Phenomenology and Mental Disorders: Heidegger or Husserl?

In his interesting and valuable paper, “Alexithymia: A Phenomenological Approach,” Fredrik Svenaeus aims to show that a Heideggerian phenomenological-hermeneutic approach to alexithymia can usefully complement the extant psychoanalytic and neurophysiological approaches. More specifically, Svenaeus maintains that the latter approaches need to be complemented because they do not enable a “coherent understanding” of alexithymia, i.e., they do not explain why feeling, language, and the body “fail to relate to each other in a proper way in the alexithymic personality type.” This “coherent understanding” can be provided, Svenaeus believes, through application of Heidegger’s notion of “attunement” or “the phenomenon which gathers the relevance of a certain totality of tools to the particular point of view of an acting, understanding individual.” Attunement is correlated with authentic existence or authenticity, whereas lack of attunement is correlated with inauthentic existence.

Svenaeus’s view is that alexithymia is best understood as a deficit of meaning, i.e., that alexithymic patients, like Das Man in Heidegger’s early magnum opus Sein und Zeit (Being and Time), have a defective attunement to the world, and this defective attunement is manifest as an inability to invest the world with meaning and as inauthentic existence. Defective attunement explains the inability of the alexithymic patient to relate feeling, language, and the body to one another properly. Where the world is experienced as meaningful, that is, where attunement is optimal, these “territories” are properly related to one another, for they are “meaning-structuring” phenomena.

In introducing Heidegger’s notions of attunement and authenticity, Svenaeus explicitly refers only to Heidegger’s early work, Being and Time. However, it is questionable whether or not this approach yields an accurate understanding of Heidegger’s early thought. As one interpreter of Heidegger wrote,

Being and Time’s analysis of authenticity is so appealing because it deals in part with the universal problem of individuation. Although the book’s major intention was to demonstrate the relation between human temporality and the event of Being (unconcealment), it was largely received as an existentialist manifesto favoring individual self-actualization. Heidegger’s readers seized on the powerful dramatic theme of authenticity, to the neglect of the overriding ontological theme. Dismayed by this reception of his work, he set out to emphasize his ontological concerns.

(Zimmerman 133–34).

And indeed, in his subsequent work, rather than any activity of the individual, Heidegger emphasized the passivity of both the individual and authenticity: “Such a world-historical revelation [the self-disclosure of Being] is not achieved by an individual but happens through him. Authenticity . . . means being ‘appropriated’ by the ‘event of appropriation’” (Zimmerman 135). According to Svenaeus, “Authentic existence . . . is not an individualistic way of living . . . but it still means an independent way of understanding, where the world becomes visible as a meaning-and-communication-structure.” However, it is difficult to comprehend the meaning of “independence” where “Authenticity . . . means ‘being appropriated’ by the ‘event of appropriation.’” Thus, Heidegger’s early thought cannot unproblematically be severed from his later thought.

Insofar as Svenaeus aims to show that the understanding of mental disorders requires an understanding of the fundamental role and significance for human beings of the constitution of meaning, his effort is to be applauded. This foregrounding of meaning as the fundamental character of human relatedness to the world and others is just the contribution that phenomenology can make to psychiatry and psychotherapy, and indeed to all of the human sciences. However, the question remains as to whether or not Heidegger’s version of phenomenology can complement the psychoanalytic and neurophysiological approaches to alexithymia.

In his survey of psychoanalytic approaches to alexithymia, Svenaeus briefly describes the work of Krystal (1982) and McDougall. Krystal uses a psychoanalytic regression model, and McDougall uses a psychoanalytic defense model. Svenaeus does not dispute the importance or value of these models, nor does he take a stand on which, if either, is to be preferred. Svenaeus also mentions the self-psychological and relational models of psychoanalysis. His point is that all of these models fail to explain the connection between the alexithymic patient’s inability to feel, to verbally express feelings, and...