COMMENTARY

New directions in science and psychology are in the wind for

America in the 1980s. Boss has always been ahead of his time, and
the psychiatric and psychological fraternities will catch up with him,
perhaps toward the latter part of this decade. F o r now, most col
leagues will approach this b o o k with predispositions, preconcep
tions, and prior prejudices, thus giving the b o o k short shrift. To do
so will prove a point that Boss makes repeatedly in his b o o k : one's
preconceptions (world view, prior philosophical picture of the world,
or theoretical disposition) guide one to recognize as valid only that
which falls within or supports the preconceptions.
Gerald Epstein

Existential Foundations
of
Medicine and Psychology

by MEDARD B O S S

translated from the

German

by
Stephen Conway and Anne Cleaves
with an introduction
by Paul J. Stem

NEW Y O R K

JASON ARONSON

LONDON

Copyright
!

1 9 8 3 , 1979 b y M e d a r d Boss
ir
,

All rights reserved. Printed in the U n i t e d States of A m e r i c a . No part of this

b o o k m a y be used or reproduced in any m a n n e r whatsoever without writ
ten permission from Jason Aronson, Inc. except in t h e case of b r i e f quota
tions in reviews for inclusion in a magazine, newspaper or broadcast.

N e w Printing 1 9 8 3

ISBN: 0-87668-667-6

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

Manufactured in the U n i t e d States of A m e r i c a .

CONTENTS

Introduction to the English Translation

Preface to t h e First Edition
Preface t o t h e S e c o n d Edition
Introduction

ix
xxiii
xxv
xxvii

Part I:
T h e Traditional Foundation of Medicine
Chapter

1.

A Test Case: Regula Zrcher

Chapter

2.

T h e Natural Scientific View of Medicine

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

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

Chapter

Fundamental Characteristics of Human

Beings

85

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

Chapter

9.

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 10.

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
Chapter 11.

Testing an Existential Research M e t h o d on

S e v e r a l P a t h o l o g i c a l P h e n o m e n a o f the T e s t
Case

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.

A General Daseinsanalytic Phenomenology of

Illness

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

it

Contents

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.

T h e " L o c u s " of the Therapeutic Interaction

("Transference")

257

Chapter 17.

T h o s e W h o Are Therapeutically Active

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

299

INTRODUCTION TO THE
ENGLISH TRANSLATION

Existential Foundations of Medicine and Psychology is M e d a r d B o s s ' s m a g n u m

o p u s . Ideas set f o r t h in e a r l i e r w o r k s s p a n n i n g t h i r t y y e a r s a r e developed
in t h e p r e s e n t v o l u m e and w o v e n i n t o a richly t e x t u r e d w h o l e .
I f t o b e "radical" m e a n s a s t h e w o r d ' s e t y m o l o g y s u g g e s t s t o g o t o
t h e r o o t s of t h i n g s , this is u n d o u b t e d l y a radical b o o k . It p r o p o s e s
n o t h i n g less t h a n d e m o l i s h i n g t h e n a t u r a l s c i e n c e paradigm t h a t
u n d e r l i e s m o d e r n m e d i c i n e , and replacing it by a radically different o n e
t h a t is b a s e d upon H e i d e g g e r ' s o n t o l o g y of Da-sein. P r o f e s s o r B o s s is in
e a r n e s t a b o u t this r e v o l u t i o n a r y e n t e r p r i s e . T h e i n t e n t o f t h e p r e s e n t
w o r k is to h u m a n i z e m e d i c i n e by giving it a n e w existential f o u n d a t i o n and
to a r t i c u l a t e t h e vast t h e o r e t i c a l and practical c o n s e q u e n c e s of such a
changeover.
L e s t t h e r e a d e r be put o f f by t h e s h e e r a m b i t i o u s n e s s of Foundations, let
him be r e a s s u r e d at t h e o u t s e t t h a t D r . B o s s is n e i t h e r a naive v i s i o n a r y
n o r a f a n a t i c . While u n s p a r i n g in his e x p o s u r e of t h e s h o r t c o m i n g s of
m o d e r n n a t u r a l - s c i e n t i f i c m e d i c i n e , B o s s is far from d e n y i n g its brilliant
a c c o m p l i s h m e n t s . Even if s u c h a t h i n g w e r e possible, he w o u l d n o t w a n t
t o d o a w a y w i t h t h e vast b u r g e o n i n g m a c h i n e r y o f m o d e r n m e d i c i n e . H e
m e r e l y q u e s t i o n s t h e i m p e r a t i v e s t h a t the prevailing f o r m s o f p r e s e n t day medical practice s e r v e , and t h e p r e s u p p o s i t i o n s a b o u t h u m a n n a t u r e
upon w h i c h t h e y a r e built. I n t h e r e c o n s t r u c t e d m a n s i o n o f medicine
e r e c t e d b y B o s s , t h e r e i s ample and h o n o r a b l e r o o m for medical p r a c t i c e

EXISTENTIAL

FOUNDATIONS

as c o n s t i t u t e d today. F r a c t u r e d b o n e s will still h a v e to be set, m a j o r

i n f e c t i o n s t o b e c o n t a i n e d b y a n t i b i o t i c s o r o t h e r a g e n t s , and t u m o r s t o b e
excised o r t r e a t e d b y c h e m o t h e r a p y . B u t b o t h t h e scope and the u l t i m a t e
m e a n i n g o f t h e s e and o t h e r traditional medical i n t e r v e n t i o n s would b e
s t r i n g e n t l y redefined i n t h e D a s e i n s a n a l y t i c f r a m e w o r k p r o p o s e d b y
Boss.
B o s s ' s e f f o r t s at a t h o r o u g h g o i n g r e f o r m of m e d i c i n e (and p s y c h o l o g y )
a r e fueled, as a t t e m p t s of this n a t u r e usually a r e , by a vivid s e n s e of crisis,
s h a r e d b y m a n y o f B o s s ' s m o s t e m i n e n t c o l l e a g u e s . His o w n c o n c e r n i s
not primarily with t h e m u c h - d e b a t e d b a c k l a s h p h e n o m e n a s u c h a s t h e
proliferation of I a t r o g e n i c illness and the g r o w i n g i n t r a c t a b i l i t y of side
e f f e c t s produced b y the t r i u m p h a n t e x t e n s i o n o f m o d e r n t e c h n i q u e s o f
medical i n t e r v e n t i o n . N o r does B o s s focus o n t h e c o m p l e x p r a g m a t i c and
e t h i c a l issues raised by t h e v e r y a d v a n c e s of medical t e c h n o l o g y , e.g., t h e
issue a b o u t w h e n t o r e m o v e life-support s y s t e m s o r w h e n t o p r o n o u n c e
a dying patient dead. B o s s ' s focus is e l s e w h e r e . To t h e e x t e n t he looks
at t h e s e issues at all, he r e g a r d s t h e m as s y m p t o m a t i c of a m u c h m o r e
g e n e r a l crisis g o i n g far b e y o n d the c o n f i n e s o f m e d i c i n e a c u l t u r a l c r i s i s
t h a t involves t h e u l t i m a t e q u e s t i o n o f w h a t i t m e a n s t o b e h u m a n . T h e
issue, in o t h e r w o r d s , is t h e v e r y self-definition of m a n . A n d t h e u r g e n c y
of t h e crisis is s u c h t h a t it calls for t h e m i n i s t r a t i o n s of the physician of
last r e s o r t of sick c i v i l i z a t i o n s t h e p h i l o s o p h e r . It is in the forbidding,
and s e e m i n g l y e s o t e r i c o n t o l o g y of M a r t i n H e i d e g g e r t h a t B o s s and a few
like-minded clinicians d i s c o v e r t h e e l e m e n t s for a r e c o n s t r u c t e d s c i e n c e
o f man.
To clear t h e g r o u n d for a n e w b e g i n n i n g , H e i d e g g e r found it n e c e s s a r y
to demolish t h e proud office of D e s c a r t e s ' s p h i l o s o p h y w h i c h , in its t u r n ,
had o p e n e d up and s h e l t e r e d a place for the a l m o s t m i r a c u l o u s g r o w t h of
W e s t e r n n a t u r a l s c i e n c e . A s H e i d e g g e r s a w it, t h e p r e c o n d i t i o n for this
e f f l o r e s c e n c e , and also t h e p r i m e c a u s e o f m a n ' s p r e s e n t m e t a p h y s i c a l
u p r o o t e d n e s s , w a s D e s c a r t e s ' s d i c h o t o m i z i n g of m a n into res cogitans
("mind") and res extensa ( " m a t t e r " ) and the s h a r p o p p o s i t i o n he posited
b e t w e e n t h o s e t w o f u n d a m e n t a l r e a l m s . H e i d e g g e r ' s polemic a g a i n s t
C a r t e s i a n dualism, w h i c h h e v i e w e d a s p e r n i c i o u s , and t h e a t t e m p t t o
o v e r c o m e it, is a m a j o r s t r a n d of H e i d e g g e r ' s w o r k . It is t h e strand m o s t
relevant to B o s s ' s c h a l l e n g e to m o d e r n m e d i c i n e .
I [eideggei and B o s s a r g u e t h a t by placing t h e h u m a n body s q u a r e l y
w i l l i m the realm of res extensa, of s p a c e - o c c u p y i n g m a t t e r s u b j e c t to
m e t li.inic .il laws, I ) e s c a r t e s e n s u r e d t h e s u b s e q u e n t , practically unlimit
ed use ol natural science m e t h o d o l o g y in e x p l o r i n g t h e h u m a n b o d y .
["he history ol medicine o v e r the last t h r e e c e n t u r i e s d e m o n s t r a t e s
beyond any r e a s o n a b l e doubt that the h u m a n body can indeed be
explored, and mosl successfully so, willim the c a t e g o r i e s and by the
1

Introduction to the English Translation

xi

m e t h o d s of n a t u r a l s c i e n c e u p to a point. It is this "up to a p o i n t " t h a t

c o n s t i t u t e s t h e rub for H e i d e g g e r and B o s s . T h e n a t u r a l s c i e n c e grid
s u p e r i m p o s e d upon t h e h u m a n body does indeed reveal s t r u c t u r e s ,
r e l a t i o n s h i p s , and s e q u e n c e s o f e v e n t s w o r t h k n o w i n g , and t h e
k n o w l e d g e thus g a i n e d is useful in fighting disease. B u t H e i d e g g e r asks
w h e t h e r t h e reductive paradigm of n a t u r a l s c i e n c e really does yield or
further comprehension of what is most characteristic of the human
being and o f t h a t realm o f h u m a n e x i s t e n c e w h i c h w e call the bodily
s p h e r e . E x t e n d i n g t h e a r g u m e n t , B o s s i n q u i r e s if a medical s c i e n c e fully
c o g n i z a n t o f the e x i s t e n t i a l h u m a n c h a r a c t e r i s t i c s a r t i c u l a t e d b y
H e i d e g g e r would n o t b e m o r e e f f e c t i v e i n c o m i n g t o t e r m s w i t h disease
t h a n medical s c i e n c e based o n t h e a s t r i n g e n t n a t u r a l s c i e n c e paradigm.
A n d , B o s s g o e s on to s u g g e s t , s u c h a revitalized s c i e n c e of m e d i c i n e
m i g h t e v e n discover m e a n i n g (of a n e x i s t e n t i a l n a t u r e ) i n b o u t s o f illness
w h i c h , v i e w e d w i t h i n t h e c o n t e x t o f t h e o r t h o d o x paradigm, are
fortuitous.
2

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.
It w a s precisely F r e u d i a n t h e o r y and m e t a p s y c h o l o g y t h a t for
p h e n o m e n o l o g i c a l and e x i s t e n t i a l i s t r e s e a r c h e r s b e c a m e t h e t e s t case for
t h e l i m i t a t i o n s o f t h e n a t u r a l science paradigm i n p s y c h i a t r y . T h u s
Ludwig B i n s w a n g e r a r g u e d t h a t Freud's u n d e r l y i n g n o t i o n of homo natura,
of m a n seen in t h e n a t u r a l s c i e n c e f r a m e w o r k , w a s at a loss to a s s i m i l a t e
w i t h o u t u n d u e d i s l o c a t i o n t h e historical d i m e n s i o n s o f h u m a n e x i s t e n c e
h i g h l i g h t e d b y p s y c h o a n a l y t i c p r a c t i c e . P s y c h o a n a l y t i c m a n , w i t h his
c o n s c i o u s and u n c o n s c i o u s w i s h e s , his n e e d to u n d e r s t a n d and to
r a t i o n a l i z e , his h i s t o r y unfolding in t i m e , his a f f i r m a t i o n s and denials, his
e n t a n g l e m e n t s and d i s e n g a g e m e n t s t h i s m a n did n o t fit into t h e
P r o c r u s t e a n c o n c e p t of homo natura. B i n s w a n g e r implied (and B o s s w a s
later to e x t e n d t h e a r g u m e n t ) t h a t Freud had b e e n a practicing
e x i s t e n t i a l i s t w h i l e t h e o r i z i n g like a n a t u r a l s c i e n t i s t . Freud's u n w i t t i n g
r e v e l a t i o n o f t h e i n a d e q u a c y o f t h e ruling paradigm signaled t h e s t a t e o f
crisis in p s y c h i a t r y and g e n e r a l m e d i c i n e .
It is hardly a c c i d e n t a l t h a t , by and l a r g e , this s t a t e of crisis w a s m o s t
k e e n l y felt b y a n u m b e r o f p s y c h i a t r i s t s . W h e r e a s i n t e r n i s t s , s u r g e o n s ,
n e u r o l o g i s t s , c a r d i o l o g i s t s , and o t h e r p r a c t i t i o n e r s w h o deal directly
w i t h t h e v a g a r i e s of palpable h u m a n tissue are apt to look to t h e
perfectibility o f specific medical t e c h n i q u e s w h e n i n t r a c t a b l e medical
p r o b l e m s stop t h e m cold, t h e p s y c h o t h e r a p i s t p e r p l e x e d b y the r e p e a t e d
failures of his s t o c k in trade is aptto b e c o m e a p h i l o s o p h e r . T h i s is
exactly what happened to Medard Boss.
A t r a i n e d psychoanalyst, personally acquainted with Freud, Boss came
over the years to resent the "strenuous mental acrobatics" imposed by
p s y c h o a n a l y s i s upon a n a l y s t s and a n a l y s a n d s alike. O n l y b y c e a s e l e s s
m e n t a l c o n t o r t i o n s , B o s s felt, could t h e i n t e r p e r s o n a l p h e n o m e n a
o b s e r v e d in p s y c h o a n a l y t i c practice be fitted i n t o t h e f r a m e w o r k of
Freudian t h e o r i e s . H e e x p e r i e n c e d a p r o f o u n d s e n s e o f liberation w h e n
h e first c a m e a c r o s s B i n s w a n g e r ' s p h e n o m e n o l o g i c a l c r i t i q u e o f t h e
Freudian paradigm. A t t h e t i m e h e d i s c o v e r e d B i n s w a n g e r , B o s s w a s
particularly u n e a s y a b o u t t h e h i g h h a n d e d f a s h i o n i n w h i c h Freudian
analysis dealt w i t h t h e p h e n o m e n a o f d r e a m s . N o w , his sight s h a r p e n e d
as a r e s u l t of B i n s w a n g e r ' s a c u t e o b s e r v a t i o n s , B o s s began to
" u n d e r s t a n d t h a t Freud had b e e n compelled t o i n v e n t his w h o l e t h e o r y o f
d r e a m s , as well as his n o t i o n of an ' u n c o n s c i o u s , ' b e c a u s e as a child of his
era he felt required to s u b j e c t the dream p h e n o m e n a , t o o , to the . . .

Introduction to the English Translation

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

I f B i n s w a n g e r ' s c r i t i q u e o f F r e u d ' s t h e o r e t i c a l t r a n s g r e s s i o n s fell upon

fertile g r o u n d for B o s s , his singling o u t o f p h e n o m e n o l o g y a s t h e p r o p e r
a p p r o a c h t o t h e study o f m a n p r o v e d t o b e o f e v e n m o r e c o n s e q u e n c e .
W h e n , a f t e r a long and u l t i m a t e l y disappointing d e t o u r via C a r l J u n g ,
B o s s finally c a m e t o grips directly w i t h H e i d e g g e r ' s o n t o l o g y , h e a t first
felt philosophically o v e r t a x e d , b u t t r e m e n d o u s l y e x c i t e d as well. His
i n t u i t i o n seizing u p o n islets of m e a n i n g in a vast sea of i n c o m p r e h e n s i o n ,
told h i m t h a t h e had c o m e u p o n s o m e t h i n g m o m e n t o u s . A p r o c e s s o f
t o t a l i m m e r s i o n i n t o H e i d e g g e r ' s o n t o l o g y , f u r t h e r e d l a t e r by a close
friendship with the philosopher, enabled Boss to articulate by degrees
w h a t h e had i n t u i t e d r i g h t a w a y . N o t o n l y did H e i d e g g e r ' s o n t o l o g y
p r o p o s e a r e c o n s t r u c t e d i m a g e of m a n t h a t boldly a b o l i s h e d long
e n t r e n c h e d a n t i n o m i e s , but this i m a g e also p r o v e d t o b e a m a z i n g l y
r e l e v a n t and applicable directly to p s y c h i a t r y and p s y c h o l o g y . In clinical
a r e a a f t e r clinical a r e a , B o s s d e m o n s t r a t e d t h e p o w e r o f H e i d e g g e r ' s
ideas t o i l l u m i n a t e t h e h u m a n r e a l i t i e s and u n r e a l i t i e s w i t h w h i c h t h e
p s y c h i a t r i s t finds h i m s e l f at grips in his daily w o r k .
T h u s H e i d e g g e r ' s so-called e x i s t e n t i a l s provided t h e basis for a n e w
p s y c h o d i a g n o s t i c s c h e m e . M o r e i m p o r t a n t l y , his Daseinsanalytik directly
c h a l l e n g e d and led to a radical redefinition of s u c h f u n d a m e n t a l n o t i o n s
a s reality and r e a l i t y - t e s t i n g , dispensed w i t h w h a t e v e r philosophical
respectability such concepts as the unconscious or repression might have
a c q u i r e d , and h i g h l i g h t e d t h e sterility w i t h w h i c h v a r i o u s c h r o n i c
p r e o c c u p a t i o n s had p r e v i o u s l y b e e n f r a m e d s u c h a s t h e b o d y - m i n d
q u e s t i o n . H e i d e g g e r ' s t r e n c h a n t philosophical analysis m a d e explicit b y
B o s s , e n d e d up by leveling, to a large d e g r e e , traditional d i s t i n c t i o n s
b e t w e e n psychic and o r g a n i c illness. T h e leveling o f t h e traditional
p a r t i t i o n s b e t w e e n p s y c h i a t r y and g e n e r a l m e d i c i n e w a s t h e inevitable
corollary.
T h e first b o o k b y M e d a r d B o s s t o r e f l e c t his H e i d e g g e r i a n approach
w a s Meaning and Content of Sexual Perversions, published in 1 9 4 7 . T h i s b o o k ,
subtitled "A Daseinsanalytic Contribution to the Psychopathology of the
P h e n o m e n o n o f L o v e , " p r e s e n t e d p h e n o m e n o l o g i c a l c a s e studies o f six
c a t e g o r i e s o f s e x u a l d e v i a n t s . T h e s e case studies w e r e n o t e w o r t h y for
t h e w a y in w h i c h t h e Gestalt, t h e e x i s t e n t i a l p a t t e r n i n g , of individual
h u m a n lives w a s p e r m i t t e d to a r t i c u l a t e itself, as it w e r e , u n d i m m e d by

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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

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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

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FOUNDATIONS

conflict p a t t e r n s o r e m o t i o n a l c o n s t e l l a t i o n s w a s called off. I n s t e a d , B o s s

a r t i c u l a t e d c h a r a c t e r i s t i c , pathologically c o n s t r i c t e d m o d e s o f being
w h i c h "bodied f o r t h , " a s h e put it, t h e n e x u s o f dislocations usually
labeled a s " p s y c h o s o m a t i c . " T h u s B o s s described t h e e x i s t e n t i a l s i t u a t i o n
c h a r a c t e r i s t i c for t h e h y p e r t e n s i v e a s t h a t o f being "walled-in alive." B o s s
n o t e d t h a t t h e s e p a t i e n t s w e r e typically trapped in a s o r t of p r e s s u r e
c o o k e r s i t u a t i o n w i t h o u t t h e s a f e t y valve o f e m o t i o n a l e x p r e s s i v e n e s s . H e
p o i n t e d out h o w , i n e x a c t a n a l o g y t o the c o n t r a c t i o n o f t h e i r e x i s t e n t i a l
space, t h e blood s t r e a m o f t h e s e p a t i e n t s "is s u b j e c t e d t o e v e r rising
p r e s s u r e i n t h e c o n f i n e m e n t o f n a r r o w i n g , calcifying v e s s e l s : thus this
kind of h y p e r t e n s i v e c o n t i n u e s to live until finally s o m e t h i n g w h i c h is
filled t o b u r s t i n g d o e s b u r s t . " C o n t r a s t i n g t h e h y p e r t e n s i v e with t h e
a c c i d e n t - p r o n e , B o s s w e n t on to say: " W h a t t e a r s in such p a t i e n t s is n o t ,
as in t h e c a s e s p r e v i o u s l y studied, a p e r i p h e r a l b o n e or s o m e m u s c l e
t i s s u e draped o v e r it, b u t r a t h e r i n accord w i t h t h e i r life style of stoic
f o r b e a r a n c e a blood vessel deep and s e c r e t in the body w h i c h , in
b u r s t i n g , r e l e a s e s t h e m from t h e t o o h e a v y b u r d e n o f e a r t h l y e x i s t e n c e . "
B o s s ' s v i e w o f " p s y c h o s o m a t i c " illness a s " b o d y i n g f o r t h " deficient
m o d e s o f b e i n g - i n - t h e - w o r l d w a s s o o n a b a n d o n e d b y h i m a t first
r a t h e r t e n t a t i v e l y t o t h e r e a l m o f o r g a n i c d i s e a s e . T h e first s t e p s o f this
e x t r a p o l a t i o n are t r a c e a b l e in his b o o k on p s y c h o s o m a t i c s . In t h e s a m e
b o o k , B o s s also b e g a n to redefine the role of the physician in
D a s e i n s a n a l y t i c t e r m s . In this p e r s p e c t i v e , it w a s n o t l o n g e r e n o u g h for
t h e d o c t o r t o b e a n e x p e r t r e p a i r m a n o f bodily o r psychic d y s f u n c t i o n s .
T h e D a s e i n s a n a l y t i c h e a l e r is called upon to deal w i t h t h e existential
l i m i t a t i o n s and deficiencies of w h i c h , in the D a s e i n s a n a l y t i c c a n o n ,
individual d i s e a s e s , b o t h psychic and o r g a n i c , a r e o r , at least, m a y
besymptomatic.
.In his n e x t m a j o r w o r k , Psychoanalyse and Daseinsanalytik ( 1 9 5 7 ) , " B o s s
l a u n c h e d his first s y s t e m a t i c a t t e m p t t o d i s m a n t l e Freud's t h e o r e t i c a l
s y s t e m . T a k i n g F r e u d at his w o r d t h a t his t h e o r i e s m a t t e r e d less than his
o b s e r v a t i o n s , B o s s t o o k u p and developed B i n s w a n g e r ' s earlier a r g u m e n t
t h a t p s y c h o a n a l y s i s is r e n t by a fatal i n t e r n a l c o n t r a d i c t i o n : t h a t t h e
empirical p h e n o m e n a t h e m a t i z e d b y F r e u d d o n o t really m e s h w i t h his
t h e o r i e s . It w a s o n l y logical, in B o s s ' s e y e s , to discard the t o p - h e a v y
t h e o r e t i c a l s t r u c t u r e , t h e m o r e so as he had c o m e to discern a
providential affinity b e t w e e n t h e empirical data o f p s y c h o a n a l y s i s and
H e i d e g g e r ' s m e t a p h y s i c s . ( B o s s even w e n t s o far a s t o s u g g e s t t h a t
F r e u d , w h e n h e w a s n o t t h e o r i z i n g , was a n u n w i t t i n g e x i s t e n t i a l i s t
w h o s e historically c o n d i t i o n e d prejudices a l o n e p r e v e n t e d him from
r e c o g n i z i n g the full philosophical i m p o r t of his discoveries.)
In o r d e r to i l l u s t r a t e t h e s h o r t c o m i n g s of p s y c h o a n a l y t i c tht jorizing,

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B o s s focused o n the i n t e r p e r s o n a l p h e n o m e n o n o f t r a n s f e r e n c e which,

by w i d e s p r e a d c o n s e n s u s , is c e n t r a l to the p s y c h o t h e r a p e u t i c p r o c e s s .
B o s s a r g u e d t h a t t h e w h o l e n o t i o n o f t r a n s f e r e n c e i s based upon r a t h e r
d e b a t a b l e p r e s u p p o s i t i o n s , such as t h e e x i s t e n c e of m o r e or less isolated,
d e t a c h a b l e feelings w h i c h can be t r a n s p o r t e d ( t r a n s f e r r e d ) from o n e love
o b j e c t , e.g., t h e f a t h e r , to a n o t h e r , e.g., the t h e r a p i s t . T h e r e is also t h e
a s s u m p t i o n t h a t t r a n s f e r e n c e love is v e r y d i f f e r e n t in kind f r o m g e n u i n e
love, e v e n t h o u g h F r e u d B o s s m a i n t a i n s w a s u n a b l e t o d i f f e r e n t i a t e
t h e o n e clearly from t h e o t h e r . N o t only i s t r a n s f e r e n c e love a s s u m e d t o
be d i f f e r e n t in kind; it is also v i e w e d as less real. T h e t h e r a p i s t loved by
his p a t i e n t with t r a n s f e r e n c e love is held n o t to be the real o b j e c t of this
love. W h i l e this r e d u c t i o n of t h e love p h e n o m e n a arising in p s y c h o t h e r
apy is i n t r i n s i c to p s y c h o a n a l y t i c t h e o r i z i n g , it is c e r t a i n l y n o t dictated by
these p h e n o m e n a themselves. Boss dispenses with theoretical construc
t i o n s a b o u t t h e t r a n s f e r o f d e t a c h a b l e feelings f r o m o n e o b j e c t t o a n o t h e r
and g r a n t s t h e m t h e reality t h e y display w h e n g i v e n t h e i r full s w a y . H e
feels t h a t such a p h e n o m e n o l o g i c a l approach, l o a t h t o d e r e a l i z e w h a t e v e r
m a n i f e s t s itself, e n h a n c e s n o t o n l y o u r p o w e r s o f a p p r e h e n s i o n , but also
o u r t h e r a p e u t i c e f f e c t i v e n e s s . A n d indeed, t h e i l l u s t r a t i v e c a s e h i s t o r y
n e a r t h e end of Psychoanalyse und Daseinsanalytik m a k e s a v e r y s t r o n g case
for t h e p o w e r o f a r t i c u l a t i o n and t h e r a p e u t i c p o t e n c y o f D a s e i n s a n a l y s i s .
T h e t h e m e s a d u m b r a t e d i n B o s s ' s w o r k s discussed s o far w e r e fully
developed and o r c h e s t r a t e d in his m o n u m e n t a l Grundriss der Medizin
( 1 9 7 1 ) o f w h i c h t h e p r e s e n t v o l u m e i s t h e s o m e w h a t abridged E n g l i s h
v e r s i o n . T h i s w o r k w a s b o u n d t o stir u p c o n t r o v e r s y i n t h a t i t e x t e n d e d
B o s s ' s c r i t i q u e o f t h e applicability o f t h e n a t u r a l s c i e n c e p a r a d i g m t o
m a n from t h e a r e a o f 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 t o t h e vast r e a l m o f
g e n e r a l medicine. W h e r e a s B o s s ' s e a r l i e r w o r k s a r g u i n g t h e i n a d e q u a c y
o f t h e n a t u r a l s c i e n c e p a r a d i g m i n p s y c h i a t r y did n o t a r o u s e m u c h
p a s s i o n a t e c o n t r o v e r s y , his i n c u r s i o n i n t o t h e w e l l - d e f e n d e d d o m a i n o f
somatic medicine was an entirely different matter. Unlike theologians,
B o s s ' s medical c o l l e a g u e s s e e m e d quite disposed n o t t o c o n t e s t t h e
p o s s e s s i o n of the h u m a n soul by D a s e i n s a n a l y s i s as long as it did n o t
meddle w i t h t h e i r claims t o t h e h u m a n body. B u t w h e n D a s e i n s a n a l y s i s
began to trespass upon their ground, the temperature of criticism from
t h e medical r a n k s r o s e n o t i c e a b l y .
S u c h zeal in t h e c a u s e of o r t h o d o x y s e e m e d hardly called for. B o s s is no
Ivan IUich; he is n o t i n t e n t upon b r i n g i n g d o w n t h e e n t i r e s t r u c t u r e of
m o d e r n m e d i c i n e . In fact, his c o n c e r n s are n o t primarily p r a g m a t i c , even
though bound to have important pragmatic consequences. Conceding
quite readily m o d e r n m e d i c i n e ' s v i r t u o s i t y i n m a n i p u l a t i n g t h e h u m a n
body, h e m e r e l y i n q u i r e s w h e t h e r such m a s t e r y g u a r a n t e e s i n a n y w a y

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

B o s s ' s critique of t h e n a t u r a l scientific paradigm in m o d e r n medicine is

based upon his f u n d a m e n t a l distinction b e t w e e n t h e realm of o b j e c t s and
t h e realm of m a n . O n l y m a n is said to exist in t h e precise s e n s e given to
this t e r m by H e i d e g g e r ' s o n t o l o g y of Da-sein. T h i s implies, a l m o s t by
definition, t h a t the w h o l e h u m a n realm, inclusive o f the h u m a n body,
c a n n o t be a p p r e h e n d e d a d e q u a t e l y in t e r m s of a paradigm (the n a t u r a l
scientific o n e ) o r i g i n a t i n g from and fully s o v e r e i g n o n l y in t h e
n o n h u m a n realm. W h a t H e i d e g g e r and B o s s a r e aiming at, in o t h e r
w o r d s , i s t o w i t h d r a w t h e h u m a n body from the d o m a i n o f n a t u r e w h e r e
D e s c a r t e s had placed it and to r e i n t e g r a t e it into the e x i s t e n t i a l r e a l m .
H e n c e t h e i m p o r t a n c e a t t a c h e d to t h e t e r m bodyhood s t r e s s i n g , as it does,
the q u a s i - i m m a t e r i a l a s p e c t s o f t h e bodily side o f m a n .
In o r d e r to r e m a i n close to i m m e d i a t e e x p e r i e n c e , Foundations is
o r g a n i z e d a r o u n d a case h i s t o r y d r a w n from medical practice. Using t h e
a s t u t e l y c h o s e n c a s e o f R e g u l a Z i i r c h e r a s a point o f a n c h o r a g e for t h e
w h o l e c o m p l e x l y s t r u c t u r e d w o r k t u r n s out to be a didactic m a s t e r
s t r o k e . It e n d o w s t h e b o o k w i t h an a m a z i n g s e n s e of u n i t y and
c o h e r e n c e , besides b e s t o w i n g upon R e g u l a Z i i r c h e r , w h o i s viewed from
e v e r v a r y i n g p e r s p e c t i v e s and t h r o u g h t h e m o s t diverse t h e o r e t i c a l
l e n s e s , a n a b u n d a n c e o f i n c a r n a t i o n hardly e v e r v o u c h s a f e d t o t h e
subject o! a medical case study.
I )l part icular i n t e r e s t to m o s t readers will be t h e w a y in w h i c h M e d a r d
B o s s draws upon the s o m a t i c illnesses and t r i b u l a t i o n s of his h e r o i n e to

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xix

illustrate his r e f o r m u l a t i o n o f t h e b o d y - m i n d issue. R e a d i n g t h e s e

s e c t i o n s o f the b o o k closely o n e realizes t h a t t h e s a m e o r g a n i c disease
befalling different individuals is n o t t h e s a m e disease. E v e r y t h i n g h i n g e s
on the existential context, as Boss's passages about the existential
m e a n i n g of a h e r n i a or a f r a c t u r e d tibia m a k e clear. If, as B o s s believes,
even t h e s e e m i n g l y m o s t trivial physical a c c i d e n t a f f e c t s t h e p e r s o n ' s
w h o l e b e i n g - i n - t h e - w o r l d , it follows t h a t no illness can be c o n s i d e r e d to
have b e e n truly cured u n l e s s t h e d i s t o r t i o n s o f b e i n g - i n - t h e - w o r l d
c o r r e l a t e d w i t h it a r e also c o r r e c t e d . T h u s , in f o r m u l a t i o n s of stress, B o s s
t r i e s t o establish n o t o n l y t h e p s y c h o l o g i z a t i o n o f o r g a n i c i t y , b u t also t h e
need for a truly c o m p r e h e n s i v e e x i s t e n t i a l t h e r a p y w h i c h in t h e face of
any f o r m o f illness n e v e r loses s i g h t o f t h e total c o n f i g u r a t i o n o f t h e
s u f f e r e r ' s Da-sein and does n o t c o n s i d e r its task a c c o m p l i s h e d w h e n it has
r e s t o r e d o p t i m a l physical f u n c t i o n i n g . O n c e a p a t i e n t w h o s e s e x u a l
c o n t a c t s are limited t o call girls h a s b e e n c u r e d o f t h e g o n o r r h e a t h a t
b r o u g h t h i m t o medical a t t e n t i o n , t h e main p r o b l e m still r e m a i n s t o b e
t a c k l e d a c c o r d i n g t o B o s s . T h e q u e s t i o n s n e e d t o b e raised, B o s s feels,
W h a t peculiar c o n s t r i c t i o n s o f t h e p e r s o n ' s e x i s t e n t i a l p o t e n t i a l c o m p e l
h i m t o h a v e r e c o u r s e t o t h e c h e a p c o i n a g e o f c o u n t e r f e i t l o v e ? and H o w
can h e b e helped t o o v e r c o m e t h e s e g r o w t h - s t u n t i n g l i m i t a t i o n s (which,
incidentally, e x p o s e h i m c o n t i n u o u s l y t o t h e risk o f r e i n f e c t i o n ) ?
N o less a r r e s t i n g t h a n B o s s ' s p a s s a g e s a b o u t t h e e x i s t e n t i a l d i m e n s i o n s
o f o r g a n i c illnesses are his o b s e r v a t i o n s a b o u t s c h i z o p h r e n i a , " t h e m o s t
h u m a n and the m o s t i n h u m a n of all d i s e a s e s , " and a p a r t i c u l a r l y pivotal
o n e w i t h i n t h e D a s e i n s a n a l y t i c paradigm. W h a t m a k e s B o s s ' s t r e a t m e n t
of s c h i z o p h r e n i a so striking is t h a t he deals w i t h it p r i m a r i l y u n d e r t h e
heading of "the pathology of (existential) freedom." Boss sees as the
e s s e n t i a l f e a t u r e o f s c h i z o p h r e n i c illness t h e a b r o g a t i o n o f t h e m o s t basic
e x i s t e n t i a l ( c o n s t i t u e n t ) of h u m a n Da-seinits f u n d a m e n t a l f r e e d o m and
o p e n n e s s t o w a r d o t h e r h u m a n b e i n g s and t o w a r d the w h o l e realm o f
phenomena.
B o s s ' s e m p h a s i s o n t h e s c h i z o p h r e n i c ' s f o r f e i t u r e o f his e x i s t e n t i a l
a u t o n o m y , on his being engulfed and d e v o u r e d by t h e b e i n g s and o b j e c t s
h e m e e t s w i t h , e n a b l e s u s t o r e c o g n i z e t h e overall c o n f i g u r a t i o n s o f
s c h i z o p h r e n i c m o d e s of being as well as t h e i r m o s t s u b t l e a r t i c u l a t i o n s . A
case in p o i n t is t h a t of t h e s c h i z o p h r e n i c patient of F. F i s c h e r c o m m e n t e d
upon b y B o s s . W h e r e a s F i s c h e r i n t e r p r e t e d the patient's c o m m u n i c a t i o n s
as indicative of the collapse of his " t e m p o r a l - s p a t i a l f r a m e of r e f e r e n c e , "
B o s s , less t h e o r y - b o u n d , n o t e d t h a t this patient w h o kept talking a b o u t
his clock w a s n o t really c o n c e r n e d w i t h its t i m e - m e a s u r i n g p r o p e r t i e s .
R a t h e r h e w a s w h o l l y p r e o c c u p i e d w i t h the different w a y s h e related t o
t h e clock and the clock to him: At t i m e s he would e x p e r i e n c e it as t h e

XX

EXISTENTIAL

FOUNDATIONS

familiar, clearly d e l i n e a t e d clock on t h e wall, a significant object in a

w o r l d of o b j e c t s t h a t g r a n t e d him a dwelling place; at o t h e r m o m e n t s , it
dissolved i n t o a " m e r e " clock, cut o f f f r o m its m o o r i n g s in t h e
e n v i r o n m e n t , floating in a d i r e c t i o n l e s s , h o m o g e n i z e d space i n t o w h i c h
t h e p a t i e n t w a s s w e p t , b e n u m b e d and " d i s p e r s e d , " r o b b e d o f t h e " t h r e a d
to [ h i m s e l f ] . " It w a s t h e h e l p l e s s , passive s w a y i n g b a c k and f o r t h b e t w e e n
t h e s e t w o m o d e s o f e n c o u n t e r w i t h t h e clock, and t h e v e r t i g o a t t e n d a n t
upon this loss o f e x i s t e n t i a l a u t o n o m y , w h i c h i n B o s s ' s v i e w
constituted the main c o n t e n t of the patient's communications.
B o s s ' s r e s p e c t for w h a t is i m m e d i a t e l y given in e x p e r i e n c e , in w h a t e v e r
guise it m a y p r e s e n t itself, also i n f o r m s his a t t i t u d e t o w a r d so-called
h a l l u c i n a t o r y o r delusional p h e n o m e n a . S i n c e D a s e i n s a n a l y s i s does n o t
r e c o g n i z e the c o n s t r u c t w e call o b j e c t i v e o r i n t e r s u b j e c t i v e reality a s t h e
u l t i m a t e judge of w h a t is real, t h e d a s e i n s a n a l y s t has little difficulty in
t a k i n g a s c h i z o p h r e n i c ' s h a l l u c i n a t o r y e x p e r i e n c e s for real. In doing so,
w i t h o u t c o n d e s c e n s i o n o r l a b o r i o u s s u s p e n s i o n o f disbelief, t h e
daseinsanalyst gains the great advantage of an immediate relatedness
with the schizophrenic patient.
W h i l e n o t q u e s t i o n i n g t h e r e a l n e s s o f w h a t discloses itself i n
hallucinatory experiences, the daseinsanalyst wants to know what
specific m o d i f i c a t i o n s o f n o r m a l b e i n g - i n - t h e - w o r l d give rise t o such
e x p e r i e n c e s . I n t h e t h r e e c a s e s o f s c h i z o p h r e n i c forfeit o f a u t o n o m y
discussed by B o s s , this q u e s t i o n is p a r a m o u n t . T h u s t h e Sun-Man's b r i t t l e ,
s e q u e s t e r e d w o r l d has collapsed w h e n he felt b e t r a y e d by his o n l y friend.
A s o r t of e x p l o s i v e d e c o n s t r i c t i o n of his e x i s t e n t i a l space had o c c u r r e d ,
and i n t o this e x i s t e n t i a l v a c u u m s o m e t h i n g " s u p e r n a t u r a l , " " s t r o n g e r
t h a n m a n , " had s u r g e d t h e weird, spectral ("hallucinated") sun t h a t
h a u n t e d him for a w h o l e n i g h t . T h e p a t i e n t ' s a g o n y o f f o r l o r n n e s s had
m a d e t h e sun e m e r g e i n t o its b o u n d l e s s n e s s and reveal itself to h i m in a
w a y t h a t u p t o t h e n h e had n e v e r i m a g i n e d . " . . .he w a s 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 s u n , w h i c h f a s c i n a t e d him and
t h r e a t e n e d t o 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 the 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 f r i e n d " (pp. 3 7 5 - 3 7 6 ) . B o s s is at pains to point o u t t h a t
this e n t i r e l y n e w reality of the i n c a n d e s c e n t sun w a s as real for t h e
p a t i e n t as his f o r m e r reality, if n o t m o r e so.
A r t i c u l a t i n g t h e e x i s t e n t i a l situation o f t h e s c h i z o p h r e n i c e n a b l e s t h e
d a s e i n s a n a l y s t to induce c h a n g e s in this s i t u a t i o n t h a t a r e apt to m a k e
d r a m a t i c s y m p t o m s o f p s y c h o s i s vanish a s i f b y m a g i c . S i n c e D a s e i n s a n
alysis does n o t look upon s c h i z o p h r e n i a as a p r o c e s s w i t h a d y n a m i s m
m o r e or less its o w n , but v i e w s the p a t h o l o g i c a l s y n d r o m e as t h e
i m m e d i a t e c o n c o m i t a n t of a c e r t a i n d e f e c t i v e m o d e of b e i n g - i n - t h e -

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w o r l d , it is plausible t h a t a n y beneficial c h a n g e in this m o d e , h o w e v e r

e f f e c t e d , will lead to an a b a t e m e n t of s y m p t o m s . W h a t is c h a r a c t e r i s t i c of
t h e d e f e c t i v e m o d e of being called s c h i z o p h r e n i c is, according to
D a s e i n s a n a l y s i s , t h e d i s c r e p a n c y b e t w e e n t h e d e m a n d s i m p o s e d b y his
e x i s t e n t i a l situation upon t h e s c h i z o p h r e n i c and his ability to cope w i t h
these demands. In other words, the schizophrenic is somebody who has
been existentially overtaxed. In the eyes of the daseinsanalyst, there is no
s c h i z o p h r e n i a or s c h i z o p h r e n i c per se. In t h e p r e s e n c e of each p a t i e n t ,
the q u e s t i o n n e e d s to be asked: S c h i z o p h r e n i c due to t h e (for this p e r s o n )
e x c e s s i v e d e m a n d s o f w h a t kind o f e x i s t e n t i a l s i t u a t i o n ? And i f t h e
d e m a n d s o f t h e s i t u a t i o n a r e judiciously r e d u c e d f o r i n s t a n c e , b y
e n a b l i n g t h e p a t i e n t to lead a m o r e s h e l t e r e d , m o r e childlike e x i s t e n c e
e v e r y t h i n g s c h i z o p h r e n i c a b o u t a g i v e n p a t i e n t m a y suddenly fade a w a y
as if it had n e v e r e x i s t e d . Of c o u r s e , in this case t h e d a s e i n s a n a l y s t will
n o t f l a t t e r h i m s e l f of h a v i n g p r o d u c e d a c u r e . T h e r e s t r u c t u r i n g of a
p a t i e n t ' s e x i s t e n t i a l s i t u a t i o n b y e x t e r n a l i n t e r v e n t i o n m u s t b e followed
b y t h e l a b o r i o u s p r o c e s s o f a p p r o p r i a t i n g u n r e a l i z e d m o d e s o f being.
T h e final c h a p t e r s o f t h e p r e s e n t b o o k c o n v e y t h e e s s e n c e o f B o s s ' s
t h e r a p e u t i c m o d e o f o p e r a t i o n s . T h e y amply s u p p o r t his claim t h a t
D a s e i n s a n a l y s i s c a t a l y z e s t h e fullest possible r e a l i z a t i o n o f the h u m a n
potential inherent in the therapeutic encounter. T h e therapist's
r e a d i n e s s t o open h i m s e l f widely (and w i t h o u t t h e s u b t e r f u g e o f
theoretical dogmatism) to w h a t e v e r manifests itself in the interpersonal
space c l e a r e d b y t h e r a p y , his w i l l i n g n e s s t o w e l c o m e t h e p h e n o m e n a
appearing t h e r e a s real, n o m a t t e r h o w o u t l a n d i s h t h e i r g u i s e t h i s
o p e n - a r m e d , h o s p i t a b l e s t a n c e f r e e s t h e a n a l y s a n d i n his t u r n t o u n b e n d ,
t o e x p e r i e n c e w i t h p r e v i o u s l y d i s o w n e d m o d e s o f c o n d u c t , and t o
g r a d u a l l y m a k e t h e m his o w n .
T h e a u t h o r o f this i n t r o d u c t i o n had occasion t o talk t o f o r m e r p a t i e n t s
o f M e d a r d B o s s . T h e y s t r e s s e d h o w p r o f o u n d l y and dependably t h e y felt
u n d e r s t o o d and s u p p o r t e d , f r o m t h e v e r y first t h e r a p y h o u r , b y B o s s ' s
prodigal r e c e p t i v e n e s s . It is safe to a s s u m e t h a t B o s s ' s g r e a t n a t u r a l
w a r m t h and e m p a t h y , w h i c h e v e n his o p p o n e n t s c o n c e d e , play a large
role in inviting t h e s p o n t a n e o u s t r u s t of people w h o , a l m o s t by
definition, are m o s t p a r s i m o n i o u s w i t h t h e i r t r u s t . B u t , t h e n , it is equally
safe t o a s s u m e t h a t i t w a s n o c h a n c e h a p p e n i n g w h i c h m a d e M e d a r d B o s s
d i s c o v e r in H e i d e g g e r ' s Daseinsanalytik t h e f o u n d a t i o n s of a boldly
h u m a n i s t i c medicine and p s y c h o l o g y .
Paul ] . S t e r n

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

mechanization of the image of man.

2. In The Structure of Scientific Revolutions ( C h i c a g o : U n i v e r s i t y of C h i c a g o P r e s s , 1 9 6 2 ) .
3. In L . J . P o n g r a t z , ed., Psychotherapie in Selbstdarstellungen ( B e r n : H a n s H u b e r , 1 9 7 3 ) , pp.
87-88.
4. Der

Traum

5. Einfhrung

und
in

seme

Auslegung.

(Bern:

Hans

Huber,

1953).

die psychosomatische Medizin ( B e r n : H a n s H u b e r , 1 9 5 4 ) .

6. P u b l i s h e d in a m u c h e x p a n d e d E n g l i s h v e r s i o n as Psychoanalysis ami Daseinanalysis. INew

York:

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

line between general medicine and medical psychology almost to the

FROM THE PREFACE

TO THE FIRST EDITION

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

Heidegger's watchful eye. T h e r e is not one section of "philosophical"

i m p o r t w h i c h w a s denied his g e n e r o u s c r i t i c i s m .
N o w a d a y s , a n y a t t e m p t to put f o r t h a f o u n d a t i o n of medicine is likely
to run t h e risk of b e i n g c o n d e m n e d by medical opinion as "purely
p h i l o s o p h i c a l " t h a t is, as i r r e l e v a n t and devoid of practical potential. To
m a n y in t h e h u m a n i t i e s , by c o n t r a s t , a f o u n d a t i o n like the o n e s k e t c h e d
h e r e m u s t s e e m " t o o s i m p l e . " I n o u r age o f logistics and c y b e r n e t i c s ,
usually o n l y the m o s t c o m p l e x and a b s t r a c t s c h e m e s m a y pass for t r u t h .
Y e t I h a v e tried at all t i m e s to k e e p e x c l u s i v e l y to w h a t could be k n o w n
simply and directly, an a t t i t u d e w h i c h has s u b j e c t e d me on occasion to t h e
c r i t i c i s m o f being " t o o u n p h i l o s o p h i c a l , " o r e v e n " n a i v e . "
T h e m e m b e r s o f t h e C o m m i t t e e for t h e S w i s s National Fund
(Kommission des Schweizerischen Nationalfonds), from t h e sciences and from the
h u m a n i t i e s alike, w e r e n o t m o v e d b y t h e s e p r e j u d i c e s , h o w e v e r . T h e i r
impartial g e n e r o s i t y m e r i t s a v e r y special e x p r e s s i o n of t h a n k s .
February 1 9 7 0

Medard Boss

PREFACE TO THE SECOND EDITION

T h e fact t h a t this b o o k h a s already g o n e i n t o a s e c o n d edition, despite

the d e m a n d s it m a k e s of its r e a d e r s , should be t a k e n as p r o o f of a wide
n e e d for a n e w and s o u n d e r basis of medical t h e o r y and p r a c t i c e . T h e title
of t h e first edition, as it t u r n e d o u t , failed to e x p r e s s t h e a u t h o r ' s original
i n t e n t ; it s e e m e d to indicate t h a t t h e b o o k could be u n d e r s t o o d o n l y by
physicians. I had a s s u m e d w i t h t o o m u c h h a s t e t h a t e v e r y o n e w o u l d
r e c o g n i z e a f o u n d a t i o n of m e d i c i n e b a s e d on h u m a n n a t u r e as,
n e c e s s a r i l y , a f o u n d a t i o n of p s y c h o l o g y and s o c i o l o g y as well. In a n y c a s e ,
this e r r o r has n o w b e e n c o r r e c t e d b y e x p a n d i n g t h e title o f t h e s e c o n d
edition to read Foundation of Medicine and Psychology. T h e r e a d e r n e e d no
l o n g e r r e f e r to a l e n g t h y s u b t i t l e for clarification. In k e e p i n g w i t h t h e
n e w title, m o r e space h a s n o w b e e n given t o discussing traditional
psychological c o n c e p t s .
Spring 1 9 7 4

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

m u s t u n d e r t a k e a g a i n and again t o r e t h i n k and r e a r t i c u l a t e t h e p r e m i s e s

on w h i c h it is based. O n l y this can a s s u r e reliable f u n c t i o n i n g and
p r o d u c t i v i t y for t h e s c i e n c e . T h e e x e r c i s e also s e r v e s t o r e m i n d i t o f its
proper domain, protecting against boundary transgressions whose
c o n s e q u e n c e s are, p r e d i c t a b l y , c o n f u s i o n o f i n t e n t and m i s u s e o f m e t h o d .
B e n e a t h t h e f o u n d a t i o n s o f m o d e r n m e d i c i n e , u n d e r l y i n g all o f its
t h e o r i e s and all of its t h e r a p e u t i c p r o c e d u r e s , lies a c o n c e p t i o n of n a t u r e
w h o s e currency has risen markedly with the development of modern
n a t u r a l s c i e n c e . T h e medical application t o h u m a n b e i n g s o f c o n c e p t s and
r e s e a r c h m e t h o d s d r a w n f r o m t h e n a t u r a l s c i e n c e s led, a m o n g o t h e r
t h i n g s , t o t h e r a p e u t i c a c h i e v e m e n t s t h a t s u r p a s s e d all e x p e c t a t i o n .
T a k e n b y t h e m s e l v e s , t h e s e a c h i e v e m e n t s leave n o r o o m t o d o u b t t h a t
this kind of application of the n a t u r a l scientific r e s e a r c h m e t h o d is
justifiable and n e c e s s a r y . Y e t t h e e x t e n t t o w h i c h this m e t h o d i s justified
in claiming total d o m i n i o n o v e r medicine is m o r e h o t l y c o n t e n d e d today
than ever before.
T o keep o u r s t u d y o f f u n d a m e n t a l s r o o t e d i n i m m e d i a t e e x p e r i e n c e ,
we shall use a t e s t c a s e . It will d e m o n s t r a t e t h e l e g i t i m a c y of the positive
r e s u l t s o f medical r e s e a r c h m e t h o d s t o d a t e and will a t the s a m e t i m e
s h o w t h e limits o f t h e s e m e t h o d s . T h e c a s e h i s t o r y p r e s e n t e d h e r e h a s
b e e n d r a w n from medical p r a c t i c e and is well suited to the r e q u i r e m e n t s
o f this d e m o n s t r a t i o n . All c o n s i d e r a t i o n s w h i c h follow t h e case are
o r i e n t e d t o w a r d factually r e p o r t e d e v e n t s o f t h e p a r t i c u l a r h u m a n
existence they represent.
A s s u m i n g t h a t the t r u e s u b j e c t m a t t e r o f m e d i c i n e i s m a n , the w h o l e
reality o f d a y - t o - d a y h u m a n e x i s t e n c e , w e shall l e a r n from o u r study t h a t
t h e n a t u r a l scientific a p p r o a c h repeatedly finds i t s e l f c o n f r o n t i n g a r e a l m
to w h i c h it c a n n o t gain a c c e s s . It is precisely t h e e s s e n c e of the w a y people
b e h a v e a m o n g t h e m s e l v e s i n t h e i r daily lives, h o w t h e y c o n d u c t
t h e m s e l v e s t o w a r d t h e w o r l d and o t h e r c r e a t u r e s , t h a t m o d e r n
m e d i c i n e ' s n a t u r a l scientific r e s e a r c h m e t h o d fails e v e n t o a p p r o a c h ,
m u c h less to clarify in its u n i q u e n e s s .
We shall look at e f f o r t s b o t h psychological and p s y c h o s o m a t i c t h a t
p r o p o s e t o s u p p l e m e n t t h a t 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
and m a k e a n a l l - e n c o m p a s s i n g w h o l e . B u t w h e n t h e y a r e t e s t e d a g a i n s t
t h e case h i s t o r y , t h e s e p s y c h o l o g i c a l and p s y c h o s o m a t i c e x p l a n a t i o n s ,
t o o , c o m e u p a g a i n s t the b o u n d a r i e s o f t h a t r e a l m w h i c h has already
p r o v e n inaccessible t o 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 . T h i s i n
turn
requires an e x a m i n a t i o n o f the basic a s s u m p t i o n s o f t h e
psychological and p s y c h o s o m a t i c s c i e n c e s .
( )ui 11 c . h i o n s i d e r a l i o n of principles leads to t h e c o n c l u s i o n of P a r t I:
the psychological a n d p s y c h o s o m a t i c a s well a s t h e natural scientific

Introduction

xxix

r e s e a r c h m e t h o d s of m e d i c i n e a c c o u n t far t o o p o o r l y for a fact t h a t is, in

fact, f u n d a m e n t a l . T h e y largely o v e r l o o k h o w radically t h e n a t u r e o f
t h e i r o b j e c t o f s t u d y h u m a n r e a l i t y d i f f e r s from t h e m a k e u p o f e v e r y
o t h e r r e a l m k n o w n t o us.
L e t us t h e r e f o r e give u r g e n t e m p h a s i s and t e r m i n o l o g i c a l precision to
this d i f f e r e n c e b e f o r e we begin. We declare t h a t only m a n exists. T h i s is
n o t t o say t h a t m a t e r i a l , i n o r g a n i c n a t u r e and n o n h u m a n b e i n g s
a n i m a l s and p l a n t s a r e in a n y s e n s e u n r e a l , i n s u b s t a n t i a l , or illusory
b e c a u s e t h e y do n o t so exist. We m e r e l y s t a t e t h a t t h e reality of t h e s e
n o n h u m a n r e a l m s differs f r o m t h a t o f h u m a n e x i s t e n c e , w h o s e p r i m a r y
c h a r a c t e r i s t i c is Da-sein (literally " b e i n g - t h e - t h e r e " ) .
I n s o f a r as Da-sein is t h e d i s t i n g u i s h i n g c h a r a c t e r i s t i c of h u m a n
e x i s t e n c e , t h e d e s i g n a t i o n Da-sem m u s t be u n d e r s t o o d in a s e n s e t h a t
differs f r o m the c u r r e n t u s a g e of t h e G e r m a n w o r d Dasein. As it is
c o m m o n l y used, Dasein signifies little m o r e t h a n p r e s e n c e , as for e x a m p l e
in p r o o f s of G o d ' s Dasein. T h e h u m a n being, t h o u g h , is a h u m a n being n o t
m e r e l y b e c a u s e he is, and can be o b s e r v e d to b e , s o m e t h i n g t h a t is
p r e s e n t . T h e table i n f r o n t o f m e , t h e s t o n e i n t h e g a r d e n t h e s e are
m e r e l y p r e s e n t . M a n as m a n is p r e s e n t , h o w e v e r , in a m a n n e r w h o l l y
d i f f e r e n t from t h e s e i n a n i m a t e t h i n g s . O u r e n t i r e d i s c u s s i o n h i n g e s
u p o n o u r ability t o c a s t light o n w h a t i s distinctively p e c u l i a r t o h u m a n
being, to s e e it and s t a y f o c u s s e d on it. O n l y t h e n , by p u t t i n g medicine on
a basis t h a t is suited to h u m a n b e i n g s and t h e i r Da-sein, shall we c a r r y o u t
the physician's charge.
T h e p a r t i c u l a r w a y i n w h i c h medical u n d e r s t a n d i n g t o date h a s
g e n e r a l l y b e e n s h o r t s i g h t e d p o i n t s t h e w a y for o u r o w n w o r k . W e begin
P a r t II by grappling o n c e again w i t h the familiar, individual, h e a l t h y
b e h a v i o r a l p h e n o m e n a o f o u r test case. T h i s t i m e , h o w e v e r , w e are
helped by a point of v i e w t h a t is totally d i f f e r e n t and m o r e suited to Da
sein. T o its vision, f e a t u r e s o f h u m a n being t h a t w e r e i n a c c e s s i b l e b e f o r e
are i m m e d i a t e l y r e c o g n i z a b l e .
T h e s e f e a t u r e s c o m e t o light w i t h o u t t h e n e e d for a b s t r a c t d e d u c t i o n s
or conclusions, without any speculative suppositions or hypotheses. T h e
initial v e r i f i c a t i o n of this n e w p e r s p e c t i v e is followed by an e x p l i c a t i o n of
t h e D a - s - b a s e d * u n d e r s t a n d i n g o f the h u m a n b e i n g ( w h i c h w a s t h e
implicit basis o f t h e p r e c e d i n g d e s c r i p t i o n s o f individual h e a l t h y
p h e n o m e n a i n o u r h u m a n t e s t s u b j e c t ) . T h i s explication p r e s e n t s t h e
traits o f h u m a n e x i s t e n c e t h a t a r e m o s t i m p o r t a n t for m e d i c i n e . T h e
c h a r a c t e r i s t i c s t r u c t u r e o f h u m a n e x i s t e n c e t h a t i s set f o r t h , t h o u g h i t
does n o t claim to be a c o m p r e h e n s i v e D a - s m i - b a s e d a n t h r o p o l o g y , will
s e r v e as a solid f o u n d a t i o n for m e d i c i n e . O n c e r e s t o r e d to this basis, the
e n t i r e s t r u c t u r e o f the c o n c e p t s and f u n d a m e n t a l a s s u m p t i o n s o f

XXX

EXISTENTIAL

FOUNDATIONS

p h y s i o l o g y and p s y c h o l o g y can be t r a n s f o r m e d i n t o a p h y s i o l o g y based

on h u m a n b e i n g s and a p s y c h o l o g y based on Da-sein.
R o u n d i n g o u t P a r t II is a c h a p t e r discussing t h e b a r r i e r s t h a t o b s t r u c t a
g e n u i n e t r a n s f e r o f t h e D a s e i n s a n a l y t i c p e r s p e c t i v e t o physicians
s c h o o l e d in n a t u r a l s c i e n c e and p s y c h o l o g y .
P a r t III, c o n t i n u i n g along familiar p r o c e d u r a l lines, b e g i n s by t e s t i n g
t h e D a s e i n s a n a l y t i c p e r s p e c t i v e a g a i n s t the individual pathological
s y m p t o m s of t h e t e s t c a s e . All t h e u n h e a l t h y p h e n o m e n a of a u n i q u e Dasein are h e r e disclosed as o u t c o m e s of failure to c a r r y o u t c e r t a i n basic
c h a r a c t e r i s t i c s o f h u m a n e x i s t e n c e . S t a r t i n g from t h e s e findings, P a r t III,
t h e " R u d i m e n t s o f a n E x i s t e n t i a l G e n e r a l P a t h o l o g y , " i s primarily
c o n c e r n e d w i t h c h a r a c t e r i z i n g all t h o s e h u m a n traits w h i c h until n o w
h a v e b e e n o b j e c t i f i e d and a b s t r a c t e d i n t o physical and psychic disease
symptoms as particular limitations in carrying various characteristics of
h u m a n e x i s t e n c e t o fulfillment.
T h i s r e s o l v e s a q u e s t i o n t h a t m a y h a v e a r i s e n for the reader during the
first c h a p t e r s o f this w o r k . T h e s e c h a p t e r s m a y i n m a n y w a y s h a v e
s e e m e d suited m o r e to the title Medunl Psychology t h a n to t h e actual
heading, Existential Foundations of Medicine and Psychology. B u t t h e s t a t e m e n t s
c o n c e r n i n g 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 s u b s t a n t i a t e t h e fact
t h a t Medical Psychology and Foundation of Medicine are identical. Medical
p s y c h o l o g y is in i t s e l f t h e f o u n d a t i o n of m e d i c i n e in g e n e r a l . It is so by
v i r t u e of h u m a n n a t u r e . T h e a s s u m p t i o n h e r e is t h a t Medical Psychology
finally r e l i n q u i s h e s its d o m i n a n t c o n c e p t o f p s y c h e , t h e r e b y o v e r c o m i n g
and b r o a d e n i n g its l i m i t a t i o n s to b e c o m e a discipline of Da-sein and of
h u m a n life in this world.
T h e f o u r t h and final part o f this w o r k a n a l y z e s t h e c o n s e q u e n c e s for
t h e r a p y held in a m o r e Da-smi-based and m o r e h u m a n f o u n d a t i o n of
m e d i c i n e . H e r e w e h a v e deliberately r e s t r i c t e d o u r s e l v e s t o e m p l o y i n g
c o m p a r a t i v e s , for it is n o t t h e purpose of this s t u d y to a r o u s e even t h e
suspicion that w e c o n s i d e r this g r o u n d w o r k t h e o n l y possibility, o r o n e
t h a t is definitive for all t i m e . B u t as t h i n g s stand today, t h e r e a p p e a r s to
be no s o u n d e r basis for medicine b e f o r e us.
If this is actually so, t h e n o u r f o u n d a t i o n o w e s its s t r e n g t h to the
p r e s c i e n t i f i c philosophical basis w i t h o u t w h i c h its s u b s e q u e n t scientific
a s s e r t i o n s would b e i m p o s s i b l e . W e h a v e already discussed t h e
t h e o r e t i c a l d e p e n d e n c e of all scientific r e s e a r c h upon philosophical
p r e s u p p o s i t i o n s a b o u t its o b j e c t s o f study. J u s t a s t h e t r a d i t i o n a l n a t u r a l
scientific and psychological f o u n d a t i o n s for m e d i c i n e g r e w o u t ofand
still d r a w t h e i r vitality w h o l l y f r o m t h e p r e s c i e n t i f i c philosophical
c o n c e p t i o n o f n a t u r e r e p r e s e n t e d b y D e s c a r t e s , G a l i l e o , and N e w t o n , s o
M a r t i n H e i d e g g e r ' s philosophical D a s e i n s a n a l y t i k first cleared g r o u n d

Introduction

xxxi

f o r o u r p h e n o m e n o l o g i c a l f o u n d a t i o n for m e d i c i n e and for p s y c h o l o g y .

Heidegger's fundamental philosophic thinking never revolved around
m a n t a k e n by h i m s e l f . F r o m t h e first it w a s directed, r a t h e r , t o w a r d
s e e k i n g t h e m e a n i n g o f B e i n g a s s u c h . Y e t this f u n d a m e n t a l o n t o l o g i c a l
inquiry i n t o B e i n g can n e i t h e r b e tackled n o r r e s o l v e d u n l e s s w e can
explain a t t h e s a m e t i m e t h e n a t u r e o f h u m a n b e i n g s and o u r primal
being t o g e t h e r in a s h a r e d world. T h u s the decisive i m p o r t a n c e of M a r t i n
H e i d e g g e r ' s D a s e i n s a n a l y t i k for m e d i c i n e and p s y c h o l o g y .
* Editor's note: A l t h o u g h t h e G e r m a n Daseinsgemdss is h e r e a n d t h r o u g h o u t t h e b o o k
translated as " D a s e i n - b a s e d , " phrase "appropriate to the D a s e i n " might be n e a r e r the mark.
For r e a s o n s of style, h o w e v e r , and to maintain c o n s i s t e n c y with earlier translations of D r .
Boss's work, the f o r m e r translation has been retained. "Appropriate to the D a s e i n " might
also be used in certain passages as an alternate rendering w h e r e the adjectives "existential"
and " D a s e i n s a n a l y t i c " appear. T h e reader m a y m a k e the substitution for h i m s e l f w h e r e v e r
a g a i n in u n d e r s t a n d i n g m i g h t r e s u l t .

Part
T h e Traditional Foundation
o f Medicine

Chapter 1
A TEST CASE: REGULA ZRCHER

T h e first fact t h a t t h e p a t i e n t ' s m o t h e r r e p o r t e d a b o u t R e g u l a Z i i r c h e r

was that t h e infant r e q u i r e d t h e help of a pediatrician j u s t a few w e e k s
.il ter h e r b i r t h w h e n s h e developed a c u t e w e e p i n g e c z e m a t h a t c o v e r e d
I u imarily large a r e a s of h e r a r m s and legs.
I h e family medical h i s t o r y , w h i c h this first p h y s i c i a n o f R e g u l a
/ ii ri h e r had already t a k e n w i t h g r e a t c a r e , indicated no m a j o r h e r e d i t a r y
taint. N o n e o f h e r a n c e s t o r s o r close r e l a t i v e s h a d s u f f e r e d f r o m
n e u r o l o g i c a l o r m e n t a l d i s o r d e r s o r f r o m any allergies. O n t h e c o n t r a r y ,
e v e r y o n e d e s c r i b e d b o t h h e r p a t e r n a l and h e r m a t e r n a l families a s
pai ticularly v i g o r o u s a n d h e a l t h y people.
r h e t r e a t m e n t o f t h e i n f a n t ' s e c z e m a t u r n e d o u t t o b e v e r y difficult
and p r o l o n g e d . S e v e r a l y e a r s o f medical c a r e w e r e n e e d e d b e f o r e t h e
e x a g g e r a t e d irritability o f h e r skin subsided. B u t e v e n a f t e r t h e e c z e m a
finally receded, R e g u l a Z i i r c h e r still held t h e s c h o o l r e c o r d s f o r a b s e n c e
due to illness. C o l d s and e n i g m a t i c s t o m a c h a c h e s kept h e r c o n s t a n t l y in
bed, h e n s h e w a s s e v e n , h e r t o n s i l s , w h i c h w e r e i n f e c t e d m u c h o f t h e
time, had to be r e m o v e d . At t h e age of fifteen, w h e n s h e b e g a n to
m e n s t r u a t e , she b e g a n c o m p l a i n i n g o f s e v e r e c o n s t i p a t i o n , w h i c h soon
i <-<111111'Li w h o l e s a l e c o n s u m p t i o n o f l a x a t i v e s . W i t h o u t m e d i c a t i o n , h e r
b o w e l s s o m e t i m e s did not m o v e for o n e o r t w o w e e k s . T h e patient

EXISTENTIAL

FOUNDATIONS

always felt w e a k , a p p e a r e d to v e g e t a t e , and r e m a i n e d so thin t h a t h e r

d o c t o r s , r e p e a t e d l y s u s p e c t i n g t u b e r c u l o s i s , kept X - r a y i n g h e r .
W h e n s h e was n i n e t e e n , R e g u l a Z u r c h e r m a r r i e d a m a n a f e w y e a r s
older t h a n she. T h e y had k n o w n each o t h e r f r o m h e r s c h o o l days. A t
t w e n t y - o n e s h e b o r e h e r first and o n l y child. D u r i n g p r e g n a n c y , s h e felt
b e t t e r t h a n s h e e v e r had, b u t t w o m o n t h s a f t e r t h e delivery, h e r h e a l t h
d e t e r i o r a t e d rapidly. H e r c o n s t i p a t i o n as well as h e r s t o m a c h and
i n t e s t i n a l a c h e s g r e w m o r e i n t e n s e despite t h e u s e o f a n e n t i r e a r s e n a l o f
medications. Increasingly, the constipation alternated with severe
a t t a c k s o f d i a r r h e a w h i c h w o u l d s t a r t v e r y a b r u p t l y and last for days.
Blood w a s f o u n d in h e r s t o o l , and h e r d o c t o r s d i a g n o s e d a s e v e r e colitis.
S h o r t l y b e f o r e h e r m a r r i a g e , R e g u l a Z u r c h e r had added a g y n e c o l o g i s t
t o t h e r e g i m e n t o f d o c t o r s a t t e n d i n g h e r . S h e had b e g u n t o s u f f e r from
u n b e a r a b l e pains i n h e r b r e a s t s . F o r a b o u t t h r e e w e e k s o f each m e n s t r u a l
cycle, h e r b r e a s t s b e c a m e hard a s s t o n e , and t h e l i g h t e s t t o u c h w o u l d b e
s o painful t h a t s h e could h a v e s c r e a m e d . T h e first g y n e c o l o g i s t w a s s o o n
s u p p l e m e n t e d by o t h e r s , including a n o t e d p r o f e s s o r of g y n e c o l o g y . His
r e p o r t : "I h a v e n o t s e e n a m o r e p r o n o u n c e d case of a functional h o r m o n a l
i m b a l a n c e in t h e s e n s e of an e x c e s s i v e p r o d u c t i o n of follicle s t i m u l a t i n g
hormone. An anti-estrogen therapy, consisting of the administration of
androgens remained without success."
B e c a u s e o f h e r i n t e s t i n a l s y m p t o m s , s h e w a s forced t o u n d e r g o , w i t h
i n c r e a s i n g f r e q u e n c y , long s t a y s in t h e hospital. T h e p h y s i c i a n s at t h e
hospital w e r e at a loss to d i a g n o s e and t r e a t h e r illness. T h e y tried
v a r i o u s diets and m e d i c a t i o n s w i t h little s u c c e s s . D u r i n g o n e o f t h e s e
s t a y s , an a c u t e p a n c r e a t i t i s w a s diagnosed. It w a s t r e a t e d w i t h pain
killers, penicillin, and c a t a p l a s m s , and h e r h e a l t h i m p r o v e d rapidly.
F o u r y e a r s l a t e r s h e had to be hospitalized again, this t i m e for
u n b e a r a b l e back pains. H e r X - r a y s and l a b o r a t o r y t e s t s s h o w e d n o m a j o r
a b n o r m a l i t i e s , e x c e p t for a n i n c r e a s e d s e c r e t o r y activity o f h e r small
intestine.
A specialist in a r t h r i t i s w a s called in. He f o u n d signs of r h e u m a t i s m ,
but n o t e d t h a t t h e usual t h e r a p e u t i c p r o c e d u r e s w e r e o f n o use w i t h this
difficult patient. In fact, s o m e h i g h - p o w e r e d a n a l g e s i c s t h a t he
p r e s c r i b e d w e r e i n c r e a s i n g h e r pains instead o f s o o t h i n g t h e m . H e s e n t
h e r back to t h e i n t e r n i s t w h o , at a loss for f u r t h e r m e a s u r e s , s u g g e s t e d
s h e " t a k e a holiday trip w i t h h e r h u s b a n d . "
A few y e a r s l a t e r , u n d e r t h e c a r e o f a n o t h e r physician, s h e w a s again
put t h r o u g h a b a t t e r y of clinical t e s t s , t h e s y m p t o m s at t h a t t i m e b e i n g
mainly i n t e s t i n a l pains and c o n s t i p a t i o n w h i c h a l t e r n a t e d w i t h d i a r r h e a .
T h e test findings indicated a n " i r r i t a b l e c o l o n . " T h e patient h a p p e n e d t o

.1

Test Case: Regula Zrcher

m r n I ion a t t h e t i m e t h a t d r i n k i n g milk made h e r c o n d i t i o n w o r s e , s o h e r

d o c t o r put h e r on a m i l k - f r e e diet. R e g u l a Z u r c h e r r e s p o n d e d by n o t i n g
Mi.it s h e felt s o m e w h a t b e t t e r , b u t w a s still far f r o m well.
In the c o u r s e of s e v e r a l m o r e h o s p i t a l s t a y s w h i c h followed each o t h e r
at d e c r e a s i n g i n t e r v a l s , t h e p a t i e n t w a s s u b j e c t e d to v e r y i n t e n s i v e and
e x p e n s i v e opium and m o r p h i u m t r e a t m e n t s . B u t , e a c h t i m e , h e r pains
returned with undiminished strength as soon as the drugs were
w i t hdrawn.
I n view o f h e r d e t e r i o r a t i n g c o n d i t i o n , h e r d o c t o r p r e s c r i b e d
n u reasingly s t r i c t diets, and s o o n s h e w a s r e d u c e d t o eating thick gruel
and v a r i o u s kinds of pap. Finally h e r food i n t a k e b e c a m e so limited t h a t it
had to be s u p p l e m e n t e d by i n t r a v e n o u s i n f u s i o n s . T h e p a t i e n t kept
losing w e i g h t until s h e had dwindled t o e i g h t y - t h r e e and o n e - h a l f
pounds (she w a s five f e e t t e n i n c h e s tall). T h e small a r m y o f six d o c t o r s
1 1 e.it m g h e r w a s p r e p a r e d for t h e w o r s t . T h e i n t e r n i s t s h e t r u s t e d m o s t
told h e r p o i n t b l a n k t h a t he w a s at his w i t s ' e n d .
I his admission of defeat s e e m e d to m a r k t h e end of t h e clinical h i s t o r y
which s o m a n y pediatricians, i n t e r n i s t s , r h e u m a t o l o g i s t s , r a d i o s c o p i s t s ,
e n d o c r i n o l o g i s t s , s u r g e o n s , and g y n e c o l o g i s t s had tried t o u n r a v e l . S o m e
nt t h e s e physicians had tried to p r o b e b e y o n d R e g u l a Z u r c h e r ' s medical
history and find o u t s o m e t h i n g m o r e a b o u t h e r past, b u t t h e patient
i m p l y could n o t t h i n k o f a n y t h i n g s h e c o n s i d e r e d r e l e v a n t . T h e
quesl ions o f h e r d o c t o r s w e r e a i m e d primarily a t u n c o v e r i n g h e r past and
pi e s e n t physical pains and s y m p t o m s ; t h e p a t i e n t n e v e r had t h e s l i g h t e s t
i n l e n t i o n o f hiding a n y i n f o r m a t i o n from t h e d o c t o r s w h o w e r e trying t o
help her. T i m e and again, w h e n h e r d o c t o r s p u m p e d h e r for m o r e
Information, she would repeat that nothing of any importance occurred
11' h e r .

B u i h e r c a s e took o n n e w depth, s o t o speak, w h e n t h e patient decided

H I h e r o w n initiative t o s e e k o u t a p s y c h o t h e r a p i s t . S h e w a s t h e n
i w e n t y - e i g h t y e a r s old. O w i n g to h e r endless i n f i r m i t i e s and d e s p e r a t i o n
\ I I psychological s y m p t o m s w h i c h will b e described b e l o w , s h e had
fallen into a s e v e r e d e p r e s s i o n and felt increasingly t e m p t e d to c o m m i t
.1111 Illl'

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.
T h e p a t i e n t ' s f a t h e r w a s t h e y o u n g e s t o f t h e s e eleven children. H e w a s
the only o n e of his b r o t h e r s and s i s t e r s w h o w a s able to rise up o u t of
their e x t r e m e l y m o d e s t social milieu b e c a u s e of his high i n t e l l i g e n c e , his
u n c o m m o n l y s t r o n g will, and his b u r n i n g a m b i t i o n . He e v e n t u a l l y
b e c a m e the c h i e f d i r e c t o r o f o n e o f t h e m o s t i m p o r t a n t industrial
e n t e r p r i s e s in his c o u n t r y .
Like his f a t h e r , he also played t h e role of an a b s o l u t e , o m n i p o t e n t
tyrant in the life of his o w n family. He would n o t t o l e r a t e t h e s l i g h t e s t
opposition, not even the e x p r e s s i o n of i n d e p e n d e n t will, from a n y of his

'1 Test Case: Regula Ziircher

l o u r d a u g h t e r s o r f r o m his wife. T h e f a t h e r ' s e x p l o s i o n s o f a n g e r w e r e

e v e r y d a y o c c u r r e n c e s p r o v o k e d by t h e least i n s u b o r d i n a t i o n from his
family. C o m p l e t e l y u n r e s t r a i n e d in e v e r y r e s p e c t h i m s e l f , he d e m a n d e d
I net discipline and m o d e s t y f r o m e v e r y o n e else in his family.
S o m e t i m e s , during o n e of his s a v a g e d o m e s t i c r a g e s in w h i c h he had
< o m p l e t e l y c r u s h e d the victim of his a n g e r , he would do an a b r u p t a b o u t face and feel r e m o r s e for w h a t h e had d o n e . T h e n h e w o u l d t a k e t h e h a n d
o l the punished o n e and press m o n e y into i t t o buy b a c k h e r a f f e c t i o n .
( Hlen his d a u g h t e r s w o u l d h a v e p r e f e r r e d to t h r o w this c o n s c i e n c e
m o n e y into his face, b u t as long as t h e y w e r e small, t h e y j u s t said t h a n k
y o u . I t w a s n o t h a r d t o i m a g i n e t h e n e w o u t b r e a k o f fury t h a t refusal o f
I lie m o n e y would h a v e a r o u s e d . W h e n e v e r the f a t h e r w a s at h o m e , the
family a t m o s p h e r e w a s h e a v y w i t h t e n s i o n , like t h e air b e f o r e a s t o r m .
T h e g r a n d p a r e n t s o n t h e m o t h e r ' s side w e r e b o t h e m i n e n t and s t r o n g
personalities. T h e y w e r e k n o w n to a large public as h i g h l y i n t e l l i g e n t
people w h o p a s s i o n a t e l y s t o o d u p for t h e i r f e l l o w m e n . T h e y w e r e loved
and h o n o r e d accordingly by t h o s e a r o u n d t h e m . As a couple, h o w e v e r ,
they had little t o d o w i t h each o t h e r . B y t h e end o f t h e i r first y e a r o f
m a r r i a g e , t h e y w e r e already c o m p l e t e l y e s t r a n g e d , and f r o m t h a t t i m e
o n , their r e l a t i o n s h i p w a s c h a r a c t e r i z e d b y a g r e a t deal o f i r r i t a t i o n . T h e
g r a n d f a t h e r lived o n l y for his c a r e e r , while t h e g r a n d m o t h e r e x i s t e d
entirely for h e r children and h e r social w o r k .
I he p a t i e n t ' s m o t h e r g r e w up to be a v e r y s h a d o w y c r e a t u r e u n d e r t h e
o v e r p o w e r i n g i n f l u e n c e o f h e r p a r e n t s ' e x c e p t i o n a l l y vital p e r s o n a l i t i e s ,
i hildlike, i m m a t u r e and n a i v e , e x t r e m e l y lacking in feeling, s h e w a s
,i I ways c o n t r o l l e d by t h e i r e x c e e d i n g l y puritanical ideas. D e s p i t e h e r o w n
i 11.ii itable e f f o r t s , in w h i c h s h e o n l y i m i t a t e d h e r o w n m o t h e r ' s social
behavior, this n e e d y m o t h e r actually cared little a b o u t o t h e r people. S h e
made e x o r b i t a n t d e m a n d s , h o w e v e r , o n t h e w o r l d a r o u n d h e r . F r o m
e.n Iy childhood, s h e c u r s e d t h e f a t e t h a t m a d e h e r a w o m a n ; she would
greatly h a v e p r e f e r r e d b e i n g a m a n . S h e n e v e r m a d e real friends w i t h
ni her girls. W i t h h e r h u s b a n d she w a s frigid and s u b s e r v i e n t . He, an
u n c o m m o n l y v i g o r o u s and a g g r e s s i v e m a n , indulged in an endless r a n g e
i l l e x t r a m a r i t a l affairs, w h i l e she w a s t e d a w a y from t h e fatigue o f
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

R e g u l a Z r c h e r , o u r p a t i e n t , w a s t h e y o u n g e s t o f this couple's four

d a u g h t e r s . T h e r e w a s a d i f f e r e n c e o f n i n e y e a r s b e t w e e n h e r and h e r
n e x t oldest s i s t e r , so practically speaking she g r e w up as an only child.
S h e w a s , m o r e o v e r , a n o n l y child t o w h o m h e r p a r e n t s paid little
a t t e n t i o n . T h e y w e r e s o c o m p l e t e l y a b s o r b e d i n t h e i r o w n perpetual
q u a r r e l s t h a t t h e y left t h e child m o s t l y t o h e r o w n devices. A t t h e s a m e
t i m e , t h e y forbade h e r a n y c o n t a c t w i t h o t h e r children i n the
n e i g h b o r h o o d . A s t h e i r " p r o p e r t y , " t h e y felt s h e w a s t o o h i g h b o r n t o
mingle with ordinary children.
W h e n R e g u l a Z r c h e r w a s s e n t to s c h o o l , t h e r e f o r e , she did not at all
u n d e r s t a n d h o w t o g e t along w i t h o t h e r c h i l d r e n . T i m i d and helpless, she
would stand off to o n e side and from a d i s t a n c e w a t c h the o t h e r children
play. I t t o o k m a n y m o n t h s and u n d e r s t a n d i n g k i n d e r g a r t e n t e a c h e r s
b e f o r e she dared e n t e r , little b y little, i n t o a n y o f t h e g a m e s . B u t she
n e v e r lost t h e s e n s e o f being, basically, a n u t t e r l y l o n e s o m e c r e a t u r e .
In later s c h o o l y e a r s , R e g u l a t o o k r e f u g e in reading for long h o u r s at a
time and would live o n l y i n t h e w o r l d o f h e r s t o r y b o o k h e r o e s . O t h e r
t i m e s she would r e s i g n h e r s e l f to playing t h e piano all day long in t h e
lonely r o o m s o f h e r p a r e n t s ' m a n s i o n . M o s t o f all she loved the m u s i c o f
B a c h , especially his " I n v e n t i o n s . " In t h e s e , as n o w h e r e else, d i f f e r e n t
melodies would a l t e r n a t e , s i m u l t a n e o u s l y q u e s t i o n i n g and a n s w e r i n g
each o t h e r . T h i s w a s t h e o n l y f o r m o f dialogue t o w h i c h this girl had
access.
D e s p i t e h e r o w n e x p e r i e n c e of a s e r i o u s l y d i s t u r b e d family life, h e r
girlish plans w e r e based on s o m e d a y s e t t i n g up a family of h e r o w n .
A s s i g n e d a t h e m e of "A S u n d a y O u t i n g " in f o u r t h grade, she p o r t r a y e d ,
in m e t i c u l o u s detail and w i t h c o n s i d e r a b l e inspiration, an o u t i n g in t h e
c o u n t r y m a d e b y h e r h u s b a n d , herself, and t h e i r t e n children. T h i s piece
o f w r i t i n g w a s s o q u a i n t and p i c t u r e s q u e t h a t h e r t e a c h e r later
f r e q u e n t l y and l a u g h i n g l y r e f e r r e d to it.
In spite of h e r reading, piano playing, and e s s a y w r i t i n g , R e g u l a
suffered g r e a t l y , as far back as s h e could r e m e m b e r , from t h e p e r p e t u a l l y
t e n s e , o p p r e s s i v e , and j o y l e s s a t m o s p h e r e o f t h e family. T h o u g h s h e w a s
v e r y i n t e l l i g e n t , she had t o s t r u g g l e t o get t h r o u g h t h e n o r m a l c o u r s e o f
schooling; the tensions of her parents' house demanded too much of her.
A t the o n s e t o f h e r p u b e r t y , the s c e n e s w i t h h e r f a t h e r b e c a m e
i n c r e a s i n g l y p a s s i o n a t e . S h e n o l o n g e r k n u c k l e d u n d e r t o him. W i t h each
o f his unjust p u n i s h m e n t s , verbal o r physical, s h e t o o b e c a m e e x t r e m e l y
a g g r e s s i v e . S h e s c r e a m e d back at him and c u r s e d him in t h e m o s t
o f f e n s i v e l a n g u a g e . I t o f t e n c a m e t o reciprocal a c t s o f v i o l e n c e . S e v e r a l
t i m e s , despite h e r fragility, s h e s t r u c k h e r f a t h e r s o hard t h a t h e reeled
into a c o r n e r of the r o o m .

A Test Case: Regula Zrcher

Regula Z r c h e r hated her m o t h e r too, though for very different

r e a s o n s . A l o n g w i t h h e r t h r e e s i s t e r s , s h e w a s deeply disgusted w i t h h e r
m o t h e r ' s perpetual s u b m i s s i v e n e s s t o h e r f a t h e r . N e v e r had t h e m o t h e r
made t h e least effort to t a k e t h e side of a d a u g h t e r and p r o t e c t h e r from
the f a t h e r ' s rage. F u r t h e r m o r e , R e g u l a r e s e n t e d h e r m o t h e r ' s i m m e d i a t e
s u p p r e s s i o n o f the least s h o w o f feeling f r o m h e r t e m p e r a m e n t a l
d a u g h t e r . If s h e s h o w e d e v e n a t r a c e of e n t h u s i a s m for a m e l o d y s h e had
just l e a r n e d , or delighted in a f l o w e r , h e r m o t h e r w o u l d r e p r i m a n d h e r
for h e r " f a n a t i c a l " c h a r a c t e r . R e g u l a ' s desire for p r e t t y c l o t h e s b r o u g h t
d o w n a c c u s a t i o n s o f i n d e c e n c y and i m m o r a l i t y . Indeed, h e r m o t h e r
m a n a g e d to s t u f f the child full of p s e u d o m o r a l guilt feelings and to r o b
h e r of all o p e n n e s s and f r a n k n e s s . In addition to this, h e r p a r e n t s s e n t h e r
to a private s c h o o l w i t h a v e r y n a r r o w religious o r i e n t a t i o n , w h e r e t h e
o r d e r t o o k g r e a t c a r e t h a t t h e children recited the T e n C o m m a n d m e n t s
daily. R e g u l a had originally h o p e d and longed to find help and s u p p o r t at
least i n religion, b u t t h e daily r e c i t a t i o n o f the T e n C o m m a n d m e n t s ,
including t h e F o u r t h C o m m a n d m e n t t o love and h o n o r o n e ' s p a r e n t s ,
t h r e w h e r into g r e a t e r t u r m o i l . H o w i n t h e world w a s s h e t o s u m m o n u p
any love and h o n o r for t h e s e t o r m e n t o r s ? S h e would s o o n e r h a v e
t h r o w n a c o o k i n g - p o t at t h e i r h e a d s .
W h e n , in h e r t e e n s , R e g u l a Z r c h e r received h e r first i n v i t a t i o n to a
dance, h e r p a r e n t s b e g a n w a r n i n g h e r daily n o t t o g e t involved w i t h a n y
o n e b o y . A p r e t t y girl, s h e w a s flooded w i t h i n v i t a t i o n s . U n d e r t h e
p r e s s u r e o f p a r e n t a l m o r a l i z i n g , s h e o b e d i e n t l y limited a c c e p t a n c e s t o
t h o s e w h o w e r e easily kept a t a d i s t a n c e . T o c o m p l e t e t h e t r a g e d y o f h e r
y o u t h , R e g u l a Z r c h e r w a s used b y b o t h o f h e r p a r e n t s a s s o m e kind o f
wailing wall o r g a r b a g e d u m p , w h e r e t h e y would s h a m e l e s s l y pour o u t
their love and m a r i t a l p r o b l e m s .
W i t h h e r varied t a l e n t s , R e g u l a Z r c h e r would h a v e loved t o a t t e n d
the G y m n a s i u m , b u t h e r p a r e n t s would n o t h e a r o n e w o r d a b o u t
" e d u c a t e d " d a u g h t e r s . A h i g h e r e d u c a t i o n , t h e y said, m e a n t t h a t the child
would r e m a i n in t h e h o m e t o o long and be a b u r d e n to t h e p a r e n t s . T h u s ,
i m m e d i a t e l y after s e c o n d a r y s c h o o l , R e g u l a Z r c h e r had n o c h o i c e b u t t o
take an a p p r e n t i c e s h i p in o n e of the city's f o r e m o s t f a s h i o n s a l o n s .
F o r t u n a t e l y , she w a s w a r m l y r e c e i v e d t h e r e b y a g r o u p o f v e r y t a l e n t e d
d e s i g n e r s , w h o s h a r e d a c o m m o n passion to c r e a t e . H e r e , e v e n as an
a p p r e n t i c e , s h e found h e r ideas and j u d g m e n t s g i v e n equal s t a t u s w i t h
t h o s e o f h e r s u p e r i o r s . F o r t h e first t i m e i n h e r life she w a s n o t r u n n i n g
up a g a i n s t c o n s t a n t c r i t i c i s m b u t i n s t e a d w a s e x p e r i e n c i n g gratifying
c o n f i r m a t i o n o f h e r e x c e l l e n t t a s t e and a r t i s t i c t a l e n t s .
I n c o n n e c t i o n w i t h t h e h i s t o r y o f h e r physical a i l m e n t s t h e p s y c h o t h e r -

10

EXISTENTIAL

FOUNDATIONS

apist l e a r n e d t h a t e v e n a f t e r the w o r s t s y m p t o m s o f R e g u l a ' s early

childhood e c z e m a disappeared, h e r skin r e m a i n e d h y p e r s e n s i t i v e t o
w o o l . H e r m o t h e r paid n o a t t e n t i o n t o this, h o w e v e r , and r e p e a t e d l y
forced h e r d a u g h t e r t o w e a r w o o l l e n s t o c k i n g s , believing t h a t such s t r i c t
m e a s u r e s w o u l d put a c h e c k on f e m i n i n i t y as well as t h e v a n i t y and
a r r o g a n c e t h a t t h e w e a r i n g o f silk s t o c k i n g s m i g h t e n g e n d e r .
A t n i n e t e e n , t h e p a t i e n t t o o k r e f u g e i n m a r r i a g e , w h i c h according t o
h e r w a s h e r o n l y e s c a p e from t h e i n h u m a n a t m o s p h e r e o f h e r p a r e n t s '
h o m e . H e r family e x p e r i e n c e i n f l u e n c e d h e r t o c h o o s e t h e a d m i r e r w h o
appeared m o s t c o m p o s e d , e m o t i o n a l l y w e l l - b a l a n c e d , s e c u r e , and
u n o b t r u s i v e . T h i s friend o f h e r y o u t h , w h o m s h e t o o k a s h e r h u s b a n d ,
appeared t h e o p p o s i t e o f h e r f r i g h t e n i n g and u n t r u s t w o r t h y f a t h e r . F o r
h e r s e l f , s h e h o p e d to be able to be happy in t h e role of a simple, q u i e t
h o u s e w i f e and m o t h e r . N o t t h a t she had e v e r b e e n in love w i t h this m a n .
S h e a t t a c h e d h e r s e l f to him in t h e m a n n e r of a little s i s t e r looking for
p r o t e c t i o n and s u p p o r t from a big b r o t h e r .
T o h e r dismay, and t o t h e a s t o n i s h m e n t o f t h o s e a r o u n d h e r , R e g u l a
Z i i r c h e r ' s physical h e a l t h g r e w c o n s i d e r a b l y w o r s e after h e r m a r r i a g e .
S h e a d m i t t e d t o n o o n e t h a t , while still o n t h e h o n e y m o o n , she had
realized t h a t h e r m a r r i a g e had b e e n a big m i s t a k e . It b e c a m e a p p a r e n t
t h e n t h a t w h a t s h e had t a k e n for reliability and e a s y - g o i n g w a y s in this
m a n w a s n o t h i n g m o r e t h a n a lack of i n t e r e s t and vitality, a kind of
childish i m m a t u r i t y .
T h e y o u n g h u s b a n d w a s incapable o f any h e a r t f e l t w a r m t h t o w a r d his
wife. H e e n g a g e d i n s e x u a l i n t i m a c y w i t h h e r o n l y e v e r y f e w w e e k s , and,
s o o n , only e v e r y few m o n t h s . M o r e o v e r , his physical i n v o l v e m e n t w i t h
his wife c o n s i s t e d o n l y of a v e r y brief, a b r u p t s e x u a l act, a f t e r w h i c h he
would e x t r i c a t e h i m s e l f as quickly as possible from the e m b r a c e , roll o v e r
'on his side, and go to sleep. In t h e long periods b e t w e e n t h e s e m e a g e r
" i n t i m a c i e s , " t h e h u s b a n d c o n t e n t e d h i m s e l f w i t h s t r o k i n g and l o o k i n g a t
his wife as she lay n a k e d beside him. T h e n he would suddenly leave h e r
by h e r s e l f and s h u t h i m s e l f alone in his b a t h r o o m . P h o t o g r a p h s of t h e
naked bodies o f o t h e r w o m e n spoke t o h i m m o r e u r g e n t l y t h a n t h e
physical p r e s e n c e o f his l o v e - s t a r v e d y o u n g wife. F r o m t h e v e r y first
days o f t h e i r s h a r e d h o u s e k e e p i n g , h e p l a s t e r e d t h e b a t h r o o m walls w i t h
nude pin-ups. G i v e n t h e " e n l i g h t e n m e n t " h e r m o t h e r had b e s t o w e d o n
h e r , R e g u l a Z i i r c h e r believed all m e n w e r e like t h a t and h e n c e settled for
such a marital s i t u a t i o n . N e e d l e s s to say, in t h e m a r r i a g e w i t h such a
p a r t n e r she p r o v e d s e x u a l l y frigid and r e m a i n e d so.
B u t t h e n c a m e t h e birth o f h e r child. C o m p l e t e l y u n e x p e c t e d l y , t h e
final birth c o n t r a c t i o n s released t h e first s e x u a l o r g a s m of R e g u l a

A Test Case: Regula Ziircher

II

Z i i r c h e r ' s life. T h i s s t o r m o f s e n s a t i o n flooded h e r w h o l e being,

o b l i t e r a t i n g h e r labor pains and filling h e r w i t h an i m m e n s e s e n s e ol
pleasure and j o y . S h e t o r e t h e a n e s t h e s i a m a s k f r o m t h e h a n d s o f the
midwife, w h o w a s a b o u t t o help e a s e t h e final p u s h e s o f t h e delivery, and
Hung it a w a y . H o w could s h e let h e r s e l f be a n e s t h e t i z e d at t h e happiest
m o m e n t o f h e r life?
A f t e r this o v e r w h e l m i n g e x p e r i e n c e , she w a s m o r e physically
d e m a n d i n g o f h e r h u s b a n d , w a n t i n g him c l o s e r and w i t h h e r m o r e o f t e n .
A p p a r e n t l y , t h o u g h , h e r p a r t n e r felt h i m s e l f m o r e put u p o n t h a n b e f o r e
with t h e n e w n e s s o f h e r i n o r d i n a t e desire and w i t h t h e f a t h e r role h e had
g o t t e n i n t o . H e r e t r e a t e d m o r e and m o r e i n t o h i m s e l f , r a r e l y paying a n y
a t t e n t i o n to t h e child and t r e a t i n g his wife as t h o u g h she w e r e a total
s t r a n g e r . H e n o l o n g e r t o o k h e r o u t t o plays, c o n c e r t s , o r social f u n c t i o n s ,
.md he m a d e it impossible for h e r to e n t e r t a i n h e r old friends at h o m e
b e c a u s e h e d r o v e e v e r y o n e a w a y w i t h the h e a v y silence and l e t h a r g y t h a t
c a m e o v e r him a t e v e r y social g a t h e r i n g .
T h u s R e g u l a Z i i r c h e r g r e w m o r e and m o r e isolated. S h e r e l a t e d t o n o
o n e but h e r child. As a r e s u l t of this deprivation, s h e s a n k i n t o a
d e t e r i o r a t i n g h u m o r and b e c a m e i n c r e a s i n g l y t e n s e , irritable, and c r o s s .
O n top o f t h i s , she w a s a s h a m e d o f h e r b e h a v i o r and scolded h e r s e l f for
this g r o w i n g h a t e f u l n e s s w h i c h , s t r o n g e r t h a n s h e , w a s leading h e r t o
m o r e and m o r e f r e q u e n t o u t b u r s t s o f a n g e r t o w a r d h e r h u s b a n d . T h e s e
o l t e n b e c a m e o u t - a n d - o u t a t t a c k s o n him. I n despair s h e s t a r e d down
into t h e a b y s s b e t w e e n h e r a w a r m - h e a r t e d , musically t a l e n t e d
w o m a n , so alive and v i v a c i o u s , and inspired by e v e r y t h i n g beautiful
and h e r s p o u s e , a m i s e r a b l e h u m a n f o r m w h o s e o n l y i n t e r e s t s lay in his
c r a z e for cars and his s t a m p c o l l e c t i o n . O t h e r t h a n t h e s e , h e k n e w o n l y
I n s t e c h n i c a l j o b i n a small w o r k s h o p , w h e r e h e w o r k e d t w e l v e t o
l o u r t e e n h o u r s a day to m a k e as m u c h m o n e y as he could.
A few w e e k s a f t e r t h e crucial e v e n t of h e r child's birth, t h e p a t i e n t w a s
surprised, for t h e first t i m e , b y phobic s y m p t o m s . G i v e n h e r h u s b a n d ' s
h uman denial of h e r , t h e o n l y living c r e a t u r e on e a r t h she had to love was
her baby d a u g h t e r . B u t j u s t a t t h o s e t i m e s w h e n she felt m o s t i n t i m a t e l y
hound t o h e r childwhile b a t h i n g her, o r putting h e r t o bed w i t h h u g s
and kisses, o r j u s t a f t e r w a r d w h e n s h e w a s saying t h e b e d t i m e p r a y e r
t h e r e c a m e o v e r h e r , out o f t h e blue, m o r e and m o r e o f t e n , t h e a l m o s t
it r e s i s t a b l e u r g e to s t a b t h e tiny body of h e r d a u g h t e r w i t h a knife. T h e
patient described this in t h e following way:
I )uring t h e s e especially happy m o m e n t s w i t h t h e child, if my e y e s even
c h a n c e d to fall upon s o m e s h a r p t h i n g t h a t w a s lying a r o u n d , a nail file
or a knife, t h e n t h e u r g e t o o k hold of me to stab it i n t o h e r body.

