Existential Foundations of Medicine and Psychology - Medard Boss

COMMENTARY

New directions in science and psychology are in the wind for America in the 1980s. Boss has always been ahead of his time, and the psychiatric and psychological fraternities will catch up with him, perhaps toward the latter part of this decade. F o r now, most col­ leagues will approach this b o o k with predispositions, preconcep­ tions, and prior prejudices, thus giving the b o o k short shrift. To do so will prove a point that Boss makes repeatedly in his b o o k : one's preconceptions (world view, prior philosophical picture of the world, or theoretical disposition) guide one to recognize as valid only that which falls within or supports the preconceptions. Gerald Epstein

Existential Foundations of Medicine and Psychology

by MEDARD B O S S

translated from the

German

by Stephen Conway and Anne Cleaves with an introduction by Paul J. Stem

NEW Y O R K

•

JASON ARONSON

•

LONDON

M

Copyright© !

1 9 8 3 , 1979 b y M e d a r d Boss ir ,

All rights reserved. Printed in the U n i t e d States of A m e r i c a . No part of this b o o k m a y be used or reproduced in any m a n n e r whatsoever without writ­ ten permission from Jason Aronson, Inc. except in t h e case of b r i e f quota­ tions in reviews for inclusion in a magazine, newspaper or broadcast.

N e w Printing 1 9 8 3

ISBN: 0-87668-667-6

Library o f C o n g r e s s C a t a l o g N u m b e r : 8 4 - 2 8 2 2

Manufactured in the U n i t e d States of A m e r i c a .

CONTENTS

Introduction to the English Translation Preface to t h e First Edition Preface t o t h e S e c o n d Edition Introduction

ix xxiii xxv xxvii

Part I: T h e Traditional Foundation of Medicine Chapter

1.

A Test Case: Regula Zürcher

3

Chapter

2.

T h e Natural Scientific View of Medicine

19

Chapter

3.

T h e N a t u r a l S c i e n t i f i c V i e w o f P s y c h o l o g y and Psychosomatics

33

vi

EXISTENTIAL FOUNDATIONS

Chapter

4.

Applying T h i s V i e w t o R e g u l a Z i i r c h e r

43

Chapter

5.

T h e Fundamental Conditionality of P s y c h o l o g y and P s y c h o s o m a t i c s

57

Part II: An Adequately H u m a n Foundation for Medicine Chapter

6.

Applying t h e E x i s t e n t i a l O u t l o o k t o S o m e Aspects of the Test Case

81

Chapter

7

Fundamental Characteristics of Human Beings

85

Chapter

8.

A n E x i s t e n t i a l S t u d y o f the B a s i c C o n c e p t s o f B i o l o g y , P h y s i o l o g y , and P s y c h o l o g y

127

Chapter

9.

C r i t i c i s m s o f a n E x i s t e n t i a l M e t h o d o f Medical Investigation

155

T r a n s i t i o n a l Difficulties i n U n d e r s t a n d i n g Daseinsanalytic Insights

161

Chapter 10.

Part III: T h e R u d i m e n t s of an Existential G e n e r a l Pathology Chapter 11.

Testing an Existential Research M e t h o d on S e v e r a l P a t h o l o g i c a l P h e n o m e n a o f the T e s t Case

167

Chapter 12.

G e n e r a l D a s e i n s a n a l y t i c Etiology and Pathogenesis

191

C h a p t e r 13.

A General Daseinsanalytic Phenomenology of Illness

197

( haptei

A D a s e i n s a n a l y t i c E x a m i n a t i o n of S o m e Prevailing, C o n c e p t s o f G e n e r a l P a t h o l o g y

241

it

Contents

vii

Part IV: Suggestions for a Daseinsanalytic T h e r a p y Preliminary Remarks

249

Chapter 15.

T h e Patient to Be Treated

251

Chapter 16.

T h e " L o c u s " of the Therapeutic Interaction ("Transference")

257

Chapter 17.

T h o s e W h o Are Therapeutically Active

273

Afterword:

T h e F o u n d a t i o n s o f a Ds-sein-Based S o c i a l P s y c h o l o g y and Social P r e v e n t i v e M e d i c i n e in M o d e r n Industrial S o c i e t y

285

Index

299

INTRODUCTION TO THE ENGLISH TRANSLATION

Existential Foundations of Medicine and Psychology is M e d a r d B o s s ' s m a g n u m o p u s . Ideas set f o r t h in e a r l i e r w o r k s s p a n n i n g t h i r t y y e a r s a r e developed in t h e p r e s e n t v o l u m e and w o v e n i n t o a richly t e x t u r e d w h o l e . I f t o b e "radical" m e a n s — a s t h e w o r d ' s e t y m o l o g y s u g g e s t s — t o g o t o t h e r o o t s of t h i n g s , this is u n d o u b t e d l y a radical b o o k . It p r o p o s e s n o t h i n g less t h a n d e m o l i s h i n g t h e n a t u r a l s c i e n c e paradigm t h a t u n d e r l i e s m o d e r n m e d i c i n e , and replacing it by a radically different o n e t h a t is b a s e d upon H e i d e g g e r ' s o n t o l o g y of Da-sein. P r o f e s s o r B o s s is in e a r n e s t a b o u t this r e v o l u t i o n a r y e n t e r p r i s e . T h e i n t e n t o f t h e p r e s e n t w o r k is to h u m a n i z e m e d i c i n e by giving it a n e w existential f o u n d a t i o n and to a r t i c u l a t e t h e vast t h e o r e t i c a l and practical c o n s e q u e n c e s of such a changeover. L e s t t h e r e a d e r be put o f f by t h e s h e e r a m b i t i o u s n e s s of Foundations, let him be r e a s s u r e d at t h e o u t s e t t h a t D r . B o s s is n e i t h e r a naive v i s i o n a r y n o r a f a n a t i c . While u n s p a r i n g in his e x p o s u r e of t h e s h o r t c o m i n g s of m o d e r n n a t u r a l - s c i e n t i f i c m e d i c i n e , B o s s is far from d e n y i n g its brilliant a c c o m p l i s h m e n t s . Even if s u c h a t h i n g w e r e possible, he w o u l d n o t w a n t t o d o a w a y w i t h t h e vast b u r g e o n i n g m a c h i n e r y o f m o d e r n m e d i c i n e . H e m e r e l y q u e s t i o n s t h e i m p e r a t i v e s t h a t the prevailing f o r m s o f p r e s e n t day medical practice s e r v e , and t h e p r e s u p p o s i t i o n s a b o u t h u m a n n a t u r e upon w h i c h t h e y a r e built. I n t h e r e c o n s t r u c t e d m a n s i o n o f medicine e r e c t e d b y B o s s , t h e r e i s ample and h o n o r a b l e r o o m for medical p r a c t i c e

X

EXISTENTIAL

FOUNDATIONS

as c o n s t i t u t e d today. F r a c t u r e d b o n e s will still h a v e to be set, m a j o r i n f e c t i o n s t o b e c o n t a i n e d b y a n t i b i o t i c s o r o t h e r a g e n t s , and t u m o r s t o b e excised o r t r e a t e d b y c h e m o t h e r a p y . B u t b o t h t h e scope and the u l t i m a t e m e a n i n g o f t h e s e and o t h e r traditional medical i n t e r v e n t i o n s would b e s t r i n g e n t l y redefined i n t h e D a s e i n s a n a l y t i c f r a m e w o r k p r o p o s e d b y Boss. B o s s ' s e f f o r t s at a t h o r o u g h g o i n g r e f o r m of m e d i c i n e (and p s y c h o l o g y ) a r e fueled, as a t t e m p t s of this n a t u r e usually a r e , by a vivid s e n s e of crisis, s h a r e d b y m a n y o f B o s s ' s m o s t e m i n e n t c o l l e a g u e s . His o w n c o n c e r n i s not primarily with t h e m u c h - d e b a t e d b a c k l a s h p h e n o m e n a — s u c h a s t h e proliferation of I a t r o g e n i c illness and the g r o w i n g i n t r a c t a b i l i t y of side e f f e c t s produced b y the t r i u m p h a n t e x t e n s i o n o f m o d e r n t e c h n i q u e s o f medical i n t e r v e n t i o n . N o r does B o s s focus o n t h e c o m p l e x p r a g m a t i c and e t h i c a l issues raised by t h e v e r y a d v a n c e s of medical t e c h n o l o g y , e.g., t h e issue a b o u t w h e n t o r e m o v e life-support s y s t e m s o r w h e n t o p r o n o u n c e a dying patient dead. B o s s ' s focus is e l s e w h e r e . To t h e e x t e n t he looks at t h e s e issues at all, he r e g a r d s t h e m as s y m p t o m a t i c of a m u c h m o r e g e n e r a l crisis g o i n g far b e y o n d the c o n f i n e s o f m e d i c i n e — a c u l t u r a l c r i s i s t h a t involves t h e u l t i m a t e q u e s t i o n o f w h a t i t m e a n s t o b e h u m a n . T h e issue, in o t h e r w o r d s , is t h e v e r y self-definition of m a n . A n d t h e u r g e n c y of t h e crisis is s u c h t h a t it calls for t h e m i n i s t r a t i o n s of the physician of last r e s o r t of sick c i v i l i z a t i o n s — t h e p h i l o s o p h e r . It is in the forbidding, and s e e m i n g l y e s o t e r i c o n t o l o g y of M a r t i n H e i d e g g e r t h a t B o s s and a few like-minded clinicians d i s c o v e r t h e e l e m e n t s for a r e c o n s t r u c t e d s c i e n c e o f man. To clear t h e g r o u n d for a n e w b e g i n n i n g , H e i d e g g e r found it n e c e s s a r y to demolish t h e proud office of D e s c a r t e s ' s p h i l o s o p h y w h i c h , in its t u r n , had o p e n e d up and s h e l t e r e d a place for the a l m o s t m i r a c u l o u s g r o w t h of W e s t e r n n a t u r a l s c i e n c e . A s H e i d e g g e r s a w it, t h e p r e c o n d i t i o n for this e f f l o r e s c e n c e , and also t h e p r i m e c a u s e o f m a n ' s p r e s e n t m e t a p h y s i c a l u p r o o t e d n e s s , w a s D e s c a r t e s ' s d i c h o t o m i z i n g of m a n into res cogitans ("mind") and res extensa ( " m a t t e r " ) and the s h a r p o p p o s i t i o n he posited b e t w e e n t h o s e t w o f u n d a m e n t a l r e a l m s . H e i d e g g e r ' s polemic a g a i n s t C a r t e s i a n dualism, w h i c h h e v i e w e d a s p e r n i c i o u s , and t h e a t t e m p t t o o v e r c o m e it, is a m a j o r s t r a n d of H e i d e g g e r ' s w o r k . It is t h e strand m o s t relevant to B o s s ' s c h a l l e n g e to m o d e r n m e d i c i n e . I [eideggei and B o s s a r g u e t h a t by placing t h e h u m a n body s q u a r e l y w i l l i m the realm of res extensa, of s p a c e - o c c u p y i n g m a t t e r s u b j e c t to m e t li.inic .il laws, I ) e s c a r t e s e n s u r e d t h e s u b s e q u e n t , practically unlimit­ ed use ol natural science m e t h o d o l o g y in e x p l o r i n g t h e h u m a n b o d y . ["he history ol medicine o v e r the last t h r e e c e n t u r i e s d e m o n s t r a t e s beyond any r e a s o n a b l e doubt that the h u m a n body can indeed be explored, and mosl successfully so, willim the c a t e g o r i e s and by the 1

Introduction to the English Translation

xi

m e t h o d s of n a t u r a l s c i e n c e — u p to a point. It is this "up to a p o i n t " t h a t c o n s t i t u t e s t h e rub for H e i d e g g e r and B o s s . T h e n a t u r a l s c i e n c e grid s u p e r i m p o s e d upon t h e h u m a n body does indeed reveal s t r u c t u r e s , r e l a t i o n s h i p s , and s e q u e n c e s o f e v e n t s w o r t h k n o w i n g , and t h e k n o w l e d g e thus g a i n e d is useful in fighting disease. B u t H e i d e g g e r asks w h e t h e r t h e reductive paradigm of n a t u r a l s c i e n c e really does yield or further comprehension of what is most characteristic of the human being and o f t h a t realm o f h u m a n e x i s t e n c e w h i c h w e call the bodily s p h e r e . E x t e n d i n g t h e a r g u m e n t , B o s s i n q u i r e s if a medical s c i e n c e fully c o g n i z a n t o f the e x i s t e n t i a l h u m a n c h a r a c t e r i s t i c s a r t i c u l a t e d b y H e i d e g g e r would n o t b e m o r e e f f e c t i v e i n c o m i n g t o t e r m s w i t h disease t h a n medical s c i e n c e based o n t h e a s t r i n g e n t n a t u r a l s c i e n c e paradigm. A n d , B o s s g o e s on to s u g g e s t , s u c h a revitalized s c i e n c e of m e d i c i n e m i g h t e v e n discover m e a n i n g (of a n e x i s t e n t i a l n a t u r e ) i n b o u t s o f illness w h i c h , v i e w e d w i t h i n t h e c o n t e x t o f t h e o r t h o d o x paradigm, are fortuitous. 2

T h o m a s K u h n h a s pointed o u t t h a t n o s c i e n c e , e v e n d u r i n g s e t t l e d periods of its h i s t o r y is e v e r e n t i r e l y free of t r o u b l e spots ("anomalies") t h a t r e s i s t a s s i m i l a t i o n b y t h e prevailing paradigm. A s long a s t h e s e z o n e s of i n t r a c t a b i l i t y a r e f e w , c i r c u m s c r i b e d , and p e r c e i v e d as fairly p e r i p h e r a l , t h e y pose little t h r e a t t o o r t h o d o x y . Y e t e a c h o n e o f t h e s e z o n e s can b e c o m e t h e s t a g i n g a r e a for i n v e s t i g a t i o n s t h a t g r a d u a l l y e r o d e t h e prevailing f r a m e w o r k of m e t a t h e o r y . It will be discarded, h o w e v e r , if a sizable n u m b e r of s c i e n t i s t s c o m e to feel t h a t t h e i r field is indeed in a s t a t e o f crisis, t h a t t h e a n o m a l i e s p r e v i o u s l y perceived a s i n c o n s e q u e n t i a l do in fact m a t t e r . T h e r e m u s t also be a p o t e n t i a l r e p l a c e m e n t w a i t i n g in t h e w i n g s — a n e w p a r a d i g m t h a t solves a n u m b e r o f p r o b l e m s insoluble u n d e r t h e old d i s p e n s a t i o n . In t h e field of m e d i c i n e , o n e of t h e p r o b l e m a r e a s h a s b e e n for a long t i m e t h e r e a l m o f m e n t a l illness. T h e s e illnesses w e r e d i s c o n c e r t i n g for t h e C a r t e s i a n paradigm i n t h a t t h e y s e e m e d t o b e p r i m a r i l y diseases o f t h e cogito w i t h o u t definite s o m a t i c locus. T h e medical s t r u c t u r e built upon t h a t p a r a d i g m had a hard t i m e coping w i t h this n o t i o n of l a r g e l y d i s e m b o d i e d illness, and its leading n i n e t e e n t h - c e n t u r y s p o k e s m e n used t h e d i s c o v e r y of t h e syphilitic a n t e c e d e n t s of paresis to p o s t u l a t e t h a t all m e n t a l illness w a s o f s o m a t i c origin. T h a t " m e n t a l d i s e a s e s are, a t b o t t o m d i s e a s e s o f t h e b r a i n " h a s b e e n o n e o f t h e m o s t widely a c c e p t e d articles o f faith o f m o d e r n p s y c h i a t r y . T h e a x i o m a t i c value a t t a c h e d t o this d o g m a w a s s o s t r o n g t h a t its lack o f empirical s u p p o r t s e e m e d o f m i n o r c o n s e q u e n c e . I n e v i t a b l y , f u t u r e a d v a n c e s in t h e u n d e r s t a n d i n g of n e u r o a n a t o m y and n e u r o p h y s i o l o g y would provide the (as y e t ) missing c l u e s . Even Freud, the r e d i s c o v e r e r o f the p r i m a c y o f psychic factors

xii

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a m o n g t h e a n t e c e d e n t s o f m a j o r f o r m s o f m e n t a l illness, e m b r a c e d this s o m a t i c prejudice. A t t i m e s h e s e e m e d t o v i e w e v e n n e u r o s e s a s u l t i m a t e l y o r g a n i c in n a t u r e and p s y c h o a n a l y s i s as a t e m p o r a r y e x p e d i e n t to be replaced in t i m e by m o r e direct, s o m a t i c m e t h o d s of treatment. It w a s precisely F r e u d i a n t h e o r y and m e t a p s y c h o l o g y t h a t for p h e n o m e n o l o g i c a l and e x i s t e n t i a l i s t r e s e a r c h e r s b e c a m e t h e t e s t case for t h e l i m i t a t i o n s o f t h e n a t u r a l science paradigm i n p s y c h i a t r y . T h u s Ludwig B i n s w a n g e r a r g u e d t h a t Freud's u n d e r l y i n g n o t i o n of homo natura, of m a n seen in t h e n a t u r a l s c i e n c e f r a m e w o r k , w a s at a loss to a s s i m i l a t e w i t h o u t u n d u e d i s l o c a t i o n t h e historical d i m e n s i o n s o f h u m a n e x i s t e n c e h i g h l i g h t e d b y p s y c h o a n a l y t i c p r a c t i c e . P s y c h o a n a l y t i c m a n , w i t h his c o n s c i o u s and u n c o n s c i o u s w i s h e s , his n e e d to u n d e r s t a n d and to r a t i o n a l i z e , his h i s t o r y unfolding in t i m e , his a f f i r m a t i o n s and denials, his e n t a n g l e m e n t s and d i s e n g a g e m e n t s — t h i s m a n did n o t fit into t h e P r o c r u s t e a n c o n c e p t of homo natura. B i n s w a n g e r implied (and B o s s w a s later to e x t e n d t h e a r g u m e n t ) t h a t Freud had b e e n a practicing e x i s t e n t i a l i s t w h i l e t h e o r i z i n g like a n a t u r a l s c i e n t i s t . Freud's u n w i t t i n g r e v e l a t i o n o f t h e i n a d e q u a c y o f t h e ruling paradigm signaled t h e s t a t e o f crisis in p s y c h i a t r y and g e n e r a l m e d i c i n e . It is hardly a c c i d e n t a l t h a t , by and l a r g e , this s t a t e of crisis w a s m o s t k e e n l y felt b y a n u m b e r o f p s y c h i a t r i s t s . W h e r e a s i n t e r n i s t s , s u r g e o n s , n e u r o l o g i s t s , c a r d i o l o g i s t s , and o t h e r p r a c t i t i o n e r s w h o deal directly w i t h t h e v a g a r i e s of palpable h u m a n tissue are apt to look to t h e perfectibility o f specific medical t e c h n i q u e s w h e n i n t r a c t a b l e medical p r o b l e m s stop t h e m cold, t h e p s y c h o t h e r a p i s t p e r p l e x e d b y the r e p e a t e d failures of his s t o c k in trade is apt—to b e c o m e a p h i l o s o p h e r . T h i s is exactly what happened to Medard Boss. A t r a i n e d psychoanalyst, personally acquainted with Freud, Boss came over the years to resent the "strenuous mental acrobatics" imposed by p s y c h o a n a l y s i s upon a n a l y s t s and a n a l y s a n d s alike. O n l y b y c e a s e l e s s m e n t a l c o n t o r t i o n s , B o s s felt, could t h e i n t e r p e r s o n a l p h e n o m e n a o b s e r v e d in p s y c h o a n a l y t i c practice be fitted i n t o t h e f r a m e w o r k of Freudian t h e o r i e s . H e e x p e r i e n c e d a p r o f o u n d s e n s e o f liberation w h e n h e first c a m e a c r o s s B i n s w a n g e r ' s p h e n o m e n o l o g i c a l c r i t i q u e o f t h e Freudian paradigm. A t t h e t i m e h e d i s c o v e r e d B i n s w a n g e r , B o s s w a s particularly u n e a s y a b o u t t h e h i g h h a n d e d f a s h i o n i n w h i c h Freudian analysis dealt w i t h t h e p h e n o m e n a o f d r e a m s . N o w , his sight s h a r p e n e d as a r e s u l t of B i n s w a n g e r ' s a c u t e o b s e r v a t i o n s , B o s s began to " u n d e r s t a n d t h a t Freud had b e e n compelled t o i n v e n t his w h o l e t h e o r y o f d r e a m s , as well as his n o t i o n of an ' u n c o n s c i o u s , ' b e c a u s e as a child of his era he felt required to s u b j e c t the dream p h e n o m e n a , t o o , to the . . .

Introduction to the English Translation

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n a t u r a l scientific d o g m a o f a c o n t i n u o u s causal n e x u s b e t w e e n everything that exists. D o u b t after doubt about Freud's theoretical m e t a p s y c h o l o g y ' n o w b e g a n t o assail m e . H o w w a s i t t h a t Freud had e v e n i n v e n t e d t h e label of ' m e t a p s y c h o l o g y , ' t h a t is, a p s y c h o l o g y b e y o n d p s y c h o l o g y ? ' M e t a ' ? O b v i o u s l y b e c a u s e h e w a s i n t e n t upon o v e r s t e p p i n g w h a t w a s actually e x p e r i e n c e d and p e r c e i v e d . " 3

I f B i n s w a n g e r ' s c r i t i q u e o f F r e u d ' s t h e o r e t i c a l t r a n s g r e s s i o n s fell upon fertile g r o u n d for B o s s , his singling o u t o f p h e n o m e n o l o g y a s t h e p r o p e r a p p r o a c h t o t h e study o f m a n p r o v e d t o b e o f e v e n m o r e c o n s e q u e n c e . W h e n , a f t e r a long and u l t i m a t e l y disappointing d e t o u r via C a r l J u n g , B o s s finally c a m e t o grips directly w i t h H e i d e g g e r ' s o n t o l o g y , h e a t first felt philosophically o v e r t a x e d , b u t t r e m e n d o u s l y e x c i t e d as well. His i n t u i t i o n seizing u p o n islets of m e a n i n g in a vast sea of i n c o m p r e h e n s i o n , told h i m t h a t h e had c o m e u p o n s o m e t h i n g m o m e n t o u s . A p r o c e s s o f t o t a l i m m e r s i o n i n t o H e i d e g g e r ' s o n t o l o g y , f u r t h e r e d l a t e r by a close friendship with the philosopher, enabled Boss to articulate by degrees w h a t h e had i n t u i t e d r i g h t a w a y . N o t o n l y did H e i d e g g e r ' s o n t o l o g y p r o p o s e a r e c o n s t r u c t e d i m a g e of m a n t h a t boldly a b o l i s h e d long e n t r e n c h e d a n t i n o m i e s , but this i m a g e also p r o v e d t o b e a m a z i n g l y r e l e v a n t and applicable directly to p s y c h i a t r y and p s y c h o l o g y . In clinical a r e a a f t e r clinical a r e a , B o s s d e m o n s t r a t e d t h e p o w e r o f H e i d e g g e r ' s ideas t o i l l u m i n a t e t h e h u m a n r e a l i t i e s and u n r e a l i t i e s w i t h w h i c h t h e p s y c h i a t r i s t finds h i m s e l f at grips in his daily w o r k . T h u s H e i d e g g e r ' s so-called e x i s t e n t i a l s provided t h e basis for a n e w p s y c h o d i a g n o s t i c s c h e m e . M o r e i m p o r t a n t l y , his Daseinsanalytik directly c h a l l e n g e d and led to a radical redefinition of s u c h f u n d a m e n t a l n o t i o n s a s reality and r e a l i t y - t e s t i n g , dispensed w i t h w h a t e v e r philosophical respectability such concepts as the unconscious or repression might have a c q u i r e d , and h i g h l i g h t e d t h e sterility w i t h w h i c h v a r i o u s c h r o n i c p r e o c c u p a t i o n s had p r e v i o u s l y b e e n f r a m e d — s u c h a s t h e b o d y - m i n d q u e s t i o n . H e i d e g g e r ' s t r e n c h a n t philosophical analysis m a d e explicit b y B o s s , e n d e d up by leveling, to a large d e g r e e , traditional d i s t i n c t i o n s b e t w e e n psychic and o r g a n i c illness. T h e leveling o f t h e traditional p a r t i t i o n s b e t w e e n p s y c h i a t r y and g e n e r a l m e d i c i n e w a s t h e inevitable corollary. T h e first b o o k b y M e d a r d B o s s t o r e f l e c t his H e i d e g g e r i a n approach w a s Meaning and Content of Sexual Perversions, published in 1 9 4 7 . T h i s b o o k , subtitled "A Daseinsanalytic Contribution to the Psychopathology of the P h e n o m e n o n o f L o v e , " p r e s e n t e d p h e n o m e n o l o g i c a l c a s e studies o f six c a t e g o r i e s o f s e x u a l d e v i a n t s . T h e s e case studies w e r e n o t e w o r t h y for t h e w a y in w h i c h t h e Gestalt, t h e e x i s t e n t i a l p a t t e r n i n g , of individual h u m a n lives w a s p e r m i t t e d to a r t i c u l a t e itself, as it w e r e , u n d i m m e d by

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t h e r e f r a c t i n g m e d i u m o f i n t r u s i v e e x p l a n a t o r y t h e o r i e s . While t h e s e c a s e studies b y t h e m s e l v e s offered striking t e s t i m o n y for the t e x t u r a l r i c h n e s s and c o m p r e h e n s i v e g r a s p yielded b y the D a s e i n s a n a l y t i c approach, B o s s ' s m o r e g e n e r a l o b s e r v a t i o n s a b o u t t h e p s y c h o p a t h o l o g y o f s e x w e r e equally a r r e s t i n g . A s s t a r t i n g p o i n t for his e x p l o r a t i o n B o s s used a description of w h a t he viewed as t h e ideal n o r m of love. To a t t a i n to t h e dual m o d e of loving e x i s t e n c e w i t h its t r a n s c e n d e n c e of selfa b s o r b e d s i n g u l a r i t y , a c c o r d i n g to B o s s a person m u s t be capable of m a t u r e s u r r e n d e r o f t h e s e l f and m u s t freely e m b r a c e his spiritual a s well a s his s e n s u a l p o t e n t i a l i t i e s o f being. T h o s e w h o e x h i b i t m a j o r s e x u a l p a t h o l o g y a r e , in B o s s ' s v i e w , psychically impaired; trapped in a n a r r o w a s t r i n g e n t world, t h e y y e t s t r i v e t o a t t a i n , i n t h e face o f g r e a t o u t e r and i n n e r o b s t a c l e s , as m u c h as t h e y can of love's r i c h n e s s , in t h e only w a y o p e n t o t h e m : t h e d e v i a n t s e x u a l act. S u c h a c t s , i n o t h e r w o r d s , w e r e s e e n by Boss as tortured attempts to come to terms with personality defects t h a t prohibit t h e a c t u a l i z a t i o n o f t h e dual m o d e o f e x i s t e n c e . Y e t e v e n these impoverished erotic configurations are illuminated—as Boss d o c u m e n t e d in his case s t u d i e s — b y at least part of t h e aura i n t r i n s i c to fully realized loving t r a n s c e n d e n c e . " T h e o m n i p o t e n c e of love is p e r h a p s n o w h e r e m o r e e v i d e n t t h a n i n t h e s e , its a b e r r a t i o n s . " Freud's o b s e r v a ­ tion w a s amply c o n f i r m e d b y B o s s ' s study o f s e x u a l p a t h o l o g y . 4

I n his n e x t b o o k , B o s s e x t e n d e d t h e r e a c h o f D a s e i n s a n a l y s i s t o t h e r e a l m o f d r e a m s . O n c e m o r e , h e t o o k F r e u d a s his point o f r e f e r e n c e . F r e u d a c c o m p l i s h e d m u c h i n r e s c u i n g the r e a l m o f d r e a m i n g from the d i s r e p u t e i n t o w h i c h it had fallen a m o n g his positivistic c o n t e m p o r a r i e s . V i e w i n g t h e d r e a m as a m a j o r bridge b e t w e e n t h e d o m a i n s of t h e c o n ­ s c i o u s and the u n c o n s c i o u s , F r e u d w a s able t o s h o w t h a t t h e s e g o s s a m e r c r e a t i o n s of sleep could be made to yield i m p o r t a n t m e s s a g e s by m e a n s of p s y c h o a n a l y t i c m a n i p u l a t i o n s . In a s e n s e , F r e u d t h u s r e i n s t a t e d t h e reality of d r e a m s . Y e t , as B o s s w a s to point o u t , o n l y to a d e g r e e . Freud c o n t i n u e d t o regard t h e d r e a m from t h e s t a n d p o i n t and w i t h the c a t e g o r i e s o f t h e w a k i n g s t a t e , w i t h o u t e v e r allowing t h e d r e a m r e a l m t o c h a l l e n g e t h e claim t o c l e a r - c u t p r e e m i n e n c e o f the w a k i n g world. ( T h e t h o u g h t t h a t such a c h a l l e n g e w a s possible hardly o c c u r r e d to h i m . ) W h i l e c o n f e r r i n g upon t h e d r e a m t h e s t a t u s o f being " p s y c h o l o g i c a l l y r e a l , " Freud t o o k it for g r a n t e d t h a t this m e r e l y psychological reality w a s s u b s t a n t i a l l y less real t h a n the solid reality of w a k i n g . In his b o o k on d r e a m s B o s s s h o w e d t h a t Freud's a priori a s s u m p t i o n s a b o u t d r e a m reality's lack o f a u t o n o m y vis-a-vis t h e w a k i n g s t a t e led him to use p r o c e d u r e s t h a t w e r e needlessly h i g h h a n d e d and forceful in dealing with d r e a m s . T r e a t i n g the d r e a m as a m a s t e r of deception, Freud tore aparl its web, f r a g m e n t i n g and shredding it. Impatient with the

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s y m b o l i c disguises he i m p u t e d to t h e d r e a m , F r e u d ripped t h e s e s y m b o l i c m a s k s o f f so e n e r g e t i c a l l y t h a t in t h e p r o c e s s he denuded t h e d r e a m and r e d u c e d it to an a m o r p h o u s pulp, u n a b l e to resist t h e m o s t a r b i t r a r y interpretations. Repudiating such methods, Boss attempted to show that with p r o c e d u r e s t h a t w e r e less u n g e n t l e and m o r e r e s p e c t f u l o f t h e p h e n o m e n a disclosing t h e m s e l v e s i n d r e a m s , d r e a m s w o u l d yield t h e i r m e a n i n g s o f t h e m s e l v e s . T h e d r e a m m e s s a g e s e x p l i c a t e d i n this seemingly simple-minded m a n n e r , rather than extracted by cunning F r e u d i a n c r y p t o g r a p h y , are apt to p r o d u c e p r o f o u n d l y illuminating t h e r a p e u t i c e f f e c t s upon t h e d r e a m e r . T h e p o t e n t i a l impact o f d r e a m s o n t h e a w a k e n e d d r e a m e r is f u r t h e r s u p p o r t e d by B o s s ' s refusal to d o w n g r a d e t h e reality o f t h e d r e a m w o r l d i n favor o f w a k i n g reality. B y taking d r e a m s s e r i o u s l y , i n q u e s t i o n i n g t h e claim o f t h e daylight w o r l d to be t h e u n c o n t e s t e d a r b i t e r of w h a t is real, by allowing t h e p h e n o m e n a o f t h e d r e a m w o r l d t o appear u n d i m m e d , w i t h o u t prejudging t h e m b y t h e c a t e g o r i e s o f a w a k e n e s s , B o s s was i n e l u c t a b l y led t o s t r u g g l e w i t h s o m e v e r y old m e t a p h y s i c a l riddles: I f t h e d r e a m w o r l d appears as real to us while we a r e d r e a m i n g as t h e w a k i n g w o r l d does w h i l e w e a r e a w a k e , w h a t m a k e s u s decide w h i c h i s w h i c h ? H o w can w e b e s u r e t h a t t h e w o r l d o f o u r a w a k e n e s s i s not j u s t a n o t h e r d r e a m ? A r e t h e r e c r i t e r i a w h i c h allow u s t o distinguish reliably b e t w e e n w a k i n g and dreaming? T h e i n t e r e s t e d r e a d e r m a y w a n t t o p u r s u e t h e s e and similar puzzles b y reading B o s s ' s b o o k on d r e a m s . W h a t is of p a r t i c u l a r r e l e v a n c e h e r e is t h a t B o s s w a s able t o s h o w t h a t i n its d r e a m i n g m o d e h u m a n e x i s t e n c e c o r r e s p o n d s , as o n e r e v i e w e r of t h e b o o k put it, "in its spatiality, t e m p o r a l i t y , and its e n c o u n t e r w i t h the w o r l d e x a c t l y t o t h e c o n c e p t i o n s a d v a n c e d by M a r t i n H e i d e g g e r — c o n c e p t i o n s t h a t h a v e led us, or could lead us, to a r e f l e c t i v e r e - a p p r o p r i a t i o n of t h e m o d e s of b e i n g - i n - t h e world." B o s s ' s b o o k on d r e a m s signified a m a j o r step in t h e p r o c e s s of t h e " d e s t r u c t i o n o f psychological t h e o r y " ( G u s t a v Bally) t h a t w a s t o clear t h e g r o u n d for t h e e x i s t e n t i a l i s t paradigm. T a k i n g this p r o c e s s o n e step f u r t h e r , B o s s n e x t t u r n e d t o t h e d o m a i n o f so-called p s y c h o s o m a t i c i l l n e s s e s . T h e traditional n o t i o n t h a t t h e s e illnesses w e r e s o m a t i c d i s o r d e r s of primarily psychic origin would n o t do for B o s s . By positing the bodily and psychic r e a l m s as equally basic Ausiragsmedien ("media of a r t i c u l a t i o n " ) o f h u m a n e x i s t e n c e , B o s s bypassed t h e t i m e - w o r n d e b a t e s a b o u t p s y c h o g e n e s i s vs. s o m a t o g e n e s i s . I n t h e B o s s i a n s c h e m e o f t h i n g s , no s o m a t i c e v e n t could c a u s e a psychic o n e or vice v e r s a . S i m i l a r l y , s o m e l o n g - s t a n d i n g puzzles such as c h o i c e of illness and choice of o r g a n w e r e r e f o r m u l a t e d ; the s e a r c h for c a u s a t i v e factors in the guise of specific 5

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conflict p a t t e r n s o r e m o t i o n a l c o n s t e l l a t i o n s w a s called off. I n s t e a d , B o s s a r t i c u l a t e d c h a r a c t e r i s t i c , pathologically c o n s t r i c t e d m o d e s o f being w h i c h "bodied f o r t h , " a s h e put it, t h e n e x u s o f dislocations usually labeled a s " p s y c h o s o m a t i c . " T h u s B o s s described t h e e x i s t e n t i a l s i t u a t i o n c h a r a c t e r i s t i c for t h e h y p e r t e n s i v e a s t h a t o f being "walled-in alive." B o s s n o t e d t h a t t h e s e p a t i e n t s w e r e typically trapped in a s o r t of p r e s s u r e c o o k e r s i t u a t i o n w i t h o u t t h e s a f e t y valve o f e m o t i o n a l e x p r e s s i v e n e s s . H e p o i n t e d out h o w , i n e x a c t a n a l o g y t o the c o n t r a c t i o n o f t h e i r e x i s t e n t i a l space, t h e blood s t r e a m o f t h e s e p a t i e n t s "is s u b j e c t e d t o e v e r rising p r e s s u r e i n t h e c o n f i n e m e n t o f n a r r o w i n g , calcifying v e s s e l s : thus this kind of h y p e r t e n s i v e c o n t i n u e s to live until finally s o m e t h i n g w h i c h is filled t o b u r s t i n g d o e s b u r s t . " C o n t r a s t i n g t h e h y p e r t e n s i v e with t h e a c c i d e n t - p r o n e , B o s s w e n t on to say: " W h a t t e a r s in such p a t i e n t s is n o t , as in t h e c a s e s p r e v i o u s l y studied, a p e r i p h e r a l b o n e or s o m e m u s c l e t i s s u e draped o v e r it, b u t r a t h e r — i n accord w i t h t h e i r life style of stoic f o r b e a r a n c e — a blood vessel deep and s e c r e t in the body w h i c h , in b u r s t i n g , r e l e a s e s t h e m from t h e t o o h e a v y b u r d e n o f e a r t h l y e x i s t e n c e . " B o s s ' s v i e w o f " p s y c h o s o m a t i c " illness a s " b o d y i n g f o r t h " deficient m o d e s o f b e i n g - i n - t h e - w o r l d w a s s o o n a b a n d o n e d b y h i m — a t first r a t h e r t e n t a t i v e l y — t o t h e r e a l m o f o r g a n i c d i s e a s e . T h e first s t e p s o f this e x t r a p o l a t i o n are t r a c e a b l e in his b o o k on p s y c h o s o m a t i c s . In t h e s a m e b o o k , B o s s also b e g a n to redefine the role of the physician in D a s e i n s a n a l y t i c t e r m s . In this p e r s p e c t i v e , it w a s n o t l o n g e r e n o u g h for t h e d o c t o r t o b e a n e x p e r t r e p a i r m a n o f bodily o r psychic d y s f u n c t i o n s . T h e D a s e i n s a n a l y t i c h e a l e r is called upon to deal w i t h t h e existential l i m i t a t i o n s and deficiencies of w h i c h , in the D a s e i n s a n a l y t i c c a n o n , individual d i s e a s e s , b o t h psychic and o r g a n i c , a r e — o r , at least, m a y be—symptomatic. .In his n e x t m a j o r w o r k , Psychoanalyse and Daseinsanalytik ( 1 9 5 7 ) , " B o s s l a u n c h e d his first s y s t e m a t i c a t t e m p t t o d i s m a n t l e Freud's t h e o r e t i c a l s y s t e m . T a k i n g F r e u d at his w o r d t h a t his t h e o r i e s m a t t e r e d less than his o b s e r v a t i o n s , B o s s t o o k u p and developed B i n s w a n g e r ' s earlier a r g u m e n t t h a t p s y c h o a n a l y s i s is r e n t by a fatal i n t e r n a l c o n t r a d i c t i o n : t h a t t h e empirical p h e n o m e n a t h e m a t i z e d b y F r e u d d o n o t really m e s h w i t h his t h e o r i e s . It w a s o n l y logical, in B o s s ' s e y e s , to discard the t o p - h e a v y t h e o r e t i c a l s t r u c t u r e , t h e m o r e so as he had c o m e to discern a providential affinity b e t w e e n t h e empirical data o f p s y c h o a n a l y s i s and H e i d e g g e r ' s m e t a p h y s i c s . ( B o s s even w e n t s o far a s t o s u g g e s t t h a t F r e u d , w h e n h e w a s n o t t h e o r i z i n g , was a n u n w i t t i n g e x i s t e n t i a l i s t w h o s e historically c o n d i t i o n e d prejudices a l o n e p r e v e n t e d him from r e c o g n i z i n g the full philosophical i m p o r t of his discoveries.) In o r d e r to i l l u s t r a t e t h e s h o r t c o m i n g s of p s y c h o a n a l y t i c tht jorizing,

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B o s s focused o n the i n t e r p e r s o n a l p h e n o m e n o n o f t r a n s f e r e n c e which, by w i d e s p r e a d c o n s e n s u s , is c e n t r a l to the p s y c h o t h e r a p e u t i c p r o c e s s . B o s s a r g u e d t h a t t h e w h o l e n o t i o n o f t r a n s f e r e n c e i s based upon r a t h e r d e b a t a b l e p r e s u p p o s i t i o n s , such as t h e e x i s t e n c e of m o r e or less isolated, d e t a c h a b l e feelings w h i c h can be t r a n s p o r t e d ( t r a n s f e r r e d ) from o n e love o b j e c t , e.g., t h e f a t h e r , to a n o t h e r , e.g., the t h e r a p i s t . T h e r e is also t h e a s s u m p t i o n t h a t t r a n s f e r e n c e love is v e r y d i f f e r e n t in kind f r o m g e n u i n e love, e v e n t h o u g h F r e u d — B o s s m a i n t a i n s — w a s u n a b l e t o d i f f e r e n t i a t e t h e o n e clearly from t h e o t h e r . N o t only i s t r a n s f e r e n c e love a s s u m e d t o be d i f f e r e n t in kind; it is also v i e w e d as less real. T h e t h e r a p i s t loved by his p a t i e n t with t r a n s f e r e n c e love is held n o t to be the real o b j e c t of this love. W h i l e this r e d u c t i o n of t h e love p h e n o m e n a arising in p s y c h o t h e r ­ apy is i n t r i n s i c to p s y c h o a n a l y t i c t h e o r i z i n g , it is c e r t a i n l y n o t dictated by these p h e n o m e n a themselves. Boss dispenses with theoretical construc­ t i o n s a b o u t t h e t r a n s f e r o f d e t a c h a b l e feelings f r o m o n e o b j e c t t o a n o t h e r and g r a n t s t h e m t h e reality t h e y display w h e n g i v e n t h e i r full s w a y . H e feels t h a t such a p h e n o m e n o l o g i c a l approach, l o a t h t o d e r e a l i z e w h a t e v e r m a n i f e s t s itself, e n h a n c e s n o t o n l y o u r p o w e r s o f a p p r e h e n s i o n , but also o u r t h e r a p e u t i c e f f e c t i v e n e s s . A n d indeed, t h e i l l u s t r a t i v e c a s e h i s t o r y n e a r t h e end of Psychoanalyse und Daseinsanalytik m a k e s a v e r y s t r o n g case for t h e p o w e r o f a r t i c u l a t i o n and t h e r a p e u t i c p o t e n c y o f D a s e i n s a n a l y s i s . T h e t h e m e s a d u m b r a t e d i n B o s s ' s w o r k s discussed s o far w e r e fully developed and o r c h e s t r a t e d in his m o n u m e n t a l Grundriss der Medizin ( 1 9 7 1 ) o f w h i c h t h e p r e s e n t v o l u m e i s t h e s o m e w h a t abridged E n g l i s h v e r s i o n . T h i s w o r k w a s b o u n d t o stir u p c o n t r o v e r s y i n t h a t i t e x t e n d e d B o s s ' s c r i t i q u e o f t h e applicability o f t h e n a t u r a l s c i e n c e p a r a d i g m t o m a n from t h e a r e a o f p s y c h o l o g y and p s y c h o s o m a t i c s t o t h e vast r e a l m o f g e n e r a l medicine. W h e r e a s B o s s ' s e a r l i e r w o r k s a r g u i n g t h e i n a d e q u a c y o f t h e n a t u r a l s c i e n c e p a r a d i g m i n p s y c h i a t r y did n o t a r o u s e m u c h p a s s i o n a t e c o n t r o v e r s y , his i n c u r s i o n i n t o t h e w e l l - d e f e n d e d d o m a i n o f somatic medicine was an entirely different matter. Unlike theologians, B o s s ' s medical c o l l e a g u e s s e e m e d quite disposed n o t t o c o n t e s t t h e p o s s e s s i o n of the h u m a n soul by D a s e i n s a n a l y s i s as long as it did n o t meddle w i t h t h e i r claims t o t h e h u m a n body. B u t w h e n D a s e i n s a n a l y s i s began to trespass upon their ground, the temperature of criticism from t h e medical r a n k s r o s e n o t i c e a b l y . S u c h zeal in t h e c a u s e of o r t h o d o x y s e e m e d hardly called for. B o s s is no Ivan IUich; he is n o t i n t e n t upon b r i n g i n g d o w n t h e e n t i r e s t r u c t u r e of m o d e r n m e d i c i n e . In fact, his c o n c e r n s are n o t primarily p r a g m a t i c , even though bound to have important pragmatic consequences. Conceding quite readily m o d e r n m e d i c i n e ' s v i r t u o s i t y i n m a n i p u l a t i n g t h e h u m a n body, h e m e r e l y i n q u i r e s w h e t h e r such m a s t e r y g u a r a n t e e s i n a n y w a y

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a n a d e q u a t e u n d e r s t a n d i n g o f t h e o b j e c t t h u s m a n i p u l a t e d . T o b e able t o describe in g r e a t detail t h e physically a c c e s s i b l e f e a t u r e s of s o m a t i c p h e n o m e n a and t h e i r p h y s i c o c h e m i c a l a n t e c e d e n t s is n o t the s a m e as being able t o c o m p r e h e n d t h e i r c o n t e x t o f s i g n i f i c a n c e . S i n c e m o d e r n medicine has so little to say a b o u t t h e e x i s t e n t i a l m e a n i n g of m o s t physical illness—in fact, c o n s i d e r s the q u e s t i o n of m e a n i n g as largely i r r e l e v a n t — w e m i g h t be well advised to lend o u r e a r to a d i v e r g e n t approach, such as B o s s ' s , t h a t views t h e issue of the m e a n i n g of disease as central. Far from w a n t i n g to abolish the u s e of n a t u r a l science m e t h o d o l o g y in m e d i c i n e , B o s s is b e n t on pointing out its l i m i t a t i o n s . T h a t w i t h i n c e r t a i n limits t h e use of this m e t h o d o l o g y is justifiable and n e c e s s a r y B o s s t a k e s for g r a n t e d . It is t h e claim of this m e t h o d o l o g y to total dominion o v e r m e d i c i n e t h a t B o s s c o n t e s t s . T h e first part o f t h e p r e s e n t b o o k c o n s t i t u t e s in fact a forceful e s s a y on the inability of the n a t u r a l scientific approach t o gain a c c e s s t o t h e w h o l e reality o f day-to-day h u m a n e x i s t e n c e . It is only t h e fullest possible a r t i c u l a t i o n of t h i s r e a l m from a p h e n o m e n o l o g i c a l point o f view, B o s s c o n t e n d s , t h a t can e n s u r e a n a d e q u a t e u n d e r s t a n d i n g o f t h e h u m a n being i n h e a l t h and i l l n e s s . 7

B o s s ' s critique of t h e n a t u r a l scientific paradigm in m o d e r n medicine is based upon his f u n d a m e n t a l distinction b e t w e e n t h e realm of o b j e c t s and t h e realm of m a n . O n l y m a n is said to exist in t h e precise s e n s e given to this t e r m by H e i d e g g e r ' s o n t o l o g y of Da-sein. T h i s implies, a l m o s t by definition, t h a t the w h o l e h u m a n realm, inclusive o f the h u m a n body, c a n n o t be a p p r e h e n d e d a d e q u a t e l y in t e r m s of a paradigm (the n a t u r a l scientific o n e ) o r i g i n a t i n g from and fully s o v e r e i g n o n l y in t h e n o n h u m a n realm. W h a t H e i d e g g e r and B o s s a r e aiming at, in o t h e r w o r d s , i s t o w i t h d r a w t h e h u m a n body from the d o m a i n o f n a t u r e w h e r e D e s c a r t e s had placed it and to r e i n t e g r a t e it into the e x i s t e n t i a l r e a l m . H e n c e t h e i m p o r t a n c e a t t a c h e d to t h e t e r m bodyhood s t r e s s i n g , as it does, the q u a s i - i m m a t e r i a l a s p e c t s o f t h e bodily side o f m a n . In o r d e r to r e m a i n close to i m m e d i a t e e x p e r i e n c e , Foundations is o r g a n i z e d a r o u n d a case h i s t o r y d r a w n from medical practice. Using t h e a s t u t e l y c h o s e n c a s e o f R e g u l a Z i i r c h e r a s a point o f a n c h o r a g e for t h e w h o l e c o m p l e x l y s t r u c t u r e d w o r k t u r n s out to be a didactic m a s t e r ­ s t r o k e . It e n d o w s t h e b o o k w i t h an a m a z i n g s e n s e of u n i t y and c o h e r e n c e , besides b e s t o w i n g upon R e g u l a Z i i r c h e r , w h o i s viewed from e v e r v a r y i n g p e r s p e c t i v e s and t h r o u g h t h e m o s t diverse t h e o r e t i c a l l e n s e s , a n a b u n d a n c e o f i n c a r n a t i o n hardly e v e r v o u c h s a f e d t o t h e subject o! a medical case study. I )l part icular i n t e r e s t to m o s t readers will be t h e w a y in w h i c h M e d a r d B o s s draws upon the s o m a t i c illnesses and t r i b u l a t i o n s of his h e r o i n e to

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illustrate his r e f o r m u l a t i o n o f t h e b o d y - m i n d issue. R e a d i n g t h e s e s e c t i o n s o f the b o o k closely o n e realizes t h a t t h e s a m e o r g a n i c disease befalling different individuals is n o t t h e s a m e disease. E v e r y t h i n g h i n g e s on the existential context, as Boss's passages about the existential m e a n i n g of a h e r n i a or a f r a c t u r e d tibia m a k e clear. If, as B o s s believes, even t h e s e e m i n g l y m o s t trivial physical a c c i d e n t a f f e c t s t h e p e r s o n ' s w h o l e b e i n g - i n - t h e - w o r l d , it follows t h a t no illness can be c o n s i d e r e d to have b e e n truly cured u n l e s s t h e d i s t o r t i o n s o f b e i n g - i n - t h e - w o r l d c o r r e l a t e d w i t h it a r e also c o r r e c t e d . T h u s , in f o r m u l a t i o n s of stress, B o s s t r i e s t o establish n o t o n l y t h e p s y c h o l o g i z a t i o n o f o r g a n i c i t y , b u t also t h e need for a truly c o m p r e h e n s i v e e x i s t e n t i a l t h e r a p y w h i c h in t h e face of any f o r m o f illness n e v e r loses s i g h t o f t h e total c o n f i g u r a t i o n o f t h e s u f f e r e r ' s Da-sein and does n o t c o n s i d e r its task a c c o m p l i s h e d w h e n it has r e s t o r e d o p t i m a l physical f u n c t i o n i n g . O n c e a p a t i e n t w h o s e s e x u a l c o n t a c t s are limited t o call girls h a s b e e n c u r e d o f t h e g o n o r r h e a t h a t b r o u g h t h i m t o medical a t t e n t i o n , t h e main p r o b l e m still r e m a i n s t o b e t a c k l e d — a c c o r d i n g t o B o s s . T h e q u e s t i o n s n e e d t o b e raised, B o s s feels, W h a t peculiar c o n s t r i c t i o n s o f t h e p e r s o n ' s e x i s t e n t i a l p o t e n t i a l c o m p e l h i m t o h a v e r e c o u r s e t o t h e c h e a p c o i n a g e o f c o u n t e r f e i t l o v e ? and H o w can h e b e helped t o o v e r c o m e t h e s e g r o w t h - s t u n t i n g l i m i t a t i o n s (which, incidentally, e x p o s e h i m c o n t i n u o u s l y t o t h e risk o f r e i n f e c t i o n ) ? N o less a r r e s t i n g t h a n B o s s ' s p a s s a g e s a b o u t t h e e x i s t e n t i a l d i m e n s i o n s o f o r g a n i c illnesses are his o b s e r v a t i o n s a b o u t s c h i z o p h r e n i a , " t h e m o s t h u m a n and the m o s t i n h u m a n of all d i s e a s e s , " and a p a r t i c u l a r l y pivotal o n e w i t h i n t h e D a s e i n s a n a l y t i c paradigm. W h a t m a k e s B o s s ' s t r e a t m e n t of s c h i z o p h r e n i a so striking is t h a t he deals w i t h it p r i m a r i l y u n d e r t h e heading of "the pathology of (existential) freedom." Boss sees as the e s s e n t i a l f e a t u r e o f s c h i z o p h r e n i c illness t h e a b r o g a t i o n o f t h e m o s t basic e x i s t e n t i a l ( c o n s t i t u e n t ) of h u m a n Da-sein—its f u n d a m e n t a l f r e e d o m and o p e n n e s s t o w a r d o t h e r h u m a n b e i n g s and t o w a r d the w h o l e realm o f phenomena. B o s s ' s e m p h a s i s o n t h e s c h i z o p h r e n i c ' s f o r f e i t u r e o f his e x i s t e n t i a l a u t o n o m y , on his being engulfed and d e v o u r e d by t h e b e i n g s and o b j e c t s h e m e e t s w i t h , e n a b l e s u s t o r e c o g n i z e t h e overall c o n f i g u r a t i o n s o f s c h i z o p h r e n i c m o d e s of being as well as t h e i r m o s t s u b t l e a r t i c u l a t i o n s . A case in p o i n t is t h a t of t h e s c h i z o p h r e n i c patient of F. F i s c h e r c o m m e n t e d upon b y B o s s . W h e r e a s F i s c h e r i n t e r p r e t e d the patient's c o m m u n i c a t i o n s as indicative of the collapse of his " t e m p o r a l - s p a t i a l f r a m e of r e f e r e n c e , " B o s s , less t h e o r y - b o u n d , n o t e d t h a t this patient w h o kept talking a b o u t his clock w a s n o t really c o n c e r n e d w i t h its t i m e - m e a s u r i n g p r o p e r t i e s . R a t h e r h e w a s w h o l l y p r e o c c u p i e d w i t h the different w a y s h e related t o t h e clock and the clock to him: At t i m e s he would e x p e r i e n c e it as t h e

