Friday, 1 January 2021

The Myth of ‘Mental Health’ and ‘Psychopathology’ in Existential Analysis and Daseinsanalysis. Keith Hoeller, Albert Pacheco, Anthony Stadlen conduct Inner Circle Seminar 267 (9 May 2021)


The Myth of ‘Mental Health’ and Psychopathology
in Existential Analysis and Daseinsanalysis

Keith Hoeller   Albert Pacheco   Anthony Stadlen
(with assistance from Miles Groth)
conduct
Inner Circle Seminar No. 267
Sunday 9 May 2021
10 a.m. to 5 p.m.

Martin Heidegger

Thomas Szasz

Aaron Esterson

Medard Boss

  

Heidegger was interested in psychiatry, especially with schizophrenics, with whom he sought contact and conversations when this was possible for him. On walks he regularly remained standing lost in thought for a while before the villa of the Freiburg psychiatrist Ruffin [...]. Once he said forthrightly that he was not convinced of the correctness of the solely medical interpretation of schizophrenia as illness. Could it not even simply be a question of an ‘other’ kind of thinking?

Wiesenhütter, E. Die Begegnung zwischen Philosophie und Tiefenpsychologie.

(1979: 158, translation by A. Stadlen)

In our Covid-oriented time, when everyone is talking about so-called mental health’, this seminar offers an urgently needed perspective, one which might actually help people come to terms with this unprecedented existential, emotional, psychological, interpersonal, spiritual, religious challenge better than the confused perspective of mental health’. This does not mean that people offering ‘talking therapy’ within the mental health’ system are doing no good; some may do much good; but this seminar asks: might they not do better, and perhaps even much better, if their thinking and practice were not muddled and muddied by the mystifying discourse of mental health’? Does not this pseudo-medical approach besmirch even the most sophisticated daseinsanalytic or existential therapy? The seminar will be an opportunity to examine the evidence without which answers to these questions can only be dogmatic or speculative. 

What did Martin Heidegger mean? What Eckart Wiesenhütter says he said (above), three years after Heideggers death, is ambiguous. The words solely’ (allein’) and ‘simply’ (einfach’) in the last two sentences suggest two possible ways of understanding schizophrenia, the second more radical than the first.

The first sentence says Heidegger doubted the ‘solely medical interpretation of schizophrenia as illness’, implying ‘schizophrenia’ might be both an ‘illness’ and ‘an “other” kind of thinking’. But the second sentence says he wondered if it was ‘simply a question of an “other” kind of thinking’, implying not an ‘illness’ at all.

Even if Heidegger did have the temerity to suggest the second, more radical, possibility on that one occasion, he was usually careful to explain that what he endorsed was the first possibility. He did revere the maddest’ writings of HölderlinNietzscheTraklCelan as an “other” kind of thinking’, but he emphasised that the medical interpretation that they were ill’ was correct.

Of course, when Heidegger used the word ‘correcthe usually meant wrong, in the light of his more profound understanding. But he still meant ‘correct! How, though, did he know that the medical diagnosis was correct? He was not a doctor. But he deferred as a layman to the medical expertise of such psychiatrists as Ludwig Binswanger and, especially, his friend Medard Boss.

With Boss he founded a form of psychotherapy, Daseinsanalysis, grounded in his own philosophy. In Boss’s home from 1959 to 1969 he conducted the Zollikon seminars for psychiatrists and doctors. Both men opposed reductive natural-scientism. They insisted on a holistic approach to illness. But they assumed, in relation to ‘schizophrenics’, neurotics, and others who sought daseinsanalytic therapy, that it was illness that they were holistically approaching.

In the 1960s, the decade of the Zollikon seminars, the psychiatrists Thomas Szasz in the United States and R. D. Laing and Aaron Esterson in the United Kingdom, were also seriously questioning the foundations of their discipline, if it could be called a discipline. Laing and Esterson endorsed much of Bosss work while deploring Bossrecklessness’ (Laing) and lack of clarity’ (Esterson). The crucial difference was that Szasz, Laing and Esterson questioned the presumption of illness.

