jaspers, k. (1968) - the phenomenological approach in psychopathology

7/27/2019 Jaspers, K. (1968) - The Phenomenological Approach in Psychopathology

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10.1192/bjp.114.516.1313Access the most recent version at DOI:1968, 114:1313-1323.BJP

KARL JASPERSThe Phenomenological Approach in Psychopathology

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Brit.. Psychiat.1968),114, 13131323

Editorial Note: This article was originally published inth e Z eitsc hrz ft fu r d ie g esa mte J 'fe uro lo gie u nd P sy ch ia tr ie in1912 (Vol. 9, pp. 39 1408). W e give it here in translation(on the initiative of Dr. J. N . Curran), in view of thepresent interest in Professor Jaspers's work and in phenom enology in ge neral.

T i@ SU BJEC TIV ITY O F PSY CH IC Ev@ wrsIn the examination of a psychiatric patient it

is usual to distinguish between objective andsubjective symptoms. Objective symptoms include all concrete events that can be perceivedby the senses, e.g. reflexes, registrable movements, an individual's physiognomy, his motor@ activity, verbal expression, written productions,actions and general conduct, etc.; all measurable performances, such as the patient'scapacity to work, his ability to learn, the extentof his memory, and so forth, also belong here. Itis also usual to include under objective symptoms such features as delusional ideas, falsifications of memory, etc., in other words therational contents of what the patient tells us.

These, it is true, are not perceived by the senses,but only understood; nevertheless, this understanding is achieved through rational thought,without the help of any empathy into thepatient's psyche.Objective symptoms can all be directly andconvincingly demonstrated to anyone capableof sense-perception and logical thought; butsubjective symptoms, if they are to be understood, must be referred to some process which,in contrast to sense-perception and logicalthought, is usually described by the same term,subjective.Subjective sym ptom s cannot beperceived by the sense-organs, but have to begrasped by transferring oneself, so to say, intothe other individual's psyche; that is, by empathy. They can only become an inner realityfor the observer by his participating in the otherperson's experiences, not by any intellectual

effort. Subjective symptoms include all thoseemotions and inner processes, such as fear,sorrow, joy, which we feel we can grasp immediately from their physical concomitants;these we thus take to expressh e u nd erl yin gemotion. Then there are all those psychicexperiences and phenomena which patientsdescribe to us and which only become accessibleto us at secondhand through the patient's ownjudgment and presentation. Lastly, subjectivesymptoms also include those mental processeswhich we have to infer from fragments of thetwo previous kinds of data, manifested by thepatient's actions and the way he conducts hislife.It is usual to connect with this classificationinto objective and subjective symptoms a verydefinite contrast of values. According to this,only the objective symptoms offer certainty;they alone form a basis for scientific study,whereas subjective symptoms, though we cannoteasily do without them for our preliminaryassessm ents, are considered to be quite unreliablefor making final judgments and unfruitful forthe purpose of any further scientific investigation. There is a widespread desire to base ourstudy of mental disorder on objective symptomsalone and ideally to disregard subjective symptoms altogether. This is a viewpoint which hasits adherentsnot all equally consistentinpsychology, just as it has in psychiatry. Anobjective p sychology is set up in oppositionto su bjec tiv e ps yc ho lo gy . T he fo rm er claim sto concern itself with objective data only; itsnatural consequence is psychology without apsyche. The supporters of the latter (who, itshould be said, have never failed to recognize thereal but different values of the former) take intoaccount self-observation, subjective analysis, thedeterm ination of the different modes of psychiclife and of the specific nature of its phenomena,and ascribe value to such investigations even if

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The Phenom enological A pproach in PsychopathologyBy KARL JASPERS


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1314 THE PHENOMENOLOGICAL APPROACH IN PSYCHOPATHOLOGYthey are made in the absence of any objectivecriteria. A s exam ples of objective psychology w emay cite the w hole field of sense-perception,mnemometrics, performance curves and theircom ponents. T he last w ill serve here to illustratethe fact that such investigations do lead quitesystem atically to the elim ination of everythingthat can be called mental or psychic. It is not thefeeling of fatigue but objectiveatigue whichis being investigated. A ll such concepts asfatiguability, the pow er of recovery, learningability, practice, the effects of rest periods, etc.,refer to performances that can be measuredobjectively, and it does not matter whether oneis dealing here with a machine, a live but m indless organism , or a human being endowed witha mind. Nevertheless, those who claim to bep ure ly o bje ctiv e in ve stig ato rs d o q uite fre qu en tlymake a secondary use of subjective psychicphenomena to further their interpretations ofobjective perform ances and m ake com parisonspossibleand, of course, they have every rightto do so. But when this happens, they aremaking use of subject ivepsychology, withwhich this paper is to deal. Now, there is nodoubt that objective psychology producesresults which are more obvious, more convincing, and easier for everyone to grasp than doessubjective psychology. B ut w hereas the differe nc e in d eg re e o f c erta in ty is s im ply q ua ntita tiv e,when it comes to the kind of certainty, thedifference is qualitative and fundam ental. Thisis so because subjective psychology alw ays aim sat the final realization of the concepts and ideaswhich form the inner representation of psychicprocesses, w hereas objective psychology findsits ultimate aim in observation in undisputedfields such as sense-perception and the rationalcontents of thought and by such means asg ra ph s a nd sta tistic s.The Syst ema ti c S tudy o f Subj ec ti ve Experi ence

