Existential Foundations of Medicine and Psychology - Medard Boss

COMMENTARY New directions in science and psychology are in the wind for America in the 1980s. Boss has always been ahead of his time, and the psychiatric and psychological fraternities will catch up with him, perhaps toward the latter part of this decade. F o r now, most col­ leagues will approach this b o o k with predispositions, preconcep­ tions, and prior prejudices, thus giving the b o o k short shrift. To do so will prove a point that Boss makes repeatedly in his b o o k : one's preconceptions (world view, prior philosophical picture of the world, or theoretical disposition) guide one to recognize as valid only that which falls within or supports the preconceptions. Gerald Epstein Existential Foundations of Medicine and Psychology by MEDARD B O S S translated from the German by Stephen Conway and Anne Cleaves with an introduction by Paul J. Stem NEW Y O R K • JASON ARONSON • LONDON M Copyright© ! 1 9 8 3 , 1979 b y M e d a r d Boss ir , All rights reserved. Printed in the U n i t e d States of A m e r i c a . No part of this b o o k m a y be used or reproduced in any m a n n e r whatsoever without writ­ ten permission from Jason Aronson, Inc. except in t h e case of b r i e f quota­ tions in reviews for inclusion in a magazine, newspaper or broadcast. N e w Printing 1 9 8 3 ISBN: 0-87668-667-6 Library o f C o n g r e s s C a t a l o g N u m b e r : 8 4 - 2 8 2 2 Manufactured in the U n i t e d States of A m e r i c a . CONTENTS Introduction to the English Translation Preface to t h e First Edition Preface t o t h e S e c o n d Edition Introduction ix xxiii xxv xxvii Part I: T h e Traditional Foundation of Medicine Chapter 1. A Test Case: Regula Zürcher 3 Chapter 2. T h e Natural Scientific View of Medicine 19 Chapter 3. T h e N a t u r a l S c i e n t i f i c V i e w o f P s y c h o l o g y and Psychosomatics 33 vi EXISTENTIAL FOUNDATIONS Chapter 4. Applying T h i s V i e w t o R e g u l a Z i i r c h e r 43 Chapter 5. T h e Fundamental Conditionality of P s y c h o l o g y and P s y c h o s o m a t i c s 57 Part II: An Adequately H u m a n Foundation for Medicine Chapter 6. Applying t h e E x i s t e n t i a l O u t l o o k t o S o m e Aspects of the Test Case 81 Chapter 7 Fundamental Characteristics of Human Beings 85 Chapter 8. A n E x i s t e n t i a l S t u d y o f the B a s i c C o n c e p t s o f B i o l o g y , P h y s i o l o g y , and P s y c h o l o g y 127 Chapter 9. C r i t i c i s m s o f a n E x i s t e n t i a l M e t h o d o f Medical Investigation 155 T r a n s i t i o n a l Difficulties i n U n d e r s t a n d i n g Daseinsanalytic Insights 161 Chapter 10. Part III: T h e R u d i m e n t s of an Existential G e n e r a l Pathology Chapter 11. Testing an Existential Research M e t h o d on S e v e r a l P a t h o l o g i c a l P h e n o m e n a o f the T e s t Case 167 Chapter 12. G e n e r a l D a s e i n s a n a l y t i c Etiology and Pathogenesis 191 C h a p t e r 13. A General Daseinsanalytic Phenomenology of Illness 197 ( haptei A D a s e i n s a n a l y t i c E x a m i n a t i o n of S o m e Prevailing, C o n c e p t s o f G e n e r a l P a t h o l o g y 241 it T h o s e W h o Are Therapeutically Active 273 Afterword: T h e F o u n d a t i o n s o f a Ds-sein-Based S o c i a l P s y c h o l o g y and Social P r e v e n t i v e M e d i c i n e in M o d e r n Industrial S o c i e t y 285 Index 299 . T h e " L o c u s " of the Therapeutic Interaction ("Transference") 257 Chapter 17. T h e Patient to Be Treated 251 Chapter 16.Contents vii Part IV: Suggestions for a Daseinsanalytic T h e r a p y Preliminary Remarks 249 Chapter 15. this is u n d o u b t e d l y a radical b o o k . and replacing it by a radically different o n e t h a t is b a s e d upon H e i d e g g e r ' s o n t o l o g y of Da-sein. B o s s is n e i t h e r a naive v i s i o n a r y n o r a f a n a t i c . It p r o p o s e s n o t h i n g less t h a n d e m o l i s h i n g t h e n a t u r a l s c i e n c e paradigm t h a t u n d e r l i e s m o d e r n m e d i c i n e . he w o u l d n o t w a n t t o d o a w a y w i t h t h e vast b u r g e o n i n g m a c h i n e r y o f m o d e r n m e d i c i n e .s c i e n t i f i c m e d i c i n e . Even if s u c h a t h i n g w e r e possible. Ideas set f o r t h in e a r l i e r w o r k s s p a n n i n g t h i r t y y e a r s a r e developed in t h e p r e s e n t v o l u m e and w o v e n i n t o a richly t e x t u r e d w h o l e . H e m e r e l y q u e s t i o n s t h e i m p e r a t i v e s t h a t the prevailing f o r m s o f p r e s e n t day medical practice s e r v e . L e s t t h e r e a d e r be put o f f by t h e s h e e r a m b i t i o u s n e s s of Foundations. B o s s is far from d e n y i n g its brilliant a c c o m p l i s h m e n t s . I n t h e r e c o n s t r u c t e d m a n s i o n o f medicine e r e c t e d b y B o s s . P r o f e s s o r B o s s is in e a r n e s t a b o u t this r e v o l u t i o n a r y e n t e r p r i s e . t h e r e i s ample and h o n o r a b l e r o o m for medical p r a c t i c e . I f t o b e "radical" m e a n s — a s t h e w o r d ' s e t y m o l o g y s u g g e s t s — t o g o t o t h e r o o t s of t h i n g s . While u n s p a r i n g in his e x p o s u r e of t h e s h o r t c o m i n g s of m o d e r n n a t u r a l .INTRODUCTION TO THE ENGLISH TRANSLATION Existential Foundations of Medicine and Psychology is M e d a r d B o s s ' s m a g n u m o p u s . let him be r e a s s u r e d at t h e o u t s e t t h a t D r . T h e i n t e n t o f t h e p r e s e n t w o r k is to h u m a n i z e m e d i c i n e by giving it a n e w existential f o u n d a t i o n and to a r t i c u l a t e t h e vast t h e o r e t i c a l and practical c o n s e q u e n c e s of such a changeover. and t h e p r e s u p p o s i t i o n s a b o u t h u m a n n a t u r e upon w h i c h t h e y a r e built. and also t h e p r i m e c a u s e o f m a n ' s p r e s e n t m e t a p h y s i c a l u p r o o t e d n e s s . It is in the forbidding.o c c u p y i n g m a t t e r s u b j e c t to m e t li. ["he history ol medicine o v e r the last t h r e e c e n t u r i e s d e m o n s t r a t e s beyond any r e a s o n a b l e doubt that the h u m a n body can indeed be explored. in its t u r n . I [eideggei and B o s s a r g u e t h a t by placing t h e h u m a n body s q u a r e l y w i l l i m the realm of res extensa. A s H e i d e g g e r s a w it. willim the c a t e g o r i e s and by the 1 . To t h e e x t e n t he looks at t h e s e issues at all. A n d t h e u r g e n c y of t h e crisis is s u c h t h a t it calls for t h e m i n i s t r a t i o n s of the physician of last r e s o r t of sick c i v i l i z a t i o n s — t h e p h i l o s o p h e r . e.d e b a t e d b a c k l a s h p h e n o m e n a — s u c h a s t h e proliferation of I a t r o g e n i c illness and the g r o w i n g i n t r a c t a b i l i t y of side e f f e c t s produced b y the t r i u m p h a n t e x t e n s i o n o f m o d e r n t e c h n i q u e s o f medical i n t e r v e n t i o n . as a t t e m p t s of this n a t u r e usually a r e . B o s s ' s e f f o r t s at a t h o r o u g h g o i n g r e f o r m of m e d i c i n e (and p s y c h o l o g y ) a r e fueled.X EXISTENTIAL FOUNDATIONS as c o n s t i t u t e d today. I ) e s c a r t e s e n s u r e d t h e s u b s e q u e n t . t h e issue a b o u t w h e n t o r e m o v e life-support s y s t e m s o r w h e n t o p r o n o u n c e a dying patient dead.inic . s h a r e d b y m a n y o f B o s s ' s m o s t e m i n e n t c o l l e a g u e s . practically unlimit­ ed use ol natural science m e t h o d o l o g y in e x p l o r i n g t h e h u m a n b o d y . It is t h e strand m o s t relevant to B o s s ' s c h a l l e n g e to m o d e r n m e d i c i n e . H e i d e g g e r found it n e c e s s a r y to demolish t h e proud office of D e s c a r t e s ' s p h i l o s o p h y w h i c h . in o t h e r w o r d s . w a s D e s c a r t e s ' s d i c h o t o m i z i n g of m a n into res cogitans ("mind") and res extensa ( " m a t t e r " ) and the s h a r p o p p o s i t i o n he posited b e t w e e n t h o s e t w o f u n d a m e n t a l r e a l m s . N o r does B o s s focus o n t h e c o m p l e x p r a g m a t i c and e t h i c a l issues raised by t h e v e r y a d v a n c e s of medical t e c h n o l o g y . F r a c t u r e d b o n e s will still h a v e to be set. is a m a j o r s t r a n d of H e i d e g g e r ' s w o r k . H e i d e g g e r ' s polemic a g a i n s t C a r t e s i a n dualism. and t h e a t t e m p t t o o v e r c o m e it. is t h e v e r y self-definition of m a n ..il laws. and t u m o r s t o b e excised o r t r e a t e d b y c h e m o t h e r a p y . His o w n c o n c e r n i s not primarily with t h e m u c h . B u t b o t h t h e scope and the u l t i m a t e m e a n i n g o f t h e s e and o t h e r traditional medical i n t e r v e n t i o n s would b e s t r i n g e n t l y redefined i n t h e D a s e i n s a n a l y t i c f r a m e w o r k p r o p o s e d b y Boss. and mosl successfully so. B o s s ' s focus is e l s e w h e r e . t h e p r e c o n d i t i o n for this e f f l o r e s c e n c e . To clear t h e g r o u n d for a n e w b e g i n n i n g . and s e e m i n g l y e s o t e r i c o n t o l o g y of M a r t i n H e i d e g g e r t h a t B o s s and a few like-minded clinicians d i s c o v e r t h e e l e m e n t s for a r e c o n s t r u c t e d s c i e n c e o f man.g. had o p e n e d up and s h e l t e r e d a place for the a l m o s t m i r a c u l o u s g r o w t h of W e s t e r n n a t u r a l s c i e n c e . w h i c h h e v i e w e d a s p e r n i c i o u s . he r e g a r d s t h e m as s y m p t o m a t i c of a m u c h m o r e g e n e r a l crisis g o i n g far b e y o n d the c o n f i n e s o f m e d i c i n e — a c u l t u r a l c r i s i s t h a t involves t h e u l t i m a t e q u e s t i o n o f w h a t i t m e a n s t o b e h u m a n . m a j o r i n f e c t i o n s t o b e c o n t a i n e d b y a n t i b i o t i c s o r o t h e r a g e n t s . T h e issue. of s p a c e . by a vivid s e n s e of crisis. A n d . h o w e v e r . if a sizable n u m b e r of s c i e n t i s t s c o m e to feel t h a t t h e i r field is indeed in a s t a t e o f crisis. s u c h a revitalized s c i e n c e of m e d i c i n e m i g h t e v e n discover m e a n i n g (of a n e x i s t e n t i a l n a t u r e ) i n b o u t s o f illness w h i c h . t h a t t h e a n o m a l i e s p r e v i o u s l y perceived a s i n c o n s e q u e n t i a l do in fact m a t t e r . B u t H e i d e g g e r asks w h e t h e r t h e reductive paradigm of n a t u r a l s c i e n c e really does yield or further comprehension of what is most characteristic of the human being and o f t h a t realm o f h u m a n e x i s t e n c e w h i c h w e call the bodily s p h e r e . Y e t e a c h o n e o f t h e s e z o n e s can b e c o m e t h e s t a g i n g a r e a for i n v e s t i g a t i o n s t h a t g r a d u a l l y e r o d e t h e prevailing f r a m e w o r k of m e t a t h e o r y . v i e w e d w i t h i n t h e c o n t e x t o f t h e o r t h o d o x paradigm. T h e medical s t r u c t u r e built upon t h a t p a r a d i g m had a hard t i m e coping w i t h this n o t i o n of l a r g e l y d i s e m b o d i e d illness. B o s s g o e s on to s u g g e s t . r e l a t i o n s h i p s . c i r c u m s c r i b e d . It is this "up to a p o i n t " t h a t c o n s t i t u t e s t h e rub for H e i d e g g e r and B o s s . are fortuitous. I n e v i t a b l y . and its leading n i n e t e e n t h . A s long a s t h e s e z o n e s of i n t r a c t a b i l i t y a r e f e w . In t h e field of m e d i c i n e . B o s s i n q u i r e s if a medical s c i e n c e fully c o g n i z a n t o f the e x i s t e n t i a l h u m a n c h a r a c t e r i s t i c s a r t i c u l a t e d b y H e i d e g g e r would n o t b e m o r e e f f e c t i v e i n c o m i n g t o t e r m s w i t h disease t h a n medical s c i e n c e based o n t h e a s t r i n g e n t n a t u r a l s c i e n c e paradigm. o n e of t h e p r o b l e m a r e a s h a s b e e n for a long t i m e t h e r e a l m o f m e n t a l illness. It will be discarded.Introduction to the English Translation xi m e t h o d s of n a t u r a l s c i e n c e — u p to a point. and s e q u e n c e s o f e v e n t s w o r t h k n o w i n g . Even Freud. and t h e k n o w l e d g e thus g a i n e d is useful in fighting disease. T h e r e m u s t also be a p o t e n t i a l r e p l a c e m e n t w a i t i n g in t h e w i n g s — a n e w p a r a d i g m t h a t solves a n u m b e r o f p r o b l e m s insoluble u n d e r t h e old d i s p e n s a t i o n . T h e n a t u r a l s c i e n c e grid s u p e r i m p o s e d upon t h e h u m a n body does indeed reveal s t r u c t u r e s . and p e r c e i v e d as fairly p e r i p h e r a l . t h e y pose little t h r e a t t o o r t h o d o x y . e v e n d u r i n g s e t t l e d periods of its h i s t o r y is e v e r e n t i r e l y free of t r o u b l e spots ("anomalies") t h a t r e s i s t a s s i m i l a t i o n b y t h e prevailing paradigm. f u t u r e a d v a n c e s in t h e u n d e r s t a n d i n g of n e u r o a n a t o m y and n e u r o p h y s i o l o g y would provide the (as y e t ) missing c l u e s . 2 T h o m a s K u h n h a s pointed o u t t h a t n o s c i e n c e . the r e d i s c o v e r e r o f the p r i m a c y o f psychic factors . E x t e n d i n g t h e a r g u m e n t . T h a t " m e n t a l d i s e a s e s are. T h e a x i o m a t i c value a t t a c h e d t o this d o g m a w a s s o s t r o n g t h a t its lack o f empirical s u p p o r t s e e m e d o f m i n o r c o n s e q u e n c e . a t b o t t o m d i s e a s e s o f t h e b r a i n " h a s b e e n o n e o f t h e m o s t widely a c c e p t e d articles o f faith o f m o d e r n p s y c h i a t r y .c e n t u r y s p o k e s m e n used t h e d i s c o v e r y of t h e syphilitic a n t e c e d e n t s of paresis to p o s t u l a t e t h a t all m e n t a l illness w a s o f s o m a t i c origin. T h e s e illnesses w e r e d i s c o n c e r t i n g for t h e C a r t e s i a n paradigm i n t h a t t h e y s e e m e d t o b e p r i m a r i l y diseases o f t h e cogito w i t h o u t definite s o m a t i c locus. B o s s felt. n e u r o l o g i s t s . w i t h his c o n s c i o u s and u n c o n s c i o u s w i s h e s . his a f f i r m a t i o n s and denials. of m a n seen in t h e n a t u r a l s c i e n c e f r a m e w o r k . O n l y b y c e a s e l e s s m e n t a l c o n t o r t i o n s . . Freud's u n w i t t i n g r e v e l a t i o n o f t h e i n a d e q u a c y o f t h e ruling paradigm signaled t h e s t a t e o f crisis in p s y c h i a t r y and g e n e r a l m e d i c i n e . P s y c h o a n a l y t i c m a n . B o s s began to " u n d e r s t a n d t h a t Freud had b e e n compelled t o i n v e n t his w h o l e t h e o r y o f d r e a m s . B i n s w a n g e r implied (and B o s s w a s later to e x t e n d t h e a r g u m e n t ) t h a t Freud had b e e n a practicing e x i s t e n t i a l i s t w h i l e t h e o r i z i n g like a n a t u r a l s c i e n t i s t . to the . A t t h e t i m e h e d i s c o v e r e d B i n s w a n g e r . It w a s precisely F r e u d i a n t h e o r y and m e t a p s y c h o l o g y t h a t for p h e n o m e n o l o g i c a l and e x i s t e n t i a l i s t r e s e a r c h e r s b e c a m e t h e t e s t case for t h e l i m i t a t i o n s o f t h e n a t u r a l science paradigm i n p s y c h i a t r y . N o w . s o m a t i c m e t h o d s of treatment. by and l a r g e . his n e e d to u n d e r s t a n d and to r a t i o n a l i z e . Boss came over the years to resent the "strenuous mental acrobatics" imposed by p s y c h o a n a l y s i s upon a n a l y s t s and a n a l y s a n d s alike. T h u s Ludwig B i n s w a n g e r a r g u e d t h a t Freud's u n d e r l y i n g n o t i o n of homo natura.xii EXISTENTIAL FOUNDATIONS a m o n g t h e a n t e c e d e n t s o f m a j o r f o r m s o f m e n t a l illness. personally acquainted with Freud. t h e p s y c h o t h e r a p i s t p e r p l e x e d b y the r e p e a t e d failures of his s t o c k in trade is apt—to b e c o m e a p h i l o s o p h e r . his e n t a n g l e m e n t s and d i s e n g a g e m e n t s — t h i s m a n did n o t fit into t h e P r o c r u s t e a n c o n c e p t of homo natura. A t t i m e s h e s e e m e d t o v i e w e v e n n e u r o s e s a s u l t i m a t e l y o r g a n i c in n a t u r e and p s y c h o a n a l y s i s as a t e m p o r a r y e x p e d i e n t to be replaced in t i m e by m o r e direct. T h i s is exactly what happened to Medard Boss. as well as his n o t i o n of an ' u n c o n s c i o u s . c a r d i o l o g i s t s . A t r a i n e d psychoanalyst. w a s at a loss to a s s i m i l a t e w i t h o u t u n d u e d i s l o c a t i o n t h e historical d i m e n s i o n s o f h u m a n e x i s t e n c e h i g h l i g h t e d b y p s y c h o a n a l y t i c p r a c t i c e . his sight s h a r p e n e d as a r e s u l t of B i n s w a n g e r ' s a c u t e o b s e r v a t i o n s . this s t a t e of crisis w a s m o s t k e e n l y felt b y a n u m b e r o f p s y c h i a t r i s t s . H e e x p e r i e n c e d a p r o f o u n d s e n s e o f liberation w h e n h e first c a m e a c r o s s B i n s w a n g e r ' s p h e n o m e n o l o g i c a l c r i t i q u e o f t h e Freudian paradigm. ' b e c a u s e as a child of his era he felt required to s u b j e c t the dream p h e n o m e n a . e m b r a c e d this s o m a t i c prejudice. . his h i s t o r y unfolding in t i m e . could t h e i n t e r p e r s o n a l p h e n o m e n a o b s e r v e d in p s y c h o a n a l y t i c practice be fitted i n t o t h e f r a m e w o r k of Freudian t h e o r i e s . and o t h e r p r a c t i t i o n e r s w h o deal directly w i t h t h e v a g a r i e s of palpable h u m a n tissue are apt to look to t h e perfectibility o f specific medical t e c h n i q u e s w h e n i n t r a c t a b l e medical p r o b l e m s stop t h e m cold. It is hardly a c c i d e n t a l t h a t . . W h e r e a s i n t e r n i s t s . s u r g e o n s . t o o . B o s s w a s particularly u n e a s y a b o u t t h e h i g h h a n d e d f a s h i o n i n w h i c h Freudian analysis dealt w i t h t h e p h e n o m e n a o f d r e a m s . H e i d e g g e r ' s t r e n c h a n t philosophical analysis m a d e explicit b y B o s s . his singling o u t o f p h e n o m e n o l o g y a s t h e p r o p e r a p p r o a c h t o t h e study o f m a n p r o v e d t o b e o f e v e n m o r e c o n s e q u e n c e . His i n t u i t i o n seizing u p o n islets of m e a n i n g in a vast sea of i n c o m p r e h e n s i o n . his Daseinsanalytik directly c h a l l e n g e d and led to a radical redefinition of s u c h f u n d a m e n t a l n o t i o n s a s reality and r e a l i t y . M o r e i m p o r t a n t l y . subtitled "A Daseinsanalytic Contribution to the Psychopathology of the P h e n o m e n o n o f L o v e . T h u s H e i d e g g e r ' s so-called e x i s t e n t i a l s provided t h e basis for a n e w p s y c h o d i a g n o s t i c s c h e m e . published in 1 9 4 7 . ' t h a t is. b u t t r e m e n d o u s l y e x c i t e d as well. T h i s b o o k . a p s y c h o l o g y b e y o n d p s y c h o l o g y ? ' M e t a ' ? O b v i o u s l y b e c a u s e h e w a s i n t e n t upon o v e r s t e p p i n g w h a t w a s actually e x p e r i e n c e d and p e r c e i v e d . T h e first b o o k b y M e d a r d B o s s t o r e f l e c t his H e i d e g g e r i a n approach w a s Meaning and Content of Sexual Perversions. N o t o n l y did H e i d e g g e r ' s o n t o l o g y p r o p o s e a r e c o n s t r u c t e d i m a g e of m a n t h a t boldly a b o l i s h e d long e n t r e n c h e d a n t i n o m i e s . to a large d e g r e e . told h i m t h a t h e had c o m e u p o n s o m e t h i n g m o m e n t o u s . D o u b t after doubt about Freud's theoretical m e t a p s y c h o l o g y ' n o w b e g a n t o assail m e . B o s s d e m o n s t r a t e d t h e p o w e r o f H e i d e g g e r ' s ideas t o i l l u m i n a t e t h e h u m a n r e a l i t i e s and u n r e a l i t i e s w i t h w h i c h t h e p s y c h i a t r i s t finds h i m s e l f at grips in his daily w o r k . as it w e r e . T h e leveling o f t h e traditional p a r t i t i o n s b e t w e e n p s y c h i a t r y and g e n e r a l m e d i c i n e w a s t h e inevitable corollary. B o s s finally c a m e t o grips directly w i t h H e i d e g g e r ' s o n t o l o g y . enabled Boss to articulate by degrees w h a t h e had i n t u i t e d r i g h t a w a y . of individual h u m a n lives w a s p e r m i t t e d to a r t i c u l a t e itself. H o w w a s i t t h a t Freud had e v e n i n v e n t e d t h e label of ' m e t a p s y c h o l o g y . h e a t first felt philosophically o v e r t a x e d . A p r o c e s s o f t o t a l i m m e r s i o n i n t o H e i d e g g e r ' s o n t o l o g y . a f t e r a long and u l t i m a t e l y disappointing d e t o u r via C a r l J u n g . W h e n .t e s t i n g . e n d e d up by leveling. dispensed w i t h w h a t e v e r philosophical respectability such concepts as the unconscious or repression might have a c q u i r e d . but this i m a g e also p r o v e d t o b e a m a z i n g l y r e l e v a n t and applicable directly to p s y c h i a t r y and p s y c h o l o g y . u n d i m m e d by . T h e s e case studies w e r e n o t e w o r t h y for t h e w a y in w h i c h t h e Gestalt. traditional d i s t i n c t i o n s b e t w e e n psychic and o r g a n i c illness. t h e e x i s t e n t i a l p a t t e r n i n g . In clinical a r e a a f t e r clinical a r e a .m i n d q u e s t i o n . " p r e s e n t e d p h e n o m e n o l o g i c a l c a s e studies o f six c a t e g o r i e s o f s e x u a l d e v i a n t s . f u r t h e r e d l a t e r by a close friendship with the philosopher.Introduction to the English Translation xiii n a t u r a l scientific d o g m a o f a c o n t i n u o u s causal n e x u s b e t w e e n everything that exists. and h i g h l i g h t e d t h e sterility w i t h w h i c h v a r i o u s c h r o n i c p r e o c c u p a t i o n s had p r e v i o u s l y b e e n f r a m e d — s u c h a s t h e b o d y . " 3 I f B i n s w a n g e r ' s c r i t i q u e o f F r e u d ' s t h e o r e t i c a l t r a n s g r e s s i o n s fell upon fertile g r o u n d for B o s s . " Freud's o b s e r v a ­ tion w a s amply c o n f i r m e d b y B o s s ' s study o f s e x u a l p a t h o l o g y . Freud c o n t i n u e d t o regard t h e d r e a m from t h e s t a n d p o i n t and w i t h the c a t e g o r i e s o f t h e w a k i n g s t a t e . ( T h e t h o u g h t t h a t such a c h a l l e n g e w a s possible hardly o c c u r r e d to h i m . In a s e n s e . psychically impaired. T r e a t i n g the d r e a m as a m a s t e r of deception. B o s s e x t e n d e d t h e r e a c h o f D a s e i n s a n a l y s i s t o t h e r e a l m o f d r e a m s . in B o s s ' s v i e w . in t h e only w a y o p e n t o t h e m : t h e d e v i a n t s e x u a l act. ) W h i l e c o n f e r r i n g upon t h e d r e a m t h e s t a t u s o f being " p s y c h o l o g i c a l l y r e a l . i n t h e face o f g r e a t o u t e r and i n n e r o b s t a c l e s . w e r e s e e n by Boss as tortured attempts to come to terms with personality defects t h a t prohibit t h e a c t u a l i z a t i o n o f t h e dual m o d e o f e x i s t e n c e . F r e u d a c c o m p l i s h e d m u c h i n r e s c u i n g the r e a l m o f d r e a m i n g from the d i s r e p u t e i n t o w h i c h it had fallen a m o n g his positivistic c o n t e m p o r a r i e s . T h o s e w h o e x h i b i t m a j o r s e x u a l p a t h o l o g y a r e . as B o s s w a s to point o u t . B o s s ' s m o r e g e n e r a l o b s e r v a t i o n s a b o u t t h e p s y c h o p a t h o l o g y o f s e x w e r e equally a r r e s t i n g . f r a g m e n t i n g and shredding it. F r e u d w a s able t o s h o w t h a t t h e s e g o s s a m e r c r e a t i o n s of sleep could be made to yield i m p o r t a n t m e s s a g e s by m e a n s of p s y c h o a n a l y t i c m a n i p u l a t i o n s . its a b e r r a t i o n s . Impatient with the . F r e u d t h u s r e i n s t a t e d t h e reality of d r e a m s . Y e t e v e n these impoverished erotic configurations are illuminated—as Boss d o c u m e n t e d in his case s t u d i e s — b y at least part of t h e aura i n t r i n s i c to fully realized loving t r a n s c e n d e n c e . O n c e m o r e . trapped in a n a r r o w a s t r i n g e n t world. o n l y to a d e g r e e . t h e y y e t s t r i v e t o a t t a i n . While t h e s e c a s e studies b y t h e m s e l v e s offered striking t e s t i m o n y for the t e x t u r a l r i c h n e s s and c o m p r e h e n s i v e g r a s p yielded b y the D a s e i n s a n a l y t i c approach.xiv EXISTENTIAL FOUNDATIONS t h e r e f r a c t i n g m e d i u m o f i n t r u s i v e e x p l a n a t o r y t h e o r i e s . A s s t a r t i n g p o i n t for his e x p l o r a t i o n B o s s used a description of w h a t he viewed as t h e ideal n o r m of love. V i e w i n g t h e d r e a m as a m a j o r bridge b e t w e e n t h e d o m a i n s of t h e c o n ­ s c i o u s and the u n c o n s c i o u s . w i t h o u t e v e r allowing t h e d r e a m r e a l m t o c h a l l e n g e t h e claim t o c l e a r . as m u c h as t h e y can of love's r i c h n e s s . " Freud t o o k it for g r a n t e d t h a t this m e r e l y psychological reality w a s s u b s t a n t i a l l y less real t h a n the solid reality of w a k i n g . To a t t a i n to t h e dual m o d e of loving e x i s t e n c e w i t h its t r a n s c e n d e n c e of selfa b s o r b e d s i n g u l a r i t y . S u c h a c t s . h e t o o k F r e u d a s his point o f r e f e r e n c e . " T h e o m n i p o t e n c e of love is p e r h a p s n o w h e r e m o r e e v i d e n t t h a n i n t h e s e . a c c o r d i n g to B o s s a person m u s t be capable of m a t u r e s u r r e n d e r o f t h e s e l f and m u s t freely e m b r a c e his spiritual a s well a s his s e n s u a l p o t e n t i a l i t i e s o f being.c u t p r e e m i n e n c e o f the w a k i n g world. Y e t . Freud tore aparl its web. i n o t h e r w o r d s . In his b o o k on d r e a m s B o s s s h o w e d t h a t Freud's a priori a s s u m p t i o n s a b o u t d r e a m reality's lack o f a u t o n o m y vis-a-vis t h e w a k i n g s t a t e led him to use p r o c e d u r e s t h a t w e r e needlessly h i g h h a n d e d and forceful in dealing with d r e a m s . 4 I n his n e x t b o o k . w i t h o u t prejudging t h e m b y t h e c a t e g o r i e s o f a w a k e n e s s . s o m e l o n g . Boss attempted to show that with p r o c e d u r e s t h a t w e r e less u n g e n t l e and m o r e r e s p e c t f u l o f t h e p h e n o m e n a disclosing t h e m s e l v e s i n d r e a m s . d r e a m s w o u l d yield t h e i r m e a n i n g s o f t h e m s e l v e s . I n t h e B o s s i a n s c h e m e o f t h i n g s . "in its spatiality. t e m p o r a l i t y . w h a t m a k e s u s decide w h i c h i s w h i c h ? H o w can w e b e s u r e t h a t t h e w o r l d o f o u r a w a k e n e s s i s not j u s t a n o t h e r d r e a m ? A r e t h e r e c r i t e r i a w h i c h allow u s t o distinguish reliably b e t w e e n w a k i n g and dreaming? T h e i n t e r e s t e d r e a d e r m a y w a n t t o p u r s u e t h e s e and similar puzzles b y reading B o s s ' s b o o k on d r e a m s . S i m i l a r l y . T h e traditional n o t i o n t h a t t h e s e illnesses w e r e s o m a t i c d i s o r d e r s of primarily psychic origin would n o t do for B o s s . B y taking d r e a m s s e r i o u s l y . no s o m a t i c e v e n t could c a u s e a psychic o n e or vice v e r s a .Introduction to the English Translation xv s y m b o l i c disguises he i m p u t e d to t h e d r e a m .a p p r o p r i a t i o n of t h e m o d e s of b e i n g . or could lead us.i n . and its e n c o u n t e r w i t h the w o r l d e x a c t l y t o t h e c o n c e p t i o n s a d v a n c e d by M a r t i n H e i d e g g e r — c o n c e p t i o n s t h a t h a v e led us." B o s s ' s b o o k on d r e a m s signified a m a j o r step in t h e p r o c e s s of t h e " d e s t r u c t i o n o f psychological t h e o r y " ( G u s t a v Bally) t h a t w a s t o clear t h e g r o u n d for t h e e x i s t e n t i a l i s t paradigm. Repudiating such methods. By positing the bodily and psychic r e a l m s as equally basic Ausiragsmedien ("media of a r t i c u l a t i o n " ) o f h u m a n e x i s t e n c e . u n a b l e to resist t h e m o s t a r b i t r a r y interpretations. s o m a t o g e n e s i s . as o n e r e v i e w e r of t h e b o o k put it.t h e world.w o r n d e b a t e s a b o u t p s y c h o g e n e s i s vs. B o s s bypassed t h e t i m e . the s e a r c h for c a u s a t i v e factors in the guise of specific 5 . F r e u d ripped t h e s e s y m b o l i c m a s k s o f f so e n e r g e t i c a l l y t h a t in t h e p r o c e s s he denuded t h e d r e a m and r e d u c e d it to an a m o r p h o u s pulp. i n q u e s t i o n i n g t h e claim o f t h e daylight w o r l d to be t h e u n c o n t e s t e d a r b i t e r of w h a t is real. by allowing t h e p h e n o m e n a o f t h e d r e a m w o r l d t o appear u n d i m m e d . to a r e f l e c t i v e r e . T a k i n g this p r o c e s s o n e step f u r t h e r .s t a n d i n g puzzles such as c h o i c e of illness and choice of o r g a n w e r e r e f o r m u l a t e d . T h e d r e a m m e s s a g e s e x p l i c a t e d i n this seemingly simple-minded m a n n e r . B o s s was i n e l u c t a b l y led t o s t r u g g l e w i t h s o m e v e r y old m e t a p h y s i c a l riddles: I f t h e d r e a m w o r l d appears as real to us while we a r e d r e a m i n g as t h e w a k i n g w o r l d does w h i l e w e a r e a w a k e . T h e p o t e n t i a l impact o f d r e a m s o n t h e a w a k e n e d d r e a m e r is f u r t h e r s u p p o r t e d by B o s s ' s refusal to d o w n g r a d e t h e reality o f t h e d r e a m w o r l d i n favor o f w a k i n g reality. W h a t is of p a r t i c u l a r r e l e v a n c e h e r e is t h a t B o s s w a s able t o s h o w t h a t i n its d r e a m i n g m o d e h u m a n e x i s t e n c e c o r r e s p o n d s . rather than extracted by cunning F r e u d i a n c r y p t o g r a p h y . are apt to p r o d u c e p r o f o u n d l y illuminating t h e r a p e u t i c e f f e c t s upon t h e d r e a m e r . B o s s n e x t t u r n e d t o t h e d o m a i n o f so-called p s y c h o s o m a t i c i l l n e s s e s . p r o n e . r e l e a s e s t h e m from t h e t o o h e a v y b u r d e n o f e a r t h l y e x i s t e n c e . I n s t e a d . . individual d i s e a s e s .h e a v y t h e o r e t i c a l s t r u c t u r e . B o s s also b e g a n to redefine the role of the physician in D a s e i n s a n a l y t i c t e r m s . w h e n h e w a s n o t t h e o r i z i n g . In this p e r s p e c t i v e . B o s s w e n t on to say: " W h a t t e a r s in such p a t i e n t s is n o t . Psychoanalyse and Daseinsanalytik ( 1 9 5 7 ) . a p e r i p h e r a l b o n e or s o m e m u s c l e t i s s u e draped o v e r it. " a s h e put it. was a n u n w i t t i n g e x i s t e n t i a l i s t w h o s e historically c o n d i t i o n e d prejudices a l o n e p r e v e n t e d him from r e c o g n i z i n g the full philosophical i m p o r t of his discoveries. i n e x a c t a n a l o g y t o the c o n t r a c t i o n o f t h e i r e x i s t e n t i a l space." B o s s n o t e d t h a t t h e s e p a t i e n t s w e r e typically trapped in a s o r t of p r e s s u r e c o o k e r s i t u a t i o n w i t h o u t t h e s a f e t y valve o f e m o t i o n a l e x p r e s s i v e n e s s . ( B o s s even w e n t s o far a s t o s u g g e s t t h a t F r e u d . to discard the t o p . " T h u s B o s s described t h e e x i s t e n t i a l s i t u a t i o n c h a r a c t e r i s t i c for t h e h y p e r t e n s i v e a s t h a t o f being "walled-in alive. b o t h psychic and o r g a n i c . as in t h e c a s e s p r e v i o u s l y studied. H e p o i n t e d out h o w . T h e first s t e p s o f this e x t r a p o l a t i o n are t r a c e a b l e in his b o o k on p s y c h o s o m a t i c s . . It w a s o n l y logical. it w a s n o t l o n g e r e n o u g h for t h e d o c t o r t o b e a n e x p e r t r e p a i r m a n o f bodily o r psychic d y s f u n c t i o n s . t h e n e x u s o f dislocations usually labeled a s " p s y c h o s o m a t i c .In his n e x t m a j o r w o r k . " B o s s ' s v i e w o f " p s y c h o s o m a t i c " illness a s " b o d y i n g f o r t h " deficient m o d e s o f b e i n g . In t h e s a m e b o o k .i n . calcifying v e s s e l s : thus this kind of h y p e r t e n s i v e c o n t i n u e s to live until finally s o m e t h i n g w h i c h is filled t o b u r s t i n g d o e s b u r s t . in the D a s e i n s a n a l y t i c c a n o n . b u t r a t h e r — i n accord w i t h t h e i r life style of stoic f o r b e a r a n c e — a blood vessel deep and s e c r e t in the body w h i c h .t h e .w o r l d w a s s o o n a b a n d o n e d b y h i m — a t first r a t h e r t e n t a t i v e l y — t o t h e r e a l m o f o r g a n i c d i s e a s e . B o s s t o o k u p and developed B i n s w a n g e r ' s earlier a r g u m e n t t h a t p s y c h o a n a l y s i s is r e n t by a fatal i n t e r n a l c o n t r a d i c t i o n : t h a t t h e empirical p h e n o m e n a t h e m a t i z e d b y F r e u d d o n o t really m e s h w i t h his t h e o r i e s .) In o r d e r to i l l u s t r a t e t h e s h o r t c o m i n g s of p s y c h o a n a l y t i c tht jorizing. in b u r s t i n g . pathologically c o n s t r i c t e d m o d e s o f being w h i c h "bodied f o r t h . " C o n t r a s t i n g t h e h y p e r t e n s i v e with t h e a c c i d e n t . T a k i n g F r e u d at his w o r d t h a t his t h e o r i e s m a t t e r e d less than his o b s e r v a t i o n s . at least.XVI EXISTENTIAL FOUNDATIONS conflict p a t t e r n s o r e m o t i o n a l c o n s t e l l a t i o n s w a s called off. t h e m o r e so as he had c o m e to discern a providential affinity b e t w e e n t h e empirical data o f p s y c h o a n a l y s i s and H e i d e g g e r ' s m e t a p h y s i c s . a r e — o r . T h e D a s e i n s a n a l y t i c h e a l e r is called upon to deal w i t h t h e existential l i m i t a t i o n s and deficiencies of w h i c h . m a y be—symptomatic. " B o s s l a u n c h e d his first s y s t e m a t i c a t t e m p t t o d i s m a n t l e Freud's t h e o r e t i c a l s y s t e m . t h e blood s t r e a m o f t h e s e p a t i e n t s "is s u b j e c t e d t o e v e r rising p r e s s u r e i n t h e c o n f i n e m e n t o f n a r r o w i n g . in B o s s ' s e y e s . B o s s a r t i c u l a t e d c h a r a c t e r i s t i c . he is n o t i n t e n t upon b r i n g i n g d o w n t h e e n t i r e s t r u c t u r e of m o d e r n m e d i c i n e . the temperature of criticism from t h e medical r a n k s r o s e n o t i c e a b l y .g.. Unlike theologians.g. h e m e r e l y i n q u i r e s w h e t h e r such m a s t e r y g u a r a n t e e s i n a n y w a y . his i n c u r s i o n i n t o t h e w e l l . the t h e r a p i s t . t h e f a t h e r .. In fact. W h e r e a s B o s s ' s e a r l i e r w o r k s a r g u i n g t h e i n a d e q u a c y o f t h e n a t u r a l s c i e n c e p a r a d i g m i n p s y c h i a t r y did n o t a r o u s e m u c h p a s s i o n a t e c o n t r o v e r s y . H e feels t h a t such a p h e n o m e n o l o g i c a l approach. T h e t h e r a p i s t loved by his p a t i e n t with t r a n s f e r e n c e love is held n o t to be the real o b j e c t of this love. it is also v i e w e d as less real. N o t only i s t r a n s f e r e n c e love a s s u m e d t o be d i f f e r e n t in kind. d e t a c h a b l e feelings w h i c h can be t r a n s p o r t e d ( t r a n s f e r r e d ) from o n e love o b j e c t . his c o n c e r n s are n o t primarily p r a g m a t i c . even though bound to have important pragmatic consequences.d e f e n d e d d o m a i n o f somatic medicine was an entirely different matter.Introduction to the English Translation xvii B o s s focused o n the i n t e r p e r s o n a l p h e n o m e n o n o f t r a n s f e r e n c e which. S u c h zeal in t h e c a u s e of o r t h o d o x y s e e m e d hardly called for. B o s s is no Ivan IUich. W h i l e this r e d u c t i o n of t h e love p h e n o m e n a arising in p s y c h o t h e r ­ apy is i n t r i n s i c to p s y c h o a n a l y t i c t h e o r i z i n g . Boss dispenses with theoretical construc­ t i o n s a b o u t t h e t r a n s f e r o f d e t a c h a b l e feelings f r o m o n e o b j e c t t o a n o t h e r and g r a n t s t h e m t h e reality t h e y display w h e n g i v e n t h e i r full s w a y . T h i s w o r k w a s b o u n d t o stir u p c o n t r o v e r s y i n t h a t i t e x t e n d e d B o s s ' s c r i t i q u e o f t h e applicability o f t h e n a t u r a l s c i e n c e p a r a d i g m t o m a n from t h e a r e a o f p s y c h o l o g y and p s y c h o s o m a t i c s t o t h e vast r e a l m o f g e n e r a l medicine. e. it is c e r t a i n l y n o t dictated by these p h e n o m e n a themselves. e n h a n c e s n o t o n l y o u r p o w e r s o f a p p r e h e n s i o n . to a n o t h e r . T h e t h e m e s a d u m b r a t e d i n B o s s ' s w o r k s discussed s o far w e r e fully developed and o r c h e s t r a t e d in his m o n u m e n t a l Grundriss der Medizin ( 1 9 7 1 ) o f w h i c h t h e p r e s e n t v o l u m e i s t h e s o m e w h a t abridged E n g l i s h v e r s i o n . such as t h e e x i s t e n c e of m o r e or less isolated. A n d indeed. T h e r e is also t h e a s s u m p t i o n t h a t t r a n s f e r e n c e love is v e r y d i f f e r e n t in kind f r o m g e n u i n e love. B o s s a r g u e d t h a t t h e w h o l e n o t i o n o f t r a n s f e r e n c e i s based upon r a t h e r d e b a t a b l e p r e s u p p o s i t i o n s . Conceding quite readily m o d e r n m e d i c i n e ' s v i r t u o s i t y i n m a n i p u l a t i n g t h e h u m a n body. but also o u r t h e r a p e u t i c e f f e c t i v e n e s s . l o a t h t o d e r e a l i z e w h a t e v e r m a n i f e s t s itself. is c e n t r a l to the p s y c h o t h e r a p e u t i c p r o c e s s . e. t h e i l l u s t r a t i v e c a s e h i s t o r y n e a r t h e end of Psychoanalyse und Daseinsanalytik m a k e s a v e r y s t r o n g case for t h e p o w e r o f a r t i c u l a t i o n and t h e r a p e u t i c p o t e n c y o f D a s e i n s a n a l y s i s . e v e n t h o u g h F r e u d — B o s s m a i n t a i n s — w a s u n a b l e t o d i f f e r e n t i a t e t h e o n e clearly from t h e o t h e r . B o s s ' s medical c o l l e a g u e s s e e m e d quite disposed n o t t o c o n t e s t t h e p o s s e s s i o n of the h u m a n soul by D a s e i n s a n a l y s i s as long as it did n o t meddle w i t h t h e i r claims t o t h e h u m a n body. by w i d e s p r e a d c o n s e n s u s . B u t w h e n D a s e i n s a n a l y s i s began to trespass upon their ground. H e n c e t h e i m p o r t a n c e a t t a c h e d to t h e t e r m bodyhood s t r e s s i n g . O n l y m a n is said to exist in t h e precise s e n s e given to this t e r m by H e i d e g g e r ' s o n t o l o g y of Da-sein. i s t o w i t h d r a w t h e h u m a n body from the d o m a i n o f n a t u r e w h e r e D e s c a r t e s had placed it and to r e i n t e g r a t e it into the e x i s t e n t i a l r e a l m . inclusive o f the h u m a n body. Far from w a n t i n g to abolish the u s e of n a t u r a l science m e t h o d o l o g y in m e d i c i n e . S i n c e m o d e r n medicine has so little to say a b o u t t h e e x i s t e n t i a l m e a n i n g of m o s t physical illness—in fact. 7 B o s s ' s critique of t h e n a t u r a l scientific paradigm in m o d e r n medicine is based upon his f u n d a m e n t a l distinction b e t w e e n t h e realm of o b j e c t s and t h e realm of m a n . T h i s implies. T h e first part o f t h e p r e s e n t b o o k c o n s t i t u t e s in fact a forceful e s s a y on the inability of the n a t u r a l scientific approach t o gain a c c e s s t o t h e w h o l e reality o f day-to-day h u m a n e x i s t e n c e .i m m a t e r i a l a s p e c t s o f t h e bodily side o f m a n . It e n d o w s t h e b o o k w i t h an a m a z i n g s e n s e of u n i t y and c o h e r e n c e . w h o i s viewed from e v e r v a r y i n g p e r s p e c t i v e s and t h r o u g h t h e m o s t diverse t h e o r e t i c a l l e n s e s . a n a b u n d a n c e o f i n c a r n a t i o n hardly e v e r v o u c h s a f e d t o t h e subject o! a medical case study. in o t h e r w o r d s . c o n s i d e r s the q u e s t i o n of m e a n i n g as largely i r r e l e v a n t — w e m i g h t be well advised to lend o u r e a r to a d i v e r g e n t approach. Foundations is o r g a n i z e d a r o u n d a case h i s t o r y d r a w n from medical practice. as it does. T o b e able t o describe in g r e a t detail t h e physically a c c e s s i b l e f e a t u r e s of s o m a t i c p h e n o m e n a and t h e i r p h y s i c o c h e m i c a l a n t e c e d e n t s is n o t the s a m e as being able t o c o m p r e h e n d t h e i r c o n t e x t o f s i g n i f i c a n c e . B o s s c o n t e n d s . the q u a s i .xviii EXISTENTIAL FOUNDATIONS a n a d e q u a t e u n d e r s t a n d i n g o f t h e o b j e c t t h u s m a n i p u l a t e d . besides b e s t o w i n g upon R e g u l a Z i i r c h e r . B o s s is b e n t on pointing out its l i m i t a t i o n s . It is only t h e fullest possible a r t i c u l a t i o n of t h i s r e a l m from a p h e n o m e n o l o g i c a l point o f view. In o r d e r to r e m a i n close to i m m e d i a t e e x p e r i e n c e . a l m o s t by definition. t h a t views t h e issue of the m e a n i n g of disease as central. t h a t can e n s u r e a n a d e q u a t e u n d e r s t a n d i n g o f t h e h u m a n being i n h e a l t h and i l l n e s s . W h a t H e i d e g g e r and B o s s a r e aiming at. T h a t w i t h i n c e r t a i n limits t h e use of this m e t h o d o l o g y is justifiable and n e c e s s a r y B o s s t a k e s for g r a n t e d . c a n n o t be a p p r e h e n d e d a d e q u a t e l y in t e r m s of a paradigm (the n a t u r a l scientific o n e ) o r i g i n a t i n g from and fully s o v e r e i g n o n l y in t h e n o n h u m a n realm. I )l part icular i n t e r e s t to m o s t readers will be t h e w a y in w h i c h M e d a r d B o s s draws upon the s o m a t i c illnesses and t r i b u l a t i o n s of his h e r o i n e to . Using t h e a s t u t e l y c h o s e n c a s e o f R e g u l a Z i i r c h e r a s a point o f a n c h o r a g e for t h e w h o l e c o m p l e x l y s t r u c t u r e d w o r k t u r n s out to be a didactic m a s t e r ­ s t r o k e . such as B o s s ' s . t h a t the w h o l e h u m a n realm. It is t h e claim of this m e t h o d o l o g y to total dominion o v e r m e d i c i n e t h a t B o s s c o n t e s t s . less t h e o r y . T h u s .m i n d issue.b o u n d . in f o r m u l a t i o n s of stress. " and a p a r t i c u l a r l y pivotal o n e w i t h i n t h e D a s e i n s a n a l y t i c paradigm. incidentally.t h e .i n . O n c e a p a t i e n t w h o s e s e x u a l c o n t a c t s are limited t o call girls h a s b e e n c u r e d o f t h e g o n o r r h e a t h a t b r o u g h t h i m t o medical a t t e n t i o n . as B o s s believes. even t h e s e e m i n g l y m o s t trivial physical a c c i d e n t a f f e c t s t h e p e r s o n ' s w h o l e b e i n g . it follows t h a t no illness can be c o n s i d e r e d to have b e e n truly cured u n l e s s t h e d i s t o r t i o n s o f b e i n g . If. B o s s ' s e m p h a s i s o n t h e s c h i z o p h r e n i c ' s f o r f e i t u r e o f his e x i s t e n t i a l a u t o n o m y .Introduction to the English Translation xix illustrate his r e f o r m u l a t i o n o f t h e b o d y . e n a b l e s u s t o r e c o g n i z e t h e overall c o n f i g u r a t i o n s o f s c h i z o p h r e n i c m o d e s of being as well as t h e i r m o s t s u b t l e a r t i c u l a t i o n s .m e a s u r i n g p r o p e r t i e s . e x p o s e h i m c o n t i n u o u s l y t o t h e risk o f r e i n f e c t i o n ) ? N o less a r r e s t i n g t h a n B o s s ' s p a s s a g e s a b o u t t h e e x i s t e n t i a l d i m e n s i o n s o f o r g a n i c illnesses are his o b s e r v a t i o n s a b o u t s c h i z o p h r e n i a ." Boss sees as the e s s e n t i a l f e a t u r e o f s c h i z o p h r e n i c illness t h e a b r o g a t i o n o f t h e m o s t basic e x i s t e n t i a l ( c o n s t i t u e n t ) of h u m a n Da-sein—its f u n d a m e n t a l f r e e d o m and o p e n n e s s t o w a r d o t h e r h u m a n b e i n g s and t o w a r d the w h o l e realm o f phenomena.s p a t i a l f r a m e of r e f e r e n c e . on his being engulfed and d e v o u r e d by t h e b e i n g s and o b j e c t s h e m e e t s w i t h . " B o s s . t h e main p r o b l e m still r e m a i n s t o b e t a c k l e d — a c c o r d i n g t o B o s s .w o r l d . n o t e d t h a t this patient w h o kept talking a b o u t his clock w a s n o t really c o n c e r n e d w i t h its t i m e . " t h e m o s t h u m a n and the m o s t i n h u m a n of all d i s e a s e s . W h e r e a s F i s c h e r i n t e r p r e t e d the patient's c o m m u n i c a t i o n s as indicative of the collapse of his " t e m p o r a l . F i s c h e r c o m m e n t e d upon b y B o s s .i n . E v e r y t h i n g h i n g e s on the existential context. B o s s t r i e s t o establish n o t o n l y t h e p s y c h o l o g i z a t i o n o f o r g a n i c i t y . W h a t peculiar c o n s t r i c t i o n s o f t h e p e r s o n ' s e x i s t e n t i a l p o t e n t i a l c o m p e l h i m t o h a v e r e c o u r s e t o t h e c h e a p c o i n a g e o f c o u n t e r f e i t l o v e ? and H o w can h e b e helped t o o v e r c o m e t h e s e g r o w t h .s t u n t i n g l i m i t a t i o n s (which. W h a t m a k e s B o s s ' s t r e a t m e n t of s c h i z o p h r e n i a so striking is t h a t he deals w i t h it p r i m a r i l y u n d e r t h e heading of "the pathology of (existential) freedom. b u t also t h e need for a truly c o m p r e h e n s i v e e x i s t e n t i a l t h e r a p y w h i c h in t h e face of any f o r m o f illness n e v e r loses s i g h t o f t h e total c o n f i g u r a t i o n o f t h e s u f f e r e r ' s Da-sein and does n o t c o n s i d e r its task a c c o m p l i s h e d w h e n it has r e s t o r e d o p t i m a l physical f u n c t i o n i n g . R e a d i n g t h e s e s e c t i o n s o f the b o o k closely o n e realizes t h a t t h e s a m e o r g a n i c disease befalling different individuals is n o t t h e s a m e disease. T h e q u e s t i o n s n e e d t o b e raised. A case in p o i n t is t h a t of t h e s c h i z o p h r e n i c patient of F.t h e . as Boss's passages about the existential m e a n i n g of a h e r n i a or a f r a c t u r e d tibia m a k e clear. R a t h e r h e w a s w h o l l y p r e o c c u p i e d w i t h the different w a y s h e related t o t h e clock and the clock to him: At t i m e s he would e x p e r i e n c e it as t h e . B o s s feels.w o r l d c o r r e l a t e d w i t h it a r e also c o r r e c t e d . h o m o g e n i z e d space i n t o w h i c h t h e p a t i e n t w a s s w e p t . t h e d a s e i n s a n a l y s t has little difficulty in t a k i n g a s c h i z o p h r e n i c ' s h a l l u c i n a t o r y e x p e r i e n c e s for real. floating in a d i r e c t i o n l e s s . A s o r t of e x p l o s i v e d e c o n s t r i c t i o n of his e x i s t e n t i a l space had o c c u r r e d . w h i c h — i n B o s s ' s v i e w — constituted the main c o n t e n t of the patient's communications. T h e p a t i e n t ' s a g o n y o f f o r l o r n n e s s had m a d e t h e sun e m e r g e i n t o its b o u n d l e s s n e s s and reveal itself to h i m in a w a y t h a t u p t o t h e n h e had n e v e r i m a g i n e d . if n o t m o r e so. B o s s is at pains to point o u t t h a t this e n t i r e l y n e w reality of the i n c a n d e s c e n t sun w a s as real for t h e p a t i e n t as his f o r m e r reality. the daseinsanalyst wants to know what specific m o d i f i c a t i o n s o f n o r m a l b e i n g . it dissolved i n t o a " m e r e " clock. w i t h o u t c o n d e s c e n s i o n o r l a b o r i o u s s u s p e n s i o n o f disbelief. but v i e w s the p a t h o l o g i c a l s y n d r o m e as t h e i m m e d i a t e c o n c o m i t a n t of a c e r t a i n d e f e c t i v e m o d e of b e i n g . Its limitless i n c a n d e s c e n c e replaced the lost w a r m t h o f his c o n c r e t e . 3 7 5 . " had s u r g e d — t h e weird. in w h a t e v e r guise it m a y p r e s e n t itself. clearly d e l i n e a t e d clock on t h e wall. and t h e v e r t i g o a t t e n d a n t upon this loss o f e x i s t e n t i a l a u t o n o m y .he w a s o v e r p o w e r e d b y t h e c o s m i c i n c a n d e s c e n c e o f t h e s u n . at o t h e r m o m e n t s .XX EXISTENTIAL FOUNDATIONS familiar. T h u s t h e Sun-Man's b r i t t l e . t h e daseinsanalyst gains the great advantage of an immediate relatedness with the schizophrenic patient. S i n c e D a s e i n s a n ­ alysis does n o t look upon s c h i z o p h r e n i a as a p r o c e s s w i t h a d y n a m i s m m o r e or less its o w n . cut o f f f r o m its m o o r i n g s in t h e e n v i r o n m e n t . " It w a s t h e h e l p l e s s . and i n t o this e x i s t e n t i a l v a c u u m s o m e t h i n g " s u p e r n a t u r a l . this q u e s t i o n is p a r a m o u n t . I n t h e t h r e e c a s e s o f s c h i z o p h r e n i c forfeit o f a u t o n o m y discussed by B o s s . B o s s ' s r e s p e c t for w h a t is i m m e d i a t e l y given in e x p e r i e n c e .i n . s e q u e s t e r e d w o r l d has collapsed w h e n he felt b e t r a y e d by his o n l y friend.i n . a significant object in a w o r l d of o b j e c t s t h a t g r a n t e d him a dwelling place. W h i l e n o t q u e s t i o n i n g t h e r e a l n e s s o f w h a t discloses itself i n hallucinatory experiences. " . b e n u m b e d and " d i s p e r s e d . " r o b b e d o f t h e " t h r e a d to [ h i m s e l f ] . w h i c h f a s c i n a t e d him and t h r e a t e n e d t o s c o r c h and s w a l l o w him and t h e e n t i r e e a r t h .t h e .w o r l d give rise t o such e x p e r i e n c e s . also i n f o r m s his a t t i t u d e t o w a r d so-called h a l l u c i n a t o r y o r delusional p h e n o m e n a . . A r t i c u l a t i n g t h e e x i s t e n t i a l situation o f t h e s c h i z o p h r e n i c e n a b l e s t h e d a s e i n s a n a l y s t to induce c h a n g e s in this s i t u a t i o n t h a t a r e apt to m a k e d r a m a t i c s y m p t o m s o f p s y c h o s i s vanish a s i f b y m a g i c . In doing so. spectral ("hallucinated") sun t h a t h a u n t e d him for a w h o l e n i g h t . .3 7 6 ) . passive s w a y i n g b a c k and f o r t h b e t w e e n t h e s e t w o m o d e s o f e n c o u n t e r w i t h t h e clock. " " s t r o n g e r t h a n m a n . limited r e l a t i o n s h i p to his f r i e n d " (pp.t h e - . S i n c e D a s e i n s a n a l y s i s does n o t r e c o g n i z e the c o n s t r u c t w e call o b j e c t i v e o r i n t e r s u b j e c t i v e reality a s t h e u l t i m a t e judge of w h a t is real. a r m e d . B u t . t h e d i s c r e p a n c y b e t w e e n t h e d e m a n d s i m p o s e d b y his e x i s t e n t i a l situation upon t h e s c h i z o p h r e n i c and his ability to cope w i t h these demands. Paul ] . in this case t h e d a s e i n s a n a l y s t will n o t f l a t t e r h i m s e l f of h a v i n g p r o d u c e d a c u r e . it is plausible t h a t a n y beneficial c h a n g e in this m o d e . T h e a u t h o r o f this i n t r o d u c t i o n had occasion t o talk t o f o r m e r p a t i e n t s o f M e d a r d B o s s . a l m o s t by definition. are m o s t p a r s i m o n i o u s w i t h t h e i r t r u s t . and t o g r a d u a l l y m a k e t h e m his o w n . Of c o u r s e . b y B o s s ' s prodigal r e c e p t i v e n e s s . t h e n . h o s p i t a b l e s t a n c e f r e e s t h e a n a l y s a n d i n his t u r n t o u n b e n d . there is no s c h i z o p h r e n i a or s c h i z o p h r e n i c per se.Introduction to the English Translation xxi w o r l d . S t e r n . his w i l l i n g n e s s t o w e l c o m e t h e p h e n o m e n a appearing t h e r e a s real. T h e y amply s u p p o r t his claim t h a t D a s e i n s a n a l y s i s c a t a l y z e s t h e fullest possible r e a l i z a t i o n o f the h u m a n potential inherent in the therapeutic encounter. T h e y s t r e s s e d h o w p r o f o u n d l y and dependably t h e y felt u n d e r s t o o d and s u p p o r t e d . will lead to an a b a t e m e n t of s y m p t o m s . T h e r e s t r u c t u r i n g of a p a t i e n t ' s e x i s t e n t i a l s i t u a t i o n b y e x t e r n a l i n t e r v e n t i o n m u s t b e followed b y t h e l a b o r i o u s p r o c e s s o f a p p r o p r i a t i n g u n r e a l i z e d m o d e s o f being. it is equally safe t o a s s u m e t h a t i t w a s n o c h a n c e h a p p e n i n g w h i c h m a d e M e d a r d B o s s d i s c o v e r in H e i d e g g e r ' s Daseinsanalytik t h e f o u n d a t i o n s of a boldly h u m a n i s t i c medicine and p s y c h o l o g y . the q u e s t i o n n e e d s to be asked: S c h i z o p h r e n i c due to t h e (for this p e r s o n ) e x c e s s i v e d e m a n d s o f w h a t kind o f e x i s t e n t i a l s i t u a t i o n ? And i f t h e d e m a n d s o f t h e s i t u a t i o n a r e judiciously r e d u c e d — f o r i n s t a n c e . T h e therapist's r e a d i n e s s t o open h i m s e l f widely (and w i t h o u t t h e s u b t e r f u g e o f theoretical dogmatism) to w h a t e v e r manifests itself in the interpersonal space c l e a r e d b y t h e r a p y . b y e n a b l i n g t h e p a t i e n t to lead a m o r e s h e l t e r e d . T h e final c h a p t e r s o f t h e p r e s e n t b o o k c o n v e y t h e e s s e n c e o f B o s s ' s t h e r a p e u t i c m o d e o f o p e r a t i o n s . play a large role in inviting t h e s p o n t a n e o u s t r u s t of people w h o . In t h e p r e s e n c e of each p a t i e n t . according to D a s e i n s a n a l y s i s . W h a t is c h a r a c t e r i s t i c of t h e d e f e c t i v e m o d e of being called s c h i z o p h r e n i c is. It is safe to a s s u m e t h a t B o s s ' s g r e a t n a t u r a l w a r m t h and e m p a t h y . w h i c h e v e n his o p p o n e n t s c o n c e d e . the schizophrenic is somebody who has been existentially overtaxed. t o e x p e r i e n c e w i t h p r e v i o u s l y d i s o w n e d m o d e s o f c o n d u c t . In the eyes of the daseinsanalyst. n o m a t t e r h o w o u t l a n d i s h t h e i r g u i s e — t h i s o p e n . In other words. h o w e v e r e f f e c t e d . f r o m t h e v e r y first t h e r a p y h o u r . m o r e childlike e x i s t e n c e — e v e r y t h i n g s c h i z o p h r e n i c a b o u t a g i v e n p a t i e n t m a y suddenly fade a w a y as if it had n e v e r e x i s t e d . INew York: Basil Books. ed. Einführung und in seme Auslegung. the traditional dividing line between general medicine and medical psychology almost to the . favored the subsequent mechanization of the image of man. J . die psychosomatische Medizin ( B e r n : H a n s H u b e r . Boss's attempt to define the boundaries of the natural scientific method in medicine has the interesting side effect o\ eroding vanishing point. pp. 1 9 7 3 ) . B u t his notion of l e corps machine. D e s c a r t e s did n o t c o n c e i v e of m a n . IQbil 7. as I'homme machine. In L . P u b l i s h e d in a m u c h e x p a n d e d E n g l i s h v e r s i o n as Psychoanalysis ami Daseinanalysis. (Bern: Hans Huber. the human body as mechanism. 4. P o n g r a t z . 1 9 5 4 ) . 1953). 6.xxii EXISTENTIAL FOUNDATIONS NOTES 1. 2. 1 9 6 2 ) . 87-88. In The Structure of Scientific Revolutions ( C h i c a g o : U n i v e r s i t y of C h i c a g o P r e s s .. 3. Der Traum 5. Psychotherapie in Selbstdarstellungen ( B e r n : H a n s H u b e r . as La M e t t r i e l a t e r did. R. t h e m o s t influential a m o n g them being the physiologist W. along w i t h o t h e r s I had arrived at l a t e r on my o w n . and t h e depth p s y c h o l o g i s t s S i g m u n d F r e u d and C a r l J u n g . H e i d e g g e r has held t w o o r t h r e e s e m i n a r s e a c h s e m e s t e r for t h e b e n e f i t o f medical s t u d e n t s . including m i n e . m a n y of my t e a c h e r s w e r e o f u n c o m m o n i n t e l l e c t u a l c a l i b e r . T h e d i s c u s s i o n s c o m i n g o u t o f t h e s e " Z o l l i k o n S e m i n a r s " also figure significantly i n this w o r k . T h e y f o r c e d m e t o r e e v a l u a t e c o n t i n u a l l y ideas I had t a k e n o v e r from m y o w n t e a c h e r s . M o r e i m p o r t a n t . the psychiatrists Eugen B l e u l e r and W a g n e r v o n J a u r e g g . m o r e o v e r . F o r t h e past fifteen y e a r s . I o w e a special debt of g r a t i t u d e to a whole generation of students w h o have persistently engaged me in s c i e n t i f i c and philosophical d i s c u s s i o n s . T o t h e s e m e n I a m i n d e b t e d n o less t h a n t o m y s t u d e n t s . B u t a b o v e all. L o e f f l e r and C h v o s t e k . It r e f l e c t s t h e c o u n t l e s s c o n v e r s a t i o n s in w h i c h I w a s privileged to p a r t i c i p a t e o v e r t w o d e c a d e s o f friendship. By a happy c h a n c e . Hess. it is t h e p h i l o s o p h e r M a r t i n H e i d e g g e r w h o is r e s p o n s i b l e for this a t t e m p t to lay out a f o u n d a t i o n f o r m e d i c i n e . t h o u g h . i s t h e fact t h a t this w o r k actually evolved under . t h e i n t e r n a l specialists W .FROM THE PREFACE TO THE FIRST EDITION I w o u l d n e v e r h a v e b e e n able t o c o m p l e t e t h e v o l u m e n o w b e f o r e y o u w i t h o u t t h e help of m a n y o t h e r people. an a t t i t u d e w h i c h has s u b j e c t e d me on occasion to t h e c r i t i c i s m o f being " t o o u n p h i l o s o p h i c a l . w e r e n o t m o v e d b y t h e s e p r e j u d i c e s . from t h e sciences and from the h u m a n i t i e s alike. " I n o u r age o f logistics and c y b e r n e t i c s . a n y a t t e m p t to put f o r t h a f o u n d a t i o n of medicine is likely to run t h e risk of b e i n g c o n d e m n e d by medical opinion as "purely p h i l o s o p h i c a l " — t h a t is. by c o n t r a s t . a f o u n d a t i o n like the o n e s k e t c h e d h e r e m u s t s e e m " t o o s i m p l e . as i r r e l e v a n t and devoid of practical potential. T h e i r impartial g e n e r o s i t y m e r i t s a v e r y special e x p r e s s i o n of t h a n k s . February 1 9 7 0 Medard Boss . h o w e v e r . " o r e v e n " n a i v e . Y e t I h a v e tried at all t i m e s to k e e p e x c l u s i v e l y to w h a t could be k n o w n simply and directly. T h e r e is not one section of "philosophical" i m p o r t w h i c h w a s denied his g e n e r o u s c r i t i c i s m . N o w a d a y s .xxi V EXISTENTIAL FOUNDATIONS Heidegger's watchful eye. " T h e m e m b e r s o f t h e C o m m i t t e e for t h e S w i s s National Fund (Kommission des Schweizerischen Nationalfonds). To m a n y in t h e h u m a n i t i e s . usually o n l y the m o s t c o m p l e x and a b s t r a c t s c h e m e s m a y pass for t r u t h . PREFACE TO THE SECOND EDITION T h e fact t h a t this b o o k h a s already g o n e i n t o a s e c o n d edition. a f o u n d a t i o n of p s y c h o l o g y and s o c i o l o g y as well. I had a s s u m e d w i t h t o o m u c h h a s t e t h a t e v e r y o n e w o u l d r e c o g n i z e a f o u n d a t i o n of m e d i c i n e b a s e d on h u m a n n a t u r e as. In a n y c a s e . should be t a k e n as p r o o f of a wide n e e d for a n e w and s o u n d e r basis of medical t h e o r y and p r a c t i c e . T h e title of t h e first edition. failed to e x p r e s s t h e a u t h o r ' s original i n t e n t . T h e r e a d e r n e e d no l o n g e r r e f e r to a l e n g t h y s u b t i t l e for clarification. despite the d e m a n d s it m a k e s of its r e a d e r s . it s e e m e d to indicate t h a t t h e b o o k could be u n d e r s t o o d o n l y by physicians. In k e e p i n g w i t h t h e n e w title. n e c e s s a r i l y . Spring 1 9 7 4 Medard Boss . as it t u r n e d o u t . m o r e space h a s n o w b e e n given t o discussing traditional psychological c o n c e p t s . this e r r o r has n o w b e e n c o r r e c t e d b y e x p a n d i n g t h e title o f t h e s e c o n d edition to read Foundation of Medicine and Psychology. W h e n e v e r we p e r c e i v e s o m e t h i n g as s o m e t h i n g . N o less i m p o r t a n t . n o m a t t e r h o w v a g u e this i n t e r p r e t a t i o n m a y b e a t t h e o u t s e t . A n y s c i e n c e t h a t w o u l d be w o r t h y to be called a s c i e n c e is accordingly obligated to keep its f o u n d a t i o n clear of a m b i g u i t y and a p p r o x i m a t i o n . i s t h a t t h e w o r k specify t h e p r o p e r t i e s w h i c h t h e s c i e n c e has a s s i g n e d t o its o b j e c t s o f s t u d y f r o m t h e v e r y s t a r t . It can t a k e for its s u b j e c t only s o m e t h i n g it has already p e r c e i v e d as being s o m e t h i n g . It s e t s t h e goals for t h e s c i e n c e and e s t a b l i s h e s t h e p r o c e d u r e s g u a r a n t e e i n g c o r r e c t practical application o f t h e o r y . w e h a v e already i n t e r p r e t e d its m o d e o f being i n s o m e w a y o r o t h e r . b u t f u r t h e r m o r e d e t e r m i n e s t h e v e r y c h a r a c t e r o f t h e s c i e n c e and t h e e x t e n t to w h i c h its r e s u l t s will be significant. It is as i m p o s s i b l e for a s c i e n c e as for a n y o t h e r h u m a n e n d e a v o r t o avoid a n t i c i p a t i n g t h e g e n e r a l n a t u r e o f its o b j e c t s o f study. h o w e v e r . It . Every science is therefore necessarily—and thus always—based on prescientific premises. E v e n a scientific e n t e r p r i s e c a n n o t begin vis-a-vis an i n d e t e r m i ­ n a t e n o t h i n g n e s s . T h e s e constitute a fundamental structure that n o t m e r e l y sets f o r t h i n a d v a n c e w h i c h inquiries a r e p o s s i b l e and w h i c h are n o t . and o f t e n w i t h o u t e x p r e s s d e l i b e r a t i o n .x xvii INTRODUCTION T h e p r i m a r y f u n c t i o n of a study on t h e f o u n d a t i o n of a s c i e n c e is to lay o u t t h e field o f p h e n o m e n a i n t e n d e d for i n v e s t i g a t i o n . c o n f u s i o n o f i n t e n t and m i s u s e o f m e t h o d .xxviii EXISTENTIAL FOUNDATIONS m u s t u n d e r t a k e a g a i n and again t o r e t h i n k and r e a r t i c u l a t e t h e p r e m i s e s on w h i c h it is based. h i o n s i d e r a l i o n of principles leads to t h e c o n c l u s i o n of P a r t I: the psychological a n d p s y c h o s o m a t i c a s well a s t h e natural scientific . T h i s i n turn requires an e x a m i n a t i o n o f the basic a s s u m p t i o n s o f t h e psychological and p s y c h o s o m a t i c s c i e n c e s . Y e t t h e e x t e n t t o w h i c h this m e t h o d i s justified in claiming total d o m i n i o n o v e r medicine is m o r e h o t l y c o n t e n d e d today than ever before. T h e c a s e h i s t o r y p r e s e n t e d h e r e h a s b e e n d r a w n from medical p r a c t i c e and is well suited to the r e q u i r e m e n t s o f this d e m o n s t r a t i o n . B e n e a t h t h e f o u n d a t i o n s o f m o d e r n m e d i c i n e . We shall look at e f f o r t s — b o t h psychological and p s y c h o s o m a t i c — t h a t p r o p o s e t o s u p p l e m e n t t h a t n a t u r a l scientific f o u n d a t i o n o f m e d i c i n e and m a k e a n a l l .t o . O n l y this can a s s u r e reliable f u n c t i o n i n g and p r o d u c t i v i t y for t h e s c i e n c e . t h a t m o d e r n m e d i c i n e ' s n a t u r a l scientific r e s e a r c h m e t h o d fails e v e n t o a p p r o a c h . t h e s e p s y c h o l o g i c a l and p s y c h o s o m a t i c e x p l a n a t i o n s . All c o n s i d e r a t i o n s w h i c h follow t h e case are o r i e n t e d t o w a r d factually r e p o r t e d e v e n t s o f t h e p a r t i c u l a r h u m a n existence they represent. T h e e x e r c i s e also s e r v e s t o r e m i n d i t o f its proper domain. T a k e n b y t h e m s e l v e s . u n d e r l y i n g all o f its t h e o r i e s and all of its t h e r a p e u t i c p r o c e d u r e s . T o keep o u r s t u d y o f f u n d a m e n t a l s r o o t e d i n i m m e d i a t e e x p e r i e n c e . h o w t h e y c o n d u c t t h e m s e l v e s t o w a r d t h e w o r l d and o t h e r c r e a t u r e s . t h e s e a c h i e v e m e n t s leave n o r o o m t o d o u b t t h a t this kind of application of the n a t u r a l scientific r e s e a r c h m e t h o d is justifiable and n e c e s s a r y . lies a c o n c e p t i o n of n a t u r e w h o s e currency has risen markedly with the development of modern n a t u r a l s c i e n c e . w e shall l e a r n from o u r study t h a t t h e n a t u r a l scientific a p p r o a c h repeatedly finds i t s e l f c o n f r o n t i n g a r e a l m to w h i c h it c a n n o t gain a c c e s s . B u t w h e n t h e y a r e t e s t e d a g a i n s t t h e case h i s t o r y .d a y h u m a n e x i s t e n c e . a m o n g o t h e r t h i n g s . protecting against boundary transgressions whose c o n s e q u e n c e s are.e n c o m p a s s i n g w h o l e . m u c h less to clarify in its u n i q u e n e s s . c o m e u p a g a i n s t the b o u n d a r i e s o f t h a t r e a l m w h i c h has already p r o v e n inaccessible t o t h e n a t u r a l scientific r e s e a r c h m e t h o d . ( )ui 11 c . t o o . t o t h e r a p e u t i c a c h i e v e m e n t s t h a t s u r p a s s e d all e x p e c t a t i o n . It is precisely t h e e s s e n c e of the w a y people b e h a v e a m o n g t h e m s e l v e s i n t h e i r daily lives. It will d e m o n s t r a t e t h e l e g i t i m a c y of the positive r e s u l t s o f medical r e s e a r c h m e t h o d s t o d a t e and will a t the s a m e t i m e s h o w t h e limits o f t h e s e m e t h o d s . we shall use a t e s t c a s e . the w h o l e reality o f d a y . p r e d i c t a b l y . T h e medical application t o h u m a n b e i n g s o f c o n c e p t s and r e s e a r c h m e t h o d s d r a w n f r o m t h e n a t u r a l s c i e n c e s led. A s s u m i n g t h a t the t r u e s u b j e c t m a t t e r o f m e d i c i n e i s m a n . and can be o b s e r v e d to b e . I n s o f a r as Da-sein is t h e d i s t i n g u i s h i n g c h a r a c t e r i s t i c of h u m a n e x i s t e n c e . i n o r g a n i c n a t u r e and n o n h u m a n b e i n g s — a n i m a l s and p l a n t s — a r e in a n y s e n s e u n r e a l . or illusory b e c a u s e t h e y do n o t so exist. T h e h u m a n being. Dasein signifies little m o r e t h a n p r e s e n c e . to s e e it and s t a y f o c u s s e d on it. shall we c a r r y o u t the physician's charge. without any speculative suppositions or hypotheses.b a s e d * u n d e r s t a n d i n g o f the h u m a n b e i n g ( w h i c h w a s t h e implicit basis o f t h e p r e c e d i n g d e s c r i p t i o n s o f individual h e a l t h y p h e n o m e n a i n o u r h u m a n t e s t s u b j e c t ) .s « « . h e a l t h y b e h a v i o r a l p h e n o m e n a o f o u r test case.Introduction xxix r e s e a r c h m e t h o d s of m e d i c i n e a c c o u n t far t o o p o o r l y for a fact t h a t is. T h e y largely o v e r l o o k h o w radically t h e n a t u r e o f t h e i r o b j e c t o f s t u d y — h u m a n r e a l i t y — d i f f e r s from t h e m a k e u p o f e v e r y o t h e r r e a l m k n o w n t o us. T h i s t i m e . as for e x a m p l e in p r o o f s of G o d ' s Dasein. T h e p a r t i c u l a r w a y i n w h i c h medical u n d e r s t a n d i n g t o date h a s g e n e r a l l y b e e n s h o r t s i g h t e d p o i n t s t h e w a y for o u r o w n w o r k . O n l y t h e n . O n c e r e s t o r e d to this basis. T h i s explication p r e s e n t s t h e traits o f h u m a n e x i s t e n c e t h a t a r e m o s t i m p o r t a n t for m e d i c i n e . t h o u g h . W e begin P a r t II by grappling o n c e again w i t h the familiar. We m e r e l y s t a t e t h a t t h e reality of t h e s e n o n h u m a n r e a l m s differs f r o m t h a t o f h u m a n e x i s t e n c e . We declare t h a t only m a n exists. individual. O u r e n t i r e d i s c u s s i o n h i n g e s u p o n o u r ability t o c a s t light o n w h a t i s distinctively p e c u l i a r t o h u m a n being.b a s e d a n t h r o p o l o g y . T o its vision. s o m e t h i n g t h a t is p r e s e n t . T h i s is n o t t o say t h a t m a t e r i a l . T h e s e f e a t u r e s c o m e t o light w i t h o u t t h e n e e d for a b s t r a c t d e d u c t i o n s or conclusions. h o w e v e r .t h e r e " ) . f u n d a m e n t a l . T h e c h a r a c t e r i s t i c s t r u c t u r e o f h u m a n e x i s t e n c e t h a t i s set f o r t h . t h e s t o n e i n t h e g a r d e n — t h e s e are m e r e l y p r e s e n t . the e n t i r e s t r u c t u r e o f the c o n c e p t s and f u n d a m e n t a l a s s u m p t i o n s o f . w e are helped by a point of v i e w t h a t is totally d i f f e r e n t and m o r e suited to Da­ sein. t h e d e s i g n a t i o n Da-sem m u s t be u n d e r s t o o d in a s e n s e t h a t differs f r o m the c u r r e n t u s a g e of t h e G e r m a n w o r d Dasein. L e t us t h e r e f o r e give u r g e n t e m p h a s i s and t e r m i n o l o g i c a l precision to this d i f f e r e n c e b e f o r e we begin. T h e table i n f r o n t o f m e .t h e . T h e initial v e r i f i c a t i o n of this n e w p e r s p e c t i v e is followed by an e x p l i c a t i o n of t h e D a . f e a t u r e s o f h u m a n being t h a t w e r e i n a c c e s s i b l e b e f o r e are i m m e d i a t e l y r e c o g n i z a b l e . t h o u g h i t does n o t claim to be a c o m p r e h e n s i v e D a . M a n as m a n is p r e s e n t . h o w e v e r . is a h u m a n being n o t m e r e l y b e c a u s e he is.s m i . w h o s e p r i m a r y c h a r a c t e r i s t i c is Da-sein (literally " b e i n g . i n s u b s t a n t i a l . by p u t t i n g medicine on a basis t h a t is suited to h u m a n b e i n g s and t h e i r Da-sein. As it is c o m m o n l y used. in a m a n n e r w h o l l y d i f f e r e n t from t h e s e i n a n i m a t e t h i n g s . will s e r v e as a solid f o u n d a t i o n for m e d i c i n e . in fact. t h e r e a p p e a r s to be no s o u n d e r basis for medicine b e f o r e us. for it is n o t t h e purpose of this s t u d y to a r o u s e even t h e suspicion that w e c o n s i d e r this g r o u n d w o r k t h e o n l y possibility. J u s t a s t h e t r a d i t i o n a l n a t u r a l scientific and psychological f o u n d a t i o n s for m e d i c i n e g r e w o u t of—and still d r a w t h e i r vitality w h o l l y f r o m — t h e p r e s c i e n t i f i c philosophical c o n c e p t i o n o f n a t u r e r e p r e s e n t e d b y D e s c a r t e s .XXX EXISTENTIAL FOUNDATIONS p h y s i o l o g y and p s y c h o l o g y can be t r a n s f o r m e d i n t o a p h y s i o l o g y based on h u m a n b e i n g s and a p s y c h o l o g y based on Da-sein. t h e " R u d i m e n t s o f a n E x i s t e n t i a l G e n e r a l P a t h o l o g y . G a l i l e o . o r o n e t h a t is definitive for all t i m e . W e h a v e already discussed t h e t h e o r e t i c a l d e p e n d e n c e of all scientific r e s e a r c h upon philosophical p r e s u p p o s i t i o n s a b o u t its o b j e c t s o f study. B u t t h e s t a t e m e n t s c o n c e r n i n g a g e n e r a l D a s e i n s a n a l y t i c p a t h o l o g y s u b s t a n t i a t e t h e fact t h a t Medical Psychology and Foundation of Medicine are identical. T h i s r e s o l v e s a q u e s t i o n t h a t m a y h a v e a r i s e n for the reader during the first c h a p t e r s o f this w o r k . t h e n o u r f o u n d a t i o n o w e s its s t r e n g t h to the p r e s c i e n t i f i c philosophical basis w i t h o u t w h i c h its s u b s e q u e n t scientific a s s e r t i o n s would b e i m p o s s i b l e . T h e f o u r t h and final part o f this w o r k a n a l y z e s t h e c o n s e q u e n c e s for t h e r a p y held in a m o r e Da-smi-based and m o r e h u m a n f o u n d a t i o n of m e d i c i n e . Medical p s y c h o l o g y is in i t s e l f t h e f o u n d a t i o n of m e d i c i n e in g e n e r a l . If this is actually so. and N e w t o n . B u t as t h i n g s stand today. S t a r t i n g from t h e s e findings. H e r e w e h a v e deliberately r e s t r i c t e d o u r s e l v e s t o e m p l o y i n g c o m p a r a t i v e s . P a r t III. s o M a r t i n H e i d e g g e r ' s philosophical D a s e i n s a n a l y t i k first cleared g r o u n d . c o n t i n u i n g along familiar p r o c e d u r a l lines. All t h e u n h e a l t h y p h e n o m e n a of a u n i q u e Dasein are h e r e disclosed as o u t c o m e s of failure to c a r r y o u t c e r t a i n basic c h a r a c t e r i s t i c s o f h u m a n e x i s t e n c e . " i s primarily c o n c e r n e d w i t h c h a r a c t e r i z i n g all t h o s e h u m a n traits w h i c h until n o w h a v e b e e n o b j e c t i f i e d and a b s t r a c t e d i n t o physical and psychic disease symptoms as particular limitations in carrying various characteristics of h u m a n e x i s t e n c e t o fulfillment. T h e a s s u m p t i o n h e r e is t h a t Medical Psychology finally r e l i n q u i s h e s its d o m i n a n t c o n c e p t o f p s y c h e . It is so by v i r t u e of h u m a n n a t u r e . T h e s e c h a p t e r s m a y i n m a n y w a y s h a v e s e e m e d suited m o r e to the title Medunl Psychology t h a n to t h e actual heading. t h e r e b y o v e r c o m i n g and b r o a d e n i n g its l i m i t a t i o n s to b e c o m e a discipline of Da-sein and of h u m a n life in this world. Existential Foundations of Medicine and Psychology. R o u n d i n g o u t P a r t II is a c h a p t e r discussing t h e b a r r i e r s t h a t o b s t r u c t a g e n u i n e t r a n s f e r o f t h e D a s e i n s a n a l y t i c p e r s p e c t i v e t o physicians s c h o o l e d in n a t u r a l s c i e n c e and p s y c h o l o g y . b e g i n s by t e s t i n g t h e D a s e i n s a n a l y t i c p e r s p e c t i v e a g a i n s t the individual pathological s y m p t o m s of t h e t e s t c a s e . P a r t III. Boss's work. T h e reader m a y m a k e the substitution for h i m s e l f w h e r e v e r a g a i n in u n d e r s t a n d i n g m i g h t r e s u l t . Heidegger's fundamental philosophic thinking never revolved around m a n t a k e n by h i m s e l f . T h u s the decisive i m p o r t a n c e of M a r t i n H e i d e g g e r ' s D a s e i n s a n a l y t i k for m e d i c i n e and p s y c h o l o g y . F r o m t h e first it w a s directed. t o w a r d s e e k i n g t h e m e a n i n g o f B e i n g a s s u c h . For r e a s o n s of style. r a t h e r . and to maintain c o n s i s t e n c y with earlier translations of D r . h o w e v e r . " phrase "appropriate to the D a s e i n " might be n e a r e r the mark.b a s e d . Y e t this f u n d a m e n t a l o n t o l o g i c a l inquiry i n t o B e i n g can n e i t h e r b e tackled n o r r e s o l v e d u n l e s s w e can explain a t t h e s a m e t i m e t h e n a t u r e o f h u m a n b e i n g s and o u r primal being t o g e t h e r in a s h a r e d world. .Introduction xxxi f o r o u r p h e n o m e n o l o g i c a l f o u n d a t i o n for m e d i c i n e and for p s y c h o l o g y . "Appropriate to the D a s e i n " might also be used in certain passages as an alternate rendering w h e r e the adjectives "existential" and " D a s e i n s a n a l y t i c " appear. * Editor's note: A l t h o u g h t h e G e r m a n Daseinsgemdss is h e r e a n d t h r o u g h o u t t h e b o o k translated as " D a s e i n . the f o r m e r translation has been retained. Part í T h e Traditional Foundation o f Medicine . w h i c h w e r e i n f e c t e d m u c h o f t h e time. At t h e age of fifteen. N o n e o f h e r a n c e s t o r s o r close r e l a t i v e s h a d s u f f e r e d f r o m n e u r o l o g i c a l o r m e n t a l d i s o r d e r s o r f r o m any allergies. B u t e v e n a f t e r t h e e c z e m a finally receded. had to be r e m o v e d . R e g u l a Z i i r c h e r still held t h e s c h o o l r e c o r d s f o r a b s e n c e due to illness. W i t h o u t m e d i c a t i o n . w h e n s h e b e g a n to m e n s t r u a t e . I h e family medical h i s t o r y . indicated no m a j o r h e r e d i t a r y taint. r h e t r e a t m e n t o f t h e i n f a n t ' s e c z e m a t u r n e d o u t t o b e v e r y difficult and p r o l o n g e d . w h i c h soon i <-<111111'Li w h o l e s a l e c o n s u m p t i o n o f l a x a t i v e s . S e v e r a l y e a r s o f medical c a r e w e r e n e e d e d b e f o r e t h e e x a g g e r a t e d irritability o f h e r skin subsided. e v e r y o n e d e s c r i b e d b o t h h e r p a t e r n a l and h e r m a t e r n a l families a s pai ticularly v i g o r o u s a n d h e a l t h y people. w h i c h this first p h y s i c i a n o f R e g u l a / ii ri h e r had already t a k e n w i t h g r e a t c a r e . T h e patient .il ter h e r b i r t h w h e n s h e developed a c u t e w e e p i n g e c z e m a t h a t c o v e r e d I u imarily large a r e a s of h e r a r m s and legs. O n t h e c o n t r a r y . h e r b o w e l s s o m e t i m e s did not m o v e for o n e o r t w o w e e k s . h e r t o n s i l s . h e n s h e w a s s e v e n . C o l d s and e n i g m a t i c s t o m a c h a c h e s kept h e r c o n s t a n t l y in bed.Chapter 1 A TEST CASE: REGULA ZÜRCHER T h e first fact t h a t t h e p a t i e n t ' s m o t h e r r e p o r t e d a b o u t R e g u l a Z i i r c h e r was that t h e infant r e q u i r e d t h e help of a pediatrician j u s t a few w e e k s . she b e g a n c o m p l a i n i n g o f s e v e r e c o n s t i p a t i o n . D u r i n g o n e o f t h e s e s t a y s . H e s e n t h e r back to t h e i n t e r n i s t w h o . consisting of the administration of androgens remained without success. He f o u n d signs of r h e u m a t i s m . s h e felt b e t t e r t h a n s h e e v e r had. H e r c o n s t i p a t i o n as well as h e r s t o m a c h and i n t e s t i n a l a c h e s g r e w m o r e i n t e n s e despite t h e u s e o f a n e n t i r e a r s e n a l o f medications. and h e r d o c t o r s d i a g n o s e d a s e v e r e colitis. S h e had b e g u n t o s u f f e r from u n b e a r a b l e pains i n h e r b r e a s t s ." B e c a u s e o f h e r i n t e s t i n a l s y m p t o m s . " A few y e a r s l a t e r . It w a s t r e a t e d w i t h pain­ killers. an a c u t e p a n c r e a t i t i s w a s diagnosed. long s t a y s in t h e hospital. Increasingly. R e g u l a Z u r c h e r had added a g y n e c o l o g i s t t o t h e r e g i m e n t o f d o c t o r s a t t e n d i n g h e r . h e r h e a l t h d e t e r i o r a t e d rapidly. A specialist in a r t h r i t i s w a s called in. but n o t e d t h a t t h e usual t h e r a p e u t i c p r o c e d u r e s w e r e o f n o use w i t h this difficult patient.r a y i n g h e r . An anti-estrogen therapy. W h e n s h e was n i n e t e e n . at a loss for f u r t h e r m e a s u r e s . w i t h i n c r e a s i n g f r e q u e n c y . and r e m a i n e d so thin t h a t h e r d o c t o r s . h e r b r e a s t s b e c a m e hard a s s t o n e .r a y s and l a b o r a t o r y t e s t s s h o w e d n o m a j o r a b n o r m a l i t i e s .p o w e r e d a n a l g e s i c s t h a t he p r e s c r i b e d w e r e i n c r e a s i n g h e r pains instead o f s o o t h i n g t h e m . s h e w a s forced t o u n d e r g o . e x c e p t for a n i n c r e a s e d s e c r e t o r y activity o f h e r small intestine. r e p e a t e d l y s u s p e c t i n g t u b e r c u l o s i s . t h e s y m p t o m s at t h a t t i m e b e i n g mainly i n t e s t i n a l pains and c o n s t i p a t i o n w h i c h a l t e r n a t e d w i t h d i a r r h e a . b u t t w o m o n t h s a f t e r t h e delivery. including a n o t e d p r o f e s s o r of g y n e c o l o g y . this t i m e for u n b e a r a b l e back pains. the constipation alternated with severe a t t a c k s o f d i a r r h e a w h i c h w o u l d s t a r t v e r y a b r u p t l y and last for days. T h e test findings indicated a n " i r r i t a b l e c o l o n . D u r i n g p r e g n a n c y . In fact. and c a t a p l a s m s . T h e p h y s i c i a n s at t h e hospital w e r e at a loss to d i a g n o s e and t r e a t h e r illness. R e g u l a Z u r c h e r m a r r i e d a m a n a f e w y e a r s older t h a n she. a p p e a r e d to v e g e t a t e . S h o r t l y b e f o r e h e r m a r r i a g e . and t h e l i g h t e s t t o u c h w o u l d b e s o painful t h a t s h e could h a v e s c r e a m e d .o n e s h e b o r e h e r first and o n l y child. F o r a b o u t t h r e e w e e k s o f each m e n s t r u a l cycle. T h e y tried v a r i o u s diets and m e d i c a t i o n s w i t h little s u c c e s s . and h e r h e a l t h i m p r o v e d rapidly. kept X . s o m e h i g h . T h e y had k n o w n each o t h e r f r o m h e r s c h o o l days. T h e first g y n e c o l o g i s t w a s s o o n s u p p l e m e n t e d by o t h e r s . s u g g e s t e d s h e " t a k e a holiday trip w i t h h e r h u s b a n d . u n d e r t h e c a r e o f a n o t h e r physician. penicillin. F o u r y e a r s l a t e r s h e had to be hospitalized again.4 EXISTENTIAL FOUNDATIONS always felt w e a k . Blood w a s f o u n d in h e r s t o o l . A t t w e n t y . H e r X . s h e w a s again put t h r o u g h a b a t t e r y of clinical t e s t s . His r e p o r t : "I h a v e n o t s e e n a m o r e p r o n o u n c e d case of a functional h o r m o n a l i m b a l a n c e in t h e s e n s e of an e x c e s s i v e p r o d u c t i o n of follicle s t i m u l a t i n g hormone. " T h e patient h a p p e n e d t o . | M i I s in her suffering. S h e w a s t h e n i w e n t y . t h e y had c o n s i d e r e d • e i m u ' . B u i h e r c a s e took o n n e w depth. b u t w a s still far f r o m well. s o t o speak. she would repeat that nothing of any importance occurred 11' h e r . R e g u l a Z u r c h e r r e s p o n d e d by n o t i n g Mi. T h e p a t i e n t kept losing w e i g h t until s h e had dwindled t o e i g h t y . s h e had fallen into a s e v e r e d e p r e s s i o n and felt increasingly t e m p t e d to c o m m i t . b u t t h e patient • i m p l y could n o t t h i n k o f a n y t h i n g s h e c o n s i d e r e d r e l e v a n t . Finally h e r food i n t a k e b e c a m e so limited t h a t it had to be s u p p l e m e n t e d by i n t r a v e n o u s i n f u s i o n s . I n view o f h e r d e t e r i o r a t i n g c o n d i t i o n . O w i n g to h e r endless i n f i r m i t i e s and d e s p e r a t i o n • • \ I I psychological s y m p t o m s w h i c h will b e described b e l o w . l y the idea o f telling t h e p a t i e n t t h a t t h e r e m i g h t be p s y c h o l o g i c a l • i. w h e n t h e patient decided • H I h e r o w n initiative t o s e e k o u t a p s y c h o t h e r a p i s t .it s h e felt s o m e w h a t b e t t e r . w h e n h e r d o c t o r s p u m p e d h e r for m o r e Information. e a c h t i m e .f r e e diet. t h e p a t i e n t n e v e r had t h e s l i g h t e s t i n l e n t i o n o f hiding a n y i n f o r m a t i o n from t h e d o c t o r s w h o w e r e trying t o help her. i n t e r n i s t s . B u t .it m g h e r w a s p r e p a r e d for t h e w o r s t . and s o o n s h e w a s r e d u c e d t o eating thick gruel and v a r i o u s kinds of pap.t h r e e and o n e .. h e r d o c t o r p r e s c r i b e d n u reasingly s t r i c t diets. T h e quesl ions o f h e r d o c t o r s w e r e a i m e d primarily a t u n c o v e r i n g h e r past and pi e s e n t physical pains and s y m p t o m s .1111 Illl' I I i s t r u e that h e r f o r m e r p h y s i c i a n s w e r e n o t u n a w a r e o f possible p yi h o s o m a t i c r a m i f i c a t i o n s in h e r c a s e . r a d i o s c o p i s t s . and g y n e c o l o g i s t s had tried t o u n r a v e l . h e r pains returned with undiminished strength as soon as the drugs were w i t hdrawn. T h e small a r m y o f six d o c t o r s 1 1 e. B u t d u r i n g t h e long y e a r s of t r e a t m e n t . In the c o u r s e of s e v e r a l m o r e h o s p i t a l s t a y s w h i c h followed each o t h e r at d e c r e a s i n g i n t e r v a l s . I his admission of defeat s e e m e d to m a r k t h e end of t h e clinical h i s t o r y which s o m a n y pediatricians. s u r g e o n s . T h e i n t e r n i s t s h e t r u s t e d m o s t told h e r p o i n t b l a n k t h a t he w a s at his w i t s ' e n d . T i m e and again. s o h e r d o c t o r put h e r on a m i l k .•1 Test Case: Regula Zürcher 5 m r n I ion a t t h e t i m e t h a t d r i n k i n g milk made h e r c o n d i t i o n w o r s e .h a l f pounds (she w a s five f e e t t e n i n c h e s tall). . S o m e nt t h e s e physicians had tried to p r o b e b e y o n d R e g u l a Z u r c h e r ' s medical history and find o u t s o m e t h i n g m o r e a b o u t h e r past. e n d o c r i n o l o g i s t s .e i g h t y e a r s old. In fact. t h e y had mil in l i n e d any s y m p t o m s o f h e i g h t e n e d n e r v o u s n e s s o r h y s t e r i c a l in • iei y oi a n y t h i n g else t h a t s u g g e s t e d e m o t i o n a l illness and concluded thai any suspicion of n e u r o t i c c o m p l i c a t i o n s o u g h t to be discarded. t h e p a t i e n t w a s s u b j e c t e d to v e r y i n t e n s i v e and e x p e n s i v e opium and m o r p h i u m t r e a t m e n t s . r h e u m a t o l o g i s t s . w o r k i n g . He e v e n t u a l l y b e c a m e the c h i e f d i r e c t o r o f o n e o f t h e m o s t i m p o r t a n t industrial e n t e r p r i s e s in his c o u n t r y . H e r t w o hands w e r e t w i s t e d t o g e t h e r o n h e r k n e e s in the folds of an e x q u i s i t e l y tasteful dress. h e f a t h e r e d one child after a n o t h e r w i t h o u t r e s t r a i n t . a b a n d o n his studies. while intellectually limited. a f t e r m a k i n g a f e w c o n v e n t i o n a l r e m a r k s . his u n c o m m o n l y s t r o n g will. H e w a s the only o n e of his b r o t h e r s and s i s t e r s w h o w a s able to rise up o u t of their e x t r e m e l y m o d e s t social milieu b e c a u s e of his high i n t e l l i g e n c e . but his disposition w a s fiery and b a r e l y c o n t r o l l a b l e . w a s s t r o n g . We r e p r o d u c e h e r e a few w h i c h c o m p l e m e n t the h i s t o r y and medical findings. t h e r e w a s no o n e else like him in his family. b u t full o f g r a c e . from a n y of his . T h e b u r d e n o f t h e h u g e flock o f children was piled u p on his wife. v e r y h a r d . T h e r e s t o f t h e t i m e she s t a r e d a t t h e floor i n f r o n t o f her. t o n e o f voice.w i l l e d . a l m o s t c o n d e s c e n d i n g . In fact. H e n e v e r a m o u n t e d t o m u c h p r o f e s s i o n a l l y and was c o n s i d e r e d the black s h e e p of t h e family. H e r figure w a s girllike. o n l y t h e lids w i t h t h e i r long dark l a s h e s could b e s e e n . not even the e x p r e s s i o n of i n d e p e n d e n t will. v e r y f e m i n i n e . and elope w i t h h e r t o a n o t h e r c o u n t r y . t h e p a t i e n t fell silent and v e n t u r e d t o say n o t h i n g m o r e o n h e r o w n . Like all his b r o t h e r s and s i s t e r s . and his b u r n i n g a m b i t i o n . o m n i p o t e n t tyrant in the life of his o w n family. n e a r l y closed e y e s . O n l y for m o m e n t s at a t i m e did s h e dare look up and m e e t t h e e y e s of h e r t h e r a p i s t . very s e n s i t i v e y o u n g w o m a n . S h e responded to the d o c t o r ' s q u e s t i o n s in a r a t h e r p r o v o c a t i v e . he had p u r s u e d an a c a d e m i c c o u r s e of study. h e r face w a s beautiful. I n the c o u r s e o f t h e s e y e a r s . W h i l e he w a s still quite y o u n g . Regula Ziircher appeared to be a shy.6 EXISTENTIAL FOUNDATIONS H e n c e t h e y t h o u g h t it u n w i s e to a r o u s e false h o p e s in the p a t i e n t by s u g g e s t i n g p s y c h o t h e r a p y . Like his f a t h e r . T h i s i n t e r v i e w was t h e first session of a p s y c h o t h e r a p e u t i c c u r e w h i c h w a s to last for t h r e e y e a r s and a total of m o r e t h a n six h u n d r e d h o u r s of analysis. t h e i r c a u t i o n w e n t so far t h a t t h e y did not even m e n t i o n t h e possibility t o h e r . He would n o t t o l e r a t e t h e s l i g h t e s t opposition. U l t i m a t e l y he d e g e n e r a t e d into a c h r o n i c alcoholic. T h e p a t i e n t ' s f a t h e r w a s t h e y o u n g e s t o f t h e s e eleven children. soft f e a t u r e s . w i t h delicate. w h o . he also played t h e role of an a b s o l u t e . s o t h a t of h e r large. To the therapist she chose. and kind. t o o thin. H e r f a t h e r ' s f a t h e r c a m e from an upper-class family. his p a s s i o n a t e n a t u r e led him to fall head o v e r h e e l s in love w i t h a y o u n g s e r v a n t . D i s r e g a r d i n g the e c o n o m i c m i s e r y o f his o w n family. D u r i n g t h e first i n t e r v i e w . m a n y details o f R e g u l a Z u r c h e r ' s life h i s t o r y w e r e disclosed. t h e y could • l e h o w disgusting all m e n are. the family a t m o s p h e r e w a s h e a v y w i t h t e n s i o n . and f r o m t h a t t i m e o n . t h e y j u s t said t h a n k y o u . o n t h e w o r l d a r o u n d h e r . e x t r e m e l y lacking in feeling. h o w e v e r . she would greatly h a v e p r e f e r r e d b e i n g a m a n . he d e m a n d e d ••I net discipline and m o d e s t y f r o m e v e r y o n e else in his family. S h e made e x o r b i t a n t d e m a n d s . e v e r y day. W h e n e v e r the f a t h e r w a s at h o m e . B y t h e end o f t h e i r first y e a r o f m a r r i a g e . In him. s h e c u r s e d t h e f a t e t h a t m a d e h e r a w o m a n . D e s p i t e h e r o w n i 11. indulged in an endless r a n g e i l l e x t r a m a r i t a l affairs. their r e l a t i o n s h i p w a s c h a r a c t e r i z e d b y a g r e a t deal o f i r r i t a t i o n .t . W i t h h e r h u s b a n d she w a s frigid and s u b s e r v i e n t .ii itable e f f o r t s . I he p a t i e n t ' s m o t h e r g r e w up to be a v e r y s h a d o w y c r e a t u r e u n d e r t h e o v e r p o w e r i n g i n f l u e n c e o f h e r p a r e n t s ' e x c e p t i o n a l l y vital p e r s o n a l i t i e s . T h e y w e r e loved and h o n o r e d accordingly by t h o s e a r o u n d t h e m . an u n c o m m o n l y v i g o r o u s and a g g r e s s i v e m a n . T h e y w e r e k n o w n to a large public as h i g h l y i n t e l l i g e n t people w h o p a s s i o n a t e l y s t o o d u p for t h e i r f e l l o w m e n . w h i l e she w a s t e d a w a y from t h e fatigue o f • hronic jealousy. they had little t o d o w i t h each o t h e r . ( Hlen his d a u g h t e r s w o u l d h a v e p r e f e r r e d to t h r o w this c o n s c i e n c e m o n e y into his face. t h a t w o m e n can e x p e c t only i n g r a t i t u d e and b r u t a l i t y from m e n ? O n l y t h e most si upid girl would be taken in by their s e d u c t i o n s or give t h e m h e r II le. i m m a t u r e and n a i v e . T h e g r a n d p a r e n t s o n t h e m o t h e r ' s side w e r e b o t h e m i n e n t and s t r o n g personalities. t h e y w e r e already c o m p l e t e l y e s t r a n g e d . F r o m e.'1 Test Case: Regula Ziircher 7 l o u r d a u g h t e r s o r f r o m his wife. T h e n h e w o u l d t a k e t h e h a n d o l the punished o n e and press m o n e y into i t t o buy b a c k h e r a f f e c t i o n . this n e e d y m o t h e r actually cared little a b o u t o t h e r people. during o n e of his s a v a g e d o m e s t i c r a g e s in w h i c h he had < o m p l e t e l y c r u s h e d the victim of his a n g e r . C o m p l e t e l y u n r e s t r a i n e d in e v e r y r e s p e c t h i m s e l f . h e r g r e a t e s t c o n c e r n w a s t e a c h i n g h e r d a u g h t e r s absolute r e s t r a i n t o f t h e i r feelings. i hildlike. S h e n e v e r m a d e real friends w i t h ni her girls. I t w a s n o t h a r d t o i m a g i n e t h e n e w o u t b r e a k o f fury t h a t refusal o f I lie m o n e y would h a v e a r o u s e d . he would do an a b r u p t a b o u t face and feel r e m o r s e for w h a t h e had d o n e . like t h e air b e f o r e a s t o r m . while t h e g r a n d m o t h e r e x i s t e d entirely for h e r children and h e r social w o r k . S h e c o n s t a n t l y held u p t h e awful i • ample of their f a t h e r as a w a r n i n g . s h e w a s . b u t as long as t h e y w e r e small.n Iy childhood. S o m e t i m e s . she would say. T h e g r a n d f a t h e r lived o n l y for his c a r e e r . h o w e v e r . As a couple. in w h i c h s h e o n l y i m i t a t e d h e r o w n m o t h e r ' s social behavior. He. As a m o t h e r .i I ways c o n t r o l l e d by t h e i r e x c e e d i n g l y puritanical ideas. T h e f a t h e r ' s e x p l o s i o n s o f a n g e r w e r e e v e r y d a y o c c u r r e n c e s p r o v o k e d by t h e least i n s u b o r d i n a t i o n from his family. D i d n ' t t h e i r f a t h e r p r o v e . . the tensions of her parents' house demanded too much of her. A t the o n s e t o f h e r p u b e r t y . an o u t i n g in t h e c o u n t r y m a d e b y h e r h u s b a n d . a n u t t e r l y l o n e s o m e c r e a t u r e . T h e r e w a s a d i f f e r e n c e o f n i n e y e a r s b e t w e e n h e r and h e r n e x t oldest s i s t e r . she did not at all u n d e r s t a n d h o w t o g e t along w i t h o t h e r c h i l d r e n . she p o r t r a y e d . o u r p a t i e n t . W i t h each o f his unjust p u n i s h m e n t s . t h e r e f o r e . I t o f t e n c a m e t o reciprocal a c t s o f v i o l e n c e .8 EXISTENTIAL FOUNDATIONS R e g u l a Z ü r c h e r . I t t o o k m a n y m o n t h s and u n d e r s t a n d i n g k i n d e r g a r t e n t e a c h e r s b e f o r e she dared e n t e r . M o s t o f all she loved the m u s i c o f B a c h . T h i s piece o f w r i t i n g w a s s o q u a i n t and p i c t u r e s q u e t h a t h e r t e a c h e r later f r e q u e n t l y and l a u g h i n g l y r e f e r r e d to it. from t h e p e r p e t u a l l y t e n s e . W h e n R e g u l a Z ü r c h e r w a s s e n t to s c h o o l . i n t o a n y o f t h e g a m e s . she had t o s t r u g g l e t o get t h r o u g h t h e n o r m a l c o u r s e o f schooling. T h i s w a s t h e o n l y f o r m o f dialogue t o w h i c h this girl had access. as far back as s h e could r e m e m b e r . S h e s c r e a m e d back at him and c u r s e d him in t h e m o s t o f f e n s i v e l a n g u a g e . s i m u l t a n e o u s l y q u e s t i o n i n g and a n s w e r i n g each o t h e r . A t t h e s a m e t i m e . in m e t i c u l o u s detail and w i t h c o n s i d e r a b l e inspiration. A s t h e i r " p r o p e r t y . and t h e i r t e n children. t h e y forbade h e r a n y c o n t a c t w i t h o t h e r children i n the n e i g h b o r h o o d . basically. so practically speaking she g r e w up as an only child. In spite of h e r reading. s h e t o o b e c a m e e x t r e m e l y a g g r e s s i v e . a n o n l y child t o w h o m h e r p a r e n t s paid little a t t e n t i o n . as n o w h e r e else. T h e y w e r e s o c o m p l e t e l y a b s o r b e d i n t h e i r o w n perpetual q u a r r e l s t h a t t h e y left t h e child m o s t l y t o h e r o w n devices. o p p r e s s i v e . R e g u l a suffered g r e a t l y . and j o y l e s s a t m o s p h e r e o f t h e family. and e s s a y w r i t i n g . little b y little. the s c e n e s w i t h h e r f a t h e r b e c a m e i n c r e a s i n g l y p a s s i o n a t e . T h o u g h s h e w a s v e r y i n t e l l i g e n t . A s s i g n e d a t h e m e of "A S u n d a y O u t i n g " in f o u r t h grade. piano playing. " In t h e s e . B u t she n e v e r lost t h e s e n s e o f being. " t h e y felt s h e w a s t o o h i g h b o r n t o mingle with ordinary children. h e r girlish plans w e r e based on s o m e d a y s e t t i n g up a family of h e r o w n . w a s t h e y o u n g e s t o f this couple's four d a u g h t e r s . S h e w a s . especially his " I n v e n t i o n s . T i m i d and helpless. verbal o r physical. D e s p i t e h e r o w n e x p e r i e n c e of a s e r i o u s l y d i s t u r b e d family life. R e g u l a t o o k r e f u g e in reading for long h o u r s at a time and would live o n l y i n t h e w o r l d o f h e r s t o r y b o o k h e r o e s . S e v e r a l t i m e s . herself. O t h e r t i m e s she would r e s i g n h e r s e l f to playing t h e piano all day long in t h e lonely r o o m s o f h e r p a r e n t s ' m a n s i o n . she would stand off to o n e side and from a d i s t a n c e w a t c h the o t h e r children play. d i f f e r e n t melodies would a l t e r n a t e . In later s c h o o l y e a r s . despite h e r fragility. S h e n o l o n g e r k n u c k l e d u n d e r t o him. s h e s t r u c k h e r f a t h e r s o hard t h a t h e reeled into a c o r n e r of the r o o m . m o r e o v e r . F o r t u n a t e l y . w h o s h a r e d a c o m m o n passion to c r e a t e . s h e w a s deeply disgusted w i t h h e r m o t h e r ' s perpetual s u b m i s s i v e n e s s t o h e r f a t h e r . W h e n . R e g u l a Z ü r c h e r received h e r first i n v i t a t i o n to a dance. t h e y said. F o r t h e first t i m e i n h e r life she w a s n o t r u n n i n g up a g a i n s t c o n s t a n t c r i t i c i s m b u t i n s t e a d w a s e x p e r i e n c i n g gratifying c o n f i r m a t i o n o f h e r e x c e l l e n t t a s t e and a r t i s t i c t a l e n t s . I n c o n n e c t i o n w i t h t h e h i s t o r y o f h e r physical a i l m e n t s t h e p s y c h o t h e r - . t h r e w h e r into g r e a t e r t u r m o i l . A p r e t t y girl. e v e n as an a p p r e n t i c e . H e r e . w h e r e t h e o r d e r t o o k g r e a t c a r e t h a t t h e children recited the T e n C o m m a n d m e n t s daily. R e g u l a Z ü r c h e r w a s used b y b o t h o f h e r p a r e n t s a s s o m e kind o f wailing wall o r g a r b a g e d u m p . b u t t h e daily r e c i t a t i o n o f the T e n C o m m a n d m e n t s . T h u s . w h e r e t h e y would s h a m e l e s s l y pour o u t their love and m a r i t a l p r o b l e m s . h e r m o t h e r w o u l d r e p r i m a n d h e r for h e r " f a n a t i c a l " c h a r a c t e r . If s h e s h o w e d e v e n a t r a c e of e n t h u s i a s m for a m e l o d y s h e had just l e a r n e d .A Test Case: Regula Zürcher 9 Regula Z ü r c h e r hated her m o t h e r too. h e r p a r e n t s b e g a n w a r n i n g h e r daily n o t t o g e t involved w i t h a n y o n e b o y . R e g u l a ' s desire for p r e t t y c l o t h e s b r o u g h t d o w n a c c u s a t i o n s o f i n d e c e n c y and i m m o r a l i t y . U n d e r t h e p r e s s u r e o f p a r e n t a l m o r a l i z i n g . including t h e F o u r t h C o m m a n d m e n t t o love and h o n o r o n e ' s p a r e n t s . In addition to this. A h i g h e r e d u c a t i o n . s h e o b e d i e n t l y limited a c c e p t a n c e s t o t h o s e w h o w e r e easily kept a t a d i s t a n c e . R e g u l a Z ü r c h e r had n o c h o i c e b u t t o take an a p p r e n t i c e s h i p in o n e of the city's f o r e m o s t f a s h i o n s a l o n s . i m m e d i a t e l y after s e c o n d a r y s c h o o l . s h e w a s flooded w i t h i n v i t a t i o n s . W i t h h e r varied t a l e n t s . or delighted in a f l o w e r . R e g u l a r e s e n t e d h e r m o t h e r ' s i m m e d i a t e s u p p r e s s i o n o f the least s h o w o f feeling f r o m h e r t e m p e r a m e n t a l d a u g h t e r . h e r p a r e n t s s e n t h e r to a private s c h o o l w i t h a v e r y n a r r o w religious o r i e n t a t i o n . m e a n t t h a t the child would r e m a i n in t h e h o m e t o o long and be a b u r d e n to t h e p a r e n t s . F u r t h e r m o r e . A l o n g w i t h h e r t h r e e s i s t e r s . though for very different r e a s o n s . R e g u l a had originally h o p e d and longed to find help and s u p p o r t at least i n religion. T o c o m p l e t e t h e t r a g e d y o f h e r y o u t h . s h e found h e r ideas and j u d g m e n t s g i v e n equal s t a t u s w i t h t h o s e o f h e r s u p e r i o r s . R e g u l a Z ü r c h e r would h a v e loved t o a t t e n d the G y m n a s i u m . h e r m o t h e r m a n a g e d to s t u f f the child full of p s e u d o m o r a l guilt feelings and to r o b h e r of all o p e n n e s s and f r a n k n e s s . Indeed. H o w i n t h e world w a s s h e t o s u m m o n u p any love and h o n o r for t h e s e t o r m e n t o r s ? S h e would s o o n e r h a v e t h r o w n a c o o k i n g . N e v e r had t h e m o t h e r made t h e least effort to t a k e t h e side of a d a u g h t e r and p r o t e c t h e r from the f a t h e r ' s rage. she w a s w a r m l y r e c e i v e d t h e r e b y a g r o u p o f v e r y t a l e n t e d d e s i g n e r s . in h e r t e e n s .p o t at t h e i r h e a d s . b u t h e r p a r e n t s would n o t h e a r o n e w o r d a b o u t " e d u c a t e d " d a u g h t e r s . and u n o b t r u s i v e .g o i n g w a y s in this m a n w a s n o t h i n g m o r e t h a n a lack of i n t e r e s t and vitality. R e g u l a Z i i r c h e r ' s physical h e a l t h g r e w c o n s i d e r a b l y w o r s e after h e r m a r r i a g e . " t h e h u s b a n d c o n t e n t e d h i m s e l f w i t h s t r o k i n g and l o o k i n g a t his wife as she lay n a k e d beside him. w h o m s h e t o o k a s h e r h u s b a n d . R e g u l a Z i i r c h e r believed all m e n w e r e like t h a t and h e n c e settled for such a marital s i t u a t i o n . N o t t h a t she had e v e r b e e n in love w i t h this m a n . P h o t o g r a p h s of t h e naked bodies o f o t h e r w o m e n spoke t o h i m m o r e u r g e n t l y t h a n t h e physical p r e s e n c e o f his l o v e . N e e d l e s s to say. B u t t h e n c a m e t h e birth o f h e r child. C o m p l e t e l y u n e x p e c t e d l y . t h e p a t i e n t t o o k r e f u g e i n m a r r i a g e . appeared t h e o p p o s i t e o f h e r f r i g h t e n i n g and u n t r u s t w o r t h y f a t h e r . T h e n he would suddenly leave h e r by h e r s e l f and s h u t h i m s e l f alone in his b a t h r o o m .s t a r v e d y o u n g wife. a f t e r w h i c h he would e x t r i c a t e h i m s e l f as quickly as possible from the e m b r a c e . S h e a d m i t t e d t o n o o n e t h a t . s e c u r e . in t h e m a r r i a g e w i t h such a p a r t n e r she p r o v e d s e x u a l l y frigid and r e m a i n e d so. T o h e r dismay. and. In t h e long periods b e t w e e n t h e s e m e a g e r " i n t i m a c i e s . h e r skin r e m a i n e d h y p e r s e n s i t i v e t o w o o l .b a l a n c e d . H e e n g a g e d i n s e x u a l i n t i m a c y w i t h h e r o n l y e v e r y f e w w e e k s . w h i c h according t o h e r w a s h e r o n l y e s c a p e from t h e i n h u m a n a t m o s p h e r e o f h e r p a r e n t s ' h o m e . his physical i n v o l v e m e n t w i t h his wife c o n s i s t e d o n l y of a v e r y brief. she had realized t h a t h e r m a r r i a g e had b e e n a big m i s t a k e . a b r u p t s e x u a l act. F r o m t h e v e r y first days o f t h e i r s h a r e d h o u s e k e e p i n g . A t n i n e t e e n . F o r h e r s e l f . T h e y o u n g h u s b a n d w a s incapable o f any h e a r t f e l t w a r m t h t o w a r d his wife. H e r m o t h e r paid n o a t t e n t i o n t o this. and r e p e a t e d l y forced h e r d a u g h t e r t o w e a r w o o l l e n s t o c k i n g s . while still o n t h e h o n e y m o o n . T h i s friend o f h e r y o u t h . and go to sleep. and t o t h e a s t o n i s h m e n t o f t h o s e a r o u n d h e r . only e v e r y few m o n t h s . h e p l a s t e r e d t h e b a t h r o o m walls w i t h nude pin-ups. s o o n . M o r e o v e r . e m o t i o n a l l y w e l l . roll o v e r 'on his side. a kind of childish i m m a t u r i t y . It b e c a m e a p p a r e n t t h e n t h a t w h a t s h e had t a k e n for reliability and e a s y .10 EXISTENTIAL FOUNDATIONS apist l e a r n e d t h a t e v e n a f t e r the w o r s t s y m p t o m s o f R e g u l a ' s early childhood e c z e m a disappeared. G i v e n t h e " e n l i g h t e n m e n t " h e r m o t h e r had b e s t o w e d o n h e r . believing t h a t such s t r i c t m e a s u r e s w o u l d put a c h e c k on f e m i n i n i t y as well as t h e v a n i t y and a r r o g a n c e t h a t t h e w e a r i n g o f silk s t o c k i n g s m i g h t e n g e n d e r . h o w e v e r . t h e final birth c o n t r a c t i o n s released t h e first s e x u a l o r g a s m of R e g u l a . q u i e t h o u s e w i f e and m o t h e r . S h e a t t a c h e d h e r s e l f to him in t h e m a n n e r of a little s i s t e r looking for p r o t e c t i o n and s u p p o r t from a big b r o t h e r . H e r family e x p e r i e n c e i n f l u e n c e d h e r t o c h o o s e t h e a d m i r e r w h o appeared m o s t c o m p o s e d . s h e h o p e d to be able to be happy in t h e role of a simple. md he m a d e it impossible for h e r to e n t e r t a i n h e r old friends at h o m e b e c a u s e h e d r o v e e v e r y o n e a w a y w i t h the h e a v y silence and l e t h a r g y t h a t c a m e o v e r him a t e v e r y social g a t h e r i n g . if my e y e s even c h a n c e d to fall upon s o m e s h a r p t h i n g t h a t w a s lying a r o u n d . t h e p a t i e n t w a s surprised.o u t a t t a c k s o n him. t h e a l m o s t it r e s i s t a b l e u r g e to s t a b t h e tiny body of h e r d a u g h t e r w i t h a knife. irritable. O n top o f t h i s . and c r o s s . and inspired by e v e r y t h i n g beautiful— and h e r s p o u s e . so alive and v i v a c i o u s . . G i v e n h e r h u s b a n d ' s h uman denial of h e r . B u t j u s t a t t h o s e t i m e s w h e n she felt m o s t i n t i m a t e l y hound t o h e r child—while b a t h i n g her. she w a s a s h a m e d o f h e r b e h a v i o r and scolded h e r s e l f for this g r o w i n g h a t e f u l n e s s w h i c h . m o r e and m o r e o f t e n . out o f t h e blue. o r j u s t a f t e r w a r d w h e n s h e w a s saying t h e b e d t i m e p r a y e r — t h e r e c a m e o v e r h e r . H e r e t r e a t e d m o r e and m o r e i n t o h i m s e l f . h e k n e w o n l y I n s t e c h n i c a l j o b i n a small w o r k s h o p . w a s leading h e r t o m o r e and m o r e f r e q u e n t o u t b u r s t s o f a n g e r t o w a r d h e r h u s b a n d . H e n o l o n g e r t o o k h e r o u t t o plays. I n despair s h e s t a r e d down into t h e a b y s s b e t w e e n h e r — a w a r m . and Hung it a w a y . S h e t o r e t h e a n e s t h e s i a m a s k f r o m t h e h a n d s o f the midwife. A p p a r e n t l y . S h e r e l a t e d t o n o o n e but h e r child.h e a r t e d . T h e patient described this in t h e following way: I )uring t h e s e especially happy m o m e n t s w i t h t h e child. w a n t i n g him c l o s e r and w i t h h e r m o r e o f t e n . r a r e l y paying a n y a t t e n t i o n to t h e child and t r e a t i n g his wife as t h o u g h she w e r e a total s t r a n g e r . she w a s m o r e physically d e m a n d i n g o f h e r h u s b a n d .a n d . T h i s s t o r m o f s e n s a t i o n flooded h e r w h o l e being. H o w could s h e let h e r s e l f be a n e s t h e t i z e d at t h e happiest m o m e n t o f h e r life? A f t e r this o v e r w h e l m i n g e x p e r i e n c e . T h e s e o l t e n b e c a m e o u t . c o n c e r t s . b y phobic s y m p t o m s . s t r o n g e r t h a n s h e . o r social f u n c t i o n s . T h u s R e g u l a Z i i r c h e r g r e w m o r e and m o r e isolated. h e r p a r t n e r felt h i m s e l f m o r e put u p o n t h a n b e f o r e with t h e n e w n e s s o f h e r i n o r d i n a t e desire and w i t h t h e f a t h e r role h e had g o t t e n i n t o . A few w e e k s a f t e r t h e crucial e v e n t of h e r child's birth. a nail file or a knife. O t h e r t h a n t h e s e .A Test Case: Regula Ziircher II Z i i r c h e r ' s life. musically t a l e n t e d w o m a n . . As a r e s u l t of this deprivation. w h e r e h e w o r k e d t w e l v e t o l o u r t e e n h o u r s a day to m a k e as m u c h m o n e y as he could. o r putting h e r t o bed w i t h h u g s and kisses. s h e s a n k i n t o a d e t e r i o r a t i n g h u m o r and b e c a m e i n c r e a s i n g l y t e n s e . t h e n t h e u r g e t o o k hold of me to stab it i n t o h e r body. o b l i t e r a t i n g h e r labor pains and filling h e r w i t h an i m m e n s e s e n s e ol pleasure and j o y . a m i s e r a b l e h u m a n f o r m w h o s e o n l y i n t e r e s t s lay in his c r a z e for cars and his s t a m p c o l l e c t i o n . t h e o n l y living c r e a t u r e on e a r t h she had to love was her baby d a u g h t e r . for t h e first t i m e . w h o w a s a b o u t t o help e a s e t h e final p u s h e s o f t h e delivery. t h o u g h . it could o n l y be m a d n e s s to s t a b or s t r a n g l e t h e d e a r e s t t h i n g you h a v e . I felt a p r e s s u r e to s t r a n g l e h e r w i t h my o w n hands. t h e m o r e p o w e r t h e k n i v e s g a i n e d o v e r m e . In t h e s e n i g h t e v e n t s . A n d t h e s e k n i v e s c o m i n g in on me o u t of t h i n air put t r e m e n d o u s p r e s s u r e o n m e t o run wild w i t h t h e m . A l t h o u g h she had b e c o m e bedridden on a c c o u n t of h e r debilitation. I had b e c o m e a p o t e n t i a l child m u r d e r e r . at •the point of ending h e r life w i t h an o v e r d o s e of sleeping pills. by that time. . b u t this did n o t c o m e o v e r me as o f t e n as t h e s t a b b i n g u r g e . w h o was often. To m y s e l f I w a s such a depraved c r e a t u r e t h a t I felt I had used up e v e r y r i g h t to life in this w o r l d . So r i g h t a w a y I would run o u t of the r o o m i n t o t h e hall. M y fears o f t h e k n i v e s and t h e s t r a n g l i n g w e r e w o r s t w h e n m y h u s b a n d b a n i s h e d me by m y s e l f w i t h t h e child to a secluded cabin in the m o u n t a i n s for long w e e k s of v a c a t i o n . I w a s s e e i n g d o z e n s of k n i v e s flash past me in t h e air. the d r e a m e r always found h e r s e l f c o m p l e t e l y naked and a l o n e . S h e c h o s e this p a r t i c u l a r specialist and n o o t h e r b e c a u s e s h e k n e w t h a t h e had o n c e t r e a t e d o n e o f h e r relatives w i t h s o m e s u c c e s s . This is the account of the patient herself. J u s t t h e n i g h t b e f o r e she had a w a k e d from this d r e a m . I could n o t e v e n look at a knife at all. T h e l o n g e r t h e v a c a t i o n w e n t on. terrified and b a t h e d in s w e a t . e v e n w h e n t h e little o n e w a s n ' t n e a r . s h e appeared a f e w days l a t e r for a c o n s u l t a t i o n w i t h h e r f u t u r e p s y c h o t h e r a p i s t . As t i m e w e n t on. S o t h e knife d r a w e r b e c a m e a n u n b e a r a b l e p r o v o c a t i o n and t e m p t a t i o n for me. h e s e e m e d t o o f f e r a g u a r a n t e e o f g o o d experience. W h o o r w h a t didn't m a t t e r . f o r c e m e t o j a b t h e m i n t o s o m e t h i n g . T h e r e I had to lean a g a i n s t t h e wall and hold my right h a n d t i g h t l y w i t h m y left. Every minute I was sure I was going completely mad. T h e s e h o r r i b l e h a l l u c i n a t i o n s m a d e it c l e a r to me t h a t e i t h e r I had to c o m m i t m y s e l f or find a psychotherapist. R e g u l a Z u r c h e r decided t o u n d e r g o p s y c h o t h e r a p y .12 EXISTENTIAL FOUNDATIONS S o m e t i m e s t h e u r g e w a s so s t r o n g I w a s afraid of losing my mind and g o i n g c r a z y in t h e n e x t s e c o n d . A n d b e c a u s e h e w a s a good t h i r t y y e a r s older t h a n s h e . Finally. A f t e r r e t u r n i n g f r o m this c a t a s t r o p h i c s u m m e r v a c a t i o n . I would m i s t a k e a n y glint on a polished s u r f a c e for t h e flash of a knife blade. I simply could n o t stand t h e s i g h t of t h e k n i v e s in t h e k i t c h e n d r a w e r a n y m o r e . T h e n . R e a l l y . In the v e r y first t h e r a p e u t i c s e s s i o n t h e p a t i e n t c o m p l a i n e d of a r e c u r r i n g d r e a m t h a t had p u r s u e d h e r since earliest childhood at intervals of a few w e e k s to a f e w m o n t h s . O n e day it no l o n g e r e v e n t o o k a real knife to m a k e me panic. t h i n k i n g t h e m so real I g r a b b e d at t h e m . t o k e e p m y s e l f from doing t h e h o r r i b l e t h i n g . and could. It w a s as if t h e y w a n t e d to. A f t e r a few m o n t h s . an arctic wind b l e w t h r o u g h t h e d o o r s and s e a m s o f t h e b o x c a r .n I |i | a r m s w e r e folded for p r o t e c t i o n o v e r h e r k n e e s and in front of her t&i e T h e b o x c a r sat at t h e b o t t o m of an ice-cold o c e a n in which t h e r e was not l single fish or g r o w i n g plant. she b e c a m e sleepless.t h r e a t e n i n g physical s y m p t o m s disappeared o f t h e i r o w n a c c o r d . T h o u g h t h e patient tried hard t o comply w i t h d o c t o r ' s r e q u e s t s t o free a s s o c i a t e . b r o k e f o r t h and flooded her. T o t h e p a t i e n t ' s a s t o n i s h m e n t . ) H e r e we n e e d say o n l y the following t h i n g s a b o u t t h e c o u r s e o f t r e a t m e n t . S h e was c o n v i n c e d . D e e p in t h e s e a . a l t h o u g h h e r d o c t o r advised h e r t o wait. a l t h o u g h t h e y had n e v e r b e e n p a r t i c u l a r l y discussed in the t h e r a p e u t i c s e s s i o n s . a s s h e b e g a n t o tell t h e s t o r y o f h e r life t o s o m e o n e else. S h e fell i n t o raving a t t a c k s o f a n g e r and h a t r e d t o w a r d h e r p a r e n t a l t o r m e n t o r s . by m a k i n g t h e s e p a r a t i o n than by e n d u r i n g w i t h h i m l o n g e r . h e had the p a t i e n t o b s e r v e t h e f u n d a m e n t a l rules o f analysis. h o w e v e r . F r o m w e e k to w e e k she g r e w m o r e settled in t h e t h e r a p e u t i c s i t u a t i o n . S h e w a s frightfully cold. T h e t h e r a p i s t . F o r a f e w days t h e t h e r a p i s t a b s t a i n e d from discussing this dream First. m a l t r e a t m e n t . the g a s t r o ­ i n t e s t i n a l c r a m p s and t h e bloody v i s c o u s d i a r r h e a w h i c h a l t e r n a t e d w i t h s e v e r e c o n s t i p a t i o n faded a w a y . M o r e and m o r e o f t e n t h e child w a s h a v i n g t o w i t n e s s t h e strain b e t w e e n t h e p a r e n t s . and spiritual a s s a u l t s she had had t o e n d u r e from h e r p a r e n t s . t h e first e f f e c t s o f t r e a t m e n t w e r e n o t v e r y p r o m i s i n g . t h a t she w a s doing a g r e a t e r s e r v i c e for h e r s e l f . t o o . and for h e r child especially. A f t e r o n e y e a r of p s y c h o t h e r a p y .A Test Case: Regula Zürcher c r o u c h e d and c o w e r i n g in t h e c o r n e r of an e m p t y railroad boxi. as did the r e c e n t disruption of sleep. T h e c o m p a r a b l e m e m o r y o f h e r o w n childhood w i t h c o n s t a n t p a r e n t a l quarrelling w a s a g r u e s o m e o n e that . H e r s l e e p l e s s n e s s depleted t h e s t r e n g t h o f t h e already w e a k p a t i e n t . and r e m a i n e d so. t h o u g h it also s o o n lost m u c h of its t h r e a t b e c a u s e of the p a t i e n t ' s t r u s t i n t h e t h e r a p e u t i c capability o f h e r d o c t o r . M e m o r i e s o f h e r d e s p e r a t e childhood. s o t h a t e v e r y n i g h t she lay t h i n k i n g o f t h e i n c e s s a n t denials. (This t h e r a p e u t i c m e t h o d and its practical o u t c o m e s will be t a k e n up in m o r e detail in t h e f o u r t h part of this b o o k . T h e b r e a s t swelling and h a r d n e s s . did n o t last m u c h l o n g e r . and h e soon o b s e r v e d t h a t his s t e a d i n e s s b e g a n t o give t h e p a t i e n t support. S h e h e r s e l f believed s h e could n o l o n g e r refrain from taking large d o s a g e s of sleeping pills. long p u s h e d aside. T h e stabbing u r g e did not yield so quickly. did n o t let h i m s e l f be t u r n e d aside in his t r e a t m e n t b y this d r a m a t i c s h a r p e n i n g o f t h e s i t u a t i o n . F r o m t h a t h o u r on. t h e p a t i e n t decided to g e t a divorce from h e r h u s b a n d . S h e could d o n o t h i n g b u t c o n s t a n t l y t h i n k o v e r and p o n d e r a n e w t h e s e m e m o r i e s . w h i c h had c a u s e d h e r s o m u c h u n b e a r a b l e pain. t h e m o t h e r ' s g r o w i n g irritation and o u t b u r s t s a t t h e f a t h e r . all h e r l i f e . to evolve from t h e totally frigid childlike c r e a t u r e . and kissed him. she could n o t m o v e a n o t h e r step. T h i s t i m e . T h e y w e r e both familiar with t h e vacation h o u s e they . as t h o u g h it would leap from h e r b r e a s t . the patient m e t a y o u n g m a n at a cocktail p a r t y . It r e q u i r e d j u s t o n e m o r e full y e a r of p s y c h o t h e r a p e u t i c e f f o r t s for a m a t u r e w o m a n . He responded w i t h e m b r a c e s and equal pleasure. S h e ran to h e r l o v e r impulsively. T h e n t h e y walked a r m in arm down the s t r e e t . He i m m e d i a t e l y i m p r e s s e d h e r b u t a t t h e s a m e t i m e disturbed h e r peculiarly. H e r h e a r t b e g a n to b e a t wildly. S u d d e n l y she collapsed. paralyzed. O n e day she h a p p e n e d t o m e e t h e r n e w l o v e r o n the s a m e s t r e e t w h e r e she had seen h i m t h e y e a r b e f o r e and had g o n e h y s t e r i c a l l y lame. she w a s glad to leave t h e party w h e n it w a s o v e r t o flee t o t h e s e c u r i t y o f h e r h o m e . S h e was hardly a w a r e o f t h e b u s t l e o n t h e s t r e e t . m a k i n g plans for t h e i r c o m i n g v a c a t i o n in the C a n a r y Islands. t o o . Having t o stand o n h e r o w n t w o f e e t w a s n o t e a s y for this w o m a n w h o was used t o being indulged i n e x t e r n a l m a t t e r s . f u t u r e l e s s m a r r i a g e . F o l l o w i n g this incident. she said. A f e w days l a t e r s h e s a w t h e s a m e y o u n g m a n c o m i n g t o w a r d h e r o n the o t h e r side o f o n e o f t h e t o w n ' s m a i n s t r e e t s . T h e y did not r e t u r n . T h r e e y e a r s a l t o g e t h e r o f analysis m a d e h e r ready for t e r m i n a t i o n o f t r e a t m e n t . t h e r e was m u c h for h e r t o d o a f t e r t h e c o m p l e t e s e p a r a t i o n from h e r h u s b a n d . Afraid o f falling head o v e r heels in love w i t h him. B u t she n e v e r r e g r e t t e d t h e step t o free h e r s e l f from h e r h o p e l e s s . S o o n t h e y w e r e l o v e r s . t h e sight of him filled h e r with jubilation.14 EXISTENTIAL FOUNDATIONS she w a n t e d t o s p a r e h e r child. B o t h o f h e r legs w e r e limp w i t h h y s t e r i c a l paralysis. she lost t h e last t r a c e s o f h e r u r g e s t o s t a b h e r little d a u g h t e r . she felt nailed t o t h e spot. t h e p s y c h o t h e r a p y w a s c o n t i n u e d w i t h o u t a b r e a k in t h e hospital. t h o u g h R e g u l a Z ü r c h e r w a s n e v e r h i n d e r e d b y t h e p r e s e n c e of h e r d a u g h t e r as m u c h as s h e w a s at this t i m e of h e r life w i t h its m a n y undertakings. After another year of further intensive psychotherapeutic work. able to love and w o r k . S h e w a s barely back h o m e from t h e hospital b e f o r e h e b e g a n skillfully and p e r s i s t e n t l y c o u r t i n g h e r . In t h r e e w e e k s she w a s a b l e to use h e r legs again and leave t h e hospital. she s a w him c o m i n g t o w a r d h e r u n e x p e c t e d l y o n t h e o t h e r side of the s t r e e t . far from fear. B e l i e v i n g t h a t h e had r e c o g n i z e d h e r and w a s a b o u t t o c r o s s t h e s t r e e t and speak t o h e r . S h e had to be t a k e n to a hospital by a m b u l a n c e . h u g g e d him. for t h e first t i m e able t o e x p r e s s h e r m a t u r e capacity t o l o v e . A n d n o w . T h i s t i m e . U n a c c u s t o m e d t o being o n h e r o w n . T h e y o u n g m a n w h o s e sudden a p p e a r a n c e o n t h e s t r e e t o n e y e a r b e f o r e had o c c a s i o n e d t h e h y s t e r i c a l paralysis of h e r legs and had not been intimidated by the exceedingly impressive symptoms of the p a t i e n t ' s illness. like claustrophobia. R e g u l a Z ü r c h e r longed for t h e c l o s e n e s s o f t h e m a n s h e loved. A l t h o u g h he w a s a pleasant sort. In h e r despair o v e r this a p p a r e n t l y i n e s c a p a b l e s i t u a t i o n . It w a s n o t at all t h a t feelings of guilt g o t in h e r w a y . s w i m m i n g and w a n d e r i n g in o p e n fields. h o w e v e r . i t b e c a m e evident that c i r c u m s t a n c e s would n e v e r allow a p e r m a n e n t b o n d o f m a r r i a g e w i t h h e r l o v e r . Regula Z ü r c h e r b e c a m e u n b e a r a b l y agitated. B u t she found she w a s c o m p l e t e l y u n a b l e t o satisfy h e r s e l f this w a y . and w h o had g r o w n physically capable of a full f e m a l e o r g a s m in s e x u a l t o g e t h e r n e s s w i t h a m a n .A Test Case: Regula Zürcher IS w o u l d m o v e i n t o in a f e w w e e k s . E v e n w i t h t h e b e s t o f i n t e n t i o n s . e i t h e r physically or. never to return. especially. artistically. he w a s in no w a y suitable for h e r . w h i c h s h e had t h o u g h t g o n e f o r e v e r . S e v e r e irritability. like a p u r e b r e d h o r s e in a n a r r o w stall. hoping t o a c h i e v e s o m e s o r t o f r e l e a s e from h e r d e s t r u c t i v e u r g e s . B e c a u s e h e r life had b e e n r e d u c e d so suddenly to t a k i n g c a r e of h e r child and small a p a r t m e n t . A f t e r t w o y e a r s o f u n t r o u b l e d h a p p i n e s s . t h e old u r g e s to s t a b and t o s t r a n g l e . S h e had little t r o u b l e a t t a i n i n g a purely physical o r g a s m w i t h h i m . E v e r y t h i n g she e n c o u n t e r e d u p s e t h e r and g o t i n h e r w a y . i I detail and t h o u g h t a b o u t t h e c o m i n g sun-filled h o u r s t o g e t h e r . t h e m a n left for t h e F a r East. she h e r s e l f spoke of a m e n a c i n g panic. S o m e t i m e a f t e r this happy v a c a t i o n . but t h a t m a s t u r b a t i o n simply did n o t put h e r in t o u c h w i t h h e r s e l f . In this situation of r e n e w e d l o n e l i n e s s and isolation. she could no l o n g e r find e n o u g h t i m e to do h e r daily h o u s e w o r k . S h e was c o n s t a n t l y a w a r e o f this m a n ' s distance from h e r o w n spiritual sensibilities and d i s c r i m i n a t i o n s and of his inability to s h a r e hei . the w o m a n w h o had k n o w n the flowing feeling of loving a m a n body and soul. and i n t o l e r a n c e seized her. b u t h e r ability to a b a n d o n h e r s e l f to him r e m a i n e d o n l y a s h a d o w of w h a t it was w i t h h e r f o r m e r lover. e v e n during h e r daily r o u t i n e w h e n she m o s t w a n t e d t o b e d i s t r a c t e d . she tried t o m a s t u r b a t e . h o w e v e r . s h e looked for an o u t l e t in p r o f e s s i o n a l a r t i s t i c w o r k and also r e n e w e d social c o n n e c t i o n s w i t h f o r m e r friends and a c q u a i n t a n c e s . r e t u r n e d t o h e r surprise and h o r r o r . A c o n s t a n t i m p a t i e n c e p u s h e d h e r f r o m o n e thing t o a n o t h e r . a c c o m p l i s h e d n o t h i n g . T h r e e weeks after the separation. T h e s e d i v e r s i o n s . ill will o v e r s h a d o w e d h e r w h o l e day. s p i t e f u l n e s s . T h e y pictured it in t h e i r m i n d s in g r e . A t t r i b u t i n g h e r a n i m o s i t y and t e n s e n e s s t o s e x u a l f r u s t r a t i o n . S h e felt b o x e d in. N o t o n c e did she reach any sexual e x c i t e m e n t t h r o u g h h e r m a s t u r b a t i o n . N e i t h e r h e r irritabili­ t y n o r h e r u r g e s t o stab o r s t r a n g l e disappeared. H e r l o n g i n g for h i m n e v e r left h e r . let alone o r g a s m . R e g u l a Z ü r c h e r e n t e r e d i n t o a s e x u a l r e l a t i o n s h i p with a n o t h e r m a n . T r y i n g t o e x p a n d h e r s e v e r e l y limited w a y o f life. S m a l l w o n d e r t h a t h e r s e x u a l c o n t a c t s w i t h this m a n did n o t help c o u n t e r the u r g e s t o s t a b and s t r a n g l e t h a t s h e c o n t i n u e d t o e x p e r i e n c e t o w a r d h e r d a u g h t e r . as well as for h e r spirituality. e v e n w h e n s h e lay in bed w i t h him. Finally. s h e c h o s e t o end t h e r e l a t i o n s h i p . and a r t i s t i c e n d o w m e n t . S h e felt as lonely as e v e r in his p r e s e n c e . t h e s e u r g e s no l o n g e r e v o k e d a d a n g e r of suicide. loving his wife for h e r w o m a n l y g e n t l e n e s s . T h i s friendship w a s followed by s e v e r a l o t h e r love r e l a t i o n s h i p s in the c o u r s e o f t h e n e x t few y e a r s . b o d y and soul. S i n c e she has b e e n w i t h this m a n . A r e c k l e s s y o u n g d r i v e r lost c o n t r o l of his s p o r t s c a r drove i n t o a g r o u p o f p e d e s t r i a n s . b u t had to stay in for six w e e k s . five y e a r s a f t e r t h e c o n c l u s i o n o f t h e a n a l y t i c c u r e . S h e e m e r g e d w i t h only a b r o k e n s h i n b o n e . He w a s e x c e p t i o n a l l y c h a r i s m a t i c and well k n o w n in his profession far b e y o n d the b o r d e r s of his o w n c o u n t r y . he easily adapted to h e r d e m a n d s for affection and s e x u a l i t y . a m a n she could freely love. R e g u l a Z u r c h e r has n o t e x p e r i e n c e d t h e least sign o f a n y u r g e s to s t a b or s t r a n g l e . S h e h e r s e l f r e c o g n i z e s this as a sign of g r e a t e r f r e e d o m . and ability to love. w h i c h w a s so e s s e n t i a l to h e r . in t h e periods of f r u s t r a t i o n in b e t w e e n . a s well a s t r y i n g t o l e a r n t o love him. vital. and as long as s h e did. T h e s e t o o w e r e o n l y o f a t e m p o r a r y n a t u r e . A n d . T h e p a t i e n t had also lost all o f h e r fear o f going i n s a n e . T h e r e has been o n l y o n e f u r t h e r disruption o f h e r well-being since s e c o n d m a r r i a g e . He also r e s e m b l e d h e r to a g r e a t d e g r e e in his s e n s i t i v i t i e s . R e g u l a Z u r c h e r w a s a m o n g victims. h e r lively intellect. her and the bed . h e r s t a b b i n g and s t r a n g l i n g u r g e s and phobias disappeared c o m p l e t e l y . B u t w h e n e v e r R e g u l a Z u r c h e r allowed h e r s e l f a rich and full a b a n d o n ­ m e n t . a e s t h e t i c j u d g m e n t s . H e appreciated h e r p r e s e n c e . like h e r first real lover.16 EXISTENTIAL FOUNDATIONS e n j o y m e n t of art. R e g u l a Z u r c h e r is especially glad t h a t she is able to b e a r h e r h u s b a n d ' s a b s e n c e s on b u s i n e s s trips for l o n g e r and l o n g e r periods w i t h o u t h a v i n g to fear e v e n a fleeting r e c u r r e n c e of t h e old u r g e s . T h e lack o f e s s e n t i a l h a r m o n y w i t h him had brought her more anguish than release. S h e has n o t f o r g o t t e n h o w suddenly t h e relapses used to set in w h e n she had to g e t along w i t h o u t the physical c l o s e n e s s of a l o v e r for e v e n t w o or t h r e e w e e k s . R e g u l a Z u r c h e r was f o r t u n a t e e n o u g h to find a m a r r i a g e p a r t n e r . h i g h spirited w o m a n . t h e y set i n again w i t h p e r s i s t e n t r e g u l a r i t y . as t h e y had b e f o r e p s y c h o t h e r a p y . T o d a y e v e r y o n e delights in this radiant. and h e r n a t u r a l s e n s e o f h u m o r . N e v e r t h e l e s s . F u r t h e r m o r e . A f t e r a few w e e k s of h o n e s t but futile e f f o r t s to r e s p e c t and accept h e r n e w p a r t n e r a s h e w a s . w h i c h c o n s t a n t l y inspired him t o n e w ideas and c r e a t i v e i m p u l s e s . t e n d e r n e s s . I c o u l d n ' t m o v e my leg e v e n a m i l l i m e t e r . I b e c a m e n o t h i n g m o r e t h a n o n e e n o r m o u s ripping pain. w h e n I look b a c k at m y life b e f o r e and a f t e r t h e e x i s t e n t i a l a n a l y t i c t r e a t m e n t . Y o u k n o w that under the influence of my utterly incompatible parents I was c o m p l e t e l y a l i e n a t e d from m y s e l f and could lead o n l y a s h a d o w life up until t h e b e g i n n i n g of my c u r e by y o u . or a t e a r i n g pain would s h o o t f r o m my leg t h r o u g h my w h o l e body. F r o m h e r hospital bed s h e w r o t e a l e t t e r o f a p p r e c i a t i o n t o h e r f o r m e r t h e r a p i s t . D u r i n g t h e r e m a i n i n g w e e k s o f h e r time a s a n invalid s h e w r o t e s h o r t s t o r i e s . w h i c h w e r e s o u g h t a f t e r by t h e b e s t n e w s p a p e r s . hardly a day w e n t by w h e n h a l f a dozen friends didn't c o m e to visit h e r . In reality I was first b o r n in t h e e x i s t e n t i a l a n a l y s i s t r e a t m e n t . T h e h e a v y pain o f t h e first f e w days e x h a u s t e d h e r c o n s i d e r a b l y . b e c o m e lost in it. A n d so.u n c o n s c i o u s . I felt m y s e l f sink c o m p l e t e l y into this pain. but s o o n she w a s h e r old self again. S h e had r e c o v e r e d totally in t h r e e m o n t h s . I m y s e l f basically n e v e r had a n y t h i n g t o d o w i t h t h e small p e r s o n t h a t I w a s t h e n . f a s t e n e d to t h e bed by t r a c t i o n a p p a r a t u s . e v e n in t h e last w e e k s o f h e r t r e a t m e n t . t o w a r d t h e end o f t h e t r e a t m e n t I t h o u g h t o f m y s e l f m o r e and m o r e o u t r i g h t as a woman without a past or earlier life. I w a s lying flat on my back on the c e m e n t . w h o had t r e a t e d h e r t h r o u g h e x i s t e n t i a l a n a l y s i s . O n l y t h e n did it b e c o m e c l e a r to me t h a t I had p r o b a b l y b r o k e n my s h i n . s t r o n g s i d e w a y s b l o w k n o c k e d me o f f balance. I w a s able to t e a r m y s e l f o u t of this and pull m y s e l f t o g e t h e r again. Luckily.A Test Case: Regula Zürcher 17 S h e described t h e m o m e n t o f impact t h u s : S u d d e n l y . I am a s t o n i s h e d by t h e c o u r s e of my d e v e l o p m e n t . in a r o o m in t h e surgical clinic. I didn't k n o w j u s t e x a c t l y w h e r e it w a s at first. . B e s i d e s t h a t . T i m e dragged. B u t t h e n it flooded t h r o u g h me w i t h l i g h t n i n g speed. T h e pain shifted t o t h e b a c k g r o u n d . T h e people and t h i n g s a r o u n d m e also b e c a m e h a z y and distant. In it s h e r e p e a t e d a richly i n f o r m a t i v e t h o u g h t she had o f t e n e x p r e s s e d . a hard. B e f o r e I k n e w w h a t had h a p p e n e d . A m a d d e n i n g pain s t a r t e d up s o m e w h e r e d o w n in my leg. I n e a r l y lost my s e n s e s and fell h a l f . In t h e first m o m e n t s t h e pain w a s like a ball of h o t . t h a t w a s n o t m e at all. g l o w i n g s t e e l . I fell asleep and a w a k e d n e x t . T h e n a first-aid a t t e n d a n t g a v e me a s h o t . It w a s d o w n low and c a m e f r o m v e r y deep inside. D e s c a r t e s .Chapter 2 THE NATURAL SCIENTIFIC VIEW OF MEDICINE T h e field o f p h e n o m e n a t o w h i c h m o d e r n n a t u r a l scientific r e s e a r c h m u s t r e s t r i c t itself w a s precisely o u t l i n e d by its actual founder. T h e Bible enjoined m a n t o rule o v e r t h e e a r t h and r e n d e r i t s u b j e c t t o h i m . O n l y i n o r g a n i c m a t t e r g r a n t s u s s u c h p e r c e p t i o n . s o t h o r o u g h l y does i t satisfy n a t u r a l law t h a t this v e r y s a t i s f a c t i o n c o n t i n u e s today to s e r v e as the only useful definition for t h e d o m i n a n t n a t u r a l s c i e n c e s . W h i l e t h u s fencing o f f the a r e a w i t h i n w h i c h r e s e a r c h could b e a u t h o r i t a t i v e . His s e c o n d L a w o f C o g n i t i o n reads: It is advisable to a t t e n d o n l y to t h e circle of o b j e c t s for w h i c h o u r n a t u r a l faculties suffice t o p e r c e i v e w i t h c e r t a i n t y and w i t h o u t d o u b t . for t h o u g h a n e m p e r o r m i g h t c o m m a n d the lives and d e a t h s o f s u b j e c t s . T h e n o t i o n o f h u m a n d o m i n a t i o n o f n a t u r e had appeared long b e f o r e . D e m o c r i t u s . D e s c a r t e s e f f e c t i v e l y p r o m i s e d m a n d o m i n i o n o v e r all p h e n o m e n a w i t h i n t h e s e limits. is credited w i t h h a v i n g said t h a t he would r a t h e r find o n e cause t h a n sit on t h e t h r o n e of P e r s i a . He a p p a r e n t l y realized t h a t a m a n w h o l e a r n e d t o r e c o g n i z e precisely calculable causal c o n n e c t i o n s would b e the m i g h t i e r o f t h e t w o . the a n c i e n t G r e e k p h i l o s o p h e r . h e would not k n o w t h e s o u r c e o f his p o w e r . . as m u s t be a s s u m e d for living t h i n g s . e v e n to a t h e r a p e u t i c end.20 EXISTENTIAL FOUNDATIONS B u t D e s c a r t e s w a s t h e first t o p r o m i s e u n e q u i v o c a l l y t h a t m a n would indeed b e c o m e "lord and m a s t e r of n a t u r e " if he would o n l y learn h o w to use t h e n e w c o g n i t i v e m e t h o d o f calculating t h e fixed position o f o b j e c t s . H u m a n e x i s t e n c e can in fact be i n v e s t i g a t e d as a calculable causal r e l a t i o n s h i p a m o n g o r g a n i c s t r u c t u r e s . is the j u s t i f i c a t i o n for applying t h e r e s e a r c h m e t h o d o f n a t u r a l s c i e n c e t o medical p r a c t i c e . also g u a r a n t e e s t h a t t h e o b j e c t s w h i c h are being successfully m a n i p u l a t e d are c o m p e t e n t l y u n d e r s t o o d . diseased m a n . h e tells us. L a w s t h a t g o v e r n spatial o r t e m p o r a l e f f e c t s w h i c h m o v e f r o m a distance t o w a r d a goal. d e m a n d to be u n d e r s t o o d f r o m a second and teleological p e r s p e c t i v e . physicists h a v e r e c e n t l y m a d e b i o l o g i s t s p a r t i c u l a r l y a w a r e t h a t t h e laws o f physics can l e g i t i m a t e l y d e s c r i b e only e f f e c t s t h a t t r a v e r s e o n e point and its i m m e d i a t e vicinity and o c c u p y n e i g h b o r i n g m o m e n t s i n t i m e . and t r a n s f e r r e d it to t h e i r o w n o b j e c t of study. had already r e c o g n i z e d t h a t scientific t h o u g h t . T h e v e r y simplest b e i n g s . t h e y u n h e s i t a t i n g l y adopted t h e i n v e s t i g a t i v e principle of the c e r t a i n t y of e x a c t m e a s u r i n g calculation. B e c a u s e it held o u t this p r o m i s e . for i n s t a n c e . T h e rich yield physicians have reaped. T h e y applied t h e C a r t e s i a n principle o f i n v e s t i g a t i o n to an o b j e c t of study—diseased h u m a n b e i n g s — w h o can in no w a y be finally calculated and t h e r e b y fixed. T h i s . T h e old vitalists. and also for t h e i n c r e a s e of individuals. for in p u r s u i n g t h e i r task. t h o u g h t it n e c e s s a r y to posit a u n i q u e life force to a c c o u n t for the m o s t c o n s p i c u o u s p r o p e r t i e s of living t h i n g s . B e y o n d this. Physicians h a v e f r o m t i m e i m m e m o r i a l c o n s i d e r e d t h e i r p r i m a r y o b j e c t i v e to be m a s t e r y o v e r at least t h e diseases of m a n . physicians in fact flagrantly i g n o r e d D e s c a r t e s ' s w a r n i n g . an o b j e c t in space. in spite of t h e i r violation of the limits D e s c a r t e s indicated. particularly for the a s t o u n d i n g m a i n t e n a n c e o f equilibrium b e t w e e n t w o v a r y i n g c h e m o physical p r o c e s s e s . B u t n o m a n i p u l a t i o n . w h i c h applied only t h e principle of c a u s a l i t y . E v e n biological r e s e a r c h e r s placed additional c o n c e p t i o n s alongside t h e purely causal p e r s p e c t i v e in t h e i r s c i e n c e and in m e d i c i n e . K a n t . simply. n o m a t t e r h o w striking. by this t i m e . did n o t suffice to c o m p r e h e n d living b e i n g s . physical and c h e m i c a l p r o c e s s e s in specific l o c a t i o n s in space. S o m e t h i n g a b o u t this e x i s t e n c e (and this s o m e t h i n g c o n f o r m s w i t h t h e life o f o t h e r o r g a n i c b e i n g s ) does allow its i n t e r p r e t a t i o n as. It w a s n o t self-evident t h a t this t r a n s p l a n t a t i o n o f m e t h o d would produce t h e a s t o u n d i n g s u c c e s s e s o f m o d e r n m e d i c i n e . . s t e m s f r o m a r a t h e r a s t o n i s h i n g aspect o f h u m a n e x i s t e n c e . t h e n . T h r o u g h p r o c e d u r e s o f n a t u r a l s c i e n c e t h e physical basis o f h u m a n e x i s t e n c e can be i n t e r p r e t e d and the h u m a n body m a n i p u l a t e d . T h i s n e w science c l a i m s t h a t i t can r e s t o r e t o t h e rule o f o n e causal m o d e o f t h o u g h t all t h e p r o p e r t i e s w h i c h had s e e m e d r e s e r v e d o n l y for the living. T h i s decision will d e t e r m i n e and limit b o t h t h e s o u n d n e s s o f any f o u n d a t i o n for m e d i c i n e possible n o w and t h e f u r t h e r practical and e p i s t e m o l o g i c a l possibilities of t h a t f o u n d a t i o n as well. C o n s e q u e n t l y W i e n e r defines t h e h u m a n being as a " m e s s a g e . " w h i c h .. m e a n s n o t h i n g but a spatially or t e m p o r a l l y o r d e r e d s y s t e m or model of c h e m i c a l particles or e l e c t r i c a l i m p u l s e s t h a t is a b s o l u t e l y quantifiable and e x a c t l y m e a s u r a b l e . N o r b e r t W i e n e r . b u t t h e y w e r e all t u r n e d aside w i t h a single parry by c y b e r n e t i c s . t h e laws of p r o b a b i l i t y e n t i r e l y rule o u t t h e e x p e c t a t i o n t h a t an o r g a n i s m o f the c o m p l e x i t y o f a s q u i r r e l m i g h t e m e r g e p h y l o g e n e t i c a l l y f r o m t h e d o m i n a n c e o f m e r e n a t u r a l laws. and u n c o n d i t i o n a l r i g h t s t o m e d i c i n e .. 1 We shall t r y t h e s e e x p l a n a t o r y capabilities on a p r o c e s s t h a t m a k e s up R e g u l a Z u r c h e r ' s e x i s t e n c e after she has r e c o v e r e d . a b s o l u t e .e. c y b e r n e t i c s i s u n d e r t a k i n g t o a c c o u n t c o m p l e t e l y n o t o n l y for g o a l o r i e n t e d equilibrium p h e n o m e n a in living b e i n g s (i. t h e f o u n d e r o f c y b e r n e t i c s . c h a r a c t e r i z e s his c o n c e p t o f i n f o r m a t i o n a s s o m e t h i n g t o t a l l y n o v e l and d e s c r i b e s " i n f o r m a t i o n " itself a s n o l o n g e r m e r e l y e n e r g e t i c o r m e r e l y m a t e r i a l . T h e s e o b j e c t i o n s from p h i l o s o p h y . as t h e t e r m is used in i n f o r m a t i o n t h e o r y . and t h e r e f o r e u n d e r the rule o f t h e causal principle. for e x a m p l e . A c c o r d i n g ­ ly. B u t t h e l e g i t i m a c y o f c y b e r n e t i c s and i n f o r m a t i o n t h e o r y falls e n t i r e l y w i t h i n t h e d i m e n s i o n s o f scientific calculability n e v e r t h e l e s s . physics. p r e d e t e r m i n e d ) f o r m . b u t for t h e p r o p a g a t i o n o f individuals and t h e i r h e r e d i t a r y f u n c t i o n s as well. W i t h its t h e o r i e s of f e e d b a c k and i n f o r m a t i o n .s u s t a i n i n g h o m e o s t a s i s o f c h e m o p h y s i c a l p r o c e s s e s ) . w h y cell division in an o r g a n stops j u s t w h e n t h e o r g a n r e a c h e s its p r o p e r (i. P h y s i c a l . T h e m a t t e r o f deciding w h e t h e r this m e t h o d can l e g i t i m a t e l y m a k e s u c h a claim is f u n d a m e n t a l l y i m p o r t a n t for medical s c i e n c e . W e shall call n a t u r a l s c i e n c e ' s p o w e r s o f e x p l a n a t i o n t o a c c o u n t and shall t e s t t h e i r ability to stand up in t h e face of c o n c r e t e data from a specific c a s e h i s t o r y . O n e could hardly find a m o r e radical f o r m u l a t i o n for t h e i n t e n t o f t h e n a t u r a l scientific r e s e a r c h m e t h o d t o s e c u r e e x c l u s i v e . T h e r e is no r o o m for speculation and a b s t r a c t i o n t h a t d o n o t directly c o n c e r n t h e p h e n o m e n a o f h u m a n p a t h o l o g y .The Natural Scientific View of Medicine 21 c a n n o t e x i s t in t h e scientific c o n c e p t i o n of physics. W e c h o o s e this r a t h e r t h a n a p a t h o l o g i c a l c a s e in point to w o r k from b e c a u s e s i c k n e s s is invariably n o t h i n g m o r e t h a n deficient h e a l t h i n e s s . O n l y w h e n w e have . and b i o l o g y c h a l l e n g e d t h e u n c o n d i t i o n a l j u s t i f i c a t i o n o f t h e n a t u r a l scientific r e s e a r c h m e t h o d i n m e d i c i n e . t h e s e l f .c a u s a l laws could n e v e r explain.e. a p p a r e n t l y in spite of o u r s e l v e s . t h e desire t o b e c l o s e r t o him. the feeling o f pleasure. S i n c e the n u m b e r o f n a t u r a l scientific a t t e m p t s t o explain t h e n o r m a l . It is 11 c m e n d o u s l y i m p o r t a n t to see t h a t this e n c o u n t e r w i t h h e r l o v e r is . and h u g s and k i s s e s h i m . t o speak o f p h e n o m e n a t h a t clearly display s o m e t h i n g n o n p h y s i c a l : t h e p e r c e p t i o n o f t h e lover. h e r act of will in r u n n i n g to h e r lover. T h e n t h e y walk h o m e a r m in a r m . T h i s t i m e she r u s h e s a c r o s s t h e s t r e e t t o h e r lover. particularly its " a f f e c t i v e c o l o r a t i o n . T h i s c o u r s e o f e v e n t s c o n f o r m s t h o r o u g h l y t o h e r vivacious. T h e n a t u r a l scientific m e t h o d o f i n v e s t i g a t i o n b e g i n s b y dividing such a p h e n o m e n o n i n t o t h r e e s e p a r a t e p r o c e s s e s . c h e e r f u l n a t u r e and m a y s e r v e as a c o n v e n i e n t model of n o r m a l . h e r h e a r t pounding w i t h delight. t h e y e a r b e f o r e . " is i m p o r t a n t in d e t e r m i n i n g fixation in m e m o r y . h e a l t h y m a n i f e s t a t i o n s o f h u m a n e x i s t e n c e h a s g r o w n s o i n o r d i n a t e l y large lately. O u r s t a t e m e n t s a s s u m e d a c o n s c i o u s n e s s as a precondition for t h e s e activities. and we did n o t begin to n o t i c e the physicality o f R e g u l a Z i i r c h e r until w e o b s e r v e d t h e m o t o r r e a c t i o n t o t h e perceptual s t i m u l u s . and especially r e g a r d i n g t h e i r r e m i n i s c e n c e s a b o u t a past v a c a t i o n . on the o t h e r h a n d . It has long b e e n r e c o g n i z e d t h a t p r o c e s s e s of p e r c e p t i o n are a l w a y s a c c o m p a n i e d b y c e r t a i n m o t i v e impulses. discussing plans for t h e i r c o m i n g v a c a t i o n in a place both k n o w v e r y well. B u t w h a t is m o s t significant h e r e is t h a t in d e s c r i b i n g an i n s t a n c e of h e a l t h y b e h a v i o r in o u r test case we c a m e . h y s t e r i c a l l y lamed. A n d long a g o it w a s s e e n t h a t t h e m o d e of p e r c e p t i o n . N a t u r a l scientific p h y s i o l o g y realizes t h a t a c e r t a i n artificiality a t t a c h e s to this subdividing. T h i s perception is followed by a r e c o g n i t i o n : this m a n is h e r lover. T h i s r e s t r i c t i o n will n o t h a r m the m a t t e r at hand. h e a l t h y human behavior. we can n e v e r derive a p i c t u r e of h u m a n h e a l t h from d e f e c t i v e pathological m a n i f e s t a t i o n s . T h e first is identified as a process of perception: R e g u l a Z i i r c h e r p e r c e i v e s a m a n a c r o s s t h e s t r e e t .22 EXISTENTIAL FOUNDATIONS seen well e n o u g h i n t o h e a l t h i n e s s can w e u n d e r s t a n d p a t h o l o g i c a l m a n i f e s t a t i o n s . n a t u r a l scientific e x p l a n a t i o n s speak n e x t of a memory performance. w e shall u s e single e x a m p l e s t o r e p r e s e n t w h o l e a r e a s o f related natural scientific f o r m u l a t i o n s . t h e t h o u g h t o f r u s h i n g o v e r t o him. w h i l e . impulsive. and the i m p u l s e of will. t h e r e c o l l e c t i o n . Finally. In r e f e r r i n g to this r e c o g n i t i o n . h e r r u s h i n g to h e r l o v e r is s e e n as a third p r o c e s s . a motor reaction. t h e p e r f o r m a n c e of an impulse of will. T h e first m a n i f e s t a t i o n o f h e a l t h i n e s s w e find i n R e g u l a Z i i r c h e r ' s life is her behavior when she unexpectedly meets the man at whose glance she had collapsed. for all i n t e r p r e t a t i o n s w h i c h c o n f o r m in t h e i r f u n d a m e n t a l s h a v e t h e s a m e kind o f l e g i t i m a c y and t h e s a m e limits. from scientific s t a n d p o i n t . o r t h e c y b e r n e t i c . 