Szasz compared the presumption of illness to the presumption of guilt in inquisitorial legal systems. He held, on both scientific and ethical grounds, that people should be presumed healthy until proven ill, just as they are presumed innocent until proven guilty in accusatorial legal systems. He argued that both the presumption of illness and the presumption of guilt invalidate people.

However, the presumption of illness differs from the presumption of guilt in a fundamental way. The presumption of guilt at least attributes agency and responsibility; indeed, it insists on it. But the presumption of illness, and especially mental illness’, attributes lack of agency and responsibility: it literally invalidates by treating the person as an invalid.

Szasz was as committed as Heidegger and Boss were to holistic medicine. He was no dualist. His first papers and first book Pain and Pleasure were on psychosomatic medicine, and he stood by them at the end of his life more than half a century later, seeing this as an important field for research. But he pointed out that illness (disease) still has first to be established by a natural-scientific criterion such as Virchows, of cellular pathology or pathophysiology. A holistic approach to illness makes no sense if there is no illness to approach. Holistic (or any other kind of) medicine should not degenerate into making the presumption of illness.

Laing and Esterson, in Sanity, Madness and the Family (1964), and Esterson, in The Leaves of Spring (1970), demonstrated in concrete detail how, in each of eleven families in which a daughter had been medically diagnosed as schizophrenic, the presumption by the other family members that this young woman was ‘ill served to mystify her and invalidate her experience. Some of the diagnosed women fluctuated between accepting and challenging the familys and the psychiatrists’ (not, of course, Laings or Estersons) definition of them as ill. Others simply accepted, in a defeated and demoralised way, that they were ill’.

Laing and Esterson emphasised in the preface to the second edition of their book that readers had ignored their question, namely (1970 [1964]: viii):

Are the experience and behaviour that psychiatrists take as [boldface added] signs and symptoms of schizophrenia more socially intelligible than has come to be supposed?

They were questioning the existence of schizophrenia. But for more than half a century they have been misread as if they had left out the words here in boldface.

This is not an obscure detail. It is the heart of their argument. But it is so simple that almost all readers manage not to see it.

‘Readers’ (misreaders or non-readers) wrongly assume Laing and Esterson claimed families cause’ (contribute to the ‘aetiology’ of) a (hypothetical) mental illness’, ‘schizophrenia’. That is to say, readers mistakenly assume it was this presumed illness’, not the presumption of such an ‘illness, that these authors claimed was socially intelligible.

Among those who have misread in this way are Emmy van Deurzen and Raymond Kenward who assert in their influential Dictionary of Existential Psychotherapy and Counselling (2005: 118): 

Laing […] believed schizophrenia was the result of the alienating power of the schizophrenogenic family.

This is what almost all of the few existential therapists and Daseinsanalysts who even claim to have read the book say Laing and Esterson were saying.

In two series of Inner Circle Seminars on the eleven families, for the 40th and 50th anniversaries of the book, we have seen how difficult it is for existential therapists whose careers depend on it to examine their belief in mental healthmental illness’, and schizophrenia. Daseinsanalysts have expressed similar puzzlement. But for the laywoman Dame Hilary Mantel, the great writer who introduced our second series of seminars, the phenomenological point was obvious. [See: 

Of course, as Szasz pointed out, it is possible that some persons now diagnosed as schizophrenic are indeed ill: they may have an undiscovered brain abnormality. If such an abnormality were discovered then it would constitute a bona fide disease with mental symptoms: the province of neurologists.

But often, as Esterson says in Families, Breakdown and Psychiatry (1976: 296),

Such was the hypnotic effect of the prior assumption of illness, that one had constantly to remind oneself that there was no evidence to substantiate this assumption.