W hat then are the precise aims of this muchabused subjective psychology? W hile objectivepsychology, by elim inating everything psychic,transforms itself into physiology, subjectivepsychology w ishes to preserve this sam e psychiclife as its ob je ct o f stud y. It ask s itselfsp eak in gquite generallyw hat does m ental experience

depend on, what are its consequences, and w hatrelationships can be discerned in it? Theanswers to such questions are its special aims.But in approaching each problem subjectivepsychologists have to face the need to m ake clearboth to them selves and to others w hat particularpsychic experience is meant, for they areconfronted w ith a m anifold diversity of psychicphenomena which cannot be surveyed or investigated as a w hole but from w hich particularelements must be selected for investigation. Sobefore real inquiry can begin it is necessary toidentify the specific psychic phenom ena w hichare to be its subject, and form a clear picture ofthe resem blances and differences betw een themand other phenomena with which they mustnot be confused. This prelim inary work ofrepresenting, defining, and classifying psychicphenom ena, pursued as an independent activity,constitutes phenomenology. The difficult andcom prehensive nature of this prelim inary w orkmakes it inevitable that it should become forthe time being an end in itself.So long as such independent, systematicinvestigations had not been undertaken, thisphenom enological approach rem ained lim ited toa number of unconnected opinions based onchance incidents or implications and ad hocconstructions; am ong these som e useful pointerscan certainly be found, but it is essential thatthey should be follow ed up by further research.

W ithin the sphere of psychological researchE. Husserl has taken the first decisive steptow ards a systematic phenomenology, his predecessors in this having been Brentano and hisschool and Th. Lipps. In psychopathology, therehave been a number of attempts to create aphenomenology,* though there has not yet beenconstituted a generally recognized field of* Ka ndi nsk y's Kr ili scl ze u nd k li nis ch e B et ra cht wzg en im

Geb ie te d er S in ne st ii us ch un ge n. B er lin , 1 88 5, is a lm os t e nt ir el yphenom enological in character. O esterreich's D ie Plthnomen ol og ie d es I ch i n ih re n G ru nd pr ob leme n, L ei pz ig , 1 91 0, a ndH ac ke r's Syst emat ischeTraumbeobach tungen , Archiv .f .P sych. w l. 21.1, 1911, both c onduct system atic phenom enological investigations into phenom ena particularly vital forpsychopathology. I have myself made efforts in thisdirection in two papers: Z ur na ly se d er T ru gw ahmn ehmun ge n a nd D ieru gw ah rn eh mu ng en . (R ep rin te d inGesamme lt e S ch rz ft en z ur P sychopat ho lo gi e, S pr in ge r-Ve rl ag ,Ber lin , 1 96 3. )


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BY KARL JASPERS 1315research intended to prepare the ground systematically for the tasks of psychopathologyproper. Since phenomenology does in fact offera productive field of work in which everyone cantake part, some programmatic exposition of itsaim s and m ethods seem s indicated.The L im ita tio ns o f Empath yIn everyday life no one ever thinks in terms ofisolated mental phenomena, whether his ownor som eone else's. O ur inw ard concern is alw ayswith that which is the object of our experience,not w ith the m ental processes w hich accom panyour experiencing. W e understand other people,not through considering and analysing theirmental life, but by living with them in the context of events, actions and personal destinies.Even when we do on occasion give consideration to mental experience as such, we do thisonly in a context of causes and effects as understood by us, or else we make a practice of classifying personalities into categories, etc. W e neverfeel prom pted to consider a m ental phenom enonin isolation, e.g. a perception or a feeling perSe, a nd to describe it in terms of its appearanceand essence. S o w ith the attitude of a psychiatristto his patient. He can share the patient's experiencesalw ays provided this happens spontaneously without his having to take thoughtover it. In this way he can gain an essentiallyp erson al, in defin able an d d irect u nd erstan din g,which, however, remains for him a matter ofpure experience, not of explicit knowledge; heacquires practice in understanding, but doesnot build up a store of case materialexperience in the professional sensew hichwould be more useful to him than mere vaguefeelings and impressions, and which he couldcompare, set in order, or subject to tests.This attitude of mere sympathetic understanding, w hich can be enorm ously satisfying toindividual personalities-so much so that to oneso predisposed this may well become his finalprofessional goalis, one must admit, su bjective in a very special sense; and whenspecific assertions or formulations are made onthis basis without any reference to more farreaching study or to any regular system of concepts this w ell-grounded conceptualization doesindeed deserve to be dism issed as me relyub

jectiv e in a dero gato ry sen se. A ssertio ns o f thissort cannot be discussed or verified. We mayappreciate this type of understanding; we mayadmire it for the valuable human qualitieswhich it reveals; but we can never give itrecognition as a science,hether we meet itin the everyday form practised by civilized andcultivated people over the centuries, or in itsclinical guise as the instinctive concern ofp sy ch ia trists fo r th eir p atie nts.If, how ever, w e still w ish to develop a scienceof psychology, we must realize from the start,on the one hand, that its ideal is a fully conscious understanding of mental processes, onethat can be presented in definite terms andforms, in contrast to the vague or unconsciousunderstanding which is reached only in apersonal and subjective w ay through the speciala ttitu des an d ap titu des o f p articu lar in div id uals;but w e m ust realize also that psychology cannothope to approach this scientific ideal; instead itmust engage in many promising approaches.These, indeed, open up perspectives, but theirideal solution remains infinitely remote. Thisis why so many people exercise their personalunderstanding purely for their ow n satisfaction,and from the heights of their vague yet penetrating comprehension they look down condescendingly on all attem pts to define conceptsat a conscious psychological level, dism issingthese as innocuous platitudes or trivialities. Y etthe fact that only such deliberately madepsychological determ inations constitute contributions to knowledge gives them from ascientific point of view a unique valuebutonly from that point of view.IS OLA TIN G T HE P HE NO ME NA