3 . desire. n a t u r a l s c i e n c e can d o n o t h i n g b u t m e a s u r e and r e c k o n . Faced w i t h this ticklish s i t u a t i o n . calculable m a t e r i a l and e n e r g e t i c . " n o n .m a t e r i a l and n o n e n e r g e t i c e n t i t i e s " a r e a s s u c h u n w e i g h a b l e . a c t i o n . M a n y will n o t discuss the psychic at all. B u t g i v e n its philosophical predisposition. contestable. and p a r t i c u l a r l y n e u r o l o g y . p o s i t i o n s . W h a t d o t h e e x p l a n a t i o n s o f n a t u r a l s c i e n c e say a b o u t p e r c e p t i o n . volition. n a t u r a l scientific r e s e a r c h e r s h a v e taken widely v a r y i n g . M c L e a n holds t h a t this logical i n c o n s i s t e n c y can be g o t t e n a r o u n d if we will avail o u r s e l v e s of a n e w definition for t h e "psychic. ' " ( T h e t e r m " m i n d " c o r r e s p o n d s t o D e s c a r t e s ' s cogitatw. as n o n s o m a t i c s t r u c t u r e s and as p r o c e s s e s neither material nor energetic in nature. t h i n k i n g . even a n a t u r a l scientific i n v e s t i g a t o r ." In t h e past 1 0 0 y e a r s t h e old G r e e k n o t i o n t h a t t h e " p s y c h e " is capable of an i n d e p e n d e n t e x i s t e n c e h a s gradually died o u t and the mind h a s c o m e to be looked upon as i n s e p a r a b l e from a f u n c t i o n i n g o r g a n i c s y s t e m . u n m e a s u r a b l e . b u t also t h o s e o f volition. C o n s e q u e n t l y . and opinion.The Natural Scientific View of Medicine 23 m a d e u p o f e v e n t s t h a t p r e s e n t t h e m s e l v e s t o e v e r y o b s e r v e r . e v e n opposing. especially c o n s i d e r e d as an o r g a n i c s y s t e m s e r v i n g t o adjust t h e total o r g a n i s m t o t h e e n v i r o n m e n t . and t h e r e f o r e also u n c a l c u l a b l e . r e m e m b e r i n g . 2 M c L e a n o p e n s his a t t e m p t b y allowing t h a t e v e r y r e p r e s e n t a t i o n w h i c h c o m b i n e s t h e p s y c h e w i t h a s o m a is. " T h e definition could h a v e g o n e a s t e p f u r t h e r and s t a t e d t h a t t h e c e n t r a l n e r v o u s s y s t e m i s r e c o g n i z e d a s being t h e e s s e n t i a l c o m p o n e n t o f the organic system. and c o n s c i o u s ­ n e s s ? N a t u r a l scientific m e d i c i n e . feeling. w h i c h includes n o t o n l y t h e c o n c e p t o f t h i n k i n g . b y a t t e m p t i n g t o derive t h e psychic e n t i r e l y f r o m t h e s o m a t i c . which is w h a t t h e m o d e r n r e s e a r c h e r is in t h e h a b i t of addressing as the s u m of m a t e r i a l s t r u c t u r e s and c h e m o p h y s i c a l p r o c e s s e s holding t h e h u m a n body t o g e t h e r . T h e psychic a s p e c t i s m o r e n a r r o w l y defined b y o n e leading neurophysiologist—I refer to McLean—as "the non-material attributes o f t h e ' m i n d . b u t m o s t spend c o n s i d e r a b l e t i m e and e f f o r t t r y i n g to find s o m e w a y t o bring t h e psychic back i n t o t h e realm o f t h e m e a s u r a b l e . label "psychic" anything which is not immediately perceived as somatic. For the assumption of a closer relationship between the two c a r r i e s t h e implicit n o t i o n t h a t t h e n o n m a t e r i a l p s y c h e m a y affect the s u b s t a n c e o f t h e body. o n e can today pick up a s t a n d a r d d i c t i o n a r y and find " p s y c h e " defined as " t h e mind.) N o w . r e c o g n i t i o n . such i n t r o s p e c t i o n b e c o m e s possible b e c a u s e t h e n e r v o u s s y s t e m can. . I n the light of this and t h e f o r e g o i n g c o n s i d e r a t i o n s . c o n t r i b u t i n g t o and c o n d i t i o n e d b y t h o s e neural locales and activities c o n c e r n e d w i t h set o r a f f e c t — t h a t t h e s e neural activities do t h e m s e l v e s lead to and a r e in fact t h e v e r y e s s e n c e of t he private e v e n t of p e r c e p t i o n . H e also a d m i t s t h a t i f t h e r e w e r e n o s u b j e c t i v e i n t r o s p e c t i o n . a s p e r c e p t i o n . feelings. c o n s c i o u s n e s s . In o r d e r to g r a s p physiologically t h e n o n m a t e r i a l psychic aspect of a c o n s c i o u s n e s s and of p e r c e p t i o n . M o u n t c a s t l e a d v a n c e s a " t h e o r e t i c a l a l t e r n a t i v e " for clarifying this p r o b l e m . t h a t t h e n e u r a l activity set in m o t i o n by s e n s o r y stimuli. a p s y c h o l o g i c a l p r o c e s s m i g h t be i n f e r e n t i a l l y defined as a n e u r o n a l l y d e t e r m i n e d p r o c e s s w h i c h derives i n f o r m a t i o n i n c o n j u n c t i o n w i t h s o m e e l e m e n t o f s u b j e c t i v i t y and w h i c h m a y or m a y n o t u s e this i n f o r m a t i o n to effect a decision. " M c L e a n b e l i e v e s . and t h o u g h t s . S u c h a definition o f t h e " p s y c h o l o g i c a l f u n c t i o n s o f the n e r v o u s s y s t e m . e v o l v e s an activity of its o w n w h i c h is r e g a r d e d as a basically m e n t a l or psychic t h i n g . and t h e o t h e r c o n c o m i t a n t a s p e c t s o f t h e i n n e r life o f m a n . S. as it w e r e . M o u n t c a s t l e b e l i e v e s t h a t 4 On t h e o n e h a n d is t h e c o m m o n l y held idea t h a t t h e r e is r e p r e s e n t e d in n e u r a l space and t i m e an i s o m o r p h i c p h a n t o m of the real w o r l d . w h i c h m a y b e s u m m a r i z e d u n d e r t h e t e r m p s y c h o n e u r a l identity. i s " c o m p a t i b l e w i t h scientific o b j e c t i v i t y . p e r c e p ­ t i o n s . F r o m this h e d r a w s t h e surprising c o n c l u s i o n : I t i s t h e e l e m e n t o f s u b j e c t i v i t y t h a t m o s t clearly d i s t i n g u i s h e s p s y c h o l o g i c a l from o t h e r f u n c t i o n s o f t h e n e r v o u s s y s t e m . I n M c L e a n ' s t h i n k i n g . . . M c L e a n i m m e d i a t e l y s e e s t h a t h e m u s t a c k n o w l e d g e t h e impossibility o f deriving p s y c h i c f u n c t i o n s directly f r o m t h e c h e m o p h y s i c a l and i n f o r m a t i o n a l data t h a t can be g a t h e r e d from t h e brain and its f u n c t i o n s . complexed a g a i n s t s t o r e d i n f o r m a t i o n . and.24 EXISTENTIAL FOUNDATIONS His c o m m o n falsification o f t h e a n c i e n t G r e e k c o n c e p t o f p s y c h e aside. at c h o i c e . " V. deriving input from this c o n j u n c t i o n . n e u r o p h y s i o l o g i s t s would n e v e r h a v e b e e n able to f o r m u l a t e even a single t h o u g h t a b o u t p s y c h i c realities o r a w a r e n e s s . a phantom then surmised to be interfaced with some other process of • u n c e r t a i n n a t u r e w h i c h . s u c c e s s i v e l y t r a n s f o r m e d t h r o u g h successively interconnected populations of neurons. reflect and i n t e r p r e t t h e flow of data t h r o u g h a m i r r o r l i k e s u b j e c t i v i t y in which it is r e f l e c t e d . its public e x p r e s s i o n . On t h e o t h e r hand is t h e set of a s s u m p t i o n s c o m p o s i n g t h e modus labori o f m a n y n e u r o p h y s i o l o g i s t s . T h a t is. e m o t i o n s . 5 M o u n t c a s t l e ' s n o t i o n o f the " e s s e n c e " o f t h e psychic and t h e a t t r i b u t e s M c L e a n assigns t o t h e psychic a r e s t r i k i n g l y similar.The Natural Scientific View of Medicine 25 in t h e f o r m of a d i s c r i m i n a t i o n . t h a n k s t o it. or a description of q u a l i t y . C o n s i d e r i n g t h e s e similar s t a t e m e n t s o f d o u b t i n t h e M c L e a n and M o u n t c a s t l e articles. B o t h w r i t e r s are r e p r e s e n t a t i v e . a b s t a i n s f r o m t r e a t i n g t h e psychic as t h e p r o d u c t i o n of " n e u r a l a c t i v i t y " in o r d e r to indicate m o r e accurately how we might envision a production of the "psychic through n e u r a l a c t i v i t y .r a t e . m a t e r i a l n e r v o u s s y s t e m can hold a m i r r o r to itself and c o m p r e h e n d its o w n significance f r o m t h e r e f l e c t i o n it p e r c e i v e s . a localization. as typical as t h e y are f i r s t . He says. including w h a t is called p s y c h i c . M o u n t c a s t l e c o n f e s s e s i n the end t h a t " o u r u n d e r s t a n d i n g o f these things in these terms (the production of mental experience t h r o u g h n e u r a l activity) i s p r e s e n t l y v e r y primitive i n d e e d . " Still less c o m p r e h e n s i b l e to him is t h e w a y in w h i c h a n e u r a l activity m i g h t b e c o m e t h e actual e s s e n c e o f t h e p s y c h i c . ' since w e h a v e a t o u r disposal n o o t h e r basis for c o n s c i o u s e x p e r i e n c e e x c e p t p r o c e s s e s of e x c i t a t i o n in t h e brain. it is n o t s u r p r i s i n g t h a t b o t h end in e s s e n t i a l l y t h e s a m e s o r t o f r e s i g n a t i o n . of t h e p s y c h o n e u r a l identity t h e o r y w h i c h p r e d o m i n a t e s i n m o d e r n m e d i c i n e ." R o h r a c h e r believes t h a t h e can d i f f e r e n t i a t e a m o n g t h e s e . " T h e m o s t c o n s e q u e n t i a l t r e a t m e n t s o f t h e psychic aspect are b y researchers working from cybernetics. "It is c l e a r t h a t a c e r e b r a l t h e o r y of psychic p r o c e s s m u s t c o n c e r n itself a b o v e all w i t h t h e s e ' e x c i t a t i o n s . H o w t h e n e r v o u s s y s t e m can u s e c h e m o p h y s i ­ cal p r o c e s s e s t h a t take place in i t s e l f to p r o d u c e v o l u n t a r y decisions and o t h e r psychic f u n c t i o n s u l t i m a t e l y r e m a i n s a " c o m p l e t e m y s t e r y " for M c L e a n . t h e c h e m o p h y s i c a l l y d e t e r m i n a b l e . o n t h e o t h e r h a n d . H. Rohracher undertakes to derive all psychic f u n c t i o n s f r o m " e x c i t a t i o n s " in t h e n e r v e cells. M o u n t c a s t l e ' s proposal. H o w is M c L e a n ' s i n t r o d u c t i o n of a s u b j e c t i v e e l e m e n t to bring us o n e step c l o s e r to u n d e r s t a n d i n g a n y t h i n g psychic if we are n o t at t h e s a m e t i m e given precise i n s t r u c t i o n i n t h e n a t u r e o f this s u b j e c t i v e e l e m e n t ? M c L e a n should be able to tell us at least h o w this e l e m e n t is so c o n s t i t u t e d that. B o t h are c o n v i n c e d t h a t it is t h e t a s k of n e u r o p h y s i o l o g y to explain all h u m a n b e h a v i o r in n e u r a l t e r m s . Y e t only b e c a u s e t h e y h a v e u n t h i n k i n g l y t a k e n w h a t n a t u r a l s c i e n c e has declared to be t h e e s s e n c e of t h e o r g a n i c as c r i t e r i a for t h e i r d e t e r m i n a t i o n o f the psychic a r e t h e y able t o s i m u l a t e a n y c o m p a t i b i l i t y b e t w e e n t h e i r definitions o f " p s y c h i c f u n c t i o n s " and scientific o b j e c ­ tivity. an e s t i m a t e d m a g n i t u d e . the neurophysiological explanations of inspired by c y b e r n e t i c s are e x e r t i n g an e v e r g r e a t e r m l l u e n i e m medicine. w i t h all o f t h e c h e m o e l e c t r i c a l chain r e a c t i o n s t h a t g o w i t h it. T h e solution (to a t h o u g h t . " He h a s in mind d i f f e r e n c e s in t h e f r e q u e n c i e s and a m p t i t u d e s of t h e electrical impulses and d i f f e r e n c e s in the r a t e s at w h i c h t h e y are p r o p a g a t e d in the n e r v o u s s t r u c t u r e of the brain. ' Even less c o m p r e h e n s i b l e is h o w t h e r e could possibly be a " c o n t r a d i c ­ t i o n " a m o n g t h e e x c i t a t i o n s o f individual n e r v e cells. W h a t t a k e s place in t h e s e cells is—properly s p e a k i n g — o n l y repetition o f such p r o c e s s e s a s t h e rapid e x c h a n g e o f p o t a s s i u m i o n s . s e n s e . g e n u i n e l y e x c i t e d . As he s e e s it. or b e c o m e . s t r i c t l y speaking. and physicians c a n n o t dispense with a t h o r o u g h c o n s i d e r a t i o n o l its f u n d a m e n t a l s . T h u s . b u t r e q u i r e s as well a d i f f e r e n c e in the types of the participating e x c i t a t i o n s . o r the c o n v i c t i o n t h a t a s o l u t i o n to a p r o b l e m is c o r r e c t . Despite human such phenomena . n o t h i n g to do w i t h an e x c i t a t i o n . can no m o r e be derived from a sodium p o t a s s i u m e x c h a n g e in t h e cells of t h e brain t h a n an e x c i t a t i o n could be.2o EXISTENTIAL FOUNDATIONS " f u n d a m e n t a l " c e r e b r a l e x c i t a t i o n s . Rohracher's theory of cognition is grounded on the hypothesis that "the laws of logic a r e in t r u t h laws of e x c i t a t o r y a c t i v i t y in the c e r e b r u m . C o n t r a d i c t i o n a s s u m e s diction. absurdities. cells t h e m s e l v e s can n e v e r c o n t r a d i c t e a c h o t h e r . N o m a t t e r h o w fast such an e x c h a n g e m a y g o . o n e billiard ball can b u m p into a n o t h e r . A n d the ability t o t h i n k a b o u t the M a t t e r h o r n o r social j u s t i c e . T o speak o f excited n e r v e cells is t a n t a m o u n t to a n t h r o p o m o r p h i z i n g c h e m o e l e c t r i cal p r o c e s s e s .p r o b l e m ) lies in t h e u n i f i c a t i o n of the c o n s t e l l a ­ tions (of e x c i t a t i o n s ) to p r o d u c e a total c o n s t e l l a t i o n . scientific. O n l y a w h o l e living being can ever be. j u s t a s t h e y are n e v e r in a position to e f f e c t t h e psychic s y m p t o m of t h e c o n v i c t i o n t h a t a solution to a p r o b l e m is c o r r e c t . " 0 T h i s t h e o r y et o n c e raises the o b j e c t i o n t h a t in a strict. t h e r e can b e n o s u c h t h i n g a s e x c i t e d n e r v e cells. Cell r e a c t i o n s can w o r k a g a i n s t e a c h o t h e r . B u t speech is a l w a y s an i n d i c a t o r of m e a n i n g w h i c h a r e c e p t i v e being has perceived in s o m e t h i n g it e n c o u n t e r s . it is possible t h a t " t h e d i f f e r e n c e b e t w e e n t h e t h o u g h t ' M a t t e r h o r n ' and the c o n t e n t 'social j u s t i c e ' c o n s i s t s n o t m e r e l y in a d i f f e r e n c e in t h e n u m b e r of participating e x c i t a t i o n s . Cells can n e v e r perceive t h e m e a n i n g o f s o m e t h i n g o n t h e basis o f a n ion e x c h a n g e . and the psychic s y m p t o m t h a t such a c o n s t e l l a t i o n has f o r m e d is t h e c o n v i c t i o n t h a t t h e solution is c o r r e c t : t h e r e is no l o n g e r any c o n t r a d i c t i o n a m o n g the individual e x c i t a t i o n s . it h a s . t h e capacity to speak. b u t n e v e r can it c o n t r a d i c t t h a t o t h e r . T h i s h a p p e n s w h e n s o m e t h i n g t h a t has just s t a r t l e d i t has been perceived as o b t r u s i v e and understood as s o m e h o w u n s e t t l i n g . C y b e r n e t i c s n o w h e r e p r o v e s t h a t this identification is justified. . b u t it is n e v e r t h e l e s s . 7 M e a n t i m e . i n f o r m a t i o n a l c o n c e p t s add n o t h i n g decisively n e w t o t h e t h e o r y o f t h e s e n s e s . for " i n f o r m a t i o n " originally m e a n s t h e t r a n s m i s s i o n o f a m e s s a g e a m o n g socially o r g a n i z e d people. T h e v e r y n a m e w a s b o r r o w e d from s o c i o l o g y . in its f o u n d e r ' s c o n c e p t i o n . this would c o n t i n u e p h y s i o l o g y ' s peculiar tradition of d r a w i n g its t e r m i n o l o g y from the m o m e n t a r i l y prevailing n a t u r a l s c i e n c e and t e c h n o l o g y instead of s e t t i n g up an i n d e p e n d e n t t h e o r e t i c a l f r a m e ­ w o r k for i t s e l f . " In addition. w h e n e v e r p h y s i o l o g y and biology i n t r o d u c e i n f o r m a t i o n t h e o r y into their bodies o f k n o w l e d g e . H e n s e l .l o n g c r i t i q u e of i n f o r m a t i o n t h e o r y . W h a t could have b e e n m o r e w e l c o m e t o n e u r o p h y s i o l o g i s t s than such a c o n c e p t o f i n f o r m a t i o n ? W h a t else could h a v e g i v e n t h e m g r e a t e r h o p e s of h a v i n g found. writes: S e e n from a philosophical s t a n d p o i n t . I n f o r m a ­ tion i s c o m m u n i c a t i o n . at long last. W h e n e v e r c o n t e m p o r a r y i n f o r m a t i o n t h e o r y is applied to biology and p h y s i o l o g y . I n relation t o t h e p h e n o m e n a t h e m s e l v e s .The Natural Scientific View of Medicine 27 C y b e r n e t i c t h i n k i n g is based on t h e c o n c e p t s of i n f o r m a t i o n and feed­ back of bits of i n f o r m a t i o n . I n f o r m a t i o n is n e i t h e r simply m a t e r i a l n o r simply e n e r g e t i c . for i n s t a n c e . o f m e a n i n g f u l c o n t e n t w h i c h h a s b e e n revealed t o t h e i n f o r m a n t s b y s o m e t h i n g e n c o u n t e r e d in t h e i r s h a r e d w o r l d . t h e y h a v e the s a m e a r b i t r a r y c h a r a c t e r a s t h e c o n c e p t u a l f r a m e w o r k s o f e v e r y o t h e r positive s c i e n c e . a m o n g h u m a n b e i n g s . i n f o r m a t i o n suddenly b e c o m e s a p a r t i c u l a r a r r a n g e ­ m e n t o f c h e m o p h y s i c a l p r o c e s s e s and s t r u c t u r i n g s w h i c h e n t e r t h e brain a l o n g w i t h p e r c e p t i o n s and c o m m u n i c a t i o n s . concluding a c h a p t e r . t h e t r a n s m i s s i o n . a d e s c r i p t i v e principle t h a t m i g h t help t h e m g e t a scientific hold on e v e n t h o s e psychic m a n i f e s t a t i o n s t h a t had b e e n o u t o f r e a c h b e c a u s e t h e y could n o t b e m e a s u r e d ? F o r m a n y p h y s i o l o g i s t s . t h e y a r e n o t m e r e l y b o r r o w i n g the c o n c e p t i o n s o f i n o r g a n i c o b j e c t s t h a t t e c h n i c a l scientific t h i n k i n g provides b u t a r e taking loans from sociology a s well. quantitatively measurable. and w h i c h can b e m e a s u r e d and quantified f r o m the brain m a t t e r . H. d i s i l l u s i o n m e n t set in at o n c e . B a s i n g a t h e o r y o f p e r c e p t i o n o n c y b e r n e t i c s would b e adding t o t h e old e r r o r o f n a t u r a l i s m a n e w o n e — " c y b e r n e t i c i s m " or " i n f o r m a t i s m . y e t i n f o r m a t i o n as the m e a s u r a b l y o r d e r e d s y s t e m o f c h e m o e l e c t r i c a l p r o c e s s e s i s n o n e t h e l e s s c o n s i d e r e d t h e f u n d a m e n t a l i d e n t i t y o f t h e p s y c h i c and the s o m a t i c . p r e f e r r i n g t o set aside the unclarified c o n c e p t o f i n f o r m a t i o n . It is e n t i r e l y b e y o n d t h e capabilities o f a n y t h i n g m a t e r i a l o r e n e r g e t i c . " B u t in fact t h e r e is in i n f o r m a t i o n p r o c e s s e s in t h e brain n o t a t r a c e of a m e s s a g e . i n t h e m s e l v e s dark and e m p t y . I he vei y nol ion of a " c o r r e l a t i o n . relay. is n o t to establish a r e l a t i o n s h i p t h a t is a n y less q u e s t i o n a b l e . " " a t t e n d i n g . In t h e p r o c e s s it e x a g g e r a t e s and anthropomorphizes these molecular systems into analogs to con­ s c i o u s n e s s o r c o n s c i o u s n e s s l i k e m e s s a g e s . R a t h e r . " of a " j o i n i n g " and " c o u p l i n g . c a n n o t c o m e t o t e r m s with t h e r e l a t i o n s h i p b e t w e e n p s y c h e and s o m a . t h e s e specifically h u m a n p h e n o m e n a are a l w a y s directly r e l a t e d — s t r i c t l y s p e a k i n g — t o the p e r c e p t i o n and c o m m u n i c a t i o n of m e a n i n g . T h u s i t t a k e s t h e affiliations a m o n g e l e c t r o c h e m i c a l s y s t e m s and i n f o r m a t i o n s y s t e m s t o b e j u s t a n o t h e r cause-effect relationship. s y m b o l . C a u s a l i t y m e a n s r e d u c t i o n t o t h e purely f o r m a l l e g i t i m a c y o f t e m p o r a l s u c c e s s i o n . Besides. or l a n g u a g e to be found as such. including m a t e r i a l e n e r g e t i c s y s t e m s .28 EXISTENTIAL FOUNDATIONS T o stop r e l a t i n g t h e psychic aspect t o t h e n e r v o u s s y s t e m ' s c h e m o p h y s i c a l b a s e and r e l a t e i t i n s t e a d t o t h e s y s t e m ' s m o l e c u l a r structure. r e m a i n s as indefinite as it is in p h y s i o l o g y . " or " j o i n i n g " ass limes • > previous dividing and objectifying of h u m a n e x i s t e n c e into . the psyche. Even t h e m o s t c a u t i o u s brain r e s e a r c h e r s . T h e v a g u e n e s s with w h i c h e x a c t s c i e n c e defines i n f o r m a t i o n s t r e n g t h e n s t h e t e n d e n c y t o use this definition a s t h e basis for supposed i n t e r a c t i o n s b e t w e e n all s o r t s of s y s t e m s . script." as " m o l e c u l a r s c r i p t " or " t r a n s l a t i o n . It is impossible to o v e r l o o k t h e p r o f o u n d d i f f e r e n c e s b e t w e e n c h e m i s t r y and l a n g u a g e u n l e s s o n e ' s vision i s s o i n t e n t o n t h e c o n c e p t o f i n f o r m a t i o n t h a t e v e r y t h i n g else m u s t a p p e a r d i s t o r t e d . I t r e d u c e s t h e h u m a n ability t o perceive m e a n i n g t o specific c h a i n r e a c t i o n s o f m o l e c u l a r p r o c e s s e s i n s t e a d o f c r u d e c h e m o p h y s i c a l b r a i n a c t i v i t y . But the new vocabulary of information t h e o r y t a m e s and plays d o w n the puzzling. " of " c o u n t e r p a r t s " and i n e v i t a b l e " a t t e n d a n t m a n i f e s t a t i o n s . T h e c y b e r n e t i c i n t e r p r e t a t i o n of man is a l e g i t i m a t e offspring of t h e n a t u r a l scientific m e n t a l i t y . or to ordered s e q u e n c e s of electrical i m p u l s e s . C a u s a l r e l a t i o n s h i p s a m o n g s y s t e m s . or to stochastic processes within the molecule. look m o r e h u m a n and accessible w h e n t h e y a r e r e w r i t t e n for information theory as "message relaying" or "symbol transference. t o p e r c e i v e and c o m m u n i c a t e m e a n i n g . they speak only of a " c o r r e l a t i o n . disquieting v a c u u m t h a t is f u n d a m e n t a l l y i n h e r e n t i n t h e c a u s a l i t y principle. " B u t a " c o r r e l a t i o n " is highly q u e s t i o n a b l e as long as o n e of t h e t w o t h i n g s c o r r e l a t e d . W h e n r e f e r r i n g t o t h e t w o . B o t h this and t h e c h e m o ­ physical r e d u c t i o n p r e s u p p o s e o b l i v i o u s n e s s t o t h e e s s e n t i a l c h a r a c t e r and s u b s t a n c e of t h e r e a l m of m a t e r i a l .e n e r g e t i c p r o c e s s e s as well as t h e realm of l a n g u a g e and h u m a n c o n d u c t . T h i s i s yet a n o t h e r i n s t a n c e o f h o w t h e n a t u r a l scientific r e s e a r c h m e t h o d c o m e s up a g a i n s t a s t o n e wall w h e n i t tries t o d i s c o v e r t h e particular n a t u r e o f h u m a n e x i s t e n c e . A n d t o d i s c o v e r w h y n a t u r a l scientific e x p l a n a t i o n s c a n n o t c o h e r e n t l y deduce t h e psychic f r o m t h e s o m a t i c is also to raise t h e possibility n o t m e r e l y of c i r c u m v e n t i n g t h e s e e x p l a n a t i o n s but o f g e n u i n e l y t r a n s c e n d i n g them. t h e r e i s n o s p e c u l a t i o n t h a t can rejoin t h e p a r t s again t o m a k e t h e unified b e h a v i o r w h i c h h u m a n e x i s t e n c e c o n s t a n t l y displays. i n t h e w o r l d t h e y s h a r e .t o . w i t h all its c o m m o n p l a c e . coincide with o n e a n o t h e r . we c a n n o t avoid t h e c o n c l u s i o n t h a t n e u r o p h y s i ological h y p o t h e s e s . B u t this w a s possible for t h e m — t w o a c t u a l individual h u m a n b e i n g s — b e c a u s e t h e w a y all h u m a n b e i n g s a r e i n n a t e l y c o n s t i t u t e d as h u m a n beings is c h a r a c t e r i z e d by an o p e n w o r l d . A t first. It is precisely the i n e x p e d i e n c y of this a p p r o a c h t h a t lets us r e c o g n i z e s o quickly the r e a s o n s b e h i n d t h e i n e x p e d i e n c y . e v e n w h e n t h e y a r e helped along b y t h e l at es t i n f o r m a t i o n t h e o r i e s . are dead e n d s . W e find all the so-called psychic p h e n o m e n a i n o u r t e s t s u b j e c t ' s e n c o u n t e r w i t h h e r l o v e r e c h o e d and s u s t a i n e d . only t h e n e g a t i v e e m e r g e s w i t h c e r t a i n t y . desire. in w h i c h t h i n g s can reveal t h e m s e l v e s as m e a n i n g f u l . It is a world.u h o t h e r . and n o t s o c o m m o n p l a c e . B u t for t h e t h e o r y and p r a c t i c e o f medicine. j o y s and s o r r o w s . feeling.d a y e x i s t e n c e in a w o r l d . b e j oi ned o r coupled. an ability to p e r c e i v e r e l a t i o n s h i p s in t h e w o r l d . w i t h t h e i r m e a n i n g s and c o n t e x t s o f r e f e r e n c e . In looking back o v e r o u r e x a m p l e s of n a t u r a l scientific e x p l a n a t i o n s for h e a l t h y p s y c h e s . in o t h e r w o r d s . b e c o u n t e r p a r t s t o o n e a n o t h e r . B u t in s u c h a world t h e r e is n o t h i n g at all t h a t s u b m i t s directly t o m e a s u r e m e n t o r calculation. m u c h less a b o u t t h e n a t u r e and c o m p o s i t i o n o f t h e s e supposedly p r e s e n t t h i n g s . w h e r e e v e r y t h i n g psychic actually dwells. and c o n s c i o u s n e s s . T h o s e n a t u r a l scientific h y p o t h e s e s i n t e n t o n explaining t h e psychic a s p e c t o n the basis o f c h e m o p h y s i c a l o r c y b e r n e t i c s o m a t i c p r o c e s s e s n e v e r t o u c h t h a t r e a l m w h i c h is t h e actual place of all p e r c e p t i o n . d e t e r m i n i n g the limits o f the n a t u r a l scientific r e s e a r c h m e t h o d i s n o t t h e m o s t i m p o r t a n t . t h e i r o b v i o u s i n e x p e d i e n c y with r e g a r d to a full u n d e r s t a n d i n g of t h e h e a l t h y p s y c h i c aspect does n o t a m o u n t to n o t h i n g and is n o t p u r e l y n e g a t i v e . T h a t realm is d a y . O n l y t h i n g s t h u s divided can c o r r e l a t e . m e m o r y . O n c e a n y s u c h division o f h u m a n e x i s t e n c e h a s b e e n a s s u m e d . t h o u g h t . N o o n e p r o c e e d i n g from this dualistic m o d e o f t h o u g h t h a s m a n a g e d t o say a n y t h i n g c o m p r e h e n s i b l e a b o u t this p o s t u l a t e d r e l a t i o n s h i p b e t w e e n t h e p s y c h e and t h e n e r v o u s s y s t e m . N e v e r t h e l e s s .The Natural Scientific View of Medicine 29 at least t w o p h e n o m e n a w h i c h a r e t h o u g h t of as i n d e p e n d e n t of e. t h a t is. o r p a t h o l o g y is t h e r e a n y precise indication of w h a t " b a s i c " m e a n s . are c o n d u c t e d w i t h i n the h o r i z o n s o f t h e o r y s o prescribed and are a i m e d a t c o n f i r m i n g t h a t t h e o r y . It m i g h t appear at first t h a t t h e n o t i o n c o m m o n in physics should apply in medicine as well. P r e s u m a b l y . B u t n o t e v e n t h e least part of h u m a n b e h a v i o r can b e t h o r o u g h l y explained o n t h e basis o f w h a t a n a t o m y . in t u r n . c o n c e p t u a l i z e d as a physical o r g a n i s m in a s p a c e . T h i s d o g g e d n e s s c o m p l e t e s t h e e f f e c t o f fascination and i n t i m i d a t i o n w i t h w h i c h t h e m a r v e l s o f n a t u r a l scientific m a n i p u l a t i o n h a v e e n t r a n c e d m a n k i n d in t h e a g e of t e c h n o l o g y . medical r e s e a r c h e r s t h i n k of a basis primarily as s o m e u n d e r m o s t . t h e y m u s t b e able t o s h o w t h a t the physical body as t h e y define it is capable of i n d e p e n d e n t l y g e n e r a t i n g e v e r y c o n c e i v a b l e h u m a n a c t i v i t y . T h a t is. W e can b e g i n t o u n d e r s t a n d n o w t h e s t u b b o r n s e l f . n o w h e r e i n t h e s c i e n c e s o f biology. S i n c e t h e w h o l e s p e c t r u m o f basic r e s e a r c h in physical s c i e n c e (including m e d i c i n e ) is g r o u n d e d on t h e a s s u m p t i o n t h a t w h a t e v e r is real m u s t be m e a s u r a b l e and calculable. basic i m p o r t a n c e . this p o w e r t o m a n i p u l a t e h a s tended t o blind n a t u r a l scientific researchers to their own theoretical transgressions. B u t such a p r o o f does n o t exist a n y w h e r e .30 EXISTENTIAL FOUNDATIONS c o n c e r n .t i m e c o n t i n u u m . H o w e v e r . B e s i d e s . E v e n a description of the c o u n t l e s s c h e m o p h y s i c a l p r o c e s s e s in the h u m a n body. It is of far g r e a t e r c o n s e q u e n c e t h a t t h r o u g h its claims of u n i v e r s a l validity it so o f t e n o v e r r e a c h e s its p r o p e r b o u n d a r i e s in the field of m e d i c i n e . a n a t o m y . t h e p h e n o m e n a of h u m a n e x i s t e n c e . t h e s e s u b s c i e n c e s m u s t first b e able t o prove t h a t t h e physical c o m p o n e n t t h e y m a n i p u l a t e so e f f e c t i v e l y is of p r i m a r y . in p h y s i c s . E x p e r i m e n t s . N a t u r a l s c i e n c e insists on t r y i n g to define and clarify a set of p h e n o m e n a to w h i c h it h a s no a c c e s s . p h y s i o l o g y and p a t h o l o g y as e v i d e n c e t h a t it is the g e n u i n e basis of m e d i c i n e .c o n f i d e n c e w i t h w h i c h n a t u r a l s c i e n c e holds u p biology. n a t u r a l scientific medicine will n e v e r h a v e a n y t h i n g f u n d a m e n t a l l y n e w to say a b o u t a h u m a n body w h o s e n a t u r e it has stipulated as calculable. basic r e s e a r c h is r e s e a r c h t h a t f o r m u l a t e s the t h e o r e t i c a l s u p p o s i t i o n s u n d e r l y i n g t h e s u c c e s s o f physical e x p e r i m e n t a t i o n . biology. it is n e c e s s a r y to f r a m e a n e w t h e o r y w h i c h p e r m i t s the n e w findings to be fitted i n t o an u n b r o k e n p a t t e r n o f causality. o b j e c t i v e level from w h i c h all h u m a n p h e n o m e n a can be derived in a c a u s a l . c a n n o t lead to a n y u n d e r s t a n d i n g of even such a simple bodily p h e n o m e n o n of h u m a n . p h y s i o l o g y .g e n e t i c way. B u t to justify this claim. and since n o e x p e r i m e n t can c a r r y n a t u r a l s c i e n c e b e y o n d its o w n f u n d a m e n t a l p r e c e p t s . and p h y s i o l o g y h a v e b r o u g h t to light. In t h e final a n a l y s i s . W h e n such c o n f i r m a t i o n is n o t f o r t h c o m i n g . a n a t o m y . " in Brain and Conscious Experience. German Use of Human Beings: Cybernetics and Society t r a n s l a t i o n : Mensch-Maschine ( 1 9 5 2 ) . S . NOTES 1. s o m e t i m e in the foreseeable future. 8 5 . J . p . Mifflin. V . it has n o t b e e n able to give a n y goal or purpose to medical practice. A d a w n i n g i n s i g h t i n t o t h e l i m i t a t i o n s of the n a t u r a l scientific r e s e a r c h m e t h o d and t h e d a n g e r s of raising it to an a b s o l u t e in biology and m e d i c i n e h a s for s o m e t i m e n o w b e e n e n c o u r a g i n g p h y s i c i a n s t o look for a s o u n d e r basis for m e d i c i n e . 3 . ed. a n e w . M c L e a n ' s " P s y c h o s o m a t i c s . nor a g e s t u r e in r e s p o n s e could e v e r o r i g i n a t e in c h e m o p h y s i c a l p r o c e s s e s or c y b e r n e t i c s t r u c t u r e s . 1 9 6 0 ) . p. 4 . . no m a t t e r h o w slight. a basis m o r e a p p r o p r i a t e to the illness of h u m a n b e i n g s . a r r o g a n c e h a s blinded t h e m t o facts.b r e e d i n g n o clue a b o u t w h i c h g e n e t i c d i r e c t i o n will be beneficial to m a n and his w o r l d and w h i c h m o r e apt t o a n n i h i l a t e b o t h . " in Handbook of Physiology ( W a s h i n g t o n . it w o u l d still be illicit to simply discard p r e v i o u s n a t u r a l scientific a d v a n c e s . with t h e e x p e c t a t i o n t h a t t h e i r e x p l a n a t o r y capabilities would c o m p l e m e n t m e d i c i n e ' s s o m a t o l o g i c a p p r o a c h to f o r m a c o m p r e h e n s i v e v i e w p o i n t . 1 7 2 5 . n o r p h y s i o l o g y d e s e r v e s to be called a basic s c i e n c e . deliberate intervention in c h r o m o s o m e s t r u c t u r e m a k e s c o n t r o l l e d b r e e d i n g o f t h e h u m a n race possible. F o r a g e s t u r e . a n a t o m y . : A m e r i c a r Physiological Society. while u n l o c k i n g u n d r e a m e d . A s s u m i n g t h a t t h e y should d i s c o v e r such a b a s i s . O E c c l e s ( N e w Y o r k : 19t>t>) p. S c i e n t i s t s h a v e l o o k e d particularly t o p s y c h o l o g y and p s y c h o s o m a t i c m e d i c i n e for help in e l a b o r a t i n g a m o r e h u m a n u n d e r s t a n d i n g o f the k n o w n p h e n o m e n a o f h u m a n e x i s t e n c e .The Natural Scientific View of Medicine 31 e x i s t i n g as a g e s t u r e .o f possibilities for t h e medical m a n i p u l a t i o n o f h u m a n b e i n g s . m o r e h u m a n f o u n d a t i o n o f m e d i c i n e would k n o w h o w t o i n t e r p r e t t h e findings o f n a t u r a l scientific r e s e a r c h m o r e suitably. W h e n . W i e n e r . As a r e s u l t . 2.. its scientific c r i t e r i a will give t h e n a t u r a l s c i e n c e o f h u m a n . pp. always indicates s o m e t h i n g t h a t h a s already b e e n perceived in its particular significance. " T h e Neural Replication of S e n s o r y E v e n t s ' in the S o m a l i A f f e r e n t . 1 7 2 4 . N e i t h e r the d i s c e r n i n g r e a l i z a t i o n of m e a n i n g . N.. A n d t h u s n e i t h e r biology. 5. The Human 1949). D . M o u n t c a s t l e . If this is w h a t they call t h e m s e l v e s . C . Ibid. B e c a u s e t h e n a t u r a l scientific r e s e a r c h m e t h o d h a s n o t b e e n able t o b r i n g f o r t h a n a d e q u a t e u n d e r s t a n d i n g o f h u m a n e x i s t e n c e . its t r a n s g r e s s i o n s b e c o m e i n c r e a s i n g l y d a n g e r o u s to the survival of h u m a n n a t u r e as its p o t e n t i a l for t e c h n o l o g i c a l i n t e r v e n t i o n is r e f i n e d to p e r f e c t i o n . Ibid. (Boston: Hough tor 94ff. pp. 12. Hautsinne. Gehirn R o h r a c h e r . Vorgänge. Geruch . H. H. p.. N e w York: 1 9 6 6 ) . Geschmack. Sinnesphysiologie.32 EXISTENTIAL 6. Die Arbeitsweise dea und das geistige Leben 7. Hensel. Lehrbuch (Munich: der Gehirns und psychische 1 9 5 3 ) . FOUNDATIONS 3d ed. Allgemeine (Berlin Heidelberg. Die Vorgänge im 153. 87 a n d Physiologie. w h i c h is to say. i t b e c a m e a p p a r e n t t h a t t h e i r p a t h o g e n e s i s could n o t b e explained o n a n o r g a n i c . W h e n m e d i c i n e applies this t o h u m a n b e i n g s . it became necessary to make a theoretical distinction. T h e new diseases w e r e s e p a r a t e d f r o m t h o s e w h o s e c a u s e s w e r e c o n s i d e r e d primarily o r g a n i c — t h e s o m a t o g e n i c d i s e a s e s — a n d w e r e called primarily psychic d i s t u r b a n c e s . o r p s y c h o g e n i c n e u r o s e s . t o w a r d o t h e r people. only w i t h r e s p e c t t o t h e i r c h e m o p h y s i c a l p r o c e s s e s a n d t h e i r c y b e r n e t i cally q u a n t i f i a b l e c o m p o s i t i o n s . B u t t h e overall m o r b i d i t y o f m a n k i n d has r i s e n . i l l n e s s e s have appeared which conventional therapeutic measures cannot combat. n a t u r a l scientific basis but instead had to do w i t h a p a t i e n t ' s o r i e n t a t i o n t o w a r d his s u r r o u n d i n g s . and its scientific a d v a n c e s h a v e c o n t r o l l e d diseases t h a t used t o b e t h e m o s t c o m m o n a n d m o s t dealy. F o r a w h i l e . T h u s .Chapter 3 THE NATURAL SCIENTIFIC VIEW OF PSYCHOLOGY AND PSYCHOSOMATICS N a t u r a l scientific r e s e a r c h m e t h o d s r e a c h t h e i r o b j e c t s o f study only i n r e l a t i o n to t h e i r m e a s u r a b l e and calculable s t r u c t u r e s . it is t h e body w h i c h p r e s e n t s i t s e l f for precise m e a s u r e m e n t s and c a l c u l a t i o n s . B u t a s t i m e passed. p h y s i c i a n s looked hopefully to t h e f u t u r e . c e r t a i n t h a t w i t h i m p r o v e d m e t h o d s t h e y w o u l d find o r g a n i c c h a n g e s t o explain t h e p a t h o g e n e s i s o f t h e s e n e w d i s e a s e s . and t o w a r d h i m s e l f . n o t fallen.o f possibilities t o m e d i c i n e for m a n i p u l a t i n g t h e h u m a n body. T h i s p e r s p e c t i v e o n m a n o p e n e d u n h e a r d . . r e c o g n i z i n g t h e s i g n i f i c a n c e .f r e e . F r e u d c o n s i d e r e d it i m p o r t a n t to i n t r o d u c e i n t o m e d i c i n e a r e s e a r c h m e t h o d a t t u n e d t o m e a n i n g . o f a p a t i e n t ' s c o n c e p t i o n s of good and evil. close. W h i l e the n a m i n g o f t h e n e w s c i e n c e s o f medical p s y c h o l o g y and p s y c h o p a t h o l o g y t o o k i n t o a c c o u n t t h a t all n o n s o m a t i c m a n i f e s t a t i o n s o f h u m a n e x i s t e n c e w e r e s e e n a s e f f e c t s o r f u n c t i o n s o f the p s y c h e . PSYCHOLOGICAL HYPOTHESES S i g m u n d F r e u d o p e n e d n e w d i m e n s i o n s t o medicine t h r o u g h his o b s e r v a t i o n s o f t h e p s y c h i c b e h a v i o r o f his p a t i e n t s . F r e u d held s t e a d f a s t l y t o t h e old c o n c e p t i o n s of biology and p h y s i o l o g y . causally c o n n e c t e d r e l a t i o n s h i p s a m o n g q u a n t i t i e s . and h e m a d e p h y s i c i a n s s e e t h a t a specifically h u m a n . in t h e final analysis. of beautiful and ugly. N o t least. be ascribed to d i s t u r b a n c e s in t h e n e u r o n s . J u s t as t h e s e s c i e n c e s had visualized t h e h u m a n body as a physical o r g a n i s m e x i s t i n g i n d e p e n d e n t l y and p r e s e n t at a specific point in a p r e e x i s t i n g e m p t y space. His first g r e a t w o r k . P h y s i c i a n s w e r e compelled to a c k n o w l e d g e p a t i e n t s ' m e n t a l o r i e n t a t i o n s as a s e c o n d and d i f f e r e n t a r e a o f r e a l i t y e x i s t i n g a l o n g w i t h t h e s o m a t i c . b e g a n w i t h t h e bold s e n t e n c e s : "In the following pages. the physical n e r v e cells and the n e r v e p a t h w a y s . w e r e s u r p a s s i n g t h e e f f e c t s o f all t h e primarily o r g a n i c illnesses t a k e n t o g e t h e r . and t h e y had t o give this n o n s o m a t i c realm i n d e p e n d e n t scientific c o n s i d e r a t i o n . " In all of his s u b s e q u e n t a t t e m p t s to m a s t e r t h e psychic m a n i f e s t a t i o n s o f h u m a n b e i n g s t h e o r e t i c a l l y . of e n t a n g l i n g guilt and o u t l e t s to f r e e d o m . and t h e e c o n o m i c d a m a g e for w h i c h t h e y w e r e r e s p o n s i b l e . H e pointed t o t h e n e e d f o r t r e a t i n g p a t i e n t s not j u s t from t h e p r e s c r i b e d position o f d i s t a n c e . a w a k e n e d to a n e w reality. B e s i d e s t h i s . w h e r e t h e y w e r e o r g a n i s m s t h o u g h t o f a s o b j e c t s . t h e i n t e n s i t y o f the s u f f e r i n g t h e y e n g e n d e r e d . appeared in Freud's p s y c h o a n a l y t i c t h e o r y as e f f e c t s or f u n c t i o n s of a 1 . m u t u a l l y e n g a g i n g r e l a t i o n s h i p b e t w e e n physician and p a t i e n t was in i t s e l f p o w e r f u l l y t h e r a p e u t i c . for t h e g e n e s i s o f m a n y i l l n e s s e s . I shall deliver p r o o f t h a t t h e r e is a p s y c h o l o g i c a l t e c h n i q u e w h i c h p e r m i t s d r e a m s to be i n t e r p r e t e d and t h a t w h e n this p r o c e d u r e is applied e v e r y d r e a m t u r n s o u t to be a meaningful p s y c h i c s t r u c t u r e w h i c h can be fitted i n t o t h e m e n t a l o p e r a t i o n s o f the w a k i n g s t a t e a t specific p o i n t s . The Interpretation of Dreams. so the nonphysical p h e n o m e n a of h u m a n e x i s t i n g . F r e u d t a u g h t p h y s i c i a n s t o see the t h e r a p e u t i c value i n t h e w a y s t h e y dealt w i t h p a t i e n t s . t h e n e o l o g i s m " n e u r o s i s " e c h o e s t h e old prejudice t h a t e v e n t h e p s y c h o g e n i c illnesses c a n .34 EXISTENTIAL FOUNDATIONS I t b e c a m e i n c r e a s i n g l y c l e a r t h a t t h e relative and a b s o l u t e n u m b e r o f t h e s e n e u r o s e s . w h i c h would stand beside t h e n a t u r a l scientific p e r s p e c t i v e t h a t s a w o n l y m e a n i n g . so. S u c h a p s y c h e had o n l y to t r a n s f e r to t h e o u t s i d e world p a r t s of t h e libidinal q u a n t i t i e s it had c o l l e c t e d and t h e n u s e t h e s e q u a n t i t i e s to i n v e s t ( " c a t h e c t " ) p h e n o m e n a in the s u r r o u n d i n g s . T h e m o s t i m p o r t a n t i n F r e u d ' s t h e o r y are defects in t h e i n t e g r a t i o n of m e n t a l drives. If p h y s i o l o g y had declared t h e m a t e r i a l c e n t r a l n e r v o u s s y s t e m t o b e t h e basis o f all h u m a n b e h a v i o r . and displaceable. of—in s h o r t — t h e p s y c h e . F r e u d c o m p l e t e d his p s y c h o a n a l y t i c t h e o r y w i t h t h e f u r t h e r a s s u m p ­ tion of a psychic e n e r g y . S i n c e Freud m a d e his initial t h e o r e t i c a l f o r m u l a t i o n s . e g o . and t h e n b e displaced o n t o n e w c o n c e p t i o n s . a p r e c o n s c i o u s . r e g r e s s i o n t o f o r m e r d e v e l o p m e n t a l s t a g e s of t h e libido. and s u p e r e g o b r o u g h t w i t h it n o t h i n g fundamentally new. and already. to w h i c h he could n o w a s c r i b e t h e m o s t varied kinds of drives and partial drives. t h e libido.The Natural Scientific View 35 psychic o r g a n . able to be m i x e d and t h e n isolated again. P a t h o l o g i c a l p h e n o m e n a w e r e explained b y a s s u m i n g d i s t u r b a n c e s o f t h e drives w i t h i n t h e p s y c h i c a p p a r a t u s . B y this h e m e a n t psychic r e p r e s e n t a t i o n s o f o b j e c t s from t h e world o u t s i d e t h e mind. and d i s p l a c e m e n t of painful m e n t a l associations—along with the affects accompanying t h e m — t o inaccessi­ ble s y s t e m s o f t h e p s y c h i c a p p a r a t u s . t h e so-called affects and drives. Freud w a s n o w d e s i g n a t i n g t h e u n c o n s c i o u s a s the e s s e n t i a l and o n l y real part o f all p s y c h i c m a n i f e s t a t i o n s . capable o f s u b l i m a t i o n and r e a c t i o n . C o r r e s p o n d i n g t o the c h e m o p h y s i c a l p r o c e s s e s medical s c i e n c e could t r a c e in t h e realm of the s o m a t i c . T h e c e n t r a l role assigned t o the m a t e r i a l s u b s t r a t u m o f the c e n t r a l n e r v o u s s y s t e m b y physiology w a s a n a l o g o u s l y a s s u m e d by the u n c o n s c i o u s . In e l a b o r a t i n g his t h e o r y . t h e originally a u t o e r o t i c o r totally n a r c i s s i s t i c p s y c h e had m a d e ties t o t h e outside world. He visualized t h e s e drives a s " q u a n t i t i e s o f e x c i t a t i o n " t h a t w e r e variable. o r the m e r e d i s e n g a g e m e n t o f such a s s o c i a t i o n s from their libidinal i n v e s t m e n t s . also called c o n c e p t i o n s . and q u a n t a of p s y c h i c e x c i t a t i o n . F r e u d s u g g e s t e d t h a t this a p p a r a t u s be visualized as a t h r e e part e n t i t y . p s y c h i c a p p a r a t u s . L a t e r m o d i f i c a t i o n o f this subdivision i n t o t h e triad of id. psychic s y s t e m . o r g a n i c s t r u c t u r e s and p r o c e s s e s o f t h e body. in F r e u d ' s opinion. T h e s e affects and drives w e r e t h o u g h t t o b e c o m e a t t a c h e d t o the p s y c h i c c o n c e p t i o n s . b e able t o b r e a k l o o s e f r o m t h e m . and in this w a y he m a d e his p s y c h i c apparatus w o r k a b l e . F r e u d believed. t h e crudely m e c h a n i c a l notion of a psychic a p p a r a t u s h a s g o n e t h r o u g h m a n y . p a t h o l o g i c a l fixation o f t h e libido o n a r c h a i c c o n c e p t i o n s . and an u n c o n s c i o u s . divided into t h e s u b s y s t e m s of a c o n s c i o u s . w a s t h e psychic a p p a r a t u s filled w i t h psychic m a t e r i a l . F r e u d tried to fit all of t h e s e a s s u m e d c o m p o n e n t s i n t o a flawless c a u s a l c o n t e x t t h a t w o u l d follow e x a c t l y physical m e d i c i n e ' s p r e c e p t s r e g a r d i n g t h e c h e m o p h y s i c a l . T h e s e c a m e f r o m Freud h i m s e l f . " S h o r t l y a f t e r w a r d s . V . He and his circle s u g g e s t e d t h a t e g o be visualized as a c o m p o s i t e of various partial-ego a p p a r a t u s e s . Adler a c c e n t e d the so-called a g g r e s s i v e drives and the " m a s c u l i n e p r o t e s t . Even b e f o r e H a r t m a n n . F r o m its v e r y b e g i n n i n g . In addition. J u n g e x p a n d e d Freud's c o n c e p t of the libido. w i t h w h i c h h e r e p r e s e n t e d i n t r a p s y c h i c i n s t i n c t i v e drives and m e n t a l f o r c e s t h a t equally affected all people. While this d e s i g n a t i o n had long had a p l a c e purely as a title—in p s y c h o a n a l y t i c l i t e r a t u r e . " It had to be accorded its o w n " s p o n t a n e i t y " and " b e seen as an e n t i t y acting i n d e p e n d e n t l y in r e l a t i o n to i t s e l f . this b r a n c h o f p s y c h o l o g y a t t r i b u t e d t o the ee o an a u t o c h t h o n o u s s t r u c t u r e . the s u b j e c t w a s to a large e x t e n t r e s p o n s i b l e for d e t e r m i n i n g t h e particular t i m e a p e r s o n would b e c o m e ill. H. In a n o t h e r d i r e c t i o n . H a r t m a n n w o r k e d on refining t h e n o t i o n of e g o . In this layer he a s s u m e d the p r e s e n c e of a r c h e t y p e s . R a t h e r . h e replaced t h e psychic apparatus w i t h t h e c o n c e p t of t h e s u b j e c t . J u n g believed t h a t in t h e last analysis t h e s e a r c h e t y p e s c o n t r o l people's p e r c e p t i o n s o f t h e outside w o r l d and d e t e r m i n e t h e i n n e r p a t t e r n s o f b e h a v i o r o f e v e r y h u m a n being. so t h a t it coincided g e n e r a l l y w i t h the n o t i o n of psychic e n e r g y . t h o u g h t . from his disciples. W e i z s ä c k e r s t h e o r y c o n t r a s t e d sharply w i t h all n a t u r a l scientific b r a n c h e s o f p s y c h o l o g y b e f o r e and since in a s s e r t i n g t h a t this s u b j e c t w a s always "causally u n d e r . On the c o n t r a r y . B u t h e w a r n e d a g a i n s t m i s t a k i n g the s u b j e c t for a solipsistic m o n a d . and t h e particular o r g a n affected. i n t r i n s i c to t h e subject was a close and vital bond with its s u r r o u n d i n g s . A l e x a n d e r and K. " and " m e s h e d " t h a t it w a s n e c e s s a r y to speak of a "polarly b o u n d federalism o f s u b j e c t and o b j e c t . e v e r y t h i n g i n s t i n c t i v e w a s always s u b s u m e d in t h e total p e r s o n a l i t y and could be g r a s p e d o n l y by e x a m i n i n g t h e total p e r s o n a l i t y . and so f o r t h . e a c h o f w h i c h w a s a s s u m e d t o b e specialized for a p a r t i c u l a r e g o f u n c t i o n — p e r c e p t i o n . " For this r e a s o n . von W e i z s ä c k e r a t t a c k e d the s t r i c t d e t e r m i n i s m o f t h e original p s y c h o a n a l y t i c t h e o r y . F i r s t ." H e r e causality's c o n c e r n for s o m e " r e l a t i o n s h i p a m o n g 2 . " W e i z s ä c k e r ^ m o s t pointed opposition t o t h e n a t u r a l scientifically o r i e n t e d b r a n c h e s o f psychology lies in his c o n c e p t of the " f u n d a m e n t a l c a t e g o r y of the pathic. t h e t w o being so " j o i n e d . and f r o m his o p p o n e n t s . F. and e n e r g y r e s o u r c e s t h a t did n o t h a v e t o b e d r a w n from t h e g e n e r a l r e s e r v o i r o f e r o t i c libido.d e t e r m i n e d . he h u n g from t h e F r e u d i a n p s y c h e an e v e n d e e p e r layer. w h i c h he called the collective u n c o n s c i o u s . H o r n e y set F r e u d ' s apparatus on its head by pointing o u t t h a t h u m a n b e h a v i o r could n o t be u n d e r s t o o d o n t h e basis o f individual drives o r partial drives. and additions. t h e p a r t i c u l a r type of illness. c o r r e c t i o n s . Fairly early.36 EXISTENTIAL FOUNDATIONS r e f i n e m e n t s . " " f u s e d . " A n t h r o p o l o g i c a l m e d i c i n e w a s a n o t h e r r e s e a r c h o r i e n t a t i o n t h a t left p s y c h o l o g y ' s w o r l d o f n a t u r a l scientific c o n c e p t s far b e h i n d . of w h o m Eugene Minkowski. o r t h e so-called v e g e t a t i v e d e p t h . s t a m p e d by. Ey sees a plane w h i c h develops into the p e r s o n a l i t y c o m p l e x and is r e s p o n s i b l e for m a k i n g a h u m a n b e i n g g e n u i n e l y h u m a n . 3 In t h e s a m e g e n e r a l a r e a . o r t h e l a y e r o f t h e drives t o b e t h e actual e s s e n c e o f t h e p s y c h i c . C o n r a d calls this s a m e psychic realm a "field of e x p e r i e n c e . A c c o r d i n g l y . t h e l a y e r . s o m e p s y c h o l o g i s t s a r e a s s u m i n g an unspatial. C u r r e n t t h e o r i e s o f l a y e r s see t h e f o r m a t i o n o f a n e w p s y c h i c layer o r o r g a n i z a t i o n a l s t a g e i n t h e p e r s o n a s " s o w o v e n i n t o e a r l i e r o n e s t h a t the older d e s i g n s are n o t o n l y e x p a n d e d and c h a n g e d b y t h e n e w e r . von G e b s a t t e l . as for e x a m p l e o n e of c a u s e and e f f e c t . b u t t o s o m e e x t e n t actually p e r m e a t e d . planned. T h e goal of all l a y e r f u n c t i o n s is to realize this e n t e l e c h y as fully as possible. in place of t h e calculability o f h u m a n p h e n o m e n a h e and t h e o t h e r s t h r u s t h u m a n f r e e d o m i n t o the f o r e g r o u n d . i m m a t e r i a l . " He visualizes t h e p s y c h e ' s life as figuratively projected o n t o s u c h a s c r e e n and i n t e r p r e t s d i f f e r e n c e s in t h e clarity of c o n s c i o u s n e s s as differences in t h e s t r u c t u r e of this psychic field of e x p e r i e n c e . a b a n d o n e d from t h e o u t s e t t h e n o t i o n o f p r e c i s e .The Natural Scientific 37 View r e c o g n i z a b l e t h i n g s . and Ludwig B i n s w a n g e r w e r e p r o m i n e n t r e p r e s e n t a t i v e s . In f r e e d o m t h e y saw t h e basis for t h e i r c e n t r a l t h e m e o f " b e c o m i n g . W h i l e Freud r e m a i n e d a b s o r b e d e s s e n t i a l l y 4 . " T o bring s o m a n y l a y e r s o f p e r s o n a l i t y u n d e r o n e r o o f . T h e r e h a v e been m a n y e f f o r t s t o m a k e a n e v e r m o r e refined and inclusive t h e o r y o f l a y e r s i n h u m a n p e r s o n a l i t y . and calls it a "field of c o n s c i o u s n e s s . " is a b a n d o n e d for t h e s u b j e c t ' s r e l a t i o n to an " u n o b j e c t i f i a b l e b a s i s . " K. H. and i n t e g r a t e d w i t h t h e m . a s i t w e r e . A m e r i c a n p s y c h o a n a l y t i c e g o p s y c h o l o g y w a s f r o m its b e g i n n i n g s directed far m o r e t h a n E u r o p e a n depth p s y c h o l o g y t o w a r d e n v i r o n m e n tal and social r e l a t i o n s h i p s . T h e s e e f f o r t s b r o a d e n e d Freud's conceptual framework to the extent that they no longer took the layer o f t h e e r o g e n o u s z o n e s . T h e s e anthropologists among physicians. t o t h e m t h e n o n i n s t i n c t i v e p s y c h i c p h e n o m e n a w e r e n o l o n g e r m e r e l y the p r o d u c t s o f s u b l i m a t i o n and r e a c t i o n . T h u s . "disb e c o m i n g . and e s s e n t i a l e n t e l e c h y as t h e e n d c a u s e of all layer f o r m a t i o n . B i n s w a n g e r criticized w i t h p a r t i c u l a r f o r c e t h e l i m i t a t i o n s m e d i c i n e placed on its o b j e c t of study.s u b j e c t .t h e o r i s t s call upon K a n t ' s s t a t e m e n t t h a t living m a t t e r can n e v e r be fully c o m p r e h e n d e d f r o m a causal d e r i v a t i o n a l o n e and r e q u i r e s a n additional teleological p e r s p e c t i v e . E. " a n d t h e y held t h a t its o p p o s i t e . V. " prevailed in p a t h o l o g i c a l s y m p t o m s . n a t u r a l scientific calculability o f h u m a n p h e n o m e n a . b o t h in t h e physical o r g a n i s m and in t h e psychic f u n c t i o n s . or t h r o u g h e x p e r i e n c e — b u t aided by precise c o n t r o l . theorists of wholeness have gained prominence among p s y c h o l o g i s t s . T h i s idea has b e c o m e v e r y w i d e s p r e a d . w r i t e s : " T h e y all a g r e e t h a t t h e individual p e r s o n as a p a t t e r n e d e n t i t y m u s t s e r v e a s t h e c e n t e r o f g r a v i t y for p s y c h o l o g y . t h e p e r s o n a l i t y is an open i n t e r p e r s o n a l s y s t e m e x i s t i n g o n l y i n social a c t i o n s a m o n g people. " t h e " t h o u . m a t h e m a t i c s ." E v e n o u t s i d e t h e rapidly s p l i n t e r i n g s c h o o l s of p s y c h o a n a l y s i s in America.r e l a t i o n s h i p " e s s e n t i a l f o r h u m a n b e i n g . say. or l i n g u i s t i c s — t r u t h could be arrived at only through deductions that meet criteria of mathematical logic. W h i t e p r e f e r s t h e c o n c e p t of self to p e r s o n a l i t y . and we r e l a t i o n s h i p s . o r t r e a t e d s t a t i s t i c a l l y . e v e n t o t h e point o f a s s e r t i o n s t h a t m a n a c t u a l l y lives i n a n " i n . c o r r e s p o n d i n g ideas d e v e l o p e d i n E u r o p e . t h o u . T h e " I . R o b e r t W . T r u t h i s n o t t o b e gained e x c e p t t h r o u g h d e d u c t i o n — b u t b y m e a n s o f precise a l g o r i t h m s . Leading r e s e a r c h e r s c o n t i n u e t o r e g a r d a s real and scientific only t h o s e h u m a n c h a r a c t e r i s t i c s t h a t c a n b e m e a s u r e d . especially i n G e r m a n . J e a n P i a g e t a s s e r t e d t h a t in p s y c h o l o g y and s o c i o l o g y — n o less t h a n in.b a s e d p s y c h o l o g y r e m a i n s p o w e r f u l . Sullivan and his pupils d r e w a t t e n t i o n q u i t e e a r l y t o t h e fact t h a t h u m a n b e i n g s begin t h e i r lives in an i n t e r p e r s o n a l r e a l m and e x i s t p r i m a r i l y in " i n t e r . T h e i n t e n t i o n o f p e r s o n a l i s m i s t o r e w r i t e t h e s c i e n c e o f m e n t a l life e n t i r e l y a r o u n d this f o c u s . b u t b e y o n d this. G o r d o n A l l p o r t . " F o r M a r t i n B u b e r this w a s t h e m i d d l e g r o u n d b e t w e e n t h e " 1 " and t h e " t h o u " j o i n i n g t h e two. N o t long a g o . n a t u r a l s c i e n t i f i c . 5 0 7 Independent of America's concepts of intersubjective humanness. c o n s i d e r i n g it a c o n c e p t n e c e s s a r y to p s y c h o l o g y b e c a u s e o n l y s e l f can help us s t a y focused on t h e basic fact t h a t an o r g a n i s m is a u n i t y . N o t w i t h s t a n d i n g t h e s e m a n y and varied a t t e m p t s t o b r e a k its hold. It is ." which is intended to function as t h e basis of t h e I. c a u s a l i t y . T h i s s t a r t l i n g p a s s a g e reads: 8 0 N o w t h e f u n d a m e n t a l illusion a g a i n s t w h i c h w e s e e k t o a s s e r t o u r s e l v e s c o n s i s t s i n believing t h a t o n e c a n find t r u t h t h r o u g h simple reflection w i t h o u t stepping out o f his study o r library.b e t w e e n o f d i a l o g u e . " Allport in p a r t i c u l a r d e f i n e s p e r s o n a l i t y as a s y s t e m and c o m p l e x psychic u n i t y o f m a n y a r e a s w h i c h m u t u a l l y a f f e c t o n e a n o t h e r . " and t h e u n i t i n g middle g r o u n d w e r e d e s i g n a t e d a s t h e ' ' w e .s u b j e c t i v e relationships. biology.38 EXISTENTIAL FOUNDATIONS by s t r u c t u r e s and m e c h a n i s m s w i t h i n t h e m i n d .s p e a k i n g a r e a s . calculated. o n e o f its n o t a b l e r e p r e s e n t a t i v e s . o r t h r o u g h e x p e r i m e n t s w h o s e r e s u l t s could b e verified u n e q u i v o ­ cally. E r i k s o n supple­ mented it with the notion of "basic trust. A t t h e h e i g h t o f t h e m a c h i n e age i n m e d i c i n e . n e v e r d o u b t i n g t h a t s o m e day. W e w o u l d d o a n i n j u s t i c e t o t h e s e m e t h o d s o f i n v e s t i g a t i o n i f w e c o u n t e d t h e m a m o n g t h e c o r r e c t i o n s and s u p p l e m e n t s t o F r e u d ' s t h e o r i e s o r called t h e m p s y c h o l o g i e s . Freud came into the realm of psychosomatic medicine through the n o t i o n of a psychic a p p a r a t u s t h a t o p e n e d i n t o t h e s o m a t i c at its id end. t h e p s y c h i c a s p e c t s had dwindled to a m e r e c e r e b r a l s e c r e t i o n . T h r o u g h this portal. H e h i m s e l f s a w his w h o l e p s y c h o l o g y and p s y c h o s o m a t i c m e d i c i n e a s p r o v i s i o n a l . for i n s t a n c e . factually s p e a k i n g . a n d t h e s e c a n b e m e a s u r e d and put i n t o m a t h e m a t i c a l t e r m s . t h i s would give rise t o h y s t e r i c a l c o n v e r s i o n s y m p t o m s o r n e u r o t i c o r g a n i c d i s t u r b a n c e s . o n c e a g a i n . B e h a v i o r i s t s say t h a t s u c h t h i n g s h a v e no place at all in scientific s y s t e m . n o r w a s t h e r e a n y lack o f e x p r e s s i o n s w h i c h could b e used i n t r y i n g t o d e t e r m i n e t h e u n i q u e n a t u r e o f this r e l a t i o n s h i p b e t w e e n p s y c h e and s o m a . b u t today t h e g r e a t m a j o r i t y o f scientific f o r m u l a t i o n s address s o m a t i c p h e n o m e n a a s e x p r e s s i v e . Finally. t h e first t o lay t h e f o u n d a t i o n f o r t h e s y s t e m a t i c d e v e l o p m e n t o f a p s y c h o s o m a t i c t h e o r y . and t h e p e r s o n a l had c o m e i n t o t h e i r o w n again a s distinct a r e a s o f r e a l i t y . 1 0 We need not here go into the theories w h o s e intent it is to be absorbed i n t o n e u r o p h y s i o l o g y — l i k e A m e r i c a n b e h a v i o r i s m . a f t e r f u r t h e r p r o g r e s s i n s o m a t i c m e d i c i n e . s i n c e . q u a n t i t i e s o f psychic e x c i t a t i o n s w h i c h for s o m e r e a s o n could n o t find s u f f i c i e n t o u t l e t i n t o a p e r s o n ' s c o n s c i o u s n e s s and a c t i o n s m i g h t b e c o m e d a m m e d up within t h e body's o w n i n n e r v a t i o n . o r a t t e n d a n t . o r vice versa. PSYCHOSOMATIC HYPOTHESES W h e n t h e p s y c h i c . t h e n . w i t h t h e help o f . T h i s s a m e open space w o u l d also c o n t r i b u t e t o t h e r e a l i z a t i o n o f n o r m a l physical e x p r e s s i v e m a n i f e s t a t i o n s o f c o n s c i o u s a f f e c t s . for i n s t a n c e — o r t h o s e t h a t try t o divest t h e m s e l v e s o f t h e c o n c e p t s o f c o n s c i o u s n e s s o r s p o n t a n e i t y . h u m a n b e h a v i o r r e p r e s e n t s m e r e l y t h e s u m o f all r e a c t i o n s t o s t i m u l i . t h e old b o d y . teachings about the psyche. Intimated relationships that r e p r e s e n t e d t h e t w o a s p s y c h e and s o m a had o f c o u r s e b e e n familiar t o m e d i c i n e for a g e s . T h e idea of a p s y c h e . and not t h e n a t u r e o f t h e p r o b l e m s a t h a n d . O n s u c h a path. F r e u d w a s . w a s o n l y a t e m p o r a r y r e q u i s i t e . t h a t is. t h e s u b j e c t i v e . t h e p s y c h e and t h e s o m a could e x e r t m u t u a l influence o n each o t h e r . m a n i f e s t a t i o n s o f t h e p s y c h i c aspect.The Natural Scientific View t h e s e a l g o r i t h m s o r t h e s e c o n t r o l s w h i c h d i s t i n g u i s h t h e s c i e n c e s from p h i l o s o p h y . t h e p s y c h i c aspect could b e t r a c e d back t o t h e e x c h a n g e o f m a t e r i a l i n s o m a t i c p r o c e s s e s .s o u l c o n t r o v e r s y gained n e w importance in medicine. depending on the fixed a s s u m p t i o n s built i n t o t h e m . " L a t e r he says: 11 T h e m a t t e r o f h o w psychic and s o m a t i c p r o c e s s e s m a y i n f l u e n c e and c h a n g e e a c h o t h e r can b e a n s w e r e d n e i t h e r w i t h physical. using s o u n d scientific m e t h o d s . It is we w h o c a r r y the idea of opposition into n a t u r e . n o r with psychological. R e c e n t k n o w l e d g e c o m p e l s us to r e v i s e o u r e n t i r e c o n c e p t u a l s y s t e m . only one of these h y p o t h e s e s s e t s o u t to a t t a c k the p s y c h o s o m a t i c problem in an original and f u n d a m e n t a l l y d i f f e r e n t w a y . and c o n s t i p a t e d . It c a n n o t be solved as long as we s t a r t w i t h the traditional idea t h a t reality is m a d e up of s o m a t i c and psychic c o m p o n e n t s . m e t h o d s . we collide w i t h a philosophical d i l e m m a . 4 2 ) F r o m this Uexkiill c o n c l u d e s t h a t the c o n c r e t e t a s k o f m e d i c i n e c o n s t r a i n s physicians to s e e k out a s p e c t s of reality w h i c h do n o t c a r r y into n a t u r e the opposition b e t w e e n t h e psychic and t h e s o m a t i c and to develop m e t h o d s w h i c h p e r m i t d i f f e r e n t i a t i o n w i t h o u t a division i n t o p s y c h i c and physical. W e can n o l o n g e r simply a s s u m e c o n c e p t s like . . pedantic. H e r e within m e d i c i n e . i n t e r p r e t w h a t is seen a s e i t h e r c h e m o p h y s i c a l p r o c e s s e s o r a s psychic e v e n t s . (p. "a circle s e e m s to close w h e n pathological a c t i v i t y is allowed an unlimited o v e r f l o w from t h e psychic into the s o m a t i c . t h e n . All t h e t h e o r i e s of l a y e r s in m o d e r n p s y c h o s o m a t i c medicine produced analogous conceptual schemes. It is to be found in Uexkull's w o r k . " He g o e s on to say. B o t h m e t h o d s take s e c t i o n s from this reality and. h o w e v e r . Basic Questions of Psychosomatic Medicine. F r e u d explained the origins of allied p s y c h o s o m a t i c m a n i f e s t a t i o n s like t h o s e w h i c h m i g h t be e n c o u n t e r e d in anal e r o t i c s . b o t h start w i t h t h o s e a s p e c t s o f reality w h i c h w e m a r k off for t h e i r particular possibilities o f a s s o c i a t i o n . In the p h e n o m e n a t h a t i n t e r e s t p s y c h o s o m a t i c m e d i c i n e . To our knowledge. R a t h e r . Each o f t h e s e m e t h o d s sees only its o w n domain and is incapable of r e c o g n i z i n g t h e affiliations t h a t e x i s t b e t w e e n t h e m . . T h e physical and psychic factors w h i c h t h e n c o n f r o n t each o t h e r s as i n c o m m e n s u r a b l e o p p o s i t e s are in fact—and h e r e is the fruit of o u r t h o u g h t s — n o t originally parts o f reality.40 EXISTENTIAL FOUNDATIONS this c o n c e p t . w e would n e e d t o revise b e y o n d t h e i r p r e s e n t s t a t e all o u r n o t i o n s and c o n c e p t s c o n c e r n i n g the life p r o c e s s e s and the i n t e r a c t i o n of the psychic and the s o m a t i c . M e d i c i n e m u s t instead look for its o w n solution. " T o be able really to prove t h i s . w h o w e r e a t the s a m e t i m e stingy. W e m u s t clearly r e c o g n i z e t h a t b o t h t h e psychic and t h e s o m a t i c m e t h o d s are n o t h i n g m o r e than a t t e m p t s to find o u r w a y in an u n k n o w n and puzzling reality. he says. . Der Geslalllcreis: Theorie der Einheit von Wahrnekmm und Bewegen ( S t u t t g a r t : 1 9 4 7 ) . p h e n o m e n o l o g i c a l s t a n c e in opposition to traditional c o n c e p t s . B i n d e r . In the next chapter. in the c o m p a n y of my fellow a c t o r s and props. . . 2 / 3 ( L o n d o n : 1 9 4 2 ) . " T h e c o n c e p t o f action leads h i m t o a " n e w c o n c e p t o f m o t i v a t i o n . it gives me acting i n s t r u c t i o n s and s e t s up a role for my i n t e r c o u r s e w i t h t h e w o r l d . V . shaped to all s o r t s o f disparate realities. B e f o r e a m o t i v a t i o n e m e r g e s . . . W e m u s t see i n t h e m o t i v a t i o n t h e p o t e n t i a l t h a t gives birth to t h e a c t i o n . . these attempts to supplement m e d i c i n e ' s c u r r e n t foundation will be t e s t e d against t h e case h i s t o r y . "action i s i n t e r c o u r s e w i t h t h e w o r l d . 2. . r a t h e r .9 7 ) In U e x k u l l ' s e y e s .41 The Natural Scientific View " b o d y . (pp. T h e e s s e n t i a l and i r r e v e r s i b l e e l e m e n t h e r e is t h e r e f o r e t h e t r a n s f o r m a t i o n of a m o t i v a t i o n into a specific a c t i o n . By his o w n definition. t h e r e f o r e . m e r e l y " u n a r t i c u l a t e d m a t t e r t h a t can be c o n n e c t e d and i n t e r p r e t e d in t h e g r e a t e s t v a r i e t y of w a y s . W h a t is initially " h e r e " is. " w o r l d " is n o t a given thing w h o s e p r e s e n c e h e r e is i n d e p e n d e n t of us. t o s e c t i o n i n g s o f t h e w o r l d w h i c h can affect us. . (p. F r e u d . t h e e g o fills the role of a d i r e c t o r m o r e t h a n t h a t of a producer. 4 1 . " T h e s e m o t i v a t i o n s . v o l . H. as an i n d e p e n d e n t p h e n o m e n o n . In this p r o c e s s . a r e p r i m a r i l y r e s p o n s i b l e — b e i n g a s t h e y a r e t h e f o r c e s and potentialities t h a t c o n f r o n t us— for i n t e r p r e t i n g t h e e n v i r o n m e n t . " " w o r l d . 9 4 . t h e r e can be no o b j e c t upon w h i c h s o m e t h i n g can be p r o j e c t e d . for s e c t i o n i n g it and t h r o w i n g up backdrops from which I can m a k e my a p p e a r a n c e . NOTES 1. h e says. W e i s a c k e r . Gesammelie Werke. really is. v . . .r e a l m a t t e r ' is . . . . 177. t h a t is. . " N o r can t h e r e be a n y t h i n g able to proclaim as its " a c t o r s " both the physical aspect ( r e p r e s e n t i n g t h e s i m p l e r c o n t e x t s o f life) and t h e psychic ( r e p r e s e n t i n g the more complex). " as if we w e r e dealing w i t h firm. 3. S. " " m i n d . e s t a b l i s h e d facts. . p. In the i n s t a n t in w h i c h a m o t i v a t i o n i n t e r p r e t s t h e w o r l d . W i t h this s k e t c h o f U e x k u l l ' s t r a i n o f t h o u g h t . w e m a y c o n c l u d e o u r o v e r v i e w o f t h e leading c o n c e p t s o f m o d e r n p s y c h o l o g y and p s y c h o s o ­ matic medicine. T h i s ' p r e . p. p. . 1. 8 1 ) Uexkiill tries to take a n e w . " He t h e n g o e s on at o n c e to ask w h a t an action. Die menschlicke Person ( B e r n a n d S t u t t g a r t : 1 9 6 4 ) . H e s u g g e s t s " t h e a c t i o n " a s t h e " n e w model which will allow p h e n o m e n a to be i n t e r p r e t e d . and n e v e r t h e h u m a n e g o . and w h i c h we can also a f f e c t . 1 5 5 . ( N e w Y o r k : 1 9 5 6 ) . C o n r a d . v o l . 1963). Dialogisches Leben ( Z u r i c h : 1 9 4 7 ) . W h i t e . 11. Encyclopédie de la Pléiade: Logique et Connaissance Humaine ( P a r i s : P l é i a d e . 2 n d ed. 5 5 2 . ed. 2 ( B e r l i n . N o r t o n & C o . E r i k s o n . . Pattern and Growth in Personality ( N e w Y o r k : 1 9 6 1 ) . J e a n P i a g e t . " in Psychiatrie der Gegenwarts-Forschung und Praxis. p. 13. 8.V e r l a g . M u l l a h y . A l l p o r t . G o r d o n W. 6 9 . 1 9 6 0 ) . 5. P. 1 9 o 4 ) p . T h o m p s o n . The Abnormal Personality. 1 9 6 7 ) . p. 7 . K. 13 ff. Psychoanalysis and Development ( N e w Y o r k : 1 9 5 0 ) . " D i e s y m p t o m a t i s c h e n P s y c h o s e n .. The Contributions of Harry Stack Sullivan: A Symposium ( N e w Y o r k : 1 9 5 2 ) . C o m p a r e also. W . p . 9 . 6. Insight and Responsibility ( N e w Y o r k : W . Grundfragen Rowohlt-Taschenbuchverlag. a n d C . 3 6 9 . 1 0 . pp. p . R o b e r t W .EXISTENTIAL 42 FOUNDATIONS 4. 105. p . p . der psychosomatischen Medizin (Rheinbeck-bei-Hamburg: . von Uexküll. T. M a r t i n B u b e r . 1 0 5 . G ö t t i n g e n a n d H e i d e l b e r g : S p r i n g e r . E r i k H . T h e drives and e m o t i o n s d o r m a n t i n R e g u l a Z i i r c h e r ' s u n c o n s c i o u s . B u t t h e r e is no change in the notion that perception involves endopsychic consciousness-immanent images. 2 . T h o u g h they would not refer to distinct organic regions of the brain.Chapter 4 APPLYING THIS VIEW TO REGULA ZÜRCHER PSYCHOLOGICAL HYPOTHESES Psychological explanations of healthy behavior T o explain t h e b e h a v i o r R e g u l a Z i i r c h e r e x h i b i t e d a f t e r h e r r e c o v e r y w h e n s h e s a w h e r l o v e r a p p r o a c h i n g o n t h e o p p o s i t e side o f t h e s t r e e t . F r e u d i a n h y p o t h e s e s would point o u t t h a t s e n s o r y stimuli f r o m t h e l o v e r had b e e n r e f l e c t e d t h r o u g h Regula Ziircher's sense organs as though through a telescope or camera i n t o h e r p s y c h i c s y s t e m o f w a k i n g c o n s c i o u s n e s s . F r o m t h e s e stimuli would a r i s e s e n s o r y p e r c e p t i o n s w h i c h would b e i m m e d i a t e l y i n t e g r a t e d to form an endopsychic image or consciousness-immanent representa­ tion o f h e r lover. G e s t a l t p s y c h o l o g y g o e s a g a i n s t this only t o t h e e x t e n t that its e x p e r i m e n t s h a v e led it to speak a b o u t w h o l e and o r d e r e d f o r e g r o u n d c o n f i g u r a t i o n s in p r e f e r e n c e to m o r e diffuse p e r c e p t i o n of a b a c k g r o u n d . t r a d i t i o n a l p s y c h o l o g y o f f e r s t h e following: 1. t h e F r e u d i a n t h e o r y o f t h e i n s t i n c t s and all r e l a t e d t h e o r i e s would affirm h y p o t h e s e s v e r y m u c h like t h o s e f o u n d i n c o n t e m p o r a r y p h y s i o l o g i e s o f t h e brain and o f t h e s e n s e s . s u b j e c t . T h i s desire w o u l d u l t i m a t e l y be fulfilled a f t e r modification i n t o a c o r r e s p o n d i n g act o f will. 3. and a s t a t e of rest. B o t h people e n g a g e d in such a w e . (In the s c h e m e o f F r e u d ' s m e t a p s y c h o l o g y . this stasis p r o p e r t o lifeless i n o r g a n i c m a t t e r is t h a t to w h i c h all o r g a n i s m s . " T h i s allows the significance o f t h e e x t e r n a l object t o b e grasped and t h e n allows t h e a p p r o p r i a t e r e a c t i o n t o t a k e place. t o o . T h e layer t h e o r i e s would see i n the b e h a v i o r o f R e g u l a Z i i r c h e r and her lover the operation of two mental entelechies. as it had e x i s t e d b e f o r e t h e e x c i t a t i o n o f t h e drives. N o t o n e o f t h e p s y c h i c p h e n o m e n a t h e y put forth to m a k e the puzzling object of study c o m p r e h e n s i b l e can be s h o w n to be actually t h e r e in or behind the p h e n o m e n a ol R e g u l a Z i i r c h e r ' s e n c o u n t e r . w o u l d b e r e c o v e r e d . basically i n t e n d . and a f t e r the p s y c h i c e n e r g y o f t h e desire had b e e n t r a n s f e r r e d t o t h e m o t o r c e n t e r s o f t h e brain. T h e e m o t i o n a l t e n s i o n would find its r e l e a s e . via the c e r e b r a l c o r t e x . and t h e e m o t i o n s .r e l a t i o n s h i p w o u l d be led t o g e t h e r to a fuller realization of self by a single g e n e r a t i v e impulse. T h e only p r e r e q u i s i t e for this p r o c e s s w o u l d b e t h e p r o j e c t i o n o f t h e m e n t a l r e p r e s e n t a t i o n back o n t o its original in t h e outside world. " s h o w i n g t h a t t h e y had g e n e r a t e d t h e m u t u a l embrace. the e x c i t a t o r y q u a n t i t i e s o f t h e mobilized drives and a f f e c t s w o u l d a c t i v a t e t h e a u t o n o m i c n e r v o u s s y s t e m . All t h e e x p l a n a t i o n s s k e t c h e d h e r e s h a r e t h e s a m e s e r i o u s deficiency i n the analysis o f a n o r m a l h u m a n e n c o u n t e r . t h e " t r i g g e r i n g i m a g e .b e t w e e n . A s psychic s t r u c t u r e s . " an " i n t e r s u b j e c t i v e " r e a l m . T o t h e a n t h r o p o l o g i c a l and dialogical b r a n c h e s o f p s y c h o l o g y t h e m o s t i m p o r t a n t t h i n g would b e t h a t i n this e n c o u n t e r t h e h u m a n s u b j e c t — o r p e r s o n — o f R e g u l a Z i i r c h e r and t h e s e c o n d p e r s o n o f h e r l o v e r had. c o i n c i d e s w i t h a p r e f o r m e d i m a g e i m m a n e n t in t h e p s y c h e . a r o u s e t h e i n s t i n c t i v e desire to fall i n t o t h e l o v e r ' s a r m s . and would t h e n b r i n g t h e s e l a y e r s t o g e t h e r into a unified " p s y c h i s m . t h e drives. t h e y a r e said t o a t t a c h t h e m s e l v e s i m m e d i a t e l y t o t h e i m a g e of t h e l o v e r i m m a n e n t in t h e c o n s c i o u s n e s s and to i n v e s t ( c a t h e c t ) it as a libidinal o b j e c t .44 EXISTENTIAL FOUNDATIONS would b e a r o u s e d b y t h e e n d o p s y c h i c i m a g e o f h e r lover. c a u s i n g h e r h e a r t t o pound. T h e s e theories would bring into play t h e d e e p e r psychic l a y e r s o f t h e v e g e t a t i v e d e p t h . In t h e m o t o r a b r e a c t i o n — t h e actual e m b r a c e o f t h e l o v e r and t h e s e x u a l act w h i c h e v e n t u a l l y f o l l o w s — t h e drives first mobilized b y p e r c e p t i o n would a c h i e v e t h e i r goal.d i a l o g u e . ) T o t h e s e older F r e u d i a n c o n c e p t s g e s t a l t p s y c h o l o g y and c o n t e m p o r ­ ary animal p s y c h o l o g y w o u l d a t t a c h t h e idea t h a t t h e i m a g e o f the lover. w h e n i t h a s g o t t e n i n t o t h e brain o r p s y c h e f r o m t h e outside. and would also. F u r t h e r m o r e . " e n t e r e d i n t o a " w e . " H e r e t h e I of t h e o n e and the t h o u of t h e o t h e r would dwell in a h u m a n " i n . a s a n " I " and a " t h o u . T h e r e is in her perceivable . T h e image of the ocean has u p s t a g e d t h e o n e actually i n t e n d e d b e c a u s e . T h e r e is a s o m e w h a t d i f f e r e n t d r e a m t h e o r y — i n t e r p r e t a t i o n on t h e s u b j e c t i v e l e v e l — w h i c h i s c o m m o n l y c o n t r a s t e d w i t h t h e first type— i n t e r p r e t a t i o n on t h e o b j e c t i v e level. it can appear by duping t h e dream censor. of b e i n g b a s e d on s y s t e m a t i c and scientifically f o r m u l a t e d t h e o r i e s . Until F r e u d . o r a r g u e s for t h e e x i s t e n c e o f i n s t i n c t s t h a t could set an e g o or p s y c h e in m o t i o n from w i t h i n . p s y c h o a n a l y t i c d r e a m t h e o r y would a s s e r t t h a t o u r p a t i e n t ' s r e c u r r i n g n i g h t t i m e e x p e r i e n c e s o n t h e o c e a n floor w e r e p r o d u c t s o f endopsychic. w o u l d b e seen disguised i n the representation of the dreamed ocean. m a n y d r e a m t h e o r i e s h a v e c o m e f o r t h t o c o r r e c t and c o m p l e m e n t h i s . T h e proposed i n t e r s u b j e c t i v e m i d d l e g r o u n d d o e s n o t bring u n d e r s t a n d i n g o f t h e actual e n c o u n t e r . to this prudish d r e a m e r . and a s w o r t h y o f s e r i o u s a t t e n t i o n . T h e d r e a m o b j e c t . t h e w o m b . and J u n g . and r e p r e s e n t a t i o n s . i n s t i n c t i v e desire t o r e t u r n t o t h e w o m b would b e held r e s p o n s i b l e for t h e r e a l i z a t i o n o f t h e d r e a m i m a g e . T h e d r e a m t h e o r y o n the s u b j e c t i v e level w o u l d see i n the d r e a m i m a g e o f t h e o c e a n t h e p a t i e n t ' s o w n individual u n c o n s c i o u s . S i n c e his Interpretation of Dreams a p p e a r e d . Psychological interpretations of the stereotypical boxcar dream. t r i g g e r i n g i m a g e s . or a r g u e s for t h e p r e s e n c e o f a n e n t e l e c h y and o t h e r psychic l a y e r s . this is a l w a y s an i n f a n t i l e . t h e i n f a n t i l e . hallucinatory dream images.Applying This View to Regula Zürcher 45 behavior no evidence that supports assertions of the presence of e n d o p s y c h i c s e n s o r y stimuli. In Freud's view. w e h a v e n e v e r yet c o m e a c r o s s a h e a l t h y p e r s o n w h o could h a v e s u c h a d r e a m . T h e s e manifest dream images would be f u r t h e r explained as e f f e c t s of a d r e a m c a u s a t i o n or as p r o d u c t s of a d r e a m m o t o r w h i c h g e n e r a t e d all d r e a m s in o n e and t h e s a m e w a y . W i t h r e f e r e n c e t o o u r patient's b o x c a r d r e a m . It t o o is f o r e s h a d o w e d in Interpretation of Dreams b u t w a s n o t fully developed until later by S i l b e r e r . a w o m b w o u l d p r o b a b l y be t o o indelicate a t h i n g to appear undisguised. a s the waking encounter with her lover. t h e r e w e r e n o e x p l i c a t i o n s o f d r e a m s t h a t had t h e a p p e a r a n c e . W e can c o n s i d e r R e g u l a Z i i r c h e r ' s b o x c a r d r e a m a p h e n o m e n o n j u s t a s i m p o r t a n t t o h e r e x i s t e n c e . 1 T o b e g i n . M a e d e r . e n d o p s y c h i c g e s t a l t c o n f i g u r a t i o n s . M a s k e d in t h e n e u t r a l i m a g e of an o c e a n . i n s t i n c t i v e d e s i r e . T h i s dream belongs unmistakably to t h e p s y c h o p a t h o l o g i c a l p h e n o m e n a o f h e r e x i s t e n c e . at least. f o r i t leaves b o t h t h e I o f R e g u l a Z i i r c h e r and the t h o u o f h e r l o v e r w i t h o u t clarification. We shall limit o u r s e l v e s t h e r e f o r e t o a n e x a m i n a t i o n o f its e x p l a n a t o r y capabilities. A n d since w e h a v e m a d e e x t e n s i v e studies o f F r e u d i a n and m o d e r n d r e a m t h e o r i e s i n t w o o t h e r w o r k s . b u t n o n e differs basically from Freud's original. w e shall focus h e r e o n a f e w c h a r a c t e r i s t i c f e a t u r e s . or projected o u t w a r d in the f o r m of an i m a g e . F u r t h e r m o r e .w o r k w h i c h can t h e n b e said t o employ the trick o f " r e v e r s a l i n t o t h e o p p o s i t e . F r e u d h i m s e l f a d m i t t e d t h a t s u c h a s u p p o s i t i o n w e n t b e y o n d w h a t can b e d e m o n s t r a t e d . n o t e v e n in t h e f o r m o f a n e n d o p s y c h i c s t r u c t u r e . individual or c o l l e c t i v e . this o c e a n is t h e d i a m e t r i c a l o p p o s i t e of a w o m b . while d r e a m i n g . B o t h had t o allow t h a t t h e t w o u n c o n s c i o u s ­ n e s s e s c o u l d n e i t h e r be o b s e r v e d as such n o r d e m o n s t r a t e d t o be actual e n t i t i e s bul must be i n t e r r e d from the o b s e r v a b l e p h e n o m e n a (which are already a^sutned t o h e t h e i r effects).46 EXISTENTIAL FOUNDATIONS r e p r e s e n t e d s y m b o l i c a l l y . safe. c a n n o t c o m m a n d e v i d e n c e in its b e h a l f w h e n it would say t h a t I he ocean r e p r e s e n t s t h e d r e a m e r ' s u n c o n s c i o u s . i n t h e b o x c a r d r e a m t h e r e w a s n o i n s t i n c t i v e infantile desire to be f o u n d as c a u s e or m o t i v e . J u n g ' s analysis in p a r t i c u l a r would a s s u m e t h a t the o c e a n s y m b o l i z e d a collective u n c o n s c i o u s w i t h i n t h e d r e a m e r . R a t h e r . m u s t be s e e n in t h e light of a d m i s s i o n s m a d e by I i e n d and |ung t h e m s e l v e s . and s h e l t e r i n g . too. has done nothing but project mental images of external objects or symbols of s u b j e c t i v e a s p e c t s o f h e r o w n self. " B u t t h e t h e o r y i s hard put t o e x t r a c t f r o m the actual p h e n o m e n a o f this d r e a m a single p r o o f for t h e e x i s t e n c e o f such d r e a m . T h e d r e a m ' s puzzling p h e n o m e n a are n o t t h i n g s a p e r s o n can have. N o w . we can find little validity in t h e a s s e r t i o n t h a t all of this is m e r e l y r e p r e s e n t a t i o n or m e r e l y hallucinated u n r e a l i t y . w h i c h is w a r m . I his c o n s t r u c t i o n . S t r i c t l y speaking. n o u r i s h i n g . R e g u l a Z ü r c h e r . perceiving and c o n d u c t i n g h e r s e l f t o w a r d t h e p h e n o m e n a o f t h a t d r e a m i n g world j u s t a s she did t o w a r d h e r w a k i n g world. T h e r e is no e v i d e n c e in t h e s e p h e n o m e n a to support t h e h y p o t h e s i s t h a t R e g u l a Z ü r c h e r . F r e u d i a n d r e a m i n t e r p r e t a t i o n c o n t r a s t s m o s t strikingly w i t h the actuality o f the p h e n o m e n a t h e m s e l v e s w h e n i t claims t h a t t h e o c e a n o f t h e d r e a m really m e a n s t h e w o m b . 2 P s y c h o a n a l y t i c d r e a m t h e o r y deals w i t h c o n t r a d i c t i o n b e t w e e n its e x p l a n a t i o n s and t h e actual p h e n o m e n a b y c o n t r i v i n g t h e o p e r a t i o n o f u n c o n s c i o u s d r e a m . t o o . while s h e was d r e a m i n g R e g u l a Z ü r c h e r found h e r s e l f e x i s t i n g in a world. R e g u l a Z ü r c h e r did n o t have a dream at all. Interpretation of the boxcar dream from the theory of the subjective l e v e l . if we hold t h e s e e x p l a n a t i o n s up to w h a t we actually see h a p p e n i n g w i t h o u r d r e a m e r . and w i t h the w a y she c o n d u c t s h e r s e l f t o w a r d w h a t is in h e r d r e a m world. .w o r k . W i t h its icy cold and its t e r r i f y i n g l o n e l i n e s s . T h e o c e a n ' s coldness and t h e d r e a m e r ' s s e n s e of being lost t h e r e would p r o b a b l y be i n t e r p r e t e d as the g r a p h i c r e p r e s e n t a t i o n o f h e r poor r e l a t i o n s h i p t o t h e s e levels o f h e r psyche. especially w h e n caring for t h e child kept h e r f r o m being c o n s t a n t l y w i t h h e r l o v e r . in p a r t i c u l a r .Applying This View to Regula Zürcher •17 Psychological explanations of the knife phobia P h o b i a s r e g a r d i n g s t r a n g l i n g and k n i v e s are a s e c o n d pathological m a n i f e s t a t i o n in R e g u l a Z ü r c h e r ' s life h i s t o r y . from R e g u l a Z ü r c h e r ' s u r g e s to stab. c o m p e l l i n g h e r t o a s s u m e t h e p h a l l i c . and t o identify t h e s l i g h t e s t indications o f u n c o n s c i o u s desires t o kill o r h o m o s e x u a l l y a b u s e h e r d a u g h t e r . a proper obsessional symptom must evidence the foreignness of t h e o c c u r r i n g t h o u g h t and u r g e to act. h o m o s e x u a l feelings t h e m o t h e r h a r b o r s t o w a r d h e r d a u g h t e r . T h e a t t a c k s o f t h e s e u r g e s t o s t a b and t o s t r a n g l e w e r e n o t . as t h e child of a m a n h a t e d for his lack o f love. c o n t i n g e n t h y p o t h e s i s r e g a r d i n g the u r g e to stab.m a s c u l i n e role o f p e n e t r a t i o n w i t h r e s p e c t t o t h e o t h e r f e m a l e . t h e t h e o r y would point o u t t h a t t h e u r g e s t o s t a b w o u l d o c c u r o n l y (and a l w a y s ) w h e n the p a t i e n t h a d n o adult m a l e s e x u a l p a r t n e r . p s y c h o a n a l y t i c t h e o r y p r o f f e r s t h e idea t h a t an u n c o n s c i o u s d e a t h w i s h a g a i n s t t h e p a t i e n t ' s child m u s t be w o r k i n g i n t h e b a c k g r o u n d . w h e n she could have been the s e x u a l p a r t n e r of a m a n . T h e y p r o d u c e d in h e r the m o s t p r e s s i n g and t o r m e n t i n g s y m p t o m s . t h e p a t i e n t o f t e n — a n d quite c o n s c i o u s l y — f e l t h e r d a u g h t e r a s a n e n c u m b r a n c e . B o t h p s y c h o a n a l y t i c e x p l a n a t i o n s for t h e p a t h o l o g i c a l s y m p t o m s o f R e g u l a Z ü r c h e r deal i n u n c o n s c i o u s desires and u n c o n s c i o u s i n s t i n c t s . A s e c o n d . failed t o elicit from this p a t i e n t t h e s l i g h t e s t s u b s t a n t i a t i o n t h a t a n y such e n d o p s y c h i c c o n s t i t u ­ e n t s w e r e actually p r e s e n t . P s y c h o a n a l y t i c t h e o r y w o u l d close its case b y calling o n t h e w i d e s p r e a d v i e w t h a t w h e n e v e r a k n i f e a p p e a r s in d r e a m s or n e u r o t i c s y m p t o m s it a l w a y s r e f e r s s y m b o l i c a l l y t o t h e penis. T h e v i c t i m of t h e d e s t r u c t i v e a g g r e s s i v e drives. i t s e l f b e c o m e s the object o f u n c o n s c i o u s h a t r e d . C e r t a i n l y . T h e final point o f e v i d e n c e for this v e r s i o n i s t h a t t h e s e u r g e s tended t o s u r f a c e w h e n t h e p a t i e n t w a s i n p a r t i c u l a r l y c l o s e physical c o n t a c t w i t h h e r little d a u g h t e r . T o explain s u c h m a n i f e s t a t i o n s . T h e s e t w o r e q u i r e m e n t s are c o n s p i c u o u s l y a b s e n t i n R e g u l a Z ü r c h e r ' s s t r a n g l i n g and s t a b b i n g u r g e s . b r e a k i n g halfway t h r o u g h i n h e r s y m p t o m s . o n e m i g h t infer. h e r w h o l e libido would b e applied t o h e r h o m o s e x u a l c o m p o n e n t i n s t i n c t . T o s u p p o r t this. says t h a t u n d e r c e r t a i n c i r c u m s t a n c e s such a s y m p t o m could also be a w o r k i n g o u t of u n c o n s c i o u s . D u r i n g t i m e s o f s u c h s e x u a l f r u s t r a t i o n . B u t j u s t a t t h o s e t i m e s . and a c e r t a i n d i s t a n c e of t h e s u b j e c t f r o m t h e m . t h e i n f l u e n c e of a symbolically disguising d i s p l a c e m e n t i n t h e o u t w a r d direction o f t h e u n c o n s c i o u s desire t o p e n e t r a t e t h e d a u g h t e r ' s g e n i t a l s w i t h a n i m a g i n a r y penis. h o w e v e r . w h e n h e r child's p r e s e n c e was . t r u e o b s e s s i o n a l m a n i f e s t a t i o n s . phallic. i n t h e s t r i c t e s t s e n s e o f t h e t e r m . T h r e e w h o l e y e a r s o f o b s e r v a t i o n . A c c o r d i n g to t h e definition c u r r e n t in psychiatry. A c c o r d i n g l y . As this t h e o r y h a s it.o b s e r v e r w a s e v e r able t o e s t a b l i s h b e t w e e n t h e k n i v e s and t h e m a l e g e n i t a l s the s o r t o f c o n n e c t i o n p s y c h o a n a l y t i c t h e o r y has in mind.a g g r e s s i v e aspect of t h e p a t i e n t ' s n a t u r e . all sadism e x p r e s s e s a s e c r e t inclination to m o v e " f r o m a b o v e to b e l o w . P s y c h o a n a l y t i c t h e o r y c o u n t e r s o b j e c t i o n s like t h e s e b y saying t h a t w e are dealing h e r e w i t h u n c o n s c i o u s . w h i c h is so i m p o r t a n t in all t h e p s y c h o l o g i c a l explanations. t h e u r g e s t o s t r a n g l e and s t a b w e r e e n t i r e l y a b s e n t . b e i n g p r e s e n t o n l y i n the u n c o n s c i o u s o f t h e p a t i e n t ' s p s y c h e . the knives always remained m e r e l y k n i v e s . " f r o m " a n i m a t i o n t o a n n i h i l a t i o n . she n e v e r felt a n y t h i n g m a s c u l i n e a b o u t h e r s e l f . T h e p a t i e n t ' s c o n s t i t u t i o n h a s a n u n e q u i v o c a l l y f e m i n i n e s t a m p . h e r h a p p i n e s s depended. E v e n w h e n s h e w a s o v e r c o m e b y t h e u r g e t o stab. M o r e o v e r . o n h e r being free t o b e a w o m a n . H o w t h e n is an unconscious. " from " w h o l e n e s s t o d i s m e m b e r m e n t .48 EXISTENTIAL F O U N D A T I O N S h i n d e r i n g h e r t h e m o s t . and still does. " from " w e a l t h t o p o v e r t y . " from " b e i n g t o n o n . S h e n e v e r e x p e r i e n c e d t h e desire to be a m a n . " from " a f f i r m a ­ tion t o n e g a t i o n . O n the c o n t r a r y . N e i t h e r she n o r the p h y s i c i a n . " from " e l e v a t i o n t o d e g r a d a t i o n . N o r m a l l y . t h e e x p l a n a t i o n s o f medical a n t h r o p o l o g y a r e a s crudely i n c o n s i s t e n t a s t h o s e o f p s y c h o a n a l y t i c t h e o r y .b e i n g . M a n y a n a l y s t s would no longer reduce the unconscious symbolic content of the knives to a literal penis. T o t h e m a n y q u e s t i o n s h e r t h e r a p i s t asked while l o o k i n g for e v i d e n c e o f m a s c u l i n e t e n d e n c i e s . B u t t h e t h e o r y n e g l e c t s t o explain t h e n h o w it can k n o w in t h e first place t h a t such u n c o n s c i o u s d e s i r e s do e x i s t . R e g u l a Z i i r c h e r r e p e a t e d l y r e s p o n d e d b y h e r s e l f asking w h e t h e r it was senseless to inquire into the gender of the thrashing a b o u t t h a t h a p p e n e d w h e n a m a n o r w o m a n w a s being t h r o t t l e d . " from " f o r m t o c h a o s . e v e r y act of w i s h i n g i n e v i t a b l y p r e s u p p o s e s a w a r e n e s s of w h a t is w i s h e d for. " N o t h i n g w h a t s o e v e r o f t h a t s o r t o f e x i s t e n t i a l m o v e m e n t can b e 3 . unknowing knowledge supposed to be constituted? T h e same thing happens to the psychoanalytic interpretation of the knife as phallic s y m b o l . t h e a w a r e n e s s t h a t a beloved child is a b u r d e n s o m e t i m e s is still miles f r o m being a d e a t h w i s h . T h e y would p r e f e r to see in t h e s t a b b i n g u r g e t h e disguised b r e a k t h r o u g h of a g e n e r a l m a l e . B u t e v e n this e x p l a n a t i o n does n o t keep t o facts t h a t could actually b e e x p e r i e n c e d . F o r t h e s e p s y c h o p a t h o l o g i c a l p h e n o m e n a . It fails also t o m e n t i o n w h a t t h e n a t u r e o f a n u n c o n s c i o u s desire o r i n s t i n c t is and of w h a t s t u f f it is m a d e . c a n n o t b e o b s e r v e d directly. r e p r e s s e d d e s i r e s — w i t h d e s i r e s w h i c h . C o n t e m p o r a r y p s y c h o a n a l y t i c t h e o r y would o f c o u r s e b e prepared t o a m e n d its original s y m b o l i c i n t e r p r e t a t i o n s o m e w h a t . As the patient perceived them. T h e u r g e s t o s t r a n g l e and stab would d o u b t l e s s b e e x p l a i n e d according to t h e i r t h e o r y of sadism. t h e p s y c h i a t r i c c o n d e m n a t i o n o f so-called h a l l u c i n a t i o n s t o t h e s t a t u s o f t h e unreal is o n l y a n e g a t i v e d e t e r m i n a t i o n . o r m e r e l y o u t w a r d p r o j e c t i o n s o f s o m e t h i n g inside. T h e y a r e called h a l l u c i n a t i o n s and t h e r e b y s t a m p e d a s p h a n t o m s . w i t h its fields of p r o j e c t i o n . E v e n given c o n t e m p o r a r y m e d i c i n e ' s i n t e r p r e t a t i o n o f s e n s a t i o n a s w h a t scientific r e s e a r c h m e t h o d s can r e g i s t e r from t h e c h e m o p h y s i c a l p r o c e s s e s o f all t h e s e n s e o r g a n s . it can tell us n o t h i n g a b o u t t h e h a l l u c i n a t i o n as such. w e can d i s c e r n n o e v i d e n c e t o a r g u e for t h i s .t h o u r e l a t i o n s h i p w o u l d g o along w i t h t h e s e p s y c h o p a t h o l o g i c a l p h e n o m e n a . t o t h e h a l l u c i n a t i n g p e r s o n . a t t r i b u t e d h a l l u c i n a t i o n s to o v e r w h e l m i n g i n n e r s u b j e c t i v e t h e m e s . for life and b r e a t h . B u t this does n o t e n a b l e u s t o u n d e r s t a n d t h e s e m a n i f e s t a t i o n s . t h a t is. On the contrary. w h e n h e r e n t i r e being. s e n s o r y illusions. plus t h e i r c o n n e c t i v e p a t h w a y s i n t h e brain. t h e h u m a n s e n s e o r g a n s a r e w h o l l y u n a b l e t o perceive. T o begin w i t h . k n i v e s w h i r r e d t h r o u g h t h e air b e f o r e h e r e y e s . I n t h e actual case o f R e g u l a Z ü r c h e r ' s knife h a l l u c i n a t i o n s .Applying This View to Regula Zürcher d i s c e r n e d i n t h e p h e n o m e n a o f o u r p a t i e n t ' s i m p u l s e s t o s t a b and strangle. o r p r o j e c t i o n s o f m e n t a l c o n t e n t s o u t w a r d into t h e e x t e r n a l world. these urges overcame her only in extremely pressing c i r c u m s t a n c e s . B y t h e m s e l v e s . p a t h o l o g y is still far from such an a c c o m p l i s h m e n t . Q u i t e t h e r e v e r s e . w h i c h w a s called for a t i m e " p s y c h i a t r i c I )aseinsanalysis". W h a t c a n n o t p e r c e i v e c a n n o t b e deceived. M o r e o v e r . T h e y a r e distin­ g u i s h e d by a singularly i n t e n s e p r e s e n c e and reality in t h e w o r l d of t h e patient. I he p a t i e n t a l w a y s r e c e i v e d t h e u r g e n t c o m m a n d s to p l u n g e t h e knife into h e r child's body j u s t at t h e m o m e n t of h e r h a l l u c i n a t i o n . cried o u t for space and f r e e d o m . F u r t h e r m o r e . T h e s e k n i v e s w e r e s o palpable t o h e r t h a t s h e w o u l d g r a b for t h e m and fear r u n n i n g a m o k w i t h t h e m . and from a . Psychological explanations for the knife hallucinations A t t i m e s o f g r e a t e s t t o r m e n t for R e g u l a Z ü r c h e r . N e e d l e s s t o say. B u t this f o r m u l a t i o n c o n t r i b u t e s n o t h i n g t o help u n d e r s t a n d t h e p h e n o m e n a . i t w o u l d h a v e s o m e scientific v a l u e . t h e t h i n g s hallucinated are i n n o w a y m e r e l y illusory. h o w e v e r . It is no m o r e successful to c h a r a c t e r i z e h a l l u c i n a t i o n s as s e n s o r y illusions. If we could d e s c r i b e b e f o r e h a n d e x a c t l y w h a t reality is. t o g r a s p t h e m e a n i n g f u l c o n t e n t o f s o m e t h i n g . while t h e p s y c h o a n a l y t i c p r o j e c t i o n t h e o r y could a t b e s t tell u s s o m e t h i n g a b o u t t h e f o r m i n g m e c h a n i s m o f a n h a l l u c i n a t i o n . still t h e s e n s e o r g a n s a l o n e c a n n o t perceive. A n o t h e r s c h o o l of p s y c h i a t r y . w r a c k e d w i t h t h e t e r r o r of s u f f o c a t i o n . T h e p s y c h o l o g i e s of dialogue w o u l d be c o r r e c t in c l a i m i n g t h a t a s e r i o u s disruption o f t h e I . T h e e x p l a n a t i o n s o f t r a d i t i o n a l p s y c h o p a t h o l o g y o n l y give a n a m e t o t h e s e p h e n o m e n a . are basically limited to s e e k i n g out m o t i v e s in t h e life h i s t o r y t h a t u l t i m a t e l y lead t o t h e o u t b r e a k o f s y m p t o m s . It can also call itself the first scientifically modified p s y c h o s o m a t i c i n t e r p r e t a t i o n in c o n t e m p o r a r y m e d i c i n e . T h e a c c u m u l a t e d e n e r g y o f t h e r e p r e s s e d drive would finally h a v e s w i t c h e d i t s e l f o v e r o n t o the s o m a t i c i n n e r v a t i o n of the leg. Finally. the pathological a t t u n e m e n t to a most e x t r e m e fear o f s u f f o c a t i o n . this desire w o u l d have b e e n totally i n c o m p a t i b l e w i t h t h e p s e u d o m o r a l i t y forced u p o n R e g u l a Z i i r c h e r b y h e r p a r e n t s . I n t h e p a r t i c u l a r i n s t a n c e o f R e g u l a Z i i r c h e r ' s h y s t e r i c a l paralysis a t t h e y o u n g m a n ' s g l a n c e . w h i c h d o m i n a t e d all h e r r e l a t i o n s h i p s t o t h e world. i t w a s n o spell c a s t b y t h e e m e r g e n c e o f a n endopsychic t h e m e but externally present objects that t h r e a t e n e d to m a k e R e g u l a Z i i r c h e r a blind slave.50 EXISTENTIAL FOUNDATIONS knife u n e q u i v o c a l l y p e r c e i v e d to be o u t s i d e . m this case. w a s r e s p o n s i b l e . t o g e t h e r w i t h t h e e m o t i o n s a t t a c h i n g t o t h e i m a g e . T h e e n d o p s y c h i c i m a g e o f the lover. T h e c o n s e q u e n c e o f this i r r e c o n c i l a b l e c o n t r a d i c t i o n b e t w e e n an i n s t i n c t i v e desire and m o r a l i s t i c p r e c e p t s would b e r e p r e s s i o n o f t h e desire. and in this w a y t h e a c c u m u l a t e d libininal e x c i t a t o r y q u a n t i t y would h a v e c a u s e d t h e h y s t e r i c a l l a m e n e s s . A n d it w a s no e n d o p s y c h i c t h e m e w h i c h m a d e the knife and t h e h a n d s a p p e a r a f t e r a t i m e o n l y as instruments of murder. F r e u d n a m e d this a s s u m e d s w i t c h i n g p r o c e s s " h y s t e r i c a l c o n v e r s i o n . R a t h e r . at s o m e p a r t i c u l a r spot in h e r s u r r o u n d i n g s . h o w e v e r . W h e n i t appeared. A s w e will discuss in detail l a t e r . h o w e v e r . the F r e u d i a n t h e o r y o f r e p r e s s i o n and c o n v e r s i o n still h a s t h e largest following. T h u s . would h a v e a r o u s e d t h e i n s t i n c t i v e desire t o r u s h o v e r t o the a r o u s i n g m a n and e m b r a c e h i m . " 4 F r e u d would have c o n s i d e r e d the h y s t e r i c a l paralysis o f t h e p a t i e n t ' s legs the s y m b o l i c physical m a n i f e s t a t i o n of a conflict in the u n c o n s c i o u s . G e n e t i c e x p l a ­ n a t i o n s . t h e r e a r e m a n y e x p l a n a t i o n s w h i c h would call R e g u l a Z i i r c h e r ' s knife h a l l u c i n a t i o n s p s y c h o g e n i c p h e n o m e n a . PSYCHOSOMATIC HYPOTHESES Psychosomatic explanations of the hysterical paralysis of the leg A m o n g t h e p s y c h o s o m a t i c e x p l a n a t i o n s o f physical h y s t e r i c a l s y m p ­ t o m s . the t e n s i o n b e t w e e n t h e u n c o n s c i o u s desire to e m b r a c e the . Freudian t h e o r y w o u l d s e e the r e l e a s e o f a r o u s e d s e x u a l drives and c o r r e s p o n d i n g e m o t i o n s . this s o r t of e x p l a n a t i o n c o n f u s e s t h e e s t a b l i s h m e n t o f m o t i v e s and c o n d i t i o n s for t h e m a n i f e s t a t i o n o f p a r t i c u l a r m o d e s o f human behavior with the understanding of these phenomena t h e m ­ selves. a r e t a k e n to be m e r e l y a u t o n o m i c bodily . T h e s e w e r e followed by m u c o u s y and bloody dial i h e a s . o r g a n i c n e u r o t i c d i s t u r b a n c e s . i n t r o j e c t e d by h e r parents. w o u l d h a v e c o d e t e r m i n e d and s t r e n g t h e n e d t h e h y s t e r i c a l s y m p t o m s . W i t h t h e c o n s t e l l a t i o n o f the a n i m u s . p e r c e p t i o n o f t h e y o u n g man would h a v e r e l e a s e d i n s t i n c t i v e sexual drives t o w a r d the f a t h e r i m a g e . A c c o r d i n g to his i n t e r p r e t a t i o n . and r e p r e s s i o n of. R e g u l a / i m her suffered from c o n s t i p a t i o n s o s e v e r e t h a t m e d i c a t i o n w a s o f little use. t h e psychic e x c i t a t i o n o c c a s i o n e d b y the p e r c e p t i o n o f the young m a n would h a v e g o n e b e y o n d the f a t h e r i m a g e i n R e g u l a / u r c h e r ' s individual u n c o n s c i o u s t o c o n s t e l l a t e the a r c h e t y p e o f t h e a n i m u s i n t h e e v e n d e e p e r layer o f the collective u n c o n s c i o u s . would h a v e b e e n n o m a t c h for t h e o v e r w h e l m ­ ing p o w e r s o f this layer. In a s h o r t t i m e . I t g o e s w i t h o u t saying t h a t s u c h i n c e s t u o u s i n s t i n c t i v e desires would appear particularly depraved and have t o b e fully r e p r e s s e d . and r e s i s t a n c e to. t h e p e r c e p t i o n o f the young m a n would i n s t a n t l y have a c t i v a t e d the i m a g e o f h e r o w n f a t h e r . this w a s j o i n e d b y a t t a c k s o f s t o m a c h and Intestinal c r a m p s w h i c h . i m m a n e n t in r e p r e s s e d form in h e r u n c o n s c i o u s . A few m o n t h s a f t e r h e r m a r r i a g e . i n c r e a s i n g l y f r e q u e n t . T h e a c c u m u l a t e d e x c i t a t o r y q u a n t i t i e s o f these u n c o n s c i o u s incest w i s h e s w o u l d furnish additional c o n v e r s i o n e n e r g y and. t h e t i m e of h e r first m e n s t r u a t i o n . M a n y p s y c h o a n a l y t i c a l l y o r i e n t e d t h e r a p i s t s a r g u e thai o r g a n i c n e u r o t i c s y m p t o m s h a p p e n e n t i r e l y w i t h i n t h e body's a u t o n o m i c .Applying This View to Regula Zürcher man and t h e p s e u d o m o r a l c o m m a n d m e n t a g a i n s t it. o n c e c o n v e r t e d i n t o t h e s o m a t i c . i n i outcast to h y s t e r i c a l o n e s . Such disturbances in the realm of the control system of the autonomic n e r v o u s c e n t e r s are usually called o r g a n i c n e u r o s e s as opposed to hystei ical s y m p t o m s . I he fear of libidinal i m p u l s e s t o w a r d t h e y o u n g m a n has b e e n multiplied. i n v o l u n t a r y s y s t e m . t h e p a t i e n t h a s w a s t e d a w a y to a n e a r s k e l e t o n . lung's a n a l y t i c p s y c h o l o g y adds a n o t h e r supposition. A n o t h e r assumption enters here: that the inverse Oedipus c o m p l e x had b e e n decisive in s t a v i n g o f f t h e u n c o n s c i o u s i n s t i n c t i v e desire t o w a r d t h e y o u n g m a n .a r c h e t y p e . w h i l e h y s t e r i c a l g e s t u r e s claim o n l y the voluntary m u s c l e s . still w e a k . T h e patient's e g o . w e r e a s s u m i n g a n iii' i easingly s e r i o u s f o r m . Psychosomatic explanations of the irritable colon f r o m h e r fifteenth y e a r . I n o t h e r w o r d s . the u n c o n s c i o u s d e s i r e s h a s b e e n doubled. T h i s i m a g e would still be in t h e p a t i e n t ' s u n c o n s c i o u s b e c a u s e h e r libido had r e m a i n e d u n c o n s c i o u s l y fixated on h e r f a t h e r in a childish w a y . U n d e r t h e s e c o n d i t i o n s . F u r t h e r m o r e . O f t e n s h e w o u l d n o t pass s t o o l s for t h r e e to ten days. If. Psychosomatic explanations of Regula Ziircher's breast pains O u r p a t i e n t ' s u n u s u a l l y painful b r e a s t swelling would also be classified by c u r r e n t medicine as an o r g a n n e u r o t i c s u b f o r m of p s y c h o s o m a t i c . T h i s dispute o v e r d i s t i n c t i o n s b e t w e e n h y s t e r i c a l and o r g a n i c n e u r o t i c s y m p t o m s h a s b e e n g o i n g o n i n t h e p s y c h o a n a l y t i c s c h o o l s for decades. t h e r e are m a n y o t h e r p s y c h o l o g i s t s w h o believe t h a t c h r o n i c a l l y c o n s t i p a t e d people h a v e n o t received e n o u g h in t h e i r lives. such sufferers a r e t h o u g h t t o c a r r y w i t h i n t h e m s e l v e s s o g r e a t a n u n c o n s c i o u s desire t o be set at p e a c e and c a r e d for t h a t t h e y u n c o n s c i o u s l y feel obligated to yield j u s t a s m u c h . S o m e p s y c h o s o m a t i c speculation g o e s so far as to see in t h e painful a b d o m i n a l s u r g i n g t h e e x p r e s s i o n of a life-and-death s t r u g g l e w i t h an i n t r o j e c t e d u n c o n s c i o u s i m a g e of an evil m o t h e r . For instance. like t h o s e t o r m e n t i n g o u r organically n e u r o t i c patient.e r o t i c s t a g e . t h a t bloody and m u c o u s y d i a r r h e a s . and their p l e a s u r a b l e e x p u l s i o n o r r e t e n t i o n t h e i n s t i n c t i v e goal o f this aspiration. this w e a k a r e a o f t h e physical c o n s t i t u t i o n would h a v e b e e n the first t o b e c o m e involved. T h i s i s t h e a s s u m p t i o n t h a t p a t i e n t s like o u r s h a v e b e e n visited by a libidinal r e g r e s s i o n w h i c h h a s t h r o w n t h e m back to t h e anal-sadistic s t a g e of libidinal d e v e l o p m e n t . B u t all of t h e s e depth psychological e x p l a n a t i o n s h a v e o n e t h i n g in c o m m o n . T h e r e f o r e . t h e i r a c c u m u l a t i o n w o u l d p r e s u m a b l y c a u s e their n o r m a l physical m a n i f e s t a t i o n s t o b e c o m e c h r o n i c a l l y e x a g g e r a t e d i n t o o r g a n i c neurotic disturbances. not expressions of unique. are. like h y s t e r i c a l s y m p t o m s . h o w e v e r . e m o t i o n a l t e n s i o n s o r affects w e r e p e r s i s t e n t l y h i n d e r e d i n t h e i r n o r m a l d i s c h a r g e . O n t h e o t h e r hand. physical m a n i f e s t a t i o n s o f overcompensation. T h e a r g u m e n t would h a v e b e e n t h a t . for s o m e i n t e r n a l o r e x t e r n a l r e a s o n . t h e y u n c o n s c i o u s l y d o n o t w a n t t o give o u t a n y t h i n g e i t h e r and w o u l d like t o k e e p e v e n t h e i r feces for t h e m s e l v e s . charged with meaning. t h e y a r e o n l y able t o give o u t t o o m u c h e x c r e m e n t . T h e n o t i o n o f c o n g e n i t a l o r g a n i n f e r i o r i t y s t e m m i n g from Adler's individual p s y c h o l o g y . w i t h t h e p r o p e r e m o t i o n a l t e n s i o n s and conflicts. B u t instead o f giving t h e i r fellow m e n s o m e t h i n g useful. O t h e r t h e o r i e s o f depth p s y c h o l o g y insist. a c o n g e n i t a l defect of the i n t e s t i n a l t r a c t w o u l d no d o u b t h a v e b e e n allotted first place as a c a u s e . In t h e case of o u r s u b j e c t ' s s e v e r e colitis. T h e feces b e c o m e t h e o b j e c t o f t h e drive. H e r e all sexual aspiration c o m e s from s t i m u l a t i o n o f t h e e r o g e n o u s z o n e o f t h e last part o f t h e i n t e s t i n e . and the c o n c e p t o f u n c o n s c i o u s m a s c u l i n e p r o t e s t . s y m b o l i c a l l y disguised m e a n i n g .52 EXISTENTIAL FOUNDATIONS accompaniments of emotional tensions. w e r e for s o m e t i m e v e r y popular i n e x p l a n a t i o n s o f n e u r o t i c s y m p t o m s . also called t h e a n a l . c o n f l i c t s . the pain and r o c k h a r d s w e l l i n g of R e g u l a Z i i r c h e r ' s b r e a s t s m a y justifiably be a t t r i b u t e d to a h y p e r f u n c t i o n i n g of her o v a r i e s . b r o u g h t a b o u t b y p e r s i s t e n t u n c o n s c i o u s e m o t i o n a l impulses t h a t issue f o r t h f r o m a libidinally o v e r l o a d e d p s y c h e to affect the s e x u a l o r g a n s . physical p a t h o l o g i c a l m a n i f e s t a t i o n s in R e g u l a Z i i r c h e r all r e f e r to p u r e l y psychic c o n s t r u c t s w h o s e p r e s e n c e in t h e p h e n o m e n a t h e m s e l v e s is n o t s u p p o r t e d by actual I'vidence. and despite d e l i b e r a t e q u e s t i o n i n g . b e c a u s e of a r e c k l e s s driver. in a psychic l a y e r so deep t h a t it is by definition inaccessible. T h e n w e m u s t w o n d e r h o w s o m e t h i n g s o w e a k could e f f e c t such a . N a t u r a l l y . In s u m m i n g up. disappeared r e l a t i v e l y quickly during p s y c h o t h e r a p e u t i c t r e a t m e n t . I )espite m o n t h s of i n t e n t l i s t e n i n g as t h e p a t i e n t d e s c r i b e d the • in u m s t a n c e s t h a t c u l m i n a t e d in h e r h y s t e r i c a l collapse w h e n she m e t i he man w h o w a s later to be h e r lover. w h i c h had for t h e m o s t part defied all simple h o r m o n e t r e a t m e n t s . with t h e p a t i e n t ' s circle of i n t e r e s t s h r i n k i n g to t h e t h i n g s and people in her hospital r o o m . Y e t t lie actual p r e s e n c e of s u c h u n c o n s c i o u s . drives. T h e b r e a s t pains. b u t w i t h c h a n g e s i n t i s s u e s t r u c t u r e . B u t in spite of this. as in the case o f t h e i n t e s t i n a l s p a s m s . Somatopsychic explanations of Regula Ziircher's behavior after her leg (racture R e g u l a Z i i r c h e r ' s leg f r a c t u r e o c c u r r e d w h e n s h e w a s c o m p l e t e l y healthy. we m u s t s t a t e t h a t t h e v a r i o u s p s y c h o s o m a t i c e x p l a n a t i o n s w e h a v e s e e n o f f e r e d for individual. II may be o b j e c t e d t h a t this desire w a s t o o w e a k to a t t r a c t t h e p a t i e n t ' s notice. distinct f r o m h e r earlier p s y c h o s o m a t i c illnesses.Applying This View to Regula Zürcher 53 illnesses. N o t h i n g h e r e p o i n t s to a p s y c h o n e u r o t i c accident p r o n e n e s s . t h e r e w a s to be f o u n d no t r a c e of a desire to fall i n t o the y o u n g m a n ' s a r m s . a powerful psychic c h a n g e set in as an i m m e d i a t e r e s u l t of t h e accident. P s y c h o a n a l y t i c t h e o r y explains t h e loss of i n t e r e s t as a r e t r e a t of t h e libido to an infantile. all supposedly b u r i e d in an individual or collective u n c o n • I i o n s .11 id ( l o s e a t t e n t i o n to t h e free a s s o c i a t i o n s t h a t followed. a s p i r a t i o n s . H y s t e r i c a l and o r g a n i c n e u r o t i c s y m p t o m s w e r e m o s t o f t e n explained by n o t i o n s of v a r i o u s d e s i r e s . and s o h e r leg f r a c t u r e m a y b e c h a r a c t e r i z e d as an e n t i r e l y s o m a t i c h e a l t h d i s t u r b a n c e . narcissistic s t a g e o f d e v e l o p m e n t . P s y c h o s o m a t i c m e d i c i n e h e r e posits simply a periodic hyperfolliculation. and an h e t y p e s . T h i s can be d e s i g n a t e d a s o m a t o p s y c h i c o c c u r r e n c e . P s y c h o s o m a t i c m e d i c i n e w o u l d n o t b e d e t e r r e d b y t h e fact t h a t we are no l o n g e r dealing h e r e simply w i t h f u n c t i o n a l d i s t u r b a n c e s . e n d o p s y c h i c i m p u l s e s could n o t he verified in R e g u l a Z i i r c h e r ' s b e h a v i o r . we all live in such a perceived world. it is a r g u e d t h a t t h e desire w a s so u n b e a r a b l y s t r o n g t h a t it had to be r e p r e s s e d i n t o the u n c o n s c i o u s . this w o r l d is. h e r w o r l d s h r a n k t o the d i m e n s i o n s o f h e r hospital r o o m and to o b j e c t s and people she could perceive in t h a t r o o m . a c o n t e x t o f m e a n i n g s and r e f e r e n c e s . and s o m a t o p s y c h i c i n t e r p r e t a t i o n s : n o kind o f psychic e n e r g i e s o r i n s t i n c t i v e f o r c e s could. i n and o f t h e m s e l v e s . t o o . b u t n o t h i n g in this p a t h o l o g i c a l e v e n t could be f o u n d to a r g u e t h e p r e s e n c e of an active a r c h e t y p e in t h e collective u n c o n s c i o u s . p s y c h o s o m a t ­ ic. e x i s t s i n h e r r e l a t i o n s h i p s t o t h e p h e n o m e n a of h e r w o r l d and as t h e s e r e l a t i o n s h i p s . b u t at no t i m e did R e g u l a Z i i r c h e r e x h i b i t libidinal p l e a s u r e in h e r feces or in rectal s t i m u l a t i o n . h o w e v e r . particularly i n t o t h e affected part. T h e r e is a g r e a t e r m y s t e r y h e r e . Psychoanalytic theory construes the temporary narrowing of interests w h i c h t h e p a t i e n t e x p e r i e n c e d a f t e r h e r leg f r a c t u r e as t h e libido's w i t h d r a w a l from t h e e x t e r n a l w o r l d and its s u b s e q u e n t r e t r e a t i n t o itself. and it applies f u n d a m e n t a l l y to all p s y c h o l o g i c a l . Psychoanalytic theory attributes the patient's intestinal symptoms to a r e g r e s s i o n of t h e libido to t h e a n a l . It does n o t appear likely t h a t t h e s e p e r s p e c t i v e s will e v e r b e h o l d individual pathological s y m p t o m s a s t h e m a n i f e s t a t i o n s o f h u m a n e x i s t e n c e t h e y are. T h o u g h such a n e x p l a n a t i o n deals w i t h a s o m a t o p s y c h i c p h e n o m e n o n . As a c o n s e q u e n c e of this. R e g u l a Z i i r c h e r ' s i n t e s t i n a l tract w a s far m o r e robust than average.54 EXISTENTIAL FOUNDATIONS d r a m a t i c paralysis. c o n s t r u c t o r d i s m a n t l e t h e w o r l d of a h u m a n being. s i n c e .e r o t i c s t a g e . and e v e r y day of o u r lives. S i m i l a r l y . If. p s y c h o s o m a t i c and s o m a t o p s y c h i c e x p l a n a t i o n s w h i c h o p e r a t e w i t h t h e c o n c e p t s of libido and drive h a v e n e v e r m a n a g e d to get at the basis of t h e puzzling p h e n o m e n a o f h u m a n e x i s t e n c e — n o s u r p r i s e . and is perceived as. Adler's t h e o r y o f i n n a t e o r g a n i c i n f e r i o r i t y does n o t m e r i t s e r i o u s c o n s i d e r a t i o n a s a n e x p l a n a t i o n for t h e s e d i s t u r b a n c e s . it m u s t n e v e r t h e l e s s be held a c c o u n t a b l e for e s t a b l i s h i n g t h a t s o m e t h i n g like a libido actually e x i s t s and can be e x t e n d e d or w i t h d r a w n . a f t e r h e r leg f r a c t u r e . on t h e o t h e r h a n d . Yet the m o s t q u e s t i o n a b l e o u t c o m e o f c o n t e m p o r a r y p s y c h o s o m a t i c (and s o m a t o p s y c h i c ) thinking is the r e l a t i o n s h i p it e n v i s i o n s e x i s t i n g . the m a t t e r b e c o m e s totally i n c o m p r e h e n s i b l e . An u n c o n s c i o u s desire is a c o n t r a d i c t i o n in itself. Invariably. R e g u l a Z u r c h e r . w h e n h e r t h e r a p y ended. since this basis c o n s i s t s in e x i s t i n g b e i n g ' s r e l a t e d n e s s to t h e w o r l d at a g i v e n t i m e . N o t only w a s t h e r e n o e v i d e n c e o f a n u n c o n s c i o u s s e x u a l desire i n t h e h y s t e r i c a l paralysis of the leg. T h e r e is no libido or drive capable of seeing or h e a r i n g or of c o m p r e h e n d i n g s o m e t h i n g as s o m e t h i n g . F r o m o u r b e g i n n i n g s . S h e lived in this w a y even w h e n . o r a s e x p r e s s i o n o f o n e b y t h e o t h e r . " S ü c h t i g e s V e r h a l t e n i m G e b i e t s e x u e l l e r v e r i r r u n g e n . ( L o n d o n : I m a g o . v o n G e b s a t t e l . p . 1 3 7 a n d 1 8 3 . e a c h o f t h e s e p e r s p e c t i v e s — t h e p s y c h o l o g i c a l . the p s y c h o s o m a t i c . . i n aspiring t o c o m p l e t e t h e scientific t h e o r y o f physical m e d i c i n e . T h e o n l y q u e s t i o n r e m a i n i n g i s w h e t h e r this o b s e r v a t i o n i s justified only w i t h r e g a r d t o R e g u l a Z i i r c h e r ' s particular c a s e o r w h e t h e r i t h a s g e n e r a l and f u n d a m e n t a l validity. F r e u d . DerTraum und seine Auslegung ( B e r n : H a n s H u b e r . 1 9 4 3 ) . NOTES 1 M. 8 2 . and t h e s o m a t o p s y c h i c — t r e a t s t h e p h e n o m e n a o f o u r lest c a s e . 1. ( 1 9 3 2 ) . 6 3 . we reach a c o n c l u s i o n as u n m i s t a k a b l e as it is striking. pp. 1 9 5 3 ) . P s y c h o s o m a t i c thinking d e s c r i b e s t h e r e l a t i o n s h i p b e t w e e n p s y c h e and soma a s i n t e r a c t i o n . vergangene Nacht ( B e r n : H a n s H u b e r . B o s s . . 3 . vol. I n c . Die Abwehr-Neuropsychosen. F r e u d . I f w e c o n s i d e r h o w . 1942). Die Traumdeutung. V . eil. E . •I S. 1 9 7 5 ) . " Monatssch­ rift fur Psychologie. in Gesammelte Werke. a n d Es träumte mir 2 . I n c . B u t i t n e v e r explains how a n y such r e l a t i o n s h i p could e x i s t at all b e t w e e n t w o such heterogeneous things. i n G e s a m m e l t e W e r k e . and t h e r e is no e v i d e n c e w h a t s o e v e r t h a t m o s t o f t h e m actually exist. T h e i r e x p l a n a t i o n s for R e g u l a Z i i r c h e r ' s h e a l t h y b e h a v i o r and h e r p a t h o l o g i c a l s y m p t o m s a s well c o n s i s t e n t l y r e f e r t o psychic e n t i t i e s . vol 2 / 3 ( L o n d o n : I m a g o .55 Applying This View to Regula Ziircher b e t w e e n t h e s o m a and t h e p s y c h i c e n t i t i e s it p o s i t s . . T h e s e e n t i t i e s suffer from o n e o r b o t h o f t h e following s e v e r e flaws: t h e precise n a t u r e and m o d e of being of s o m e of t h e m is n e v e r specified. p. H e e x p r e s s e d this i n a s t a t e m e n t w h i c h s e t s f o r t h t h e f u n d a m e n t a l i n t e n t o f his e n t i r e p s y c h o l o g y : " W e a r e w o r k i n g t o w a r d a dynamic p s y c h o l o g y . and i n fact h e did n o t 1 n o w w h y . p e r c e i v e d p h e n o m e n a m u s t t a k e a s e c o n d place t o a s s u m e d drives. In o u r view. F o r him i t w a s t h e o n l y p a t h t o t r u t h . and he w a s willing to pay a n y price to m e e t its d e m a n d t h a t t h e o b j e c t of M s i n v e s t i g a t i o n b e a s c e r t a i n a b l e b y its m e t h o d o f e x a c t m e a s u r e m e n t and c o m p u t a t i o n . h e w a s totally u n d e r t h e spell o f t h e natural scientific r e s e a r c h m e t h o d . T h o u g h Freud r a i s e d t h e h u m a n p s y c h i c a s p e c t o n c e m o r e t o t h e s t a t u s o f a unique reality. I l o w little Freud realized w h e r e t h e f u n d a m e n t a l i n t e n t of his l isy< h o a n a l y t i c t h e o r y had actually c o m e f r o m is d e m o n s t r a t e d clearly in .57 Chapter 5 THE FUNDAMENTAL C O N D I T I O N A L L Y OF PSYCHOLOGY AND PSYCHOSOMATICS PSYCHOLOGICAL HYPOTHESES N o o n e w o u l d dispute t h a t m o s t o f t h e ruling c o n c e p t s i n t h e b r a n c h e s dl c u r r e n t medical p s y c h o l o g y o r i g i n a t e in F r e u d i a n t h i n k i n g . t h o u g h ." 1 W h y t h i s m u s t b e so. F r e u d believed h e w a s d u t y . As a r e s e a r c h e r w h o w a n t e d to be t a k e n s e r i o u s l y . F r e u d n e v e r says. A s a child o f his t i m e .b o u n d t o f o r c e h u m a n p h e n o m e n a — e v e r y last o n e o l t h e m — i n t o t h e old c o n c e p t u a l f r a m e w o r k o f n a t u r a l s c i e n c e . it was characteristic of him that he never thought of developing a n e w m e t h o d o f r e s e a r c h suited t o t h e p a r t i c u l a r n a t u r e o f I his r e a l m . d a t e B a e d e c k e r is an a t t e m p t to replace an old c a t e c h i s m t h a t is v e r y c o m f o r t a b l e and v e r y c o m p l e t e . F r e u d ( t h o u g h h e h i m s e l f m a y n e v e r have s u s p e c t e d t h i s ) s h o w s h i m s e l f a C a r t e s i a n o f t h e p u r e s t dye. psychic aspect o f m a n a s t h e f u n c t i o n i n g o f an apparatus a n a l o g o u s to the c h e m o p h y s i c a l f u n c t i o n s m e a s u r a b l e in t h e physical o r g a n i s m .58 EXISTENTIAL FOUNDATIONS an especially v e h e m e n t p o l e m i c against " p h i l o s o p h e r s . 2 In d e m a n d i n g t h a t all psychic p h e n o m e n a be established w i t h c e r t a i n t y . We h a v e already pointed o u t t h a t F r e u d . let us s e e k c o m f o r t in the t h o u g h t t h a t all t h e s e "guides to l i v i n g " a r e s o o n o u t of date. finally. B u t Freud's i n t e n t i l l u s t r a t e s w i t h p a r t i c u l a r force N i e t z s c h e ' s a p h o r i s m t h a t the n i n e ­ t e e n t h c e n t u r y had so far b r o u g h t a b o u t n o t t h e v i c t o r y of s c i e n c e b u t r a t h e r t h e v i c t o r y of m e t h o d o l o g y over s c i e n c e . " A n d it is precisely h e r e t h a t he r e v e a l s t h e philosophic spirit t h a t sired him. and. Symptom and Anxiety we m a y read: I am n o t at all in f a v o r of f a b r i c a t i n g p h i l o s o p h i e s of life. all w h o followed his t h e o r y . F r e u d did c o n c e d e t h a t he could find no direct p r o o f for t h e actual p r e s e n c e o f this p s y c h i c a p p a r a t u s . A s w e t o o c a n n o t d e n y o u r n a r c i s s i s t i c pride. 3 . w i t h all t h e individual psychic s t r u c t u r e s and d y n a m i s m s supposedly p r e s e n t w i t h i n it. He and. find life's j o u r n e y impossible to m a k e w i t h o u t s u c h a B a e d e c k e r as their t o u r guide.t o . and this still holds. So he assigned this basic c o n c e p t i o n . T h a t I leave to p h i l o s o p h e r s . in t r u e technical spirit. b y t h e i r o w n a d m i s s i o n . In Inhibition. w h i c h could o n l y be i n f e r r e d from its o b s e r v a b l e e f f e c t s and f u n c t i o n s . o n l y p a t i e n t c o n t i n u a t i o n of w o r k t h a t s u b o r d i n a t e s e v e r y t h i n g to a single Demand for Certainly [Freud's e m p h a s i s ] can slowly bring a b o u t c h a n g e . to "mefapsychology"—a t h e o r y of psychic e n t i t i e s beyond the o b s e r v a b l e . i n t e r p r e t e d t h e n o n p h y s i c a l . w h o . " T h i s episodic insight did n o t keep F r e u d from t u r n i n g a r o u n d to posit it again as a fact. N o n u m b e r o f h e c t o r i n g p h i l o s o p h e r s can c h a n g e t h a t a hair. by implication. W e k n o w quite well h o w little light s c i e n c e h a s s o far b e e n able t o c a s t o n t h e puzzles o f this world. t h a t e v e n t h e m o s t u p . L e t us humbly accept the contempt with which philosophers gaze down upon u s from t h e s t a n d p o i n t o f t h e i r h e i g h t e n e d need. t h a t it is precisely t h e s p a d e w o r k o f o u r m y o p i c vision t h a t m a k e s a n e w edition n e c e s s a r y . He o n c e even exiled this basic a s s u m p t i o n o f his t h e o r y r o t h e r e a l m o f s h e e r m e n t a l i n v e n t i o n (the italics are h i s ) : " W e hed i m m e r s e d o u r s e l v e s in t h e fiction of a primitive psychic a p p a r a t u s w h o s e o p e r a t i o n w a s m o t i v a t e d b y t h e t e n d e n c y t o avoid the a c c u m u l a t i o n of e x c i t a t i o n and to m a i n t a i n the g r e a t e s t possible t r a n q u i l i t y . t o o . only a h u m a n being w h o is already seeing can " s e e " i m a g e s in t h e i r m e a n i n g f u l n e s s . how would a person ever k n o w thet these were images coming from an outside w o r l d . believed t h a t e v e n t h e r e l a t i v e l y simple p h e n o m e n a o f h u m a n p e r c e p t i o n could n o t b e u n d e r s t o o d w i t h o u t this m e t a p s y c h o l o g i ­ cal c o n s t r u c t . n e g l e c t i n g to c o n s i d e r t h a t a c a m e r a is w o r t h n o t h i n g w i t h o u t a p h o t o g r a p h e r w h o can see and perceive b e f o r e he e v e r lays h a n d s on it. or. B u t the p r e s e n c e of such r e p r e s e n t a t i o n s can n e v e r b e a s c e r t a i n e d . t h a t t h e r e w a s a n o u t s i d e w o r l d a t all? O b v i o u s l y .The Fundamental Conditionality 50 t h e r e b y i g n o r e d t h a t i n h e r e n t l y all such m e t a p s y c h o l o g i c a l c o n c l u s i o n s beg the question: F r e u d could i n t e r p r e t p h e n o m e n a w h i c h he could perceive directly as f u n c t i o n s w h i c h implied t h e p r e s e n c e of a psychic apparatus he could not p e r c e i v e directly o n l y b e c a s s e he had already a s s u m e d t h e p r e s e n c e o f this a p p a r a t u s . o r e m o t i o n s in a psyche. I n t h e p s y c h i c p h e n o m e n a t h e m s e l v e s t h e r e i s n o t h i n g f o r c i n g u s t o a s s u m e t h a t t h e y are e f f e c t s o f a n y c a u s e at all. is as i n a c c e s s i b l e to F r e u d i a n m e t a p s y c h o l o g y as it is to t h e m o d e r n n e u r o p h y s i o l o g i c a l t h e o r i e s o f p e r c e p t i o n — a n d for t h e s a m e r e a s o n s . and b e f o r e a n y s u b s e q u e n t r e p r e s e n t a t i o n s . E v e n if t h e r e w e r e s u c h t h i n g s . In fact. N o t o n l y does he n o t need a c a m e r a to see a s u b j e c t as s o m e t h i n g w o r t h p h o t o g r a p h i n g . even il t h e y did c o n s t i t u t e t h e mind's initial k n o w l e d g e of t h e e x t e r n a l world. for t h a t m a t t e r . T h e y are i n v e n t i o n s . w i t h t h e w o r l d outside. this k n o w l e d g e can c o m e to a p e r s o n — t h i s b e a r s c o n s t a n t r e p e a t i n g — o n l y if t h a t p e r s o n ' s s i g h t and p e r c e p t i o n dwell from t h e v e r y beginning. Y e t F r e u d w e n t o n t o i m a g i n e t h a t a p e r s o n gained a c c e s s t o t h e outside world primarily t h r o u g h an e n e r g y a s s u m e d to be p r e s e n t in t h e p s y c h e a n d t h r o u g h t h e drives and e m o t i o n s t h a t c a m e from this e n e r g y . F u r t h e r . H e believed t h a t t h e s e c a t h e c t e d t h e o b j e c t s o f t h e e x t e r n a l w o r l d . Y e t . F r e u d . B u t n o o n e has y e t been able t o establish t h e p r e s e n c e o f the libido. T h e n o t i o n of a c a m e r a as a c r u t c h to facilitate u n d e r s t a n d i n g o f t h e h u m a n ability t o perceive i s t h e r e f o r e s u p e r f l u o u s . b u t he could n e v e r focus his a p p a r a t u s on a p a r t i c u l a r s u b j e c t and c a p t u r e it on film if he w e r e n o t already a s e e i n g and c o m p r e h e n d i n g b e i n g . h o w e v e r . P s y c h o a n a l y s i s depends o n t h e a s s u m p t i o n o f e n d o p s y c h i c r e p r e s e n t a ­ tions o f o b j e c t s o f t h e e x t e r n a l w o r l d t o explain t h e h u m a n ability t o perceive a thing as s o m e t h i n g m e a n i n g f u l . B u t e x a c t l y this specifically h u m a n ability to see and perceive as such. t h e libido would have to possess sight in o r d e r to direct itself to e x t e r n a l t h i n g s as o b j e c t s . t h e drives. for t h e o p e r a t i o n of a c a m e r a can be u n d e r s t o o d o n l y o n t h e basis o f t h e h u m a n ability t o see and p e r c e i v e . it is b a c k w a r d . He had a p e n c h a n t for c o m p a r i n g it to a c a m e r a . film i t s e l f does n o t see t h e significance of w h a t has b e e n r e p r o d u c e d on it. P s y c h i a t r y i n particular is t o o o f t e n c o n t e n t to adopt ideas from popular p s y c h o l o g y w i t h o u t s u b j e c t i n g t h e m t o f u n d a m e n t a l c o n s i d e r a t i o n and clarification b e f o r e it uses t h e m in analysis. his p r i m a r y c o n c e r n h e r e w a s n o t w i t h explaining o b s e r v a b l e psychic p h e n o m e n a as s u c h but with g e t t i n g rid of f r a g m e n t a t i o n solely for t h e sake of t h e scientific r e s e a r c h m e t h o d and its application to the 5 6 . w r o t e : Feeling is the n a m e we give to all m e n t a l a c t i v i t y t h a t does n o t clearly belong e i t h e r t o t h e p h e n o m e n a o f o b j e c t i v e c o n s c i o u s n e s s o r t o e m o t i o n a l drives and v o l u n t a r y a c t s . feelings. w h o s u b s u m e d all t h e e m o t i o n s u n d e r it. H e r e — a s n e a r l y e v e r y w h e r e i n m e d i c i n e today—we c o m e u p against t h e f r i g h t e n i n g fact t h a t this s c i e n c e . r e l a x e s this precision to an a s t o n i s h i n g d e g r e e r e g a r d i n g the p h e n o m e n a t h e m s e l v e s . in a w o r d . and m o o d s are t h i n g s p r e s e n t w i t h i n t h e p s y c h e . he said. B u t n o e n e r g y o r e x c i t a t o r y q u a n t i t y has the ability to perceive s o m e t h i n g in its m e a n i n g f u l n e s s . T h e t e r m i t s e l f c a m e n o t from F r e u d b u t f r o m E u g e n B l e u l e r . I f c o n t e m p o r a r y p s y c h o l o g i s t s and p s y c h o p a t h o l o g i s t s a r e u n a n i m o u s in giving affectivity such p r e d o m i n a n c e in h u m a n life. H e c h a r a c t e r i z e d the e m o t i o n s as all t h a t m a t t e r e d for m a n ' s i n n e r life. E v e r y u n d e v e l o p e d and foggy m e n t a l s t r u c t u r e . or libidinal p r o c e s s e s . are i m p o r t a n t only in r e l a t i o n to t h e i r a p t i t u d e for e v o k i n g feelings. he considered affectivity practically the o n l y d e t e r m i n i n g f a c t o r i n h u m a n c h a r a c t e r d e v e l o p m e n t . he b r o a d l y c o n f e s s e s t h a t we have n o idea w h a t a n e m o t i o n i s . so precise in the t h e o r i e s t h a t derive from the p h e n o m e n a it a s s u m e s . e v e r y t h i n g to w h i c h we c a n give no o t h e r n a m e . 4 F r e u d said t h a t he did n o t c o n s i d e r his u n d e r s t a n d i n g of the e m o t i o n s very solid and t h o u g h t of it as a first a t t e m p t to g e t o r i e n t e d in this dark realm. Symptom and Anxiety. J a s p e r s . T h e a t t e m p t t o dispose t h e o r e t i c a l l y o f " f r a g m e n t a t i o n i n the s u c c e s s i o n o f c o n s c i o u s a c t i o n " was a t a s k e v e n m o r e p r e s s i n g for F r e u d . this foggy n o t i o n of affectivity is hardly in a position to r e n d e r h u m a n b e h a v i o r comprehensible. libidinal s t a g e s .60 EXISTENTIAL FOUNDATIONS of its drives. No h u m a n r e l a t i o n s h i p to the world can b e u n d e r s t o o d o n t h e basis o f a s s u m e d q u a n t i t i e s o f e m o t i o n . e v e r y t h i n g impalpable t h a t eludes analysis. T h e t r a d i t i o n a l p s y c h o l o g i e s a r e c e r t a i n at least t h a t e m o t i o n s . b u t as the c e n t r a l e n d o p s y c h i c activity. F r e u d w a s n o t a l o n e in giving a f f e c t i v i t y t h e c e n t r a l role in psychic life. In fact. In Inhibition. O n c e again. or to c a t h e c t t h e m in o r d e r to a t t a i n t h e goal of the drives— r e l a x a t i o n o f t e n s i o n . B u t i t w a s F r e u d w h o e m p h a s i z e d i t m o s t . P s y c h i c e n e r g i e s . is called a feeling. for i n s t a n c e . t h e y are c o r r e s p o n d i n g l y u n a n i m o u s i n t h e p o v e r t y o f t h e i r u n d e r s t a n d i n g o f its n a t u r e . r e g a r d or m o r a l v i e w s and w h i c h had b e e n r e p r e s s e d precisely b e c a u s e o f t h e i r i m p o r t a n c e . H u m a n desire and striving c a n n o t e x i s t in a v a c u u m . t h e r e is a c o n t r a d i c t i o n i n h e r e n t i n this m a t t e r s o c e n t r a l t o Freudian t h e o r y .m a k i n g w o r k . A s far a s t h e p s y c h i c p h e n o m e n a t h e m s e l v e s a r e c o n c e r n e d . as we pointed o u t in t h e last c h a p t e r . T o m a k e his d r e a m t h e o r y c o n f o r m r e a s o n a b l y t o the d e m a n d s of t h e n a t u r a l scientific r e s e a r c h m e t h o d . unconscious entities by arguing that in the darkness of t h e u n c o n s c i o u s n o t h i n g could be s e e n in its basic detail. C o n s i d e r i n g h o w forcibly F r e u d tried t o fit t h e p h e n o m e n a o f h u m a n e x i s t e n c e i n t o t h e mold o f n a t u r a l scientific t h o u g h t . I t w a s t h e r e f o r e o n l y i n t h e i n t e r e s t s o f t h e scientific r e s e a r c h m e t h o d t h a t F r e u d h y p o t h e s i z e d a p s y c h i c u n c o n s c i o u s as t h e b o t t o m .The Fundamental Conditionality 61 p s y c h i c . t h e r e i s n o r e a s o n w h y t h e y m i g h t n o t b e a b r o k e n s u c c e s s i o n . d e s i r e s . W h e n this i s n o l o n g e r t a k e n a s a b s o l u t e and n o l o n g e r u n t h i n k i n g l y p r e s u p p o s e d a s applying t o all p h e n o m e n a o f h u m a n e x i s t e n c e . F r e u d w a s free t o a s s u m e . and it is precisely this calculability t h a t is p o s t u l a t e d as a basic a x i o m applicable to all t r u e b e i n g s by t h e n a t u r a l scientific r e s e a r c h m e t h o d . B e s i d e s . In . t h e observable "successions of conscious actions" no longer appear in the least f r a g m e n t a r y . i t w a s i n e v i t a b l e that his o b j e c t s o f s t u d y w o u l d suffer s o m e m u t i l a t i o n . t e n d e n c i e s . t h e s e w e r e pure i n v e n t i o n s w h o s e actual p r e s e n c e w a s n o t scientifically c o n f i r m e d . S u c h f r a g m e n t a t i o n i s i n c o m p a t i b l e w i t h u n i v e r s a l calculability. o r d e e p e s t s y s t e m . O n c e m o r e .m o s t layer. and w h i c h h e h i m s e l f had called t h e " r o y a l r o a d " o f his depth p s y c h o l o g y : t h e d r e a m . w e r e drives. O n c e this supposition w a s t h e o r e t i c a l l y e s t a b l i s h e d . he had to find a u n i v e r s a l l y valid c a u s a t i o n and e n e r g y for t h e p r o d u c t i o n of d r e a m s . T h i s m e a n s t h a t e v e r y act of w i s h i n g or striving is aware o f the m e a n i n g f u l n e s s t h a t m a k e s u p w h a t i s desired o r s t r i v e n for. t h e y m u s t r e f e r to s o m e t h i n g o t h e r t h a n t h e m s e l v e s . B u t F r e u d w o u l d n e v e r h a v e s u c c e e d e d i n applying t h e n a t u r a l scientific m o d e o f t h o u g h t t o t h e r e a l m o f t h e psychic i f h e had b e e n forced t o a d m i t t h a t b r o k e n causal c h a i n s w e r e p r e s e n t i n this r e a l m . and r e p r e s e n t a t i o n s w h i c h w e r e i n c o m p a t i b l e w i t h a p e r s o n ' s s e l f . o f t h e p s y c h e . T h e m o s t i m p o r t a n t c o n t e n t s o f t h e u n c o n s c i o u s . H e sidestepped his scientific d u t y t o d o c u m e n t t h e w o r k i n g p r e s e n c e o f these endopsychic. especially if this s u c c e s s i o n is t h o u g h t of—as it is in F r e u d ' s t h e o r y — a s a m e r e chain o f c a u s e s and e f f e c t s . h o w e v e r . w h e n e v e r i n v e s t i g a t i o n o f a p h e n o m e n o n could n o t t u r n up a link to c o m p l e t e t h e causal c h a i n he had i n v e n t e d . T h e n o t i o n of u n c o n s c i o u s desire is an i n h e r e n t c o n t r a d i c t i o n . F r e u d held. T h i s fate befell e v e n t h e p h e n o m e n a h e t o o k a s t h e t h e m e o f his first e p o c h . t h a t t h e m i s s i n g link w a s t o b e found w i t h i n this u n c o n s c i o u s . 62 EXISTENTIAL FOUNDATIONS infantile d e s i r e s he believed he had found b o t h . T h i s desire was supposed t o r e p r e s e n t t h e m o t o r and the e n e r g y needed t o c r e a t e t h e " m a n i f e s t d r e a m i m a g e " out o f p r e c o n s c i o u s m a t e r i a l . S o t h a t e v e r y d r e a m m i g h t appear in this light, F r e u d c o n c e i v e d a c o m p l e x , u n c o n s c i o u s d r e a m w o r k . B u t t o r e i t e r a t e w h a t w e have already s t a t e d : n o d r e a m i n g p e r s o n has e v e r g i v e n a n y e v i d e n c e for this. T h e e n t i r e Freudian c o n c e p t i o n o f the d r e a m , w h i c h i s also t h e m o d e l for t h e later t h e o r y o f t h e n e u r o s e s , r e s t s on an i n v e n t e d f o u n d a t i o n . T h e r e is an equally p o w e r f u l e x a m p l e of t h e m u t i l a t i n g f o r c e e x e r t e d in Freud's p r o c e e d i n g s a g a i n s t psychic p h e n o m e n a in his " A n a l y s i s of the Phobia o f a Five Y e a r - O l d B o y . " I n t e n t o n explaining t h e child's b e h a v i o r at a n y price on a n a t u r a l scientific, c a u s a l , p s y c h o d y n a m i c basis, this t r e a t i s e is such an a c c u m u l a t i o n of u n v e r i f i a b l e , a r b i t r a r y s u p p o s i t i o n s t h a t it c a n n o t be classified as a scientific i n v e s t i g a t i o n . 7 A f e w h e s t i t a n t and a m b i g u o u s a n s w e r s w h i c h esacped five y e a r - o l d H a n s u n d e r a b a r r a g e of heavily s u g g e s t i v e q u e s t i o n s from his f a t h e r sufficed t o " p r o v e " t h e s o n ' s u n c o n s c i o u s death wish a g a i n s t his f a t h e r . T h i s death w i s h , s o called, along w i t h t h e a t t e n d a n t f e a r o f p u n i s h m e n t a s s u m e d to be in t h e u n c o n s c i o u s , was declared t h e cause of the boy's f e a r o f h o r s e s . F r e u d did n o t even s h r i n k f r o m t r a n s f o r m i n g the frantic s t r u g g l e s of a h o r s e t h a t had fallen into t h e i r opposite, implying t h a t in t h e s t r u g g l e s o f t h e h o r s e — a vitally powerful c r e a t u r e — y o u n g H a n s had s e e n t h e a n i m a l ' s d e a t h t h r o e s . F u r t h e r on, t h e accidental fall of a t o y h o r s e is read as a g e s t u r e of d e s t r u c t i v e a g g r e s s i o n e x p r e s s i n g an u n c o n s c i o u s desire to upset t h i n g s . T h i s i n t e r p r e t a t i o n w a s in t u r n still a n o t h e r p r o o f for t h e h y p o t h e s i s o f the death wish p r e s u m e d p r e s e n t i n Hans's unconscious. It is no surprise t h a t Freud could claim t h a t direct o b s e r v a t i o n of a phobic child e x p o s e d n o t h i n g he had n o t already s e e n in the b e h a v i o r of phobic adults. In y o u n g H a n s ' s case, F r e u d was c o n c e r n e d n o t w i t h o b j e c t i v e o b s e r v a t i o n o f phobic b e h a v i o r b u t w i t h fitting this b e h a v i o r i n t o a t h e o r y t h a t already e x i s t e d and w h i c h he had already applied to adult phobias. T h u s t h e s a m e n e s s i n the i n t e r p r e t a t i o n s o f b o t h s o r t s o f phobias, as well as the d e a r t h of n e w m a t e r i a l in t h e i n t e r p r e t a t i o n of young Hans's anxieties. D e s p i t e t h e s e and c o u n t l e s s similar p r o o f s o f t h e fictitious and u n o b j e c t i v e c h a r a c t e r o f p s y c h o a n a l y t i c t h e o r y , F r e u d ' s pupils n e v e r tire, even today, of trying to establish its scientific s o u n d n e s s . B u t e v e r y e f f o r t o f w h i c h w e h a v e b e e n a w a r e , m e a n w h i l e , has avoided a n a d e q u a t e d e t e r m i n a t i o n o f the f u n d a m e n t a l n a t u r e o f t h e n a t u r a l scientific r e s e a r c h m e t h o d . In fact, m o s t of the p s y c h o a n a l y t i c w r i t i n g s in this a r e a a r c c o n t e n t m e r e l y t o adopt o u t r i g h t t e c h n i c a l t e r m i n o l o g y from physics. The Fundamental Conditionally 03 O n e i n s t a n c e of this is " w o r k i n g h y p o t h e s i s , " w h i c h is used i n c r e a s i n g l y t o c h a r a c t e r i z e p s y c h o a n a l y t i c t h e o r e m s . D e s p i t e the shared t e r m , t h e r e is an u n b r i d g e a b l e gap b e t w e e n t h e s u p p o s i t i o n s ol p s y c h o a n a l y s i s and t h e w o r k i n g h y p o t h e s e s o f t h e n a t u r a l s c i e n c e s . T h e l a t t e r a r e i n f e r e n c e s a b o u t t h e c o m p o s i t i o n o f t h i n g s and t h e p r o c e s s e s t h a t o c c u r a m o n g t h i n g s , a l w a y s adducible t o p h e n o m e n a t h a t are available t o s e n s o r y p e r c e p t i o n and a l w a y s adducible t o p h e n o m e n a t h a t a r e available t o s e n s o r y p e r c e p t i o n and can b e p r e c i s e l y d e t e r m i n e d . T h e n a t u r a l scientific w o r k i n g h y p o t h e s i s can b e verified t h r o u g h i n c r e a s i n g ­ ly p r e c i s e o b s e r v a t i o n until it is finally e i t h e r raised f r o m c o n j e c t u r e to scientific fact or else r e c o g n i z e d as e r r o r and a b a n d o n e d . N o t h i n g like this is possible w i t h t h e w o r k i n g h y p o t h e s e s of p s y c h o a n a l y t i c t h e o r y , b e c a u s e t h e s e deal w i t h t h i n g s n o t r a c e o f w h i c h can b e a s c e r t a i n e d i n t h e o b j e c t s o f study t h e m s e l v e s . T h e i r c o n t e x t s are a s s u m e d , and t h e i r i n f e r e n c e s t a k e place only in t h e mind. W h a t e v e r is posited b y p s y c h o a n a l y t i c t h e o r y c o n s i s t e n t l y and f u n d a m e n t a l l y b a c k s off f r o m all a t t e m p t s to s u b s t a n t i a t e its actual p r e s e n c e , b e i n g a s s u m e d to reside in a black b o x called t h e u n c o n s c i o u s , w h i c h is n e v e r a c c e s s i b l e to direct i n v e s t i g a t i o n . A s e c o n d t e c h n i c a l t e r m p s y c h o a n a l y t i c t h e o r y has b o r r o w e d from physics for t h e sake of appearing like a n a t u r a l s c i e n c e is " m o d e l , " or "model r e p r e s e n t a t i o n . " B u t w e a r e n e v e r told e x a c t l y w h a t t h e t e r m m e a n s w h e n it is applied in p s y c h o l o g y . M o d e l s are s u p e r f l u o u s and senseless to an understanding of human nature, anyway, because human beings are s e l f - c o n s c i o u s b e i n g s capable o f e x p r e s s i n g t h e m s e l v e s t h r o u g h l a n g u a g e . T h e m o d e l - b u i l d i n g o f p s y c h o l o g y and p s y c h o p a t h o l ogy m i s s e s and m i s c o n s t r u e s t h e decisive c h a r a c t e r o f h u m a n n a t u r e i n visualizing h u m a n n a t u r e as an o b j e c t t h a t , like all o t h e r o b j e c t s in t h e world, is o c c u p y i n g at a n y o n e t i m e o n l y a single place in a given space. O n c e h u m a n n a t u r e has b e e n t h u s m i s r e p r e s e n t e d , t h e m o s t a n y t h e r a p y can h o p e to do is m a k e a b e t t e r o b j e c t , n o t a h e a l t h i e r p e r s o n . E f f o r t s t o d e m o n s t r a t e t h e scientific s o u n d n e s s o f p s y c h o a n a l y t i c t h e o r y p o i n t t o its supposedly empirical basis. F r e u d ' s t h e o r y o f r e p r e s s i o n , for i n s t a n c e , is said to be g r o u n d e d in empirical fact. M e e r w e i n w r i t e s t h a t i n F r e u d ' s first a t t e m p t s a t t h e r a p y h e d i s c o v e r e d that r e c o l l e c t i o n e f f e c t e d b y h y p n o s i s o r b y the analysis o f r e s i s t a n c e could bring a b o u t an a b n o r m a l c o n d i t i o n or t h e d i s a p p e a r a n c e of a s y m p t o m . T h i s is said to h a v e led F r e u d to infer a p r o c e s s w h i c h w e n t in I he o p p o s i t e direction to f o r m s y m p t o m s , n a m e l y , r e p r e s s i o n . He t h e n w e n t on to prove this hypothesis w i t h additional r e s e a r c h . H e r e v/e need only r e m e m b e r t h e s t o r y o f y o u n g H a n s , w i t h w h o s e help F r e u d d e m o n s t r a t ­ ed his t h e o r i e s of the libido and d e f e n s e . 