y s o f being, e v e n
t h o s e we call n e u r o t i c , are g i v e n to a p e r s o n at b i r t h as possibilities of
e x i s t e n c e . T h e r e i s n o n e e d for t h e m t o b e m a n u f a c t u r e d a f t e r t h e fact.
B e c a u s e we h u m a n b e i n g s e x i s t in such a w a y t h a t o u r p r e s e n t is
a l w a y s e n g a g e d i n c o m i n g t o t e r m s w i t h o u r past, w e a r e also b y n a t u r e
d i r e c t e d t o w a r d w h a t a p p r o a c h e s from t h e f u t u r e and i n m o v i n g t o w a r d
it m u s t open o u r being to it. H o w we see w h a t has b e e n and w h a t is n o w is
a l w a y s r e l a t e d t o t h e w a y w e a r e a d d r e s s e d b y w h a t w e e x p e c t from the
f u t u r e . F o r e x a m p l e , t h e w a y t h e w o r l d is o r g a n i z e d d e p e n d s partly on
t h e p o t e n t i a l for f u t u r e a t o m i c w a r . F r o m the p e r s p e c t i v e o f this s a m e
f u t u r e t h e past i s judged i n c a p a b l e r e g a r d i n g m a s t e r y o f t h e p r o b l e m s o f
a t o m i c fission. F u r t h e r m o r e , i t i s o n l y b e c a u s e o f t h e t h r e a t o f a t o m i c
w a r f a r e i n t h e f u t u r e t h a t w e can p r o p e r l y a p p r e c i a t e Galileo's
conceptual advance. Everything that goes on in the world of human
beings begins from the standpoint of the future. T h u s the future may
claim t h e p r i m a c y o v e r t h e o t h e r t w o o f t h e t e m p o r a l e x t e n s i o n s o f
h u m a n e x i s t e n c e , t h e e c s t a s e s o f past and p r e s e n t . T h i s fact i s o f p r i m a r y
i m p o r t a n c e t o m e d i c i n e , b o t h for p a t h o g e n e s i s and t h e r a p y . W e should
r e m e m b e r , t h o u g h , t h a t t h e v a n t a g e e n j o y e d b y the f u t u r e i n n o w a y
d i m i n i s h e s t h e significance o f past e x p e r i e n c e s for b o t h p r e s e n t and
future.
B o t h a p p r o a c h e s t o p a t h o g e n e s i s , t h e c a u s a l - g e n e t i c and the
m o t i v a t i o n a l - g e n e t i c , h a v e i m p o r t a n t places i n m e d i c i n e . W e h a v e
already stated the value o f t h e c a u s a l - g e n e t i c o r i e n t a t i o n o f n a t u r a l
s c i e n c e , u n d e r s c o r i n g its u n i q u e capacity for d i s c o v e r i n g n e w c h e m o physical t h e r a p i e s . O f c o u r s e , w e also pointed o u t t h e limited application
of c a u s a l - g e n e t i c t h i n k i n g to m e d i c i n e , since it s e r v e s o n l y if h u m a n
bodyhood is i n t e r p r e t e d as a physical o b j e c t . W i t h a n y t h i n g t h a t is n o t
c o n c e i v a b l e i n physical t e r m s t h e e n t i r e r e a l m o f psychic p h e n o m e n a
the c a u s a l - g e n e t i c o r i e n t a t i o n loses its s e n s e and j u s t i f i c a t i o n , n o r d o e s it
r e c o v e r m e a n i n g simply b y g e t t i n g the n e w n a m e " p s y c h o d y n a m i c s . " B u t
dl t h o s e p h e n o m e n a of h u m a n Da-sein t h a t c a n n o t be c o n c e i v e d of
com r c t e l y o r m a t e r i a l l y , t h o s e like u n d e r s t a n d i n g , intuition, w i s h i n g ,
desiring, acting (in s h o r t , all t h o s e t h i n g s t h a t m a k e a h u m a n being
h u m a n ) , are inaccessible t o any b u t t h e m o t i v a t i o n a l - g e n e t i c p e r s p e c t i v e .
I he pi ,n in a I medical i m p o r t a n c e of this o r i e n t a t i o n will be s h o w n w h e n
w e d r . i uss | i h e n o m e n o l o g i c a l , d a s e i n s a n a l y t i c t h e r a p y .
I In . r . the place, h o w e v e r , to c o u n t e r t h e c o m m o n criticism t h a t
p h e n o m e n o l o g i c a l pathology does n o t a c t u a l l y r e c o g n i z e any sort o f
I n o r d e r t o a n s w e r t h e prejudiced r e p r o a c h t h a t t h e D a s e i n s a n a l y t i c ,
p h e n o m e n o l o g i c a l o r i e n t a t i o n i g n o r e s t h e g e n e s i s o f pathological
p h e n o m e n a , let u s look a t o n e o f t h e m o s t c u r r e n t c o n c e r n s o f e t i o l o g y .
F r e u d singled o u t a l m o s t solely t h e e x p e r i e n c e s o f t h e infant a t the h a n d s
of its p a r e n t s or p a r e n t s u b s t i t u t e s as t h e decisive p a t h o g e n i c
motivations. Since then it has been shown that many postinfantile
e x p e r i e n c e s as well can also induce a limiting f i x a t i o n on n e u r o t i c m o d e s
of b e h a v i o r , t h o u g h no o n e d e n i e s t h a t all t h e older m o t i v e s are at w o r k
in t h e s e l a t e r m o t i v a t i o n s as w e l l .
On t h e o t h e r h a n d , m o r e a t t e n t i o n will n e e d to be paid to the fact I ha I
t h e w a y p a r e n t s and l a t e r m e n t o r s b e h a v e does n o t g r o w out ol a
v a c u u m , e i t h e r . T h e i r field of vision, and t h e b e h a v i o r t h a t follows I rom
it, a r e f u n d a m e n t a l l y shaped b y t h e spirit o f t h e t i m e s . E v e r y age g r a n t s
to h u m a n i t y a Da-sein, an e x i s t e n c e as a p e r c e p t i v e open realm, w h o s e
limits a r e peculiar t o t h a t a g e . H e r e , " l i m i t " should b e u n d e r s t o o d i n its
double m e a n i n g : w h e r e s o m e t h i n g ends and also as wh.it t h r o w . I In
form peculiar to a thing i n t o relief. Limits, then, are w h a t allow a thing tu
appear as w h a t it is, w h a t allow a being, to be what it is.
g e n e t i c o r i e n t a t i o n , o r a t a n y r a t e w o e f u l l y n e g l e c t s it. N o description o l
human nature is more aware than the Daseinsanalytic that the entire
past of Da-sein p e r s i s t s in, c o d e t e r m i n e s , and t h u s r e m a i n s p r e s e n t in its
p r e s e n t being. B u t it is in the f o r m of motivations t h a t t h e past a d d r e s s e s
t h e p r e s e n t ; past e x p e r i e n c e s do n o t causally effect p r e s e n t b e h a v i o r in the
w a y in w h i c h , in a physical s e q u e n c e of e v e n t s , specific c a u s e s n e c e s s a r i l y
r e s u l t in specific e f f e c t s .
EXISTENTIAL
194
FOUNDATIONS
I t would s e e m , t h e n , t h a t w h e n a n e m e r g i n g a g e m o v e s h u m a n i t y i n t o
a n e w f o r m of o p e n n e s s , a seal is placed o v e r s o m e of t h e m e a n i n g s t h a t
had b e e n visible b e f o r e . T h e d e s t i n y t h a t s e t s t h e limits o f t h e possible
open r e a l m of h u m a n e x i s t e n c e in a g i v e n e r a of h u m a n h i s t o r y is s e e n
m o s t clearly t h r o u g h t h e w a y i n w h i c h t h e f u n d a m e n t a l n a t u r e o f
p r e s e n c e s h o w s i t s e l f t o t h o s e living i n t h a t a g e . N o t o n l y individuals b u t
s o c i e t y as a w h o l e a r e m o t i v a t e d by t h a t fate to specific m o d e s of
r e s p o n d i n g t o w h a t h a s b e e n s h o w n t o it.
R e s e a r c h i n t o t h e h i s t o r i c a l l y set b o r d e r s t h a t limit t h e possibilities for
h u m a n b e i n g - i n - t h e - w o r l d f o r m s t h e basis o f e v e r y t y p e o f s o c i o l o g y and
social p s y c h i a t r y . T h e s e disciplines h a v e d i s c o v e r e d t h a t s o m e w o r l d
s i t u a t i o n s appear t o b e m u c h m o r e i n t u n e w i t h h u m a n b e i n g t h a n
o t h e r s , t h a t at s o m e t i m e s people in g e n e r a l are allowed to fulfill t h e i r
possibilities for e x i s t i n g m o r e freely and c o m p l e t e l y , and t o s t a y
h e a l t h i e r , t h a n t h e y can in o t h e r a g e s . It has also b e e n found t h a t t h e
p a r t i c u l a r f r e e d o m allotted to h u m a n b e i n g - i n - t h e - w o r l d in a given e r a is
n o t equally favorable to all h u m a n b e i n g s . At t i m e s , the historical d e s t i n y
delimiting h u m a n r e s p o n s e favors c e r t a i n kinds o f people o v e r o t h e r s ,
and t h e f o r m o f o p e n n e s s possible t o t h e n e x t h i s t o r i c a l period m a y b e
h e a l t h i e r for t h o s e w h o w e r e s h o r t c h a n g e d b e f o r e . ( B y " h e a l t h i e r , " w e
m e a n m o r e c o n d u c i v e t o t h e possibilities for e x i s t e n c e t h a t t h e s e people
have brought with t h e m into the world than to those of others.)
T h e Middle A g e s i n t h e w e s t , for i n s t a n c e , are usually d e s i g n a t e d
" d a r k . " T h e i r abilities t o d e s c r i b e n a t u r e q u a n t i t a t i v e l y w e r e i n fact far
o v e r s h a d o w e d b y t h e scientific a c h i e v e m e n t s o f m o d e r n t i m e s . I n place
of t h e s e , h o w e v e r , t h e d a r k ages had a c l a r i t y of vision t h a t a l l o w e d t h e
divinity and the a n g e l s to be p r e s e n t and to c o m e close in a w a y a l m o s t
totally lost t o t h o s e living n o w . M o r e o v e r , t h e r e w e r e t i m e s d u r i n g
w h i c h epidemics radically d e s t r o y e d t h e possibilities for e x i s t e n c e o f
t h o s e living in a c e r t a i n r e g i o n , and t h e s e p a r t i c u l a r r e s t r i c t i o n s on
h u m a n b e i n g - i n - t h e - w o r l d h a v e b e e n largely e l i m i n a t e d b y m o d e r n
physical m e d i c i n e . O n t h e o t h e r h a n d , w e all k n o w t h a t h u m a n b e i n g - i n t h e - w o r l d faces a n e v e n g r e a t e r t h r e a t i n t h e n e a r f u t u r e f r o m t h e
pollution o f air, w a t e r , and soil, n o t t o m e n t i o n t h e a t o m b o m b . B e s i d e s
w h a t we h a v e said already, t h e r e is also t h e fact t h a t t h e reigning n a t u r a l
scientific w a y o f i n v e s t i g a t i n g m a t e r i a l t h i n g s has s e r i o u s c o n s e q u e n c e s
for 1 he h u m a n r e s e a r c h e r h i m s e l f . T h i s r e v e r s i o n h a p p e n s in such a w a y
that h u m a n b e i n g s are less and less able to see t h e m s e l v e s e x c e p t as
met n a n i s m s w h o s e p u r p o s e it is to f u n c t i o n s m o o t h l y and efficiently.
M e a s u r e d against the g e n u i n e , rich n a t u r e of m a n , this sell image
r e p r e s e n t s a m o n s t r o u s p e r v e r s i o n , an i m p o v e r i s h m e n t b o r d e r i n g on
sell d e s t r u c t i o n Hy n a t u r e , the h u m a n being il a clear, open realm
1
General
Daseinsanalylic
Etiology
195
196
EXISTENTIAL
FOUNDATIONS
f e m i n i n i t y . He w r i t e s : "It is n o t in t h e n a t u r e of p s y c h o a n a l y s i s to
a t t e m p t to d e s c r i b e w h a t a w o m a n i s t h a t is h a r d l y f e a s i b l e b u t simply
t o explain h o w a w o m a n b e c o m e s a w o m a n , h o w s h e develops o u t o f t h e
b i s e x u a l l y disposed c h i l d . " Y e t h o w can p s y c h o a n a l y s i s even begin this
u n d e r t a k i n g w h e n , by its o w n a d m i s s i o n , it h a s prejudged its s t a r t i n g
point, t h e f e m a l e child, as b i s e x u a l l y disposed and is u n a b l e to u n d e r s t a n d
or explain t h e n a t u r e of its end p r o d u c t , t h e adult f e m a l e ? S i n c e s u c h an
e n t e r p r i s e is d o o m e d to failure f r o m t h e s t a r t , it follows t h a t t h e
psychodynamic-genetic hypotheses of psychoanalytic theory must be
s t a b s in t h e dark, c o n s i s t i n g as t h e y do in a s e r i e s of h i g h l y a b s t r a c t
presuppositions.
2
Chapter 13
A GENERAL DASEINSANALYTIC PHENOMENOLOGY
T h e p h e n o m e n o n i t s e l f should t a k e p r e c e d e n c e o v e r any i n v e s t i g a t i o n
i n t o o r i g i n s . T h i s holds n o t o n l y in t h e p a r t i c u l a r area of p s y c h o a n a l y t i c
t h e o r y but in all medical t h i n k i n g . It is t h e p a r t i c u l a r d u t y of t h e
p h e n o m e n o l o g i c a l o r i e n t a t i o n t o clarify t h e e s s e n t i a l m e a n i n g s i n h e r e n t
in the o b j e c t of i n v e s t i g a t i o n itself. T h e following s k e t c h of a g e n e r a l
p a t h o l o g y t h a t is a d e q u a t e l y h u m a n , p h e n o m e n o l o g i c a l , and scientific is
based on an u n d e r s t a n d i n g w h i c h defines the p e r s o n w h o is ill in a c c o r d
w i t h his n a t u r e as a h u m a n b e i n g , as Dasein, as e x i s t e n c e . O u r first s t e p s
t o w a r d a g e n e r a l , D a s e i n s a n a l y t i c p a t h o l o g y a r e t h e r e f o r e directed
t o w a r d t h o s e l i m i t a t i o n s o f p o t e n t i a l i t i e s w h i c h affect t h e e x i s t e n t i a l
traits medicine considers most essential.
OF ILLNESS
Preliminary remarks
NOTES
1. C f . F. W a g n e r , Die Wissenschaft und die gefhrdete Well ( M u n i c h : C . H . B e c k , 1 9 6 4 ) , pp. 1 0 4
ff. a n d 4 0 1 ff.
2 . S . F r e u d , " N e u e F o l g e d e r V o r l e s u n g e n z u r E i n f h r u n g i n die P s y c h o a n a l y s e , "
X X X I I I . Vorlesung: Die Weiblichkeil, in Ges. W., v o l . 1 5 ( L o n d o n : I m a g o , I n c . , 1 9 4 0 ) , p. 1 2 4 .
W e p r o g r e s s e d t o w a r d a d a s e i n s a n a l y t i c d e s c r i p t i o n o f o u r test
s u b j e c t ' s p a t h o l o g i c a l s y m p t o m s b y repeatedly asking h e r t h e simple
question: "Well now, Frau Z r c h e r , just what is lacking?" From time
i m m e m o r i a l this i s h o w p h y s i c i a n s t h e w o r l d o v e r h a v e b e g u n t h e i r
d i a g n o s e s , j u s t a s predictably, t h o u g h , t h e a n s w e r t h e y are given i s
a n y t h i n g but a r e s p o n s e t o t h e q u e s t i o n . P a t i e n t s r e p o r t n o t w h a t t h e y
lack, w h a t t h e y do n o t h a v e , b u t w h a t t h e y have: "I h a v e a h e a d a c h e , " "I
h a v e a b r o k e n leg," "I h a v e this or t h a t c o m p u l s i v e t h o u g h t . "
E v e n so, t h e p h y s i c i a n s and p a t i e n t s a r e n o t really talking past each
o t h e r . B o t h a r e speaking a b o u t t h e m o d e o f being ill, t h o u g h from
o p p o s i t e p o i n t s o f v i e w . I t i s t h e illness itself t h a t h a s t w o f a c e s . T h e
p h y s i c i a n ' s q u e s t i o n posits illness as a lack of h e a l t h ; t h e p a t i e n t simply
d e s c r i b e s w h a t h e " h a s . " H e r e p o r t s w h a t disturbs h i m , w h i c h is, thai
b e c a u s e of his deficient h e a l t h he is forced to e x i s t in the form ol
p a t h o l o g i c a l s y m p t o m s . His r e p o r t f u r t h e r m o r e r e v e a l s his attitude
t o w a r d his c o n d i t i o n , and t h e physician m a y learn w h e t h e r the patienl
has a c c e p t e d the illness as a c h a l l e n g e , revolted a g a i n s t it, tried to deny itl
e x i s t e n c e , o r s u r r e n d e r e d t o it. T h e a t t i t u d e t o w a r d illness ig an
i m p o r t a n t part of t h e p h e n o m e n o l o g y ol the suffering. A tuberculfll
1
198
EXISTENTIAL FOUNDATIONS
General
Daseinsanalytic
Phenomenology
199
200
EXISTENTIAL
FOUNDATIONS
SL2
human existence
^ 9J
W e h a v e already s e e n t h a t t h e b o d y h o o d o f h u m a n b e i n g s i s n o t t o b e
V
t h o u g h t of as simply a physically p r e s e n t , m e a s u r a b l e body, n o r as s o m e
ca
s e l f - c o n t a i n e d t h i n g sufficient u n t o itself. W h i l e e v e r y t h i n g h u m a n i s
bodily, this is b u t the bodying f o r t h of a p e r s o n ' s r e l a t e d n e s s to t h e w o r l d
at a given m o m e n t , t h e r e l a t e d n e s s as w h i c h he e x i s t s . W h e n illness
impairs t h e body, t h e r e are t w o q u e s t i o n s w h i c h a n y h u m a n l y a d e q u a t e
t h e o r y will ask: J u s t h o w is t h e bodily s p h e r e of Da-sein d i s t u r b e d P and
W h a t w a y of relating to t h e w o r l d is it t h a t is d i s t u r b e d ?
O f all f o r m s o f illness w h i c h s h o w m a r k e d d i s t u r b a n c e s w i t h i n t h e
bodily s p h e r e , t h e m o s t p r o m i n e n t are t h o s e traditional p a t h o l o g y
classifies a s primarily o r g a n i c , o r s o m a t o g e n i c . T h e p r o t o t y p e s o f this
c a t e g o r y are d i s e a s e s t h a t a r e i n h e r i t e d and t h o s e t h a t a r e c o n t r a c t e d in
ulero, like H u n t i n g t o n ' s C h o r e a , c o l o r b l i n d n e s s , c e r t a i n f o r m s of
diabetes, m o n g o l i s m , and e m b r y o n i c d a m a g e c a u s e d b y thalidomide.
N a t u r a l scientific r e s e a r c h can d e m o n s t r a t e specific g e n e t i c d e f e c t s w i t h
regard t o m a n y such i m p a i r m e n t s . M o l e c u l a r biology has d i s c o v e r e d
c h a n g e s in the n u m b e r and type of c h r o m o s o m e s in a cell and d e v i a t i o n s
in the a r r a n g e m e n t of t h e four basic u n i t s of the D N A m o l e c u l e s within
the c h r o m o s o m e s .
10
General
Daseinsanalytic
Phenomenology
201
202
EXISTENTIAL FOUNDATIONS
A n a c u t e r h e u m a t i c i n f l a m m a t i o n o f t h e right e l b o w and s h o u l d e r j o i n t
could also m a k e it impossible to body f o r t h a g r e e t i n g r e l a t i o n s h i p . T h e n
it would be t h e pain t h a t i n t e r f e r e d , t h o u g h such an i m p a i r m e n t would
presumably be temporary.
B r a c h i a l paralysis o c c a s i o n e d b y h y s t e r i a , s o m e t i m e s misleadingly
called p s y c h o g e n i c p a r a l y s i s , r e p r e s e n t s still a n o t h e r w a y in w h i c h the
bodying f o r t h of a g r e e t i n g m a y be impaired. T h a t this t o o should be s e e n
a s a n i m p a i r m e n t o f t h e free c a r r y i n g o u t o f h u m a n b e i n g - i n - t h e - w o r l d
does n o t need t o b e discussed h e r e , given d i s c u s s i o n s o f o u r t e s t s u b j e c t ' s
h y s t e r i c a l leg paralysis.
T h e s a m e p o t e n t i a l i t y for g r e e t i n g can also be impaired by a s e v e r e
head w o u n d . F o r i n s t a n c e , s o m e o n e m i g h t b e s h o t t h r o u g h t h e head, s o
t h a t h e a f t e r w a r d s s u f f e r s from a c u t e , p o s t t r a u m a t i c d e m e n t i a . T h e n i t
m a y happen t h a t t h e affected p e r s o n n o l o n g e r r e c o g n i z e s t h e
m e a n i n g f u l n e s s of a g i v e n s i t u a t i o n as an e n c o u n t e r t h a t calls for a
g r e e t i n g . To him, n o w this s i t u a t i o n m i g h t m e a n n o t h i n g at all, or it
m i g h t be e x p e r i e n c e d as s o m e t h i n g from w h i c h it is b e s t to flee. In e i t h e r
c a s e , the injured p e r s o n will not be able to body f o r t h a friendly g r e e t i n g
with a handshake.
E v e n for this type of being ill, t h e d e s i g n a t i o n " p r i m a r i l y o r g a n i c "
m i s s e s the point. It p r e j u d g e s t h e h e a d injury as s o m e t h i n g t h a t c o n s i s t s
solely i n t h e d e s t r u c t i o n o f o r g a n i c brain m a t t e r . O n c e i t h a s b e e n s o
m i s c o n s t r u e d , t h e r e is no l o n g e r any w a y to r e e s t a b l i s h a c o n n e c t i o n
b e t w e e n this d a m a g e d o r g a n i c m a t t e r and t h e p a t h o l o g i c a l b e h a v i o r o f
the person suffering from the traumatic dementia. T h e one way to
u n d e r s t a n d this b e h a v i o r is t h r o u g h seeing t h a t t h e injury to t h e brain is
directly and p r i m a r i l y a n i m p a i r m e n t o f the p e r s o n ' s ability t o c a r r y o u t
e s s e n t i a l h u m a n w a y s of relating to t h e w o r l d , t h e brain being b u t a
bodily s p h e r e o f t h e w h o l e e x i s t e n c e . W h a t h a p p e n e d w a s t h a t his ability
t o g r e e t o t h e r people i n t h e m o d e s o f s h a k i n g h a n d s w a s also w o u n d e d .
A n equally s e v e r e i m p a i r m e n t o f t h e ability t o body f o r t h g r e e t i n g can
o c c u r in idiotia phenylpyruvica. H e r e t h e d a m a g e to t h e brain r e s u l t s f r o m
the presence in the metabolism of poisonous substances which intervene
d e s t r u c t i v e l y in t h e i n t e l l e c t u a l possibilities of t h e affected children by
damaging w h a t s c i e n c e c o n c e p t u a l i z e s as t h e c e r e b r u m . W h i l e it can be
p r e v e n t e d simply by w i t h h o l d i n g t h e foods t h a t , in t h e v a c u u m left by an
i n n a t e e n z y m e deficiency, b e c o m e t h e r a w m a t e r i a l s for t h e m e t a b o l i c
poisons t h a t d a m a g e t h e brain, t h e availability of a purely m a t e r i a l
therapy does not diminish t h e validity of saying t h a t , even h e r e , w h a t is
a l l c c l e d directly and i m m e d i a t e l y are w a y s of b e i n g with o i l i e r people.
I h e c o r r e s p o n d i n g p h y s i o c h e m i c a l pathological i m p a i r m e n t s c a n b e
e l u c i d a t e d by natural scientific i n v e s t i g a t i o n within the p h e n o m e n a l
General
Daseinsanalytic
Phenomenology
2(U
204
EXISTENTIAL FOUNDATIONS
In m a k i n g a t r a n s i t i o n to a m o r e h u m a n l y a d e q u a t e , p h e n o m e n o l o g i cally o r i e n t e d g e n e r a l p a t h o l o g y , it is all t h e m o r e i n s t r u c t i v e to c o n s i d e r
so significant a failure of t h e old w a y of t h i n k i n g a b o u t a form of illness as
t h e a c u t e , e x o g e n i c r e a c t i o n type. A t t h e v e r y edge o f t r a d i t i o n a l
p a t h o l o g y ' s c o n c e p t u a l h o r i z o n , B l e u l e r w a s able t o divide a c u t e ,
e x o g e n i c r e a c t i o n t y p e s i n t o t h r e e g r o u p i n g s . I n t o t h e first g r o u p i n g h e
placed p a t i e n t s suffering f r o m a " g e n e r a l dimming, or dimunition, of
c o n s c i o u s n e s s . " T h e s e c o n d g r o u p i n g is c h a r a c t e r i z e d by an alteration of
c o n s c i o u s n e s s , i n w h i c h t h e individual b o n d s t h a t g u a r a n t e e t h e o r d e r
and u n i t y of psychic life a r e disturbed, o p e n i n g up t h e w a y to s t a t e s of
c o n f u s i o n a c c o m p a n i e d b y h a l l u c i n a t i o n s . T h e third g r o u p i n g , finally,
involved a " m o r e simple o r d e r i n g " of c o n s c i o u s n e s s .
T h e s e t h r e e g r o u p i n g s a r e t h e n c o m p a r e d w i t h t h e activity o f a t r o o p
o f soldiers o f w h i c h B l e u l e r says: " I t s f o r c e i s e x t i n g u i s h e d w h e n each
individual's s t r e n g t h g o e s ; if t h e c o m m a n d e r fails, it b e c o m e s d i s o r d e r e d ,
aimless and i n e f f e c t i v e , e a c h m e m b e r a c t i n g as he t h i n k s b e s t ; it r e g a i n s
its order, but not its spirit or skill, w h e n s o m e o n e of less ability replaces
the fallen c o m m a n d e r , e v e n t h o u g h each m e m b e r is slill capable of
ai I i n ) ; " ( 0 1 responding to this a n a l o g y , B l e u l e r i m a g i n e s diminution o f
i O H M iousness as affecting c e r e b r a l f u n c t i o n i n g as a w h o l e , a l t e r a t i o n o f
General
Daseinsanalylic
Phenomenology
205
c o n s c i o u s n e s s a s injury t o t h e i n t r a c e r e b r a l c o n n e c t i v e p a s s a g e w a y s ; and
ordering on a more simple level as a reduction of t h e s e possibilities for
connection.
In so far as this a n a l o g y to a t r o o p is i n t e n d e d to i l l u s t r a t e a t h e o r y
t r a c i n g t h e p a t h o l o g y o f t h e a c u t e , e x o g e n i c r e a c t i o n type b a c k t o t h e
n o t i o n of a physical brain w i t h its manifold l e s i o n s , it h a s o v e r r e a c h e d its
p o w e r s . W h a t w e h a v e said b e f o r e a b o u t t h e impossibility o f deriving any
h u m a n m o d e s o f b e h a v i o r f r o m p h y s i c a l - n e r v o u s s t r u c t u r e s and
p r o c e s s e s n a t u r a l l y applies also t o p a t i e n t s suffering f r o m a c u t e ,
e x o g e n i c r e a c t i o n types. H e r e , t o o , o n e can o n l y d e m o n s t r a t e t h a t certain
c e r e b r a l p r o c e s s e s and h u m a n w a y s o f being are s i m u l t a n e o u s .
