The Importance of Heidegger for Psychiatry

As we approach the final moments of the “decade of the brain,” it is perhaps timely to reflect upon some limitations of neurobiological and other forms of technical/scientific understandings of human reality. There can be little doubt that these approaches have come to dominate the fields of psychology and psychiatry in recent years. One of the attractions of a technical idiom is that it reveals a world that is open to prediction and manipulation. The power of this paradigm has meant that it has largely gone unchallenged. However, paradigms can sometimes work to conceal more than they reveal. Scientific psychology and psychiatry tell us that human experience is “something” that can be analyzed and explained in much the same way as other “things” in the world. This is the key assumption of all technical/scientific approaches and underscores currently popular cognitive developments.

Although Heidegger’s Being and Time is a complex and difficult work, in it we find the strongest arguments yet developed against the validity of technical paradigms. Heidegger asks us to begin our reflections without assumptions of the sort which would posit human beings as “rational animals” or “embodied computers.” Likewise, he asks us not to begin with the supposition of an internal mind relating to an external world. Instead, he wants us to start with lived human experience. If we do so, he says, we find that such experience is never separate from the world in which it exists, but, in fact, experience makes that world and, in turn, is made by that world. In Heidegger’s words human being is always “being-in-the-world.” As such it is always embodied, encultured, and temporal. It is simply wrong to think of it as self-contained or fixed in any way. Thus it cannot be grasped through an idiom of causal logic. Because of this, any approach which seeks to reductively explain human experience within the terms of a nonhuman explanatory frame is doomed to cause confusion and, ultimately, to fail.

Svenaeus successfully uses Heideggerian phenomenology to give a rich description of what has been called alexithymia. Through this approach he is able to develop an understanding of the phenomenon that points to its intersubjective nature. This resonates with anthropological accounts of the complex ways in which different cultures articulate relationships between language, emotion, and the body (for examples, see the contributions to Kleinman and Good, 1985). These accounts have challenged Julian Leff’s proposal that there is a unitary pathway of linguistic “evolution” along which various cultures can be ranked according to their ability to differentiate emotional states (Leff 1973, 1981).

Somatic ailments are often said to accompany the phenomenon of alexithymia. Svenaeus draws on the work of Merleau-Ponty to develop a phenomenological account of these ailments. He notes that the “body” does not receive a great deal of direct attention in Being and Time. However, in the years 1959–69 Heidegger was invited by the psychiatrist Medard Boss to give a series of seminars for doctors at Boss’s home in Switzerland. In these Zollikon seminars, Heidegger discussed the nature of the body at some length. ¹ These ideas then were applied directly to the area of illness and medicine in Boss’s own writings. Again, we find a determination to resist any reduction of the human body to explanation in the terms of a purely technical idiom:

By positing the human body as some self-contained material thing, natural science disregards everything that is specifically human about human bodyhood. The natural scientific research method treats the body as it might treat works of art. Given a collection of Picasso paintings, for instance, this method would see only material objects whose length and breadth could be measured, whose weight could be determined, and whose substance could be analyzed chemically. All the resulting data lumped together would tell us nothing about what makes these paintings what they are, their character as works of art is not even touched by this approach. (Boss 1979, 100)

Like Svenaeus, I believe that narrow “existentialist” readings of Heidegger are too limited, and I concur with...