64 EXISTENTIAL FOUNDATIONS P s y c h o a n a l y t i c t h e o r e t i c i a n s , o n e and all, fail to indicate h o w t h e y have used t h e t e r m " p r o o f . " I f w e u n d e r s t a n d " p r o o f " t o m e a n a d e m o n s t r a ­ tion o f t r u t h o r e v e n m e r e l y a s u b s t a n t i a t i o n o f c o r r e c t n e s s , t h e n n o n u m b e r o f case h i s t o r i e s can e v e r " p r o v e " F r e u d ' s r e p r e s s i o n h y p o t h e s i s . T h e a c c u m u l a t i o n o f c o n c r e t e empirical facts r e s u l t s only i n e n c a p s u l a t ­ ing t h e m o s t d i v e r s e s o r t s of h u m a n b e h a v i o r in a single p r e c o n c e i v e d t h e o r y w h i c h i s o c c a s i o n a l l y read i n t o t h e p h e n o m e n a t h e m s e l v e s . S u c h " p r o o f " calls up t h e i m a g e of a m a n w h o l o o k s at all t h e o b j e c t s he studies t h r o u g h r o s e - c o l o r e d g l a s s e s and t h i n k s he h a s " p r o v e n " all t h i n g s are red. On the o t h e r hand, Waelder believes that psychoanalytic theory is j u s t i f i e d as a n a t u r a l scientific discipline on t h e g r o u n d s t h a t it h a s e x a m i n e d a l a r g e e n o u g h n u m b e r o f life h i s t o r i e s t o c o m p a r e t h e m and e x t r a c t w h a t t h e y all h a v e i n c o m m o n . B u t t h e p r o c e s s o f t h u s crystallizing a c o n c e p t — t r a n s f e r e n c e , for e x a m p l e — i s n o t pure e m p i r i ­ cism b u t a v e r y specific i n t e r p r e t a t i o n o f p a r t i c u l a r h u m a n b e h a v i o r . B y i n t e r p r e t i n g this b e h a v i o r in t h e s a m e w a y e a c h t i m e it o c c u r s we are m e r e l y a m a s s i n g a large n u m b e r of i n s t a n c e s of a p r e d e t e r m i n e d interpretation, nothing more. It is s o m e t i m e s said t h a t psychological h y p o t h e s e s can c o m m a n d t h e a u t h o r i t y o f p r o v a b l e scientific fact o n l y i f t h e y allow o t h e r p h e n o m e n a to be e x p l a i n e d or i n t e r p r e t e d . It is n o t e n o u g h t h a t t h e y suffice for u n d e r s t a n d i n g t h e single o b s e r v a t i o n t h a t g a v e rise t o t h e m . Y e t , t o define t h e p r o v a b i l i t y o f a n h y p o t h e s i s this w a y m i s s e s t h e p o i n t o f scientific p r o o f . A h y p o t h e s i s m u s t allow us to predict t h e b e h a v i o r of like p h e n o m e n a and to reproduce t h e m at will. B u t t h e r e is no h y p o t h e s i s in all o f p s y c h o a n a l y t i c t h e o r y t h a t m e e t s t h e s e d e m a n d s . I t i s n o g r e a t feat t o explain like p h e n o m e n a c o n s i s t e n t l y w i t h t h e s a m e s u p p o s i t i o n s , and this is e v e n e a s i e r to do w h e n t h e o b j e c t is s o m e t h i n g u n c o n s c i o u s w h o s e actual p r e s e n c e n e e d n o t be verified. P s y c h o a n a l y s t s are p a r t i c u l a r l y fond o f pointing t o the flashes o f insight patients may experience as proof of the correctness of psychoanalytic theory. Certainly, it is not u n c o m m o n in therapy that the a n a l y s t ' s i n t e r p r e t a t i o n of a p a r t i c u l a r trait suddenly appears so o b v i o u s t o t h e p a t i e n t t h a t h e a b a n d o n s t h e trait w i t h a n " A h a ! " B u t this s o r t o f " A h a - e x p e r i e n c e " is a n y t h i n g b u t definitive p r o o f t h a t an i n t e r p r e t a t i o n is faithful to the p h e n o m e n o n itself. M o r e o f t e n t h a n n o t , it appears to r e s u l t w h e n a n i n t e r p r e t a t i o n fits readily i n t o t h e p a t i e n t ' s already e x i s t i n g u n d e r s t a n d i n g of h i m s e l f . People w h o live in the t e c h n o l o g i c a l age are a t h o m e w i t h m a c h i n e s and e v e n p r o n e t o d r a w i n f e r e n c e s a b o u t h u m a n n a t u r e from t h e m . A n d t h u s p s y c h o a n a l y t i c i n t e r p r e t a t i o n s , based as t h e y are on c h e m i c a l and m e c h a n i c a l p r o c e s s e s , m a y look The Fundamental Conditionally 65 o b v i o u s and self-evident t o t h e m . E x p e r i e n c e s o f this " A h a ! " type too often c o n f i r m a m e c h a n i s t i c s e l f - i m a g e p r o f o u n d l y at odds w i t h the p a t i e n t as a h u m a n being. T h e i n a d e q u a c y o f F r e u d ' s o r i g i n a l libidinal m o d e l did n o t escape the notice of many modern theoreticians, even those within the psychoana­ lytic fold, and t h e b e s t a m o n g t h e m w o r k e d w i t h a s e n s e o f u r g e n c y t o t r a n s f o r m it. T h e m o s t n o t a b l e w o r k h e r e w a s p e r h a p s t h a t d o n e b y the F r e n c h w r i t e r s P. M a r t y , M. de M ' U z a n , and C. D a v i d as well as by the A m e r i c a n , M . S c h u r . T h e i r a l t e r e d c o n c e p t u a l m o d e l can b e s t b e visualized using t h e i m a g e of a s t u d e n t petrified during an e x a m i n a t i o n . 8 A c c o r d i n g t o t h e m o s t r e c e n t p s y c h o a n a l y t i c t h e o r y , this s t u d e n t — o r t h e p a t i e n t — w o u l d begin b y losing his c o n n e c t i o n w i t h t h e p e r t i n e n t o b j e c t i n t h e e x t e r n a l world—in this case, t h e e x a m i n e r . N e x t this e x t e r n a l o b j e c t would be replaced by a m e r e r e p r e s e n t a t i o n . A t r u e neurotic condition is said to arise at this point. T h e e x a m i n i n g p r o f e s s o r , at h e a r t an a m i a b l e m a n i n t e r e s t e d in a d v a n c i n g t h e c a n d i d a t e , would take o n t h e a p p e a r a n c e o f a n e n e m y o u t t o d e s t r o y h i m , and this would a c t i v a t e r e s i s t a n c e t o t h e r e p r e s e n t a t i o n . T h e n would c o m e " o b j e c t - f r e e psychic a c t i v i t y " during w h i c h h e m i g h t feel n o t h i n g b u t a n x i e t y , for i n s t a n c e , o r d e s t r u c t i v e u r g e s . T h i s s t a t e would r e s e m b l e psychosis. U l t i m a t e l y , e v e n the feeling o f a n x i e t y m i g h t go. T h e s t u d e n t would sit petrified, s h o w i n g signs o f i n c r e a s e d blood p r e s s u r e and c o r o n a r y activity, in a state of functionally disturbed somatic activity. W h e n a n x i e t y is believed to o r i g i n a t e like this, it is n o t difficult to i m a g i n e t h e r e s u l t i n g s t a t e b e c o m i n g p e r m a n e n t i n c e r t a i n c i r c u m s t a n c e s . P e r s o n a l i t y traits would t h e n c o r r e s p o n d c l o s e l y to t h o s e found in t h e p s y c h o s o m a t i c a l l y ill p a t i e n t s o f M a r t y e t al. T h e t r o u b l e h e r e i s t h a t w e h a v e p r o o f a t o u r f i n g e r t i p s t h a t even this m o s t r e c e n t m o d e l o f n e u r o s i s a i m s v e r y wide o f its m a r k : o b s e r v a b l e h u m a n reality. It is simply n o t t r u e — a n d a n y o n e willing to o b s e r v e h i m s e l f o r o t h e r s can c o n v i n c e h i m s e l f o f t h i s — t h a t s u c h a n e x a m i n e e would find t h e e x t e r n a l o b j e c t , t h e p r o f e s s o r , replaced by a m e r e e n d o p s y c h i c r e p r e s e n t a t i o n o f s o m e o n e b e n t o n his d e s t r u c t i o n . O n t h e c o n t r a r y , an e x a m i n e e would be b o u n d h e a r t and soul to t h e p r o f e s s o r in I ront of him. He would m e r e l y mistake him, but it is t h e p r o f e s s o r h i m s e l f w h o w o u l d b e m i s t a k e n for a n e n e m y , n o t s o m e r e p r e s e n t a t i o n o f him i n I h e s t u d e n t ' s p s y c h e . W e m a y dispense for the m o m e n t w i t h biographical m a t t e r s t h a t m a k e this kind o f e r r o r inevitable. T h e point i s t h a t while i t is o n e t h i n g to e n u m e r a t e e v e r y t h i n g in the s t u d e n t ' s life t h a t tends to limit his perceptual ability, so t h a t o n l y t h e h o s t i l e t e n d e n c i e s of a u t h o r i t y figures would be perceived, it is a n o t h e r thing a l t o g e t h e r to 66 EXISTENTIAL FOUNDATIONS u n d e r s t a n d t h e sole p r e s e n t l y available m o d e s o f perceiving and b e h a v i n g a s t h e p h e n o m e n a w h i c h t h e y are. We can s h o w f u r t h e r t h a t it is n o t valid to say t h a t t h e s t u d e n t ' s s e c o n d step w o u l d b e p u t t i n g u p r e s i s t a n c e t o t h e a s s u m e d hostile e n d o p s y c h i c r e p r e s e n t a t i o n , p r o d u c i n g o b j e c t - f r e e psychic activity. W h a t m i g h t this o b j e c t - f r e e p s y c h i c a c t i v i t y be? To claim t h a t it c o n s i s t s m e r e l y in perceiving a n x i e t y and d e s t r u c t i v e feelings is to c o n t r a d i c t b o t h o n e s e l f and t h e m o d e r n m o d e l s o f r e g r e s s i o n , for feelings o f a n x i e t y and d e s t r u c t i o n a r e a n y t h i n g b u t o b j e c t - f r e e psychic activity. I n perceiving t h e s e feelings, t h e e x a m i n e e i s c o n n e c t e d t o t h e t h r e a t e n i n g e x a m i n e r a s well as to t h e c o n d i t i o n of his being t h r e a t e n e d , and it is his v e r y r e l a t i o n t o t h e s e t w o " o b j e c t s " t h a t i s t h e s o u r c e o f his a n x i e t y . E v e n if, in t h e third p h a s e , t h e s t u d e n t did sit in his seat petrified, e x h i b i t i n g i n c r e a s e d h e a r t activity and blood p r e s s u r e , his e x i s t e n c e w o u l d by no m e a n s h a v e r e g r e s s e d to a " s t a t e of functionally d i s t u r b e d s o m a t i c a c t i v i t y . " I f this actually h a p p e n e d , w e w o u l d n o l o n g e r b e dealing w i t h a living, b r e a t h i n g h u m a n being. T h o u g h he a p p e a r s petrified, t h e s t u d e n t h a s n o t b e c o m e a m e r e l u m p o f physical m a t t e r . H e r e m a i n s t h r o u g h and t h r o u g h a n e x i s t i n g h u m a n being, a n " o b j e c t r e l a t e d " c r e a t u r e w h o dwells i n his c o n d u c t t o w a r d w h a t h e e n c o u n t e r s . In relation to t h e e x a m i n e r , he b e c a m e e x t r e m e l y u n f r e e , all but totally s w a y e d by his p r e s e n c e , and at o n e w i t h t h i s , he lost t h e relation to his o w n selfhood. H e lacked, t h e n , t h e f r e e d o m t o w a r d , and distance f r o m , t h e e x a m i n e r t h a t a r e t h e n e c e s s a r y p r e c o n d i t i o n o f a t h e m a t i c selfa w a r e n e s s o f being afraid o f a n o t h e r . O u t s i d e p s y c h o a n a l y t i c t h e o r y are m a n y o t h e r p s y c h o l o g i e s : n a t u r a l scientific p s y c h o l o g i e s , g e s t a l t p s y c h o l o g y , and t h e p e r s o n a l and a n t h r o p o l o g i c a l p s y c h o l o g i e s . F o r an e x a m p l e of a natural scientific p s y c h o l o g i s t w h o r e m a i n e d outside t h e p s y c h o a n a l y t i c school w e m a y t u r n again to P i a g e t . H i s peculiar s k e t c h of t h e s e a r c h for t r u t h as it is m a d e by c l o s e t e d p h i l o s o p h e r s we m a y leave to speak for itself. W h a t is i m p o r t a n t for us is t h e u n e x a m i n e d w a y in w h i c h P i a g e t has c o n t i n u e d , e v e n a s late a s 1 9 6 7 , t o t r a n s f e r t h e s t r u c t u r e s o f t h e o r e t i c a l and e x p e r i m e n t a l physics o n t o p s y c h o l o g y ; t h e w a y i n w h i c h , w i t h o u t j u s t i f i c a t i o n , h e d o g m a t i c a l l y declares t h e r e s e a r c h m e t h o d o f this physical s c i e n c e to be the standard of t r u t h in his o w n scientific r e a l m of p s y c h o l o g y as well. L i k e all of his n a t u r a l s c i e n c e - o r i e n t e d p r e d e c e s s o r s , Piaget c a n n o t see t h a t applying e i t h e r deductive, t h e o r e t i c a l , o r e x p e r i m e n t a l physics t o h u m a n b e i n g s i n a n y w a y m a k e s v e r y specific p r e s u p p o s i t i o n s . It can be done only a f t e r h u m a n n a t u r e h a s b e e n r e i n t e r p r e t e d along t h e lines of n a t u r a l s c i e n c e s as a c o n t i n u o u s and quantifiable causal n e x u s of particles h a v i n g m a s s and e x t e n s i o n . In the The Fundamental Conditionality 07 domain of physical s c i e n c e , t r u t h is e q u a t e d w i t h c e r t a i n t y ; truth c o i n c i d e s w i t h t h e validity o f t h e s c i e n c e ' s a f f i r m a t i v e proposition. W i t h o u t f u r t h e r e l a b o r a t i o n , for e x a m p l e , he tells us t h a t a child, w h o (like m a n y p o e t s ) sees a t r e e giving shade, is m u c h f u r t h e r from the t r u t h — t h e c o r r e c t e x p l a n a t i o n — t h a n a n older p e r s o n , w h o can explain t h e s e s h a d o w s according t o t h e laws o f physics a s r e s u l t i n g from t h e a b s o r p t i o n of e l e c t r o - m a g n e t i c light w a v e s by a c o n g l o m e r a t i o n of m o l e c u l e s : t h e t r e e . P i a g e t c o n s i d e r s i t u n n e c e s s a r y t o j u s t i f y his v e r y different valuation o f t h e s e t w o w a y s o f looking, a p p a r e n t l y u n a w a r e o f t h e e x t e n t t o w h i c h a d e q u a t e c r i t e r i a a r e lacking for his j u d g m e n t . 9 10 A n y o v e r v i e w o f t h e s t a t e o f m o d e r n p s y c h o l o g y m a k e s i t clear t h a t even younger psychologists, too, who have abandoned the p s y c h o a n a l y t i c — b u t n o t t h e n a t u r a l s c i e n t i f i c — a p p r o a c h a r e open t o t h e c h a r g e o f giving t o o little t h o u g h t t o t h e s u p p o s i t i o n s b e h i n d t h e i r m e t h o d o l o g y and t h e r e f o r e insufficiently r e s p e c t i n g l i m i t a t i o n s w h i c h t h o s e s u p p o s i t i o n s i m p o s e . F o r if F r e u d seized on t h e n o t i o n of a psychic u n c o n s c i o u s t o g e t o u t o f p r o v i n g t h e u n p r o v a b l e p a r t s o f his t h e o r y , t h e r e a r e p s y c h o l o g i s t s o f a n o t h e r n a t u r a l scientific p e r s u a s i o n t h e s e days w h o e m p l o y t h e d u b i o u s t e c h n i q u e called b u r y i n g o n e ' s head i n t h e sand. T h e y a r e t h e n o n m e d i c a l l y t r a i n e d p s y c h o l o g i s t s w h o r e t r e a t i n t o neurology whenever the phenomena of human behavior present them w i t h a difficulty. T h e s e p s y c h o l o g i s t s a r e o b v i o u s l y s u b j e c t to t h e s a m e c r i t i c i s m w e applied e a r l i e r t o r e p r e s e n t a t i v e s o f t h e s o m a t i c t h e o r y o f t h e p s y c h e . N o m a t t e r h o w n u m e r o u s o r diverse t h e findings o f n e u r o l o g y m a y b e c o m e , t h e y will n e v e r b e able t o m a k e o n e part o f human behavior understandable. M a n y c o n t e m p o r a r y p s y c h o l o g i s t s , o f c o u r s e , u s e n a t u r a l scientific t e c h n i q u e s o f m e a s u r e m e n t w i t h o u t r e s o r t i n g t o n e u r o l o g y . Y e t all t h e i r o b j e c t s of i n v e s t i g a t i o n likewise p r e s u p p o s e a h u m a n c a p a c i t y for perceiving t h e p r e s e n c e s of t h i n g s in t h e i r particular m e a n i n g f u l n e s s and c o n t e x t o f r e f e r e n c e . B u t a s such, n e i t h e r the p r i m a r y p e r c e p t i o n o f a p h e n o m e n o n , n o r its m e a n i n g f u l n e s s and c o n t e x t , s u b m i t s t o m e a s u r e ­ m e n t . C o n s e q u e n t l y , n o scientific p s y c h o l o g y can set forth t h e c o n d i t i o n s for t h e p h e n o m e n a o f h u m a n b e h a v i o r , w h e t h e r t h e s e p h e n o m e n a a r e called h u m a n c o n s c i o u s n e s s , p e r c e p t i o n , s e n s a t i o n , e x p e r i e n c e and m o t i v a t i o n , o r l e a r n i n g and r e a c t i n g . Modern "scientific" branches of psychology congratulate themselves for having " d e m y t h o l o g i z e d " h u m a n b e h a v i o r . B u t , to t a k e a case in point, i s a n y t h i n g m o r e " m y t h o l o g i c a l " i n this s e n s e t h a n t h e s t a t e m e n t : 11 It is t h e r e f o r e my h y p o t h e s i s t h a t we e x p e r i e n c e c e r t a i n of the p r o c e s s e s that o c c u r in t h e brain, but n o t o t h e r s . If this h y p o t h e s i s is 68 EXISTENTIAL FOUNDATIONS a c c e p t e d , it follows as a c o r o l l a r y t h a t n e r v e impulse activity, and t h e r e f o r e b e h a v i o r (including linguistic b e h a v i o r ) , is n o t n e c e s s a r i l y directly and i m m e d i a t e l y available to c o n s c i o u s n e s s . 12 N o t h i n g o b j e c t i v e (i.e., factually p r e s e n t ) d e m o n s t r a t e s a n ability t o e x p e r i e n c e e v e n t s o c c u r r i n g i n t h e brain, n o r t h e i r r e t e n t i o n i n m e m o r y , n o r t h e identity o f n e r v e i m p u l s e a c t i v i t y and h u m a n b e h a v i o r , n o r t h e identity o f n e r v e i m p u l s e activity and l a n g u a g e , n o r the availability o f n e r v e impulses t o c o n s c i o u s n e s s . N o less " m y t h o l o g i c a l " i s t h e s c i e n t i f i c - p s y c h o l o g i c a l n o t i o n t h a t w h e n s o m e t h i n g w h i c h has b e e n s e e n b e f o r e is r e c o g n i z e d , it is t h e t h i n g ' s d e n o t a t i o n t h a t i s s e e n i n t h e f o r m o f s o m e n e u r a l a l t e r a t i o n . H o w , and by w h o m , this n e u r a l a l t e r a t i o n is read, r e m a i n s a m y s t e r y . Finally, n o n m e d i c a l l y t r a i n e d p s y c h o l o g i s t s are j u s t as fond as their medically t r a i n e d c o u n t e r p a r t s o f using t h e m a g i c w o r d s " e n c o d i n g " and " d e c o d i n g " for t h e r e l a t i o n s h i p b e t w e e n e x p e r i e n c e d e v e n t s and specific cerebral processes. H a s e l o f f , a m o n g o t h e r s , t h e r e f o r e e r r s i n saying t h a t o n l y this type o f s t r i c t l y scientific p s y c h o l o g y is n o t set a g a i n s t t h e realities of a c h a n g i n g s o c i e t y and t h a t o n l y it is in a position to i n t e r p r e t h u m a n b e i n g s and s o c i e t y in a s o b e r , r a t i o n a l w a y . W h e r e t h e r e is so m u c h i n h e r e n t " m y t h o l o g y " t h e r e can b e n o talk o f s o b e r t h o u g h t . B e s i d e s , t h e s t r i c t l y n a t u r a l scientific b r a n c h e s o f p s y c h o l o g y are v e r y m u c h opposed t o t h e realities of c h a n g i n g s o c i e t y , as far as t h e y a r e m e s m e r i z e d by the prevailing spirit of t e c h n o l o g y c u t t i n g t h e m s e l v e s o f f from a c o n s i d e r a ­ ble part of h u m a n reality and liable—if t h e y w e r e given full r e i n — t o preclude a n y f u n d a m e n t a l social c h a n g e . 1 3 T h e v e r y n a t u r e o f n a t u r a l scientific ( q u a n t i f y i n g ) p s y c h o l o g i e s w h i c h are not p s y c h o a n a l y t i c a l l y inclined limits t h e i r practical p e r f o r m a n c e to c o m p a r a t i v e s t a t i s t i c a l a n a l y s e s . F o r t h e m e a n s o f n a t u r a l s c i e n c e can only c o m p a r e t h e m o s t peripheral t r a i t s o f h u m a n b e h a v i o r w i t h e a c h o t h e r . O n l y t h o s e t r a i t s can b e m a t h e m a t i c a l l y p r o c e s s e d — a d d e d together or subtracted from one another—to produce average values. C o n s e q u e n t l y , the c l o s e r a psychological i n v e s t i g a t i o n aims for t h e n a t u r a l scientific ideal o f t r u t h , the m o r e e x t e r n a l l y f o r m a l , and i n t e r n a l l y e m p t y , t h e scientific e l a b o r a t i o n s o f h u m a n b e h a v i o r m u s t b e c o m e . T h e r e i s n o o t h e r w a y t o e x p r e s s b e h a v i o r statistically. T h i s i s a s clear i n statistical a n a l y s e s o f t h e b e h a v i o r o f p a r e n t s w h o h a v e s c h i z o p h r e n i c children as it is, for i n s t a n c e , in m a r k e t i n g a n a l y s e s or statistical s u r v e y s o f large g r o u p s o r studies o f epidemic diseases d o n e o n e n t i r e cities and r e g i o n s . All of t h e s e studies m a y have c o n s i d e r a b l e t h e r a p e u t i c and p r o p h y l a c ti< application. B u t n o n e is likely to p r o m o t e f u n d a m e n t a l u n d e r s t a n d i n g The Fundamental Conditionality 69 of h u m a n n a t u r e . In and of t h e m s e l v e s , q u a n t i f y i n g p s y c h o l o g i e s can do n o m o r e t h a n locate and m e a s u r e c o n c r e t e p r o c e s s e s and c h a n g e s o f the psychic aspect. T h e y are n o t equipped even to ask w h a t this psychic aspect is or w h a t part it plays in m a k i n g a h u m a n life. W h a t is e s s e n t i a l in h u m a n b e h a v i o r — o u r p e r c e p t i o n s , a c t i o n s , and r e s p o n s e s i n t h e face o f d e m a n d s made b y o t h e r people and w h a t s u r r o u n d s us—is f r o m t h e o u t s e t b e y o n d the p o w e r s of statistical c o m p u t a t i o n . Even F r e u d s p o k e in his practical writings of greater freedom through psychoanalytic therapy, though this principal w a s in radical o p p o s i t i o n to his o w n t h e o r y . A n a t u r a l scientific, d e t e r m i n i s t i c basis for h u m a n freedom is a c o n t r a d i c t i o n in terms. S i n c e its inception, G e s t a l t t h e o r y has e m p h a s i z e d t h a t o u r initial e x p e r i e n c e i s o f unified s t r u c t u r e s o f m e a n i n g f u l " G e s t a l t q u a l i t i e s . " T h e w h o l e is n o t o n l y greater t h a n t h e sum of its p a r t s b u t also p r e c e d e s its parts, since the w a y parts a r e p e r c e i v e d depends o n t h e G e s t a l t , t h e w h o l e . B u t like its p r e d e c e s s o r , G e s t a l t p s y c h o l o g y r e m a i n s fixed o n a n e n d o p s y c h i c e x p e r i e n c i n g o f s t r u c t u r e s . S t u m p f m e n t i o n s t h e possibility t h a t u n k n o w n (that is, a s y e t u n k n o w n ) c o n s c i o u s c o n t e n t m a y b e t h e p r e r e q u i s i t e for unified p e r c e p t i o n . O t h e r G e s t a l t t h e o r e t i c i a n s still dispute w h e t h e r the e x p l a n a t i o n lies in c h e m o p h y s i c a l p r o c e s s e s and "shifting force fields" in t h e c e r e b r a l c o r t e x or in u n c o n s c i o u s and e x t r e m e l y rapid e v e n t s r a t h e r like t h e o b s e r v a b l e e n d o p s y c h i c p r o c e s s e s of calculating, m a k i n g a j u d g m e n t , or r e a c h i n g a c o n c l u s i o n . For o t h e r t h e o r i s t s , G e s t a l t f o r m a t i o n t a k e s place "in the p r i m i t i v e m a t e r n a l soil o f f e e l i n g . " A n d , again, t h e r e i s C o n r a d ' s e n d o p s y c h i c "field o f e x p e r i e n c e " o n t o w h i c h o b j e c t s o f t h e e x t e r n a l w o r l d are p r o j e c t e d a s i m a g e s , w i t h c h a n g i n g " e m p h a s i s given t o t h e basic c o n f i g u r a t i o n . " W e can o n l y r e p e a t t h a t t h e r e i s n o h u m a n e v i d e n c e y e t t o a r g u e for t h e actual o c c u r r e n c e o f this s o r t o f e n d o p s y c h i c , r e p r e s e n t a t i o n a l " c o n ­ scious c o n t e x t , " and t h a t t h e s e n o t i o n s are h y p o t h e t i c a l i n v e n t i o n s . G e s t a l t t h e r a p y h a s n o t c o m e u p w i t h any e x p l a n a t i o n for t h e p i c t u r e i t offers. W h a t w e perceive f r o m t h e o u t s e t , r a t h e r , a r e v a r i o u s i n a n i m a t e o b j e c t s , living c r e a t u r e s , fellow h u m a n b e i n g s , and w h a t e v e r else w e c o m e u p o n o u t t h e r e i n the w o r l d , w h e r e t h e y address t h e m s e l v e s t o us, w i t h all t h e i r c o l l e c t i o n s of r e l a t i o n s h i p s and f r a m e s of r e f e r e n c e in t i m e and space. T h e q u e s t i o n o f h o w precisely o r i m p r e c i s e l y t h e s e t h i n g s s h o w t h e m s e l v e s to us is of s e c o n d a r y i m p o r t a n c e . T h e i n n a t e s t r u c t u r e s p r o p o s e d b y c u r r e n t a n i m a l p s y c h o l o o y are likewise e n d o p s y c h i c o r c e r e b r a l i n n a t u r e and t h e r e f o r e elso e n t i r e l y h y p o t h e t i c a l . O f c o u r s e , a n i m a l p s y c h o l o g i s t s believe t h a t t h e i r e x p e r i m e n t s , w h i c h u s e so-called c o n t r o l l e d s i t u a t i o n s , succeed in 70 EXISTENTIAL FOUNDATIONS e s t a b l i s h i n g identity b e t w e e n t h e i r o w n a s s u m e d i n t e r n a l s c h e m e s and t h e actual e v e n t s . B u t a t best, controlled e x p e r i m e n t s can d e m o n s t r a t e t h e e x t e n t to w h i c h a c r e a t u r e can be deceived by an e x p e r i m e n t e r . T h e y tell u s n o t h i n g a b o u t t h e e x i s t e n c e o r n o n e x i s t e n c e o f i n n a t e , i n h e r i t e d s t r u c t u r a l c o n f i g u r a t i o n s within an o r g a n i s m , n o r do t h e y help illuminate t h e ability to p e r c e i v e a thing as s o m e t h i n g . W e have s e e n t h a t r e c e n t psychological t h e o r i e s o f layers i n t r o d u c e d m a n y m e t a p h y s i c a l c o n c e p t s like field of c o n s c i o u s n e s s , s u b j e c t , self, e x i s t e n c e , and e n t e l e c h y i n t o medicine. T h e m o r e s h a l l o w psychic layers a r e allowed to s t a n d on t h e i r o w n as primal m e n t a l e n t i t i e s , and t h e i r g r e a t e s t possible e x t e n s i o n i n t o t h e o r g a n i s m and the deeper psychic f u n c t i o n s is seen as the end c a u s e of all layer f o r m a t i o n . T h e primal upper psychic l a y e r s are the place of t h a t h u m a n f r e e d o m and r e s p o n s i b i t i t y w h i c h n a t u r a l s c i e n c e c a n n o t grasp, and r e s p o n s i b i l i t y and c o n s c i e n c e are w h a t actually defined self, s u b j e c t , e x i s t e n c e , and e n t e l e c y , in t h e m s e l v e s and a g a i n s t h i g h e r t h i n g s . But a s far a s w e k n o w , n o n e o f t h e s e t h e o r i e s o f layers g e t s t h r o u g h t o the q u e s t i o n o f the specific n a t u r e o f psychic layers, t h o u g h only an a d e q u a t e a n s w e r to this q u e s t i o n can m a k e r e s p o n s i b i l i t y and c o n s c i e n c e c o m p r e h e n s i b l e . T h e n o t i o n o f a s u p r e m e e n t e l e c h y is, as a scientific h y p o t h e s i s , p u r e i n f e r e n c e . No d i s c e r n i b l e p h e n o m e n o n o f h u m a n e x i s t e n c e o f f e r s p r o o f for t h e actual p r e s e n c e o f any entelechy. T h e latest t r e a t i s e o f H . E y i s b a s e d — n o d o u b t b o r r o w i n g from the field t h e o r y of m o d e r n p h y s i c s — o n t h e n o t i o n of a h u m a n field of c o n s c i o u s n e s s . Ey himself, h o w e v e r , admits t h a t t h e t e r m , derived from a m e r e i n f e r e n c e , is n o t h i n g m o r e than a " h y p o t h e t i c a l t r a n s c r i p t i o n " of c o n s c i o u s n e s s . S e c o n d l y , his definition allows him to d e s c r i b e o n l y t h e b e h a v i o r and n o t t h e actual n a t u r e of this a s s u m e d field of c o n s c i o u s n e s s . A n d his description of this field of c o n s c i o u s n e s s as an o r d e r e d s t r u c t u r e does n o t help us v e r y m u c h ; a rock c r y s t a l is also an o r d e r e d s t r u c t u r e , yet it can n e v e r p e r c e i v e a t h i n g as s o m e t h i n g t h a t m e a n s this or that. In trying to define h u m a n c o n s c i o u s n e s s on t h e basis of its ability to c o n s t r u c t a model w o r l d from v a r i o u s e x p e r i e n c e s and t h e n to a r r a n g e actual e x p e r i e n c e s to f o r m a field, Ey p u t s this definition u n d e r t h e s a m e r e s e r v a t i o n s t h a t apply to all h y p o t h e s i s of r e p r e s e n t a t i v e e n d o p s y c h i c c o n s c i o u s c o n t e n t . F u r t h e r m o r e , the c o n s t r u c t i o n of a model w o r l d p r e s u m e s prior a w a r e n e s s , a k n o w l e d g e t h a t a t h i n g is s o m e t h i n g in particular, a p a r t i c u l a r u n d e r s t a n d i n g of t h e w o r l d . Ey's " c o n s c i o u s n e s s , " in c o n s t r u c t i n g , a r r a n g i n g , and o r d e r i n g e x p e r i e n c e , directs itself to things w h i c h c a n n o t e x i s t at all if t h e r e is n o t prior a w a r e n e s s . E x p e r i e n c e is always of s o m e t h i n g specific, of s o m e t h i n g as being s o m e t h i n g , of s o m e t h i n g we s o m e h o w already h a v e a s e n s e of. Ey The Fundamental 71 Conditionally similarly has c o n s c i o u s n e s s " e m e r g e from t h e s h o c k i n g r e c o g n i t i o n of a r e s i s t a n c e t h a t m u s t b e o v e r c o m e , " while t h e r e could b e n o r e c o g n i t i o n w i t h o u t a n already e m e r g e d c o n s c i o u s n e s s . In t h e end, Ey s h a r e s a f o r m u l a w i t h B i n d e r , in w h i c h b o t h speak of a level o r l a y e r d e v o t e d t o t h e field o f c o n s c i o u s n e s s w h i c h unfolds t o become the subjective system that makes human beings human. Neither explains precisely w h a t " s u b j e c t " m e a n s o r h o w t h e l a y e r o f c o n s c i o u s ­ n e s s is e m p o w e r e d to u n f o l d . T h e c o n c e p t of an e x i s t e n t i a l l a y e r , w h i c h is i n a c c e s s i b l e to r e a s o n and i n h a b i t s s o m e h i g h e r m e t a p h y s i c a l plane, is gaining c u r r e n c y . It, t o o , is c h a r a c t e r i z e d by a surprising lack of definition; its n a t u r e and s t r u c t u r e a r e left o b s c u r e . T h i s is n o t m e r e l y an o v e r s i g h t t h a t will be c o r r e c t e d in time. T h e psychological t h e o r i e s o f drives and layers will n e v e r explain human existence. T h i s is because each of these theories posits human n a t u r e as s o m e sort of geological f o r m a t i o n , s o m e t h i n g t h a t e x i s t s in and of i t s e l f a m o n g all t h e o t h e r s u b s t a n c e s t h a t m a k e up t h e w o r l d , a t h i n g t h a t can be located at a specific point in space. G i v e n this a priori conceptualization of human beings, even the latest existentially oriented l a y e r t h e o r y p s y c h o l o g i e s c o n j u r e u p t h e s a m e riddle t h a t w r a c k e d t h e e a r l i e r t h e o r y o f i n s t i n c t s : i f m a n e x i s t s i n and o f himself, a n i m m a n e n t being from his v e r y b e g i n n i n g s , f u n d a m e n t a l l y e n c a p s u l a t e d w i t h i n his p s y c h e , h o w does h e e v e r gain the s o r t o f vision t h a t would p e r m i t him e v e n t o i n t u i t s o m e w o r l d o u t s i d e ? H o w does h e leave and t r a n s c e n d h i m s e l f t o a p p r o a c h t h i n g s o u t s i d e , and h o w d o t h e s e t h i n g s o f e x t e r n a l reality g e t i n t o t h e c o n s c i o u s n e s s of a p e r s o n w h o is m a d e this w a y ? 14 In this d i s t r e s s i n g s i t u a t i o n , m o r e and m o r e p s y c h o l o g i s t s and p s y c h o p a t h o l o g i s t s h a v e looked for help to H e i d e g g e r ' s e x p r e s s i o n " b e i n g - i n - t h e - w o r l d . " M o d e r n p s y c h o p a t h o l o g y o w e s a special debt to B i n s w a n g e r for d r a w i n g its a t t e n t i o n t o his t h o u g h t . B u t all o t h e r psychological t h e o r i e s , including B i n s w a n g e r ' s o w n r e p r e s e n t a t i o n o f s u b j e c t i v i t y , r e t a i n an i n h e r i t e d p i c t u r e of m a n as a p s y c h i c , or s u b j e c t i v e , stratified thing primarily e n c a p s u l a t e d w i t h i n itself, and c o n s i s t e n t l y c o n s t r u e t h e " b e i n g - i n - t h e - w o r l d " o f e x i s t e n t i a l analysis a s o n e m o r e p r o p e r t y to be added to t h e n o t i o n of m a n as s u b j e c t , in v o g u e since D e s c a r t e s . W h a t i s t h e use o f c h a r a c t e r i z i n g " b e i n g - i n - t h e - w o r l d " a s t h e ability t o t r a n s c e n d s u b j e c t i v e i m m a n e n c e and a p p r o a c h o b j e c t s o f the e x t e r n a l w o r l d as long as this " b e i n g " is s e e n as j u s t o n e m o r e trait of a primarily e n c a p s u l a t e d s u b j e c t i v i t y ? O f the a n t h r o p o l o g i c a l p s y c h o l o g i e s H . G o p p e r t h a s r i g h t l y said that despite t h e i r u n i q u e m e t h o d o l o g i c a l s t a r t i n g points, t h e i r a n a l y s e s a r e 72 EXISTENTIAL FOUNDATIONS s t r i k i n g l y similar t o p s y c h o a n a l y t i c i n t e r p r e t a t i o n s . T h e m o s t a p p a r e n t similarity i s t h e c o n s t r u c t i o n o f f u n d a m e n t a l opposition a m o n g t h e d y n a m i c f a c t o r s o f d e s t r u c t i v e a g g r e s s i o n , t h e u r g e t o o r d e r , and e r o t i c d e v e l o p m e n t . B u t t h e precise n a t u r e of t h e subject as it is v i e w e d by t h e s e t h e o r i e s r e m a i n s u n c l e a r . Fifteen y e a r s b e f o r e , M a r t i n H e i d e g g e r said o f t h e field: " A n t h r o p o l o g y i s t h a t i n t e r p r e t a t i o n o f m a n w h i c h k n o w i n g i n a d v a n c e w h a t m a n basically i s can n e v e r ask w h a t h e is. T h e q u e s t i o n would b e a n a d m i s s i o n o f s h a k i n e s s and defeat. H o w can a n t h r o p o l o g y b e e x p e c t e d to ask this q u e s t i o n w h e n its sole t a s k is to s h o r e up t h e selfcertainty of the s u b j e c t ? " B e c a u s e o f this failing, t h e c o n c r e t e m a n i f e s t a t i o n s o f h u m a n b e h a v i o r r e m a i n u n c l e a r and inaccessible t o t h e e x i s t e n t i a l p s y c h o l o g i e s and psychological a n t h r o p o l o g i e s w h i c h , like p s y c h o a n a l y s i s , w o u l d i l l u m i n a t e dark places w i t h s u p p o s i t i o n s t h a t are even more obscure. American ego psychology, always m o r e oriented to the h u m a n e n v i r o n m e n t , physical and i n t e r p e r s o n a l , t h a n E u r o p e a n p s y c h o l o g i e s , claims t h a t from his b e g i n n i n g s m a n lives in an i n t e r p e r s o n a l r e a l m and e x i s t s primarily i n his i n t e r s u b j e c t i v e r e l a t i o n s and e x c h a n g e s w i t h o t h e r people. W h i l e t h e s e s t a t e m e n t s r e p r e s e n t a g r e a t a d v a n c e , the i n t e r s u b j e c t i v e r e l a t e d n e s s of m a n is viewed o n l y as a psychologically describable p r o p e r t y , an unclarified p s y c h e , b u t n o t as an e s s e n t i a l d e t e r m i n a n t o f h u m a n n a t u r e itself. 1 5 S i m i l a r ideas a b o u t h u m a n e x i s t e n c e developed i n d e p e n d e n t l y in E u r o p e , c u l m i n a t i n g in t h e a s s e r t i o n t h a t m a n actually lives in a " b e t w e e n . " B u b e r ' s " I , " " t h o u , " and ' w e " s c h e m e f o u n d global r e s o n a n c e i n c o n t e m p o r a r y p s y c h o l o g y . Y e t even i n this " t h e o r y o f d i a l o g u e " t h e n a t u r e of m a n is n o t e x p l a i n e d clearly e n o u g h to c o n v i n c e us t h a t it is m a n k i n d as a w h o l e and n o t o n l y t h e t e s t c a s e t h a t can be e x p e r i e n c e d as a n " I , " " t h o u , " and " w e . " O n e thing o n l y e m e r g e s w i t h c e r t a i n t y — t h a t all of t h e s e p s y c h o l o g i e s of dialogue posit h u m a n b e i n g s as individual s u b j e c t s i n h e r e n t l y opposed to e a c h o t h e r . A " b e t w e e n " can take place only a m o n g a t least t w o s e l f - c o n t a i n e d , and s e l f - s u p p o r t i n g , e n t i t i e s . W e c a n n o t learn f r o m t h e s e t h e o r i e s h o w t h e s e s u b j e c t i v e poles are m a d e s o t h a t t h e y e n t e r i n t o r e l a t i o n s h i p s o f a n y kind w i t h o n e a n o t h e r — e s s e n t i a l o r i n e s s e n t i a l , direct o r indirect, i n t i m a t e o r r e m o t e . Because of their inadequate determinations of human nature, a n t h r o p o l o g i c a l p s y c h o l o g i e s and p s y c h o l o g i e s of dialogue also fail to establish a s o u n d basis for an a d e q u a t e l y h u m a n m e d i c i n e . I n s t e a d of clarifying t h e basic n a t u r e o f h u m a n e x i s t e n c e t h e m s e l v e s , b o t h p s y c h o l o g i e s adopt a f e w traditional W e s t e r n v i e w s of m a n w h i c h h a v e e m e r g e d in the c o u r s e of h i s t o r y and t h e n u s e t h e s e c o n c e p t i o n s to support their o w n d e t e r m i n a t i o n s . T h e n a m e s b y which these' conceptions go—"subjectivity," "self," "existence," " I , " "thou," " w e , " "basic t r u s t , " or "basic d i s t a n c e " — m a k e little d i f f e r e n c e . c o n t e m p o r a r y b r a n c h e s o f psy­ c h o l o g y and p s y c h o p a t h o l o g y h a v e c o m e a long w a y since Freud's b e g i n n i n g . M o r e o v e r . PSYCHOSOMATIC HYPOTHESES W e h a v e s h o w n t h a t i n t e r p r e t a t i o n s based o n t h e traditional f o u n d a t i o n s o f m e d i c i n e could h a n d l e n e i t h e r t h e e x c l u s i v e l y s o m a t i c m a n i f e s t a t i o n s o f o u r t e s t s u b j e c t . t h e i n t e r e s t o f p s y c h o l o g i s t s s o o n e x p a n d e d t o include e v e r l a r g e r c o m p l e x e s o f social r e l a t i o n s h i p s . n e i t h e r o f w h i c h h a s b e e n a d e q u a t e l y or appropriately elucidated by t h e s c i e n c e of m e d i c i n e . p s y c h o s o m a t i c m e d i c i n e h a s o v e r s t e p p e d its b o u n d s as a n a t u r a l s c i e n c e . it is in fact p h i l o s o p h i z ­ ing. w h i c h w e r e s e e n m o r e and m o r e a s the primary phenomena of human existence. and this is n o t t h e affair of a science. t h e b e i n g n e s s of s o m e being. m e a s u r e m e n t is j u s t a w a y by w h i c h t h e i n v e s t i g a t o r a p p r o a c h e s t h e object he is investigating. h o w e v e r . w h e r e a s the psychic aspect is o n l y intuitively p e r c e i v a b l e .c o n t r a d i c t i o n in w h i c h this c r i t e r i o n of m e a s u r a b i l i t y e n t a n g l e s p s y c h o s o m a t i c medicine. W h i l e t h e m a i n focus w a s for a t i m e t h e various s t r u c t u r e s and p r o c e s s e s a s s u m e d t o e x i s t w i t h i n t h e individual p s y c h e . the phrases current in the most recent theories— " i n t e r s u b j e c t i v e r e l a t i o n s h i p s " and " i n t e r a c t i o n s " — a r e n o m o r e t h a n e x p r e s s i o n s g r o p i n g in t h e dark. T h e fact t h a t s o m e t h i n g i s m e a s u r a b l e tells u s n o t h i n g a b o u t the n a t u r e o f t h e t h i n g itself. and n o t only w i t h r e s p e c t to o u r particular case. In voicing an opinion c o n c e r n i n g t h e e s s e n t i a l c h a r a c t e r of t h e reality of s o m e actual being. T h e definitions that result from characterizing the t w o a s p e c t s on such a basis a r e . h e e x t r e m e l y n a r r o w original f r a m e w o r k f o r m e d b y the n o t i o n of a primarily a u t o e r o t i c . In m a k i n g this claim. W h a t m a t t e r s m o r e . T h i s s i t u a t i o n will n o t be r e m e d i e d until s c i e n c e h a s actually discovered t h e c o n d i t i o n s t h a t m a k e s u c h r e l a t i o n ­ ships possible. T h e s e t w o c o n c e p t s are p s y c h e and s o m a . t o t a l l y n a r c i s s i s t i c p s y c h i c apparatus w a s exploded long ago. P s y c h o s o m a t i c m e d i c i n e usually d i s t i n g u i s h e s b e t w e e n t h e t w o b y saying t h a t t h e s o m a can b e w e i g h e d and m e a s u r e d . But in the meantime. It is a f u n d a m e n t a l c o n t r a d i c t i o n t o a t t r i b u t e i m m e a s u r a b i l i t y t o t h e psychic . t h e n . as it faces t h e h e r c u l e a n t a s k o f d i f f e r e n t i a t i n g and c o r r e l a t i n g t w o c o n c e p t s . T h e y p a r t i c u l a r l y failed t o c o m e t o t e r m s w i t h R e g u l a Z i i r c h e r ' s p s y c h o s o m a t ­ ic m a n i f e s t a t i o n s . is a s e l f . the n o t i o n s of m e a s u r a b i l i t y and i m m e a s u r a b i l i t y are n o t c r i t e r i a i n t r i n s i c t o the psychic and s o m a t i c a s p e c t s o f t h e m s e l v e s . Y e t p s y c h o s o m a t i c medicine itself s t a n d s helpless h e r e . n o r h e r purely psychic b e h a v i o r .The Fundamental Conditionality 73 T h e s e o b j e c t i o n s n o t w i t h s t a n d i n g . h o w e v e r . highly s u b j e c t i v e . n a t u r a l scientific p r o o f for a p s y c h o s o m a t i c r e l a t i o n s h i p is precluded. w h i c h can be m e a s u r e d and e x p r e s s e d in n u m b e r s . quantifiable) p r o o f of t h e p s y c h o s o m a t i c r e l a t i o n s h i p is n o t only f u n d a m e n t a l l y i m p o s s i b l e b u t w h o l l y unjustified a s well. if it f u n c t i o n s according to its a x i o m t h a t e v e r y t h i n g actual is also calculable. w h a t is m o r e i m p o r t a n t . It leaves t h e psychic aspect a l t o g e t h e r out of consideration. B e h i n d this r e q u i r e m e n t is a d o g m a t h a t puts t r e m e n d o u s r e s t r i c t i o n s on t h e scope of reality. e v e n p s y c h o s o m a t i c m e d i c i n e m u s t u n d e r s t a n d h o w i m p o r t a n t it is to see t h a t a strictly scientific s e p a r a t i o n a d e q u a t e to each o f the t w o r e s u l t i n g o b j e c t s o f study would b e possible o n l y a f t e r bringing to light t h e similarities t h a t n e c e s s i t a t e a s e p a r a t i o n . Traditional psychosomatic medicine generally construes the one thing uniting b o t h p s y c h e and s o m a to be t h e u n i f o r m i n t e r a c t i o n w i t h i n a p s y c h o p h y s i c a l o r g a n i s m .74 EXISTENTIAL FOUNDATIONS aspect w h i l e i n t h e s a m e b r e a t h d e m a n d i n g for p s y c h o s o m a t i c r e l a t i o n s h i p s p r o o f s t h a t w o u l d c o n v i n c e e v e n a physician schooled in t h e n a t u r a l scientific o r i e n t a t i o n . t h e failure of such a poorly founded p r o o f does n o t p r e c l u d e t h e actual r e l a t e d n e s s o f w h a t i s c o m m o n l y s e p a r a t e d and given t h e n a m e s " p s y c h i c " and " s o m a t i c .. T h u s . A n a t u r a l scientific proof. m u s t a l w a y s place the m a t t e r s it i n v e s t i g a t e s i n t o a set of r e l a t i o n s t h a t c o r r e s p o n d to this law.e. . and t h u s n o t h i n g m e a n i n g f u l can c o m e o u t o f a n a t t e m p t t o distinguish between them. E v e n t w o p r o p e r t i e s as e l e m e n t a r y as the r e d n e s s and g r e e n n e s s of a thing can be distinguished only i f w e h a v e already g r a s p e d t h e significance o f c o l o r . A p r o o f b a s e d on o n l y o n e o f t h e t w o t e r m s o f t h e r e l a t i o n s h i p can affirm n o t h i n g a b o u t t h e p s y c h o s o m a t i c r e l a t i o n s h i p itself. " T h i s being so. T h e d e m a n d for a n a t u r a l scientific (i. B u t this s o r t o f n o t i o n o b j e c t i f i e s t h e u n d e r l y i n g h u m a n n a t u r e i n such a n e x t r e m e and i n a p p r o p r i a t e m a n n e r that not even t h e simplest p s y c h o s o m a t i c p h e n o m e n o n is m a d e comprehensible. " By c o n t r a s t . B u t the actuality of a r e l a t i o n s h i p b e t w e e n t w o t h i n g s can be so p r o v e n o n l y if each is m e a s u r a b l e and q u a n t i f i a b l e . and. is n o t itself open to a n y s o r t of scientific c o n f i r m a t i o n . T h i s d e m a n d g r o w s n o t o u t o f t h e m a t t e r u n d e r i n v e s t i g a t i o n but c o m e s from the traditional n a t u r a l scientific r e q u i r e m e n t t h a t all reality be empirically m e a s u r a b l e . T h e basis for a calculated p r o o f would have to be e n t i r e l y s o m a t i c in n a t u r e . If t h e p s y c h i c e n t i t y is by definition i m m e a s u r a b l e . for o n l y t h e s o m a t i c aspect of h u m a n being can be m e a s u r e d . " r e d " and " h e a v y " do n o t b e l o n g to a c o m m o n c a t e g o r y . B o t h red and g r e e n are s u b s u m e d u n d e r t h e c o m m o n c a t e g o r y " c o l o r . it follows t h a t the possibility of a valid. and vice v e r s a . T h e t e a r . is totally d i f f e r e n t f r o m an a d e q u a t e d e t e r m i n a t i o n of what s u c h a g e n e r a t e d s y m p t o m is. m o u r n i n g can be n e i t h e r weighed n o r m e a s u r e d . w h a t we e n d up holding is j u s t a drop of liquid. T h e additional e x i s t e n c e of a p s y c h e . On its w a y to a s c e r t a i n i n g the biographical c a u s e s o f s y m p t o m s . T h e a s s u m p t i o n o f a r e l a t i o n s h i p b e t w e e n t w o e n t i t i e s d o e s n o t a d e q u a t e l y explain e i t h e r t h e expressive. is a b s o l u t e l y b e y o n d proving. and e x c e p t for this i t r e m a i n s e n t i r e l y o b s c u r e . or the expressed. so it has r e s t r i c t e d itself t o c l a r i f y i n g t h e g e n e s i s o f t h e s e s y m p t o m s instead. can b e w e i g h e d and c h e m i c a l l y analysed. it is no l o n g e r a tear. W h i l e t h e w i l l i n g n e s s o f p s y c h o s o m a t i c m e d i c i n e t o c o n s i d e r relation­ ships b e t w e e n t w o t o t a l l y h e t e r o g e n e o u s t h i n g s calls its scientific s o u n d n e s s into q u e s t i o n . of c o u r s e . m u c h less a n s w e r e d . on t h e o t h e r h a n d . p s y c h o s o m a t i c m e d i c i n e alludes t o the p o t e n t i a l o f e n d o p s y c h i c p h e n o m e n a for affecting o r g a n i c f u n c t i o n s . A s with t h e tear.e x p r e s s i o n . traditional p s y c h o s o m a t i c m e d i c i n e c a n n o t specify the t r u e n a t u r e of any o t h e r so-called p s y c h o s o m a t i c s y m p t o m s . W h e n psychosomatic medicine abandons the notion of interaction b e t w e e n p s y c h e and s o m a in favor of a r e l a t i o n s h i p of e x p r e s s i o n imagining. T h i s . W e h a v e indicated b e f o r e t h a t t h e n a t u r a l scientific i n t e r p r e t a t i o n of t h e living h u m a n body as a m e r e s o m a m i s s e s its peculiar m o d e of b e i n g . O n c e a t e a r h a s b e e n w e i g h e d and m e a s u r e d . or w h e t h e r it suffices to d e t e r m i n e t h e puzzling. t h e n w h a t actually c o n s t i t u t e s a t e a r ? T h e n a t u r a l scientific c r i t e r i o n o f m e a s u r a b i l i t y d o e s not allow this q u e s t i o n e v e n to be raised. c o n s i d e r a t i o n s o f t h e i r p o t e n t i a l i n t e r a c t i o n a r e n e v e r scientifically s o u n d and m u s t a l w a y s r e m a i n h a z y . it follows t h a t all s e c o n d a r y . is il si ill a t e a r ? Hardly. Is the t e a r t h e n p s y c h i c or s o m a t i c . or is 11 n e i t h e r ? If it is n e i t h e r . the l e u ol a p e r s o n in m o u r n i n g . h o w e v e r . its o w n n a t u r e n e v e r b e i n g analyzed. for i n s t a n c e . T h e expressed one. B u t w h e r e t w o such h e t e r o g e n e o u s t h i n g s are c o n c e r n e d . B e i n g psychic. for if we m e a s u r e it. h o w e v e r . T h e expressive one is assigned only o n e quality. We are n e v e r told e x a c t l y what " e x p r e s s i o n " m e a n s . If it is t r u e t h a t t h e c o n c e p t u a l approach of p s y c h o s o m a t i c medicine has not made it possible to d e t e r m i n e a d e q u a t e l y w h a t kind of r e l a t i o n s h i p o p e r a t e s b e t w e e n p s y c h e and s o m a . t h a t t h e s o m a t i c a l l y r e g i s t e r e d t e a r is an expression of the psychic mourning—then the connection between p s y c h e and s o m a is still f u r t h e r confused. for i n s t a n c e . is r e d u c e d to t h e s t a t u s of a m e r e derivative o f this o b s c u r i t y . w h a t u n d e r c u t s i t m o r e i s t h e fact t h a t t h e s e t h i n g s simply d o n o t e x i s t . in and of itself. r e l a t i o n s h i p b e t w e e n s o m a and p s y c h e .The Fundamental Conditionality C o n s i d e r as a simple p s y c h o s o m a t i c s y m p t o m . likewise p r e s e n t and in s o m e w a y j o i n e d to t h e s o m a . t h e capacity for s e l f . At o n e and t h e s a m e t i m e — n o t in s o m e s u c c e s s i o n of p r i m a r y and s e c o n d a r y e v e n t s — t h e s e p h e n o m e n a induce o r m o t i v a t e m e t o a n action. alle n c o m p a s s i n g m o t i v a t i o n such a s U e x k u l l p r o p o s e s . i f w e are t o c r e a t e s e p a r a t e o b j e c t s . F u r t h e r m o r e . t h a t w h e n t h e p h e n o m e n a o f m y w o r l d c o n f r o n t m e t h e y reveal. It is r e s p o n s i b l e for i n t e r p r e t i n g his s u r r o u n d i n g s and g e n e r a t i n g — o n its o w n — a p p r o p r i a t e action. I l e x ! Lill's proposal does not a m o u n t to a factual p h e n o m e n o l o g i c a l description ol demonst i able m a n i f e s t a t i o n s .76 EXISTENTIAL FOUNDATIONS c o n s i d e r a t i o n s c o n c e r n i n g the activation of specific s y m p t o m s in the body t h r o u g h specific psychic conflicts are futile. T h e a s c e r t a i n a b l e facts indicate. A'. u n a r t i c u l a t e d m a t t e r .r e a l " and " u n a r t i c u l a t e d " m a t t e r o n t o w h i c h . . quite o b s c u r e . a b o v e me and t h e w i n Id's "pre-real m a t t e r . appropriate to t h e m e a n i n g I have perceived in t hem. U e x k u l l gives the c a s e of a p e r s o n c o n f r o n t i n g an apple t r e e to illustrate t h i s . we m u s t project m e a n i n g s . T h e c o n c e p t s o f traditional p s y c h o s o m a t i c medicine will t h e r e f o r e n e v e r yield an explanation o f the i m p o r t a n t m a t t e r o f the specificity o f p s y c h o s o m a t i c symptoms. "In o u r illustration. or n o n a c t i o n ." B u t t h e r e is no e v i d e n c e for the p r e s e n c e of an i n n a t e . M o t i v a t i o n is w h a t shapes the " p r e . can o c c u r o n l y in r e s p o n s e to my perception of w h a t I e n c o u n t e r in my world. we can say t h a t t h e appetite is e t e r n a l but t h a t t h e e a t e r and t h e scenic p r o p e r t i e s are subject to change. w h o s e p e r c e p t i o n o f t h e m e a n i n g o r significance of s o m e t h i n g is dictated by a m o t i v a t i o n . A t t e n t i o n has already b e e n d r a w n to U e x k u l l ' s a t t e m p t from t h e q u a r t e r o f a n t h r o p o l o g i c a l p s y c h o l o g y t o c o r r e c t t h e faults o f earlier p s y c h o s o m a t i c t h i n k i n g and t o d e t e r m i n e a d e q u a t e l y just w h a t does unite the psychic and s o m a t i c a s p e c t s . picking apples and eating t h e m . we said t h a t a " m o t i v a t i o n " is a l w a y s seen as the unifying basis of all h u m a n p h e n o m e n a . t h e m o t i v a t i o n a p p r o p r i a t e s b o t h t h e psychic e g o (as director) and t h e h u m a n b o d y (as props). o n l y t h o s e t o w h i c h m y p e r c e p t i o n — i n t h e s t a t e o f m y e x i s t e n c e a t the t i m e — is open. o f t h e i r g r e a t s t o r e o f m e a n i n g s . s u c h a depiction of t h e situation leaves t h e n a t u r e o f a n ego. T o produce an action. " M o t i v a t i o n s . He c o n c l u d e s . n o r does e x p e r i e n c e c o n f i r m t h a t o u r w o r l d appears to us initially as m e r e l y " p r e . his t h e o r y does n o t allow us io understand what we actually o b s e r v e in a p s y c h o s o m a t i c s y m p t o m . the world is m e r e l y t h e r e . In s u m m a r i z i n g the c o n c e p t u a l approach of his Foundation of Psychosomatic Medicine.r e a l m a t t e r " into t h e m o s t diverse realities. to appear in the s c e n e w h i c h it (the m o t i v a t i o n ) h a s laid out. o r i n d u c e m e n t s . B e f o r e a m o t i v a t i o n e m e r g e s . r a t h e r . T h e m o t i v a t i o n i n t e r p r e t s t h e apples h a n g i n g o n the t r e e s a s things t o b e e a t e n t h e n produces t h e a p p r o p r i a t e h u m a n r e a c t i o n s . T h u s the m o t i v a t i o n does not stand opposite m e . the ideas o f p s y c h o l o g y and p s y c h o s o m a t i c m e d i c i n e h a v e been in part m e r e r a t i o n a l i s t i c c o n s t r u c t i o n and i n v e n t i o n . and p h y s i o l o g y . And thus the phenomena of human existence.t h e . h a v e r e m a i n e d as closed to t h e e x p l a n a t i o n s of t h e s e s c i e n c e s a s t h e y h a v e b e e n t o t h e older s c i e n c e s o f biology.i n . I n this e n t e r p r i s e . B u t this s e e m s t o e x h a u s t t h e i r c o n t r i b u t i o n . a n a t o m y . All o u r c o n s i d e r a t i o n s s o far point t o t h e c o n c l u s i o n t h a t t h e e s s e n t i a l f e a t u r e s o f t h e h e a l t h y and p a t h o l o g i c a l m a n i f e s t a t i o n s o f h u m a n n a t u r e are inaccessible t o the h y p o t h e s e s o f n a t u r a l s c i e n c e and t o t h e m o r e r e c e n t h y p o t h e s e s o f p s y c h o l o g y and p s y c h o s o m a t i c m e d i c i n e . In reality. h o w e v e r . T h e n a r r o w r a n g e o f t h e i r c o m p e t e n c e is due to the fact t h a t t h e i r p r o m i s i n g b e g i n n i n g s s o o n fell u n d e r t h e s w a y o f a r e s e a r c h m e t h o d t h a t i s n o t suited t o h u m a n n a t u r e . in t h e i r t r u e c h a r a c t e r . w h a t we m u s t at all c o s t avoid in f u t u r e e f f o r t s to lay a s t u r d i e r foundation for m e d i c i n e . t h e y a r e a false f o o t i n g for t h e u n t h i n k i n g . t h e e x i s t e n c e o f m a n . T h e i r j u s t i f i c a t i o n c o n s i s t s in t h e fact t h a t b o t h disciplines e m p h a t i c a l l y r e a s s e r t s o m e t h i n g n o n s o m a t i c in h u m a n e x i s t e n c e as a p r o p e r a r e a of h u m a n reality. in r a s h a n a l o g y to the lifeless o b j e c t s of t h e world. S i n c e this image o f h u m a n e x i s t e n c e b e c a m e a s c e n d a n t . E v e r y o n e o f t h e n o t i o n s o f p s y c h o l o g y and p s y c h o s o m a t i c m e d i c i n e i s based upon t h e C a r t e s i a n division o f the w o r l d into t w o c o m p o n e n t s . and in part the o u t c o m e o f psychic p h e n o m e n a w h o s e significance r e m a i n s largely o b s c u r e . T h i s c o n c l u s i o n also indicates t h a t medical r e s e a r c h has n o t a s k m o r e u r g e n t than t h e s e a r c h for a n e w . t h e special l e s s o n s t h a t g r o w o u t o f r e n o u n c i n g t h e traditional r e s e a r c h m e t h o d s can b e o f g r e a t help. C u r r e n t p s y c h o l o g i c a l and p s y c h o s o m a t i c t h e o r i e s h a v e i n c o m m o n t h e desire t o explain t h e u n k n o w n p h e n o m e n a o f h u m a n e x i s t e n c e o n the basis o f s o m e t h i n g e v e n less k n o w n . T h e y yielded t o p r e s s u r e from t h e old r a t i o n a l i s t i c tradition w h i c h holds t h a t all b e i n g is by n a t u r e s u b s t a n t i a l and physically p r e s e n t . N o d o u b t t h e r e a r e m a n y w h o believe t h a t t h e s e f o r m u l a t i o n s i n imitation of m a t h e m a t i c a l p r e c i s i o n c o n s t i t u t e a solid t h e o r e t i c a l g r o u n d i n g . the e x a c t l y calculable e x t e n d e d (tangible) s u b s t a n c e and w h a t is i m a g i n e d as t h e e n c a p s u l a t e d t h i n k i n g s u b s t a n c e o f the h u m a n s u b j e c t . first. T h e y t e a c h u s t h a t h u m a n e x i s t e n c e can n o longer be v i e w e d .The Fundamental Conditionality 77 L e t us n o w s u m up the j u s t i f i c a t i o n and l i m i t a t i o n s of p s y c h o l o g y and p s y c h o s o m a t i c medicine i n light o f o u r discussion. m o r e broadly h u m a n a p p r o a c h to its o b j e c t of study. T h e y indicate.w o r l d " has b e e n n e i t h e r r e f o r m u l a t e d n o r advanced b y t h o s e w h o p r a c t i c e p s y c h o l o g y and psychosomatic medicine. as m e r e l y a n o t h e r t h i n g w h i c h is p r e s e n t at a p a r t i c u l a r point in a . B e c a u s e o f t h e i r u n s u i t a b l e c o n c e p t u a l a p p r o a c h e s . i n q u i r y into t h e precise c h a r a c t e r o f h u m a n n a t u r e a s " b e i n g . 103. p. d e G r u y t e r . 9. Cologne. Ey. 1 9 4 1 ) . 3 2 . S . 1 9 4 1 ) . and p s y c h o s o m a t i c m e d i c i n e . as o b v i o u s l y injurious to h u m a n n a t u r e . 5. Struktur und Dynamik des menschlichen Verhallens. 7. In c o n t r a s t to traditional psychological and p s y c h o s o m a t i c h y p o t h e s e s . Les Origines de 1'animisme enfantin ( P a r i s : 1 9 2 6 ) . P i a g e t . 2 0 3 . o n c e and for all. Inc. p s y c h o l o g y . vol. 2 1 5 . (Stuttgart. vol. w e shall call the n e w . 6 . 10. p . pp. M a r t y . Freud. H a s e l o f f . 1 9 2 3 ) . 9 4 . J a s p e r s . in Gesammelte Werke. II ( L o n d o n : I m a g o . A b o v e all. h o w e v e r . " i n Gesammelte Werke. Gesammelle Werke. p. Mainz: Verlag W. 123. 1 9 7 0 ) . 2/3 (London: 1 9 4 2 ) . p. F r e u d . D a i d . vol. 1 4 . . S. 243ff. de M ' U z a n . 1 0 ( L o n d o n : I m a g o . M. " D i e S t r u k t u r des G e d ä c h t n i s s e s . P r i b r a m .See O. Die Traumdeutung. p. (Frankfurt-am-Main: Klostermann. F r e u d . p. F o r r e a s o n s t h a t will b e c o m e a p p a r e n t later. Holzwege: Die Zeil des Weltbildes 182. L investigation psychosomatique ( P a r i s : G a l l i m a r d . at. . ed. the traditional c o n c e p t u a l a p p r o a c h o f m e d i c i n e . Gesammelte Werke. In t h e n e x t part of this book we will test a p e r s p e c t i v e w h i c h m e a n s assiduously to avoid. 14. 7 (London: Imago. 4 . phenomenological i n v e s t i g a t i v e m e t h o d . Kohlhammer. 3. 1963). (Neuchatel: Delachauxet Nieshe. Freud. p. in 14 ( L o n d o n : Gesammelte 1 9 4 8 ) . Berlin. c i t . 1 9 4 0 ) . 8. S p r i n g e r . M. a n d C h . 1 9 6 7 ) . 1 9 6 4 ) . p.5 2 . " in Struktur und Dynamik.. 604). Le causalite physique chez [enfant ( P a r i s : 1 9 5 7 ) . Le symbolisme mconsaent et les schemes affectives. . S e e also: La representation du monde chez lenfant. H .78 EXISTENTIAL FOUNDATIONS p r e c o n c e i v e d space. e f f o r t s to explain o b s e r v a b l e p h e n o m e n a directly on the basis of t h i n g s a s s u m e d to be operating behind them. vol. p . (Gesammelte Werke.. 2 3 . and it h a s no p u r p o s e o t h e r t h a n to a r t i c u l a t e t h e m e a n i n g f u l n e s s and c o n t e x t s o f r e f e r e n c e w h i c h the p h e n o m e n a t h e m s e l v e s reveal. p. S. op. 1 0 . W. Haseloff. 1 3 . It s t a k e s e v e r y t h i n g on keeping s t r i c t l y to p h e n o m e n a t h a t are directly visible to it. Ibid. 3rd ed. H. vol. Heidegger. Das Bewusstem ( B e r l i n : W . 2 6 5 . pp. NOTES 1. op. t h e inadequacies o f traditional medical o r i e n t a t i o n s c o u n s e l us to a b a n d o n . vol. Werke. Freud. K. Allgemeine Psychopathologie ( B e r l i n : I. and La formation du Symbole chez I'enfant. 6 2 . p. " D a s U n b e w u s s t e . 1 2 . I n c . 15. J. P. F r e u d . K .. 1950). 162. S. 1 1 . S. T h i s n e w o r i e n t a t i o n will be applied to t h e very s a m e h e a l t h y and p a t h o l o g i c a l m a n i f e s t a t i o n s o f t h e c a s e h i s t o r y against w h i c h w e t e s t e d the c u r r e n t r e s e a r c h m e t h o d s o f s c i e n c e . Vorlesungen zur Einführung in die Psychoanalyse. m o r e broadly h u m a n o r i e n t a t i o n an existential. a m o r e broadly h u m a n medical r e s e a r c h m e t h o d will n o t need to v i e w its findings as m e r e supplements to the o u t c o m e s of n a t u r a l scientific i n v e s t i g a t i o n s . 3 0 . 2. Part II An Adequately H u m a n Foundation for Medicine . of fleeting g l i m p s e s o f people h u r r y i n g by. h o w e v e r p e r i p h e r a l and u n t h e m a t i c this p e r c e i v i n g m a y h a v e b e e n . N o t w i t h s t a n d i n g t h e spell t h e s e c l o t h e s ( ast. and o f d o z e n s o f o t h e r t h i n g s s h e e n c o u n t e r e d . B u t it is w o r t h asking what new aspects might turn up if we examined this sequence in a way t h a t a l l o w e d t h e e v e n t s t o speak for t h e m s e l v e s and kept e x c l u s i v e l y t o w h a t t h e y r e v e a l e d directly. o f t h e sign o f park r u l e s s h e had t o s t e p a r o u n d . R e g u l a Z i i r c h e r d a s h e d o v e r and kissed and h u g g e d h i m a s t h o u g h this w e r e t h e m o s t n a t u r a l t h i n g i n t h e world. T h e n t h e couple strolled h o m e a r m i n a r m . h e r a t t e n t i o n w a s f o c u s s e d o n c l o t h e s s h e w a s going t o b u y for t h e v a c a t i o n . s h e w a s fully a w a r e of t h e s i d e w a l k on w h i c h s h e walked. s h e w o u l d n e v e r h a v e b e e n able t o find h e r w a y . t h e y w e r e j u s t a s m u c h t h e r e for her. W i t h o u t perceiving t h e i r p r e s e n c e and s i g n i f i c a n c e . All in all. T h o u g h t h e s e things did n o t h a v e t h e s a m e s o r t o f i m m e d i a t e . helping d e t e r m i n e h e r walk. Y e t i t w a s n o t only t h e m o m e n t a r i l y p r e s e n t t h i n g s o f h e r world t h a t w e r e t h e r e i n . discussing plans for I heir c o m i n g v a c a t i o n in t h e C a n a r y Islands on t h e w a y . this looks like an u n c o m p l i c a t e d s e q u e n c e of e v e n t s . A s R e g u l a Z i i r c h e r w a l k e d along t h e main s t r e e t o f h e r t o w n b e f o r e she ran i n t o h e r lover. f o r e g r o u n d p r e s e n c e a s the c l o t h e s s h e w a s c o n c e n t r a t i n g o n .Chapter 6 APPLYING THE EXISTENTIAL OUTLOOK TO SOME ASPECTS OF THE TEST CASE S e e i n g h e r l o v e r a c r o s s t h e s t r e e t . in fact. W h a t a scientific o b s e r v e r would i n t e r p r e t as a physical body m o v i n g t h r o u g h space appears. t h e r e can be no talk of a feeling or e m o t i o n a s a n e n t i t y p r e s e n t w i t h i n t h e p s y c h e . s i m u l t a n e o u s l y . T h e u n e x p e c t e d c h a n c e t o b e close t o h i m a t o n c e c h a n g e d h e r m o o d o f n e u t r a l i t y t o w a r d t h e world. the most striking manifestation in her e n c o u n t e r would h a v e b e e n the m o v e m e n t o f h e r b o d y from o n e side o f the s t r e e t t o t h e o t h e r . C e r t a i n l y . h e r w h o l e e x i s t e n c e . the a n o n y m o u s p a s s e r s . W h a t b e c a m e a t t u n e d t o h a p p i n e s s w a s n o t j u s t s o m e t h i n g within R e g u l a Z ü r c h e r . He had.o u t c l o t h e s . A n o t h e r p h e n o m e n o n t h a t d e s e r v e s a t t e n t i o n i s t h e feeling t h a t c a m e with her e n c o u n t e r with her lover." a b o u t t h e m a t t e r . T h o u g h . since t h e y had last seen e a c h o t h e r . b u t he r e m a i n e d an i m p o r t a n t c o d e t e r m i n a n t in t h e affairs of h e r life. his p r e s e n c e did n o t persist in such a w a y t h a t s h e w a s pointedly a w a r e of him e v e r y m o m e n t . To an outside observer. t h a t m o t i v a t e d h e r walk during t h e present. b u t R e g u l a Z ü r c h e r h e r s e l f . T h i s happy h u m o r did n o t o r i g i n a t e w i t h this e n c o u n t e r . Because of this. from the standpoint ol the p h e n o m e n o n itself. h o w e v e r . All t h a t c h a n g e d in this physical e n c o u n t e r w a s t h e m o d e of his p r e s e n c e in h e r w o r l d . R e g u l a Z ü r c h e r h e r s e l f . her relationship to him continued as much more than the mere cerebral e n g r a m posited by n e u r o p h y s i o l o g y . Regula Ziircher's unexpected sighting of her lover c a n n o t b e called " r e . o b j e c t i v e findings. as t h e approach of R e g u l a 1 . his p r e s e n c e m a y s o m e t i m e s h a v e g r o w n v e r y dim. she w o u l d n o t h a v e had t h e n o t i o n t o buy a n e w w a r d r o b e had s h e n o t r e m a i n e d c o n c e r n e d w i t h h e r old. or of a p s y c h e or psychic drives t h a t seized this body and impelled it into m o t i o n . even w h e n h e had disappeared f r o m h e r optical field of vision at t h e i r last parting and could n o l o n g e r s t i m u l a t e h e r r e t i n a l cells.c o g n i t i o n . and s h o p w i n d o w s . i n t o a m o o d o f h a p p i n e s s . A l t h o u g h s h e w a s n o t t h i n k i n g p a r t i c u l a r l y o f h e r l o v e r o n this o u t i n g . w o r n . A n d a p p r o a c h i n g h e r from t h e f u t u r e w a s h e r v a c a t i o n . H e r walk w a s c o d e t e r m i n e d . a s it is of e v e r y h u m a n e x i s t e n c e .b y . " T h e r e i s n o " r e . i n t h e w o r l d t h e y b o t h s h a r e d . in w h i c h a d i s t a n t p r e s e n c e w a s t r a n s f o r m e d i n t o a n i m m e d i a c y s h e could see and t o u c h . since h e had n e v e r disappeared from h e r w o r l d . o u t s i d e . did n o t s e n s e the p r e s e n c e of a body. n e v e r stopped being p r e s e n t t o h e r . If we restrict ourselves to d e m o n s t r a b l e .EXISTENTIAL 82 FOUNDATIONS t h e i r a p p r o p r i a t e places. a b o v e all. h e w a s n o n e t h e l e s s a l w a y s t h e r e . b y e v e r y t h i n g t h a t had e v e r b e e n . T h e p o t e n t i a l for b e i n g a t t u n e d t o h a p p i n e s s had always b e e n a n i n n a t e part o f h e r e x i s t e n c e . T h e physical n e a r n e s s in the e n c o u n t e r w i t h h e r l o v e r simply allowed h e r to live this p o t e n t i a l . All w e m a y factually s t a t e is t h a t as a h u m a n r e l a t i o n s h i p R e g u l a Z i i r c h e r ' s e n c o u n t e r w i t h h e r l o v e r w a s happily disposed. I t w a s h e r r e l a t i o n t o t h e f u t u r e . far to t h e s o u t h . a p o u n d i n g t h a t was h e r s e l f . b o t h w e r e freely being t o g e t h e r in their r e l a t i o n t o t h e s a m e t h i n g and during t h e v i s u a l i z a t i o n w e r e a t the h o t e l itself. In this v i s u a l i z a t i o n . is t h a t t w o people visualized t h e s a m e building at the s a m e t i m e . B u t it w a s precisely in this fulfillment that she b e c a m e totally u n a w a r e o f h e r o w n b o d y h o o d . In r u n n i n g o v e r to him. h o w e v e r . h e r w h o l e being—in h e r powerful e x i s t e n t i a l c o n n e c t i o n w i t h h e r lover.i m m a n e n t r e p r e s e n t a t i o n s o f s o m e o b j e c t of t h e e x t e r n a l w o r l d . o n t h e w a y h o m e . D i a l o g u e m e a n s speaking back and f o r t h . S i n c e t h e i r love affair had begun. according t o c u r r e n t p s y c h o l o g i c a l t e a c h i n g . G e n u i n e r e m e m b e r i n g r e q u i r e s an e x p r e s s .Applying the Existential Outlook 83 Z i i r c h e r ' s w h o l e and indivisible e x i s t e n c e . w h a t e m e r g e d w a s n o t s o m e dialogue i n t h e u s u a l psychological usage. and t h u s it can be u n d e r s t o o d as t h e h u m a n p h e n o m e n o n it is as t h e bodying f o r t h of t h e i r i n t i m a t e w a y of being t o g e t h e r in a s h a r e d world. H e r body was not s o m e physical i n s t r u m e n t s e p a r a t e from h e r used t o t r a n s p o r t h e r p s y c h e . t h e t w o b e g a n talking o v e r plans for t h e i r vacation. " W i t h t h e s e w o r d s she u t t e r s h e r a w a r e n e s s o f b e c o m i n g a b s o r b e d body and s o u l — w i t h e v e r y t h i n g s h e w a s . A n o t h e r manifestation of the bodyhood of her existence here was a n o t i c e a b l y i n c r e a s e d pulse r a t e and a c o n s i d e r a b l y f r e e r c o n t r a c t i o n and dilation o f h e r h e a r t . w i t h an i m a g e in e a c h brain. in this case e n d o p s y c h i c r e p r e s e n t a t i o n s of a r e s o r t h o t e l . N o w . T h i s sort o f physical p r o c e s s b e t w e e n t w o people can n e v e r b e c o m p r e h e n d e d from the s t a n d p o i n t o f t h e b o d y h o o d o f a n e x i s t e n c e s o long as t h a t b o d y h o o d has b e e n p r e c o n c e i v e d as a m e r e l y physical s y s t e m o f m u s c l e s . W a l k i n g this w a y w a s a n i n t e g r a l part o f the couple's i n t i m a c y . S h e h e r s e l f did n o t discern t h e p r e s e n c e o f a n o r g a n a n y w h e r e w i t h i n h e r body. All t h a t could be factually d e t e r m i n e d . she was m e r e l y actualizing bodily an already e x i s t i n g e x i s t e n t i a l c l o s e n e s s to him. b o n e s . t w o s u b j e c t s could talk back and forth only a b o u t e n t i r e l y c o n s c i o u s n e s s . or of a n y t h i n g she had inside. S h e felt a d i s t a n t r u s h i n g in t h e r e g i o n of h e r h e a r t . A c u r s o r y e x a m i n a t i o n w o u l d n o doubt a s c r i b e the l o v e r s ' t h o u g h t s o f their old v a c a t i o n spot t o m e m o r y . "I h u r r i e d t o w a r d him. the visualization ol the h o t e l w a s o n l y a m a i n point of focus: t h e pair was c o n c e r n e d primarily w i t h t h e h o t e l as a building presently appearing in a c e r t a i n w a y and as a future place to b e . or she would n o t h a v e b e e n in a position to say. B u t strictly speaking. T h e s a m e i s t r u e o f t h e couple's stroll h o m e a r m i n a r m . and n e r v e s . my h e a r t p o u n d i n g . W h a t appears in a scientific i n t e r p r e t a t i o n to be t h e b e a t i n g and p u m p i n g of a physical o r g a n r e v e a l s i t s e l f a s t h e bodying f o r t h o f R e g u l a Z u r c h e r and her lover's w a y o f b e i n g t o g e t h e r . R e g u l a Z u r c h e r felt t h a t h e r lover w a s in h e r h e a r t . W h e n . t h e following q u e s t i o n n o w i n e v i t a b l y a r i s e s : w h a t s o r t o f basic i n s i g h t s m a d e possible the a b o v e . If any of these existential descriptions of healthy human phenomena is c o m p a r e d w i t h h y p o t h e s e s o f traditional p h y s i o l o g y o r p s y c h o l o g y a s t h e y are applied t o the s a m e e v e n t . simple. a y e a r a g o today. w e have t o c o n s i d e r t h e m a t i c a l l y t h o s e basic f e a t u r e s o f h e a l t h y h u m a n e x i s t i n g m o s t significant for m e d i c i n e and w h i c h we h a v e up to n o w illustrated only in t h e description of a few e x a m p l e s o f h u m a n b e h a v i o r . a p p r o p r i a t e t o t h e D a . n o t t o speak o f his e v e r u n d e r s t a n d i n g it as a thing of this or t h a t m e a n i n g f u l n e s s . supposedly take place b e h i n d the p h e n o m e n a t h e m s e l v e s .s e i n description of a few h e a l t h y p h e n o m e n a of o u r test c a s e ' s e x i s t i n g ? I n o t h e r w o r d s . w i t h a b s t r a c t i o n s and c o n c l u s i o n s t h a t depart f r o m w h a t can actually b e s e e n .84 EXISTENTIAL FOUNDATIONS relation to the past. F o r this r e a s o n . w e m a y n o t o v e r l o o k t h a t t h e r e can b e n o appearing o r revealing of a n y p h e n o m e n a t h a t is n o t already in a d v a n c e b o r n by a specific insight into t h e n a t u r e o f t h e i r m o d e o f being. T h e only r e m e m b e r i n g t h e y did w a s the l o v e r ' s r e m a r k . . W i t h o u t the illumination o f such i n s i g h t i n t o t h e basic n a t u r e o f t h e appearing p h e n o m e n a — n o m a t t e r h o w u n d e t e r m i n e d and u n r e f l e c t e d this insight m a y b e — n o h u m a n b e i n g would e v e r see a n y t h i n g . T h e m e a n i n g s and c o n t e x t s o f r e f e r e n c e t h a t belong to and c o m p r i s e t h e p h e n o m e n a are simply allowed to reveal themselves. O u r e x i s t e n t i a l point of v i e w allows us to dispense w i t h d e d u c t i o n s t h a t a r e alien to the actual a p p e a r a n c e of o u r o b j e c t s o f study. w e flew into Las P a l m a s i n t h a t dazzling s u n l i g h t ? " F o r t h e i n s t a n t o f the q u e s t i o n . O f c o u r s e . " D o y o u r e m e m b e r h o w . t h o u g h t h e y c a n n o t b e d e m o n s t r a t e d . the e x i s t e n t i a l description can b e seen at o n c e to be c l o s e r to reality. and t o e x p l i c a t e t h e m t o the d i s t i n g u i s h i n g c h a r a c t e r i s t i c s of h u m a n being as a w h o l e . and w i t h t h e u s e o f psychic e n t i t i e s w h i c h . b o t h people stopped to c o n t e m p l a t e an e v e n t of s o m e t i m e past w h i c h had b e e n p r e s e r v e d in t h e lives. he is to be found. and as w h a t . s o m e h o w in space and in time. using e x a m p l e s o f h e a l t h y p h e n o m e n a from R e g u l a Z i i r c h e r ' s life t o i l l u m i n a t e t h e s e traits. will be a n y t h i n g but a philosophical diversion. at any g i v e n t i m e . the m o r e solid this e x i s t e n t i a l f o u n d a t i o n for m e d i c i n e will b e . at s o m e particular point i n space. and t h a t m a n ' s p r e s e n c e in this w o r l d is such t h a t as long as he is h e r e . t h e n . along w i t h e v e r y t h i n g else that is. o r b e e n i n a c c e s s i b l e to. T h e first task of m e d i c i n e as a strictly rational s c i e n c e of m a n is to define precisely p r e s c i e n t i f i c n o t i o n s of " s o m e w h e r e in s p a c e " and . T h e m o r e strictly o u r d e s c r i p t i o n o f t h e t r a i t s o f h e a l t h y e x i s t e n c e a d h e r e s t o t h e i r h u m a n c h a r a c t e r . T h e a n s w e r c l o s e s t t o hand h a s long b e e n t h a t m a n ' s e x i s t e n c e i s such t h a t he is p r e s e n t in a w o r l d . It is a c o n s i d e r a t i o n of e v e r y t h i n g a b o u t t h e actual m o d e o f h u m a n e x i s t e n c e t h a t h a s s o far been o v e r l o o k e d by. L e t us begin by asking in w h a t w a y .Chapter 7 FUNDAMENTAL CHARACTERISTICS OF HUMAN BEINGS Preliminary remarks S i n c e h u m a n beings c a n n o t q u a l i t a t i v e l y p e r c e i v e o r u n d e r s t a n d e x c e p t i n light o f s o m e p r i o r i n s i g h t s into the m e a n i n g and n a t u r e o f each thing t h e y p e r c e i v e . the n a t u r a l s c i e n c e s . O u r e x a m i n a t i o n o f t h e s e t r a i t s . T h u s w e are led t o t h e i n f e r e n c e t h a t h u m a n beings a r e . m a n m a n i f e s t s h i m s e l f . w e should n o w direct o u r a t t e n t i o n t o explicating the f u n d a m e n t a l c h a r a c t e r i s t i c s o f h u m a n being. g o o d s s t o r e b o t h o f u s k n o w well. T h e r e are s t r o n g a r g u m e n t s a g a i n s t this s o r t o f spatiality i n h u m a n b e i n g s . S e c o n d . S i n c e h u m a n b e i n g s b e l o n g a m o n g all t h e o t h e r t h i n g s i n t h e world. gap-like d i s t a n c e s . " medicine m u s t leave b e h i n d t h e p r e c o n c e p t i o n s o f c o g n i t i v e t h e o r y and m a k e a n e w b e g i n n i n g in looking at t h e spatial and t e m p o r a l p r e s e n c e of h u m a n beings. w h i c h w a s originally c o n c e r n e d o n l y w i t h i n a n i m a t e o b j e c t s as it s o u g h t to establish a reliable basis for calculating and fixing spatial r e l a t i o n s h i p s a m o n g t h e m . If it would g e t past t h e v a g u e n e s s o f " s o m e w h e r e " and " s o m e h o w . e x t e n d i n g b e t w e e n individual o b j e c t s . W e w a l k along t h e m a i n s t r e e t of o u r t o w n . We w a n t to k n o w w h a t would b e c o m e of my friend's shopping e x p e d i t i o n if. w a s t r a n s f e r r e d w i t h o u t t h o u g h t t o t h e spatiality o f h u m a n e x i s t e n c e . First. h o m o g e n e o u s d i s t a n c e s . i t c r e a t e d t h e c o n c e p t i o n o f m e r e m e a s u r a b l e . t h a t w e r e p r e v i o u s l y c h a r a c t e r i z e d b y t h e significations o f t h e t h i n g s t h a t o c c u p e d t h e m . He would have stopped e x i s t i n g as a h u m a n being. is g e n e r a l l y r e p r e s e n t e d in this way. Let us take a simple e x a m p l e . t h e i r p r e s e n c e in space. and s o w e m u s t e x a m i n e a n e w the special n a t u r e o f m a n ' s spatial p r e s e n c e i n t h e world. In front of h i m is a s i g n p o s t of park r u l e s . I can see my fftrend ahead of me on the sidewalk. It achieved this by totally e m p t y i n g t h e r e g i o n s and places o f space. admirably suited t o t h e m a s t e r y o f i n a n i m a t e o b j e c t s . g o m e t r i c d i m e n s i o n s and m a t h e m ­ atical spatial f u n c t i o n s . and o n e yard b e y o n d t h a t is a thick black l a m p p o s t . such a being would be m i apable o l taking even o n e m o r e h u m a n step t o w a r d the s p o r t i n g o o d s stoi e . The spatiality of existence We are all familiar w i t h t h e idea t h a t e v e r y t h i n g in t h e w o r l d is p r e s e n t in space. at this v e r y m o m e n t . A n d we can i m a g i n e i n t e r v a l s in space.86 EXISTENTIAL FOUNDATIONS " s o m e h o w in t i m e . t h e r e would no l o n g e r be any friend w a l k i n g beside m e . t o o . his r e l a t i o n s h i p w i t h space w e r e t r a n s f o r m e d into o n e like t h a t o f the i n a n i m a t e s i g n p o s t o r lamppost. t h a t a g i v e n t h i n g is to be f o u n d at a n y g i v e n t i m e at s o m e specific point w i t h i n a p r e e x i s t i n g h o l l o w c o s m i c c o n t a i n e r and t h a t it would o c c u p y a part of t h a t space c o r r e s p o n d i n g to its m e a s u r a b l e d i m e n s i o n s and calculable v o l u m e . w h e r e t h e s t o r e we w a n t is l o c a t e d . I am going on a w a l k w i t h my friend to a s p o r t i n g . T h r o u g h t h e r e d u c t i o n o f space t o the i n t e r v a l s b e t w e e n t h e s e points. S c i e n c e t h u s r e a c h e d its c o n c e p t i o n o f u n i f o r m p o i n t s i n space. T h i s c o n c e p t i o n of space provided a felicitous point of d e p a r t u r e for the g e o m e t r i c a l and m a t h e m a t i c a l c o n q u e s t o f space b y m o d e r n n a t u r a l s c i e n c e . T h i s g e o m e t r i c a l r e p r e s e n t a t i o n o f space. " w h i c h h a v e b e e n used familiarly for a g e s . h o w e v e r . T h e r o b o t w o u l d p r e s u m a b l y e v e n h a v e b e e n able to c a r r y a s p o r t s s h i r t from t h e s t o r e to my friend's home. w h i c h e x t e n d s to t h e limits of its m a t e r i a l body or e n e r g e t i c fields.Fundamental Characteristics of Human Beings 87 B u t let u s a s s u m e t h a t m y t r a n s f o r m e d friend h a s b e e n equipped with roller s k a t e s and an i n t e r n a l m o t o r t h a t can i n i t i a t e m o t i o n in any d i r e c t i o n . I am n e v e r "there"—"da"—for them. from parking s i g n s to c o m p u t e r s . B u t a b o v e all. the p h e n o m e n a o f t h e r o b o t and t h e shopping e x p e d i t i o n o f a n e x i s t i n g h u m a n being r e m a i n for m a n y r e a s o n s i n c o m p a r a b l e . w h a t e v e r its capabilities. N e x t . as w i t h a r u l e r . It ends at t h e s e physical and electrical b o r d e r s . N o m a t t e r h o w m a n y o r h o w i n t e n s e the impulses r e a c h i n g t h e e n e r g e t i c fields of a c o m p u t e r . and it occupies o n l y a part of space t h a t c o r r e s p o n d s to its m a t e r i a l v o l u m e and t h e r a n g e of its electrical fields. possibly w i t h the s a m e effects. Now. is an i n a n i m a t e o b j e c t . not the most modern computer has a w o r l d . It is p r e s e n t o n l y at s o m e specific point in a space t h a t is p r e c o n c e i v e d as a h o l l o w c o n t a i n e r . A c o m p u t e r . It is the least of o u r c o n c e r n s t h a t such an a p p a r a t u s would probably leave the print of its skull on the s i g n p o s t in a m a t t e r ol m o m e n t s . All non-living b e i n g s . it is n e v e r so open . i n t o w h o s e o p e n n e s s o t h e r b e i n g s can appear. t h e world of d i f f e r e n c e b e t w e e n a r o b o t ' s c h a n g e s of location and t h e a c t i o n s of an e x i s t i n g h u m a n being is due to t h e fact t h a t t h e s e t w o are spatial in f u n d a m e n t a l l y different w a y s . and b e r e c e i v e d . N e v e r t h e l e s s . as a h u m a n being. h o o k e d up in t u r n to other computers attached to objects in the surroundings. No m a t t e r t h e n . a r e spatial o n l y in this l a t t e r s e n s e . In other words. T h e e s s e n t i a l p r e c o n d i t i o n for a h u m a n being's shopping e x p e d i t i o n is t h a t he d o e s n o t exist spatially as does a r o b o t . S u c h a m i s h a p could be forestalled by installing a p h o t o s e n s i ­ tive s e l e n i u m cell w i t h a closed circuit or feedback m e c h a n i s m . would h a v e already a p p r e h e n d e d the s p o r t i n g . f r o m w h i c h the d i s t a n c e t o o t h e r o b j e c t s m a y b e m e a s u r e d w i t h precision.g o o d s s t o r e . n o r o b o t could p e r f o r m i n w a y s like this w i t h o u t a p r o g r a m supplied by a h u m a n being w h o . certain s e q u e n c e s o f electrical i m p u l s e s fed i n t o and s t o r e d b y t h e r o b o t ' s c o m p u t e r s m i g h t impel the r o b o t t o c h a n g e s o f location w h i c h — f r o m a purely g e o m e t r i c p e r s p e c t i v e — w o u l d c o n f o r m e x a c t l y t o t h e shopping e x p e d i t i o n my friend would h a v e m a d e if he had r e m a i n e d an e x i s t i n g h u m a n being. h o w g e o m e t r i c a l l y " c l o s e " I am to t h e m . C o m p u t e r s are n o t h i n g m o r e t h a n p r o d u c t s of h u m a n b e i n g s w h o can u n d e r s t a n d the c o n t e x t s o f m e a n i n g and r e f e r e n c e o f p h e n o m e n a t h a t appear t o t h e m . like e f f e c t s do n o t n e c e s s a r i l y imply like m e a n s of producing o r r e l e a s i n g t h e s e e f f e c t s . reveal t h e m s e l v e s .g o o d s s t o r e as a s p o r t i n g . First. T h i s r o b o t could also be fitted out w i t h a v a r i e t y of c o m p u t e r s . O n e can be in an expansive—augeräumten—mood. f r e e d o m . and this space would t h e n n o l o n g e r b e o p e n for o u r p e r c e p t i o n o f t h e sign. p e r c e i v e s n o t h i n g of its own p r e s e n c e in " s p a c e . As such an o p e n n e s s . t o allow that another may be right—"ihm einräumen. " w o r l d . clear and a c c e s s i b l e for t h e e r e c t i o n of a wall. is of a f u n d a m e n t a l l y different kind. . B u t t h e n n o h u m a n could have raised t h e wall if t h e space w e r e n o t c o m p r e h e n s i b l e to h i m as open. It is n o t even so t h a t non-living b e i n g s . T h e i r spatial r e l a t i o n s h i p is the s h o r t distance b e t w e e n t h e m . O t h e r w i s e . S i m i l a r l y . c o r r e s p o n d s m o r e closely t o w h a t h a p p e n s t o b o o k s h e l v e s w h e n s o m e o n e h a s b e e n c a r e l e s s i n lending his b o o k s . to give it a worldly dwelling place in the cleared— aufgeräumten—openness. Yel I he spatial quality of the h u m a n w o r l d is in no w a y c o m p a r a b l e to the g e o m e t ric space in w h i c h i n a n i m a t e . O n e is then attuned to openness. M y space and t h a t o f m y friend. m a k i n g r o o m for. O n e i s able t o m a k e r o o m — R a u m g e b e n — f o r t h e o p i n i o n s o f o t h e r s . a " c l e a r i n g " — L i c h t u n g — i s o p e n e d up in the forest w h e n all of t h e t r e e s w i t h i n a c e r t a i n area have b e e n felled and cleared a w a y . make room for. g r a s p their significance and r e s p o n d appropriately to w h a t is u n d e r s t o o d of t h e m . lichten as räumen.88 EXISTENTIAL FOUNDATIONS t h a t it can p e r c e i v e t h e i m p u l s e s as such. t h a t w h i c h a l l o w s p a s s a g e t h r o u g h das "Durchlässige"). s e r e n i t y . Räumen means to clear. R a t h e r .e. n o r o f t h e significance and r e f e r e n t i a l c o n t e x t t h a t c o n s t i t u t e the specific c h a r a c t e r o f w h a t i s p r e s e n t . W h a t e v e r is in space as n o n . " R ä u m e n h a s primarily t h e m e a n i n g o f clearing—lichten.l i v i n g m a t t e r is. T h e space b e t w e e n us and t h e parking sign is t h e o p e n n e s s . S u c h c l o s e d n e s s o c c u r s only as a privative p h e n o m e n o n of o p e n n e s s . I n the G e r m a n l a n g u a g e . " n o r o f t h e p r e s e n c e o f o t h e r b e i n g s . a s clearing. etwas zu Recht zu b e h a u p t e n . It is n o t o n l y possible to i n s t a l l — e i n r ä u m e n — a piece of f u r n i t u r e in a cleared aufgeräumten—room. b e t w e e n us and it.l e s s " o b j e c t s are p r e s e n t . t h e sign could n e v e r appear as a sign to us t h r o u g h space. it is free and clear. O n e could build a wall b e t w e e n us and t h e sign. T h i s lichten is f u n d a m e n t a l l y different from the m e r e illuminating of a p r e v i o u s l y dark r o o m w i t h physical light—Licht.. w h i c h can be m e a s u r e d by a h u m a n being and u n d e r s t o o d by h i m as a s h o r t d i s t a n c e . T h e p r e s e n c e of a parking sign " n e a r " a l a m p m e a n s only t h a t t h e t w o points in space occupied by t h e s e b e i n g s a r e s e p a r a t e d by a given s h o r t i n t e r v a l . i. in c o n t r a s t to h u m a n b e i n g s . perhaps in order to install—einräumen—something in the cleared space. and r e a d i n e s s for t h e a p p e a r a n c e o f o t h e r b e i n g s . a s t h e spatiality o f e x i s t i n g h u m a n b e i n g s . the s u b s t a n t i v e " s p a c e " — R a u m (closely related to t h e English " r o o m " ) — i s derived from t h e v e r b räumen. It is also idiomatic in G e r m a n to speak of h a i r "clearing itself"—sich lichten—falling o u t to m a k e " r o o m " for b a l d n e s s . are simply closed t o t h e p e r c e p t i o n o f t h e i r o w n p r e s e n c e and the p r e s e n c e s of o t h e r b e i n g s . N o w . it is n o t h i n g o t h e r t h a n b e i n g open for perceiving and u n d e r s t a n d i n g t h e t h i n g s it e n c o u n t e r s for w h a t t h e y are. T h e s e c o n s t i t u t e the t r u e n a t u r e o f spatiality i n the h u m a n world. o w i n g to t h e fact t h a t h u m a n e x i s t e n c e is i t s e l f spatial. e v e n the m o s t m i n i m a l . I am to p e r c e i v e t h e s i g n p o s t o f park r u l e s . R a t h e r . n o physical o b j e c t can o c c u p y t w o p o s i t i o n s i n s p a c e s i m u l t a n e o u s ­ ly. . t h e l a m p p o s t . W h a t m a d e my b e h a v i o r human w a s t h a t I w a s p r e s e n t n o t o n l y as my w a l k i n g . is f u n d a m e n t a l l y o p e n n e s s in t h e s e n s e of a c a p a c i t y to perceive s o m e t h i n g as s o m e t h i n g . for his part. I can p e r c e i v e only w h a t I h a v e already r e a c h e d or arrived at. B u t h o w is the e x i s t i n g h u m a n being related. and n o t for a n y t h i n g else. It is spatial in t h e s e n s e t h a t t h e basic c h a r a c t e r i s t i c of its e x i s t e n c e is o p e n n e s s and receptivity. physical body. " o p e n n e s s and c l e a r n e s s c a n n o t b e s e c o n d a r y d e r i v a t i v e s o f h u m a n spatiality. this clearing is t h e f u n d a m e n t a l c h a r a c t e r of spatiality in the h u m a n world. 1 l u m a n e x i s t e n c e does n o t possess this o p e n n e s s in t h e form of o n e of a n u m b e r of d i s c r e t e p r o p e r t i e s . t h e n logically this spatiality c a n n o t b e t h e o p e n n e s s and c l e a r n e s s t h e m s e l v e s . R a t h e r . c o n c e i v e d of as a physical body. " i s n o t itself this " t r e e . B u t as an e x i s t i n g h u m a n being. on my walk to t h e s p o r t i n g .Fundamental Characteristics of Human Beings 89 As in o u r e x a m p l e . I c a n n o t be w a l k i n g h e r e and s i m u l t a n e o u s l y t h e r e in the s t o r e . u n o b s t r u c t e d and clear t o t h e e x t e n t t h a t p h e n o m e n a m a y address u s t h r o u g h i t w i t h t h e i r m e a n i n g s and c o n t e x t s o f r e f e r e n c e . t h e c u r b o n m y left and the buildings o n m y r i g h t a s w h a t t h e y are. A s a n o a k o r birch.g o o d s s t o r e . ill-defined and fleeting p e r c e p t i o n would n o t h a v e b e e n possible. t h e n my spatial p r e s e n c e m u s t be of a kind e n t i r e l y d i f f e r e n t f r o m t h a t of inanimate objects. but at the s a m e time as already being w i t h w h a t I set m y c o u r s e by. to the spatiality o f his w o r l d ? W h a t e v e r c o n f r o n t s man t h r o u g h t h e o p e n n e s s and c l e a r n e s s of space will i n e v i t a b l y address him in its s i g n i f i c a n c e . H u m a n p r e s e n c e is in no w a y c o n f i n e d to t h e p o i n t in space at w h i c h t h e h u m a n b o d y (as a s e l f . t o o . n o t h i n g like h u m a n spatiality could e v e r c o m e i n t o being in a p a r t i c u l a r w o r l d u n l e s s o p e n n e s s and c l e a r n e s s w e r e already r e i g n i n g t h e r e . h o w else could I e v e r h a v e a n y s e n s e t h a t a n y t h i n g in t h e w o r l d even e x i s t s and t h a t it is w h e r e it is? H o w could I desire or a p p r o a c h a n y t h i n g in t h e r e a l m of my w o r l d if I had not a l r e a d y grasped it p e r c e p t i v e l y and t h e r e b y already b e e n w i t h it? A h u m a n b e i n g can c o n d u c t h i m s e l f this w a y t o w a r d t h e o p e n n e s s t h e c l e a r n e s s of his world's spatiality b e c a u s e his being. t h e spatiality of t h e h u m a n world is open. If. each a t t h e p r o p e r i n s t a n t . W e r e this n o t so. m u c h less the possibility of s t e e r i n g m y s e l f t o w a r d s o m e t h i n g . as the o p e n i n g and s p a n n i n g of a realm by my ability to p e r c e i v e . t h o u g h its e s s e n c e i s " t r e e n e s s .n e s s . o t h e r p e d e s t r i a n s .c o n t a i n e d physical o b j e c t ) is to be found. I am b o t h h e r e and t h e r e . B u t i f this o p e n n e s s . T h u s a n o p e n r e a l m o f p e r c e p t i o n like t h a t of h u m a n e x i s t e n c e is the o n e being t h a t m a k e s being possible. is t h a t to e x i s t as a h u m a n being is to be r e c e p t i v e l y o p e n n o t m e r e l y in a passive or u n s p e a k i n g w a y . and in a w a y suited to t h e m e a n i n g t h e y p e r c e i v e . a n e n t i t y r e q u i r e s s o m e s o r t o f o p e n r e a l m i n w h i c h p r e s e n c e and p e r s i s t e n c e can take place. if he w e r e n o t e n g a g e d in this capacity. so e s s e n t i a l l y spatial t h a t t h e y dwell from t h e b e g i n n i n g with w h a t e v e r is a c c e s s i b l e to p e r c e p t i o n . N o n e t h e l e s s . n o t h i n g could e n t e r t h e field of vision of a h u m a n e x i s t e n c e in its actual significance and shine f o r t h . In people. A friend w h o m a y be t h o u s a n d s of miles apart from m e . will n a t u r a l l y r e m a i n blind to t h e peculiar n a t u r e o f h u m a n r e c e p t i v e o p e n n e s s t o t h e significance o f w h a t i t e n c o u n t e r s . t h o u g h t h e r e is no physically m e a s u r a b l e d i s t a n c e at all s e p a r a t i n g it from t h e soles of my s h o e s . m e a n s " p r e s e n c e " and " p e r s i s t e n c e . " T o a c h i e v e p r e s e n c e . clear r e a l m of p e r c e p t i o n . and t h e r e b y being. each h u m a n e x i s t e n c e spans t h e open spatiality o f its o w n world. a n s w e r t h e m i n p a r t i c u l a r w a y s . able t o r e l a t e i t s e l f t o t h i n g s . as f u r n i t u r e is put i n t o an e m p t y r o o m . c l o s e n e s s and d i s t a n c e c o n c e r n if and h o w w h a t we e n c o u n t e r m a t t e r s to us. D i s t a n c e s b e t w e e n i n a n i m a t e o b j e c t s can be m e a s u r e d w i t h a s t a n d a r d . A n o t h e r c o n s i d e r a t i o n . is i n h e r e n t l y o p e n to c o m p r e h e n d i n g t h e possiblity o f t h e i r b e i n g s o m e t h i n g r a t h e r t h a n n o t h i n g a t all. H u m a n e x i s t e n c e i s r e s p o n s i v e . It is n o t m e r e l y r e c e p t i v e to t h e e x t e n t t h a t it passively r e c e i v e s and r e c o r d s t h e p r e s e n c e and m e a n i n g f u l n e s s o f w h a t e v e r a d d r e s s e s it. Y e t this r e c e p t i v i t y i s t h e o n l y e x p l a n a t i o n for m a n ' s ability t o b e s i m u l t a n e o u s l y h e r e and t h e r e w i t h w h a t e v e r h e p e r c e i v e s .s t a t i c f r e e d o m . H u m a n e x i s t e n c e i s n o t m e r e l y a n open space i n t o w h i c h o t h e r t h i n g s can be i n s e r t e d . no less i m p o r t a n t . " B e i n g . F o r i n s t a n c e . s u s t a i n i n g i t and m a i n t a i n i n g its e c .90 EXISTENTIAL FOUNDATIONS In t h e f o r m of p e r c e p t i v e c o n n e c t i o n s w i t h all it e n c o u n t e r s . If m a n did n o t e x i s t as a w o r l d . but an i n h e r e n t l y d i f f e r e n t m e a s u r e applies to d i s t a n c e s in the h u m a n world. H u m a n beings are. n o t h i n g at all could e x i s t . is i n c o m p a r a b l y c l o s e r to me t h a n t h e c o n c r e t e I am w a l k i n g on right n o w . w h o would i n t e r p r e t e v e n h u m a n b e i n g s a s psychic a p p a r a t u s e s a n a l o g o u s t o the c a m e r a or t h e t e l e s c o p e . T h i n g s can appear in this open r e a l m of p e r c e p t i o n in a wide r a n g e of locations and p e r s p e c t i v e s . t h e figure is perceived as the w h o l e . A n y o n e w h o insists t h a t all t h i n g s b e r e g a r d e d a s i n a n i m a t e o b j e c t s e x i s t i n g in and of t h e m s e l v e s at s o m e specific location in space.s p a n n i n g r e c e p t i v e r e a l m of p e r c e p t i o n . " i n its traditional u s a g e . t h e back of him is not actually p r e s e n t at all. as an open. To the strictly optical field of vision. If this w e r e n o t so. H u m a n e x i s t e n c e i s c o n t i n u a l l y o p e n t o t h e claim o f each thing it e n c o u n t e r s . an a p p r o a c h i n g p e r s o n is s e e n from t h e f r o n t . the e x p r e s s i o n " v i s i o n " is a m b i g u o u s . holds o u t possibilities of m a n y o t h e r kinds of vision. w i t h r e g a r d t o o u r e x a m p l e . t r a d i t i o n a l p s y c h o l o g i c a l t h e o r y would c h a r a c t e r i z e the visuali­ zation of s o m e t h i n g n o t physically p r e s e n t . its perceiving o p e n n e s s . for i n s t a n c e . It is n o t sufficient to say t h a t we can be s i m u l t a n e o u s l y h e r e w i t h the physical. As a "being with this t h i n g or t h a t . physiological h y p o t h e s e s a b o u t t h e s u b s e q u e n t " c o m p l e t i o n " a r e d o o m e d to failure. and t h a t we can easily be s o m e w h e r e besides w h e r e w e a r e physically. We can e v e n visualize s o m e t h i n g w h i c h is n o t available to t h e s e n s e s at all b e c a u s e it does n o t actually e x i s t . B u t w h e n e v e n t h e optical p e r c e p t i o n c a n n o t be fully explained on t h e basis of physiological brain p r o c e s s e s . " v i s i o n " m e a n s perceiving a being as t h e w h o l e w h i c h it is. b y saying t h a t t h e p e r s o n involved has " a c t u a l l y " r e m a i n e d .p e r c e p t i b l e o b j e c t s of o u r place in the city and at the visualized c o t t a g e i n t h e m o u n t a i n s . t h e r e c e p t i v e "being . then. B u t t h e v e r y fact t h a t w e can visualize s o m e t h i n g d i s t a n t s h o w s t h a t w e a r e capable o f having s o m e t h i n g t h a t i s not optically p e r c e p t i b l e b e f o r e o u r e y e s . T h i s m e a n s . during his visualization. like a d i s t a n t vacation c o t t a g e . R a t h e r . " v i s i o n " refers solely to w h a t o c c u r s to t h e optical field. In o n e i n s t a n c e . is also. in t h e o t h e r . the r e c e p t i v e " b e i n g h e r e " of e x i s t e n c e . " No o n e is claiming t h a t this p e r s o n physically t r a n s p o r t e d h i m s e l f . likewise as an o p e n r e a l m of p e r c e p t i o n . he is at t h e c o t t a g e "in t h o u g h t . s e n s e .Fundamental Characteristics of Human Beings 9I p e r s o n h e is. " in t h e r o o m in w h i c h he h a s b e e n physically sitting. to s o m e far o f f thing. " h u m a n vision ordinarily m e a n s s e e i n g s o m e t h i n g w h i c h is physically p r e s e n t and t h u s s e n s e . n o t s o m e b a c k l e s s . At m o s t . or t h a t he u l t i m a t e l y s t o o d n e x t to it as a taxi t h a t pulls up to a h o t e l s t a n d s n e x t t o t h e h o t e l . visualize a golden mountain. is a p r i m a r y c o n c e r n of m o d e r n p h y s i o l o g i s t s o f s e n s a t i o n . W h e n it p i c t u r e s s o m e d i s t a n t t h i n g . Evidently. W e a r e n o t dealing h e r e with t w o m o d e s o f being w h i c h are b o t h t a k i n g place a t t h e s a m e t i m e . and in its ability to visualize. T h i s p r o c e s s o f " c o m p l e t i o n . N o w . h u m a n e x i s t e n c e as a r e a l m of p e r c e p t i o n is w i t h w h a t it visualizes and with t h e physically perceptible o b j e c t s o f its i m m e d i a t e s u r r o u n d i n g s . " w h e r e b y a purely optical s i g h t b e c o m e s an i n t e g r a l l y perceived p h e n o m e n o n . " o f c o u r s e . t h a t a p e r s o n ' s " b e i n g h e r e " as t h e open realm of p e r c e p t i o n he is also e n t a i l s "being t h e r e " at t h e visualized c o t t a g e in t h e distant m o u n t a i n s . T h e f u n d a m e n t a l c h a r a c t e r o f h u m a n e x i s t i n g . We can. t h e physical p r e s e n c e in the city. m u t i l a t e d h u m a n s h a p e .p e r c e p t i b l e . by its very nature. Y e t all of us e n g a g e in a kind of " v i s i o n " of s o m e t h i n g t h a t is n o t physically p r e s e n t w h e n e v e r w e p i c t u r e s o m e physical p r e s e n c e w e h a v e perceived b e f o r e . in v i e w of the open r e a l m of p e r c e p t i o n i n h e r e n t to h u m a n e x i s t e n c e . w e o n l y think we a r e at the visualized c o t t a g e . W h e n we visualize s o m e t h i n g . t r a d i t i o n a l psychological t h e o r y claims the opposite. If. is with t h a t t h i n g . n o t t o s o m e m e r e s u b j e c t i v e r e p r e s e n t a t i o n o f i t inside us. o u t s i d e . T h e " b e i n g h e r e " i n t h e city place i s n o t l e s s e n e d but m e r e l y modified in such a w a y t h a t during t h e visualization of t h e c o t t a g e a t t e n t i o n is no long f o c u s s e d primarily on t h e o b j e c t s in t h e i m m e d i a t e surroundings. B u t does a simple visualization require the thought: Here I am at the cottage? Certainly not. Psychology w o r k e d o u t its n o t i o n a f t e r t h e fact. w h a t we would be visualizing would be n o t the c o t t a g e but t h e p r e s e n c e o f t h e p e r s o n visualizing the c o t t a g e .92 EXISTENTIAL FOUNDATIONS t h e r e " a t t h e c o t t a g e . B u t if we a t t e n d e x c l u s i v e l y to w h a t is in the visualization itself. a h u m a n being. T h e peculiarity of visualization c o n s i s t s in t h e v e r y fact that it p e r m i t s . a m e r e illusion in w h i c h we fancy we are at t h e c o t t a g e . If to visualize t h e d i s t a n t c o t t a g e m e a n t o n l y to think t h a t we w e r e s t a n d i n g n e x t to it. w h a t s e n s e can t h e r e b e i n i n t e r p r e t i n g o u r visualized p r e s e n c e a t the v a c a t i o n c o t t a g e a s " b e i n g t h e r e only i n t h o u g h t " ? W h a t can "in t h o u g h t " m e a n ? A c c o r d i n g t o the m a i n s t r e a m o f p s y c h o l o g i c a l t h e o r y . actually at the place w h e r e t h e thing i s p r e s e n t . i n t h e p h e n o m e n o n o f visualization i t s e l f t h e r e is n o t h i n g r e s e m b l i n g t h o u g h t . we e s t a b l i s h a r e l a t i o n s h i p to t h e t h i n g itself. o n l y to be p r o j e c t e d o u t w a r d as a s e c o n d step from t h e locus of a s u b j e c t i v e c o n s c i o u s n e s s . t h e r e i s n o t u r n i n g back. T h i s is v e r y different f r o m visualizing the c o t t a g e itself. O n c e this c o n c e s s i o n h a s b e e n m a d e . W e m u s t e m p h a s i z e t h a t w e a r e not dealing h e r e w i t h a p r o c e s s in w h i c h s o m e s o r t of e n d o p s y c h i c i m a g e of the visualized c o t t a g e c o m e s to v i e w first. e x i s t i n g as an open r e a l m of p e r c e p t i o n . I n s t e a d of k e e p i n g o u r vision free and open we h a v e i n a d v e r t e n t l y supposed t h a t a p e r s o n is actually physically p r e s e n t at a d i s t a n t c o t t a g e . traditional p s y c h o l o g y c o n c e d e s t h a t in s o m e w a y at l e a s t — i n t h o u g h t — a p e r s o n can be w i t h a visualized o b j e c t . T h e i m p o r t a n t fact of this p h e n o m e n o n r e m a i n s t h a t in visualizing a spatially d i s t a n t physically n o n p r e s e n t o b j e c t . t h e r e w e r e a n y s e n s e at all in d i s t i n g u i s h i n g b e t w e e n a n i n t e r n a l and a n e x t e r n a l w o r l d . w e would still h a v e t o c o n c e d e t h a t o n t h e basis o f this c h a r a c t e r i s t i c r e c e p t i v i t y h u m a n e x i s t e n c e is. we find n o t h i n g to indicate t h a t it is in t h o u g h t o n l y . t h a t a p e r s o n can be at a far a w a y v a c a t i o n c o t t a g e o n l y in t h o u g h t and t h a t he h a s really s t a y e d in his city r e s i d e n c e all t h e t i m e . m o r e o v e r . i n t h e i m m e d i a t e p r e s e n c e o f w h a t it e n c o u n t e r s . T h u s . In stating t h a t it is possible to be s o m e w h e r e in t h o u g h t . f r o m t h e v e r y first. and t h e r e is no e v i d e n c e in a c t u a l findings to s u p p o r t a n y claim t h a t t h e r e is. A s w e h a v e said. T h i s i s n o t w h a t w e i n t r o d u c e d i n o u r e x a m p l e and h a s b e c o m e . or how much t i m e m u s t still pass b e f o r e s o m e t h i n g will o c c u r . " W h e n e v e r I say. o n l y s o m e t h i n g t h a t i s already t h e r e can b e m e a s u r e d and calculated. o r i s it in u s ? P e r h a p s b o t h we and the w a t c h a r e in t i m e ? W h a t h a p p e n s to t i m e if t h e w a t c h s t o p s ? T i m e does n o t simply disappear. The temporality of existence T i m e . But w e d o n o t address o u r s e l v e s t o time o n l y w h e n w e t h i n k o f this " n o w . and w h a t i s e x p e c t e d t o be. "It w a s jwsf such and such a t i m e . how much t i m e has passed. N o w . I could n e v e r e v e n read t h e w a t c h w i t h o u t t h i n k i n g : "Now it is such and such a t i m e . and f u t u r e are t e r m s indicating s o m e t h i n g t e m p o r a l . w e have already c o m e upon t h e i n t r i n s i c r e l a t i o n s h i p o f t e m p o r a l i t y t o spatiality. " I am addressing . h o w e v e r foggy or illdefined this perception may be. In speaking of the spatiality of e x i s t e n c e as a m e r g i n g i n t o r e l a t i o n s h i p w i t h w h a t has b e e n . H u m a n b e i n g s a r e i n s o m e sort o f p e r m a n e n t r e l a t i o n s h i p t o t i m e . p r e s e n t . B u t can time actually be read from a w a t c h ? Is time in t h e w a t c h . w a t c h e s are o u r m o s t c o m m o n c o n n e c t i o n w i t h t i m e . A w a t c h can o n l y tell us how much t i m e it is. a l t h o u g h t h e y seldom pay p a r t i c u l a r a t t e n t i o n e i t h e r t o t i m e itself or to this r e l a t i o n s h i p . " T h e v e r y fact t h a t his " n o w " is usually u n a r t i c u l a t e d s h o w s t h a t it is t a k e n for g r a n t e d . Past.Fundamental Characteristics of Human Beings 93 t h e visualizer h i m s e l f to be p r e s e n t at w h a t is visualized. W h i l e h u m a n e x i s t e n c e is able to retain and visualize w h a t it has e n c o u n t e r e d in the past and to p e r c e i v e w i t h t h e s e n s e s w h a t is p r e s e n t at a g i v e n m o m e n t . T h e s e s t a t e m e n t s are related n o t t o time i t s e l f b u t o n l y t o its m e a s u r e m e n t o r calculation. s o m e t h i n g besides m e a s u r e m e n t o c c u r s w h e n e v e r w e read t i m e f r o m a w a t c h . It is a special mode of being-at-something. and t h a t if we really h o p e to track d o w n t i m e w e have t o ask i n s t e a d . B u t " n o w " is n o t limited to t h e t i m e s we c o n s u l t o u t w a t c h e s . T h e first s t e p o u t o f this c o n f u s i o n is to see t h a t g l a n c i n g at a w a t c h does n o t let us see i n t o t h e n a t u r e of t i m e . T h i s r e l a t e d n e s s t o t h e f u t u r e o p e n s o u t to h u m a n e x i s t e n c e a third primal m o d e of being. Is it a l w a y s " n o w " ? Is e v e r y " n o w " a d i f f e r e n t n o w ? In w h a t w a y ? T h e difference is simply in t h a t o n e " n o w " is earlier or later than another. w h a t n o w is. ' W h e n ? " B u t " W h e n i s t i m e ? " i s asking a b o u t a t i m e e n c l o s e d in s o m e o t h e r t i m e . E v e r y m e a s u r e m e n t o f t i m e c o n f i r m s t h a t we h a v e already t i m e as a g i v e n . N o w a d a y s . t h e a w a i t e d or expected. like space. I t m a y b e o b j e c t e d t h a t this q u e s t i o n "'Where' is t i m e ? " is spatial. is in s o m e w a y familiar to us from o u r v e r y b e g i n n i n g s . It is no m o r e a p p r o p r i a t e to ask w h e n time i s t h a n t o ask w h e r e space is. it is also directed and r e l a t e d to w h a t stirs its a w a r e n e s s from t h e direction o f t h e f u t u r e . I n a n y e v e n t . " we e x p r e s s a s e c o n d f u n d a m e n t a l c h a r a c t e r i s t i c of time: dalability. " t h e w o r d is being used as time for s o m e t h i n g . " n o t h a v i n g a n y t i m e . B u t w h a t d o e s " h a v i n g t i m e " m e a n ? H e r e . p r e s e n t . By indicating t h a t t i m e is a l w a y s time for s o m e t h i n g we n a m e t h e first f u n d a m e n t a l c h a r a c t e r i s t i c of t i m e : significance. All o u r m e a s u r i n g and p a r t i t i o n i n g o f t i m e reveals n e i t h e r the c h a r a c t e r o f o u r r e l a t i o n s h i p t o t i m e n o r t h e n a t u r e o f t i m e itself. as I w r i t e this c h a p t e r a b o u t t i m e . T h e w a t c h can lead u s t o m o r e precise d e t e r m i n a t i o n s o f s o m e y e s t e r d a y . and f u t u r e . and f u t u r e are supposed to exist only in s u c c e s s i o n . Past. ' " or "when I g e t this b o o k finished.p o i n t s . C o r r e s p o n d i n g to this physical idea of p r e s e n c e is the n o t i o n of p r e s e n t time: t h e o n l y t h i n g p r e s e n t a b o u t t i m e i s the n o w . this r e f e r r a l to an activity or e v e n t for which a given t i m e is p r e s e n t is a p r i m a r y c o n s t i t u e n t of t i m e . particularly w h e n it is claimed t h a t t h e s e are simultaneous. " T i m e c o n s i s t e n t l y s h o w s a certain e x p a n s i v e n e s s . " t h e n e g a t i o n is n o t of t i m e but of h a v i n g time for a particular t h i n g . a x i o m a t i c since t h e v e r y b e g i n n i n g s o f W e s t e r n philosophy. the f u t u r e . o r t o m o r r o w . today. as m e r e l y a s u c c e s s i o n of " n o w . b u t w i t h o u t t h e i r e x i s t e n c e the w a t c h would be u s e l e s s . If I s a y I don't h a v e t i m e for skiing. t h a t being i s p r e s e n c e . A s w e have said. past. " A n y o n e w h o posits such a t i m e — a n d all of m o d e r n s c i e n c e does—will find it s t r a n g e to h e a r time spoken as h a v i n g t h r e e d i m e n s i o n s . w h e n I m i s i n t e r p r e t e d t i m e as a l i n e a r chain of ' n o w . " T h e p r e e m i n e n c e o f " n o w " i s based solely upon t h e idea. In "I don't have t i m e .p o i n t s . not successive. m o r e and m o r e . and f u t u r e . and e v e n m o r e obviously in its c o n v e r s e . " or "hack then. " h o w e v e r ." 1 am r e f e r r i n g to a time t h a t h a s n o t yet arrived. S o m e o n e m i g h t say t h a t he has r e s e r v e d the . We a l w a y s c o n s t r u e time as t i m e nor s o m e t h i n g or o t h e r . yet while space is usually t h o u g h t of as h a v i n g t h r e e s i m u l t a n e o u s d i m e n s i o n s . " W a i t a few m i n u t e s until then. " and " t o m o r r o w . W h e n e v e r we say s o m e t h i n g like. "now. T h o u g h it m a y r e m a i n u n c l e a r w h a t a particular t i m e is for. e v e r y d e t e r m i n a t i o n o f h o w m u c h t i m e a s s u m e s t h a t w e " h a v e " t i m e . t i m e is given only o n e . " " y e s t e r d a y . time is p i c t u r e d as s o m e sort of line of " n o w p o i n t s .94 EXISTENTIAL FOUNDATIONS t h e past. I am really saying t h a t I plan to spend my t i m e doing s o m e t h i n g else. T h u s w e see h o w time could c o m e to be t h o u g h t of. In this v i e w . " w h i c h e x p r e s s a r e l a t i o n s h i p to time m o r e e l e m e n t a r y than the n u m e r i c a l " h o w m u c h " the w a t c h provides. T h e s a m e holds t r u e w h e n I say " t o d a y . W h e n I say. T i m e i s n o t always m e r e l y " t i m e for s o m e t h i n g . B u t t h e s e e x p r e s s i o n s d e t e r m i n e d b y t h e n u m e r a l s o n the w a t c h are n o t t h e only w o r d s w e have for addressing p r e s e n t . But time n e v e r c o n s i s t s only in " p o i n t s . T i m e can be divided i n t o past. p r e s e n t . e v e r y d a y time as m e a s u r e d w i t h a w a t c h is a l w a y s so and so m u c h t i m e for s o m e t h i n g or other. he would no doubt go i n s a n e . n o t o n l y by me but by b o t h m y wife and m e and a n y o n e else w h o h a p p e n s t o b e t h e r e t o h e a r . Y e t . T h e s e indications o f " n o w . By the s a m e r e a s o n i n g . T h e application of n o w is c o n f i n e d to a specific location of s o m e m o v i n g o b j e c t at a g i v e n t i m e . F o r i n s t a n c e . datable. W h e n a downhill race on skis is t i m e d on a stop w a t c h i n h u n d r e d t h s o f s e c o n d s . actually h a v e a q u a l i t a t i v e n a t u r e . e x p a n s i v e . T i m e ' s f o u r t h f e a t u r e . T h e r e i s n o n e e d t o e n t e r first i n t o c o n s i d e r a t i o n s a b o u t t h e individual people involved. " w h i c h appear t o b e m e r e l y n u m e r i c and q u a n t i t a t i v e . t h e r e s u l t i n g t i m e still actually indicates t h a t o n e c o n t e s t a n t has b e e n f a s t e r t h a n a n o t h e r . N o h u m a n e x i s t e n c e could c o n t i n u e . time i n t e r p r e t e d as a simple s u c c e s s i o n of " n o w . we m u s t first be in a position to be e x . this " n o w " can be u n d e r s t o o d i m m e d i a t e l y . U l t i m a t e l y . and so no living p e r s o n could e v e r be d i s t r a c t e d into it. t h e n . Applied to t i m e . " I n this w a y . " B u t no " n o w " is r o o t e d e n t i r e l y in o n e individual h u m a n being. and " n o w " c o m e s to be u n d e r s t o o d only in r e l a t i o n to itself as "this i n s t a n t . he would be u n a b l e to do even this. In l a b o r a t o r y e x p e r i m e n t s all t h a t is m e a s u r e d is t h e d u r a t i o n of a p r o c e d u r e . w h e n I tell my wife t h a t I h a v e w r i t t e n e n o u g h for o n e day and am g o i n g to bed n o w . this m e a n s t h a t it would h a v e to be possible for us to be e x t r a c t e d from the t i m e n o r m a l l y given to us and c a u g h t up in an e m p t y and u n i f o r m time s e q u e n c e in which the e x p r e s s i o n " t i m e f o r " had n o m e a n i n g . n o indication o f t i m e i s m e a n t for m e a l o n e . t o o . w h i c h r e d u c e s its four c h a r a c t e r i s t i c s t o a n e m p t y s u c c e s s i o n o f " n o w s " w e r e t o be t h e o n l y w a y he e x p e r i e n c e d t i m e in his life.p o i n t s " could n e v e r c o n t r i b u t e to an understanding of human phenomena . i t signifies elapsed t i m e w i t h r e g a r d to an optimal p e r f o r m a n c e .t r a c t e d from o n e t h i n g and a t . For to b e c o m e dis­ t r a c t e d .p o i n t s " — b u t o n l y while he is c o n d u c t i n g e x p e r i m e n t s in his l a b o r a t o r y . If e a c h p e r s o n e x p r e s s e d a p e r s o n a l " n o w . even w h e n t h e s e a r e e x a c t l y d e t e r m i n e d w i t h a w a t c h . in s u c h a t i m e s e q u e n c e .t r a c t e d to a n o t h e r . t i m e is n e v e r m e a n t simply as a q u a n t i t a t i v e r e c k o n i n g . T h i s e x t e n s i o n of t i m e o v e r a w h o l e e v e n i n g or an e n t i r e w i n t e r m a n i f e s t s its third f e a t u r e : expansiveness. and public. e v e n t h a t application disappears. Finally. a s t h e i n t e n d e d m o m e n t . t h e n a t u r a l scientific r e s e a r c h e r i n t e r p r e t s time h o m o g e n o u s l y as a s u c c e s s i o n of " n o w . T h e four f u n d a m e n t a l c h a r a c t e r i s t i c s o f t i m e apply n o t o n l y t o " n o w " but t o e v e r y " t h e n " and " w h e n " a s well. If this n o t i o n of t i m e . L i k e w i s e . h o w e v e r .Fundamental Characteristics of Human Beings e v e n i n g for t h e t h e a t e r and t h a t h e h a s s p e n t t h e w i n t e r w o r k i n g o n the plans f o r his h o u s e . T h e y r e f e r to t i m e as significant. " a s u b s e q u e n t c o n f e r e n c e would be needed to a g r e e upon a single identity for t h e s e " n o w s . is its public character. Even as it is c o m m o n l y m e a s u r e d w i t h a w a t c h . " mentally coordinating these w i t h t i m e . W e s p e a k t h e s e days. B u t w h a t is s u b j e c t e d to this m e a s u r e m e n t i s i t s e l f t a k e n a s a g i v e n . m e a s u r e d and e x p e r i e n c e d t i m e . and u n e x p l a i n e d p r e s u p p o s i t i o n s a b o u t t h e n a t u r e o f m a n and his r e l a t i o n s h i p t o t i m e . for i n s t a n c e . I f t h e soul w e r e n o t capable o f perceiving and e x p r e s s i n g itself a b o u t t i m e . T h i s " e v e r y o n e " also p r e s u p p o s e s t h a t o n l y t h e findings o f physics can deliver strictly scientific t r u t h and t h a t it is no l o n g e r i m p o r t a n t to a s k w h a t i s b e h i n d t h e n o t i o n o f s c i e n c e itself." about "consciousness of time. h a s b e e n a m a j o r t h e m e in r u m i n a t i o n s a b o u t t i m e for a g e s . t o o . O b j e c t i v e h e r e m e a n s " f o r e v e r y o n e . q u a n t i t a t i v e c o n f i r m a t i o n w h i c h i s t h e n o b j e c t i v e l y binding. T h e r e are those w h o think that Einstein's theory of relativity s u p e r s e d e d t h e n o t i o n s o f time h a n d e d d o w n from the philosophical tradition. T h i s i s e v i d e n t f r o m t h e w a y t h e p r o b l e m o f t i m e i s posed. after t h e fact. but this t o o is a f u n d a m e n t a l e r r o r . T h i s h a b i t .9t> EXISTENTIAL FOUNDATIONS In spite of t h i s . T h e t h e o r y of relativity is a physical t h e o r y c o n c e r n e d w i t h finding o u t h o w t i m e . a b o u t " t i m e experience. " can be measured. " b u t " e v e r y o n e " includes o n l y people w h o h a v e a c c e p t e d t h e w a y physics t h i n k s a b o u t n a t u r e and believe t h a t t h e s c i e n c e of physics is t h e o n l y valid f o r m for d i s c o v e r i n g t r u t h and for h u m a n k n o w l e d g e in g e n e r a l . T h e y a r e t o o q u e s t i o n a b l e t o form the basis for a f u n d a m e n t a l study of t h e r e l a t i o n s h i p b e t w e e n m a n and t i m e . c o n c e i v e d of as a s u c c e s s i o n of " n o w s . w h e t h e r it is possible to m e a s u r e time a b s o l u t e l y or w h e t h e r e v e r y m e a s u r e m e n t is n e c e s s a r i l y r e l a t i v e . F o r e x a m p l e . T h e i r u n s h a k a b l e c o n f i d e n c e in this v i e w c o m e s from t h e fact t h a t t i m e — a s physics m e a s u r e s it—is a l w a y s s u b j e c t t o o b j e c t i v e . t h e c o n c u r r e n c e o f m a n and t i m e . a c t u a l t i m e . " C o n t e m p o r a r y t h o u g h t . t h e n t i m e could n o t possibly e x i s t u n l e s s t h e soul also e x i s t e d . w h e n we d i s t i n g u i s h b e t w e e n a s u b j e c t i v e and . and for the m a n on t h e s t r e e t t h e t r u t h of physics is p r o v e d by its effects: his car is p r o o f e n o u g h for him t h a t p h y s i c s h a s t h e capacity t o u t t e r t h e t r u t h a b o u t t i m e a s well. all r e s t on illc o n s i d e r e d . m a n y physicists will p e r s i s t in claiming t h a t the s u c c e s s i o n o f " n o w s " c o n s t i t u t e s real. w o r l d and e g o t i m e . M a c h i n e s c a n b e c o n s t r u c t e d on t h e basis of p h y s i c s ' c o n c e p t u a l a p p r o a c h . u n p r o v e n . a s well a s t h e c o m m o n d i s t i n c t i o n s t h a t a r e m a d e b e t w e e n s u b j e c t i v e and o b j e c t i v e t i m e . T h e t h e o r y o f relativity m e r e l y asks. W e t h e r e f o r e feel justified i n m a i n t a i n i n g t h a t t h e w h o l e e s s e n c e of t i m e c a n n o t possibly be r e p r e s e n t e d in t h e ideas c u r r e n t in contemporary natural science. a b o u t " t i m e s e n s e " o r s e n s e o f t i m e . A r i s t o t l e said: "It is w o r t h e x a m i n i n g h o w t i m e i s related t o t h e soul. It a t t e n d s as little as a n y o t h e r scientific t h e o r y o f t i m e t o t h e n a t u r e o f w h a t i s b e i n g m e a s u r e d . p r e s u p p o s e s t h e c o n c u r r e n c e o f t i m e and t h e h u m a n e s s e n c e . M a n ' s r e l a t i o n s h i p t o t i m e . q u a n t i t a t i v e and q u a l i t a t i v e t i m e . and its u s e w i t h m a n . W a s it in t i m e already b e f o r e m a n a r r i v e d o n t h e s c e n e ? N o o n e t o d a y w o u l d h e s i t a t e a m o m e n t i n saying y e s . o f o b j e c t i v i t y and s u b j e c t i v i t y .t i m e o f such a t h i n g identical to t h e b e i n g . N o w . T h a t i s w h y w e can n e v e r k n o w w h a t w a s h e r e w h e n m a n had n o t y e t arrived. Its t i m e has to do w i t h its u s e .i n .t i m e t h e basis o f o u r h a v i n g t i m e . B u t in r e s p e c t to t h e s e c o n c e p t s . o f c o u r s e . s o m e kind of c o n t a i n e r in w h i c h t h i n g s are.i n .i n . W e h a v e already m e n t i o n e d o n e h u m a n r e l a t i o n s h i p t o t i m e t h a t can b e e x p e r i e n c e d directly. t h a t t h e d r i n k i n g glass h a s its o w n t i m e to be a drinking glass. and perish in t i m e . s o m e only for a short time. t h e h u m a n being. o r i s t h e r e v e r s e t r u e ? W h a t d o e s b e i n g . since o n l y m a n can m a n u f a c t u r e d r i n k i n g g l a s s e s . i f m a n c e a s e d t o e x i s t w o u l d t h e r e b e a n y d r i n k i n g g l a s s e s ? T h e a n s w e r is. a n d i n o u r e v e r y d a y t h i n k i n g we find t h a t t h i n g s and e v e n t s o c c u r . Its t i m e is n o t simply e m p t y p e r s i s t e n c e but a t i m e for. I s o u r b e i n g . Y e t e v e n t h e t i m e w e r e f e r t o w h e n w e say " b e f o r e m a n " is u n e q u i v o c a l l y r e l a t e d to m a n as t h e t i m e w h i c h r e v e a l s itself to him.i n . D o e s o u r indication o f this p e r s i s t e n c e a d e q u a t e l y define t h e o b j e c t ' s b e i n g . w e m a y ask.Fundamental Characteristics of Human Beings 97 o b j e c t i v e t i m e . p e r s i s t . a s long past. N o w w e m u s t ask w h a t m a k e s this r e l a t i o n s h i p t o t i m e possible. I f t h e s e f r a g m e n t s g e t i n t o t h e g a r b a g e . t h e q u e s t i o n is o p e n w h e t h e r t h e y can b e a p p r o p r i a t e l y defined b e f o r e t h e n a t u r e o f t i m e has been adquately illuminated. w h o h a s t i m e for t h i n g s . w e hold t o t h e n o t i o n s o f C a r t e s i a n dualism. b u t t h e y no l o n g e r p e r s i s t as a d r i n k i n g g l a s s . n o . S o m e p e r s i s t for a long time. c o n t i n u e s to persist. it t o o h a s its t i m e . Do objects need to do anything to p e r s i s t ? W h e r e is p e r s i s t e n c e to be found in a t h i n g ? W h a t h a p p e n s to an o b j e c t w h e n t h e r e i s n o l o n g e r a n y o n e n e a r it? D o e s i t c o n t i n u e t o persist? A d r i n k i n g g l a s s m a y be b r o k e n w h i l e t h e table is b e i n g c l e a r e d . o r in. H o w long i t h a s b e e n o r will r e m a i n t h e r e i s o f n o c o n c e r n t o m e . but t h e fact t h a t it w a s already and will r e m a i n t h e r e m e a n s t h a t it has p e r s i s t e d during. P e r s i s t e n c e is a c h a r a c t e r i s t i c of all o b j e c t s . O b j e c t s like t h e g l a s s e n t e r t i m e b y v i r t u e o f t h e fact t h a t t h e y h a v e b e e n m a d e . H u m a n b e i n g s can e i t h e r have t i m e or not have t i m e . W h a t t h e n o f a m o u n t a i n ? Y e s . W e c a n n o t e v e n decide w h e t h e r . t h e y a r e s e p a r a t e d f r o m e a c h o t h e r and are j u s t isolated pieces o f glass. M a n gives t i m e t o t h e g l a s s . W e realize.i n .t i m e ? A n d i s t h e b e i n g . As glass pieces t h e y c o n t i n u e to p e r s i s t .t i m e of an e x i s t i n g h u m a n b e i n g ? In e i t h e r c a s e w e m u s t avoid falling i n t o t h e easy e r r o r t h a t time i s s o m e h o w spatial. We a r e t h e n left w i t h the b r o k e n pieces. I can say simply t h a t t h e table in f r o n t of me w a s already p r e s e n t b e f o r e I s e t e y e s on it and will r e m a i n w h e r e it is w h e n I am no l o n g e r looking a t it. A n d . t h e n . t i m e .t i m e m e a n ? D o w e n e e d t o ask this a t all? N a t u r a l s c i e n c e m e a s u r e s all n a t u r a l p r o c e s s e s a s t h e y o c c u r i n t i m e . is in t i m e . W e can also have s u c h t h i n g s a s affect u s directly. a N o b e l P r i z e — b u t n o t t i m e . G e o l o g i s t s m e a s u r i n g t i m e w i t h t h e a t o m i c clock a r e c o n f i d e n t t h a t t h e y h a v e b e e n able t o find e r a s o f t i m e c o n t a i n i n g t h i n g s millions o f y e a r s b e f o r e t h e r e w e r e h u m a n b e i n g s . W e a r e u s e d t o saying t h a t we a r e in t i m e . " " h a s b e e n " and "will b e " lose all m e a n i n g .t h e . b e c a u s e t h e data it p r o d u c e s a r e also tied to t h e h u m a n b e i n g w h o reads t h e m . B u t e v e n t h e a t o m i c clock does n o t bring u s a n y c l o s e r t o u n d e r s t a n d i n g b e i n g .i n . B e f o r e w e can u n d e r s t a n d t h e i n h e r e n t n a t u r e o f " h a v i n g " t i m e . W i t h o u t t h e possibility of indicating t i m e to a r e c e p t i v e and p e r c e i v i n g c r e a t u r e like m a n . " T h e e x a m p l e o f " h a v i n g a w o r r y " s h o w s m o s t readily t h a t " h a v i n g " can m e a n far m o r e t h a n j u s t p o s s e s s i n g s o m e t h i n g . we m u s t first b r e a k a w a y from o u r o r d i n a r y h a b i t s o f s p e e c h . pain. I am w o r r i e d .t i m e of i n a n i m a t e o b j e c t s as well. w a s in fact n o t " h a d . all f u n d a m e n t a l w o r d s like " b e i n g . T h e r e v e r s e i s m o r e likely. We a r e n o t in t i m e as s m a l l e r C h i n e s e ivory balls can b e found inside l a r g e r o n e s . we will n e v e r g e t past their b e i n g . " r e f e r s t h e n to a specific m o d e in w h i c h a p e r s o n is. " H a v e . a h o u s e . We can h a v e c e r t a i n t h i n g s in this s e n s e — a car.i n time t o u n d e r s t a n d t h e h u m a n r e l a t i o n s h i p t o t i m e . In o r d e r to see in its p r o p e r light t h e special w a y in w h i c h time applies to h u m a n b e i n g s . M a n ' s r e l a t i o n s h i p t o his t i m e i s c e r t a i n l y s o m e t h i n g m o r e t h a n the w a y in w h i c h a d r i n k i n g g l a s s . an e a r a c h e .w o r l d . and is e x i s t i n g . w e m u s t n o t c o n c l u d e t h a t " h a v i n g t i m e " m e a n s t h a t t h e r e i s time o n t h e o n e h a n d . t h a t an a d e q u a t e i n s i g h t i n t o the h u m a n r e l a t i o n s h i p to time will give us a v i e w of t h e b e i n g . Similarly. and on t h e o t h e r a " h a v i n g " t h a t h a s n o t h i n g to do w i t h t h e t i m e itself.i n . " It would be m o r e a p p r o p r i a t e to say t h a t t h e w o r r y has a p e r s o n . " " w a s . . I f e v e r y d e t e r m i n a t i o n o f time available from n o n h u m a n e v e n t s and o b j e c t s is i n e v i t a b l y r e l a t e d to m a n . It is t o this h u m a n being t h a t t h e t e s t e d e n t i t i e s appear t o b e o f such and s u c h an age. at a given time. and also t h a t we have t i m e . for i n s t a n c e . H o w does " h a v e " w o r k h e r e ? W e see t h a t w h a t w e s e e m e d to " h a v e . or b e t t e r still (to s h o w t h a t it is n o t I w h o c r e a t e t h e w o r r y ) : I am o v e r c o m e b y w o r r y . this " i n " should n o t be t a k e n in a n y spatial s e n s e . " " i s . w e can n e v e r say w h a t was b e f o r e m a n . " t h e w o r r y . " as in t h e e x p r e s s i o n " t o h a v e a w o r r y . AH p r e s u p p o s e t h e possibility o f p r e s e n c e e n t e r i n g i n t o a n open r e a l m o f p e r c e p t i o n and being p e r c e i v e d t h e r e . or a w o r r y .98 EXISTENTIAL FOUNDATIONS o r n o t i t i s p r o p e r t o say t h a t t h e Alps w e r e h e r e b e f o r e t h e r e w e r e h u m a n b e i n g s . w e m u s t carefully d i s t i n g u i s h a m o n g t h e v a r i o u s possibilities o f " h a v i n g . To s t a r t w i t h . being part of us: I have a b r o k e n a r m . I nave a w o r r y . It is s o m e m o d e in w h i c h we find o u r s e l v e s . S t r i c t l y s p e a k i n g . Fundamental Characteristics of Human Beings C e r t a i n l y . w e c a n n o t simply t r a n s f e r o u r s t a t e m e n t s a b o u t " h a v i n g " . t h e dwelling of h u m a n being holds o u t a t i m e for e a c h t h i n g . " in this v e r y s e n s e of a t h r e e f o l d e x i s t e n c e is a m o d e of h u m a n being. on w h a t is to be d o n e — t h e t h i n g I am e x p e c t i n g . W h e t h e r w e h a v e i t o r n o t . n o r is it e v e n w h a t is f o c u s s e d on. "Will you h a v e time for a w a l k t o m o r r o w a f t e r n o o n ? " A f t e r t h i n k i n g it o v e r briefly. Any timel "have. B u t w e have discussed " h a v i n g " w o r r i e s b e f o r e w e consider " h a v i n g " t i m e t o point o u t t h e peculiarities t h a t o b t a i n b e t w e e n the w o r d ' s c o m m o n u s a g e and t h e p a r t i c u l a r t h i n g s t h a t a r e " h a d . A n d . It has on hand t h e " w h e n e v e r . " B u t t i m e or s o m e t h i n g does n o t lie b e f o r e us like s o m e object w h i c h w e can i g n o r e o r pick up. s o . w h i c h i s t h e fulfillment o f t h e e x t r e m e .i n . I a n s w e r . aware of what is present." 1 have in such a way that I am expectant of which is to come. This threefold mode in what 1 am constitutes "having" time for this or that. My a t t e n t i o n is f o c u s s e d r a t h e r on t h e t h i n g for which I shall h a v e t i m e . w h e t h e r w e plan o r squander it. 1 w o r r y to t h e h a v i n g of t i m e . in t h a t w h a t m a t u r e s sich zeitigt in this " h a v i n g " is w h a t we m a y d e s i g n a t e a s m a n ' s b e i n g . unlike t i m e . . " N o w . being a w a r e o f t h e p r e s e n t . similarly. O n e o b v i o u s d i f f e r e n c e b e t w e e n the two ¡8 t h a t w o r r y . I n its t h r e e f o l d capacity. In this having of t i m e and the c a r r y i n g o u t o f p o t e n t i a l w a y s o f being. " H e r e t i m e has n o t b e e n m a d e i n t o an o b j e c t . " a s well a s t o s h o w h o w i n e x a c t and u n s c i e n t i f i c w e would b e i f w e w e r e t o lump t o g e t h e r all i n s t a n c e s o f " h a v i n g . w h i c h would sidestep t h e p h e n o m e n o n o f " h a v i n g .w o r l d . e f f e c t s its o w n d e m i s e . All o f this should d e m o n s t r a t e a t least t h a t w e d o n o t c o m p r e h e n d t h e p h e n o m e n o n of h a v i n g t i m e for s o m e t h i n g simply by r e f o r m u l a t i n g it to say t h a t t i m e i s p r e s e n t . w h a t he is a w a r e o f p r e s e n t l y . h a v i n g t i m e is being e x p e c t a n t of t h e f u t u r e . does n o t affect us i n e v i t a b l y and at e v e r y m o m e n t . " t h e ' n o w . 1 T h i s dwelling in t h e w o r l d is c h a r a c t e r i z e d by its c o n t a i n i n g — a l l d i f f e r e n t b u t all equally e l e m e n t a r y — w h a t is c o m i n g to m a n . a friend m a y ask m e . and retentive of what has been. a n e x i s t e n c e develops and m a t u r e s . It e x p e n d s its t i m e and finally w h e n it has used up t h e t i m e a p p r o p r i a t e t o a n e x i s t e n c e . u n s u r p a s s a b l e e x i s t e n t i a l possibility. " H a v i n g t i m e . O u r r e l a t i o n s h i p t o t i m e — w h a t e v e r it m a y be at a n y m o m e n t — i s t h e basis of o u r dwelling in the w o r l d . as h a v i n g a w o r r y actually m e a n s being w o r r i e d . I am also dwelling in w h a t is p r e s e n t to me at this m o m e n t . I'll h a v e t i m e . h o w e v e r . according t o w h i m . o r his worldly dwelling ( v e r b a l ) . t h a t e v e n w h i l e I am e x p e c t a n t . and w h a t h a s already b e e n . " and t h e ' t h e n " w h i c h w e use i n o u r c a l c u l a t i o n s of t i m e . " Y e s . My e x p e c t a t i o n is so c o n s t i t u t e d .t h e . T h u s . I a l s o — t h o u g h I a m n o t n e c e s s a r i l y a w a r e o f i t — r e t a i n all t h a t has e v e r o c c u p i e d m e u p t o this m o m e n t . and r e t a i n i n g w h a t h a s passed. t h e " h a v i n g " i n t h e h a v i n g o f t i m e i s t h e actual t e m p o r a l i t y o f h u m a n being. W h a t we c a n n o t do is a l t e r t h e fact t h a t it is t i m e . w h o s e w e i g h t could b e d e t e r m i n e d . At a n y g i v e n t i m e . and s i m u l t a n e o u s l y hold it ready for f u t u r e t h i n g s . All t h e r e s u l t i n g data lumped t o g e t h e r would tell u s n o t h i n g a b o u t w h a t m a k e s t h e s e p a i n t i n g s w h a t t h e y a r e . W e m a y e v e n b e trapped i n o n e o f t h e t h r e e . T h e n a t u r a l scientific r e s e a c h m e t h o d t r e a t s t h e body as it m i g h t t r e a t w o r k s of a r t . W h i l e dwelling i n t h e w o r l d m e a n s e x t e n d i n g o u r s e l v e s s i m u l t a n e o u s ­ ly into the three temporal dimensions—extensions or ecstasies—of the past. Human bodyhood 2 T h e traditional. O n l y w h e n it is defined this w a y is b o d y h o o d a c c e s s i b l e to t h e n a t u r a l scientific r e s e a r c h m e t h o d . We can t a k e and h a v e o u r t i m e in t h a t we r e t a i n it in visualizing. w e a r e c o n s t a n t l y bringing past. Even t h e n . p r e s e n t . in a s e n s e . B o d y h o o d i t s e l f s u g g e s t s t h a t it be c o n s i d e r e d as t h o u g h it w e r e a m a t e r i a l o b j e c t . this m e t h o d would see o n l y m a t e r i a l o b j e c t s w h o s e l e n g t h and b r e a d t h could b e m e a s u r e d . i t i s still o b s c u r e h o w t h e u n i t y o f t h e " t h r e e f o l d n e s s " o f t i m e i s t o b e defined. i n v e s t i g a t e d and m a n i p u l a t e d as a c h e m o p h y s i c a l or c y b e r n e t i c s t r u c t u r e . A t v a r i o u s t i m e s . and f u t u r e t o g e t h e r i n a u n i q u e w a y . S u c h a f o r c e . B y positing t h e h u m a n body a s s o m e s e l f .c o n t a i n e d m a t e r i a l t h i n g . w h i c h t h e n t a k e s this definition as the r e a l i t y of human existence. w e p r o d u c e and f o r m t h e m o m e n t a r y s t r u c t u r e of t i m e . N o r will it suffice to say t h a t s o m e t h i n g else is p r e s e n t in t h e a n i m a t e body of a h u m a n being. o n e o r a n o t h e r o f t h e d i m e n s i o n s will be m o s t c o m m a n d i n g . for i n s t a n c e . s o m e selfc o n t a i n e d t h i n g p r e s e n t at s o m e specific l o c a t i o n in a p r e e x i s t i n g space. h o w e v e r . s o m e s u p e r n a t u r a l life f o r c e closed to I he nal ural scientific r e s e a r c h m e t h o d . and w h o s e s u b s t a n c e could be analyzed c h e m i c a l l y . and so c a r r y out o u r w o r l d l y dwelling in its t e m p o r a l i t y . n a t u r a l s c i e n c e d i s r e g a r d s e v e r y t h i n g t h a t i s specifically h u m a n a b o u t h u m a n b o d y h o o d . n a t u r a l scientific f o u n d a t i o n o f m e d i c i n e a s s i g n s t h e h u m a n b o d y a position of singular p r o m i n e n c e .100 EXISTENTIAL FOUNDATIONS t i m e is s o m e t h i n g t h a t is. m a k e it p r e s e n t . t h e o t h e r t w o a r e n e v e r n e g a t e d o r d e s t r o y e d b u t only deprived o r c o n c e a l e d . t h e r e for us to o r g a n i z e as we w i s h . p r e s e n t . in its t h r e e f o l d u n i t y . and b e i n g p r e s e n t . It is t h e o n l y aspect of t h e h u m a n c o n s t i t u t i o n w h i c h can b e posited. r e t a i n i n g . i n physical . T h u s . and at t h o s e t i m e s we e n t e r i n t o it m u c h m o r e t h a n t h e o t h e r s . G i v e n a collection of P i c a s s o p a i n t i n g s . t h e i r c h a r a c t e r a s w o r k s o f art i s n o t e v e n t o u c h e d b y this approach. s e p a r a t e from h u m . T o b e s u r e . is t h e t e m p o r a l i t y o f t h e t i m e w h i c h w e h a v e o r d o n o t h a v e . T h e disposable and disposed of t i m e is c o n s t i t u t e d in w a i t i n g . and f u t u r e . t h e s e d i m e n s i o n s are n a t u r a l l y n o t a l w a y s o p e n equally t o e a c h e x i s t e n c e . at o u r disposal. T h i s . say. b u t t h e y are n o t all t h a t is bodily. p e r h a p s in a sociology l e c t u r e . a m a t h e m a t i c s t e x t . A n d e v e n w h e n w e are e n g a g e d i n purely i n t e l l e c t u a l and a b s t r a c t t h o u g h t . E v e r y t h i n g we s e e in t h e mind's e y e is s e e n . and to r e s p o n d to t h a t address or claim. To u n d e r s t a n d t h e b o d y h o o d t h a t i n h e r e s in all h u m a n e x i s t e n t i a l p h e n o m e n a . H e r b o d y h o o d w a s e n g a g e d c o m p l e t e l y in h e r longing to be w i t h h e r lover and in h e r h u r r y i n g t o close t h e d i s t a n c e b e t w e e n t h e m . A p e r s o n ' s c o n c r e t e dealings w i t h o t h e r people and his direct p e r c e p t i o n o f o b j e c t s t h a t p r e s e n t t h e m s e l v e s physically t o his s i g h t and t o u c h a r e especially o b v i o u s bodily r e l a t i o n s h i p s .c y b e r n e t i c . T h i s u n a w a r e n e s s h a p p e n s a t t i m e s i n h e a l t h y h u m a n e x i s t i n g but in no w a y implies t h a t this particular m o d e of e x i s t e n c e is n o t bodily. In looking for the special w a y in w h i c h t h e h u m a n body is b o d y h o o d . a particular smell. All of o u r e x p e r i e n c e tells us t h a t j u s t w h e n a h u m a n being is e x i s t i n g in t h e m o s t h i g h l y c h a r a c t e r i s t i c h u m a n w a y . was p o s t u l a t e d b y t h e vitalists o f t h e last c e n t u r y and the n e o v i t a l i s t s of this. we shall begin by looking a w a y from b o d y h o o d to s o m e t h i n g else. All s u c h s u p p o s i t i o n s s h a r e t h e c o n v i c t i o n thai the h u m a n body h a s at least o n e c h e m o p h y s i c a l . b u t as r e . and w h a t we h a v e h e a r d w i t h o u r e a r s . E v e n w h a t w e m e r e l y visualize. w e see it as n o t physically p r e s e n t . O n the c o n t r a r y . V i s u a l i z a t i o n s o f t h i n g s t h e s e n s e s d o n o t p e r c e i v e a r e also bodily. t h e n . is s e e n bodily. w e m u s t distinguish b e t w e e n h u m a n b o d y h o o d and the m a t e r i a l n a t u r e o f i n a n i m a t e o b j e c t s . c o n s i d e r . w i t h the s e n s e s . i m a g i n e . o r r e m e m b e r appears h a v i n g a p a r t i c u l a r s h a p e . Y e t n o o n e h a s b e e n able t o s u r m i s e h o w t w o t h i n g s a s f u n d a m e n t a l l y different as m e t a p h y s i c a l life f o r c e and i n a n i m a t e c h e m i c a l s u b s t a n c e could e v e r m e r g e t o f o r m t h e u n i t y t h a t i s h u m a n bodyhood.p r e s e n t e d . w e d o n o t s e e i t a s physically p r e s e n t . purely biologk al c o m p o n e n t . t a s t e . t e x t u r e . A t t h e m o m e n t w h e n she w a s d a s h i n g a c r o s s t h e s t r e e t t o h e r lover. R e g u l a Z u r c h e r was n o t a w a r e o f p o s s e s s i n g a body. T h e r e is no m a n i f e s t a t i o n of h u m a n e x i s t e n c e w h i c h is n o t bodily. N e v e r t h e l e s s . T h e first is t h e a b s o l u t e difference b e t w e e n t h e limits of o u r b o d y h o o d and the m a t e r i a l b o r d e r s of i n a n i m a t e .Fundamental Characteristics of Human Beings e n e r g y . To exist in a c h a r a c t e r i s t i c h u m a n w a y m e a n s to be e n g a g e d body and soul by s o m e t h i n g t h a t claims o n e . T h e h u m a n being c o m p l e t e l y loses his a w a r e n e s s o f his b o d y h o o d as a physical body j u s t w h e n he is a c t i n g m o s t g e n u i n e l y h u m a n . W e can approach this distinction from t w o different s t a r t i n g p o i n t s . a p a r t i c u l a r c o l o r and shading. h e i s totally u n a w a r e o f his body as s u c h . T h a t s h e was n o l o n g e r a w a r e o f h e r b o d y h o o d does n o t m e a n t h a t h e r b o d y h o o d had disappeared. t h o u g h w h a t w e visualize m a y b e visible only t o t h e mind's e y e . w h a t we visualize still b e a r s relation to w h a t we h a v e s e e n w i t h o u r e y e s in. t h o u g h m a n y o f t h e m m i g h t r e m a i n u n t h e m a t i c and v a g u e in t h e b a c k g r o u n d at this m o m e n t . In fact. my bodily e x i s t e n c e as a h u m a n being does n o t end at t h e tip of my index finger.s t a g e p r o c e s s in w h i c h . t h e d i f f e r e n c e b e t w e e n t h e t w o types o f b o r d e r i s simply q u a n t i t a t i v e . t h a t n o m a t t e r w h e r e w e are w e a r e always i n s o m e s o r t o f r e l a t i o n s h i p t o s o m e t h i n g outside o u r skin.c o n t a i n e d . It w o u l d be a m i s u n d e r s t a n d i n g of t h e p h e n o m e n o n of b o d y h o o d as well as t h e p h e n o m e n a of Da-sein.c o n t a i n e d physical s t r u c t u r e e x i s t i n g in i t s e l f and of itself. t h e d i f f e r e n t w a y s in w h i c h t h e i r l o c a t i o n s at a given t i m e are d e t e r m i n e d . t h e n its b o r d e r s would b e t h e skin. t h e b o r d e r s of the h u m a n b o d y would coincide w i t h t h e body's physical limits. p r e s e n t o r m e r e l y visualized r e ­ p r e s e n t e d o n e s . While perceiving the w i n d o w s i l l and m y c o n v e r s a t i o n a l p a r t n e r w i t h m y e y e s . s e c o n d l y . w i t h t h e s a m e i m m e d i a c y . b u t it is d e c e p t i v e . It is t h e o r e t i c a l l y possible to i m a g i n e the h u m a n body physically e x t e n d i n g t o s o m e w i n d o w t h a t p r e s e n t l y f o r m s the b o u n d a r y o f t h e optical field of my p e r c e p t i o n . T o this e c s t a t i c r e l a t i o n s h i p b e l o n g b o t h m y optical perception o f t h e o b j e c t and. m a t e r i a l b o d y .102 EXISTENTIAL FOUNDATIONS o b j e c t s . S h o u l d w e t h e n c o n c l u d e t h a t w e a r e c o n s t a n t l y b e y o n d o u r physical body's b o r d e r s . All my e x p e r i e n c e tells m e . B u t b o d y h o o d and its limits differ from t h o s e of a physical body n o t q u a n t i t a t i v e l y b u t qualitatively. W h e n I direct s o m e o n e t o w a r d a w i n d o w s i l l w i t h a g e s t u r e of my r i g h t h a n d . and n e v e r w h o l l y w i t h i n t h e m ? S u c h a c o n c l u s i o n is appealing. I am i n h e r e n t l y settled into t h e open space of my world to t h e e x t e n t t h a t I. If h u m a n b o d y h o o d w e r e a physical. Y e t t h e v e r y a s s u m p t i o n of this possibility c l e a r l y reveals t h a t t h e t w o types of b o r d e r s are fundamentally different. w i t h e v e r y t h i n g I am. bodily I r e a c h o u t e v e n f u r t h e r t h a n this to t o u c h all the p h e n o m e n a o f m y w o r l d . T h e fact is. initially. actually dwell in my perceiving r e l a t i o n s h i p to t h e windowsill. m y g e s t u r e t o w a r d it. h o w e v e r . m a t e r i a l m e d i u m t h r o u g h w h i c h can be s e n t . N o r is t h e g e s t u r e t o w a r d the w i n d o w s i l l t h e r e s u l t of a t w o . At best. this m i g h t allow us to d e t e r m i n e t h a t t h e b o r d e r s o f the h u m a n body e x t e n d b e y o n d t h o s e o f t h e physical body and t h a t . in isolation from t h e w o r l d . B o t h m a y p e r h a p s b e s t be d e s i g n a t e d as t h e bodying forth of this existential relationship. T h e s e c o n d i s t h e f u n d a m e n t a l dissimilarity o f t h e local c h a r a c t e r s o f e x i s t i n g h u m a n b e i n g s and i n a n i m a t e o b j e c t s . c o n s e q u e n t l y . 