B u t a b o v e all, w e h a v e p o i n t e d o u t t h a t t r a d i t i o n a l p s y c h o l o g y has
found n o h a r d e v i d e n c e for t h e e x i s t e n c e , n a t u r e , o r c o n t e n t s o f the
c o n s c i o u s n e s s it posits, n o r h a s it b e e n able to d e m o n s t r a t e h o w a p e r s o n ,
o r s u b j e c t , can " h a v e " c o n s c i o u s n e s s . A s long a s t h e t h i n g i t s e l f r e m a i n s
u n k n o w n , supposed a t t r i b u t e s like " d i m m i n g , " " d i m i n u t i o n , " and
" a l t e r a t i o n " can m e a n v e r y little. S i m i l a r l y , t h e idea of a d i s t u r b a n c e of
o r d e r and u n i t y a m o n g individual t h o u g h t p r o c e s s e s and a s s o c i a t i o n s in
the p s y c h e h a s no factual basis. As we h a v e said again and again, it has n o t
b e e n possible to u n c o v e r a single piece of e v i d e n c e to p r o v e t h a t s u c h
e n d o p s y c h i c e n t i t i e s e x i s t . T h u s , i t should b e c l e a r e n o u g h t h a t t h e
c o n c e p t u a l a p p r o a c h of t r a d i t i o n a l p a t h o l o g y is i n a d e q u a t e to explain the
p h e n o m e n a o f t h e a c t u e , e x o g e n i c r e a c t i o n type.
W h a t p s y c h o l o g y h a s falsely t e r m e d t h e d i m i n u t i o n , a l t e r a t i o n , and
d i m m i n g o f a n e n d o p s y c h i c c o n s c i o u s n e s s can b e h u m a n l y u n d e r s t o o d
o n l y i f w e finally discard, o n c e and for all, t h e p s y c h o l o g i c a l n o t i o n o f
c o n s c i o u s n e s s and learn to r e c o g n i z e t h a t t h e Da-sein e v e n of ill p e r s o n s is
a p r i m a r y b e i n g - i n - t h e - w o r l d . O n l y t h e n will we finally be able to see the
so-called p s y c h o p a t h o l o g i c a l s y m p t o m s o f t h e a c u t e , e x o g e n i c r e a c t i o n
type f o r w h a t t h e y t r u l y are, a s a n i m p a i r m e n t o f t h e b r e a d t h and
c l e a r n e s s of t h e w o r l d - r e a l m w h i c h t h e Da-sein of t h e afflicted p e r s o n can
hold open. F u r t h e r m o r e , the usual e x p l a n a t i o n o f so-called hallucina
t i o n s g i v e s o n l y t h e a p p e a r a n c e o f u n d e r s t a n d i n g . N o m a t t e r w h a t the
u n d e r l y i n g illness, t h e r e h a s n e v e r b e e n s u b s t a n t i a l e v i d e n c e o f a n actual
a l t e r a t i o n in an equally u n s u b s t a n t i a t e d e n d o p s y c h i c c o n s c i o u s n e s s , or
of a l o o s e n i n g of e n d o p s y c h i c ties or a disruption of a s s o c i a t i v e t h o u g h t
p r o c e s s e s . All w e m a y l e g i t i m a t e l y s a y o f people h a l l u c i n a t i n g w i t h i n the
c o n t e x t of an a c u t e , e x o g e n i c r e a c t i o n type is t h a t t h e y a r e being
e n c o u n t e r e d and e n g a g e d by t h i n g s of their w o r l d o t h e r t h a n , and in
o t h e r w a y s t h a n , t h e h e a l t h y people a r o u n d t h e m . W h a t e v e r n o x i o u s
i n f l u e n c e is p r e s e n t directly affects t h e f u n d a m e n t a l e x i s t e n t i a l trait thai
is the ability to e n g a g e in spatial r e l a t i o n s h i p s to the t h i n g s of a shai ed
206
EXISTENTIAL FOUNDATIONS
General
Daseinsanalytic
Phenomenology
207
EXISTENTIAL
208
FOUNDATIONS
O n c e this h a s b e e n d o n e , t h e n a t u r a l s c i e n c e s d o n o t c o n s i d e r i t
i m p o r t a n t t o i n q u i r e w h e t h e r the u n a m b i g u o u s n o t i o n o f s t r e s s t h a t
r e s u l t s still c o r r e s p o n d s at all to w h a t it w a s m e a n t to d e s c r i b e . N o r is
sleep lost o v e r t h e fact t h a t in reality t h e r e a r e no such t h i n g s as
unspecific or s e l f - c o n t a i n e d stimuli. T h i s f r e q u e n t l y e m p l o y e d idea is
r o o t e d in an u n r e a l i s t i c a b s t r a c t i o n . In c o n t e m p o r a r y p s y c h o s o m a t i c
medicine, for i n s t a n c e , t h e t e r m " s t r e s s s t i m u l u s " i s o f t e n applied
reductively t o clearly q u a n t i f i a b l e m e a s u r e s o f s o u n d , light, o r p r e s s u r e .
Y e t s o m e sound s t i m u l u s , m e a s u r e d i n decibels and credited w i t h t h e
p o w e r to p r o d u c e a c e r t a i n i n t e n s i t y of s e n s e p e r c e p t i o n in the h u m a n
n e r v o u s s y s t e m , h a s l o s t all c o n n e c t i o n t o t h e o b j e c t o f study. I n fact,
such t h i n g s as s o u n d stimuli do n o t e x i s t for a p e r s o n w h o is e x p o s e d and
asked t o r e s p o n d t o s t r e s s . T h e y e x i s t o n l y a s h y p o t h e t i c a l c o n s t r u c t s and
a b s t r a c t i o n s from t h e t h i n g s t h a t e n g a g e u s according t o the m e a n i n g s
they allow us to p e r c e i v e .
E v e r y s t r e s s , as s t r e s s , is c o n s t a n t l y o r i e n t e d to a p e r s o n ' s m o m e n t a r y
relation to w h a t he p e r c e i v e s as it appears in o n e significance or a n o t h e r .
B u t a h u m a n b e i n g ' s r e l a t e d n e s s to t h e w o r l d is n o t s o m e t h i n g t h a t
h a p p e n s o n l y from t i m e to t i m e . He is, by n a t u r e , a l w a y s in o n e or
a n o t h e r e c - s t a t i c , i.e., o p e n , perceptive, w o r l d - s p a n n i n g , r e l a t i o n s h i p t o
w h a t e n g a g e s him. He e x i s t s as such r e l a t e d n e s s . T h i s r e l a t e d n e s s is n o t ,
like t h e h y p o t h e t i c a l e x p l a n a t i o n s of n a t u r a l s c i e n c e , posited for the
p u r p o s e of i n t e r p r e t i n g h u m a n being. A h u m a n being can a l w a y s be s e e n
directly as a b e i n g - i n - t h e - w o r l d , a p e r c e p t i v e being o p e n to t h e
m e a n i n g f u l address o f p h e n o m e n a t h a t a r e n o t himself. W i t h o u t this
m e a n i n g f u l address from e x i s t i n g t h i n g s , t h e h u m a n being could n o t
exist. H u m a n s t r e s s , t h e n , a d e q u a t e l y u n d e r s t o o d , b e l o n g s t o t h e
f u n d a m e n t a l c o n d i t i o n of t h e h u m a n being; it is an E x i s t e n t i a l . S t r e s s or
b u r d e n i n g , as this indispensable m e a n i n g f u l address, s u p p o r t s and
p r o m o t e s life. S t r e s s c a n also be healing. It is n o w well k n o w n t h a t
i n t e n s e e m o t i o n a l s t r e s s does n o t n e c e s s a r i l y p r o v o k e d e p r e s s i o n ; i t can
e v e n c u r e o n e . T h a t s t r e s s i s n e c e s s a r y f o r life r e m a i n s o b s c u r e a s long
as the h u m a n being is w r o n g l y s e e n as a primarily w o r d l e s s e g o or s u b j e c t
w h o s e life h i s t o r y is objectified as a s e q u e n c e of e v e n t s and p r o c e s s e s .
6
T h e n o t i o n of a p e r s o n as a f u n d a m e n t a l l y w o r l d l e s s s u b j e c t also
p r e v e n t s a n u n d e r s t a n d i n g o f h o w i t i s t h a t m a n y people e x p e r i e n c e
reliefthe ending o f s t r e s s a s b u r d e n s o m e , e x h a u s t i n g , and d e p r e s s
ing. O n e w o u l d e x p e c t , for i n s t a n c e , t h a t e x a m i n e e s , o n c e t h e y h a v e
passed an e x a m , w o u l d feel relieved of all b u r d e n s and feel f r e e r and
e a s i e r than e v e r b e f o r e . T h e s t r e s s o f t h e i m p e n d i n g e x a m i n a t i o n , w e
a r g u e , is n o w o v e r and all r e a s o n s for feeling o p p r e s s e d should have
disappeared. Y e t m a n y people fall i n t o d e e p d e p r e s s i o n jus 1 artei passing
General
Daseinsanalytic
Phenomenology
2 0 <>
T h e r e f o r e , the a p p a r e n t relief b r o u g h t a b o u t i n l a b o r a t o r y s i t u a t i o n s
designed for m a x i m u m e x c l u s i o n o f all tactile, a c o u s t i c a l , a n d optical
e n v i r o n m e n t a l stimuli are actually n o t h i n g m o r e t h a n e x t r e m e
o v e r b u r d e n i n g . M a n y o f t h e s u b j e c t s living for days i n l i g h t - and
s o u n d p r o o f r o o m s b r e a k d o w n u n d e r this s t r e s s and begin t o
h a l l u c i n a t e w h i c h m e a n s i n this c o n t e x t t h a t i n o r d e r t o b e able t o
c o n t i n u e e x i s t i n g a s h u m a n b e i n g s , t h e y are forced t o g r a s p a t the
p r e s e n c e s and e n g a g e m e n t s o f p h e n o m e n a t h a t d o n o t reveal t h e m s e l v e s
to t h e h e a l t h y w a k i n g h u m a n b e i n g s w h o live in t h e e v e r y d a y world
around them.
T h e varied m e a n i n g s o f s t r e s s and t h e beneficial and pathological
c o n s e q u e n c e s of s t r e s s s i t u a t i o n s in life are far m o r e a c c e s s i b l e t h r o u g h
D a s e i n s a n a l y t i c insight t h a n t h r o u g h the c o n c e p t s o f s c i e n c e 0 1
210
EXISTENTIAL FOUNDATIONS
General
Daseinsanalytic
Phenomenology
by a l e c t u r e I am to give this c o m i n g s e m e s t e r , in t h e f u t u r e . My w a y . ol
r e l a t i n g t o m y past and p r e s e n t are f o r m e d b y t h e fact that, h a v i n g
decided to give this l e c t u r e , I am already e n g a g e d by this f u t u r e e v e n !
B e i n g - t h e r e as an o p e n r e a l m of t i m e and space, my e x i s t e n t i a l
p o t e n t i a l i t i e s are realized in t h e w a y m o s t p r e c i s e l y suited to m e , and my
e x i s t e n c e a s a n open p e r c e p t i v e r e s p o n s i v e n e s s r e a c h e s its g r e a t e s t r a n g e
and f r e e d o m . As a c o n s e q u e n c e , my Da-sein is at this m o m e n t a t t u n e d to a
m o o d of c o m p o s e d , r e l a x e d s e r e n i t y . A Da-sein is a t t u n e d to happiness il it
is able to realize t h e p o t e n t i a l i t i e s e s s e n t i a l to it.
B u t suddenly, i n t h e v e r y m i d s t o f m y happy and o p e n r e l a t e d n e s s t o
t h e w o r l d , m y old c h a i s e l o u n g e collapses u n d e r m e , a s s u c h t h i n g s are
w o n t t o do, and the ring f i n g e r o f m y r i g h t h a n d i s j a m m e d b e t w e e n the
w o o d e n slats of t h e chair. G o n e in a flash is t h e wide e x p a n s e of my
f o r m e r , happy c o n n e c t i o n t o t h e world, g o n e t h e r e w a r d i n g t h e m e o f
p r e s e n t - d a y m e d i c i n e ; b o t h h a v e r e t r e a t e d t o a n e x t r e m e l y undefined,
u n t h e m a t i c d i s t a n c e . T h e b r o a d e x t e n s i o n o f m y b e i n g - i n - t h e - w o r l d into
its past and f u t u r e h a s s u d d e n l y s h r u n k , a t t u n e d as I am to a t h r o b b i n g
pain, t o the m e a g e r p r o p o r t i o n s o f a c o n n e c t i o n t o m y injured fingertip.
My f u t u r e is limited to a plan for ending this awful pain as quickly as
possible. N o w , n o o b j e c t - p s y c h e h a s b e e n altered i n this p r o c e s s , n o r a n y
t h o u g h t p r o c e s s e s o r a f f e c t s w i t h i n such a n o b j e c t - p s y c h e . W h a t has
b e e n c h a n g e d and r e a t t u n e d is, r a t h e r , the p e r c e p t i v e o p e n n e s s o f the
b e i n g in space and time t h a t is t h e e s s e n c e of my Da-sein.
T r a d i t i o n a l m e d i c i n e m i g h t h a v e i n t e r p r e t e d this e v e n t as a s o m a t o
psychic disturbance, or an acute, exogenic reaction. If we intend to
d e m y t h o l o g i z e such i n a p p r o p r i a t e n o t i o n s a b o u t p r i m a r i l y o r g a n i c
h e a l t h d i s t u r b a n c e s , w e m u s t carefully avoid t h e all t o o f r e q u e n t
m i s i n t e r p r e t a t i o n t h a t t h e p i n c h e d fingertip is a physical o b j e c t in itsell
w h i c h , w h e n injured, a c t u a t e s , e v e n c a u s e s , a n a t t e n d a n t p s y c h o p a t h o
logical p h e n o m e n o n . T h i s i s n o t so. S e e n o b j e c t i v e l y t h a t is, scientifical
ly and in a w a y t h a t is a p p r o p r i a t e to h u m a n b e i n g s t h e pinching of my
fingertip, i.e., a bodily s p h e r e of my e x i s t e n c e , a f f e c t e d my w h o l e being,
i n - t h e - w o r l d directly, w i t h o u t t h e i n t e r v e n t i o n of a n y e x o g e n i c physi< a I
o b j e c t , t o such a n e x t e n t t h a t m y e n t i r e w a y o f r e l a t i n g i n space and time
to t h e w o r l d w a s r e a t t u n e d , e x a c t l y as it w a s described a b o v e .
T h e r e appears t o b e q u i t e s o m e discrepancy h e r e b e t w e e n a relatively
m i n o r injury t o t h e bodily s p h e r e o f m y e x i s t e n c e , t h e pinching o l one
finger, and t h e s e v e r e i m p a i r m e n t visited o n m y e n t i r e being-in the
w o r l d . P e r h a p s it is by v i r t u e of t h e fact t h a t t h e f i n g e r is t h e most h i g h l y
s o p h i s t i c a t e d r e a l m o f m y ability to r e l a t e t o t h i n g s bodily that the lone
of this painful e x p e r i e n c e could so powerfully affect t h e e x t e n s i o n ol my
b e i n g - t h e r e in space and t i m e . T h r o u g h his fingers, a person can c a r r y
212
EXISTENTIAL FOUNDATIONS
General
Daseinsanalytic
Phenomenology
213
T h e m o s t e v i d e n t i m p a i r m e n t o f t h e basic e x i s t e n t i a l t r a i t s o f spatiality
and t e m p o r a l i t y in r e l a t i n g to t h e p h e n o m e n a of t h e w o r l d h a p p e n s in
t h o s e i l l n e s s e s t h a t p s y c h i a t r i s t s classify as o r g a n i c p s y c h o s e s . In p a t i e n t s
w h o s u f f e r f r o m p r o g r e s s i v e paralysis, for i n s t a n c e , o r senile d e m e n t i a , i t
is n o t m e r e l y t h e v o l u m e of t h e p s y c h e t h a t is reduced, b u t t h e size of t h e
s p a t i o - t e m p o r a l w o r l d held o p e n by t h e s e people's Da-sein. T h e r a n g e of
t h i n g s and people to w h i c h such a p a t i e n t m a y still r e s p o n d h a s s h r u n k to
t h e d i m e n s i o n s o f t h e i m m e d i a t e p e r c e i v a b l e e n v i r o n m e n t , and even
h e r e t h e r e is such a closed d o o r b l i n d n e s s to t h e m e a n i n g of w h a t is
perceived t h a t spatial d i s o r i e n t a t i o n often r e s u l t s . O f t h e t h r e e t e m p o r a l
e x i s t e n t i a l e x t e n s i o n s o f past, p r e s e n t , and f u t u r e , the first and third a r e
n e a r l y totally c o v e r e d up in s u c h p a t i e n t s , so m u c h so t h a t t h e i r e x i s t e n c e
i s practically reduced t o t h e p r e s e n t . E v e n older people w h o are h e a l t h y
are far less likely t h a n t h e i r y o u n g and middle-aged c o u n t e r p a r t s to be
c o n c e r n e d w i t h plans for t h e f u t u r e and a r e apt t o focus r a t h e r
s t e a d f a s t l y o n t h e p r e s e n t . T h e y m a k e u p for this b y h a v i n g g r e a t e r
access to their pasts. T h e events of their youth draw nearer to them than
e v e r b e f o r e , and t h e i r Da-sein g o e s o u t to r e m e m b r a n c e of t h i n g s past.
T h u s t h e r e i s a t least o n e t e m p o r a l e x t e n s i o n t h a t r e m a i n s open, from
t h e i r p r e s e n t to t h e i r past, for t h e y do realize t h a t t h e y a r e dwelling in
w h a t has b e e n . N o w , w h e n w e h e a r t h a t people s u f f e r i n g from s e v e r e
senile d e m e n t i a i m a g i n e t h a t t h e y a r e actually children again and m i s t a k e
a n y o n e in t h e i r i m m e d i a t e p r e s e n c e for a f o r m e r p l a y m a t e , we say t h e s e
people a r e " l i v i n g in t h e p a s t . " B u t this is n o t so. To say this a s c r i b e s to the
illness s o m e t h i n g e x t e r n a l and s u p e r f l u o u s , s o m e t h i n g taken from the
s t a n d p o i n t of an o b j e c t i v e o b s e r v e r , but t h e p h e n o m e n o n itsell reveal*
t h a t t h e s e senile people do n o t live in relation to t h e i r past as the pail, the
s p a c e - t i m e r a n g e of t h e i r b e i n g - i n - t h e - w o r l d does not go from the
214
EXISTENTIAL FOUNDATIONS
p r e s e n t b a c k i n t o t h e p a s t a n y m o r e . T h e i r t e m p o r a l i t y has b e e n r e d u c e d
a l m o s t e x c l u s i v e l y t o t h e p r e s e n t . B u t t h e y live i n t h e p r e s e n t
r e l a t i o n s h i p s to t h e people and t h i n g s of t h e i r childhood. E v e r y t h i n g a
h e a l t h y p e r s o n would e x p e r i e n c e in t h e p r e s e n t is a b s o r b e d in t h e s e
r e l a t i o n s h i p s and c o r r e s p o n d i n g l y m i s p e r c e i v e d .
I n discussing t h e s e e x t r e m e illnesses, w e h a v e s t u d i o u s l y avoided
claiming t h a t t h e t e m p o r a l e x t e n s i o n s are e v e r actually lost, saying
r a t h e r t h a t t h e y a r e m a s k e d , o r c o v e r e d up. H u m a n t e m p o r a l i t y c o n s i s t s
o f all t h r e e e x t e n s i o n s p a s t , p r e s e n t , and f u t u r e . B e i n g e s s e n t i a l t o
h u m a n n a t u r e , n o n e of t h e m can simply disappear and still leave a h u m a n
Da-sein b e h i n d . N o w , c h i l d r e n a r e said to live e n t i r e l y in t h e p r e s e n t , n o t
y e t having a c c e s s to a past or a f u t u r e . B u t this living in the p r e s e n t is
v e r y d i f f e r e n t from t h a t of senile p a t i e n t s , for it is n o t t h a t children do
n o t live t h e d i m e n s i o n of t h e past b u t t h a t t h e r e is n o t yet e n o u g h past to
e f f e c t i v e l y d e t e r m i n e t h e i r p r e s e n t . As for the f u t u r e , it b e g i n s to s t a m p
t h e p r e s e n t w i t h i n c r e a s i n g force for children a s t h e i r c u r i o s i t y g r o w s ,
w h i l e in old people this f u t u r e - d i r e c t e d n e s s m o r e and m o r e declines.
P s y c h i a t r y has m a d e it all t h e m o r e difficult to a c h i e v e a D a s e i n s a n a l y t i c v i e w o f o r g a n i c p s y c h o t i c s t h r o u g h the v e r y c h o i c e o f this p h r a s e t o
d e s c r i b e s u c h p a t i e n t s . S u c h illnesses a r e n o t c a u s e d b y biophysical,
functional, and s t r u c t u r a l d i s t u r b a n c e s in a brain organ. E v e r y o n e h a s
from birth t h e p o t e n t i a l for e x i s t i n g in t h e p a t h o l o g i c a l m a n n e r a s c r i b e d
t o o r g a n i c p s y c h o t i c s . W e m a y see this b y t h e fact t h a t h e a l t h y people,
while d r e a m i n g , can c o n d u c t t h e m s e l v e s i n t h e v e r y s a m e w a y a s o r g a n i c
p s y c h o t i c s , a l t h o u g h t h e y r a r e l y e n g a g e in and c a r r y o u t this p o t e n t i a l in
t h e i r w a k i n g lives. If t h e s e p s y c h o t i c p o t e n t i a l i t i e s h a v e a l w a y s b e e n
t h e r e , t h e r e is no c a u s e to p r o d u c e t h e m in o r g a n i c p s y c h o t i c s t h r o u g h
l a t e r biophysical c h a n g e s in the brain. T h i s would hardly be possible, in
fact. N o m a t t e r h o w a p e r s o n ' s w a y s o f being m a y b e pathologically
c h a n g e d i n r e l a t i o n t o w h a t h e e n c o u n t e r s , t h e v e r y fact t h a t t h e s e are
w a y s o f being m e a n s t h e y c a n n o t h a v e o r i g i n a t e d i n biophysical
p r o c e s s e s . T h e r e i s t h e r e f o r e n o o r g a n i c e x p l a n a t i o n for t h e illness o f
supposedly o r g a n i c p s y c h o t i c s . E v e n t h e i r w a y o f b e h a v i n g i s g r o u n d e d
in ability to p e r c e i v e w h a t t h e y e n c o u n t e r in t h e i r world as m e a n i n g f u l
things or people.
N o ability t o p e r c e i v e m e a n i n g f u l n e s s , n o m a t t e r h o w impaired i t has
b e c o m e , can e v e r be derived from biophysical p r o c e s s e s . F o r e x a m p l e , if
w e tried t o explain the m o n o m a n i c b e h a v i o r o f a p r o g r e s s i v e paralytic o n
t h e basis o f the biophysical p r o c e s s e s a c c e s s i b l e to natural s c i e n c e , we
w o u l d reach u t terly absurd c o n c l u s i o n s . W e m i g h t h a v e t o a t t r i b u t e the
l a c I thai t h e m o n o m a n i c n o t i o n s o f paralytic s t h e s e d a y s a r e SO m u c h less
a m b i t i o u s than t h o s e o f their p r e d e c e s s o r s t o a n n u l e a s i n g e n n u i i n
General
Daseinsanalytic
Phenomenology
215
p r e s e n t - d a y s p i r o c h e t e s , w i t h t h e r e s u l t t h a t t h e d i s t u r b a n c e s in the
n e r v e cells o f t h e f r o n t a l lobe a r e less t u r b u l e n t t h a n t h o s e caused b y the
a n c e s t o r s of t h e s e s a m e s p i r o c h e t e s . S o m e t h i n g t h a t is biophysical in
n a t u r e c a n p r o d u c e o n l y s o m e t h i n g else t h a t is b i o p h y s i c a l in n a t u r e .
T h u s , i t m a t t e r s v e r y little w h e t h e r n a t u r a l s c i e n c e d i s c u s s e s a p a r t i c u l a r
i n s t a n c e of p r o g r e s s i v e p a r a l y s i s in r e l a t i o n to an i m m u n e biologicr e a c t i o n , or a c h r o n i c e n c e p h a l i t i c r e a c t i o n , or a d e g e n e r a t i v e p r o c e s s , or
a n y o t h e r m a t e r i a l p r o c e s s i n t h e brain o f t h e p a t i e n t . W h a t e v e r t h e
particular e x p l a n a t i o n m a y b e , it is basically akin to m a g i c if, f o r i n s t a n c e ,
it tries to explain t h e b e h a v i o r of a paralytic w h o m i s t a k e s h i m s e l f and his
s u r r o u n d i n g s for t h e b e i n g - i n - t h e - w o r l d of a C h i n e s e e m p e r o r as
deriving f r o m injury to s o m e bodily r e a l m c o n c e p t u a l i z e d as a brain
organ.
W e m a i n t a i n t h a t t h e r o l e o f p h y s i c a l i t y i n o r g a n i c p s y c h o s e s can b e
described a t b e s t t h r o u g h t h e f o l l o w i n g p r o p o s i t i o n s . T h e m o s t w e can
say is, first, t h a t t h e r e is a r e g u l a r s i m u l t a n e i t y b e t w e e n p a t h o l o g i c a l
b e h a v i o r in paralytics and a c e r t a i n c o n d i t i o n of t h e brain. S e c o n d , w h a t
n a t u r a l s c i e n c e i n t e r p r e t s a s f r o n t a l lobe d a m a g e c a u s e d b y lues
s p i r o c h e t e s is actually p r i m a r y and direct injury to t h e b e i n g - i n - t h e w o r l d o f a n e x i s t i n g h u m a n b e i n g w h i c h d e s t r o y s t h e bodily c a p a c i t y for
carrying out most of the normal, appropriate ways of responding to what
a p e r s o n e n c o u n t e r s . It f o l l o w s , third, t h a t a p e r s o n so a f f e c t e d h a s at his
disposal o n l y an e x t r e m e l y s e l f - c e n t e r e d , r e s t r i c t e d m o d e of h u m a n Dasein. S t r i c t l y speaking, t h e s u b s t r a t u m of o r g a n i c illness is only t h a t
s p h e r e of t h e r e d u c e d spatiality and t e m p o r a l i t y of paralytically ill h u m a n
b e i n g s w h i c h m a y also be i n t e r p r e t e d , t h o u g h i n a d e q u a t e l y , as d e f e c t s in
biophysical brain m a t t e r at a specific location in s p a c e .