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familiar, clearly d e l i n e a t e d clock on t h e wall, a significant object in a w o r l d of o b j e c t s t h a t g r a n t e d him a dwelling place; at o t h e r m o m e n t s , it dissolved i n t o a " m e r e " clock, cut o f f f r o m its m o o r i n g s in t h e e n v i r o n m e n t , floating in a d i r e c t i o n l e s s , h o m o g e n i z e d space i n t o w h i c h t h e p a t i e n t w a s s w e p t , b e n u m b e d and " d i s p e r s e d , " r o b b e d o f t h e " t h r e a d to [ h i m s e l f ] . " It w a s t h e h e l p l e s s , passive s w a y i n g b a c k and f o r t h b e t w e e n t h e s e t w o m o d e s o f e n c o u n t e r w i t h t h e clock, and t h e v e r t i g o a t t e n d a n t upon this loss o f e x i s t e n t i a l a u t o n o m y , w h i c h — i n B o s s ' s v i e w — constituted the main c o n t e n t of the patient's communications. B o s s ' s r e s p e c t for w h a t is i m m e d i a t e l y given in e x p e r i e n c e , in w h a t e v e r guise it m a y p r e s e n t itself, also i n f o r m s his a t t i t u d e t o w a r d so-called h a l l u c i n a t o r y o r delusional p h e n o m e n a . S i n c e D a s e i n s a n a l y s i s does n o t r e c o g n i z e the c o n s t r u c t w e call o b j e c t i v e o r i n t e r s u b j e c t i v e reality a s t h e u l t i m a t e judge of w h a t is real, t h e d a s e i n s a n a l y s t has little difficulty in t a k i n g a s c h i z o p h r e n i c ' s h a l l u c i n a t o r y e x p e r i e n c e s for real. In doing so, w i t h o u t c o n d e s c e n s i o n o r l a b o r i o u s s u s p e n s i o n o f disbelief, t h e daseinsanalyst gains the great advantage of an immediate relatedness with the schizophrenic patient. W h i l e n o t q u e s t i o n i n g t h e r e a l n e s s o f w h a t discloses itself i n hallucinatory experiences, the daseinsanalyst wants to know what specific m o d i f i c a t i o n s o f n o r m a l b e i n g - i n - t h e - w o r l d give rise t o such e x p e r i e n c e s . I n t h e t h r e e c a s e s o f s c h i z o p h r e n i c forfeit o f a u t o n o m y discussed by B o s s , this q u e s t i o n is p a r a m o u n t . T h u s t h e Sun-Man's b r i t t l e , s e q u e s t e r e d w o r l d has collapsed w h e n he felt b e t r a y e d by his o n l y friend. A s o r t of e x p l o s i v e d e c o n s t r i c t i o n of his e x i s t e n t i a l space had o c c u r r e d , and i n t o this e x i s t e n t i a l v a c u u m s o m e t h i n g " s u p e r n a t u r a l , " " s t r o n g e r t h a n m a n , " had s u r g e d — t h e weird, spectral ("hallucinated") sun t h a t h a u n t e d him for a w h o l e n i g h t . T h e p a t i e n t ' s a g o n y o f f o r l o r n n e s s had m a d e t h e sun e m e r g e i n t o its b o u n d l e s s n e s s and reveal itself to h i m in a w a y t h a t u p t o t h e n h e had n e v e r i m a g i n e d . " . . .he w a s o v e r p o w e r e d b y t h e c o s m i c i n c a n d e s c e n c e o f t h e s u n , w h i c h f a s c i n a t e d him and t h r e a t e n e d t o s c o r c h and s w a l l o w him and t h e e n t i r e e a r t h . Its limitless i n c a n d e s c e n c e replaced the lost w a r m t h o f his c o n c r e t e , limited r e l a t i o n s h i p to his f r i e n d " (pp. 3 7 5 - 3 7 6 ) . B o s s is at pains to point o u t t h a t this e n t i r e l y n e w reality of the i n c a n d e s c e n t sun w a s as real for t h e p a t i e n t as his f o r m e r reality, if n o t m o r e so. A r t i c u l a t i n g t h e e x i s t e n t i a l situation o f t h e s c h i z o p h r e n i c e n a b l e s t h e d a s e i n s a n a l y s t to induce c h a n g e s in this s i t u a t i o n t h a t a r e apt to m a k e d r a m a t i c s y m p t o m s o f p s y c h o s i s vanish a s i f b y m a g i c . S i n c e D a s e i n s a n ­ alysis does n o t look upon s c h i z o p h r e n i a as a p r o c e s s w i t h a d y n a m i s m m o r e or less its o w n , but v i e w s the p a t h o l o g i c a l s y n d r o m e as t h e i m m e d i a t e c o n c o m i t a n t of a c e r t a i n d e f e c t i v e m o d e of b e i n g - i n - t h e -

Introduction to the English Translation

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w o r l d , it is plausible t h a t a n y beneficial c h a n g e in this m o d e , h o w e v e r e f f e c t e d , will lead to an a b a t e m e n t of s y m p t o m s . W h a t is c h a r a c t e r i s t i c of t h e d e f e c t i v e m o d e of being called s c h i z o p h r e n i c is, according to D a s e i n s a n a l y s i s , t h e d i s c r e p a n c y b e t w e e n t h e d e m a n d s i m p o s e d b y his e x i s t e n t i a l situation upon t h e s c h i z o p h r e n i c and his ability to cope w i t h these demands. In other words, the schizophrenic is somebody who has been existentially overtaxed. In the eyes of the daseinsanalyst, there is no s c h i z o p h r e n i a or s c h i z o p h r e n i c per se. In t h e p r e s e n c e of each p a t i e n t , the q u e s t i o n n e e d s to be asked: S c h i z o p h r e n i c due to t h e (for this p e r s o n ) e x c e s s i v e d e m a n d s o f w h a t kind o f e x i s t e n t i a l s i t u a t i o n ? And i f t h e d e m a n d s o f t h e s i t u a t i o n a r e judiciously r e d u c e d — f o r i n s t a n c e , b y e n a b l i n g t h e p a t i e n t to lead a m o r e s h e l t e r e d , m o r e childlike e x i s t e n c e — e v e r y t h i n g s c h i z o p h r e n i c a b o u t a g i v e n p a t i e n t m a y suddenly fade a w a y as if it had n e v e r e x i s t e d . Of c o u r s e , in this case t h e d a s e i n s a n a l y s t will n o t f l a t t e r h i m s e l f of h a v i n g p r o d u c e d a c u r e . T h e r e s t r u c t u r i n g of a p a t i e n t ' s e x i s t e n t i a l s i t u a t i o n b y e x t e r n a l i n t e r v e n t i o n m u s t b e followed b y t h e l a b o r i o u s p r o c e s s o f a p p r o p r i a t i n g u n r e a l i z e d m o d e s o f being. T h e final c h a p t e r s o f t h e p r e s e n t b o o k c o n v e y t h e e s s e n c e o f B o s s ' s t h e r a p e u t i c m o d e o f o p e r a t i o n s . T h e y amply s u p p o r t his claim t h a t D a s e i n s a n a l y s i s c a t a l y z e s t h e fullest possible r e a l i z a t i o n o f the h u m a n potential inherent in the therapeutic encounter. T h e therapist's r e a d i n e s s t o open h i m s e l f widely (and w i t h o u t t h e s u b t e r f u g e o f theoretical dogmatism) to w h a t e v e r manifests itself in the interpersonal space c l e a r e d b y t h e r a p y , his w i l l i n g n e s s t o w e l c o m e t h e p h e n o m e n a appearing t h e r e a s real, n o m a t t e r h o w o u t l a n d i s h t h e i r g u i s e — t h i s o p e n - a r m e d , h o s p i t a b l e s t a n c e f r e e s t h e a n a l y s a n d i n his t u r n t o u n b e n d , t o e x p e r i e n c e w i t h p r e v i o u s l y d i s o w n e d m o d e s o f c o n d u c t , and t o g r a d u a l l y m a k e t h e m his o w n . T h e a u t h o r o f this i n t r o d u c t i o n had occasion t o talk t o f o r m e r p a t i e n t s o f M e d a r d B o s s . T h e y s t r e s s e d h o w p r o f o u n d l y and dependably t h e y felt u n d e r s t o o d and s u p p o r t e d , f r o m t h e v e r y first t h e r a p y h o u r , b y B o s s ' s prodigal r e c e p t i v e n e s s . It is safe to a s s u m e t h a t B o s s ' s g r e a t n a t u r a l w a r m t h and e m p a t h y , w h i c h e v e n his o p p o n e n t s c o n c e d e , play a large role in inviting t h e s p o n t a n e o u s t r u s t of people w h o , a l m o s t by definition, are m o s t p a r s i m o n i o u s w i t h t h e i r t r u s t . B u t , t h e n , it is equally safe t o a s s u m e t h a t i t w a s n o c h a n c e h a p p e n i n g w h i c h m a d e M e d a r d B o s s d i s c o v e r in H e i d e g g e r ' s Daseinsanalytik t h e f o u n d a t i o n s of a boldly h u m a n i s t i c medicine and p s y c h o l o g y . Paul ] . S t e r n

xxii

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NOTES 1. D e s c a r t e s did n o t c o n c e i v e of m a n , as La M e t t r i e l a t e r did, as I'homme machine. B u t his notion

of

l e corps

machine,

the

human

body

as

mechanism,

favored

the

subsequent

mechanization of the image of man. 2. In The Structure of Scientific Revolutions ( C h i c a g o : U n i v e r s i t y of C h i c a g o P r e s s , 1 9 6 2 ) . 3. In L . J . P o n g r a t z , ed., Psychotherapie in Selbstdarstellungen ( B e r n : H a n s H u b e r , 1 9 7 3 ) , pp. 87-88. 4. Der

Traum

5. Einführung

und in

seme

Auslegung.

(Bern:

Hans

Huber,

1953).

die psychosomatische Medizin ( B e r n : H a n s H u b e r , 1 9 5 4 ) .

6. P u b l i s h e d in a m u c h e x p a n d e d E n g l i s h v e r s i o n as Psychoanalysis ami Daseinanalysis. INew York:

Basil

Books.

IQbil

7. Boss's attempt to define the boundaries of the natural scientific method in medicine has the interesting side effect o\

eroding

vanishing

point.

the

traditional

dividing

line between general medicine and medical psychology almost to the

FROM THE PREFACE TO THE FIRST EDITION

I w o u l d n e v e r h a v e b e e n able t o c o m p l e t e t h e v o l u m e n o w b e f o r e y o u w i t h o u t t h e help of m a n y o t h e r people. I o w e a special debt of g r a t i t u d e to a whole generation of students w h o have persistently engaged me in s c i e n t i f i c and philosophical d i s c u s s i o n s . T h e y f o r c e d m e t o r e e v a l u a t e c o n t i n u a l l y ideas I had t a k e n o v e r from m y o w n t e a c h e r s , along w i t h o t h e r s I had arrived at l a t e r on my o w n . By a happy c h a n c e , m a n y of my t e a c h e r s w e r e o f u n c o m m o n i n t e l l e c t u a l c a l i b e r , t h e m o s t influential a m o n g them being the physiologist W. R. Hess, the psychiatrists Eugen B l e u l e r and W a g n e r v o n J a u r e g g , t h e i n t e r n a l specialists W . L o e f f l e r and C h v o s t e k , and t h e depth p s y c h o l o g i s t s S i g m u n d F r e u d and C a r l J u n g . T o t h e s e m e n I a m i n d e b t e d n o less t h a n t o m y s t u d e n t s . B u t a b o v e all, it is t h e p h i l o s o p h e r M a r t i n H e i d e g g e r w h o is r e s p o n s i b l e for this a t t e m p t to lay out a f o u n d a t i o n f o r m e d i c i n e . It r e f l e c t s t h e c o u n t l e s s c o n v e r s a t i o n s in w h i c h I w a s privileged to p a r t i c i p a t e o v e r t w o d e c a d e s o f friendship. F o r t h e past fifteen y e a r s , m o r e o v e r , H e i d e g g e r has held t w o o r t h r e e s e m i n a r s e a c h s e m e s t e r for t h e b e n e f i t o f medical s t u d e n t s , including m i n e . T h e d i s c u s s i o n s c o m i n g o u t o f t h e s e " Z o l l i k o n S e m i n a r s " also figure significantly i n this w o r k . M o r e i m p o r t a n t , t h o u g h , i s t h e fact t h a t this w o r k actually evolved under

xxi V

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FOUNDATIONS

Heidegger's watchful eye. T h e r e is not one section of "philosophical" i m p o r t w h i c h w a s denied his g e n e r o u s c r i t i c i s m . N o w a d a y s , a n y a t t e m p t to put f o r t h a f o u n d a t i o n of medicine is likely to run t h e risk of b e i n g c o n d e m n e d by medical opinion as "purely p h i l o s o p h i c a l " — t h a t is, as i r r e l e v a n t and devoid of practical potential. To m a n y in t h e h u m a n i t i e s , by c o n t r a s t , a f o u n d a t i o n like the o n e s k e t c h e d h e r e m u s t s e e m " t o o s i m p l e . " I n o u r age o f logistics and c y b e r n e t i c s , usually o n l y the m o s t c o m p l e x and a b s t r a c t s c h e m e s m a y pass for t r u t h . Y e t I h a v e tried at all t i m e s to k e e p e x c l u s i v e l y to w h a t could be k n o w n simply and directly, an a t t i t u d e w h i c h has s u b j e c t e d me on occasion to t h e c r i t i c i s m o f being " t o o u n p h i l o s o p h i c a l , " o r e v e n " n a i v e . " T h e m e m b e r s o f t h e C o m m i t t e e for t h e S w i s s National Fund (Kommission des Schweizerischen Nationalfonds), from t h e sciences and from the h u m a n i t i e s alike, w e r e n o t m o v e d b y t h e s e p r e j u d i c e s , h o w e v e r . T h e i r impartial g e n e r o s i t y m e r i t s a v e r y special e x p r e s s i o n of t h a n k s . February 1 9 7 0

Medard Boss

PREFACE TO THE SECOND EDITION

T h e fact t h a t this b o o k h a s already g o n e i n t o a s e c o n d edition, despite the d e m a n d s it m a k e s of its r e a d e r s , should be t a k e n as p r o o f of a wide n e e d for a n e w and s o u n d e r basis of medical t h e o r y and p r a c t i c e . T h e title of t h e first edition, as it t u r n e d o u t , failed to e x p r e s s t h e a u t h o r ' s original i n t e n t ; it s e e m e d to indicate t h a t t h e b o o k could be u n d e r s t o o d o n l y by physicians. I had a s s u m e d w i t h t o o m u c h h a s t e t h a t e v e r y o n e w o u l d r e c o g n i z e a f o u n d a t i o n of m e d i c i n e b a s e d on h u m a n n a t u r e as, n e c e s s a r i l y , a f o u n d a t i o n of p s y c h o l o g y and s o c i o l o g y as well. In a n y c a s e , this e r r o r has n o w b e e n c o r r e c t e d b y e x p a n d i n g t h e title o f t h e s e c o n d edition to read Foundation of Medicine and Psychology. T h e r e a d e r n e e d no l o n g e r r e f e r to a l e n g t h y s u b t i t l e for clarification. In k e e p i n g w i t h t h e n e w title, m o r e space h a s n o w b e e n given t o discussing traditional psychological c o n c e p t s . Spring 1 9 7 4

Medard Boss

x xvii

INTRODUCTION

T h e p r i m a r y f u n c t i o n of a study on t h e f o u n d a t i o n of a s c i e n c e is to lay o u t t h e field o f p h e n o m e n a i n t e n d e d for i n v e s t i g a t i o n . N o less i m p o r t a n t , h o w e v e r , i s t h a t t h e w o r k specify t h e p r o p e r t i e s w h i c h t h e s c i e n c e has a s s i g n e d t o its o b j e c t s o f s t u d y f r o m t h e v e r y s t a r t , and o f t e n w i t h o u t e x p r e s s d e l i b e r a t i o n . It is as i m p o s s i b l e for a s c i e n c e as for a n y o t h e r h u m a n e n d e a v o r t o avoid a n t i c i p a t i n g t h e g e n e r a l n a t u r e o f its o b j e c t s o f study. E v e n a scientific e n t e r p r i s e c a n n o t begin vis-a-vis an i n d e t e r m i ­ n a t e n o t h i n g n e s s . It can t a k e for its s u b j e c t only s o m e t h i n g it has already p e r c e i v e d as being s o m e t h i n g . W h e n e v e r we p e r c e i v e s o m e t h i n g as s o m e t h i n g , w e h a v e already i n t e r p r e t e d its m o d e o f being i n s o m e w a y o r o t h e r , n o m a t t e r h o w v a g u e this i n t e r p r e t a t i o n m a y b e a t t h e o u t s e t . Every science is therefore necessarily—and thus always—based on prescientific premises. T h e s e constitute a fundamental structure that n o t m e r e l y sets f o r t h i n a d v a n c e w h i c h inquiries a r e p o s s i b l e and w h i c h are n o t , b u t f u r t h e r m o r e d e t e r m i n e s t h e v e r y c h a r a c t e r o f t h e s c i e n c e and t h e e x t e n t to w h i c h its r e s u l t s will be significant. It s e t s t h e goals for t h e s c i e n c e and e s t a b l i s h e s t h e p r o c e d u r e s g u a r a n t e e i n g c o r r e c t practical application o f t h e o r y . A n y s c i e n c e t h a t w o u l d be w o r t h y to be called a s c i e n c e is accordingly obligated to keep its f o u n d a t i o n clear of a m b i g u i t y and a p p r o x i m a t i o n . It

xxviii

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m u s t u n d e r t a k e a g a i n and again t o r e t h i n k and r e a r t i c u l a t e t h e p r e m i s e s on w h i c h it is based. O n l y this can a s s u r e reliable f u n c t i o n i n g and p r o d u c t i v i t y for t h e s c i e n c e . T h e e x e r c i s e also s e r v e s t o r e m i n d i t o f its proper domain, protecting against boundary transgressions whose c o n s e q u e n c e s are, p r e d i c t a b l y , c o n f u s i o n o f i n t e n t and m i s u s e o f m e t h o d . B e n e a t h t h e f o u n d a t i o n s o f m o d e r n m e d i c i n e , u n d e r l y i n g all o f its t h e o r i e s and all of its t h e r a p e u t i c p r o c e d u r e s , lies a c o n c e p t i o n of n a t u r e w h o s e currency has risen markedly with the development of modern n a t u r a l s c i e n c e . T h e medical application t o h u m a n b e i n g s o f c o n c e p t s and r e s e a r c h m e t h o d s d r a w n f r o m t h e n a t u r a l s c i e n c e s led, a m o n g o t h e r t h i n g s , t o t h e r a p e u t i c a c h i e v e m e n t s t h a t s u r p a s s e d all e x p e c t a t i o n . T a k e n b y t h e m s e l v e s , t h e s e a c h i e v e m e n t s leave n o r o o m t o d o u b t t h a t this kind of application of the n a t u r a l scientific r e s e a r c h m e t h o d is justifiable and n e c e s s a r y . Y e t t h e e x t e n t t o w h i c h this m e t h o d i s justified in claiming total d o m i n i o n o v e r medicine is m o r e h o t l y c o n t e n d e d today than ever before. T o keep o u r s t u d y o f f u n d a m e n t a l s r o o t e d i n i m m e d i a t e e x p e r i e n c e , we shall use a t e s t c a s e . It will d e m o n s t r a t e t h e l e g i t i m a c y of the positive r e s u l t s o f medical r e s e a r c h m e t h o d s t o d a t e and will a t the s a m e t i m e s h o w t h e limits o f t h e s e m e t h o d s . T h e c a s e h i s t o r y p r e s e n t e d h e r e h a s b e e n d r a w n from medical p r a c t i c e and is well suited to the r e q u i r e m e n t s o f this d e m o n s t r a t i o n . All c o n s i d e r a t i o n s w h i c h follow t h e case are o r i e n t e d t o w a r d factually r e p o r t e d e v e n t s o f t h e p a r t i c u l a r h u m a n existence they represent. A s s u m i n g t h a t the t r u e s u b j e c t m a t t e r o f m e d i c i n e i s m a n , the w h o l e reality o f d a y - t o - d a y h u m a n e x i s t e n c e , w e shall l e a r n from o u r study t h a t t h e n a t u r a l scientific a p p r o a c h repeatedly finds i t s e l f c o n f r o n t i n g a r e a l m to w h i c h it c a n n o t gain a c c e s s . It is precisely t h e e s s e n c e of the w a y people b e h a v e a m o n g t h e m s e l v e s i n t h e i r daily lives, h o w t h e y c o n d u c t t h e m s e l v e s t o w a r d t h e w o r l d and o t h e r c r e a t u r e s , t h a t m o d e r n m e d i c i n e ' s n a t u r a l scientific r e s e a r c h m e t h o d fails e v e n t o a p p r o a c h , m u c h less to clarify in its u n i q u e n e s s . We shall look at e f f o r t s — b o t h psychological and p s y c h o s o m a t i c — t h a t p r o p o s e t o s u p p l e m e n t t h a t n a t u r a l scientific f o u n d a t i o n o f m e d i c i n e and m a k e a n a l l - e n c o m p a s s i n g w h o l e . B u t w h e n t h e y a r e t e s t e d a g a i n s t t h e case h i s t o r y , t h e s e p s y c h o l o g i c a l and p s y c h o s o m a t i c e x p l a n a t i o n s , t o o , c o m e u p a g a i n s t the b o u n d a r i e s o f t h a t r e a l m w h i c h has already p r o v e n inaccessible t o t h e n a t u r a l scientific r e s e a r c h m e t h o d . T h i s i n turn requires an e x a m i n a t i o n o f the basic a s s u m p t i o n s o f t h e psychological and p s y c h o s o m a t i c s c i e n c e s . ( )ui 11 c . h i o n s i d e r a l i o n of principles leads to t h e c o n c l u s i o n of P a r t I: the psychological a n d p s y c h o s o m a t i c a s well a s t h e natural scientific

Introduction

xxix

r e s e a r c h m e t h o d s of m e d i c i n e a c c o u n t far t o o p o o r l y for a fact t h a t is, in fact, f u n d a m e n t a l . T h e y largely o v e r l o o k h o w radically t h e n a t u r e o f t h e i r o b j e c t o f s t u d y — h u m a n r e a l i t y — d i f f e r s from t h e m a k e u p o f e v e r y o t h e r r e a l m k n o w n t o us. L e t us t h e r e f o r e give u r g e n t e m p h a s i s and t e r m i n o l o g i c a l precision to this d i f f e r e n c e b e f o r e we begin. We declare t h a t only m a n exists. T h i s is n o t t o say t h a t m a t e r i a l , i n o r g a n i c n a t u r e and n o n h u m a n b e i n g s — a n i m a l s and p l a n t s — a r e in a n y s e n s e u n r e a l , i n s u b s t a n t i a l , or illusory b e c a u s e t h e y do n o t so exist. We m e r e l y s t a t e t h a t t h e reality of t h e s e n o n h u m a n r e a l m s differs f r o m t h a t o f h u m a n e x i s t e n c e , w h o s e p r i m a r y c h a r a c t e r i s t i c is Da-sein (literally " b e i n g - t h e - t h e r e " ) . I n s o f a r as Da-sein is t h e d i s t i n g u i s h i n g c h a r a c t e r i s t i c of h u m a n e x i s t e n c e , t h e d e s i g n a t i o n Da-sem m u s t be u n d e r s t o o d in a s e n s e t h a t differs f r o m the c u r r e n t u s a g e of t h e G e r m a n w o r d Dasein. As it is c o m m o n l y used, Dasein signifies little m o r e t h a n p r e s e n c e , as for e x a m p l e in p r o o f s of G o d ' s Dasein. T h e h u m a n being, t h o u g h , is a h u m a n being n o t m e r e l y b e c a u s e he is, and can be o b s e r v e d to b e , s o m e t h i n g t h a t is p r e s e n t . T h e table i n f r o n t o f m e , t h e s t o n e i n t h e g a r d e n — t h e s e are m e r e l y p r e s e n t . M a n as m a n is p r e s e n t , h o w e v e r , in a m a n n e r w h o l l y d i f f e r e n t from t h e s e i n a n i m a t e t h i n g s . O u r e n t i r e d i s c u s s i o n h i n g e s u p o n o u r ability t o c a s t light o n w h a t i s distinctively p e c u l i a r t o h u m a n being, to s e e it and s t a y f o c u s s e d on it. O n l y t h e n , by p u t t i n g medicine on a basis t h a t is suited to h u m a n b e i n g s and t h e i r Da-sein, shall we c a r r y o u t the physician's charge. T h e p a r t i c u l a r w a y i n w h i c h medical u n d e r s t a n d i n g t o date h a s g e n e r a l l y b e e n s h o r t s i g h t e d p o i n t s t h e w a y for o u r o w n w o r k . W e begin P a r t II by grappling o n c e again w i t h the familiar, individual, h e a l t h y b e h a v i o r a l p h e n o m e n a o f o u r test case. T h i s t i m e , h o w e v e r , w e are helped by a point of v i e w t h a t is totally d i f f e r e n t and m o r e suited to Da­ sein. T o its vision, f e a t u r e s o f h u m a n being t h a t w e r e i n a c c e s s i b l e b e f o r e are i m m e d i a t e l y r e c o g n i z a b l e . T h e s e f e a t u r e s c o m e t o light w i t h o u t t h e n e e d for a b s t r a c t d e d u c t i o n s or conclusions, without any speculative suppositions or hypotheses. T h e initial v e r i f i c a t i o n of this n e w p e r s p e c t i v e is followed by an e x p l i c a t i o n of t h e D a - s « « - b a s e d * u n d e r s t a n d i n g o f the h u m a n b e i n g ( w h i c h w a s t h e implicit basis o f t h e p r e c e d i n g d e s c r i p t i o n s o f individual h e a l t h y p h e n o m e n a i n o u r h u m a n t e s t s u b j e c t ) . T h i s explication p r e s e n t s t h e traits o f h u m a n e x i s t e n c e t h a t a r e m o s t i m p o r t a n t for m e d i c i n e . T h e c h a r a c t e r i s t i c s t r u c t u r e o f h u m a n e x i s t e n c e t h a t i s set f o r t h , t h o u g h i t does n o t claim to be a c o m p r e h e n s i v e D a - s m i - b a s e d a n t h r o p o l o g y , will s e r v e as a solid f o u n d a t i o n for m e d i c i n e . O n c e r e s t o r e d to this basis, the e n t i r e s t r u c t u r e o f the c o n c e p t s and f u n d a m e n t a l a s s u m p t i o n s o f

XXX

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FOUNDATIONS

p h y s i o l o g y and p s y c h o l o g y can be t r a n s f o r m e d i n t o a p h y s i o l o g y based on h u m a n b e i n g s and a p s y c h o l o g y based on Da-sein. R o u n d i n g o u t P a r t II is a c h a p t e r discussing t h e b a r r i e r s t h a t o b s t r u c t a g e n u i n e t r a n s f e r o f t h e D a s e i n s a n a l y t i c p e r s p e c t i v e t o physicians s c h o o l e d in n a t u r a l s c i e n c e and p s y c h o l o g y . P a r t III, c o n t i n u i n g along familiar p r o c e d u r a l lines, b e g i n s by t e s t i n g t h e D a s e i n s a n a l y t i c p e r s p e c t i v e a g a i n s t the individual pathological s y m p t o m s of t h e t e s t c a s e . All t h e u n h e a l t h y p h e n o m e n a of a u n i q u e Dasein are h e r e disclosed as o u t c o m e s of failure to c a r r y o u t c e r t a i n basic c h a r a c t e r i s t i c s o f h u m a n e x i s t e n c e . S t a r t i n g from t h e s e findings, P a r t III, t h e " R u d i m e n t s o f a n E x i s t e n t i a l G e n e r a l P a t h o l o g y , " i s primarily c o n c e r n e d w i t h c h a r a c t e r i z i n g all t h o s e h u m a n traits w h i c h until n o w h a v e b e e n o b j e c t i f i e d and a b s t r a c t e d i n t o physical and psychic disease symptoms as particular limitations in carrying various characteristics of h u m a n e x i s t e n c e t o fulfillment. T h i s r e s o l v e s a q u e s t i o n t h a t m a y h a v e a r i s e n for the reader during the first c h a p t e r s o f this w o r k . T h e s e c h a p t e r s m a y i n m a n y w a y s h a v e s e e m e d suited m o r e to the title Medunl Psychology t h a n to t h e actual heading, Existential Foundations of Medicine and Psychology. B u t t h e s t a t e m e n t s c o n c e r n i n g a g e n e r a l D a s e i n s a n a l y t i c p a t h o l o g y s u b s t a n t i a t e t h e fact t h a t Medical Psychology and Foundation of Medicine are identical. Medical p s y c h o l o g y is in i t s e l f t h e f o u n d a t i o n of m e d i c i n e in g e n e r a l . It is so by v i r t u e of h u m a n n a t u r e . T h e a s s u m p t i o n h e r e is t h a t Medical Psychology finally r e l i n q u i s h e s its d o m i n a n t c o n c e p t o f p s y c h e , t h e r e b y o v e r c o m i n g and b r o a d e n i n g its l i m i t a t i o n s to b e c o m e a discipline of Da-sein and of h u m a n life in this world. T h e f o u r t h and final part o f this w o r k a n a l y z e s t h e c o n s e q u e n c e s for t h e r a p y held in a m o r e Da-smi-based and m o r e h u m a n f o u n d a t i o n of m e d i c i n e . H e r e w e h a v e deliberately r e s t r i c t e d o u r s e l v e s t o e m p l o y i n g c o m p a r a t i v e s , for it is n o t t h e purpose of this s t u d y to a r o u s e even t h e suspicion that w e c o n s i d e r this g r o u n d w o r k t h e o n l y possibility, o r o n e t h a t is definitive for all t i m e . B u t as t h i n g s stand today, t h e r e a p p e a r s to be no s o u n d e r basis for medicine b e f o r e us. If this is actually so, t h e n o u r f o u n d a t i o n o w e s its s t r e n g t h to the p r e s c i e n t i f i c philosophical basis w i t h o u t w h i c h its s u b s e q u e n t scientific a s s e r t i o n s would b e i m p o s s i b l e . W e h a v e already discussed t h e t h e o r e t i c a l d e p e n d e n c e of all scientific r e s e a r c h upon philosophical p r e s u p p o s i t i o n s a b o u t its o b j e c t s o f study. J u s t a s t h e t r a d i t i o n a l n a t u r a l scientific and psychological f o u n d a t i o n s for m e d i c i n e g r e w o u t of—and still d r a w t h e i r vitality w h o l l y f r o m — t h e p r e s c i e n t i f i c philosophical c o n c e p t i o n o f n a t u r e r e p r e s e n t e d b y D e s c a r t e s , G a l i l e o , and N e w t o n , s o M a r t i n H e i d e g g e r ' s philosophical D a s e i n s a n a l y t i k first cleared g r o u n d

Introduction

xxxi

f o r o u r p h e n o m e n o l o g i c a l f o u n d a t i o n for m e d i c i n e and for p s y c h o l o g y . Heidegger's fundamental philosophic thinking never revolved around m a n t a k e n by h i m s e l f . F r o m t h e first it w a s directed, r a t h e r , t o w a r d s e e k i n g t h e m e a n i n g o f B e i n g a s s u c h . Y e t this f u n d a m e n t a l o n t o l o g i c a l inquiry i n t o B e i n g can n e i t h e r b e tackled n o r r e s o l v e d u n l e s s w e can explain a t t h e s a m e t i m e t h e n a t u r e o f h u m a n b e i n g s and o u r primal being t o g e t h e r in a s h a r e d world. T h u s the decisive i m p o r t a n c e of M a r t i n H e i d e g g e r ' s D a s e i n s a n a l y t i k for m e d i c i n e and p s y c h o l o g y . * Editor's note: A l t h o u g h t h e G e r m a n Daseinsgemdss is h e r e a n d t h r o u g h o u t t h e b o o k translated as " D a s e i n - b a s e d , " phrase "appropriate to the D a s e i n " might be n e a r e r the mark. For r e a s o n s of style, h o w e v e r , and to maintain c o n s i s t e n c y with earlier translations of D r . Boss's work, the f o r m e r translation has been retained. "Appropriate to the D a s e i n " might also be used in certain passages as an alternate rendering w h e r e the adjectives "existential" and " D a s e i n s a n a l y t i c " appear. T h e reader m a y m a k e the substitution for h i m s e l f w h e r e v e r a g a i n in u n d e r s t a n d i n g m i g h t r e s u l t .

Part í T h e Traditional Foundation o f Medicine

Chapter 1 A TEST CASE: REGULA ZÜRCHER

T h e first fact t h a t t h e p a t i e n t ' s m o t h e r r e p o r t e d a b o u t R e g u l a Z i i r c h e r was that t h e infant r e q u i r e d t h e help of a pediatrician j u s t a few w e e k s .il ter h e r b i r t h w h e n s h e developed a c u t e w e e p i n g e c z e m a t h a t c o v e r e d I u imarily large a r e a s of h e r a r m s and legs. I h e family medical h i s t o r y , w h i c h this first p h y s i c i a n o f R e g u l a / ii ri h e r had already t a k e n w i t h g r e a t c a r e , indicated no m a j o r h e r e d i t a r y taint. N o n e o f h e r a n c e s t o r s o r close r e l a t i v e s h a d s u f f e r e d f r o m n e u r o l o g i c a l o r m e n t a l d i s o r d e r s o r f r o m any allergies. O n t h e c o n t r a r y , e v e r y o n e d e s c r i b e d b o t h h e r p a t e r n a l and h e r m a t e r n a l families a s pai ticularly v i g o r o u s a n d h e a l t h y people. r h e t r e a t m e n t o f t h e i n f a n t ' s e c z e m a t u r n e d o u t t o b e v e r y difficult and p r o l o n g e d . S e v e r a l y e a r s o f medical c a r e w e r e n e e d e d b e f o r e t h e e x a g g e r a t e d irritability o f h e r skin subsided. B u t e v e n a f t e r t h e e c z e m a finally receded, R e g u l a Z i i r c h e r still held t h e s c h o o l r e c o r d s f o r a b s e n c e due to illness. C o l d s and e n i g m a t i c s t o m a c h a c h e s kept h e r c o n s t a n t l y in bed, h e n s h e w a s s e v e n , h e r t o n s i l s , w h i c h w e r e i n f e c t e d m u c h o f t h e time, had to be r e m o v e d . At t h e age of fifteen, w h e n s h e b e g a n to m e n s t r u a t e , she b e g a n c o m p l a i n i n g o f s e v e r e c o n s t i p a t i o n , w h i c h soon i

EXISTENTIAL

FOUNDATIONS

In spite of t h i s , m a n y physicists will p e r s i s t in claiming t h a t the s u c c e s s i o n o f " n o w s " c o n s t i t u t e s real, a c t u a l t i m e . T h e i r u n s h a k a b l e c o n f i d e n c e in this v i e w c o m e s from t h e fact t h a t t i m e — a s physics m e a s u r e s it—is a l w a y s s u b j e c t t o o b j e c t i v e , q u a n t i t a t i v e c o n f i r m a t i o n w h i c h i s t h e n o b j e c t i v e l y binding. O b j e c t i v e h e r e m e a n s " f o r e v e r y o n e , " b u t " e v e r y o n e " includes o n l y people w h o h a v e a c c e p t e d t h e w a y physics t h i n k s a b o u t n a t u r e and believe t h a t t h e s c i e n c e of physics is t h e o n l y valid f o r m for d i s c o v e r i n g t r u t h and for h u m a n k n o w l e d g e in g e n e r a l . T h i s " e v e r y o n e " also p r e s u p p o s e s t h a t o n l y t h e findings o f physics can deliver strictly scientific t r u t h and t h a t it is no l o n g e r i m p o r t a n t to a s k w h a t i s b e h i n d t h e n o t i o n o f s c i e n c e itself. M a c h i n e s c a n b e c o n s t r u c t e d on t h e basis of p h y s i c s ' c o n c e p t u a l a p p r o a c h , and for the m a n on t h e s t r e e t t h e t r u t h of physics is p r o v e d by its effects: his car is p r o o f e n o u g h for him t h a t p h y s i c s h a s t h e capacity t o u t t e r t h e t r u t h a b o u t t i m e a s well. T h e r e are those w h o think that Einstein's theory of relativity s u p e r s e d e d t h e n o t i o n s o f time h a n d e d d o w n from the philosophical tradition, but this t o o is a f u n d a m e n t a l e r r o r . T h e t h e o r y of relativity is a physical t h e o r y c o n c e r n e d w i t h finding o u t h o w t i m e , c o n c e i v e d of as a s u c c e s s i o n of " n o w s , " can be measured. B u t w h a t is s u b j e c t e d to this m e a s u r e m e n t i s i t s e l f t a k e n a s a g i v e n . T h e t h e o r y o f relativity m e r e l y asks, after t h e fact, w h e t h e r it is possible to m e a s u r e time a b s o l u t e l y or w h e t h e r e v e r y m e a s u r e m e n t is n e c e s s a r i l y r e l a t i v e . It a t t e n d s as little as a n y o t h e r scientific t h e o r y o f t i m e t o t h e n a t u r e o f w h a t i s b e i n g m e a s u r e d . W e t h e r e f o r e feel justified i n m a i n t a i n i n g t h a t t h e w h o l e e s s e n c e of t i m e c a n n o t possibly be r e p r e s e n t e d in t h e ideas c u r r e n t in contemporary natural science. M a n ' s r e l a t i o n s h i p t o t i m e , t h e c o n c u r r e n c e o f m a n and t i m e , h a s b e e n a m a j o r t h e m e in r u m i n a t i o n s a b o u t t i m e for a g e s . A r i s t o t l e said: "It is w o r t h e x a m i n i n g h o w t i m e i s related t o t h e soul. I f t h e soul w e r e n o t capable o f perceiving and e x p r e s s i n g itself a b o u t t i m e , t h e n t i m e could n o t possibly e x i s t u n l e s s t h e soul also e x i s t e d . " C o n t e m p o r a r y t h o u g h t , t o o , p r e s u p p o s e s t h e c o n c u r r e n c e o f t i m e and t h e h u m a n e s s e n c e . T h i s i s e v i d e n t f r o m t h e w a y t h e p r o b l e m o f t i m e i s posed. W e s p e a k t h e s e days, for i n s t a n c e , a b o u t " t i m e s e n s e " o r s e n s e o f t i m e , a b o u t " t i m e experience," about "consciousness of time," mentally coordinating these w i t h t i m e . T h i s h a b i t , a s well a s t h e c o m m o n d i s t i n c t i o n s t h a t a r e m a d e b e t w e e n s u b j e c t i v e and o b j e c t i v e t i m e , w o r l d and e g o t i m e , m e a s u r e d and e x p e r i e n c e d t i m e , q u a n t i t a t i v e and q u a l i t a t i v e t i m e , all r e s t on illc o n s i d e r e d , u n p r o v e n , and u n e x p l a i n e d p r e s u p p o s i t i o n s a b o u t t h e n a t u r e o f m a n and his r e l a t i o n s h i p t o t i m e . T h e y a r e t o o q u e s t i o n a b l e t o form the basis for a f u n d a m e n t a l study of t h e r e l a t i o n s h i p b e t w e e n m a n and t i m e . F o r e x a m p l e , w h e n we d i s t i n g u i s h b e t w e e n a s u b j e c t i v e and

Fundamental

Characteristics

of Human

Beings

97

o b j e c t i v e t i m e , w e hold t o t h e n o t i o n s o f C a r t e s i a n dualism, o f o b j e c t i v i t y and s u b j e c t i v i t y . B u t in r e s p e c t to t h e s e c o n c e p t s , t h e q u e s t i o n is o p e n w h e t h e r t h e y can b e a p p r o p r i a t e l y defined b e f o r e t h e n a t u r e o f t i m e has been adquately illuminated. W e h a v e already m e n t i o n e d o n e h u m a n r e l a t i o n s h i p t o t i m e t h a t can b e e x p e r i e n c e d directly. H u m a n b e i n g s can e i t h e r have t i m e or not have t i m e . N o w w e m u s t ask w h a t m a k e s this r e l a t i o n s h i p t o t i m e possible. I s o u r b e i n g - i n - t i m e t h e basis o f o u r h a v i n g t i m e , o r i s t h e r e v e r s e t r u e ? W h a t d o e s b e i n g - i n - t i m e m e a n ? D o w e n e e d t o ask this a t all? N a t u r a l s c i e n c e m e a s u r e s all n a t u r a l p r o c e s s e s a s t h e y o c c u r i n t i m e , a n d i n o u r e v e r y d a y t h i n k i n g we find t h a t t h i n g s and e v e n t s o c c u r , p e r s i s t , and perish in t i m e . N o w , I can say simply t h a t t h e table in f r o n t of me w a s already p r e s e n t b e f o r e I s e t e y e s on it and will r e m a i n w h e r e it is w h e n I am no l o n g e r looking a t it. H o w long i t h a s b e e n o r will r e m a i n t h e r e i s o f n o c o n c e r n t o m e , but t h e fact t h a t it w a s already and will r e m a i n t h e r e m e a n s t h a t it has p e r s i s t e d during, o r in, t i m e . D o e s o u r indication o f this p e r s i s t e n c e a d e q u a t e l y define t h e o b j e c t ' s b e i n g - i n - t i m e ? A n d i s t h e b e i n g - i n - t i m e o f such a t h i n g identical to t h e b e i n g - i n - t i m e of an e x i s t i n g h u m a n b e i n g ? In e i t h e r c a s e w e m u s t avoid falling i n t o t h e easy e r r o r t h a t time i s s o m e h o w spatial, s o m e kind of c o n t a i n e r in w h i c h t h i n g s are. P e r s i s t e n c e is a c h a r a c t e r i s t i c of all o b j e c t s . S o m e p e r s i s t for a long time, s o m e only for a short time. Do objects need to do anything to p e r s i s t ? W h e r e is p e r s i s t e n c e to be found in a t h i n g ? W h a t h a p p e n s to an o b j e c t w h e n t h e r e i s n o l o n g e r a n y o n e n e a r it? D o e s i t c o n t i n u e t o persist? A d r i n k i n g g l a s s m a y be b r o k e n w h i l e t h e table is b e i n g c l e a r e d . We a r e t h e n left w i t h the b r o k e n pieces. I f t h e s e f r a g m e n t s g e t i n t o t h e g a r b a g e , t h e y a r e s e p a r a t e d f r o m e a c h o t h e r and are j u s t isolated pieces o f glass. As glass pieces t h e y c o n t i n u e to p e r s i s t , b u t t h e y no l o n g e r p e r s i s t as a d r i n k i n g g l a s s . W e realize, t h e n , t h a t t h e d r i n k i n g glass h a s its o w n t i m e to be a drinking glass. Its t i m e is n o t simply e m p t y p e r s i s t e n c e but a t i m e for. Its t i m e has to do w i t h its u s e , and its u s e w i t h m a n , w h o h a s t i m e for t h i n g s . M a n gives t i m e t o t h e g l a s s . A n d , w e m a y ask, i f m a n c e a s e d t o e x i s t w o u l d t h e r e b e a n y d r i n k i n g g l a s s e s ? T h e a n s w e r is, o f c o u r s e , n o , since o n l y m a n can m a n u f a c t u r e d r i n k i n g g l a s s e s . O b j e c t s like t h e g l a s s e n t e r t i m e b y v i r t u e o f t h e fact t h a t t h e y h a v e b e e n m a d e . W h a t t h e n o f a m o u n t a i n ? Y e s , it t o o h a s its t i m e , c o n t i n u e s to persist. W a s it in t i m e already b e f o r e m a n a r r i v e d o n t h e s c e n e ? N o o n e t o d a y w o u l d h e s i t a t e a m o m e n t i n saying y e s . Y e t e v e n t h e t i m e w e r e f e r t o w h e n w e say " b e f o r e m a n " is u n e q u i v o c a l l y r e l a t e d to m a n as t h e t i m e w h i c h r e v e a l s itself to him, t h e h u m a n being, a s long past. T h a t i s w h y w e can n e v e r k n o w w h a t w a s h e r e w h e n m a n had n o t y e t arrived. W e c a n n o t e v e n decide w h e t h e r

98

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o r n o t i t i s p r o p e r t o say t h a t t h e Alps w e r e h e r e b e f o r e t h e r e w e r e h u m a n b e i n g s . S t r i c t l y s p e a k i n g , w e can n e v e r say w h a t was b e f o r e m a n . G e o l o g i s t s m e a s u r i n g t i m e w i t h t h e a t o m i c clock a r e c o n f i d e n t t h a t t h e y h a v e b e e n able t o find e r a s o f t i m e c o n t a i n i n g t h i n g s millions o f y e a r s b e f o r e t h e r e w e r e h u m a n b e i n g s . B u t e v e n t h e a t o m i c clock does n o t bring u s a n y c l o s e r t o u n d e r s t a n d i n g b e i n g - i n - t h e - w o r l d , b e c a u s e t h e data it p r o d u c e s a r e also tied to t h e h u m a n b e i n g w h o reads t h e m . It is t o this h u m a n being t h a t t h e t e s t e d e n t i t i e s appear t o b e o f such and s u c h an age. W i t h o u t t h e possibility of indicating t i m e to a r e c e p t i v e and p e r c e i v i n g c r e a t u r e like m a n , all f u n d a m e n t a l w o r d s like " b e i n g , " " i s , " " w a s , " " h a s b e e n " and "will b e " lose all m e a n i n g . AH p r e s u p p o s e t h e possibility o f p r e s e n c e e n t e r i n g i n t o a n open r e a l m o f p e r c e p t i o n and being p e r c e i v e d t h e r e . I f e v e r y d e t e r m i n a t i o n o f time available from n o n h u m a n e v e n t s and o b j e c t s is i n e v i t a b l y r e l a t e d to m a n , we will n e v e r g e t past their b e i n g - i n time t o u n d e r s t a n d t h e h u m a n r e l a t i o n s h i p t o t i m e . T h e r e v e r s e i s m o r e likely, t h a t an a d e q u a t e i n s i g h t i n t o the h u m a n r e l a t i o n s h i p to time will give us a v i e w of t h e b e i n g - i n - t i m e of i n a n i m a t e o b j e c t s as well. M a n ' s r e l a t i o n s h i p t o his t i m e i s c e r t a i n l y s o m e t h i n g m o r e t h a n the w a y in w h i c h a d r i n k i n g g l a s s , for i n s t a n c e , is in t i m e . In o r d e r to see in its p r o p e r light t h e special w a y in w h i c h time applies to h u m a n b e i n g s , we m u s t first b r e a k a w a y from o u r o r d i n a r y h a b i t s o f s p e e c h . W e a r e u s e d t o saying t h a t we a r e in t i m e , and also t h a t we have t i m e . To s t a r t w i t h , this " i n " should n o t be t a k e n in a n y spatial s e n s e . We a r e n o t in t i m e as s m a l l e r C h i n e s e ivory balls can b e found inside l a r g e r o n e s . Similarly, w e m u s t n o t c o n c l u d e t h a t " h a v i n g t i m e " m e a n s t h a t t h e r e i s time o n t h e o n e h a n d , and on t h e o t h e r a " h a v i n g " t h a t h a s n o t h i n g to do w i t h t h e t i m e itself. We can h a v e c e r t a i n t h i n g s in this s e n s e — a car, a h o u s e , a N o b e l P r i z e — b u t n o t t i m e . W e can also have s u c h t h i n g s a s affect u s directly, being part of us: I have a b r o k e n a r m , an e a r a c h e , pain, or a w o r r y . B e f o r e w e can u n d e r s t a n d t h e i n h e r e n t n a t u r e o f " h a v i n g " t i m e , w e m u s t carefully d i s t i n g u i s h a m o n g t h e v a r i o u s possibilities o f " h a v i n g . " T h e e x a m p l e o f " h a v i n g a w o r r y " s h o w s m o s t readily t h a t " h a v i n g " can m e a n far m o r e t h a n j u s t p o s s e s s i n g s o m e t h i n g . I nave a w o r r y . I am w o r r i e d , or b e t t e r still (to s h o w t h a t it is n o t I w h o c r e a t e t h e w o r r y ) : I am o v e r c o m e b y w o r r y . H o w does " h a v e " w o r k h e r e ? W e see t h a t w h a t w e s e e m e d to " h a v e , " t h e w o r r y , w a s in fact n o t " h a d . " It would be m o r e a p p r o p r i a t e to say t h a t t h e w o r r y has a p e r s o n . It is s o m e m o d e in w h i c h we find o u r s e l v e s . " H a v e , " as in t h e e x p r e s s i o n " t o h a v e a w o r r y , " r e f e r s t h e n to a specific m o d e in w h i c h a p e r s o n is, and is e x i s t i n g , at a given time.

Fundamental

Characteristics of Human

Beings

C e r t a i n l y , w e c a n n o t simply t r a n s f e r o u r s t a t e m e n t s a b o u t " h a v i n g " . 1 w o r r y to t h e h a v i n g of t i m e . O n e o b v i o u s d i f f e r e n c e b e t w e e n the two ¡8 t h a t w o r r y , unlike t i m e , does n o t affect us i n e v i t a b l y and at e v e r y m o m e n t . B u t w e have discussed " h a v i n g " w o r r i e s b e f o r e w e consider " h a v i n g " t i m e t o point o u t t h e peculiarities t h a t o b t a i n b e t w e e n the w o r d ' s c o m m o n u s a g e and t h e p a r t i c u l a r t h i n g s t h a t a r e " h a d , " a s well a s t o s h o w h o w i n e x a c t and u n s c i e n t i f i c w e would b e i f w e w e r e t o lump t o g e t h e r all i n s t a n c e s o f " h a v i n g . " N o w , a friend m a y ask m e , "Will you h a v e time for a w a l k t o m o r r o w a f t e r n o o n ? " A f t e r t h i n k i n g it o v e r briefly, I a n s w e r , " Y e s , I'll h a v e t i m e . " H e r e t i m e has n o t b e e n m a d e i n t o an o b j e c t , n o r is it e v e n w h a t is f o c u s s e d on. My a t t e n t i o n is f o c u s s e d r a t h e r on t h e t h i n g for which I shall h a v e t i m e , on w h a t is to be d o n e — t h e t h i n g I am e x p e c t i n g . My e x p e c t a t i o n is so c o n s t i t u t e d , h o w e v e r , t h a t e v e n w h i l e I am e x p e c t a n t , I am also dwelling in w h a t is p r e s e n t to me at this m o m e n t . I a l s o — t h o u g h I a m n o t n e c e s s a r i l y a w a r e o f i t — r e t a i n all t h a t has e v e r o c c u p i e d m e u p t o this m o m e n t . Any timel "have," 1 have in such a way that I am expectant of which is to come, aware of what is present, and retentive of what has been. This threefold mode in what 1 am constitutes "having" time for this or that. " H a v i n g t i m e , " in this v e r y s e n s e of a t h r e e f o l d e x i s t e n c e is a m o d e of h u m a n being. In this having of t i m e and the c a r r y i n g o u t o f p o t e n t i a l w a y s o f being, a n e x i s t e n c e develops and m a t u r e s . It e x p e n d s its t i m e and finally w h e n it has used up t h e t i m e a p p r o p r i a t e t o a n e x i s t e n c e , e f f e c t s its o w n d e m i s e , w h i c h i s t h e fulfillment o f t h e e x t r e m e , u n s u r p a s s a b l e e x i s t e n t i a l possibility. T h u s , t h e " h a v i n g " i n t h e h a v i n g o f t i m e i s t h e actual t e m p o r a l i t y o f h u m a n being, in t h a t w h a t m a t u r e s sich zeitigt in this " h a v i n g " is w h a t we m a y d e s i g n a t e a s m a n ' s b e i n g - i n - t h e - w o r l d , o r his worldly dwelling ( v e r b a l ) . 1

T h i s dwelling in t h e w o r l d is c h a r a c t e r i z e d by its c o n t a i n i n g — a l l d i f f e r e n t b u t all equally e l e m e n t a r y — w h a t is c o m i n g to m a n , w h a t he is a w a r e o f p r e s e n t l y , and w h a t h a s already b e e n . I n its t h r e e f o l d capacity, t h e dwelling of h u m a n being holds o u t a t i m e for e a c h t h i n g . It has on hand t h e " w h e n e v e r , " t h e ' n o w , " and t h e ' t h e n " w h i c h w e use i n o u r c a l c u l a t i o n s of t i m e . A n d , as h a v i n g a w o r r y actually m e a n s being w o r r i e d , s o , similarly, h a v i n g t i m e is being e x p e c t a n t of t h e f u t u r e , being a w a r e o f t h e p r e s e n t , and r e t a i n i n g w h a t h a s passed. All o f this should d e m o n s t r a t e a t least t h a t w e d o n o t c o m p r e h e n d t h e p h e n o m e n o n of h a v i n g t i m e for s o m e t h i n g simply by r e f o r m u l a t i n g it to say t h a t t i m e i s p r e s e n t , w h i c h would sidestep t h e p h e n o m e n o n o f " h a v i n g . " B u t t i m e or s o m e t h i n g does n o t lie b e f o r e us like s o m e object w h i c h w e can i g n o r e o r pick up, according t o w h i m . O u r r e l a t i o n s h i p t o t i m e — w h a t e v e r it m a y be at a n y m o m e n t — i s t h e basis of o u r dwelling in the w o r l d . W h e t h e r w e h a v e i t o r n o t , w h e t h e r w e plan o r squander it,

100

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FOUNDATIONS

t i m e is s o m e t h i n g t h a t is, in a s e n s e , at o u r disposal, t h e r e for us to o r g a n i z e as we w i s h . W h a t we c a n n o t do is a l t e r t h e fact t h a t it is t i m e . At a n y g i v e n t i m e , w e a r e c o n s t a n t l y bringing past, p r e s e n t , and f u t u r e t o g e t h e r i n a u n i q u e w a y . T h u s , w e p r o d u c e and f o r m t h e m o m e n t a r y s t r u c t u r e of t i m e , and so c a r r y out o u r w o r l d l y dwelling in its t e m p o r a l i t y . We can t a k e and h a v e o u r t i m e in t h a t we r e t a i n it in visualizing, m a k e it p r e s e n t , and s i m u l t a n e o u s l y hold it ready for f u t u r e t h i n g s . T h e disposable and disposed of t i m e is c o n s t i t u t e d in w a i t i n g , r e t a i n i n g , and b e i n g p r e s e n t . T h i s , in its t h r e e f o l d u n i t y , is t h e t e m p o r a l i t y o f t h e t i m e w h i c h w e h a v e o r d o n o t h a v e . T o b e s u r e , i t i s still o b s c u r e h o w t h e u n i t y o f t h e " t h r e e f o l d n e s s " o f t i m e i s t o b e defined. W h i l e dwelling i n t h e w o r l d m e a n s e x t e n d i n g o u r s e l v e s s i m u l t a n e o u s ­ ly into the three temporal dimensions—extensions or ecstasies—of the past, p r e s e n t , and f u t u r e , t h e s e d i m e n s i o n s are n a t u r a l l y n o t a l w a y s o p e n equally t o e a c h e x i s t e n c e . A t v a r i o u s t i m e s , o n e o r a n o t h e r o f t h e d i m e n s i o n s will be m o s t c o m m a n d i n g , and at t h o s e t i m e s we e n t e r i n t o it m u c h m o r e t h a n t h e o t h e r s . W e m a y e v e n b e trapped i n o n e o f t h e t h r e e . Even t h e n , h o w e v e r , t h e o t h e r t w o a r e n e v e r n e g a t e d o r d e s t r o y e d b u t only deprived o r c o n c e a l e d .