1 luman bodyhood is always the bodying forth of the ways ol being in . I e x t e n d m y s e l f bodily far b e y o n d this f i n g e r t i p t o t h a t windowsill. my o u t s t r e t c h e d a r m and index f i n g e r c o n s t i t u t e a s e l f . In this c a s e . We can n e v e r grasp t h e p h e n o m e n o n of b o d y h o o d if we c o n t i n u e to i m a g i n e it as a s e l f . s o m e flow o f m e n t a l o r e x i s t e n t i a l relating t h a t t r a n s c e n d s the physical a s p e c t of b o d y h o o d . we m a y t u r n to a p a r t i c u l a r s i t u a t i o n f r o m the life h i s t o r y o f o u r t e s t s u b j e c t .c o n t a i n e d physical body sitting in an a r m c h a i r disappeared. T h e y are in fact at a n y given t i m e identical. We know. Like e v e r y t h i n g else bodily. j u s t a s t h e r e can b e n o i n d e p e n d e n t l y e x i s t i n g t i m e . T o i l l u s t r a t e t h e special quality o f h u m a n b o d y h o o d a s t h e bodying f o r t h of t h e p o t e n t i a l w a y s of b e i n g t h a t m a k e up a h u m a n e x i s t e n c e at a n y g i v e n m o m e n t . t h e limits o f w h a t w e c o n c e p t u a l i z e as o u r physical b o d y usually r e m a i n fixed. S h e w a s e x i s t i n g as all eyes and e a r s for w h a t w a s being talked a b o u t . t h e h u m a n hand b e l o n g s so directly to h u m a n b e i n g .p r e s e n t e d r e s o r t and t o t h e peaceful s t a y s h e h o p e d t o h a v e t h e r e w i t h h e r friend. f u n d a m e n t a l . s h e s p a n n e d t h e A t l a n t i c O c e a n from h e r h o m e i n E u r o p e t o the warm waters of the Equator. she w a s n o static physical m a s s . I n c o n t r a s t t o t h e b o r d e r s o f h u m a n b o d y h o o d . T h u s . A t r e s t i n h e r a r m c h a i r .Fundamental Characteristics of Human Beings 103 w h i c h we are dwelling and w h i c h c o n s t i t u t e o u r e x i s t e n c e at any given m o m e n t . S h e was bodying f o r t h h e r p a r t i c u l a r r e l a t i o n s h i p t o t h e r e s o r t . N o w . n e r v e and s i n e w . t h o u g h t h e y are a l w a y s c h a n g i n g w i t h t h e fluid e x p a n s i o n and c o n t r a c t i o n o f m y r e l a t i o n s h i p t o t h e world. by way of comparison. and as she r e l a x e d in h e r a r m c h a i r she c h a t t e d w i t h him a b o u t v a c a t i o n plans. open r e a l m of p e r c e p t i o n . R e g u l a Z i i r c h e r and h e r friend had m o v e d i n t o h e r parlor for c o f f e e . T h e b o r d e r s o f m y b o d y h o o d coincide w i t h t h o s e o f m y o p e n n e s s to the w o r l d . how i m p o s s i b l e t h o u g h t f u l c o n v e r s a t i o n is at a cocktail p a r t y as the p a r t i c i p a n t s ' milling a b o u t bodies f o r t h t h e i r superficial a s s o c i a t i o n amid t h e trifles o f t h e i r social w o r l d . And j u s t as m a n ' s actual t e m p o r a l i t y e m e r g e s o n l y in t h e p a r t i c u l a r m o d e s of h u m a n e x i s t e n c e . w h i c h she visualized j u s t as it w a s to be s e e n . In fact. t h e n e v e n t h e least g e s t u r e of t h e h a n d can n e v e r be fully u n d e r s t o o d u n l e s s t h e hand is no l o n g e r r e g a r d e d as m e r e l y a p h y s i c a l i n s t r u m e n t m a d e of m u s c l e and b o n e . h e r bodily sitting b e l o n g e d so i n t i m a t e l y to h e r m o m e n t a r y r e l a t i o n s h i p t o t h e world t h a t h e r a w a r e n e s s o f h e r s e l f a s a s e l f .i n .c o n t a i n e d . s o his b o d y h o o d o c c u r s e x c l u s i v e l y a s t h e bodying f o r t h o f his e x i s t e n t i a l dwelling amid t h e b e i n g s t h a t a d d r e s s t h e m s e l v e s at a n y g i v e n time to his p e r c e p t i o n and r e q u i r e of him an a p p r o p r i a t e r e s p o n s e . at m o s t c h a n g i n g slightly w h e n w e gain o r lose w e i g h t . As a r e c e p t i v e . Y e t e v e n t h e s e a r e n o t simply m a t e r i a l p h e n o m e n a b u t bodily e v e n t s to be u n d e r s t o o d in c o n t e x t w i t h a c h a n g e d r e l a t i o n s h i p to t h e w o r l d . and final h u m a n b o d y h o o d . O n e day. It c a n n o t e x i s t e x c e p t as the bodying forth ol .t h e . e v e n t h e w a y s h e sat in the a r m c h a i r b e l o n g e d i m m e d i a t e l y t o h e r relaxed r e l a t i o n s h i p t o the visualized r e . t h e r e can be no s e l f .w o r l d t h a t it is d e t e r m i n e d in e v e r y t h i n g it is and does by h o w its o w n e r is relating to w h a t he is at t h a t m o m e n t e n c o u n t e r i n g . If th is is t h e real n a t u r e of h u m a n b o d y h o o d . S i g h t and h e a r i n g r a n g e f u r t h e r t h a n s m e l l . O n e kind o f e x p e r i e n c e m i g h t appear t o radically c o n t r a d i c t t h e s e findings on t h e bodying f o r t h of o u r e x i s t e n c e . B u t o u r r e l a t i o n s h i p t o w h a t w e p e r c e i v e varies with w h i c h of t h e s e n s e s is in o p e r a t i o n . we are in the . It is n o t the e x i s t e n c e o f o u r bodily s e n s e o r g a n s t h a t allows u s t o s e e . w e can h a v e and u s e such t h i n g s a s s e n s e o r g a n s only b y v i r t u r e o f t h e fact t h a t w e a r e e s e n t i a l l y r e c e p t i v e — seeing. W h e n I am blinded by an e x t r e m e l y b r i g h t light. s m e l l i n g . W h e n e v e r bodily pain o c c u r s . A l s o . Y e t . R a t h e r . f r i g h t e n e d by an u n b e a r a b l y loud e x p l o s i o n . t a s t e . B u t my sight (like my h e a r i n g ) o p e r a t e s at g r e a t e r d i s t a n c e s from t h i n g s t h a n m y t o u c h does. it s e e m s I am no l o n g e r u n a w a r e of my own b o d y h o o d . bodying f o r t h is i n h e r e n t l y s e t t l e d into space.w o r l d . and smell. h e a r i n g . a p e r s o n holding a glass ? While t o u c h i n g does n o t b r i n g a w a r e n e s s of t h e hand as s u c h . t o u c h .t h e . T h i s in t u r n a r g u e s t h a t h u m a n e x i s t e n c e is n o t spatial b e c a u s e it is bodily.104 EXISTENTIAL FOUNDATIONS active h u m a n r e l a t i o n s h i p s to t h e w o r l d . t o u c h i n g — c r e a t u r e s . In fact. B u t is this w h a t t h e y actually do? In m a k i n g this claim. T h e fact t h a t s i g h t e x t e n d s f u r t h e r t h a n t o u c h only c o n f i r m s t h a t b o t h a r e r o o t e d in t h e spatial relationships of h u m a n b e i n g . h a v e n ' t we fallen into the prejudice of t r e a t i n g the bodying f o r t h of o u r e x i s t e n c e as if it w e r e simply a physical body? It is significant t h a t t h e s e pains involve t h e p e r c e p t i o n of extremes w h i c h strain o u r bodily s e n s e p e r c e p t i o n s to t h e b r e a k i n g point. t h a t I am n o t at all a w a r e of my h a n d as a distinct area of the body but am perceiving m y s e l f as a w h o l e e n t i t y . W h e n I s e e a glass I do n o t p e r c e i v e my o w n e y e s . b u t t h a t s o m e t h i n g like b o d y h o o d can c o m e a b o u t o n l y b e c a u s e e x i s t e n c e (as e n t e r i n g i n t o close or d i s t a n t r e l a t i o n s h i p s to o b j e c t s ) is itself spatial. T h e y do n o t p e r m i t me to p e r c e i v e a n y t h i n g but t h e fact t h a t I am body. I do n o t perceive w i t h my e y e s t h e w a y I p e r c e i v e w i t h my f i n g e r s . it d o e s include a s e n s a t i o n of tangible c l o s e n e s s . I can see o n l y w h a t is in front of m e . and t o u c h . h e a r . my eyes or e a r s or f i n g e r s c a u s e me pain and m o v e into the f o r e g r o u n d as painful bodily o r g a n s .t h e . but w h e n I pick up a glass. and t o u c h t h i n g s . h e a r . or burn my finger on a tea k e t t l e . t a s t i n g . I feel n o t j u s t t h e glass but t h e h a n d w i t h w h i c h I pick it up as well.i n . t h e w o r l d w i d e perceiving o p e n n e s s w h i c h is the e s s e n t i a l o n t o l o g i c a l t r a i t of o u r being bodies i t s e l f f o r t h in the distinct o n t i c m o d e s in w h i c h we s e e . B y v i r t u e o f t h e fact t h a t i t b e l o n g s t o h u m a n b e i n g . r a t h e r . smell. it is endowed with the whole range of temporal-spatial-ecstatic relationships t o w h a t m a n e n c o u n t e r s .w o r l d . Put a n o t h e r w a y . it they do not actually d a m a g e t h e m .i n . C o n s e q u e n t l y . t a s t e . Even at r e s t a hand still bodies forth an act of r e s t . is it actually my hand t h a t is perceived in t h e p r o c e s s ? Isn't it. t a s t e . My e y e does n o t . W h i c h e v e r a n g l e w e take t o a p p r o a c h b o d y h o o d . free t i m e .d dissimilarity of t h e i r b o r d e r s but in where each is at a p a r t i c u l a r m o m e n t . and as long as he does. w h a t r o l e ? W h e n w e say t h a t s o m e o n e "is h e r e . with p h e n o m e n a that are "there.h e r e .h e r e . " h e r e " and " h e r e . since it is n e v e r open to perceiving a " t h e r e " — a s a p h e n o m e n o n w i t h p a r t i c u l a r s i g n i f i c a n c e — can n e v e r u n d e r s t a n d its " b e i n g . " but ' h e r e " i s n o t a l w a y s t h e s a m e place. my body on a chair and p r e s e n t i n t h e s a m e w a y a s t h e chair. T h e p e r s o n walking t o w a r d me m i g h t be t h i n k i n g j u s t n o w of a friend in S a n F r a n c i s c o . E x i s t e n c e is t h a t w h i c h bodies f o r t h .c o n t a i n e d and i n d e p e n d e n t l y p r e s e n t physical body. H u m a n b e i n g s can. " T h e q u e s t i o n is.h e r e " o n t h e basis o f t h e " t h e r e " o f b e i n g s t h a t reveal t h e m s e l v e s t o it. T h e r e f o r e w e shall hold o u r investigal ion of pain for o u r discussion of p a t h o l o g y .h e r e " is f u n d a m e n t a l l y different from t h e kind of p r e s e n c e n a t u r a l science a s s i g n s to bodies. In light of w h a t we h a v e said so far a b o u t t h e peculiar w a y in w h i c h h u m a n e x i s t e n c e is p r e s e n t in t i m e and space. and h u m a n b o d y h o o d s e e m s to play an e s s e n t i a l role in this " b e i n g . w e discover t h a t bodying f o r t h p r e s u p p o s e s p e r c e i v i n g and acting e x i s t e n c e . B u t this i m a g e r e f e r s n o l o n g e r to h u m a n " b e i n g . A c t u a l l y . h u m a n b o d y h o o d i s p h e n o m e n o logically s e c o n d a r y . N a t u r a l l y . it is n o t e n o u g h t o i n t e r p r e t h u m a n coexistence simply a s the a p p e a r a n c e . A h u m a n being is a l w a y s " h e r e " w i t h r e s p e c t to s o m e place. " o f physical h u m a n bodies. If he is e x i s t e n t i a l l y t h e r e and I am h e r e . and people dwell in their relationship to what they encounter. On the other hand. " his w h o l e e x i s t i n g a b s o r b e d in this r e l a t i o n s h i p to his friend in s u c h a w a y t h a t he e x t e n d s far b e y o n d the o b s e r v a b l e v o l u m e of his body a c r o s s an o c e a n . T h i s ' b e i n g . " o n l y to t h e p r e s e n c e of a s e l f . ' h e r e " is a l w a y s t h e dwelling place of t h e m o m e n t . he is o v e r " t h e r e .s p a c e — a m dwelling. t h e n . F o r h u m a n b e i n g s . I can i m a g i n e t h a t I am seated at a t a b l e . I am always " h e r e ." At a n y given m o m e n t my " h e r e " is defined by t h e " t h e r e " o f the beings at w h i c h las an open r e a l m of p e r c e p t i o n dwelling in an open. e n c o u n t e r i n g t h e m w h e r e t h e y a r e . n o t h i n g about pain a p p e a r s to c o n t r a d i c t o u r findings on b o d y h o o d in undisturbed e x i s t e n t e N o w . M e a n w h i l e . W e i n e v i t a b l y e n c o u n t e r c r e a t u r e s o f o u r o w n kind a m o n g all the t h i n g s we m a y c o m e upon.Fundamental Characteristics of Human Beings 105 s p h e r e o f d i s t u r b e d e x i s t e n c e . there is some ambiguity attached to the statement t h a t e v e r y h u m a n being is a l w a y s " h e r e " w i t h r e s p e c t to s o m e place. w h i c h . t h o u g h o u r s e n s e s tell us t h a t it is p r i m a r y . t h e n h o w and w h e r e do h u m a n b e g i n s c o e x i s t in the world? . " w e usually r e f e r his body's specific location in space and t h i n k of his p r e s e n c e at that location confined to t h e v o l u m e of space b o u n d e d by his skin. w e can s e e t h e radical d i f f e r e n c e b e t w e e n h u m a n bodyhood and t h e physical n a t u r e o f i n a n i m a t e o b j e c t s n o t o n l y i n t h e fundament. and no o n e has m a n a g e d e v e n t o o f f e r a n h y p o t h e s i s t o explain h o w s u c h p r o j e c t i o n could a r i s e in a s u b j e c t a s s u m e d to be originally w o r l d . No o n e c a n be l o n e l y w h o s e b e i n g is n o t ordinarily m a r k e d by a t o g e t h e r n e s s w i t h o t h e r s o f his kind. w i t h o u t a n y h y p o t h e t i c a l e m p a t h y . T h e f u n d a m e n t a l trait o f t h e existential coexistence of human beings appears in their jointly s u s t a i n i n g and m a i n t a i n i n g t h e o p e n n e s s o f t h e w o r l d t h e y c l e a r i n c o m m o n . but we have nevertheless reproduced t w o drawings in an a t t e m p t t o i l l u s t r a t e t h e decisive d i f f e r e n c e b e t w e e n t h e traditional psychological view o f m a n and his c o e x i s t e n c e a n d t h e e x i s t e n t i a l c o u n t e r p a r t o f this view. or i n t o w h a t this p r o j e c t i o n m i g h t b e p r o j e c t e d . T h e y could only try t o say s o m e t h i n g a b o u t t h e i m a g e each h a s in his isolated p s y c h e . L o n e l i n e s s a l w a y s p o i n t s b e y o n d i t s e l f t o s o m e c o e x i s t e n c e . so a h u m a n b e i n g also p e r c e i v e s o t h e r people directly. each c o n s i s t i n g o f a strictly delimited and spatially localized p s y c h i c or c o n s c i o u s capsule in w h i c h r e p r e s e n t a t i o n s o f o b j e c t s o f t h e e x t e r n a l w o r l d are m i r r o r e d .106 EXISTENTIAL FOUNDATIONS Human coexistence in a shared world T h e h u m a n c a p a c i t y to be l o n e l y is a g o o d point to s t a r t f r o m in understanding the inherent coexistence of h u m a n beings in their shared w o r l d . I n t h e s a m e w a y i n w h i c h o b j e c t s r e v e a l t h e i r i d e n t i t i e s and m e a n i n g fulness directly in t h e o p e n n e s s of h u m a n e x i s t e n c e . B u t no o n e has y e t actually s u b s t a n t i a t e d t h i s claim w i t h p r o o f . It is c a r r i e d o u t in s h a r e d w a y s of p e r c e i v i n g and r e s p o n d i n g to whatever is commonly encountered. t h e y r e v e a l o n l y t h a t t h e y are j o i n t l y and i n h e r e n t l y dwelling i n t h e s a m e r e l a t i o n s h i p t o t h e c o m m o n o b j e c t s o f t h e i r s h a r e d world. w h e n people are t o g e t h e r . and h u m a n l o n e l i n e s s e x i s t s o n l y a s p r i v a t i o n o f m a n ' s p r i m a r y t o g e t h e r n e s s w i t h o t h e r s .l e s s . I f h u m a n e x i s t e n c e a c t u a l l y w e r e m a d e a l o n g s u c h lines. T h e fact i s t h a t . P s y c h o l o g i s t s do claim t h a t it is self-evident that the c o n s c i o u s n e s s . B u t in t h e p h e n o m e n a of collective h u m a n b e h a v i o r t h e r e i s n o e v i d e n c e o f individual p s y c h e s h a v i n g dialogues a b o u t e n d o p s y c h i c m a t e r i a l . i t would b e impossible for people t o discuss t h i n g s w i t h i m m e d i a t e r e c o g n i t i o n o f w h a t i s b e i n g discussed. T h i s e x i s t e n t i a l c o e x i s t e n c e in a s h a r e d w o r l d s h o u l d n o t be p i c t u r e d as s o m e kind o f c o l l e c t i v e p r e s e n c e o f individual s u b j e c t s . i m m e d i a t e l y and automatical­ ly. but simply b y v i r t u r e o f t h e fact t h a t all a r e b e i n g s o f t h e s a m e kind w h o dwell t o g e t h e r i n t h e i r u n d e r s t a n d i n g r e l a t i o n s h i p s t o t h e s a m e phenomena which shine through the world-openness they sustain in common.i m m a n e n t representations of the e x t e r n a l w o r l d are p r o j e c t e d o u t w a r d again. It is difficult to give e v e n an a p p r o x i m a t e g r a p h i c r e p r e s e n t a t i o n of this existence. . 5: External world. 2b Brain of her lover. 6: Light stimuli of t h e external-world object. Brain of Regula Zürcher. lb Body of her lover. in Regula Zürcher. Psyche of Regula Zürcher. 7: External-world object. la 2a 3a 4a .Fundamental Characteristics of Human Beings 107 SUBJECTIVISTIC REPRESENTATION OF THE INTERPERSONAL DIALOGUE Body of Regula Zürcher. 8a b : S p e a k i n g b a c k and f o r t h (dia-logue) o f R e g u l a Z i i r c h e r and h e r l o v e r a b o u t t h e i r s e p a r a t e e n d o p s y c h i c r e p r e s e n t a t i o n s o f the external-world hotel. 3b Psyche of her lover. Endopsychic representation 4b Endopsychic representation of the external-world hotel of the external-world hotel in h e r l o v e r . c l e a r e d r e a l m o f p e r c e p t i v e and r e s p o n s i v e o p e n n e s s t o t h e w o r l d o f p h e n o m e n a a s localized p r e s e n c e s . 5 . +++ C r o s s e s i n d i c a t e t h e l o v e r ' s e c . T h e couple's t h e m a t i c being t o g e t h e r a t t h e i r r e s o r t h o t e l i n t h e C a n a r y Islands. buildings. in t h e f o r m of a p e r c e p t i v e visualization of this object. . in t h e s e n s e o f a n open and p e r c e p t i v e b e i n g a t w h a t h e e n c o u n t e r s . C i r c l e s indicate R e g u l a Z i i r c h e r ' s o p e n a n d p e r c e p t i v e b e i n g a t what she encounters. ooo T h e varied t h i c k n e s s e s o f t h e c r o s s e s and circles indicate m o m e n t a r y variations in the existential closeness of relation­ ships to w h a t is p r e s e n t in t h e s h a r e d w o r l d . 4 .s t a t i c dwelling in t h e w o r l d . 6 : T h e lovers' being t o g e t h e r with the sense-perceptible street-car. t h e m o d e of this r a n g e s f r o m a s c a r c e l y n o t i c e d c o m m o n p e r c e p t i o n t o totally u n t h e m a t i c a w a r e n e s s o f them. Hiddenness.108 EXISTENTIAL FOUNDATIONS 5 OPTIMAL EXISTENTIAL SKETCH OF HUMAN EXISTENCE AS PRIMARY BEING TOGETHER AT THE COMMON OBJECTS OF A SHARED WORLD 1: 2: 3: T h e existence of Regula Z u r c h e r and the existence of her lover as t h e j o i n t l y s u s t a i n e d . and sidewalk. T h i s e s s e n t i a l c o e x i s t e n c e is t h e basis n o t only o f o u r j o i n t u n d e r t a k i n g s w i t h t h e t h i n g s o f o u r world but of every sort of relationship among human beings themselves. For example. The question of mood (attunement) We have seen that existence is essentially an o p e n n e s s to perceiving w h a t e v e r e n t e r s t h e r e a l m o f this o p e n n e s s . i t would b e difficult t o u n d e r s t a n d h o w t h e s a m e c a u s e (the s a m e m a n ) could have produced t h e radically d i f f e r e n t e f f e c t o f c a t a s t r o p h i c a n x i e t y b e f o r e I h e . now enjoying great popularity. " w h i c h d e r i v e s f r o m a G r e e k w o r d t h a t m e a n s "a being's r e v e a l i n g i t s e l f . a n y s t a t e m e n t a b o u t sociological p h e n o m e n a is left h a n g i n g in thin air. If the l o v e r h i m s e l f w e r e a c t u a l l y t h e c a u s e o f h e r h a p p i n e s s . S i n c e h e r happy m o o d e x i s t e d a l r e a d y as an i n n a t e p o t e n t i a l of h e r b e i n g . and. T h i s f u n d a m e n t a l . accessible to psychological description. and free. always concerns itself—consciously or u n c o n s c i o u s l y — w i t h this o n t o l o g i c a l p h e n o m e n a of e x i s t e n c e . n e i t h e r a world n o r a n y t h i n g in a world. clear.Fundamental Characteristics of Human Beings 10' I It is n o t o n l y m e d i c i n e t h a t n e e d s to see this p r i m a r y t o g e t h e r n e s s ol h u m a n beings around the objects of their shared world. B e c a u s e h u m a n e x i s t e n c e i s b y n a t u r e a n o p e n and c l e a r r e a l m o f u n d e r s t a n d i n g . s h i n e s f o r t h w i t h i n it. this p r i m a r y t o g e t h e r n e s s is explicitly t h e sole b a s i s of s o c i o l o g y . Sociology. S h e could b e joyful o n l y in so far as t h e possibility of a happy. Supplementary c a u s e s h a v e no part in p r o d u c i n g d i s p o s i t i o n s . I n t o this a being can s h i n e forth as " p h e n o m e n o n . t h e possibility w a s c a r r i e d to fulfillment. " T h e r e is no s u c h t h i n g as an initially u n a t t u n e d e x i s t e n c e in w h i c h a disposition of s o m e kind simply a r i s e s n o w and t h e n through the intrusion of some internal or external cause." of " p r e s e n t " p r e s u p p o s e s an open r e a l m . T h e " p r e . " o n t i c . " W i t h o u t this r e a l m o f p e r c e p t i v e o p e n n e s s — a s w h i c h h u m a n being is e n g a g e d — n o t h i n g at all could b e . or m o o d s . in the jargon of p h i l o s o p h y . and u n l e s s e a c h m o d e of o n t i c social b e h a v i o r is s e e n in r e l a t i o n to the p r i m a r y c o e x i s t e n c e o f h u m a n b e i n g . and s o c o m e s to be p r e s e n t as a b e i n g w i t h its o w n m e a n i n g f u l n e s s . B e i n g as p r e s e n c e is n o t possible e x c e p t i n t o a r e a l m t h a t is p e r c e p t i v e l y o p e n . w h e t h e r t h e y a r e dealing w i t h e a c h o t h e r a s useful o b j e c t s o r e x p r e s s i n g s o m e f o r m o f love o r h a t e t o w a r d e a c h o t h e r . it is i n h e r e n t l y attuned in s o m e w a y or o t h e r . it did n o t need to be p r o d u c e d or e f f e c t e d . All t h e d i s p o s i t i o n s . of w h i c h a p e r s o n is c a p a b l e a r e given to him i n n a t e l y as e x i s t e n t i a l possibilities and as s u c h a r e a l w a y s m a k i n g up his e x i s t e n c e . o n t o l o g i c a l c h a r a c t e r i s t i c o f a t t u n e m e n t m a k e s i t possible for e x i s t e n c e to be p e r m e a t e d a l w a y s by s o m e d i s p o s i t i o n t h a t is demonstrable. spirited a t t u n e m e n t had a l w a y s b e l o n g e d to h e r . In fact. even the happy mood into which Regula Z u r c h e r c a m e w h e n s h e m e t h e r l o v e r w a s n o t c a u s e d b y t h e e n c o u n t e r . In the s u r p r i s e e n c o u n t e r . T h i s o v e r l o o k s i m p o r t a n t d i f f e r e n c e s . All t h a t e x i s t s for a p a r t i c u l a r p h e n o m e n o l o g y of m o o d s . w e o u r s e l v e s can only give a f e w clues c o n c e r n i n g a possible d i f f e r e n t i a t i o n . E v e r y a t t u n e m e n t as a t t u n e m e n t is a particular m o d e of t h e p e r c e p t i v e o p e n n e s s o f o u r e x i s t e n c e . An agitated person " t a k e s leave of h i m s e l f " and is t h e n "beside h i m s e l f . is v i b r a t i n g . e m o t i o n s . that s o m e o n e is beside h i m s e l f w i t h j o y . a f f e c t s us. t h e s e n e v e r appear a s isolated s e l f . t h e y a r e particular m o d e s in w h i c h h u m a n e x i s t e n t i a l a t t u n e m e n t is fulfilled. Y e t both are called feelings. W h e n we say " h a t e . t h e v a r i o u s s h a d i n g s of e x i s t e n c e w e r e crudely g r o u p e d a s " a f f e c t i v i t y . s o b r i e t y and e q u a n i m i t y . or r e c e p t i v i t y . Each predicates the o t h e r . . B u t i n t h e m e a n t i m e h e r r e l a t i o n s h i p t o the world had b e c o m e free and o p e n e n o u g h to let t h e i n n a t e possibility of a happy m o o d be realized. and s t a t e s are the c o n c r e t e m o d e s in w h i c h the possibilities for being o p e n are fulfilled. brightness or obscurity of that existence. " T h e d i s t i n c t i o n s a m o n g t h e m w e r e n o t scientifically m a i n t a i n e d . o u r s e l v e s and o t h e r people. " we r e f e r to a passion. for i n s t a n c e .c o n t a i n e d e n d o p s y c h i c e n t i t i e s o f t h e sort that a p e r s o n m i g h t have or p o s s e s s . T h e prevailing a t t u n e m e n t i s a t any given time the c o n d i t i o n o f o u r o p e n n e s s for perceiving and dealing w i t h w h a t we e n c o u n t e r . the pitch at w h i c h o u r e x i s t e n c e . W h a t we call m o o d s . Like m o o d s and dispositions. W h a t e v e r its m o m e n t a r y a t t u n e m e n t . for i n s t a n c e . W h e n e v e r w e s e e s o m e o n e e n t e r a p a r t i c u l a r m o o d . b o r e d o m and a n x i e t y . but also o u r e m o t i o n s . as a set of r e l a t i o n s h i p s to o b j e c t s .110 EXISTENTIAL FOUNDATIONS y o u n g w o m a n ' s r e c o v e r y . O p e n n e s s . and the s e c o n d e n c o u n t e r with t h e y o u n g m a n ended i n t h e m a n i f e s t a t i o n o f happy a t t u n e m e n t . e m o t i o n s and feelings are a f e w t e n t a t i v e s t a t e m e n t s . w h a t we are actually w i t n e s s i n g is o n l y a r e a t t u n e m e n t of his e x i s t e n c e from an old r e i g n i n g disposition into a new one. In traditional medical r e s e a r c h . t h e o p e n n e s s t h a t i s o u r e x i s t e n c e a l w a y s d e t e r m i n e s a s well the particular breadth or narrowness. A n g e r is not s o m e t h i n g t h a t can be put on or taken o f f at will. It a s s a u l t s us. falls upon us. But i n t h e e s s e n t i a l a t t u n e m e n t o f o u r e x i s t e n c e are r o o t e d n o t o n l y the manifold p a r t i c u l a r o n t i c m o o d s and dispositions of h a p p i n e s s and s o r r o w . and in the f r a m e w o r k o f this g e n e r a l f o u n d a t i o n for m e d i c i n e . o u r feelings and a f f e c t s . d i s t o r t e d . T h e y are at the s a m e time t h e m o d e s in w h i c h this p e r c e p t i v e o p e n n e s s can be n a r r o w e d . is called an affect. its a t t a c k t r a n s p o r t i n g us in such a way t h a t we are no l o n g e r m a s t e r s of o u r s e l v e s . feelings. can e x i s t only in c o n j u n c t i o n w i t h r e s t r i c t i o n . It can t h e r e f o r e be said t h a t e v e r y r e s t r i c t i o n is a p a r t i c u l a r privation of o p e n n e s s . or closed off. i n d i f f e r e n c e . A n g e r . " We say. a f f e c t s . blind. a n e x i s t e n c e is o p e n to t h e p e r c e p t i o n of p h e n o m e n a only in limited w a y s . o n t h e o t h e r hand. e v e n i n its c o n c e n t r a t e d a t t u n e m e n t t o love o r h a t e . " i t s vision so impaired in t h e p r o c e s s that it can n o l o n g e r d i f f e r e n t i a t e b e t w e e n the l e t t e r w r i t t e r and the l e t t e r carrier." a s s u m i n g w i t h its o b j e c t i f i c a tion of h u m a n b e i n g s t h a t a f f e c t i v e e x c i t a t i o n s are e n t i t i e s p r e s e n t in t h e p s y c h e of t h e a n g r y p e r s o n and have spread or " i r r a d i a t e d " like an electrical field from t h e i r actual c e n t e r . a s g r e a t l o v e r s and h a t e r s we a r e especially w i s e and p e r c e p t i v e w i t h regard to c e r t a i n qualities. Ill definition. to its deliverer. or j o y and love are d i s t i n g u i s h e d not o n h SI different a f f e c t s . shifts to b e c o m e "beside i t s e l f . having no feeling for a d v e r s i t y . o u r being is m u c h m o r e with t h a n beside itself. H a t e can e r u p t suddenly i n t o an a c t i o n . T r a d i t i o n a l p s y c h o l o g y t r i e s t o explain a w a y this s o r t of t h i n g as " a f f e c t i v e irradiation. It is well k n o w n h o w s e n s i t i v e p a r a n o i d h a t r e d is to e v e n t h e m o s t subtle s t i r r i n g s i n o t h e r s .l a d e n individual has lost a c l e a r vision of t h e significant m e a n i n g s a d d r e s s i n g him in his world. O n the c o n t r a r y . as the realm of p e r c e p t i o n it is. tin a t t a c k o f h a t e i s quite unlike t h a t o f a n g e r . And people p a s s i o n a t e l y in love have a special s e n s e for t h e hidden g o o d n e s s and b e a u t y . in its a t t u n e m e n t to h a t e . and o t h e r sudden. "beside h i m s e l f . T h u s t h e r e is blind h a t r e d . It w a s a p p a r e n t l y n o t so r a r e o n c e for kings to h a v e b e a r e r s of bad tidings s u m m a r i l y e x e c u t e d . but o n l y b e c a u s e it h a s had us u n d e r a t t a c k for a long t i m e . In its a t t u n e m e n t . or u n k i n d . forceful a f f e c t s . W h a t actually h a p p e n s with the a n g r y king is t h a t his e n t i r e e x i s t e n c e . T h e fact t h a t h u m a n being is c o n s t a n t l y c o n c e n t r a t e d in its a t t u n e m e n t t o t h e p a s s i o n s o f g r e a t love o r g r e a t h a t e does n o t m e a n that the h u m a n being b e c o m e s closed off. t h e p o t e n t i a l h u m a n r i c h n e s s . t h e y d e m a n d m o r e pie. h a t e is n o t p r o d u c e d at will and it t o o seems to o v e r c o m e us like an a t t a c k of a n g e r . can n e v e r b e beside t h e m s e l v e s w i t h a n g e r . Like a n g e r . C >ui w h o l e being is c o n c e n t r a t e d in its a t t u n e m e n t to a p a s s i o n like love and a l s o . B u t b e c a u s e of its a t t u n e m e n t . T h e a n g r y p e r s o n . in a c e r t a i n s e n s e . w h o r e c o g n i z e t h e s e feelings a s u n f r i e n d l y . B u t t h i n g s like e l e c t r i c a l fields. " loses all s e n s e of p r o p o r t i o n w i t h r e g a r d to t h e o p e n or closed p e r c e p t i o n w h i c h is t h a t self. o f t h o s e t h e y love. o v e r p o w e r i n g a n g e r . 3 N o w . w h i l e t h e r e v e r s e is t r u e c o n c e r n i n g i m m o d e r a t e p l e a s u r e . People w h o h a t e p a s s i o n a t e l y are no l o n g e r r e s p o n s i v e to . As long as he is furious or i n f a t u a t e d t h e a f f e c t . or e v e n h o s t i l e . t h e writer of t h e l e t t e r .Fundamental Characteristics of Human Beings B u t if a n g e r and h a t e . for t h e f u n d a m e n t a l c h a r a c t e r i s t i c of o u r being is an o p e n n e s s to p e r c e p t i o n and this is j u s t w h a t is in s o m e w a y c o n c e n t r a t e d in t h e p a s s i o n s . b u t as a f f e c t s and p a s s i o n s . C o n v e r s e l y . r e v e a l s i t s e l f to an e x i s t e n c e so a t t u n e d as a p r o c e s s of being b r o u g h t b e f o r e a void. e x i s t e n c e is c o n c e r n e d w i t h its o w n p o w e r . a n o t h e r basic s t a t e o f h u m a n being. For i n s t a n c e . A n x i e t y in . h e r e x i s t e n c e m e r g e s s o m u c h i n t o t h e i r being t o g e t h e r . of being t h r o w n back e n t i r e l y upon itself. H e r e x i s t e n c e is so w r a p p e d up in h e r r e l a t i o n s h i p to h e r child. T r a d i t i o n a l p s y c h o l o g y o f t e n m a k e s a d i s t i n c t i o n b e t w e e n realistic. In h a t r e d . S u c h a s e r e n i t y is a c l e a r n e s s and o p e n n e s s in w h i c h a h u m a n being is emotionally connected to everything he meets.112 EXISTENTIAL FOUNDATIONS t h e good side o f w h a t e v e r t h e y h a t e . B u t i n the very act of e n t e r i n g into its possibilities. s h e i s a n x i o u s a b o u t t h e d e s t r u c t i o n o f h e r s e l f . s o m e o n e w h o i s p a s s i o n a t e l y in love t e n d s to o v e r l o o k ugly a s p e c t s of the beloved p e r s o n o r t h i n g . D e a t h . i n n e r i n s t i n c t i v e a n x i e t y . e x t e i nal a n x i e t y and an u n r e a l i s t i c . a n x i e t y e x p o s e s t h e n e c e s s i t y of d e a t h o n l y as the possibility o f n o l o n g e r being h e r e . wanting n o t to h a v e t h i n g s in his o w n p o w e r b u t c o n t e n t to let t h e m be and develop on t h e i r o w n . A n o t h e r m a j o r e m o t i o n a l m o d e is a c o m p o s e d . R e m e m b e r t h a t e x i s t e n c e c o n s i s t s solely in its possibilities for r e l a t i o n s h i p s . j o y o u s s e r e n i t y o p e n s a h u m a n being t o t h e b r o a d e s t possible r e s p o n s i v e n e s s . F o r e v e r y h u m a n e x i s t e n c e is by i t s e l f a t t u n e d to happiness w h e n e v e r all its i n n a t e p o t e n t i a l w a y s of being stand o p e n to it. t h a t b r e a k i n g this r e l a t i o n s h i p would b e t a n t a m o u n t t o d e s t r o y i n g h e r e x i s t e n c e . i n e i t h e r o f t h e s e s t a t e s . A n x i e t y is t h e a t t u n e m e n t in w h i c h e x i s t e n c e is b o t h o p e n e d up and r e s t r i c t e d to perceiving t h e possibility of losing its hold on all o t h e r being. e x i s t e n c e e n t e r s d a n g e r . A n e x i s t e n c e free t o e n g a g e i t s e l f i n s u c h a n a t t u n e m e n t can a c c e p t s e r e n e l y e v e n t h e possibility o f its o w n d e a t h . t h e s u r e s t o f all realities. A p a s s i o n a t e l y loving e x i s t e n c e s e e s in t h e loved o n e t h e p o t e n t i a l for a t o g e t h e r n e s s t h a t would o f f e r a m u c h g r e a t e r s t o r e of h u m a n possibilities t h a n its o w n single e x i s t e n c e could e v e r c o m p o s e by itself. e v e n w h e n a m o t h e r fears n o t for h e r o w n life b u t for h e r child's. B e c a u s e this c o m p o s e d . an e x i s t e n c e e x p e r i e n c e s a n y t h i n g t h a t s t a n d s in t h e w a y of its p o w e r as an o b s t r u c t i o n to be o v e r r i d e n and d e s t r o y e d . T h e m a s k i n g p r o c e s s c o m m o n t o p a s s i o n a t e h a t e and p a s s i o n a t e love p r e s u m a b l y d e r i v e s f r o m t h e fact t h a t . t h e void appears no l o n g e r an e m p t y n o t h i n g n e s s but a void so a b u n d a n t l y rich t h a t all being could issue f r o m it. and c e a s i n g to be. i t c o n s t i t u t e s h a p p i n e s s as well. j o y o u s s e r e n i t y . T h u s people w h o arc" m o s t afraid of death a r e t h o s e w h o h a v e t h e g r e a t e s t a n x i e t y about life. In c o n t r a s t to s e r e n i t y . In this u n d e r s t a n d i n g s e r e n i t y differs m o s t p r o f o u n d l y from a n x i e t y . o f perishing i n t o e m p t i n e s s . To this e x i s t e n c e . It can give h u m a n e x i s t e n c e t h e kind of r e c e p t i v i t y t h a t allows it to see in the b r i g h t e s t light t h e m e a n i n g f u l n e s s and c o n n e c t i o n s o f e v e r y p h e n o m e n ­ on t h a t r e v e a l s itself. in total isolation. for e x i s t e n c e e x h a u s t s itself in t h e c o u r s e of e x i s t i n g . u n r e a l i s t i c i n s t i n c t i v e a n x i e t y . w h a t is s o r r o w e d for c o m e s close to the s o r r o w i n g p e r s o n in a p a r t i c u l a r w a y . y e t e v e n m i s u n d e r ­ stood t o this e x t e n t t h e t h i n g r e m a i n s a n actual p h e n o m e n o n o u t s i d e i n the w o r l d . h o w e v e r . W h a t h a p p e n s h e r e i s t h a t t h e " o u t e r r e a l i t y " is m i s t a k e n u n d e r the i n f l u e n c e of a s t a t e of a n x i e t y t h a t r u n s t h r o u g h the v e r y f o u n d a t i o n s o f a n e x i s t e n c e . or d e a t h . M o r e o v e r . E x i s t e n c e is a t t u n e d to t r u e s o r r o w w h e n it e x p e r i e n c e s a b r e a k or r u p t u r e in its r e l a t i o n s h i p to a c l o s e h u m a n a c q u a i n t a n c e o r s o m e c h e r i s h e d o b j e c t . n e i t h e r is it e g o c e n t r i c self-pity. n e u r o t i c . all a n x i e t i e s a r e realistic a n x i e t i e s . E n e r g y i s e n t i r e l y w i t h o u t vision. and n o m e r e e n e r g y can c o m p r e h e n d a n y t h i n g in its significance as s o m e t h i n g d a n g e r o u s . t h e e g o w a s m a d e the seal of a n x i e t y and e v e r y a n x i e t y t h e n b e c a m e a kind of w a r n i n g to t h e e g o ol s o m e d a n g e r facing it. a n e u r o t i c fear of mice is n o t a w a r n i n g signal d e s i g n e d to m a k e t h e e g o a w a r e of s o m e d a n g e r o u s unrealistic inner thing. inner anxieties as transformation p r o d u c t s of a c c u m u l a t e d i n s t i n c t s is precluded by t h e v e r y fact that i n s t i n c t s are b y definition c o m p o s e d o f psychic e n e r g y . w o u l d n o l o n g e r be t h e r e . T h e lear ol mice t h a t impels n u m b e r s of w o m e n i n t o panicked flight or o n t o chairs is an e x a m p l e of a so-called i n n e r . and t h e o b j e c t o f c o n c e r n i s t h e capability o f c o n t i n u e d e x i s t e n c e in a h u m a n w o r l d w h i c h is t h r e a t e n e d by t h e feared t h i n g . this q u e s t i o n does n o t t o u c h at all on the p h e n o m e n o n o f fearing mice a s s u c h . It is a l w a y s s o m e t h i n g a c t u a l t h a t is feared.Fundamental Characteristics of Human Beings the face of an a t t a c k by a rabid dog w o u l d qualify as realistic. Y e t a n x i e t y p r e s u p p o s e s and is based upon a p e r c e p t i o n of s o m e t h i n g like d a n g e r . a n e x i s t e n c e m a y i n t e r p r e t s o m e t h i n g h a r m l e s s as a dire t h r e a t . But the existence of unrealistic. L a t e r . b u t i m p o r t a n t as it is. a n n o y a n c e . S o r r o w as a p o t e n t i a l w a y of being in h e a l t h y people is n o t to be c o n f u s e d w i t h pathological f o r m s o f d e p r e s s i o n — d i s c o n t e n t . h o p e l e s s n e s s and t h e petrified v a r i e t i e s — w h i c h will be discussed later on. T h e r u p t u r e perceived in s o r r o w c o n c e r n s s o m e actual p a r t i c u l a r m o d e o f being w i t h t h e o b j e c t which the . t h a t t h i n g would simply h a v e fallen o u t o f t h e w o r l d and b e e n f o r g o t t e n . It is a fear of a n e x t e r n a l and real m o u s e . H o w e v e r t h e y m a y a r i s e . " In s o r r o w . b u t t h e o b j e c t o f s o r r o w i s not lost w i t h this r u p t u r e . T h i s i n s t i n c t i v e a n x i e t y was first t h o u g h t to be a d i r e c t product ol the t r a n s f o r m a t i o n o f a c c u m u l a t e d libido. 4 O u r final e x a m p l e o f basic h u m a n s t a t e s i s t h e m o o d o f s o r r o w . I n this a t t u n e m e n t . I f t h e c a p a c i t y t o b e w i t h t h e o b j e c t o f s o r r o w w e r e really b r o k e n o r r u p t u r e d t o t h e e x t e n t t h a t t h e r e l a t i o n s h i p was d e s t r o y e d a l t o g e t h e r this s o r r o w a t loss could n o t arise. An e n t i r e l y d i f f e r e n t p r o b l e m is c o n t a i n e d in t h e s e a r c h for biographical f a c t o r s t h a t m i g h t e l u c i d a t e w h y a n e x i s t e n c e h a s b e e n r e s t r i c t e d t o t h e single basic s t a t e o f fearing a n i m a l i t y i n t h e f o r m o f m i c e . G o n e i s t h e possibility o f e v e r again being w i t h and at t h a t o b j e c t . As novel as this p r e l i m i n a r y p h e n o m e n o l o g i c a l description of m e m o r y may s e e m to us today. n o r e n g r a m t r a c e s o f s e n s e i m p r e s s i o n s o f t h e kind w h i c h can b e a s c e r t a i n e d physiologically i n t h e b r a i n ' s s u b s t a n c e . S o r r o w p e r v a d e s h u m a n e x i s t e n c e . t o o b j e c t s o f the s u r r o u n d i n g w o r l d . in m i n d and body. it actually relies on i n s i g h t s predating all . T h e b r e a k i n g . or does bodily pain depend. on s o r r o w . i n t h e c o u r s e o f a n a l y s i s . T h e close k i n s h i p b e t w e e n bodily pain and s o r r o w is e x p r e s s e d in calling s o r r o w " h e a r t b r e a k . A medical s t u d e n t failing t h e s t a t e e x a m t h r e e t i m e s will m o u r n a lost o p p o r t u n i t y for a n e w m o d e of being. Injuries t o the body are e x p e r i e n c e d as bodily pain. Human memory and the historicity of human existence W e first e n c o u n t e r e d t h e issue o f r e t e n t i o n o f e a r l i e r p e r c e p t i o n i n o u r discussion o f t h e v a r i o u s m o d e s o f p r e s e n c e . and t o the a b s o l u t e can also e m p h a t i c a l l y affect t h e b o d y h o o d o f a n e x i s t e n c e . until w e c o m e t o talk a b o u t t h e pathological p h e n o m e n a o f e x i s t e n c e . a s w e p o s t p o n e d t h e topic o f bodily pain. H e a v y d a m a g e is done to t h e e x i s t e n c e of a lover w h o s e p a r t n e r has died. t h e r e t h a t w h a t i s r e t a i n e d in m e m o r y is n e i t h e r a series of e n d o p s y c h i c r e p r e s e n t a t i o n s of e x t e r n a l o b j e c t s . " in t h e "pain and s o r r o w " o f a n g u i s h . Will s o r r o w — i n n e r pain b e u n d e r s t o o d o n t h e basis of bodily pain. and d a m a g i n g o f e x i s t e n t i a l r e l a t i o n s h i p s t o o t h e r people. r a t h e r . n o m a t t e r h o w o f t e n it is d r o w n e d o u t . S u c h an e x i s t e n c e s u f f e r s a g r e a t r e d u c t i o n i n t h e n u m b e r o f r e l a t i o n s h i p s o n c e possible w i t h r e s p e c t t o t h e o b j e c t o f s o r r o w . or w h o has b e e n a b a n d o n e d for a n o t h e r . B u t h u m a n b e i n g s k n o w s o r r o w not o n l y i n t h e f o r m o f isolated pain­ ful e x p e r i e n c e s o f s e p a r a t i o n . the h u m a n e x i s t e n c e is in fact r u p t u r e d and b r o k e n in a c e r t a i n s e n s e . at t h e painful insight i n t o t h e finite limits o f e x i s t e n c e and its e s s e n t i a l s e p a r a t i o n from the a b s o l u t e and unconditional. r e n d i n g . for b e c o m i n g a d o c t o r . T h e y a r e the perceived e n t i t i e s t h e m s e l v e s w h i c h are r e t a i n e d a s t h e singularly m e a n i n g f u l p h e n o m e n a t h e y r e v e a l t h e m s e l v e s t o b e t e m p o r a r i l y and spatially w i t h i n t h e w o r l d l y r e a l m held o p e n by a h u m a n e x i s t e n c e .114 EXISTENTIAL FOUNDATIONS r u p t u r e n o l o n g e r a l l o w s . M a n y p a t i e n t s g o i n t o deep s o r r o w w h e n . While t h e bonds of the r e l a t i o n s h i p m a y b e c o m e m o r e i n t i m a t e t h a n e v e r i n t h e m o d e o f visualization. t h e y r e c o g n i z e t h e m u l t i t u d e o f possibilities lost f o r e v e r and t o r n a w a y from t h e i r e x i s t e n c e b e c a u s e t h e i r a c t u a l i z a t i o n had b e e n blocked in t h e past. t h e r e c o g n i t i o n o f a flaw r u n n i n g t h r o u g h t h e a b u n d a n c e o f r e l a t i o n a l possibilities? W e m u s t p o s t p o n e discussing this q u e s t i o n . T h e p h e n o m e n o n of m e m o r y plays no part in a n y visualization ol the h o m e as it n o w is. and n o t t h e i r i m a g e s . reveal t h e m s e l v e s directly to us f r o m t h e l o c a t i o n at w h i c h t h e y are p r e s e n t in t h e open r e a l m o f o u r w o r l d . m e m o r y is r e n d e r e d i n a c c e s s i b l e to scientific i n v e s t i g a t i o n as t h e p h e n o m e n o n it truly is. it e n t e r s in only il I visualize the p u r c h a s e ol the . m a t e r i a l . From the phenomenological p e r s p e c t i v e s t h e r e is a g r e a t d i f f e r e n c e b e t w e e n this and actually r e m e m b e r i n g e a r l i e r e v e n t s . B u t the a p p e a r a n c e o f c o n t r a d i c t i o n p e r s i s t s only if we p i c t u r e t h o u g h t as simply a c e r e b r a l p r o c e s s and t h o u g h t s t h e m s e l v e s a s c a r b o n copies o f e n t i t i e s w i t h i n t h e p s y c h e and r e m e m b e r i n g s o m e t h i n g as a r e a w a k e n i n g of e n d o p s y c h i c i m a g e s from t h e e n g r a m m a t i c . Even t h e n a t u r a l scientific w a y of t h i n k i n g is only a p a r t i c u l a r m o d e of l e t t i n g b e i n g s appear. s t r i c t l y speaking. t o g e t h e r w i t h all o f t h e i r m e a n i n g s and c o n n e c t i o n s . t h a t I h a v e p r e s e r v e d in my m e m o r y . If I am visualizing my c o t t a g e in the m o u n t a i n s . B u t t h e actual t h i n g s signified b y t h e s e s o u n d s I h a v e n e v e r g r a s p e d w i t h a n y o f m y physical s e n s e s n o r s e e n t h e m a n y w h e r e out t h e r e in f r o n t of my mind. Unless the notion of retention is understood existentially.Fundamental Characteristics of Human Beings c o n t e m p o r a r y n a t u r a l scientific t h e o r i e s o f m e m o r y . T h e first is t h e ability to visualize something that was once perceived but afterwards receded to become an uncontemplated. t h a t reduced w a y in w h i c h b e i n g s t e n d to reveal t h e m s e l v e s solely as c h a i n s of p r e s u m e d and calculable causal e f f e c t s . background presence. the word " m e m o r y " carries associations that seem to c o n t r a d i c t t h e facts o f t h e m a t t e r . I am n o t r e m e m b e r i n g it b u t am e x i s t i n g in s o m e r e l a t i o n s h i p to it in this visualizing w a y of b e i n g t h e r e w h e r e it is. " 5 Admittedly. I t s e e m s t o b e c o n n e c t e d w i t h recalling t o m i n d and r e t a i n i n g m e r e t h o u g h t . O r d i n a r i l y . M o r e t h a n fifteen h u n d r e d y e a r s a g o i n t h e W e s t e r n tradition A u g u s t i n e w r o t e i n the t e n t h b o o k of his Confessions: " a n d I k n o w t h a t t h e y [the s o u n d s t h a t c o m p r i s e words] a r e b l o w n a w a y w i t h t h e i r r e s o n a n c e s i n t h e w i n d and are n o m o r e . w h a t really h a p p e n s w h e n w e t h i n k and h a v e t h o u g h t s i s simply t h a t w e b e c o m e a w a r e o f c e r t a i n o f t h e p h e n o m e n a o f o u r world. t h e n . T h i n k i n g .s p a c e o f o u r w o r l d t o arise again t h e m a t i c a l l y .e n e r g e t i c s t r u c t u r e s o f t h e brain. B u t e v e n a n u n t h e m a t i c p r e s e n c e i s p r e s e n c e and can address t h e p e r s o n w h o r e t a i n s it as s o m e t h i n g of a particular meaning. i s allowing w h a t a d d r e s s e s u s t h r o u g h t h e o p e n n e s s o f t h e t i m e . T h e s e p h e n o m e n a t h e m s e l v e s . is s o m e t h i n g like buying it in 1 9 4 5 . T h e o n l y sort ol thing I could r e m e m b e r . t w o v e r y d i f f e r e n t h u m a n m o d e s o f b e i n g are indiscrimi­ n a t e l y a t t r i b u t e d to m e m o r y . and so it is t h e y t h e m s e l v e s . M o s t o f w h a t w e r e t a i n quickly r e c e d e s i n t o t h e b a c k g r o u n d o f n o n t h e m a t i c p r e s e n c e . A s a n y o n e can learn from his o w n e x p e r i e n c e . if at t h e close of a s t i m u l a t i n g e v e n i n g I leave my u m b r e l l a at a friend's h o u s e . A n y t h i n g n o t in t a n g i b l e p r o x i m i t y c a n n o t add r e s s me as a t h i n g to be t a k e n along. all that is k n o w n is t h a t r e c o l l e c t i o n is n o t in o u r p o w e r . it is a s s o c i a t e d with lethe. T h e m o d e o f its being present to me h a s ihanged . t h a t stands in o u r p o w e r ? " In Zarathustra we m a y read: " T h a t t h e r e is such a thing as f o r g e t t i n g h a s n e v e r b e e n p r o v e n . I c a n n o t really f o r g e t to t a k e it along. n o t e v e n t h e possibility of t a k i n g it along o c c u r s to m e . t h a t w h i c h r e m a i n s hidden. N o w . I h a v e n o t f o r g o t t e n it at all. for I r e m a i n a b s o r b e d . " T h e v a r i o u s labels this p h e n o m e n o n has w o r n in the course of history attest to the uncertainty of its n a t u r e . body and soul.116 EXISTENTIAL FOUNDATIONS h o m e as an act t h a t o c c u r r e d at s o m e definite time in t h e past. m o s t people would t h i n k m e guilty o f f o r g e t t i n g it. For t h e t i m e being. oblivisci: f o r g e t t i n g as a wiping o u t . I can t h i n k of it and p i c t u r e it to m y s e l f at a n y t i m e I c h o o s e . i t I I . T h e u m b r e l l a ' s p r e s e n c e h a s thus become so distant to me that it would not occur to me actually to pick it up and take it a l o n g . a notion unknown to the t h o u g h t o f classical G r e e c e . B u t i f f o r g e t t i n g is defined as h a v i n g t h e p r e s e n c e of t h e u m b r e l l a lost to t h e c o l l e c t i o n of o b j e c t s p r e s e n t in my w o r l d .illy p r e s e n t . B u t i n u n d e r s t a n d i n g m e m o r y w e m u s t also c o n s i d e r its deficient m a n i f e s t a t i o n w h i c h w e call " f o r g e t t i n g . ' as if f o r g e t t i n g m e m o r y w e r e j u s t a n o t h e r ability in o u r r e g i s t e r . To r e m e m b e r is to visualize a thing of t h e past as s o m e t h i n g e x p e r i e n c e d at that time. T h i s w o u l d n o t be possible u n l e s s t h e u m b r e l l a had r e m a i n e d in my world. t h o u g h it r e m a i n s m i l h c m . we h a v e filled this gap w i t h t h e w o r d f o r g e t . In classical G r e e k ." T h e q u i c k e s t w a y t o u n d e r s t a n d this p r o b l e m a t i c p h e n o m e n o n i s t o d i s t i n g u i s h a m o n g t h e diverse m o d e s o f b e i n g t h a t pass for f o r g e t t i n g . w h e n all is said and d o n e . In a c t u a l fact. I h a v e f o r g o t t e n n e i t h e r t h e u m b r e l l a i t s e l f n o r t h e possibility o f t a k i n g i t a l o n g . T h e G e r m a n v e r b ergessen ( " f o r g e t " ) is c o n n e c t e d w i t h t h e English " g e t . simply r e f e r s to t h e fact t h a t s o m e t h i n g is no longei c o n s i d e r e d t h e m a t i c a l l y in its p r e s e n c e . In Latin it is described by oblivo. T h e u m b r e l l a is simply an especially distant b a c k g r o u n d p r e s e n c e as I am leaving my friend. as it is used h e r e .prefix gives a n e g a t i v e twist to " g e t " so t h a t vergessen—like " f o r g e t " — m e a n s " n o t to k e e p . ut w h a t is t h e r e . As long as this t h i n g is n o t p r e s e n t as s o m e t h i n g to be t a k e n along. but o n l y t h a t t h e r e a r e m a n y t h i n g s w h i c h d o n o t occur to us when we want them to. N i e t z s c h e w r i t e s in Morgenr'dthe: "It has n o t been p r o v e n t h a t s u c h a thing as f o r g e t t i n g e x i s t s . F o r g e t t i n g . w i t h my friend and i n t h e topic o f o u r c o n v e r s a t i o n . t h o u g h its presence be unthematic. " " W i p e o u t " and " n o t k e e p " both set out from the standpoint of an ego. " T h e ver. My forgetting cannot be caused by the repression into an unconscious of my c o n c e p t i o n of t h e u m b r e l l a . H e r e . In this c a s e it is a deficiency in my ability to r e l a t e m y s e l f to a p e r s o n w i t h such and such a n a m e . According to psychoanalytic theory. T h e supposed u n c o n s c i o u s i n t e n t i s p r e s e n t e d r i g h t from t h e s t a r t as t h e cause w h i c h b r i n g s a b o u t t h e so-called faulty a c t i o n . B u t w h a t has the n a m e e s c a p e d f r o m ? E v i d e n t l y f r o m my capacity for a s s o c i a t i n g it with t h e p e r s o n . c o n s c i o u s l y o r u n c o n s c i o u s l y . T h e n a m e . T h u s I c a n n o t possibly be o c c u p i e d w i t h a desire to f o r g e t it so I m a y visit him again. thematically c o n s i d e r e d p r e s e n c e in a h u m a n r e a l m of o p e n n e s s to its n o n i m m e d i a t e and u n t h e m a t i c p r e s e n c e s o m e w h e r e i n t h e w o r l d . I n s t e a d it r e s t s on a h y p o t h e t i c a l a s s u m p t i o n t h a t h a s n o t h i n g t o d o w i t h t h e p h e n o m e n o n u n d e r i n v e s t i g a t i o n . as s u c h . F o r o n e t h i n g . h i d d e n . In o r d e r to f o r c e s o m e t h i n g inward. c o n s t i t u t e s a special f o r m of my o t h e r w i s e i n t a c t r e l a t i o n s h i p to a t h i n g . It is a n o t h e r kind of f o r g e t t i n g w h e n I lose t r a c k of t h e n a m e ol s o m e o n e I k n o w and c a n n o t c o m e up w i t h it. But more important is that from the very beginning the psychoanalytic a c c o u n t m a k e s n o e f f o r t t o explain t h e f o r g e t t i n g o f m y u m b r e l l a a s f o r g e t t i n g . I am close e n o u g h to my friend to visit w h e n e v e r I w i s h w i t h o u t a p r e t e x t . H e r e t h e t h i n g i t s e l f (in this c a s e . b u t w h a t c a u s e s a p h e n o m e n o n to o c c u r is a n y t h i n g but t h e p h e n o m e n o n itself. B u t this p s y c h o a n a l y t i c i n t e r p r e t a t i o n is u n c o n v i n c i n g . my forgetting of the umbrella would have been c a u s e d by an u n c o n s c i o u s i n t e n t to r e t u r n to see my friend again as s o o n as possible. no m a t t e r h o w hard I try. t h o u g h f o r g o t t e n . f o r g e t t i n g i s n o t h i n g more than the changing of a phenomenon's immediate. w h i c h i s t h e leaving b e h i n d o f m y u m b r e l l a . S u c h desire c a n n o t b e o p e r a t i n g a t t h a t m o m e n t . t h e n a m e ) e s c a p e s m e .Fundamental Characteristics of Human Beings B y c o n t r a s t . b e c a u s e my w h o l e being is occupied w i t h my friend and w i t h t h e topic o f t h e e v e n i n g ' s c o n v e r s a t i o n . and w h a t d e m a n d s e x p l a n a t i o n i s t h e p h e n o m e n o n itself. 1 w o u l d need to h a v e it w i t h i n my grasp. T h i s type of f o r g e t t i n g m a n i f e s t s a deficiency in my p e r c e p t i v e r e t e n t i v e capacity and. By leaving my u m b r e l l a b e h i n d . I am w i t h h i m . Y e t it is c l e a r t h a t w h i l e I am taking leave of my friend. p s y c h o a n a l y t i c t h e o r y e m p h a t i c a l l y m a i n t a i n s t h a t such an o c c u r r e n c e is a h i g h l y s i g n i f i c a n t f o r g e t t i n g of t h e u m b r e l l a and of the possibility of t a k i n g it a l o n g . as something. n o t w i t h my u m b r e l l a . S u c h p h e n o m e n a are s t a m p e d as i n s t a n c e s of faulty action (parapraxis) and t h e r e b y m a d e — l i k e all f o r g e t t i n g — effects of the repression of an unconscious desire. I w o u l d u n c o n s c i o u s l y h a v e c r e a t e d an e x c u s e for g o i n g b a c k for a visit right a w a y . is n e v e r t h e l e s s still k n o w n to me in a c e r t a i n s e n s e as s o m e t h i n g t h a t has escaped me. w h o m I still r e t a i n . T o the e x t e n t to w h i c h p r e s e n c e s escape me and I f o r g e t t h e m . h a v i n g revealed t h e m s e l v e s from t h e i r places in the w o r l d . which. t h a t it r e m a i n s c o n s t a n t l y p r e s e n t m the pi e s e n t . o n e t o w h i c h w e are given o v e r at all t i m e s . T h e o p e n n e s s o f h u m a n e x i s t e n c e c o n s i s t s o f t h e capacity for perceiving t h e p r e s e n c e and m e a n i n g f u l n e s s o f w h a t e v e r appears. It is an o c c u r r e n c e of o u r o p e n r e a l m o f p e r c e p t i v e b e i n g . and t h e s e r e l a t i o n s h i p s to w h a t is p r e s e n t in my e x i s t e n t i a l o p e n n e s s a r e j u s t w h a t m a k e u p m y e x i s t e n c e and m a k e m e w h a t l a m . T h i s is a far t o o limited n o t i o n of o u r r e t e n t i v e m e m o r y . e v e r y h u m a n being dwells in tradition and history H u m a n m e m o r y is this c o n s t a n t dwelling in t r a d i t i o n . t o o wrapped up in a s i n g l e . f o r g e t t i n g c a r r i e s w i t h i t t h e possibility t h a t u n d e r c e r t a i n c i r c u m s t a n c e s w h a t h a s fallen out can r e t u r n into t h e openness of my being-in-the-world. T h a t w h i c h has b e e n " l i v e s " o n t h e n . t o o a b s t r a c t . t h e n m e m o r y and visualization o f past t h i n g s m u s t also b e m o r e than simple r e t e n t i o n like a passive s t o r a g e of t h i n g s in a h o l l o w space t h a t is o p e n b u t e m p t y and u n i n v o l v e d . necessarily c o d e t e r m i n e s all f u t u r e b e h a v i o r . this " p a s t . my relationship to that thing is also lost.i n . but even this a w a r e n e s s o f h a v i n g s o m e t h i n g can w i t h d r a w . finished. t o g e t h e r w i t h the present. I am d i m i n i s h e d as a h u m a n e x i s t e n c e . H u m a n e x i s t e n c e is equally r e c e p t i v e to w h a t h a s b e e n perceived at s o m e f o r m e r time and has been r e t a i n e d . It is without exception the names themselves.w o r l d . It is p r e c i s e l y this a w a r e n e s s w h i c h lets me realize I h a v e f o r g o t t e n it. W h a t h a s o n c e b e e n p r e s e n t to a h u m a n e x i s t e n c e is n e v e r simply past. " p r e s e n t as h a v i n g b e e n . speaking into this p r e s e n t and c o d e t e r m i n i n g all p r e s e n t conduct o l t h e h u m a n . It does not involve t h e d i s p l a c e m e n t o f s o m e a s s u m e d e n d o p s y c h i c r e p r e s e n t a ­ tions o f e x t e r n a l . It . it c o n c e r n s t h e t h i n g s of my w o r l d .w o r l d o b j e c t s .o p e n n e s s as w h i c h I am e x i s t i n g . w e also f o r g e t s o m e t h i n g o f ourselves. \ VI HI I in he Is a w a r e of it or n o t . U n d e r s t o o d as t h e falling out of an e n t i t y ' s p r e s e n c e from my e x i s t e n t i a l r e a l m o f o p e n n e s s . lost. Like r e m e m b e r i n g . W h a t h a s b e e n is r e t a i n e d in the o p e n n e s s of the h u m a n Da-sein s o . h o w e v e r . i n the present ["hereby.118 EXISTENTIAL FOUNDATIONS from m e . E v e r y t i m e w e f o r g e t s o m e t h i n g . M e m o r y and r e t e n t i o n m u s t be seen in a m u c h b r o a d e r c o n t e x t . and t h e n I would no l o n g e r e v e n realize t h a t I e v e r k n e w t h e n a m e . the capacity for r e s p o n d i n g m e a n i n g f u l l y to t h e perceived significance of t h e s e p h e n o m e n a in a w a y t h a t c o r r e s p o n d s to t h e i r s i g n i f i c a n c e . can e i t h e r be r e t a i n e d or slip a w a y f r o m m e .t h e . isolated facet. If this is w h a t we call f o r g e t t i n g in h u m a n b e i n g s . When something escapes me. the persons or objects. It should n o w be clear t h a t f o r g e t t i n g is n o t a s e p a r a t e m e n t a l ability a n y m o r e t h a n r e m e m b e r i n g or r e t a i n i n g . Every day o f t h e i r lives. T h e k n o w l e d g e o f d e a t h l e a v e s m a n n o c h o i c e . t h e n it m u s t truly b e l o n g to this e x i s t e n c e .u n t o . In death. h u m a n e x i s t e n c e could well be called a " b e i n g . " T h i s " b e i n g . only not .i n .Fundamental Characteristics of Human Beings constitutes that fundamental human characteristic of histoiuii. R e t a i n i n g or n o t r e t a i n i n g s o m e single p h e n o m e n o n as h a v i n g o n c e bei 11 n o w a p p e a r s as a definite. We usually r e l e g a t e t h e s e d e a t h s to t h e i n c o n s p i c u o u s n e s s ol an e v e r y d a y e v e n t . T h e d e a t h s o f o t h e r s b e c o m e m e r e c a s e s o f death whii h can be passed o v e r .d e a t h " m a n i f e s t s i t s e l f i n manifold w a y s .u n t o . H u m a n e x i s t e n c e is also h i s t o r i c a l in t h a t it is its e n t i r e life h i s t o r y . W h a t r e m a i n s puzzling is t h e w a y in w h i c h h u m a n life and death a r e part of e a c h o t h e r . as e v e r y b o r d e r b e l o n g s to w h a t it delimits. e x i s t e n c e as bodily b e i n g . S o for ages m o r t a l i t y h a s been t h o u g h t of as a p r i m a r y trait of h u m a n e x i s t e n c e .d e a t h .t h e .it Parmenides named men mortals. but plants and animals do notdie. n o foundation o f m e d i c i n e can dispense w i t h discussing t h e m e a n i n g and n a t u r e o f h u m a n m o r t a l i t y . T h e s a m e applies also to n o n h u m a n life.e. a s n o t lasting e t e r n a l l y . T h e y simply perish. D e a t h is g i v e n such an i m p o r t a n t place in medicine t h a t o n e could say this s c i e n c e is p e r m a n e n t l y o r i e n t e d t o w a r d death: m e d i c i n e w a n t s e i t h e r to w a r d o f f death or to p o s t p o n e it as long as possible. o n t i c possibility of t h e ontologli II h u m a n ability to e x i s t h i s t o r i c a l l y .w o r l d has its final end. O n l y h u m a n b e i n g s die having k n o w n f r o m a n early age o f t h e i r m o r t a l i t y . If death is t h e u t m o s t limit of h i s t o r i c a l h u m a n e x i s t e n c e . I n a n i m a t e o b j e c t s a r e also described a s finite. T h i s ability is | c h a r a c t e r i s t i c f e a t u r e of h u m a n being and d i s t i n g u i s h e s it from all o t h e r present beings. N e c e s s a r i l y related to d e a t h . R e c o g n i t i o n of h u m a n m o r t a l i t y is always learned first from t h e de. T h e m a c a b r e c o m e d i e s played o u t in c e r t a i n A m e r i c a n funeral h o m e s r e p r e s e n t an e x t r e m e ol this. i. isolated. for it is impossible n o t to r e l a t e t o s o m e t h i n g w h i c h h a s o n c e b e e n perceived. D e a t h and h u m a n m o r t a l i t y D e a t h is t h e u n s u r p a s s a b l e limit of h u m a n e x i s t e n c e . H e i s compelled t o exist in s o m e sort of p e r m a n e n t r e l a t i o n s h i p to d e a t h . his ability to dwell by the beings l 'I his w o r l d in t h e t e m p o r a l e k . T h e m o s t c o m m o n is flight from death and f r o m t h e a w a r e n e s s of h u m a n m o r t a l i t y .. so m u c h so th. people m a k e c o u n t l e s s a t t e m p t s t o d e c e i v e t h e m s e l v e s a b o u t this m o s t c e r t a i n aspect o f h u m a n life. T h e e x i s t e n c e of a p e r s o n a l w a y s e x t e n d s f r o m his b i r t h to his d e a t h . t h e k n o w l e d g e of personal m o r t a l i t y is allowed lo dissipate in t h e t h o u g h t t h a t we t o o shall c e r t a i n l y die s o m e d a y .it lis of others. as h u m a n b e i n g s do. B e c a u s e o f this fact.s t a s e of t h e past. M e a n w h i l e . all that is c e r t a i n is t h a t e x i s t e n c e a f t e r death is no l o n g e r in t h e world in the s a m e w a y as b e f o r e . T h i s r e l a t i o n s h i p to t h e dead is t h e basis for all feelings o f r e v e r e n c e . s o r r o w . Y e t o u r r e l a t i o n s h i p to death can also be c h a r a c t e r i z e d by naked fear.120 EXISTENTIAL FOUNDATIONS j u s t y e t . W e also m a k e e v e r y e f f o r t t o s t e e r t h e s u r v i v o r s o f t h o s e w h o die.i n . It is . related to h i m as to a fellow being. r e m a i n s . a w a y from t h o u g h t s o f d e a t h . t h e end of all t h i n g s . T o t h e family o f s o m e o n e w h o has r e c e n t l y died. to e x p e r i e n c e it as t h e m a n i f e s t a t i o n o f a n e x i s t e n t i a l possibility e n c o m p a s s i n g and c o n s u m ­ m a t i n g all e x i s t e n c e but based in a d i m e n s i o n n o t at m a n ' s disposal. t h e dead person is m u c h m o r e t h a n an i n a n i m a t e o b j e c t and t h e i r r e l a t i o n s h i p to him m u c h m o r e t h a n a t t e n d a n c e t o his physical r e m a i n s . and e v e n t h e dying t h e m s e l v e s .n e s s as such t h a t is hidden from t h e living. D e a t h is m a d e to appear as simply a c h a n g e from o n e m o d e of being to a n o t h e r . o n e t h a t is inaccessible to a m o r t a l ' s p e r c e p t i o n while he is still alive. w h i c h can use him as t h a t r e a l m of o p e n n e s s w h i c h is the n e c e s s a r y p r e c o n d i t i o n for the a p p e a r a n c e and p r e s e n c e of all being. an e n c o m p a s s i n g d i m e n s i o n . It is e v e n possible t h a t in death e x i s t e n c e e n t e r s i n t o s o m e t h i n g t h a t is prior to all being. t h e s u r v i v o r s a r e in a c e r t a i n s e n s e still with t h e o n e w h o is dead. and d e f e r e n c e i n t h e face o f s o m e t h i n g g r e a t e r and m o r e p o w e r f u l .t h e . D e a t h is m a d e an e v e n t u a l i t y that does n o t m a t t e r for the p r e s e n t . It could also m e a n h a v i n g o n e ' s previous e x i s t e n t i a l m a n n e r o f bodily b e i n g . T h i s does n o t at all preclude t h e possibility t h a t death is n o t t h e radical annihilation o u r fear and a n x i e t y m a k e it out to b e . the dead m a y attain a r e l a t i o n s h i p to B e i n g . h u m a n m o r t a l i t y s h o w s t h a t m a n ' s being is o p e n at all t i m e s to t h a t w h i c h is w h o l l y o t h e r t h a n any finite o n t i c being and w h i c h e n g a g e s man as the r e a l m w h e r e m e a n i n g f u l n e s s is perceived. Not o n l y for o u r s e l v e s do we try to c u s h i o n the fact of o u r m o r t a l i t y . w h i c h t h e y perceive in and t h r o u g h t h e i r " o m n i p o t e n t " p a r e n t s . f e a r . a lifeless o b j e c t . To t h e e x i s t e n c e liberated and e x p a n s i v e e n o u g h t o reach this s e r e n i t y . w h i c h lets death appear as the e x t i n c t i o n of e x i s t e n c e in an e m p t y void. to a condition in w h i c h only t h e c o r p s e . a w e . children usually have no fear of dying. T h e r e l a t i o n s h i p is o n e of actual care in t h e f o r m of o b s e q u i e s . o f c o u r s e . m o u r n i n g and r e m e m b e r i n g . C h i l d r e n do n o t see t h e m s e l v e s as s e l f . m a i n t e n a n c e of t h e g r a v e and e v e n a n c e s t o r w o r s h i p . as a t r a n s i t i o n f r o m being alive to no l o n g e r e x i s t i n g . It may be this possibility t h a t e n a b l e s c e r t a i n rare h u m a n b e i n g s to accept death w i t h a c o m p o s e d s e r e n i t y . t h a t t h e y are b o r n e along by s o m e t h i n g . w o n d e r .c o n t a i n e d and i n d e p e n d e n t s u b j e c t s . t h o u g h in a v e r y u n d e l i b e r a t e d w a y . In t h e i r caring. It is well k n o w n t h a t b e f o r e t h e y reach p u b e r t y .w o r l d t r a n s f o r m e d into an u t t e r l y d i f f e r e n t s o r t of being. T h e y s e n s e . A s n u m e r o u s a s t h e p a r t i c u l a r w a y s o f b e h a v i n g t o w a r d death are. a fear of death usually s e t s in. i n c r e a s i n g in i n t e n s i t y t h e m o r e an a d o l e s c e n t p e r c e i v e s h i m s e l l .it m o m e n t is i r r e v o c a b l y lost to h i m . isolated. B u t for s o m e o n e w h o is m o r t a l . t e s t i f y t o t h e insight t h a t h u m a n m o r t a l i t y is n o t j u s t an e v e n t destined for s o m e t i m e in t h e f u t u r e but i r r e l e v a n t for t h e t i m e b e i n g . i n s u l a r s u b j e c t . and t r u l y h u m a n s t a n c e b e f o r e death s e t s all o t h e r e x i s t e n t i a l p o t e n t i a l i t i e s in t h e i r p r o p e r places. for t h e y h a v e used up t h e i r e x i s t e n c e by actualizing all of its e s s e n t i a l r e l a t i o n a l possibilities. in t h e m o d e r n spirit. passive fixation on w h a t m u s t h a p p e n s o o n e r or l a t e r . B u t a f t e r p u b e r t y . all. and t h e y appear in . B u t t h e r e are also u t t e r l y u n h e r o i c old people w h o are able to die as peacefully and willingly as c h i l d r e n . Each Da-sein dies its o w n death i n total l o n e l i n e s s . A b e i n g . As an i r r e v o c a b l e annihilation o f e v e r y t h i n g . If w h a t he does is n o t in t u n e w i t h t h e m o m e n t . I f m a n w e r e n o t finite and m o r t a l .u n t o . death i s r e s u r r e c t i o n i n t o t h e beloved c a u s e t o w h i c h t h e y a r e s u b o r d i n a t e . N o w . including t h e m o s t s t u b b o r n flight from d e a t h . a n d — e x c e p t for t h e actual m o m e n t o f d e a t h — c e r t a i n e x i s t e n t i a l possibility.Fundamental Characteristics of Human Beings b e c a u s e of this feeling t h a t t h e y let death e x t i n g u i s h t h e i r individual e x i s t e n c e s w i t h o u t r e s i s t a n c e . m a n first realizes his r e s p o n s i b i l i t y for e v e r y i n s t a n t of his e x i s t e n c e . t h e r e are o t h e r old people w h o r e s i s t e d e n t e r i n g full and c a r i n g r e l a t i o n s h i p s t o w h a t t h e y e n c o u n t e r e d during t h e i r lives and h e n c e b e c a m e guiltily i n d e b t e d t o t h e i r o w n e x i s t e n c e . O n l y such a b e i n g . final. n e i t h e r fleeing from it n o r hiding it. the m o s t t h o r o u g h l y p e r v a s i v e and peculiarly h u m a n trait of all. O n t h e c o n t r a r y . T h e c o n s e q u e n c e o f this i n s i g h t i s b y n o m e a n s a r e s i g n e d . th. T h e h o n o r a b l e . T h e s e people a r e terrified o f death a s o f s o m e t h i n g t h a t c o m e s far t o o s o o n . h e w o u l d n e v e r miss a n y t h i n g . i n a c c e p t i n g m o r t a l i t y a s his m o s t c h a r a c t e r i s t i c . In s h o r t .d e a t h can g u a r a n t e e t h e precondition t h a t t h e Da-sein be able to free i t s e l f from its a b s o r p t i o n in. and to r e t u r n to itself. no situation h a p p e n s t w i c e in quite the s a m e w a y .d e a t h r e v e a l s death as t h e last possibility of t h e Da-sein in t h a t it r e v e a l s dying as t h e loss of all s u p p o r t f r o m o t h e r b e i n g s . m a r t y r s dying for a h o l y c a u s e can e n t e r death happily. b e c a u s e for t h e m . no m a t t e r w h a t t h e i r age. death m u s t s e n d him into panic. T h e r e would a l w a y s b e t i m e t o c a t c h u p and m a k e s o m e t h i n g g o o d . as an i n d e p e n d e n t l y f o r m e d . his c o n s c i e n c e will r e m i n d him t h a t he has fallen b e h i n d in fulfilling his e x i s t e n c e . T h e n again. its s u b m i s s i o n and s u r r e n d e r o f i t s e l f t o t h e t h i n g s and r e l a t i o n s h i p s o f e v e r y d a y living. h u m a n and n o n h u m a n . t h e y h a v e c o m p l e t e d t h e t a s k given t h e m . o p e n . T h e m o s t dignified h u m a n r e l a t i o n s h i p t o death c o n s i s t s i n keeping t h e k n o w l e d g e of p e r s o n a l m o r t a l i t y c o n s t a n t l y in a w a r e n e s s . T h e y all m a k e clear t h a t m o r t a l i t y is an i n n a t e p o t e n t i a l o f h u m a n e x i s t e n c e .u n t o . and m o r t a l i t y . n o m a t t e r h o w trifling. b o d y h c o d . All t h e s e possibilities of e x i s t e n c e are of t h e n a t u r e of an ability t h a t allows t h e m e a n i n g f u l n e s s of w h a t m a n e n c o u n t e r s to disclose itself as w h a t it is. t h e y are equally primordial. a t t u n e m e n t . and their development into the freedom of the authentic human being T h e c h a r a c t e r i s t i c s o f h u m a n e x i s t e n c e m o s t i m p o r t a n t for m e d i c i n e . b u t also his h i s t o r i c i t y . N o w . T h i s o p e n n e s s i s t h e unified and unifying f u n d a m e n t a l origin m a k i n g possible and c o n s t i t u t ­ ing the basic c h a r a c t e r n o t o n l y of m a n ' s spatiality and t e m p o r a l i t y . this does n o t preclude t h e p r e d o m i n a n c e of o n e c h a r a c t e r i s t i c at a n y given t i m e in a particular h u m a n b e h a v i o r .122 EXISTENTIAL FOUNDATIONS p r o p e r p e r s p e c t i v e as e x i s t e n t i a l m o d e s f u n c t i o n i n g as p r e l i m i n a r i e s for t h e e x t r e m e m o d e of d e a t h . O b v i o u s l y . be . as an " e x . the f u n d a m e n t a l e x i s t e n t i a l c h a r a c t e r i s t i c s can be equally primordial only w h e n t h e y belong t o g e t h e r i n o n e and the s a m e u n i t y . We h a v e s e e n this u n d e r l y i n g u n i t y all along in t h e o p e n n e s s and c l a r i t y peculiar t o h u m a n e x i s t e n c e . w h i c h s h o w s i t s e l f t o a n i n v e s t i g a t o r a s s o m e t h i n g o p e n . c o e x i s t e n c e . At the same time. b o d y h o o d . are its primordial spatiality and t e m p o r a l i t y . letting h i m u n d e r s t a n d t h e i r e x i s t e n t i a l possibilities o n the basis of a solid f o u n d a t i o n . T h e p r o c e s s o f b e c o m i n g free for t h e e x t r e m e p o t e n t i a l i t y o f o n e ' s o w n death also frees a person w i t h r e s p e c t t o o t h e r s . con-dscious acceptance of mortality as a n e s s e n t i a l trait o f e x i s t e n c e c o u n t e r b a l a n c e s t h e f e a r s o m e k n o w l e d g e t h a t each p e r s o n m u s t die a l o n e . c o e x i s t e n c e in a shared world. m e m o r y as it is based in h i s t o r i c i t y . F r o m this p e r s p e c t i v e e x i s t e n c e is not in danger of having one or the other of the more prominent potentialities made absolute.p a t i e n t r e l a t i o n s h i p . a physician will be c o n c e r n e d o n l y w i t h t h e t r e a t m e n t of a t e r m i n a l case of illness or w i t h helping o n e in his c a r e die a good d e a t h . t h e n . It is to be r e i t e r a t e d t h a t this o p e n n e s s m a y n o t be reified and so m i s u n d e r s t o o d as a kind of h o l l o w space i n t o w h i c h b e i n g s m a y fall. " a s u s t a i n i n g and m a i n t a i n i n g of t h e w o r l d w i d e clear and o p e n r e a l m o f p e r c e p t i o n . e x i s t e n c e ' s e s s e n t i a l a t t u n e m e n t . a n u n d e r s t a n d i n g o f death a d e q u a t e t o the p h e n o m e n o n o f m o r t a l i t y is decisively i m p o r t a n t for t h e p h y s i c i a n . and m o r t a l i t y . T h i s s e q u e n t i a l listing is not a h i e r a r c h i c a l a r r a n g e m e n t o f t h e e x i s t e n t i a l possibilities.i s t i n g . i s i n h e r e n t l y c o n s t i t u t e d o f e v e r y o n e o f t h e s e c h a r a c t e r i s t i c s . D e p e n d i n g on h o w p r o f o u n d this u n d e r s t a n d i n g is in him. E v e r y single h u m a n p h e n o m e n o n . N a t u r a l l y . The fundamental characteristics of the Da-sein as being equally primordial. T h o u g h t h e y are equally primordial. appropriate t h e s e w a y s a s his o w n . e x p e r i e n c e d e m o n s t r a t e s t h a t m a n i s capable o f m a k i n g f r e e choices at any time. O f c o u r s e . t h e r e could be no guilt. I t s e e m s o n l y fitting. a h u m a n being is able to allow w h a t e v e r a p p e a r s in t h e r e a l m of his p e r c e p t i o n simply t o b e . t o e x a m i n e critically t h e l e g i t i m a c y o f such denials. C o n s o n a n t with t h e overall f i n i t e n e s s of h u m a n e x i s t e n c e . h e a l t h y o r p a t h o l o g i c a l . T h a n k s t o his e x i s t e n t i a l o p e n n e s s to a n y p r e s e n c e t h a t r e v e a l s i t s e l f to h i m . Only w h e r e t h e r e is a multiplicity o f p h e n o m e n a d o c h o o s i n g and deciding b e c o m e p o s s i b l e . its actual r a n g e is b o u n d e d by the n u m b e r and v a r i e t y of t h e i n n a t e ways by w h i c h an individual can r e l a t e h i m s e l f t o w h a t h e e n c o u n t e r s .Fundamental Characteristics of Human Beings 123 p r e s e n t . B u t it is i m p o r t a n t to r e m e m b e r t h a t e v e n a r e s t r i c t e d f r e e d o m is n o n e t h e l e s s a f o r m of f r e e d o m . 6 T h e u n q u e s t i o n a b l e e x i s t e n c e o f a f r e e d o m o f will. physicians s c h o o l e d in n a t u r a l s c i e n c e t e n d to m i s i n t e r p r e t a t h o u g h t s e q u e n c e like t h e o n e a b o v e as an attempt to prove one thing with another. h u m a n e x i s t e n c e is " m e r e l y " a r e a l m of f u n d a m e n t a l p e r c e p t i v e r e s p o n s i v e n e s s t o t h e p h e n o m e n a o f t h e w o r l d . In t h e light of t h e i r o w n e x p e r i e n c e . t h e y d o n o t r e q u i r e a n y proof. W e d o n o t m a k e this p r e s u m p t i o n . i n t h e n a t u r a l scientific s e n s e o f t h e w o r d . and n o t h e r a p e u t i c r e l e a s e . c o n s i d e r i n g t h e decisive i m p o r t a n c e o f h u m a n f r e e d o m t o m e d i c i n e . o f c h o i c e . 7 . M o r e o v e r . and u s e t h e m in f o r m i n g his a u t o n o m o u s e x i s t e n c e . it is possible for o n e of t h e m to be t h e condition of the manifestation of the other. A s t h e open realm o f p e r c e p t i o n w h i c h i t is. f o r m s t h e basis of a h u m a n being's obligation to fulfill his e x i s t e n c e . T h a t i s w h y o u r w o r l d can n e v e r b e divided i n t o o p e n n e s s o f h u m a n e x i s t e n c e o n t h e o n e hand and t h e t o t a l i t y o f c o n c r e t e n o n h u m a n b e i n g s o n t h e o t h e r . In addition to t h e s e limits t h e r e a r e a n y n u m b e r o f pathological deficiencies o f f r e e d o m . T h i s allowing d o e s n o t m e a n b e n i g n n e g l e c t o r i n d i f f e r e n c e . A s s u c h . and b e s t o r e d t h e r e . B o t h o p e n n e s s and f r e e d o m o f will a r e equally e l e m e n t a r y p h e n o m e n a t h a t reveal t h e m s e l v e s directly. h o w e v e r . Y e t e v i d e n c e p o i n t i n g to even a v e r y limited sort of h u m a n f r e e d o m is highly r e p u g n a n t to n a t u r a l scientific r e s e a r c h e r s w h o s e d e t e r m i n i s m denies a n y kind o f freedom for m a n . If h u m a n b e i n g s w e r e n o t free t o decide w h e t h e r o r not t o take o n and c a r r y out t h e b e h a v i o r a l possibilities i n h e r e n t in t h e i r e x i s t e n c e s . T h i s is t h e condition of m a n ' s f r e e d o m . T h e y mistakenly accuse it of p r e s u m i n g to h a v e p r o v e n h u m a n freedom of will b e c a u s e it h a s d e m o n s t r a t e d t h e o p e n n e s s o f h u m a n e x i s t e n c e . f r e e d o m o f will—like a n y t h i n g h u m a n — i s n o t a b s o l u t e . It m e a n s e n t e r i n g i n t o a r e l a t i o n s h i p to t h a t t h i n g in a w a y t h a t p e r m i t s it to fully e v o l v e its p a r t i c u l a r m e a n i n g f u l n e s s . At m o s t . an i n s t a n c e of a-causality. w i t h its c h a r a c t e r i s t i c spatiality and t e m p o r a l i t y . h i m t o r e s p o n d t o w h a t reveals i t s e l f t o him. a t t u n e m e n t . F r e e d o m . or m o t i v a t e s . T h i s understanding openness to potential e n g a g e m e n t by meaningful p r e s e n c e s — t h e p r e c o n d i t i o n for h u m a n f r e e d o m — l i e s e n t i r e l y outside o f t h e a r e n a o f c a u s a l i t y and t h a t i s w h y c r i t i c i s m from t h e s t a n d p o i n t o f natural scientific d e t e r m i n i s m i s u n a b l e t o p e n e t r a t e t o t h e r e a l m o f h u m a n f r e e d o m . b o d y h o o d ." T h e s e indications o f t h e free and o p e n n a t u r e o f h u m a n e x i s t e n c e . r e v e a l i n g o u t o f h i d d e n n e s s {entbergende).s i s t i n g . R e g a r d l e s s o f its ability t o p r o d u c e all. c o n c l u d e o u r . T h e h u m a n does n o t p o s s e s s freedom as o n e of his p r o p e r t i e s . t h a t h u m a n f r e e d o m i n h e r e s i n a n open r e a l m o f perception to the presence of what human beings encounter. T h i s is b e c a u s e t h e i r line of a r g u m e n t . h i s t o r i c i t y . m u c h less to pin d o w n and nullify t h e s e a c t s . t h e s a m e insight i n t o t h e basis o f h u m a n f r e e d o m reveals t h a t i t i s not h u m a n pleasure t h a t disposes o v e r f r e e d o m . T h e e n g a g e m e n t of a h u m a n being by a p a r t i c u l a r p h e n o m e n o n m o v e s . it has n o t h i n g to say a b o u t the actual basis o f f r e e d o m . T r u e . T h e e x p e r i e n c e o f n a t u r a l s c i e n c e i t s e l f d e m o n s t r a t e s .124 EXISTENTIAL FOUNDATIONS It is a s s u m e d t h a t h u m a n freedom can be d i s m i s s e d as a m e r e illusion simply by r e i n t e r p r e t i n g the s e r i e s of free m o t i v a t i o n s leading up to a particular decision as a p r e d e t e r m i n e d and c o m p l e t e causal chain. and t o r e s p o n d i n a c c o r d a n c e w i t h the perceived m e a n i n g f u l n e s s o f t h a t t h i n g . a n o n c a u s a l e v e n t . it is n o t y e t possible to m a k e an a c c u r a t e prediction of a n y f u n d a m e n t a l m o d e o f h u m a n b e h a v i o r . world opening {eröffnende) Dasein p o s s e s s e s the h u m a n being. m e a n i n g t h a t it is purely quantitative c o n s i d e r a t i o n s w h i c h s t a n d in t h e i r way. E v e n p s y c h o a n a l y s i s and b e h a v i o r a l s c i e n t i s t s . In fact. To a p e r s o n s c h o o l e d in t h e n a t u r a l s c i e n c e s . h o w e v e r . c o e x i s t e n c e with o t h e r s . t h e y i m m e d i a t e l y t r y t o m o d e r a t e this admission b y pointing t o t h e h u g e v a r i e t y and n u m b e r o f subsidiary c a u s e s a t w o r k i n t h e life h i s t o r y of a h u m a n being. it is the r e v e r s e . like all n a t u r a l scientific e x p l a n a t i o n s . h o w e v e r . t h a t n o such psychic causal chain can be posited w i t h c e r t a i n t y for any h u m a n decision. w h o are i m m e n s e l y e x p e r i e n c e d i n t h e t h e o r e t i c a l c o n s t r u c t i o n o f causal c o n n e c t i o n s w i t h i n t h e m i n d . o r s o m e . n a m e l y the e k . o r n o n e of the c a u s e s of a p a r t i c u l a r piece of h u m a n b e h a v i o r . O n t h e o t h e r h a n d . All such a t t e m p t s t o d e n y h u m a n freedom p r o c e e d u n a w a r e t h a t t h e y fail e v e n to r e a c h the basic d i m e n s i o n of all acts of free will. f r e e d o m m e a n s at best f r e e d o m f r o m causal l a w s . I t h a p p e n s . n e v e r b e f o r e t h e fact. admit t h a t t h e y can give reliable i n d i c a t i o n s o f causal s e q u e n c e s o n l y a f t e r t h e fact. and m o r t a l i t y . is ruled by t h e a x i o m t h a t a n y t h i n g t h a t is really real m u s t e x i s t in a faultless causal c o n n e c t i o n . Still this f r a m e ­ w o r k will s e r v e to s u g g e s t an a d e q u a t e e x i s t e n t i a l f o u n d a t i o n f o r m e d i c i n e .Fundamental Characteristics of Human 125 Beings discussion of the f u n d a m e n t a l c h a r a c t e r i s t i c s of h u m a n b e i n g .. a c o n s c i o u s .e. w h i c h a total m e d i c i n e t r i e s t o g r a s p . T h e r e is no m e n t i o n of a h u m a n s o m a n o r is a n y a t t e n t i o n paid to n o t i o n s of a p s y c h e . on t w o c o u n t s . It has m e r e l y t r a c e d t h o s e E x i s t e n t i a l s w h i c h are m o s t i m p o r t a n t for m e d i c i n e . t h a n t h e c u r r e n t l y d o m i n a n t f r a m e w o r k based o n biological. " using t h e initial capital to distinguish t h e n o u n from t h e adjective. and spirit. First o f all. p h y s i o l o g y . mind. A n e w vision and u n d e r s t a n d i n g of s o m e t h i n g d e m a n d s a n e w w a y of talking a b o u t it. physiologicalpsychological) fact. the findings o f t h e s e t h r e e s c i e n c e s d o n o t really c o m e into their own—as manifestations of human existence—until they are seen from t h e e x i s t e n t i a l f o u n d a t i o n w e h a v e p r e s e n t e d . an e x i s t e n t i a l f o u n d a t i o n for m e d i c i n e e n a b l e s us t o assail successfully t h e u n s c i e n t i f i e n c v a g u e n e s s and m y s t i f i c a t i o n surrounding many of the standard concepts of the modern science of healing. . A n y a t t e m p t to o p e n o u t an a d e q u a t e l y h u m a n vista o n t o t h e p h e n o m e n a ol u n d i s t u r b e d e x i s t e n c e m u s t include a critique of the m o s t important ideas o f traditional biology. " w e can use the w o r d " E x i s t e n t i a l . S t u b b o r n l y e n t r e n c h e d behind t h e w o r d s coined by a particular c o n c e p t u a l o r i e n t a t i o n a r e its s e c r e t prejudices. o u r f r a m e w o r k can supply r i g o r o u s . In place of t h e t e r m s "basic t r a i t " and " f u n d a m e n t a l c h a r a c t e r i s t i c . For t h e E x i s t e n t i a l s pervade t h e empirical findings as an essence w i t h o u t w h i c h t h e y could n o t be w h a t t h e y are. A b o v e all. O u r p r e s e n t a t i o n o f t h e basic t r a i t s o f h u m a n being does n o t claim t o be a c o m p l e t e e x i s t e n t i a l a n t h r o p o l o g y . T h e s e t h r e e d e s i g n a t i o n s h a v e t h e s a m e r e l a t i o n t o m a n ' s being a s t h e n o t i o n o f c a t e g o r y h a s t o i n a n i m a t e o b j e c t s . physiological. It m a y s t r i k e t h e r e a d e r as odd t h a t a description of t h e e x i s t e n t i a l traits m o s t i m p o r t a n t for m e d i c i n e a b a n d o n s e v e r y o n e o f t h e n o t i o n s n a t i v e t o traditional physiology and p s y c h o l o g y . It is s o u n d e r . an affect. this n e w e r foundation m a k e s possible an i n t e r p r e t a t i o n t h a t is m o r e j u s t to empirical fact and more adequate to human beings. t h e n it is far f r o m t h e purpose of o u r e x i s t e n t i a l f o u n d a t i o n for m e d i c i n e t o d e t r a c t from t h e i m p o r t a n c e o f t h e s e " c o n c r e t e " medical findings. and t h e u n i t y o f his e x i s t i n g are first capable o f decisive c h a r a c t e r i z a t i o n i n t e r m s o f t h e a b o v e described E x i s t e n t i a l s . for the old t e r m i n o l o g y g e t s in the w a y of this e f f o r t . 9 In the s e c o n d place. a n d p s y c h o l o g y . T h e t o t a l i t y and w h o l e n e s s of m a n . If this is t h e s o r t of r e l a t i o n s h i p t h a t o b t a i n s b e t w e e n the basic traits of h u m a n being and empirical (i. and p s y c h o l o g i c a l d e t e r m i ­ nations of human nature. or an u n c o n s c i o u s . concrete d e t e r m i n a t i o n s o f h u m a n being w i t h w h i c h t o fill t h e v a c u u m a r o u n d the i n c r e a s i n g l y popular n o t i o n s of a total medicine and a u n i t y of body. O n t h e c o n t r a r y . H e i d e g g e r . d e e x i s t e n t i a l e S t r u k t u r des im G e w i s s e n b e z e u g t e n e i g e n t l i c h e n S e i n k ö n n e n s . H e i d e g g e r . p. p . For t h e s u b s e q u e n t r e a s o n i n g n e e d e d t o i l l u m i n a t e w h a t still r e m a i n s o b s c u r e a b o u t t i m e . K e l l e r . H e i d e g g e r . 1 9 6 3 ) and Menschliche Existenz. 9 . Unpublished introductory lecture to philosophy. S t u t t g a r t . ) . 1 9 6 1 ) . A n r u f v e r s t e h e n u n d S c h u l d . All t h a t i s e s s e n t i a l f o r a n e x i s t e n t i a l u n d e r s t a n d i n g o f t h e s t r u c t u r e o f h u m a n g u i l t and t h e h u m a n conscience c a n b e f o u n d in: M . 5 1 0 . W e i n : H a n s H u b e r . 1 9 6 4 ) . Confessiones. " in Zein und Zeit ( H a l l e : Niemeyer. Cf. lb) M.6 3 . 1927).. 5 . M . T h e p o s s i b i l i t y o f d r e a m i n g a s a n o t h e r E x i s t e n t i a l i s d i s c u s s e d a t l e n g t h in: M . "Es t r ä u m t e m i r v e r g a n g e n e N a c h t . " ( B e r n . p.. Lebensangst.M a i n : K l o s t e r m a n . w h i c h h a s t h e c o n n o t a t i o n o f b o d y a s lived b o d y l i n e s s . 2 8 f f a n d 3 9 ff.V e r l a g . H e i d e g g e r . v o l .1 1 . Nietzsche.126 EXISTENTIAL FOUNDATIONS 1 . 1 9 6 9 ) . s e e : M. Willensfreiheit und Schuld ( Z u r i c h : S c h u l t h e s s & Co. T h i s w o r d i s c o n g r u e n t w i t h t h e G e r m a n Leib. . C o m p a r e a l s o : la) W. Vom Wesen der menschlichen Freiheit. pp. pp. " t h e q u a l i t y o f h a v i n g a b o d y o r o f being body" ( O . 8.o n t o l o g i s c h e n F u n d a m e n t e d e r G e w i s s e n s als R u f d e r S o r g e . Schuldgefühle und psychotherapeutische Befrciunt ( B e r n and S t u t t g a r t : H a n s H u b e r V e r l a g . 2 d ed. ( F r a n k f u r t . Cf. 1 9 6 0 ) . 1 9 3 0 . " D i e e x i s t e n t i a l . S c h u l t h e s s & Co. 1 ( P f u l l i n g e n : V e r l a g N e s k e . 3 . ( M u n i c h : K o s e l . Zur Sache des Denkens ( T u b i n g e n : N i e m e y e r . M. . M. 3d e d . T h e w o r d " b o d y h o o d " w a s f i r s t d o c u m e n t e d i n t h e E n g l i s h l a n g u a g e i n 1 6 7 4 and h a s t h e m e a n i n g . . Vom Wesen der Wahrheit. B o t h w o r k s c o n t a i n i m p r e s s i v e i l l u s t r a t i o n s o f t h e f u n d a m e n t a l p o s i t i o n s first e l a b o r a t e d in H e i d e g g e r ' s Sein und Zeit. Das Problem der Willensfreiheit ( B e r n and M u n i c h : F r a n c k e . pp. 1 9 7 5 ) . 2 . die e x i s t e n t i a l e I n t e r p r e t a t i o n d e s G e w i s s e n s u n d die v u l g ä r e G e w i s s e n s a u s l e g u n g . 267ff. B o s s . 1 4 and 1 6 . 4. Boss. D . 5 3 . . E . 7 . 1 9 6 2 ) . 6.a m . A u r e l i u s A u g u s t i n u s . H e i d e g g e r . 1 4 . 1 9 5 4 ) . Cf. T h i s c o n c e p t u a l a d v a n c e is so f u n d a m e n t a l l y i m p o r t a n t for m e d i c i n e t h a t w e felt c o m p e l l e d t o p u r s u e t h e m a t t e r f u r t h e r . PHYSIOLOGY. It m a y be e a s i e r to m a k e t h e t r a n s i t i o n if we a d v a n c e o n l y a half step at first. W e h a v e also indicated h o w this c o n c e p t i o n can be left b e h i n d for o n e t h a t r e c o g n i z e s all bodily p h e n o m e n a o f h u m a n e x i s t e n c e a s t h e bodying f o r t h o f t h e r e l a t i o n s h i p to t h e world in w h i c h and as w h i c h a particular Da-sdn is e x i s t i n g at a given m o m e n t . AND PSYCHOLOGY From human body as a physical organism to bodyhood I n t h e preceding c h a p t e r s w e have e m p h a s i z e d t h e n e c e s s i t y for c o n s i d e r i n g the p h e n o m e n o n o f h u m a n e x i s t e n c e w h i c h traditional m e d i c i n e calls t h e h u m a n body. T h e findings of m o d e r n F r e n c h phenomenologues existentiels m a y fairly be described as a h a l f step a d v a n c e f r o m the n a t u r a l scientific c o n c e p t of t h e body. W e h a v e u n d e r s c o r e d t h e conditional j u s t i f i c a t i o n for c o n c e i v i n g o f bodyhood's s o m a and for t h e g e n e r a l p r e e m i n e n c e g r a n t e d the s o m a i n m e d i c i n e . It still r e m a i n s difficult for t h e m to e s c a p e t h e d o m i n a t i n g i n f l u e n c e o f D e s c a r t e s .Chapter 8 AN EXISTENTIAL STUDY OF THE BASIC CONCEPTS OF BIOLOGY. and this i s w h y t h e y h a v e m a n a g e d t o g e t only h a l f w a y t o w a r d a n e x i s t e n t i a l u n d e r s t a n d i n g o f the b o d y h o o d of h u m a n Da-sein. N o o t h e r r e s e a r c h e r s o f t h e last decades h a v e w o r k e d s o i n t e n t l y t o w a r d a m o r e appropriately h u m a n f o r m u l a t i o n o f t h e p h e n o m e n o n of b o d y h o o d t h a n t h e y . A n d y e t t h e s e p h i l o s o p h e r s do d e s e r v e lasting credit for pointing i n s i s t e n t l y to the n e c e s s i t y for r e c o n s i d e r i n g 1 . It is no s u r p r i s e t h a t m a n r e g a r d s il with a lifelong s e n s e of s h a m e . n o t h i n g but totally m e a n i n g l e s s p r e s e n c e . for t h i n g s to be in t h e first place. of c o u r s e . a d e q u a t e insight into t h e n a t u r e of t h e corps humain d e p e n d s o n w h a t h e views a s t h e m o s t basic e x i s t e n t i a l m o o d : n a u s e a . People do n o t simply p o s s e s s t h e i r bodies as t h e y do t h e tools t h e y m a k e t h e m s e l v e s . disgust. N o w t h e h u m a n body reveals i t s e l f as pure flesh. he a r g u e s . a v e r y peculiar sort of t o o l . as a tool. and is n o t shaped b y . O n l y in n a u s e a . g i v e n this reciprocal r e l a t e d n e s s . B u t h e a t o n c e g o e s o n t o a s s e r t that. t h e y actually e x i s t t h e i r bodies.128 EXISTENTIAL FOUNDATIONS 2 the h u m a n b o d y . the h u m a n body. T h e b o d y is draped o v e r a h u m a n being. W e h a v e already s h o w n h o w h u m a n e x i s t e n c e can b e bodily only b e c a u s e e x i s t e n c e itself is i n h e r e n t l y spatial. we will h a v e to travel q u i t e a w a y past S a r t r e ' s d e t e r m i n a t i o n of t h e corps humain b e f o r e we a r r i v e at a truly e x i s t e n t i a l view. at t h e p a r t i c u l a r m o m e n t . S a r t r e n e g l e c t s t o specify e x a c t l y h o w this m o v e m e n t o u t w a r d to t h i n g s is supposed to happen or h o w such a s i g n i f i c a n c e c r e a t i n g r e l a t i o n s h i p m i g h t arise in and t r a n s c e n d a b o d y t h a t is m e r e l y in space.i n t o . T h i s is m o r e o b s c u r e in light of his v i e w t h a t all being is. of t h e human body. w h i c h m e a n s t h a t p r o c e e d i n g from t h e pivot o f his body t h r o u g h s i g n i f i c a n c e . 3 4 On t h e o t h e r h a n d . W e shall limit o u r e x a m i n a t i o n h e r e t o a f e w particularly c h a r a c t e r i s t i c and r e v e a l i n g s t a t e m e n t s f r o m t h e w o r k s o f S a r t r e and M e r l e a u . S a r t r e tell us t h a t a h u m a n being and his w o r l d a r e m u t u a l l y r e l a t e d p h e n o m e n a and t h a t t h e f u n d a m e n t a l c h a r a c t e r i s t i c of each is relation. S a r t r e also sees corps humain as t h e v e s t i g e of pure p r e s e n c e f r o m w h i c h h u m a n c o n s c i o u s n e s s m a y b r e a k f o r t h i n t o a n o n t o l o g i c a l act. R e f i n i n g this v i e w . in fact. by l o c a t i o n .c r e a t i n g r e l a t i o n s h i p s . does a h u m a n being e n t e r an o n t o l o g i c a l frame in w h i c h t h e pure b e i n g of all t h i n g s can disclose i t s e l f and p h e n o m e n a appear. for t h e first t i m e .P o n t y . in e s s e n c e . S u c h a v i e w m u s t m a k e clear in opposition to S a r t r e ' s opinion t h a t the spatiality of h u m a n being does n o t o r i g i n a t e in. o r l o a t h i n g . A p e r s o n ' s r e l a t i o n s h i p s to t h i n g s would e m a n a t e from this specific point in space. i t follows t h a t t h e r e l a t i o n s h i p i t s e l f m u s t arise from t h e h u m a n reality and g o o u t from i t t o t h e t h i n g s o f t h e w o r l d . F o r S a r t r e . A p p a r e n t l y . of all t h i n g s . a h u m a n being t r a n s c e n d s t h e body to a r r i v e at t h e t h i n g s o f his world. A c c o r d i n g l y . c o m i n g . o n c e he h a s b e c o m e c o n s c i o u s . w i t h o u t t h e l a c q u e r . N o w h e r e d o e s S a r t r e explain w h y it is n a u s e a . s i m u l t a n e o u s l y . t hat allows 5 .t h e w o r l d m e a n s n o t h i n g m o r e for h u m a n b e i n g s t h a n e s t a b l i s h i n g d i s t a n c e s from t h i n g s and t h e r e b y m a k i n g it possible. he says t h a t to be h u m a n m e a n s to be imprisoned perpetually in some particular perspective determined. s i l e n c e . he i m p r o v e d on S a r t r e ' s t r a n s l a t i o n o f H e i d e g g e r ' s definition for h u m a n b e i n g . w h i c h does n o t in a n y w a y a s s e r t t h a t a n x i e t y is the basic a t t u n e m e n t of e x i s t e n c e — a s S a r t r e does w i t h n a u s e a . n a u s e a . and i n a c c e s s i ­ bility a r e explicitly m e a n i n g f u l qualities f o r h u m a n e x i s t e n c e . O n t h e o n e h a n d . A n x i e t y is. m e a n i n g l e s s . " 8 A l t h o u g h h e calls t h e soul's dwelling in the b o d y a f u n d a m e n t a l mode . nausea is the very condition that most stubbornly prevents us from experiencing the bodyhood of our being. t . o r l o a t h i n g . e x a c t l y t h o s e m e a n i n g f u l qualities w h i c h appear i n t h a t e x t r e m e l y deficient m o d e o f a t t u n e m e n t . H e i d e g g e r ' s designation of anxiety as the all-important human a t t u n e m e n t repre­ s e n t s . a b s o l u t e n e s s . t o solve t h e puzzles o f t h e link b e t w e e n t w o s u c h radically d i f f e r e n t p h e n o m e n a and " t h e p r o c e s s o f e x c h a n g e c o n s t a n t l y o c c u r r i n g a m o n g t h e s e t w o and t h e w o r l d a r o u n d t h e m . M e r l e a u . 7 N e x t t o S a r t r e . and Psychology 129 us to r e c o g n i z e all p h e n o m e n a . like loving s o m e o n e o r s o m e t h i n g . i n a c c e s s i b l e .w o r l d i s t h r o w n b a c k e n t i r e l y o n itself. h e b e l i e v e s t h a t t h r o u g h his discovery of nausea as the fundamental a t t u n e m e n t of h u m a n beings. l o a t h i n g . M e r l e a u . v o i c e l e s s . m o r e o p e n . p a s t . e x i s t e n c e i s m o s t a w a r e o f i t s e l f i n a n x i e t y .P o n t y d e s e r v e s r e c o g n i t i o n for his e f f o r t s t o e s t a b l i s h a basis for h u m a n b o d y h o o d . B e c a u s e S a r t r e ' s etre-dans-le-monde implicitly reified h u m a n n a t u r e and r e n d e r e d it m e r e o b j e c t in s p a c e . disgust.i n . First. H e i d e g g e r n a m e s a n x i e t y solely a s o n e o f a n u m b e r o f possible basic a t t u n e m e n t s a n d s i n g l e s i t o u t o n l y w h e r e the ontological determination of human existence is concerned. ttre-au-monde.a n d f u t u r e l e s s . especially significant in this o n e r e s p e c t .u e . b y i n t r o d u c i n g t h e c o n c e p t o f dwelling. F a r f r o m l e t t i n g u s s e e the most fundamental nature of human bodyhood. o n t o l o g i c a l n a t u r e a s pure p r e s e n c e .Basic Concepts of Biology. in S a r t r e ' s o p i n i o n . t h o u g h . t h a t disposition i n w h i c h w h a t e v e r t h e h u m a n s u b j e c t e n c o u n t e r s r e v e a l s i t s e l f i n its a b s o l u t e .t h e . h e calls n a u s e a . H e h o p e d . T h e y a r e . i n t h e i r t r u e n a t u r e s . 6 In looking at the h u m a n body from the perspective of nausea. in fact. a t t u n e m e n t . Physiology. S a r t r e not only distorts Heidegger' D a s e i n s a n a l y t i k b u t also c o n t r a d i c t s h i m s e l f . d u m b p r e s e n c e . o n l y a first step t o w a r d valid u n d e r s t a n d i n g . T h i s does n o t mean that the phenomena of the human world might not reveal t h e m s e l v e s far m o r e m e a n i n g f u l l y and richly i n s o m e o t h e r . M e a n w h i l e . including t h e p u r e l y c a r n a l h u m a n body. n a m e l e s s . C o n s e q u e n t l y . He also set h i m s e l f t h e special t a s k o f t r a n s c e n d i n g t h e C a r t e s i a n dualism t h a t s e p a r a t e s body and soul. N e v e r t h e l e s s .P o n t y p r e f e r r e d t h e w o r d i n g . t h a t in a n x i e t y h u m a n b e i n g . c a r n a l i t y . S a r t r e ' s claim g r o s s l y falsifies H e i d e g g e r ' s Dasiensanalytik. he has f o r g e d far a h e a d o f H e i d e g g e r i n i n t e r p r e t i n g h u m a n n a t u r e : a t t h e c o r e of all t h i n g s is pure and m e a n i n g l e s s p r e s e n c e . S o m e t i m e s it is t h e soul's " i n h e r ­ e n c e " i n t h e body.P o n t y ' s s c h e m e . T h i s dwelling i s totally o t h e r t h a n a m a t e r i a l p r e s e n c e . his e x i s t i n g in th o p e n n e s s of a c l e a r e d w o r l d l y r e a l m . s o m e t h i n g t o u c h i n g and s o m e t h i n g t a n g i b l e .b o d y i n t o a h u m a n s u b j e c t . M e r l e a u . and adapts to its spatial e n v i r o n m e n t .P o n t y ' s r e f l e c t i o n s on the soul's dwelling in the body w e r e p r e c e d e d b y H e i d e g g e r ' s v e r y d i f f e r e n t n o t i o n o f h u m a n d w e l l i n g . It is r a t h e r m a n ' s e k . t h e body is an o b j e c t . It is n e v e r o n l y my body.P o n t y a d m i t s t h a t this alleged m e t a m o r p h o s i s is i n e x p l i c a b l e . C o n s e q u e n t l y . by virtue of the fact t h a t it is his body t h a t inexplicably b e g i n s to see. o r vice v e r s a . b u t an o b j e c t in w h i c h we d w e l l . His t h i n k i n g i s o n t h e o n e h a n d a s e l f . thinks. a t o t h e r t i m e s t h e " a r t i c u l a t i o n " o f t h e soul t h r o u g h t h e body. E v e n M e r l e a u .P o n t y ' s d e s c r i p t i o n s o f dwelling s h o w s t h a t h e h a s n o t t r a n s c e n d e d C a r t e s i a n dualism.s t a t i c abiding by. t h e b o d y is m e r e l y physically t h e r e until it is t r a n s f o r m e d . m u c h less for a s e c o n d a r y m e t a m o r p h o s i s of t h e physical o b j e c t . B u t t h e r e i s n o t o n e o b s e r v a t i o n t o c o n f i r m t h a t t h e b o d y e x i s t s initially u n i n h a b i t e d by soul or spirit. by c o n t r a s t . t h a n k s t o this i n h e r e n c e and e x c h a n g e . and we may assume that Merleau-Ponty's introduction to the concept into French p h e n o m e n o l o g y was not entirely independent of Heidegger's i n v e s t i g a t i o n s . B u t . 1 5 .P o n t y g o e s a g a i n s t all e x p e r i e n c e s i n c l a i m i n g t h a t t h e h u m a n b e i n g .s u f f i c i e n t .P o n t y allows t h e c o n c e p t o f dwelling t o r e m a i n a m b i g u o u s and c o m p l i c a t e d . is c a r r i e d o u t in t h e c o n c r e t e p e r c e i v i n g and a n s w e r i n g r e l a t i o n s h i p s t o t h e b e i n g s o f his w o r l d .. h e speaks s o m e t i m e s o f a c o n s t a n t e x c h a n g e b e t w e e n s o m e t h i n g s e e i n g and s o m e t h i n g visible. to r e f l e c t .EXISTENTIAL 130 FOUNDATIONS o f h u m a n b e h a v i o r . a n u n b r i d g e a b l e gap s e p a r a t e s t h e t w o c o n c e p t s . as a selfc o n t a i n e d I Inn). M e r l e a u . T h e n again. e a c h o f M e r l e a u . 9 10 11 12 13 14 M e r l e a u . abiding by. s u b s t a n t i v e h u m a n soul. H e o n l y a s s e r t s t h a t . I ha! s e e s . B u t h e does n o t explain h o w w e a r e t o i m a g i n e this i n h e r e n c e o r this e x c h a n g e b e t w e e n t w o s u c h h e t e r o g e n e o u s t h i n g s . T h i s dwelling. t h e body i s " t h e abode o f t h e soul. In M e r l e a u . dwelling r e f e r s t o h u m a n e x i s t e n c e ' s d w e l l i n g . and t h e possibility o f v i e w i n g t h e e x t e r n a l w o r l d . by t h e soul's dwelling in it. a t r a n s f o r m a t i o n i n w h i c h s o m e simple physical o b j e c t w o u l d s u d d e n l y s t a r t t o p e r c e i v e i t s e l f . and t h e physical eye t h e w i n d o w i n t h e b o d y t h r o u g h w h i c h t h e soul m a y p e e r o u t .t h e . i n t o a living h u m a n body.b o d y . D e s p i t e t h e i r v a r i e t y .w o r l d .i n .P o n t y ' s c o n c e p t of dwelling e n t a i l s at least a bipolar r e l a t i o n s h i p b e t w e e n t h e t w o e n t i t i e s . t h e spirit n o t o n l y m a k e s u s e o f t h e b o d y b u t actually unfolds i t s e l f t h r o u g h t h e m e d i u m o f t h e b o d y and m a k e s i t t r a n s c e n d t h e p u r e l y physical. IN H e i d e g g e r ' s Daseinsanalytik. " I n his v i e w . M e r l e a u . and on t h e o t h e r a physical body. and to adapt itself to t h e s u r r o u n d i n g space. is a n c h o r e d in the WOI Id solely t h r o u g h this b o d y . e x i s t i n g . drives.w o r l d .t h e . and he develops as a h u m a n being in this r e l a t i o n s h i p . C e r t a i n l y t h e r e a r e p h e n o m e n a o f this h u m a n e x i s t e n c e that can be i n t e r p r e t e d . By m e d i e v a l t i m e s . o n e would h o p e . w h o a m able t o b e a w a r e of m y s e l f as being p r e s e n t . t h o u g h i n a d e q u a t e l y . m a n ' s existential relatedness—as w h i c h each of us e x i s t s in his p a r t i c u l a r and limited w a y — i s a p r i m a r y dwelling w i t h w h a t c o m e s to be in t h e world s p a n n i n g o p e n n e s s he s u s t a i n s .i n . M e d i c a l t h i n k i n g will g e t past this b o t t l e n e c k o n l y by c o m p l e t e l y r e l i n q u i s h i n g t h e n o t i o n of a s u b s t a n t i a l o b j e c t i v e l y p r e s e n t p s y c h e and c o n s i d e r i n g h u m a n being as Da-sein. p s y c h e w a s a m a t e r i a l l y p r e s e n t — t h o u g h still i m m o r t a l — s p i r i t u a l s u b s t a n c e b y itself. P a s s i n g definitions t h a t label i t t h e seat o f t h e m e n t a l f a c u l t i e s . is a . t h e m o d e of b e i n g of t h e p s y c h e itself. I n q u i r y i n t o its e x a c t n a t u r e is c o n s i d e r e d u n n e c e s s a r y .s p a n n i n g o p e n n e s s ol a n ability t o p e r c e i v e s o m e t h i n g a s s o m e t h i n g . a m e n a b l e t o c a l c u l a t i o n . R a t h e r . A r i s t o t l e still called psyche t h e d i s t i n g u i s h i n g mode of being of an e n t i t y w i t h t h e p o t e n t i a l for b e i n g alive. Physiology. N e v e r t h e l e s s . or j u s t h o w this p s y c h e is in a position to h a v e s u c h t h i n g s as d r i v e s . All t h a t is s o u g h t . a n a l o g i z i n g f r o m its c o n c e p t o f t h e b o d y . e m o t i o n s .s p a n n i n g r e a l m o f p e r c e p t i o n . t o hold o p e n this r e a l m i n t o w h i c h w h a t e v e r can b e m a y s h i n e f o r t h and be p e r c e i v e d in its m e a n i n g and its place. From psyche to human being-in-the-world T h e v e r y w o r d p s y c h e h a s b e e n a p l a y t h i n g o f h i s t o r y . as t h e p h e n o m e n a of a m a t e r i a l body situated s o m e w h e r e i n space. and i n s t i n c t s as its faculties or f u n c t i o n s . then. and Psychology 131 It is I. or p r o p o s e d . w h o s e f u n d a m e n t a l c h a r a c t e r is t h e w o r l d . So it is t h a t a p h e n o m e n o n can e n g a g e t h e h u m a n being in s u c h a w a y t h a t he can r e s p o n d to it a c c o r d i n g to its m e a n i n g f u l n e s s . and to be in t h e r e l a t i o n s h i p to w h a t I have p e r c e i v e d . are p r o c e s s e s o c c u r r i n g i n t h e p s y c h e and. In this w a y . A n d t h e c o l l e c t i o n s o f p s y c h i c faculties bandied a b o u t s o f r e e l y b y c o n t e m p o r a r y b r a n c h e s o f faculty p s y c h o l o g y says v e r y little a b o u t e i t h e r t h e e x i s t e n c e o f t h e s e p o w e r s t h e p s y c h e allegedly holds.Basic Concepts of Biology. T h i s r e l a t e d n e s s is not biploar. T h e p s y c h e i n w h i c h all o f t h e s e m e c h a n i s m s and p s y c h i s m s a r e alleged to t a k e place eludes strict scientific definition. and e m o t i o n s can hardly b e r e c o g n i z e d a s scientific c h a r a c t e r i z a t i o n s . T h e m o d e r n a g e . o b j e c t . o u r u n d e r s t a n d i n g o f t h e b o d y h o o d o f h u m a n e x i s t e n c e b e c o m e s a d e q u a t e o n l y w h e n this b o d y h o o d in its e n t i r e l y is s e e n as bodying f o r t h w a y s of b e i n g in relation to w h a t a h u m a n being e n c o u n t e r s p e r c e p t i v e l y and r e s p o n s i v e l y at any given m o m e n t . To e x i s t as Da-sein m e a n s t o s u s t a i n and m a i n t a i n t h e c l e a r n e s s o f a w o r l d . i m a g i n e s the p s y c h e a s a n o r g a n i s m l i k e . t h e h u m a n being is c o n t i n u o u s l y r e l a t e d to w h a t he e n c o u n t e r s . m o r e o r less a u t o n o m o u s . H u m a n b e i n g . o f i n s t i n c t s . is the " u n c o n s c i o u s . Even p h y s i o l o g y and biology a r e p e r p e t u a l l y c o n c e r n e d w i t h t h e idea o f c o n s c i o u s n e s s t o t h e e x t e n t t h a t t h e y t r y t o t r a c e i t back t o n e u r o p h y s i o l o g i c a l s t r u c t u r e s and p r o c e s s e s o r t o e l i m i n a t e i t e n t i r e l y . o r f u n c t i o n s of a h y p o t h e s i z e d boxlike p s y c h e b e c o m e visible as t h e h i g h l y various. and a s p i r a t i o n s .t h e w o r l d . T h e y a r e . and h a s s u c c e e d e d in seeing the h o r i z o n o f t h e D a s e i n s a n a l y t i k v i e w o f h u m a n being. O n c e one has managed to explode the theoretical myths of p s y c h o l o g i s m and s u b j e c t i v i s m .. o b s e r v e d and d e s c r i b e d . " its c o n c e p t u a l n e g a t i o n . In an e x i s t e n t i a l p e r s p e c t i v e . While t h e y can speak o f a l t e r a t i o n s i n c o n s c i o u s n e s s .EXISTENTIAL FOUNDATIONS 132 m u l t i t u d e o f w a y s o f p e r c e i v i n g and r e s p o n d i n g . K a r l J a s p e r s had t o s e e k refuge in a m e t a p h o r : " W e give t h e n a m e c o n s c i o u s n e s s to the w h o l e . 1 6 From consciousness to the fundamental openness of human existence T h e t e r m " c o n s c i o u s n e s s " claims a u n i q u e place in c o n t e m p o r a r y philosophy and in t h e s c i e n c e s of p s y c h o l o g y . T h e s e m o d e s can b e scientifically. O n c e human existence is seen as bearing the spatio-temporal w o r l d w i d e r e a l m of o p e n n e s s as. T h e form o f t h e q u e r y only s h o w s t h a t t h e q u e s t i o n e r is still u n a b l e to get out of t h e traditional v i e w in w h i c h people are n o t h i n g m o r e t h a n e n t i t i e s p r e s e n t a t p a r t i c u l a r l o c a t i o n s w i t h i n a p r e s u p p o s e d w o r l d space. faculties.e. and p a t h o l o g y . t h e p r o b l e m of location t a k e s on a w h o l l y d i f f e r e n t aspect.e v i d e n t t h a t t h e possibilities for r e l a t e d n e s s b e l o n g f u n d a m e n t a l l y and i m m e d i a t e l y t o t h e w h o l e r e a l m o f p e r c e p t i v e o p e n n e s s . t h e y h a v e v e r y little t o say a b o u t t h e n a t u r e o f c o n s c i o u s n e s s itself. T h i s o p e n n e s s is t h e primordial spatiality or prespatiality in w h i c h t h e possibility of a p h e n o m e n o n ' s being located at a n y p o i n t in space is grounded. all t h e p h e n o m e n a t h a t h a v e until n o w been inexplicably m i s i n t e r p r e t e d a s t h e p o s s e s s i o n s . w h a t c o n s t i t u t e h u m a n b e i n g . drives. t h e possibilities o f perceiving and a c t i n g w h i c h m a k e u p h u m a n e x i s t e n c e are t o b e f o u n d . concrete modes of existing as the world-spanning openness that is h u m a n Da-sein. Leading p s y c h o l o g i s t s h a v e also had to give up a t t e m p t s to find a scientific e x p l a n a t i o n for t h e n o t i o n o f c o n s c i o u s n e s s . o n t i c a l l y . T h e idea is f u n d a m e n t a l to depth p s y c h o l o g y and p s y c h o p a t h o l o g y in t h a t their m o s t i m p o r t a n t c o n c e p t . t h a t c o n t a i n m e n t a l faculties. a p e r c e p t i v e and a c t i v e l y r e s p o n s i v e o p e n n e s s . o n e should also h a v e s e e n t h e a b s u r d i t y of t h e c o m m o n q u e s t i o n of where. p h y s i o l o g y . itself. It is t h e n s e l f . i. after t h e p s y c h e c o n c e p t h a s d i s a p p e a r e d . t h o u g h . i n fact. isolated b o d i e s . w h e t h e r m a t e r i a l or i m m a t e r i a l .i n . I am p r e s e n t i n g to m y s e l f w h a t is p r e s e n t in my world.s a c . I n " r e p r e s e n t .Basic Concepts of Biology. o r a s t h e m e d i u m i n w h i c h t h e y m o v e . C o n s c i o u s n e s s w a s t h o u g h t of as a s e l f . all t h e t h o u g h t p r o c e s s e s of w h i c h a p e r s o n is a w a r e . In r e s p o n s e to t h e i n s u r m o u n t a b l e difficulties i n h e r e n t in t h e s e notions. " t h e " r e " prefix indicates t h a t k n o w l e d g e r e f e r s back to t h e k n o w e r . w h i c h m e a n s " t o h a v e a c o n s c i o u s n e s s . and t h o u g h t itself. Bewusstsein. It . w h i c h a r e in t u r n usually s e e n a s c o n n e c t i o n s a m o n g e n d o p s y c h i c r e p r e s e n t a t i o n s . figuratively a s t h e s t a g e o n w h i c h t h e p a r t i c u l a r psychicp h e n o m e n a c o m e and g o .p r e s e n t . A s t a g e c a n n o t p e r c e i v e w h a t is b e i n g played on it. a r e c o m p o s e d of. " I t i s n o t h a r d t o see w h y this s t a g e m e t a p h o r c a n n o t b e t a k e n v e r y far. t h a t h u m a n b e h a v i o r supplies n o c o n c r e t e e v i d e n c e t o j u s t i f y t h e s e c o n c e p t i o n s o f c o n s c i o u s n e s s and its c o n t e n t o f t h o u g h t and e n d o p s y c h i c representations. " C o n s c i o u s n e s s i s g e n e r a l l y r e p r e s e n t e d a s s o m e specific thing e x i s t i n g as a b o x l i k e c o n t a i n e r . W h i l e we speak of c o n s c i o u s n e s s w e a l w a y s h a v e i n m i n d t h e ability t o b e c o m e c o n s c i o u s o f things as phenomena of particular meanings. M o r e can be g l e a n e d f r o m t h e Latin conscientia. T o t h e c a t e g o r y o f c o n s c i o u s p s y c h i c p r o c e s s e s b e l o n g . as it w e r e . the suggestion has been made many times to dispense with the s u b s t a n t i v e s Bewusstsein and " c o n s c i o u s n e s s " and i n s t e a d u s e only t h e adjectives bewusst and " c o n s c i o u s . Physiology. We m a y d i s c o v e r t h a t t h e t e r m Bewusstsein is a surprisingly r e c e n t c o i n a g e . I c o n t i n u e in a w a r e n e s s of m y s e l f as a being t h a t is c o n s c i o u s of s o m e t h i n g . Y e t p s y c h o l o g i s t s and p s y c h i a t r i s t s a r e still at a loss to explain e x a c t l y w h a t t h e s e t h o u g h t p r o c e s s e s . is a little u n f o r t u n a t e . and Psychology 133 of p s y c h i c life at a g i v e n m o m e n t . B u t conscientia ( c o n s c i o u s n e s s ) and its ability to r e p r e s e n t w e r e also s u b j e c t e d t o t h e m u t i l a t i n g p r o c e s s o f reification u n d e r t h e n a t u r a l scientific a p p r o a c h . and r e p r e s e n t a t i o n s w e r e s e e n as i m a g e s of o b j e c t s in t h e e x t e r n a l w o r l d . f o r m i n g a part of t h e e n d o p s y c h i c m a t e r i a l of c o n s c i o u s n e s s and filling its i n n e r field. W h e n I r e . We can o n c e again look to l a n g u a g e for a w a y out of this c u l . It has g e n e r a t e d t h e idiom ein Bewusstsein hahen.d e . W h e n e v e r I am conscious of something that is not m y s e l f . 1 7 T h e G e r m a n w o r d for c o n s c i o u s n e s s . And a l t h o u g h this a w a r e n e s s o f m y s e l f i s n o t t h e m a t i c . o n e w e h a v e e m p h a s i z e d o f t e n e n o u g h .i m m a n e n t p s y c h i c p r o c e s s e s and a b o v e all could help distinguish a m o n g c o n s c i o u s and u n c o n s c i o u s psychic p r o c e s s e s . We i m a g i n e this c o n s c i o u s n e s s . T h e con prefix r e f e r s to the h u m a n subject. consciousness nevertheless by nature always entails consciousness of self. a m o n g o t h e r t h i n g s . " T h e s e could d e s i g n a t e c e r t a i n c o n s c i o u s .c o n t a i n e d b o x l i k e — t h o u g h i m m a t e r i a l — p h e n o m e n o n . T h e y c a n n o t g e t a r o u n d t h e fact. t h e . w h o is—in m o d e r n p s y c h i a t r i c j a r g o n — " o r i e n t e d . w h a t w e h a v e said c o n c e r n i n g t h e r e l a t i o n s h i p b e t w e e n c o n s c i o u s n e s s and Da-sein has n o t g o n e u n c h a l l e n g e d . r e p r e s e n t s t h e s e i m a g e s t o h i m s e l f w i t h i n s o m e supposedly e n c a p s u l a t e d c o n s c i o u s n e s s . or if it is the o t h e r w a y a r o u n d . being and r e m a i n i n g o u t t h e r e in t h e w o r l d in the revealing c l e a r n e s s o f his b e i n g .w o r l d .s t a t i c " dwelling in t h e c l e a r o p e n n e s s peculiar to h u m a n Da-sein is i n d i s p e n s a b l e . in p a r t i c u l a r . " " t o b e a w a r e o f s o m e t h i n g a s being s o m e t h i n g . or associations. T h i s raises t h e q u e s t i o n of w h e t h e r c o n s c i o u s n e s s (as being bewisst) is t h e p r e c o n d i t i o n for h u m a n b e i n g . R a t h e r t h e p h e n o m e n a t h e m s e l v e s .i n . F r o m its I n d o g e r m a n i c r o o t vid-. e n t e r t h e r e a l m o f his p e r c e p t i v e o p e n n e s s . of b e i n g .t h e r e " and " b e i n g .t h e . But just this is t h e s i n g u l a r c o n t r i b u t i o n o f I ).w o r l d .i-. As it m u s t always r e m a i n 1 1 . is evident as s o o n as this h u m a n " b e i n g . t h r o u g h w h i c h t h e act o f p e r c e p t i o n w a s split i n t o t h e o b j e c t i f i c a t i o n o f t h i n g s o u t s i d e and t h e i r r e p r e s e n t a t i o n w i t h i n a h u m a n s u b j e c t . a p p r e h e n d i n g w h e r e t h e s e t h i n g s b e l o n g and w h a t t h e y are for. t h a t p e r s o n is bewisst w h o h a s found his place in his e n v i r o n m e n t and a m o n g t h e o b j e c t s a r o u n d h i m . T h e y appear b e f o r e him. It is not man w h o forms images of the things around him. C e r t a i n l y . . b e c o m e p r e s e n t t o him and s t a n d revealed i n t h e i r c o n t e x t o f r e f e r e n c e s . 1 1 \ ' • .i n . " S o m e o n e can b e c o m e o r i e n t e d o n l y a f t e r h e has g r a s p e d t h e m e a n i n g s o f w h a t h e h a s s e e n .s p a n n i n g o p e n n e s s to perceiving w h a t is t h e r e in its p r e s e n c e .t h e . and t h e n m a k e s c o n n e c t i o n s b e t w e e n t h e m . o r t h o u g h t p r o c e s s e s . T h e priority of Da-sein.134 EXISTENTIAL FOUNDATIONS and the adjective bewusst did n o t a p p e a r until t h e e i g h t e e n t h c e n t u r y .t h e . T h e y still largely r e t a i n t h e original m e a n i n g s i m p a r t e d t o t h e m i n a n era t h a t w o r e t h e philosophical spectacles o f C a r t e s i a n i s m . " A c c o r d i n g l y . and a d d r e s s him w i t h their m e a n i n g s . i n t h e s e n s e o f connections. for being bewisst and finding o n e ' s place in t h e w o r l d . Ey. " is u n d e r s t o o d e x i s t e n t i a l l y . 1 1 1 . .i• 1 1 1 . to psychology and p s y c h i a t r y . h a s a c c u s e d t h e e x i s t e n t i a l v i e w of inflating c o n s c i o u s n e s s to t h e b u r s t i n g point until it e v a p o r a t e s i n t o ml m i l e ex stasies.i n . i . t h e n t h e " e c . M u c h o l d e r t h a n Bewusstsein and bewusst is t h e a r c h a i c G e r m a n w o r d bewissen. T h i s kind of r e l a t i o n s h i p b e t w e e n Da-sein and c o n s c i o u s n e s s also m a k e s it e a s i e r to u n d e r s t a n d w h y t h e r e can be no s u c h things as c o n s c i o u s e n d o p s y c h i c ideas. among intrapsychic representations or images. the v e r b wissen m e a n s " t o h a v e s e e n s o m e t h i n g . By c o n t r a s t . T h e F r e n c h psychiatrist 11. We h a v e said t h a t the f u n d a m e n t a l trait of h u m a n Da-sein is its w o r l d .i n . If t h e r e is to be a capacity f o r p e r c e p t i o n .i n .w o r l d . a p s y c h o l o g i c a l l y conceived boxlike consciousness cannot be the condition of h u m a n being-in-the-world. He called it t h e s t a r t i n g point and real m o t o r of all d r e a m p r o c e s s e s . " s e e m e d initially to be n o t h i n g m o r e t h a n a puzzling f e a t u r e of a c e r t a i n p r o c e s s . bul a l i o .Basic Concepts of Biology. B o t h t i m e s . " F r e u d w r o t e . T h i s i s n o t t h e s a m e a s saying t h a t t h e clock and H a n s h a v e disappeared from m y e x t e r n a l w o r l d . u n c o n s c i o u s w a s an adjective used o n l y to r e f e r to a specific " c h a r a c t e r i s t i c o f c e r t a i n psychic c o n f i g u r a t i o n s . and Psychology 135 a m y s t e r y h o w a s e l f . Freud c o n t i n u e d to use " u n c o n s c i o u s " as a descriptive adjective.c o n t a i n e d i n n e r w o r l d l y e n t i t y — w h a t e v e r it is called—would p e r c e i v e s o m e t h i n g o u t s i d e i t s e l f a s m e a n i n g f u l . t o u n d e r s t a n d h u m a n b e i n g . D u r i n g this s a m e t i m e . t h o u g h . H e e q u a t e d i t w i t h psychic reality. for t h i n g s like t h e e n d o p s y c h i c c o n f i g u r a t i o n s w h i c h a r e alleged t o b e u n c o n s c i o u s c a n n o t b e s h o w n t o e x i s t . it is n o t a c e r t a i n p s y c h i c p r o c e s s or an i n t r a p s y c h i c i m a g e w i t h i n a p s y c h e t h a t is u n c o n s c i o u s .i n . u n c o n s c i o u s i s s y n o n y m o u s w i t h t h e s t a t e m e n t : s o m e p h e n o m e n o n out t h e r e i n t h e open r e a l m o f m y w o r l d i s n o t for t h e t i m e being t h e m a t i c a l l y p r e s e n t for m e . and m y r e l a t i o n s h i p t o H a n s . for t h e m o m e n t ." T h r o u g h Freud. p e r h a p s I m i g h t call t h e clock on t h e wall b e h i n d me u n c o n s c i o u s . If hard p r e s s e d . 18 At first. In b o t h i n s t a n c e s . a t h i n g on t h e wall. b u t m e r e l y t h a t . T h e distinction b e t w e e n c o n s c i o u s and u n c o n s c i o u s psychic p r o c e s s e s s e e m e d t o h i m " t h e o n l y light i n the d a r k n e s s o f depthpsychology.t h e world. If s o m e t h i n g does n o t e x i s t in t h e first place. w i t h its e n c l o s e d field o f c o n s c i o u s n e s s . m y r e l a t i o n s h i p t o m y friend H a n s m a y also be u n c o n s c i o u s in t h a t s e n s e . F r e u d gave t h e t e r m its p r e s e n t psychological m e a n i n g . the t r a d i t i o n a l w a y o f s t a t i n g the p r o b l e m o f c o n s c i o u s n e s s can actually best be served by being b r o u g h t " t o t h e b u r s t i n g p o i n t . and t h e c o n c e p t of a psychic u n c o n s c i o u s rapidly b e c a m e t h e m o s t i m p o r t a n t o f his e n t i r e t h e o r y . 1 9 In t h e s u b s e q u e n t d e v e l o p m e n t of his m e t a p s y c h o l o g y . at least while I am w r i t i n g and n o t a w a r e of t h e c l o c k . it can be n e i t h e r c o n s c i o u s n o r u n c o n s c i o u s . " E v e n this e a r l y application of t h e t e r m is s u s p e c t . " " T h e u n c o n s c i o u s . " It is n e c e s s a r y to e x p l o d e the traditional n o t i o n s of an e n c a p s u l a t e d p s y c h e . a r e n o t t h e focus o f m y a t t e n t i o n . Physiology. the notion of the unconscious became so crucial for m o s t o f t h e prevailing t h e o r i e s a b o u t h u m a n b e i n g s t h a t t h e y w e r e labeled a s depth p s y c h o l o g i e s . T h e " d e p t h " c a m e f r o m t h e fact t h a t Freud posited v a r i o u s p s y c h i c levels and w i s h e d t h e u n c o n s c i o u s t o b e u n d e r s t o o d as t h e psychic locale or p s y c h i c s y s t e m t h a t lay beneath consciousness. h o w e v e r . and it should be clear by n o w t h a t to do so is a main goal of this existential foundation of medicine. From a psychic unconscious to a fundamental "hiddenness" T h e unconscious is one of the most frequently employed concepts of m o d e r n p s y c h o l o g y and p s y c h i a t r y . as well as m o s t p s y c h o l o g i s t s and p s y c h o p a t h o l o g i s t s a f t e r him to f o r g e t quickly t h a t the h y p o t h e s i z e d d y n a m i c u n c o n s c i o u s is e v e n f u r t h e r from a n a d e q u a t e u n d e r s t a n d i n g o f h u m a n b e i n g s t h a n t h e e a r l i e r descriptive n o t i o n o f c e r t a i n psychic p r o c e s s e s a s u n c o n s c i o u s . w h a t had b e e n r e p r e s e n t e d initially a s m e r e l y the p r o p e r t y o f a n e n d o p s y c h i c p r o c e s s g r e w t o b e c o m e a n e n t i t y o f its o w n and w a s accorded all m a n n e r o f p r o p e r t i e s and laws. N o w it w a s said. p r e f e r r i n g m o r e and m o r e t h e idea o f libido w i t h d r a w a l t o t h a t of d e s c e n t i n t o a topically deeper psychic s y s t e m . A s e c o n d c h a r a c t e r i s t i c F r e u d a s c r i b e d to this reified u n c o n s c i o u s was t h e peculiar w a y in w h i c h t h o u g h t p r o c e s s e s t o o k place in it. 21 T h e s e c h a r a c t e r i s t i c s o f the d y n a m i c u n c o n s c i o u s look a s t h o u g h t h e y w e r e precise d e t e r m i n a t i o n s of a definable o b j e c t . were m a r k e d b y t h e unparalleled fluidity o f its mobile psychic e n e r g y . h o w e v e r . t h e h y p o t h e s i s of a psychological u n c o n s c i o u s r e m a i n s m i s l e a d i n g and d i s t o r t s the t r u e p i c t u r e o f h u m a n b e i n g . " Freud's reified psychic s y s t e m can be called a dynamic u n c o n s c i o u s . T h e s e p r i m a r y p r o c e s s e s . o n t o a single o n e . 20 T h a t i s h o w . T h i s fluidity p e r m i t t e d disparate ideas to c o a l e s c e to a u n i t y and e n a b l e d t h e f o r c e of m a n y ideas to be shifted. In c o n t r a s t to a m e r e l y descriptive u s e of t h e w o r d " u n c o n s c i o u s . F r e u d a s s u m e d t h a t t h e psychic p r o c e s s e s and ideational c o n t e n t s o f the u n c o n s c i o u s had b e e n r e p r e s s e d t h e r e t h r o u g h t h e p o w e r o f a p s y c h i c c e n s o r and w e r e held t h e r e b y the s a m e psychic d y n a m i s m . it [the u n c o n s c i o u s ] m e a n s more We apply t h e t e r m ' t h e u n c o n s c i o u s ' to a system w h o s e distinctive f e a t u r e is t h a t t h e individual p r o c e s s e s c o m p r i s i n g it a r e u n c o n s c i o u s . i n F r e u d ' s m e t a p s y c h o l o g y . F r e u d had so c o m p l e t e l y f o r g o t t e n the purely h y p o t h e t i c a l n a t u r e o f t h e u n c o n s c i o u s t h a t h e boldly a t t e m p t e d t o p r o v e I he e x i s t e n c e of t h e s y s t e m he had i n v e n t e d . P e r h a p s it was this t h a t allowed F r e u d . This is the most important sense that the expression 'unconscious' has acquired in p s y c h o a n a l y s i s . primary thought process showed no r e s p e c t for t i m e . In a s h o r t t i m e . in contradistinction to the secondary processes of conscious thought.136 EXISTENTIAL FOUNDATIONS i n c r e a s i n g l y indulged in an e n t i r e l y novel u s a g e t h a t a m o u n t e d to a reification o f the original a t t r i b u t e . F r e u d s u b s e q u e n t l y c h a n g e d his opinion o n h o w psychic data b e c a m e u n c o n s c i o u s . the unconscious. t h a t t h e u n c o n s c i o u s e x h i b i t e d a s o v e r e i g n disdain for t h e laws of logic. but e v e n in its n e w r o b e s . he declared . for i n s t a n c e . Moreoever. As a first step. T h e s e n t e n c e f r o m F r e u d w e cited a b o v e was followed w i t h : " n o w . replacing e x t e r n a l reality w i t h a psychic reality w i t h i n w h i c h psychic p r o c e s s e s w e r e s u b j e c t e x c l u s i v e l y t o t h e p l e a s u r e principle. in t h e u n c o n s c i o u s . T h e legitimacy of the two assumptions is comparable. b u t t h e y a r r a n g e t h e m s e l v e s in a d e m o n s t r a b l e orderly c o n t e x t a s s o o n a s w e i n t e r p o l a t e t h e i n f e r r e d u n c o n s c i o u s o p e r a t i o n s . Here we must agree with Freud. "as long as we insist on a p p r o a c h i n g t h e m e x c l u s i v e l y t h r o u g h c o n s c i o u s n e s s . A s o n e p r o o f for t h e e x i s t e n c e o f a psychic u n c o n s c i o u s F r e u d cites t h e e v e r y d a y o b s e r v a t i o n t h a t an idea of w h i c h we a r e c o n s c i o u s in a given m o m e n t m a y n o l o n g e r b e c o n s c i o u s for u s i n t h e n e x t . ideas w h o s e origins elude u s and c o n c l u s i o n s t h a t s e e m t o c o m e f r o m n o w h e r e . T a k e . t h e data o f c o n s c i o u s n e s s a l w a y s r e m a i n i n g f r a g m e n t a r y o t h e r w i s e . A n y c o n t e x t m a d e up of i n f e r r e d and i n t e r p o l a t e d e n t i t i e s is n o t demonstrable. F r e u d ignored t h e fact t h a t causal c o n n e c t i o n s — t h e o n l y kind h e tried w i t h his h y p o t h e s i z e d u n c o n s c i o u s to establish among conscious acts—can do no m o r e than demonstrate the r e g u l a r i t y of a purely t e m p o r a l . " F r e u d g o e s on to say. b u t in i t s e l f e n t i r e l y m e a n i n g l e s s . F r e u d a r g u e s similarly t o 2 4 . T h e a c c r u a l o f m e a n i n g and c o n t e x t i s a r e s u l t t h a t fully j u s t i f i e s o u r going b e y o n d i m m e d i a t e e x p e r i e n c e . and Psychology 137 his h y p o t h e s i s of an u n c o n s c i o u s " l e g i t i m a t e . " in so far as the a s s u m p t i o n of o t h e r people being e n d o w e d with consciousness is itself only inferred by a n a l o g y . B u t F r e u d tells us t h a t to i n f e r t h e e x i s t e n c e of an u n c o n s c i o u s is n o t o n l y l e g i t i m a t e but actually n e c e s s a r y . from t h e standpoint of the phenomena of h u m a n existence. s u b j e c t i v e c o n s c i o u s n e s s is itself justified. t h r o u g h u n i n t e r r u p t e d c a u s a l c h a i n s . it m u s t in the m e a n t i m e h a v e b e e n l a t e n t . s u c c e s s i o n i n t h e m a n i f e s t a t i o n o f c e r t a i n p h e n o m e n a . " b e c a u s e "in positing it.Basic Concepts of Biology. for e x a m p l e . F u r t h e r m o r e . So enslaved was Freud to the command of the natural scientific m e t h o d t h a t h e failed t o see t h e j a r r i n g c o n t r a d i c t i o n i n h e r e n t i n t h e r e a s o n i n g b e h i n d his h y p o t h e s i s o f a n u n c o n s c i o u s . as F r e u d a r g u e s it is. H e a s k s . with e v i d e n t g o o d r e a s o n . w h e r e t h e idea m i g h t have c o m e from and w h e r e it could h a v e g o n e to. u n c o n s c i o u s . we do n o t v e e r a single step from t h e w a y of t h i n k i n g we c o n s i d e r c u s t o m a r y and c o r r e c t . t o s o m e hidden psychic c a u s e . and his c o m p a r i s o n does u l t i m a t e l y raise t h e q u e s t i o n o f t h e e x t e n t t o w h i c h t h e a s s u m p t i o n of an i n d e p e n d e n t . there is absolutely no n e c e s s i t y or m o t i v e for positing a psychic u n c o n s c i o u s . Physiology. S i n c e i t could n o t simply h a v e g o n e o u t o f e x i s t e n c e (or it could n o t h a v e r e a p p e a r e d in t h e n e x t i n s t a n t ) . T h e n o n e would h a v e t o h y p o t h e s i z e a n u n c o n s c i o u s t o supply t h e m i s s i n g links in the causal chain in t h e a b s e n c e of a c t u a l d e m o n s t r a t i o n s of their existence. "All o f t h e s e p a r t i c u l a r o p e r a t i o n s r e m a i n i n c o m p r e h e n s i b l e and d i s c o n n e c t e d . I n s u m . " 22 2 3 We pointed out earlier that the series of observable conscious o p e r a t i o n s appears f r a g m e n t a r y o n l y if o n e p r e s u p p o s e s it m u s t be reducible. its actual place. B e c a u s e t h e h y p n o t i z e d s u b j e c t h a s s u r r e n d e r e d his i n d e p e n d e n t s e l f n e s s . N o t o n e o f t h e s e p r o o f s stands u p u n d e r s c r u t i n y . as we h a v e t a k e n pains to point o u t . or p e r s o n . B u t h e s e e s i n e v e r y d a y slips t h e m o s t c o n v i n c i n g e v i d e n c e for a n unconscious. I c o n s c i o u s l y visualize t h e F r e i b u r g C a t h e d r a l . t h a t I can in t h e n e x t i n s t a n t cut off m y specific r e s p o n s e t o t h e c a t h e d r a l . for t h e d u r a t i o n of t h e visualization. t h e c h a i r will address him a s s o m e t h i n g t o b e set o n t h e table. for i n s t a n c e . it is e a s y for the h y p n o t i s t to p r e v e n t him f r o m r e c o g n i z i n g t h e origin o f his p o s t h y p n o t i c r e l a t i o n s h i p t o t h e chair." In a similar w a y . it is possible for t h e h y p n o t i z e d p e r s o n to r e n o u n c e his i n d e p e n d e n t s e l f n e s s to s u c h a d e g r e e t h a t h e n c e f o r t h he can e x i s t o n l y t h r o u g h t h e h y p n o t i s t . a f t e r e m e r g i n g from h y p n o s i s .138 EXISTENTIAL FOUNDATIONS explain t h e e x p e r i e n c e o f s u b j e c t s c a r r y i n g o u t p o s t h y p n o t i c s u g g e s ­ t i o n s . by t h e c a t h e d r a l . T h u s the p e r s o n w h o had b e e n h y p n o t i z e d will e x p r e s s i n t h e first p e r s o n wh. is not the activation of an intrapsychic representation but that the c a t h e d r a l i t s e l f appears t h e m a t i c a l l y i n t h e p e r c e p t i v e r e a l m o f m y b e i n g in-the-world. T h e s t a t e o f h y p n o s i s m a y b e defined a s o n e i n w h i c h t h e h y p n o t i z e d h a s c o m e a l m o s t totally u n d e r t h e spell o f the h y p n o t i s t . h a s n o t y e t r e e s t a b l i s h e d h i m s e l f as an i n d e p e n d e n t self. as F r e u d posited. n o t realizing t h a t t h e i r t h o u g h t s and a c t i o n s a r e fulfilling n o t t h e i r o w n e x i s t e n t i a l p o t e n t i a l i t i e s . First o f all. come forward into the center of my perceptive realm. J u s t as ill suited as p r o o f s for t h e e x i s t e n c e of a p s y c h i c u n c o n s c i o u s a r e t h e h y p n o s i s e x p e r i m e n t s o f B e r n h e i m . w i t h all t h a t I a m . dwelling a s o n e w i t h him i n t h e i r s h a r e d world. l e t t i n g its presence retreat into the nonthematic background of the worldo p e n n e s s as w h i c h I am e x i s t i n g and l e t t i n g a n o t h e r thing. t h e first t o h a v e people p e r f o r m a c t i o n s h e had s u g g e s t e d t o t h e m e a r l i e r u n d e r h y p n o s i s . It is only b e c a u s e . I e n t e r ino an open. F r e u d ' s description is already an i n t e r p r e t a t i o n of h u m a n b e h a v i o r and i n a d e q u a t e at t h a t . All o f this m e r e l y s h o w s t h a t t h e s u b j e c t . w h a t h a p p e n s . T h e r e is no evidence of the endopsychic representation of t h e c a t h e d r a l . d e m o n s t r a b l e pure fact. m a n y people a r e h y p n o t i z e d by tradition en l>v I l i e a n o n y m o u s " t h e y " of t h e i r c u l t u r e . If. O w i n g t o people's f u n d a m e n t a l being t o g e t h e r in a s h a r e d w o r l d . T h e h y p n o t i s t can. t h e e v e r y d a y o b s e r v a t i o n t h a t a c o n s c i o u s idea can s u d d e n l y be n o t c o n s c i o u s is far from b e i n g an empirical. at this v e r y m o m e n t . fifteen m i n u t e s a f t e r t h e t r a n c e h a s b e e n b r o k e n .it is actually t h e h y p n o t i s t ' s act of v o l i t i o n : "I will n o w place t h e c h a i r on the table. l u m i n a t i n g r e l a t e d n e s s to t h e c a t h e d r a l and am. o r d e r his s u b j e c t to e s t a b l i s h a r e l a t i o n s h i p to a chair so t h a t . T h i s e n a b l e s t h e h y p n o t i s t t o a r b i t r a r i l y c o m m a n d o b j e c t s to b e c o m e t h e focal point of his s u b j e c t ' s field of vision and to s h a p e t h e s u b j e c t ' s r e l a t i o n s h i p y t o t h e s e o b j e c t s . T h e y are c o n s i s t e n t l y a c t u a l i z a t i o n s . slips.Basic Concepts of Biology. E v e n F r e u d s e e m s t o h a v e b e c o m e a w a r e o f this c i r c u m s t a n c e . and being w i t h t h e s e people for t h e m e e t i n g w a s a n y t h i n g b u t a p u r e p l e a s u r e h e w o u l d h a v e w i s h e d t o p r o l o n g . T h e p a r t i c u l a r h y p o t h e t i c a l c a u s e F r e u d s t e e r e d t o w a r d i n his d r e a m t h e o r y can be found on page 4 4 2 of The Interpretation of Dreams: " F r o m the t h e o r y o f h y s t e r i a w e b o r r o w t h e principle t h a t a n o r m a l train o f t h o u g h l is s u b j e c t e d to a b n o r m a l psychic e l a b o r a t i o n only w h e n it has b e c o m e the . w h i c h t h e c h a i r m a n would c o n f i r m . A s i t u a t i o n is a l w a y s m a d e up of a total e n v i r o n m e n t . Physiology.w o r l d . i s likewise u n c o n v i n c i n g . 25 L a s t b u t n o t least. B u t t h e d r e a m i n g Da-sein of a p e r s o n yields to an i n v e s t i g a t o r t h e n o t i o n of an u n c o n s c i o u s only if he is d e t e r m i n e d at all c o s t s t o p r o c e e d i n t h e m a n n e r o f n a t u r a l s c i e n c e . F r e u d deduced t h e e x i s t e n c e in t h e u n c o n s c i o u s of a c o u n t e r f o r c e lurking u n s e e n for j u s t such a c h a n c e to b r e a k t h r o u g h and disrupt c o n s c i o u s ­ n e s s . H e w a s d o u b t l e s s e n g a g e d in a n e g a t i v e r e l a t i o n s h i p to t h e a s s e m b l y . " In s h o r t . e m p l o y i n g purely h y p o t h e t i c a l c o n c l u s i o n s in o r d e r to t r a c e t h e d r e a m back to a universally valid c a u s e t h a t does n o t really e x i s t at all. W e n e e d o n l y the i n s i g h t t h a t t h e c h a i r m a n e x i s t s . In his e r r o r . F r e u d w o u l d i n t r o d u c e d r e a m s a s e v i d e n c e o f the psychic u n c o n s c i o u s . and Psychology but t h e w i s h e s and t h o u g h t s o f t h e i r f o r e b e a r s o r o f popular opinion N e v e r t h e l e s s . " O n t h e basis o f this.i n . F r e u d ' s third c a t e g o r y of e v i d e n c e for t h e e x i s t e n c e of a psychic u n c o n s c i o u s . we do n o t n e e d a F r e u d i a n u n c o n s c i o u s to explain p o s t h y p n o t i c b e h a v i o r a n y m o r e t h a n w e n e e d i t t o u n d e r s t a n d the b e h a v i o r o f s o m e o n e m e s m e r i z e d b y tradition o r popular s a n c t i o n . u n s c i e n t i f i c h y p o t h e s i s o f a n u n c o n s c i o u s . w h i c h a r e n o t to be found w i t h i n a p s y c h e b u t are m o d e s o f t h e h u m a n b e i n g . " I t h i n k this i s r i g h t o r w r o n g . t h e c h a i r m a n w a s acting from a v e r y specific r e l a t i o n s h i p w i t h his fellow club m e m b e r s . t h a t he c o n s c i o u s l y w a n t e d o n l y t o o p e n t h e m e e t i n g .t h e . o f a r e l a t i o n s h i p b e t w e e n people.w o r l d t h a t p e r v a d e s t h e o p e n r e a l m o f the w o r l d c o m m o n t o all people. b u t in no case a r e t h e y c a u s e d by an i n s t i n c t i v e desire p r e s e n t w i t h i n a capsulelike p s y c h e . w e d o n o t n e e d the u n p r o v a b l e .t h e .i n . W a s n ' t it a fact. T o affirm t h e e x i s t e n c e o f t h e u n c o n s c i o u s h e m e n t i o n s t h e case o f the c h a i r m a n w h o s e opening r e m a r k s ended: " I declare this m e e t i n g a d j o u r n e d . and as s u c h c o n s i s t s in t h e t o t a l i t y of his p o t e n t i a l for r e l a t e d n e s s to w h a t he e n c o u n t e r s in his w o r l d . for he did r e a c h the c o n c l u s i o n t h a t clues to u n d e r s t a n d i n g slips m u s t be t a k e n f r o m t h e situation of t h e p e r s o n w h o m a k e s t h e slips. t o deal w i t h t h e p h e n o m e n o n o f his e r r o r i n speaking. a s b e i n g . n o t t o adjourn it? N e v e r t h e l e s s . t h e y t o o say. " " ! intend t o d o this or t h a t . r a t h e r . Slips of t h e t o n g u e can h a p p e n in a n y n u m b e r of w a y s . I t m a t t e r s little w h e t h e r o r n o t h e was t h e m a t i c a l l y a w a r e o f this p o o r r e l a t i o n s h i p a t t h e i n s t a n t h e m a d e his slip. w i t h its i n t e n s i v e u s e o f t h e p s y c h i c u n c o n s c i o u s . T o g e t h e r w i t h all t h e a r c h e t y p a l i m a g e s . admittedly. Conceding that these dreams are not very interesting in t h e m s e l v e s . T h e r e is n o need . and f o r c e s t h a t i n h a b i t it. the very same psychologistic way of t h i n k i n g . B u t it is m u c h m o r e likely t h a t t h e y reveal t h e m s e l v e s . S e c o n d . or p s y c h e s . in m u c h t h e s a m e w a y w i t h i n t h e open realm o f h u m a n p e r c e p t i o n . s o m e t h i n g t h a t . c a n n o t b e g e n e r a l l y p r o v e n . T h e first i s t h a t h u m a n b e i n g s c o n s i s t . would t h e n d r e a m o f o r g i e s of eating. aside from t h e i r bodies. b e c a u s e they t h e m s e l v e s s h i n e fori h in the s a m e w a y e v e r y w h e r e and at all t i m e s . T h i s fact is i n c o n t e s t a b l e . of an i n d e p e n d e n t . by t h e i r v e r y n a t u r e s ." This conclusion is no m o r e c o n v i n c i n g t h a n it would be to claim t h a t b e c a u s e t h e r e are s u c h t h i n g s as w h i t e r o s e s . It is in accordance with this principle t h a t we h a v e c o n s t r u c t e d o u r t h e o r y o f t h e d r e a m o n t h e assumption t h a t t h e impelling desire c o n s i s t e n t l y arises i n t h e u n c o n s c i o u s . b u t J u n g ' s interpretation of it r e s t s on t w o faulty a s s u m p t i o n s . n o t dismissed o u t o f h a n d . w a s c r e a t e d n o t for t h e sake of t h e u n m a n i p u l a t e d d r e a m p h e n o m e n a t h e m s e l v e s b u t solely to suit a p r e c o n c e i v e d principle. F r e u d added t h a t " t h e y are obviously of i n e s t i m a b l e value as proofs that dreams are. t h e collective u n c o n s c i o u s is n o t h i n g m o r e than an a t t e m p t t o explain t h a t m a n y p h e n o m e n a reveal t h e m s e l v e s i n t h e s a m e w a y to people w h o a r e widely s e p a r a t e d in space and t i m e . T h e collective u n c o n s c i o u s d e r i v e s from t h e v e r y s a m e subjectivistic understanding of man. s t r u c t u r e s . in essence.140 EXISTENTIAL FOUNDATIONS m e d i u m for a n u n c o n s c i o u s desire t h a t h a s b e e n r e p r e s s e d b e c a u s e o f its infantile n a t u r e . He illustrated his point w i t h r e p o r t s o f children w h o . wish-fulfillments. all r o s e s of o t h e r c o l o r s m u s t be. in disguise. 