‘Medical
Daseinsanalysis’
Anthony
Stadlen
[Existential Analysis 16.1 (January 2005): 169-177]
Copyright © Anthony Stadlen 2005
1
In a number of lectures[1]
and publications[2], as well
as in the Inner Circle Seminars[3],
I have drawn attention to two aspects, or more precisely, two aspirations,
quite explicit, of the ‘Daseinsanalysis’ that the psychiatrist Medard Boss
developed with the assistance of the philosopher Martin Heidegger. On the one
hand, Boss and Heidegger wanted Daseinsanalysis to be a ‘purified’
psychoanalysis[4]:
‘purified’, that is, of what they saw as the reductive natural-scientism of
Freud’s so-called ‘metapsychology’, the better to bring out the existential-phenomenological
aspects of Freud’s practice[5].
On the other hand, both Boss and Heidegger always spoke and wrote of Daseinsanalysis
as ‘medical’[6].
Decades after Freud defended so-called
‘lay’ psychoanalysis in his book The
Question of Lay Analysis[7],
writing that ‘doctors form a preponderating contingent of quacks in analysis’[8],
while Jung encouraged non-medical practitioners such as John Layard to undertake
Jungian analytical psychotherapy[9],
Medard Boss was actually refusing to allow non-medical professionals, with the
exception of a few philosophers who did not aspire to be therapists, even to
attend the Zollikon seminars which Heidegger conducted for a decade in Boss’s
home[10].
The first edition of Boss’s magnum opus bore the simple title, Grundriss der Medizin[11]
(Foundations of Medicine). In the
second edition, Boss explains that he had wrongly ‘presupposed’ that his
readers would have had the ‘insight’ that ‘a loadbearing foundation for
medicine must also be a foundation for psychology and sociology’[12].
He has therefore now changed the title to Grundriss
der Medizin und der Psychologie[13],
and this is reflected in the title of the English translation, Existential Foundations of Medicine and
Psychology[14].
However, he makes it clear that, in his view, the word ‘medicine’ ought to have
been enough by itself. He implies, here and elsewhere, that medicine, in the
‘daseinsanalytic’ sense, always already includes all of psychology and Daseinsanalysis.
In this short paper, I do not argue for or
against either of these two aspirations of Daseinsanalysis. As it happens, in
common with Thomas Szasz and Aaron Esterson (but, it seems, with few others), I
approve of the first aspiration (to purify Daseinsanalysis of
natural-scientism) and disapprove of the second aspiration (to preserve Daseinsanalysis
as part of medicine), because in my view the second contradicts the first. However,
in this paper I have limited myself to the task of demonstrating the simple fact
of Heidegger’s and Boss’s second, medical, aspiration.
2
I am fortunate to be able to refer to the address by
Professor Friedrich-Wilhelm von Herrmann, ‘Medard Boss und die Zollikoner
Seminare Martin Heideggers’[15],
to participants in the 5th Forum of the International Federation of
Daseinsanalysis at a gala dinner in the Vienna Rathaus on 3 October 2003, the
eve of the centenary of Medard Boss’s birth. I am also fortunate that Frau
Salomé Hangartner has made a translation of Professor von Herrmann’s address,
and that they have given permission to publish her translation in this issue of
this Journal[16].
Professor von Herrmann, a colleague of
Heidegger’s in Freiburg , was entrusted by him decades
ago with the task of editing the vast, today still appearing, Heidegger Gesamtausgabe[17]
(Collected Edition). Professor von
Herrmann’s address is a particularly faithful, succinct, and pellucid summary
of the book Zollikoner Seminare[18].
It will surely be of great value as a map or guide to students of that work.
Frau Hangartner is a most sensitive and
intelligent translator.
In part III of this paper, I shall simply quote,
from Frau Hangartner’s translation of Professor von Herrmann’s address, the thirty-one
sentences, and the one title of a section, that contain the words ‘medicine’, ‘physician’,
‘psychiatry’, ‘mentally ill’, and so on. I have printed these words in boldface
(in one instance, underlining) in these quotations.
There are one hundred and twenty sentences,
and two titles of other sections, that do not
contain such words.
Thus, about twenty per cent of the sentences
in the address contain such words.
The reader may easily compare my quotations
with Professor von Herrmann’s address, to see whether my quotations are
accurate, as the address is printed in this issue of this Journal.
The reader may also compare Professor von
Herrmann’s address with the ‘American’ translation, Zollikon Seminars[19],
of Zollikoner Seminare, to see
whether the address is a fair summary of the book. Although I have criticised[20]
the failings of the ‘American’ translation, it is good enough for this purpose.
Hence, the reader may, without too much
difficulty, judge whether or not it is a fact
that Heidegger’s and Boss’s view was that ‘Daseinsanalysis’ is, and should be, medical.