12

EXISTENTIAL

FOUNDATIONS

S o m e t i m e s t h e u r g e w a s so s t r o n g I w a s afraid of losing my mind and

g o i n g c r a z y in t h e n e x t s e c o n d . So r i g h t a w a y I would run o u t of the
r o o m i n t o t h e hall. T h e r e I had to lean a g a i n s t t h e wall and hold my
right h a n d t i g h t l y w i t h m y left, t o k e e p m y s e l f from doing t h e h o r r i b l e
t h i n g . As t i m e w e n t on, I felt a p r e s s u r e to s t r a n g l e h e r w i t h my o w n
hands, b u t this did n o t c o m e o v e r me as o f t e n as t h e s t a b b i n g u r g e .
M y fears o f t h e k n i v e s and t h e s t r a n g l i n g w e r e w o r s t w h e n m y
h u s b a n d b a n i s h e d me by m y s e l f w i t h t h e child to a secluded cabin in the
m o u n t a i n s for long w e e k s of v a c a t i o n . T h e n , I could n o t e v e n look at a
knife at all, e v e n w h e n t h e little o n e w a s n ' t n e a r . I simply could n o t
stand t h e s i g h t of t h e k n i v e s in t h e k i t c h e n d r a w e r a n y m o r e . It w a s as if
t h e y w a n t e d to, and could, f o r c e m e t o j a b t h e m i n t o s o m e t h i n g . W h o
o r w h a t didn't m a t t e r . S o t h e knife d r a w e r b e c a m e a n u n b e a r a b l e
p r o v o c a t i o n and t e m p t a t i o n for me.
T h e l o n g e r t h e v a c a t i o n w e n t on, t h e m o r e p o w e r t h e k n i v e s g a i n e d
o v e r m e . O n e day it no l o n g e r e v e n t o o k a real knife to m a k e me panic. I
would m i s t a k e a n y glint on a polished s u r f a c e for t h e flash of a knife
blade. Finally, I w a s s e e i n g d o z e n s of k n i v e s flash past me in t h e air,
t h i n k i n g t h e m so real I g r a b b e d at t h e m .
A n d t h e s e k n i v e s c o m i n g in on me o u t of t h i n air put t r e m e n d o u s
p r e s s u r e o n m e t o run wild w i t h t h e m . T h e s e h o r r i b l e h a l l u c i n a t i o n s
m a d e it c l e a r to me t h a t e i t h e r I had to c o m m i t m y s e l f or find a
psychotherapist. Every minute I was sure I was going completely
mad. R e a l l y , it could o n l y be m a d n e s s to s t a b or s t r a n g l e t h e d e a r e s t
t h i n g you h a v e . I had b e c o m e a p o t e n t i a l child m u r d e r e r . To m y s e l f I
w a s such a depraved c r e a t u r e t h a t I felt I had used up e v e r y r i g h t to life
in this w o r l d .
This is the account of the patient herself, w h o was often, by that time, at
the point of ending h e r life w i t h an o v e r d o s e of sleeping pills.
A f t e r r e t u r n i n g f r o m this c a t a s t r o p h i c s u m m e r v a c a t i o n , R e g u l a
Z u r c h e r decided t o u n d e r g o p s y c h o t h e r a p y . A l t h o u g h she had b e c o m e
bedridden on a c c o u n t of h e r debilitation, s h e appeared a f e w days l a t e r
for a c o n s u l t a t i o n w i t h h e r f u t u r e p s y c h o t h e r a p i s t . S h e c h o s e this
p a r t i c u l a r specialist and n o o t h e r b e c a u s e s h e k n e w t h a t h e had o n c e
t r e a t e d o n e o f h e r relatives w i t h s o m e s u c c e s s . A n d b e c a u s e h e w a s a
good t h i r t y y e a r s older t h a n s h e , h e s e e m e d t o o f f e r a g u a r a n t e e o f g o o d
experience.
In the v e r y first t h e r a p e u t i c s e s s i o n t h e p a t i e n t c o m p l a i n e d of a
r e c u r r i n g d r e a m t h a t had p u r s u e d h e r since earliest childhood at
intervals of a few w e e k s to a f e w m o n t h s . J u s t t h e n i g h t b e f o r e she had
a w a k e d from this d r e a m , terrified and b a t h e d in s w e a t . In t h e s e n i g h t
e v e n t s , the d r e a m e r always found h e r s e l f c o m p l e t e l y naked and a l o n e ,

A Test Case: Regula Zrcher

c r o u c h e d and c o w e r i n g in t h e c o r n e r of an e m p t y railroad boxi.n I |i |
a r m s w e r e folded for p r o t e c t i o n o v e r h e r k n e e s and in front of her t&i e
T h e b o x c a r sat at t h e b o t t o m of an ice-cold o c e a n in which t h e r e was not l
single fish or g r o w i n g plant. D e e p in t h e s e a , an arctic wind b l e w t h r o u g h
t h e d o o r s and s e a m s o f t h e b o x c a r . S h e w a s frightfully cold.
F o r a f e w days t h e t h e r a p i s t a b s t a i n e d from discussing this dream
First, h e had the p a t i e n t o b s e r v e t h e f u n d a m e n t a l rules o f analysis. (This
t h e r a p e u t i c m e t h o d and its practical o u t c o m e s will be t a k e n up in m o r e
detail in t h e f o u r t h part of this b o o k . ) H e r e we n e e d say o n l y the
following t h i n g s a b o u t t h e c o u r s e o f t r e a t m e n t . T h o u g h t h e patient tried
hard t o comply w i t h d o c t o r ' s r e q u e s t s t o free a s s o c i a t e , t h e first e f f e c t s o f
t r e a t m e n t w e r e n o t v e r y p r o m i s i n g . F r o m t h a t h o u r on, a s s h e b e g a n t o
tell t h e s t o r y o f h e r life t o s o m e o n e else, she b e c a m e sleepless. M e m o r i e s
o f h e r d e s p e r a t e childhood, long p u s h e d aside, b r o k e f o r t h and flooded
her, s o t h a t e v e r y n i g h t she lay t h i n k i n g o f t h e i n c e s s a n t denials,
m a l t r e a t m e n t , and spiritual a s s a u l t s she had had t o e n d u r e from h e r
p a r e n t s . S h e could d o n o t h i n g b u t c o n s t a n t l y t h i n k o v e r and p o n d e r
a n e w t h e s e m e m o r i e s . S h e fell i n t o raving a t t a c k s o f a n g e r and h a t r e d
t o w a r d h e r p a r e n t a l t o r m e n t o r s . H e r s l e e p l e s s n e s s depleted t h e s t r e n g t h
o f t h e already w e a k p a t i e n t . S h e h e r s e l f believed s h e could n o l o n g e r
refrain from taking large d o s a g e s of sleeping pills.
T h e t h e r a p i s t , h o w e v e r , did n o t let h i m s e l f be t u r n e d aside in his
t r e a t m e n t b y this d r a m a t i c s h a r p e n i n g o f t h e s i t u a t i o n , and h e soon
o b s e r v e d t h a t his s t e a d i n e s s b e g a n t o give t h e p a t i e n t support. F r o m
w e e k to w e e k she g r e w m o r e settled in t h e t h e r a p e u t i c s i t u a t i o n . A f t e r a
few m o n t h s , all h e r l i f e - t h r e a t e n i n g physical s y m p t o m s disappeared o f
t h e i r o w n a c c o r d , a l t h o u g h t h e y had n e v e r b e e n p a r t i c u l a r l y discussed in
the t h e r a p e u t i c s e s s i o n s . T o t h e p a t i e n t ' s a s t o n i s h m e n t , the g a s t r o
i n t e s t i n a l c r a m p s and t h e bloody v i s c o u s d i a r r h e a w h i c h a l t e r n a t e d w i t h
s e v e r e c o n s t i p a t i o n faded a w a y , as did the r e c e n t disruption of sleep. T h e
b r e a s t swelling and h a r d n e s s , t o o , w h i c h had c a u s e d h e r s o m u c h
u n b e a r a b l e pain, did n o t last m u c h l o n g e r . T h e stabbing u r g e did not yield
so quickly, t h o u g h it also s o o n lost m u c h of its t h r e a t b e c a u s e of the
p a t i e n t ' s t r u s t i n t h e t h e r a p e u t i c capability o f h e r d o c t o r .
A f t e r o n e y e a r of p s y c h o t h e r a p y , t h e p a t i e n t decided to g e t a divorce
from h e r h u s b a n d , a l t h o u g h h e r d o c t o r advised h e r t o wait. S h e was
c o n v i n c e d , and r e m a i n e d so, t h a t she w a s doing a g r e a t e r s e r v i c e for
h e r s e l f , and for h e r child especially, by m a k i n g t h e s e p a r a t i o n than by
e n d u r i n g w i t h h i m l o n g e r . M o r e and m o r e o f t e n t h e child w a s h a v i n g t o
w i t n e s s t h e strain b e t w e e n t h e p a r e n t s , t h e m o t h e r ' s g r o w i n g irritation
and o u t b u r s t s a t t h e f a t h e r . T h e c o m p a r a b l e m e m o r y o f h e r o w n
childhood w i t h c o n s t a n t p a r e n t a l quarrelling w a s a g r u e s o m e o n e that

14

EXISTENTIAL FOUNDATIONS

she w a n t e d t o s p a r e h e r child. U n a c c u s t o m e d t o being o n h e r o w n , t h e r e

was m u c h for h e r t o d o a f t e r t h e c o m p l e t e s e p a r a t i o n from h e r h u s b a n d .
Having t o stand o n h e r o w n t w o f e e t w a s n o t e a s y for this w o m a n w h o
was used t o being indulged i n e x t e r n a l m a t t e r s . B u t she n e v e r r e g r e t t e d
t h e step t o free h e r s e l f from h e r h o p e l e s s , f u t u r e l e s s m a r r i a g e .
After another year of further intensive psychotherapeutic work, the
patient m e t a y o u n g m a n at a cocktail p a r t y . He i m m e d i a t e l y i m p r e s s e d
h e r b u t a t t h e s a m e t i m e disturbed h e r peculiarly. Afraid o f falling head
o v e r heels in love w i t h him, she w a s glad to leave t h e party w h e n it w a s
o v e r t o flee t o t h e s e c u r i t y o f h e r h o m e .
A f e w days l a t e r s h e s a w t h e s a m e y o u n g m a n c o m i n g t o w a r d h e r o n
the o t h e r side o f o n e o f t h e t o w n ' s m a i n s t r e e t s . B e l i e v i n g t h a t h e had
r e c o g n i z e d h e r and w a s a b o u t t o c r o s s t h e s t r e e t and speak t o h e r , she felt
nailed t o t h e spot; she could n o t m o v e a n o t h e r step. S u d d e n l y she
collapsed, paralyzed. S h e had to be t a k e n to a hospital by a m b u l a n c e . B o t h
o f h e r legs w e r e limp w i t h h y s t e r i c a l paralysis.
F o l l o w i n g this incident, t h e p s y c h o t h e r a p y w a s c o n t i n u e d w i t h o u t a
b r e a k in t h e hospital. In t h r e e w e e k s she w a s a b l e to use h e r legs again
and leave t h e hospital. It r e q u i r e d j u s t o n e m o r e full y e a r of
p s y c h o t h e r a p e u t i c e f f o r t s for a m a t u r e w o m a n , able to love and w o r k , to
evolve from t h e totally frigid childlike c r e a t u r e . T h r e e y e a r s a l t o g e t h e r
o f analysis m a d e h e r ready for t e r m i n a t i o n o f t r e a t m e n t .
T h e y o u n g m a n w h o s e sudden a p p e a r a n c e o n t h e s t r e e t o n e y e a r
b e f o r e had o c c a s i o n e d t h e h y s t e r i c a l paralysis of h e r legs and had not
been intimidated by the exceedingly impressive symptoms of the
p a t i e n t ' s illness. S h e w a s barely back h o m e from t h e hospital b e f o r e h e
b e g a n skillfully and p e r s i s t e n t l y c o u r t i n g h e r . S o o n t h e y w e r e l o v e r s .
A n d n o w , for t h e first t i m e able t o e x p r e s s h e r m a t u r e capacity t o l o v e ,
she lost t h e last t r a c e s o f h e r u r g e s t o s t a b h e r little d a u g h t e r . T h e y did
not r e t u r n , t h o u g h R e g u l a Z r c h e r w a s n e v e r h i n d e r e d b y t h e p r e s e n c e
of h e r d a u g h t e r as m u c h as s h e w a s at this t i m e of h e r life w i t h its m a n y
undertakings.
O n e day she h a p p e n e d t o m e e t h e r n e w l o v e r o n the s a m e s t r e e t w h e r e
she had seen h i m t h e y e a r b e f o r e and had g o n e h y s t e r i c a l l y lame. T h i s
t i m e , t o o , she s a w him c o m i n g t o w a r d h e r u n e x p e c t e d l y o n t h e o t h e r side
of the s t r e e t . T h i s t i m e , far from fear, t h e sight of him filled h e r with
jubilation. H e r h e a r t b e g a n to b e a t wildly, she said, as t h o u g h it would
leap from h e r b r e a s t . S h e was hardly a w a r e o f t h e b u s t l e o n t h e s t r e e t .
S h e ran to h e r l o v e r impulsively, h u g g e d him, and kissed him. He
responded w i t h e m b r a c e s and equal pleasure. T h e n t h e y walked a r m in
arm down the s t r e e t , m a k i n g plans for t h e i r c o m i n g v a c a t i o n in the
C a n a r y Islands. T h e y w e r e both familiar with t h e vacation h o u s e they

A Test Case: Regula Zrcher

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

e n j o y m e n t of art, w h i c h w a s so e s s e n t i a l to h e r . S h e felt as lonely as e v e r

in his p r e s e n c e , e v e n w h e n s h e lay in bed w i t h him. S m a l l w o n d e r t h a t
h e r s e x u a l c o n t a c t s w i t h this m a n did n o t help c o u n t e r the u r g e s t o s t a b
and s t r a n g l e t h a t s h e c o n t i n u e d t o e x p e r i e n c e t o w a r d h e r d a u g h t e r .
A f t e r a few w e e k s of h o n e s t but futile e f f o r t s to r e s p e c t and accept h e r
n e w p a r t n e r a s h e w a s , a s well a s t r y i n g t o l e a r n t o love him, s h e c h o s e t o
end t h e r e l a t i o n s h i p . T h e lack o f e s s e n t i a l h a r m o n y w i t h him had
brought her more anguish than release.
T h i s friendship w a s followed by s e v e r a l o t h e r love r e l a t i o n s h i p s in the
c o u r s e o f t h e n e x t few y e a r s . T h e s e t o o w e r e o n l y o f a t e m p o r a r y n a t u r e .
B u t w h e n e v e r R e g u l a Z u r c h e r allowed h e r s e l f a rich and full a b a n d o n
m e n t , and as long as s h e did, h e r s t a b b i n g and s t r a n g l i n g u r g e s and
phobias disappeared c o m p l e t e l y . A n d , in t h e periods of f r u s t r a t i o n in
b e t w e e n , t h e y set i n again w i t h p e r s i s t e n t r e g u l a r i t y . N e v e r t h e l e s s ,
t h e s e u r g e s no l o n g e r e v o k e d a d a n g e r of suicide, as t h e y had b e f o r e
p s y c h o t h e r a p y . T h e p a t i e n t had also lost all o f h e r fear o f going i n s a n e .
Finally, five y e a r s a f t e r t h e c o n c l u s i o n o f t h e a n a l y t i c c u r e , R e g u l a
Z u r c h e r was f o r t u n a t e e n o u g h to find a m a r r i a g e p a r t n e r , a m a n she
could freely love, b o d y and soul, like h e r first real lover. He w a s
e x c e p t i o n a l l y c h a r i s m a t i c and well k n o w n in his profession far b e y o n d
the b o r d e r s of his o w n c o u n t r y . He also r e s e m b l e d h e r to a g r e a t d e g r e e
in his s e n s i t i v i t i e s , a e s t h e t i c j u d g m e n t s , and a r t i s t i c e n d o w m e n t .
F u r t h e r m o r e , he easily adapted to h e r d e m a n d s for affection and
s e x u a l i t y , loving his wife for h e r w o m a n l y g e n t l e n e s s , t e n d e r n e s s , and
ability to love, as well as for h e r spirituality, h e r lively intellect, and h e r
n a t u r a l s e n s e o f h u m o r . H e appreciated h e r p r e s e n c e , w h i c h c o n s t a n t l y
inspired him t o n e w ideas and c r e a t i v e i m p u l s e s . S i n c e she has b e e n w i t h
this m a n , R e g u l a Z u r c h e r has n o t e x p e r i e n c e d t h e least sign o f a n y u r g e s
to s t a b or s t r a n g l e . T o d a y e v e r y o n e delights in this radiant, vital, h i g h spirited w o m a n .
R e g u l a Z u r c h e r is especially glad t h a t she is able to b e a r h e r h u s b a n d ' s
a b s e n c e s on b u s i n e s s trips for l o n g e r and l o n g e r periods w i t h o u t h a v i n g
to fear e v e n a fleeting r e c u r r e n c e of t h e old u r g e s . S h e h e r s e l f r e c o g n i z e s
this as a sign of g r e a t e r f r e e d o m . S h e has n o t f o r g o t t e n h o w suddenly t h e
relapses used to set in w h e n she had to g e t along w i t h o u t the physical
c l o s e n e s s of a l o v e r for e v e n t w o or t h r e e w e e k s .
T h e r e has been o n l y o n e f u r t h e r disruption o f h e r well-being since
s e c o n d m a r r i a g e . A r e c k l e s s y o u n g d r i v e r lost c o n t r o l of his s p o r t s c a r
drove i n t o a g r o u p o f p e d e s t r i a n s . R e g u l a Z u r c h e r w a s a m o n g
victims. S h e e m e r g e d w i t h only a b r o k e n s h i n b o n e , b u t had to stay in
for six w e e k s .

her
and
the
bed

A Test Case: Regula Zrcher

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 ,

The Natural Scientific View of Medicine

21

c a n n o t e x i s t in t h e scientific c o n c e p t i o n of physics. P h y s i c a l - c a u s a l laws

could n e v e r explain, for e x a m p l e , w h y cell division in an o r g a n stops j u s t
w h e n t h e o r g a n r e a c h e s its p r o p e r (i.e., p r e d e t e r m i n e d ) f o r m . A c c o r d i n g
ly, t h e laws of p r o b a b i l i t y e n t i r e l y rule o u t t h e e x p e c t a t i o n t h a t an
o r g a n i s m o f the c o m p l e x i t y o f a s q u i r r e l m i g h t e m e r g e p h y l o g e n e t i c a l l y
f r o m t h e d o m i n a n c e o f m e r e n a t u r a l laws.
T h e s e o b j e c t i o n s from p h i l o s o p h y , physics, and b i o l o g y c h a l l e n g e d t h e
u n c o n d i t i o n a l j u s t i f i c a t i o n o f 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 i n
m e d i c i n e , b u t t h e y w e r e all t u r n e d aside w i t h a single parry by
c y b e r n e t i c s . T h i s n e w science c l a i m s t h a t i t can r e s t o r e t o t h e rule o f o n e
causal m o d e o f t h o u g h t all t h e p r o p e r t i e s w h i c h had s e e m e d r e s e r v e d
o n l y for the living. W i t h its t h e o r i e s of f e e d b a c k and i n f o r m a t i o n ,
c y b e r n e t i c s i s u n d e r t a k i n g t o a c c o u n t c o m p l e t e l y n o t o n l y for g o a l o r i e n t e d equilibrium p h e n o m e n a in living b e i n g s (i.e., t h e s e l f - s u s t a i n i n g
h o m e o s t a s i s o f c h e m o p h y s i c a l p r o c e s s e s ) , b u t for t h e p r o p a g a t i o n o f
individuals and t h e i r h e r e d i t a r y f u n c t i o n s as well.
N o r b e r t W i e n e r , t h e f o u n d e r o f c y b e r n e t i c s , c h a r a c t e r i z e s his c o n c e p t
o f i n f o r m a t i o n a s s o m e t h i n g t o t a l l y n o v e l and d e s c r i b e s " i n f o r m a t i o n "
itself a s n o l o n g e r m e r e l y e n e r g e t i c o r m e r e l y m a t e r i a l . B u t t h e
l e g i t i m a c y o f c y b e r n e t i c s and i n f o r m a t i o n t h e o r y falls e n t i r e l y w i t h i n t h e
d i m e n s i o n s o f scientific calculability n e v e r t h e l e s s , and t h e r e f o r e u n d e r
the rule o f t h e causal principle. C o n s e q u e n t l y W i e n e r defines t h e h u m a n
being as a " m e s s a g e , " w h i c h , as t h e t e r m is used in i n f o r m a t i o n t h e o r y ,
m e a n s n o t h i n g but a spatially or t e m p o r a l l y o r d e r e d s y s t e m or model of
c h e m i c a l particles or e l e c t r i c a l i m p u l s e s t h a t is a b s o l u t e l y quantifiable
and e x a c t l y m e a s u r a b l e . O n e could hardly find a m o r e radical
f o r m u l a t i o n for t h e i n t e n t o f 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 t o
s e c u r e e x c l u s i v e , a b s o l u t e , and u n c o n d i t i o n a l r i g h t s t o m e d i c i n e .
T h e m a t t e r o f deciding w h e t h e r this m e t h o d can l e g i t i m a t e l y m a k e
s u c h a claim is f u n d a m e n t a l l y i m p o r t a n t for medical s c i e n c e . T h i s
decision will d e t e r m i n e and limit b o t h t h e s o u n d n e s s o f any f o u n d a t i o n
for m e d i c i n e possible n o w and t h e f u r t h e r practical and e p i s t e m o l o g i c a l
possibilities of t h a t f o u n d a t i o n as well. T h e r e is no r o o m for speculation
and a b s t r a c t i o n t h a t d o n o t directly c o n c e r n t h e p h e n o m e n a o f h u m a n
p a t h o l o g y . W e shall call n a t u r a l s c i e n c e ' s p o w e r s o f e x p l a n a t i o n t o
a c c o u n t and shall t e s t t h e i r ability to stand up in t h e face of c o n c r e t e data
from a specific c a s e h i s t o r y .
1

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

seen well e n o u g h i n t o h e a l t h i n e s s can w e u n d e r s t a n d p a t h o l o g i c a l

m a n i f e s t a t i o n s , w h i l e , on the o t h e r h a n d , we can n e v e r derive a p i c t u r e of
h u m a n h e a l t h from d e f e c t i v e pathological m a n i f e s t a t i o n s . S i n c e the
n u m b e r o f n a t u r a l scientific a t t e m p t s t o explain t h e n o r m a l , h e a l t h y
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 h a s g r o w n s o i n o r d i n a t e l y large
lately, w e shall u s e single e x a m p l e s t o r e p r e s e n t w h o l e a r e a s o f related
natural scientific f o r m u l a t i o n s . T h i s r e s t r i c t i o n will n o t h a r m the m a t t e r
at hand, for all i n t e r p r e t a t i o n s w h i c h c o n f o r m in t h e i r f u n d a m e n t a l s
h a v e t h e s a m e kind o f l e g i t i m a c y and t h e s a m e limits.
T h e first m a n i f e s t a t i o n o f h e a l t h i n e s s w e find i n R e g u l a Z i i r c h e r ' s life
is her behavior when she unexpectedly meets the man at whose glance
she had collapsed, h y s t e r i c a l l y lamed, t h e y e a r b e f o r e . T h i s t i m e she
r u s h e s a c r o s s t h e s t r e e t t o h e r lover, h e r h e a r t pounding w i t h delight,
and h u g s and k i s s e s h i m . T h e n t h e y walk h o m e a r m in a r m , discussing
plans for t h e i r c o m i n g v a c a t i o n in a place both k n o w v e r y well. T h i s
c o u r s e o f e v e n t s c o n f o r m s t h o r o u g h l y t o h e r vivacious, impulsive,
c h e e r f u l n a t u r e and m a y s e r v e as a c o n v e n i e n t model of n o r m a l , h e a l t h y
human behavior.
T h e n a t u r a l scientific m e t h o d o f i n v e s t i g a t i o n b e g i n s b y dividing such
a p h e n o m e n o n i n t o t h r e e s e p a r a t e p r o c e s s e s . T h e first is identified as a
process of perception: R e g u l a Z i i r c h e r p e r c e i v e s a m a n a c r o s s t h e s t r e e t . T h i s
perception is followed by a r e c o g n i t i o n : this m a n is h e r lover. In r e f e r r i n g
to this r e c o g n i t i o n , and especially r e g a r d i n g t h e i r r e m i n i s c e n c e s a b o u t a
past v a c a t i o n , n a t u r a l scientific e x p l a n a t i o n s speak n e x t of a memory
performance. Finally, h e r r u s h i n g to h e r l o v e r is s e e n as a third p r o c e s s , t h e
p e r f o r m a n c e of an impulse of will, a motor reaction.
N a t u r a l scientific p h y s i o l o g y realizes t h a t a c e r t a i n artificiality
a t t a c h e s to this subdividing. It has long b e e n r e c o g n i z e d t h a t p r o c e s s e s of
p e r c e p t i o n are a l w a y s a c c o m p a n i e d b y c e r t a i n m o t i v e impulses. A n d long
a g o it w a s s e e n t h a t t h e m o d e of p e r c e p t i o n , particularly its " a f f e c t i v e
c o l o r a t i o n , " is i m p o r t a n t in d e t e r m i n i n g fixation in m e m o r y .
B u t w h a t is m o s t significant h e r e is t h a t in d e s c r i b i n g an i n s t a n c e of
h e a l t h y b e h a v i o r in o u r test case we c a m e , a p p a r e n t l y in spite of
o u r s e l v e s , t o speak o f p h e n o m e n a t h a t clearly display s o m e t h i n g
n o n p h y s i c a l : t h e p e r c e p t i o n o f t h e lover, t h e r e c o l l e c t i o n , the feeling o f
pleasure, t h e t h o u g h t o f r u s h i n g o v e r t o him, t h e desire t o b e c l o s e r t o
him, and the i m p u l s e of will. O u r s t a t e m e n t s a s s u m e d a c o n s c i o u s n e s s as
a precondition for t h e s e activities, and we did n o t begin to n o t i c e the
physicality o f R e g u l a Z i i r c h e r until w e o b s e r v e d t h e m o t o r r e a c t i o n t o
t h e perceptual s t i m u l u s , h e r act of will in r u n n i n g to h e r lover. It is
11 c m e n d o u s l y i m p o r t a n t to see t h a t this e n c o u n t e r w i t h h e r l o v e r is

The Natural Scientific View of Medicine

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

His c o m m o n falsification o f t h e a n c i e n t G r e e k c o n c e p t o f p s y c h e aside,

M c L e a n i m m e d i a t e l y s e e s t h a t h e m u s t a c k n o w l e d g e t h e impossibility o f
deriving p s y c h i c f u n c t i o n s directly f r o m t h e c h e m o p h y s i c a l and
i n f o r m a t i o n a l data t h a t can be g a t h e r e d from t h e brain and its f u n c t i o n s .
H e also a d m i t s t h a t i f t h e r e w e r e n o s u b j e c t i v e i n t r o s p e c t i o n ,
n e u r o p h y s i o l o g i s t s would n e v e r h a v e b e e n able to f o r m u l a t e even a
single t h o u g h t a b o u t p s y c h i c realities o r a w a r e n e s s , feelings, p e r c e p
t i o n s , e m o t i o n s , and t h o u g h t s . I n M c L e a n ' s t h i n k i n g , such i n t r o s p e c t i o n
b e c o m e s possible b e c a u s e t h e n e r v o u s s y s t e m can, as it w e r e , reflect and
i n t e r p r e t t h e flow of data t h r o u g h a m i r r o r l i k e s u b j e c t i v i t y in which it is
r e f l e c t e d . F r o m this h e d r a w s t h e surprising c o n c l u s i o n :
I t i s t h e e l e m e n t o f s u b j e c t i v i t y t h a t m o s t clearly d i s t i n g u i s h e s
p s y c h o l o g i c a l from o t h e r f u n c t i o n s o f t h e n e r v o u s s y s t e m . I n the light
of this and t h e f o r e g o i n g c o n s i d e r a t i o n s , a p s y c h o l o g i c a l p r o c e s s m i g h t
be i n f e r e n t i a l l y defined as a n e u r o n a l l y d e t e r m i n e d p r o c e s s w h i c h
derives i n f o r m a t i o n i n c o n j u n c t i o n w i t h s o m e e l e m e n t o f s u b j e c t i v i t y
and w h i c h m a y or m a y n o t u s e this i n f o r m a t i o n to effect a decision.
S u c h a definition o f t h e " p s y c h o l o g i c a l f u n c t i o n s o f the n e r v o u s
s y s t e m , " M c L e a n b e l i e v e s , i s " c o m p a t i b l e w i t h scientific o b j e c t i v i t y . "
V. S. M o u n t c a s t l e a d v a n c e s a " t h e o r e t i c a l a l t e r n a t i v e " for clarifying
this p r o b l e m . In o r d e r to g r a s p physiologically t h e n o n m a t e r i a l psychic
aspect of a c o n s c i o u s n e s s and of p e r c e p t i o n , M o u n t c a s t l e b e l i e v e s t h a t
4

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

The Natural Scientific View of Medicine

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

M o u n t c a s t l e ' s n o t i o n o f the " e s s e n c e " o f t h e psychic and t h e a t t r i b u t e s

M c L e a n assigns t o t h e psychic a r e s t r i k i n g l y similar. B o t h w r i t e r s are
r e p r e s e n t a t i v e , as typical as t h e y are f i r s t - r a t e , of t h e p s y c h o n e u r a l
identity t h e o r y w h i c h p r e d o m i n a t e s i n m o d e r n m e d i c i n e . B o t h are
c o n v i n c e d t h a t it is t h e t a s k of n e u r o p h y s i o l o g y to explain all h u m a n
b e h a v i o r in n e u r a l t e r m s , including w h a t is called p s y c h i c .
Y e t only b e c a u s e t h e y h a v e u n t h i n k i n g l y t a k e n w h a t n a t u r a l s c i e n c e
has declared to be t h e e s s e n c e of t h e o r g a n i c as c r i t e r i a for t h e i r
d e t e r m i n a t i o n o f the psychic a r e t h e y able t o s i m u l a t e a n y c o m p a t i b i l i t y
b e t w e e n t h e i r definitions o f " p s y c h i c f u n c t i o n s " and scientific o b j e c
tivity.
H o w is M c L e a n ' s i n t r o d u c t i o n of a s u b j e c t i v e e l e m e n t to bring us o n e
step c l o s e r to u n d e r s t a n d i n g a n y t h i n g psychic if we are n o t at t h e s a m e
t i m e given precise i n s t r u c t i o n i n t h e n a t u r e o f this s u b j e c t i v e e l e m e n t ?
M c L e a n should be able to tell us at least h o w this e l e m e n t is so
c o n s t i t u t e d that, t h a n k s t o it, t h e c h e m o p h y s i c a l l y d e t e r m i n a b l e ,
m a t e r i a l n e r v o u s s y s t e m can hold a m i r r o r to itself and c o m p r e h e n d its
o w n significance f r o m t h e r e f l e c t i o n it p e r c e i v e s .
M o u n t c a s t l e ' s proposal, o n t h e o t h e r h a n d , a b s t a i n s f r o m t r e a t i n g t h e
psychic as t h e p r o d u c t i o n of " n e u r a l a c t i v i t y " in o r d e r to indicate m o r e
accurately how we might envision a production of the "psychic through
n e u r a l a c t i v i t y . " Still less c o m p r e h e n s i b l e to him is t h e w a y in w h i c h a
n e u r a l activity m i g h t b e c o m e t h e actual e s s e n c e o f t h e p s y c h i c .
C o n s i d e r i n g t h e s e similar s t a t e m e n t s o f d o u b t i n t h e M c L e a n and
M o u n t c a s t l e articles, it is n o t s u r p r i s i n g t h a t b o t h end in e s s e n t i a l l y t h e
s a m e s o r t o f r e s i g n a t i o n . H o w t h e n e r v o u s s y s t e m can u s e c h e m o p h y s i
cal p r o c e s s e s t h a t take place in i t s e l f to p r o d u c e v o l u n t a r y decisions and
o t h e r psychic f u n c t i o n s u l t i m a t e l y r e m a i n s a " c o m p l e t e m y s t e r y " for
M c L e a n . M o u n t c a s t l e c o n f e s s e s i n the end t h a t " o u r u n d e r s t a n d i n g o f
these things in these terms (the production of mental experience
t h r o u g h n e u r a l activity) i s p r e s e n t l y v e r y primitive i n d e e d . "
T h e m o s t c o n s e q u e n t i a l t r e a t m e n t s o f t h e psychic aspect are b y
researchers working from cybernetics. H. Rohracher undertakes to
derive all psychic f u n c t i o n s f r o m " e x c i t a t i o n s " in t h e n e r v e cells. He says,
"It is c l e a r t h a t a c e r e b r a l t h e o r y of psychic p r o c e s s m u s t c o n c e r n itself
a b o v e all w i t h t h e s e ' e x c i t a t i o n s , ' since w e h a v e a t o u r disposal n o o t h e r
basis for c o n s c i o u s e x p e r i e n c e e x c e p t p r o c e s s e s of e x c i t a t i o n in t h e
brain." R o h r a c h e r believes t h a t h e can d i f f e r e n t i a t e a m o n g t h e s e

2o

EXISTENTIAL FOUNDATIONS

" f u n d a m e n t a l " c e r e b r a l e x c i t a t i o n s . As he s e e s it, it is possible t h a t " t h e

d i f f e r e n c e b e t w e e n t h e t h o u g h t ' M a t t e r h o r n ' and the c o n t e n t 'social
j u s t i c e ' c o n s i s t s n o t m e r e l y in a d i f f e r e n c e in t h e n u m b e r of participating
e x c i t a t i o n s , b u t r e q u i r e s as well a d i f f e r e n c e in the types of the
participating e x c i t a t i o n s . " He h a s in mind d i f f e r e n c e s in t h e f r e q u e n c i e s
and a m p t i t u d e s of t h e electrical impulses and d i f f e r e n c e s in the r a t e s at
w h i c h t h e y are p r o p a g a t e d in the n e r v o u s s t r u c t u r e of the brain.
Rohracher's theory of cognition is grounded on the hypothesis that "the
laws of logic a r e in t r u t h laws of e x c i t a t o r y a c t i v i t y in the c e r e b r u m . T h e
solution (to a t h o u g h t - p r o b l e m ) lies in t h e u n i f i c a t i o n of the c o n s t e l l a
tions (of e x c i t a t i o n s ) to p r o d u c e a total c o n s t e l l a t i o n ; and the psychic
s y m p t o m t h a t such a c o n s t e l l a t i o n has f o r m e d is t h e c o n v i c t i o n t h a t t h e
solution is c o r r e c t : t h e r e is no l o n g e r any c o n t r a d i c t i o n a m o n g the
individual e x c i t a t i o n s . "
0

T h i s t h e o r y et o n c e raises the o b j e c t i o n t h a t in a strict, scientific,

s e n s e , t h e r e can b e n o s u c h t h i n g a s e x c i t e d n e r v e cells. T o speak o f
excited n e r v e cells is t a n t a m o u n t to a n t h r o p o m o r p h i z i n g c h e m o e l e c t r i cal p r o c e s s e s . W h a t t a k e s place in t h e s e cells isproperly s p e a k i n g o n l y
repetition o f such p r o c e s s e s a s t h e rapid e x c h a n g e o f p o t a s s i u m i o n s ,
w i t h all o f t h e c h e m o e l e c t r i c a l chain r e a c t i o n s t h a t g o w i t h it. N o m a t t e r
h o w fast such an e x c h a n g e m a y g o , it h a s , s t r i c t l y speaking, n o t h i n g to do
w i t h an e x c i t a t i o n . O n l y a w h o l e living being can ever be, or b e c o m e ,
g e n u i n e l y e x c i t e d . T h i s h a p p e n s w h e n s o m e t h i n g t h a t has just s t a r t l e d i t
has been perceived as o b t r u s i v e and understood as s o m e h o w u n s e t t l i n g . A n d
the ability t o t h i n k a b o u t the M a t t e r h o r n o r social j u s t i c e , o r the
c o n v i c t i o n t h a t a s o l u t i o n to a p r o b l e m is c o r r e c t , can no m o r e be derived
from a sodium p o t a s s i u m e x c h a n g e in t h e cells of t h e brain t h a n an
e x c i t a t i o n could be.
' Even less c o m p r e h e n s i b l e is h o w t h e r e could possibly be a " c o n t r a d i c
t i o n " a m o n g t h e e x c i t a t i o n s o f individual n e r v e cells. Cell r e a c t i o n s can
w o r k a g a i n s t e a c h o t h e r ; o n e billiard ball can b u m p into a n o t h e r , b u t
n e v e r can it c o n t r a d i c t t h a t o t h e r . C o n t r a d i c t i o n a s s u m e s diction, t h e
capacity to speak. B u t speech is a l w a y s an i n d i c a t o r of m e a n i n g w h i c h a
r e c e p t i v e being has perceived in s o m e t h i n g it e n c o u n t e r s . Cells can n e v e r
perceive t h e m e a n i n g o f s o m e t h i n g o n t h e basis o f a n ion e x c h a n g e .
T h u s , cells t h e m s e l v e s can n e v e r c o n t r a d i c t e a c h o t h e r , j u s t a s t h e y are
n e v e r in a position to e f f e c t t h e psychic s y m p t o m of t h e c o n v i c t i o n t h a t a
solution to a p r o b l e m is c o r r e c t .
absurdities, the neurophysiological explanations of
inspired by c y b e r n e t i c s are e x e r t i n g an e v e r g r e a t e r
m l l u e n i e m medicine, and physicians c a n n o t dispense with a t h o r o u g h
c o n s i d e r a t i o n o l its f u n d a m e n t a l s .
Despite

human

such

phenomena

The Natural Scientific

View of Medicine

27

C y b e r n e t i c t h i n k i n g is based on t h e c o n c e p t s of i n f o r m a t i o n and feed

back of bits of i n f o r m a t i o n . I n f o r m a t i o n is n e i t h e r simply m a t e r i a l n o r
simply e n e r g e t i c , b u t it is n e v e r t h e l e s s , in its f o u n d e r ' s c o n c e p t i o n ,
quantitatively measurable.
W h a t could have b e e n m o r e w e l c o m e t o n e u r o p h y s i o l o g i s t s than such
a c o n c e p t o f i n f o r m a t i o n ? W h a t else could h a v e g i v e n t h e m g r e a t e r h o p e s
of h a v i n g found, at long last, a d e s c r i p t i v e principle t h a t m i g h t help t h e m
g e t a scientific hold on e v e n t h o s e psychic m a n i f e s t a t i o n s t h a t had b e e n
o u t o f r e a c h b e c a u s e t h e y could n o t b e m e a s u r e d ?
F o r m a n y p h y s i o l o g i s t s , d i s i l l u s i o n m e n t set in at o n c e . H. H e n s e l , for
i n s t a n c e , concluding a c h a p t e r - l o n g c r i t i q u e of i n f o r m a t i o n t h e o r y ,
writes:
S e e n from a philosophical s t a n d p o i n t , i n f o r m a t i o n a l c o n c e p t s add
n o t h i n g decisively n e w t o t h e t h e o r y o f t h e s e n s e s . I n relation t o t h e
p h e n o m e n a t h e m s e l v e s , t h e y h a v e the s a m e a r b i t r a r y c h a r a c t e r a s t h e
c o n c e p t u a l f r a m e w o r k s o f e v e r y o t h e r positive s c i e n c e . B a s i n g a
t h e o r y o f p e r c e p t i o n o n c y b e r n e t i c s would b e adding t o t h e old e r r o r o f
n a t u r a l i s m a n e w o n e " c y b e r n e t i c i s m " or " i n f o r m a t i s m . " In addition,
this would c o n t i n u e p h y s i o l o g y ' s peculiar tradition of d r a w i n g its
t e r m i n o l o g y from the m o m e n t a r i l y prevailing n a t u r a l s c i e n c e and
t e c h n o l o g y instead of s e t t i n g up an i n d e p e n d e n t t h e o r e t i c a l f r a m e
w o r k for i t s e l f .
7

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 .

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EXISTENTIAL

FOUNDATIONS

T o stop r e l a t i n g t h e psychic aspect t o t h e n e r v o u s s y s t e m ' s

c h e m o p h y s i c a l b a s e and r e l a t e i t i n s t e a d t o t h e s y s t e m ' s m o l e c u l a r
structure, or to stochastic processes within the molecule, or to ordered
s e q u e n c e s of electrical i m p u l s e s , is n o t to establish a r e l a t i o n s h i p t h a t is
a n y less q u e s t i o n a b l e . I t r e d u c e s t h e h u m a n ability t o perceive m e a n i n g
t o specific c h a i n r e a c t i o n s o f m o l e c u l a r p r o c e s s e s i n s t e a d o f c r u d e
c h e m o p h y s i c a l b r a i n a c t i v i t y . In t h e p r o c e s s it e x a g g e r a t e s and
anthropomorphizes these molecular systems into analogs to con
s c i o u s n e s s o r c o n s c i o u s n e s s l i k e m e s s a g e s . B o t h this and t h e c h e m o
physical r e d u c t i o n p r e s u p p o s e o b l i v i o u s n e s s t o t h e e s s e n t i a l c h a r a c t e r
and s u b s t a n c e of t h e r e a l m of m a t e r i a l - e n e r g e t i c p r o c e s s e s as well as
t h e realm of l a n g u a g e and h u m a n c o n d u c t . It is impossible to o v e r l o o k
t h e p r o f o u n d d i f f e r e n c e s b e t w e e n c h e m i s t r y and l a n g u a g e u n l e s s
o n e ' s vision i s s o i n t e n t o n t h e c o n c e p t o f i n f o r m a t i o n t h a t e v e r y t h i n g
else m u s t a p p e a r d i s t o r t e d . T h e v a g u e n e s s with w h i c h e x a c t s c i e n c e
defines i n f o r m a t i o n s t r e n g t h e n s t h e t e n d e n c y t o use this definition a s
t h e basis for supposed i n t e r a c t i o n s b e t w e e n all s o r t s of s y s t e m s .
T h e c y b e r n e t i c i n t e r p r e t a t i o n of man is a l e g i t i m a t e offspring of t h e
n a t u r a l scientific m e n t a l i t y . T h u s i t t a k e s t h e affiliations a m o n g
e l e c t r o c h e m i c a l s y s t e m s and i n f o r m a t i o n s y s t e m s t o b e j u s t a n o t h e r
cause-effect relationship. But the new vocabulary of information
t h e o r y t a m e s and plays d o w n the puzzling, disquieting v a c u u m t h a t is
f u n d a m e n t a l l y i n h e r e n t i n t h e c a u s a l i t y principle. C a u s a l i t y m e a n s
r e d u c t i o n t o t h e purely f o r m a l l e g i t i m a c y o f t e m p o r a l s u c c e s s i o n .
C a u s a l r e l a t i o n s h i p s a m o n g s y s t e m s , i n t h e m s e l v e s dark and e m p t y ,
look m o r e h u m a n and accessible w h e n t h e y a r e r e w r i t t e n for
information theory as "message relaying" or "symbol transference," as
" m o l e c u l a r s c r i p t " or " t r a n s l a t i o n . " B u t in fact t h e r e is in i n f o r m a t i o n
p r o c e s s e s in t h e brain n o t a t r a c e of a m e s s a g e , relay, s y m b o l , script, or
l a n g u a g e to be found as such. R a t h e r , t h e s e specifically h u m a n
p h e n o m e n a are a l w a y s directly r e l a t e d s t r i c t l y s p e a k i n g t o the
p e r c e p t i o n and c o m m u n i c a t i o n of m e a n i n g . It is e n t i r e l y b e y o n d t h e
capabilities o f a n y t h i n g m a t e r i a l o r e n e r g e t i c , including m a t e r i a l e n e r g e t i c s y s t e m s , t o p e r c e i v e and c o m m u n i c a t e m e a n i n g .
Even t h e m o s t c a u t i o u s brain r e s e a r c h e r s , p r e f e r r i n g t o set aside the
unclarified c o n c e p t o f i n f o r m a t i o n , c a n n o t c o m e t o t e r m s with 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 s o m a . W h e n r e f e r r i n g t o t h e t w o ,
they speak only of a " c o r r e l a t i o n , " of " c o u n t e r p a r t s " and i n e v i t a b l e
" a t t e n d a n t m a n i f e s t a t i o n s , " of a " j o i n i n g " and " c o u p l i n g . " B u t a
" c o r r e l a t i o n " is highly q u e s t i o n a b l e as long as o n e of t h e t w o t h i n g s
c o r r e l a t e d , the psyche, r e m a i n s as indefinite as it is in p h y s i o l o g y .
Besides, I he vei y nol ion of a " c o r r e l a t i o n , " " a t t e n d i n g , " or " j o i n i n g "
ass limes > previous dividing and objectifying of h u m a n e x i s t e n c e into

The Natural Scientific View of Medicine

29

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 oi ned 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 at es 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

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FOUNDATIONS

c o n c e r n . It is of far g r e a t e r c o n s e q u e n c e t h a t t h r o u g h its claims of

u n i v e r s a l validity it so o f t e n o v e r r e a c h e s its p r o p e r b o u n d a r i e s in the
field of m e d i c i n e . N a t u r a l s c i e n c e insists on t r y i n g to define and clarify
a set of p h e n o m e n a to w h i c h it h a s no a c c e s s , t h e p h e n o m e n a of h u m a n
e x i s t e n c e . T h i s d o g g e d n e s s c o m p l e t e s t h e e f f e c t o f fascination and
i n t i m i d a t i o n w i t h w h i c h t h e m a r v e l s o f n a t u r a l scientific m a n i p u l a t i o n
h a v e e n t r a n c e d m a n k i n d in t h e a g e of t e c h n o l o g y . In t h e final a n a l y s i s ,
this p o w e r t o m a n i p u l a t e h a s tended t o blind n a t u r a l scientific
researchers to their own theoretical transgressions.
W e can b e g i n t o u n d e r s t a n d n o w t h e s t u b b o r n s e l f - c o n f i d e n c e w i t h
w h i c h n a t u r a l s c i e n c e holds u p biology, a n a t o m y , p h y s i o l o g y and
p a t h o l o g y as e v i d e n c e t h a t it is the g e n u i n e basis of m e d i c i n e . B u t to
justify this claim, t h e s e s u b s c i e n c e s m u s t first b e able t o prove t h a t t h e
physical c o m p o n e n t t h e y m a n i p u l a t e so e f f e c t i v e l y is of p r i m a r y , basic
i m p o r t a n c e . T h a t is, t h e y m u s t b e able t o s h o w t h a t the physical body
as t h e y define it is capable of i n d e p e n d e n t l y g e n e r a t i n g e v e r y
c o n c e i v a b l e h u m a n a c t i v i t y . B u t such a p r o o f does n o t exist a n y w h e r e .
B e s i d e s , n o w h e r e i n t h e s c i e n c e s o f biology, a n a t o m y , p h y s i o l o g y , o r
p a t h o l o g y is t h e r e a n y precise indication of w h a t " b a s i c " m e a n s . It
m i g h t appear at first t h a t t h e n o t i o n c o m m o n in physics should apply in
medicine as well. H o w e v e r , in p h y s i c s , basic r e s e a r c h is r e s e a r c h t h a t
f o r m u l a t e s the t h e o r e t i c a l s u p p o s i t i o n s u n d e r l y i n g t h e s u c c e s s o f
physical e x p e r i m e n t a t i o n . E x p e r i m e n t s , in t u r n , are c o n d u c t e d w i t h i n
the h o r i z o n s o f t h e o r y s o prescribed and are a i m e d a t c o n f i r m i n g t h a t
t h e o r y . W h e n such c o n f i r m a t i o n is n o t f o r t h c o m i n g , it is n e c e s s a r y to
f r a m e a n e w t h e o r y w h i c h p e r m i t s the n e w findings to be fitted i n t o an
u n b r o k e n p a t t e r n o f causality. S i n c e t h e w h o l e s p e c t r u m o f basic
r e s e a r c h in physical s c i e n c e (including m e d i c i n e ) is g r o u n d e d on t h e
a s s u m p t i o n t h a t w h a t e v e r is real m u s t be m e a s u r a b l e and calculable,
and since n o e x p e r i m e n t can c a r r y n a t u r a l s c i e n c e b e y o n d its o w n
f u n d a m e n t a l p r e c e p t s , n a t u r a l scientific medicine will n e v e r h a v e
a n y t h i n g f u n d a m e n t a l l y n e w to say a b o u t a h u m a n body w h o s e n a t u r e
it has stipulated as calculable.
P r e s u m a b l y , medical r e s e a r c h e r s t h i n k of a basis primarily as s o m e
u n d e r m o s t , o b j e c t i v e level from w h i c h all h u m a n p h e n o m e n a can be
derived in a c a u s a l - g e n e t i c way. B u t n o t e v e n t h e least part of h u m a n
b e h a v i o r can b e t h o r o u g h l y explained o n t h e basis o f w h a t a n a t o m y ,
biology, and p h y s i o l o g y h a v e b r o u g h t to light. E v e n a description of the
c o u n t l e s s c h e m o p h y s i c a l p r o c e s s e s in the h u m a n body, c o n c e p t u a l i z e d
as a physical o r g a n i s m in a s p a c e - t i m e c o n t i n u u m , c a n n o t lead to a n y
u n d e r s t a n d i n g of even such a simple bodily p h e n o m e n o n of h u m a n

The Natural Scientific

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

Beings: Cybernetics and Society

t r a n s l a t i o n : Mensch-Maschine ( 1 9 5 2 ) ,

pp.

(Boston:

Hough tor

94ff.

2. M c L e a n ' s " P s y c h o s o m a t i c s , " in Handbook of Physiology ( W a s h i n g t o n , D . C . : A m e r i c a r

Physiological Society, 1 9 6 0 ) , p. 1 7 2 4 .
3 . Ibid., p . 1 7 2 5 .
4 . Ibid.
5. V . S .

M o u n t c a s t l e , " T h e Neural Replication of S e n s o r y E v e n t s ' in the S o m a l i

A f f e r e n t , " in Brain and Conscious Experience, ed., J . O E c c l e s ( N e w Y o r k : 19t>t>) p. 8 5 .

32

EXISTENTIAL

6. H.
Gehirn

R o h r a c h e r , Die Arbeitsweise dea

und das geistige Leben

7. H.

Hensel,

Lehrbuch

(Munich:
der

Gehirns und psychische

1 9 5 3 ) , pp. 87 a n d

Physiologie.

Allgemeine

(Berlin Heidelberg, N e w York: 1 9 6 6 ) , p. 12.

Vorgnge,

FOUNDATIONS

3d ed.,

Die

Vorgnge im

153.

Sinnesphysiologie,

Hautsinne,

Geschmack,

Geruch

Chapter 3

THE NATURAL SCIENTIFIC VIEW OF PSYCHOLOGY

AND PSYCHOSOMATICS

N a t u r a l scientific r e s e a r c h m e t h o d s r e a c h t h e i r o b j e c t s o f study only i n

r e l a t i o n to t h e i r m e a s u r a b l e and calculable s t r u c t u r e s , w h i c h is to say,
only w i t h r e s p e c t t o t h e i r c h e m o p h y s i c a l p r o c e s s e s a n d t h e i r c y b e r n e t i cally q u a n t i f i a b l e c o m p o s i t i o n s . W h e n m e d i c i n e applies this t o h u m a n
b e i n g s , it is t h e body w h i c h p r e s e n t s i t s e l f for precise m e a s u r e m e n t s and
c a l c u l a t i o n s . T h i s p e r s p e c t i v e o n m a n o p e n e d u n h e a r d - o f possibilities t o
m e d i c i n e for m a n i p u l a t i n g t h e h u m a n body, and its scientific a d v a n c e s
h a v e c o n t r o l l e d diseases t h a t used t o b e t h e m o s t c o m m o n a n d m o s t
dealy. B u t t h e overall m o r b i d i t y o f m a n k i n d has r i s e n , n o t fallen; i l l n e s s e s
have appeared which conventional therapeutic measures cannot combat.
F o r a w h i l e , p h y s i c i a n s looked hopefully to t h e f u t u r e , c e r t a i n t h a t w i t h
i m p r o v e d m e t h o d s t h e y w o u l d find o r g a n i c c h a n g e s t o explain t h e
p a t h o g e n e s i s o f t h e s e n e w d i s e a s e s . B u t a s t i m e passed, i t b e c a m e
a p p a r e n t t h a t t h e i r p a t h o g e n e s i s could n o t b e explained o n a n o r g a n i c ,
n a t u r a l scientific basis but instead had to do w i t h a p a t i e n t ' s o r i e n t a t i o n
t o w a r d his s u r r o u n d i n g s , t o w a r d o t h e r people, and t o w a r d h i m s e l f .
T h u s , it became necessary to make a theoretical distinction. T h e new
diseases w e r e s e p a r a t e d f r o m t h o s e w h o s e c a u s e s w e r e c o n s i d e r e d
primarily o r g a n i c t h e s o m a t o g e n i c d i s e a s e s a n d w e r e called primarily
psychic d i s t u r b a n c e s , o r p s y c h o g e n i c n e u r o s e s .

34

EXISTENTIAL

FOUNDATIONS

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

The Natural Scientific

View

35

psychic o r g a n , psychic s y s t e m , p s y c h i c a p p a r a t u s , ofin s h o r t t h e

p s y c h e . In e l a b o r a t i n g his t h e o r y , F r e u d s u g g e s t e d t h a t this a p p a r a t u s be
visualized as a t h r e e part e n t i t y , divided into t h e s u b s y s t e m s of a
c o n s c i o u s , a p r e c o n s c i o u s , and an u n c o n s c i o u s . T h e c e n t r a l role assigned
t o the m a t e r i a l s u b s t r a t u m o f the c e n t r a l n e r v o u s s y s t e m b y physiology
w a s a n a l o g o u s l y a s s u m e d by the u n c o n s c i o u s . If p h y s i o l o g y had declared
t h e m a t e r i a l c e n t r a l n e r v o u s s y s t e m t o b e t h e basis o f all h u m a n
b e h a v i o r , Freud w a s n o w d e s i g n a t i n g t h e u n c o n s c i o u s a s the e s s e n t i a l
and o n l y real part o f all p s y c h i c m a n i f e s t a t i o n s . L a t e r m o d i f i c a t i o n o f this
subdivision i n t o t h e triad of id, e g o , and s u p e r e g o b r o u g h t w i t h it n o t h i n g
fundamentally new.
C o r r e s p o n d i n g t o the c h e m o p h y s i c a l p r o c e s s e s medical s c i e n c e could
t r a c e in t h e realm of the s o m a t i c , so, F r e u d believed, w a s t h e psychic
a p p a r a t u s filled w i t h psychic m a t e r i a l . B y this h e m e a n t psychic
r e p r e s e n t a t i o n s o f o b j e c t s from t h e world o u t s i d e t h e mind, also called
c o n c e p t i o n s , and q u a n t a of p s y c h i c e x c i t a t i o n , t h e so-called affects and
drives. T h e s e affects and drives w e r e t h o u g h t t o b e c o m e a t t a c h e d t o the
p s y c h i c c o n c e p t i o n s , b e able t o b r e a k l o o s e f r o m t h e m , and t h e n b e
displaced o n t o n e w c o n c e p t i o n s . F r e u d tried to fit all of t h e s e a s s u m e d
c o m p o n e n t s i n t o a flawless c a u s a l c o n t e x t t h a t w o u l d follow e x a c t l y
physical m e d i c i n e ' s p r e c e p t s r e g a r d i n g t h e c h e m o p h y s i c a l , o r g a n i c
s t r u c t u r e s and p r o c e s s e s o f t h e body.
F r e u d c o m p l e t e d his p s y c h o a n a l y t i c t h e o r y w i t h t h e f u r t h e r a s s u m p
tion of a psychic e n e r g y , t h e libido, to w h i c h he could n o w a s c r i b e t h e
m o s t varied kinds of drives and partial drives. He visualized t h e s e drives
a s " q u a n t i t i e s o f e x c i t a t i o n " t h a t w e r e variable, capable o f s u b l i m a t i o n
and r e a c t i o n , and displaceable, able to be m i x e d and t h e n isolated again,
and in this w a y he m a d e his p s y c h i c apparatus w o r k a b l e . S u c h a p s y c h e
had o n l y to t r a n s f e r to t h e o u t s i d e world p a r t s of t h e libidinal q u a n t i t i e s it
had c o l l e c t e d and t h e n u s e t h e s e q u a n t i t i e s to i n v e s t ( " c a t h e c t " )
p h e n o m e n a in the s u r r o u n d i n g s , and already, in F r e u d ' s opinion, t h e
originally a u t o e r o t i c o r totally n a r c i s s i s t i c p s y c h e had m a d e ties t o t h e
outside world.
P a t h o l o g i c a l p h e n o m e n a w e r e explained b y a s s u m i n g d i s t u r b a n c e s o f
t h e drives w i t h i n t h e p s y c h i c a p p a r a t u s . T h e m o s t i m p o r t a n t i n F r e u d ' s
t h e o r y are defects in t h e i n t e g r a t i o n of m e n t a l drives; p a t h o l o g i c a l
fixation o f t h e libido o n a r c h a i c c o n c e p t i o n s ; r e g r e s s i o n t o f o r m e r
d e v e l o p m e n t a l s t a g e s of t h e libido; and d i s p l a c e m e n t of painful m e n t a l
associationsalong with the affects accompanying t h e m t o inaccessi
ble s y s t e m s o f t h e p s y c h i c a p p a r a t u s , o r the m e r e d i s e n g a g e m e n t o f such
a s s o c i a t i o n s from their libidinal i n v e s t m e n t s .
S i n c e Freud m a d e his initial t h e o r e t i c a l f o r m u l a t i o n s , t h e crudely
m e c h a n i c a l notion of a psychic a p p a r a t u s h a s g o n e t h r o u g h m a n y

36

EXISTENTIAL

FOUNDATIONS

r e f i n e m e n t s , c o r r e c t i o n s , and additions. T h e s e c a m e f r o m Freud h i m s e l f ,

from his disciples, and f r o m his o p p o n e n t s . Fairly early, Adler a c c e n t e d
the so-called a g g r e s s i v e drives and the " m a s c u l i n e p r o t e s t . " S h o r t l y
a f t e r w a r d s , J u n g e x p a n d e d Freud's c o n c e p t of the libido, so t h a t it
coincided g e n e r a l l y w i t h the n o t i o n of psychic e n e r g y . In addition, he
h u n g from t h e F r e u d i a n p s y c h e an e v e n d e e p e r layer, w h i c h he called the
collective u n c o n s c i o u s . In this layer he a s s u m e d the p r e s e n c e of
a r c h e t y p e s , w i t h w h i c h h e r e p r e s e n t e d i n t r a p s y c h i c i n s t i n c t i v e drives
and m e n t a l f o r c e s t h a t equally affected all people. J u n g believed t h a t in
t h e last analysis t h e s e a r c h e t y p e s c o n t r o l people's p e r c e p t i o n s o f t h e
outside w o r l d and d e t e r m i n e t h e i n n e r p a t t e r n s o f b e h a v i o r o f e v e r y
h u m a n being.
In a n o t h e r d i r e c t i o n , H. H a r t m a n n w o r k e d on refining t h e n o t i o n of
e g o . He and his circle s u g g e s t e d t h a t e g o be visualized as a c o m p o s i t e of
various partial-ego a p p a r a t u s e s , e a c h o f w h i c h w a s a s s u m e d t o b e
specialized for a p a r t i c u l a r e g o f u n c t i o n p e r c e p t i o n , t h o u g h t , and so
f o r t h . F r o m its v e r y b e g i n n i n g , this b r a n c h o f p s y c h o l o g y a t t r i b u t e d t o
the ee o an a u t o c h t h o n o u s s t r u c t u r e , and e n e r g y r e s o u r c e s t h a t did n o t
h a v e t o b e d r a w n from t h e g e n e r a l r e s e r v o i r o f e r o t i c libido.
Even b e f o r e H a r t m a n n , F. A l e x a n d e r and K. H o r n e y set F r e u d ' s
apparatus on its head by pointing o u t t h a t h u m a n b e h a v i o r could n o t be
u n d e r s t o o d o n t h e basis o f individual drives o r partial drives. R a t h e r ,
e v e r y t h i n g i n s t i n c t i v e w a s always s u b s u m e d in t h e total p e r s o n a l i t y and
could be g r a s p e d o n l y by e x a m i n i n g t h e total p e r s o n a l i t y .
V . von W e i z s c k e r a t t a c k e d the s t r i c t d e t e r m i n i s m o f t h e original
p s y c h o a n a l y t i c t h e o r y . F i r s t , h e replaced t h e psychic apparatus w i t h t h e
c o n c e p t of t h e s u b j e c t . While this d e s i g n a t i o n had long had a p l a c e purely as a titlein p s y c h o a n a l y t i c l i t e r a t u r e , W e i z s c k e r s t h e o r y
c o n t r a s t e d sharply w i t h all n a t u r a l scientific b r a n c h e s o f p s y c h o l o g y
b e f o r e and since in a s s e r t i n g t h a t this s u b j e c t w a s always "causally
u n d e r - d e t e r m i n e d . " It had to be accorded its o w n " s p o n t a n e i t y " and " b e
seen as an e n t i t y acting i n d e p e n d e n t l y in r e l a t i o n to i t s e l f . " For this
r e a s o n , the s u b j e c t w a s to a large e x t e n t r e s p o n s i b l e for d e t e r m i n i n g t h e
particular t i m e a p e r s o n would b e c o m e ill, t h e p a r t i c u l a r type of illness,
and t h e particular o r g a n affected. B u t h e w a r n e d a g a i n s t m i s t a k i n g the
s u b j e c t for a solipsistic m o n a d . On the c o n t r a r y , i n t r i n s i c to t h e subject
was a close and vital bond with its s u r r o u n d i n g s , t h e t w o being so
" j o i n e d , " " f u s e d , " and " m e s h e d " t h a t it w a s n e c e s s a r y to speak of a
"polarly b o u n d federalism o f s u b j e c t and o b j e c t . " W e i z s c k e r ^ m o s t
pointed opposition t o t h e n a t u r a l scientifically o r i e n t e d b r a n c h e s o f
psychology lies in his c o n c e p t of the " f u n d a m e n t a l c a t e g o r y of the
pathic." H e r e causality's c o n c e r n for s o m e " r e l a t i o n s h i p a m o n g
2

The Natural Scientific

37

View

r e c o g n i z a b l e t h i n g s , as for e x a m p l e o n e of c a u s e and e f f e c t , " is

a b a n d o n e d for t h e s u b j e c t ' s r e l a t i o n to an " u n o b j e c t i f i a b l e b a s i s . "
A n t h r o p o l o g i c a l m e d i c i n e w a s a n o t h e r r e s e a r c h o r i e n t a t i o n t h a t left
p s y c h o l o g y ' s w o r l d o f n a t u r a l scientific c o n c e p t s far b e h i n d . T h e s e
anthropologists among physicians, of w h o m Eugene Minkowski, V. E.
von G e b s a t t e l , and Ludwig B i n s w a n g e r w e r e p r o m i n e n t r e p r e s e n t a t i v e s ,
a b a n d o n e d from t h e o u t s e t t h e n o t i o n o f p r e c i s e , n a t u r a l scientific
calculability o f h u m a n p h e n o m e n a . B i n s w a n g e r criticized w i t h p a r t i c u l a r
f o r c e t h e l i m i t a t i o n s m e d i c i n e placed on its o b j e c t of study; in place of t h e
calculability o f h u m a n p h e n o m e n a h e and t h e o t h e r s t h r u s t h u m a n
f r e e d o m i n t o the f o r e g r o u n d . In f r e e d o m t h e y saw t h e basis for t h e i r
c e n t r a l t h e m e o f " b e c o m i n g , " a n d t h e y held t h a t its o p p o s i t e , "disb e c o m i n g , " prevailed in p a t h o l o g i c a l s y m p t o m s .
T h e r e h a v e been m a n y e f f o r t s t o m a k e a n e v e r m o r e refined and
inclusive t h e o r y o f l a y e r s i n h u m a n p e r s o n a l i t y . T h e s e e f f o r t s b r o a d e n e d
Freud's conceptual framework to the extent that they no longer took the
layer o f t h e e r o g e n o u s z o n e s , o r t h e so-called v e g e t a t i v e d e p t h - s u b j e c t ,
o r t h e l a y e r o f t h e drives t o b e t h e actual e s s e n c e o f t h e p s y c h i c . T h u s , t o
t h e m t h e n o n i n s t i n c t i v e p s y c h i c p h e n o m e n a w e r e n o l o n g e r m e r e l y the
p r o d u c t s o f s u b l i m a t i o n and r e a c t i o n .
C u r r e n t t h e o r i e s o f l a y e r s see t h e f o r m a t i o n o f a n e w p s y c h i c layer o r
o r g a n i z a t i o n a l s t a g e i n t h e p e r s o n a s " s o w o v e n i n t o e a r l i e r o n e s t h a t the
older d e s i g n s are n o t o n l y e x p a n d e d and c h a n g e d b y t h e n e w e r , b u t t o
s o m e e x t e n t actually p e r m e a t e d , s t a m p e d by, and i n t e g r a t e d w i t h
t h e m . " T o bring s o m a n y l a y e r s o f p e r s o n a l i t y u n d e r o n e r o o f , a s i t w e r e ,
t h e l a y e r - t h e o r i s t s call upon K a n t ' s s t a t e m e n t t h a t living m a t t e r can
n e v e r be fully c o m p r e h e n d e d f r o m a causal d e r i v a t i o n a l o n e and r e q u i r e s
a n additional teleological p e r s p e c t i v e . A c c o r d i n g l y , s o m e p s y c h o l o g i s t s
a r e a s s u m i n g an unspatial, i m m a t e r i a l , planned, and e s s e n t i a l e n t e l e c h y
as t h e e n d c a u s e of all layer f o r m a t i o n . T h e goal of all l a y e r f u n c t i o n s is to
realize this e n t e l e c h y as fully as possible, b o t h in t h e physical o r g a n i s m
and in t h e psychic f u n c t i o n s .
3

In t h e s a m e g e n e r a l a r e a , H. Ey sees a plane w h i c h develops into the

p e r s o n a l i t y c o m p l e x and is r e s p o n s i b l e for m a k i n g a h u m a n b e i n g
g e n u i n e l y h u m a n , and calls it a "field of c o n s c i o u s n e s s . " K. C o n r a d calls
this s a m e psychic realm a "field of e x p e r i e n c e , " He visualizes t h e p s y c h e ' s
life as figuratively projected o n t o s u c h a s c r e e n and i n t e r p r e t s d i f f e r e n c e s
in t h e clarity of c o n s c i o u s n e s s as differences in t h e s t r u c t u r e of this
psychic field of e x p e r i e n c e .
A m e r i c a n p s y c h o a n a l y t i c e g o p s y c h o l o g y w a s f r o m its b e g i n n i n g s
directed far m o r e t h a n E u r o p e a n depth p s y c h o l o g y t o w a r d e n v i r o n m e n
tal and social r e l a t i o n s h i p s . W h i l e Freud r e m a i n e d a b s o r b e d e s s e n t i a l l y
4

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EXISTENTIAL

FOUNDATIONS

by s t r u c t u r e s and m e c h a n i s m s w i t h i n t h e m i n d , Sullivan and his pupils

d r e w a t t e n t i o n q u i t e e a r l y t o t h e fact t h a t h u m a n b e i n g s begin t h e i r 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 p r i m a r i l y in " i n t e r - s u b j e c t i v e
relationships."
E v e n o u t s i d e t h e rapidly s p l i n t e r i n g s c h o o l s of p s y c h o a n a l y s i s in
America, theorists of wholeness have gained prominence among
p s y c h o l o g i s t s . G o r d o n A l l p o r t , o n e o f its n o t a b l e r e p r e s e n t a t i v e s , w r i t e s :
" T h e y all a g r e e t h a t t h e individual p e r s o n as a p a t t e r n e d e n t i t y m u s t
s e r v e a s t h e c e n t e r o f g r a v i t y for p s y c h o l o g y . T h e i n t e n t i o n o f
p e r s o n a l i s m i s t o r e w r i t e t h e s c i e n c e o f m e n t a l life e n t i r e l y a r o u n d this
f o c u s . " Allport in p a r t i c u l a r d e f i n e s p e r s o n a l i t y as a s y s t e m and c o m p l e x
psychic u n i t y o f m a n y a r e a s w h i c h m u t u a l l y a f f e c t o n e a n o t h e r , b u t
b e y o n d this, t h e p e r s o n a l i t y is an open i n t e r p e r s o n a l s y s t e m e x i s t i n g
o n l y i n social a c t i o n s a m o n g people. R o b e r t W . W h i t e p r e f e r s t h e c o n c e p t
of self to p e r s o n a l i t y , c o n s i d e r i n g it a c o n c e p t n e c e s s a r y to p s y c h o l o g y
b e c a u s e o n l y s e l f can help us s t a y focused on t h e basic fact t h a t an
o r g a n i s m is a u n i t y .
5

Independent of America's concepts of intersubjective humanness,

c o r r e s p o n d i n g ideas d e v e l o p e d i n E u r o p e , e v e n t o t h e point o f a s s e r t i o n s
t h a t m a n a c t u a l l y lives i n a n " i n - b e t w e e n o f d i a l o g u e . " F o r M a r t i n B u b e r
this w a s t h e m i d d l e g r o u n d b e t w e e n t h e " 1 " and t h e " t h o u " j o i n i n g t h e
two.
T h e " I , " t h e " t h o u , " and t h e u n i t i n g middle g r o u n d w e r e d e s i g n a t e d a s
t h e ' ' w e - r e l a t i o n s h i p " e s s e n t i a l f o r h u m a n b e i n g . T h i s idea has b e c o m e
v e r y w i d e s p r e a d , especially i n G e r m a n - s p e a k i n g a r e a s . E r i k s o n supple
mented it with the notion of "basic trust," which is intended to function
as t h e basis of t h e I, t h o u , and we r e l a t i o n s h i p s .
N o t w i t h s t a n d i n g t h e s e m a n y and varied a t t e m p t s t o b r e a k its hold,
n a t u r a l s c i e n t i f i c , c a u s a l i t y - b a s e d p s y c h o l o g y r e m a i n s p o w e r f u l . Leading
r e s e a r c h e r s c o n t i n u e t o r e g a r d a s real and scientific only t h o s e h u m a n
c h a r a c t e r i s t i c s t h a t c a n b e m e a s u r e d , calculated, o r t r e a t e d s t a t i s t i c a l l y .
N o t long a g o , J e a n P i a g e t a s s e r t e d t h a t in p s y c h o l o g y and s o c i o l o g y n o
less t h a n in, say, m a t h e m a t i c s , biology, or l i n g u i s t i c s t r u t h could be
arrived at only through deductions that meet criteria of mathematical
logic, o r t h r o u g h e x p e r i m e n t s w h o s e r e s u l t s could b e verified u n e q u i v o
cally. T h i s s t a r t l i n g p a s s a g e reads:
8

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

The Natural Scientific

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

We need not here go into the theories w h o s e intent it is to be absorbed

i n t o n e u r o p h y s i o l o g y l i k e A m e r i c a n b e h a v i o r i s m , for i n s t a n c e o r
t h o s e t h a t try t o divest t h e m s e l v e s o f t h e c o n c e p t s o f c o n s c i o u s n e s s o r
s p o n t a n e i t y . B e h a v i o r i s t s say t h a t s u c h t h i n g s h a v e no place at all in
scientific s y s t e m , s i n c e , factually s p e a k i n g , h u m a n b e h a v i o r r e p r e s e n t s
m e r e l y t h e s u m o f all r e a c t i o n s t o s t i m u l i , a n d t h e s e c a n b e m e a s u r e d and
put i n t o m a t h e m a t i c a l t e r m s . W e w o u l d d o a n i n j u s t i c e t o t h e s e m e t h o d s
o f i n v e s t i g a t i o n i f w e c o u n t e d t h e m a m o n g t h e c o r r e c t i o n s and
s u p p l e m e n t s t o F r e u d ' s t h e o r i e s o r called t h e m p s y c h o l o g i e s , t h a t is,
teachings about the psyche.
PSYCHOSOMATIC HYPOTHESES
W h e n t h e p s y c h i c , t h e s u b j e c t i v e , and t h e p e r s o n a l had c o m e i n t o t h e i r
o w n again a s distinct a r e a s o f r e a l i t y , t h e old b o d y - s o u l c o n t r o v e r s y
gained n e w importance in medicine. Intimated relationships that
r e p r e s e n t e d t h e t w o a s p s y c h e and s o m a had o f c o u r s e b e e n familiar t o
m e d i c i n e for a g e s , n o r w a s t h e r e a n y lack o f e x p r e s s i o n s w h i c h could b e
used i n t r y i n g t o d e t e r m i n e t h e u n i q u e n a t u r e o f this 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 s o m a . A t t h e h e i g h t o f t h e m a c h i n e age i n m e d i c i n e ,
t h e p s y c h i c a s p e c t s had dwindled to a m e r e c e r e b r a l s e c r e t i o n , b u t today
t h e g r e a t m a j o r i t y o f scientific f o r m u l a t i o n s address s o m a t i c p h e n o m e n a
a s e x p r e s s i v e , o r a t t e n d a n t , m a n i f e s t a t i o n s o f t h e p s y c h i c aspect; o r vice
versa.
F r e u d w a s , o n c e a g a i n , t h e first t o lay t h e f o u n d a t i o n f o r t h e s y s t e m a t i c
d e v e l o p m e n t o f a p s y c h o s o m a t i c t h e o r y . H e h i m s e l f s a w his w h o l e
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 a s p r o v i s i o n a l , n e v e r d o u b t i n g
t h a t s o m e day, a f t e r f u r t h e r p r o g r e s s i n s o m a t i c m e d i c i n e , t h e p s y c h i c
aspect could b e t r a c e d back t o t h e e x c h a n g e o f m a t e r i a l i n s o m a t i c
p r o c e s s e s . T h e idea of a p s y c h e , t h e n , w a s o n l y a t e m p o r a r y r e q u i s i t e .
Freud came into the realm of psychosomatic medicine through the
n o t i o n of a psychic a p p a r a t u s t h a t o p e n e d i n t o t h e s o m a t i c at its id end.
T h r o u g h this portal, t h e p s y c h e and t h e s o m a could e x e r t m u t u a l
influence o n each o t h e r . O n s u c h a path, for i n s t a n c e , q u a n t i t i e s o f
psychic e x c i t a t i o n s w h i c h for s o m e r e a s o n could n o t find s u f f i c i e n t o u t l e t
i n t o a p e r s o n ' s c o n s c i o u s n e s s and a c t i o n s m i g h t b e c o m e d a m m e d up
within t h e body's o w n i n n e r v a t i o n ; t h i s would give rise t o h y s t e r i c a l
c o n v e r s i o n s y m p t o m s o r n e u r o t i c o r g a n i c d i s t u r b a n c e s . T h i s s a m e open
space w o u l d also c o n t r i b u t e t o t h e r e a l i z a t i o n o f n o r m a l physical
e x p r e s s i v e m a n i f e s t a t i o n s o f c o n s c i o u s a f f e c t s . Finally, w i t h t h e help o f

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EXISTENTIAL

FOUNDATIONS

this c o n c e p t , F r e u d explained the origins of allied p s y c h o s o m a t i c

m a n i f e s t a t i o n s like t h o s e w h i c h m i g h t be e n c o u n t e r e d in anal e r o t i c s ,
w h o w e r e a t the s a m e t i m e stingy, pedantic, and c o n s t i p a t e d .
All t h e t h e o r i e s of l a y e r s in m o d e r n p s y c h o s o m a t i c medicine produced
analogous conceptual schemes. To our knowledge, only one of these
h y p o t h e s e s s e t s o u t to a t t a c k the p s y c h o s o m a t i c problem in an original
and f u n d a m e n t a l l y d i f f e r e n t w a y . It is to be found in Uexkull's w o r k , Basic
Questions of Psychosomatic Medicine. In the p h e n o m e n a t h a t i n t e r e s t
p s y c h o s o m a t i c m e d i c i n e , he says, "a circle s e e m s to close w h e n
pathological a c t i v i t y is allowed an unlimited o v e r f l o w from t h e psychic
into the s o m a t i c . " He g o e s on to say, " T o be able really to prove t h i s , using
s o u n d scientific m e t h o d s , h o w e v e r , w e would n e e d t o revise b e y o n d t h e i r
p r e s e n t s t a t e all o u r n o t i o n s and c o n c e p t s c o n c e r n i n g the life p r o c e s s e s
and the i n t e r a c t i o n of the psychic and the s o m a t i c . " L a t e r he says:
11

T h e m a t t e r o f h o w psychic and s o m a t i c p r o c e s s e s m a y i n f l u e n c e and

c h a n g e e a c h o t h e r can b e a n s w e r e d n e i t h e r w i t h physical, n o r with
psychological, m e t h o d s . Each o f t h e s e m e t h o d s sees only its o w n
domain and is incapable of r e c o g n i z i n g t h e affiliations t h a t e x i s t
b e t w e e n t h e m . H e r e within m e d i c i n e , t h e n , we collide w i t h a
philosophical d i l e m m a . It c a n n o t be solved as long as we s t a r t w i t h the
traditional idea t h a t reality is m a d e up of s o m a t i c and psychic
c o m p o n e n t s . M e d i c i n e m u s t instead look for its o w n solution. W e m u s t
clearly r e c o g n i z e t h a t b o t h t h e psychic and t h e s o m a t i c m e t h o d s are
n o t h i n g m o r e than a t t e m p t s to find o u r w a y in an u n k n o w n and
puzzling reality. B o t h m e t h o d s take s e c t i o n s from this reality and,
depending on the fixed a s s u m p t i o n s built i n t o t h e m , i n t e r p r e t w h a t is
seen a s e i t h e r c h e m o p h y s i c a l p r o c e s s e s o r a s psychic e v e n t s . T h e
physical and psychic factors w h i c h t h e n c o n f r o n t each o t h e r s as
i n c o m m e n s u r a b l e o p p o s i t e s are in factand h e r e is the fruit of o u r
t h o u g h t s n o t originally parts o f reality. R a t h e r , b o t h start w i t h t h o s e
a s p e c t s o f reality w h i c h w e m a r k off for t h e i r particular possibilities o f
a s s o c i a t i o n . It is we w h o c a r r y the idea of opposition into n a t u r e , (p. 4 2 )
F r o m this Uexkiill c o n c l u d e s t h a t the c o n c r e t e t a s k o f m e d i c i n e
c o n s t r a i n s physicians
to s e e k out a s p e c t s of reality w h i c h do n o t c a r r y into n a t u r e the
opposition b e t w e e n t h e psychic and t h e s o m a t i c and to develop
m e t h o d s w h i c h p e r m i t d i f f e r e n t i a t i o n w i t h o u t a division i n t o p s y c h i c
and physical. . . . R e c e n t k n o w l e d g e c o m p e l s us to r e v i s e o u r e n t i r e
c o n c e p t u a l s y s t e m . W e can n o l o n g e r simply a s s u m e c o n c e p t s like

41

The Natural Scientific View

" b o d y , " " w o r l d , " " m i n d , " as if we w e r e dealing w i t h firm, e s t a b l i s h e d

facts, (p. 8 1 )
Uexkiill tries to take a n e w , p h e n o m e n o l o g i c a l s t a n c e in opposition to
traditional c o n c e p t s . H e s u g g e s t s " t h e a c t i o n " a s t h e " n e w model which
will allow p h e n o m e n a to be i n t e r p r e t e d . " He t h e n g o e s on at o n c e to ask
w h a t an action, as an i n d e p e n d e n t p h e n o m e n o n , really is. By his o w n
definition, "action i s i n t e r c o u r s e w i t h t h e w o r l d . " T h e c o n c e p t o f action
leads h i m t o a " n e w c o n c e p t o f m o t i v a t i o n . " T h e s e m o t i v a t i o n s , h e says,
and n e v e r t h e h u m a n e g o , a r e p r i m a r i l y r e s p o n s i b l e b e i n g a s t h e y a r e
t h e f o r c e s and potentialities t h a t c o n f r o n t us
for i n t e r p r e t i n g t h e e n v i r o n m e n t , for s e c t i o n i n g it and t h r o w i n g up
backdrops from which I can m a k e my a p p e a r a n c e , in the c o m p a n y of
my fellow a c t o r s and props. . . . In the i n s t a n t in w h i c h a m o t i v a t i o n
i n t e r p r e t s t h e w o r l d , it gives me acting i n s t r u c t i o n s and s e t s up a role
for my i n t e r c o u r s e w i t h t h e w o r l d . . . . T h e e s s e n t i a l and i r r e v e r s i b l e
e l e m e n t h e r e is t h e r e f o r e t h e t r a n s f o r m a t i o n of a m o t i v a t i o n into a
specific a c t i o n . W e m u s t see i n t h e m o t i v a t i o n t h e p o t e n t i a l t h a t gives
birth to t h e a c t i o n . . . . In this p r o c e s s , t h e e g o fills the role of a d i r e c t o r
m o r e t h a n t h a t of a producer, (pp. 9 4 - 9 7 )
In U e x k u l l ' s e y e s , t h e r e f o r e , " w o r l d " is n o t a given thing w h o s e p r e s e n c e
h e r e is i n d e p e n d e n t of us. W h a t is initially " h e r e " is, r a t h e r , m e r e l y
" u n a r t i c u l a t e d m a t t e r t h a t can be c o n n e c t e d and i n t e r p r e t e d in t h e
g r e a t e s t v a r i e t y of w a y s . . . . T h i s ' p r e - r e a l m a t t e r ' is . . . shaped to all
s o r t s o f disparate realities, t h a t is, t o s e c t i o n i n g s o f t h e w o r l d w h i c h can
affect us, and w h i c h we can also a f f e c t . B e f o r e a m o t i v a t i o n e m e r g e s ,
t h e r e can be no o b j e c t upon w h i c h s o m e t h i n g can be p r o j e c t e d . " N o r can
t h e r e be a n y t h i n g able to proclaim as its " a c t o r s " both the physical aspect
( r e p r e s e n t i n g t h e s i m p l e r c o n t e x t s o f life) and t h e psychic ( r e p r e s e n t i n g
the more complex).
W i t h this s k e t c h o f U e x k u l l ' s t r a i n o f t h o u g h t , w e m a y c o n c l u d e o u r
o v e r v i e w o f t h e leading c o n c e p t s o f m o d e r n p s y c h o l o g y and p s y c h o s o
matic medicine. In the next chapter, these attempts to supplement
m e d i c i n e ' s c u r r e n t foundation will be t e s t e d against t h e case h i s t o r y .
NOTES
1. S. F r e u d , Gesammelie Werke, v o l . 2 / 3 ( L o n d o n : 1 9 4 2 ) , p. 1.
2. V . v .

W e i s a c k e r , Der Geslalllcreis:

Theorie der Einheit von

Wahrnekmm und Bewegen ( S t u t t g a r t :

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

4. K. C o n r a d , " D i e s y m p t o m a t i s c h e n P s y c h o s e n , " in Psychiatrie der Gegenwarts-Forschung und

Praxis, v o l . 2 ( B e r l i n , G t t i n g e n a n d H e i d e l b e r g : S p r i n g e r - V e r l a g , 1 9 6 0 ) , p . 3 6 9 .
5. C o m p a r e also; P. M u l l a h y , ed., The Contributions of Harry Stack Sullivan: A Symposium ( N e w
Y o r k : 1 9 5 2 ) , p . 1 0 5 ; a n d C . T h o m p s o n , Psychoanalysis and Development ( N e w Y o r k : 1 9 5 0 ) , p .
105.
6. G o r d o n W. A l l p o r t , Pattern and Growth in Personality ( N e w Y o r k : 1 9 6 1 ) , p. 5 5 2 .
7 . R o b e r t W . W h i t e , The Abnormal Personality, 2 n d ed. ( N e w Y o r k : 1 9 5 6 ) , p . 1 5 5 .
8. M a r t i n B u b e r , Dialogisches Leben ( Z u r i c h : 1 9 4 7 ) , pp. 13 ff.
9 . E r i k H . E r i k s o n , Insight and Responsibility ( N e w Y o r k : W . W . N o r t o n & C o . , 1 9 o 4 ) p . 6 9 .
1 0 . J e a n P i a g e t , Encyclopdie de la Pliade: Logique et Connaissance Humaine ( P a r i s : P l i a d e ,
1 9 6 7 ) , p. 13.
11.

T.

von

Uexkll,

Grundfragen

Rowohlt-Taschenbuchverlag,

1963).

der

psychosomatischen

Medizin

(Rheinbeck-bei-Hamburg:

Chapter 4
APPLYING THIS VIEW TO REGULA ZRCHER

PSYCHOLOGICAL HYPOTHESES

Psychological explanations of healthy behavior

T o explain t h e b e h a v i o r R e g u l a Z i i r c h e r e x h i b i t e d a f t e r h e r r e c o v e r y
w h e n s h e s a w h e r l o v e r a p p r o a c h i n g o n t h e o p p o s i t e side o f t h e s t r e e t ,
t r a d i t i o n a l p s y c h o l o g y o f f e r s t h e following:
1. T h o u g h they would not refer to distinct organic regions of the
brain, t h e F r e u d i a n t h e o r y o f t h e i n s t i n c t s and all r e l a t e d t h e o r i e s would
affirm h y p o t h e s e s v e r y m u c h like t h o s e f o u n d i n c o n t e m p o r a r y
p h y s i o l o g i e s o f t h e brain and o f t h e s e n s e s . F r e u d i a n h y p o t h e s e s would
point o u t t h a t s e n s o r y stimuli f r o m t h e l o v e r had b e e n r e f l e c t e d t h r o u g h
Regula Ziircher's sense organs as though through a telescope or camera
i n t o h e r p s y c h i c s y s t e m o f w a k i n g c o n s c i o u s n e s s . F r o m t h e s e stimuli
would a r i s e s e n s o r y p e r c e p t i o n s w h i c h would b e i m m e d i a t e l y i n t e g r a t e d
to form an endopsychic image or consciousness-immanent representa
tion o f h e r lover.
G e s t a l t p s y c h o l o g y g o e s a g a i n s t this only t o t h e e x t e n t that its
e x p e r i m e n t s h a v e led it to speak a b o u t w h o l e and o r d e r e d f o r e g r o u n d
c o n f i g u r a t i o n s in p r e f e r e n c e to m o r e diffuse p e r c e p t i o n of a b a c k g r o u n d .
B u t t h e r e is no change in the notion that perception involves endopsychic
consciousness-immanent images.
2 . T h e drives and e m o t i o n s d o r m a n t i n R e g u l a Z i i r c h e r ' s u n c o n s c i o u s

44

EXISTENTIAL

FOUNDATIONS

would b e a r o u s e d b y t h e e n d o p s y c h i c i m a g e o f h e r lover. A s psychic

s t r u c t u r e s , t h e y a r e said t o a t t a c h t h e m s e l v e s i m m e d i a t e l y t o t h e i m a g e
of t h e l o v e r i m m a n e n t in t h e c o n s c i o u s n e s s and to i n v e s t ( c a t h e c t ) it as a
libidinal o b j e c t . F u r t h e r m o r e , the e x c i t a t o r y q u a n t i t i e s o f t h e mobilized
drives and a f f e c t s w o u l d a c t i v a t e t h e a u t o n o m i c n e r v o u s s y s t e m , c a u s i n g
h e r h e a r t t o pound, and would also, via the c e r e b r a l c o r t e x , a r o u s e t h e
i n s t i n c t i v e desire to fall i n t o t h e l o v e r ' s a r m s .
3. T h i s desire w o u l d u l t i m a t e l y be fulfilled a f t e r modification i n t o a
c o r r e s p o n d i n g act o f will, and a f t e r the p s y c h i c e n e r g y o f t h e desire had
b e e n t r a n s f e r r e d t o t h e m o t o r c e n t e r s o f t h e brain. T h e only p r e r e q u i s i t e
for this p r o c e s s w o u l d b e t h e p r o j e c t i o n o f t h e m e n t a l r e p r e s e n t a t i o n
back o n t o its original in t h e outside world. In t h e m o t o r a b r e a c t i o n t h e
actual e m b r a c e o f t h e l o v e r and t h e s e x u a l act w h i c h e v e n t u a l l y f o l l o w s
t h e drives first mobilized b y p e r c e p t i o n would a c h i e v e t h e i r goal. T h e
e m o t i o n a l t e n s i o n would find its r e l e a s e , and a s t a t e of rest, as it had
e x i s t e d b e f o r e t h e e x c i t a t i o n o f t h e drives, w o u l d b e r e c o v e r e d . (In the
s c h e m e o f F r e u d ' s m e t a p s y c h o l o g y , this stasis p r o p e r t o lifeless i n o r g a n i c
m a t t e r is t h a t to w h i c h all o r g a n i s m s , t o o , basically i n t e n d . )
T o t h e s e older F r e u d i a n c o n c e p t s g e s t a l t p s y c h o l o g y and c o n t e m p o r
ary animal p s y c h o l o g y w o u l d a t t a c h t h e idea t h a t t h e i m a g e o f the lover,
w h e n i t h a s g o t t e n i n t o t h e brain o r p s y c h e f r o m t h e outside, c o i n c i d e s
w i t h a p r e f o r m e d i m a g e i m m a n e n t in t h e p s y c h e , t h e " t r i g g e r i n g i m a g e . "
T h i s allows the significance o f t h e e x t e r n a l object t o b e grasped and t h e n
allows t h e a p p r o p r i a t e r e a c t i o n t o t a k e place.
T h e layer t h e o r i e s would see i n the b e h a v i o r o f R e g u l a Z i i r c h e r and
her lover the operation of two mental entelechies. T h e s e theories would
bring into play t h e d e e p e r psychic l a y e r s o f t h e v e g e t a t i v e d e p t h - s u b j e c t ,
t h e drives, and t h e e m o t i o n s , and would t h e n b r i n g t h e s e l a y e r s t o g e t h e r
into a unified " p s y c h i s m , " s h o w i n g t h a t t h e y had g e n e r a t e d t h e m u t u a l
embrace.
T o t h e a n t h r o p o l o g i c a l and dialogical b r a n c h e s o f p s y c h o l o g y t h e m o s t
i m p o r t a n t t h i n g would b e t h a t i n this e n c o u n t e r t h e h u m a n s u b j e c t o r
p e r s o n o f R e g u l a Z i i r c h e r and t h e s e c o n d p e r s o n o f h e r l o v e r had, a s a n
" I " and a " t h o u , " e n t e r e d i n t o a " w e - d i a l o g u e . " H e r e t h e I of t h e o n e and
the t h o u of t h e o t h e r would dwell in a h u m a n " i n - b e t w e e n , " an " i n t e r s u b j e c t i v e " r e a l m . B o t h people e n g a g e d in such a w e - r e l a t i o n s h i p w o u l d
be led t o g e t h e r to a fuller realization of self by a single g e n e r a t i v e
impulse.
All t h e e x p l a n a t i o n s s k e t c h e d h e r e s h a r e t h e s a m e s e r i o u s deficiency i n
the analysis o f a n o r m a l h u m a n e n c o u n t e r . N o t o n e o f t h e p s y c h i c
p h e n o m e n a t h e y put forth to m a k e the puzzling object of study
c o m p r e h e n s i b l e can be s h o w n to be actually t h e r e in or behind the
p h e n o m e n a ol R e g u l a Z i i r c h e r ' s e n c o u n t e r . T h e r e is in her perceivable

Applying This View to Regula Zrcher

45

behavior no evidence that supports assertions of the presence of

e n d o p s y c h i c s e n s o r y stimuli, e n d o p s y c h i c g e s t a l t c o n f i g u r a t i o n s ,
t r i g g e r i n g i m a g e s , and r e p r e s e n t a t i o n s , o r a r g u e s for t h e e x i s t e n c e o f
i n s t i n c t s t h a t could set an e g o or p s y c h e in m o t i o n from w i t h i n , or a r g u e s
for t h e p r e s e n c e o f a n e n t e l e c h y and o t h e r psychic l a y e r s . T h e proposed
i n t e r s u b j e c t i v e m i d d l e g r o u n d d o e s n o t bring u n d e r s t a n d i n g o f t h e actual
e n c o u n t e r , f o r i t leaves b o t h t h e I o f R e g u l a Z i i r c h e r and the t h o u o f h e r
l o v e r w i t h o u t clarification.

Psychological interpretations of the stereotypical boxcar dream.

W e can c o n s i d e r R e g u l a Z i i r c h e r ' s b o x c a r d r e a m a p h e n o m e n o n j u s t a s
i m p o r t a n t t o h e r e x i s t e n c e , and a s w o r t h y o f s e r i o u s a t t e n t i o n , a s the
waking encounter with her lover. T h i s dream belongs unmistakably to
t h 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 o f h e r e x i s t e n c e ; w e h a v e n e v e r yet
c o m e a c r o s s a h e a l t h y p e r s o n w h o could h a v e s u c h a d r e a m .
Until F r e u d , t h e r e w e r e n o e x p l i c a t i o n s o f d r e a m s t h a t had t h e
a p p e a r a n c e , at least, of b e i n g b a s e d on s y s t e m a t i c and scientifically
f o r m u l a t e d t h e o r i e s . S i n c e his Interpretation of Dreams a p p e a r e d , m a n y
d r e a m t h e o r i e s h a v e c o m e f o r t h t o c o r r e c t and c o m p l e m e n t h i s , b u t n o n e
differs basically from Freud's original. We shall limit o u r s e l v e s t h e r e f o r e
t o a n e x a m i n a t i o n o f its e x p l a n a t o r y capabilities. A n d since w e h a v e m a d e
e x t e n s i v e studies o f F r e u d i a n and m o d e r n d r e a m t h e o r i e s i n t w o o t h e r
w o r k s , w e shall focus h e r e o n a f e w c h a r a c t e r i s t i c f e a t u r e s .
1

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

46

EXISTENTIAL

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).

Applying This View to Regula Zrcher

17

Psychological explanations of the knife phobia

P h o b i a s r e g a r d i n g s t r a n g l i n g and k n i v e s are a s e c o n d pathological
m a n i f e s t a t i o n in R e g u l a Z r c h e r ' s life h i s t o r y . T h e y p r o d u c e d in h e r the
m o s t p r e s s i n g and t o r m e n t i n g s y m p t o m s . T h e a t t a c k s o f t h e s e u r g e s t o
s t a b and t o s t r a n g l e w e r e n o t , i n t h e s t r i c t e s t s e n s e o f t h e t e r m , t r u e
o b s e s s i o n a l m a n i f e s t a t i o n s . A c c o r d i n g to t h e definition c u r r e n t in
psychiatry, a proper obsessional symptom must evidence the foreignness
of t h e o c c u r r i n g t h o u g h t and u r g e to act, and a c e r t a i n d i s t a n c e of t h e
s u b j e c t f r o m t h e m . T h e s e t w o r e q u i r e m e n t s are c o n s p i c u o u s l y a b s e n t i n
R e g u l a Z r c h e r ' s s t r a n g l i n g and s t a b b i n g u r g e s .
T o explain s u c h m a n i f e s t a t i o n s , p s y c h o a n a l y t i c t h e o r y p r o f f e r s t h e
idea t h a t an u n c o n s c i o u s d e a t h w i s h a g a i n s t t h e p a t i e n t ' s child m u s t be
w o r k i n g i n t h e b a c k g r o u n d , b r e a k i n g halfway t h r o u g h i n h e r s y m p t o m s .
T h e v i c t i m of t h e d e s t r u c t i v e a g g r e s s i v e drives, as t h e child of a m a n
h a t e d for his lack o f love, i t s e l f b e c o m e s the object o f u n c o n s c i o u s h a t r e d .
A s e c o n d , c o n t i n g e n t h y p o t h e s i s r e g a r d i n g the u r g e to stab, in
p a r t i c u l a r , says 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 such a s y m p t o m could
also be a w o r k i n g o u t of u n c o n s c i o u s , phallic, h o m o s e x u a l feelings t h e
m o t h e r h a r b o r s t o w a r d h e r d a u g h t e r . T o s u p p o r t this, t h e t h e o r y would
point o u t t h a t t h e u r g e s t o s t a b w o u l d o c c u r o n l y (and a l w a y s ) w h e n the
p a t i e n t h a d n o adult m a l e s e x u a l p a r t n e r . D u r i n g t i m e s o f s u c h s e x u a l
f r u s t r a t i o n , h e r w h o l e libido would b e applied t o h e r h o m o s e x u a l
c o m p o n e n t i n s t i n c t , c o m p e l l i n g h e r t o a s s u m e t h e p h a l l i c - m a s c u l i n e role
o f p e n e t r a t i o n w i t h r e s p e c t t o t h e o t h e r f e m a l e . T h e final point o f
e v i d e n c e for this v e r s i o n i s t h a t t h e s e u r g e s tended t o s u r f a c e w h e n t h e
p a t i e n t w a s i n p a r t i c u l a r l y c l o s e physical c o n t a c t w i t h h e r little d a u g h t e r .
P s y c h o a n a l y t i c t h e o r y w o u l d close its case b y calling o n t h e w i d e s p r e a d
v i e w t h a t w h e n e v e r a k n i f e a p p e a r s in d r e a m s or n e u r o t i c s y m p t o m s it
a l w a y s r e f e r s s y m b o l i c a l l y t o t h e penis. A c c o r d i n g l y , o n e m i g h t infer,
from R e g u l a Z r c h e r ' s u r g e s to stab, t h e i n f l u e n c e of a symbolically
disguising d i s p l a c e m e n t i n t h e o u t w a r d direction o f t h e u n c o n s c i o u s
desire t o p e n e t r a t e t h e d a u g h t e r ' s g e n i t a l s w i t h a n i m a g i n a r y penis.
B o t h 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 for t h e p a t h o l o g i c a l s y m p t o m s o f
R e g u l a Z r c h e r deal i n u n c o n s c i o u s desires and u n c o n s c i o u s i n s t i n c t s .
T h r e e w h o l e y e a r s o f o b s e r v a t i o n , h o w e v e r , failed t o elicit from this
p a t i e n t t h e s l i g h t e s t s u b s t a n t i a t i o n t h a t a n y such e n d o p s y c h i c c o n s t i t u
e n t s w e r e actually p r e s e n t , and t o identify t h e s l i g h t e s t indications o f
u n c o n s c i o u s desires t o kill o r h o m o s e x u a l l y a b u s e h e r d a u g h t e r .
C e r t a i n l y , t h e p a t i e n t o f t e n a n d quite c o n s c i o u s l y f e l t h e r d a u g h t e r a s
a n e n c u m b r a n c e , especially w h e n caring for t h e child kept h e r f r o m being
c o n s t a n t l y w i t h h e r l o v e r . B u t j u s t a t t h o s e t i m e s , w h e n she could have
been the s e x u a l p a r t n e r of a m a n , w h e n h e r child's p r e s e n c e was

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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

Applying This View to Regula Zrcher

d i s c e r n e d i n t h e p h e n o m e n a o f o u r p a t i e n t ' s i m p u l s e s t o s t a b and
strangle. On the contrary, these urges overcame her only in extremely
pressing c i r c u m s t a n c e s , w h e n h e r e n t i r e being, w r a c k e d w i t h t h e t e r r o r
of s u f f o c a t i o n , cried o u t for space and f r e e d o m , for life and b r e a t h .
T h e p s y c h o l o g i e s of dialogue w o u l d be c o r r e c t in c l a i m i n g t h a t a
s e r i o u s disruption o f t h e I - t h o u r e l a t i o n s h i p w o u l d g o along w i t h 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 . B u t this f o r m u l a t i o n c o n t r i b u t e s
n o t h i n g t o help u n d e r s t a n d t h e p h e n o m e n a .