Now this attitude, which is not satisfied withunderstanding as mere experience but wishesto promote it to the level of knowledge that canbe communicated, investigated and arguedabout, finds itself faced with an infinity ofmany-sided psychic phenomena, which aregoverned by correlations w hich are still far fromclear and whose relations of dependence andconsequence have yet to be elucidated. W ithout doubt, the first step towards a scientificcom prehension m ust be the sorting out, defining,


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1316d ifferen tiating an d d escrib in g o f sp ecific p sy ch icphenomena, which are thereby actualized andare regularly described in specific term s.W e must begin w ith a clear representation ofwhat is actually going on in the patient, what heis really experiencing, how things arise in hisconsciousness, what are his own feelings, andso forth; and at this stage we must put asidealtogether such considerations as the relationships betw een experiences, or their sum mationas a whole, and more especially must we avoidtrying to supply any basic constructs or framesof reference. We should picture only what isreally present in the patient's consciousness;anything that has not really presented itself tohis consciousness is outside our consideration.W e must set aside all outmoded theories,psychological constructs or materialist mythologies of cerebral processes; we must turn ourattention only to that which we can understandas having real existence, and which we candifferentiate and describe. This, as experiencehas shown, is in itself a very difficult task. Thisparticular freedom from preconception w hichphenomenology demands is not something onepossesses from the beginning, but somethingthat is laboriously acquired after prolongedcritical work and m uch effortoften fruitlessin framing constructs and mythologies. W henwe were children, we first drew things as weimagined them, not as we saw them; so aspsychologists and psychopathologists we gothrough a stage where we form our own ideas,in one way or another, of psychic events, andonly later acquire an unprejudiced direct graspof these events as they really are. And so thisphenomenological attitude is to be acquiredonly by ever-repeated effort and by the everren ew ed ov erco min g o f p reju dice.How then do we proceed when we isolate,characterize and give conceptual form to thesepsychic phenomena? We cannot portray them ,or bring them before our eyes in any way thatcan be perceived by the senses. We can onlyguide ourselves and others by a multipleapproach. We have to be led, starting from theoutside, to a real appreciation of a particularpsychic phenomenon by looking at its genesis,the conditions for its appearance, its configurations, its context and possible concrete contents;

THE PHENOMENOLOGICAL APPROACH IN PSYCHOPATHOLOGYalso by making use of intuitive comparison andsymbolization, by directing our observations inwhatever ways may suggest themselves (asartists do so penetratingly) and by dem onstratingalready known phenomena which appear toplay some part in the formation of the phenom enon studied. A ll this constitutes an incentive,reinforced by these indirect hints, for others toactualize these phenom ena for them selves, w hilewe too are encouraged to make use of ourfindings in later studies. The more numerousand specific these indirect hints become, themore well-defined and characteristic do thephenomena studied appear. Indeed, this personal effort to represent psychic phenomena tooneself under the guidance of these purelyexternal hints is the condition under whichalone we can speak of any kind of psychologicalwork at all.A histologist w ill provide an exhaustivedescription of particular morphological elements, but he will do it in such a way as to makeit easier for others to see these elements forthemselves, and he has to presume, or elseinduce, this seeing or oneself in those w horeally want to understand him . In the same waythe phenomenologist can indicate features andcharacteristics, and show how they can bedistinguished and confusion avoided, all with aview to describing the qualitatively separatepsychic data. But he must make sure that thoseto whom he addresses himself do not simplythink along with him, but that they see alongwith him in contact and conversation withpatients and through their own observations.This seeings not done through the senses,but through the understanding. This is something quite special, irreducible and ultimate;and if we are to take even one single step forwardin phenomenology we have to train ourselves init and master itincluding such things as ep re se nt in g d at a t o one se lf , understanding,graspingr actualizing. nly so do w eacquire a fruitful critical faculty which will setitself ag ain st th e fram in g o f th eo retical con structions as much as against the barren deadlydenial of any possibility of progress. Whoeverhas no eyes to see cannot practise histology;whoever is unwilling or incapable of actualizingpsychic events and representing them vividly


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1317Y KARL JASPERScannot acquire an understanding of phenomenology.