Human bodyhood

2

T h e traditional, n a t u r a l scientific f o u n d a t i o n o f m e d i c i n e a s s i g n s t h e h u m a n b o d y a position of singular p r o m i n e n c e . It is t h e o n l y aspect of t h e h u m a n c o n s t i t u t i o n w h i c h can b e posited, i n v e s t i g a t e d and m a n i p u l a t e d as a c h e m o p h y s i c a l or c y b e r n e t i c s t r u c t u r e . B o d y h o o d i t s e l f s u g g e s t s t h a t it be c o n s i d e r e d as t h o u g h it w e r e a m a t e r i a l o b j e c t , s o m e selfc o n t a i n e d t h i n g p r e s e n t at s o m e specific l o c a t i o n in a p r e e x i s t i n g space. O n l y w h e n it is defined this w a y is b o d y h o o d a c c e s s i b l e to t h e n a t u r a l scientific r e s e a r c h m e t h o d , w h i c h t h e n t a k e s this definition as the r e a l i t y of human existence. B y positing t h e h u m a n body a s s o m e s e l f - c o n t a i n e d m a t e r i a l t h i n g , n a t u r a l s c i e n c e d i s r e g a r d s e v e r y t h i n g t h a t i s specifically h u m a n a b o u t h u m a n b o d y h o o d . T h e n a t u r a l scientific r e s e a c h m e t h o d t r e a t s t h e body as it m i g h t t r e a t w o r k s of a r t . G i v e n a collection of P i c a s s o p a i n t i n g s , for i n s t a n c e , this m e t h o d would see o n l y m a t e r i a l o b j e c t s w h o s e l e n g t h and b r e a d t h could b e m e a s u r e d , w h o s e w e i g h t could b e d e t e r m i n e d , and w h o s e s u b s t a n c e could be analyzed c h e m i c a l l y . All t h e r e s u l t i n g data lumped t o g e t h e r would tell u s n o t h i n g a b o u t w h a t m a k e s t h e s e p a i n t i n g s w h a t t h e y a r e ; t h e i r c h a r a c t e r a s w o r k s o f art i s n o t e v e n t o u c h e d b y this approach. N o r will it suffice to say t h a t s o m e t h i n g else is p r e s e n t in t h e a n i m a t e body of a h u m a n being, s o m e s u p e r n a t u r a l life f o r c e closed to I he nal ural scientific r e s e a r c h m e t h o d . S u c h a f o r c e , s e p a r a t e from h u m . i n physical

Fundamental

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e n e r g y , was p o s t u l a t e d b y t h e vitalists o f t h e last c e n t u r y and the n e o v i t a l i s t s of this. All s u c h s u p p o s i t i o n s s h a r e t h e c o n v i c t i o n thai the h u m a n body h a s at least o n e c h e m o p h y s i c a l - c y b e r n e t i c , purely biologk al c o m p o n e n t . Y e t n o o n e h a s b e e n able t o s u r m i s e h o w t w o t h i n g s a s f u n d a m e n t a l l y different as m e t a p h y s i c a l life f o r c e and i n a n i m a t e c h e m i c a l s u b s t a n c e could e v e r m e r g e t o f o r m t h e u n i t y t h a t i s h u m a n bodyhood. In looking for the special w a y in w h i c h t h e h u m a n body is b o d y h o o d , we shall begin by looking a w a y from b o d y h o o d to s o m e t h i n g else. All of o u r e x p e r i e n c e tells us t h a t j u s t w h e n a h u m a n being is e x i s t i n g in t h e m o s t h i g h l y c h a r a c t e r i s t i c h u m a n w a y , h e i s totally u n a w a r e o f his body as s u c h . To exist in a c h a r a c t e r i s t i c h u m a n w a y m e a n s to be e n g a g e d body and soul by s o m e t h i n g t h a t claims o n e , and to r e s p o n d to t h a t address or claim. T h e h u m a n being c o m p l e t e l y loses his a w a r e n e s s o f his b o d y h o o d as a physical body j u s t w h e n he is a c t i n g m o s t g e n u i n e l y h u m a n . A t t h e m o m e n t w h e n she w a s d a s h i n g a c r o s s t h e s t r e e t t o h e r lover, R e g u l a Z u r c h e r was n o t a w a r e o f p o s s e s s i n g a body. H e r b o d y h o o d w a s e n g a g e d c o m p l e t e l y in h e r longing to be w i t h h e r lover and in h e r h u r r y i n g t o close t h e d i s t a n c e b e t w e e n t h e m . T h a t s h e was n o l o n g e r a w a r e o f h e r b o d y h o o d does n o t m e a n t h a t h e r b o d y h o o d had disappeared. T h i s u n a w a r e n e s s h a p p e n s a t t i m e s i n h e a l t h y h u m a n e x i s t i n g but in no w a y implies t h a t this particular m o d e of e x i s t e n c e is n o t bodily. T h e r e is no m a n i f e s t a t i o n of h u m a n e x i s t e n c e w h i c h is n o t bodily. A p e r s o n ' s c o n c r e t e dealings w i t h o t h e r people and his direct p e r c e p t i o n o f o b j e c t s t h a t p r e s e n t t h e m s e l v e s physically t o his s i g h t and t o u c h a r e especially o b v i o u s bodily r e l a t i o n s h i p s , b u t t h e y are n o t all t h a t is bodily. V i s u a l i z a t i o n s o f t h i n g s t h e s e n s e s d o n o t p e r c e i v e a r e also bodily, t h o u g h w h a t w e visualize m a y b e visible only t o t h e mind's e y e . E v e n w h a t w e m e r e l y visualize, c o n s i d e r , i m a g i n e , o r r e m e m b e r appears h a v i n g a p a r t i c u l a r s h a p e , a p a r t i c u l a r c o l o r and shading, a particular smell, t a s t e , t e x t u r e . A n d e v e n w h e n w e are e n g a g e d i n purely i n t e l l e c t u a l and a b s t r a c t t h o u g h t , w h a t we visualize still b e a r s relation to w h a t we h a v e s e e n w i t h o u r e y e s in, say, a m a t h e m a t i c s t e x t , and w h a t we h a v e h e a r d w i t h o u r e a r s , p e r h a p s in a sociology l e c t u r e . E v e r y t h i n g we s e e in t h e mind's e y e is s e e n , t h e n , w i t h the s e n s e s , is s e e n bodily. N e v e r t h e l e s s , w e d o n o t s e e i t a s physically p r e s e n t . O n the c o n t r a r y , w e see it as n o t physically p r e s e n t , b u t as r e - p r e s e n t e d . To u n d e r s t a n d t h e b o d y h o o d t h a t i n h e r e s in all h u m a n e x i s t e n t i a l p h e n o m e n a , w e m u s t distinguish b e t w e e n h u m a n b o d y h o o d and the m a t e r i a l n a t u r e o f i n a n i m a t e o b j e c t s . W e can approach this distinction from t w o different s t a r t i n g p o i n t s . T h e first is t h e a b s o l u t e difference b e t w e e n t h e limits of o u r b o d y h o o d and the m a t e r i a l b o r d e r s of i n a n i m a t e

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o b j e c t s . T h e s e c o n d i s t h e f u n d a m e n t a l dissimilarity o f t h e local c h a r a c t e r s o f e x i s t i n g h u m a n b e i n g s and i n a n i m a t e o b j e c t s , t h e d i f f e r e n t w a y s in w h i c h t h e i r l o c a t i o n s at a given t i m e are d e t e r m i n e d . If h u m a n b o d y h o o d w e r e a physical, m a t e r i a l b o d y , t h e n its b o r d e r s would b e t h e skin. T h e fact is, h o w e v e r , t h a t n o m a t t e r w h e r e w e are w e a r e always i n s o m e s o r t o f r e l a t i o n s h i p t o s o m e t h i n g outside o u r skin. S h o u l d w e t h e n c o n c l u d e t h a t w e a r e c o n s t a n t l y b e y o n d o u r physical body's b o r d e r s , and n e v e r w h o l l y w i t h i n t h e m ? S u c h a c o n c l u s i o n is appealing, b u t it is d e c e p t i v e . It w o u l d be a m i s u n d e r s t a n d i n g of t h e p h e n o m e n o n of b o d y h o o d as well as t h e p h e n o m e n a of Da-sein. We can n e v e r grasp t h e p h e n o m e n o n of b o d y h o o d if we c o n t i n u e to i m a g i n e it as a s e l f - c o n t a i n e d physical s t r u c t u r e e x i s t i n g in i t s e l f and of itself, in isolation from t h e w o r l d . At best, this m i g h t allow us to d e t e r m i n e t h a t t h e b o r d e r s o f the h u m a n body e x t e n d b e y o n d t h o s e o f t h e physical body and t h a t , c o n s e q u e n t l y , t h e d i f f e r e n c e b e t w e e n t h e t w o types o f b o r d e r i s simply q u a n t i t a t i v e . B u t b o d y h o o d and its limits differ from t h o s e of a physical body n o t q u a n t i t a t i v e l y b u t qualitatively. It is t h e o r e t i c a l l y possible to i m a g i n e the h u m a n body physically e x t e n d i n g t o s o m e w i n d o w t h a t p r e s e n t l y f o r m s the b o u n d a r y o f t h e optical field of my p e r c e p t i o n . In this c a s e , t h e b o r d e r s of the h u m a n b o d y would coincide w i t h t h e body's physical limits. Y e t t h e v e r y a s s u m p t i o n of this possibility c l e a r l y reveals t h a t t h e t w o types of b o r d e r s are fundamentally different. W h e n I direct s o m e o n e t o w a r d a w i n d o w s i l l w i t h a g e s t u r e of my r i g h t h a n d , my bodily e x i s t e n c e as a h u m a n being does n o t end at t h e tip of my index finger. While perceiving the w i n d o w s i l l and m y c o n v e r s a t i o n a l p a r t n e r w i t h m y e y e s , I e x t e n d m y s e l f bodily far b e y o n d this f i n g e r t i p t o t h a t windowsill. In fact, bodily I r e a c h o u t e v e n f u r t h e r t h a n this to t o u c h all the p h e n o m e n a o f m y w o r l d , p r e s e n t o r m e r e l y visualized r e ­ p r e s e n t e d o n e s , t h o u g h m a n y o f t h e m m i g h t r e m a i n u n t h e m a t i c and v a g u e in t h e b a c k g r o u n d at this m o m e n t . N o r is t h e g e s t u r e t o w a r d the w i n d o w s i l l t h e r e s u l t of a t w o - s t a g e p r o c e s s in w h i c h , initially, my o u t s t r e t c h e d a r m and index f i n g e r c o n s t i t u t e a s e l f - c o n t a i n e d , m a t e r i a l m e d i u m t h r o u g h w h i c h can be s e n t , s e c o n d l y , s o m e flow o f m e n t a l o r e x i s t e n t i a l relating t h a t t r a n s c e n d s the physical a s p e c t of b o d y h o o d . All my e x p e r i e n c e tells m e , I am i n h e r e n t l y settled into t h e open space of my world to t h e e x t e n t t h a t I, w i t h e v e r y t h i n g I am, actually dwell in my perceiving r e l a t i o n s h i p to t h e windowsill. T o this e c s t a t i c r e l a t i o n s h i p b e l o n g b o t h m y optical perception o f t h e o b j e c t and, w i t h t h e s a m e i m m e d i a c y , m y g e s t u r e t o w a r d it. B o t h m a y p e r h a p s b e s t be d e s i g n a t e d as t h e bodying forth of this existential relationship. 1

luman bodyhood is always the bodying forth of the

ways

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w h i c h we are dwelling and w h i c h c o n s t i t u t e o u r e x i s t e n c e at any given m o m e n t . T h u s , j u s t a s t h e r e can b e n o i n d e p e n d e n t l y e x i s t i n g t i m e , t h e r e can be no s e l f - c o n t a i n e d , f u n d a m e n t a l , and final h u m a n b o d y h o o d . And j u s t as m a n ' s actual t e m p o r a l i t y e m e r g e s o n l y in t h e p a r t i c u l a r m o d e s of h u m a n e x i s t e n c e , s o his b o d y h o o d o c c u r s e x c l u s i v e l y a s t h e bodying f o r t h o f his e x i s t e n t i a l dwelling amid t h e b e i n g s t h a t a d d r e s s t h e m s e l v e s at a n y g i v e n time to his p e r c e p t i o n and r e q u i r e of him an a p p r o p r i a t e r e s p o n s e . T h e b o r d e r s o f m y b o d y h o o d coincide w i t h t h o s e o f m y o p e n n e s s to the w o r l d . T h e y are in fact at a n y given t i m e identical, t h o u g h t h e y are a l w a y s c h a n g i n g w i t h t h e fluid e x p a n s i o n and c o n t r a c t i o n o f m y r e l a t i o n s h i p t o t h e world. I n c o n t r a s t t o t h e b o r d e r s o f h u m a n b o d y h o o d , t h e limits o f w h a t w e c o n c e p t u a l i z e as o u r physical b o d y usually r e m a i n fixed, at m o s t c h a n g i n g slightly w h e n w e gain o r lose w e i g h t . Y e t e v e n t h e s e a r e n o t simply m a t e r i a l p h e n o m e n a b u t bodily e v e n t s to be u n d e r s t o o d in c o n t e x t w i t h a c h a n g e d r e l a t i o n s h i p to t h e w o r l d . T o i l l u s t r a t e t h e special quality o f h u m a n b o d y h o o d a s t h e bodying f o r t h of t h e p o t e n t i a l w a y s of b e i n g t h a t m a k e up a h u m a n e x i s t e n c e at a n y g i v e n m o m e n t , we m a y t u r n to a p a r t i c u l a r s i t u a t i o n f r o m the life h i s t o r y o f o u r t e s t s u b j e c t . O n e day, R e g u l a Z i i r c h e r and h e r friend had m o v e d i n t o h e r parlor for c o f f e e , and as she r e l a x e d in h e r a r m c h a i r she c h a t t e d w i t h him a b o u t v a c a t i o n plans. N o w , e v e n t h e w a y s h e sat in the a r m c h a i r b e l o n g e d i m m e d i a t e l y t o h e r relaxed r e l a t i o n s h i p t o the visualized r e - p r e s e n t e d r e s o r t and t o t h e peaceful s t a y s h e h o p e d t o h a v e t h e r e w i t h h e r friend. In fact, h e r bodily sitting b e l o n g e d so i n t i m a t e l y to h e r m o m e n t a r y r e l a t i o n s h i p t o t h e world t h a t h e r a w a r e n e s s o f h e r s e l f a s a s e l f - c o n t a i n e d physical body sitting in an a r m c h a i r disappeared. S h e w a s e x i s t i n g as all eyes and e a r s for w h a t w a s being talked a b o u t . A t r e s t i n h e r a r m c h a i r , she w a s n o static physical m a s s . S h e was bodying f o r t h h e r p a r t i c u l a r r e l a t i o n s h i p t o t h e r e s o r t , w h i c h she visualized j u s t as it w a s to be s e e n . As a r e c e p t i v e , open r e a l m of p e r c e p t i o n , s h e s p a n n e d t h e A t l a n t i c O c e a n from h e r h o m e i n E u r o p e t o the warm waters of the Equator. We know, by way of comparison, how i m p o s s i b l e t h o u g h t f u l c o n v e r s a t i o n is at a cocktail p a r t y as the p a r t i c i p a n t s ' milling a b o u t bodies f o r t h t h e i r superficial a s s o c i a t i o n amid t h e trifles o f t h e i r social w o r l d . If th is is t h e real n a t u r e of h u m a n b o d y h o o d , t h e n e v e n t h e least g e s t u r e of t h e h a n d can n e v e r be fully u n d e r s t o o d u n l e s s t h e hand is no l o n g e r r e g a r d e d as m e r e l y a p h y s i c a l i n s t r u m e n t m a d e of m u s c l e and b o n e , n e r v e and s i n e w . Like e v e r y t h i n g else bodily, t h e h u m a n hand b e l o n g s so directly to h u m a n b e i n g - i n - t h e - w o r l d t h a t it is d e t e r m i n e d in e v e r y t h i n g it is and does by h o w its o w n e r is relating to w h a t he is at t h a t m o m e n t e n c o u n t e r i n g . It c a n n o t e x i s t e x c e p t as the bodying forth ol

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active h u m a n r e l a t i o n s h i p s to t h e w o r l d . Even at r e s t a hand still bodies forth an act of r e s t . B y v i r t u e o f t h e fact t h a t i t b e l o n g s t o h u m a n b e i n g - i n - t h e - w o r l d , bodying f o r t h is i n h e r e n t l y s e t t l e d into space. C o n s e q u e n t l y , it is endowed with the whole range of temporal-spatial-ecstatic relationships t o w h a t m a n e n c o u n t e r s . B u t o u r r e l a t i o n s h i p t o w h a t w e p e r c e i v e varies with w h i c h of t h e s e n s e s is in o p e r a t i o n . S i g h t and h e a r i n g r a n g e f u r t h e r t h a n s m e l l , t a s t e , and t o u c h . I do n o t perceive w i t h my e y e s t h e w a y I p e r c e i v e w i t h my f i n g e r s . W h e n I s e e a glass I do n o t p e r c e i v e my o w n e y e s , but w h e n I pick up a glass, I feel n o t j u s t t h e glass but t h e h a n d w i t h w h i c h I pick it up as well. Y e t , is it actually my hand t h a t is perceived in t h e p r o c e s s ? Isn't it, r a t h e r , t h a t I am n o t at all a w a r e of my h a n d as a distinct area of the body but am perceiving m y s e l f as a w h o l e e n t i t y , a p e r s o n holding a glass ? While t o u c h i n g does n o t b r i n g a w a r e n e s s of t h e hand as s u c h , it d o e s include a s e n s a t i o n of tangible c l o s e n e s s . My e y e does n o t . A l s o , I can see o n l y w h a t is in front of m e . B u t my sight (like my h e a r i n g ) o p e r a t e s at g r e a t e r d i s t a n c e s from t h i n g s t h a n m y t o u c h does. T h e fact t h a t s i g h t e x t e n d s f u r t h e r t h a n t o u c h only c o n f i r m s t h a t b o t h a r e r o o t e d in t h e spatial relationships of h u m a n b e i n g - i n - t h e - w o r l d . T h i s in t u r n a r g u e s t h a t h u m a n e x i s t e n c e is n o t spatial b e c a u s e it is bodily, b u t t h a t s o m e t h i n g like b o d y h o o d can c o m e a b o u t o n l y b e c a u s e e x i s t e n c e (as e n t e r i n g i n t o close or d i s t a n t r e l a t i o n s h i p s to o b j e c t s ) is itself spatial. It is n o t the e x i s t e n c e o f o u r bodily s e n s e o r g a n s t h a t allows u s t o s e e , h e a r , t a s t e , t o u c h , and smell. R a t h e r , w e can h a v e and u s e such t h i n g s a s s e n s e o r g a n s only b y v i r t u r e o f t h e fact t h a t w e a r e e s e n t i a l l y r e c e p t i v e — seeing, h e a r i n g , s m e l l i n g , t a s t i n g , t o u c h i n g — c r e a t u r e s . Put a n o t h e r w a y , t h e w o r l d w i d e perceiving o p e n n e s s w h i c h is the e s s e n t i a l o n t o l o g i c a l t r a i t of o u r being bodies i t s e l f f o r t h in the distinct o n t i c m o d e s in w h i c h we s e e , h e a r , smell, t a s t e , and t o u c h t h i n g s . O n e kind o f e x p e r i e n c e m i g h t appear t o radically c o n t r a d i c t t h e s e findings on t h e bodying f o r t h of o u r e x i s t e n c e . W h e n I am blinded by an e x t r e m e l y b r i g h t light, f r i g h t e n e d by an u n b e a r a b l y loud e x p l o s i o n , or burn my finger on a tea k e t t l e , it s e e m s I am no l o n g e r u n a w a r e of my own b o d y h o o d . In fact, my eyes or e a r s or f i n g e r s c a u s e me pain and m o v e into the f o r e g r o u n d as painful bodily o r g a n s . T h e y do n o t p e r m i t me to p e r c e i v e a n y t h i n g but t h e fact t h a t I am body. B u t is this w h a t t h e y actually do? In m a k i n g this claim, h a v e n ' t we fallen into the prejudice of t r e a t i n g the bodying f o r t h of o u r e x i s t e n c e as if it w e r e simply a physical body? It is significant t h a t t h e s e pains involve t h e p e r c e p t i o n of extremes w h i c h strain o u r bodily s e n s e p e r c e p t i o n s to t h e b r e a k i n g point, it they do not actually d a m a g e t h e m . W h e n e v e r bodily pain o c c u r s , we are in the

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s p h e r e o f d i s t u r b e d e x i s t e n c e . T h e r e f o r e w e shall hold o u r investigal ion of pain for o u r discussion of p a t h o l o g y . M e a n w h i l e , n o t h i n g about pain a p p e a r s to c o n t r a d i c t o u r findings on b o d y h o o d in undisturbed e x i s t e n t e N o w , w e can s e e t h e radical d i f f e r e n c e b e t w e e n h u m a n bodyhood and t h e physical n a t u r e o f i n a n i m a t e o b j e c t s n o t o n l y i n t h e fundament.d dissimilarity of t h e i r b o r d e r s but in where each is at a p a r t i c u l a r m o m e n t . A h u m a n being is a l w a y s " h e r e " w i t h r e s p e c t to s o m e place, and h u m a n b o d y h o o d s e e m s to play an e s s e n t i a l role in this " b e i n g - h e r e . " T h e q u e s t i o n is, w h a t r o l e ? W h e n w e say t h a t s o m e o n e "is h e r e , " w e usually r e f e r his body's specific location in space and t h i n k of his p r e s e n c e at that location confined to t h e v o l u m e of space b o u n d e d by his skin. N a t u r a l l y , I can i m a g i n e t h a t I am seated at a t a b l e , my body on a chair and p r e s e n t i n t h e s a m e w a y a s t h e chair. B u t this i m a g e r e f e r s n o l o n g e r to h u m a n " b e i n g - h e r e , " o n l y to t h e p r e s e n c e of a s e l f - c o n t a i n e d and i n d e p e n d e n t l y p r e s e n t physical body. On the other hand, there is some ambiguity attached to the statement t h a t e v e r y h u m a n being is a l w a y s " h e r e " w i t h r e s p e c t to s o m e place. I am always " h e r e , " but ' h e r e " i s n o t a l w a y s t h e s a m e place. F o r h u m a n b e i n g s , ' h e r e " is a l w a y s t h e dwelling place of t h e m o m e n t ; and people dwell in their relationship to what they encounter, with p h e n o m e n a that are "there." At a n y given m o m e n t my " h e r e " is defined by t h e " t h e r e " o f the beings at w h i c h las an open r e a l m of p e r c e p t i o n dwelling in an open, free t i m e - s p a c e — a m dwelling, e n c o u n t e r i n g t h e m w h e r e t h e y a r e . T h i s ' b e i n g - h e r e " is f u n d a m e n t a l l y different from t h e kind of p r e s e n c e n a t u r a l science a s s i g n s to bodies, w h i c h , since it is n e v e r open to perceiving a " t h e r e " — a s a p h e n o m e n o n w i t h p a r t i c u l a r s i g n i f i c a n c e — can n e v e r u n d e r s t a n d its " b e i n g - h e r e " o n t h e basis o f t h e " t h e r e " o f b e i n g s t h a t reveal t h e m s e l v e s t o it. H u m a n b e i n g s can. W h i c h e v e r a n g l e w e take t o a p p r o a c h b o d y h o o d , w e discover t h a t bodying f o r t h p r e s u p p o s e s p e r c e i v i n g and acting e x i s t e n c e . E x i s t e n c e is t h a t w h i c h bodies f o r t h . A c t u a l l y , t h e n , h u m a n b o d y h o o d i s p h e n o m e n o logically s e c o n d a r y , t h o u g h o u r s e n s e s tell us t h a t it is p r i m a r y . W e i n e v i t a b l y e n c o u n t e r c r e a t u r e s o f o u r o w n kind a m o n g all the t h i n g s we m a y c o m e upon. In light of w h a t we h a v e said so far a b o u t t h e peculiar w a y in w h i c h h u m a n e x i s t e n c e is p r e s e n t in t i m e and space, it is n o t e n o u g h t o i n t e r p r e t h u m a n coexistence simply a s the a p p e a r a n c e , " h e r e " and " h e r e , " o f physical h u m a n bodies. T h e p e r s o n walking t o w a r d me m i g h t be t h i n k i n g j u s t n o w of a friend in S a n F r a n c i s c o , and as long as he does, he is o v e r " t h e r e , " his w h o l e e x i s t i n g a b s o r b e d in this r e l a t i o n s h i p to his friend in s u c h a w a y t h a t he e x t e n d s far b e y o n d the o b s e r v a b l e v o l u m e of his body a c r o s s an o c e a n . If he is e x i s t e n t i a l l y t h e r e and I am h e r e , t h e n h o w and w h e r e do h u m a n b e g i n s c o e x i s t in the world?

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Human coexistence in a shared world T h e h u m a n c a p a c i t y to be l o n e l y is a g o o d point to s t a r t f r o m in understanding the inherent coexistence of h u m a n beings in their shared w o r l d . No o n e c a n be l o n e l y w h o s e b e i n g is n o t ordinarily m a r k e d by a t o g e t h e r n e s s w i t h o t h e r s o f his kind. L o n e l i n e s s a l w a y s p o i n t s b e y o n d i t s e l f t o s o m e c o e x i s t e n c e , and h u m a n l o n e l i n e s s e x i s t s o n l y a s p r i v a t i o n o f m a n ' s p r i m a r y t o g e t h e r n e s s w i t h o t h e r s . T h e f u n d a m e n t a l trait o f t h e existential coexistence of human beings appears in their jointly s u s t a i n i n g and m a i n t a i n i n g t h e o p e n n e s s o f t h e w o r l d t h e y c l e a r i n c o m m o n . It is c a r r i e d o u t in s h a r e d w a y s of p e r c e i v i n g and r e s p o n d i n g to whatever is commonly encountered. T h i s e x i s t e n t i a l c o e x i s t e n c e in a s h a r e d w o r l d s h o u l d n o t be p i c t u r e d as s o m e kind o f c o l l e c t i v e p r e s e n c e o f individual s u b j e c t s , each c o n s i s t i n g o f a strictly delimited and spatially localized p s y c h i c or c o n s c i o u s capsule in w h i c h r e p r e s e n t a t i o n s o f o b j e c t s o f t h e e x t e r n a l w o r l d are m i r r o r e d . I f h u m a n e x i s t e n c e a c t u a l l y w e r e m a d e a l o n g s u c h lines, i t would b e impossible for people t o discuss t h i n g s w i t h i m m e d i a t e r e c o g n i t i o n o f w h a t i s b e i n g discussed. T h e y could only try t o say s o m e t h i n g a b o u t t h e i m a g e each h a s in his isolated p s y c h e . B u t in t h e p h e n o m e n a of collective h u m a n b e h a v i o r t h e r e i s n o e v i d e n c e o f individual p s y c h e s h a v i n g dialogues a b o u t e n d o p s y c h i c m a t e r i a l . P s y c h o l o g i s t s do claim t h a t it is self-evident that the c o n s c i o u s n e s s - i m m a n e n t representations of the e x t e r n a l w o r l d are p r o j e c t e d o u t w a r d again, i m m e d i a t e l y and automatical­ ly. B u t no o n e has y e t actually s u b s t a n t i a t e d t h i s claim w i t h p r o o f , and no o n e has m a n a g e d e v e n t o o f f e r a n h y p o t h e s i s t o explain h o w s u c h p r o j e c t i o n could a r i s e in a s u b j e c t a s s u m e d to be originally w o r l d - l e s s , or i n t o w h a t this p r o j e c t i o n m i g h t b e p r o j e c t e d . T h e fact i s t h a t , w h e n people are t o g e t h e r , t h e y r e v e a l o n l y t h a t t h e y are j o i n t l y and i n h e r e n t l y dwelling i n t h e s a m e r e l a t i o n s h i p t o t h e c o m m o n o b j e c t s o f t h e i r s h a r e d world. I n t h e s a m e w a y i n w h i c h o b j e c t s r e v e a l t h e i r i d e n t i t i e s and m e a n i n g fulness directly in t h e o p e n n e s s of h u m a n e x i s t e n c e , so a h u m a n b e i n g also p e r c e i v e s o t h e r people directly, w i t h o u t a n y h y p o t h e t i c a l e m p a t h y , but simply b y v i r t u r e o f t h e fact t h a t all a r e b e i n g s o f t h e s a m e kind w h o dwell t o g e t h e r i n t h e i r u n d e r s t a n d i n g r e l a t i o n s h i p s t o t h e s a m e phenomena which shine through the world-openness they sustain in common. It is difficult to give e v e n an a p p r o x i m a t e g r a p h i c r e p r e s e n t a t i o n of this existence, but we have nevertheless reproduced t w o drawings in an a t t e m p t t o i l l u s t r a t e t h e decisive d i f f e r e n c e b e t w e e n t h e traditional psychological view o f m a n and his c o e x i s t e n c e a n d t h e e x i s t e n t i a l c o u n t e r p a r t o f this view.

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SUBJECTIVISTIC REPRESENTATION OF THE INTERPERSONAL DIALOGUE Body of Regula Zürcher. lb Body of her lover. Brain of Regula Zürcher. 2b Brain of her lover. Psyche of Regula Zürcher. 3b Psyche of her lover. Endopsychic representation 4b Endopsychic representation of the external-world hotel of the external-world hotel in h e r l o v e r . in Regula Zürcher. 5: External world. 6: Light stimuli of t h e external-world object. 7: External-world object, 8a b : S p e a k i n g b a c k and f o r t h (dia-logue) o f R e g u l a Z i i r c h e r and h e r l o v e r a b o u t t h e i r s e p a r a t e e n d o p s y c h i c r e p r e s e n t a t i o n s o f the external-world hotel.

la 2a 3a 4a

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5

OPTIMAL EXISTENTIAL SKETCH OF HUMAN EXISTENCE AS PRIMARY BEING TOGETHER AT THE COMMON OBJECTS OF A SHARED WORLD 1:

2: 3:

T h e existence of Regula Z u r c h e r and the existence of her lover as t h e j o i n t l y s u s t a i n e d , c l e a r e d r e a l m o f p e r c e p t i v e and r e s p o n s i v e o p e n n e s s t o t h e w o r l d o f p h e n o m e n a a s localized p r e s e n c e s .

Hiddenness. T h e couple's t h e m a t i c being t o g e t h e r a t t h e i r r e s o r t h o t e l i n t h e C a n a r y Islands, in t h e f o r m of a p e r c e p t i v e visualization of this object. 4 , 5 , 6 : T h e lovers' being t o g e t h e r with the sense-perceptible street-car, buildings, and sidewalk; t h e m o d e of this r a n g e s f r o m a s c a r c e l y n o t i c e d c o m m o n p e r c e p t i o n t o totally u n t h e m a t i c a w a r e n e s s o f them. +++ C r o s s e s i n d i c a t e t h e l o v e r ' s e c - s t a t i c dwelling in t h e w o r l d , in t h e s e n s e o f a n open and p e r c e p t i v e b e i n g a t w h a t h e e n c o u n t e r s . C i r c l e s indicate R e g u l a Z i i r c h e r ' s o p e n a n d p e r c e p t i v e b e i n g a t what she encounters, ooo T h e varied t h i c k n e s s e s o f t h e c r o s s e s and circles indicate m o m e n t a r y variations in the existential closeness of relation­ ships to w h a t is p r e s e n t in t h e s h a r e d w o r l d .

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I

It is n o t o n l y m e d i c i n e t h a t n e e d s to see this p r i m a r y t o g e t h e r n e s s ol h u m a n beings around the objects of their shared world. Sociology, now enjoying great popularity, always concerns itself—consciously or u n c o n s c i o u s l y — w i t h this o n t o l o g i c a l p h e n o m e n a of e x i s t e n c e . In fact, this p r i m a r y t o g e t h e r n e s s is explicitly t h e sole b a s i s of s o c i o l o g y , and u n l e s s e a c h m o d e of o n t i c social b e h a v i o r is s e e n in r e l a t i o n to the p r i m a r y c o e x i s t e n c e o f h u m a n b e i n g , a n y s t a t e m e n t a b o u t sociological p h e n o m e n a is left h a n g i n g in thin air. T h i s e s s e n t i a l c o e x i s t e n c e is t h e basis n o t only o f o u r j o i n t u n d e r t a k i n g s w i t h t h e t h i n g s o f o u r world but of every sort of relationship among human beings themselves, w h e t h e r t h e y a r e dealing w i t h e a c h o t h e r a s useful o b j e c t s o r e x p r e s s i n g s o m e f o r m o f love o r h a t e t o w a r d e a c h o t h e r .

The question of mood (attunement) We have seen that existence is essentially an o p e n n e s s to perceiving w h a t e v e r e n t e r s t h e r e a l m o f this o p e n n e s s , s h i n e s f o r t h w i t h i n it, and s o c o m e s to be p r e s e n t as a b e i n g w i t h its o w n m e a n i n g f u l n e s s . T h e " p r e - " of " p r e s e n t " p r e s u p p o s e s an open r e a l m . I n t o this a being can s h i n e forth as " p h e n o m e n o n , " w h i c h d e r i v e s f r o m a G r e e k w o r d t h a t m e a n s "a being's r e v e a l i n g i t s e l f . " W i t h o u t this r e a l m o f p e r c e p t i v e o p e n n e s s — a s w h i c h h u m a n being is e n g a g e d — n o t h i n g at all could b e , n e i t h e r a world n o r a n y t h i n g in a world. B e i n g as p r e s e n c e is n o t possible e x c e p t i n t o a r e a l m t h a t is p e r c e p t i v e l y o p e n , clear, and free. B e c a u s e h u m a n e x i s t e n c e i s b y n a t u r e a n o p e n and c l e a r r e a l m o f u n d e r s t a n d i n g , it is i n h e r e n t l y attuned in s o m e w a y or o t h e r . T h i s f u n d a m e n t a l , o n t o l o g i c a l c h a r a c t e r i s t i c o f a t t u n e m e n t m a k e s i t possible for e x i s t e n c e to be p e r m e a t e d a l w a y s by s o m e d i s p o s i t i o n t h a t is demonstrable, accessible to psychological description, and, in the jargon of p h i l o s o p h y , " o n t i c . " T h e r e is no s u c h t h i n g as an initially u n a t t u n e d e x i s t e n c e in w h i c h a disposition of s o m e kind simply a r i s e s n o w and t h e n through the intrusion of some internal or external cause. Supplementary c a u s e s h a v e no part in p r o d u c i n g d i s p o s i t i o n s . All t h e d i s p o s i t i o n s , or m o o d s , of w h i c h a p e r s o n is c a p a b l e a r e given to him i n n a t e l y as e x i s t e n t i a l possibilities and as s u c h a r e a l w a y s m a k i n g up his e x i s t e n c e . For example, even the happy mood into which Regula Z u r c h e r c a m e w h e n s h e m e t h e r l o v e r w a s n o t c a u s e d b y t h e e n c o u n t e r . S h e could b e joyful o n l y in so far as t h e possibility of a happy, spirited a t t u n e m e n t had a l w a y s b e l o n g e d to h e r . S i n c e h e r happy m o o d e x i s t e d a l r e a d y as an i n n a t e p o t e n t i a l of h e r b e i n g , it did n o t need to be p r o d u c e d or e f f e c t e d . In the s u r p r i s e e n c o u n t e r , t h e possibility w a s c a r r i e d to fulfillment. If the l o v e r h i m s e l f w e r e a c t u a l l y t h e c a u s e o f h e r h a p p i n e s s , i t would b e difficult t o u n d e r s t a n d h o w t h e s a m e c a u s e (the s a m e m a n ) could have produced t h e radically d i f f e r e n t e f f e c t o f c a t a s t r o p h i c a n x i e t y b e f o r e I h e

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y o u n g w o m a n ' s r e c o v e r y . B u t i n t h e m e a n t i m e h e r r e l a t i o n s h i p t o the world had b e c o m e free and o p e n e n o u g h to let t h e i n n a t e possibility of a happy m o o d be realized, and the s e c o n d e n c o u n t e r with t h e y o u n g m a n ended i n t h e m a n i f e s t a t i o n o f happy a t t u n e m e n t . W h e n e v e r w e s e e s o m e o n e e n t e r a p a r t i c u l a r m o o d , w h a t we are actually w i t n e s s i n g is o n l y a r e a t t u n e m e n t of his e x i s t e n c e from an old r e i g n i n g disposition into a new one. But i n t h e e s s e n t i a l a t t u n e m e n t o f o u r e x i s t e n c e are r o o t e d n o t o n l y the manifold p a r t i c u l a r o n t i c m o o d s and dispositions of h a p p i n e s s and s o r r o w , s o b r i e t y and e q u a n i m i t y , i n d i f f e r e n c e , b o r e d o m and a n x i e t y , but also o u r e m o t i o n s , o u r feelings and a f f e c t s . Like m o o d s and dispositions, t h e s e n e v e r appear a s isolated s e l f - c o n t a i n e d e n d o p s y c h i c e n t i t i e s o f t h e sort that a p e r s o n m i g h t have or p o s s e s s ; t h e y a r e particular m o d e s in w h i c h h u m a n e x i s t e n t i a l a t t u n e m e n t is fulfilled. E v e r y a t t u n e m e n t as a t t u n e m e n t is a particular m o d e of t h e p e r c e p t i v e o p e n n e s s o f o u r e x i s t e n c e . T h e prevailing a t t u n e m e n t i s a t any given time the c o n d i t i o n o f o u r o p e n n e s s for perceiving and dealing w i t h w h a t we e n c o u n t e r ; the pitch at w h i c h o u r e x i s t e n c e , as a set of r e l a t i o n s h i p s to o b j e c t s , o u r s e l v e s and o t h e r people, is v i b r a t i n g . W h a t we call m o o d s , feelings, a f f e c t s , e m o t i o n s , and s t a t e s are the c o n c r e t e m o d e s in w h i c h the possibilities for being o p e n are fulfilled. T h e y are at the s a m e time t h e m o d e s in w h i c h this p e r c e p t i v e o p e n n e s s can be n a r r o w e d , d i s t o r t e d , or closed off. O p e n n e s s , or r e c e p t i v i t y , can e x i s t only in c o n j u n c t i o n w i t h r e s t r i c t i o n . Each predicates the o t h e r . It can t h e r e f o r e be said t h a t e v e r y r e s t r i c t i o n is a p a r t i c u l a r privation of o p e n n e s s . W h a t e v e r its m o m e n t a r y a t t u n e m e n t , t h e o p e n n e s s t h a t i s o u r e x i s t e n c e a l w a y s d e t e r m i n e s a s well the particular breadth or narrowness, brightness or obscurity of that existence. In traditional medical r e s e a r c h , t h e v a r i o u s s h a d i n g s of e x i s t e n c e w e r e crudely g r o u p e d a s " a f f e c t i v i t y . " T h e d i s t i n c t i o n s a m o n g t h e m w e r e n o t scientifically m a i n t a i n e d . All t h a t e x i s t s for a p a r t i c u l a r p h e n o m e n o l o g y of m o o d s , e m o t i o n s and feelings are a f e w t e n t a t i v e s t a t e m e n t s , and in the f r a m e w o r k o f this g e n e r a l f o u n d a t i o n for m e d i c i n e , w e o u r s e l v e s can only give a f e w clues c o n c e r n i n g a possible d i f f e r e n t i a t i o n . A n g e r , for i n s t a n c e , is called an affect. W h e n we say " h a t e , " we r e f e r to a passion. Y e t both are called feelings. T h i s o v e r l o o k s i m p o r t a n t d i f f e r e n c e s . A n g e r is not s o m e t h i n g t h a t can be put on or taken o f f at will. It a s s a u l t s us, falls upon us, a f f e c t s us, its a t t a c k t r a n s p o r t i n g us in such a way t h a t we are no l o n g e r m a s t e r s of o u r s e l v e s . An agitated person " t a k e s leave of h i m s e l f " and is t h e n "beside h i m s e l f . " We say, for i n s t a n c e , that s o m e o n e is beside h i m s e l f w i t h j o y .

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B u t if a n g e r and h a t e , or j o y and love are d i s t i n g u i s h e d not o n h SI different a f f e c t s , b u t as a f f e c t s and p a s s i o n s , t h e y d e m a n d m o r e pie. Ill definition. Like a n g e r , h a t e is n o t p r o d u c e d at will and it t o o seems to o v e r c o m e us like an a t t a c k of a n g e r . B u t b e c a u s e of its a t t u n e m e n t , tin a t t a c k o f h a t e i s quite unlike t h a t o f a n g e r . H a t e can e r u p t suddenly i n t o an a c t i o n , but o n l y b e c a u s e it h a s had us u n d e r a t t a c k for a long t i m e . C >ui w h o l e being is c o n c e n t r a t e d in its a t t u n e m e n t to a p a s s i o n like love and a l s o , in a c e r t a i n s e n s e , in its a t t u n e m e n t to h a t e . In its a t t u n e m e n t , o u r being is m u c h m o r e with t h a n beside itself, w h i l e t h e r e v e r s e is t r u e c o n c e r n i n g i m m o d e r a t e p l e a s u r e , o v e r p o w e r i n g a n g e r , and o t h e r sudden, forceful a f f e c t s . T h e fact t h a t h u m a n being is c o n s t a n t l y c o n c e n t r a t e d in its a t t u n e m e n t t o t h e p a s s i o n s o f g r e a t love o r g r e a t h a t e does n o t m e a n that the h u m a n being b e c o m e s closed off, blind. O n the c o n t r a r y , a s g r e a t l o v e r s and h a t e r s we a r e especially w i s e and p e r c e p t i v e w i t h regard to c e r t a i n qualities, for t h e f u n d a m e n t a l c h a r a c t e r i s t i c of o u r being is an o p e n n e s s to p e r c e p t i o n and this is j u s t w h a t is in s o m e w a y c o n c e n t r a t e d in t h e p a s s i o n s . It is well k n o w n h o w s e n s i t i v e p a r a n o i d h a t r e d is to e v e n t h e m o s t subtle s t i r r i n g s i n o t h e r s , w h o r e c o g n i z e t h e s e feelings a s u n f r i e n d l y , or u n k i n d , or e v e n h o s t i l e . And people p a s s i o n a t e l y in love have a special s e n s e for t h e hidden g o o d n e s s and b e a u t y , t h e p o t e n t i a l h u m a n r i c h n e s s , o f t h o s e t h e y love. T h e a n g r y p e r s o n , o n t h e o t h e r hand, "beside h i m s e l f , " loses all s e n s e of p r o p o r t i o n w i t h r e g a r d to t h e o p e n or closed p e r c e p t i o n w h i c h is t h a t self. As long as he is furious or i n f a t u a t e d t h e a f f e c t - l a d e n individual has lost a c l e a r vision of t h e significant m e a n i n g s a d d r e s s i n g him in his world. It w a s a p p a r e n t l y n o t so r a r e o n c e for kings to h a v e b e a r e r s of bad tidings s u m m a r i l y e x e c u t e d . T r a d i t i o n a l p s y c h o l o g y t r i e s t o explain a w a y this s o r t of t h i n g as " a f f e c t i v e irradiation," a s s u m i n g w i t h its o b j e c t i f i c a tion of h u m a n b e i n g s t h a t a f f e c t i v e e x c i t a t i o n s are e n t i t i e s p r e s e n t in t h e p s y c h e of t h e a n g r y p e r s o n and have spread or " i r r a d i a t e d " like an electrical field from t h e i r actual c e n t e r , t h e writer of t h e l e t t e r , to its deliverer. B u t t h i n g s like e l e c t r i c a l fields, having no feeling for a d v e r s i t y , can n e v e r b e beside t h e m s e l v e s w i t h a n g e r . W h a t actually h a p p e n s with the a n g r y king is t h a t his e n t i r e e x i s t e n c e , as the realm of p e r c e p t i o n it is, shifts to b e c o m e "beside i t s e l f , " i t s vision so impaired in t h e p r o c e s s that it can n o l o n g e r d i f f e r e n t i a t e b e t w e e n the l e t t e r w r i t t e r and the l e t t e r carrier. 3

N o w , e v e n i n its c o n c e n t r a t e d a t t u n e m e n t t o love o r h a t e , a n e x i s t e n c e is o p e n to t h e p e r c e p t i o n of p h e n o m e n a only in limited w a y s . T h u s t h e r e is blind h a t r e d . People w h o h a t e p a s s i o n a t e l y are no l o n g e r r e s p o n s i v e to

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t h e good side o f w h a t e v e r t h e y h a t e . C o n v e r s e l y , s o m e o n e w h o i s p a s s i o n a t e l y in love t e n d s to o v e r l o o k ugly a s p e c t s of the beloved p e r s o n o r t h i n g . T h e m a s k i n g p r o c e s s c o m m o n t o p a s s i o n a t e h a t e and p a s s i o n a t e love p r e s u m a b l y d e r i v e s f r o m t h e fact t h a t , i n e i t h e r o f t h e s e s t a t e s , e x i s t e n c e is c o n c e r n e d w i t h its o w n p o w e r . In h a t r e d , an e x i s t e n c e e x p e r i e n c e s a n y t h i n g t h a t s t a n d s in t h e w a y of its p o w e r as an o b s t r u c t i o n to be o v e r r i d e n and d e s t r o y e d . A p a s s i o n a t e l y loving e x i s t e n c e s e e s in t h e loved o n e t h e p o t e n t i a l for a t o g e t h e r n e s s t h a t would o f f e r a m u c h g r e a t e r s t o r e of h u m a n possibilities t h a n its o w n single e x i s t e n c e could e v e r c o m p o s e by itself. A n o t h e r m a j o r e m o t i o n a l m o d e is a c o m p o s e d , j o y o u s s e r e n i t y . It can give h u m a n e x i s t e n c e t h e kind of r e c e p t i v i t y t h a t allows it to see in the b r i g h t e s t light t h e m e a n i n g f u l n e s s and c o n n e c t i o n s o f e v e r y p h e n o m e n ­ on t h a t r e v e a l s itself. S u c h a s e r e n i t y is a c l e a r n e s s and o p e n n e s s in w h i c h a h u m a n being is emotionally connected to everything he meets, wanting n o t to h a v e t h i n g s in his o w n p o w e r b u t c o n t e n t to let t h e m be and develop on t h e i r o w n . B e c a u s e this c o m p o s e d , j o y o u s s e r e n i t y o p e n s a h u m a n being t o t h e b r o a d e s t possible r e s p o n s i v e n e s s , i t c o n s t i t u t e s h a p p i n e s s as well. F o r e v e r y h u m a n e x i s t e n c e is by i t s e l f a t t u n e d to happiness w h e n e v e r all its i n n a t e p o t e n t i a l w a y s of being stand o p e n to it. A n e x i s t e n c e free t o e n g a g e i t s e l f i n s u c h a n a t t u n e m e n t can a c c e p t s e r e n e l y e v e n t h e possibility o f its o w n d e a t h . D e a t h , t h e s u r e s t o f all realities, r e v e a l s i t s e l f to an e x i s t e n c e so a t t u n e d as a p r o c e s s of being b r o u g h t b e f o r e a void. To this e x i s t e n c e , t h e void appears no l o n g e r an e m p t y n o t h i n g n e s s but a void so a b u n d a n t l y rich t h a t all being could issue f r o m it. In this u n d e r s t a n d i n g s e r e n i t y differs m o s t p r o f o u n d l y from a n x i e t y , a n o t h e r basic s t a t e o f h u m a n being. A n x i e t y is t h e a t t u n e m e n t in w h i c h e x i s t e n c e is b o t h o p e n e d up and r e s t r i c t e d to perceiving t h e possibility of losing its hold on all o t h e r being, of being t h r o w n back e n t i r e l y upon itself, and c e a s i n g to be, in total isolation. For i n s t a n c e , e v e n w h e n a m o t h e r fears n o t for h e r o w n life b u t for h e r child's, s h e i s a n x i o u s a b o u t t h e d e s t r u c t i o n o f h e r s e l f . H e r e x i s t e n c e is so w r a p p e d up in h e r r e l a t i o n s h i p to h e r child, h e r e x i s t e n c e m e r g e s s o m u c h i n t o t h e i r being t o g e t h e r , t h a t b r e a k i n g this r e l a t i o n s h i p would b e t a n t a m o u n t t o d e s t r o y i n g h e r e x i s t e n c e . R e m e m b e r t h a t e x i s t e n c e c o n s i s t s solely in its possibilities for r e l a t i o n s h i p s . In c o n t r a s t to s e r e n i t y , a n x i e t y e x p o s e s t h e n e c e s s i t y of d e a t h o n l y as the possibility o f n o l o n g e r being h e r e , o f perishing i n t o e m p t i n e s s . B u t i n the very act of e n t e r i n g into its possibilities, e x i s t e n c e e n t e r s d a n g e r , for e x i s t e n c e e x h a u s t s itself in t h e c o u r s e of e x i s t i n g . T h u s people w h o arc" m o s t afraid of death a r e t h o s e w h o h a v e t h e g r e a t e s t a n x i e t y about life. T r a d i t i o n a l p s y c h o l o g y o f t e n m a k e s a d i s t i n c t i o n b e t w e e n realistic, e x t e i nal a n x i e t y and an u n r e a l i s t i c , i n n e r i n s t i n c t i v e a n x i e t y . A n x i e t y in

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the face of an a t t a c k by a rabid dog w o u l d qualify as realistic. T h e lear ol mice t h a t impels n u m b e r s of w o m e n i n t o panicked flight or o n t o chairs is an e x a m p l e of a so-called i n n e r , n e u r o t i c , u n r e a l i s t i c i n s t i n c t i v e a n x i e t y . T h i s i n s t i n c t i v e a n x i e t y was first t h o u g h t to be a d i r e c t product ol the t r a n s f o r m a t i o n o f a c c u m u l a t e d libido. L a t e r , t h e e g o w a s m a d e the seal of a n x i e t y and e v e r y a n x i e t y t h e n b e c a m e a kind of w a r n i n g to t h e e g o ol s o m e d a n g e r facing it. But the existence of unrealistic, inner anxieties as transformation p r o d u c t s of a c c u m u l a t e d i n s t i n c t s is precluded by t h e v e r y fact that i n s t i n c t s are b y definition c o m p o s e d o f psychic e n e r g y , and n o m e r e e n e r g y can c o m p r e h e n d a n y t h i n g in its significance as s o m e t h i n g d a n g e r o u s . E n e r g y i s e n t i r e l y w i t h o u t vision. Y e t a n x i e t y p r e s u p p o s e s and is based upon a p e r c e p t i o n of s o m e t h i n g like d a n g e r , or d e a t h . M o r e o v e r , a n e u r o t i c fear of mice is n o t a w a r n i n g signal d e s i g n e d to m a k e t h e e g o a w a r e of s o m e d a n g e r o u s unrealistic inner thing. It is a fear of a n e x t e r n a l and real m o u s e . W h a t h a p p e n s h e r e i s t h a t t h e " o u t e r r e a l i t y " is m i s t a k e n u n d e r the i n f l u e n c e of a s t a t e of a n x i e t y t h a t r u n s t h r o u g h the v e r y f o u n d a t i o n s o f a n e x i s t e n c e . I n this a t t u n e m e n t , a n e x i s t e n c e m a y i n t e r p r e t s o m e t h i n g h a r m l e s s as a dire t h r e a t , y e t e v e n m i s u n d e r ­ stood t o this e x t e n t t h e t h i n g r e m a i n s a n actual p h e n o m e n o n o u t s i d e i n the w o r l d . An e n t i r e l y d i f f e r e n t p r o b l e m is c o n t a i n e d in t h e s e a r c h for biographical f a c t o r s t h a t m i g h t e l u c i d a t e w h y a n e x i s t e n c e h a s b e e n r e s t r i c t e d t o t h e single basic s t a t e o f fearing a n i m a l i t y i n t h e f o r m o f m i c e , b u t i m p o r t a n t as it is, this q u e s t i o n does n o t t o u c h at all on the p h e n o m e n o n o f fearing mice a s s u c h . H o w e v e r t h e y m a y a r i s e , all a n x i e t i e s a r e realistic a n x i e t i e s . It is a l w a y s s o m e t h i n g a c t u a l t h a t is feared, and t h e o b j e c t o f c o n c e r n i s t h e capability o f c o n t i n u e d e x i s t e n c e in a h u m a n w o r l d w h i c h is t h r e a t e n e d by t h e feared t h i n g . 4

O u r final e x a m p l e o f basic h u m a n s t a t e s i s t h e m o o d o f s o r r o w . S o r r o w as a p o t e n t i a l w a y of being in h e a l t h y people is n o t to be c o n f u s e d w i t h pathological f o r m s o f d e p r e s s i o n — d i s c o n t e n t , a n n o y a n c e , h o p e l e s s n e s s and t h e petrified v a r i e t i e s — w h i c h will be discussed later on; n e i t h e r is it e g o c e n t r i c self-pity. E x i s t e n c e is a t t u n e d to t r u e s o r r o w w h e n it e x p e r i e n c e s a b r e a k or r u p t u r e in its r e l a t i o n s h i p to a c l o s e h u m a n a c q u a i n t a n c e o r s o m e c h e r i s h e d o b j e c t , b u t t h e o b j e c t o f s o r r o w i s not lost w i t h this r u p t u r e . I f t h e c a p a c i t y t o b e w i t h t h e o b j e c t o f s o r r o w w e r e really b r o k e n o r r u p t u r e d t o t h e e x t e n t t h a t t h e r e l a t i o n s h i p was d e s t r o y e d a l t o g e t h e r this s o r r o w a t loss could n o t arise; t h a t t h i n g would simply h a v e fallen o u t o f t h e w o r l d and b e e n f o r g o t t e n , w o u l d n o l o n g e r be t h e r e . " In s o r r o w , h o w e v e r , w h a t is s o r r o w e d for c o m e s close to the s o r r o w i n g p e r s o n in a p a r t i c u l a r w a y . T h e r u p t u r e perceived in s o r r o w c o n c e r n s s o m e actual p a r t i c u l a r m o d e o f being w i t h t h e o b j e c t which the

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r u p t u r e n o l o n g e r a l l o w s . G o n e i s t h e possibility o f e v e r again being w i t h and at t h a t o b j e c t , in m i n d and body. While t h e bonds of the r e l a t i o n s h i p m a y b e c o m e m o r e i n t i m a t e t h a n e v e r i n t h e m o d e o f visualization, the h u m a n e x i s t e n c e is in fact r u p t u r e d and b r o k e n in a c e r t a i n s e n s e . H e a v y d a m a g e is done to t h e e x i s t e n c e of a lover w h o s e p a r t n e r has died, or w h o has b e e n a b a n d o n e d for a n o t h e r . S u c h an e x i s t e n c e s u f f e r s a g r e a t r e d u c t i o n i n t h e n u m b e r o f r e l a t i o n s h i p s o n c e possible w i t h r e s p e c t t o t h e o b j e c t o f s o r r o w . A medical s t u d e n t failing t h e s t a t e e x a m t h r e e t i m e s will m o u r n a lost o p p o r t u n i t y for a n e w m o d e of being, for b e c o m i n g a d o c t o r . M a n y p a t i e n t s g o i n t o deep s o r r o w w h e n , i n t h e c o u r s e o f a n a l y s i s , t h e y r e c o g n i z e t h e m u l t i t u d e o f possibilities lost f o r e v e r and t o r n a w a y from t h e i r e x i s t e n c e b e c a u s e t h e i r a c t u a l i z a t i o n had b e e n blocked in t h e past. B u t h u m a n b e i n g s k n o w s o r r o w not o n l y i n t h e f o r m o f isolated pain­ ful e x p e r i e n c e s o f s e p a r a t i o n . S o r r o w p e r v a d e s h u m a n e x i s t e n c e , n o m a t t e r h o w o f t e n it is d r o w n e d o u t , at t h e painful insight i n t o t h e finite limits o f e x i s t e n c e and its e s s e n t i a l s e p a r a t i o n from the a b s o l u t e and unconditional. T h e b r e a k i n g , r e n d i n g , and d a m a g i n g o f e x i s t e n t i a l r e l a t i o n s h i p s t o o t h e r people, t o o b j e c t s o f the s u r r o u n d i n g w o r l d , and t o the a b s o l u t e can also e m p h a t i c a l l y affect t h e b o d y h o o d o f a n e x i s t e n c e . Injuries t o the body are e x p e r i e n c e d as bodily pain. T h e close k i n s h i p b e t w e e n bodily pain and s o r r o w is e x p r e s s e d in calling s o r r o w " h e a r t b r e a k , " in t h e "pain and s o r r o w " o f a n g u i s h . Will s o r r o w — i n n e r pain b e u n d e r s t o o d o n t h e basis of bodily pain, or does bodily pain depend, r a t h e r , on s o r r o w , t h e r e c o g n i t i o n o f a flaw r u n n i n g t h r o u g h t h e a b u n d a n c e o f r e l a t i o n a l possibilities? W e m u s t p o s t p o n e discussing this q u e s t i o n , a s w e p o s t p o n e d t h e topic o f bodily pain, until w e c o m e t o talk a b o u t t h e pathological p h e n o m e n a o f e x i s t e n c e .