Psychological explanations for the knife hallucinations

A t t i m e s o f g r e a t e s t t o r m e n t for R e g u l a Z r c h e r , k n i v e s w h i r r e d
t h r o u g h t h e air b e f o r e h e r e y e s . T h e s e k n i v e s w e r e s o palpable t o h e r t h a t
s h e w o u l d g r a b for t h e m and fear r u n n i n g a m o k w i t h t h e m .
T h e e x p l a n a t i o n s o f t r a d i t i o n a l p s y c h o p a t h o l o g y o n l y give a n a m e t o
t h e s e p h e n o m e n a . T h e y a r e called h a l l u c i n a t i o n s and t h e r e b y s t a m p e d a s
p h a n t o m s , s e n s o r y illusions, o r p r o j e c t i o n s o f m e n t a l c o n t e n t s o u t w a r d
into t h e e x t e r n a l world. B u t this does n o t e n a b l e u s t o u n d e r s t a n d t h e s e
m a n i f e s t a t i o n s . T o begin w i t h , t o t h e h a l l u c i n a t i n g p e r s o n , t h e t h i n g s
hallucinated are i n n o w a y m e r e l y illusory, o r m e r e l y o u t w a r d
p r o j e c t i o n s o f s o m e t h i n g inside. Q u i t e t h e r e v e r s e . T h e y a r e distin
g u i s h e d by a singularly i n t e n s e p r e s e n c e and reality in t h e w o r l d of t h e
patient. M o r e o v e r , while t h e p s y c h o a n a l y t i c p r o j e c t i o n t h e o r y could a t
b e s t tell u s s o m e t h i n g a b o u t t h e f o r m i n g m e c h a n i s m o f a n h a l l u c i n a t i o n ,
it can tell us n o t h i n g a b o u t t h e h a l l u c i n a t i o n as such. F u r t h e r m o r e , t h e
p s y c h i a t r i c c o n d e m n a t i o n o f so-called h a l l u c i n a t i o n s t o t h e s t a t u s o f t h e
unreal is o n l y a n e g a t i v e d e t e r m i n a t i o n . If we could d e s c r i b e b e f o r e h a n d
e x a c t l y w h a t reality is, i t w o u l d h a v e s o m e scientific v a l u e . N e e d l e s s t o
say, p a t h o l o g y is still far from such an a c c o m p l i s h m e n t .
It is no m o r e successful to c h a r a c t e r i z e h a l l u c i n a t i o n s as s e n s o r y
illusions. B y t h e m s e l v e s , t h e h u m a n s e n s e o r g a n s a r e w h o l l y u n a b l e t o
perceive, t h a t is, t o g r a s p t h e m e a n i n g f u l c o n t e n t o f s o m e t h i n g . E v e n
given c o n t e m p o r a r y m e d i c i n e ' s i n t e r p r e t a t i o n o f s e n s a t i o n a s w h a t
scientific r e s e a r c h m e t h o d s can r e g i s t e r from t h e c h e m o p h y s i c a l
p r o c e s s e s o f all t h e s e n s e o r g a n s , plus t h e i r c o n n e c t i v e p a t h w a y s i n t h e
brain, w i t h its fields of p r o j e c t i o n , still t h e s e n s e o r g a n s a l o n e c a n n o t
perceive. W h a t c a n n o t p e r c e i v e c a n n o t b e deceived.
A n o t h e r s c h o o l of p s y c h i a t r y , w h i c h w a s called for a t i m e " p s y c h i a t r i c
I )aseinsanalysis", a t t r i b u t e d h a l l u c i n a t i o n s to o v e r w h e l m i n g i n n e r
s u b j e c t i v e t h e m e s . I n t h e actual case o f R e g u l a Z r c h e r ' s knife
h a l l u c i n a t i o n s , h o w e v e r , w e can d i s c e r n n o e v i d e n c e t o a r g u e for t h i s .
I he p a t i e n t a l w a y s r e c e i v e d t h e u r g e n t c o m m a n d s to p l u n g e t h e knife
into h e r child's body j u s t at t h e m o m e n t of h e r h a l l u c i n a t i o n , and from a

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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

Psychosomatic explanations of the hysterical paralysis of the leg

A m o n g t h e p s y c h o s o m a t i c e x p l a n a t i o n s o f physical h y s t e r i c a l s y m p
t o m s , the F r e u d i a n t h e o r y o f r e p r e s s i o n and c o n v e r s i o n still h a s t h e
largest following. It can also call itself the first scientifically modified
p s y c h o s o m a t i c i n t e r p r e t a t i o n in c o n t e m p o r a r y m e d i c i n e .
I n t h e p a r t i c u l a r i n s t a n c e o f R e g u l a Z i i r c h e r ' s h y s t e r i c a l paralysis a t
t h e y o u n g m a n ' s g l a n c e , Freudian t h e o r y w o u l d s e e the r e l e a s e o f
a r o u s e d s e x u a l drives and c o r r e s p o n d i n g e m o t i o n s . T h e e n d o p s y c h i c
i m a g e o f the lover, t o g e t h e r w i t h t h e e m o t i o n s a t t a c h i n g t o t h e i m a g e ,
would h a v e a r o u s e d t h e i n s t i n c t i v e desire t o r u s h o v e r t o the a r o u s i n g
m a n and e m b r a c e h i m . W h e n i t appeared, h o w e v e r , this desire w o u l d
have b e e n totally i n c o m p a t i b l e w i t h t h e p s e u d o m o r a l i t y forced u p o n
R e g u l a Z i i r c h e r b y h e r p a r e n t s . T h e c o n s e q u e n c e o f this i r r e c o n c i l a b l e
c o n t r a d i c t i o n b e t w e e n an i n s t i n c t i v e desire and m o r a l i s t i c p r e c e p t s
would b e r e p r e s s i o n o f t h e desire. T h e a c c u m u l a t e d e n e r g y o f t h e
r e p r e s s e d drive would finally h a v e s w i t c h e d i t s e l f o v e r o n t o the s o m a t i c
i n n e r v a t i o n of the leg, and in this w a y t h e a c c u m u l a t e d libininal
e x c i t a t o r y q u a n t i t y would h a v e c a u s e d t h e h y s t e r i c a l l a m e n e s s . F r e u d
n a m e d this a s s u m e d s w i t c h i n g p r o c e s s " h y s t e r i c a l c o n v e r s i o n . "
4

F r e u d would have c o n s i d e r e d the h y s t e r i c a l paralysis o f t h e p a t i e n t ' s

legs the s y m b o l i c physical m a n i f e s t a t i o n of a conflict in the u n c o n s c i o u s ,
m this case, the t e n s i o n b e t w e e n t h e u n c o n s c i o u s desire to e m b r a c e the

Applying This View to Regula Zrcher

man and t h e p s e u d o m o r a l c o m m a n d m e n t a g a i n s t it, i n t r o j e c t e d by h e r
parents. A n o t h e r assumption enters here: that the inverse Oedipus
c o m p l e x had b e e n decisive in s t a v i n g o f f t h e u n c o n s c i o u s i n s t i n c t i v e
desire t o w a r d t h e y o u n g m a n . I n o t h e r w o r d s , t h e p e r c e p t i o n o f the
young m a n would i n s t a n t l y have a c t i v a t e d the i m a g e o f h e r o w n f a t h e r ,
i m m a n e n t in r e p r e s s e d form in h e r u n c o n s c i o u s . T h i s i m a g e would still
be in t h e p a t i e n t ' s u n c o n s c i o u s b e c a u s e h e r libido had r e m a i n e d
u n c o n s c i o u s l y fixated on h e r f a t h e r in a childish w a y . U n d e r t h e s e
c o n d i t i o n s , p e r c e p t i o n o f t h e y o u n g man would h a v e r e l e a s e d i n s t i n c t i v e
sexual drives t o w a r d the f a t h e r i m a g e . I t g o e s w i t h o u t saying t h a t s u c h
i n c e s t u o u s i n s t i n c t i v e desires would appear particularly depraved and
have t o b e fully r e p r e s s e d . T h e a c c u m u l a t e d e x c i t a t o r y q u a n t i t i e s o f
these u n c o n s c i o u s incest w i s h e s w o u l d furnish additional c o n v e r s i o n
e n e r g y and, o n c e c o n v e r t e d i n t o t h e s o m a t i c , w o u l d h a v e c o d e t e r m i n e d
and s t r e n g t h e n e d t h e h y s t e r i c a l s y m p t o m s .
lung's a n a l y t i c p s y c h o l o g y adds a n o t h e r supposition. A c c o r d i n g to his
i n t e r p r e t a t i o n , t h e psychic e x c i t a t i o n o c c a s i o n e d b y the p e r c e p t i o n o f the
young m a n would h a v e g o n e b e y o n d the f a t h e r i m a g e i n R e g u l a
/ u r c h e r ' s individual u n c o n s c i o u s t o c o n s t e l l a t e the a r c h e t y p e o f t h e
a n i m u s i n t h e e v e n d e e p e r layer o f the collective u n c o n s c i o u s . T h e
patient's e g o , still w e a k , would h a v e b e e n n o m a t c h for t h e o v e r w h e l m
ing p o w e r s o f this layer. W i t h t h e c o n s t e l l a t i o n o f the a n i m u s - a r c h e t y p e ,
I he fear of libidinal i m p u l s e s t o w a r d t h e y o u n g m a n has b e e n multiplied,
and r e s i s t a n c e to, and r e p r e s s i o n of, the u n c o n s c i o u s d e s i r e s h a s b e e n
doubled.

Psychosomatic explanations of the irritable colon

f r o m h e r fifteenth y e a r , t h e t i m e of h e r first m e n s t r u a t i o n , R e g u l a
/ i m her suffered from c o n s t i p a t i o n s o s e v e r e t h a t m e d i c a t i o n w a s o f
little use. O f t e n s h e w o u l d n o t pass s t o o l s for t h r e e to ten days. A few
m o n t h s a f t e r h e r m a r r i a g e , this w a s j o i n e d b y a t t a c k s o f s t o m a c h and
Intestinal c r a m p s w h i c h , i n c r e a s i n g l y f r e q u e n t , w e r e a s s u m i n g a n
iii' i easingly s e r i o u s f o r m . T h e s e w e r e followed by m u c o u s y and bloody
dial i h e a s . In a s h o r t t i m e , t h e p a t i e n t h a s w a s t e d a w a y to a n e a r s k e l e t o n .
Such disturbances in the realm of the control system of the autonomic
n e r v o u s c e n t e r s are usually called o r g a n i c n e u r o s e s as opposed to
hystei ical s y m p t o m s . M a n y p s y c h o a n a l y t i c a l l y o r i e n t e d t h e r a p i s t s a r g u e
thai o r g a n i c n e u r o t i c s y m p t o m s h a p p e n e n t i r e l y w i t h i n t h e body's
a u t o n o m i c , i n v o l u n t a r y s y s t e m , w h i l e h y s t e r i c a l g e s t u r e s claim o n l y the
voluntary m u s c l e s . F u r t h e r m o r e , o r g a n i c n e u r o t i c d i s t u r b a n c e s , i n
i outcast to h y s t e r i c a l o n e s , a r e t a k e n to be m e r e l y a u t o n o m i c bodily

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EXISTENTIAL FOUNDATIONS

accompaniments of emotional tensions, not expressions of unique,

s y m b o l i c a l l y disguised m e a n i n g . If, for s o m e i n t e r n a l o r e x t e r n a l r e a s o n ,
e m o t i o n a l t e n s i o n s o r affects w e r e p e r s i s t e n t l y h i n d e r e d i n t h e i r n o r m a l
d i s c h a r g e , t h e i r a c c u m u l a t i o n w o u l d p r e s u m a b l y c a u s e their n o r m a l
physical m a n i f e s t a t i o n s t o b e c o m e c h r o n i c a l l y e x a g g e r a t e d i n t o o r g a n i c
neurotic disturbances.
O t h e r t h e o r i e s o f depth p s y c h o l o g y insist, h o w e v e r , t h a t bloody and
m u c o u s y d i a r r h e a s , like t h o s e t o r m e n t i n g o u r organically n e u r o t i c
patient, are, like h y s t e r i c a l s y m p t o m s , physical m a n i f e s t a t i o n s o f
overcompensation, charged with meaning. For instance, such sufferers
a r e t h o u g h t t o c a r r y w i t h i n t h e m s e l v e s s o g r e a t a n u n c o n s c i o u s desire t o
be set at p e a c e and c a r e d for t h a t t h e y u n c o n s c i o u s l y feel obligated to
yield j u s t a s m u c h . B u t instead o f giving t h e i r fellow m e n s o m e t h i n g
useful, t h e y a r e o n l y able t o give o u t t o o m u c h e x c r e m e n t . O n t h e o t h e r
hand, t h e r e are m a n y o t h e r p s y c h o l o g i s t s w h o believe t h a t c h r o n i c a l l y
c o n s t i p a t e d people h a v e n o t received e n o u g h in t h e i r lives. T h e r e f o r e ,
t h e y u n c o n s c i o u s l y d o n o t w a n t t o give o u t a n y t h i n g e i t h e r and w o u l d
like t o k e e p e v e n t h e i r feces for t h e m s e l v e s . S o m e p s y c h o s o m a t i c
speculation g o e s so far as to see in t h e painful a b d o m i n a l s u r g i n g t h e
e x p r e s s i o n of a life-and-death s t r u g g l e w i t h an i n t r o j e c t e d u n c o n s c i o u s
i m a g e of an evil m o t h e r .
T h i s dispute o v e r d i s t i n c t i o n s b e t w e e n h y s t e r i c a l and o r g a n i c n e u r o t i c
s y m p t o m s h a s b e e n g o i n g o n i n t h e p s y c h o a n a l y t i c s c h o o l s for decades.
B u t all of t h e s e depth psychological e x p l a n a t i o n s h a v e o n e t h i n g in
c o m m o n . T h i s i s t h e a s s u m p t i o n t h a t p a t i e n t s like o u r s h a v e b e e n visited
by a libidinal r e g r e s s i o n w h i c h h a s t h r o w n t h e m back to t h e anal-sadistic
s t a g e of libidinal d e v e l o p m e n t , also called t h e a n a l - e r o t i c s t a g e . H e r e all
sexual aspiration c o m e s from s t i m u l a t i o n o f t h e e r o g e n o u s z o n e o f t h e
last part o f t h e i n t e s t i n e . T h e feces b e c o m e t h e o b j e c t o f t h e drive, and
their p l e a s u r a b l e e x p u l s i o n o r r e t e n t i o n t h e i n s t i n c t i v e goal o f this
aspiration.
T h e n o t i o n o f c o n g e n i t a l o r g a n i n f e r i o r i t y s t e m m i n g from Adler's
individual p s y c h o l o g y , and the c o n c e p t o f u n c o n s c i o u s m a s c u l i n e p r o t e s t ,
w e r e for s o m e t i m e v e r y popular i n e x p l a n a t i o n s o f n e u r o t i c s y m p t o m s .
In t h e case of o u r s u b j e c t ' s s e v e r e colitis, a c o n g e n i t a l defect of the
i n t e s t i n a l t r a c t w o u l d no d o u b t h a v e b e e n allotted first place as a c a u s e .
T h e a r g u m e n t would h a v e b e e n t h a t , w i t h t h e p r o p e r e m o t i o n a l t e n s i o n s
and conflicts, this w e a k a r e a o f t h e physical c o n s t i t u t i o n would h a v e b e e n
the first t o b e c o m e involved.

Psychosomatic explanations of Regula Ziircher's breast pains

O u r p a t i e n t ' s u n u s u a l l y painful b r e a s t swelling would also be classified
by c u r r e n t medicine as an o r g a n n e u r o t i c s u b f o r m of p s y c h o s o m a t i c

Applying This View to Regula Zrcher

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 .

Somatopsychic explanations of Regula Ziircher's behavior after her leg

(racture
R e g u l a Z i i r c h e r ' s leg f r a c t u r e o c c u r r e d w h e n s h e w a s c o m p l e t e l y
healthy, b e c a u s e of a r e c k l e s s driver. N o t h i n g h e r e p o i n t s to a
p s y c h o n e u r o t i c accident p r o n e n e s s , and s o h e r leg f r a c t u r e m a y b e
c h a r a c t e r i z e d as an e n t i r e l y s o m a t i c h e a l t h d i s t u r b a n c e . N a t u r a l l y , a
powerful psychic c h a n g e set in as an i m m e d i a t e r e s u l t of t h e accident,
with t h e p a t i e n t ' s circle of i n t e r e s t s h r i n k i n g to t h e t h i n g s and people in
her hospital r o o m . T h i s can be d e s i g n a t e d a s o m a t o p s y c h i c o c c u r r e n c e ,
distinct f r o m h e r earlier p s y c h o s o m a t i c illnesses. P s y c h o a n a l y t i c t h e o r y
explains t h e loss of i n t e r e s t as a r e t r e a t of t h e libido to an infantile,
narcissistic s t a g e o f d e v e l o p m e n t .
In s u m m i n g up, we m u s t s t a t e t h a t t h e v a r i o u s p s y c h o s o m a t i c
e x p l a n a t i o n s w e h a v e s e e n o f f e r e d for individual, physical p a t h o l o g i c a l
m a n i f e s t a t i o n s in R e g u l a Z i i r c h e r all r e f e r to p u r e l y psychic c o n s t r u c t s
w h o s e p r e s e n c e in t h e p h e n o m e n a t h e m s e l v e s is n o t s u p p o r t e d by actual
I'vidence. H y s t e r i c a l and o r g a n i c n e u r o t i c s y m p t o m s w e r e m o s t o f t e n
explained by n o t i o n s of v a r i o u s d e s i r e s , a s p i r a t i o n s , c o n f l i c t s , drives, and
an h e t y p e s , all supposedly b u r i e d in an individual or collective u n c o n I i o n s , in a psychic l a y e r so deep t h a t it is by definition inaccessible. Y e t
t lie actual p r e s e n c e of s u c h u n c o n s c i o u s , e n d o p s y c h i c i m p u l s e s could n o t
he verified in R e g u l a Z i i r c h e r ' s b e h a v i o r .
I )espite m o n t h s of i n t e n t l i s t e n i n g as t h e p a t i e n t d e s c r i b e d the
in u m s t a n c e s t h a t c u l m i n a t e d in h e r h y s t e r i c a l collapse w h e n she m e t
i he man w h o w a s later to be h e r lover, and despite d e l i b e r a t e q u e s t i o n i n g
.11 id ( l o s e a t t e n t i o n to t h e free a s s o c i a t i o n s t h a t followed, t h e r e w a s to be
f o u n d no t r a c e of a desire to fall i n t o the y o u n g m a n ' s a r m s .
II may be o b j e c t e d t h a t this desire w a s t o o w e a k to a t t r a c t t h e p a t i e n t ' s
notice. T h e n w e m u s t w o n d e r h o w s o m e t h i n g s o w e a k could e f f e c t such a

54

EXISTENTIAL

FOUNDATIONS

d r a m a t i c paralysis. If, on t h e o t h e r h a n d , it is a r g u e d t h a t t h e desire w a s

so u n b e a r a b l y s t r o n g t h a t it had to be r e p r e s s e d i n t o the u n c o n s c i o u s , the
m a t t e r b e c o m e s totally i n c o m p r e h e n s i b l e . An u n c o n s c i o u s desire is a
c o n t r a d i c t i o n in itself.
N o t only w a s t h e r e n o e v i d e n c e o f a n u n c o n s c i o u s s e x u a l desire i n t h e
h y s t e r i c a l paralysis of the leg, b u t n o t h i n g in this p a t h o l o g i c a l e v e n t
could be f o u n d to a r g u e t h e p r e s e n c e of an active a r c h e t y p e in t h e
collective u n c o n s c i o u s .
Psychoanalytic theory attributes the patient's intestinal symptoms to a
r e g r e s s i o n of t h e libido to t h e a n a l - e r o t i c s t a g e , b u t at no t i m e did R e g u l a
Z i i r c h e r e x h i b i t libidinal p l e a s u r e in h e r feces or in rectal s t i m u l a t i o n .
S i m i l a r l y , Adler's t h e o r y o f i n n a t e o r g a n i c i n f e r i o r i t y does n o t m e r i t
s e r i o u s c o n s i d e r a t i o n a s a n e x p l a n a t i o n for t h e s e d i s t u r b a n c e s , s i n c e ,
w h e n h e r t h e r a p y ended, R e g u l a Z i i r c h e r ' s i n t e s t i n a l tract w a s far m o r e
robust than average.
Psychoanalytic theory construes the temporary narrowing of interests
w h i c h t h e p a t i e n t e x p e r i e n c e d a f t e r h e r leg f r a c t u r e as t h e libido's
w i t h d r a w a l from t h e e x t e r n a l w o r l d and its s u b s e q u e n t r e t r e a t i n t o
itself, particularly i n t o t h e affected part. T h o u g h such a n e x p l a n a t i o n
deals w i t h a s o m a t o p s y c h i c p h e n o m e n o n , it m u s t n e v e r t h e l e s s be held
a c c o u n t a b l e for e s t a b l i s h i n g t h a t s o m e t h i n g like a libido actually e x i s t s
and can be e x t e n d e d or w i t h d r a w n . T h e r e is a g r e a t e r m y s t e r y h e r e ,
h o w e v e r , and it applies f u n d a m e n t a l l y to all p s y c h o l o g i c a l , p s y c h o s o m a t
ic, and s o m a t o p s y c h i c i n t e r p r e t a t i o n s : n o kind o f psychic e n e r g i e s o r
i n s t i n c t i v e f o r c e s could, i n and o f t h e m s e l v e s , c o n s t r u c t o r d i s m a n t l e t h e
w o r l d of a h u m a n being. Invariably, this w o r l d is, and is perceived as, a
c o n t e x t o f m e a n i n g s and r e f e r e n c e s .
F r o m o u r b e g i n n i n g s , and e v e r y day of o u r lives, we all live in such a
perceived world. R e g u l a Z u r c h e r , t o o , e x i s t s i n h e r r e l a t i o n s h i p s t o t h e
p h e n o m e n a of h e r w o r l d and as t h e s e r e l a t i o n s h i p s . S h e lived in this w a y
even w h e n , a f t e r h e r leg f r a c t u r e , h e r w o r l d s h r a n k t o the d i m e n s i o n s o f
h e r hospital r o o m and to o b j e c t s and people she could perceive in t h a t
r o o m . T h e r e is no libido or drive capable of seeing or h e a r i n g or of
c o m p r e h e n d i n g s o m e t h i n g as s o m e t h i n g . As a c o n s e q u e n c e of this,
p s y c h o s o m a t i c and s o m a t o p s y c h i c e x p l a n a t i o n s w h i c h o p e r a t e w i t h t h e
c o n c e p t s of libido and drive h a v e n e v e r m a n a g e d to get at the basis of t h e
puzzling 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 n o s u r p r i s e , since this basis
c o n s i s t s in e x i s t i n g 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 at a g i v e n t i m e . It
does n o t appear likely t h a t t h e s e p e r s p e c t i v e s will e v e r b e h o l d individual
pathological s y m p t o m s a s t h e 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 t h e y
are.
Yet the m o s t q u e s t i o n a b l e o u t c o m e o f 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
(and s o m a t o p s y c h i c ) thinking is the r e l a t i o n s h i p it e n v i s i o n s e x i s t i n g

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Applying This View to Regula Ziircher

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

2 . F r e u d , Die Traumdeutung, i n G e s a m m e l t e W e r k e , vol 2 / 3 ( L o n d o n : I m a g o , I n c . , 1 9 4 3 ) , p .

eil.
3 . V . E . v o n G e b s a t t e l , " S c h t i g e s V e r h a l t e n i m G e b i e t s e x u e l l e r v e r i r r u n g e n , " Monatssch
rift fur Psychologie. 8 2 . ( 1 9 3 2 ) , pp. 1 3 7 a n d 1 8 3 .
I

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 . ,

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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

W h y t h i s m u s t b e so, t h o u g h , F r e u d n e v e r says, and i n fact h e did n o t

1 n o w w h y . A s a child o f his t i m e , h e w a s totally u n d e r t h e spell o f t h e
natural scientific r e s e a r c h m e t h o d . F o r him i t w a s t h e o n l y p a t h t o t r u t h ,
and he w a s willing to pay a n y price to m e e t its d e m a n d t h a t t h e o b j e c t of
M s i n v e s t i g a t i o n b e a s c e r t a i n a b l e b y its m e t h o d o f e x a c t m e a s u r e m e n t
and c o m p u t a t i o n .
I l o w little Freud realized w h e r e t h e f u n d a m e n t a l i n t e n t of his
l isy< h o a n a l y t i c t h e o r y had actually c o m e f r o m is d e m o n s t r a t e d clearly in

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an especially v e h e m e n t p o l e m i c against " p h i l o s o p h e r s . " A n d it is

precisely h e r e t h a t he r e v e a l s t h e philosophic spirit t h a t sired him. In
Inhibition, Symptom and Anxiety we m a y read:
I am n o t at all in f a v o r of f a b r i c a t i n g p h i l o s o p h i e s of life. T h a t I leave to
p h i l o s o p h e r s , w h o , b y t h e i r o w n a d m i s s i o n , find life's j o u r n e y
impossible to m a k e w i t h o u t s u c h a B a e d e c k e r as their t o u r guide. L e t
us humbly accept the contempt with which philosophers gaze down
upon u s from t h e s t a n d p o i n t o f t h e i r h e i g h t e n e d need. A s w e t o o
c a n n o t d e n y o u r n a r c i s s i s t i c pride, let us s e e k c o m f o r t in the t h o u g h t
t h a t all t h e s e "guides to l i v i n g " a r e s o o n o u t of date, t h a t it is precisely
t h e s p a d e w o r k o f o u r m y o p i c vision t h a t m a k e s a n e w edition
n e c e s s a r y , and, finally, t h a t e v e n t h e m o s t u p - t o - d a t e B a e d e c k e r is an
a t t e m p t to replace an old c a t e c h i s m t h a t is v e r y c o m f o r t a b l e and v e r y
c o m p l e t e . W e k n o w quite well h o w little light s c i e n c e h a s s o far b e e n
able t o c a s t o n t h e puzzles o f this world. N o n u m b e r o f h e c t o r i n g
p h i l o s o p h e r s can c h a n g e t h a t a hair; o n l y p a t i e n t c o n t i n u a t i o n of w o r k
t h a t s u b o r d i n a t e s e v e r y t h i n g to a single Demand for Certainly [Freud's
e m p h a s i s ] can slowly bring a b o u t c h a n g e .
2

In d e m a n d i n g t h a t all psychic p h e n o m e n a be established w i t h

c e r t a i n t y , F r e u d ( t h o u g h h e h i m s e l f m a y n e v e r have s u s p e c t e d t h i s )
s h o w s h i m s e l f a C a r t e s i a n o f t h e p u r e s t dye. B u t Freud's i n t e n t
i l l u s t r a t e s w i t h p a r t i c u l a r force N i e t z s c h e ' s a p h o r i s m t h a t the n i n e
t e e n t h c e n t u r y had so far b r o u g h t a b o u t n o t t h e v i c t o r y of s c i e n c e b u t
r a t h e r t h e v i c t o r y of m e t h o d o l o g y over s c i e n c e , and this still holds.
We h a v e already pointed o u t t h a t F r e u d , in t r u e technical spirit,
i n t e r p r e t e d t h e n o n p h y s i c a l , psychic aspect o f m a n a s t h e f u n c t i o n i n g o f
an apparatus a n a l o g o u s to the c h e m o p h y s i c a l f u n c t i o n s m e a s u r a b l e in
t h e physical o r g a n i s m . F r e u d did c o n c e d e t h a t he could find no direct
p r o o f for t h e actual p r e s e n c e o f this p s y c h i c a p p a r a t u s , w h i c h could o n l y
be i n f e r r e d from its o b s e r v a b l e e f f e c t s and f u n c t i o n s . So he assigned this
basic c o n c e p t i o n , w i t h all t h e individual psychic s t r u c t u r e s and
d y n a m i s m s supposedly p r e s e n t w i t h i n it, to "mefapsychology"a t h e o r y
of psychic e n t i t i e s beyond the o b s e r v a b l e . He o n c e even exiled this basic
a s s u m p t i o n o f his t h e o r y r o t h e r e a l m o f s h e e r m e n t a l i n v e n t i o n (the
italics are h i s ) : " W e hed i m m e r s e d o u r s e l v e s in t h e fiction of a primitive
psychic a p p a r a t u s w h o s e o p e r a t i o n w a s m o t i v a t e d b y t h e t e n d e n c y t o
avoid the a c c u m u l a t i o n of e x c i t a t i o n and to m a i n t a i n the g r e a t e s t
possible t r a n q u i l i t y . "
T h i s episodic insight did n o t keep F r e u d from t u r n i n g a r o u n d to posit it
again as a fact. He and, by implication, all w h o followed his t h e o r y ,
3

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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

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of its drives, or to c a t h e c t t h e m in o r d e r to a t t a i n t h e goal of the drives

r e l a x a t i o n o f t e n s i o n . B u t n o e n e r g y o r e x c i t a t o r y q u a n t i t y has the ability
to perceive s o m e t h i n g in its m e a n i n g f u l n e s s . No h u m a n r e l a t i o n s h i p to
the world can b e u n d e r s t o o d o n t h e basis o f a s s u m e d q u a n t i t i e s o f
e m o t i o n , libidinal s t a g e s , or libidinal p r o c e s s e s .
F r e u d w a s n o t a l o n e in giving a f f e c t i v i t y t h e c e n t r a l role in psychic life.
T h e t e r m i t s e l f c a m e n o t from F r e u d b u t f r o m E u g e n B l e u l e r , w h o
s u b s u m e d all t h e e m o t i o n s u n d e r it. In fact, he considered affectivity
practically the o n l y d e t e r m i n i n g f a c t o r i n h u m a n c h a r a c t e r d e v e l o p m e n t .
B u t i t w a s F r e u d w h o e m p h a s i z e d i t m o s t . H e c h a r a c t e r i z e d the e m o t i o n s
as all t h a t m a t t e r e d for m a n ' s i n n e r life. P s y c h i c e n e r g i e s , he said, are
i m p o r t a n t only in r e l a t i o n to t h e i r a p t i t u d e for e v o k i n g feelings.
I 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 a r e u n a n i m o u s
in giving affectivity such p r e d o m i n a n c e in h u m a n life, t h e y are
c o r r e s p o n d i n g l y u n a n i m o u s i n t h e p o v e r t y o f t h e i r u n d e r s t a n d i n g o f its
n a t u r e . H e r e a s n e a r l y e v e r y w h e r e i n m e d i c i n e todaywe c o m e u p
against t h e f r i g h t e n i n g fact t h a t this s c i e n c e , so precise in the t h e o r i e s
t h a t derive from the p h e n o m e n a it a s s u m e s , r e l a x e s this precision to an
a s t o n i s h i n g d e g r e e r e g a r d i n g the p h e n o m e n a t h e m s e l v e s . P s y c h i a t r y i n
particular is t o o o f t e n c o n t e n t to adopt ideas from popular p s y c h o l o g y
w i t h o u t s u b j e c t i n g t h e m t o f u n d a m e n t a l c o n s i d e r a t i o n and clarification
b e f o r e it uses t h e m in analysis. J a s p e r s , for i n s t a n c e , w r o t e :
Feeling is the n a m e we give to all m e n t a l a c t i v i t y t h a t does n o t clearly
belong e i t h e r t o t h e p h e n o m e n a o f o b j e c t i v e c o n s c i o u s n e s s o r t o
e m o t i o n a l drives and v o l u n t a r y a c t s . E v e r y u n d e v e l o p e d and foggy
m e n t a l s t r u c t u r e , e v e r y t h i n g impalpable t h a t eludes analysis, is called a
feeling; in a w o r d , e v e r y t h i n g to w h i c h we c a n give no o t h e r n a m e .
4

F r e u d said t h a t he did n o t c o n s i d e r his u n d e r s t a n d i n g of the e m o t i o n s

very solid and t h o u g h t of it as a first a t t e m p t to g e t o r i e n t e d in this dark
realm. In Inhibition, Symptom and Anxiety, he b r o a d l y c o n f e s s e s t h a t we
have n o idea w h a t a n e m o t i o n i s . T h e t r a d i t i o n a l p s y c h o l o g i e s a r e
c e r t a i n at least t h a t e m o t i o n s , feelings, and m o o d s are t h i n g s p r e s e n t
w i t h i n t h e p s y c h e , b u t as the c e n t r a l e n d o p s y c h i c activity, this foggy
n o t i o n of affectivity is hardly in a position to r e n d e r h u m a n b e h a v i o r
comprehensible.
T h e a t t e m p t t o dispose t h e o r e t i c a l l y o f " f r a g m e n t a t i o n i n the
s u c c e s s i o n o f c o n s c i o u s a c t i o n " was a t a s k e v e n m o r e p r e s s i n g for F r e u d .
O n c e again, his p r i m a r y c o n c e r n h e r e w a s n o t w i t h explaining o b s e r v a b l e
psychic p h e n o m e n a as s u c h but with g e t t i n g rid of f r a g m e n t a t i o n solely
for t h e sake of t h e scientific r e s e a r c h m e t h o d and its application to the
5

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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

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infantile d e s i r e s he believed he had found b o t h . T h i s desire was supposed

t o r e p r e s e n t t h e m o t o r and the e n e r g y needed t o c r e a t e t h e " m a n i f e s t
d r e a m i m a g e " out o f p r e c o n s c i o u s m a t e r i a l . S o t h a t e v e r y d r e a m m i g h t
appear in this light, F r e u d c o n c e i v e d a c o m p l e x , u n c o n s c i o u s d r e a m w o r k . B u t t o r e i t e r a t e w h a t w e have already s t a t e d : n o d r e a m i n g p e r s o n
has e v e r g i v e n a n y e v i d e n c e for this. T h e e n t i r e Freudian c o n c e p t i o n o f
the d r e a m , w h i c h i s also t h e m o d e l for t h e later t h e o r y o f t h e n e u r o s e s ,
r e s t s on an i n v e n t e d f o u n d a t i o n .
T h e r e is an equally p o w e r f u l e x a m p l e of t h e m u t i l a t i n g f o r c e e x e r t e d in
Freud's p r o c e e d i n g s a g a i n s t psychic p h e n o m e n a in his " A n a l y s i s of the
Phobia o f a Five Y e a r - O l d B o y . " I n t e n t o n explaining t h e child's b e h a v i o r
at a n y price on a n a t u r a l scientific, c a u s a l , p s y c h o d y n a m i c basis, this
t r e a t i s e is such an a c c u m u l a t i o n of u n v e r i f i a b l e , a r b i t r a r y s u p p o s i t i o n s
t h a t it c a n n o t be classified as a scientific i n v e s t i g a t i o n .
7

A f e w h e s t i t a n t and a m b i g u o u s a n s w e r s w h i c h esacped five y e a r - o l d

H a n s u n d e r a b a r r a g e of heavily s u g g e s t i v e q u e s t i o n s from his f a t h e r
sufficed t o " p r o v e " t h e s o n ' s u n c o n s c i o u s death wish a g a i n s t his f a t h e r .
T h i s death w i s h , s o called, along w i t h t h e a t t e n d a n t f e a r o f p u n i s h m e n t
a s s u m e d to be in t h e u n c o n s c i o u s , was declared t h e cause of the boy's f e a r
o f h o r s e s . F r e u d did n o t even s h r i n k f r o m t r a n s f o r m i n g the frantic
s t r u g g l e s of a h o r s e t h a t had fallen into t h e i r opposite, implying t h a t in
t h e s t r u g g l e s o f t h e h o r s e a vitally powerful c r e a t u r e y o u n g H a n s had
s e e n t h e a n i m a l ' s d e a t h t h r o e s . F u r t h e r on, t h e accidental fall of a t o y
h o r s e is read as a g e s t u r e of d e s t r u c t i v e a g g r e s s i o n e x p r e s s i n g an
u n c o n s c i o u s desire to upset t h i n g s . T h i s i n t e r p r e t a t i o n w a s in t u r n still
a n o t h e r p r o o f for t h e h y p o t h e s i s o f the death wish p r e s u m e d p r e s e n t i n
Hans's unconscious.
It is no surprise t h a t Freud could claim t h a t direct o b s e r v a t i o n of a
phobic child e x p o s e d n o t h i n g he had n o t already s e e n in the b e h a v i o r of
phobic adults. In y o u n g H a n s ' s case, F r e u d was c o n c e r n e d n o t w i t h
o b j e c t i v e o b s e r v a t i o n o f phobic b e h a v i o r b u t w i t h fitting this b e h a v i o r
i n t o a t h e o r y t h a t already e x i s t e d and w h i c h he had already applied to
adult phobias. T h u s t h e s a m e n e s s i n the i n t e r p r e t a t i o n s o f b o t h s o r t s o f
phobias, as well as the d e a r t h of n e w m a t e r i a l in t h e i n t e r p r e t a t i o n of
young Hans's anxieties.
D e s p i t e t h e s e and c o u n t l e s s similar p r o o f s o f t h e fictitious and
u n o b j e c t i v e c h a r a c t e r o f p s y c h o a n a l y t i c t h e o r y , F r e u d ' s pupils n e v e r tire,
even today, of trying to establish its scientific s o u n d n e s s . B u t e v e r y e f f o r t
o f w h i c h w e h a v e b e e n a w a r e , m e a n w h i l e , has avoided a n a d e q u a t e
d e t e r m i n a t i o n o f the f u n d a m e n t a l n a t u r e o f 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 . In fact, m o s t of the p s y c h o a n a l y t i c w r i t i n g s in this a r e a
a r c c o n t e n t m e r e l y t o adopt o u t r i g h t t e c h n i c a l t e r m i n o l o g y from physics.

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03

O n e i n s t a n c e of this is " w o r k i n g h y p o t h e s i s , " w h i c h is used

i n c r e a s i n g l y t o c h a r a c t e r i z e p s y c h o a n a l y t i c t h e o r e m s . D e s p i t e the shared
t e r m , t h e r e is an u n b r i d g e a b l e gap b e t w e e n t h e s u p p o s i t i o n s ol
p s y c h o a n a l y s i s and t h e w o r k i n g h y p o t h e s e s o f t h e n a t u r a l s c i e n c e s . T h e
l a t t e r a r e i n f e r e n c e s a b o u t t h e c o m p o s i t i o n o f t h i n g s and t h e p r o c e s s e s
t h a t o c c u r a m o n g t h i n g s , a l w a y s adducible t o p h e n o m e n a t h a t are
available t o s e n s o r y p e r c e p t i o n and a l w a y s adducible t o p h e n o m e n a t h a t
a r e available t o s e n s o r y p e r c e p t i o n and can b e p r e c i s e l y d e t e r m i n e d . T h e
n a t u r a l scientific w o r k i n g h y p o t h e s i s can b e verified t h r o u g h i n c r e a s i n g
ly p r e c i s e o b s e r v a t i o n until it is finally e i t h e r raised f r o m c o n j e c t u r e to
scientific fact or else r e c o g n i z e d as e r r o r and a b a n d o n e d .
N o t h i n g like this is possible w i t h t h e w o r k i n g h y p o t h e s e s of
p s y c h o a n a l y t i c t h e o r y , b e c a u s e t h e s e deal w i t h t h i n g s n o t r a c e o f w h i c h
can b e a s c e r t a i n e d i n t h e o b j e c t s o f study t h e m s e l v e s . T h e i r c o n t e x t s are
a s s u m e d , and t h e i r i n f e r e n c e s t a k e place only in t h e mind. W h a t e v e r is
posited b y p s y c h o a n a l y t i c t h e o r y c o n s i s t e n t l y and f u n d a m e n t a l l y b a c k s
off f r o m all a t t e m p t s to s u b s t a n t i a t e its actual p r e s e n c e , b e i n g a s s u m e d
to reside in a black b o x called t h e u n c o n s c i o u s , w h i c h is n e v e r a c c e s s i b l e
to direct i n v e s t i g a t i o n .
A s e c o n d t e c h n i c a l t e r m p s y c h o a n a l y t i c t h e o r y has b o r r o w e d from
physics for t h e sake of appearing like a n a t u r a l s c i e n c e is " m o d e l , " or
"model r e p r e s e n t a t i o n . " B u t w e a r e n e v e r told e x a c t l y w h a t t h e t e r m
m e a n s w h e n it is applied in p s y c h o l o g y . M o d e l s are s u p e r f l u o u s and
senseless to an understanding of human nature, anyway, because human
beings are s e l f - c o n s c i o u s b e i n g s capable o f e x p r e s s i n g t h e m s e l v e s
t h r o u g h l a n g u a g e . T h e m o d e l - b u i l d i n g 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 ogy m i s s e s and m i s c o n s t r u e s t h e decisive c h a r a c t e r o f h u m a n n a t u r e i n
visualizing h u m a n n a t u r e as an o b j e c t t h a t , like all o t h e r o b j e c t s in t h e
world, is o c c u p y i n g at a n y o n e t i m e o n l y a single place in a given space.
O n c e h u m a n n a t u r e has b e e n t h u s m i s r e p r e s e n t e d , t h e m o s t a n y t h e r a p y
can h o p e to do is m a k e a b e t t e r o b j e c t , n o t a h e a l t h i e r p e r s o n .
E f f o r t s t o d e m o n s t r a t e t h e scientific s o u n d n e s s o f p s y c h o a n a l y t i c
t h e o r y p o i n t t o its supposedly empirical basis. F r e u d ' s t h e o r y o f
r e p r e s s i o n , for i n s t a n c e , is said to be g r o u n d e d in empirical fact.
M e e r w e i n w r i t e s t h a t i n F r e u d ' s first a t t e m p t s a t t h e r a p y h e d i s c o v e r e d
that r e c o l l e c t i o n e f f e c t e d b y h y p n o s i s o r b y the analysis o f r e s i s t a n c e
could bring a b o u t an a b n o r m a l c o n d i t i o n or t h e d i s a p p e a r a n c e of a
s y m p t o m . T h i s is said to h a v e led F r e u d to infer a p r o c e s s w h i c h w e n t in
I he o p p o s i t e direction to f o r m s y m p t o m s , n a m e l y , r e p r e s s i o n . He t h e n
w e n t on to prove this hypothesis w i t h additional r e s e a r c h . H e r e v/e need only
r e m e m b e r t h e s t o r y o f y o u n g H a n s , w i t h w h o s e help F r e u d d e m o n s t r a t
ed his t h e o r i e s of the libido and d e f e n s e .

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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 , o n e and all, fail to indicate h o w t h e y have

used t h e t e r m " p r o o f . " I f w e u n d e r s t a n d " p r o o f " t o m e a n a d e m o n s t r a
tion o f t r u t h o r e v e n m e r e l y a s u b s t a n t i a t i o n o f c o r r e c t n e s s , t h e n n o
n u m b e r o f case h i s t o r i e s can e v e r " p r o v e " F r e u d ' s r e p r e s s i o n h y p o t h e s i s .
T h e a c c u m u l a t i o n o f c o n c r e t e empirical facts r e s u l t s only i n e n c a p s u l a t
ing t h e m o s t d i v e r s e s o r t s of h u m a n b e h a v i o r in a single p r e c o n c e i v e d
t h e o r y w h i c h i s o c c a s i o n a l l y read i n t o t h e p h e n o m e n a t h e m s e l v e s . S u c h
" p r o o f " calls up t h e i m a g e of a m a n w h o l o o k s at all t h e o b j e c t s he studies
t h r o u g h r o s e - c o l o r e d g l a s s e s and t h i n k s he h a s " p r o v e n " all t h i n g s are
red.
On the o t h e r hand, Waelder believes that psychoanalytic theory is
j u s t i f i e d as a n a t u r a l scientific discipline on t h e g r o u n d s t h a t it h a s
e x a m i n e d a l a r g e e n o u g h n u m b e r o f life h i s t o r i e s t o c o m p a r e t h e m and
e x t r a c t w h a t t h e y all h a v e i n c o m m o n . B u t t h e p r o c e s s o f t h u s
crystallizing a c o n c e p t t r a n s f e r e n c e , for e x a m p l e i s n o t pure e m p i r i
cism b u t a v e r y specific i n t e r p r e t a t i o n o f p a r t i c u l a r h u m a n b e h a v i o r . B y
i n t e r p r e t i n g this b e h a v i o r in t h e s a m e w a y e a c h t i m e it o c c u r s we are
m e r e l y a m a s s i n g a large n u m b e r of i n s t a n c e s of a p r e d e t e r m i n e d
interpretation, nothing more.
It is s o m e t i m e s said t h a t psychological h y p o t h e s e s can c o m m a n d t h e
a u t h o r i t y o f p r o v a b l e scientific fact o n l y i f t h e y allow o t h e r p h e n o m e n a
to be e x p l a i n e d or i n t e r p r e t e d . It is n o t e n o u g h t h a t t h e y suffice for
u n d e r s t a n d i n g t h e single o b s e r v a t i o n t h a t g a v e rise t o t h e m . Y e t , t o
define t h e p r o v a b i l i t y o f a n h y p o t h e s i s this w a y m i s s e s t h e p o i n t o f
scientific p r o o f . A h y p o t h e s i s m u s t allow us to predict t h e b e h a v i o r of like
p h e n o m e n a and to reproduce t h e m at will. B u t t h e r e is no h y p o t h e s i s in all
o f p s y c h o a n a l y t i c t h e o r y t h a t m e e t s t h e s e d e m a n d s . I t i s n o g r e a t feat t o
explain like p h e n o m e n a c o n s i s t e n t l y w i t h t h e s a m e s u p p o s i t i o n s , and this
is e v e n e a s i e r to do w h e n t h e o b j e c t is s o m e t h i n g u n c o n s c i o u s w h o s e
actual p r e s e n c e n e e d n o t be verified.
P s y c h o a n a l y s t s are p a r t i c u l a r l y fond o f pointing t o the flashes o f
insight patients may experience as proof of the correctness of
psychoanalytic theory. Certainly, it is not u n c o m m o n in therapy that the
a n a l y s t ' s i n t e r p r e t a t i o n of a p a r t i c u l a r trait suddenly appears so o b v i o u s
t o t h e p a t i e n t t h a t h e a b a n d o n s t h e trait w i t h a n " A h a ! " B u t this s o r t o f
" A h a - e x p e r i e n c e " is a n y t h i n g b u t definitive p r o o f t h a t an i n t e r p r e t a t i o n
is faithful to the p h e n o m e n o n itself. M o r e o f t e n t h a n n o t , it appears to
r e s u l t w h e n a n i n t e r p r e t a t i o n fits readily i n t o t h e p a t i e n t ' s already
e x i s t i n g u n d e r s t a n d i n g of h i m s e l f . People w h o live in the t e c h n o l o g i c a l
age are a t h o m e w i t h m a c h i n e s and e v e n p r o n e t o d r a w i n f e r e n c e s a b o u t
h u m a n n a t u r e from t h e m . A n d t h u s 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 ,
based as t h e y are on c h e m i c a l and m e c h a n i c a l p r o c e s s e s , m a y look

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o b v i o u s and self-evident t o t h e m . E x p e r i e n c e s o f this " A h a ! " type too

often c o n f i r m a m e c h a n i s t i c s e l f - i m a g e p r o f o u n d l y at odds w i t h the
p a t i e n t as a h u m a n being.
T h e i n a d e q u a c y o f F r e u d ' s o r i g i n a l libidinal m o d e l did n o t escape the
notice of many modern theoreticians, even those within the psychoana
lytic fold, and t h e b e s t a m o n g t h e m w o r k e d w i t h a s e n s e o f u r g e n c y t o
t r a n s f o r m it. T h e m o s t n o t a b l e w o r k h e r e w a s p e r h a p s t h a t d o n e b y the
F r e n c h w r i t e r s P. M a r t y , M. de M ' U z a n , and C. D a v i d as well as by the
A m e r i c a n , M . S c h u r . T h e i r a l t e r e d c o n c e p t u a l m o d e l can b e s t b e
visualized using t h e i m a g e of a s t u d e n t petrified during an e x a m i n a t i o n .
8

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

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u n d e r s t a n d t h e sole p r e s e n t l y available m o d e s o f perceiving and

b e h a v i n g a s t h e p h e n o m e n a w h i c h t h e y are.
We can s h o w f u r t h e r t h a t it is n o t valid to say t h a t t h e s t u d e n t ' s s e c o n d
step w o u l d b e p u t t i n g u p r e s i s t a n c e t o t h e a s s u m e d hostile 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 , p r o d u c i n g o b j e c t - f r e e psychic activity. W h a t m i g h t this
o b j e c t - f r e e p s y c h i c a c t i v i t y be? To claim t h a t it c o n s i s t s m e r e l y in
perceiving a n x i e t y and d e s t r u c t i v e feelings is to c o n t r a d i c t b o t h o n e s e l f
and t h e m o d e r n m o d e l s o f r e g r e s s i o n , for feelings o f a n x i e t y and
d e s t r u c t i o n a r e a n y t h i n g b u t o b j e c t - f r e e psychic activity. I n perceiving
t h e s e feelings, t h e e x a m i n e e i s c o n n e c t e d t o t h e t h r e a t e n i n g e x a m i n e r a s
well as to t h e c o n d i t i o n of his being t h r e a t e n e d , and it is his v e r y r e l a t i o n
t o t h e s e t w o " o b j e c t s " t h a t i s t h e s o u r c e o f his a n x i e t y .
E v e n if, in t h e third p h a s e , t h e s t u d e n t did sit in his seat petrified,
e x h i b i t i n g i n c r e a s e d h e a r t activity and blood p r e s s u r e , his e x i s t e n c e
w o u l d by no m e a n s h a v e r e g r e s s e d to a " s t a t e of functionally d i s t u r b e d
s o m a t i c a c t i v i t y . " I f this actually h a p p e n e d , w e w o u l d n o l o n g e r b e
dealing w i t h a living, b r e a t h i n g h u m a n being. T h o u g h he a p p e a r s
petrified, t h e s t u d e n t h a s n o t b e c o m e a m e r e l u m p o f physical m a t t e r . H e
r e m a i n s t h r o u g h and t h r o u g h a n e x i s t i n g h u m a n being, a n " o b j e c t r e l a t e d " c r e a t u r e w h o dwells i n his c o n d u c t t o w a r d w h a t h e e n c o u n t e r s .
In relation to t h e e x a m i n e r , he b e c a m e e x t r e m e l y u n f r e e , all but totally
s w a y e d by his p r e s e n c e , and at o n e w i t h t h i s , he lost t h e relation to his
o w n selfhood. H e lacked, t h e n , t h e f r e e d o m t o w a r d , and distance f r o m ,
t h e e x a m i n e r t h a t a r e t h e n e c e s s a r y p r e c o n d i t i o n o f a t h e m a t i c selfa w a r e n e s s o f being afraid o f a n o t h e r .
O u t s i d e p s y c h o a n a l y t i c t h e o r y are m a n y o t h e r p s y c h o l o g i e s : n a t u r a l
scientific p s y c h o l o g i e s , g e s t a l t p s y c h o l o g y , and t h e p e r s o n a l and
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 . F o r an e x a m p l e of a natural scientific
p s y c h o l o g i s t w h o r e m a i n e d outside t h e p s y c h o a n a l y t i c school w e m a y
t u r n again to P i a g e t . H i s peculiar s k e t c h of t h e s e a r c h for t r u t h as it is
m a d e by c l o s e t e d p h i l o s o p h e r s we m a y leave to speak for itself. W h a t is
i m p o r t a n t for us is t h e u n e x a m i n e d w a y in w h i c h P i a g e t has c o n t i n u e d ,
e v e n a s late a s 1 9 6 7 , t o t r a n s f e r t h e s t r u c t u r e s o f t h e o r e t i c a l and
e x p e r i m e n t a l physics o n t o p s y c h o l o g y ; t h e w a y i n w h i c h , w i t h o u t
j u s t i f i c a t i o n , h e d o g m a t i c a l l y declares t h e r e s e a r c h m e t h o d o f this
physical s c i e n c e to be the standard of t r u t h in his o w n scientific r e a l m of
p s y c h o l o g y as well. L i k e all of his n a t u r a l s c i e n c e - o r i e n t e d p r e d e c e s s o r s ,
Piaget c a n n o t see t h a t applying e i t h e r deductive, t h e o r e t i c a l , o r
e x p e r i m e n t a l physics t o h u m a n b e i n g s i n a n y w a y m a k e s v e r y specific
p r e s u p p o s i t i o n s . It can be done only a f t e r h u m a n n a t u r e h a s b e e n
r e i n t e r p r e t e d along t h e lines of n a t u r a l s c i e n c e s as a c o n t i n u o u s and
quantifiable causal n e x u s of particles h a v i n g m a s s and e x t e n s i o n . In the

The

Fundamental

Conditionality

07

domain of physical s c i e n c e , t r u t h is e q u a t e d w i t h c e r t a i n t y ; truth

c o i n c i d e s w i t h t h e validity o f t h e s c i e n c e ' s a f f i r m a t i v e proposition.
W i t h o u t f u r t h e r e l a b o r a t i o n , for e x a m p l e , he tells us t h a t a child, w h o
(like m a n y p o e t s ) sees a t r e e giving shade, is m u c h f u r t h e r from the
t r u t h t h e c o r r e c t e x p l a n a t i o n t h a n a n older p e r s o n , w h o can explain
t h e s e s h a d o w s according t o t h e laws o f physics a s r e s u l t i n g from t h e
a b s o r p t i o n of e l e c t r o - m a g n e t i c light w a v e s by a c o n g l o m e r a t i o n of
m o l e c u l e s : t h e t r e e . P i a g e t c o n s i d e r s i t u n n e c e s s a r y t o j u s t i f y his v e r y
different valuation o f t h e s e t w o w a y s o f looking, a p p a r e n t l y u n a w a r e o f
t h e e x t e n t t o w h i c h a d e q u a t e c r i t e r i a a r e lacking for his j u d g m e n t .
9

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

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a c c e p t e d , it follows as a c o r o l l a r y t h a t n e r v e impulse activity, and

t h e r e f o r e b e h a v i o r (including linguistic b e h a v i o r ) , is n o t n e c e s s a r i l y
directly and i m m e d i a t e l y available to c o n s c i o u s n e s s .
12

N o t h i n g o b j e c t i v e (i.e., factually p r e s e n t ) d e m o n s t r a t e s a n ability t o

e x p e r i e n c e e v e n t s o c c u r r i n g i n t h e brain, n o r t h e i r r e t e n t i o n i n m e m o r y ,
n o r t h e identity o f n e r v e i m p u l s e a c t i v i t y and h u m a n b e h a v i o r , n o r t h e
identity o f n e r v e i m p u l s e activity and l a n g u a g e , n o r the availability o f
n e r v e impulses t o c o n s c i o u s n e s s .
N o less " m y t h o l o g i c a l " i s t h e s c i e n t i f i c - p s y c h o l o g i c a l n o t i o n t h a t w h e n
s o m e t h i n g w h i c h has b e e n s e e n b e f o r e is r e c o g n i z e d , it is t h e t h i n g ' s
d e n o t a t i o n t h a t i s s e e n i n t h e f o r m o f s o m e n e u r a l a l t e r a t i o n . H o w , and
by w h o m , this n e u r a l a l t e r a t i o n is read, r e m a i n s a m y s t e r y . Finally,
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 are j u s t as fond as their medically
t r a i n e d c o u n t e r p a r t s o f using t h e m a g i c w o r d s " e n c o d i n g " and
" d e c o d i n g " for t h e r e l a t i o n s h i p b e t w e e n e x p e r i e n c e d e v e n t s and specific
cerebral processes.
H a s e l o f f , a m o n g o t h e r s , t h e r e f o r e e r r s i n saying t h a t o n l y this type o f
s t r i c t l y scientific p s y c h o l o g y is n o t set a g a i n s t t h e realities of a c h a n g i n g
s o c i e t y and t h a t o n l y it is in a position to i n t e r p r e t h u m a n b e i n g s and
s o c i e t y in a s o b e r , r a t i o n a l w a y . W h e r e t h e r e is so m u c h i n h e r e n t
" m y t h o l o g y " t h e r e can b e n o talk o f s o b e r t h o u g h t . B e s i d e s , t h e s t r i c t l y
n a t u r a l scientific b r a n c h e s o f p s y c h o l o g y are v e r y m u c h opposed t o t h e
realities of c h a n g i n g s o c i e t y , as far as t h e y a r e m e s m e r i z e d by the
prevailing spirit of t e c h n o l o g y c u t t i n g t h e m s e l v e s o f f from a c o n s i d e r a
ble part of h u m a n reality and liableif t h e y w e r e given full r e i n t o
preclude a n y f u n d a m e n t a l social c h a n g e .
1 3

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

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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

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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

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similarly has c o n s c i o u s n e s s " e m e r g e from t h e s h o c k i n g r e c o g n i t i o n of a

r e s i s t a n c e t h a t m u s t b e o v e r c o m e , " while t h e r e could b e n o r e c o g n i t i o n
w i t h o u t a n already e m e r g e d c o n s c i o u s n e s s .
In t h e end, Ey s h a r e s a f o r m u l a w i t h B i n d e r , in w h i c h b o t h speak of a
level o r l a y e r d e v o t e d t o t h e field o f c o n s c i o u s n e s s w h i c h unfolds t o
become the subjective system that makes human beings human. Neither
explains precisely w h a t " s u b j e c t " m e a n s o r h o w t h e l a y e r o f c o n s c i o u s
n e s s is e m p o w e r e d to u n f o l d .
T h e c o n c e p t of an e x i s t e n t i a l l a y e r , w h i c h is i n a c c e s s i b l e to r e a s o n and
i n h a b i t s s o m e h i g h e r m e t a p h y s i c a l plane, is gaining c u r r e n c y . It, t o o , is
c h a r a c t e r i z e d by a surprising lack of definition; its n a t u r e and s t r u c t u r e
a r e left o b s c u r e . T h i s is n o t m e r e l y an o v e r s i g h t t h a t will be c o r r e c t e d in
time.
T h e psychological t h e o r i e s o f drives and layers will n e v e r explain
human existence. T h i s is because each of these theories posits human
n a t u r e as s o m e sort of geological f o r m a t i o n , s o m e t h i n g t h a t e x i s t s in and
of i t s e l f a m o n g all t h e o t h e r s u b s t a n c e s t h a t m a k e up t h e w o r l d , a t h i n g
t h a t can be located at a specific point in space. G i v e n this a priori
conceptualization of human beings, even the latest existentially oriented
l a y e r t h e o r y p s y c h o l o g i e s c o n j u r e u p t h e s a m e riddle t h a t w r a c k e d t h e
e a r l i e r t h e o r y o f i n s t i n c t s : i f m a n e x i s t s i n and o f himself, a n i m m a n e n t
being from his v e r y b e g i n n i n g s , f u n d a m e n t a l l y e n c a p s u l a t e d w i t h i n his
p s y c h e , h o w does h e e v e r gain the s o r t o f vision t h a t would p e r m i t him
e v e n t o i n t u i t s o m e w o r l d o u t s i d e ? H o w does h e leave and t r a n s c e n d
h i m s e l f t o a p p r o a c h t h i n g s o u t s i d e , and h o w d o t h e s e t h i n g s o f e x t e r n a l
reality g e t i n t o t h e c o n s c i o u s n e s s of a p e r s o n w h o is m a d e this w a y ?
14

In this d i s t r e s s i n g s i t u a t i o n , m o r e and m o r e 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 h a v e looked for help to H e i d e g g e r ' s e x p r e s s i o n
" b e i n g - i n - t h e - w o r l d . " M o d e r n p s y c h o p a t h o l o g y o w e s a special debt to
B i n s w a n g e r for d r a w i n g its a t t e n t i o n t o his t h o u g h t . B u t all o t h e r
psychological t h e o r i e s , including B i n s w a n g e r ' s o w n r e p r e s e n t a t i o n o f
s u b j e c t i v i t y , r e t a i n an i n h e r i t e d p i c t u r e of m a n as a p s y c h i c , or s u b j e c t i v e ,
stratified thing primarily e n c a p s u l a t e d w i t h i n itself, and c o n s i s t e n t l y
c o n s t r u e t h e " b e i n g - i n - t h e - w o r l d " o f e x i s t e n t i a l analysis a s o n e m o r e
p r o p e r t y to be added to t h e n o t i o n of m a n as s u b j e c t , in v o g u e since
D e s c a r t e s . W h a t i s t h e use o f c h a r a c t e r i z i n g " b e i n g - i n - t h e - w o r l d " a s t h e
ability t o t r a n s c e n d s u b j e c t i v e i m m a n e n c e and a p p r o a c h o b j e c t s o f the
e x t e r n a l w o r l d as long as this " b e i n g " is s e e n as j u s t o n e m o r e trait of a
primarily e n c a p s u l a t e d s u b j e c t i v i t y ?
O f the 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 H . G o p p e r t h a s r i g h t l y said that
despite t h e i r u n i q u e m e t h o d o l o g i c a l s t a r t i n g points, t h e i r a n a l y s e s a r e

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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 .

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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

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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

C o n s i d e r as a simple p s y c h o s o m a t i c s y m p t o m , for i n s t a n c e , the l e u ol

a p e r s o n in m o u r n i n g . B e i n g psychic, m o u r n i n g can be n e i t h e r weighed
n o r m e a s u r e d . T h e t e a r , h o w e v e r , can b e w e i g h e d and c h e m i c a l l y
analysed. O n c e a t e a r h a s b e e n w e i g h e d and m e a s u r e d , h o w e v e r , is il si ill
a t e a r ? Hardly, for if we m e a s u r e it, w h a t we e n d up holding is j u s t a drop
of liquid; it is no l o n g e r a tear. Is the t e a r t h e n p s y c h i c or s o m a t i c , or is 11
n e i t h e r ? If it is n e i t h e r , t h e n w h a t actually c o n s t i t u t e s a t e a r ? T h e
n a t u r a l scientific c r i t e r i o n o f m e a s u r a b i l i t y d o e s not allow this q u e s t i o n
e v e n to be raised, m u c h less a n s w e r e d .
A s with t h e tear, traditional p s y c h o s o m a t i c m e d i c i n e c a n n o t specify
the t r u e n a t u r e of any o t h e r so-called p s y c h o s o m a t i c s y m p t o m s , so it has
r e s t r i c t e d itself t o c l a r i f y i n g t h e g e n e s i s o f t h e s e s y m p t o m s instead. T h i s ,
of c o u r s e , is totally d i f f e r e n t f r o m an a d e q u a t e d e t e r m i n a t i o n of what
s u c h a g e n e r a t e d s y m p t o m is, in and of itself. On its w a y to a s c e r t a i n i n g
the biographical c a u s e s o f s y m p t o m s , p s y c h o s o m a t i c m e d i c i n e alludes t o
the p o t e n t i a l o f e n d o p s y c h i c p h e n o m e n a for affecting o r g a n i c f u n c t i o n s ,
and vice v e r s a . B u t w h e r e t w o such h e t e r o g e n e o u s t h i n g s are c o n c e r n e d ,
c o n s i d e r a t i o n s o f t h e i r p o t e n t i a l i n t e r a c t i o n a r e n e v e r scientifically
s o u n d and m u s t a l w a y s r e m a i n h a z y .
W h i l e t h e w i l l i n g n e s s o f p s y c h o s o m a t i c m e d i c i n e t o c o n s i d e r relation
ships b e t w e e n t w o t o t a l l y h e t e r o g e n e o u s t h i n g s calls its scientific
s o u n d n e s s into q u e s t i o n , w h a t u n d e r c u t s i t m o r e i s t h e fact t h a t t h e s e
t h i n g s simply d o n o t e x i s t . W e h a v e indicated b e f o r e t h a t t h e n a t u r a l
scientific i n t e r p r e t a t i o n of t h e living h u m a n body as a m e r e s o m a m i s s e s
its peculiar m o d e of b e i n g . T h e additional e x i s t e n c e of a p s y c h e , likewise
p r e s e n t and in s o m e w a y j o i n e d to t h e s o m a , is a b s o l u t e l y b e y o n d
proving.
W h e n psychosomatic medicine abandons the notion of interaction
b e t w e e n p s y c h e and s o m a in favor of a r e l a t i o n s h i p of e x p r e s s i o n imagining, for i n s t a n c e , t h a t t h e s o m a t i c a l l y r e g i s t e r e d t e a r is an
expression of the psychic mourningthen the connection between
p s y c h e and s o m a is still f u r t h e r confused. We are n e v e r told e x a c t l y what
" e x p r e s s i o n " m e a n s , or w h e t h e r it suffices to d e t e r m i n e t h e puzzling,
r e l a t i o n s h i p b e t w e e n s o m a and p s y c h e . T h e a s s u m p t i o n o f a r e l a t i o n s h i p
b e t w e e n t w o e n t i t i e s d o e s n o t a d e q u a t e l y explain e i t h e r t h e expressive, or
the expressed. T h e expressive one is assigned only o n e quality, t h e capacity for
s e l f - e x p r e s s i o n , and e x c e p t for this i t r e m a i n s e n t i r e l y o b s c u r e . T h e
expressed one, on t h e o t h e r h a n d , is r e d u c e d to t h e s t a t u s of a m e r e
derivative o f this o b s c u r i t y , its o w n n a t u r e n e v e r b e i n g analyzed.
If it is t r u e t h a t t h e c o n c e p t u a l approach of p s y c h o s o m a t i c medicine has
not made it possible to d e t e r m i n e a d e q u a t e l y w h a t kind of r e l a t i o n s h i p
o p e r a t e s b e t w e e n p s y c h e and s o m a , it follows t h a t all s e c o n d a r y

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EXISTENTIAL

FOUNDATIONS

c o n s i d e r a t i o n s c o n c e r n i n g the activation of specific s y m p t o m s in the

body t h r o u g h specific psychic conflicts are futile. T h e c o n c e p t s o f
traditional p s y c h o s o m a t i c medicine will t h e r e f o r e n e v e r yield an
explanation o f the i m p o r t a n t m a t t e r o f the specificity o f p s y c h o s o m a t i c
symptoms.
A t t e n t i o n has already b e e n d r a w n to U e x k u l l ' s a t t e m p t from t h e
q u a r t e r o f a n t h r o p o l o g i c a l p s y c h o l o g y t o c o r r e c t t h e faults o f earlier
p s y c h o s o m a t i c t h i n k i n g and t o d e t e r m i n e a d e q u a t e l y just w h a t does
unite the psychic and s o m a t i c a s p e c t s . In s u m m a r i z i n g the c o n c e p t u a l
approach of his Foundation of Psychosomatic Medicine, we said t h a t a
" m o t i v a t i o n " is a l w a y s seen as the unifying basis of all h u m a n
p h e n o m e n a . It is r e s p o n s i b l e for i n t e r p r e t i n g his s u r r o u n d i n g s and
g e n e r a t i n g o n its o w n a p p r o p r i a t e action. B e f o r e a m o t i v a t i o n
e m e r g e s , the world is m e r e l y t h e r e , u n a r t i c u l a t e d m a t t e r . M o t i v a t i o n is
w h a t shapes the " p r e - r e a l m a t t e r " into t h e m o s t diverse realities. T o
produce an action, t h e m o t i v a t i o n a p p r o p r i a t e s b o t h t h e psychic e g o (as
director) and t h e h u m a n b o d y (as props), to appear in the s c e n e w h i c h it
(the m o t i v a t i o n ) h a s laid out.
U e x k u l l gives the c a s e of a p e r s o n c o n f r o n t i n g an apple t r e e to
illustrate t h i s . T h e m o t i v a t i o n i n t e r p r e t s t h e apples h a n g i n g o n the t r e e s
a s things t o b e e a t e n t h e n produces t h e a p p r o p r i a t e h u m a n r e a c t i o n s ;
picking apples and eating t h e m . He c o n c l u d e s , "In o u r illustration, we can
say t h a t t h e appetite is e t e r n a l but t h a t t h e e a t e r and t h e scenic p r o p e r t i e s
are subject to change."
B u t t h e r e is no e v i d e n c e for the p r e s e n c e of an i n n a t e , alle n c o m p a s s i n g m o t i v a t i o n such a s U e x k u l l p r o p o s e s , n o r does e x p e r i e n c e
c o n f i r m t h a t o u r w o r l d appears to us initially as m e r e l y " p r e - r e a l " and
" u n a r t i c u l a t e d " m a t t e r o n t o w h i c h , i f w e are t o c r e a t e s e p a r a t e o b j e c t s ,
we m u s t project m e a n i n g s . F u r t h e r m o r e , s u c h a depiction of t h e
situation leaves t h e n a t u r e o f a n ego, w h o s e p e r c e p t i o n o f t h e m e a n i n g o r
significance of s o m e t h i n g is dictated by a m o t i v a t i o n , quite o b s c u r e .
T h e a s c e r t a i n a b l e facts indicate, r a t h e r , t h a t w h e n t h e p h e n o m e n a o f
m y w o r l d c o n f r o n t m e t h e y reveal, o f t h e i r g r e a t s t o r e o f m e a n i n g s , o n l y
t h o s e t o w h i c h m y p e r c e p t i o n i n t h e s t a t e o f m y e x i s t e n c e a t the t i m e
is open. At o n e and t h e s a m e t i m e n o t in s o m e s u c c e s s i o n of p r i m a r y
and s e c o n d a r y e v e n t s t h e s e p h e n o m e n a induce o r m o t i v a t e m e t o a n
action, or n o n a c t i o n , appropriate to t h e m e a n i n g I have perceived in
t hem. T h u s the m o t i v a t i o n does not stand opposite m e , a b o v e me and t h e
w i n Id's "pre-real m a t t e r . " M o t i v a t i o n s , o r i n d u c e m e n t s , can o c c u r o n l y
in r e s p o n s e to my perception of w h a t I e n c o u n t e r in my world.
A'. I l e x ! Lill's proposal does not a m o u n t to a factual p h e n o m e n o l o g i c a l
description ol demonst i able m a n i f e s t a t i o n s , his t h e o r y does n o t allow us
io understand what we actually o b s e r v e in a p s y c h o s o m a t i c s y m p t o m .

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Fundamental

Conditionality

77

L e t us n o w s u m up the j u s t i f i c a t i o n and l i m i t a t i o n s 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 medicine i n light o f o u r discussion. T h e i r j u s t i f i c a t i o n
c o n s i s t s in t h e fact t h a t b o t h disciplines e m p h a t i c a l l y r e a s s e r t s o m e t h i n g
n o n s o m a t i c in h u m a n e x i s t e n c e as a p r o p e r a r e a of h u m a n reality. B u t
this s e e m s t o e x h a u s t t h e i r c o n t r i b u t i o n . T h e n a r r o w r a n g e o f t h e i r
c o m p e t e n c e is due to the fact t h a t t h e i r p r o m i s i n g b e g i n n i n g s s o o n fell
u n d e r t h e s w a y o f a r e s e a r c h m e t h o d t h a t i s n o t suited t o h u m a n n a t u r e .
T h e y yielded t o p r e s s u r e from t h e old r a t i o n a l i s t i c tradition w h i c h holds
t h a t all b e i n g is by n a t u r e s u b s t a n t i a l and physically p r e s e n t .
E v e r y o n e o f t h e n o t i o n s o f 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 i s
based upon t h e C a r t e s i a n division o f the w o r l d into t w o c o m p o n e n t s , the
e x a c t l y calculable e x t e n d e d (tangible) s u b s t a n c e and w h a t is i m a g i n e d as
t h e e n c a p s u l a t e d t h i n k i n g s u b s t a n c e o f the h u m a n s u b j e c t . S i n c e this
image o f h u m a n e x i s t e n c e b e c a m e a s c e n d a n t , i n q u i r y into t h e precise
c h a r a c t e r o f h u m a n n a t u r e a s " b e i n g - i n - t h e - w o r l d " has b e e n n e i t h e r
r e f o r m u l a t e d n o r advanced b y t h o s e w h o p r a c t i c e p s y c h o l o g y and
psychosomatic medicine. And thus the phenomena of human existence,
in t h e i r t r u e c h a r a c t e r , h a v e r e m a i n e d as closed to t h e e x p l a n a t i o n s of
t h e s e s c i e n c e s a s t h e y h a v e b e e n t o t h e older s c i e n c e s o f biology,
a n a t o m y , and p h y s i o l o g y . B e c a u s e o f t h e i r u n s u i t a b l e c o n c e p t u a l
a p p r o a c h e s , the ideas o f 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 h a v e
been in part m e r e r a t i o n a l i s t i c c o n s t r u c t i o n and i n v e n t i o n , and in part the
o u t c o m e o f psychic p h e n o m e n a w h o s e significance r e m a i n s largely
o b s c u r e . N o d o u b t t h e r e a r e m a n y w h o believe t h a t t h e s e f o r m u l a t i o n s i n
imitation of m a t h e m a t i c a l p r e c i s i o n c o n s t i t u t e a solid t h e o r e t i c a l
g r o u n d i n g . In reality, h o w e v e r , t h e y a r e a false f o o t i n g for t h e
u n t h i n k i n g . C u r r e n t p s y c h o l o g i c a l and p s y c h o s o m a t i c t h e o r i e s h a v e i n
c o m m o n t h e desire t o explain t h e u n 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 o n the basis o f s o m e t h i n g e v e n less k n o w n .
All o u r c o n s i d e r a t i o n s s o far point t o t h e c o n c l u s i o n t h a t t h e e s s e n t i a l
f e a t u r e s o f t h e h e a l t h y and p a t h o l o g i c a l m a n i f e s t a t i o n s o f h u m a n n a t u r e
are inaccessible t o the h y p o t h e s e s o f n a t u r a l s c i e n c e and t o t h e m o r e
r e c e n t h y p o t h e s e s o f 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 . T h i s
c o n c l u s i o n also indicates t h a t medical r e s e a r c h has n o t a s k m o r e u r g e n t
than t h e s e a r c h for a n e w , m o r e broadly h u m a n a p p r o a c h to its o b j e c t of
study, t h e e x i s t e n c e o f m a n .
I n this e n t e r p r i s e , t h e special l e s s o n s t h a t g r o w o u t o f r e n o u n c i n g t h e
traditional r e s e a r c h m e t h o d s can b e o f g r e a t help. T h e y indicate, first,
w h a t we m u s t at all c o s t avoid in f u t u r e e f f o r t s to lay a s t u r d i e r
foundation for m e d i c i n e . T h e y t e a c h u s t h a t h u m a n e x i s t e n c e can n o
longer be v i e w e d , in r a s h a n a l o g y to the lifeless o b j e c t s of t h e world, as
m e r e l y a n o t h e r t h i n g w h i c h is p r e s e n t at a p a r t i c u l a r point in a

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FOUNDATIONS

p r e c o n c e i v e d space. A b o v e all, h o w e v e r , t h e inadequacies o f traditional

medical o r i e n t a t i o n s c o u n s e l us to a b a n d o n , o n c e and for all, e f f o r t s to
explain o b s e r v a b l e p h e n o m e n a directly on the basis of t h i n g s a s s u m e d to
be operating behind them.
In c o n t r a s t to traditional psychological and p s y c h o s o m a t i c h y p o t h e s e s ,
a m o r e broadly h u m a n medical r e s e a r c h m e t h o d will n o t need to v i e w its
findings as m e r e supplements to the o u t c o m e s of n a t u r a l scientific
i n v e s t i g a t i o n s . In t h e n e x t part of this book we will test a p e r s p e c t i v e
w h i c h m e a n s assiduously to avoid, as o b v i o u s l y injurious to h u m a n
n a t u r e , the traditional c o n c e p t u a l a p p r o a c h o f m e d i c i n e . T h i s n e w
o r i e n t a t i o n will be applied to t h e very s a m e h e a l t h y and p a t h o l o g i c a l
m a n i f e s t a t i o n s o f t h e c a s e h i s t o r y against w h i c h w e t e s t e d the c u r r e n t
r e s e a r c h m e t h o d s o f s c i e n c e , 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 .
F o r r e a s o n s t h a t will b e c o m e a p p a r e n t later, w e shall call the n e w , m o r e
broadly h u m a n o r i e n t a t i o n an existential, phenomenological i n v e s t i g a t i v e
m e t h o d . It s t a k e s e v e r y t h i n g on keeping s t r i c t l y to p h e n o m e n a t h a t are
directly visible to it, and it h a s no p u r p o s e o t h e r t h a n to a r t i c u l a t e t h e
m e a n i n g f u l n e s s and c o n t e x t s o f r e f e r e n c e w h i c h the p h e n o m e n a
t h e m s e l v e s reveal.

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 ,

Gesammelle Werke, vol.

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.

6 . S . F r e u d , " D a s U n b e w u s s t e , " i n Gesammelte Werke, vol. 1 0 ( L o n d o n : I m a g o , I n c . , 1 9 4 1 ) ,

p. 2 6 5 .
7. S. F r e u d ,

Gesammelte

Werke, vol.

7 (London:

Imago,

1 9 4 1 ) , p.

243ff.

8. P. M a r t y , M. de M ' U z a n , a n d C h . D a i d , L investigation psychosomatique ( P a r i s : G a l l i m a r d ,

1963).
9. J. P i a g e t , Le causalite physique chez [enfant ( P a r i s : 1 9 5 7 ) , p. 2 1 5 . S e e also: La representation du
monde chez lenfant; Les Origines de 1'animisme enfantin ( P a r i s : 1 9 2 6 ) , pp. 2 0 3 - 5 2 ; and La formation du
Symbole

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,

Berlin, Cologne, Mainz: Verlag W. Kohlhammer, 1 9 7 0 ) .

1 1 . Ibid., p . 1 0 .
1 2 . K. H. P r i b r a m , " D i e S t r u k t u r des G e d c h t n i s s e s , " in Struktur und Dynamik.
1 3 . H a s e l o f f , op. c i t . , p . 1 4 .
14. H . Ey, Das Bewusstem ( B e r l i n : W . d e G r u y t e r , 1 9 6 7 ) , pp. 3 0 , 3 2 , 9 4 ,
15. M.
1950),

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

Applying the Existential

Outlook

83

Z i i r c h e r ' s w h o l e and indivisible e x i s t e n c e . S i n c e t h e i r love affair had

begun, R e g u l a Z u r c h e r felt t h a t h e r lover w a s in h e r h e a r t . In r u n n i n g
o v e r to him, she was m e r e l y actualizing bodily an already e x i s t i n g
e x i s t e n t i a l c l o s e n e s s to him. B u t it w a s precisely in this fulfillment that
she b e c a m e totally u n a w a r e o f h e r o w n b o d y h o o d .
T h e s a m e i s t r u e o f t h e couple's stroll h o m e a r m i n a r m . H e r body was
not s o m e physical i n s t r u m e n t s e p a r a t e from h e r used t o t r a n s p o r t h e r
p s y c h e . W a l k i n g this w a y w a s a n i n t e g r a l part o f the couple's i n t i m a c y ,
and t h u s it can be u n d e r s t o o d as t h e h u m a n p h e n o m e n o n it is as t h e
bodying f o r t h of t h e i r i n t i m a t e w a y of being t o g e t h e r in a s h a r e d world.
T h i s sort o f physical p r o c e s s b e t w e e n t w o people can n e v e r b e
c o m p r e h e n d e d from the s t a n d p o i n t o f t h e b o d y h o o d o f a n e x i s t e n c e s o
long as t h a t b o d y h o o d has b e e n p r e c o n c e i v e d as a m e r e l y physical s y s t e m
o f m u s c l e s , b o n e s , and n e r v e s .
A n o t h e r manifestation of the bodyhood of her existence here was a
n o t i c e a b l y i n c r e a s e d pulse r a t e and a c o n s i d e r a b l y f r e e r c o n t r a c t i o n and
dilation o f h e r h e a r t . S h e h e r s e l f did n o t discern t h e p r e s e n c e o f a n o r g a n
a n y w h e r e w i t h i n h e r body, or of a n y t h i n g she had inside. S h e felt a
d i s t a n t r u s h i n g in t h e r e g i o n of h e r h e a r t , a p o u n d i n g t h a t was h e r s e l f , or
she would n o t h a v e b e e n in a position to say, "I h u r r i e d t o w a r d him, my
h e a r t p o u n d i n g . " W i t h t h e s e w o r d s she u t t e r s h e r a w a r e n e s s o f
b e c o m i n g a b s o r b e d body and s o u l w i t h e v e r y t h i n g s h e w a s , h e r w h o l e
beingin h e r powerful e x i s t e n t i a l c o n n e c t i o n w i t h h e r lover. W h a t
appears in a scientific i n t e r p r e t a t i o n to be t h e b e a t i n g and p u m p i n g of a
physical o r g a n r e v e a l s i t s e l f a s t h e bodying f o r t h o f R e g u l a Z u r c h e r and
her lover's w a y o f b e i n g t o g e t h e r .
W h e n , o n t h e w a y h o m e , t h e t w o b e g a n talking o v e r plans for t h e i r
vacation, w h a t e m e r g e d w a s n o t s o m e dialogue i n t h e u s u a l psychological
usage. D i a l o g u e m e a n s speaking back and f o r t h . N o w , according t o
c u r r e n t p s y c h o l o g i c a l t e a c h i n g , t w o s u b j e c t s could talk back and forth
only a b o u t e n t i r e l y c o n s c i o u s n e s s - i m m a n e n t r e p r e s e n t a t i o n s o f s o m e
o b j e c t of t h e e x t e r n a l w o r l d , in this case 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 a
r e s o r t h o t e l , w i t h an i m a g e in e a c h brain. All t h a t could be factually
d e t e r m i n e d , h o w e v e r , is t h a t t w o people visualized t h e s a m e building at
the s a m e t i m e . In this v i s u a l i z a t i o n , b o t h w e r e freely being t o g e t h e r in
their r e l a t i o n t o t h e s a m e t h i n g and during t h e v i s u a l i z a t i o n w e r e a t the
h o t e l itself, far to t h e s o u t h .
A c u r s o r y e x a m i n a t i o n w o u l d n o doubt a s c r i b e the l o v e r s ' t h o u g h t s o f
their old v a c a t i o n spot t o m e m o r y . B u t strictly speaking, the visualization
ol the h o t e l w a s o n l y a m a i n point of focus: t h e pair was c o n c e r n e d
primarily w i t h t h e h o t e l as a building presently appearing in a c e r t a i n w a y
and as a future place to b e . G e n u i n e r e m e m b e r i n g r e q u i r e s an e x p r e s s

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EXISTENTIAL

FOUNDATIONS

relation to the past. T h e only r e m e m b e r i n g t h e y did w a s the l o v e r ' s

r e m a r k , " D o y o u r e m e m b e r h o w , a y e a r a g o today, w e flew into Las
P a l m a s i n t h a t dazzling s u n l i g h t ? " F o r t h e i n s t a n t o f the q u e s t i o n , b o t h
people stopped to c o n t e m p l a t e an e v e n t of s o m e t i m e past w h i c h had
b e e n p r e s e r v e d in t h e lives.
If any of these existential descriptions of healthy human phenomena is
c o m p a r e d w i t h h y p o t h e s e s o f traditional p h y s i o l o g y o r p s y c h o l o g y a s
t h e y are applied t o the s a m e e v e n t , the e x i s t e n t i a l description can b e seen
at o n c e to be c l o s e r to reality. O u r e x i s t e n t i a l point of v i e w allows us to
dispense w i t h d e d u c t i o n s t h a t a r e alien to the actual a p p e a r a n c e of o u r
o b j e c t s o f study, w i t h a b s t r a c t i o n s and c o n c l u s i o n s t h a t depart f r o m
w h a t can actually b e s e e n , and w i t h t h e u s e o f psychic e n t i t i e s w h i c h ,
t h o u g h t h e y c a n n o t b e d e m o n s t r a t e d , supposedly take place b e h i n d the
p h e n o m e n a t h e m s e l v e s . T h e 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 t h a t
belong to and c o m p r i s e t h e p h e n o m e n a are simply allowed to reveal
themselves.
O f c o u r s e , w e m a y n o t o v e r l o o k t h a t t h e r e can b e n o appearing o r
revealing of a n y p h e n o m e n a t h a t is n o t already in a d v a n c e b o r n by a
specific insight into t h e n a t u r e o f t h e i r m o d e o f being. W i t h o u t the
illumination o f such i n s i g h t i n t o t h e basic n a t u r e o f t h e appearing
p h e n o m e n a n o m a t t e r h o w u n d e t e r m i n e d and u n r e f l e c t e d this insight
m a y b e n o h u m a n b e i n g would e v e r see a n y t h i n g , n o t t o speak o f his
e v e r u n d e r s t a n d i n g it as a thing of this or t h a t m e a n i n g f u l n e s s .
F o r this r e a s o n , t h e following q u e s t i o n n o w i n e v i t a b l y a r i s e s : w h a t
s o r t o f basic i n s i g h t s m a d e possible the a b o v e , simple, a p p r o p r i a t e t o t h e
D a - s e i n description of a few h e a l t h y p h e n o m e n a of o u r test c a s e ' s
e x i s t i n g ? I n o t h e r w o r d s , w e have t o c o n s i d e r t h e m a t i c a l l y t h o s e basic
f e a t u r e s o f h e a l t h y h u m a n e x i s t i n g m o s t significant for m e d i c i n e and
w h i c h we h a v e up to n o w illustrated only in t h e description of a few
e x a m p l e s o f h u m a n b e h a v i o r , and t o e x p l i c a t e t h e m t o the d i s t i n g u i s h i n g
c h a r a c t e r i s t i c s of h u m a n being as a w h o l e .

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

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EXISTENTIAL FOUNDATIONS

" s o m e h o w in t i m e , " w h i c h h a v e b e e n used familiarly for a g e s . If it would

g e t past t h e v a g u e n e s s o f " s o m e w h e r e " and " s o m e h o w , " medicine m u s t
leave b e h i n d t h e p r e c o n c e p t i o n s o f c o g n i t i v e t h e o r y and m a k e a n e w
b e g i n n i n g in looking at t h e spatial and t e m p o r a l p r e s e n c e of h u m a n
beings.

The spatiality of existence

We are all familiar w i t h t h e idea t h a t e v e r y t h i n g in t h e w o r l d is p r e s e n t
in space, t h a t a g i v e n t h i n g is to be f o u n d at a n y g i v e n t i m e at s o m e
specific point w i t h i n a p r e e x i s t i n g h o l l o w c o s m i c c o n t a i n e r and t h a t it
would o c c u p y a part of t h a t space c o r r e s p o n d i n g to its m e a s u r a b l e
d i m e n s i o n s and calculable v o l u m e . A n d we can i m a g i n e i n t e r v a l s in
space, gap-like d i s t a n c e s , e x t e n d i n g b e t w e e n individual o b j e c t s . S i n c e
h u m a n b e i n g s b e l o n g a m o n g all t h e o t h e r t h i n g s i n t h e world, t h e i r
p r e s e n c e in space, t o o , is g e n e r a l l y r e p r e s e n t e d in this way.
T h i s c o n c e p t i o n of space provided a felicitous point of d e p a r t u r e for
the g e o m e t r i c a l and m a t h e m a t i c a l c o n q u e s t o f space b y m o d e r n n a t u r a l
s c i e n c e , w h i c h w a s originally c o n c e r n e d o n l y w i t h i n a n i m a t e o b j e c t s as it
s o u g h t to establish a reliable basis for calculating and fixing spatial
r e l a t i o n s h i p s a m o n g t h e m . It achieved this by totally e m p t y i n g t h e
r e g i o n s and places o f space, t h a t w e r e p r e v i o u s l y c h a r a c t e r i z e d b y t h e
significations o f t h e t h i n g s t h a t o c c u p e d t h e m . S c i e n c e t h u s r e a c h e d its
c o n c e p t i o n o f u n i f o r m p o i n t s i n space. T h r o u g h t h e r e d u c t i o n o f space t o
the i n t e r v a l s b e t w e e n t h e s e points, i t c r e a t e d t h e c o n c e p t i o n o f m e r e
m e a s u r a b l e , h o m o g e n e o u s d i s t a n c e s , g o m e t r i c d i m e n s i o n s and m a t h e m
atical spatial f u n c t i o n s . T h i s g e o m e t r i c a l r e p r e s e n t a t i o n o f space,
admirably suited t o t h e m a s t e r y o f i n a n i m a t e o b j e c t s , w a s t r a n s f e r r e d
w i t h o u t t h o u g h t t o t h e spatiality o f h u m a n e x i s t e n c e . T h e r e are s t r o n g
a r g u m e n t s a g a i n s t this s o r t o f spatiality i n h u m a n b e i n g s , h o w e v e r , and
s o w e m u s t e x a m i n e a n e w the special n a t u r e o f m a n ' s spatial p r e s e n c e i n
t h e world.
Let us take a simple e x a m p l e . I am going on a w a l k w i t h my friend to a
s p o r t i n g - g o o d s s t o r e b o t h o f u s k n o w well. W e w a l k along t h e m a i n
s t r e e t of o u r t o w n , w h e r e t h e s t o r e we w a n t is l o c a t e d . I can see my fftrend
ahead of me on the sidewalk. In front of h i m is a s i g n p o s t of park r u l e s ,
and o n e yard b e y o n d t h a t is a thick black l a m p p o s t . We w a n t to k n o w
w h a t would b e c o m e of my friend's shopping e x p e d i t i o n if, at this v e r y
m o m e n t , his r e l a t i o n s h i p w i t h space w e r e t r a n s f o r m e d into o n e like t h a t
o f the i n a n i m a t e s i g n p o s t o r lamppost.
First, t h e r e would no l o n g e r be any friend w a l k i n g beside m e . He would
have stopped e x i s t i n g as a h u m a n being. S e c o n d , such a being would be
m i apable o l taking even o n e m o r e h u m a n step t o w a r d the s p o r t i n g o o d s
stoi e

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B u t let u s a s s u m e t h a t m y t r a n s f o r m e d friend h a s b e e n equipped with

roller s k a t e s and an i n t e r n a l m o t o r t h a t can i n i t i a t e m o t i o n in any
d i r e c t i o n . It is the least of o u r c o n c e r n s t h a t such an a p p a r a t u s would
probably leave the print of its skull on the s i g n p o s t in a m a t t e r ol
m o m e n t s . S u c h a m i s h a p could be forestalled by installing a p h o t o s e n s i
tive s e l e n i u m cell w i t h a closed circuit or feedback m e c h a n i s m . T h i s r o b o t
could also be fitted out w i t h a v a r i e t y of c o m p u t e r s , h o o k e d up in t u r n to
other computers attached to objects in the surroundings. Now, certain
s e q u e n c e s o f electrical i m p u l s e s fed i n t o and s t o r e d b y t h e r o b o t ' s
c o m p u t e r s m i g h t impel the r o b o t t o c h a n g e s o f location w h i c h f r o m a
purely g e o m e t r i c p e r s p e c t i v e w o u l d c o n f o r m e x a c t l y t o t h e shopping
e x p e d i t i o n my friend would h a v e m a d e if he had r e m a i n e d an e x i s t i n g
h u m a n being, possibly w i t h the s a m e effects. T h e r o b o t w o u l d p r e s u m a b l y
e v e n h a v e b e e n able to c a r r y a s p o r t s s h i r t from t h e s t o r e to my friend's
home.
N e v e r t h e l e s s , the p h e n o m e n a o f t h e r o b o t and t h e shopping
e x p e d i t i o n o f a n e x i s t i n g h u m a n being r e m a i n for m a n y r e a s o n s
i n c o m p a r a b l e . First, like e f f e c t s do n o t n e c e s s a r i l y imply like m e a n s of
producing o r r e l e a s i n g t h e s e e f f e c t s . N e x t , n o r o b o t could p e r f o r m i n
w a y s like this w i t h o u t a p r o g r a m supplied by a h u m a n being w h o , as a
h u m a n being, would h a v e already a p p r e h e n d e d the s p o r t i n g - g o o d s s t o r e
as a s p o r t i n g - g o o d s s t o r e . C o m p u t e r s are n o t h i n g m o r e t h a n p r o d u c t s of
h u m a n b e i n g s w h o can u n d e r s t a n d the c o n t e x t s o f m e a n i n g and
r e f e r e n c e o f p h e n o m e n a t h a t appear t o t h e m .
B u t a b o v e all, t h e world of d i f f e r e n c e b e t w e e n a r o b o t ' s c h a n g e s of
location and t h e a c t i o n s of an e x i s t i n g h u m a n being is due to t h e fact t h a t
t h e s e t w o are spatial in f u n d a m e n t a l l y different w a y s . A c o m p u t e r ,
w h a t e v e r its capabilities, is an i n a n i m a t e o b j e c t . It is p r e s e n t o n l y at s o m e
specific point in a space t h a t is p r e c o n c e i v e d as a h o l l o w c o n t a i n e r , and it
occupies o n l y a part of space t h a t c o r r e s p o n d s to its m a t e r i a l v o l u m e and
t h e r a n g e of its electrical fields. It ends at t h e s e physical and electrical
b o r d e r s , f r o m w h i c h the d i s t a n c e t o o t h e r o b j e c t s m a y b e m e a s u r e d w i t h
precision, as w i t h a r u l e r .
T h e e s s e n t i a l p r e c o n d i t i o n for a h u m a n being's shopping e x p e d i t i o n is
t h a t he d o e s n o t exist spatially as does a r o b o t , w h i c h e x t e n d s to t h e limits
of its m a t e r i a l body or e n e r g e t i c fields. All non-living b e i n g s , from
parking s i g n s to c o m p u t e r s , a r e spatial o n l y in this l a t t e r s e n s e . No
m a t t e r t h e n , h o w g e o m e t r i c a l l y " c l o s e " I am to t h e m , I am n e v e r
"there""da"for them. In other words, not the most modern computer
has a w o r l d , i n t o w h o s e o p e n n e s s o t h e r b e i n g s can appear, reveal
t h e m s e l v e s , and b e r e c e i v e d . N o m a t t e r h o w m a n y o r h o w i n t e n s e the
impulses r e a c h i n g t h e e n e r g e t i c fields of a c o m p u t e r , it is n e v e r so open

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t h a t it can p e r c e i v e t h e i m p u l s e s as such, g r a s p their significance and

r e s p o n d appropriately to w h a t is u n d e r s t o o d of t h e m . W h a t e v e r is in
space as n o n - l i v i n g m a t t e r is, p e r c e i v e s n o t h i n g of its own p r e s e n c e in
" s p a c e , " n o r o f t h e p r e s e n c e o f o t h e r b e i n g s , n o r o f t h e significance and
r e f e r e n t i a l c o n t e x t t h a t c o n s t i t u t e the specific c h a r a c t e r o f w h a t i s
p r e s e n t . It is n o t even so t h a t non-living b e i n g s , in c o n t r a s t to h u m a n
b e i n g s , are simply closed t o t h e p e r c e p t i o n o f t h e i r o w n p r e s e n c e and the
p r e s e n c e s of o t h e r b e i n g s . S u c h c l o s e d n e s s o c c u r s only as a privative
p h e n o m e n o n of o p e n n e s s . T h e p r e s e n c e of a parking sign " n e a r " a l a m p
m e a n s only t h a t t h e t w o points in space occupied by t h e s e b e i n g s a r e
s e p a r a t e d by a given s h o r t i n t e r v a l . T h e i r spatial r e l a t i o n s h i p is the s h o r t
distance b e t w e e n t h e m , w h i c h can be m e a s u r e d by a h u m a n being and
u n d e r s t o o d by h i m as a s h o r t d i s t a n c e .
M y space and t h a t o f m y friend, a s t h e spatiality o f e x i s t i n g h u m a n
b e i n g s , is of a f u n d a m e n t a l l y different kind. T h e space b e t w e e n us and
t h e parking sign is t h e o p e n n e s s , t h a t w h i c h a l l o w s p a s s a g e t h r o u g h das
"Durchlssige"), b e t w e e n us and it. As such an o p e n n e s s , it is free and clear.
O t h e r w i s e , t h e sign could n e v e r appear as a sign to us t h r o u g h space.
O n e could build a wall b e t w e e n us and t h e sign, and this space would t h e n
n o l o n g e r b e o p e n for o u r p e r c e p t i o n o f t h e sign. B u t t h e n n o h u m a n
could have raised t h e wall if t h e space w e r e n o t c o m p r e h e n s i b l e to h i m as
open, clear and a c c e s s i b l e for t h e e r e c t i o n of a wall.
I n the G e r m a n l a n g u a g e , the s u b s t a n t i v e " s p a c e " R a u m (closely
related to t h e English " r o o m " ) i s derived from t h e v e r b rumen. Rumen
means to clear, make room for, perhaps in order to installeinrumensomething in
the cleared space, to give it a worldly dwelling place in the cleared
aufgerumtenopenness. It is n o t o n l y possible to i n s t a l l e i n r u m e n a
piece of f u r n i t u r e in a cleared aufgerumtenroom. O n e can be in an
expansiveaugerumtenmood. O n e is then attuned to openness,
f r e e d o m , s e r e n i t y , and r e a d i n e s s for t h e a p p e a r a n c e o f o t h e r b e i n g s . O n e
i s able t o m a k e r o o m R a u m g e b e n f o r t h e o p i n i o n s o f o t h e r s , t o allow
that another may be right"ihm einrumen, etwas zu Recht zu
b e h a u p t e n . " R u m e n h a s primarily t h e m e a n i n g o f clearinglichten. T h i s
lichten is f u n d a m e n t a l l y different from the m e r e illuminating of a
p r e v i o u s l y dark r o o m w i t h physical lightLicht, R a t h e r , lichten as rumen,
i.e., a s clearing, m a k i n g r o o m for, c o r r e s p o n d s m o r e closely t o w h a t
h a p p e n s t o b o o k s h e l v e s w h e n s o m e o n e h a s b e e n c a r e l e s s i n lending his
b o o k s . It is also idiomatic in G e r m a n to speak of h a i r "clearing itself"sich
lichtenfalling o u t to m a k e " r o o m " for b a l d n e s s . S i m i l a r l y , a " c l e a r i n g "
L i c h t u n g i s o p e n e d up in the forest w h e n all of t h e t r e e s w i t h i n a c e r t a i n
area have b e e n felled and cleared a w a y .
Yel I he spatial quality of the h u m a n w o r l d is in no w a y c o m p a r a b l e to
the g e o m e t ric space in w h i c h i n a n i m a t e , " w o r l d - l e s s " o b j e c t s are p r e s e n t .

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As in o u r e x a m p l e , t h e spatiality of t h e h u m a n world is open,

u n o b s t r u c t e d and clear t o t h e e x t e n t t h a t p h e n o m e n a m a y address u s
t h r o u g h i t 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 . B u t i f this
o p e n n e s s , this clearing is t h e f u n d a m e n t a l c h a r a c t e r of spatiality in the
h u m a n world, t h e n logically this spatiality c a n n o t b e t h e o p e n n e s s and
c l e a r n e s s t h e m s e l v e s . A s a n o a k o r birch, t h o u g h its e s s e n c e i s " t r e e n e s s , " i s n o t itself this " t r e e - n e s s , " o p e n n e s s and c l e a r n e s s c a n n o t b e
s e c o n d a r y d e r i v a t i v e s o f h u m a n spatiality. R a t h e r , n o t h i n g like h u m a n
spatiality could e v e r c o m e i n t o being in a p a r t i c u l a r w o r l d u n l e s s
o p e n n e s s and c l e a r n e s s w e r e already r e i g n i n g t h e r e . T h e s e c o n s t i t u t e
the t r u e n a t u r e o f spatiality i n the h u m a n world.
B u t h o w is the e x i s t i n g h u m a n being related, for his part, to the
spatiality o f his w o r l d ? W h a t e v e r c o n f r o n t s man t h r o u g h t h e o p e n n e s s
and c l e a r n e s s of space will i n e v i t a b l y address him in its s i g n i f i c a n c e ,
o w i n g to t h e fact t h a t h u m a n e x i s t e n c e is i t s e l f spatial. It is spatial in t h e
s e n s e t h a t t h e basic c h a r a c t e r i s t i c of its e x i s t e n c e is o p e n n e s s and
receptivity. H u m a n p r e s e n c e is in no w a y c o n f i n e d to t h e p o i n t in space at
w h i c h t h e h u m a n b o d y (as a s e l f - c o n t a i n e d physical o b j e c t ) is to be found.
If, on my walk to t h e s p o r t i n g - g o o d s s t o r e , I am to p e r c e i v e t h e s i g n p o s t
o f park r u l e s , t h e l a m p p o s t , o t h e r p e d e s t r i a n s , t h e c u r b o n m y left and the
buildings o n m y r i g h t a s w h a t t h e y are, each a t t h e p r o p e r i n s t a n t , t h e n
my spatial p r e s e n c e m u s t be of a kind 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 of
inanimate objects.
W h a t m a d e my b e h a v i o r human w a s t h a t I w a s p r e s e n t n o t o n l y as my
w a l k i n g , physical body, but at the s a m e time as already being w i t h w h a t I
set m y c o u r s e by. W e r e this n o t so, e v e n the m o s t m i n i m a l , ill-defined and
fleeting p e r c e p t i o n would n o t h a v e b e e n possible, m u c h less the
possibility of s t e e r i n g m y s e l f t o w a r d s o m e t h i n g . N o w , c o n c e i v e d of as a
physical body, I c a n n o t be w a l k i n g h e r e and s i m u l t a n e o u s l y t h e r e in the
s t o r e ; n o physical o b j e c t can o c c u p y t w o p o s i t i o n s i n s p a c e s i m u l t a n e o u s
ly. B u t as an e x i s t i n g h u m a n being, as the o p e n i n g and s p a n n i n g of a
realm by my ability to p e r c e i v e , I am b o t h h e r e and t h e r e . I can p e r c e i v e
only w h a t I h a v e already r e a c h e d or arrived at; h o w else could I e v e r h a v e
a n y s e n s e t h a t a n y t h i n g in t h e w o r l d even e x i s t s and t h a t it is w h e r e it is?
H o w could I desire or a p p r o a c h a n y t h i n g in t h e r e a l m of my w o r l d if I had
not a l r e a d y grasped it p e r c e p t i v e l y and t h e r e b y already b e e n w i t h it?
A h u m a n b e i n g can c o n d u c t h i m s e l f this w a y t o w a r d t h e o p e n n e s s t h e
c l e a r n e s s of his world's spatiality b e c a u s e his being, t o o , is f u n d a m e n t a l l y
o p e n n e s s in t h e s e n s e of a c a p a c i t y to perceive s o m e t h i n g as s o m e t h i n g .
1 l u m a n e x i s t e n c e does n o t possess this o p e n n e s s in t h e form of o n e of a
n u m b e r of d i s c r e t e p r o p e r t i e s . R a t h e r , it is n o t h i n g o t h e r t h a n b e i n g open
for perceiving and u n d e r s t a n d i n g t h e t h i n g s it e n c o u n t e r s for w h a t t h e y
are, and n o t for a n y t h i n g else.