26 Freud saw undisguised wish-fulfillment dreams as the one proof that infantile d e s i r e s e x i s t e d in t h e u n c o n s c i o u s and w e r e t h e u n i v e r s a l l y valid c a u s e of all m a n i f e s t d r e a m i m a g e s . " T h e r e i s n o m o r e i m p r e s s i v e p r o o f t h a n this t h a t Freud's e n t i r e d r e a m t h e o r y . 27 S u m m i n g u p w h a t w e h a v e said. H e r e . All we h a v e said to c o u n t e r Freud's h y p o t h e s i s of an individual u n c o n s c i o u s applies in kind to t h e collective u n c o n s c i o u s posited in C a r l J u n g ' s a n a l y t i c p s y c h o l o g y as an a t t e m p t to c o m p l e t e and underpin Freudian t h e o r y . n o t o n e o f t h e p h e n o m e n a o r a r g u m e n t s F r e u d i n t r o d u c e s to justify his a s s u m p t i o n of a p s y c h i c u n c o n s c i o u s actually does w h a t it is supposed to do. w h e r e b y a given diversity of p h e n o m e n a is s u b j e c t e d to a logical g e n e r a l i z a t i o n . of all h u m a n b e i n g s . in t h e i r t r u e e s s e n c e . h a v i n g g o n e t o bed h u n g r y . p h e n o m e n a t h a t a r e m e r e l y similar in v a r i o u s t i m e s and places lead to t h e c o n c l u s i o n t h a t t h e r e i s s o m e s t r u c t u r e e x i s t i n g identically within t h e brains. w h i t e r o s e s . stratified p s y c h e . t h e v e r y n o t i o n of a collective u n c o n s c i o u s is an i n s t a n c e of r e d u c t i o n i s m . All n o t i o n s of a p s y c h i c u n c o n s c i o u s t h a t h a v e b e c o m e r o o t e d in m o d e r n p s y c h o l o g y t u r n o u t t o b e artificial p r o d u c t s o f t h e o r y .c e n t u r y physicists have b e e n w o r k i n g s o far without the advantage of a new ontological orientation appropriate to their findings. F r o m t h e i r o w n c o n c e p t u a l s t a n d p o i n t . superficiality. W h i l e believing t h e m s e l v e s t o b e p r o g r e s s i v e s c i e n t i s t s . can we b e g i n e v e n to g r o p e t o w a r d t h e h e a r t of t h e m a t t e r .Basic Concepts of Biology. as t h e t h e o r e t i c a l physicist W. his w o r l d . false footholds m a d e to a d v a n c e a p r e c o n c e i v e d and i n a d e q u a t e approach to h u m a n being. t h a t i n fact t h e o b s e r v e r and o b s e r v e d belong t o g e t h e r in a m y s t e r i o u s . T h e y have n o t h i n g t o d o w i t h t h e actual p h e n o m e n a o f h u m a n Da-sein and as a r e s u l t actually o b s t r u c t a d e q u a t e i n s i g h t into t h e n a t u r e o f people. s u b j e c t i v i s t i c . N o t e v e n t h e g r e a t p h i l o s o p h e r s i n t h e W e s t e r n m e t a p h y s i c a l tradition h a v e b e e n able to m a p o u t a s o l u t i o n to this p r o b l e m . i t h a s t h e r e f o r e been impossible t o grasp t h e e s s e n t i a l c o h e r e n c e o f p e r c e i v e r and perceived.w o r l d o b j e c t s disappearing into . S e v e r a l t i m e s already. B u t e v e n t w e n t i e t h . T h e positivistic. w e spoke o f p h e n o m e n a t h a t had o n c e b e e n t h e m a t i c a l l y p r e s e n t dropping out of t h e o p e n realm of an individual h u m a n Da-sein or b e i n g . and t h e r e l a t i o n s h i p between them. e m p h a s i z i n g t h a t this is n o t j u s t a m a t t e r of e n d o p s y c h i c r e p r e s e n t a t i o n s o f e x t e r n a l . and Psychology 141 to s u p p o s e t h a t a collective u n c o n s c i o u s or o t h e r e n d o p s y c h i c e n t i t y e x i s t s t o give t h e s e p h e n o m e n a similar shapes a f t e r t h e fact. P h y s i c i s t s first realized t h a t no radical s e p a r a t i o n can be m a d e b e t w e e n perceived p h e n o m e n a and the people w h o p e r c e i v e t h e m . T h e idea of a psychic u n c o n s c i o u s would n e v e r h a v e b e e n able to e f f e c t a global t r a n s f o r m a t i o n of the s c i e n c e s of h u m a n n a t u r e had it n o t at least v a g u e l y indicated t h e d i m e n s i o n t h a t e n c o m p a s s e s m a n . o b s c u r e r e a l m . for e x a m p l e . in i m i t a t i n g a d v a n c e s m a d e in physics in t h e nineteenth c e n t u r y . H e i t l e r c o r r e c t l y r e m i n d s us.t h e r e . and h a r m f u l n e s s of this h y p o t h e s i z i n g . It is t h e r e f o r e high t i m e t h a t t h e p h r a s e psychic u n c o n s c i o u s w a s e x p u n g e d from t h e v o c a b u l a r y o f p s y c h o l o g y and p s y c h o p a t h o l o g y .t h e . O n l y by inquiring into being itself. t h e y are actually still e n g a g e d . m e d i c i n e ' s o b j e c t o f study h a s b r o u g h t u s v e r y close to t h e m a t t e r at h a n d . In discussing g e n u i n e f o r g e t t i n g . o b j e c t i f y i n g a p p r o a c h e s o f c o n t e m p o r a r y p s y c h o l o g i s t s and p s y c h o p a t h o l o g i s t s limp decades b e h i n d this insight. T h i s c a n n o t be a c h i e v e d m e r e l y by pointing o u t the artificiality. as M a r t i n H e i d e g g e r h a s been doing n o w for t h e space of a h u m a n lifetime. Physiology. We m a k e a b e g i n n i n g in this f o u n d a t i o n of medicine in t u r n i n g o u r regard a w a y from t h e i n a d e q u a t e n o t i o n of a psychic u n c o n s c i o u s and t o w a r d w h a t physicians really o u g h t to keep in v i e w and c o n s i d e r . In colloquial u s a g e . it will be s e e n as the origin and s o u r c e of all t h o s e p h e n o m e n a w h i c h p s y c h o l o g y and p s y c h o p a t h o l o g y h a v e tried in vain to clarify t h r o u g h s u b j e c t i v i s t i c . h u m a n b e i n g s . W h a t is m o r e — a n d we will c o m e back to this l a t e r — a t any o n e time in h i s t o r y t h e r e are c e r t a i n p h e n o m e n a t h a t are invisible to all of m a n k i n d . T h e p r e s e n t age. t e m p o r a r i l y . w h e r e it is released from h i d d e n n e s s and d a r k n e s s . free. reifying t h i n k i n g w h i c h o p e r a t e s w i t h c o n s t r u c t s like psy( hie u n c o n s c i o u s . B u t in t h e g r e a t h i d d e n n e s s t h e r e is no already e x i s t i n g p a r t i c u l a r being. which releases all t h a t is out o f itself. N e i t h e r t h e clearing n o r the h i d d e n n e s s o r i g i n a t e s in c o n c r e t e t h i n g s . M a n y would try t o .142 EXISTENTIAL FOUNDATIONS a different r e g i o n of an e n c a p s u l a t e d p s y c h e . we a g r e e t h a t it w a s always t h e r e u n d e r n e a t h in its final form and d i m e n s i o n s . a m o n u m e n t m a y be hidden by draperies until t h e m o m e n t o f its dedication. and p r e h u m a n . W e also t o u c h e d o n t h e p r o p e r d i m e n s i o n o f t h e p r o b l e m i n o u r a t t e m p t t o define t h e f u n d a m e n t a l trait o f h u m a n Da-sein. and t h o u g h w e c a n n o t see t h e m o n u m e n t until t h e c l o t h is r e m o v e d . n o t t h a t . n o t . prespatial. or in t h e p s y c h e . If W e s t e r n t h i n k i n g s o m e d a y i l l u m i n a t e s this h i d d e n n e s s . for i n s t a n c e . T h e h u m a n being e x i s t s as a s p a n n i n g . F o r i n s t a n c e .lrmi. R a t h e r . T h i s d i m e n s i o n has b e e n c o n s i d e r e d for ages b y n o n w e s t e r n t h i n k e r s as well. and holding open of a realm of perception t h a t i s r e s p o n s i v e t o t h e p r e s e n c e o f w h a t e v e r p h e n o m e n a r e v e a l t h e m s e l v e s in it. not . " h i d d e n " r e f e r s to s o m e t h i n g t h a t is already t h e r e w h i c h has m e r e l y b e e n c o v e r e d and s o w i t h d r a w n . spanning and m a i n t a i n i n g it in its o w n w a y . T h e condition of such e x i s t e n c e is an open. it is no e a s y m a t t e r to c a t c h sight of and t h i n k this hhl. It is t h u s p r e t e m p o r a l . S u c h a realm is possible only t h e r e . this h i d d e n n e s s is the m y s t e r i o u s s o u r c e from w h i c h all t h a t is c o m e s f o r t h to be. Admittedly. T h e y h a v e a l w a y s circled a r o u n d it in t h e w a y of " n e t .".n e t . A n d as it is also p r e l i n g u i s t i c . " saying "it is n o t t h i s ." It is described t h e n as t h a t w h i c h is totally o t h e r .-. w e m a y i n t h e f r a m e w o r k of a f u n d a m e n t a l study of m e d i c i n e call it h i d d e n n e s s . clear realm in w h i c h t h e h u m a n Da-sein can dwell. In f o r g e t t i n g . T h e w o r d " h i d d e n n e s s " m i g h t lead u s t o believe t h a t this primal p h e n o m e n o n m u s t b e u n d e r s t o o d o n t h e basis o f w h a t already is. f r o m view. is often described as t h a t age in w h i c h divinity h a s w i t h d r a w n from t h e o p e n realm o f h u m a n e x i s t e n c e and t h e r e f o r e can no l o n g e r be h e a r d by m a n . the w o r d itself t h a t d e s i g n a t e s this primal p h e n o m e n o n r e p r e s e n t s only a m a k e s h i f t s o l u t i o n f r a u g h t w i t h the d a n g e r o f being misleading. R e m a i n i n g mindful o f t h e ineffability o f this d i m e n s i o n . objectifying. t h e o b j e c t s of the world t h e m s e l v e s e s c a p e from t h e o p e n realm of a h u m a n e x i s t e n c e . b e a r i n g . T h e w o r d still did n o t m e a n " i n n e r c o m p u l s i o n . satisfied w i t h a m y t h o l o g i ­ cal basis.Basic Concepts of Biology. Tnebfeder ("mainspring"). dating from 1 6 8 5 : " a d u l t e r y r o b s n e c k . if a n y t h i n g d e s e r v e s to be called i r r a t i o n a l . Indeed." N o t until t h e e i g h t e e n t h c e n t u r y did p s y c h o l o g y begin to describe Triebe as drives and " p r i m i t i v e . t h e k e r n e l from w h i c h all o t h e r psychic m a n i f e s t a t i o n s spring a s p r o d u c t s o f s u b l i m a t i o n o r a s r e a c t i o n f o r m a t i o n s . T h i s c o n c e p t is prominent in most other contemporary branches of psychology. 2 8 From drive to the human potential for relating specifically to the world around T h e p s y c h i c u n c o n s c i o u s is s o m e t i m e s depicted as a r e s e r v o i r of drives. 1 low could t h e m e a n i n g of Trieb h a v e evolved in any o t h e r w a y ? I ) e s c a r t e s ' s philosophical division of the world into s u b j e c t and object and his d i s c o v e r y t h e r e b y of t h e basis for t e c h n o l o g i c a l m a s t e r y o v e r the . T h e d i c t i o n a r y o f the B r o t h e r s G r i m m c o n f i r m s this by including a v e r s e of Agrippina. B u t if it is s u r p r i s i n g t h a t a m o d e r n t h e o r y i n t e n t on p r e s e n t i n g i t s e l f as e x a c t i n g l y scientific is. t h o u g h m o s t n o n p s y c h o a n a l y t i c t h e o r i e s d o n o t follow F r e u d i n m a k i n g drives an a b s o l u t e .i t s e l f can be p r o p e r l y s e e n o n l y in r e l a t i o n to h i d d e n n e s s and t h e o p e n r e a l m released f r o m h i d d e n n e s s . O n l y i n t h e s e v e n t e e n t h c e n t u r y w e r e drives s p o k e n o f c o n c e r n i n g people. and Psychology 143 dismiss an i n t e r p r e t a t i o n like o u r s as g r o u n d l e s s m y s t i c i s m or p e r n i c i o u s i r r a t i o n a l i t y . w h i c h p s y c h o a n a l y t i c t h e o r y holds t o b e t h e u l t i m a t e reality o f psychic p h e n o m e n a . and belly o f all t h e i r drive (appeal). a m o n g them Triebrad ("drive-wheel"). t h e a c c u s a t i o n o f i r r a t i o n a l i t y aimed a t t h e p h e n o m e n o l o g ical a p p r o a c h will r e m a i n h o l l o w . Trieb ("drive") a r o s e . Physiology. n a t u r a l s t i r r i n g s . M a n y t e c h n i c a l t e r m s a r o s e i n c o m b i n a t i o n w i t h it. F r e u d called drives " m y t h i c a l c r e a t u r e s o f u n k n o w n o r i g i n " and did n o t h e s i t a t e t o d e s c r i b e his t h e o r y o f drives a s t h e m y t h o l o g y o f p s y c h o a n a l y t i c t h e o r y . g a m e . in fact. A n y s t u d y o f t h e e x t e n s i v e l i t e r a t u r e o n drives s h o w s t h a t while i t h a s g r e a t i m p o r t a n c e for p s y c h o l o g i s t s and p s y c h o p a t h o l o g i s t s t h e r e is only v e r y s c a n t y i n f o r m a t i o n a b o u t w h a t drive i s supposed t o b e . it is t h e m i n d l e s s r a m p a g e of r a t i o n a l i t y in t h e d e v e l o p m e n t of t e c h n o l o g y t h a t i s d o m i n a t i n g t h e industrialized w o r l d . b r e a s t s . by its o w n a d m i s s i o n . m e r e l y as the s u b s t a n t i v e f o r m of the v e r b triel ten. As long as r e a s o n and t h e r a t i o n a l a r e left as v a g u e as t h e y a r e n o w ." and r e f e r r i n g principally to c a t t l e . m e a n i n g "drive" or "drift. " but r e f e r r e d to t h e " s t i m u l u s " or "appeal" e x e r t e d on a person b y s o m e t h i n g o r s o m e o n e from o u t s i d e h i m s e l f . too. o r o c e a n c u r r e n t s . m o r e striking i s t h e v e r y r e c e n t v i n t a g e o f t h e c o n c e p t . " S o o n afte r w a r d s Triebe found its fullest and m o s t c h a r a c t e r i s t i c d e v e l o p m e n t in m e c h a n i c s . Triebstoff ("fuel"). n e g l e c t i n g to c o n s i d e r t h a t t h e i r e s t e e m e d ratio. N o w t h e r e is. or m o v e d . Its b o d y i n g f o r t h can h a p p e n i n t h e f o r m o f so-called s e x u a l s e n s a t i o n s . and the u n c o n s c i o u s . and m u t u a l l y c o n t r a d i c t o r y . T h e w h o l e p r o c e s s w a s v i e w e d as w h a t it is. and a b s o r p t i o n i n t o . F r o m t h e m a n i f o l d c o m p l e x i t y o f p o t e n t i a l h u m a n w a y s o f being. as a t h i n g driven. and id. i t had t o p e r f o r m m a n y c o m p l e x a b s t r a c t i o n s and f o r c e d r e i f i c a t i o n s . " o r i g i n a t e d in G e r m a n as a judicial c o n c e p t r e f e r r i n g t o a body a u t h o r i z e d t o pass j u d g m e n t . o n e p a r t i c u l a r m o d e t h a t c a n b e c a t e g o r i z e d a s a n i n v o l u n t a r y s u b m i s s i o n to. it was necessary to conceptualize the observed phenomenon as the effect o f a n i n t e r n a l m o t i v e force and t o r e d u c e h u m a n b e i n g s t o t h i n g s r e s e m b l i n g billiard balls. T h i s i n n o v a t i o n tripled t h e i n s u r m o u n t a b l e difficulties t h a t had b e e n plaguing p s y c h o l o g y e v e n w i t h only a single s u b j e c t . W i t h such n o t i o n s . t h e o n e of w h i c h Freud had b o a s t e d in r e f e r e n c e to his e a r l i e r n o t i o n s of c o n s c i o u s n e s s . or psyche. diverse. it w a s u s e d t o d e s i g n a t e t h r e e different a g e n t s i n e a c h p e r s o n ' s p s y c h e — e g o . s u p e r e g o . I t i s n o t difficult t o s e e h o w m u c h c l o s e r t o reality t h e original m e a n i n g of Trieb w a s w h e n t h e w o r d still r e f e r r e d to t h e appeal of a w o m a n to a m a n . T h e n t h e r e w e r e no drives w i t h i n i m a g i n e d e n d o p s y c h i c c o n t a i n e r s t o impel a m a n t o w a r d a n appealing w o m a n . h e said. a m o n g all t h e varied p o t e n t i a l i t i e s o f relating t o w h a t i s perceived. O n t h e c o n t r a r y . in a n a l o g y to an e n g i n e . as an e v e n t in t h e open realm o f a n " e x t e r n a l . W h e n it is bodied f o r t h in t h e r e a l m of h u m a n r e l a t i o n s h i p it can lead to a n o r g a s m i c bodily m e r g i n g o f o n e w i t h t h e o t h e r . In t h e process.144 EXISTENTIAL FOUNDATIONS e x t e r n a l w o r l d o p e n e d t h e w a y for m o d e r n p s y c h o l o g y t o develop its c o n c e p t s of Trieb or drives. i t w a s from t h e w o m a n t h a t t h e appeal c a m e t o d r a w t h e m a n to h e r . b u t did yield o n e a d v a n t a g e . f r o m inside o r f r o m b e h i n d . especially a c o u r t o f law. p r e c o n s c i o u s n e s s . " h u m a n r e l a t e d n e s s . O n l y t h e n could h u m a n n a t u r e b e r e p r e s e n t e d . and it m a y v e r y well h a p p e n as an e r o t i c a t t r a c t i o n of o v e r w h e l m i n g p o w e r . T h e scientific d i l l n ulties thai g o with t h e m b e c o m e c l e a r e r w h e n w e n o t e t h a t t h e i r definitions are n u m e r o u s . " a g e n c y ." But the t h r e e psychic a g e n c i e s can b e h a n d y t h e o r e t i c a l p l a y t h i n g s o n l y a s long a s their n a t u r e s are allowed t o r e m a i n u n e x a c t . From psychic agencies to an existential understanding of human ways of behaving lnstanz. Freud . this or t h a t t h i n g or being. o n e could " o p e r a t e comfortably. B u t b e f o r e p s y c h o l o g y could a r r i v e at its p r e s e n t n o t i o n o f drives. T h e t e r m r e f e r s to an e n t i r e t y but w h e n it w a s adopted by p s y c h o l o g y . a psychological t h e o r y b e n t o n arriving a t t h e p r e s e n t c o n c e p t o f d r i v e s isolated this o n e m o d e and declared it to be t h e only psychic reality. m u c h less m o v e o u t o f i t s e l f i n t o t h a t e x t e r n a l w o r l d . a m o n g o t h e r t h i n g s . W e could easily give m o r e e x a m p l e s o f c u r r e n t d e f i n i t i o n s . " r e f e r r i n g to h i m s e l f as t h a t c r e a t u r e w h o . T h e y all s u f f e r from t h e s a m e flaw. T h e n again. w h i c h c o n t r o l s t h e flow o f e x c i t a t i o n s i n t o t h e e x t e r n a l w o r l d b y m e a n s o f m o t i v i t y . T o this day. " A n o t h e r psychological school e l e v a t e s t h e e g o to t h e r a n k of a poniifex oppositorum. n o o n e w h o has n o t b e e n c o n t a m i n a t e d b y p s y c h o l o g i c a l t h i n k i n g — w o u l d n o r m a l l y d e s c r i b e his e g o a s doing this 0 1 t h a t . W h e n this pet son s a y s " I .a g e n c y is m a d e up. i n t e r n a l o r g a n i z a t i o n o f psychic p r o c e s s e s a t t a c h e d t o c o n s c i o u s n e s s . or t h i n k i n g . But t o t h e less a r r o g a n t .a g e n c y did n o t s t a y hidden from critical psychologists. the part t h a t e x p e r i e n c e s i t s e l f as a s u b j e c t . o r a s t h e s e a t o f r e l a t i o n s h i p t o t h e " t h o u . s u b j e c t and o b j e c t . T h e v a g u e n e s s o f t h e s e r e p r e s e n t a t i o n s o f t h e e g o . a c o n n e c t i v e c e n t e r .a g e n c y can do all this. T h e a n c i e n t W e s t e r n w o r l d did n o t k n o w t h e c o n c e p t " e g o . r e l a t i o n s h i p to s o m e t h i n g he e n c o u n t e r s in his w o r l d . " h e m e a n s t h e v a r i o u s p o t e n t i a l w a y s o f r e l a t i n g and b e h a v i n g o l .a g e n c y as. this i n d i c a t e s t h e possibility t h a t h u m a n n a t u r e might be better understood without hypothesized endopsychic agencies. Jung. T h e e g o . it still posits people as e x i s t i n g i n d e p e n d e n t l y in s o m e space. b e t w e e n G o d and p o w e r l e s s m a n . and Psychology 14 5 defined t h e e g o .Basic Concepts of Biology. i s e n g a g e d i n s o m e s o r t o f p e r c e p t i v e .a g e n c y .i m p o r t a n t f a c t — o f h o w s u c h a p s y c h i c c o n f i g u r a t i o n could e v e r begin to s u s p e c t t h a t an outside w o r l d is t h e r e . He w o u l d say " I . it is claimed. o r active. t h e m u n d a n e and t h e t r a n s c e n d e n t . and psychic e x p e r i e n c e s . n o t a s a d v a n c e d a s w e a r e today. in opposition to the realm o f o b j e c t s . No m a t t e r h o w this psychic ^ g o . at a g i v e n m o m e n t . w a s s t e e p e d i n m e t a p h y s i c a l o b s c u r i t y . N o t o n e definition says e n o u g h a b o u t the t r u e n a t u r e o f t h e e g o e v e n t o explain h o w this e g o m a k e s it possible to p e r c e i v e w h a t we e n c o u n t e r in o u r w o r l d . " Y e t o n e can also h e a r t h a t the e g o is a m e n t a l .a g e n t would f u n c t i o n a s a bridge. h e r e t h e e g o . s u b s t a n c e . mind and n a t u r e . " C e r t a i n w r i t e r s o u t s i d e the p s y c h o a n a l y t i c fold c h a r a c t e r i z e t h e e g o a s "an i n s u b s t a n t i a l c l u s t e r o f p e r c e p t i o n s . " M a n y have tried to g e t a r o u n d this by claiming t h a t t h e a n c i e n t G r e e k s w e r e not as a s t u t e c o n c e r n i n g p s y c h o l o g y . t h e self. b e c a u s e it is descended from an i n h e r e n t u r g e t o p a r t i c i p a t e and s o i s able t o t r a n s c e n d its o w n b o r d e r s . T h e p r o b l e m i s t h a t for t h e last s e v e n t y y e a r s c r i t i c s h a v e b e e n c o n t e n t t o stop a t s u c h n e g a t i v e o b j e c t i o n s and c o n t i n u e d t h i n k i n g i n t e r m s o f physically p r e s e n t psychic e n t i t i e s . T h e m y s t e r y still r e m a i n s — t o r e i t e r a t e this a l l . o r c e n t e r o f i n t e n t i o n a l action. ideas. confessed that the foundation of the e g o . n o o n e — t h a t is. Physiology. b e t w e e n w a k i n g and d r e a m i n g . " a c o h e s i v e . t h e e g o can be supposed to be t h e e s s e n t i a l aspect of a h u m a n being. for instance. b u t t o d o s o w o u l d b e u s e l e s s and u n n e c e s s a r y . o r m e d i u m . T h e e n g a g e m e n t o f a p e r s o n b y w h a t e v e r h e e n c o u n t e r s in his w o r l d . h o w e v e r this dwelling—i. As s u c h . Freud b o r r o w e d the t e r m "id" . W h i l e e n g a g e d in my p r e s e n t r e l a t e d n e s s to t h e w o r l d . All " s h o u l d ' s " are g r o u n d e d in this e x i s t e n t i a l e n g a g e m e n t . and t h e r e s u l t i n g c o n s c i e n t i o u s " s h o u l d " are b o t h e s s e n t i a l t r a i t s of h u m a n b e i n g . and e v e n less its c a u s e or s o u r c e are t h o s e w h o falsify its light. It is often d r o w n e d o u t for children by the s c r e a m i n g o f s e n s e l e s s p a r e n t s . relatedness to the world—changes in time. as t h e perceiving o p e n b e i n g he is. T h e s u p e r e g o . the psychological egoa g e n c y is an a b s t r a c t i o n par e x c e l l e n c e .s p a t i a l w o r l d . " I " r e f e r s t o t h e m o s t c o n c r e t e o f all b e i n g s . " 2 My Da-sein a l w a y s i n v o l v e s me as t h e w h o l e c r e a t u r e I am. Of itself it has nothing to do with time. N o w . No e n d o p s y c h i c a g e n c y is involved. W h a t i s m o s t i m p o r t a n t t o n o t e h e r e i s t h a t n o m a t t e r h o w m a n y t i m e s I say " I " t h e r e is still no a c t u a l p s y c h i c a g e n c y involved. " it is j u s t this t h a t c o n s t i t u t e s t h e primordial t e m p o r a l i t y o f t h e h u m a n s e l f . is e n g a g e d in b e a r i n g and holding o p e n t h a t i n t o w h i c h w h a t h a s t o b e can s h i n e f o r t h and s o c o m e i n t o b e i n g . W h a t p s y c h o l o g y labels t h e s u p e r e g o is a p a r t i c u l a r m o d e of h u m a n r e l a t e d n e s s t o t h i n g s for t h e sake o f w h o s e d e v e l o p m e n t h e e x i s t s .a g e n c y is an equally a b s t r a c t c o n s t r u c t i o n .146 EXISTENTIAL FOUNDATIONS w h i c h h e i s a t t h a t m o m e n t t h e m a t i c a l l y a w a r e and h a s m a d e his o w n . T h e identity o r s e l f n e s s h a p p e n s only a s the e x i s t e n c e ' s "living o u t its t i m e . the constancy of physical s u b s t a n c e c o n s i s t s of its r e m a i n i n g on h a n d for a g i v e n span of time. b e disguised or d i s t o r t e d .e. a b s o r b e d in t h e m o d e s of b e h a v i o r I am c a r r y i n g o u t at a given m o m e n t . By contrast.i n . T o d e s i g n a t e the third psychic a g e n c y . t h e Da-sein i n its having grown as one with the world. In p s y c h o l ­ ogy. T h e constancy of the p e r s o n ' s selfness appears as this h u m a n self "lives o u t its t i m e " in c a r r y i n g t o fulfillment its possibilities for r e l a t i n g t o t h e p h e n o m e n a o f its t e m p o r a l . a h u m a n being. like any p e r c e p t i o n . s o b e c o m i n g a self. i s t h e r e . By contrast. t h e s u p e r e g o is e m p l o y e d as a s y n o n y m for t h e c o n s c i e n c e ..t h e . W h a t is involved is my e c ­ static b e i n g . h o w e v e r . It is t h e h y p o s t a t i c r e i f i c a t i o n of c e r t a i n p h e n o m e n a of t h e u n o b j e c t i f i a b l e Da-sein. as well as t h o s e I see as p o t e n t i a l i t i e s for m y s e l f in t h e f u t u r e . Its c o n s t a n c y is s u c h t h a t t h e Da-sein can at all t i m e s r e t u r n to itself and find its i d e n t i t y in its dwelling by t h e b e i n g s of its w o r l d .w o r l d to t h e e x t e n t t h a t I h a v e m a d e its p o t e n t i a l i t i e s m y o w n . t h e y c a n n o t be c a u s e d at a later time by m e c h a n i s m s h y p o t h e t i c a l l y i n t r o j e c t e d into the p s y c h e . T h i s f u n d a m e n t a l a w a r e n e s s c a n . b u t t h a t does n o t alter i n t h e least t h e p o t e n t i a l i t y for h a v i n g a c o n s c i e n c e . I r e t a i n all t h o s e w a y s of b e i n g r e l a t e d t h a t I r e m e m b e r h a v i n g c a r r i e d o u t in t h e past. It is to this t h a t c o n s c i e n c e r e f e r s w h e n e v e r a p e r s o n falls b e h i n d in fulfilling e s s e n t i a l e x i s t e n t i a l t a s k s . It is this s e l f t h a t e n d u r e s t h r o u g h t h e life h i s t o r y of a Dasein and w h i c h is a d d r e s s e d w h e n e v e r t h e Da-sein says " I " . I n s e v e r a l s t a t e m e n t s o n t h e id. T h e three psychic agencies must c a t e g o r i e s o f h u m a n b e h a v i n g and relating a i r . we said. In t h e id b e l o n g t h o s e e n d o p s y c h i c r e p r e s e n t a t i o n s of e x t e r n a l . the possibility o f o n e b e h a v i o r being followed. and Psychology 147 from G r o d d e c k . F r e u d anticipated m u c h o f w h a t J u n g later a t t r i b u t e d t o t h e c o l l e c t i v e u n c o n s c i o u s . and is a b s o r b e d . and t h e i r p e r t i n e n t a f f e c t s .t h e . and reifies a p a r t i c u l a r h u m a n p o t e n t i a l i t y of relating to w h a t is in t h e world. This supposedly p e r m i t s o n e . D e p t h p s y c h o l o g y deduced all t h r e e o f t h e s e a g e n c i e s from p a r t i c u l a r h u m a n p o t e n t i a l i t i e s o f r e l a t i n g t o the world. artificially i s o l a t e s . T h e v e r y c h a r a c t e r i s t i c that d i s t i n g u i s h e s h u m a n Da-sein is t h e unified w a y in w h i c h it e n g a g e s .w o r l d . 1 1 acted. T h i s fact implies. It n e v e r happens t h a t in a p a r t i c u l a r h u m a n b e h a v i o r only o n e piece of a p e r s o n ' s being is e n g a g e d .w o r l d o b j e c t s . u n c o n s c i o u s r e p r e s e n t a t i o n s and affect c o n f i g u r a t i o n s are scientifically u n t e n a b l e .t h e . W e h a v e already pointed o u t t h a t e n d o p s y c h i c . b y a n o t h e r t h a t m a n i f e s t s a n e n t i r e l y different w a y o f r e l a t i n g t o t h e w o r l d . w h i c h likewise t e n d t o a b s t r a c t and p e r s o n i f y . I n u s i n g s u c h c o n s t r u c ­ tions. T h e i d s h a r e s w i t h t h e older u n c o n s c i o u s its d e s i g n a t i o n a s t h e actual r e s e r v o i r of t h e drives. c o n t e m p o r a r y t h e o r i e s a r e m e r e l y b o r r o w i n g t h e m e t h o d o l o g y o f lairy t a l e s . traditional p s y c h o l o g y a s s i g n s t o the h u m a n mind the c a p a c i t y for e m p a t h y . for t h e simple r e a s o n t h a t h u m a n b e i n g .w o r l d is b y n a t u r e indivisible. i n t o this id. T h e p s y c h o l o g i c a l c o n c e p t o f t h e id. Physiology. w i t h l i g h t n i n g s u d d e n n e s s and for a n y n u m b e r o f r e a s o n s . w h i c h a p e r s o n ' s selfr e g a r d o r m o r a l feeling r e f u s e s t o r e c o g n i z e a s b e l o n g i n g t o him and r e p r e s s e s . W h a t is actually g o i n g on.i n . like t h o s e o f t h e e g o and s u p e r e g o . T h i s s o r t of i n t e r p r e t a t i o n is h a r m l e s s e n o u g h in fairy t a l e s . and n e e d n o t r e p e a t o u r s e l v e s here. s o o u r c r i t i c i s m o f t h e collective u n c o n s c i o u s applies equally t o t h e Freudian n o t i o n . B u t drive is an a b s t r a c t i o n t h a t d i s t o r t s . p e r s o n i f i e d a b s t r a c t i o n . t u r n s o u t to be n o t h i n g m o r e t h a n a reified. is w h a t we can see as a p e r s o n ' s i n v o l u n t a r y s u b m i s s i o n to s o m e t h i n g he e n c o u n t e r s . demonstrable phenomena a distorting conceptual b e r e t u r n e d t o t h e diverse from w h i c h t h e y w e r e I K i m empathy to an understanding of how human beings ire directly perceived by each other Besides the rational faculty. All o f this p o i n t s t o t h e n e e d for freeing t h e ol h u m a n Da-sein from t h e s h a c k l e s of 11 amework. r e n d e r i n g the pleasing b e h a v i o r of adults the a g e n c y of a good fairy and displeasing b e h a v i o r t h e a g e n c y of a w i c k e d w i t c h . dynamically o r t o p o g r a p h i c a l l y . in t h e w a y s of r e l a t i n g to w h a t it e n c o u n t e r s . b u t in p s y c h o l o g y it is h a r m f u l b e c a u s e it artificially f r a g m e n t s h u m a n b e i n g .Basic Concepts of Biology.i n . r a t h e r t h a n p r e c l u d e s . or an o b j e c t to be used. T h e ability to u n d e r s t a n d o t h e r s directly as fellow h u m a n b e i n g s is r o o t e d in this basic t r a i t . It m a y be a m i s i n t e r p r e t a t i o n . From psychic cause and psychodynamics to an understanding of motivational contexts F r e u d ' s g r e a t e s t i n t e l l e c t u a l a c h i e v e m e n t w a s his supposition t h a t each p e r s o n ' s life h i s t o r y w a s pervaded w i t h m e a n i n g . N o t o n e o f t h e s e w a y s o f understanding another person. B u t a n y n o t i o n o f e m p a t h y . A s long a s h e w a s i n v e s t i g a t i n g m e a n i n g f u l n e s s i n b i o g r a p h i c a l p h e n o m e n a . tacitly a s s u m e s t h a t a n u n d e r s t a n d i n g o f t h a t o t h e r i s already t h e r e : if I did n o t r e c o g n i z e t h a t o t h e r as a being of my o w n kind. In this w a y . and t h e n e x p l o r e . t h e first individual is s u p p o s e d to be able to r e c o g n i z e w h a t kind of p e r s o n t h e o t h e r is. and i m m e d i a t e u n d e r s t a n d i n g o f t h e o t h e r a s t h e being h e is. superficial p e r c e p t i o n of t h e o t h e r as s o m e h o w different f r o m o n e s e l f . as it w e r e . It o p e n e d up n e w d i m e n s i o n s to m e d i c i n e .148 EXISTENTIAL FOUNDATIONS individual to s t e p o u t s i d e of h i m s e l f . H e b e g a n b y e x a m i n i n g h y s t e r i c a l s y m p t o m s . H e h i m s e l f c h a r a c t e r ­ ized this claim as a " b o l d " a s s u m p t i o n . t o o . F r e u d p r o c e e d e d t o t e s t its validity o n o n e a r e a o f h u m a n p h e n o m e n a a f t e r a n o t h e r . T h e w o r d " m e a n i n g f u l " can b e applied w i t h c e r t a i n t y only t o h u m a n b e h a v i o r . for o n l y o u r o w n a c t i o n s d o w e k n o w t o b e m o t i v a t e d b y t h e m e a n i n g f u l n e s s o f w h a t r e v e a l s itself i n o u r w o r l d . It m a y m a n i f e s t i t s e l f in a g r e a t m a n y w a y s . this o t h e r f r o m t h e inside. W h i l e he c o n t i n u e d paying lip service to the m e . primordial. of symptoms. however. Freud i n c r e a s i n g l y r e i n t e r p r e t e d what was . d r e a m s . Y e t it is also possible for o n e person to b e c o m e e n g a g e d in his r e l a t e d n e s s to a n o t h e r in such a w a y t h a t t h e o t h e r ' s m o s t subtle c h a r a c t e r i s t i c s are i l l u m i n a t e d for him. H a v i n g m a d e this a s s u m p t i o n . w h i c h until t h e n had dealt e x c l u s i v e l y in n o n m e a n i n g f u l causal c o n n e c t i o n s . c a m e u n d e r t h e d i c t a t o r s h i p o f the d o g m a t h a t reality was c o m p o s e d e n t i r e l y o f o b j e c t s c o n n e c t e d t h r o u g h u n b r o k e n calculable causal c h a i n s . m m ) ' . slip i n t o a n o t h e r individual. F r e u d quite logically used t h e w o r d " m o t i v e " to m e a n a c o m p r e h e n s i b l e i n s t i g a t o r of h u m a n action o r i n a c t i o n . B u t n o s o o n e r w a s Freud's bold a s s u m p t i o n c o n c e i v e d t h a n it. and e v e r y d a y slips. I would n e v e r k n o w h o w t o begin directing m y e m p a t h y t o t h a t o t h e r . concerns some human subject empathizing with the psyche of another. T h i s u n d e r s t a n d i n g o r perceiving is a p a r t i c u l a r o n t i c fulfillment of t h e f u n d a m e n t a l h u m a n c h a r a c t e r i s t i c of being able to perceive s o m e t h i n g as s o m e t h i n g . w h e r e b y t h e o t h e r p e r s o n is m i s t a k e n as s o m e t h i n g t h a t is simply t h e r e . T h e p r e c o n d i t i o n of e m p a t h y is t h e n the prior. It w a s bold. o f t h e ability t o feel o n e ' s w a y i n t o a n o t h e r . It m a y happen as a v a g u e . In a n y c a s e . In t h e c o u r s e of its 5 0 0 pages. In ( J e r m a n . w r i t e s : " T h e only p a t e n t l y u n a l t e r a b l e a s p e c t o f m o t i v a t i o n i s t h e n e g a t i v e affective s t a t e c r e a t e d i n t e r n a l l y b y m e t a b o l i s m . Let u s a s s u m e that a s t r o n g wind b l o w s t h e w i n d o w o f m y study s h u t b e f o r e m y eyes Th is c o r r e s p o n d s to an o b s e r v a t i o n . o t h e r s f o l l o w e d suit. " H e s o o n used t h e t w o t e r m s i n t e r c h a n g e a b l y . If this s a m e s u c c e s s i o n o c c u r s r e p e a t e d l y . T h e first e n t a i l s a c a u s e . and Psychology 149 m e a n i n g f u l i n the c o n t e x t s o f h u m a n e x i s t e n t i a l p h e n o m e n a t o c o n f o r m t o t h e m e a n i n g l e s s n e s s o f causal c o n n e c t i o n s . t h e e x t e n t to w h i c h this c o n f u s i o n o f p s y c h i c c a u s e and m o t i v e t o o k hold i n m o d e r n p s y c h o l o g y and p s y c h i a t r y i s n o t h i n g t o b e proud of. t h e s e c o n d an a c t i o n m o t i v a t e d by a h u m a n being and a p p a r e n t l y similar t o t h e c a u s e . in reality.a n d . w h o w r i t e s : "In r e a l i t y i t i s this w a y : t h e m a n i f e s t a t i o n o f an a c t i o n is a c c o m p a n i e d by t h e f o r m a t i o n of a m o t i v a t i o n a l c l u s t e r or. like K r e t s c h m e r . an e x p l a n a t i o n in a c c o r d a n c e with the principle of c a u s a l i t y .E u r o p e a n r o o t ) . " M c C l e l l a n d . I n r e v e r t i n g from a n h i s t o r i c a l t o a n a t u r a l scientific v i e w o f h u m a n b e i n g s . a p s y c h i c . It m e a n t " w h i l e " (with which it s h a r e s an I n d o . h e i n e x o r a b l y m a d e t h e t e r m " m o t i v e " s y n o n y m o u s w i t h t h e idea o f " p s y c h i c c a u s e . to put it m o r e g e n e r a l l y . after t h e b l o w i n g of wind. T h i s p e r p l e x i t y spread b e y o n d t h e p s y c h o a n a l y t i c s c h o o l t o infect m o s t o t h e r t h e o r i e s . scientific c o n s i d e r a t i o n of t h e radical difference between these concepts. W h e n e v e n F r e u d n o l o n g e r d i s t i n g u i s h e d b e t w e e n t h e t w o . the w i n d o w i s s h u t .e f f e c t r e l a t i o n s h i p . w i t h o u t a n y t h o u g h t being g i v e n t o the m a t t e r . Physiology. I will a s s e r t t h a t t h e w i n d o w w a s s h u t because (weil) t h e wind c a m e up. By putting in this " b e c a u s e " (weil). " ) . t h e causal c o n j u n c t i o n weil ("because") r e f e r r e d originally to time.a n d . t h e n . A n i n e v i t a b l e s u c c e s s i o n has n o w b e c o m e s o m e t h i n g m o r e : t h e w i n d o w ' s s h u t t i n g i s n o w i n t e r p r e t e d a s t h e effect ol a c a u s e . w i n d o w closed. . causal c l u s t e r . . positive o r n e g a t i v e . a p r a c t i c e t h a t s u r r o u n d e d his t h e o r y w i t h i m m e n s e t e r m i n o l o g i c a l c o n f u s i o n .") into a s t a t e m e n t of e x p e r i e n c e ( " B e c a u s e [weil] t h e wind blows. t h o u g h in s o m e it had a r i s e n i n d e p e n d e n t l y . " B u t t h e m o s t i m p r e s s i v e e v i d e n c e o f the c o n f u s i o n s u r r o u n d i n g m o t i v e and psychic c a u s e i n c o n t e m p o r a r y p s y c h o l o g y and p s y c h i a t r y is t h e v o l u m i n o u s a n t h o l o g y e n t i t l e d Die Motivation menschlichen Handelns. and a l w a y s f u n c t i o n i n g as a motive. the t w o t e r m s a r e used i n t e r c h a n g e a b l y . T h i s i n t e r p r e t a t i o n is.Basic Concepts of Biology. . m e a n i n g t h a t it is c o n n e c t e d w i t h f u r t h e r c h a n g e s . a c i r c u m s t a n c e directly perceptible t h r o u g h t h e s e n s e s . N o w h e r e d o e s t h e r e appear a s t r i c t . on t h e o t h e r hand.e f f e c t r e l a t i o n s h i p a m o n g n o n h u m a n e v e n t s . 3 0 31 T h e e a s i e s t w a y o u t o f this c o n f u s i o n i s t o let t w o s i t u a t i o n s speak for t h e m s e l v e s . I have t r a n s f o r m e d t h e simple s t a t e m e n t o f a p e r c e p t i o n ( " W h e n t h e w i n d blows. d o z e n s o f t i m e s and b y a n e x t r e m e l y varied sampling o f w r i t e r s . T w o s t a t e s a r e seen t o succeed e a c h o t h e r : w i n d o w open and. t h e r e f o r e . S u c h r e a s o n s allow me f r e e d o m of < h o n e . A g u s t o f w i n d . C o n s e q u e n t l y . " W e h a v e s t r e s s e d t h a t t h e r e i s s o m e limited j u s t i f i c a t i o n for applying t h e principle o f c a u s a l i t y i n t h e practical t r e a t m e n t o f d i s t u r b a n c e s o f physical h e a l t h . M o t i v e s . T o g e t back t o o u r i l l u s t r a t i o n . T h e w i n d o w w o u l d n e v e r h a v e b e e n closed. b u t this reason is s o m e t h i n g totally d i f f e r e n t f r o m t h e cause as n a t u r a l s c i e n c e s e e s c a u s e . t h a t m e a n t peace and quiet. a f t e r t h e w i n d o w had b e e n s h u t . . causal r e l a t i o n s h i p s do n o t m a k e us c o m p r e h e n d m e a n i n g . T r u e . . o r o f p e a c e and quiet. T h e r e a s o n s u n d e r l y i n g m y h u m a n a c t i o n s are the distracting s t r e e t n o i s e and t h e peace and q u i e t I w o u l d like to h a v e in m y r o o m ." "on the occasion of. S u c h m e a n i n g s can r e v e a l t h e m s e l v e s only w i t h i n t h e s o r t o f p e r c e p t i v e o p e n n e s s t h a t c o n s t i t u t e s t h e specifically h u m a n m o d e o f being. i n t h e last a n a l y s i s . N o w t h e r e a s o n t h e w i n d o w is s h u t b e c o m e s a g e n u i n e m o t i v e : n a m e l y . b u t by m e . to a n t i c i p a t e a f u t u r e s t a t e . W h a t t h e y yield is i n h e r e n t l y r e s t r i c t e d to t h e purely t e m p o r a l s t a t e m e n t : " w h e n . P h y s i c i s t s long a g o r e d i s c o v e r e d t h a t t h e i r c a u s a l i t y can m e a n n o t h i n g but a description of a simple t i m e r e l a t i o n s h i p . i t m i g h t well h a v e h a p p e n e d t h a t t h e w i n d o w w a s s h u t not by a g u s t of w i n d . M y motive i n closing t h e w i n d o w is. can k n o w n o t h i n g o f t h e s i g n i f i c a n c e o f n o i s e . T h e e v e n t s a r e not b o u n d t o g e t h e r b y a n y d i s c e r n i b l e meaning. t h e f u t u r e o f t h e book 1 feel an obligation to w r i t e . t h e w i s h e d . i f I had n o t been in a position to a p p r e h e n d s o m e t h i n g t h e r e t h a t m e a n t n o i s e . perceiving n o i s e and e x p e c t i n g peace do not compel m e I o at I 1 could leave the w i n d o w o p e n in spite o f the n o i s e a n d p o s t p o n e m y w i Iting T h e noise and the open w i n d o w a r e not like9« i e n t i f i c e v e n t s obeying the principles o f c a u s a l i t y i n t h a t t h e y d o not s u c c e e d e a c h o t h e r . b y n o m e a n s r e p r e s e n t s a m e r e inevitable s u c c e s s i o n o f s t a t e s . my desire for p e a c e and quiet. as well as t h a t t o w a r d w h i c h m o t i v e s are directed. H o w does this m o t i v e c o m p a r e w i t h w h a t w e called t h e c a u s e o f t h e first instance of the shut window. t h e n . A s m o t i v e s . a r e d e t e r m i n e d by an i m p e n d i n g t a s k t h a t h a s been r e c o g n i z e d and a c c e p t e d . t h a t t h e causal c o n n e c t i o n s t h e y find in n a t u r e are no m o r e than records of regularities in the order of temporal s u c c e s s i o n o f c e r t a i n p h e n o m e n a . and a b o v e all. b e c a u s e t h e s t r e e t n o i s e w a s distracting m e . b u t t h a t it is i m p e r a t i v e to r e m e m b e r t h a t this principle is wholly inadequate w h e r e a proper understanding of any human mode of being i s c o n c e r n e d . t h o u g h i t t o o m a y s h u t t h e w i n d o w . m o t i v a t e d as it is by my wish for peace and quiet.f o r p e a c e and quiet is t h e reason b e h i n d my closing t h e w i n d o w . the wind? My closing t h e w i n d o w .150 EXISTENTIAL FOUNDATIONS "during." It is often forgotten that the meaning of this w o r d w a s t r a n s f o r m e d to d e s c r i b e a causal r e l a t i o n s h i p as s o m e t h i n g t h a t p r o d u c e s s o m e t h i n g d i f f e r e n t o u t o f itself. b e g i n s w i t h a s e v e r e reduction o f t h e original m e a n i n g o f t h e s e t e r m s . t h e r e a s o n b e h i n d a p a r t i c u l a r h u m a n a c t i o n . T h e m o t i v e for my closing t h e w i n d o w . in t h e p s y c h o l o g i c a l tradition. is no such blind c a u s e . into a causal r e l a t i o n s h i p or p s y c h o d y n a m i c p r o c e s s t h u s : t h e s i g h t o f t h e b e g g a r i s alleged t o a w a k e n the idea of m i s e r y in my e g o .c o n s c i o u s n e s s . T h i s d i f f e r e n c e i s n o t c o n f i n e d t o t h e n e c e s s i t y o f n o n h u m a n . scientific s e n s e o f t h e w o r d . m e a n i n g " t o m o v e . for this s e c o n d illustration s h o w s t h a t m o t i v a t i o n may be . in s o m e m y s t e r i o u s fashion. m o t i v a t i o n is s o m e t h i n g m o r e than a m e r e efficient c a u s e . E v e n a m o t i v e like this is t r a n s l a t e d . b e f o r e b l o w i n g it shut. T h u s it is concluded. or r e q u i r e d . T h i s i n t e r n a l drive. and drives w i t h s u c h i n t e n s i t y and p e r s i s t e n c e t h a t its p s y c h o d y n a m i s m is able to m o v e my e g o and my body to give t h e b e g g a r a coin. a wind can n e v e r c h o o s e and act. C o n s e q u e n t l y . " I n A r i s t o t l e ' s t i m e . t h a t an i n s u f f i c i e n t c o n c e n t r a t i o n of s u g a r in t h e blood will a c t u a t e . motus. f o u r distinct types o f m o t i o n w e r e r e c o g n i z e d . f u n c t i o n i n g as a causal m o t i v e in t h e p s y c h o d y n a m i c p r o d u c t i o n of a specific b e h a v i o r a l s e q u e n c e . E v e r y h u m a n action i s m o t i v a t e d o n a c c o u n t o f s o m e t h i n g r e c o g n i z e d by t h e person in q u e s t i o n . e f f e c t e d by a f o r c e a c t i n g upon t h a t body. o r s u b j e c t . w h e r e it stirs up altruistic i m p u l s e s . a p e r s o n m a y be m o t i v a t e d to an a c t i o n by t h e sight of a r a g g e d b e g g a r s q u a t t i n g by t h e c u r b . or m o t i v a t i o n s . to perceive in t h e w i n d o w a m e a n i n g f u l n e s s . n o r is it a b l e . movi. and this r e c o g n i t i o n is g r o u n d e d in a p e r s o n ' s being e n g a g e d by s o m e p h e n o m e n o n t h a t a d d r e s s e s h i m . o r t h e h u m a n body. " a physical body's c h a n g e of location in t i m e . T h a t w h i c h is m o v e d is called. should t h e r e f o r e n e v e r be t h o u g h t of as a c a u s e . f o r i n s t a n c e . m o d e r n p s y c h o d y n a m ic t h e o r i e s h a v e also divided h u m a n b e i n g s into t w o c o m p o n e n t s . M o t i v e . t h e e g o . a f f e c t s . v a r i o u s l y . I n keeping w i t h this n a r r o w definition. T h e g u s t o f wind t h a t closed t h e w i n d o w — a t r u e c a u s e — h a s no f r e e d o m of decision. and Psychology in t i m e w i t h r e g u l a r i t y . causal p r o c e s s e s as o p p o s e d to t h e f r e e d o m c h e r a c t e r i s t i c of a p e r s o n ' s r e l a t e d n e s s to a m o t i v e . in t h e strict. B o t h " m o t i v e " and " m o t i v a t i o n " s t e m f r o m t h e Latin v e r b movere. will t h e n impel t h e h u n g r y p e r s o n t o eat s o m e t h i n g s w e e t . B y n o w i t should b e p a t e n t l y o b v i o u s t h a t c a u s e and m o t i v e are t w o v e r y different t h i n g s . C e r t a i n l y . w h i c h t h e n p e n e t r a t e s to an e v e n g r e a t e r p s y c h i c d e p t h . one the domain of causes. the o t h e r of motives. T h e process of interpretation that psychological theories have p e r f o r m e d on t h e idea of p s y c h i c m o t i v e s . a h u n g e r drive and desire for e a t i n g w i t h i n the p s y c h e . a m o v i n g f o r c e and a m o v e d t h i n g .Basic Concepts of Biology. O r . in c o n t e m p o r a r y p s y c h o l o g y . Physiology. T h e m o v i n g f o r c e i s m o s t o f t e n given t h e n a m e drive. t h e p o t e n t i a l f o r being closed. it implies t h a t t h e r e a r e t w o radically different dimensions. o r n e e d . on t h e o t h e r h a n d . M o d e r n n a t u r a l s c i e n c e h a s lost sight o f all b u t " m o t i o n . 2 2 5 . " i n Vorträge und Aufsätze ( P f u l l i n g e n : N e s k e .152 EXISTENTIAL FOUNDATIONS used to m e a n a f u t u r e . A. F o r a m o r e d e t a i l e d d i s c u s s i o n t h a t i s p o s s i b l e h e r e o f t h e r e l a t i o n s h i p b e t w e e n t h e o p e n n e s s o f h u m a n e x i s t e n c e and t h e clearing t h a t yields this o p e n n e s s . Ibid.P o n t y . 1 3 . Jean-paul Sartre. P s y c h i c c a u s e s and p s y c h o d y n a m i c s c a n n o t e x i s t . 1. 1 9 2 3 ) . 1 5 . Einführung in dir psychosomatische Medizin ( B e r n a n d S t u t t g a r t : H a n s H u b e r . M e r l e a u . p . 8. H e i d e g g e r . 1 9 5 4 ) . 5. M e r l e a u . 1 0 . b e c a u s e t h e psychic part of t h e m is c o n c e r n e d e x c l u s i v e l y w i t h a p e r s o n ' s w a y s of r e l a t i n g — e m o t i o n a l . hopeful. s e e : M. L'Imagination ( P a r i s : 1 9 3 6 ) . r a t i o n a l . Phénoménologie de la Perception ( P a r i s : 1 9 4 5 ) . see M . Recognition of the unbridgeable chasm that separates causes from m o t i v e s lets us see h o w f u n d a m e n t a l l y u n h u m a n a r e all p s y c h o l o g i c a l t h e o r i e s w h i c h . 17. B o s s . 1 6 2 f ï . de Waelhens. 1 4 . Still. Phénoménologie de la Perception ( P a r i s : 1 9 4 5 ) . 1 9 8 . Inc. F o r a d i s c u s s i o n of t h e i r s t u d i e s . and in his d i m e n s i o n t h e r e are o n l y comprehensible motivational contexts. 16 a n d 2 2 . pp. pp. 2 1 0 . Of these philosophers. Signes ( P a r i s : 1 9 6 0 ) . T h e italics are m i n e . G. La Nause'e ( P a r i s . L'Oeil et l'Espirit ( P a r i s : P r e s s e s U n i v e r s i t a i r e s . p e r c e p t i v e . " B a u e n . Any psychological theory that t r a n s l a t e s a m o t i v e or m o t i v a t i o n a l c o n t e x t i n t o a psychic c a u s e or a p s y c h o d y n a m i c causal chain d e s t r o y s t h e v e r y f o u n d a t i o n o f h u m a n being. S a r t r e . S a r t r e . " in La Structure du Comportment ( P a r i s : 1 9 4 2 ) . and P. C f . Allgemeine Psychopathologie ( B e r l i n : S p r i n g e r . 2.P o n t y . 5 1 .P o n t y . M. p . NOTES 1. 1 9 6 9 ) . 1 9 5 3 ) . p. physical and m e n t a l c h a n g e s o f place c o r r e s p o n d i n g t o shifts w i t h i n an e n d o p s y c h i c s y s t e m . 6. J. 1 9 3 8 ) . S a r t r e . . R i c o e u r d e s e r v e special m e n t i o n in this c o n n e c t i o n . 2 1 0 . 1 4 5 f f . 9. W o h n e n . 1 0 9 . this added m e a n i n g does n o t f u n d a m e n t a l l y a l t e r the c u r r e n t l y m o s t popular i n t e r p r e t a t i o n of m o t i v a t i o n as a causal r e l a t i o n s h i p b e t w e e n p o w e r f u l psychic c a u s e s and their e f f e c t s . 2 2 3 1 1 . and s o f o r t h — t o w h a t m a t t e r s to him in his world.P.P o n t y . t r y to force m o t i v a t e d h u m a n b e h a v i o r into the d i m e n s i o n o f t h e principle o f physical causality. 3 7 0 .P o n t y . S u c h n o t i o n s fail t o a c c o m m o d a t e t h e g r e a t a b u n d a n c e o f c o n t e x t s of m e a n i n g and r e f e r e n c e i n h e r e n t in t h i n g s t h a t m a k e up a c o m p r e h e n s i b l e h u m a n w o r l d and exile t h e scientific i m a g i n a t i o n f r o m t h e only d i m e n s i o n in w h i c h h u m a n being can disclose i t s e l f as it t r u l y is. Merleau-Ponty. p. p. P . p. M . M e r l e a u . H e i d e g g e r . M e r l e a u . 9 6 . finalistic c a u s e . p. Marcel. 4. M.. p. Sein und Zeit.m Sache des Denkens ( T u b i n g e n : N i e m e y e r . 3. a c t i v e . allegedly for the sake of being scientific. 16. D e n k e n . pp.6 6 . L'Etre et le N é a n t (Paris: Librarie G a l i m a r d .d i r e c t e d . K J a s p e r s . H e i d e g g e r . 4 0 . p. 1 9 6 1 ) . /. pp. M e r l e a u . M e r l e a u . p. 7. Signe: la philosophie et son ombre ( P a r i s : 1 9 6 0 ) . 1 2 . " L ' e s p i r i t n u t i l i s e p a s l e c o r p s m a i s s e fait a t r a v e r s lui e n l e t r a n s f é r a n t h o r s de l ' e s p a c e p h y s i q u e ..P o n t y . J . 1 9 3 4 ) . . pp. 1 9 4 3 ) . v o l 2 / 3 . v o l . T h e r e a l d e p t h s o f t h i s m a t t e r a r e s o u n d e d b y H e i d e g g e r i n h i s Zur Sache des Denkest! (Tubingen: Niemeyer. i n h a v i n g t h e v e r b zeitigen. ( L o n d o n : I m a g o .C r o f t s . vol. I n c . 4 3 8 . in Gesammelte Werke ( L o n d o n : I m a g o . F r e u d . then. M c C l e l l a n d . 2 / 3 . 1 0 : Das Unbewusste. S. |0. L . 1 0 . T h e G e r m a n language provides a special access to understanding the p h e n o m e n o n of t h e p r i m o r d i a l t e m p o r a l i t y o f h u m a n e x i s t e n c e . 13 ( L o n d o n : I m a g o . vol. p p . ( L o n d o n : 1 9 4 6 ) .C e n t u r y . S a n s k r i t and G r e e k a l l o w t h i s p a r t i c u l a r p h e n o m e n o n t o b e s p o k e n o f a n d i l l u m i n a t e d . p . 2 6 5 . 3 1 . Die Traumdeutung. then. S . F r e u d . and t h a t its possibilities of e x i s t i n g h a v e to be actualized in this time at an appropriate time. F r e u d . A l s o : Das Ich und das Es. Das Ich und das Es. F r e u d . G e r m a n . W .. Inc. 3 0 . one which m a y be partially or totally inaccessible to the first. F r e u d . 7 5 f f . 1 1 . T h a t a w o r d c a n n o t be translated.). S. 2 9 . 5 4 6 . Ibid. I n c . 2 8 . p . " D i e R e c h t f e r t i g u n g d e s U n b e w u s s t e n . is an i m m e d i a t e recognition of the f u n d a m e n t a l and n e c e s s a r y c o n n e c t i o n b e t w e e n a being's being and t i m e . 2 4 0 . H. Physiology. p. 1 9 5 3 ) . 2 6 4 ff. J . 2 4 5 . in Gesammelte Werke. " In t h e English and t h e R o m a n c e l a n g u a g e s it is difficult to i l l u m i n a t e this p h e n o m e n o n so directly and immediately. ) . p.. " i n Gesammelle Werke. I t a l i c s m i n e . F r e u d . v o l . p .. " o r b e t t e r " a c t u a l i z i n g i t s e l f i n its g i v e n time at the appropriate t i m e . 1969). 1 3 . 2 6 . 2 3 . p . 1 9 6 5 ) . a s e c o n d allows a different p h e n o m e n o n to be seen. 1 9 .4 7 a n d 6 1 7 . 2 8 5 f f . T h o m a e . and Psychology 153 1 8 . Witsch. sich zeitigen. T h e v e r b has the sense of "using one's t i m e " or "living out one's t i m e . by c o n t r a s t . I n c . Vorlesungen zur Einfuhrung in die Psychoanalyse. ) . p. 4 3 9 . " In this verb. 2 5 . v o l . T h i s w o r d m e a n s a b e i n g ' s " s h i n i n g f o r t h . pp. Die Motivation menschlichen Handelns. " in Ges. v o l . 2 4 . W. p. 4 3 7 ff. 2 7 .Basic Concepts of Biology. Die Traumdeutung. " " m a t u r i n g . The Achievement Motive ( N e w Y o r k : A p p l e t o n . in no w a y m e a n s that the p h e n o m e n o n w h i c h this w o r d b r i n g s to light is illusory simply b e c a u s e a second l a n g u a g e d o e s n o t k n o w it. 2 1 . t h a t it has a c e r t a i n t i m e at its disposal. Berlin: K i e p e n h e u e r and . L o w e l l . 3 4 . S. . O n e allows a c e r t a i n p h e n o m e n o n t o b e s e e n and t h o u g h t m o r e clearly. in Gesammelte Werke. " E i n i g e B e m e r k u n g e n ü b e r d e n B e g r i f f d e s U n b e w u s s t e n . E v e r y l a n g u a g e h a s its w e a k n e s s e s and s t r e n g t h s . in Gesammelte Werke ( L o n d o n : I m a g o . A t k i n s o n . T h e italics are mine. ( L o n d o n : I m a g o . 1 3 2 . while.|2). p . R A . (Cologne. C l a r k . a n d Das Unbewusste. 2 0 . Ibid. S. 8. Inc. vol. 2 2 . Ibid. a n d E . W e m a y say o f t h e o b j e c t i o n s i n t h e first g r o u p t h a t t h e s e c h a r g e s are closely r e l a t e d in t h a t a n y o n e levelling t h e m o u g h t to be in a position at least t o deliver precise definitions for the t e r m s " s c i e n t i f i c . t h e following t w o c a t e g o r i e s s t a n d o u t : (1) T h e e x i s t e n t i a l approach is said to be u n s c i e n t i f i c . f o r at b o t t o m all t h r e e are really a single o b j e c t i o n t h a t is basically c h a r g i n g t h e Dasnn-based approach to m e d i c i n e w i t h n o t being a natural scientific r e s e a r c h m e t h o d . lacking in o b j e c t i v i t y . O n l y b y m a k i n g a n a b s o l u t e d o g m a o f the basic t e n e t s o f natural s c i e n c e could its a d h e r e n t s e v e r inflate the simple fact o f the n o n n a t u r a l . (2) T h e d e s c r i p t i o n s of Da-sein and t h e basis for t h e possibility of t h e Da-sein a r e m e r e l y allegorical and n a r r o w l y f u n c t i o n a l . but p h e n o m e n o l o g i c a l — a s o p e n i n g up an u n d e r s t a n d i n g of all t h e a r e a s of h u m a n Da-sein to w h i c h t h e n a t u r a l scientific o r i e n t a t i o n can n e v e r gain access. hostile to c o n c e p t s . " " c o n c e p t . T h i s a p p r o a c h sees its perspective—decidedly n o t n a t u r a l scientific.Chapter 9 CRITICISMS OF AN EXISTENTIAL METHOD OF MEDICAL INVESTIGATION Of the most common objections to introducing an existential research m e t h o d i n t o m e d i c i n e . " and " o b j e c t i v e . " T h e v e r y fact t h a t t h e s e c h a r g e s a r e a l m o s t a l w a y s raised s e p a r a t e l y r e v e a l s t h a t t h e r e i s n o c l e a r r e c o g n i t i o n o f t h e n a t u r e o f the a c c u s a t i o n s . W h a t is being o b j e c t e d to is e x a c t l y w h a t t h e e x i s t e n t i a l a p p r o a c h s e e s as its main c o n t r i b u t i o n to m e d i c i n e . It c a n n o t s e r i o u s l y be held t h a t this a p p r o a c h tries to g e t b y e n t i r e l y w i t h o u t b e n e f i t o f c o n c e p t u a l i z a t i o n . far m o r e c o m p l e t e l y t h a n t h e r e d u c e d definition b a s e d upon c l e a r . d o e s n o t set out to c a p t u r e w h a t it studies in e x a c t . O u t s i d e t h e c h a r m e d circle o f s u c h i n t e l l e c t u a l fallacies t h e c h a r g e o f u n s c i e n t i f i c n e s s levelled at D a s e i n s a n a l y s i s falls apart. unequivocal definition? Might not some entity appear whose inherently c o m p l e x m e a n i n g f u l n e s s c a n n o t be r e d u c e d to a single u n e q u i v o c a l piece o f i n f o r m a t i o n ? F e a r and a n x i e t y . T h e r e s u l t i s t h a t n o f i r s t . t h o u g h t h e n u m b e r o f physicians w h o cling t o i t r e m a i n s high. A c c o r d i n g l y . t h e i n t e r p r e t a t i o n h a s p r e s u m a b l y conceived t h a t p h e n o m e n o n .c u t . is on equally thin ice.r a t e r e p r e s e n t a t i v e o f t r u e n a t u r a l s c i e n c e i s e v e n willing t o m a k e this claim a n y m o r e . c l e a r . If. can this a c c u s a t i o n declare t h a t e v e r y t h i n g t h a t is can be d e t e r m i n e d . (2) O n l y o b j e c t s c o n c e p t u a l i z e d u n e q u i v o c a l l y can b e precisely d e t e r m i n e d . f u n c t i o n a l c o n c e p t u a l i z a t i o n s of s u c h p h e n o m e n a will f u n c t i o n i n c o m p u t e r s and m a t h e m a t i c a l o p e r a ­ t i o n s . (3) W i t h o u t u n e q u i v o c a l c o n c e p t u a l i z a t i o n . a r e n o t s u b j e c t t o e x a c t m e a s u r e m e n t . that Daseinsanalysis is hostile to concepts.156 EXISTENTIAL FOUNDATIONS scientific c h a r a c t e r o f a n e x i s t e n t i a l f o u n d a t i o n o f m e d i c i n e t o t h e d e g r e e t h a t it b e c o m e s a triple a c c u s a t i o n . n a t u r a l scientific c a l c u l a t i o n s . It is t r u e t h a t precise. T h i s claim is as u n f o u n d e d as it is a r r o g a n t and c e r t a i n l y does n o t i t s e l f admit of scientific verification. T h e steps o f this logical a r e o b v i o u s : (1) C a l c u l a b i l i t y n e c e s s a r i l y p r e s u p p o s e s t h e precise d e t e r m i n a ­ tion o f a n y t h i n g . o n the other hand. t h e r e can be no precise calculability. t h e r e can be no natural s c i e n c e . for i n s t a n c e . unlike t h a t o f n a t u r a l s c i e n c e . (5) In t h e a b s e n c e of n a t u r a l s c i e n c e . t h r o u g h e x a c t . in e v e r y aspect of its r e a l i t y . w e m a y well ask. quantifiable c o n c e p t s . It is s u p p o r t e d o n l y b y t h e claim o f n a t u r a l s c i e n c e t h a t n o o t h e r w a y o f t h i n k i n g has the p o w e r to d e t e r m i n e w h a t is real and w h a t is n o t . an existential interpretation of an ambiguous pheno­ m e n o n r e n d e r s it in all its a m b i g u i t y . . T h e second charge. O n c e t h e total calculability of all t h i n g s is p o s t u l a t e d as a u n i v e r s a l t r u t h . (4) W i t h o u t precise calculability. u n e q u i v o c a l . all t h e s t e p s leading up to t h e triple a c c u s a t i o n s e e m t h o r o u g h l y logical. t h e r e is no s c i e n c e at all. t h e c h a r g e o f hostility to c o n c e p t s is t u r n e d back upon t h e n a t u r a l scientific critics t hemselves. All t h a t can actually b e c o n t e n d e d i s t h a t this a p p r o a c h . but it should n e v e r be f o r g o t t e n t h a t this m e t h o d c a p t u r e s o n l y an insignificant part o f t h e i m m e a s u r a b l e reality o f t h e s e e m o t i o n s . as it t a k e s place in t h e w o r l d of a h u m a n e x i s t e n c e . B y w h a t r i g h t .c u t m a t h e m a t i c a l f o r m u l a t i o n s ? W h o i s t o say t h a t t h e r e m i g h t n o t also be a p h e n o m e n a w h o s e v e r y n a t u r e s defy precise. " W e n e e d t o ask c o n c e r n i n g t h e m o d e r n t e r m " c o n c e p t " j u s t h o w i t would " t a k e hold o f " t h i n g s . w h e r e b y t h e specific p r o p e r t i e s o f e a c h type of t r e e . is r e . a r e stripped a w a y . In this w a y a p a r t i c u l a r t h i n g is d i s t i n g u i s h e d f r o m e v e r y o t h e r thing. T h e word "tree" discloses a n identical " t r e e . Y e t it is difficult to u n d e r s t a n d h o w m e r e l y t a k i n g t h i n g s a w a y can produce a c o n c e p t . or eidos ("idea"). I could n e v e r c o m p a r e e v e n two t r e e s u n l e s s I already k n e w t h e n a t u r e of " t r e e . F o r i n s t a n c e . w h e n I say " t r e e . C o n s e q u e n t l y . o n t h e g r o u n d s t h a t it is i m p o s s i b l e for o n e p e r s o n to perceive s i m u l t a n e o u s l y . t h o u g h a s s u r e d l y n o less agile o f mind t h a n w e . and hold t h e m up for c o m p a r i s o n w i t h e a c h o t h e r . is n a m i n g t h e specific d i f f e r e n c e . T h e usual a n s w e r w o u l d be: t h r o u g h a definition. t h e n . t h o u g h . and s o m e t h i n g specific. we define " t a b l e " by saying t h a t it is a useful o b j e c t . say. or a pine. t h e c o n t e x t s o f m e a n i n g and r e f e r e n c e o f this . n e i t h e r a p u r e l y c o n c e p t u a l abstraction. a n o u n deriving from t h e v e r b capere. T o t h i s w e o b j e c t . say. this is its g e n e r i c definition. Y e t logos is d i f f e r e n t . To isolate t h e table as t h e specific useful o b j e c t t h a t it is. " T h i s kind of c o n c e p t u a l i z a t i o n is said t o arise o u t o f a n a b s t r a c t i o n . e v e r y t r e e . w h i c h m a k e an o a k an oak and a pine a pine. I can a b s t r a c t s o m e t h i n g (the specific p r o p e r t i e s ) f r o m s o m e t h i n g else o n l y w h e n t h e t h i n g from w h i c h s o m e t h i n g i s a b s t r a c t e d is already p r e s e n t for m e . of a p h e n o m e n o n . " s o m e t h i n g " p r e s e n t s " itself. It is i m p o r t a n t to u n d e r s t a n d t h a t e v e r y c o n c e p t u a l i z a t i o n is a kind of r e . an o a k and a pine. " " t o c a p t u r e . it is t h e f r a m e of r e f e r e n c e t h a t lets me see s o m e t h i n g in c o m m o n b e t w e e n . For e x a m p l e . nor a product of mental comparison. or a maple. D e f i n i n g the specific u s e of t h e table as a g a i n s t t h e u s e s of. T h e so-called g e n e r i c t r e e is.n e s s " pervading all t r e e s . O t h e r s say w e a r r i v e a t t h e g e n e r i c c o n c e p t " t r e e " t h r o u g h c o m p a r i n g all t r e e s w i t h e a c h o t h e r . t h e r e c o g n i t i o n o f w h a t m a k e s a t r e e e s s e n t i a l l y a t r e e m u s t precede a n y c o m p a r i s o n of individual t r e e s .p r e s e n t e d to m e . a b o u t t h e o b j e c t t o w h i c h i t r e f e r s . and to c o m p a r e . did n o t h a v e t h e idea " c o n c e p t . we m u s t specify w h a t particular p u r p o s e it s e r v e s . " t o t a k e hold o f . T h e definition will say s o m e t h i n g g e n e r a l . T h i s a f f i r m a ­ tion is n o t a grasping of t h e p h e n o m e n o n in o b e d i e n c e to s o m e p r e f o r m e d c o n c e p t i o n of it. M o r e t h a n t h i s . first o f all. but i n s t e a d a f i r s t h a n d visualizing of its a p p e a r a n c e . I do n o t m e a n an o a k . It m e a n s w h a t can be said a b o u t the particular a p p e a r a n c e . " T h e n e a r e s t equivalent w a s logos. the a n c i e n t G r e e k s .n e s s . I am t h i n k i n g of a " t r e e . T h e " c o n c r e t e " R o m a n s first c a m e up w i t h t h e idea of a conceptus. a pencil or a glass.p r e s e n t i n g of a t h i n g . W h e n e v e r w e perceive a n individual t r e e .Criticisms of Medical Investigation 157 C h a r a c t e r i s t i c a l l y . " W i t h o u t this k n o w l e d g e . I could n o t p e r c e i v e t h e t w o t h i n g s as t r e e s . this "all" should n o t be t a k e n as a failing. and t h e r e is as well s o m e a b s t r a c t i o n o f e s s e n t i a l f e a t u r e s a t w o r k i n this p r o c e s s .f o r m a t i o n . R a t h e r . B u t f u n d a m e n t a l to a n y c o n c e p t u a l i z a t i o n is perceiving and r e t a i n i n g t h e u n c h a n g i n g i d e n t i t y t h a t c o m p r i s e s t h e f u n d a m e n t a l n a t u r e o f each thing t h a t is d e s i g n a t e d by a c o n c e p t . A b o u t identity. N o w it is t i m e to ask again w h e t h e r e v e r y t h i n g t h a t is can be c a p t u r e d i n p r e c i s e . w h e r e h u m a n being s t a n d s i n t h e f o r e g r o u n d . T h e y h a v e t o b e s e e n perceivingly and u n d e r s t a n d i n g l y i n t h a t t h e y c a n n o t b e g r a s p e d b y t h e s e n s e s o r t h e scientific i n s t r u m e n t s w h i c h are t h e i r e x t e n s i o n s . o r n o t a t all. t h e r e could b e n o n a t u r a l s c i e n c e . And s o t h e r e a r e s o m e t h i n g s — t h e v e r y t h i n g s . in c o n c e p t . this p a r t i c u l a r m e t h o d is far from having d e m o n s t r a t e d its unequaled suitability to describe h u m a n n.158 EXISTENTIAL FOUNDATIONS " t r e e . this n a t u r e m u s t have b e e n perceived in a d v a n c e . And in e v e r y c a s e . T h e s e we could o n l y point o u t and r e f e r to as such. t h a t p r e d i c a t e and s u p p o r t h u m a n b e i n g s — w h i c h can b e grasped o n l y i f t h e y a r e allowed t o p r e s e n t t h e m s e l v e s a s w h a t t h e y are and c a n n o t be e x p l a i n e d by c o m p a r i s o n and a b s t r a c t i o n . f u n c t i o n a l c o n c e p t s . H e r e m o d e s o f n a t u r a l scientific c o n c e p t u a l i z a t i o n a r e n o t m e r e l y i n a d e q u a t e but do n o t belong in t h e first place. M i g h t n o t this w a y o f c a p t u r i n g t h i n g s have its l i m i t a t i o n s ? T h e c o m p a r i s o n o f varied i n s t a n c e s o r c a s e s does play a part. It can be declared o n l y t h a t i d e n t i t y is identity. W h e n w e say t h a t t h e s e p h e n o m e n a are " g i v e n . in l a n g u a g e as s u c h . i f o n e ' s p e r c e p t i o n i s blind t o t h e m . W h e n e v e r n a t u r a l scientific critics a c c u s e d a s e i n s a n a l y s i s o f hostility to c o n c e p t s . such p e r c e i v i n g preceeds and u n d e r l i e s all c o n c e p t u a l i z a t i o n .il in i' . and it is o n l y on t h e basis of this p r e s e n c e t h a t we r e c o g n i z e w h a t e v e r it is as being a t r e e . in fact. t h e y are placing t h e m s e l v e s in a d a n g e r o u s position. W h a t is the n a t u r e of t h e identity u n d e r l y i n g all c o n c e p t u a l i z a t i o n s ? To claim identity for a t h i n g m e a n s t h a t this t h i n g e n d u r e s as o n e and t h e s a m e with itself. T h e r e may be phenomena that resist being g r a s p e d in this w a y . o n l y n e g a t i v e s t a t e m e n t s can be m a d e . functional concepts. S u c h p h e n o m e n a e x i s t n o t least of all in t h e r e a l m of m e d i c i n e . T h e y a r e e i t h e r s e e n i m m e d i a t e l y . for e x a m p l e . for it m a y well be t h a t medical t h i n k i n g is m o s t a d e q u a t e to its t a s k w h e n it is able to deal w i t h p h e n o m e n a t h a t a r e not s u b j e c t to d e t e r m i n a t i o n through exact. directly. t h o u g h s e c o n d a r y . F u r t h e r m o r e . in calling a being this or t h a t . W e r e this i d e n t i t y not c h a r a c t e r i s t i c of all o n t i c b e i n g s . It arises only out o f d o g m a t i z a t i o n o f o n e o f t h e m a n y possible scientific m e t h o d s : the natural scientific m e t h o d . a t r u e t a u t o l o g y . T h e c r i t i c i s m t h a t t h e r e can b e n o scientific s e e i n g o r knowing without conceptual abstraction proves groundless. All c o n c e p t u a l i z a t i o n is p r e f i g u r e d in t h e n a m i n g of t h i n g s . " and t h a t all we can do is point t h e m o u t .n e s s " a r e i n h e r e n t l y p r e s e n t . i. the a c c u s a t i o n o f lack o f o b j e c t i v i t y i n o u r m e t h o d also b e c o m e s m e a n i n g l e s s We should r e m e m b e r that objects—in the strictest sense of the word h a v e e x i s t e d for o n l y 3 0 0 y e a r s . t h e third o b j e c t i o n .t h e r e in this w a y . W e h a v e r e p e a t e d l y described this all-founding r e l a t i o n ­ ship as a p e r c e p t i v e o p e n n e s s to w h a t e v e r r e v e a l s i t s e l f to h u m a n being. o u r i n h e r e n t worldly r e l a t i o n s h i p o f b e i n g . i t r e v e a l s i t s e l f directly. Its v i e w of h u m a n being as o p e n n e s s to p e r c e p t i o n . to t h e s t a t u s of t h e sole s u b j e c t upon w h i c h all o t h e r b e i n g s depend for t h e i r being a s o b j e c t s . A s w e h a v e said. T h e s e c o n d g e n e r a l c a t e g o r y o f o b j e c t i o n s t o t h e Da-sein-based description o f h u m a n being c o n c e r n s the allegedly allegorical and a p p a r e n t l y m e r e l y o p e r a t i o n a l d e s c r i p t i o n s of t h e Da-sein. T h e s e f u n d a m e n t a l d e s c r i p t i o n s a r e simply m i s u n d e r s t o o d a s u n r e a l i s t i c . is often c o n f u s e d .e. m y s t i c a l a b s t r a c t i o n s . and t h e f o u n d a t i o n for b o t h o f t h e s e . a h u m a n being can allow w h a t e v e r r e v e a l s i t s e l f to h i m in its c o n t e x t of m e a n i n g and r e f e r e n c e w i t h i n an o p e n vis-a-vis at its p r o p e r place in his w o r l d and t h e n e n t e r i n t o a free dialogue w i t h it. T h e e x i s t e n t i a l s t a t e m e n t a b o u t clearing. or as vivid allegorical and m e t a p h o r i c a l f i g u r e s of s p e e c h . n o r could t h e r e be. W h e n e v e r w e direct o u r a t t e n t i o n t o this basic trait o f h u m a n e x i s t e n c e . strict and s o b e r . t h e r e w e r e n o o b j e c t i v e o b j e c t s .t h e . t h e o n l y possible a l t e r n a t i v e s e e m s t o b e a n u n f o c u s s e d e m o t i v e e n t h u s i a s m for experience in which the human observer would come to merge entirely w i t h w h a t i s o b s e r v e d until b o t h s i n k i n a s o g g y p a s t e . prior t o all e m o t i o n a l e n t h u s i a s t i c e x p e r i e n c e . b e f o r e D e s c a r t e s e l e v a t e d t h e h u m a n mind a s res cogitans. B e i n g .e.i n . w h i c h i s actually n o t h i n g b u t s u b j e c t i v i s m carried t o t h e e x t r e m e . T o a n y o n e i m m e r s e d i n t h e C a r t e s i a n s u b j e c t . poetic. T o c r i t i c s w h o s e e o n l y this a l t e r n a t i v e .t h i n k i n g ) s c i e n c e o f m a n .o p e n n e s s as the dwelling of the h u m a n being. T h e y w e r e t h e n c o n c e i v e d o f solely a s s o m e t h i n g r e p r e s e n t e d b y t h e h u m a n s u b j e c t .. w h i c h should h a v e no place in a scientific (i. since it o f f e r s a n y unbiased t h i n k e r a c o n s i d e r a b l y s t r i c t e r d i s t i n c t i o n b e t w e e n t h e h u m a n and n o n h u m a n t h a n t h e old C a r t e s i a n o b j e c t i v i t y . T h e s e o t h e r b e i n g s w e r e posited a s o b ­ j e c t e d (Lat.Criticisms of Medical Investigation 159 A g a i n s t t h e b a c k g r o u n d o f t h e s e f a c t s .. w o r l d .h o s t i l e e n t h u s i a s m for e x p e r i e n c e .. and this t h e n w a s t h e i r m o d e o f being. and as r e s p o n s i v e ­ ness to what it encounters is often misconstrued as mere analogy.o b j e c t division. I t i s t h e f u n d a m e n t a l r e l a t e d n e s s o f h u m a n being t o w h a t is.: ohjacere). as clearing. B u t we h a v e already s p o k e n of a third possible r e l a t i o n s h i p to t h e w o r l d . t h e m e r e fact t h a t t h e o r i e n t a t i o n o f d a s e i n s a n a l y s i s is n o n n a t u r a l scientific is sufficient to classify it as a b r a n d of u n o b j e c t i v e e n t h u s i a s m for e x p e r i e n c e . o n e t h a t is p r i o r to all e x a c t n a t u r a l scientific c o n c e p t u a l i z a t i o n . T h i s is c e r t a i n l y no o b j e c t . t h r o w n a g a i n s t t h e h u m a n faculty of i m a g i n a t i o n .w o r l d . m e t a p h o r s . o n c e and for all. T h i s i s a n a t t e m p t t o i n t e g r a t e D a s e i n s a n a l y s i s into the p r a g m a t i c t h i n k i n g o f m o d e r n n a t u r a l s c i e n c e . t h e n a m e c o r r e s p o n d i n g directly t o the primordial p h e n o m e n o n t h a t is t h e p r i m a l origin of b e i n g . a r e to be t a k e n as m e r e s i m i l e s . t h e Dasei'n-based d e s c r i p t i o n s o f the c h a r a c t e r i s t i c s o f t h e h u m a n being and t h e i r primordial s o u r c e — a s opposed to c a u s e — a r e labeled as p u r e l y f u n c t i o n a l or o p e r a t i o n a l c o n c e p t s . so D a s e i n s a n a l y s i s is t h o u g h t to o p e r a t e w i t h its basic terms. 1 F r o m t h e opposite e x t e m e . 50 a n d 7 2 .n e s s as such and of all p a r t i c u l a r b e i n g s in space and t i m e as well: m a n . . and the relatedness between them.t h e . M. is. o r o p e n n e s s . NOTE 1 C f . J u s t as c o n t e m p o r a r y physics and physicalistic p s y c h o l o g y e m p l o y t h e i r c o n c e p t s o n l y for t h e sake o f c o n v e n i e n c e o f a r g u m e n t . as t h a t w h i c h i l l u m i n a t e s and c a s t s s h a d o w s .i n . pp. r a t h e r . or allegories.w o r l d . W e o b j e c t t o t h e p r a g m a t i c m i s u s e o f d a s e i n s a n a l y t i c descriptions o f h u m a n e x i s t e n c e and its b e i n g . H e i d e g g e r . T h e s e s t a t e m e n t s are directed e x c l u s i v e l y t o w a r d a n a p p r o p r i a t e direct c h a r a c t e r i z a t i o n o f the o n t o l o g i c a l and o n t i c p h e n o m e n a o f h u m a n e x i s t i n g . Zur Sache des Denkens ( T u b i n g e n : 1 9 6 9 ) . is n o t t h e c l e a r i n g w h i c h r e f e r s to u n o b s t r u c t e d n e s s and o p e n n e s s . C l e a r i n g . w i t h o u t a t t r i b u t i n g a n y real m e a n i n g t o the c o n c e p t ' s n a m e . s o t h a t this alien a p p r o a c h can be disposed of. T o c o u n t e r this g r a v e m i s u n d e r s t a n d i n g we can o n l y affirm t h a t light. his world. N e i t h e r this c l e a r i n g n o r the e x i s t e n t i a l o p e n n e s s in it.EXISTENTIAL 160 FOUNDATIONS w i t h the light m e t a p h o r from Plato's p a r a b l e o f t h e cave. T h e r e i s n o i n t e n t t o m i s r e p r e s e n t t h e c h a r a c t e r of t h e Da-sein for o p e r a t i o n a l r e a s o n s . t h e Dasem-based a p p r o a c h clearly d e m o n s t r a t e d its e x c l u s i v e ability t o elucidate t h e individual. B e i n g a first e f f o r t . No a p p r o a c h can s u c c e e d h e r e if it is tied to t r a d i t i o n a l c o n c e p t i o n s o f h u m a n b e i n g s a s physical bodies. as b e i n g . b e t t e r still. T h e Da-sein o f all h u m a n b e i n g s t o g e t h e r c o m p r i s e s a n open r e a l m t h a t a l o n e m a k e s i t possible for t h i n g s t o s h i n e f o r t h and c o m e i n t o being. o b s e r v a b l e p h e n o m e n a of a p a r t i c u l a r h u m a n being as t h e o n t i c p h e n o m e n a t h e y are.t h e r e . whit h . open realm of perception that is the essence of human b e i n g . c o n c r e t e . in t h e s e r u d i m e n t s . It is m o r e t h a n m e r e e x p e c t a t i o n . as Dasein.Chapter 10 TRANSITIONAL DIFFICULTIES IN UNDERSTANDING DASEINSANALYTIC INSIGHTS From our attempts to describe the existential traits that are most significant for m e d i c i n e h a v e c o m e r u d i m e n t s of a Dasefn-based a n t h r o p o l o g y . r e c e i v i n g . or.t h e . T h e n u n c a p p r o p r i a t e Dasein-based v i e w of h u m a n b e i n g s b e g i n s o n l y w h e n I he long e s t a b l i s h e d cliches a r e a b a n d o n e d in favor of a totally n e w point ol d e p a r t u r e : t h e simple a s s e n t . b u t t h e y can s e r v e n e v e r t h e l e s s as a s o u n d basis for t h e a r t of h e a l i n g . W h e n c o n f r o n t e d w i t h t h e t e s t c a s e . T h e e s s e n c e of h u m a n being is s e e n . or as t h e s u b j e c t h a l f of a s u b j e c t . o r a s r e a s o n i n g o r g a n i s m s . or as the self-actualizing creatures M a r x sees.t h e r e . as b e i n g . t h e s e do n o t claim to be c o m p r e h e n ­ sive.o b j e c t relationship. and it is also v e r y d i f f e r e n t f r o m t h e natural scientific a s s u m p t i o n . w h e r e there r e f e r s to the whole. are i m m e d i a t e l y perceptible and are t h e r e f o r e w h o l l y d i f f e r e n t in kind from t h e a b s t r a c t s u p p o s i t i o n s c o n t a i n e d in n a t u r a l scientific. t h o s e p h e n o m e n a t h a t a r e e x p e r i e n c e d and s e e n d i r e c t l y . i t i s t e m p t i n g t o e q u a t e o n t o l o g i c a l p h e n o m e n a w i t h t h e a b s t r a c t i o n s and h y p o t h e s e s o f n a t u r a l s c i e n c e . T h e Dasrin-based a c c e p t a n c e o f w h a t h u m a n b e i n g s e n c o u n t e r i s s o m e t h i n g else indeed. a r e called o n t i c . can b o t h be p e r c e i v e d .162 EXISTENTIAL FOUNDATIONS inspires t h e f o r m u l a s " a s s u m i n g t h a t . t e x t u r e . and so o n . and w h a t i s s u m m o n e d u n d e r t h e n o t i o n o f i n s t i n c t o r affect. N o w . " P h e n o m e n a o f t h e first kind. b u t a p e r s o n will also p e r c e i v e t h e p h e n o m e n o n of t h e table's being " t h e r e . s o t h a t the scientific f o r m o f a c c e p t a n c e i s t a n t a m o u n t to a h y p o t h e s i s a b o u t t h e feasibility of an e x p e r i m e n t . c o l o r . l e n g t h . T w o s o r t s o f p h e n o m e n a a r e a l w a y s e v i d e n c e d i n this kind of a c c e p t i n g and r e c e i v i n g . T h e table in f r o n t of a p e r s o n r e v e a l s itself. " and " i f . for i n s t a n c e . All s e n s o r y and o n t o l o g i c a l p h e n o m e n a . " W e could i n v e s t i g a t e t h e table t o o u r h e a r t s ' c o n t e n t — s a w it i n t o pieces. t h e o b j e c t ' s p r e s e n c e and utility a r e b o t h g e n u i n e p h e n o m e n a . w h i c h m e a n s " t o reveal i t s e l f . t h e p r e s e n c e of t h e table as table. is the ontological. s o m a t o l o g i c a l . I n s t i n c t s and a f f e c t s are n o t h i n g m o r e t h a n i n t e l l e c t u a l c o n s t r u c t s w h i c h w e r e t h o u g h t o u t for t h e e x p r e s s p u r p o s e o f m a k i n g t h e p s y c h i c p h e n o m e n o n in q u e s t i o n c o m p a r a b l e to physical b e i n g s so it could be rendered calculable and be derived from s o m e h y p o t h e t i c a l c a u s e . w e i g h t . t h e n . c o n s i s t i n g o f all t h a t m a y b e p e r c e i v e d o f s o m e t h i n g t h r o u g h t h e s e n s e s . n o t t h r o u g h t h e medium of the senses. as an o b j e c t t h a t can be perceived t h r o u g h t h e s e n s e s . A n a t u r a l scientific t h e o r y a l w a y s c o n s i s t s in suppositions c o n c e r n i n g t h e feasibility of an e x p e r i m e n t . t h e n . p s y c h o l o g i c a l t h e o r i e s . " T h e n a t u r a l scientific a s s u m p t i o n stipulates c o n d i t i o n s t h a t are n e i t h e r directly perceived. It is i m p o r t a n t t o r e m e m b e r t h a t t h e actual e x i s t e n c e o f such t h i n g s a s instincts and affects c a n n o t be d e m o n s t r a t e d . . b u t t h e y h a v e n o t h i n g in c o m m o n . like the p r e s e n c e and utility of t h e table. N e v e r ­ t h e l e s s . T h e r e i s n o affinity w h a t s o e v e r b e t w e e n t h e p r e s e n c e and utility o f t h e t a b l e . i n t h e s e n s e o f the G r e e k phainesthai. w h i l e o n t o l o g i c a l p h e n o m e n a . W h e n e v e r I see s o m e t h i n g I r e c o g n i z e as a table. w i d t h . o n the o t h e r h a n d . t h e fact t h a t it is. S u c h a t h e o r y has no literal e x i s t e n c e of its o w n . . I n s u m . s u b j e c t it to c h e m i c a l a n a l y s i s — a n d still we w o u l d n o t h a v e found its p r e s e n c e as t a b l e . w i t h its c h a r a c t e r i s t i c qualities o f h e i g h t . . say. t h e s e c o n d c a t e g o r y . and what it is (a useful o b j e c t ) . i n h e r e directly in i In' i respective o b j e c t s . " T h e table m a y also be e x p e r i e n c e d as a useful o b j e c t . t h o u g h such perceiving is n o t directly b o u n d t o s e n s e p e r c e p t i o n . . B e c a u s e t h e y c a n n o t b e perceived t h r o u g h t h e s e n s e s . . n o r p e r c e i v a b l e . " b r o w n . the p r e s e n c e and t h e utility o f t h e table a r e n o t perceptible qualities o n t h e o r d e r of. b r e a k it a p a r t . If a person did not perceive. that t h e r e really are such p h e n o m e n a a s space. T h e o c c u r r e n c e o f p e r c e i v e d p h e n o m e n a does n o t n e e d t o b e proved. T h i s i s w h y o n t o l o g i c a l p h e n o m e ­ n a are n e v e r p r e s e n t i n d e p e n d e n t o f ontically p r e s e n t p h e n o m e n a : t h e o n t o l o g i c a l p h e n o m e n a .Transitional Difficulties L63 I m u s t also and already h a v e p e r c e i v e d t h e p r e s e n c e and utility ol I ha I thing. is i t s e l f the u l t i m a t e g r o u n d for any s t a t e m e n t m a d e a b o u t it. w h a t m a k e s i t w h a t i t is. and c a u s a l i t y . A c c e p t i n g space t h a t can be perceived and t i m e t h a t can be e x p e r i e m ed brings a l o n g w i t h it t h e a s s u m p t i o n of s o m e h u m a n r e l a t e d n e s s to Spa( e and t i m e . m u s t a l w a y s indwell " i n " t h e m . m u s t r e c o g n i z e t h a t n o t e v e r y g r o u n d i n g o f a p h e n o m e n o n n e e d b e a p r o o f and t h a t . for t h e c o n t e m p o r a r y s c i e n t i s t . being t h e e s s e n c e s o f s e n s o r y p h e n o m e n a . Indeed. m o t i o n . A r i s t o t l e p o i n t e d o u t t h a t t h e ability t o m a k e this d i s t i n c t i o n d i s t i n g u i s h e s t h e real t h i n k e r from t h e d i l e t t a n t e . h a s m a d e m a n y a s s u m p t i o n s . t h e f u n d a m e n t a l c h a r a c t e r of a c o n c r e t e being is. H y p o t h e t i c a l a s s u m p t i o n and Daser'n-based a c c e p t a n c e a r e n o t o f equal s t a t u s and a r e n o t i n t e r c h a n g e a b l y applicable. It is an a priori a s s u m p t i o n of science that h u m a n b e i n g s exisl In relation to t h e s e t w o p h e n o m e n a . t h o u g h a g r o u n d i n g o r f o u n d a t i o n o f t h e h i g h e s t o r d e r does e x i s t . the capacity t o dispense w i t h a r g u m e n t a t i o n can be gained o n l y a f t e r p a i n s t a k i n g exercise. o n t h e o t h e r h a n d . M e d i c i n e n e e d s to d i s t i n g u i s h b e t w e e n s i t u a t i o n s t h a t d e m a n d p r o o f and s i t u a t i o n s i n w h i c h p r o o f i s s u p e r f l u o u s . All t h a t is n e e d e d is a simple p o i n t i n g o u t of w h a t h a s been p e r c e i v e d . O n l y b y first a c c e p t i n g w i t h o u t q u e s t i o n t h a t time and space e x i s t can n a t u r a l s c i e n c e g o o n t o i m p o s e upon t h e m t h a t u n i f o r m i t y w i t h o u t w h i c h m a t h e m a t i c a l c a l c u l a t i o n s using t i m e and space would be i m p o s s i b l e . for p e r c e p t i o n does n o t d e m a n d r e c o u r s e t o a r g u m e n t a t i o n . and c o u n t i n g i s predicated o n t h e idea o f u n i f o r m u n i t s . for e v e n t h e s e a s s u m p t i o n s b e g i n w i t h t h e admission o f p h e n o m e n a w h i c h a r e n o t s u b j e c t to scientific p r o o f . A c c o r d i n g l y . B u t in n a t u r a l s c i e n c e this initial step is usually t a k e n u n w i t t i n g l y . T h e n a t u r a l scientific o r i e n t a t i o n . first o f all. E v e r y n a t u r a l scientific a s s u m p t i o n is n e c e s s a r i l y r o o t e d in s o m e m o d e of a c c e p t a n c e . i n positing n a t u r e as a calculable s y s t e m of m o v i n g m a s s p o i n t s and s p a t i o . e v e r y scientific p r o o f is o n l y a special kind of g r o u n d i n g .) W h a t is t r u e g e n e r a l l y for t h e n a t u r e of a n y being in its p r e s e n c e is also t r u e for t h e h u m a n being in particular.t e m p o r a l c o n t i n u a . t i m e . In s h a r p c o n t r a s t to t h e s u p p o s i t i o n s c o n t a i n e d in scientific t h e o r i e s . and a< i epl . W h a t is perceived s h o w s itself. as the s c i e n c e o f h u m a n being. as an o n t o l o g i c a l phe­ n o m e n o n . O n l y w h a t can b e c o u n t e d can b e c a l c u l a t e d . I t h a s a s s u m e d . in fact. m e d i c i n e . ( T h o u g h . n o r m a l Da-sein will r e m a i n o b s c u r e d .t i m e c o n t e x t s . space.e x i s t e n t i a l v i e w p o i n t c a n n o t b e g o t f r o m reading b o o k s . i s t o g o b e y o n d t h e r e a l m o f t h e n a t u r a l s c i e n c e s . a p o s s e s s i v e . T h i s v i e w p o i n t can b e r e a c h e d o n l y t h r o u g h a q u a n t u m leap i n t h i n k i n g . T h e d r i n k e r ' s visible m o v e m e n t s can b e m e a s u r e d and c a l c u l a t e d in a n u m b e r of s p a c e . o u r fellow m e n . s p a c e and t i m e . n o t o n l y t h e f u n d a m e n t a l s of undisturbed. W e m u s t leap o u t o f t h e o r i e n t a t i o n i n w h i c h w e are held spellbound b y t h e spirit o f t e c h n o l o g y — a s u b j e c t i v i s t i c . though often unrecognized. or that there are such t h i n g s as utility and spatiality. t h o u g h t h e ability o f t h e n a t u r a l s c i e n c e s t o m e a s u r e and c a l c u l a t e i s based o n this a d m i s s i o n . . o b j e c t s . he w o u l d be u n a b l e e v e n to pick up a glass and put i t t o his m o u t h . is n o t a n a t u r a l scientific s t a t e m e n t . T h u s u n u s u a l e f f o r t i s r e q u i r e d o f a n i n v e s t i g a t o r w h o would e x p e r i e n c e t h e n o n . and so o n . T h e n e w . n o r can it be a c h i e v e d t h r o u g h logical d e d u c t i o n s from already e x i s t i n g ideas. It is t h e fate of m o d e r n m a n to be e n t r e n c h e d by and l a r g e in the n a t u r a l scientific t r a d i t i o n o f s e e i n g o n l y causal r e l a t i o n s h i p s a m o n g isolated o b j e c t s . feeling. for u n l e s s t h e n e c e s s a r y e f f o r t is m a d e we shall also n o t be able t o o p e n t h e w a y for a m o r e a d e q u a t e l y h u m a n g e n e r a l p a t h o l o g y and therapy. foundation of our actual being-there.o b j e c t i f i a b l e o p e n n e s s w h i c h t h e Dasein-based o r i e n t a t i o n s h o w s a s t h e t r u e basis o f a h u m a n n a t u r e . and e v e r y t h i n g else i n t h e w o r l d — a n d o n t o t h e c o n c r e t e . and o f t h e e x i s t e n c e o f all t h a t is. and p e r c e i v i n g . and a b s t r a c t a t t i t u d e vis-a-vis o u r s e l v e s . O n l y philosophical c o n t e m p l a t i o n is suited to elucidating t h e fact t h a t t h e r e actually are such t h i n g s as t i m e . but t h e a c c e p t a n c e o f space and t i m e t h a t c o m e first i s n o t s u b j e c t t o experimentation. To admit o f t h e s e t h i n g s . T h e statement that time exists. If the headway won by Daseinsanalytic phenomenology is not taken advantage of. p h e n o m e n o l o g i c a l .164 EXISTENTIAL FOUNDATIONS t h e e x i s t e n c e of. Part III e R u d i m e n t s of an Existential G e n e r a l Pathology . A p h e n o m e n o l o g i c a l i n v e s t i g a t i o n d i s p e n s e s w i t h all t h e presupposi tions o f c o n t e m p o r a r y d r e a m t h e o r y . dark. T h e b o x c a r s t o o d on t h e floor of an ice-cold. Regula Ziircher r e p o r t e d a s t e r e o t y p i c a l d r e a m t h a t had afflicted h e r all h e r life at i n t e r v a l s o f days o r w e e k s f r o m e a r l i e s t c h i l d h o o d r i g h t u p t o t h e day o f h e r first s e s s i o n o f t h e r a p y — t h o u g h n e v e r again a f t e r t h a t . n o t o n e fish. we c a n say o n l y t h a t it c o n s i s t e n t l y r e v e a l s a s e v e r e l y d e f o r m e d w o r l d and e x t r e m e l y pathological b e h a v i o r of t h e patient wil h respect t o t h a t w o r l d . c r o u c h i n g terrified i n t h e c o r n e r o f a n e m p t y railroad b o x c a r . T h e d r e a m e r w a s fearfully cold. Approaching Regula Zurchei's d r e a m t h u s . b o u n d l e s s sea in w h i c h w a s n o t o n e p l a n t . I n t h e d r e a m s h e w o u l d find h e r s e l f . w h e t h e r t h e s e apply t o h u m a n c o n d u c t o r t o n o n h u m a n t h i n g s i n d r e a m s . h e r k n e e s d r a w n u p a n d h e r h a n d s held for p r o t e c t i o n i n f r o n t o f h e r f a c e . T h o u g h t h e b o x c a r w a s s u b m e r g e d deep i n t h e sea. a n a r c t i c wind b l e w t h r o u g h its d o o r s and c r a c k s . a n d holds t o n o t h i n g but the phenomena as they present themselves. n a k e d and a b s o l u t e l y a l o n e .Chapter 11 TESTING AN EXISTENTIAL RESEARCH METHOD ON SEVERAL PATHOLOGICAL PHENOMENA OF THE TEST CASE THE PSYCHOPATHOLOGICAL PHENOMENA T h e stereotypical dream At the very beginning of her psychoanalytic therapy. . a b a n d o n m e n t . s h e could see h e r s e l f o n l y as a f o r g o t t e n piece of m e r c h a n d i s e . s h e u n d e r s t o o d t h a t s u c h a disposition could o p e n to h e r o n l y a world t h a t w a s dark and e m p t y . S h e w a s t h e r e f o r e p a t i e n t l y urged t o d o n o t h i n g else this o n e t i m e e x c e p t a t t e n d t o t h e e l e m e n t s o f h e r d r e a m s e x a c t l y a s s h e perceived t h e m . cold and s h r o u d e d . t h e b o x c a r lets e v e r y t h i n g in it—including the d r e a m e r w h o c o w e r s n a k e d in a c o r n e r — a p p e a r as m e r e goods s h u n t e d back and forth .w o r l d t h r o u g h t h e d r e a m . H e could h a v e offered n o p r o o f o f t h e s e t h i n g s . w h i c h figures in traditional d r e a m i n t e r p r e t a t i o n s on t h e so-called o b j e c t i v e and subjective levels. A d e s o l a t e b o x c a r w a s t h e dwelling place that c o r r e s ­ ponded to such a self. t h e p a t i e n t became intensely aware of her extremely restricted way of being-int h e . S h e r e c o g n i z e d t h a t h e r w h o l e being. w a s p e r m e a t e d b y a n a t t u n e m e n t o f a n x i e t y . t h e t h e r a p i s t g u a r d e d a g a i n s t leading t h e p a t i e n t t o i n t e r p r e t the d r e a m a s a n e x p r e s s i o n o f a n u n c o n s c i o u s urge t o r e t u r n t o a n o c e a n i c w o m b . S h e was encouraged to abandon her r e c e n t l y acquired k n o w l e d g e o f t h e w i s h . All at o n c e . of libidinal and a r c h e t y p a l d r e a m s o u r c e s and d r e a m m o t o r s . i n this c a s e t r a n s f o r m i n g t h e w a r m t h o f t h e u t e r u s i n t o t h e o c e a n ' s icy cold. void of any r e l a t i o n s h i p to h u m a n b e i n g s o r any o t h e r living c r e a t u r e s . a b y s m a l d a r k n e s s and an e m p t y b o x c a r . a n anima c o n t a i n i n g the f e m a l e aspect of h e r being and m a n i f e s t i n g itself in t h e d r e a m i m a g e of t h e o c e a n . and i n s e c u r i t y . H e also avoided i m p r e s s i n g o n h e r t h e belief i n a n u n c o n s c i o u s d r e a m . s h e w a s already far t o o involved i n t h e o r e t i c a l s p e c u l a t i o n t h a t kept h e r from r e c o g n i z i n g w h a t h e r d r e a m w a s r e v e a l i n g . In this dark disposition. As a c o n t a i n e r of m e r c h a n d i s e t h a t has not yet r e a c h e d its d e s t i n a t i o n . as well a s h e r a c q u a i n t a n c e w i t h t h e o r i e s o f p s y c h i c p r o j e c t i o n . H o w could h e h a v e defended t h e m i f she had levelled t h e c r i t i c i s m t h a t all such a s s e r t i o n s are n o t h i n g m o r e t h a n a r b i t r a r y a s s u m p t i o n s w i t h o u t t h e s l i g h t e s t basis in fact? B e s i d e s . A f t e r a bit of p r a c t i c e in this s t r a i g h t f o r w a r d w a y of seeing. 1 F o r his part. H e m a d e n o a t t e m p t t o m a k e h e r a w a r e o f t h e p r e s e n c e i n h e r collective u n c o n s c i o u s of s o m e a r c h e t y p a l f e m a l e . b y feelings of total isolation.168 EXISTENTIAL FOUNDATIONS M a n y t h e o r e t i c a l h y p o t h e s e s and m a n y u n p r o v e n s u p p o s i t i o n s had t o b e cleared a w a y b e f o r e t h e d r e a m e r could learn t o s e e the significance o f her dream world without distortion. S h e w a s i n s t r u c t e d t o i g n o r e a n y m e a n i n g o r c o n t e x t o f r e f e r e n c e t h a t was n o t revealed t o h e r p e r c e p t i o n b y t h e t h i n g s t h e m s e l v e s in the d r e a m .w o r l d w h i c h could c o n v e r t t h e d r e a m e l e m e n t s into t h e i r o p p o s i t e s . S h e realized h o w s u c h a disposition could close o f f h e r field of vision to e v e r y t h i n g but a m e r c i l e s s l y cold. d r e a m i n g and w a k i n g .f u l f i l l m e n t t h e o r y o f t h e d r e a m . during t h o s e d i s c o r d a n t t i m e s w h e n she w a s f o r c e d t o live w i t h o u t h e r l o v e r and suffered f r o m s e v e r e s e x u a l f r u s t r a t i o n . dreaming means being-in-the-world in some particular w a y for t h e d u r a t i o n o f t h e d r e a m . b u t she also s a w t h r o u g h t h e s i t u a t i o n s t h a t i r r e s i s t i b l y b r o u g h t o n t h e feared s y m p t o m s . t h e p h e n o m e n o l o g i c a l a p p r o a c h t o t h e s t e r e o t y p i c a l dream a l l o w e d t h e d r e a m e r t o u n d e r s t a n d t h a t w h a t s h e e x p e r i e n c e d a t night w a s n o t at all a d r e a m in t h e s e n s e of s o m e t h i n g t h a t can be p o s s e s s e d or made. A n y t h i n g added a t this point w o u l d b e i n t h e n a t u r e o f a r b i t r a r y i n v e n t i o n s and p s e u d o s c i e n t i f i c violation o f t h e given facts. T h e s e u r g e s t u r n e d u p w i t h predictable r e g u l a r i t y . " she w e n t o n t o say. t h o u g h . Regula Ziircher n o t o n l y l e a r n e d t o r e c o g n i z e t h e periods during w h i c h s h e e n j o y e d total f r e e d o m from u r g e s t o s t a b and s t r a n g l e . could a p p e a r in t h e realm of this e x i s t e n c e and be perceived t h e r e : a cold e m p t y o c e a n . " A n o t h e r t i m e . an e m p t y b o x c a r . R a t h e r . S h e w a s n e v e r visited b y t h e s e u r g e s w h e n — a n d a s long a s — s h e w a s able t o live i n physical p r o x i m i t y t o t h e m a n s h e loved. The urge to stab and strangle At the conclusion of her psychoanalytic treatment. w h e n h e r child w a s t h e o n l y p e r s o n o n w h o m she m i g h t a l w a y s lavish a f f e c t i o n . W e appear t o h a v e g l e a n e d e v e r y t h i n g o f i m p o r t a n c e t h a t the s t e r e o t y p i c a l d r e a m will allow u s t o say a b o u t o u r t e s t s u b j e c t ' s deficient m o d e o f e x i s t e n c e . an icy w i n d . It is a c o e x i s t e n c e of w o m a n and m a n so i n t e n s e t h a t it o p e n s up to b o t h o f t h e m p r e v i o u s l y u n k n o w n . a n e x i s t e n t i a l i n t e r p r e t a t i o n o f this d r e a m s e e m s poor indeed a l o n g s i d e c u s t o m a r y d r e a m e x p l i c a t i o n s . c o n s i s t e d by h e r o w n a c c o u n t in " b e i n g free to e x p e r i e n c e all the w a y s in w h i c h a w o m a n can s u r r e n d e r to t h e m a n she l o v e s . " w h e n I a m t o g e t h e r w i t h him and s e n s e t h a t I h a v e freed him for a total m a s c u l i n e s u r r e n d e r t o m e . t h e n . and she h e r s e l f as a f o r g o t t e n piece of m e r c h a n d i s e a l o n e in a c o r n e r . she e x p e r i e n c e d h e r s e l f as an e x i s t i n g h u m a n being e n g a g e d in and dwelling in her perceptive relationships to things in her world. H e r t i m e s o f h a p p i n e s s . " " M y j o y i s c o m p l e t e . w h e n t h e r e could b e n o t r a c e o f a n u r g e t o s t a b or s t r a n g l e h e r child. A t first g l a n c e . h o w e v e r . D r e a m i n g a s well a s w a k i n g . T h e t w o l o v e r s m e r g e t o b e c o m e a unity that infinitely e x t e n d s t h e b o r d e r s w i t h i n w h i c h t h i n g s n o r m a l l y reveal t h e m s e l v e s t o . she said o f t h e s a m e c i r c u m s t a n c e .Only those things t o w h i c h h e r e x t r e m e l y c o n s t r i c t e d e x i s t e n c e w a s o p e n . " w h a t w e usually call s e x u a l love is a v e r y special w a y of b r i n g i n g t o g e t h e r t w o people. B u t it p r o v e d rich e n o u g h in r e a l i t y to l a u n c h a t h e r a p e u t i c p r o c e d u r e t h a t led to an a s t o n i s h i n g l y rapid c u r e . infinitely rich and e x p a n s i v e r e a l m s o f e x i s t e n c e .Testing and Research on Pathological Phenomena L69 Finally. s i n k i n g i n t o deep. S h e w a s happy w a t c h i n g the little girl splashing in t h e b a t h t u b . h e a r i n g h e r s h o u t foi |oy ( a i i vii')'. w h o m s h e loved i n t e n s e l y . s h e said. t h e p a t i e n t felt n e a r s u f f o c a t i o n and s u f f e r e d f r o m attacks of breathlessness that forced her to t h r o w open every window in t h e h o u s e . All t h a t w a s held s e c u r e l y in its e v e r y d a y c o n t o u r s j u s t a m o m e n t b e f o r e dissolves i n t o an infinite b r i g h t n e s s . Regular Z ü r c h e r knew m o m e n t s of great happiness. T h e s e usually happened during t h e e v e n i n g h o u r s .170 EXISTENTIAL FOUNDATIONS s e p a r a t e m a l e or f e m a l e people. w h e n s h e w a s u n t r o u b l e d a n d could lose h e r s e l f i n h e r m a t e r n a l m i n i s t r a t i o n s o f h e r child. T r u e . hurling us b e y o n d o u r s e l v e s . H u m a n being e x p a n d s i n t o a b o u n d l e s s . the love e c s t a s y c a n n o t a c c o m p l i s h this sort o f r e b i r t h i n t o t h e w a k i n g . e v e r y d a y w o r l d if t h e t r a n s p o r t w i t h a s e x u a l p a r t n e r is c o n f i n e d to a single s t o l e n m o m e n t . S h e w a s u n a b l e t o c o n c e n t r a t e o n any o n e activity. s h e g r e w m o r e and m o r e lonely. b e a m i n g r e a l m o f light. E v e r y t h i n g would s e e m to rise up a g a i n s t h e r as a b a r r i e r o b s t r u c t i n g h e r u n f o c u s s e d urge t o g e t o u t i n t o t h e o p e n . s e p a r a t e d from h e r beloved. T h i s i s t h e m o m e n t o f s e x u a l o r g a s m and t h e peak of a literal e c s t a s y of t h e w h o l e l o v e r and m e . t h e r e w a s still h e r little d a u g h t e r . T h e t w o kinds of t r a n s p o r t a r e related as well in t h a t each can re-place us i n t o a m o r e e n e r g e t i c and a f f e c t i o n a t e c o e x i s t e n c e w i t h t h e people and t h i n g s o f o u r e v e r y d a y w o r l d t h a n w e e n j o y e d b e f o r e . p r o v o k i n g fits o f s c r e a m i n g and o u t b u r s t s o f rage i n w h i c h she w a n t e d t o c r u s h a n y t h i n g t h a t stood in h e r w a y and h e a v e it t h r o u g h t h e w i n d o w . b u t w a s driven f r o m o n e t h i n g t o t h e n e x t . S h e b e c a m e i n c r e a s i n g l y r e s t l e s s and u n e a s y . a s t h e y n e e d t h e e c s t a s i e s o f love. T h e m o s t m i n o r difficulty a n n o y e d h e r n o e n d . e s t r a n g e d from h e r h u s b a n d . she could enfold the ( hild in her m o t h e r i n g love." R e g u l a Z ü r c h e r s o m e t i m e s c o m p a r e d t h e love e c s t a s y w i t h a m u c h g e n t l e r t r a n s p o r t . . In t h e final a n a l y s i s . S h e felt as if s h e w e r e locked in a prison. her to bed a f t e r w a r d s and praying with h e r . Y e t in t h e midst of t h e s e periods of s e v e r e f r u s t r a t i o n and ill humor. N a t u r a l l y . R e g u l a Z ü r c h e r w a s q u i t e d i f f e r e n t during the t i m e s w h e n . T h e b r e a d t h o f a w o r l d o f love like this has n o r e g a r d for boundaries. B u t h a v i n g h e r e n t i r e e x i s t e n c e r e d u c e d t o a single m o t h e r l y r e l a t i o n s h i p t o h e r child w a s a n u n b e a r a b l e r e s t r i c t i o n for this h i g h l y gifted and spirited p e r s o n . I t w a s this s t a t e o f e x t r e m e c o n s t r i c t i o n t h a t paved t h e w a y for t h e i n t r u s i o n o f t h e u r g e s t o s t a b and s t r a n g l e . It m u s t be a p r e s e n t w h i c h is s u s t a i n e d by long i n t i m a c y and t h e e x p e c t a t i o n of a f u t u r e life t o g e t h e r . this t r a n s p o r t t o o w a s s o m e t h i n g t h a t people n e e d from t i m e t o t i m e t o r e m a i n h e a l t h y . s u m m e r and w i n t e r alike. P h y s i c a l b o u n d a r i e s s t o p e x i s t i n g . I n t h e s e p h a s e s o f h e r life. d r e a m l e s s sleep. R e g u l a Z i i r c h e r had t o c o n t a i n h e r s e l f for t h e sake o f the child. this h a p p i n e s s w a s e n t i r e l y d i f f e r e n t f r o m t h a t w h i c h she felt in the e c s t a s i e s s h e s h a r e d w i t h h e r lover. E v e n w h e n she was a n n o y e d t o t h e b r e a k i n g point and full o f m a l i c e . It w a s t h e n t h a t c a r i n g for the child w o u l d o f t e n k e e p h e r f r o m b e i n g c o n s t a n t l y w i t h h e r lover. n o t h i n g o f t h e p a t i e n t ' s e x i s t e n c e could j u s t i f y s u c h a n a s s u m p t i o n . o f u n b e a r a b l e c o n s t r i c t i o n and c o n s t r a i n t r e i g n e d . i n c o m p a r a b l y m o r e placid b u t also m o r e limited. m e t i c u l o u s o b s e r v a t i o n o f h e r s e l f o r i n h e r physician's p r o l o n g e d i n v e s t i g a t i o n . I n n o time a t all t h e y would d e s t r o y t h e i n t i m a c y b e t w e e n m o t h e r and child. Still. far from t r a n s p o r t and s e l f . w h i c h w e r e i n h e r l o v e r ' s a b s e n c e predictably f o l l o w e d b y t h e s t a b b i n g impulses. w h e n t h e i m p u l s e s t o s t a b and s t r a n g l e o v e r c a m e h e r . No t r a c e of s u c h a desire was u n c o v e r e d e i t h e r in the p a t i e n t ' s m o n t h l o n g . S h e e x p e r i e n c e d n o death w i s h e i t h e r during t h e happy m o m e n t s . w e r e n e v e r s o free o f t h r e a t e n i n g a n x i e t y a s during t h e periods w h e n s h e could be n e a r an adult l o v e r . I n h e r loving c o n c e r n for h e r child. T h e p a t i e n t h e r s e l f could n o t r u n o u t i n t o t h e hall fast e n o u g h . this d e v o t i o n t o h e r child w a s a blessing to h e r . from o n e s e c o n d t o t h e n e x t splitting t h e m i n t o p o t e n t i a l m u r d e r e r and p o t e n t i a l v i c t i m .c h i l d r e l a t i o n s h i p m a d e h e r happy. t o a t t e n d o n l y t o t h e child's w a n t s and n e v e r t h i n k o f h e r s e l f . n o r a f t e r w a r d s . she w o u l d r e s t r a i n t h e offending right h a n d w i t h t h e left. h o r r i f i e d a t h e r s e l f . a s she . F u r t h e r . H a p p i n e s s w i t h t h e child w a s . w h e n a m o o d o f d e s p e r a t e and s u f f o c a t i n g a n x i e t y . B u t i t w a s precisely t h e isolated m o m e n t s o f deep h a p p i n e s s r e m a i n i n g t o h e r t h a t called u p t h e i m p u l s e s t o stab and s t r a n g l e m o s t p o w e r f u l l y .Testing and Research on Pathological Phenomena 171 W h i l e t h e i n t i m a c y o f this m o t h e r . w e m u s t first m a k e i t c l e a r t h a t a t n o t i m e could t h e p a t i e n t b e s h o w n t o e x h i b i t a n u n c o n s c i o u s d e a t h w i s h t o w a r d h e r d a u g h t e r . W e h a v e even h e a r d t h a t t h e s e t i m e s o f happy i n t i m a c y b e t w e e n m o t h e r and child. A s i f t h e y c a m e o u t o f t h e c l e a r blue s k y — s o w e are t o l d — t h e s e d e s t r u c t i v e u r g e s w o u l d d e s c e n d and t h r e a t e n t o c a r r y h e r a w a y . s h e n e v e r felt t h e p r e s e n c e o f a n y m a s c u l i n e u r g e to p e n e t r a t e .s u r r e n d e r . to s e e k o u t a f e m a l e being for sacrifice to a m a s c u l i n e desire to ravish and v i o l a t e . I f w e a r e t o u n d e r s t a n d this e x t r e m e l y p a t h o l o g i c a l b e h a v i o r solely o n t h e basis o f t h e given s i t u a t i o n and t h e p h e n o m e n a lying b e f o r e u s . E v e n during t h e h o u r s b e f o r e the e p h e m e r a l m o m e n t s o f h a p p i n e s s w i t h t h e d a u g h t e r . w h e r e . t h e e x i s t e n c e of a d e a t h w i s h t o w a r d t h e child w o u l d hardly be c o m p a t i b l e w i t h t h e fact t h a t t h e i m p u l s e s to s t a b never a r o s e at t i m e s w h e n t h e child she w a s c a r i n g for s t o o d m o s t i n h e r w a y and should h a v e e v o k e d m o s t s t r o n g l y t h e s e c r e t d e s i r e t o d o a w a y w i t h it. a s she h e r s e l f said. t h o u g h for a little while it w a s n o t t h e m a t i c a l l y h e e d e d . T h a t t h e s e impulses c a m e m o s t often j u s t w h e n s h e w a s happily and intimately close to h e r child is as clear an indication as we might wish of the c o n s t a n t p r e d o m i n a n c e in h e r e x i s t e n c e ot a lundaiiienl. W e t u r n first t o the f u n d a m e n t a l a t t u n e m e n t t h a t pervaded h e r w h o l e e x i s t e n c e during the periods w h e n she felt t h e i m p u l s e s t o s t a b and s t r a n g l e .d e f e n s e t o free h e r from h e r own suffocating imprisonment. carried w i t h it an e n s l a v e m e n t to a n y i n s t r u m e n t t h a t could b e e m p l o y e d i n s e l f . h e r l o v e r left n o d o u b t t h a t h e would have preferred her without dependents. as a f e a r of s u f f o c a t i n g . t o b o r e t h r o u g h b a r r i e r s . T o seal t h e m a t t e r . an e x t r e m e feeling of being closed in. T h i s f u n d a m e n t a l a t t u n e m e n t n e v e r disappeared e n t i r e l y . T h i s a c c o u n t s for t h e t e r r o r o f k n i v e s and o f h e r o w n m u r d e r o u s h a n d t h a t seized h e r w h e n e v e r she felt s u f f o c a t e d .172 EXISTENTIAL FOUNDATIONS w a n t e d t o be. a c c o r d i n g to t h e p a t i e n t . to b r e a k it up and s m a s h it to pieces. and t o kill w h a t t h r e a t e n s t o d e s t r o y . T o this f r a m e o f mind. t h r o t t l i n g . O n l y such a d e s p e r a t e selfd e f e n s e held o u t h o p e t o h e r for r e s c u e f r o m h e r o w n e x i s t e n t i a l s t r a n g u l a t i o n and d e s t r u c t i o n . t h i n g s a r e perceived solely in their potential a s prison walls. a p e r s o n can perceive his o w n h a n d s o n l y a s t h a t part o f h i m s e l f w h i c h can s t r a n g l e t h e a t t a c k e r h i m s e l f and k e e p him f r o m c a r r y i n g o u t his m u r d e r o u s i n t e n t . a c h o k i n g a n x i e t y . T h e s a m e applied to t h e p a t i e n t ' s o w n h a n d s . and h e r totally i n v o l u n t a r y a b s o r p t i o n i n t o this a t t u n e m e n t . this e n v i r o n m e n t b e c a m e t h e m o t i v a t i o n o f a violent u r g e t o a t t a c k a n y t h i n g s h e m e t . D u r i n g t h e w o r s t periods o f h e r p s y c h o n e u r o t i c illness. In t h e panic of being s t r a n g l e d . and of all t h e i r p r o p e r t i e s o n l y that t h e y can be d e v o u r e d . T h i s p h e n o m e n o n i s a n a l o g o u s t o t h e limitation o f p e r c e p t i o n t h a t o c c u r s in a s e v e r e l y h u n g r y p e r s o n . T h i s is b e c a u s e i n h e r e n t in e v e r y knife is t h e p o t e n t i a l for u s e a s a n i n s t r u m e n t t o cut t h r o u g h b o n d s . T h e r e i s t h e r e f o r e n o need t o w r a c k o u r b r a i n s s e a r c h i n g o u t hidden e x p l a n a t i o n s for t h e p s y c h o p a t h o l o g i c a l c o m p u l s i o n . to engulf her c o m p l e t e l y . n o t even i n h e r m o m e n t s of h a p p i n e s s as a m o t h e r . t o force open w h a t i s locked. H e r e x i s t e n t i a l a t t u n e m e n t t o e x t r e m e a n x i e t y . In a similar w a y . W e can c o n c e n t r a t e e x c l u s i v e l y o n w h a t could actually b e o b s e r v e d i n t h e patient. s h a r p o b j e c t s — especially k n i v e s — e x e r t e d a n o v e r p o w e r i n g f a s c i n a t i o n . It s h o w e d itself. He sees only w h a t is edible a r o u n d h i m . t h e p a t i e n t s u c c u m b e d t o t h e i m p u l s e s t o stab and s t r a n g l e s o c o m p l e t e l y t h a t s h e was compelled t o t a k e action a g a i n s t a n y t h i n g and e v e r y t h i n g . O n c e an a t t u n e m e n t like this t a k e s hold. o r i n s t r u m e n t s o f t o r t u r e and m u r d e r . and s u f f o c a t i n g . As s u c h . K n i v e s p r e s e n t ­ ed a challenge that threatened to overwhelm her.il a t t u n e - . o u r patient w a s reduced to e x p e r i e n c i n g h e r w h o l e e n v i r o n m e n t as i m p r i s o n i n g . H o w did it happen. T h i s i s h o w R e g u l a Z i i r c h e r ' s u r g e s t o s t a b and s t r a n g l e happened. N o t h i n g we h a v e seen j u s t i f i e s t h e opinion t h a t t h e s e p h e n o m e n a derive f r o m s o m e hidden d e a t h i n s t i n c t o r death wish. t h e c h a r a c t e r of t h e s e u r g e s as s h e e x p e r i e n c e d it and as it r e v e a l e d i t s e l f t o the u n p r e j u d i c e d p e r c e p t i o n o f h e r p h y s i c i a n .c o n s c i o u s endopsychii . t h e m o r e t h e y t o o k o n the significance o f t h r e a t e n i n g b a r r i e r s and s t r a n g l i n g c h a i n s . T h e s e u r g e s a r e w h a t h e r blinded e x i s t e n c e . h e r fear o f s u f f o c a t i o n . s u f f o c a t i n g . B u t at the bottom of her existence there was—as we have established—a constant feeling of being closed in. t h e p a t i e n t would s u d d e n l y perceive h e r g e n u i n e l y beloved child as c h o k i n g . t h a t just this happy i n t i m a c y b e t w e e n m o t h e r and child w a s m o s t o f t e n r e s p o n s i b l e for e v o k i n g fresh. w a s still o p e n to at a p a r t i c u l a r m o m e n t . O n t h e c o n t r a r y . t h o u g h . W h a t w e h a v e said s o far m a k e s e v i d e n t n o t o n l y w h a t t h e p a t i e n t ' s p a t h o l o g i c a l c o m p u l s i o n s w e r e not. it is c h a r a c t e r i z e d by a n e a r l y c o m p l e t e lack of f r e e d o m . W h e n h e r n e a r n e s s t o t h e child a t b a t h and b e d t i m e p r o c e e d e d to t h e d e e p e s t i n t i m a c y .Testing and Research on Pathological Phenomena 173 m e n t t o a n x i e t y . t h e n . T h e y a r e just t h a t p a r t i c u l a r m o d e o f o u r patient's ability t o e x i s t . T h i s a t t u n e m e n t was s o p e r v a s i v e t h a t e v e n t h e happy m o o d o f t h e m o t h e r . C l o s e s t t o h e r o f all w a s h e r little d a u g h t e r .c h i l d i n t i m a c y was hard put to c o n c e a l it f o r a s h o r t t i m e . A t this m o m e n t s h e s u c c u m b e d s o c o m p l e t e l y t o this e x p e r i e n c e o f t h e child t h a t t h e e r u p t i o n o f the u r g e s t o s t a b and s t r a n g l e t h e child can b e c o m p a r e d o n l y t o t h e d e s p e r a t e s t r u g g l e s o f s o m e o n e w h o is being s t r a n g l e d by a m u r d e r e r . and l e t h a l t o h e r o w n e x i s t e n c e . H e r d e f e n s i v e r e l a t i o n s h i p to t h e w o r l d at t h e s e t i m e s is deeply pathological. e v e r y t h i n g a r g u e s t h a t t h e y c o r r e s p o n d t o specific h u m a n m o d e s of r e l a t i n g to w h a t e v e r a p e r s o n e n c o u n t e r s in his world. and n o t h i n g m o r e . this v e r y i n t i m a c y had to call f o r t h t h e c a t a s t r o p h i c c h a n g e f r o m h e r f u n d a m e n t a l a n x i e t y . but also e n a b l e s us to d e s c r i b e t h e i r n a t u r e in a positive m a n n e r . e x a c t l y b e c a u s e t h e child w a s c l o s e s t t o h e r of all. I n this basic a t t u n e m e n t o f e x t r e m e a l a r m . q a u s i . s o n a r r o w l y a t t u n e d in a l a r m . p o t e n t w a v e s o f a n x i e t y and t h e p a n i c k y r e s c u e o p e r a t i o n s t h a t followed t h e m ? It w a s so b e c a u s e in this i n t i m a c y R e g u l a Z i i r c h e r g e n u i n e l y loved h e r d a u g h t e r and b e c a u s e this d a u g h t e r was for h e r a n y t h i n g but a n i n d i f f e r e n t o b j e c t or a c r e a t u r e s h e w i s h e d w o u l d go a w a y . W h a t actually w a s s e e n t o o c c u r i n t h e patient e x p o s e s psychological p r e s u p p o s i t i o n s and h y p o t h e s e s c o n c e r n i n g an u n c o n s c i o u s death w i s h o r a n a m b i v a l e n c e b e t w e e n t w o conflicting. and a f e a r o f s u f f o c a t i o n . so t h a t e v e r y t h i n g a r o u n d h e r a p p e a r e d a s prison w a l l s . T h e c l o s e r t h i n g s c a m e t o h e r . T h i s is. w i t h a r e s u l t i n g m o o d of c h o k i n g a n x i e t y . At Once t h e child b e c a m e s o m e t h i n g to be d e s t r o y e d i m m e d i a t e l y . A n y t h i n g e x t r a added t o t h e s e t h r e e equally e l e m e n t a r y . W h a t t h e p a t i e n t actually e x p e r i e n c e d w a s .. It is a r e n u n c i a t i o n of s t r i c t scientific t h i n k i n g n o t to distinguish c l e a r l y b e t w e e n a n impulsive. T h e s e h y p o t h e s e s n o t o n l y lack t h e capacity t o clarify t h e actual p h e n o m e n a (and are t h e r e f o r e s u p e r f l u o u s ) . it is t h e fact t h a t in s u c c u m b i n g to t h e s e u r g e s she was unable to t h i n k specifically a b o u t t h e i r e s s e n t i a l c o n n e c t i o n to h e r p r e d o m i n a n i a t t u n e m e n t . i n v o l u n t a r y s u r r e n d e r t o s o m e t h i n g and a n a c t i v e wish or desire for t h a t t h i n g . It is j u s t as u n s c i e n t i f i c to c o n f u s e o n e of t h e t h r e e m o d e s o f b e h a v i o r n a m e d a b o v e w i t h a n o t h e r . but t h e y a c t u a l l y distort o u r vision o f the peculiar n a t u r e o f t h e s e i m p u l s e s . J u s t as t h e r e is no s u c c u m b i n g e x c e p t to s o m e t h i n g . T h e p a t i e n t ' s i n v o l u n t a r y s u r r e n d e r t o t h e u r g e t o act a g a i n s t t h e child n e a r h e r and t h e d e f e n s i v e . r a t h e r . the fear of suffocating. b e c a u s e this freedom was simply n o t available t o t h e p a t i e n t w h e n she s u c c u m b e d t o h e r a c u t e fear and a n x i e t y . T h e s a m e can b e said for all the patient's w a n t s and d e s i r e s . m o d e s o f b e h a v i o r s h o w s i n t h e light o f faithful observation as psychological invention. yet radically d i f f e r e n t .c o m p u l s i v e a c t i v i t y following upon t h e m i s a p p r e h e n s i o n of t h e child are specific. and finally flight f r o m c o m m i t t i n g t h e m u r d e r . initially a brief and r e l a t i v e l y free period of h a p p i n e s s during w h i c h s h e w a s p e r m i t t e d t o love t h e child. Impulsive and c o m p u l s i v e s u r r e n d e r . so also w a n t i n g and w i s h i n g m u s t be directed t o w a r d t h i n g s . o r t o derive o n e from a n o t h e r and t h e r e b y c o n f o u n d all t h r e e . A p s y c h o l o g y s t r a y s e v e n f a r t h e r from a scientific m e t h o d of i n v e s t i g a t i o n w h e n it tries to derive an immediately obvious compulsion to stab from unconscious desires or i n s t i n c t s . t h e n a n a l m o s t e n t i r e l y u n f r e e urge t o s t a b and s t r a n g l e t h e child.174 EXISTENTIAL FOUNDATIONS drives o r t e n d e n c i e s t o w a r d t h e child a s g r o u n d l e s s fabrication. j u s t a s i t can e n t e r into a n y o n e o f t h e h u n d r e d s o f o t h e r m o d e s o f b e h a v i o r t h a t c o n s t i t u t e t h e e x i s t e n c e of a p e r s o n . If a n y t h i n g a b o u t o u r p a t i e n t ' s i m p u l s e s to s t a b and s t r a n g l e m i g h t be labeled u n c o n s c i o u s . l a b o r i o u s l y a c h i e v e d w i t h t h e small r e m n a n t o f freedom r e m a i n i n g t o h e r . p r i m a r y m o d e s of relating and t h e r e f o r e c a n n o t b e derived f r o m a n y t h i n g e l s e . We could n e v e r speak of a wish or desire in c o n n e c t i o n w i t h the p a t i e n t ' s u r g e to s t a b and s t r a n g l e h e r child. W i s h i n g and desiring p r e s u p p o s e a c o n s i d e r a b l e m e a s u r e of f r e e d o m . But the m e r e fa< I thai she was not . w a n t i n g and desiring— t h e s e a r e all d i f f e r e n t but equally e l e m e n t a r y possibilities of b e h a v i n g in relation to s o m e t h i n g t h a t e n c o u n t e r s a h u m a n being. A h u m a n e x i s t e n c e can e n t e r i n t o a n y o n e o f t h e s e w a y s o f relating. W e s h o w e d this earlier w h e n w e p o i n t e d o u t t h e i n h e r e n t c o n t r a d i c t i o n in such e x p l a n a t i o n s . ["his c o n n e c t i o n was available to hei in an u n t h e m a t i c w a y . s e n s u a l c o m m u n i o n — t h e i r so-called c o n s t i t u t i o n a l h y p e r s e x u a l i t y — u s m a r k e d ly r e d u c e d . Yet in the course of therapy m a n y o f t h e s e p a t i e n t s c o m p l e t e l y relinquish t h e i r h y p e r s e x u a l b e h a v i o r . P s y c h i a t r y m i s t a k e n l y classifies m o s t o f t h e s e a s c o n s t i t u t i o n a l l y hypersexual.s e n s u a l c o m p o n e n t has t h e e f f e c t o f e x a g g e r a t i n g and inflating the i m p o r t a n c e o f t h e bodily g e n i t a l r e g i o n o f t h e i r e x i s t e n c e . t h e r e w a s n o w n o part o f h e r w o r l d t o w h i c h she had n o t w o n a free r e l a t i o n s h i p . B u t this s o r t of d e v e l o p m e n t n e v e r o c c u r r e d in the first place with R e g u l a Z ü r c h e r . R e g u l a Z ü r c h e r could feel free o f t h e i m p u l s e s t o s t a b o n l y w h e n h e r s i t u a t i o n allowed h e r t o live w i t h a m a n she loved. T h e y d i s c o v e r t h a t t h e i r feelings had b e e n n e u r o t i c a l l y fixed in a w a y t h a t r e s t r i c t e d t h e i r r e l a t i o n s h i p w i t h p a r t n e r s of t h e o p p o s i t e sex to a physical c o m m u n i o n o f g e n i t a l s .Testing and Research on Pathological Phenomena 175 t h i n k i n g t h e m a t i c a l l y a b o u t s o m e t h i n g available to h e r is still a long way f r o m j u s t i f y i n g t h e s u p p o s i t i o n of a d y n a m i c u n c o n s c i o u s o p e r a t i n g within her. i t still c o n t r i b u t e s n o t h i n g t o a n u n d e r s t a n d i n g o f t h a t o n e remaining mode. bodily. b u t n o m a t t e r h o w c o m p l e t e t h e list o f m o t i v a t i o n s for a p a t h o l o g i c a l r e d u c t i o n of an e x i s t e n c e to a single m o d e o f b e h a v i o r . and a n i m a l r e a l m s . F o r y e a r s s h e had b e e n free o f t h e i n t e s t i n a l problems which psychoanalytic theory regularly—and unjustifiably— a t t r i b u t e s t o r e g r e s s i o n t o a n a n a l . instinct-enslaved psychopaths. It is a n o t h e r m a t t e r e n t i r e l y to decide j u s t w h a t in t h e p a t i e n t ' s life impelled h e r to a p a t h o l o g i c a l a t t u n e m e n t and a r e d u c t i o n of h e r e x i s t e n t i a l possibilities. for s u c h a long t i m e a f t e r t h e c o n c l u s i o n o f p s y c h o t h e r a p y . T o c o n f i n e h u m a n e o e x i s t e n c e t o its p h y s i c a l . D o e s n ' t this s t a t e of affairs indicate t h e p e r s i s t e n c e of a n e u r o t i c f i x a t i o n ? Y e t aside f r o m h e r fully r e c o g n i z e d d e p e n d e n c e on t h e physical p r e s e n c e o f a l o v e r . T h e q u e s t i o n still r e m a i n s w h y .t o g e t h e r w h i c h can e m c o m p a s s t h e w h o l e realm o f possibilities for r e l a t i n g . b u t R e g u l a Z ü r c h e r had for s o m e t i m e b e e n able t o r e l a t e freely t o t h e e a r t h y .e r o t i c libidinal s t a g e . P s y c h o a n a l y t i c t h e o r y likes to link u r g e s and c o m p u l s i o n s t o w h a t i t t e r m s anal e r o t i c i s m . B u t t o the e x t e n t t h a t t h e i r e x i s t e n c e s o p e n up in t h e c o u r s e of t h e r a p y to a full h u m a n b e i n g . S h e w a s n e v e r able to reach sexual o r g a s m wil houl I n ••! . W h y i s i t t h a t m e r e l y t h i n k i n g o f t h e m a n s h e loved and i m a g i n i n g a n e c s t a t i c u n i o n w i t h him w a s n o t sufficient t o keep R e g u l a Z ü r c h e r free o f t h e u r g e t o s t a b ? W h y did s h e c o n t i n u e for y e a r s t o r e q u i r e t h e physical presence of a male lover in order to remain healthy? T h e r e are many c a s e s of p s y c h o n e u r o t i c a l l y ill people w h o e n t e r t h e r a p y s u f f e r i n g f r o m a similar lack of f r e e d o m and n e e d i n g s e x u a l e c s t a s y as o f t e n as she did. t h e i r e n s l a v e m e n t t o p h y s i c a l . fecal. B u t p e r h a p s we h a v e been too hasty in also reje< ting the second c o m m o n t h e o r e t i c a l a s s u m p t i o n 1 rom hei reading . R e g u l a Z ü r c h e r k n o w s o t h e r w o m e n w h o h a v e b e e n happily m a r r i e d t o t h e s a m e m a n for y e a r s t h o u g h t h e i r s e x u a l i n t i m a c i e s n e v e r end o n a m o r e t h a n moderately exciting note. on the other hand. he t o o would h a v e to be classified as n e u r o t i c a l l y o b s e s s e d . t u n K were r e s p o n s i b l e for the patient's impulses to Stab does not si and up under close s c r u t i n y . I t w a s . a c c u m u l a t e d a g g r e s s i v e i i r . w a s t h e i m p u l s e to s t a b simply a c a s e of i n n a t e a g g r e s s i v e i n s t i n c t s a c c u m u l a t i n g u n d e r inhibition until t h e y had to erupt? Y e t the patient's entirely open—and often very aggressive— b e h a v i o r t o w a r d b o t h h e r f a t h e r and h e r first h u s b a n d e x e m p t s h e r f r o m categorization as an aggression-inhibited woman. to extricate it from r e p r e s s i o n . t h e h y p o t h e s i s t h a t inhibited. In o t h e r w o r d s . C o n s e q u e n t l y . N o n e o f t h e s e u n r e m i t t i n g e f f o r t s t o help t h e p a t i e n t w o r k t h r o u g h h e r a g g r e s s i v e n e s s kept h e r from being o v e r c o m e b y irritability w h e n she had to live w i t h o u t a s e x u a l p a r t n e r . physical fulfillment o f t h e u r g e s a t t e n d i n g t h e s e a t t u n e m e n t s . e v e n w h e n this irritability w a s c o n s t a n t l y c o n n e c t e d w i t h a t t u n e m e n t s appearing earlier i n h e r life. and d e p e n d e n t o n s o m e t h i n g o u t s i d e o f h i m s e l f : t h e o x y g e n he m u s t b r e a t h all his life from t h e a t m o s p h e r e a r o u n d him. t h e " b e i n g beside o n e s e l f . w h o m she liked t o call " t h e pillars o f s o c i e t y . full of death i n s t i n c t s . practice s e x u a l self-denial and e f f o r t l e s s l y r e n o u n c e e r o t i c .176 EXISTENTIAL FOUNDATIONS i m m e r s i n g h e r s e l f c o m p l e t e l y in a loving u n i o n w i t h h e r p a r t n e r . S h e reports that m a n y of the w o m e n she knows. S h e r e s p o n d e d to all q u e s t i o n s in this a r e a by asking in t u r n w h e t h e r t h e a n a l y s t m i g h t n o t also t h r a s h a b o u t i f h e w e r e being c h o k e d b y s o m e o n e . h e r opinion t h a t t h e s e w o m e n w e r e simply f o r t u n a t e — a n d limited— e n o u g h by n a t u r e to be shielded m o r e solidly a g a i n s t perceiving a r e a s of reality t h a t e x t e n d b e y o n d t h e n a r r o w day t o day. P e r h a p s we still need to ask if R e g u l a Z ü r c h e r ' s c o n t i n u e d d e p e n d e n c e on a physically p r e s e n t l o v e r m i g h t n o t h a v e r e s u l t e d from a failure to work through her aggressiveness in psychotherapy. " o u r t e s t s u b j e c t e x p e r i e n c e d . T h e s e friends c o n s i d e r t h e m s e l v e s less s t r o n g l y inclined t o s e n s u a l i t y and are t h e r e f o r e c o n s t i t u t i o n a l l y alien t o t h e kind o f e c s t a t i c r e l e a s e . I f h e a n s w e r e d yes. s e n s u a l e c s t a s y . their orgasms never induce the e c s t a t i c e s c a p e f r o m all limits and c o n f i n e s w h i c h R e g u l a Z ü r c h e r e x p e r i e n c e d i n h e r s . " w e r e s o m e h o w h e a l t h i e r and w o r t h i e r t h a n s h e . Equally u n r e w a r d i n g w e r e allusions t o t h e possibility o f g a i n i n g m o r e open r e l a t i o n s h i p s t o h e r a t t u n e m e n t s and l e a r n i n g t o relinquish t h e n e e d for i m m e d i a t e . Countless sessions spent discussing t h e a g g r e s s i v e irritability t h a t plagued h e r during periods o f f r u s t r a t i o n g a v e h e r n o relief. and still is. In any case. R e g u l a Z ü r c h e r f o u g h t a g a i n s t t h e idea t h a t t h e s e f u n d a m e n t a l l y d i f f e r e n t w o m e n . S h e simply asked t h e a n a l y s t i f t h e r e w a s really a n y s e n s e i n w o r r y i n g a b o u t t h e g e n d e r o r s e x u a l o r i e n t a t i o n o f s o m e o n e w h o was t h r a s h i n g a b o u t while being s t r a n g l e d . s h a d o w e x i s t e n c e . T h i s deficiency helps explain w h y she so d e s p e r a t e l y needed to be t o g e t h e r physically w i t h a m a l e l o v e r . f o r c i n g h e r to lead a false. Perhaps we should no l o n g e r r e s t r i c t this h o m o s e x u a l a s p e c t to a p r e c o n c e i v e d t h e o r e t i c a l c o n s t r u c t like t h a t o f c o r r e s p o n d i n g partial i n s t i n c t s .h o m o s e x u a l a t t i t u d e b e e n o u g h t o free h e r f r o m t h e i m p u l s e s t h a t afflicted h e r during t i m e s o f l o n e l i n e s s ? U n f o r t u n a t e l y for t h e t h e o r i e s . s h e simply a s s u m e d t h e m a s c u l i n e role h e r s e l f . w e m i g h t b e able t o s e e t h e p a t i e n t ' s h o m o s e x u a l aspect solely i n relation to an unconscious. T h e p a t i e n t ' s r e l a t i o n s h i p to h e r o w n past provides a first clue to an u n d e r s t a n d i n g o f w h y she r e m a i n e d s o long i n d a n g e r o f relapsing i n t o the u r g e t o s t a b . w h o was n o t e v e n b o r n until she b e g a n p s y c h o a n a l y s i s . T h e p a t i e n t w a s i n fact e x p r e s s i n g h e r a p p a r e n t lack o f a n y s o u n d footing in a p e r s o n a l past to w h i c h s h e m i g h t t u r n for s u p p o r t w h e n e v e r the p r e s e n t w a s n o t e n o u g h f o r h e r . A c h i l d h o o d e n v i r o n m e n t e x t r e m e l y antagonistic to her nature alienated her from h e r s e l f . she r e m a i n e d totally c o n s c i o u s o f b e i n g f e m a l e . E v e n w h i l e c a r r i e d a w a y b y t h e i m p u l s e s t o stab. T o all o f t h e a n a l y s t ' s h i n t s i n this d i r e c t i o n she posed t h e s a m e d i s a r m i n g q u e s t i o n s h e had used b e f o r e a g a i n s t allusions t o t h e p e r s i s t e n c e o f r e p r e s s e d a g g r e s s i v e i n s t i n c t s . Still. h e r o t h e r w i s e l a t e n t h o m o s e x u a l i t y o v e r w h e l m i n g h e r and a c t i v e l y u r g i n g h e r t o s t a b . w a s s o m e o n e o t h e r t h a n R e g u l a Z ü r c h e r . N o t o n c e did s h e feel t h e least bit m o r e m a s c u l i n e t h a n b e f o r e .h o m o s e x u a l aspect o f h e r impulses t o s t a b h e r d a u g h t e r equally a b s u r d . t h e l o n g e r she can b e n e f i t from t h e n e w b e g i n n i n g that a d a s e i n s a n a l y t i c t r e a t m e n t made p o s s i b l e — t h e l o n g e r s h e can untold her e x i s t e n c e by c a r r y i n g to .Testing and Research on Pathological Phenomena 177 o f p s y c h o a n a l y t i c l i t e r a t u r e . W e m i g h t b e able t o say t h a t w h e n e v e r R e g u l a Z ü r c h e r did n o t h a v e a m a n to act as h e r l o v e r . S h e f o u n d his q u e s t i o n s r e l a t i n g t o t h e phallic. m a s c u l i n e .h o m o s e x u a l t e n d e n c i e s t o include m o r e t h a n j u s t a c o n c r e t e d e s i r e to act using a m o r e or less disguised male g e n i t a l . s h e r e p o r t e d seeing h e r s e l f as a w o m a n a l m o s t e n t i r e l y devoid of a past. T h a t y o u n g girl. t h e p a t i e n t ' s p e r s o n a l e x p e r i e n c e s t a n d s d i a m e t r i c a l l y o p p o s e d t o s o l u t i o n s o f this kind. M i g h t n o t simply m a k i n g h e r fully a w a r e o f t h e n a t u r e o f h e r p h a l l i c . I h e r e is little h o p e t h a t she will e v e r r e c o v e r t h e past t h a t p a r e n t a l discipline p r e v e n t e d h e r from e x p e r i e n c i n g f i r s t h a n d . I f w e b r o a d e n o u r c o n c e p t i o n o f p h a l l i c . penetrating p e r s o n a l i t y . S h e claimed to h a v e v e r y little i n c o m m o n w i t h t h e y o u n g p e r s o n she had b e e n t h e n . predominantly masculine-active. t h e p a t i e n t had l e a r n e d t h a t t h e r e m i g h t b e something homosexual operating in her impulses to stab. s h e insisted. A t t h e c l o s e o f h e r p s y c h i a t r i c t r e a t m e n t . T h e walls o f t h e c o t t a g e . p r e s e n t . r e l a t i o n s h i p s t o w h a t she e n c o u n t e r e d . e v e n w h e n s h e had t o g o for long t i m e s w i t h o u t s e x u a l love. or h i g h l y r e s t r a i n e d . h e a l t h y h u m a n being Bui then o n e . suffocating. I n t h a t she w a s n o t s e l f .r e l i a n t s h e felt h e r self shrivel. t h e m o u n t a i n s i n f r o n t o f t h e w i n d o w s .r e l i a n c e . The knife hallucinations Shortly before her therapy began. the m o r e R e g u l a Z i i r c h e r was able to gain a p e r s o n a l past a f t e r h e r t h e r a p y had ended. T h e m i n u t e w o r l d o f t h e p a t i e n t ' s p r e s e n t m i r r o r e d t h e c o n s t r i c t i o n o f h e r f u t u r e : a s a c o n s e q u e n c e o f h e r legal ties t o a n i n a d e q u a t e h u s b a n d . t h e y p r o v o k e d h e r i r r e s i s t i b l y i n t o a v i o l e n t . a n d f u t u r e of its o w n . S h e could n o t e v e n g o o n h i k e s o f m o d e r a t e l e n g t h b e c a u s e t h e child w a s still t o o small e i t h e r t o b e t a k e n along o r left a l o n e a t h o m e . G r o w i n g i n i n d e p e n d e n c e and s e l f . i n a n u n b e a r a b l y n a r r o w prison cell. despairing s t r u g g l e to b r e a k free. T o a c o r r e s p o n d i n g d e g r e e s h e will b e m o r e o p e n for h e r o w n p a r t i c u l a r w a y o f allowing t h i n g s t o approach h e r . " T h e d a n g e r o f b e i n g o v e r w h e l m e d b y h e r u r g e s and c o m p u l s i o n s d e c r e a s e d c o r r e s p o n d i n g l y . the patient returned from an especially long s t a y w i t h h e r little d a u g h t e r in a r e m o t e c o t t a g e in t h e S w i s s Alps w h e r e s h e had b e e n m o r e t h a n e v e r b e f o r e cut o f f f r o m all o t h e r h u m a n c o n t a c t . Corresponding to her misperception of them as murderous. T h e p s e u d o m o r a l p r e s s u r e of h e r u p b r i n g i n g had left h e r a c r e a t u r e living e x c l u s i v e l y in forbidden. H e r o n l y s p h e r e o f a c t i v i t y c o n s i s t e d i n caring for t h e child and c l e a n i n g t h e little h o u s e . t h e daily r o u t i n e o f h e r h o u s e h o l d c h o r e s . she s a w a n e x t r e m e l y n a r r o w scope for t h e unfolding o f h e r e x i s t e n c e . a past. I n s h o r t . during t h a t s u m m e r v a c a t i o n . s t r a n g l i n g . t h a t c h a r a c t e r o f limiting. all hci a c t i o n s w e r e c o n c e r n e d with knives such as would be available. H e r past w a s equally c o n s t r i c t e d .178 EXISTENTIAL FOUNDATIONS fulfillment t h e possibilities o f b e h a v i n g and r e l a t i n g t h a t are specifically h e r o w n — t h e m o r e s h e will h a v e a past o f h e r o w n i n t o w h i c h h e r e x i s t e n c e e x t e n d s . In fact. Up to this point. S h e had n o m e m o r i e s o f t i m e s w h e n she had b e e n able t o c o m m i t h e r s e l f i n r e l a t i o n to t h i n g s and people in a w a y all h e r o w n . s h e will h a v e a w e a l t h of h e r o w n past to rely on and an i n d e p e n d e n t f u t u r e to r e a c h i n t o . We h a v e already discussed h o w this s t a t e i n e v i t a b l y led to her urge to s t a b and s t r a n g l e h e r child. B o t h o f t h e s e d i m e n s i o n s will provide h e r w i t h s u p p o r t . to any w a k i n g . the m o r e deeply and s e c u r e l y she felt h e r s e l f " g r o w i n t o a realm t h a t could s u p p o r t h e r r o o t s . h e r e x i s t e n c e will b e c o m e m o r e and m o r e t h a t o f a h e a l t h y and m a t u r e h u m a n being w h o s p a n s s i m u l t a n e o u s l y . and t h e d e m a n d s of caring for a small child r e v e a l e d to h e r o n l y o n e o f t h e i r s i g n i f i c a n c e s . o p e n and free. in I he same way and at the same location. however. outside h e r s e l f . c o n f i n i n g — m o s t . J u s t like t h e real k n i v e s . i t had b e c o m e a p p a r e n t t h a t t h e p a t i e n t ' s m a t u r i n g had b e e n a r r e s t e d at a s t a g e of helpless. I n this s t a t e . a l m o s t e n t i r e l y to a single r e l a t i o n s h i p c o n s i s t i n g in a v i o l e n t a t t e m p t to t e a r d o w n b a r r i e r s and b r e a k free o f t h e s u f f o c a t i n g c o n f i n e m e n t o f h e r world. to t h e o b s e r v a t i o n t h a t t h e knife h a l l u c i n a t i o n s c a m e t o t h e p a t i e n t a t t i m e s w h e n t h e scope o f h e r life w a s a t its m i n i m u m and h e r e x i s t e n t i a l a t t u n e m e n t t o a n x i e t y and c o n f i n e m e n t a t its m a x i m u m . S h e could s e e and feel t h e m . T h e r e i s n o point i n a r g u i n g h e r e w h e t h e r t h e s e p h e n o m e n a should b e called h y s t e r i c a l o r already s c h i z o p h r e n i c . T h e s y m p t o m had passed f r o m illusion i n t o t r u e h a l l u c i n a t i o n .Testing and Research on Pathological Phenomena 179 p h e n o m e n o n a r o s e t h a t falls i n t o t h e p s y c h i a t r i c c a t e g o r y o f illusion.p e r c e p t i b l e t o h e r i n places w h e r e for o t h e r s t h e r e w a s o n l y air. b e c a u s e it w a s t h e c l o s e s t — b o n d of all.d e f e n s e . e x c i t i n g feelings in h e r . S h e w a s taken by an a n x i e t y by no m e a n s mild and was glad to flee to t h e s a f e t y of her own tour walls. w h e n e v e r t h e u r g e s o v e r c a m e h e r . T h e patient b e g a n t o m i s t a k e sparkling facets o f c e r t a i n o b j e c t s for k n i v e s . . S h a r p k n i v e s c o r r e s p o n d e d m o s t e x a c t l y t o t h e w a y o f b e i n g i n w h i c h s h e e x i s t e d . t h e child she loved. W h e n it had r e a c h e d a c e r t a i n i n t e n s i t y . T h e phenomenological view attaches great importance. K n i v e s w e r e s e n s e . As long as h e r selfhood w a s so fragile and u n r e s i s t i n g it w a s inevitable t h a t she fall p r e y t o t h e o n e m o d e o f b e h a v i o r still r e m a i n i n g o p e n t o h e r : blind. A knife could free h e r from t h e m o s t s t r a n g l i n g . At first sight. h e r selfhood totally lost. the h a l l u c i n a t i o n s left h e r n o c h o i c e b u t t o g r a b t h e m and s t a b wildly. A n d R e g u l a Z i i r c h e r s u c c u m b e d as well to t h e s e h a l l u c i n a t e d k n i v e s . T h e l o n g e r t h e c o n f i n e m e n t p e r s i s t e d — t h e s m a l l e r and m o r e l o n e l y h e r w o r l d b e c a m e — t h e m o r e c o m p l e t e l y w o u l d she s u r r e n d e r t o this m o d e and b e c o m e a b s o r b e d i n t o it. childish d e p e n d e n c e on t h e p a r e n t s . r e f l e x i v e s e l f . he waked s t r a n g e . A f t e r a time she s a w k n i v e s w h e r e a h e a l t h y p e r s o n w o u l d see n o t even a h i n t o f a n y t h i n g knifelike i n t h e vicinity. S h e collapsed w h e n s h e s a w a p p r o a c h i n g on t h e o t h e r side of the s t r e e t a m a n she had met a few days b e f o r e at a c o c k t a i l p a r t y . this w a y of c o n n e c t i n g w i t h the w o r l d gave rise o u t of i t s e l f to h a l l u c i n a t e d t h i n g s t h a t could be used for d e f e n s e and escape. t h e r e . S h e w a s still far f r o m a selfhood o f significant a u t o n o m y and e n d u r a n c e . THE PSYCHOSOMATIC AND SOMATOPSYCHIC SYMPTOMS The hysterical paralysis of the leg I n t h e middle o f t h e c o u r s e o f h e r d a s e i n s a n a l y t i c t r e a t m e n t . w h e r e h e a l t h y h u m a n b e i n g s could see n o t h i n g . h e r e x i s t e n c e w a s reduced. R e g u l a Z ü r c h e r w a s s t r i c k e n w i t h h y s t e r i c a l paralysis o f t h e legs. A l s o . she w a s so c o m p l e t e l y ruled by t h e c o n t r a d i c t o r y r e l a t i o n s h i p to the y o u n g man . s e e m e d t o h e r t o b e m a d e o f i n a n i m a t e m a t t e r from t h e w a i s t d o w n . I n t h e r a p e u t i c s e s s i o n s a f t e r t h e paralysis o f h e r legs. R e g u l a Z i i r c h e r ' s e n t i r e e x i s t e n c e fell i n t o a c o n t r a d i c t o r y r e l a t i o n s h i p m a d e u p o f a n u r g e o v e r t o h i m and o n e a w a y from h i m . T h u s i t c a m e a b o u t t h a t . quickly and c o m p l e t e l y buried all o f t h e p a t i e n t ' s e m e r g i n g possibilities for l o v e . B u t w h y did t h e p a t i e n t ' s s i m u l t a n e o u s a t t r a c t i o n and r e p u l s i o n t a k e t h e form o f a physical. O n l y briefly in e a r l y p u b e r t y had s h e e x p e r i e n c e d a similar o p e n i n g and been able to e n t e r f o r a s h o r t t i m e i n t o r e l a t i o n s h i p s w i t h m a l e p e e r s t h a t w e r e t a n t a l i z i n g and e r o t i c a l l y tinged. as a possible p a r t n e r in s e x u a l love. t h e y s e e m e d like w o o d e n puppets w i t h o u t s e x u a l o r g a n s . from p u b e r t y until t h e birth o f h e r child. t h e y w e r e n o t u n d e r h e r c o n t r o l R a t h e r . if o n l y in a r e m o t e w a y . to perceive a m a n as a m a n . A rolling s t o n e t h a t is s u d d e n t l y s t o p p e d c a n n o t be called paralyzed. applied w i t h r e d o u b l e d e f f o r t . O n l y something that can perceive a meaningful address from a n o t h e r being and—depending on t h e r e s p o n s e or lack of it to this a d d r e s s — e i t h e r be m o t i v a t e d to m o v e t o w a r d or a w a y f r o m its s o u r c e is in a position to be paralyzed. and sinful c r e a t u r e s . i n o t h e r w o r d s . W h e n e v e r m e n p r e s s e d h e r w i t h t h e i r u r g e s for s e x u a l c o n t a c t . t h e p a t i e n t b e c a m e m o r e deeply a w a r e t h a n e v e r o f h o w e n s l a v e d she r e m a i n e d t o her mother's mentality. h y s t e r i c a l p a r a l y s i s ? W h y w e r e t h e y n o t c o n s i d e r e d freely i n a n o p e n and c o n s c i o u s d e l i b e r a t i o n ? T h e h y s t e r i c a l paralysis o f t h e legs had t o o c c u r b e c a u s e t h e p a t i e n t was still totally u n f r e e and d e p e n d e n t i n r e l a t i o n t o b o t h o f t h e s e c o n t r a d i c t o r y m o d e s o f c o n d u c t t o w a r d t h e y o u n g m a n . S h e w a s n o w a b l e . B u t h e r p a r e n t ' s r e p r e s s i v e m e a s u r e s . t o b e paralyzed.180 EXISTENTIAL FOUNDATIONS T o a k n o w l e d g e a b l e p e r s o n . S h e had not appropriated t h e s e possibilities a s h e r o w n . T h u s she could r e s p o n d t o t h e y o u n g m a n w h o a p p r o a c h e d h e r and called o u t for h e r t o c r o s s t h e s t r e e t t o h i m o n l y b y holding b a c k and r e t r e a t i n g f r o m his a t t r a c t i o n . d a n g e r o u s . T o b e s i m u l t a n e o u s l y d r a w n t o w a r d and also pulled a w a y from s o m e t h i n g m e a n s t o b e u n a b l e t o m o v e f r o m t h e spot. T h e i n s t a n t she c a u g h t s i g h t o f h i m . including h e r h u s b a n d . T h e m a n would o t h e r w i s e n e v e r h a v e affected h e r i n such a n e x c i t i n g and f r i g h t e n i n g w a y . t h a t is. S h e recognized that her dependent imprison­ m e n t w i t h i n this alien life style forced h e r to misidentify m e n as e x t r e m e l y i n d e c e n t . this n e w r e s p o n s i v e o p e n n e s s t o t h e y o u n g m a n and h e r fear of his a p p r o a c h w o u l d signify an early p s y c h o t h e r a p e u t i c s u c c e s s . forbidden. All o f t h e m . m e n could n o t b e p r e s e n t i n h e r w o r l d a s w h o l e m e n . for b o t h r e a c t i o n s r e v e a l a c e r t a i n b r o a d e n ­ ing of R e g u l a Z i i r c h e r ' s e x i s t e n c e . l o n g i n g for. w a s carried o u t directly in and as the h y s t e r i c a l paralysis. A n e x i s t e n t i a l e x a m i n a t i o n o f t h e facts o f h y s t e r i c a l p h e n o m e n a r e q u i r e s a scientific w a y o f t h i n k i n g t h a t can m a k e s h a r p d i s t i n c t i o n s a m o n g t h e m a n y m o d e s o f h u m a n r e l a t i o n s h i p s t o t h e world. t h e r e w a s n e v e r a n y e v i d e n c e in t h e h y s t e r i c a l paralysis to s u g g e s t an a c t u a l wish to a p p r o a c h t h e m a n or a compunction to flee f r o m his p r e s e n c e . m o d e s . or t h i n k i n g it. and this f r e e d o m is n o t p r e s e n t in any h y s t e r i c a l s u c c u m b i n g to t h e e n t i t i e s in q u e s t i o n . as we p o i n t e d o u t in o u r d i s c u s s i o n of c o m p u l s i v e p h e n o m e n a . S u c h a spastic paralysis w o u l d c o r r e s p o n d t o t h e n e u r o t i c bodying f o r t h o f a m u c h m o r e v i g o r o u s and less n e u r o t i c a l l y r e d u c e d r e l a t i o n s h i p t o the w o r l d t h a n t h a t o f R e g u l a Zürcher. or to judge. T h i s fact would n o t be a l t e r e d in t h e least e v e n if t h e paradoxical u n c o n s c i o u s d e s i r e o r m o r a l c o m p u n c t i o n really did e x i s t . p s e u d o m o r a l p r o h i b i t i o n o f this d e s i r e . t h e p a t i e n t ' s contradictory relationship to the young man occurred from the b e g i n n i n g o n l y w i t h i n t h e bodily s p h e r e o f this n e u r o t i c a l l y r e d u c e d e x i s t e n c e as t h e h y s t e r i c a l paralysis of t h e legs. w i s h i n g it. S u c h e n d o p s y c h i c e n t i t i e s are nothing m o r e than undemonstrable. erotic desire f o r t h e m a n and a n equally u n c o n s c i o u s . T h e m e r e fact of w i s h i n g or i m p o s i n g a m o r a l j u d g m e n t implies a c e r t a i n a m o u n t o f f r e e d o m w i t h r e s p e c t t o w h a t i s w i s h e d for o r judged. or a flight f r o m . it is f u n d a m e n t a l l y i m p o s s i b l e for h y s t e r i c a l s y m p t o m s to appear w h e n a p e r s o n is g e n u i n e l y able to wish. T h e paralysis involved h e r l e g s b e c a u s e t h e y are w h a t c a r r y o u t bodily a n a p p r o a c h t o . T h i s e x p l a i n s w h y s h e did n o t simply stand h y s t e r i c a l l y r o o t e d to t h e s p o t . we should r e m a i n c o n s t a n t l y a w a r e t h a t bodying f o r t h . to will s o m e t h i n g . S h e lived o u t this loss as t h e physical collapse. S h e e v i d e n c e d n o prior o r s i m u l t a n e o u s p s y c h i c d e s i r e s o r c o m p u n c t i o n s w i t h r e g a r d t o t h e y o u n g m a n . W h a t i s o f decisive i m p o r t a n c e i s t h a t t h e c o n t r a d i c t o r y r e l a t i o n s h i p t o t h e y o u n g m a n . T o the c o m m o n m e t a p s y c h o l o g i c a l s u p p o s i t i o n t h a t h y s t e r i c a l s y m p t o m s o r i g i n a t e w h e n e v e r e n d o p s y c h i c conflict has b e e n r e p r e s s e d into the u n c o n s c i o u s . It w a s ifse//the i m m e d i a t e fulfillment o f h e r p a t h o l o g i c a l r e l a t i o n s h i p t o h i m . yet equally p r i m a r y . w e m a y apply t h e s a m e c r i t i c i s m w e m o u n t e d i n o u r discussion o f t h e p a t i e n t ' s u r g e s t o stab. Her surrender to the conflicting urges regarding the young m a n held h e r e n t i r e e x i s t e n c e s o s p e l l b o u n d t h a t s h e w a s r o b b e d o f a n y ability to s t a n d on h e r o w n . T h e r e i s n o t h i n g t o s u p p o r t t h e m e t a p s y c h o l o g i c a l introduction of an endopsychic conflict between an unconscious. s o m e t h i n g . In fact.Testing and Research on Pathological Phenomena 181 t h a t s h e w a s w r e n c h e d i n t o it w i t h o u t willing it. A s w i t h t h e u r g e s t o s t a b and s t r a n g l e . and j u s t t h a t . S h e could c a r r y o u t this r e l a t i o n s h i p o n l y dully and u n t h e m a t i c a l l y in t h e bodily r e a l m o f h e r e x i s t e n c e . and w a n t i n g a r e t h r e e f u n d a m e n t a l l y d i f f e r e n t . arbitrary inventions. First o l all. I n s t e a d . s h e w a s ' d i r e c t e d from outside h e r self. ( T h i s p r e s u p p o s e s t h a t t h e attraction was not opposed by the neurotic misperception of the man as s o m e t h i n g sinful a n d t h e r e f o r e to be avoided. But after her marriage. can b e c a r r i e d o u t o r inhibited. F o r i n s t a n c e . . s o m e t h i n g t o w a r d w h i c h t h e w a n t i n g p e r s o n has already set o u t — w h e t h e r in t h i n k i n g and p l a n n i n g or in bodily a c t i v i t y — but n o t yet r e a c h e d . like a m a r i o n e t t e . R e g u l a Z i i r c h e r ' s r e s p o n s e t o t h e a t t r a c t i o n she felt to t h e y o u n g m a n w o u l d h a v e b e e n o n l y bodily if she had u n t h i n k i n g l y and u n t h e m a t i c a l l y h u r r i e d o v e r t o h i m . the relationship to the young man remained nothing other than a wishing for him t o b e n e a r . we can safely c o n c l u d e r e g a r d i n g t h e h y s t e r i c a l paralysis o f o u r t e s t s u b j e c t t h a t w h a t s h e fled f r o m and w a s also d r a w n t o w a s n o t a n e n d o p s y c h i c r e p r e s e n t a t i o n o f t h e y o u n g m a n . T h e s t r i n g s w e r e b e i n g pulled by t h e alien m e n t a l i t y o f h e r m o t h e r . It was not her self that commanded her not to a p p r o a c h t h e m a n and t o r e h e r a w a y f r o m h i m . is a r e l a t i o n s h i p to t h e w o r l d t h a t is d i r e c t e d t o w a r d s o m e t h i n g c o n s i d e r e d a t t a i n a b l e . T h e patient's o r g a n i c n e u r o t i c d i s t u r b a n c e s had n o w a s s u m e d a m o s t t h r e a t e n i n g a s p e c t . I t w a s n o r e p r e s e n t a t i o n . R e g u l a Z i i r c h e r had b e e n tormented by organic neurotic disturbances of the alimentary canal. t h e n his a p p r o a c h would o n l y b e r e c k o n e d w i t h . viscous d i a r r h e a . S u c h f u n d a m e n t a l d i f f e r e n c e s in individual possibilities of b e h a v i o r and relating t o t h e world preclude their b e i n g simply m e r g e d o r t r a n s f o r m e d i n t o o n e a n o t h e r . Wanting s o m e t h i n g . If it is t r u e . n o w a n o t h e r . T h e organic neurotic disturbances L o n g b e f o r e h e r h y s t e r i c a l paralysis. Initially. All w e can a s c e r t a i n i s t h a t n o w o n e . R a t h e r . t h e r e w a s nothing more than stubborn constipation. t h a t e n d o p s y c h i c . a r e l a t i o n s h i p can r e m a i n in t h a t s t a t e . t h e s e latest s y m p t o m s had b e g u n to be followed in t u r n by a t t a c k s of bloody. T h e s e first b e c a m e n o t i c e a b l e during p u b e r t y . W h e n p s y c h o t h e r a p y w a s b e g i n n i n g . u n c o n s c i o u s d e s i r e s and acts of will a r e as little e v i d e n t in h y s t e r i c a l g e s t u r e s as in h e a l t h y b e h a v i o r . T h e r e can c l e a r l y b e w i s h e s t h a t f r o m t h e o u t s e t c a n n o t b e fulfilled. b u t the m a n h i m s e l f . t h e n .) If. f r o m t h e place i n h e r w o r l d w h e r e h e w a s seen w a l k i n g . w h o m o v e d h e r t o stop s h o r t and collapse. o r visualized. S h e could barely take any noui i s h m e n l at all and had b e c o m e horribly e m a c i a t e d . h o w e v e r . s t o m a c h pains and i n t e s t i n a l c r a m p s o c c u r r e d m o r e and m o r e f r e q u e n t l y a s well.182 EXISTENTIAL FOUNDATIONS of realizing possibilities of r e l a t i n g to w h a t a p e r s o n e n c o u n t e r s in his world. on t h e o t h e r h a n d . T h e o n l y r e a s o n R e g u l a Z i i r c h e r h e r s e l f did n o t r e c o g n i z e w h a t w a s h a p p e n i n g to h e r is t h a t she had not yet become herself. childlike b e h a v i o r t h a t actually allowed h e r t o b e h e r s e l f . T h e time a t w h i c h h e r s u f f e r i n g s b e g a n p r o v i d e s a clue h e r e .e r o t i c drives o n t h e i r t e r m i n a l o r g a n s . A s w e h a v e h e a r d b e f o r e . and c o m p l e t e l y n o r m a l b o w e l m o v e m e n t s . as well as c e r t a i n fats and c a b b a g e s t h a t had p r e v i o u s l y been indigestible. g a s t r o i n t e s t i n a l specialists had forbidden h e r o n e food a f t e r t h e o t h e r and placed h e r o n m o r e and m o r e s c a n t y diets. c o n s i d e r e d t h e t r i g g e r i n g a g e n t for g a s t r o i n t e s t i n a l allergies and e c z e m a . S y m p t o m s o f i n t e s t i n a l disorder first b e c a m e v e r y p r o n o u n c e d j u s t w h e n y o u n g g e n t l e m e n began to n o t i c e this beautiful girl and ask h e r o u t to d a n c e s . Up to this t i m e . a p s y c h o a n a l y t i c i n t e r p r e t a t i o n w o u l d o f f e r as e x p l a n a t i o n the r e g r e s s i o n o f t h e p a t i e n t t o a n a n a l . R e g u l a Z i i r c h e r ' s case h i s t o r y r e v e a l s o n l y o n e c o n n e c t i o n b e t w e e n t h e pathological i n t e s t i n a l s y m p t o m s and t h e w a y i n w h i c h she w a s a p p a r e n t l y related a t this t i m e t o t h e w o r l d a r o u n d h e r . W h e n e v e r t h e o p p o r t u n i t y for p e t t i n g a r o s e . T h e i n s t a n t t h e p a t i e n t o v e r c a m e h e r initial r e s i s t a n c e and e n t e r e d i n t o a t r u s t i n g d a u g h t e r . O n days following t h e s e parties periods o f c o n s t i p a t i o n first a p p e a r e d . g r o w n . bodily c l o s e n e s s t o w a r d o t h e r s was n o w added this c o n s t r a i n t i n t h e face o f a n e w l y a r i s e n s e x u a l a t t r a c t i o n t o w a r d y o u n g men. S h e was soon able to take for g r a n t e d d a i l y .f a t h e r r e l a t i o n s h i p w i t h h e r physician. taken daily f o r o v e r a decade.s a d i s t i c s t a g e o f libidinal d e v e l o p m e n t . t h e p a t i e n t ' s i n t e s t i n a l c r a m p s and d i a r r h e a disappeared quite suddenly. a s i f o f t h e i r o w n a c c o r d . w h e n s h e w a s again able t o eat a n y t h i n g she d e s i r e d . T o h e r already e x i s t i n g r e s e r v e c o n c e r n i n g t e n d e r .u p lady and f o u n d r e l e a s e in the i m m a t u r e . s p o n t a n e o u s . In h e r circle of friends. E v e n milk. P s y c h o s o m a t i c medicine would t a k e this idea f u r t h e r t o t r a c e t h e real c a u s e o f t h e d i s t u r b a n c e t o t h e a c t i o n s o f depressive a f f e c t s upon t h e a u t o n o m i c c e n t e r s o f the c e r e b r a l c o r t e x . the s y m p t o m s c e a s e d . t h e patient n o l o n g e r n e e d e d t h e p o w e r f u l l a x a t i v e s she had.Testing and Research on Pathological Phenomena Traditional medicine would ascribe the patient's intestinal symptoms t o a d y s f u n c t i o n o f t h e a u t o n o m i c s y s t e m . h o w e v e r . with only m o d e s t results. she could n o w c o n s u m e w i t h o u t difficulty. Finally. t h e s t o m a c h and i n t e s t i n a l s y m p t o m s would b e s e e n i n g e n e r a l a s e f f e c t s o f a n a l . It w a s as if t h e y simply b l e w a w a y o n c e s h e gave up trying to play t h e role of a h a u g h t y . Y e t R e g u l a Z i i r c h e r w a s still s o totally d o m i n a t e d b y p a r e n t a l d i r e c t i v e s t h a t she denied b o t h h e r s e l f and t h e y o u n g m e n a n y bodily c l o s e n e s s and t e n d e r n e s s . she could feel h e r b o w e l s t i g h t e n . N o t o n l y did t h e u n b e a r a b l e s t o m a c h c r a m p s disappear. it w a s c u s t o m a r y for t h e s e affairs to t u r n quickly i n t o p e t t i n g parties. . s o o n a f t e r t h e s t a r t o f h e r t h e r a p y . All o f h e r s t o m a c h pains had stopped long b e f o r e t h e f u n c t i o n i n g o f h e r i n t e s t i n e s and h e r r e l a t i o n s h i p t o feces w e r e d i s c u s s e d . S h e had barely b e g u n h e r p s y c h o t h e r a p y . w h i c h w e r e c h a r a c t e r i s t i c s o f h e r b e h a v i o r during t h e t i m e s h e w a s s u f f e r i n g f r o m g a s t r o i n t e s t i n a l d i s t u r b a n c e s . B u t . b r o k e n r h y t h m o f h e r bodily m o v e m e n t s . If it is t r u e t h a t t h e w a y s i n w h i c h people b e h a v e t o w a r d w h a t s u r r o u n d s t h e m a r e i n a c c e s s i b l e t o o r d i n a r y medical t h e o r i e s . T h e s e e m i n g l y m o r e c a u t i o u s and less prejudicial d e s i g n a t i o n o f s i m u l t a n e i t y o f p s y c h i c and o r g a n i c e v e n t s o r o f t e m p o r a l c o r r e l a t i o n actually prejudices m u c h m o r e . N o t o n e o f t h e s e t h e o r i e s e v e n a p p r o a c h e s t h e issue o f h u m a n r e l a t i o n s h i p s . bloody d i a r r h e a s . T h i s r e l a t i o n s h i p also m a n i f e s t e d i t s e l f in h e r aloof and d i s t a n t m a n n e r of speaking.f a t h e r r e l a t i o n s h i p w i t h h e r t h e r a p i s t . or closing o n e s e l f o f f from it. n o r t h e s u p p o s i t i o n o f s o m e e n d o p s y c h i c affect o r o f e n e r g i e s and i n s t i n c t s has a n y t h i n g to do w i t h ability to p e r c e i v e fellow h u m a n b e i n g s as c r e a t u r e s to be t r u s t e d or feared. a t a n y r a t e . A s t o w h y t h e p a t i e n t ' s pathological r e l a t i o n s h i p t o a y o u n g man s h e m e t during the c o u r s e o f h e r p s y c h o t h e r a p y was b o d i e d I 0 1 1 h n o t as an o r g a n i c n e u r o t i c s y m p t o m . W h e n e v e r she w a s o v e r w h e l m e d by a b o t t o m l e s s fear of this w o r l d in w h i c h she had no t r u s t w h a t s o e v e r . Y e t as s o o n as s h e dared e n t e r i n t o a t r u s t i n g d a u g h t e r . b u t as an h y s t e r i c a l paralysis <>l t h e leg. but it is i m p e r a t i v e t h a t we u n d e r s t a n d this p h e n o m e n o n i f w e are t o learn a n y t h i n g a b o u t m o d e s o f b e h a v i o r like o p e n i n g o n e s e l f up to t h e world. O n l y t w o primarily s e p a r a t e e n t i t i e s can b e c o r r e l a t e d o r act s i m u l t a n e o u s l y . in h e r stiff m i m i c r y . N e i t h e r a d y s f u n c t i o n of t h e c e r e b r a l c o r t e x . J u s t i c e i s d o n e t o t h e s e facts only if the p a t i e n t ' s i n t e s t i n a l vicissitudes a r e s e e n as t h e bodying f o r t h of h e r overall r e l a t i o n s h i p t o the world. and w h i c h yielded t o n o r m a l f e m a l e w a y s o f m o v i n g a t the s a m e time t h e i n t e s t i n a l s p a s m s and i r r i t a t i o n s w e n t away. t h e p a t i e n t ' s i n t e s t i n a l s p a s m s w e r e only o n e — a l b e i t t h e m o s t d a n g e r o u s — f o r m i n w h i c h h e r e x t r e m e r e s e r v e vis-a-vis t h e world was bodied f o r t h . B o t h t e r m s p r e s u p p o s e t h e division of h u m a n e x i s t e n c e i n t o a p s y c h e and a s o m a . we . and in t h e affected. physical d i s t u r b a n c e s . in fact. h e r c r a m p s would give w a y t o v i s c o u s . t h e s e p o t e n t i a l l y lethal p a t h o l o g i c a l s y m p t o m s gave w a y t o n o r m a l g a s t r o i n t e s t i n a l f u n c t i o n i n g . t h e n t h e s e t h e o r i e s c a n n o t e x p e c t t o elucidate t h e c o n n e c t i o n b e t w e e n d i s t u r b e d h u m a n r e l a t i o n ­ ships and o r g a n i c .184 EXISTENTIAL FOUNDATIONS N o n e o f t h e t r a d i t i o n a l medical t h e o r i e s are able t o explain this a p p a r e n t and i m p o r t a n t c o n n e c t i o n b e t w e e n t h e p a t i e n t ' s o r g a n i c n e u r o t i c d i s t u r b a n c e s and t h e particular b e n t o f h e r h u m a n r e l a t i o n ­ ships. t h o u g h in an u n p r e j u d i c e d o b s e r v a t i o n — e x i s t i e n c e a l w a y s a p p e a r s as a unified w h o l e . O n e thing immediately apparent in our test subject was that horrible i n t e s t i n a l c r a m p s w e n t along with a forced and c r a m p e d r e s t r i c t i o n of h e r e x i s t e n c e w i t h r e s p e c t t o the w o r l d a r o u n d h e r . t h a t she could fall " b o d y " and " s o u l " in love w i t h a m a n and joyfully w e l c o m e his t e n d e r c a r e s s e s — t h o u g h . T h e e x i s t e n t i a l d i s t u r b a n c e e x p r e s s e d t h e p a t i e n t ' s lack o f freedom t o realize her potential for loving a m a n .Testing and Research on Pathological Phenomena 185 r e f e r t h e r e a d e r to an e a r l i e r publication dealing w i t h this precise question. T h e p a t i e n t w a s for a long time given i n j e c t i o n s of m a l e h o r m o n e s . . t h e r e can b e n o d o u b t t h a t i n this c a s e o v e r a c t i v i t y o f t h e p i t u i t a r y gland and t h e o v a r i e s did play a n e c e s s a r y role. i n t h e c o u r s e o f h e r t h e r a p y .e. so all t h e o r i z i n g a b o u t an e f f e c t i v e c o n n e c t i o n b e t w e e n an indefinable p s y c h e and a s o m a t i c p i t u i t a r y . T h e c u r e b r o u g h t a b o u t b y t h e g e n t l e t o u c h o f a m a n she loved h a p p e n e d well b e f o r e she w a s able t o e x p e r i e n c e s e x u a l o r g a s m w i t h him.t o g e t h e r with a man in a s h a r e d world. T r u e . R e g u l a Z i i r c h e r ' s b r e a s t p h e n o m e n a can b e d e s i g n a t e d o n l y a s the bodying f o r t h of a s e v e r e l y d i s t u r b e d w a y of relating to o t h e r s . y e t t h e r a p e u t i c m e a s u r e s b a s e d o n this a s s u m p t i o n failed to h a v e e f f e c t . in t e r m s of e x a c t l y m e a s u r a b l e . Faced w i t h o r g a n . finally. 