Psychiatry further misinterprets the nature of organic psychotics
w h e n i t s e e s a s o n e o f t h e i r crucial s y m p t o m s a n i m p o v e r i s h m e n t o f
t h o u g h t p r o c e s s e s , defined as a deficiency of a s s o c i a t i o n s in t h e brain or
a s a disruption o f t h e p r o c e s s o f r e t r i e v a l o f c e r e b r a l e n g r a m s . W e h a v e
r e p e a t e d l y indicated, h o w e v e r , t h a t t h e r e is no real e v i d e n c e for the
e x i s t e n c e o f e n d o p s y c h i c t h o u g h t p r o c e s s e s and a s s o c i a t i o n s , disturbed
or u n d i s t u r b e d . S o - c a l l e d i m p o v e r i s h m e n t of c o n s c i o u s n e s s is actually a
s h r i n k i n g o f t h a t r e a l m o f p e r c e p t i v e o p e n n e s s and r e s p o n s i v e n e s s a s
w h i c h t h e p a t i e n t e x i s t s . T h e r e s u l t i s t h a t a n y t h i n g t h e patient
e n c o u n t e r s r e v e a l s o n l y a p o r t i o n of its c o n t e x t s of meaning, and
r e f e r e n c e c o m p a r e d w i t h w h a t i t r e v e a l s t o h e a l t h y people.
N o r a r e t h e w e a k m e m o r i e s o f t h e s e p a t i e n t s c a u s e d b y ini reased
difficulty in r e t r i e v i n g r e p r e s e n t a t i o n s f r o m o r g a n i c a l l y s t o r e d c ei e b l >l
e n g r a m s . R a t h e r , t h e presences o f w h a t w a s o n c e perceived in the o p e n
realm of t h e p a t i e n t ' s e x i s t e n c e fall out of t h e o p e n n e s s ol his I >ii *eln l.n
216
EXISTENTIAL
FOUNDATIONS
General
Daseinsanalytic
Phenomenology
217
h u m a n c o n t a c t s . T h e n a r r o w dwelling space a s w h i c h t h e y e x i s t c o n f i n e s
t h e i r Da-sein to an a t t u n e m e n t of c o n s t a n t fear of s u f f o c a t i o n . F r o m the
p e r s p e c t i v e o f this pervasive a t t u n e m e n t t h e y see e v e r y c o n t o u r o f e v e r y
o b j e c t in t h e i r vicinity as an u n b e a r a b l e i m p r i s o n m e n t or c o n s t r i c t i o n .
In all t h e s e e x a m p l e s of illness in w h i c h t h e r e is s e v e r e i m p a i r m e n t of
spatiality (the h u m a n being's dwelling a l w a y s , f r o m t h e b e g i n n i n g , and
n e c e s s a r i l y , in relation to close and d i s t a n t b e i n g s ) and t e m p o r a l i t y (the
h u m a n being's living o u t his t i m e in c a r r y i n g his possibilities of relating
to fulfillment at t h e appropriate t i m e ) , it is n o t j u s t t h e s e t w o traits of
h u m a n b e i n g - i n - t h e - w o r l d t h a t a r e disturbed. C l e a r l y , t h e r e is also a
d i s t u r b a n c e o f the E x i s t e n t i a l o f a t t u n e m e n t o r m o o d i n p h o b i c illnesses,
in epilepsy, and in t h e o r g a n i c p s y c h o s e s . W h e r e t h e l a t t e r a r e c o n c e r n e d ,
i n fact, t h e d i s t u r b a n c e o f a t t u n e m e n t r a n k s w i t h t h e i m p a i r m e n t s o f
spatiality and t e m p o r a l i t y as a third cardinal s y m p t o m .
218
EXISTENTIAL
FOUNDATIONS
General
Daseinsanalytic
Phenomenology
219
T h i s s t e a m r o l l e r e f f e c t g i v e s t h e i m p r e s s i o n o f a truly p o w e r f u l s e n s e o f
self, b u t this is an illusion, b o t h to t h e p a t i e n t h i m s e l f a n d to t h e o u t s i d e
o b s e r v e r . T h a t this is so is e v i d e n t from t h e false, f o r c e d e u p h o r i a t h e s e
p a t i e n t s e x p e r i e n c e ; it is still m o r e a p p a r e n t f r o m t h e p o w e r in any
obstacle to their self-glorification. T h e slightest opposition is enough to
d e s t r o y t h e i r e q u a n i m i t y , c a u s i n g t h e m to b r e a k o u t again and again in
blind, d e s t r u c t i v e r a g e s .
T h e melancholic disposition is l i k e w i s e a m o d e of fulfilling t h e E x i s t e n t i a l
o f a t t u n e m e n t w h i c h i n v o l v e s r e d u c t i o n i n t h e p e r c e p t i v e o p e n n e s s and
responsiveness to the address of w h a t is encountered. T h i s reduction is
v e r y d i f f e r e n t from t h a t p r e d o m i n a t i n g i n t h e m a n i c p h a s e . Like m a n i c s ,
m e l a n c h o l i e s can see o n l y t h e m s e l v e s , and t h e w o r l d a r o u n d t h e m t h e y
s e e o n l y as far as it is directly r e l a t e d to t h e m in a p a r t i c u l a r w a y . B u t
w h i l e t h e m a n i c s e e s h i m s e l f a s a n o m n i p o t e n t , godlike c r e a t u r e for
w h o m e v e r y t h i n g e x i s t s o n l y a s m a t e r i a l t o c o m p l e t e his o w n e x t e n d e d
dimensions, the melancholic sees in himself nothing but emptiness,
i n f e r i o r i t y , w o r t h l e s s n e s s , and culpability. A n y t h i n g t h a t m a y r e m a i n
o p e n to his limited p e r c e p t i o n is e x p e r i e n c e d as an a c c u s a t i o n and a p r o o f
o f his w o r t h l e s s n e s s . H e o f t e n l a t c h e s o n t o o t h e r s t h e w a y d r o w n i n g
people lock o n t h e life p r e s e r v e r s t h a t a r e t h r o w n t h e m . M e l a n c h o l i e s can
discover no thing of worth in their existence because their modes of
r e l a t i n g t o t h e w o r l d (as w h i c h t h e y e x i s t ) are n o t t h e i r o w n . T h e y will
c o m p l a i n m o n o t o n o u s l y t h a t n o t h i n g i n t h e i r lives w o r k s a n y m o r e .
T h e r e a s o n n o t h i n g w o r k s a n y m o r e i s t h a t for t h e m t i m e h a s stopped.
T h i s a l o n e c o n s i g n s t h e m t o a n e m p t i n e s s t h a t i s b e n e a t h h u m a n dignity,
for h u m a n being can h a p p e n o n l y in living o u t its t i m e , c a r r y i n g to
fulfillment its i n b o r n possibilities f o r r e l a t i n g to w h a t e v e r a d d r e s s e s it.
M e l a n c h o l i e s are b a r r e d f r o m this kind o f r e s p o n s e t o w h a t a d d r e s s e s
t h e i r Da-sein. N o t h i n g is p r e s e n t to t h e m e x c e p t w h a t t e s t i f i e s to t h e i r
guilt, and t h e f u t u r e , no less d o o m e d , is r e s t r i c t e d to t h e fearful
e x p e c t a t i o n of t h e i r o w n , and t h e w o r l d ' s , a n n i h i l a t i o n . S u c h a f u t u r e is
b o u n d up e n t i r e l y w i t h t h e past. M e l a n c h o l i e s are e n t a n g l e d in a n e t of
e n d l e s s c o m p l a i n t s a b o u t s o m e m o r t a l sin t h e y c o m m i t t e d i n t h e distant
past.
M i n i s t r a t i o n s f r o m t h e o u t s i d e w o r l d , n o m a t t e r h o w well i n t e n t i o n e d
o r p e r s i s t e n t , c a n n o t free t h e m f r o m t h e m e s h e s o f t h e long a g o . T h e r a p y
along t h e s e lines m u s t i n e v i t a b l y fail, b e c a u s e t h e p a t i e n t s are c o r r e c t in
e x p e r i e n c i n g feelings o f guilt. T h e p r o b l e m i s t h a t w i t h o u t proper
g u i d a n c e t h e y s t u b b o r n l y single o u t s o m e m i n o r y o u t h f u l folly a s the
i r r e p a r a b l e o f f e n s e t h a t is t h e s o u r c e of t h e i r u n h a p p i n e s s and guilt
feelings. Clinical psychiatry's m e t h o d of routine questioning is equally
b a r r e d from d i s c o v e r i n g t h e t r u e n a t u r e of t h e guilt t h a t s e t t l e s so e.u ly
220
EXISTENTIAL FOUNDATIONS
on m e l a n c h o l i e s . In p s y c h o t h e r a p e u t i c t r e a t m e n t s e x t e n d i n g o v e r a
period o f y e a r s , h o w e v e r , w h e r e t h e patient i s led t o c o n f r o n t h i m s e l f
w i t h r e l e n t l e s s s e l f - h o n e s t y , t h e t r u e n a t u r e o f his individual m o r t a l sin
becomes apparent.
All e n d o g e n i c m e l a n c h o l i e s w h o h a v e u n d e r g o n e r i g o r o u s , a p p r o p r i a t e
analysis h a v e r e v e a l e d t h e s o u r c e for t h e i r illness. E a c h b e g a n b y l e a r n i n g
t h a t the m e a n i n g of h u m a n being i n h e r e s in r e s p o n d i n g , w i t h all of o u r
i n b o r n possibilities, t o w h a t w e e n c o u n t e r , t h e r e b y allowing w h a t i s
e n c o u n t e r e d to unfold i t s e l f in o u r o p e n r e a l m of p e r c e p t i o n . It is
precisely t h i s , h o w e v e r , t h a t proved i m p o s s i b l e for e v e r y f u t u r e
m e l a n c h o l i c w h o has b e e n t h o r o u g h l y e x a m i n e d . T h e y had, i n fact,
always p e r c e i v e d t h e m e a n i n g f u l appealing a d d r e s s o f t h i n g s and had
n e v e r c e a s e d t o h e a r this appeal, n o t e v e n during t h e i r t i m e s o f
m e l a n c h o l i a . W e r e this n o t so, t h e y would n o t h a v e had t o s u f f e r a s f e w
o t h e r h u m a n b e i n g s e v e r m u s t . R e m a i n i n g painfully open t o this appeal,
yet unable to respond with authentic behavior of their own, they grew
daily m o r e i n d e b t e d to t h e i r Da-sein. T h e y e x p e r i e n c e d this g r o w i n g debt
to t h e i r unfulfilled i n b o r n possibilities for e x i s t i n g a u t h e n t i c a l l y as t h e
t r u e basis o f t h e i r i n c e s s a n t s e l f - r e c r i m i n a t i o n s a b o u t the past, despite
t h e fact t h a t t h e s e r e c r i m i n a t i o n s o f t e n a s s u m e d a b s t r u s e , delusional
forms.
F u r t h e r m o r e , all e n d o g e n i c m e l a n c h o l i e s q u e s t i o n e d a p p r o p r i a t e l y
h a v e s h o w n a similar p a t t e r n in t h e d e v e l o p m e n t of t h e i r " s i n f u l "
b e h a v i o r . F r o m a v e r y e a r l y age, e a c h o f t h e m r e l e g a t e d t h e significance
o f his o w n i n b o r n possibilities s o far b e l o w t h a t o f t h e d i c t a t e s a c t u a l o r
i m a g i n e d o f t h e s u r r o u n d i n g w o r l d t h a t t h e y w e r e n o t able t o g a t h e r
t h e i r e x i s t e n c e i n t o a reliable, g e n u i n e self and c a r r y it to fulfillment.
Instead, t h e y p e r s i s t e n t l y denied t h e i r selfhood, afraid to risk losing t h e
f a v o r a b l e r e g a r d of o t h e r s , practicing this lifelong s e l f - a n n i h i l a t i o n on a
scale far e x c e e d i n g t h a t of t h e self-violation s h o w n in people s u f f e r i n g
f r o m h y s t e r i c a l o r c o m p u l s i v e illnesses.
T h e i m p o r t a n t q u e s t i o n n o w arises o f precisely h o w t h o s e w h o will b e
m e l a n c h o l i e s a c q u i r e a d e p e n d e n c y and n e e d for love so s t r o n g t h a t it can
c o m m a n d t h e m to p r a c t i c e such a c o m p l e t e self-denial vis-a-vis t h e
world. T h e r e a r e , for e a c h case, a t least t w o distinct possibilities. F i r s t ,
t h e r e m a y be s o m e i n n a t e deficiency t h a t p r e v e n t s a person from
developing early e n o u g h i n t o a n a u t o n o m o u s self and, a s such, w i n n i n g
distinction as an i n d e p e n d e n t being. O r , s e c o n d , p o s t n a t a l i n f l u e n c e s
m a y i n t e r v e n e to disrupt t h e realization o f i n d e p e n d e n l sell h o o d In o n e
case, t h e n e g a t i v e a t t i t u d e o f t e a c h e r s and p e e r s might m o v e a pel son to
p a t h o g e n i c self-denial; i n a n o t h e r , c h e m i c a l t o x i n s , endo 0 1 e x o g e n i c ,
m i g h t affect his m a t u r i n g t o an independent s e n s e ol gel!
General
Daseinsanalytic
Phenomenology
O n e t h i n g a b o u t the p a t h o g e n e s i s o f e n d o g e n i c m e l a n c h o l i a , h o w e v e i ,
is c e r t a i n from t h e s t a r t . E v e n if it w e r e d e m o n s t r a t e d that c e r t a i n
m e l a n c h o l i e s e x h i b i t m e t a b o l i c d y s f u n c t i o n s o r toxicity during then
periods o f d e p r e s s i o n , this w o u l d still n o t explain t h e i r illness a s the
h u m a n e x i s t e n t i a l p h e n o m e n o n it is, and even if f u t u r e discoveries
produced a c o m p l e t e l y reliable p h a r m a c e u t i c a l t h e r a p y , we would not
t h e r e b y h a v e a real u n d e r s t a n d i n g of t h e p h e n o m e n o n itself. B e y o n d the
fact t h a t it is difficult to k n o w w h e t h e r physical e v i d e n c e in m e l a n c h o l i e s
is simply a c o n s e q u e n c e of b e h a v i o r a l d i s t u r b a n c e s , t h e t r u e n a t u r e of
m e l a n c h o l i a can only b e u n d e r s t o o d i n t e r m s o f loss o f freedom o v e r
m o d e s o f a t t u n e m e n t and o f d i s t u r b a n c e s i n actualizing t h e o t h e r basic
e x i s t e n t i a l traits. W h e r e e n d o g e n i c m e l a n c h o l i a i s c o n c e r n e d , t h e t e r m
" e n d o g e n i c , " implying a bodily c o n t a i n e r , is as m e a n i n g l e s s as it is in
relation to any other pathological h u m a n p h e n o m e n o n . No m a t t e r what
m e t h o d is u s e d in e x a m i n i n g t h e b o d y h o o d of m e l a n c h o l i c p a t i e n t s , t h e
ruling principle of t h e D a s e i n s a n a l y t i c p a t h o l o g y r e m a i n s valid. All
bodily p a t h o l o g i c a l s y m p t o m s a r e t o b e s e e n e x c l u s i v e l y a s impaii m e n t s ,
i n n a t e o r acquired, o f t h e ability t o body f o r t h specific h u m a n w a y s o f
being.
O n l y o n e e s s e n t i a l possibility r e m a i n s o p e n t o m e l a n c h o l i e s t h e m o s t
e x t r e m e , m o s t a u t h e n t i c , and u n s u r p a s s a b l e e x i s t e n t i a l p o t e n t i a l i t y :
dying. T h i s i s w h y m e l a n c h o l i e s a r e s o p r o n e t o suicide. T h i s m a y c o m e
a b o u t i n t w o w a y s . I t h a p p e n s , o n t h e o n e hand, w h e n m e l a n c h o l i e s are
d r a w n i r r e s i s t i b l y t o w a r d it as t h e o n l y w a y o u t of t h e i r u n e n d u r a b l e
n u m b n e s s . Q u i t e o f t e n , h o w e v e r , a m e l a n c h o l i c will c h o o s e suicide as the
last available act o f f r e e will. K n o w i n g t h i s , w e can u n d e r s t a n d w h y s o m e
m e l a n c h o l i e s e x p e r i e n c e t h e t i m e b e t w e e n t h e decision and the act o f
suicide as o n e of joyful fulfilling liberation. In t h e t e s t a m e n t s t h e y leave
behind, m a n y o f t h e s e suicides r e p o r t t h a t being able t o c h o o s e death w a s
like a leap o u t of a t o r t u r e d d e s p e r a t i o n and a d e v a s t a t i n g isolation into a
comforting embrace.
It is possible t h a t t h e suicides of m e l a n c h o l i e s r e p r e s e n t t h e s a m e
a t t e m p t t h a t leads to feelings of godlike o m n i p o t e n c e in t h e f r e n e t i c selfinflation o f m a n i c s . I n fact, o n e o f t h e e a r l i e s t c o m p l a i n t s o f m e l a n c h o l i e s
m a y h i n t a t s o m e t h i n g s t r i v e n for i n b o t h kinds o f illness. N o s o o n e r has
m e l a n c h o l y cast its first s h a d o w s o v e r t h e m than e v e n t h e m o s t devout
b e l i e v e r s find t h e y can n o l o n g e r pray. T h e y a r e h o r r i f i e d t o d i s c o v e r t h a I
t h e y h a v e suddenly b e e n t o r n l o o s e from G o d . All h u m a n beings are
f u n d a m e n t a l l y m o r e or less cut o f f from the a b s o l u t e and reduced to
individual limited e x i s t e n c e s ; s o r r o w is g r o u n d e d in this condition
M e l a n c h o l i e s s e e m to be e x c e e d i n g l y s e n s i t i v e to this schism. I hell
s o r r o w is o f such i n t e n s i t y t h a t it o f t e n involves the bodily s p h e r e ol t h e n
222
EXISTENTIAL FOUNDATIONS
General
Daseinsanalytic
Phenomenology
223
224
EXISTENTIAL
FOUNDATIONS
e n c r o a c h m e n t , a d i s t u r b a n c e so s e r i o u s t h a t it is of c o n c e r n not only to
p s y c h i a t r i s t s and s c h i z o p h r e n i c s , but to h u m a n i t y as a w h o l e . Indeed,
s u c h illness lends i t s e l f to e x p l o r a t i o n of t h e fragile f r e e d o m t h a t is
peculiar t o h u m a n e x i s t e n c e . U n f o r t u n a t e l y , s o c i e t y i t s e l f often p r e v e n t s
s u c h r e s e a r c h by d i s a v o w i n g and locking a w a y people suffering from
s c h i z o p h r e n i a . N o t only a r e t h e s e people t h e n deprived o f t h e loving
h u m a n a t t e n t i o n t h e y s o s t r o n g l y r e q u i r e , b u t t h e i r j a i l e r s , w h o are their
fellow h u m a n b e i n g s , t h e r e b y a b a n d o n a w a y to a c h i e v e a w a r e n e s s and
insight into t h e i r o w n n a t u r e .
T h e r e are i m p o r t a n t r e a s o n s to include a d i s c u s s i o n of s c h i z o p h r e n i a in
a D a s e i n s a n a l y t i c approach to m e d i c i n e . F i r s t , s c h i z o p h r e n i a is o n e of the
c o m m o n e s t o f h u m a n illnesses. I t d o m i n a t e s p s y c h i a t r i c r e s e a r c h . O n the
o t h e r hand, medical s c i e n c e h a s so far failed to u n d e r s t a n d it in scientific
t e r m s . R e s e a r c h into its g e n e s i s and e t i o l o g y in h o p e of finding c o n c r e t e ,
causal, g e n e t i c a l l y d e t e r m i n e d f a c t o r s h a v e had n o c o n v i n c i n g result.
Equally fruitless have been a t t r i b u t i o n s of m e t a b o l i c d i s t u r b a n c e , specific
f o r m s o f e m o t i o n a l t r a u m a , o r family p a t t e r n s a s u n e q u i v o c a l c a u s e s o f
modes of schizophrenia.
E v e n if definite s o m a t o g e n e t i c or p s y c h o g e n e t i c f a c t o r s had been
discovered and e s t a b l i s h e d b e y o n d a n y d o u b t , h o w e v e r , t h e y would
n e v e r in principle h a v e led to a clarification of s c h i z o p h r e n i c b e h a v i o r as
w h a t it is in itself. O n l y a t r u e p h e n o m e n o l o g i c a l a p p r o a c h can clarify a
h u m a n p h e n o m e n o n a s such. I f t h e p h e n o m e n o l o g i c a l definitions o f
s c h i z o p h r e n i a have up to n o w failed, t o o , it is b e c a u s e t h e y have g e n e r a l l y
outlined in less t h a n scientifically a d e q u a t e t e r m i n o l o g y the following
s y m p t o m triad: (a) l o o s e n i n g and d i s i n t e g r a t i o n of t h o u g h t p r o c e s s e s ; (b)
d i s t u r b a n c e of affect; and (c) s u b j e c t i v e d e p e r s o n a l i z a t i o n of t h e e g o . All
t h r e e o f t h e s e supposedly p r i m a r y s y m p t o m s a r e r e g a r d e d a s the
expression of a disturbance of the whole personality. T h e alteration of
single d i s c r e t e psychic f u n c t i o n s , such a s t h e a p p e a r a n c e o f hallucina
t i o n s o r delusions, i s n o t c o n s i d e r e d t o b e s c h i z o p h r e n i a . O n t h e
c o n t r a r y , it is believed t h a t c h a n g e s in t h e individual psychic f u n c t i o n s
appear w h e n the p e r s o n a l i t y as a w h o l e is sick.
T h e scientific value of this p s y c h i a t r i c c o n c e p t of t h e p e r s o n a l i t y is in
q u e s t i o n , h o w e v e r . C u r r e n t p s y c h i a t r y , even i n its s t a t e m e n t s o n s c h i z o
p h r e n i a , tends to use v a g u e c o n c e p t s . P e r s o n a l i t y is r e g a r d e d w i t h o u t
e x c e p t i o n as a p r i m a r y i n n e r life, and t h e illness of s c h i z o p h r e n i c p a t i e n t s
is t h e n v i e w e d as an e x t r e m e d i s i n t e g r a t i o n and discord a m o n g the
i n t r a p s y c h i c a s p e c t s t h a t m a k e up t h e p e r s o n a l i t y . Y e t t h e r e is a g r e a t
deal of c o n v i n c i n g e v i d e n c e , a m a s s e d by p s y c h o a n a l y s i s w h o treat
s c h i z o p h r e n i a , t h a t levels of i n n e r d i s i n t e g r a t i o n and opposition b e t w e e n
c o n t r a d i c t o r y i n n e r d e v e l o p m e n t a l t e n d e n c i e s , whu h . 1 1 < hoi h below or
General
Daseinsanalytic
Phenomenology
225
a b o v e a v e r a g e in v a r i o u s p a t i e n t p o p u l a t i o n s , h a v e little to no
r e l a t i o n s h i p to t h e d e v e l o p m e n t of s c h i z o p h r e n i a in t h e s e p a t i e n t s . It
would s e e m , t h e n , t h a t c o n t r a s t s and o p p o s i t i o n s w i t h i n t h e c o n s t i t u
tional e l e m e n t s of t h e p e r s o n a l i t y c a n n o t be r e g a r d e d as a p a t h o g n o m i c
feature of schizophrenia.
C l e a r l y , medical s c i e n c e m u s t a b a n d o n all c u r r e n t s u b j e c t i v i s t i c
h y p o t h e s e s i n its c o n c e p t u a l i z a t i o n o f t h e n a t u r e o f s c h i z o p h r e n i a .
H u m a n behavior cannot be comprehended in t e r m s of a boxlike psyche
n o r as a similarly c o n s t i t u t e d e g o , c o n s c i o u s n e s s , s u b j e c t i v i t y , or p e r s o n .
W h e r e , in h u m a n b e h a v i o r , m a y we find e v e n a t r a c e of t h e actual
p r e s e n c e of such a psychic c a p s u l e ? A n d we h a v e y e t to s e e a
d e m o n s t r a t i o n o f the actual e x i s t e n c e o f i n t r a p s y c h i c m e n t a l r e p r e s e n t a
t i o n s o f reality o r o f q u a n t i t a t i v e l y m e a s u r a b l e drives. T h e c o n c e p t i o n o f
h u m a n e x p e r i e n c e as a s e r i e s of p h y s i o c h e m i c a l r e a c t i o n s t h a t relay
i m p r e s s i o n s from t h e s e n s e o r g a n s t o t h a t m y s t e r i o u s p s y c h i c capsule i s
such a m i s c o n s t r u c t i o n that, if it w e r e so, we w o u l d be a m i s e r a b l e species
w i t h n o inkling t h a t t h e r e i s a n o u t s i d e w o r l d . T o k n o w and c o m p r e h e n d
the outside w o r l d t h e p e r s o n w h o is n o t a passive r e c e p t a b l e m u s t
literally g r a s p it, and he can do this o n l y by e x t e n d i n g to t h a t w o r l d in
w h o s e i m m e d i a t e vicinity h e already is.
It is in this s e n s e t h a t scientific u n d e r s t a n d i n g of t h e s c h i z o p h r e n i c Dasein is a p h a s e in t h e c o m p r e h e n s i o n of t h e p h e n o m e n o n of h u m a n
e x i s t e n c e as a w h o l e . S c h i z o p h r e n i a will be r e c o g n i z e d in its e n c r o a c h
m e n t o n t h e freedom o f b e i n g - i n - t h e - w o r l d w h e n h u m a n e x p e r i e n c e
i t s e l f is s e e n as open, r e s p o n s i v e , e c - s t a t i c b e i n g - i n - t h e - w o r l d . It is
h u m a n e x i s t e n c e as a p r i m a r y r e a l m of o p e n n e s s t h a t m a k e s possible a n y
relation to t h a t w h i c h is and will be e n c o u n t e r e d . A D a s e i n s a n a l y t i c v i e w
of the existence of the Schizophrenic reveals it to be unable to sustain or
m a i n t a i n t h a t open worldly r e a l m o f the ability t o p e r c e i v e i n t h e w a y
t h a t h e a l t h y h u m a n b e i n g s do. N e i t h e r i n e n c o u n t e r i n g n o r i n
c o n f r o n t i n g t h e i r fellow h u m a n b e i n g s and the t h i n g s t h a t c o n s t i t u t e t h e
w o r l d o f e x p e r i e n c e a r e t h e y able t o m a i n t a i n t h e free s t a n c e
c h a r a c t e r i s t i c of h e a l t h y people and h e a l t h y r e l a t i o n s h i p s . It is this lack of
f r e e d o m and o p e n n e s s w i t h r e g a r d t o w h a t i s e n c o u n t e r e d t h a t
demonstrates fundamental disturbance in the very existence of the
schizophrenic, not some postulated lessening of assumed thought
processes or associations. O n l y thus may we understand w h y schizo
p h r e n i a cripples t h e s u f f e r e r ' s r e s p o n s e t o the p h e n o m e n a o f t h e world
t o such a n e x t r e m e d e g r e e : w h a t h e e n c o u n t e r s e n g u l f s t h e s c h i z o
phrenic; i t d e s t r o y s his selfhood. N o w o n d e r , t h e n , t h a t h e s t r i v e s t o
escape this d e s t r u c t i o n by m a i n t a i n i n g a rigid d i s t a n c e from e n c o u n t e i
ing b e i n g s , especially h u m a n b e i n g s . T h i s , t h o u g h , is t a n t a m o u n l to
226
EXISTENTIAL
FOUNDATIONS
General
Daseinsanalytic
Phenomenology
P s y c h i a t r y m i s c o n s t r u e s s u c h p h e n o m e n a a s s c h i z o p h r e n i c compul
sive t h i n k i n g o r p r e s s u r e t h o u g h t s . O u r p a t i e n t i n s i s t e d t h a t h e was nol
e x p e r i e n c i n g u n c o n t r o l l a b l e i n t r a p s y c h i c t h o u g h t p r o c e s s e s or assoi La
t i o n s of a s u b j e c t i v e n a t u r e ; r a t h e r , t h i n g s called to h i m from outside,
w h e t h e r t h e y w e r e physically p r e s e n t o r had c o m e t o m i n d . T h e y made
e x a g g e r a t e d , e r r a t i c d e m a n d s o f h i m t h a t h e f o u n d i r r e s i s t i b l e . B u i even
m o r e t h a n t h e p o w e r o f t h i n g s , t h e a b s o l u t e a u t h o r i t y o f o t h e r people,
for s u c h a p a t i e n t , is t e r r i f y i n g . If o u r y o u n g m a n e n c o u n t e r e d a g a r d e n e i
at w o r k , he felt so e m o t i o n a l l y s w a l l o w e d by h i m t h a t he had to do e x a c t l y
w h a t t h e g a r d e n e r did and, t h r o u g h h i m , b e c o m e a g a r d e n e r . His p a r e n t s
had o n c e said t h a t he w a s p e r h a p s b e s t suited to b e c o m e a g a r d e n e r . And
since h e w a s c o m p l e t e l y d o m i n a t e d b y his p a r e n t s ' v i e w s and i n t e n t i o n s ,
t h e i r t h o u g h t w a s his c o m m a n d .
