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Daseinsanalytic Psychotherapy

by Gion Condrau

Daseinsanalysis owes its origin and development to the spiritual renewal in the wake of the two world wars. In the realm of psychiatry, a movement began in the twenties which was partly triggered by the discussions around Freudian psychoanalysis, partly by a scientific unease with regard to the traditional, systematizing, clinical psychopathology, and which was searching for a new understanding of the basics of human existence and its disturbances. The one-sided, natural-scientific orientation of psychiatry and psychotherapy, in particular, was the subject of heated criticism. This gave rise to the so-called "anthropological" psychiatry, initiated by renowned researchers such as Ludwig Binswanger, Viktor von Weizsäcker, Viktor von Gebsattel, Eugene Minkowski, Erwin Straus, Rollo May, R.D. Laing, and others.

Ludwig Binswanger (1881-1966) is considered the actual initiator of daseinsanalytical psychiatry. In the beginning, however, subsequent to his intense studies of Husserl's phenomenology, he called his research orientation "phenomenological anthropology." From 1941 onwards, he preferred "Daseinsanalysis" for his new scientific approach. At that time, Binswanger had already been decidedly influenced by Martin Heidegger's work, especially by the latter's book "Being and Time," published in 1927. Ludwig Binswanger's main oeuvre "Grundformen und Erkenntnis menschlichen Daseins" (basic forms and perception of human Dasein) was published in 1942. This was followed by a whole series of publications on Daseinsanalysis, the language and behavior of schizophrenics as well as studies on melancholy and mania. It has to be mentioned that Binswanger was also influenced by Sigmund Freud with whom he maintained a life-long friendship, even though he disagreed with the main issues of psychoanalytical theory.

After World War II, a School of Daseinsanalysis that differed from Binswanger evolved in Zurich. Its primary concern was the practical application of Heidegger's phenomenology to the theory of neuroses and psychotherapy. Medard Boss (1903-1990) had managed to interest Heidegger personally for the concerns of psychotherapists, and to make him participate in the corresponding training program. To begin with, this led to a discussion and critique of the metapsychology of Freudian psychoanalysis and C.G. Jung's analytical psychology. While Boss, in his first daseinsanalytical publications was clearly under the influence of Ludwig Binswanger, he quite abruptly distanced himself from the latter. In 1957, after a conference in Madrid, Boss published a decisive critique of Freud, Jung, and Binswanger which, unfortunately led to a split between the two scientists. Binswanger felt betrayed by Boss as well as by Heidegger, and from then on referred more to Husserl, while Boss was sponsored by Heidegger, with whom he developed a personal and scientific friendship. While Binswanger overtly refused to institutionalize his "psychiatric Daseinsanalysis" and concentrated on basic research (rather than on psychotherapeutic values), Medard Boss, together with Gion Condrau, founded the Swiss Society for Daseinsanalysis in 1970 and the Zurich Institute for Daseinsanalytic Psychotherapy and Psychosomatics in 1971, later known as Medard Boss Foundation. From 1959 to 1968, Heidegger visited Boss in Zollikon where he held the famous, world-renowned "Zollikon Seminars." In 1984 the Swiss Professional Federation for Daseinsanalysis has been founded in Zurich.

Consequently, Daseinsanalysis as psychotherapy is based on Martin Heidegger's ontology and on his phenomenological view of the human being's existence as the area of openness of Dasein to everything it encounters. This means that human Dasein is, on principle, open and free to perceive everything undistorted which discloses itself naturally from its meaning-content. In this aspect, phenomenology differs from the dualistic world view of natural sciences which ultimately are based on the philosophy of René Descartes according to which an unbridgable chasm exists between the human mind and measurable matter.

Such a view of the nature of human being necessarily leads to a new anthropology, i.e. a science detached from a purely natural-scientific reduction, but equally so from metapsychological speculations. Whereas biology can only grasp a partial aspect of human existence, metapsychology of the positivistic school - according to the daseinsanalytical view - relinquishes the ground of visible reality.

