110 years of Karl Jaspers’s <i>Allgemeine Psychopathologie</i>: is there still a role for Jaspers’s phenomenological approach to psychopathology in the DSM era?

Rocha, Paulo Marcos Brasil

doi:10.47626/1516-4446-2023-3262

Karl Jaspers had accomplished no more than a few years of psychiatric practice in Heidelberg University Clinic when General Psychopathology (Allgemeine Psychopathologie) was first published in 1913, in a personal journey that would later lead the young author and physician to become a famous philosopher – a profession he embraced intensively until his death.¹,²

Jaspers applied Husserl’s phenomenological method to develop an innovative way of clinically assessing a patient’s inner psychic states.² While the sophistication of his proposal was unequivocal, it also caused resistance and divergence. In fact, acceptance of Jaspers’s method differed from place to place, apparently greater in Europe and lower in the U.S.² Later, when Jaspers was supposedly trying to evade the Nazi regime, the complexity of his philosophical work would have led Albert Einstein to oppose his hiring by Princeton University in 1945, declaring Jaspers to be as obscure as Hegel.³

More than a century since its first edition, General Psychopathology has undoubtedly influenced several generations of psychiatrists worldwide, although the neo-kraepelinian nosological model of the DSM took on dominant status in clinical practice in recent decades.² Thus, today, one might inquire as to the remaining relevance of Jaspers’s phenomenological approach to psychopathology for psychiatry; more specifically, whether it should be taught in psychiatry residencies.

Obviously, this inquiry may have more than one answer depending on the ontological and clinical perspectives of the respondent. We shall offer one possible answer by pointing out some of Jaspers’s core conceptual features for advocating the use of the phenomenological approach to assess psychiatric patients. First, it was his intention to create a method to assess psychic states in an aprioristic manner, thus freeing psychiatrists from both a priori physicalist and psychic determinisms of human mind and behavior. Second, it was his belief that psychiatry was a hybrid field of knowledge, straddling the natural and social sciences. Thus, adequate assessment of psychic phenomena required a different approach, which should involve using empathy to understand another person’s perspectives. Third, by doing so, Jaspers’s intention was eminently scientific, although a distinct method was demanded due to the specific nature of the object to be studied – namely, man in his uniqueness. Fourth, while aiming to describe as precisely as possible the patient’s conscious psychic phenomenon, Jaspers achieved some of the most comprehensive and systematic knowledge of psychopathological phenomenon manifestations, which still serves as a relevant theoretical reference for current Brazilian psychopathology manuals.⁴,⁵

Finally, and perhaps most importantly, Jaspers wanted to elevate psychopathology as a science to access first-person experience, a method he pointed out (in the seventh edition, revised by Kurt Schneider) as more comprehensive even though his peers often described it as phenomenological. In our opinion, alongside other fundamental disciplines for the training of psychiatrists, Jaspers’ psychopathology remains essential, whether because of its historical relevance or its unique descriptive psychopathological framework, but mainly because Jaspers’s belief in the irreducibility of conscious experience places first-person experience as an object of interest for psychiatrists. As some have stated, “put the person back into psychiatry.”⁶

References

¹ Jaspers K. Allgemeine psychopathologie, ein leitfaden für studierende, ärzte und psychologen. Berlin: Springer; 1913.
² De Leon J. One hundred years of limited impact of Jaspers’ General Psychopathology on US psychiatry. J Nerv Ment Dis. 2014;202:79-87.
³ Oliver HH. Karl Jaspers and modern physics. In Ehrlich LH, Wisser R, editors. Karl Jaspers today: Philosophy at the threshold of the future. Pittsburgh: Center for Advanced Research in Phenomenology; 1988. p. 111-31.
⁴ Dalgalarrondo P. Psicopatologia e semiologia dos transtornos mentais. 3rd ed. Porto Alegre: Artmed; 2019.
⁵ Cheniaux Jr E. Manual de psicopatologia. 6th ed. Rio de Janeiro: Guanabara Koogan; 2020.
⁶ Chisolm MS. Putting the person back into psychiatry. 2021. https://www.psychiatrictimes.com/view/putting-the-person-back-into-psychiatry
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