And (302):
[…] study the designated schizophrenic directly in his relevant social context in a phenomenologically and dialectically valid manner, and to a significant extent the apparent signs and symptoms of the presumed illness disappear like morning mist before the sun […]

Boss says (Grundriss der Medizin, 1971: 506, translation by A. Stadlen):
[…] with no single patient can one speak of his being schizophrenic per se. Rather, one must always ask: schizophrenic under the excessive demands of what pattern of human relationships?
But Boss’s language still begs the question of what ‘schizophrenic’ means. And he has defined Daseinsanalysis, in the title of his book and elsewhere, as part of medicine. He and Heidegger constantly refer to ‘patients’ as ‘ill’. [See:
by A. Stadlen.]
Non-medical psychotherapists were not invited to the 1960s Zollikon seminars. Boss thought Daseinsanalysts should be medical doctors. But Freud had argued in the 1920s that ‘doctors form a preponderating contingent of quacks in psychoanalysis’, which he insisted was not part of medicine but ‘weltliche Seelsorge’ (‘secular [worldly] soul-care’). Boss, starting with a modest claim that, as a student, he had visited Freud for some sessions in 1925, eventually claimed to have had psychoanalysis with him six times a week for six months, though Boss’s deputy and successor Gion Condrau and Stadlen proved that he cannot have been in Vienna for at least half that time. If he did visit Freud, he seems not to have grasped that Freud did not regard their analytic or therapeutic meetings as medicalHeidegger appears to have accepted Boss’s view that psychotherapy was a medical treatment without question.
Today we shall ask whether this is an unnecessary limitation of Daseinsanalysis and existential analysis or whether Heidegger’s and Boss’s conception of illness’ is more daseinappropriate’ after all. Your contribution to the discussion will be warmly welcome.

Professor Keith Hoeller, translator of Heidegger’s Elucidations of Hölderlin’s Poetry (2001), will again join us from Seattle, where he was Professor of Philosophy for many years. He has edited the Review of Existential Psychology and Psychotherapy from 1978, as well as books of key papers on Binswanger, Merleau-Ponty, Heidegger, Boss, Sartre, Szasz, Foucault, May. He is one of the very few authorities on both Heidegger and Szasz. He edited Thomas Szasz: Moral Philosopher of Psychiatry (1997). He contributed a chapter on Szasz to Existential Therapy (ed. Barnett, L. and Madison, G., 2012). He received the Thomas S. Szasz Award for Outstanding Services to the Cause of Civil Liberties (professional category) from the Center for Independent Thought, New York City.

Professor Hoeller co-conducted (by Zoom from Seattle, heroically through the night) Inner Circle Seminars No. 258 (The Myth of Thomas Szasz) on 14 June 2020 and No. 259 (Heidegger and Levinas on the ‘Holy’) on 2 August 2020.

Dr Albert Pacheco is Director of Behavioral Health Services for South Central Family Health Services in Los Angeles, CA. He has over 20 years of clinical experience. His doctoral dissertation, based on the work of Medard Boss, was reviewed and approved by Boss himself, and he has discussed with both Boss and Szasz their positions on mental illness. He has published articles on Boss and existential psychology and is an editorial board member of the Review of Existential Psychology and Psychiatry, which published (!) his important paper The Myth of Existential PsychiatryHe is completing a book,  An Introduction to the Existential Psychology of Medard Boss.

Professor Miles Groth will join us for the afternoon. He is an existential therapist since 1975; Professor Emeritus in Psychology at Wagner College, Staten Island, New York City; translator of Heidegger; author of books and papers on Heidegger and Boss, including Medard Boss and the Promise of Therapy (2020); collaborator with Todd DuBose in The Soul of Existential Therapy (2020) and a Society for Existential Analysis symposium in November 2020.

This will be an online seminar, using Zoom.