THE SEARCH FOR IRREDUCIBLE PHENOMENAThis ultimate irreducible quality of psychicphenomena, which can only acquire identicalmeaning for numbers of people through theincentive and the multiple clues and leadsmentioned previously, may already be found inthe case of the simplest sensory qualities, suchas red, blue, colour, tone; it comes into playalso with sp atial aw areness, o bject aw are ness, p erception, imagery, thought, etc. In psychopathology w e have exam ples in pseudo-hallucination,the d ju phenomenon, derealization, heautoscopy, experience of the doublend so on;though all these terms merely describe groupsof psychic phenomena which are in themselvesstill m ore subtly differentiated from each other.For the actualization to ourselves of all thesephenom enologically ultimate characteristics, wehave such expressions as seeing,viewing, ee lin gone se lf i nt o , empathy,understanding and so on. These expressions alwaysdenote the kind of ultimate concept-fitting experience which plays the same role in psychologyas sensory perception plays in the naturalsciences. Just as sense-perceptions are evoked bythe demonstration of an object, so this meaningful empathic actualization w ill be evoked in

u s b y th e ab ov e-m entio ned hints an d in dicatio ns,by our immediate grasp of expressive phenomena and our self-immersion in other people'sself-description. From this terminology it followsthat empathy and understanding are by nomeans simple ultimate phenomena in themselves, but probably contain a whole series ofelements yet to be defined. In the same way asperception, empathy has its tasks to set: first forphenomenology itself, of which it is the veryfoundation, and next for the investigation ofpsychogenesis. At this point we are not concernedwith either of these; we need only to note thecontribution made to our knowledge by thisempathic, understanding experience, and toraise the question of the reliability of this way ofgaining access to the facts. If, on the analogy ofperceptual experience, we recognize empathicexperience as ultimate, the question can be

answered on these lines: in the field of empathicexperience the technical means of retaining whathas been seen but once, for later comparison andother purposes, are so inadequate that far moredifficulties are encountered than in the case ofsensory perception. But in principle reliabilityis established in the same way, i.e. by comparison, repetition and verification of suchempathic experiences as reach actualization. Inboth fields there is much uncertainty; onecannot deny that in the psychological field it isgreater than in the natural sciences, but this isonly a difference of degree.Whether we are representing our own pastpsychic experiences or those of other people isimmaterial. The only important differenceseems to be between observations which aresystematic, experimental self-observations ofpersisting experiences, and those which areordinary empathic representations. In theinvestigation of psychopathological phenom ena,only the latter can really be considered, sincepatients can rarely be induced to carry out selfobservation in the former sense, and then onlyin very favourable conditions, in regard tosimple disturbances such as agnosias or hallucinations in clear consciousness. However, suchempathic representations of phenomena amongthe mentally ill may well be furthered by concepts that have been won from the moreelaborate phenomenological investigations ofthe former kind.

M ETH OD S O F PHEN OM EN OLO GIC AL A NA LYSISThe methods by which we carry out a phenomenological analysis and determine whatpatients really experience are of three kinds: (i)one immerses oneself, so to speak, in their

gestures, behaviour, expressive movements; (2)exploration, by direct questioning of thepatients and by means of accounts which theythemselves, under our guidance, give of theirown experiences; (@ ) written self-descriptionsseldom really good, but then all the morevaluable; they can, in fact, be made use of evenif one has not known the writer personally. Inall these instances we are pursuing phenomenology in so far as we are orientated towards sub


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1318 THE PHENOMENOLOGICAL APPROACH IN PSYCHOPATHOLOGYjective psychic experience and not tow ards objective m anifestations, w hich in this context areonly stages in our journeythe means, not theobject, of our investigation. O f all these sourcesof inform ation, good self-descriptions have theh ig he st v alu e. *When, using these methods, we try to comecloser to the patient's psychic life, our first imp ressio n is of an u nsu rv ey ab le ch ao s o f co nstan tlychanging phenomena. Our first aim must be tocapture and delim it some particular item andby depicting it to form a conception of it, ofwhich we and others can make permanent use;and we must supply it with a name by which wecan always identify it. Psychopathologicalphenomena seem to call for just such anapproach, one which will isolate, will makeabstractions from related observations, willpresent as realities only the data themselveswithout attempting to understand how theyhave arisen; an approach which only wants tosee, not to explain. Under pathological conditions, numerous psychic phenomena maketheir appearance w ithout meaningful antecedents; psychologically speaking they em ergefrom nothing; seen causally they are occasionedby a disease process. Vivid memories of thingsnever experienced; ideas held w ith a convictionof their truth without any intelligible basis forsuch conviction; m oods and em otions appearingspontaneously and not based on any relevantexperiences or ideas; all these, and manyothers, are common examples. These are theo bje cts o fp he nome no lo gic al in ve stig atio n, wh ic hdeterm ines and represents them as they actuallyare.Three groups of phenomena can be ascertained in this manner. The first consists of

* F or t ho se i nt er es te d, I l is ta f ew o f t h e b es t s el f- de sc ri ptio ns so fa r p ub lish ed :S ch re be r Memo ir s o f a N eu ro tic . L eip zig , 1 90 3.Thom as de Q uin ceyC onfessions o f an O pium E ater.Gera rd d e Ne rval Au r li e.J . J . DavidHallucinat ions .eueRundschau,No. i 7,

874.K an din sk y O n th e s tu dy o f h allu cin atio n. A rc hiv . f.Psych ., i i,Kl inkeJa /z r. f. Psych ., 9 .K ie se r Al lg em ei ne Z ei ts ch r. f. P sy ch ., 1 0, 4 23 .Eng el ke n Ib id ., 6 , 5 86 .Me in er t An A lc oh ol ic Madman. Dre sd en , i go 7.

