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Published online by Cambridge University Press:  02 January 2018

M. Broome*
Affiliation:
Section of Neuroimaging, Division of Psychological Medicine, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF, UK
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Abstract

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Columns
Copyright
Copyright © Royal College of Psychiatrists, 2002 

I read Drs Bhui & Bhugra's (Reference Bhui and Bhugra2002) editorial with interest. The authors advocate a socio-anthropologically informed method for both clinical and academic psychiatry, an opinion with which I strongly agree and one that may have come to psychiatry earlier. If one returns to the pages of Jaspers' General Psychopathology (Jaspers, 1913, current edition in English translation Reference Jaspers, Hoenig and Hamilton1997), and his seminal paper ‘The phenomenological approach in psychopathology’ (Reference JaspersJaspers, 1912), there is a clear tension between his claim to practise a phenomenology of mental illness, where the transcendentally ideal mental state abnormalities are elucidated and described, and his call to ‘understand’ the patient's symptoms in the light of their world view. This latter approach owes much to his mentor Weber's conception of ‘ideal types’ and there is a clear debt to the hermeneutics and historicism of Dilthey in his suggestion that Verstehen (variously translated as interpretive understanding or empathy) is the correct method for psychopathology, rather than the phenomenology of Husserl (Reference BerriosBerrios, 1993). The approach of Husserl in Logical Investigations (1913, current edition in English translation Reference Husserl, Moran and Findlay2001) could be described as the search for certain features of consciousness that are ideal, pure and a priori and structure the meaning of experience and as such are true for all men at all times. Dilthey, in contrast, would argue for the contingency of world view which could only be viewed in others by a thorough, and possibly impossible, immersion in the meaningful structure of their lived environment — Verstehen (Reference OuthwaiteOuthwaite, 1986). This latter method is likely to be only partially successful, even in the hands of a very skilled practitioner, as in a very real sense, one's life can only ever be lived from ‘within’ and it is a question of degree as to how far an external observer could ever appreciate its subtleties. For the attempt to be made, however, would require a depth of knowledge of the various socio-anthropological models before an investigator could even begin to frame hypotheses regarding explanatory models of distress.

Thus, the insights of a sociologically and anthropologically informed psychopathology may have been with us sooner, rather than us constantly having to be on guard against seduction by the ideal forms of psychopathology handed down to us by Jaspers. After all, the psychotic disorders and their symptoms are unlikely to be wholly discrete entities and, similarly, psychosis lies along a continuum with normal reasoning and experiences.

References

Berrios, G. E. (1993) Phenomenology and psychopathology: was there ever a relationship? Comprehensive Psychiatry, 34, 213220.CrossRefGoogle ScholarPubMed
Bhui, K. & Bhugra, D. (2002) Explanatory models for mental distress: implications for clinical practice and research. British Journal of Psychiatry, 181, 67.CrossRefGoogle ScholarPubMed
Jaspers, K. (1912) Zeitschrift für die gesamte Neurologie und Psychiatrie, 9, 391408. English translation (1968) The phenomenological approach in psychopathology. British Journal of Psychiatry, 114, 1313–1323.CrossRefGoogle Scholar
Jaspers, K. (1997) General Psychopathology (trans. Hoenig, J. & Hamilton, M. W.). Baltimore, MD: Johns Hopkins University Press.Google Scholar
Husserl, E. (2001) Logical Investigations (ed. Moran, D., trans. Findlay, J. N.). London: Routledge.Google Scholar
Outhwaite, W. (1986) Understanding Social Life — The Method Called Versstehen (2nd edn). London: Jean Stroud.Google Scholar
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