Cost: Psychotherapy trainees £132, others £165, some bursaries; payable in advance by bank transfer or PayPal; no refunds or transfers unless seminar cancelled
Apply to: Anthony Stadlen, ‘Oakleigh’, 2A Alexandra Avenue, London N22 7XE
Tel: +44 (0) 7809 433250    E-mail: stadlenanthony@gmail.com
For further information on seminars, visit: http://anthonystadlen.blogspot.com/

The Inner Circle Seminars were founded by Anthony Stadlen in 1996 as an ethical, existential, phenomenological search for truth in psychotherapy. They have been kindly described by Thomas Szasz as ‘Institute for Advanced Studies in the Moral Foundations of Human Decency and Helpfulness’. But they are independent of all institutes, schools and universities.

Freedom, Love, Psychotherapy. For the 25th anniversary of the first Inner Circle Seminar. Anthony Stadlen conducts Inner Circle Seminar 266 (18 April 2021)

 

Freedom, Love, Psychotherapy

for the 25th anniversary of the Inner Circle Seminars

and four other anniversaries

Luther, Freud, Binswanger, Eichmann


Anthony Stadlen

conducts

Inner Circle Seminar No. 266

Sunday 18 April 2021

10 a.m. to 5 p.m.


Sigmund Freud
Dora and her brother

















Martin Luther

‘Ellen West
Ludwig Binswanger















Adolf Eichmann

Luther 500: ‘Here I stand. I can do no other’

18 April 1521


Five hundred years ago today, on 18 April 1521, Martin Luther, an excommunicated Augustinian monk, Professor of Theology at the University of Wittenberg, was asked at the Diet of Worms to recant his published books. At risk of being burned as a heretic, he carefully considered his various books in turn, from the pile before him. He acknowledged that some were perhaps rather vehemently written. But, he said, nobody had shown him that he had misquoted any detail from the Bible. Therefore, he concluded: 

    ‘I can not and will not recant anything. 

He is also said to have added (though this is not proven): 

Here I stand. I can do no other. So help me God.’

 

Freud 125: ‘...a source of the Nile...’

21 April 1896


Sigmund Freud, in The Psychopathology of Everyday Life (1901), without naming Luther, cited this renowned reported declaration of Luther’s as evidence, not of his free will, his moral self-determination, but, rather, of ‘complete psychic determinism’. After all, argued Freud, was not Luther himself saying he could not act otherwise? Freud appears prima facie to be blankly ignoring the obvious truth that Luther’s declaration derives its moral stature from its implied assumption that, were he to let conscience make a coward of him, he could indeed ‘do other’.

Or is Freud, without quite realising it, confusedly invoking a more profound freedom than that of the conscious ego’? He is apparently affirming mechanistic scientific determinism applied to human events, and thus making nonsense of his own project of helping people discover their freedom through psychoanalysis. But is it possible that he is invoking, even though in an alienated and alienating way, with his concept of ‘psychic’ ‘determinism’, a determinism which is in truth a freedom of the psyche, the soul, beyond mere egoic subjectivity, and closer to, or consonant with, the philosopher Schellings understanding of freedom, in which, as Heidegger put it, freedom is not a property of the human being but the human being is a property of freedom? Is authentic, demystified psychoanalysis or Daseinsanalysis a quest to discover this profound freedom? 

In Of the Freedom of the Christian Human (1520), the book then most recently published in the pile which Luther refused to retract at the Diet of Worms, he argued that true freedom is inextricably linked with faith in God and love of one’s neighbour; thinkers in other religious traditions have said similar things.

Thomas Szasz, in his book The Myth of Psychotherapy: Mental Healing as Religion, Rhetoric and Repression (1978), hails Luther as a fellow thinker who advocated the ‘cure of souls’ as a form of psychotherapy entailing personal repentance; this was Szasz’s model for what psychotherapy could and should be.