2 Periodic swelling and pain i n t h e b r e a s t s w e r e also part o f t h e patient's p s y c h o s o m a t i c p a t h o l o g y . i t also p r o d u c e d s u c h s e v e r e irritability and r e s t l e s s n e s s t h a t it a l w a y s had to be d i s c o n t i n u e d quickly. and while this m e a s u r e did succeed in r e d u c i n g t h e swelling s o m e w h a t .r e l a t i o n w i t h a m a n . T h e pain and t e n s i o n i n t h e p a t i e n t ' s b r e a s t s disappeared f o r e v e r . and m a m m a r y glands is c o n c e p t u a l l y u n c l e a r . B u t j u s t as p s y c h i c e f f e c t on t h e i n t e s t i n e is n o t scientifically definable. had d i s c o v e r e d and accepted h e r w o m a n h o o d so. from a purely physical s t a n d p o i n t ..n e u r o t i c p a t h o l o g y like t h i s . i. p s y c h o g e n i c b r e a s t pain a r o s e . H e r g y n e c o l o g i s t was n o d o u b t c o r r e c t i n c o n n e c t i n g t h e s e s y m p t o m s t o o v e r p r o d u c t i o n o f e s t r o g e n . but a p h y s i o t h e r a p i s t ' s a t t e m p t to e a s e t h e painful swelling and h a r d n e s s by light m a s s a g e failed e n t i r e l y . H e r b r e a s t s would b e c o m e h a r d a s s t o n e s during t h e s e c o n d h a l f o f e v e r y m e n s t r u a l cycle and s o s w o l l e n t h a t h e r c h e s t m e a s u r e m e n t w a s i n c r e a s e d b y a t least a n inch a t t h e o n s e t o f menstruation. S h e w a s far from able to fulfill these possibilities in a decisively w a n t e d and active b e i n g . h e r l o v e r ' s c a r e s s e s did n o t differ g r e a t l y from t h e e a r l i e r m a s s a g e s given h e r b y h e r p h y s i o t h e r a p i s t . p h y s i c i a n s can n o l o n g e r be satisfied w i t h t h e p s e u d o e x p l a n a t i o n t h a t a s e x u a l l y a r o u s e d p s y c h e had a c t e d t h r o u g h t h e p i t u i t a r y gland. o v a r i e s . w h e n s h e . c o m p a t a b l e and c a u s a l l y related c o n c e p t s . in p a r t i c u l a r of bodying f o r t h a l o v e . Application o f a l c o h o l c o m p r e s s e s t o t h e b r e a s t s g a v e h e r s o m e relief. c a u s i n g t h e o v a r i e s t o b e c o m e h y p e r a c t i v e until. s o t h e d i s a p p e a r a n c e o f h e r b r e a s t pains c a n n o t b e a s c r i b e d t o a n y physiological change brought on by sexual intercourse. s o m e n e u r o t i c a c c i d e n t p r o n e n e s s . it was a b o v e all h e r potential for bodily a p p r o a c h i n g o t h e r p h e n o m e n a that was d e s t r o y e d w h e n h e r b o n e was b r o k e n . e x i s t i n g p e r s o n s h e w a s . even as a broken something. A s w e h a v e n o t e d b e f o r e . for i n s t a n c e . since she w a s in t r a c t i o n . n o less t h a n t h e h y s t e r i c a l paralysis. B u t did R e g u l a Z i i r c h e r e v e r u s e h e r leg as such a tool? If she examined what happened w h e n she was hurring across t h e s t r e e t t o h e r l o v e r . B u t t h e r e is a d i f f e r e n c e b e t w e e n t h e f o r m e r paralysis and t h e leg f r a c t u r e . T h i s e x p e r i e n c e d e m o n s t r a t e s clearly h o w directly t h e bodily s p h e r e o f a h u m a n e x i s t e n c e i n h e r e s in a loving r e l a t i o n s h i p to a n o t h e r h u m a n being c o e x i s t i n g in a s h a r e d w o r l d . N o o n e w o u l d b l a m e this f r a c t u r e on a faulty a t t i t u d e on t h e p a t i e n t ' s part. " and in a c o r r e s p o n d i n g r e s p o n s e to this a t t r a c t i o n h u r r i e d o v e r to h i m as t h e w h o l e . t h e c a r e l e s s d r i v e r did n o t simply s h a t t e r a physical leg w h e n he ran i n t o R e g u l a Z i i r c h e r . t h a t r e s u l t e d in a m i s h a p for which she was ultimately responsible.186 EXISTENTIAL FOUNDATIONS T h e leg f r a c t u r e T h e leg f r a c t u r e R e g u l a Z i i r c h e r suffered s o m e t i m e a f t e r t h e finish o f t h e r a p y kept h e r in bed for s e v e r a l w e e k s and. belonged to Regula Z i i r c h e r ' s dwelling in h e r r e l a t i o n s h i p s to t h e w o r l d . h e r leg c a n n o t be u n d e r s t o o d p r o p e r i y as t h e h u m a n limb it is u n l e s s we see in it the bodying f o r t h o f t h e possibilities o f a p p r o a c h i n g o r r e t r e a t i n g from s o m e p r e s e n c e . . In b r i e f . It could be said t h a t a f r a c t u r e of t h e tibia p r e v e n t s a p e r s o n f r o m u s i n g t h e leg as an a m b u l a t o r y tool. and it w a s n o t j u s t a piece of t h e s k e l e t o n t h a t w a s broken. a t t h e s a m e t i m e felt a t t r a c t e d t o h i m " b o d y " a n d " s o u l . all t h a t t h e p a t i e n t e x p e r i e n c e d t h e n w a s h e r l o v e r ' s u n e x p e c t e d e n t r a n c e i n t o h e r field o f vision. even t h o u g h s o m e part of t h e body—a leg. she could n o t h o n e s t l y say t h a t she had used h e r legs a s i n s t r u m e n t s for t h e purpose o f c r o s s i n g t h e s t r e e t . T h e car accident. s t r u c k n o t s o m e m e r e i n s t r u m e n t . for i n s t a n c e — m a y also be d e s i g n a t e d as a distinct physical component. s h e had b e e n r u n d o w n from b e h i n d o n t h e sidewalk b y t h e a u t o m o b i l e of a t o t a l s t r a n g e r . literally nailed h e r to it. W h a t actually o c c u r r e d w a s s o m e t h i n g v e r y d i f f e r e n t . This something. S h e w a s n o w as u n a b l e to take a step as she had b e e n i m m e d i a t e l y a f t e r h e r e a r l i e r h y s t e r i c a l paralysis. she did n o t p e r c e i v e h e r s e l f t h e n as a p s y c h e t h a t s o m e h o w seized t h e body as an i n s t r u m e n t for t r a n s p o r t i n g it a c r o s s t h e s t r e e t . In p a r t i c u l a r . undivided i n t o s e p a r a t e physical o r psychic c o m p o n e n t s . F a c t u a l l y speaking. T o g e t h e r with a number of other people. T h u s h e r f r a c t u r e can be c h a r a c t e r i z e d as clearly physical in o r i g i n . S h e i n s t a n t l y r e c o g n i z e d him a s h e r lover. A little b u r s t of n o i s e . Each of t h e s e pains had a c h a r a c t e r all its o w n . and c u m b e r s o m e r e a l m e n d i n g a t t h e walls o f the s i c k r o o m and allowing t h e approach o f n o t h i n g but w h a t w e n t o n inside t h o s e four walls. T i m e s e e m e d t o s t a n d still for h e r . h o w v e r y fragile the h u m a n w o r l d and all its r i c h e s w e r e . T i m e had b e c o m e a n e m p t y v e s s e l . S h e also felt a n u r g e t o w r i t e s h o r t s t o r i e s for m a g a z i n e s . s h e t h o u g h t . L a t e r . Finally. T h e first she r e m e m b e r s w e r e p r o d u c e d b y e c z e m a o f t h e l e g s . v e r y d i f f e r e n t . m a s s i v e . S u c h t h o u g h t s caused all o f t h e t h i n g s o f h e r e v e r y d a y w o r l d t o t a k e o n a n unwanted transcience. F o r o n e thing. h o w e v e r . she c a m e t o e x p e r i e n c e t h o s e a g o n i z i n g g a s t r o i n t e s t i n a l s p a s m s and a t about the s a m e t i m e b e g a n t o s u f f e r f r o m i n t e r m i t t e n t a t t a c k s o f v a s o m o t o r h e a d a c h e s . r e s t r i c t i o n o f physical m o v e m e n t was n o t the only r e s u l t o f t h e leg f r a c t u r e . w e r e limited i n s t e a d to m o r o s e r e f l e c t i o n s . T h e a c c i d e n t had r e m i n d e d h e r . T o h e r o w n a s t o n i s h m e n t . t h e fear o f death s e n t suddenly c o u r s i n g t h r o u g h h e r v e i n s w a s partly a t fault. S o little h a p p e n e d t h a t w h e n she a w a k e d i n t h e m o r n i n g t h e a p p r o a c h o f e v e n i n g s e e m e d a n e t e r n i t y a w a y . I t a f f e c t e d also h e r w h o l e r e l a t i o n s h i p t o the w o r l d . R e g u l a Z i i r c h e r had had pains o f the m o s t d i v e r s e s o r t s and i n t h e m o s t d i v e r s e l o c a t i o n s t h r o u g h h e r body. but o b j e c t s f r o m t h e s p h e r e s o f h e r h o m e and o c c u p a t i o n . a f t e r she had l e a r n e d to o v e r c o m e all of h e r o t h e r pain. and s h e f o c u s s e d a large part of h e r a t t e n t i o n on plans for t h e f u t u r e . S h e b e g a n t o s e e h e r s e l f a s a n e x t r e m e l y n a r r o w . T h e patient des< I Ibrd the pains a s s o c i a t e d w i t h e c z e m a as a superficial b u r n i n g thai lelt as II ihf . A n d t h e n ? B u t " t h e n " and " t h e r e " would n o l o n g e r e x i s t e i t h e r . type o f pain. T h e r e w a s also t h e pain t h a t w e n t w i t h t h e swelling in hei b r e a s t s .. P e r h a p s . H e r days w e r e filled b y t h e visits o f h e r friends. t h e w h o l e w a y i n w h i c h s h e e x i s t e d . h e r f u t u r e d e t e r m i n e d h e r p r e s e n t and d r e w n o u r i s h m e n t f r o m t h e e x p e r i e n c e s o f h e r past. A f t e r t h a t s h e s c a r c e l y g a v e a n y t h o u g h t t o h e r b r o k e n leg. h e r r e l a t i o n s h i p s t o h e r friends. C l a i m i n g the f o r e g r o u n d o f h e r a w a r e n e s s w a s h e r o w n b r o k e n leg. w h i c h w e r e t o h a v e b e e n actualized the n e x t day in a b i r t h d a y c e l e b r a t i o n . in a n y c a s e . d r a w i n g h e r w h o l e e x i s t e n c e u p i n t o t h e r e l a t i o n t o it. and suddenly all w o u l d disappear.Testing and Research on Pathological Phenomena 187 C o n s e q u e n t l y . T h i s c i r c u m s t a n c e p e r s i s t e d for o n l y t w o o r t h r e e days. for t h e t i m e a f t e r h e r r e c o v e r y . All t h a t had been claiming h e r w h o l e h e a r t e d a t t e n t i o n n o w m e a n t a l m o s t n o t h i n g t o h e r . a leg f r a c t u r e b r o u g h t h e r a n o t h e r . s h e o b s e r v e d h o w far i n t o t h e distance e v e r y t h i n g receded during t h e first days o f h e r hospital s t a y — n o t o n l y o t h e r people. T h e bodily pains F r o m e a r l i e s t childhood o n w a r d . O n c e again. N o m a t t e r h o w familiar t h e s e s e n s a t i o n s a r e t o t h e n o s e and palate o f t h e p e r s o n r e p o r t i n g . W h e n w e look o v e r t h e p a t i e n t ' s d e s c r i p t i o n s . A l m o s t i m m e d i a t e l y . as R e g u l a Z i i r c h e r did in h e r a t t e m p t to describe h e r pains. B e f o r e this happened. F o r the first m o m e n t . 3 Bodily e x pei ICI pains are u ed. can g e t t h e n a t u r e o f bodily pain. S h e also d e s c r i b e d h e r b r e a s t pains a s a n u n b e a r a b l e i n n e r t e n s i o n . It is likely t h a t t h e p h e n o m e n o n of pain itself. to s e n s e . t h o u g h . o f pain. N o w a n y o n e would b e hard p r e s s e d t o d e s c r i b e . big as a barn and filled w i t h a g o n y . T h e r e i s n o biophysical o b j e c t t h a t has t h e capacity t o e x p e r i e n c e . I n t h e end. w e spea k a l w a y s e x p e r i e n c e d as h u r l i n g . Regula Zurcher's characterizations of her pains s u f f e r from t h e s a m e lack of precision s e e n in all s u c h d e s c r i p t i o n s i n scientific t e x t b o o k s . r a t h e r t h a n t h e p a t i e n t . and t h e r e w e r e t i m e s w h e n i t s e e m e d t o h e r t h a t h e r b r e a s t s would have to e x p l o d e a n y m o m e n t . the e a r t h b e l o w . f o r i n s t a n c e . n o t e v e n w h e n t h e n u m b e r o f electrical i m p u l s e s racing t h r o u g h t h e m i s raised t o ml m i l y. i t s e e m e d o n l y as large (spatially) as a volley ball. is at fault h e r e . h o w e v e r . N o a n a t o m y . o l the perception a n d s e n s a t i o n o l p a i n is Y e t pain is Suue pam . w e are s t r u c k b y t h e fact t h a t this w o m a n . Pain itself is n o t biophysical in n a t u r e . Pain is v e r y m u c h akin t o e x p e r i e n c e s o f smell and t a s t e . T h e h e a d a c h e s c o n s i s t e d in a painful e x p a n s i o n and c o n t r a c t i o n o f h e r skull. n o r m a l l y a m a s t e r o f o b s e r v a t i o n and e x p r e s s i o n . h e r head h u r t i n g h e r s o m u c h s o m e t i m e s t h a t s h e felt as t h o u g h s h e w e r e n o t h i n g but a head.c a l f region. and she h e r s e l f . have n o t h i n g at all in c o m m o n w i t h pain itself. o r p h y s i o l o g y . S h e e x p e r i e n c e d t h e g a s t r o i n t e s t i n a l c r a m p s a s s u r g i n g and a g i t a t e d c o n s t r i c t i o n o f t h e e n t i r e a b d o m i n a l r e g i o n . an i m m e n s e sea in w h i c h e v e r y t h i n g a r o u n d h e r w a s d r o w n i n g : t h e o n l o o k e r s . T h e pain t h e n c o n t r a c t e d to form a s p h e r e . Pain from t h e b r o k e n leg did n o t begin until the p a t i e n t w a s already on t h e g r o u n d . t h e w o n d e r f u l a r o m a and flavor o f m a n g o t o s o m e o n e w h o n e v e r smelled and t a s t e d o n e .188 EXISTENTIAL FOUNDATIONS w e r e s t a n d i n g w i t h b o t h feet on a blazing pyre. he will n e v e r s u c c e e d in c o m m u n i c a t i n g to his l i s t e n e r precisely w h i c h s e n s e p e r c e p t i o n he m e a n s and will p r o b a b l y . r e s o r t u l t i m a t e l y to metaphorical comparison. she was n o t h i n g m o r e t h a n pain and w a s being a b s o r b e d into this pain to t h e e x t e n t t h a t she n e a r l y lost c o n s c i o u s n e s s . w a s s u r p r i s i n g l y i n e x a c t w h e r e h e r pains w e r e c o n c e r n e d . t h e h o u s e s . n o m a t t e r h o w precise. it e x p a n d e d to i n u n d a t e h e r e n t i r e l y . S h e felt it first as a t e a r i n g h u r t s o m e w h e r e b e l o w and t o the r i g h t . for it e x i s t s only as an e x p e r i e n c e . t h e sky a b o v e . she w a s able t o t e a r h e r s e l f loose from t h e a g o n y and step back t o c o n f r o n t t h e painful a r e a of h e r body. w i t h all t h e i r a t t e n d a n t biophysical p r o c e s s e s . o r t o perceive w h a t s o m e t h i n g i s . a b o u t t w e n t y c e n t i m e t e r s in d i a m e t e r . in t h e r i g h t l o w e r . T h e bodily a r e a s r e f e r r e d t o a s pain c e n t e r s and pain p a t h w a y s . g o t o . the pain also let h e r k n o w i n w h a t w a y she had b e e n hit. p r e s e n t i n t e n t t o k e e p t h e leg still and t h e h o p e t h a t t h e d o c t o r would a r r i v e as s o o n as possible. w h i c h until t h e n had e x t e n d e d i n e x t r e m e l y b r o a d r e l a t i o n s h i p s t o h e r past. pp. Es träumte mir vergangene Nacht ( B e r n e : H a n s H u b e r . T h e special w a y in w h i c h such a r e n d i n g is felt is n o t a d i s t a n t o b s e r v a t i o n o f s o m e e n t i t y but the p e r c e p t i o n o f already e x i s t i n g d a m a g e to o n e ' s o w n e x i s t e n c e . totally and a b s o l u t e l y . H u b e r . at its location in t h e o b s e r v e r ' s w o r l d . 1 9 6 5 ) . R e f e r a l s o t o t h e e x c e l l e n t s u m m a t i o n a n d c r i t i q u e o f e x i s t i n g n o t i o n s a b o u t pain i n a w o r k by G . NOTES 1. . and f u t u r e .Testing and Research on Pathological Phenomena 180 a v e r y p a r t i c u l a r s o r t of p e r c e p t i o n . R e g u l a Z u r c h e r ' s p e r c e p t i o n of pain a f t e r h e r leg f r a c t u r e did n o t include t h e a c t u a l c a u s e s of the pain. I n h e r pain t h e r e w a s n o a w a r e n e s s o f t h e a u t o m o b i l e b u m p e r that had s p l i n t e r e d h e r leg. 1 9 5 4 ) a n d M . Der Traum und seine Auslegung ( B e r n e : H a n s H u b e r . w e n o t e d t h a t t h e t h i n g " c a u g h t s i g h t o f " is o b s e r v e d and its s i g n i f i c a n c e perceived. f u n d a m e n t a l l y d i f f e r e n t f r o m all the o t h e r so-called s e n s e p e r c e p t i o n s . W h e n s h e tried to stand up. F o r a m o r e d e t a i l e d d i s c u s s i o n o f t h i s . I n o u r discussion o f s i g h t . Explaining t h e s e principles will help us t o w a r d a g e n e r a l e x i s t e n t i a l p a t h o l o g y . of a similar a c c i d e n t s h e had s u f f e r e d as a y o u n g child. T h i s d i s c u s s i o n o f t h e p a t i e n t ' s bodily pains c o m p l e t e s t h e e x a m p l e s o f individual p a t h o l o g y w h i c h w e r e i n t r o d u c e d as a practical t e s t of t h e e x i s t e n t i a l r e s e a r c h m e t h o d . S h e l e a r n e d t h a t h e r bodily ability t o s t a n d by. O u r n e x t t a s k will b e t o e x t r a c t f r o m t h e s e e x a m p l e s t h e principles implicit in t h e m . o r a w a y f r o m . Einfuhrung in die psychosomatische Medizin ( B e r n e a n d S t u t t g a r t : H a n s H u b e r . B o s s . In the hours just after her accident. p r e s e n t . on the other hand. W h a t t h e pain told h e r a t first w a s o n l y t h a t h e r e x i s t e n c e had b e e n hit hard and injured. a perceiving w h i c h i n v o l v e s t h e Da-sein. C o n d r a u e n t i t l e d Psychosomatik der Frauenheilkunde ( B e r n a n d S t u t t g a r t : H. the hand or tongue can b e perceived along w i t h t h e o b j e c t itself. W h e n something is touched or tasted. M . All t h a t r e m a i n e d of h e r past w a s a m e m o r y . 2 . 3 . s h r a n k t o t h e single. 1974). s e e M . 1 9 9 ff. Regula Ziircher was so absorbed in t h e pain s h e w a s e x p e r i e n c i n g t h a t h e r e x i s t e n c e . but t h a t n e i t h e r t h e act of seeing n o r t h e e y e as t h e involved bodily r e g i o n is part of w h a t is s e e n . t h e t h i n g s o f h e r w o r l d had b e e n t o r n f r o m h e r . B o s s . B o s s . at t h e edge of c o n s c i o u s n e s s . 1 9 7 5 ) . had s h e n o t e n t e r e d t h e w o r l d w i t h h e r o w n specific i n b o r n p o t e n t i a l i t i e s for b e h a v i n g . W h e r e v e r we t u r n in t h e r e a l m of p a t h o l o g y . and had t h e e v e n t s of h e r life n o t impelled h e r t o w a r d t h e v e r y e x p e r i e n c e s t h a t a c t u a l l y h a p p e n e d t o h e r . a t least n o t i n q u i t e t h e s a m e w a y s . t h e n o t i o n of causal p a t h o g e n e s i s is r o o t e d in thai philosophical v i e w w h i c h p o s i t s all that e x i s t s as raw material l"i i . O n e i m p o r t a n t d i s t i n c t i o n in t h i s a r e a h a s already b e e n partly made in o u r discussion o f t h e u n b r i d g e a b l e g a p b e t w e e n n a t u r a l s c i e n c e ' s concept o f c a u s e and t h e e x i s t e n t i a l c o n c e p t o f m o t i v a t i o n . h o w e v e r . t h e s e d e s c r i p t i o n s fail t o give a d e q u a t e and specific c o n s i d e r a t i o n t o t h e s i n g u l a r n a t u r e o f t h e i m p o r t a n t r e l a t i o n s h i p b e t w e e n a p a t i e n t ' s p r e s e n t c o n d i t i o n and previous history. o r p a t h o g e n e s i s . F r o m thai d e a l distinction it follows t h a t we m u s t distinguish s h a r p l y n o w b e t w e e n a causal and a m o t i v a t i o n a l p a t h o g e n e s i s or e t i o l o g y . Like th:" c a u s e and e f f e c t s c h e m e . R e g u l a Z i i r c h e r is n o t an isolated case in this r e s p e c t .Chapter 12 GENERAL DASEINSANALYTIC ETIOLOGY AND PATHOGENESIS I n looking back o v e r t h e p a t h o l o g i c a l p h e n o m e n a o f o u r t e s t c a s e . F o r t h e m o s t part. w e begin t o s u s p e c t t h a t t h e p a t i e n t m i g h t n e v e r h a v e b e c o m e ill. o f h u m a n illness. we find a s t r o n g c o n n e c t i o n b e t w e e n p r e s e n t illness and w h a t h a s c o m e b e f o r e it. T h i s c o n n e c t i o n is described i n w h a t i s c o m m o n l y called t h e e t i o l o g y . acting (in s h o r t . " Genesis. d a s e i n s a n a l y t i c t h e r a p y . o r e f f e c t . the place. t h e a b u n d a n c e of his i n b o r n possibilities of r e l a t i n g so t h a t he fulfills o n l y a f e w n e u r o t i c m o d e s of relation to his w o r l d . W i t h i n a g e n e r a l p a t h o l o g y . t h o s e like u n d e r s t a n d i n g . W e h a v e already stated the value o f t h e c a u s a l . since it s e r v e s o n l y if h u m a n bodyhood is i n t e r p r e t e d as a physical o b j e c t . b e c a u s e all w a y s o f being. A D a s e i n s a n a l y t i c s t u d y of p a t h o g e n e s i s does n o t aim to t r a c e p h e n o m e n a back to c a u s e s .G a l i l i e a n w o r l d v i e w also s e e s all real t h i n g s j o i n e d t o g e t h e r i n t o a n i n t e g r a l w o r l d t h r o u g h t h e o p e r a t i o n of a fixed. e v e n t h o s e we call n e u r o t i c . W i t h o u t t h e s e p r e s c i e n t i f i c s u p p o s i t i o n s . t h e s e m o d e s . then. w a s r e i n t e r p r e t e d as a s e q u e n c e o f c a u s e s and e f f e c t s . h a v e i m p o r t a n t places i n m e d i c i n e .g e n e t i c p e r s p e c t i v e . O f c o u r s e .g e n e t i c and the m o t i v a t i o n a l .192 EXISTENTIAL FOUNDATIONS r e p r e s e n t i n g s u b j e c t . b u t is c o n c e r n e d w i t h d i s c o v e r i n g biographical i n c i d e n t s w h i c h t h e n m o t i v a t e d a h u m a n being to c o n d u c t h i m s e l f in a c e r t a i n w a y and w h i c h still m o t i v a t e him t o p e r p e t u a t e t h e s e m o d e s . P a t h o g e n i c . " " o c c a s i o n . n e i t h e r t h e n a t u r a l scientific principal o f causality i n g e n e r a l . " and "guilt. the G r e e k w o r d for " i m p e t u s . F r o m t h e p e r s p e c t i v e o f c o n t e m p o r a r y medicine. intuition. precisely calculable c a u s a l i t y . B o t h a p p r o a c h e s t o p a t h o g e n e s i s . desiring. h o w e v e r ." n o w c a m e t o m e a n ' c a u s e .g e n e t i c . this c a u s a l . u n d e r s c o r i n g its u n i q u e capacity for d i s c o v e r i n g n e w c h e m o physical t h e r a p i e s . both words became near s y n o n y m s . n o r d o e s it r e c o v e r m e a n i n g simply b y g e t t i n g the n e w n a m e " p s y c h o d y n a m i c s . " B u t •dl t h o s e p h e n o m e n a of h u m a n Da-sein t h a t c a n n o t be c o n c e i v e d of com r c t e l y o r m a t e r i a l l y . T h e r e i s n o n e e d for t h e m t o b e m a n u f a c t u r e d a f t e r t h e fact. are inaccessible t o any b u t t h e m o t i v a t i o n a l . T h i s C a r t e s i a n . But this w a y o f t h i n k i n g allowed t h e n o u n s " e t i o l o g y " and " g e n e s i s " t o a s s u m e m e a n i n g s v e r y distant from t h e i r o r i g i n s . t h e c a u s a l . or partially blind him to. W i t h a n y t h i n g t h a t is n o t c o n c e i v a b l e i n physical t e r m s — t h e e n t i r e r e a l m o f psychic p h e n o m e n a — the c a u s a l . m o t i v a t i o n a l g e n e s i s . n o r a n y causal g e n e s i s in p a r t i c u l a r could e v e r h a v e b e e n thought out. are g i v e n to a p e r s o n at b i r t h as possibilities of e x i s t e n c e . i uss | i h e n o m e n o l o g i c a l . I he pi . c a u s e .g e n e t i c v i e w can be c o n t r a s t e d to the D a s e i n s a n a l y t i c .g e n e t i c t h i n k i n g to m e d i c i n e .n in a I medical i m p o r t a n c e of this o r i e n t a t i o n will be s h o w n w h e n w e d r . I In . w e also pointed o u t t h e limited application of c a u s a l .g e n e t i c o r i e n t a t i o n loses its s e n s e and j u s t i f i c a t i o n . w i s h i n g . w h i c h had o n c e r e f e r r e d to t h e s o u r c e of an illness. to c o u n t e r t h e c o m m o n criticism t h a t p h e n o m e n o l o g i c a l pathology does n o t a c t u a l l y r e c o g n i z e any sort o f . Aitia.g e n e t i c o r i e n t a t i o n o f n a t u r a l s c i e n c e . We should r e m e m b e r t h a t t h e p a t h o g e n i c m o m e n t s t h e m s e l v e s c a n n o t produce. b i o g r a p h i c a l m o t i v a t i n g i n c i d e n t s a r e m o t i v e s w h i c h induce a person to r e s t r i c t . all t h o s e t h i n g s t h a t m a k e a h u m a n being h u m a n ) . r . t h a t t h e v a n t a g e e n j o y e d b y the f u t u r e i n n o w a y d i m i n i s h e s t h e significance o f past e x p e r i e n c e s for b o t h p r e s e n t and future. an e x i s t e n c e as a p e r c e p t i v e open realm. Since then it has been shown that many postinfantile e x p e r i e n c e s as well can also induce a limiting f i x a t i o n on n e u r o t i c m o d e s of b e h a v i o r . . H e r e . and t h e b e h a v i o r t h a t follows I rom it. F u r t h e r m o r e . specific c a u s e s n e c e s s a r i l y r e s u l t in specific e f f e c t s . F r e u d singled o u t a l m o s t solely t h e e x p e r i e n c e s o f t h e infant a t the h a n d s of its p a r e n t s or p a r e n t s u b s t i t u t e s as t h e decisive p a t h o g e n i c motivations. w h o s e limits a r e peculiar t o t h a t a g e . and t h u s r e m a i n s p r e s e n t in its p r e s e n t being. t h e w a y t h e w o r l d is o r g a n i z e d d e p e n d s partly on t h e p o t e n t i a l for f u t u r e a t o m i c w a r . e i t h e r . I In form peculiar to a thing i n t o relief. w h a t allow a being. F r o m the p e r s p e c t i v e o f this s a m e f u t u r e t h e past i s judged i n c a p a b l e r e g a r d i n g m a s t e r y o f t h e p r o b l e m s o f a t o m i c fission. " l i m i t " should b e u n d e r s t o o d i n its double m e a n i n g : w h e r e s o m e t h i n g ends and also as wh. w e a r e also b y n a t u r e d i r e c t e d t o w a r d w h a t a p p r o a c h e s from t h e f u t u r e and i n m o v i n g t o w a r d it m u s t open o u r being to it. t h e e c s t a s e s o f past and p r e s e n t . N o description o l human nature is more aware than the Daseinsanalytic that the entire past of Da-sein p e r s i s t s in. F o r e x a m p l e . then. W e should r e m e m b e r . o r a t a n y r a t e w o e f u l l y n e g l e c t s it. B u t it is in the f o r m of motivations t h a t t h e past a d d r e s s e s t h e p r e s e n t . m o r e a t t e n t i o n will n e e d to be paid to the fact I ha I t h e w a y p a r e n t s and l a t e r m e n t o r s b e h a v e does n o t g r o w out ol a v a c u u m . to be what it is. i t i s o n l y b e c a u s e o f t h e t h r e a t o f a t o m i c w a r f a r e i n t h e f u t u r e t h a t w e can p r o p e r l y a p p r e c i a t e Galileo's conceptual advance. T h e i r field of vision. Everything that goes on in the world of human beings begins from the standpoint of the future. I n o r d e r t o a n s w e r t h e prejudiced r e p r o a c h t h a t t h e D a s e i n s a n a l y t i c . T h u s the future may claim t h e p r i m a c y o v e r t h e o t h e r t w o o f t h e t e m p o r a l e x t e n s i o n s o f h u m a n e x i s t e n c e . c o d e t e r m i n e s . T h i s fact i s o f p r i m a r y i m p o r t a n c e t o m e d i c i n e .it t h r o w . t h o u g h . Limits. in a physical s e q u e n c e of e v e n t s . On t h e o t h e r h a n d . b o t h for p a t h o g e n e s i s and t h e r a p y . B e c a u s e we h u m a n b e i n g s e x i s t in such a w a y t h a t o u r p r e s e n t is a l w a y s e n g a g e d i n c o m i n g t o t e r m s w i t h o u r past. H o w we see w h a t has b e e n and w h a t is n o w is a l w a y s r e l a t e d t o t h e w a y w e a r e a d d r e s s e d b y w h a t w e e x p e c t from the f u t u r e . E v e r y age g r a n t s to h u m a n i t y a Da-sein. past e x p e r i e n c e s do n o t causally effect p r e s e n t b e h a v i o r in the w a y in w h i c h . t h o u g h no o n e d e n i e s t h a t all t h e older m o t i v e s are at w o r k in t h e s e l a t e r m o t i v a t i o n s as w e l l .General Daseinsanalytic Etiology 193 g e n e t i c o r i e n t a t i o n . a r e f u n d a m e n t a l l y shaped b y t h e spirit o f t h e t i m e s . are w h a t allow a thing tu appear as w h a t it is. let u s look a t o n e o f t h e m o s t c u r r e n t c o n c e r n s o f e t i o l o g y . p h e n o m e n o l o g i c a l o r i e n t a t i o n i g n o r e s t h e g e n e s i s o f pathological p h e n o m e n a . T h i s r e v e r s i o n h a p p e n s in such a w a y that h u m a n b e i n g s are less and less able to see t h e m s e l v e s e x c e p t as met n a n i s m s w h o s e p u r p o s e it is to f u n c t i o n s m o o t h l y and efficiently. T h e s e disciplines h a v e d i s c o v e r e d t h a t s o m e w o r l d s i t u a t i o n s appear t o b e m u c h m o r e i n t u n e w i t h h u m a n b e i n g t h a n o t h e r s . rich n a t u r e of m a n . open realm 1 .EXISTENTIAL 194 FOUNDATIONS I t would s e e m .) T h e Middle A g e s i n t h e w e s t .t h e . M o r e o v e r .i n . are usually d e s i g n a t e d " d a r k .t h e .i n .i n t h e . h o w e v e r . the historical d e s t i n y delimiting h u m a n r e s p o n s e favors c e r t a i n kinds o f people o v e r o t h e r s . t h e r e is also t h e fact t h a t t h e reigning n a t u r a l scientific w a y o f i n v e s t i g a t i n g m a t e r i a l t h i n g s has s e r i o u s c o n s e q u e n c e s for 1 he h u m a n r e s e a r c h e r h i m s e l f . t h a t at s o m e t i m e s people in g e n e r a l are allowed to fulfill t h e i r possibilities for e x i s t i n g m o r e freely and c o m p l e t e l y . " T h e i r abilities t o d e s c r i b e n a t u r e q u a n t i t a t i v e l y w e r e i n fact far o v e r s h a d o w e d b y t h e scientific a c h i e v e m e n t s o f m o d e r n t i m e s .i n . At t i m e s . M e a s u r e d against the g e n u i n e . t h a t w h e n a n e m e r g i n g a g e m o v e s h u m a n i t y i n t o a n e w f o r m of o p e n n e s s .w o r l d faces a n e v e n g r e a t e r t h r e a t i n t h e n e a r f u t u r e f r o m t h e pollution o f air. T h e d e s t i n y t h a t s e t s t h e limits o f t h e possible open r e a l m of h u m a n e x i s t e n c e in a g i v e n e r a of h u m a n h i s t o r y is s e e n m o s t clearly t h r o u g h t h e w a y i n w h i c h t h e f u n d a m e n t a l n a t u r e o f p r e s e n c e s h o w s i t s e l f t o t h o s e living i n t h a t a g e . w a t e r . ( B y " h e a l t h i e r . N o t o n l y individuals b u t s o c i e t y as a w h o l e a r e m o t i v a t e d by t h a t fate to specific m o d e s of r e s p o n d i n g t o w h a t h a s b e e n s h o w n t o it. this sell image r e p r e s e n t s a m o n s t r o u s p e r v e r s i o n . the h u m a n being il a clear. " w e m e a n m o r e c o n d u c i v e t o t h e possibilities for e x i s t e n c e t h a t t h e s e people have brought with t h e m into the world than to those of others. R e s e a r c h i n t o t h e h i s t o r i c a l l y set b o r d e r s t h a t limit t h e possibilities for h u m a n b e i n g . a seal is placed o v e r s o m e of t h e m e a n i n g s t h a t had b e e n visible b e f o r e .w o r l d in a given e r a is n o t equally favorable to all h u m a n b e i n g s .t h e . t h e r e w e r e t i m e s d u r i n g w h i c h epidemics radically d e s t r o y e d t h e possibilities for e x i s t e n c e o f t h o s e living in a c e r t a i n r e g i o n . for i n s t a n c e . t h e n .w o r l d h a v e b e e n largely e l i m i n a t e d b y m o d e r n physical m e d i c i n e . I n place of t h e s e . and t h e f o r m o f o p e n n e s s possible t o t h e n e x t h i s t o r i c a l period m a y b e h e a l t h i e r for t h o s e w h o w e r e s h o r t c h a n g e d b e f o r e . It has also b e e n found t h a t t h e p a r t i c u l a r f r e e d o m allotted to h u m a n b e i n g . and t h e s e p a r t i c u l a r r e s t r i c t i o n s on h u m a n b e i n g . n o t t o m e n t i o n t h e a t o m b o m b . O n t h e o t h e r h a n d . w e all k n o w t h a t h u m a n b e i n g . t h e d a r k ages had a c l a r i t y of vision t h a t a l l o w e d t h e divinity and the a n g e l s to be p r e s e n t and to c o m e close in a w a y a l m o s t totally lost t o t h o s e living n o w . an i m p o v e r i s h m e n t b o r d e r i n g on sell d e s t r u c t i o n Hy n a t u r e . and t o s t a y h e a l t h i e r . t h a n t h e y can in o t h e r a g e s .w o r l d f o r m s t h e basis o f e v e r y t y p e o f s o c i o l o g y and social p s y c h i a t r y . B e s i d e s w h a t we h a v e said already. and soil. at a level of h u m a n c o n t a c t and t r u s t far b e l o w t h e m i n i m u m t h e y n e e d t o e x i s t . h o w e v e r . T h e i n c o n t e s t a b l e g r e a t practical s u c c e s s o f b o t h g e n e t i c i n v e s t i g a t i v e a p p r o a c h e s has seduced us i n t o believing t h a t t h e d i s c l o s u r e of a pathogenesis constitutes a way—the only way.g e n e t i c idea i n t h e t h e o r y o f h u m a n illness t h a t n e e d s t o b e put i n its p r o p e r place.General Daseinsanalylic Etiology 195 c o n s t i t u t e d of t h e ability to p e r c e i v e and r e s p o n d . A c t u a l l y . In t h e age o f t e c h n o l o g y . t h e y are f o r c e d to v e g e t a t e all a l o n e . t h e n w e will h a v e a w o r l d in w h i c h it will be less and less w o r t h w h i l e to be h e a l t h y . t o b e and t o unfold t h e i r m e a n i n g s and c o n t e x t s o f r e f e r e n c e . t h e r e would be p h y s i c i a n s and a t t e n d a n t s . T h u s . N o m a t t e r w h a t t h e f o r m a n i n v e s t i g a t i o n i n t o o r i g i n s m a y be. I f i t e v e r c o m e s a b o u t t h a t n o n h u m a n p r e s e n c e s a s well a s h u m a n b e i n g s a r e t h o u g h t o f simply a s m a c h i n e r y parts t h a t can b e m a t h e m a t i c a l l y d e s c r i b e d . like s o m e o n e t r y i n g to r e a c h a goal he h a s n e v e r glimpsed. at least. I f t h e y are ill. in f a c t — o f adequately understanding any pathological phenomena we confront. To explain w h a t w e n t b e f o r e s o m e t h i n g i s n o t t o e l u c i d a t e t h e t h i n g itself. M e d i c i n e is t h e r e f o r e c o n f r o n t e d w i t h a r e m a r k a b l e p a r a d o x : t h e s a m e causal-genetic orientation that permits unprecedented therapeutic s u c c e s s e s b e c o m e s a s e r i o u s pathogenic m o t i v a t i o n w h e n t u r n e d back upon man. accomplish r e g a r d i n g . and its t a s k is to allow t h e p r e s e n c e s i t p e r c e i v e s t o e n t e r i n t o this c l e a r n e s s . t h e y r e c e i v e m u c h less o f t h e h u m a n and e n v i r o n m e n t a l address o f m e a n i n g f u l n e s s s o n e c e s s a r y f o r life t h a n w h e n t h e y b e c o m e ill and are cared for. T h e i m p o r t a n c e t h a t m o t i v a t i o n a l p a t h o g e n e s i s c l a i m s f o r i t s e l f m u s t a l s o b e modified. B e i n g h e a l t h y . i t can h a v e n o claim t o t h e s t a t u s o f a r i g o r o u s l y scientific r e s e a r c h m e t h o d u n l e s s it h a s first m a d e t h e p a t h o l o g i c a l p h e n o m e n o n i t s e l f visible as it stands. and c a n n o t . to a n s w e r t h e i r h u m a n n e e d s . that have come before what is under investigation. C a u s e s and m o t i v a t i o n s a r e a l t o g e t h e r different f r o m w h a t i s c a u s e d o r motivated. h e a l t h y people h a v e t o live and e x i s t a l m o s t e x c l u s i v e l y as cogs in a m a c h i n e r y g e a r e d to p r o d u c t i o n . A n y o n e w h o insists on taking a genetic approach without having first s u f f i c i e n t l y e x p l a i n e d t h e n a t u r e o f t h e p h e n o m e n o n u n d e r i n v e s t i g a t i o n is i g n o r a n t of t h e v e r y t h i n g w h o s e o r i g i n s he is looking for. But genetic i n v e s t i g a t i o n s invariably o n l y e n u m e r a t e and d e s c r i b e t h e c a u s e s . F r e u d h i m s e l f o f f e r s t h e c l e a r e s t p r o o f o f t h i s i n his opinion o n w h a t p s y c h o a n a l y s i s can. I t i s n o t o n l y t h e c a u s a l . o r motivations. w h e n t h e y a r e well. o r t h o d o x p s y c h o a n a l y t i c t h e o r y has a l w a y s set out t o w a r d t h a t i m p o s s i b l e goal. T h i s s t a t e of affairs is p r e s u m a b l y a s u b s t a n t i a l p a t h o g e n i c m o t i v a t i o n for t h e r e l a t i v e and a b s o l u t e i n c r e a s e in the incidence o f p s y c h o s o m a t i c illness. " N e u e F o l g e d e r V o r l e s u n g e n z u r E i n f ü h r u n g i n die P s y c h o a n a l y s e . " Y e t h o w can p s y c h o a n a l y s i s even begin this u n d e r t a k i n g w h e n . T h i s holds n o t o n l y in t h e p a r t i c u l a r area of p s y c h o a n a l y t i c t h e o r y but in all medical t h i n k i n g . pp. t h e f e m a l e child. as Dasein. t h e adult f e m a l e ? S i n c e s u c h an e n t e r p r i s e is d o o m e d to failure f r o m t h e s t a r t . by its o w n a d m i s s i o n . W. C f . and scientific is based on an u n d e r s t a n d i n g w h i c h defines the p e r s o n w h o is ill in a c c o r d w i t h his n a t u r e as a h u m a n b e i n g . h o w s h e develops o u t o f t h e b i s e x u a l l y disposed c h i l d . p. Vorlesung: Die Weiblichkeil. D a s e i n s a n a l y t i c p a t h o l o g y a r e t h e r e f o r e directed t o w a r d t h o s e l i m i t a t i o n s o f p o t e n t i a l i t i e s w h i c h affect t h e e x i s t e n t i a l traits medicine considers most essential. in Ges. O u r first s t e p s t o w a r d a g e n e r a l . I n c .. . 2 T h e p h e n o m e n o n i t s e l f should t a k e p r e c e d e n c e o v e r any i n v e s t i g a t i o n i n t o o r i g i n s . it h a s prejudged its s t a r t i n g point. " X X X I I I . W a g n e r . 1 9 6 4 ) . 1 9 4 0 ) . as e x i s t e n c e . c o n s i s t i n g as t h e y do in a s e r i e s of h i g h l y a b s t r a c t presuppositions. F. . He w r i t e s : "It is n o t in t h e n a t u r e of p s y c h o a n a l y s i s to a t t e m p t to d e s c r i b e w h a t a w o m a n i s — t h a t is h a r d l y f e a s i b l e — b u t simply t o explain h o w a w o m a n b e c o m e s a w o m a n . B e c k . 1 2 4 . 2 . v o l . 1 0 4 ff. NOTES 1. p h e n o m e n o l o g i c a l . 1 5 ( L o n d o n : I m a g o . H . as b i s e x u a l l y disposed and is u n a b l e to u n d e r s t a n d or explain t h e n a t u r e of its end p r o d u c t . T h e following s k e t c h of a g e n e r a l p a t h o l o g y t h a t is a d e q u a t e l y h u m a n . It is t h e p a r t i c u l a r d u t y of t h e p h e n o m e n o l o g i c a l o r i e n t a t i o n t o clarify t h e e s s e n t i a l m e a n i n g s i n h e r e n t in the o b j e c t of i n v e s t i g a t i o n itself. it follows t h a t t h e psychodynamic-genetic hypotheses of psychoanalytic theory must be s t a b s in t h e dark. F r e u d . a n d 4 0 1 ff. Die Wissenschaft und die gefährdete Well ( M u n i c h : C . S .196 EXISTENTIAL FOUNDATIONS f e m i n i n i t y . revolted a g a i n s t it. His r e p o r t f u r t h e r m o r e r e v e a l s his attitude t o w a r d his c o n d i t i o n . t h e p a t i e n t simply d e s c r i b e s w h a t h e " h a s . " "I h a v e a b r o k e n leg. T h e a t t i t u d e t o w a r d illness ig an i m p o r t a n t part of t h e p h e n o m e n o l o g y ol the suffering. b u t w h a t t h e y have: "I h a v e a h e a d a c h e . " E v e n so. tried to deny itl e x i s t e n c e . P a t i e n t s r e p o r t n o t w h a t t h e y lack. t h e p h y s i c i a n s and p a t i e n t s a r e n o t really talking past each o t h e r . j u s t a s predictably. T h e p h y s i c i a n ' s q u e s t i o n posits illness as a lack of h e a l t h . Frau Z ü r c h e r . I t i s t h e illness itself t h a t h a s t w o f a c e s . " H e r e p o r t s w h a t disturbs h i m . B o t h a r e speaking a b o u t t h e m o d e o f being ill. t h o u g h ." "I h a v e this or t h a t c o m p u l s i v e t h o u g h t . w h a t t h e y do n o t h a v e .Chapter 13 A GENERAL DASEINSANALYTIC PHENOMENOLOGY OF ILLNESS Preliminary remarks W e p r o g r e s s e d t o w a r d a d a s e i n s a n a l y t i c d e s c r i p t i o n o f o u r test s u b j e c t ' s p a t h o l o g i c a l s y m p t o m s b y repeatedly asking h e r t h e simple question: "Well now. and t h e physician m a y learn w h e t h e r the patienl has a c c e p t e d the illness as a c h a l l e n g e . w h i c h is. just what is lacking?" From time i m m e m o r i a l this i s h o w p h y s i c i a n s t h e w o r l d o v e r h a v e b e g u n t h e i r d i a g n o s e s . A tuberculfll 1 . o r s u r r e n d e r e d t o it. t h o u g h from o p p o s i t e p o i n t s o f v i e w . thai b e c a u s e of his deficient h e a l t h he is forced to e x i s t in the form ol p a t h o l o g i c a l s y m p t o m s . t h e a n s w e r t h e y are given i s a n y t h i n g but a r e s p o n s e t o t h e q u e s t i o n . S o m e t h i n g else b e c a m e a p p a r e n t . B e t w e e n t h e s e e x t r e m e s . and h o w . a s well. and if the n a t u r e of this s t a t e of h e a l t h can be d e t e r m i n e d a d e q u a t e l y o n l y t h r o u g h e n u m e r a t i n g t h e w a y s i n w h i c h t h e e x i s t e n t i a l t r a i t s can b e carried out. F u r t h e r m o r e . a s w e w e n t t h r o u g h this p r o c e s s . If all illness is in fact t h e lack of t h e c o n d i t i o n of h e a l t h . t h e state of health.t h e . W e shall n o w s y s t e m a t i c a l l y explain this p h e n o m e n o l o g i c a l r e s e a r c h m e t h o d . and s o m a t o p s y ­ chic o r s o m a t o g e n i c . w e m a y h a v e 111 h e '.and p s y c h o p a t h o l o g i c a l e x p l a n a t i o n s o f medical s c i e n c e could gain no a c c e s s to h u m a n e x i s t e n c e as a r e a l m of w o r l d . T h e s e a r e t h e only c r i t e r i a t h a i a l l o w us t o M ' i o g n i / e 11 te e x i s t e n t i a l n a t u r e o f pathological p h e n o m e n a a n d o r g a n i z e I h e m appropi lately Foi the time being. T h i s principle has b e e n f u n c t i o n i n g all along in o u r D a s e i n s a n a l y t i c i n v e s t i g a t i o n i n t o t h e patient's pathological symptoms. W e m i g h t a s well h a v e t a k e n r e f u g e i n a n y o t h e r c o m m o n s y s t e m o f classification. for health cannot be c o n s t r u c t e d f r o m w h a t i s its o w n deficient s t a t e . I l e d w i t h . as m o d e s of a h u m a n b e i n g . illness. w h i l e the traditional s o m a t o . o r a c c o r d i n g t o t h e w a y i n w h i c h t h e p r o g r e s s o f t h e disease a f f e c t s a n o r g a n . o r a c c o r d i n g t o t h e i r e t i o l o g i e s and p a t h o g e n e s e s . t h e p h e n o m e n o l o g i c a l approach did n o t n e e d to rely on a n y h y p o t h e t i c a l e n t i t e s supposedly o p e r a t i n g u n d e r t h e s u r f a c e . B u t w h a t e v e r classifications we did u s e . T h i s insight is unavoidable. A s y s t e m a t i c e x p l a n a t i o n would n e e d t o e x a m i n e t h e w h o l e r a n g e o f possible pathological m a n i f e s t a t i o n s to d i s c o v e r for each particular i n s t a n c e w h i c h of the basic e x i s t e n t i a l t r a i t s h a s been impaired m o s t deeply a n d directly.o p e n n e s s . e v e n if at this point we can o n l y g e t as far as t h e r u d i m e n t s of a g e n e r a l p a t h o l o g y t h a t is a d e q u a t e to h u m a n n a t u r e .a I i'. w e a r r a n g e d t h e m a c c o r d i n g t o o n e o r a n o t h e r o f t h e m a n y classification s y s t e m s o n w h i c h traditional p a t h o l o g i e s h a v e b e e n based. t h e n illness is n e c e s s a r i l y a l w a y s r e l a t e d to. W e m i g h t h a v e classified pathological p h e n o m e n a a c c o r d i n g t o w h i c h o r g a n o r o r g a n i c s y s t e m i s first affected b y t h e d i s t u r b a n c e . a v e r y d i f f e r e n t o r d e r a l w a y s emerged through our descriptions of symptoms. in fact.i n . and u n d e r s t a n d a b l e o n l y in t e r m s of. B e f o r e looking i n t o t h e s y m p t o m s . T h e reverse is never true.w o r l d . if illness is s e e n c o r r e c t l y as s o m e kind of deficiency in h e a l t h .198 EXISTENTIAL FOUNDATIONS infection of t h e s a m e v i r u l e n c e and location m a y s p u r o n e p e r s o n on to a c r e a t i v e e x i s t e n c e w h i l e a n o t h e r v e g e t a t e s helplessly in a s a n i t o r i u m . an orientation around the fundamental traits of human existence. First c a m e t h e division o f t h e illnesses i n t o t h e primarily o r g a n i c and primarily p s y c h i c . w e located t h e c a t e g o r i e s o f p s y c h o s o m a t i c o r p s y c h o g e n i c . T h e results of our step-by-step testing o f t h e p h e n o m e n o l o g i c a l r e s e a r c h m e t h o d a g a i n s t individual p a t h o l o g i c a l s y m p t o m s of a p a r t i c u l a r p e r s o n s h o w e d u n e q u i v o c a l l y t h a t this a p p r o a c h could elucidate t h e p a t h o l o g i c a l p h e n o m e n a in t h e i r actual aspect. and a s t h e i r all pervading m e a n i n g f u l n e s s o r s i g n i f i c a t i o n s . its b o d y h o o d . finally. and t h e y a r e c e r t a i n l y n o t s u p p o s i t i o n s e x t r a n e o u s t o t h e o n t i c . equally p r i m a r y . its a t t u n e m e n t . W h a t is a c t u a l l y impaired in a g i v e n illness is t h e ill p e r s o n ' s ability to e n g a g e in c a r r y i n g o u t t h e s e p a r t i c u l a r p o t e n t i a l i t i e s a s free b e h a v i o r t o w a r d w h a t h e e n c o u n t e r s i n his w o r l d . t h e s e t r a i t s .i n . b u t e v e n w h e n t h e i r abilities t o b e a r e c o v e r e d up. its o p e n n e s s and. I n b e g i n n i n g t h e a t t e m p t t o describe t h e c h a r a c t e r o f possible m o d e s o f illness as d i s t u r b a n c e s in fulfilling basic f e a t u r e s of h u m a n b e i n g . W e h a v e a l r e a d y said all w e can a b o u t i m p a i r m e n t i n c a r r y i n g o u t t h e u l t i m a t e e x i s t e n t i a l trait o f mortality.t e m p o r a l c h a r a c t e r o f Da-sein. p a r t i c u l a r p h e n o m e n a o f h u m a n e x i s t i n g . Given the newness of the phenomenological a p p r o a c h in m e d i c i n e . w e list o n c e m o r e t h o s e t r a i t s o r E x i s t e n t i a l s m o s t i m p o r t a n t for m e d i c i n e . T h e y c o n s t i t u t e t h e basic n a t u r e o f t h e s e p h e n o m e n a . F o r t h e basic f e a t u r e s o f h u m a n e x i s t e n c e a r e a n y t h i n g b u t a b s t r a c t and t h e o r e t i c a l . w h o s e fulfillment is d i s t u r b e d in illness. e v e r y o t h e r trait as well is a f f e c t e d to s o m e e x t e n t . and w h e n e v e r t h e fulfillment o f a n y one e s s e n t i a l trait is d i s t u r b e d . Add to this w h a t we h a v e already said in o u r c h a r a c t e r i z a t i o n ol u n d i s t u r b e d h u m a n Da-sein a b o u t h e a l t h as f r e e d o m . o b s e r v a b l e . s e n s o r i l y o b s e r v a b l e . W e m u s t also b e a r i n mind t h a t t h e f u n d a m e n t a l t r a i t s o f h u m a n being a r e n o t j u s t s o m a n y b r i c k s w i t h w h i c h Da-sein i s put t o g e t h e r . m a k e t h e m t o t h e p h e n o m e na which they are.A General Daseinsanalytic Phenomenology 199 tentative explorations. T h e y a r e t h e s p a t i o . p a r t i c u l a r d i s t u r b a n c e s o f h e a l t h . e v e n t h e f o r m u l a t i o n of a f e w appropriate q u e s t i o n s w o u l d b e n o small a c c o m p l i s h m e n t . C o n v e r s e l y . R a t h e r . All are i n s e p a r a b l e . Illness involves t h e a s c e n d a n c y o r r e t r e a t o f s o m e trait w i t h r e s p e c t t o the o t h e r s . c o n c r e t e . A n y attempt to formulate a general Daseinsanalytic pathology must begin b y i n v e s t i g a t i n g t h e d i f f e r e n t m o d e s o f illness and t h e c o r r e s p o n d ­ ing d i s t u r b a n c e in fulfilling t h e E x i s t e n t i a l s o n — a n d on n o t h i n g b u t — t h e basis o f definite. its c o e x i s t e n c e o r being t o g e t h e r w i t h o t h e r people in a s h a r e d w o r l d . a r e t h e m o s t c o n c r e t e o f all: T h e y a r e t h a t i n w h i c h all t h e s e n s o r i l y a s c e r t a i n a b l e p h e n o m e n a o f h u m a n c o n d u c t c o a l e s c e t o a unity.i n . T h e y a r e n o less c o n c r e t e t h a n t h e d i s c r e t e . all t h e t r a i t s still p e r s i s t as p o t e n t i a l i t i e s . it is i m p o s s i b l e for e v e n o n e of t h e s e t r a i t s to disappear a l t o g e t h e r . T h e y c a n n o t simply be a n a l y t i c a l l y t a k e n a p a r t and o b s e r v e d o n e by o n e .t h e . a s long a s a p e r s o n still e x i s t s .w o r l d . t h e unfolding of i n h e r e n t p o t e n t i a l i t i e s i n t o e x i s t e n t i a l f r e e d o m . and the basil q u e s t i o n of a D a s e i n s a n a l y t i c g e n e r a l pathology a s s u m e s a tripartita . o n t i c p h e n o m e n a o f h u m a n being itself. m e m b e r s o f t h e unified s t r u c t u r e t h a t i s h u m a n b e i n g . n o m a t t e r h o w s e v e r e t h e illness.t h e w o r l d . M e t h o d o l o g i c a l l y . B o d y h o o d i s n o t h i n g b u t t h e bodily s p h e r e o f t h e fulfillment o f h u m a n e x i s t e n c e . o r s o m a t o g e n i c . W h i l e e v e r y t h i n g h u m a n i s bodily. since the body is the only easily m e a s u r a b l e and calculable p h e n o m e n o n of h u m a n Da-sein. like H u n t i n g t o n ' s C h o r e a . We k n o w already t h a t traditional m e d i c i n e . It t a k e s first place o n l y in t h a t it is directly and i m m e d i a t e l y accessible to the senses. for b o d y h o o d p r e s u p p o s e s b e i n g .200 EXISTENTIAL FOUNDATIONS aspect: ( l ) H o w is a p e r s o n ' s f r e e d o m to c a r r y o u t his p o t e n t i a l i t i e s impaired a t a n y g i v e n t i m e . M o d e s of i l l n e s s s h o w i n g e v i d e n t i m p a i r m e n t of t h e b o d y i n g f o r t h of human existence W e h a v e already s e e n t h a t t h e b o d y h o o d o f h u m a n b e i n g s i s n o t t o b e t h o u g h t of as simply a physically p r e s e n t . ( 2 ) W h a t a r e t h e s e p o t e n t i a l i t i e s . s u n k as it is in t h e c o n c e p t u a l w o r l d o f n a t u r a l s i c e n c e . this is b u t the bodying f o r t h of a p e r s o n ' s r e l a t e d n e s s to t h e w o r l d at a given m o m e n t . W h e n illness impairs t h e body. M o l e c u l a r biology has d i s c o v e r e d c h a n g e s in the n u m b e r and type of c h r o m o s o m e s in a cell and d e v i a t i o n s in the a r r a n g e m e n t of t h e four basic u n i t s of the D N A m o l e c u l e s within the c h r o m o s o m e s . the natural scientific: way ol t h i n k i n g immediately t r a n s f o r m s t h e s e c h a n g e s into the cau$es ol the diseases. It had no o t h e r c h o i c e .i n . N a t u r a l scientific r e s e a r c h can d e m o n s t r a t e specific g e n e t i c d e f e c t s w i t h regard t o m a n y such i m p a i r m e n t s . And n a t u r a l s c i e n c e . we shall begin by discussing illnesses t h a t m a r k e d l y d i s t u r b t h e bodily being of h u m a n Da-sein. g i v e n its c o n c e p t i o n o f n a t u r e .c o n t a i n e d t h i n g sufficient u n t o itself. As o n e m i g h t e x p e c t . has n o a c c e s s t o w h a t c a n n o t b e m e a s u r e d and calculated. has declared t h e body t h e sole reality of h u m a n b e i n g s . T h e p r o t o t y p e s o f this c a t e g o r y are d i s e a s e s t h a t a r e i n h e r i t e d and t h o s e t h a t a r e c o n t r a c t e d in ulero. t h e r e are t w o q u e s t i o n s w h i c h a n y h u m a n l y a d e q u a t e t h e o r y will ask: J u s t h o w is t h e bodily s p h e r e of Da-sein d i s t u r b e d P and W h a t w a y of relating to t h e w o r l d is it t h a t is d i s t u r b e d ? O f all f o r m s o f illness w h i c h s h o w m a r k e d d i s t u r b a n c e s w i t h i n t h e bodily s p h e r e . n o r as s o m e s e l f . B o d y h o o d does n o t in and of i t s e l f m e r i t first place in t h e unified s t r u c t u r e of D a .s e i n . it w o u l d p r o p e r l y c o m e last. and e m b r y o n i c d a m a g e c a u s e d b y thalidomide. t h e r e l a t e d n e s s as w h i c h he e x i s t s . and ( 3 ) W i t h r e s p e c t t o w h i c h e n t i t i e s o f t h e p e r s o n ' s w o r l d does this i m p a i r m e n t occur? In order to maintain some connection to traditional general patholo­ gies. m o n g o l i s m .w o r l d . m e a s u r a b l e body. t h e m o s t p r o m i n e n t are t h o s e traditional p a t h o l o g y classifies a s primarily o r g a n i c .t h e . . c e r t a i n f o r m s of diabetes. c o l o r b l i n d n e s s . F o r i n s t a n c e . c o l o r b l i n d n e s s . w e e m p h a s i z e d t h a t its o n l y n o v e l t y w a s a r e f i n e m e n t of t h e c o n c e p t of c a u s e . T a k e . m u c h of his e x i s t e n t i a l potential is d e s t r o y e d . w h i c h is supposed to be primarily h e r e d i t a r y . in t h e i n a d e q u a t e .a n d . A m o n g m o d e s o f illness t h a t s h o w evident i m p a i r m e n t i n t h e bodying f o r t h o f b e i n g . as i n f o r m a t i o n s o u r c e points.e f feet.w o r l d w e can also c o u n t supposedly s o m a t o g e n i c h e a l t h d i s t u r b a n c e s t h a t arise in utero or a f t e r b i r t h . h e i s cut o f f f r o m this w a y o f relating w i t h o t h e r s . o b j e c t i f y i n g c o n c e p t u a l i t y of n a t u r a l s c i e n c e . " b o r r o w e d f r o m t h e realm o f i n t e r p e r s o n a l c o n t a c t . I n f e c t i o u s diseases should b e u n d e r s t o o d similarly. If we w a n t to u n d e r s t a n d w h a t it really is. is.A General Daseinsanalytic Phenomenology 201 while t h e simple. old c o n c e p t of c a u s e is being supplanted by t h e c o n c e p t s of c y b e r n e t i c s and i n f o r m a t i o n t h e o r y .. F o r i n s t a n c e .h e r e d i t a r y illnesses are b y n a t u r e n o t h i n g m o r e t h a n deficiencies i n t h e ability t o freely c a r r y out p o t e n t i a l w a y s o f being w h i c h are usually t h e r e for people. for o n e t h i n g . w h e n polio paralyzed s o m e o n e ' s a r m s . H e c a n n o t s h a k e h a n d s . " Y e t t h e p o t e n t i a l i t y i n u n d e r s t a n d i n g " r e d " for w h a t i t i s c a n n o t b e u n d e r s t o o d o n t h e basis o f a n y m o l e c u l a r s t r u c t u r e . w e pointed o u t t h a t i n f o r m a t i o n t h e o r y has b e e n applied t o h u m a n p a t h o l o g y only a t t h e c o s t o f e x t e n d i n g t h e c o n c e p t of i n f o r m a t i o n to t h e p o i n t of e x t r e m e a m b i g u i t y . a b s t r a c t .o r g a n i c .g. In o u r critical evaluation ol i n f o r m a t i o n t h e o r y and its application t o h u m a n b e i n g s . t h e possibility of bodying f o r t h g r e e t i n g with a h a n d s h a k e . for i n s t a n c e . T h e Da-sein of a child b o r n w i t h a r m s b u t u n a b l e to use t h e m b e c a u s e of paralysis at b i r t h h a s b e e n r o b b e d j u s t as e f f e c t i v e l y of its ability t o body f o r t h t h e g r e e t i n g r e l a t i o n s h i p . scientific s e n s e . it is n o t simply his spinal cord and physical limbs t h a t are affected. as we h a v e said. w h i c h o u t of t h e m s e l v e s supposedly e f f e c t w a y s of being ( w h i c h . t h e old c o n c e p t o f causality w a s shifted c o n s i d e r a b l y t o w a r d t h e a n t h r o p o m o r p h i c and r o m a n t i c w i t h e x p r e s s i o n s like " i n f o r m a t i o n . F u r t h e r m o r e .i n . W e will d i s c o v e r t h a t h e c a n n o t r e s p o n d t o t h e m e a n i n g s " r e d " and " g r e e n . e. T h e virus h a s d e s t r o y e d t h a t s p h e r e of t h e p e r s o n ' s pot en t i.d m o d e s of b e i n g w h i c h is called. Like c o l o r b l i n d n e s s . we will h a v e to find o u t f r o m t h e afflicted p e r s o n e x a c t l y h o w his ability to r e l a t e h i m s e l f t h r o u g h p e r c e p t i o n t o w h a t r e v e a l s i t s e l f t o h i m i n his w o r l d h a s b e e n impaired.t h e . " " w r i t i n g . always r e q u i r e a p e r c e p t i o n of w h a t is t h e r e and of m e a n i n g f u l n e s s ) . all of t h e o t h e r so-called primarily o r g a n i c . " and " l a n g u a g e . In a strict. it is n o t possible to i m a g i n e w h a t h a p p e n s w h e n the m o l e c u l a r c h a n g e s w h i c h are p r o d u c e d in h e r e d i t a r y or primarily physical d i s t u r b a n c e s and can b e r e c o r d e d c h e m o p h y s i c a l l y o r c y b e r n e t i cally are s t a m p e d as c a u s e s . a child w h o has s u f f e r e d p r e n a t a l t h a l i d o m i d e d a m a g e and c o m e s i n t o t h e w o r l d w i t h o u t a r m s . t h e a n t e r i o r h o r n cells of t h e spinal ( o r d . directly affected in his ability to g r e e t people. A t t h e s a m e t i m e . W h a t h a p p e n e d w a s t h a t his ability t o g r e e t o t h e r people i n t h e m o d e s o f s h a k i n g h a n d s w a s also w o u n d e d .i n .202 EXISTENTIAL FOUNDATIONS A n a c u t e r h e u m a t i c i n f l a m m a t i o n o f t h e right e l b o w and s h o u l d e r j o i n t could also m a k e it impossible to body f o r t h a g r e e t i n g r e l a t i o n s h i p . I h e c o r r e s p o n d i n g p h y s i o c h e m i c a l pathological i m p a i r m e n t s c a n b e e l u c i d a t e d by natural scientific i n v e s t i g a t i o n within the p h e n o m e n a l . t h e r e is no l o n g e r any w a y to r e e s t a b l i s h a c o n n e c t i o n b e t w e e n this d a m a g e d o r g a n i c m a t t e r and t h e p a t h o l o g i c a l b e h a v i o r o f the person suffering from the traumatic dementia. B r a c h i a l paralysis o c c a s i o n e d b y h y s t e r i a . W h i l e it can be p r e v e n t e d simply by w i t h h o l d i n g t h e foods t h a t . b e c o m e t h e r a w m a t e r i a l s for t h e m e t a b o l i c poisons t h a t d a m a g e t h e brain. t h e availability of a purely m a t e r i a l therapy does not diminish t h e validity of saying t h a t . r e p r e s e n t s still a n o t h e r w a y in w h i c h the bodying f o r t h of a g r e e t i n g m a y be impaired. t h o u g h such an i m p a i r m e n t would presumably be temporary. or it m i g h t be e x p e r i e n c e d as s o m e t h i n g from w h i c h it is b e s t to flee. To him. w h a t is a l l c c l e d directly and i m m e d i a t e l y are w a y s of b e i n g with o i l i e r people. s o t h a t h e a f t e r w a r d s s u f f e r s from a c u t e . F o r i n s t a n c e . T h e n i t m a y happen t h a t t h e affected p e r s o n n o l o n g e r r e c o g n i z e s t h e m e a n i n g f u l n e s s of a g i v e n s i t u a t i o n as an e n c o u n t e r t h a t calls for a g r e e t i n g . t h e d e s i g n a t i o n " p r i m a r i l y o r g a n i c " m i s s e s the point. s o m e o n e m i g h t b e s h o t t h r o u g h t h e head. It p r e j u d g e s t h e h e a d injury as s o m e t h i n g t h a t c o n s i s t s solely i n t h e d e s t r u c t i o n o f o r g a n i c brain m a t t e r .w o r l d does n o t need t o b e discussed h e r e . O n c e i t h a s b e e n s o m i s c o n s t r u e d . s o m e t i m e s misleadingly called p s y c h o g e n i c p a r a l y s i s . n o w this s i t u a t i o n m i g h t m e a n n o t h i n g at all. T h e n it would be t h e pain t h a t i n t e r f e r e d . even h e r e . H e r e t h e d a m a g e to t h e brain r e s u l t s f r o m the presence in the metabolism of poisonous substances which intervene d e s t r u c t i v e l y in t h e i n t e l l e c t u a l possibilities of t h e affected children by damaging w h a t s c i e n c e c o n c e p t u a l i z e s as t h e c e r e b r u m . in t h e v a c u u m left by an i n n a t e e n z y m e deficiency. E v e n for this type of being ill. In e i t h e r c a s e . A n equally s e v e r e i m p a i r m e n t o f t h e ability t o body f o r t h g r e e t i n g can o c c u r in idiotia phenylpyruvica. T h a t this t o o should be s e e n a s a n i m p a i r m e n t o f t h e free c a r r y i n g o u t o f h u m a n b e i n g . p o s t t r a u m a t i c d e m e n t i a . T h e s a m e p o t e n t i a l i t y for g r e e t i n g can also be impaired by a s e v e r e head w o u n d .t h e . T h e one way to u n d e r s t a n d this b e h a v i o r is t h r o u g h seeing t h a t t h e injury to t h e brain is directly and p r i m a r i l y a n i m p a i r m e n t o f the p e r s o n ' s ability t o c a r r y o u t e s s e n t i a l h u m a n w a y s of relating to t h e w o r l d . t h e brain being b u t a bodily s p h e r e o f t h e w h o l e e x i s t e n c e . given d i s c u s s i o n s o f o u r t e s t s u b j e c t ' s h y s t e r i c a l leg paralysis. the injured p e r s o n will not be able to body f o r t h a friendly g r e e t i n g with a handshake. w o r l d t h a t is disturbed from its b e g i n n i n g . t h a t B o n h o e f f e r classed t o g e t h e r i n 1 9 1 2 a s " a c u t e exogenic reaction t y p e s . N o w a d a y s . J u s t a s t h e bodily findings o f n a t u r a l s c i e n c e lose n o t h i n g o f t h e i r s i g n i f i c a n c e for m o n g o l o i d idiocy in a D a s e i n s a n a l y t i c a p p r o a c h .t h e . T h i s i s a n i m p a i r m e n t o f w h a t constitutes human existence. o r s o u r c e o f i n f o r m a t i o n for the later d e v e l o p m e n t o f p o s t n a t a l . m o n g o l o i d idiocy can be diagnosed p r e n a t a l l y by o b s e r v a ­ tion of c h r o m o s o m e d a m a g e in fetal cells in placental fluid. . this p e r s p e c t i v e keeps medical u n d e r s t a n d i n g from losing t h e c o n n e c t i o n o f t h e s e p h e n o m e n a t o the c o n t e x t of t h e w h o l e bodily lived e x i s t e n c e of t h e ill p e r s o n . T h e chromosomal changes in the i n t r a u t e r i n e fetal cells a r e j u s t t h e first a s c e r t a i n a b l e p a t h o l o g i c a l p h e n o m e n a in t h e bodily s p h e r e of a b e i n g . S e c o n d . T h i s p r o c e d u r e s e p a r a t e s the d e s t r u c t i o n o f h u m a n p o t e n t i a l for r e l a t i o n s h i p from t h e u n i t y of t h e Da-sein and reduces it to m e r e m e t a b o l i c and c e r e b r a l d i s o r d e r s . t h e s e findings can b e r e c o g n i z e d as t h e i n d i s p e n s a b l e condition of directed physical and c h e m i c a l t h e r a p e u t i c m e a s u r e s only w h e n t h e y are v i e w e d d a s e i n s a n a l y t i c a l l y .t h e . T h i s priority i n t i m e d o e s n o t j u s t i f y t h e e l e v a t i o n o f this c h r o m o s o m a l finding t o the r a n k o f p r i m a r y c a u s e .A General Daseinsanalytic Phenomenology 2(U region split o f f from t h e h u m a n e x i s t e n c e and c o n c e p t u a l i z e d as c e r e b r a I and m e t a b o l i c . T h u s . Indeed. W h a t is of first i m p o r t a n c e is the specific i m p a i r m e n t o f t h e ability t o fulfull definite possibilities o f r e l a t i o n s h i p w h i c h are o p e n t o t h e a v e r a g e p e r s o n .i n . T h e y w e r e m a r k e d l y bodily d i s t u r b a n c e s o f b e i n g .i n . so t o o w i t h findings for o t h e r d i s e a s e s . l o o .w o r l d . S u c c e s s i n t w o scientific a c h i e v e m e n t s o f t h e h i g h e s t o r d e r d e m a n d s the c o n s t a n t e f f o r t t o b e a w a r e t h a t all pathological findings o n t h e body o f t h e h u m a n being w h i c h can b e scientifically a s c e r t a i n e d are b u l p h e n o m e n a of the disturbed bodyhood of human being-in-the-world. o n l y a d a s e i n s a n a l y t i c p e r s p e c t i v e can keep t h e pathological bodily p h e n o m e n a o f t h e e x i s t i n g h u m a n being f r o m b e c o m i n g i n c o m p r e h e n s i ­ ble a s w h a t t h e y factually are. It is impossible to ascei l a i n thai h u m a n b e i n g . W h e n a scientific a p p r o a c h w h i c h h a s lost a s e n s e of its c o n d i t i o n a l i t y and r e l a t i v i t y applies a b s o l u t i z e d c o n c e p t s h e r e w h i c h r e d u c e a patient's p a t h o l o g i c a l bodily s i m p t o m s to isolated p r o p e r t i e s of a m a t e r i a l body.w o r l d is factually divided i n t o i n t e r n a l and e x t e i rial r e a l m s . " H i s d e s i g n a t i o n w a s u n f o r t u n a t e . u n d e r s t a n d i n g of t h a t c o n t e x t is i n e v i t a b l y lost. s t r u c t u r a l bodily c h a n g e s and b e h a v i o r a l a b n o r m a l i t i e s of this disease unless t h e m e a n i n g of c a u s e is limited to d e s i g n a t e w h a t can b e r e g u l a r l y d e m o n s t r a t e d t e m p o r a r i l y t o precede t h e s u p p o s e d effect. F i r s t . basis.t h e . s e e n i n t h e t o t a l i t y o f t h e i r m e a n i n g f u l n e s s and c o n t e x t o f r e f e r e n c e s . w h e r e v e r t h e y a r e used i n m e d i c i n e . the t e r m s " e x o g e n l i and " e n d o g e n i c " c o n f u s e m o r e t h a n they clarify.i n . if t h e c o m m a n d e r fails. it is all t h e m o r e i n s t r u c t i v e to c o n s i d e r so significant a failure of t h e old w a y of t h i n k i n g a b o u t a form of illness as t h e a c u t e . T h e s e t h r e e g r o u p i n g s a r e t h e n c o m p a r e d w i t h t h e activity o f a t r o o p o f soldiers o f w h i c h B l e u l e r says: " I t s f o r c e i s e x t i n g u i s h e d w h e n each individual's s t r e n g t h g o e s . it r e g a i n s its order. e x o g e n i c reaction types. T h e y indicate r a t h e r t h a t t h e m o s t direct d e t e r m i n a n t o f any such illness is t h e p a r t i c u l a r w a y in w h i c h the p a t i e n t ' s b e i n g . of c o n s c i o u s n e s s . neuropathological causes are not at the base of the psychopathological behavioral phenomena. o p e n i n g up t h e w a y to s t a t e s of c o n f u s i o n a c c o m p a n i e d b y h a l l u c i n a t i o n s . T h e i r i m p r e s s i v e e x p e r i m e n t a l r e s u l t s leave n o r o o m t o d o u b t t h a t all supposedly primarily physical d i s t u r b a n c e s .t h e . I n t o t h e first g r o u p i n g h e placed p a t i e n t s suffering f r o m a " g e n e r a l dimming. i n w h i c h t h e individual b o n d s t h a t g u a r a n t e e t h e o r d e r and u n i t y of psychic life a r e disturbed. T h e third g r o u p i n g . B l e u l e r i m a g i n e s diminution o f i O H M iousness as affecting c e r e b r a l f u n c t i o n i n g as a w h o l e . that is. a l t e r a t i o n o f . o r identical. p h e n o m e n o l o g i cally o r i e n t e d g e n e r a l p a t h o l o g y . and fears for t h e f u t u r e . or dimunition. involved a " m o r e simple o r d e r i n g " of c o n s c i o u s n e s s . and t h e s e r e s e a r c h e r s w e r e t h e m s e l v e s painfully a w a r e o f this. T h e y tell u s t h a t t h e y did n o t k n o w w h e t h e r t h e i r f o r m u l a t i o n s a b o u t a c u t e . finally. p s y c h o p a t h o l o g i c a l b e h a v i o r . e a c h m e m b e r a c t i n g as he t h i n k s b e s t .204 EXISTENTIAL FOUNDATIONS W e can safely let this p r o b l e m o f labelling b e for t h e m o m e n t . t h a t t h e s a m e h a r m f u l c h e m o p h y s i c a l c o n d i t i o n will b e followed b y d i f f e r e n t d i s t u r b a n c e s in t h e p e r c e p t i o n and b e h a v i o r of each p e r s o n it a f f e c t s . " ( 0 1 responding to this a n a l o g y . A t t h e v e r y edge o f t r a d i t i o n a l p a t h o l o g y ' s c o n c e p t u a l h o r i z o n . it b e c o m e s d i s o r d e r e d . desires. T h e ideas o f t r a d i t i o n a l p a t h o l o g y could n o t g r a s p this t h o r o u g h l y significant fact. n o m a t t e r h o w d i f f e r e n t t h e y m a y be. T h e l a t e s t findings. i n fact. e x o g e n i c r e a c t i o n t y p e s i n t o t h r e e g r o u p i n g s . e x o g e n i c r e a c t i o n type. but not its spirit or skill. a t least w i t h i n t h e b r o a d area o f a c u t e . B l e u l e r w a s able t o divide a c u t e . e x o g e n i c r e a c t i o n t y p e s . the apparent chemophysical. It is j u s t as c e r t a i n .i n . are a c c o m p a n i e d b y similar. " T h e s e c o n d g r o u p i n g is c h a r a c t e r i z e d by an alteration of c o n s c i o u s n e s s . t h o u g h . T h i s p r o v e s t h a t . e v e n t h o u g h each m e m b e r is slill capable of ai I i n ) . aimless and i n e f f e c t i v e .w o r l d e x t e n d s i n t o his life h i s t o r y and i n t o his h o p e s . 2 In m a k i n g a t r a n s i t i o n to a m o r e h u m a n l y a d e q u a t e . t h e y are n o t g e n u i n e c a u s e s o f t h e s e afflictions. w h e n s o m e o n e of less ability replaces the fallen c o m m a n d e r . for m u c h m o r e i m p o r t a n t are t h e findings t h a t r e c e n t l y led r e s e a r c h e r s t o r e h a b i l i t a t e and e x p a n d c o n s i d e r a b l y B o n h o e f f e r ' s classification o f a c u t e . point a w a y from s o m a t o g e n i c n o t i o n s a b o u t such d i s t u r b a n c e s . e x o g e n i c r e a c t i o n types would t o u c h o n t h e n e u r o p a t h o l o g i ­ cal facts o f the m a t t e r o r m e r e l y e c h o f a n t a s i e s . t h e h e a l t h y people a r o u n d t h e m . it has n o t b e e n possible to u n c o v e r a single piece of e v i d e n c e to p r o v e t h a t s u c h e n d o p s y c h i c e n t i t i e s e x i s t . a s a n i m p a i r m e n t o f t h e b r e a d t h and c l e a r n e s s of t h e w o r l d . All w e m a y l e g i t i m a t e l y s a y o f people h a l l u c i n a t i n g w i t h i n the c o n t e x t of an a c u t e .t h e . t o o . In so far as this a n a l o g y to a t r o o p is i n t e n d e d to i l l u s t r a t e a t h e o r y t r a c i n g t h e p a t h o l o g y o f t h e a c u t e . " " d i m i n u t i o n . e x o g e n i c r e a c t i o n type. o r s u b j e c t . supposed a t t r i b u t e s like " d i m m i n g . N o m a t t e r w h a t the u n d e r l y i n g illness. and d i m m i n g o f a n e n d o p s y c h i c c o n s c i o u s n e s s can b e h u m a n l y u n d e r s t o o d o n l y i f w e finally discard. or of a l o o s e n i n g of e n d o p s y c h i c ties or a disruption of a s s o c i a t i v e t h o u g h t p r o c e s s e s . it h a s o v e r r e a c h e d its p o w e r s . w e h a v e p o i n t e d o u t t h a t t r a d i t i o n a l p s y c h o l o g y has found n o h a r d e v i d e n c e for t h e e x i s t e n c e . As we h a v e said again and again. e x o g e n i c r e a c t i o n type f o r w h a t t h e y t r u l y are. n a t u r e . B u t a b o v e all. t h e r e h a s n e v e r b e e n s u b s t a n t i a l e v i d e n c e o f a n actual a l t e r a t i o n in an equally u n s u b s t a n t i a t e d e n d o p s y c h i c c o n s c i o u s n e s s . e x o g e n i c r e a c t i o n types. S i m i l a r l y . e x o g e n i c r e a c t i o n type is t h a t t h e y a r e being e n c o u n t e r e d and e n g a g e d by t h i n g s of their w o r l d o t h e r t h a n .r e a l m w h i c h t h e Da-sein of t h e afflicted p e r s o n can hold open. W h a t w e h a v e said b e f o r e a b o u t t h e impossibility o f deriving any h u m a n m o d e s o f b e h a v i o r f r o m p h y s i c a l . o r c o n t e n t s o f the c o n s c i o u s n e s s it posits. F u r t h e r m o r e .n e r v o u s s t r u c t u r e s and p r o c e s s e s n a t u r a l l y applies also t o p a t i e n t s suffering f r o m a c u t e .A General Daseinsanalylic Phenomenology 205 c o n s c i o u s n e s s a s injury t o t h e i n t r a c e r e b r a l c o n n e c t i v e p a s s a g e w a y s . A s long a s t h e t h i n g i t s e l f r e m a i n s u n k n o w n . o n e can o n l y d e m o n s t r a t e t h a t certain c e r e b r a l p r o c e s s e s and h u m a n w a y s o f being are s i m u l t a n e o u s . O n l y t h e n will we finally be able to see the so-called p s y c h o p a t h o l o g i c a l s y m p t o m s o f t h e a c u t e . " and " a l t e r a t i o n " can m e a n v e r y little. and ordering on a more simple level as a reduction of t h e s e possibilities for connection. W h a t p s y c h o l o g y h a s falsely t e r m e d t h e d i m i n u t i o n . T h u s . W h a t e v e r n o x i o u s i n f l u e n c e is p r e s e n t directly affects t h e f u n d a m e n t a l e x i s t e n t i a l trait thai is the ability to e n g a g e in spatial r e l a t i o n s h i p s to the t h i n g s of a shai ed . the usual e x p l a n a t i o n o f so-called hallucina­ t i o n s g i v e s o n l y t h e a p p e a r a n c e o f u n d e r s t a n d i n g . o n c e and for all.w o r l d . H e r e . t h e p s y c h o l o g i c a l n o t i o n o f c o n s c i o u s n e s s and learn to r e c o g n i z e t h a t t h e Da-sein e v e n of ill p e r s o n s is a p r i m a r y b e i n g . n o r h a s it b e e n able to d e m o n s t r a t e h o w a p e r s o n .i n . i t should b e c l e a r e n o u g h t h a t t h e c o n c e p t u a l a p p r o a c h of t r a d i t i o n a l p a t h o l o g y is i n a d e q u a t e to explain the p h e n o m e n a o f t h e a c t u e . e x o g e n i c r e a c t i o n type b a c k t o t h e n o t i o n of a physical brain w i t h its manifold l e s i o n s . a l t e r a t i o n . t h e idea of a d i s t u r b a n c e of o r d e r and u n i t y a m o n g individual t h o u g h t p r o c e s s e s and a s s o c i a t i o n s in the p s y c h e h a s no factual basis. can " h a v e " c o n s c i o u s n e s s . and in o t h e r w a y s t h a n . T h e s a m e applies. O n e c a t e g o r y o f illness m a r k e d b y i m p a i r m e n t i n t h e bodily s p h e r e o f e x i s t e n c e w h i c h has b e c o m e e x t r a o r d i n a r i l y i m p o r t a n t i n m o d e r n t i m e s i s t h e c o n d i t i o n k n o w n . r e d u c e d to an o p e n n e s s only for v e s t i g e s of t h e m e a n i n g s and c o n t e x t o f r e f e r e n c e s m a k i n g u p t h e i r world. f o c u s s e d e x c l u s i v e l y on an e v e r i n c r e a s i n g d o m i n a t i o n of the world. holds t h e m in a m e r c i l e s s and n e v e r . A g a i n . since S e l y e ' s studies. T o t h e c a t e g o r y o f m a r k e d l y bodily illnesses b e l o n g n o t o n l y all o f t h e h e a l t h d i s t u r b a n c e s until n o w w r o n g l y labelled s o m a t o p s y c h i c . t h e r e can be no such t h i n g as an o v e r e x e r t i o n t h a t is. w e discussed a t l e n g t h t h e precise w a y i n w h i c h t h e s e illnesses are to be seen as i m p a i r m e n t s in bodying f o r t h specific w a y s of relating t o t h e world. W h e n the people w h o e x i s t in t h e m e x p e r i e n i c s i n h w a y . In c o n n e c t i o n w i t h o u r t e s t s u b j e c t ' s h y s t e r i c a l and o r g a n i c .r e a l m of p e r c e p t i o n as w h i c h t h e y e x i s t is. S t r e s s m e a n s t e n s i o n . a s t h e s t r e s s s y n d r o m e . usually p o r t r a y e d as a r e d u c t i o n . all t h e so-called p s y c h o s o m a t i c illnesses.n e u r o t i c s y m p t o m s . t h e l a t t e r o v e r t a x e d b e c a u s e m o d e r n industrial s o c i e t y . w h i l e for a n o t h e r i t m a y involve s e v e r e l y p a t h o g e n i c s t r e s s . a b s o l u t e and u n i v e r s a l . B e c a u s e e v e r y t h i n g d e p e n d s on t h e p a r t i c u l a r m e a n i n g e x p e r i e n c e d in a particular s i t u a t i o n . t o t h e third s u b g r o u p i n g o f t h e a c u t e . b u r d e n s o m e n e s s . w i t h all o f its c o u n t l e s s n e u r e s t h e n i c s y m p t o m s . W h a t a p p e a r s f r o m t h e o u t s i d e as t h e v e r y s a m e kind o f s i t u a t i o n can p r e s e n t a n e a s y t a s k t o o n e p e r s o n . ol i elating to 3 .e n d i n g c o m p e t i t i o n that n e v e r lets t h e m c a t c h t h e i r b r e a t h . O n e i n s t a n c e o f t h e bodying f o r t h o f a n o v e r s t r a i n e d r e l a t i o n s h i p t o t h e world is found in t h e illness w h i c h m o d e r n m e d i c i n e has n a m e d " v e g e t a t i v e d y s f u n c t i o n . e x o g e n i c r e a c t i o n type. in the o r d e r i n g of t h o u g h t p r o c e s s e s and a s s o c i a t i o n s w i t h i n t h e psychic realm o f t h e a f f e c t e d p e r s o n . finally. or simplification. u n d e r c e r t a i n c o n d i t i o n s . in itself. " T h i s is defined as disorder of the a u t o n o m i c n e r v o u s c e n t e r ' s r e g u l a t o r y s y s t e m . the former burdened beyond their powers with responsibili­ ty for a high s t a n d a r d of d o m e s t i c and c u l i n a r y e x c e l l e n c e w i t h o u t t h e d o m e s t i c help this would r e q u i r e . all t h a t can be factually o b s e r v e d in p a t i e n t s w h o c o m e u n d e r this third g r o u p i n g is t h a t t h e o p e n w o r l d . T h e v e r y idea o f n o r m a l e n d o p s y c h i c t h o u g h t p r o c e s s e s and a s s o c i a t i o n s c o n n e c t i n g t h e c o n t e n t s o f c o n s c i o u s n e s s t u r n s o u t t o be a factually g r o u n d l e s s supposition.206 EXISTENTIAL FOUNDATIONS world and t o live o n e ' s t i m e w i t h i n t h o s e r e l a t i o n s h i p s . e f f o r t . Its victims are p r e d o m i n a n t l y middle-class h o u s e w i v e s and executives. we mean the consequences of the overstraining or overbur­ dening of a p e r s o n w h i c h a p a r t i c u l a r life s i t u a t i o n m e a n s for h i m . b u t also. n o t w i t h s t a n d i n g t h e i r supposed origin in t h e p s y c h e and t h e i r a s s u m e d p s y c h o g e n i c d e v e l o p m e n t . W h e n w e speak o f s t r e s s syndrome. this multiplicity o f m e a n i n g s i n h e r e s i n w h a t t h e w o r d designates. which are wholly oriented t o w a r d calculability. t h a t is. O n l y in the natural sciences. In the abstract dimensions of p h y s i o l o g y .A General Daseinsanalytic Phenomenology 207 t h e w o r l d a s p e r m a n e n t s t r e s s s i t u a t i o n s . w h o can o f t e n e n o u g h " s t i m u l a t e " {reizen: " e x c i t e " ) e a c h o t h e r t o love o r fury. depending o n t h e p a r t i c u l a r r e g i o n i n w h i c h t h e s t i m u l u s o c c u r s . as n o r m a l day-to-day s t r a i n and e x e r t i o n in t h e r e a l m of Da-sein. a s t h e c o m m o n basis for t h e g r e a t d i v e r s i t y o f physical and psychic s t r e s s e s . actually m e a n s . e s s e n t i a l o r idiopathic high blood p r e s s u r e . s t r e s s i s r e g u l a r l y c o n c e i v e d of as being a s t i m u l u s . but the e x p r e s s i o n " s t r e s s s t i m u l u s " simply says t h e s a m e t h i n g m o r e t h a n o n c e . a s t i m u l u s initiated by s o u n d w a v e s — m e a n s s o m e t h i n g v e r y d i f f e r e n t t h a n in t h e a r e a of a p e r s o n ' s e v e r y d a y dwelling in his w o r l d . r e a s o n e n o u g h for p h y s i c i a n s t o look i n t o t h e i r natures. g a s t r o i n t e s t i n a l u l c e r s . c h r o n i c colitis. and n o t o u t o f r e g a r d for t h e o b j e c t o f study itsell. i m m e n s e e f f o r t is e x p e n d e d in t h e n a t u r a l s c i e n c e s . w i t h its n o t i o n s o f isolated s e n s e p e r c e p t i o n s . is a m b i g u i t y — m o r e t h a n o n e m e a n i n g for a d e s i g n a t i o n o r d e s i g n a t e d t h i n g — n o t admissible. T h e n a t u r a l s c i e n c e s can do n o t h i n g but c a l c u l a t e . m o r e o v e r . for e x a m p l e . I n t h e biological v i e w o f t h i n g s . b u t o f s t r e s s stimuli. and it is impossible to p e r f o r m calculations o n t w o t h i n g s t h a t are n o t a b s o l u t l e y free from a m b i g u i t y . 4 5 T h i s diversity o f stimuli r e v e a l s different m o d e s o f e n g a g e m e n t . or in w h a t i t r e f e r s to. a " s t i m u l a t i n g " {reizende: " c h a r m i n g " ) landscape to " s t i m u l a t e " (reizen: " i n v i t e " ) us to t a k e a w a l k t h r o u g h it. s t i m u l u s — a s . B i o l o g i s t s o f t e n speak n o t only o f s t r e s s e s . I f w e a r e really t o u n d e r s t a n d t h e s e s t r e s s d i s e a s e s . t h e i r bodying f o r t h can g o far b e y o n d m e r e v e g e t a t i v e d y s f u n c t i o n s t o s e v e r e l y d a m a g e d bodily s t r u c t u r e s . T a k e . o f so-called s t r e s s . Y e t t h e fact t h a t s t r e s s m a y h a v e m a n y m e a n i n g s should n o t be t a k e n to indicate s o m e deficiency in t h e w o r d itself. w e m u s t first b e able to explain w h a t s t r e s s . Reiz ("stimulus") c a n m e a n m a n y t h i n g s . . T h e i n t e n t b e h i n d t h e t e r m m a y b e to unify t h e e x t e r n a l and t h e i n t e r n a l in p h y s i o l o g y and biology. say. to get rid of t h e i n h e r e n t a m b i g u i t y of p h e n o m e n a and r e d u c e t h e m to a c o n d i i i o n o f u n a m b i g u o u s calculability. C o n t e m p o r a r y m e d i c i n e s e e s the u n v a r y i n g t h y m o l y m p h a t i c r e a c t i o n s . We also n o t e d t h a t " s t i m u l a t i o n " (Reizen: " e x c i t a t i o n ) h a p p e n s as well in the c o e x i s t e n c e o f people. c o r o n a r y i n f a r c t i o n . for i n s t a n c e . S o m e o f t h e s e have g r o w n i n t o plague p r o p o r t i o n s for m a s s e s o f people. B o t h w o r d s are being used h e r e i n t h e p s y c h o l o g i c a l s e n s e o f w h a t e n g a g e s and a f f e c t s a p e r s o n . T o suit this peculiar r e q u i r e m e n t . It is possible for. T h e t e r m i s m i g h t i l y lacking i n t h e s o r t o f u n e q u i v o c a l precision demanded in natural science. right down to their existential meanings. and accident p r o n e n e s s . including medicine. B u t e v e n in its older u s a g e . also called physical adaptation s y m p t o m s . EXISTENTIAL 208 FOUNDATIONS O n c e this h a s b e e n d o n e , t h e n a t u r a l s c i e n c e s d o n o t c o n s i d e r i t i m p o r t a n t t o i n q u i r e w h e t h e r the u n a m b i g u o u s n o t i o n o f s t r e s s t h a t r e s u l t s still c o r r e s p o n d s at all to w h a t it w a s m e a n t to d e s c r i b e . N o r is sleep lost o v e r t h e fact t h a t in reality t h e r e a r e no such t h i n g s as unspecific or s e l f - c o n t a i n e d stimuli. T h i s f r e q u e n t l y e m p l o y e d idea is r o o t e d in an u n r e a l i s t i c a b s t r a c t i o n . In c o n t e m p o r a r y p s y c h o s o m a t i c medicine, for i n s t a n c e , t h e t e r m " s t r e s s s t i m u l u s " i s o f t e n applied reductively t o clearly q u a n t i f i a b l e m e a s u r e s o f s o u n d , light, o r p r e s s u r e . Y e t s o m e sound s t i m u l u s , m e a s u r e d i n decibels and credited w i t h t h e p o w e r to p r o d u c e a c e r t a i n i n t e n s i t y of s e n s e p e r c e p t i o n in the h u m a n n e r v o u s s y s t e m , h a s l o s t all c o n n e c t i o n t o t h e o b j e c t o f study. I n fact, such t h i n g s as s o u n d stimuli do n o t e x i s t for a p e r s o n w h o is e x p o s e d and asked t o r e s p o n d t o s t r e s s . T h e y e x i s t o n l y a s h y p o t h e t i c a l c o n s t r u c t s and a b s t r a c t i o n s from t h e t h i n g s t h a t e n g a g e u s according t o the m e a n i n g s they allow us to p e r c e i v e . E v e r y s t r e s s , as s t r e s s , is c o n s t a n t l y o r i e n t e d to a p e r s o n ' s m o m e n t a r y relation to w h a t he p e r c e i v e s as it appears in o n e significance or a n o t h e r . B u t a h u m a n b e i n g ' s r e l a t e d n e s s to t h e w o r l d is n o t s o m e t h i n g t h a t h a p p e n s o n l y from t i m e to t i m e . He is, by n a t u r e , a l w a y s in o n e or a n o t h e r e c - s t a t i c , i.e., o p e n , perceptive, w o r l d - s p a n n i n g , r e l a t i o n s h i p t o w h a t e n g a g e s him. He e x i s t s as such r e l a t e d n e s s . T h i s r e l a t e d n e s s is n o t , like t h e h y p o t h e t i c a l e x p l a n a t i o n s of n a t u r a l s c i e n c e , posited for the p u r p o s e of i n t e r p r e t i n g h u m a n being. A h u m a n being can a l w a y s be s e e n directly as a b e i n g - i n - t h e - w o r l d , a p e r c e p t i v e being o p e n to t h e m e a n i n g f u l address o f p h e n o m e n a t h a t a r e n o t himself. W i t h o u t this m e a n i n g f u l address from e x i s t i n g t h i n g s , t h e h u m a n being could n o t exist. H u m a n s t r e s s , t h e n , a d e q u a t e l y u n d e r s t o o d , b e l o n g s t o t h e f u n d a m e n t a l c o n d i t i o n of t h e h u m a n being; it is an E x i s t e n t i a l . S t r e s s or b u r d e n i n g , as this indispensable m e a n i n g f u l address, s u p p o r t s and p r o m o t e s life. S t r e s s c a n also be healing. It is n o w well k n o w n t h a t i n t e n s e e m o t i o n a l s t r e s s does n o t n e c e s s a r i l y p r o v o k e d e p r e s s i o n ; i t can e v e n c u r e o n e . T h a t s t r e s s i s n e c e s s a r y f o r life r e m a i n s o b s c u r e a s long as the h u m a n being is w r o n g l y s e e n as a primarily w o r d l e s s e g o or s u b j e c t w h o s e life h i s t o r y is objectified as a s e q u e n c e of e v e n t s and p r o c e s s e s . 6 T h e n o t i o n of a p e r s o n as a f u n d a m e n t a l l y w o r l d l e s s s u b j e c t also p r e v e n t s a n u n d e r s t a n d i n g o f h o w i t i s t h a t m a n y people e x p e r i e n c e relief—the ending o f s t r e s s — a s b u r d e n s o m e , e x h a u s t i n g , and d e p r e s s ­ ing. O n e w o u l d e x p e c t , for i n s t a n c e , t h a t e x a m i n e e s , o n c e t h e y h a v e passed an e x a m , w o u l d feel relieved of all b u r d e n s and feel f r e e r and e a s i e r than e v e r b e f o r e . T h e s t r e s s o f t h e i m p e n d i n g e x a m i n a t i o n , w e a r g u e , is n o w o v e r and all r e a s o n s for feeling o p p r e s s e d should have disappeared. Y e t m a n y people fall i n t o d e e p d e p r e s s i o n jus 1 artei passing A General Daseinsanalytic Phenomenology 2 0 <> an exam. In 1 9 5 1 , Schulte warned, not without justification, that "Far m o r e a t t e n t i o n o u g h t t o b e g i v e n , i n o u r opinion, t o t h e i m p o r t a n c e o f relief as a m o t i v a t o r of d e p r e s s i o n . " Y e t S c h u l t e h i m s e l f later had t o a d m i t t h a t , "in t h e face o f myriad c o n v o l u t i o n s and o v e r l a p p i n g s , w e c a n n o t g e t past t h e b u r n i n g q u e s t i o n of w h a t it is t h a t really m a k e s this period of relief so dangerous and susceptible." I f w e look, h o w e v e r , a t t h e e s s e n t i a l p e r c e p t i v e r e s p o n s i v e n e s s o f h u m a n being to b e i n g e n g a g e d , we can s e e at o n c e h o w r e l i e f can h a v e a b u r d e n s o m e aspect. If h u m a n being is in fact p e r c e p t i v e r e s p o n s i v e n e s s to w h a t e v e r is present, then human being is existentially dependent on w h a t a d d r e s s e s o r b u r d e n s it. I n t h a t case, r e l i e f from s o m e t h i n g t h a t e n g a g e s a p e r s o n is an e x t i n c t i o n of his h u m a n b e i n g as t h e p e r c e p t i v e r e s p o n s i v e n e s s he is. W h e n this b u r d e n falls a w a y , w h a t is left is n o t j u s t s o m e n e g a t i v e , a n o n b u r d e n , b u t t h e e n d of a life-giving e n g a g e m e n t on the part of w h a t is r e l e a s e d . If a h u m a n being is deprived e n t i r e l y of s u c h e n g a g e m e n t , totally u n b u r d e n e d , h e i s r o b b e d o f t h e possibility o f c o n t i n u i n g to b e - t h e r e as a h u m a n being. A d e p r e s s i n g relief s i t u a t i o n is m o s t likely to happen w h e n e v e r a p e r s o n h a s allowed h i m s e l f to be a b s o r b e d totally b y s o m e t h i n g , w h i l e o t h e r t h i n g s t h a t m i g h t h a v e e n g a g e d a n d used him as a h u m a n b e i n g - i n - t h e - w o r l d h a v e in t h e m e a n t i m e r e c e d e d far i n t o t h e b a c k g r o u n d . I f t h e o n e r e m a i n i n g b u r d e n t h e n disappears, t h e p e r s o n n o l o n g e r h a s a n y t h i n g t o w h i c h h e can r e l a t e and w i t h w h i c h he is e n g a g e d ; t h e r e is no r e l a t e d n e s s in w h i c h and as w h i c h h e can dwell. H e can n o l o n g e r b e - t h e r e , n o l o n g e r e x i s t . S e e i n g this, S c h u l t e w r o t e , again i n 1 9 5 1 : " U n d e r the i m p r e s s o f t h e s e findings w e m u s t a d m i t , against t h e grain o f p r e s e n t practice, n o t o n l y t h a t a n o r g a n i s m ' s c a p a c i t y of being b u r d e n e d is a m e a s u r e of its h e a l t h , b u t t h a t a h u m a n being can be described as t r u l y healthy if we can d e c l a r e him capable of a c c e p t i n g and r e l i n q u i s h i n g b u r d e n s . " 7 8 9 T h e r e f o r e , the a p p a r e n t relief b r o u g h t a b o u t i n l a b o r a t o r y s i t u a t i o n s designed for m a x i m u m e x c l u s i o n o f all tactile, a c o u s t i c a l , a n d optical e n v i r o n m e n t a l stimuli are actually n o t h i n g m o r e t h a n e x t r e m e o v e r b u r d e n i n g . M a n y o f t h e s u b j e c t s living for days i n l i g h t - and s o u n d p r o o f r o o m s b r e a k d o w n u n d e r this s t r e s s and begin t o h a l l u c i n a t e — w h i c h m e a n s i n this c o n t e x t t h a t i n o r d e r t o b e able t o c o n t i n u e e x i s t i n g a s h u m a n b e i n g s , t h e y are forced t o g r a s p a t the p r e s e n c e s and e n g a g e m e n t s o f p h e n o m e n a t h a t d o n o t reveal t h e m s e l v e s to t h e h e a l t h y w a k i n g h u m a n b e i n g s w h o live in t h e e v e r y d a y world around them. T h e varied m e a n i n g s o f s t r e s s and t h e beneficial and pathological c o n s e q u e n c e s of s t r e s s s i t u a t i o n s in life are far m o r e a c c e s s i b l e t h r o u g h D a s e i n s a n a l y t i c insight t h a n t h r o u g h the c o n c e p t s o f s c i e n c e 0 1 210 EXISTENTIAL FOUNDATIONS psychology. We have seen that Daseinsanalytic understanding shows the primary nature of human being-in-the-world to consist in maintaining an o p e n r e a l m of r e s p o n s i v e n e s s and p e r c e p t i o n , a r e a l m in w h i c h w h a t e v e r r e v e a l s i t s e l f to a p e r s o n can address him. It follows from this t h a t a h u m a n b e i n g always finds h i m s e l f e n g a g e d in s o m e s i t u a t i o n or o t h e r , and is t h e r e f o r e always u n d e r s o m e b u r d e n . No h u m a n s i t u a t i o n can b e r e p r e s e n t e d , c o n s e q u e n t l y , a s i f i t w e r e s o m e c o m p o s i t e m i x t u r e of s e p a r a t e i n g r e d i e n t s like t h e e g o , t h e body, and a w o r l d . S u c h i n g r e d i e n t s can f u n d a m e n t a l l y b e c o n c e i v e d o n l y a s p a r t s o f t h e u n i t y t h a t is b e i n g - i n - t h e - w o r l d . O n l y b e i n g - i n - t h e - w o r l d is c o m p r e h e n s i v e enough to submit to diverse articulations. B u t even the observations that a h u m a n b e i n g c a n n o t be s e p a r a t e d from his world fails to r e a c h t h e m a r k , since it t o o r e s t s upon t h e puzzling n o t i o n of a u n i o n of h u m a n being and w o r l d . If t h e specific m o d e of h u m a n b e i n g - i n - t h e - w o r l d is a d e q u a t e l y c o n s i d e r e d , h o w e v e r , this m a t t e r o f separability b e c o m e s i r r e l e v a n t for h u m a n Da-sein and can be dispensed w i t h from t h e o u t s e t . A s t h e final p h e n o m e n o n b e l o n g i n g t o the g r o u p o f s e v e r e bodily i m p a i r m e n t s o f b e i n g - i n - t h e - w o r l d , physical pain n o w d e s e r v e s m e n t i o n . T h e t e n d e n c y t o label pain a n e x c l u s i v e l y pathological s y m p t o m s o m e w h a t c o n t r a d i c t s its f u n c t i o n , w h i c h i s t o w a t c h o v e r h e a l t h b y w a r n i n g a p e r s o n of i m m i n e n t d a m a g e to his i n t e g r i t y ; b u t e v e n in its role as guardian, t h e p h e n o m e n o n of pain is c o n c e r n e d w i t h injury. In dealing w i t h o u t t e s t s u b j e c t , we l e a r n e d to see h e r bodily pains as m o d e s of o p e n n e s s t h a t allowed h e r t o r e c o g n i z e t h a t o b v i o u s injury w a s b e i n g done, o r had b e e n done, t o o n e o r a n o t h e r o f h e r p o t e n t i a l i t i e s for relating bodily to w h a t is in h e r world. To bring in a n o t h e r i n s t a n c e , let us say t h a t I am r e l a x i n g in my g a r d e n , s t r e t c h e d o u t c o m f o r t a b l y on a chaise l o u n g e , t h i n k i n g at l e i s u r e a b o u t t h e f o u n d a t i o n of c o n t e m p o r a r y m e d i c i n e . As I do this, I am b e i n g - i n - t h e world in s u c h a w a y t h a t , bodily at e a s e in k e e p i n g w i t h my p r e s e n t m o o d of o p e n r e l a x a t i o n , I am s i t u a t e d in the familiar c o n f i n e s of my o w n g a r d e n . At t h e s a m e t i m e I e x t e n d , as t h e o p e n and p e r c e p t i v e r e a l m I a m , o v e r the e n t i r e r a n g e of t h e w o r l d t h a t is a c c e s s i b l e to m e . I p e r m e a t e t h a t world, e x i s t i n g as a w o r l d - s p a n n i n g r e s p o n s i v e n e s s . W h i l e I lie in my g a r d e n , e n g a g e d i n visualizing t h e topic o f c o n t e m p o r a r y m e d i c i n e , m y b e i n g - i n - t h e - w o r l d e x t e n d s t h r o u g h space at least as far as A m e r i c a and Indonesia, and t h r o u g h t i m e t e n y e a r s i n t o my past. F o r as relax in t h e g a r d e n , I visualize t h e c o n v e r s a t i o n s I had back then, with P r o f e s s o r Allport at H a r v a r d U n i v e r s i t y and w i t h P r o f e s s o r S l a m e t in [akarta. No less f u n d a m e n t a l l y , my b e i n g - i n - t h e - w o r l d e x t e n d ' , .it I hr. m o m e n t i n t o my future. M y r e m i n i s c e n c e o f t h i n g s p a s t , my p r e s e n t p i . i c e in the garden, m y reflections o n m e d i c i n e — e a c h a n d all o l t h e t e I N d e t e r m i n e d A General Daseinsanalytic Phenomenology by a l e c t u r e I am to give this c o m i n g s e m e s t e r , in t h e f u t u r e . My w a y . ol r e l a t i n g t o m y past and p r e s e n t are f o r m e d b y t h e fact that, h a v i n g decided to give this l e c t u r e , I am already e n g a g e d by this f u t u r e e v e n ! B e i n g - t h e r e as an o p e n r e a l m of t i m e and space, my e x i s t e n t i a l p o t e n t i a l i t i e s are realized in t h e w a y m o s t p r e c i s e l y suited to m e , and my e x i s t e n c e a s a n open p e r c e p t i v e r e s p o n s i v e n e s s r e a c h e s its g r e a t e s t r a n g e and f r e e d o m . As a c o n s e q u e n c e , my Da-sein is at this m o m e n t a t t u n e d to a m o o d of c o m p o s e d , r e l a x e d s e r e n i t y . A Da-sein is a t t u n e d to happiness il it is able to realize t h e p o t e n t i a l i t i e s e s s e n t i a l to it. B u t suddenly, i n t h e v e r y m i d s t o f m y happy and o p e n r e l a t e d n e s s t o t h e w o r l d , m y old c h a i s e l o u n g e collapses u n d e r m e , a s s u c h t h i n g s are w o n t t o do, and the ring f i n g e r o f m y r i g h t h a n d i s j a m m e d b e t w e e n the w o o d e n slats of t h e chair. G o n e in a flash is t h e wide e x p a n s e of my f o r m e r , happy c o n n e c t i o n t o t h e world, g o n e t h e r e w a r d i n g t h e m e o f p r e s e n t - d a y m e d i c i n e ; b o t h h a v e r e t r e a t e d t o a n e x t r e m e l y undefined, u n t h e m a t i c d i s t a n c e . T h e b r o a d e x t e n s i o n o f m y b e i n g - i n - t h e - w o r l d into its past and f u t u r e h a s s u d d e n l y s h r u n k , a t t u n e d as I am to a t h r o b b i n g pain, t o the m e a g e r p r o p o r t i o n s o f a c o n n e c t i o n t o m y injured fingertip. My f u t u r e is limited to a plan for ending this awful pain as quickly as possible. N o w , n o o b j e c t - p s y c h e h a s b e e n altered i n this p r o c e s s , n o r a n y t h o u g h t p r o c e s s e s o r a f f e c t s w i t h i n such a n o b j e c t - p s y c h e . W h a t has b e e n c h a n g e d and r e a t t u n e d is, r a t h e r , the p e r c e p t i v e o p e n n e s s o f the b e i n g in space and time t h a t is t h e e s s e n c e of my Da-sein. T r a d i t i o n a l m e d i c i n e m i g h t h a v e i n t e r p r e t e d this e v e n t as a s o m a t o ­ psychic disturbance, or an acute, exogenic reaction. If we intend to d e m y t h o l o g i z e such i n a p p r o p r i a t e n o t i o n s a b o u t p r i m a r i l y o r g a n i c h e a l t h d i s t u r b a n c e s , w e m u s t carefully avoid t h e all t o o f r e q u e n t m i s i n t e r p r e t a t i o n t h a t t h e p i n c h e d fingertip is a physical o b j e c t in itsell w h i c h , w h e n injured, a c t u a t e s , e v e n c a u s e s , a n a t t e n d a n t p s y c h o p a t h o logical p h e n o m e n o n . T h i s i s n o t so. S e e n o b j e c t i v e l y — t h a t is, scientifical­ ly and in a w a y t h a t is a p p r o p r i a t e to h u m a n b e i n g s — t h e pinching of my fingertip, i.e., a bodily s p h e r e of my e x i s t e n c e , a f f e c t e d my w h o l e being, i n - t h e - w o r l d directly, w i t h o u t t h e i n t e r v e n t i o n of a n y e x o g e n i c physi< a I o b j e c t , t o such a n e x t e n t t h a t m y e n t i r e w a y o f r e l a t i n g i n space and time to t h e w o r l d w a s r e a t t u n e d , e x a c t l y as it w a s described a b o v e . T h e r e appears t o b e q u i t e s o m e discrepancy h e r e b e t w e e n a relatively m i n o r injury t o t h e bodily s p h e r e o f m y e x i s t e n c e , t h e pinching o l one finger, and t h e s e v e r e i m p a i r m e n t visited o n m y e n t i r e being-in the w o r l d . P e r h a p s it is by v i r t u e of t h e fact t h a t t h e f i n g e r is t h e most h i g h l y s o p h i s t i c a t e d r e a l m o f m y ability to r e l a t e t o t h i n g s bodily that the lone of this painful e x p e r i e n c e could so powerfully affect t h e e x t e n s i o n ol my b e i n g - t h e r e in space and t i m e . T h r o u g h his fingers, a person can c a r r y 212 EXISTENTIAL FOUNDATIONS out w i t h m a r v e l o u s d e x t e r i t y his e c - s t a t i c w a y s o f relating t o t h e w o r l d . C o n s i d e r t h e d e x t e r i t y o f t h e v i r t u o s o pianist, w h o s e f i n g e r s give h i m a highly refined w a y o f r e l a t i n g t o his a u d i e n c e and t o t h e m u s i c h e i s playing. M o r e p r e c i s e p h e n o m e n o l o g i c a l r e s e a r c h m a y s o m e d a y b e able to find a close c o r r e l a t i o n b e t w e e n t h e function and s o p h i s t i c a t i o n of an injured bodily r e g i o n and t h e r e l a t i v e f o r c e and quality of t h e pain t h a t is e x p e r i e n c e d . It m a y be a r g u e d t h a t t h e brain, w h i c h is t h e m o s t s o p h i s t i c a t e d a r e a o f t h e bodily r e a l m o f h u m a n e x i s t e n c e , i s also t h e m o s t i n s e n s i t i v e t o pain, b u t w e should k e e p i n m i n d t h e g r e a t s e n s i t i v i t y o f t h e m e n i n g e s . A n y i n j u r y w h i c h t h r e a t e n s t h e brain from t h e o u t s i d e , and m i g h t possibly t h e r e f o r e b e a v e r t e d , can h a p p e n o n l y a f t e r this p r o t e c t i v e m e m b r a n e h a s s u f f e r e d a n e x t r e m e l y painful lesion. s W h a t is i m p o r t a n t to glean from o u r e x a m p l e is t h e fact t h a t bodily pain a l w a y s i n h e r e s in s o m e injury done to a p e r s o n ' s r e l a t e d n e s s to t h e w o r l d — t h a t is, t o t h e p e r s o n ' s v e r y e x i s t i n g . B o t h are s o closely r e l a t e d t h a t bodily pain actually m a k e s it possible for a p e r s o n to perceive injury to Da-sein. In this p r o p e r t y of pain lies t h e a n s w e r to a q u e s t i o n t h a t h a s u p t o n o w r e m a i n e d open. T h e r e has b e e n g r e a t u n c e r t a i n t y a b o u t t h e n a t u r e o f t h e r e l a t i o n s h i p b e t w e e n bodily and m e n t a l pain. W e did m a n a g e to define m e n t a l pain, in t h e f o r m of s o r r o w , as an E x i s t e n t i a l . W s a w t h a t t h e e v e r p r e s e n t p o t e n t i a l for a p p a r e n t l y g r o u n d l e s s s o r r o w i s in reality an a t t u n e m e n t w h i c h o p e n s us to perceiving t h a t o u r Da-sein h a s b e e n t o r n l o o s e f r o m t h e u n c o n d i t i o n a l a b s o l u t e . B u t bodily pain is a v e r y specific kind of m e s s e n g e r . It heralds e x c l u s i v e l y injury to o u r ability to body f o r t h o u r r e l a t e d n e s s t o t h e w o r l d . S o r r o w , t h e r e f o r e , i s t h e o n l y basis for fully g r a s p i n g t h e m e a n i n g of bodily pain. S o r r o w c a n n o t be a p p r o a c h e d from t h e s t a n d p o i n t o f physical pain, h o w e v e r . T h e p s y c h i c pain of s o r r o w r e v e a l s t h e f u n d a m e n t a l , e x i s t e n t i a l l a c e r a t i o n of Da-sein; physical pain o n l y p e r m i t s us to p e r c e i v e partial i m p a i r m e n t s in t h e bodily s p h e r e o f w a y s o f being. S e e i n g i n t o t h e affinity b e t w e e n bodily pain and o u r e c - s t a t i c relatedness to the world brings us closer to understanding two extremely puzzling pain p h e n o m e n a . T h e first is t h e p h a n t o m pain e x p e r i e n c e d in limbs t h a t h a v e b e e n a m p u t a t e d ; t h e s e c o n d , t h e fact t h a t w h e n pains e n s i t i v e n e r v e s a r e s t i m u l a t e d , t h e r e s u l t i n g pain is felt o n l y at t h e o u t e r m o s t ends o f t h e s e n e r v e s . W e m a k e o u r first step t o w a r d understanding these phenomena w h e n we extend our narrow picture of s e p a r a t e n e r v o u s o r g a n s t o e n c o m p a s s o u r e x i s t e n t i a l w a y s o f relating t o the world, t h e t r u e dwelling place o f all bodily p h e n o m e n a . W e have pointed out that t h e s e w a y s o f relating r a n g e far be v e n d I h e v o l u m e o f space hounded by the skin. F r o m t h e r e , it lake', no great leap to under.land both p h a n t o m pain and what h . e . b e e n i a i l e d in e r r o r A General Daseinsanalytic Phenomenology 213 " p r o j e c t i o n i n t o the n e r v e e n d i n g s . " A f o u n d a t i o n of m e d i c i n e is not the place t o t h o r o u g h l y e x p l i c a t e t h e s e p h e n o m e n a , h o w e v e r — a m a t t e r m o r e f o r a specialized, p h e n o m e n o l o g i c a l l y o r i e n t e d p a t h o l o g y . L o o k i n g back o v e r o u r c a t a l o g o f bodily i m p a i r m e n t s o f b e i n g - i n - t h e world, w e can clearly see t h a t i t i n c o r p o r a t e s m o d e s o f illness w h i c h traditional g e n e r a l p a t h o l o g i e s h a v e s c a t t e r e d a c r o s s t h e w h o l e s p e c t r u m o f classification, and i t e x p l o d e s t h e h i e r a r c h y w h i c h o n c e provided t h e only f r a m e w o r k for t h e p a t h o l o g i c a l s y m p t o m s o f o u r o w n t e s t c a s e . F o r h o w could we p r e s e r v e a h i e r a r c h y t h a t b e g i n s w i t h a c a t e g o r y of s o called primarily o r g a n i c physical i l l n e s s e s o n c e w e r e c o g n i z e d t h a t , given t h e n a t u r e o f h u m a n n e s s , such illnesses simply c a n n o t e x i s t . Modes of illness showing severe impairment in the spatiality and temporality of human being-in-the-world T h e m o s t e v i d e n t i m p a i r m e n t o f t h e basic e x i s t e n t i a l t r a i t s o f spatiality and t e m p o r a l i t y in r e l a t i n g to t h e p h e n o m e n a of t h e w o r l d h a p p e n s in t h o s e i l l n e s s e s t h a t p s y c h i a t r i s t s classify as o r g a n i c p s y c h o s e s . In p a t i e n t s w h o s u f f e r f r o m p r o g r e s s i v e paralysis, for i n s t a n c e , o r senile d e m e n t i a , i t is n o t m e r e l y t h e v o l u m e of t h e p s y c h e t h a t is reduced, b u t t h e size of t h e s p a t i o - t e m p o r a l w o r l d held o p e n by t h e s e people's Da-sein. T h e r a n g e of t h i n g s and people to w h i c h such a p a t i e n t m a y still r e s p o n d h a s s h r u n k to t h e d i m e n s i o n s o f t h e i m m e d i a t e p e r c e i v a b l e e n v i r o n m e n t , and even h e r e t h e r e is such a closed d o o r b l i n d n e s s to t h e m e a n i n g of w h a t is perceived t h a t spatial d i s o r i e n t a t i o n often r e s u l t s . O f t h e t h r e e t e m p o r a l e x i s t e n t i a l e x t e n s i o n s o f past, p r e s e n t , and f u t u r e , the first and third a r e n e a r l y totally c o v e r e d up in s u c h p a t i e n t s , so m u c h so t h a t t h e i r e x i s t e n c e i s practically reduced t o t h e p r e s e n t . E v e n older people w h o are h e a l t h y are far less likely t h a n t h e i r y o u n g and middle-aged c o u n t e r p a r t s to be c o n c e r n e d w i t h plans for t h e f u t u r e and a r e apt t o focus r a t h e r s t e a d f a s t l y o n t h e p r e s e n t . T h e y m a k e u p for this b y h a v i n g g r e a t e r access to their pasts. T h e events of their youth draw nearer to them than e v e r b e f o r e , and t h e i r Da-sein g o e s o u t to r e m e m b r a n c e of t h i n g s past. T h u s t h e r e i s a t least o n e t e m p o r a l e x t e n s i o n t h a t r e m a i n s open, from t h e i r p r e s e n t to t h e i r past, for t h e y do realize t h a t t h e y a r e dwelling in w h a t has b e e n . N o w , w h e n w e h e a r t h a t people s u f f e r i n g from s e v e r e senile d e m e n t i a i m a g i n e t h a t t h e y a r e actually children again and m i s t a k e a n y o n e in t h e i r i m m e d i a t e p r e s e n c e for a f o r m e r p l a y m a t e , we say t h e s e people a r e " l i v i n g in t h e p a s t . " B u t this is n o t so. To say this a s c r i b e s to the illness s o m e t h i n g e x t e r n a l and s u p e r f l u o u s , s o m e t h i n g taken from the s t a n d p o i n t of an o b j e c t i v e o b s e r v e r , but t h e p h e n o m e n o n itsell reveal* t h a t t h e s e senile people do n o t live in relation to t h e i r past as the pail, the s p a c e - t i m e r a n g e of t h e i r b e i n g - i n - t h e - w o r l d does not go from the P s y c h i a t r y has m a d e it all t h e m o r e difficult to a c h i e v e a D a s e i n s a n a l y t i c v i e w o f o r g a n i c p s y c h o t i c s t h r o u g h the v e r y c h o i c e o f this p h r a s e t o d e s c r i b e s u c h p a t i e n t s . N o w . saying r a t h e r t h a t t h e y a r e m a s k e d . o r c o v e r e d up. E v e r y t h i n g a h e a l t h y p e r s o n would e x p e r i e n c e in t h e p r e s e n t is a b s o r b e d in t h e s e r e l a t i o n s h i p s and c o r r e s p o n d i n g l y m i s p e r c e i v e d . As for the f u t u r e . E v e n t h e i r w a y o f b e h a v i n g i s g r o u n d e d in ability to p e r c e i v e w h a t t h e y e n c o u n t e r in t h e i r world as m e a n i n g f u l things or people. functional. we w o u l d reach u t terly absurd c o n c l u s i o n s . and s t r u c t u r a l d i s t u r b a n c e s in a brain organ.214 EXISTENTIAL FOUNDATIONS p r e s e n t b a c k i n t o t h e p a s t a n y m o r e . t h e v e r y fact t h a t t h e s e are w a y s o f being m e a n s t h e y c a n n o t h a v e o r i g i n a t e d i n biophysical p r o c e s s e s . I n discussing t h e s e e x t r e m e illnesses. w e h a v e s t u d i o u s l y avoided claiming t h a t t h e t e m p o r a l e x t e n s i o n s are e v e r actually lost. and f u t u r e .d i r e c t e d n e s s m o r e and m o r e declines. can c o n d u c t t h e m s e l v e s i n t h e v e r y s a m e w a y a s o r g a n i c p s y c h o t i c s . W e m a y see this b y t h e fact t h a t h e a l t h y people. S u c h illnesses a r e n o t c a u s e d b y biophysical. B u t t h e y live i n t h e p r e s e n t r e l a t i o n s h i p s to t h e people and t h i n g s of t h e i r childhood. c h i l d r e n a r e said to live e n t i r e l y in t h e p r e s e n t . N o ability t o p e r c e i v e m e a n i n g f u l n e s s . t h e r e is no c a u s e to p r o d u c e t h e m in o r g a n i c p s y c h o t i c s t h r o u g h l a t e r biophysical c h a n g e s in the brain. W e m i g h t h a v e t o a t t r i b u t e the l a c I thai t h e m o n o m a n i c n o t i o n s o f paralytic s t h e s e d a y s a r e SO m u c h less a m b i t i o u s than t h o s e o f their p r e d e c e s s o r s t o a n n u l e a s i n g e n n u i i n . B e i n g e s s e n t i a l t o h u m a n n a t u r e . if w e tried t o explain the m o n o m a n i c b e h a v i o r o f a p r o g r e s s i v e paralytic o n t h e basis o f the biophysical p r o c e s s e s a c c e s s i b l e to natural s c i e n c e . B u t this living in the p r e s e n t is v e r y d i f f e r e n t from t h a t of senile p a t i e n t s . T h e i r t e m p o r a l i t y has b e e n r e d u c e d a l m o s t e x c l u s i v e l y t o t h e p r e s e n t . while d r e a m i n g . N o m a t t e r h o w a p e r s o n ' s w a y s o f being m a y b e pathologically c h a n g e d i n r e l a t i o n t o w h a t h e e n c o u n t e r s . H u m a n t e m p o r a l i t y c o n s i s t s o f all t h r e e e x t e n s i o n s — p a s t . it b e g i n s to s t a m p t h e p r e s e n t w i t h i n c r e a s i n g force for children a s t h e i r c u r i o s i t y g r o w s . T h i s would hardly be possible. n o m a t t e r h o w impaired i t has b e c o m e . n o t y e t having a c c e s s to a past or a f u t u r e . F o r e x a m p l e . w h i l e in old people this f u t u r e . for it is n o t t h a t children do n o t live t h e d i m e n s i o n of t h e past b u t t h a t t h e r e is n o t yet e n o u g h past to e f f e c t i v e l y d e t e r m i n e t h e i r p r e s e n t . p r e s e n t . in fact. n o n e of t h e m can simply disappear and still leave a h u m a n Da-sein b e h i n d . T h e r e i s t h e r e f o r e n o o r g a n i c e x p l a n a t i o n for t h e illness o f supposedly o r g a n i c p s y c h o t i c s . E v e r y o n e h a s from birth t h e p o t e n t i a l for e x i s t i n g in t h e p a t h o l o g i c a l m a n n e r a s c r i b e d t o o r g a n i c p s y c h o t i c s . a l t h o u g h t h e y r a r e l y e n g a g e in and c a r r y o u t this p o t e n t i a l in t h e i r w a k i n g lives. can e v e r be derived from biophysical p r o c e s s e s . If t h e s e p s y c h o t i c p o t e n t i a l i t i e s h a v e a l w a y s b e e n t h e r e . c a l l e d i m p o v e r i s h m e n t of c o n s c i o u s n e s s is actually a s h r i n k i n g o f t h a t r e a l m o f p e r c e p t i v e o p e n n e s s and r e s p o n s i v e n e s s a s w h i c h t h e p a t i e n t e x i s t s . as d e f e c t s in biophysical brain m a t t e r at a specific location in s p a c e .i n . T h e r e s u l t i s t h a t a n y t h i n g t h e patient e n c o u n t e r s r e v e a l s o n l y a p o r t i o n of its c o n t e x t s of meaning. w i t h t h e r e s u l t t h a t t h e d i s t u r b a n c e s in the n e r v e cells o f t h e f r o n t a l lobe a r e less t u r b u l e n t t h a n t h o s e caused b y the a n c e s t o r s of t h e s e s a m e s p i r o c h e t e s . or a c h r o n i c e n c e p h a l i t i c r e a c t i o n . third.t h e . W h a t e v e r t h e particular e x p l a n a t i o n m a y b e . it tries to explain t h e b e h a v i o r of a paralytic w h o m i s t a k e s h i m s e l f and his s u r r o u n d i n g s for t h e b e i n g . S e c o n d . It f o l l o w s . t h o u g h i n a d e q u a t e l y . r e s t r i c t e d m o d e of h u m a n Dasein. t h a t a p e r s o n so a f f e c t e d h a s at his disposal o n l y an e x t r e m e l y s e l f . t h e s u b s t r a t u m of o r g a n i c illness is only t h a t s p h e r e of t h e r e d u c e d spatiality and t e m p o r a l i t y of paralytically ill h u m a n b e i n g s w h i c h m a y also be i n t e r p r e t e d . appropriate ways of responding to what a p e r s o n e n c o u n t e r s . S o .A General Daseinsanalytic Phenomenology 215 p r e s e n t . w h a t n a t u r a l s c i e n c e i n t e r p r e t s a s f r o n t a l lobe d a m a g e c a u s e d b y lues s p i r o c h e t e s is actually p r i m a r y and direct injury to t h e b e i n g .i n . T h e m o s t w e can say is.c e n t e r e d . t h e presences o f w h a t w a s o n c e perceived in the o p e n realm of t h e p a t i e n t ' s e x i s t e n c e fall out of t h e o p e n n e s s ol his I >ii *eln l. disturbed or u n d i s t u r b e d . R a t h e r . W e m a i n t a i n t h a t t h e r o l e o f p h y s i c a l i t y i n o r g a n i c p s y c h o s e s can b e described a t b e s t t h r o u g h t h e f o l l o w i n g p r o p o s i t i o n s . W e h a v e r e p e a t e d l y indicated. defined as a deficiency of a s s o c i a t i o n s in t h e brain or a s a disruption o f t h e p r o c e s s o f r e t r i e v a l o f c e r e b r a l e n g r a m s .d a y s p i r o c h e t e s . t h a t t h e r e is no real e v i d e n c e for the e x i s t e n c e o f e n d o p s y c h i c t h o u g h t p r o c e s s e s and a s s o c i a t i o n s . f o r i n s t a n c e . t h a t t h e r e is a r e g u l a r s i m u l t a n e i t y b e t w e e n p a t h o l o g i c a l b e h a v i o r in paralytics and a c e r t a i n c o n d i t i o n of t h e brain.t h e w o r l d o f a n e x i s t i n g h u m a n b e i n g w h i c h d e s t r o y s t h e bodily c a p a c i t y for carrying out most of the normal. N o r a r e t h e w e a k m e m o r i e s o f t h e s e p a t i e n t s c a u s e d b y ini reased difficulty in r e t r i e v i n g r e p r e s e n t a t i o n s f r o m o r g a n i c a l l y s t o r e d c ei e b l >l e n g r a m s . T h u s .w o r l d of a C h i n e s e e m p e r o r as deriving f r o m injury to s o m e bodily r e a l m c o n c e p t u a l i z e d as a brain organ. or a n y o t h e r m a t e r i a l p r o c e s s i n t h e brain o f t h e p a t i e n t . or a d e g e n e r a t i v e p r o c e s s . S t r i c t l y speaking. first. h o w e v e r .n . and r e f e r e n c e c o m p a r e d w i t h w h a t i t r e v e a l s t o h e a l t h y people. Psychiatry further misinterprets the nature of organic psychotics w h e n i t s e e s a s o n e o f t h e i r crucial s y m p t o m s a n i m p o v e r i s h m e n t o f t h o u g h t p r o c e s s e s . S o m e t h i n g t h a t is biophysical in n a t u r e c a n p r o d u c e o n l y s o m e t h i n g else t h a t is b i o p h y s i c a l in n a t u r e . i t m a t t e r s v e r y little w h e t h e r n a t u r a l s c i e n c e d i s c u s s e s a p a r t i c u l a r i n s t a n c e of p r o g r e s s i v e p a r a l y s i s in r e l a t i o n to an i m m u n e biologicr e a c t i o n . it is basically akin to m a g i c if. e.i n . I m p a i r m e n t of the ability to retain f o r m e r l y e n c o u n t e r e d p r e s e n c e s in o n e ' s w o r l d is an i n h e r e n t part of a n y p a t h o l o g i c a l r e d u c t i o n of a p e r s o n ' s ability to e x i s t e c . t h a t bodying f o r t h of t h e i r e x i s t e n t i a l inability to s t a y firm as an a u t o n o m o u s selfhood in t h e face of the meaningful but overwhelming address of what is present. S u c h spaces also d e m a n d t h a t a n y o n e w h o p e r c e i v e s t h e m s u s t a i n all t h e unfamiliar and u n c e r t a i n t h i n g s t h a t m a y e n t e r t h e i r wide b o r d e r s f r o m t h e outside. O p e n spaces and b r o a d a v e n u e s e n g a g e e v e r y o n e i n such a w a y t h a t o u r Da-sein h a s to m a t c h t h e i r d i m e n s i o n s . W h e n c o n f r o n t e d w i t h such spaces.216 EXISTENTIAL FOUNDATIONS m o r e readily t h a n from t h e Da-sein of a h e a l t h y p e r s o n . t h e r e is also an o b s t r u c t i v e i m p a i r m e n t i n t h e spatiality o f people w h o a r e a g o r a p h o b i c o r c l a u s t r o p h o b i c . T h e a g o r a p h o b i c p e r s o n can find s u p p o r t and e x i s t in a c o m p a r a t i v e l y free w a y o n l y in r e l a t i o n to a n a r r o w circle of familiar t h i n g s and people. l a l e w . with its o b v i o u s c l a u s t r o p h o b i c traits. to e x t e n d to r e l a t i o n s h i p s t o t h i n g s o n t h e b o r d e r s o f t h e s e places. o p e n a r e a s b y expanding t h e i r e x i s t e n c e s accordingly. their Da-sein often e x p e r i e n c e s s p a c e . so t h a t it is impossible for t h e m t o m e e t t h e d e m a n d s o f large. a g o r a p h o b i c s e x p e r i e n c e open space a s s o m e t h i n g o v e r p o w e r i n g . m e a g e r . W e h a v e l e a r n e d from o u r test case. s o m e t h i n g t h a t a b s o r b s and a n n i h i l a t e s t h e i r Da-sein. e x p e r i e n c e a n y e n v i r o n m e n t a l limitation as s u f f o c a t i o n c o n f i n e m e n t . W h i l e the o r i g i n s and n a t u r e o f t h e s e d i s t u r b a n c e s a r e v e r y d i f f e r e n t from t h o s e of t h e o r g a n i c p s y c h o s e s . It is n o t u n c o m m o n to h e a r t h e m describe their e x p e r i e n c e as a t r u l y celestial bliss. In the aura of their seizures. Y e t t h e v e r y t h i n g t h a t c h a r a c t e r i z e s the Da-sexn o f a g o r a p h o b i c people is a lack of i n d e p e n d e n t f i r m n e s s . o r a t m o . T h e y panic in t h e middle ol closed. t h e y t h e r e f o r e f e a r bodily collapse and loss of c o n s c i o u s n e s s .t e m p o r a l a r e n a o f t h e i r Da-sein m a y b e subject to an overwhelming expansion. c r o w d e d r o o m s w h i c h o b s t r u c t the possibility of i m m e d i a t e escape at any m o m e n t . o n t h e o t h e r hand. t h e s e areas o v e r t a x and o v e r w h e l m t h e m . C l a u s t r o p h o b i c s .. In an i n s t a n t . C o n s e q u e n t l y . t h a t t h e ability of such people to r e l a t e to w h a t is in I h e n world i s severely reduced t o only o n e .s t a t i c a l l y in a s h a r e d h u m a n world. I n s t e a d . i.o p e n n e s s t h e y are e x i s t i n g i n t h e t i m e b e f o r e t h e i r s e i z u r e b e c o m e s infinite in r i c h n e s s and e x t e n t .t i m e t r a n s p o r t i n t o u n f a t h o m a b l e r e a l m s . T h u s w e p e r v a d e t h e open spaces w i t h o u r o w n e x i s t e n t i a l p e r c e p t i v e o p e n n e s s . Another instance of extremely severe impairment in the existential t e m p o r a l i t y of a Da-sein is s e e n in t h e m o d e of b e i n g .t h e .w o r l d t h a t epileptics m a n i f e s t . this e x i s t e n t i a l w o r l d . I f t h e a c c o u n t s o f t h e epileptics t h e m s e l v e s are believed. T h e s p a t i o .o p e n n e s s o f infinite g r a n d e u r m a y collapse i n t o t h e blackest o b s c u r i t y o f p r o f o u n d u n c o n s c i o u s n e s s . h o w e v e r . the w o r l d . t h e . and puts i t i n t o t h e p s y c h i c r e a l m . M o r e s t r i k i n g l y d i s t u r b e d i s t h e a t t u n e m e n t o f p a t i e n t s s u f f e r i n g from e n d o g e n o u s . T h e y c a n n o t decide w h i c h o f t h e p h e n o m e n a t h e y e n c o u n t e r t o dwell by. C l e a r l y . F r o m the p e r s p e c t i v e o f this pervasive a t t u n e m e n t t h e y see e v e r y c o n t o u r o f e v e r y o b j e c t in t h e i r vicinity as an u n b e a r a b l e i m p r i s o n m e n t or c o n s t r i c t i o n . p s y c h i a t r y ' s n o t i o n o f affective i n c o n t i n e n c e is based on t h e a s s u m p t i o n t h a t t h e r e is in people a kind of psychic c o n t a i n e r w h i c h holds. W h a t e v e r t h e y e n c o u n t e r t h e y s t a y w i t h . in epilepsy. Modes of illness showing severe disturbances in actualizing the existential of attunement or mood T h e disturbance of a t t u n e m e n t in the organic psychoses is k n o w n in p s y c h i a t r y a s affective i n c o n t i n e n c e . m a n i c . s o t h a t e v e n t h e s l i g h t e s t p r e s s u r e is e n o u g h to m a k e its c o n t e n t s spill o u t . W h e r e t h e l a t t e r a r e c o n c e r n e d . P a t i e n t s w h o a r e m a n i c inslsl . A h e a l t h y p e r s o n m a y t o a g r e a t e x t e n t decide w h e t h e r t o e n g a g e i n t h e a t t u n e m e n t p r e s e n t l y d o m i n a n t in his e x i s t e n c e and to c h o o s e h o w he will or will not c o n d u c t h i m s e l f t o w a r d w h a t a p p e a r s t o him i n this a t t u n e m e n t . f r o m t h e b e g i n n i n g . T h i s t e r m t a k e s a n idea from t h e r e a l m o f physical p a t h o l o g y . n a m e l y . and in t h e o r g a n i c p s y c h o s e s . a m o n g o t h e r t h i n g s . p a t i e n t s o f this c a t e g o r y are actually s p e l l b o u n d by w h a t t h e y e n c o u n t e r . a psychic s u b s t a n c e in the n a t u r e of an affect. and t h e y p e r s i s t i n t h e m o o d t h a t c o r r e s p o n d s t o its m e a n i n g . A c c o r d i n g l y . In t h e case of o r g a n i c p s y c h o t i c s . t h e d i s t u r b a n c e o f a t t u n e m e n t r a n k s w i t h t h e i m p a i r m e n t s o f spatiality and t e m p o r a l i t y as a third cardinal s y m p t o m .w o r l d t h a t a r e disturbed. i n fact. In all t h e s e e x a m p l e s of illness in w h i c h t h e r e is s e v e r e i m p a i r m e n t of spatiality (the h u m a n being's dwelling a l w a y s . t h e r e is also a d i s t u r b a n c e o f the E x i s t e n t i a l o f a t t u n e m e n t o r m o o d i n p h o b i c illnesses. W h a t e v e r t h e y e n c o u n t e r s u b j u g a t e s and i m p o s e s a n a t t u n e m e n t w h i c h c o r r e s p o n d s t o t h e m e a n i n g i t r e v e a l s . A f f e c t i v e l y i n c o n t i n e n t o r labile p a t i e n t s h a v e lost this f r e e d o m o f c h o i c e . in relation to close and d i s t a n t b e i n g s ) and t e m p o r a l i t y (the h u m a n being's living o u t his t i m e in c a r r y i n g his possibilities of relating to fulfillment at t h e appropriate t i m e ) .i n . for t h i n g s e x e r t s u c h g r e a t p o w e r o v e r t h e m t h a t e a c h n e w p h e n o m e n o n d r a w s t h e m a w a y from the o n e b e f o r e . T h e n a r r o w dwelling space a s w h i c h t h e y e x i s t c o n f i n e s t h e i r Da-sein to an a t t u n e m e n t of c o n s t a n t fear of s u f f o c a t i o n . it is n o t j u s t t h e s e t w o traits of h u m a n b e i n g . P e o p l e w i t h a n epileptic d i s t u r b a n c e a r e v e r y d i f f e r e n t .A General Daseinsanalytic Phenomenology 217 h u m a n c o n t a c t s .d e p r e s s i v e p s y c h o s e s . I n c o n t r a s t t o this u n r e a l i s t i c p s y c h i a t r i c h y p o t h e s i s . it is i m a g i n e d t h a t this c o n t a i n e r loses its i n t e g r i t y . u r i n a r y i n c o n t i n e n c e . and n e c e s s a r i l y . quickly r e a t t u n i n g t h e m i n t h e p r o c e s s . and in t h e m e a n t i m e lose t h e first. n e i t h e r t o w h a t t h e y t h e m s e l v e s are. and happy. Life s e e m s o n e big c a r n i v a l t o t h e m . this h a p p i n e s s looks v e r y d i f f e r e n t from t h e open. O n c e again.