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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

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9I

p e r s o n h e is, n o t s o m e b a c k l e s s , m u t i l a t e d h u m a n s h a p e . Evidently, then,

the e x p r e s s i o n " v i s i o n " is a m b i g u o u s . In o n e i n s t a n c e , " v i s i o n " refers
solely to w h a t o c c u r s to t h e optical field; in t h e o t h e r , " v i s i o n " m e a n s
perceiving a being as t h e w h o l e w h i c h it is.
T h i s p r o c e s s o f " c o m p l e t i o n , " w h e r e b y a purely optical s i g h t b e c o m e s
an i n t e g r a l l y perceived p h e n o m e n o n , is a p r i m a r y c o n c e r n of m o d e r n
p h y s i o l o g i s t s o f s e n s a t i o n . B u t w h e n e v e n t h e optical p e r c e p t i o n c a n n o t
be fully explained on t h e basis of physiological brain p r o c e s s e s ,
physiological h y p o t h e s e s a b o u t t h e s u b s e q u e n t " c o m p l e t i o n " a r e d o o m e d
to failure.
T h e f u n d a m e n t a l c h a r a c t e r o f h u m a n e x i s t i n g , its perceiving
o p e n n e s s , holds o u t possibilities of m a n y o t h e r kinds of vision. As a "being
with this t h i n g or t h a t , " h u m a n vision ordinarily m e a n s s e e i n g s o m e t h i n g
w h i c h is physically p r e s e n t and t h u s s e n s e - p e r c e p t i b l e . Y e t all of us
e n g a g e in a kind of " v i s i o n " of s o m e t h i n g t h a t is n o t physically p r e s e n t
w h e n e v e r w e p i c t u r e s o m e physical p r e s e n c e w e h a v e perceived b e f o r e .
We can e v e n visualize s o m e t h i n g w h i c h is n o t available to t h e s e n s e s at all
b e c a u s e it does n o t actually e x i s t . We can, for i n s t a n c e , visualize a golden
mountain.
N o w , t r a d i t i o n a l p s y c h o l o g i c a l t h e o r y would c h a r a c t e r i z e the visuali
zation of s o m e t h i n g n o t physically p r e s e n t , like a d i s t a n t vacation
c o t t a g e , b y saying t h a t t h e p e r s o n involved has " a c t u a l l y " r e m a i n e d , " o f
c o u r s e , " in t h e r o o m in w h i c h he h a s b e e n physically sitting. At m o s t , he
is at t h e c o t t a g e "in t h o u g h t . " No o n e is claiming t h a t this p e r s o n
physically t r a n s p o r t e d h i m s e l f , during his visualization, to s o m e far o f f
thing, or t h a t he u l t i m a t e l y s t o o d n e x t to it as a taxi t h a t pulls up to a h o t e l
s t a n d s n e x t t o t h e h o t e l . B u t t h e v e r y fact t h a t w e can visualize
s o m e t h i n g d i s t a n t s h o w s t h a t w e a r e capable o f having s o m e t h i n g t h a t i s
not optically p e r c e p t i b l e b e f o r e o u r e y e s , and t h a t we can easily be
s o m e w h e r e besides w h e r e w e a r e physically.
W h e n it p i c t u r e s s o m e d i s t a n t t h i n g , h u m a n e x i s t e n c e as a r e a l m of
p e r c e p t i o n is w i t h w h a t it visualizes and with t h e physically perceptible
o b j e c t s o f its i m m e d i a t e s u r r o u n d i n g s . T h i s m e a n s , w i t h r e g a r d t o o u r
e x a m p l e , t h a t a p e r s o n ' s " b e i n g h e r e " as t h e open realm of p e r c e p t i o n he
is also e n t a i l s "being t h e r e " at t h e visualized c o t t a g e in t h e distant
m o u n t a i n s , likewise as an o p e n r e a l m of p e r c e p t i o n .
It is n o t sufficient to say t h a t we can be s i m u l t a n e o u s l y h e r e w i t h the
physical, s e n s e - p e r c e p t i b l e o b j e c t s of o u r place in the city and at the
visualized c o t t a g e i n t h e m o u n t a i n s . W e a r e n o t dealing h e r e with t w o
m o d e s o f being w h i c h are b o t h t a k i n g place a t t h e s a m e t i m e . R a t h e r , the
r e c e p t i v e " b e i n g h e r e " of e x i s t e n c e , t h e physical p r e s e n c e in the city, is
also, by its very nature, and in its ability to visualize, t h e r e c e p t i v e "being

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t h e r e " a t t h e c o t t a g e . T h e " b e i n g h e r e " i n t h e city place i s n o t l e s s e n e d but

m e r e l y modified in such a w a y t h a t during t h e visualization of t h e c o t t a g e
a t t e n t i o n is no long f o c u s s e d primarily on t h e o b j e c t s in t h e i m m e d i a t e
surroundings.
T h e i m p o r t a n t fact of this p h e n o m e n o n r e m a i n s t h a t in visualizing a
spatially d i s t a n t physically n o n p r e s e n t o b j e c t , a h u m a n being, e x i s t i n g as
an open r e a l m of p e r c e p t i o n , is with t h a t t h i n g , actually at the place w h e r e
t h e thing i s p r e s e n t . W e m u s t e m p h a s i z e t h a t w e a r e not dealing h e r e w i t h
a p r o c e s s in w h i c h s o m e s o r t of e n d o p s y c h i c i m a g e of the visualized
c o t t a g e c o m e s to v i e w first, o n l y to be p r o j e c t e d o u t w a r d as a s e c o n d step
from t h e locus of a s u b j e c t i v e c o n s c i o u s n e s s . If, in v i e w of the open r e a l m
of p e r c e p t i o n i n h e r e n t to h u m a n e x i s t e n c e , t h e r e w e r e a n y s e n s e at all in
d i s t i n g u i s h i n g b e t w e e n a n i n t e r n a l and a n e x t e r n a l w o r l d , w e would still
h a v e t o c o n c e d e t h a t o n t h e basis o f this c h a r a c t e r i s t i c r e c e p t i v i t y h u m a n
e x i s t e n c e is, f r o m t h e v e r y first, o u t s i d e , i n t h e i m m e d i a t e p r e s e n c e o f
w h a t it e n c o u n t e r s .
A s w e h a v e said, t r a d i t i o n a l psychological t h e o r y claims the opposite,
t h a t a p e r s o n can be at a far a w a y v a c a t i o n c o t t a g e o n l y in t h o u g h t and
t h a t he h a s really s t a y e d in his city r e s i d e n c e all t h e t i m e . In stating t h a t it
is possible to be s o m e w h e r e in t h o u g h t , traditional p s y c h o l o g y c o n c e d e s
t h a t in s o m e w a y at l e a s t i n t h o u g h t a p e r s o n can be w i t h a visualized
o b j e c t . O n c e this c o n c e s s i o n h a s b e e n m a d e , t h e r e i s n o t u r n i n g back.
W h e n we visualize s o m e t h i n g , we e s t a b l i s h a r e l a t i o n s h i p to t h e t h i n g
itself, n o t t o s o m e m e r e s u b j e c t i v e r e p r e s e n t a t i o n o f i t inside us. T h u s ,
w h a t s e n s e can t h e r e b e i n i n t e r p r e t i n g o u r visualized p r e s e n c e a t the
v a c a t i o n c o t t a g e a s " b e i n g t h e r e only i n t h o u g h t " ? W h a t can "in t h o u g h t "
m e a n ? A c c o r d i n g t o the m a i n s t r e a m o f p s y c h o l o g i c a l t h e o r y , w e o n l y
think we a r e at the visualized c o t t a g e . B u t does a simple visualization
require the thought: Here I am at the cottage? Certainly not. Psychology
w o r k e d o u t its n o t i o n a f t e r t h e fact; i n t h e p h e n o m e n o n o f visualization
i t s e l f t h e r e is n o t h i n g r e s e m b l i n g t h o u g h t , and t h e r e is no e v i d e n c e in
a c t u a l findings to s u p p o r t a n y claim t h a t t h e r e is.
If to visualize t h e d i s t a n t c o t t a g e m e a n t o n l y to think t h a t we w e r e
s t a n d i n g n e x t to it, w h a t we would be visualizing would be n o t the
c o t t a g e but t h e p r e s e n c e o f t h e p e r s o n visualizing the c o t t a g e . T h i s i s n o t
w h a t w e i n t r o d u c e d i n o u r e x a m p l e and h a s b e c o m e , m o r e o v e r , a m e r e
illusion in w h i c h we fancy we are at t h e c o t t a g e . T h i s is v e r y different
f r o m visualizing the c o t t a g e itself. I n s t e a d of k e e p i n g o u r vision free and
open we h a v e i n a d v e r t e n t l y supposed t h a t a p e r s o n is actually physically
p r e s e n t at a d i s t a n t c o t t a g e . B u t if we a t t e n d e x c l u s i v e l y to w h a t is in the
visualization itself, we find n o t h i n g to indicate t h a t it is in t h o u g h t o n l y .
T h e peculiarity of visualization c o n s i s t s in t h e v e r y fact that it p e r m i t s

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t h e visualizer h i m s e l f to be p r e s e n t at w h a t is visualized. It is a special

mode of being-at-something.
W h i l e h u m a n e x i s t e n c e is able to retain and visualize w h a t it has
e n c o u n t e r e d in the past and to p e r c e i v e w i t h t h e s e n s e s w h a t is p r e s e n t at
a g i v e n m o m e n t , it is also directed and r e l a t e d to w h a t stirs its a w a r e n e s s
from t h e direction o f t h e f u t u r e . T h i s r e l a t e d n e s s t o t h e f u t u r e o p e n s o u t
to h u m a n e x i s t e n c e a third primal m o d e of being, t h e a w a i t e d or
expected.
In speaking of the spatiality of e x i s t e n c e as a m e r g i n g i n t o r e l a t i o n s h i p
w i t h w h a t has b e e n , w h a t n o w is, and w h a t i s e x p e c t e d t o be, w e have
already c o m e upon t h e i n t r i n s i c r e l a t i o n s h i p o f t e m p o r a l i t y t o spatiality.
Past, p r e s e n t , and f u t u r e are t e r m s indicating s o m e t h i n g t e m p o r a l .

The temporality of existence

T i m e , like space, is in s o m e w a y familiar to us from o u r v e r y
b e g i n n i n g s . H u m a n b e i n g s a r e i n s o m e sort o f p e r m a n e n t r e l a t i o n s h i p t o
t i m e , a l t h o u g h t h e y seldom pay p a r t i c u l a r a t t e n t i o n e i t h e r t o t i m e itself
or to this r e l a t i o n s h i p .
N o w a d a y s , w a t c h e s are o u r m o s t c o m m o n c o n n e c t i o n w i t h t i m e . B u t
can time actually be read from a w a t c h ? Is time in t h e w a t c h , o r i s it in u s ?
P e r h a p s b o t h we and the w a t c h a r e in t i m e ? W h a t h a p p e n s to t i m e if t h e
w a t c h s t o p s ? T i m e does n o t simply disappear. I t m a y b e o b j e c t e d t h a t this
q u e s t i o n "'Where' is t i m e ? " is spatial, and t h a t if we really h o p e to track
d o w n t i m e w e have t o ask i n s t e a d , ' W h e n ? " B u t " W h e n i s t i m e ? " i s asking
a b o u t a t i m e e n c l o s e d in s o m e o t h e r t i m e . It is no m o r e a p p r o p r i a t e to ask
w h e n time i s t h a n t o ask w h e r e space is. T h e first s t e p o u t o f this
c o n f u s i o n is to see t h a t g l a n c i n g at a w a t c h does n o t let us see i n t o t h e
n a t u r e of t i m e . A w a t c h can o n l y tell us how much t i m e it is, how much t i m e
has passed, or how much t i m e m u s t still pass b e f o r e s o m e t h i n g will o c c u r .
T h e s e s t a t e m e n t s are related n o t t o time i t s e l f b u t o n l y t o its
m e a s u r e m e n t o r calculation. N o w , o n l y s o m e t h i n g t h a t i s already t h e r e
can b e m e a s u r e d and calculated. E v e r y m e a s u r e m e n t o f t i m e c o n f i r m s
t h a t we h a v e already t i m e as a g i v e n , h o w e v e r foggy or illdefined this
perception may be.
I n a n y e v e n t , s o m e t h i n g besides m e a s u r e m e n t o c c u r s w h e n e v e r w e
read t i m e f r o m a w a t c h . I could n e v e r e v e n read t h e w a t c h w i t h o u t
t h i n k i n g : "Now it is such and such a t i m e . " T h e v e r y fact t h a t his " n o w " is
usually u n a r t i c u l a t e d s h o w s t h a t it is t a k e n for g r a n t e d . B u t " n o w " is n o t
limited to t h e t i m e s we c o n s u l t o u t w a t c h e s . Is it a l w a y s " n o w " ? Is e v e r y
" n o w " a d i f f e r e n t n o w ? In w h a t w a y ? T h e difference is simply in t h a t o n e
" n o w " is earlier or later than another.
But w e d o n o t address o u r s e l v e s t o time o n l y w h e n w e t h i n k o f this
" n o w . " W h e n e v e r I say, "It w a s jwsf such and such a t i m e , " I am addressing

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t h e past. W h e n I say, " W a i t a few m i n u t e s until then," 1 am r e f e r r i n g to a

time t h a t h a s n o t yet arrived, the f u t u r e . B u t t h e s e e x p r e s s i o n s
d e t e r m i n e d b y t h e n u m e r a l s o n the w a t c h are n o t t h e only w o r d s w e have
for addressing p r e s e n t , past, and f u t u r e . T h e s a m e holds t r u e w h e n I say
" t o d a y , " " y e s t e r d a y , " and " t o m o r r o w , " w h i c h e x p r e s s a r e l a t i o n s h i p to
time m o r e e l e m e n t a r y than the n u m e r i c a l " h o w m u c h " the w a t c h
provides. T h e w a t c h can lead u s t o m o r e precise d e t e r m i n a t i o n s o f s o m e
y e s t e r d a y , today, o r t o m o r r o w , b u t w i t h o u t t h e i r e x i s t e n c e the w a t c h
would be u s e l e s s .
T i m e can be divided i n t o past, p r e s e n t , and f u t u r e , yet while space is
usually t h o u g h t of as h a v i n g t h r e e s i m u l t a n e o u s d i m e n s i o n s , t i m e is
given only o n e . Past, p r e s e n t , and f u t u r e are supposed to exist only in
s u c c e s s i o n . In this v i e w , time is p i c t u r e d as s o m e sort of line of " n o w p o i n t s . " T h e p r e e m i n e n c e o f " n o w " i s based solely upon t h e idea,
a x i o m a t i c since t h e v e r y b e g i n n i n g s o f W e s t e r n philosophy, t h a t being i s
p r e s e n c e . C o r r e s p o n d i n g to this physical idea of p r e s e n c e is the n o t i o n of
p r e s e n t time: t h e o n l y t h i n g p r e s e n t a b o u t t i m e i s the n o w . T h u s w e see
h o w time could c o m e to be t h o u g h t of, m o r e and m o r e , as m e r e l y a
s u c c e s s i o n of " n o w - p o i n t s . " A n y o n e w h o posits such a t i m e a n d all of
m o d e r n s c i e n c e doeswill find it s t r a n g e to h e a r time spoken as h a v i n g
t h r e e d i m e n s i o n s , particularly w h e n it is claimed t h a t t h e s e are
simultaneous, not successive.
All o u r m e a s u r i n g and p a r t i t i o n i n g o f t i m e reveals n e i t h e r the
c h a r a c t e r o f o u r r e l a t i o n s h i p t o t i m e n o r t h e n a t u r e o f t i m e itself. A s w e
have said, e v e r y d e t e r m i n a t i o n o f h o w m u c h t i m e a s s u m e s t h a t w e
" h a v e " t i m e . B u t w h a t d o e s " h a v i n g t i m e " m e a n ? H e r e , and e v e n m o r e
obviously in its c o n v e r s e , " n o t h a v i n g a n y t i m e , " t h e w o r d is being used
as time for s o m e t h i n g . In "I don't have t i m e , " t h e n e g a t i o n is n o t of t i m e
but of h a v i n g time for a particular t h i n g . If I s a y I don't h a v e t i m e for
skiing, I am really saying t h a t I plan to spend my t i m e doing s o m e t h i n g
else. We a l w a y s c o n s t r u e time as t i m e nor s o m e t h i n g or o t h e r . T h o u g h it
m a y r e m a i n u n c l e a r w h a t a particular t i m e is for, this r e f e r r a l to an
activity or e v e n t for which a given t i m e is p r e s e n t is a p r i m a r y
c o n s t i t u e n t of t i m e . By indicating t h a t t i m e is a l w a y s time for s o m e t h i n g
we n a m e t h e first 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 of t i m e : significance.
T i m e i s n o t always m e r e l y " t i m e for s o m e t h i n g , " h o w e v e r . W h e n e v e r
we say s o m e t h i n g like, "now, as I w r i t e this c h a p t e r a b o u t t i m e , " or "hack
then, w h e n I m i s i n t e r p r e t e d t i m e as a l i n e a r chain of ' n o w - p o i n t s , ' " or
"when I g e t this b o o k finished," we e x p r e s s a s e c o n d 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 of time: dalability.
But time n e v e r c o n s i s t s only in " p o i n t s . " T i m e c o n s i s t e n t l y s h o w s a
certain e x p a n s i v e n e s s . S o m e o n e m i g h t say t h a t he has r e s e r v e d the

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e v e n i n g for t h e t h e a t e r and t h a t h e h a s s p e n t t h e w i n t e r w o r k i n g o n the

plans f o r his h o u s e . T h i s e x t e n s i o n of t i m e o v e r a w h o l e e v e n i n g or an
e n t i r e w i n t e r m a n i f e s t s its third f e a t u r e : expansiveness.
Finally, n o indication o f t i m e i s m e a n t for m e a l o n e . F o r i n s t a n c e , w h e n
I tell my wife t h a t I h a v e w r i t t e n e n o u g h for o n e day and am g o i n g to bed
n o w , this " n o w " can be u n d e r s t o o d i m m e d i a t e l y , n o t o n l y by me but by
b o t h m y wife and m e and a n y o n e else w h o h a p p e n s t o b e t h e r e t o h e a r , a s
t h e i n t e n d e d m o m e n t . T h e r e i s n o n e e d t o e n t e r first i n t o c o n s i d e r a t i o n s
a b o u t t h e individual people involved. If e a c h p e r s o n e x p r e s s e d a p e r s o n a l
" n o w , " a s u b s e q u e n t c o n f e r e n c e would be needed to a g r e e upon a single
identity for t h e s e " n o w s . " B u t no " n o w " is r o o t e d e n t i r e l y in o n e
individual h u m a n being. T i m e ' s f o u r t h f e a t u r e , t h e n , is its public character.
T h e four 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 t i m e apply n o t o n l y t o " n o w "
but t o e v e r y " t h e n " and " w h e n " a s well, even w h e n t h e s e a r e e x a c t l y
d e t e r m i n e d w i t h a w a t c h . T h e s e indications o f " n o w , " w h i c h appear t o b e
m e r e l y n u m e r i c and q u a n t i t a t i v e , actually h a v e a q u a l i t a t i v e n a t u r e , t o o .
T h e y r e f e r to t i m e as significant, datable, e x p a n s i v e , and public. Even as it
is c o m m o n l y m e a s u r e d w i t h a w a t c h , t i m e is n e v e r m e a n t simply as a
q u a n t i t a t i v e r e c k o n i n g . W h e n a downhill race on skis is t i m e d on a stop
w a t c h i n h u n d r e d t h s o f s e c o n d s , t h e r e s u l t i n g t i m e still actually indicates
t h a t o n e c o n t e s t a n t has b e e n f a s t e r t h a n a n o t h e r ; i t signifies elapsed t i m e
w i t h r e g a r d to an optimal p e r f o r m a n c e . L i k e w i s e , e v e r y d a y time as
m e a s u r e d w i t h a w a t c h is a l w a y s so and so m u c h t i m e for s o m e t h i n g or
other.
In l a b o r a t o r y e x p e r i m e n t s all t h a t is m e a s u r e d is t h e d u r a t i o n of a
p r o c e d u r e . T h e application of n o w is c o n f i n e d to a specific location of
s o m e m o v i n g o b j e c t at a g i v e n t i m e . U l t i m a t e l y , e v e n t h a t application
disappears, and " n o w " c o m e s to be u n d e r s t o o d only in r e l a t i o n to itself as
"this i n s t a n t . " I n this w a y , t h e n a t u r a l scientific r e s e a r c h e r i n t e r p r e t s
time h o m o g e n o u s l y as a s u c c e s s i o n of " n o w - p o i n t s " b u t o n l y while he
is c o n d u c t i n g e x p e r i m e n t s in his l a b o r a t o r y . If this n o t i o n of t i m e , w h i c h
r e d u c e s its four c h a r a c t e r i s t i c s t o a n e m p t y s u c c e s s i o n o f " n o w s " w e r e t o
be t h e o n l y w a y he e x p e r i e n c e d t i m e in his life, he would no doubt go
i n s a n e . Y e t , he would be u n a b l e to do even this. For to b e c o m e dis
t r a c t e d , we m u s t first be in a position to be e x - t r a c t e d from o n e t h i n g and
a t - t r a c t e d to a n o t h e r . Applied to t i m e , this m e a n s t h a t it would h a v e to be
possible for us to be e x t r a c t e d from the t i m e n o r m a l l y given to us and
c a u g h t up in an e m p t y and u n i f o r m time s e q u e n c e in which the
e x p r e s s i o n " t i m e f o r " had n o m e a n i n g . N o h u m a n e x i s t e n c e could
c o n t i n u e , h o w e v e r , in s u c h a t i m e s e q u e n c e , and so no living p e r s o n could
e v e r be d i s t r a c t e d into it. By the s a m e r e a s o n i n g , time i n t e r p r e t e d as a
simple s u c c e s s i o n of " n o w - p o i n t s " could n e v e r c o n t r i b u t e to an
understanding of human phenomena

9t>

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FOUNDATIONS

In spite of t h i s , m a n y physicists will p e r s i s t in claiming t h a t the

s u c c e s s i o n o f " n o w s " c o n s t i t u t e s real, a c t u a l t i m e . T h e i r u n s h a k a b l e
c o n f i d e n c e in this v i e w c o m e s from t h e fact t h a t t i m e a s physics
m e a s u r e s itis a l w a y s s u b j e c t t o o b j e c t i v e , q u a n t i t a t i v e c o n f i r m a t i o n
w h i c h i s t h e n o b j e c t i v e l y binding. O b j e c t i v e h e r e m e a n s " f o r e v e r y o n e , "
b u t " e v e r y o n e " includes o n l y people w h o h a v e a c c e p t e d t h e w a y physics
t h i n k s a b o u t n a t u r e and believe t h a t t h e s c i e n c e of physics is t h e o n l y
valid f o r m for d i s c o v e r i n g t r u t h and for h u m a n k n o w l e d g e in g e n e r a l .
T h i s " e v e r y o n e " also p r e s u p p o s e s t h a t o n l y t h e findings o f physics can
deliver strictly scientific t r u t h and t h a t it is no l o n g e r i m p o r t a n t to a s k
w h a t i s b e h i n d t h e n o t i o n o f s c i e n c e itself. M a c h i n e s c a n b e c o n s t r u c t e d
on t h e basis of p h y s i c s ' c o n c e p t u a l a p p r o a c h , and for the m a n on t h e
s t r e e t t h e t r u t h of physics is p r o v e d by its effects: his car is p r o o f e n o u g h
for him t h a t p h y s i c s h a s t h e capacity t o u t t e r t h e t r u t h a b o u t t i m e a s well.
T h e r e are those w h o think that Einstein's theory of relativity
s u p e r s e d e d t h e n o t i o n s o f time h a n d e d d o w n from the philosophical
tradition, but this t o o is a f u n d a m e n t a l e r r o r . T h e t h e o r y of relativity is a
physical t h e o r y c o n c e r n e d w i t h finding o u t h o w t i m e , c o n c e i v e d of as a
s u c c e s s i o n of " n o w s , " can be measured. B u t w h a t is s u b j e c t e d to this
m e a s u r e m e n t i s i t s e l f t a k e n a s a g i v e n . T h e t h e o r y o f relativity m e r e l y
asks, after t h e fact, w h e t h e r it is possible to m e a s u r e time a b s o l u t e l y or
w h e t h e r e v e r y m e a s u r e m e n t is n e c e s s a r i l y r e l a t i v e . It a t t e n d s as little as
a n y o t h e r scientific t h e o r y o f t i m e t o t h e n a t u r e o f w h a t i s b e i n g
m e a s u r e d . W e t h e r e f o r e feel justified i n m a i n t a i n i n g t h a t t h e w h o l e
e s s e n c e of t i m e c a n n o t possibly be r e p r e s e n t e d in t h e ideas c u r r e n t in
contemporary natural science.
M a n ' s r e l a t i o n s h i p t o t i m e , t h e c o n c u r r e n c e o f m a n and t i m e , h a s b e e n
a m a j o r t h e m e in r u m i n a t i o n s a b o u t t i m e for a g e s . A r i s t o t l e said: "It is
w o r t h e x a m i n i n g h o w t i m e i s related t o t h e soul. I f t h e soul w e r e n o t
capable o f perceiving and e x p r e s s i n g itself a b o u t t i m e , t h e n t i m e could
n o t possibly e x i s t u n l e s s t h e soul also e x i s t e d . " C o n t e m p o r a r y t h o u g h t ,
t o o , p r e s u p p o s e s t h e c o n c u r r e n c e o f t i m e and t h e h u m a n e s s e n c e . T h i s i s
e v i d e n t f r o m t h e w a y t h e p r o b l e m o f t i m e i s posed. W e s p e a k t h e s e days,
for i n s t a n c e , a b o u t " t i m e s e n s e " o r s e n s e o f t i m e , a b o u t " t i m e
experience," about "consciousness of time," mentally coordinating these
w i t h t i m e . T h i s h a b i t , a s well a s t h e c o m m o n d i s t i n c t i o n s t h a t a r e m a d e
b e t w e e n s u b j e c t i v e and o b j e c t i v e t i m e , w o r l d and e g o t i m e , m e a s u r e d and
e x p e r i e n c e d t i m e , q u a n t i t a t i v e and q u a l i t a t i v e t i m e , all r e s t on illc o n s i d e r e d , u n p r o v e n , and u n e x p l a i n e d p r e s u p p o s i t i o n s a b o u t t h e
n a t u r e o f m a n and his r e l a t i o n s h i p t o t i m e . T h e y a r e t o o q u e s t i o n a b l e t o
form the basis for a f u n d a m e n t a l study of t h e r e l a t i o n s h i p b e t w e e n m a n
and t i m e . F o r e x a m p l e , w h e n we d i s t i n g u i s h b e t w e e n a s u b j e c t i v e and

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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

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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.

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C e r t a i n l y , w e c a n n o t simply t r a n s f e r o u r s t a t e m e n t s a b o u t " h a v i n g " . 1

w o r r y to t h e h a v i n g of t i m e . O n e o b v i o u s d i f f e r e n c e b e t w e e n the two 8
t h a t w o r r y , unlike t i m e , does n o t affect us i n e v i t a b l y and at e v e r y
m o m e n t . B u t w e have discussed " h a v i n g " w o r r i e s b e f o r e w e consider
" h a v i n g " t i m e t o point o u t t h e peculiarities t h a t o b t a i n b e t w e e n the
w o r d ' s c o m m o n u s a g e and t h e p a r t i c u l a r t h i n g s t h a t a r e " h a d , " a s well a s
t o s h o w h o w i n e x a c t and u n s c i e n t i f i c w e would b e i f w e w e r e t o lump
t o g e t h e r all i n s t a n c e s o f " h a v i n g . "
N o w , a friend m a y ask m e , "Will you h a v e time for a w a l k t o m o r r o w
a f t e r n o o n ? " A f t e r t h i n k i n g it o v e r briefly, I a n s w e r , " Y e s , I'll h a v e t i m e . "
H e r e t i m e has n o t b e e n m a d e i n t o an o b j e c t , n o r is it e v e n w h a t is
f o c u s s e d on. My a t t e n t i o n is f o c u s s e d r a t h e r on t h e t h i n g for which I shall
h a v e t i m e , on w h a t is to be d o n e t h e t h i n g I am e x p e c t i n g . My
e x p e c t a t i o n is so c o n s t i t u t e d , h o w e v e r , t h a t e v e n w h i l e I am e x p e c t a n t , I
am also dwelling in w h a t is p r e s e n t to me at this m o m e n t . I a l s o t h o u g h I
a m n o t n e c e s s a r i l y a w a r e o f i t r e t a i n all t h a t has e v e r o c c u p i e d m e u p t o
this m o m e n t . Any timel "have," 1 have in such a way that I am expectant of which is
to come, aware of what is present, and retentive of what has been. This threefold mode in
what 1 am constitutes "having" time for this or that. " H a v i n g t i m e , " in this v e r y
s e n s e of a t h r e e f o l d e x i s t e n c e is a m o d e of h u m a n being. In this having of
t i m e and the c a r r y i n g o u t o f p o t e n t i a l w a y s o f being, a n e x i s t e n c e
develops and m a t u r e s . It e x p e n d s its t i m e and finally w h e n it has used up
t h e t i m e a p p r o p r i a t e t o a n e x i s t e n c e , e f f e c t s its o w n d e m i s e , w h i c h i s t h e
fulfillment o f t h e e x t r e m e , u n s u r p a s s a b l e e x i s t e n t i a l possibility. T h u s ,
t h e " h a v i n g " i n t h e h a v i n g o f t i m e i s t h e actual t e m p o r a l i t y o f h u m a n
being, in t h a t w h a t m a t u r e s sich zeitigt in this " h a v i n g " is w h a t we m a y
d e s i g n a t e a s m a n ' s b e i n g - i n - t h e - w o r l d , o r his worldly dwelling ( v e r b a l ) .
1

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,

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t i m e is s o m e t h i n g t h a t is, in a s e n s e , at o u r disposal, t h e r e for us to

o r g a n i z e as we w i s h . W h a t we c a n n o t do is a l t e r t h e fact t h a t it is t i m e . At
a n y g i v e n t i m e , w e a r e c o n s t a n t l y bringing past, p r e s e n t , and f u t u r e
t o g e t h e r i n a u n i q u e w a y . T h u s , w e p r o d u c e and f o r m t h e m o m e n t a r y
s t r u c t u r e of t i m e , and so c a r r y out o u r w o r l d l y dwelling in its
t e m p o r a l i t y . We can t a k e and h a v e o u r t i m e in t h a t we r e t a i n it in
visualizing, m a k e it p r e s e n t , and s i m u l t a n e o u s l y hold it ready for f u t u r e
t h i n g s . T h e disposable and disposed of t i m e is c o n s t i t u t e d in w a i t i n g ,
r e t a i n i n g , and b e i n g p r e s e n t . T h i s , in its t h r e e f o l d u n i t y , is t h e
t e m p o r a l i t y o f t h e t i m e w h i c h w e h a v e o r d o n o t h a v e . T o b e s u r e , i t i s still
o b s c u r e h o w t h e u n i t y o f t h e " t h r e e f o l d n e s s " o f t i m e i s t o b e defined.
W h i l e dwelling i n t h e w o r l d m e a n s e x t e n d i n g o u r s e l v e s s i m u l t a n e o u s
ly into the three temporal dimensionsextensions or ecstasiesof the
past, p r e s e n t , and f u t u r e , t h e s e d i m e n s i o n s are n a t u r a l l y n o t a l w a y s o p e n
equally t o e a c h e x i s t e n c e . A t v a r i o u s t i m e s , o n e o r a n o t h e r o f t h e
d i m e n s i o n s will be m o s t c o m m a n d i n g , and at t h o s e t i m e s we e n t e r i n t o it
m u c h m o r e t h a n t h e o t h e r s . W e m a y e v e n b e trapped i n o n e o f t h e t h r e e .
Even t h e n , h o w e v e r , t h e o t h e r t w o a r e n e v e r n e g a t e d o r d e s t r o y e d b u t
only deprived o r c o n c e a l e d .

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

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Characteristics of Human

Beings

e n e r g y , was p o s t u l a t e d b y t h e vitalists o f t h e last c e n t u r y and the

n e o v i t a l i s t s of this. All s u c h s u p p o s i t i o n s s h a r e t h e c o n v i c t i o n thai the
h u m a n body h a s at least o n e c h e m o p h y s i c a l - c y b e r n e t i c , purely biologk al
c o m p o n e n t . Y e t n o o n e h a s b e e n able t o s u r m i s e h o w t w o t h i n g s a s
f u n d a m e n t a l l y different as m e t a p h y s i c a l life f o r c e and i n a n i m a t e
c h e m i c a l s u b s t a n c e could e v e r m e r g e t o f o r m t h e u n i t y t h a t i s h u m a n
bodyhood.
In looking for the special w a y in w h i c h t h e h u m a n body is b o d y h o o d ,
we shall begin by looking a w a y from b o d y h o o d to s o m e t h i n g else. All of
o u r e x p e r i e n c e tells us t h a t j u s t w h e n a h u m a n being is e x i s t i n g in t h e
m o s t h i g h l y c h a r a c t e r i s t i c h u m a n w a y , h e i s totally u n a w a r e o f his body
as s u c h . To exist in a c h a r a c t e r i s t i c h u m a n w a y m e a n s to be e n g a g e d body
and soul by s o m e t h i n g t h a t claims o n e , and to r e s p o n d to t h a t address or
claim. T h e h u m a n being c o m p l e t e l y loses his a w a r e n e s s o f his b o d y h o o d
as a physical body j u s t w h e n he is a c t i n g m o s t g e n u i n e l y h u m a n .
A t t h e m o m e n t w h e n she w a s d a s h i n g a c r o s s t h e s t r e e t t o h e r lover,
R e g u l a Z u r c h e r was n o t a w a r e o f p o s s e s s i n g a body. H e r b o d y h o o d w a s
e n g a g e d c o m p l e t e l y in h e r longing to be w i t h h e r lover and in h e r
h u r r y i n g t o close t h e d i s t a n c e b e t w e e n t h e m . T h a t s h e was n o l o n g e r
a w a r e o f h e r b o d y h o o d does n o t m e a n t h a t h e r b o d y h o o d had
disappeared. T h i s u n a w a r e n e s s h a p p e n s a t t i m e s i n h e a l t h y h u m a n
e x i s t i n g but in no w a y implies t h a t this particular m o d e of e x i s t e n c e is n o t
bodily.
T h e r e is no m a n i f e s t a t i o n of h u m a n e x i s t e n c e w h i c h is n o t bodily. A
p e r s o n ' s c o n c r e t e dealings w i t h o t h e r people and his direct p e r c e p t i o n o f
o b j e c t s t h a t p r e s e n t t h e m s e l v e s physically t o his s i g h t and t o u c h a r e
especially o b v i o u s bodily r e l a t i o n s h i p s , b u t t h e y are n o t all t h a t is bodily.
V i s u a l i z a t i o n s o f t h i n g s t h e s e n s e s d o n o t p e r c e i v e a r e also bodily,
t h o u g h w h a t w e visualize m a y b e visible only t o t h e mind's e y e . E v e n
w h a t w e m e r e l y visualize, c o n s i d e r , i m a g i n e , o r r e m e m b e r appears
h a v i n g a p a r t i c u l a r s h a p e , a p a r t i c u l a r c o l o r and shading, a particular
smell, t a s t e , t e x t u r e . A n d e v e n w h e n w e are e n g a g e d i n purely
i n t e l l e c t u a l and a b s t r a c t t h o u g h t , w h a t we visualize still b e a r s relation to
w h a t we h a v e s e e n w i t h o u r e y e s in, say, a m a t h e m a t i c s t e x t , and w h a t
we h a v e h e a r d w i t h o u r e a r s , p e r h a p s in a sociology l e c t u r e . E v e r y t h i n g
we s e e in t h e mind's e y e is s e e n , t h e n , w i t h the s e n s e s , is s e e n bodily.
N e v e r t h e l e s s , w e d o n o t s e e i t a s physically p r e s e n t . O n the c o n t r a r y , w e
see it as n o t physically p r e s e n t , b u t as r e - p r e s e n t e d .
To u n d e r s t a n d t h e b o d y h o o d t h a t i n h e r e s in all 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 , w e m u s t distinguish b e t w e e n h u m a n b o d y h o o d and the
m a t e r i a l n a t u r e o f i n a n i m a t e o b j e c t s . W e can approach this distinction
from t w o different s t a r t i n g p o i n t s . T h e first is t h e a b s o l u t e difference
b e t w e e n t h e limits of o u r b o d y h o o d and the m a t e r i a l b o r d e r s of i n a n i m a t e

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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

luman bodyhood is always the bodying forth of the

ways

ol being in

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103

w h i c h we are dwelling and w h i c h c o n s t i t u t e o u r e x i s t e n c e at any given

m o m e n t . T h u s , j u s t a s t h e r e can b e n o i n d e p e n d e n t l y e x i s t i n g t i m e , t h e r e
can be no s e l f - c o n t a i n e d , f u n d a m e n t a l , and final h u m a n b o d y h o o d . And
j u s t as m a n ' s actual t e m p o r a l i t y e m e r g e s o n l y in t h e p a r t i c u l a r m o d e s of
h u m a n e x i s t e n c e , s o his b o d y h o o d o c c u r s e x c l u s i v e l y a s t h e bodying
f o r t h o f his e x i s t e n t i a l dwelling amid t h e b e i n g s t h a t a d d r e s s t h e m s e l v e s
at a n y g i v e n time to his p e r c e p t i o n and r e q u i r e of him an a p p r o p r i a t e
r e s p o n s e . T h e b o r d e r s o f m y b o d y h o o d coincide w i t h t h o s e o f m y
o p e n n e s s to the w o r l d . T h e y are in fact at a n y given t i m e identical,
t h o u g h t h e y are a l w a y s c h a n g i n g w i t h t h e fluid e x p a n s i o n and
c o n t r a c t i o n o f m y r e l a t i o n s h i p t o t h e world.
I n c o n t r a s t t o t h e b o r d e r s o f h u m a n b o d y h o o d , t h e limits o f w h a t w e
c o n c e p t u a l i z e as o u r physical b o d y usually r e m a i n fixed, at m o s t
c h a n g i n g slightly w h e n w e gain o r lose w e i g h t . Y e t e v e n t h e s e a r e n o t
simply m a t e r i a l p h e n o m e n a b u t bodily e v e n t s to be u n d e r s t o o d in
c o n t e x t w i t h a c h a n g e d r e l a t i o n s h i p to t h e w o r l d .
T o i l l u s t r a t e t h e special quality o f h u m a n b o d y h o o d a s t h e bodying
f o r t h of t h e p o t e n t i a l w a y s of b e i n g t h a t m a k e up a h u m a n e x i s t e n c e at
a n y g i v e n m o m e n t , we m a y t u r n to a p a r t i c u l a r s i t u a t i o n f r o m the life
h i s t o r y o f o u r t e s t s u b j e c t . O n e day, R e g u l a Z i i r c h e r and h e r friend had
m o v e d i n t o h e r parlor for c o f f e e , and as she r e l a x e d in h e r a r m c h a i r she
c h a t t e d w i t h him a b o u t v a c a t i o n plans. N o w , e v e n t h e w a y s h e sat in the
a r m c h a i r b e l o n g e d i m m e d i a t e l y t o h e r relaxed r e l a t i o n s h i p t o the
visualized r e - p r e s e n t e d r e s o r t and t o t h e peaceful s t a y s h e h o p e d t o h a v e
t h e r e w i t h h e r friend. In fact, h e r bodily sitting b e l o n g e d so i n t i m a t e l y to
h e r m o m e n t a r y r e l a t i o n s h i p t o t h e world t h a t h e r a w a r e n e s s o f h e r s e l f a s
a s e l f - c o n t a i n e d physical body sitting in an a r m c h a i r disappeared. S h e
w a s e x i s t i n g as all eyes and e a r s for w h a t w a s being talked a b o u t .
A t r e s t i n h e r a r m c h a i r , she w a s n o static physical m a s s . S h e was
bodying f o r t h h e r p a r t i c u l a r r e l a t i o n s h i p t o t h e r e s o r t , w h i c h she
visualized j u s t as it w a s to be s e e n . As a r e c e p t i v e , open r e a l m of
p e r c e p t i o n , s h e s p a n n e d t h e A t l a n t i c O c e a n from h e r h o m e i n E u r o p e t o
the warm waters of the Equator. We know, by way of comparison, how
i m p o s s i b l e t h o u g h t f u l c o n v e r s a t i o n is at a cocktail p a r t y as the
p a r t i c i p a n t s ' milling a b o u t bodies f o r t h t h e i r superficial a s s o c i a t i o n amid
t h e trifles o f t h e i r social w o r l d .
If th is is t h e real n a t u r e of h u m a n b o d y h o o d , t h e n e v e n t h e least
g e s t u r e of t h e h a n d can n e v e r be fully u n d e r s t o o d u n l e s s t h e hand is no
l o n g e r r e g a r d e d as m e r e l y a p h y s i c a l i n s t r u m e n t m a d e of m u s c l e and
b o n e , n e r v e and s i n e w . Like e v e r y t h i n g else bodily, t h e h u m a n hand
b e l o n g s so directly to h u m a n b e i n g - i n - t h e - w o r l d t h a t it is d e t e r m i n e d in
e v e r y t h i n g it is and does by h o w its o w n e r is relating to w h a t he is at t h a t
m o m e n t e n c o u n t e r i n g . It c a n n o t e x i s t e x c e p t as the bodying forth ol

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active h u m a n r e l a t i o n s h i p s to t h e w o r l d . Even at r e s t a hand still bodies

forth an act of r e s t .
B y v i r t u e o f t h e fact t h a t i t b e l o n g s t o h u m a n b e i n g - i n - t h e - w o r l d ,
bodying f o r t h is i n h e r e n t l y s e t t l e d into space. C o n s e q u e n t l y , it is
endowed with the whole range of temporal-spatial-ecstatic relationships
t o w h a t m a n e n c o u n t e r s . B u t o u r r e l a t i o n s h i p t o w h a t w e p e r c e i v e varies
with w h i c h of t h e s e n s e s is in o p e r a t i o n .
S i g h t and h e a r i n g r a n g e f u r t h e r t h a n s m e l l , t a s t e , and t o u c h . I do n o t
perceive w i t h my e y e s t h e w a y I p e r c e i v e w i t h my f i n g e r s . W h e n I s e e a
glass I do n o t p e r c e i v e my o w n e y e s , but w h e n I pick up a glass, I feel n o t
j u s t t h e glass but t h e h a n d w i t h w h i c h I pick it up as well. Y e t , is it actually
my hand t h a t is perceived in t h e p r o c e s s ? Isn't it, r a t h e r , t h a t I am n o t at all
a w a r e of my h a n d as a distinct area of the body but am perceiving m y s e l f
as a w h o l e e n t i t y , a p e r s o n holding a glass ? While t o u c h i n g does n o t b r i n g
a w a r e n e s s of t h e hand as s u c h , it d o e s include a s e n s a t i o n of tangible
c l o s e n e s s . My e y e does n o t . A l s o , I can see o n l y w h a t is in front of m e . B u t
my sight (like my h e a r i n g ) o p e r a t e s at g r e a t e r d i s t a n c e s from t h i n g s t h a n
m y t o u c h does.
T h e fact t h a t s i g h t e x t e n d s f u r t h e r t h a n t o u c h only c o n f i r m s t h a t b o t h
a r e r o o t e d in t h e spatial relationships of h u m a n b e i n g - i n - t h e - w o r l d . T h i s in
t u r n a r g u e s t h a t h u m a n e x i s t e n c e is n o t spatial b e c a u s e it is bodily, b u t
t h a t s o m e t h i n g like b o d y h o o d can c o m e a b o u t o n l y b e c a u s e e x i s t e n c e (as
e n t e r i n g i n t o close or d i s t a n t r e l a t i o n s h i p s to o b j e c t s ) is itself spatial. It is
n o t the e x i s t e n c e o f o u r bodily s e n s e o r g a n s t h a t allows u s t o s e e , h e a r ,
t a s t e , t o u c h , and smell. R a t h e r , w e can h a v e and u s e such t h i n g s a s s e n s e
o r g a n s only b y v i r t u r e o f t h e fact t h a t w e a r e e s e n t i a l l y r e c e p t i v e
seeing, h e a r i n g , s m e l l i n g , t a s t i n g , t o u c h i n g c r e a t u r e s . Put a n o t h e r
w a y , t h e w o r l d w i d e perceiving o p e n n e s s w h i c h is the e s s e n t i a l
o n t o l o g i c a l t r a i t of o u r being bodies i t s e l f f o r t h in the distinct o n t i c
m o d e s in w h i c h we s e e , h e a r , smell, t a s t e , and t o u c h t h i n g s .
O n e kind o f e x p e r i e n c e m i g h t appear t o radically c o n t r a d i c t t h e s e
findings on t h e bodying f o r t h of o u r e x i s t e n c e . W h e n I am blinded by an
e x t r e m e l y b r i g h t light, f r i g h t e n e d by an u n b e a r a b l y loud e x p l o s i o n , or
burn my finger on a tea k e t t l e , it s e e m s I am no l o n g e r u n a w a r e of my
own b o d y h o o d . In fact, my eyes or e a r s or f i n g e r s c a u s e me pain and
m o v e into the f o r e g r o u n d as painful bodily o r g a n s . T h e y do n o t p e r m i t
me to p e r c e i v e a n y t h i n g but t h e fact t h a t I am body. B u t is this w h a t t h e y
actually do? In m a k i n g this claim, h a v e n ' t we fallen into the prejudice of
t r e a t i n g the bodying f o r t h of o u r e x i s t e n c e as if it w e r e simply a physical
body? It is significant t h a t t h e s e pains involve t h e p e r c e p t i o n of extremes
w h i c h strain o u r bodily s e n s e p e r c e p t i o n s to t h e b r e a k i n g point, it they do
not actually d a m a g e t h e m . W h e n e v e r bodily pain o c c u r s , we are in the

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s p h e r e o f d i s t u r b e d e x i s t e n c e . T h e r e f o r e w e shall hold o u r investigal ion

of pain for o u r discussion of p a t h o l o g y . M e a n w h i l e , n o t h i n g about pain
a p p e a r s to c o n t r a d i c t o u r findings on b o d y h o o d in undisturbed e x i s t e n t e
N o w , w e can s e e t h e radical d i f f e r e n c e b e t w e e n h u m a n bodyhood and
t h e physical n a t u r e o f i n a n i m a t e o b j e c t s n o t o n l y i n t h e fundament.d
dissimilarity of t h e i r b o r d e r s but in where each is at a p a r t i c u l a r m o m e n t .
A h u m a n being is a l w a y s " h e r e " w i t h r e s p e c t to s o m e place, and h u m a n
b o d y h o o d s e e m s to play an e s s e n t i a l role in this " b e i n g - h e r e . " T h e
q u e s t i o n is, w h a t r o l e ? W h e n w e say t h a t s o m e o n e "is h e r e , " w e usually
r e f e r his body's specific location in space and t h i n k of his p r e s e n c e at that
location confined to t h e v o l u m e of space b o u n d e d by his skin.
N a t u r a l l y , I can i m a g i n e t h a t I am seated at a t a b l e , my body on a chair
and p r e s e n t i n t h e s a m e w a y a s t h e chair. B u t this i m a g e r e f e r s n o l o n g e r
to h u m a n " b e i n g - h e r e , " o n l y to t h e p r e s e n c e of a s e l f - c o n t a i n e d and
i n d e p e n d e n t l y p r e s e n t physical body.
On the other hand, there is some ambiguity attached to the statement
t h a t e v e r y h u m a n being is a l w a y s " h e r e " w i t h r e s p e c t to s o m e place. I am
always " h e r e , " but ' h e r e " i s n o t a l w a y s t h e s a m e place. F o r h u m a n b e i n g s ,
' h e r e " is a l w a y s t h e dwelling place of t h e m o m e n t ; and people dwell in
their relationship to what they encounter, with p h e n o m e n a that are
"there." At a n y given m o m e n t my " h e r e " is defined by t h e " t h e r e " o f the
beings at w h i c h las an open r e a l m of p e r c e p t i o n dwelling in an open, free
t i m e - s p a c e a m dwelling, e n c o u n t e r i n g t h e m w h e r e t h e y a r e . T h i s
' b e i n g - h e r e " is f u n d a m e n t a l l y different from t h e kind of p r e s e n c e
n a t u r a l science a s s i g n s to bodies, w h i c h , since it is n e v e r open to
perceiving a " t h e r e " a s a p h e n o m e n o n w i t h p a r t i c u l a r s i g n i f i c a n c e
can n e v e r u n d e r s t a n d its " b e i n g - h e r e " o n t h e basis o f t h e " t h e r e " o f
b e i n g s t h a t reveal t h e m s e l v e s t o it. H u m a n b e i n g s can.
W h i c h e v e r a n g l e w e take t o a p p r o a c h b o d y h o o d , w e discover t h a t
bodying f o r t h p r e s u p p o s e s p e r c e i v i n g and acting e x i s t e n c e . E x i s t e n c e is
t h a t w h i c h bodies f o r t h . A c t u a l l y , t h e n , h u m a n b o d y h o o d i s p h e n o m e n o logically s e c o n d a r y , t h o u g h o u r s e n s e s tell us t h a t it is p r i m a r y .
W e i n e v i t a b l y e n c o u n t e r c r e a t u r e s o f o u r o w n kind a m o n g all the
t h i n g s we m a y c o m e upon. In light of w h a t we h a v e said so far a b o u t t h e
peculiar w a y in w h i c h h u m a n e x i s t e n c e is p r e s e n t in t i m e and space, it is
n o t e n o u g h t o i n t e r p r e t h u m a n coexistence simply a s the a p p e a r a n c e ,
" h e r e " and " h e r e , " o f physical h u m a n bodies. T h e p e r s o n walking t o w a r d
me m i g h t be t h i n k i n g j u s t n o w of a friend in S a n F r a n c i s c o , and as long as
he does, he is o v e r " t h e r e , " his w h o l e e x i s t i n g a b s o r b e d in this
r e l a t i o n s h i p to his friend in s u c h a w a y t h a t he e x t e n d s far b e y o n d the
o b s e r v a b l e v o l u m e of his body a c r o s s an o c e a n . If he is e x i s t e n t i a l l y t h e r e
and I am h e r e , t h e n h o w and w h e r e do h u m a n b e g i n s c o e x i s t in the
world?

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Human coexistence in a shared world

T h e h u m a n c a p a c i t y to be l o n e l y is a g o o d point to s t a r t f r o m in
understanding the inherent coexistence of h u m a n beings in their shared
w o r l d . No o n e c a n be l o n e l y w h o s e b e i n g is n o t ordinarily m a r k e d by a
t o g e t h e r n e s s w i t h o t h e r s o f his kind. L o n e l i n e s s a l w a y s p o i n t s b e y o n d
i t s e l f t o s o m e c o e x i s t e n c e , and h u m a n l o n e l i n e s s e x i s t s o n l y a s p r i v a t i o n
o f m a n ' s p r i m a r y t o g e t h e r n e s s w i t h o t h e r s . T h e f u n d a m e n t a l trait o f t h e
existential coexistence of human beings appears in their jointly
s u s t a i n i n g and m a i n t a i n i n g t h e o p e n n e s s o f t h e w o r l d t h e y c l e a r i n
c o m m o n . It is c a r r i e d o u t in s h a r e d w a y s of p e r c e i v i n g and r e s p o n d i n g to
whatever is commonly encountered.
T h i s e x i s t e n t i a l c o e x i s t e n c e in a s h a r e d w o r l d s h o u l d n o t be p i c t u r e d as
s o m e kind o f c o l l e c t i v e p r e s e n c e o f individual s u b j e c t s , each c o n s i s t i n g o f
a strictly delimited and spatially localized p s y c h i c or c o n s c i o u s capsule in
w h i c h r e p r e s e n t a t i o n s 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 are m i r r o r e d . I f
h u m a n e x i s t e n c e a c t u a l l y w e r e m a d e a l o n g s u c h lines, i t would b e
impossible for people t o discuss t h i n g s w i t h i m m e d i a t e r e c o g n i t i o n o f
w h a t i s b e i n g discussed. T h e y could only try t o say s o m e t h i n g a b o u t t h e
i m a g e each h a s in his isolated p s y c h e . B u t in t h e p h e n o m e n a of collective
h u m a n b e h a v i o r t h e r e i s n o e v i d e n c e o f individual p s y c h e s h a v i n g
dialogues a b o u t e n d o p s y c h i c m a t e r i a l . P s y c h o l o g i s t s do claim t h a t it is
self-evident that the c o n s c i o u s n e s s - i m m a n e n t representations of the
e x t e r n a l w o r l d are p r o j e c t e d o u t w a r d again, i m m e d i a t e l y and automatical
ly. B u t no o n e has y e t actually s u b s t a n t i a t e d t h i s claim w i t h p r o o f , and no
o n e has m a n a g e d e v e n t o o f f e r a n h y p o t h e s i s t o explain h o w s u c h
p r o j e c t i o n could a r i s e in a s u b j e c t a s s u m e d to be originally w o r l d - l e s s , or
i n t o w h a t this p r o j e c t i o n m i g h t b e p r o j e c t e d . T h e fact i s t h a t , w h e n
people are t o g e t h e r , t h e y r e v e a l o n l y t h a t t h e y are j o i n t l y and i n h e r e n t l y
dwelling i n t h e s a m e r e l a t i o n s h i p t o t h e c o m m o n o b j e c t s o f t h e i r s h a r e d
world.
I n t h e s a m e w a y i n w h i c h o b j e c t s r e v e a l t h e i r i d e n t i t i e s and m e a n i n g fulness directly in t h e o p e n n e s s of h u m a n e x i s t e n c e , so a h u m a n b e i n g
also p e r c e i v e s o t h e r people directly, w i t h o u t a n y h y p o t h e t i c a l e m p a t h y ,
but simply b y v i r t u r e o f t h e fact t h a t all a r e b e i n g s o f t h e s a m e kind w h o
dwell t o g e t h e r i n t h e i r u n d e r s t a n d i n g r e l a t i o n s h i p s t o t h e s a m e
phenomena which shine through the world-openness they sustain in
common.
It is difficult to give e v e n an a p p r o x i m a t e g r a p h i c r e p r e s e n t a t i o n of this
existence, but we have nevertheless reproduced t w o drawings in an
a t t e m p t t o i l l u s t r a t e t h e decisive d i f f e r e n c e b e t w e e n t h e traditional
psychological view o f m a n and his c o e x i s t e n c e a n d t h e e x i s t e n t i a l
c o u n t e r p a r t o f this view.

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SUBJECTIVISTIC REPRESENTATION OF THE INTERPERSONAL DIALOGUE

Body of Regula Zrcher.
lb Body of her lover.
Brain of Regula Zrcher.
2b Brain of her lover.
Psyche of Regula Zrcher.
3b Psyche of her lover.
Endopsychic representation
4b Endopsychic representation
of the external-world hotel
of the external-world hotel
in h e r l o v e r .
in Regula Zrcher.
5: External world.
6: Light stimuli of t h e
external-world object.
7: External-world object,
8a b : S p e a k i n g b a c k and f o r t h (dia-logue) o f R e g u l a Z i i r c h e r and h e r
l o v e r a b o u t t h e i r s e p a r a t 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 o f the
external-world hotel.

la
2a
3a
4a

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OPTIMAL EXISTENTIAL SKETCH OF HUMAN EXISTENCE AS PRIMARY BEING

TOGETHER AT THE COMMON OBJECTS OF A SHARED WORLD
1:

2:
3:

T h e existence of Regula Z u r c h e r and the existence of her lover as

t h e j o i n t l y s u s t a i n e d , c l e a r e d r e a l m o f p e r c e p t i v e and r e s p o n s i v e
o p e n n e s s t o t h e w o r l d o f p h e n o m e n a a s localized p r e s e n c e s .

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 .

Fundamental

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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 .

The question of mood (attunement)

We have seen that existence is essentially an o p e n n e s s to perceiving
w h a t e v e r e n t e r s t h e r e a l m o f this o p e n n e s s , s h i n e s f o r t h w i t h i n it, and s o
c o m e s to be p r e s e n t as a b e i n g w i t h its o w n m e a n i n g f u l n e s s . T h e " p r e - "
of " p r e s e n t " p r e s u p p o s e s an open r e a l m . I n t o this a being can s h i n e forth
as " p h e n o m e n o n , " w h i c h d e r i v e s f r o m a G r e e k w o r d t h a t m e a n s "a
being's r e v e a l i n g i t s e l f . " W i t h o u t this 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 a s
w h i c h h u m a n being is e n g a g e d n o t h i n g at all could b e , n e i t h e r a world
n o r a n y t h i n g in a world. B e i n g as p r e s e n c e is n o t possible e x c e p t i n t o a
r e a l m t h a t is p e r c e p t i v e l y o p e n , clear, and free.
B e c a u s e h u m a n e x i s t e n c e i s b y n a t u r e a n o p e n and c l e a r r e a l m o f
u n d e r s t a n d i n g , it is i n h e r e n t l y attuned in s o m e w a y or o t h e r . T h i s
f u n d a m e n t a l , o n t o l o g i c a l c h a r a c t e r i s t i c o f a t t u n e m e n t m a k e s i t possible
for e x i s t e n c e to be p e r m e a t e d a l w a y s by s o m e d i s p o s i t i o n t h a t is
demonstrable, accessible to psychological description, and, in the jargon
of p h i l o s o p h y , " o n t i c . " T h e r e is no s u c h t h i n g as an initially u n a t t u n e d
e x i s t e n c e in w h i c h a disposition of s o m e kind simply a r i s e s n o w and t h e n
through the intrusion of some internal or external cause. Supplementary
c a u s e s h a v e no part in p r o d u c i n g d i s p o s i t i o n s . All t h e d i s p o s i t i o n s , or
m o o d s , of w h i c h a p e r s o n is c a p a b l e a r e given to him i n n a t e l y as
e x i s t e n t i a l possibilities and as s u c h a r e a l w a y s m a k i n g up his e x i s t e n c e .
For example, even the happy mood into which Regula Z u r c h e r c a m e
w h e n s h e m e t h e r l o v e r w a s n o t c a u s e d b y t h e e n c o u n t e r . S h e could b e
joyful o n l y in so far as t h e possibility of a happy, spirited a t t u n e m e n t had
a l w a y s b e l o n g e d to h e r . S i n c e h e r happy m o o d e x i s t e d a l r e a d y as an
i n n a t e p o t e n t i a l of h e r b e i n g , it did n o t need to be p r o d u c e d or e f f e c t e d . In
the s u r p r i s e e n c o u n t e r , t h e possibility w a s c a r r i e d to fulfillment. If the
l o v e r h i m s e l f w e r e a c t u a l l y t h e c a u s e o f h e r h a p p i n e s s , i t would b e
difficult t o u n d e r s t a n d h o w t h e s a m e c a u s e (the s a m e m a n ) could have
produced t h e radically d i f f e r e n t e f f e c t o f c a t a s t r o p h i c a n x i e t y b e f o r e I h e

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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 .

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B u t if a n g e r and h a t e , or j o y and love are d i s t i n g u i s h e d not o n h SI

different a f f e c t s , b u t as a f f e c t s and p a s s i o n s , t h e y d e m a n d m o r e pie. Ill
definition. Like a n g e r , h a t e is n o t p r o d u c e d at will and it t o o seems to
o v e r c o m e us like an a t t a c k of a n g e r . B u t b e c a u s e of its a t t u n e m e n t , tin
a t t a c k o f h a t e i s quite unlike t h a t o f a n g e r . H a t e can e r u p t suddenly i n t o
an a c t i o n , but o n l y b e c a u s e it h a s had us u n d e r a t t a c k for a long t i m e . C >ui
w h o l e being is c o n c e n t r a t e d in its a t t u n e m e n t to a p a s s i o n like love and
a l s o , in a c e r t a i n s e n s e , in its a t t u n e m e n t to h a t e . In its a t t u n e m e n t , o u r
being is m u c h m o r e with t h a n beside itself, w h i l e t h e r e v e r s e is t r u e
c o n c e r n i n g i m m o d e r a t e p l e a s u r e , o v e r p o w e r i n g a n g e r , and o t h e r
sudden, forceful a f f e c t s .
T h e fact t h a t h u m a n being is c o n s t a n t l y c o n c e n t r a t e d in its
a t t u n e m e n t t o t h e p a s s i o n s o f g r e a t love o r g r e a t h a t e does n o t m e a n that
the h u m a n being b e c o m e s closed off, blind. O n the c o n t r a r y , a s g r e a t
l o v e r s and h a t e r s we a r e especially w i s e and p e r c e p t i v e w i t h regard to
c e r t a i n qualities, for t h e 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 of o u r being is an
o p e n n e s s to p e r c e p t i o n and this is j u s t w h a t is in s o m e w a y c o n c e n t r a t e d
in t h e p a s s i o n s . It is well k n o w n h o w s e n s i t i v e p a r a n o i d h a t r e d is to e v e n
t h e m o s t subtle s t i r r i n g s i n o t h e r s , w h o r e c o g n i z e t h e s e feelings a s
u n f r i e n d l y , or u n k i n d , or e v e n h o s t i l e . And people p a s s i o n a t e l y in love
have a special s e n s e for t h e hidden g o o d n e s s and b e a u t y , t h e p o t e n t i a l
h u m a n r i c h n e s s , o f t h o s e t h e y love.
T h e a n g r y p e r s o n , o n t h e o t h e r hand, "beside h i m s e l f , " loses all s e n s e
of p r o p o r t i o n w i t h r e g a r d to t h e o p e n or closed p e r c e p t i o n w h i c h is t h a t
self. As long as he is furious or i n f a t u a t e d t h e a f f e c t - l a d e n individual has
lost a c l e a r vision of t h e significant m e a n i n g s a d d r e s s i n g him in his
world.
It w a s a p p a r e n t l y n o t so r a r e o n c e for kings to h a v e b e a r e r s of bad
tidings s u m m a r i l y e x e c u t e d . T r a d i t i o n a l p s y c h o l o g y t r i e s t o explain a w a y
this s o r t of t h i n g as " a f f e c t i v e irradiation," a s s u m i n g w i t h its o b j e c t i f i c a tion of h u m a n b e i n g s t h a t a f f e c t i v e e x c i t a t i o n s are e n t i t i e s p r e s e n t in t h e
p s y c h e of t h e a n g r y p e r s o n and have spread or " i r r a d i a t e d " like an
electrical field from t h e i r actual c e n t e r , t h e writer of t h e l e t t e r , to its
deliverer. B u t t h i n g s like e l e c t r i c a l fields, having no feeling for a d v e r s i t y ,
can n e v e r b e beside t h e m s e l v e s w i t h a n g e r . W h a t actually h a p p e n s with
the a n g r y king is t h a t his e n t i r e e x i s t e n c e , as the realm of p e r c e p t i o n it is,
shifts to b e c o m e "beside i t s e l f , " i t s vision so impaired in t h e p r o c e s s that it
can n o l o n g e r d i f f e r e n t i a t e b e t w e e n the l e t t e r w r i t t e r and the l e t t e r
carrier.
3

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

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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

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Beings

the face of an a t t a c k by a rabid dog w o u l d qualify as realistic. T h e lear ol

mice t h a t impels n u m b e r s of w o m e n i n t o panicked flight or o n t o chairs is
an e x a m p l e of a so-called i n n e r , n e u r o t i c , u n r e a l i s t i c i n s t i n c t i v e a n x i e t y .
T h i s i n s t i n c t i v e a n x i e t y was first t h o u g h t to be a d i r e c t product ol the
t r a n s f o r m a t i o n o f a c c u m u l a t e d libido. L a t e r , t h e e g o w a s m a d e the seal
of a n x i e t y and e v e r y a n x i e t y t h e n b e c a m e a kind of w a r n i n g to t h e e g o ol
s o m e d a n g e r facing it.
But the existence of unrealistic, inner anxieties as transformation
p r o d u c t s of a c c u m u l a t e d i n s t i n c t s is precluded by t h e v e r y fact that
i n s t i n c t s are b y definition c o m p o s e d o f psychic e n e r g y , and n o m e r e
e n e r g y can c o m p r e h e n d a n y t h i n g in its significance as s o m e t h i n g
d a n g e r o u s . E n e r g y i s e n t i r e l y w i t h o u t vision. Y e t a n x i e t y p r e s u p p o s e s
and is based upon a p e r c e p t i o n of s o m e t h i n g like d a n g e r , or d e a t h .
M o r e o v e r , a n e u r o t i c fear of mice is n o t a w a r n i n g signal d e s i g n e d to
m a k e t h e e g o a w a r e of s o m e d a n g e r o u s unrealistic inner thing. It is a fear of
a n e x t e r n a l and real m o u s e . W h a t h a p p e n s h e r e i s t h a t t h e " o u t e r r e a l i t y "
is m i s t a k e n u n d e r the i n f l u e n c e of a s t a t e of a n x i e t y t h a t r u n s t h r o u g h
the v e r y f o u n d a t i o n s o f a n e x i s t e n c e . I n this a t t u n e m e n t , a n e x i s t e n c e
m a y i n t e r p r e t s o m e t h i n g h a r m l e s s as a dire t h r e a t , y e t e v e n m i s u n d e r
stood t o this e x t e n t t h e t h i n g r e m a i n s a n actual p h e n o m e n o n o u t s i d e i n
the w o r l d . An e n t i r e l y d i f f e r e n t p r o b l e m is c o n t a i n e d in t h e s e a r c h for
biographical f a c t o r s t h a t m i g h t e l u c i d a t e w h y a n e x i s t e n c e h a s b e e n
r e s t r i c t e d t o t h e single basic s t a t e o f fearing a n i m a l i t y i n t h e f o r m o f
m i c e , b u t i m p o r t a n t as it is, this q u e s t i o n does n o t t o u c h at all on the
p h e n o m e n o n o f fearing mice a s s u c h . H o w e v e r t h e y m a y a r i s e , all
a n x i e t i e s a r e realistic a n x i e t i e s . It is a l w a y s s o m e t h i n g a c t u a l t h a t is
feared, and t h e o b j e c t o f c o n c e r n i s t h e capability o f c o n t i n u e d e x i s t e n c e
in a h u m a n w o r l d w h i c h is t h r e a t e n e d by t h e feared t h i n g .
4

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

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r u p t u r e n o l o n g e r a l l o w s . G o n e i s t h e possibility o f e v e r again being w i t h

and at t h a t o b j e c t , in m i n d and body. While t h e bonds of the r e l a t i o n s h i p
m a y b e c o m e m o r e i n t i m a t e t h a n e v e r i n t h e m o d e o f visualization, the
h u m a n e x i s t e n c e is in fact r u p t u r e d and b r o k e n in a c e r t a i n s e n s e . H e a v y
d a m a g e is done to t h e e x i s t e n c e of a lover w h o s e p a r t n e r has died, or w h o
has b e e n a b a n d o n e d for a n o t h e r . S u c h an e x i s t e n c e s u f f e r s a g r e a t
r e d u c t i o n i n t h e n u m b e r o f r e l a t i o n s h i p s o n c e possible w i t h r e s p e c t t o
t h e o b j e c t o f s o r r o w . A medical s t u d e n t failing t h e s t a t e e x a m t h r e e t i m e s
will m o u r n a lost o p p o r t u n i t y for a n e w m o d e of being, for b e c o m i n g a
d o c t o r . M a n y p a t i e n t s g o i n t o deep s o r r o w w h e n , i n t h e c o u r s e o f
a n a l y s i s , t h e y r e c o g n i z e t h e m u l t i t u d e o f possibilities lost f o r e v e r and
t o r n a w a y from t h e i r e x i s t e n c e b e c a u s e t h e i r a c t u a l i z a t i o n had b e e n
blocked in t h e past.
B u t h u m a n b e i n g s k n o w s o r r o w not o n l y i n t h e f o r m o f isolated pain
ful e x p e r i e n c e s o f s e p a r a t i o n . S o r r o w p e r v a d e s h u m a n e x i s t e n c e , n o
m a t t e r h o w o f t e n it is d r o w n e d o u t , at t h e painful insight i n t o t h e finite
limits o f e x i s t e n c e and its e s s e n t i a l s e p a r a t i o n from the a b s o l u t e and
unconditional.
T h e b r e a k i n g , r e n d i n g , and d a m a g i n g o f e x i s t e n t i a l r e l a t i o n s h i p s t o
o t h e r people, t o o b j e c t s o f the s u r r o u n d i n g w o r l d , and t o the a b s o l u t e can
also e m p h a t i c a l l y affect t h e b o d y h o o d o f a n e x i s t e n c e . Injuries t o the
body are e x p e r i e n c e d as bodily pain. T h e close k i n s h i p b e t w e e n bodily
pain and s o r r o w is e x p r e s s e d in calling s o r r o w " h e a r t b r e a k , " in t h e "pain
and s o r r o w " o f a n g u i s h . Will s o r r o w i n n e r pain b e u n d e r s t o o d o n t h e
basis of bodily pain, or does bodily pain depend, r a t h e r , on s o r r o w , t h e
r e c o g n i t i o n o f a flaw r u n n i n g t h r o u g h t h e a b u n d a n c e o f r e l a t i o n a l
possibilities? W e m u s t p o s t p o n e discussing this q u e s t i o n , a s w e
p o s t p o n e d t h e topic o f bodily pain, until w e c o m e t o talk a b o u t t h e
pathological p h e n o m e n a o f e x i s t e n c e .

Human memory and the historicity of human existence

W e first e n c o u n t e r e d t h e issue o f r e t e n t i o n o f e a r l i e r p e r c e p t i o n i n
o u r discussion o f t h e v a r i o u s m o d e s o f p r e s e n c e , t h e r e t h a t w h a t i s
r e t a i n e d in m e m o r y is n e i t h e r a series 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 of
e x t e r n a l o b j e c t s , n o r e n g r a m t r a c e s o f s e n s e i m p r e s s i o n s o f t h e kind
w h i c h can b e a s c e r t a i n e d physiologically i n t h e b r a i n ' s s u b s t a n c e . T h e y
a r e the perceived e n t i t i e s t h e m s e l v e s w h i c h are r e t a i n e d a s t h e singularly
m e a n i n g f u l p h e n o m e n a t h e y r e v e a l t h e m s e l v e s t o b e t e m p o r a r i l y and
spatially w i t h i n t h e w o r l d l y r e a l m held o p e n by a h u m a n e x i s t e n c e .
As novel as this p r e l i m i n a r y p h e n o m e n o l o g i c a l description of m e m o r y
may s e e m to us today, it actually relies on i n s i g h t s predating all

Fundamental

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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

Admittedly, the word " m e m o r y " carries associations that seem to

c o n t r a d i c t t h e facts o f t h e m a t t e r . I t s e e m s t o b e c o n n e c t e d w i t h recalling
t o m i n d and r e t a i n i n g m e r e t h o u g h t . B u t the a p p e a r a n c e o f c o n t r a d i c t i o n
p e r s i s t s only if we p i c t u r e t h o u g h t as simply a c e r e b r a l p r o c e s s and
t h o u g h t s t h e m s e l v e s a s c a r b o n copies o f e n t i t i e s w i t h i n t h e p s y c h e and
r e m e m b e r i n g s o m e t h i n g as a r e a w a k e n i n g of e n d o p s y c h i c i m a g e s from
t h e e n g r a m m a t i c , m a t e r i a l - e n e r g e t i c s t r u c t u r e s o f t h e brain.
A s a n y o n e can learn from his o w n e x p e r i e n c e , w h a t really h a p p e n s
w h e n w e t h i n k and h a v e t h o u g h t s i s simply t h a t w e b e c o m e a w a r e o f
c e r t a i n o f t h e p h e n o m e n a o f o u r world. T h e s e p h e n o m e n a t h e m s e l v e s ,
t o g e t h e r w i t h all o f t h e i r m e a n i n g s and c o n n e c t i o n s , reveal t h e m s e l v e s
directly to us f r o m t h e l o c a t i o n at w h i c h t h e y are p r e s e n t in t h e open
r e a l m o f o u r w o r l d . T h i n k i n g , t h e n , i s allowing w h a t a d d r e s s e s u s
t h r o u g h t h e o p e n n e s s o f t h e t i m e - s p a c e o f o u r w o r l d t o arise again
t h e m a t i c a l l y . Even t h e n a t u r a l scientific w a y of t h i n k i n g is only a
p a r t i c u l a r m o d e of l e t t i n g b e i n g s appear, t h a t reduced w a y in w h i c h
b e i n g s t e n d to reveal t h e m s e l v e s solely as c h a i n s of p r e s u m e d and
calculable causal e f f e c t s .
M o s t o f w h a t w e r e t a i n quickly r e c e d e s i n t o t h e b a c k g r o u n d o f
n o n t h e m a t i c p r e s e n c e . B u t e v e n a n u n t h e m a t i c p r e s e n c e i s p r e s e n c e and
can address t h e p e r s o n w h o r e t a i n s it as s o m e t h i n g of a particular
meaning. Unless the notion of retention is understood existentially,
m e m o r y is r e n d e r e d i n a c c e s s i b l e to scientific i n v e s t i g a t i o n as t h e
p h e n o m e n o n it truly is.
O r d i n a r i l y , t w o v e r y d i f f e r e n t h u m a n m o d e s o f b e i n g are indiscrimi
n a t e l y a t t r i b u t e d to m e m o r y . T h e first is t h e ability to visualize
something that was once perceived but afterwards receded to become an
uncontemplated, background presence. From the phenomenological
p e r s p e c t i v e s t h e r e is a g r e a t d i f f e r e n c e b e t w e e n this and actually
r e m e m b e r i n g e a r l i e r e v e n t s . If I am visualizing my c o t t a g e in the
m o u n t a i n s , I am n o t r e m e m b e r i n g it b u t am e x i s t i n g in s o m e r e l a t i o n s h i p
to it in this visualizing w a y of b e i n g t h e r e w h e r e it is. T h e o n l y sort ol
thing I could r e m e m b e r , s t r i c t l y speaking, is s o m e t h i n g like buying it in
1 9 4 5 . T h e p h e n o m e n o n of m e m o r y plays no part in a n y visualization ol
the h o m e as it n o w is; it e n t e r s in only il I visualize the p u r c h a s e ol the

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h o m e as an act t h a t o c c u r r e d at s o m e definite time in t h e past. To

r e m e m b e r is to visualize a thing of t h e past as s o m e t h i n g e x p e r i e n c e d at
that time.
B u t i n u n d e r s t a n d i n g m e m o r y w e m u s t also c o n s i d e r its deficient
m a n i f e s t a t i o n w h i c h w e call " f o r g e t t i n g . " T h e v a r i o u s labels this
p h e n o m e n o n has w o r n in the course of history attest to the uncertainty
of its n a t u r e . In classical G r e e k , it is a s s o c i a t e d with lethe; t h a t w h i c h
r e m a i n s hidden. In Latin it is described by oblivo, oblivisci: f o r g e t t i n g as a
wiping o u t . T h e G e r m a n v e r b ergessen ( " f o r g e t " ) is c o n n e c t e d w i t h t h e
English " g e t . " T h e ver- prefix gives a n e g a t i v e twist to " g e t " so t h a t
vergessenlike " f o r g e t " m e a n s " n o t to k e e p . " " W i p e o u t " and " n o t k e e p "
both set out from the standpoint of an ego, a notion unknown to the
t h o u g h t o f classical G r e e c e .
N i e t z s c h e w r i t e s in Morgenr'dthe: "It has n o t been p r o v e n t h a t s u c h a
thing as f o r g e t t i n g e x i s t s ; all that is k n o w n is t h a t r e c o l l e c t i o n is n o t in
o u r p o w e r . For t h e t i m e being, we h a v e filled this gap w i t h t h e w o r d
f o r g e t , ' as if f o r g e t t i n g m e m o r y w e r e j u s t a n o t h e r ability in o u r r e g i s t e r ,
ut w h a t is t h e r e , w h e n all is said and d o n e , t h a t stands in o u r p o w e r ? " In
Zarathustra we m a y read: " T h a t t h e r e is such a thing as f o r g e t t i n g h a s
n e v e r b e e n p r o v e n , but o n l y t h a t t h e r e a r e m a n y t h i n g s w h i c h d o n o t
occur to us when we want them to."
T h e q u i c k e s t w a y t o u n d e r s t a n d this p r o b l e m a t i c p h e n o m e n o n i s t o
d i s t i n g u i s h a m o n g t h e diverse m o d e s o f b e i n g t h a t pass for f o r g e t t i n g .
N o w , if at t h e close of a s t i m u l a t i n g e v e n i n g I leave my u m b r e l l a at a
friend's h o u s e , m o s t people would t h i n k m e guilty o f f o r g e t t i n g it. B u t i f
f o r g e t t i n g is defined as h a v i n g t h e p r e s e n c e of t h e u m b r e l l a lost to t h e
c o l l e c t i o n of o b j e c t s p r e s e n t in my w o r l d , I h a v e n o t f o r g o t t e n it at all. I
can t h i n k of it and p i c t u r e it to m y s e l f at a n y t i m e I c h o o s e . T h i s w o u l d
n o t be possible u n l e s s t h e u m b r e l l a had r e m a i n e d in my world, t h o u g h its
presence be unthematic.
T h e u m b r e l l a is simply an especially distant b a c k g r o u n d p r e s e n c e as I
am leaving my friend, for I r e m a i n a b s o r b e d , body and soul, w i t h my
friend and i n t h e topic o f o u r c o n v e r s a t i o n . T h e u m b r e l l a ' s p r e s e n c e h a s
thus become so distant to me that it would not occur to me actually to
pick it up and take it a l o n g . A n y t h i n g n o t in t a n g i b l e p r o x i m i t y c a n n o t
add r e s s me as a t h i n g to be t a k e n along; n o t e v e n t h e possibility of t a k i n g
it along o c c u r s to m e . As long as this t h i n g is n o t p r e s e n t as s o m e t h i n g to
be t a k e n along, I c a n n o t really f o r g e t to t a k e it along. In a c t u a l fact, I h a v e
f o r g o t t e n n e i t h e r t h e u m b r e l l a i t s e l f n o r t h e possibility o f t a k i n g i t a l o n g .
F o r g e t t i n g , as it is used h e r e , simply r e f e r s to t h e fact t h a t s o m e t h i n g is
no longei c o n s i d e r e d t h e m a t i c a l l y in its p r e s e n c e , t h o u g h it r e m a i n s
m i l h c m . i t I I .illy p r e s e n t . T h e m o d e o f its being present
to me h a s
ihanged

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

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from m e . It is p r e c i s e l y this a w a r e n e s s w h i c h lets me realize I h a v e

f o r g o t t e n it, but even this a w a r e n e s s o f h a v i n g s o m e t h i n g can w i t h d r a w ,
and t h e n I would no l o n g e r e v e n realize t h a t I e v e r k n e w t h e n a m e .
U n d e r s t o o d as t h e falling out of an e n t i t y ' s p r e s e n c e from my
e x i s t e n t i a l r e a l m o f o p e n n e s s , f o r g e t t i n g c a r r i e s w i t h i t t h e possibility
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 w h a t h a s fallen out can r e t u r n into t h e
openness of my being-in-the-world.
E v e r y t i m e w e f o r g e t s o m e t h i n g , w e also f o r g e t s o m e t h i n g o f
ourselves. When something escapes me, my relationship to that thing is
also lost, and t h e s e r e l a t i o n s h i p s to w h a t is p r e s e n t in my e x i s t e n t i a l
o p e n n e s s a r e j u s t w h a t m a k e u p m y e x i s t e n c e and m a k e m e w h a t l a m . T o
the e x t e n t to w h i c h p r e s e n c e s escape me and I f o r g e t t h e m , I am
d i m i n i s h e d as a h u m a n e x i s t e n c e .
It should n o w be clear t h a t f o r g e t t i n g is n o t a s e p a r a t e m e n t a l ability
a n y m o r e t h a n r e m e m b e r i n g or r e t a i n i n g . It is an o c c u r r e n c e of o u r o p e n
r e a l m o f p e r c e p t i v e b e i n g - i n - t h e - w o r l d , o n e t o w h i c h w e are given o v e r
at all t i m e s . Like r e m e m b e r i n g , it c o n c e r n s t h e t h i n g s of my w o r l d . It is
without exception the names themselves, the persons or objects, which,
h a v i n g revealed t h e m s e l v e s from t h e i r places in the w o r l d - o p e n n e s s as
w h i c h I am e x i s t i n g , can e i t h e r be r e t a i n e d or slip a w a y f r o m m e . It does
not involve t h e d i s p l a c e m e n t o f s o m e a s s u m e d e n d o p s y c h i c r e p r e s e n t a
tions o f e x t e r n a l - w o r l d o b j e c t s .
If this is w h a t we call f o r g e t t i n g in h u m a n b e i n g s , h o w e v e r , t h e n
m e m o r y and visualization o f past t h i n g s m u s t also b e m o r e than simple
r e t e n t i o n like a passive s t o r a g e of t h i n g s in a h o l l o w space t h a t is o p e n b u t
e m p t y and u n i n v o l v e d . T h i s is a far t o o limited n o t i o n of o u r r e t e n t i v e
m e m o r y , t o o a b s t r a c t , t o o wrapped up in a s i n g l e , isolated facet. M e m o r y
and r e t e n t i o n m u s t be seen in a m u c h b r o a d e r c o n t e x t .
T h e o p e n n e s s o f h u m a n e x i s t e n c e c o n s i s t s o f t h e capacity for
perceiving 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 appears, the
capacity for r e s p o n d i n g m e a n i n g f u l l y to t h e perceived significance of
t h e s e p h e n o m e n a in a w a y t h a t c o r r e s p o n d s to t h e i r s i g n i f i c a n c e . H u m a n
e x i s t e n c e is equally r e c e p t i v e to w h a t h a s b e e n perceived at s o m e f o r m e r
time and has been r e t a i n e d . W h a t h a s o n c e b e e n p r e s e n t to a h u m a n
e x i s t e n c e is n e v e r simply past, finished, lost. W h a t h a s b e e n is r e t a i n e d in
the o p e n n e s s of the h u m a n Da-sein s o , t h a t it r e m a i n s c o n s t a n t l y p r e s e n t
m the pi e s e n t , speaking into this p r e s e n t and c o d e t e r m i n i n g all p r e s e n t
conduct o l t h e h u m a n . T h a t w h i c h has b e e n " l i v e s " o n t h e n , i n the
present
["hereby, this " p a s t , " p r e s e n t as h a v i n g b e e n , t o g e t h e r w i t h the
present, necessarily c o d e t e r m i n e s all f u t u r e b e h a v i o r .
\ VI HI I in he Is a w a r e of it or n o t , e v e r y h u m a n being dwells in tradition
and history H u m a n m e m o r y is this c o n s t a n t dwelling in t r a d i t i o n . It

Fundamental

Characteristics of Human

Beings

constitutes that fundamental human characteristic of histoiuii.

R e t a i n i n g or n o t r e t a i n i n g s o m e single p h e n o m e n o n as h a v i n g o n c e bei 11
n o w a p p e a r s as a definite, isolated, o n t i c possibility of t h e ontologli II
h u m a n ability to e x i s t h i s t o r i c a l l y , i.e., his ability to dwell by the beings l 'I
his w o r l d in t h e t e m p o r a l e k - s t a s e of t h e past. T h i s ability is |
c h a r a c t e r i s t i c f e a t u r e of h u m a n being and d i s t i n g u i s h e s it from all o t h e r
present beings.
H u m a n e x i s t e n c e is also h i s t o r i c a l in t h a t it is its e n t i r e life h i s t o r y . T h e
e x i s t e n c e of a p e r s o n a l w a y s e x t e n d s f r o m his b i r t h to his d e a t h . If death
is t h e u t m o s t limit of h i s t o r i c a l h u m a n e x i s t e n c e , t h e n it m u s t truly
b e l o n g to this e x i s t e n c e , as e v e r y b o r d e r b e l o n g s to w h a t it delimits.
W h a t r e m a i n s puzzling is t h e w a y in w h i c h h u m a n life and death a r e part
of e a c h o t h e r . D e a t h is g i v e n such an i m p o r t a n t place in medicine t h a t
o n e could say this s c i e n c e is p e r m a n e n t l y o r i e n t e d t o w a r d death:
m e d i c i n e w a n t s e i t h e r to w a r d o f f death or to p o s t p o n e it as long as
possible. B e c a u s e o f this fact, n o foundation o f m e d i c i n e can dispense
w i t h discussing t h e m e a n i n g and n a t u r e o f h u m a n m o r t a l i t y .
D e a t h and h u m a n m o r t a l i t y
D e a t h is t h e u n s u r p a s s a b l e limit of h u m a n e x i s t e n c e . In death,
e x i s t e n c e as bodily b e i n g - i n - t h e - w o r l d has its final end. I n a n i m a t e
o b j e c t s a r e also described a s finite, a s n o t lasting e t e r n a l l y . T h e s a m e
applies also to n o n h u m a n life, but plants and animals do notdie, as h u m a n
b e i n g s do. T h e y simply perish. O n l y h u m a n b e i n g s die having k n o w n
f r o m a n early age o f t h e i r m o r t a l i t y . S o for ages m o r t a l i t y h a s been
t h o u g h t of as a p r i m a r y trait of h u m a n e x i s t e n c e , so m u c h so th.it
Parmenides named men mortals.
T h e k n o w l e d g e o f d e a t h l e a v e s m a n n o c h o i c e . H e i s compelled t o exist
in s o m e sort of p e r m a n e n t r e l a t i o n s h i p to d e a t h , for it is impossible n o t to
r e l a t e t o s o m e t h i n g w h i c h h a s o n c e b e e n perceived. N e c e s s a r i l y related
to d e a t h , h u m a n e x i s t e n c e could well be called a " b e i n g - u n t o - d e a t h . " T h i s
" b e i n g - u n t o - d e a t h " m a n i f e s t s i t s e l f i n manifold w a y s . T h e m o s t c o m m o n
is flight from death and f r o m t h e a w a r e n e s s of h u m a n m o r t a l i t y . Every
day o f t h e i r lives, people m a k e c o u n t l e s s a t t e m p t s t o d e c e i v e t h e m s e l v e s
a b o u t this m o s t c e r t a i n aspect o f h u m a n life. T h e m a c a b r e c o m e d i e s
played o u t in c e r t a i n A m e r i c a n funeral h o m e s r e p r e s e n t an e x t r e m e ol
this.
R e c o g n i t i o n of h u m a n m o r t a l i t y is always learned first from t h e de.it lis
of others. We usually r e l e g a t e t h e s e d e a t h s to t h e i n c o n s p i c u o u s n e s s ol an
e v e r y d a y e v e n t . T h e d e a t h s o f o t h e r s b e c o m e m e r e c a s e s o f death whii h
can be passed o v e r , t h e k n o w l e d g e of personal m o r t a l i t y is allowed lo
dissipate in t h e t h o u g h t t h a t we t o o shall c e r t a i n l y die s o m e d a y , only not

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j u s t y e t . D e a t h is m a d e an e v e n t u a l i t y that does n o t m a t t e r for the

p r e s e n t . Not o n l y for o u r s e l v e s do we try to c u s h i o n the fact of o u r
m o r t a l i t y . W e also m a k e e v e r y e f f o r t t o s t e e r t h e s u r v i v o r s o f t h o s e w h o
die, and e v e n t h e dying t h e m s e l v e s , a w a y from t h o u g h t s o f d e a t h . D e a t h
is m a d e to appear as simply a c h a n g e from o n e m o d e of being to a n o t h e r ,
as a t r a n s i t i o n f r o m being alive to no l o n g e r e x i s t i n g , to a condition in
w h i c h only t h e c o r p s e , a lifeless o b j e c t , r e m a i n s .
T o t h e family o f s o m e o n e w h o has r e c e n t l y died, o f c o u r s e , t h e dead
person is m u c h m o r e t h a n an i n a n i m a t e o b j e c t and t h e i r r e l a t i o n s h i p to
him m u c h m o r e t h a n a t t e n d a n c e t o his physical r e m a i n s . T h e
r e l a t i o n s h i p is o n e of actual care in t h e f o r m of o b s e q u i e s , m a i n t e n a n c e of
t h e g r a v e and e v e n a n c e s t o r w o r s h i p . In t h e i r caring, m o u r n i n g and
r e m e m b e r i n g , t h e s u r v i v o r s a r e in a c e r t a i n s e n s e still with t h e o n e w h o
is dead, related to h i m as to a fellow being. T h i s r e l a t i o n s h i p to t h e dead is
t h e basis for all feelings o f r e v e r e n c e , f e a r , a w e , w o n d e r , s o r r o w , and
d e f e r e n c e i n t h e face o f s o m e t h i n g g r e a t e r and m o r e p o w e r f u l .
Y e t o u r r e l a t i o n s h i p to death can also be c h a r a c t e r i z e d by naked fear,
w h i c h lets death appear as the e x t i n c t i o n of e x i s t e n c e in an e m p t y void,
t h e end of all t h i n g s . M e a n w h i l e , all that is c e r t a i n is t h a t e x i s t e n c e a f t e r
death is no l o n g e r in t h e world in the s a m e w a y as b e f o r e . T h i s does n o t at
all preclude t h e possibility t h a t death is n o t t h e radical annihilation o u r
fear and a n x i e t y m a k e it out to b e . It could also m e a n h a v i n g o n e ' s
previous e x i s t e n t i a l m a n n e r o f bodily b e i n g - i n - t h e - w o r l d t r a n s f o r m e d
into an u t t e r l y d i f f e r e n t s o r t of being, o n e t h a t is inaccessible to a
m o r t a l ' s p e r c e p t i o n while he is still alive. It is e v e n possible t h a t in death
e x i s t e n c e e n t e r s i n t o s o m e t h i n g t h a t is prior to all being; the dead m a y
attain a r e l a t i o n s h i p to B e i n g - n e s s as such t h a t is hidden from t h e living.
It may be this possibility t h a t e n a b l e s c e r t a i n rare h u m a n b e i n g s to
accept death w i t h a c o m p o s e d s e r e n i t y , to e x p e r i e n c e it as t h e
m a n i f e s t a t i o n o f a n e x i s t e n t i a l possibility e n c o m p a s s i n g and c o n s u m
m a t i n g all e x i s t e n c e but based in a d i m e n s i o n n o t at m a n ' s disposal. To
t h e e x i s t e n c e liberated and e x p a n s i v e e n o u g h t o reach this s e r e n i t y ,
h u m a n m o r t a l i t y s h o w s t h a t m a n ' s being is o p e n at all t i m e s to t h a t
w h i c h is w h o l l y o t h e r t h a n any finite o n t i c being and w h i c h e n g a g e s man
as the r e a l m w h e r e m e a n i n g f u l n e s s is perceived, w h i c h can use him as
t h a t r e a l m of o p e n n e s s w h i c h is the n e c e s s a r y p r e c o n d i t i o n for the
a p p e a r a n c e and p r e s e n c e of all being.
It is well k n o w n t h a t b e f o r e t h e y reach p u b e r t y , children usually have
no fear of dying. C h i l d r e n do n o t see t h e m s e l v e s as s e l f - c o n t a i n e d and
i n d e p e n d e n t s u b j e c t s . T h e y s e n s e , t h o u g h in a v e r y u n d e l i b e r a t e d w a y ,
t h a t t h e y are b o r n e along by s o m e t h i n g , an e n c o m p a s s i n g d i m e n s i o n ,
w h i c h t h e y perceive in and t h r o u g h t h e i r " o m n i p o t e n t " p a r e n t s . It is

Fundamental

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b e c a u s e of this feeling t h a t t h e y let death e x t i n g u i s h t h e i r individual

e x i s t e n c e s w i t h o u t r e s i s t a n c e . B u t a f t e r p u b e r t y , a fear of death usually
s e t s in, i n c r e a s i n g in i n t e n s i t y t h e m o r e an a d o l e s c e n t p e r c e i v e s h i m s e l l ,
in t h e m o d e r n spirit, as an i n d e p e n d e n t l y f o r m e d , i n s u l a r s u b j e c t . As an
i r r e v o c a b l e annihilation o f e v e r y t h i n g , death m u s t s e n d him into panic.
N o w , m a r t y r s dying for a h o l y c a u s e can e n t e r death happily, no m a t t e r
w h a t t h e i r age, b e c a u s e for t h e m , death i s r e s u r r e c t i o n i n t o t h e beloved
c a u s e t o w h i c h t h e y a r e s u b o r d i n a t e . B u t t h e r e are also u t t e r l y u n h e r o i c
old people w h o are able to die as peacefully and willingly as c h i l d r e n , for
t h e y h a v e used up t h e i r e x i s t e n c e by actualizing all of its e s s e n t i a l
r e l a t i o n a l possibilities. In s h o r t , t h e y h a v e c o m p l e t e d t h e t a s k given
t h e m . T h e n again, t h e r e are o t h e r old people w h o r e s i s t e d e n t e r i n g full
and c a r i n g r e l a t i o n s h i p s t o w h a t t h e y e n c o u n t e r e d during t h e i r lives and
h e n c e b e c a m e guiltily i n d e b t e d t o t h e i r o w n e x i s t e n c e . T h e s e people a r e
terrified o f death a s o f s o m e t h i n g t h a t c o m e s far t o o s o o n .
A s n u m e r o u s a s t h e p a r t i c u l a r w a y s o f b e h a v i n g t o w a r d death are, all,
including t h e m o s t s t u b b o r n flight from d e a t h , t e s t i f y t o t h e insight t h a t
h u m a n m o r t a l i t y is n o t j u s t an e v e n t destined for s o m e t i m e in t h e f u t u r e
but i r r e l e v a n t for t h e t i m e b e i n g . T h e y all m a k e clear t h a t m o r t a l i t y is an
i n n a t e p o t e n t i a l o f h u m a n e x i s t e n c e , the m o s t t h o r o u g h l y p e r v a s i v e and
peculiarly h u m a n trait of all.
T h e m o s t dignified h u m a n r e l a t i o n s h i p t o death c o n s i s t s i n keeping t h e
k n o w l e d g e of p e r s o n a l m o r t a l i t y c o n s t a n t l y in a w a r e n e s s , n e i t h e r fleeing
from it n o r hiding it. O n l y such a b e i n g - u n t o - d e a t h can g u a r a n t e e t h e
precondition t h a t t h e Da-sein be able to free i t s e l f from its a b s o r p t i o n in,
its s u b m i s s i o n and s u r r e n d e r o f i t s e l f t o t h e t h i n g s and r e l a t i o n s h i p s o f
e v e r y d a y living, and to r e t u r n to itself. A b e i n g - u n t o - d e a t h r e v e a l s death
as t h e last possibility of t h e Da-sein in t h a t it r e v e a l s dying as t h e loss of all
s u p p o r t f r o m o t h e r b e i n g s , h u m a n and n o n h u m a n . Each Da-sein dies its
o w n death i n total l o n e l i n e s s . T h e c o n s e q u e n c e o f this i n s i g h t i s b y n o
m e a n s a r e s i g n e d , passive fixation on w h a t m u s t h a p p e n s o o n e r or l a t e r .
O n t h e c o n t r a r y , i n a c c e p t i n g m o r t a l i t y a s his m o s t c h a r a c t e r i s t i c , final,
isolated, a n d e x c e p t for t h e actual m o m e n t o f d e a t h c e r t a i n e x i s t e n t i a l
possibility, m a n first realizes his r e s p o n s i b i l i t y for e v e r y i n s t a n t of his
e x i s t e n c e . I f m a n w e r e n o t finite and m o r t a l , h e w o u l d n e v e r miss
a n y t h i n g . T h e r e would a l w a y s b e t i m e t o c a t c h u p and m a k e s o m e t h i n g
g o o d . B u t for s o m e o n e w h o is m o r t a l , no situation h a p p e n s t w i c e in quite
the s a m e w a y . If w h a t he does is n o t in t u n e w i t h t h e m o m e n t , th.it
m o m e n t is i r r e v o c a b l y lost to h i m ; his c o n s c i e n c e will r e m i n d him t h a t he
has fallen b e h i n d in fulfilling his e x i s t e n c e .
T h e h o n o r a b l e , o p e n , and t r u l y h u m a n s t a n c e b e f o r e death s e t s all
o t h e r 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 in t h e i r p r o p e r places, and t h e y appear in

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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 .

The fundamental characteristics of the Da-sein as being equally

primordial, and their development into the freedom of the authentic
human being
T h e c h a r a c t e r i s t i c s o f h u m a n e x i s t e n c e m o s t i m p o r t a n t for m e d i c i n e ,
t h e n , are its primordial spatiality and t e m p o r a l i t y , b o d y h o o d , c o e x i s t e n c e
in a shared world, e x i s t e n c e ' s e s s e n t i a l a t t u n e m e n t , m e m o r y as it is based
in h i s t o r i c i t y , and m o r t a l i t y . T h i s s e q u e n t i a l listing is not a h i e r a r c h i c a l
a r r a n g e m e n t o f t h e e x i s t e n t i a l possibilities; t h e y are equally primordial.
E v e r y single h u m a n p h e n o m e n o n , n o m a t t e r h o w trifling, i s i n h e r e n t l y
c o n s t i t u t e d o f e v e r y o n e o f t h e s e c h a r a c t e r i s t i c s . N a t u r a l l y , this does n o t
preclude t h e p r e d o m i n a n c e of o n e c h a r a c t e r i s t i c at a n y given t i m e in a
particular h u m a n b e h a v i o r .
N o w , the f u n d a m e n t a l e x i s t e n t i a l c h a r a c t e r i s t i c s can be equally
primordial only w h e n t h e y belong t o g e t h e r i n o n e and the s a m e u n i t y .
We h a v e s e e n this u n d e r l y i n g u n i t y all along in t h e o p e n n e s s and c l a r i t y
peculiar t o h u m a n e x i s t e n c e , w h i c h s h o w s i t s e l f t o a n i n v e s t i g a t o r a s
s o m e t h i n g o p e n , as an " e x - i s t i n g , " a s u s t a i n i n g and m a i n t a i n i n g of t h e
w o r l d w i d e clear and o p e n r e a l m o f p e r c e p t i o n . T h i s o p e n n e s s i s t h e
unified and unifying f u n d a m e n t a l origin m a k i n g possible and c o n s t i t u t
ing the basic c h a r a c t e r n o t o n l y of m a n ' s spatiality and t e m p o r a l i t y , b u t
also his h i s t o r i c i t y , b o d y h c o d , c o e x i s t e n c e , a t t u n e m e n t , and m o r t a l i t y .
All t h e s e possibilities of e x i s t e n c e are of t h e n a t u r e of an ability t h a t
allows t h e m e a n i n g f u l n e s s of w h a t m a n e n c o u n t e r s to disclose itself as
w h a t it is.
It is to be r e i t e r a t e d t h a t this o p e n n e s s m a y n o t be reified and so
m i s u n d e r s t o o d as a kind of h o l l o w space i n t o w h i c h b e i n g s m a y fall, be

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123

p r e s e n t , and b e s t o r e d t h e r e . A s t h e open realm o f p e r c e p t i o n w h i c h i t is,

h u m a n e x i s t e n c e is " m e r e l y " a r e a l m of f u n d a m e n t a l p e r c e p t i v e
r e s p o n s i v e n e s s t o t h e p h e n o m e n a o f t h e w o r l d . T h a t i s w h y o u r w o r l d can
n e v e r b e divided i n t o o p e n n e s s o f h u m a n e x i s t e n c e o n t h e o n e hand and
t h e t o t a l i t y o f c o n c r e t e n o n h u m a n b e i n g s o n t h e o t h e r . T h a n k s t o his
e x i s t e n t i a l o p e n n e s s to a n y p r e s e n c e t h a t r e v e a l s i t s e l f to h i m , a h u m a n
being is able to allow w h a t e v e r a p p e a r s in t h e r e a l m of his p e r c e p t i o n
simply t o b e . T h i s allowing d o e s n o t m e a n b e n i g n n e g l e c t o r i n d i f f e r e n c e .
It m e a n s e n t e r i n g i n t o a r e l a t i o n s h i p to t h a t t h i n g in a w a y t h a t p e r m i t s it
to fully e v o l v e its p a r t i c u l a r m e a n i n g f u l n e s s .
T h i s is t h e condition of m a n ' s f r e e d o m . Only w h e r e t h e r e is a
multiplicity o f p h e n o m e n a d o c h o o s i n g and deciding b e c o m e p o s s i b l e .
M o r e o v e r , e x p e r i e n c e d e m o n s t r a t e s t h a t m a n i s capable o f m a k i n g f r e e
choices at any time.
In t h e light of t h e i r o w n e x p e r i e n c e , physicians s c h o o l e d in n a t u r a l
s c i e n c e t e n d to m i s i n t e r p r e t a t h o u g h t s e q u e n c e like t h e o n e a b o v e as an
attempt to prove one thing with another. T h e y mistakenly accuse it of
p r e s u m i n g to h a v e p r o v e n h u m a n freedom of will b e c a u s e it h a s
d e m o n s t r a t e d t h e o p e n n e s s o f h u m a n e x i s t e n c e . W e d o n o t m a k e this
p r e s u m p t i o n , h o w e v e r , B o t h o p e n n e s s and f r e e d o m o f will a r e equally
e l e m e n t a r y p h e n o m e n a t h a t reveal t h e m s e l v e s directly. A s s u c h , t h e y d o
n o t r e q u i r e a n y proof, i n t h e n a t u r a l scientific s e n s e o f t h e w o r d . T h o u g h
t h e y are equally primordial, it is possible for o n e of t h e m to be t h e
condition of the manifestation of the other.