Szasz does not mention, however, what he had briefly alluded to in The Manufacture of Madness: A Comparative Study of the Inquisition and the Mental Health Movement (1970), that Luther, disappointed that the Jews of his time did not find his critique of the Vatican sufficient reason to convert to his version of Christianity, responded by inciting ferocious persecution of the Jews, a precursor to Nazism. Central to his indignation was that the Jews were the supposed killers of God and, as Jesus (himself a Jew) allegedly said (John 8.44), the children of the devil; and that they preferred vengeance to love, or at least and at best wanted love spiced with vengeance. This last remained a Christian view of Judaism, for example in Kierkegaard’s first Upbuilding Discourse of 16 October 1843 which Geoffrey Pattison brilliantly elucidated in Inner Circle Seminar No. 263, even though Kierkegaard is clear in Works of Love that ‘Love your neighbour as yourself’ was a Jewish principle before it became a Christian one.

To this day, many Christians, Jews, agnostics and atheists are aware that Jesus asserted that ‘Love your neighbour as yourself’ is one of the two greatest principles (Matthew 22.39, Mark 12.31, Luke 10.27). Far fewer realise that he, a Jew, was stating it as one of the two greatest existing Jewish principles. And fewer still realise that the very verse in which this principle is stated in the Torah, long before Jesus lived, states (Leviticus 19.18 [italics added]): ‘Do not take revenge or bear a grudge, but love your neighbour as yourself.’

In The Future of an Illusion (1927), Freud asserted that God is an infantile phantasy-projection, and religion a ‘universal obsessional neurosis of mankind’. In Civilization and its Discontents (1929) Freud ridiculed the idea of loving his neighbour. His love, he insisted, was something precious, not to be wasted on his neighbour unless his neighbour happened to be sufficiently like Freud for Freud to love himself in the neighbour. Love, in other words, was, for the founder of psychoanalysis, also a projection: projected narcissism. Civilization, he said, entailed the emotional crippling of human beings by the injunction (from the ‘collective super-ego’, as he saw it) to love one’s neighbour as oneself.

How did Freud reach this position? In the first Inner Circle Seminar, twenty-five years ago on 21 April 1996, we focussed on the occasion exactly one hundred years earlier, on 21 April 1896, when Freud first presented his avant-garde method of therapy and research, and its name, ‘psychoanalysis’, to his colleagues at the Society for Psychiatry and Neurology in Vienna.

The title of his presentation was ‘The Aetiology of Hysteria’. He claimed to have made a ‘momentous discovery’, ‘a caput Nili [source of the Nile] in neuropathology’, namely, the ‘specific aetiology’ of the supposed ‘mental illness’ ‘hysteria’, analogous, he claimed, to Robert Koch’s discovery of the Koch bacillus as the specific aetiology of the disease tuberculosis the previous decade.

What was, according to Freud, the ‘specific aetiology’ of ‘hysteria’? It was sexual abuse in childhood, ‘before the age of second dentition’. This he claimed to have discovered in all eighteen cases he had investigated. It was an all-or-nothing theory, as specific aetiology is a factor in whose absence the illness cannot occur. One counter-example would, not partially but wholly, refute the theory.

Less than eighteen months later, Freud began to admit to his friend Wilhelm Fliess that he did not have the evidence of childhood sexual abuse required by his theory in every case. He did not publicly acknowledge this for nearly a decade, and even then confused the matter by purporting to explain his error, but in fact ‘confessing’ an ‘error’ which was not the one he had actually made.

In the original theory he stated that only under the ‘strongest compulsion’ of his new method, psychoanalysis, could his patients be induced to ‘reproduce’ the ‘scenes’ of sexual abuse that he admitted he was suggesting to them. And he reported that the patients insisted that these scenes, even if ‘reproduced’ with emotion, did not have the feeling of being memories. This, Freud pronounced, was the most decisive proof that they were in fact memories!

However, when he began to doubt the universality of his supposed specific aetiology, he had the problem of explaining to his colleagues how he had made such an error. His solution was to blame the patient. He now claimed that his original theory had been that the patients had come to him volunteering stories of sexual abuse, which he, by implication the enlightened and compassionate therapist, had at first believed, but had now discovered in some cases to be fantasies.

What the seduction theory and his retraction had in common was that he was right and the patient was wrong.

His method he explicitly compared to that of the inquisitors in the early-modern ‘witch’ trials.