-in I h e . W h a t psychiatry found most arresting in the characteristic manic way o f relating t o t h e w o r l d w e r e t h o s e p h e n o m e n a w h i c h its s u b j e c t i v i s t i c theory saw as disturbances of two separate psychic functions. c h e e r f u l c a l m o f h e a l t h y people w h o h a v e m a t u r e d e n o u g h to c a r r y o u t t h e i r i n h e r e n t p o t e n t i a l i t i e s in a g e n u i n e l y free and i n d e p e n d e n t w a y . . b u t t h e m a n i c p e r s o n does lose h i m s e l f and t h e b e i n g s of his w o r l d in a dizzying spiral o f s n a t c h i n g a t a n y t h i n g t h a t c o m e s his w a y . " In t h e m a n i c s t a t e . h o w e v e r . T h e y c a n n o t m a i n t a i n w h a t t h e y e n c o u n t e r i n space a n d t i m e w h e r e it is n o r let it c o m e i n t o being as w h a t it has to be. B u t a s n e a r t o t h i n g s a s t h e y i m a g i n e t h e m s e l v e s . s t r o n g .w o r l d . n o r t h a t t h e r e is a c o m p u l s i o n driving t h e m f r o m s o m e w h e r e inside t o c e a s e l e s s activity.218 EXISTENTIAL FOUNDATIONS t h a t t h e y h a v e n e v e r b e f o r e felt s o h e a l t h y . m e l a n c h o l y v e r y o f t e n s h o w s t h r o u g h t h e wildest a r r o g a n c e . p a t i e n t s h a v e available a s t h e i r w o r l d o n l y t h e m o s t n a r r o w r e a l m o f t i m e . o b s e r v e d t h a t "during t h e w h o l e m a n i c p h a s e . It h a s n o t . T h e y are g r a n t e d n o s e r i o u s e n g a g e m e n t i n w h a t t h e y h a v e greedily looted but i m m e d i a t e l y fall prey to w h a t e v e r it is t h a t n e x t m e e t s t h e i r e y e s . W h e n w e look a t w h a t h a p p e n s . In t h e middle of t h e last c e n t u r y . and o v e r s h o o t a n y p l a n n e d future a s well. t h e r e i s n o e v i d e n c e t o indicate t h a t ideas o r r e p r e s e n t a t i o n s r a c e a r o u n d i n t h e heads o f t h e s e p a t i e n t s . T h e p h e n o m e n a t h e p a t i e n t e n c o u n t e r s i n his world have irresistible p o w e r to seduce h i m i n t o s u r r e n d e r i n g greedily to I hem M a n n p a t i e n t s o v e r r u n t h e past and p r e s e n t . Psychia­ t r i s t s s p o k e o f typically m a n i c c o m p u l s i v e activity and o f t h e m a n i c flight o f ideas. h o w e v e r . T h e p e r c e p t i o n of t h e s e p a t i e n t s is so s e v e r e l y r e s t r i c t e d t h a t in e a c h t h i n g t h e y e n c o u n t e r t h e y s e e a l m o s t n o t h i n g b u t a single s i g n i f i c a n c e G e v e r y t h i n g a d d r e s s e s t h e m only as s o m e t h i n g to be seized and g o b b l e d up. Griesinger. w e m u s t explode t h e traditional m y t h o f a n e n c a p s u l a t e d p s y c h e and learn t o r e c o g n i z e manically disturbed Da-sein as a deficient m o d e of f u n d a m e n t a l being.s p a c e . t h e y can n e v e r c o m e close t o a n y p r e s e n c e . an acknowledged expert on manic-depressive insanity. t h o u g h also e m p t y and u n ­ grounded. T h i s w h i r l w i n d s w e e p s his w h o l e past and f u t u r e i n t o t h e p r e s e n t i n s t a n t . swelling o u t o f p r o p o r t i o n for him t h e i m p o r t a n c e o f t h e e x i s t e n c e o f t h e m o m e n t .c e n t e r e d . like a dark b a c k d r o p . T h e y k n o w n o open free e n c o u n t e r w i t h t h e p h e n o m e n a o f t h e i r w o r l d . O n c l o s e r i n s p e c t i o n . e n t i r e l y dropped o u t o f t h e i r o p e n r e a l m o f p e r c e p t i o n . as w i t h o r g a n i c p s y c h o t i c s . n o r t o w h a t i s n o t t h e m . T h e y m u s t t h e n t r y t o bring t h e n e w thing u n d e r t h e i r p o w e r . T h i s inflation is m a n i f e s t e d in a feeling of o m n i p o t e n c e t h a t is b o u n d l e s s and a b s o l u t e l y s e l f . and culpability. and t h e f u t u r e . and t h e w o r l d ' s . b u t this is an illusion.u ly . T h e r a p y along t h e s e lines m u s t i n e v i t a b l y fail. w o r t h l e s s n e s s . T h i s reduction is v e r y d i f f e r e n t from t h a t p r e d o m i n a t i n g i n t h e m a n i c p h a s e . B u t w h i l e t h e m a n i c s e e s h i m s e l f a s a n o m n i p o t e n t . it is still m o r e a p p a r e n t f r o m t h e p o w e r in any obstacle to their self-glorification. T h i s a l o n e c o n s i g n s t h e m t o a n e m p t i n e s s t h a t i s b e n e a t h h u m a n dignity. is r e s t r i c t e d to t h e fearful e x p e c t a t i o n of t h e i r o w n . Like m a n i c s .A General Daseinsanalytic Phenomenology 219 T h i s s t e a m r o l l e r e f f e c t g i v e s t h e i m p r e s s i o n o f a truly p o w e r f u l s e n s e o f self. M e l a n c h o l i e s are e n t a n g l e d in a n e t of e n d l e s s c o m p l a i n t s a b o u t s o m e m o r t a l sin t h e y c o m m i t t e d i n t h e distant past. c a u s i n g t h e m to b r e a k o u t again and again in blind. T h e y will c o m p l a i n m o n o t o n o u s l y t h a t n o t h i n g i n t h e i r lives w o r k s a n y m o r e . a n n i h i l a t i o n . M e l a n c h o l i e s can discover no thing of worth in their existence because their modes of r e l a t i n g t o t h e w o r l d (as w h i c h t h e y e x i s t ) are n o t t h e i r o w n . T h e melancholic disposition is l i k e w i s e a m o d e of fulfilling t h e E x i s t e n t i a l o f a t t u n e m e n t w h i c h i n v o l v e s r e d u c t i o n i n t h e p e r c e p t i v e o p e n n e s s and responsiveness to the address of w h a t is encountered. godlike c r e a t u r e for w h o m e v e r y t h i n g e x i s t s o n l y a s m a t e r i a l t o c o m p l e t e his o w n e x t e n d e d dimensions. T h a t this is so is e v i d e n t from t h e false. M e l a n c h o l i e s are b a r r e d f r o m this kind o f r e s p o n s e t o w h a t a d d r e s s e s t h e i r Da-sein. b o t h to t h e p a t i e n t h i m s e l f a n d to t h e o u t s i d e o b s e r v e r . M i n i s t r a t i o n s f r o m t h e o u t s i d e w o r l d . c a n n o t free t h e m f r o m t h e m e s h e s o f t h e long a g o . d e s t r u c t i v e r a g e s . N o t h i n g is p r e s e n t to t h e m e x c e p t w h a t t e s t i f i e s to t h e i r guilt. n o m a t t e r h o w well i n t e n t i o n e d o r p e r s i s t e n t . and t h e w o r l d a r o u n d t h e m t h e y s e e o n l y as far as it is directly r e l a t e d to t h e m in a p a r t i c u l a r w a y . T h e r e a s o n n o t h i n g w o r k s a n y m o r e i s t h a t for t h e m t i m e h a s stopped. for h u m a n being can h a p p e n o n l y in living o u t its t i m e . S u c h a f u t u r e is b o u n d up e n t i r e l y w i t h t h e past. f o r c e d e u p h o r i a t h e s e p a t i e n t s e x p e r i e n c e . m e l a n c h o l i e s can see o n l y t h e m s e l v e s . H e o f t e n l a t c h e s o n t o o t h e r s t h e w a y d r o w n i n g people lock o n t h e life p r e s e r v e r s t h a t a r e t h r o w n t h e m . T h e p r o b l e m i s t h a t w i t h o u t proper g u i d a n c e t h e y s t u b b o r n l y single o u t s o m e m i n o r y o u t h f u l folly a s the i r r e p a r a b l e o f f e n s e t h a t is t h e s o u r c e of t h e i r u n h a p p i n e s s and guilt feelings. no less d o o m e d . A n y t h i n g t h a t m a y r e m a i n o p e n to his limited p e r c e p t i o n is e x p e r i e n c e d as an a c c u s a t i o n and a p r o o f o f his w o r t h l e s s n e s s . Clinical psychiatry's m e t h o d of routine questioning is equally b a r r e d from d i s c o v e r i n g t h e t r u e n a t u r e of t h e guilt t h a t s e t t l e s so e. T h e slightest opposition is enough to d e s t r o y t h e i r e q u a n i m i t y . b e c a u s e t h e p a t i e n t s are c o r r e c t in e x p e r i e n c i n g feelings o f guilt. i n f e r i o r i t y . c a r r y i n g to fulfillment its i n b o r n possibilities f o r r e l a t i n g to w h a t e v e r a d d r e s s e s it. the melancholic sees in himself nothing but emptiness. F u r t h e r m o r e .h o n e s t y . p o s t n a t a l i n f l u e n c e s m a y i n t e r v e n e to disrupt t h e realization o f i n d e p e n d e n l sell h o o d In o n e case. m i g h t affect his m a t u r i n g t o an independent s e n s e ol gel! . afraid to risk losing t h e f a v o r a b l e r e g a r d of o t h e r s . always p e r c e i v e d t h e m e a n i n g f u l appealing a d d r e s s o f t h i n g s and had n e v e r c e a s e d t o h e a r this appeal. t h a t proved i m p o s s i b l e for e v e r y f u t u r e m e l a n c h o l i c w h o has b e e n t h o r o u g h l y e x a m i n e d . T h e y e x p e r i e n c e d this g r o w i n g debt to t h e i r unfulfilled i n b o r n possibilities for e x i s t i n g a u t h e n t i c a l l y as t h e t r u e basis o f t h e i r i n c e s s a n t s e l f . i n fact. t h e n e g a t i v e a t t i t u d e o f t e a c h e r s and p e e r s might m o v e a pel son to p a t h o g e n i c self-denial. n o t e v e n during t h e i r t i m e s o f m e l a n c h o l i a . for e a c h case.a n n i h i l a t i o n on a scale far e x c e e d i n g t h a t of t h e self-violation s h o w n in people s u f f e r i n g f r o m h y s t e r i c a l o r c o m p u l s i v e illnesses. t h e r e b y allowing w h a t i s e n c o u n t e r e d to unfold i t s e l f in o u r o p e n r e a l m of p e r c e p t i o n . delusional forms. endo 0 1 e x o g e n i c . T h e i m p o r t a n t q u e s t i o n n o w arises o f precisely h o w t h o s e w h o will b e m e l a n c h o l i e s a c q u i r e a d e p e n d e n c y and n e e d for love so s t r o n g t h a t it can c o m m a n d t h e m to p r a c t i c e such a c o m p l e t e self-denial vis-a-vis t h e world. T h e r e a r e . R e m a i n i n g painfully open t o this appeal. O r . a s such. F i r s t . t h e y would n o t h a v e had t o s u f f e r a s f e w o t h e r h u m a n b e i n g s e v e r m u s t . yet unable to respond with authentic behavior of their own.220 EXISTENTIAL FOUNDATIONS on m e l a n c h o l i e s . s e c o n d . t h e y p e r s i s t e n t l y denied t h e i r selfhood. g e n u i n e self and c a r r y it to fulfillment. practicing this lifelong s e l f . h o w e v e r . In p s y c h o t h e r a p e u t i c t r e a t m e n t s e x t e n d i n g o v e r a period o f y e a r s . w i n n i n g distinction as an i n d e p e n d e n t being. F r o m a v e r y e a r l y age. a t least t w o distinct possibilities. Instead. E a c h b e g a n b y l e a r n i n g t h a t the m e a n i n g of h u m a n being i n h e r e s in r e s p o n d i n g . All e n d o g e n i c m e l a n c h o l i e s w h o h a v e u n d e r g o n e r i g o r o u s . w h e r e t h e patient i s led t o c o n f r o n t h i m s e l f w i t h r e l e n t l e s s s e l f . t h e t r u e n a t u r e o f his individual m o r t a l sin becomes apparent. t h e r e m a y be s o m e i n n a t e deficiency t h a t p r e v e n t s a person from developing early e n o u g h i n t o a n a u t o n o m o u s self and. T h e y had. t o w h a t w e e n c o u n t e r . c h e m i c a l t o x i n s . all e n d o g e n i c m e l a n c h o l i e s q u e s t i o n e d a p p r o p r i a t e l y h a v e s h o w n a similar p a t t e r n in t h e d e v e l o p m e n t of t h e i r " s i n f u l " b e h a v i o r . h o w e v e r . i n a n o t h e r . w i t h all of o u r i n b o r n possibilities. W e r e this n o t so. a p p r o p r i a t e analysis h a v e r e v e a l e d t h e s o u r c e for t h e i r illness. despite t h e fact t h a t t h e s e r e c r i m i n a t i o n s o f t e n a s s u m e d a b s t r u s e . It is precisely t h i s . e a c h o f t h e m r e l e g a t e d t h e significance o f his o w n i n b o r n possibilities s o far b e l o w t h a t o f t h e d i c t a t e s — a c t u a l o r i m a g i n e d — o f t h e s u r r o u n d i n g w o r l d t h a t t h e y w e r e n o t able t o g a t h e r t h e i r e x i s t e n c e i n t o a reliable. they grew daily m o r e i n d e b t e d to t h e i r Da-sein.r e c r i m i n a t i o n s a b o u t the past. A General Daseinsanalytic Phenomenology O n e t h i n g a b o u t the p a t h o g e n e s i s o f e n d o g e n i c m e l a n c h o l i a . I hell s o r r o w is o f such i n t e n s i t y t h a t it o f t e n involves the bodily s p h e r e ol t h e n . o f t h e ability t o body f o r t h specific h u m a n w a y s o f being. is c e r t a i n from t h e s t a r t . E v e n if it w e r e d e m o n s t r a t e d that c e r t a i n m e l a n c h o l i e s e x h i b i t m e t a b o l i c d y s f u n c t i o n s o r toxicity during then periods o f d e p r e s s i o n . Q u i t e o f t e n . w h e n m e l a n c h o l i e s are d r a w n i r r e s i s t i b l y t o w a r d it as t h e o n l y w a y o u t of t h e i r u n e n d u r a b l e n u m b n e s s . T h e y a r e h o r r i f i e d t o d i s c o v e r t h a I t h e y h a v e suddenly b e e n t o r n l o o s e from G o d . and u n s u r p a s s a b l e e x i s t e n t i a l p o t e n t i a l i t y : dying. I n fact. No m a t t e r what m e t h o d is u s e d in e x a m i n i n g t h e b o d y h o o d of m e l a n c h o l i c p a t i e n t s . this w o u l d still n o t explain t h e i r illness a s the h u m a n e x i s t e n t i a l p h e n o m e n o n it is. B e y o n d the fact t h a t it is difficult to k n o w w h e t h e r physical e v i d e n c e in m e l a n c h o l i e s is simply a c o n s e q u e n c e of b e h a v i o r a l d i s t u r b a n c e s . m o s t a u t h e n t i c . h o w e v e r . w e can u n d e r s t a n d w h y s o m e m e l a n c h o l i e s e x p e r i e n c e t h e t i m e b e t w e e n t h e decision and the act o f suicide as o n e of joyful fulfilling liberation. N o s o o n e r has m e l a n c h o l y cast its first s h a d o w s o v e r t h e m than e v e n t h e m o s t devout b e l i e v e r s find t h e y can n o l o n g e r pray. W h e r e e n d o g e n i c m e l a n c h o l i a i s c o n c e r n e d . K n o w i n g t h i s . and even if f u t u r e discoveries produced a c o m p l e t e l y reliable p h a r m a c e u t i c a l t h e r a p y . o n t h e o n e hand. is as m e a n i n g l e s s as it is in relation to any other pathological h u m a n p h e n o m e n o n . It is possible t h a t t h e suicides of m e l a n c h o l i e s r e p r e s e n t t h e s a m e a t t e m p t t h a t leads to feelings of godlike o m n i p o t e n c e in t h e f r e n e t i c selfinflation o f m a n i c s . h o w e v e i . t h e ruling principle of t h e D a s e i n s a n a l y t i c p a t h o l o g y r e m a i n s valid. t h e t e r m " e n d o g e n i c . T h i s m a y c o m e a b o u t i n t w o w a y s . o n e o f t h e e a r l i e s t c o m p l a i n t s o f m e l a n c h o l i e s m a y h i n t a t s o m e t h i n g s t r i v e n for i n b o t h kinds o f illness. t h e t r u e n a t u r e of m e l a n c h o l i a can only b e u n d e r s t o o d i n t e r m s o f loss o f freedom o v e r m o d e s o f a t t u n e m e n t and o f d i s t u r b a n c e s i n actualizing t h e o t h e r basic e x i s t e n t i a l traits. i n n a t e o r acquired. a m e l a n c h o l i c will c h o o s e suicide as the last available act o f f r e e will. T h i s i s w h y m e l a n c h o l i e s a r e s o p r o n e t o suicide. All h u m a n beings are f u n d a m e n t a l l y m o r e or less cut o f f from the a b s o l u t e and reduced to individual limited e x i s t e n c e s . All bodily p a t h o l o g i c a l s y m p t o m s a r e t o b e s e e n e x c l u s i v e l y a s impaii m e n t s . m a n y o f t h e s e suicides r e p o r t t h a t being able t o c h o o s e death w a s like a leap o u t of a t o r t u r e d d e s p e r a t i o n and a d e v a s t a t i n g isolation into a comforting embrace. I t h a p p e n s . In t h e t e s t a m e n t s t h e y leave behind. " implying a bodily c o n t a i n e r . s o r r o w is g r o u n d e d in this condition M e l a n c h o l i e s s e e m to be e x c e e d i n g l y s e n s i t i v e to this schism. f O n l y o n e e s s e n t i a l possibility r e m a i n s o p e n t o m e l a n c h o l i e s — t h e m o s t e x t r e m e . we would not t h e r e b y h a v e a real u n d e r s t a n d i n g of t h e p h e n o m e n o n itself. finally falling into simple d e p r e s s i o n . d e p r e s s i o n s . F u r t h e r m o r e . g e n u i n e m e l a n c h o l i e s a r e far o u t n u m b e r e d b y people suffering from t h e p r e s e n t r e p r e s e n t a t i v e f o r m o f n e u r o s i s . t h e d i a g n o s e s often c h a n g e d w i t h t i m e from m o o d d i s t u r b a n c e to s c h i z o p h r e n i a . T h i s applies t o b o t h e n d o g e n o u s and r e a c t i v e d e p r e s s i o n . w h o has said t h a t " e n d o g e n o u s d e p r e s s i o n is n o t n e a r l y as devoid of e x t e r n a l influence as is generally supposed. from t h e n o n o r g a n i c n e u r o t i c d i s t u r b a n c e s quickly gained a s c e n d a n c y . M o r e a t t e n t i o n should also be paid in t h e f u t u r e to the s t a t e m e n t s o f clinical r e s e a r c h e r s a s e x p e r i e n c e d a s W . S c h u l t e . s o t h a t he no l o n g e r practiced n e g a t i o n of his selfhood as a d e f e n s e a g a i n s t loss o f love b u t i n s t e a d s t a y e d t r u e t o his i n n e r m o s t n a t u r e i n e v e r y t h i n g he did. E v e n a m o n g n o n h o s p i t a l i z e d p s y c h o n e u r o t i c a l l y disturbed people. display sufficient m o t i v a t i o n in t h e p a t i e n t ' s situation at a g i v e n t i m e . 10 T o d a y . u n l i k e e n d o g e n o u s .222 EXISTENTIAL FOUNDATIONS e x i s t e n c e . I f h y s t e r i c a l p h e n o m e n a c o m m a n d e d t h e field o f n e u r o s e s from t h e t i m e o f C h a r c o t and F r e u d u p t o t h e end o f t h e F i r s t W o r l d W a r . T h e t e n d e n c y today i s i n c r e a s i n g l y t o w a r d d e p r e s s i v e illnesses. P s y c h i a t r y c o m m o n l y d i s t i n g u i s h e s b e t w e e n e n d o g e n o u s and r e a c t i v e d e p r e s s i o n s . R e a c t i v e . m o s t w h o seek help today are people h o r r i b l y d e p r e s s e d by t h e m e a n i n g l e s s n e s s and tedium ol t h e n lives. it is n o t r a r e for m e l a n c h o l i e s to feel pain at the back o f t h e i r e y e s o c k e t s ." But the greatest reason to doubt t h e distinction is t h e fact t h a t h i g h l y successful p s y c h o t h e r a p e u t i c c u r e s h a v e b e e n e f f e c t e d e v e n o n p a t i e n t s w h o had b e e n clearly diagnosed beforehand as endogenous melancholies. especially in his h u m a n r e l a t i o n s h i p s . t h e value o f any distinction m a d e b e t w e e n t h e t w o types of d e p r e s s i o n is dubious in any e t i o l o g y . N o w a d a y s . and t h e y a r e p r o n e t o c h e s t pains t h a t s e e m t o t i g h t e n a r o u n d t h e i r u p p e r t o r s o s like i r o n b a n d s . p a t i e n t s initially classified as s c h i z o p h r e n i c lose t h e i r specifically s c h i z o p h r e n i c s y m p t o m s o v e r the y e a r s . T h e s e cures came about in c a s e s w h e r e t h e p s y c h o t h e r a p i s t w a s able t o give his e n d o g e n o u s d e p r e s s i v e p a t i e n t t h e c o u r a g e t o radically c h a n g e t h e w a y h e lived. a m o n g p a t i e n t s w h o w e r e hospitalized r e p e a t e d l y . S u r v e y i n g old case h i s t o r i e s o f m e n t a l i n s t i t u t i o n s w e find t h a t . A n e x p e r i e n c e d clinical r e s e a r c h e r will freely c o n c e d e t h a t e n d o g e n o u s and r e a c t i v e d e p r e s s i o n s c a n n o t b e s e p a r a t e d p h e n o m e n a l l y . but only a c c o r d i n g t o t h e i r r e s p e c t i v e c a u s e s . S i n c e n e i t h e r definitive e m o t i o n a l n o r psyi h o i o m a t i i s y m p t o m s . this distinction is on s h a k y footing. B u t we m u s t e m p h a s i z e o n c e again t h a t n o e t i o l o g y suffices t o explain pathological h u m a n b e h a v i o r a s t h e e x i s t e n t i a l p h e n o m e n o n i t is. T h e s e s u f f e r i n g s o f m e l a n c h o l i e s t e s t i f y c l e a r l y t o t h e e s s e n t i a l c o n n e c t i o n b e t w e e n physical and m e n t a l pain w e indicated earlier. S i n c e the c a u s e o f e n d o g e n o u s d e p r e s s i o n is admittedly u n k n o w n . F o r i n s t a n c e . w h a t is. In the a n x i o u s e x p e c t a t i o n o f i m m i n e n t a n n i h i l a t i o n o f its b e i n g . and we s e e d r a m a t i c a l l y t h e i m p a i r m e n t o f p e r c e p t i v e o p e n n e s s w h i c h b o r e d o m is.i n . t h e s e p a t i e n t s and t h e i r physicians a r e at a loss. p r e s e n t . T h e r e is no genuine future. and w h a t is e x p e c t e d . t h e sick p e r s o n in his e n t i r e t y is b o r e d and w e a r i e d . i t still r e m a i n s w i t h i n the w o r l d of t h e o n e w h o is b o r e d . no s u p p o r t i n g past. only a m e a n i n g l e s s p r e s e n t . and tedious. In the m o d e r n n e u r o t i c w h a t is m o s t deeply affected is his ability to actualize h i m s e l f i n time a t t h e r i g h t t i m e . as t h e y do in b o r e d o m . Da-sein f e a r s t h e approach of an e m p t i n e s s . S u f f e r i n g as t h e y do. b u t far e n o u g h so it hardly c o n c e r n s t h e afflicted p e r s o n a n y m o r e . T h e m o s t salient c h a r a c t e r i s t i c o f s c h i z o p h r e n i a l l this . for n o m a t t e r h o w far o f f s o m e t h i n g m a y g e t . w e a r i s o m e . o r d r u g s . W e h a v e already described a n x i e t y a s a n a t t u n e m e n t t h a t limits t h e p e r c e p t i v e r e s p o n s i v e o p e n n e s s of t h e Da-sein to perceiving t h e o n e possibility t h a t it can lose all r e l a t e d n e s s to t h e w o r l d . Da-sein f e a r s t h e total r e m o v a l of all t h a t s u p p o r t s it. t h e depressive a t t u n e m e n t o f b o r e d o m and m e a n i n g l e s s n e s s t h a t prevails in this age s h o w s clearly. of its n o t b e i n g . t h e s e people often try to d r o w n o u t t h e i r d e s p e r a t i o n t h r o u g h addiction t o w o r k . a n x i e t y i n t r o d u c e s Dasein to t h e possibility of its o w n ending. t o o . In the c o n v e n t i o n a l s e n s e . T h e m o d e r n c l e r g y m a n . W h e n this fails. Modes of illness encroaching primarily on the openness and freedom of the da-sein All f o r m s of illness described so far e n c r o a c h on t h e possibility ol realizing t h e basic o n t o l o g i c a l n a t u r e o f h u m a n e x i s t e n c e : freedom and o p e n n e s s t o w a r d o t h e r h u m a n b e i n g s and t o w a r d all the o t h e i b e i n g s e n c o u n t e r e d . In s u c h a n x i e t y a h u m a n being finds no support in his fellows n o r in t h e t h i n g s of his world. i n t a n g i b l e a n x i e t y usually t a k e s hold of people s u f f e r i n g f r o m n e u r o s e s o f b o r e d o m and m e a n i n g l e s s n e s s . B u t in a n x i e t y . In a n x i e t y . At t h e s a m e t i m e .t h e r e a n y m o r e . all t h e o t h e r possibilities of relating to past. W h a t e v e r does r e v e a l i t s e l f t o him i m m e d i a t e l y r e t r e a t s — n o t e n t i r e l y o u t of his world.w o r l d . a v a g u e . p l e a s u r e . t h e t h r e a t is n o t m e r e l y t h a t p r e s e n c e s recede i n t o an i n d i f f e r e n t d i s t a n c e . T h e t h r e e t e m p o r a l d i m e n s i o n s a r e voided i n t o m e a n i n g l e s s c o n n e c t i o n t o w h a t has b e e n . and f u t u r e a r e b l a n k e t e d in d a r k n e s s . It is in t h e n a t u r e of b o r e d o m to let p h e n o m e n a be p e r c e i v e d as t h e y r e v e a l t h e m s e l v e s to a p e r s o n only to the e x t e n t t h a t all o b j e c t s and o t h e r people are r e v e a l e d a s u n i f o r m l y m e a n i n g l e s s e n t i t i e s . is at a loss to help. A n e s s e n t i a l l y b o r e d and depressed p e r s o n can b e w h o l e h e a r t e d l y e n g a g e d b y n o t h i n g .t h e .A General Daseinsanalytic Phenomenology 223 p r e d o m i n a t e . an all-annihilating void. 1 1 O v e r t i m e . t h e y are n o t sick. N o t o n l y p a r t i c u l a r t h i n g s b e c o m e b o r i n g . T h e scientific value of this p s y c h i a t r i c c o n c e p t of t h e p e r s o n a l i t y is in q u e s t i o n . I f t h e p h e n o m e n o l o g i c a l definitions o f s c h i z o p h r e n i a have up to n o w failed. 1 1 <• hoi h below or . s c h i z o p h r e n i a is o n e of the c o m m o n e s t o f h u m a n illnesses. o r family p a t t e r n s a s u n e q u i v o c a l c a u s e s o f modes of schizophrenia. causal. O n l y a t r u e p h e n o m e n o l o g i c a l a p p r o a c h can clarify a h u m a n p h e n o m e n o n a s such.224 EXISTENTIAL FOUNDATIONS e n c r o a c h m e n t . such a s t h e a p p e a r a n c e o f hallucina­ t i o n s o r delusions. and (c) s u b j e c t i v e d e p e r s o n a l i z a t i o n of t h e e g o . All t h r e e o f t h e s e supposedly p r i m a r y s y m p t o m s a r e r e g a r d e d a s the expression of a disturbance of the whole personality. tends to use v a g u e c o n c e p t s . t h e y would n e v e r in principle h a v e led to a clarification of s c h i z o p h r e n i c b e h a v i o r as w h a t it is in itself. b u t t h e i r j a i l e r s . w h o are their fellow h u m a n b e i n g s . t h e r e b y a b a n d o n a w a y to a c h i e v e a w a r e n e s s and insight into t h e i r o w n n a t u r e . T h e r e are i m p o r t a n t r e a s o n s to include a d i s c u s s i o n of s c h i z o p h r e n i a in a D a s e i n s a n a l y t i c approach to m e d i c i n e . O n the o t h e r hand. C u r r e n t p s y c h i a t r y . s u c h illness lends i t s e l f to e x p l o r a t i o n of t h e fragile f r e e d o m t h a t is peculiar t o h u m a n e x i s t e n c e . h o w e v e r . Equally fruitless have been a t t r i b u t i o n s of m e t a b o l i c d i s t u r b a n c e . whu h . F i r s t . but to h u m a n i t y as a w h o l e . T h e alteration of single d i s c r e t e psychic f u n c t i o n s . g e n e t i c a l l y d e t e r m i n e d f a c t o r s h a v e had n o c o n v i n c i n g result. Indeed. s o c i e t y i t s e l f often p r e v e n t s s u c h r e s e a r c h by d i s a v o w i n g and locking a w a y people suffering from s c h i z o p h r e n i a . R e s e a r c h into its g e n e s i s and e t i o l o g y in h o p e of finding c o n c r e t e . medical s c i e n c e h a s so far failed to u n d e r s t a n d it in scientific t e r m s . it is b e c a u s e t h e y have g e n e r a l l y outlined in less t h a n scientifically a d e q u a t e t e r m i n o l o g y the following s y m p t o m triad: (a) l o o s e n i n g and d i s i n t e g r a t i o n of t h o u g h t p r o c e s s e s . E v e n if definite s o m a t o g e n e t i c or p s y c h o g e n e t i c f a c t o r s had been discovered and e s t a b l i s h e d b e y o n d a n y d o u b t . i s n o t c o n s i d e r e d t o b e s c h i z o p h r e n i a . a d i s t u r b a n c e so s e r i o u s t h a t it is of c o n c e r n not only to p s y c h i a t r i s t s and s c h i z o p h r e n i c s . Y e t t h e r e is a g r e a t deal of c o n v i n c i n g e v i d e n c e . I t d o m i n a t e s p s y c h i a t r i c r e s e a r c h . U n f o r t u n a t e l y . t o o . t h a t levels of i n n e r d i s i n t e g r a t i o n and opposition b e t w e e n c o n t r a d i c t o r y i n n e r d e v e l o p m e n t a l t e n d e n c i e s . O n t h e c o n t r a r y . N o t only a r e t h e s e people t h e n deprived o f t h e loving h u m a n a t t e n t i o n t h e y s o s t r o n g l y r e q u i r e . even i n its s t a t e m e n t s o n s c h i z o ­ p h r e n i a . specific f o r m s o f e m o t i o n a l t r a u m a . P e r s o n a l i t y is r e g a r d e d w i t h o u t e x c e p t i o n as a p r i m a r y i n n e r life. (b) d i s t u r b a n c e of affect. h o w e v e r . a m a s s e d by p s y c h o a n a l y s i s w h o treat s c h i z o p h r e n i a . it is believed t h a t c h a n g e s in t h e individual psychic f u n c t i o n s appear w h e n the p e r s o n a l i t y as a w h o l e is sick. and t h e illness of s c h i z o p h r e n i c p a t i e n t s is t h e n v i e w e d as an e x t r e m e d i s i n t e g r a t i o n and discord a m o n g the i n t r a p s y c h i c a s p e c t s t h a t m a k e up t h e p e r s o n a l i t y . T o k n o w and c o m p r e h e n d the outside w o r l d t h e p e r s o n w h o is n o t a passive r e c e p t a b l e m u s t literally g r a s p it. C l e a r l y . W h e r e . e c . h a v e little to no r e l a t i o n s h i p to t h e d e v e l o p m e n t of s c h i z o p h r e n i a in t h e s e p a t i e n t s . N e i t h e r i n e n c o u n t e r i n g n o r i n c o n f r o n t i n g t h e i r fellow h u m a n b e i n g s and the t h i n g s t h a t c o n s t i t u t e t h e w o r l d o f e x p e r i e n c e a r e t h e y able t o m a i n t a i n t h e free s t a n c e c h a r a c t e r i s t i c of h e a l t h y people and h e a l t h y r e l a t i o n s h i p s . m a y we find e v e n a t r a c e of t h e actual p r e s e n c e of such a psychic c a p s u l e ? A n d we h a v e y e t to s e e a d e m o n s t r a t i o n o f the actual e x i s t e n c e o f i n t r a p s y c h i c m e n t a l r e p r e s e n t a ­ t i o n s o f reality o r o f q u a n t i t a t i v e l y m e a s u r a b l e drives. i t d e s t r o y s his selfhood. c o n s c i o u s n e s s .w o r l d w h e n h u m a n e x p e r i e n c e i t s e l f is s e e n as open.t h e .i n . t h e n . and he can do this o n l y by e x t e n d i n g to t h a t w o r l d in w h o s e i m m e d i a t e vicinity h e already is. H u m a n behavior cannot be comprehended in t e r m s of a boxlike psyche n o r as a similarly c o n s t i t u t e d e g o . It is this lack of f r e e d o m and o p e n n e s s w i t h r e g a r d t o w h a t i s e n c o u n t e r e d t h a t demonstrates fundamental disturbance in the very existence of the schizophrenic. It is in this s e n s e t h a t scientific u n d e r s t a n d i n g of t h e s c h i z o p h r e n i c Dasein is a p h a s e in t h e c o m p r e h e n s i o n of t h e p h e n o m e n o n of h u m a n e x i s t e n c e as a w h o l e . It would s e e m . t h e n . It is h u m a n e x i s t e n c e as a p r i m a r y r e a l m of o p e n n e s s t h a t m a k e s possible a n y relation to t h a t w h i c h is and will be e n c o u n t e r e d . T h i s . is t a n t a m o u n l to . S c h i z o p h r e n i a will be r e c o g n i z e d in its e n c r o a c h ­ m e n t o n t h e freedom o f b e i n g . t h a t h e s t r i v e s t o escape this d e s t r u c t i o n by m a i n t a i n i n g a rigid d i s t a n c e from e n c o u n t e i ing b e i n g s . we w o u l d be a m i s e r a b l e species w i t h n o inkling t h a t t h e r e i s a n o u t s i d e w o r l d .A General Daseinsanalytic Phenomenology 225 a b o v e a v e r a g e in v a r i o u s p a t i e n t p o p u l a t i o n s . A D a s e i n s a n a l y t i c v i e w of the existence of the Schizophrenic reveals it to be unable to sustain or m a i n t a i n t h a t open worldly r e a l m o f the ability t o p e r c e i v e i n t h e w a y t h a t h e a l t h y h u m a n b e i n g s do. or p e r s o n .s t a t i c b e i n g . t h a t c o n t r a s t s and o p p o s i t i o n s w i t h i n t h e c o n s t i t u ­ tional e l e m e n t s of t h e p e r s o n a l i t y c a n n o t be r e g a r d e d as a p a t h o g n o m i c feature of schizophrenia.i n . T h e c o n c e p t i o n o f h u m a n e x p e r i e n c e as a s e r i e s of p h y s i o c h e m i c a l r e a c t i o n s t h a t relay i m p r e s s i o n s from t h e s e n s e o r g a n s t o t h a t m y s t e r i o u s p s y c h i c capsule i s such a m i s c o n s t r u c t i o n that. if it w e r e so. N o w o n d e r . r e s p o n s i v e .w o r l d . in h u m a n b e h a v i o r . medical s c i e n c e m u s t a b a n d o n all c u r r e n t s u b j e c t i v i s t i c h y p o t h e s e s i n its c o n c e p t u a l i z a t i o n o f t h e n a t u r e o f s c h i z o p h r e n i a . s u b j e c t i v i t y . especially h u m a n b e i n g s .t h e . not some postulated lessening of assumed thought processes or associations. O n l y thus may we understand w h y schizo­ p h r e n i a cripples t h e s u f f e r e r ' s r e s p o n s e t o the p h e n o m e n a o f t h e world t o such a n e x t r e m e d e g r e e : w h a t h e e n c o u n t e r s e n g u l f s t h e s c h i z o ­ phrenic. t h o u g h . t h e sole c o n c e r n of his life. H e r e w e shall d e m o n s t r a t e and s u p p o r t this v i e w w i t h m a t e r i a l t a k e n from t h e c a s e of a y o u n g m a n . T h e t h e r a p i s t s saw this patient in t h e earliest p h a s e of s e r i o u s s c h i z o p h r e n i c illness. T h i s problem would b e c o m e . to fix it in a n e t w o r k of c a u s a l and t e m p o r a l r e l a t i o n s h i p s . and s o this c h a r a c t e r i s t i c m o d e o f b e h a v i o r o f t h e s c h i z o p h r e n i c — i n p s y c h i a t r y called schizoid b e h a v i o r o r a u t i s m — a m o u n t s to a radical d e s t r u c t i o n of h u m a n being. which d e m a n d e d c o m p l e t e clarification. a b o u t w h i c h h e t h o u g h t o r felt. N o t o n l y did his lack of a w i l l i n g . m o r e insidiously. inviting. in t h a t i n s t a n t .226 EXISTENTIAL FOUNDATIONS refusing t h e m e a n i n g f u l address of t h e s e b e i n g s and is. S u d d e n l y h e m i g h t feel c o m p e l l e d to e s t a b l i s h t h e origin and p u r p o s e of a spot he had n o t i c e d on the wall. so t h a t . i n freedom. to p r e s e r v e t h e p a t i e n t from slipping i n t o c o n f u s i o n . Just . o b s e r v a b l e a b n o r m a l i ­ ties o f c o n d u c t o f t h e s e p a t i e n t s are easily and i m m e d i a t e l y c o m p r e h e n s i ­ ble w i t h o u t t h e help o f a n y traditional psychological s u p p o s i t i o n s . h e had blindly o b e y e d . w h o w a s highly i n t e l l i g e n t and fluent in d e s c r i b i n g and f o r m u l a t i n g his e x p e r i e n ­ c e s . H u m a n being is n o t h i n g b u t its p e r c e p t i v e . and to bring t h e p a t i e n t gradually t o r e c o g n i t i o n o f t h e world w h i c h . as such.r e l i a n t person w h o dared e n j o y life as a n o n c o n f o r m i s t . for e x a m p l e . His slavish s u b m i s s i o n t o t h e appealing. forcing h i m to i n t e g r a t e its m e a n i n g into his e x p e r i e n c e lest he be t o t a l l y o v e r w h e l m e d by it. until t h e n . W h e n the fundamental disturbance in schizophrenic being-in-theworld is u n d e r s t o o d in this w a y . he w o u l d feel c o m m a n d e d b y t h e d o z e n s o f t h i n g s t h a t c a u g h t his a t t e n t i o n t o b e h a v e t o w a r d t h e m in a w a y appropriate to t h e i r c h a r a c t e r . a chair could c o m p e l h i m to sit on it j u s t b e c a u s e it w a s t h e r e to be sat on. b e c a m e a s e l f . T h e y o u n g m a n first c o m p l a i n e d t h a t h e had a l w a y s felt h i m s e l f a t t h e beck and call of e v e r y t h i n g and e v e r y o n e he e n c o u n t e r e d . t h e t h e r a p i s t was able to a r r e s t t h e illness from f u r t h e r p r o g r e s s i o n . to an a s t o n i s h i n g d e g r e e . i t m a d e h i m t h e victim o f a n y t h i n g t h a t c a m e t o m i n d . S u c h w a s t h e s u c c e s s o f t h e t r e a t m e n t t h a t n o t only w a s t h e y o u n g m a n n o l o n g e r afflicted b y t h e t o r t u r e s o f s c h i z o ­ p h r e n i c d i s t u r b a n c e but. forcing him i n t o a frantic b r o o d i n g .s e l f place h i m u n d e r t h e s w a y of t h i n g s he could s e e and t o u c h . but. c h a l l e n g i n g c h a r a c t e r o f w h a t e v e r was p r e s e n t in his e x p e r i e n c e gradually b e c a m e g r o t e s q u e . r e s p o n s i v e o p e n n e s s . In r e p o r t i n g his h i s t o r y w e a r e aided c o n s i d e r a b l y b y t h e y o u n g m a n h i m s e l f . all t h e ontically. A m o m e n t later. t r e a t e d for e i g h t y e a r s . O n t h e basis o f his u n d e r s t a n d i n g o f t h e h u m a n being as Da-sein. on t h e w a y to t h e cellar to f e t c h a bicycle p u m p . and he w o u l d be similarly e n s n a r e d by the problem of h u m . i s suddenly the spot could go. i he re< ollection of a small w i n e glass he had used yeai s ago would i ompel bun to be e n l i g h t e n e d in respecl to its whei e a b o u t i and t e m p o r a l 0 1 igins . O r . a radical c o n s t r i c t i o n o n t h e fulfillment o f t h e basic trait o f h u m a n b e i n g — i t s p e r c e p t i v e r e s p o n s i v e o p e n n e s s . T h e y made e x a g g e r a t e d . t h r o u g h h i m . B u i even m o r e t h a n t h e p o w e r o f t h i n g s . is t e r r i f y i n g . h e w o u l d suddenly feel c o m p e l l e d b y t h e o u t s i d e w o r l d o f o t h e r people t o e n g a g e i n s o m e k i n d o f actively useful w o r k . w h o l e . And. H i s past and p r e s e n t w e r e e q u a l l y n o t his o w n . r a t h e r . u n o c c u p i e d and e x h a u s t e d . r a t h e r . H e k n e w h e w o u l d b e u n a b l e t o be h i m s e l f in a n y s o r t of e n c o u n t e r w h e t h e r in t h e n e x t five m i n u t e s . " T h i n g s give me no peace. and t h e unfolding of his f u t u r e . And since h e w a s c o m p l e t e l y d o m i n a t e d b y his p a r e n t s ' v i e w s and i n t e n t i o n s .r e l i a n c e . he fell h o p e l e s s l y u n d e r t h e i r s w a y . w h e t h e r t h e y w e r e physically p r e s e n t o r had c o m e t o m i n d . H e e x i s t e d i n such d e p e r s o n a l i z e d f o r m t h a t his o w n a r m s and legs s e e m e d t o b e lifeless a p p e n d a g e s n o t b e l o n g i n g to h i m . It r e q u i r e d c o u r a g e to re m a i n in his bed.A General Daseinsanalytic Phenomenology P s y c h i a t r y m i s c o n s t r u e s s u c h p h e n o m e n a a s s c h i z o p h r e n i c compul sive t h i n k i n g o r p r e s s u r e t h o u g h t s . a c c o r d i n g to t h e e x a m p l e set by his m o t h e r . death. t h e a b s o l u t e a u t h o r i t y o f o t h e r people. T h e p a t i e n t s u m m e d up t h e specific c h a r a c t e r of his s c h l z o p h r r n t i e x i s t e n c e in t h e s e n t e n c e . s u c h as a n o i s y m a c h i n e in a n e i g h b o r i n g g a r d e n . for a y e a r he could b e a r to c o n f r o n t o n l y t h e limited space ol his b e d r o o m w h e r e h e w a s able t o feel m o r e o r less h i m s e l f . O u r p a t i e n t i n s i s t e d t h a t h e was nol e x p e r i e n c i n g u n c o n t r o l l a b l e i n t r a p s y c h i c t h o u g h t p r o c e s s e s or assoi La t i o n s of a s u b j e c t i v e n a t u r e . as he lay in bed. T h e c o m p u l s i o n t o b e t o t a l l y o b e d i e n t t o t h i n g s and t o people robbed this p a t i e n t o f a t e m p o r a l i t y o f his o w n . In fact. H i s o w n p e r s o n w a s alien to h i m . b e c a u s e t h e claims o f t h e t h i n g s p r e s e n t w e r e m a x i m a l l y reduced. t h e s o m a t i c h a l l u c i n a t i o n s of this p a t i e n t finally disappeared o n c e he had s t r u g g l e d t h r o u g h to t h e self-reliant c o u r a g e he required to fulfill his Dasein. and I ( a n n o ! le. e r r a t i c d e m a n d s o f h i m t h a t h e f o u n d i r r e s i s t i b l e . for he had s p e n t his life copying t h e b e h a v i o r p a t t e r n s o f his m o t h e r and o t h e r people. His t i m e w o u l d n o t pass b e c a u s e it w a s not his t i m e . W h e n additional t h i n g s c a u g h t his a t t e n t i o n . t h e i r t h o u g h t w a s his c o m m a n d . It o f t e n h a p p e n e d t h a t . t h i n g s called to h i m from outside. At t h a t t i m e he had already lost his i n d e p e n d e n t self. His p a r e n t s had o n c e said t h a t he w a s p e r h a p s b e s t suited to b e c o m e a g a r d e n e r . H e felt h e m u s t a n s w e r this call by g e t t i n g up and busily r u s h i n g a b o u t .n i . If o u r y o u n g m a n e n c o u n t e r e d a g a r d e n e i at w o r k . b e c o m e a g a r d e n e r . he felt so e m o t i o n a l l y s w a l l o w e d by h i m t h a t he had to do e x a c t l y w h a t t h e g a r d e n e r did and. w a s d e t e r m i n e d b y o t h e r people. In fact. t r u e to his c o n d i t i o n and his o w n w i s h e s . as in t h e o t h e r t w o t e m p o r a l d i m e n s i o n s . for s u c h a p a t i e n t . In k e e p i n g w i t h t h e t o t a l o t h e r .d i r e c t n e s s that sprang from his lack o f s e l f . this p a t i e n t had to lie in bed. or in a h u n d r e d days. F o r a long t i m e . h e w o u l d e v e n e x p e r i e n c e electric c u r r e n t s b e i n g s e n t t h r o u g h his legs by his m o t h e r . in an h o u r . he lived in t h e t i m e of o t h e r s . his a n x i e t y w a s t h a t of impending. It did n o t r e q u i r e him to b r o o d o v e r a t h o u s a n d details c o n c e r n i n g its n a t u r e . this y o u n g s c h i z o p h r e n i c g a v e vivid d e s c r i p t i o n s of his c o n d i t i o n . T h e r e a r e s o m a n y t i m e s and all o f t h e m a r e d i f f e r e n t . until he c a m e i n t o t h e r a p y . S h e w o u l d i n c e s s a n t l y bid h i m find s o m e t h i n g o r o t h e r o f i n t e r e s t i n the t r e e s o r o n t h e f o r e s t floor and p o n d e r its u s e f u l n e s s o r n o x i o u s n e s s . A similar e x a m p l e of t h e specifically s c h i z o p h r e n i c f o r m of e n c r o a c h ­ m e n t on h u m a n f r e e d o m is t h a t of a p a t i e n t w h o w a s i n v e s t i g a t e d and o b s e r v e d in t h e s u b a c u t e s t a g e of p s y c h o t i c illness. his first w a l k t h r o u g h a f o r e s t during w h i c h t h e f o r e s t r e m a i n e d a f o r e s t w a s an a d v a n c e in his t h e r a p y . o r t o recall t h e b o t a n i c a l n a m e s o f p l a n t s . " as n o t u n u s u a l . It will n o t g e t t h e b e t t e r of m e . I can n o w do s o m e t h i n g m y s e l f to b r i n g o r d e r to t h i n g s again. I h a v e s c a r c e l y g r a s p e d h o w t h e t r e e s s w a y back and f o r t h and h a v e again found t i m e on t h e m . Early in his illness t h e p a t i e n t says: 12 W h y do I look at t r e e s ? I see h o w t h e y m o v e . I m o v e t h e t r e e . It frees me again. Am 1 mysell not a clock. it c h a n g e s too much. T h a t is my salvation. If t h e r e w e r e no clock on t h e wall. "apart from t h e d i s t u r b a n c e s of t h i n k i n g and t i m e . T h e a t t e n d i n g p h y s i c i a n c o n s i d e r e d t h e p s y c h o s i s . and t h e n it falls a w a y from m e . I h e . I am driven to it to look at it. and so find a c e r t a i n w a y o u t .228 EXISTENTIAL FOUNDATIONS t h e m in p e a c e . Like t h e p a t i e n t w h o s e case w e h a v e j u s t r e p o r t e d . A n o t h e r t i m e this p a t i e n t w a s looking at a wall clock and said: W h a t should I do w i t h t h e c l o c k ? I m u s t look at it all the time. I g e t s t u c k in t h e s a m e spot. It c o m e s o v e r me and drives me to t h e t r e e . w h i l e e v e r y t h i n g b e c o m e s so c o n f u s e d in me t h a t I can no l o n g e r d i s t i n g u i s h o n e t h i n g f r o m a n o t h e r . . and n o w again I h a v e t i m e . . W h o k n o w s w h a t i s w i t h t h e m ? A m 1 m y s e l f p e r h a p s t i m e . b u t o n l y in m y t h o u g h t s . or a living c l o c k w o r k ? W h e n I c o m b i n e t h e t r e e w i t h it. W h e n h e n o w dared a p p r o a c h t h e f o r e s t freely and w i t h o u t p r e m e d i t a t i o n . T h e r e is so m u c h t i m e I am always different. t h e n I am again h e r e as m y s e l f . " T h u s . His r e l a t i o n s h i p w i t h his m o t h e r had developed in him s u c h infantile d e p e n d e n c y t h a t . m i g h t h a v e s o m e t h i n g t o d o w i t h t h e fact t h a t this w a s w h a t his m o t h e r had a l w a y s e x p e c t e d h i m t o d o o n s u c h walks w h e n s h e w a s w i t h him. N o w I am again o b s e r v i n g I l i e ( loi !• the h a n d . A n d so I go to t h e t r e e . I would have to die. T o d a y I am b e t t e r . it had n e v e r o c c u r r e d to h i m t h a t his irresistible u r g e on such w a l k s to find s o m e t h i n g particularly i n t e r e s t i n g i n t h e f o r e s t . i t g r e e t e d him peacefully. T h u s did h e begin t o feel his s e p a r a t e h u m a n existence. e v e r y w h e r e and at all p o i n t s ? B u t I can do n o t h i n g e l s e . t h e n I again look to t h e wall clock. a m e r e clock t h a t no longei c o n f r o n t s him face to face f r o m its place on t h e wall but is w i t h o u l a whereabouts. and I am involved b u t can c h a n g e n o t h i n g . t h e clock hops a b o u t w i t h its m a n y h a n d s and c a n n o t b e properly r e a s s e m b l e d . and ll s w e p t " i n t o t h e o t h e r k i n d " — t h e r e l a t i o n s h i p w i t h t h e m e r e i lot !• on the o t h e r . H e r e w e m a y find t h e decisive discrepancy o n w h i c h e v e r y t h i n g h i n g e s . It is a r u n n i n g a w a y f r o m o n e s e l f : I am fleeing and am no l o n g e r h e r e . N o w it is again e n o u g h of t h e wall c l o c k . ) N o w . I am a s t o n i s h e d . I m u s t say t h a t it is no f u n c t i o n i n g clock w h e n it leaps and c h a n g e s so.T i m e S t r u c t u r e i n S c h i z o p h r e n i a . and I m u s t g o t o t h e o t h e r position. t o m i s c o n s t r u e t h e m a t t e r . I m u s t go to t h e o t h e r position. ( T h e m e a n i n g . " s e e m s t o believe t h a t t h e p a t i e n t is c o n c e r n e d w i t h his e x p e r i e n c e of t i m e . W h e n I t e a r m y s e l f a w a y again b e c a u s e e v e r y t h i n g is so c o n f u s e d . T h e r e | | a peculiar i m p r e s s i o n . It can help m e . T h e wall clock c o m p e l s him to look at it. c l o c k f a c e . already. like t h e t r e e i n f r o n t o f t h e w i n d o w . N o w it is h e r e . B e c a u s e I am m y s e l f a clock. . but n o t according t o m y will. t h e wall clock is t h e r e to be looked al ll In . w h o calls t h e r e p o r t " S p a c e . b u t it is i n t a c t . As I h a v e said. b e c a u s e it is a l w a y s so c o n f u s e d . I o n l y k n o w . I am all of this—I lose it all w h e n I look at t h e clock on t h e wall. I am e v e r y w h e r e c l o c k — a n d so it k e e p s c o m i n g and g o i n g . t h e wall clock and the m e r e clock. and i t g o e s . . it t e a r s i t s e l f apart. i n t o t h e o t h e r k i n d . Y e t it is striking t h a t n o w h e r e does t h e p a t i e n t m e n t i o n t i m e o r data r e l a t i n g t o t i m e . I say again and again t h a t it is a clock. O n e is so e n g r o s s e d in looking at t h e clock a n d loses t h e t h r e a d to o n e s e l f . " T h e p a t i e n t s e e m s t o say t h a t h e g o e s from looking at the clock on t h e wall to o b s e r v i n g a f r a g m e n t e d clock thai w o r k s e r r a t i c a l l y and c a n n o t be r e a s s e m b l e d . e v e r y w h e r e in m e . w h o r e p e a t e d l y puts a n e w h a n d in. of " m e r e " is lack of a definite plai e ui familiar s u r r o u n d i n g s . h e r e . . and t h a t it g o e s . e n o u g h of the wall clock. T h e p a t i e n t is in r e l a t i o n to the wall clock. I h a v e n e v e r e x p e r i e n c e d a n y t h i n g similar. B u t t h e r e is s o m e t h i n g else as well. i n t o t h e o t h e r kind. T h e h a n d is a l w a y s different. and t h e n it practically leaps a w a y and r o t a t e s . but t h e n e x t m o m e n t it is " not a c c o r d i n g to my will . b u t t h e r e a r e i n c o n g r u i t i e s : hand. t h e p a t i e n t m a d e t h e f o l l o w i n g s t a t e m e n t . T h e r e p o r t o n this p a t i e n t i n t r o d u c e s this soliloquy b y t h e p a t i e n t o n t h e clock as follows: " W h i l e o b s e r v i n g t h e h a n d s of a wall clock. h e talks a b o u t a c l o c k . and e a c h t i m e at a d i f f e r e n t place. as if it had s p r u n g apart. . Indeed. As if of its o w n accord.A General Daseinsanalytk Phenomenology dial." T h i s i n t r o d u c t i o n s e e m s . Is it a l w a y s a different h a n d ? P e r h a p s t h e r e is s o m e b o d y b e h i n d t h e wall. N o i s e s a r e n o t s o g o o d . the w r i t e r . on the o n e hand. I am a living clock. or r a t h e r a b o u t t w o different clocks. " I am. for e x a m p l e . w i t h n o i s e s . W e m a y see. h e i s s o b e n u m b e d b y w h a t h e o b s e r v e s t h a t h e loses his d i s t a n c e from it. it is for this r e a s o n t h a t t h e p a t i e n t t h e n says. clocklike . t h e p a t i e n t does n o t . w i t h o u t w h i c h t h e patient c a n n o t live.m e a s u r i n g apparatus 1 he p a t i e n t ' s w o r d s do n o t t o u c h upon t h e p r o b l e m ol time Wh.o p e n n e s s to t h e m e r e clock w h e r e h e i s d e r a n g e d . A t o t h e r t i m e s h e e x i s t s a s t h e r e l a t i o n t o a m e r e clock. T h e m e r e clock h a s b e c o m e i n d i s t i n g u i s h ­ able from his o w n e x i s t e n c e . In this c a s e . "I lose it all": his b e i n g . h o w e v e r . t h a t t h e i n t e r p r e t a t i o n o f r e p o r t s like this o n e i s n o t self-evident. O n l y w h e n h e can n o l o n g e r m a i n t a i n t h e s t a n c e of c o n f r o n t a t i o n is he o n c e again b a n i s h e d from w o r l d .h i m s e l f is lost to h i m .il we have a t t e m p t e d h e r e is a rough sketch ol the way a . t h e issue is n o t t h a t of time or time s t r u c t u r e b u t of t h e differing r e l a t i o n s of a schizophrenic person to a clock. I a m clock. . In order to understand these schizophrenic experiences we must very c l e a r l y distinguish b e t w e e n t h e t w o different kinds o f r e l a t i o n s h i p t o w a r d t h e clock. " N o i s e s are n o t s o g o o d . according t o m y n a t u r e . we m a i n t a i n . m a k e a psychic or s u b j e c t i v e t r a n s f e r o f a n y t h i n g from his psychic capsule i n t o t h e clock. T h e m o m e n t t h e p a t i e n t is again able to c o n f r o n t t h e clock as a wall clock h a n g i n g o v e r t h e r e and to m a i n t a i n a clear d i s t a n c e in r e l a t i o n to it. " H e m e a n s . place. It no l o n g e r g r a n t s him an open and free r e l a t i o n s h i p t o w a r d it as a dwelling space for his e x i s t e n c e . t h e t r e e outside his w i n d o w provides him w i t h a n a t u r a l s u r r o u n d i n g world to w h i c h he can r e l a t e t h r o u g h perception: t h e r e is solidarity.230 EXISTENTIAL FOUNDATIONS familiar.p o i n t s . T h i s m e r e clock n o l o n g e r h a s a n y place o f its o w n o u t s i d e i n a n open realm of a h u m a n w o r l d w h i c h would leave him an open and free space b e t w e e n i t and h i m s e l f . " In so seeing himself. S i m i l a r l y . t h e n . G o o d for w h a t ? F o r t h e r e f e r e n c e t o m e a n i n g f u l c o n c r e t e r e a l i t y w i t h its c o n t e x t o f r e f e r e n c e s t o o t h e r b e i n g s o f this world. It is i n d i s p e n s a b l e to c o n s i d e r critically t h e w r i t e r ' s guiding c o n c e p t s and a s s u m p t i o n s . d e f i n i t i o n — a s t h e r e is n o t . R a t h e r . d e s i g n a t e s a r e l a t i o n s h i p in w h i c h t h e o b s e r v e r is e n g u l f e d by t h e o b s e r v e d . which he does n o t regard as a t i m e . T h e r e i s n o l o n g e r a n y t h i n g available face t o face t o w h i c h h e could r e l a t e in an o p e n w a y and t h e r e f o r e he " l o s e s the t h r e a d " to h i m s e l f . e v e r y w h e r e i n m e . At o n e m o m e n t the issue is his r e l a t i o n s h i p to a clock h a n g i n g o v e r t h e r e o n t h e wall. this familiar o b j e c t helps him r e c o l l e c t his s e l f by g r a n t i n g his e x i s t e n c e a dwelling space in his r e l a t i o n s h i p w i t h it. " h e says. he is in t h e w o r l d in a m o r e or less h e a l t h y w a y and can p e r c e i v e t h a t world a s a n open r e a l m . H e can n o m o r e e x i s t t h r o u g h m e r e s o u n d s t h a n h e can t h r o u g h t i m e as a m e r e s u c c e s s i o n of n o w . " I a m m y s e l f c l o c k . T h e m e r e clock. i n t o w h i c h he is s w e p t and t h r o u g h o u t w h i c h he is dispersed. and w h e n t h e p a t i e n t stands opposite it. . w e r e capable o f being o v e r s h a d o w e d and engulfed i n e n c o u n t e r w i t h o t h e r t h i n g s . Doctor: Did y o u see it in t h e s a m e w a y t h a t y o u could h a v e seen the lamp b u r n i n g o n t h e c e i l i n g ? Patient: N o ! I w a s c o m p l e t e l y d i s c o n c e r t e d by t h e disc. h o w e v e r . " i n w h o s e illness h a l l u c i n a t i o n s and d e l u s i o n s p r e d o m i n a t e d . T h i s w a s n o t t h e case for the " S u n . o p e n r e a l m o f h u m a n p e r c e p t i o n and response. c o m p l e t e l y deprives his w o r l d of its o p e n n e s s and f r e e d o m . and i n t h e c o u r s e o f the n i g h t it m o v e d f r o m left to r i g h t along the wall. t h e r e are n o t t w o d i f f e r e n t clocks. I s p e n t t h e w h o l e n i g h t looking at t h e sun. t h e s h u t t e r s w e r e closed. In this c a s e . w a s a n i n t e l l i g e n t patient w h o w a s hospitalized in a u n i v e r s i t y clinic. it c l i m b e d gradually. S u d d e n l y . and t h e r o o m w a s i n total d a r k n e s s . A m a n lay sleeping on the floor u n d e r t h e sun. It m a d e m e a n x i o u s . a b o u t 9 : 3 0 p. T h e r e w e r e no definite component parts.m a n . W e p r e s e n t this s h o r t h i s t o r y b e c a u s e t h e c a s e clearly i l l u s t r a t e s o u r v i e w t h a t s e c o n d a r y s y m p t o m s o f s c h i z o p h r e n i c illness can b e u n d e r s t o o d properly o n l y i n r e f e r e n c e t o t h e n o r m a l . I n t h e t w o c a s e s w e h a v e s o far p r e s e n t e d . I w a s lying in bed.m a n . it is e s s e n t i a l to r e c o g n i z e t h a t .A General Daseinsanalytic Phenomenology 231 s c h i z o p h r e n i c p h e n o m e n o n m u s t be a p p r o a c h e d if it is to be u n d e r s t o o d . but a single o n e : at o n e m o m e n t he s e e s it as a wall clock o u t t h e r e in t h e o p e n r e a l m of his world. R a t h e r t h a n a s s u m i n g a n i n n e r life t h a t i s hidden f r o m v i e w . W h i l e doing so. w e c o n c e r n o u r s e l v e s w i t h t h e w a y s i n w h i c h t h e actual t h i n g t h a t p r e o c c u p i e s the p a t i e n t r e f e r s t o t h e w o r l d and t h e r e b y defines t h e p a t i e n t ' s r e l a t i o n s h i p to it. t h i c k s e t p e r s o n . s o m e t h i n g . T h e p r o m p t a d m i n i s t r a t i o n o f d r u g s rapidly stabilized him s o t h a t he could hold t h e following c o n v e r s a t i o n w i t h his d o c t o r in t h e first w e e k o f his admission: Doctor: W h y w e r e y o u s o e x t r e m e l y a n x i o u s ? Patient: S h o r t l y b e f o r e I c a m e i n t o the hospital. T h e disc w a s a b o u t head high. T h e s e s y m p t o m s . t h e s u n w a s t h e r e on t h e wall o p p o s i t e my bed. He w a s initially m u t e w h e n a d m i t t e d .m. Doctor: H o w w a s t h e disc c o n s t i t u t e d ? Patient: It w a s an i n t e n s e pale y e l l o w light. for the p a t i e n t . t h e p a t i e n t s had s e c o n d a r y s y m p t o m s o f s c h i z o p h r e n i a : h a l l u c i n a t i o n s and d e l u s i o n s . T h e " S u n . t h e r e f o r e . and a m o m e n t l a t e r it s w e e p s h i m a w a y and c o n s u m e s him.. Doctor: C a n y o u d e s c r i b e t h e sun m o r e e x a c t l y ? Patient: It w a s a r o u n d disc of a b o u t fifteen to t w e n t y c e n t i m e t e r s in d i a m e t e r . If I had lost s i g h t of it for even a m o m e n t . " a s h o r t . If I had lost sight of t h e sun on t h e wall. H e w a s still living w i t h his p a r e n t s . t h e y w e r e n o n e t h e l e s s unintelligible. M y a n x i e t y i n t h e face o f i t b e c a m e steadily g r e a t e r .u p i n t e r v i e w . t h a t t h e r e w a s n o t h i n g on w h i c h he could rely. t h o u g h his e x p e r i e n c e s during t h a t illness still felt m e a n i n g f u l . to neglect one's relationship to the o t h e r leaves o n e w i t h o u t d i r e c t i o n . If I had closed my e y e s for j u s t a m o m e n t . W i t h i n a f e w w e e k s . a h e a d y hinted a t b y his relatives. I w a s t e r r i b l y a n x i o u s and did n o t dare g e t o u t of bed.il i o n . B u t I dared n o t lose sight of it. Doctor: W e r e y o u n o t surprised w h e n y o u suddenly saw this s h a p e ? Patient: N o ! F r o m t h e first m o m e n t . B u t e v e n during t h e day. Doctor: W h y do you call this apparition t h e s u n ? Patient: I k n o w it is n o t t h e real sun. along w i t h his i m m e d i a t e family. H i s r e c o l l e c t i o n of his illness w a s vivid to t h e last detail. t h e p a t i e n t had sufficiently r e c o v e r e d f r o m t h e a c u t e s c h i z o p h r e n i c episode to be d i s c h a r g e d and to r e s u m e his j o b in a factory. D u r i n g this i n t e r v i e w t h e patient revealed iiilorm. I had to take c a r e t h a t it did n o t suddenly a t t a c k m e . w e r e s t i m u l a t e d by it.232 EXISTENTIAL FOUNDATIONS t e r r i b l e would h a v e h a p p e n e d . It w a s m o r e p o w e r f u l t h a n m a n . t h a t he w a s so at t h e m e r c y of e v e r y t h i n g h e n o l o n g e r k n e w h o w t o distinguish b e t w e e n the real and the unreal. and felt it. w i t h w h o m h e n o t o n l y g o t along splendidly b u t w h o w e r e . w h o m h e t r u s t e d t o a c c e p t t h e reality and significance o f w h a t h e had u n d e r g o n e : "In t h e m o s t h u m d r u m a s p e c t s o f my daily life. and w o r k e d r e g u l a r l y at a j o b t h a t paid good w a g e s . I k n e w t h a t if y o u had b e e n in t h e r o o m . his sole companions. in a f o l l o w . and t h e e a r t h w o u l d have g o n e u p i n f l a m e s . c o n c e r n i n g a painful hurI h e h a d u n d e r g o n e b e f o r e the . I had b e g u n to t h i n k c o n t i n u o u s l y a b o u t the sun. it w o u l d h a v e c o m e close t o t h e e a r t h . yet. I am c o n v i n c e d t h a t y o u w o u l d h a v e s e e n it if y o u had b e e n w i t h m e . B u t I k n e w i m m e d i a t e l y w h a t it m e a n t . In doing so I had t h e feeling t h a t my g e n i t a l s w e r e in t o u c h w i t h t h e sun in t h e sky. I could n o t h a v e s e e n t h e s u n a n y m o r e . I k n e w w h a t it m e a n t . t h e p a t i e n t insisted t h a t he felt v e r y well. d u r i n g his illness. " T h e p a t i e n t felt. j u s t as if you could h a v e s e e n t h e l a m p b u r n i n g o n t h e ceiling? Patient: Y e s . y o u m i g h t h a v e g o n e up to it. e x a c t l y ! I still h a v e t h e i m a g e b e f o r e my e y e s . A y e a r later. looked at it. j u s t as if it w e r e y e s t e r d a y . S u c h w a s t h e i m p o r t o f t h e following o b s e r v a t i o n s t o his d o c t o r . Doctor: D i d y o u really s e e t h e sun on t h e wall w i t h y o u r e y e s . w a s in c o n t r o l . t h e r e w a s s o m e t h i n g t h a t w a s a l w a y s p r e s e n t b u t w h i c h is difficult to r e f e r to a specific s i t u a t i o n . My illness m a d e it clear to me t h a t one is dependent on others. t h e patient did not intend to t r y to r e e s t a b l i s h t h e friendship s i n c e . F o r this p a t i e n t . t o w h o m t h e p a t i e n t w a s still deeply a t t a c h e d at t h e t i m e of this i n t e r v i e w . Y e t he could n o t exist in this w o r l d as does a g r o w n m a n w h o is a w a k e .t h e . " T h e t h e r a p i s t . I t w a s . a f i g m e n t o f his i m a g i n a t i o n . " A n y w a y . r e s t r a i n e d his scientific c u r i o s i t y in this i n s t a n c e in d e f e r e n c e to t h e w e l f a r e o f t h e patient. T h e p a t i e n t also w a n t e d t o avoid explaining t o t h e d o c t o r t h e m e a n i n g this e x p e r i e n c e had for him. t h e s u p r e m e p o w e r from w h i c h all g r o w t h and life p r o c e e d s . w h o s e i n s t a b i l i t y w a s e x t r e m e . I don't w a n t to b e c o m e ill a g a i n . He saw. " D i s c u s s i n g this incident. bring him again u n d e r t h e s w a y o f t h a t vision. would. H e perceived t h e loss in t h e h a l l u c i n a t e d apparition of t h e m a n w h o slept b e n e a t h t h e sun. h o w e v e r n a r r o w and secluded. in this single g r o w n u p sleeping in his p s y c h o t i c world. He b r o k e it off. " T h e p a t i e n t still brooded o v e r this deep h u r t during t h e i n t e r v i e w and felt t h a t this incident. the u n a w a k e n e d adult p o t e n t i a l i t y t o b e a w a k e and adult. i t can also s c o r c h and a n n i h i l a t e e v e r y t h i n g .w o r l d . t h e w h o l e w o r l d . a friend. he could only s e e w h a t w a s n o t h i m s e l f a s s o m e t h i n g t h a t w a s all t h e m o r e p o w e i ful. "I am n o t going to talk a n y m o r e . " D o n o t t h i n k I've m a d e a god o u t o f t h e sun. w h o s e c h a r a c t e r w a s o v e r w h e l m i n g and c o s m i c . for m e . w h i c h w a s . " T h i s a m o u n t o f e x p l a n a t i o n w a s all t h e p a t i e n t could t o l e r a t e in t h e i n t e r v i e w . s u c h e x i s t e n c e w a s lost t o his b e i n g . as in t h e i n t e r v i e w . suddenly and u n e x p e c t e d l y failed to appear for a d a t e t h e y had a g r e e d upon. A f e w w e e k s b e f o r e this n e r v o u s b r e a k d o w n . t h e patient b e c a m e i n c r e a s i n g l y s o a g i t a t e d t h a t t h e d o c t o r c h a n g e d t h e s u b j e c t t o inquire a b o u t t h e m a n ' s m o s t vivid e x p e r i e n c e during his illness. of t h e sun in his r o o m . h e k n e w . It w a s . had c e r t a i n l y b e e n chiefly r e s p o n s i b l e for his illness. provided him w i t h reliably p r o t e c t i n g . T h e friend also failed t o c o n t a c t h i m a t a n y t i m e a f t e r this " b e t r a y a l . M o r e o v e r .A General Daseinsanalytic Phenomenology 233 o n s e t of his illness. t h e vision. W i t h e m b a r r a s s m e n t h e said. familiar world. t h e p a t i e n t replied.s t r u c t u r e of his Da-sein had b e e n m a d e up of r e l a t i o n s h i p s w i t h his friend and his family w h i c h . during t h e n i g h t . S c h i z o p h r e n i c a l l y ill. saying.i n . plunging him i n t o a n u n f a m i l i a r o p e n n e s s o f being. . it is n o t possible to f o r c e a f r i e n d s h i p . filtering r e l a t i o n s to a s e c u r e .r e l a t i o n suddenly and drastically e x p a n d e d t h e limita­ tions o f his e x i s t e n c e . of c o u r s e . j u s t talking a b o u t it. . " His a n x i e t y and panic on seeing t h e sun c a m e from t h e c o n v i c t i o n t h a t " . he . M o r e o v e r .r e l i a n c e and t h e p o w e r l e s s n e s s he felt in losing t h e s e m i it y of t h e c i r c u m s c r i b e d r e l a t i o n s h i p of his lifelong friendship. C o r r e s p o n d i n g t o his lost s e l f . which he i n t e r p r e t e d to m e a n t h a t t h e friend s t o o d h i m up f o r a girl. he believed. s c r e e n i n g . t h e p e r s o n closest t o him from e a r l y childhood. T h e collapse of this c o n f i n e d w o r l d . a p r e s e n c e so p o w e r f u l t h a t he s a w it as an actual e v e n t . and p h i l o s o p h e r s . i n s t e a d . It is. poets. B u t the p a t i e n t k n e w t h e m e a n i n g o f t h e hallucinated disc o f light a s a n all p o w e r f u l sun b e c a u s e k n o w l e d g e of t h e n a t u r e of all s u n s — " s u n n e s s " as s u c h — h a d already d a w n e d (aufgehen) on h i m . particular s i t u a t i o n . O n l y so could he u n d e r s t a n d i m m e d i a t e l y t h e significance o f t h e p a r t i c u l a r sun disc o n his wall as " t h e s o v e r e i g n s w a y of a sunlike s u p r e m e p o w e r from w h i c h all g r o w t h and life p r o c e e d s " b u t w h i c h a t t h e s a m e t i m e " c a n also s c o r c h and a n n i h i l a t e e v e r y t h i n g . so to speak. T h e p s y c h o t i c disruption of t h e b o u n d a r i e s of a Da-sein o f t e n s e e m s to b r i n g w i t h it a s u p e r h u m a n p e n e t r a b i l i t y i n t o t h a t w h i c h . B u t a b o v e all. w h i c h fascinated him and t h r e a t e n e d to s c o r c h and s w a l l o w him and t h e e n t i r e e a r t h . particular s i t u a t i o n " b u t is n e v e r t h e l e s s in " t h e e v e r y d a y . U n f o r t u n a t e l y . " it c a n n o t e x i s t in its o w n right as a p a r t i c u l a r . s c h i z o p h r e n i c p a t i e n t s c a n n o t cope w i t h this s e n s i t i v i t y and w h a t it reveals. " A n d since it is e s s e n t i a l l y different f r o m " e v e r y t h i n g t h a t simply i s . its precisely w h a t u n d e r l i e s it.l i g h t t h a t d a w n s as the intelligent. o b s e r v a b l e t h i n g . a f t e r his illness. " P e r h a p s t h e sun o f his p s y c h o t i c .234 EXISTENTIAL FOUNDATIONS was o v e r p o w e r e d b y t h e c o s m i c i n c a n d e s c e n c e o f t h e sun. F r o m this he c a m e to k n o w a d a w n i n g (aufgehen) of w h a t had c o m e into p r e s e n c e in its o w n form and n a t u r e . and also i n t o its dissolution (aufgehen) and n o t h i n g n e s s . or t h e i r p e r c e p t i o n s would lead t h e m to b e c o m e v i s i o n a r i e s . h e a t t r i b u t e d g r e a t m e a n i n g f u l n e s s t o his e x p e r i e n c e during p s y c h o s i s . T h u s ." even if he " c o u l d n o t apply it to t h e e v e r y d a y . u n b o u n d e d b e i n g i n .w o r l d had disclosed t h e m o s t hidden n a t u r e o f t h a t w h i c h holds s w a y b e h i n d all a p p e a r a n c e . the b u r s t i n g of limits in the Da-sein ol s c h i z o p h r e n i c s s e r i o u s l y e n c r o a c h e s on t h e freedom o f t h e i r e x i s t e n t e I h e n . a s c h i z o p h r e n i c s e n s i t i v i t y t o t h a t ordinarily hidden from h u m a n perception. Its limitless i n c a n d e s c e n c e replaced t h e lost w a r m t h o f his c o n c r e t e . limited r e l a t i o n s h i p to his friend. u n d e r s t a n d i n g p e r c e p t i o n illuminating the m e a n i n g of s o m e t h i n g as s o m e t h i n g . it is s u c h a sunlike dawning (aufgehen) t h a t is t h e n a t u r e of t h e h u m a n Da-sein. I t m a y h a v e disclosed t o him s o m e t h i n g f u n d a m e n t a l t h a t i s n o t usually g r a n t e d t o m u n d a n e p e r c e p t i o n . W i t h j u s t i f i c a t i o n .t h e . n o t a c c e s s i b l e to c o m m o n e x p e r i e n c e . an e x p e r i e n c e t h a t e n r i c h e d his life. this sun allowed t h e patient to p e r c e i v e a b e i n g . t h a t w h i c h is " n o t applicable to t h e specific. "something that was t h e r e in e v e r y d a y life. It is h i g h l y likely t h a t t h e " h a l l u c i n a t e d " sun p r e s e n t e d o u r p a t i e n t w i t h a n y t h i n g but m e r e n o n s e n s e . It had e n a b l e d him to sense something impenetrable but fundamental. u p e r s e n - . " T h e h a l l u c i n a t e d sun revealed t o him s o m e t h i n g t h a t e n c o m p a s s e d all being and n o n b e i n g as well. the p a t i e n t p r o t e s t e d e n e r g e t i c a l l y against a n y i n t e r p r e t a t i o n of his apparition as a n o n s e n s i c a l trick of t h e mind. t h e y b e c o m e ill Paradoxically. his e x i s t e n t i a l f r e e d o m collapses.A General Daseinsanalytic Phenomenology 235 sitivity. It placed all the o t h e r realities of his p r e v i o u s w o r l d in a m i s t y half-reality.w o r l d w h i c h i s the n a t u r e o f h u m a n being. it s w e p t him u n d e r . We cannot emphasize too much that being-in-the-world is the carrying. i ^ r . a disorder in i n t r a p s y c h i c r e p r e s e n t a t i o n s o f o b j e c t s i n t h e o u t s i d e world.i n . s c h i z o ­ p h r e n i c s c a n n o t o p e n t h e m s e l v e s fully t o t h e m e a n i n g f u l address o f w h a t t h e y e n c o u n t e r . s u s t a i n i n g . F i r s t . r o b b i n g him of all f r e e d o m . F i r s t . o f his o w n g r o u n d . t h e individual's perceiving e x i s t e n c e is opened to p o w e r f u l n e w d e m a n d s from o t h e r s . all of w h i c h w o u l d reside in a capsulelike p s y c h e . t h e y a r e u n a b l e to m a i n t a i n a free s t a n c e vis-a-vis t h e i r p e r c e p t i o n s of what t h e y e n c o u n t e r . W e h a v e n o w p r e s e n t e d t h r e e e x a m p l e s o f a D a s e i n s a n a l y t i c approach t o s c h i z o p h r e n i c illness. t h e real n a t u r e and m e a n i n g of t h e sun. T h e e n c r o a c h m e n t is of a twofold n a t u r e . c u r r e n t c o n c e p t i o n s n o t w i t h s t a n d i n g . W e m a y s u m u p o u r c o n c l u s i o n s c o n c e r n i n g the c h a r a c t e r of this illness as follows. instead. r a r e in children. t h e s y m p t o m of i n n e r collapse of a selfhood t h a t w a s always p r e c a r i o u s . so t h a t the t r e e s in a little f o r e s t w h e r e he w a l k e d a f t e r t h e w o r s t a g i t a t i o n w a s past r e a c h e d his vision in t h e f o r m of a c o m p l e x of s h a d o w s . T h e s e c o n c e p t i o n s v i e w e d i n r e l a t i o n t o s c h i z o p h r e n i a p r o v e m o r e clearly than e v e r t o b e i n a d e q u a t e and i n a p p r o p r i a t e for u n d e r s t a n d i n g h u m a n e x i s t e n c e in g e n e r a l . a s t h e i r m o r e h e a l t h y fellows can. T h i s e x p l a i n s w h y it is thai s c h i z o p h r e n i a is u n k n o w n in a n i m a l s . t h o u g h e a c h in his o w n individual way. d e m a n d s t o c o m e close and c n ^ . S e c o n d . S e c o n d . and holding o p e n of a clear w o r l d l y realm of p e r c e p t i o n and r e s p o n s i v e n e s s t h a t all people c a r r y o u t . w h e n e v e r t h e s c h i z o p h r e n i c ' s ability t o respond to t h e e n c o u n t e r e d is o v e r e x t e n d e d or claimed m o r e i n t e n s i v e l y than he can b e a r . is n o t the fruit ol m a t u r a t i o n b u t is.t h e . B e i n g h u m a n also m e a n s t o b e c o m m i t t e d t o w h a t is e n c o u n t e r e d so as to c a r e for it and help it unfold to its fullest extent. W e h a v e n o w s e e n t h a t s c h i z o p h r e n i c s suffer from e n c r o a c h m e n t specifically on t h e i r ability to be r e s p o n s i v e and o p e n to w h a t is e n c o u n t e r e d . u n s t a b l e . n o t infrequenl In w o m e n a f t e r childbirth. s c h i z o p h r e n i c illness is not. In the lattei t w o s i t u a t i o n s . s c h i z o p h r e n i a m u s t be s e e n as a d i s t u r b a n c e o f t h e specific b e i n g . T h u s . w h i c h b r e a k s t h r o u g h t h e limits of t h e i r Da-sein. m a i n t a i n i n g . s o t h a t t h e y c a n n o t r e s p o n d w i t h all t h e i r f a c u l t i e s to t h e n o r m a l l y a c c e p t e d significance or m e a n i n g f u l n e s s and m e a n i n g o f t h o s e t h i n g s and e v e n t s . o r o f i n n e r drives and a s p i r a t i o n s . E v e n b a n i s h e d t o t h e wall o f his r o o m t h e c o s m i c t h i n g w i t h its e x t r a v a g a n t d i m e n s i o n s s w a l l o w e d him and ruled him with t h e m i g h t of its n o w visible s u p e r t e r r e s t r i a l s i g n i f i c a n c e . and m o s t f r e q u e n t a f t e r p u b e r t y . I n s t e a d . t h e s c h i z o p h r e n i c " S u n m a n " could n o t b e a r his p e r c e p t i o n o f t h e s u p e r s e n s o r y . L i k e w i s e . H o w e v e i . T h e s c h i z o p h r e n i c b e c o m e s s u b j e c t . I n addition. S u c h psychological fictions for w h i c h . T h e r e i s n o special kind o f r e l a t i o n s h i p t h a t t h e s c h i z o p h r e n i c m a i n t a i n s w i t h o t h e r s t h a t i s n o t t o b e found. h u m a n and n o n h u m a n .236 EXISTENTIAL FOUNDATIONS fully in r e l a t i o n s h i p s s u c h as t h a t of a m a t u r e s e x u a l love. c a n n o t c o n t r i b u t e to the elucidation of such a s e r i o u s d i s t u r b a n c e B e f o r e a n y t h i n g can be p r o j e c t e d from an inside to an outside. a m o n g h e a l t h y people. t h e s c h i z o p h r e n i a o f s e v e r e l y ill hospitalized p a t i e n t s w i t h i n t e n s e s o m a t i c h a l l u c i n a t i o n s and d e l u s i o n s can disappear o v e r n i g h t w h e n t h e y feel t r u s t in a t h e r a p i s t w i t h w h o m t h e y can e n t e r i n t o a p a r e n t . u n d e r c e r t a i n c i r c u m s t a n c e s . free. schizophrenia is an illness t h a t can be c h a r a c t e r i z e d o n l y n e g a t i v e l y . o r feel t h a t t h e i r t h o u g h t s and a c t i o n s a r e n o t t h e i r o w n but are performed by others. it has no positive c h a r a c t e r i z a t i o n . including m a r k e d a u t i s m . T h e r e f o r e . t h e r e f o r e . caring w a y oriented to the future. to r e l a t e to t h e i r r e s p o n s i b i l i t y in a p l a n n i n g . t h e p e r c e p t i o n o f t h e a d o l e s c e n t h u m a n b e i n g b e g i n s t o o p e n t o m u l t i t u d i n o u s claims from o t h e r b e i n g s . w h o w a s c u r e d j u s t a s s o o n a s she w a s freed from h e r o v e r t a x i n g life s i t u a t i o n a s wife and m o t h e r o f t h r e e c h i l d r e n t o m e e t t h e m o r e limited d e m a n d s of t h e life of a single w o m a n w o r k i n g as a l a b o r a t o r y a s s i s t a n t . t h e r e is no piece of c o n c r e t e e v i d e n c e . as we h a v e said.r e l i a n t . or a m o t h e r child love. or affect i m p u l s e s into an outside world. h o w e v e r . T h e p a t h o l o g y i n s u c h p a t i e n t s is t h e i r lack of t h e possibility available to t h e h e a l t h y p e r s o n to a s s e m b l e his r e s p o n s e s and b e h a v i o r to be s e l f . hi/ ophi e n H patients . T o a n e x t e n t u n k n o w n t o o t h e r i l l n e s s e s . It is i m p o r t a n t . to qualify any d i a g n o s i s of s c h i z o p h r e n i a . t o t h e m o d e s o f being o f o t h e r people and o f t h i n g s i n t h e world. il must lirst have been in the p o s s e s s i o n of the p r o j e c t o r . m e n t a l i m a g e s .c h i l d r e l a t i o n s h i p from w h i c h t h e y can g r o w (having indeed r e m a i n e d in t h e i r lives helpless. T h e s e o b s e r v a t i o n s lead us to define s c h i z o p h r e n i c being-ill as a radically i n c o m p l e t e m a n i f e s t a t i o n o f t h e free and s e l f . W h a t is perceived in this w a y h a s n o t h i n g to do. and e n d u r i n g i n t h e face o f w h a t e v e r m a y b e e n c o u n t e r e d . t h e Da-sein of t h e s c h i z o p h r e n i c is e n g u l f e d in the o v e r w h e l m ­ ing o t h e r . i n v a r y i n g d e g r e e s . A c c o r d i n g l y .r e l i a n t selfhood that normally characterizes human being. childlike c r e a t u r e s ) into free and independent adulthood. s u f f e r e r s o f this illness e x i s t l a r g e l y o u t s i d e t h e m s e l v e s . t h e y o f t e n e x p e r i e n c e t h i n g s t h r o u g h v o i c e s t h a t speak t o t h e m . w i t h a psychic p r o j e c t i o n o f t h e i r o w n i n t r a p s y c h i c t h o u g h t p r o c e s s e s . T h e q u e s t i o n a l w a y s t o b e r a i s e d is: s c h i z o p h r e n i c u n d e r t h e e x c e s s i v e demands of which pattern of human relationships? An example is that of a w o m a n w h o s h o w e d s c h i z o p h r e n i c s y m p t o m a t o l o g y . o p e n . w h i c h it calls " t h e psychic t r a n s f o r m a t i o n of a biological c o n s t i t u t i o n subject to a multiple g e n e i n h e r i t a n c e . T h e first p a t i e n t described in this c h a p t e r is a case in point. R u d i m e n t a r y as this initial c h a r a c t e r i z a t i o n of s c h i z o p h r e n i a is.s o u g h t a d e q u a t e c o n c e p t i o n of h e r e d i t y m a y be found in t h e p h e n o m e n o l o g i c a l c o n c e p t i o n o f t h e basic c h a r a c t e r o f s c h i z o p h r e n i c being-ill. h a s no " i n s i d e " in the s e n s e of a c o n s c i o u s and u n c o n s c i o u s r e s e m b l i n g a capsulelike p s y c h e t h a t is a c o n t a i n e r of s o r t s . s e c o n d . I t s e e m s likely. t h e i r p r o p o s i t i o n s c o n c e r n i n g a multiple g e n e i n h e r i t a n c e of s c h i z o p h r e n i a are u n c l e a r and totally lacking in a n y factual basis.A General Daseinsanalytic Phenomenology 237 are. it could s e r v e as a s t a r t i n g point for the d e v e l o p m e n t of a scientific a p p r o a c h to t h e illness. F o r o n e thing. as well as t h a t of t h e s c h i z o p h r e n i c . a r e m u c h less c o l l e c t e d to a s e l f . " as r e s p o n s i b l e for an " i n d e t e r m i n a t e possibility for t h e d e v e l o p m e n t o f t h e p e r s o n a l i t y . it could help f r a m e a d e q u a t e and a p p r o p r i a t e q u e s t i o n s a b o u t s c h i z o p h r e n i a — a n d . We h a v e used s c h i z o p h r e n i a to exemplify t h e d i s t u r b a n c e of health t h a t r e s u l t s w h e n t h e f u n d a m e n t a l c h a r a c t e r i s t i c of Da-sein perceptive r e s p o n s i v e o p e n n e s s t o t h e p r e s e n c e and m e a n i n g o f all e n c o u n t e r e d beings—is drastically e n c r o a c h e d upon. It is all t h e m o r e fallacious. E v e n h e a l t h y people h a v e n o t h i n g inside t h e m ­ s e l v e s . t h e s o r t of r e s e a r c h t h a t is b e i n g d o n e can o n l y d e s i g n a t e w h a t it r e g a r d s as a c t u a l l y i n h e r i t e d in s c h i z o p h r e n i a . F i r s t and f o r e m o s t . w h i c h b e g i n s w i t h the u n d e r s t a n d t h a t being is Da-sein.r e l i a n t selfhood t h a n a r e h e a l t h y people. " S u c h s t a t e m e n t s hardly d e s c r i b e f u n d a m e n t a l s w h o s e i n h e r i t a n c e can b e i n v e s t i g a t e d . T h i s approach n o t o n l y can provide sufficiently c o n c r e t e c o n t e n t for t h e still e m p t y c o n c e p t i o n s o f h e r e d i t y . t h a t the l o n g . o n t h e o t h e r h a n d . D e c a d e s a g o E u g e n B l e u l e r n o t e d its a b s e n c e . t o w o r k o u t a n a d e q u a t e c o n c e p t i o n o f h e r e d i t y . from a n e x i s t e n t i a l point o f view. p e r s o n is r e c o g n i z e d as being a perceptive responsive openness to the meaningfulness of the p h e n o m e ­ na of this world. W h e n t h e basic c h a r a c t e r i s t i c o f t h e h e a l t h y . A n d . t h e m s e l v e s . t h e n . precisely in r e s p e c t to t h e supposedly h a l l u c i n a t e d and p r o j e c t e d t h i n g s . it will be c l e a r t h a t t h e e s s e n t i a l f e a t u r e of s c h i z o p h r e n i c being i s t h e specific e n c r o a c h m e n t o n t h e o p e n n e s s and f r e e d o m o f the Da-sein. While it might appeal thai ii . fully outside t h e m s e l v e s and lost i n t o t h a t w h i c h t h e y . are not. and e v e n today g e n e t i c i s t s h a v e b e e n able t o w o r k o u t t h e i n t a n g i b l e p r e r e q u i s i t e s for useful r e s e a r c h i n t o t h e role o f h e r e d i t y i n s c h i z o p h r e ­ nia. to speak of i n t r a p s y c h i c m a t e r i a l t h a t can b e p r o j e c t e d o n t o t h e o u t s i d e w o r l d i f o n e r e f e r s t o s c h i z o p h r e n i c s w h o . b e c a u s e h u m a n e x i s t i n g . but it m a y also s e r v e as a reliable basis for t h e r a p e u t i c w o r k with s c h i z o p h r e n i c p a t i e n t s . by its v e r y n a t u r e . a b o u t a n y o t h e r f o r m o f h u m a n being. in fact. O n this basis i t m a y b e possible. for i n s t a n c e . T h e o b s e s s i v e .238 EXISTENTIAL FOUNDATIONS b e t t e r choice f o r this p u r p o s e would h a v e b e e n o b s e s s i v e . | Willi. based on a description of t h e f u n d a m e n t a l c h a r a c t e r i s t i c s of h e a l t h y h u m a n living. t h e s e studies i n g e n e r a l p a t h o l o g y relating to Da-sein should lead us to u n d e r t a k e a critical e x a m i n a t i o n of s o m e of the c e n t r a l c o n c e p t s of traditional biology. h o w e v e r . w e h a v e c o m p l e t e d o u r discussion o f e x a m p l e s illustrating pathological e n c r o a c h m e n t o n t h e main f e a t u r e s o f h u m a n being. 11 R. and p s y c h o l o g y . O b s e s s i v e . but it does n o t e n g e n d e r its d e s t r u c t i o n . A revision of t h e basic c o n c e p t s of traditional medical s c i e n c e . " W h a t is w r o n g w i t h you?". a s t o n e . Buhler. T h e English-speaking physician is more apt to . w h i c h s e e m to pose a perfect c o n t r a s t to f r e e d o m and o p e n n e s s . even if he is not I l n i n . especially t h o s e signifying dirtiness.c o m p u l s i o n m a y e n c r o a c h on the patient's f r e e d o m . In the G e r m a n approach to the ill patient. It is clear. It is true that t h e freedom and o p e n n e s s o f o b s e s s i v e . thematic or unthematic. H a v i n g r e a c h e d this point.c o m p u l s i v e n e u r o s i s d e s i g n a t e a s e l f . i s k .p r o t e c t i n g b e h a v i o r similar to the p a t t e r n of w i t h d r a w a l described in schizoid and a u t i s t i c p e r s o n s . l 9 6 6 ) .' M Itleulei. k n o w s n o t h i n g of being compelled to do so. f o u l n e s s . 11"' phyaii 1411 li immediately related to illness as a lack of health. is indispensable. o f falling helpless u n d e r the s w a y of t h i n g s t h a t a r e judged to be filthy. of the basii cha rat teristic of illness as a lack of health. In s c h i z o p h r e n i a . such diseases are n e v e r t h e opposite of f r e e d o m . N e v e r t h e l e s s . w h e n it falls. i l u all v t w i r r «• I i I n . t h e patient loses his f r e e d o m and w i t h it his dwelling place in t h e w o r l d to a m u c h h i g h e r d e g r e e . "Tell me all about it!" Here is an instance ol how language itself shapes the understanding of phenomena and determines how they i . T h u s . h o w e v e r impaired o r reduced t h a t f r e e d o m m a y be. p h y s i o l o g y .c o m p u l s i v e p a t i e n t is n e v e r so c o m p l e t e l y engulfed in w h a t he h a s perceived t h a t he m u s t b e c o m e it and t h e r e b y perish as a h u m a n being. Akutepsychische BegMlmrlieinmiHi'ii kmftrhihri Kraitkhrilen (Stuttgai i I hieme. . This f o r m u l a t i o n rests on the understanding. m i eve. in fact. NOTES I.c o m p u l s i v e s a r e s o limited that t h e y m u s t keep a c o n t r o l l e d distance from c e r t a i n r e l a t i o n s and t h i n g s . O n l y beings w h o .c o m p u l s i v e diseases. o r s o m e aspect o f the p a t h o g e n i c . "What is the matter?". the pathological m a n i f e s t a t i o n s o f o b s e s s i v e . f o r e x a m p l e . but are a special f o r m o t it.11 I hem selves. and u n w o r t h y of h u m a n being. are e n d o w e d w i t h f r e e d o m can e x p e r i e n c e t h e m e a n i n g of o b s e s s i o n s and c o m p u l s i o n s . "Was f eh It Ihnen?" is the question posed by the German-speaking physician. t h a t o b s e s s i o n s and c o m p u l s i o n s d o n o t reduce the realm o f being open and being free vis-a-vis w h a t is e n c o u n t e r e d to t h e s a m e e x t e n t as is the case with s c h i z o p h r e n i c s . T h e c o m p u l s i o n in this disease to be s c r e e n e d off from such t h i n g s is b o r n of the fear t h a t the s u f f e r e r ' s s e l f h o o d is in c o n s t a n t d a n g e r o f d i s i n t e g r a t i n g i n t o t h e s u b h u m a n . b y n a t u r e . Selye. refers directly t o t h e disturbance i n t h e temporality o f Da-sein in these states. i n c i t e " a n d w a s first used in English in t h e eighteenth c e n t u r y in the science of Physiology. 9. 1 4 5 . p. 7. T h e G e r m a n w o r d . 22 (1951).. 5. " D i e Entlastungssituation als W e t t e r w i n k e l f ü r Pathogenese u n d M a n i f e s t i e r u n g neurologischer u n d psychiatrischer K r a n k h e i t e n . Langeweile. 1 4 7 W. 4 . Physiology a n d Pathology of Exposure to Stress: A Treatise Based on t h e Concepts of G e n e r a l . Ibid. See M. Schulte. w h i c h has a quite d i f f e r e n t etymological history f r o m t h e English w o r d " s t i m u l u s . W. It w a s more widely applied in o t h e r realms of h u m a n existance only later.. " Der Nervenarzt. pp. "Stress. " " S t i m u l u s " comes f r o m t h e Latin w o r d meaning " t o prick. on the other hand. Ibid. 1 4 5 . 1 4 7 .. o p . Boss. 1 9 5 4 ) . Ibid. Reiz or reizen. 145. T h e distinctions among t h e stress situations w h i c h a r e bodied f o r t h as the various stress diseases have received more detailed t r e a t m e n t in an earlier w o r k . H. Einführung in die psychosomatische Medizin (Bern a n d S t u t t g a r t : Hans Huber. p. . 1 9 5 0 ) . " Acta (Montreal.S y n d r o m e a n d t h e Disease of A d a p t a t i o n . goad. 1 2 3 f t . T h e w o r d in t h e G e r m a n t e x t is Reiz. p. p.A General Daseinsanalytic Phenomenology 239 3. cit. 6. 11.A d a p t a t i o n . originally h a d more abundant meanings. 10. Schulte. 8.. O n c e a p s y c h i c p r o j e c t i o n h a s b e e n a c t i v a t e d . i t o u g h t t o b e taken as d e v a s t a t i n g p r o o f t h a t no s u c h p r o j e c t i o n t a k e s place. t e n d e n c i e s o r facets of being are projected from the "inside" of the patient's psyche o u t w a r d o n t o o n e o r s e v e r a l o t h e r people. can h a t r e d sufficient t o p r o d u c e w a r l i k e a g g r e s s i o n b e s u m m o n e d u p for t h e evil e n e m y . B u t t h e v e r y o p p o s i t e i s t r u e o f people w h o are supposedly p r o j e c t i n g . P s y c h o l o g i s t s claim t h a t p a t h o l o g i c a l individuals deal w i t h e a c h o t h e r in an a n a l a g o u s w a y . t h e p r o j e c t i n g p a r t y i m a g i n e s h e h a s e v e r y r i g h t t o s e e t h e o t h e r a s solely guilty and b e g g i n g for d e s t r u c t i o n . I w o u l d b e c o m e e m p t i e d of all m a l i c e . I t i s e v e n said t h a t w h o l e g o v e r n m e n t s and n a t i o n s p r o j e c t t h e i r o w n ill will o n t o o t h e r n a t i o n s w h e n e v e r t h e y w a n t to p r e c i p i t a t e a w a r . O n l y in this w a y . so it is said. t h e n .Chapter 14 A DASEINSANALYTIC EXAMINATION OF SOME PREVAILING CONCEPTS OF GENERAL PATHOLOGY Psychic projection A g r e a t m a n y o f t h e p a t h o l o g i c a l p h e n o m e n a o f h u m a n e x i s t e n c e are still b e i n g e x p l a i n e d o n t h e a s s u m p t i o n t h a t c e r t a i n d r i v e s . In s h o r t . all p s y c h o l o g i c a l t h e o r i e s of p r o j e c t i o n bypass . F o r if I w e r e actually capable of p r o j e c t i n g ill will o u t of m y s e l f a n d o n t o a n o t h e r . O n t h e c o n t r a r y . I w o u l d be t h e m o s t p e a c e a b l e person o n this e a r t h . Y e t t h e m e r e fact t h a t o n e p e r s o n m a y i n t e r p r e t a n o t h e r as evil i n c a r n a t e is far f r o m c o n s t i t u t i n g p r o o f for t h e e x i s t e n c e o f psychic p r o j e c t i o n . If we give up the n o t i o n of psychic p r o j e c t i o n as i n a p p r o p r i a t e . T h i s h a p p e n s b e c a u s e t h e y d o n o t see t h a t being t o g e t h e r in a s h a r e d world is a f u n d a m e n t a l trait of Da-sein. T h o u g h t h e p r e s e n c e o f t h e i m a g i n e d d a n c e r s m a y b e n o t h i n g b u t a g e n e r a l l y u n t h e m a t i c f a n t a s y . visual p a t t e r n t e s t does n o t o r i g i n a t e in c o n s c i o u s n e s s . t h u s s e e i n g t h e malice of t h e o t h e r as t h r o u g h a m a g n i f y i n g glass. for i n s t a n c e . At any given m o m e n t . i n t h e open r e a l m o f p e r c e p t i o n t h a t i s t h a t p e r s o n ' s Da-sein. People o f t e n s u c c e e d i n r e s i s t i n g this insight b y f o c u s s i n g e x c l u s i v e l y o n t h e m a l i c i o u s n e s s o f s o m e o t h e r p e r s o n or p e r s o n s . t h a t s o m e o n e seeing t w o f e m a l e d a n c e r s in Plate VII or t h e R o r s c h a c h s e r i e s h a s actually p r o j e c t e d o n t o t h e blots i n f r o n t o f h i m s o m e r e p r e s e n t a t i o n o f d a n c e r s t h a t had b e e n p r e s e n t in a c o n t a i n e r l i k e c o n s c i o u s n e s s or u n c o n s c i o u s . T h e p h e n o m e n a t h a t o c c u r t o a p e r s o n taking su< h a test c o m e n o t from his head but are p h e n o m e n a in the o p e n realm ol perception Currently available t o his Da-sein. It is. and this o p e n n e s s is in t u r n d e t e r m i n e d by t h e a t t u n e m e n t of t h e p e r s o n ' s Da-sein at that given moment. It is this t h a t i n v e s t s e v e r y Da-sein w i t h t h e p o t e n t i a l for being n e g a t i v e and d e s t r u c t i v e in relation to w h a t it e n c o u n t e r s . t h e o n l y t h i n g s t h a t can e n t e r a p e r s o n ' s w o r l d are t h o s e to w h i c h t h a t p e r s o n ' s Da-sein is o p e n . M a l i c e t o w a r d fellow m e n is a p o t e n t i a l i t y i n h e r e n t in e v e r y h u m a n Da-sein.i m m a n e n t in and as each of t h e o t h e r p o t e n t i a l w a y s of b e i n g w i t h o t h e r s t h a t c o n s t i t u t e my Da-sein. like any o t h e r d a n c e r s he m i g h t see or h a v e s e e n . l i g h t h e a r t e d a t t u n e m e n t o f t h e t e s t p e r s o n ' s o p e n n e s s t o t h e world a t t h e g i v e n m o m e n t d e t e r m i n e s t h a t d a n c e r s r a t h e r t h a n devils should o c c u r t o him w h i l e h e s t a r e s a t P l a t e V I I o f t h e R o r s c h a c h s e r i e s . t h e y a r e n o n e t h e l e s s in the p e r s o n ' s w o r l d . in t h e m s e l v e s o u t t h e r e . What actually happens w h e n s i n I) a n . It is a f u n d a m e n t a l fact t h a t e v e n w h a t we o n l y i m a g i n e n e v e r o c c u r s in o u r heads.242 EXISTENTIAL FOUNDATIONS h u m a n reality. T h e i r dwelling place r e m a i n s t h a t open r e a l m as w h i c h he e x i s t s . To r e p e a t . T h e fact t h a t it is n o t carried o u t in e v e r y i n s t a n c e does n o t should o c c u r t o him w h i l e h e s t a r e s a t Plate VII o f t h e R o r s c h a c h s e r i e s . t h e n we c a n n o t go on c a t e g o r i z i n g c e r t a i n popular p s y c h o l o g i c a l r e s e a r c h devices a s p r o j e c t i o n t e s t s .o p e n n e s s . y e t a n o t h e r of the E x i s t e n t i a l s . B u t s u c h m i s i n t e r p r e t a t i o n o f o n e s e l f and o t h e r s h a s n o t h i n g i n c o m m o n w i t h t h e psychic projection o f m e n t a l c o n t e n t s f r o m a person's own internal psyche onto that of a n o t h e r person. T h e d a n c e r s t h a t are recalled t o t h e t e s t s u b j e c t o n this occasion are. T h e r e i s n o e v i d e n c e . t h e c a p a c i t y of a c t i n g in malice b e l o n g s i n h e r e n t l y t o e v e r y o n e o f us. b u t r e v e a l s i t s e l f always in a worldly c o n t e x t o f m e a n i n g and r e f e r e n c e . t h e n . t h e n . T h e d a n c e r r e s p o n s e is j u s t o n e case in point to s h o w tha t r e s p o n s e to a visual p a t t e r n t e s t d o e s n o t o r i g i n a t e in c o n s c i o u s n e s s i m m a n e n t i m a g e s . T h e free. u n d e r c e r t a i n c i r c u m s t a n c e s .w o r l d : it is n o t y e t an i n d e p e n d e n t Da-sein capable of c a r r y i n g o u t its o w n w a y s of being. s o u g h t to address himsell to I In­ p a t i e n t ' s h e a l t h y a s p e c t s and t h u s s t r e n g t h e n him.t h e . If t h e child is n o t yet being w i t h an a u t h e n t i c and a u t o n o m o u s selfhood. T h e m o s t familiar e x a m p l e o f this i s t h e r e e m e r g e n c e o f b e d w e t t i n g i n older children w h e n a n e w child c o m e s i n t o t h e family. it is a n y t h i n g b u t psychic i n t r o j e c t i o n of t h e m o t h e r . T h e child a c t u a l i z e s its Da-sein in t h e w a y s it s e e s it m o t h e r c a r r y i n g o u t h e r s . h o w e v e r . T h e b e d w e t t e r r e t u r n s to a m o d e of b e h a v i o r appropriate and p r o p e r for t h e n e w b o r n infant w h i c h h a s b e c o m e t h e focus o f p a r e n t a l c a r e and a t t e n t i o n . n o long appear. T h i s is possible only if t h e child is i t s e l f a b e i n g .w o r l d and. t h e n t h e child has adjusted its b e h a v i o r t o t h e m o t h e r ' s b e h a v i o r . t h e child could n e v e r s h a p e its b e i n g i n . a p e r s o n m a y r e s u m e b e h a v i o r s w h i c h c h a r a c t e r i z e d his infantile e x i s t e n c e but w h i c h . . n o w t h a t h e h a s g r o w n older.t h e . " " r e g r e s s i o n " h a s b e e n u s e d i n t w o distinct s e n s e s . T h i s supposedly p r o v o k e s and e m p h a s i z e s pathologic al childish b e h a v i o r . i t can h a r d l y i n t r o j e c t a n y t h i n g i n t o itself. T h e specificity o f t h e appearing p h e n o m e n o n depends o n its m e a n i n g f u l n e s s " r e s o n a t i n g " w i t h t h e f o r m s a p p e a r i n g in t h e visual field o f t h e t e s t s u b j e c t . O n e o f t h e s e r e f e r s t o a n o c c u r r e n c e t h a t m a y b e o b s e r v e d directly. Psychic regression R e g r e s s i o n is a n o t h e r c o n c e p t t h a t h a s played a part in t h e traditional p i c t u r e o f p a t h o l o g y .t h e . J u n g . " It is another m a t t e r when Jung. a primordial ability to be t o g e t h e r w i t h o t h e r s in a s h a r e d w o r l d .i n . S o h e condui l e d i n t e r v i e w s b e t w e e n physician and patient like an e n c o u n t e r b e t w e e n two h e a l t h y adults. T h i s m e a n s t h a t t h e child has n o t y e t b e e n able t o win its a u t o n o m y from t h e m o t h e r ' s b e i n g i n . W h e n a child c o n d u c t s i t s e l f in t h e v e r y s a m e w a y its m o t h e r does. We do n o t o b j e c t to this u s a g e of t h e w o r d " r e g r e s s i o n . W h e n e v e r such e n g a g e m e n t d o e s take place. sitting face to face. t h e child dwells w h o l l y o u t s i d e i t s e l f in t h e m a t e r n a l Da-sein.w o r l d t o m a t c h its m o t h e r ' s . E v e r y o n e r e c o g n i z e s t h a t . In l e t t i n g its Da-sein be a b s o r b e d in its m o t h e r ' s w a y s of b e i n g . among many others. W i t h o u t this a b s o l u t e p r e r e q u i s i t e . Like t h e adjective " u n c o n s c i o u s . Psychic introjection T h e n o t i o n o f psychic i n t r o j e c t i o n i s a s deceptive a s t h a t o f psychic p r o j e c t i o n . by c o n t r a s t . as s u c h . asserts that patients t r e a t e d p s y c h o a n a l y t i c a l l y o r d a s e i n s a n a l y t i c a l l y a r e compelled t o r e g r e s s b e c a u s e t h e y are made to lie d o w n on a c o u c h j u s t as a child is made to he d o w n in a cradle.Prevailing Concepts of General Pathology 243 idea o c c u r s t o the t e s t s u b j e c t i s t h a t o n e o r m o r e o f t h e s e p h e n o m e n a a r e recalled from an u n t h e m a t i c m o d e of p r e s e n c e to o n e of a t h e m a t i c visualization. In t h e c o u r s e of a c o u c h analysis t h e p a t i e n t e l i m i n a t e s his d e s p e r a t e a t t e m p t t o hide his i m m a t u r e . At b e s t . w h i c h a l w a y s p r e s u p p o s e s a n ability t o u n d e r s t a n d t h e m e a n i n g f u l n e s s o f w h a t i s e n c o u n t e r e d . r e n e w e d b e d w e t t i n g in older children can n e v e r b e explained according t o t h e c a u s a l principle o f r e g r e s s i o n to s o m e e a r l i e r libidinal s t a g e . such as t h o s e of an u n c o n s c i o u s . S i g m u n d Freud o r i g i n a t e d t h e t h e o r y o l repression w e . T h i s alleged p h e n o m e n o n i s s e e n . it h a s b e c o m e an indispensable e x p l a n a t o r y principle in p s y c h o p a t h o l o g y and p s y c h o s o ­ matic medicine. T h e p a t i e n t would n o t h a v e b e e n sick. It can be u n d e r s t o o d o n l y in relation t o t h e affected child's c u r r e n t r e l a t i o n s h i p t o its m o t h e r . f u r t h e r m o r e . i. without any openness or responsiveness to meanings. t h e y r e m a i n u n c h a n g e d . T h i s is b u t a first n e c e s s a r y t h e r a p e u t i c s t e p t o w a r d a d e f e r r e d m a t u r a t i o n . Psychic repression T h e c o n c e p t o f r e p r e s s i o n t a k e s its place alongside t h e m o s t i m p o r t a n t ideas of c o n t e m p o r a r y p a t h o l o g y . f u n d a m e n t a l l y worldless. Here regression is t r a n s f o r m e d i n t o an e x p l a n a t o r y principle in w h i c h it c o m e s to m e a n a r e t u r n to a libidinal s t a t e of less m a t u r i t y f r o m o n e of g r e a t e r m a t u r i t y . a s t h e c a u s e o f c e r t a i n s y m p t o m s .e.244 EXISTENTIAL FOUNDATIONS But in the course of a psychoanalytic or Daseinsanalytic treatment. w h i c h is.. No less i m p o r t a n t is t h e i n a p p r o p r i a t e c o n c e p t u a l i z i n g of r e g r e s s i o n within the framework of Freud's psychoanalytic theory. in t h a t t h e m e a n i n g f u l n e s s of w h a t e v e r is e n c o u n t e r e d is able to r e v e a l itself. T h u s . H o w a n y piece o f h u m a n b e h a v i o r . even t h o u g h t h e a n a l y s t addresses h i m s e l f i n t e n s i v e l y to his p a t i e n t ' s h e a l t h y adult possibilities. d i s t o r t e d c h i l d i s h n e s s . Libido c o n c e i v e d of as p s y c h i c e n e r g y is akin to t h e physicalistic c o n c e p t o f e n e r g y . and of disturbed f u n c t i o n s of a body. this e n a b l e s t h e p a t i e n t t o hide his c h i l d i s h n e s s m o r e e f f e c t i v e l y . i f h e had n o t from e a r l y childhood r e m a i n e d i n a n i n f a n t i l e . This means that the p a t i e n t is already in a s t a t e of pathological i m m a t u r i t y long b e f o r e t h e c o u c h t r e a t m e n t b e g i n s . o u t o f blind q u a n t i t i e s o f e n e r g y . the f o r m of t h e t r e a t m e n t d o e s n o t m o t i v a t e a p a t i e n t to a r e g r e s s i o n . w h i c h t h e n b e c o m e s clearly visible. In particular. could e v e r arise o u t o f libido. I f t h e p a t h o l o g i c a l infantile m o d e s o f b e h a v i n g a r e i g n o r e d . is a m y s t e r y . i m m a t u r e s t a g e o f d e v e l o p m e n t w i t h respect to many important modes of behaving. n o r w o u l d h e h a v e e n t e r e d analysis. Y e t w e k n o w b y n o w t h a t s u c h e x p l a n a t i o n s actually explain n o t h i n g a t all. he c a n n o t be returned to it. T h e p h e n o m e n o n of h u m a n being is p r e d i c a t e d on t h e possibility of a perceiving o p e n n e s s . H e does n o t b e c o m e m o r e free f o r his i n n a t e p o t e n t i a l i t y t o e x i s t a s a n adult h u m a n being. h o w e v e r . n o r does a r e g r e s s i o n o c c u r f o r a n y o t h e r r e a s o n . and i m p u l s e s supposedly a t t a c h e d t o t h e s e i n t r a p s y c h i c r e p r e s e n ­ t a t i o n s . b u t also t h e a f f e c t s . H e r e t h e d e c e i v e r and t h e deceived a r e o n e 1 0 1 . h o w e v e r . he tried to f o r c e this e v e n t i n t o t h e c o n f i n e s of a d y n a m i c . h e d i s t o r t e d t h e p h e n o m e n o n i t s e l f b e y o n d r e c o g n i t i o n and p r o d u c e d a p u r e l y fictive m e n t a l c o n s t r u c t . It is n o t difficult to p i n p o i n t t h e g r a v e i n j u r y d o n e to t h e original p h e n o m e n o n t h r o u g h its i n t e r p r e t a t i o n b y F r e u d ' s m e t a p s y c h o l o g i c a l t h e o r y .l o v e and v a n i t y c a n e f f e c t a r e p r e s s i o n w h e n t h e y a r e injured by c e r t a i n i n t r a p s y c h i c m a t e r i a l . m e c h a n i s t i c t h e o r y . T h e c a u s e o f r e p r e s s i o n w i t h i n t h e psychic a p p a r a t u s w a s seen by F r e u d in an i n c o m p a t i b i l i t y b e t w e e n the o b j e c t i o n a b l e psychic m a t e r i a l and t h e individual's i n t r a p s y c h i c r e p r e s e n ­ t a t i o n s o f w h a t i s s h a m e f u l .w o r l d o b j e c t s w i t h i n t h e p s y c h e . this m a t e r i a l could r e t u r n o n l y i n t h e c a m o u f l a g e o f n e u r o t i c symptoms. I n p a t i e n t s s u f f e r i n g from n e u r o s e s .s e a t e d psychic c o n t a i n e r . t h e u n c o n ­ s c i o u s . n o o n e u s e d t h e w o r d a s i t i s u s e d n o w . W h a t w e r e p r e s s i n t o the u n c o n s c i o u s is w h a t w e hide from o u r s e l v e s . n o t o n l y in t h a t t h e p s y c h e is m i s t a k e n about itself. r e p r e s s i o n is e s s e n t i a l l y a c r a s s self-deception. i n w h i c h c a t e g o r y h e included n o t o n l y i m a g e s o f e x t e r n a l . A t first. A c c o r d i n g t o t h e l a t t e r . M o r e t h a n a m e r e linguistic i n n o v a t i o n .Prevailing Concepts of General Pathology 245 h a v e today. t h e n . I n s t e a d . F r e u d claimed t h a t p s y c h i c r e p r e s s i o n i s c o n c e r n e d primarily w i t h e n d o p s y c h i c m a t e r i a l . F r e u d ' s t h e o r y p o r t r a y e d psychic r e p r e s s i o n a s a n expulsion of unpleasant endopsychic material from one compartment of t h e p s y c h e i n t o a n o t h e r . I n this m u t i l a t e d f o r m t h e F r e u d i a n t h e o r y o f repression has been uncritically adopted by most current practitioners of p s y c h o t h e r a p y and p s y c h o s o m a t i c m e d i c i n e . and will r e m a i n . a n x i e t y o r guilt p r o v o k i n g . I n doing this. W h a t F r e u d s a w a s t h e g r e a t e s t signifi­ cance of such endopsychic processes was the return of repressed material from t h e u n c o n s c i o u s t o t h e c o n s c i o u s s y s t e m . F r e u d held t h a t r e p r e s e n t a t i o n s and a f f e c t s actually c h a n g e d l o c a t i o n s . d i s g u s t i n g . e x t r e m e l y m e a n i n g f u l for h u m a n p a t h o l o g y . T h e r e is little d o u b t t h a t F r e u d d i s c o v e r e d a facet o f h u m a n e e x i s t e n c e w h o s e s i g n i f i c a n c e can h a r d l y b e e x a g g e r a t e d . m o v i n g from t h e p s y c h i c s y s t e m o f c o n s c i o u s n e s s i n t o a m o r e d e e p . b u t also in that it is actually deceived by itself. his c o n c e p t o f p s y c h i c r e p r e s s i o n p o i n t s to a p h e n o m e n o n t h a t is. As F r e u d s a w it. B e f o r e him. drives. E v e n s e l f . H e s h o r t l y gave this t o p o g r a p h i c a l t h e o r y a d y n a m i c c o u n t e r p a r t . Y e t F r e u d ' s t h e o r e t i c a l bias t o w a r d t h e p h i l o s o p h y o f t h e n a t u r a l s c i e n c e s blinded h i m to an u n d e r s t a n d i n g of r e p r e s s i o n as a p h e n o m e n o n of existence. t h e s a m e e f f e c t i s a c h i e v e d w h e n libidinal c a t h e x i s i s d i s e n g a g e d from t h e u n w a n t e d e n d o p s y c h i c r e p r e s e n t a t i o n s and a f f e c t s . until t h e y a r e n o l o n g e r s t r o n g e n o u g h t o a t t r a c t t h e a t t e n t i o n o f c o n s c i o u s n e s s . T h i s is a flight from t h e c o n c r e t e b e i n g s actually p e n eived in a world. a fleeing from t h e m . In o r d e r to c r e a t e t h e duality t h a t w a s logically n e c e s s a r y t o a c c o m m o d a t e r e p r e s s i o n a s s e l f . e x i s t s u l t i m a t e l y i n t h e i n c o n g r u i t y o f first h a v i n g t o k n o w something in order not to have to know that same something.. 1 K o h l i . except that here it is one of our own. S h e pointed o u t t h a t Freud had advised us to t h i n k of t h e r e l a t i o n s h i p of self t h a t is involved in r e p r e s s i v e selfdeception a s a n a l o g o u s t o t h e m o d e o f d e c e p t i o n b e t w e e n people.t h e .d e c e p t i o n . w e r e f e r t o a n e x c e r p t from S a r t r e ' s c h a p t e r on " B a d F a i t h . as this F r e u d i a n selfd e c e p t i o n . t h e r e is no p r o b l e m . We stand in t h e s a m e r e l a t i o n to this as to s o m e psychic p r o c e s s in another person.w o r l d and his c o m p a r t m e n t a l i z a tion o f t h e p s y c h e i n t o t h e t w o s y s t e m s o f c o n s c i o u s n e s s and t h e u n c o n s c i o u s .i n . r e p r e s s i o n . 3 . a w a r e of t h e t r u t h . In t h e p h e n o m e n o l o g i c a l o u t l o o k . a looking a w a y from t h e m . T h e r e are his o w n w o r d s : " T h e t e r m ' u n c o n s c i o u s ' r e f e r s t o a n y psychic p r o c e s s w h o s e e x i s t e n c e w e a r e forced t o a s s u m e o n t h e e v i d e n c e o f its o u t w a r d e f f e c t s b u t o f w h i c h w e k n o w n o t h i n g directly.w o r l d . F o r a n y c e n s o r of t h e p r o p e r t i e s h e specifies w o u l d b e o n l y a n ' u n c o n s c i o u s c o n s c i o u s n e s s . t h e s a m e t r u t h w h i c h I. Y e t if I realize t h a t I w a n t to deceive m y s e l f . As d e c e i v e r . this o t h e r a c c e p t s m y d e c e p t i o n a s being t h e t r u t h . B u t if we t r y to define t h e n a t u r e of a c e n s o r h a v i n g such a f u n c t i o n . t h e r e m u s t e x i s t s o m e special a g e n t t o decide w h i c h r e p r e s s e d m a t e r i a l i s t o b e c o m e c o n s c i o u s . ' T h e h y p o t h e s i s o f a c e n s o r r e i n f o r c e s t h e original d i l e m m a . I k n o w t h e t r u t h t h a t I distort.e. as t h e deceived. i. for I can be deceived only if I w a n t to k n o w t h e t r u t h . and split it i n t o t w o pieces.246 EXISTENTIAL FOUNDATIONS a n e x p l a n a t i o n o f h o w this can b e so.K u n z n o t long a g o d e m o n s t r a t e d w i t h striking clarity h o w F r e u d m a n a g e d t o s i d e s t e p t h e logical d i l e m m a h e faced. w h i c h s e e s h u m a n Dasem as i n t e g r a l .s a c is to r e j e c t is reification o f h u m a n b e i n g . the c o n s c i o u s n e s s and t h e u n c o n s c i o u s . I am a w a r e of my i n t e n t to deceive. F r e u d calls this t h e c e n s o r .t h e . Freud t o o k t h e i n t e g r a l selfhood of h u m a n e x i s t e n c e . r e p r e s s i o n b e c o m e s a v e r y specific m o d e o f h u m a n c o n d u c t t o w a r d s o m e t h i n g that i s e n c o u n t e r e d . we m u s t label Freud's solution a failure. T h e o n l y w a y o u t of Freud's t h e o r e t i c a l c u l .i n . fail to r e c o g n i z e . d e c e i v e t h e o t h e r . W h e r e d e c e i v e r and deceived are t w o o r m o r e s e p a r a t e p e r s o n s . I can no l o n g e r be deceived.d e . "In lying. a refusal to admit t h e address and urgent appeal of e n c o u n t e r e d b e i n g s . " A n d in fact. objectified it as a p s y c h i c a p p a r a t u s . indivisible b e i n g . H e r e it is a m a t t e r of my b e h a v i o r t o w a r d a n o t h e r : I. " w h e r e he w r i t e s ." 2 If this is the r e l a t i o n s h i p o b t a i n i n g b e t w e e n w h a t is c o n s c i o u s a n d w h a t i s r e p r e s s e d . "Das sogenannte Unbewusste. is a n y t h i n g but a mechanical shuttling of representations between c o m p a r t m e n t s of a p s y c h e .-P. 4 .Prevailing Concepts of General Pathology 247 T h e i r p r e s e n c e i n t h e p e r c e p t i v e l y open r e a l m o f his e x i s t i n g f o r c e t h e m s e l v e s o n h i m but. H . K o h l i . D r u c k & Verlag A G .K u n z . 1 9 4 3 . T h e final s e c t i o n is t h e r e f o r e d e v o t e d to considering these consequences. 1 5 . 7 6 . 2 S.w o r l d c a n n o t a d m i t b e c o m e s m o r e and m o r e i n t e n s e . p. it b e c o m e s i n c r e a s i n g l y o b t r u s i v e . Sartre. w h a t is r e p r e s s e d is n o t set aside. R e p r e s s i o n . Freud. L'Etre et le Ne'ant (Paris: Librarie Gallimard." Zeitschrift fur psychosomatische Medizin und Psychoanalyse. R a t h e r . m u s t i n e v i t a b l y h a v e c o n s e q u e n c e s for practical t h e r a p y in t h e s e fields. 94 ff. b e c a u s e this o p e n n e s s h a s b e e n d i s t o r t e d b y o t h e r s . 3 A. In r e p r e s s i o n . t h e n . S o l o t h u r n . V o l . A D a s e i n s a n a l y t i c f o u n d a t i o n of medicine and p s y c h o l o g y . p.i n . T h e u r g e n c y o f t h e appeal o f w h a t t h e closed and n a r r o w e d b e i n g . vol. NOTES 1 J. Gesammelle Werke. 6 . 1 9 7 6 . .t h e . c a n n o t find a w a y i n t o his w o r l d . such as w e h a v e outlined i n this w o r k . c o m m o n l y understood as that concerned with treating illnesses. t h e r a p e u t i c m e a s u r e s c a n b e divided i n t o t h r e e p a r t s : (a) t h o s e w h o a r e t o b e a c t e d upon. e l u c i d a t i n g t h e m i n a w a y t h a t s u i t s t h e field t o w h i c h t h e y b e l o n g . are the exclusive prerogative of h u m a n beings. t h e p a t i e n t . (b) t h e locus o f t h e i h e i a p e u t l i a c t i o n . Like all o t h e r a c t i o n s . Because only people h a v e t h e c a p a c i t y to act. all g e n u i n e a c t i o n s .Part IV S u g g e s t i o n s for a Daseinsanalytic Therapy Preliminary Remarks " T h e r a p y " is t h e n a m e given to a p a r t i c u l a r kind of h u m a n activity. O u r d e f i n i t i o n limits w h a t qualifies a s g e n u i n e a c t i o n s o n l y t o r e s p o n s e s t o w h a t h a s already b e e n p e r c e i v e d i n its c o n t e x t o f m e a n i n g and r e f e r e n c e . i n this c o n t e x t . including therapeutic procedures. W e j u s t i f y this l i m i t a t i o n w i t h t h e age-old c o m m a n d m e n t that all s c i e n t i f i c r e s e a r c h yields t o t h e facts t h e m s e l v e s . . and (c) t h o s e w h o a r e t h e r a p e u t i c a l l y a c t i v e . and m o r t a l i t y . c e r t a i n of a p e r s o n ' s p o t e n t i a l i t i e s for relating h i m s e l f t o w h a t h e e n c o u n t e r e d b e c a m e less available t h a n o t h e r s . h i s t o r i c i t y . and t e m p o r a l i t y . being t o g e t h e r in a s h a r e d w o r l d . A c c o r d i n g l y . i n t h e b r o a d e s t s e n s e o f t h e w o r d . the various m o d e s of h u m a n illness can be classified e x i s t e n t i a l l y . Y e t it is t h e t o t a l i t y of t h e potential w a y s of b e i n g i n h e r e n t in a p e r s o n . a t t u n e m e n t .Chapter 15 THE PATIENT TO BE TREATED W e c o m m o n l y say t h a t t h e o b j e c t s o f t h e r a p y a r e h u m a n d i s e a s e s . Da-sein is in t u r n r e c o g n i z e d in its medically significant c h a r a c t e r i s t i c s of o p e n n e s s . In t r y i n g to m a p o u t a g e n e r a l p a t h o l o g y . W e found t h a t n o m a t t e r w h a t t h e p a r t i c u l a r illness. t h a t c o n s t i t u t e s his h u m a n Da-sein. w e a t t e m p t e d t o give a c c u r a t e l y h u m a n d e s c r i p t i o n s o f t h e m o d e s o f illness t h a t r e q u i r e t r e a t m e n t . W e have seen t h a t this applies equally to people afflicted with p s y c h o n e u i o l ii and .w o r l d . we f o u n d t h a t illness is a l w a y s an i m p a i r m e n t or limitation of a h u m a n b e i n g ' s f r e e d o m o f m o v e m e n t . T h e scientific c o n c e p t of disease is an a b s t r a c t i o n gleaned from t h e p a r t i c u l a r m o d e s of h u m a n illness. In t h e i m m e d i a t e l y p r e c e d i n g s e c t i o n o f this w o r k . spatiality.t h e . and n o t h i n g else. a c c o r d i n g to t h e i r t r u e n a t u r e s — o n l y in relation to the p a r t i c u l a i i m p a i r m e n t t h a t affects t h e m a n i f e s t a t i o n o f t h e s e E x i s t e n t i a l s . his b e i n g i n .that i s . b u t it is m o r e appropriate to speak of t r e a t i n g this or t h a t h u m a n b e i n g w h o is ill at a p a r t i c u l a r t i m e in this or t h a t w a y . s i n c e t h e pain o f c a r r y i n g a h e a v y k n a p s a c k p r e v e n t s h i m from h i k i n g . While the pneumonia lasts. t o t h o s e s u f f e r i n g f r o m b a c t e r i a l i n f e c t i o n . T h e natural scientific outlook diagnoses a hernia. In r e c o g n i z i n g t h a t this i s t h e basic n a t u r e o f e v e r y h u m a n m o d e o f b e i n g ill. F o r s o m e t i m e . N o r does it m a k e a n y d i f f e r e n c e w h e t h e r a p a t h o l o g i c a l loss of f r e e d o m r e s u l t s f r o m a c o n g e n i t a l d e f e c t . b r i n g i n g w i t h i t part o f t h e i n t e s t i n e . h e had had t o r e s t r i c t his w o r k as a b r i c k l a y e r ' s f o r e m a n . B u t t h e D a s e i n s a n a l y t i c v i e w . r e c o g n i z e s t h a t t h e ill p a t i e n t ' s c o m p l a i n t is t h a t t h e possibility of playing w i t h his y o u n g s o n h a s b e e n s e v e r e l y limited. t h e s e a r e t h e disrupted w a y s o f r e l a t i n g w i t h t h e g i v e n s o f the patient's world that the surgeon affects w h e n he restores the p a t i e n t ' s f r e e d o m t o dispose o v e r t h e possibilities f o r r e l a t i n g w h i c h had b e e n disrupted. for instance. T h e s e are t h e kinds o f t h i n g s t h e D a s e i n s a n a l y t i c v i e w s e e s as f u n d a m e n t a l in t h a t w a y of b e i n g ill w h i c h m e d i c i n e c o m m o n l y calls a n inguinal h e r n i a . and t o t h o s e w h o c o m e a w a y f r o m a n a u t o m o b i l e a c c i d e n t w i t h a n injured limb.252 EXISTENTIAL FOUNDATIONS p s y c h o t i c s y m p t o m s . i n t e r v e n e s directly in t h e h u m a n b e i n g ' s f r e e d o m t o c a r r y o u t his i n n a t e c o n c r e t e possibilities f o r relating t o w h a t he e n c o u n t e r s — i s s i g n i f i c a n t n o t o n l y f o r a D a s e i n s a n a l y t i c g e n e r a l p a t h o l o g y b u t f o r a D a s e i n s a n a l y t i c a p p r o a c h to t h e r a p y as well. in principle all a r e o n e and t h e s a m e in t h e i r fundamental nature. we c a n see t h a t t h e r a p e u t i c m e a s u r e s likewise h a v e a direct e f f e c t on w h i c h e v e r c o n c r e t e e x i s t e n t i a l w a y o f being h a s b e e n p a t h o l o g i c a l l y impaired. In p r e s c r i b i n g the a p p r o p r i a t e . or from d a m a g e t h a t has b e e n i n c u r r e d . w h e n e v e r it sees the peritoneum protruding through an enlarged inguinal o p e n i n g . B u t t h e fact t h a t e v e r y s i t u a t i o n w h i c h leads to being ill a f f e c t s a p e r s o n ' s Da-sein—that is.t h e . to an area taking in o n l y t h e h o s p i t a l bed a n d its i m m e d i a t e s u r r o u n d i n g s .w o r l d s h r i n k s at least as m u c h as t h a t of o u r t e s t subject at ter h e r c a r accident. the human beingi n . T h e pain e v e n c a u s e s h i m t o s h r i n k from t h e p r o s p e c t o f e m b r a c i n g his wife p a s s i o n a t e l y . s i n c e i t h a s b e c o m e i m p o s s i b l e t o t o s s t h e b o y u p i n t o t h e air a n d c a t c h h i m . his f a v o r i t e sport. pre. f o r all practical p u r p o s e s . In b o t h i n s t a n c e s . T h e p a t i e n t also says t h a t h e can n o l o n g e r g o m o u n t a i n c l i m b i n g . He no l o n g e r feels c o n f i d e n t e n o u g h to pitch in and help t h o s e h e i s s u p e r v i s i n g .or postnatally. A l t h o u g h medical t r e a t m e n t m a y a p p e a r in a t h o u s a n d different o u t w a r d f o r m s . Its t e m p o r a l i t y c o n s i s t s in its u s i n g t i m e by w a i t i n g for t h e d o c t o r . and little m o r e . t h e spatiality of t h e Da sein is reduced. f u r t h e r m o r e . w h i c h a d h e r e s t o t h e basic n a t u r e o f h u m a n b e i n g . F r o m a n a d e q u a t e l y h u m a n p e r s p e c t i v e . S o m e t h i n g a n a l o g o u s o c c u r s in t h e t r e a t m e n t of a p e r s o n ill w i t h a pneumococcous infection. H u m a n m o o d s can n o w b e d i r e c t e d f r o m o u t s i d e . simply to free h u m a n b e i n g .w o r l d . capable o f b e i n g r e a t t u n e d b y m a n y d i f f e r e n t m e a n s . T h e electrical i m p u l s e ! i n t r o d u c e d i n t o t h e c e r e b r a l bodily s p h e r e o f t h e h u m a n e x i s t e n c e . a s the b o d y h o o d o f t h e e x i s t i n g Da-sein. b u t as s u c h its specific h u m a n n e s s is lost to v i e w . W h a t m a t t e r s far m o r e a t t h i s point i s t h e k n o w l e d g e t h a t e v e n t h e s e most innovative of neuropsychiatric experiments remain incomprehen­ sible as long as t h e y are c o n c e p t u a l i z e d as c o n s i s t i n g of t h r e e s e p a r a t e c o m p o n e n t s : a physical b r a i n . It is i m p o s s i b l e to c o m p r e h e n d h o w a brain c o n c e p t u a l i z e d as a p u r e l y m a t e r i a l . A n o t h e r e x a m p l e o f t h e s a m e basic type can b e f o u n d i n t h e latest d e v e l o p m e n t s t o w a r d a n e u r o p s y c h i a t r i c t h e r a p y . and i t is. t h e n i t i s n o l o n g e r m y s t e r i o u s h o w t h e e l e c t r i c a l i m p u l s e s w h i c h t h e physician i n t r o d u c e s via e l e c t r o d e s c a n i n t e r v e n e directly i n t h e p e r s o n ' s e x i s t e n t i a l a t t u n e m e n t and b r i n g a b o u l a r e a t t u n e m e n t o f his w h o l e b e i n g . N o t o n l y can t h e p e r s o n ' s disposition at t h e t i m e be r e a d f r o m a c u r v e of e l e c t r i c a l p o t e n t i a l s w i t h i n t h e b r a i n .253 The Patient to Be Treated a n t i b i o t i c s . and e l e c t r i c a l i m p u l s e s f r o m t h e o u t s i d e .i n . T h e t i m e h a s n o t yet c o m e t o a s s e s s t h e definitive t h e r a p e u t i c v a l u e o f s u c h e l e c t r i c a l i n t e r v e n t i o n .i n . 1 T h e s e n e w neuropsychiatric experiments are understandable in their full s i g n i f i c a n c e o n l y w h e n h u m a n b e i n g i s s e e n a s a n a t t u n e d w o r l d s p a n n i n g r e a l m o f t h e ability t o p e r c e i v e t h e m e a n i n g o f w h a t i s e n c o u n t e r e d . like the s u r g e o n w i t h his o p e r a t i o n on a h e r n i a or his s e t t i n g of a b o n e .t h e . physical o r g a n e x i s t i n g i n isolation could p r o d u c e o u t o f itself an a t t u n e m e n t of the open worldy realm of the h u m a n being with its ability to perceive t h e m e a n i n g f u l n e s s of w h a t it e n c o u n t e r s . a i m s . T h e logic o f e q u a t i n g t h e s e t w o p h e n o m e n a i s less c o n v i n c i n g t h a n a claim t h a t t h e b l o s s o m s of t h e r o s e are m e r e l y a v a r i e t y of t h o r n on t h e basis o f t h e o b s e r v a t i o n t h a t b o t h t h o r n s and b l o s s o m s are t o b e s e e n o c c u r r i n g s i m u l t a n e o u s l y o n t h e s a m e plant.w o r l d o f p a t h o l o g i c a l l i m i t a t i o n . a p s y c h e . though inadequately. b y m e a n s o f e l e c t r o d e s i n t r o d u c e d i n t o t h e limbic lobe o f t h e c e r e b r u m . w h e t h e r h e k n o w s i t o r n o t . w h i l e a t t u n e d . as an objectifiable.t h e . b u t e l e c t r i c a l i m p u l s e s c a n a c t u a l l y b e fed i n t o t h e s a m e a r e a s o f brain i n o r d e r t o c h a n g e a p a t i e n t ' s m o o d f r o m c l o s e d o f f d i s c o n t e n t t o c h e e r f u l r e s p o n s i v e n e s s . It is e v e n m o r e i n c o m p r e h e n s i b l e w h e n e x t r a n e o u s e l e c t r i c a l i m p u l s e s are a t t r i b u t e d t h e capacity t o p r o d u c e o u t o f t h e m s e l v e s h u m a n a t t u n e m e n t s . as it is r e p r e s e n t e d by H e s s ' s e x p e r i m e n t s involving e l e c t r i c a l s t i m u l a t i o n o f t h e c e r e b r a l c o r t e x i n a n i m a l s . T h e limbic s y s t e m o f t h e brain i s f u n d a m e n t a l l y t h e bodily s p h e r e of a h u m a n e x i s t e n c e ' s a t t u n e m e n t . measurable organ of the p h y s i c a l body. It can be i n t e r p r e t e d . W h e n this so-called brain is u n d e r s t o o d as a n e c e s s a r y and i m m e d i a t e s p h e r e of t h e f u n d a m e n t a l l y a t t u n e d e x i s t e n c e o f t h e h u m a n b e i n g . t h e i n t e r n i s t . A t o n e w i t h t h e c h a n g e i n this s p h e r e o f a t t u n e m e n t . all s h a r e t h e goal of s e e k i n g to r e s t r i c t the p e r c e p t i v e r e s p o n s i v e o p e n n e s s o f the s c h i z o p h r e n i c for t h e m e a n i n g s o f w h a t h e e n c o u n t e r s . r e m e m b e r i n g . J u s t as a careful r e g i m e n of diet and insulin i n j e c t i o n s reduce t h e d e m a n d s on t h e w e a k e n e d p a n c r e a s of a diabetic and allow it to r e a c h partial r e c o v e r y . t h e a t t u n e m e n t i t s e l f i s i n e v i t a b l y and n e c e s s a r i l y c h a n g e d . surgical and i n t e r n i s t t h e r a p i e s b o t h s t r i v e . are addressed and e n g a g e d b y t h e w o r l d . a D a s e i n s a n a l y t i c t h e r a p y s e e k s first t o p r e s e r v e t h e s c h i z o p h r e n i c p a t i e n t from a n e x c e s s i v e . passed o n t o t h e e v e n m o r e v i o l e n t m e a s u r e s o f p s y c h o s u r g e r y .w o r l d . It is the broad r a n g e of D a s e i n s a n a l y t i c t h e r a p y t h a t allows it to reveal w i t h singular clarity w h a t is t h e f u n d a m e n t a l basis of all medical t r e a t m e n t : a lusis. and e m o t i o n a l engagement. T h e o n l y d i f f e r e n c e b e t w e e n i t and surgical o r i n t e r n i s t t h e r a p i e s is t h a t t h e s e l a t t e r usually i n t e r v e n e o n l y in t h e bodily s p h e r e o f t h e pathologically impaired p o t e n t i a l i t i e s for e x i s t e n t i a l r e l a t i o n s h i p s . m o r e f r e e . particularly l o b o t o m i e s . t h e a n c i e n t G r e e k w o r d for l i b e r a t i o n . t h e n t o drug t r e a t m e n t s . does n o t h a r m t h e D a s e i n s a n a l y t i c u n d e r s t a n d i n g of biophysical m o o d c r e a t i o n . A s varied a s t h e s e m e t h o d s o f t r e a t m e n t m a y s e e m a t first g l a n c e .254 EXISTENTIAL FOUNDATIONS i n e v i t a b l y alter t h e e l e c t r i c a l p o t e n t i a l s — d e m o n s t r a t e d and i n t e r p r e t e d a s such b y n a t u r a l s c i e n c e — o f this c e r e b r a l b o d y h o o d o f t h e given a t t u n e m e n t . e x p l a i n i n g w h a t e n e r g y i t s e l f is). W e n e e d also t o r e c o g n i z e t h e e x i s t e n t i a l basis o f h u m a n n a t u r e i n understanding the modern treatment of schizophrenia.i n . For. desire. w h o s e e x i s t e n t i a l f r e e d o m is r e d u c e d relative to t h e n o r m . as we have s e e n . E v e n t h e s o r t o f i n t e n s i v e t h e r a p y o u t l i n e d i n o u r t e s t case a i m s for t h e s a m e o u t c o m e . P s y c h o t h e r a p y o f s c h i z o p h r e n i a usually g o e s a s t e p f u r t h e r . T h e y all a t t e m p t t o r e d u c e t h e d e g r e e and i n t e n s i t y t o w h i c h t h e p a t i e n t s . n o less than . T h e fact t h a t t h e n a t u r a l s c i e n c e s can define e l e c t r i c i t y o n l y as a p a r t i c u l a r sort of e n e r g y ( w i t h o u t . m o r e m a t u r e possibilities o f p e r c e i v i n g and r e s p o n d i n g to a f r e e r b e i n g . h o w e v e r . while p s y c h o t h e r a p y p r o c e e d s against pathological i m p a i r m e n t s o f t h o s e r e a l m s o f h u m a n r e l a t e d n e s s t o t h e w o r l d t h a t c o m e u n d e r s u c h broad h e a d i n g s as visualization. d e s t r u c t i v e w o r l d e n g a g e m e n t so he can a c h i e v e a m e a s u r e of a u t h e n t i c selfhood and slowly g o o n t o r i c h e r . will. It is e n o u g h to u n d e r s t a n d t h a t t h e w o r d energy is e m p l o y e d w h e n e v e r the p o t e n t i a l e x i s t s for o n e p a r t i c u l a r p h e n o m e n o n t o s u c c e e d a n o t h e r w i t h strict temporal regularity. which began w i t h insulin and e l e c t r i c s h o c k t h e r a p y .t h e . A d e q u a t e r e d u c t i o n m a k e s him able t o m a i n t a i n a m o r e or less free selfhood in t h e face of w h a t he p e r c e i v e s and to conduct himself toward it in ways congruent with the conduct of the n o r m a l w a k i n g people a r o u n d h i m . It r e v e a l s t h e t r u e locus of medical t h e r a p y . b y t h e s a m e a u t h o r . t h e n . M . C f .. R .s t i m u l a t i o n and recoding in c o m p l e t e l y free p a t i e n t s . " ] . Ment. Basel.The Patient to Be Treated 255 p s y c h o t h e r a p y . t o c a s t aside t h e pathological o b s t r u c t i o n s t o t h e free c a r r y i n g o u t o f all possible w a y s o f r e l a t e d n e s s w i t h w h a t is e n c o u n t e r e d . NOTE 1. t h o u g h less explicitly. t h e r e is j u s t i f i c a t i o n for calling all medical t h e r a p i e s D a s e i n s a n a l y t i c t h e r a p i e s of r e s i s t a n c e . Nerv. " T e l e m e t r i c M e t h o d s in Brain R e s e a r c h . a n d . In a v e r y b r o a d b u t s t r i c t s e n s e . July 1 9 6 9 . J . Dis. . " delivered at the IVth International C o n g r e s s on Pharmacol­ ogy. 1 4 7 ( 1 9 6 8 ) . 3 2 9 . " I n t r a c e r e b r a l r a d i o . D e l g a d o .4 0 . D a s e i n s a n a l y t i c t h e r a p y is a paradigm for all medical t h e r a p y in still a n o t h e r r e s p e c t . Switzerland. m a d e explicit s o m e t h i n g t h a t t h e b e s t p h y s i c i a n s had a l w a y s implicitly t a k e n i n t o a c c o u n t . not j u s t t h o s e w h o specialize in p s y c h o t h e r a p y . recognizing the nature of the relationship and l e a r n i n g h o w to u s e it p r o p e r l y are h i g h l y r e l e v a n t for all physician'. T h u s .p a t i e n t r e l a t i o n s h i p w a s t h e g e n u i n e basis o f all f o r m s o f t r e a t m e n t . F r e u d called a t t e n t i o n t o t h e t r u e locus o f all t h e r a p e u t i c efforts. T h e i m p o r t a n c e o f t h i s finding h a s b e e n c o n f i r m e d since F r e u d ' s t i m e in all t h e medical specialties. T i m e and again F r e u d s t r e s s e d t h a t e v e r y type o f medical t h e r a p y w a s f u n d a m e n ­ tally r o o t e d in s u c h a b e i n g t o g e t h e r . t h a t t h e p h y s i c i a n . In focussing on the physician-patient r e l a t i o n s h i p . I n fact. or psychotherapeutic. S i g m u n d F r e u d . t h e h u m a n b e i n g . in p o i n t i n g o u t t h e r e l a t i o n s h i p b e t w e e n p h y s i c i a n and p a t i e n t .p a t i e n t r e l a t i o n s h i p largely d e t e r m i n e s n o t only t h e e f f i c a c y o f p s y c h o t h e r a p e u t i c m e a s u r e s but also o f m o s t s u r g i c a l and pharmaceutical ones. F r e u d called this t h e " a r e n a o r p l a y g r o u n d " w h e r e t h e p a t i e n t could c a r r y out p r e v i o u s l y impaired and i n a c e s s i b l e possibilities of e x i s t i n g in " a l m o s t t o t a l f r e e d o m . T h e r e c a n no l o n g e r be a n y d o u b t t h a t t h e n a t u r e o f t h e p h y s i c i a n .c e n t u r y a g o .Chapter 16 THE "LOCUS" OF THE THERAPEUTIC INTERACTION ("TRANSFERENCE") A g o o d h a l f . " o n t h e c o n d i t i o n t h a t t h e physician could skillfully "handle" this human relationship. In a D a s e i n s a n a l y t k t h e r a p y o f n e u r o t i c illness. internal. w h e t h e r they were surgical.t o g e t h e r o f p h y s i c i a n a n d .. but s o o n t h e physician w a s able t o w i t h d r a w i n t o t h e kind o f r e l a t i o n s h i p t o w a r d the patient t h a t Freud had r e c o m m e n d e d a s b e s t for t h e t h e r a p y o f psychoneurotic patients. R e g u l a Z i i r c h e r w a s asked t o follow t h e basic r e g i m e n o f classic a n a l y t i c p s y c h o t h e r a p y . S h e h e r s e l f had t o c o n t r i b u t e even m o r e . and m o r e o f t e n . n o r should it function as a m e r e c o n v e n i e n c e or p r o t e c t i v e device for the physician. w h i l e i t kept h e r f r o m m e a s u r i n g h e r n o t i o n s a g a i n s t his r e a c t i o n s and adjusting t h e m a c c o r d i n g l y e v e n b e f o r e s h e put t h e m i n t o w o r d s .t h e . w e r e perceived by) t h e p a t i e n t during t h e s e s s i o n . S h e lay on his c o u c h so t h a t he could see h e r b u t s h e could n o t see him. his persisting infantile w a y s o f c o n d u c t i n g h i m s e l f t o w a r d o t h e r s . P s y c h o t h e r a p e u t i c j a r g o n d e s i g n a t e s (and d i s t o r t s ) t h e p h e n o m e n o n o f p h y s i c i a n . E v e n t h o u g h t h e y m a k e u p t h e significant d e t e r m i n a n t s o f his b e i n g .i n . r u t h l e s s l y h o n e s t t o w a r d h e r s e l f and h e r t h e r a p i s t i n r e p o r t i n g a n y t h i n g t h a t c a m e " i n t o h e r h e a d o r h e a r t " a s s h e w a s lying t h e r e . T h i s is the only r e a s o n for the choice of a t e s t c a s e in w h i c h a D a s e i n s a n a l y t i c t h e r a p y in the s t r i c t e r s e n s e o f t h e t e r m w a s indicated.258 EXISTENTIAL FOUNDATIONS p a t i e n t is o n l y m o r e clearly and directly r e c o g n i z a b l e as the actual locus of the t r e a t m e n t t h a n in o t h e r t h e r a p e u t i c f o r m s .t o g e t h e r a s t r a n s f e r e n c e and c o u n t e r t r a n s f e r e n c e . T h e p a t i e n t w a s told t o b e a b s o l u t e l y . P e r c e i v ­ ing h i m s e l f in w h a t looks like a n y r a t i o n a l c o n v e r s a t i o n b e t w e e n p e e r s . t h o r o u g h l y h e a l t h y Da-sein w h i c h R e g u l a Z i i r c h e r finally a t t a i n e d could n o t h a v e c o m e a b o u t w i t h o u t c o n s i d e r a b l e e f f o r t from h e r p h y s i c i a n . the classic . The existential unfolding of the physician-patient relationship in the therapy of the test case T h e m a t u r e . T h e c o u c h p o s t u r e o f t h e patient should n o t b e m a d e into a d o g m a . a n u m b e r of e m e r g e n c y m e a s u r e s w e r e in o r d e r .p a t i e n t b e i n g . F u r t h e r m o r e . A t t h e v e r y s t a r t of t r e a t m e n t . T h i s g a v e t h e physician t h e w i d e s t possible scope for o b s e r v i n g w h a t e v e r t h i n g s o r people o c c u r r e d t o (that is. t h e y will n o t c o m e i n t o his h e a d . w h e n the patient w a s still in a highly suicidal s t a t e . t h e patient i s o f t e n u n a b l e t o e x p e r i e n c e his h i g h l y e m o t i o n a l . W h e r e v e r y s e r i o u s illness is involved. i n d e p e n d e n t .t o g e t h e r o f physician and patient i s w h e r e t h e t r e a t m e n t actually t a k e s place and h o w t h e D a s e i n s a n a l y t i c i l l u m i n a t i o n o f this e m e r g i n g p h e n o m e n o n h e a l s .l o n g visits a w e e k .w o r l d . W e shall r e t u r n o n c e m o r e t o o u r t e s t case t o s h o w h o w t h e b e i n g . w h i c h is to say. H e r physician r e q u i r e d h e r t o pay h i m four h o u r . t h e m e r e p o s t u r e o f physician and patient s i t t i n g face to face in t h e position of t w o equally m a t u r e people in c o n v e r s a t i o n will largely p r e v e n t w h a t is c e n t r a l to the illness f r o m o c c u r r i n g to t h e p a t i e n t and being actualized. h o w e v e r . i m m a t u r e b e h a v i o r s . T h e s e constant reminders of the limitedness of their present existence are what give p a t i e n t s t h e first i n t i m a t i o n t h a t t h e y m i g h t c o m e t o w a y s o f being in r e l a t i o n to w h a t is in t h e i r w o r l d t h a t a r e m o r e open and a u t o n o m o u s t h a n t h o s e t h e y h a v e b e e n living u p t o the p r e s e n t . T o f o r c e t h e patient t o lie o n t h e c o u c h a t such t i m e s would g o a g a i n s t e v e r y t h i n g analysis s t a n d s for. t h e t h e r a p i s t c a n n o t b e c o n t i n u a l l y pointing u p the p a t h o l o g i c a l limits o f t h e r e a l m o f o p e n n e s s available t o t h e patient. I t i s t h e r e f o r e n e c e s s a r y t h a t t h e physician pay c l o s e a t t e n t i o n t o t h e m e a n i n g o f h o w t h e patient r e l a t e s bodily a t each m o m e n t o f t h e r a p y . t h e r e a r e t i m e s w h e n sitting face to face in t h e p o s i t i o n of t w o equally m a t u r e people in r e l a t i o n s h i p in a w a y w h i c h c o r r e s p o n d s m o r e to t h e m o d e of his e x i s t e n c e a t the m o m e n t . D u r i n g t h e v e r y first c o n v e r s a t i o n w i t h t h e test s u b j e c t . F r e u d had a n o t h e r practical r e c o m m e n d a t i o n : during t h e r a p y t h e physician m u s t a s s u m e a s t a n c e c o m p l e t e l y free of all i n t e n t i o n . T h e first thing s h e told him w a s t h a t h e r i n t e s t i n a l colic and g e n e r a l m i s e r y had w e a k e n e d h e r s o m u c h t h a t s h e had b e e n forced t o d e l e g a t e h e r m a t e r i a l and h o u s e h o l d . Even w h e n the analysand is h e a l t h y or o n l y mildly ill.t o g e t h e r to ripen in a w a y t h a t would be fruitful to t h e p a t i e n t . of all t h e r a p e u t i c . the h u m a n relationship of physician and p a t i e n t w a s t h e p h e n o m e n o n t h a t forced i t s e l f i n t o t h e f o r e g r o u n d .The "Locus" of the Therapeutic Interaction 259 a r r a n g e m e n t may o v e r t a x t h e p a t i e n t and is o f t e n to be avoided. a p a t i e n t ' s refusal to lie d o w n m a y indicate r e s i s t a n c e to e x p o s i n g s o m e w a y s o f his b e h a v i n g t h a t h e h a s carefully p r e s e r v e d h i m s e l f from b e c o m i n g t h e m a t i c a l l y a w a r e of. and scientific a m b i t i o n . In the course of our test subject's therapy. T h e first p r e c o n d i t i o n for s u c h a d e v e l o p m e n t is t h e physician's constant a w a r e n e s s of the way he himself relates to the patient. W i t h o u t this a t t e n t i v e n e s s . T h i s p h e n o m e n a i s usually (and e r r o n e o u s l y . as we shall s e e . It was clear e v e n at t h e s t a r t t h a t s u c c e s s w o u l d depend p r i m a r l y on t h e physician's ability to allow this b e i n g . O n t h e o t h e r h a n d . A t h e r a p i s t involved in t h e a n a l y t i c s i t u a t i o n b e c o m e s s e n s i t i v e n o t only to what is revealed to his p a t i e n t ' s Da-sein b u t also to precisely how t h e p a t i e n t r e l a t e s h i m s e l f t o w h a t o c c u r s t o him. no m a t t e r h o w this r e l a t i o n s h i p m a y c h a n g e . e d u c a t i o n a l . d e m a n d i n g t r e a t m e n t . the t h e r a p i s t b e c a m e a w a r e o f his highly a m b i v a l e n t s t a n c e t o w a r d h e r . T h e t r u e art o f t h e r a p y lies i n paying careful a t t e n t i o n t o " w h a t " t h e p a t i e n t visualizes and " h o w " he c o n d u c t s h i m s e l f in r e l a t i o n to it. h o w e v e r . ) called c o u n t e r t r a n s f e r e n c e . t o e a c h o f t h e p h e n o m e n a t h a t appear in t h e open r e a l m of his Da-sein and e n g a g e h i m during t h e s e s s i o n . T o f o s t e r t h e p h y s i c i a n ' s r e c e p t i v i t y t o t h e " w h a t " and " h o w " o f t h e p a t i e n t . nor the limitations in the patient's own ways of responding to w h a t i s able t o e n t e r his e x i s t e n c e ' s open r e a l m o f a w a r e n e s s . positive e m o t i o n a l basis for t h e r a p y . H e r d a w n i n g r e l a t i o n s h i p t o t h e physician w a s an i n s t a n c e of w h a t F r e u d had w i s e l y d e s c r i b e d as a mild. t h e p h e n o m e n o l o g i ­ cal w a y h e r physician dealt w i t h h e r d r e a m i n g c o n v i n c e d h e r t h a t h e u n d e r s t o o d t h e v e r y e s s e n c e o f h e r n a t u r e .260 EXISTENTIAL FOUNDATIONS d u t i e s t o hired help. A n d he was repelled by t h e peculiar o d o r t h a t s u r r o u n d e d h e r . and to r e l a t e to him with filial . S h e had n e v e r b e f o r e b e e n s o boldly c o n f r o n t e d w i t h t h e u t t e r lack o f a n y h u m a n c o n n e c t i o n s t h a t c h a r a c t e r i z e d h e r w h o l e life. she c o n f e s s e d . t h e o n l y w a y o f r e l a t i n g t o t h e w o r l d she ever had? T h e immediate consequence of the phenomenological approach to the p a t i e n t ' s d r e a m i n g o f t h e b o x c a r w a s t h a t . not to be q u e s t i o n e d or d o n e a w a y w i t h in analysis. did n o t n e e d to be dealt w i t h for quite s o m e t i m e . for a s long a s s h e could r e m e m b e r . S h e followed his s u g g e s t i o n s . t h e t h e r a p i s t tried t o pawn h e r off o n y o u n g e r c o l l e a g u e s . w h a t i s often misleadingly labeled t r a n s f e r e n c e . S h e had r e p o r t e d h e r s t e r e o t y p i c a l b o x c a r d r e a m i n t h e v e r y first t h e r a p e u t i c s e s s i o n . T h e b u r d e n o f h e r illness b e c a m e a n appeal t o t h e p h y s i c i a n ' s s e n s e o f p h i l a n t h r o p y . a smell r e m i n i s c e n t o f t h e m o r t u a r y . and h e might n o t h a v e b e c o m e a w a r e o f t h e m until t o o late. He k n e w t h a t a n y p e r s o n so e x t e n s i v e l y denied h u m a n w a r m t h from i n f a n c y w o u l d s o o n e r o r later s u c c u m b t o a n a l m o s t insatiable n e e d for p r o o f s o f love. h e found h e r a f f e c t e d c h i l d i s h n e s s and artificial doll-like a p p e a r a n c e u n i n t e r e s t i n g . and t h e p r o m p t p h e n o m e n o l o g i c a l i n t e r p r e t a ­ tion o f this d r e a m had s h a k e n h e r w o r l d t o its r o o t s . and w i t h it t h e n e e d to be fully a c c e p t e d by h e r analyst as the a b a n d o n e d helpless little girl she still w a s . T h e t h e r a p i s t ' s s y m p a t h y finally prevailed o v e r his caution and r e s i s t a n c e . B u t had he n o t had a c c e s s to his less noble s e n t i m e n t s t h e y m i g h t well h a v e s t a y e d hidden to play tricks on h i m during t h e r a p y . m o r e d e s p e r a t e l y d e t e r m i n e d t h a n e v e r t o r e c e i v e t r e a t m e n t from him. M o r e o e v e r . T h e s e n s e of t r u s t w o k e t r e m e n d o u s g r a t i t u d e in the patient. S h e said she had m a n a g e d o n l y w i t h t h e g r e a t e s t difficulty to drag h e r s e l f o u t of bed to k e e p this a p p o i n t m e n t w i t h him. A t t h e s a m e t i m e . T h e w a y t h e p a t i e n t related t o h e r p h y s i c i a n . t o h e r o w n a m a z e m e n t . I n any c a s e . N e v e r in h e r life. All of his p r o f e s s i o n a l e x p e r i e n c e c a u t i o n e d him a g a i n s t a c c e p t i n g this w o m a n as a p a t i e n t . h e w a s already o v e r b u r d e n e d b y his o t h e r p a t i e n t s . she b e g a n to look on t h e t h e r a p i s t as s o m e t h i n g like a t r u s t w o r t h y p a r e n t a l p r o t e c t o r . and t h e w a y h e r e f e r r e d t o t h e m e a n i n g o f h e r d r e a m i n g e x i s t e n c e also s h o w e d t h a t h e s e e m e d t o k n o w o f e n t i r e l y d i f f e r e n t p o t e n t i a l i t i e s . had s h e e x p e r i e n c e d such good feelings t o w a r d s o m e o n e else. t i r e l e s s l y r e c o m m e n d i n g o t h e r t h e r a p i s t s t o h e r . W h y else w o u l d h e h a v e called c u r i o u s t h a t isolation w h i c h s h o n e f o r t h i n h e r d r e a m i n g and had b e e n . B e s i d e s . b u t e a c h n e w c o n s u l t a t i o n s e n t h e r b a c k t o him. in itself. A r m e d w i t h this a r s e n a l o f m o t i v e s . however. h e r pride and s e l f . seductive presence of the t h e r a p i s t b e c a m e t h e o b j e c t o f all h e r t h o u g h t s and a c t i o n s . S u d d e n l y all o u t w a r d signs o f a f f e c t i o n disappeared. for him she could b e n o t h i n g m o r e t h a n j u s t a n o t h e r o n e o f his m a n y c a s e s . S h e called t h e t h e r a p i s t a stupid idiot. C h i l d h o o d is. instead o f ridding h e r s e l f o f him. It is entirely out of the question that the procedure of therapy i t s e l f c a u s e d i n h e r s o m e r e g r e s s i o n t o c h i l d i s h n e s s . ( )| n e c e s s i t y . S h e called h e r t r e a t m e n t a hellish m e t h o d t h a t m a d e h e r s i c k e r and m o r e m i s e r a b l e i n s t e a d o f b e t t e r . N e v e r t h e l e s s . possible only in r e l a t i o n to parent'.r e g a r d r o s e u p a g a i n s t this possibility. B u t t h e r a p y can n e v e r b r i n g o u t a n y t h i n g e x c e p t e s s e n t i a l e x i s t e n t i a l traits t h a t a r e already. In her defensiveness. E v e r y o t h e r p e r s o n and o b j e c t o f h e r w o r l d r e t r e a t e d t o a n o b s c u r e d i s t a n c e . s h e had b e e n t a u g h t b y h e r m o t h e r t o believe t h a t a n y e x p r e s s i o n o f feeling for a n o t h e r p e r s o n s h o w e d a p o o r . h e r t h e r a p i s t . and a l w a y s . W h e n s h e entered into a child-parent relationship with her therapist. t h e n . a s s h e had b e e n for t h e last t w e n t y y e a r s . S h e n e v e r needed t o b e c o a x e d t o recall childhood e v e n t s .s i d e d n e s s . diabolical seducer bent on destroying her. T h e threatening. S h e was m o r e t h a n simply a n x i o u s . B u t h e r m a i n o b j e c t i o n t o l e t t i n g h e r s e l f e n t e r freely i n t o a n open and t r u s t i n g c h i l d . m e m o r i e s o f t h e actual p a r e n t s w h o h a d s o t e r r i b l j m i s t r e a t e d h e r b e g a n t o o v e r w h e l m her.The "Locus" of the Therapeutic Interaction 2b I affection. T h i s i s t h e kind o f d a n g e r o u s side effect o f t e n a s c r i b e d t o a n a l y t i c t r e a t m e n t b y o u t s i d e r s . t h e p a t i e n t f o u g h t t o o t h and nail a g a i n s t h e r i n c r e a s i n g l y o b t r u s i v e a f f e c t i o n for h e r p h y s i c i a n . t h e r e . t h r o u g h hej verbally a g g r e s s i v e behavior.p a r e n t r e l a t i o n s h i p t o w a r d h e r p h y s i c i a n w a s its o n e . F u r t h e r m o r e . t o w a r d h e r therapist t h e p a t i e n t kepi hei . h e r persisting c h i l d h o o d w a s revealed w i t h all of its c h a r a c t e r i s t i c f e a t u r e s and b e e a m e a c t u a l . s h e a c t u a l l y s u r r e n d e r e d t o t a l l y t o t h i s m a n she so wished to get away from. T h e m o r e t h e p h y s i c i a n patient relationship took on the character of a genuine parent-child r e l a t i o n s h i p — t h o u g h at t h e t i m e it o c c u r r e d in t h e f o r m of a d e s p e r a t e r e s i s t a n c e t o this r e l a t i o n s h i p — t h e m o r e h e r c h i l d h o o d e x p e r i e n c e s i n t h e r e l a t i o n s h i p w i t h h e r actual p a r e n t s s p o n t a n e o u s l y o c c u r r e d t o h e r . T h e c o n s t a n t p r e s e n c e i n h e r w o r l d o f t h e physician c o v e r e d o v e r h e r r e l a t i o n s h i p t o h e r o w n f u t u r e and h e r c o n n e c t i o n w i t h h e r past life B u t for o n e c a t e g o r y t h e r e w a s a n e x c e p t i o n . and b o u n d t o . S h e b e c a m e a b u s i v e . m e r e l y p a i n t e d o v e r b y the n e c e s s i t y o f acting like a n adult i n e v e r y d a y life. I n p a r t i c u l a r s h e feared b e c o m i n g totally d e p e n d e n t o n . B u t s o o n s h e b e g a n t o b e afraid o f h e r o w n f e e l i n g s . T h e p a t i e n t w a s for t h e m o s t part actually j u s t s u c h a childish c r e a t u r e w h e n s h e b e g a n t h e r a p y . T h e s a m e p h y s i c i a n w h o had w o n h e r t r u s t n o w s e e m e d a n evil. fanatic c h a r a c t e r and w a s u n b e c o m i n g t o a lady. t h e p h y s i c i a n limited h i m s e l f to a s k i n g o n l y a v e r y f e w q u e s t i o n s . T h e p a t i e n t tried t o s c r e e n o u t t h e v i s u a l i z a t i o n s o f h e r p a r e n t s and t h e i r m i s t r e a t m e n t o f h e r t h a t b e g a n i n t r u d i n g o n h e r w i t h o u t letup. drive h e r i n s a n e . first o f all. h e a l t h y love of a small d a u g h t e r for p a r e n t s w o r t h y ol this name. o f h e l p l e s s n e s s . P r e s u m a b l y . In this first p h a s e of t h e r a p y . It is this w e a r i n g s t r u g g l e a g a i n s t t h e i n t o l e r a b l e p r e s e n c e s o f h e r p a r e n t s and therapist that engendered the severe insomnia she experienced shortly a f t e r s h e began t h e r a p y . o n e . e v e r y t i m e t h e o p p o r t u n i t y a r o s e . finally. h o w n a t u r a l it w a s to feel g r a t i t u d e and affection for s o m e o n e w h o w a s t r y i n g t o help. H e asked t h e p a t i e n t . W h a t she s t r u g g l e d w i t h w a s t h e o b t r u s i v e and i n c r e a s i n g l y i n t e n s e address o f h e r t h e r a p i s t and h e r p a r e n t s as this address c a m e f r o m t h e m in t h e places s h e k n e w t h e m to be in t h e p e r c e p t i v e l y o p e n realm of h e r world. H e would r e p e a t t h e m . a f t e r w e e k s o f s t r u g g l i n g a g a i n s t h e r s e l f and h e r t h e r a p i s t . S h e o f t e n felt u n e q u a l to this d o u b l e a t t a c k . s h e dared r e c o g n i z e this o n l y a f t e r t h e h u m a n r e l a t i o n s h i p w i t h h e r t h e r a p i s t had o p e n e d a n e w place f o r h e r e x i s t e n c e to dwell in t h e w o r l d . very m u c h like t h e g e n u i n e . w h e r e s h e had g o t t e n t h e idea t h a t s h e m e a n t n o t h i n g m o r e t o h i m t h a n a n u m b e r . felt as t h o u g h i t would c r u s h h e r w i t h its w e i g h t . t h e o t h e r . S h e had t o d o b a t t l e o n t w o f r o n t s . It w a s this u n s h a k a b l e d a u g h t e r . n o r w o u l d s h e h a v e c o m p l a i n e d s o b i t t e r l y w h e n a s e s s i o n had t o be c a n c e l l e d for o u t s i d e r e a s o n s . T h r o u g h this m e t h o d t h e patient w a s led t o r e c o g n i z e . M o r e and m o r e s h e r e l i n q u i s h e d h e r guilt and fear and let h e r s e l f e n t e r a r e l a t i o n s h i p of open t r u s t t o w a r d h e r physician. t h e visualized p r e s e n c e s o f h e r p e r s i s t e n t l y h a t e d actual p a r e n t s . F o r t h e p a t i e n t ' s s t r u g g l e w a s n o t w i t h simple e n d o p s y c h i c r e p r e s e n t a t i o n s o f p a r e n t s and e m o t i o n s . B e f o r e t h i s . and o f falling i n t o an a b y s s . h o w e v e r . h e w a n t e d t o k n o w w h e t h e r t h e d e m i s e o f t h e p a t h e t i c and m i s e r a b l e c r e a t u r e a s w h i c h s h e e x i s t e d and a s which she alone knew herself would be such a great loss. such as p s y c h o a n a l y t i c t h e o r y sees rising o u t of a theoretical unconscious into the stratum of consciousness. .f a t h e r r e l a t i o n s h i p w i t h h e r p h y s i c i a n t h a t let t h e p a t i e n t see h o w v e r y difficult h e r r e l a t i o n s h i p t o h e r a c t u a l p a r e n t s had b e e n . He inquired.f a t h e r . O t h e r w i s e s h e w o u l d n o t h a v e a r r i v e d p u n c t u a l l y for e v e r y s e s s i o n . t h e s t r o n g and loving affinity t o h e r t h e r a p i s t . S e c o n d .262 EXISTENTIAL FOUNDATIONS t r u s t i n h i m . full i n s i g h t i n t o h e r p a r e n t s ' c a t a s t r o p h i c failure had a l w a y s b e e n held in c h e c k b y a n o v e r w h e l m i n g s e n s e o f d e s o l a t i o n . w h e t h e r t h e w i l l i n g n e s s t o give u p h e r d e f e n s e and s u r r e n d e r t o t h e r e l a t i o n s h i p m i g h t n o t b e j u s t w h a t would m a k e d i s c o v e r y o f a g e n u i n e s e l f h o o d possible. o n e m o r e s u b j e c t for t r e a t m e n t . should never exact any personal advantage. s h e n o t i c e d t h a t t h e y o u n g m e n i n h e r life had b e g u n to s t r i k e h e r in a m o s t c u r i o u s w a y . T h i s discovery immediately evoked other w a y s o f d r e a m i n g . as an intelligent adult. S h e w o u l d o f t e n a w a k e s c r e a m i n g . o r bandits. Psychoanalysts. H e b e g a n to s e n s e in h e r a w e a l t h of b u r i e d h u m a n gifts. S h e w o u l d catch herself imagining the tender erotic demands they might make of her. His initial r e s i s t a n c e to t h e idea of t a k i n g on still a n o t h e r difficult c a s e . h o w e v e r . T h e o n l y a p p r o p r i a t e gains w e r e to be m a d e t h r o u g h i m p o s i n g a fee sufficient to r e p r e s e n t a real financial sacrifice f o r t h e p a t i e n t . o r R u s s i a n soldiers a r m e d w i t h rifles. s e l f l e s s . even h u n d r e d s o l t i m e s s h e w a s a s k e d w h e t h e r today. I n h e r w a k i n g life. especially a g r e a t c a p a c i t y for love. his r e v u l s i o n t o w a r d h e r initial b e h a v i o r . it occurred to h e r t h a t s i n c e t h e t r e a t m e n t b e g a n s h e had n o t o n c e b e e n visited b y t h e stereotypical boxcar dream. As a r e s u l t . T h i s does n o t c h a n g e t h e fact t h a t t h e a n a l y s t ' s p e r s o n a l i n v e s t m e n t i n t h e r a p y can n e v e r b e c o u n t e r b a l a n c e d b y t h e financial fees paid b y t h e p a t i e n t . P a y m e n t on this scale w o u l d help keep p a t i e n t s f r o m using t h e t h e r a p e u t i c s i t u a t i o n as a lifelong c r u t c h . S h e w a s s w a m p e d w i t h t h e kind o f d r e a m t h a t i s all t o o familiar t o n e u r o t i c a l l y e n s l a v e d people. a r e l a t i o n s h i p akin to t h a t of a g o o d g a r d e n e r caring for his p l a n t s . s h e was ••! ill . n o m a t t e r h o w large t h e y a r e . t h e t h e r a p i s t w a s able to e n t e r a selfless r e l a t i o n s h i p to h e r t h a t r e c o g n i z e d h e r a s and g a v e h e r t h e r e s p e c t due a n o t h e r h u m a n b e i n g . I t also freed t h e a n a l y s t f r o m financial w o r r y s o h e could a t t e n d e q u a n i m o u s l y t o t h e t h e r a p e u t i c s e s s i o n s and give freely o f h i m s e l f t o t h e p a t i e n t . T h e analyst countered the patient's n e w relationship toward h e i d r e a m b a n d i t s and t h e e r o t i c s u i t o r s of h e r w a k i n g life w i t h a patient. no m a t t e r h o w eagerly it may be prof erred. 