The Concepts of Psychiatry: A Pluralistic Approach to the Mind and Mental Illness

5 Reading Karl Jaspers’s General Psychopathology

C H A P T E R 5 Reading Karl Jaspers’s General Psychopathology To sum up: If anyone thinks he can exclude philosophy and leave it aside as useless he will eventually be defeated by it in some obscure form or other. —KARL JASPERS, 1913 Certain books, such as Karl Marx’s Capital, Charles Darwin’s Origin of Species, or Freud’s Interpretation of Dreams, are often discussed and rarely read. There must be a reason for this. Length, outdated language, the seepage of ideas from great books into the general culture—all these no doubt play a part. But there is a danger in relying on discussions about great books without having read them: each discussion introduces an often tiny, perhaps imperceptible, change in the original thought, until, after many such ripples of misinterpretation, later concepts hardly approximate the views of their originator. It was not without reason that Marx famously remarked (in French, for added effect): “Moi, je ne suis pas Marxiste.” I wish to avoid that fate with Karl Jaspers. I already have referred to him many times and will continue to do so. Since his original work is little read these days, I will take some space to allow him to express his thoughts directly, based on his prime psychiatric work, the General Psychopathology (hereafter GP).1 I also am entering into his ideas in great detail because my own views set forth in this book relate most closely to his. Readers who are familiar with his ideas, or who have limited interest in the details of the GP, may wish to skip this chapter altogether and proceed to the next, where I analyze Jaspers’s two main contributions to psychiatry. But I hope this chapter can serve as a detailed description and commentary on Jaspers’s thought for those new to him and stimulate a wider audience for the GP. 1. Until the age of thirty, Jaspers did not study or teach philosophy. He was first a medical student and then a resident in psychiatry at the University of Heidelberg. It is noteworthy that the philosopher John Locke was a trained physician, and one might call Aristotle a proto-physician, since that was his father ’s profession and he closely observed and followed its practitioners. But the philosophical personality closest to Jaspers, especially in terms of his background in medicine and psychiatry, might be William James, who also trained in medicine and then studied and taught experimental psychology, before turning to philosophy. It was James who made the comment that the first philosophy course he ever attended was the first one he taught! There are, interestingly , many similarities between James and Jaspers (a pluralistic theory, a strong interest in science, a respect for religious faith, a mistrust of philosophical systems, a devoted coterie of students, political liberalism). All of this leads up to the point of this introduction: Jaspers believed strongly that the way into philosophy passed through the fields of science. And in his case, the particular science he experienced was the medical science of psychiatry. As a result, his first major work, the psychiatric tome entitled the General Psychopathology, was, for Jaspers, not simply a psychiatric book but a compendium of thinking that marked his transition to philosophy. For the field of psychiatry, Jaspers’s work was more than an introduction to his philosophical career, however; it was an uncommon achievement in itself that has continued to influence this branch of medicine for almost a century. “Here . . . was a rare bonus for psychiatry ,” commented the psychiatrist Michael Shepherd. “One of the foremost thinkers of the day, a trained physician, had spent a long enough period in the practice of the subject to write a major volume on its foundations” (1982).2 2. Jaspers wrote the GP when he was just shy of age thirty. He appeared to suffer from a chronic illness, perhaps the lung condition bronchiectasis, which impeded him from engaging in the physically taxing work of a medical resident . He proposed an idea to his departmental chairman, Franz Nissl (most famous in medicine for developing a special staining technique for neuronal cells): let me spend the final year of residency in the library, working on a dissertation on the theoretical basis of psychiatry. Nissl was at first skeptical, but, Reading Karl Jaspers’s General Psychopathology 55 convinced by Jaspers that there was much methodological confusion and conceptual...