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This "Metaphysics of Madness" appears as a "sinister mirror of madness", and the madman as a victim of the violence of his conflicts. This has come to reinforce the "tragic" anthropology which was already latent in the ancient pests, in the battles, in the mass suicides. An effort was made to determine the space where madness operates in our cultural context by means of an internationally guaranteed survey of symptoms. The analysis of madness lays out hermeneutics of multiple levels through which the most profound and conflictive structures of our culture become visible. Even if madness is principally entered upon as a psychiatric category, it presents a similar incidence as a category of cultural anthropology, it being necessary to add besides its importance as a literary category, the deciphering of the psychotic discourse as a linguistic category, the necessity of a sociological contextualization and its foundation on philosophic and even theological categories. Madness as a category of the spirit is the daring effort of understanding its liberation "in this deceit of destiny which fools it as to a liberty it has not conquered". After a consideration of texts of two decisive figures related to the philosophic history of madness--Kant and Hegel--the important position of Ludwig Binswanger and his conception of the Ideenflucht (flight of ideas) in the history of psychiatry is brought out. Finally, the theory of the madness of the masses (Massenwahntheorie) stated by Broch--a double madness, of fragmentation, on the one hand, and of aberration and paranoia of power, on the other--shows a universally valid analysis in which the particular, recurrent tragic model of our culture inscribes itself. This model is to be identified with Massenwahntheorie VII, i.e., as a prolongation of the prodigious work carried out by Broch.
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PMID:[Theory of mass madness. Epilogue of the Research Program on Psychiatric Epidemiology of the National Council of Scientific and Technical Research]. 332 66

The appearance of Freud's earliest writings at the beginning of this century marked the birth of modern systematic and scientific psychotherapy. The following development was explosive in its depth and breadth. It was primarily the group psychotherapies that contributed most to the development in breadth. They practised the reverse of Freud's basic teaching that the whole healing process should occur within a psychic realm. A development in depth was not possible until a reflective review of the presuppositions of psychotherapy concerning the nature of the human being was admitted. Prior to this, the rapidly appearing new schools of psychotherapy were superficial and even thoughtless in their basic tenets. Ludwig Binswanger's thinking initiated a new approach to the understanding of the basic condition and meaning of human existence. Following the example of the philosopher Martin Heidegger, he was able to replace the name of what had previously been called "psychotherapy" with the designation "Daseinsanalyse". It then became possible to give up the ever vague and opaque conception of a "psyche" in favour of the strictly scientifically defined "Da-sein" of the human being.
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PMID:[The development of psychotherapy in the 20th century]. 702 70

Clinical experience of psychotherapists is getting more and more circumscribed by the boundaries of theoretical references. The Freudian "psychic treatment" for neurosis got its impetus from the friendship between Sigmund Freud and Ludwig Binswanger, the phenomenological psychiatrist. This relationship laid the foundation for the references of psychoanalytic psychotherapy in Europe. Then, the Freudian conception of actual neurosis led to a psychosomatic approach. Later, the study of narcissistic neurosis opened up to borderline patients. Today, scientific and medical progress greatly influence psychopathological research and the way we look at our patients and their requests. These changes come from the patients' sayings and their expectancy of well-being. At the same time psychotherapists have to take a new look at their theoretical references. On the one hand, a dynamic concept for psychotherapy is necessary for integrating the phenomenologic approach into psychoanalysis, and providing the understanding of situations emerging in neurological dysfunction. On the other hand, psychotherapists pay more attention to the different actors contributing to a pathology (Who is suffering? What about the life-partner or the relatives?). These changes lead to a new look into the processes of identification as well as the notion of identity. This article discusses these influences on psychotherapy and clinical research showing how clinical situations get ahead of theoretical references.
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PMID:Neurological dysfunction, psychic conflict, and psychotherapy. 1100 32

Ludwig Binswanger, a founder of the existential school of psychiatry, attempted to apply philosophical ideas derived from Martin Heidegger, such as Heidegger's views on the mind-body problem, to the understanding and treatment of psychiatric patients. Binswanger also interpreted Heidegger's concept of the existing individual (Dasein) as Being-in-the-World, in the sense of seeking out the existential structure of individuals' lives. I discuss concrete clinical cases from Binswanger's work, along with a contemporary example of how to use these existential methods in psychiatric practice.
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PMID:Rediscovering existential psychotherapy: the contribution of Ludwig Binswanger. 1129 Nov 91

This paper examines the drugs used in Ludwig Binswanger's private sanatorium "Bellevue" in Kreuzlingen on the Lake of Constance between 1857 and 1870. The available patient records have revealed the administrated drugs, prescriptions have been transcribed, and the guidelines for the use of the drugs have been reconstructed by means of the literature. It becomes obvious that the armamentarium of drugs prescribed was limited and can be connected with the treatment of physical ailments which the "somatist" Binswanger considered as the main cause for psychic disorders. Binswanger was very careful when prescribing one of the few available "psychotropic" drugs like opium and morphine. This restraint in using drugs is in contrast with many recommendations and habits of Binswanger's contemporaries and shows that he put higher emphasis on the effectiveness of the "therapeutic milieu" than on a pharmacotherapy of insanity.
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PMID:[Drug therapy of psychiatric patients in the middle of the 19th century: the drug armamentarium of Ludwig Binswanger sen. in his "Asyl Bellevue" ]. 1258 4