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

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It is a s s u m e d t h a t h u m a n freedom can be d i s m i s s e d as a m e r e illusion

simply by r e i n t e r p r e t i n g the s e r i e s of free m o t i v a t i o n s leading up to a
particular decision as a p r e d e t e r m i n e d and c o m p l e t e causal chain. T h e
e x p e r i e n c e o f n a t u r a l s c i e n c e i t s e l f d e m o n s t r a t e s , h o w e v e r , t h a t n o such
psychic causal chain can be posited w i t h c e r t a i n t y for any h u m a n
decision. In fact, it is n o t y e t possible to m a k e an a c c u r a t e prediction of
a n y f u n d a m e n t a l m o d e o f h u m a n b e h a v i o r . E v e n p s y c h o a n a l y s i s and
b e h a v i o r a l s c i e n t i s t s , w h o are i m m e n s e l y e x p e r i e n c e d i n t h e t h e o r e t i c a l
c o n s t r u c t i o n o f causal c o n n e c t i o n s w i t h i n t h e m i n d , admit t h a t t h e y can
give reliable i n d i c a t i o n s o f causal s e q u e n c e s o n l y a f t e r t h e fact, n e v e r
b e f o r e t h e fact. T r u e , t h e y i m m e d i a t e l y t r y t o m o d e r a t e this admission b y
pointing t o t h e h u g e v a r i e t y and n u m b e r o f subsidiary c a u s e s a t w o r k i n
t h e life h i s t o r y of a h u m a n being, m e a n i n g t h a t it is purely quantitative
c o n s i d e r a t i o n s w h i c h s t a n d in t h e i r way.
All such a t t e m p t s t o d e n y h u m a n freedom p r o c e e d u n a w a r e t h a t t h e y
fail e v e n to r e a c h the basic d i m e n s i o n of all acts of free will, m u c h less to
pin d o w n and nullify t h e s e a c t s . T h i s is b e c a u s e t h e i r line of a r g u m e n t ,
like all n a t u r a l scientific e x p l a n a t i o n s , is ruled by t h e a x i o m t h a t a n y t h i n g
t h a t is really real m u s t e x i s t in a faultless causal c o n n e c t i o n . To a p e r s o n
s c h o o l e d in t h e n a t u r a l s c i e n c e s , f r e e d o m m e a n s at best f r e e d o m f r o m
causal l a w s , a n o n c a u s a l e v e n t , an i n s t a n c e of a-causality.
I t h a p p e n s , h o w e v e r , t h a t h u m a n f r e e d o m i n h e r e s i n a n open r e a l m o f
perception to the presence of what human beings encounter. T h e
e n g a g e m e n t of a h u m a n being by a p a r t i c u l a r p h e n o m e n o n m o v e s , or
m o t i v a t e s , h i m t o r e s p o n d t o w h a t reveals i t s e l f t o him, and t o r e s p o n d i n
a c c o r d a n c e w i t h the perceived m e a n i n g f u l n e s s o f t h a t t h i n g . T h i s
understanding openness to potential e n g a g e m e n t by meaningful
p r e s e n c e s t h e p r e c o n d i t i o n for h u m a n f r e e d o m l i e s e n t i r e l y outside
o f t h e a r e n a o f c a u s a l i t y and t h a t i s w h y c r i t i c i s m from t h e s t a n d p o i n t o f
natural scientific d e t e r m i n i s m i s u n a b l e t o p e n e t r a t e t o t h e r e a l m o f
h u m a n f r e e d o m . R e g a r d l e s s o f its ability t o p r o d u c e all, o r s o m e , o r n o n e
of the c a u s e s of a p a r t i c u l a r piece of h u m a n b e h a v i o r , it has n o t h i n g to
say a b o u t the actual basis o f f r e e d o m .
O n t h e o t h e r h a n d , t h e s a m e insight i n t o t h e basis o f h u m a n f r e e d o m
reveals t h a t i t i s not h u m a n pleasure t h a t disposes o v e r f r e e d o m . T h e
h u m a n does n o t p o s s e s s freedom as o n e of his p r o p e r t i e s . At m o s t , it is
the r e v e r s e . F r e e d o m , n a m e l y the e k - s i s t i n g , r e v e a l i n g o u t o f h i d d e n n e s s
{entbergende), world opening {erffnende) Dasein p o s s e s s e s the h u m a n
being."
T h e s e indications o f t h e free and o p e n n a t u r e o f h u m a n e x i s t e n c e , w i t h
its c h a r a c t e r i s t i c spatiality and t e m p o r a l i t y , h i s t o r i c i t y , b o d y h o o d ,
c o e x i s t e n c e with o t h e r s , a t t u n e m e n t , and m o r t a l i t y , c o n c l u d e o u r

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Characteristics of Human

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Beings

discussion of 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 of h u m a n b e i n g . In place of

t h e t e r m s "basic t r a i t " and " 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 , " w e can use the
w o r d " E x i s t e n t i a l , " using t h e initial capital to distinguish t h e n o u n from
t h e adjective. T h e s e t h r e e d e s i g n a t i o n s h a v e t h e s a m e r e l a t i o n t o m a n ' s
being a s t h e n o t i o n o f c a t e g o r y h a s t o i n a n i m a t e o b j e c t s .
O u r p r e s e n t a t i o n o f t h e basic t r a i t s o f h u m a n being does n o t claim t o
be a c o m p l e t e e x i s t e n t i a l a n t h r o p o l o g y . It has m e r e l y t r a c e d t h o s e
E x i s t e n t i a l s w h i c h are m o s t i m p o r t a n t for m e d i c i n e . Still this f r a m e
w o r k will s e r v e to s u g g e s t an a d e q u a t e e x i s t e n t i a l f o u n d a t i o n f o r
m e d i c i n e . It is s o u n d e r , on t w o c o u n t s , t h a n t h e c u r r e n t l y d o m i n a n t
f r a m e w o r k based o n biological, physiological, and p s y c h o l o g i c a l d e t e r m i
nations of human nature.
First o f all, the findings o f t h e s e t h r e e s c i e n c e s d o n o t really c o m e into
their ownas manifestations of human existenceuntil they are seen
from t h e e x i s t e n t i a l f o u n d a t i o n w e h a v e p r e s e n t e d . For t h e E x i s t e n t i a l s
pervade t h e empirical findings as an essence w i t h o u t w h i c h t h e y could n o t
be w h a t t h e y are. If this is t h e s o r t of r e l a t i o n s h i p t h a t o b t a i n s b e t w e e n
the basic traits of h u m a n being and empirical (i.e., physiologicalpsychological) fact, t h e n it is far f r o m t h e purpose of o u r 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 t o d e t r a c t from t h e i m p o r t a n c e o f t h e s e
" c o n c r e t e " medical findings. O n t h e c o n t r a r y , this n e w e r foundation
m a k e s possible an i n t e r p r e t a t i o n t h a t is m o r e j u s t to empirical fact and
more adequate to human beings.
9

In the s e c o n d place, an 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 e n a b l e s us

t o assail successfully t h e u n s c i e n t i f i e n c v a g u e n e s s and m y s t i f i c a t i o n
surrounding many of the standard concepts of the modern science of
healing. A b o v e all, o u r f r a m e w o r k can supply r i g o r o u s , concrete
d e t e r m i n a t i o n s o f h u m a n being w i t h w h i c h t o fill t h e v a c u u m a r o u n d the
i n c r e a s i n g l y popular n o t i o n s of a total medicine and a u n i t y of body,
mind, and spirit. T h e t o t a l i t y and w h o l e n e s s of m a n , w h i c h a total
m e d i c i n e t r i e s t o g r a s p , and t h e u n i t y o f his e x i s t i n g are first capable o f
decisive c h a r a c t e r i z a t i o n i n t e r m s o f t h e a b o v e described E x i s t e n t i a l s .
It m a y s t r i k e t h e r e a d e r as odd t h a t a description of t h e e x i s t e n t i a l traits
m o s t i m p o r t a n t for m e d i c i n e a b a n d o n s e v e r y o n e o f t h e n o t i o n s n a t i v e t o
traditional physiology and p s y c h o l o g y . T h e r e is no m e n t i o n of a h u m a n
s o m a n o r is a n y a t t e n t i o n paid to n o t i o n s of a p s y c h e , a c o n s c i o u s , an
affect, or an u n c o n s c i o u s . A n e w vision and u n d e r s t a n d i n g of s o m e t h i n g
d e m a n d s a n e w w a y of talking a b o u t it, for the old t e r m i n o l o g y g e t s in the
w a y of this e f f o r t . S t u b b o r n l y e n t r e n c h e d behind t h e w o r d s coined by a
particular c o n c e p t u a l o r i e n t a t i o n a r e its s e c r e t prejudices. A n y a t t e m p t
to o p e n o u t an a d e q u a t e l y h u m a n vista o n t o t h e p h e n o m e n a ol
u n d i s t u r b e d e x i s t e n c e m u s t include a critique of the m o s t important
ideas o f traditional biology, p h y s i o l o g y , a n d p s y c h o l o g y .

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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

From human body as a physical organism to bodyhood

I n t h e preceding c h a p t e r s w e have e m p h a s i z e d t h e n e c e s s i t y for
c o n s i d e r i n g the 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 w h i c h traditional
m e d i c i n e calls t h e h u m a n body. W e h a v e u n d e r s c o r e d t h e conditional
j u s t i f i c a t i o n for c o n c e i v i n g o f bodyhood's s o m a and for t h e g e n e r a l
p r e e m i n e n c e g r a n t e d the s o m a i n m e d i c i n e . W e h a v e also indicated h o w
this c o n c e p t i o n can be left b e h i n d for o n e t h a t r e c o g n i z e s all bodily
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 a s t h e bodying f o r t h o f t h e r e l a t i o n s h i p
to t h e world in w h i c h and as w h i c h a particular Da-sdn is e x i s t i n g at a
given m o m e n t . T h i s c o n c e p t u a l a d v a n c e is so f u n d a m e n t a l l y i m p o r t a n t
for m e d i c i n e t h a t w e felt c o m p e l l e d t o p u r s u e t h e m a t t e r f u r t h e r .
It m a y be e a s i e r to m a k e t h e t r a n s i t i o n if we a d v a n c e o n l y a half step at
first. T h e findings of m o d e r n F r e n c h phenomenologues existentiels m a y fairly
be described as a h a l f step a d v a n c e f r o m the n a t u r a l scientific c o n c e p t of
t h e body. N o o t h e r r e s e a r c h e r s o f t h e last decades h a v e w o r k e d s o
i n t e n t l y t o w a r d a m o r e appropriately h u m a n f o r m u l a t i o n o f t h e
p h e n o m e n o n of b o d y h o o d t h a n t h e y . It still r e m a i n s difficult for t h e m to
e s c a p e t h e d o m i n a t i n g i n f l u e n c e o f D e s c a r t e s , and this i s w h y t h e y h a v e
m a n a g e d t o g e t only h a l f w a y t o w a r d 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 the
b o d y h o o d of h u m a n Da-sein. A n d y e t t h e s e p h i l o s o p h e r s do d e s e r v e
lasting credit for pointing i n s i s t e n t l y to the n e c e s s i t y for r e c o n s i d e r i n g
1

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the h u m a n b o d y . W e shall limit o u r e x a m i n a t i o n h e r e t o a f e w

particularly c h a r a c t e r i s t i c and r e v e a l i n g s t a t e m e n t s f r o m t h e w o r k s o f
S a r t r e and M e r l e a u - P o n t y .
S a r t r e tell us t h a t a h u m a n being and his w o r l d a r e m u t u a l l y r e l a t e d
p h e n o m e n a and t h a t t h e 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 of each is relation.
B u t h e a t o n c e g o e s o n t o a s s e r t that, g i v e n this reciprocal r e l a t e d n e s s , i t
follows t h a t t h e r e l a t i o n s h i p i t s e l f m u s t arise from t h e h u m a n reality and
g o o u t from i t t o t h e t h i n g s o f t h e w o r l d . A c c o r d i n g l y , c o m i n g - i n t o - t h e w o r l d m e a n s n o t h i n g m o r e for h u m a n b e i n g s t h a n e s t a b l i s h i n g d i s t a n c e s
from t h i n g s and t h e r e b y m a k i n g it possible, s i m u l t a n e o u s l y , for t h i n g s to
be in t h e first place. R e f i n i n g this v i e w , he says t h a t to be h u m a n m e a n s
to be imprisoned perpetually in some particular perspective determined,
in fact, by l o c a t i o n , at t h e p a r t i c u l a r m o m e n t , of t h e human body. A
p e r s o n ' s r e l a t i o n s h i p s to t h i n g s would e m a n a t e from this specific point in
space.
3

On t h e o t h e r h a n d , S a r t r e also sees corps humain as t h e v e s t i g e of

pure p r e s e n c e f r o m w h i c h h u m a n c o n s c i o u s n e s s m a y b r e a k f o r t h i n t o a n
o n t o l o g i c a l act. T h e b o d y is draped o v e r a h u m a n being, o n c e he h a s
b e c o m e c o n s c i o u s , as a tool, a v e r y peculiar sort of t o o l , of c o u r s e . People
do n o t simply p o s s e s s t h e i r bodies as t h e y do t h e tools t h e y m a k e
t h e m s e l v e s ; t h e y actually e x i s t t h e i r bodies, w h i c h m e a n s t h a t
p r o c e e d i n g from t h e pivot o f his body t h r o u g h s i g n i f i c a n c e - c r e a t i n g
r e l a t i o n s h i p s , a h u m a n being t r a n s c e n d s t h e body to a r r i v e at t h e t h i n g s
o f his world. S a r t r e n e g l e c t s t o specify e x a c t l y h o w this m o v e m e n t
o u t w a r d to t h i n g s is supposed to happen or h o w such a s i g n i f i c a n c e c r e a t i n g r e l a t i o n s h i p m i g h t arise in and t r a n s c e n d a b o d y t h a t is m e r e l y in
space. T h i s is m o r e o b s c u r e in light of his v i e w t h a t all being is, in e s s e n c e ,
n o t h i n g but totally m e a n i n g l e s s p r e s e n c e .
A p p a r e n t l y , we will h a v e to travel q u i t e a w a y past S a r t r e ' s
d e t e r m i n a t i o n of t h e corps humain b e f o r e we a r r i v e at a truly e x i s t e n t i a l
view. S u c h a v i e w m u s t m a k e clear in opposition to S a r t r e ' s opinion t h a t
the spatiality of h u m a n being does n o t o r i g i n a t e in, and is n o t shaped b y ,
the h u m a n body. W e h a v e already s h o w n h o w h u m a n e x i s t e n c e can b e
bodily only b e c a u s e e x i s t e n c e itself is i n h e r e n t l y spatial.
F o r S a r t r e , a d e q u a t e insight into t h e n a t u r e of t h e corps humain d e p e n d s
o n w h a t h e views a s t h e m o s t basic e x i s t e n t i a l m o o d : n a u s e a , disgust, o r
l o a t h i n g . O n l y in n a u s e a , he a r g u e s , does a h u m a n being e n t e r an
o n t o l o g i c a l frame in w h i c h t h e pure b e i n g of all t h i n g s can disclose i t s e l f
and p h e n o m e n a appear, for t h e first t i m e , w i t h o u t t h e l a c q u e r . N o w t h e
h u m a n body reveals i t s e l f as pure flesh. It is no s u r p r i s e t h a t m a n r e g a r d s
il with a lifelong s e n s e of s h a m e .
N o w h e r e d o e s S a r t r e explain w h y it is n a u s e a , of all t h i n g s , t hat allows
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us to r e c o g n i z e all p h e n o m e n a , including t h e p u r e l y c a r n a l h u m a n body,

i n t h e i r t r u e n a t u r e s . N e v e r t h e l e s s , h e b e l i e v e s t h a t t h r o u g h his
discovery of nausea as the fundamental a t t u n e m e n t of h u m a n beings, he
has f o r g e d far a h e a d o f H e i d e g g e r i n i n t e r p r e t i n g h u m a n n a t u r e : a t t h e
c o r e of all t h i n g s is pure and m e a n i n g l e s s p r e s e n c e . H e i d e g g e r ' s
designation of anxiety as the all-important human a t t u n e m e n t repre
s e n t s , in S a r t r e ' s o p i n i o n , o n l y a first step t o w a r d valid u n d e r s t a n d i n g .
S a r t r e ' s claim g r o s s l y falsifies H e i d e g g e r ' s Dasiensanalytik, w h i c h
does n o t in a n y w a y a s s e r t t h a t a n x i e t y is the basic a t t u n e m e n t of
e x i s t e n c e a s S a r t r e does w i t h n a u s e a . H e i d e g g e r n a m e s a n x i e t y solely
a s o n e o f a n u m b e r o f possible basic a t t u n e m e n t s a n d s i n g l e s i t o u t o n l y
w h e r e the ontological determination of human existence is concerned.
A n x i e t y is, in fact, especially significant in this o n e r e s p e c t , t h a t in
a n x i e t y h u m a n b e i n g - i n - t h e - w o r l d i s t h r o w n b a c k e n t i r e l y o n itself.
C o n s e q u e n t l y , e x i s t e n c e i s m o s t a w a r e o f i t s e l f i n a n x i e t y . T h i s does n o t
mean that the phenomena of the human world might not reveal
t h e m s e l v e s far m o r e m e a n i n g f u l l y and richly i n s o m e o t h e r , m o r e o p e n ,
a t t u n e m e n t , like loving s o m e o n e o r s o m e t h i n g .
6

In looking at the h u m a n body from the perspective of nausea, S a r t r e

not only distorts Heidegger'
D a s e i n s a n a l y t i k b u t also c o n t r a d i c t s
h i m s e l f . O n t h e o n e h a n d , h e calls n a u s e a , disgust, o r l o a t h i n g , t h a t
disposition i n w h i c h w h a t e v e r t h e h u m a n s u b j e c t e n c o u n t e r s r e v e a l s
i t s e l f i n its a b s o l u t e , t - u e , n a m e l e s s , v o i c e l e s s , m e a n i n g l e s s , p a s t - a n d
f u t u r e l e s s , i n a c c e s s i b l e , o n t o l o g i c a l n a t u r e a s pure p r e s e n c e . M e a n w h i l e ,
l o a t h i n g , s i l e n c e , d u m b p r e s e n c e , a b s o l u t e n e s s , c a r n a l i t y , and i n a c c e s s i
bility a r e explicitly m e a n i n g f u l qualities f o r h u m a n e x i s t e n c e . T h e y a r e ,
t h o u g h , e x a c t l y t h o s e m e a n i n g f u l qualities w h i c h appear i n t h a t
e x t r e m e l y deficient m o d e o f a t t u n e m e n t , n a u s e a . F a r f r o m l e t t i n g u s s e e
the most fundamental nature of human bodyhood, nausea is the very
condition that most stubbornly prevents us from experiencing the
bodyhood of our being.
7

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

A l t h o u g h h e calls t h e soul's dwelling in the b o d y a f u n d a m e n t a l

mode

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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

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

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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 .

From psyche to human being-in-the-world

T h e v e r y w o r d p s y c h e h a s b e e n a p l a y t h i n g o f h i s t o r y . A r i s t o t l e still
called psyche t h e d i s t i n g u i s h i n g mode of being of an e n t i t y w i t h t h e
p o t e n t i a l for b e i n g alive. By m e d i e v a l t i m e s , p s y c h e w a s a m a t e r i a l l y
p r e s e n t t h o u g h still i m m o r t a l s p i r i t u a l s u b s t a n c e b y itself. T h e
m o d e r n a g e , a n a l o g i z i n g f r o m its c o n c e p t o f t h e b o d y , i m a g i n e s the
p s y c h e a s a n o r g a n i s m l i k e , m o r e o r less a u t o n o m o u s , o b j e c t . I n q u i r y i n t o
its e x a c t n a t u r e is c o n s i d e r e d u n n e c e s s a r y . All t h a t is s o u g h t , or
p r o p o s e d , are p r o c e s s e s o c c u r r i n g i n t h e p s y c h e and, o n e would h o p e ,
a m e n a b l e t o c a l c u l a t i o n . T h e p s y c h e i n w h i c h all o f t h e s e m e c h a n i s m s
and p s y c h i s m s a r e alleged to t a k e place eludes strict scientific definition.
P a s s i n g definitions t h a t label i t t h e seat o f t h e m e n t a l f a c u l t i e s , o f
i n s t i n c t s , drives, and e m o t i o n s can hardly b e r e c o g n i z e d a s scientific
c h a r a c t e r i z a t i o n s . A n d t h e c o l l e c t i o n s o f p s y c h i c faculties bandied a b o u t
s o f r e e l y b y c o n t e m p o r a r y b r a n c h e s o f faculty p s y c h o l o g y says v e r y little
a b o u t e i t h e r t h e e x i s t e n c e o f t h e s e p o w e r s t h e p s y c h e allegedly holds, t h e
m o d e of b e i n g of t h e p s y c h e itself, or j u s t h o w this p s y c h e is in a position
to h a v e s u c h t h i n g s as d r i v e s , e m o t i o n s , and i n s t i n c t s as its faculties or
f u n c t i o n s . M e d i c a l t h i n k i n g will g e t past this b o t t l e n e c k o n l y by
c o m p l e t e l y r e l i n q u i s h i n g t h e n o t i o n of a s u b s t a n t i a l o b j e c t i v e l y p r e s e n t
p s y c h e and c o n s i d e r i n g h u m a n being as Da-sein. To e x i s t as Da-sein
m e a n s t o s u s t a i n and m a i n t a i n t h e c l e a r n e s s o f a w o r l d - s p a n n i n g r e a l m
o f p e r c e p t i o n , t o hold o p e n this r e a l m i n t o w h i c h w h a t e v e r can b e m a y
s h i n e f o r t h and be p e r c e i v e d in its m e a n i n g and its place. So it is t h a t a
p h e n o m e n o n can e n g a g e t h e h u m a n being in s u c h a w a y t h a t he can
r e s p o n d to it a c c o r d i n g to its m e a n i n g f u l n e s s . In this w a y , t h e h u m a n
being is c o n t i n u o u s l y r e l a t e d to w h a t he e n c o u n t e r s , and he develops as a
h u m a n being in this r e l a t i o n s h i p . T h i s r e l a t e d n e s s is not biploar. R a t h e r ,
m a n ' s existential relatednessas w h i c h each of us e x i s t s in his p a r t i c u l a r and
limited w a y i s a p r i m a r y dwelling w i t h w h a t c o m e s to be in t h e world
s p a n n i n g o p e n n e s s he s u s t a i n s . H u m a n b e i n g - i n - t h e - w o r l d , then, is a

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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

From consciousness to the fundamental openness

of human existence
T h e t e r m " c o n s c i o u s n e s s " claims a u n i q u e place in c o n t e m p o r a r y
philosophy and in t h e s c i e n c e s of p s y c h o l o g y , p h y s i o l o g y , and p a t h o l o g y .
T h e idea is f u n d a m e n t a l to depth 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 in
t h a t their m o s t i m p o r t a n t c o n c e p t , is the " u n c o n s c i o u s , " its c o n c e p t u a l
n e g a t i o n . Even p h y s i o l o g y and biology a r e p e r p e t u a l l y c o n c e r n e d w i t h
t h e idea o f c o n s c i o u s n e s s t o t h e e x t e n t t h a t t h e y t r y t o t r a c e i t back t o
n e u r o p h y s i o l o g i c a l s t r u c t u r e s and p r o c e s s e s o r t o e l i m i n a t e i t e n t i r e l y .
While t h e y can speak o f a l t e r a t i o n s i n c o n s c i o u s n e s s , t h o u g h , t h e y h a v e
v e r y little t o say a b o u t t h e n a t u r e o f c o n s c i o u s n e s s itself.
Leading p s y c h o l o g i s t s h a v e also had to give up a t t e m p t s to find a
scientific e x p l a n a t i o n for t h e n o t i o n o f c o n s c i o u s n e s s . K a r l J a s p e r s had t o
s e e k refuge in a m e t a p h o r : " W e give t h e n a m e c o n s c i o u s n e s s to the w h o l e

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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

T h e G e r m a n w o r d for c o n s c i o u s n e s s , Bewusstsein, is a little u n f o r t u n a t e .

It has g e n e r a t e d t h e idiom ein Bewusstsein hahen, w h i c h m e a n s " t o h a v e a
c o n s c i o u s n e s s . " C o n s c i o u s n e s s i s g e n e r a l l y r e p r e s e n t e d a s s o m e specific
thing e x i s t i n g as a b o x l i k e c o n t a i n e r .
M o r e can be g l e a n e d f r o m t h e Latin conscientia. T h e con prefix r e f e r s to
the h u m a n subject. W h e n e v e r I am conscious of something that is not
m y s e l f , I c o n t i n u e in a w a r e n e s s of m y s e l f as a being t h a t is c o n s c i o u s of
s o m e t h i n g . And a l t h o u g h this a w a r e n e s s o f m y s e l f i s n o t t h e m a t i c ,
consciousness nevertheless by nature always entails consciousness of
self. I n " r e p r e s e n t , " t h e " r e " prefix indicates t h a t k n o w l e d g e r e f e r s back
to t h e k n o w e r . W h e n I r e - p r e s e n t , I am p r e s e n t i n g to m y s e l f w h a t is
p r e s e n t in my world.
B u t conscientia ( c o n s c i o u s n e s s ) and its ability to r e p r e s e n t w e r e also
s u b j e c t e d t o t h e m u t i l a t i n g p r o c e s s o f reification u n d e r t h e n a t u r a l
scientific a p p r o a c h . C o n s c i o u s n e s s w a s t h o u g h t of as a s e l f - c o n t a i n e d
b o x l i k e t h o u g h i m m a t e r i a l p h e n o m e n o n , and r e p r e s e n t a t i o n s w e r e
s e e n as i m a g e s of o b j e c t s in t h e e x t e r n a l w o r l d , f o r m i n g a part of t h e
e n d o p s y c h i c m a t e r i a l of c o n s c i o u s n e s s and filling its i n n e r field.
In r e s p o n s e to t h e i n s u r m o u n t a b l e difficulties i n h e r e n t in t h e s e
notions, the suggestion has been made many times to dispense with the
s u b s t a n t i v e s Bewusstsein and " c o n s c i o u s n e s s " and i n s t e a d u s e only t h e
adjectives bewusst and " c o n s c i o u s . " T h e s e could d e s i g n a t e c e r t a i n
c o n s c i o u s - i m m a n e n t p s y c h i c p r o c e s s e s and a b o v e all could help
distinguish a m o n g c o n s c i o u s and u n c o n s c i o u s psychic p r o c e s s e s . T o t h e
c a t e g o r y o f c o n s c i o u s p s y c h i c p r o c e s s e s b e l o n g , a m o n g o t h e r t h i n g s , all
t h e t h o u g h t p r o c e s s e s of w h i c h a p e r s o n is a w a r e , w h i c h a r e in t u r n
usually s e e n a s c o n n e c t i o n s a m o n g 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 . Y e t
p s y c h o l o g i s t s and p s y c h i a t r i s t s a r e still at a loss to explain e x a c t l y w h a t
t h e s e t h o u g h t p r o c e s s e s , and t h o u g h t itself, a r e c o m p o s e d of. T h e y
c a n n o t g e t a r o u n d t h e fact, o n e w e h a v e e m p h a s i z e d o f t e n e n o u g h , t h a t
h u m a n b e h a v i o r supplies n o c o n c r e t e e v i d e n c e t o j u s t i f y t h e s e
c o n c e p t i o n s o f c o n s c i o u s n e s s and its c o n t e n t o f t h o u g h t and e n d o p s y c h i c
representations.
We can o n c e again look to l a n g u a g e for a w a y out of this c u l - d e - s a c . We
m a y d i s c o v e r t h a t t h e t e r m Bewusstsein is a surprisingly r e c e n t c o i n a g e . It

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FOUNDATIONS

and the adjective bewusst did n o t a p p e a r until t h e e i g h t e e n t h c e n t u r y .

T h e y still largely r e t a i n t h e original m e a n i n g s i m p a r t e d t o t h e m i n a n era
t h a t w o r e t h e philosophical spectacles o f C a r t e s i a n i s m , t h r o u g h w h i c h
t h e act o f p e r c e p t i o n w a s split i n t o t h e o b j e c t i f i c a t i o n o f t h i n g s o u t s i d e
and t h e i r r e p r e s e n t a t i o n w i t h i n a h u m a n s u b j e c t .
M u c h o l d e r t h a n Bewusstsein and bewusst is t h e a r c h a i c G e r m a n w o r d
bewissen. F r o m its I n d o g e r m a n i c r o o t vid-, the v e r b wissen m e a n s " t o h a v e
s e e n s o m e t h i n g , " " t o b e a w a r e o f s o m e t h i n g a s being s o m e t h i n g . "
A c c o r d i n g l y , t h a t p e r s o n is bewisst w h o h a s found his place in his
e n v i r o n m e n t and a m o n g t h e o b j e c t s a r o u n d h i m , w h o isin m o d e r n
p s y c h i a t r i c j a r g o n " o r i e n t e d . " S o m e o n e can b e c o m e o r i e n t e d o n l y a f t e r
h e has g r a s p e d t h e m e a n i n g s o f w h a t h e h a s s e e n , a p p r e h e n d i n g w h e r e
t h e s e t h i n g s b e l o n g and w h a t t h e y are for.
T h i s raises t h e q u e s t i o n of w h e t h e r c o n s c i o u s n e s s (as being bewisst) is
t h e p r e c o n d i t i o n for h u m a n b e i n g - i n - t h e - w o r l d , or if it is the o t h e r w a y
a r o u n d . T h e priority of Da-sein, of b e i n g - i n - t h e - w o r l d , is evident as s o o n
as this h u m a n " b e i n g - i n - t h e - t h e r e " and " b e i n g - i n . . " is u n d e r s t o o d
e x i s t e n t i a l l y . We h a v e said t h a t the f u n d a m e n t a l trait of h u m a n Da-sein is
its w o r l d - s p a n n i n g o p e n n e s s to perceiving w h a t is t h e r e in its p r e s e n c e . If
t h e r e is to be a capacity f o r p e r c e p t i o n , for being bewisst and finding o n e ' s
place in t h e w o r l d , t h e n t h e " e c - s t a t i c " dwelling in t h e c l e a r o p e n n e s s
peculiar to h u m a n Da-sein is i n d i s p e n s a b l e . By c o n t r a s t , a p s y c h o l o g i c a l l y
conceived boxlike consciousness cannot be the condition of h u m a n
being-in-the-world.
T h i s kind of r e l a t i o n s h i p b e t w e e n Da-sein and c o n s c i o u s n e s s also
m a k e s it e a s i e r to u n d e r s t a n d w h y t h e r e can be no s u c h things as
c o n s c i o u s e n d o p s y c h i c ideas, o r t h o u g h t p r o c e s s e s , i n t h e s e n s e o f
connections, or associations, among intrapsychic representations or
images. It is not man w h o forms images of the things around him,
r e p r e s e n t s t h e s e i m a g e s t o h i m s e l f w i t h i n s o m e supposedly e n c a p s u l a t e d
c o n s c i o u s n e s s , and t h e n m a k e s c o n n e c t i o n s b e t w e e n t h e m . R a t h e r t h e
p h e n o m e n a t h e m s e l v e s , being and r e m a i n i n g o u t t h e r e in t h e w o r l d in
the revealing c l e a r n e s s o f his b e i n g - i n - t h e - w o r l d , b e c o m e p r e s e n t t o him
and s t a n d revealed i n t h e i r c o n t e x t o f r e f e r e n c e s . T h e y appear b e f o r e
him, e n t e r t h e r e a l m o f his p e r c e p t i v e o p e n n e s s , and a d d r e s s him w i t h
their m e a n i n g s .
C e r t a i n l y , w h a t w e h a v e said c o n c e r n i n g t h e r e l a t i o n s h i p b e t w e e n
c o n s c i o u s n e s s and Da-sein has n o t g o n e u n c h a l l e n g e d . T h e F r e n c h
psychiatrist 11. Ey, in p a r t i c u l a r , h a s a c c u s e d t h e e x i s t e n t i a l v i e w of
inflating c o n s c i o u s n e s s to t h e b u r s t i n g point until it e v a p o r a t e s i n t o
ml m i l e ex stasies. But just this is t h e s i n g u l a r c o n t r i b u t i o n o f
I ).i-.i 1 1 1 . . 1 1 1 . 1 1 \ ' . i . to psychology and p s y c h i a t r y . As it m u s t always r e m a i n
1

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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.

From a psychic unconscious to a fundamental "hiddenness"

T h e unconscious is one of the most frequently employed concepts of
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 . F r e u d gave t h e t e r m its p r e s e n t
psychological m e a n i n g , and t h e c o n c e p t of a psychic u n c o n s c i o u s rapidly
b e c a m e t h e m o s t i m p o r t a n t o f his e n t i r e t h e o r y . H e e q u a t e d i t w i t h
psychic reality. He called it t h e s t a r t i n g point and real m o t o r of all d r e a m
p r o c e s s e s . T h e distinction b e t w e e n c o n s c i o u s and u n c o n s c i o u s psychic
p r o c e s s e s s e e m e d t o h i m " t h e o n l y light i n the d a r k n e s s o f depthpsychology." T h r o u g h Freud, the notion of the unconscious became so
crucial for m o s t o f t h e prevailing t h e o r i e s a b o u t h u m a n b e i n g s t h a t t h e y
w e r e labeled a s depth p s y c h o l o g i e s . T h e " d e p t h " c a m e f r o m t h e fact t h a t
Freud posited v a r i o u s p s y c h i c levels and w i s h e d t h e u n c o n s c i o u s t o b e
u n d e r s t o o d as t h e psychic locale or p s y c h i c s y s t e m t h a t lay beneath
consciousness.
18

At first, u n c o n s c i o u s w a s an adjective used o n l y to r e f e r to a specific

" c h a r a c t e r i s t i c o f c e r t a i n psychic c o n f i g u r a t i o n s . " " T h e u n c o n s c i o u s , "
F r e u d w r o t e , " s e e m e d initially to be n o t h i n g m o r e t h a n a puzzling
f e a t u r e of a c e r t a i n p r o c e s s . " E v e n this e a r l y application of t h e t e r m is
s u s p e c t , t h o u g h , for t h i n g s like t h e e n d o p s y c h i c c o n f i g u r a t i o n s w h i c h
a r e alleged t o b e u n c o n s c i o u s c a n n o t b e s h o w n t o e x i s t .
If s o m e t h i n g does n o t e x i s t in t h e first place, it can be n e i t h e r c o n s c i o u s
n o r u n c o n s c i o u s . If hard p r e s s e d , p e r h a p s I m i g h t call t h e clock on t h e
wall b e h i n d me u n c o n s c i o u s , at least while I am w r i t i n g and n o t a w a r e of
t h e c l o c k . D u r i n g this s a m e t i m e , m y r e l a t i o n s h i p t o m y friend H a n s m a y
also be u n c o n s c i o u s in t h a t s e n s e . In b o t h i n s t a n c e s , h o w e v e r , it is n o t a
c e r t a i n p s y c h i c p r o c e s s or an i n t r a p s y c h i c i m a g e w i t h i n a p s y c h e t h a t is
u n c o n s c i o u s , b u t m e r e l y t h a t , for t h e m o m e n t , a t h i n g on t h e wall, and
m y r e l a t i o n s h i p t o H a n s , a r e n o t t h e focus o f m y a t t e n t i o n . B o t h t i m e s ,
u n c o n s c i o u s i s s y n o n y m o u s w i t h t h e s t a t e m e n t : s o m e p h e n o m e n o n out
t h e r e i n t h e open r e a l m o f m y w o r l d i s n o t for t h e t i m e being t h e m a t i c a l l y
p r e s e n t for m e . T h i s i s n o t t h e s a m e a s saying t h a t t h e clock and H a n s
h a v e disappeared from m y e x t e r n a l w o r l d .
1 9

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

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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

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137

his h y p o t h e s i s of an u n c o n s c i o u s " l e g i t i m a t e , " b e c a u s e "in positing it, we

do n o t v e e r a single step from t h e w a y of t h i n k i n g we c o n s i d e r c u s t o m a r y
and c o r r e c t , " in so far as the a s s u m p t i o n of o t h e r people being e n d o w e d
with consciousness is itself only inferred by a n a l o g y . Here we must
agree with Freud. T h e legitimacy of the two assumptions is comparable;
and his c o m p a r i s o n does u l t i m a t e l y raise t h e q u e s t i o n o f t h e e x t e n t t o
w h i c h t h e a s s u m p t i o n of an i n d e p e n d e n t , s u b j e c t i v e c o n s c i o u s n e s s is
itself justified.
B u t F r e u d tells us t h a t to i n f e r t h e e x i s t e n c e of an u n c o n s c i o u s is n o t
o n l y l e g i t i m a t e but actually n e c e s s a r y , t h e data o f c o n s c i o u s n e s s a l w a y s
r e m a i n i n g f r a g m e n t a r y o t h e r w i s e . T a k e , for e x a m p l e , ideas w h o s e
origins elude u s and c o n c l u s i o n s t h a t s e e m t o c o m e f r o m n o w h e r e . "All o f
t h e s e p a r t i c u l a r o p e r a t i o n s r e m a i n i n c o m p r e h e n s i b l e and d i s c o n n e c t e d , "
F r e u d g o e s on to say, "as long as we insist on a p p r o a c h i n g t h e m
e x c l u s i v e l y t h r o u g h c o n s c i o u s n e s s , b u t t h e y a r r a n g e t h e m s e l v e s in a
d e m o n s t r a b l e orderly c o n t e x t a s s o o n a s w e i n t e r p o l a t e t h e i n f e r r e d
u n c o n s c i o u s o p e r a t i o n s . T h e a c c r u a l o f m e a n i n g and c o n t e x t i s a r e s u l t
t h a t fully j u s t i f i e s o u r going b e y o n d i m m e d i a t e e x p e r i e n c e . "
22

2 3

We pointed out earlier that the series of observable conscious

o p e r a t i o n s appears f r a g m e n t a r y o n l y if o n e p r e s u p p o s e s it m u s t be
reducible, t h r o u g h u n i n t e r r u p t e d c a u s a l c h a i n s , t o s o m e hidden psychic
c a u s e . T h e n o n e would h a v e t o h y p o t h e s i z e a n u n c o n s c i o u s t o supply t h e
m i s s i n g links in the causal chain in t h e a b s e n c e of a c t u a l d e m o n s t r a t i o n s
of their existence. So enslaved was Freud to the command of the natural
scientific m e t h o d t h a t h e failed t o see t h e j a r r i n g c o n t r a d i c t i o n i n h e r e n t
i n t h e r e a s o n i n g b e h i n d his h y p o t h e s i s o f a n u n c o n s c i o u s . A n y c o n t e x t
m a d e up of i n f e r r e d and i n t e r p o l a t e d e n t i t i e s is n o t demonstrable, as F r e u d
a r g u e s it is. F u r t h e r m o r e , F r e u d ignored t h e fact t h a t causal
c o n n e c t i o n s t h e o n l y kind h e tried w i t h his h y p o t h e s i z e d u n c o n s c i o u s
to establish among conscious actscan do no m o r e than demonstrate the
r e g u l a r i t y of a purely t e m p o r a l , b u t in i t s e l f e n t i r e l y m e a n i n g l e s s ,
s u c c e s s i o n i n t h e m a n i f e s t a t i o n o f c e r t a i n p h e n o m e n a . I n s u m , from t h e
standpoint of the phenomena of h u m a n existence, there is absolutely no
n e c e s s i t y or m o t i v e for positing a psychic u n c o n s c i o u s .
A s o n e p r o o f for t h e e x i s t e n c e o f a psychic u n c o n s c i o u s F r e u d cites 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 an idea of w h i c h we a r e c o n s c i o u s in a given
m o m e n t m a y n o l o n g e r b e c o n s c i o u s for u s i n t h e n e x t . H e a s k s , with
e v i d e n t g o o d r e a s o n , w h e r e t h e idea m i g h t have c o m e from and w h e r e it
could h a v e g o n e to. S i n c e i t could n o t simply h a v e g o n e o u t o f e x i s t e n c e
(or it could n o t h a v e r e a p p e a r e d in t h e n e x t i n s t a n t ) , it m u s t in the
m e a n t i m e h a v e b e e n l a t e n t , u n c o n s c i o u s . F r e u d a r g u e s similarly t o
2 4

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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

Basic Concepts of Biology, Physiology, and Psychology

but t h e w i s h e s and t h o u g h t s o f t h e i r f o r e b e a r s o r o f popular opinion
N e v e r t h e l e s s , t h e y t o o say, " I t h i n k this i s r i g h t o r w r o n g , " " ! intend t o d o
this or t h a t . " In s h o r t , we do n o t n e e d a F r e u d i a n u n c o n s c i o u s to explain
p o s t h y p n o t i c b e h a v i o r a n y m o r e t h a n w e n e e d i t t o u n d e r s t a n d the
b e h a v i o r o f s o m e o n e m e s m e r i z e d b y tradition o r popular s a n c t i o n .
F r e u d ' s third c a t e g o r y of e v i d e n c e for t h e e x i s t e n c e of a psychic
u n c o n s c i o u s , slips, i s likewise u n c o n v i n c i n g . T o affirm t h e e x i s t e n c e o f
t h e u n c o n s c i o u s h e m e n t i o n s t h e case o f the c h a i r m a n w h o s e opening
r e m a r k s ended: " I declare this m e e t i n g a d j o u r n e d . " O n t h e basis o f this,
F r e u d deduced t h e e x i s t e n c e in t h e u n c o n s c i o u s of a c o u n t e r f o r c e lurking
u n s e e n for j u s t such a c h a n c e to b r e a k t h r o u g h and disrupt c o n s c i o u s
n e s s . W a s n ' t it a fact, w h i c h t h e c h a i r m a n would c o n f i r m , t h a t he
c o n s c i o u s l y w a n t e d o n l y t o o p e n t h e m e e t i n g , n o t t o adjourn it?
N e v e r t h e l e s s , t o deal w i t h t h e p h e n o m e n o n o f his e r r o r i n speaking, w e
d o n o t n e e d the u n p r o v a b l e , u n s c i e n t i f i c h y p o t h e s i s o f a n u n c o n s c i o u s .
W e n e e d o n l y the i n s i g h t t h a t t h e c h a i r m a n e x i s t s , a s b e i n g - i n - t h e - w o r l d ,
and as s u c h c o n s i s t s in t h e t o t a l i t y of his p o t e n t i a l for r e l a t e d n e s s to w h a t
he e n c o u n t e r s in his w o r l d . In his e r r o r , t h e c h a i r m a n w a s acting from a
v e r y specific r e l a t i o n s h i p w i t h his fellow club m e m b e r s . H e w a s
d o u b t l e s s e n g a g e d in a n e g a t i v e r e l a t i o n s h i p to t h e a s s e m b l y , and being
w i t h t h e s e people for t h e m e e t i n g w a s a n y t h i n g b u t a p u r e p l e a s u r e h e
w o u l d h a v e w i s h e d t o p r o l o n g . I t m a t t e r s little w h e t h e r o r n o t h e was
t h e m a t i c a l l y a w a r e o f this p o o r r e l a t i o n s h i p a t t h e i n s t a n t h e m a d e his
slip. Slips of t h e t o n g u e can h a p p e n in a n y n u m b e r of w a y s , b u t in no case
a r e t h e y c a u s e d by an i n s t i n c t i v e desire p r e s e n t w i t h i n a capsulelike
p s y c h e . T h e y are c o n s i s t e n t l y a c t u a l i z a t i o n s , r a t h e r , o f a r e l a t i o n s h i p
b e t w e e n people, w h i c h a r e n o t to be found w i t h i n a p s y c h e b u t are m o d e s
o f t h e h u m a n b e i n g - i n - t h e - w o r l d t h a t p e r v a d e s t h e o p e n r e a l m o f the
w o r l d c o m m o n t o all people. E v e n F r e u d s e e m s t o h a v e b e c o m e a w a r e o f
this c i r c u m s t a n c e , for he did r e a c h the c o n c l u s i o n t h a t clues to
u n d e r s t a n d i n g slips m u s t be t a k e n f r o m t h e situation of t h e p e r s o n w h o
m a k e s t h e slips. A s i t u a t i o n is a l w a y s m a d e up of a total e n v i r o n m e n t .
25

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

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m e d i u m for a n u n c o n s c i o u s desire t h a t h a s b e e n r e p r e s s e d b e c a u s e o f its

infantile n a t u r e . It is in accordance with this principle t h a t we h a v e c o n s t r u c t e d
o u r t h e o r y o f t h e d r e a m o n t h e assumption t h a t t h e impelling desire
c o n s i s t e n t l y arises i n t h e u n c o n s c i o u s , s o m e t h i n g t h a t , admittedly,
c a n n o t b e g e n e r a l l y p r o v e n , n o t dismissed o u t o f h a n d . " T h e r e i s n o
m o r e i m p r e s s i v e p r o o f t h a n this t h a t Freud's e n t i r e d r e a m t h e o r y , w i t h
its i n t e n s i v e u s e o f t h e p s y c h i c u n c o n s c i o u s , w a s c r e a t e d n o t for t h e sake
of t h e u n m a n i p u l a t e d d r e a m p h e n o m e n a t h e m s e l v e s b u t solely to suit a
p r e c o n c e i v e d principle.
26

Freud saw undisguised wish-fulfillment dreams as the one proof that

infantile d e s i r e s e x i s t e d in t h e u n c o n s c i o u s and w e r e t h e u n i v e r s a l l y valid
c a u s e of all m a n i f e s t d r e a m i m a g e s . He illustrated his point w i t h r e p o r t s
o f children w h o , h a v i n g g o n e t o bed h u n g r y , would t h e n d r e a m o f o r g i e s
of eating. Conceding that these dreams are not very interesting in
t h e m s e l v e s , F r e u d added t h a t " t h e y are obviously of i n e s t i m a b l e value as
proofs that dreams are, in essence, wish-fulfillments." This conclusion
is no m o r e c o n v i n c i n g t h a n it would be to claim t h a t b e c a u s e t h e r e are
s u c h t h i n g s as w h i t e r o s e s , all r o s e s of o t h e r c o l o r s m u s t be, in t h e i r t r u e
e s s e n c e , w h i t e r o s e s , in disguise.
27

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

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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

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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 .
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

Basic Concepts of Biology, Physiology,

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

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

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FOUNDATIONS

e x t e r n a l w o r l d o p e n e d t h e w a y for m o d e r n p s y c h o l o g y t o develop its

c o n c e p t s of Trieb or drives. B u t b e f o r e p s y c h o l o g y could a r r i v e at its
p r e s e n t n o t i o n o f drives, i t had t o p e r f o r m m a n y c o m p l e x a b s t r a c t i o n s
and f o r c e d r e i f i c a t i o n s .
N o w t h e r e is, a m o n g all t h e varied p o t e n t i a l i t i e s o f relating t o w h a t i s
perceived, o n e p a r t i c u l a r m o d e t h a t c a n b e c a t e g o r i z e d a s a n i n v o l u n t a r y
s u b m i s s i o n to, and a b s o r p t i o n i n t o , this or t h a t t h i n g or being. Its
b o d y i n g f o r t h can h a p p e n i n t h e f o r m o f so-called s e x u a l s e n s a t i o n s , and
it m a y v e r y well h a p p e n as an e r o t i c a t t r a c t i o n of o v e r w h e l m i n g p o w e r .
W h e n it is bodied f o r t h in t h e r e a l m of h u m a n r e l a t i o n s h i p it can lead to
a n o r g a s m i c bodily m e r g i n g o f o n e w i t h t h e o t h e r .
F r o m t h e m a n i f o l d c o m p l e x i t y o f p o t e n t i a l h u m a n w a y s o f being, a
psychological t h e o r y b e n t o n arriving a t t h e p r e s e n t c o n c e p t o f d r i v e s
isolated this o n e m o d e and declared it to be t h e only psychic reality. In t h e
process, it was necessary to conceptualize the observed phenomenon as
the effect o f a n i n t e r n a l m o t i v e force and t o r e d u c e h u m a n b e i n g s t o
t h i n g s r e s e m b l i n g billiard balls. O n l y t h e n could h u m a n n a t u r e b e
r e p r e s e n t e d , in a n a l o g y to an e n g i n e , as a t h i n g driven, or m o v e d , f r o m
inside o r f r o m b e h i n d . I t i s n o t difficult t o s e e h o w m u c h c l o s e r t o reality
t h e original m e a n i n g of Trieb w a s w h e n t h e w o r d still r e f e r r e d to t h e
appeal of a w o m a n to a m a n . T h e n t h e r e w e r e no drives w i t h i n i m a g i n e d
e n d o p s y c h i c c o n t a i n e r s t o impel a m a n t o w a r d a n appealing w o m a n . O n
t h e c o n t r a r y , i t w a s from t h e w o m a n t h a t t h e appeal c a m e t o d r a w t h e
m a n to h e r . T h e w h o l e p r o c e s s w a s v i e w e d as w h a t it is, as an e v e n t in t h e
open realm o f a n " e x t e r n a l , " h u m a n r e l a t e d n e s s .

From psychic agencies to an existential understanding

of human ways of behaving
lnstanz, " a g e n c y , " o r i g i n a t e d in G e r m a n as a judicial c o n c e p t r e f e r r i n g
t o a body a u t h o r i z e d t o pass j u d g m e n t , especially a c o u r t o f law. T h e t e r m
r e f e r s to an e n t i r e t y but w h e n it w a s adopted by p s y c h o l o g y , it w a s u s e d
t o d e s i g n a t e t h r e e different a g e n t s i n e a c h p e r s o n ' s p s y c h e e g o ,
s u p e r e g o , and id. T h i s i n n o v a t i o n tripled t h e i n s u r m o u n t a b l e difficulties
t h a t had b e e n plaguing p s y c h o l o g y e v e n w i t h only a single s u b j e c t , or
psyche, b u t did yield o n e a d v a n t a g e , t h e o n e of w h i c h Freud had b o a s t e d
in r e f e r e n c e to his e a r l i e r n o t i o n s of c o n s c i o u s n e s s , p r e c o n s c i o u s n e s s ,
and the u n c o n s c i o u s . W i t h such n o t i o n s , h e said, o n e could " o p e r a t e
comfortably."
But the t h r e e psychic a g e n c i e s can b e h a n d y t h e o r e t i c a l p l a y t h i n g s o n l y
a s long a s their n a t u r e s are allowed t o r e m a i n u n e x a c t . T h e scientific
d i l l n ulties thai g o with t h e m b e c o m e c l e a r e r w h e n w e n o t e t h a t t h e i r
definitions are n u m e r o u s , diverse, and m u t u a l l y c o n t r a d i c t o r y . Freud

Basic Concepts of Biology, Physiology, and Psychology

14 5

defined t h e e g o - a g e n c y as, a m o n g o t h e r t h i n g s , " a c o h e s i v e , i n t e r n a l

o r g a n i z a t i o n o f psychic p r o c e s s e s a t t a c h e d t o c o n s c i o u s n e s s , w h i c h
c o n t r o l s t h e flow o f e x c i t a t i o n s i n t o t h e e x t e r n a l w o r l d b y m e a n s o f
m o t i v i t y . " C e r t a i n w r i t e r s o u t s i d e the p s y c h o a n a l y t i c fold c h a r a c t e r i z e
t h e e g o a s "an i n s u b s t a n t i a l c l u s t e r o f p e r c e p t i o n s , ideas, and psychic
e x p e r i e n c e s . " Y e t o n e can also h e a r t h a t the e g o is a m e n t a l , or t h i n k i n g ,
s u b s t a n c e , a c o n n e c t i v e c e n t e r , o r c e n t e r o f i n t e n t i o n a l action. T h e n
again, t h e e g o can be supposed to be t h e e s s e n t i a l aspect of a h u m a n
being, the part t h a t e x p e r i e n c e s i t s e l f as a s u b j e c t , in opposition to the
realm o f o b j e c t s , o r a s t h e s e a t o f r e l a t i o n s h i p t o t h e " t h o u . " A n o t h e r
psychological school e l e v a t e s t h e e g o to t h e r a n k of a poniifex oppositorum;
h e r e t h e e g o - a g e n t would f u n c t i o n a s a bridge, o r m e d i u m , b e t w e e n G o d
and p o w e r l e s s m a n , b e t w e e n w a k i n g and d r e a m i n g , mind and n a t u r e ,
s u b j e c t and o b j e c t , t h e m u n d a n e and t h e t r a n s c e n d e n t . T h e e g o - a g e n c y
can do all this, it is claimed, b e c a u s e it is descended from an i n h e r e n t u r g e
t o p a r t i c i p a t e and s o i s able t o t r a n s c e n d its o w n b o r d e r s .
W e could easily give m o r e e x a m p l e s o f c u r r e n t d e f i n i t i o n s , b u t t o d o s o
w o u l d b e u s e l e s s and u n n e c e s s a r y . T h e y all s u f f e r from t h e s a m e flaw.
N o t o n e definition says e n o u g h a b o u t the t r u e n a t u r e o f t h e e g o e v e n t o
explain h o w this e g o m a k e s it possible to p e r c e i v e w h a t we e n c o u n t e r in
o u r w o r l d . No m a t t e r h o w this psychic ^ g o - a g e n c y is m a d e up, it still
posits people as e x i s t i n g i n d e p e n d e n t l y in s o m e space. T h e m y s t e r y still
r e m a i n s t o r e i t e r a t e this a l l - i m p o r t a n t f a c t o f h o w s u c h a p s y c h i c
c o n f i g u r a t i o n could e v e r begin to s u s p e c t t h a t an outside w o r l d is t h e r e ,
m u c h less m o v e o u t o f i t s e l f i n t o t h a t e x t e r n a l w o r l d . T h e v a g u e n e s s o f
t h e s e r e p r e s e n t a t i o n s o f t h e e g o - a g e n c y did n o t s t a y hidden from critical
psychologists. Jung, for instance, confessed that the foundation of the
e g o - a g e n c y , t h e self, w a s s t e e p e d i n m e t a p h y s i c a l o b s c u r i t y . T h e p r o b l e m
i s t h a t for t h e last s e v e n t y y e a r s c r i t i c s h a v e b e e n c o n t e n t t o stop a t s u c h
n e g a t i v e o b j e c t i o n s and c o n t i n u e d t h i n k i n g i n t e r m s o f physically p r e s e n t
psychic e n t i t i e s .
T h e a n c i e n t W e s t e r n w o r l d did n o t k n o w t h e c o n c e p t " e g o . " M a n y have
tried to g e t a r o u n d this by claiming t h a t t h e a n c i e n t G r e e k s w e r e not as
a s t u t e c o n c e r n i n g p s y c h o l o g y , n o t a s a d v a n c e d a s w e a r e today. But t o
t h e less a r r o g a n t , this i n d i c a t e s t h e possibility t h a t h u m a n n a t u r e might
be better understood without hypothesized endopsychic agencies.
T o this day, n o o n e t h a t is, n o o n e w h o has n o t b e e n c o n t a m i n a t e d b y
p s y c h o l o g i c a l t h i n k i n g w o u l d n o r m a l l y d e s c r i b e his e g o a s doing this 0 1
t h a t . He w o u l d say " I , " r e f e r r i n g to h i m s e l f as t h a t c r e a t u r e w h o , at a
g i v e n m o m e n t , i s e n g a g e d i n s o m e s o r t o f p e r c e p t i v e , o r active,
r e l a t i o n s h i p to s o m e t h i n g he e n c o u n t e r s in his w o r l d . W h e n this pet son
s a y s " I , " h e m e a n s t h e v a r i o u s p o t e n t i a l w a y s o f r e l a t i n g and b e h a v i n g o l

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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"

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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

I K i m empathy to an understanding of how human beings

ire directly perceived by each other
Besides the rational faculty, traditional p s y c h o l o g y a s s i g n s t o the
h u m a n mind the c a p a c i t y for e m p a t h y . This supposedly p e r m i t s o n e

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individual to s t e p o u t s i d e of h i m s e l f , slip i n t o a n o t h e r individual, and

t h e n e x p l o r e , as it w e r e , this o t h e r f r o m t h e inside. In this w a y , t h e first
individual is s u p p o s e d to be able to r e c o g n i z e w h a t kind of p e r s o n t h e
o t h e r is. B u t a n y n o t i o n o f e m p a t h y , o f t h e ability t o feel o n e ' s w a y i n t o
a n o t h e r , tacitly a s s u m e s t h a t a n u n d e r s t a n d i n g o f t h a t o t h e r i s already
t h e r e : if I did n o t r e c o g n i z e t h a t o t h e r as a being of my o w n kind, I would
n e v e r k n o w h o w t o begin directing m y e m p a t h y t o t h a t o t h e r . T h e
p r e c o n d i t i o n of e m p a t h y is t h e n the prior, primordial, and i m m e d i a t e
u n d e r s t a n d i n g o f t h e o t h e r a s t h e being h e is. T h i s u n d e r s t a n d i n g o r
perceiving is a p a r t i c u l a r o n t i c fulfillment of t h e f u n d a m e n t a l h u m a n
c h a r a c t e r i s t i c of being able to perceive s o m e t h i n g as s o m e t h i n g .
T h e ability to u n d e r s t a n d o t h e r s directly as fellow h u m a n b e i n g s is
r o o t e d in this basic t r a i t . It m a y m a n i f e s t i t s e l f in a g r e a t m a n y w a y s . It
m a y happen as a v a g u e , superficial p e r c e p t i o n of t h e o t h e r as s o m e h o w
different f r o m o n e s e l f . It m a y be a m i s i n t e r p r e t a t i o n , w h e r e b y t h e o t h e r
p e r s o n is m i s t a k e n as s o m e t h i n g t h a t is simply t h e r e , or an o b j e c t to be
used. Y e t it is also possible for o n e person to b e c o m e e n g a g e d in his
r e l a t e d n e s s to a n o t h e r in such a w a y t h a t t h e o t h e r ' s m o s t subtle
c h a r a c t e r i s t i c s are i l l u m i n a t e d for him. N o t o n e o f t h e s e w a y s o f
understanding another person, however, concerns some human subject
empathizing with the psyche of another.

From psychic cause and psychodynamics to

an understanding of motivational contexts
F r e u d ' s g r e a t e s t i n t e l l e c t u a l a c h i e v e m e n t w a s his supposition t h a t each
p e r s o n ' s life h i s t o r y w a s pervaded w i t h m e a n i n g . H e h i m s e l f c h a r a c t e r
ized this claim as a " b o l d " a s s u m p t i o n . It w a s bold. It o p e n e d up n e w
d i m e n s i o n s to m e d i c i n e , w h i c h until t h e n had dealt e x c l u s i v e l y in
n o n m e a n i n g f u l causal c o n n e c t i o n s . H a v i n g m a d e this a s s u m p t i o n , F r e u d
p r o c e e d e d t o t e s t its validity o n o n e a r e a o f h u m a n p h e n o m e n a a f t e r
a n o t h e r . H e b e g a n b y e x a m i n i n g h y s t e r i c a l s y m p t o m s , d r e a m s , and
e v e r y d a y slips.
T h e w o r d " m e a n i n g f u l " can b e applied w i t h c e r t a i n t y only t o h u m a n
b e h a v i o r , for o n l y o u r o w n a c t i o n s d o w e k n o w t o b e m o t i v a t e d b y t h e
m e a n i n g f u l n e s s o f w h a t r e v e a l s itself i n o u r w o r l d . A s long a s h e w a s
i n v e s t i g a t i n g m e a n i n g f u l n e s s i n b i o g r a p h i c a l p h e n o m e n a , F r e u d quite
logically used t h e w o r d " m o t i v e " to m e a n a c o m p r e h e n s i b l e i n s t i g a t o r of
h u m a n action o r i n a c t i o n . B u t n o s o o n e r w a s Freud's bold a s s u m p t i o n
c o n c e i v e d t h a n it, t o o , c a m e u n d e r t h e d i c t a t o r s h i p o f the d o g m a t h a t
reality was c o m p o s e d e n t i r e l y o f o b j e c t s c o n n e c t e d t h r o u g h u n b r o k e n
calculable causal c h a i n s . W h i l e he c o n t i n u e d paying lip service to the
m e . m m ) ' , of
symptoms,
Freud i n c r e a s i n g l y r e i n t e r p r e t e d what was

Basic Concepts of Biology, Physiology, and Psychology

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

T h e e a s i e s t w a y o u t o f this c o n f u s i o n i s t o let t w o s i t u a t i o n s speak for

t h e m s e l v e s . T h e first e n t a i l s a c a u s e - a n d - e f f e c t r e l a t i o n s h i p a m o n g
n o n h u m a n e v e n t s , t h e s e c o n d an a c t i o n m o t i v a t e d by a h u m a n being and
a p p a r e n t l y similar t o t h e c a u s e - a n d - e f f e c t r e l a t i o n s h i p . Let u s a s s u m e
that a s t r o n g wind b l o w s t h e w i n d o w o f m y study s h u t b e f o r e m y eyes
Th is c o r r e s p o n d s to an o b s e r v a t i o n , a c i r c u m s t a n c e directly perceptible
t h r o u g h t h e s e n s e s . T w o s t a t e s a r e seen t o succeed e a c h o t h e r : w i n d o w
open and, after t h e b l o w i n g of wind, w i n d o w closed. If this s a m e
s u c c e s s i o n o c c u r s r e p e a t e d l y , I will a s s e r t t h a t t h e w i n d o w w a s s h u t
because (weil) t h e wind c a m e up. By putting in this " b e c a u s e " (weil), I have
t r a n s f o r m e d t h e simple s t a t e m e n t o f a p e r c e p t i o n ( " W h e n t h e w i n d
blows, t h e n . . .") into a s t a t e m e n t of e x p e r i e n c e ( " B e c a u s e [weil] t h e wind
blows, the w i n d o w i s s h u t . " ) . A n i n e v i t a b l e s u c c e s s i o n has n o w b e c o m e
s o m e t h i n g m o r e : t h e w i n d o w ' s s h u t t i n g i s n o w i n t e r p r e t e d a s t h e effect
ol a c a u s e . T h i s i n t e r p r e t a t i o n is, in reality, an e x p l a n a t i o n in a c c o r d a n c e
with the principle of c a u s a l i t y .
In ( J e r m a n , t h e causal c o n j u n c t i o n weil ("because") r e f e r r e d originally
to time. It m e a n t " w h i l e " (with which it s h a r e s an I n d o - E u r o p e a n r o o t ) ,

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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 . "
W e h a v e s t r e s s e d t h a t t h e r e i s s o m e limited j u s t i f i c a t i o n for applying
t h e principle o f c a u s a l i t y i n t h e practical t r e a t m e n t o f d i s t u r b a n c e s o f
physical h e a l t h , b u t t h a t it is i m p e r a t i v e to r e m e m b e r t h a t this principle is
wholly inadequate w h e r e a proper understanding of any human mode of
being i s c o n c e r n e d . T o g e t back t o o u r i l l u s t r a t i o n , i t m i g h t well h a v e
h a p p e n e d t h a t t h e w i n d o w w a s s h u t not by a g u s t of w i n d , b u t by m e ,
b e c a u s e t h e s t r e e t n o i s e w a s distracting m e . N o w t h e r e a s o n t h e w i n d o w
is s h u t b e c o m e s a g e n u i n e m o t i v e : n a m e l y , my desire for p e a c e and quiet.
H o w does this m o t i v e c o m p a r e w i t h w h a t w e called t h e c a u s e o f t h e first
instance of the shut window, the wind?
My closing t h e w i n d o w , m o t i v a t e d as it is by my wish for peace and
quiet, b y n o m e a n s r e p r e s e n t s a m e r e inevitable s u c c e s s i o n o f s t a t e s .
T r u e , t h e w i s h e d - f o r p e a c e and quiet is t h e reason b e h i n d my closing t h e
w i n d o w , b u t this reason is s o m e t h i n g totally d i f f e r e n t f r o m t h e cause as
n a t u r a l s c i e n c e s e e s c a u s e . T h e r e a s o n s u n d e r l y i n g m y h u m a n a c t i o n s are
the distracting s t r e e t n o i s e and t h e peace and q u i e t I w o u l d like to h a v e in
m y r o o m . T h e w i n d o w w o u l d n e v e r h a v e b e e n closed, t h e r e f o r e , i f I had
n o t been in a position to a p p r e h e n d s o m e t h i n g t h e r e t h a t m e a n t n o i s e ,
and a b o v e all, to a n t i c i p a t e a f u t u r e s t a t e , a f t e r t h e w i n d o w had b e e n
s h u t , t h a t m e a n t peace and quiet. S u c h m e a n i n g s can r e v e a l t h e m s e l v e s
only w i t h i n t h e s o r t o f p e r c e p t i v e o p e n n e s s t h a t c o n s t i t u t e s t h e
specifically h u m a n m o d e o f being. A g u s t o f w i n d , t h o u g h i t t o o m a y s h u t
t h e w i n d o w , can k n o w n o t h i n g o f t h e s i g n i f i c a n c e o f n o i s e , o r o f p e a c e
and quiet.
M o t i v e s , as well as t h a t t o w a r d w h i c h m o t i v e s are directed, a r e
d e t e r m i n e d by an i m p e n d i n g t a s k t h a t h a s been r e c o g n i z e d and a c c e p t e d .
M y motive i n closing t h e w i n d o w is, i n t h e last a n a l y s i s , t h e f u t u r e o f t h e
book 1 feel an obligation to w r i t e . S u c h r e a s o n s allow me f r e e d o m of
< h o n e . A s m o t i v e s , perceiving n o i s e and e x p e c t i n g peace do not compel m e
I o at I
1 could leave the w i n d o w o p e n in spite o f the n o i s e a n d p o s t p o n e
m y w i Iting T h e noise and the open w i n d o w a r e not like9 i e n t i f i c e v e n t s
obeying the principles o f c a u s a l i t y i n t h a t t h e y d o not s u c c e e d e a c h o t h e r

Basic Concepts of Biology, Physiology, and Psychology

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 .
B y n o w i t should b e p a t e n t l y o b v i o u s t h a t c a u s e and m o t i v e are t w o
v e r y different t h i n g s . T h i s d i f f e r e n c e i s n o t c o n f i n e d t o t h e n e c e s s i t y o f
n o n h u m a n , causal p r o c e s s e s as o p p o s e d to t h e f r e e d o m c h e r a c t e r i s t i c of a
p e r s o n ' s r e l a t e d n e s s to a m o t i v e ; it implies t h a t t h e r e a r e t w o radically
different dimensions, one the domain of causes, the o t h e r of motives.
T h e process of interpretation that psychological theories have
p e r f o r m e d on t h e idea of p s y c h i c m o t i v e s , or m o t i v a t i o n s , b e g i n s w i t h a
s e v e r e reduction o f t h e original m e a n i n g o f t h e s e t e r m s . B o t h " m o t i v e "
and " m o t i v a t i o n " s t e m f r o m t h e Latin v e r b movere, movi, motus, m e a n i n g
" t o m o v e . " I n A r i s t o t l e ' s t i m e , f o u r distinct types o f m o t i o n w e r e
r e c o g n i z e d . M o d e r n n a t u r a l s c i e n c e h a s lost sight o f all b u t " m o t i o n , " a
physical body's c h a n g e of location in t i m e , e f f e c t e d by a f o r c e a c t i n g upon
t h a t body. I n keeping w i t h this n a r r o w definition, m o d e r n p s y c h o d y n a m ic t h e o r i e s h a v e also divided h u m a n b e i n g s into t w o c o m p o n e n t s , a
m o v i n g f o r c e and a m o v e d t h i n g . T h a t w h i c h is m o v e d is called, v a r i o u s l y ,
t h e e g o , o r s u b j e c t , o r t h e h u m a n body. T h e m o v i n g f o r c e i s m o s t o f t e n
given t h e n a m e drive, o r n e e d .
T h u s it is concluded, f o r i n s t a n c e , t h a t an i n s u f f i c i e n t c o n c e n t r a t i o n of
s u g a r in t h e blood will a c t u a t e , in s o m e m y s t e r i o u s fashion, a h u n g e r
drive and desire for e a t i n g w i t h i n the p s y c h e . T h i s i n t e r n a l drive,
f u n c t i o n i n g as a causal m o t i v e in t h e p s y c h o d y n a m i c p r o d u c t i o n of a
specific b e h a v i o r a l s e q u e n c e , will t h e n impel t h e h u n g r y p e r s o n t o eat
s o m e t h i n g s w e e t . O r , a p e r s o n m a y be m o t i v a t e d to an a c t i o n by t h e sight
of a r a g g e d b e g g a r s q u a t t i n g by t h e c u r b . E v e n a m o t i v e like this is
t r a n s l a t e d , in t h e p s y c h o l o g i c a l tradition, into a causal r e l a t i o n s h i p or
p s y c h o d y n a m i c p r o c e s s t h u s : t h e s i g h t o f t h e b e g g a r i s alleged t o a w a k e n
the idea of m i s e r y in my e g o - c o n s c i o u s n e s s , w h i c h t h e n p e n e t r a t e s to an
e v e n g r e a t e r p s y c h i c d e p t h , w h e r e it stirs up altruistic i m p u l s e s , a f f e c t s ,
and drives w i t h s u c h i n t e n s i t y and p e r s i s t e n c e t h a t its p s y c h o d y n a m i s m
is able to m o v e my e g o and my body to give t h e b e g g a r a coin. C e r t a i n l y ,
in c o n t e m p o r a r y p s y c h o l o g y , m o t i v a t i o n is s o m e t h i n g m o r e than a m e r e
efficient c a u s e , for this s e c o n d illustration s h o w s t h a t m o t i v a t i o n may be

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EXISTENTIAL

FOUNDATIONS

used to m e a n a f u t u r e - d i r e c t e d , finalistic c a u s e . Still, this added m e a n i n g

does n o t f u n d a m e n t a l l y a l t e r the c u r r e n t l y m o s t popular i n t e r p r e t a t i o n
of m o t i v a t i o n as a causal r e l a t i o n s h i p b e t w e e n p o w e r f u l psychic c a u s e s
and their e f f e c t s , physical and m e n t a l c h a n g e s o f place c o r r e s p o n d i n g t o
shifts w i t h i n an e n d o p s y c h i c s y s t e m .
P s y c h i c c a u s e s and p s y c h o d y n a m i c s c a n n o t e x i s t , b e c a u s e t h e psychic
part of t h e m is c o n c e r n e d e x c l u s i v e l y w i t h a p e r s o n ' s w a y s of r e l a t i n g
e m o t i o n a l , r a t i o n a l , hopeful, a c t i v e , p e r c e p t i v e , and s o f o r t h t o w h a t
m a t t e r s to him in his world, and in his d i m e n s i o n t h e r e are o n l y
comprehensible motivational contexts. Any psychological theory that
t r a n s l a t e s a m o t i v e or m o t i v a t i o n a l c o n t e x t i n t o a psychic c a u s e or a
p s y c h o d y n a m i c causal chain d e s t r o y s t h e v e r y f o u n d a t i o n o f h u m a n
being.
Recognition of the unbridgeable chasm that separates causes from
m o t i v e s lets us see h o w f u n d a m e n t a l l y u n h u m a n a r e all p s y c h o l o g i c a l
t h e o r i e s w h i c h , allegedly for the sake of being scientific, t r y to force
m o t i v a t e d h u m a n b e h a v i o r into the d i m e n s i o n o f t h e principle o f physical
causality. S u c h n o t i o n s fail t o a c c o m m o d a t e t h e g r e a t a b u n d a n c e o f
c o n t e x t s of m e a n i n g and r e f e r e n c e i n h e r e n t in t h i n g s t h a t m a k e up a
c o m p r e h e n s i b l e h u m a n w o r l d and exile t h e scientific i m a g i n a t i o n f r o m
t h e only d i m e n s i o n in w h i c h h u m a n being can disclose i t s e l f as it t r u l y is.
NOTES
1. Of these philosophers, Jean-paul Sartre, Merleau-Ponty, A. de Waelhens, G. Marcel,
and P. R i c o e u r d e s e r v e special m e n t i o n in this c o n n e c t i o n .
2. F o r a d i s c u s s i o n of t h e i r s t u d i e s , s e e : M. B o s s , Einfhrung in dir psychosomatische Medizin
( B e r n a n d S t u t t g a r t : H a n s H u b e r , 1 9 5 4 ) , pp. 5 1 - 6 6 .
3. J.P. S a r t r e , L'Etre et le N a n t (Paris: Librarie G a l i m a r d , 1 9 5 3 ) , p. 3 7 0 .
4. T h e italics are m i n e .
5. J . P . S a r t r e , La Nause'e ( P a r i s ; 1 9 3 8 ) , pp. 1 6 2 f .
6. M. H e i d e g g e r , Sein und Zeit, p. 4 0 .
7. C f . S a r t r e , L'Imagination ( P a r i s : 1 9 3 6 ) , p. 1.
8. M. M e r l e a u - P o n t y , Phnomnologie de la Perception ( P a r i s : 1 9 4 5 ) .
9. M e r l e a u - P o n t y , L'Oeil et l'Espirit ( P a r i s : P r e s s e s U n i v e r s i t a i r e s , 1 9 6 1 ) , p. 1 9 8 .
1 0 . Ibid., p . 2 2 3
1 1 . M e r l e a u - P o n t y , Signes ( P a r i s : 1 9 6 0 ) , p . 2 1 0 .
1 2 . M e r l e a u - P o n t y , " L ' e s p i r i t n u t i l i s e p a s l e c o r p s m a i s s e fait a t r a v e r s lui e n l e
t r a n s f r a n t h o r s de l ' e s p a c e p h y s i q u e , " in La Structure du Comportment ( P a r i s : 1 9 4 2 ) , p. 2 2 5 .
1 3 . M e r l e a u - P o n t y , Signe: la philosophie et son ombre ( P a r i s : 1 9 6 0 ) , p. 2 1 0 .
1 4 . M . H e i d e g g e r , " B a u e n , W o h n e n , D e n k e n , " i n Vortrge und Aufstze ( P f u l l i n g e n : N e s k e ,
Inc., 1 9 3 4 ) , pp. 1 4 5 f f .
1 5 . M e r l e a u - P o n t y , Phnomnologie de la Perception ( P a r i s : 1 9 4 5 ) , p. 1 0 9 .
16. 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 t h a t i s p o s s i b l e h e r e o f t h e r e l a t i o n s h i p b e t w e e n t h e
o p e n n e s s o f h u m a n e x i s t e n c e and t h e clearing t h a t yields this o p e n n e s s , see M . H e i d e g g e r ,
/.m Sache des Denkens ( T u b i n g e n : N i e m e y e r , 1 9 6 9 ) , pp. 16 a n d 2 2 .
17. K

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 .

Basic Concepts of Biology, Physiology, and Psychology

153

1 8 . S. F r e u d , Die Traumdeutung, in Gesammelte Werke, vol. 2 / 3 , ( L o n d o n : I m a g o , I n c . ,

pp. 5 4 6 - 4 7 a n d 6 1 7 . A l s o : Das Ich und das Es, v o l . 1 3 , p. 2 4 5 .

|0.|2),

1 9 . F r e u d , " E i n i g e B e m e r k u n g e n b e r d e n B e g r i f f d e s U n b e w u s s t e n , " i n Gesammelle Werke,

vol. 8, ( L o n d o n : I m a g o , Inc., 1 9 4 3 ) , p. 4 3 8 .
2 0 . Ibid., p . 4 3 9 .
2 1 . Ibid., p . 4 3 7 ff. a n d Das Unbewusste, v o l . 1 0 , p . 2 8 5 f f .
2 2 . S . F r e u d , " D i e R e c h t f e r t i g u n g d e s U n b e w u s s t e n , " in Ges. W. v o l . 1 0 : Das Unbewusste,
( L o n d o n : 1 9 4 6 ) , p p . 2 6 4 ff.
2 3 . Ibid., p . 2 6 5 . I t a l i c s m i n e .
2 4 . S. F r e u d , Das Ich und das Es, in Gesammelte Werke, v o l . 13 ( L o n d o n : I m a g o , I n c . ) , p. 2 4 0 .
2 5 . S. F r e u d , Vorlesungen zur Einfuhrung in die Psychoanalyse, in Gesammelte Werke ( L o n d o n :
I m a g o , Inc.), vol. 1 1 , p . 3 4 .
2 6 . T h e italics are mine.
2 7 . S. F r e u d , Die Traumdeutung, in Gesammelte Werke ( L o n d o n : I m a g o , I n c . ) , v o l 2 / 3 , p. 1 3 2 .
2 8 . T h e r e a l d e p t h s o f t h i s m a t t e r a r e s o u n d e d b y H e i d e g g e r i n h i s Zur Sache des Denkest!
(Tubingen: Niemeyer, 1969).
2 9 . T h e G e r m a n language provides a special access to understanding the p h e n o m e n o n of
t h e p r i m o r d i a l t e m p o r a l i t y o f h u m a n e x i s t e n c e , i n h a v i n g t h e v e r b zeitigen, sich zeitigen. T h i s
w o r d m e a n s a b e i n g ' s " s h i n i n g f o r t h , " " m a t u r i n g , " o r b e t t e r " a c t u a l i z i n g i t s e l f i n its g i v e n
time at the appropriate t i m e . " In this verb, then, is an i m m e d i a t e recognition of the
f u n d a m e n t a l and n e c e s s a r y c o n n e c t i o n b e t w e e n a being's being and t i m e , t h a t it has a
c e r t a i n t i m e at its disposal, and t h a t its possibilities of e x i s t i n g h a v e to be actualized in this
time at an appropriate time. T h e v e r b has the sense of "using one's t i m e " or "living out one's
t i m e . " In t h e English and t h e R o m a n c e l a n g u a g e s it is difficult to i l l u m i n a t e this
p h e n o m e n o n so directly and immediately, while, by c o n t r a s t , G e r m a n , S a n s k r i t and G r e e k
a l l o w t h i s p a r t i c u l a r p h e n o m e n o n t o b e s p o k e n o f a n d i l l u m i n a t e d . E v e r y l a n g u a g e h a s its
w e a k n e s s e s and s t r e n g t h s . O n e allows a c e r t a i n p h e n o m e n o n t o b e s e e n and t h o u g h t m o r e
clearly, a s e c o n d allows a different p h e n o m e n o n to be seen, one which m a y be partially or
totally inaccessible to the first. T h a t a w o r d c a n n o t be translated, then, in no w a y m e a n s
that the p h e n o m e n o n w h i c h this w o r d b r i n g s to light is illusory simply b e c a u s e a second
l a n g u a g e d o e s n o t k n o w it.
3 0 . 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 ) , pp. 7 5 f f .
3 1 . H. T h o m a e ,
Witsch, 1 9 6 5 ) .

Die Motivation menschlichen Handelns,

(Cologne, Berlin:

K i e p e n h e u e r and

Chapter 9
CRITICISMS OF AN EXISTENTIAL METHOD OF
MEDICAL INVESTIGATION

Of the most common objections to introducing an existential research

m e t h o d i n t o m e d i c i n e , t h e following t w o c a t e g o r i e s s t a n d o u t : (1) T h e
e x i s t e n t i a l approach is said to be u n s c i e n t i f i c , hostile to c o n c e p t s , lacking
in o b j e c t i v i t y ; (2) T h e d e s c r i p t i o n s of Da-sein and t h e basis for t h e
possibility of t h e Da-sein a r e m e r e l y allegorical and n a r r o w l y f u n c t i o n a l .
W e m a y say o f t h e o b j e c t i o n s i n t h e first g r o u p t h a t t h e s e c h a r g e s are
closely r e l a t e d in t h a t a n y o n e levelling t h e m o u g h t to be in a position at
least t o deliver precise definitions for the t e r m s " s c i e n t i f i c , " " c o n c e p t , "
and " o b j e c t i v e . " T h e v e r y fact t h a t t h e s e c h a r g e s a r e a l m o s t a l w a y s raised
s e p a r a t e l y r e v e a l s t h a t t h e r e i s n o c l e a r r e c o g n i t i o n o f t h e n a t u r e o f the
a c c u s a t i o n s , f o r at b o t t o m all t h r e e are really a single o b j e c t i o n t h a t is
basically c h a r g i n g t h e Dasnn-based approach to m e d i c i n e w i t h n o t being a
natural scientific r e s e a r c h m e t h o d . W h a t is being o b j e c t e d to is e x a c t l y
w h a t t h e e x i s t e n t i a l a p p r o a c h s e e s as its main c o n t r i b u t i o n to m e d i c i n e .
T h i s a p p r o a c h sees its perspectivedecidedly n o t n a t u r a l scientific, but
p h e n o m e n o l o g i c a l a s o p e n i n g up an u n d e r s t a n d i n g of all t h e a r e a s of
h u m a n Da-sein to w h i c h t h e n a t u r a l scientific o r i e n t a t i o n can n e v e r gain
access.
O n l y b y m a k i n g a n a b s o l u t e d o g m a o f the basic t e n e t s o f natural
s c i e n c e could its a d h e r e n t s e v e r inflate the simple fact o f the n o n n a t u r a l

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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.

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C h a r a c t e r i s t i c a l l y , the a n c i e n t G r e e k s , t h o u g h a s s u r e d l y n o less agile

o f mind t h a n w e , did n o t h a v e t h e idea " c o n c e p t . " T h e n e a r e s t equivalent
w a s logos. Y e t logos is d i f f e r e n t . It m e a n s w h a t can be said a b o u t the
particular a p p e a r a n c e , or eidos ("idea"), of a p h e n o m e n o n . T h i s a f f i r m a
tion is n o t a grasping of t h e p h e n o m e n o n in o b e d i e n c e to s o m e p r e f o r m e d
c o n c e p t i o n of it, but i n s t e a d a f i r s t h a n d visualizing of its a p p e a r a n c e . T h e
" c o n c r e t e " R o m a n s first c a m e up w i t h t h e idea of a conceptus, a n o u n
deriving from t h e v e r b capere, " t o t a k e hold o f , " " t o c a p t u r e . "
W e n e e d t o ask c o n c e r n i n g t h e m o d e r n t e r m " c o n c e p t " j u s t h o w i t
would " t a k e hold o f " t h i n g s . T h e usual a n s w e r w o u l d be: t h r o u g h a
definition. For e x a m p l e , we define " t a b l e " by saying t h a t it is a useful
o b j e c t ; this is its g e n e r i c definition. To isolate t h e table as t h e specific
useful o b j e c t t h a t it is, we m u s t specify w h a t particular p u r p o s e it s e r v e s .
D e f i n i n g the specific u s e of t h e table as a g a i n s t t h e u s e s of, say, a pencil or
a glass, is n a m i n g t h e specific d i f f e r e n c e . T h e definition will say
s o m e t h i n g g e n e r a l , and s o m e t h i n g specific, a b o u t t h e o b j e c t t o w h i c h i t
r e f e r s . In this w a y a p a r t i c u l a r t h i n g is d i s t i n g u i s h e d f r o m e v e r y o t h e r
thing.
It is i m p o r t a n t to u n d e r s t a n d t h a t e v e r y c o n c e p t u a l i z a t i o n is a kind of
r e - p r e s e n t i n g of a t h i n g . F o r i n s t a n c e , w h e n I say " t r e e , " s o m e t h i n g
" p r e s e n t s " itself, is r e - p r e s e n t e d to m e . I do n o t m e a n an o a k , or a maple,
or a pine, I am t h i n k i n g of a " t r e e . " T h i s kind of c o n c e p t u a l i z a t i o n is said
t o arise o u t o f a n a b s t r a c t i o n , w h e r e b y t h e specific p r o p e r t i e s o f e a c h
type of t r e e , w h i c h m a k e an o a k an oak and a pine a pine, a r e stripped
a w a y . Y e t it is difficult to u n d e r s t a n d h o w m e r e l y t a k i n g t h i n g s a w a y can
produce a c o n c e p t . I can a b s t r a c t s o m e t h i n g (the specific p r o p e r t i e s ) f r o m
s o m e t h i n g else o n l y w h e n t h e t h i n g from w h i c h s o m e t h i n g i s a b s t r a c t e d
is already p r e s e n t for m e .
O t h e r s say w e a r r i v e a t t h e g e n e r i c c o n c e p t " t r e e " t h r o u g h c o m p a r i n g
all t r e e s w i t h e a c h o t h e r . T o t h i s w e o b j e c t , first o f all, o n t h e g r o u n d s
t h a t it is i m p o s s i b l e for o n e p e r s o n to perceive s i m u l t a n e o u s l y , and to
c o m p a r e , e v e r y t r e e . M o r e t h a n t h i s , t h o u g h , I could n e v e r c o m p a r e e v e n
two t r e e s u n l e s s I already k n e w t h e n a t u r e of " t r e e - n e s s . " W i t h o u t this
k n o w l e d g e , I could n o t p e r c e i v e t h e t w o t h i n g s as t r e e s , and hold t h e m up
for c o m p a r i s o n w i t h e a c h o t h e r . C o n s e q u e n t l y , t h e r e c o g n i t i o n o f w h a t
m a k e s a t r e e e s s e n t i a l l y a t r e e m u s t precede a n y c o m p a r i s o n of individual
t r e e s ; it is t h e f r a m e of r e f e r e n c e t h a t lets me see s o m e t h i n g in c o m m o n
b e t w e e n , say, an o a k and a pine.
T h e so-called g e n e r i c t r e e is, t h e n , n e i t h e r a p u r e l y c o n c e p t u a l
abstraction, nor a product of mental comparison. T h e word "tree"
discloses a n identical " t r e e - n e s s " pervading all t r e e s . W h e n e v e r w e
perceive a n individual t r e e , t h e c o n t e x t s o f m e a n i n g and r e f e r e n c e o f this

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" t r e e - n e s s " a r e i n h e r e n t l y p r e s e n t , and it is o n l y on t h e basis of this

p r e s e n c e t h a t we r e c o g n i z e w h a t e v e r it is as being a t r e e . All
c o n c e p t u a l i z a t i o n is p r e f i g u r e d in t h e n a m i n g of t h i n g s , in calling a being
this or t h a t , in l a n g u a g e as s u c h .
N o w it is t i m e to ask again w h e t h e r e v e r y t h i n g t h a t is can be c a p t u r e d
i n p r e c i s e , f u n c t i o n a l c o n c e p t s . M i g h t n o t this w a y o f c a p t u r i n g t h i n g s
have its l i m i t a t i o n s ? T h e c o m p a r i s o n o f varied i n s t a n c e s o r c a s e s does
play a part, t h o u g h s e c o n d a r y , in c o n c e p t - f o r m a t i o n , and t h e r e is as well
s o m e a b s t r a c t i o n o f e s s e n t i a l f e a t u r e s a t w o r k i n this p r o c e s s . B u t
f u n d a m e n t a l to a n y c o n c e p t u a l i z a t i o n is perceiving and r e t a i n i n g t h e
u n c h a n g i n g i d e n t i t y t h a t c o m p r i s e s t h e f u n d a m e n t a l n a t u r e o f each
thing t h a t is d e s i g n a t e d by a c o n c e p t . And in e v e r y c a s e , this n a t u r e m u s t
have b e e n perceived in a d v a n c e .
W h a t is the n a t u r e of t h e identity u n d e r l y i n g all c o n c e p t u a l i z a t i o n s ?
To claim identity for a t h i n g m e a n s t h a t this t h i n g e n d u r e s as o n e and t h e
s a m e with itself. W e r e this i d e n t i t y not c h a r a c t e r i s t i c of all o n t i c b e i n g s ,
t h e r e could b e n o n a t u r a l s c i e n c e . And s o t h e r e a r e s o m e t h i n g s t h e
v e r y t h i n g s , in fact, t h a t p r e d i c a t e and s u p p o r t h u m a n b e i n g s w h i c h can
b e grasped o n l y i f t h e y a r e allowed t o p r e s e n t t h e m s e l v e s a s w h a t t h e y
are and c a n n o t be e x p l a i n e d by c o m p a r i s o n and a b s t r a c t i o n . A b o u t
identity, for e x a m p l e , o n l y n e g a t i v e s t a t e m e n t s can be m a d e . It can be
declared o n l y t h a t i d e n t i t y is identity, a t r u e t a u t o l o g y .
S u c h p h e n o m e n a e x i s t n o t least of all in t h e r e a l m of m e d i c i n e , w h e r e
h u m a n being s t a n d s i n t h e f o r e g r o u n d . H e r e m o d e s o f 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 a r e n o t m e r e l y i n a d e q u a t e but do n o t belong in t h e
first place. W h e n e v e r n a t u r a l scientific critics a c c u s e d a s e i n s a n a l y s i s o f
hostility to c o n c e p t s , t h e y are placing t h e m s e l v e s in a d a n g e r o u s position,
for it m a y well be t h a t medical t h i n k i n g is m o s t a d e q u a t e to its t a s k w h e n
it is able to deal w i t h p h e n o m e n a t h a t a r e not s u b j e c t to d e t e r m i n a t i o n
through exact, functional concepts. T h e r e may be phenomena that resist
being g r a s p e d in this w a y . T h e s e we could o n l y point o u t and r e f e r to as
such. T h e y h a v e t o b e s e e n perceivingly and u n d e r s t a n d i n g l y i n t h a t t h e y
c a n n o t b e g r a s p e d b y t h e s e n s e s o r t h e scientific i n s t r u m e n t s w h i c h are
t h e i r e x t e n s i o n s . T h e y a r e e i t h e r s e e n i m m e d i a t e l y , directly, o r n o t a t all,
i f o n e ' s p e r c e p t i o n i s blind t o t h e m . W h e n w e say t h a t t h e s e p h e n o m e n a
are " g i v e n , " and t h a t all we can do is point t h e m o u t , this "all" should n o t
be t a k e n as a failing. R a t h e r , such p e r c e i v i n g preceeds and u n d e r l i e s all
c o n c e p t u a l i z a t i o n . T h e c r i t i c i s m t h a t t h e r e can b e n o scientific s e e i n g o r
knowing without conceptual abstraction proves groundless. It arises
only out o f d o g m a t i z a t i o n o f o n e o f t h e m a n y possible scientific m e t h o d s :
the natural scientific m e t h o d . F u r t h e r m o r e , this p a r t i c u l a r m e t h o d is far
from having d e m o n s t r a t e d its unequaled suitability to describe h u m a n
n.il in i'

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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

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w i t h the light m e t a p h o r from Plato's p a r a b l e o f t h e cave. T o c o u n t e r this

g r a v e m i s u n d e r s t a n d i n g we can o n l y affirm t h a t light, as t h a t w h i c h
i l l u m i n a t e s and c a s t s s h a d o w s , is n o t t h e c l e a r i n g w h i c h r e f e r s to
u n o b s t r u c t e d n e s s and o p e n n e s s . N e i t h e r this c l e a r i n g n o r the e x i s t e n t i a l
o p e n n e s s in it, a r e to be t a k e n as m e r e s i m i l e s , m e t a p h o r s , or allegories.
C l e a r i n g , o r o p e n n e s s , is, r a t h e r , t h e n a m e c o r r e s p o n d i n g directly t o the
primordial p h e n o m e n o n t h a t is t h e p r i m a l origin of b e i n g - n e s s as such
and of all p a r t i c u l a r b e i n g s in space and t i m e as well: m a n , his world, and
the relatedness between them.
1

F r o m t h e opposite e x t e m e , t h e Dasei'n-based d e s c r i p t i o n s o f the

c h a r a c t e r i s t i c s o f t h e h u m a n being and t h e i r primordial s o u r c e a s
opposed to c a u s e a r e labeled as p u r e l y f u n c t i o n a l or o p e r a t i o n a l
c o n c e p t s . T h i s i s a n a t t e m p t t o i n t e g r a t e D a s e i n s a n a l y s i s into the
p r a g m a t i c t h i n k i n g o f m o d e r n n a t u r a l s c i e n c e , s o t h a t this alien a p p r o a c h
can be disposed of, o n c e and for all. J u s t as c o n t e m p o r a r y physics and
physicalistic p s y c h o l o g y e m p l o y t h e i r c o n c e p t s o n l y for t h e sake o f
c o n v e n i e n c e o f a r g u m e n t , w i t h o u t a t t r i b u t i n g a n y real m e a n i n g t o the
c o n c e p t ' s n a m e , so D a s e i n s a n a l y s i s is t h o u g h t to o p e r a t e w i t h its basic
terms.
W e o b j e c t t o t h e p r a g m a t i c m i s u s e o f d a s e i n s a n a l y t i c descriptions o f
h u m a n e x i s t e n c e and its b e i n g - i n - t h e - w o r l d . T h e s e s t a t e m e n t s are
directed e x c l u s i v e l y t o w a r d a n a p p r o p r i a t e direct c h a r a c t e r i z a t i o n o f the
o n t o l o g i c a l and o n t i c p h e n o m e n a o f h u m a n e x i s t i n g . T h e r e i s n o i n t e n t t o
m i s r e p r e s e n t t h e c h a r a c t e r of t h e Da-sein for o p e r a t i o n a l r e a s o n s .
NOTE
1

C f . M. H e i d e g g e r , Zur Sache des Denkens ( T u b i n g e n : 1 9 6 9 ) , pp. 50 a n d 7 2 .

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

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inspires t h e f o r m u l a s " a s s u m i n g t h a t . . . " and " i f . . . t h e n . " T h e n a t u r a l

scientific a s s u m p t i o n stipulates c o n d i t i o n s t h a t are n e i t h e r directly
perceived, n o r p e r c e i v a b l e , s o t h a t the scientific f o r m o f a c c e p t a n c e i s
t a n t a m o u n t to a h y p o t h e s i s a b o u t t h e feasibility of an e x p e r i m e n t .
T h e Dasrin-based a c c e p t a n c e o f w h a t h u m a n b e i n g s e n c o u n t e r i s
s o m e t h i n g else indeed. T w o s o r t s o f p h e n o m e n a a r e a l w a y s e v i d e n c e d i n
this kind of a c c e p t i n g and r e c e i v i n g . T h e table in f r o n t of a p e r s o n r e v e a l s
itself, for i n s t a n c e , as an o b j e c t t h a t can be perceived t h r o u g h t h e s e n s e s ,
w i t h its c h a r a c t e r i s t i c qualities o f h e i g h t , l e n g t h , w i d t h , w e i g h t , c o l o r ,
t e x t u r e , and so o n , b u t a p e r s o n will also p e r c e i v e t h e p h e n o m e n o n of t h e
table's being " t h e r e . " T h e table m a y also be e x p e r i e n c e d as a useful o b j e c t .
N o w , the p r e s e n c e and t h e utility o f t h e table a r e n o t perceptible qualities
o n t h e o r d e r of, say, " b r o w n . " W e could i n v e s t i g a t e t h e table t o o u r
h e a r t s ' c o n t e n t s a w it i n t o pieces, b r e a k it a p a r t , s u b j e c t it to c h e m i c a l
a n a l y s i s a n d still we w o u l d n o t h a v e found its p r e s e n c e as t a b l e . N e v e r
t h e l e s s , t h e p r e s e n c e of t h e table as table, t h e fact t h a t it is, and what it is (a
useful o b j e c t ) , can b o t h be p e r c e i v e d , t h o u g h such perceiving is n o t
directly b o u n d t o s e n s e p e r c e p t i o n . I n s u m , t h e n , t h e o b j e c t ' s p r e s e n c e
and utility a r e b o t h g e n u i n e p h e n o m e n a , i n t h e s e n s e o f the G r e e k
phainesthai, w h i c h m e a n s " t o reveal i t s e l f . "
P h e n o m e n a o f t h e first kind, c o n s i s t i n g o f all t h a t m a y b e p e r c e i v e d o f
s o m e t h i n g t h r o u g h t h e s e n s e s , a r e called o n t i c ; t h e s e c o n d c a t e g o r y ,
t h o s e p h e n o m e n a t h a t a r e e x p e r i e n c e d and s e e n d i r e c t l y , n o t t h r o u g h t h e
medium of the senses, is the ontological.
B e c a u s e t h e y c a n n o t b e perceived t h r o u g h t h e s e n s e s , i t i s t e m p t i n g t o
e q u a t e o n t o l o g i c a l p h e n o m e n a w i t h t h e a b s t r a c t i o n s and h y p o t h e s e s o f
n a t u r a l s c i e n c e , b u t t h e y h a v e n o t h i n g in c o m m o n . A n a t u r a l scientific
t h e o r y a l w a y s c o n s i s t s in suppositions c o n c e r n i n g t h e feasibility of an
e x p e r i m e n t . S u c h a t h e o r y has no literal e x i s t e n c e of its o w n . All s e n s o r y
and o n t o l o g i c a l p h e n o m e n a , o n the o t h e r h a n d , are i m m e d i a t e l y
perceptible and are t h e r e f o r e w h o l l y d i f f e r e n t in kind from t h e a b s t r a c t
s u p p o s i t i o n s c o n t a i n e d in n a t u r a l scientific, s o m a t o l o g i c a l , p s y c h o l o g i c a l
t h e o r i e s . T h e r e i s n o affinity w h a t s o e v e r b e t w e e n t h e p r e s e n c e and
utility o f t h e t a b l e , and w h a t i s s u m m o n e d u n d e r t h e n o t i o n o f i n s t i n c t o r
affect. I n s t i n c t s and a f f e c t s are n o t h i n g m o r e t h a n i n t e l l e c t u a l c o n s t r u c t s
w h i c h w e r e t h o u g h t o u t for t h e e x p r e s s p u r p o s e o f m a k i n g t h e p s y c h i c
p h e n o m e n o n in q u e s t i o n c o m p a r a b l e to physical b e i n g s so it could be
rendered calculable and be derived from s o m e h y p o t h e t i c a l c a u s e . It is
i m p o r t a n t t o r e m e m b e r t h a t t h e actual e x i s t e n c e o f such t h i n g s a s
instincts and affects c a n n o t be d e m o n s t r a t e d , w h i l e o n t o l o g i c a l
p h e n o m e n a , like the p r e s e n c e and utility of t h e table, i n h e r e directly in
i In' i respective o b j e c t s . W h e n e v e r I see s o m e t h i n g I r e c o g n i z e as a table,

Transitional

Difficulties

L63

I m u s t also and already h a v e p e r c e i v e d t h e p r e s e n c e and utility ol I ha I

thing.
In s h a r p c o n t r a s t to t h e s u p p o s i t i o n s c o n t a i n e d in scientific t h e o r i e s ,
t h e f u n d a m e n t a l c h a r a c t e r of a c o n c r e t e being is, as an o n t o l o g i c a l phe
n o m e n o n , w h a t m a k e s i t w h a t i t is. T h i s i s w h y o n t o l o g i c a l p h e n o m e
n a are n e v e r p r e s e n t i n d e p e n d e n t o f ontically p r e s e n t p h e n o m e n a :
t h e o n t o l o g i c a l p h e n o m e n a , being t h e e s s e n c e s o f s e n s o r y p h e n o m e n a ,
m u s t a l w a y s indwell " i n " t h e m .
T h e o c c u r r e n c e o f p e r c e i v e d p h e n o m e n a does n o t n e e d t o b e proved.
W h a t is perceived s h o w s itself, is i t s e l f the u l t i m a t e g r o u n d for any
s t a t e m e n t m a d e a b o u t it. All t h a t is n e e d e d is a simple p o i n t i n g o u t of
w h a t h a s been p e r c e i v e d , for p e r c e p t i o n does n o t d e m a n d r e c o u r s e t o
a r g u m e n t a t i o n . ( T h o u g h , for t h e c o n t e m p o r a r y s c i e n t i s t , the capacity t o
dispense w i t h a r g u m e n t a t i o n can be gained o n l y a f t e r p a i n s t a k i n g
exercise.)
W h a t is t r u e g e n e r a l l y for t h e n a t u r e of a n y being in its p r e s e n c e is also
t r u e for t h e h u m a n being in particular. A c c o r d i n g l y , m e d i c i n e , as the
s c i e n c e o f h u m a n being, m u s t r e c o g n i z e t h a t n o t e v e r y g r o u n d i n g o f a
p h e n o m e n o n n e e d b e a p r o o f and t h a t , o n t h e o t h e r h a n d , e v e r y scientific
p r o o f is o n l y a special kind of g r o u n d i n g . M e d i c i n e n e e d s to d i s t i n g u i s h
b e t w e e n s i t u a t i o n s t h a t d e m a n d p r o o f and s i t u a t i o n s i n w h i c h p r o o f i s
s u p e r f l u o u s , t h o u g h a g r o u n d i n g o r f o u n d a t i o n o f t h e h i g h e s t o r d e r does
e x i s t . Indeed, A r i s t o t l e p o i n t e d o u t t h a t t h e ability t o m a k e this
d i s t i n c t i o n d i s t i n g u i s h e s t h e real t h i n k e r from t h e d i l e t t a n t e .
H y p o t h e t i c a l a s s u m p t i o n and Daser'n-based a c c e p t a n c e a r e n o t o f equal
s t a t u s and a r e n o t i n t e r c h a n g e a b l y applicable. E v e r y n a t u r a l scientific
a s s u m p t i o n is n e c e s s a r i l y r o o t e d in s o m e m o d e of a c c e p t a n c e , in fact, for
e v e n t h e s e a s s u m p t i o n s b e g i n w i t h t h e admission o f p h e n o m e n a w h i c h
a r e n o t s u b j e c t to scientific p r o o f . B u t in n a t u r a l s c i e n c e this initial step is
usually t a k e n u n w i t t i n g l y . T h e n a t u r a l scientific o r i e n t a t i o n , i n positing
n a t u r e as a calculable s y s t e m of m o v i n g m a s s p o i n t s and s p a t i o - t e m p o r a l
c o n t i n u a , h a s m a d e m a n y a s s u m p t i o n s . I t h a s a s s u m e d , first o f all, that
t h e r e really are such p h e n o m e n a a s space, t i m e , m o t i o n , and c a u s a l i t y .
O n l y b y first a c c e p t i n g w i t h o u t q u e s t i o n t h a t time and space e x i s t can
n a t u r a l s c i e n c e g o o n t o i m p o s e upon t h e m t h a t u n i f o r m i t y w i t h o u t
w h i c h m a t h e m a t i c a l c a l c u l a t i o n s using t i m e and space would be
i m p o s s i b l e . O n l y w h a t can b e c o u n t e d can b e c a l c u l a t e d , and c o u n t i n g i s
predicated o n t h e idea o f u n i f o r m u n i t s .
A c c e p t i n g space t h a t can be perceived and t i m e t h a t can be e x p e r i e m ed
brings a l o n g w i t h it t h e a s s u m p t i o n of s o m e h u m a n r e l a t e d n e s s to Spa( e
and t i m e . It is an a priori a s s u m p t i o n of science that h u m a n b e i n g s exisl In
relation to t h e s e t w o p h e n o m e n a . If a person did not perceive, and a< i epl

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FOUNDATIONS

t h e e x i s t e n c e of, s p a c e and t i m e , he w o u l d be u n a b l e e v e n to pick up a

glass and put i t t o his m o u t h . T h e d r i n k e r ' s visible m o v e m e n t s can b e
m e a s u r e d and c a l c u l a t e d in a n u m b e r of s p a c e - t i m e c o n t e x t s , but t h e
a c c e p t a n c e o f space and t i m e t h a t c o m e first i s n o t s u b j e c t t o
experimentation. T h e statement that time exists, or that there are such
t h i n g s as utility and spatiality, is n o t a n a t u r a l scientific s t a t e m e n t . To
admit o f t h e s e t h i n g s , and o f t h e e x i s t e n c e o f all t h a t is, i s t o g o b e y o n d
t h e r e a l m o f t h e n a t u r a l s c i e n c e s , t h o u g h t h e ability o f t h e n a t u r a l
s c i e n c e s t o m e a s u r e and c a l c u l a t e i s based o n this a d m i s s i o n . O n l y
philosophical c o n t e m p l a t i o n is suited to elucidating t h e fact t h a t t h e r e
actually are such t h i n g s as t i m e , space, o b j e c t s , and so o n .
It is t h e fate of m o d e r n m a n to be e n t r e n c h e d by and l a r g e in the
n a t u r a l scientific t r a d i t i o n o f s e e i n g o n l y causal r e l a t i o n s h i p s a m o n g
isolated o b j e c t s . T h u s u n u s u a l e f f o r t i s r e q u i r e d o f a n i n v e s t i g a t o r w h o
would e x p e r i e n c e t h e n o n - o b j e c t i f i a b l e o p e n n e s s w h i c h t h e Dasein-based
o r i e n t a t i o n s h o w s a s t h e t r u e basis o f a h u m a n n a t u r e . T h e n e w ,
p h e n o m e n o l o g i c a l - e x i s t e n t i a l v i e w p o i n t c a n n o t b e g o t f r o m reading
b o o k s , n o r can it be a c h i e v e d t h r o u g h logical d e d u c t i o n s from already
e x i s t i n g ideas. T h i s v i e w p o i n t can b e r e a c h e d o n l y t h r o u g h a q u a n t u m
leap i n t h i n k i n g , feeling, and p e r c e i v i n g . W e m u s t leap o u t o f t h e
o r i e n t a t i o n i n w h i c h w e are held spellbound b y t h e spirit o f t e c h n o l o g y
a s u b j e c t i v i s t i c , a p o s s e s s i v e , and a b s t r a c t a t t i t u d e vis-a-vis o u r s e l v e s ,
o u r fellow m e n , and e v e r y t h i n g else i n t h e w o r l d a n d o n t o t h e c o n c r e t e ,
though often unrecognized, foundation of our actual being-there. If the
headway won by Daseinsanalytic phenomenology is not taken advantage
of, n o t o n l y t h e f u n d a m e n t a l s of undisturbed, n o r m a l Da-sein will r e m a i n
o b s c u r e d , for u n l e s s t h e n e c e s s a r y e f f o r t is m a d e we shall also n o t be able
t o o p e n t h e w a y for a m o r e a d e q u a t e l y h u m a n g e n e r a l p a t h o l o g y and
therapy.