Freud loved to give detailed evidence, in the manner of a German Novelle, when he had it. But for neither the seduction theory nor its retraction did he give evidence. The closest he came was the lengthy ‘Dora’ case study of 1905. But this further obfuscated matters because he introduced it as intended to ‘substantiate’ his assertions of 1895 and 1896, which included the seduction theory, when in fact it embodied a shift towards the hypothesis of infantile sexuality and a new conception of ‘love’.

Dora was sexually molested at thirteen by her father’s friend Herr K. with her father’s implicit collusion in return for sexual favours from Herr K.’s wife. Freud diagnosed Dora as an ‘hysteric’ because she objected both to this perverted notion of ‘love’ and to the insistence of her father and the K.s that she was fantasising Herr K.s molesting of her and her fathers affair with Frau K. Freud accepts that Doras allegations are accurate, but he sees her as sick for making them. A healthy girl, he insists, should take this in her stride. He attributes to her a remorseless craving for revenge’. This is a new twist to the traditional ‘Christian’ idea of the Jew, witch, or heretic, and now the psychiatric idea of the heretical ‘mental patient’, who cannot love but prefers revenge.

Freud adduces, among other evidence’ of Dora’s remorseless craving for revenge’, that she: (1) pulled herself free from Herr K.’s sexual molesting when she was thirteen; (2) slapped his face when he tried again when she was fifteen; and (3) elicited, when she was eighteen, admissions from Herr K. that he had sexually molested her and from Frau K. that she had an affair with Doras father.

The Dora case, a paper in a journal, contains more references (24) to Rache (revenge) and its cognates than any other work of Freud’s. Even The Interpretation of Dreams (1900), by far Freud’s longest book, contains only 23. 

The psychoanalyst Ernest Jones, in his authorised biography of Freud, praised the ‘Dora’ case study as ‘a model for students of psychoanalysis’. He called Dora ‘a disagreeable creature who preferred revenge to love’ (italics added).


Binswanger 100: ‘Allowing Annihilation of Life Unworthy of Life’

5 April 1921


In general, psychoanalysis and psychotherapy, from the late nineteenth century to the twenty-first century, developed strange, natural-scientifically reduced notions of both freedom and love.

The Swiss psychiatrist Ludwig Binswanger as a young man accompanied Carl Gustav Jung on a first visit to Freud in Vienna in 1907. Freud and Binswanger remained lifelong friends, although Binswanger severely criticised Freud’s theoretical position, with love, as he put it in a letter to Freud. In a speech in Vienna for Freud’s eightieth birthday in 1936 Binswanger argued: 

... the natural-scientific idea of ‘homo natura’ must destroy the human being as a being living in manifold directions of meaning and only to be understood from them … until … precisely everything which makes a human being into a human being and not a brutish creature is annihilated …

Thus Freud stands before us as the paradigmatic man of the twentieth century.

Binswanger saw ‘homo natura’, the natural-scientism of Freud’s concept of the human being, as destroying the understanding of human freedom and love. Binswanger wrote a large book (1942) about the phenomenology of love. In it he attempted to develop Martin Heidegger’s and Martin Buber’s thinking, but Heidegger said that Binswanger had misunderstood him.

In 1944-5, Binswanger published ‘The Case of Ellen West’, a very long and complex case study, as a ‘paradigm’ of ‘schizophrenia’. He later republished it, with four other long case studies, in his book Schizophrenie (1957). It is translated in Existence: A New Dimension in Psychiatry and Psychology edited by Rollo May, Ernest Angel, and Henri F. Ellenberger (1958: 237-364).

He makes plain that he also intends ‘The Case of Ellen West’ as a paradigm of ‘love’: her alleged inability to love, and his ‘love’ which he claims is what makes possible his ‘scientific’ method of understanding her.

He writes that ‘love alone, and the imagination originating from it’ can rise above a ‘single point of view’ in order, by means of ‘historical science’, ‘to test and compare “personal” judgements […] and to place them in a scientific perspective’.

