Karl Jaspers: 100 years of General Psychopathology – reflection

I first read Jaspers' General Psychopathology as a trainee in Newcastle-upon-Tyne. I have returned to it as a resource for thinking through difficult concepts in psychopathology but mostly as a model of how to combine a humane yet exacting system of reasoning to psychiatry.

Karl Jaspers (1883-1969) was born into an upper-middle-class family. He was a sickly child but it was only in April 1901 that bronchiectasis was diagnosed. This was a lifelong condition that influenced his choice of career but also his outlook as he was not expected to live long. Jaspers studied medicine in Berlin, Göttingen and Heidelberg. At Heidelberg, he came into contact with many of the leading intellectuals of his day: Max Weber, Friedrich Gundolf, Georg Lukács, and Ernst Bloch. It was here, too, that he met Ernst Mayer whose sister, Gertrud, Jaspers married in 1910. Jaspers and Gertrud had remained in Heidelberg throughout the war years despite Gertrud being Jewish and it is a remarkable fact that they survived. Jaspers was retired as professor of philosophy at the end of September 1937 because of a Nazi law excluding from office any civil servant married to a Jew.

Jaspers is regarded as an existential philosopher influenced by Nietzsche and Kierkegaard. He is probably best known for The Question of German Guilt, a work dealing with the consequences of collaboration with the Nazis. He was a contemporary of Martin Heidegger, and influenced Hannah Arendt. Publication of General Psychopathology marked both the end of Jaspers' career in psychiatry and the beginning of his career in philosophy.

In the preface to the first edition, Jaspers wrote:

‘… in psychopathology it is dangerous merely to learn the matter, our task is not to ‘'learn psychopathology” but to learn to observe, ask questions, analyse and think in psychopathological terms. I would like to help the student to acquire a well-ordered body of knowledge, which will offer a point of departure for new observations and enable him to set freshly acquired knowledge in its proper place’.

It is clear from this quotation that Jaspers aimed for a methodology. His aim was to take an individual case and abstract from it broad concepts that assist in the description of distinguishable psychic phenomena such that these become communicable concepts. The special problem for psychopathology was that Man is not merely an animal but that he is conscious and self-aware.

Jaspers' influence in analysing the nature of explanatory theories and of causal explanations is less recognised. He exposed the risks to reasoning of analogies and metaphors in the construction of explanatory theories. He cites one fundamental error, namely that of transforming anatomical cerebral structures into fantastic mechanistic theories. This propensity remains with us even today.

It is apposite to ask whether psychopathology is still relevant. Whether Jaspers had said all that there was so say in 1913. General Psychopathology is often read as if it was a compendium of established (rigid) knowledge rather than a point of view that is open, flexible and provisional. And it is forgotten that Jaspers' real objective was to lay the foundations for an attitude, a method, rather than to foreclose inquiry.

Perhaps the need for psychopathology is even more urgent today, as the preoccupation with lists, check boxes and menus invariably leads towards a superficial and arid psychiatry where the subjective experience of the person who ought to be at the centre of our attention takes second place. At the same time, the most minimal dose of empathy, wonder or curiosity is deployed by the clinician.

This is the last of a series of articles to commemorate in this Journal the centenary of publication of Karl Jaspers' General Psychopathology. Other articles were published in January, February, April, June and August of this year.