1 A f t e r t h e p a t i e n t had s u m m o n e d t h e c o u r a g e t o r e c o g n i z e and fully accept her father-daughter relationship with the therapist. a t o n c e a r r o g a n t and artificial—all o f t h e s e g a v e w a y t o a lively i n t e r e s t and e n d u r i n g b e n e v o l e n c e . r e s p e c t f u l . bu I n o s o o n e r w o u l d s h e b e c o m e a w a r e o f t h e s e possible i n t i m a c i e s than s h e w o u l d b e seized w i t h f e a r and disgust. A l m o s t e v e r y n i g h t s h e d r e a m e d o f being c h a s e d b y a n i m a l s . m e a n w h i l e . b o t h t o w a r d h e r s e l f and men.w o r l d .t h e . F r e u d r e c o g n i z e d t h a t s u c h a r e l a t i o n s h i p is t h e p r e c o n d i t i o n for s u c c e s s f u l t h e r a p y : n u r t u r i n g .i n . a p p r o p r i a t e l y modified t h e r a p y o f r e s i s t a n c e . from their patients' temporary dependence on them. his s t a n c e t o w a r d h e r had a l s o c h a n g e d m a r k e d l y during t h e first f e w m o n t h s o f t r e a t m e n t . D o z e n s . as Freud w r o t e a n u m b e r of times. O t h e r w i s e the analyst w o u l d h a v e t o accept r e s p o n s i b i l i t y for t h e t r e a t m e n t ' s failure.The "Locus" of the Therapeutic Interaction 263 I t w a s n o t only t h e p a t i e n t ' s a t t i t u d e t o w a r d t h e t h e r a p i s t t h a t w e n t t h r o u g h such i m p o r t a n t t r a n s f o r m a t i o n s . c o m p r o m i s e his f r e e d o m a s a n a n a l y s t in t h e t h e r a p e u t i c p r o c e s s . s e x u a l w a y s in w h i c h m e n and w o m e n r e l a t e t o each o t h e r w e r e d a m n a b l e . w h a t s h e had h e a r d could o n l y c o n f i r m h e r i n h e r w o m a n h o o d . a s h e w a s o n l y h u m a n . T h a n k s t o this realistic e x p l a n a t i o n . T h i s w a s possible o n l y i f t h e a n a l y s t p r e s e r v e d t o t a l f r e e d o m i n t h e r e l a t i o n s h i p . S h e learned from her analyst to relinquish the demand that he fulfill h e r w i s h e s i n this r e s p e c t . s e x u a l and fully capable of loving. a p a s s i o n a t e love in w h i c h t h e a n a l y s t w a s seen as a p o t e n t i a l lover. d i s g u s t i n g . a s s o m e t h i n g sinful. A l e s s skilled approach to this m o s t ticklish o f all therapeutic p r o b l e m s . a f t e r a period of r e s e n t m e n t and a t t e m p t e d flight. In t h e relatively s h o r t space of e i g h t e e n m o n t h s . F o r had the d o c t o r n o t c o n f e s s e d t h a t . childishly d e p e n d e n t c r e a t u r e into a m a t u r e w o m a n . while m a k i n g available to h e r a w i d e r h u m a n a r e n a i n t o w h i c h she could bring f o r t h h e r h u m a n p o t e n t i a l . for o t h e r w i s e h e w o u l d i n e v i t a b l y . O n t h e c o n t r a r y . t h e r a p y s u c c e e d e d in t r a n s f o r m i n g a totally frigid. e x p l o i t h e r for his o w n o r s o m e o t h e r p u r p o s e . e v e n t h o u g h n o t w i s h i n g it. and c h a r g e d w i t h d a n g e r ? M i g h t i t n o t b e possible t h a t s h e w o u l d find f r e e d o m . R e g u l a Z i i r c h e r could i n t e r p r e t t h e refusal o f h e r s e x u a l d e m a n d s o n t h e a n a l y s t a s s o m e t h i n g o t h e r t h a n a h u m i l i a t i n g r e j e c t i o n of t h e s o r t s h e had e x p e r i e n c e d so m u c h during c h i l d h o o d . W h a t had b e g u n a s a n infantile a f f e c t i o n for a good f a t h e r based on t r u s t b e c a m e . w i t h o u t the u t m o s t r e s t r a i n t on his part. H e w o u l d n o l o n g e r b e free t o let h e r b e c o m e e n t i r e l y h e r s e l f . w h i l e this v e r y f r e e d o m in r e l a t i o n to h e r was a b s o l u t e l y n e c e s s a r y for t h e t h e r a p y t o s u c c e e d . e v e r y m o d e o f s e n s u a l b e h a v i o r like w h a t filled h e r d r e a m w o r l d . D u r i n g this s t a g e t h e p a t i e n t p r e s s e d him w i t h s e x u a l demands. T h e p a t i e n t ' s gradual m a t u r i n g was m i r r o r e d in a c h a n g e d h u m a n r e l a t i o n s h i p t o h e r p h y s i c i a n . fulfillment. she m i g h t succeed in seducing h i m ? He must t h e r e f o r e take h e r v e r y s e r i o u s l y as a w o m a n . A dawning insight into the dubiousness of her restricted ways of behaving c h a l l e n g e d h e r t o adopt n e w and m o r e i n d e p e n d e n t a t t i t u d e s t o w a r d kinds of p h e n o m e n a s h e had avoided b e f o r e .264 EXISTENTIAL FOUNDATIONS willing to put up w i t h t h e n o n s e n s e t h a t all physical. I t w a s t h e r e f o r e t h e a n a l y s t ' s d u t y t o r e m a i n selfless and t o r e s t r i c t t h e r e l a t i o n s h i p t o p r e v e n t his exploiting h e r for his o w n s a t i s f a c t i o n . S h e l e a r n e d t h a t a n y e r o t i c r e s p o n s e o n his part w o u l d . and happiness if she w e r e t o face s t e a d f a s t l y e v e r y t h i n g t h a t p r e s e n t e d i t s e l f t o h e r and w i t h r e s p o n s i b l e c o n c e r n c a r e for t h e unfolding o f its b e i n g ? Regula Zurcher's fear of greater freedom with respect to w h a t r e v e a l e d i t s e l f in h e r w o r l d w a s c o n s t a n t l y q u e s t i o n e d in this w a y . W o u l d she f o r e v e r act in blind o b e d i e n c e to t h e silly advice h e r p a r e n t s had g i v e n h e r w h e n s h e w a s a y o u n g girl? W o u l d s h e insist o n s e e i n g e v e r y n a t u r a l act. F r e u d w e n t o n t o d e g r a d e t h e v e r y n a t u r e of this p h e n o m e n o n by describing it. H e n c e his r e c o m m e n d a ­ tions for t r e a t i n g t h e t r a n s f e r e n c e : t h a t t h e t h e r a p i s t act quickly a g a i n s t i t t h r o u g h a n a l y z i n g this s y m p t o m o f r e s i s t a n c e b y e m p h a s i z i n g t o t h e p a t i e n t t h e false and d e c e p t i v e n a t u r e o f a n y m o d e s o f e m o t i o n a l c o n d u c t t h a t had b e e n t r a n s f e r r e d t o t h e physician. as a m e r e d e c e p t i o n on t h e p a t i e n t ' s part. I f t h e o l d e r p s y c h o a n a l y t i c t h e o r y had b e e n f o l l o w e d . a s t r a n s f e r e n c e : t h a t is. as something merely transferred from s o m e w h e r e else. i t m i g h t well h a v e b e e n d i s a s t r o u s t o i n t e r p r e t h e r r e l a t i o n s h i p t o t h e a n a l y s t i n p s y c h o a n a l y t i c fashion.p a t i e n t r e l a t i o n s h i p t h a t o f t e n h a s d i s a s t r o u s c o n s e q u e n c e s . N o w a d a y s t h e c o n c e p t o f t r a n s f e r e n c e i s so w i d e s p r e a d it would s e e m impossible to e r a d i c a t e this t e r m . b u t b e l o n g e d r a t h e r t o s o m e e n d o p s y c h i c r e p r e s e n t a t i o n o f t h e p a t i e n t ' s a c t u a l p a r e n t s . did n o t actually m e a n h i m .The "Locus" of the Therapeutic Interaction 265 m i g h t easily h a v e n e g a t e d w h a t e v e r p r o g r e s s t h e p a t i e n t had m a d e and d e s t r o y e d all c h a n c e s f o r s u c c e s s f u l t r e a t m e n t . S h e was m e r e l y t r a n s f e r r i n g t h e s e a f f e c t s and i m a g e s o n t o t h e physician o u l o f r e s i s t a n c e s o t h a t s h e n e e d n o t t h i n k a b o u t h e r unhappy c h i l d h o o d memories. F u r t h e r m o r e . . T h e feelings w e r e simply t r a n s f e r r e d (in G e r m a n . according to his n a t u r a l i s t i c view of h u m a n n e s s . n o t o n l y in p s y c h o t h e r a p e u t i c s e s s i o n . T h e physician w o u l d h a v e r e s p o n d e d t o R e g u l a Z u r c h e r ' s v a r i o u s feelings t o w a r d him w i t h t h e i n t e r p r e t a t i o n t h a t s h e w a s deceiving h e r s e l f in believing t h a t t h e s e e m o t i o n s w e r e t r u l y m e a n t for him and t h a t t h e y actually b e l o n g e d to the representations of her parents existing in her unconscious. F r e u d s a w t h e p r i m a r y aim o f t r a n s f e r e n c e in t h e r e s i s t a n c e it c r e a t e d to t h e reliving of painful childhood e x p e r i e n c e s c o n n e c t e d w i t h p a r e n t s . And y e t this w a y of i n t e r p r e t i n g w h a t all medical t r e a t m e n t is based on is scientifically u n s o u n d . The fallacy of handling the physician-patient r e l a t i o n s h i p as transfer­ ence A f t e r pointing o u t t h e s i g n i f i c a n c e in all types of t r e a t m e n t of the r e l a t i o n s h i p o f physician and p a t i e n t . while also p o i n t i n g o u t t h e i r actual c o n n e c t i o n w i t h t h e i m a g e s o f t h e p a r e n t s . W h a t e v e r feelings t h e p a t i e n t developed for t h e a n a l y s t during t h e c o u r s e o f t h e r a p y . In a p a t i e n t as s e n s i t i v e and i n t e l l i g e n t a s R e g u l a Z i i r c h e r . This presentation of the physician-patient relationship reverberated far b e y o n d t h e field o f m e d i c i n e . w e r e directed n o t t o w a r d t h e a n a l y s t h i m s e l f . literally " c a r r i e d o v e r " ) f r o m t h e s e r e p r e s e n t a t i o n s t o t h e p h y s i c i a n . b u t in t h e t r e a t m e n t r o o m s o f e v e r y g e n e r a l p r a c t i t i o n e r and specialist. h e t h o u g h t . it has p r o d u c e d a m e t h o d for handling t h e p h y s i c i a n . t h e t r e a t m e n t o f o u r t e s t s u b j e c t m i g h t h a v e p r o c e e d e d quite d i f f e r e n t l y . T h e physician i n t h e t e s t c a s e carefully g u a r d e d a g a i n s t explaining t h e p a t i e n t ' s d r e a m s o f b a n d i t s and R u s s i a n s a s c a s e s o f t r a n s f e r e n c e . B e c a u s e t h e p a t i e n t w a s s o i n t e l l i g e n t and s e n s i t i v e . o u t in t h e w o r l d from w h i c h t h e y had a p p r o a c h e d h e r . T h e d r e a m e x p e r i e n c e s t h e m s e l v e s . and t h e R u s s i a n s R u s s i a n s .266 EXISTENTIAL FOUNDATIONS T h e p a t i e n t ' s d r e a m s o f t h r e a t e n i n g bandits and R u s s i a n soldiers w o u l d also h a v e b e e n m a d e m a n i f e s t a t i o n s o f t r a n s f e r e n c e . a r e l a t i o n s h i p of t r u s t b e t w e e n patient and p h y s i c i a n could n e v e r h a v e developed. e r r o n e o u s . S h e w o u l d p r o b a b l y h a v e rebelled v i g o r o u s l y a g a i n s t a n y p h y s i c i a n w h o i n t e r p r e t e d h e r s i t u a t i o n in this w a y . and it w o u l d h a v e availed t h e physician little to put t h e b u r d e n o f guilt o n t h e p a t i e n t b y a c c u s i n g h e r o f p u t t i n g u p r e s i s t a n c e . w e r e t h e real t a r g e t s o f t h e a n x i e t y e x p e r i e n c e d i n t h e d r e a m s . s o h e let t h e b a n d i t s r e m a i n b a n d i t s . h e w o u l d h a v e b e e n u n j u s t l y labelling as false. B y i n t r o d u c i n g such n o t i o n s o f t r a n s f e r e n c e . H e also let t h e m stay distinct f r o m t h e p a t i e n t . f u r t h e r c o n f u s i n g a w o m a n a l r e a d y t h o r o u g h l y n e u r o t i c and u n s u r e o f h e r s e l f . and c h a r a c t e r i s t i c part of h e r s e l f . held n o t h i n g t h a t p o i n t e d t o t h e physician. i m p o r t a n t . and d e c e p t i v e just w h a t t h e patient e x p e r i e n c e d as t h e m o s t real. and w i t h g o o d r e a s o n . j u s t a s t h e y had appeared i n t h e p a t i e n t ' s d r e a m i n g w o r l d . T h e d r e a m e r would have been made to believe that behind the figures of her dreams s h e w a s hiding t h e p h y s i c i a n h i m s e l f . F o r if t h e physician had i n t e r p r e t e d h e r e m o t i o n a l r e l a t i o n s h i p to h i m as t r a n s f e r e n c e actually a i m e d a t h e r p a r e n t s . t h e physician m i g h t h a v e c a u s e d his p a t i e n t u n n e c e s s a r y o f f e n s e and injury. All s u c h s p e c u l a t i o n w o u l d h a v e fared p o o r l y w i t h a p a t i e n t as c l e v e r and i n t e l l i g e n t as t h e t e s t s u b j e c t . t h a t h e . i n a n y case. H e did n o t t r y t o m a k e h e r believe t h a t t h e y dwelt i n h e r o w n p s y c h e a s m e r e e n d o p s y c h i c p a t t e r n s t h a t had b e e n personified t h r o u g h o u t w a r d p r o j e c t i o n . U n d e r such c i r c u m s t a n c e s . and b e h i n d h i m t h e p a r e n t a l i m a g e s . T h e patient w o u l d h a v e felt m i s u n d e r s t o o d . F o r s h e w o u l d h a v e b e e n t h o r o u g h l y justified i n r e s i s t i n g such m i s t r e a t m e n t by her physician. H e w o u l d h a v e m i s h a n d l e d t h e puzzling p h e n o m e n o n w i t h o u t a n y j u s t i f i c a t i o n in fact. B u t t h e physician w o r k i n g in t h e t e s t c a s e had a D a s e i n s a n a l y t i c o r i e n t a t i o n and a c c o r d i n g l y set o u t t o avoid s p e c u l a t i n g a b o u t t r a n s f e r ­ e n c e a t all c o s t s . and t h a t s h e had t r a n s f e r r e d h e r feelings o n t o t h e d r e a m figures o f bandits and R u s s i a n s b e c a u s e e v e n i n h e r d r e a m s s h e w a s afraid t o o p e n l y c o n f e s s h e r f e e l i n g s for t h e physician. H o w could t h e t h e r a p i s t h a v e justified such a r b i t r a r y i n t e r p r e t a ­ tions in light of t h e p h e n o m e n a t h e m s e l v e s ? W h a t e v i d e n c e could he h a v e found in the a c c o u n t s of t h e p a t i e n t ' s d r e a m i n g Pu sein that would have supported his s t a t e m e n t s a b o u t psychic projection a n d affective displat e m e n t ? . s u c h speculation would probably have wrecked the whole therapeutic process. But w e h a v e r e p e a t e d l y s t r e s s e d t h a t t h e r e is no e v i d e n c e w h a t s o e v e r in the phenomena of human existence to demonstrate the presence ol eithei G i v e n t h i s . he w o u l d h a v e o p e n e d a w a y to discussion o f t h o s e p o t e n t i a l i t i e s . s h e had m a d e s o m e p r o g r e s s in this r e s p e c t : n o w s h e could in s o m e s e n s e . q u i t e u n d e r s t a n d a b l y . h e r o w n lack o f m a t u r i t y c o m p e l l e d h e r t o look upon adult m a l e n e s s a s s o m e t h i n g t h a t t h r e a t e n e d t o o v e r p o w e r . T h e a n a l y s t w e n t o n t o say t h a t this indicated a b l i n d n e s s to t h e positive a s p e c t s of m a l e b e i n g . f o r o t h e r w i s e n o m e n a t all. F o r t h e t i m e being.The "Locus" of the Therapeutic Interaction 267 A n d s o t h e t h e r a p i s t w a s c o n t e n t t o s u g g e s t w h a t could b e k n o w n from t h e d r e a m p h e n o m e n a t h e m s e l v e s . n o t h i n g can r e d e e m t h e t r a n s f e r e n c e t h e o r y . t h a t s h e could p e r c e i v e t h e m o n l y a s p o t e n t i a l d e s t r o y e r s and rapists. at least. d a n g e r o u s l y a r m e d m e n s h o w e d e v e n m o r e s t r i k i n g l y t h a t . If a f f e c t s a r e to be displaced from s o m e r e p r e s e n t a t i o n w i t h i n t h e p s y c h e o u t o n t o o b j e c t s i n t h e e x t e r n a l world. At l e a s t . F o r t h e p r e s e n t . i n spite o f h e r h i g h level o f i n t e l l e c t u a l d e v e l o p m e n t . n o t e v e n hostile o n e s . e x c e p t b y i n v e n t i n g facts w h e r e n o n e e x i s t e d ? E v e n i n d r e a m s . To i n t e r p r e t t h e g u n as a s y m b o l i c penis w o u l d m o s t likely h a v e had far less d i s a s t r o u s c o n s e q u e n c e s for t h e patient t h a n t o c o n s t r u e h e r feelings for t h e a n a l y s t as s o m e s o r t of t r a n s f e r e n c e . w h i c h m i g h t h a v e e v e n t u a l l y encouraged the patient to go beyond the reductive genital interpretation itself and adopt a m o r e o p e n a t t i t u d e t o w a r d m a l e n e s s . a n x i e t y and flight. p e r c e i v e and r e s p o n d t o m a l e n e s s . and d e s t r o y h e r . o n l y m e n w h o w e r e d a n g e r o u s could be p e r m i t t e d to e n t e r and a p p e a r in t h e p e r c e i v i n g o p e n n e s s o f h e r d r e a m i n g w o r l d . for t h e fictive c h a r a c t e r of its a s s u m p t i o n s is o b v i o u s . t h e s e e n d o p s y c h i c a f f e c t s and r e p r e s e n t a t i o n s m u s t first e x i s t . T h e only r e s p o n s e s h e k n e w w a s . w h e t h e r w e p e r c e i v e t h e m w a k i n g o r d r e a m i n g t h e y r e t a i n t h e c h a r a c t e r o f lethal w e a p o n s . Had t h e a n a l y s t o p t e d to m e n t i o n t h e p e n i s . the analyst chose not to interpret the guns of the p u r s u i n g R u s s i a n s a s phallic s y m b o l s . I t i s a s t o n i s h i n g t h a t t h e t h e o r y o f t r a n s f e r e n c e t o o k o v e r medical t h i n k i n g so quickly and p r o f o u n d l y . as a w o m a n . rape. could h a v e g o t i n t o h e r d r e a m i n g world. g u n s a r e n o t h i n g but g u n s . h o w e v e r . could e v o k e and b r i n g t o fruition. T r u e . t h e a n a l y s t would h a v e b e e n a d d r e s s i n g h i m s e l f t o s o m e t h i n g w i t h direct b e a r i n g on m a l e s e x u a l p o t e n t i a l i t i e s in r e l a t i o n to w o m e n . h e r i m m a t u r i t y kept h e r f r o m c o n f r o n t i n g m e n o n a n adult basis. C o n c e r n i n g t h e d r e a m s o f bandits and R u s s i a n s . not e v e n the later a t t e m p t o f p s y c h o a n a l y t i c t h e o r e t i c i a n s t o divide t h e p h y s i c i a n . T h e fact t h a t t h e p a t i e n t could d r e a m o n l y o f such h o s t i l e . h e simply helped t h e p a t i e n t see o n t h e basis o f h e r d r e a m e x p e r i e n c e s t h a t h e r e x i s t e n t i a l u n d e r s t a n d i n g o f m e n w a s s o childishly i m m a t u r e and d i s t o r t e d . H o w could h e h a v e d o n e so. F u r t h e r m o r e . in t a l k i n g a b o u t a penis. t h a t s h e . t h e f a l s e n e s s o f t r a n s f e r e n c e love could b e s e e n i n t h e fact t h a t it c o n t a i n e d n o t a single trait arising o u t of t h e t h e r a p e u t i c s i t u a t i o n i t s e l f but simply r e p e a t e d o r b u r l e s q u e d e a r l i e r . nor the behavior of the therapist in particular. while i n s t e a d t h e y d e m a n d e d t a n g i b l e p r o o f s o f love f r o m t h e analyst. t h e t h e r a p e u t i c s i t u a t i o n is in a c t u a l i t y as rich in g r a t i f i c a t i o n and denial as a n y p a r e n t . F i r s t . First. W h a t m a y look like a n e u r o t i c t r a n s f e r e n c e is in reality a h u m a n Da-sein w h o s e o p e n n e s s has been s u b s t a n t i a l l y r e s t r i c t e d .t o g e t h e r i n v o l v e s m o r e radical f o r m s o f f r u s t r a t i o n and denial than those met within the therapeutic situation? F r e u d ' s s e c o n d p r o o f a r g u e s the d e c e p t i v e n e s s o f t h e p a t i e n t . A m o n g a d u l t s is t h e r e a n y other human relationship so gratifying. S e c o n d . All t h e s e facts n o t w i t h s t a n d i n g . F r e u d g a v e n o f e w e r t h a n t h r e e arguments which therapists might use to convince patients that their e m o t i o n a l r e l a t i o n s h i p s t o p h y s i c i a n s w e r e d e c e p t i v e a n d u n r e a l . Sue h I >fl sein may persist into adulthood. c o n t a i n e d a n y t h i n g t o m o v e t h e p a t i e n t t o feelings o f love o r h a t e . and p s y c h i a t r i s t s freely c o n c e d e t h a t s u c h a n e x p l a n a ­ tion e x c e e d s t h e i r c o m p e t e n c e . t h e w a y supposedly t r a n s f e r r i n g p a t i e n t s act s e e m s to be diametrically opposed to all n o t i o n s of t r a n s f e r e n c e . a s t h a t of analysts to patients? On the other hand. p a t i e n t s in a s t a t e of t r a n s f e r e n c e should b e r e m i n d e d t h a t i f t h e i r love for t h e a n a l y s t w e r e g e n u i n e . any other in which one person is e v e n half a s helpful and u n s h a k a b l y b e n e v o l e n t t o w a r d a n o t h e r .p h y s i c i a n r e l a t i o n s h i p o n a c c o u n t o f its i m i t a t i v e n a t u r e . In fact. and o n s o m e deeper level.268 EXISTENTIAL FOUNDATIONS p a t i e n t r e l a t i o n s h i p i n t o a t r a n s f e r e n c e c o m p o n e n t and a n o r m a l c o m p o n e n t . t h e y would h a v e s u b m i t t e d a t o n c e t o his m e t h o d o f total free a s s o c i a t i o n . a r e really m e a n t not for c o n t e m p o r a r i e s b u t r a t h e r . e i t h e r t h r o u g h s o m e i n h e r e n t o b s t a c l e t o m a t u r i n g or t h r o u g h p a r e n t a l m i s g u i d a n c e in early life. w h i c h a r e involved i n t h e m .c h i l d r e l a t i o n s h i p . what o t h e r form of human b e i n g . infantile w a y s o f b e h a v i n g t o w a r d p a r e n t s . S u c h a d i s t i n c t i o n w o u l d do no g o o d e v e n if p s y c h o a n a l y t i c t h e o r y w e r e able t o e x p l a i n w h a t c o n s t i t u t e s a n o r m a l r e l a t i o n s h i p b e t w e e n people. B u t all t h a t m a y b e said w i t h c e r t a i n t y is t h a t t h e form w h i c h a p a t i e n t ' s b e h a v i o r t o w a r d his physician t a k e s m a y h a v e r e m a i n e d d i s t o r t e d and i n f a n t i l e b e c a u s e o f s o m e u n f o r t u n a t e h i n d r a n c e put i n t h e w a y o f t h e p a t i e n t ' s m a t u r i n g i n e a r l y childhood. F r e u d said. B u t t h e m e r e p e r s i s t e n c e of an i n f a n t i l e form in relating b y n o m e a n s p r o v e s t h a t t h e feelings a s such. t h e y begin t o fall apart. A n d third. for the g u a r d i a n s and c o m p a n i o n s o f o n e ' s i n f a n c y . W h e n t h e s e so-called a r g u m e n t s are s c r u t i n i z e d . he s u g g e s t e d t h a t it s h o u l d be m a d e c l e a r t o t h e patient c a u g h t i n t h e toils o f t r a n s f e r e n c e t h a t n e i t h e r t h e p r e s e n t therapeutic situation in general. unable to p e r c e i v e or respond to Other adults . simply products of t r a n s f e r e n c e . original. will appear in t h a t s a m e .. but it is t h o r o u g h l y g e n u i n e .p h y s i c i a n r e l a t i o n s h i p r e s t s . T h e f o r m of t h e love is childish. r a t h e r than t h e usual c o n e . because the earlier mode has never given way to any other. T h i s is so p a t e n t l y t r u e t h a t e v e n F r e u d c o n t r a d i c t e d o n e o f his o w n s t a t e m e n t s o n t h e m a t t e r .t o g e t h e r . i m m a t u r e love r e l a t i o n s h i p is its o v e r r i d i n g d e s i r e to take. A s s u m e t h a t a little girl is playing w i t h a b u r n i n g c a n d l e . N o w a s s u m e t h a t while s h e is playing with the candle t h e child b u r n s b o t h eyelids s e v e r e l y and t h a t t h e r e s u l t i n g seal . It is a fact t h a t m a n y p a t i e n t s w h o c o m e to t h e i r family d o c t o r s o r specialists for s o m e p u r e l y physical a i l m e n t e x h i b i t b e h a v i o r e v e r y bit as i m m a t u r e as t h e t e s t s u b j e c t ' s early d e m a n d s on h e r physician. Since proper guidance of the human being-together between physician and p a t i e n t has such i m p o r t a n c e for t h e w h o l e realm o f m e d i c i n e .u p and t h e t h e r a p e u t i c s i t u a t i o n w h i c h his participation is helping s h a p e . A p e r s o n w h o s e e x i s t e n c e h a s b e e n r e s t r a i n e d t h u s from childhood will. t h e r e f o r e . g o t h r o u g h his w h o l e life s e e i n g i n o t h e r adults o n l y t h o s e c h a r a c t e r i s t i c s t h a t fit t h e limited p e r c e p t i o n h e w a s p e r m i t t e d i n childhood.s h a p e d flame. for w h a t r i g h t had t h e a n a l y s t to c o n c l u d e t h a t a p a s s i o n a t e l o v e developing i n t h e r a p y could n o t b e g e n u i n e l o v e ? 2 O u t o f t h e v e r y n a t u r e o f h u m a n e x i s t e n c e a p a t i e n t and his f u t u r e t h e r a p i s t a r e already. But neurotics would never have become neurotic in the first place if t h e y had b e e n able to develop t h e i r i n h e r e n t p o t e n t i a l for relating t o o t h e r s t o s u c h a s t a t e o f m a t u r i t y . f r o m t h e first m o m e n t t h e y k n o w s o m e t h i n g a b o u t e a c h o t h e r . His t h e s i s b e g i n s w i t h t h e false p r e m i s e t h a t the patient is an adult and t h e r e f o r e able to love in a m a t u r e .The "Locus" of the Therapeutic Interaction 269 e x c e p t in t h e f e w r e s t r i c t e d m o d e s t h a t his p a t h o g e n i c elders had p e r m i t t e d him during childhood. T h e p r i m a r y c h a r a c t e r i s t i c of an infantile. T r e a t i n g such b e h a v i o r o n t h e basis o f t h e t r a n s f e r e n c e t h e o r y can b e j u s t a s d e s t r u c t i v e o f o u t c o m e s o f physical a s o f p s y c h o a n a l y t i c therapy. let u s look a t t w o a n a l o g i e s t h a t f u r t h e r i l l u s t r a t e t h e d a n g e r and u n t e n a b i l i t y o f t h e t h e o r y o f t r a n s f e r e n c e . F r e u d ' s third a r g u m e n t for t h e d e c e p t i v e n e s s o f t h e p a t i e n t . I n d e m a n d i n g c o n s t a n t p r o o f s o f love. H e o p e n l y a d m i t t e d t h a t applying t h e t h e o r y o f t r a n s f e r e n c e i n analysis m i g h t b e n d the t r u t h s o m e w h a t . like t h e o t h e r s . and it is e n t i r e l y c o n s i s t e n t w i t h t h e p a t i e n t ' s p r e s e n t m a k e . B o t h c o n t r i b u t e to this r e l a t i o n s h i p . a r a d i a n t s t a r . t h a t t h e t h e r a p i s t . t h e r e can b e n o q u e s t i o n o f transference into an earlier mode of perception. T h i s m e a n s . a m o n g o t h e r t h i n g s . t h e so-called t r a n s f e r r i n g patient is e x p r e s s i n g love. w i t h o u t help f r o m p s y c h o t h e r a p y . childishly limited light. S h e is s q u i n t i n g a t t h e candle and s e e s . e n g a g e d in a h u m a n r e l a t i o n s h i p . t o suckle. like a n y o t h e r adult. o n a m i s i n t e r p r e t a t i o n o f w h a t h a p p e n s i n t h e r a p e u t i c b e i n g . generous way. 270 EXISTENTIAL FOUNDATIONS t i s s u e p e r m a n e n t l y r e d u c e s h e r vision t o w h a t can b e s e e n t h r o u g h t w o n a r r o w slits. t h e p a t h o g e n i c b e h a v i o r o f p a r e n t s has d a m a g e d " m e r e l y " t h e mind's eye. B u t even this w a t e r e d . P e o p l e w h o are n e u r o t i c a l l y ill s h o w as little e v i d e n c e of a n y t r a n s f e r e n c e as t h e physically h u r t people in o u r i l l u s t r a t i o n . t h a t o n e f l a m e w h i c h had originally b u r n e d h e r eyelids while s h e w a s s q u i n t i n g at it. W i t h o u t s u r g i c a l i n t e r v e n t i o n . i n e s s e n c e . T h e b o n e w o u l d n o t m e n d properly.f o u r . B u t t h e s a m e i s t r u e for all children w h o l a t e r b e c o m e n e u r o t i c s . and t h e child had w a l k e d w i t h a limp e v e r s i n c e . t h e injured child will perceive t h e flame o f a n y c a n d l e she e v e r s e e s . s o t h a t w h e n e v e r a f t e r w a r d she looked a t f l a m e s s h e w o u l d see n o t t h e s e p r e s e n t f l a m e s t h e m s e l v e s b u t a l w a y s . F o r t h e s e . N o r is t h e w o r d transference used a n y l o n g e r to indicate t h e d i s p l a c e m e n t o f feelings from e n d o p s y c h i c p a r e n t . P r o f e s s i o n a l s n o l o n g e r speak o f t r a n s f e r e n c e d r e a m s i n w h i c h c e r t a i n f e a t u r e s o f t h e p a r e n t s a r e shifted first o n t o the a n a l y s t and t h e n o n t o d r e a m i m a g e s o f still o t h e r people. t h i n g s . classical definitions i n t o t h e b a c k g r o u n d .i m a g e s o n t o t h e a n a l y s t . N o w a d a y s . h o w e v e r . W h o w o u l d dare claim t h a t this child is m e r e l y p r o j e c t i n g — t r a n s f e r r i n g — a n a b n o r m a l flame i m a g e t h a t had b e e n f o r m e d long a g o i n h e r p s y c h e . at t h e age of t w e n t y . Still less could it be a r g u e d t h a t t h e p r e s e n t limping o n c e caused by the patient's father constituted unequivocal proof that the c u r r e n t walks t o t h e a n a l y s t e x p r e s s e d a n i n t e n t i o n — d i s p l a c e d and transferred—to seek out the father. f r o m this t i m e until t h e end of h e r days. . No o n e would s e r i o u s l y c o n t e n d in this c a s e t h a t this p a t i e n t w h o is limping to his a n a l y s t does n o t really w a n t to go to his a n a l y s t . F o r o u r s e c o n d case let us say t h a t a m a n d r o v e i n t o his g a r a g e a f t e r w o r k and a c c i d e n t a l y r a n i n t o his son. or t h e child's ability to dispose freely o v e r his e x i s t e n t i a l p o t e n t i a l for e m o t i o n a l l y a p p r o a c h i n g . t h e w o r d is used by m o s t p h y s i c i a n s and p s y c h o l o ­ gists t o r e f e r e x c l u s i v e l y t o t h e i m m e d i a t e feelings o f the m o m e n t t h a t t h e patient e x p r e s s e s t o w a r d the physician. as a s t a r .d o w n n o t i o n o f t r a n s f e r e n c e c o n s i d e r a b l y d i s t o r t s t h e puzzling p h e n o m e n o n ol h u m a n e x i s t e n c e . o r w i t h d r a w i n g from. a third u s a g e of t h e t e r m transference h a s b e g u n to push t h e older. T h e original n o t i o n o f hidden d i s p l a c e m e n t plays hardly a n y part in this n e w e s t v e r s i o n . He is still limping w h e n .s h a p e d r a d i a n c e . he u n d e r g o e s as part of his t r a i n i n g a didactic a n a l y s i s . B o t h p e r s o n s s u f f e r e d g r e a t injury t o t h e i r e x i s t e n t i a l f r e e d o m o f m o v e m e n t i n t h e i r childhood. He always g e t s to the a n a l y s t ' s office on foot. Y e t t h e s t o r i e s o f t h e s e t w o children are n o t e s s e n t i a l l y d i f f e r e n t f r o m t h o s e w h i c h are t a k e n w i t h o u t q u e s t i o n a s o v e r w h e l m i n g d e m o n s t r a ­ tions o f t r a n s f e r e n c e i n adult n e u r o t i c s . w h o s e leg w a s b r o k e n b y t h e collision. L a t e l y . m o r e fully t h a n e v e r b e f o r e . o r p e r s o n .i n .w o r l d w h i c h can be c h a r a c t e r i z e d as an i n h e r e n t . B u t t h e h u m a n m o d e o f dwelling i n t h e w o r l d i s c o n s t a n t l y a t t u n e d t o o n e m o o d o r a n o t h e r .t o g e t h e r is a basic trait of h u m a n b e i n g . t h e y m u s t d o this i n t h e i r e n c o u n t e r s w i t h fellow h u m a n b e i n g s a s well. securing it there. F r o m t h e n e w p e r s p e c t i v e . including a f f e c t s and e m o t i o n s . Y e t all o u r e x p e r i e n c e t e a c h e s u s t h a t h u m a n c o m m u n i c a ­ tion p r o c e e d s in a w h o l l y d i f f e r e n t w a y . t h a t all e m o t i o n a l r e l a t i o n s h i p s b e t w e e n p h y s i c i a n and patient are n o t h i n g m o r e t h a n particularly attuned e n g a g e m e n t s of two h u m a n beings in their c o m m o n dwelling b y t h e s a m e p h e n o m e n a o f t h e i r s h a r e d world. w e can r e c o g n i z e this r e l a t i o n s h i p o n c e again. pal t In it are a w a r e o f its t h e r a p e u t i c s i g n i f i c a n c e . a s t h e p h e n o m e n o n F r e u d s a w as t h e focal point of t h e r a p y . psyche. B u t i f t h a t w e r e really so. I n s t e a d . h u m a n b e i n g s i n h e r e n t l y dwell t o g e t h e r " o u t t h e r e " in a s h a r e d w o r l d . h o w e v e r . and t h e n transferring it to the other. t h a t w e h a v e s h o w n t h e r e is no e v i d e n c e for t h e actual p r e s e n c e in people of t h e kind of i n t e r n a l i t y represented in the container concepts of ego. s h a r e d e n g a g e m e n t in t h e o p e n r e a l m o f p e r c e p t i o n and r e s p o n s i v e n e s s a s w h i c h m a n f u n d a m e n t a l l y e x i s t s . T h e s e p h e n o m e n o l o g i c a l i n s i g h t s g u a r d t h e p h y s i c i a n . N o m e r e t h e o r y can a l t e r this i n t h e least. T h i s m e a n s . for the h u m a n r e l a t i o n s h i p of physician and p a t i e n t r e m a i n s t h e v e r y c o r e ol I hei apeul 1( a c t i o n . t h e n e v e r y p s y c h o l o g i c a l a b s t r a c t i o n . A c c o r d i n g l y .The "Locus" of the Therapeutic Interaction 271 t h e e n d o f s o m e e m o t i o n a l tie. I f people a l w a y s s h o w and e x p e r i e n c e a p a r t i c u l a r a t t u n e m e n t .p a t i e n t rela­ t i o n s h i p a g a i n s t all t h r e e o f t h e m i s i n t e r p r e t a t i o n s c u r r e n t i n t r a n s f e r ­ e n c e t h e o r y . t h e actual basis of all medii al t r e a t m e n t . a t t u n e m e n t b e i n g o n e o f t h e basic f e a t u r e s . in its b r o a d e s t s e n s e . This would be necessary o n l y if e a c h p e r s o n w e r e t h e r e initially as an isolated s u b j e c t . an e g o . We c a n n o t p e r c e i v e s o m e t h i n g u n l e s s o u r s e e i n g .p o l e . w o u l d h a v e t o b e c a r r i e d b a c k and f o r t h s o m e h o w b e t w e e n t w o s u c h h u m a n polarities for t h e r e t o b e a n y c o m m u n i c a t i o n b e t w e e n t h e m .t h e . t h a t t w o people a r e already w i t h each o t h e r f r o m the v e r y i n s t a n t t h e y e n c o u n t e r and p e r c e i v e each o t h e r directly o r indirectly (for e x a m p l e . s u b j e c t . b y h e a r i n g o r reading o f t h e o t h e r ) .t o g e t h e r t a k e s place. consciousness. in t u r n . its basis and a r e n a . c a r r y i n g i t t o his n e i g h b o r . and h o w could w e e v e r g r a s p s o m e t h i n g u n l e s s w e w e r e already b y it? " O u t t h e r e " i s i n q u o t a t i o n m a r k s t o e m p h a s i z e t h a t this e x p r e s s i o n a l w a y s p r e s u p p o s e s a s e p a r a t e " i n n e r " r e a l m a s well. o f h u m a n n a t u r e . . a special e m o t i o n a l a c c e n t in t h e i r e n c o u n t e r s w i t h a n y p h e n o m e n a . o n e o f t h e E x i s t e n t i a l s . i s already b y it. n o m a t t e r w h e r e this b e i n g . T h e r e a d e r will recall. S u c h b e i n g . w h e t h e r or not the people taking. h u m a n b e i n g s are i n h e r e n t l y e n g a g e d i n r e l a t e d n e s s t o w h a t e v e r p h e n o m e n a address t h e m f r o m t h e i r l o c a t i o n s i n t h e h u m a n w o r l d and e x i s t a s t h e s e p e r c e i v i n g and r e s p o n d i n g r e l a t i o n s h i p s . t o g e t h e r o f p h y s i c i a n and patient m a y not always necessarily reduce the effectiveness of medical t h e r a p y . 1 9 4 7 ) . t h a t k n o w l e d g e a b o u t t h e t h e r a p e u t i c e f f e c t i v e n e s s o f t h e p h y s i c i a n . also. 8 . Gesammelte .EXISTENTIAL 272 FOUNDATIONS I g n o r a n c e o f t h e t r u e n a t u r e o f t h e b e i n g . 3 7 7 . that the m a t t e r deserves separate consideration. 4 5 8 a n d 464-65. a s well a s all p r a c t i c a l a t t e m p t s t o t a k e a d v a n t a g e o f this k n o w l e d g e i n a c t u a l t h e r a p y . 315-17. 1949). fur den A r z t bei d e r p s y c h o a n a l y t i s c h e n B e h a n d l u n g " . vol. " B e m e r k u n g e n ü b e r die U b e r t r a g u n g s l i e b e " . Gesammelte psychoanalytischen Werke. pp. p . Therapie. "Bemerkungen pp. v o l . 3 1 8 . (London: Freud. v o l . . It is a fact. über and die Ubertragungsliebe.p a t i e n t r e l a t i o n s h i p . F r e u d : " R a t s c h l a g e . S. p . 1 0 . c o n s t i t u t e e x i s t e n t i a l m a n i f e s t a t i o n s o n t h e part o f t h e therapeutically active person. " Z u r E i n l e i t u n g der B e h a n d l u n g " : i n Gesammelte Werke ( L o n d o n : I m a g o . 1 2 ( L o n d o n : I m a g o . NOTES 1. 2. I n c . p . 8 . b u t v e r y o f t e n it d o e s . So diverse are these ways of existing of different physicians and their therapeutic successes." vol. 1 8 9 ." "Wege der Werke. v o l . S. 1 9 4 1 ) . 10. there are. Y e t in e i t h e r c a s e . t o c o m e t o b e i n g i n t h e light o f his healing u n d e r s t a n d i n g a n d b e h a v i o r . N e v e r is it only t h e t h e r a p i s t w h o a c t s . F o r e v e n w h e n a p s y c h o a n a l y s t a p p e a r s t o b e passively l i s t e n i n g h e h a s a c t i v e l y o p e n e d his p e r c e p t i o n t o t h e p a t i e n t .Chapter 17 THOSE WHO ARE THERAPEUTICALLY ACTIVE In a therapeutic situation. the a n a l y s t m a y r e s t r i c t his role t o t h a t o f l i s t e n e r . C o n v e r s e l y . . t o all a p p e a r a n c e s h e sits p a s s i v e l y w h i l e t h e p a t i e n t i n i t i a t e s w h a t e v e r talk o r a c t i v i t y m a y o c c u r . those w h o are therapeutically active. d i s t u r b e d . o r d i s t o r t e d . I n o u r o t h e r e x a m p l e . t h e w h o l e b u r d e n o f t h e r a p y s e e m s t o fall o n t h e s u r g e o n w h o i s r e m o v i n g a n i n f l a m e d appendix f r o m a n a n e s t h e t i z e d p a t i e n t . on the one hand. physician and p a t i e n t alike a r e i n v o l v e d in t h e t h e r a p e u t i c p r o c e d u r e . on the other. In the sort of psychotherapy we have in mind. t h e patient must have a c t i v e l y a g r e e d to allow t h e o p e r a t i o n and to place h i m s e l f in the s u r g e o n ' s h a n d s b e f o r e he is a n e s t h e t i z e d for s u r g e r y . allowing h i m t o a p p e a r . W i t h o u t the. those being acted upon and. T h e healing r e s p o n s e o f t h e a n a l y s t t o t h e appealing a d d r e s s of t h e p a t i e n t is to e n a b l e h i m to a p p r o p r i a t e as his o w n the i n n a t e h u m a n p o t e n t i a l i t i e s w h i c h u p until t r e a t m e n t had been hidden. T h e p a t i e n t a l w a y s a c t s t h e r a p e u t i c a l l y w i t h t h e p h y s i c i a n . T h i s i s t r u e e v e n i n c a s e s a t t h e e x t r e m e s o f medical therapy: from analytic psychotherapies to surgery performed under general anesthesia. however.i n . E v e n in t h e case of i n t e r n a l d i s o r d e r s . is already u n h e a l t h y and i m m a t u r e . N o t w i t h s t a n d i n g his e x t r e m e l y limited r e s p o n s e . T h e only m e t h o d of t r e a t m e n t he k n e w did n o t r e c o g n i z e t h e p a t i e n t as a h u m a n Da-sein. His medical r e l a t i o n s h i p to h e r c o n c e r n e d n o t h i n g b u t t h e repair o f s o m e b o n e s y s t e m t h a t could b e located. t h e i r a t t i t u d e s t o w a r d t h e r a p y and t h e being ill m a y v a r y g r e a t l y . In o u r t e s t c a s e . w h e n it is applied to a n u m b e r of o t h e r health d i s o r d e r s t h a t look like simple physical a i l m e n t s — w h e n e v e r .w o r l d . s o m e w h e r e in a physical space.t h e . t h e r e is o f t e n small h a r m d o n e in m i s i n t e r p r e t i n g t h e a c t u a l n a t u r e of t h e a i l m e n t . T h e p a r t n e r s w h o a r e acting t o g e t h e r i n t h e s e w a y s can b e v e r y different kinds o f people. e v e n in purely practical t e r m s . A b o v e all. surgical i n t e r v e n t i o n would n o t b e possible. T h e physician therefore deliberately challenged each of her a t t e m p t s t o r e s i s t g r e a t e r f r e e d o m for h e r s e l f . H e t o o k for g r a n t e d t h e overall validity o f t h e n a t u r a l scientific t h i n k i n g t h a t pervaded m e d i c i n e . b o t h t h e active p s y c h o t h e r a p i s t and t h e a c t e d u p o n p a t i e n t realized f r o m t h e o u t s e t t h a t t h e goal o f t h e r a p y w o u l d b e t o l i b e r a t e t h e p a t i e n t f r o m h e r n e u r o t i c a l l y r e s t r i c t e d w a y s o f r e l a t i n g t o t h e people and t h i n g s o f h e r world. T h e fact t h a t t h e a c c i d e n t had n o t o n l y b r o k e n a b o n e b u t s e v e r e l y a f f e c t e d t h e p a t i e n t ' s e n t i r e b e i n g . f o r e x a m p l e . T h e s a m e applies t o all t h e r a p e u t i c m e t h o d s t h a t lie b e t w e e n t h e s e t w o e x t r e m e s .t h e . no other therapist—certainly not a psychotherapist—could h a v e d o n e a m o r e t h o r o u g h and speedy j o b o f r e s t o r i n g h e r h u m a n f r e e d o m t h a n this s u r g e o n w i t h his skillful t e c h n i c a l m i n i s t r a t i o n s t o w h a t he i n t e r p r e t e d as a b r o k e n shin. a f r a c t u r e or i n f e c t i o n afflicts a h u m a n e x i s t e n c e that. t h e s a m e a p p r o a c h t o t h e r a p y p r o v e s d e f i c i e n t . O n t h e o t h e r hand. as well as a r e s p o n s e to t h e s e p h e n o m e n a . S i n c e t h e a g r e e m e n t is based on a p e r c e p t i o n and u n d e r s t a n d i n g of p h e n o m e n a t h a t h a v e b e e n e n c o u n t e r e d . H e r e t h e t h e r a p i s t pays bitterly for . as Da-sein.g e n e t i c a p p r o a c h o f t e n suffices. a bacterial c o l o n y and a h u m a n being r e i n f o r c e d w i t h a n t i b i o t i c s . and r e m o v i n g w h a t is seen as t h e causal a g e n t o f t h e illness usually does a w a y w i t h t h e illness i t s e l f and t h e resulting impairment of human freedom. W h e r e practical t h e r a p e u t i c o u t c o m e s a r e c o n c e r n e d . t h e n a r r o w s o m a t i c c a u s a l .w o r l d and r e d u c e d it to t h e s m a l l e s t spatiality and t e m p o r a l i t y i m a g i n a b l e did n o t t r o u b l e t h e s u r g e o n i n t h e least. and t h e r e is a p r o m p t r e c o v e r y i n spite o f t h e fact t h a t t h e physician s e e s a s his t a s k o n l y t h e c r e a t i o n of a c h e m o p h y s i c a l i n t e r a c t i o n b e t w e e n t w o o r g a n i c s y s t e m s . B u t t h e s u r g e o n she l a t e r c o n s u l t e d for h e r leg f r a c t u r e had n e v e r b o t h e r e d t o c o n s i d e r t h e n a t u r e o r p u r p o s e o f h u m a n b e i n g . t h e b e h a v i o r of this p a t i e n t is no less a g e n u i n e h u m a n act t h a n i s the a n a l y s t ' s a t t e n t i v e n e s s i n t h e o t h e r c a s e .274 EXISTENTIAL FOUNDATIONS a g r e e m e n t o n t h e p a t i e n t ' s part.i n . d a m a g e d . for i n s t a n c e . t h e r e a r e sick people w h o . does n o m o r e t h a n p r o m o t e p r o p e r callous f o r m a t i o n . in e v e r y a r e a of medical specialization. will be decisively i m p o r t a n t . B u t this does n o t c h a n g e t h e basic s h a p e o f t h e p r o b l e m . with their strong tendencies t o infantilize t h e i r m e m b e r s . his w h o l e e x i s t e n c e . N a t u r a l l y . all t o o often d e g e n e r a t e i n t o i n t e r m i n a b l e c h r o n i c n e u r o s e s o r h y p o c h o n d r i a chal i l l n e s s e s . T h i s i n s i g h t will n o t c o m p e l s u r g e o n s and i n t e r n i s t s t o c h a n g e t h e i r t h e r a p e u t i c t e c h n i q u e at all. b u t in t h e long run. as Da-sein. o r t h e d e s t r u c t i o n o f p n e u m o c o c c i i n t h e body. n o m a t t e r w h a t his p a r t i c u l a r a i l m e n t . A t t h e v e r y least. T h e process of genuine healing involves the way the patient is e x i s t e n t i a l l y related t o t h e w o r l d a t t h e t i m e . If he does n o t c o n s t a n t l y k e e p s i g h t of t h e fact t h a t all medical i n t e r v e n t i o n — b e it surgical. To s e e t h a t p a r t i c u l a r t h e r a p y is m e r e l y a p r e p a r a t i o n is n o t to criticize t h e t h e r a p y itself. the physician will n o t realize t h a t his m a n i p u l a t i o n of t h e p a t i e n t ' s bodily s p h e r e is no m o r e t h a n a prelude t o t h e r e c o v e r y o f t h e w h o l e h u m a n e x i s t e n c e . W i t h o u t this u n d e r s t a n d i n g . to h u m a n s o c i e t y as a w h o l e . w h e t h e r o r n o t t h e m a n i p u l a t i o n s o f s u r g e o n s and i n t e r n i s t s a r e r o o t e d in an a d e q u a t e u n d e r s t a n d i n g of h u m a n being. until h e h a s r e c o v e r e d full u s e of all t h e p o t e n t i a l i t i e s n a t i v e to his Da-sein. a r e r o b u s t and h e a l t h y e n o u g h b e f o r e t h e i r surgical o r medical t r o u b l e s t o b e able t o o v e r c o m e the i n e v i t a b l e afflictions of t h e i r Dasein w h i c h a n y illness leads t o . his b l i n d n e s s m a y h a v e o n e o f t w o c o n s e q u e n c e s . o r p s y c h o t h e r a p e u t i c — a i m s a t r e s t o r i n g t h e u s e o f all i n n a t e e x i s t e n t i a l p o t e n t i a l i t i e s t o t h e p a t i e n t . p r e p a r a t i o n s a r e t o b e valued and c a r r i e d t h r o u g h w i t h greal c a r e . m a n y m o r e d o c t o r s a w a r e t h a t s u c h t h i n g s a s t h e s e t t i n g o f a b o n e . c h e m i c a l . To c o n c e i v e of t h e p a t i e n t as a purely physical o r g a n i s m only s o m e t i m e s r e s u l t s i n h a r m c o n c e r n i n g health disorders like t h o i t u i . o r t h e i n t r o d u c t i o n o f a n t i b i o t i c s i n t o t h e body. e x c e p t in r a r e i n s t a n c e s . t h e physician. T o t h e d e g r e e t h a t t h e y c o n t r i b u t e t o the s u c c e s s o l a n e n t e r p r i s e . T h e y d o h a r m i n t h e r a p y o n l y w h e n t h e y t r y t o pass t h e m s e l v e s o l I as t h e be-all and end-all in medical p r o c e d u r e . T h i s d o e s i m m e a s u r a b l e h a r m t o t h e p a t i e n t . t h e f r a c t u r e o r i n f e c t i o n heals m o r e slowly t h a n usual. and t h a t is to h a v e . N o p a t i e n t i s g e n u i n e l y h e a l e d . and. B u t t h e far g r e a t e r d a n g e r f r o m this m y o p i a o f therapists is that in modern welfare states. w h a t m a y first look like simple physical a i l m e n t s . o r a n y o t h e r a p p a r e n t l y purely physical i n t e r v e n t i o n .Those Who Are Therapeutically Active 275 his i g n o r a n c e of t h e e x i s t e n t i a l basis t h a t u n d e r l i e s all t h e r a p y . I n light o f t h e v a s t n u m b e r s o f people w h o are e x i s t e n t i a l l y i m m a t u r e and d i s t o r t e d b e f o r e t h e y are affected b y s e e m i n g l y bodily illness. t h e r e would seem to be only one workable way to control the development of e v e n m o r e s e v e r e n e u r o s e s . last but n o t least. a m e n a b l e t o t h e i n t e r v e n t i o n o f s u r g e r y o r m e d i c a t i o n . 1 T h e s a m e u n d e r s t a n d i n g o f the basis o f all t h e r a p y i s r e q u i r e d o f t h e physician t r e a t i n g " p u r e p s y c h o s e s " and " c h a r a c t e r n e u r o s e s . " a i l m e n t s in t h a t t h e d i s t u r b e d r e l a t i o n s h i p s to t h e world are less s t r i k i n g l y evident w i t h i n t h e i r bodily s p h e r e s .w o r l d . Identical s y m p t o m s m a y b e produced in l a b o r a t o r y a n i m a l s . little s e r i o u s d o u b t remains that the incidence of these unique ailments is connected to particular d i s t u r b a n c e s i n t h e w a y t h e s u f f e r e r r e l a t e s t o the w o r l d . t h a t t h e specialist in v e n e r e a l d i s e a s e s w o u l d be o v e r t a x e d by t h e added b u r d e n o f t e n d i n g t o d i s t u r b e d h u m a n w a y s o f r e l a t i n g t o t h e w o r l d . T h e diseases k n o w n a s p s y c h o n e u r o s e s m o s t directly affect p o t e n t i a l i t i e s i n t h e r e a l m s o f t h i n k i n g .t h e . I n order t o heal w h e n t h e s e areas are a f f e c t e d . and a c t i n g . T h e physician's d u t y t o c o u n t e n a n c e a n e x i s t e n t i a l . t h e y m u s t c o n s c i o u s l y focus t h e i r t h e r a p i e s o n r e a t t u n i n g t h e p a t i e n t ' s p a t h o g e n i cally reduced w a y s of b e i n g in relation to t h e p h e n o m e n a of his w o r l d . A n d if to be a t h e r a p i s t m e a n s to offer f u n d a m e n t a l help. t h e physician m u s t often explode t h e a s s u m p t i o n s o f classical p s y c h o a n a l y t i c t h e o r y . a s t h m a . C o n s e q u e n t l y . for t h e a n i m a l s w o u l d n e v e r h a v e b e c o m e sick i n quite t h a t w a y i f people had n o t had a h a n d in it. o r p s y c h o s o m a t i c . D a s e i n s a n a l y t i c approach b e c o m e s e v e n c l e a r e r w i t h t h a t g r o u p o f h e a l t h d i s o r d e r s w h i c h . " T h e s e illnesses differ from t h e "specifically h u m a n . N o n e o f t h e s e steadily i n c r e a s i n g diseases h a p p e n s o u t s i d e t h e r e a l m o f h u m a n b e i n g . and a c c i d e n t p r o n e n e s s . B u t t h e e f f e c t s o f this o r i e n t a t i o n a r e m o r e predictably h a r m f u l in t h e c a s e . He w o u l d no l o n g e r h a v e to be like a f i r e f i g h t e r w h o can do n o t h i n g b u t put up s m o k e s c r e e n s a r o u n d t h e wall of a b u r n i n g h o u s e . disease-ridden a m b i e n c e o f a b r o t h e l . b u t t h e a i l m e n t s a r e still u n i q u e l y h u m a n . thai libido and . a n u m b e r o f c h r o n i c g a s t r o i n t e s t i n a l d i s o r d e r s . feeling.276 EXISTENTIAL FOUNDATIONS h a v e been discussing. Of c o u r s e he w o u l d h a v e a lot to do. S u c h e x i s t e n t i a l d e m a n d s o n t h e physician will d o u b t l e s s face t h e usual o b j e c t i o n . B u t o n l y by o p e n i n g his m i n d to this pressing t h e r a p e u t i c c o n c e r n can he b e c o m e a t r u e healer.i n . since J o r e s . o r h e w o u l d h a r d l y h a v e had t o m a k e t h e m o s t i n t i m a t e o f his h u m a n c o n n e c t i o n s i n t h e seedy. let us say. h a v e b e e n called specifically h u m a n a i l m e n t s . according to w h i c h t h e w h o l e p r o b l e m is to r e l e a s e libido that h a s b e e n fixated o n infantile e n d o p s y c h i c c o n t e n t s b y m a k i n g t h e s e c o n t e n t s c o n s c i o u s . able to do m o r e t h a n sit idly b y until t h e patient r e t u r n s w i t h a n o t h e r v e n e r e a l i n f e c t i o n . h o w e v e r . It has been pointed o u t o f t e n e n o u g h . T h e y m a n i f e s t t h e m s e l v e s m o s t f r e q u e n t l y t h e s e days a s e s s e n t i a l h y p e r t o n i a . A h u m a n l y a d e q u a t e t h e r a p y would n e e d to go b e y o n d t h e approach o f n a t u r a l s c i e n c e and take i n t o a c c o u n t t h e likelihood t h a t t h e w h o l e e x i s t e n c e of t h e syphillitic h a s u n d e r g o n e a s e v e r e p a t h o l o g i c a l r e s t r i c t i o n . of a m a n i n f e c t e d w i t h syphillis. F o r m a n y people w h o have b e c o m e n e u r o t i c t h r o u g h l o n e l i n e s s . F r e u d h i m s e l f did n o t allow his t h e r a p e u t i c m e t h o d s to be ruled e n t i r e l y by his t h e o r e t i c a l findings. B u t this is an ability w i t h o u t w h i c h h u m a n b e i n g s could n e v e r live in t h e w o r l d as t h e y do. F i r s t . W h a t h a p p e n s has m u c h m o r e t o d o w i t h that decisively i m p o r t a n t a s p e c t of t h e r a p y t h a t can o n l y be g r a s p e d by a D a s e i n s a n a l y t i c a p p r o a c h . T h e causal i m a g i n a t i o n beholds o n l y rigidly c h r o n o l o g i c a l sequences of events meaningless in themselves. We have pointed o u t a b o v e t h a t v e r y f e w adults indeed e v e r e x p e r i e n c e from a n o t h e r adult the kind o f e n d u r i n g . close h u m a n c o n t a c l with . and not by a p s y c h o a n a l y t i c o n e . At decisive p o i n t s . w h a t e v e r h i s s c h o o l o f t h o u g h t .Those Who Are Therapeutically Active 277 endopsychic contents are things for whose existence there is no proof at all. t h e r e is m u c h d i s c u s s i o n o f t h e m e a n i n g o f s y m p t o m s and o f t h e g r e a t e r f r e e d o m t o w h i c h p a t i e n t s can b e led t h r o u g h p s y c h o a n a l y t i c t r e a t m e n t . and t h a t e v e n if s u c h a t h i n g as libido did e x i s t it could n e v e r of its o w n a c c o r d p r o d u c e a h u m a n w o r l d of p e r c e i v e d m e a n i n g s . T h i r d . e v e n w h e n t h e physician i s t h e m o s t t h e o r e t i c a l l y o r t h o d o x p s y c h o a n a l y s t . B u t b e c a u s e t h e analysl | g m o r e open and c o u r a g e o u s than t h e p a r e n t s . B u t in F r e u d ' s practical advice for c o n d u c t i n g p s y c h o t h e r a p y . n e i t h e r m e a n i n g n o r f r e e d o m h a s a n y place in a s t r i c t l y d e t e r m i n i s t i c t h e o r y . e v e n i n c o n c e p t u a l l y o u t m o d e d p r o g r a m s o f psychoanalytit t r e a t m e n t t h e p a t i e n t o f t e n g a i n s at least a foggy a w a r e n e s s o f t h e r e a l m . b e n e v o l e n t . which i s largely due t o i n a d e q u a t e a n d i n a p p r o p r i a t e upbringing. such b e i n g . F a r less could it c h a n g e o r heal t h a t w o r l d . N o kind o f e n e r g y o r f o r c e can p e r c e i v e s o m e t h i n g in its s i g n i f i c a n c e . T h e s e c o n d r e a s o n for t h e s u c c e s s o f such c u r e s i s t h a t . in fact. T h e t h e o r e t i c a l s u p e r s t r u c t u r e m e a n s to be a n a t u r a l scientific s y s t e m and t h e r e f o r e c o n f o r m s s t r i c t l y t o t h e d e t e r m i n i s t i c principle o f c a u s a l i t y . and tactful d e v o t i o n t h a t a p a t i e n t r e g u l a r l y r e c e i v e s from a n a n a l y s t .t o g e t h e r is in itself a v e r y e f f e c t i v e therapeutic tool. h e b e c a m e n e u r o t i c . of p h e n o m e n a from w h i c h his e x i s t e n c e has so far been cul oil An a result o f this being cut off. infinitely m o r e h a p p e n s during t h e r a p y t h a n the m e r e r e p o r t a g e o f libidinal t h e o r i e s t o t h e p a t i e n t . H o w t h e n does i t h a p p e n t h a t p h y s i c i a n s w h o a r e e n s l a v e d t o the libido t h e o r y and o t h e r s p e c u l a t i o n s o f p s y c h o a n a l y t i c m e t a p s y c h o l o g y can o f t e n free p a t i e n t s o f t h e i r p s y c h o s o m a t i c s y m p t o m s ? S i m p l y b e c a u s e t h e s e p a t i e n t s r e c o v e r n o t because of faulty t h e o r y b u t in spite of it. h e a c t e d i n radical o p p o s i t i o n t o h i s o w n m e t a p s y c h o l o g y . T h i s can b e s e e n i n t h e striking c o n t r a d i c t i o n s t h a t e x i s t b e t w e e n his papers o n t e c h n i q u e and his w o r k s o n t h e s u b j e c t o f m e t a p s y c h o l o g y . u n s h a k a b l e . T h e r e a r e a t least t h r e e w a y s t o explain h o w c u r e s can t a k e place u n d e r such c i r c u m s t a n c e s . N o w . 278 EXISTENTIAL FOUNDATIONS him gradually t e a c h e s t h e p a t i e n t to e n g a g e i n d e p e n d e n t l y in r e l a t i n g m o r e freely t o r e a l m s o f p h e n o m e n a h e had b e e n avoiding. S o s u c c e s s can b e g a i n e d i n spite o f t h e fact t h a t n o e v i d e n c e e m e r g e s i n the course of therapy to support the theoretical statements of the o r t h o d o x p s y c h o a n a l y s t . B u t t h o s e p a t i e n t s w h o are n o t able t o see e v e n t h e dim o u t l i n e s o f w h a t lies b e y o n d t h e c o n c e p t u a l f r a m e w o r k o f o r t h o d o x p s y c h o a n a l y s i s usually w i n d u p trading t h e i r first n e u r o s i s for a n e w one: "psychoanalysitis." T h e y begin suffering from a compulsive u r g e to drill t h e m s e l v e s in t h e i n t e l l e c t u a l a c r o b a t i c s of p s y c h o a n a l y t i c t h e o r y . O b v i o u s l y , this kind o f m o n o m a n i a p r e c l u d e s t h e d e v e l o p m e n t o f r e l a t i n g m o r e freely t o t h e w o r l d . Q u i t e a f e w o f t h e s e p a t i e n t s can n e v e r t h e l e s s b e m a d e g e n u i n e l y h e a l t h y , i f t h e y a r e willing and able t o c h a n g e p h y s i c i a n s . W h a t t h e y n e e d i s a n a n a l y s t w h o s e h u m a n u n d e r s t a n d i n g a l l o w s h i m t o m a k e t h e leap f r o m a b s t r a c t ideas, like p s y c h e or psychic c o n t e n t s , to a m o r e a p p r o p r i a t e g r a s p of h u m a n Da-sein as b e i n g - i n - t h e - w o r l d . S u c h a physician e x c h a n g e s t h e t e c h n i q u e s o f a p s y c h o a n a l y t i c t h e r a p y o f r e s i s t a n c e for a D a s e i n s a n a l y t i c t r e a t m e n t of t h e c o n s t r i c t i o n s of t h e Dasein. T h e t h e r a p i s t s e e s t h e " D a - " of his p a t i e n t ' s Da-sein as t h a t o p e n r e a l m o f p e r c e p t i o n and r e s p o n s i v e n e s s t o t h e p r e s e n c e o f b e i n g s , w h i c h i s b o r n b y his, and t h a t o f all o t h e r h u m a n b e i n g s , e x i s t e n c e . A t o n e w i t h t h i s , t h a t for t h e sake o f w h i c h , for w h a t and t o w h a t end, t h e Da-sein o f his p a t i e n t is claimed as t h e " D a - " will be c o n s t a n t l y p r e s e n t for t h e D a s e i n s a n a l y t i c t h e r a p i s t . H e will t h e r e f o r e guide e v e r y p a t i e n t t o w a r d t h e s a m e goal of r e n d e r i n g t h e Da-sein of e a c h as p e r c e p t i v e l y o p e n and r e s p o n s i v e a s i t can b e t o t h e p r e s e n c e s o f e v e r y single p h e n o m e n o n t h a t a d d r e s s e s him w i t h t h e appeal to e n t e r i n t o t h e light of his fully freed e x i s t e n c e , and s o c o m e t o b e . D a s e i n s a n a l y t i c t h e r a p y can heal p a t i e n t s s u f f e r i n g f r o m p s y c h o n e u r o s e s , c h a r a c t e r n e u r o s e s , and p e r v e r s i o n s b e c a u s e t h e s e people c a n , w i t h an a d e q u a t e l y t h e r a p e u t i c a l l y active a n a l y s t , l e a r n to live purposeful lives o f t o t a l a u t o n o m y and f r e e d o m . T h e goal o f D a s e i n s a n a l y t i c t h e r a p y t h u s c o i n c i d e s e x a c t l y w i t h t h e m o s t s u i t a b l e definition for a h e a l t h y Da-sein. I n his p u r s u i t o f t h e u n i v e r s a l goal o f D a s e i n s a n a l y t i c t h e r a p y , t h e physician can n e v e r r e m i n d h i m s e l f t o o o f t e n t h a t his t a s k i n t h e r a p y does n o t c o n s i s t a n y l o n g e r m e r e l y i n dredging u p i n t r a p s y c h i c i m a g e s o f e x t e r n a l - w o r l d o b j e c t s , painful o r forbidden p o r t r a i t s t h a t w e r e supposedly r e p r e s s e d a t o n e t i m e i n t o t h e n e t h e r m o s t l a y e r o f a n e n c a p s u l a t e d p s y c h e . His duties are far m o r e p r o f o u n d . F o r t h e D a s e i n s a n a l y t i c t h e r a p y o f r e s i s t a n c e does m o r e than simply help p a t i e n t s find the c o u r a g e to face s h a d o w y i m a g e s supposed to exist inside Those Who Are Therapeutically Active 279 s o m e s o r t o f psychic s t r u c t u r e ; t h e y m u s t e s t a b l i s h o p e n r e l a t i o n s w i t h each one of the phenomena that inhabit their world, no m a t t e r w h e r e in t h e i r o p e n realm of p e r c e p t i o n it c h o o s e s to appear. A n d this bold act m u s t b e t a k e n o n n o t o n l y i n r e l a t i o n t o i n a n i m a t e o b j e c t s b u t for e v e r y living c r e a t u r e , e v e r y o t h e r p e r s o n , and for t h e p o t e n t i a l i t i e s o f o n e ' s o w n e x i s t e n c e : i n s h o r t , for e v e r y t h i n g i n h e a v e n and e a r t h f r o m w h i c h t h e p a t i e n t has e v e r fled, e v e r y t h i n g t h a t , for r e a s o n s o f s h a m e , o r disgust, o r injured pride, o r s o m e p s e u d o m o r a l i t y , h e w o u l d n o t face a t a n y c o s t . R e p e a t e d q u e s t i o n i n g o f t h e p a t i e n t ' s a t t e m p t s t o flee f r o m s u c h p h e n o m e n a e n c o u r a g e s h i m t o p e r c e i v e , and c a r r y o u t , t h e g r e a t t a s k t h a t is placed b e f o r e h i m as a h u m a n b e i n g - i n - t h e - w o r l d , t h e t a s k of facing u p t o e v e r y t h i n g t h a t a d d r e s s e s him f r o m t h e o p e n r e a l m o f his b e i n g - t h e r e , and o f r e s p o n d i n g t o t h a t call a p p r o p r i a t e l y . S u c h t h e r a p y can r e m o v e t h e f o u n d a t i o n o f t h e illness. N e u r o s i s develops o n l y through ignoring, turning away from the existential task of committing o n e s e l f i n p e r c e p t i v e , r e s p o n s i v e r e l a t i o n s h i p w i t h w h a t r e v e a l s itself. W h a t allows t h e D a s e i n s a n a l y t i c t h e r a p i s t t o e x p e c t s o m u c h o f his p a t i e n t s i s his o w n w i l l i n g n e s s t o provide t h e m w i t h t h e dwelling place o f t h e p h y s i c i a n - p a t i e n t r e l a t i o n s h i p t h e y n e e d and c a n rely on. T h i s h u m a n t w o - n e s s s e r v e s a s t h e firm f o u n d a t i o n for t h e p a t i e n t ' s n e w l y l i b e r a t e d Da-sein u n t i l h e n o l o n g e r n e e d s t h e p r o t e c t i o n o f t h e s a f e m i n i a t u r e t e s t w o r l d . T h i s m e a n s , a s far a s practical t h e r a p y g o e s , t h a t t h e physician m u s t i m m e d i a t e l y d i s p e n s e w i t h t h e old w h y - q u e s t i o n s o f p s y c h o a n a l y ­ sis. All t o o o f t e n it h a s b e e n s e e n t h a t p a t i e n t s i n t e r p r e t such q u e s t i o n s as t h e r a p e u t i c a l l y u s e l e s s c o m m a n d s to dredge up s o m e i n f a n t i l e c a u s e f o r a p r e s e n t a i l m e n t , a s its e f f e c t , w i t h o u t e v e r l e a r n i n g t o u n d e r s t a n d t h e present pathological modes of relationship as they actually are. For a n o t h e r t h i n g , n e u r o t i c a l l y ill people f r e q u e n t l y m i s t a k e w h y questions—contrary to the analyst's intent—for prohibitions. T h e a n a l y s t s e e m s t o b e asking t h e m : " W h y are y o u still doing t h i s , w h e n y o u should h a v e given it up as i n a p p r o p r i a t e long a g o ? " In t h e v o c a b u l a r y of t h e D a s e i n s a n a l y t i c t h e r a p i s t , " w h y ? " i s replaced a s t h e m o s t i m p o r t a n t w o r d by t h e q u e s t i o n , " W h y in t h e w o r l d not?" At e v e r y available o p p o r t u n i t y , the D a s e i n s a n a l y t i c t h e r a p i s t will ask t h e p a t i e n t w h y i n the w o r l d he h a s n o t dared to p e r c e i v e and r e s p o n d to s o m e t h i n g in his world f r o m w h i c h he has c o n s t a n t l y b e e n looking a w a y . W a s it really n e c e s s a i y t o flee and hide f r o m t h i n g s t h a t r e v e a l e d t h e m s e l v e s t o h i m ? S u c h " w h y n o t " questions are particularly indispensable whenevei there is a barrier to the honest, open verbalizing of the patient's hum.in r e l a t i o n s h i p to t h e t h e r a p i s t , c o n c r e t e e x a m p l e s of w h i c h a b o u n d m the p r e c e d i n g description of o u r t e s t c a s e . In fact, " W h y in the world nol la ; 280 EXISTENTIAL FOUNDATIONS really a t t h e h e a r t o f a n y c o m p r e h e n s i v e p s y c h o t h e r a p y . B u t i f t h e t h e r a p i s t u s e s this q u e s t i o n a s j u s t a n o t h e r t e c h n i c a l tool, h e will s u r e l y apply it at t h e w r o n g t i m e s and places. He can u s e it successfully in t h e r a p y o n l y i f h e k n o w s well e n o u g h t h e o n t o l o g i c a l s t r u c t u r e o f h u m a n b e i n g - t o g e t h e r i n a s h a r e d w o r l d . T h e t h e r a p i s t m u s t realize t h a t t h e real r e a s o n for c o n f r o n t i n g p a t i e n t s w i t h such precisely f o r m u l a t e d , specific o n t o l o g i c a l q u e s t i o n s i s t o rid t h e m o f t h e n o t i o n t h a t t h e y a r e n o t h i n g t o him b u t n u m b e r s and t h i n g s , and to h a v e t h e m gradually e x p e r i e n c e a genuine human relationship shared by both. W i t h o u t the potentiality of such an insight into the ontological structure of human being-in-thew o r l d , t h e t h e r p i s t w o u l d h a v e n o o t h e r w a y b u t t o g r o p e i n t h e dark. W i t h it, he can s y s t e m a t i c a l l y s h o w his p a t i e n t s t h a t he is c o m m u n i c a t i n g w i t h t h e m in t h e r e a l m of a h u m a n b e i n g - t o g e t h e r . It s e e m s to be a p r e r e q u i s i t e for s u c c e s s in t h e r a p y t h a t in t h e c o u r s e of t r e a t m e n t t h e p a t i e n t b e s h o w n this v e r y t h i n g d o z e n s and h u n d r e d s o f t i m e s . It is n o t n e c e s s a r y t h a t the patient h i m s e l f learn to r e c o g n i z e thematically the ontological, existential structure of human being-int h e - w o r l d . His insight need n o t e x t e n d b e y o n d t h e limits o f his individual, directly p e r c e p t i b l e o n t i c w a y s o f r e l a t i n g t o t h e t h e r a p i s t . B u t it is t h e d u t y of t h e l a t t e r to b e c o m e t h o r o u g h l y a c q u a i n t e d w i t h , and clearly a w a r e of, t h e o n t o l o g i c a l n a t u r e o f b e i n g - t o g e t h e r i n o r d e r t o give his t r e a t m e n t a scientific f o u n d a t i o n . G i v e n this s o r t o f f o u n d a t i o n , i t m a y o n t h e s u r f a c e appear n o n s e n s i c a l to apply t h e label " a n a l y s i s . " It w o u l d s e e m r a t h e r to be a " s y n t h e s i s , " in t h a t the p a t i e n t is c o n s c i o u s l y guided i n t o t h e w h o l e n e s s of a free and a u t o n o m o u s e x i s t e n c e . B u t t h e w o r d analysis is o b j e c t i o n a b l e in this c o n t e x t o n l y if it keeps t h e m e a n i n g it has t a k e n on in t h e m o d e r n t e c h n i c a l age, of s e p a r a t i n g c o m p o n e n t s , b u t n o t w h e n it is u n d e r s t o o d in its original s e n s e of r e v e a l i n g t h e a r t i c u l a t i o n of a w h o l e . S t r i c t l y s p e a k i n g , t h e w a y in w h i c h a p h y s i c i a n heals t h e Da-sein of his p a t i e n t t h r o u g h " w h y n o t " q u e s t i o n s i s m o r e radical i n its e f f e c t s t h a n a n y h e a r t t r a n s p l a n t could e v e r be. T h e l i b e r a t i o n o f a p a t i e n t f r o m n e u r o t i c and p s y c h o s o m a t i c captivity b r o u g h t a b o u t w i t h t h e aid o f t h e s e q u e s t i o n s a l w a y s h a s to be, quite literally, a w o r l d - s h a k i n g e x p e r i e n c e for physician and p a t i e n t alike. It lacks o n l y t h e s p e c t a c u l a r m a t e r i a l e x p e n s e of a physical h e a r t t r a n s p l a n t and t h e r e s p e c t t h a t m o s t people a c c o r d to physical m a t t e r t h e y can see w i t h t h e i r o w n e y e s . A D a s e i n s a n a l y t i c t h e r a p i s t can e v e n g e t t h r o u g h to t h a t m o s t difficult class o f p a t i e n t s , m o s t o f t h e m y o u n g , w h o a r e n o t medically ill a t all. T h e y e x h i b i t n o specific medical s y m p t o m s , y e t t h e y d o suffer, filling t h e w a i t i n g r o o m s o f physicians i n i n c r e a s i n g n u m b e r s . W e h a v e already said that t h e s e y o u n g people suffer o n l y from g e n e r a l b o r e d o m , t h e Those Who Are Therapeutically Active 281 m e a n i n g l e s s n e s s o f h u m a n e x i s t e n c e i n g e n e r a l and t h e h o p e l e s s n e s s o f t h e i r o w n lives i n particular. T h e i r f a v o r i t e e x p r e s s i o n s e e m s t o be, "It d o e s n ' t m a t t e r . " T h e y say this e v e n a b o u t t h i n g s t h e y have j u s t c o m p l a i n e d of. N e v e r t h e l e s s , m o r e and m o r e , physicians w h o t r y t o t r e a t such p a t i e n t s e x i s t e n t i a l l y h a v e c o m e u n d e r h e a v y c r i t i c i s m f r o m influential sectors of society. Certainly, these critics are correct in pointing out that t h e p h y s i c i a n and his p a t i e n t do n o t e x i s t in a v a c u u m b u t w i t h i n t h e l a r g e r , d a y - t o - d a y reality o f m o d e r n industrial s o c i e t y . T h e r e are m a n y leading p h y s i c i a n s , t o o , w h o a r e o p p o s e d from t h e s t a r t t o a n y t h e r a p y t h a t dwells o n s u c h t h i n g s a s h u m a n o p e n n e s s t o p h e n o m e n a l p r e s e n c e s and t h e o p e n space o f p h y s i c i a n - p a t i e n t b e i n g - t o g e t h e r . T o t h e s e critics, s u c h a f o u n d a t i o n for t h e r a p y s h a r e s m o r e w i t h p o e t r y t h a n w i t h practical s c i e n c e . W h e t h e r D a s e i n s a n a l y t i c t h e r a p y is poetic is i r r e l e v a n t . T h e c h a r g e o f u n s c i e n t i f i c n e s s , h o w e v e r , i s valid o n l y o f s c i e n c e a r b i t r a r i l y r e s t r i c t e d to n a t u r a l scientific o r i e n t a t i o n , a r e s t r i c t i o n m a d e w i t h i n c r e a s i n g f r e q u e n c y t h e s e days. F u r t h e r m o r e , i t s h o u l d first b e demonstrated that Daseinsanalytic therapy involves an approach that is less s t r i c t and less o b j e c t i v e , w i t h r e g a r d t o t h e m a t t e r a t h a n d , t h a n n a t u r a l scientific o r i e n t a t i o n . B u t s o far n o critic h a s b e e n able t o p r o v e such statements. It is a b s u r d , in any c a s e , t h a t t h e v e r y p h y s i c i a n s w h o t r y to s u m m o n t h e i r D a s e i n s a n a l y t i c c o l l e a g u e s b a c k i n t o t h e fold o f n a t u r a l s c i e n c e should b e t h e o n e s w h o fight, t h r o u g h t h e i r p r o f e s s i o n a l o r g a n i z a t i o n s , a g a i n s t t h e socialization o f m e d i c i n e . F o r t h e m o r e t h e y think o f t h e m s e l v e s e x c l u s i v e l y a s p r e c i s e , n a t u r a l , scientific h e a l t h e n g i n e e r s , t h e m o r e t h e y a b a n d o n all claim to i n d e p e n d e n t p r o f e s s i o n a l standing. M e m b e r s o f all e x i s t i n g t e c h n i c a l p r o f e s s i o n s h a v e w o n t h e s t a t u s o f e m p l o y e e s on fixed salaries; this fact gives a h o l l o w s o u n d to t h e cries for i n d e p e n d e n c e issued b y w o u l d - b e t e c h n i c i a n s a m o n g t h e medical p r o f e s s i o n . T h e d o c t o r s ' fight a g a i n s t socialization w o u l d be justified, in t h e l o n g r u n , o n l y if a m a j o r i t y of t h e m w e r e able to s t r u g g l e t h r o u g h to a b e t t e r e x i s t e n t i a l u n d e r s t a n d i n g o f t h e healing art. O n l y t h e n could t h e y p r o c l a i m t h e f r e e d o m and o p e n n e s s c h a r a c t e r i s t i c of a h e a l t h y h u m a n e x i s t e n c e . O n c e t h e y h a v e this u n d e r s t a n d i n g , t h e y will h a v e a they will h a v e a c o n v i n c i n g a r g u m e n t for t h e n e c e s s i t y of an i n d e p e n d e n t medic al p r o f e s s i o n . F o r no o n e will d e n y t h a t , if h u m a n h e a l t h c o n s i s t s in I In­ c a p a c i t y to e n g a g e freely in i n n a t e e x i s t e n t i a l p o t e n t i a l i t i e s , this health can be realized o n l y in an a d e q u a t e l y free p h y s i c i a n - p a t i e n t r e l a t i o n s h i p S u c c e s s f u l p r e v e n t i v e m e d i c i n e relies, for the s a m e r e a s o n s , o n the i n d e p e n d e n c e o f t h e physician. C e r t a i n p h y s i c i a n s , and m a n y leading industrialists as well, want no dealings with a t h e r a p e u t i c m e t h o d thai aims at freeing the paticnl f r o m EXISTENTIAL 282 FOUNDATIONS t h e p a t h o l o g i c a l i m p a i r m e n t of his p o t e n t i a l i t i e s and i n t r o d u c i n g h i m to a f r e e , a u t o n o m o u s b e i n g - i n - t h e - w o r l d . It w o u l d be difficult, t h e y say, to i m a g i n e a t h e r a p y less s u i t e d t o t h e p r e s e n t a g e o f t h e c o m p u t e r . F o r people s e l d o m t h i n k o f t h e m s e l v e s a n y m o r e a s d i s t i n c t individuals. T h e y r a r e l y s a y " I . " T h e y say " w e " i n s t e a d , m e a n i n g t h e s u m t o t a l o f e m p l o y e e s a t " t h e i r " g i a n t industrial c o n c e r n . All t h e e m o t i o n s , t h o u g h t s , and a c t i o n s o f t h e s e w o r k e r s a r e d i r e c t e d t o w a r d m a x i m u m p r o d u c t i o n and g r o w t h for " t h e i r " c o r p o r a t i o n . T h e i r life goal c o n s i s t s , a c c o r d i n g l y , i n a t t a i n i n g t h e m o s t efficient and p e r m a n e n t c o o p e r a t i o n possible a m o n g fellow w o r k e r s , w h o a r e all i m a g i n e d as cogs in a w h e e l . T h e aforementioned physician-technicians argue that, in the vast m a j o r i t y o f c a s e s , individual and g r o u p t h e r a p i e s a r e c o u n t e r p r o d u c t i v e i n c o n t e m p o r a r y s o c i e t y . T h e physician can o n l y h a r m his c h a r g e s b y helping t h e m a t t a i n a n i n d e p e n d e n t and free s e l f h o o d , w h i c h o n l y m a k e s it h a r d e r for t h e m to fit i n t o t h e m a s s s o c i e t y of i n d u s t r i a l e m p l o y e e s . T h e y would h a v e m o r e c o n f l i c t s w i t h c o w o r k e r s and s u p e r v i s o r s . Anyone coming out of Daseinsanalysis, therefore, would be sure to lose his j o b , be d i s m i s s e d , and u l t i m a t e l y be h a n d e d o v e r to social and physical ruin. O u t o f c o n s i d e r a t i o n for t h e s e c o n s e q u e n c e s , s o m e d i r e c t o r s o f i n d u s t r y h a v e already t a k e n i t u p o n t h e m s e l v e s t o forbid t h e i r e m p l o y e e s to undergo programs of analytic therapy. C e r t a i n scientific p u b l i c a t i o n s , l a r g e l y o f A m e r i c a n origin, imply t h a t this a t t i t u d e i n i n d u s t r i a l l e a d e r s h i p h a s i n f l u e n c e d p h y s i c i a n s t h e m s e l v e s , h a s c a u s e d t h e m t o allow p s y c h o t h e r a p y t o slip m o r e and m o r e out of their hands. According to these articles, physicians have delegated t h e i r p s y c h o t h e r a p e u t i c a c t i v i t y m o r e and m o r e t o s o c i o l o g i s t s , w h o c a r r y o u t a psychic i n d o c t r i n a t i o n o f t h o s e e n t r u s t e d t o t h e i r c a r e . T h e s e s o c i o l o g i s t s , p r a c t i c e a b r a n d of m a s s t h e r a p y aimed at e x t e r n a l p s y c h o l o g i c a l c o n t r o l of all p e r s o n n e l . A s t a t i s t i c a l description of all Americans undergoing some form of psychological t r e a t m e n t would s h o w t h a t t h o s e b e i n g s h a p e d to a s m o o t h fit in i n d u s t r y e x c e e d t h o s e being guided to a t t a i n m e n t of an i n d e p e n d e n t f r e e selfhood by a r a t i o of a b o u t a t h o u s a n d to o n e . 2 T h a t this is so already in A m e r i c a , and will be s o o n all o v e r t h e w o r l d , is n o t s u r p r i s i n g . D e v e l o p m e n t s i n t h e r a p y t a k e t h e i r lead f r o m t h e l a r g e r v i e w o f h u m a n n a t u r e t h a t p r e d o m i n a t e s today. Y e t i t i s doubtful w h e t h e r i n t h e long r u n this a p p r o a c h t o t h e r a p y will p r o m o t e e v e n s u c h a n a r r o w goal as i n c r e a s e d p r o d u c t i v i t y in i n d u s t r y . B e c a u s e h u m a n Dasein is i n n a t e l y disposed to an e x t r e m e l y b r o a d e x p e r i e n c e , it is m o r e likely t h a t the m a s s e s o f industrial w o r k e r s will r e a c t t o t h e a t t e m p t t o r e p r e s s their unique n a t u r e s by s h o w i n g s e v e r e l y p a t h o l o g i c a l b e h a v i o r apt to n i p p l e even the l a r g e s t industrial g i a n t s . T h i s pathological r e s p o n s e t o Those Who Are Therapeutically Active 283 d e p r i v a t i o n is taking s h a p e as m a s s c r i m i n a l i t y and m a s s addiction, and o n a scale t h a t c h a l l e n g e s t h e i m m e n s e r e s o u r c e s o f t h e s t a t e itself, n o t t o s p e a k o f t h e fragile i n s t r u m e n t a r i u m o f t h e p h y s i c i a n s w h o , a s a body, a r e t h e m s e l v e s o r i e n t e d t o t h e f u n c t i o n i n g o f t h e i r c h a r g e s and o f a n i n d u s t r i a l s o c i e t y . A rapid i n c r e a s e in c r i m e and addiction, m u c h l a m e n t e d t h o u g h i t b e t h e s e days, i s n o n e t h e l e s s t h e i n e v i t a b l e r e a c t i o n t o t h e g r o w i n g c r i m e s p e r p e t r a t e d upon t h e h u m a n soul b y the a p o t h e o s i z e d spirit o f t e c h n o l o g y . Addiction, w h a t e v e r its f o r m , h a s a l w a y s b e e n a d e s p e r a t e s e a r c h , on a false and h o p e l e s s path, for t h e fulfillment of a h u m a n f r e e d o m . O u r d i s c u s s i o n o f h u m a n p a t h o l o g y b r i n g s u s face t o face again w i t h t h e fact t h a t h u m a n illness and its t r e a t m e n t a r e b o t h peculiarly r o o t e d i n f u n d a m e n t a l h u m a n n a t u r e , i n m a n ' s b e i n g - i n - t h e - w o r l d and his i n h e r e n t b e i n g - t o g e t h e r w i t h o t h e r s in a s h a r e d world. O n c e again we s e e t h a t all illness and t r e a t m e n t develops o u t o f t h e p a t i e n t ' s disturbed h u m a n r e l a t i o n s h i p s ; in o t h e r w o r d s , social b e h a v i o r is n e c e s s a r i l y i n v o l v e d i n illness. C o n s e q u e n t l y , a n y p r o g r a m o f t h e r a p y , e v e n t h e m o s t trifling, is e s s e n t i a l l y an i n s t a n c e of social m e d i c i n e . NOTES 1. A . J o r e s , Vom kranken Menschen ( S t u t t g a r t : T h i e m e , 1 9 õ 6 ) ; Menschsein als Auftrag ( B e r n a n d S t u t t g a r t : H . H u b e r , 1 9 6 7 ) ; a n d Urn eine Medizin von morgen ( B e r n a n d S t u t t g a r t : H . Huber, 1 9 6 6 ) . 2 . S t . L e s s e a n d W . W o l f , Proceedings of lhe Vlllh International Congress of Psychotherapy, 1 9 6 7 (Basel and N e w Y o r k : S. K a r g e r , 1 9 6 9 ) , 2: 2 7 - 5 4 ; and J. R e u s c h , " P s y c h o t h e r a p y in the C o m p u t e r A g e , " ibid., 2 : 3 2 - 4 6 . a r e n o w m o r e c o m m o n t h a n t h e o l d e r f o r m s o l h y s t e r i a and o r g a n i c n e u r o s e s . w h i c h i n t h e last c h a p t e r w e called n e u r o s e s o f m e a n i n g l e s s n e s s and b o r e d o m . T h e s e u n h e a l t h y f o r m s o f social b e h a v i o r .Afterword THE FOUNDATIONS OF A DA-SEIN-BASED SOCIAL PSYCHOLOGY AND SOCIAL PREVENTIVE MEDICINE IN MODERN INDUSTRIAL SOCIETY T h e medical s c i e n c e s o f social p s y c h i a t r y and social p r e v e n t i v e m e d i c i n e . c o r r e c t d i a g n o s i s and a p p r o p r i a t e i n s i g h t i n t o t h e basic n a t u r e ol what Is . it is p r e c i s e l y t h e field of m e n t a l h y g i e n e w h i c h is e s p e c i a l l y i m p o r t a n t . t h o u g h still v e r y y o u n g . Its t a s k i s t o w o r k out a p p r o p r i a t e m e a s u r e s t h a t c a n c h e c k . t h e c o n t a m i n a t i o n o f o u r food. o r e v e n w h o l l y p r e v e n t . P r e c o n d i t i o n s f o r s u c c e s s f u l t h e r a p y and p r e v e n t i o n o f social u n r e s l a m o n g t h e y o u n g a r e . h a v e already r e g i s t e r e d a s t o u n d i n g s u c c e s s e s . the accidents that are always t h r e a t e n i n g t h e i n d u s t r i a l w o r k e r . and a n u m b e r o f a n a l o g o u s e n c r o a c h m e n t s on people's h e a l t h . as t h e y a r e f o r a scientific art of healing in a n y area. M a n y of t h e s e e f f o r t s in social m e d i c i n e are still in t h e i r first p h a s e s . t h e kinds o f d i s t u r b e d social b e h a v i o r t h a t h a v e spread like s o m e e p i d e m i c a m o n g t h e y o u n g people w h o n o w s t a n d f o r t h e f u t u r e o f h u m a n i t y . t h e pollution o f o u r e n v i r o n m e n t . and t h i s i s s o p a r t i c u l a r l y f o r t h e e n o r m o u s e f f o r t s o f t h e field o f m e n t a l h y g i e n e . In t h e s e t i m e s . T h e i r m o s t i m p o r t a n t a c h i e v e m e n t s are limited p r i m a r i l y t o the struggle against bacterial disease. B u t for t h e y o u n g w h o are p e r c e p t i v e . and the l o n g e r i t g o e s o n . T h e d e s t i n y t h a t arises f r o m such a w o r l d v i e w r e c o g n i z e s o n l y t h e single goal o f m a x i m u m e x t e n s i o n o f p o w e r o v e r all t h i n g s t h a t can b e useful and s e r v i c e a b l e . B u t t h e value o f t h e s e studies depends o n t h e c r i t e r i a b y w h i c h t h e s o c i o l o g i s t s a s s e s s t h e people t h e y i n v e s t i g a t e . and t h e h u m a n i s o l a t i o n t h a t follows f r o m it—has heavily i n f e c t e d t h e r e l a t i o n s h i p o f m o s t c o n t e m p o r a r y p a r e n t s w i t h t h e i r c h i l d r e n . t h e w o r s e i t b e c o m e s . a g h a s t l y b o r e d o m and e m p t i n e s s g a p e s in this w o r l d v i e w . t h e o l o g i c a l . o r a t least a c c e p t a b l e . a .286 EXISTENTIAL FOUNDATIONS g o i n g o n . e v e r y t h i n g and all t h a t l i v e s — plants and animals and e v e n h u m a n b e i n g s t h e m s e l v e s — m o r e and m o r e as n o t h i n g b u t i n t e r c h a n g e a b l e parts of a p l a n e t a r y m a c h i n e t h a t t a k e s in t h e w h o l e w o r l d .c h i l d r e l a t i o n s h i p . F u r t h e r m o r e . I t e a t s a t t h e m t h a t this fate o f t h e i r s p r e s s u r e s t h e m t o r e g a r d e v e r y t h i n g in t h e w o r l d and u n i v e r s e . and t h a t t h e particular kind and p a r t i c u l a r m e a n i n g of t h e p r o d u c t is a m a t t e r of diminishing s i g n i f i c a n c e . their times. T h e r e h a v e b e e n m a n y sociological i n v e s t i g a t i o n s w h i c h appear t o c o n t r a d i c t this and t o d e m o n s t r a t e t h a t m a n y y o u n g r e b e l s and t h e i r p a r e n t s have g e n e r a l l y g o o d . T h e y k n o w t h a t c o m p o n e n t s e x i s t only t o b e m e s h e d i n t o p r o d u c t i o n a p p a r a t u s e s w h i c h m u s t yield m o r e e n e r g y and m o r e g o o d s purely for t h e sake o f i n c r e a s i n g p r o d u c t i o n . B u t t h e u s e f u l n e s s of such i n v e s t i g a t i o n is n e c e s s a r i l y d e t e r m i n e d b y t h e quality o f u n d e r s t a n d i n g a b o u t w h a t n e e d s c h a n g i n g . r e l a t i o n s h i p s . I t o f t e n h a p p e n s t h a t t h e b e h a v i o r a l d e f e c t s o f people s u f f e r i n g f r o m n e u r o s e s o f b o r e d o m and m e a n i n g l e s s n e s s a r e a t t r i b u t e d t o s o m e a b s t r a c t c o n c e p t like " t h e malaise o f t h e t i m e . and i t w o u l d appear t h a t this g r o u n d w o r k h a s s c a r c e l y received its due a t t e n t i o n . and f u t u r e studies. A d i s c e r n i n g c o n v e r s a t i o n w i t h a n y typical o n e o f t h e s e m e m b e r s o f o u r s o c i e t y s h o w s t h a t t h e y all suffer—whether they consider themselves healthy or disturbed—the fate of the times. t h e i n v e s t i g a t i o n s w h i c h lead to such c o n c l u s i o n s regularly use the t e c h n i q u e of the q u e s t i o n n a i r e . t h i n g s t h a t can o n l y b e a m a s s e d — t h e h u m a n being included. T h i s d e s t i n y c e r t a i n l y d o e s bring the Biblical m a n d a t e o f h u m a n d o m i n i o n o v e r h e a v e n and e a r t h c l o s e r t o realization. and t h e s e criteria g e n e r a l l y c o r r e s p o n d t o t h e m e a g e r n o r m o f the c o n t e m p o r a r y p a r e n t . sociological. and i n this n o d o u b t lay its passing f a s c i n a t i o n for t h o s e w h o a r e n o w t h e g e n e r a t i o n o f p a r e n t s and g r a n d p a r e n t s . T h e r e i s n o lack o f p s y c h o l o g i c a l . political. t h i n g s w h i c h i n t h e m s e l v e s h a v e b e e n d r a i n e d o f m e a n i n g . T h i s s e l f . " B u t t h e n i t b e c o m e s difficult t o decide w h e t h e r t h e fault lies w i t h t h e y o u n g people t h e m s e l v e s or t h e t i m e s t h e y live in. and for the y o u n g this is p a r t i c u l a r l y d e v a s t a t i n g .a l i e n a t i o n — t h e oblivion i n t o w h i c h t h e c h a r a c t e r i s t i c t r a i t s o f h u m a n being h a v e s u n k . W i t h t h e s e b l i n d e r s t h e y can s e e . adults t h e m s e l v e s d o n o t k n o w w h a t has h a p p e n e d and still is h a p p e n i n g to t h e m .Afterword 287 methodology that is inherently unreliable regarding any matters c h a r a c t e r i s t i c of and basic to h u m a n b e i n g s . w i t h w h o m t h e y can b e o p e n . from this e r a ' s d e s t i n y .t h e . g r o w o u t r a g e d and d e s t r u c t i v e . For t h e m o s t part. h o w e v e r . T h e y o u n g o v e r s h o o t t h e m a r k . b e . h o w could t h e y h o n o r and r e s p e c t s u c h e l d e r s ? T h e p a r e n t a l g e n e r a t i o n in the industrialized c o u n t r i e s h a s largely forfeited its l e g i t i m a t e claim to love. O n e i s a l w a y s h e a r i n g t h e s e days t h a t t h e y o u n g are h o s t i l e t o w a r d a u t h o r i t y . T h e y h a v e hardly a clue that t h e y are p r i s o n e r s o f t h e t e c h n o l o g i c a l spirit o f t h e t i m e s . r a t h e r . a g e n u i n e a u t h o r i t y is o n l y s o m e o n e w h o can e x i s t e n t i a l l y e n r i c h t h e i r Da-sein. And s o they are e v e n less a w a r e t h a t t h e w a y t h e i r w o r l d v i e w has b e e n blocked out t o s o e x t r e m e l y n a r r o w a vision follows n o t from t h e i r o w n dealings and i n t r i g u e s but. B u t w i t h e v e r y single o n e o f t h e s e r e b e l l i o u s y o u n g people ( w h o is n o t c o n s t i t u t i o n a l l y impaired) t h e e x a c t o p p o s i t e h a p p e n s as s o o n a s t h e r e i s s o m e o n e t h e y can c o m e t o t r u s t .w o r l d t h e y are m e a n t t o be. a c c o r d i n g t o t h e i r o w n i n b o r n p o t e n t i a l . " W h y ? " H o w could a g r a t e f u l love b e e x p e c t e d o f y o u n g people w h o t h e m s e l v e s h a v e n e v e r r e c e i v e d f r o m their o w n p a r e n t s t h e f u r t h e r i n g help t o w h i c h t h e y a s children had e v e r y r i g h t ? T h e y h a v e b e e n s o shaped i n t h e h o m e s o f t h e i r p a r e n t s . of all t h e w a y s to be in relation to the world. T h e w o r d i t s e l f c o m e s f r o m t h e Latin augere. In talking a b o u t t h e i r lives w i t h s o m e o n e t h e y can t r u s t . w h o k n o w s h o w t o help t h e m b e c o m e the h u m a n b e i n g s t h e y could. T h e y w o u l d like n o t h i n g b e t t e r t h a n finding a u t h o r i t y w o r t h y o f t h e n a m e . w h i c h m e a n s " t o i n c r e a s e or m u l t i p l y . o n l y t h e increase ol . a u t o n o m o u s b e i n g s . t h e v e r y s a m e y o u n g people m u s t often reverse the judgment they recorded in the questionnaire response. L o v e and r e s p e c t a r e i n t i m a t e l y b o u n d up w i t h e a c h o t h e r . An u n r e a s o n a b l e d e m a n d of this kind is usually a n s w e r e d w i t h a n u n c o m p r e h e n d i n g . t h e n . In t h e original n a t u r e o f h u m a n b e i n g s t h e y o u n g always d o g e n u i n e l y love and r e s p e c t p a r e n t s and a u t h o r i t i e s as l o n g as t h e s e elders s t a n d by t h e m in w a y s w h i c h help t h e m a s t h e y e n d e a v o r t o g r o w i n t o the free. w h e n t h e y m a k e t h e s e adult pillars of s o c i e t y p e r s o n a l l y r e s p o n s i b l e for t h e i r o w n failure as a u t h o r i t i e s . " F o r t h e y o u n g . o n l y b e c a u s e t h e i r s e a r c h for s u c h a u t h o r i t y is fruitless and t h e y m u s t e x p e r i e n c e again and again t h e fact t h a t t h o s e adults w h o would b e t h e i r a u t h o r i t i e s are h i n d e r i n g i n s t e a d o f f u r t h e r i n g t h e i r e f f o r t s to lead m e a n i n g f u l lives.i n . T h e best a m o n g the rebellious y o u n g despair. It is no w o n d e r t h a t u n d e r s u c h family c o n d i t i o n s m a n y a d o l e s c e n t s today n o l o n g e r grasp w h y s o m e o n e should e v e r d o s o m e t h i n g simply t o oblige s o m e o n e e l s e . "increasers" of their existence. t e c h n o l o g i c a l . from s o m e t h i n g h u m a n t o a c o m m o d i t y w h i c h is alien to h u m a n being. or h u m a n l y m e a n i n g f u l . believes t h a t it already h a s t h e t e c h n i q u e s of social t h e r a p y n e e d e d to a n n u l t h e d e s t r u c t i v e c o n s e q u e n c e s o f t h e n e w age's t e c h n o l o g i c a l destiny. M a r x i s m e x p a n d s D e s c a r t e s ' s old s u b j e c t t o h u m a n i t y as a collective b u t faithfully p r e s e r v e s all t h e c h a r a c t e r i s t i c f e a t u r e s of t h e t h i n k i n g s u b s t a n c e as D e s c a r t e s applied it to t h e individual s u b j e c t . W i t h t h e degradation o f w h a t h e p r o d u c e s . t h e w o r k e r ' s w o r k and t h e w o r k e r h i m s e l f are degraded. M a r x i s m simply c a r r i e s t h a t C a r t e s i a n s u b j e c t i v i t y w h i c h i s t h e m o t h e r e a r t h o f W e s t e r n industrial s o c i e t y t o its m o s t e x t r e m e f o r m . m o n o p o l i s t i c capitalist f a n a t i c i s m t o a c h i e v e . s u r e l y t h e y o u n g c a n n o t b e faulted for w a n t i n g t o have t h e i r w a y and take t h e i r part in shaping society and t h e i r o w n lives.s u b j e c t arbitrarily d e t e r m i n e s t h e m e a n i n g and signifi­ c a n c e of e v e r y t h i n g else and h o w it is to be e x p l o i t e d to a u g m e n t the s u b j e c t ' s p o w e r . M o r e t h a n a c e n t u r y a g o . not t h e least a r e t h e dead s e r i o u s style and violent c o n d u c t o f M a r x i s t p r o g r e s s i v e s a m o n g s t u d e n t s t h e m s e l v e s . t o o . In fact.288 EXISTENTIAL FOUNDATIONS p o w e r o v e r t h i n g s for t h e sake o f c o n t r o l and for t h e c o n s e q u e n t i a l i n c r e m e n t of p o w e r for w h o is in c o n t r o l . w h o used alienation t o m e a n t h e not yet accomplished coming-to-be-itself of the absolute subjectivity. M o d e r n M a r x i s m . H e t o o k t h e c o n c e p t from t h e p h i l o s o p h y o f H e g e l . But when the elders no l o n g e r h a v e m u c h to say t h a t is h u m a n l y useful. M a r x ' s collective s u b j e c t is u n c o m p r o m i s i n g l y c o n c e p t u a l i z e d as t h a t s u b j e c t i v e being w h i c h u n d e r l i e s and s u s t a i n s all o t h e r b e i n g s . In his a t h e i s m . " t h r o w n u n d e r t h e m .j e c t e d . M a r x t r a n s f e r r e d t h e n o t i o n of a l i e n a t i o n from a b s o l u t e spirit to individual w o r k e r . B u t in his e a r l i e s t w r i t i n g s . What he produces is degraded to a purely m a t e r i a l saleable c o m m o d i t y . t u r n i n g Hegel's p h i l o s o p h y on its h e a d . w h i c h i s allegedly based o n M a r x ' s p h i l o s o p h y . A s s u c h . T h e ubiquity o f this social u n r e s t raises t h e likelihood t h a t M a r x i s m ' s f u n d a m e n t a l idea is all t o o closely b o u n d to t h e p h i l o s o p h y t h a t already s p a w n e d the alienating. furtherers. i s literally " s u b . and r e v o l t o f t h e y o u n g t o d a y s p a r e s n e i t h e r liberal n o r M a r x i s t social f o r m s . M a r x o f f e r e d alienation as an e x p l a n a t i o n for t h e malaise o f t h e people i n m o d e r n industrial s o c i e t y . t h e c o n t i n u i n g disquiet. r e s t l e s s n e s s . It is n o t h i n g s h o r t of impossible for this g e n e r a t i o n t o fulfill t h e d e m a n d o f t h e y o u n g t h a t t h e y b e t r u e authorities. t h e capitalist and M a r x i s t industrial s o c i e t i e s h a v e a close kindred c o n n e c t i o n indeed. O f s u c h i n d i c a t i o n s . M a r x w e n t a step f u r t h e r than . M a r x ' s s o c i e t y . H e s a w t h e r o o t s o f self-alienation i n t h e c i r c u m s t a n c e t h a t t h e good a m a n p r o d u c e s at w o r k in t h e f a c t o r y is no l o n g e r directed t o w a r d a n o t h e r person w h o stands in an immediate relationship to him. B u t i n t h e m e a n t i m e . . w i t h o u t a prior t r a n s f o r m a t i o n o f h o w w e i n t e r p r e t the world. M a r x ' s v e r y call t o c h a n g e t h e w o r l d r e s t s on a definite i n t e r p r e t a t i o n of t h e w o r l d and s o c i e t y . T h e y o u n g M a r x w r o t e : A being is an i n d e p e n d e n t being o n l y w h e n it stands on its o w n f e e t . T h e point. "Humanity makes itself. o n t h e basis o f w h i c h h e s a w w h a t had t o b e c h a n g e d and w h a t i t had t o b e c h a n g e d i n t o . h a v e s t a y e d b o g g e d down i n c o n t r a d i c t o r y and m u t u a l l y e x c l u s i v e c o n c e p t s . t o o . is to c h a n g e it. let a l o n e first inquiring a d e q u a t e l y a f t e r the c h a r a c t e r o f h u m a n s o c i e t y .e. T h a t it r e m a i n s hidden from the M a r x i s t s t h e m s e l v e s m a y b e due t o t h e i r fascination w i t h a s t a t e m e n t o f M a r x ' s i n w h i c h h e r e p r o a c h e d p h i l o s o p h e r s for m e r e l y i n t e r p r e t i n g the w o r l d . i t w a s n o l o n g e r t h e individual person w h o m Sartre rendered absolute but the totality of historical h u m a n i t y . w h i c h t h e y r e g a r d a s t h e n e c e s s a r y revolt o f p r i s o n e r ' a g a i n s t t h e i r prison walls. T h e r e a r e t o o m a n y y o u n g r e b e l s w h o aim at a r a s h and radical d e s t r u c t i o n of t h e e x i s t i n g social o r d e r . i. . w h i l e t h e y e x p e c t as a m a t t e r of c o u r s e to k e e p g e t t i n g t h e i r g r a n t s and s c h o l a r s h i p s after t h e d e s t r u c t i o n ol i n d i e . Calling M a r x " t h e i n s u r p a s s a b l e p h i l o s o p h e r o f o u r t i m e . T h e failure o f all a t t e m p t s s o far t o p r e v e n t and heal social malaise o r i g i n a t e in t h i s . he said. 1 1 ial s o c i e t y ." 2 3 T h e o u t c o m e o f this s h a r e d p r e m i s e t h a t u n d e r l i e s and s u s t a i n s t h e t e c h n o l o g i c a l world in East and W e s t alike h a s s h o w n us t h a t in t h e s o c i e t i e s shaped b y M a r x i s m . T h e y do n o t r e c o g n i z e t h a t only a totally a d m i n i s t e r e d . 1 S a r t r e e m u l a t e d M a r x i n c a r r y i n g C a r t e s i a n s u b j e c t i v i t y t o its f u r t h e s t e x t r e m e . N o w this s u b j e c t had t o m a k e e v e n itself. A h u m a n being w h o lives by t h e g r a c e of a n o t h e r r e g a r d s h i m s e l f as a d e p e n d e n t being . B u t t h e r e can be no c h a n g e in t h e w o r l d w i t h o u t c h a n g e in h o w we c o n c e i v e of t h e w o r l d .280 Afterword D e s c a r t e s ' s s u b j e c t i v i s m and a t t r i b u t e d t o t h e collective h u m a n subject w h a t had f o r m e r l y been r e g a r d e d a s t h e c r e a t i v e p o w e r s o f divinity. " L a t e r . people h a v e b e e n u n a b l e t o r e e s t a b l i s h t h e i m m e d i a t e c o n n e c t i o n t o t h i n g s and o t h e r people w h i c h would r e s t o r e e a c h p e r s o n f r o m a l i e n a t i o n and m a k e h i m feel a t h o m e o n c e again o n t h e face o f t h e e a r t h . as well as the a t t e m p t s o f t h e a n a r c h i s t r e v o l u t i o n a r i e s . " T h e h u m a n b e i n g i s n o t h i n g o t h e r t h a n w h a t h e m a k e s o f h i m s e l f . I n a n early w o r k h e w r o t e . Only a shrinking remnant of modern progressives think Marx's a s s e r t i o n t h r o u g h to its end. " h e too proclaims. and it s t a n d s on its o w n feet o n l y w h e n it r e c e i v e s its D a s e i n f r o m itself. . and m o d e r n industrial s o c i e t y for o n e . and my life n e c e s s a r i l y has s u c h a s o u r c e outside itself when it is not of my own making. S t u d e n t e f f o r t s to a c c o m p l i s h e v o l u t i o n a r y social c h a n g e .. T h e t o t a l i t y o f t h e w o r l d v i e w s i n w h i c h the people o f t h e s e u n d e r d e v e l o p e d c o u n t r i e s a r e still dwelling. and t h e people o f u n d e r d e v e l o p e d c o u n t r i e s will likewise h a v e t o a p p r o p r i a t e t h e t e c h n o l o g i c a l w o r l d v i e w t o free t h e m s e l v e s f r o m t h e b o n d a g e o f physical h u n g e r . s o o n e could hardly c a n c e l o u t t h e i n c r e a s i n g l y p e r f e c t e d a d m i n i s t r a t i o n o f things from the technical worker up to the general manager.c o n t r a d i c t o r y social d o c t r i n e s could e f f e c t . T h e i r o w n a c h i e v e m e n t m o t i v e is o p e r a t i n g . it is n e c e s s a r y to t r a n s f o r m the m o d e s in w h i c h it is possible to b e c o m e a w a r e of t h e world's p h e n o m e n a and to t r a n s f o r m the world. m u s t first b e t r a n s f o r m e d f r o m t h e g r o u n d up. F o r this r e a s o n . S u c h a t t e m p t s . To e x i s t in a t e c h n o l o g i c a l w o r l d v i e w m e a n s t h a t o n e uses all t h i n g s he e n c o u n t e r s as e f f i c i e n t l y as possible so t h e y yield all t h e i r e n e r g i e s to h i m . W h a t d o m i n a t e s i n t h e c o m i n g s and g o i n g s of t h e p o p u l a t i o n s of t h e u n d e r d e v e l o p e d c o u n t r i e s is still a far c r y f r o m t h e W e s t e r n goal o f t h e m o s t efficient possible e x p l o i t a t i o n o f w h a t t h e y e n c o u n t e r . 4 L e a s t able t o heal t h e pathological o u t c o m e s o f m o d e r n industrial s o c i e t y is s o m e h a r k i n g b a c k to t h e good old days to appeal for d e r a t i o n a l i z i n g and d e m a t e r i a l i z i n g today's t o t a l l y a d m i n i s t e r e d p r o f e s ­ sional w o r l d . in a w a y far m o r e radical t h a n w h a t v a r i o u s intrinsically s e l f . o n l y a small part o f h u m a n i t y h a s g o t b e y o n d this s t a g e . and f r o m w h i c h all t h a t m o v e s t h e m c o m e s . Even t o d a y . T h i s s h r i n k i n g i s t h e e s s e n c e and basis o f t h e spirit o f m o d e r n t e c h n o l o g y . allegedly so r e v o l u t i o n a r y . b u t in a v e r y different r e a l m from t h a t o f m a t e r i a l w e a l t h and t e m p o r a l p o w e r . W e s t e r n m a n h a s s o u g h t t o e x p o r t his achievement motive to underdeveloped countries. c o m p l e t e l y m a t e r i a l i s t i c . R a t i o n a l i s m . . E x p o r t i n g single m o t i v e s is a p r o f o u n d l y t h o u g h t l e s s b u s i n e s s . industrial s o c i e t y can m a i n t a i n large n u m b e r s o f u n p r o d u c t i v e s t u d e n t s . B u t t h e m a s s e s of people in t h e s e places prove to be r a t h e r r e l u c t a n t in yielding to such a c o m p l e t e c h a n g e . W e s t e r n p s y c h o l o g i s t s and f a c t o r y m a n a g e r s s e e m t o h a v e a hard t i m e m a k i n g t h e w h o l e vision o f t h e s e people s h r i n k t o t h e point t h a t w h a t discloses i t s e l f t o t h e m o f t h e i r w o r l d is o n l y w h a t can be p r e c i s e l y calculated and t i g h t l y o r d e r e d i n t o flawless c h a i n s o f c a u s e and e f f e c t . J u s t a s o n e can h a r d l y r e v e r s e t h e e r o s i v e s p r e a d o f t h e industrial s y s t e m . m a t e r i a l i s m . C l e a r l y . and d e p e r s o n a l i z a t i o n a r e c h a r a c t e r i s t i c s of t h e p r e s e n t d e s t i n y of a t e c h n o l o g i c a l w o r l d v i e w . It is still n o t long since t h e lives of all h u m a n i t y — e x c e p t for t h e few w h o r u l e d — w e r e spent i n d r u d g e r y u n w o r t h y o f h u m a n b e i n g . thereby running into g r e a t difficulties. w h o t h e n h a s t h e m a t his disposal for f u r t h e r i n g his p o w e r o v e r m a t e r i a l g o o d s .290 EXISTENTIAL FOUNDATIONS t h o r o u g h l y o r g a n i z e d . T h e collapse o f t h e t e c h n o l o g i c a l w o r l d w o u l d m e a n s i m u l t a n e o u s l y giving u p t h e c o m f o r t s o f affluent s o c i e t y and r e t u r n i n g t o t h e b i t t e r s t r u g g l e o f o t h e r c e n t u r i e s for s h e e r physical e x i s t e n c e . and a r c h i t e i I s . and t h e r e is an I n t e r n a t i o n a l R e c r e a t i o n A s s o c i a t i o n already at w o r k w i t h t h e a v o w e d p u r p o s e of c o o r d i n a t i n g a w o r l d w i d e policy for r e c r e a t i o n t i m e . S o m e heads o f i n d u s t r y a r e already s e r i o u s l y c o n s i d e r i n g actually paying t h e m a j o r i t y o f t h e i r e m p l o y e e s n o t t o appear for w o r k . h o w e v e r . H o w e v e r t h a t m a y b e . H o w i t stands u p t o s c r u t i n y i n t h e s e s p h e r e s of m e d i c i n e . and t h a t t h e y will w a n t to s t a r t building at o n c e w i t h o u t first c o n s i d e r i n g well e n o u g h t h e " f o r w h a t " o f t h e i r building. w h i c h a r e involved m o r e deeply t h a n e v e n in t h e n a t u r a l scientific world v i e w — a m o d e w h i c h t h e t h e o r e t i c a l physicist H e i t l e r has called f u n d a m e n t a l l y hostile t o l i f e . city p l a n n e r s . All is in vain. a r c h i t e c t s . T h e p h e n o m e n o l o g i c a l o r D a s e i n s a n a l y t i c a p p r o a c h i s available t o t h e s c i e n c e s of social p s y c h i a t r y and p r e v e n t i v e medicine as a g e n u i n e l y r e v o l u t i o n a r y w a y o f s e e i n g . e d u c a t o r s . w h i c h f u r t h e r s life. People do incomparably m o r e damage at work with their mistakes than t h e far less fallible a u t o m a t e d m a c h i n e r y . possessive relation­ ship w i t h t h e world o n w h i c h t h e social o r d e r t h e y w o u l d c h a n g e i s based. t o c o l l a b o r a t e i n this e n o r m o u s task. F u t u r e o r i e n t e d leaders a m o n g p s y c h o l o g i s t s . T h e d a n g e r e x i s t s from t h e o u t s e t t h a t t h o s e w h o have t h e first say i n t h e d e l i b e r a t i o n s o f t h e I n t e r n a t i o n a l R e c r e a t i o n A s s o c i a t i o n will be t h e i n d u s t r i a l i s t s .c r e a t i o n of h u m a n beings In im idei n industrial society. will s u c c e e d o n l y w h e n t h e s o c i e t y of days to c o m e l e a r n s to r e g a r d its r e c r e a t i o n a l i n s t r u c t o r s as h a v i n g a significance equal to t h a t of p r o f e s s i o n a l i n s t r u c t o r s . T h o s e w h o specialize i n p r e v e n t i v e m e d i c i n e are called on.Afterword 2^1 retain fundamentally unchanged the subjectivistic. " and in t h e f o r e s e e a b l e f u t u r e m o s t people will h a v e a c c e s s t o m o r e h o u r s o f r e c r e a t i o n t i m e t h a n t h e y h a v e t o spend o n t h e j o b i n offices and f a c t o r i e s . w h i c h a p e r s o n m a y spend w i t h family and friends. city p l a n n e r s . R e c r e a t i o n a l planning t h a t c o m p e n s a t e s for this. can b e illustrated t h r o u g h o n e o f m o d e r n industrial s o c i e t y ' s m o s t positive a c h i e v e m e n t s . i t w o u l d b e s i g n i f i c a n t l y c h e a p e r t o c o m p e n s a t e m o s t o f t h e w o r k e r s for not working than to repair the mistakes they make. n o less t h a n t h e s e o t h e r specialists. B u t in fact all t h a t m a t t e r s is w h e t h e r such an e m i n e n t panel s u c c e e d s in r e n d e r i n g t h e ample t i m e for re-creation. if t h e s e r e c r e a t i o n a l p l a n n e r s allow t h e m s e l v e s t o b e engulfed b y t h e t e c h n o l o g i cal v i e w o f t h e w o r l d . as well as in t h e healing a r t s we h a v e already discussed. A c c o r d i n g t o t h e industrialists. It is called " r e c r e a t i o n t i m e . 5 T h i s " f o r w h a t " is the t i m e for r e . t h e h i t h e r t o u n k n o w n a m o u n t o f available time o u t s i d e w o r k i n g h o u r s . as a h e a l i n g c o u n t e r b a l a n c e to t e c h n i c a l o c c u p a t i o n s . T h e primary task ol those w h o plan this recreation . s o c i o l o g i s t s . and i n d u s t r i a l i s t s have c e r t a i n l y n o t i c e d its g r o w i n g s i g n i f i c a n c e . p l a n n i n g for r e c r e a t i o n t i m e h a s b e c o m e a n e x t r a o r d i n a r i l y s e r i o u s i s s u e for t h e f u t u r e o f h u m a n i t y . I n d i s c u s s i n g t h e difficulty o f s u c h a t r a n s i t i o n e a r l i e r in this b o o k . t h i n k i n g . i n t o t h e m e n t a l activity o f a h u m a n s u b j e c t . their physiochemical composition. feeling.e a s e " i n civilization t h e m s e l v e s first win t h e f r e e d o m t h a t w o u l d m a k e t h e m able t o c o m m i t t h e m s e l v e s w h o l l y t o a n o t h e r w a y o f s e e i n g the w o r l d . A n y o n e can s a y this. T h e s e days. And so we do n o t g o b b l e it up at o n c e .M a r x i s t s t a n c e t o w a r d t h e world into t h e n o l o n g e r p o w e r h u n g r y . B u t m o s t o f u s t h e s e days would t h i n k : " W e r e p r e s e n t t h e t r e e t o o u r s e l v e s .EXISTENTIAL FOUNDATIONS 292 t i m e is to ponder its n a t u r e in t h o r o u g h and f u n d a m e n t a l t e r m s . . h u n g r y for p o w e r . i lality o f t h i n g s . W e do not d e g r a d e it . w i s h i n g . \?e m a y illustrate t h e p a r t i c u l a r w a y in w h i c h this p h e n o m e n o l o g i c a l leap is to be followed w i t h t h e e x a m p l e of an apple t r e e in full b l o s s o m . f r o m w h i c h place it a d d r e s s e s itself to us. h o w e v e r . whole. in t h e W e s t e r n world. " If. b u t the being and l e t t i n g . If t h e y n e g l e c t t o clarify t h e r e c r e a t i o n o f t h e h u m a n b e i n g and t h e f u n d a m e n t a l n a t u r e o f h u m a n t i m e b e f o r e t h e y m o v e i n t o a c t i o n . we m a y say only: " W e are presenting ourselves to the tree. hidden t h o u g h t h e y are from t h e vision o f m o s t people n o w . We stand in front of a f l o w e r i n g t r e e and t h e t r e e stands b e f o r e u s i n t h e m e a d o w . intact. their mass. T h e y m u s t leap o u t of today's a b s o l u t e l y subjectivistic. W h o e v e r s u c c e e d s in m a k i n g this leap will r e c o g n i z e t h e c h a s m t h a t e x i s t s b e t w e e n w h a t m o s t people can still see o f t h e p h e n o m e n a o f o u r w o r l d and w h a t a b u n d a n t m e a n i n g and significance t h e s e p h e n o m e n a h a v e . willing. and so on. 6 It is t h e r e f o r e indispensable t h a t t h e r e c r e a t i o n t i m e i n s t r u c t o r s and all o t h e r s c o n c e r n e d w i t h t h e g r o w i n g " d i s . encountering the tree. undisguised. n o l o n g e r s u b j e c t d e p e n d e n t .c a p i t a l i s t / t e c h n o l o g i c a l . H e i d e g g e r ' s Daseinsanalytik s h o w e d t h e w a y . T h o s e w h o a r e ruled b y t h e spirit o f t e c h n o l o g y have a c c e s s o n l y t o w h a t can b e m e a s u r e d and calculated a b o u t t h i n g s and people: t h e v o l u m e o f visible objects. u n f e i g n e d . o n l y so do we let it be t h e r e in t h e middle of a m e a d o w w h e r e it is in its actual p r e s e n c e . B u t a f t e r t h e leap i n t o t h e p h e n o m e n o l o g i cal v i e w of t h e world. t h e level of selling price. w h i c h has j u s t c o m e i n t o v i e w . t h e world's p h e n o m e n a r e v e a l t h e m s e l v e s in an actuality much more "pure"—undamaged. we r e m a i n t r u e to w h a t is h a p p e n i n g as it is. their cybernetically c o m p r e h e n s i b l e g e n e t i c c o d e . t h e r e is a predilection for calling such e x a c t l y m e a s u r a b l e q u a n t i t i e s t h e " p u r e " » . t h e y could easily b e c o m e a m e r e R e c r e a t i o n T i m e I n s t i t u t e and m a k e this field j u s t o n e m o r e technological concern in which they would incarcerate human b e i n g s w h e n t h e y are n o t o n t h e j o b . undistorted. acquisitive." Only so do we leave t h e t r e e as t h e t r e e it is.b e w o r l d v i e w i n t o w h i c h . and sensibility s u c c e e d in b r i n g i n g t h e m s e l v e s face to face w i t h t h e w o r l d in a n e w w a y . t e c h n o l o g i c a l . we h a v e a l r e a d y said t h a t o n l y t h o s e w h o d a r e leap w i t h t h e i r w h o l e s e e i n g . and a c c o r d i n g to w h i c h a b l o s s o m i n g apple t r e e e x i s t s o n l y by t h e g r a c e of a h u m a n s u b j e c t ' s r e p r e s e n t a t i o n of it in his p s y c h e . e n c o u n t e r i n g t h e t r e e with c a r e . s o c i o l o g i s t s . in a w a y t h a t is j u s t to t h e p h e n o m e n a . And for o u r part.s p a n n i n g r e s p o n s i v e n e s s t o t h e being and m e a n i n g f u l n e s s o f w h a t has c o m e t o b e p r e s e n t . a single t h i n g . T h e fruit p r o m i s e d b y its f l o w e r s e x p r e s s t h e p o t e n t i a l i t y o f s o m e d a y i n a u t u m n n o u r i s h i n g t h e h u m a n b e i n g . 8 W h a t is t r u e for this t r e e is no less t r u e for all t h e o t h e r p h e n o m e n a of o u r w o r l d — i n c l u d i n g the o t h e r h u m a n b e i n g s w e e n c o u n t e r . o p e n i n g to us and at the s a m e time limiting us to the t i m e spat e w h i t h . its o w n . c l e a r o p e n n e s s in w h i c h it can a p p e a r and w h i c h e n a b l e s it.o p e n n e s s we are. W e h u m a n b e i n g s can d o t h e t r e e this s e r v i c e b e c a u s e we are w o r l d . g a t h e r s h e a v e n and e a r t h . t h e n w h a t h a p p e n s i s n o t h i n g less t h a n t h a t " w e " — t h e r e p r e s e n t i n g s u b j e c t and t h e t r e e as its r e p r e s e n t e d o b j e c t — r a d i c a l l y disappear. as t h e f r e e . w i t h c i r c u m s p e c t i o n . in t h a t fullness of its m e a n i n g and significance w h i c h a r e . It s t a n d s b e f o r e us as w h a t — a c c o r d i n g to t h e m e a n i n g s and c o n t e x t s of r e f e r e n c e t h a t c o n s t i t u t e it as a t r e e — i t i s . T h i s t e c h n o l o g i c a l spirit is not itsell . It w o u l d be v e r y m u c h indeed if this w e r e u n d e r s t o o d by the d o c t o r s .1 technical t h i n g . as e x i s t i n g h u m a n b e i n g s . in his o w n w o r d s . T h e t e c h n o l o g i c a l spirit i s d o m i n e e r i n g and hostile t o w a r d h u m a n being. i n w h i c h t h e apple t r e e in b l o o m is e x p e r i e n c e d as t h a t w h i c h is p r e s e n t t h e r e b e f o r e us. we e x i s t e s s e n t i a l l y as a w o r l d . and all o t h e r s w h o a r e called upon to t r a n s f o r m m o d e s o f t h i n k i n g and feeling w h i c h will b e t h e g r o u n d w o r k for fruitful social life in a m o d e r n industrial s o c i e t y w h i c h would be h u m a n l y just and n o u r i s h i n g . In this w a y t h e apple t r e e in b l o s s o m . We offer o u r s e l v e s to it as the r e a l m of w o r l d . 7 If. we n o w only put o u r s e l v e s .o p e n n e s s . at its disposal.p r e s e n t . Its g e r m i n a t i o n and g r o w t h r e v e a l p o w e r s o f c r e a t i o n t h a t w e r e from a n t i q u i t y called divine. We h a v e t a k e n in its place the h u m b l e r and m o r e r e v e r e n t p h e n o m e n o l o g i c a l w a y o f s e e i n g . a i m s a t t h e m a s t e r y and p o s s e s s i o n o f n a t u r e . W h e n w e c o n d u c t o u r s e l v e s i n this w a y . in t h e light of o u r p e r c e p t i o n . t h e divine and the h u m a n . It is w h a t reveals itself as the destiny of t h i s e p o c h . t o c o m e t o b e p r e s e n t . A n d we have left t h a t o v e r b e a r i n g p o s s e s s i v e s u b j e c t i v i s m of D e s c a r t e s w h i c h . p s y c h o l o g i s t s . we a c c o r d t h e t r e e its full b e i n g .Afterword 203 w i t h a w a v e of t h e hand i n t o a m e r e i n t r a p s y c h i c r e p r e s e n t a t i o n within an encapsulated human consciousness. by its v e r y n a t u r e . i n t h e w a y w e c o n d u c t o u r s e l v e s t o w a r d this b l o o m i n g apple t r e e . t h e n it e n c o u n t e r s us as s o m e t h i n g e x t e n d i n g w i t h its r o o t s i n t o t h e r e a l m o f e a r t h and w i t h its s o a r i n g b r a n c h e s i n t o the light o f t h e h e a v e n s . it can n o w be u n d e r s t o o d in a t r u l y liberating w a y as a vision of t h e w o r l d . is w h a t m a k e s all t h o s e guilt f e e l i n g s possible. t h e a c t i v i t y o f t h e h u m a n s u b j e c t loses t h e s u p r e m a c y claimed for it n o w . T h e b e i n g . b e i n g indebted by n a t u r e .t h e . h o w e v e r . it is t h e p h e n o m e n o l o g i c a l w a y of l o o k i n g . t h o s e w h o o n l y c u r s e o r try escaping this p a r t i c u l a r d e s t i n y i n w h i c h w e w h o live today are y o k e d . a r e a l w a y s evading t h e m s e l v e s and s h i r k i n g t h e i r destined m i s s i o n . t o s e e k o u t t h e t h i n g s o f t h e w o r l d t h a t a p p e a r in t h e light of o u r p o t e n t i a l for perceiving and u n d e r s t a n d i n g and to c a r e for t h e i r unfolding. b e i n g . to be c l a i m e d or called upon.w o r l d o n l y to a r e l a t i v e l y m o d e s t d e g r e e . F o r the d r e a m t h a t people could be led—as F r e u d h o p e d to do t h r o u g h p s y c h o a n a l y s i s — b a c k i n t o t h e happy c o n d i t i o n o f a n i n n o c e n t child o r noble s a v a g e . and n o t for all e t e r n i t y . For this r e a s o n . u l t i m a t e t r u t h . On t h e c o n t r a r y . b e i n g . N o w . Such a destiny is never the o u t c o m e of the e f f o r t s o f t h e h u m a n b e i n g a s s o m e s u b j e c t w h i c h d e t e r m i n e s all t h i n g s from n o t h i n g b u t itself. T o b e h u m a n i s t o e x i s t a s t h e m a n d a t e . T h e y pay for t h e i r flight w i t h a bad c o n ­ science.g u i l t y .g u i l t y b y n a t u r e . At a n y given t i m e . and feeling w h i c h itself b e s t u n d e r s t a n d s t h a t the t e c h n o l o g i c a l a p p r o a c h t o t h e world. a b a s i c and indelible n a t u r a l f e a t u r e of h u m a n b e i n g .i n . At the same time.i n d e b t e d .294 EXISTENTIAL FOUNDATIONS natural science conceives. it is i n c u m b e n t on him to fulfill t h o s e e x i s t e n t i a l possibilities w h i c h will a p p r o a c h h i m f r o m t h e f u t u r e and call upon h i m . is c o m p l e t e l y different from t h e m e r e guilt feelings o f w h i c h p s y c h o l o g y and p s y c h o p a t h o l o g y g e n e r a l l y speak. T h e spirit o f t e c h n o l o g y n o l o n g e r s e e m s like a b s o l u t e . At the same t i m e .i n d e b t e d of h u m a n b e i n g s is an E x i s t e n t i a l . F o r t h e fulfillment o f t h e r e s t h e m u s t r e m a i n i n d e b t e d .t h e . o n e w h i c h can claim h u m a n b e i n g i n . a c c o r d i n g t o o n e ' s c o n s c i e n c e and b e s t k n o w l e d g e . O n c e this i s s e e n . has long since b e e n d r e a m e d t o its e n d . E x i s t e n t i a l i n d e b t e d n e s s h a s n o t h i n g t o d o with s o m e " p o o r . t h i n k i n g . t r u t h itself. does h a v e t h e a u t h o r i t y to claim t h e m o d e r n h u m a n being to c a r r y it to fulfillment. Daseinsanalytic insight into h u m a n existence frees people for a f u n d a m e n t a l l y m o r e a u t o n o m o u s s t a n c e t o w a r d t h a t t e c h n o l o g i c a l w o r l d v i e w in w h i c h m o s t people t o d a y are exiled.h u m a n is a l w a y s to be a d d r e s s e d . a p e r s o n can c a r r y t o fulfillment o n l y o n e o f t h e t h o u s a n d f o l d p o t e n t i a l i t i e s t h a t lie open t o him.g u i l t y . i n s h o r t . It is r o o t e d in t h e c o n d i t i o n t h a t b e i n g .w o r l d . d e f i n i t i v e . B e s i d e s t h i s . this e x i s t e n t i a l b e i n g . T h i s i n s i g h t clears t h e w a y f o r r e c o g n i z i n g t h a t t h e t e c h n o l o g i c a l a p p r o a c h t o t h e w o r l d i s o n l y o n e a m o n g m a n y possible r e l a t i o n s h i p s . t h o s e which a r e n o r m a l and i n e v i t a b l e a s well a s t h o s e w h i c h a r e p a t h o l o g i c a l and c u r a b l e . T h i s b e i n g . a s t h e d e s t i n y o f today's h u m a n i t y . w h i c h c o m e s i n t o t h e light o f m y p e r c e i v i n g . B u t quite apart f r o m the fact t h a t B e i n g as such is a n y t h i n g b u t a b s t r a c t . m a n y m o d e r n s o c i o l o g i s t s flatly d e n y t h e suitability of t h e p h e n o m e n o l o g i c a l v i e w of h u m a n being as a basis for a practical social s c i e n c e . w h e n they t h e m s e l v e s h a v e n o t found a d e q u a t e freedom in relation to the . It is o b v i o u s that w i t h o u t s u c h a c l e a r a w a r e n e s s o f t h e goal and m e a n i n g o f h u m a n e x i s t e n c e . T h u s t h e D a s e i n s a n a l y t i c u n d e r s t a n d i n g o f the h u m a n being n e e d n o t look e l s e w h e r e first f o r its e t h i c a l principles T h e u n i q u e " m i n e . t h e n . n o less t h a n m y o w n c a r i n g for m y s e l f . Its w e i g h t and o p p r e s s i v e n e s s can be o v e r c o m e t h r o u g h o u r r e a d i n e s s t o place o u r s e l v e s w i t h o u t r e s e r v a t i o n .Afterword 295 s i n n e r t h a t I a m " face. f r o m t h e v e r y n a t u r e o f its s o u r c e . s o e m p h a s i z e d b y this w a y of l o o k i n g at e x i s t e n c e . B u t t o t h e fulfillment o f t h o s e p o t e n t i a l i t i e s w h i c h a r e u n i q u e l y m i n e b e l o n g t h e c h e r i s h i n g o f all t h a t i s b e y o n d m e . a t t h e disposal o f t h o s e phenomena. h o w e v e r .u s e d . F i r s t . i n w o r k i n g o u t t h e c h a r a c t e r i s t i c s o f b e i n g . All this n o t w i t h s t a n d i n g . u n d e r no c i r c u m s t a n c e s is it m e a n i n g f u l in a n y w a y to i n q u i r e a f t e r B e i n g w i t h o u t a t t h e s a m e t i m e i n q u i r i n g a f t e r t h e c o n c r e t e e x i s t e n c e o f people with each o t h e r in their shared world. a n i n n a t e e t h i c w h i c h s u s t a i n s all social b e h a v i o r . And h o w . o u r e y e s a r e o p e n e d t o the f u n d a m e n t a l m e a n i n g and goal of being h u m a n .t o g e t h e r . u n d e r s t a n d i n g . c a n n o t be m i s t a k e n for s o m e sign of a r u t h l e s s e g o i s m . being-in-the-world. S e c o n d . medical and n o n m e d i c a l t h e r a p i s t s are helpless in t h e f a c e ol t h e b u r g e o n i n g n u m b e r s o f p a t i e n t s w h o suffer from the m o d e m n e u r o s i s o f b o r e d o m and m e a n i n g l e s s n e s s . S u r e l y . o f t h e h u m a n being g r o w s c l e a r i n t h e light o f t h e p h e n o m e n o l o g i c a l v i e w . w e can s e e a t t h e s a m e t i m e t h a t a n a n t h r o p o l o g y w h i c h s p r i n g s from this p e r s p e c t i v e p o s s e s s e s . the Daseinsanalytic approach is actually so earnestly concerned with the c o n c r e t e human being and his social r e l a t i o n s h i p s t h a t it is precisely this a p p r o a c h w h i c h . A s this p r i m a r y b e i n g .n e s s " o f e a c h h u m a n Da-sein. Given this. a s t h e c l e a r r e a l m o f o p e n n e s s t h a t m a k e s i t possible for t h e world's p h e n o m e n a t o s h i n e f o r t h i n t o t h a t c l e a r i n g . T h e leap o u t of a t e c h n o l o g i c a l s t a n c e i n t o a p h e n o m e n o l o g i c a l r e l a t i o n s h i p w i t h t h e w o r l d yields t w o t h i n g s . i n q u i r i n g o n l y a f t e r a b s t r a c t B e i n g .c a l l e d . O n e can a l w a y s h e a r t h e t h o u g h t l e s s r e p r o a c h t h a t t h e D a s e i n s a n a l y t i c v i e w t a k e s n o a c c o u n t o f c o n c r e t e social r e l a t i o n s h i p s b e t w e e n people. w a s able t o lay o u t the f o u n d a t i o n m o s t c a p a b l e o f s u s t a i n i n g e a c h s c h o o l o f s o c i o l o g y . b e i n g .u p o n . in its light the phenomena of the world reveal themselves in an incomparably richer c o n t e x t o f m e a n i n g and r e f e r e n c e . it is for e a c h p e r s o n to t a k e on t h e p o t e n t i a l w a y s o f b e i n g w h i c h a r e g i v e n him and t o c a r r y t h e m t o fulfillment. 296 EXISTENTIAL FOUNDATIONS i m p o v e r i s h e d m e a n i n g s s e e n i n t h i n g s and people t h r o u g h t h e w o r l d v i e w o f t e c h n o l o g y . D a s e i n s a n a l y t i c v i e w is c u r s e d w i t h f u n d a m e n t a l p o w e r l e s s for all t i m e . It is not groundless to hope. a r e t h e specialists i n p r e v e n t i v e m e d i c i n e . T h e r e will n e v e r be m o r e t h a n a handful of people capable of p e r f e c t i n g p h e n o m e n o l o g i c a l i n s i g h t i n t o t h e basic condition o f m a n and his w o r l d . I n d u s t r y ' s f a s c i n a t i o n w i t h the m a d n e s s of e x p o n e n t i a l g r o w t h is r o o t e d in this s a m e goal. w h o are n o t sick b u t a r e rebelling a g a i n s t t h e e x i s t i n g social o r d e r . e x e r t a c o r r e s p o n d i n g l y wide i n f l u e n c e on the spirit of h o w people live in this society. h o w t o p r o d u c e c o u n t l e s s television s e t s .t h e .i n . s o m a n y t i m e s g r e a t e r i n n u m b e r t h a n t h o s e t e c h n i c i a n s and u n d e r s t a n d i n g so v e r y m u c h less of p h y s i c s . w h a t is b r o u g h t f o r t h is no h e a l t h y f o r m t h a t can g e n e r a t e a f u t u r e . and t h e r e c r e a t i o n t i m e p l a n n e r t o guide t h e e n e r g i e s o f t h o s e y o u t h . and t h e o n t o l o g i c a l r e l a t i o n s h i p b e t w e e n t h e m . in t i m e . and C h i n a e x p e r i e n c e s h o w t h e i r b e i n g . then. into a c r e a t i v e r e n e w a l ? T e c h n o l o g y c o m p r e h e n d s o n l y t h e p r o f o u n d l y m e a n i n g l e s s and m e a g e r goal o f t h e u n r e l e n t i n g i n c r e a s e o f p o w e r — b y a n individual o r c o l l e c t i v e s u b j e c t — o v e r n a t u r a l o b j e c t s . but a c a n c e r o u s d e g e n e r a t i o n . c o n t i n u a l l y . from d e r i v a t i v e s o f t h e s e principles. W h o e v e r has t h e good f o r t u n e t o b e i n close and e x t e n d e d a s s o c i a t i o n w i t h the people o f India. and decisively by a t r a d i t i o n a l r e l a t i o n s h i p w i t h t h e w o r l d t h a t is a s t o n i s h i n g l y close to t h e vision of E u r o p e a n p h e n o m e n o l o g y j u s t n o w unfolding. Japan. W e m a y a s s u m e t h a t t h e b r e a k t h r o u g h the t e c h n o l o g i c a l f r a m e w o r k of m o d e r n industrial s o c i e t y i n t o a g e n u i n e f r e e d o m in r e l a t i o n to this t e c h n o l o g y will n o t be d o n e first by t h e W e s t . the s o c i o l o g i s t . and yet t h e r e a r e millions o f t e c h n i c a l w o r k e r s w h o k n o w . . B u t i n all r e a l m s o f living t h i n g s w h e r e such u n l i m i t e d g r o w t h t a k e s hold. It is r a t h e r to be hoped for from t h e peoples o f t h e F a r E a s t . G i v e n t h e h u g e a g g l o m e r a t i o n s built b y and for t e c h n o l o g y and n a t u r a l s c i e n c e . B u t t h e n u m b e r o f r e s e a r c h e r s w h o g r a s p t h e f u n d a m e n t a l principles o f q u a n t u m physics i s n o g r e a t e r . a r e able to o p e r a t e and u s e t h e s e devices. that the fundamental ontological i n s i g h t s of D a s e i n s a n a l y t i c p h e n o m e n o l o g y could. A n d m a s s e s o f people w h o listen t o radios and w a t c h television.w o r l d — w i t h o u t d e t r i m e n t t o the vigor w i t h w h i c h t h e y a p p r o p r i a t e and exploit W e s t e r n s c i e n c e — i s shaped a l w a y s . t h e r e m a y be a s e n s e t h a t a p h e n o m e n o l o g i c a l . ( S t u t t g a r t : T h i e m e . 2d ed. A t k i n s o n . K. . Martin Heidegger denken und die japanische Philosophie. T s u j i m u r a .C e n t u r y . p. 8. 1 6 5 ff. p. H e i t i e r . Kunst und Literatur. Wissenchaft. 5. M. Was heisst denken ( T u b i n g e n : K l o s t e r m a n n . S a r t r e . Critique de la raison dialectique ( P a r i s : 1 9 6 0 ) . H e i d e g g e r . S e e M .Afterword FOOTNOTES 1 . " Universitas: Zschr. 1 9 5 3 ) . a n d E . C l a r k . 1 9 5 4 ) . 98 4 . R. H e i d e g g e r . 1954) . J . 1 9 6 9 ) . (Braunschweig- 6. p . S e e . 2 4 6 2. S e e also.C r o f t s . W . J g . M a r x . J . A . 7 . " D a s pp. a n d K . " in: Vortrage und Autsatze ( P f u l l e n g e n : Neske. p. M c C l e l l a n d . 1 9 6 2 ) . Der Mensch und die naturwissenschaftliche Erkenntris. 1 9 5 3 ) . L'exislenlialisme est un humanisme ( P a r i s : 1 9 4 6 ) . " D i e Gesellschaft von heute zwischen g e s t e r n und m o r g e n . Freiburg/Munich. . Geburtstag (Martin Heidegger im Gesprach. Alber. 2. p. H. L . f o r e x a m p l e . L o w e l l . W. 9. K . D . 1 6 . p . R . in: Ansprachen zum 89.P . S a r t r e . D i n g . 1 9 6 7 ) . Die Fruhschriften ( S t u t t g a r t : K r o n e r . J . 2 2 .P . . Konig. 1 1 . 3. The Achievement Motive ( N e w Y o r k : A p p l e t o n . 36. H. 38 B i n d e r . 1 0 2 . 6 9 . 2 5 . xii-xiii.1 3 . 8 8 . G..2 9 D a . 1 3 1 .0 . xiii. J. 155-60 o f R é g u l a Z i i r c h e r case.4 illnesses s h o w i n g i m p a i r m e n t of.1 3 boredom. 1 0 7 . m a s s . 2 2 3 brachial paralysis. xviii. G . i x . 2 0 2 Buber. 37. 73-78 Condrau. 2 1 6 . 48-49. 1 9 7 . K. 8 1 8 4 . 3 8 animal psychologies. 1 1 2 . 72 calculability. 2 1 . 5 4 affective incontinence. A.b a s e d social p s y c h o l o g y and social p r e v e n t i v e medi­ cine. f r e e d o m and.s e i n . 1 3 2 . xviii. 222 China. 163 attunement. xxiii." 38 b e c o m i n g .1 4 agoraphobia.1 5 h u m a n b o d y a s physical o r g a ­ n i s m and. 2 0 1 conditionality of psychosomatics. | . 2 9 6 claustrophobia. St. 2 1 6 Agrippina. 2 0 4 .. 1 2 7 .6 5 A l e x a n d e r . Jungian. 3 6 Allport. 1 8 9 Conrad..3 5 countertransference... 1 9 1 . exogenic reaction types. 1 0 6 . 2 8 3 cybernetics. 1 5 1 .1 4 s e v e r e d i s t u r b a n c e s in a c t u a l i z ­ ing e x i s t e n t i a l of." 6 4 . 76 anxiety.experience.9 6 Daseinsanalysis c r i t i c i s m s o f medical use o l . x x i x . 2 0 0 . 1 4 3 "Aha .6 0 criminality. 115 Bally. 7 8".INDEX acute. 69 consciousness. 1 1 0 . 210-13 b o d y h o o d . 96. 3 7 behaviorism. 161 <"l .. 203-6 addiction.M. 7 1 B l e u l e r . 3 7 . mass. 2 8 3 Adler. 2 0 5 .7 0 anthropological medicine. 2 8 5 . G. 2 0 0 .2 3 Augustine. xv "basic trust.. 2 3 7 bodily pains. 129 Aristotle. 147 color blindness. F. 3 6 . 1 0 0 .. 1 8 7 . 1 0 9 . 1 5 6 Charcot. 6 0 . o n t o l o g y of. fundamental open­ ness of human existence and.1 7 c l e a r n e s s o f h u m a n space. E. 2 5 9 . 37.x ..8 9 .. phenomenological i n v e s t i g a t i o n of. 2 1 7 affectivity.s e i n .9 collective unconscious. . 1 0 1 .3 1 bodying f o r t h . M„ 38. L. 5 2 . 258-e>7 ( t ransitional difficulties in undei standing insights of.9 0 c o e x i s t e n c e i n s h a r e d space. 2 1 7 .x x x i D a . 103. 71 B i n s w a n g e r . H e i t i e r ..3 8 61-62 stereotypic. 9 4 David. 1 9 3 G e b s a t t e l . 244-46. 6 9 G ö p p e r t . 3 7 illnesses e n c r o a c h i n g on.2 2 Democritus. x. 9 6 electric shock therapy. 2 0 3 . 5 7 . Gestalt psychology. 2 1 7 . 2 2 2 epilepsy.. 277. 143. 191-96 reaction types. von. 195-96. . E. xiv. 2 3 7 H e s s . 49 H a r t m a n n . . x x x . 1 9 depression. R. xiii. 67. W.6 9 .144-46 psychology. 1 4 7 etiology 191-96 acute.. 3 7 general Daseinsanalytic and p a t h o g e n e s i s .F. hallucinations phenomenological investigation of 178-79 p s y c h o a n a l y t i c e x p l a n a t i o n for. 1 1 6 . ix. xxii. F i s c h e r . 144-49. x x x . 1 2 9 . 2 9 1 Hensel. 39-40. 2 1 7 E r i k s o n . 3 7 dreams Daseinsanalytic theory of. 259. x.W. xvi. Einstein. 143-44 dwelling. A. 268-69. 1 3 G a l i l e o Galilei.300 EXISTENTIAL FOUNDATIONS datability o f t i m e . W . Freud. 1 4 3 G r o d d e c k .. 1 6 7 . 222. x x x . 34-37. 71. general Daseinsanalytic. pathological s y m p ­ t o m s and. E . 1 3 6 ego. 265. 159.H. 7 1 Grimm brothers.4 3 fundamental openness. 6 5 death. xiv-xv p s y c h o a n a l y t i c t h e o r y of. e x p a n s i v e n e s s o f time. psychoanalytic. 2 0 8 . 2 6 0 drive. 4 5 . M . 71-72. V .4 6 . 1 4 7 . 271. xi.. ego S. 70-71.6 H. 19-20.. h u m a n p o t e n t i a l for r e l a t i n g specifically to w o r l d and.1 8 free a s s o c i a t i o n . 37. 294 fundamental "hiddenness.3 5 f u n d a m e n t a l rules o f analysis. xii. 2 8 8 H e i d e g g e r . 127. 1 3 5 . 3 6 Haseloff. diabetes.3 0 dynamic unconscious. 23. 2 2 3 . H „ 2 7 heredity.2 3 s t r e s s and. conscious­ n e s s and.2 4 b e c o m i n g and. 2 5 3 292 . 288-89. 134 fees for t h e r a p y . 9 5 Ey. 2 1 6 . 293 34.W.. xxi. H. G." un­ c o n s c i o u s and. 1 3 2 .. 257. 2 0 0 d i s b e c o m i n g . 3 8 etiology.. . 135-40. 1 1 9 . human mortality and. 6 8 Hegel. xxiii.x v i i i . H.6 5 . 45-46. 1 2 2 .x x i v .9 D e s c a r t e s . 2 5 4 empathy. 260. x i . C . xv. F . x x i i i . xxiii. 130.x x x i . 69.4 7 endogenous depressions. G.. O. 263. 37-38 exogenic 73. 2 6 3 129. 193. xix forgetting. R .. 1 3 freedom. 2 9 6 industrial technology. 2 0 2 . 1 4 . 3 6 . 2 9 6 Jaspers. 3 6 human being-in-the-world.. 2 5 4 L o e f f l e r .3 2 Huntington's Chorea. human.4 6 .. 1 1 4 .6 3 psychoses. 6 5 140." fundamental. 1 9 .8 2 melancholia. 2 1 7 . Daseinsanalytic e x ­ a m i n a t i o n o f c o n c e p t of.. 1 9 4 M i n k o w s k i .S.. xi little H a n s . M.8 2 146-47 idiottca phenylpyruvica. case o f ( F r e u d ) . xxvii-xxx. P. 2 0 .1 9 memory performance. K.5 2 Mountcastle. 281-83.1 4 s e v e r e d i s t u r b a n c e s in a c t u a l i z ­ ing e x i s t e n t i a l of. 2 9 1 introjection.5 4 n e u r o s e s see specific types N e w t o n . 1 0 6 manic-depressive 2 1 7 . 2 0 0 hysterical paralysis.2 3 mortality. 2 2 . 4 8 . de. 1 5 medical a n t h r o p o l o g y .K u n z .2 2 m e m o r y . 76 medicine n a t u r a l s c i e n c e m e t h o d o l o g y . 1 1 9 . lobotomies. A. G. xxiii. xiii. x-xii.8 9 Marxism. id. persistence ol.. T . 2 5 3 . 147. m e m o r y and. psyche and. xxiii J o r e s . 2 8 1 . 1 5 2 M a r t y . 243 K a n t . K. E. 2 1 9 . 4 5 .2 9 neovitalists. 3 7 . 144. 3 7 mongolism. 1 2 8 . 2 9 2 m a s s addiction and c r i m i n a l i t y . . of.2 5 M ' U z a n . W. C . 5 0 .5 1 phenomenological investigation of. W . 1 2 8 . F. 2 0 0 .. 2 8 8 . I.3 0 m e t a p s y c h o l o g y . von.. psychodyn a m i c s and.2 2 motivational contexts. 135-43 historicity of human existence.. 2 4 6 K u h n .3 mood.4 9 . 1 4 9 . historicity of human e x i s t e n c e and. 2 5 4 International Recreation Associa­ tion..3 3 J a u r e g g . 2 0 2 "in-between o f dialogue." 3 8 India. 1 1 4 . 3 7 K o h l i . I. 238 . 2 8 8 . 2 7 6 Jung. 2 8 8 . 3 4 Middle A g e s . K. 6 0 .1 9 Horney. 2 4 . 2 8 3 masturbation. x x x N i e t z s c h e .4 2 nausea. 6 5 M a r x . 1 3 2 .Index 301 "hiddenness. 2 4 3 Japan. x-xii.. xiii. V. 07 98 obsessive-compulsive neuroses. natural science methodology. 5 1 ....8 9 .. Marcel. M . 2 2 Merleau-Ponty. F r e u d i a n .2 3 6 2 . 1 0 1 neuropsychiatrie therapy. 1 7 9 . 1 6 1 . xxvii-xxx. 1 9 .9 6 insulin t h e r a p y . 1 0 9 . 145. 5 8 objects. xxiii loneliness. 1 3 1 . A.3 2 socialization of. see also e g o .9 8 p h e n o m e n o l o g y o f illness. h y s t e r i c a l . 2 4 1 .3 8 psychoanalytic theory o f d r e a m s . 254 public c h a r a c t e r o f t i m e .1 1 . 22.2 3 9 phobias. xii. Daseinsanalytic exami­ n a t i o n o f c o n c e p t of.2 "pre-real matter. 61-62 paralysis.p a t i e n t r e l a t i o n s h i p in Daseinsanalytic therapy.5 3 phenomenological investigation of. 48-49 . 2 2 3 .. 187-89. Freudian. American. 9 7 .4 6 .9 1 i l l n e s s e s e n c r o a c h i n g on. p h e n o m e n o l o g i c a l investigation of. 1 0 . 4 5 . 73-78 natural science methology of. 5 1 . psychology. 3 7 .3 2 "psychiatric Daseinsanalysis. D a s e i n ­ sanalytic. 47-48.1 7 p s y c h o a n a l y t i c e x p l a n a t i o n s of. 2 0 1 .9 2 regression. 9 5 reactive depressions. 2 2 2 recreation time. P. s u p e r ­ 35-36.5 2 perception process. and. 3 4 . social. id.4 2 210-13 apy. 2 4 3 . o f phobias. natural science m e ­ t h o d o l o g y of. 6 3 motivational contexts psychosurgery.8 2 parapraxis. ego psychoanalytic ego psychology. 6 6 . xii.3 8 organic n e u r o s i s . 251-55 62 physical pain. 1 9 1 . 50-51.4 2 p s y c h o s e s see specific types psychosomatics Daseinsanalytic theory of. 1 9 7 .. Daseinsanalytic exami­ n a t i o n o f c o n c e p t of. 2 5 9 . 14.4 4 relativity theory. 3 4 . 2 1 6 . general Daseinsanalytic. xv-xvii.1 6 psychic apparatus. 1 5 2 1 3 .4 7 rheumatic inflammations." 4 9 sadism. 2 9 1 ." 7 6 preventive medicine. 1 5 2 R o h r a c h e r . . Daseinsanalytic exami­ n a t i o n o f c o n c e p t of. xxix-xxx f u n d a m e n t a l c o n d i t i o n a l i t y of. 2 0 2 R i c o e u r . 1 6 0 polio. 285-96 projection.2 6 R o r s c h a c h series.4 4 o f repression.9 6 p a t i e n t in D a s e i n s a n a l y t i c t h e r a p y . 2 2 persistence of objects.3 9 . 2 5 .EXISTENTIAL FOUNDATIONS 302 o p e n n e s s o f h u m a n space. 8 8 .6 7 Plato.4 7 o f u n c o n s c i o u s . 6 2 of projection. 2 4 3 . 9 6 repression. 2 4 3 . P l a t e VII of. human being-in-the-world and.4 3 psyche. 1 1 7 Parmenides. H. 182-85 organic psychoses. 2 4 3 . 3 9 . physician i n D a s e i n s a n a l y t i c t h e r ­ 273-83 p h y s i c i a n . xiv. 1 7 9 . orgasm. 2 4 . 1 4 9 .7 2 Piaget J .4 3 of regression. 119 pathogenesis. 2 4 2 1 3 1 . 3 3 . 3 8 .3 5 w o r k i n g h y p o t h e s i s in. H .. de. x i i i . Waelder.8 2 sorrow. 3 4 . 2 3 1 . N. . psychoana­ lytic. 101.4 1 . S . temporality o f existence. 2 2 working hypothesis.. 1 5 2 W e i z s ä c k e r . 3 . 1 0 1 2 0 6 . 285-96 socialization o f medicine. 135-43 psychoanalytic theory of. 167-69. 167-89. 2 0 1 transference. 2 2 2 . R. 3 8 " S u n . u r g e s to. 1 4 7 dynamic. 169-78 stereotypic dream. D a . 2 8 8 . 2 0 9 . J. p h e n o m e n o ­ logical investigation of. 281-83. 260 stress syndrome. 4 0 . 2 2 1 . 9 0 . 2 1 will. x i x .. 2 0 6 senile d e m e n t i a . 197.1 0 0 illnesses s h o w i n g s e v e r e impair m e n t of. T . 81-85. 43-56.. 9 4 social p s y c h o l o g y . 6 4 W a e l h e n s . visualization. 2 1 3 . 3 6 White.x x i methods o f treating. R . 191. 6 3 Zürcher. 21. 2 5 4 significance o f t i m e .1 0 suicide o f m e l a c h o l i c s . 107 258-07 9. 2 6 5 . 3 8 W i e n e r .7 2 traumatic dementia. 1 1 . 1 1 3 .1 7 thalidomide damage.b a s e d . (case h i s t o r y ) . V .2 9 .9 3 vitalists. 2 8 9 schizophrenia. c o e x i s t e n c e in.x i v shared space. 2 0 6 . 2 1 3 .-P. 2 6 0 . 1 0 6 . 1 4 6 technology. R. von.3 8 forfeiture of existential auto­ n o m y and. 2 8 1 . 9 3 . Daseinsanalyt­ ic t h e o r y of.1 8 .9 3 illnesses s h o w i n g s e v e r e impair­ m e n t of.3 5 vegetative dysfunctions. 2 0 0 . 1 1 2 sexual perversions. 103.2 2 Sullivan. 3 6 . W. 2 0 2 U e x k ü l l .1 4 spatiality o f e x i s t e n c e . impulse of. 6 5 Selye.1 4 serenity. Regula xviii. 1 4 4 .s e i n . 2 4 6 .9 6 industrial.9 shock therapy.1 2 . M. 8 6 ..W. 2 5 4 S c h u l t e .Index Sartre. von. 2 2 2 Schur. 1 3 6 f u n d a m e n t a l " h i d d e n n e s s " and. xii.3 4 superego.7 14-16 phenomenological investigation of.7 2 fallacy of handling p h y s i c i a n patient relationship as. A . . 73.1 7 s t a b and s t r a n g l e . 1 2 8 . 2 1 3 .m a n " (case h i s t o r y ) . 7 6 unconscious collective..