T h e c o m p u l s i o n t o b e t o t a l l y o b e d i e n t t o t h i n g s and t o people robbed
this p a t i e n t o f a t e m p o r a l i t y o f his o w n . H e k n e w h e w o u l d b e u n a b l e t o
be h i m s e l f in a n y s o r t of e n c o u n t e r w h e t h e r in t h e n e x t five m i n u t e s , in
an h o u r , or in a h u n d r e d days. His t i m e w o u l d n o t pass b e c a u s e it w a s not
his t i m e ; r a t h e r , he lived in t h e t i m e of o t h e r s . H i s past and p r e s e n t w e r e
e q u a l l y n o t his o w n , and t h e unfolding of his f u t u r e , as in t h e o t h e r t w o
t e m p o r a l d i m e n s i o n s , w a s d e t e r m i n e d b y o t h e r people.
H i s o w n p e r s o n w a s alien to h i m , for he had s p e n t his life copying t h e
b e h a v i o r p a t t e r n s o f his m o t h e r and o t h e r people. H e e x i s t e d i n such
d e p e r s o n a l i z e d f o r m t h a t his o w n a r m s and legs s e e m e d t o b e lifeless
a p p e n d a g e s n o t b e l o n g i n g to h i m . F o r a long t i m e , this p a t i e n t had to lie in
bed. In fact, for a y e a r he could b e a r to c o n f r o n t o n l y t h e limited space ol
his b e d r o o m w h e r e h e w a s able t o feel m o r e o r less h i m s e l f , w h o l e ,
b e c a u s e t h e claims o f t h e t h i n g s p r e s e n t w e r e m a x i m a l l y reduced. W h e n
additional t h i n g s c a u g h t his a t t e n t i o n , s u c h as a n o i s y m a c h i n e in a
n e i g h b o r i n g g a r d e n , he fell h o p e l e s s l y u n d e r t h e i r s w a y . At t h a t t i m e he
had already lost his i n d e p e n d e n t self; his a n x i e t y w a s t h a t of impending,
death. It o f t e n h a p p e n e d t h a t , as he lay in bed, u n o c c u p i e d and e x h a u s t e d ,
h e w o u l d suddenly feel c o m p e l l e d b y t h e o u t s i d e w o r l d o f o t h e r people t o
e n g a g e i n s o m e k i n d o f actively useful w o r k . H e felt h e m u s t a n s w e r this
call by g e t t i n g up and busily r u s h i n g a b o u t , a c c o r d i n g to t h e e x a m p l e set
by his m o t h e r . In k e e p i n g w i t h t h e t o t a l o t h e r - d i r e c t n e s s that sprang
from his lack o f s e l f - r e l i a n c e , h e w o u l d e v e n e x p e r i e n c e electric c u r r e n t s
b e i n g s e n t t h r o u g h his legs by his m o t h e r . It r e q u i r e d c o u r a g e to re
m a i n in his bed, t r u e to his c o n d i t i o n and his o w n w i s h e s . And, In
fact, t h e s o m a t i c h a l l u c i n a t i o n s of this p a t i e n t finally disappeared
o n c e he had s t r u g g l e d t h r o u g h to t h e self-reliant c o u r a g e he required
to fulfill his Dasein.
T h e p a t i e n t s u m m e d up t h e specific c h a r a c t e r of his s c h l z o p h r r n t i
e x i s t e n c e in t h e s e n t e n c e , " T h i n g s give me no peace, and I ( a n n o ! le.n i
228
EXISTENTIAL FOUNDATIONS
General
Daseinsanalytk
Phenomenology
230
EXISTENTIAL
FOUNDATIONS
General
Daseinsanalytic
Phenomenology
231
s c h i z o p h r e n i c p h e n o m e n o n m u s t be a p p r o a c h e d if it is to be u n d e r s t o o d .
R a t h e r t h a n a s s u m i n g a n i n n e r life t h a t i s hidden f r o m v i e w , w e c o n c e r n
o u r s e l v e s w i t h t h e w a y s i n w h i c h t h e actual t h i n g t h a t p r e o c c u p i e s the
p a t i e n t r e f e r s t o t h e w o r l d and t h e r e b y defines t h e p a t i e n t ' s r e l a t i o n s h i p
to it. In this c a s e , t h e r e f o r e , it is e s s e n t i a l to r e c o g n i z e t h a t , for the
p a t i e n t , t h e r e are n o t t w o d i f f e r e n t clocks, but a single o n e : at o n e
m o m e n t he s e e s it as a wall clock o u t t h e r e in t h e o p e n r e a l m of his world;
and a m o m e n t l a t e r it s w e e p s h i m a w a y and c o n s u m e s him, c o m p l e t e l y
deprives his w o r l d of its o p e n n e s s and f r e e d o m .
I n t h e t w o c a s e s w e h a v e s o far p r e s e n t e d , t h e p a t i e n t s had s e c o n d a r y
s y m p t o m s o f s c h i z o p h r e n i a : h a l l u c i n a t i o n s and d e l u s i o n s . T h e s e
s y m p t o m s , h o w e v e r , w e r e capable o f being o v e r s h a d o w e d and engulfed
i n e n c o u n t e r w i t h o t h e r t h i n g s . T h i s w a s n o t t h e case for the " S u n - m a n , "
i n w h o s e illness h a l l u c i n a t i o n s and d e l u s i o n s p r e d o m i n a t e d . W e p r e s e n t
this s h o r t h i s t o r y b e c a u s e t h e c a s e clearly i l l u s t r a t e s o u r v i e w t h a t
s e c o n d a r y s y m p t o m s o f s c h i z o p h r e n i c illness can b e u n d e r s t o o d properly
o n l y i n r e f e r e n c e t o t h e n o r m a l , o p e n r e a l m o f h u m a n p e r c e p t i o n and
response.
T h e " S u n - m a n , " a s h o r t , t h i c k s e t p e r s o n , w a s a n i n t e l l i g e n t patient
w h o w a s hospitalized in a u n i v e r s i t y clinic. He w a s initially m u t e w h e n
a d m i t t e d . T h e p r o m p t a d m i n i s t r a t i o n o f d r u g s rapidly stabilized him s o
t h a t he could hold t h e following c o n v e r s a t i o n w i t h his d o c t o r in t h e first
w e e k o f his admission:
Doctor: W h y w e r e y o u s o e x t r e m e l y a n x i o u s ?
Patient: S h o r t l y b e f o r e I c a m e i n t o the hospital, I s p e n t t h e w h o l e
n i g h t looking at t h e sun. I w a s lying in bed, t h e s h u t t e r s w e r e closed,
and t h e r o o m w a s i n total d a r k n e s s . S u d d e n l y , a b o u t 9 : 3 0 p.m., t h e
s u n w a s t h e r e on t h e wall o p p o s i t e my bed. A m a n lay sleeping on the
floor u n d e r t h e sun.
Doctor: C a n y o u d e s c r i b e t h e sun m o r e e x a c t l y ?
Patient: It w a s a r o u n d disc of a b o u t fifteen to t w e n t y c e n t i m e t e r s in
d i a m e t e r . T h e disc w a s a b o u t head high, and i n t h e c o u r s e o f the
n i g h t it m o v e d f r o m left to r i g h t along the wall. W h i l e doing so, it
c l i m b e d gradually.
Doctor: H o w w a s t h e disc c o n s t i t u t e d ?
Patient: It w a s an i n t e n s e pale y e l l o w light. T h e r e w e r e no definite
component parts.
Doctor: Did y o u see it in t h e s a m e w a y t h a t y o u could h a v e seen the
lamp b u r n i n g o n t h e c e i l i n g ?
Patient: N o ! I w a s c o m p l e t e l y d i s c o n c e r t e d by t h e disc. It m a d e m e
a n x i o u s . If I had lost s i g h t of it for even a m o m e n t , s o m e t h i n g
232
EXISTENTIAL FOUNDATIONS
t e r r i b l e would h a v e h a p p e n e d . It w a s m o r e p o w e r f u l t h a n m a n . I had
to take c a r e t h a t it did n o t suddenly a t t a c k m e .
Doctor: W e r e y o u n o t surprised w h e n y o u suddenly saw this s h a p e ?
Patient: N o ! F r o m t h e first m o m e n t , I k n e w w h a t it m e a n t . I k n e w t h a t
if y o u had b e e n in t h e r o o m , y o u m i g h t h a v e g o n e up to it, looked at
it, and felt it. B u t I k n e w i m m e d i a t e l y w h a t it m e a n t . I w a s t e r r i b l y
a n x i o u s and did n o t dare g e t o u t of bed.
Doctor: D i d y o u really s e e t h e sun on t h e wall w i t h y o u r e y e s , j u s t as if
you could h a v e s e e n t h e l a m p b u r n i n g o n t h e ceiling?
Patient: Y e s , e x a c t l y ! I still h a v e t h e i m a g e b e f o r e my e y e s , j u s t as if it
w e r e y e s t e r d a y . If I had closed my e y e s for j u s t a m o m e n t , I could n o t
h a v e s e e n t h e s u n a n y m o r e . B u t I dared n o t lose sight of it. I am
c o n v i n c e d t h a t y o u w o u l d h a v e s e e n it if y o u had b e e n w i t h m e .
Doctor: W h y do you call this apparition t h e s u n ?
Patient: I k n o w it is n o t t h e real sun. B u t e v e n during t h e day, I had
b e g u n to t h i n k c o n t i n u o u s l y a b o u t the sun. In doing so I had t h e
feeling t h a t my g e n i t a l s w e r e in t o u c h w i t h t h e sun in t h e sky, w e r e
s t i m u l a t e d by it. If I had lost sight of t h e sun on t h e wall, it w o u l d
h a v e c o m e close t o t h e e a r t h , and t h e e a r t h w o u l d have g o n e u p i n
f l a m e s . M y a n x i e t y i n t h e face o f i t b e c a m e steadily g r e a t e r .
W i t h i n a f e w w e e k s , t h e p a t i e n t had sufficiently r e c o v e r e d f r o m t h e
a c u t e s c h i z o p h r e n i c episode to be d i s c h a r g e d and to r e s u m e his j o b in a
factory.
A y e a r later, in a f o l l o w - u p i n t e r v i e w , t h e p a t i e n t insisted t h a t he felt
v e r y well, w a s in c o n t r o l , and w o r k e d r e g u l a r l y at a j o b t h a t paid good
w a g e s . H e w a s still living w i t h his p a r e n t s , w i t h w h o m h e n o t o n l y g o t
along splendidly b u t w h o w e r e , along w i t h his i m m e d i a t e family, his sole
companions.
H i s r e c o l l e c t i o n of his illness w a s vivid to t h e last detail; yet, t h o u g h his
e x p e r i e n c e s during t h a t illness still felt m e a n i n g f u l , t h e y w e r e
n o n e t h e l e s s unintelligible. S u c h w a s t h e i m p o r t o f t h e following
o b s e r v a t i o n s t o his d o c t o r , w h o m h e t r u s t e d t o a c c e p t t h e reality and
significance o f w h a t h e had u n d e r g o n e : "In t h e m o s t h u m d r u m a s p e c t s o f
my daily life, t h e r e w a s s o m e t h i n g t h a t w a s a l w a y s p r e s e n t b u t w h i c h is
difficult to r e f e r to a specific s i t u a t i o n . My illness m a d e it clear to me t h a t
one is dependent on others; to neglect one's relationship to the o t h e r
leaves o n e w i t h o u t d i r e c t i o n . " T h e p a t i e n t felt, d u r i n g his illness, t h a t
t h e r e w a s n o t h i n g on w h i c h he could rely, t h a t he w a s so at t h e m e r c y of
e v e r y t h i n g h e n o l o n g e r k n e w h o w t o distinguish b e t w e e n the real and
the unreal.
D u r i n g this i n t e r v i e w t h e patient revealed iiilorm.il i o n , a h e a d y hinted
a t b y his relatives, c o n c e r n i n g a painful hurI h e h a d u n d e r g o n e b e f o r e the
General
Daseinsanalytic
Phenomenology
233
234
EXISTENTIAL FOUNDATIONS
was o v e r p o w e r e d b y t h e c o s m i c i n c a n d e s c e n c e o f t h e sun, w h i c h
fascinated him and t h r e a t e n e d to s c o r c h and s w a l l o w him and t h e e n t i r e
e a r t h . Its limitless i n c a n d e s c e n c e replaced t h e lost w a r m t h o f his
c o n c r e t e , limited r e l a t i o n s h i p to his friend.
B u t the p a t i e n t k n e w t h e m e a n i n g o f t h e hallucinated disc o f light a s a n
all p o w e r f u l sun b e c a u s e k n o w l e d g e of t h e n a t u r e of all s u n s " s u n n e s s "
as s u c h h a d already d a w n e d (aufgehen) on h i m . O n l y so could he
u n d e r s t a n d i m m e d i a t e l y t h e significance o f t h e p a r t i c u l a r sun disc o n his
wall as " t h e s o v e r e i g n s w a y of a sunlike s u p r e m e p o w e r from w h i c h all
g r o w t h and life p r o c e e d s " b u t w h i c h a t t h e s a m e t i m e " c a n also s c o r c h
and a n n i h i l a t e e v e r y t h i n g . " T h e h a l l u c i n a t e d sun revealed t o him
s o m e t h i n g t h a t e n c o m p a s s e d all being and n o n b e i n g as well. F r o m this he
c a m e to k n o w a d a w n i n g (aufgehen) of w h a t had c o m e into p r e s e n c e in its
o w n form and n a t u r e , and also i n t o its dissolution (aufgehen) and
n o t h i n g n e s s . B u t a b o v e all, this sun allowed t h e patient to p e r c e i v e a
b e i n g - l i g h t t h a t d a w n s as the intelligent, u n d e r s t a n d i n g p e r c e p t i o n
illuminating the m e a n i n g of s o m e t h i n g as s o m e t h i n g ; it is s u c h a sunlike
dawning (aufgehen) t h a t is t h e n a t u r e of t h e h u m a n Da-sein.
T h u s , a f t e r his illness, the p a t i e n t p r o t e s t e d e n e r g e t i c a l l y against a n y
i n t e r p r e t a t i o n of his apparition as a n o n s e n s i c a l trick of t h e mind. W i t h
j u s t i f i c a t i o n , h e a t t r i b u t e d g r e a t m e a n i n g f u l n e s s t o his e x p e r i e n c e
during p s y c h o s i s , an e x p e r i e n c e t h a t e n r i c h e d his life. It had e n a b l e d him
to sense something impenetrable but fundamental, "something that was
t h e r e in e v e r y d a y life," even if he " c o u l d n o t apply it to t h e e v e r y d a y ,
particular s i t u a t i o n . " P e r h a p s t h e sun o f his p s y c h o t i c , u n b o u n d e d b e i n g i n - t h e - w o r l d had disclosed t h e m o s t hidden n a t u r e o f t h a t w h i c h holds
s w a y b e h i n d all a p p e a r a n c e , t h a t w h i c h is " n o t applicable to t h e specific,
particular s i t u a t i o n " b u t is n e v e r t h e l e s s in " t h e e v e r y d a y . " A n d since it is
e s s e n t i a l l y different f r o m " e v e r y t h i n g t h a t simply i s , " it c a n n o t e x i s t in
its o w n right as a p a r t i c u l a r , o b s e r v a b l e t h i n g .
It is h i g h l y likely t h a t t h e " h a l l u c i n a t e d " sun p r e s e n t e d o u r p a t i e n t w i t h
a n y t h i n g but m e r e n o n s e n s e . I t m a y h a v e disclosed t o him s o m e t h i n g
f u n d a m e n t a l t h a t i s n o t usually g r a n t e d t o m u n d a n e p e r c e p t i o n . T h e
p s y c h o t i c disruption of t h e b o u n d a r i e s of a Da-sein o f t e n s e e m s to b r i n g
w i t h it a s u p e r h u m a n p e n e t r a b i l i t y i n t o t h a t w h i c h , n o t a c c e s s i b l e to
c o m m o n e x p e r i e n c e , its precisely w h a t u n d e r l i e s it. It is, so to speak, a
s c h i z o p h r e n i c s e n s i t i v i t y t o t h a t ordinarily hidden from h u m a n
perception. U n f o r t u n a t e l y , s c h i z o p h r e n i c p a t i e n t s c a n n o t cope w i t h this
s e n s i t i v i t y and w h a t it reveals, or t h e i r p e r c e p t i o n s would lead t h e m to
b e c o m e v i s i o n a r i e s , poets, and p h i l o s o p h e r s ; i n s t e a d , t h e y b e c o m e ill
Paradoxically, the b u r s t i n g of limits in the Da-sein ol s c h i z o p h r e n i c s
s e r i o u s l y e n c r o a c h e s on t h e freedom o f t h e i r e x i s t e n t e I h e n . u p e r s e n -
General
Daseinsanalytic
Phenomenology
235
236
EXISTENTIAL
FOUNDATIONS
General
Daseinsanalytic
Phenomenology
237
238
EXISTENTIAL FOUNDATIONS
General
Daseinsanalytic
Phenomenology
239
7.
8.
9.
10.
11.
Ibid., p. 1 4 5 .
Ibid., p. 1 4 7 .
Ibid., p. 1 4 7
W. Schulte, o p . cit., p. 1 4 5 .
T h e G e r m a n w o r d , Langeweile, refers directly t o t h e disturbance i n t h e temporality o f
Chapter 14
A DASEINSANALYTIC EXAMINATION OF SOME
PREVAILING CONCEPTS OF GENERAL PATHOLOGY
Psychic projection
A g r e a t m a n y o f t h e p a t h o l o g i c a l p h e n o m e n a o f h u m a n e x i s t e n c e are
still b e i n g e x p l a i n e d o n t h e a s s u m p t i o n t h a t c e r t a i n d r i v e s , t e n d e n c i e s o r
facets of being are projected from the "inside" of the patient's psyche
o u t w a r d o n t o o n e o r s e v e r a l o t h e r people. I t i s e v e n said t h a t w h o l e
g o v e r n m e n t s and n a t i o n s p r o j e c t t h e i r o w n ill will o n t o o t h e r n a t i o n s
w h e n e v e r t h e y w a n t to p r e c i p i t a t e a w a r . O n l y in this w a y , so it is said,
can h a t r e d sufficient t o p r o d u c e w a r l i k e a g g r e s s i o n b e s u m m o n e d u p for
t h e evil e n e m y .
P s y c h o l o g i s t s claim t h a t p a t h o l o g i c a l individuals deal w i t h e a c h o t h e r
in an a n a l a g o u s w a y . O n c e a p s y c h i c p r o j e c t i o n h a s b e e n a c t i v a t e d , t h e
p r o j e c t i n g p a r t y i m a g i n e s h e h a s e v e r y r i g h t t o s e e t h e o t h e r a s solely
guilty and b e g g i n g for d e s t r u c t i o n . Y e t t h e m e r e fact t h a t o n e p e r s o n
m a y i n t e r p r e t a n o t h e r as evil i n c a r n a t e is far f r o m c o n s t i t u t i n g p r o o f for
t h e e x i s t e n c e o f psychic p r o j e c t i o n . O n t h e c o n t r a r y , i t o u g h t t o b e taken
as d e v a s t a t i n g p r o o f t h a t no s u c h p r o j e c t i o n t a k e s place. F o r if I w e r e
actually capable of p r o j e c t i n g ill will o u t of m y s e l f a n d o n t o a n o t h e r , I
w o u l d b e c o m e e m p t i e d of all m a l i c e . I w o u l d be t h e m o s t p e a c e a b l e person
o n this e a r t h . B u t t h e v e r y o p p o s i t e i s t r u e o f people w h o are supposedly
p r o j e c t i n g . In s h o r t , t h e n , all p s y c h o l o g i c a l t h e o r i e s of p r o j e c t i o n bypass
242
EXISTENTIAL FOUNDATIONS
243
idea o c c u r s t o the t e s t s u b j e c t i s t h a t o n e o r m o r e o f t h e s e p h e n o m e n a a r e
recalled from an u n t h e m a t i c m o d e of p r e s e n c e to o n e of a t h e m a t i c
visualization. T h e specificity o f t h e appearing p h e n o m e n o n depends o n
its m e a n i n g f u l n e s s " r e s o n a t i n g " w i t h t h e f o r m s a p p e a r i n g in t h e visual
field o f t h e t e s t s u b j e c t .
Psychic introjection
T h e n o t i o n o f psychic i n t r o j e c t i o n i s a s deceptive a s t h a t o f psychic
p r o j e c t i o n . W h e n a child c o n d u c t s i t s e l f in t h e v e r y s a m e w a y its m o t h e r
does, t h e n t h e child has adjusted its b e h a v i o r t o t h e m o t h e r ' s b e h a v i o r .
T h e child a c t u a l i z e s its Da-sein in t h e w a y s it s e e s it m o t h e r c a r r y i n g o u t
h e r s . T h i s is possible only if t h e child is i t s e l f a b e i n g - i n - t h e - w o r l d and, as
s u c h , a primordial ability to be t o g e t h e r w i t h o t h e r s in a s h a r e d w o r l d .
W i t h o u t this a b s o l u t e p r e r e q u i s i t e , t h e child could n e v e r s h a p e its b e i n g i n - t h e - w o r l d t o m a t c h its m o t h e r ' s . W h e n e v e r such e n g a g e m e n t d o e s
take place, h o w e v e r , it is a n y t h i n g b u t psychic i n t r o j e c t i o n of t h e m o t h e r .
In l e t t i n g its Da-sein be a b s o r b e d in its m o t h e r ' s w a y s of b e i n g , t h e child
dwells w h o l l y o u t s i d e i t s e l f in t h e m a t e r n a l Da-sein. T h i s m e a n s t h a t t h e
child has n o t y e t b e e n able t o win its a u t o n o m y from t h e m o t h e r ' s b e i n g i n - t h e - w o r l d : it is n o t y e t an i n d e p e n d e n t Da-sein capable of c a r r y i n g o u t
its o w n w a y s of being. If t h e child is n o t yet being w i t h an a u t h e n t i c and
a u t o n o m o u s selfhood, i t can h a r d l y i n t r o j e c t a n y t h i n g i n t o itself.
Psychic regression
R e g r e s s i o n is a n o t h e r c o n c e p t t h a t h a s played a part in t h e traditional
p i c t u r e o f p a t h o l o g y . Like t h e adjective " u n c o n s c i o u s , " " r e g r e s s i o n " h a s
b e e n u s e d i n t w o distinct s e n s e s . O n e o f t h e s e r e f e r s t o a n o c c u r r e n c e
t h a t m a y b e o b s e r v e d directly. E v e r y o n e r e c o g n i z e s t h a t , u n d e r c e r t a i n
c i r c u m s t a n c e s , a p e r s o n m a y r e s u m e b e h a v i o r s w h i c h c h a r a c t e r i z e d his
infantile e x i s t e n c e but w h i c h , n o w t h a t h e h a s g r o w n older, n o long
appear. T h e m o s t familiar e x a m p l e o f this i s t h e r e e m e r g e n c e o f
b e d w e t t i n g i n older children w h e n a n e w child c o m e s i n t o t h e family. T h e
b e d w e t t e r r e t u r n s to a m o d e of b e h a v i o r appropriate and p r o p e r for t h e
n e w b o r n infant w h i c h h a s b e c o m e t h e focus o f p a r e n t a l c a r e and
a t t e n t i o n . We do n o t o b j e c t to this u s a g e of t h e w o r d " r e g r e s s i o n . " It is
another m a t t e r when Jung, among many others, asserts that patients
t r e a t e d p s y c h o a n a l y t i c a l l y o r d a s e i n s a n a l y t i c a l l y a r e compelled t o r e g r e s s
b e c a u s e t h e y are made to lie d o w n on a c o u c h j u s t as a child is made to he
d o w n in a cradle. T h i s supposedly p r o v o k e s and e m p h a s i z e s pathologic al
childish b e h a v i o r . J u n g , by c o n t r a s t , s o u g h t to address himsell to I In
p a t i e n t ' s h e a l t h y a s p e c t s and t h u s s t r e n g t h e n him. S o h e condui l e d
i n t e r v i e w s b e t w e e n physician and patient like an e n c o u n t e r b e t w e e n two
h e a l t h y adults, sitting face to face.
244
EXISTENTIAL FOUNDATIONS
Prevailing
245
h a v e today. B e f o r e him, n o o n e u s e d t h e w o r d a s i t i s u s e d n o w . M o r e
t h a n a m e r e linguistic i n n o v a t i o n , his c o n c e p t o f p s y c h i c r e p r e s s i o n
p o i n t s to a p h e n o m e n o n t h a t is, and will r e m a i n , e x t r e m e l y m e a n i n g f u l
for h u m a n p a t h o l o g y . T h e r e is little d o u b t t h a t F r e u d d i s c o v e r e d a facet
o f h u m a n e e x i s t e n c e w h o s e s i g n i f i c a n c e can h a r d l y b e e x a g g e r a t e d .
Y e t F r e u d ' s t h e o r e t i c a l bias t o w a r d t h e p h i l o s o p h y o f t h e n a t u r a l
s c i e n c e s blinded h i m to an u n d e r s t a n d i n g of r e p r e s s i o n as a p h e n o m e n o n
of existence. I n s t e a d , he tried to f o r c e this e v e n t i n t o t h e c o n f i n e s of a
d y n a m i c , m e c h a n i s t i c t h e o r y . I n doing this, h o w e v e r , h e d i s t o r t e d t h e
p h e n o m e n o n i t s e l f b e y o n d r e c o g n i t i o n and p r o d u c e d a p u r e l y fictive
m e n t a l c o n s t r u c t . I n this m u t i l a t e d f o r m t h e F r e u d i a n t h e o r y o f
repression has been uncritically adopted by most current practitioners of
p s y c h o t h e r a p y and p s y c h o s o m a t i c m e d i c i n e .