If, as I hope, we are in this way able to
reach agreement that this is a fact,
then we shall be in a position to begin, elsewhere, to try to evaluate it.
3
The sentences and title from Professor von Hermann’s
address that use the terms ‘medicine’, ‘physician’, ‘psychiatry’, ‘mentally ill’,
and so on are as follows:
1. The 100th
birthday of Medard Boss, on 4
October 2003 , provides a welcome opportunity for all of us to
remember a great human being and thinking physician
with gratitude and admiration.
2. (1) The thinking physician
3. ‘There is a dire
need for thinking physicians who are
not willing to leave the field to scientific technicians’ (8 July 1965 : S. 134, p. 103)[21].
4. Medard Boss
proved to be such a thinking physician
in 1947 when he first sought to make contact with Martin Heidegger by writing
to him.
5. What made him
create this bridge between psychiatric
medicine and philosophy was the insight that had matured in him, namely
that the predominantly natural-scientific orientation of scientific psychiatry, psychotherapy, and
psychology cannot do justice to the human being in his/her Being-human, that
therefore this science of human beings required a changed, new foundation
oriented on the question as to the Being-human of human beings.
6. Medard Boss knew
that such a foundation would not be laid by medical science itself, but only by philosophical thinking; still,
the scientist would have to cooperate personally with the thinker in creating
the foundation.
7. As a scientific physician, Medard Boss had the mental
freedom to question his own science with regard to its fundamentals and to ask
for the required help from philosophy.
8. Medard Boss
sensed that the terms of his medical science
that are based on physical thinking were not derived from the Being-human of
human beings.
9. Thus, it was
probably also the ability of Medard Boss to gain a certain distance from his
own science and his reckless preparedness to learn from the thoughts of
philosophy which induced Martin Heidegger – after more than ten years of a
friendly relationship with Medard Boss – to get involved, with unparalleled
intensity, in the seminars with 50 to 70 medical
doctors of natural-scientific orientation.
10. The minutes kept
in shorthand by Medard Boss, corrected by Heidegger, and in part supplemented
by additions, are a top-ranking source for the daseinsanalytical foundation of psychiatry, psychotherapy, and
psychology.
11. If there had
been no Zollikon Seminars and if we did not have the minutes of those seminars,
the transmission of the philosophical Daseinsanalytics to the medical Daseinsanalysis would be
missing.
12. In the Zollikon
Seminars, Heidegger effected this transmission primarily by opening the view
channel for the thinking of medical
Daseinsanalysis and directing the seminar participants as well as the
readers of the seminar texts towards the specific view of a daseinsanalytically
oriented science of the human being.
13. Without the
Zollikon Seminars, Medard Boss could not have written his Grundriss der Medizin either.
14. The Zollikon
Seminars were guided by the intention to point out to psychiatrists, psychotherapists, and psychologists that their
natural-scientific fundamentals were insufficient, and to direct them towards
the view on Being-human which was concealed by said fundamentals.
15. The topics
chosen are of particular importance for psychiatry,
psychotherapy, and psychology, so that they may serve as examples in showing to
what extent the common natural-scientific view of these topics misses out on
the Being-human of human beings.
16. The range of
topics of the Zollikon Seminars can be stated as follows: Da-sein of the human
being as the area of being able to discern significances; assumption as
supposition and acceptance of What-shows-itself; the Being of human beings in
space as opposed to the animal and the object of use; causality and motivation;
man’s Having-time as opposed to the idea of physical time; the phenomenon of
envisaging as a way of Owning-the-world; the difference between the inanimate
body (Körper) and animate body (Leib); being embodied (leiben) of humans as a
way in which he/she is in the world with things within-the-world; philosophical
Daseinsanalytics and medical
Daseinsanalysis.
17. Within psychiatry, psychotherapy, and
psychology – if they want to see themselves from the unadulterated view of
Being-human – causality thinking will have to disappear in favour of
motivational thinking which alone can do justice to the freedom of existence of
the human being in the worlds of significances in case of
significance-determined things with others.
18. Heidegger points
out that the medical participants in
the seminar were particularly interested in the question ‘what the human
being’s relationship is to time and how he/she lives it’ (S. 75, p. 58), in
particular in view of the disturbed time relation of the mentally ill person.
19. In view of the
fact that scientifically trained physicians
are ‘largely determined by the thinking mode of natural sciences,’ the question
arises ‘whether the idea of time governing natural sciences is at all suitable
to discuss the relationship of existing human beings to time, or whether the
idea of time determining natural science does not block the way to discussing
the relationship of human beings to time and thus hinders the meaningful asking
for the particularity of time’ (S. 75 f., p. 58 f.).
20. According to
Heidegger, there are two aspects that determine the question regarding time:
firstly, the aspect of the ‘medical
profession and its scope: the existing person in his/her distress’, and,
secondly, the aspect of ‘medical-scientific
training – modern natural science and its technical structure’ (S. 76, p. 58).