This he sets out to do, twenty-three years after Ellen West’s death

At thirty-three, on 5 April 1921, a hundred years ago, she had poisoned herself with the help of her husband. This event was facilitated by Binswanger himself. The full nature of the participation of her husband and Binswanger has only become clear from recent research. It is not acknowledged in the case study itself.

She was a ‘patient’ in Binswanger’s ‘sanatorium’, Bellevue, at Kreuzlingen in Switzerland. He convened a case conference there with two other eminent psychiatrists: his colleague Eugen Bleuler and an unnamed ‘foreign’ psychiatrist.

Binswanger and Bleuler agreed she was a case of ‘schizophrenia’, the new ‘illness’ that Bleuler had proposed in 1908. The third psychiatrist disagreed with this diagnosis; he ‘would label it a psychopathic constitution progressively unfolding’. But, wrote Binswanger, ‘…all three of us agree that ... no definitely reliable therapy is possible.’ And: ‘Both gentlemen agree completely with my prognosis.’ 

All three agreed that Binswanger should put it to her husband that he and his wife must decide whether Binswanger should lock her up with no hope of a ‘cure’ or discharge her as a hopeless case. All three agreed that her suicide was inevitable. It would be caused by, and be a ‘symptom’ of, the ‘illness’ she was supposedly suffering from.

Whatever this ‘illness’ was, Binswanger explained, in his case study, that it made Ellen West incapable of ‘love’.

But he also wrote, without indicating any sense of contradiction, that her suicide was ‘authentic’. This implies it was a freely chosen act. Moreover, in her suicide, he claimed, she glimpsed for the first time the ‘dual mode’ of ‘being-in-the-world-beyond-the-world’ in ‘love’:

Only in the face of nonbeing does Ellen West actually stand in being, does she triumph over the finiteness of being, including her own. But this is possible only where the existence knows or senses itself as Gestalt of this being, as a passing expression of the eternal Gestalt-metamorphosis. This knowing or sensing is the knowing or sensing of love. [My emphasis]

The third psychiatrist at the case conference was in fact Alfred Hoche, coauthor with the lawyer Karl Binding of the book Allowing the Annihilation of Life Unworthy of Life (1920). (See Inner Circle Seminar No. 176.)

Binswanger and Bleuler had shared a copy of this book, published the previous year, and corresponded about it. Ellen West and her husband had also read it, knew who Hoche was, and welcomed his visit. This book was later used by the National Socialists as a textbook justifying the extermination of the ‘ballast existences’ of the ‘mentally handicapped’ and ‘mentally ill’.

Hoche mentions in his autobiography, published in 1935, this very case conference. It was, he says, ‘the strangest consultation in which I have ever taken part’. He does not name Binswanger, Bleuler, or the ‘young woman, highly gifted, sensitive, full of intellectual interests of every kind’. Hoche writes that the task of the triumvirate was to decide whether this was ‘still a life worthy of life’. ‘To this question we had to answer: No.’

In 1944-5, when Binswanger wrote and published ‘The Case of Ellen West’, the extermination of ‘ballast existences’ had been for some years a reality. He does not mention this. He remained friendly with Hoche and mentions in his obituary of Hoche that he has read Hoche’s book on so-called ‘euthanasia’ but will not discuss it. Nor does he allude in ‘The Case of Ellen West’ to Hoche’s account of what Hoche called ‘the strangest consultation in which I have ever taken part’.

Binswanger explicitly attributes to Ellen West an inability to love. She is condemned by her ‘world project’ to a loveless life. This is not a ‘fundamental project’ such as Jean-Paul Sartre supposes the child freely chooses as a way of making sense of how he or she has been treated by others; it appears to be predetermined. Binswanger disparages Ellen’s devoted social work and provision of children’s libraries as a search for fame, although the testimony after her death of people she had helped is unequivocally appreciative of her kindness.