It is n o t difficult to p i n p o i n t t h e g r a v e i n j u r y d o n e to t h e original
p h e n o m e n o n t h r o u g h its i n t e r p r e t a t i o n b y F r e u d ' s m e t a p s y c h o l o g i c a l
t h e o r y . F r e u d claimed t h a t p s y c h i c r e p r e s s i o n i s c o n c e r n e d primarily
w i t h e n d o p s y c h i c m a t e r i a l , i n w h i c h c a t e g o r y h e included n o t o n l y
i m a g e s o f e x t e r n a l - w o r l d o b j e c t s w i t h i n t h e p s y c h e , b u t also t h e a f f e c t s ,
drives, and i m p u l s e s supposedly a t t a c h e d t o t h e s e i n t r a p s y c h i c r e p r e s e n
t a t i o n s . A t first, F r e u d ' s t h e o r y p o r t r a y e d psychic r e p r e s s i o n a s a n
expulsion of unpleasant endopsychic material from one compartment of
t h e p s y c h e i n t o a n o t h e r . F r e u d held t h a t r e p r e s e n t a t i o n s and a f f e c t s
actually c h a n g e d l o c a t i o n s , m o v i n g from t h e p s y c h i c s y s t e m o f
c o n s c i o u s n e s s i n t o a m o r e d e e p - s e a t e d psychic c o n t a i n e r , t h e u n c o n
s c i o u s . H e s h o r t l y gave this t o p o g r a p h i c a l t h e o r y a d y n a m i c c o u n t e r p a r t .
A c c o r d i n g t o t h e l a t t e r , t h e s a m e e f f e c t i s a c h i e v e d w h e n libidinal
c a t h e x i s i s d i s e n g a g e d from t h e u n w a n t e d e n d o p s y c h i c r e p r e s e n t a t i o n s
and a f f e c t s , until t h e y a r e n o l o n g e r s t r o n g e n o u g h t o a t t r a c t t h e
a t t e n t i o n o f c o n s c i o u s n e s s . T h e c a u s e o f r e p r e s s i o n w i t h i n t h e psychic
a p p a r a t u s w a s seen by F r e u d in an i n c o m p a t i b i l i t y b e t w e e n the
o b j e c t i o n a b l e psychic m a t e r i a l and t h e individual's i n t r a p s y c h i c r e p r e s e n
t a t i o n s o f w h a t i s s h a m e f u l , d i s g u s t i n g , a n x i e t y o r guilt p r o v o k i n g . E v e n
s e l f - l o v e and v a n i t y c a n e f f e c t a r e p r e s s i o n w h e n t h e y a r e injured by
c e r t a i n i n t r a p s y c h i c m a t e r i a l . W h a t F r e u d s a w a s t h e g r e a t e s t signifi
cance of such endopsychic processes was the return of repressed material
from t h e u n c o n s c i o u s t o t h e c o n s c i o u s s y s t e m . I n p a t i e n t s s u f f e r i n g from
n e u r o s e s , this m a t e r i a l could r e t u r n o n l y i n t h e c a m o u f l a g e o f n e u r o t i c
symptoms.
As F r e u d s a w it, t h e n , r e p r e s s i o n is e s s e n t i a l l y a c r a s s self-deception,
n o t o n l y in t h a t t h e p s y c h e is m i s t a k e n about itself, b u t also in that it is
actually deceived by itself. W h a t w e r e p r e s s i n t o the u n c o n s c i o u s is w h a t
w e hide from o u r s e l v e s . H e r e t h e d e c e i v e r and t h e deceived a r e o n e 1 0 1
246
EXISTENTIAL FOUNDATIONS
Prevailing
247
T h e i r p r e s e n c e i n t h e p e r c e p t i v e l y open r e a l m o f his e x i s t i n g f o r c e
t h e m s e l v e s o n h i m but, b e c a u s e this o p e n n e s s h a s b e e n d i s t o r t e d b y
o t h e r s , c a n n o t find a w a y i n t o his w o r l d . R e p r e s s i o n , t h e n , is a n y t h i n g
but a mechanical shuttling of representations between c o m p a r t m e n t s
of a p s y c h e . In r e p r e s s i o n , w h a t is r e p r e s s e d is n o t set aside. R a t h e r , it
b e c o m e s i n c r e a s i n g l y o b t r u s i v e . T h e u r g e n c y o f t h e appeal o f w h a t t h e
closed and n a r r o w e d b e i n g - i n - t h e - w o r l d c a n n o t a d m i t b e c o m e s m o r e
and m o r e i n t e n s e .
If this is the r e l a t i o n s h i p o b t a i n i n g b e t w e e n w h a t is c o n s c i o u s a n d
w h a t i s r e p r e s s e d , t h e r e m u s t e x i s t s o m e special a g e n t t o decide w h i c h
r e p r e s s e d m a t e r i a l i s t o b e c o m e c o n s c i o u s . F r e u d calls this t h e c e n s o r .
B u t if we t r y to define t h e n a t u r e of a c e n s o r h a v i n g such a f u n c t i o n , we
m u s t label Freud's solution a failure. F o r a n y c e n s o r of t h e p r o p e r t i e s
h e specifies w o u l d b e o n l y a n ' u n c o n s c i o u s c o n s c i o u s n e s s . ' T h e
h y p o t h e s i s o f a c e n s o r r e i n f o r c e s t h e original d i l e m m a .
T h e o n l y w a y o u t of Freud's t h e o r e t i c a l c u l - d e - s a c is to r e j e c t is
reification o f h u m a n b e i n g - i n - t h e - w o r l d and his c o m p a r t m e n t a l i z a tion o f t h e p s y c h e i n t o t h e t w o s y s t e m s o f c o n s c i o u s n e s s and t h e
u n c o n s c i o u s . In t h e p h e n o m e n o l o g i c a l o u t l o o k , w h i c h s e e s h u m a n Dasem as i n t e g r a l , indivisible b e i n g - i n - t h e - w o r l d , r e p r e s s i o n b e c o m e s a
v e r y specific m o d e o f h u m a n c o n d u c t t o w a r d s o m e t h i n g that i s
e n c o u n t e r e d , i.e., a refusal to admit t h e address and urgent appeal of
e n c o u n t e r e d b e i n g s , a looking a w a y from t h e m , a fleeing from t h e m .
T h i s is a flight from t h e c o n c r e t e b e i n g s actually p e n eived in a world.
3
NOTES
1 J.-P. Sartre, L'Etre et le Ne'ant (Paris: Librarie Gallimard; 1 9 4 3 , p. 94 ff.
Part IV
S u g g e s t i o n s for a
Daseinsanalytic Therapy
Preliminary Remarks
" T h e r a p y " is t h e n a m e given to a p a r t i c u l a r kind of h u m a n activity,
c o m m o n l y understood as that concerned with treating illnesses. Because
only people h a v e t h e c a p a c i t y to act, all g e n u i n e a c t i o n s , including
therapeutic procedures, are the exclusive prerogative of h u m a n beings.
O u r d e f i n i t i o n limits w h a t qualifies a s g e n u i n e a c t i o n s o n l y t o r e s p o n s e s
t o w h a t h a s already b e e n p e r c e i v e d i n its c o n t e x t o f m e a n i n g and
r e f e r e n c e . W e j u s t i f y this l i m i t a t i o n w i t h t h e age-old c o m m a n d m e n t that
all s c i e n t i f i c r e s e a r c h yields t o t h e facts t h e m s e l v e s , e l u c i d a t i n g t h e m i n a
w a y t h a t s u i t s t h e field t o w h i c h t h e y b e l o n g . Like all o t h e r a c t i o n s ,
t h e r a p e u t i c m e a s u r e s c a n b e divided i n t o t h r e e p a r t s : (a) t h o s e w h o a r e t o
b e a c t e d upon, i n this c o n t e x t , t h e p a t i e n t ; (b) t h e locus o f t h e i h e i a p e u t l i
a c t i o n ; and (c) t h o s e w h o a r e t h e r a p e u t i c a l l y a c t i v e .
Chapter 15
THE PATIENT TO BE TREATED
W e c o m m o n l y say t h a t t h e o b j e c t s o f t h e r a p y a r e h u m a n d i s e a s e s , b u t
it is m o r e appropriate to speak of t r e a t i n g this or t h a t h u m a n b e i n g w h o is
ill at a p a r t i c u l a r t i m e in this or t h a t w a y . T h e scientific c o n c e p t of disease
is an a b s t r a c t i o n gleaned from t h e p a r t i c u l a r m o d e s of h u m a n illness. In
t h e i m m e d i a t e l y p r e c e d i n g s e c t i o n o f this w o r k , w e a t t e m p t e d t o give
a c c u r a t e l y h u m a n d e s c r i p t i o n s o f t h e m o d e s o f illness t h a t r e q u i r e
t r e a t m e n t . In t r y i n g to m a p o u t a g e n e r a l p a t h o l o g y , we f o u n d t h a t
illness is a l w a y s an i m p a i r m e n t or limitation of a h u m a n b e i n g ' s f r e e d o m
o f m o v e m e n t , i n t h e b r o a d e s t s e n s e o f t h e w o r d . W e found t h a t n o
m a t t e r w h a t t h e p a r t i c u l a r illness, c e r t a i n of a p e r s o n ' s p o t e n t i a l i t i e s for
relating h i m s e l f t o w h a t h e e n c o u n t e r e d b e c a m e less available t h a n
o t h e r s . Y e t it is t h e t o t a l i t y of t h e potential w a y s of b e i n g i n h e r e n t in a
p e r s o n , and n o t h i n g else, t h a t c o n s t i t u t e s his h u m a n Da-sein, his b e i n g i n - t h e - w o r l d . Da-sein is in t u r n r e c o g n i z e d in its medically significant
c h a r a c t e r i s t i c s of o p e n n e s s , spatiality, and t e m p o r a l i t y , being t o g e t h e r in
a s h a r e d w o r l d , a t t u n e m e n t , h i s t o r i c i t y , and m o r t a l i t y . A c c o r d i n g l y , the
various m o d e s of h u m a n illness can be classified e x i s t e n t i a l l y - that i s ,
a c c o r d i n g to t h e i r t r u e n a t u r e s o n l y in relation to the p a r t i c u l a i
i m p a i r m e n t t h a t affects t h e m a n i f e s t a t i o n o f t h e s e E x i s t e n t i a l s . W e have
seen t h a t this applies equally to people afflicted with p s y c h o n e u i o l ii and
252
EXISTENTIAL
FOUNDATIONS
p s y c h o t i c s y m p t o m s , t o t h o s e s u f f e r i n g f r o m b a c t e r i a l i n f e c t i o n , and t o
t h o s e w h o c o m e a w a y f r o m a n a u t o m o b i l e a c c i d e n t w i t h a n injured limb.
N o r does it m a k e a n y d i f f e r e n c e w h e t h e r a p a t h o l o g i c a l loss of f r e e d o m
r e s u l t s f r o m a c o n g e n i t a l d e f e c t , or from d a m a g e t h a t has b e e n i n c u r r e d ,
pre- or postnatally.
B u t t h e fact t h a t e v e r y s i t u a t i o n w h i c h leads to being ill a f f e c t s a
p e r s o n ' s Da-seinthat is, i n t e r v e n e s directly in t h e h u m a n b e i n g ' s
f r e e d o m t o c a r r y o u t his i n n a t e c o n c r e t e possibilities f o r relating t o w h a t
he e n c o u n t e r s i s s i g n i f i c a n t n o t o n l y f o r a D a s e i n s a n a l y t i c g e n e r a l
p a t h o l o g y b u t f o r a D a s e i n s a n a l y t i c a p p r o a c h to t h e r a p y as well. In
r e c o g n i z i n g t h a t this i s t h e basic n a t u r e o f e v e r y h u m a n m o d e o f b e i n g ill,
we c a n see t h a t t h e r a p e u t i c m e a s u r e s likewise h a v e a direct e f f e c t on
w h i c h e v e r c o n c r e t e e x i s t e n t i a l w a y o f being h a s b e e n p a t h o l o g i c a l l y
impaired. A l t h o u g h medical t r e a t m e n t m a y a p p e a r in a t h o u s a n d
different o u t w a r d f o r m s , in principle all a r e o n e and t h e s a m e in t h e i r
fundamental nature.
T h e natural scientific outlook diagnoses a hernia, for instance,
w h e n e v e r it sees the peritoneum protruding through an enlarged
inguinal o p e n i n g , b r i n g i n g w i t h i t part o f t h e i n t e s t i n e . B u t t h e
D a s e i n s a n a l y t i c v i e w , w h i c h a d h e r e s t o t h e basic n a t u r e o f h u m a n b e i n g ,
r e c o g n i z e s t h a t t h e ill p a t i e n t ' s c o m p l a i n t is t h a t t h e possibility of playing
w i t h his y o u n g s o n h a s b e e n s e v e r e l y limited, s i n c e i t h a s b e c o m e
i m p o s s i b l e t o t o s s t h e b o y u p i n t o t h e air a n d c a t c h h i m . T h e p a t i e n t also
says t h a t h e can n o l o n g e r g o m o u n t a i n c l i m b i n g , his f a v o r i t e sport, s i n c e
t h e pain o f c a r r y i n g a h e a v y k n a p s a c k p r e v e n t s h i m from h i k i n g . T h e
pain e v e n c a u s e s h i m t o s h r i n k from t h e p r o s p e c t o f e m b r a c i n g his wife
p a s s i o n a t e l y . F o r s o m e t i m e , f u r t h e r m o r e , h e had had t o r e s t r i c t his w o r k
as a b r i c k l a y e r ' s f o r e m a n . He no l o n g e r feels c o n f i d e n t e n o u g h to pitch in
and help t h o s e h e i s s u p e r v i s i n g . T h e s e are t h e kinds o f t h i n g s t h e
D a s e i n s a n a l y t i c v i e w s e e s as f u n d a m e n t a l in t h a t w a y of b e i n g ill w h i c h
m e d i c i n e c o m m o n l y calls a n inguinal h e r n i a . F r o m a n a d e q u a t e l y h u m a n
p e r s p e c t i v e , t h e s e a r e t h e disrupted w a y s o f r e l a t i n g w i t h t h e g i v e n s o f
the patient's world that the surgeon affects w h e n he restores the
p a t i e n t ' s f r e e d o m t o dispose o v e r t h e possibilities f o r r e l a t i n g w h i c h had
b e e n disrupted.
S o m e t h i n g a n a l o g o u s o c c u r s in t h e t r e a t m e n t of a p e r s o n ill w i t h a
pneumococcous infection. While the pneumonia lasts, the human beingi n - t h e - w o r l d s h r i n k s at least as m u c h as t h a t of o u r t e s t subject at ter h e r
c a r accident. In b o t h i n s t a n c e s , t h e spatiality of t h e Da sein is reduced, f o r
all practical p u r p o s e s , to an area taking in o n l y t h e h o s p i t a l bed a n d its
i m m e d i a t e s u r r o u n d i n g s . Its t e m p o r a l i t y c o n s i s t s in its u s i n g t i m e by
w a i t i n g for t h e d o c t o r , and little m o r e . In p r e s c r i b i n g the a p p r o p r i a t e
253
a n t i b i o t i c s , t h e i n t e r n i s t , w h e t h e r h e k n o w s i t o r n o t , a i m s , like the
s u r g e o n w i t h his o p e r a t i o n on a h e r n i a or his s e t t i n g of a b o n e , simply to
free h u m a n b e i n g - i n - t h e - w o r l d o f p a t h o l o g i c a l l i m i t a t i o n .
A n o t h e r e x a m p l e o f t h e s a m e basic type can b e f o u n d i n t h e latest
d e v e l o p m e n t s t o w a r d a n e u r o p s y c h i a t r i c t h e r a p y , as it is r e p r e s e n t e d by
H e s s ' s e x p e r i m e n t s involving e l e c t r i c a l s t i m u l a t i o n o f t h e c e r e b r a l c o r t e x
i n a n i m a l s . H u m a n m o o d s can n o w b e d i r e c t e d f r o m o u t s i d e , b y m e a n s o f
e l e c t r o d e s i n t r o d u c e d i n t o t h e limbic lobe o f t h e c e r e b r u m . N o t o n l y can
t h e p e r s o n ' s disposition at t h e t i m e be r e a d f r o m a c u r v e of e l e c t r i c a l
p o t e n t i a l s w i t h i n t h e b r a i n , b u t e l e c t r i c a l i m p u l s e s c a n a c t u a l l y b e fed i n t o
t h e s a m e a r e a s o f brain i n o r d e r t o c h a n g e a p a t i e n t ' s m o o d f r o m c l o s e d o f f d i s c o n t e n t t o c h e e r f u l r e s p o n s i v e n e s s . T h e t i m e h a s n o t yet c o m e t o
a s s e s s t h e definitive t h e r a p e u t i c v a l u e o f s u c h e l e c t r i c a l i n t e r v e n t i o n .
W h a t m a t t e r s far m o r e a t t h i s point i s t h e k n o w l e d g e t h a t e v e n t h e s e
most innovative of neuropsychiatric experiments remain incomprehen
sible as long as t h e y are c o n c e p t u a l i z e d as c o n s i s t i n g of t h r e e s e p a r a t e
c o m p o n e n t s : a physical b r a i n , a p s y c h e , and e l e c t r i c a l i m p u l s e s f r o m t h e
o u t s i d e . It is i m p o s s i b l e to c o m p r e h e n d h o w a brain c o n c e p t u a l i z e d as a
p u r e l y m a t e r i a l , physical o r g a n e x i s t i n g i n isolation could p r o d u c e o u t o f
itself an a t t u n e m e n t of the open worldy realm of the h u m a n being with
its ability to perceive t h e m e a n i n g f u l n e s s of w h a t it e n c o u n t e r s . It is e v e n
m o r e i n c o m p r e h e n s i b l e w h e n e x t r a n e o u s e l e c t r i c a l i m p u l s e s are
a t t r i b u t e d t h e capacity t o p r o d u c e o u t o f t h e m s e l v e s h u m a n a t t u n e m e n t s . T h e logic o f e q u a t i n g t h e s e t w o p h e n o m e n a i s less c o n v i n c i n g
t h a n a claim t h a t t h e b l o s s o m s of t h e r o s e are m e r e l y a v a r i e t y of t h o r n on
t h e basis o f t h e o b s e r v a t i o n t h a t b o t h t h o r n s and b l o s s o m s are t o b e s e e n
o c c u r r i n g s i m u l t a n e o u s l y o n t h e s a m e plant.
1
254
EXISTENTIAL
FOUNDATIONS
i n e v i t a b l y alter t h e e l e c t r i c a l p o t e n t i a l s d e m o n s t r a t e d and i n t e r p r e t e d
a s such b y n a t u r a l s c i e n c e o f this c e r e b r a l b o d y h o o d o f t h e given
a t t u n e m e n t . A t o n e w i t h t h e c h a n g e i n this s p h e r e o f a t t u n e m e n t , t h e
a t t u n e m e n t i t s e l f i s i n e v i t a b l y and n e c e s s a r i l y c h a n g e d . T h e fact t h a t t h e
n a t u r a l s c i e n c e s can define e l e c t r i c i t y o n l y as a p a r t i c u l a r sort of e n e r g y
( w i t h o u t , h o w e v e r , e x p l a i n i n g w h a t e n e r g y i t s e l f is), does n o t h a r m t h e
D a s e i n s a n a l y t i c u n d e r s t a n d i n g of biophysical m o o d c r e a t i o n . It is
e n o u g h to u n d e r s t a n d t h a t t h e w o r d energy is e m p l o y e d w h e n e v e r the
p o t e n t i a l e x i s t s for o n e p a r t i c u l a r p h e n o m e n o n t o s u c c e e d a n o t h e r w i t h
strict temporal regularity.
W e n e e d also t o r e c o g n i z e t h e e x i s t e n t i a l basis o f h u m a n n a t u r e i n
understanding the modern treatment of schizophrenia, which began
w i t h insulin and e l e c t r i c s h o c k t h e r a p y , passed o n t o t h e e v e n m o r e
v i o l e n t m e a s u r e s o f p s y c h o s u r g e r y , particularly l o b o t o m i e s , t h e n t o drug
t r e a t m e n t s . A s varied a s t h e s e m e t h o d s o f t r e a t m e n t m a y s e e m a t first
g l a n c e , all s h a r e t h e goal of s e e k i n g to r e s t r i c t the p e r c e p t i v e r e s p o n s i v e
o p e n n e s s o f the s c h i z o p h r e n i c for t h e m e a n i n g s o f w h a t h e e n c o u n t e r s .
T h e y all a t t e m p t t o r e d u c e t h e d e g r e e and i n t e n s i t y t o w h i c h t h e p a t i e n t s ,
w h o s e e x i s t e n t i a l f r e e d o m is r e d u c e d relative to t h e n o r m , are addressed
and e n g a g e d b y t h e w o r l d . A d e q u a t e r e d u c t i o n m a k e s him able t o
m a i n t a i n a m o r e or less free selfhood in t h e face of w h a t he p e r c e i v e s and
to conduct himself toward it in ways congruent with the conduct of the
n o r m a l w a k i n g people a r o u n d h i m . P s y c h o t h e r a p y o f s c h i z o p h r e n i a
usually g o e s a s t e p f u r t h e r . J u s t as a careful r e g i m e n of diet and insulin
i n j e c t i o n s reduce t h e d e m a n d s on t h e w e a k e n e d p a n c r e a s of a diabetic
and allow it to r e a c h partial r e c o v e r y , a D a s e i n s a n a l y t i c t h e r a p y s e e k s
first t o p r e s e r v e t h e s c h i z o p h r e n i c p a t i e n t from a n e x c e s s i v e , d e s t r u c t i v e
w o r l d e n g a g e m e n t so he can a c h i e v e a m e a s u r e of a u t h e n t i c selfhood and
slowly g o o n t o r i c h e r , m o r e f r e e , m o r e m a t u r e possibilities o f p e r c e i v i n g
and r e s p o n d i n g to a f r e e r b e i n g - i n - t h e - w o r l d .
E v e n t h e s o r t o f i n t e n s i v e t h e r a p y o u t l i n e d i n o u r t e s t case a i m s for t h e
s a m e o u t c o m e . T h e o n l y d i f f e r e n c e b e t w e e n i t and surgical o r i n t e r n i s t
t h e r a p i e s is t h a t t h e s e l a t t e r usually i n t e r v e n e o n l y in t h e bodily s p h e r e
o f t h e pathologically impaired p o t e n t i a l i t i e s for e x i s t e n t i a l r e l a t i o n s h i p s ,
while p s y c h o t h e r a p y p r o c e e d s against pathological i m p a i r m e n t s o f t h o s e
r e a l m s o f h u m a n r e l a t e d n e s s t o t h e w o r l d t h a t c o m e u n d e r s u c h broad
h e a d i n g s as visualization, r e m e m b e r i n g , desire, will, and e m o t i o n a l
engagement.
It is the broad r a n g e of D a s e i n s a n a l y t i c t h e r a p y t h a t allows it to reveal
w i t h singular clarity w h a t is t h e f u n d a m e n t a l basis of all medical
t r e a t m e n t : a lusis, t h e a n c i e n t G r e e k w o r d for l i b e r a t i o n . For, as we have
s e e n , surgical and i n t e r n i s t t h e r a p i e s b o t h s t r i v e , n o less than
255
151
Chapter 16
THE "LOCUS" OF THE THERAPEUTIC INTERACTION
("TRANSFERENCE")
A g o o d h a l f - c e n t u r y a g o , S i g m u n d F r e u d , in p o i n t i n g o u t t h e
r e l a t i o n s h i p b e t w e e n p h y s i c i a n and p a t i e n t , m a d e explicit s o m e t h i n g t h a t
t h e b e s t p h y s i c i a n s had a l w a y s implicitly t a k e n i n t o a c c o u n t . T i m e and
again F r e u d s t r e s s e d t h a t e v e r y type o f medical t h e r a p y w a s f u n d a m e n
tally r o o t e d in s u c h a b e i n g t o g e t h e r , t h a t t h e p h y s i c i a n - p a t i e n t
r e l a t i o n s h i p w a s t h e g e n u i n e basis o f all f o r m s o f t r e a t m e n t . I n fact,
F r e u d called this t h e " a r e n a o r p l a y g r o u n d " w h e r e t h e p a t i e n t could c a r r y
out p r e v i o u s l y impaired and i n a c e s s i b l e possibilities of e x i s t i n g in " a l m o s t
t o t a l f r e e d o m , " o n t h e c o n d i t i o n t h a t t h e physician could skillfully
"handle" this human relationship. In focussing on the physician-patient
r e l a t i o n s h i p , F r e u d called a t t e n t i o n t o t h e t r u e locus o f all t h e r a p e u t i c
efforts, w h e t h e r they were surgical, internal, or psychotherapeutic.
T h e i m p o r t a n c e o f t h i s finding h a s b e e n c o n f i r m e d since F r e u d ' s t i m e
in all t h e medical specialties. T h e r e c a n no l o n g e r be a n y d o u b t t h a t t h e
n a t u r e o f t h e p h y s i c i a n - p a t i e n t r e l a t i o n s h i p largely d e t e r m i n e s n o t only
t h e e f f i c a c y o f p s y c h o t h e r a p e u t i c m e a s u r e s but also o f m o s t s u r g i c a l and
pharmaceutical ones. T h u s , recognizing the nature of the relationship
and l e a r n i n g h o w to u s e it p r o p e r l y are h i g h l y r e l e v a n t for all physician'.,
not j u s t t h o s e w h o specialize in p s y c h o t h e r a p y . In a D a s e i n s a n a l y t k
t h e r a p y o f n e u r o t i c illness, t h e h u m a n b e i n g - t o g e t h e r o f p h y s i c i a n a n d
258
EXISTENTIAL FOUNDATIONS
259
260
EXISTENTIAL FOUNDATIONS
2b
262
EXISTENTIAL
FOUNDATIONS
t r u s t i n h i m . O t h e r w i s e s h e w o u l d n o t h a v e a r r i v e d p u n c t u a l l y for e v e r y
s e s s i o n , n o r w o u l d s h e h a v e c o m p l a i n e d s o b i t t e r l y w h e n a s e s s i o n had t o
be c a n c e l l e d for o u t s i d e r e a s o n s . It w a s this u n s h a k a b l e d a u g h t e r - f a t h e r
r e l a t i o n s h i p w i t h h e r p h y s i c i a n t h a t let t h e p a t i e n t see h o w v e r y difficult
h e r r e l a t i o n s h i p t o h e r a c t u a l p a r e n t s had b e e n . P r e s u m a b l y , s h e dared
r e c o g n i z e this o n l y a f t e r t h e h u m a n r e l a t i o n s h i p w i t h h e r t h e r a p i s t had
o p e n e d a n e w place f o r h e r e x i s t e n c e to dwell in t h e w o r l d . B e f o r e t h i s ,
full i n s i g h t i n t o h e r p a r e n t s ' c a t a s t r o p h i c failure had a l w a y s b e e n held in
c h e c k b y a n o v e r w h e l m i n g s e n s e o f d e s o l a t i o n , o f h e l p l e s s n e s s , and o f
falling i n t o an a b y s s .