This has consequences for therapy. In a certain sense, Daseinsanalysis can be seen as a further development of psychoanalysis. The extemal setting has been kept more or less unchanged. There are, however, substantial differences concerning the interpretation of symptoms, behaviour, and dreams. In those areas, Daseinsanalysis proceeds phenomenologically; it does without causal-genetic interpretations and, instead, inquires more intensely into the meaning and meaning-content of the observed phenomena. The concem of Daseinsanalysis is to see (sehen), not to explain (erklären). The importance and meaning of this "Seeing" becomes manifest in the theory of neuroses and psychosomatic diseases.

There is no doubt that Martin Heidegger's thinking has influenced psychotherapeutic theory and practice to an extent that cannot be ignored (see Gion Condrau: Martin Heidegger's Impact on Psychotherapy, New York, Vienna 1998). The Zurich school of Daseinsanalysis has explored many times the possibilities of translating the word "Dasein" into other languages, especially into French and English. We came to the conclusion that "Dasein" as such loses its intrinsic meaning by any attempt at translation. We therefore decided to keep the term "Daseinsanalysis" in order to differentiate it from the so-called existential, interpersonal, or humanistic psychotherapies since it refers uniquely to Martin Heidegger's ontological analytic of Dasein. Of course, when we speak of theory and practice, we move on a scientific, not philosophical ground, but as Heidegger himself always maintained, and also repeatedly stated at the time of his seminars in Zollikon, every science has its roots in philosophical tenets. This is equally valid for the natural sciences, as for any other scientific approach, even if these roots are not specifically acknowledged or mentioned. Daseinsanalysis, according to its global view, tries to overcome the Cartesian dualism of subject and object, therefore also the dualism of psyche and soma. Insofar, we do not speak of psychogenetic or somatogenetic diseases, although for the sake of mutual understanding, Daseinsanalysis still keeps the term "psychosomatics." The daseinsanalytic approach to human suffering is a phenomenological one. Phenomenology, as Heidegger defines it (unlike Edmund Husserl) is not a question of conscience but a question of insight which means that it refrains from interpretations and lets the phenomena speak for themselves. In this respect, of course, it differs from psychoanalytic or Jungian theories, although it has adopted some of the practical recommendations, especially from Freud.

Modern scientists, psychiatrists, psychologists, and doctors have mostly lost sight of the real importance of the obvious. They often overlook the richness of what can be immediately experienced, and concentrate on coming as soon as possible to an indirect, background-based, theoretical explanation of all they meet, thereby making their object of investigation calculable and thus also reproducible. In contrast to this is the phenomenological or existential analytical approach, which emphasizes a simple experience of the perceived phenomena. lt dwells on the very matter to be explored, always trying to grasp its meaning more explicitly. It is thus in an excellent way 'objective' or real. The right to a special position in the field of psychiatry, psychology, psychotherapy, and psychosomatics derives from the fact that all these sciences principally have to do with the human being. Less than anything else can human being be dissolved into calculable quantities. The priority of the existential analytical scientific method in these areas has its further basis in the nature of the neurotic, psychosomatic and psychotic way of being ill. This, in its essence, is primarily not founded on countable quantities, as would be the case if natural sciences dealt with them. lt can only be understood through insight in the incalculable qualities of the always different, disturbed, of key and unfree relationships, of the individual patient to the eventualities of his world. This, of course, does not exclude, but includes the fact that, by methods of natural science, data can be found in the existence of human beings both healthy and sick, which can be useful and somatically important. But by this method, one never finds the specifically human cause of being healthy and sick.

lt is obviously not correct - as occasionally is done - to put existential analysis as 'philosophy' in contrast to psychoanalysis as 'science'. They both are sciences of the human being, both so-to-say 'anthropologies;' they both belong to psychiatry, psychology, and psychotherapy. This still is so in a time when the more narrow meanings of the medical terms 'disease' and 'health' have been expanded by the sociological point of view. Today, psychiatrists, psychologists, and psychotherapists are not satisfied with merely formulating theories. Increasingly, they ask about the sense and meaning of what is sick and has to be healed. To clear the relationship between body and soul, and to try to escape the blind alley of the dualistic way of looking upon life, they are forced to consult philosophers in order to perceive better the existence of the human being. Every attempt at explaining and acting of human beings, including the psychological and medical sciences, relies on presuppositions that are philosophical and pre-scientific.

By considering these philosophical presumptions, the quality of the practical work of the psychiatrist and the psychotherapist is established, because their work is certainly influenced by their way of understanding the world.

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