Jaspers' Critique of Essentialist Theories of Schizophrenia and the Phenomenological Response

Abstract

This contribution reviews the fin de siècle and immediately following efforts (Berze, Gross, Jung, Stransky, Weygandt, and others) to find a fundamental psychological disturbance (psychologische Grundstörung) underlying the symptoms of dementia praecox, later renamed schizophrenia by Bleuler (1908, 1911). In his General Psychopathology (1913), Jaspers brings order into the field by bringing to psychopathology a scientific basis coupled with phenomenological rigor. He was critical of theories that proposed an essence of schizophrenia, which is merely asserted verbally. This imperative is reiterated by other members of the Heidelberg School (Gruhle, Mayer-Gross, and K. Schneider). Gruhle (1929) contended that the primary symptoms of schizophrenia, indicating an underlying but still unknown neurobiological disease process, are independent from one another. They cannot be brought under a single, current theoretical model. That is, schizophrenia cannot be explained in terms of a ‘catchword', which is only thought but not empirically studied. Sobered but also inspired by Jaspers' rigor, phenomenological psychiatrists (Binswanger, Blankenburg, Conrad, Ey, and others) proposed more tempered models, which could be studied empirically or tested scientifically. This historical progression may be viewed as a dialectical process: First, bold, merely verbal assertions without method were made, then Jaspers followed with a sobering critique, and finally, the existential-phenomenological clinicians/researchers responded by producing fine-grained, rigorous phenomenological models, tempered by humility and self-critique, which led to hypotheses that could be tested in current clinical neuroscience.

De-othering “schizophrenia”

“…Perhaps most notable is the study of schizophrenia via the qualitative method for investigating human consciousness developed by Austrian mathematician and philosopher Edmund Husserl (e.g., 1913/1962, 1939/1970, 1948/1973), namely, phenomenology. The German-Swiss psychiatrist Karl Jaspers (1913/1963, 1912/1968) is often (perhaps falsely; Berrios, 1992; Rulf, 2003) credited as the first to posit phenomenology’s potential utility in investigating psychopathology via systematic descriptions of “what the psychiatric patient really experiences” (Jaspers, 1912/1968, p. 1323; see also Mishara & Schwartz, 2013; Wertz, 2010, 2011, 2015). Jaspers believed that the manifestations of schizophrenia could be described as individual symptoms and life-historical experiences but not as universal, monothetic, or underlying biological phenomena.…”

Self-disturbances in Schizophrenia: History, Phenomenology, and Relevant Findings From Research on Metacognition

“…As can be seen from table 1, most formulations of a fundamental disturbance (Grundstörung) were based on a splitting and/or weakening of the I's binding of self-components. 7 Scharfetter summarizes the fin-desiècle efforts: "The common interpretation dissociation, the separation of psychic functions, was a certain psychic a. l. Mishara et al impairment: a weakness of the psyche to bring and hold together various functions into one integrated…field. This low synthetic capacity of the psyche kept some personalities vulnerable to insanity."…”

“…Jaspers and other members of the Heidelberg School of Psychiatry (Gruhle, Mayer-Gross, and Schneider) introduced phenomenological method to psychiatry to overcome the initial tendency to merely verbally assert a theoretical "essence" of schizophrenia, which putatively "explains" all its symptoms, without basis in replicable method (see review Mishara and Schwartz 7 ). Schneider [43][44][45] went on to systematize the phenomenology of self-disturbances in schizophrenia, which he included among its first-rank symptoms (well known because Schneiderian auditory hallucinations-2 or more voices conversing-were incorporated into Diagnostic and Statistical Manual of Mental Disorders [DSM]-III/-IV/ IV-TR but removed from DSM-5).…”

Eugen Bleuler's schizophrenia—a modern perspective

“…39 Whilst not explicitly addressing its phenomenological status, ie, the question of whether this core disturbance has itself phenomenal quality, Bleuler was adamant that it was not a theoretically inferred construct, but a phenomenon open to empirical observation and testing. 19 He thus challenges the view recently put forward by Mishara and Schwartz, 40 that only nonessentialist, phenomenological accounts of mental illness can provide hypotheses that can be tested by experimental neuroscience. With regard to the relationship between neurobiological and psychological understandings and approaches in psychiatry, it seems that whilst psychological theories and therapeutic approaches have gained recognition in research and treatment, there is currently a strong tendency to naturalize the mind, ie, to hold the mind to be exhausted by nature as understood by the natural sciences.…”