phenomena known to us all from our ownexperience. They come into existence in thesame way as the corresponding psychic processes which in normal conditions arise out ofothers in an intelligible way; they differ only intheir mode of origin from phenomena, otherw ise quite sim ilar, occurring in the m entally ill,e.g. m any falsifications of m em ory. N ext, thereare phenomena which are to be understood asexaggerations, dim inutions or com binations ofphenom ena w hich w e ourselves experience, e.g.the ecstasies of some acute psychoses, pseudohallucinations, perverted im pulses. H ow far ouru nde rstan din g an go in such case s, w hen w ecannot base it on any conscious experiences ofa sim ilar kind, is a question that cannot be conclusively answ ered. Som etim es it seem s as if ouru nderstan din g can g o far b ey on d th e p ossib ilitiesafforded by experiences, even if sim ilar ones, ofour ow n.The third group of pathological phenomenaare distinguished from the tw o previous groupsb y th eir c om plete in accessib ility to an y em path icunderstanding. W e can only get closer to themby means of analogies and metaphors. W e perceive them individually, not through anypositive understanding of them , but through theshock w hich the course of our comprehensionreceives in the face of the incomprehensible. Inthis group we may perhaps include thoseabricatedhoughts and moods which manypatients report as undoubted experiences (passivity experience), but which we can neveridentify except by using such term s as these, andby a series of observations designed to ascertainwhat these phenomena are not. Some patientswho, notw ithstanding their psychosis, haveretained the awareness of their normal mentallife readily ad mit th e im po ssib ility o f d escribingtheir experiences in ordinary language. Onepatient explained: Partlyne has to do withthings which simply cannot be expressed inhuman language. If I am to be understood, evento some extent, I shall have to use figures ofspeech and analogies which can do no more thanget somewhere near the truth; the only way isto m ake som e com parison w ith w ell-know n factsof human experience. ... In another conte xt: O neas also to consider that it is m ostlya matter of visions; I have the images in my


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BY KARL JASPERS 1319head, but it is uncom monly difficult to describethem in words, in part frankly impossible.Som ethough not m anyof the neologism scoined by patients are based on sim ilar effortsto give a name to their own experiences; onepatient sought to describe a sensation he felt inhis hip more precisely in this way: W hen askedw heth er w hat he felt w as a witch in g ,e sa id :No,t isn't a twitching, it's a plotching'.From its beginnings, psychiatry has had toconcern itself w ith delim iting and nam ing thesedifferent forms of experience; there could, ofcourse, have been no advance at all withoutsuch phenom enological definitions. D elusions,sen se-d ecep tio ns, d epressive an d ex pan siv e m oodchanges and m uch else have thus been described.A ll of this w ill rem ain the foundation for furtherphenomenological research. O ften, how ever,we have first to clear away a ballast of theoriesconcerning the supposed physical basis orpsychological fram ew ork of these phenom ena.N um erous phenom enological approaches havebeen smothered almost at once by such theoretical endeavours. W e cannot now be satisfiedw ith just a few m eagre categories, but w ill devoteourselves w ithout any preconceptions to thephenomena themselves, and whenever we canidentify one w e w ill seek to realize and describeit as com pletely as possible, w ithout claim ing toknow in advance what the phenomenon is byvirtue of our knowledge of psychology. Thecurrent classification of symptom s of insanityinto sense-deceptions and delusions may beuseful in a rough and ready way, but theseterm s conceal a hitherto unexplored m ultitudeo f d iv ers e p he nome na .A few examples will illustrate the sort ofphenomena that can be delim ited. Kandinskygave a description of pseudo-hallucinations, aparticular kind of pathological imagery. Theydiffer from normal images in their greatersensory concreteness, clarity and detail, theirappearance independently of, and even against,the subject's w ill, and by the accompanyingexperience of passivity and receptiveness. Onthe other hand, they differ both from truehallucination and from normal perception inthat they do not appear in external space asperceptions do, but in the internal space inwhich images also are experienced. This con

ception of pseudo-hallucinations has beenattack ed o n th e g ro und s of th eo re tical con sid erations. H ow ever, the problem is purely a phenomenological and descriptive one. It m ight bepossible to represent the reported cases in someother more convincing way; one could adduceother cases (self-d escrip tio ns, the resu lts o f o th erinvestigations); but it is only through clearlyrealized representations of this kind thatKandinsky's views could be refuted, never bymere theoretical considerations. The task ofphenomenology is an independent one, andawareness of this will guard against criticismbased on misunderstanding and hence unproductive.Again, it is not uncommon for patients toreport an experience, of which they are acutelyaware, of there being somebody just behind orabove them . W hen they look around, this somebody turns round, too; they eelt, th ere re allyis somebody there. But they have no sensationof actual contact, or indeed any sensation, norcan they ever com e face to face w ith the supposedperson. Some of these patients come to theconclusion that there is nobody there, othersremain convinced of the existence of thissomeone whose presence they feel so vividly.Here it is obviously not a matter of sensedeception, since the sense-elem ent is lacking;nor of a delusional idea, since there is an actualexperience which is subjected to an act ofjudgment, and this judgment may be either corrector delusional. A third example, taken from theemotional sphere, w ill show how, simply bysinkingneself in the individual phenom enaw ithout the aid of any theory or system , one canarrive at a representation and delim itation ofsuch phenomena. For instance, one hears of eelings f ecstasy: am ong these one canreadily distinguish if not different phenom enaat least different shades of feeling. W e are nothere concerned with whether we are right orwrong in any particular instance. One cand is tin gu ish in th e first p la ce a g en era l e nth usia sm ,emotion or rapture, embracing everything conceivable; secondly, a deep inner happiness outof w hich som e joy-bringing im age w ill occasionally arise; thirdly, a feeling of exaltation andgrace, of holiness and high significance. Inorder to be of lasting value, such rapidly made