Human memory and the historicity of human existence W e first e n c o u n t e r e d t h e issue o f r e t e n t i o n o f e a r l i e r p e r c e p t i o n i n o u r discussion o f t h e v a r i o u s m o d e s o f p r e s e n c e , t h e r e t h a t w h a t i s r e t a i n e d in m e m o r y is n e i t h e r a series of e n d o p s y c h i c r e p r e s e n t a t i o n s of e x t e r n a l o b j e c t s , n o r e n g r a m t r a c e s o f s e n s e i m p r e s s i o n s o f t h e kind w h i c h can b e a s c e r t a i n e d physiologically i n t h e b r a i n ' s s u b s t a n c e . T h e y a r e the perceived e n t i t i e s t h e m s e l v e s w h i c h are r e t a i n e d a s t h e singularly m e a n i n g f u l p h e n o m e n a t h e y r e v e a l t h e m s e l v e s t o b e t e m p o r a r i l y and spatially w i t h i n t h e w o r l d l y r e a l m held o p e n by a h u m a n e x i s t e n c e . As novel as this p r e l i m i n a r y p h e n o m e n o l o g i c a l description of m e m o r y may s e e m to us today, it actually relies on i n s i g h t s predating all

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c o n t e m p o r a r y n a t u r a l scientific t h e o r i e s o f m e m o r y . M o r e t h a n fifteen h u n d r e d y e a r s a g o i n t h e W e s t e r n tradition A u g u s t i n e w r o t e i n the t e n t h b o o k of his Confessions: " a n d I k n o w t h a t t h e y [the s o u n d s t h a t c o m p r i s e words] a r e b l o w n a w a y w i t h t h e i r r e s o n a n c e s i n t h e w i n d and are n o m o r e . B u t t h e actual t h i n g s signified b y t h e s e s o u n d s I h a v e n e v e r g r a s p e d w i t h a n y o f m y physical s e n s e s n o r s e e n t h e m a n y w h e r e out t h e r e in f r o n t of my mind, and so it is t h e y t h e m s e l v e s , and n o t t h e i r i m a g e s , t h a t I h a v e p r e s e r v e d in my m e m o r y . " 5

Admittedly, the word " m e m o r y " carries associations that seem to c o n t r a d i c t t h e facts o f t h e m a t t e r . I t s e e m s t o b e c o n n e c t e d w i t h recalling t o m i n d and r e t a i n i n g m e r e t h o u g h t . B u t the a p p e a r a n c e o f c o n t r a d i c t i o n p e r s i s t s only if we p i c t u r e t h o u g h t as simply a c e r e b r a l p r o c e s s and t h o u g h t s t h e m s e l v e s a s c a r b o n copies o f e n t i t i e s w i t h i n t h e p s y c h e and r e m e m b e r i n g s o m e t h i n g as a r e a w a k e n i n g of e n d o p s y c h i c i m a g e s from t h e e n g r a m m a t i c , m a t e r i a l - e n e r g e t i c s t r u c t u r e s o f t h e brain. A s a n y o n e can learn from his o w n e x p e r i e n c e , w h a t really h a p p e n s w h e n w e t h i n k and h a v e t h o u g h t s i s simply t h a t w e b e c o m e a w a r e o f c e r t a i n o f t h e p h e n o m e n a o f o u r world. T h e s e p h e n o m e n a t h e m s e l v e s , t o g e t h e r w i t h all o f t h e i r m e a n i n g s and c o n n e c t i o n s , reveal t h e m s e l v e s directly to us f r o m t h e l o c a t i o n at w h i c h t h e y are p r e s e n t in t h e open r e a l m o f o u r w o r l d . T h i n k i n g , t h e n , i s allowing w h a t a d d r e s s e s u s t h r o u g h t h e o p e n n e s s o f t h e t i m e - s p a c e o f o u r w o r l d t o arise again t h e m a t i c a l l y . Even t h e n a t u r a l scientific w a y of t h i n k i n g is only a p a r t i c u l a r m o d e of l e t t i n g b e i n g s appear, t h a t reduced w a y in w h i c h b e i n g s t e n d to reveal t h e m s e l v e s solely as c h a i n s of p r e s u m e d and calculable causal e f f e c t s . M o s t o f w h a t w e r e t a i n quickly r e c e d e s i n t o t h e b a c k g r o u n d o f n o n t h e m a t i c p r e s e n c e . B u t e v e n a n u n t h e m a t i c p r e s e n c e i s p r e s e n c e and can address t h e p e r s o n w h o r e t a i n s it as s o m e t h i n g of a particular meaning. Unless the notion of retention is understood existentially, m e m o r y is r e n d e r e d i n a c c e s s i b l e to scientific i n v e s t i g a t i o n as t h e p h e n o m e n o n it truly is. O r d i n a r i l y , t w o v e r y d i f f e r e n t h u m a n m o d e s o f b e i n g are indiscrimi­ n a t e l y a t t r i b u t e d to m e m o r y . T h e first is t h e ability to visualize something that was once perceived but afterwards receded to become an uncontemplated, background presence. From the phenomenological p e r s p e c t i v e s t h e r e is a g r e a t d i f f e r e n c e b e t w e e n this and actually r e m e m b e r i n g e a r l i e r e v e n t s . If I am visualizing my c o t t a g e in the m o u n t a i n s , I am n o t r e m e m b e r i n g it b u t am e x i s t i n g in s o m e r e l a t i o n s h i p to it in this visualizing w a y of b e i n g t h e r e w h e r e it is. T h e o n l y sort ol thing I could r e m e m b e r , s t r i c t l y speaking, is s o m e t h i n g like buying it in 1 9 4 5 . T h e p h e n o m e n o n of m e m o r y plays no part in a n y visualization ol the h o m e as it n o w is; it e n t e r s in only il I visualize the p u r c h a s e ol the

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h o m e as an act t h a t o c c u r r e d at s o m e definite time in t h e past. To r e m e m b e r is to visualize a thing of t h e past as s o m e t h i n g e x p e r i e n c e d at that time. B u t i n u n d e r s t a n d i n g m e m o r y w e m u s t also c o n s i d e r its deficient m a n i f e s t a t i o n w h i c h w e call " f o r g e t t i n g . " T h e v a r i o u s labels this p h e n o m e n o n has w o r n in the course of history attest to the uncertainty of its n a t u r e . In classical G r e e k , it is a s s o c i a t e d with lethe; t h a t w h i c h r e m a i n s hidden. In Latin it is described by oblivo, oblivisci: f o r g e t t i n g as a wiping o u t . T h e G e r m a n v e r b ergessen ( " f o r g e t " ) is c o n n e c t e d w i t h t h e English " g e t . " T h e ver- prefix gives a n e g a t i v e twist to " g e t " so t h a t vergessen—like " f o r g e t " — m e a n s " n o t to k e e p . " " W i p e o u t " and " n o t k e e p " both set out from the standpoint of an ego, a notion unknown to the t h o u g h t o f classical G r e e c e . N i e t z s c h e w r i t e s in Morgenr'dthe: "It has n o t been p r o v e n t h a t s u c h a thing as f o r g e t t i n g e x i s t s ; all that is k n o w n is t h a t r e c o l l e c t i o n is n o t in o u r p o w e r . For t h e t i m e being, we h a v e filled this gap w i t h t h e w o r d f o r g e t , ' as if f o r g e t t i n g m e m o r y w e r e j u s t a n o t h e r ability in o u r r e g i s t e r , ut w h a t is t h e r e , w h e n all is said and d o n e , t h a t stands in o u r p o w e r ? " In Zarathustra we m a y read: " T h a t t h e r e is such a thing as f o r g e t t i n g h a s n e v e r b e e n p r o v e n , but o n l y t h a t t h e r e a r e m a n y t h i n g s w h i c h d o n o t occur to us when we want them to." T h e q u i c k e s t w a y t o u n d e r s t a n d this p r o b l e m a t i c p h e n o m e n o n i s t o d i s t i n g u i s h a m o n g t h e diverse m o d e s o f b e i n g t h a t pass for f o r g e t t i n g . N o w , if at t h e close of a s t i m u l a t i n g e v e n i n g I leave my u m b r e l l a at a friend's h o u s e , m o s t people would t h i n k m e guilty o f f o r g e t t i n g it. B u t i f f o r g e t t i n g is defined as h a v i n g t h e p r e s e n c e of t h e u m b r e l l a lost to t h e c o l l e c t i o n of o b j e c t s p r e s e n t in my w o r l d , I h a v e n o t f o r g o t t e n it at all. I can t h i n k of it and p i c t u r e it to m y s e l f at a n y t i m e I c h o o s e . T h i s w o u l d n o t be possible u n l e s s t h e u m b r e l l a had r e m a i n e d in my world, t h o u g h its presence be unthematic. T h e u m b r e l l a is simply an especially distant b a c k g r o u n d p r e s e n c e as I am leaving my friend, for I r e m a i n a b s o r b e d , body and soul, w i t h my friend and i n t h e topic o f o u r c o n v e r s a t i o n . T h e u m b r e l l a ' s p r e s e n c e h a s thus become so distant to me that it would not occur to me actually to pick it up and take it a l o n g . A n y t h i n g n o t in t a n g i b l e p r o x i m i t y c a n n o t add r e s s me as a t h i n g to be t a k e n along; n o t e v e n t h e possibility of t a k i n g it along o c c u r s to m e . As long as this t h i n g is n o t p r e s e n t as s o m e t h i n g to be t a k e n along, I c a n n o t really f o r g e t to t a k e it along. In a c t u a l fact, I h a v e f o r g o t t e n n e i t h e r t h e u m b r e l l a i t s e l f n o r t h e possibility o f t a k i n g i t a l o n g . F o r g e t t i n g , as it is used h e r e , simply r e f e r s to t h e fact t h a t s o m e t h i n g is no longei c o n s i d e r e d t h e m a t i c a l l y in its p r e s e n c e , t h o u g h it r e m a i n s m i l h c m . i t I I .illy p r e s e n t . T h e m o d e o f its being present to me h a s ihanged

Fundamental

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B y c o n t r a s t , p s y c h o a n a l y t i c t h e o r y e m p h a t i c a l l y m a i n t a i n s t h a t such an o c c u r r e n c e is a h i g h l y s i g n i f i c a n t f o r g e t t i n g of t h e u m b r e l l a and of the possibility of t a k i n g it a l o n g . S u c h p h e n o m e n a are s t a m p e d as i n s t a n c e s of faulty action (parapraxis) and t h e r e b y m a d e — l i k e all f o r g e t t i n g — effects of the repression of an unconscious desire. According to psychoanalytic theory, my forgetting of the umbrella would have been c a u s e d by an u n c o n s c i o u s i n t e n t to r e t u r n to see my friend again as s o o n as possible. By leaving my u m b r e l l a b e h i n d , I w o u l d u n c o n s c i o u s l y h a v e c r e a t e d an e x c u s e for g o i n g b a c k for a visit right a w a y . B u t this p s y c h o a n a l y t i c i n t e r p r e t a t i o n is u n c o n v i n c i n g . F o r o n e t h i n g , I am close e n o u g h to my friend to visit w h e n e v e r I w i s h w i t h o u t a p r e t e x t . But more important is that from the very beginning the psychoanalytic a c c o u n t m a k e s n o e f f o r t t o explain t h e f o r g e t t i n g o f m y u m b r e l l a a s f o r g e t t i n g . I n s t e a d it r e s t s on a h y p o t h e t i c a l a s s u m p t i o n t h a t h a s n o t h i n g t o d o w i t h t h e p h e n o m e n o n u n d e r i n v e s t i g a t i o n , w h i c h i s t h e leaving b e h i n d o f m y u m b r e l l a . T h e supposed u n c o n s c i o u s i n t e n t i s p r e s e n t e d r i g h t from t h e s t a r t as t h e cause w h i c h b r i n g s a b o u t t h e so-called faulty a c t i o n ; b u t w h a t c a u s e s a p h e n o m e n o n to o c c u r is a n y t h i n g but t h e p h e n o m e n o n itself, and w h a t d e m a n d s e x p l a n a t i o n i s t h e p h e n o m e n o n itself. My forgetting cannot be caused by the repression into an unconscious of my c o n c e p t i o n of t h e u m b r e l l a . In o r d e r to f o r c e s o m e t h i n g inward, 1 w o u l d need to h a v e it w i t h i n my grasp. Y e t it is c l e a r t h a t w h i l e I am taking leave of my friend, I am w i t h h i m , n o t w i t h my u m b r e l l a . T h u s I c a n n o t possibly be o c c u p i e d w i t h a desire to f o r g e t it so I m a y visit him again. S u c h desire c a n n o t b e o p e r a t i n g a t t h a t m o m e n t , c o n s c i o u s l y o r u n c o n s c i o u s l y , b e c a u s e my w h o l e being is occupied w i t h my friend and w i t h t h e topic o f t h e e v e n i n g ' s c o n v e r s a t i o n . H e r e , f o r g e t t i n g i s n o t h i n g more than the changing of a phenomenon's immediate, thematically c o n s i d e r e d p r e s e n c e in a h u m a n r e a l m of o p e n n e s s to its n o n i m m e d i a t e and u n t h e m a t i c p r e s e n c e s o m e w h e r e i n t h e w o r l d . It is a n o t h e r kind of f o r g e t t i n g w h e n I lose t r a c k of t h e n a m e ol s o m e o n e I k n o w and c a n n o t c o m e up w i t h it, no m a t t e r h o w hard I try. H e r e t h e t h i n g i t s e l f (in this c a s e , t h e n a m e ) e s c a p e s m e . B u t w h a t has the n a m e e s c a p e d f r o m ? E v i d e n t l y f r o m my capacity for a s s o c i a t i n g it with t h e p e r s o n , w h o m I still r e t a i n . T h i s type of f o r g e t t i n g m a n i f e s t s a deficiency in my p e r c e p t i v e r e t e n t i v e capacity and, as s u c h , c o n s t i t u t e s a special f o r m of my o t h e r w i s e i n t a c t r e l a t i o n s h i p to a t h i n g . In this c a s e it is a deficiency in my ability to r e l a t e m y s e l f to a p e r s o n w i t h such and such a n a m e . T h e n a m e , t h o u g h f o r g o t t e n , is n e v e r t h e l e s s still k n o w n to me in a c e r t a i n s e n s e as s o m e t h i n g t h a t has escaped me, as something, h i d d e n

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from m e . It is p r e c i s e l y this a w a r e n e s s w h i c h lets me realize I h a v e f o r g o t t e n it, but even this a w a r e n e s s o f h a v i n g s o m e t h i n g can w i t h d r a w , and t h e n I would no l o n g e r e v e n realize t h a t I e v e r k n e w t h e n a m e . U n d e r s t o o d as t h e falling out of an e n t i t y ' s p r e s e n c e from my e x i s t e n t i a l r e a l m o f o p e n n e s s , f o r g e t t i n g c a r r i e s w i t h i t t h e possibility t h a t u n d e r c e r t a i n c i r c u m s t a n c e s w h a t h a s fallen out can r e t u r n into t h e openness of my being-in-the-world. E v e r y t i m e w e f o r g e t s o m e t h i n g , w e also f o r g e t s o m e t h i n g o f ourselves. When something escapes me, my relationship to that thing is also lost, and t h e s e r e l a t i o n s h i p s to w h a t is p r e s e n t in my e x i s t e n t i a l o p e n n e s s a r e j u s t w h a t m a k e u p m y e x i s t e n c e and m a k e m e w h a t l a m . T o the e x t e n t to w h i c h p r e s e n c e s escape me and I f o r g e t t h e m , I am d i m i n i s h e d as a h u m a n e x i s t e n c e . It should n o w be clear t h a t f o r g e t t i n g is n o t a s e p a r a t e m e n t a l ability a n y m o r e t h a n r e m e m b e r i n g or r e t a i n i n g . It is an o c c u r r e n c e of o u r o p e n r e a l m o f p e r c e p t i v e b e i n g - i n - t h e - w o r l d , o n e t o w h i c h w e are given o v e r at all t i m e s . Like r e m e m b e r i n g , it c o n c e r n s t h e t h i n g s of my w o r l d . It is without exception the names themselves, the persons or objects, which, h a v i n g revealed t h e m s e l v e s from t h e i r places in the w o r l d - o p e n n e s s as w h i c h I am e x i s t i n g , can e i t h e r be r e t a i n e d or slip a w a y f r o m m e . It does not involve t h e d i s p l a c e m e n t o f s o m e a s s u m e d e n d o p s y c h i c r e p r e s e n t a ­ tions o f e x t e r n a l - w o r l d o b j e c t s . If this is w h a t we call f o r g e t t i n g in h u m a n b e i n g s , h o w e v e r , t h e n m e m o r y and visualization o f past t h i n g s m u s t also b e m o r e than simple r e t e n t i o n like a passive s t o r a g e of t h i n g s in a h o l l o w space t h a t is o p e n b u t e m p t y and u n i n v o l v e d . T h i s is a far t o o limited n o t i o n of o u r r e t e n t i v e m e m o r y , t o o a b s t r a c t , t o o wrapped up in a s i n g l e , isolated facet. M e m o r y and r e t e n t i o n m u s t be seen in a m u c h b r o a d e r c o n t e x t . T h e o p e n n e s s o f h u m a n e x i s t e n c e c o n s i s t s o f t h e capacity for perceiving t h e p r e s e n c e and m e a n i n g f u l n e s s o f w h a t e v e r appears, the capacity for r e s p o n d i n g m e a n i n g f u l l y to t h e perceived significance of t h e s e p h e n o m e n a in a w a y t h a t c o r r e s p o n d s to t h e i r s i g n i f i c a n c e . H u m a n e x i s t e n c e is equally r e c e p t i v e to w h a t h a s b e e n perceived at s o m e f o r m e r time and has been r e t a i n e d . W h a t h a s o n c e b e e n p r e s e n t to a h u m a n e x i s t e n c e is n e v e r simply past, finished, lost. W h a t h a s b e e n is r e t a i n e d in the o p e n n e s s of the h u m a n Da-sein s o , t h a t it r e m a i n s c o n s t a n t l y p r e s e n t m the pi e s e n t , speaking into this p r e s e n t and c o d e t e r m i n i n g all p r e s e n t conduct o l t h e h u m a n . T h a t w h i c h has b e e n " l i v e s " o n t h e n , i n the present ["hereby, this " p a s t , " p r e s e n t as h a v i n g b e e n , t o g e t h e r w i t h the present, necessarily c o d e t e r m i n e s all f u t u r e b e h a v i o r . \ VI HI I in he Is a w a r e of it or n o t , e v e r y h u m a n being dwells in tradition and history H u m a n m e m o r y is this c o n s t a n t dwelling in t r a d i t i o n . It

Fundamental

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constitutes that fundamental human characteristic of histoiuii. R e t a i n i n g or n o t r e t a i n i n g s o m e single p h e n o m e n o n as h a v i n g o n c e bei 11 n o w a p p e a r s as a definite, isolated, o n t i c possibility of t h e ontologli II h u m a n ability to e x i s t h i s t o r i c a l l y , i.e., his ability to dwell by the beings l 'I his w o r l d in t h e t e m p o r a l e k - s t a s e of t h e past. T h i s ability is | c h a r a c t e r i s t i c f e a t u r e of h u m a n being and d i s t i n g u i s h e s it from all o t h e r present beings. H u m a n e x i s t e n c e is also h i s t o r i c a l in t h a t it is its e n t i r e life h i s t o r y . T h e e x i s t e n c e of a p e r s o n a l w a y s e x t e n d s f r o m his b i r t h to his d e a t h . If death is t h e u t m o s t limit of h i s t o r i c a l h u m a n e x i s t e n c e , t h e n it m u s t truly b e l o n g to this e x i s t e n c e , as e v e r y b o r d e r b e l o n g s to w h a t it delimits. W h a t r e m a i n s puzzling is t h e w a y in w h i c h h u m a n life and death a r e part of e a c h o t h e r . D e a t h is g i v e n such an i m p o r t a n t place in medicine t h a t o n e could say this s c i e n c e is p e r m a n e n t l y o r i e n t e d t o w a r d death: m e d i c i n e w a n t s e i t h e r to w a r d o f f death or to p o s t p o n e it as long as possible. B e c a u s e o f this fact, n o foundation o f m e d i c i n e can dispense w i t h discussing t h e m e a n i n g and n a t u r e o f h u m a n m o r t a l i t y . D e a t h and h u m a n m o r t a l i t y D e a t h is t h e u n s u r p a s s a b l e limit of h u m a n e x i s t e n c e . In death, e x i s t e n c e as bodily b e i n g - i n - t h e - w o r l d has its final end. I n a n i m a t e o b j e c t s a r e also described a s finite, a s n o t lasting e t e r n a l l y . T h e s a m e applies also to n o n h u m a n life, but plants and animals do notdie, as h u m a n b e i n g s do. T h e y simply perish. O n l y h u m a n b e i n g s die having k n o w n f r o m a n early age o f t h e i r m o r t a l i t y . S o for ages m o r t a l i t y h a s been t h o u g h t of as a p r i m a r y trait of h u m a n e x i s t e n c e , so m u c h so th.it Parmenides named men mortals. T h e k n o w l e d g e o f d e a t h l e a v e s m a n n o c h o i c e . H e i s compelled t o exist in s o m e sort of p e r m a n e n t r e l a t i o n s h i p to d e a t h , for it is impossible n o t to r e l a t e t o s o m e t h i n g w h i c h h a s o n c e b e e n perceived. N e c e s s a r i l y related to d e a t h , h u m a n e x i s t e n c e could well be called a " b e i n g - u n t o - d e a t h . " T h i s " b e i n g - u n t o - d e a t h " m a n i f e s t s i t s e l f i n manifold w a y s . T h e m o s t c o m m o n is flight from death and f r o m t h e a w a r e n e s s of h u m a n m o r t a l i t y . Every day o f t h e i r lives, people m a k e c o u n t l e s s a t t e m p t s t o d e c e i v e t h e m s e l v e s a b o u t this m o s t c e r t a i n aspect o f h u m a n life. T h e m a c a b r e c o m e d i e s played o u t in c e r t a i n A m e r i c a n funeral h o m e s r e p r e s e n t an e x t r e m e ol this. R e c o g n i t i o n of h u m a n m o r t a l i t y is always learned first from t h e de.it lis of others. We usually r e l e g a t e t h e s e d e a t h s to t h e i n c o n s p i c u o u s n e s s ol an e v e r y d a y e v e n t . T h e d e a t h s o f o t h e r s b e c o m e m e r e c a s e s o f death whii h can be passed o v e r , t h e k n o w l e d g e of personal m o r t a l i t y is allowed lo dissipate in t h e t h o u g h t t h a t we t o o shall c e r t a i n l y die s o m e d a y , only not

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j u s t y e t . D e a t h is m a d e an e v e n t u a l i t y that does n o t m a t t e r for the p r e s e n t . Not o n l y for o u r s e l v e s do we try to c u s h i o n the fact of o u r m o r t a l i t y . W e also m a k e e v e r y e f f o r t t o s t e e r t h e s u r v i v o r s o f t h o s e w h o die, and e v e n t h e dying t h e m s e l v e s , a w a y from t h o u g h t s o f d e a t h . D e a t h is m a d e to appear as simply a c h a n g e from o n e m o d e of being to a n o t h e r , as a t r a n s i t i o n f r o m being alive to no l o n g e r e x i s t i n g , to a condition in w h i c h only t h e c o r p s e , a lifeless o b j e c t , r e m a i n s . T o t h e family o f s o m e o n e w h o has r e c e n t l y died, o f c o u r s e , t h e dead person is m u c h m o r e t h a n an i n a n i m a t e o b j e c t and t h e i r r e l a t i o n s h i p to him m u c h m o r e t h a n a t t e n d a n c e t o his physical r e m a i n s . T h e r e l a t i o n s h i p is o n e of actual care in t h e f o r m of o b s e q u i e s , m a i n t e n a n c e of t h e g r a v e and e v e n a n c e s t o r w o r s h i p . In t h e i r caring, m o u r n i n g and r e m e m b e r i n g , t h e s u r v i v o r s a r e in a c e r t a i n s e n s e still with t h e o n e w h o is dead, related to h i m as to a fellow being. T h i s r e l a t i o n s h i p to t h e dead is t h e basis for all feelings o f r e v e r e n c e , f e a r , a w e , w o n d e r , s o r r o w , and d e f e r e n c e i n t h e face o f s o m e t h i n g g r e a t e r and m o r e p o w e r f u l . Y e t o u r r e l a t i o n s h i p to death can also be c h a r a c t e r i z e d by naked fear, w h i c h lets death appear as the e x t i n c t i o n of e x i s t e n c e in an e m p t y void, t h e end of all t h i n g s . M e a n w h i l e , all that is c e r t a i n is t h a t e x i s t e n c e a f t e r death is no l o n g e r in t h e world in the s a m e w a y as b e f o r e . T h i s does n o t at all preclude t h e possibility t h a t death is n o t t h e radical annihilation o u r fear and a n x i e t y m a k e it out to b e . It could also m e a n h a v i n g o n e ' s previous e x i s t e n t i a l m a n n e r o f bodily b e i n g - i n - t h e - w o r l d t r a n s f o r m e d into an u t t e r l y d i f f e r e n t s o r t of being, o n e t h a t is inaccessible to a m o r t a l ' s p e r c e p t i o n while he is still alive. It is e v e n possible t h a t in death e x i s t e n c e e n t e r s i n t o s o m e t h i n g t h a t is prior to all being; the dead m a y attain a r e l a t i o n s h i p to B e i n g - n e s s as such t h a t is hidden from t h e living. It may be this possibility t h a t e n a b l e s c e r t a i n rare h u m a n b e i n g s to accept death w i t h a c o m p o s e d s e r e n i t y , to e x p e r i e n c e it as t h e m a n i f e s t a t i o n o f a n e x i s t e n t i a l possibility e n c o m p a s s i n g and c o n s u m ­ m a t i n g all e x i s t e n c e but based in a d i m e n s i o n n o t at m a n ' s disposal. To t h e e x i s t e n c e liberated and e x p a n s i v e e n o u g h t o reach this s e r e n i t y , h u m a n m o r t a l i t y s h o w s t h a t m a n ' s being is o p e n at all t i m e s to t h a t w h i c h is w h o l l y o t h e r t h a n any finite o n t i c being and w h i c h e n g a g e s man as the r e a l m w h e r e m e a n i n g f u l n e s s is perceived, w h i c h can use him as t h a t r e a l m of o p e n n e s s w h i c h is the n e c e s s a r y p r e c o n d i t i o n for the a p p e a r a n c e and p r e s e n c e of all being. It is well k n o w n t h a t b e f o r e t h e y reach p u b e r t y , children usually have no fear of dying. C h i l d r e n do n o t see t h e m s e l v e s as s e l f - c o n t a i n e d and i n d e p e n d e n t s u b j e c t s . T h e y s e n s e , t h o u g h in a v e r y u n d e l i b e r a t e d w a y , t h a t t h e y are b o r n e along by s o m e t h i n g , an e n c o m p a s s i n g d i m e n s i o n , w h i c h t h e y perceive in and t h r o u g h t h e i r " o m n i p o t e n t " p a r e n t s . It is

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b e c a u s e of this feeling t h a t t h e y let death e x t i n g u i s h t h e i r individual e x i s t e n c e s w i t h o u t r e s i s t a n c e . B u t a f t e r p u b e r t y , a fear of death usually s e t s in, i n c r e a s i n g in i n t e n s i t y t h e m o r e an a d o l e s c e n t p e r c e i v e s h i m s e l l , in t h e m o d e r n spirit, as an i n d e p e n d e n t l y f o r m e d , i n s u l a r s u b j e c t . As an i r r e v o c a b l e annihilation o f e v e r y t h i n g , death m u s t s e n d him into panic. N o w , m a r t y r s dying for a h o l y c a u s e can e n t e r death happily, no m a t t e r w h a t t h e i r age, b e c a u s e for t h e m , death i s r e s u r r e c t i o n i n t o t h e beloved c a u s e t o w h i c h t h e y a r e s u b o r d i n a t e . B u t t h e r e are also u t t e r l y u n h e r o i c old people w h o are able to die as peacefully and willingly as c h i l d r e n , for t h e y h a v e used up t h e i r e x i s t e n c e by actualizing all of its e s s e n t i a l r e l a t i o n a l possibilities. In s h o r t , t h e y h a v e c o m p l e t e d t h e t a s k given t h e m . T h e n again, t h e r e are o t h e r old people w h o r e s i s t e d e n t e r i n g full and c a r i n g r e l a t i o n s h i p s t o w h a t t h e y e n c o u n t e r e d during t h e i r lives and h e n c e b e c a m e guiltily i n d e b t e d t o t h e i r o w n e x i s t e n c e . T h e s e people a r e terrified o f death a s o f s o m e t h i n g t h a t c o m e s far t o o s o o n . A s n u m e r o u s a s t h e p a r t i c u l a r w a y s o f b e h a v i n g t o w a r d death are, all, including t h e m o s t s t u b b o r n flight from d e a t h , t e s t i f y t o t h e insight t h a t h u m a n m o r t a l i t y is n o t j u s t an e v e n t destined for s o m e t i m e in t h e f u t u r e but i r r e l e v a n t for t h e t i m e b e i n g . T h e y all m a k e clear t h a t m o r t a l i t y is an i n n a t e p o t e n t i a l o f h u m a n e x i s t e n c e , the m o s t t h o r o u g h l y p e r v a s i v e and peculiarly h u m a n trait of all. T h e m o s t dignified h u m a n r e l a t i o n s h i p t o death c o n s i s t s i n keeping t h e k n o w l e d g e of p e r s o n a l m o r t a l i t y c o n s t a n t l y in a w a r e n e s s , n e i t h e r fleeing from it n o r hiding it. O n l y such a b e i n g - u n t o - d e a t h can g u a r a n t e e t h e precondition t h a t t h e Da-sein be able to free i t s e l f from its a b s o r p t i o n in, its s u b m i s s i o n and s u r r e n d e r o f i t s e l f t o t h e t h i n g s and r e l a t i o n s h i p s o f e v e r y d a y living, and to r e t u r n to itself. A b e i n g - u n t o - d e a t h r e v e a l s death as t h e last possibility of t h e Da-sein in t h a t it r e v e a l s dying as t h e loss of all s u p p o r t f r o m o t h e r b e i n g s , h u m a n and n o n h u m a n . Each Da-sein dies its o w n death i n total l o n e l i n e s s . T h e c o n s e q u e n c e o f this i n s i g h t i s b y n o m e a n s a r e s i g n e d , passive fixation on w h a t m u s t h a p p e n s o o n e r or l a t e r . O n t h e c o n t r a r y , i n a c c e p t i n g m o r t a l i t y a s his m o s t c h a r a c t e r i s t i c , final, isolated, a n d — e x c e p t for t h e actual m o m e n t o f d e a t h — c e r t a i n e x i s t e n t i a l possibility, m a n first realizes his r e s p o n s i b i l i t y for e v e r y i n s t a n t of his e x i s t e n c e . I f m a n w e r e n o t finite and m o r t a l , h e w o u l d n e v e r miss a n y t h i n g . T h e r e would a l w a y s b e t i m e t o c a t c h u p and m a k e s o m e t h i n g g o o d . B u t for s o m e o n e w h o is m o r t a l , no situation h a p p e n s t w i c e in quite the s a m e w a y . If w h a t he does is n o t in t u n e w i t h t h e m o m e n t , th.it m o m e n t is i r r e v o c a b l y lost to h i m ; his c o n s c i e n c e will r e m i n d him t h a t he has fallen b e h i n d in fulfilling his e x i s t e n c e . T h e h o n o r a b l e , o p e n , and t r u l y h u m a n s t a n c e b e f o r e death s e t s all o t h e r e x i s t e n t i a l p o t e n t i a l i t i e s in t h e i r p r o p e r places, and t h e y appear in

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p r o p e r p e r s p e c t i v e as e x i s t e n t i a l m o d e s f u n c t i o n i n g as p r e l i m i n a r i e s for t h e e x t r e m e m o d e of d e a t h . F r o m this p e r s p e c t i v e e x i s t e n c e is not in danger of having one or the other of the more prominent potentialities made absolute. At the same time, con-dscious acceptance of mortality as a n e s s e n t i a l trait o f e x i s t e n c e c o u n t e r b a l a n c e s t h e f e a r s o m e k n o w l e d g e t h a t each p e r s o n m u s t die a l o n e . T h e p r o c e s s o f b e c o m i n g free for t h e e x t r e m e p o t e n t i a l i t y o f o n e ' s o w n death also frees a person w i t h r e s p e c t t o o t h e r s , letting h i m u n d e r s t a n d t h e i r e x i s t e n t i a l possibilities o n the basis of a solid f o u n d a t i o n . O b v i o u s l y , a n u n d e r s t a n d i n g o f death a d e q u a t e t o the p h e n o m e n o n o f m o r t a l i t y is decisively i m p o r t a n t for t h e p h y s i c i a n - p a t i e n t r e l a t i o n s h i p . D e p e n d i n g on h o w p r o f o u n d this u n d e r s t a n d i n g is in him, a physician will be c o n c e r n e d o n l y w i t h t h e t r e a t m e n t of a t e r m i n a l case of illness or w i t h helping o n e in his c a r e die a good d e a t h .

The fundamental characteristics of the Da-sein as being equally primordial, and their development into the freedom of the authentic human being T h e c h a r a c t e r i s t i c s o f h u m a n e x i s t e n c e m o s t i m p o r t a n t for m e d i c i n e , t h e n , are its primordial spatiality and t e m p o r a l i t y , b o d y h o o d , c o e x i s t e n c e in a shared world, e x i s t e n c e ' s e s s e n t i a l a t t u n e m e n t , m e m o r y as it is based in h i s t o r i c i t y , and m o r t a l i t y . T h i s s e q u e n t i a l listing is not a h i e r a r c h i c a l a r r a n g e m e n t o f t h e e x i s t e n t i a l possibilities; t h e y are equally primordial. E v e r y single h u m a n p h e n o m e n o n , n o m a t t e r h o w trifling, i s i n h e r e n t l y c o n s t i t u t e d o f e v e r y o n e o f t h e s e c h a r a c t e r i s t i c s . N a t u r a l l y , this does n o t preclude t h e p r e d o m i n a n c e of o n e c h a r a c t e r i s t i c at a n y given t i m e in a particular h u m a n b e h a v i o r . N o w , the f u n d a m e n t a l e x i s t e n t i a l c h a r a c t e r i s t i c s can be equally primordial only w h e n t h e y belong t o g e t h e r i n o n e and the s a m e u n i t y . We h a v e s e e n this u n d e r l y i n g u n i t y all along in t h e o p e n n e s s and c l a r i t y peculiar t o h u m a n e x i s t e n c e , w h i c h s h o w s i t s e l f t o a n i n v e s t i g a t o r a s s o m e t h i n g o p e n , as an " e x - i s t i n g , " a s u s t a i n i n g and m a i n t a i n i n g of t h e w o r l d w i d e clear and o p e n r e a l m o f p e r c e p t i o n . T h i s o p e n n e s s i s t h e unified and unifying f u n d a m e n t a l origin m a k i n g possible and c o n s t i t u t ­ ing the basic c h a r a c t e r n o t o n l y of m a n ' s spatiality and t e m p o r a l i t y , b u t also his h i s t o r i c i t y , b o d y h c o d , c o e x i s t e n c e , a t t u n e m e n t , and m o r t a l i t y . All t h e s e possibilities of e x i s t e n c e are of t h e n a t u r e of an ability t h a t allows t h e m e a n i n g f u l n e s s of w h a t m a n e n c o u n t e r s to disclose itself as w h a t it is. It is to be r e i t e r a t e d t h a t this o p e n n e s s m a y n o t be reified and so m i s u n d e r s t o o d as a kind of h o l l o w space i n t o w h i c h b e i n g s m a y fall, be

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p r e s e n t , and b e s t o r e d t h e r e . A s t h e open realm o f p e r c e p t i o n w h i c h i t is, h u m a n e x i s t e n c e is " m e r e l y " a r e a l m of f u n d a m e n t a l p e r c e p t i v e r e s p o n s i v e n e s s t o t h e p h e n o m e n a o f t h e w o r l d . T h a t i s w h y o u r w o r l d can n e v e r b e divided i n t o o p e n n e s s o f h u m a n e x i s t e n c e o n t h e o n e hand and t h e t o t a l i t y o f c o n c r e t e n o n h u m a n b e i n g s o n t h e o t h e r . T h a n k s t o his e x i s t e n t i a l o p e n n e s s to a n y p r e s e n c e t h a t r e v e a l s i t s e l f to h i m , a h u m a n being is able to allow w h a t e v e r a p p e a r s in t h e r e a l m of his p e r c e p t i o n simply t o b e . T h i s allowing d o e s n o t m e a n b e n i g n n e g l e c t o r i n d i f f e r e n c e . It m e a n s e n t e r i n g i n t o a r e l a t i o n s h i p to t h a t t h i n g in a w a y t h a t p e r m i t s it to fully e v o l v e its p a r t i c u l a r m e a n i n g f u l n e s s . T h i s is t h e condition of m a n ' s f r e e d o m . Only w h e r e t h e r e is a multiplicity o f p h e n o m e n a d o c h o o s i n g and deciding b e c o m e p o s s i b l e . M o r e o v e r , e x p e r i e n c e d e m o n s t r a t e s t h a t m a n i s capable o f m a k i n g f r e e choices at any time. In t h e light of t h e i r o w n e x p e r i e n c e , physicians s c h o o l e d in n a t u r a l s c i e n c e t e n d to m i s i n t e r p r e t a t h o u g h t s e q u e n c e like t h e o n e a b o v e as an attempt to prove one thing with another. T h e y mistakenly accuse it of p r e s u m i n g to h a v e p r o v e n h u m a n freedom of will b e c a u s e it h a s d e m o n s t r a t e d t h e o p e n n e s s o f h u m a n e x i s t e n c e . W e d o n o t m a k e this p r e s u m p t i o n , h o w e v e r , B o t h o p e n n e s s and f r e e d o m o f will a r e equally e l e m e n t a r y p h e n o m e n a t h a t reveal t h e m s e l v e s directly. A s s u c h , t h e y d o n o t r e q u i r e a n y proof, i n t h e n a t u r a l scientific s e n s e o f t h e w o r d . T h o u g h t h e y are equally primordial, it is possible for o n e of t h e m to be t h e condition of the manifestation of the other.

6

T h e u n q u e s t i o n a b l e e x i s t e n c e o f a f r e e d o m o f will, o f c h o i c e , f o r m s t h e basis of a h u m a n being's obligation to fulfill his e x i s t e n c e . If h u m a n b e i n g s w e r e n o t free t o decide w h e t h e r o r not t o take o n and c a r r y out t h e b e h a v i o r a l possibilities i n h e r e n t in t h e i r e x i s t e n c e s , t h e r e could be no guilt, h e a l t h y o r p a t h o l o g i c a l , and n o t h e r a p e u t i c r e l e a s e . O f c o u r s e , f r e e d o m o f will—like a n y t h i n g h u m a n — i s n o t a b s o l u t e . C o n s o n a n t with t h e overall f i n i t e n e s s of h u m a n e x i s t e n c e , its actual r a n g e is b o u n d e d by the n u m b e r and v a r i e t y of t h e i n n a t e ways by w h i c h an individual can r e l a t e h i m s e l f t o w h a t h e e n c o u n t e r s , appropriate t h e s e w a y s a s his o w n , and u s e t h e m in f o r m i n g his a u t o n o m o u s e x i s t e n c e . In addition to t h e s e limits t h e r e a r e a n y n u m b e r o f pathological deficiencies o f f r e e d o m . B u t it is i m p o r t a n t to r e m e m b e r t h a t e v e n a r e s t r i c t e d f r e e d o m is n o n e t h e l e s s a f o r m of f r e e d o m . Y e t e v i d e n c e p o i n t i n g to even a v e r y limited sort of h u m a n f r e e d o m is highly r e p u g n a n t to n a t u r a l scientific r e s e a r c h e r s w h o s e d e t e r m i n i s m denies a n y kind o f freedom for m a n . I t s e e m s o n l y fitting, c o n s i d e r i n g t h e decisive i m p o r t a n c e o f h u m a n f r e e d o m t o m e d i c i n e , t o e x a m i n e critically t h e l e g i t i m a c y o f such denials. 7

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It is a s s u m e d t h a t h u m a n freedom can be d i s m i s s e d as a m e r e illusion simply by r e i n t e r p r e t i n g the s e r i e s of free m o t i v a t i o n s leading up to a particular decision as a p r e d e t e r m i n e d and c o m p l e t e causal chain. T h e e x p e r i e n c e o f n a t u r a l s c i e n c e i t s e l f d e m o n s t r a t e s , h o w e v e r , t h a t n o such psychic causal chain can be posited w i t h c e r t a i n t y for any h u m a n decision. In fact, it is n o t y e t possible to m a k e an a c c u r a t e prediction of a n y f u n d a m e n t a l m o d e o f h u m a n b e h a v i o r . E v e n p s y c h o a n a l y s i s and b e h a v i o r a l s c i e n t i s t s , w h o are i m m e n s e l y e x p e r i e n c e d i n t h e t h e o r e t i c a l c o n s t r u c t i o n o f causal c o n n e c t i o n s w i t h i n t h e m i n d , admit t h a t t h e y can give reliable i n d i c a t i o n s o f causal s e q u e n c e s o n l y a f t e r t h e fact, n e v e r b e f o r e t h e fact. T r u e , t h e y i m m e d i a t e l y t r y t o m o d e r a t e this admission b y pointing t o t h e h u g e v a r i e t y and n u m b e r o f subsidiary c a u s e s a t w o r k i n t h e life h i s t o r y of a h u m a n being, m e a n i n g t h a t it is purely quantitative c o n s i d e r a t i o n s w h i c h s t a n d in t h e i r way. All such a t t e m p t s t o d e n y h u m a n freedom p r o c e e d u n a w a r e t h a t t h e y fail e v e n to r e a c h the basic d i m e n s i o n of all acts of free will, m u c h less to pin d o w n and nullify t h e s e a c t s . T h i s is b e c a u s e t h e i r line of a r g u m e n t , like all n a t u r a l scientific e x p l a n a t i o n s , is ruled by t h e a x i o m t h a t a n y t h i n g t h a t is really real m u s t e x i s t in a faultless causal c o n n e c t i o n . To a p e r s o n s c h o o l e d in t h e n a t u r a l s c i e n c e s , f r e e d o m m e a n s at best f r e e d o m f r o m causal l a w s , a n o n c a u s a l e v e n t , an i n s t a n c e of a-causality. I t h a p p e n s , h o w e v e r , t h a t h u m a n f r e e d o m i n h e r e s i n a n open r e a l m o f perception to the presence of what human beings encounter. T h e e n g a g e m e n t of a h u m a n being by a p a r t i c u l a r p h e n o m e n o n m o v e s , or m o t i v a t e s , h i m t o r e s p o n d t o w h a t reveals i t s e l f t o him, and t o r e s p o n d i n a c c o r d a n c e w i t h the perceived m e a n i n g f u l n e s s o f t h a t t h i n g . T h i s understanding openness to potential e n g a g e m e n t by meaningful p r e s e n c e s — t h e p r e c o n d i t i o n for h u m a n f r e e d o m — l i e s e n t i r e l y outside o f t h e a r e n a o f c a u s a l i t y and t h a t i s w h y c r i t i c i s m from t h e s t a n d p o i n t o f natural scientific d e t e r m i n i s m i s u n a b l e t o p e n e t r a t e t o t h e r e a l m o f h u m a n f r e e d o m . R e g a r d l e s s o f its ability t o p r o d u c e all, o r s o m e , o r n o n e of the c a u s e s of a p a r t i c u l a r piece of h u m a n b e h a v i o r , it has n o t h i n g to say a b o u t the actual basis o f f r e e d o m . O n t h e o t h e r h a n d , t h e s a m e insight i n t o t h e basis o f h u m a n f r e e d o m reveals t h a t i t i s not h u m a n pleasure t h a t disposes o v e r f r e e d o m . T h e h u m a n does n o t p o s s e s s freedom as o n e of his p r o p e r t i e s . At m o s t , it is the r e v e r s e . F r e e d o m , n a m e l y the e k - s i s t i n g , r e v e a l i n g o u t o f h i d d e n n e s s {entbergende), world opening {eröffnende) Dasein p o s s e s s e s the h u m a n being." T h e s e indications o f t h e free and o p e n n a t u r e o f h u m a n e x i s t e n c e , w i t h its c h a r a c t e r i s t i c spatiality and t e m p o r a l i t y , h i s t o r i c i t y , b o d y h o o d , c o e x i s t e n c e with o t h e r s , a t t u n e m e n t , and m o r t a l i t y , c o n c l u d e o u r

Fundamental

Characteristics of Human

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discussion of the f u n d a m e n t a l c h a r a c t e r i s t i c s of h u m a n b e i n g . In place of t h e t e r m s "basic t r a i t " and " f u n d a m e n t a l c h a r a c t e r i s t i c , " w e can use the w o r d " E x i s t e n t i a l , " using t h e initial capital to distinguish t h e n o u n from t h e adjective. T h e s e t h r e e d e s i g n a t i o n s h a v e t h e s a m e r e l a t i o n t o m a n ' s being a s t h e n o t i o n o f c a t e g o r y h a s t o i n a n i m a t e o b j e c t s . O u r p r e s e n t a t i o n o f t h e basic t r a i t s o f h u m a n being does n o t claim t o be a c o m p l e t e e x i s t e n t i a l a n t h r o p o l o g y . It has m e r e l y t r a c e d t h o s e E x i s t e n t i a l s w h i c h are m o s t i m p o r t a n t for m e d i c i n e . Still this f r a m e ­ w o r k will s e r v e to s u g g e s t an a d e q u a t e e x i s t e n t i a l f o u n d a t i o n f o r m e d i c i n e . It is s o u n d e r , on t w o c o u n t s , t h a n t h e c u r r e n t l y d o m i n a n t f r a m e w o r k based o n biological, physiological, and p s y c h o l o g i c a l d e t e r m i ­ nations of human nature. First o f all, the findings o f t h e s e t h r e e s c i e n c e s d o n o t really c o m e into their own—as manifestations of human existence—until they are seen from t h e e x i s t e n t i a l f o u n d a t i o n w e h a v e p r e s e n t e d . For t h e E x i s t e n t i a l s pervade t h e empirical findings as an essence w i t h o u t w h i c h t h e y could n o t be w h a t t h e y are. If this is t h e s o r t of r e l a t i o n s h i p t h a t o b t a i n s b e t w e e n the basic traits of h u m a n being and empirical (i.e., physiologicalpsychological) fact, t h e n it is far f r o m t h e purpose of o u r e x i s t e n t i a l f o u n d a t i o n for m e d i c i n e t o d e t r a c t from t h e i m p o r t a n c e o f t h e s e " c o n c r e t e " medical findings. O n t h e c o n t r a r y , this n e w e r foundation m a k e s possible an i n t e r p r e t a t i o n t h a t is m o r e j u s t to empirical fact and more adequate to human beings. 9

In the s e c o n d place, an e x i s t e n t i a l f o u n d a t i o n for m e d i c i n e e n a b l e s us t o assail successfully t h e u n s c i e n t i f i e n c v a g u e n e s s and m y s t i f i c a t i o n surrounding many of the standard concepts of the modern science of healing. A b o v e all, o u r f r a m e w o r k can supply r i g o r o u s , concrete d e t e r m i n a t i o n s o f h u m a n being w i t h w h i c h t o fill t h e v a c u u m a r o u n d the i n c r e a s i n g l y popular n o t i o n s of a total medicine and a u n i t y of body, mind, and spirit. T h e t o t a l i t y and w h o l e n e s s of m a n , w h i c h a total m e d i c i n e t r i e s t o g r a s p , and t h e u n i t y o f his e x i s t i n g are first capable o f decisive c h a r a c t e r i z a t i o n i n t e r m s o f t h e a b o v e described E x i s t e n t i a l s . It m a y s t r i k e t h e r e a d e r as odd t h a t a description of t h e e x i s t e n t i a l traits m o s t i m p o r t a n t for m e d i c i n e a b a n d o n s e v e r y o n e o f t h e n o t i o n s n a t i v e t o traditional physiology and p s y c h o l o g y . T h e r e is no m e n t i o n of a h u m a n s o m a n o r is a n y a t t e n t i o n paid to n o t i o n s of a p s y c h e , a c o n s c i o u s , an affect, or an u n c o n s c i o u s . A n e w vision and u n d e r s t a n d i n g of s o m e t h i n g d e m a n d s a n e w w a y of talking a b o u t it, for the old t e r m i n o l o g y g e t s in the w a y of this e f f o r t . S t u b b o r n l y e n t r e n c h e d behind t h e w o r d s coined by a particular c o n c e p t u a l o r i e n t a t i o n a r e its s e c r e t prejudices. A n y a t t e m p t to o p e n o u t an a d e q u a t e l y h u m a n vista o n t o t h e p h e n o m e n a ol u n d i s t u r b e d e x i s t e n c e m u s t include a critique of the m o s t important ideas o f traditional biology, p h y s i o l o g y , a n d p s y c h o l o g y .