T h e p a t i e n t tried t o s c r e e n o u t t h e v i s u a l i z a t i o n s o f h e r p a r e n t s and
t h e i r m i s t r e a t m e n t o f h e r t h a t b e g a n i n t r u d i n g o n h e r w i t h o u t letup. S h e
had t o d o b a t t l e o n t w o f r o n t s , o n e , t h e s t r o n g and loving affinity t o h e r
t h e r a p i s t - f a t h e r , t h e o t h e r , t h e visualized p r e s e n c e s o f h e r p e r s i s t e n t l y
h a t e d actual p a r e n t s . S h e o f t e n felt u n e q u a l to this d o u b l e a t t a c k , felt as
t h o u g h i t would c r u s h h e r w i t h its w e i g h t , drive h e r i n s a n e . F o r t h e
p a t i e n t ' s s t r u g g l e w a s n o t w i t h simple e n d o p s y c h i c r e p r e s e n t a t i o n s o f
p a r e n t s and e m o t i o n s , such as p s y c h o a n a l y t i c t h e o r y sees rising o u t of a
theoretical unconscious into the stratum of consciousness. W h a t she
s t r u g g l e d w i t h w a s t h e o b t r u s i v e and i n c r e a s i n g l y i n t e n s e address o f h e r
t h e r a p i s t and h e r p a r e n t s as this address c a m e f r o m t h e m in t h e places
s h e k n e w t h e m to be in t h e p e r c e p t i v e l y o p e n realm of h e r world. It is this
w e a r i n g s t r u g g l e a g a i n s t t h e i n t o l e r a b l e p r e s e n c e s o f h e r p a r e n t s and
therapist that engendered the severe insomnia she experienced shortly
a f t e r s h e began t h e r a p y .
In this first p h a s e of t h e r a p y , t h e p h y s i c i a n limited h i m s e l f to a s k i n g
o n l y a v e r y f e w q u e s t i o n s . H e would r e p e a t t h e m , h o w e v e r , e v e r y t i m e
t h e o p p o r t u n i t y a r o s e . H e asked t h e p a t i e n t , first o f all, w h e r e s h e had
g o t t e n t h e idea t h a t s h e m e a n t n o t h i n g m o r e t o h i m t h a n a n u m b e r , o n e
m o r e s u b j e c t for t r e a t m e n t . S e c o n d , h e w a n t e d t o k n o w w h e t h e r t h e
d e m i s e o f t h e p a t h e t i c and m i s e r a b l e c r e a t u r e a s w h i c h s h e e x i s t e d and a s
which she alone knew herself would be such a great loss. He inquired,
finally, w h e t h e r t h e w i l l i n g n e s s t o give u p h e r d e f e n s e and s u r r e n d e r t o
t h e r e l a t i o n s h i p m i g h t n o t b e j u s t w h a t would m a k e d i s c o v e r y o f a
g e n u i n e s e l f h o o d possible.
T h r o u g h this m e t h o d t h e patient w a s led t o r e c o g n i z e , a f t e r w e e k s o f
s t r u g g l i n g a g a i n s t h e r s e l f and h e r t h e r a p i s t , h o w n a t u r a l it w a s to feel
g r a t i t u d e and affection for s o m e o n e w h o w a s t r y i n g t o help. M o r e and
m o r e s h e r e l i n q u i s h e d h e r guilt and fear and let h e r s e l f e n t e r a
r e l a t i o n s h i p of open t r u s t t o w a r d h e r physician, very m u c h like t h e
g e n u i n e , h e a l t h y love of a small d a u g h t e r for p a r e n t s w o r t h y ol this
name.
263
I t w a s n o t only t h e p a t i e n t ' s a t t i t u d e t o w a r d t h e t h e r a p i s t t h a t w e n t
t h r o u g h such i m p o r t a n t t r a n s f o r m a t i o n s , h o w e v e r ; his s t a n c e t o w a r d
h e r had a l s o c h a n g e d m a r k e d l y during t h e first f e w m o n t h s o f t r e a t m e n t .
His initial r e s i s t a n c e to t h e idea of t a k i n g on still a n o t h e r difficult c a s e , his
r e v u l s i o n t o w a r d h e r initial b e h a v i o r , a t o n c e a r r o g a n t and artificialall
o f t h e s e g a v e w a y t o a lively i n t e r e s t and e n d u r i n g b e n e v o l e n c e . H e
b e g a n to s e n s e in h e r a w e a l t h of b u r i e d h u m a n gifts, especially a g r e a t
c a p a c i t y for love.
As a r e s u l t , t h e t h e r a p i s t w a s able to e n t e r a selfless r e l a t i o n s h i p to h e r
t h a t r e c o g n i z e d h e r a s and g a v e h e r t h e r e s p e c t due a n o t h e r h u m a n
b e i n g - i n - t h e - w o r l d , a r e l a t i o n s h i p akin to t h a t of a g o o d g a r d e n e r caring
for his p l a n t s . F r e u d r e c o g n i z e d t h a t s u c h a r e l a t i o n s h i p is t h e
p r e c o n d i t i o n for s u c c e s s f u l t h e r a p y : n u r t u r i n g , s e l f l e s s , r e s p e c t f u l .
Psychoanalysts, as Freud w r o t e a n u m b e r of times, should never exact
any personal advantage, no m a t t e r h o w eagerly it may be prof erred, from
their patients' temporary dependence on them. O t h e r w i s e the analyst
w o u l d h a v e t o accept r e s p o n s i b i l i t y for t h e t r e a t m e n t ' s failure. T h e o n l y
a p p r o p r i a t e gains w e r e to be m a d e t h r o u g h i m p o s i n g a fee sufficient to
r e p r e s e n t a real financial sacrifice f o r t h e p a t i e n t . P a y m e n t on this scale
w o u l d help keep p a t i e n t s f r o m using t h e t h e r a p e u t i c s i t u a t i o n as a
lifelong c r u t c h . I t also freed t h e a n a l y s t f r o m financial w o r r y s o h e could
a t t e n d e q u a n i m o u s l y t o t h e t h e r a p e u t i c s e s s i o n s and give freely o f
h i m s e l f t o t h e p a t i e n t . T h i s does n o t c h a n g e t h e fact t h a t t h e a n a l y s t ' s
p e r s o n a l i n v e s t m e n t i n t h e r a p y can n e v e r b e c o u n t e r b a l a n c e d b y t h e
financial fees paid b y t h e p a t i e n t , n o m a t t e r h o w large t h e y a r e .
1
264
EXISTENTIAL FOUNDATIONS
265
266
EXISTENTIAL
FOUNDATIONS
267
A n d s o t h e t h e r a p i s t w a s c o n t e n t t o s u g g e s t w h a t could b e k n o w n from
t h e d r e a m p h e n o m e n a t h e m s e l v e s . C o n c e r n i n g t h e d r e a m s o f bandits
and R u s s i a n s , h e simply helped t h e p a t i e n t see o n t h e basis o f h e r d r e a m
e x p e r i e n c e s t h a t h e r e x i s t e n t i a l u n d e r s t a n d i n g o f m e n w a s s o childishly
i m m a t u r e and d i s t o r t e d , t h a t s h e could p e r c e i v e t h e m o n l y a s p o t e n t i a l
d e s t r o y e r s and rapists. F o r t h e t i m e being, o n l y m e n w h o w e r e
d a n g e r o u s could be p e r m i t t e d to e n t e r and a p p e a r in t h e p e r c e i v i n g
o p e n n e s s o f h e r d r e a m i n g w o r l d . T h e a n a l y s t w e n t o n t o say t h a t this
indicated a b l i n d n e s s to t h e positive a s p e c t s of m a l e b e i n g , t h a t s h e , as a
w o m a n , could e v o k e and b r i n g t o fruition.
F u r t h e r m o r e , the analyst chose not to interpret the guns of the
p u r s u i n g R u s s i a n s a s phallic s y m b o l s . H o w could h e h a v e d o n e so, e x c e p t
b y i n v e n t i n g facts w h e r e n o n e e x i s t e d ? E v e n i n d r e a m s , g u n s a r e n o t h i n g
but g u n s ; w h e t h e r w e p e r c e i v e t h e m w a k i n g o r d r e a m i n g t h e y r e t a i n t h e
c h a r a c t e r o f lethal w e a p o n s . T h e fact t h a t t h e p a t i e n t could d r e a m o n l y o f
such h o s t i l e , d a n g e r o u s l y a r m e d m e n s h o w e d e v e n m o r e s t r i k i n g l y t h a t ,
i n spite o f h e r h i g h level o f i n t e l l e c t u a l d e v e l o p m e n t , h e r i m m a t u r i t y kept
h e r f r o m c o n f r o n t i n g m e n o n a n adult basis. T r u e , s h e had m a d e s o m e
p r o g r e s s in this r e s p e c t : n o w s h e could in s o m e s e n s e , at least, p e r c e i v e
and r e s p o n d t o m a l e n e s s , f o r o t h e r w i s e n o m e n a t all, n o t e v e n hostile
o n e s , could h a v e g o t i n t o h e r d r e a m i n g world. F o r t h e p r e s e n t , h o w e v e r ,
h e r o w n lack o f m a t u r i t y c o m p e l l e d h e r t o look upon adult m a l e n e s s a s
s o m e t h i n g t h a t t h r e a t e n e d t o o v e r p o w e r , rape, and d e s t r o y h e r . T h e
only r e s p o n s e s h e k n e w w a s , q u i t e u n d e r s t a n d a b l y , a n x i e t y and flight.
To i n t e r p r e t t h e g u n as a s y m b o l i c penis w o u l d m o s t likely h a v e had far
less d i s a s t r o u s c o n s e q u e n c e s for t h e patient t h a n t o c o n s t r u e h e r feelings
for t h e a n a l y s t as s o m e s o r t of t r a n s f e r e n c e . At l e a s t , in t a l k i n g a b o u t a
penis, t h e a n a l y s t would h a v e b e e n a d d r e s s i n g h i m s e l f t o s o m e t h i n g w i t h
direct b e a r i n g on m a l e s e x u a l p o t e n t i a l i t i e s in r e l a t i o n to w o m e n . Had t h e
a n a l y s t o p t e d to m e n t i o n t h e p e n i s , he w o u l d h a v e o p e n e d a w a y to
discussion o f t h o s e p o t e n t i a l i t i e s , w h i c h m i g h t h a v e e v e n t u a l l y
encouraged the patient to go beyond the reductive genital interpretation
itself and adopt a m o r e o p e n a t t i t u d e t o w a r d m a l e n e s s .
I t i s a s t o n i s h i n g t h a t t h e t h e o r y o f t r a n s f e r e n c e t o o k o v e r medical
t h i n k i n g so quickly and p r o f o u n d l y , for t h e fictive c h a r a c t e r of its
a s s u m p t i o n s is o b v i o u s . If a f f e c t s a r e to be displaced from s o m e
r e p r e s e n t a t i o n w i t h i n t h e p s y c h e o u t o n t o o b j e c t s i n t h e e x t e r n a l world,
t h e s e e n d o p s y c h i c a f f e c t s and r e p r e s e n t a t i o n s m u s t first e x i s t . But w e
h a v e r e p e a t e d l y s t r e s s e d t h a t t h e r e is no e v i d e n c e w h a t s o e v e r in the
phenomena of human existence to demonstrate the presence ol eithei
G i v e n t h i s , n o t h i n g can r e d e e m t h e t r a n s f e r e n c e t h e o r y , not e v e n the
later a t t e m p t o f p s y c h o a n a l y t i c t h e o r e t i c i a n s t o divide t h e p h y s i c i a n
268
EXISTENTIAL
FOUNDATIONS
p a t i e n t r e l a t i o n s h i p i n t o a t r a n s f e r e n c e c o m p o n e n t and a n o r m a l
c o m p o n e n t . S u c h a d i s t i n c t i o n w o u l d do no g o o d e v e n if p s y c h o a n a l y t i c
t h e o r y w e r e able t o e x p l a i n w h a t c o n s t i t u t e s a n o r m a l r e l a t i o n s h i p
b e t w e e n people, and p s y c h i a t r i s t s freely c o n c e d e t h a t s u c h a n e x p l a n a
tion e x c e e d s t h e i r c o m p e t e n c e .
All t h e s e facts n o t w i t h s t a n d i n g , F r e u d g a v e n o f e w e r t h a n t h r e e
arguments which therapists might use to convince patients that their
e m o t i o n a l r e l a t i o n s h i p s t o p h y s i c i a n s w e r e d e c e p t i v e a n d u n r e a l , simply
products of t r a n s f e r e n c e . F i r s t , he s u g g e s t e d t h a t it s h o u l d be m a d e c l e a r
t o t h e patient c a u g h t i n t h e toils o f t r a n s f e r e n c e t h a t n e i t h e r t h e p r e s e n t
therapeutic situation in general, nor the behavior of the therapist in
particular, c o n t a i n e d a n y t h i n g t o m o v e t h e p a t i e n t t o feelings o f love o r
h a t e . S e c o n d , t h e f a l s e n e s s o f t r a n s f e r e n c e love could b e s e e n i n t h e fact
t h a t it c o n t a i n e d n o t a single trait arising o u t of t h e t h e r a p e u t i c s i t u a t i o n
i t s e l f but simply r e p e a t e d o r b u r l e s q u e d e a r l i e r , infantile w a y s o f
b e h a v i n g t o w a r d p a r e n t s . A n d third, F r e u d said, p a t i e n t s in a s t a t e of
t r a n s f e r e n c e should b e r e m i n d e d t h a t i f t h e i r love for t h e a n a l y s t w e r e
g e n u i n e , t h e y would h a v e s u b m i t t e d a t o n c e t o his m e t h o d o f total free
a s s o c i a t i o n , while i n s t e a d t h e y d e m a n d e d t a n g i b l e p r o o f s o f love f r o m
t h e analyst.
W h e n t h e s e so-called a r g u m e n t s are s c r u t i n i z e d , t h e y begin t o fall
apart. First, t h e t h e r a p e u t i c s i t u a t i o n is in a c t u a l i t y as rich in g r a t i f i c a t i o n
and denial as a n y p a r e n t - c h i l d r e l a t i o n s h i p . A m o n g a d u l t s is t h e r e a n y
other human relationship so gratifying, any other in which one person is
e v e n half a s helpful and u n s h a k a b l y b e n e v o l e n t t o w a r d a n o t h e r , a s t h a t
of analysts to patients? On the other hand, what o t h e r form of human
b e i n g - t o g e t h e r i n v o l v e s m o r e radical f o r m s o f f r u s t r a t i o n and denial
than those met within the therapeutic situation?
F r e u d ' s s e c o n d p r o o f a r g u e s the d e c e p t i v e n e s s o f t h e p a t i e n t - p h y s i c i a n
r e l a t i o n s h i p o n a c c o u n t o f its i m i t a t i v e n a t u r e . B u t all t h a t m a y b e said
w i t h c e r t a i n t y is t h a t t h e form w h i c h a p a t i e n t ' s b e h a v i o r t o w a r d his
physician t a k e s m a y h a v e r e m a i n e d d i s t o r t e d and i n f a n t i l e b e c a u s e o f
s o m e u n f o r t u n a t e h i n d r a n c e put i n t h e w a y o f t h e p a t i e n t ' s m a t u r i n g i n
e a r l y childhood. B u t t h e m e r e p e r s i s t e n c e of an i n f a n t i l e form in relating
b y n o m e a n s p r o v e s t h a t t h e feelings a s such, w h i c h a r e involved i n t h e m ,
a r e really m e a n t not for c o n t e m p o r a r i e s b u t r a t h e r , and o n s o m e deeper
level, for the g u a r d i a n s and c o m p a n i o n s o f o n e ' s i n f a n c y .
In fact, t h e w a y supposedly t r a n s f e r r i n g p a t i e n t s act s e e m s to be
diametrically opposed to all n o t i o n s of t r a n s f e r e n c e . W h a t m a y look like a
n e u r o t i c t r a n s f e r e n c e is in reality a h u m a n Da-sein w h o s e o p e n n e s s has
been s u b s t a n t i a l l y r e s t r i c t e d , e i t h e r t h r o u g h s o m e i n h e r e n t o b s t a c l e t o
m a t u r i n g or t h r o u g h p a r e n t a l m i s g u i d a n c e in early life, Sue h I >fl sein may
persist into adulthood, unable to p e r c e i v e or respond to Other adults
269
O u t o f t h e v e r y n a t u r e o f h u m a n e x i s t e n c e a p a t i e n t and his f u t u r e
t h e r a p i s t a r e already, f r o m t h e first m o m e n t t h e y k n o w s o m e t h i n g a b o u t
e a c h o t h e r , e n g a g e d in a h u m a n r e l a t i o n s h i p . B o t h c o n t r i b u t e to this
r e l a t i o n s h i p . It is a fact t h a t m a n y p a t i e n t s w h o c o m e to t h e i r family
d o c t o r s o r specialists for s o m e p u r e l y physical a i l m e n t e x h i b i t b e h a v i o r
e v e r y bit as i m m a t u r e as t h e t e s t s u b j e c t ' s early d e m a n d s on h e r
physician. T r e a t i n g such b e h a v i o r o n t h e basis o f t h e t r a n s f e r e n c e t h e o r y
can b e j u s t a s d e s t r u c t i v e o f o u t c o m e s o f physical a s o f p s y c h o a n a l y t i c
therapy. Since proper guidance of the human being-together between
physician and p a t i e n t has such i m p o r t a n c e for t h e w h o l e realm o f
m e d i c i n e , let u s look a t t w o a n a l o g i e s t h a t f u r t h e r i l l u s t r a t e t h e d a n g e r
and u n t e n a b i l i t y o f t h e t h e o r y o f t r a n s f e r e n c e .
A s s u m e t h a t a little girl is playing w i t h a b u r n i n g c a n d l e . S h e is
s q u i n t i n g a t t h e candle and s e e s , r a t h e r than t h e usual c o n e - s h a p e d
flame, a r a d i a n t s t a r . N o w a s s u m e t h a t while s h e is playing with the
candle t h e child b u r n s b o t h eyelids s e v e r e l y and t h a t t h e r e s u l t i n g seal
270
EXISTENTIAL
FOUNDATIONS
t i s s u e p e r m a n e n t l y r e d u c e s h e r vision t o w h a t can b e s e e n t h r o u g h t w o
n a r r o w slits. W i t h o u t s u r g i c a l i n t e r v e n t i o n , t h e injured child will
perceive t h e flame o f a n y c a n d l e she e v e r s e e s , f r o m this t i m e until t h e
end of h e r days, as a s t a r - s h a p e d r a d i a n c e . W h o w o u l d dare claim t h a t this
child is m e r e l y p r o j e c t i n g t r a n s f e r r i n g a n a b n o r m a l flame i m a g e t h a t
had b e e n f o r m e d long a g o i n h e r p s y c h e , s o t h a t w h e n e v e r a f t e r w a r d she
looked a t f l a m e s s h e w o u l d see n o t t h e s e p r e s e n t f l a m e s t h e m s e l v e s b u t
a l w a y s , i n e s s e n c e , t h a t o n e f l a m e w h i c h had originally b u r n e d h e r
eyelids while s h e w a s s q u i n t i n g at it.
F o r o u r s e c o n d case let us say t h a t a m a n d r o v e i n t o his g a r a g e a f t e r
w o r k and a c c i d e n t a l y r a n i n t o his son, w h o s e leg w a s b r o k e n b y t h e
collision. T h e b o n e w o u l d n o t m e n d properly, and t h e child had w a l k e d
w i t h a limp e v e r s i n c e . He is still limping w h e n , at t h e age of t w e n t y - f o u r ,
he u n d e r g o e s as part of his t r a i n i n g a didactic a n a l y s i s . He always g e t s to
the a n a l y s t ' s office on foot. No o n e would s e r i o u s l y c o n t e n d in this c a s e
t h a t this p a t i e n t w h o is limping to his a n a l y s t does n o t really w a n t to go to
his a n a l y s t . Still less could it be a r g u e d t h a t t h e p r e s e n t limping o n c e
caused by the patient's father constituted unequivocal proof that the
c u r r e n t walks t o t h e a n a l y s t e x p r e s s e d a n i n t e n t i o n d i s p l a c e d and
transferredto seek out the father.
Y e t t h e s t o r i e s o f t h e s e t w o children are n o t e s s e n t i a l l y d i f f e r e n t f r o m
t h o s e w h i c h are t a k e n w i t h o u t q u e s t i o n a s o v e r w h e l m i n g d e m o n s t r a
tions o f t r a n s f e r e n c e i n adult n e u r o t i c s . B o t h p e r s o n s s u f f e r e d g r e a t
injury t o t h e i r e x i s t e n t i a l f r e e d o m o f m o v e m e n t i n t h e i r childhood. B u t
t h e s a m e i s t r u e for all children w h o l a t e r b e c o m e n e u r o t i c s . F o r t h e s e ,
h o w e v e r , t h e p a t h o g e n i c b e h a v i o r o f p a r e n t s has d a m a g e d " m e r e l y " t h e
mind's eye, or t h e child's ability to dispose freely o v e r his e x i s t e n t i a l
p o t e n t i a l for e m o t i o n a l l y a p p r o a c h i n g , o r w i t h d r a w i n g from, t h i n g s .
P e o p l e w h o are n e u r o t i c a l l y ill s h o w as little e v i d e n c e of a n y t r a n s f e r e n c e
as t h e physically h u r t people in o u r i l l u s t r a t i o n .
L a t e l y , a third u s a g e of t h e t e r m transference h a s b e g u n to push t h e older,
classical definitions i n t o t h e b a c k g r o u n d . T h e original n o t i o n o f hidden
d i s p l a c e m e n t plays hardly a n y part in this n e w e s t v e r s i o n . P r o f e s s i o n a l s
n o l o n g e r speak o f t r a n s f e r e n c e d r e a m s i n w h i c h c e r t a i n f e a t u r e s o f t h e
p a r e n t s a r e shifted first o n t o the a n a l y s t and t h e n o n t o d r e a m i m a g e s o f
still o t h e r people. N o r is t h e w o r d transference used a n y l o n g e r to indicate
t h e d i s p l a c e m e n t o f feelings from e n d o p s y c h i c p a r e n t - i m a g e s o n t o t h e
a n a l y s t . N o w a d a y s , t h e w o r d is used by m o s t p h y s i c i a n s and p s y c h o l o
gists t o r e f e r e x c l u s i v e l y t o t h e i m m e d i a t e feelings o f the m o m e n t t h a t
t h e patient e x p r e s s e s t o w a r d the physician. B u t even this w a t e r e d - d o w n
n o t i o n o f t r a n s f e r e n c e c o n s i d e r a b l y d i s t o r t s t h e puzzling p h e n o m e n o n
ol h u m a n e x i s t e n c e .
271
EXISTENTIAL
272
FOUNDATIONS
I g n o r a n c e o f t h e t r u e n a t u r e o f t h e b e i n g - t o g e t h e r o f p h y s i c i a n and
patient m a y not always necessarily reduce the effectiveness of medical
t h e r a p y , b u t v e r y o f t e n it d o e s . It is a fact, also, t h a t k n o w l e d g e a b o u t t h e
t h e r a p e u t i c e f f e c t i v e n e s s o f t h e p h y s i c i a n - p a t i e n t r e l a t i o n s h i p , a s well a s
all p r a c t i c a l a t t e m p t s t o t a k e a d v a n t a g e o f this k n o w l e d g e i n a c t u a l
t h e r a p y , c o n s t i t u t e e x i s t e n t i a l m a n i f e s t a t i o n s o n t h e part o f t h e
therapeutically active person. So diverse are these ways of existing of
different physicians and their therapeutic successes, that the m a t t e r
deserves separate consideration.
Chapter 17
THOSE WHO ARE THERAPEUTICALLY ACTIVE
NOTES
1. S. F r e u d : " R a t s c h l a g e , fur den A r z t bei d e r p s y c h o a n a l y t i s c h e n B e h a n d l u n g " ;
" B e m e r k u n g e n b e r die U b e r t r a g u n g s l i e b e " ; " Z u r E i n l e i t u n g der B e h a n d l u n g " : i n
Gesammelte Werke ( L o n d o n : I m a g o , I n c . , 1 9 4 1 ) , v o l . 8 , p . 3 7 7 ; v o l . 1 0 , p . 3 1 8 ; v o l . 8 , pp. 4 5 8 a n d
464-65.
2. S.
(London:
Freud,
1949),
"Bemerkungen
pp.
315-17;
ber
and
die
Ubertragungsliebe,"
"Wege
der
Gesammelte
psychoanalytischen
Werke,
Therapie,"
vol.
10,
Gesammelte
Werke, vol. 1 2 ( L o n d o n : I m a g o , 1 9 4 7 ) , p . 1 8 9 .
In a therapeutic situation, there are, on the one hand, those being acted
upon and, on the other, those w h o are therapeutically active. N e v e r is it
only t h e t h e r a p i s t w h o a c t s . T h e p a t i e n t a l w a y s a c t s t h e r a p e u t i c a l l y w i t h
t h e p h y s i c i a n . T h i s i s t r u e e v e n i n c a s e s a t t h e e x t r e m e s o f medical
therapy: from analytic psychotherapies to surgery performed under
general anesthesia. In the sort of psychotherapy we have in mind, the
a n a l y s t m a y r e s t r i c t his role t o t h a t o f l i s t e n e r ; t o all a p p e a r a n c e s h e sits
p a s s i v e l y w h i l e t h e p a t i e n t i n i t i a t e s w h a t e v e r talk o r a c t i v i t y m a y o c c u r .
C o n v e r s e l y , t h e w h o l e b u r d e n o f t h e r a p y s e e m s t o fall o n t h e s u r g e o n
w h o i s r e m o v i n g a n i n f l a m e d appendix f r o m a n a n e s t h e t i z e d p a t i e n t . Y e t
in e i t h e r c a s e , physician and p a t i e n t alike a r e i n v o l v e d in t h e t h e r a p e u t i c
p r o c e d u r e . F o r e v e n w h e n a p s y c h o a n a l y s t a p p e a r s t o b e passively
l i s t e n i n g h e h a s a c t i v e l y o p e n e d his p e r c e p t i o n t o t h e p a t i e n t , allowing
h i m t o a p p e a r , t o c o m e t o b e i n g i n t h e light o f his healing u n d e r s t a n d i n g
a n d b e h a v i o r . T h e healing r e s p o n s e o f t h e a n a l y s t t o t h e appealing
a d d r e s s of t h e p a t i e n t is to e n a b l e h i m to a p p r o p r i a t e as his o w n the
i n n a t e h u m a n p o t e n t i a l i t i e s w h i c h u p until t r e a t m e n t had been hidden,
d i s t u r b e d , o r d i s t o r t e d . I n o u r o t h e r e x a m p l e , t h e patient must have
a c t i v e l y a g r e e d to allow t h e o p e r a t i o n and to place h i m s e l f in the
s u r g e o n ' s h a n d s b e f o r e he is a n e s t h e t i z e d for s u r g e r y . W i t h o u t the.
274
EXISTENTIAL
FOUNDATIONS
Those
Who Are
Therapeutically Active
275
276
EXISTENTIAL FOUNDATIONS
Those
Who Are
Therapeutically Active
277
278
EXISTENTIAL
FOUNDATIONS
him gradually t e a c h e s t h e p a t i e n t to e n g a g e i n d e p e n d e n t l y in r e l a t i n g
m o r e freely t o r e a l m s o f p h e n o m e n a h e had b e e n avoiding.