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1320 THE PHENOM ENOLOGICAL APPROACH IN PSYCHOPATHOLOGYdifferentiations should then be subjected tofu th er p he nome no lo gic al e la bo ra tio n.T he m ethods of psychopathological phenom enology have now been discussed (grasp of expressive m ovem ents, exploration of patients' experie nc e, a nd s elf-d es crip tio ns); a ls o th e in dire ct le ad sby which we are guided towards our own representation of the phenom ena (noting their genesis,the conditions and circumstances under whichthey appear, their content, any already wellknow n elem ents they m ay contain, the sym bolicindications, etc.); and the only question thatremains is how we can provide an incentive forothers to form their own representations of thephenomena in the light of all that has beenbrought forw ard. In a w ork on phenom enology,therefore, individual cases will be presented,general descriptions w ill be derived from them ,and a term inology will be established. Thatphenomenology deals only with immediatelypresented data is no reproach to it, merely thestatem ent of a fact. B ut it w ill alw ays be difficultto find how one can lead from the individualcase to a more general understanding and amore complete delim itation. It must be borne inm ind that the experiences of individual patientsare infinitely manifold; that phenomenologyonly extracts from them some general featurewhich can be found equally in some other caseand therefore can be called the same feature,w hereas the infinity of individual experiencecontinues to change. We therefore have theposition that on the one hand phenomenologyab stracts from an in finity o f co nstan tly ch an gingconstituents, and on the other hand is definitelyorientated towards the perceptible and theconcrete, not the abstract. Only where something can be reduced to ealitynd becom esan im mediate datum , i.e. becom es concrete, canit form the subject for phenom enology.

C LA SSIF YIN G G RO UP S O F P HE NOME NALet us assume that, in the ways describedabove, a number of phenomena can be de

lineated and clarified. We now seem to findourselves once more in the presence of a freshchaos of innumerable phenomena which havebeen described and defined, but still cannotsatisfy our scientific needs. D elim itation m ust be

followed by the bringing of phenomena intosome kind of order, so that we can becomeaw are of the diversity of psychic life in a systematic way, and make it possible to survey themup to the lim its w e have progressively reached.Phenomena can be arranged in quite differentways according to the purpose one has in view.For example, they can be arranged accordingto their origin, their physical determ inants,their contents, their significance from someparticular point of view, such as the logical,ethical or aesthetic. All these principles ofclassification should be made use of in theirrightful place; but for phenomenology itselfthey are not very satisfactory. W e seek a classification w hich w ill arrange psychic phenom enaaccording to their phenom enological affinitiesw ith each other, somewhat in the way thatinfinite numbers of colours are arranged in thespectrum in a manner which is phenomenologically satisfying. Now in the present state ofphenomenology, it would seem that there existnumerous groups of phenomena between w hichno relationship can be perceived. Senseperceptions and ideas, hallucinations anddelusions, seem to be phenomena separated bya gulf rather than united by transitions. Suchtotally unrelated phenom ena can only be placedunder separate headings and cannot be organizedinto any particular pattern within the psychiclife.

But there are other groups of phenomenawhich can be related and arranged systematically. B etw een these, transitions can usually bemade out (as between colours). An exampleof such a systematic arrangement of relatedphenomena can be given in the case of pseudohallucinations. O n close consideration of individual cases, it appears that transitions existbetween normal imagery and the completelydeveloped pseudo-hallucination (w hich neverbecomes substantial but always remains in theinternal psychic space, that occupied byimagery). Surveying these phenomena, it ispossible to find four main points of contrast,between which they can oscillate through awhole series of transitions. If, then, we candescribe each phenomenon in terms of where itcan be approximately located in the series, weshall have satisfactorily characterized in pheno


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BY KARL JASPERS 1321m en olo gical term s tha t p articu lar p he no men on,lying as it does somewhere between an imageand a pseudo-hallucination. These four pointsof contrast are as follow s:

This example, which will not be discussedfurther here, shows how we set about groupingrelated phenomena on a purely phenomenological basis, using only those aspects of thephenomena which are really experienced as thepoints of difference, and excluding any addednotions or theories. Further, it show s how vitalit is to distinguish betw een phenom enologicaltransitions and phenomenological gaps. Transitions w ill allow us to place phenom ena in theirorder, but where there are gaps we can onlyenumerate or contrast opposites. It is at thesame time evident that to recognize a group ofphenomena as a phenomenologically new one,separated by a gap from those already recognized, is something only to be decided aftercareful consideration of clear evidence. Atpresent, however, when so many people seek toreduce psychic data to the narrowest andsim plest term s possible, it is preferable to acceptrather too many phenomenathey can beorganized laterthan to lapse into someshallow psychological system made up of just af ew e lement s.For while the ideal of phenomenology is anin fin ity o f irre du cib le p sy ch ic q ua litie s, c la ss ifie dand ordered to perm it of their survey, thereexists another, opposite ideal, that of the few estpossible ultimate elements, as in chemistry.According to this school, all complex psychicphenomena could be derived from such ele

ments, and all psychic phenomena could besatisfactorily presented by breaking them dow ninto those elements. To be consistent, such anattitude m ust envisage the possibility of m akingdo w ith a single ultimate psychic atom , everything psychic being built up from varying configurations of this particle. This ideal takes itscue from the natural sciences, and certainly hasa meaning in relation to the origins of psychicqualities. Just as the infinite variety of colourscan be traced to purely quantitative differencesin wave-length, so one could wish to explain theo rig in s of p sy ch ic q ualities an d p erhap s estab lishdifferent classifications on this basis. Forphenom enology itself, how ever, such requirements seem quite pointless. The aim of phenom en olo gical an aly sis is to in crease its aw aren essof psychic phenomena by clearly delim itingthem . As one procedure among others, phenomenology brings to light psychic qualities thatappear as constituents of w hat is being studied.This breaking down of complex structures intoconstituents is only one way of proceeding; butthose who adopt the point of view alreadydescribed, which is valid only in relation to theorigination of psychic phenomena, speak as ifit w ere the only way. They w ould, for example,explain perception by analysing it into theelements of sensation, spatial perception andintentional act, w hereas true phenom enologywould first compare perception w ith imagery,which is composed of the same elements, andcome to the conclusion that perception must becharacterized as an irreducible psychic quality.Even when occasionally the conception ofanalysisn to u ltim ate elem en ts d oes, lik e tha tof analysisas a delim itation of ultimatequalities, appear to present itself as purelyphenomenological and uninfluenced by thegenetic point of view, it still tends to relapse atevery opportunity into confusion with geneticconsiderations: once again complex psychicstructures are said to arise from com binations ofelements. Phenomenology, on the other hand,rejects the ideal of the few est possible elem ents;on the contrary it has no wish to restrict theinfinite variety of psychic phenomena, only, asfar as possible (for the task is, of course, boundless), to try to make them more lucid, preciseand individually recognizable at any tim e.

Ful ly-formed pseudo-hallucinationi. Clear-cut, complete indetail.2. The sensory elementsare each adequatelyperceived, as in norm alperception.3. There is consistencya nd e asy re te ntio n.4. It is involuntary; nothing can be called forthor changed by choice.A ss oc ia te d w ith f ee lin gso f p assiv ity a nd re ce pti

vity.

Norma l imager y1. Vague, incomplete indetail.2. A few sensory elementsare adequately perceived, or none. e.g. anim agined face is neutralin to ne .3. The im ages dissolve, disperse, hav e constantly to

be recreated.4. Itisvolitional;tcan beinvoked or changed bychoice. Feelings areth os e o f a cti vit y.


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1322 THE PHENOMENOLOGICAL APPROACH IN PSYCHOPATHOLOGYTH E B OUNDAR IE S O F P HENOMENOLOG YIn the foregoing we have presented, if only inbroad outline, the aims and methods of phenom enology, w hich has, of course, been practised

since psychiatry began, but has never yet beengiven its opportunity for unfettered development. Since it has suffered most harm frombeing confused with other lines of research, wewill briefly restate what it is that phenomenology does not intend to pursue, and w ith whatphenom enology should not be confused.Phenomenology concerns itself only withactual experiences, only with the perceptibleand concrete, not with any factors that may bethought to underlie psychic events and are thesubject of theoretical constructs. For every oneof its findings phenomenology must ask: hasthis actually been experienced? D oes this reallypresent itself to the subject's consciousness?P hen om en olo gical find in gs d eriv e th eir v alid ityfrom the fact that the various elements of thepsychic reality can be evoked repeatedly. Itsfindings can thus only be refuted if the facts of acase have previously been w rongly representedor are not represented correctly; they can neverbe refuted by dem onstrating their im possibilityor error on the basis of som e theoretical proposition. Phenomenology can gain nothing fromtheory: it can only lose. The accuracy of aparticular representation cannot be checked byits c on fo rm ity to g en era l c rite ria ; p he nome no lo gym ust alw ays find its standards w ithin itself.

Phenomenology, then, deals w ith what isactually experienced. It view s psychic events asfrom w ithin, and brings them into im mediaterealization. It therefore does not concern itselfw ith external m anifestations, w ith m otor phenomena, expressive movements as such, nor w ithany kind of objective performance. We havealready explained to what extent expressivemovements and self-descriptions can be used asthe means, but not as the subject, of phenomenology.Further, phenomenology has nothing to dow ith the genesis of psychic phenom ena. Thoughits practice is a prerequisite for any causalinvestigation it leaves genetic issues aside, andthey can neither refute nor further its findings.Causal studies relating to colour, perception,etc. are alien to it; y et su ch factu al in vestig atio ns