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1 . For t h e s u b s e q u e n t r e a s o n i n g n e e d e d t o i l l u m i n a t e w h a t still r e m a i n s o b s c u r e a b o u t t i m e , s e e : M. H e i d e g g e r , Zur Sache des Denkens ( T u b i n g e n : N i e m e y e r , 1 9 6 9 ) , p. 1 4 . 2 . T h e w o r d " b o d y h o o d " w a s f i r s t d o c u m e n t e d i n t h e E n g l i s h l a n g u a g e i n 1 6 7 4 and h a s t h e m e a n i n g , " t h e q u a l i t y o f h a v i n g a b o d y o r o f being body" ( O . E . D . ) . T h i s w o r d i s c o n g r u e n t w i t h t h e G e r m a n Leib, w h i c h h a s t h e c o n n o t a t i o n o f b o d y a s lived b o d y l i n e s s . 3 . Cf. M . H e i d e g g e r , Nietzsche, v o l . 1 ( P f u l l i n g e n : V e r l a g N e s k e , 1 9 6 1 ) , pp. 5 3 - 6 3 . 4. Cf. M. Boss, Lebensangst, Schuldgefühle und psychotherapeutische Befrciunt ( B e r n and S t u t t g a r t : H a n s H u b e r V e r l a g , 1 9 6 2 ) , p . 2 8 f f a n d 3 9 ff. 5 . A u r e l i u s A u g u s t i n u s , Confessiones, 2 d ed. ( M u n i c h : K o s e l - V e r l a g , 1 9 6 0 ) , pp. 5 1 0 - 1 1 . 6. C o m p a r e a l s o : la) W. K e l l e r , Das Problem der Willensfreiheit ( B e r n and M u n i c h : F r a n c k e , S c h u l t h e s s & Co., 1 9 6 3 ) and Menschliche Existenz, Willensfreiheit und Schuld ( Z u r i c h : S c h u l t h e s s & Co., 1 9 6 4 ) . B o t h w o r k s c o n t a i n i m p r e s s i v e i l l u s t r a t i o n s o f t h e f u n d a m e n t a l p o s i t i o n s first e l a b o r a t e d in H e i d e g g e r ' s Sein und Zeit; lb) M. H e i d e g g e r , Vom Wesen der menschlichen Freiheit. Unpublished introductory lecture to philosophy, 1 9 3 0 . 7 . All t h a t i s e s s e n t i a l f o r a n e x i s t e n t i a l u n d e r s t a n d i n g o f t h e s t r u c t u r e o f h u m a n g u i l t and t h e h u m a n conscience c a n b e f o u n d in: M . H e i d e g g e r , " D i e e x i s t e n t i a l - o n t o l o g i s c h e n F u n d a m e n t e d e r G e w i s s e n s als R u f d e r S o r g e , A n r u f v e r s t e h e n u n d S c h u l d , die e x i s t e n t i a l e I n t e r p r e t a t i o n d e s G e w i s s e n s u n d die v u l g ä r e G e w i s s e n s a u s l e g u n g , d e e x i s t e n t i a l e S t r u k t u r des im G e w i s s e n b e z e u g t e n e i g e n t l i c h e n S e i n k ö n n e n s , " in Zein und Zeit ( H a l l e : Niemeyer, 1927), p. 267ff. 8. Cf. M. H e i d e g g e r , Vom Wesen der Wahrheit, 3d e d . ( F r a n k f u r t - a m - M a i n : K l o s t e r m a n , 1 9 5 4 ) , pp. 1 4 and 1 6 . 9 . T h e p o s s i b i l i t y o f d r e a m i n g a s a n o t h e r E x i s t e n t i a l i s d i s c u s s e d a t l e n g t h in: M . B o s s , "Es t r ä u m t e m i r v e r g a n g e n e N a c h t . . . . " ( B e r n , S t u t t g a r t , W e i n : H a n s H u b e r , 1 9 7 5 ) .

Chapter 8 AN EXISTENTIAL STUDY OF THE BASIC CONCEPTS OF BIOLOGY, PHYSIOLOGY, AND PSYCHOLOGY

From human body as a physical organism to bodyhood I n t h e preceding c h a p t e r s w e have e m p h a s i z e d t h e n e c e s s i t y for c o n s i d e r i n g the p h e n o m e n o n o f h u m a n e x i s t e n c e w h i c h traditional m e d i c i n e calls t h e h u m a n body. W e h a v e u n d e r s c o r e d t h e conditional j u s t i f i c a t i o n for c o n c e i v i n g o f bodyhood's s o m a and for t h e g e n e r a l p r e e m i n e n c e g r a n t e d the s o m a i n m e d i c i n e . W e h a v e also indicated h o w this c o n c e p t i o n can be left b e h i n d for o n e t h a t r e c o g n i z e s all bodily p h e n o m e n a o f h u m a n e x i s t e n c e a s t h e bodying f o r t h o f t h e r e l a t i o n s h i p to t h e world in w h i c h and as w h i c h a particular Da-sdn is e x i s t i n g at a given m o m e n t . T h i s c o n c e p t u a l a d v a n c e is so f u n d a m e n t a l l y i m p o r t a n t for m e d i c i n e t h a t w e felt c o m p e l l e d t o p u r s u e t h e m a t t e r f u r t h e r . It m a y be e a s i e r to m a k e t h e t r a n s i t i o n if we a d v a n c e o n l y a half step at first. T h e findings of m o d e r n F r e n c h phenomenologues existentiels m a y fairly be described as a h a l f step a d v a n c e f r o m the n a t u r a l scientific c o n c e p t of t h e body. N o o t h e r r e s e a r c h e r s o f t h e last decades h a v e w o r k e d s o i n t e n t l y t o w a r d a m o r e appropriately h u m a n f o r m u l a t i o n o f t h e p h e n o m e n o n of b o d y h o o d t h a n t h e y . It still r e m a i n s difficult for t h e m to e s c a p e t h e d o m i n a t i n g i n f l u e n c e o f D e s c a r t e s , and this i s w h y t h e y h a v e m a n a g e d t o g e t only h a l f w a y t o w a r d a n e x i s t e n t i a l u n d e r s t a n d i n g o f the b o d y h o o d of h u m a n Da-sein. A n d y e t t h e s e p h i l o s o p h e r s do d e s e r v e lasting credit for pointing i n s i s t e n t l y to the n e c e s s i t y for r e c o n s i d e r i n g 1

128

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2

the h u m a n b o d y . W e shall limit o u r e x a m i n a t i o n h e r e t o a f e w particularly c h a r a c t e r i s t i c and r e v e a l i n g s t a t e m e n t s f r o m t h e w o r k s o f S a r t r e and M e r l e a u - P o n t y . S a r t r e tell us t h a t a h u m a n being and his w o r l d a r e m u t u a l l y r e l a t e d p h e n o m e n a and t h a t t h e f u n d a m e n t a l c h a r a c t e r i s t i c of each is relation. B u t h e a t o n c e g o e s o n t o a s s e r t that, g i v e n this reciprocal r e l a t e d n e s s , i t follows t h a t t h e r e l a t i o n s h i p i t s e l f m u s t arise from t h e h u m a n reality and g o o u t from i t t o t h e t h i n g s o f t h e w o r l d . A c c o r d i n g l y , c o m i n g - i n t o - t h e w o r l d m e a n s n o t h i n g m o r e for h u m a n b e i n g s t h a n e s t a b l i s h i n g d i s t a n c e s from t h i n g s and t h e r e b y m a k i n g it possible, s i m u l t a n e o u s l y , for t h i n g s to be in t h e first place. R e f i n i n g this v i e w , he says t h a t to be h u m a n m e a n s to be imprisoned perpetually in some particular perspective determined, in fact, by l o c a t i o n , at t h e p a r t i c u l a r m o m e n t , of t h e human body. A p e r s o n ' s r e l a t i o n s h i p s to t h i n g s would e m a n a t e from this specific point in space. 3

4

On t h e o t h e r h a n d , S a r t r e also sees corps humain as t h e v e s t i g e of pure p r e s e n c e f r o m w h i c h h u m a n c o n s c i o u s n e s s m a y b r e a k f o r t h i n t o a n o n t o l o g i c a l act. T h e b o d y is draped o v e r a h u m a n being, o n c e he h a s b e c o m e c o n s c i o u s , as a tool, a v e r y peculiar sort of t o o l , of c o u r s e . People do n o t simply p o s s e s s t h e i r bodies as t h e y do t h e tools t h e y m a k e t h e m s e l v e s ; t h e y actually e x i s t t h e i r bodies, w h i c h m e a n s t h a t p r o c e e d i n g from t h e pivot o f his body t h r o u g h s i g n i f i c a n c e - c r e a t i n g r e l a t i o n s h i p s , a h u m a n being t r a n s c e n d s t h e body to a r r i v e at t h e t h i n g s o f his world. S a r t r e n e g l e c t s t o specify e x a c t l y h o w this m o v e m e n t o u t w a r d to t h i n g s is supposed to happen or h o w such a s i g n i f i c a n c e c r e a t i n g r e l a t i o n s h i p m i g h t arise in and t r a n s c e n d a b o d y t h a t is m e r e l y in space. T h i s is m o r e o b s c u r e in light of his v i e w t h a t all being is, in e s s e n c e , n o t h i n g but totally m e a n i n g l e s s p r e s e n c e . A p p a r e n t l y , we will h a v e to travel q u i t e a w a y past S a r t r e ' s d e t e r m i n a t i o n of t h e corps humain b e f o r e we a r r i v e at a truly e x i s t e n t i a l view. S u c h a v i e w m u s t m a k e clear in opposition to S a r t r e ' s opinion t h a t the spatiality of h u m a n being does n o t o r i g i n a t e in, and is n o t shaped b y , the h u m a n body. W e h a v e already s h o w n h o w h u m a n e x i s t e n c e can b e bodily only b e c a u s e e x i s t e n c e itself is i n h e r e n t l y spatial. F o r S a r t r e , a d e q u a t e insight into t h e n a t u r e of t h e corps humain d e p e n d s o n w h a t h e views a s t h e m o s t basic e x i s t e n t i a l m o o d : n a u s e a , disgust, o r l o a t h i n g . O n l y in n a u s e a , he a r g u e s , does a h u m a n being e n t e r an o n t o l o g i c a l frame in w h i c h t h e pure b e i n g of all t h i n g s can disclose i t s e l f and p h e n o m e n a appear, for t h e first t i m e , w i t h o u t t h e l a c q u e r . N o w t h e h u m a n body reveals i t s e l f as pure flesh. It is no s u r p r i s e t h a t m a n r e g a r d s il with a lifelong s e n s e of s h a m e . N o w h e r e d o e s S a r t r e explain w h y it is n a u s e a , of all t h i n g s , t hat allows 5

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us to r e c o g n i z e all p h e n o m e n a , including t h e p u r e l y c a r n a l h u m a n body, i n t h e i r t r u e n a t u r e s . N e v e r t h e l e s s , h e b e l i e v e s t h a t t h r o u g h his discovery of nausea as the fundamental a t t u n e m e n t of h u m a n beings, he has f o r g e d far a h e a d o f H e i d e g g e r i n i n t e r p r e t i n g h u m a n n a t u r e : a t t h e c o r e of all t h i n g s is pure and m e a n i n g l e s s p r e s e n c e . H e i d e g g e r ' s designation of anxiety as the all-important human a t t u n e m e n t repre­ s e n t s , in S a r t r e ' s o p i n i o n , o n l y a first step t o w a r d valid u n d e r s t a n d i n g . S a r t r e ' s claim g r o s s l y falsifies H e i d e g g e r ' s Dasiensanalytik, w h i c h does n o t in a n y w a y a s s e r t t h a t a n x i e t y is the basic a t t u n e m e n t of e x i s t e n c e — a s S a r t r e does w i t h n a u s e a . H e i d e g g e r n a m e s a n x i e t y solely a s o n e o f a n u m b e r o f possible basic a t t u n e m e n t s a n d s i n g l e s i t o u t o n l y w h e r e the ontological determination of human existence is concerned. A n x i e t y is, in fact, especially significant in this o n e r e s p e c t , t h a t in a n x i e t y h u m a n b e i n g - i n - t h e - w o r l d i s t h r o w n b a c k e n t i r e l y o n itself. C o n s e q u e n t l y , e x i s t e n c e i s m o s t a w a r e o f i t s e l f i n a n x i e t y . T h i s does n o t mean that the phenomena of the human world might not reveal t h e m s e l v e s far m o r e m e a n i n g f u l l y and richly i n s o m e o t h e r , m o r e o p e n , a t t u n e m e n t , like loving s o m e o n e o r s o m e t h i n g . 6

In looking at the h u m a n body from the perspective of nausea, S a r t r e not only distorts Heidegger' D a s e i n s a n a l y t i k b u t also c o n t r a d i c t s h i m s e l f . O n t h e o n e h a n d , h e calls n a u s e a , disgust, o r l o a t h i n g , t h a t disposition i n w h i c h w h a t e v e r t h e h u m a n s u b j e c t e n c o u n t e r s r e v e a l s i t s e l f i n its a b s o l u t e , t - u e , n a m e l e s s , v o i c e l e s s , m e a n i n g l e s s , p a s t - a n d f u t u r e l e s s , i n a c c e s s i b l e , o n t o l o g i c a l n a t u r e a s pure p r e s e n c e . M e a n w h i l e , l o a t h i n g , s i l e n c e , d u m b p r e s e n c e , a b s o l u t e n e s s , c a r n a l i t y , and i n a c c e s s i ­ bility a r e explicitly m e a n i n g f u l qualities f o r h u m a n e x i s t e n c e . T h e y a r e , t h o u g h , e x a c t l y t h o s e m e a n i n g f u l qualities w h i c h appear i n t h a t e x t r e m e l y deficient m o d e o f a t t u n e m e n t , n a u s e a . F a r f r o m l e t t i n g u s s e e the most fundamental nature of human bodyhood, nausea is the very condition that most stubbornly prevents us from experiencing the bodyhood of our being. 7

N e x t t o S a r t r e , M e r l e a u - P o n t y d e s e r v e s r e c o g n i t i o n for his e f f o r t s t o e s t a b l i s h a basis for h u m a n b o d y h o o d . First, he i m p r o v e d on S a r t r e ' s t r a n s l a t i o n o f H e i d e g g e r ' s definition for h u m a n b e i n g . B e c a u s e S a r t r e ' s etre-dans-le-monde implicitly reified h u m a n n a t u r e and r e n d e r e d it m e r e o b j e c t in s p a c e , M e r l e a u - P o n t y p r e f e r r e d t h e w o r d i n g , ttre-au-monde. He also set h i m s e l f t h e special t a s k o f t r a n s c e n d i n g t h e C a r t e s i a n dualism t h a t s e p a r a t e s body and soul. H e h o p e d , b y i n t r o d u c i n g t h e c o n c e p t o f dwelling, t o solve t h e puzzles o f t h e link b e t w e e n t w o s u c h radically d i f f e r e n t p h e n o m e n a and " t h e p r o c e s s o f e x c h a n g e c o n s t a n t l y o c c u r r i n g a m o n g t h e s e t w o and t h e w o r l d a r o u n d t h e m . " 8

A l t h o u g h h e calls t h e soul's dwelling in the b o d y a f u n d a m e n t a l

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o f h u m a n b e h a v i o r , M e r l e a u - P o n t y allows t h e c o n c e p t o f dwelling t o r e m a i n a m b i g u o u s and c o m p l i c a t e d . S o m e t i m e s it is t h e soul's " i n h e r ­ e n c e " i n t h e body; a t o t h e r t i m e s t h e " a r t i c u l a t i o n " o f t h e soul t h r o u g h t h e body, o r vice v e r s a . T h e n again, h e speaks s o m e t i m e s o f a c o n s t a n t e x c h a n g e b e t w e e n s o m e t h i n g s e e i n g and s o m e t h i n g visible, s o m e t h i n g t o u c h i n g and s o m e t h i n g t a n g i b l e . B u t h e does n o t explain h o w w e a r e t o i m a g i n e this i n h e r e n c e o r this e x c h a n g e b e t w e e n t w o s u c h h e t e r o g e n e o u s t h i n g s . H e o n l y a s s e r t s t h a t , t h a n k s t o this i n h e r e n c e and e x c h a n g e , t h e body i s " t h e abode o f t h e soul, and t h e physical eye t h e w i n d o w i n t h e b o d y t h r o u g h w h i c h t h e soul m a y p e e r o u t . " I n his v i e w , t h e body is an o b j e c t , b u t an o b j e c t in w h i c h we d w e l l . C o n s e q u e n t l y , t h e spirit n o t o n l y m a k e s u s e o f t h e b o d y b u t actually unfolds i t s e l f t h r o u g h t h e m e d i u m o f t h e b o d y and m a k e s i t t r a n s c e n d t h e p u r e l y physical. D e s p i t e t h e i r v a r i e t y , e a c h o f M e r l e a u - P o n t y ' s d e s c r i p t i o n s o f dwelling s h o w s t h a t h e h a s n o t t r a n s c e n d e d C a r t e s i a n dualism. His t h i n k i n g i s o n t h e o n e h a n d a s e l f - s u f f i c i e n t , s u b s t a n t i v e h u m a n soul, and on t h e o t h e r a physical body. In M e r l e a u - P o n t y ' s s c h e m e , t h e b o d y is m e r e l y physically t h e r e until it is t r a n s f o r m e d , by t h e soul's dwelling in it, i n t o a living h u m a n body. B u t t h e r e i s n o t o n e o b s e r v a t i o n t o c o n f i r m t h a t t h e b o d y e x i s t s initially u n i n h a b i t e d by soul or spirit, m u c h less for a s e c o n d a r y m e t a m o r p h o s i s of t h e physical o b j e c t - b o d y i n t o a h u m a n s u b j e c t - b o d y , a t r a n s f o r m a t i o n i n w h i c h s o m e simple physical o b j e c t w o u l d s u d d e n l y s t a r t t o p e r c e i v e i t s e l f . E v e n M e r l e a u - P o n t y a d m i t s t h a t this alleged m e t a m o r p h o s i s is i n e x p l i c a b l e . M e r l e a u - P o n t y ' s r e f l e c t i o n s on the soul's dwelling in the body w e r e p r e c e d e d b y H e i d e g g e r ' s v e r y d i f f e r e n t n o t i o n o f h u m a n d w e l l i n g , and we may assume that Merleau-Ponty's introduction to the concept into French p h e n o m e n o l o g y was not entirely independent of Heidegger's i n v e s t i g a t i o n s . B u t , a n u n b r i d g e a b l e gap s e p a r a t e s t h e t w o c o n c e p t s . M e r l e a u - P o n t y ' s c o n c e p t of dwelling e n t a i l s at least a bipolar r e l a t i o n s h i p b e t w e e n t h e t w o e n t i t i e s , and t h e possibility o f v i e w i n g t h e e x t e r n a l w o r l d . IN H e i d e g g e r ' s Daseinsanalytik, by c o n t r a s t , dwelling r e f e r s t o h u m a n e x i s t e n c e ' s d w e l l i n g - i n - t h e - w o r l d . T h i s dwelling i s totally o t h e r t h a n a m a t e r i a l p r e s e n c e . It is r a t h e r m a n ' s e k - s t a t i c abiding by, his e x i s t i n g in th o p e n n e s s of a c l e a r e d w o r l d l y r e a l m . T h i s dwelling, abiding by, e x i s t i n g , is c a r r i e d o u t in t h e c o n c r e t e p e r c e i v i n g and a n s w e r i n g r e l a t i o n s h i p s t o t h e b e i n g s o f his w o r l d . 9

10

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M e r l e a u - P o n t y g o e s a g a i n s t all e x p e r i e n c e s i n c l a i m i n g t h a t t h e h u m a n b e i n g , by virtue of the fact t h a t it is his body t h a t inexplicably b e g i n s to see, to r e f l e c t , and to adapt itself to t h e s u r r o u n d i n g space, is a n c h o r e d in the WOI Id solely t h r o u g h this b o d y . It is n e v e r o n l y my body, as a selfc o n t a i n e d I Inn);. I ha! s e e s , thinks, and adapts to its spatial e n v i r o n m e n t . 1 5

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It is I, w h o s e f u n d a m e n t a l c h a r a c t e r is t h e w o r l d - s p a n n i n g o p e n n e s s ol a n ability t o p e r c e i v e s o m e t h i n g a s s o m e t h i n g , w h o a m able t o b e a w a r e of m y s e l f as being p r e s e n t , and to be in t h e r e l a t i o n s h i p to w h a t I have p e r c e i v e d . C e r t a i n l y t h e r e a r e p h e n o m e n a o f this h u m a n e x i s t e n c e that can be i n t e r p r e t e d , t h o u g h i n a d e q u a t e l y , as t h e p h e n o m e n a of a m a t e r i a l body situated s o m e w h e r e i n space. N e v e r t h e l e s s , o u r u n d e r s t a n d i n g o f t h e b o d y h o o d o f h u m a n e x i s t e n c e b e c o m e s a d e q u a t e o n l y w h e n this b o d y h o o d in its e n t i r e l y is s e e n as bodying f o r t h w a y s of b e i n g in relation to w h a t a h u m a n being e n c o u n t e r s p e r c e p t i v e l y and r e s p o n s i v e l y at any given m o m e n t .

From psyche to human being-in-the-world T h e v e r y w o r d p s y c h e h a s b e e n a p l a y t h i n g o f h i s t o r y . A r i s t o t l e still called psyche t h e d i s t i n g u i s h i n g mode of being of an e n t i t y w i t h t h e p o t e n t i a l for b e i n g alive. By m e d i e v a l t i m e s , p s y c h e w a s a m a t e r i a l l y p r e s e n t — t h o u g h still i m m o r t a l — s p i r i t u a l s u b s t a n c e b y itself. T h e m o d e r n a g e , a n a l o g i z i n g f r o m its c o n c e p t o f t h e b o d y , i m a g i n e s the p s y c h e a s a n o r g a n i s m l i k e , m o r e o r less a u t o n o m o u s , o b j e c t . I n q u i r y i n t o its e x a c t n a t u r e is c o n s i d e r e d u n n e c e s s a r y . All t h a t is s o u g h t , or p r o p o s e d , are p r o c e s s e s o c c u r r i n g i n t h e p s y c h e and, o n e would h o p e , a m e n a b l e t o c a l c u l a t i o n . T h e p s y c h e i n w h i c h all o f t h e s e m e c h a n i s m s and p s y c h i s m s a r e alleged to t a k e place eludes strict scientific definition. P a s s i n g definitions t h a t label i t t h e seat o f t h e m e n t a l f a c u l t i e s , o f i n s t i n c t s , drives, and e m o t i o n s can hardly b e r e c o g n i z e d a s scientific c h a r a c t e r i z a t i o n s . A n d t h e c o l l e c t i o n s o f p s y c h i c faculties bandied a b o u t s o f r e e l y b y c o n t e m p o r a r y b r a n c h e s o f faculty p s y c h o l o g y says v e r y little a b o u t e i t h e r t h e e x i s t e n c e o f t h e s e p o w e r s t h e p s y c h e allegedly holds, t h e m o d e of b e i n g of t h e p s y c h e itself, or j u s t h o w this p s y c h e is in a position to h a v e s u c h t h i n g s as d r i v e s , e m o t i o n s , and i n s t i n c t s as its faculties or f u n c t i o n s . M e d i c a l t h i n k i n g will g e t past this b o t t l e n e c k o n l y by c o m p l e t e l y r e l i n q u i s h i n g t h e n o t i o n of a s u b s t a n t i a l o b j e c t i v e l y p r e s e n t p s y c h e and c o n s i d e r i n g h u m a n being as Da-sein. To e x i s t as Da-sein m e a n s t o s u s t a i n and m a i n t a i n t h e c l e a r n e s s o f a w o r l d - s p a n n i n g r e a l m o f p e r c e p t i o n , t o hold o p e n this r e a l m i n t o w h i c h w h a t e v e r can b e m a y s h i n e f o r t h and be p e r c e i v e d in its m e a n i n g and its place. So it is t h a t a p h e n o m e n o n can e n g a g e t h e h u m a n being in s u c h a w a y t h a t he can r e s p o n d to it a c c o r d i n g to its m e a n i n g f u l n e s s . In this w a y , t h e h u m a n being is c o n t i n u o u s l y r e l a t e d to w h a t he e n c o u n t e r s , and he develops as a h u m a n being in this r e l a t i o n s h i p . T h i s r e l a t e d n e s s is not biploar. R a t h e r , m a n ' s existential relatedness—as w h i c h each of us e x i s t s in his p a r t i c u l a r and limited w a y — i s a p r i m a r y dwelling w i t h w h a t c o m e s to be in t h e world s p a n n i n g o p e n n e s s he s u s t a i n s . H u m a n b e i n g - i n - t h e - w o r l d , then, is a

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m u l t i t u d e o f w a y s o f p e r c e i v i n g and r e s p o n d i n g . T h e s e m o d e s can b e scientifically, i.e., o n t i c a l l y , o b s e r v e d and d e s c r i b e d . In an e x i s t e n t i a l p e r s p e c t i v e , all t h e p h e n o m e n a t h a t h a v e until n o w been inexplicably m i s i n t e r p r e t e d a s t h e p o s s e s s i o n s , faculties, o r f u n c t i o n s of a h y p o t h e s i z e d boxlike p s y c h e b e c o m e visible as t h e h i g h l y various, concrete modes of existing as the world-spanning openness that is h u m a n Da-sein. O n c e one has managed to explode the theoretical myths of p s y c h o l o g i s m and s u b j e c t i v i s m , and h a s s u c c e e d e d in seeing the h o r i z o n o f t h e D a s e i n s a n a l y t i k v i e w o f h u m a n being, o n e should also h a v e s e e n t h e a b s u r d i t y of t h e c o m m o n q u e s t i o n of where, after t h e p s y c h e c o n c e p t h a s d i s a p p e a r e d , t h e possibilities o f perceiving and a c t i n g w h i c h m a k e u p h u m a n e x i s t e n c e are t o b e f o u n d . T h e form o f t h e q u e r y only s h o w s t h a t t h e q u e s t i o n e r is still u n a b l e to get out of t h e traditional v i e w in w h i c h people are n o t h i n g m o r e t h a n e n t i t i e s p r e s e n t a t p a r t i c u l a r l o c a t i o n s w i t h i n a p r e s u p p o s e d w o r l d space, isolated b o d i e s , w h e t h e r m a t e r i a l or i m m a t e r i a l , t h a t c o n t a i n m e n t a l faculties, drives, and a s p i r a t i o n s . O n c e human existence is seen as bearing the spatio-temporal w o r l d w i d e r e a l m of o p e n n e s s as, itself, a p e r c e p t i v e and a c t i v e l y r e s p o n s i v e o p e n n e s s , t h e p r o b l e m of location t a k e s on a w h o l l y d i f f e r e n t aspect. It is t h e n s e l f - e v i d e n t t h a t t h e possibilities for r e l a t e d n e s s b e l o n g f u n d a m e n t a l l y and i m m e d i a t e l y t o t h e w h o l e r e a l m o f p e r c e p t i v e o p e n n e s s . T h e y a r e , i n fact, w h a t c o n s t i t u t e h u m a n b e i n g - i n - t h e w o r l d . T h i s o p e n n e s s is t h e primordial spatiality or prespatiality in w h i c h t h e possibility of a p h e n o m e n o n ' s being located at a n y p o i n t in space is grounded. 1 6

From consciousness to the fundamental openness of human existence T h e t e r m " c o n s c i o u s n e s s " claims a u n i q u e place in c o n t e m p o r a r y philosophy and in t h e s c i e n c e s of p s y c h o l o g y , p h y s i o l o g y , and p a t h o l o g y . T h e idea is f u n d a m e n t a l to depth p s y c h o l o g y and p s y c h o p a t h o l o g y in t h a t their m o s t i m p o r t a n t c o n c e p t , is the " u n c o n s c i o u s , " its c o n c e p t u a l n e g a t i o n . Even p h y s i o l o g y and biology a r e p e r p e t u a l l y c o n c e r n e d w i t h t h e idea o f c o n s c i o u s n e s s t o t h e e x t e n t t h a t t h e y t r y t o t r a c e i t back t o n e u r o p h y s i o l o g i c a l s t r u c t u r e s and p r o c e s s e s o r t o e l i m i n a t e i t e n t i r e l y . While t h e y can speak o f a l t e r a t i o n s i n c o n s c i o u s n e s s , t h o u g h , t h e y h a v e v e r y little t o say a b o u t t h e n a t u r e o f c o n s c i o u s n e s s itself. Leading p s y c h o l o g i s t s h a v e also had to give up a t t e m p t s to find a scientific e x p l a n a t i o n for t h e n o t i o n o f c o n s c i o u s n e s s . K a r l J a s p e r s had t o s e e k refuge in a m e t a p h o r : " W e give t h e n a m e c o n s c i o u s n e s s to the w h o l e

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of p s y c h i c life at a g i v e n m o m e n t . We i m a g i n e this c o n s c i o u s n e s s , as it w e r e , figuratively a s t h e s t a g e o n w h i c h t h e p a r t i c u l a r psychicp h e n o m e n a c o m e and g o , o r a s t h e m e d i u m i n w h i c h t h e y m o v e . " I t i s n o t h a r d t o see w h y this s t a g e m e t a p h o r c a n n o t b e t a k e n v e r y far. A s t a g e c a n n o t p e r c e i v e w h a t is b e i n g played on it. W h i l e we speak of c o n s c i o u s n e s s w e a l w a y s h a v e i n m i n d t h e ability t o b e c o m e c o n s c i o u s o f things as phenomena of particular meanings. 1 7

T h e G e r m a n w o r d for c o n s c i o u s n e s s , Bewusstsein, is a little u n f o r t u n a t e . It has g e n e r a t e d t h e idiom ein Bewusstsein hahen, w h i c h m e a n s " t o h a v e a c o n s c i o u s n e s s . " C o n s c i o u s n e s s i s g e n e r a l l y r e p r e s e n t e d a s s o m e specific thing e x i s t i n g as a b o x l i k e c o n t a i n e r . M o r e can be g l e a n e d f r o m t h e Latin conscientia. T h e con prefix r e f e r s to the h u m a n subject. W h e n e v e r I am conscious of something that is not m y s e l f , I c o n t i n u e in a w a r e n e s s of m y s e l f as a being t h a t is c o n s c i o u s of s o m e t h i n g . And a l t h o u g h this a w a r e n e s s o f m y s e l f i s n o t t h e m a t i c , consciousness nevertheless by nature always entails consciousness of self. I n " r e p r e s e n t , " t h e " r e " prefix indicates t h a t k n o w l e d g e r e f e r s back to t h e k n o w e r . W h e n I r e - p r e s e n t , I am p r e s e n t i n g to m y s e l f w h a t is p r e s e n t in my world. B u t conscientia ( c o n s c i o u s n e s s ) and its ability to r e p r e s e n t w e r e also s u b j e c t e d t o t h e m u t i l a t i n g p r o c e s s o f reification u n d e r t h e n a t u r a l scientific a p p r o a c h . C o n s c i o u s n e s s w a s t h o u g h t of as a s e l f - c o n t a i n e d b o x l i k e — t h o u g h i m m a t e r i a l — p h e n o m e n o n , and r e p r e s e n t a t i o n s w e r e s e e n as i m a g e s of o b j e c t s in t h e e x t e r n a l w o r l d , f o r m i n g a part of t h e e n d o p s y c h i c m a t e r i a l of c o n s c i o u s n e s s and filling its i n n e r field. In r e s p o n s e to t h e i n s u r m o u n t a b l e difficulties i n h e r e n t in t h e s e notions, the suggestion has been made many times to dispense with the s u b s t a n t i v e s Bewusstsein and " c o n s c i o u s n e s s " and i n s t e a d u s e only t h e adjectives bewusst and " c o n s c i o u s . " T h e s e could d e s i g n a t e c e r t a i n c o n s c i o u s - i m m a n e n t p s y c h i c p r o c e s s e s and a b o v e all could help distinguish a m o n g c o n s c i o u s and u n c o n s c i o u s psychic p r o c e s s e s . T o t h e c a t e g o r y o f c o n s c i o u s p s y c h i c p r o c e s s e s b e l o n g , a m o n g o t h e r t h i n g s , all t h e t h o u g h t p r o c e s s e s of w h i c h a p e r s o n is a w a r e , w h i c h a r e in t u r n usually s e e n a s c o n n e c t i o n s a m o n g e n d o p s y c h i c r e p r e s e n t a t i o n s . Y e t p s y c h o l o g i s t s and p s y c h i a t r i s t s a r e still at a loss to explain e x a c t l y w h a t t h e s e t h o u g h t p r o c e s s e s , and t h o u g h t itself, a r e c o m p o s e d of. T h e y c a n n o t g e t a r o u n d t h e fact, o n e w e h a v e e m p h a s i z e d o f t e n e n o u g h , t h a t h u m a n b e h a v i o r supplies n o c o n c r e t e e v i d e n c e t o j u s t i f y t h e s e c o n c e p t i o n s o f c o n s c i o u s n e s s and its c o n t e n t o f t h o u g h t and e n d o p s y c h i c representations. We can o n c e again look to l a n g u a g e for a w a y out of this c u l - d e - s a c . We m a y d i s c o v e r t h a t t h e t e r m Bewusstsein is a surprisingly r e c e n t c o i n a g e . It

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and the adjective bewusst did n o t a p p e a r until t h e e i g h t e e n t h c e n t u r y . T h e y still largely r e t a i n t h e original m e a n i n g s i m p a r t e d t o t h e m i n a n era t h a t w o r e t h e philosophical spectacles o f C a r t e s i a n i s m , t h r o u g h w h i c h t h e act o f p e r c e p t i o n w a s split i n t o t h e o b j e c t i f i c a t i o n o f t h i n g s o u t s i d e and t h e i r r e p r e s e n t a t i o n w i t h i n a h u m a n s u b j e c t . M u c h o l d e r t h a n Bewusstsein and bewusst is t h e a r c h a i c G e r m a n w o r d bewissen. F r o m its I n d o g e r m a n i c r o o t vid-, the v e r b wissen m e a n s " t o h a v e s e e n s o m e t h i n g , " " t o b e a w a r e o f s o m e t h i n g a s being s o m e t h i n g . " A c c o r d i n g l y , t h a t p e r s o n is bewisst w h o h a s found his place in his e n v i r o n m e n t and a m o n g t h e o b j e c t s a r o u n d h i m , w h o is—in m o d e r n p s y c h i a t r i c j a r g o n — " o r i e n t e d . " S o m e o n e can b e c o m e o r i e n t e d o n l y a f t e r h e has g r a s p e d t h e m e a n i n g s o f w h a t h e h a s s e e n , a p p r e h e n d i n g w h e r e t h e s e t h i n g s b e l o n g and w h a t t h e y are for. T h i s raises t h e q u e s t i o n of w h e t h e r c o n s c i o u s n e s s (as being bewisst) is t h e p r e c o n d i t i o n for h u m a n b e i n g - i n - t h e - w o r l d , or if it is the o t h e r w a y a r o u n d . T h e priority of Da-sein, of b e i n g - i n - t h e - w o r l d , is evident as s o o n as this h u m a n " b e i n g - i n - t h e - t h e r e " and " b e i n g - i n . . " is u n d e r s t o o d e x i s t e n t i a l l y . We h a v e said t h a t the f u n d a m e n t a l trait of h u m a n Da-sein is its w o r l d - s p a n n i n g o p e n n e s s to perceiving w h a t is t h e r e in its p r e s e n c e . If t h e r e is to be a capacity f o r p e r c e p t i o n , for being bewisst and finding o n e ' s place in t h e w o r l d , t h e n t h e " e c - s t a t i c " dwelling in t h e c l e a r o p e n n e s s peculiar to h u m a n Da-sein is i n d i s p e n s a b l e . By c o n t r a s t , a p s y c h o l o g i c a l l y conceived boxlike consciousness cannot be the condition of h u m a n being-in-the-world. T h i s kind of r e l a t i o n s h i p b e t w e e n Da-sein and c o n s c i o u s n e s s also m a k e s it e a s i e r to u n d e r s t a n d w h y t h e r e can be no s u c h things as c o n s c i o u s e n d o p s y c h i c ideas, o r t h o u g h t p r o c e s s e s , i n t h e s e n s e o f connections, or associations, among intrapsychic representations or images. It is not man w h o forms images of the things around him, r e p r e s e n t s t h e s e i m a g e s t o h i m s e l f w i t h i n s o m e supposedly e n c a p s u l a t e d c o n s c i o u s n e s s , and t h e n m a k e s c o n n e c t i o n s b e t w e e n t h e m . R a t h e r t h e p h e n o m e n a t h e m s e l v e s , being and r e m a i n i n g o u t t h e r e in t h e w o r l d in the revealing c l e a r n e s s o f his b e i n g - i n - t h e - w o r l d , b e c o m e p r e s e n t t o him and s t a n d revealed i n t h e i r c o n t e x t o f r e f e r e n c e s . T h e y appear b e f o r e him, e n t e r t h e r e a l m o f his p e r c e p t i v e o p e n n e s s , and a d d r e s s him w i t h their m e a n i n g s . C e r t a i n l y , w h a t w e h a v e said c o n c e r n i n g t h e r e l a t i o n s h i p b e t w e e n c o n s c i o u s n e s s and Da-sein has n o t g o n e u n c h a l l e n g e d . T h e F r e n c h psychiatrist 11. Ey, in p a r t i c u l a r , h a s a c c u s e d t h e e x i s t e n t i a l v i e w of inflating c o n s c i o u s n e s s to t h e b u r s t i n g point until it e v a p o r a t e s i n t o ml m i l e ex stasies. But just this is t h e s i n g u l a r c o n t r i b u t i o n o f I ).i-.i• 1 1 1 . . 1 1 1 . 1 1 \ ' • . i . to psychology and p s y c h i a t r y . As it m u s t always r e m a i n 1

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a m y s t e r y h o w a s e l f - c o n t a i n e d i n n e r w o r l d l y e n t i t y — w h a t e v e r it is called—would p e r c e i v e s o m e t h i n g o u t s i d e i t s e l f a s m e a n i n g f u l , the t r a d i t i o n a l w a y o f s t a t i n g the p r o b l e m o f c o n s c i o u s n e s s can actually best be served by being b r o u g h t " t o t h e b u r s t i n g p o i n t . " It is n e c e s s a r y to e x p l o d e the traditional n o t i o n s of an e n c a p s u l a t e d p s y c h e , w i t h its e n c l o s e d field o f c o n s c i o u s n e s s , t o u n d e r s t a n d h u m a n b e i n g - i n - t h e world, and it should be clear by n o w t h a t to do so is a main goal of this existential foundation of medicine.

From a psychic unconscious to a fundamental "hiddenness" T h e unconscious is one of the most frequently employed concepts of m o d e r n p s y c h o l o g y and p s y c h i a t r y . F r e u d gave t h e t e r m its p r e s e n t psychological m e a n i n g , and t h e c o n c e p t of a psychic u n c o n s c i o u s rapidly b e c a m e t h e m o s t i m p o r t a n t o f his e n t i r e t h e o r y . H e e q u a t e d i t w i t h psychic reality. He called it t h e s t a r t i n g point and real m o t o r of all d r e a m p r o c e s s e s . T h e distinction b e t w e e n c o n s c i o u s and u n c o n s c i o u s psychic p r o c e s s e s s e e m e d t o h i m " t h e o n l y light i n the d a r k n e s s o f depthpsychology." T h r o u g h Freud, the notion of the unconscious became so crucial for m o s t o f t h e prevailing t h e o r i e s a b o u t h u m a n b e i n g s t h a t t h e y w e r e labeled a s depth p s y c h o l o g i e s . T h e " d e p t h " c a m e f r o m t h e fact t h a t Freud posited v a r i o u s p s y c h i c levels and w i s h e d t h e u n c o n s c i o u s t o b e u n d e r s t o o d as t h e psychic locale or p s y c h i c s y s t e m t h a t lay beneath consciousness. 18

At first, u n c o n s c i o u s w a s an adjective used o n l y to r e f e r to a specific " c h a r a c t e r i s t i c o f c e r t a i n psychic c o n f i g u r a t i o n s . " " T h e u n c o n s c i o u s , " F r e u d w r o t e , " s e e m e d initially to be n o t h i n g m o r e t h a n a puzzling f e a t u r e of a c e r t a i n p r o c e s s . " E v e n this e a r l y application of t h e t e r m is s u s p e c t , t h o u g h , for t h i n g s like t h e e n d o p s y c h i c c o n f i g u r a t i o n s w h i c h a r e alleged t o b e u n c o n s c i o u s c a n n o t b e s h o w n t o e x i s t . If s o m e t h i n g does n o t e x i s t in t h e first place, it can be n e i t h e r c o n s c i o u s n o r u n c o n s c i o u s . If hard p r e s s e d , p e r h a p s I m i g h t call t h e clock on t h e wall b e h i n d me u n c o n s c i o u s , at least while I am w r i t i n g and n o t a w a r e of t h e c l o c k . D u r i n g this s a m e t i m e , m y r e l a t i o n s h i p t o m y friend H a n s m a y also be u n c o n s c i o u s in t h a t s e n s e . In b o t h i n s t a n c e s , h o w e v e r , it is n o t a c e r t a i n p s y c h i c p r o c e s s or an i n t r a p s y c h i c i m a g e w i t h i n a p s y c h e t h a t is u n c o n s c i o u s , b u t m e r e l y t h a t , for t h e m o m e n t , a t h i n g on t h e wall, and m y r e l a t i o n s h i p t o H a n s , a r e n o t t h e focus o f m y a t t e n t i o n . B o t h t i m e s , u n c o n s c i o u s i s s y n o n y m o u s w i t h t h e s t a t e m e n t : s o m e p h e n o m e n o n out t h e r e i n t h e open r e a l m o f m y w o r l d i s n o t for t h e t i m e being t h e m a t i c a l l y p r e s e n t for m e . T h i s i s n o t t h e s a m e a s saying t h a t t h e clock and H a n s h a v e disappeared from m y e x t e r n a l w o r l d . 1 9

In t h e s u b s e q u e n t d e v e l o p m e n t of his m e t a p s y c h o l o g y , Freud c o n t i n u e d to use " u n c o n s c i o u s " as a descriptive adjective, bul a l i o

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i n c r e a s i n g l y indulged in an e n t i r e l y novel u s a g e t h a t a m o u n t e d to a reification o f the original a t t r i b u t e . T h e s e n t e n c e f r o m F r e u d w e cited a b o v e was followed w i t h : " n o w , h o w e v e r , it [the u n c o n s c i o u s ] m e a n s more We apply t h e t e r m ' t h e u n c o n s c i o u s ' to a system w h o s e distinctive f e a t u r e is t h a t t h e individual p r o c e s s e s c o m p r i s i n g it a r e u n c o n s c i o u s . This is the most important sense that the expression 'unconscious' has acquired in p s y c h o a n a l y s i s . 20

T h a t i s h o w , i n F r e u d ' s m e t a p s y c h o l o g y , w h a t had b e e n r e p r e s e n t e d initially a s m e r e l y the p r o p e r t y o f a n e n d o p s y c h i c p r o c e s s g r e w t o b e c o m e a n e n t i t y o f its o w n and w a s accorded all m a n n e r o f p r o p e r t i e s and laws. N o w it w a s said, for i n s t a n c e , t h a t t h e u n c o n s c i o u s e x h i b i t e d a s o v e r e i g n disdain for t h e laws of logic. A s e c o n d c h a r a c t e r i s t i c F r e u d a s c r i b e d to this reified u n c o n s c i o u s was t h e peculiar w a y in w h i c h t h o u g h t p r o c e s s e s t o o k place in it. T h e s e p r i m a r y p r o c e s s e s , in contradistinction to the secondary processes of conscious thought, were m a r k e d b y t h e unparalleled fluidity o f its mobile psychic e n e r g y . T h i s fluidity p e r m i t t e d disparate ideas to c o a l e s c e to a u n i t y and e n a b l e d t h e f o r c e of m a n y ideas to be shifted, in t h e u n c o n s c i o u s , o n t o a single o n e . Moreoever, the unconscious, primary thought process showed no r e s p e c t for t i m e , replacing e x t e r n a l reality w i t h a psychic reality w i t h i n w h i c h psychic p r o c e s s e s w e r e s u b j e c t e x c l u s i v e l y t o t h e p l e a s u r e principle. In c o n t r a s t to a m e r e l y descriptive u s e of t h e w o r d " u n c o n s c i o u s , " Freud's reified psychic s y s t e m can be called a dynamic u n c o n s c i o u s . F r e u d a s s u m e d t h a t t h e psychic p r o c e s s e s and ideational c o n t e n t s o f the u n c o n s c i o u s had b e e n r e p r e s s e d t h e r e t h r o u g h t h e p o w e r o f a p s y c h i c c e n s o r and w e r e held t h e r e b y the s a m e psychic d y n a m i s m . 21

T h e s e c h a r a c t e r i s t i c s o f the d y n a m i c u n c o n s c i o u s look a s t h o u g h t h e y w e r e precise d e t e r m i n a t i o n s of a definable o b j e c t . P e r h a p s it was this t h a t allowed F r e u d , as well as m o s t p s y c h o l o g i s t s and p s y c h o p a t h o l o g i s t s a f t e r him to f o r g e t quickly t h a t the h y p o t h e s i z e d d y n a m i c u n c o n s c i o u s is e v e n f u r t h e r from a n a d e q u a t e u n d e r s t a n d i n g o f h u m a n b e i n g s t h a n t h e e a r l i e r descriptive n o t i o n o f c e r t a i n psychic p r o c e s s e s a s u n c o n s c i o u s . F r e u d s u b s e q u e n t l y c h a n g e d his opinion o n h o w psychic data b e c a m e u n c o n s c i o u s , p r e f e r r i n g m o r e and m o r e t h e idea o f libido w i t h d r a w a l t o t h a t of d e s c e n t i n t o a topically deeper psychic s y s t e m ; but e v e n in its n e w r o b e s , t h e h y p o t h e s i s of a psychological u n c o n s c i o u s r e m a i n s m i s l e a d i n g and d i s t o r t s the t r u e p i c t u r e o f h u m a n b e i n g . In a s h o r t t i m e , F r e u d had so c o m p l e t e l y f o r g o t t e n the purely h y p o t h e t i c a l n a t u r e o f t h e u n c o n s c i o u s t h a t h e boldly a t t e m p t e d t o p r o v e I he e x i s t e n c e of t h e s y s t e m he had i n v e n t e d . As a first step, he declared

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his h y p o t h e s i s of an u n c o n s c i o u s " l e g i t i m a t e , " b e c a u s e "in positing it, we do n o t v e e r a single step from t h e w a y of t h i n k i n g we c o n s i d e r c u s t o m a r y and c o r r e c t , " in so far as the a s s u m p t i o n of o t h e r people being e n d o w e d with consciousness is itself only inferred by a n a l o g y . Here we must agree with Freud. T h e legitimacy of the two assumptions is comparable; and his c o m p a r i s o n does u l t i m a t e l y raise t h e q u e s t i o n o f t h e e x t e n t t o w h i c h t h e a s s u m p t i o n of an i n d e p e n d e n t , s u b j e c t i v e c o n s c i o u s n e s s is itself justified. B u t F r e u d tells us t h a t to i n f e r t h e e x i s t e n c e of an u n c o n s c i o u s is n o t o n l y l e g i t i m a t e but actually n e c e s s a r y , t h e data o f c o n s c i o u s n e s s a l w a y s r e m a i n i n g f r a g m e n t a r y o t h e r w i s e . T a k e , for e x a m p l e , ideas w h o s e origins elude u s and c o n c l u s i o n s t h a t s e e m t o c o m e f r o m n o w h e r e . "All o f t h e s e p a r t i c u l a r o p e r a t i o n s r e m a i n i n c o m p r e h e n s i b l e and d i s c o n n e c t e d , " F r e u d g o e s on to say, "as long as we insist on a p p r o a c h i n g t h e m e x c l u s i v e l y t h r o u g h c o n s c i o u s n e s s , b u t t h e y a r r a n g e t h e m s e l v e s in a d e m o n s t r a b l e orderly c o n t e x t a s s o o n a s w e i n t e r p o l a t e t h e i n f e r r e d u n c o n s c i o u s o p e r a t i o n s . T h e a c c r u a l o f m e a n i n g and c o n t e x t i s a r e s u l t t h a t fully j u s t i f i e s o u r going b e y o n d i m m e d i a t e e x p e r i e n c e . " 22

2 3

We pointed out earlier that the series of observable conscious o p e r a t i o n s appears f r a g m e n t a r y o n l y if o n e p r e s u p p o s e s it m u s t be reducible, t h r o u g h u n i n t e r r u p t e d c a u s a l c h a i n s , t o s o m e hidden psychic c a u s e . T h e n o n e would h a v e t o h y p o t h e s i z e a n u n c o n s c i o u s t o supply t h e m i s s i n g links in the causal chain in t h e a b s e n c e of a c t u a l d e m o n s t r a t i o n s of their existence. So enslaved was Freud to the command of the natural scientific m e t h o d t h a t h e failed t o see t h e j a r r i n g c o n t r a d i c t i o n i n h e r e n t i n t h e r e a s o n i n g b e h i n d his h y p o t h e s i s o f a n u n c o n s c i o u s . A n y c o n t e x t m a d e up of i n f e r r e d and i n t e r p o l a t e d e n t i t i e s is n o t demonstrable, as F r e u d a r g u e s it is. F u r t h e r m o r e , F r e u d ignored t h e fact t h a t causal c o n n e c t i o n s — t h e o n l y kind h e tried w i t h his h y p o t h e s i z e d u n c o n s c i o u s to establish among conscious acts—can do no m o r e than demonstrate the r e g u l a r i t y of a purely t e m p o r a l , b u t in i t s e l f e n t i r e l y m e a n i n g l e s s , s u c c e s s i o n i n t h e m a n i f e s t a t i o n o f c e r t a i n p h e n o m e n a . I n s u m , from t h e standpoint of the phenomena of h u m a n existence, there is absolutely no n e c e s s i t y or m o t i v e for positing a psychic u n c o n s c i o u s . A s o n e p r o o f for t h e e x i s t e n c e o f a psychic u n c o n s c i o u s F r e u d cites t h e e v e r y d a y o b s e r v a t i o n t h a t an idea of w h i c h we a r e c o n s c i o u s in a given m o m e n t m a y n o l o n g e r b e c o n s c i o u s for u s i n t h e n e x t . H e a s k s , with e v i d e n t g o o d r e a s o n , w h e r e t h e idea m i g h t have c o m e from and w h e r e it could h a v e g o n e to. S i n c e i t could n o t simply h a v e g o n e o u t o f e x i s t e n c e (or it could n o t h a v e r e a p p e a r e d in t h e n e x t i n s t a n t ) , it m u s t in the m e a n t i m e h a v e b e e n l a t e n t , u n c o n s c i o u s . F r e u d a r g u e s similarly t o 2 4

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explain t h e e x p e r i e n c e o f s u b j e c t s c a r r y i n g o u t p o s t h y p n o t i c s u g g e s ­ t i o n s . B u t h e s e e s i n e v e r y d a y slips t h e m o s t c o n v i n c i n g e v i d e n c e for a n unconscious. N o t o n e o f t h e s e p r o o f s stands u p u n d e r s c r u t i n y . First o f all, t h e e v e r y d a y o b s e r v a t i o n t h a t a c o n s c i o u s idea can s u d d e n l y be n o t c o n s c i o u s is far from b e i n g an empirical, d e m o n s t r a b l e pure fact. F r e u d ' s description is already an i n t e r p r e t a t i o n of h u m a n b e h a v i o r and i n a d e q u a t e at t h a t . If, at this v e r y m o m e n t , I c o n s c i o u s l y visualize t h e F r e i b u r g C a t h e d r a l , w h a t h a p p e n s , as we h a v e t a k e n pains to point o u t , is not the activation of an intrapsychic representation but that the c a t h e d r a l i t s e l f appears t h e m a t i c a l l y i n t h e p e r c e p t i v e r e a l m o f m y b e i n g in-the-world. T h e r e is no evidence of the endopsychic representation of t h e c a t h e d r a l , as F r e u d posited. It is only b e c a u s e , for t h e d u r a t i o n of t h e visualization, I e n t e r ino an open, l u m i n a t i n g r e l a t e d n e s s to t h e c a t h e d r a l and am, w i t h all t h a t I a m , by t h e c a t h e d r a l , its actual place, t h a t I can in t h e n e x t i n s t a n t cut off m y specific r e s p o n s e t o t h e c a t h e d r a l , l e t t i n g its presence retreat into the nonthematic background of the worldo p e n n e s s as w h i c h I am e x i s t i n g and l e t t i n g a n o t h e r thing, or p e r s o n , come forward into the center of my perceptive realm. J u s t as ill suited as p r o o f s for t h e e x i s t e n c e of a p s y c h i c u n c o n s c i o u s a r e t h e h y p n o s i s e x p e r i m e n t s o f B e r n h e i m , t h e first t o h a v e people p e r f o r m a c t i o n s h e had s u g g e s t e d t o t h e m e a r l i e r u n d e r h y p n o s i s . T h e s t a t e o f h y p n o s i s m a y b e defined a s o n e i n w h i c h t h e h y p n o t i z e d h a s c o m e a l m o s t totally u n d e r t h e spell o f the h y p n o t i s t . O w i n g t o people's f u n d a m e n t a l being t o g e t h e r in a s h a r e d w o r l d , it is possible for t h e h y p n o t i z e d p e r s o n to r e n o u n c e his i n d e p e n d e n t s e l f n e s s to s u c h a d e g r e e t h a t h e n c e f o r t h he can e x i s t o n l y t h r o u g h t h e h y p n o t i s t , dwelling a s o n e w i t h him i n t h e i r s h a r e d world. T h i s e n a b l e s t h e h y p n o t i s t t o a r b i t r a r i l y c o m m a n d o b j e c t s to b e c o m e t h e focal point of his s u b j e c t ' s field of vision and to s h a p e t h e s u b j e c t ' s r e l a t i o n s h i p y t o t h e s e o b j e c t s . T h e h y p n o t i s t can, for i n s t a n c e , o r d e r his s u b j e c t to e s t a b l i s h a r e l a t i o n s h i p to a chair so t h a t , fifteen m i n u t e s a f t e r t h e t r a n c e h a s b e e n b r o k e n , t h e c h a i r will address him a s s o m e t h i n g t o b e set o n t h e table. B e c a u s e t h e h y p n o t i z e d s u b j e c t h a s s u r r e n d e r e d his i n d e p e n d e n t s e l f n e s s , it is e a s y for the h y p n o t i s t to p r e v e n t him f r o m r e c o g n i z i n g t h e origin o f his p o s t h y p n o t i c r e l a t i o n s h i p t o t h e chair. All o f this m e r e l y s h o w s t h a t t h e s u b j e c t , a f t e r e m e r g i n g from h y p n o s i s , h a s n o t y e t r e e s t a b l i s h e d h i m s e l f as an i n d e p e n d e n t self. T h u s the p e r s o n w h o had b e e n h y p n o t i z e d will e x p r e s s i n t h e first p e r s o n wh.it is actually t h e h y p n o t i s t ' s act of v o l i t i o n : "I will n o w place t h e c h a i r on the table." In a similar w a y , m a n y people a r e h y p n o t i z e d by tradition en l>v I l i e a n o n y m o u s " t h e y " of t h e i r c u l t u r e , n o t realizing t h a t t h e i r t h o u g h t s and a c t i o n s a r e fulfilling n o t t h e i r o w n e x i s t e n t i a l p o t e n t i a l i t i e s