S o s u c c e s s can b e g a i n e d i n spite o f t h e fact t h a t n o e v i d e n c e e m e r g e s i n
the course of therapy to support the theoretical statements of the
o r t h o d o x p s y c h o a n a l y s t . B u t t h o s e p a t i e n t s w h o are n o t able t o see e v e n
t h e dim o u t l i n e s o f w h a t lies b e y o n d t h e c o n c e p t u a l f r a m e w o r k o f
o r t h o d o x p s y c h o a n a l y s i s usually w i n d u p trading t h e i r first n e u r o s i s for
a n e w one: "psychoanalysitis." T h e y begin suffering from a compulsive
u r g e to drill t h e m s e l v e s in t h e i n t e l l e c t u a l a c r o b a t i c s of p s y c h o a n a l y t i c
t h e o r y . O b v i o u s l y , this kind o f m o n o m a n i a p r e c l u d e s t h e d e v e l o p m e n t o f
r e l a t i n g m o r e freely t o t h e w o r l d .
Q u i t e a f e w o f t h e s e p a t i e n t s can n e v e r t h e l e s s b e m a d e g e n u i n e l y
h e a l t h y , i f t h e y a r e willing and able t o c h a n g e p h y s i c i a n s . W h a t t h e y n e e d
i s a n a n a l y s t w h o s e h u m a n u n d e r s t a n d i n g a l l o w s h i m t o m a k e t h e leap
f r o m a b s t r a c t ideas, like p s y c h e or psychic c o n t e n t s , to a m o r e
a p p r o p r i a t e g r a s p of h u m a n Da-sein as b e i n g - i n - t h e - w o r l d . S u c h a
physician e x c h a n g e s t h e t e c h n i q u e s o f a p s y c h o a n a l y t i c t h e r a p y o f
r e s i s t a n c e for a D a s e i n s a n a l y t i c t r e a t m e n t of t h e c o n s t r i c t i o n s of t h e Dasein. T h e t h e r a p i s t s e e s t h e " D a - " of his p a t i e n t ' s Da-sein as t h a t o p e n
r e a l m o f p e r c e p t i o n and r e s p o n s i v e n e s s t o t h e p r e s e n c e o f b e i n g s , w h i c h
i s b o r n b y his, and t h a t o f all o t h e r h u m a n b e i n g s , e x i s t e n c e . A t o n e w i t h
t h i s , t h a t for t h e sake o f w h i c h , for w h a t and t o w h a t end, t h e Da-sein o f
his p a t i e n t is claimed as t h e " D a - " will be c o n s t a n t l y p r e s e n t for t h e
D a s e i n s a n a l y t i c t h e r a p i s t . H e will t h e r e f o r e guide e v e r y p a t i e n t t o w a r d
t h e s a m e goal of r e n d e r i n g t h e Da-sein of e a c h as p e r c e p t i v e l y o p e n and
r e s p o n s i v e a s i t can b e t o t h e p r e s e n c e s o f e v e r y single p h e n o m e n o n t h a t
a d d r e s s e s him w i t h t h e appeal to e n t e r i n t o t h e light of his fully freed
e x i s t e n c e , and s o c o m e t o b e .
D a s e i n s a n a l y t i c t h e r a p y can heal p a t i e n t s s u f f e r i n g f r o m p s y c h o n e u r o s e s , c h a r a c t e r n e u r o s e s , and p e r v e r s i o n s b e c a u s e t h e s e people c a n ,
w i t h an a d e q u a t e l y t h e r a p e u t i c a l l y active a n a l y s t , l e a r n to live purposeful
lives o f t o t a l a u t o n o m y and f r e e d o m . T h e goal o f D a s e i n s a n a l y t i c
t h e r a p y t h u s c o i n c i d e s e x a c t l y w i t h t h e m o s t s u i t a b l e definition for a
h e a l t h y Da-sein.
I n his p u r s u i t o f t h e u n i v e r s a l goal o f D a s e i n s a n a l y t i c t h e r a p y , t h e
physician can n e v e r r e m i n d h i m s e l f t o o o f t e n t h a t his t a s k i n t h e r a p y
does n o t c o n s i s t a n y l o n g e r m e r e l y i n dredging u p i n t r a p s y c h i c i m a g e s o f
e x t e r n a l - w o r l d o b j e c t s , painful o r forbidden p o r t r a i t s t h a t w e r e
supposedly r e p r e s s e d a t o n e t i m e i n t o t h e n e t h e r m o s t l a y e r o f a n
e n c a p s u l a t e d p s y c h e . His duties are far m o r e p r o f o u n d . F o r t h e
D a s e i n s a n a l y t i c t h e r a p y o f r e s i s t a n c e does m o r e than simply help
p a t i e n t s find the c o u r a g e to face s h a d o w y i m a g e s supposed to exist inside
Those
Who Are
Therapeutically Active
279
s o m e s o r t o f psychic s t r u c t u r e ; t h e y m u s t e s t a b l i s h o p e n r e l a t i o n s w i t h
each one of the phenomena that inhabit their world, no m a t t e r w h e r e in
t h e i r o p e n realm of p e r c e p t i o n it c h o o s e s to appear. A n d this bold act
m u s t b e t a k e n o n n o t o n l y i n r e l a t i o n t o i n a n i m a t e o b j e c t s b u t for e v e r y
living c r e a t u r e , e v e r y o t h e r p e r s o n , and for t h e p o t e n t i a l i t i e s o f o n e ' s
o w n e x i s t e n c e : i n s h o r t , for e v e r y t h i n g i n h e a v e n and e a r t h f r o m w h i c h
t h e p a t i e n t has e v e r fled, e v e r y t h i n g t h a t , for r e a s o n s o f s h a m e , o r
disgust, o r injured pride, o r s o m e p s e u d o m o r a l i t y , h e w o u l d n o t face a t
a n y c o s t . R e p e a t e d q u e s t i o n i n g o f t h e p a t i e n t ' s a t t e m p t s t o flee f r o m
s u c h p h e n o m e n a e n c o u r a g e s h i m t o p e r c e i v e , and c a r r y o u t , t h e g r e a t
t a s k t h a t is placed b e f o r e h i m as a h u m a n b e i n g - i n - t h e - w o r l d , t h e t a s k of
facing u p t o e v e r y t h i n g t h a t a d d r e s s e s him f r o m t h e o p e n r e a l m o f his
b e i n g - t h e r e , and o f r e s p o n d i n g t o t h a t call a p p r o p r i a t e l y . S u c h t h e r a p y
can r e m o v e t h e f o u n d a t i o n o f t h e illness. N e u r o s i s develops o n l y
through ignoring, turning away from the existential task of committing
o n e s e l f i n p e r c e p t i v e , r e s p o n s i v e r e l a t i o n s h i p w i t h w h a t r e v e a l s itself.
W h a t allows t h e D a s e i n s a n a l y t i c t h e r a p i s t t o e x p e c t s o m u c h o f his
p a t i e n t s i s his o w n w i l l i n g n e s s t o provide t h e m w i t h t h e dwelling place o f
t h e p h y s i c i a n - p a t i e n t r e l a t i o n s h i p t h e y n e e d and c a n rely on. T h i s h u m a n
t w o - n e s s s e r v e s a s t h e firm f o u n d a t i o n for t h e p a t i e n t ' s n e w l y l i b e r a t e d
Da-sein u n t i l h e n o l o n g e r n e e d s t h e p r o t e c t i o n o f t h e s a f e m i n i a t u r e t e s t w o r l d . T h i s m e a n s , a s far a s practical t h e r a p y g o e s , t h a t t h e physician
m u s t i m m e d i a t e l y d i s p e n s e w i t h t h e old w h y - q u e s t i o n s o f p s y c h o a n a l y
sis. All t o o o f t e n it h a s b e e n s e e n t h a t p a t i e n t s i n t e r p r e t such q u e s t i o n s as
t h e r a p e u t i c a l l y u s e l e s s c o m m a n d s to dredge up s o m e i n f a n t i l e c a u s e f o r a
p r e s e n t a i l m e n t , a s its e f f e c t , w i t h o u t e v e r l e a r n i n g t o u n d e r s t a n d t h e
present pathological modes of relationship as they actually are. For
a n o t h e r t h i n g , n e u r o t i c a l l y ill people f r e q u e n t l y m i s t a k e w h y questionscontrary to the analyst's intentfor prohibitions. T h e
a n a l y s t s e e m s t o b e asking t h e m : " W h y are y o u still doing t h i s , w h e n y o u
should h a v e given it up as i n a p p r o p r i a t e long a g o ? " In t h e v o c a b u l a r y of
t h e D a s e i n s a n a l y t i c t h e r a p i s t , " w h y ? " i s replaced a s t h e m o s t i m p o r t a n t
w o r d by t h e q u e s t i o n , " W h y in t h e w o r l d not?" At e v e r y available
o p p o r t u n i t y , the D a s e i n s a n a l y t i c t h e r a p i s t will ask t h e p a t i e n t w h y i n the
w o r l d he h a s n o t dared to p e r c e i v e and r e s p o n d to s o m e t h i n g in his world
f r o m w h i c h he has c o n s t a n t l y b e e n looking a w a y . W a s it really n e c e s s a i y
t o flee and hide f r o m t h i n g s t h a t r e v e a l e d t h e m s e l v e s t o h i m ?
S u c h " w h y n o t " questions are particularly indispensable whenevei
there is a barrier to the honest, open verbalizing of the patient's hum.in
r e l a t i o n s h i p to t h e t h e r a p i s t , c o n c r e t e e x a m p l e s of w h i c h a b o u n d m the
p r e c e d i n g description of o u r t e s t c a s e . In fact, " W h y in the world nol
la
;
280
EXISTENTIAL FOUNDATIONS
really a t t h e h e a r t o f a n y c o m p r e h e n s i v e p s y c h o t h e r a p y . B u t i f t h e
t h e r a p i s t u s e s this q u e s t i o n a s j u s t a n o t h e r t e c h n i c a l tool, h e will s u r e l y
apply it at t h e w r o n g t i m e s and places. He can u s e it successfully in
t h e r a p y o n l y i f h e k n o w s well e n o u g h t h e o n t o l o g i c a l s t r u c t u r e o f h u m a n
b e i n g - t o g e t h e r i n a s h a r e d w o r l d . T h e t h e r a p i s t m u s t realize t h a t t h e real
r e a s o n for c o n f r o n t i n g p a t i e n t s w i t h such precisely f o r m u l a t e d , specific
o n t o l o g i c a l q u e s t i o n s i s t o rid t h e m o f t h e n o t i o n t h a t t h e y a r e n o t h i n g t o
him b u t n u m b e r s and t h i n g s , and to h a v e t h e m gradually e x p e r i e n c e a
genuine human relationship shared by both. W i t h o u t the potentiality of
such an insight into the ontological structure of human being-in-thew o r l d , t h e t h e r p i s t w o u l d h a v e n o o t h e r w a y b u t t o g r o p e i n t h e dark.
W i t h it, he can s y s t e m a t i c a l l y s h o w his p a t i e n t s t h a t he is c o m m u n i c a t i n g
w i t h t h e m in t h e r e a l m of a h u m a n b e i n g - t o g e t h e r . It s e e m s to be a
p r e r e q u i s i t e for s u c c e s s in t h e r a p y t h a t in t h e c o u r s e of t r e a t m e n t t h e
p a t i e n t b e s h o w n this v e r y t h i n g d o z e n s and h u n d r e d s o f t i m e s .
It is n o t n e c e s s a r y t h a t the patient h i m s e l f learn to r e c o g n i z e
thematically the ontological, existential structure of human being-int h e - w o r l d . His insight need n o t e x t e n d b e y o n d t h e limits o f his
individual, directly p e r c e p t i b l e o n t i c w a y s o f r e l a t i n g t o t h e t h e r a p i s t . B u t
it is t h e d u t y of t h e l a t t e r to b e c o m e t h o r o u g h l y a c q u a i n t e d w i t h , and
clearly a w a r e of, t h e o n t o l o g i c a l n a t u r e o f b e i n g - t o g e t h e r i n o r d e r t o give
his t r e a t m e n t a scientific f o u n d a t i o n .
G i v e n this s o r t o f f o u n d a t i o n , i t m a y o n t h e s u r f a c e appear n o n s e n s i c a l
to apply t h e label " a n a l y s i s . " It w o u l d s e e m r a t h e r to be a " s y n t h e s i s , " in
t h a t the p a t i e n t is c o n s c i o u s l y guided i n t o t h e w h o l e n e s s of a free and
a u t o n o m o u s e x i s t e n c e . B u t t h e w o r d analysis is o b j e c t i o n a b l e in this
c o n t e x t o n l y if it keeps t h e m e a n i n g it has t a k e n on in t h e m o d e r n
t e c h n i c a l age, of s e p a r a t i n g c o m p o n e n t s , b u t n o t w h e n it is u n d e r s t o o d in
its original s e n s e of r e v e a l i n g t h e a r t i c u l a t i o n of a w h o l e .
S t r i c t l y s p e a k i n g , t h e w a y in w h i c h a p h y s i c i a n heals t h e Da-sein of his
p a t i e n t t h r o u g h " w h y n o t " q u e s t i o n s i s m o r e radical i n its e f f e c t s t h a n
a n y h e a r t t r a n s p l a n t could e v e r be. T h e l i b e r a t i o n o f a p a t i e n t f r o m
n e u r o t i c and p s y c h o s o m a t i c captivity b r o u g h t a b o u t w i t h t h e aid o f t h e s e
q u e s t i o n s a l w a y s h a s to be, quite literally, a w o r l d - s h a k i n g e x p e r i e n c e for
physician and p a t i e n t alike. It lacks o n l y t h e s p e c t a c u l a r m a t e r i a l e x p e n s e
of a physical h e a r t t r a n s p l a n t and t h e r e s p e c t t h a t m o s t people a c c o r d to
physical m a t t e r t h e y can see w i t h t h e i r o w n e y e s .
A D a s e i n s a n a l y t i c t h e r a p i s t can e v e n g e t t h r o u g h to t h a t m o s t difficult
class o f p a t i e n t s , m o s t o f t h e m y o u n g , w h o a r e n o t medically ill a t all.
T h e y e x h i b i t n o specific medical s y m p t o m s , y e t t h e y d o suffer, filling t h e
w a i t i n g r o o m s o f physicians i n i n c r e a s i n g n u m b e r s . W e h a v e already said
that t h e s e y o u n g people suffer o n l y from g e n e r a l b o r e d o m , t h e
Those
Who
Are
Therapeutically Active
281
m e a n i n g l e s s n e s s o f h u m a n e x i s t e n c e i n g e n e r a l and t h e h o p e l e s s n e s s o f
t h e i r o w n lives i n particular. T h e i r f a v o r i t e e x p r e s s i o n s e e m s t o be, "It
d o e s n ' t m a t t e r . " T h e y say this e v e n a b o u t t h i n g s t h e y have j u s t
c o m p l a i n e d of.
N e v e r t h e l e s s , m o r e and m o r e , physicians w h o t r y t o t r e a t such
p a t i e n t s e x i s t e n t i a l l y h a v e c o m e u n d e r h e a v y c r i t i c i s m f r o m influential
sectors of society. Certainly, these critics are correct in pointing out that
t h e p h y s i c i a n and his p a t i e n t do n o t e x i s t in a v a c u u m b u t w i t h i n t h e
l a r g e r , d a y - t o - d a y reality o f m o d e r n industrial s o c i e t y . T h e r e are m a n y
leading p h y s i c i a n s , t o o , w h o a r e o p p o s e d from t h e s t a r t t o a n y t h e r a p y
t h a t dwells o n s u c h t h i n g s a s h u m a n o p e n n e s s t o p h e n o m e n a l p r e s e n c e s
and t h e o p e n space o f p h y s i c i a n - p a t i e n t b e i n g - t o g e t h e r . T o t h e s e critics,
s u c h a f o u n d a t i o n for t h e r a p y s h a r e s m o r e w i t h p o e t r y t h a n w i t h
practical s c i e n c e . W h e t h e r D a s e i n s a n a l y t i c t h e r a p y is poetic is i r r e l e v a n t .
T h e c h a r g e o f u n s c i e n t i f i c n e s s , h o w e v e r , i s valid o n l y o f s c i e n c e
a r b i t r a r i l y r e s t r i c t e d to n a t u r a l scientific o r i e n t a t i o n , a r e s t r i c t i o n m a d e
w i t h i n c r e a s i n g f r e q u e n c y t h e s e days. F u r t h e r m o r e , i t s h o u l d first b e
demonstrated that Daseinsanalytic therapy involves an approach that is
less s t r i c t and less o b j e c t i v e , w i t h r e g a r d t o t h e m a t t e r a t h a n d , t h a n
n a t u r a l scientific o r i e n t a t i o n . B u t s o far n o critic h a s b e e n able t o p r o v e
such statements.
It is a b s u r d , in any c a s e , t h a t t h e v e r y p h y s i c i a n s w h o t r y to s u m m o n
t h e i r D a s e i n s a n a l y t i c c o l l e a g u e s b a c k i n t o t h e fold o f n a t u r a l s c i e n c e
should b e t h e o n e s w h o fight, t h r o u g h t h e i r p r o f e s s i o n a l o r g a n i z a t i o n s ,
a g a i n s t t h e socialization o f m e d i c i n e . F o r t h e m o r e t h e y think o f
t h e m s e l v e s e x c l u s i v e l y a s p r e c i s e , n a t u r a l , scientific h e a l t h e n g i n e e r s ,
t h e m o r e t h e y a b a n d o n all claim to i n d e p e n d e n t p r o f e s s i o n a l standing.
M e m b e r s o f all e x i s t i n g t e c h n i c a l p r o f e s s i o n s h a v e w o n t h e s t a t u s o f
e m p l o y e e s on fixed salaries; this fact gives a h o l l o w s o u n d to t h e cries for
i n d e p e n d e n c e issued b y w o u l d - b e t e c h n i c i a n s a m o n g t h e medical
p r o f e s s i o n . T h e d o c t o r s ' fight a g a i n s t socialization w o u l d be justified, in
t h e l o n g r u n , o n l y if a m a j o r i t y of t h e m w e r e able to s t r u g g l e t h r o u g h to a
b e t t e r e x i s t e n t i a l u n d e r s t a n d i n g o f t h e healing art. O n l y t h e n could t h e y
p r o c l a i m t h e f r e e d o m and o p e n n e s s c h a r a c t e r i s t i c of a h e a l t h y h u m a n
e x i s t e n c e . O n c e t h e y h a v e this u n d e r s t a n d i n g , t h e y will h a v e a they will
h a v e a c o n v i n c i n g a r g u m e n t for t h e n e c e s s i t y of an i n d e p e n d e n t medic al
p r o f e s s i o n . F o r no o n e will d e n y t h a t , if h u m a n h e a l t h c o n s i s t s in I In
c a p a c i t y to e n g a g e freely in i n n a t e e x i s t e n t i a l p o t e n t i a l i t i e s , this health
can be realized o n l y in an a d e q u a t e l y free p h y s i c i a n - p a t i e n t r e l a t i o n s h i p
S u c c e s s f u l p r e v e n t i v e m e d i c i n e relies, for the s a m e r e a s o n s , o n the
i n d e p e n d e n c e o f t h e physician.
C e r t a i n p h y s i c i a n s , and m a n y leading industrialists as well, want no
dealings with a t h e r a p e u t i c m e t h o d thai aims at freeing the paticnl f r o m
EXISTENTIAL
282
FOUNDATIONS
Those
Who Are
Therapeutically Active
283
t h e p a t h o l o g i c a l i m p a i r m e n t of his p o t e n t i a l i t i e s and i n t r o d u c i n g h i m to a
f r e e , a u t o n o m o u s b e i n g - i n - t h e - w o r l d . It w o u l d be difficult, t h e y say, to
i m a g i n e a t h e r a p y less s u i t e d t o t h e p r e s e n t a g e o f t h e c o m p u t e r . F o r
people s e l d o m t h i n k o f t h e m s e l v e s a n y m o r e a s d i s t i n c t individuals. T h e y
r a r e l y s a y " I . " T h e y say " w e " i n s t e a d , m e a n i n g t h e s u m t o t a l o f
e m p l o y e e s a t " t h e i r " g i a n t industrial c o n c e r n . All t h e e m o t i o n s ,
t h o u g h t s , and a c t i o n s o f t h e s e w o r k e r s a r e d i r e c t e d t o w a r d m a x i m u m
p r o d u c t i o n and g r o w t h for " t h e i r " c o r p o r a t i o n . T h e i r life goal c o n s i s t s ,
a c c o r d i n g l y , i n a t t a i n i n g t h e m o s t efficient and p e r m a n e n t c o o p e r a t i o n
possible a m o n g fellow w o r k e r s , w h o a r e all i m a g i n e d as cogs in a w h e e l .
NOTES
Afterword
THE FOUNDATIONS
OF A DA-SEIN-BASED
286
EXISTENTIAL
FOUNDATIONS
g o i n g o n . T h e r e i s n o lack o f p s y c h o l o g i c a l , sociological, t h e o l o g i c a l ,
political, and f u t u r e studies. B u t t h e u s e f u l n e s s of such i n v e s t i g a t i o n is
n e c e s s a r i l y d e t e r m i n e d b y t h e quality o f u n d e r s t a n d i n g a b o u t w h a t
n e e d s c h a n g i n g , and i t w o u l d appear t h a t this g r o u n d w o r k h a s s c a r c e l y
received its due a t t e n t i o n . I t o f t e n h a p p e n s t h a t t h e b e h a v i o r a l d e f e c t s o f
people s u f f e r i n g f r o m n e u r o s e s o f b o r e d o m and m e a n i n g l e s s n e s s a r e
a t t r i b u t e d t o s o m e a b s t r a c t c o n c e p t like " t h e malaise o f t h e t i m e . " B u t
t h e n i t b e c o m e s difficult t o decide w h e t h e r t h e fault lies w i t h t h e y o u n g
people t h e m s e l v e s or t h e t i m e s t h e y live in. A d i s c e r n i n g c o n v e r s a t i o n
w i t h a n y typical o n e o f t h e s e m e m b e r s o f o u r s o c i e t y s h o w s t h a t t h e y all
sufferwhether they consider themselves healthy or disturbedthe
fate of the times, their times.
I t e a t s a t t h e m t h a t this fate o f t h e i r s p r e s s u r e s t h e m t o r e g a r d
e v e r y t h i n g in t h e w o r l d and u n i v e r s e , e v e r y t h i n g and all t h a t l i v e s
plants and animals and e v e n h u m a n b e i n g s t h e m s e l v e s m o r e and m o r e
as n o t h i n g b u t i n t e r c h a n g e a b l e parts of a p l a n e t a r y m a c h i n e t h a t t a k e s in
t h e w h o l e w o r l d . T h e y k n o w t h a t c o m p o n e n t s e x i s t only t o b e m e s h e d
i n t o p r o d u c t i o n a p p a r a t u s e s w h i c h m u s t yield m o r e e n e r g y and m o r e
g o o d s purely for t h e sake o f i n c r e a s i n g p r o d u c t i o n , and t h a t t h e
particular kind and p a r t i c u l a r m e a n i n g of t h e p r o d u c t is a m a t t e r of
diminishing s i g n i f i c a n c e . T h e d e s t i n y t h a t arises f r o m such a w o r l d v i e w
r e c o g n i z e s o n l y t h e single goal o f m a x i m u m e x t e n s i o n o f p o w e r o v e r all
t h i n g s t h a t can b e useful and s e r v i c e a b l e , t h i n g s w h i c h i n t h e m s e l v e s
h a v e b e e n d r a i n e d o f m e a n i n g , t h i n g s t h a t can o n l y b e a m a s s e d t h e
h u m a n being included. T h i s d e s t i n y c e r t a i n l y d o e s bring the Biblical
m a n d a t e o f h u m a n d o m i n i o n o v e r h e a v e n and e a r t h c l o s e r t o realization,
and i n this n o d o u b t lay its passing f a s c i n a t i o n for t h o s e w h o a r e n o w t h e
g e n e r a t i o n o f p a r e n t s and g r a n d p a r e n t s . B u t for t h e y o u n g w h o are
p e r c e p t i v e , a g h a s t l y b o r e d o m and e m p t i n e s s g a p e s in this w o r l d v i e w ,
and the l o n g e r i t g o e s o n , t h e w o r s e i t b e c o m e s .
T h i s s e l f - a l i e n a t i o n t h e oblivion i n t o w h i c h t h e c h a r a c t e r i s t i c t r a i t s
o f h u m a n being h a v e s u n k , and t h e h u m a n i s o l a t i o n t h a t follows f r o m
ithas heavily i n f e c t e d t h e r e l a t i o n s h i p o f m o s t c o n t e m p o r a r y p a r e n t s
w i t h t h e i r c h i l d r e n , and for the y o u n g this is p a r t i c u l a r l y d e v a s t a t i n g .
T h e r e h a v e b e e n m a n y sociological i n v e s t i g a t i o n s w h i c h appear t o
c o n t r a d i c t this and t o d e m o n s t r a t e t h a t m a n y y o u n g r e b e l s and t h e i r
p a r e n t s have g e n e r a l l y g o o d , o r a t least a c c e p t a b l e , r e l a t i o n s h i p s . B u t t h e
value o f t h e s e studies depends o n t h e c r i t e r i a b y w h i c h t h e s o c i o l o g i s t s
a s s e s s t h e people t h e y i n v e s t i g a t e , and t h e s e criteria g e n e r a l l y
c o r r e s p o n d t o t h e m e a g e r n o r m o f the c o n t e m p o r a r y p a r e n t - c h i l d
r e l a t i o n s h i p . F u r t h e r m o r e , t h e i n v e s t i g a t i o n s w h i c h lead to such
c o n c l u s i o n s regularly use the t e c h n i q u e of the q u e s t i o n n a i r e , a
Afterword
287
288
EXISTENTIAL FOUNDATIONS
280
Afterword
S a r t r e e m u l a t e d M a r x i n c a r r y i n g C a r t e s i a n s u b j e c t i v i t y t o its f u r t h e s t
e x t r e m e . I n a n early w o r k h e w r o t e , " T h e h u m a n b e i n g i s n o t h i n g o t h e r
t h a n w h a t h e m a k e s o f h i m s e l f . " L a t e r , i t w a s n o l o n g e r t h e individual
person w h o m Sartre rendered absolute but the totality of historical
h u m a n i t y . Calling M a r x " t h e i n s u r p a s s a b l e p h i l o s o p h e r o f o u r t i m e , " h e
too proclaims, "Humanity makes itself."