have been less of a danger than those cerebralm ythologies w hich have sought to interpretphenomenology and replace it by theoreticalcon struc tio ns o f ph ysiolog ic al an d p ath olo gicalcerebral processes. Thus W ernicke, who in factdid make important phenomenological discoveries, distorted them by interpretations interm s of connectiveibres,sejunctionsndthe like. These sort of constructs constantlyprevent phenom enological investigations fromreach in g their p ro pe r go al. A t first th e o rig in ato rsof such constructs must necessarily practisephenom enology, but having reached this theorythey feel on safer ground, and with a remarkable failure to recognize their ow n sources theydeclare all phenom enological conclusions to behighlyubjectiv e.L astly, phenom enology m ust be kept separatefrom what we call the geneticnderstandingof psychic events, i.e. the com prehension of theirm eaningful relationships. This is a unique formof understanding w hich only applies to psychicevents; it grasps as self-evident how one psychicevent emerges from another; how a manattacked should be angry, a betrayed loverjealous. W e have made use of the word understan din g b oth fo r th e epresen tatio nso fphenomenology and for this graspf thepsychic connections. To avoid confusion theformer is termed s ta ticn de rs ta nd in g ; it isthe basis on which their definition must rest,and com prehends only data, experiences, m odesof consciousness and delim itation. The latter w ecall gene ti cnder st and ing ' thenderstanding of the meaningful connections betw een onepsychic experience and another, the emergence of the psychic from the psychic. Nowphenomenology itself has nothing to do withthis geneticunderstanding and m ust betreated as something entirely separate; yet,where required, it may legitimately studyregular sequences of psychic events, if these areactually experienced and as such together forma p hen om eno lo gical u nit sui g en eris. A n exa mple,perhaps, is the experience of the W ill. But sucha phenom enological sequence is quite a differentthing from a meaningful flow of psychic eventsemerging one from the other. W e restrictphenom enology to w hatever can be understoodstatically.


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BY KARL JASPERS 1323If we look at psychopathology as a whole,obviously our m ost essential interest lies in w hatis g ene tically u nd erstan dab le , in ex traconscious causal connections, and in theascertainment of the physical basis of psychicprocessesin other w ords, in the w ay things are

related. Phenomenology only makes known to usthe different form s in w hich all our experiences,all psychic reality, take place; it does not teachus anything about the contents of the personalexperience of the individual, nor anything aboutthe extra-c on scio us basis o n w hich p sy ch ic ev entsseem to float like a thin layer of foam on thesurface of the sea. Penetrating these extraconscious depths w ill alw ays be m ore attractivethan m erely dem onstrating phenom enologicalfindings, yet the completion of this latter task isan essen tial p rereq uisite for all fu rth er in vestig ation. It is only in the setting of these phenom enologically established form s that actual life,accessible to our immediate understanding,unfolds itself; and it is, after all, in order toarrive at a better com prehension of this psychiclife that w e are prom pted to investigate its extraconsc ious re la t ionships.F UT UR E TA SK S F OR PH ENOMENOLOG Y

In conclusion we will indicate a few specifictasks for phenomenology. Not one field ofpsychopathological phenomenology can as yetbe regarded as fully worked over. Even wherethe nature of a phenomenon is apparentlyclear-cut, as w ith som e kinds of hallucinations,really good case-material that can serve toenlarge and verify one's experience is so scantythat careful and detailed case-descriptions arestill of great value. Much work still needs to bedone on the different types of hallucination,e sp ecially th ose o f th e h ig her se nses, w hich o ug htto be thoroughly investigated. An obviousinstance is the problem of visual hallucinationsoccurring sim ultaneously w ith real perceptionsin objective space. The phenomenology ofdelusional experiences has hardly been treatedat all; all that exists so far on this subject is to be

found in publications on emotional changes asthe first sym ptom in paranoia. The phenom enology of pathological em otions is unbelievablyscanty. The best is contained in the excellentwork ofJanet, in which, however, little value isp la ced o n careful d elim itation o r classificatio n.The subjective experience of one's ow n personality has been treated system atically by O esterreic h. F or a ll th ese pro blem s p heno men olo gicaldescriptions by psychiatrists w ith material tohand, as well as self-descriptions more penetrating than those so far available, would be ofth e g reatest v alu e.In histology, when examining the cerebralcortex, one is required to account for everyfibre, every nucleus. In the same way phenomenology demands that we should account forev ery p sy ch ic p hen om en on an d eve ry exp erien cethat comes to light in the investigation of ourpatients or in their own self-descriptions. W eshould in no circumstances be content with ageneral impression extracted from the totalpicture, but should get to know, as regards eachdetail, how it is to be viewed and assessed.Then, if we practise this method for some time,much will appear less startling to us because ithas been frequently observed; whereas thosewho only go on generalmpre ss ions wi ll no thave m ade them selves aw are of the phenom enain question, and so, every time these do come totheir notice through the m om entary direction ofth eir m pression ab ility ,h ey w ill a pp ear asnovel and surprising. But the practised phenomenologist w ill pay attention to what is reallynew and unknown, and may then be justifiablysurprised; one need not be afraid that surprisesw ill ever cease! Needless to say, many psychiatrists already make it their practice to act onthese lines and would rightly think it an impertinence if we claimed to be telling themsomething new. But the phenomenologicalapproach is not yet so widespread as not torequire repeated efforts to promote it. O ne mayhope that its application will further enrich ourknow ledge of w hat the psychiatric patient reallyexperiences.

jaspers, k. (1968) - the phenomenological approach in psychopathology

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