Basic Concepts of Biology, Physiology, and Psychology but t h e w i s h e s and t h o u g h t s o f t h e i r f o r e b e a r s o r o f popular opinion N e v e r t h e l e s s , t h e y t o o say, " I t h i n k this i s r i g h t o r w r o n g , " " ! intend t o d o this or t h a t . " In s h o r t , we do n o t n e e d a F r e u d i a n u n c o n s c i o u s to explain p o s t h y p n o t i c b e h a v i o r a n y m o r e t h a n w e n e e d i t t o u n d e r s t a n d the b e h a v i o r o f s o m e o n e m e s m e r i z e d b y tradition o r popular s a n c t i o n . F r e u d ' s third c a t e g o r y of e v i d e n c e for t h e e x i s t e n c e of a psychic u n c o n s c i o u s , slips, i s likewise u n c o n v i n c i n g . T o affirm t h e e x i s t e n c e o f t h e u n c o n s c i o u s h e m e n t i o n s t h e case o f the c h a i r m a n w h o s e opening r e m a r k s ended: " I declare this m e e t i n g a d j o u r n e d . " O n t h e basis o f this, F r e u d deduced t h e e x i s t e n c e in t h e u n c o n s c i o u s of a c o u n t e r f o r c e lurking u n s e e n for j u s t such a c h a n c e to b r e a k t h r o u g h and disrupt c o n s c i o u s ­ n e s s . W a s n ' t it a fact, w h i c h t h e c h a i r m a n would c o n f i r m , t h a t he c o n s c i o u s l y w a n t e d o n l y t o o p e n t h e m e e t i n g , n o t t o adjourn it? N e v e r t h e l e s s , t o deal w i t h t h e p h e n o m e n o n o f his e r r o r i n speaking, w e d o n o t n e e d the u n p r o v a b l e , u n s c i e n t i f i c h y p o t h e s i s o f a n u n c o n s c i o u s . W e n e e d o n l y the i n s i g h t t h a t t h e c h a i r m a n e x i s t s , a s b e i n g - i n - t h e - w o r l d , and as s u c h c o n s i s t s in t h e t o t a l i t y of his p o t e n t i a l for r e l a t e d n e s s to w h a t he e n c o u n t e r s in his w o r l d . In his e r r o r , t h e c h a i r m a n w a s acting from a v e r y specific r e l a t i o n s h i p w i t h his fellow club m e m b e r s . H e w a s d o u b t l e s s e n g a g e d in a n e g a t i v e r e l a t i o n s h i p to t h e a s s e m b l y , and being w i t h t h e s e people for t h e m e e t i n g w a s a n y t h i n g b u t a p u r e p l e a s u r e h e w o u l d h a v e w i s h e d t o p r o l o n g . I t m a t t e r s little w h e t h e r o r n o t h e was t h e m a t i c a l l y a w a r e o f this p o o r r e l a t i o n s h i p a t t h e i n s t a n t h e m a d e his slip. Slips of t h e t o n g u e can h a p p e n in a n y n u m b e r of w a y s , b u t in no case a r e t h e y c a u s e d by an i n s t i n c t i v e desire p r e s e n t w i t h i n a capsulelike p s y c h e . T h e y are c o n s i s t e n t l y a c t u a l i z a t i o n s , r a t h e r , o f a r e l a t i o n s h i p b e t w e e n people, w h i c h a r e n o t to be found w i t h i n a p s y c h e b u t are m o d e s o f t h e h u m a n b e i n g - i n - t h e - w o r l d t h a t p e r v a d e s t h e o p e n r e a l m o f the w o r l d c o m m o n t o all people. E v e n F r e u d s e e m s t o h a v e b e c o m e a w a r e o f this c i r c u m s t a n c e , for he did r e a c h the c o n c l u s i o n t h a t clues to u n d e r s t a n d i n g slips m u s t be t a k e n f r o m t h e situation of t h e p e r s o n w h o m a k e s t h e slips. A s i t u a t i o n is a l w a y s m a d e up of a total e n v i r o n m e n t . 25

L a s t b u t n o t least, F r e u d w o u l d i n t r o d u c e d r e a m s a s e v i d e n c e o f the psychic u n c o n s c i o u s . B u t t h e d r e a m i n g Da-sein of a p e r s o n yields to an i n v e s t i g a t o r t h e n o t i o n of an u n c o n s c i o u s only if he is d e t e r m i n e d at all c o s t s t o p r o c e e d i n t h e m a n n e r o f n a t u r a l s c i e n c e , e m p l o y i n g purely h y p o t h e t i c a l c o n c l u s i o n s in o r d e r to t r a c e t h e d r e a m back to a universally valid c a u s e t h a t does n o t really e x i s t at all. T h e p a r t i c u l a r h y p o t h e t i c a l c a u s e F r e u d s t e e r e d t o w a r d i n his d r e a m t h e o r y can be found on page 4 4 2 of The Interpretation of Dreams: " F r o m the t h e o r y o f h y s t e r i a w e b o r r o w t h e principle t h a t a n o r m a l train o f t h o u g h l is s u b j e c t e d to a b n o r m a l psychic e l a b o r a t i o n only w h e n it has b e c o m e the

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m e d i u m for a n u n c o n s c i o u s desire t h a t h a s b e e n r e p r e s s e d b e c a u s e o f its infantile n a t u r e . It is in accordance with this principle t h a t we h a v e c o n s t r u c t e d o u r t h e o r y o f t h e d r e a m o n t h e assumption t h a t t h e impelling desire c o n s i s t e n t l y arises i n t h e u n c o n s c i o u s , s o m e t h i n g t h a t , admittedly, c a n n o t b e g e n e r a l l y p r o v e n , n o t dismissed o u t o f h a n d . " T h e r e i s n o m o r e i m p r e s s i v e p r o o f t h a n this t h a t Freud's e n t i r e d r e a m t h e o r y , w i t h its i n t e n s i v e u s e o f t h e p s y c h i c u n c o n s c i o u s , w a s c r e a t e d n o t for t h e sake of t h e u n m a n i p u l a t e d d r e a m p h e n o m e n a t h e m s e l v e s b u t solely to suit a p r e c o n c e i v e d principle. 26

Freud saw undisguised wish-fulfillment dreams as the one proof that infantile d e s i r e s e x i s t e d in t h e u n c o n s c i o u s and w e r e t h e u n i v e r s a l l y valid c a u s e of all m a n i f e s t d r e a m i m a g e s . He illustrated his point w i t h r e p o r t s o f children w h o , h a v i n g g o n e t o bed h u n g r y , would t h e n d r e a m o f o r g i e s of eating. Conceding that these dreams are not very interesting in t h e m s e l v e s , F r e u d added t h a t " t h e y are obviously of i n e s t i m a b l e value as proofs that dreams are, in essence, wish-fulfillments." This conclusion is no m o r e c o n v i n c i n g t h a n it would be to claim t h a t b e c a u s e t h e r e are s u c h t h i n g s as w h i t e r o s e s , all r o s e s of o t h e r c o l o r s m u s t be, in t h e i r t r u e e s s e n c e , w h i t e r o s e s , in disguise. 27

S u m m i n g u p w h a t w e h a v e said, n o t o n e o f t h e p h e n o m e n a o r a r g u m e n t s F r e u d i n t r o d u c e s to justify his a s s u m p t i o n of a p s y c h i c u n c o n s c i o u s actually does w h a t it is supposed to do. All we h a v e said to c o u n t e r Freud's h y p o t h e s i s of an individual u n c o n s c i o u s applies in kind to t h e collective u n c o n s c i o u s posited in C a r l J u n g ' s a n a l y t i c p s y c h o l o g y as an a t t e m p t to c o m p l e t e and underpin Freudian t h e o r y . T h e collective u n c o n s c i o u s d e r i v e s from t h e v e r y s a m e subjectivistic understanding of man, the very same psychologistic way of t h i n k i n g . T o g e t h e r w i t h all t h e a r c h e t y p a l i m a g e s , s t r u c t u r e s , and f o r c e s t h a t i n h a b i t it, t h e collective u n c o n s c i o u s is n o t h i n g m o r e than an a t t e m p t t o explain t h a t m a n y p h e n o m e n a reveal t h e m s e l v e s i n t h e s a m e w a y to people w h o a r e widely s e p a r a t e d in space and t i m e . T h i s fact is i n c o n t e s t a b l e , b u t J u n g ' s interpretation of it r e s t s on t w o faulty a s s u m p t i o n s . T h e first i s t h a t h u m a n b e i n g s c o n s i s t , aside from t h e i r bodies, of an i n d e p e n d e n t , stratified p s y c h e . S e c o n d , t h e v e r y n o t i o n of a collective u n c o n s c i o u s is an i n s t a n c e of r e d u c t i o n i s m , w h e r e b y a given diversity of p h e n o m e n a is s u b j e c t e d to a logical g e n e r a l i z a t i o n . H e r e , p h e n o m e n a t h a t a r e m e r e l y similar in v a r i o u s t i m e s and places lead to t h e c o n c l u s i o n t h a t t h e r e i s s o m e s t r u c t u r e e x i s t i n g identically within t h e brains, or p s y c h e s , of all h u m a n b e i n g s . B u t it is m u c h m o r e likely t h a t t h e y reveal t h e m s e l v e s , by t h e i r v e r y n a t u r e s , in m u c h t h e s a m e w a y w i t h i n t h e open realm o f h u m a n p e r c e p t i o n , b e c a u s e they t h e m s e l v e s s h i n e fori h in the s a m e w a y e v e r y w h e r e and at all t i m e s . T h e r e is n o need

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to s u p p o s e t h a t a collective u n c o n s c i o u s or o t h e r e n d o p s y c h i c e n t i t y e x i s t s t o give t h e s e p h e n o m e n a similar shapes a f t e r t h e fact. All n o t i o n s of a p s y c h i c u n c o n s c i o u s t h a t h a v e b e c o m e r o o t e d in m o d e r n p s y c h o l o g y t u r n o u t t o b e artificial p r o d u c t s o f t h e o r y , false footholds m a d e to a d v a n c e a p r e c o n c e i v e d and i n a d e q u a t e approach to h u m a n being. T h e y have n o t h i n g t o d o w i t h t h e actual p h e n o m e n a o f h u m a n Da-sein and as a r e s u l t actually o b s t r u c t a d e q u a t e i n s i g h t into t h e n a t u r e o f people. It is t h e r e f o r e high t i m e t h a t t h e p h r a s e psychic u n c o n s c i o u s w a s e x p u n g e d from t h e v o c a b u l a r y o f p s y c h o l o g y and p s y c h o p a t h o l o g y . T h i s c a n n o t be a c h i e v e d m e r e l y by pointing o u t the artificiality, superficiality, and h a r m f u l n e s s of this h y p o t h e s i z i n g . T h e idea of a psychic u n c o n s c i o u s would n e v e r h a v e b e e n able to e f f e c t a global t r a n s f o r m a t i o n of the s c i e n c e s of h u m a n n a t u r e had it n o t at least v a g u e l y indicated t h e d i m e n s i o n t h a t e n c o m p a s s e s m a n , his w o r l d , and t h e r e l a t i o n s h i p between them. N o t e v e n t h e g r e a t p h i l o s o p h e r s i n t h e W e s t e r n m e t a p h y s i c a l tradition h a v e b e e n able to m a p o u t a s o l u t i o n to this p r o b l e m . P h y s i c i s t s first realized t h a t no radical s e p a r a t i o n can be m a d e b e t w e e n perceived p h e n o m e n a and the people w h o p e r c e i v e t h e m , t h a t i n fact t h e o b s e r v e r and o b s e r v e d belong t o g e t h e r in a m y s t e r i o u s , o b s c u r e r e a l m . T h e positivistic, s u b j e c t i v i s t i c , o b j e c t i f y i n g a p p r o a c h e s o f c o n t e m p o r a r y p s y c h o l o g i s t s and p s y c h o p a t h o l o g i s t s limp decades b e h i n d this insight. W h i l e believing t h e m s e l v e s t o b e p r o g r e s s i v e s c i e n t i s t s , t h e y are actually still e n g a g e d , as t h e t h e o r e t i c a l physicist W. H e i t l e r c o r r e c t l y r e m i n d s us, in i m i t a t i n g a d v a n c e s m a d e in physics in t h e nineteenth c e n t u r y . B u t e v e n t w e n t i e t h - c e n t u r y physicists have b e e n w o r k i n g s o far without the advantage of a new ontological orientation appropriate to their findings. F r o m t h e i r o w n c o n c e p t u a l s t a n d p o i n t , i t h a s t h e r e f o r e been impossible t o grasp t h e e s s e n t i a l c o h e r e n c e o f p e r c e i v e r and perceived. O n l y by inquiring into being itself, as M a r t i n H e i d e g g e r h a s been doing n o w for t h e space of a h u m a n lifetime, can we b e g i n e v e n to g r o p e t o w a r d t h e h e a r t of t h e m a t t e r . We m a k e a b e g i n n i n g in this f o u n d a t i o n of medicine in t u r n i n g o u r regard a w a y from t h e i n a d e q u a t e n o t i o n of a psychic u n c o n s c i o u s and t o w a r d w h a t physicians really o u g h t to keep in v i e w and c o n s i d e r . S e v e r a l t i m e s already, m e d i c i n e ' s o b j e c t o f study h a s b r o u g h t u s v e r y close to t h e m a t t e r at h a n d . In discussing g e n u i n e f o r g e t t i n g , for e x a m p l e , w e spoke o f p h e n o m e n a t h a t had o n c e b e e n t h e m a t i c a l l y p r e s e n t dropping out of t h e o p e n realm of an individual h u m a n Da-sein or b e i n g - t h e - t h e r e , e m p h a s i z i n g t h a t this is n o t j u s t a m a t t e r of e n d o p s y c h i c r e p r e s e n t a t i o n s o f e x t e r n a l - w o r l d o b j e c t s disappearing into

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a different r e g i o n of an e n c a p s u l a t e d p s y c h e . In f o r g e t t i n g , t h e o b j e c t s of the world t h e m s e l v e s e s c a p e from t h e o p e n realm of a h u m a n e x i s t e n c e . W h a t is m o r e — a n d we will c o m e back to this l a t e r — a t any o n e time in h i s t o r y t h e r e are c e r t a i n p h e n o m e n a t h a t are invisible to all of m a n k i n d . T h e p r e s e n t age, for i n s t a n c e , is often described as t h a t age in w h i c h divinity h a s w i t h d r a w n from t h e o p e n realm o f h u m a n e x i s t e n c e and t h e r e f o r e can no l o n g e r be h e a r d by m a n . W e also t o u c h e d o n t h e p r o p e r d i m e n s i o n o f t h e p r o b l e m i n o u r a t t e m p t t o define t h e f u n d a m e n t a l trait o f h u m a n Da-sein. T h e h u m a n being e x i s t s as a s p a n n i n g , b e a r i n g , and holding open of a realm of perception t h a t i s r e s p o n s i v e t o t h e p r e s e n c e o f w h a t e v e r p h e n o m e n a r e v e a l t h e m s e l v e s in it. T h e condition of such e x i s t e n c e is an open, free, clear realm in w h i c h t h e h u m a n Da-sein can dwell, spanning and m a i n t a i n i n g it in its o w n w a y . S u c h a realm is possible only t h e r e , w h e r e it is released from h i d d e n n e s s and d a r k n e s s . N e i t h e r t h e clearing n o r the h i d d e n n e s s o r i g i n a t e s in c o n c r e t e t h i n g s , h u m a n b e i n g s , or in t h e p s y c h e . R a t h e r , this h i d d e n n e s s is the m y s t e r i o u s s o u r c e from w h i c h all t h a t is c o m e s f o r t h to be. It is t h u s p r e t e m p o r a l , prespatial, and p r e h u m a n . A n d as it is also p r e l i n g u i s t i c , the w o r d itself t h a t d e s i g n a t e s this primal p h e n o m e n o n r e p r e s e n t s only a m a k e s h i f t s o l u t i o n f r a u g h t w i t h the d a n g e r o f being misleading. T h e w o r d " h i d d e n n e s s " m i g h t lead u s t o believe t h a t this primal p h e n o m e n o n m u s t b e u n d e r s t o o d o n t h e basis o f w h a t already is. In colloquial u s a g e , " h i d d e n " r e f e r s to s o m e t h i n g t h a t is already t h e r e w h i c h has m e r e l y b e e n c o v e r e d and s o w i t h d r a w n , t e m p o r a r i l y , f r o m view. F o r i n s t a n c e , a m o n u m e n t m a y be hidden by draperies until t h e m o m e n t o f its dedication, and t h o u g h w e c a n n o t see t h e m o n u m e n t until t h e c l o t h is r e m o v e d , we a g r e e t h a t it w a s always t h e r e u n d e r n e a t h in its final form and d i m e n s i o n s . B u t in t h e g r e a t h i d d e n n e s s t h e r e is no already e x i s t i n g p a r t i c u l a r being. T h i s d i m e n s i o n has b e e n c o n s i d e r e d for ages b y n o n w e s t e r n t h i n k e r s as well. T h e y h a v e a l w a y s circled a r o u n d it in t h e w a y of " n e t - n e t , " saying "it is n o t t h i s , n o t t h a t , n o t , not ." It is described t h e n as t h a t w h i c h is totally o t h e r . R e m a i n i n g mindful o f t h e ineffability o f this d i m e n s i o n , w e m a y i n t h e f r a m e w o r k of a f u n d a m e n t a l study of m e d i c i n e call it h i d d e n n e s s . If W e s t e r n t h i n k i n g s o m e d a y i l l u m i n a t e s this h i d d e n n e s s , it will be s e e n as the origin and s o u r c e of all t h o s e p h e n o m e n a w h i c h p s y c h o l o g y and p s y c h o p a t h o l o g y h a v e tried in vain to clarify t h r o u g h s u b j e c t i v i s t i c , objectifying, reifying t h i n k i n g w h i c h o p e r a t e s w i t h c o n s t r u c t s like psy( hie u n c o n s c i o u s . Admittedly, it is no e a s y m a t t e r to c a t c h sight of and t h i n k this hhl.lrmi.".-. which releases all t h a t is out o f itself. M a n y would try t o

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dismiss an i n t e r p r e t a t i o n like o u r s as g r o u n d l e s s m y s t i c i s m or p e r n i c i o u s i r r a t i o n a l i t y , n e g l e c t i n g to c o n s i d e r t h a t t h e i r e s t e e m e d ratio- i t s e l f can be p r o p e r l y s e e n o n l y in r e l a t i o n to h i d d e n n e s s and t h e o p e n r e a l m released f r o m h i d d e n n e s s . As long as r e a s o n and t h e r a t i o n a l a r e left as v a g u e as t h e y a r e n o w , t h e a c c u s a t i o n o f i r r a t i o n a l i t y aimed a t t h e p h e n o m e n o l o g ical a p p r o a c h will r e m a i n h o l l o w . Indeed, if a n y t h i n g d e s e r v e s to be called i r r a t i o n a l , it is t h e m i n d l e s s r a m p a g e of r a t i o n a l i t y in t h e d e v e l o p m e n t of t e c h n o l o g y t h a t i s d o m i n a t i n g t h e industrialized w o r l d . 2 8

From drive to the human potential for relating specifically to the world around T h e p s y c h i c u n c o n s c i o u s is s o m e t i m e s depicted as a r e s e r v o i r of drives, w h i c h p s y c h o a n a l y t i c t h e o r y holds t o b e t h e u l t i m a t e reality o f psychic p h e n o m e n a , t h e k e r n e l from w h i c h all o t h e r psychic m a n i f e s t a t i o n s spring a s p r o d u c t s o f s u b l i m a t i o n o r a s r e a c t i o n f o r m a t i o n s . T h i s c o n c e p t is prominent in most other contemporary branches of psychology, too, t h o u g h m o s t n o n p s y c h o a n a l y t i c t h e o r i e s d o n o t follow F r e u d i n m a k i n g drives an a b s o l u t e . A n y s t u d y o f t h e e x t e n s i v e l i t e r a t u r e o n drives s h o w s t h a t while i t h a s g r e a t i m p o r t a n c e for p s y c h o l o g i s t s and p s y c h o p a t h o l o g i s t s t h e r e is only v e r y s c a n t y i n f o r m a t i o n a b o u t w h a t drive i s supposed t o b e . F r e u d called drives " m y t h i c a l c r e a t u r e s o f u n k n o w n o r i g i n " and did n o t h e s i t a t e t o d e s c r i b e his t h e o r y o f drives a s t h e m y t h o l o g y o f p s y c h o a n a l y t i c t h e o r y . B u t if it is s u r p r i s i n g t h a t a m o d e r n t h e o r y i n t e n t on p r e s e n t i n g i t s e l f as e x a c t i n g l y scientific is, by its o w n a d m i s s i o n , satisfied w i t h a m y t h o l o g i ­ cal basis, m o r e striking i s t h e v e r y r e c e n t v i n t a g e o f t h e c o n c e p t . Trieb ("drive") a r o s e , in fact, m e r e l y as the s u b s t a n t i v e f o r m of the v e r b triel ten, m e a n i n g "drive" or "drift," and r e f e r r i n g principally to c a t t l e , g a m e , o r o c e a n c u r r e n t s . O n l y i n t h e s e v e n t e e n t h c e n t u r y w e r e drives s p o k e n o f c o n c e r n i n g people. T h e w o r d still did n o t m e a n " i n n e r c o m p u l s i o n , " but r e f e r r e d to t h e " s t i m u l u s " or "appeal" e x e r t e d on a person b y s o m e t h i n g o r s o m e o n e from o u t s i d e h i m s e l f . T h e d i c t i o n a r y o f the B r o t h e r s G r i m m c o n f i r m s this by including a v e r s e of Agrippina, dating from 1 6 8 5 : " a d u l t e r y r o b s n e c k , b r e a s t s , and belly o f all t h e i r drive (appeal)." N o t until t h e e i g h t e e n t h c e n t u r y did p s y c h o l o g y begin to describe Triebe as drives and " p r i m i t i v e , n a t u r a l s t i r r i n g s . " S o o n afte r w a r d s Triebe found its fullest and m o s t c h a r a c t e r i s t i c d e v e l o p m e n t in m e c h a n i c s . M a n y t e c h n i c a l t e r m s a r o s e i n c o m b i n a t i o n w i t h it, a m o n g them Triebrad ("drive-wheel"), Tnebfeder ("mainspring"), Triebstoff ("fuel"). 1 low could t h e m e a n i n g of Trieb h a v e evolved in any o t h e r w a y ? I ) e s c a r t e s ' s philosophical division of the world into s u b j e c t and object and his d i s c o v e r y t h e r e b y of t h e basis for t e c h n o l o g i c a l m a s t e r y o v e r the

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e x t e r n a l w o r l d o p e n e d t h e w a y for m o d e r n p s y c h o l o g y t o develop its c o n c e p t s of Trieb or drives. B u t b e f o r e p s y c h o l o g y could a r r i v e at its p r e s e n t n o t i o n o f drives, i t had t o p e r f o r m m a n y c o m p l e x a b s t r a c t i o n s and f o r c e d r e i f i c a t i o n s . N o w t h e r e is, a m o n g all t h e varied p o t e n t i a l i t i e s o f relating t o w h a t i s perceived, o n e p a r t i c u l a r m o d e t h a t c a n b e c a t e g o r i z e d a s a n i n v o l u n t a r y s u b m i s s i o n to, and a b s o r p t i o n i n t o , this or t h a t t h i n g or being. Its b o d y i n g f o r t h can h a p p e n i n t h e f o r m o f so-called s e x u a l s e n s a t i o n s , and it m a y v e r y well h a p p e n as an e r o t i c a t t r a c t i o n of o v e r w h e l m i n g p o w e r . W h e n it is bodied f o r t h in t h e r e a l m of h u m a n r e l a t i o n s h i p it can lead to a n o r g a s m i c bodily m e r g i n g o f o n e w i t h t h e o t h e r . F r o m t h e m a n i f o l d c o m p l e x i t y o f p o t e n t i a l h u m a n w a y s o f being, a psychological t h e o r y b e n t o n arriving a t t h e p r e s e n t c o n c e p t o f d r i v e s isolated this o n e m o d e and declared it to be t h e only psychic reality. In t h e process, it was necessary to conceptualize the observed phenomenon as the effect o f a n i n t e r n a l m o t i v e force and t o r e d u c e h u m a n b e i n g s t o t h i n g s r e s e m b l i n g billiard balls. O n l y t h e n could h u m a n n a t u r e b e r e p r e s e n t e d , in a n a l o g y to an e n g i n e , as a t h i n g driven, or m o v e d , f r o m inside o r f r o m b e h i n d . I t i s n o t difficult t o s e e h o w m u c h c l o s e r t o reality t h e original m e a n i n g of Trieb w a s w h e n t h e w o r d still r e f e r r e d to t h e appeal of a w o m a n to a m a n . T h e n t h e r e w e r e no drives w i t h i n i m a g i n e d e n d o p s y c h i c c o n t a i n e r s t o impel a m a n t o w a r d a n appealing w o m a n . O n t h e c o n t r a r y , i t w a s from t h e w o m a n t h a t t h e appeal c a m e t o d r a w t h e m a n to h e r . T h e w h o l e p r o c e s s w a s v i e w e d as w h a t it is, as an e v e n t in t h e open realm o f a n " e x t e r n a l , " h u m a n r e l a t e d n e s s .

From psychic agencies to an existential understanding of human ways of behaving lnstanz, " a g e n c y , " o r i g i n a t e d in G e r m a n as a judicial c o n c e p t r e f e r r i n g t o a body a u t h o r i z e d t o pass j u d g m e n t , especially a c o u r t o f law. T h e t e r m r e f e r s to an e n t i r e t y but w h e n it w a s adopted by p s y c h o l o g y , it w a s u s e d t o d e s i g n a t e t h r e e different a g e n t s i n e a c h p e r s o n ' s p s y c h e — e g o , s u p e r e g o , and id. T h i s i n n o v a t i o n tripled t h e i n s u r m o u n t a b l e difficulties t h a t had b e e n plaguing p s y c h o l o g y e v e n w i t h only a single s u b j e c t , or psyche, b u t did yield o n e a d v a n t a g e , t h e o n e of w h i c h Freud had b o a s t e d in r e f e r e n c e to his e a r l i e r n o t i o n s of c o n s c i o u s n e s s , p r e c o n s c i o u s n e s s , and the u n c o n s c i o u s . W i t h such n o t i o n s , h e said, o n e could " o p e r a t e comfortably." But the t h r e e psychic a g e n c i e s can b e h a n d y t h e o r e t i c a l p l a y t h i n g s o n l y a s long a s their n a t u r e s are allowed t o r e m a i n u n e x a c t . T h e scientific d i l l n ulties thai g o with t h e m b e c o m e c l e a r e r w h e n w e n o t e t h a t t h e i r definitions are n u m e r o u s , diverse, and m u t u a l l y c o n t r a d i c t o r y . Freud

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defined t h e e g o - a g e n c y as, a m o n g o t h e r t h i n g s , " a c o h e s i v e , i n t e r n a l o r g a n i z a t i o n o f psychic p r o c e s s e s a t t a c h e d t o c o n s c i o u s n e s s , w h i c h c o n t r o l s t h e flow o f e x c i t a t i o n s i n t o t h e e x t e r n a l w o r l d b y m e a n s o f m o t i v i t y . " C e r t a i n w r i t e r s o u t s i d e the p s y c h o a n a l y t i c fold c h a r a c t e r i z e t h e e g o a s "an i n s u b s t a n t i a l c l u s t e r o f p e r c e p t i o n s , ideas, and psychic e x p e r i e n c e s . " Y e t o n e can also h e a r t h a t the e g o is a m e n t a l , or t h i n k i n g , s u b s t a n c e , a c o n n e c t i v e c e n t e r , o r c e n t e r o f i n t e n t i o n a l action. T h e n again, t h e e g o can be supposed to be t h e e s s e n t i a l aspect of a h u m a n being, the part t h a t e x p e r i e n c e s i t s e l f as a s u b j e c t , in opposition to the realm o f o b j e c t s , o r a s t h e s e a t o f r e l a t i o n s h i p t o t h e " t h o u . " A n o t h e r psychological school e l e v a t e s t h e e g o to t h e r a n k of a poniifex oppositorum; h e r e t h e e g o - a g e n t would f u n c t i o n a s a bridge, o r m e d i u m , b e t w e e n G o d and p o w e r l e s s m a n , b e t w e e n w a k i n g and d r e a m i n g , mind and n a t u r e , s u b j e c t and o b j e c t , t h e m u n d a n e and t h e t r a n s c e n d e n t . T h e e g o - a g e n c y can do all this, it is claimed, b e c a u s e it is descended from an i n h e r e n t u r g e t o p a r t i c i p a t e and s o i s able t o t r a n s c e n d its o w n b o r d e r s . W e could easily give m o r e e x a m p l e s o f c u r r e n t d e f i n i t i o n s , b u t t o d o s o w o u l d b e u s e l e s s and u n n e c e s s a r y . T h e y all s u f f e r from t h e s a m e flaw. N o t o n e definition says e n o u g h a b o u t the t r u e n a t u r e o f t h e e g o e v e n t o explain h o w this e g o m a k e s it possible to p e r c e i v e w h a t we e n c o u n t e r in o u r w o r l d . No m a t t e r h o w this psychic ^ g o - a g e n c y is m a d e up, it still posits people as e x i s t i n g i n d e p e n d e n t l y in s o m e space. T h e m y s t e r y still r e m a i n s — t o r e i t e r a t e this a l l - i m p o r t a n t f a c t — o f h o w s u c h a p s y c h i c c o n f i g u r a t i o n could e v e r begin to s u s p e c t t h a t an outside w o r l d is t h e r e , m u c h less m o v e o u t o f i t s e l f i n t o t h a t e x t e r n a l w o r l d . T h e v a g u e n e s s o f t h e s e r e p r e s e n t a t i o n s o f t h e e g o - a g e n c y did n o t s t a y hidden from critical psychologists. Jung, for instance, confessed that the foundation of the e g o - a g e n c y , t h e self, w a s s t e e p e d i n m e t a p h y s i c a l o b s c u r i t y . T h e p r o b l e m i s t h a t for t h e last s e v e n t y y e a r s c r i t i c s h a v e b e e n c o n t e n t t o stop a t s u c h n e g a t i v e o b j e c t i o n s and c o n t i n u e d t h i n k i n g i n t e r m s o f physically p r e s e n t psychic e n t i t i e s . T h e a n c i e n t W e s t e r n w o r l d did n o t k n o w t h e c o n c e p t " e g o . " M a n y have tried to g e t a r o u n d this by claiming t h a t t h e a n c i e n t G r e e k s w e r e not as a s t u t e c o n c e r n i n g p s y c h o l o g y , n o t a s a d v a n c e d a s w e a r e today. But t o t h e less a r r o g a n t , this i n d i c a t e s t h e possibility t h a t h u m a n n a t u r e might be better understood without hypothesized endopsychic agencies. T o this day, n o o n e — t h a t is, n o o n e w h o has n o t b e e n c o n t a m i n a t e d b y p s y c h o l o g i c a l t h i n k i n g — w o u l d n o r m a l l y d e s c r i b e his e g o a s doing this 0 1 t h a t . He w o u l d say " I , " r e f e r r i n g to h i m s e l f as t h a t c r e a t u r e w h o , at a g i v e n m o m e n t , i s e n g a g e d i n s o m e s o r t o f p e r c e p t i v e , o r active, r e l a t i o n s h i p to s o m e t h i n g he e n c o u n t e r s in his w o r l d . W h e n this pet son s a y s " I , " h e m e a n s t h e v a r i o u s p o t e n t i a l w a y s o f r e l a t i n g and b e h a v i n g o l

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w h i c h h e i s a t t h a t m o m e n t t h e m a t i c a l l y a w a r e and h a s m a d e his o w n , s o b e c o m i n g a self. It is this s e l f t h a t e n d u r e s t h r o u g h t h e life h i s t o r y of a Dasein and w h i c h is a d d r e s s e d w h e n e v e r t h e Da-sein says " I " . Its c o n s t a n c y is s u c h t h a t t h e Da-sein can at all t i m e s r e t u r n to itself and find its i d e n t i t y in its dwelling by t h e b e i n g s of its w o r l d , h o w e v e r this dwelling—i.e., relatedness to the world—changes in time. By contrast, the constancy of physical s u b s t a n c e c o n s i s t s of its r e m a i n i n g on h a n d for a g i v e n span of time. Of itself it has nothing to do with time. T h e constancy of the p e r s o n ' s selfness appears as this h u m a n self "lives o u t its t i m e " in c a r r y i n g t o fulfillment its possibilities for r e l a t i n g t o t h e p h e n o m e n a o f its t e m p o r a l - s p a t i a l w o r l d . T h e identity o r s e l f n e s s h a p p e n s only a s the e x i s t e n c e ' s "living o u t its t i m e ; " it is j u s t this t h a t c o n s t i t u t e s t h e primordial t e m p o r a l i t y o f t h e h u m a n s e l f . " 2

My Da-sein a l w a y s i n v o l v e s me as t h e w h o l e c r e a t u r e I am, a b s o r b e d in t h e m o d e s of b e h a v i o r I am c a r r y i n g o u t at a given m o m e n t . W h i l e e n g a g e d in my p r e s e n t r e l a t e d n e s s to t h e w o r l d , h o w e v e r , I r e t a i n all t h o s e w a y s of b e i n g r e l a t e d t h a t I r e m e m b e r h a v i n g c a r r i e d o u t in t h e past, as well as t h o s e I see as p o t e n t i a l i t i e s for m y s e l f in t h e f u t u r e . W h a t i s m o s t i m p o r t a n t t o n o t e h e r e i s t h a t n o m a t t e r h o w m a n y t i m e s I say " I " t h e r e is still no a c t u a l p s y c h i c a g e n c y involved. W h a t is involved is my e c ­ static b e i n g - i n - t h e - w o r l d to t h e e x t e n t t h a t I h a v e m a d e its p o t e n t i a l i t i e s m y o w n . " I " r e f e r s t o t h e m o s t c o n c r e t e o f all b e i n g s , t h e Da-sein i n its having grown as one with the world. By contrast, the psychological egoa g e n c y is an a b s t r a c t i o n par e x c e l l e n c e . It is t h e h y p o s t a t i c r e i f i c a t i o n of c e r t a i n p h e n o m e n a of t h e u n o b j e c t i f i a b l e Da-sein. T h e s u p e r e g o - a g e n c y is an equally a b s t r a c t c o n s t r u c t i o n . In p s y c h o l ­ ogy, t h e s u p e r e g o is e m p l o y e d as a s y n o n y m for t h e c o n s c i e n c e . N o w , a h u m a n being, as t h e perceiving o p e n b e i n g he is, is e n g a g e d in b e a r i n g and holding o p e n t h a t i n t o w h i c h w h a t h a s t o b e can s h i n e f o r t h and s o c o m e i n t o b e i n g . All " s h o u l d ' s " are g r o u n d e d in this e x i s t e n t i a l e n g a g e m e n t . It is to this t h a t c o n s c i e n c e r e f e r s w h e n e v e r a p e r s o n falls b e h i n d in fulfilling e s s e n t i a l e x i s t e n t i a l t a s k s . No e n d o p s y c h i c a g e n c y is involved. W h a t p s y c h o l o g y labels t h e s u p e r e g o is a p a r t i c u l a r m o d e of h u m a n r e l a t e d n e s s t o t h i n g s for t h e sake o f w h o s e d e v e l o p m e n t h e e x i s t s , i s t h e r e . T h i s f u n d a m e n t a l a w a r e n e s s c a n , like any p e r c e p t i o n , b e disguised or d i s t o r t e d . It is often d r o w n e d o u t for children by the s c r e a m i n g o f s e n s e l e s s p a r e n t s , b u t t h a t does n o t alter i n t h e least t h e p o t e n t i a l i t y for h a v i n g a c o n s c i e n c e , and e v e n less its c a u s e or s o u r c e are t h o s e w h o falsify its light. T h e e n g a g e m e n t o f a p e r s o n b y w h a t e v e r h e e n c o u n t e r s in his w o r l d , and t h e r e s u l t i n g c o n s c i e n t i o u s " s h o u l d " are b o t h e s s e n t i a l t r a i t s of h u m a n b e i n g . As s u c h , t h e y c a n n o t be c a u s e d at a later time by m e c h a n i s m s h y p o t h e t i c a l l y i n t r o j e c t e d into the p s y c h e . T o d e s i g n a t e the third psychic a g e n c y , Freud b o r r o w e d the t e r m "id"

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from G r o d d e c k . In t h e id b e l o n g t h o s e e n d o p s y c h i c r e p r e s e n t a t i o n s of e x t e r n a l - w o r l d o b j e c t s , and t h e i r p e r t i n e n t a f f e c t s , w h i c h a p e r s o n ' s selfr e g a r d o r m o r a l feeling r e f u s e s t o r e c o g n i z e a s b e l o n g i n g t o him and r e p r e s s e s , dynamically o r t o p o g r a p h i c a l l y , i n t o this id. W e h a v e already pointed o u t t h a t e n d o p s y c h i c , u n c o n s c i o u s r e p r e s e n t a t i o n s and affect c o n f i g u r a t i o n s are scientifically u n t e n a b l e , and n e e d n o t r e p e a t o u r s e l v e s here. T h e i d s h a r e s w i t h t h e older u n c o n s c i o u s its d e s i g n a t i o n a s t h e actual r e s e r v o i r of t h e drives. B u t drive is an a b s t r a c t i o n t h a t d i s t o r t s , artificially i s o l a t e s , and reifies a p a r t i c u l a r h u m a n p o t e n t i a l i t y of relating to w h a t is in t h e world. W h a t is actually g o i n g on, we said, is w h a t we can see as a p e r s o n ' s i n v o l u n t a r y s u b m i s s i o n to s o m e t h i n g he e n c o u n t e r s . I n s e v e r a l s t a t e m e n t s o n t h e id, F r e u d anticipated m u c h o f w h a t J u n g later a t t r i b u t e d t o t h e c o l l e c t i v e u n c o n s c i o u s , s o o u r c r i t i c i s m o f t h e collective u n c o n s c i o u s applies equally t o t h e Freudian n o t i o n . T h e p s y c h o l o g i c a l c o n c e p t o f t h e id, like t h o s e o f t h e e g o and s u p e r e g o , t u r n s o u t to be n o t h i n g m o r e t h a n a reified, p e r s o n i f i e d a b s t r a c t i o n . D e p t h p s y c h o l o g y deduced all t h r e e o f t h e s e a g e n c i e s from p a r t i c u l a r h u m a n p o t e n t i a l i t i e s o f r e l a t i n g t o the world. I n u s i n g s u c h c o n s t r u c ­ tions, c o n t e m p o r a r y t h e o r i e s a r e m e r e l y b o r r o w i n g t h e m e t h o d o l o g y o f lairy t a l e s , w h i c h likewise t e n d t o a b s t r a c t and p e r s o n i f y , r e n d e r i n g the pleasing b e h a v i o r of adults the a g e n c y of a good fairy and displeasing b e h a v i o r t h e a g e n c y of a w i c k e d w i t c h . T h i s s o r t of i n t e r p r e t a t i o n is h a r m l e s s e n o u g h in fairy t a l e s , b u t in p s y c h o l o g y it is h a r m f u l b e c a u s e it artificially f r a g m e n t s h u m a n b e i n g - i n - t h e - w o r l d . T h e v e r y c h a r a c t e r i s t i c that d i s t i n g u i s h e s h u m a n Da-sein is t h e unified w a y in w h i c h it e n g a g e s , and is a b s o r b e d , in t h e w a y s of r e l a t i n g to w h a t it e n c o u n t e r s . It n e v e r happens t h a t in a p a r t i c u l a r h u m a n b e h a v i o r only o n e piece of a p e r s o n ' s being is e n g a g e d , for t h e simple r e a s o n t h a t h u m a n b e i n g - i n - t h e - w o r l d is b y n a t u r e indivisible. T h i s fact implies, r a t h e r t h a n p r e c l u d e s , the possibility o f o n e b e h a v i o r being followed, w i t h l i g h t n i n g s u d d e n n e s s and for a n y n u m b e r o f r e a s o n s , b y a n o t h e r t h a t m a n i f e s t s a n e n t i r e l y different w a y o f r e l a t i n g t o t h e w o r l d . All o f this p o i n t s t o t h e n e e d for freeing t h e ol h u m a n Da-sein from t h e s h a c k l e s of 11 amework. T h e three psychic agencies must c a t e g o r i e s o f h u m a n b e h a v i n g and relating a i r . 1 1 acted.

demonstrable phenomena a distorting conceptual b e r e t u r n e d t o t h e diverse from w h i c h t h e y w e r e

I K i m empathy to an understanding of how human beings ire directly perceived by each other Besides the rational faculty, traditional p s y c h o l o g y a s s i g n s t o the h u m a n mind the c a p a c i t y for e m p a t h y . This supposedly p e r m i t s o n e

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individual to s t e p o u t s i d e of h i m s e l f , slip i n t o a n o t h e r individual, and t h e n e x p l o r e , as it w e r e , this o t h e r f r o m t h e inside. In this w a y , t h e first individual is s u p p o s e d to be able to r e c o g n i z e w h a t kind of p e r s o n t h e o t h e r is. B u t a n y n o t i o n o f e m p a t h y , o f t h e ability t o feel o n e ' s w a y i n t o a n o t h e r , tacitly a s s u m e s t h a t a n u n d e r s t a n d i n g o f t h a t o t h e r i s already t h e r e : if I did n o t r e c o g n i z e t h a t o t h e r as a being of my o w n kind, I would n e v e r k n o w h o w t o begin directing m y e m p a t h y t o t h a t o t h e r . T h e p r e c o n d i t i o n of e m p a t h y is t h e n the prior, primordial, and i m m e d i a t e u n d e r s t a n d i n g o f t h e o t h e r a s t h e being h e is. T h i s u n d e r s t a n d i n g o r perceiving is a p a r t i c u l a r o n t i c fulfillment of t h e f u n d a m e n t a l h u m a n c h a r a c t e r i s t i c of being able to perceive s o m e t h i n g as s o m e t h i n g . T h e ability to u n d e r s t a n d o t h e r s directly as fellow h u m a n b e i n g s is r o o t e d in this basic t r a i t . It m a y m a n i f e s t i t s e l f in a g r e a t m a n y w a y s . It m a y happen as a v a g u e , superficial p e r c e p t i o n of t h e o t h e r as s o m e h o w different f r o m o n e s e l f . It m a y be a m i s i n t e r p r e t a t i o n , w h e r e b y t h e o t h e r p e r s o n is m i s t a k e n as s o m e t h i n g t h a t is simply t h e r e , or an o b j e c t to be used. Y e t it is also possible for o n e person to b e c o m e e n g a g e d in his r e l a t e d n e s s to a n o t h e r in such a w a y t h a t t h e o t h e r ' s m o s t subtle c h a r a c t e r i s t i c s are i l l u m i n a t e d for him. N o t o n e o f t h e s e w a y s o f understanding another person, however, concerns some human subject empathizing with the psyche of another.

From psychic cause and psychodynamics to an understanding of motivational contexts F r e u d ' s g r e a t e s t i n t e l l e c t u a l a c h i e v e m e n t w a s his supposition t h a t each p e r s o n ' s life h i s t o r y w a s pervaded w i t h m e a n i n g . H e h i m s e l f c h a r a c t e r ­ ized this claim as a " b o l d " a s s u m p t i o n . It w a s bold. It o p e n e d up n e w d i m e n s i o n s to m e d i c i n e , w h i c h until t h e n had dealt e x c l u s i v e l y in n o n m e a n i n g f u l causal c o n n e c t i o n s . H a v i n g m a d e this a s s u m p t i o n , F r e u d p r o c e e d e d t o t e s t its validity o n o n e a r e a o f h u m a n p h e n o m e n a a f t e r a n o t h e r . H e b e g a n b y e x a m i n i n g h y s t e r i c a l s y m p t o m s , d r e a m s , and e v e r y d a y slips. T h e w o r d " m e a n i n g f u l " can b e applied w i t h c e r t a i n t y only t o h u m a n b e h a v i o r , for o n l y o u r o w n a c t i o n s d o w e k n o w t o b e m o t i v a t e d b y t h e m e a n i n g f u l n e s s o f w h a t r e v e a l s itself i n o u r w o r l d . A s long a s h e w a s i n v e s t i g a t i n g m e a n i n g f u l n e s s i n b i o g r a p h i c a l p h e n o m e n a , F r e u d quite logically used t h e w o r d " m o t i v e " to m e a n a c o m p r e h e n s i b l e i n s t i g a t o r of h u m a n action o r i n a c t i o n . B u t n o s o o n e r w a s Freud's bold a s s u m p t i o n c o n c e i v e d t h a n it, t o o , c a m e u n d e r t h e d i c t a t o r s h i p o f the d o g m a t h a t reality was c o m p o s e d e n t i r e l y o f o b j e c t s c o n n e c t e d t h r o u g h u n b r o k e n calculable causal c h a i n s . W h i l e he c o n t i n u e d paying lip service to the m e . m m ) ' , of symptoms, Freud i n c r e a s i n g l y r e i n t e r p r e t e d what was

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m e a n i n g f u l i n the c o n t e x t s o f h u m a n e x i s t e n t i a l p h e n o m e n a t o c o n f o r m t o t h e m e a n i n g l e s s n e s s o f causal c o n n e c t i o n s . I n r e v e r t i n g from a n h i s t o r i c a l t o a n a t u r a l scientific v i e w o f h u m a n b e i n g s , h e i n e x o r a b l y m a d e t h e t e r m " m o t i v e " s y n o n y m o u s w i t h t h e idea o f " p s y c h i c c a u s e . " H e s o o n used t h e t w o t e r m s i n t e r c h a n g e a b l y , a p r a c t i c e t h a t s u r r o u n d e d his t h e o r y w i t h i m m e n s e t e r m i n o l o g i c a l c o n f u s i o n . T h i s p e r p l e x i t y spread b e y o n d t h e p s y c h o a n a l y t i c s c h o o l t o infect m o s t o t h e r t h e o r i e s , t h o u g h in s o m e it had a r i s e n i n d e p e n d e n t l y . In a n y c a s e , t h e e x t e n t to w h i c h this c o n f u s i o n o f p s y c h i c c a u s e and m o t i v e t o o k hold i n m o d e r n p s y c h o l o g y and p s y c h i a t r y i s n o t h i n g t o b e proud of. W h e n e v e n F r e u d n o l o n g e r d i s t i n g u i s h e d b e t w e e n t h e t w o , o t h e r s f o l l o w e d suit, like K r e t s c h m e r , w h o w r i t e s : "In r e a l i t y i t i s this w a y : t h e m a n i f e s t a t i o n o f an a c t i o n is a c c o m p a n i e d by t h e f o r m a t i o n of a m o t i v a t i o n a l c l u s t e r or, to put it m o r e g e n e r a l l y , a p s y c h i c , causal c l u s t e r . " M c C l e l l a n d , on t h e o t h e r hand, w r i t e s : " T h e only p a t e n t l y u n a l t e r a b l e a s p e c t o f m o t i v a t i o n i s t h e n e g a t i v e affective s t a t e c r e a t e d i n t e r n a l l y b y m e t a b o l i s m , and a l w a y s f u n c t i o n i n g as a motive, m e a n i n g t h a t it is c o n n e c t e d w i t h f u r t h e r c h a n g e s , positive o r n e g a t i v e . " B u t t h e m o s t i m p r e s s i v e e v i d e n c e o f the c o n f u s i o n s u r r o u n d i n g m o t i v e and psychic c a u s e i n c o n t e m p o r a r y p s y c h o l o g y and p s y c h i a t r y is t h e v o l u m i n o u s a n t h o l o g y e n t i t l e d Die Motivation menschlichen Handelns. In t h e c o u r s e of its 5 0 0 pages, the t w o t e r m s a r e used i n t e r c h a n g e a b l y , w i t h o u t a n y t h o u g h t being g i v e n t o the m a t t e r , d o z e n s o f t i m e s and b y a n e x t r e m e l y varied sampling o f w r i t e r s . N o w h e r e d o e s t h e r e appear a s t r i c t , scientific c o n s i d e r a t i o n of t h e radical difference between these concepts. 3 0

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T h e e a s i e s t w a y o u t o f this c o n f u s i o n i s t o let t w o s i t u a t i o n s speak for t h e m s e l v e s . T h e first e n t a i l s a c a u s e - a n d - e f f e c t r e l a t i o n s h i p a m o n g n o n h u m a n e v e n t s , t h e s e c o n d an a c t i o n m o t i v a t e d by a h u m a n being and a p p a r e n t l y similar t o t h e c a u s e - a n d - e f f e c t r e l a t i o n s h i p . Let u s a s s u m e that a s t r o n g wind b l o w s t h e w i n d o w o f m y study s h u t b e f o r e m y eyes Th is c o r r e s p o n d s to an o b s e r v a t i o n , a c i r c u m s t a n c e directly perceptible t h r o u g h t h e s e n s e s . T w o s t a t e s a r e seen t o succeed e a c h o t h e r : w i n d o w open and, after t h e b l o w i n g of wind, w i n d o w closed. If this s a m e s u c c e s s i o n o c c u r s r e p e a t e d l y , I will a s s e r t t h a t t h e w i n d o w w a s s h u t because (weil) t h e wind c a m e up. By putting in this " b e c a u s e " (weil), I have t r a n s f o r m e d t h e simple s t a t e m e n t o f a p e r c e p t i o n ( " W h e n t h e w i n d blows, t h e n . . .") into a s t a t e m e n t of e x p e r i e n c e ( " B e c a u s e [weil] t h e wind blows, the w i n d o w i s s h u t . " ) . A n i n e v i t a b l e s u c c e s s i o n has n o w b e c o m e s o m e t h i n g m o r e : t h e w i n d o w ' s s h u t t i n g i s n o w i n t e r p r e t e d a s t h e effect ol a c a u s e . T h i s i n t e r p r e t a t i o n is, in reality, an e x p l a n a t i o n in a c c o r d a n c e with the principle of c a u s a l i t y . In ( J e r m a n , t h e causal c o n j u n c t i o n weil ("because") r e f e r r e d originally to time. It m e a n t " w h i l e " (with which it s h a r e s an I n d o - E u r o p e a n r o o t ) ,