2
T h e o u t c o m e o f this s h a r e d p r e m i s e t h a t u n d e r l i e s and s u s t a i n s t h e
t e c h n o l o g i c a l world in East and W e s t alike h a s s h o w n us t h a t in t h e
s o c i e t i e s shaped b y M a r x i s m , t o o , people h a v e b e e n u n a b l e t o r e e s t a b l i s h
t h e i m m e d i a t e c o n n e c t i o n t o t h i n g s and o t h e r people w h i c h would
r e s t o r e e a c h p e r s o n f r o m a l i e n a t i o n and m a k e h i m feel a t h o m e o n c e
again o n t h e face o f t h e e a r t h . T h e failure o f all a t t e m p t s s o far t o p r e v e n t
and heal social malaise o r i g i n a t e in t h i s . T h a t it r e m a i n s hidden from the
M a r x i s t s t h e m s e l v e s m a y b e due t o t h e i r fascination w i t h a s t a t e m e n t o f
M a r x ' s i n w h i c h h e r e p r o a c h e d p h i l o s o p h e r s for m e r e l y i n t e r p r e t i n g the
w o r l d . T h e point, he said, is to c h a n g e it. B u t t h e r e can be no c h a n g e in
t h e w o r l d w i t h o u t c h a n g e in h o w we c o n c e i v e of t h e w o r l d , i.e., w i t h o u t a
prior t r a n s f o r m a t i o n o f h o w w e i n t e r p r e t the world. M a r x ' s v e r y call t o
c h a n g e t h e w o r l d r e s t s on a definite i n t e r p r e t a t i o n of t h e w o r l d and
s o c i e t y , o n t h e basis o f w h i c h h e s a w w h a t had t o b e c h a n g e d and w h a t i t
had t o b e c h a n g e d i n t o .
Only a shrinking remnant of modern progressives think Marx's
a s s e r t i o n t h r o u g h to its end, let a l o n e first inquiring a d e q u a t e l y a f t e r the
c h a r a c t e r o f h u m a n s o c i e t y , and m o d e r n industrial s o c i e t y for o n e .
S t u d e n t e f f o r t s to a c c o m p l i s h e v o l u t i o n a r y social c h a n g e , as well as the
a t t e m p t s o f t h e a n a r c h i s t r e v o l u t i o n a r i e s , h a v e s t a y e d b o g g e d down i n
c o n t r a d i c t o r y and m u t u a l l y e x c l u s i v e c o n c e p t s . T h e r e a r e t o o m a n y
y o u n g r e b e l s w h o aim at a r a s h and radical d e s t r u c t i o n of t h e e x i s t i n g
social o r d e r , w h i c h t h e y r e g a r d a s t h e n e c e s s a r y revolt o f p r i s o n e r '
a g a i n s t t h e i r prison walls, w h i l e t h e y e x p e c t as a m a t t e r of c o u r s e to k e e p
g e t t i n g t h e i r g r a n t s and s c h o l a r s h i p s after t h e d e s t r u c t i o n ol i n d i e . 1 1 ial
s o c i e t y . T h e y do n o t r e c o g n i z e t h a t only a totally a d m i n i s t e r e d ,
290
EXISTENTIAL
FOUNDATIONS
t h o r o u g h l y o r g a n i z e d , c o m p l e t e l y m a t e r i a l i s t i c , industrial s o c i e t y can
m a i n t a i n large n u m b e r s o f u n p r o d u c t i v e s t u d e n t s . T h e collapse o f t h e
t e c h n o l o g i c a l w o r l d w o u l d m e a n s i m u l t a n e o u s l y giving u p t h e c o m f o r t s
o f affluent s o c i e t y and r e t u r n i n g t o t h e b i t t e r s t r u g g l e o f o t h e r c e n t u r i e s
for s h e e r physical e x i s t e n c e . It is still n o t long since t h e lives of all
h u m a n i t y e x c e p t for t h e few w h o r u l e d w e r e spent i n d r u d g e r y
u n w o r t h y o f h u m a n b e i n g . Even t o d a y , o n l y a small part o f h u m a n i t y h a s
g o t b e y o n d this s t a g e , and t h e people o f u n d e r d e v e l o p e d c o u n t r i e s will
likewise h a v e t o a p p r o p r i a t e t h e t e c h n o l o g i c a l w o r l d v i e w t o free
t h e m s e l v e s f r o m t h e b o n d a g e o f physical h u n g e r .
To e x i s t in a t e c h n o l o g i c a l w o r l d v i e w m e a n s t h a t o n e uses all t h i n g s he
e n c o u n t e r s as e f f i c i e n t l y as possible so t h e y yield all t h e i r e n e r g i e s to h i m ,
w h o t h e n h a s t h e m a t his disposal for f u r t h e r i n g his p o w e r o v e r m a t e r i a l
g o o d s . F o r this r e a s o n , W e s t e r n m a n h a s s o u g h t t o e x p o r t his
achievement motive to underdeveloped countries, thereby running into
g r e a t difficulties. E x p o r t i n g single m o t i v e s is a p r o f o u n d l y t h o u g h t l e s s
b u s i n e s s . T h e t o t a l i t y o f t h e w o r l d v i e w s i n w h i c h the people o f t h e s e
u n d e r d e v e l o p e d c o u n t r i e s a r e still dwelling, and f r o m w h i c h all t h a t
m o v e s t h e m c o m e s , m u s t first b e t r a n s f o r m e d f r o m t h e g r o u n d up. B u t
t h e m a s s e s of people in t h e s e places prove to be r a t h e r r e l u c t a n t in
yielding to such a c o m p l e t e c h a n g e . W e s t e r n p s y c h o l o g i s t s and f a c t o r y
m a n a g e r s s e e m t o h a v e a hard t i m e m a k i n g t h e w h o l e vision o f t h e s e
people s h r i n k t o t h e point t h a t w h a t discloses i t s e l f t o t h e m o f t h e i r w o r l d
is o n l y w h a t can be p r e c i s e l y calculated and t i g h t l y o r d e r e d i n t o flawless
c h a i n s o f c a u s e and e f f e c t . T h i s s h r i n k i n g i s t h e e s s e n c e and basis o f t h e
spirit o f m o d e r n t e c h n o l o g y . W h a t d o m i n a t e s i n t h e c o m i n g s and g o i n g s
of t h e p o p u l a t i o n s of t h e u n d e r d e v e l o p e d c o u n t r i e s is still a far c r y f r o m
t h e W e s t e r n goal o f t h e m o s t efficient possible e x p l o i t a t i o n o f w h a t t h e y
e n c o u n t e r . T h e i r o w n a c h i e v e m e n t m o t i v e is o p e r a t i n g , b u t in a v e r y
different r e a l m from t h a t o f m a t e r i a l w e a l t h and t e m p o r a l p o w e r .
4
Afterword
2^1
EXISTENTIAL FOUNDATIONS
292
Afterword
203
w i t h a w a v e of t h e hand i n t o a m e r e i n t r a p s y c h i c r e p r e s e n t a t i o n within
an encapsulated human consciousness.
W h e n w e c o n d u c t o u r s e l v e s i n this w a y , e n c o u n t e r i n g t h e t r e e with
c a r e , w i t h c i r c u m s p e c t i o n , in a w a y t h a t is j u s t to t h e p h e n o m e n a , t h e n
w h a t h a p p e n s i s n o t h i n g less t h a n t h a t " w e " t h e r e p r e s e n t i n g s u b j e c t
and t h e t r e e as its r e p r e s e n t e d o b j e c t r a d i c a l l y disappear. A n d we have
left t h a t o v e r b e a r i n g p o s s e s s i v e s u b j e c t i v i s m of D e s c a r t e s w h i c h , in his
o w n w o r d s , a i m s a t t h e m a s t e r y and p o s s e s s i o n o f n a t u r e , and a c c o r d i n g
to w h i c h a b l o s s o m i n g apple t r e e e x i s t s o n l y by t h e g r a c e of a h u m a n
s u b j e c t ' s r e p r e s e n t a t i o n of it in his p s y c h e . We h a v e t a k e n in its place the
h u m b l e r and m o r e r e v e r e n t p h e n o m e n o l o g i c a l w a y o f s e e i n g , i n w h i c h
t h e apple t r e e in b l o o m is e x p e r i e n c e d as t h a t w h i c h is p r e s e n t t h e r e
b e f o r e us. It s t a n d s b e f o r e us as w h a t a c c o r d i n g to t h e m e a n i n g s and
c o n t e x t s of r e f e r e n c e t h a t c o n s t i t u t e it as a t r e e i t i s . And for o u r part,
we n o w only put o u r s e l v e s , as e x i s t i n g h u m a n b e i n g s , at its disposal. We
offer o u r s e l v e s to it as the r e a l m of w o r l d - o p e n n e s s we are, as t h e f r e e ,
c l e a r o p e n n e s s in w h i c h it can a p p e a r and w h i c h e n a b l e s it, in t h e light of
o u r p e r c e p t i o n , t o c o m e t o b e p r e s e n t . W e h u m a n b e i n g s can d o t h e t r e e
this s e r v i c e b e c a u s e we are w o r l d - o p e n n e s s ; we e x i s t e s s e n t i a l l y as a
w o r l d - s p a n n i n g r e s p o n s i v e n e s s t o t h e being and m e a n i n g f u l n e s s o f w h a t
has c o m e t o b e p r e s e n t .
7
294
EXISTENTIAL FOUNDATIONS
Afterword
295
296
EXISTENTIAL
FOUNDATIONS
i m p o v e r i s h e d m e a n i n g s s e e n i n t h i n g s and people t h r o u g h t h e w o r l d
v i e w o f t e c h n o l o g y , a r e t h e specialists i n p r e v e n t i v e m e d i c i n e , the
s o c i o l o g i s t , and t h e r e c r e a t i o n t i m e p l a n n e r t o guide t h e e n e r g i e s o f t h o s e
y o u t h , w h o are n o t sick b u t a r e rebelling a g a i n s t t h e e x i s t i n g social o r d e r ,
into a c r e a t i v e r e n e w a l ? T e c h n o l o g y c o m p r e h e n d s o n l y t h e p r o f o u n d l y
m e a n i n g l e s s and m e a g e r goal o f t h e u n r e l e n t i n g i n c r e a s e o f p o w e r b y
a n individual o r c o l l e c t i v e s u b j e c t o v e r n a t u r a l o b j e c t s . I n d u s t r y ' s
f a s c i n a t i o n w i t h the m a d n e s s of e x p o n e n t i a l g r o w t h is r o o t e d in this
s a m e goal. B u t i n all r e a l m s o f living t h i n g s w h e r e such u n l i m i t e d g r o w t h
t a k e s hold, w h a t is b r o u g h t f o r t h is no h e a l t h y f o r m t h a t can g e n e r a t e a
f u t u r e , but a c a n c e r o u s d e g e n e r a t i o n .
G i v e n t h e h u g e a g g l o m e r a t i o n s built b y and for t e c h n o l o g y and
n a t u r a l s c i e n c e , t h e r e m a y be a s e n s e t h a t a p h e n o m e n o l o g i c a l ,
D a s e i n s a n a l y t i c v i e w is c u r s e d w i t h f u n d a m e n t a l p o w e r l e s s for all t i m e .
T h e r e will n e v e r be m o r e t h a n a handful of people capable of p e r f e c t i n g
p h e n o m e n o l o g i c a l i n s i g h t i n t o t h e basic condition o f m a n and his w o r l d ,
and t h e o n t o l o g i c a l r e l a t i o n s h i p b e t w e e n t h e m . B u t t h e n u m b e r o f
r e s e a r c h e r s w h o g r a s p t h e f u n d a m e n t a l principles o f q u a n t u m physics i s
n o g r e a t e r , and yet t h e r e a r e millions o f t e c h n i c a l w o r k e r s w h o k n o w ,
from d e r i v a t i v e s o f t h e s e principles, h o w t o p r o d u c e c o u n t l e s s television
s e t s . A n d m a s s e s o f people w h o listen t o radios and w a t c h television, s o
m a n y t i m e s g r e a t e r i n n u m b e r t h a n t h o s e t e c h n i c i a n s and u n d e r s t a n d i n g
so v e r y m u c h less of p h y s i c s , a r e able to o p e r a t e and u s e t h e s e devices. It
is not groundless to hope, then, that the fundamental ontological
i n s i g h t s of D a s e i n s a n a l y t i c p h e n o m e n o l o g y could, in t i m e , e x e r t a
c o r r e s p o n d i n g l y wide i n f l u e n c e on the spirit of h o w people live in this
society.
W e m a y a s s u m e t h a t t h e b r e a k t h r o u g h the t e c h n o l o g i c a l f r a m e w o r k
of m o d e r n industrial s o c i e t y i n t o a g e n u i n e f r e e d o m in r e l a t i o n to this
t e c h n o l o g y will n o t be d o n e first by t h e W e s t . It is r a t h e r to be hoped for
from t h e peoples o f t h e F a r E a s t . W h o e v e r has t h e good f o r t u n e t o b e i n
close and e x t e n d e d a s s o c i a t i o n w i t h the people o f India, Japan, and C h i n a
e x p e r i e n c e s h o w t h e i r b e i n g - i n - t h e - w o r l d w i t h o u t d e t r i m e n t t o the
vigor w i t h w h i c h t h e y a p p r o p r i a t e and exploit W e s t e r n s c i e n c e i s
shaped a l w a y s , c o n t i n u a l l y , and decisively by a t r a d i t i o n a l r e l a t i o n s h i p
w i t h t h e w o r l d t h a t is a s t o n i s h i n g l y close to t h e vision of E u r o p e a n
p h e n o m e n o l o g y j u s t n o w unfolding.
Afterword
FOOTNOTES
1 . K . M a r x , Die Fruhschriften ( S t u t t g a r t : K r o n e r , 1 9 5 3 ) , p . 2 4 6
2. J . - P . S a r t r e , L'exislenlialisme est un humanisme ( P a r i s : 1 9 4 6 ) , p. 2 2 .
3. J . - P . S a r t r e , Critique de la raison dialectique ( P a r i s : 1 9 6 0 ) , p. 98
4 . S e e , f o r e x a m p l e , D . M c C l e l l a n d , J . W . A t k i n s o n , R . A . C l a r k , a n d E . L . L o w e l l , The
Achievement Motive ( N e w Y o r k : A p p l e t o n - C e n t u r y - C r o f t s , 1 9 5 3 ) .
5. W. H e i t i e r ,
1 9 6 2 ) , p. 2.
Der
Mensch
und die
naturwissenschaftliche
Erkenntris,
2d
ed.
(Braunschweig-
D i n g , " in:
Vortrage
und Autsatze ( P f u l l e n g e n :
Neske,
1954)
INDEX
acute,
2 0 0 - 1 3
boredom, 2 2 3
brachial paralysis, 2 0 2
Buber, M 38, 72
calculability, 1 5 6
Charcot, J.M., 222
China, 2 9 6
claustrophobia, 2 1 6 - 1 7
c l e a r n e s s o f h u m a n space, 8 8 - 9 0
c o e x i s t e n c e i n s h a r e d space, 1 0 6 - 9
collective unconscious, Jungian,
36, 147
color blindness, 2 0 0 , 2 0 1
conditionality of psychosomatics,
73-78
Condrau, G., 1 8 9
Conrad, K., 37, 69
consciousness, fundamental open
ness of human existence
and, 1 3 2 - 3 5
countertransference, 2 5 9 - 6 0
criminality, mass, 2 8 3
cybernetics, 2 1 , 2 5 - 2 9
D a - s e i n , o n t o l o g y of, i x - x , xiii,
xviii, x x i x - x x x i
D a - s e i n - b a s e d social p s y c h o l o g y
and social p r e v e n t i v e medi
cine, 2 8 5 - 9 6
Daseinsanalysis
c r i t i c i s m s o f medical use o l ,
155-60
o f R g u l a Z i i r c h e r case, 8 1 8 4 ,
1 0 1 , 103, 1 0 7 - 0 , | , 7 8",
1 9 1 , 1 9 7 , 258-e>7
(
300
datability o f t i m e , 9 4
David, C , 6 5
death,
human
mortality
and,
1 1 9 - 2 2
Democritus, 1 9
depression, 2 1 7 - 2 3
s t r e s s and, 2 0 8 - 9
D e s c a r t e s , R., x, xxii, x x x ,
23,
71,
288-89,
127,
143,
xiv,
34,
19-20,
159,
293
45-46,
ego,144-46
37-38
191-96
types,
2 0 3 - 6
H.,
37,
70-71,
222,
260,
144-49,
193,
244-46,
257,
263,
265,
268-69,
fundamental
"hiddenness,"
un
c o n s c i o u s and, 1 3 5 - 4 3
fundamental openness, conscious
n e s s and, 1 3 2 - 3 5
f u n d a m e n t a l rules o f analysis, 1 3
G a l i l e o Galilei, x x x , 1 9 3
G e b s a t t e l , V . E . von, 3 7
general Daseinsanalytic
and p a t h o g e n e s i s ,
Gestalt psychology, 6 9
G p p e r t , H., 7 1
Grimm brothers, 1 4 3
G r o d d e c k , G., 1 4 7
134
fees for t h e r a p y , 2 6 3
o
o
>
o
o
a
o
acute,
H - 99
191-96
hallucinations
phenomenological investigation
of
of,
id,
:^c3
etiology
1 3 1 - 3 2
Huntington's Chorea, 2 0 0
hysterical paralysis, 1 4 , 2 2 , 5 0 - 5 1
phenomenological investigation
o
>
11
III
(7)
144,
1 7 9 - 8 2
146-47
idiottca phenylpyruvica, 2 0 2
"in-between o f dialogue," 3 8
India, 2 9 6
industrial
technology,
281-83,
2 8 8 - 9 6
insulin t h e r a p y , 2 5 4
International Recreation Associa
tion, 2 9 1
introjection, Daseinsanalytic e x
a m i n a t i o n o f c o n c e p t of, 2 4 3
Japan, 2 9 6
Jaspers, K., 6 0 , 1 3 2 - 3 3
J a u r e g g , W . von, xxiii
J o r e s , A., 2 7 6
Jung, C , xiii, xxiii, 3 6 , 4 5 - 4 6 , 5 1 ,
49
H a r t m a n n , H., 3 6
Haseloff, O.W., 6 8
Hegel, G.W.F., 2 8 8
H e i d e g g e r , M . , ix, x, xi, xiii, xv, xvi,
xxi, x x i i i - x x i v , x x x - x x x i ,
129,
Marcel, G., 1 5 2
M a r t y , P., 6 5
M a r x , K., 1 6 1 , 2 8 8 - 8 9
Marxism, 2 8 8 - 8 9 , 2 9 2
m a s s addiction and c r i m i n a l i t y , 2 8 3
masturbation, 1 5
medical a n t h r o p o l o g y , 3 7 , 4 8 - 4 9 ,
76
medicine
n a t u r a l s c i e n c e m e t h o d o l o g y , of,
x-xii, xxvii-xxx, 1 9 - 3 2
socialization of, 2 8 1 - 8 2
melancholia, 2 1 9 - 2 2
m e m o r y , historicity of human
e x i s t e n c e and, 1 1 4 - 1 9
memory performance, 2 2
Merleau-Ponty, M., 1 2 8 - 3 0
m e t a p s y c h o l o g y , F r e u d i a n , xiii, 3 4
Middle A g e s , 1 9 4
M i n k o w s k i , E., 3 7
mongolism, 2 0 0 , 2 0 2 - 3
mood, 1 0 9 - 1 4
s e v e r e d i s t u r b a n c e s in a c t u a l i z
ing e x i s t e n t i a l of, 2 1 7 - 2 3
mortality, human, 1 1 9 - 2 2
motivational contexts, psychodyn a m i c s and, 1 4 9 - 5 2
Mountcastle, V.S., 2 4 - 2 5
M ' U z a n , M . de, 6 5
178-79
p s y c h o a n a l y t i c e x p l a n a t i o n for,
71-72,
e x p a n s i v e n e s s o f time, 9 5
and,
34-37,
psychoanalytic,
Einstein, A., 9 6
electric shock therapy, 2 5 4
empathy, 1 4 7 - 4 7
endogenous depressions, 2 2 2
epilepsy, 2 1 6 , 2 1 7
E r i k s o n , E.H., 3 8
etiology, general Daseinsanalytic,
Ey,
2 2 3 - 3 8
4 5 - 4 6 , 5 7 - 6 5 , 67, 69,
135-40,
259,
<
dwelling, 1 2 9 - 3 0
dynamic unconscious, 1 3 6
reaction
73,
fundamental,
135-43
x i - x v i i i , xxiii,
39-40,
301
"hiddenness,"
61-62
143-44
exogenic
S.,
195-96,
stereotypic, 1 6 7 - 6 9 , 2 6 0
drive, h u m a n p o t e n t i a l for r e l a t i n g
specifically to w o r l d and,
psychology,
F i s c h e r , F . , xix
forgetting, 1 1 6 - 1 8
free a s s o c i a t i o n , 1 3
freedom, 1 2 2 - 2 4
b e c o m i n g and, 3 7
illnesses e n c r o a c h i n g on,
Freud,
diabetes, 2 0 0
d i s b e c o m i n g , pathological s y m p
t o m s and, 3 7
dreams
Daseinsanalytic
theory
of,
xiv-xv
p s y c h o a n a l y t i c t h e o r y of, xii,
ego
Index
EXISTENTIAL FOUNDATIONS
130,
H e i t i e r , W., 2 9 1
Hensel, H 2 7
heredity, 2 3 7
H e s s , W . R . , xxiii, 2 5 3
292
K a n t , I., 2 0 , 3 7
K o h l i - K u n z , A., 2 4 6
K u h n , T . , xi
little H a n s , case o f ( F r e u d ) ,
lobotomies, 2 5 4
L o e f f l e r , W., xxiii
loneliness, 1 0 6
manic-depressive
2 1 7 - 2 3
6 2 - 6 3
psychoses,
natural
science
methodology,
x-xii, xxvii-xxx, 1 9 - 4 2
nausea, 1 2 8 - 2 9
neovitalists, 1 0 1
neuropsychiatrie therapy, 2 5 3 - 5 4
n e u r o s e s see specific types
N e w t o n , I., x x x
N i e t z s c h e , F., 5 8
objects, persistence ol, 07 98
obsessive-compulsive
neuroses,
238
EXISTENTIAL FOUNDATIONS
302
o p e n n e s s o f h u m a n space, 8 8 - 9 1
i l l n e s s e s e n c r o a c h i n g on, 2 2 3 - 3 8
organic n e u r o s i s , 5 1 - 5 3
phenomenological investigation
of,
182-85
organic psychoses,
orgasm, 1 0 - 1 1 , 1 5
2 1 3 - 1 6
psychic
apparatus,
Freudian,
3 5 - 3 6 ; see also e g o ; id; s u p e r
ego
psychoanalytic ego psychology,
American, 3 7 - 3 8
psychoanalytic theory
o f d r e a m s , xii, xiv, 3 4 , 4 5 - 4 6 ,
61-62
paralysis, h y s t e r i c a l ,
1 7 9 - 8 2
parapraxis, 1 1 7
Parmenides,
119
pathogenesis, general Daseinsanalytic, 1 9 1 - 9 6
p a t i e n t in D a s e i n s a n a l y t i c t h e r a p y ,
perception process, 2 2
persistence of objects, 9 7 - 9 8
p h e n o m e n o l o g y o f illness, D a s e i n
sanalytic, 1 9 7 - 2 3 9
phobias, 2 1 6 - 1 7
p s y c h o a n a l y t i c e x p l a n a t i o n s of,
62
physical pain, p h e n o m e n o l o g i c a l
investigation
of,
187-89,
210-13
273-83
p h y s i c i a n - p a t i e n t r e l a t i o n s h i p in
Daseinsanalytic
therapy,
2 5 9 - 7 2
Piaget J . , 3 8 - 3 9 , 6 6 - 6 7
Plato, 1 6 0
polio, 2 0 1 - 2
"pre-real matter," 7 6
preventive
medicine,
social,
285-96
science
Sartre, J.-P., 1 2 8 - 2 9 , 2 4 6 , 2 8 9
schizophrenia, 2 2 2 - 3 8
forfeiture of existential auto
n o m y and, x i x - x x i
methods o f treating, 2 5 4
S c h u l t e , W., 2 0 9 , 2 2 2
Schur, M., 6 5
Selye, R , 2 0 6
senile d e m e n t i a , 2 1 3 - 1 4
serenity, 1 1 2
sexual perversions, Daseinsanalyt
ic t h e o r y of, x i i i - x i v
shared space, c o e x i s t e n c e in, 1 0 6 - 9
shock therapy, 2 5 4
significance o f t i m e , 9 4
social p s y c h o l o g y , D a - s e i n - b a s e d ,
285-96
socialization o f medicine, 2 8 1 - 8 2
sorrow, 1 1 3 - 1 4
spatiality o f e x i s t e n c e , 8 6 - 9 3
illnesses s h o w i n g s e v e r e impair
m e n t of, 2 1 3 - 1 7
s t a b and s t r a n g l e , u r g e s to, 1 1 - 1 2 ,
methology
of,
phenomenological investigation
of,
169-78
psychosurgery,
254
public c h a r a c t e r o f t i m e , 9 5
stereotypic dream, p h e n o m e n o
logical
investigation
of,
reactive depressions, 2 2 2
recreation time, 2 9 1 - 9 2
regression, Daseinsanalytic exami
n a t i o n o f c o n c e p t of, 2 4 3 - 4 4
relativity theory, 9 6
repression, Daseinsanalytic exami
n a t i o n o f c o n c e p t of, 2 4 3 - 4 7
rheumatic inflammations, 2 0 2
R i c o e u r , P., 1 5 2
R o h r a c h e r , H., 2 5 - 2 6
R o r s c h a c h series, P l a t e VII of, 2 4 2
stress syndrome, 2 0 6 - 1 0
suicide o f m e l a c h o l i c s , 2 2 1 - 2 2
Sullivan, H . S . , 3 8
" S u n - m a n " (case h i s t o r y ) , 2 3 1 - 3 4
superego, 1 4 4 , 1 4 6
167-69,
technology,
260
industrial,
281-83,
2 8 8 - 9 6
1 3 1 - 3 2
"psychiatric Daseinsanalysis," 4 9
sadism,
48-49
temporality o f existence, 9 3 - 1 0 0
illnesses s h o w i n g s e v e r e impair
m e n t of, 2 1 3 - 1 7
thalidomide damage, 2 0 0 , 2 0 1
transference, 2 6 0 - 7 2
fallacy of handling p h y s i c i a n patient
relationship
as,
2 6 5 - 7 2
traumatic dementia, 2 0 2
U e x k l l , T . von, 4 0 - 4 1 , 7 6
unconscious
collective, 3 6 , 1 4 7
dynamic, 1 3 6
f u n d a m e n t a l " h i d d e n n e s s " and,
135-43
psychoanalytic
theory
of,
xii,
3 4 - 3 5
vegetative dysfunctions,
visualization, 9 0 - 9 3
vitalists, 1 0 1
2 0 6 - 7
14-16
73-78
3 9 - 4 2
physician i n D a s e i n s a n a l y t i c t h e r
apy,
and,
1 4 9 - 5 2
251-55
47-48,
o f phobias, 6 2
of projection, 2 4 1 - 4 3
of regression, 2 4 3 - 4 4
o f repression, 2 4 3 - 4 7
o f u n c o n s c i o u s , xii, 3 4 - 3 5
w o r k i n g h y p o t h e s i s in, 6 3
motivational
contexts
Index
Liv,
1 k;fVT
Waelder, R., 6 4
W a e l h e n s , A . de, 1 5 2
W e i z s c k e r , V . von, 3 6
White, R.W., 3 8
W i e n e r , N., 2 1
will, impulse of, 2 2
working hypothesis, psychoana
lytic, 6 3
Zrcher, Regula
xviii, 3 - 1 8 ,
81-85,
101,
167-89,
191,
(case h i s t o r y ) ,
21,
43-56,
103,
197,
73,
107
258-07
9,