21. In view of this
understanding of time derived from natural existence, Heidegger says that ‘the
disturbed reference to time of the mentally
ailing person can only be understood from the original, naturally
perceived, always interpretable and dated reference to the time of human
beings, but not with a view to calculated time which originates from the idea
of time as a sequence of intrinsically empty, “nondescript” Nows’ (S. 55, p.
43).
22. It is World-time
that is moved into the focus of psychiatry,
psychotherapy, and psychology, delimiting it from the natural-scientific
concept of time.
23. The disturbance
of the reference to time of the mentally
ill is a disturbance of World-time reference.
24. The
phenomenological insight into the ecstatic openness of all ways of the existing
Being with the bodily or non-bodily presence (of things present) enables the psychiatrist to pertinently understand
the lack of contact found in schizophrenia
from the point of view of Being-human as a privation of openness of the human
being (S. 95, p. 73).
25. This question is
of great importance to psychiatry,
psychotherapy, and psychology in view of psychosomatics.
26.
In the November seminars of the year 1965, ontologic Daseinsanalytics and medical Daseinsanalysis are finally
taken on as a topic (S. 147–173, pp. 112–132).
27. The comments
given by Heidegger are of the utmost importance for the self-understanding of daseinsanalytically-oriented psychiatry,
psychotherapy, and psychology.
28. Against this
ontological Daseinsanalysis, Heidegger differentiates the medical Daseinsanalysis ‘for the purpose of showing and describing
factually the phenomena each showing in a specific, existing Dasein’ (ibid.).
29. Medical Daseinsanalysis in its extended
meaning of Dasein-oriented psychiatry,
psychotherapy, and psychology is itself an ontic-existential analysis, but
based on existential-ontological Daseinsanalytics.
30. Whereas medical Daseinsanalysis is primarily
the name for the daseinsanalytically
oriented medical practice, ontic
Daseinsanalysis in the second meaning refers to the scientific topic of medical Daseinsanalysis.
31. Simultaneously,
it is the method for practice and the science of medical Daseinsanalysis and its disciplines.
32. The
phenomenological attitude thus characterized, in which Medard Boss performed
his medical science and his medical profession, was also the
keynote of his attitude as a human being in which he was always open to the
fellow human beings he encountered with warm benevolence.
4
I hope that the above quotations from Professor von
Herrmann’s superb summary of Zollikoner
Seminare make it clear that Heidegger and Boss assumed that Daseinsanalysis
was medical, and intended that it should remain so.
‘Medical Daseinsanalysis’ was not just a
concept. It was Boss’s practice,
endorsed by Heidegger. It entailed, for example, Boss’s permitting, as
Professor von Herrmann says, ‘50 to 70 medical doctors’[22]
to attend Heidegger's Zollikon seminars, and not permitting non-doctors to do
so. This was a political act, just as
much as Boss’s forbidding these ‘50 to 70 medical doctors’ to question
Heidegger about his Nazism[23],
and just as much as Heidegger’s Nazism itself[24].
These seem to me inescapable facts. There
will surely be disagreement about how to evaluate them, and I shall not try to
do so here.
Anthony Stadlen has practised since 1970 as an
existential-phenomenological psychotherapist with individuals, couples and
families. He teaches and supervises at several London Freud Museum , London
Correspondence to: stadlen@aol.com.
[2] Stadlen 2003a,b,c;
Stadlen & Stadlen 2005.
[3] Stadlen 2002b,c; 2003e,f,g.
[4] Boss and Holzhey-Kunz 1982 [1981]: 111;
Stadlen 2003c: 364.
[5] Boss 1957, 1963 [1957].
[6] Stadlen 2003b: 166–167, 173–175; Stadlen and
Stadlen 2005.
[7] Freud GW
14, SE 20.
[8] Freud GW
14: 262; SE 20: 230.
[9] Layard 1944.
[10] Condrau 2002; Stadlen 2003b: 174.
[11] Boss 1971.
[12] Boss 1975[1971].
[13] Boss 1975[1971]: 10.
[14] Boss 1983 [1979].
[15] von Herrmann 2003.
[16] von Herrmann 2005
[2003].
[17] Heidegger 1975– .
[18] Heidegger 1994 [1987].
[19] Heidegger 2001 [1994].
[20] Stadlen 2002a, 2003c.
[21] S. = page in Zollikoner Seminare, p. = page in Zollikon Seminars.
[22] See sentence no. 9 from Professor von
Herrmann’s address (in part III of this paper).
[23] Condrau 2000: 31; Stadlen
2003b: 167; also confirmed by Gion Condrau at the 3rd Forum of the
International Federation of Daseinsanalysis, 28–29 September 1996, London
[24] Ott 1993, Safranski 1998
[1994].
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