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"during," "on the occasion of." It is often forgotten that the meaning of this w o r d w a s t r a n s f o r m e d to d e s c r i b e a causal r e l a t i o n s h i p as s o m e t h i n g t h a t p r o d u c e s s o m e t h i n g d i f f e r e n t o u t o f itself. P h y s i c i s t s long a g o r e d i s c o v e r e d t h a t t h e i r c a u s a l i t y can m e a n n o t h i n g but a description of a simple t i m e r e l a t i o n s h i p , t h a t t h e causal c o n n e c t i o n s t h e y find in n a t u r e are no m o r e than records of regularities in the order of temporal s u c c e s s i o n o f c e r t a i n p h e n o m e n a . T h e e v e n t s a r e not b o u n d t o g e t h e r b y a n y d i s c e r n i b l e meaning. C o n s e q u e n t l y , causal r e l a t i o n s h i p s do n o t m a k e us c o m p r e h e n d m e a n i n g . W h a t t h e y yield is i n h e r e n t l y r e s t r i c t e d to t h e purely t e m p o r a l s t a t e m e n t : " w h e n . . . t h e n . " W e h a v e s t r e s s e d t h a t t h e r e i s s o m e limited j u s t i f i c a t i o n for applying t h e principle o f c a u s a l i t y i n t h e practical t r e a t m e n t o f d i s t u r b a n c e s o f physical h e a l t h , b u t t h a t it is i m p e r a t i v e to r e m e m b e r t h a t this principle is wholly inadequate w h e r e a proper understanding of any human mode of being i s c o n c e r n e d . T o g e t back t o o u r i l l u s t r a t i o n , i t m i g h t well h a v e h a p p e n e d t h a t t h e w i n d o w w a s s h u t not by a g u s t of w i n d , b u t by m e , b e c a u s e t h e s t r e e t n o i s e w a s distracting m e . N o w t h e r e a s o n t h e w i n d o w is s h u t b e c o m e s a g e n u i n e m o t i v e : n a m e l y , my desire for p e a c e and quiet. H o w does this m o t i v e c o m p a r e w i t h w h a t w e called t h e c a u s e o f t h e first instance of the shut window, the wind? My closing t h e w i n d o w , m o t i v a t e d as it is by my wish for peace and quiet, b y n o m e a n s r e p r e s e n t s a m e r e inevitable s u c c e s s i o n o f s t a t e s . T r u e , t h e w i s h e d - f o r p e a c e and quiet is t h e reason b e h i n d my closing t h e w i n d o w , b u t this reason is s o m e t h i n g totally d i f f e r e n t f r o m t h e cause as n a t u r a l s c i e n c e s e e s c a u s e . T h e r e a s o n s u n d e r l y i n g m y h u m a n a c t i o n s are the distracting s t r e e t n o i s e and t h e peace and q u i e t I w o u l d like to h a v e in m y r o o m . T h e w i n d o w w o u l d n e v e r h a v e b e e n closed, t h e r e f o r e , i f I had n o t been in a position to a p p r e h e n d s o m e t h i n g t h e r e t h a t m e a n t n o i s e , and a b o v e all, to a n t i c i p a t e a f u t u r e s t a t e , a f t e r t h e w i n d o w had b e e n s h u t , t h a t m e a n t peace and quiet. S u c h m e a n i n g s can r e v e a l t h e m s e l v e s only w i t h i n t h e s o r t o f p e r c e p t i v e o p e n n e s s t h a t c o n s t i t u t e s t h e specifically h u m a n m o d e o f being. A g u s t o f w i n d , t h o u g h i t t o o m a y s h u t t h e w i n d o w , can k n o w n o t h i n g o f t h e s i g n i f i c a n c e o f n o i s e , o r o f p e a c e and quiet. M o t i v e s , as well as t h a t t o w a r d w h i c h m o t i v e s are directed, a r e d e t e r m i n e d by an i m p e n d i n g t a s k t h a t h a s been r e c o g n i z e d and a c c e p t e d . M y motive i n closing t h e w i n d o w is, i n t h e last a n a l y s i s , t h e f u t u r e o f t h e book 1 feel an obligation to w r i t e . S u c h r e a s o n s allow me f r e e d o m of < h o n e . A s m o t i v e s , perceiving n o i s e and e x p e c t i n g peace do not compel m e I o at I 1 could leave the w i n d o w o p e n in spite o f the n o i s e a n d p o s t p o n e m y w i Iting T h e noise and the open w i n d o w a r e not like9« i e n t i f i c e v e n t s obeying the principles o f c a u s a l i t y i n t h a t t h e y d o not s u c c e e d e a c h o t h e r

Basic Concepts of Biology, Physiology, and Psychology in t i m e w i t h r e g u l a r i t y . M o t i v e , t h e r e a s o n b e h i n d a p a r t i c u l a r h u m a n a c t i o n , should t h e r e f o r e n e v e r be t h o u g h t of as a c a u s e , in t h e strict, scientific s e n s e o f t h e w o r d . T h e g u s t o f wind t h a t closed t h e w i n d o w — a t r u e c a u s e — h a s no f r e e d o m of decision, n o r is it a b l e , or r e q u i r e d , to perceive in t h e w i n d o w a m e a n i n g f u l n e s s , t h e p o t e n t i a l f o r being closed, b e f o r e b l o w i n g it shut. C o n s e q u e n t l y , a wind can n e v e r c h o o s e and act. T h e m o t i v e for my closing t h e w i n d o w , on t h e o t h e r h a n d , is no such blind c a u s e . E v e r y h u m a n action i s m o t i v a t e d o n a c c o u n t o f s o m e t h i n g r e c o g n i z e d by t h e person in q u e s t i o n , and this r e c o g n i t i o n is g r o u n d e d in a p e r s o n ' s being e n g a g e d by s o m e p h e n o m e n o n t h a t a d d r e s s e s h i m . B y n o w i t should b e p a t e n t l y o b v i o u s t h a t c a u s e and m o t i v e are t w o v e r y different t h i n g s . T h i s d i f f e r e n c e i s n o t c o n f i n e d t o t h e n e c e s s i t y o f n o n h u m a n , causal p r o c e s s e s as o p p o s e d to t h e f r e e d o m c h e r a c t e r i s t i c of a p e r s o n ' s r e l a t e d n e s s to a m o t i v e ; it implies t h a t t h e r e a r e t w o radically different dimensions, one the domain of causes, the o t h e r of motives. T h e process of interpretation that psychological theories have p e r f o r m e d on t h e idea of p s y c h i c m o t i v e s , or m o t i v a t i o n s , b e g i n s w i t h a s e v e r e reduction o f t h e original m e a n i n g o f t h e s e t e r m s . B o t h " m o t i v e " and " m o t i v a t i o n " s t e m f r o m t h e Latin v e r b movere, movi, motus, m e a n i n g " t o m o v e . " I n A r i s t o t l e ' s t i m e , f o u r distinct types o f m o t i o n w e r e r e c o g n i z e d . M o d e r n n a t u r a l s c i e n c e h a s lost sight o f all b u t " m o t i o n , " a physical body's c h a n g e of location in t i m e , e f f e c t e d by a f o r c e a c t i n g upon t h a t body. I n keeping w i t h this n a r r o w definition, m o d e r n p s y c h o d y n a m ic t h e o r i e s h a v e also divided h u m a n b e i n g s into t w o c o m p o n e n t s , a m o v i n g f o r c e and a m o v e d t h i n g . T h a t w h i c h is m o v e d is called, v a r i o u s l y , t h e e g o , o r s u b j e c t , o r t h e h u m a n body. T h e m o v i n g f o r c e i s m o s t o f t e n given t h e n a m e drive, o r n e e d . T h u s it is concluded, f o r i n s t a n c e , t h a t an i n s u f f i c i e n t c o n c e n t r a t i o n of s u g a r in t h e blood will a c t u a t e , in s o m e m y s t e r i o u s fashion, a h u n g e r drive and desire for e a t i n g w i t h i n the p s y c h e . T h i s i n t e r n a l drive, f u n c t i o n i n g as a causal m o t i v e in t h e p s y c h o d y n a m i c p r o d u c t i o n of a specific b e h a v i o r a l s e q u e n c e , will t h e n impel t h e h u n g r y p e r s o n t o eat s o m e t h i n g s w e e t . O r , a p e r s o n m a y be m o t i v a t e d to an a c t i o n by t h e sight of a r a g g e d b e g g a r s q u a t t i n g by t h e c u r b . E v e n a m o t i v e like this is t r a n s l a t e d , in t h e p s y c h o l o g i c a l tradition, into a causal r e l a t i o n s h i p or p s y c h o d y n a m i c p r o c e s s t h u s : t h e s i g h t o f t h e b e g g a r i s alleged t o a w a k e n the idea of m i s e r y in my e g o - c o n s c i o u s n e s s , w h i c h t h e n p e n e t r a t e s to an e v e n g r e a t e r p s y c h i c d e p t h , w h e r e it stirs up altruistic i m p u l s e s , a f f e c t s , and drives w i t h s u c h i n t e n s i t y and p e r s i s t e n c e t h a t its p s y c h o d y n a m i s m is able to m o v e my e g o and my body to give t h e b e g g a r a coin. C e r t a i n l y , in c o n t e m p o r a r y p s y c h o l o g y , m o t i v a t i o n is s o m e t h i n g m o r e than a m e r e efficient c a u s e , for this s e c o n d illustration s h o w s t h a t m o t i v a t i o n may be

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used to m e a n a f u t u r e - d i r e c t e d , finalistic c a u s e . Still, this added m e a n i n g does n o t f u n d a m e n t a l l y a l t e r the c u r r e n t l y m o s t popular i n t e r p r e t a t i o n of m o t i v a t i o n as a causal r e l a t i o n s h i p b e t w e e n p o w e r f u l psychic c a u s e s and their e f f e c t s , physical and m e n t a l c h a n g e s o f place c o r r e s p o n d i n g t o shifts w i t h i n an e n d o p s y c h i c s y s t e m . P s y c h i c c a u s e s and p s y c h o d y n a m i c s c a n n o t e x i s t , b e c a u s e t h e psychic part of t h e m is c o n c e r n e d e x c l u s i v e l y w i t h a p e r s o n ' s w a y s of r e l a t i n g — e m o t i o n a l , r a t i o n a l , hopeful, a c t i v e , p e r c e p t i v e , and s o f o r t h — t o w h a t m a t t e r s to him in his world, and in his d i m e n s i o n t h e r e are o n l y comprehensible motivational contexts. Any psychological theory that t r a n s l a t e s a m o t i v e or m o t i v a t i o n a l c o n t e x t i n t o a psychic c a u s e or a p s y c h o d y n a m i c causal chain d e s t r o y s t h e v e r y f o u n d a t i o n o f h u m a n being. Recognition of the unbridgeable chasm that separates causes from m o t i v e s lets us see h o w f u n d a m e n t a l l y u n h u m a n a r e all p s y c h o l o g i c a l t h e o r i e s w h i c h , allegedly for the sake of being scientific, t r y to force m o t i v a t e d h u m a n b e h a v i o r into the d i m e n s i o n o f t h e principle o f physical causality. S u c h n o t i o n s fail t o a c c o m m o d a t e t h e g r e a t a b u n d a n c e o f c o n t e x t s of m e a n i n g and r e f e r e n c e i n h e r e n t in t h i n g s t h a t m a k e up a c o m p r e h e n s i b l e h u m a n w o r l d and exile t h e scientific i m a g i n a t i o n f r o m t h e only d i m e n s i o n in w h i c h h u m a n being can disclose i t s e l f as it t r u l y is. NOTES 1. Of these philosophers, Jean-paul Sartre, Merleau-Ponty, A. de Waelhens, G. Marcel, and P. R i c o e u r d e s e r v e special m e n t i o n in this c o n n e c t i o n . 2. F o r a d i s c u s s i o n of t h e i r s t u d i e s , s e e : M. B o s s , Einführung in dir psychosomatische Medizin ( B e r n a n d S t u t t g a r t : H a n s H u b e r , 1 9 5 4 ) , pp. 5 1 - 6 6 . 3. J.P. S a r t r e , L'Etre et le N é a n t (Paris: Librarie G a l i m a r d , 1 9 5 3 ) , p. 3 7 0 . 4. T h e italics are m i n e . 5. J . P . S a r t r e , La Nause'e ( P a r i s ; 1 9 3 8 ) , pp. 1 6 2 f ï . 6. M. H e i d e g g e r , Sein und Zeit, p. 4 0 . 7. C f . S a r t r e , L'Imagination ( P a r i s : 1 9 3 6 ) , p. 1. 8. M. M e r l e a u - P o n t y , Phénoménologie de la Perception ( P a r i s : 1 9 4 5 ) . 9. M e r l e a u - P o n t y , L'Oeil et l'Espirit ( P a r i s : P r e s s e s U n i v e r s i t a i r e s , 1 9 6 1 ) , p. 1 9 8 . 1 0 . Ibid., p . 2 2 3 1 1 . M e r l e a u - P o n t y , Signes ( P a r i s : 1 9 6 0 ) , p . 2 1 0 . 1 2 . M e r l e a u - P o n t y , " L ' e s p i r i t n u t i l i s e p a s l e c o r p s m a i s s e fait a t r a v e r s lui e n l e t r a n s f é r a n t h o r s de l ' e s p a c e p h y s i q u e , " in La Structure du Comportment ( P a r i s : 1 9 4 2 ) , p. 2 2 5 . 1 3 . M e r l e a u - P o n t y , Signe: la philosophie et son ombre ( P a r i s : 1 9 6 0 ) , p. 2 1 0 . 1 4 . M . H e i d e g g e r , " B a u e n , W o h n e n , D e n k e n , " i n Vorträge und Aufsätze ( P f u l l i n g e n : N e s k e , Inc., 1 9 3 4 ) , pp. 1 4 5 f f . 1 5 . M e r l e a u - P o n t y , Phénoménologie de la Perception ( P a r i s : 1 9 4 5 ) , p. 1 0 9 . 16. F o r a m o r e d e t a i l e d d i s c u s s i o n t h a t i s p o s s i b l e h e r e o f t h e r e l a t i o n s h i p b e t w e e n t h e o p e n n e s s o f h u m a n e x i s t e n c e and t h e clearing t h a t yields this o p e n n e s s , see M . H e i d e g g e r , /.m Sache des Denkens ( T u b i n g e n : N i e m e y e r , 1 9 6 9 ) , pp. 16 a n d 2 2 . 17. K

J a s p e r s , Allgemeine Psychopathologie ( B e r l i n : S p r i n g e r , 1 9 2 3 ) , p. 9 6 .

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1 8 . S. F r e u d , Die Traumdeutung, in Gesammelte Werke, vol. 2 / 3 , ( L o n d o n : I m a g o , I n c . , pp. 5 4 6 - 4 7 a n d 6 1 7 . A l s o : Das Ich und das Es, v o l . 1 3 , p. 2 4 5 .

|0.|2),

1 9 . F r e u d , " E i n i g e B e m e r k u n g e n ü b e r d e n B e g r i f f d e s U n b e w u s s t e n , " i n Gesammelle Werke, vol. 8, ( L o n d o n : I m a g o , Inc., 1 9 4 3 ) , p. 4 3 8 . 2 0 . Ibid., p . 4 3 9 . 2 1 . Ibid., p . 4 3 7 ff. a n d Das Unbewusste, v o l . 1 0 , p . 2 8 5 f f . 2 2 . S . F r e u d , " D i e R e c h t f e r t i g u n g d e s U n b e w u s s t e n , " in Ges. W. v o l . 1 0 : Das Unbewusste, ( L o n d o n : 1 9 4 6 ) , p p . 2 6 4 ff. 2 3 . Ibid., p . 2 6 5 . I t a l i c s m i n e . 2 4 . S. F r e u d , Das Ich und das Es, in Gesammelte Werke, v o l . 13 ( L o n d o n : I m a g o , I n c . ) , p. 2 4 0 . 2 5 . S. F r e u d , Vorlesungen zur Einfuhrung in die Psychoanalyse, in Gesammelte Werke ( L o n d o n : I m a g o , Inc.), vol. 1 1 , p . 3 4 . 2 6 . T h e italics are mine. 2 7 . S. F r e u d , Die Traumdeutung, in Gesammelte Werke ( L o n d o n : I m a g o , I n c . ) , v o l 2 / 3 , p. 1 3 2 . 2 8 . T h e r e a l d e p t h s o f t h i s m a t t e r a r e s o u n d e d b y H e i d e g g e r i n h i s Zur Sache des Denkest! (Tubingen: Niemeyer, 1969). 2 9 . T h e G e r m a n language provides a special access to understanding the p h e n o m e n o n of t h e p r i m o r d i a l t e m p o r a l i t y o f h u m a n e x i s t e n c e , i n h a v i n g t h e v e r b zeitigen, sich zeitigen. T h i s w o r d m e a n s a b e i n g ' s " s h i n i n g f o r t h , " " m a t u r i n g , " o r b e t t e r " a c t u a l i z i n g i t s e l f i n its g i v e n time at the appropriate t i m e . " In this verb, then, is an i m m e d i a t e recognition of the f u n d a m e n t a l and n e c e s s a r y c o n n e c t i o n b e t w e e n a being's being and t i m e , t h a t it has a c e r t a i n t i m e at its disposal, and t h a t its possibilities of e x i s t i n g h a v e to be actualized in this time at an appropriate time. T h e v e r b has the sense of "using one's t i m e " or "living out one's t i m e . " In t h e English and t h e R o m a n c e l a n g u a g e s it is difficult to i l l u m i n a t e this p h e n o m e n o n so directly and immediately, while, by c o n t r a s t , G e r m a n , S a n s k r i t and G r e e k a l l o w t h i s p a r t i c u l a r p h e n o m e n o n t o b e s p o k e n o f a n d i l l u m i n a t e d . E v e r y l a n g u a g e h a s its w e a k n e s s e s and s t r e n g t h s . O n e allows a c e r t a i n p h e n o m e n o n t o b e s e e n and t h o u g h t m o r e clearly, a s e c o n d allows a different p h e n o m e n o n to be seen, one which m a y be partially or totally inaccessible to the first. T h a t a w o r d c a n n o t be translated, then, in no w a y m e a n s that the p h e n o m e n o n w h i c h this w o r d b r i n g s to light is illusory simply b e c a u s e a second l a n g u a g e d o e s n o t k n o w it. 3 0 . M c C l e l l a n d , J . W . A t k i n s o n , R A . C l a r k , a n d E . L . L o w e l l , The Achievement Motive ( N e w Y o r k : A p p l e t o n - C e n t u r y - C r o f t s , 1 9 5 3 ) , pp. 7 5 f f . 3 1 . H. T h o m a e , Witsch, 1 9 6 5 ) .

Die Motivation menschlichen Handelns,

(Cologne, Berlin:

K i e p e n h e u e r and

Chapter 9 CRITICISMS OF AN EXISTENTIAL METHOD OF MEDICAL INVESTIGATION

Of the most common objections to introducing an existential research m e t h o d i n t o m e d i c i n e , t h e following t w o c a t e g o r i e s s t a n d o u t : (1) T h e e x i s t e n t i a l approach is said to be u n s c i e n t i f i c , hostile to c o n c e p t s , lacking in o b j e c t i v i t y ; (2) T h e d e s c r i p t i o n s of Da-sein and t h e basis for t h e possibility of t h e Da-sein a r e m e r e l y allegorical and n a r r o w l y f u n c t i o n a l . W e m a y say o f t h e o b j e c t i o n s i n t h e first g r o u p t h a t t h e s e c h a r g e s are closely r e l a t e d in t h a t a n y o n e levelling t h e m o u g h t to be in a position at least t o deliver precise definitions for the t e r m s " s c i e n t i f i c , " " c o n c e p t , " and " o b j e c t i v e . " T h e v e r y fact t h a t t h e s e c h a r g e s a r e a l m o s t a l w a y s raised s e p a r a t e l y r e v e a l s t h a t t h e r e i s n o c l e a r r e c o g n i t i o n o f t h e n a t u r e o f the a c c u s a t i o n s , f o r at b o t t o m all t h r e e are really a single o b j e c t i o n t h a t is basically c h a r g i n g t h e Dasnn-based approach to m e d i c i n e w i t h n o t being a natural scientific r e s e a r c h m e t h o d . W h a t is being o b j e c t e d to is e x a c t l y w h a t t h e e x i s t e n t i a l a p p r o a c h s e e s as its main c o n t r i b u t i o n to m e d i c i n e . T h i s a p p r o a c h sees its perspective—decidedly n o t n a t u r a l scientific, but p h e n o m e n o l o g i c a l — a s o p e n i n g up an u n d e r s t a n d i n g of all t h e a r e a s of h u m a n Da-sein to w h i c h t h e n a t u r a l scientific o r i e n t a t i o n can n e v e r gain access. O n l y b y m a k i n g a n a b s o l u t e d o g m a o f the basic t e n e t s o f natural s c i e n c e could its a d h e r e n t s e v e r inflate the simple fact o f the n o n n a t u r a l

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scientific c h a r a c t e r o f a n e x i s t e n t i a l f o u n d a t i o n o f m e d i c i n e t o t h e d e g r e e t h a t it b e c o m e s a triple a c c u s a t i o n . O n c e t h e total calculability of all t h i n g s is p o s t u l a t e d as a u n i v e r s a l t r u t h , all t h e s t e p s leading up to t h e triple a c c u s a t i o n s e e m t h o r o u g h l y logical. T h e steps o f this logical a r e o b v i o u s : (1) C a l c u l a b i l i t y n e c e s s a r i l y p r e s u p p o s e s t h e precise d e t e r m i n a ­ tion o f a n y t h i n g ; (2) O n l y o b j e c t s c o n c e p t u a l i z e d u n e q u i v o c a l l y can b e precisely d e t e r m i n e d ; (3) W i t h o u t u n e q u i v o c a l c o n c e p t u a l i z a t i o n , t h e r e can be no precise calculability; (4) W i t h o u t precise calculability, t h e r e can be no natural s c i e n c e ; (5) In t h e a b s e n c e of n a t u r a l s c i e n c e , t h e r e is no s c i e n c e at all. O u t s i d e t h e c h a r m e d circle o f s u c h i n t e l l e c t u a l fallacies t h e c h a r g e o f u n s c i e n t i f i c n e s s levelled at D a s e i n s a n a l y s i s falls apart. It is s u p p o r t e d o n l y b y t h e claim o f n a t u r a l s c i e n c e t h a t n o o t h e r w a y o f t h i n k i n g has the p o w e r to d e t e r m i n e w h a t is real and w h a t is n o t . T h i s claim is as u n f o u n d e d as it is a r r o g a n t and c e r t a i n l y does n o t i t s e l f admit of scientific verification. T h e r e s u l t i s t h a t n o f i r s t - r a t e r e p r e s e n t a t i v e o f t r u e n a t u r a l s c i e n c e i s e v e n willing t o m a k e this claim a n y m o r e , t h o u g h t h e n u m b e r o f physicians w h o cling t o i t r e m a i n s high. T h e second charge, that Daseinsanalysis is hostile to concepts, is on equally thin ice. It c a n n o t s e r i o u s l y be held t h a t this a p p r o a c h tries to g e t b y e n t i r e l y w i t h o u t b e n e f i t o f c o n c e p t u a l i z a t i o n . All t h a t can actually b e c o n t e n d e d i s t h a t this a p p r o a c h , unlike t h a t o f n a t u r a l s c i e n c e , d o e s n o t set out to c a p t u r e w h a t it studies in e x a c t , u n e q u i v o c a l , quantifiable c o n c e p t s . B y w h a t r i g h t , w e m a y well ask, can this a c c u s a t i o n declare t h a t e v e r y t h i n g t h a t is can be d e t e r m i n e d , in e v e r y aspect of its r e a l i t y , t h r o u g h e x a c t , c l e a r - c u t m a t h e m a t i c a l f o r m u l a t i o n s ? W h o i s t o say t h a t t h e r e m i g h t n o t also be a p h e n o m e n a w h o s e v e r y n a t u r e s defy precise, unequivocal definition? Might not some entity appear whose inherently c o m p l e x m e a n i n g f u l n e s s c a n n o t be r e d u c e d to a single u n e q u i v o c a l piece o f i n f o r m a t i o n ? F e a r and a n x i e t y , for i n s t a n c e , a r e n o t s u b j e c t t o e x a c t m e a s u r e m e n t . It is t r u e t h a t precise, f u n c t i o n a l c o n c e p t u a l i z a t i o n s of s u c h p h e n o m e n a will f u n c t i o n i n c o m p u t e r s and m a t h e m a t i c a l o p e r a ­ t i o n s , but it should n e v e r be f o r g o t t e n t h a t this m e t h o d c a p t u r e s o n l y an insignificant part o f t h e i m m e a s u r a b l e reality o f t h e s e e m o t i o n s . If, o n the other hand, an existential interpretation of an ambiguous pheno­ m e n o n r e n d e r s it in all its a m b i g u i t y , t h e i n t e r p r e t a t i o n h a s p r e s u m a b l y conceived t h a t p h e n o m e n o n , as it t a k e s place in t h e w o r l d of a h u m a n e x i s t e n c e , far m o r e c o m p l e t e l y t h a n t h e r e d u c e d definition b a s e d upon c l e a r - c u t , n a t u r a l scientific c a l c u l a t i o n s . A c c o r d i n g l y , t h e c h a r g e o f hostility to c o n c e p t s is t u r n e d back upon t h e n a t u r a l scientific critics t hemselves.

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C h a r a c t e r i s t i c a l l y , the a n c i e n t G r e e k s , t h o u g h a s s u r e d l y n o less agile o f mind t h a n w e , did n o t h a v e t h e idea " c o n c e p t . " T h e n e a r e s t equivalent w a s logos. Y e t logos is d i f f e r e n t . It m e a n s w h a t can be said a b o u t the particular a p p e a r a n c e , or eidos ("idea"), of a p h e n o m e n o n . T h i s a f f i r m a ­ tion is n o t a grasping of t h e p h e n o m e n o n in o b e d i e n c e to s o m e p r e f o r m e d c o n c e p t i o n of it, but i n s t e a d a f i r s t h a n d visualizing of its a p p e a r a n c e . T h e " c o n c r e t e " R o m a n s first c a m e up w i t h t h e idea of a conceptus, a n o u n deriving from t h e v e r b capere, " t o t a k e hold o f , " " t o c a p t u r e . " W e n e e d t o ask c o n c e r n i n g t h e m o d e r n t e r m " c o n c e p t " j u s t h o w i t would " t a k e hold o f " t h i n g s . T h e usual a n s w e r w o u l d be: t h r o u g h a definition. For e x a m p l e , we define " t a b l e " by saying t h a t it is a useful o b j e c t ; this is its g e n e r i c definition. To isolate t h e table as t h e specific useful o b j e c t t h a t it is, we m u s t specify w h a t particular p u r p o s e it s e r v e s . D e f i n i n g the specific u s e of t h e table as a g a i n s t t h e u s e s of, say, a pencil or a glass, is n a m i n g t h e specific d i f f e r e n c e . T h e definition will say s o m e t h i n g g e n e r a l , and s o m e t h i n g specific, a b o u t t h e o b j e c t t o w h i c h i t r e f e r s . In this w a y a p a r t i c u l a r t h i n g is d i s t i n g u i s h e d f r o m e v e r y o t h e r thing. It is i m p o r t a n t to u n d e r s t a n d t h a t e v e r y c o n c e p t u a l i z a t i o n is a kind of r e - p r e s e n t i n g of a t h i n g . F o r i n s t a n c e , w h e n I say " t r e e , " s o m e t h i n g " p r e s e n t s " itself, is r e - p r e s e n t e d to m e . I do n o t m e a n an o a k , or a maple, or a pine, I am t h i n k i n g of a " t r e e . " T h i s kind of c o n c e p t u a l i z a t i o n is said t o arise o u t o f a n a b s t r a c t i o n , w h e r e b y t h e specific p r o p e r t i e s o f e a c h type of t r e e , w h i c h m a k e an o a k an oak and a pine a pine, a r e stripped a w a y . Y e t it is difficult to u n d e r s t a n d h o w m e r e l y t a k i n g t h i n g s a w a y can produce a c o n c e p t . I can a b s t r a c t s o m e t h i n g (the specific p r o p e r t i e s ) f r o m s o m e t h i n g else o n l y w h e n t h e t h i n g from w h i c h s o m e t h i n g i s a b s t r a c t e d is already p r e s e n t for m e . O t h e r s say w e a r r i v e a t t h e g e n e r i c c o n c e p t " t r e e " t h r o u g h c o m p a r i n g all t r e e s w i t h e a c h o t h e r . T o t h i s w e o b j e c t , first o f all, o n t h e g r o u n d s t h a t it is i m p o s s i b l e for o n e p e r s o n to perceive s i m u l t a n e o u s l y , and to c o m p a r e , e v e r y t r e e . M o r e t h a n t h i s , t h o u g h , I could n e v e r c o m p a r e e v e n two t r e e s u n l e s s I already k n e w t h e n a t u r e of " t r e e - n e s s . " W i t h o u t this k n o w l e d g e , I could n o t p e r c e i v e t h e t w o t h i n g s as t r e e s , and hold t h e m up for c o m p a r i s o n w i t h e a c h o t h e r . C o n s e q u e n t l y , t h e r e c o g n i t i o n o f w h a t m a k e s a t r e e e s s e n t i a l l y a t r e e m u s t precede a n y c o m p a r i s o n of individual t r e e s ; it is t h e f r a m e of r e f e r e n c e t h a t lets me see s o m e t h i n g in c o m m o n b e t w e e n , say, an o a k and a pine. T h e so-called g e n e r i c t r e e is, t h e n , n e i t h e r a p u r e l y c o n c e p t u a l abstraction, nor a product of mental comparison. T h e word "tree" discloses a n identical " t r e e - n e s s " pervading all t r e e s . W h e n e v e r w e perceive a n individual t r e e , t h e c o n t e x t s o f m e a n i n g and r e f e r e n c e o f this

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" t r e e - n e s s " a r e i n h e r e n t l y p r e s e n t , and it is o n l y on t h e basis of this p r e s e n c e t h a t we r e c o g n i z e w h a t e v e r it is as being a t r e e . All c o n c e p t u a l i z a t i o n is p r e f i g u r e d in t h e n a m i n g of t h i n g s , in calling a being this or t h a t , in l a n g u a g e as s u c h . N o w it is t i m e to ask again w h e t h e r e v e r y t h i n g t h a t is can be c a p t u r e d i n p r e c i s e , f u n c t i o n a l c o n c e p t s . M i g h t n o t this w a y o f c a p t u r i n g t h i n g s have its l i m i t a t i o n s ? T h e c o m p a r i s o n o f varied i n s t a n c e s o r c a s e s does play a part, t h o u g h s e c o n d a r y , in c o n c e p t - f o r m a t i o n , and t h e r e is as well s o m e a b s t r a c t i o n o f e s s e n t i a l f e a t u r e s a t w o r k i n this p r o c e s s . B u t f u n d a m e n t a l to a n y c o n c e p t u a l i z a t i o n is perceiving and r e t a i n i n g t h e u n c h a n g i n g i d e n t i t y t h a t c o m p r i s e s t h e f u n d a m e n t a l n a t u r e o f each thing t h a t is d e s i g n a t e d by a c o n c e p t . And in e v e r y c a s e , this n a t u r e m u s t have b e e n perceived in a d v a n c e . W h a t is the n a t u r e of t h e identity u n d e r l y i n g all c o n c e p t u a l i z a t i o n s ? To claim identity for a t h i n g m e a n s t h a t this t h i n g e n d u r e s as o n e and t h e s a m e with itself. W e r e this i d e n t i t y not c h a r a c t e r i s t i c of all o n t i c b e i n g s , t h e r e could b e n o n a t u r a l s c i e n c e . And s o t h e r e a r e s o m e t h i n g s — t h e v e r y t h i n g s , in fact, t h a t p r e d i c a t e and s u p p o r t h u m a n b e i n g s — w h i c h can b e grasped o n l y i f t h e y a r e allowed t o p r e s e n t t h e m s e l v e s a s w h a t t h e y are and c a n n o t be e x p l a i n e d by c o m p a r i s o n and a b s t r a c t i o n . A b o u t identity, for e x a m p l e , o n l y n e g a t i v e s t a t e m e n t s can be m a d e . It can be declared o n l y t h a t i d e n t i t y is identity, a t r u e t a u t o l o g y . S u c h p h e n o m e n a e x i s t n o t least of all in t h e r e a l m of m e d i c i n e , w h e r e h u m a n being s t a n d s i n t h e f o r e g r o u n d . H e r e m o d e s o f n a t u r a l scientific c o n c e p t u a l i z a t i o n a r e n o t m e r e l y i n a d e q u a t e but do n o t belong in t h e first place. W h e n e v e r n a t u r a l scientific critics a c c u s e d a s e i n s a n a l y s i s o f hostility to c o n c e p t s , t h e y are placing t h e m s e l v e s in a d a n g e r o u s position, for it m a y well be t h a t medical t h i n k i n g is m o s t a d e q u a t e to its t a s k w h e n it is able to deal w i t h p h e n o m e n a t h a t a r e not s u b j e c t to d e t e r m i n a t i o n through exact, functional concepts. T h e r e may be phenomena that resist being g r a s p e d in this w a y . T h e s e we could o n l y point o u t and r e f e r to as such. T h e y h a v e t o b e s e e n perceivingly and u n d e r s t a n d i n g l y i n t h a t t h e y c a n n o t b e g r a s p e d b y t h e s e n s e s o r t h e scientific i n s t r u m e n t s w h i c h are t h e i r e x t e n s i o n s . T h e y a r e e i t h e r s e e n i m m e d i a t e l y , directly, o r n o t a t all, i f o n e ' s p e r c e p t i o n i s blind t o t h e m . W h e n w e say t h a t t h e s e p h e n o m e n a are " g i v e n , " and t h a t all we can do is point t h e m o u t , this "all" should n o t be t a k e n as a failing. R a t h e r , such p e r c e i v i n g preceeds and u n d e r l i e s all c o n c e p t u a l i z a t i o n . T h e c r i t i c i s m t h a t t h e r e can b e n o scientific s e e i n g o r knowing without conceptual abstraction proves groundless. It arises only out o f d o g m a t i z a t i o n o f o n e o f t h e m a n y possible scientific m e t h o d s : the natural scientific m e t h o d . F u r t h e r m o r e , this p a r t i c u l a r m e t h o d is far from having d e m o n s t r a t e d its unequaled suitability to describe h u m a n n.il in i'

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A g a i n s t t h e b a c k g r o u n d o f t h e s e f a c t s , t h e third o b j e c t i o n , the a c c u s a t i o n o f lack o f o b j e c t i v i t y i n o u r m e t h o d also b e c o m e s m e a n i n g l e s s We should r e m e m b e r that objects—in the strictest sense of the word h a v e e x i s t e d for o n l y 3 0 0 y e a r s . A s w e h a v e said, t h e r e w e r e n o o b j e c t i v e o b j e c t s , n o r could t h e r e be, b e f o r e D e s c a r t e s e l e v a t e d t h e h u m a n mind a s res cogitans, to t h e s t a t u s of t h e sole s u b j e c t upon w h i c h all o t h e r b e i n g s depend for t h e i r being a s o b j e c t s . T h e s e o t h e r b e i n g s w e r e posited a s o b ­ j e c t e d (Lat.: ohjacere), i.e., t h r o w n a g a i n s t t h e h u m a n faculty of i m a g i n a t i o n . T h e y w e r e t h e n c o n c e i v e d o f solely a s s o m e t h i n g r e p r e s e n t e d b y t h e h u m a n s u b j e c t , and this t h e n w a s t h e i r m o d e o f being. T o a n y o n e i m m e r s e d i n t h e C a r t e s i a n s u b j e c t - o b j e c t division, t h e o n l y possible a l t e r n a t i v e s e e m s t o b e a n u n f o c u s s e d e m o t i v e e n t h u s i a s m for experience in which the human observer would come to merge entirely w i t h w h a t i s o b s e r v e d until b o t h s i n k i n a s o g g y p a s t e . T o c r i t i c s w h o s e e o n l y this a l t e r n a t i v e , t h e m e r e fact t h a t t h e o r i e n t a t i o n o f d a s e i n s a n a l y s i s is n o n n a t u r a l scientific is sufficient to classify it as a b r a n d of u n o b j e c t i v e e n t h u s i a s m for e x p e r i e n c e . B u t we h a v e already s p o k e n of a third possible r e l a t i o n s h i p to t h e w o r l d , o n e t h a t is p r i o r to all e x a c t n a t u r a l scientific c o n c e p t u a l i z a t i o n , prior t o all e m o t i o n a l e n t h u s i a s t i c e x p e r i e n c e , and t h e f o u n d a t i o n for b o t h o f t h e s e . I t i s t h e f u n d a m e n t a l r e l a t e d n e s s o f h u m a n being t o w h a t is, o u r i n h e r e n t worldly r e l a t i o n s h i p o f b e i n g - i n - t h e - w o r l d . W h e n e v e r w e direct o u r a t t e n t i o n t o this basic trait o f h u m a n e x i s t e n c e , i t r e v e a l s i t s e l f directly. W e h a v e r e p e a t e d l y described this all-founding r e l a t i o n ­ ship as a p e r c e p t i v e o p e n n e s s to w h a t e v e r r e v e a l s i t s e l f to h u m a n being. B e i n g - t h e r e in this w a y , a h u m a n being can allow w h a t e v e r r e v e a l s i t s e l f to h i m in its c o n t e x t of m e a n i n g and r e f e r e n c e w i t h i n an o p e n vis-a-vis at its p r o p e r place in his w o r l d and t h e n e n t e r i n t o a free dialogue w i t h it. T h i s is c e r t a i n l y no o b j e c t - h o s t i l e e n t h u s i a s m for e x p e r i e n c e , since it o f f e r s a n y unbiased t h i n k e r a c o n s i d e r a b l y s t r i c t e r d i s t i n c t i o n b e t w e e n t h e h u m a n and n o n h u m a n t h a n t h e old C a r t e s i a n o b j e c t i v i t y , w h i c h i s actually n o t h i n g b u t s u b j e c t i v i s m carried t o t h e e x t r e m e . T h e s e c o n d g e n e r a l c a t e g o r y o f o b j e c t i o n s t o t h e Da-sein-based description o f h u m a n being c o n c e r n s the allegedly allegorical and a p p a r e n t l y m e r e l y o p e r a t i o n a l d e s c r i p t i o n s of t h e Da-sein. Its v i e w of h u m a n being as o p e n n e s s to p e r c e p t i o n , as clearing, and as r e s p o n s i v e ­ ness to what it encounters is often misconstrued as mere analogy. T h e s e f u n d a m e n t a l d e s c r i p t i o n s a r e simply m i s u n d e r s t o o d a s u n r e a l i s t i c , poetic, m y s t i c a l a b s t r a c t i o n s , or as vivid allegorical and m e t a p h o r i c a l f i g u r e s of s p e e c h , w h i c h should h a v e no place in a scientific (i.e., strict and s o b e r - t h i n k i n g ) s c i e n c e o f m a n . T h e e x i s t e n t i a l s t a t e m e n t a b o u t clearing,, w o r l d - o p e n n e s s as the dwelling of the h u m a n being, is often c o n f u s e d

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w i t h the light m e t a p h o r from Plato's p a r a b l e o f t h e cave. T o c o u n t e r this g r a v e m i s u n d e r s t a n d i n g we can o n l y affirm t h a t light, as t h a t w h i c h i l l u m i n a t e s and c a s t s s h a d o w s , is n o t t h e c l e a r i n g w h i c h r e f e r s to u n o b s t r u c t e d n e s s and o p e n n e s s . N e i t h e r this c l e a r i n g n o r the e x i s t e n t i a l o p e n n e s s in it, a r e to be t a k e n as m e r e s i m i l e s , m e t a p h o r s , or allegories. C l e a r i n g , o r o p e n n e s s , is, r a t h e r , t h e n a m e c o r r e s p o n d i n g directly t o the primordial p h e n o m e n o n t h a t is t h e p r i m a l origin of b e i n g - n e s s as such and of all p a r t i c u l a r b e i n g s in space and t i m e as well: m a n , his world, and the relatedness between them. 1

F r o m t h e opposite e x t e m e , t h e Dasei'n-based d e s c r i p t i o n s o f the c h a r a c t e r i s t i c s o f t h e h u m a n being and t h e i r primordial s o u r c e — a s opposed to c a u s e — a r e labeled as p u r e l y f u n c t i o n a l or o p e r a t i o n a l c o n c e p t s . T h i s i s a n a t t e m p t t o i n t e g r a t e D a s e i n s a n a l y s i s into the p r a g m a t i c t h i n k i n g o f m o d e r n n a t u r a l s c i e n c e , s o t h a t this alien a p p r o a c h can be disposed of, o n c e and for all. J u s t as c o n t e m p o r a r y physics and physicalistic p s y c h o l o g y e m p l o y t h e i r c o n c e p t s o n l y for t h e sake o f c o n v e n i e n c e o f a r g u m e n t , w i t h o u t a t t r i b u t i n g a n y real m e a n i n g t o the c o n c e p t ' s n a m e , so D a s e i n s a n a l y s i s is t h o u g h t to o p e r a t e w i t h its basic terms. W e o b j e c t t o t h e p r a g m a t i c m i s u s e o f d a s e i n s a n a l y t i c descriptions o f h u m a n e x i s t e n c e and its b e i n g - i n - t h e - w o r l d . T h e s e s t a t e m e n t s are directed e x c l u s i v e l y t o w a r d a n a p p r o p r i a t e direct c h a r a c t e r i z a t i o n o f the o n t o l o g i c a l and o n t i c p h e n o m e n a o f h u m a n e x i s t i n g . T h e r e i s n o i n t e n t t o m i s r e p r e s e n t t h e c h a r a c t e r of t h e Da-sein for o p e r a t i o n a l r e a s o n s . NOTE 1

C f . M. H e i d e g g e r , Zur Sache des Denkens ( T u b i n g e n : 1 9 6 9 ) , pp. 50 a n d 7 2 .

Chapter 10 TRANSITIONAL DIFFICULTIES IN UNDERSTANDING DASEINSANALYTIC INSIGHTS

From our attempts to describe the existential traits that are most significant for m e d i c i n e h a v e c o m e r u d i m e n t s of a Dasefn-based a n t h r o p o l o g y . B e i n g a first e f f o r t , t h e s e do n o t claim to be c o m p r e h e n ­ sive, b u t t h e y can s e r v e n e v e r t h e l e s s as a s o u n d basis for t h e a r t of h e a l i n g . T h e e s s e n c e of h u m a n being is s e e n , in t h e s e r u d i m e n t s , as Dasein, as b e i n g - t h e r e ; or, b e t t e r still, as b e i n g - t h e - t h e r e , w h e r e there r e f e r s to the whole, open realm of perception that is the essence of human b e i n g . T h e Da-sein o f all h u m a n b e i n g s t o g e t h e r c o m p r i s e s a n open r e a l m t h a t a l o n e m a k e s i t possible for t h i n g s t o s h i n e f o r t h and c o m e i n t o being. W h e n c o n f r o n t e d w i t h t h e t e s t c a s e , t h e Dasem-based a p p r o a c h clearly d e m o n s t r a t e d its e x c l u s i v e ability t o elucidate t h e individual, c o n c r e t e , o b s e r v a b l e p h e n o m e n a of a p a r t i c u l a r h u m a n being as t h e o n t i c p h e n o m e n a t h e y are. No a p p r o a c h can s u c c e e d h e r e if it is tied to t r a d i t i o n a l c o n c e p t i o n s o f h u m a n b e i n g s a s physical bodies, o r a s r e a s o n i n g o r g a n i s m s , or as t h e s u b j e c t h a l f of a s u b j e c t - o b j e c t relationship, or as the self-actualizing creatures M a r x sees. T h e n u n c a p p r o p r i a t e Dasein-based v i e w of h u m a n b e i n g s b e g i n s o n l y w h e n I he long e s t a b l i s h e d cliches a r e a b a n d o n e d in favor of a totally n e w point ol d e p a r t u r e : t h e simple a s s e n t , r e c e i v i n g . It is m o r e t h a n m e r e e x p e c t a t i o n , and it is also v e r y d i f f e r e n t f r o m t h e natural scientific a s s u m p t i o n , whit h

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inspires t h e f o r m u l a s " a s s u m i n g t h a t . . . " and " i f . . . t h e n . " T h e n a t u r a l scientific a s s u m p t i o n stipulates c o n d i t i o n s t h a t are n e i t h e r directly perceived, n o r p e r c e i v a b l e , s o t h a t the scientific f o r m o f a c c e p t a n c e i s t a n t a m o u n t to a h y p o t h e s i s a b o u t t h e feasibility of an e x p e r i m e n t . T h e Dasrin-based a c c e p t a n c e o f w h a t h u m a n b e i n g s e n c o u n t e r i s s o m e t h i n g else indeed. T w o s o r t s o f p h e n o m e n a a r e a l w a y s e v i d e n c e d i n this kind of a c c e p t i n g and r e c e i v i n g . T h e table in f r o n t of a p e r s o n r e v e a l s itself, for i n s t a n c e , as an o b j e c t t h a t can be perceived t h r o u g h t h e s e n s e s , w i t h its c h a r a c t e r i s t i c qualities o f h e i g h t , l e n g t h , w i d t h , w e i g h t , c o l o r , t e x t u r e , and so o n , b u t a p e r s o n will also p e r c e i v e t h e p h e n o m e n o n of t h e table's being " t h e r e . " T h e table m a y also be e x p e r i e n c e d as a useful o b j e c t . N o w , the p r e s e n c e and t h e utility o f t h e table a r e n o t perceptible qualities o n t h e o r d e r of, say, " b r o w n . " W e could i n v e s t i g a t e t h e table t o o u r h e a r t s ' c o n t e n t — s a w it i n t o pieces, b r e a k it a p a r t , s u b j e c t it to c h e m i c a l a n a l y s i s — a n d still we w o u l d n o t h a v e found its p r e s e n c e as t a b l e . N e v e r ­ t h e l e s s , t h e p r e s e n c e of t h e table as table, t h e fact t h a t it is, and what it is (a useful o b j e c t ) , can b o t h be p e r c e i v e d , t h o u g h such perceiving is n o t directly b o u n d t o s e n s e p e r c e p t i o n . I n s u m , t h e n , t h e o b j e c t ' s p r e s e n c e and utility a r e b o t h g e n u i n e p h e n o m e n a , i n t h e s e n s e o f the G r e e k phainesthai, w h i c h m e a n s " t o reveal i t s e l f . " P h e n o m e n a o f t h e first kind, c o n s i s t i n g o f all t h a t m a y b e p e r c e i v e d o f s o m e t h i n g t h r o u g h t h e s e n s e s , a r e called o n t i c ; t h e s e c o n d c a t e g o r y , t h o s e p h e n o m e n a t h a t a r e e x p e r i e n c e d and s e e n d i r e c t l y , n o t t h r o u g h t h e medium of the senses, is the ontological. B e c a u s e t h e y c a n n o t b e perceived t h r o u g h t h e s e n s e s , i t i s t e m p t i n g t o e q u a t e o n t o l o g i c a l p h e n o m e n a w i t h t h e a b s t r a c t i o n s and h y p o t h e s e s o f n a t u r a l s c i e n c e , b u t t h e y h a v e n o t h i n g in c o m m o n . A n a t u r a l scientific t h e o r y a l w a y s c o n s i s t s in suppositions c o n c e r n i n g t h e feasibility of an e x p e r i m e n t . S u c h a t h e o r y has no literal e x i s t e n c e of its o w n . All s e n s o r y and o n t o l o g i c a l p h e n o m e n a , o n the o t h e r h a n d , are i m m e d i a t e l y perceptible and are t h e r e f o r e w h o l l y d i f f e r e n t in kind from t h e a b s t r a c t s u p p o s i t i o n s c o n t a i n e d in n a t u r a l scientific, s o m a t o l o g i c a l , p s y c h o l o g i c a l t h e o r i e s . T h e r e i s n o affinity w h a t s o e v e r b e t w e e n t h e p r e s e n c e and utility o f t h e t a b l e , and w h a t i s s u m m o n e d u n d e r t h e n o t i o n o f i n s t i n c t o r affect. I n s t i n c t s and a f f e c t s are n o t h i n g m o r e t h a n i n t e l l e c t u a l c o n s t r u c t s w h i c h w e r e t h o u g h t o u t for t h e e x p r e s s p u r p o s e o f m a k i n g t h e p s y c h i c p h e n o m e n o n in q u e s t i o n c o m p a r a b l e to physical b e i n g s so it could be rendered calculable and be derived from s o m e h y p o t h e t i c a l c a u s e . It is i m p o r t a n t t o r e m e m b e r t h a t t h e actual e x i s t e n c e o f such t h i n g s a s instincts and affects c a n n o t be d e m o n s t r a t e d , w h i l e o n t o l o g i c a l p h e n o m e n a , like the p r e s e n c e and utility of t h e table, i n h e r e directly in i In' i respective o b j e c t s . W h e n e v e r I see s o m e t h i n g I r e c o g n i z e as a table,

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I m u s t also and already h a v e p e r c e i v e d t h e p r e s e n c e and utility ol I ha I thing. In s h a r p c o n t r a s t to t h e s u p p o s i t i o n s c o n t a i n e d in scientific t h e o r i e s , t h e f u n d a m e n t a l c h a r a c t e r of a c o n c r e t e being is, as an o n t o l o g i c a l phe­ n o m e n o n , w h a t m a k e s i t w h a t i t is. T h i s i s w h y o n t o l o g i c a l p h e n o m e ­ n a are n e v e r p r e s e n t i n d e p e n d e n t o f ontically p r e s e n t p h e n o m e n a : t h e o n t o l o g i c a l p h e n o m e n a , being t h e e s s e n c e s o f s e n s o r y p h e n o m e n a , m u s t a l w a y s indwell " i n " t h e m . T h e o c c u r r e n c e o f p e r c e i v e d p h e n o m e n a does n o t n e e d t o b e proved. W h a t is perceived s h o w s itself, is i t s e l f the u l t i m a t e g r o u n d for any s t a t e m e n t m a d e a b o u t it. All t h a t is n e e d e d is a simple p o i n t i n g o u t of w h a t h a s been p e r c e i v e d , for p e r c e p t i o n does n o t d e m a n d r e c o u r s e t o a r g u m e n t a t i o n . ( T h o u g h , for t h e c o n t e m p o r a r y s c i e n t i s t , the capacity t o dispense w i t h a r g u m e n t a t i o n can be gained o n l y a f t e r p a i n s t a k i n g exercise.) W h a t is t r u e g e n e r a l l y for t h e n a t u r e of a n y being in its p r e s e n c e is also t r u e for t h e h u m a n being in particular. A c c o r d i n g l y , m e d i c i n e , as the s c i e n c e o f h u m a n being, m u s t r e c o g n i z e t h a t n o t e v e r y g r o u n d i n g o f a p h e n o m e n o n n e e d b e a p r o o f and t h a t , o n t h e o t h e r h a n d , e v e r y scientific p r o o f is o n l y a special kind of g r o u n d i n g . M e d i c i n e n e e d s to d i s t i n g u i s h b e t w e e n s i t u a t i o n s t h a t d e m a n d p r o o f and s i t u a t i o n s i n w h i c h p r o o f i s s u p e r f l u o u s , t h o u g h a g r o u n d i n g o r f o u n d a t i o n o f t h e h i g h e s t o r d e r does e x i s t . Indeed, A r i s t o t l e p o i n t e d o u t t h a t t h e ability t o m a k e this d i s t i n c t i o n d i s t i n g u i s h e s t h e real t h i n k e r from t h e d i l e t t a n t e . H y p o t h e t i c a l a s s u m p t i o n and Daser'n-based a c c e p t a n c e a r e n o t o f equal s t a t u s and a r e n o t i n t e r c h a n g e a b l y applicable. E v e r y n a t u r a l scientific a s s u m p t i o n is n e c e s s a r i l y r o o t e d in s o m e m o d e of a c c e p t a n c e , in fact, for e v e n t h e s e a s s u m p t i o n s b e g i n w i t h t h e admission o f p h e n o m e n a w h i c h a r e n o t s u b j e c t to scientific p r o o f . B u t in n a t u r a l s c i e n c e this initial step is usually t a k e n u n w i t t i n g l y . T h e n a t u r a l scientific o r i e n t a t i o n , i n positing n a t u r e as a calculable s y s t e m of m o v i n g m a s s p o i n t s and s p a t i o - t e m p o r a l c o n t i n u a , h a s m a d e m a n y a s s u m p t i o n s . I t h a s a s s u m e d , first o f all, that t h e r e really are such p h e n o m e n a a s space, t i m e , m o t i o n , and c a u s a l i t y . O n l y b y first a c c e p t i n g w i t h o u t q u e s t i o n t h a t time and space e x i s t can n a t u r a l s c i e n c e g o o n t o i m p o s e upon t h e m t h a t u n i f o r m i t y w i t h o u t w h i c h m a t h e m a t i c a l c a l c u l a t i o n s using t i m e and space would be i m p o s s i b l e . O n l y w h a t can b e c o u n t e d can b e c a l c u l a t e d , and c o u n t i n g i s predicated o n t h e idea o f u n i f o r m u n i t s . A c c e p t i n g space t h a t can be perceived and t i m e t h a t can be e x p e r i e m ed brings a l o n g w i t h it t h e a s s u m p t i o n of s o m e h u m a n r e l a t e d n e s s to Spa( e and t i m e . It is an a priori a s s u m p t i o n of science that h u m a n b e i n g s exisl In relation to t h e s e t w o p h e n o m e n a . If a person did not perceive, and a< i epl

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t h e e x i s t e n c e of, s p a c e and t i m e , he w o u l d be u n a b l e e v e n to pick up a glass and put i t t o his m o u t h . T h e d r i n k e r ' s visible m o v e m e n t s can b e m e a s u r e d and c a l c u l a t e d in a n u m b e r of s p a c e - t i m e c o n t e x t s , but t h e a c c e p t a n c e o f space and t i m e t h a t c o m e first i s n o t s u b j e c t t o experimentation. T h e statement that time exists, or that there are such t h i n g s as utility and spatiality, is n o t a n a t u r a l scientific s t a t e m e n t . To admit o f t h e s e t h i n g s , and o f t h e e x i s t e n c e o f all t h a t is, i s t o g o b e y o n d t h e r e a l m o f t h e n a t u r a l s c i e n c e s , t h o u g h t h e ability o f t h e n a t u r a l s c i e n c e s t o m e a s u r e and c a l c u l a t e i s based o n this a d m i s s i o n . O n l y philosophical c o n t e m p l a t i o n is suited to elucidating t h e fact t h a t t h e r e actually are such t h i n g s as t i m e , space, o b j e c t s , and so o n . It is t h e fate of m o d e r n m a n to be e n t r e n c h e d by and l a r g e in the n a t u r a l scientific t r a d i t i o n o f s e e i n g o n l y causal r e l a t i o n s h i p s a m o n g isolated o b j e c t s . T h u s u n u s u a l e f f o r t i s r e q u i r e d o f a n i n v e s t i g a t o r w h o would e x p e r i e n c e t h e n o n - o b j e c t i f i a b l e o p e n n e s s w h i c h t h e Dasein-based o r i e n t a t i o n s h o w s a s t h e t r u e basis o f a h u m a n n a t u r e . T h e n e w , p h e n o m e n o l o g i c a l - e x i s t e n t i a l v i e w p o i n t c a n n o t b e g o t f r o m reading b o o k s , n o r can it be a c h i e v e d t h r o u g h logical d e d u c t i o n s from already e x i s t i n g ideas. T h i s v i e w p o i n t can b e r e a c h e d o n l y t h r o u g h a q u a n t u m leap i n t h i n k i n g , feeling, and p e r c e i v i n g . W e m u s t leap o u t o f t h e o r i e n t a t i o n i n w h i c h w e are held spellbound b y t h e spirit o f t e c h n o l o g y — a s u b j e c t i v i s t i c , a p o s s e s s i v e , and a b s t r a c t a t t i t u d e vis-a-vis o u r s e l v e s , o u r fellow m e n , and e v e r y t h i n g else i n t h e w o r l d — a n d o n t o t h e c o n c r e t e , though often unrecognized, foundation of our actual being-there. If the headway won by Daseinsanalytic phenomenology is not taken advantage of, n o t o n l y t h e f u n d a m e n t a l s of undisturbed, n o r m a l Da-sein will r e m a i n o b s c u r e d , for u n l e s s t h e n e c e s s a r y e f f o r t is m a d e we shall also n o t be able t o o p e n t h e w a y for a m o r e a d e q u a t e l y h u m a n g e n e r a l p a t h o l o g y and therapy.