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

THE PSYCHOPATHOLOGICAL PHENOMENA

T h e stereotypical dream
At the very beginning of her psychoanalytic therapy, Regula Ziircher
r e p o r t e d a s t e r e o t y p i c a l d r e a m t h a t had afflicted h e r all h e r life at
i n t e r v a l s o f days o r w e e k s f r o m e a r l i e s t c h i l d h o o d r i g h t u p t o t h e day o f
h e r first s e s s i o n o f t h e r a p y t h o u g h n e v e r again a f t e r t h a t .
I n t h e d r e a m s h e w o u l d find h e r s e l f , n a k e d and a b s o l u t e l y a l o n e ,
c r o u c h i n g terrified i n t h e c o r n e r o f a n e m p t y railroad b o x c a r , h e r k n e e s
d r a w n u p a n d h e r h a n d s held for p r o t e c t i o n i n f r o n t o f h e r f a c e . T h e
b o x c a r s t o o d on t h e floor of an ice-cold, dark, b o u n d l e s s sea in w h i c h w a s
n o t o n e p l a n t , n o t o n e fish. T h o u g h t h e b o x c a r w a s s u b m e r g e d deep i n
t h e sea, a n a r c t i c wind b l e w t h r o u g h its d o o r s and c r a c k s . T h e d r e a m e r
w a s fearfully cold.
A p h e n o m e n o l o g i c a l i n v e s t i g a t i o n d i s p e n s e s w i t h all t h e presupposi
tions o f c o n t e m p o r a r y d r e a m t h e o r y , w h e t h e r t h e s e apply t o h u m a n
c o n d u c t o r t o n o n h u m a n t h i n g s i n d r e a m s , a n d holds t o n o t h i n g but the
phenomena as they present themselves. Approaching Regula Zurchei's
d r e a m t h u s , we c a n say o n l y t h a t it c o n s i s t e n t l y r e v e a l s a s e v e r e l y
d e f o r m e d w o r l d and e x t r e m e l y pathological b e h a v i o r of t h e patient wil h
respect t o t h a t w o r l d .

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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

F o r his part, t h e t h e r a p i s t g u a r d e d a g a i n s t leading t h e p a t i e n t t o

i n t e r p r e t the d r e a m a s a n e x p r e s s i o n o f a n u n c o n s c i o u s urge t o r e t u r n t o
a n o c e a n i c w o m b . H e also avoided i m p r e s s i n g o n h e r t h e belief i n a n
u n c o n s c i o u s d r e a m - w o r l d w h i c h could c o n v e r t t h e d r e a m e l e m e n t s into
t h e i r o p p o s i t e s , i n this c a s e t r a n s f o r m i n g t h e w a r m t h o f t h e u t e r u s i n t o
t h e o c e a n ' s icy cold. H e could h a v e offered n o p r o o f o f t h e s e t h i n g s . H e
m a d e n o a t t e m p t t o m a k e h e r a w a r e o f t h e p r e s e n c e i n h e r collective
u n c o n s c i o u s of s o m e a r c h e t y p a l f e m a l e , a n anima c o n t a i n i n g the f e m a l e
aspect of h e r being and m a n i f e s t i n g itself in t h e d r e a m i m a g e of t h e
o c e a n . H o w could h e h a v e defended t h e m i f she had levelled t h e c r i t i c i s m
t h a t all such a s s e r t i o n s are n o t h i n g m o r e t h a n a r b i t r a r y a s s u m p t i o n s
w i t h o u t t h e s l i g h t e s t basis in fact? B e s i d e s , s h e w a s already far t o o
involved i n t h e o r e t i c a l s p e c u l a t i o n t h a t kept h e r from r e c o g n i z i n g w h a t
h e r d r e a m w a s r e v e a l i n g . S h e w a s t h e r e f o r e p a t i e n t l y urged t o d o
n o t h i n g else this o n e t i m e e x c e p t a t t e n d t o t h e e l e m e n t s o f h e r d r e a m s
e x a c t l y a s s h e perceived t h e m . S h e w a s i n s t r u c t e d t o i g n o r e a n y m e a n i n g
o r c o n t e x t o f r e f e r e n c e t h a t was n o t revealed t o h e r p e r c e p t i o n b y t h e
t h i n g s t h e m s e l v e s in the d r e a m .
A f t e r a bit of p r a c t i c e in this s t r a i g h t f o r w a r d w a y of seeing, t h e p a t i e n t
became intensely aware of her extremely restricted way of being-int h e - w o r l d t h r o u g h t h e d r e a m . S h e r e c o g n i z e d t h a t h e r w h o l e being,
d r e a m i n g and w a k i n g , w a s p e r m e a t e d b y a n a t t u n e m e n t o f a n x i e t y , b y
feelings of total isolation, a b a n d o n m e n t , and i n s e c u r i t y . All at o n c e , s h e
u n d e r s t o o d t h a t s u c h a disposition could o p e n to h e r o n l y a world t h a t
w a s dark and e m p t y , cold and s h r o u d e d , void of any r e l a t i o n s h i p to
h u m a n b e i n g s o r any o t h e r living c r e a t u r e s . S h e realized h o w s u c h a
disposition could close o f f h e r field of vision to e v e r y t h i n g but a
m e r c i l e s s l y cold, a b y s m a l d a r k n e s s and an e m p t y b o x c a r . In this dark
disposition, s h e could see h e r s e l f o n l y 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 d e s o l a t e b o x c a r w a s t h e dwelling place that c o r r e s
ponded to such a self. As a c o n t a i n e r of m e r c h a n d i s e t h a t has not yet
r e a c h e d its d e s t i n a t i o n , t h e b o x c a r lets e v e r y t h i n g in itincluding the
d r e a m e r w h o c o w e r s n a k e d in a c o r n e r a p p e a r as m e r e goods s h u n t e d
back and forth

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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 .

The urge to stab and strangle

At the conclusion of her psychoanalytic treatment, Regula Ziircher
n o t o n l y l e a r n e d t o r e c o g n i z e t h e periods during w h i c h s h e e n j o y e d total
f r e e d o m from u r g e s t o s t a b and s t r a n g l e , b u t she also s a w t h r o u g h t h e
s i t u a t i o n s t h a t i r r e s i s t i b l y b r o u g h t o n t h e feared s y m p t o m s . S h e w a s
n e v e r visited b y t h e s e u r g e s w h e n a n d a s long a s s h e w a s able t o live
i n physical p r o x i m i t y t o t h e m a n s h e loved. T h e s e u r g e s t u r n e d u p w i t h
predictable r e g u l a r i t y , t h o u g h , during t h o s e d i s c o r d a n t t i m e s w h e n she
w a s f o r c e d t o live w i t h o u t h e r l o v e r and suffered f r o m s e v e r e s e x u a l
f r u s t r a t i o n , w h e n h e r child w a s t h e o n l y p e r s o n o n w h o m she m i g h t
a l w a y s lavish a f f e c t i o n .
H e r t i m e s o f h a p p i n e s s , w h e n t h e r e could b e n o t r a c e o f a n u r g e t o s t a b
or s t r a n g l e h e r child, c o n s i s t e d by h e r o w n a c c o u n t in " b e i n g free to
e x p e r i e n c e all the w a y s in w h i c h a w o m a n can s u r r e n d e r to t h e m a n she
l o v e s . " " M y j o y i s c o m p l e t e , " she w e n t o n t o say, " w h e n I a m t o g e t h e r
w i t h him and s e n s e t h a t I h a v e freed him for a total m a s c u l i n e s u r r e n d e r
t o m e . " A n o t h e r t i m e , she said o f t h e s a m e c i r c u m s t a n c e , " w h a t w e
usually call s e x u a l love is a v e r y special w a y of b r i n g i n g t o g e t h e r t w o
people. It is a c o e x i s t e n c e of w o m a n and m a n so i n t e n s e t h a t it o p e n s up to
b o t h o f t h e m p r e v i o u s l y u n k n o w n , infinitely rich and e x p a n s i v e r e a l m s
o f e x i s t e n c e . T h e t w o l o v e r s m e r g e t o b e c o m e a unity that infinitely
e x t e n d s t h e b o r d e r s w i t h i n w h i c h t h i n g s n o r m a l l y reveal t h e m s e l v e s t o

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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.

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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

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EXISTENTIAL FOUNDATIONS

w a n t e d t o be. T o seal t h e m a t t e r , h e r l o v e r left n o d o u b t t h a t h e would

have preferred her without dependents.
T h e r e i s t h e r e f o r e n o need t o w r a c k o u r b r a i n s s e a r c h i n g o u t hidden
e x p l a n a t i o n s for t h e p s y c h o p a t h o l o g i c a l c o m p u l s i o n . W e can c o n c e n t r a t e
e x c l u s i v e l y o n w h a t could actually b e o b s e r v e d i n t h e patient. W e t u r n
first t o the f u n d a m e n t a l a t t u n e m e n t t h a t pervaded h e r w h o l e e x i s t e n c e
during the periods w h e n she felt 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 . T h i s
f u n d a m e n t a l a t t u n e m e n t n e v e r disappeared e n t i r e l y , n o t even i n h e r
m o m e n t s of h a p p i n e s s as a m o t h e r , t h o u g h for a little while it w a s n o t
t h e m a t i c a l l y h e e d e d . It s h o w e d itself, a c c o r d i n g to t h e p a t i e n t , as a f e a r of
s u f f o c a t i n g , an e x t r e m e feeling of being closed in, a c h o k i n g a n x i e t y .
O n c e an a t t u n e m e n t like this t a k e s hold, t h i n g s a r e perceived solely in
their potential a s prison walls, o r i n s t r u m e n t s o f t o r t u r e and m u r d e r .
T h i s p h e n o m e n o n i s a n a l o g o u s t o t h e limitation o f p e r c e p t i o n t h a t o c c u r s
in a s e v e r e l y h u n g r y p e r s o n . He sees only w h a t is edible a r o u n d h i m , and
of all t h e i r p r o p e r t i e s o n l y that t h e y can be d e v o u r e d .
In a similar w a y , o u r patient w a s reduced to e x p e r i e n c i n g h e r w h o l e
e n v i r o n m e n t as i m p r i s o n i n g , t h r o t t l i n g , and s u f f o c a t i n g . As s u c h , this
e n v i r o n m e n t b e c a m e t h e m o t i v a t i o n o f a violent u r g e t o a t t a c k a n y t h i n g
s h e m e t , to b r e a k it up and s m a s h it to pieces. O n l y such a d e s p e r a t e selfd e f e n s e held o u t h o p e t o h e r for r e s c u e f r o m h e r o w n e x i s t e n t i a l
s t r a n g u l a t i o n and d e s t r u c t i o n . T o this f r a m e o f mind, s h a r p o b j e c t s
especially k n i v e s e x e r t e d a n o v e r p o w e r i n g f a s c i n a t i o n . K n i v e s p r e s e n t
ed a challenge that threatened to overwhelm her, to engulf her
c o m p l e t e l y . T h i s is b e c a u s e i n h e r e n t in e v e r y knife is t h e p o t e n t i a l for u s e
a s a n i n s t r u m e n t t o cut t h r o u g h b o n d s , t o b o r e t h r o u g h b a r r i e r s , t o force
open w h a t i s locked, and t o kill w h a t t h r e a t e n s t o d e s t r o y . T h e s a m e
applied to t h e p a t i e n t ' s o w n h a n d s . In t h e panic of being s t r a n g l e d , a
p e r s o n can perceive his o w n h a n d s o n l y a s t h a t part o f h i m s e l f w h i c h can
s t r a n g l e t h e a t t a c k e r h i m s e l f and k e e p him f r o m c a r r y i n g o u t his
m u r d e r o u s i n t e n t . T h i s a c c o u n t s for t h e t e r r o r o f k n i v e s and o f h e r o w n
m u r d e r o u s h a n d t h a t seized h e r w h e n e v e r she felt s u f f o c a t e d . 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 e x t r e m e a n x i e t y , and h e r totally i n v o l u n t a r y
a b s o r p t i o n i n t o this a t t u n e m e n t , carried w i t h it an e n s l a v e m e n t to a n y
i n s t r u m e n t t h a t could b e e m p l o y e d i n s e l f - d e f e n s e t o free h e r from h e r
own suffocating imprisonment.
D u r i n g t h e w o r s t periods o f h e r p s y c h o n e u r o t i c illness, t h e p a t i e n t
s u c c u m b e d t o t h e i m p u l s e s t o stab and s t r a n g l e s o c o m p l e t e l y t h a t s h e
was compelled t o t a k e action a g a i n s t a n y t h i n g and e v e r y t h i n g . T h a t
t h e s e impulses c a m e m o s t often j u s t w h e n s h e w a s happily and
intimately close to h e r child is as clear an indication as we might wish of
the c o n s t a n t p r e d o m i n a n c e in h e r e x i s t e n c e ot a lundaiiienl.il a t t u n e -

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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

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drives o r t e n d e n c i e s t o w a r d t h e child a s g r o u n d l e s s fabrication. T h e s e

h y p o t h e s e s n o t o n l y lack t h e capacity t o clarify t h e actual p h e n o m e n a
(and are t h e r e f o r e s u p e r f l u o u s ) , but t h e y a c t u a l l y distort o u r vision o f
the peculiar n a t u r e o f t h e s e i m p u l s e s .
T h e p a t i e n t ' s i n v o l u n t a r y s u r r e n d e r t o t h e u r g e t o act a g a i n s t t h e child
n e a r h e r and t h e d e f e n s i v e - c o m p u l s i v e a c t i v i t y following upon t h e
m i s a p p r e h e n s i o n of t h e child are specific, p r i m a r y m o d e s of relating and
t h e r e f o r e c a n n o t b e derived f r o m a n y t h i n g e l s e . T h e s a m e can b e said for
all the patient's w a n t s and d e s i r e s . J u s t as t h e r e is no s u c c u m b i n g e x c e p t
to s o m e t h i n g , so also w a n t i n g and w i s h i n g m u s t be directed t o w a r d
t h i n g s . Impulsive and c o m p u l s i v e s u r r e n d e r , w a n t i n g and desiring
t h e s e a r e all d i f f e r e n t but equally e l e m e n t a r y possibilities of b e h a v i n g in
relation to s o m e t h i n g t h a t e n c o u n t e r s a h u m a n being. A h u m a n
e x i s t e n c e can e n t e r i n t o a n y o n e o f t h e s e w a y s o f relating, j u s t a s i t can
e n t e r into a n y o n e o f t h e h u n d r e d s o f o t h e r m o d e s o f b e h a v i o r t h a t
c o n s t i t u t e t h e e x i s t e n c e of a p e r s o n .
W i s h i n g and desiring p r e s u p p o s e a c o n s i d e r a b l e m e a s u r e of f r e e d o m .
We could n e v e r speak of a wish or desire in c o n n e c t i o n w i t h the p a t i e n t ' s
u r g e to s t a b and s t r a n g l e h e r child, b e c a u s e this freedom was simply n o t
available t o t h e p a t i e n t w h e n she s u c c u m b e d t o h e r a c u t e fear and
a n x i e t y . W h a t t h e p a t i e n t actually e x p e r i e n c e d w a s , r a t h e r , initially a
brief and r e l a t i v e l y free period of h a p p i n e s s during w h i c h s h e w a s
p e r m i t t e d t o love t h e child, t h e n a n a l m o s t e n t i r e l y u n f r e e urge t o s t a b
and s t r a n g l e t h e child, and finally flight f r o m c o m m i t t i n g t h e m u r d e r ,
l a b o r i o u s l y a c h i e v e d w i t h t h e small r e m n a n t o f freedom r e m a i n i n g t o
h e r . A n y t h i n g e x t r a added t o t h e s e t h r e e equally e l e m e n t a r y , yet
radically d i f f e r e n t , m o d e s o f b e h a v i o r s h o w s i n t h e light o f faithful
observation as psychological invention.
It is a r e n u n c i a t i o n of s t r i c t scientific t h i n k i n g n o t to distinguish c l e a r l y
b e t w e e n a n impulsive, i n v o l u n t a r y s u r r e n d e r t o s o m e t h i n g and a n a c t i v e
wish or desire for t h a t t h i n g . It is j u s t as u n s c i e n t i f i c to c o n f u s e o n e of t h e
t h r e e m o d e s o f b e h a v i o r n a m e d a b o v e w i t h a n o t h e r , o r t o derive o n e
from a n o t h e r and t h e r e b y c o n f o u n d all t h r e e . A p s y c h o l o g y s t r a y s e v e n
f a r t h e r from a scientific m e t h o d of i n v e s t i g a t i o n w h e n it tries to derive
an immediately obvious compulsion to stab from unconscious desires or
i n s t i n c t s . W e s h o w e d this earlier w h e n w e p o i n t e d o u t t h e i n h e r e n t
c o n t r a d i c t i o n in such e x p l a n a t i o n s .
If a n y t h i n g a b o u t o u r p a t i e n t ' s i m p u l s e s to s t a b and s t r a n g l e m i g h t be
labeled u n c o n s c i o u s , it is t h e fact t h a t in s u c c u m b i n g to t h e s e u r g e s she
was unable to t h i n k specifically a b o u t t h e i r e s s e n t i a l c o n n e c t i o n to h e r
p r e d o m i n a n i a t t u n e m e n t , the fear of suffocating,, ["his c o n n e c t i o n was
available to hei in an u n t h e m a t i c w a y . But the m e r e fa< I thai she was not

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t h i n k i n g t h e m a t i c a l l y a b o u t s o m e t h i n g available to h e r is still a long way

f r o m j u s t i f y i n g t h e s u p p o s i t i o n of a d y n a m i c u n c o n s c i o u s o p e r a t i n g
within her.
It is a n o t h e r m a t t e r e n t i r e l y to decide j u s t w h a t in t h e p a t i e n t ' s life
impelled h e r to a p a t h o l o g i c a l a t t u n e m e n t and a r e d u c t i o n of h e r
e x i s t e n t i a l possibilities, b u t n o m a t t e r h o w c o m p l e t e t h e list o f
m o t i v a t i o n s for a p a t h o l o g i c a l r e d u c t i o n of an e x i s t e n c e to a single m o d e
o f b e h a v i o r , i t still c o n t r i b u t e s n o t h i n g t o a n u n d e r s t a n d i n g o f t h a t o n e
remaining mode.
T h e q u e s t i o n still r e m a i n s w h y , for s u c h a long t i m e a f t e r t h e
c o n c l u s i o n o f p s y c h o t h e r a p y , R e g u l a Z r c h e r could feel free o f t h e
i m p u l s e s t o s t a b o n l y w h e n h e r s i t u a t i o n allowed h e r t o live w i t h a m a n
she loved. D o e s n ' t this s t a t e of affairs indicate t h e p e r s i s t e n c e of a
n e u r o t i c f i x a t i o n ? Y e t aside f r o m h e r fully r e c o g n i z e d d e p e n d e n c e on t h e
physical p r e s e n c e o f a l o v e r , t h e r e w a s n o w n o part o f h e r w o r l d t o w h i c h
she had n o t w o n a free r e l a t i o n s h i p . P s y c h o a n a l y t i c t h e o r y likes to link
u r g e s and c o m p u l s i o n s t o w h a t i t t e r m s anal e r o t i c i s m , b u t R e g u l a
Z r c h e r had for s o m e t i m e b e e n able t o r e l a t e freely t o t h e e a r t h y , fecal,
bodily, and a n i m a l r e a l m s . F o r y e a r s s h e had b e e n free o f t h e i n t e s t i n a l
problems which psychoanalytic theory regularlyand unjustifiably
a t t r i b u t e s t o r e g r e s s i o n t o a n a n a l - e r o t i c libidinal s t a g e .
W h y i s i t t h a t m e r e l y t h i n k i n g o f t h e m a n s h e loved and i m a g i n i n g a n
e c s t a t i c u n i o n w i t h him w a s n o t sufficient t o keep R e g u l a Z r c h e r free o f
t h e u r g e t o s t a b ? W h y did s h e c o n t i n u e for y e a r s t o r e q u i r e t h e physical
presence of a male lover in order to remain healthy? T h e r e are many
c a s e s of p s y c h o n e u r o t i c a l l y ill people w h o e n t e r t h e r a p y s u f f e r i n g f r o m a
similar lack of f r e e d o m and n e e d i n g s e x u a l e c s t a s y as o f t e n as she did.
P s y c h i a t r y m i s t a k e n l y classifies m o s t o f t h e s e a s c o n s t i t u t i o n a l l y
hypersexual, instinct-enslaved psychopaths. Yet in the course of therapy
m a n y o f t h e s e p a t i e n t s c o m p l e t e l y relinquish t h e i r h y p e r s e x u a l b e h a v i o r .
T h e y d i s c o v e r t h a t t h e i r feelings had b e e n n e u r o t i c a l l y fixed in a w a y t h a t
r e s t r i c t e d t h e i r r e l a t i o n s h i p w i t h p a r t n e r s of t h e o p p o s i t e sex to a
physical c o m m u n i o n o f g e n i t a l s . T o c o n f i n e h u m a n e o e x i s t e n c e t o its
p h y s i c a l - s e n s u a l c o m p o n e n t has t h e e f f e c t o f e x a g g e r a t i n g and inflating
the i m p o r t a n c e o f t h e bodily g e n i t a l r e g i o n o f t h e i r e x i s t e n c e . B u t t o the
e x t e n t t h a t t h e i r e x i s t e n c e s o p e n up in t h e c o u r s e of t h e r a p y to a full
h u m a n b e i n g - t o g e t h e r w h i c h can e m c o m p a s s t h e w h o l e realm o f
possibilities for r e l a t i n g , t h e i r e n s l a v e m e n t t o p h y s i c a l - s e n s u a l
c o m m u n i o n t h e i r so-called c o n s t i t u t i o n a l h y p e r s e x u a l i t y u s m a r k e d
ly r e d u c e d .
B u t this s o r t of d e v e l o p m e n t n e v e r o c c u r r e d in the first place with
R e g u l a Z r c h e r . S h e w a s n e v e r able to reach sexual o r g a s m wil houl I n !

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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

Testing and Research on Pathological Phenomena

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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

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FOUNDATIONS

fulfillment t h e possibilities o f b e h a v i n g and r e l a t i n g t h a t are specifically

h e r o w n t h e m o r e s h e will h a v e a past o f h e r o w n i n t o w h i c h h e r
e x i s t e n c e e x t e n d s . T o a c o r r e s p o n d i n g d e g r e e s h e will b e m o r e o p e n for
h e r o w n p a r t i c u l a r w a y o f allowing t h i n g s t o approach h e r . I n s h o r t , s h e
will h a v e a w e a l t h of h e r o w n past to rely on and an i n d e p e n d e n t f u t u r e to
r e a c h i n t o . B o t h o f t h e s e d i m e n s i o n s will provide h e r w i t h s u p p o r t .
G r o w i n g i n i n d e p e n d e n c e and s e l f - r e l i a n c e , h e r e x i s t e n c e will b e c o m e
m o r e and m o r e t h a t o f a h e a l t h y and m a t u r e h u m a n being w h o s p a n s
s i m u l t a n e o u s l y , o p e n and free, a past, p r e s e n t , a n d f u t u r e of its o w n . In
fact, the m o r e R e g u l a Z i i r c h e r was able to gain a p e r s o n a l past a f t e r h e r
t h e r a p y had ended, the m o r e deeply and s e c u r e l y she felt h e r s e l f " g r o w
i n t o a realm t h a t could s u p p o r t h e r r o o t s . " T h e d a n g e r o f b e i n g
o v e r w h e l m e d b y h e r u r g e s and c o m p u l s i o n s d e c r e a s e d c o r r e s p o n d i n g l y ,
e v e n w h e n s h e had t o g o for long t i m e s w i t h o u t s e x u a l love.

The knife hallucinations

Shortly before her therapy began, the patient returned from an
especially long s t a y w i t h h e r little d a u g h t e r in a r e m o t e c o t t a g e in t h e
S w i s s Alps w h e r e s h e had b e e n m o r e t h a n e v e r b e f o r e cut o f f f r o m all
o t h e r h u m a n c o n t a c t . H e r o n l y s p h e r e o f a c t i v i t y c o n s i s t e d i n caring for
t h e child and c l e a n i n g t h e little h o u s e . S h e could n o t e v e n g o o n h i k e s o f
m o d e r a t e l e n g t h b e c a u s e t h e child w a s still t o o small e i t h e r t o b e t a k e n
along o r left a l o n e a t h o m e . T h e m i n u t e w o r l d o f t h e p a t i e n t ' s p r e s e n t
m i r r o r e d t h e c o n s t r i c t i o n o f h e r f u t u r e : a s a c o n s e q u e n c e o f h e r legal ties
t o a n i n a d e q u a t e h u s b a n d , she s a w a n e x t r e m e l y n a r r o w scope for t h e
unfolding o f h e r e x i s t e n c e . H e r past w a s equally c o n s t r i c t e d . S h e had n o
m e m o r i e s o f t i m e s w h e n she had b e e n able t o c o m m i t h e r s e l f i n r e l a t i o n
to t h i n g s and people in a w a y all h e r o w n . T h e p s e u d o m o r a l p r e s s u r e of
h e r u p b r i n g i n g had left h e r a c r e a t u r e living e x c l u s i v e l y in forbidden, or
h i g h l y r e s t r a i n e d , r e l a t i o n s h i p s t o w h a t she e n c o u n t e r e d . I n t h a t she w a s
n o t s e l f - r e l i a n t s h e felt h e r self shrivel, during t h a t s u m m e r v a c a t i o n , i n
a n u n b e a r a b l y n a r r o w prison cell. T h e walls o f t h e c o t t a g e , t h e
m o u n t a i n s i n f r o n t o f t h e w i n d o w s , t h e daily r o u t i n e o f h e r h o u s e h o l d
c h o r e s , and t h e d e m a n d s of caring for a small child r e v e a l e d to h e r o n l y
o n e o f t h e i r s i g n i f i c a n c e s , t h a t c h a r a c t e r o f limiting, s t r a n g l i n g ,
suffocating. Corresponding to her misperception of them as murderous,
t h e y p r o v o k e d h e r i r r e s i s t i b l y i n t o a v i o l e n t , despairing s t r u g g l e to b r e a k
free.
We h a v e already discussed h o w this s t a t e i n e v i t a b l y led to her urge to
s t a b and s t r a n g l e h e r child. Up to this point, all hci a c t i o n s w e r e
c o n c e r n e d with knives such as would be available, in I he same way and at
the same location, to any w a k i n g , h e a l t h y h u m a n being Bui then o n e

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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

The hysterical paralysis of the leg

I n t h e middle o f t h e c o u r s e o f h e r d a s e i n s a n a l y t i c t r e a t m e n t , R e g u l a
Z r c h e r w a s s t r i c k e n w i t h h y s t e r i c a l paralysis o f t h e legs. S h e collapsed
w h e n s h e s a w a p p r o a c h i n g on t h e o t h e r side of the s t r e e t a m a n she had
met a few days b e f o r e at a c o c k t a i l p a r t y . At first sight, he waked s t r a n g e ,
e x c i t i n g feelings in h e r . S h e w a s taken by an a n x i e t y by no m e a n s mild
and was glad to flee to t h e s a f e t y of her own tour walls.

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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

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181

t h a t s h e w a s w r e n c h e d i n t o it w i t h o u t willing it, w i s h i n g it, or t h i n k i n g it.

S h e could c a r r y o u t this r e l a t i o n s h i p o n l y dully and u n t h e m a t i c a l l y in t h e
bodily r e a l m o f h e r e x i s t e n c e . T h i s e x p l a i n s w h y s h e did n o t simply stand
h y s t e r i c a l l y r o o t e d to t h e s p o t . S u c h a spastic paralysis w o u l d c o r r e s p o n d
t o t h e n e u r o t i c bodying f o r t h o f a m u c h m o r e v i g o r o u s and less
n e u r o t i c a l l y r e d u c e d r e l a t i o n s h i p t o the w o r l d t h a n t h a t o f R e g u l a
Zrcher. Her surrender to the conflicting urges regarding the young
m a n held h e r e n t i r e e x i s t e n c e s o s p e l l b o u n d t h a t s h e w a s r o b b e d o f a n y
ability to s t a n d on h e r o w n . S h e lived o u t this loss as t h e physical collapse.
T h e paralysis involved h e r l e g s b e c a u s e t h e y are w h a t c a r r y o u t bodily a n
a p p r o a c h t o , or a flight f r o m , s o m e t h i n g .
W h a t i s o f decisive i m p o r t a n c e i s t h a t 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 t o
t h e y o u n g m a n , and j u s t t h a t , w a s carried o u t directly in and as the
h y s t e r i c a l paralysis. T h e r e i s n o t h i n g t o s u p p o r t t h e m e t a p s y c h o l o g i c a l
introduction of an endopsychic conflict between an unconscious, erotic
desire f o r t h e m a n and a n equally u n c o n s c i o u s , p s e u d o m o r a l p r o h i b i t i o n
o f this d e s i r e . A s w i t h t h e u r g e s t o s t a b and s t r a n g l e , t h e r e w a s n e v e r a n y
e v i d e n c e in t h e h y s t e r i c a l paralysis to s u g g e s t an a c t u a l wish to a p p r o a c h
t h e m a n or a compunction to flee f r o m his p r e s e n c e . I n s t e a d , t h e p a t i e n t ' s
contradictory relationship to the young man occurred from the
b e g i n n i n g o n l y w i t h i n t h e bodily s p h e r e o f this n e u r o t i c a l l y r e d u c e d
e x i s t e n c e as t h e h y s t e r i c a l paralysis of t h e legs. It w a s ifse//the i m m e d i a t e
fulfillment o f h e r p a t h o l o g i c a l r e l a t i o n s h i p t o h i m . S h e e v i d e n c e d n o
prior o r s i m u l t a n e o u s p s y c h i c d e s i r e s o r c o m p u n c t i o n s w i t h r e g a r d t o t h e
y o u n g m a n . In fact, as we p o i n t e d o u t in o u r d i s c u s s i o n of c o m p u l s i v e
p h e n o m e n a , it is f u n d a m e n t a l l y i m p o s s i b l e for h y s t e r i c a l s y m p t o m s to
appear w h e n a p e r s o n is g e n u i n e l y able to wish, to will s o m e t h i n g , or to
judge. T h e m e r e fact of w i s h i n g or i m p o s i n g a m o r a l j u d g m e n t implies a
c e r t a i n a m o u n t o f f r e e d o m w i t h r e s p e c t t o w h a t i s w i s h e d for o r judged;
and this f r e e d o m is n o t p r e s e n t in any h y s t e r i c a l s u c c u m b i n g to t h e
e n t i t i e s in q u e s t i o n . T h i s fact would n o t be a l t e r e d in t h e least e v e n if t h e
paradoxical u n c o n s c i o u s d e s i r e o r m o r a l c o m p u n c t i o n really did e x i s t . T o
the c o m m o n m e t a p s y c h o l o g i c a l s u p p o s i t i o n t h a t h y s t e r i c a l s y m p t o m s
o r i g i n a t e w h e n e v e r e n d o p s y c h i c conflict has b e e n r e p r e s s e d into the
u n c o n s c i o u s , w e m a y apply t h e s a m e c r i t i c i s m w e m o u n t e d i n o u r
discussion o f t h e p a t i e n t ' s u r g e s t o stab. S u c h e n d o p s y c h i c e n t i t i e s are
nothing m o r e than undemonstrable, arbitrary inventions.
A n e x i s t e n t i a l e x a m i n a t i o n o f t h e facts o f h y s t e r i c a l p h e n o m e n a
r e q u i r e s a scientific w a y o f t h i n k i n g t h a t can m a k e s h a r p d i s t i n c t i o n s
a m o n g t h e m a n y m o d e s o f h u m a n r e l a t i o n s h i p s t o t h e world. First o l all,
we should r e m a i n c o n s t a n t l y a w a r e t h a t bodying f o r t h , l o n g i n g for, and
w a n t i n g a r e t h r e e f u n d a m e n t a l l y d i f f e r e n t , yet equally p r i m a r y , m o d e s

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EXISTENTIAL FOUNDATIONS

of realizing possibilities of r e l a t i n g to w h a t a p e r s o n e n c o u n t e r s in his

world. F o r i n s t a n c e , R e g u l a Z i i r c h e r ' s r e s p o n s e t o t h e a t t r a c t i o n she felt
to t h e y o u n g m a n w o u l d h a v e b e e n o n l y bodily if she had u n t h i n k i n g l y
and u n t h e m a t i c a l l y h u r r i e d o v e r t o h i m . ( T h i s p r e s u p p o s e s t h a t t h e
attraction was not opposed by the neurotic misperception of the man as
s o m e t h i n g sinful a n d t h e r e f o r e to be avoided.) If, on t h e o t h e r h a n d , the
relationship to the young man remained nothing other than a wishing
for him t o b e n e a r , t h e n his a p p r o a c h would o n l y b e r e c k o n e d w i t h , o r
visualized. T h e r e can c l e a r l y b e w i s h e s t h a t f r o m t h e o u t s e t c a n n o t b e
fulfilled; a r e l a t i o n s h i p can r e m a i n in t h a t s t a t e . Wanting s o m e t h i n g ,
h o w e v e r , is a r e l a t i o n s h i p to t h e w o r l d t h a t is d i r e c t e d t o w a r d s o m e t h i n g
c o n s i d e r e d a t t a i n a b l e , s o m e t h i n g t o w a r d w h i c h t h e w a n t i n g p e r s o n has
already set o u t w h e t h e r in t h i n k i n g and p l a n n i n g or in bodily a c t i v i t y
but n o t yet r e a c h e d .
S u c h f u n d a m e n t a l d i f f e r e n c e s in individual possibilities of b e h a v i o r
and relating t o t h e world preclude their b e i n g simply m e r g e d o r
t r a n s f o r m e d i n t o o n e a n o t h e r . All w e can a s c e r t a i n i s t h a t n o w o n e , n o w
a n o t h e r , can b e c a r r i e d o u t o r inhibited.
If it is t r u e , t h e n , 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 d e s i r e s and acts of will
a r e as little e v i d e n t in h y s t e r i c a l g e s t u r e s as in h e a l t h y b e h a v i o r , we can
safely c o n c l u d e r e g a r d i n g t h e h y s t e r i c a l paralysis o f o u r t e s t s u b j e c t t h a t
w h a t s h e fled f r o m and w a s also d r a w n t o w a s n o t a n 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 t h e y o u n g m a n . I t w a s n o r e p r e s e n t a t i o n , b u t the m a n
h i m s e l f , f r o m t h e place i n h e r w o r l d w h e r e h e w a s seen w a l k i n g , w h o
m o v e d h e r t o stop s h o r t and collapse. T h e o n l y r e a s o n R e g u l a Z i i r c h e r
h e r s e l f did n o t r e c o g n i z e w h a t w a s h a p p e n i n g to h e r is t h a t she had not
yet become herself. It was not her self that commanded her not to
a p p r o a c h t h e m a n and t o r e h e r a w a y f r o m h i m . R a t h e r , s h e w a s ' d i r e c t e d
from outside h e r self, like a m a r i o n e t t e . T h e s t r i n g s w e r e b e i n g pulled by
t h e alien m e n t a l i t y o f h e r m o t h e r .
T h e organic neurotic disturbances
L o n g b e f o r e h e r h y s t e r i c a l paralysis, R e g u l a Z i i r c h e r had b e e n
tormented by organic neurotic disturbances of the alimentary canal.
T h e s e first b e c a m e n o t i c e a b l e during p u b e r t y . Initially, t h e r e w a s
nothing more than stubborn constipation. But after her marriage,
s t o m a c h pains and i n t e s t i n a l c r a m p s o c c u r r e d m o r e and m o r e f r e q u e n t l y
a s well. W h e n p s y c h o t h e r a p y w a s b e g i n n i n g , t h e s e latest s y m p t o m s had
b e g u n to be followed in t u r n by a t t a c k s of bloody, viscous d i a r r h e a . T h e
patient's o r g a n i c n e u r o t i c d i s t u r b a n c e s had n o w a s s u m e d a m o s t
t h r e a t e n i n g a s p e c t . S h e could barely take any noui i s h m e n l at all and had
b e c o m e horribly e m a c i a t e d .

Testing and Research on Pathological Phenomena

Traditional medicine would ascribe the patient's intestinal symptoms
t o a d y s f u n c t i o n o f t h e a u t o n o m i c s y s t e m . P s y c h o s o m a t i c medicine
would t a k e this idea f u r t h e r t o t r a c e t h e real c a u s e o f t h e d i s t u r b a n c e t o
t h e a c t i o n s o f depressive a f f e c t s upon t h e a u t o n o m i c c e n t e r s o f the
c e r e b r a l c o r t e x . Finally, a 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 w o u l d o f f e r as
e x p l a n a t i o n the r e g r e s s i o n o f t h e p a t i e n t t o a n a n a l - s a d i s t i c s t a g e o f
libidinal d e v e l o p m e n t ; t h e s t o m a c h and i n t e s t i n a l s y m p t o m s would b e
s e e n i n g e n e r a l a s e f f e c t s o f a n a l - e r o t i c drives o n t h e i r t e r m i n a l o r g a n s .
R e g u l a Z i i r c h e r ' s case h i s t o r y r e v e a l s o n l y o n e c o n n e c t i o n b e t w e e n t h e
pathological i n t e s t i n a l s y m p t o m s and t h e w a y i n w h i c h she w a s
a p p a r e n t l y related a t this t i m e t o t h e w o r l d a r o u n d h e r . T h e time a t
w h i c h h e r s u f f e r i n g s b e g a n p r o v i d e s a clue h e r e . S y m p t o m s o f i n t e s t i n a l
disorder first b e c a m e v e r y p r o n o u n c e d j u s t w h e n y o u n g g e n t l e m e n
began to n o t i c e this beautiful girl and ask h e r o u t to d a n c e s . In h e r circle
of friends, it w a s c u s t o m a r y for t h e s e affairs to t u r n quickly i n t o p e t t i n g
parties. Y e t R e g u l a Z i i r c h e r w a s still s o totally d o m i n a t e d b y p a r e n t a l
d i r e c t i v e s t h a t she denied b o t h h e r s e l f and t h e y o u n g m e n a n y bodily
c l o s e n e s s and t e n d e r n e s s . W h e n e v e r t h e o p p o r t u n i t y for p e t t i n g a r o s e ,
she could feel h e r b o w e l s t i g h t e n . O n days following t h e s e parties
periods o f c o n s t i p a t i o n first a p p e a r e d . T o h e r already e x i s t i n g r e s e r v e
c o n c e r n i n g t e n d e r , bodily c l o s e n e s s t o w a r d o t h e r s was n o w added this
c o n s t r a i n t i n t h e face o f a n e w l y a r i s e n s e x u a l a t t r a c t i o n t o w a r d y o u n g
men.
A s w e h a v e h e a r d b e f o r e , t h e p a t i e n t ' s i n t e s t i n a l c r a m p s and d i a r r h e a
disappeared quite suddenly, a s i f o f t h e i r o w n a c c o r d , s o o n a f t e r t h e s t a r t
o f h e r t h e r a p y . All o f h e r s t o m a c h pains had stopped long b e f o r e t h e
f u n c t i o n i n g o f h e r i n t e s t i n e s and h e r r e l a t i o n s h i p t o feces w e r e
d i s c u s s e d . T h e i n s t a n t t h e p a t i e n t o v e r c a m e h e r initial r e s i s t a n c e and
e n t e r e d i n t o a t r u s t i n g 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 physician,
the s y m p t o m s c e a s e d . It w a s as if t h e y simply b l e w a w a y o n c e s h e gave up
trying to play t h e role of a h a u g h t y , g r o w n - u p lady and f o u n d r e l e a s e in
the i m m a t u r e , childlike b e h a v i o r t h a t actually allowed h e r t o b e h e r s e l f .
Up to this t i m e , g a s t r o i n t e s t i n a l specialists had forbidden h e r o n e food
a f t e r t h e o t h e r and placed h e r o n m o r e and m o r e s c a n t y diets. S h e had
barely b e g u n h e r p s y c h o t h e r a p y , h o w e v e r , w h e n s h e w a s again able t o
eat a n y t h i n g she d e s i r e d . E v e n milk, c o n s i d e r e d t h e t r i g g e r i n g a g e n t for
g a s t r o i n t e s t i n a l allergies and e c z e m a , she could n o w c o n s u m e w i t h o u t
difficulty, as well as c e r t a i n fats and c a b b a g e s t h a t had p r e v i o u s l y been
indigestible.
N o t o n l y did t h e u n b e a r a b l e s t o m a c h c r a m p s disappear; t h e patient n o
l o n g e r n e e d e d t h e p o w e r f u l l a x a t i v e s she had, with only m o d e s t results,
taken daily f o r o v e r a decade. S h e was soon able to take for g r a n t e d d a i l y ,
s p o n t a n e o u s , and c o m p l e t e l y n o r m a l b o w e l m o v e m e n t s .

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N o n e o f t h e t r a d i t i o n a l medical t h e o r i e s are able t o explain this

a p p a r e n t and i m p o r t a n t c o n n e c t i o n b e t w e e n t h e p a t i e n t ' s o r g a n i c
n e u r o t i c d i s t u r b a n c e s and t h e particular b e n t o f h e r h u m a n r e l a t i o n
ships. N o t o n e o f t h e s e t h e o r i e s e v e n a p p r o a c h e s t h e issue o f h u m a n
r e l a t i o n s h i p s , in fact. N e i t h e r a d y s f u n c t i o n of t h e c e r e b r a l c o r t e x , n o r
t h e s u p p o s i t i o n o f s o m e e n d o p s y c h i c affect o r o f e n e r g i e s and i n s t i n c t s
has a n y t h i n g to do w i t h ability to p e r c e i v e fellow h u m a n b e i n g s as
c r e a t u r e s to be t r u s t e d or feared, but it is i m p e r a t i v e t h a t we u n d e r s t a n d
this p h e n o m e n o n i f w e are t o learn a n y t h i n g a b o u t m o d e s o f b e h a v i o r
like o p e n i n g o n e s e l f up to t h e world, or closing o n e s e l f o f f from it. If it is
t r u e t h a t t h e w a y s i n w h i c h people b e h a v e t o w a r d w h a t s u r r o u n d s t h e m
a r e i n a c c e s s i b l e t o o r d i n a r y medical t h e o r i e s , t h e n t h e s e t h e o r i e s c a n n o t
e x p e c t t o elucidate t h e c o n n e c t i o n b e t w e e n d i s t u r b e d h u m a n r e l a t i o n
ships and o r g a n i c , physical d i s t u r b a n c e s .
O n e thing immediately apparent in our test subject was that horrible
i n t e s t i n a l c r a m p s w e n t along with a forced and c r a m p e d r e s t r i c t i o n of h e r
e x i s t e n c e w i t h r e s p e c t t o the w o r l d a r o u n d h e r . W h e n e v e r she w a s
o v e r w h e l m e d by a b o t t o m l e s s fear of this w o r l d in w h i c h she had no t r u s t
w h a t s o e v e r , h e r c r a m p s would give w a y t o v i s c o u s , bloody d i a r r h e a s . Y e t
as s o o n as s h e dared e n t e r i n t o a t r u s t i n g 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 t h e r a p i s t , t h e s e p o t e n t i a l l y lethal p a t h o l o g i c a l s y m p t o m s gave
w a y t o n o r m a l g a s t r o i n t e s t i n a l f u n c t i o n i n g . J u s t i c e i s d o n e t o t h e s e facts
only if the p a t i e n t ' s i n t e s t i n a l vicissitudes a r e s e e n as t h e bodying f o r t h of
h e r overall r e l a t i o n s h i p t o the world. T h e s e e m i n g l y m o r e c a u t i o u s and
less prejudicial d e s i g n a t i o n o f s i m u l t a n e i t y o f p s y c h i c and o r g a n i c e v e n t s
o r o f t e m p o r a l c o r r e l a t i o n actually prejudices m u c h m o r e . B o t h t e r m s
p r e s u p p o s e t h e division of h u m a n e x i s t e n c e i n t o a p s y c h e and a s o m a ,
t h o u g h in an u n p r e j u d i c e d o b s e r v a t i o n e x i s t i e n c e a l w a y s a p p e a r s as a
unified w h o l e . O n l y t w o primarily s e p a r a t e e n t i t i e s can b e c o r r e l a t e d o r
act s i m u l t a n e o u s l y .
B u t , a t a n y r a t e , t h e p a t i e n t ' s i n t e s t i n a l s p a s m s w e r e only o n e a l b e i t
t h e m o s t d a n g e r o u s f o r m i n w h i c h h e r e x t r e m e r e s e r v e vis-a-vis t h e
world was bodied f o r t h . T h i s r e l a t i o n s h i p also m a n i f e s t e d i t s e l f in h e r
aloof and d i s t a n t m a n n e r of speaking, in h e r stiff m i m i c r y , and in t h e
affected, b r o k e n r h y t h m o f h e r bodily m o v e m e n t s , w h i c h w e r e
c h a r a c t e r i s t i c s o f h e r b e h a v i o r during t h e t i m e s h e w a s s u f f e r i n g f r o m
g a s t r o i n t e s t i n a l d i s t u r b a n c e s , and w h i c h yielded t o n o r m a l f e m a l e w a y s
o f m o v i n g a t the s a m e time t h e i n t e s t i n a l s p a s m s and i r r i t a t i o n s w e n t
away.
A s t o w h y t h e p a t i e n t ' s pathological r e l a t i o n s h i p t o a y o u n g man s h e
m e t during the c o u r s e o f h e r p s y c h o t h e r a p y was b o d i e d I 0 1 1 h n o t as an
o r g a n i c n e u r o t i c s y m p t o m , b u t as an h y s t e r i c a l paralysis <>l t h e leg, we

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r e f e r t h e r e a d e r to an e a r l i e r publication dealing w i t h this precise

question.
2

Periodic swelling and pain i n t h e b r e a s t s w e r e also part o f t h e patient's

p s y c h o s o m a t i c p a t h o l o g y . H e r b r e a s t s would b e c o m e h a r d a s s t o n e s
during t h e s e c o n d h a l f o f e v e r y m e n s t r u a l cycle and s o s w o l l e n t h a t h e r
c h e s t m e a s u r e m e n t w a s i n c r e a s e d b y a t least a n inch a t t h e o n s e t o f
menstruation.
H e r g y n e c o l o g i s t was n o d o u b t c o r r e c t i n c o n n e c t i n g t h e s e s y m p t o m s
t o o v e r p r o d u c t i o n o f e s t r o g e n , y e t t h e r a p e u t i c m e a s u r e s b a s e d o n this
a s s u m p t i o n failed to h a v e e f f e c t . T h e p a t i e n t w a s for a long time given
i n j e c t i o n s of m a l e h o r m o n e s , and while this m e a s u r e did succeed in
r e d u c i n g t h e swelling s o m e w h a t , i t also p r o d u c e d s u c h s e v e r e irritability
and r e s t l e s s n e s s t h a t it a l w a y s had to be d i s c o n t i n u e d quickly.
Application o f a l c o h o l c o m p r e s s e s t o t h e b r e a s t s g a v e h e r s o m e relief, but
a p h y s i o t h e r a p i s t ' s a t t e m p t to e a s e t h e painful swelling and h a r d n e s s by
light m a s s a g e failed e n t i r e l y . T h e pain and t e n s i o n i n t h e p a t i e n t ' s b r e a s t s
disappeared f o r e v e r , w h e n s h e , i n t h e c o u r s e o f h e r t h e r a p y , had
d i s c o v e r e d and accepted h e r w o m a n h o o d so, t h a t she could fall " b o d y "
and " s o u l " in love w i t h a m a n and joyfully w e l c o m e his t e n d e r c a r e s s e s
t h o u g h , from a purely physical s t a n d p o i n t , h e r l o v e r ' s c a r e s s e s did n o t
differ g r e a t l y from t h e e a r l i e r m a s s a g e s given h e r b y h e r p h y s i o t h e r a p i s t .
T h e c u r e b r o u g h t a b o u t b y t h e g e n t l e t o u c h o f a m a n she loved h a p p e n e d
well b e f o r e she w a s able t o e x p e r i e n c e s e x u a l o r g a s m w i t h him, s o t h e
d i s a p p e a r a n c e o f h e r b r e a s t pains c a n n o t b e a s c r i b e d t o a n y physiological
change brought on by sexual intercourse.
Faced w i t h o r g a n - n e u r o t i c p a t h o l o g y like t h i s , p h y s i c i a n s can n o
l o n g e r be satisfied w i t h t h e p s e u d o e x p l a n a t i o n t h a t a s e x u a l l y a r o u s e d
p s y c h e had a c t e d t h r o u g h t h e p i t u i t a r y gland, c a u s i n g t h e o v a r i e s t o
b e c o m e h y p e r a c t i v e until, finally, p s y c h o g e n i c b r e a s t pain a r o s e . T r u e ,
t h e r e can b e n o d o u b t t h a t i n this c a s e o v e r a c t i v i t y o f t h e p i t u i t a r y gland
and t h e o v a r i e s did play a n e c e s s a r y role. B u t j u s t as p s y c h i c e f f e c t on t h e
i n t e s t i n e is n o t scientifically definable, i.e., in t e r m s of e x a c t l y
m e a s u r a b l e , c o m p a t a b l e and c a u s a l l y related c o n c e p t s , so all t h e o r i z i n g
a b o u t an e f f e c t i v e c o n n e c t i o n b e t w e e n an indefinable p s y c h e and a
s o m a t i c p i t u i t a r y , o v a r i e s , and m a m m a r y glands is c o n c e p t u a l l y u n c l e a r .
R e g u l a Z i i r c h e r ' s b r e a s t p h e n o m e n a can b e d e s i g n a t e d o n l y a s the
bodying f o r t h of a s e v e r e l y d i s t u r b e d w a y of relating to o t h e r s , in
p a r t i c u l a r of bodying f o r t h a l o v e - r e l a t i o n w i t h a m a n . T h e e x i s t e n t i a l
d i s t u r b a n c e e x p r e s s e d t h e p a t i e n t ' s lack o f freedom t o realize her
potential for loving a m a n . S h e w a s far from able to fulfill these
possibilities in a decisively w a n t e d and active b e i n g - t o g e t h e r with a man
in a s h a r e d world.

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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 .

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C o n s e q u e n t l y , r e s t r i c t i o n o f physical m o v e m e n t was n o t the only

r e s u l t o f t h e leg f r a c t u r e . I t a f f e c t e d also h e r w h o l e r e l a t i o n s h i p t o the
w o r l d , t h e w h o l e w a y i n w h i c h s h e e x i s t e d . F o r o n e thing, h e r
r e l a t i o n s h i p s t o h e r friends, w h i c h w e r e t o h a v e b e e n actualized the n e x t
day in a b i r t h d a y c e l e b r a t i o n , w e r e limited i n s t e a d to m o r o s e r e f l e c t i o n s .
T o h e r o w n a s t o n i s h m e n t , s h e o b s e r v e d h o w far i n t o t h e distance
e v e r y t h i n g receded during t h e first days o f h e r hospital s t a y n o t o n l y
o t h e r people, but o b j e c t s f r o m t h e s p h e r e s o f h e r h o m e and o c c u p a t i o n .
All t h a t had been claiming h e r w h o l e h e a r t e d a t t e n t i o n n o w m e a n t a l m o s t
n o t h i n g t o h e r . C l a i m i n g the f o r e g r o u n d o f h e r a w a r e n e s s w a s h e r o w n
b r o k e n leg, d r a w i n g h e r w h o l e e x i s t e n c e u p i n t o t h e r e l a t i o n t o it. S h e
b e g a n t o s e e h e r s e l f a s a n e x t r e m e l y n a r r o w , m a s s i v e , and c u m b e r s o m e
r e a l m e n d i n g a t t h e walls o f the s i c k r o o m and allowing t h e approach o f
n o t h i n g but w h a t w e n t o n inside t h o s e four walls. T i m e s e e m e d t o s t a n d
still for h e r . S o little h a p p e n e d t h a t w h e n she a w a k e d i n t h e m o r n i n g t h e
a p p r o a c h o f e v e n i n g s e e m e d a n e t e r n i t y a w a y . T i m e had b e c o m e a n
e m p t y v e s s e l . P e r h a p s , s h e t h o u g h t , t h e fear o f death s e n t suddenly
c o u r s i n g t h r o u g h h e r v e i n s w a s partly a t fault. T h e a c c i d e n t had
r e m i n d e d h e r , in a n y c a s e , h o w v e r y fragile the h u m a n w o r l d and all its
r i c h e s w e r e . A little b u r s t of n o i s e , and suddenly all w o u l d disappear. A n d
t h e n ? B u t " t h e n " and " t h e r e " would n o l o n g e r e x i s t e i t h e r . S u c h
t h o u g h t s caused all o f t h e t h i n g s o f h e r e v e r y d a y w o r l d t o t a k e o n a n
unwanted transcience.
T h i s c i r c u m s t a n c e p e r s i s t e d for o n l y t w o o r t h r e e days, h o w e v e r . A f t e r
t h a t s h e s c a r c e l y g a v e a n y t h o u g h t t o h e r b r o k e n leg. H e r days w e r e filled
b y t h e visits o f h e r friends. S h e also felt a n u r g e t o w r i t e s h o r t s t o r i e s for
m a g a z i n e s , and s h e f o c u s s e d a large part of h e r a t t e n t i o n on plans for t h e
f u t u r e , for t h e t i m e a f t e r h e r r e c o v e r y . O n c e again, h e r f u t u r e
d e t e r m i n e d h e r p r e s e n t and d r e w n o u r i s h m e n t f r o m t h e e x p e r i e n c e s o f
h e r past.
T h e bodily pains
F r o m e a r l i e s t childhood o n w a r d , R e g u l a Z i i r c h e r had had pains o f the
m o s t d i v e r s e s o r t s and i n t h e m o s t d i v e r s e l o c a t i o n s t h r o u g h h e r body.
T h e first she r e m e m b e r s w e r e p r o d u c e d b y e c z e m a o f t h e l e g s . L a t e r , she
c a m e t o e x p e r i e n c e t h o s e a g o n i z i n g g a s t r o i n t e s t i n a l s p a s m s and a t about
the s a m e t i m e b e g a n t o s u f f e r f r o m i n t e r m i t t e n t a t t a c k s o f v a s o m o t o r
h e a d a c h e s . T h e r e w a s also t h e pain t h a t w e n t w i t h t h e swelling in hei
b r e a s t s . Finally, a f t e r she had l e a r n e d to o v e r c o m e all of h e r o t h e r pain,, a
leg f r a c t u r e b r o u g h t h e r a n o t h e r , v e r y d i f f e r e n t , type o f pain.
Each of t h e s e pains had a c h a r a c t e r all its o w n . T h e patient des< I Ibrd
the pains a s s o c i a t e d w i t h e c z e m a as a superficial b u r n i n g thai lelt as II ihf

188

EXISTENTIAL FOUNDATIONS

w e r e s t a n d i n g w i t h b o t h feet on a blazing pyre. S h e e x p e r i e n c e d t h e

g a s t r o i n t e s t i n a l c r a m p s a s s u r g i n g and a g i t a t e d c o n s t r i c t i o n o f t h e e n t i r e
a b d o m i n a l r e g i o n . T h e h e a d a c h e s c o n s i s t e d in a painful e x p a n s i o n and
c o n t r a c t i o n o f h e r skull, h e r head h u r t i n g h e r s o m u c h s o m e t i m e s t h a t
s h e felt as t h o u g h s h e w e r e n o t h i n g but a head, big as a barn and filled
w i t h a g o n y . S h e also d e s c r i b e d h e r b r e a s t pains a s a n u n b e a r a b l e i n n e r
t e n s i o n , and t h e r e w e r e t i m e s w h e n i t s e e m e d t o h e r t h a t h e r b r e a s t s
would have to e x p l o d e a n y m o m e n t . Pain from t h e b r o k e n leg did n o t
begin until the p a t i e n t w a s already on t h e g r o u n d . S h e felt it first as a
t e a r i n g h u r t s o m e w h e r e b e l o w and t o the r i g h t . F o r the first m o m e n t , i t
s e e m e d o n l y as large (spatially) as a volley ball. A l m o s t i m m e d i a t e l y ,
h o w e v e r , it e x p a n d e d to i n u n d a t e h e r e n t i r e l y , an i m m e n s e sea in w h i c h
e v e r y t h i n g a r o u n d h e r w a s d r o w n i n g : t h e o n l o o k e r s , t h e h o u s e s , t h e sky
a b o v e , the e a r t h b e l o w , and she h e r s e l f . I n t h e end, she was n o t h i n g m o r e
t h a n pain and w a s being a b s o r b e d into this pain to t h e e x t e n t t h a t she
n e a r l y lost c o n s c i o u s n e s s . B e f o r e this happened, t h o u g h , she w a s able t o
t e a r h e r s e l f loose from t h e a g o n y and step back t o c o n f r o n t t h e painful
a r e a of h e r body. T h e pain t h e n c o n t r a c t e d to form a s p h e r e , a b o u t
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 , in t h e r i g h t l o w e r - c a l f region.
W h e n w e look o v e r t h e p a t i e n t ' s d e s c r i p t i o n s , w e are s t r u c k b y t h e fact
t h a t this w o m a n , n o r m a l l y a m a s t e r o f o b s e r v a t i o n and e x p r e s s i o n , w a s
s u r p r i s i n g l y i n e x a c t w h e r e h e r pains w e r e c o n c e r n e d . It is likely t h a t t h e
p h e n o m e n o n of pain itself, r a t h e r t h a n t h e p a t i e n t , is at fault h e r e . Pain is
v e r y m u c h akin t o e x p e r i e n c e s o f smell and t a s t e . N o w a n y o n e would b e
hard p r e s s e d t o d e s c r i b e , f o r i n s t a n c e , t h e w o n d e r f u l a r o m a and flavor o f
m a n g o t o s o m e o n e w h o n e v e r smelled and t a s t e d o n e . N o m a t t e r h o w
familiar t h e s e s e n s a t i o n s a r e t o t h e n o s e and palate o f t h e p e r s o n
r e p o r t i n g , he will n e v e r s u c c e e d in c o m m u n i c a t i n g to his l i s t e n e r
precisely w h i c h s e n s e p e r c e p t i o n he m e a n s and will p r o b a b l y , as R e g u l a
Z i i r c h e r did in h e r a t t e m p t to describe h e r pains, r e s o r t u l t i m a t e l y to
metaphorical comparison. Regula Zurcher's characterizations of her
pains s u f f e r from t h e s a m e lack of precision s e e n in all s u c h d e s c r i p t i o n s
i n scientific t e x t b o o k s . N o a n a t o m y , o r p h y s i o l o g y , o f pain, n o m a t t e r
h o w precise, can g e t t h e n a t u r e o f bodily pain. T h e bodily a r e a s r e f e r r e d
t o a s pain c e n t e r s and pain p a t h w a y s , w i t h all t h e i r a t t e n d a n t biophysical
p r o c e s s e s , have n o t h i n g at all in c o m m o n w i t h pain itself, n o t e v e n w h e n
t h e n u m b e r o f electrical i m p u l s e s racing t h r o u g h t h e m i s raised t o
ml m i l y. Pain itself is n o t biophysical in n a t u r e , for it e x i s t s only as an
e x p e r i e n c e . T h e r e i s n o biophysical o b j e c t t h a t has t h e capacity t o
e x p e r i e n c e , to s e n s e , o r t o perceive w h a t s o m e t h i n g i s .
3

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

Testing and Research on Pathological Phenomena

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

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 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

General

Daseinsanalytic

Etiology

193

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 .
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.
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.

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
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195

c o n s t i t u t e d of t h e ability to p e r c e i v e and r e s p o n d , and its t a s k is to allow

t h e p r e s e n c e s i t p e r c e i v e s t o e n t e r i n t o this c l e a r n e s s , t o b e and t o unfold
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 f i t e v e r c o m e s a b o u t t h a t
n o n h u m a n p r e s e n c e s a s well a s h u m a n b e i n g s a r e t h o u g h t o f simply a s
m a c h i n e r y parts t h a t can b e m a t h e m a t i c a l l y d e s c r i b e d , t h e n w e will h a v e
a w o r l d in w h i c h it will be less and less w o r t h w h i l e to be h e a l t h y . In t h e
age o f t e c h n o l o g y , h e a l t h y people h a v e t o live and e x i s t a l m o s t
e x c l u s i v e l y as cogs in a m a c h i n e r y g e a r e d to p r o d u c t i o n . T h u s , w h e n t h e y
a r e well, t h e y r e c e i v e m u c h less o f t h e h u m a n and e n v i r o n m e n t a l address
o f m e a n i n g f u l n e s s s o n e c e s s a r y f o r life t h a n w h e n t h e y b e c o m e ill and are
cared for. B e i n g h e a l t h y , t h e y are f o r c e d to v e g e t a t e all a l o n e , at a level of
h u m a n c o n t a c t and t r u s t far b e l o w t h e m i n i m u m t h e y n e e d t o e x i s t . I f
t h e y are ill, t h e r e would be p h y s i c i a n s and a t t e n d a n t s , at least, to a n s w e r
t h e i r h u m a n n e e d s . T h i s s t a t e of affairs is p r e s u m a b l y a s u b s t a n t i a l
p a t h o g e n i c m o t i v a t i o n for t h e r e l a t i v e and a b s o l u t e i n c r e a s e in the
incidence o f p s y c h o s o m a t i c illness.
M e d i c i n e is t h e r e f o r e c o n f r o n t e d w i t h a r e m a r k a b l e p a r a d o x : t h e s a m e
causal-genetic orientation that permits unprecedented therapeutic
s u c c e s s e s b e c o m e s a s e r i o u s pathogenic m o t i v a t i o n w h e n t u r n e d back upon
man.
I t i s n o t o n l y t h e c a u s a l - g e n e t i c idea i n t h e t h e o r y o f h u m a n illness t h a t
n e e d s t o b e put i n its p r o p e r place, h o w e v e r . T h e i m p o r t a n c e t h a t
m o t i v a t i o n a l p a t h o g e n e s i s c l a i m s f o r i t s e l f m u s t a l s o b e modified. T h e
i n c o n t e s t a b l e g r e a t practical s u c c e s s o f b o t h g e n e t i c i n v e s t i g a t i v e
a p p r o a c h e s has seduced us i n t o believing t h a t t h e d i s c l o s u r e of a
pathogenesis constitutes a waythe only way, in f a c t o f adequately
understanding any pathological phenomena we confront. But genetic
i n v e s t i g a t i o n s invariably o n l y e n u m e r a t e and d e s c r i b e t h e c a u s e s , o r
motivations, that have come before what is under investigation. To
explain w h a t w e n t b e f o r e s o m e t h i n g i s n o t t o e l u c i d a t e t h e t h i n g itself.
C a u s e s and m o t i v a t i o n s a r e a l t o g e t h e r different f r o m w h a t i s c a u s e d o r
motivated.
N o m a t t e r w h a t t h e f o r m a n i n v e s t i g a t i o n i n t o o r i g i n s m a y be, i t can
h a v e n o claim t o t h e s t a t u s o f a r i g o r o u s l y scientific r e s e a r c h m e t h o d
u n l e s s it h a s first m a d e t h e p a t h o l o g i c a l p h e n o m e n o n i t s e l f visible as it
stands. A n y o n e w h o insists on taking a genetic approach without having
first s u f f i c i e n t l y e x p l a i n e d t h e n a t u r e o f 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 is i g n o r a n t of t h e v e r y t h i n g w h o s e o r i g i n s he is looking for,
like s o m e o n e t r y i n g to r e a c h a goal he h a s n e v e r glimpsed.
A c t u a l l y , o r t h o d o x p s y c h o a n a l y t i c t h e o r y has a l w a y s set out t o w a r d
t h a t i m p o s s i b l e goal. F r e u d h i m s e l f o f f e r s t h e c l e a r e s t p r o o f o f t h i s i n his
opinion o n w h a t p s y c h o a n a l y s i s can, and c a n n o t , accomplish r e g a r d i n g

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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

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.
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 .

Chapter 13
A GENERAL DASEINSANALYTIC PHENOMENOLOGY
OF ILLNESS

Preliminary remarks
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

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EXISTENTIAL FOUNDATIONS

infection of t h e s a m e v i r u l e n c e and location m a y s p u r o n e p e r s o n on to a

c r e a t i v e e x i s t e n c e w h i l e a n o t h e r v e g e t a t e s helplessly in a s a n i t o r i u m .
If all illness is in fact t h e lack of t h e c o n d i t i o n of h e a l t h , t h e n illness is
n e c e s s a r i l y a l w a y s r e l a t e d to, and u n d e r s t a n d a b l e o n l y in t e r m s of, t h e
state of health. T h e reverse is never true, for health cannot be
c o n s t r u c t e d f r o m w h a t i s its o w n deficient s t a t e . T h i s principle has b e e n
f u n c t i o n i n g all along in o u r D a s e i n s a n a l y t i c i n v e s t i g a t i o n i n t o t h e
patient's pathological symptoms. T h e results of our step-by-step testing
o f t h e p h e n o m e n o l o g i c a l r e s e a r c h m e t h o d a g a i n s t individual p a t h o l o g i c a l
s y m p t o m s of a p a r t i c u l a r p e r s o n s h o w e d u n e q u i v o c a l l y t h a t this
a p p r o a c h could elucidate t h e p a t h o l o g i c a l p h e n o m e n a in t h e i r actual
aspect, as m o d e s of a h u m a n b e i n g - i n - t h e - w o r l d , w h i l e the traditional
s o m a t o - and p s y c h o p a t h o l o g i c a l e x p l a n a t i o n s o f medical s c i e n c e could
gain no a c c e s s to h u m a n e x i s t e n c e as a r e a l m of w o r l d - o p e n n e s s .
F u r t h e r m o r e , t h e p h e n o m e n o l o g i c a l approach did n o t n e e d to rely on a n y
h y p o t h e t i c a l e n t i t e s supposedly o p e r a t i n g u n d e r t h e s u r f a c e .
S o m e t h i n g else b e c a m e a p p a r e n t , a s well, a s w e w e n t t h r o u g h this
p r o c e s s . B e f o r e looking i n t o t h e s y m p t o m s , w e a r r a n g e d t h e m a c c o r d i n g
t o o n e o r a n o t h e r o f t h e m a n y classification s y s t e m s o n w h i c h traditional
p a t h o l o g i e s h a v e b e e n based. First c a m e t h e division o f t h e illnesses i n t o
t h e primarily o r g a n i c and primarily p s y c h i c . B e t w e e n t h e s e e x t r e m e s , w e
located t h e c a t e g o r i e s o f p s y c h o s o m a t i c o r p s y c h o g e n i c , and s o m a t o p s y
chic o r s o m a t o g e n i c , illness. W e m i g h t a s well h a v e t a k e n r e f u g e i n a n y
o t h e r c o m m o n s y s t e m o f classification. W e m i g h t h a v e classified
pathological p h e n o m e n a a c c o r d i n g t o w h i c h o r g a n o r o r g a n i c s y s t e m i s
first affected b y t h e d i s t u r b a n c e , o r a c c o r d i n g t o t h e w a y i n w h i c h t h e
p r o g r e s s o f t h e disease a f f e c t s a n o r g a n , o r a c c o r d i n g t o t h e i r e t i o l o g i e s
and p a t h o g e n e s e s .
B u t w h a t e v e r classifications we did u s e , a v e r y d i f f e r e n t o r d e r a l w a y s
emerged through our descriptions of symptoms, an orientation around
the fundamental traits of human existence. T h i s insight is unavoidable,
in fact, if illness is s e e n c o r r e c t l y as s o m e kind of deficiency in h e a l t h , and
if the n a t u r e of this s t a t e of h e a l t h can be d e t e r m i n e d a d e q u a t e l y o n l y
t h r o u g h e n u m e r a t i n g t h e w a y s i n w h i c h t h e e x i s t e n t i a l t r a i t s can b e
carried out. W e shall n o w s y s t e m a t i c a l l y explain this p h e n o m e n o l o g i c a l
r e s e a r c h m e t h o d , e v e n if at this point we can o n l y g e t as far as t h e
r u d i m e n t s 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 to h u m a n n a t u r e . A
s y s t e m a t i c e x p l a n a t i o n would n e e d t o e x a m i n e t h e w h o l e r a n g e o f
possible pathological m a n i f e s t a t i o n s to d i s c o v e r for each particular
i n s t a n c e w h i c h of the basic e x i s t e n t i a l t r a i t s h a s been impaired m o s t
deeply a n d directly, and h o w . T h e s e a r e t h e only c r i t e r i a t h a i a l l o w us t o
M ' i o g n i / e 11 te e x i s t e n t i a l n a t u r e o f pathological p h e n o m e n a a n d o r g a n i z e
I h e m appropi lately Foi the time being, w e m a y h a v e 111 h e '.a I i'. I l e d w i t h

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199

tentative explorations. Given the newness of the phenomenological

a p p r o a c h in m e d i c i n e , e v e n t h e f o r m u l a t i o n of a f e w appropriate
q u e s t i o n s w o u l d b e n o small a c c o m p l i s h m e n t .
W e m u s t also b e a r i n mind t h a t t h e f u n d a m e n t a l t r a i t s o f h u m a n being
a r e n o t j u s t s o m a n y b r i c k s w i t h w h i c h Da-sein i s put t o g e t h e r . T h e y
c a n n o t simply be a n a l y t i c a l l y t a k e n a p a r t and o b s e r v e d o n e by o n e . All are
i n s e p a r a b l e , equally p r i m a r y , m e m b e r s o f t h e unified s t r u c t u r e t h a t i s
h u m a n b e i n g - i n - t h e - w o r l d , and w h e n e v e r t h e fulfillment o f a n y one
e s s e n t i a l trait is d i s t u r b e d , e v e r y o t h e r trait as well is a f f e c t e d to s o m e
e x t e n t . C o n v e r s e l y , n o m a t t e r h o w s e v e r e t h e illness, a s long a s a p e r s o n
still e x i s t s , it is i m p o s s i b l e for e v e n o n e of t h e s e t r a i t s to disappear
a l t o g e t h e r . Illness involves t h e a s c e n d a n c y o r r e t r e a t o f s o m e trait w i t h
r e s p e c t t o the o t h e r s , b u t e v e n w h e n t h e i r abilities t o b e a r e c o v e r e d up,
all t h e t r a i t s still p e r s i s t as p o t e n t i a l i t i e s . W h a t is a c t u a l l y impaired in a
g i v e n illness is t h e ill p e r s o n ' s ability to e n g a g e in c a r r y i n g o u t t h e s e
p a r t i c u l a r p o t e n t i a l i t i e s a s free b e h a v i o r t o w a r d w h a t h e e n c o u n t e r s i n
his w o r l d .
I n b e g i n n i n g t h e a t t e m p t t o describe t h e c h a r a c t e r o f possible m o d e s o f
illness as d i s t u r b a n c e s in fulfilling basic f e a t u r e s of h u m a n b e i n g - i n - t h e w o r l d , w e list o n c e m o r e t h o s e t r a i t s o r E x i s t e n t i a l s m o s t i m p o r t a n t for
m e d i c i n e . T h e y a r e t h e s p a t i o - t e m p o r a l c h a r a c t e r o f Da-sein, its
a t t u n e m e n t , its b o d y h o o d , its c o e x i s t e n c e o r being t o g e t h e r w i t h o t h e r
people in a s h a r e d w o r l d , its o p e n n e s s and, finally, t h e unfolding of
i n h e r e n t p o t e n t i a l i t i e s i n t o e x i s t e n t i a l f r e e d o m . W e h a v e a l r e a d y said all
w e can a b o u t i m p a i r m e n t i n c a r r y i n g o u t t h e u l t i m a t e e x i s t e n t i a l trait o f
mortality.
A n y attempt to formulate a general Daseinsanalytic pathology must
begin b y i n v e s t i g a t i n g t h e d i f f e r e n t m o d e s o f illness and t h e c o r r e s p o n d
ing d i s t u r b a n c e in fulfilling t h e E x i s t e n t i a l s o n a n d on n o t h i n g b u t t h e
basis o f definite, c o n c r e t e , p a r t i c u l a r d i s t u r b a n c e s o f h e a l t h . F o r t h e basic
f e a t u r e s o f h u m a n e x i s t e n c e a r e a n y t h i n g b u t a b s t r a c t and t h e o r e t i c a l ,
and t h e y a r e c e r t a i n l y n o t s u p p o s i t i o n s e x t r a n e o u s t o t h e o n t i c , s e n s o r i l y
o b s e r v a b l e , p a r t i c u l a r p h e n o m e n a o f h u m a n e x i s t i n g . T h e y a r e n o less
c o n c r e t e t h a n t h e d i s c r e t e , o b s e r v a b l e , o n t i c p h e n o m e n a o f h u m a n being
itself. R a t h e r , t h e s e t r a i t s , w h o s e fulfillment is d i s t u r b e d in illness, a r e
t h e m o s t c o n c r e t e o f all: T h e y a r e t h a t i n w h i c h all t h e s e n s o r i l y
a s c e r t a i n a b l e p h e n o m e n a o f h u m a n c o n d u c t c o a l e s c e t o a unity. T h e y
c o n s t i t u t e t h e basic n a t u r e o f t h e s e p h e n o m e n a , and a s t h e i r all
pervading m e a n i n g f u l n e s s o r s i g n i f i c a t i o n s , m a k e t h e m t o t h e p h e n o m e
na which they are.
Add to this w h a t we h a v e already said in o u r c h a r a c t e r i z a t i o n ol
u n d i s t u r b e d h u m a n Da-sein a b o u t h e a l t h as f r e e d o m , and the basil
q u e s t i o n of a D a s e i n s a n a l y t i c g e n e r a l pathology a s s u m e s a tripartita

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aspect: ( l ) H o w is a p e r s o n ' s f r e e d o m to c a r r y o u t his p o t e n t i a l i t i e s

impaired a t a n y g i v e n t i m e ; ( 2 ) W h a t a r e t h e s e p o t e n t i a l i t i e s ; and ( 3 ) W i t h
r e s p e c t t o w h i c h e n t i t i e s o f t h e p e r s o n ' s w o r l d does this i m p a i r m e n t
occur?
In order to maintain some connection to traditional general patholo
gies, we shall begin by discussing illnesses t h a t m a r k e d l y d i s t u r b t h e
bodily being of h u m a n Da-sein. B o d y h o o d does n o t in and of i t s e l f m e r i t
first place in t h e unified s t r u c t u r e of D a - s e i n . M e t h o d o l o g i c a l l y , it w o u l d
p r o p e r l y c o m e last, for b o d y h o o d p r e s u p p o s e s b e i n g - i n - t h e - w o r l d .
B o d y h o o d i s n o t h i n g b u t t h e bodily s p h e r e o f t h e fulfillment o f h u m a n
e x i s t e n c e . It t a k e s first place o n l y in t h a t it is directly and i m m e d i a t e l y
accessible to the senses.
We k n o w already t h a t traditional m e d i c i n e , s u n k as it is in t h e
c o n c e p t u a l w o r l d o f n a t u r a l s i c e n c e , has declared t h e body t h e sole reality
of h u m a n b e i n g s . It had no o t h e r c h o i c e , since the body is the only easily
m e a s u r a b l e and calculable p h e n o m e n o n of h u m a n Da-sein. And n a t u r a l
s c i e n c e , g i v e n its c o n c e p t i o n o f n a t u r e , has n o a c c e s s t o w h a t c a n n o t b e
m e a s u r e d and calculated.
M o d e s of i l l n e s s s h o w i n g e v i d e n t i m p a i r m e n t of t h e b o d y i n g f o r t h of
human existence
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
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
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 .
As o n e m i g h t e x p e c t , the natural scientific: way ol t h i n k i n g
immediately t r a n s f o r m s t h e s e c h a n g e s into the cau$es ol the diseases,

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201

while t h e simple, old c o n c e p t of c a u s e is being supplanted by t h e c o n c e p t s

of c y b e r n e t i c s and i n f o r m a t i o n t h e o r y . In o u r critical evaluation ol
i n f o r m a t i o n t h e o r y and its application t o h u m a n b e i n g s , w e e m p h a s i z e d
t h a t its o n l y n o v e l t y w a s a r e f i n e m e n t of t h e c o n c e p t of c a u s e - a n d - e f feet.
A t t h e s a m e t i m e , t h e old c o n c e p t o f causality w a s shifted c o n s i d e r a b l y
t o w a r d t h e a n t h r o p o m o r p h i c and r o m a n t i c w i t h e x p r e s s i o n s like
" i n f o r m a t i o n , " " w r i t i n g , " and " l a n g u a g e , " b o r r o w e d f r o m t h e realm o f
i n t e r p e r s o n a l c o n t a c t . F u r t h e r m o r e , w e pointed o u t t h a t i n f o r m a t i o n
t h e o r y has b e e n applied t o h u m a n p a t h o l o g y only a t t h e c o s t o f e x t e n d i n g
t h e c o n c e p t of i n f o r m a t i o n to t h e p o i n t of e x t r e m e a m b i g u i t y . In a strict,
scientific s e n s e , it is n o t possible to i m a g i n e w h a t h a p p e n s w h e n the
m o l e c u l a r c h a n g e s w h i c h are p r o d u c e d in h e r e d i t a r y or primarily
physical d i s t u r b a n c e s and can b e r e c o r d e d c h e m o p h y s i c a l l y o r c y b e r n e t i cally are s t a m p e d as c a u s e s , as i n f o r m a t i o n s o u r c e points, w h i c h o u t of
t h e m s e l v e s supposedly e f f e c t w a y s of being ( w h i c h , as we h a v e said,
always r e q u i r e a p e r c e p t i o n of w h a t is t h e r e and of m e a n i n g f u l n e s s ) .
T a k e , for i n s t a n c e , c o l o r b l i n d n e s s , w h i c h is supposed to be primarily
h e r e d i t a r y - o r g a n i c . If we w a n t to u n d e r s t a n d w h a t it really is, we will
h a v e to find o u t f r o m t h e afflicted p e r s o n e x a c t l y h o w his ability to r e l a t e
h i m s e l f t h r o u g h p e r c e p t i o n t o w h a t r e v e a l s i t s e l f t o h i m i n his w o r l d h a s
b e e n impaired. W e will d i s c o v e r t h a t h e c a n n o t r e s p o n d t o t h e m e a n i n g s
" r e d " and " g r e e n . " Y e t t h e p o t e n t i a l i t y i n u n d e r s t a n d i n g " r e d " for w h a t i t
i s c a n n o t b e u n d e r s t o o d o n t h e basis o f a n y m o l e c u l a r s t r u c t u r e . Like
c o l o r b l i n d n e s s , all of t h e o t h e r so-called primarily o r g a n i c - h e r e d i t a r y
illnesses are b y n a t u r e n o t h i n g m o r e t h a n deficiencies i n t h e ability t o
freely c a r r y out p o t e n t i a l w a y s o f being w h i c h are usually t h e r e for
people.
A m o n g m o d e s o f illness t h a t s h o w evident i m p a i r m e n t i n t h e bodying
f o r t h o f b e i n g - i n - t h e - w o r l d w e can also c o u n t supposedly s o m a t o g e n i c
h e a l t h d i s t u r b a n c e s t h a t arise in utero or a f t e r b i r t h . F o r i n s t a n c e , a child
w h o has s u f f e r e d p r e n a t a l t h a l i d o m i d e d a m a g e and c o m e s i n t o t h e w o r l d
w i t h o u t a r m s , is, for o n e t h i n g , directly affected in his ability to g r e e t
people. H e c a n n o t s h a k e h a n d s ; h e i s cut o f f f r o m this w a y o f relating
w i t h o t h e r s . T h e Da-sein of a child b o r n w i t h a r m s b u t u n a b l e to use t h e m
b e c a u s e of paralysis at b i r t h h a s b e e n r o b b e d j u s t as e f f e c t i v e l y of its
ability t o body f o r t h t h e g r e e t i n g r e l a t i o n s h i p .
I n f e c t i o u s diseases should b e u n d e r s t o o d similarly. F o r i n s t a n c e , w h e n
polio paralyzed s o m e o n e ' s a r m s , it is n o t simply his spinal cord and
physical limbs t h a t are affected; m u c h of his e x i s t e n t i a l potential is
d e s t r o y e d , e.g., t h e possibility of bodying f o r t h g r e e t i n g with a
h a n d s h a k e . T h e virus h a s d e s t r o y e d t h a t s p h e r e of t h e p e r s o n ' s pot en t i.d
m o d e s of b e i n g w h i c h is called, in t h e i n a d e q u a t e , a b s t r a c t , o b j e c t i f y i n g
c o n c e p t u a l i t y of n a t u r a l s c i e n c e , t h e a n t e r i o r h o r n cells of t h e spinal ( o r d

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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

region split o f f from t h e h u m a n e x i s t e n c e and c o n c e p t u a l i z e d as c e r e b r a I

and m e t a b o l i c . T h i s p r o c e d u r e s e p a r a t e s the d e s t r u c t i o n o f h u m a n
p o t e n t i a l for r e l a t i o n s h i p from t h e u n i t y of t h e Da-sein and reduces it to
m e r e m e t a b o l i c and c e r e b r a l d i s o r d e r s .
N o w a d a y s , m o n g o l o i d idiocy can be diagnosed p r e n a t a l l y by o b s e r v a
tion of c h r o m o s o m e d a m a g e in fetal cells in placental fluid. T h i s priority
i n t i m e d o e s n o t j u s t i f y t h e e l e v a t i o n o f this c h r o m o s o m a l finding t o the
r a n k o f p r i m a r y c a u s e , basis, o r s o u r c e o f i n f o r m a t i o n for the later
d e v e l o p m e n t o f p o s t n a t a l , s t r u c t u r a l bodily c h a n g e s and b e h a v i o r a l
a b n o r m a l i t i e s of this disease unless t h e m e a n i n g of c a u s e is limited to
d e s i g n a t e w h a t can b e r e g u l a r l y d e m o n s t r a t e d t e m p o r a r i l y t o precede
t h e s u p p o s e d effect. W h a t is of first i m p o r t a n c e is the specific
i m p a i r m e n t o f t h e ability t o fulfull definite possibilities o f r e l a t i o n s h i p
w h i c h are o p e n t o t h e a v e r a g e p e r s o n . T h i s i s a n i m p a i r m e n t o f w h a t
constitutes human existence. T h e chromosomal changes in the
i n t r a u t e r i n e fetal cells a r e j u s t t h e first a s c e r t a i n a b l e p a t h o l o g i c a l
p h e n o m e n a in t h e bodily s p h e r e of a b e i n g - i n - t h e - w o r l d t h a t is disturbed
from its b e g i n n i n g .
J u s t a s t h e bodily findings o f n a t u r a l s c i e n c e lose n o t h i n g o f t h e i r
s i g n i f i c a n c e for m o n g o l o i d idiocy in a D a s e i n s a n a l y t i c a p p r o a c h , so t o o
w i t h findings for o t h e r d i s e a s e s . Indeed, t h e s e findings can b e r e c o g n i z e d
as t h e i n d i s p e n s a b l e condition of directed physical and c h e m i c a l
t h e r a p e u t i c m e a s u r e s only w h e n t h e y are v i e w e d d a s e i n s a n a l y t i c a l l y ,
s e e n i n t h e t o t a l i t y o f t h e i r 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 s .
S u c c e s s i n t w o scientific a c h i e v e m e n t s o f t h e h i g h e s t o r d e r d e m a n d s the
c o n s t a n t e f f o r t t o b e a w a r e t h a t all pathological findings o n t h e body o f
t h e h u m a n being w h i c h can b e scientifically a s c e r t a i n e d are b u l
p h e n o m e n a of the disturbed bodyhood of human being-in-the-world.
F i r s t , o n l y a d a s e i n s a n a l y t i c p e r s p e c t i v e can keep t h e pathological bodily
p h e n o m e n a o f t h e e x i s t i n g h u m a n being f r o m b e c o m i n g i n c o m p r e h e n s i
ble a s w h a t t h e y factually are. S e c o n d , this p e r s p e c t i v e keeps medical
u n d e r s t a n d i n g from losing t h e c o n n e c t i o n o f t h e s e p h e n o m e n a t o the
c o n t e x t of t h e w h o l e bodily lived e x i s t e n c e of t h e ill p e r s o n . W h e n a
scientific a p p r o a c h w h i c h h a s lost a s e n s e of its c o n d i t i o n a l i t y and
r e l a t i v i t y applies a b s o l u t i z e d c o n c e p t s h e r e w h i c h r e d u c e a patient's
p a t h o l o g i c a l bodily s i m p t o m s to isolated p r o p e r t i e s of a m a t e r i a l body,
u n d e r s t a n d i n g of t h a t c o n t e x t is i n e v i t a b l y lost.
T h e y w e r e m a r k e d l y bodily d i s t u r b a n c e s o f b e i n g - i n - t h e - w o r l d , l o o ,
t h a t B o n h o e f f e r classed t o g e t h e r i n 1 9 1 2 a s " a c u t e exogenic reaction
t y p e s . " H i s d e s i g n a t i o n w a s u n f o r t u n a t e . It is impossible to ascei l a i n thai
h u m a n b e i n g - i n - t h e - w o r l d is factually divided i n t o i n t e r n a l and e x t e i rial
r e a l m s . T h u s , w h e r e v e r t h e y a r e used i n m e d i c i n e , the t e r m s " e x o g e n l i
and " e n d o g e n i c " c o n f u s e m o r e t h a n they clarify.

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EXISTENTIAL FOUNDATIONS

W e can safely let this p r o b l e m o f labelling b e for t h e m o m e n t , for m u c h

m o r e i m p o r t a n t are t h e findings t h a t r e c e n t l y led r e s e a r c h e r s t o
r e h a b i l i t a t e and e x p a n d c o n s i d e r a b l y B o n h o e f f e r ' s classification o f 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 . T h e i r i m p r e s s i v e e x p e r i m e n t a l r e s u l t s leave n o
r o o m t o d o u b t t h a t all supposedly primarily physical d i s t u r b a n c e s , n o
m a t t e r h o w d i f f e r e n t t h e y m a y be, are a c c o m p a n i e d b y similar, o r
identical, p s y c h o p a t h o l o g i c a l b e h a v i o r . It is j u s t as c e r t a i n , t h o u g h , t h a t
t h e s a m e h a r m f u l c h e m o p h y s i c a l c o n d i t i o n will b e followed b y d i f f e r e n t
d i s t u r b a n c e s in t h e p e r c e p t i o n and b e h a v i o r of each p e r s o n it a f f e c t s .
T h i s p r o v e s t h a t , a t least w i t h i n t h e b r o a d area o f a c u t e , e x o g e n i c
reaction types, the apparent chemophysical, neuropathological causes
are not at the base of the psychopathological behavioral phenomena; that
is, t h e y are n o t g e n u i n e c a u s e s o f t h e s e afflictions. T h e l a t e s t findings, i n
fact, point a w a y from s o m a t o g e n i c n o t i o n s a b o u t such d i s t u r b a n c e s .
T h e y indicate r a t h e r t h a t t h e m o s t direct d e t e r m i n a n t o f any such illness
is t h e p a r t i c u l a r w a y in w h i c h the p a t i e n t ' s b e i n g - i n - t h e - w o r l d e x t e n d s
i n t o his life h i s t o r y and i n t o his h o p e s , desires, and fears for t h e f u t u r e .
T h e ideas o f t r a d i t i o n a l p a t h o l o g y could n o t g r a s p this t h o r o u g h l y
significant fact, and t h e s e r e s e a r c h e r s w e r e t h e m s e l v e s painfully a w a r e
o f this. T h e y tell u s t h a t t h e y did n o t k n o w w h e t h e r t h e i r f o r m u l a t i o n s
a b o u t a c u t e , e x o g e n i c r e a c t i o n types would t o u c h o n t h e n e u r o p a t h o l o g i
cal facts o f the m a t t e r o r m e r e l y e c h o f a n t a s i e s .
2

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

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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

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world and t o live o n e ' s t i m e w i t h i n t h o s e r e l a t i o n s h i p s . T h e s a m e applies,

finally, t o t h e third s u b g r o u p i n g 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,
usually p o r t r a y e d as a r e d u c t i o n , or simplification, in the o r d e r i n g of
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 w i t h i n t h e psychic realm o f t h e
a f f e c t e d p e r s o n . T h e v e r y idea o f n o r m a l 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 c o n n e c t i n g t h e c o n t e n t s o f c o n s c i o u s n e s s t u r n s o u t t o
be a factually g r o u n d l e s s supposition. A g a i n , all t h a t can be factually
o b s e r v e d in p a t i e n t s w h o c o m e u n d e r this third g r o u p i n g is t h a t t h e o p e n
w o r l d - r e a l m of p e r c e p t i o n as w h i c h t h e y e x i s t is, u n d e r c e r t a i n
c o n d i t i o n s , r e d u c e d to an o p e n n e s s only for v e s t i g e s of t h e m e a n i n g s and
c o n t e x t o f r e f e r e n c e s m a k i n g u p t h e i r world.
T o t h e c a t e g o r y o f m a r k e d l y bodily illnesses b e l o n g n o t o n l y all o f t h e
h e a l t h d i s t u r b a n c e s until n o w w r o n g l y labelled s o m a t o p s y c h i c , b u t also,
n o t w i t h s t a n d i n g t h e i r supposed origin in t h e p s y c h e and t h e i r a s s u m e d
p s y c h o g e n i c d e v e l o p m e n t , all t h e so-called p s y c h o s o m a t i c illnesses. In
c o n n e c t i o n w i t h 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 and o r g a n i c - n e u r o t i c
s y m p t o m s , w e discussed a t l e n g t h t h e precise w a y i n w h i c h t h e s e
illnesses are to be seen as i m p a i r m e n t s in bodying f o r t h specific w a y s of
relating t o t h e world.
O n e c a t e g o r y o f illness m a r k e d b y i m p a i r m e n t i n t h e bodily s p h e r e o f
e x i s t e n c e w h i c h has b e c o m e e x t r a o r d i n a r i l y i m p o r t a n t i n m o d e r n t i m e s
i s t h e c o n d i t i o n k n o w n , since S e l y e ' s studies, a s t h e s t r e s s s y n d r o m e .
S t r e s s m e a n s t e n s i o n , b u r d e n s o m e n e s s , e f f o r t . W h e n w e speak o f s t r e s s
syndrome, we mean the consequences of the overstraining or overbur
dening of a p e r s o n w h i c h a p a r t i c u l a r life s i t u a t i o n m e a n s for h i m .
B e c a u s e e v e r y t h i n g d e p e n d s on t h e p a r t i c u l a r m e a n i n g e x p e r i e n c e d in a
particular s i t u a t i o n , t h e r e can be no such t h i n g as an o v e r e x e r t i o n t h a t is,
in itself, a b s o l u t e and u n i v e r s a l . W h a t a p p e a r s f r o m t h e o u t s i d e as t h e
v e r y s a m e kind o f s i t u a t i o n can p r e s e n t a n e a s y t a s k t o o n e p e r s o n , w h i l e
for a n o t h e r i t m a y involve s e v e r e l y p a t h o g e n i c s t r e s s .
O n e i n s t a n c e o f t h e bodying f o r t h o f a n o v e r s t r a i n e d r e l a t i o n s h i p t o
t h e world is found in t h e illness w h i c h m o d e r n m e d i c i n e has n a m e d
" v e g e t a t i v e d y s f u n c t i o n . " T h i s is defined as disorder of the a u t o n o m i c
n e r v o u s c e n t e r ' s r e g u l a t o r y s y s t e m , w i t h all o f its c o u n t l e s s n e u r e s t h e n i c
s y m p t o m s . Its victims are p r e d o m i n a n t l y middle-class h o u s e w i v e s and
executives, the former burdened beyond their powers with responsibili
ty for a high s t a n d a r d of d o m e s t i c and c u l i n a r y e x c e l l e n c e w i t h o u t t h e
d o m e s t i c help this would r e q u i r e , t h e l a t t e r o v e r t a x e d b e c a u s e m o d e r n
industrial s o c i e t y , f o c u s s e d e x c l u s i v e l y on an e v e r i n c r e a s i n g d o m i n a t i o n
of the world, holds t h e m in a m e r c i l e s s and n e v e r - e n d i n g c o m p e t i t i o n
that n e v e r lets t h e m c a t c h t h e i r b r e a t h .
W h e n the people w h o e x i s t in t h e m e x p e r i e n i c s i n h w a y . ol i elating to
3

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t h e w o r l d a s p e r m a n e n t s t r e s s s i t u a t i o n s , t h e i r bodying f o r t h can g o far

b e y o n d m e r e v e g e t a t i v e d y s f u n c t i o n s t o s e v e r e l y d a m a g e d bodily
s t r u c t u r e s . T a k e , for i n s t a n c e , e s s e n t i a l o r idiopathic high blood
p r e s s u r e ; c o r o n a r y i n f a r c t i o n ; g a s t r o i n t e s t i n a l u l c e r s ; c h r o n i c colitis; and
accident p r o n e n e s s . S o m e o f t h e s e have g r o w n i n t o plague p r o p o r t i o n s
for m a s s e s o f people, r e a s o n e n o u g h for p h y s i c i a n s t o look i n t o t h e i r
natures, right down to their existential meanings.
I f w e a r e really t o u n d e r s t a n d t h e s e s t r e s s d i s e a s e s , w e m u s t first b e
able to explain w h a t s t r e s s , as n o r m a l day-to-day s t r a i n and e x e r t i o n in
t h e r e a l m of Da-sein, actually m e a n s . C o n t e m p o r a r y m e d i c i n e s e e s the
u n v a r y i n g t h y m o l y m p h a t i c r e a c t i o n s , also called physical adaptation
s y m p t o m s , a s t h e c o m m o n basis for t h e g r e a t d i v e r s i t y o f physical and
psychic s t r e s s e s . I n t h e biological v i e w o f t h i n g s , m o r e o v e r , s t r e s s i s
r e g u l a r l y c o n c e i v e d of as being a s t i m u l u s . B i o l o g i s t s o f t e n speak n o t
only o f s t r e s s e s , b u t o f s t r e s s stimuli. T h e i n t e n t b e h i n d t h e t e r m m a y b e
to unify t h e e x t e r n a l and t h e i n t e r n a l in p h y s i o l o g y and biology, but the
e x p r e s s i o n " s t r e s s s t i m u l u s " simply says t h e s a m e t h i n g m o r e t h a n o n c e .
B o t h w o r d s are being used h e r e i n t h e p s y c h o l o g i c a l s e n s e o f w h a t
e n g a g e s and a f f e c t s a p e r s o n . B u t e v e n in its older u s a g e , Reiz ("stimulus")
c a n m e a n m a n y t h i n g s , depending o n t h e p a r t i c u l a r r e g i o n i n w h i c h t h e
s t i m u l u s o c c u r s . T h e t e r m i s m i g h t i l y lacking i n t h e s o r t o f u n e q u i v o c a l
precision demanded in natural science. In the abstract dimensions of
p h y s i o l o g y , w i t h its n o t i o n s o f isolated s e n s e p e r c e p t i o n s , s t i m u l u s a s ,
for e x a m p l e , a s t i m u l u s initiated by s o u n d w a v e s m e a n s s o m e t h i n g
v e r y d i f f e r e n t t h a n in t h e a r e a of a p e r s o n ' s e v e r y d a y dwelling in his
w o r l d . It is possible for, say, a " s t i m u l a t i n g " {reizende: " c h a r m i n g " )
landscape to " s t i m u l a t e " (reizen: " i n v i t e " ) us to t a k e a w a l k t h r o u g h it. We
also n o t e d t h a t " s t i m u l a t i o n " (Reizen: " e x c i t a t i o n ) h a p p e n s as well in the
c o e x i s t e n c e o f people, w h o can o f t e n e n o u g h " s t i m u l a t e " {reizen: " e x c i t e " )
e a c h o t h e r t o love o r fury.
4

T h i s diversity o f stimuli r e v e a l s different m o d e s o f e n g a g e m e n t , t h a t

is, o f so-called s t r e s s . Y e t t h e fact t h a t s t r e s s m a y h a v e m a n y m e a n i n g s
should n o t be t a k e n to indicate s o m e deficiency in t h e w o r d itself, or in
w h a t i t r e f e r s to; this multiplicity o f m e a n i n g s i n h e r e s i n w h a t t h e w o r d
designates. O n l y in the natural sciences, which are wholly oriented
t o w a r d calculability, is a m b i g u i t y m o r e t h a n o n e m e a n i n g for a
d e s i g n a t i o n o r d e s i g n a t e d t h i n g n o t admissible. T h e n a t u r a l s c i e n c e s
can do n o t h i n g but c a l c u l a t e , and it is impossible to p e r f o r m calculations
o n t w o t h i n g s t h a t are n o t a b s o l u t l e y free from a m b i g u i t y . T o suit this
peculiar r e q u i r e m e n t , and n o t o u t o f r e g a r d for t h e o b j e c t o f study itsell,
i m m e n s e e f f o r t is e x p e n d e d in t h e n a t u r a l s c i e n c e s , including medicine,
to get rid of t h e i n h e r e n t a m b i g u i t y of p h e n o m e n a and r e d u c e t h e m to a
c o n d i i i o n o f u n a m b i g u o u s calculability.