This paper examines the Swiss psychiatrist Ludwig Binswanger's view of the doctor-patient relationship as a direct and trusting existential encounter in a 1935 clinical case of hysteria. Drawing upon unpublished materials from the patient record and correspondence, I show that his conception of existential encounter emerged from the Bellevue asylum context, where treatment choices were linked to maintaining order in a communal setting, and addressing a complex array of bodily and psychological symptoms. Binswanger touted the underlying, positive relationship with his patients as the critical factor in the efficacy of a wide variety of treatments, including some of the most forceful and authoritative. Sources from the patient's perspective, however, demonstrate that, in this case, a mutual relationship of trust was not clearly achieved.
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PMID:Existential encounter in the asylum: Ludwig Binswanger's 1935 case of hysteria. 1538 60

Psychoanalysis has started to recoup, often quite implicitly, a more phenomenological stance, ever since psychoanalysts have started working with borderline and psychotic patients. As many of these patients have commonly been through traumatic experiences, psychoanalysts have been using an approach that questions the role of traditional psychoanalytical interpretation and pays more attention to the patient's inner conscious experiences; this approach is characteristic of a specific form of contemporary psychiatry: phenomenological psychopathology, founded by Karl Jaspers in 1913 and developed into a form of psychotherapy by Ludwig Binswanger, with his Daseinsanalyse. If what we could call a phenomenological 'temptation' has been spreading over psychoanalysis, so too has a psychoanalytical 'temptation' always been present in phenomenological psychopathology. In fact, even though this branch of psychiatry has led us towards a deeper understanding of the characteristics of psychotic being-in-the-world, its therapeutic applications have never been adequately formalised, much less have they evolved into a specific technique or a structured psychotherapeutic approach. Likewise, phenomenological psychotherapy has always held an anaclitic attitude towards psychoanalysis, accepting its procedures but refusing its theoretical basis because it is too close to that of the objectifying natural sciences. Psychoanalytic 'temptation' and phenomenological 'temptation' can thus be considered as two sides of the same coin and outline a trend in psychoanalytic and phenomenological literature which points out the fundamental role of the patient's inner conscious experiences in the treatment of borderline and psychotic patients.
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PMID:New interpretative styles: progress or contamination?: psychoanalysis and phenomenological psychopathology. 1604 Mar 8

From phenomenological and experimental perspectives, research in schizophrenia has emphasized deficits in "higher" cognitive functions, including attention, executive function, as well as memory. In contrast, general consensus has viewed dysfunctions in basic perceptual processes to be relatively unimportant in the explanation of more complex aspects of the disorder, including changes in self-experience and the development of symptoms such as delusions. We present evidence from phenomenology and cognitive neuroscience that changes in the perceptual field in schizophrenia may represent a core impairment. After introducing the phenomenological approach to perception (Husserl, the Gestalt School), we discuss the views of Paul Matussek, Klaus Conrad, Ludwig Binswanger, and Wolfgang Blankenburg on perception in schizophrenia. These 4 psychiatrists describe changes in perception and automatic processes that are related to the altered experience of self. The altered self-experience, in turn, may be responsible for the emergence of delusions. The phenomenological data are compatible with current research that conceptualizes dysfunctions in perceptual processing as a deficit in the ability to combine stimulus elements into coherent object representations. Relationships of deficits in perceptual organization to cognitive and social dysfunction as well as the possible neurobiological mechanisms are discussed.
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PMID:Perceptual anomalies in schizophrenia: integrating phenomenology and cognitive neuroscience. 1711 73

Different studies have questioned the capacity of the categorical diagnostics to establish a clear distinction between the existence or not of a determined personality disorder. The dimensional perspective would approach more to reality, in the measure that it tries to measure the different intensity degrees in which these disorders are present in the patients. But its application is very laborious and besides, presupposes that those categories whose nuances it pretends to measure really exist. The foresaid leads us to appeal to phenomenological perspective, which seems to be more adequate for the study of complex realities, as it is the case of the personality and its disorders. The essential features of the phenomenological method in the sense of Husserl are described, as well as his contribution to the study of personality disorders. This can be summarized in three fundamental points: the ideal types, introduced in psychiatry by Karl Jaspers, the existential types, by Ludwig Binswanger, and the dialectic typologies and polarities, by Wolfgang Blankenburg and the undersigned. This author defines and develops each one of these concepts, aiming to show their advantages with respect to the categorical and dimensional systems.
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PMID:Personality disorders from a phenomenological perspective. 1828 95

The Swiss psychiatrist Ludwig Binswanger is known as the founder of the Daseinsanalyse (existential analysis) and more generally for having applied contemporary philosophical concepts and theories to psychiatry. The fortune of the philosopher Binswanger constituted a formidable obstacle to a historical scrutiny of his actual clinical practice. In the long run, the philosopher overshadowed the psychiatrist. The present paper takes the move from a "minor" work, an essay on the sterilisation of manic-depressive patients Binswanger published in 1938. This essay represents a rare exception in Binswanger's scientific production in many respects: for its editorial collocation, for the subject (a concrete medical intervention) and the complete absence of philosophical references. Nevertheless, or precisely for this reason, the essay has been largely ignored by the scholarship, both of Swiss eugenics and of Binswanger himself. This paper explores the epistemological circumstances of this negligence and its historiographic significance, with special attention to the philosophical-anthropological refashioning of a psychiatric myth.
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PMID:Philosophical whitewashing. Ludwig Binswanger (1881-1966) and the sterilisation of manic-depressive patients. 2233 41


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