Binswanger, whose family was originally Jewish but converted to Christianity, laments that Ellen West does not also choose Christianity, ‘the religion of love’. as he calls it. Only in her suicide, assisted by her husband and effectively authorised by Binswanger and his psychiatric colleagues, does he concede that she glimpses the possibility of love.


Eichmann 60: ‘I lived by Kant’s categorical imperative’

11 April 1961


Sixty years ago, on 11 April 1961, the trial of Adolf Eichmann opened in Jerusalem. During the trial he claimed to have always tried to live his life according to Immanuel Kant’s ‘categorical imperative’ from which Kant held that ‘love your neighbour as yourself’ could be deduced.

 

Inner Circle Seminars: 25th Anniversary

21 April 1996

What has the above to do with the practice of psychotherapy today? In the Inner Circle Seminars we have explored the history of Freud’s seduction theory and its retraction, the birth and then the second birth of psychoanalysis; we have followed Freud at a century’s distance almost to the day for five years, through his letters to his friend Wilhelm Fliess, and tried to rethink in existential and phenomenological terms the questions with which he wrestled; we have examined many paradigmatic case studies, including, for example, Freud’s ‘Dora’ and Binswanger’s ‘Ellen West’; we have investigated the underlying philosophies of various psychotherapeutic practices; we have studied the histories of remarkable men and women who have been locked up by psychiatrists who regarded them as crazy; we have studied many of Thomas Szasz’s books including all ten of his twenty-first century books; we had a cycle of eleven seminars following up historically the eleven families in Laing and Esterson’s Sanity, Madness and the Family after forty years, and another cycle after fifty years; we have followed Heidegger’s Zollikon seminars on the foundations of psychotherapy at fifty years’ distance, and are now doing it at sixty years’ distance; we have studied the work of many existential pioneers; we have hired Dr Samuel Johnson’s house for a day and pondered his musings on madness; we have tried to relate psychotherapy to religion, philosophy, mythology, anthropology, historiography, biography, literature; and much more besides. To this end we have invited world authorities in their fields of study. 

Has this search, in seminars, for truth in psychotherapy and its foundations, helped us become better psychotherapists? Certainly that was our intention and hope. 

But we have discussed in the seminars how the conceptualising of theory in psychotherapy training institutions and universities is alienated: so-called ‘theory’ is taught in the mornings and then ‘applied’ in ‘practical’ classes in the afternoons. This a corrupt vision of theory. Authentic theory in the ancient Greek sense elucidated by Heidegger is contemplation of practice as we are practising, while aware in some way of the divine and that the divine is contemplating us. Then, according to Aristotle, the practitioner is truly a theoretikos. Practice comes first. Hence the Biblical phrase: ‘We shall do and we shall hear.’ In that order.

What does this say about the relation between our seminars and our practice of psychotherapy? 

Perhaps it is only through immersing ourselves in the seminars, and then letting it go, shall we hear what is said, and not said, in them. 

Perhaps all true psychotherapy is conducted in the middle voice. But that is perhaps a topic for a future seminar.


Today, you are welcome to raise any question in relation to the practice of psychotherapy, whether or not it refers to the above anniversary notes. As always your contribution to the dialogue, even if it is silence, will be deeply welcomed.


This will be an online seminar, using Zoom.

Cost: Psychotherapy trainees £132, others £165, some bursaries; payable in advance by bank transfer or PayPal; no refunds or transfers unless seminar cancelled
Apply to: Anthony Stadlen, ‘Oakleigh’, 2A Alexandra AvenueLondon N22 7XE
Tel: +44 (0) 7809 433250
E-mail: stadlenanthony@gmail.com
For further information on seminars, visit: http://anthonystadlen.blogspot.com/

The Inner Circle Seminars were founded by Anthony Stadlen in 1996 as an ethical, existential, phenomenological search for truth in psychotherapy. They have been kindly described by Thomas Szasz as ‘Institute for Advanced Studies in the Moral Foundations of Human Decency and Helpfulness’. But they are independent of all institutes, schools and universities.