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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 <>

an exam. In 1 9 5 1 , Schulte warned, not without justification, that "Far

m o r e a t t e n t i o n o u g h t t o b e g i v e n , i n o u r opinion, t o t h e i m p o r t a n c e o f
relief as a m o t i v a t o r of d e p r e s s i o n . "
Y e t S c h u l t e h i m s e l f later had t o a d m i t t h a t , "in t h e face o f myriad
c o n v o l u t i o n s and o v e r l a p p i n g s , w e c a n n o t g e t past t h e b u r n i n g q u e s t i o n
of w h a t it is t h a t really m a k e s this period of relief so dangerous and susceptible."
I f w e look, h o w e v e r , a t t h e e s s e n t i a l p e r c e p t i v e r e s p o n s i v e n e s s o f h u m a n
being to b e i n g e n g a g e d , we can s e e at o n c e h o w r e l i e f can h a v e a
b u r d e n s o m e aspect. If h u m a n being is in fact p e r c e p t i v e r e s p o n s i v e n e s s
to w h a t e v e r is present, then human being is existentially dependent on
w h a t a d d r e s s e s o r b u r d e n s it. I n t h a t case, r e l i e f from s o m e t h i n g t h a t
e n g a g e s a p e r s o n is an e x t i n c t i o n of his h u m a n b e i n g as t h e p e r c e p t i v e
r e s p o n s i v e n e s s he is. W h e n this b u r d e n falls a w a y , w h a t is left is n o t j u s t
s o m e n e g a t i v e , a n o n b u r d e n , b u t t h e e n d of a life-giving e n g a g e m e n t on
the part of w h a t is r e l e a s e d . If a h u m a n being is deprived e n t i r e l y of s u c h
e n g a g e m e n t , totally u n b u r d e n e d , h e i s r o b b e d o f t h e possibility o f
c o n t i n u i n g to b e - t h e r e as a h u m a n being. A d e p r e s s i n g relief s i t u a t i o n is
m o s t likely to happen w h e n e v e r a p e r s o n h a s allowed h i m s e l f to be
a b s o r b e d totally b y s o m e t h i n g , w h i l e o t h e r t h i n g s t h a t m i g h t h a v e
e n g a g e d a n d used him as a h u m a n b e i n g - i n - t h e - w o r l d h a v e in t h e
m e a n t i m e r e c e d e d far i n t o t h e b a c k g r o u n d . I f t h e o n e r e m a i n i n g b u r d e n
t h e n disappears, t h e p e r s o n n o l o n g e r h a s a n y t h i n g t o w h i c h h e can r e l a t e
and w i t h w h i c h he is e n g a g e d ; t h e r e is no r e l a t e d n e s s in w h i c h and as
w h i c h h e can dwell. H e can n o l o n g e r b e - t h e r e , n o l o n g e r e x i s t . S e e i n g
this, S c h u l t e w r o t e , again i n 1 9 5 1 : " U n d e r the i m p r e s s o f t h e s e findings
w e m u s t a d m i t , against t h e grain o f p r e s e n t practice, n o t o n l y t h a t a n
o r g a n i s m ' s c a p a c i t y of being b u r d e n e d is a m e a s u r e of its h e a l t h , b u t t h a t
a h u m a n being can be described as t r u l y healthy if we can d e c l a r e him
capable of a c c e p t i n g and r e l i n q u i s h i n g b u r d e n s . "
7

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

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psychology. We have seen that Daseinsanalytic understanding shows the

primary nature of human being-in-the-world to consist in maintaining
an o p e n r e a l m of r e s p o n s i v e n e s s and p e r c e p t i o n , a r e a l m in w h i c h
w h a t e v e r r e v e a l s i t s e l f to a p e r s o n can address him. It follows from this
t h a t a h u m a n b e i n g always finds h i m s e l f e n g a g e d in s o m e s i t u a t i o n or
o t h e r , and is t h e r e f o r e always u n d e r s o m e b u r d e n . No h u m a n s i t u a t i o n
can b e r e p r e s e n t e d , c o n s e q u e n t l y , a s i f i t w e r e s o m e c o m p o s i t e m i x t u r e
of s e p a r a t e i n g r e d i e n t s like t h e e g o , t h e body, and a w o r l d . S u c h
i n g r e d i e n t s can f u n d a m e n t a l l y b e c o n c e i v e d o n l y a s p a r t s o f t h e u n i t y
t h a t is b e i n g - i n - t h e - w o r l d . O n l y b e i n g - i n - t h e - w o r l d is c o m p r e h e n s i v e
enough to submit to diverse articulations. B u t even the observations that
a h u m a n b e i n g c a n n o t be s e p a r a t e d from his world fails to r e a c h t h e
m a r k , since it t o o r e s t s upon t h e puzzling n o t i o n of a u n i o n of h u m a n
being and w o r l d . If t h e specific m o d e of h u m a n b e i n g - i n - t h e - w o r l d is
a d e q u a t e l y c o n s i d e r e d , h o w e v e r , this m a t t e r o f separability b e c o m e s
i r r e l e v a n t for h u m a n Da-sein and can be dispensed w i t h from t h e o u t s e t .
A s t h e final p h e n o m e n o n b e l o n g i n g t o the g r o u p o f s e v e r e bodily
i m p a i r m e n t s o f b e i n g - i n - t h e - w o r l d , physical pain n o w d e s e r v e s m e n t i o n .
T h e t e n d e n c y t o label pain a n e x c l u s i v e l y pathological s y m p t o m
s o m e w h a t c o n t r a d i c t s its f u n c t i o n , w h i c h i s t o w a t c h o v e r h e a l t h b y
w a r n i n g a p e r s o n of i m m i n e n t d a m a g e to his i n t e g r i t y ; b u t e v e n in its role
as guardian, t h e p h e n o m e n o n of pain is c o n c e r n e d w i t h injury. In dealing
w i t h o u t t e s t s u b j e c t , we l e a r n e d to see h e r bodily pains as m o d e s of
o p e n n e s s t h a t allowed h e r t o r e c o g n i z e t h a t o b v i o u s injury w a s b e i n g
done, o r had b e e n done, t o o n e o r a n o t h e r o f h e r p o t e n t i a l i t i e s for
relating bodily to w h a t is in h e r world.
To bring in a n o t h e r i n s t a n c e , let us say t h a t I am r e l a x i n g in my g a r d e n ,
s t r e t c h e d o u t c o m f o r t a b l y on a chaise l o u n g e , t h i n k i n g at l e i s u r e a b o u t
t h e f o u n d a t i o n of c o n t e m p o r a r y m e d i c i n e . As I do this, I am b e i n g - i n - t h e world in s u c h a w a y t h a t , bodily at e a s e in k e e p i n g w i t h my p r e s e n t m o o d
of o p e n r e l a x a t i o n , I am s i t u a t e d in the familiar c o n f i n e s of my o w n
g a r d e n . At t h e s a m e t i m e I e x t e n d , as t h e o p e n and p e r c e p t i v e r e a l m I a m ,
o v e r the e n t i r e r a n g e of t h e w o r l d t h a t is a c c e s s i b l e to m e . I p e r m e a t e t h a t
world, e x i s t i n g 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 . W h i l e I lie in my
g a r d e n , e n g a g e d i n visualizing t h e topic o f c o n t e m p o r a r y m e d i c i n e , m y
b e i n g - i n - t h e - w o r l d e x t e n d s t h r o u g h space at least as far as A m e r i c a and
Indonesia, and t h r o u g h t i m e t e n y e a r s i n t o my past. F o r as relax in t h e
g a r d e n , I visualize t h e c o n v e r s a t i o n s I had back then, with P r o f e s s o r
Allport at H a r v a r d U n i v e r s i t y and w i t h P r o f e s s o r S l a m e t in [akarta. No
less f u n d a m e n t a l l y , my b e i n g - i n - t h e - w o r l d e x t e n d ' , .it I hr. m o m e n t i n t o
my future. M y r e m i n i s c e n c e o f t h i n g s p a s t , my p r e s e n t p i . i c e in the
garden, m y reflections o n m e d i c i n e e a c h a n d all o l t h e t e I N d e t e r m i n e d

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

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EXISTENTIAL FOUNDATIONS

out w i t h m a r v e l o u s d e x t e r i t y his e c - s t a t i c w a y s o f relating t o t h e w o r l d .

C o n s i d e r t h e d e x t e r i t y o f t h e v i r t u o s o pianist, w h o s e f i n g e r s give h i m a
highly refined w a y o f r e l a t i n g t o his a u d i e n c e and t o t h e m u s i c h e i s
playing. M o r e p r e c i s e p h e n o m e n o l o g i c a l r e s e a r c h m a y s o m e d a y b e able
to find a close c o r r e l a t i o n b e t w e e n t h e function and s o p h i s t i c a t i o n of an
injured bodily r e g i o n and t h e r e l a t i v e f o r c e and quality of t h e pain t h a t is
e x p e r i e n c e d . It m a y be a r g u e d t h a t t h e brain, w h i c h is t h e m o s t
s o p h i s t i c a t e d a r e a o f t h e bodily r e a l m o f h u m a n e x i s t e n c e , i s also t h e
m o s t i n s e n s i t i v e t o pain, b u t w e should k e e p i n m i n d t h e g r e a t s e n s i t i v i t y
o f t h e m e n i n g e s . A n y i n j u r y w h i c h t h r e a t e n s t h e brain from t h e o u t s i d e ,
and m i g h t possibly t h e r e f o r e b e a v e r t e d , can h a p p e n o n l y a f t e r this
p r o t e c t i v e m e m b r a n e h a s s u f f e r e d a n e x t r e m e l y painful lesion.

W h a t is i m p o r t a n t to glean from o u r e x a m p l e is t h e fact t h a t bodily

pain a l w a y s i n h e r e s in s o m e injury done to 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 t h a t is, t o t h e p e r s o n ' s v e r y e x i s t i n g . B o t h are s o closely r e l a t e d
t h a t bodily pain actually m a k e s it possible for a p e r s o n to perceive injury
to Da-sein. In this p r o p e r t y of pain lies t h e a n s w e r to a q u e s t i o n t h a t h a s
u p t o n o w r e m a i n e d open. T h e r e has b e e n g r e a t u n c e r t a i n t y a b o u t t h e
n a t u r e o f t h e r e l a t i o n s h i p b e t w e e n bodily and m e n t a l pain. W e did
m a n a g e to define m e n t a l pain, in t h e f o r m of s o r r o w , as an E x i s t e n t i a l . W
s a w t h a t t h e e v e r p r e s e n t p o t e n t i a l for a p p a r e n t l y g r o u n d l e s s s o r r o w i s
in reality an a t t u n e m e n t w h i c h o p e n s us to perceiving t h a t o u r Da-sein h a s
b e e n t o r n l o o s e f r o m t h e u n c o n d i t i o n a l a b s o l u t e . B u t bodily pain is a v e r y
specific kind of m e s s e n g e r . It heralds e x c l u s i v e l y injury to o u r ability to
body f o r t h o u r r e l a t e d n e s s t o t h e w o r l d . S o r r o w , t h e r e f o r e , i s t h e o n l y
basis for fully g r a s p i n g t h e m e a n i n g of bodily pain. S o r r o w c a n n o t be
a p p r o a c h e d from t h e s t a n d p o i n t o f physical pain, h o w e v e r . T h e p s y c h i c
pain of s o r r o w r e v e a l s 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 l a c e r a t i o n of Da-sein;
physical pain o n l y p e r m i t s us to p e r c e i v e partial i m p a i r m e n t s in t h e
bodily s p h e r e o f w a y s o f being.
S e e i n g i n t o t h e affinity b e t w e e n bodily pain and o u r e c - s t a t i c
relatedness to the world brings us closer to understanding two extremely
puzzling pain p h e n o m e n a . T h e first is t h e p h a n t o m pain e x p e r i e n c e d in
limbs t h a t h a v e b e e n a m p u t a t e d ; t h e s e c o n d , t h e fact t h a t w h e n pains e n s i t i v e n e r v e s a r e s t i m u l a t e d , t h e r e s u l t i n g pain is felt o n l y at t h e
o u t e r m o s t ends o f t h e s e n e r v e s . W e m a k e o u r first step t o w a r d
understanding these phenomena w h e n we extend our narrow picture of
s e p a r a t e n e r v o u s o r g a n s t o e n c o m p a s s o u r e x i s t e n t i a l w a y s o f relating t o
the world, t h e t r u e dwelling place o f all bodily p h e n o m e n a . W e have
pointed out that t h e s e w a y s o f relating r a n g e far be v e n d I h e v o l u m e o f
space hounded by the skin. F r o m t h e r e , it lake', no great leap to
under.land
both p h a n t o m pain and what h . e . b e e n i a i l e d in e r r o r

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" p r o j e c t i o n i n t o the n e r v e e n d i n g s . " A f o u n d a t i o n of m e d i c i n e is not the

place t o t h o r o u g h l y e x p l i c a t e t h e s e p h e n o m e n a , h o w e v e r a m a t t e r
m o r e f o r a specialized, p h e n o m e n o l o g i c a l l y o r i e n t e d p a t h o l o g y .
L o o k i n g back o v e r o u r c a t a l o g o f bodily i m p a i r m e n t s o f b e i n g - i n - t h e world, w e can clearly see t h a t i t i n c o r p o r a t e s m o d e s o f illness w h i c h
traditional g e n e r a l p a t h o l o g i e s h a v e s c a t t e r e d a c r o s s t h e w h o l e s p e c t r u m
o f classification, and i t e x p l o d e s t h e h i e r a r c h y w h i c h o n c e provided t h e
only f r a m e w o r k for t h e p a t h o l o g i c a l s y m p t o m s o f o u r o w n t e s t c a s e . F o r
h o w could we p r e s e r v e a h i e r a r c h y t h a t b e g i n s w i t h a c a t e g o r y of s o called primarily o r g a n i c physical i l l n e s s e s o n c e w e r e c o g n i z e d t h a t , given
t h e n a t u r e o f h u m a n n e s s , such illnesses simply c a n n o t e x i s t .

Modes of illness showing severe impairment in the spatiality and

temporality of human being-in-the-world
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

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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

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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

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m o r e readily t h a n from t h e Da-sein of a h e a l t h y p e r s o n . I m p a i r m e n t of the

ability to retain f o r m e r l y e n c o u n t e r e d p r e s e n c e s in o n e ' s w o r l d is an
i n h e r e n t part of a n y p a t h o l o g i c a l r e d u c t i o n of a p e r s o n ' s ability to e x i s t
e c - s t a t i c a l l y in a s h a r e d h u m a n world.
Another instance of extremely severe impairment in the existential
t e m p o r a l i t y of a Da-sein is s e e n in t h e m o d e of b e i n g - i n - t h e - w o r l d t h a t
epileptics m a n i f e s t . T h e s p a t i o - t e m p o r a l a r e n a o f t h e i r Da-sein m a y b e
subject to an overwhelming expansion. In the aura of their seizures, their
Da-sein often e x p e r i e n c e s s p a c e - t i m e t r a n s p o r t i n t o u n f a t h o m a b l e
r e a l m s . I f t h e a c c o u n t s o f t h e epileptics t h e m s e l v e s are believed, the
w o r l d - o p e n n e s s t h e y are e x i s t i n g i n t h e t i m e b e f o r e t h e i r s e i z u r e
b e c o m e s infinite in r i c h n e s s and e x t e n t . It is n o t u n c o m m o n to h e a r t h e m
describe their e x p e r i e n c e as a t r u l y celestial bliss. In an i n s t a n t , h o w e v e r ,
this e x i s t e n t i a l w o r l d - o p e n n e s s o f infinite g r a n d e u r m a y collapse i n t o t h e
blackest o b s c u r i t y o f p r o f o u n d u n c o n s c i o u s n e s s .
W h i l e the o r i g i n s and n a t u r e o f t h e s e d i s t u r b a n c e s a r e v e r y d i f f e r e n t
from t h o s e of t h e o r g a n i c p s y c h o s e s , t h e r e is also an o b s t r u c t i v e
i m p a i r m e n t i n t h e spatiality o f people w h o a r e a g o r a p h o b i c o r
c l a u s t r o p h o b i c . T h e a g o r a p h o b i c p e r s o n can find s u p p o r t and e x i s t in a
c o m p a r a t i v e l y free w a y o n l y in r e l a t i o n to a n a r r o w circle of familiar
t h i n g s and people. O p e n spaces and b r o a d a v e n u e s e n g a g e e v e r y o n e i n
such a w a y t h a t o u r Da-sein h a s to m a t c h t h e i r d i m e n s i o n s , to e x t e n d to
r e l a t i o n s h i p s t o t h i n g s o n t h e b o r d e r s o f t h e s e places. T h u s w e p e r v a d e
t h e open spaces w i t h o u r o w n e x i s t e n t i a l p e r c e p t i v e o p e n n e s s . S u c h
spaces also d e m a n d t h a t a n y o n e w h o p e r c e i v e s t h e m s u s t a i n all t h e
unfamiliar and u n c e r t a i n t h i n g s t h a t m a y e n t e r t h e i r wide b o r d e r s f r o m
t h e outside. Y e t t h e v e r y t h i n g t h a t c h a r a c t e r i z e s the Da-sexn o f
a g o r a p h o b i c people is a lack of i n d e p e n d e n t f i r m n e s s , so t h a t it is
impossible for t h e m t o m e e t t h e d e m a n d s o f large, o p e n a r e a s b y
expanding t h e i r e x i s t e n c e s accordingly. I n s t e a d , t h e s e areas o v e r t a x and
o v e r w h e l m t h e m . C o n s e q u e n t l y , a g o r a p h o b i c s e x p e r i e n c e open space a s
s o m e t h i n g o v e r p o w e r i n g , s o m e t h i n g t h a t a b s o r b s and a n n i h i l a t e s t h e i r
Da-sein. W h e n c o n f r o n t e d w i t h such spaces, t h e y t h e r e f o r e f e a r bodily
collapse and loss of c o n s c i o u s n e s s , i.e., t h a t bodying f o r t h of t h e i r
e x i s t e n t i a l inability to s t a y firm as an a u t o n o m o u s selfhood in t h e face of
the meaningful but overwhelming address of what is present.
C l a u s t r o p h o b i c s , o n t h e o t h e r hand, e x p e r i e n c e a n y e n v i r o n m e n t a l
limitation as s u f f o c a t i o n c o n f i n e m e n t . T h e y panic in t h e middle ol closed,
c r o w d e d r o o m s w h i c h o b s t r u c t the possibility of i m m e d i a t e escape at any
m o m e n t . W e h a v e l e a r n e d from o u r test case, with its o b v i o u s
c l a u s t r o p h o b i c traits, t h a t t h e ability of such people to r e l a t e to w h a t is in
I h e n world i s severely reduced t o only o n e , o r a t m o . l a l e w , m e a g e r

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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 .

Modes of illness showing severe disturbances in actualizing the

existential of attunement or mood
T h e disturbance of a t t u n e m e n t in the organic psychoses is k n o w n in
p s y c h i a t r y a s affective i n c o n t i n e n c e . T h i s t e r m t a k e s a n idea from t h e
r e a l m o f physical p a t h o l o g y , n a m e l y , u r i n a r y i n c o n t i n e n c e , and puts i t
i n t o t h e p s y c h i c r e a l m . A c c o r d i n g l y , p s y c h i a t r y ' s n o t i o n o f affective
i n c o n t i n e n c e is based on t h e a s s u m p t i o n t h a t t h e r e is in people a kind of
psychic c o n t a i n e r w h i c h holds, a m o n g o t h e r t h i n g s , a psychic s u b s t a n c e
in the n a t u r e of an affect. In t h e case of o r g a n i c p s y c h o t i c s , it is i m a g i n e d
t h a t this c o n t a i n e r loses its i n t e g r i t y , s o t h a t e v e n t h e s l i g h t e s t p r e s s u r e
is e n o u g h to m a k e its c o n t e n t s spill o u t .
I n c o n t r a s t t o this u n r e a l i s t i c p s y c h i a t r i c h y p o t h e s i s , p a t i e n t s o f this
c a t e g o r y are actually s p e l l b o u n d by w h a t t h e y e n c o u n t e r . A h e a l t h y
p e r s o n m a y t o a g r e a t e x t e n t decide w h e t h e r t o e n g a g e i n t h e a t t u n e m e n t
p r e s e n t l y d o m i n a n t in his e x i s t e n c e and to c h o o s e h o w he will or will not
c o n d u c t h i m s e l f t o w a r d w h a t a p p e a r s t o him i n this a t t u n e m e n t .
A f f e c t i v e l y i n c o n t i n e n t o r labile p a t i e n t s h a v e lost this f r e e d o m o f c h o i c e .
W h a t e v e r t h e y e n c o u n t e r s u b j u g a t e s and i m p o s e s a n a t t u n e m e n t w h i c h
c o r r e s p o n d s t o t h e m e a n i n g i t r e v e a l s . T h e y c a n n o t decide w h i c h o f t h e
p h e n o m e n a t h e y e n c o u n t e r t o dwell by, for t h i n g s e x e r t s u c h g r e a t
p o w e r o v e r t h e m t h a t e a c h n e w p h e n o m e n o n d r a w s t h e m a w a y from the
o n e b e f o r e , quickly r e a t t u n i n g t h e m i n t h e p r o c e s s . P e o p l e w i t h a n
epileptic d i s t u r b a n c e a r e v e r y d i f f e r e n t . W h a t e v e r t h e y e n c o u n t e r t h e y
s t a y w i t h , and t h e y p e r s i s t i n t h e m o o d t h a t c o r r e s p o n d s t o its m e a n i n g .
M o r e s t r i k i n g l y d i s t u r b e d i s t h e a t t u n e m e n t o f p a t i e n t s s u f f e r i n g from
e n d o g e n o u s , m a n i c - d e p r e s s i v e p s y c h o s e s . P a t i e n t s w h o a r e m a n i c inslsl

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FOUNDATIONS

t h a t t h e y h a v e n e v e r b e f o r e felt s o h e a l t h y , s t r o n g , and happy. Life s e e m s

o n e big c a r n i v a l t o t h e m . O n c l o s e r i n s p e c t i o n , h o w e v e r , this h a p p i n e s s
looks v e r y d i f f e r e n t from t h e open, c h e e r f u l c a l m o f h e a l t h y people w h o
h a v e m a t u r e d e n o u g h to c a r r y o u t t h e i r i n h e r e n t p o t e n t i a l i t i e s in a
g e n u i n e l y free and i n d e p e n d e n t w a y . In t h e middle of t h e last c e n t u r y ,
Griesinger, an acknowledged expert on manic-depressive insanity,
o b s e r v e d t h a t "during t h e w h o l e m a n i c p h a s e , m e l a n c h o l y v e r y o f t e n
s h o w s t h r o u g h t h e wildest a r r o g a n c e , like a dark b a c k d r o p . " In t h e m a n i c
s t a t e , p a t i e n t s h a v e available a s t h e i r w o r l d o n l y t h e m o s t n a r r o w r e a l m
o f t i m e - s p a c e . T h e y k n o w n o open free e n c o u n t e r w i t h t h e p h e n o m e n a
o f t h e i r w o r l d . T h e y c a n n o t m a i n t a i n w h a t t h e y e n c o u n t e r i n space a n d
t i m e w h e r e it is n o r let it c o m e i n t o being as w h a t it has to be. T h e
p e r c e p t i o n of t h e s e p a t i e n t s is so s e v e r e l y r e s t r i c t e d t h a t in e a c h t h i n g
t h e y e n c o u n t e r t h e y s e e a l m o s t n o t h i n g b u t a single s i g n i f i c a n c e G
e v e r y t h i n g a d d r e s s e s t h e m only as s o m e t h i n g to be seized and g o b b l e d
up. B u t a s n e a r t o t h i n g s a s t h e y i m a g i n e t h e m s e l v e s , t h e y can n e v e r
c o m e close t o a n y p r e s e n c e , n e i t h e r t o w h a t t h e y t h e m s e l v e s are, n o r t o
w h a t i s n o t t h e m . T h e y are g r a n t e d n o s e r i o u s e n g a g e m e n t i n w h a t t h e y
h a v e greedily looted but i m m e d i a t e l y fall prey to w h a t e v e r it is t h a t n e x t
m e e t s t h e i r e y e s . T h e y m u s t t h e n t r y t o bring t h e n e w thing u n d e r t h e i r
p o w e r , and in t h e m e a n t i m e lose t h e first. It h a s n o t , as w i t h o r g a n i c
p s y c h o t i c s , e n t i r e l y dropped o u t o f t h e i r o p e n r e a l m o f p e r c e p t i o n , b u t
t h e m a n i c p e r s o n does lose h i m s e l f and t h e b e i n g s of his w o r l d in a
dizzying spiral o f s n a t c h i n g a t a n y t h i n g t h a t c o m e s his w a y . T h i s
w h i r l w i n d s w e e p s his w h o l e past and f u t u r e i n t o t h e p r e s e n t i n s t a n t ,
swelling o u t o f p r o p o r t i o n for him t h e i m p o r t a n c e o f t h e e x i s t e n c e o f t h e
m o m e n t . T h i s inflation is m a n i f e s t e d in a feeling of o m n i p o t e n c e t h a t is
b o u n d l e s s and a b s o l u t e l y s e l f - c e n t e r e d , t h o u g h also e m p t y and u n
grounded.
W h a t psychiatry found most arresting in the characteristic manic way
o f relating t o t h e w o r l d w e r e t h o s e p h e n o m e n a w h i c h its s u b j e c t i v i s t i c
theory saw as disturbances of two separate psychic functions. Psychia
t r i s t s s p o k e o f typically m a n i c c o m p u l s i v e activity and o f t h e m a n i c flight
o f ideas. W h e n w e look a t w h a t h a p p e n s , h o w e v e r , t h e r e i s n o e v i d e n c e t o
indicate t h a t ideas o r r e p r e s e n t a t i o n s r a c e a r o u n d i n t h e heads o f t h e s e
p a t i e n t s , n o r t h a t t h e r e is a c o m p u l s i o n driving t h e m f r o m s o m e w h e r e
inside t o c e a s e l e s s activity. O n c e again, w e m u s t explode t h e traditional
m y t h o f a n e n c a p s u l a t e d p s y c h e and learn t o r e c o g n i z e manically
disturbed Da-sein as a deficient m o d e of f u n d a m e n t a l being,-in I h e - w o r l d .
T h e p h e n o m e n a t h e p a t i e n t e n c o u n t e r s i n his world have irresistible
p o w e r to seduce h i m i n t o s u r r e n d e r i n g greedily to I hem M a n n p a t i e n t s
o v e r r u n t h e past and p r e s e n t , and o v e r s h o o t a n y p l a n n e d future a s well.

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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

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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

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EXISTENTIAL FOUNDATIONS

e x i s t e n c e . F o r i n s t a n c e , it is n o t r a r e for m e l a n c h o l i e s to feel pain at the

back o f t h e i r e y e s o c k e t s , and t h e y a r e p r o n e t o c h e s t pains t h a t s e e m t o
t i g h t e n a r o u n d t h e i r u p p e r t o r s o s like i r o n b a n d s . T h e s e s u f f e r i n g s o f
m e l a n c h o l i e s t e s t i f y c l e a r l y t o t h e e s s e n t i a l c o n n e c t i o n b e t w e e n physical
and m e n t a l pain w e indicated earlier.
P s y c h i a t r y c o m m o n l y d i s t i n g u i s h e s b e t w e e n e n d o g e n o u s and r e a c t i v e
d e p r e s s i o n s . R e a c t i v e , u n l i k e e n d o g e n o u s , d e p r e s s i o n s , display sufficient
m o t i v a t i o n in t h e p a t i e n t ' s situation at a g i v e n t i m e . B u t we m u s t
e m p h a s i z e o n c e again t h a t n o e t i o l o g y suffices t o explain pathological
h u m a n b e h a v i o r a s t h e e x i s t e n t i a l p h e n o m e n o n i t is. T h i s applies t o b o t h
e n d o g e n o u s and r e a c t i v e d e p r e s s i o n . F u r t h e r m o r e , t h e value o f any
distinction m a d e b e t w e e n t h e t w o types of d e p r e s s i o n is dubious in any
e t i o l o g y . A n e x p e r i e n c e d clinical r e s e a r c h e r will freely c o n c e d e t h a t
e n d o g e n o u s and r e a c t i v e d e p r e s s i o n s c a n n o t b e s e p a r a t e d p h e n o m e n a l l y ,
but only a c c o r d i n g t o t h e i r r e s p e c t i v e c a u s e s . S i n c e the c a u s e o f
e n d o g e n o u s d e p r e s s i o n is admittedly u n k n o w n , this distinction is on
s h a k y footing. M o r e a t t e n t i o n should also be paid in t h e f u t u r e to the
s t a t e m e n t s o f clinical r e s e a r c h e r s a s e x p e r i e n c e d a s W . S c h u l t e , w h o has
said t h a t " e n d o g e n o u s d e p r e s s i o n is n o t n e a r l y as devoid of e x t e r n a l
influence as is generally supposed." But the greatest reason to doubt
t h e distinction is t h e fact t h a t h i g h l y successful p s y c h o t h e r a p e u t i c c u r e s
h a v e b e e n e f f e c t e d e v e n o n p a t i e n t s w h o had b e e n clearly diagnosed
beforehand as endogenous melancholies. T h e s e cures came about in
c a s e s w h e r e t h e p s y c h o t h e r a p i s t w a s able t o give his e n d o g e n o u s d e p r e s s i v e p a t i e n t t h e c o u r a g e t o radically c h a n g e t h e w a y h e lived, s o
t h a t he no l o n g e r practiced n e g a t i o n of his selfhood as a d e f e n s e a g a i n s t
loss o f love b u t i n s t e a d s t a y e d t r u e t o his i n n e r m o s t n a t u r e i n e v e r y t h i n g
he did, especially in his h u m a n r e l a t i o n s h i p s .
10

T o d a y , g e n u i n e m e l a n c h o l i e s a r e far o u t n u m b e r e d b y people suffering

from t h e p r e s e n t r e p r e s e n t a t i v e f o r m o f n e u r o s i s . I f h y s t e r i c a l
p h e n o m e n a c o m m a n d e d t h e field o f n e u r o s e s from t h e t i m e o f C h a r c o t
and F r e u d u p t o t h e end o f t h e F i r s t W o r l d W a r , from t h e n o n o r g a n i c n e u r o t i c d i s t u r b a n c e s quickly gained a s c e n d a n c y . T h e t e n d e n c y today i s
i n c r e a s i n g l y t o w a r d d e p r e s s i v e illnesses. S u r v e y i n g old case h i s t o r i e s o f
m e n t a l i n s t i t u t i o n s w e find t h a t , a m o n g p a t i e n t s w h o w e r e hospitalized
r e p e a t e d l y , t h e d i a g n o s e s often c h a n g e d w i t h t i m e from m o o d
d i s t u r b a n c e to s c h i z o p h r e n i a . N o w a d a y s , p a t i e n t s initially classified as
s c h i z o p h r e n i c lose t h e i r specifically s c h i z o p h r e n i c s y m p t o m s o v e r the
y e a r s , finally falling into simple d e p r e s s i o n . E v e n a m o n g n o n h o s p i t a l i z e d
p s y c h o n e u r o t i c a l l y disturbed people, m o s t w h o seek help today are
people h o r r i b l y d e p r e s s e d by t h e m e a n i n g l e s s n e s s and tedium ol t h e n
lives. S i n c e n e i t h e r definitive e m o t i o n a l n o r psyi h o i o m a t i i s y m p t o m s

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p r e d o m i n a t e , t h e s e p a t i e n t s and t h e i r physicians a r e at a loss. In the

c o n v e n t i o n a l s e n s e , t h e y are n o t sick. T h e m o d e r n c l e r g y m a n , t o o , is at a
loss to help. S u f f e r i n g as t h e y do, t h e s e people often try to d r o w n o u t
t h e i r d e s p e r a t i o n t h r o u g h addiction t o w o r k , p l e a s u r e , o r d r u g s . W h e n
this fails, t h e depressive a t t u n e m e n t 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
t h a t prevails in this age s h o w s clearly, and we s e e d r a m a t i c a l l y t h e
i m p a i r m e n t o f p e r c e p t i v e o p e n n e s s w h i c h b o r e d o m is.
It is in t h e n a t u r e of b o r e d o m to let p h e n o m e n a be p e r c e i v e d as t h e y
r e v e a l t h e m s e l v e s to a p e r s o n only to the e x t e n t t h a t all o b j e c t s and o t h e r
people are r e v e a l e d a s u n i f o r m l y m e a n i n g l e s s e n t i t i e s . A n e s s e n t i a l l y
b o r e d and depressed p e r s o n can b e w h o l e h e a r t e d l y e n g a g e d b y n o t h i n g .
W h a t e v e r does r e v e a l i t s e l f t o him i m m e d i a t e l y r e t r e a t s n o t e n t i r e l y
o u t of his world, b u t far e n o u g h so it hardly c o n c e r n s t h e afflicted p e r s o n
a n y m o r e . N o t o n l y p a r t i c u l a r t h i n g s b e c o m e b o r i n g , w e a r i s o m e , and
tedious; t h e sick p e r s o n in his e n t i r e t y is b o r e d and w e a r i e d . In the
m o d e r n n e u r o t i c w h a t is m o s t deeply affected is his ability to actualize
h i m s e l f i n time a t t h e r i g h t t i m e .
T h e r e is no genuine future, no
s u p p o r t i n g past, only a m e a n i n g l e s s p r e s e n t . T h e t h r e e t e m p o r a l
d i m e n s i o n s a r e voided i n t o m e a n i n g l e s s c o n n e c t i o n t o w h a t has b e e n ,
w h a t is, and w h a t is e x p e c t e d .
1 1

O v e r t i m e , a v a g u e , i n t a n g i b l e a n x i e t y usually t a k e s hold of 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 . W e h a v e
already described a n x i e t y a s a n a t t u n e m e n t t h a t limits t h e 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 of t h e Da-sein to perceiving t h e o n e possibility t h a t it
can lose all r e l a t e d n e s s to t h e w o r l d . In a n x i e t y , t h e t h r e a t is n o t m e r e l y
t h a t p r e s e n c e s recede i n t o an i n d i f f e r e n t d i s t a n c e , as t h e y do in b o r e d o m ,
for n o m a t t e r h o w far o f f s o m e t h i n g m a y g e t , i t still r e m a i n s w i t h i n the
w o r l d of t h e o n e w h o is b o r e d . B u t in a n x i e t y , Da-sein f e a r s t h e total
r e m o v a l of all t h a t s u p p o r t s it. At t h e s a m e t i m e , a n x i e t y i n t r o d u c e s Dasein to t h e possibility of its o w n ending, of its n o t b e i n g - t h e r e a n y m o r e .
Da-sein f e a r s t h e approach of an e m p t i n e s s , an all-annihilating void. In the
a n x i o u s e x p e c t a t i o n o f i m m i n e n t a n n i h i l a t i o n o f its b e i n g - i n - t h e - w o r l d ,
all t h e o t h e r possibilities of relating to past, p r e s e n t , and f u t u r e a r e
b l a n k e t e d in d a r k n e s s . In s u c h a n x i e t y a h u m a n being finds no support in
his fellows n o r in t h e t h i n g s of his world.

Modes of illness encroaching primarily on the openness and freedom of

the da-sein
All f o r m s of illness described so far e n c r o a c h on t h e possibility ol
realizing t h e basic o n t o l o g i c a l n a t u r e o f h u m a n e x i s t e n c e : freedom and
o p e n n e s s t o w a r d o t h e r h u m a n b e i n g s and t o w a r d all the o t h e i b e i n g s
e n c o u n t e r e d . T h e m o s t salient c h a r a c t e r i s t i c o f s c h i z o p h r e n i a l l this

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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

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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

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FOUNDATIONS

refusing t h e m e a n i n g f u l address of t h e s e b e i n g s and is, as such, a radical

c o n s t r i c t i o n o n t h e fulfillment o f t h e basic trait o f h u m a n b e i n g i t s
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 . H u m a n being is n o t h i n g b u t its
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 , and s o this c h a r a c t e r i s t i c m o d e o f
b e h a v i o r o f t h e s c h i z o p h r e n i c i n p s y c h i a t r y called schizoid b e h a v i o r o r
a u t i s m a m o u n t s to a radical d e s t r u c t i o n of h u m a n being.
W h e n the fundamental disturbance in schizophrenic being-in-theworld is u n d e r s t o o d in this w a y , all t h e ontically, o b s e r v a b l e a b n o r m a l i
ties o f c o n d u c t o f t h e s e p a t i e n t s are easily and i m m e d i a t e l y c o m p r e h e n s i
ble w i t h o u t t h e help o f a n y traditional psychological s u p p o s i t i o n s .
H e r e w e shall d e m o n s t r a t e and s u p p o r t this v i e w w i t h m a t e r i a l t a k e n
from t h e c a s e of a y o u n g m a n , t r e a t e d for e i g h t y e a r s . In r e p o r t i n g his
h i s t o r y w e a r e aided c o n s i d e r a b l y b y t h e y o u n g m a n h i m s e l f , w h o w a s
highly i n t e l l i g e n t and fluent in d e s c r i b i n g and f o r m u l a t i n g his e x p e r i e n
c e s . T h e t h e r a p i s t s saw this patient in t h e earliest p h a s e of s e r i o u s
s c h i z o p h r e n i c illness. O n t h e basis o f his u n d e r s t a n d i n g o f t h e h u m a n
being as Da-sein, t h e t h e r a p i s t was able to a r r e s t t h e illness from f u r t h e r
p r o g r e s s i o n , to p r e s e r v e t h e p a t i e n t from slipping i n t o c o n f u s i o n , and to
bring t h e p a t i e n t gradually t o r e c o g n i t i o n o f t h e world w h i c h , until t h e n ,
h e had blindly o b e y e d . S u c h w a s t h e s u c c e s s o f t h e t r e a t m e n t t h a t n o t
only w a s t h e y o u n g m a n n o l o n g e r afflicted b y t h e t o r t u r e s o f s c h i z o
p h r e n i c d i s t u r b a n c e but, to an a s t o n i s h i n g d e g r e e , b e c a m e a s e l f - r e l i a n t
person w h o dared e n j o y life as a n o n c o n f o r m i s t .
T h e y o u n g m a n first c o m p l a i n e d t h a t h e had a l w a y s felt h i m s e l f a t t h e
beck and call of e v e r y t h i n g and e v e r y o n e he e n c o u n t e r e d . His slavish
s u b m i s s i o n t o t h e appealing, inviting, c h a l l e n g i n g c h a r a c t e r o f w h a t e v e r
was p r e s e n t in his e x p e r i e n c e gradually b e c a m e g r o t e s q u e , so t h a t , for
e x a m p l e , a chair could c o m p e l h i m to sit on it j u s t b e c a u s e it w a s t h e r e to
be sat on. O r , on t h e w a y to t h e cellar to f e t c h a bicycle p u m p , he w o u l d
feel c o m m a n d e d b y t h e d o z e n s o f t h i n g s t h a t c a u g h t his a t t e n t i o n t o
b e h a v e t o w a r d t h e m in a w a y appropriate to t h e i r c h a r a c t e r . N o t o n l y did
his lack of a w i l l i n g - s e l f place h i m u n d e r t h e s w a y of t h i n g s he could s e e
and t o u c h , but, m o r e insidiously, i t m a d e h i m t h e victim o f a n y t h i n g t h a t
c a m e t o m i n d , a b o u t w h i c h h e t h o u g h t o r felt. S u d d e n l y h e m i g h t feel
c o m p e l l e d to e s t a b l i s h t h e origin and p u r p o s e of a spot he had n o t i c e d on
the wall, to fix it in a n e t w o r k of c a u s a l and t e m p o r a l r e l a t i o n s h i p s . T h i s
problem would b e c o m e , in t h a t i n s t a n t , t h e sole c o n c e r n of his life,
forcing him i n t o a frantic b r o o d i n g , forcing h i m to i n t e g r a t e its m e a n i n g
into his e x p e r i e n c e lest he be t o t a l l y o v e r w h e l m e d by it. Just . i s suddenly
the spot could go, and he w o u l d be similarly e n s n a r e d by the problem of
h u m . i n freedom, which d e m a n d e d c o m p l e t e clarification. A m o m e n t
later, i he re< ollection of a small w i n e glass he had used yeai s ago would
i ompel bun to be e n l i g h t e n e d in respecl to its whei e a b o u t i and t e m p o r a l
0 1 igins

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

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EXISTENTIAL FOUNDATIONS

t h e m in p e a c e . " T h u s , his first w a l k t h r o u g h a f o r e s t during w h i c h t h e

f o r e s t r e m a i n e d a f o r e s t w a s an a d v a n c e in his t h e r a p y . His r e l a t i o n s h i p
w i t h his m o t h e r had developed in him s u c h infantile d e p e n d e n c y t h a t ,
until he c a m e i n t o t h e r a p y , it had n e v e r o c c u r r e d to h i m t h a t his
irresistible u r g e on such w a l k s to find s o m e t h i n g particularly i n t e r e s t i n g
i n t h e f o r e s t , o r t o recall t h e b o t a n i c a l n a m e s o f p l a n t s , m i g h t h a v e
s o m e t h i n g t o d o w i t h t h e fact t h a t this w a s w h a t his m o t h e r had a l w a y s
e x p e c t e d h i m t o d o o n s u c h walks w h e n s h e w a s w i t h him. S h e w o u l d
i n c e s s a n t l y bid h i m find s o m e t h i n g o r o t h e r o f i n t e r e s t i n the t r e e s o r o n
t h e f o r e s t floor and p o n d e r its u s e f u l n e s s o r n o x i o u s n e s s . W h e n h e n o w
dared a p p r o a c h t h e f o r e s t freely and w i t h o u t p r e m e d i t a t i o n , i t g r e e t e d
him peacefully. It did n o t r e q u i r e him to b r o o d o v e r a t h o u s a n d details
c o n c e r n i n g its n a t u r e . T h u s did h e begin t o feel his s e p a r a t e h u m a n
existence.
A similar e x a m p l e of t h e specifically s c h i z o p h r e n i c f o r m of e n c r o a c h
m e n t on h u m a n f r e e d o m is t h a t of a p a t i e n t w h o w a s i n v e s t i g a t e d and
o b s e r v e d in t h e s u b a c u t e s t a g e of p s y c h o t i c illness. Like t h e p a t i e n t
w h o s e case w e h a v e j u s t r e p o r t e d , this y o u n g s c h i z o p h r e n i c g a v e vivid
d e s c r i p t i o n s of his c o n d i t i o n .
T h e a t t e n d i n g p h y s i c i a n c o n s i d e r e d t h e p s y c h o s i s , "apart from t h e
d i s t u r b a n c e s of t h i n k i n g and t i m e , " as n o t u n u s u a l . Early in his illness t h e
p a t i e n t says:
12

W h y do I look at t r e e s ? I see h o w t h e y m o v e . T h a t is my salvation. It

frees me again. I g e t s t u c k in t h e s a m e spot, w h i l e e v e r y t h i n g b e c o m e s
so c o n f u s e d in me t h a t I can no l o n g e r d i s t i n g u i s h o n e t h i n g f r o m
a n o t h e r . I h a v e s c a r c e l y g r a s p e d h o w t h e t r e e s s w a y back and f o r t h and
h a v e again found t i m e on t h e m , and t h e n it falls a w a y from m e . . .
T o d a y I am b e t t e r . I can n o w do s o m e t h i n g m y s e l f to b r i n g o r d e r to
t h i n g s again. It will n o t g e t t h e b e t t e r of m e . I m o v e t h e t r e e . It c o m e s
o v e r me and drives me to t h e t r e e . A n d so I go to t h e t r e e , b u t o n l y in
m y t h o u g h t s , and n o w again I h a v e t i m e . T h e r e a r e s o m a n y t i m e s and
all o f t h e m a r e d i f f e r e n t . W h o k n o w s w h a t i s w i t h t h e m ? A m 1 m y s e l f
p e r h a p s t i m e , or a living c l o c k w o r k ? W h e n I c o m b i n e t h e t r e e w i t h it,
and so find a c e r t a i n w a y o u t , t h e n I am again h e r e as m y s e l f .
A n o t h e r t i m e this p a t i e n t w a s looking at a wall clock and said:
W h a t should I do w i t h t h e c l o c k ? I m u s t look at it all the time. I am
driven to it to look at it. T h e r e is so m u c h t i m e I am always different. If
t h e r e w e r e no clock on t h e wall, I would have to die. Am 1 mysell not a
clock, e v e r y w h e r e and at all p o i n t s ? B u t I can do n o t h i n g e l s e , it
c h a n g e s too much. N o w I am again o b s e r v i n g I l i e ( loi ! the h a n d , I h e

General

Daseinsanalytk

Phenomenology

dial, and t h a t it g o e s . As if of its o w n accord, it t e a r s i t s e l f apart, and I

am involved b u t can c h a n g e n o t h i n g . I say again and again t h a t it is a
clock, b u t t h e r e a r e i n c o n g r u i t i e s : hand, c l o c k f a c e , and i t g o e s . T h e r e | |
a peculiar i m p r e s s i o n , as if it had s p r u n g apart, b u t it is i n t a c t . B u t t h e r e
is s o m e t h i n g else as well. I am a s t o n i s h e d . I h a v e n e v e r e x p e r i e n c e d
a n y t h i n g similar. T h e h a n d is a l w a y s different. N o w it is h e r e , and t h e n
it practically leaps a w a y and r o t a t e s . Is it a l w a y s a different h a n d ?
P e r h a p s t h e r e is s o m e b o d y b e h i n d t h e wall, w h o r e p e a t e d l y puts a n e w
h a n d in, and e a c h t i m e at a d i f f e r e n t place. I m u s t say t h a t it is no
f u n c t i o n i n g clock w h e n it leaps and c h a n g e s so. O n e is so e n g r o s s e d in
looking at t h e clock a n d loses t h e t h r e a d to o n e s e l f . B e c a u s e I am m y s e l f
a clock, e v e r y w h e r e in m e , b e c a u s e it is a l w a y s so c o n f u s e d . I am all of
thisI lose it all w h e n I look at t h e clock on t h e wall. It is a r u n n i n g
a w a y f r o m o n e s e l f : I am fleeing and am no l o n g e r h e r e . I o n l y k n o w , t h e
clock hops a b o u t w i t h its m a n y h a n d s and c a n n o t b e properly
r e a s s e m b l e d . N o w it is again e n o u g h of t h e wall c l o c k , but n o t
according t o m y will, and I m u s t g o t o t h e o t h e r position, i n t o t h e o t h e r
kind. As I h a v e said, I am a living clock, I am e v e r y w h e r e c l o c k a n d so
it k e e p s c o m i n g and g o i n g . W h e n I t e a r m y s e l f a w a y again b e c a u s e
e v e r y t h i n g is so c o n f u s e d , t h e n I again look to t h e wall clock. It can help
m e , like t h e t r e e i n f r o n t o f t h e w i n d o w . N o i s e s a r e n o t s o g o o d .
T h e r e p o r t o n this p a t i e n t i n t r o d u c e s this soliloquy b y t h e p a t i e n t o n
t h e clock as follows: " W h i l e o b s e r v i n g t h e h a n d s of a wall clock, t h e
p a t i e n t m a d e t h e f o l l o w i n g s t a t e m e n t . . ." T h i s i n t r o d u c t i o n s e e m s ,
already, t o m i s c o n s t r u e t h e m a t t e r . Indeed, the w r i t e r , w h o calls t h e
r e p o r t " S p a c e - T i m e S t r u c t u r e i n S c h i z o p h r e n i a , " s e e m s t o believe t h a t
t h e p a t i e n t is c o n c e r n e d w i t h his e x p e r i e n c e of t i m e . Y e t it is striking t h a t
n o w h e r e does t h e p a t i e n t m e n t i o n t i m e o r data r e l a t i n g t o t i m e ; h e talks
a b o u t a c l o c k , or r a t h e r a b o u t t w o different clocks, t h e wall clock and the
m e r e clock.
T h e wall clock c o m p e l s him to look at it, but t h e n e x t m o m e n t it is " not
a c c o r d i n g to my will . . . e n o u g h of the wall clock, I m u s t go to t h e o t h e r
position, i n t o t h e o t h e r k i n d . " T h e p a t i e n t s e e m s t o say t h a t h e g o e s from
looking at the clock on t h e wall to o b s e r v i n g a f r a g m e n t e d clock thai
w o r k s e r r a t i c a l l y and c a n n o t be r e a s s e m b l e d , a m e r e clock t h a t no longei
c o n f r o n t s him face to face f r o m its place on t h e wall but is w i t h o u l a
whereabouts.
H e r e w e m a y find t h e decisive discrepancy o n w h i c h e v e r y t h i n g
h i n g e s . T h e p a t i e n t is in r e l a t i o n to the wall clock, on the o n e hand, and ll
s w e p t " i n t o t h e o t h e r k i n d " t h e r e l a t i o n s h i p w i t h t h e m e r e i lot !
on
the o t h e r . ( T h e m e a n i n g , h e r e , of " m e r e " is lack of a definite plai e ui
familiar s u r r o u n d i n g s . ) N o w , t h e wall clock is t h e r e to be looked al ll In

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familiar, and w h e n t h e p a t i e n t stands opposite it, this familiar o b j e c t

helps him r e c o l l e c t his s e l f by g r a n t i n g his e x i s t e n c e a dwelling space in
his r e l a t i o n s h i p w i t h it. T h e m e r e clock, h o w e v e r , d e s i g n a t e s a
r e l a t i o n s h i p in w h i c h t h e o b s e r v e r is e n g u l f e d by t h e o b s e r v e d ; it is for
this r e a s o n t h a t t h e p a t i e n t t h e n says, " I a m m y s e l f c l o c k . " H e m e a n s , " I
am, according t o m y n a t u r e , clocklike . . . I a m clock, e v e r y w h e r e i n m e . "
In so seeing himself, t h e p a t i e n t does n o t , we m a i n t a i n , m a k e a psychic or
s u b j e c t i v e t r a n s f e r o f a n y t h i n g from his psychic capsule i n t o t h e clock.
R a t h e r , h e i s s o b e n u m b e d b y w h a t h e o b s e r v e s t h a t h e loses his d i s t a n c e
from it. T h e r e i s n o l o n g e r a n y t h i n g available face t o face t o w h i c h h e
could r e l a t e in an o p e n w a y and t h e r e f o r e he " l o s e s the t h r e a d " to
h i m s e l f . "I lose it all": his b e i n g - h i m s e l f is lost to h i m .
In order to understand these schizophrenic experiences we must very
c l e a r l y distinguish b e t w e e n t h e t w o different kinds o f r e l a t i o n s h i p
t o w a r d t h e clock. At o n e m o m e n t the issue is his r e l a t i o n s h i p to a clock
h a n g i n g o v e r t h e r e o n t h e wall. A t o t h e r t i m e s h e e x i s t s a s t h e r e l a t i o n t o
a m e r e clock, i n t o w h i c h he is s w e p t and t h r o u g h o u t w h i c h he is
dispersed. T h i s m e r e clock n o l o n g e r h a s a n y place o f its o w n o u t s i d e i n a n
open realm of a h u m a n w o r l d w h i c h would leave him an open and free
space b e t w e e n i t and h i m s e l f . T h e m e r e clock h a s b e c o m e i n d i s t i n g u i s h
able from his o w n e x i s t e n c e . It no l o n g e r g r a n t s him an open and free
r e l a t i o n s h i p t o w a r d it as a dwelling space for his e x i s t e n c e .
T h e m o m e n t t h e p a t i e n t is again able to c o n f r o n t t h e clock as a wall
clock h a n g i n g o v e r t h e r e and to m a i n t a i n a clear d i s t a n c e in r e l a t i o n to it,
he is in t h e w o r l d in a m o r e or less h e a l t h y w a y and can p e r c e i v e t h a t
world a s a n open r e a l m . O n l y w h e n h e can n o l o n g e r m a i n t a i n t h e s t a n c e
of c o n f r o n t a t i o n is he o n c e again b a n i s h e d from w o r l d - o p e n n e s s to t h e
m e r e clock w h e r e h e i s d e r a n g e d . S i m i l a r l y , t h e t r e e outside his w i n d o w
provides him w i t h a n a t u r a l s u r r o u n d i n g world to w h i c h he can r e l a t e
t h r o u g h perception: t h e r e is solidarity, place, d e f i n i t i o n a s t h e r e is n o t ,
for e x a m p l e , w i t h n o i s e s . " N o i s e s are n o t s o g o o d , " h e says. G o o d for
w h a t ? F o r t h e r e f e r e n c e t o m e a n i n g f u l c o n c r e t e r e a l i t y w i t h its c o n t e x t
o f r e f e r e n c e s t o o t h e r b e i n g s o f this world, w i t h o u t w h i c h t h e patient
c a n n o t live. H e can n o m o r e e x i s t t h r o u g h m e r e s o u n d s t h a n h e can
t h r o u g h t i m e as a m e r e s u c c e s s i o n of n o w - p o i n t s .
W e m a y see, t h e n , t h a t t h e i n t e r p r e t a t i o n o f r e p o r t s like this o n e i s n o t
self-evident. It is i n d i s p e n s a b l e to c o n s i d e r critically t h e w r i t e r ' s guiding
c o n c e p t s and a s s u m p t i o n s . In this c a s e , t h e issue is n o t t h a t of time or
time s t r u c t u r e b u t of t h e differing r e l a t i o n s of a schizophrenic person to
a clock, which he does n o t regard as a t i m e - m e a s u r i n g apparatus 1 he
p a t i e n t ' s w o r d s do n o t t o u c h upon t h e p r o b l e m ol time
Wh.il we have a t t e m p t e d h e r e is a rough sketch ol the way a

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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

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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

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o n s e t of his illness. A f e w w e e k s b e f o r e this n e r v o u s b r e a k d o w n , a friend,

t h e p e r s o n closest t o him from e a r l y childhood, t o w h o m t h e p a t i e n t w a s
still deeply a t t a c h e d at t h e t i m e of this i n t e r v i e w , suddenly and
u n e x p e c t e d l y failed to appear for a d a t e t h e y had a g r e e d upon. T h e friend
also failed t o c o n t a c t h i m a t a n y t i m e a f t e r this " b e t r a y a l . " T h e p a t i e n t
still brooded o v e r this deep h u r t during t h e i n t e r v i e w and felt t h a t this
incident, which he i n t e r p r e t e d to m e a n t h a t t h e friend s t o o d h i m up f o r a
girl, had c e r t a i n l y b e e n chiefly r e s p o n s i b l e for his illness. M o r e o v e r , t h e
patient did not intend to t r y to r e e s t a b l i s h t h e friendship s i n c e , " A n y w a y ,
it is n o t possible to f o r c e a f r i e n d s h i p . " D i s c u s s i n g this incident, t h e
patient b e c a m e i n c r e a s i n g l y s o a g i t a t e d t h a t t h e d o c t o r c h a n g e d t h e
s u b j e c t t o inquire a b o u t t h e m a n ' s m o s t vivid e x p e r i e n c e during his
illness.
It w a s , t h e p a t i e n t replied, t h e vision, during t h e n i g h t , of t h e sun in his
r o o m , a p r e s e n c e so p o w e r f u l t h a t he s a w it as an actual e v e n t . M o r e o v e r ,
j u s t talking a b o u t it, as in t h e i n t e r v i e w , would, he believed, bring him
again u n d e r t h e s w a y o f t h a t vision, w h i c h w a s , h e k n e w , a f i g m e n t o f his
i m a g i n a t i o n . T h e p a t i e n t also w a n t e d t o avoid explaining t o t h e d o c t o r
t h e m e a n i n g this e x p e r i e n c e had for him. W i t h e m b a r r a s s m e n t h e said,
" D o n o t t h i n k I've m a d e a god o u t o f t h e sun. I t w a s , for m e , t h e 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 . " His a n x i e t y and panic on
seeing t h e sun c a m e from t h e c o n v i c t i o n t h a t " . . . i t can 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 i s a m o u n t o f e x p l a n a t i o n w a s all t h e p a t i e n t
could t o l e r a t e in t h e i n t e r v i e w . He b r o k e it off, saying, "I am n o t going to
talk a n y m o r e . I don't w a n t to b e c o m e ill a g a i n . " T h e t h e r a p i s t , of c o u r s e ,
r e s t r a i n e d his scientific c u r i o s i t y in this i n s t a n c e in d e f e r e n c e to t h e
w e l f a r e o f t h e patient, w h o s e i n s t a b i l i t y w a s e x t r e m e .
F o r this p a t i e n t , t h e w h o l e w o r l d - s t r u c t u r e of his Da-sein had b e e n
m a d e up of r e l a t i o n s h i p s w i t h his friend and his family w h i c h , h o w e v e r
n a r r o w and secluded, provided him w i t h reliably p r o t e c t i n g , s c r e e n i n g ,
filtering r e l a t i o n s to a s e c u r e , familiar world. T h e collapse of this
c o n f i n e d w o r l d - r e l a t i o n suddenly and drastically e x p a n d e d t h e limita
tions o f his e x i s t e n c e , plunging him i n t o a n u n f a m i l i a r o p e n n e s s o f being.
Y e t he could n o t exist in this w o r l d as does a g r o w n m a n w h o is a w a k e ;
s u c h e x i s t e n c e w a s lost t o his b e i n g - i n - t h e - w o r l d . H e perceived t h e loss
in t h e h a l l u c i n a t e d apparition of t h e m a n w h o slept b e n e a t h t h e sun. He
saw, in this single g r o w n u p sleeping in his p s y c h o t i c world, the
u n a w a k e n e d adult p o t e n t i a l i t y t o b e a w a k e and adult. C o r r e s p o n d i n g t o
his lost s e l f - r e l i a n c e and t h e p o w e r l e s s n e s s he felt in losing t h e s e m i it y
of t h e c i r c u m s c r i b e d r e l a t i o n s h i p of his lifelong friendship, he could only
s e e w h a t w a s n o t h i m s e l f a s s o m e t h i n g t h a t w a s all t h e m o r e p o w e i ful,
w h o s e c h a r a c t e r w a s o v e r w h e l m i n g and c o s m i c . S c h i z o p h r e n i c a l l y ill, he

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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 -

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sitivity, w h i c h b r e a k s t h r o u g h t h e limits of t h e i r Da-sein, is n o t the fruit ol

m a t u r a t i o n b u t is, instead, t h e s y m p t o m of i n n e r collapse of a selfhood
t h a t w a s always p r e c a r i o u s , u n s t a b l e . T h u s , t h e s c h i z o p h r e n i c " S u n
m a n " could n o t b e a r his p e r c e p t i o n o f t h e s u p e r s e n s o r y , t h e real n a t u r e
and m e a n i n g of t h e sun; it s w e p t him u n d e r , r o b b i n g him of all f r e e d o m ,
o f his o w n g r o u n d . E v e n b a n i s h e d t o t h e wall o f his r o o m t h e c o s m i c
t h i n g w i t h its e x t r a v a g a n t d i m e n s i o n s s w a l l o w e d him and ruled him with
t h e m i g h t of its n o w visible s u p e r t e r r e s t r i a l s i g n i f i c a n c e . It placed all the
o t h e r realities of his p r e v i o u s w o r l d in a m i s t y half-reality, so t h a t the
t r e e s in a little f o r e s t w h e r e he w a l k e d a f t e r t h e w o r s t a g i t a t i o n w a s past
r e a c h e d his vision in t h e f o r m of a c o m p l e x of s h a d o w s .
W e h a v e n o w p r e s e n t e d t h r e e e x a m p l e s o f a D a s e i n s a n a l y t i c approach
t o s c h i z o p h r e n i c illness. W e m a y s u m u p o u r c o n c l u s i o n s c o n c e r n i n g the
c h a r a c t e r of this illness as follows. F i r s t , s c h i z o p h r e n i c illness is not,
c u r r e n t c o n c e p t i o n s n o t w i t h s t a n d i n g , a disorder in 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 o b j e c t s i n t h e o u t s i d e world, o r o f i n n e r drives and
a s p i r a t i o n s , all of w h i c h w o u l d reside in a capsulelike p s y c h e . T h e s e
c o n c e p t i o n s v i e w e d i n r e l a t i o n t o s c h i z o p h r e n i a p r o v e m o r e clearly than
e v e r t o b e i n a d e q u a t e and i n a p p r o p r i a t e for u n d e r s t a n d i n g h u m a n
e x i s t e n c e in g e n e r a l . S e c o n d , s c h i z o p h r e n i a m u s t be s e e n as a d i s t u r b a n c e
o f t h e specific b e i n g - i n - t h e - w o r l d w h i c h i s the n a t u r e o f h u m a n being.
We cannot emphasize too much that being-in-the-world is the carrying,
s u s t a i n i n g , m a i n t a i n i n g , and holding o p e n of a clear w o r l d l y realm of
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 h a t all people c a r r y o u t , t h o u g h e a c h in
his o w n individual way. B e i n g h u m a n also m e a n s t o b e c o m m i t t e d t o
w h a t is e n c o u n t e r e d so as to c a r e for it and help it unfold to its fullest
extent.
W e h a v e n o w s e e n t h a t s c h i z o p h r e n i c s suffer from e n c r o a c h m e n t
specifically on t h e i r ability to be r e s p o n s i v e and o p e n to w h a t is
e n c o u n t e r e d . T h e e n c r o a c h m e n t is of a twofold n a t u r e . F i r s t , s c h i z o
p h r e n i c s c a n n o t o p e n t h e m s e l v e s fully t o t h e m e a n i n g f u l address o f w h a t
t h e y e n c o u n t e r , a s t h e i r m o r e h e a l t h y fellows can, s o t h a t t h e y c a n n o t
r e s p o n d w i t h all t h e i r f a c u l t i e s to t h e n o r m a l l y a c c e p t e d significance or
m e a n i n g f u l n e s s and m e a n i n g o f t h o s e t h i n g s and e v e n t s . S e c o n d , t h e y
a r e u n a b l e to m a i n t a i n a free s t a n c e vis-a-vis t h e i r p e r c e p t i o n s of what
t h e y e n c o u n t e r . I n s t e a d , w h e n e v e r t h e s c h i z o p h r e n i c ' s ability t o respond
to t h e e n c o u n t e r e d is o v e r e x t e n d e d or claimed m o r e i n t e n s i v e l y than he
can b e a r , his e x i s t e n t i a l f r e e d o m collapses. T h i s e x p l a i n s w h y it is thai
s c h i z o p h r e n i a is u n k n o w n in a n i m a l s , r a r e in children, n o t infrequenl In
w o m e n a f t e r childbirth, and m o s t f r e q u e n t a f t e r p u b e r t y . In the lattei
t w o s i t u a t i o n s , t h e individual's perceiving e x i s t e n c e is opened to
p o w e r f u l n e w d e m a n d s from o t h e r s , d e m a n d s t o c o m e close and c n ^ . i ^ r

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fully in r e l a t i o n s h i p s s u c h as t h a t of a m a t u r e s e x u a l love, or a m o t h e r child love. I n addition, t h e p e r c e p t i o n o f t h e a d o l e s c e n t h u m a n b e i n g

b e g i n s t o o p e n t o m u l t i t u d i n o u s claims from o t h e r b e i n g s , h u m a n and
n o n h u m a n , to r e l a t e to t h e i r r e s p o n s i b i l i t y in a p l a n n i n g , caring w a y
oriented to the future.
It is i m p o r t a n t , t h e r e f o r e , to qualify any d i a g n o s i s of s c h i z o p h r e n i a .
T h e q u e s t i o n a l w a y s t o b e r a i s e d is: s c h i z o p h r e n i c u n d e r t h e e x c e s s i v e
demands of which pattern of human relationships? An example is that of
a w o m a n w h o s h o w e d s c h i z o p h r e n i c s y m p t o m a t o l o g y , including m a r k e d
a u t i s m , w h o w a s c u r e d j u s t a s s o o n a s she w a s freed from h e r o v e r t a x i n g
life s i t u a t i o n a s wife and m o t h e r o f t h r e e c h i l d r e n t o m e e t t h e m o r e
limited d e m a n d s of t h e life of a single w o m a n w o r k i n g as a l a b o r a t o r y
a s s i s t a n t . L i k e w i s e , t h e s c h i z o p h r e n i a o f s e v e r e l y ill hospitalized p a t i e n t s
w i t h i n t e n s e s o m a t i c h a l l u c i n a t i o n s and d e l u s i o n s can disappear
o v e r n i g h t w h e n t h e y feel t r u s t in a t h e r a p i s t w i t h w h o m t h e y can e n t e r
i n t o a p a r e n t - c h i l d r e l a t i o n s h i p from w h i c h t h e y can g r o w (having indeed
r e m a i n e d in t h e i r lives helpless, childlike c r e a t u r e s ) into free and
independent adulthood.
T h e s e o b s e r v a t i o n s lead us to define s c h i z o p h r e n i c being-ill as a
radically i n c o m p l e t e m a n i f e s t a t i o n o f t h e free and s e l f - r e l i a n t selfhood
that normally characterizes human being. T h e r e f o r e , schizophrenia is an
illness t h a t can be c h a r a c t e r i z e d o n l y n e g a t i v e l y ; it has no positive
c h a r a c t e r i z a t i o n . T h e r e i s n o special kind o f r e l a t i o n s h i p t h a t t h e
s c h i z o p h r e n i c m a i n t a i n s w i t h o t h e r s t h a t i s n o t t o b e found, 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 m o n g h e a l t h y people. T h e p a t h o l o g y i n s u c h
p a t i e n t s is t h e i r lack of t h e possibility available to t h e h e a l t h y p e r s o n to
a s s e m b l e his r e s p o n s e s and b e h a v i o r to be s e l f - r e l i a n t , free, o p e n , and
e n d u r i n g i n t h e face o f w h a t e v e r m a y b e e n c o u n t e r e d . T h e s c h i z o p h r e n i c
b e c o m e s s u b j e c t , i n v a r y i n g d e g r e e s , t o t h e m o d e s o f being o f o t h e r
people and o f t h i n g s i n t h e world. T o a n e x t e n t u n k n o w n t o o t h e r
i l l n e s s e s , t h e Da-sein of t h e s c h i z o p h r e n i c is e n g u l f e d in the o v e r w h e l m
ing o t h e r ; s u f f e r e r s o f this illness e x i s t l a r g e l y o u t s i d e t h e m s e l v e s .
A c c o r d i n g l y , t h e y o f t e n e x p e r i e n c e t h i n g s t h r o u g h v o i c e s t h a t speak t o
t h e m , o r feel 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 n o t t h e i r o w n but are
performed by others.
W h a t is perceived in this w a y h a s n o t h i n g to do, h o w e v e r , w i t h a
psychic p r o j e c t i o n o f t h e i r o w n 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 , m e n t a l
i m a g e s , or affect i m p u l s e s into an outside world. S u c h psychological
fictions for w h i c h , as we h a v e said, t h e r e is no piece of c o n c r e t e e v i d e n c e ,
c a n n o t c o n t r i b u t e to the elucidation of such a s e r i o u s d i s t u r b a n c e B e f o r e
a n y t h i n g can be p r o j e c t e d from an inside to an outside, il must lirst have
been in the p o s s e s s i o n of the p r o j e c t o r . H o w e v e i , hi/ ophi e n H patients

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are, precisely in r e s p e c t to t h e supposedly h a l l u c i n a t e d and p r o j e c t e d

t h i n g s , fully outside t h e m s e l v e s and lost i n t o t h a t w h i c h t h e y ,
t h e m s e l v e s , are not. E v e n h e a l t h y people h a v e n o t h i n g inside t h e m
s e l v e s , b e c a u s e h u m a n e x i s t i n g , by its v e r y n a t u r e , h a s no " i n s i d e " in the
s e n s e of a c o n s c i o u s and u n c o n s c i o u s r e s e m b l i n g a capsulelike p s y c h e
t h a t is a c o n t a i n e r of s o r t s . It is all t h e m o r e fallacious, t h e n , to speak of
i n t r a p s y c h i c m a t e r i a l t h a t can b e p r o j e c t e d o n t o t h e o u t s i d e w o r l d i f o n e
r e f e r s t o s c h i z o p h r e n i c s w h o , from a n e x i s t e n t i a l point o f view, a r e m u c h
less c o l l e c t e d to a s e l f - r e l i a n t selfhood t h a n a r e h e a l t h y people.
R u d i m e n t a r y as this initial c h a r a c t e r i z a t i o n of s c h i z o p h r e n i a is, it
could s e r v e as a s t a r t i n g point for the d e v e l o p m e n t of a scientific
a p p r o a c h to t h e illness. F i r s t and f o r e m o s t , it could help f r a m e a d e q u a t e
and a p p r o p r i a t e q u e s t i o n s a b o u t s c h i z o p h r e n i a a n d , in fact, a b o u t a n y
o t h e r f o r m o f h u m a n being. W h e n t h e basic c h a r a c t e r i s t i c o f t h e h e a l t h y ,
as well as t h a t of t h e s c h i z o p h r e n i c , p e r s o n is r e c o g n i z e d as being a
perceptive responsive openness to the meaningfulness of the p h e n o m e
na of this world, it will be c l e a r t h a t t h e e s s e n t i a l f e a t u r e of s c h i z o p h r e n i c
being i s t h e specific e n c r o a c h m e n t o n t h e o p e n n e s s and f r e e d o m o f the
Da-sein.
O n this basis i t m a y b e possible, for i n s t a n c e , t o w o r k o u t a n a d e q u a t e
c o n c e p t i o n o f h e r e d i t y . D e c a d e s a g o E u g e n B l e u l e r n o t e d its a b s e n c e , and
e v e n today g e n e t i c i s t s h a v e b e e n able t o w o r k o u t t h e i n t a n g i b l e
p r e r e q u i s i t e s for useful r e s e a r c h i n t o t h e role o f h e r e d i t y i n s c h i z o p h r e
nia. F o r o n e thing, t h e i r p r o p o s i t i o n s c o n c e r n i n g a multiple g e n e
i n h e r i t a n c e of s c h i z o p h r e n i a are u n c l e a r and totally lacking in a n y factual
basis. A n d , s e c o n d , t h e s o r t of r e s e a r c h t h a t is b e i n g d o n e can o n l y
d e s i g n a t e w h a t it r e g a r d s as a c t u a l l y i n h e r i t e d in s c h i z o p h r e n i a , w h i c h it
calls " t h e psychic t r a n s f o r m a t i o n of a biological c o n s t i t u t i o n subject to a
multiple g e n e i n h e r i t a n c e , " as r e s p o n s i b l e for an " i n d e t e r m i n a t e
possibility for t h e d e v e l o p m e n t o f t h e p e r s o n a l i t y . " S u c h s t a t e m e n t s
hardly d e s c r i b e f u n d a m e n t a l s w h o s e i n h e r i t a n c e can b e i n v e s t i g a t e d . I t
s e e m s likely, o n t h e o t h e r h a n d , t h a t the l o n g - s o u g h t a d e q u a t e
c o n c e p t i o n of h e r e d i t y m a y be found in t h e p h e n o m e n o l o g i c a l c o n c e p t i o n
o f t h e basic c h a r a c t e r o f s c h i z o p h r e n i c being-ill, w h i c h b e g i n s w i t h the
u n d e r s t a n d t h a t being is Da-sein. T h i s approach n o t o n l y can provide
sufficiently c o n c r e t e c o n t e n t for t h e still e m p t y c o n c e p t i o n s o f h e r e d i t y ,
but it m a y also s e r v e as a reliable basis for t h e r a p e u t i c w o r k with
s c h i z o p h r e n i c p a t i e n t s . T h e first p a t i e n t described in this c h a p t e r is a case
in point.
We h a v e used s c h i z o p h r e n i a to exemplify t h e d i s t u r b a n c e of health
t h a t r e s u l t s w h e n t h e 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 of Da-sein
perceptive
r e s p o n s i v e o p e n n e s s t o t h e p r e s e n c e and m e a n i n g o f all e n c o u n t e r e d
beingsis drastically e n c r o a c h e d upon. While it might appeal thai ii

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b e t t e r choice f o r this p u r p o s e would h a v e b e e n o b s e s s i v e - c o m p u l s i v e

diseases, w h i c h s e e m to pose a perfect c o n t r a s t to f r e e d o m and o p e n n e s s ,
in fact, such diseases are n e v e r t h e opposite of f r e e d o m , but are a special
f o r m o t it, h o w e v e r impaired o r reduced t h a t f r e e d o m m a y be. O n l y
beings w h o , b y n a t u r e , are e n d o w e d w i t h f r e e d o m can e x p e r i e n c e t h e
m e a n i n g of o b s e s s i o n s and c o m p u l s i o n s ; a s t o n e , f o r e x a m p l e , w h e n it
falls, k n o w s n o t h i n g of being compelled to do so. It is true that t h e
freedom and o p e n n e s s o f o b s e s s i v e - c o m p u l s i v e s a r e s o limited that t h e y
m u s t keep a c o n t r o l l e d distance from c e r t a i n r e l a t i o n s and t h i n g s ,
especially t h o s e signifying dirtiness, f o u l n e s s , o r s o m e aspect o f the
p a t h o g e n i c . T h e c o m p u l s i o n in this disease to be s c r e e n e d off from such
t h i n g s is b o r n of the fear t h a t the s u f f e r e r ' s s e l f h o o d is in c o n s t a n t
d a n g e r o f d i s i n t e g r a t i n g i n t o t h e s u b h u m a n , o f falling helpless u n d e r the
s w a y of t h i n g s t h a t a r e judged to be filthy, and u n w o r t h y of h u m a n
being.
T h u s , the pathological m a n i f e s t a t i o n s o f o b s e s s i v e - c o m p u l s i v e
n e u r o s i s d e s i g n a t e a s e l f - p r o t e c t i n g b e h a v i o r similar to the p a t t e r n of
w i t h d r a w a l described in schizoid and a u t i s t i c p e r s o n s . It is clear,
h o w e v e r , t h a t o b s e s s i o n s and c o m p u l s i o n s d o n o t reduce the realm o f
being open and being free vis-a-vis w h a t is e n c o u n t e r e d to t h e s a m e
e x t e n t as is the case with s c h i z o p h r e n i c s . T h e o b s e s s i v e - c o m p u l s i v e
p a t i e n t is n e v e r so c o m p l e t e l y engulfed in w h a t he h a s perceived t h a t he
m u s t b e c o m e it and t h e r e b y perish as a h u m a n being. In s c h i z o p h r e n i a ,
t h e patient loses his f r e e d o m and w i t h it his dwelling place in t h e w o r l d to
a m u c h h i g h e r d e g r e e . O b s e s s i v e - c o m p u l s i o n m a y e n c r o a c h on the
patient's f r e e d o m , but it does n o t e n g e n d e r its d e s t r u c t i o n .
H a v i n g r e a c h e d this point, w e h a v e c o m p l e t e d o u r discussion o f
e x a m p l e s illustrating pathological e n c r o a c h m e n t o n t h e main f e a t u r e s o f
h u m a n being. N e v e r t h e l e s s , t h e s e studies i n g e n e r a l p a t h o l o g y relating
to Da-sein should lead us to u n d e r t a k e a critical e x a m i n a t i o n of s o m e of
the c e n t r a l c o n c e p t s of traditional biology, p h y s i o l o g y , and p s y c h o l o g y . A
revision of t h e basic c o n c e p t s of traditional medical s c i e n c e , based on a
description of t h e 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 of h e a l t h y h u m a n living, is
indispensable.
NOTES
I. "Was f eh It Ihnen?" is the question posed by the German-speaking physician. This
f o r m u l a t i o n rests on the understanding, thematic or unthematic, of the basii cha rat teristic
of illness as a lack of health. T h e English-speaking physician is more apt to . i s k , "What is
the matter?", " W h a t is w r o n g w i t h you?", "Tell me all about it!" Here is an instance ol how
language itself shapes the understanding of phenomena and determines how they i . m
i eve.11 I hem selves. In the G e r m a n approach to the ill patient, 11"' phyaii 1411 li immediately
related to illness as a lack of health, even if he is not I l n i n . i l u all v t w i r r I i I n .

.' M Itleulei, | Willi, 11 R. Buhler, Akutepsychische BegMlmrlieinmiHi'ii kmftrhihri Kraitkhrilen

(Stuttgai i I hieme, l 9 6 6 )

General

Daseinsanalytic

Phenomenology

239

3. H. Selye, "Stress, Physiology a n d Pathology of Exposure to Stress: A Treatise Based

on t h e Concepts of G e n e r a l - A d a p t a t i o n - S y n d r o m e a n d t h e Disease of A d a p t a t i o n , " Acta
(Montreal, 1 9 5 0 ) .
4 . T h e distinctions among t h e stress situations w h i c h a r e bodied f o r t h as the various
stress diseases have received more detailed t r e a t m e n t in an earlier w o r k . See M. Boss,
Einfhrung in die psychosomatische Medizin (Bern a n d S t u t t g a r t : Hans Huber, 1 9 5 4 ) , pp. 1 2 3 f t .
5. T h e w o r d in t h e G e r m a n t e x t is Reiz, w h i c h has a quite d i f f e r e n t etymological history
f r o m t h e English w o r d " s t i m u l u s . " " S t i m u l u s " comes f r o m t h e Latin w o r d meaning " t o
prick, goad, i n c i t e " a n d w a s first used in English in t h e eighteenth c e n t u r y in the science of
Physiology. It w a s more widely applied in o t h e r realms of h u m a n existance only later. Reiz
or reizen, on the other hand, originally h a d more abundant meanings.
6. W. Schulte, " D i e Entlastungssituation als W e t t e r w i n k e l f r Pathogenese u n d
M a n i f e s t i e r u n g neurologischer u n d psychiatrischer K r a n k h e i t e n , " Der Nervenarzt, 22
(1951), 145.

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

Da-sein in these states.

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

h u m a n reality. T h i s h a p p e n s b e c a u s e t h e y d o n o t see t h a t being t o g e t h e r

in a s h a r e d world is a f u n d a m e n t a l trait of Da-sein. It is this t h a t i n v e s t s
e v e r y Da-sein w i t h t h e p o t e n t i a l for being n e g a t i v e and d e s t r u c t i v e in
relation to w h a t it e n c o u n t e r s . M a l i c e t o w a r d fellow m e n is a p o t e n t i a l i t y
i n h e r e n t in e v e r y h u m a n Da-sein. It is, t h e n , y e t a n o t h e r of the
E x i s t e n t i a l s . T h e fact t h a t it is n o t carried o u t in e v e r y i n s t a n c e does n o t
should o c c u r t o him w h i l e h e s t a r e s a t Plate VII o f t h e R o r s c h a c h s e r i e s ,
visual p a t t e r n t e s t does n o t o r i g i n a t e in c o n s c i o u s n e s s - i m m a n e n t
in and as each of t h e o t h e r p o t e n t i a l w a y s of b e i n g w i t h o t h e r s t h a t
c o n s t i t u t e my Da-sein. To r e p e a t , t h e n , t h e c a p a c i t y of a c t i n g in malice
b e l o n g s i n h e r e n t l y t o e v e r y o n e o f us. People o f t e n s u c c e e d i n r e s i s t i n g
this insight b y f o c u s s i n g e x c l u s i v e l y o n t h e m a l i c i o u s n e s s o f s o m e o t h e r
p e r s o n or p e r s o n s , t h u s s e e i n g t h e malice of t h e o t h e r as t h r o u g h a
m a g n i f y i n g glass. B u t s u c h m i s i n t e r p r e t a t i o n o f o n e s e l f and o t h e r s h a s
n o t h i n g i n c o m m o n w i t h t h e psychic projection o f m e n t a l c o n t e n t s f r o m
a person's own internal psyche onto that of a n o t h e r person.
If we give up the n o t i o n of psychic p r o j e c t i o n as i n a p p r o p r i a t e , t h e n we
c a n n o t go on c a t e g o r i z i n g c e r t a i n popular p s y c h o l o g i c a l r e s e a r c h devices
a s p r o j e c t i o n t e s t s . T h e r e i s n o e v i d e n c e , for i n s t a n c e , t h a t s o m e o n e
seeing t w o f e m a l e d a n c e r s in Plate VII or t h e R o r s c h a c h s e r i e s h a s
actually p r o j e c t e d o n t o t h e blots i n f r o n t o f h i m s o m e r e p r e s e n t a t i o n o f
d a n c e r s t h a t had b e e n p r e s e n t in a c o n t a i n e r l i k e c o n s c i o u s n e s s or
u n c o n s c i o u s . T h e d a n c e r s t h a t are recalled t o t h e t e s t s u b j e c t o n this
occasion are, like any o t h e r d a n c e r s he m i g h t see or h a v e s e e n , in
t h e m s e l v e s o u t t h e r e , i n t h e open r e a l m o f p e r c e p t i o n t h a t i s t h a t
p e r s o n ' s Da-sein. T h o u g h t h e p r e s e n c e o f t h e i m a g i n e d d a n c e r s m a y b e
n o t h i n g b u t a g e n e r a l l y u n t h e m a t i c f a n t a s y , t h e y a r e n o n e t h e l e s s in the
p e r s o n ' s w o r l d - o p e n n e s s . T h e i r dwelling place r e m a i n s t h a t open r e a l m
as w h i c h he e x i s t s . It is a f u n d a m e n t a l fact t h a t e v e n w h a t we o n l y
i m a g i n e n e v e r o c c u r s in o u r heads, b u t r e v e a l s i t s e l f always in a worldly
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 .
T h e free, l i g h t h e a r t e d a t t u n e m e n t o f t h e t e s t p e r s o n ' s o p e n n e s s t o t h e
world a t t h e g i v e n m o m e n t d e t e r m i n e s t h a t d a n c e r s r a t h e r t h a n devils
should o c c u r t o him w h i l e h e s t a r e s a t P l a t e V I I o f t h e R o r s c h a c h s e r i e s .
At any given m o m e n t , t h e o n l y t h i n g s t h a t can e n t e r a p e r s o n ' s w o r l d are
t h o s e to w h i c h t h a t p e r s o n ' s Da-sein is o p e n , and this o p e n n e s s is in t u r n
d e t e r m i n e d by t h e a t t u n e m e n t of t h e p e r s o n ' s Da-sein at that given
moment.
T h e d a n c e r r e s p o n s e is j u s t o n e case in point to s h o w tha t r e s p o n s e to a
visual p a t t e r n t e s t d o e s n o t o r i g i n a t e in c o n s c i o u s n e s s i m m a n e n t
i m a g e s . T h e p h e n o m e n a t h a t o c c u r t o a p e r s o n taking su< h a test c o m e
n o t from his head but are p h e n o m e n a in the o p e n realm ol perception
Currently available t o his Da-sein. What actually happens w h e n s i n I) a n

Prevailing Concepts of General Pathology

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.

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EXISTENTIAL FOUNDATIONS

But in the course of a psychoanalytic or Daseinsanalytic treatment, the

f o r m of t h e t r e a t m e n t d o e s n o t m o t i v a t e a p a t i e n t to a r e g r e s s i o n , n o r
does a r e g r e s s i o n o c c u r f o r a n y o t h e r r e a s o n . T h e p a t i e n t would n o t h a v e
b e e n sick, n o r w o u l d h e h a v e e n t e r e d analysis, i f h e had n o t from e a r l y
childhood r e m a i n e d i n a n i n f a n t i l e , i m m a t u r e s t a g e o f d e v e l o p m e n t w i t h
respect to many important modes of behaving. This means that the
p a t i e n t is already in a s t a t e of pathological i m m a t u r i t y long b e f o r e t h e
c o u c h t r e a t m e n t b e g i n s ; he c a n n o t be returned to it. In t h e c o u r s e of a
c o u c h analysis t h e p a t i e n t e l i m i n a t e s his d e s p e r a t e a t t e m p t t o hide his
i m m a t u r e , d i s t o r t e d c h i l d i s h n e s s , w h i c h t h e n b e c o m e s clearly visible.
T h i s is b u t a first n e c e s s a r y t h e r a p e u t i c s t e p t o w a r d a d e f e r r e d
m a t u r a t i o n . I f t h e p a t h o l o g i c a l infantile m o d e s o f b e h a v i n g a r e i g n o r e d ,
t h e y r e m a i n u n c h a n g e d , even t h o u g h t h e a n a l y s t addresses h i m s e l f
i n t e n s i v e l y to his p a t i e n t ' s h e a l t h y adult possibilities. At b e s t , this
e n a b l e s t h e p a t i e n t t o hide his c h i l d i s h n e s s m o r e e f f e c t i v e l y . H e does n o t
b e c o m e m o r e free f o r his i n n a t e p o t e n t i a l i t y t o e x i s t a s a n adult h u m a n
being.
No less i m p o r t a n t is t h e i n a p p r o p r i a t e c o n c e p t u a l i z i n g of r e g r e s s i o n
within the framework of Freud's psychoanalytic theory. Here regression
is t r a n s f o r m e d i n t o an e x p l a n a t o r y principle in w h i c h it c o m e s to m e a n a
r e t u r n to a libidinal s t a t e of less m a t u r i t y f r o m o n e of g r e a t e r m a t u r i t y .
T h i s alleged p h e n o m e n o n i s s e e n , f u r t h e r m o r e , a s t h e c a u s e o f c e r t a i n
s y m p t o m s . Y e t w e k n o w b y n o w t h a t s u c h e x p l a n a t i o n s actually explain
n o t h i n g a t all. H o w a n y piece o f h u m a n b e h a v i o r , w h i c h a l w a y s
p r e s u p p o s e s a n ability t o u n d e r s t a n d t h e m e a n i n g f u l n e s s o f w h a t i s
e n c o u n t e r e d , could e v e r arise o u t o f libido, i.e., o u t o f blind q u a n t i t i e s o f
e n e r g y , is a m y s t e r y . Libido c o n c e i v e d of as p s y c h i c e n e r g y is akin to t h e
physicalistic c o n c e p t o f e n e r g y , w h i c h is, h o w e v e r , f u n d a m e n t a l l y
worldless, without any openness or responsiveness to meanings. T h e
p h e n o m e n o n of h u m a n being is p r e d i c a t e d on t h e possibility of a
perceiving o p e n n e s s , in t h a t t h e m e a n i n g f u l n e s s of w h a t e v e r is
e n c o u n t e r e d is able to r e v e a l itself. T h u s , r e n e w e d b e d w e t t i n g in older
children can n e v e r b e explained according t o t h e c a u s a l principle o f
r e g r e s s i o n to s o m e e a r l i e r libidinal s t a g e . It can be u n d e r s t o o d o n l y in
relation t o t h e affected child's c u r r e n t r e l a t i o n s h i p t o its m o t h e r .
Psychic repression
T h e c o n c e p t o f r e p r e s s i o n t a k e s its place alongside t h e m o s t i m p o r t a n t
ideas of c o n t e m p o r a r y p a t h o l o g y , such as t h o s e of an u n c o n s c i o u s , and of
disturbed f u n c t i o n s of a body. In particular, it h a s b e c o m e an
indispensable e x p l a n a t o r y principle in p s y c h o p a t h o l o g y and p s y c h o s o
matic medicine. S i g m u n d Freud o r i g i n a t e d t h e t h e o r y o l repression w e

Prevailing

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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

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EXISTENTIAL FOUNDATIONS

a n e x p l a n a t i o n o f h o w this can b e so, w e r e f e r t o a n e x c e r p t from S a r t r e ' s

c h a p t e r on " B a d F a i t h , " w h e r e he w r i t e s , "In lying, I k n o w t h e t r u t h t h a t I
distort, t h e s a m e t r u t h w h i c h I, as t h e deceived, fail to r e c o g n i z e . As
d e c e i v e r , I am a w a r e of my i n t e n t to deceive. Y e t if I realize t h a t I w a n t to
deceive m y s e l f , I can no l o n g e r be deceived, for I can be deceived only if I
w a n t to k n o w t h e t r u t h . " A n d in fact, r e p r e s s i o n , as this F r e u d i a n selfd e c e p t i o n , e x i s t s u l t i m a t e l y i n t h e i n c o n g r u i t y o f first h a v i n g t o k n o w
something in order not to have to know that same something.
1

K o h l i - K u n z n o t long a g o d e m o n s t r a t e d w i t h striking clarity h o w

F r e u d m a n a g e d t o s i d e s t e p t h e logical d i l e m m a h e faced. S h e pointed o u t
t h a t Freud had advised us
to t h i n k of t h e r e l a t i o n s h i p of self t h a t is involved in r e p r e s s i v e selfdeception a s a n a l o g o u s t o t h e m o d e o f d e c e p t i o n b e t w e e n people. H e r e
it is a m a t t e r of my b e h a v i o r t o w a r d a n o t h e r : I, a w a r e of t h e t r u t h ,
d e c e i v e t h e o t h e r ; this o t h e r a c c e p t s m y d e c e p t i o n a s being t h e t r u t h .
W h e r e d e c e i v e r and deceived are t w o o r m o r e s e p a r a t e p e r s o n s , t h e r e
is no p r o b l e m . In o r d e r to c r e a t e t h e duality t h a t w a s logically
n e c e s s a r y t o a c c o m m o d a t e r e p r e s s i o n a s s e l f - d e c e p t i o n , Freud t o o k t h e
i n t e g r a l selfhood of h u m a n e x i s t e n c e , objectified it as a p s y c h i c
a p p a r a t u s , and split it i n t o t w o pieces, the 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 . T h e r e are his o w n w o r d s : " T h e t e r m ' u n c o n s c i o u s ' r e f e r s
t o a n y psychic p r o c e s s w h o s e e x i s t e n c e w e a r e forced t o a s s u m e o n t h e
e v i d e n c e o f its o u t w a r d e f f e c t s b u t o f w h i c h w e k n o w n o t h i n g directly.
We stand in t h e s a m e r e l a t i o n to this as to s o m e psychic p r o c e s s in
another person, except that here it is one of our own."
2

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

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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 .
A D a s e i n s a n a l y t i c f o u n d a t i o n of medicine and p s y c h o l o g y , such as
w e h a v e outlined i n this w o r k , m u s t i n e v i t a b l y h a v e c o n s e q u e n c e s for
practical t h e r a p y in t h e s e fields. T h e final s e c t i o n is t h e r e f o r e d e v o t e d
to considering these consequences.
NOTES
1 J.-P. Sartre, L'Etre et le Ne'ant (Paris: Librarie Gallimard; 1 9 4 3 , p. 94 ff.

2 S. Freud, Gesammelle Werke, vol. 1 5 , p. 7 6 .

3 A. K o h l i - K u n z , "Das sogenannte Unbewusste." Zeitschrift fur psychosomatische Medizin und
Psychoanalyse. H . 4 . D r u c k & Verlag A G . S o l o t h u r n . V o l . 6 , 1 9 7 6 .

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

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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

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The Patient to Be Treated

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

T h e s e n e w neuropsychiatric experiments are understandable in their

full s i g n i f i c a n c e o n l y w h e n h u m a n b e i n g i s s e e n a s a n a t t u n e d w o r l d s p a n n i n g r e a l m o f t h e ability t o p e r c e i v e t h e m e a n i n g o f w h a t i s
e n c o u n t e r e d , and i t is, w h i l e a t t u n e d , capable o f b e i n g r e a t t u n e d b y m a n y
d i f f e r e n t m e a n s . T h e limbic s y s t e m o f t h e brain i s f u n d a m e n t a l l y t h e
bodily s p h e r e of a h u m a n e x i s t e n c e ' s a t t u n e m e n t . It can be i n t e r p r e t e d ,
though inadequately, as an objectifiable, measurable organ of the
p h y s i c a l body; b u t as s u c h its specific h u m a n n e s s is lost to v i e w . W h e n
this so-called brain is u n d e r s t o o d as a n e c e s s a r y and i m m e d i a t e s p h e r e of
t h e f u n d a m e n t a l l y a t t u n e d e x i s t e n c e o f t h e h u m a n b e i n g , a s the
b o d y h o o d o f t h e e x i s t i n g Da-sein, t h e n i t i s n o l o n g e r m y s t e r i o u s h o w t h e
e l e c t r i c a l i m p u l s e s w h i c h t h e physician i n t r o d u c e s via e l e c t r o d e s c a n
i n t e r v e n e directly i n t h e p e r s o n ' s e x i s t e n t i a l a t t u n e m e n t and b r i n g a b o u l
a r e a t t u n e m e n t o f his w h o l e b e i n g - i n - t h e - w o r l d . T h e electrical i m p u l s e !
i n t r o d u c e d i n t o t h e c e r e b r a l bodily s p h e r e o f t h e h u m a n e x i s t e n c e

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

The Patient to Be Treated

255

p s y c h o t h e r a p y , t h o u g h less explicitly, t o c a s t aside t h e pathological

o b s t r u c t i o n s t o t h e free c a r r y i n g o u t o f all possible w a y s o f r e l a t e d n e s s
w i t h w h a t is e n c o u n t e r e d . In a v e r y b r o a d b u t s t r i c t s e n s e , t h e n , t h e r e is
j u s t i f i c a t i o n for calling all medical t h e r a p i e s D a s e i n s a n a l y t i c t h e r a p i e s of
r e s i s t a n c e . D a s e i n s a n a l y t i c t h e r a p y is a paradigm for all medical t h e r a p y
in still a n o t h e r r e s p e c t . It r e v e a l s t h e t r u e locus of medical t h e r a p y .
NOTE
1. C f . J . M . R . D e l g a d o , " I n t r a c e r e b r a l r a d i o - s t i m u l a t i o n and recoding in c o m p l e t e l y free
p a t i e n t s , " ] . Nerv. Ment. Dis., 1 4 7 ( 1 9 6 8 ) , 3 2 9 - 4 0 ; a n d , b y t h e s a m e a u t h o r , " T e l e m e t r i c
M e t h o d s in Brain R e s e a r c h , " delivered at the IVth International C o n g r e s s on Pharmacol
ogy, July 1 9 6 9 , Basel, Switzerland.

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

p a t i e n t is o n l y m o r e clearly and directly r e c o g n i z a b l e as the actual locus

of the t r e a t m e n t t h a n in o t h e r t h e r a p e u t i c f o r m s . T h i s is the only r e a s o n
for the choice of a t e s t c a s e in w h i c h a D a s e i n s a n a l y t i c t h e r a p y in the
s t r i c t e r s e n s e o f t h e t e r m w a s indicated. W e shall r e t u r n o n c e m o r e t o o u r
t e s t case t o s h o w h o w t h e b e i n g - t o g e t h e r o f physician and patient i s
w h e r e t h e t r e a t m e n t actually t a k e s place and h o w t h e D a s e i n s a n a l y t i c
i l l u m i n a t i o n o f this e m e r g i n g p h e n o m e n o n h e a l s . P s y c h o t h e r a p e u t i c
j a r g o n d e s i g n a t e s (and d i s t o r t s ) t h e p h e n o m e n o n 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 a s t r a n s f e r e n c e and c o u n t e r t r a n s f e r e n c e .

The existential unfolding of the physician-patient relationship in the

therapy of the test case
T h e m a t u r e , i n d e p e n d e n t , t h o r o u g h l y h e a l t h y Da-sein w h i c h R e g u l a
Z i i r c h e r finally a t t a i n e d could n o t h a v e c o m e a b o u t w i t h o u t c o n s i d e r a b l e
e f f o r t from h e r p h y s i c i a n . S h e h e r s e l f had t o c o n t r i b u t e even m o r e . A t
t h e v e r y s t a r t of t r e a t m e n t , w h e n the patient w a s still in a highly suicidal
s t a t e , a n u m b e r of e m e r g e n c y m e a s u r e s w e r e in o r d e r , but s o o n t h e
physician w a s able t o w i t h d r a w i n t o t h e kind o f r e l a t i o n s h i p t o w a r d the
patient t h a t Freud had r e c o m m e n d e d a s b e s t for t h e t h e r a p y o f
psychoneurotic patients.
R e g u l a Z i i r c h e r w a s asked t o follow t h e basic r e g i m e n o f classic
a n a l y t i c p s y c h o t h e r a p y . H e r physician r e q u i r e d h e r t o pay h i m four
h o u r - l o n g visits a w e e k . S h e lay on his c o u c h so t h a t he could see h e r b u t
s h e could n o t see him. T h e p a t i e n t w a s told t o b e a b s o l u t e l y , r u t h l e s s l y
h o n e s t t o w a r d h e r s e l f and h e r t h e r a p i s t i n r e p o r t i n g a n y t h i n g t h a t c a m e
" i n t o h e r h e a d o r h e a r t " a s s h e w a s lying t h e r e . T h i s g a v e t h e physician
t h e w i d e s t possible scope for o b s e r v i n g w h a t e v e r t h i n g s o r people
o c c u r r e d t o (that is, w e r e perceived by) t h e p a t i e n t during t h e s e s s i o n ,
w h i l e i t kept h e r f r o m m e a s u r i n g h e r n o t i o n s a g a i n s t his r e a c t i o n s and
adjusting t h e m a c c o r d i n g l y e v e n b e f o r e s h e put t h e m i n t o w o r d s .
F u r t h e r m o r e , and m o r e o f t e n , t h e m e r e p o s t u r e o f physician and patient
s i t t i n g face to face in t h e position of t w o equally m a t u r e people in
c o n v e r s a t i o n will largely p r e v e n t w h a t is c e n t r a l to the illness f r o m
o c c u r r i n g to t h e p a t i e n t and being actualized, w h i c h is to say, his
persisting infantile w a y s o f c o n d u c t i n g h i m s e l f t o w a r d o t h e r s . P e r c e i v
ing h i m s e l f in w h a t looks like a n y r a t i o n a l c o n v e r s a t i o n b e t w e e n p e e r s ,
t h e patient i s o f t e n u n a b l e t o e x p e r i e n c e his h i g h l y e m o t i o n a l , i m m a t u r e
b e h a v i o r s . E v e n t h o u g h t h e y m a k e u p t h e significant d e t e r m i n a n t s o f his
b e i n g - i n - t h e - w o r l d , t h e y will n o t c o m e i n t o his h e a d .
T h e c o u c h p o s t u r e o f t h e patient should n o t b e m a d e into a d o g m a ,
h o w e v e r , n o r should it function as a m e r e c o n v e n i e n c e or p r o t e c t i v e
device for the physician. W h e r e v e r y s e r i o u s illness is involved, the classic

The "Locus" of the Therapeutic Interaction

259

a r r a n g e m e n t may o v e r t a x t h e p a t i e n t and is o f t e n to be avoided. Even

w h e n the analysand is h e a l t h y or o n l y mildly ill, t h e r e a r e t i m e s w h e n
sitting face to face in t h e p o s i t i o n of t w o equally m a t u r e people in
r e l a t i o n s h i p in a w a y w h i c h c o r r e s p o n d s m o r e to t h e m o d e of his
e x i s t e n c e a t the m o m e n t . T o f o r c e t h e patient t o lie o n t h e c o u c h a t such
t i m e s would g o a g a i n s t e v e r y t h i n g analysis s t a n d s for. O n t h e o t h e r
h a n d , h o w e v e r , a p a t i e n t ' s refusal to lie d o w n m a y indicate r e s i s t a n c e to
e x p o s i n g s o m e w a y s o f his b e h a v i n g t h a t h e h a s carefully p r e s e r v e d
h i m s e l f from b e c o m i n g t h e m a t i c a l l y a w a r e of. I t i s t h e r e f o r e n e c e s s a r y
t h a t t h e physician pay c l o s e a t t e n t i o n t o t h e m e a n i n g o f h o w t h e patient
r e l a t e s bodily a t each m o m e n t o f t h e r a p y .
A t h e r a p i s t involved in t h e a n a l y t i c s i t u a t i o n b e c o m e s s e n s i t i v e n o t
only to what is revealed to his p a t i e n t ' s Da-sein b u t also to precisely how t h e
p a t i e n t r e l a t e s h i m s e l f t o w h a t o c c u r s t o him, t o e a c h o f t h e p h e n o m e n a
t h a t appear in t h e open r e a l m of his Da-sein and e n g a g e h i m during t h e
s e s s i o n . T o f o s t e r t h e p h y s i c i a n ' s r e c e p t i v i t y t o t h e " w h a t " and " h o w " o f
t h e p a t i e n t , F r e u d had a n o t h e r practical r e c o m m e n d a t i o n : during
t h e r a p y t h e physician m u s t a s s u m e a s t a n c e c o m p l e t e l y free of all
i n t e n t i o n , of all t h e r a p e u t i c , e d u c a t i o n a l , and scientific a m b i t i o n .
T h e t r u e art o f t h e r a p y lies i n paying careful a t t e n t i o n t o " w h a t " t h e
p a t i e n t visualizes and " h o w " he c o n d u c t s h i m s e l f in r e l a t i o n to it.
W i t h o u t this a t t e n t i v e n e s s , t h e t h e r a p i s t c a n n o t b e c o n t i n u a l l y pointing
u p the p a t h o l o g i c a l limits o f t h e r e a l m o f o p e n n e s s available t o t h e
patient, nor the limitations in the patient's own ways of responding to
w h a t i s able t o e n t e r his e x i s t e n c e ' s open r e a l m o f a w a r e n e s s . T h e s e
constant reminders of the limitedness of their present existence are what
give p a t i e n t s t h e first i n t i m a t i o n t h a t t h e y m i g h t c o m e t o w a y s o f being
in r e l a t i o n to w h a t is in t h e i r w o r l d t h a t a r e m o r e open and a u t o n o m o u s
t h a n t h o s e t h e y h a v e b e e n living u p t o the p r e s e n t .
In the course of our test subject's therapy, the h u m a n relationship of
physician and p a t i e n t w a s t h e p h e n o m e n o n t h a t forced i t s e l f i n t o t h e
f o r e g r o u n d , d e m a n d i n g t r e a t m e n t . It was clear e v e n at t h e s t a r t t h a t
s u c c e s s w o u l d depend p r i m a r l y on t h e physician's ability to allow this
b e i n g - t o g e t h e r to ripen in a w a y t h a t would be fruitful to t h e p a t i e n t .
T h e first p r e c o n d i t i o n for s u c h a d e v e l o p m e n t is t h e physician's
constant a w a r e n e s s of the way he himself relates to the patient, no
m a t t e r h o w this r e l a t i o n s h i p m a y c h a n g e . T h i s p h e n o m e n a i s usually
(and e r r o n e o u s l y , as we shall s e e , ) called c o u n t e r t r a n s f e r e n c e . D u r i n g
t h e v e r y first c o n v e r s a t i o n w i t h t h e test s u b j e c t , the t h e r a p i s t b e c a m e
a w a r e o f his highly a m b i v a l e n t s t a n c e t o w a r d h e r . T h e first thing s h e told
him w a s t h a t h e r i n t e s t i n a l colic and g e n e r a l m i s e r y had w e a k e n e d h e r s o
m u c h t h a t s h e had b e e n forced t o d e l e g a t e h e r m a t e r i a l and h o u s e h o l d

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d u t i e s t o hired help. S h e said she had m a n a g e d o n l y w i t h t h e g r e a t e s t

difficulty to drag h e r s e l f o u t of bed to k e e p this a p p o i n t m e n t w i t h him.
T h e b u r d e n o f h e r illness b e c a m e a n appeal t o t h e p h y s i c i a n ' s s e n s e o f
p h i l a n t h r o p y . All of his p r o f e s s i o n a l e x p e r i e n c e c a u t i o n e d him a g a i n s t
a c c e p t i n g this w o m a n as a p a t i e n t . He k n e w t h a t a n y p e r s o n so
e x t e n s i v e l y denied h u m a n w a r m t h from i n f a n c y w o u l d s o o n e r o r later
s u c c u m b t o a n a l m o s t insatiable n e e d for p r o o f s o f love. B e s i d e s , h e w a s
already o v e r b u r d e n e d b y his o t h e r p a t i e n t s . M o r e o e v e r , h e found h e r
a f f e c t e d c h i l d i s h n e s s and artificial doll-like a p p e a r a n c e u n i n t e r e s t i n g .
A n d he was repelled by t h e peculiar o d o r t h a t s u r r o u n d e d h e r , a smell
r e m i n i s c e n t o f t h e m o r t u a r y . I n any c a s e , t h e t h e r a p i s t tried t o pawn h e r
off o n y o u n g e r c o l l e a g u e s , t i r e l e s s l y r e c o m m e n d i n g o t h e r t h e r a p i s t s t o
h e r . S h e followed his s u g g e s t i o n s , b u t e a c h n e w c o n s u l t a t i o n s e n t h e r
b a c k t o him, m o r e d e s p e r a t e l y d e t e r m i n e d t h a n e v e r t o r e c e i v e t r e a t m e n t
from him. T h e t h e r a p i s t ' s s y m p a t h y finally prevailed o v e r his caution
and r e s i s t a n c e . B u t had he n o t had a c c e s s to his less noble s e n t i m e n t s
t h e y m i g h t well h a v e s t a y e d hidden to play tricks on h i m during t h e r a p y ,
and h e might n o t h a v e b e c o m e a w a r e o f t h e m until t o o late.
T h e w a y t h e p a t i e n t related t o h e r p h y s i c i a n , w h a t i s often
misleadingly labeled t r a n s f e r e n c e , did n o t n e e d to be dealt w i t h for quite
s o m e t i m e . S h e had r e p o r t e d h e r s t e r e o t y p i c a l b o x c a r d r e a m i n t h e v e r y
first t h e r a p e u t i c s e s s i o n , and t h e p r o m p t p h e n o m e n o l o g i c a l i n t e r p r e t a
tion o f this d r e a m had s h a k e n h e r w o r l d t o its r o o t s . S h e had n e v e r b e f o r e
b e e n s o boldly c o n f r o n t e d w i t h t h e u t t e r lack o f a n y h u m a n c o n n e c t i o n s
t h a t c h a r a c t e r i z e d h e r w h o l e life. A t t h e s a m e t i m e , t h e p h e n o m e n o l o g i
cal w a y h e r physician dealt w i t h h e r d r e a m i n g c o n v i n c e d h e r t h a t h e
u n d e r s t o o d t h e v e r y e s s e n c e o f h e r n a t u r e , and t h e w a y h e r e f e r r e d t o
t h e m e a n i n g o f h e r d r e a m i n g e x i s t e n c e also s h o w e d t h a t h e s e e m e d t o
k n o w o f e n t i r e l y d i f f e r e n t p o t e n t i a l i t i e s . W h y else w o u l d h e h a v e called
c u r i o u s t h a t isolation w h i c h s h o n e f o r t h i n h e r d r e a m i n g and had b e e n ,
for a s long a s s h e could r e m e m b e r , t h e o n l y w a y o f r e l a t i n g t o t h e w o r l d
she ever had?
T h e immediate consequence of the phenomenological approach to the
p a t i e n t ' s d r e a m i n g o f t h e b o x c a r w a s t h a t , t o h e r o w n a m a z e m e n t , she
b e g a n to look on t h e t h e r a p i s t as s o m e t h i n g like a t r u s t w o r t h y p a r e n t a l
p r o t e c t o r . N e v e r in h e r life, she c o n f e s s e d , had s h e e x p e r i e n c e d such
good feelings t o w a r d s o m e o n e else. H e r d a w n i n g r e l a t i o n s h i p t o t h e
physician w a s an i n s t a n c e of w h a t F r e u d had w i s e l y d e s c r i b e d as a mild,
positive e m o t i o n a l basis for t h e r a p y , not to be q u e s t i o n e d or d o n e a w a y
w i t h in analysis. T h e s e n s e of t r u s t w o k e t r e m e n d o u s g r a t i t u d e in the
patient, and w i t h it t h e n e e d to be fully a c c e p t e d by h e r analyst as the
a b a n d o n e d helpless little girl she still w a s , and to r e l a t e to him with filial

The "Locus" of the Therapeutic Interaction

2b

affection. It is entirely out of the question that the procedure of therapy

i t s e l f c a u s e d i n h e r s o m e r e g r e s s i o n t o c h i l d i s h n e s s . T h i s i s t h e kind o f
d a n g e r o u s side effect o f t e n a s c r i b e d t o a n a l y t i c t r e a t m e n t b y o u t s i d e r s .
B u t t h e r a p y can n e v e r b r i n g o u t a n y t h i n g e x c e p t e s s e n t i a l e x i s t e n t i a l
traits t h a t a r e already, and a l w a y s , t h e r e , m e r e l y p a i n t e d o v e r b y the
n e c e s s i t y o f acting like a n adult i n e v e r y d a y life. T h e p a t i e n t w a s for t h e
m o s t part actually j u s t s u c h a childish c r e a t u r e w h e n s h e b e g a n t h e r a p y ,
a s s h e had b e e n for t h e last t w e n t y y e a r s .
B u t s o o n s h e b e g a n t o b e afraid o f h e r o w n f e e l i n g s . I n p a r t i c u l a r s h e
feared b e c o m i n g totally d e p e n d e n t o n , and b o u n d t o , h e r t h e r a p i s t . S h e
was m o r e t h a n simply a n x i o u s ; h e r pride and s e l f - r e g a r d r o s e u p a g a i n s t
this possibility. F u r t h e r m o r e , s h e had b e e n t a u g h t b y h e r m o t h e r t o
believe t h a t a n y e x p r e s s i o n o f feeling for a n o t h e r p e r s o n s h o w e d a p o o r ,
fanatic c h a r a c t e r and w a s u n b e c o m i n g t o a lady. B u t h e r m a i n o b j e c t i o n
t o l e t t i n g h e r s e l f e n t e r freely i n t o a n open and t r u s t i n g c h i l d - p a r e n t
r e l a t i o n s h i p t o w a r d h e r p h y s i c i a n w a s its o n e - s i d e d n e s s , for him she
could b e n o t h i n g m o r e t h a n j u s t a n o t h e r o n e o f his m a n y c a s e s .
A r m e d w i t h this a r s e n a l o f m o t i v e s , t h e p a t i e n t f o u g h t t o o t h and nail
a g a i n s t h e r i n c r e a s i n g l y o b t r u s i v e a f f e c t i o n for h e r p h y s i c i a n . S u d d e n l y
all o u t w a r d signs o f a f f e c t i o n disappeared. S h e b e c a m e a b u s i v e . S h e
called t h e t h e r a p i s t a stupid idiot. S h e called h e r t r e a t m e n t a hellish
m e t h o d t h a t m a d e h e r s i c k e r and m o r e m i s e r a b l e i n s t e a d o f b e t t e r . T h e
s a m e p h y s i c i a n w h o had w o n h e r t r u s t n o w s e e m e d a n evil, diabolical
seducer bent on destroying her. In her defensiveness, however, instead
o f ridding h e r s e l f o f him, s h e a c t u a l l y s u r r e n d e r e d t o t a l l y t o t h i s m a n she
so wished to get away from. T h e threatening, seductive presence of the
t h e r a p i s t b e c a m e t h e o b j e c t o f all h e r t h o u g h t s and a c t i o n s . E v e r y o t h e r
p e r s o n and o b j e c t o f h e r w o r l d r e t r e a t e d t o a n o b s c u r e d i s t a n c e . T h e
c o n s t a n t p r e s e n c e i n h e r w o r l d o f t h e physician c o v e r e d o v e r h e r
r e l a t i o n s h i p t o h e r o w n f u t u r e and h e r c o n n e c t i o n w i t h h e r past life
B u t for o n e c a t e g o r y t h e r e w a s a n e x c e p t i o n . T h e m o r e t h e p h y s i c i a n patient relationship took on the character of a genuine parent-child
r e l a t i o n s h i p t h o u g h at t h e t i m e it o c c u r r e d in t h e f o r m of a d e s p e r a t e
r e s i s t a n c e t o this r e l a t i o n s h i p t h e m o r e h e r c h i l d h o o d e x p e r i e n c e s i n
t h e r e l a t i o n s h i p w i t h h e r actual p a r e n t s s p o n t a n e o u s l y o c c u r r e d t o h e r .
S h e n e v e r needed t o b e c o a x e d t o recall childhood e v e n t s . W h e n s h e
entered into a child-parent relationship with her therapist, h e r persisting
c h i l d h o o d w a s revealed w i t h all of its c h a r a c t e r i s t i c f e a t u r e s and b e e a m e
a c t u a l . C h i l d h o o d is, in itself, possible only in r e l a t i o n to parent'. ( )|
n e c e s s i t y , t h e n , m e m o r i e s o f t h e actual p a r e n t s w h o h a d s o t e r r i b l j
m i s t r e a t e d h e r b e g a n t o o v e r w h e l m her. N e v e r t h e l e s s , t h r o u g h hej
verbally a g g r e s s i v e behavior, t o w a r d h e r therapist t h e p a t i e n t kepi hei

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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.

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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

A f t e r t h e p a t i e n t had s u m m o n e d t h e c o u r a g e t o r e c o g n i z e and fully

accept her father-daughter relationship with the therapist, it occurred to
h e r t h a t s i n c e t h e t r e a t m e n t b e g a n s h e had n o t o n c e b e e n visited b y t h e
stereotypical boxcar dream. T h i s discovery immediately evoked other
w a y s o f d r e a m i n g . S h e w a s s w a m p e d w i t h t h e kind o f d r e a m t h a t i s all
t o o familiar t o n e u r o t i c a l l y e n s l a v e d people. A l m o s t e v e r y n i g h t s h e
d r e a m e d o f being c h a s e d b y a n i m a l s , o r bandits, o r R u s s i a n soldiers
a r m e d w i t h rifles. S h e w o u l d o f t e n a w a k e s c r e a m i n g .
I n h e r w a k i n g life, m e a n w h i l e , s h e n o t i c e d t h a t t h e y o u n g m e n i n h e r
life had b e g u n to s t r i k e h e r in a m o s t c u r i o u s w a y . S h e w o u l d catch
herself imagining the tender erotic demands they might make of her, bu I
n o s o o n e r w o u l d s h e b e c o m e a w a r e o f t h e s e possible i n t i m a c i e s than s h e
w o u l d b e seized w i t h f e a r and disgust, b o t h t o w a r d h e r s e l f and men.
T h e analyst countered the patient's n e w relationship toward h e i
d r e a m b a n d i t s and t h e e r o t i c s u i t o r s of h e r w a k i n g life w i t h a patient,
a p p r o p r i a t e l y modified t h e r a p y o f r e s i s t a n c e . D o z e n s , even h u n d r e d s o l
t i m e s s h e w a s a s k e d w h e t h e r today, as an intelligent adult, s h e was ! ill

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EXISTENTIAL FOUNDATIONS

willing to put up w i t h t h e n o n s e n s e t h a t all physical, s e x u a l w a y s in

w h i c h m e n and w o m e n r e l a t e t o each o t h e r w e r e d a m n a b l e . W o u l d she
f o r e v e r act in blind o b e d i e n c e to t h e silly advice h e r p a r e n t s had g i v e n h e r
w h e n s h e w a s a y o u n g girl? W o u l d s h e insist o n s e e i n g e v e r y n a t u r a l act,
e v e r y m o d e o f s e n s u a l b e h a v i o r like w h a t filled h e r d r e a m w o r l d , a s
s o m e t h i n g sinful, d i s g u s t i n g , and c h a r g e d w i t h d a n g e r ? M i g h t i t n o t b e
possible t h a t s h e w o u l d find f r e e d o m , fulfillment, and happiness if she
w e r e t o face s t e a d f a s t l y e v e r y t h i n g t h a t p r e s e n t e d i t s e l f t o h e r and w i t h
r e s p o n s i b l e c o n c e r n c a r e for t h e unfolding o f its b e i n g ?
Regula Zurcher's fear of greater freedom with respect to w h a t
r e v e a l e d i t s e l f in h e r w o r l d w a s c o n s t a n t l y q u e s t i o n e d in this w a y . A
dawning insight into the dubiousness of her restricted ways of behaving
c h a l l e n g e d h e r t o adopt n e w and m o r e i n d e p e n d e n t a t t i t u d e s t o w a r d
kinds of p h e n o m e n a s h e had avoided b e f o r e . In t h e relatively s h o r t space
of e i g h t e e n m o n t h s , t h e r a p y s u c c e e d e d in t r a n s f o r m i n g a totally frigid,
childishly d e p e n d e n t c r e a t u r e into a m a t u r e w o m a n , s e x u a l and fully
capable of loving.
T h e p a t i e n t ' s gradual m a t u r i n g was m i r r o r e d in a c h a n g e d h u m a n
r e l a t i o n s h i p t o h e r p h y s i c i a n . W h a t had b e g u n a s a n infantile a f f e c t i o n
for a good f a t h e r based on t r u s t b e c a m e , a f t e r a period of r e s e n t m e n t and
a t t e m p t e d flight, a p a s s i o n a t e love in w h i c h t h e a n a l y s t w a s seen as a
p o t e n t i a l lover. D u r i n g this s t a g e t h e p a t i e n t p r e s s e d him w i t h s e x u a l
demands. S h e learned from her analyst to relinquish the demand that he
fulfill h e r w i s h e s i n this r e s p e c t . S h e l e a r n e d t h a t a n y e r o t i c r e s p o n s e o n
his part w o u l d , a s h e w a s o n l y h u m a n , c o m p r o m i s e his f r e e d o m a s a n
a n a l y s t in t h e t h e r a p e u t i c p r o c e s s , w h i l e this v e r y f r e e d o m in r e l a t i o n to
h e r was a b s o l u t e l y n e c e s s a r y for t h e t h e r a p y t o s u c c e e d . I t w a s t h e r e f o r e
t h e a n a l y s t ' s d u t y t o r e m a i n selfless and t o r e s t r i c t t h e r e l a t i o n s h i p t o
p r e v e n t his exploiting h e r for his o w n s a t i s f a c t i o n , while m a k i n g
available to h e r a w i d e r h u m a n a r e n a i n t o w h i c h she could bring f o r t h h e r
h u m a n p o t e n t i a l . T h i s w a s possible o n l y i f t h e a n a l y s t p r e s e r v e d t o t a l
f r e e d o m i n t h e r e l a t i o n s h i p , for o t h e r w i s e h e w o u l d i n e v i t a b l y , e v e n
t h o u g h n o t w i s h i n g it, e x p l o i t h e r for his o w n o r s o m e o t h e r p u r p o s e . H e
w o u l d n o l o n g e r b e free t o let h e r b e c o m e e n t i r e l y h e r s e l f .
T h a n k s t o this realistic e x p l a n a t i o n , R e g u l a Z i i r c h e r could i n t e r p r e t
t h e refusal o f h e r s e x u a l d e m a n d s o n t h e a n a l y s t a s s o m e t h i n g o t h e r t h a n
a h u m i l i a t i n g r e j e c t i o n of t h e s o r t s h e had e x p e r i e n c e d so m u c h during
c h i l d h o o d . O n t h e c o n t r a r y , w h a t s h e had h e a r d could o n l y c o n f i r m h e r
i n h e r w o m a n h o o d . F o r had the d o c t o r n o t c o n f e s s e d t h a t , w i t h o u t the
u t m o s t r e s t r a i n t on his part, she m i g h t succeed in seducing h i m ? He must
t h e r e f o r e take h e r v e r y s e r i o u s l y as a w o m a n .
A l e s s skilled approach to this m o s t ticklish o f all therapeutic p r o b l e m s

The "Locus" of the Therapeutic Interaction

265

m i g h t easily h a v e n e g a t e d w h a t e v e r p r o g r e s s t h e p a t i e n t had m a d e and

d e s t r o y e d all c h a n c e s f o r s u c c e s s f u l t r e a t m e n t . In a p a t i e n t as s e n s i t i v e
and i n t e l l i g e n t a s R e g u l a Z i i r c h e r , i t m i g h t well h a v e b e e n d i s a s t r o u s t o
i n t e r p r e t h e r r e l a t i o n s h i p t o t h e a n a l y s t i n p s y c h o a n a l y t i c fashion, a s
t r a n s f e r e n c e : t h a t is, as a m e r e d e c e p t i o n on t h e p a t i e n t ' s part.

The fallacy of handling the physician-patient r e l a t i o n s h i p as transfer

ence
A f t e r pointing o u t t h e s i g n i f i c a n c e in all types of t r e a t m e n t of the
r e l a t i o n s h i p o f physician and p a t i e n t , F r e u d w e n t o n t o d e g r a d e t h e v e r y
n a t u r e of this p h e n o m e n o n by describing it, according to his n a t u r a l i s t i c
view of h u m a n n e s s , as something merely transferred from s o m e w h e r e
else. W h a t e v e r feelings t h e p a t i e n t developed for t h e a n a l y s t during t h e
c o u r s e o f t h e r a p y , h e t h o u g h t , w e r e directed n o t t o w a r d t h e a n a l y s t
h i m s e l f , did n o t actually m e a n h i m , b u t b e l o n g e d r a t h e r t o s o m 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 t h e p a t i e n t ' s a c t u a l p a r e n t s . T h e feelings
w e r e simply t r a n s f e r r e d (in G e r m a n , literally " c a r r i e d o v e r " ) f r o m t h e s e
r e p r e s e n t a t i o n s t o t h e p h y s i c i a n . F r e u d s a w t h e p r i m a r y aim o f
t r a n s f e r e n c e in t h e r e s i s t a n c e it c r e a t e d to t h e reliving of painful
childhood e x p e r i e n c e s c o n n e c t e d w i t h p a r e n t s . H e n c e his r e c o m m e n d a
tions for t r e a t i n g t h e t r a n s f e r e n c e : t h a t t h e t h e r a p i s t act quickly a g a i n s t
i t t h r o u g h a n a l y z i n g this s y m p t o m o f r e s i s t a n c e b y e m p h a s i z i n g t o t h e
p a t i e n t t h e false and d e c e p t i v e n a t u r e o f a n y m o d e s o f e m o t i o n a l c o n d u c t
t h a t had b e e n t r a n s f e r r e d t o t h e physician, while also p o i n t i n g o u t t h e i r
actual c o n n e c t i o n w i t h t h e i m a g e s o f t h e p a r e n t s .
This presentation of the physician-patient relationship reverberated
far b e y o n d t h e field o f m e d i c i n e . N o w a d a y s t h e c o n c e p t o f t r a n s f e r e n c e i s
so w i d e s p r e a d it would s e e m impossible to e r a d i c a t e this t e r m . And y e t
this w a y of i n t e r p r e t i n g w h a t all medical t r e a t m e n t is based on is
scientifically u n s o u n d . F u r t h e r m o r e , it has p r o d u c e d a m e t h o d for
handling 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 a t o f t e n h a s d i s a s t r o u s
c o n s e q u e n c e s , n o t o n l y in p s y c h o t h e r a p e u t i c s e s s i o n , b u t in t h e
t r e a t m e n t r o o m s o f e v e r y g e n e r a l p r a c t i t i o n e r and specialist.
I f t h e o l d e r p s y c h o a n a l y t i c t h e o r y had b e e n f o l l o w e d , t h e t r e a t m e n t o f
o u r t e s t s u b j e c t m i g h t h a v e p r o c e e d e d quite d i f f e r e n t l y . T h e physician
w o u l d h a v e r e s p o n d e d t o R e g u l a Z u r c h e r ' s v a r i o u s feelings t o w a r d him
w i t h t h e i n t e r p r e t a t i o n t h a t s h e w a s deceiving h e r s e l f in believing t h a t
t h e s e e m o t i o n s w e r e t r u l y m e a n t for him and t h a t t h e y actually b e l o n g e d
to the representations of her parents existing in her unconscious. S h e
was m e r e l y t r a n s f e r r i n g t h e s e a f f e c t s and i m a g e s o n t o t h e physician o u l
o f r e s i s t a n c e s o t h a t s h e n e e d n o t t h i n k a b o u t h e r unhappy c h i l d h o o d
memories.

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FOUNDATIONS

T h e p a t i e n t ' s d r e a m s o f t h r e a t e n i n g bandits and R u s s i a n soldiers

w o u l d also h a v e b e e n m a d e m a n i f e s t a t i o n s o f t r a n s f e r e n c e . T h e d r e a m e r
would have been made to believe that behind the figures of her dreams
s h e w a s hiding t h e p h y s i c i a n h i m s e l f , t h a t h e , and b e h i n d h i m t h e
p a r e n t a l i m a g e s , w e r e t h e real t a r g e t s o f t h e a n x i e t y e x p e r i e n c e d i n t h e
d r e a m s , and t h a t s h e had t r a n s f e r r e d h e r feelings o n t o t h e d r e a m figures
o f bandits and R u s s i a n s b e c a u s e e v e n i n h e r d r e a m s s h e w a s afraid t o
o p e n l y c o n f e s s h e r f e e l i n g s for t h e physician.
B u t t h e physician w o r k i n g in t h e t e s t c a s e had a D a s e i n s a n a l y t i c
o r i e n t a t i o n and a c c o r d i n g l y set o u t t o avoid s p e c u l a t i n g a b o u t t r a n s f e r
e n c e a t all c o s t s . B e c a u s e t h e p a t i e n t w a s s o i n t e l l i g e n t and s e n s i t i v e , s u c h
speculation would probably have wrecked the whole therapeutic process.
F o r if t h e physician had i n t e r p r e t e d h e r e m o t i o n a l r e l a t i o n s h i p to h i m as
t r a n s f e r e n c e actually a i m e d a t h e r p a r e n t s , h e w o u l d h a v e b e e n u n j u s t l y
labelling as false, e r r o n e o u s , and d e c e p t i v e just w h a t t h e patient
e x p e r i e n c e d as t h e m o s t real, i m p o r t a n t , and c h a r a c t e r i s t i c part of
h e r s e l f . B y i n t r o d u c i n g such n o t i o n s o f t r a n s f e r e n c e , t h e physician m i g h t
h a v e c a u s e d his p a t i e n t u n n e c e s s a r y o f f e n s e and injury, f u r t h e r
c o n f u s i n g a w o m a n a l r e a d y t h o r o u g h l y n e u r o t i c and u n s u r e o f h e r s e l f .
H e w o u l d h a v e m i s h a n d l e d t h e puzzling p h e n o m e n o n w i t h o u t a n y
j u s t i f i c a t i o n in fact. U n d e r such c i r c u m s t a n c e s , a r e l a t i o n s h i p of t r u s t
b e t w e e n patient and p h y s i c i a n could n e v e r h a v e developed. T h e patient
w o u l d h a v e felt m i s u n d e r s t o o d , and w i t h g o o d r e a s o n . S h e w o u l d
p r o b a b l y h a v e rebelled v i g o r o u s l y a g a i n s t a n y p h y s i c i a n w h o i n t e r p r e t e d
h e r s i t u a t i o n in this w a y , and it w o u l d h a v e availed t h e physician little to
put t h e b u r d e n o f guilt o n t h e p a t i e n t b y a c c u s i n g h e r o f p u t t i n g u p
r e s i s t a n c e . F o r s h e w o u l d h a v e b e e n t h o r o u g h l y justified i n r e s i s t i n g
such m i s t r e a t m e n t by her physician.
T h e physician i n t h e t e s t c a s e carefully g u a r d e d a g a i n s t explaining t h e
p a t i e n t ' s d r e a m s o f b a n d i t s and R u s s i a n s a s c a s e s o f t r a n s f e r e n c e . T h e
d r e a m e x p e r i e n c e s t h e m s e l v e s , i n a n y case, held n o t h i n g t h a t p o i n t e d t o
t h e physician, s o h e let t h e b a n d i t s r e m a i n b a n d i t s , and t h e R u s s i a n s
R u s s i a n s , j u s t a s t h e y had appeared i n t h e p a t i e n t ' s d r e a m i n g w o r l d . H e
also let t h e m stay distinct f r o m t h e p a t i e n t , o u t in t h e w o r l d from w h i c h
t h e y had a p p r o a c h e d h e r . H e did n o t t r y t o m a k e h e r believe t h a t t h e y
dwelt i n h e r o w n p s y c h e a s m e r e e n d o p s y c h i c p a t t e r n s t h a t had b e e n
personified t h r o u g h o u t w a r d p r o j e c t i o n . All s u c h s p e c u l a t i o n w o u l d
h a v e fared p o o r l y w i t h a p a t i e n t as c l e v e r and i n t e l l i g e n t as t h e t e s t
s u b j e c t . H o w could t h e t h e r a p i s t h a v e justified such a r b i t r a r y i n t e r p r e t a
tions in light of t h e p h e n o m e n a t h e m s e l v e s ? W h a t e v i d e n c e could he
h a v e found in the a c c o u n t s of t h e p a t i e n t ' s d r e a m i n g Pu sein that would
have supported his s t a t e m e n t s a b o u t psychic projection a n d affective
displat e m e n t ?

The "Locus" of the Therapeutic Interaction

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

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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

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e x c e p t in t h e f e w r e s t r i c t e d m o d e s t h a t his p a t h o g e n i c elders had

p e r m i t t e d him during childhood. A p e r s o n w h o s e e x i s t e n c e h a s b e e n
r e s t r a i n e d t h u s from childhood will, w i t h o u t help f r o m p s y c h o t h e r a p y ,
g o t h r o u g h his w h o l e life s e e i n g i n o t h e r adults o n l y t h o s e c h a r a c t e r i s t i c s
t h a t fit t h e limited p e r c e p t i o n h e w a s p e r m i t t e d i n childhood. T h i s m e a n s ,
a m o n g o t h e r t h i n g s , t h a t t h e t h e r a p i s t , like a n y o t h e r adult, will appear in
t h a t s a m e , original, childishly limited light; t h e r e can b e n o q u e s t i o n o f
transference into an earlier mode of perception, because the earlier mode
has never given way to any other.
F r e u d ' s third a r g u m e n t for t h e 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 r e s t s , like t h e o t h e r s , o n a m i s i n t e r p r e t a t i o n o f w h a t
h a p p e n s i n t h e r a p e u t i c b e i n g - t o g e t h e r . His t h e s i s b e g i n s w i t h t h e false
p r e m i s e t h a t the patient is an adult and t h e r e f o r e able to love in a m a t u r e ,
generous way. But neurotics would never have become neurotic in the
first place if t h e y had b e e n able to develop t h e i r i n h e r e n t p o t e n t i a l for
relating t o o t h e r s t o s u c h a s t a t e o f m a t u r i t y . T h e p r i m a r y c h a r a c t e r i s t i c
of an infantile, i m m a t u r e love r e l a t i o n s h i p is its o v e r r i d i n g d e s i r e to take,,
t o suckle. I n d e m a n d i n g c o n s t a n t p r o o f s o f love, t h e r e f o r e , t h e so-called
t r a n s f e r r i n g patient is e x p r e s s i n g love. T h e f o r m of t h e love is childish,
but it is t h o r o u g h l y g e n u i n e , and it is e n t i r e l y c o n s i s t e n t w i t h t h e
p a t i e n t ' s p r e s e n t m a k e - u p and t h e t h e r a p e u t i c s i t u a t i o n w h i c h his
participation is helping s h a p e . T h i s is so p a t e n t l y t r u e t h a t e v e n F r e u d
c o n t r a d i c t e d o n e o f his o w n s t a t e m e n t s o n t h e m a t t e r . H e o p e n l y
a d m i t t e d t h a t applying t h e t h e o r y o f t r a n s f e r e n c e i n analysis m i g h t b e n d
the t r u t h s o m e w h a t , for w h a t r i g h t had t h e a n a l y s t to c o n c l u d e t h a t a
p a s s i o n a t e l o v e developing i n t h e r a p y could n o t b e g e n u i n e l o v e ?
2

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

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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 .

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t h e e n d o f s o m e e m o t i o n a l tie, c a r r y i n g i t t o his n e i g h b o r , and t h e n

transferring it to the other, securing it there. This would be necessary
o n l y if e a c h p e r s o n w e r e t h e r e initially as an isolated s u b j e c t , an e g o - p o l e .
B u t i f t h a t w e r e really so, t h e n e v e r y p s y c h o l o g i c a l a b s t r a c t i o n , including
a f f e c t s and e m o t i o n s , w o u l d h a v e t o b e c a r r i e d b a c k and f o r t h s o m e h o w
b e t w e e n t w o s u c h h u m a n polarities for t h e r e t o b e a n y c o m m u n i c a t i o n
b e t w e e n t h e m . Y e t all o u r e x p e r i e n c e t e a c h e s u s t h a t h u m a n c o m m u n i c a
tion p r o c e e d s in a w h o l l y d i f f e r e n t w a y , t h a t t w o people a r e already w i t h
each o t h e r f r o m the v e r y i n s t a n t t h e y e n c o u n t e r and p e r c e i v e each o t h e r
directly o r indirectly (for e x a m p l e , b y h e a r i n g o r reading o f t h e o t h e r ) .
S u c h b e i n g - t o g e t h e r is a basic trait of h u m a n b e i n g - i n - t h e - w o r l d w h i c h
can be c h a r a c t e r i z e d as an i n h e r e n t , s h a r e d e n g a g e m e n t in t h e 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 a s w h i c h m a n f u n d a m e n t a l l y
e x i s t s . A c c o r d i n g l y , h u m a n b e i n g s i n h e r e n t l y dwell t o g e t h e r " o u t t h e r e "
in a s h a r e d w o r l d . We c a n n o t p e r c e i v e s o m e t h i n g u n l e s s o u r s e e i n g , in its
b r o a d e s t s e n s e , i s already b y it, and h o w could w e e v e r g r a s p s o m e t h i n g
u n l e s s w e w e r e already b y it? " O u t t h e r e " i s i n q u o t a t i o n m a r k s t o
e m p h a s i z e t h a t this e x p r e s s i o n a l w a y s p r e s u p p o s e s a s e p a r a t e " i n n e r "
r e a l m a s well. T h e r e a d e r will recall, h o w e v e r , t h a t w e h a v e s h o w n t h e r e
is no e v i d e n c e for t h e actual p r e s e n c e in people of t h e kind of i n t e r n a l i t y
represented in the container concepts of ego, consciousness, psyche,
s u b j e c t , o r p e r s o n . I n s t e a d , h u m a n b e i n g s are i n h e r e n t l y e n g a g e d i n
r e l a t e d n e s s t o w h a t e v e r p h e n o m e n a address t h e m f r o m t h e i r l o c a t i o n s i n
t h e h u m a n w o r l d and e x i s t a s t h e s e p e r c e i v i n g and r e s p o n d i n g
r e l a t i o n s h i p s . B u t t h e h u m a n m o d e o f dwelling i n t h e w o r l d i s c o n s t a n t l y
a t t u n e d t o o n e m o o d o r a n o t h e r , a t t u n e m e n t b e i n g o n e o f t h e basic
f e a t u r e s , o n e o f t h e E x i s t e n t i a l s , o f h u m a n n a t u r e . I f people a l w a y s s h o w
and e x p e r i e n c e a p a r t i c u l a r a t t u n e m e n t , a special e m o t i o n a l a c c e n t in
t h e i r e n c o u n t e r s w i t h a n y p h e n o m e n a , t h e y m u s t d o this i n t h e i r
e n c o u n t e r s w i t h fellow h u m a n b e i n g s a s well, n o m a t t e r w h e r e this
b e i n g - t o g e t h e r t a k e s place. T h i s m e a n s , in t u r n , t h a t all e m o t i o n a l
r e l a t i o n s h i p s b e t w e e n p h y s i c i a n and patient are n o t h i n g m o r e t h a n
particularly attuned e n g a g e m e n t s of two h u m a n beings in their c o m m o n
dwelling b y t h e s a m e p h e n o m e n a o f t h e i r s h a r e d world.
T h e s e p h e n o m e n o l o g i c a l i n s i g h t s g u a r d t h e p h y s i c i a n - p a t i e n t rela
t i o n s h i p a g a i n s t all t h r e e o f t h e m i s i n t e r p r e t a t i o n s c u r r e n t i n t r a n s f e r
e n c e t h e o r y . F r o m t h e n e w p e r s p e c t i v e , w e can r e c o g n i z e this
r e l a t i o n s h i p o n c e again, m o r e fully t h a n e v e r b e f o r e , a s t h e p h e n o m e n o n
F r e u d s a w as t h e focal point of t h e r a p y , t h e actual basis of all medii al
t r e a t m e n t . N o m e r e t h e o r y can a l t e r this i n t h e least, for the h u m a n
r e l a t i o n s h i p of physician and p a t i e n t r e m a i n s t h e v e r y c o r e ol I hei apeul 1(
a c t i o n , its basis and a r e n a , w h e t h e r or not the people taking, pal t In it are
a w a r e o f its t h e r a p e u t i c s i g n i f i c a n c e .

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.
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

Werke, vol. 1 2 ( L o n d o n : I m a g o , 1 9 4 7 ) , p . 1 8 9 .

Gesammelte

psychoanalytischen

Werke,

Therapie,"

vol.

10,

Gesammelte

Chapter 17
THOSE WHO ARE THERAPEUTICALLY ACTIVE

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.

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FOUNDATIONS

a g r e e m e n t o n t h e p a t i e n t ' s part, surgical i n t e r v e n t i o n would n o t b e

possible. S i n c e t h e a g r e e m e n t is based on a p e r c e p t i o n and u n d e r s t a n d i n g
of p h e n o m e n a t h a t h a v e b e e n e n c o u n t e r e d , as well as a r e s p o n s e to t h e s e
p h e n o m e n a , t h e b e h a v i o r of this p a t i e n t is no less a g e n u i n e h u m a n act
t h a n i s the a n a l y s t ' s a t t e n t i v e n e s s i n t h e o t h e r c a s e . T h e s a m e applies t o
all t h e r a p e u t i c m e t h o d s t h a t lie b e t w e e n t h e s e t w o e x t r e m e s .
T h e p a r t n e r s w h o a r e acting t o g e t h e r i n t h e s e w a y s can b e v e r y
different kinds o f people. A b o v e all, t h e i r a t t i t u d e s t o w a r d t h e r a p y and
t h e being ill m a y v a r y g r e a t l y . In o u r t e s t c a s e , f o r e x a m p l e , b o t h t h e
active p s y c h o t h e r a p i s t and t h e a c t e d u p o n p a t i e n t realized f r o m t h e
o u t s e t t h a t t h e goal o f t h e r a p y w o u l d b e t o l i b e r a t e t h e p a t i e n t f r o m h e r
n e u r o t i c a l l y r e s t r i c t e d w a y s o f r e l a t i n g t o t h e people and t h i n g s o f h e r
world. T h e physician therefore deliberately challenged each of her
a t t e m p t s t o r e s i s t g r e a t e r f r e e d o m for h e r s e l f . B u t t h e s u r g e o n she l a t e r
c o n s u l t e d for h e r leg f r a c t u r e had n e v e r b o t h e r e d t o c o n s i d e r t h e n a t u r e
o r p u r p o s e o f h u m a n b e i n g - i n - t h e - w o r l d . H e t o o k for g r a n t e d t h e overall
validity o f t h e n a t u r a l scientific t h i n k i n g t h a t pervaded m e d i c i n e . T h e
only m e t h o d of t r e a t m e n t he k n e w did n o t r e c o g n i z e t h e p a t i e n t as a
h u m a n Da-sein. His medical r e l a t i o n s h i p to h e r c o n c e r n e d n o t h i n g b u t t h e
repair o f s o m e b o n e s y s t e m t h a t could b e located, d a m a g e d , s o m e w h e r e
in a physical space. T h e fact t h a t t h e a c c i d e n t had n o t o n l y b r o k e n a b o n e
b u t s e v e r e l y a f f e c t e d t h e p a t i e n t ' s e n t i r e b e i n g - i n - t h e - w o r l d and r e d u c e d
it to t h e s m a l l e s t spatiality and t e m p o r a l i t y i m a g i n a b l e did n o t t r o u b l e t h e
s u r g e o n i n t h e least. N o t w i t h s t a n d i n g his e x t r e m e l y limited r e s p o n s e ,
however, no other therapistcertainly not a psychotherapistcould
h a v e d o n e a m o r e t h o r o u g h and speedy j o b o f r e s t o r i n g h e r h u m a n
f r e e d o m t h a n this s u r g e o n w i t h his skillful t e c h n i c a l m i n i s t r a t i o n s t o
w h a t he i n t e r p r e t e d as a b r o k e n shin.
E v e n in t h e case of i n t e r n a l d i s o r d e r s , t h e r e is o f t e n small h a r m d o n e in
m i s i n t e r p r e t i n g t h e a c t u a l n a t u r e of t h e a i l m e n t , and t h e r e is a p r o m p t
r e c o v e r y i n spite o f t h e fact t h a t t h e physician s e e s a s his t a s k o n l y t h e
c r e a t i o n of a c h e m o p h y s i c a l i n t e r a c t i o n b e t w e e n t w o o r g a n i c s y s t e m s , a
bacterial c o l o n y and a h u m a n being r e i n f o r c e d w i t h a n t i b i o t i c s . W h e r e
practical t h e r a p e u t i c o u t c o m e s a r e c o n c e r n e d , t h e n a r r o w s o m a t i c
c a u s a l - g e n e t i c a p p r o a c h o f t e n suffices, and r e m o v i n g w h a t is seen as t h e
causal a g e n t o f t h e illness usually does a w a y w i t h t h e illness i t s e l f and t h e
resulting impairment of human freedom.
O n t h e o t h e r hand, t h e s a m e a p p r o a c h t o t h e r a p y p r o v e s d e f i c i e n t ,
e v e n in purely practical t e r m s , w h e n it is applied to a n u m b e r of o t h e r
health d i s o r d e r s t h a t look like simple physical a i l m e n t s w h e n e v e r , for
i n s t a n c e , a f r a c t u r e or i n f e c t i o n afflicts a h u m a n e x i s t e n c e that, as Da-sein,
is already u n h e a l t h y and i m m a t u r e . H e r e t h e t h e r a p i s t pays bitterly for

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his i g n o r a n c e of t h e e x i s t e n t i a l basis t h a t u n d e r l i e s all t h e r a p y . If he does

n o t c o n s t a n t l y k e e p s i g h t of t h e fact t h a t all medical i n t e r v e n t i o n b e it
surgical, c h e m i c a l , o r p s y c h o t h e r a p e u t i c a i m s a t r e s t o r i n g t h e u s e o f all
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 t o t h e p a t i e n t , his b l i n d n e s s m a y h a v e o n e
o f t w o c o n s e q u e n c e s . A t t h e v e r y least, t h e f r a c t u r e o r i n f e c t i o n heals
m o r e slowly t h a n usual. B u t t h e far g r e a t e r d a n g e r f r o m this m y o p i a o f
therapists is that in modern welfare states, with their strong tendencies
t o infantilize t h e i r m e m b e r s , w h a t m a y first look like simple physical
a i l m e n t s , a m e n a b l e t o t h e i n t e r v e n t i o n o f s u r g e r y o r m e d i c a t i o n , all t o o
often d e g e n e r a t e i n t o i n t e r m i n a b l e c h r o n i c n e u r o s e s o r h y p o c h o n d r i a chal i l l n e s s e s . T h i s d o e s i m m e a s u r a b l e h a r m t o t h e p a t i e n t , t h e physician,
and, last but n o t least, to h u m a n s o c i e t y as a w h o l e .
I n light o f t h e v a s t n u m b e r s o f people w h o are e x i s t e n t i a l l y i m m a t u r e
and d i s t o r t e d b e f o r e t h e y are affected b y s e e m i n g l y bodily illness, t h e r e
would seem to be only one workable way to control the development of
e v e n m o r e s e v e r e n e u r o s e s , and t h a t is to h a v e , in e v e r y a r e a of medical
specialization, m a n y m o r e d o c t o r s a w a r e t h a t s u c h t h i n g s a s t h e s e t t i n g
o f a b o n e , o r t h e i n t r o d u c t i o n o f a n t i b i o t i c s i n t o t h e body, o r a n y o t h e r
a p p a r e n t l y purely physical i n t e r v e n t i o n , does n o m o r e t h a n p r o m o t e
p r o p e r callous f o r m a t i o n , o r t h e d e s t r u c t i o n o f p n e u m o c o c c i i n t h e body.
T h e process of genuine healing involves the way the patient is
e x i s t e n t i a l l y related t o t h e w o r l d a t t h e t i m e , his w h o l e e x i s t e n c e . T h i s
i n s i g h t will n o t c o m p e l s u r g e o n s and i n t e r n i s t s t o c h a n g e t h e i r
t h e r a p e u t i c t e c h n i q u e at all, e x c e p t in r a r e i n s t a n c e s , b u t in t h e long run,
w h e t h e r o r n o t t h e m a n i p u l a t i o n s o f s u r g e o n s and i n t e r n i s t s a r e r o o t e d
in an a d e q u a t e u n d e r s t a n d i n g of h u m a n being, will be decisively
i m p o r t a n t . W i t h o u t this u n d e r s t a n d i n g , the physician will n o t realize
t h a t his m a n i p u l a t i o n of t h e p a t i e n t ' s bodily s p h e r e is no m o r e t h a n a
prelude t o t h e r e c o v e r y o f t h e w h o l e h u m a n e x i s t e n c e . N o p a t i e n t i s
g e n u i n e l y h e a l e d , n o m a t t e r w h a t his p a r t i c u l a r a i l m e n t , until h e h a s
r e c o v e r e d full u s e of all t h e p o t e n t i a l i t i e s n a t i v e to his Da-sein. N a t u r a l l y ,
t h e r e a r e sick people w h o , as Da-sein, a r e r o b u s t and h e a l t h y e n o u g h
b e f o r e t h e i r surgical o r medical t r o u b l e s t o b e able t o o v e r c o m e the
i n e v i t a b l e afflictions of t h e i r Dasein w h i c h a n y illness leads t o . B u t this
does n o t c h a n g e t h e basic s h a p e o f t h e p r o b l e m .
To s e e t h a t p a r t i c u l a r t h e r a p y is m e r e l y a p r e p a r a t i o n is n o t to criticize
t h e t h e r a p y itself. T o t h e d e g r e e t h a t t h e y c o n t r i b u t e t o the s u c c e s s o l a n
e n t e r p r i s e , p r e p a r a t i o n s a r e t o b e valued and c a r r i e d t h r o u g h w i t h greal
c a r e . T h e y d o h a r m i n t h e r a p y o n l y w h e n t h e y t r y t o pass t h e m s e l v e s o l I
as t h e be-all and end-all in medical p r o c e d u r e .
To c o n c e i v e of t h e p a t i e n t as a purely physical o r g a n i s m only
s o m e t i m e s r e s u l t s i n h a r m c o n c e r n i n g health disorders like t h o i t u i

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EXISTENTIAL FOUNDATIONS

h a v e been discussing. B u t t h e e f f e c t s o f this o r i e n t a t i o n a r e m o r e

predictably h a r m f u l in t h e c a s e , let us say, of a m a n i n f e c t e d w i t h
syphillis. A h u m a n l y a d e q u a t e t h e r a p y would n e e d to go b e y o n d t h e
approach o f n a t u r a l s c i e n c e and take i n t o a c c o u n t t h e likelihood t h a t t h e
w h o l e e x i s t e n c e of t h e syphillitic h a s u n d e r g o n e a s e v e r e p a t h o l o g i c a l
r e s t r i c t i o n , o r h e w o u l d h a r d l y h a v e had t o m a k e t h e m o s t i n t i m a t e o f his
h u m a n c o n n e c t i o n s i n t h e seedy, disease-ridden a m b i e n c e o f a b r o t h e l .
S u c h e x i s t e n t i a l d e m a n d s o n t h e physician will d o u b t l e s s face t h e usual
o b j e c t i o n , t h a t t h e specialist in v e n e r e a l d i s e a s e s w o u l d be o v e r t a x e d by
t h e added b u r d e n o f t e n d i n g t o d i s t u r b e d h u m a n w a y s o f r e l a t i n g t o t h e
w o r l d . Of c o u r s e he w o u l d h a v e a lot to do. B u t o n l y by o p e n i n g his m i n d
to this pressing t h e r a p e u t i c c o n c e r n can he b e c o m e a t r u e healer, able to do
m o r e t h a n sit idly b y until t h e patient r e t u r n s w i t h a n o t h e r v e n e r e a l
i n f e c t i o n . He w o u l d no l o n g e r h a v e to be like a f i r e f i g h t e r w h o can do
n o t h i n g b u t put up s m o k e s c r e e n s a r o u n d t h e wall of a b u r n i n g h o u s e .
T h e physician's d u t y t o c o u n t e n a n c e a n e x i s t e n t i a l , D a s e i n s a n a l y t i c
approach b e c o m e s e v e n c l e a r e r w i t h t h a t g r o u p o f h e a l t h d i s o r d e r s
w h i c h , since J o r e s , h a v e b e e n called specifically h u m a n a i l m e n t s . T h e y
m a n i f e s t t h e m s e l v e s m o s t f r e q u e n t l y t h e s e days a s e s s e n t i a l h y p e r t o n i a ,
a n u m b e r o f c h r o n i c g a s t r o i n t e s t i n a l d i s o r d e r s , a s t h m a , and a c c i d e n t
p r o n e n e s s . N o n e o f t h e s e steadily i n c r e a s i n g diseases h a p p e n s o u t s i d e
t h e r e a l m o f h u m a n b e i n g - i n - t h e - w o r l d . Identical s y m p t o m s m a y b e
produced in l a b o r a t o r y a n i m a l s , b u t t h e a i l m e n t s a r e still u n i q u e l y
h u m a n , for t h e a n i m a l s w o u l d n e v e r h a v e b e c o m e sick i n quite t h a t w a y i f
people had n o t had a h a n d in it. C o n s e q u e n t l y , little s e r i o u s d o u b t
remains that the incidence of these unique ailments is connected to
particular d i s t u r b a n c e s i n t h e w a y t h e s u f f e r e r r e l a t e s t o the w o r l d . A n d
if to be a t h e r a p i s t m e a n s to offer f u n d a m e n t a l help, t h e y m u s t
c o n s c i o u s l y focus t h e i r t h e r a p i e s o n r e a t t u n i n g t h e p a t i e n t ' s p a t h o g e n i cally reduced w a y s of b e i n g in relation to t h e p h e n o m e n a of his w o r l d .
1

T h e s a m e u n d e r s t a n d i n g o f the basis o f all t h e r a p y i s r e q u i r e d o f t h e

physician t r e a t i n g " p u r e p s y c h o s e s " and " c h a r a c t e r n e u r o s e s . " T h e s e
illnesses differ from t h e "specifically h u m a n , o r p s y c h o s o m a t i c , "
a i l m e n t s in t h a t t h e d i s t u r b e d r e l a t i o n s h i p s to t h e world are less
s t r i k i n g l y evident w i t h i n t h e i r bodily s p h e r e s . T h e diseases k n o w n a s
p s y c h o n e u r o s e s m o s t directly affect p o t e n t i a l i t i e s i n t h e r e a l m s o f
t h i n k i n g , feeling, and a c t i n g .
I n order t o heal w h e n t h e s e areas are a f f e c t e d , t h e physician m u s t
often explode t h e a s s u m p t i o n s o f classical p s y c h o a n a l y t i c t h e o r y ,
according to w h i c h t h e w h o l e p r o b l e m is to r e l e a s e libido that h a s b e e n
fixated o n infantile e n d o p s y c h i c c o n t e n t s b y m a k i n g t h e s e c o n t e n t s
c o n s c i o u s . It has been pointed o u t o f t e n e n o u g h , h o w e v e r , thai libido and

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endopsychic contents are things for whose existence there is no proof at

all, and t h a t e v e n if s u c h a t h i n g as libido did e x i s t it could n e v e r of its o w n
a c c o r d p r o d u c e a h u m a n w o r l d of p e r c e i v e d m e a n i n g s . F a r less could it
c h a n g e o r heal t h a t w o r l d . N o kind o f e n e r g y o r f o r c e can p e r c e i v e
s o m e t h i n g in its s i g n i f i c a n c e . B u t this is an ability w i t h o u t w h i c h h u m a n
b e i n g s could n e v e r live in t h e w o r l d as t h e y do.
H o w t h e n does i t h a p p e n t h a t p h y s i c i a n s w h o a r e e n s l a v e d t o the libido
t h e o r y and o t h e r s p e c u l a t i o n s o f p s y c h o a n a l y t i c m e t a p s y c h o l o g y can
o f t e n free p a t i e n t s o f t h e i r p s y c h o s o m a t i c s y m p t o m s ? S i m p l y b e c a u s e
t h e s e p a t i e n t s r e c o v e r n o t because of faulty t h e o r y b u t in spite of it. T h e r e
a r e a t least t h r e e w a y s t o explain h o w c u r e s can t a k e place u n d e r such
c i r c u m s t a n c e s . F i r s t , F r e u d h i m s e l f did n o t allow his t h e r a p e u t i c m e t h o d s
to be ruled e n t i r e l y by his t h e o r e t i c a l findings. At decisive p o i n t s , in fact,
h e a c t e d i n radical o p p o s i t i o n t o h i s o w n m e t a p s y c h o l o g y . T h i s can b e
s e e n i n t h e striking c o n t r a d i c t i o n s t h a t e x i s t b e t w e e n his papers o n
t e c h n i q u e and his w o r k s o n t h e s u b j e c t o f m e t a p s y c h o l o g y . T h e
t h e o r e t i c a l s u p e r s t r u c t u r e m e a n s to be a n a t u r a l scientific s y s t e m and
t h e r e f o r e c o n f o r m s s t r i c t l y t o t h e d e t e r m i n i s t i c principle o f c a u s a l i t y .
B u t in F r e u d ' s practical advice for c o n d u c t i n g p s y c h o t h e r a p y , t h e r e is
m u c h d i s c u s s i o n o f t h e m e a n i n g o f s y m p t o m s and o f t h e g r e a t e r f r e e d o m
t o w h i c h p a t i e n t s can b e led t h r o u g h p s y c h o a n a l y t i c t r e a t m e n t . N o w ,
n e i t h e r m e a n i n g n o r f r e e d o m h a s a n y place in a s t r i c t l y d e t e r m i n i s t i c
t h e o r y . T h e causal i m a g i n a t i o n beholds o n l y rigidly c h r o n o l o g i c a l
sequences of events meaningless in themselves.
T h e s e c o n d r e a s o n for t h e s u c c e s s o f such c u r e s i s t h a t , e v e n w h e n t h e
physician i s t h e m o s t t h e o r e t i c a l l y o r t h o d o x p s y c h o a n a l y s t , infinitely
m o r e h a p p e n s during t h e r a p y t h a n the m e r e r e p o r t a g e o f libidinal
t h e o r i e s t o t h e p a t i e n t . W h a t h a p p e n s has m u c h m o r e t o d o w i t h that
decisively i m p o r t a n t a s p e c t of t h e r a p y t h a t can o n l y be g r a s p e d by a
D a s e i n s a n a l y t i c a p p r o a c h , and not by a p s y c h o a n a l y t i c o n e . We have
pointed o u t a b o v e t h a t v e r y f e w adults indeed e v e r e x p e r i e n c e from
a n o t h e r adult the kind o f e n d u r i n g , u n s h a k a b l e , b e n e v o l e n t , and tactful
d e v o t i o n t h a t a p a t i e n t r e g u l a r l y r e c e i v e s from a n a n a l y s t , w h a t e v e r h i s
s c h o o l o f t h o u g h t . F o r m a n y people w h o have b e c o m e n e u r o t i c t h r o u g h
l o n e l i n e s s , such b e i n g - t o g e t h e r is in itself a v e r y e f f e c t i v e therapeutic
tool.
T h i r d , e v e n i n c o n c e p t u a l l y o u t m o d e d p r o g r a m s o f psychoanalytit
t r e a t m e n t t h e p a t i e n t o f t e n g a i n s at least a foggy a w a r e n e s s o f t h e r e a l m .
of p h e n o m e n a from w h i c h his e x i s t e n c e has so far been cul oil An a
result o f this being cut off, which i s largely due t o i n a d e q u a t e a n d
i n a p p r o p r i a t e upbringing, h e b e c a m e n e u r o t i c . B u t b e c a u s e t h e analysl | g
m o r e open and c o u r a g e o u s than t h e p a r e n t s , close h u m a n c o n t a c l with

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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

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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
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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

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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

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 .
T h e aforementioned physician-technicians argue that, in the vast
m a j o r i t y o f c a s e s , individual and g r o u p t h e r a p i e s a r e c o u n t e r p r o d u c t i v e
i n c o n t e m p o r a r y s o c i e t y . T h e physician can o n l y h a r m his c h a r g e s b y
helping t h e m a t t a i n a n i n d e p e n d e n t and free s e l f h o o d , w h i c h o n l y m a k e s
it h a r d e r for t h e m to fit i n t o t h e m a s s s o c i e t y of i n d u s t r i a l e m p l o y e e s .
T h e y would h a v e m o r e c o n f l i c t s w i t h c o w o r k e r s and s u p e r v i s o r s .
Anyone coming out of Daseinsanalysis, therefore, would be sure to lose
his j o b , be d i s m i s s e d , and u l t i m a t e l y be h a n d e d o v e r to social and physical
ruin. O u t o f c o n s i d e r a t i o n for t h e s e c o n s e q u e n c e s , s o m e d i r e c t o r s o f
i n d u s t r y h a v e already t a k e n i t u p o n t h e m s e l v e s t o forbid t h e i r e m p l o y e e s
to undergo programs of analytic therapy.
C e r t a i n scientific p u b l i c a t i o n s , l a r g e l y o f A m e r i c a n origin, imply t h a t
this a t t i t u d e i n i n d u s t r i a l l e a d e r s h i p h a s i n f l u e n c e d p h y s i c i a n s t h e m s e l v e s , h a s c a u s e d t h e m t o allow p s y c h o t h e r a p y t o slip m o r e and m o r e
out of their hands. According to these articles, physicians have delegated
t h e i r p s y c h o t h e r a p e u t i c a c t i v i t y m o r e and m o r e t o s o c i o l o g i s t s , w h o
c a r r y o u t a psychic i n d o c t r i n a t i o n o f t h o s e e n t r u s t e d t o t h e i r c a r e . T h e s e
s o c i o l o g i s t s , p r a c t i c e a b r a n d of m a s s t h e r a p y aimed at e x t e r n a l
p s y c h o l o g i c a l c o n t r o l of all p e r s o n n e l . A s t a t i s t i c a l description of all
Americans undergoing some form of psychological t r e a t m e n t would
s h o w t h a t t h o s e b e i n g s h a p e d to a s m o o t h fit in i n d u s t r y e x c e e d t h o s e
being guided to a t t a i n m e n t of an i n d e p e n d e n t f r e e selfhood by a r a t i o of
a b o u t a t h o u s a n d to o n e .
2

T h a t this is so already in A m e r i c a , and will be s o o n all o v e r t h e w o r l d , is

n o t s u r p r i s i n g . D e v e l o p m e n t s i n t h e r a p y t a k e t h e i r lead f r o m t h e l a r g e r
v i e w o f h u m a n n a t u r e t h a t p r e d o m i n a t e s today. Y e t i t i s doubtful
w h e t h e r i n t h e long r u n this a p p r o a c h t o t h e r a p y will p r o m o t e e v e n s u c h
a n a r r o w goal as i n c r e a s e d p r o d u c t i v i t y in i n d u s t r y . B e c a u s e h u m a n Dasein is i n n a t e l y disposed to an e x t r e m e l y b r o a d e x p e r i e n c e , it is m o r e likely
t h a t the m a s s e s o f industrial w o r k e r s will r e a c t t o t h e a t t e m p t t o r e p r e s s
their unique n a t u r e s by s h o w i n g s e v e r e l y p a t h o l o g i c a l b e h a v i o r apt to
n i p p l e even the l a r g e s t industrial g i a n t s . T h i s pathological r e s p o n s e t o

Those

Who Are

Therapeutically Active

283

d e p r i v a t i o n is taking s h a p e as m a s s c r i m i n a l i t y and m a s s addiction, and

o n a scale t h a t c h a l l e n g e s t h e i m m e n s e r e s o u r c e s o f t h e s t a t e itself, n o t t o
s p e a k o f t h e fragile i n s t r u m e n t a r i u m o f t h e p h y s i c i a n s w h o , a s a body,
a r e t h e m s e l v e s o r i e n t e d t o t h e f u n c t i o n i n g o f t h e i r c h a r g e s and o f a n
i n d u s t r i a l s o c i e t y . A rapid i n c r e a s e in c r i m e and addiction, m u c h
l a m e n t e d t h o u g h i t b e t h e s e days, i s n o n e t h e l e s s t h e i n e v i t a b l e r e a c t i o n
t o t h e g r o w i n g c r i m e s p e r p e t r a t e d upon t h e h u m a n soul b y the
a p o t h e o s i z e d spirit o f t e c h n o l o g y . Addiction, w h a t e v e r its f o r m , h a s
a l w a y s b e e n a d e s p e r a t e s e a r c h , on a false and h o p e l e s s path, for t h e
fulfillment of a h u m a n f r e e d o m .
O u r d i s c u s s i o n o f h u m a n p a t h o l o g y b r i n g s u s face t o face again w i t h
t h e fact t h a t h u m a n illness and its t r e a t m e n t a r e b o t h peculiarly r o o t e d i n
f u n d a m e n t a l h u m a n n a t u r e , i n m a n ' s b e i n g - i n - t h e - w o r l d and his
i n h e r e n t b e i n g - 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 world. O n c e again we
s e e t h a t all illness and t r e a t m e n t develops o u t o f t h e p a t i e n t ' s disturbed
h u m a n r e l a t i o n s h i p s ; in o t h e r w o r d s , social b e h a v i o r is n e c e s s a r i l y
i n v o l v e d i n illness. C o n s e q u e n t l y , a n y p r o g r a m o f t h e r a p y , e v e n t h e m o s t
trifling, is e s s e n t i a l l y an i n s t a n c e of social m e d i c i n e .
NOTES
1. A . J o r e s , Vom kranken Menschen ( S t u t t g a r t : T h i e m e , 1 9 6 ) ; Menschsein als Auftrag ( 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 7 ) ; a n d Urn eine Medizin von morgen ( B e r n a n d S t u t t g a r t : H .
Huber, 1 9 6 6 ) .
2 . S t . L e s s e a n d W . W o l f , Proceedings of lhe Vlllh International Congress of Psychotherapy, 1 9 6 7
(Basel and N e w Y o r k : S. K a r g e r , 1 9 6 9 ) , 2: 2 7 - 5 4 ; and J. R e u s c h , " P s y c h o t h e r a p y in the
C o m p u t e r A g e , " ibid., 2 : 3 2 - 4 6 .

Afterword
THE FOUNDATIONS

OF A DA-SEIN-BASED

SOCIAL PSYCHOLOGY AND SOCIAL

PREVENTIVE MEDICINE IN MODERN
INDUSTRIAL SOCIETY

T h e medical s c i e n c e s o f social p s y c h i a t r y and social p r e v e n t i v e

m e d i c i n e , t h o u g h still v e r y y o u n g , h a v e already r e g i s t e r e d a s t o u n d i n g
s u c c e s s e s . T h e i r m o s t i m p o r t a n t a c h i e v e m e n t s are limited p r i m a r i l y t o
the struggle against bacterial disease, the accidents that are always
t h r e a t e n i n g t h e i n d u s t r i a l w o r k e r , t h e pollution o f o u r e n v i r o n m e n t , t h e
c o n t a m i n a t i o n o f o u r food, and a n u m b e r o f a n a l o g o u s e n c r o a c h m e n t s
on people's h e a l t h . M a n y of t h e s e e f f o r t s in social m e d i c i n e are still in
t h e i r first p h a s e s , and t h i s i s s o p a r t i c u l a r l y f o r t h e e n o r m o u s e f f o r t s o f
t h e field o f m e n t a l h y g i e n e .
In t h e s e t i m e s , it is p r e c i s e l y t h e field of m e n t a l h y g i e n e w h i c h is
e s p e c i a l l y i m p o r t a n t . Its t a s k i s t o w o r k out a p p r o p r i a t e m e a s u r e s t h a t
c a n c h e c k , o r e v e n w h o l l y p r e v e n t , t h e kinds o f d i s t u r b e d social b e h a v i o r
t h a t h a v e spread like s o m e e p i d e m i c a m o n g t h e y o u n g people w h o n o w
s t a n d f o r t h e f u t u r e o f h u m a n i t y . T h e s e u n h e a l t h y f o r m s o f social
b e h a v i o r , w h i c h i n t h e last c h a p t e r w e called n e u r o s e s o f m e a n i n g l e s s
n e s s and b o r e d o m , a r e n o w m o r e c o m m o n t h a n t h e o l d e r f o r m s o l
h y s t e r i a and o r g a n i c n e u r o s e s .
P r e c o n d i t i o n s f o r s u c c e s s f u l t h e r a p y and p r e v e n t i o n o f social u n r e s l
a m o n g t h e y o u n g a r e , as t h e y a r e f o r a scientific art of healing in a n y area,
c o r r e c t d i a g n o s i s and a p p r o p r i a t e i n s i g h t i n t o t h e basic n a t u r e ol what Is

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

methodology that is inherently unreliable regarding any matters

c h a r a c t e r i s t i c of and basic to h u m a n b e i n g s . In talking a b o u t t h e i r lives
w i t h s o m e o n e t h e y can t r u s t , t h e v e r y s a m e y o u n g people m u s t often
reverse the judgment they recorded in the questionnaire response.
It is no w o n d e r t h a t u n d e r s u c h family c o n d i t i o n s m a n y a d o l e s c e n t s
today n o l o n g e r grasp w h y s o m e o n e should e v e r d o s o m e t h i n g simply t o
oblige s o m e o n e e l s e . An u n r e a s o n a b l e d e m a n d of this kind is usually
a n s w e r e d w i t h a n u n c o m p r e h e n d i n g , " W h y ? " H o w could a g r a t e f u l love
b e e x p e c t e d o f y o u n g people w h o t h e m s e l v e s h a v e n e v e r r e c e i v e d f r o m
their o w n p a r e n t s t h e f u r t h e r i n g help t o w h i c h t h e y a s children had
e v e r y r i g h t ? T h e y h a v e b e e n s o shaped i n t h e h o m e s o f t h e i r p a r e n t s ;
h o w could t h e y h o n o r and r e s p e c t s u c h e l d e r s ? T h e p a r e n t a l g e n e r a t i o n
in the industrialized c o u n t r i e s h a s largely forfeited its l e g i t i m a t e claim to
love.
L o v e and r e s p e c t a r e i n t i m a t e l y b o u n d up w i t h e a c h o t h e r . In t h e
original n a t u r e o f h u m a n b e i n g s t h e y o u n g always d o g e n u i n e l y love and
r e s p e c t p a r e n t s and a u t h o r i t i e s as l o n g as t h e s e elders s t a n d by t h e m in
w a y s w h i c h help t h e m a s t h e y e n d e a v o r t o g r o w i n t o the free,
a u t o n o m o u s b e i n g s - i n - t h e - w o r l d t h e y are m e a n t t o be.
O n e i s a l w a y s h e a r i n g t h e s e days t h a t t h e y o u n g are h o s t i l e t o w a r d
a u t h o r i t y . B u t w i t h e v e r y single o n e o f t h e s e r e b e l l i o u s y o u n g people
( w h o is n o t c o n s t i t u t i o n a l l y impaired) t h e e x a c t o p p o s i t e h a p p e n s as s o o n
a s t h e r e i s s o m e o n e t h e y can c o m e t o t r u s t , w i t h w h o m t h e y can b e o p e n .
T h e y w o u l d like n o t h i n g b e t t e r t h a n finding a u t h o r i t y w o r t h y o f t h e
n a m e . T h e w o r d i t s e l f c o m e s f r o m t h e Latin augere, w h i c h m e a n s " t o
i n c r e a s e or m u l t i p l y . " F o r t h e y o u n g , t h e n , a g e n u i n e a u t h o r i t y is o n l y
s o m e o n e w h o can e x i s t e n t i a l l y e n r i c h t h e i r Da-sein, w h o k n o w s h o w t o
help t h e m b e c o m e the h u m a n b e i n g s t h e y could, a c c o r d i n g t o t h e i r o w n
i n b o r n p o t e n t i a l , b e . T h e best a m o n g the rebellious y o u n g despair, g r o w
o u t r a g e d and d e s t r u c t i v e , o n l y b e c a u s e t h e i r s e a r c h for s u c h a u t h o r i t y is
fruitless and t h e y m u s t e x p e r i e n c e again and again t h e fact t h a t t h o s e
adults w h o would b e t h e i r a u t h o r i t i e s are h i n d e r i n g i n s t e a d o f f u r t h e r i n g
t h e i r e f f o r t s to lead m e a n i n g f u l lives.
T h e y o u n g o v e r s h o o t t h e m a r k , h o w e v e r , w h e n t h e y m a k e t h e s e adult
pillars of s o c i e t y p e r s o n a l l y r e s p o n s i b l e for t h e i r o w n failure as
a u t h o r i t i e s . For t h e m o s t part, adults t h e m s e l v e s d o n o t k n o w w h a t has
h a p p e n e d and still is h a p p e n i n g to t h e m . T h e y h a v e hardly a clue that
t h e y are p r i s o n e r s o f t h e t e c h n o l o g i c a l spirit o f t h e t i m e s . And s o they are
e v e n less a w a r e t h a t t h e w a y t h e i r w o r l d v i e w has b e e n blocked out t o s o
e x t r e m e l y n a r r o w a vision follows n o t from t h e i r o w n dealings and
i n t r i g u e s but, r a t h e r , from this e r a ' s d e s t i n y . W i t h t h e s e b l i n d e r s t h e y
can s e e , of all t h e w a y s to be in relation to the world, o n l y t h e increase ol

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EXISTENTIAL FOUNDATIONS

p o w e r o v e r t h i n g s for t h e sake o f c o n t r o l and for t h e c o n s e q u e n t i a l

i n c r e m e n t of p o w e r for w h o is in c o n t r o l . It is n o t h i n g s h o r t of impossible
for this g e n e r a t i o n t o fulfill t h e d e m a n d o f t h e y o u n g t h a t t h e y b e t r u e
authorities, furtherers, "increasers" of their existence. But when the
elders no l o n g e r h a v e m u c h to say t h a t is h u m a n l y useful, or h u m a n l y
m e a n i n g f u l , s u r e l y t h e y o u n g c a n n o t b e faulted for w a n t i n g t o have t h e i r
w a y and take t h e i r part in shaping society and t h e i r o w n lives.
M o r e t h a n a c e n t u r y a g o , M a r x o f f e r e d alienation as an e x p l a n a t i o n for
t h e malaise o f t h e people i n m o d e r n industrial s o c i e t y . H e t o o k t h e
c o n c e p t from t h e p h i l o s o p h y o f H e g e l , w h o used alienation t o m e a n t h e
not yet accomplished coming-to-be-itself of the absolute subjectivity.
B u t in his e a r l i e s t w r i t i n g s , t u r n i n g Hegel's p h i l o s o p h y on its h e a d , M a r x
t r a n s f e r r e d t h e n o t i o n of a l i e n a t i o n from a b s o l u t e spirit to individual
w o r k e r . H e s a w t h e r o o t s o f self-alienation i n t h e c i r c u m s t a n c e t h a t t h e
good a m a n p r o d u c e s at w o r k in t h e f a c t o r y is no l o n g e r directed t o w a r d
a n o t h e r person w h o stands in an immediate relationship to him. What he
produces is degraded to a purely m a t e r i a l saleable c o m m o d i t y . W i t h t h e
degradation o f w h a t h e p r o d u c e s , t h e w o r k e r ' s w o r k and t h e w o r k e r
h i m s e l f are degraded, t o o , from s o m e t h i n g h u m a n t o a c o m m o d i t y w h i c h
is alien to h u m a n being.
M o d e r n M a r x i s m , w h i c h i s allegedly based o n M a r x ' s p h i l o s o p h y ,
believes t h a t it already h a s t h e t e c h n i q u e s of social t h e r a p y n e e d e d to
a n n u l t h e d e s t r u c t i v e c o n s e q u e n c e s o f t h e n e w age's t e c h n o l o g i c a l
destiny. B u t i n t h e m e a n t i m e , t h e c o n t i n u i n g disquiet, r e s t l e s s n e s s , and
r e v o l t o f t h e y o u n g t o d a y s p a r e s n e i t h e r liberal n o r M a r x i s t social f o r m s .
T h e ubiquity o f this social u n r e s t raises t h e likelihood t h a t M a r x i s m ' s
f u n d a m e n t a l idea is all t o o closely b o u n d to t h e p h i l o s o p h y t h a t already
s p a w n e d the alienating, t e c h n o l o g i c a l , m o n o p o l i s t i c capitalist f a n a t i c i s m
t o a c h i e v e . O f s u c h i n d i c a t i o n s , not t h e least a r e t h e dead s e r i o u s style
and violent c o n d u c t o f M a r x i s t p r o g r e s s i v e s a m o n g s t u d e n t s t h e m s e l v e s .
In fact, t h e capitalist and M a r x i s t industrial s o c i e t i e s h a v e a close
kindred c o n n e c t i o n indeed. M a r x i s m simply c a r r i e s t h a t C a r t e s i a n
s u b j e c t i v i t y w h i c h i s t h e m o t h e r e a r t h o f W e s t e r n industrial s o c i e t y t o its
m o s t e x t r e m e f o r m . M a r x i s m e x p a n d s D e s c a r t e s ' s old s u b j e c t t o
h u m a n i t y as a collective b u t faithfully p r e s e r v e s all t h e c h a r a c t e r i s t i c
f e a t u r e s of t h e t h i n k i n g s u b s t a n c e as D e s c a r t e s applied it to t h e
individual s u b j e c t . M a r x ' s collective s u b j e c t is u n c o m p r o m i s i n g l y
c o n c e p t u a l i z e d as t h a t s u b j e c t i v e being w h i c h u n d e r l i e s and s u s t a i n s all
o t h e r b e i n g s , i s literally " s u b - j e c t e d , " t h r o w n u n d e r t h e m . A s s u c h ,
M a r x ' s s o c i e t y - s u b j e c t arbitrarily d e t e r m i n e s t h e m e a n i n g and signifi
c a n c e of e v e r y t h i n g else and h o w it is to be e x p l o i t e d to a u g m e n t the
s u b j e c t ' s p o w e r . In his a t h e i s m , M a r x w e n t a step f u r t h e r than

280

Afterword

D e s c a r t e s ' s s u b j e c t i v i s m and a t t r i b u t e d t o t h e collective h u m a n subject

w h a t had f o r m e r l y been r e g a r d e d a s t h e c r e a t i v e p o w e r s o f divinity. N o w
this s u b j e c t had t o m a k e e v e n itself. T h e y o u n g M a r x w r o t e :
A being is an i n d e p e n d e n t being o n l y w h e n it stands on its o w n f e e t ,
and it s t a n d s on its o w n feet o n l y w h e n it r e c e i v e s its D a s e i n f r o m
itself. A h u m a n being w h o lives by t h e g r a c e of a n o t h e r r e g a r d s h i m s e l f
as a d e p e n d e n t being . . . and my life n e c e s s a r i l y has s u c h a s o u r c e
outside itself when it is not of my own making.
1

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 ,

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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

L e a s t able t o heal t h e pathological o u t c o m e s o f m o d e r n industrial

s o c i e t y is s o m e h a r k i n g b a c k to t h e good old days to appeal for
d e r a t i o n a l i z i n g and d e m a t e r i a l i z i n g today's t o t a l l y a d m i n i s t e r e d p r o f e s
sional w o r l d . R a t i o n a l i s m , m a t e r i a l i s m , and d e p e r s o n a l i z a t i o n a r e
c h a r a c t e r i s t i c s of t h e p r e s e n t d e s t i n y of a t e c h n o l o g i c a l w o r l d v i e w . J u s t
a s o n e can h a r d l y r e v e r s e t h e e r o s i v e s p r e a d o f t h e industrial s y s t e m , s o
o n e could hardly c a n c e l o u t t h e i n c r e a s i n g l y p e r f e c t e d a d m i n i s t r a t i o n o f
things from the technical worker up to the general manager.
C l e a r l y , it is n e c e s s a r y to t r a n s f o r m the m o d e s in w h i c h it is possible to
b e c o m e a w a r e of t h e world's p h e n o m e n a and to t r a n s f o r m the world, in a
w a y far m o r e radical t h a n w h a t v a r i o u s intrinsically s e l f - c o n t r a d i c t o r y
social d o c t r i n e s could e f f e c t . S u c h a t t e m p t s , allegedly so r e v o l u t i o n a r y ,

Afterword

2^1

retain fundamentally unchanged the subjectivistic, possessive relation

ship w i t h t h e world o n w h i c h t h e social o r d e r t h e y w o u l d c h a n g e i s based.
T h e p h e n o m e n o l o g i c a l o r D a s e i n s a n a l y t i c a p p r o a c h i s available t o t h e
s c i e n c e s of social p s y c h i a t r y and p r e v e n t i v e medicine as a g e n u i n e l y
r e v o l u t i o n a r y w a y o f s e e i n g . H o w i t stands u p t o s c r u t i n y i n t h e s e
s p h e r e s of m e d i c i n e , as well as in t h e healing a r t s we h a v e already
discussed, can b e illustrated t h r o u g h o n e o f m o d e r n industrial s o c i e t y ' s
m o s t positive a c h i e v e m e n t s , t h e h i t h e r t o u n k n o w n a m o u n t o f available
time o u t s i d e w o r k i n g h o u r s . It is called " r e c r e a t i o n t i m e , " and in t h e
f o r e s e e a b l e f u t u r e m o s t people will h a v e a c c e s s t o m o r e h o u r s o f
r e c r e a t i o n t i m e t h a n t h e y h a v e t o spend o n t h e j o b i n offices and
f a c t o r i e s . S o m e heads o f i n d u s t r y a r e already s e r i o u s l y c o n s i d e r i n g
actually paying t h e m a j o r i t y o f t h e i r e m p l o y e e s n o t t o appear for w o r k .
People do incomparably m o r e damage at work with their mistakes than
t h e far less fallible a u t o m a t e d m a c h i n e r y . A c c o r d i n g t o t h e industrialists,
i t w o u l d b e s i g n i f i c a n t l y c h e a p e r t o c o m p e n s a t e m o s t o f t h e w o r k e r s for
not working than to repair the mistakes they make.
H o w e v e r t h a t m a y b e , p l a n n i n g for r e c r e a t i o n t i m e h a s b e c o m e a n
e x t r a o r d i n a r i l y s e r i o u s i s s u e for t h e f u t u r e o f h u m a n i t y . F u t u r e o r i e n t e d leaders a m o n g p s y c h o l o g i s t s , s o c i o l o g i s t s , e d u c a t o r s , city
p l a n n e r s , a r c h i t e c t s , and i n d u s t r i a l i s t s have c e r t a i n l y n o t i c e d its g r o w i n g
s i g n i f i c a n c e , and t h e r e is an I n t e r n a t i o n a l R e c r e a t i o n A s s o c i a t i o n already
at w o r k w i t h t h e a v o w e d p u r p o s e of c o o r d i n a t i n g a w o r l d w i d e policy for
r e c r e a t i o n t i m e . T h o s e w h o specialize i n p r e v e n t i v e m e d i c i n e are called
on, n o less t h a n t h e s e o t h e r specialists, t o c o l l a b o r a t e i n this e n o r m o u s
task.
B u t in fact all t h a t m a t t e r s is w h e t h e r such an e m i n e n t panel s u c c e e d s
in r e n d e r i n g t h e ample t i m e for re-creation, w h i c h a p e r s o n m a y spend w i t h
family and friends, as a h e a l i n g c o u n t e r b a l a n c e to t e c h n i c a l o c c u p a t i o n s ,
w h i c h a r e involved m o r e deeply t h a n e v e n in t h e n a t u r a l scientific world
v i e w a m o d e w h i c h t h e t h e o r e t i c a l physicist H e i t l e r has called
f u n d a m e n t a l l y hostile t o l i f e . R e c r e a t i o n a l planning t h a t c o m p e n s a t e s
for this, w h i c h f u r t h e r s life, will s u c c e e d o n l y w h e n t h e s o c i e t y of days to
c o m e l e a r n s to r e g a r d its r e c r e a t i o n a l i n s t r u c t o r s as h a v i n g a significance
equal to t h a t of p r o f e s s i o n a l i n s t r u c t o r s . All is in vain, h o w e v e r , if t h e s e
r e c r e a t i o n a l p l a n n e r s allow t h e m s e l v e s t o b e engulfed b y t h e t e c h n o l o g i
cal v i e w o f t h e w o r l d . T h e d a n g e r e x i s t s from t h e o u t s e t t h a t t h o s e w h o
have t h e first say i n t h e d e l i b e r a t i o n s o f t h e I n t e r n a t i o n a l R e c r e a t i o n
A s s o c i a t i o n will be t h e i n d u s t r i a l i s t s , city p l a n n e r s , and a r c h i t e i I s . and
t h a t t h e y will w a n t to s t a r t building at o n c e w i t h o u t first c o n s i d e r i n g well
e n o u g h t h e " f o r w h a t " o f t h e i r building.
5

T h i s " f o r w h a t " is the t i m e for r e - c r e a t i o n of h u m a n beings In im idei n

industrial society. T h e primary task ol those w h o plan this recreation

EXISTENTIAL FOUNDATIONS

292

t i m e is to ponder its n a t u r e in t h o r o u g h and f u n d a m e n t a l t e r m s . If t h e y

n e g l e c t t o clarify t h e r e c r e a t i o n o f t h e h u m a n b e i n g and t h e f u n d a m e n t a l
n a t u r e o f h u m a n t i m e b e f o r e t h e y m o v e i n t o a c t i o n , t h e y could easily
b e c o m e a m e r e R e c r e a t i o n T i m e I n s t i t u t e and m a k e this field j u s t o n e
m o r e technological concern in which they would incarcerate human
b e i n g s w h e n t h e y are n o t o n t h e j o b .
6

It is t h e r e f o r e indispensable t h a t t h e r e c r e a t i o n t i m e i n s t r u c t o r s and all

o t h e r s c o n c e r n e d w i t h t h e g r o w i n g " d i s - e a s e " i n civilization t h e m s e l v e s
first win t h e f r e e d o m t h a t w o u l d m a k e t h e m able t o c o m m i t t h e m s e l v e s
w h o l l y t o a n o t h e r w a y o f s e e i n g the w o r l d . I n d i s c u s s i n g t h e difficulty o f
s u c h a t r a n s i t i o n e a r l i e r in this b o o k , we h a v e a l r e a d y said t h a t o n l y t h o s e
w h o d a r e leap w i t h t h e i r w h o l e s e e i n g , t h i n k i n g , w i s h i n g , willing,
feeling, and sensibility s u c c e e d in b r i n g i n g t h e m s e l v e s face to face w i t h
t h e w o r l d in a n e w w a y . T h e y m u s t leap o u t of today's a b s o l u t e l y
subjectivistic, acquisitive, t e c h n o l o g i c a l - c a p i t a l i s t / t e c h n o l o g i c a l - M a r x i s t
s t a n c e t o w a r d t h e world into t h e n o l o n g e r p o w e r h u n g r y , n o l o n g e r
s u b j e c t d e p e n d e n t , b u t the being and l e t t i n g - b e w o r l d v i e w i n t o w h i c h , in
t h e W e s t e r n world, H e i d e g g e r ' s Daseinsanalytik s h o w e d t h e w a y . W h o e v e r
s u c c e e d s in m a k i n g this leap will r e c o g n i z e t h e c h a s m t h a t e x i s t s b e t w e e n
w h a t m o s t people can still see o f t h e p h e n o m e n a o f o u r w o r l d and w h a t
a b u n d a n t m e a n i n g and significance t h e s e p h e n o m e n a h a v e , hidden
t h o u g h t h e y are from t h e vision o f m o s t people n o w . T h o s e w h o a r e
ruled b y t h e spirit o f t e c h n o l o g y have a c c e s s o n l y t o w h a t can b e
m e a s u r e d and calculated a b o u t t h i n g s and people: t h e v o l u m e o f visible
objects, their mass, their physiochemical composition, their cybernetically c o m p r e h e n s i b l e g e n e t i c c o d e , t h e level of selling price, and so on. T h e s e
days, t h e r e is a predilection for calling such e x a c t l y m e a s u r a b l e q u a n t i t i e s
t h e " p u r e " . i lality o f t h i n g s . B u t a f t e r t h e leap i n t o t h e p h e n o m e n o l o g i cal v i e w of t h e world, t h e world's 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 an
actuality much more "pure"undamaged, intact, whole, undistorted,
undisguised, u n f e i g n e d .
. \?e m a y illustrate t h e p a r t i c u l a r w a y in w h i c h this p h e n o m e n o l o g i c a l
leap is to be followed w i t h t h e e x a m p l e of an apple t r e e in full b l o s s o m ,
w h i c h has j u s t c o m e i n t o v i e w . We stand in front of a f l o w e r i n g t r e e and
t h e t r e e stands b e f o r e u s i n t h e m e a d o w . A n y o n e can s a y this. B u t m o s t
o f u s t h e s e days would t h i n k : " W e r e p r e s e n t t h e t r e e t o o u r s e l v e s . " If,
h o w e v e r , we r e m a i n t r u e to w h a t is h a p p e n i n g as it is, we m a y say only:
" W e are presenting ourselves to the tree, encountering the tree." Only so
do we leave t h e t r e e as t h e t r e e it is; o n l y so do we let it be t h e r e in t h e
middle of a m e a d o w w h e r e it is in its actual p r e s e n c e , f r o m w h i c h place it
a d d r e s s e s itself to us. And so we do n o t g o b b l e it up at o n c e , h u n g r y for
p o w e r , i n t o t h e m e n t a l activity o f a h u m a n s u b j e c t . W e do not d e g r a d e it

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

If, i n t h e w a y w e c o n d u c t o u r s e l v e s t o w a r d this b l o o m i n g apple t r e e ,

we a c c o r d t h e t r e e its full b e i n g - p r e s e n t , t h e n it e n c o u n t e r s us as
s o m e t h i n g e x t e n d i n g w i t h its r o o t s i n t o t h e r e a l m o f e a r t h and w i t h its
s o a r i n g b r a n c h e s i n t o the light o f t h e h e a v e n s . Its g e r m i n a t i o n and
g r o w t h r e v e a l p o w e r s o f c r e a t i o n t h a t w e r e from a n t i q u i t y called divine.
T h e fruit p r o m i s e d b y its f l o w e r s e x p r e s s t h e p o t e n t i a l i t y o f s o m e d a y i n
a u t u m n n o u r i s h i n g t h e h u m a n b e i n g . In this w a y t h e apple t r e e in
b l o s s o m , a single t h i n g , g a t h e r s h e a v e n and e a r t h , t h e divine and the
h u m a n , in t h a t fullness of its m e a n i n g and significance w h i c h a r e , by its
v e r y n a t u r e , its o w n .
8

W h a t is t r u e for this t r e e is no less t r u e for all t h e o t h e r p h e n o m e n a of

o u r w o r l d i n c l u d i n g the o t h e r h u m a n b e i n g s w e e n c o u n t e r .
T h e t e c h n o l o g i c a l spirit i s d o m i n e e r i n g and hostile t o w a r d h u m a n
being. It w o u l d be v e r y m u c h indeed if this w e r e u n d e r s t o o d by the
d o c t o r s , p s y c h o l o g i s t s , s o c i o l o g i s t s , and all o t h e r s w h o a r e called upon to
t r a n s f o r m m o d e s o f t h i n k i n g and feeling w h i c h will b e t h e g r o u n d w o r k
for fruitful social life in a m o d e r n industrial s o c i e t y w h i c h would be
h u m a n l y just and n o u r i s h i n g . T h i s t e c h n o l o g i c a l spirit is not itsell .1
technical t h i n g . It is w h a t reveals itself as the destiny of t h i s e p o c h ,
o p e n i n g to us and at the s a m e time limiting us to the t i m e spat e w h i t h

294

EXISTENTIAL FOUNDATIONS

natural science conceives. Such a destiny is never the o u t c o m e of the

e f f o r t s o f t h e h u m a n b e i n g a s s o m e s u b j e c t w h i c h d e t e r m i n e s all t h i n g s
from n o t h i n g b u t itself. O n c e this i s s e e n , t h e a c t i v i t y o f t h e h u m a n
s u b j e c t loses t h e s u p r e m a c y claimed for it n o w .
At the same time, Daseinsanalytic insight into h u m a n existence frees
people for a f u n d a m e n t a l l y m o r e a u t o n o m o u s s t a n c e t o w a r d t h a t
t e c h n o l o g i c a l w o r l d v i e w in w h i c h m o s t people t o d a y are exiled. T h i s
i n s i g h t clears t h e w a y f o r r e c o g n i z i n g t h a t t h e t e c h n o l o g i c a l a p p r o a c h t o
t h e w o r l d i s o n l y o n e a m o n g m a n y possible r e l a t i o n s h i p s . T h e spirit o f
t e c h n o l o g y n o l o n g e r s e e m s like a b s o l u t e , d e f i n i t i v e , u l t i m a t e t r u t h , i n
s h o r t , t r u t h itself. On t h e c o n t r a r y , it can n o w be u n d e r s t o o d in a t r u l y
liberating w a y as a vision of t h e w o r l d , o n e w h i c h can claim h u m a n b e i n g i n - t h e - w o r l d o n l y to a r e l a t i v e l y m o d e s t d e g r e e , and n o t for all e t e r n i t y .
At the same t i m e , it is t h e p h e n o m e n o l o g i c a l w a y of l o o k i n g , t h i n k i n g ,
and feeling w h i c h itself b e s t u n d e r s t a n d s t h a t the t e c h n o l o g i c a l a p p r o a c h
t o t h e world, a s t h e d e s t i n y o f today's h u m a n i t y , does h a v e t h e a u t h o r i t y
to claim t h e m o d e r n h u m a n being to c a r r y it to fulfillment. For this
r e a s o n , t h o s e w h o o n l y c u r s e o r try escaping this p a r t i c u l a r d e s t i n y i n
w h i c h w e w h o live today are y o k e d , a r e a l w a y s evading t h e m s e l v e s and
s h i r k i n g t h e i r destined m i s s i o n . T h e y pay for t h e i r flight w i t h a bad c o n
science.
F o r the d r e a m t h a t people could be ledas F r e u d h o p e d to do t h r o u g h
p s y c h o a n a l y s i s b a c k i n t o t h e happy c o n d i t i o n o f a n i n n o c e n t child o r
noble s a v a g e , has long since b e e n d r e a m e d t o its e n d . T h e b e i n g - g u i l t y ,
b e i n g - i n d e b t e d of h u m a n b e i n g s is an E x i s t e n t i a l , a b a s i c and indelible
n a t u r a l f e a t u r e of h u m a n b e i n g - i n - t h e - w o r l d . It is r o o t e d in t h e
c o n d i t i o n t h a t b e i n g - h u m a n is a l w a y s to be a d d r e s s e d , to be c l a i m e d or
called upon. T o b e h u m a n i s t o e x i s t a s t h e m a n d a t e , a c c o r d i n g t o o n e ' s
c o n s c i e n c e and b e s t k n o w l e d g e , t o s e e k o u t t h e t h i n g s o f t h e w o r l d t h a t
a p p e a r in t h e light of o u r p o t e n t i a l for perceiving and u n d e r s t a n d i n g and
to c a r e for t h e i r unfolding. At a n y given t i m e , h o w e v e r , a p e r s o n can
c a r r y t o fulfillment o n l y o n e o f t h e t h o u s a n d f o l d p o t e n t i a l i t i e s t h a t lie
open t o him. F o r t h e fulfillment o f t h e r e s t h e m u s t r e m a i n i n d e b t e d .
B e s i d e s t h i s , it is i n c u m b e n t on him to fulfill t h o s e e x i s t e n t i a l possibilities
w h i c h will a p p r o a c h h i m f r o m t h e f u t u r e and call upon h i m .
N o w , this e x i s t e n t i a l b e i n g - g u i l t y , b e i n g - i n d e b t e d , is c o m p l e t e l y
different from t h e m e r e guilt feelings o f 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 g e n e r a l l y speak. T h i s b e i n g - g u i l t y b y n a t u r e , b e i n g
indebted by n a t u r e , is w h a t m a k e s all t h o s e guilt f e e l i n g s possible, t h o s e
which a r e n o r m a l and i n e v i t a b l e a s well a s t h o s e w h i c h a r e p a t h o l o g i c a l
and c u r a b l e . E x i s t e n t i a l i n d e b t e d n e s s h a s n o t h i n g t o d o with s o m e " p o o r

Afterword

295

s i n n e r t h a t I a m " face, h o w e v e r . Its w e i g h t and o p p r e s s i v e n e s s can be

o v e r c o m e t h r o u g h o u r r e a d i n e s s t o place o u r s e l v e s w i t h o u t r e s e r v a t i o n ,
a s t h e c l e a r r e a l m o f o p e n n e s s t h a t m a k e s i t possible for t h e world's
p h e n o m e n a t o s h i n e f o r t h i n t o t h a t c l e a r i n g , a t t h e disposal o f t h o s e
phenomena.
A s this p r i m a r y b e i n g - u s e d , b e i n g - c a l l e d - u p o n , o f t h e h u m a n being
g r o w s c l e a r i n t h e light o f t h e p h e n o m e n o l o g i c a l v i e w , w e can s e e a t t h e
s a m e t i m e t h a t a n a n t h r o p o l o g y w h i c h s p r i n g s from this p e r s p e c t i v e
p o s s e s s e s , f r o m t h e v e r y n a t u r e o f its s o u r c e , a n i n n a t e e t h i c w h i c h
s u s t a i n s all social b e h a v i o r . T h u s 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 o f
the h u m a n being n e e d n o t look e l s e w h e r e first f o r its e t h i c a l principles
T h e u n i q u e " m i n e - n e s s " o f e a c h h u m a n Da-sein, s o e m p h a s i z e d b y this
w a y of l o o k i n g at e x i s t e n c e , c a n n o t be m i s t a k e n for s o m e sign of a
r u t h l e s s e g o i s m . S u r e l y , it is for e a c h p e r s o n to t a k e on t h e p o t e n t i a l w a y s
o f b e i n g w h i c h a r e g i v e n him and t o c a r r y t h e m t o fulfillment. B u t t o t h e
fulfillment 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 a r e u n i q u e l y m i n e b e l o n g t h e
c h e r i s h i n g o f all t h a t i s b e y o n d m e , n o less t h a n m y o w n c a r i n g for
m y s e l f , w h i c h c o m e s i n t o t h e light o f m y p e r c e i v i n g , u n d e r s t a n d i n g ,
being-in-the-world.
All this n o t w i t h s t a n d i n g , m a n y m o d e r n s o c i o l o g i s t s flatly d e n y t h e
suitability of t h e p h e n o m e n o l o g i c a l v i e w of h u m a n being as a basis for a
practical social s c i e n c e . O n e can a l w a y s h e a r t h e t h o u g h t l e s s 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 v i e w t a k e s n o a c c o u n t o f c o n c r e t e social
r e l a t i o n s h i p s b e t w e e n people, i n q u i r i n g o n l y a f t e r a b s t r a c t B e i n g . B u t
quite apart f r o m the fact t h a t B e i n g as such is a n y t h i n g b u t a b s t r a c t ,
u n d e r no c i r c u m s t a n c e s is it m e a n i n g f u l in a n y w a y to i n q u i r e a f t e r B e i n g
w i t h o u t a t t h e s a m e t i m e i n q u i r i n g a f t e r t h e c o n c r e t e e x i s t e n c e o f people
with each o t h e r in their shared world. Given this, the Daseinsanalytic
approach is actually so earnestly concerned with the c o n c r e t e human
being and his social r e l a t i o n s h i p s t h a t it is precisely this a p p r o a c h w h i c h ,
i n w o r k i n g o u t t h e c h a r a c t e r i s t i c s o f b e i n g - t o g e t h e r , w a s able t o lay o u t
the f o u n d a t i o n m o s t c a p a b l e o f s u s t a i n i n g e a c h s c h o o l o f s o c i o l o g y .
T h e leap o u t of a t e c h n o l o g i c a l s t a n c e i n t o a p h e n o m e n o l o g i c 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 yields t w o t h i n g s , t h e n . F i r s t , in its light the
phenomena of the world reveal themselves in an incomparably richer
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 . S e c o n d , o u r e y e s a r e o p e n e d t o the
f u n d a m e n t a l m e a n i n g and goal of being h u m a n . It is o b v i o u s that
w i t h o u t s u c h a c l e a r a w a r e n e s s o f t h e goal and m e a n i n g o f h u m a n
e x i s t e n c e , medical and n o n m e d i c a l t h e r a p i s t s are helpless in t h e f a c e ol
t h e b u r g e o n i n g n u m b e r s o f p a t i e n t s w h o suffer from the m o d e m
n e u r o s i 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 . And h o w , w h e n they
t h e m s e l v e s h a v e n o t found a d e q u a t e freedom in relation to the

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-

6. S e e also, R. Konig, " D i e Gesellschaft von heute zwischen g e s t e r n und m o r g e n , "

Universitas: Zschr, Wissenchaft, Kunst und Literatur, 1 1 . J g . , H. ( S t u t t g a r t : T h i e m e , 1 9 6 7 ) .
7 . S e e M . H e i d e g g e r , Was heisst denken ( T u b i n g e n : K l o s t e r m a n n , 1 9 5 4 ) , p . 1 6 ; a n d K .
T s u j i m u r a , Martin Heidegger denken und die japanische Philosophie, in: Ansprachen zum 89. Geburtstag
(Martin Heidegger im Gesprach, K. Alber, Freiburg/Munich, 1 9 6 9 ) , p. 9.
8. M. H e i d e g g e r , " D a s
pp. 1 6 5 ff.

D i n g , " in:

Vortrage

und Autsatze ( P f u l l e n g e n :

Neske,

1954)

INDEX

acute,

exogenic reaction types,

203-6
addiction, m a s s , 2 8 3
Adler, A., 3 6 , 5 2 , 5 4
affective incontinence, 2 1 7
affectivity, 1 1 0 - 1 4
agoraphobia, 2 1 6
Agrippina, 1 4 3
"Aha - experience," 6 4 - 6 5
A l e x a n d e r , F., 3 6
Allport, G . , 3 8
animal psychologies, 6 9 - 7 0
anthropological
medicine,
37,
48-49, 76
anxiety, 1 1 2 - 1 3 , 129
Aristotle, 96, 1 3 1 , 1 5 1 , 163
attunement, 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
Augustine, St., 115
Bally, G., xv
"basic trust," 38
b e c o m i n g , f r e e d o m and, 3 7
behaviorism, 38
B i n d e r , H., 71
B i n s w a n g e r , L., xii-xiii, 3 7 , 7 1
B l e u l e r , E., xxiii, 6 0 , 2 0 4 , 2 0 5 , 2 3 7
bodily
pains,
phenomenological
i n v e s t i g a t i o n of, 1 8 7 - 8 9 ,
210-13
b o d y h o o d , xviii, 1 0 0 - 1 5
h u m a n b o d y a s physical o r g a
n i s m and, 1 2 7 - 3 1
bodying f o r t h , 1 0 2 - 4
illnesses s h o w i n g i m p a i r m e n t
of,

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
(

t ransitional difficulties in undei

standing insights of, 161 <"l

300

EXISTENTIAL FOUNDATIONS

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,

Freud,
19-20,
159,

293

34,

45-46,

143-44

dwelling, 1 2 9 - 3 0
dynamic unconscious, 1 3 6
ego,144-46

psychology,

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,
191-96

reaction

types,

2 0 3 - 6

H.,

37,

70-71,

259,

34-37,

4 5 - 4 6 , 5 7 - 6 5 , 67, 69,

135-40,
222,

260,

144-49,

193,

244-46,

257,

263,

265,

268-69,

271, 277, 294

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

etiology
191-96

acute,

hallucinations
phenomenological investigation
of

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,
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 ,
71-72,

e x p a n s i v e n e s s o f time, 9 5
Ey,

x i - x v i i i , xxiii,

psychoanalytic,

37-38

exogenic

73,

2 2 3 - 3 8

61-62

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,

ego

S.,

39-40,

195-96,

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,
xiv,

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,

134

fees for t h e r a p y , 2 6 3

129,

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

Index

301

"hiddenness,"

fundamental,

135-43

historicity of human existence,

m e m o r y and, 1 1 4 - 1 9
Horney, K., 3 6
human being-in-the-world, psyche
and,

1 3 1 - 3 2

Huntington's Chorea, 2 0 0
hysterical paralysis, 1 4 , 2 2 , 5 0 - 5 1
phenomenological investigation
of,

id,

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 ,

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

140, 145, 147, 243

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,
see also e g o ; id; s u p e r

35-36;

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 ,

14, 22, 50-51,

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 ,
251-55

62

physical pain, p h e n o m e n o l o g i c a l
investigation
of,
187-89,
physician i n D a s e i n s a n a l y t i c t h e r
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

projection, Daseinsanalytic exami

n a t i o n o f c o n c e p t of, 2 4 - 4 3
psyche, human being-in-the-world
and,

psychology, natural science m e

t h o d o l o g y of, 3 3 - 4 2
p s y c h o s e s see specific types
psychosomatics
Daseinsanalytic
theory
of,
xv-xvii, xxix-xxx
f u n d a m e n t a l c o n d i t i o n a l i t y of,
73-78

natural

science

methology

of,

3 9 - 4 2

210-13

apy,

and,

1 4 9 - 5 2

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,
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

psychosurgery,
254
public c h a r a c t e r o f t i m e , 9 5
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

1 3 1 - 3 2

"psychiatric Daseinsanalysis," 4 9

sadism,

48-49

Index
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 ,

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

phenomenological investigation
of,

169-78

stereotypic dream, p h e n o m e n o
logical
investigation
of,
167-69,

260

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
technology,
2 8 8 - 9 6

industrial,

281-83,

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,