Part III e R u d i m e n t s of an Existential G e n e r a l Pathology

Chapter 11 TESTING AN EXISTENTIAL RESEARCH METHOD ON SEVERAL PATHOLOGICAL PHENOMENA OF THE TEST CASE

THE PSYCHOPATHOLOGICAL PHENOMENA T h e stereotypical dream At the very beginning of her psychoanalytic therapy, Regula Ziircher r e p o r t e d a s t e r e o t y p i c a l d r e a m t h a t had afflicted h e r all h e r life at i n t e r v a l s o f days o r w e e k s f r o m e a r l i e s t c h i l d h o o d r i g h t u p t o t h e day o f h e r first s e s s i o n o f t h e r a p y — t h o u g h n e v e r again a f t e r t h a t . I n t h e d r e a m s h e w o u l d find h e r s e l f , n a k e d and a b s o l u t e l y a l o n e , c r o u c h i n g terrified i n t h e c o r n e r o f a n e m p t y railroad b o x c a r , h e r k n e e s d r a w n u p a n d h e r h a n d s held for p r o t e c t i o n i n f r o n t o f h e r f a c e . T h e b o x c a r s t o o d on t h e floor of an ice-cold, dark, b o u n d l e s s sea in w h i c h w a s n o t o n e p l a n t , n o t o n e fish. T h o u g h t h e b o x c a r w a s s u b m e r g e d deep i n t h e sea, a n a r c t i c wind b l e w t h r o u g h its d o o r s and c r a c k s . T h e d r e a m e r w a s fearfully cold. A p h e n o m e n o l o g i c a l i n v e s t i g a t i o n d i s p e n s e s w i t h all t h e presupposi tions o f c o n t e m p o r a r y d r e a m t h e o r y , w h e t h e r t h e s e apply t o h u m a n c o n d u c t o r t o n o n h u m a n t h i n g s i n d r e a m s , a n d holds t o n o t h i n g but the phenomena as they present themselves. Approaching Regula Zurchei's d r e a m t h u s , we c a n say o n l y t h a t it c o n s i s t e n t l y r e v e a l s a s e v e r e l y d e f o r m e d w o r l d and e x t r e m e l y pathological b e h a v i o r of t h e patient wil h respect t o t h a t w o r l d .

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M a n y t h e o r e t i c a l h y p o t h e s e s and m a n y u n p r o v e n s u p p o s i t i o n s had t o b e cleared a w a y b e f o r e t h e d r e a m e r could learn t o s e e the significance o f her dream world without distortion. S h e was encouraged to abandon her r e c e n t l y acquired k n o w l e d g e o f t h e w i s h - f u l f i l l m e n t t h e o r y o f t h e d r e a m , of libidinal and a r c h e t y p a l d r e a m s o u r c e s and d r e a m m o t o r s , as well a s h e r a c q u a i n t a n c e w i t h t h e o r i e s o f p s y c h i c p r o j e c t i o n , w h i c h figures in traditional d r e a m i n t e r p r e t a t i o n s on t h e so-called o b j e c t i v e and subjective levels. 1

F o r his part, t h e t h e r a p i s t g u a r d e d a g a i n s t leading t h e p a t i e n t t o i n t e r p r e t the d r e a m a s a n e x p r e s s i o n o f a n u n c o n s c i o u s urge t o r e t u r n t o a n o c e a n i c w o m b . H e also avoided i m p r e s s i n g o n h e r t h e belief i n a n u n c o n s c i o u s d r e a m - w o r l d w h i c h could c o n v e r t t h e d r e a m e l e m e n t s into t h e i r o p p o s i t e s , i n this c a s e t r a n s f o r m i n g t h e w a r m t h o f t h e u t e r u s i n t o t h e o c e a n ' s icy cold. H e could h a v e offered n o p r o o f o f t h e s e t h i n g s . H e m a d e n o a t t e m p t t o m a k e h e r a w a r e o f t h e p r e s e n c e i n h e r collective u n c o n s c i o u s of s o m e a r c h e t y p a l f e m a l e , a n anima c o n t a i n i n g the f e m a l e aspect of h e r being and m a n i f e s t i n g itself in t h e d r e a m i m a g e of t h e o c e a n . H o w could h e h a v e defended t h e m i f she had levelled t h e c r i t i c i s m t h a t all such a s s e r t i o n s are n o t h i n g m o r e t h a n a r b i t r a r y a s s u m p t i o n s w i t h o u t t h e s l i g h t e s t basis in fact? B e s i d e s , s h e w a s already far t o o involved i n t h e o r e t i c a l s p e c u l a t i o n t h a t kept h e r from r e c o g n i z i n g w h a t h e r d r e a m w a s r e v e a l i n g . S h e w a s t h e r e f o r e p a t i e n t l y urged t o d o n o t h i n g else this o n e t i m e e x c e p t a t t e n d t o t h e e l e m e n t s o f h e r d r e a m s e x a c t l y a s s h e perceived t h e m . S h e w a s i n s t r u c t e d t o i g n o r e a n y m e a n i n g o r c o n t e x t o f r e f e r e n c e t h a t was n o t revealed t o h e r p e r c e p t i o n b y t h e t h i n g s t h e m s e l v e s in the d r e a m . A f t e r a bit of p r a c t i c e in this s t r a i g h t f o r w a r d w a y of seeing, t h e p a t i e n t became intensely aware of her extremely restricted way of being-int h e - w o r l d t h r o u g h t h e d r e a m . S h e r e c o g n i z e d t h a t h e r w h o l e being, d r e a m i n g and w a k i n g , w a s p e r m e a t e d b y a n a t t u n e m e n t o f a n x i e t y , b y feelings of total isolation, a b a n d o n m e n t , and i n s e c u r i t y . All at o n c e , s h e u n d e r s t o o d t h a t s u c h a disposition could o p e n to h e r o n l y a world t h a t w a s dark and e m p t y , cold and s h r o u d e d , void of any r e l a t i o n s h i p to h u m a n b e i n g s o r any o t h e r living c r e a t u r e s . S h e realized h o w s u c h a disposition could close o f f h e r field of vision to e v e r y t h i n g but a m e r c i l e s s l y cold, a b y s m a l d a r k n e s s and an e m p t y b o x c a r . In this dark disposition, s h e could see h e r s e l f o n l y as a f o r g o t t e n piece of m e r c h a n d i s e . A d e s o l a t e b o x c a r w a s t h e dwelling place that c o r r e s ­ ponded to such a self. As a c o n t a i n e r of m e r c h a n d i s e t h a t has not yet r e a c h e d its d e s t i n a t i o n , t h e b o x c a r lets e v e r y t h i n g in it—including the d r e a m e r w h o c o w e r s n a k e d in a c o r n e r — a p p e a r as m e r e goods s h u n t e d back and forth

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Finally, t h e p h e n o m e n o l o g i c a l a p p r o a c h t o t h e s t e r e o t y p i c a l dream a l l o w e d t h e d r e a m e r t o u n d e r s t a n d t h a t w h a t s h e e x p e r i e n c e d a t night w a s n o t at all a d r e a m in t h e s e n s e of s o m e t h i n g t h a t can be p o s s e s s e d or made. R a t h e r , dreaming means being-in-the-world in some particular w a y for t h e d u r a t i o n o f t h e d r e a m . D r e a m i n g a s well a s w a k i n g , t h e n , she e x p e r i e n c e d h e r s e l f as an e x i s t i n g h u m a n being e n g a g e d in and dwelling in her perceptive relationships to things in her world.Only those things t o w h i c h h e r e x t r e m e l y c o n s t r i c t e d e x i s t e n c e w a s o p e n , h o w e v e r , could a p p e a r in t h e realm of this e x i s t e n c e and be perceived t h e r e : a cold e m p t y o c e a n , an icy w i n d , an e m p t y b o x c a r , and she h e r s e l f as a f o r g o t t e n piece of m e r c h a n d i s e a l o n e in a c o r n e r . W e appear t o h a v e g l e a n e d e v e r y t h i n g o f i m p o r t a n c e t h a t the s t e r e o t y p i c a l d r e a m will allow u s t o say a b o u t o u r t e s t s u b j e c t ' s deficient m o d e o f e x i s t e n c e . A n y t h i n g added a t this point w o u l d b e i n t h e n a t u r e o f a r b i t r a r y i n v e n t i o n s and p s e u d o s c i e n t i f i c violation o f t h e given facts. A t first g l a n c e , a n e x i s t e n t i a l i n t e r p r e t a t i o n o f this d r e a m s e e m s poor indeed a l o n g s i d e c u s t o m a r y d r e a m e x p l i c a t i o n s . B u t it p r o v e d rich e n o u g h in r e a l i t y to l a u n c h a t h e r a p e u t i c p r o c e d u r e t h a t led to an a s t o n i s h i n g l y rapid c u r e .

The urge to stab and strangle At the conclusion of her psychoanalytic treatment, Regula Ziircher n o t o n l y l e a r n e d t o r e c o g n i z e t h e periods during w h i c h s h e e n j o y e d total f r e e d o m from u r g e s t o s t a b and s t r a n g l e , b u t she also s a w t h r o u g h t h e s i t u a t i o n s t h a t i r r e s i s t i b l y b r o u g h t o n t h e feared s y m p t o m s . S h e w a s n e v e r visited b y t h e s e u r g e s w h e n — a n d a s long a s — s h e w a s able t o live i n physical p r o x i m i t y t o t h e m a n s h e loved. T h e s e u r g e s t u r n e d u p w i t h predictable r e g u l a r i t y , t h o u g h , during t h o s e d i s c o r d a n t t i m e s w h e n she w a s f o r c e d t o live w i t h o u t h e r l o v e r and suffered f r o m s e v e r e s e x u a l f r u s t r a t i o n , w h e n h e r child w a s t h e o n l y p e r s o n o n w h o m she m i g h t a l w a y s lavish a f f e c t i o n . H e r t i m e s o f h a p p i n e s s , w h e n t h e r e could b e n o t r a c e o f a n u r g e t o s t a b or s t r a n g l e h e r child, c o n s i s t e d by h e r o w n a c c o u n t in " b e i n g free to e x p e r i e n c e all the w a y s in w h i c h a w o m a n can s u r r e n d e r to t h e m a n she l o v e s . " " M y j o y i s c o m p l e t e , " she w e n t o n t o say, " w h e n I a m t o g e t h e r w i t h him and s e n s e t h a t I h a v e freed him for a total m a s c u l i n e s u r r e n d e r t o m e . " A n o t h e r t i m e , she said o f t h e s a m e c i r c u m s t a n c e , " w h a t w e usually call s e x u a l love is a v e r y special w a y of b r i n g i n g t o g e t h e r t w o people. It is a c o e x i s t e n c e of w o m a n and m a n so i n t e n s e t h a t it o p e n s up to b o t h o f t h e m p r e v i o u s l y u n k n o w n , infinitely rich and e x p a n s i v e r e a l m s o f e x i s t e n c e . T h e t w o l o v e r s m e r g e t o b e c o m e a unity that infinitely e x t e n d s t h e b o r d e r s w i t h i n w h i c h t h i n g s n o r m a l l y reveal t h e m s e l v e s t o

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s e p a r a t e m a l e or f e m a l e people. H u m a n being e x p a n d s i n t o a b o u n d l e s s , b e a m i n g r e a l m o f light. T h i s i s t h e m o m e n t o f s e x u a l o r g a s m and t h e peak of a literal e c s t a s y of t h e w h o l e l o v e r and m e , hurling us b e y o n d o u r s e l v e s . P h y s i c a l b o u n d a r i e s s t o p e x i s t i n g . All t h a t w a s held s e c u r e l y in its e v e r y d a y c o n t o u r s j u s t a m o m e n t b e f o r e dissolves i n t o an infinite b r i g h t n e s s . T h e b r e a d t h o f a w o r l d o f love like this has n o r e g a r d for boundaries." R e g u l a Z ü r c h e r s o m e t i m e s c o m p a r e d t h e love e c s t a s y w i t h a m u c h g e n t l e r t r a n s p o r t , s i n k i n g i n t o deep, d r e a m l e s s sleep. In t h e final a n a l y s i s , s h e said, this t r a n s p o r t t o o w a s s o m e t h i n g t h a t people n e e d from t i m e t o t i m e t o r e m a i n h e a l t h y , a s t h e y n e e d t h e e c s t a s i e s o f love. T h e t w o kinds of t r a n s p o r t a r e related as well in t h a t each can re-place us i n t o a m o r e e n e r g e t i c and a f f e c t i o n a t e c o e x i s t e n c e w i t h t h e people and t h i n g s o f o u r e v e r y d a y w o r l d t h a n w e e n j o y e d b e f o r e . N a t u r a l l y , the love e c s t a s y c a n n o t a c c o m p l i s h this sort o f r e b i r t h i n t o t h e w a k i n g , e v e r y d a y w o r l d if t h e t r a n s p o r t w i t h a s e x u a l p a r t n e r is c o n f i n e d to a single s t o l e n m o m e n t . It m u s t be a p r e s e n t w h i c h is s u s t a i n e d by long i n t i m a c y and t h e e x p e c t a t i o n of a f u t u r e life t o g e t h e r . R e g u l a Z ü r c h e r w a s q u i t e d i f f e r e n t during the t i m e s w h e n , e s t r a n g e d from h e r h u s b a n d , s e p a r a t e d from h e r beloved, s h e g r e w m o r e and m o r e lonely. T r u e , t h e r e w a s still h e r little d a u g h t e r , w h o m s h e loved i n t e n s e l y . B u t h a v i n g h e r e n t i r e e x i s t e n c e r e d u c e d t o a single m o t h e r l y r e l a t i o n s h i p t o h e r child w a s a n u n b e a r a b l e r e s t r i c t i o n for this h i g h l y gifted and spirited p e r s o n . I t w a s this s t a t e o f e x t r e m e c o n s t r i c t i o n t h a t paved t h e w a y for t h e i n t r u s i o n o f t h e u r g e s t o s t a b and s t r a n g l e . I n t h e s e p h a s e s o f h e r life, t h e p a t i e n t felt n e a r s u f f o c a t i o n and s u f f e r e d f r o m attacks of breathlessness that forced her to t h r o w open every window in t h e h o u s e , s u m m e r and w i n t e r alike. S h e felt as if s h e w e r e locked in a prison. S h e b e c a m e i n c r e a s i n g l y r e s t l e s s and u n e a s y . S h e w a s u n a b l e t o c o n c e n t r a t e o n any o n e activity, b u t w a s driven f r o m o n e t h i n g t o t h e n e x t . T h e m o s t m i n o r difficulty a n n o y e d h e r n o e n d , p r o v o k i n g fits o f s c r e a m i n g and o u t b u r s t s o f rage i n w h i c h she w a n t e d t o c r u s h a n y t h i n g t h a t stood in h e r w a y and h e a v e it t h r o u g h t h e w i n d o w . E v e r y t h i n g would s e e m to rise up a g a i n s t h e r as a b a r r i e r o b s t r u c t i n g h e r u n f o c u s s e d urge t o g e t o u t i n t o t h e o p e n . Y e t in t h e midst of t h e s e periods of s e v e r e f r u s t r a t i o n and ill humor, Regular Z ü r c h e r knew m o m e n t s of great happiness. T h e s e usually happened during t h e e v e n i n g h o u r s , w h e n s h e w a s u n t r o u b l e d a n d could lose h e r s e l f i n h e r m a t e r n a l m i n i s t r a t i o n s o f h e r child. S h e w a s happy w a t c h i n g the little girl splashing in t h e b a t h t u b , h e a r i n g h e r s h o u t foi |oy ( a i i vii')', her to bed a f t e r w a r d s and praying with h e r , she could enfold the ( hild in her m o t h e r i n g love.

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W h i l e t h e i n t i m a c y o f this m o t h e r - c h i l d r e l a t i o n s h i p m a d e h e r happy, this h a p p i n e s s w a s e n t i r e l y d i f f e r e n t f r o m t h a t w h i c h she felt in the e c s t a s i e s s h e s h a r e d w i t h h e r lover. H a p p i n e s s w i t h t h e child w a s , a s she h e r s e l f said, i n c o m p a r a b l y m o r e placid b u t also m o r e limited, far from t r a n s p o r t and s e l f - s u r r e n d e r . I n h e r loving c o n c e r n for h e r child, R e g u l a Z i i r c h e r had t o c o n t a i n h e r s e l f for t h e sake o f the child, t o a t t e n d o n l y t o t h e child's w a n t s and n e v e r t h i n k o f h e r s e l f . Still, this d e v o t i o n t o h e r child w a s a blessing to h e r . B u t i t w a s precisely t h e isolated m o m e n t s o f deep h a p p i n e s s r e m a i n i n g t o h e r t h a t called u p t h e i m p u l s e s t o stab and s t r a n g l e m o s t p o w e r f u l l y . A s i f t h e y c a m e o u t o f t h e c l e a r blue s k y — s o w e are t o l d — t h e s e d e s t r u c t i v e u r g e s w o u l d d e s c e n d and t h r e a t e n t o c a r r y h e r a w a y . I n n o time a t all t h e y would d e s t r o y t h e i n t i m a c y b e t w e e n m o t h e r and child, from o n e s e c o n d t o t h e n e x t splitting t h e m i n t o p o t e n t i a l m u r d e r e r and p o t e n t i a l v i c t i m . T h e p a t i e n t h e r s e l f could n o t r u n o u t i n t o t h e hall fast e n o u g h , w h e r e , h o r r i f i e d a t h e r s e l f , she w o u l d r e s t r a i n t h e offending right h a n d w i t h t h e left. I f w e a r e t o u n d e r s t a n d this e x t r e m e l y p a t h o l o g i c a l b e h a v i o r solely o n t h e basis o f t h e given s i t u a t i o n and t h e p h e n o m e n a lying b e f o r e u s , w e m u s t first m a k e i t c l e a r t h a t a t n o t i m e could t h e p a t i e n t b e s h o w n t o e x h i b i t a n u n c o n s c i o u s d e a t h w i s h t o w a r d h e r d a u g h t e r . E v e n during t h e h o u r s b e f o r e the e p h e m e r a l m o m e n t s o f h a p p i n e s s w i t h t h e d a u g h t e r , w h e n a m o o d o f d e s p e r a t e and s u f f o c a t i n g a n x i e t y , o f u n b e a r a b l e c o n s t r i c t i o n and c o n s t r a i n t r e i g n e d , n o t h i n g o f t h e p a t i e n t ' s e x i s t e n c e could j u s t i f y s u c h a n a s s u m p t i o n . S h e e x p e r i e n c e d n o death w i s h e i t h e r during t h e happy m o m e n t s , n o r a f t e r w a r d s , w h e n t h e i m p u l s e s t o s t a b and s t r a n g l e o v e r c a m e h e r . E v e n w h e n she was a n n o y e d t o t h e b r e a k i n g point and full o f m a l i c e , s h e n e v e r felt t h e p r e s e n c e o f a n y m a s c u l i n e u r g e to p e n e t r a t e , to s e e k o u t a f e m a l e being for sacrifice to a m a s c u l i n e desire to ravish and v i o l a t e . No t r a c e of s u c h a desire was u n c o v e r e d e i t h e r in the p a t i e n t ' s m o n t h l o n g , m e t i c u l o u s o b s e r v a t i o n o f h e r s e l f o r i n h e r physician's p r o l o n g e d i n v e s t i g a t i o n . F u r t h e r , t h e e x i s t e n c e of a d e a t h w i s h t o w a r d t h e child w o u l d hardly be c o m p a t i b l e w i t h t h e fact t h a t t h e i m p u l s e s to s t a b never a r o s e at t i m e s w h e n t h e child she w a s c a r i n g for s t o o d m o s t i n h e r w a y and should h a v e e v o k e d m o s t s t r o n g l y t h e s e c r e t d e s i r e t o d o a w a y w i t h it. W e h a v e even h e a r d t h a t t h e s e t i m e s o f happy i n t i m a c y b e t w e e n m o t h e r and child, w h i c h w e r e i n h e r l o v e r ' s a b s e n c e predictably f o l l o w e d b y t h e s t a b b i n g impulses, w e r e n e v e r s o free o f t h r e a t e n i n g a n x i e t y a s during t h e periods w h e n s h e could be n e a r an adult l o v e r . It w a s t h e n t h a t c a r i n g for the child w o u l d o f t e n k e e p h e r f r o m b e i n g c o n s t a n t l y w i t h h e r lover, a s she

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w a n t e d t o be. T o seal t h e m a t t e r , h e r l o v e r left n o d o u b t t h a t h e would have preferred her without dependents. T h e r e i s t h e r e f o r e n o need t o w r a c k o u r b r a i n s s e a r c h i n g o u t hidden e x p l a n a t i o n s for t h e p s y c h o p a t h o l o g i c a l c o m p u l s i o n . W e can c o n c e n t r a t e e x c l u s i v e l y o n w h a t could actually b e o b s e r v e d i n t h e patient. W e t u r n first t o the f u n d a m e n t a l a t t u n e m e n t t h a t pervaded h e r w h o l e e x i s t e n c e during the periods w h e n she felt t h e i m p u l s e s t o s t a b and s t r a n g l e . T h i s f u n d a m e n t a l a t t u n e m e n t n e v e r disappeared e n t i r e l y , n o t even i n h e r m o m e n t s of h a p p i n e s s as a m o t h e r , t h o u g h for a little while it w a s n o t t h e m a t i c a l l y h e e d e d . It s h o w e d itself, a c c o r d i n g to t h e p a t i e n t , as a f e a r of s u f f o c a t i n g , an e x t r e m e feeling of being closed in, a c h o k i n g a n x i e t y . O n c e an a t t u n e m e n t like this t a k e s hold, t h i n g s a r e perceived solely in their potential a s prison walls, o r i n s t r u m e n t s o f t o r t u r e and m u r d e r . T h i s p h e n o m e n o n i s a n a l o g o u s t o t h e limitation o f p e r c e p t i o n t h a t o c c u r s in a s e v e r e l y h u n g r y p e r s o n . He sees only w h a t is edible a r o u n d h i m , and of all t h e i r p r o p e r t i e s o n l y that t h e y can be d e v o u r e d . In a similar w a y , o u r patient w a s reduced to e x p e r i e n c i n g h e r w h o l e e n v i r o n m e n t as i m p r i s o n i n g , t h r o t t l i n g , and s u f f o c a t i n g . As s u c h , this e n v i r o n m e n t b e c a m e t h e m o t i v a t i o n o f a violent u r g e t o a t t a c k a n y t h i n g s h e m e t , to b r e a k it up and s m a s h it to pieces. O n l y such a d e s p e r a t e selfd e f e n s e held o u t h o p e t o h e r for r e s c u e f r o m h e r o w n e x i s t e n t i a l s t r a n g u l a t i o n and d e s t r u c t i o n . T o this f r a m e o f mind, s h a r p o b j e c t s — especially k n i v e s — e x e r t e d a n o v e r p o w e r i n g f a s c i n a t i o n . K n i v e s p r e s e n t ­ ed a challenge that threatened to overwhelm her, to engulf her c o m p l e t e l y . T h i s is b e c a u s e i n h e r e n t in e v e r y knife is t h e p o t e n t i a l for u s e a s a n i n s t r u m e n t t o cut t h r o u g h b o n d s , t o b o r e t h r o u g h b a r r i e r s , t o force open w h a t i s locked, and t o kill w h a t t h r e a t e n s t o d e s t r o y . T h e s a m e applied to t h e p a t i e n t ' s o w n h a n d s . In t h e panic of being s t r a n g l e d , a p e r s o n can perceive his o w n h a n d s o n l y a s t h a t part o f h i m s e l f w h i c h can s t r a n g l e t h e a t t a c k e r h i m s e l f and k e e p him f r o m c a r r y i n g o u t his m u r d e r o u s i n t e n t . T h i s a c c o u n t s for t h e t e r r o r o f k n i v e s and o f h e r o w n m u r d e r o u s h a n d t h a t seized h e r w h e n e v e r she felt s u f f o c a t e d . H e r e x i s t e n t i a l a t t u n e m e n t t o e x t r e m e a n x i e t y , and h e r totally i n v o l u n t a r y a b s o r p t i o n i n t o this a t t u n e m e n t , carried w i t h it an e n s l a v e m e n t to a n y i n s t r u m e n t t h a t could b e e m p l o y e d i n s e l f - d e f e n s e t o free h e r from h e r own suffocating imprisonment. D u r i n g t h e w o r s t periods o f h e r p s y c h o n e u r o t i c illness, t h e p a t i e n t s u c c u m b e d t o t h e i m p u l s e s t o stab and s t r a n g l e s o c o m p l e t e l y t h a t s h e was compelled t o t a k e action a g a i n s t a n y t h i n g and e v e r y t h i n g . T h a t t h e s e impulses c a m e m o s t often j u s t w h e n s h e w a s happily and intimately close to h e r child is as clear an indication as we might wish of the c o n s t a n t p r e d o m i n a n c e in h e r e x i s t e n c e ot a lundaiiienl.il a t t u n e -

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m e n t t o a n x i e t y , and a f e a r o f s u f f o c a t i o n . T h i s a t t u n e m e n t was s o p e r v a s i v e t h a t e v e n t h e happy m o o d o f t h e m o t h e r - c h i l d i n t i m a c y was hard put to c o n c e a l it f o r a s h o r t t i m e . H o w did it happen, t h o u g h , t h a t just this happy i n t i m a c y b e t w e e n m o t h e r and child w a s m o s t o f t e n r e s p o n s i b l e for e v o k i n g fresh, p o t e n t w a v e s o f a n x i e t y and t h e p a n i c k y r e s c u e o p e r a t i o n s t h a t followed t h e m ? It w a s so b e c a u s e in this i n t i m a c y R e g u l a Z i i r c h e r g e n u i n e l y loved h e r d a u g h t e r and b e c a u s e this d a u g h t e r was for h e r a n y t h i n g but a n i n d i f f e r e n t o b j e c t or a c r e a t u r e s h e w i s h e d w o u l d go a w a y . B u t at the bottom of her existence there was—as we have established—a constant feeling of being closed in, w i t h a r e s u l t i n g m o o d of c h o k i n g a n x i e t y , so t h a t e v e r y t h i n g a r o u n d h e r a p p e a r e d a s prison w a l l s . T h e c l o s e r t h i n g s c a m e t o h e r , t h e m o r e t h e y t o o k o n the significance o f t h r e a t e n i n g b a r r i e r s and s t r a n g l i n g c h a i n s . C l o s e s t t o h e r o f all w a s h e r little d a u g h t e r . W h e n h e r n e a r n e s s t o t h e child a t b a t h and b e d t i m e p r o c e e d e d to t h e d e e p e s t i n t i m a c y , this v e r y i n t i m a c y had to call f o r t h t h e c a t a s t r o p h i c c h a n g e f r o m h e r f u n d a m e n t a l a n x i e t y , h e r fear o f s u f f o c a t i o n . I n this basic a t t u n e m e n t o f e x t r e m e a l a r m , t h e p a t i e n t would s u d d e n l y perceive h e r g e n u i n e l y beloved child as c h o k i n g , s u f f o c a t i n g , and l e t h a l t o h e r o w n e x i s t e n c e , e x a c t l y b e c a u s e t h e child w a s c l o s e s t t o h e r of all. At Once t h e child b e c a m e s o m e t h i n g to be d e s t r o y e d i m m e d i a t e l y . A t this m o m e n t s h e s u c c u m b e d s o c o m p l e t e l y t o this e x p e r i e n c e o f t h e child t h a t t h e e r u p t i o n o f the u r g e s t o s t a b and s t r a n g l e t h e child can b e c o m p a r e d o n l y t o t h e d e s p e r a t e s t r u g g l e s o f s o m e o n e w h o is being s t r a n g l e d by a m u r d e r e r . T h i s i s h o w R e g u l a Z i i r c h e r ' s u r g e s t o s t a b and s t r a n g l e happened. T h i s is, t h e n , t h e c h a r a c t e r of t h e s e u r g e s as s h e e x p e r i e n c e d it and as it r e v e a l e d i t s e l f t o the u n p r e j u d i c e d p e r c e p t i o n o f h e r p h y s i c i a n . W h a t w e h a v e said s o far m a k e s e v i d e n t n o t o n l y w h a t t h e p a t i e n t ' s p a t h o l o g i c a l c o m p u l s i o n s w e r e not, but also e n a b l e s us to d e s c r i b e t h e i r n a t u r e in a positive m a n n e r . N o t h i n g we h a v e seen j u s t i f i e s t h e opinion t h a t t h e s e p h e n o m e n a derive f r o m s o m e hidden d e a t h i n s t i n c t o r death wish. O n t h e c o n t r a r y , e v e r y t h i n g a r g u e s t h a t t h e y c o r r e s p o n d t o specific h u m a n m o d e s of r e l a t i n g to w h a t e v e r a p e r s o n e n c o u n t e r s in his world, and n o t h i n g m o r e . T h e y a r e just t h a t p a r t i c u l a r m o d e o f o u r patient's ability t o e x i s t . T h e s e u r g e s a r e w h a t h e r blinded e x i s t e n c e , s o n a r r o w l y a t t u n e d in a l a r m , w a s still o p e n to at a p a r t i c u l a r m o m e n t . H e r d e f e n s i v e r e l a t i o n s h i p to t h e w o r l d at t h e s e t i m e s is deeply pathological; it is c h a r a c t e r i z e d by a n e a r l y c o m p l e t e lack of f r e e d o m . W h a t actually w a s s e e n t o o c c u r i n t h e patient e x p o s e s psychological p r e s u p p o s i t i o n s and h y p o t h e s e s c o n c e r n i n g an u n c o n s c i o u s death w i s h o r a n a m b i v a l e n c e b e t w e e n t w o conflicting, q a u s i - c o n s c i o u s endopsychii

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drives o r t e n d e n c i e s t o w a r d t h e child a s g r o u n d l e s s fabrication. T h e s e h y p o t h e s e s n o t o n l y lack t h e capacity t o clarify t h e actual p h e n o m e n a (and are t h e r e f o r e s u p e r f l u o u s ) , but t h e y a c t u a l l y distort o u r vision o f the peculiar n a t u r e o f t h e s e i m p u l s e s . T h e p a t i e n t ' s i n v o l u n t a r y s u r r e n d e r t o t h e u r g e t o act a g a i n s t t h e child n e a r h e r and t h e d e f e n s i v e - c o m p u l s i v e a c t i v i t y following upon t h e m i s a p p r e h e n s i o n of t h e child are specific, p r i m a r y m o d e s of relating and t h e r e f o r e c a n n o t b e derived f r o m a n y t h i n g e l s e . T h e s a m e can b e said for all the patient's w a n t s and d e s i r e s . J u s t as t h e r e is no s u c c u m b i n g e x c e p t to s o m e t h i n g , so also w a n t i n g and w i s h i n g m u s t be directed t o w a r d t h i n g s . Impulsive and c o m p u l s i v e s u r r e n d e r , w a n t i n g and desiring— t h e s e a r e all d i f f e r e n t but equally e l e m e n t a r y possibilities of b e h a v i n g in relation to s o m e t h i n g t h a t e n c o u n t e r s a h u m a n being. A h u m a n e x i s t e n c e can e n t e r i n t o a n y o n e o f t h e s e w a y s o f relating, j u s t a s i t can e n t e r into a n y o n e o f t h e h u n d r e d s o f o t h e r m o d e s o f b e h a v i o r t h a t c o n s t i t u t e t h e e x i s t e n c e of a p e r s o n . W i s h i n g and desiring p r e s u p p o s e a c o n s i d e r a b l e m e a s u r e of f r e e d o m . We could n e v e r speak of a wish or desire in c o n n e c t i o n w i t h the p a t i e n t ' s u r g e to s t a b and s t r a n g l e h e r child, b e c a u s e this freedom was simply n o t available t o t h e p a t i e n t w h e n she s u c c u m b e d t o h e r a c u t e fear and a n x i e t y . W h a t t h e p a t i e n t actually e x p e r i e n c e d w a s , r a t h e r , initially a brief and r e l a t i v e l y free period of h a p p i n e s s during w h i c h s h e w a s p e r m i t t e d t o love t h e child, t h e n a n a l m o s t e n t i r e l y u n f r e e urge t o s t a b and s t r a n g l e t h e child, and finally flight f r o m c o m m i t t i n g t h e m u r d e r , l a b o r i o u s l y a c h i e v e d w i t h t h e small r e m n a n t o f freedom r e m a i n i n g t o h e r . A n y t h i n g e x t r a added t o t h e s e t h r e e equally e l e m e n t a r y , yet radically d i f f e r e n t , m o d e s o f b e h a v i o r s h o w s i n t h e light o f faithful observation as psychological invention. It is a r e n u n c i a t i o n of s t r i c t scientific t h i n k i n g n o t to distinguish c l e a r l y b e t w e e n a n impulsive, i n v o l u n t a r y s u r r e n d e r t o s o m e t h i n g and a n a c t i v e wish or desire for t h a t t h i n g . It is j u s t as u n s c i e n t i f i c to c o n f u s e o n e of t h e t h r e e m o d e s o f b e h a v i o r n a m e d a b o v e w i t h a n o t h e r , o r t o derive o n e from a n o t h e r and t h e r e b y c o n f o u n d all t h r e e . A p s y c h o l o g y s t r a y s e v e n f a r t h e r from a scientific m e t h o d of i n v e s t i g a t i o n w h e n it tries to derive an immediately obvious compulsion to stab from unconscious desires or i n s t i n c t s . W e s h o w e d this earlier w h e n w e p o i n t e d o u t t h e i n h e r e n t c o n t r a d i c t i o n in such e x p l a n a t i o n s . If a n y t h i n g a b o u t o u r p a t i e n t ' s i m p u l s e s to s t a b and s t r a n g l e m i g h t be labeled u n c o n s c i o u s , it is t h e fact t h a t in s u c c u m b i n g to t h e s e u r g e s she was unable to t h i n k specifically a b o u t t h e i r e s s e n t i a l c o n n e c t i o n to h e r p r e d o m i n a n i a t t u n e m e n t , the fear of suffocating,, ["his c o n n e c t i o n was available to hei in an u n t h e m a t i c w a y . But the m e r e fa< I thai she was not

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t h i n k i n g t h e m a t i c a l l y a b o u t s o m e t h i n g available to h e r is still a long way f r o m j u s t i f y i n g t h e s u p p o s i t i o n of a d y n a m i c u n c o n s c i o u s o p e r a t i n g within her. It is a n o t h e r m a t t e r e n t i r e l y to decide j u s t w h a t in t h e p a t i e n t ' s life impelled h e r to a p a t h o l o g i c a l a t t u n e m e n t and a r e d u c t i o n of h e r e x i s t e n t i a l possibilities, b u t n o m a t t e r h o w c o m p l e t e t h e list o f m o t i v a t i o n s for a p a t h o l o g i c a l r e d u c t i o n of an e x i s t e n c e to a single m o d e o f b e h a v i o r , i t still c o n t r i b u t e s n o t h i n g t o a n u n d e r s t a n d i n g o f t h a t o n e remaining mode. T h e q u e s t i o n still r e m a i n s w h y , for s u c h a long t i m e a f t e r t h e c o n c l u s i o n o f p s y c h o t h e r a p y , R e g u l a Z ü r c h e r could feel free o f t h e i m p u l s e s t o s t a b o n l y w h e n h e r s i t u a t i o n allowed h e r t o live w i t h a m a n she loved. D o e s n ' t this s t a t e of affairs indicate t h e p e r s i s t e n c e of a n e u r o t i c f i x a t i o n ? Y e t aside f r o m h e r fully r e c o g n i z e d d e p e n d e n c e on t h e physical p r e s e n c e o f a l o v e r , t h e r e w a s n o w n o part o f h e r w o r l d t o w h i c h she had n o t w o n a free r e l a t i o n s h i p . P s y c h o a n a l y t i c t h e o r y likes to link u r g e s and c o m p u l s i o n s t o w h a t i t t e r m s anal e r o t i c i s m , b u t R e g u l a Z ü r c h e r had for s o m e t i m e b e e n able t o r e l a t e freely t o t h e e a r t h y , fecal, bodily, and a n i m a l r e a l m s . F o r y e a r s s h e had b e e n free o f t h e i n t e s t i n a l problems which psychoanalytic theory regularly—and unjustifiably— a t t r i b u t e s t o r e g r e s s i o n t o a n a n a l - e r o t i c libidinal s t a g e . W h y i s i t t h a t m e r e l y t h i n k i n g o f t h e m a n s h e loved and i m a g i n i n g a n e c s t a t i c u n i o n w i t h him w a s n o t sufficient t o keep R e g u l a Z ü r c h e r free o f t h e u r g e t o s t a b ? W h y did s h e c o n t i n u e for y e a r s t o r e q u i r e t h e physical presence of a male lover in order to remain healthy? T h e r e are many c a s e s of p s y c h o n e u r o t i c a l l y ill people w h o e n t e r t h e r a p y s u f f e r i n g f r o m a similar lack of f r e e d o m and n e e d i n g s e x u a l e c s t a s y as o f t e n as she did. P s y c h i a t r y m i s t a k e n l y classifies m o s t o f t h e s e a s c o n s t i t u t i o n a l l y hypersexual, instinct-enslaved psychopaths. Yet in the course of therapy m a n y o f t h e s e p a t i e n t s c o m p l e t e l y relinquish t h e i r h y p e r s e x u a l b e h a v i o r . T h e y d i s c o v e r t h a t t h e i r feelings had b e e n n e u r o t i c a l l y fixed in a w a y t h a t r e s t r i c t e d t h e i r r e l a t i o n s h i p w i t h p a r t n e r s of t h e o p p o s i t e sex to a physical c o m m u n i o n o f g e n i t a l s . T o c o n f i n e h u m a n e o e x i s t e n c e t o its p h y s i c a l - s e n s u a l c o m p o n e n t has t h e e f f e c t o f e x a g g e r a t i n g and inflating the i m p o r t a n c e o f t h e bodily g e n i t a l r e g i o n o f t h e i r e x i s t e n c e . B u t t o the e x t e n t t h a t t h e i r e x i s t e n c e s o p e n up in t h e c o u r s e of t h e r a p y to a full h u m a n b e i n g - t o g e t h e r w h i c h can e m c o m p a s s t h e w h o l e realm o f possibilities for r e l a t i n g , t h e i r e n s l a v e m e n t t o p h y s i c a l - s e n s u a l c o m m u n i o n — t h e i r so-called c o n s t i t u t i o n a l h y p e r s e x u a l i t y — u s m a r k e d ly r e d u c e d . B u t this s o r t of d e v e l o p m e n t n e v e r o c c u r r e d in the first place with R e g u l a Z ü r c h e r . S h e w a s n e v e r able to reach sexual o r g a s m wil houl I n ••!

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i m m e r s i n g h e r s e l f c o m p l e t e l y in a loving u n i o n w i t h h e r p a r t n e r . S h e reports that m a n y of the w o m e n she knows, on the other hand, practice s e x u a l self-denial and e f f o r t l e s s l y r e n o u n c e e r o t i c , s e n s u a l e c s t a s y . T h e s e friends c o n s i d e r t h e m s e l v e s less s t r o n g l y inclined t o s e n s u a l i t y and are t h e r e f o r e c o n s t i t u t i o n a l l y alien t o t h e kind o f e c s t a t i c r e l e a s e , t h e " b e i n g beside o n e s e l f , " o u r t e s t s u b j e c t e x p e r i e n c e d . R e g u l a Z ü r c h e r k n o w s o t h e r w o m e n w h o h a v e b e e n happily m a r r i e d t o t h e s a m e m a n for y e a r s t h o u g h t h e i r s e x u a l i n t i m a c i e s n e v e r end o n a m o r e t h a n moderately exciting note. In any case, their orgasms never induce the e c s t a t i c e s c a p e f r o m all limits and c o n f i n e s w h i c h R e g u l a Z ü r c h e r e x p e r i e n c e d i n h e r s . R e g u l a Z ü r c h e r f o u g h t a g a i n s t t h e idea t h a t t h e s e f u n d a m e n t a l l y d i f f e r e n t w o m e n , w h o m she liked t o call " t h e pillars o f s o c i e t y , " w e r e s o m e h o w h e a l t h i e r and w o r t h i e r t h a n s h e . I t w a s , and still is, h e r opinion t h a t t h e s e w o m e n w e r e simply f o r t u n a t e — a n d limited— e n o u g h by n a t u r e to be shielded m o r e solidly a g a i n s t perceiving a r e a s of reality t h a t e x t e n d b e y o n d t h e n a r r o w day t o day. P e r h a p s we still need to ask if R e g u l a Z ü r c h e r ' s c o n t i n u e d d e p e n d e n c e on a physically p r e s e n t l o v e r m i g h t n o t h a v e r e s u l t e d from a failure to work through her aggressiveness in psychotherapy, to extricate it from r e p r e s s i o n . In o t h e r w o r d s , w a s t h e i m p u l s e to s t a b simply a c a s e of i n n a t e a g g r e s s i v e i n s t i n c t s a c c u m u l a t i n g u n d e r inhibition until t h e y had to erupt? Y e t the patient's entirely open—and often very aggressive— b e h a v i o r t o w a r d b o t h h e r f a t h e r and h e r first h u s b a n d e x e m p t s h e r f r o m categorization as an aggression-inhibited woman. Countless sessions spent discussing t h e a g g r e s s i v e irritability t h a t plagued h e r during periods o f f r u s t r a t i o n g a v e h e r n o relief, e v e n w h e n this irritability w a s c o n s t a n t l y c o n n e c t e d w i t h a t t u n e m e n t s appearing earlier i n h e r life. Equally u n r e w a r d i n g w e r e allusions t o t h e possibility o f g a i n i n g m o r e open r e l a t i o n s h i p s t o h e r a t t u n e m e n t s and l e a r n i n g t o relinquish t h e n e e d for i m m e d i a t e , physical fulfillment o f t h e u r g e s a t t e n d i n g t h e s e a t t u n e m e n t s . N o n e o f t h e s e u n r e m i t t i n g e f f o r t s t o help t h e p a t i e n t w o r k t h r o u g h h e r a g g r e s s i v e n e s s kept h e r from being o v e r c o m e b y irritability w h e n she had to live w i t h o u t a s e x u a l p a r t n e r . S h e r e s p o n d e d to all q u e s t i o n s in this a r e a by asking in t u r n w h e t h e r t h e a n a l y s t m i g h t n o t also t h r a s h a b o u t i f h e w e r e being c h o k e d b y s o m e o n e . I f h e a n s w e r e d yes, he t o o would h a v e to be classified as n e u r o t i c a l l y o b s e s s e d , full of death i n s t i n c t s , and d e p e n d e n t o n s o m e t h i n g o u t s i d e o f h i m s e l f : t h e o x y g e n he m u s t b r e a t h all his life from t h e a t m o s p h e r e a r o u n d him. C o n s e q u e n t l y , t h e h y p o t h e s i s t h a t inhibited, a c c u m u l a t e d a g g r e s s i v e i i r . t u n K were r e s p o n s i b l e for the patient's impulses to Stab does not si and up under close s c r u t i n y . B u t p e r h a p s we h a v e been too hasty in also reje< ting the second c o m m o n t h e o r e t i c a l a s s u m p t i o n 1 rom hei reading

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o f p s y c h o a n a l y t i c l i t e r a t u r e , t h e p a t i e n t had l e a r n e d t h a t t h e r e m i g h t b e something homosexual operating in her impulses to stab. Perhaps we should no l o n g e r r e s t r i c t this h o m o s e x u a l a s p e c t to a p r e c o n c e i v e d t h e o r e t i c a l c o n s t r u c t like t h a t o f c o r r e s p o n d i n g partial i n s t i n c t s . I f w e b r o a d e n o u r c o n c e p t i o n o f p h a l l i c - h o m o s e x u a l t e n d e n c i e s t o include m o r e t h a n j u s t a c o n c r e t e d e s i r e to act using a m o r e or less disguised male g e n i t a l , w e m i g h t b e able t o s e e t h e p a t i e n t ' s h o m o s e x u a l aspect solely i n relation to an unconscious, predominantly masculine-active, penetrating p e r s o n a l i t y . W e m i g h t b e able t o say t h a t w h e n e v e r R e g u l a Z ü r c h e r did n o t h a v e a m a n to act as h e r l o v e r , s h e simply a s s u m e d t h e m a s c u l i n e role h e r s e l f , h e r o t h e r w i s e l a t e n t h o m o s e x u a l i t y o v e r w h e l m i n g h e r and a c t i v e l y u r g i n g h e r t o s t a b . M i g h t n o t simply m a k i n g h e r fully a w a r e o f t h e n a t u r e o f h e r p h a l l i c - h o m o s e x u a l a t t i t u d e b e e n o u g h t o free h e r f r o m t h e i m p u l s e s t h a t afflicted h e r during t i m e s o f l o n e l i n e s s ? U n f o r t u n a t e l y for t h e t h e o r i e s , t h e p a t i e n t ' s p e r s o n a l e x p e r i e n c e s t a n d s d i a m e t r i c a l l y o p p o s e d t o s o l u t i o n s o f this kind. E v e n w h i l e c a r r i e d a w a y b y t h e i m p u l s e s t o stab, she r e m a i n e d totally c o n s c i o u s o f b e i n g f e m a l e . N o t o n c e did s h e feel t h e least bit m o r e m a s c u l i n e t h a n b e f o r e . T o all o f t h e a n a l y s t ' s h i n t s i n this d i r e c t i o n she posed t h e s a m e d i s a r m i n g q u e s t i o n s h e had used b e f o r e a g a i n s t allusions t o t h e p e r s i s t e n c e o f r e p r e s s e d a g g r e s s i v e i n s t i n c t s . S h e simply asked t h e a n a l y s t i f t h e r e w a s really a n y s e n s e i n w o r r y i n g a b o u t t h e g e n d e r o r s e x u a l o r i e n t a t i o n o f s o m e o n e w h o was t h r a s h i n g a b o u t while being s t r a n g l e d . S h e f o u n d his q u e s t i o n s r e l a t i n g t o t h e phallic, m a s c u l i n e - h o m o s e x u a l aspect o f h e r impulses t o s t a b h e r d a u g h t e r equally a b s u r d . T h e p a t i e n t ' s r e l a t i o n s h i p to h e r o w n past provides a first clue to an u n d e r s t a n d i n g o f w h y she r e m a i n e d s o long i n d a n g e r o f relapsing i n t o the u r g e t o s t a b . A t t h e c l o s e o f h e r p s y c h i a t r i c t r e a t m e n t , s h e r e p o r t e d seeing h e r s e l f as a w o m a n a l m o s t e n t i r e l y devoid of a past. A c h i l d h o o d e n v i r o n m e n t e x t r e m e l y antagonistic to her nature alienated her from h e r s e l f , f o r c i n g h e r to lead a false, s h a d o w e x i s t e n c e . S h e claimed to h a v e v e r y little i n c o m m o n w i t h t h e y o u n g p e r s o n she had b e e n t h e n . T h a t y o u n g girl, s h e insisted, w a s s o m e o n e o t h e r t h a n R e g u l a Z ü r c h e r , w h o was n o t e v e n b o r n until she b e g a n p s y c h o a n a l y s i s . T h e p a t i e n t w a s i n fact e x p r e s s i n g h e r a p p a r e n t lack o f a n y s o u n d footing in a p e r s o n a l past to w h i c h s h e m i g h t t u r n for s u p p o r t w h e n e v e r the p r e s e n t w a s n o t e n o u g h f o r h e r . T h i s deficiency helps explain w h y she so d e s p e r a t e l y needed to be t o g e t h e r physically w i t h a m a l e l o v e r . I h e r e is little h o p e t h a t she will e v e r r e c o v e r t h e past t h a t p a r e n t a l discipline p r e v e n t e d h e r from e x p e r i e n c i n g f i r s t h a n d . Still, t h e l o n g e r she can b e n e f i t from t h e n e w b e g i n n i n g that a d a s e i n s a n a l y t i c t r e a t m e n t made p o s s i b l e — t h e l o n g e r s h e can untold her e x i s t e n c e by c a r r y i n g to

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fulfillment t h e possibilities o f b e h a v i n g and r e l a t i n g t h a t are specifically h e r o w n — t h e m o r e s h e will h a v e a past o f h e r o w n i n t o w h i c h h e r e x i s t e n c e e x t e n d s . T o a c o r r e s p o n d i n g d e g r e e s h e will b e m o r e o p e n for h e r o w n p a r t i c u l a r w a y o f allowing t h i n g s t o approach h e r . I n s h o r t , s h e will h a v e a w e a l t h of h e r o w n past to rely on and an i n d e p e n d e n t f u t u r e to r e a c h i n t o . B o t h o f t h e s e d i m e n s i o n s will provide h e r w i t h s u p p o r t . G r o w i n g i n i n d e p e n d e n c e and s e l f - r e l i a n c e , h e r e x i s t e n c e will b e c o m e m o r e and m o r e t h a t o f a h e a l t h y and m a t u r e h u m a n being w h o s p a n s s i m u l t a n e o u s l y , o p e n and free, a past, p r e s e n t , a n d f u t u r e of its o w n . In fact, the m o r e R e g u l a Z i i r c h e r was able to gain a p e r s o n a l past a f t e r h e r t h e r a p y had ended, the m o r e deeply and s e c u r e l y she felt h e r s e l f " g r o w i n t o a realm t h a t could s u p p o r t h e r r o o t s . " T h e d a n g e r o f b e i n g o v e r w h e l m e d b y h e r u r g e s and c o m p u l s i o n s d e c r e a s e d c o r r e s p o n d i n g l y , e v e n w h e n s h e had t o g o for long t i m e s w i t h o u t s e x u a l love.

The knife hallucinations Shortly before her therapy began, the patient returned from an especially long s t a y w i t h h e r little d a u g h t e r in a r e m o t e c o t t a g e in t h e S w i s s Alps w h e r e s h e had b e e n m o r e t h a n e v e r b e f o r e cut o f f f r o m all o t h e r h u m a n c o n t a c t . H e r o n l y s p h e r e o f a c t i v i t y c o n s i s t e d i n caring for t h e child and c l e a n i n g t h e little h o u s e . S h e could n o t e v e n g o o n h i k e s o f m o d e r a t e l e n g t h b e c a u s e t h e child w a s still t o o small e i t h e r t o b e t a k e n along o r left a l o n e a t h o m e . T h e m i n u t e w o r l d o f t h e p a t i e n t ' s p r e s e n t m i r r o r e d t h e c o n s t r i c t i o n o f h e r f u t u r e : a s a c o n s e q u e n c e o f h e r legal ties t o a n i n a d e q u a t e h u s b a n d , she s a w a n e x t r e m e l y n a r r o w scope for t h e unfolding o f h e r e x i s t e n c e . H e r past w a s equally c o n s t r i c t e d . S h e had n o m e m o r i e s o f t i m e s w h e n she had b e e n able t o c o m m i t h e r s e l f i n r e l a t i o n to t h i n g s and people in a w a y all h e r o w n . T h e p s e u d o m o r a l p r e s s u r e of h e r u p b r i n g i n g had left h e r a c r e a t u r e living e x c l u s i v e l y in forbidden, or h i g h l y r e s t r a i n e d , r e l a t i o n s h i p s t o w h a t she e n c o u n t e r e d . I n t h a t she w a s n o t s e l f - r e l i a n t s h e felt h e r self shrivel, during t h a t s u m m e r v a c a t i o n , i n a n u n b e a r a b l y n a r r o w prison cell. T h e walls o f t h e c o t t a g e , t h e m o u n t a i n s i n f r o n t o f t h e w i n d o w s , t h e daily r o u t i n e o f h e r h o u s e h o l d c h o r e s , and t h e d e m a n d s of caring for a small child r e v e a l e d to h e r o n l y o n e o f t h e i r s i g n i f i c a n c e s , t h a t c h a r a c t e r o f limiting, s t r a n g l i n g , suffocating. Corresponding to her misperception of them as murderous, t h e y p r o v o k e d h e r i r r e s i s t i b l y i n t o a v i o l e n t , despairing s t r u g g l e to b r e a k free. We h a v e already discussed h o w this s t a t e i n e v i t a b l y led to her urge to s t a b and s t r a n g l e h e r child. Up to this point, all hci a c t i o n s w e r e c o n c e r n e d with knives such as would be available, in I he same way and at the same location, to any w a k i n g , h e a l t h y h u m a n being Bui then o n e

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p h e n o m e n o n a r o s e t h a t falls i n t o t h e p s y c h i a t r i c c a t e g o r y o f illusion. T h e patient b e g a n t o m i s t a k e sparkling facets o f c e r t a i n o b j e c t s for k n i v e s . A f t e r a time she s a w k n i v e s w h e r e a h e a l t h y p e r s o n w o u l d see n o t even a h i n t o f a n y t h i n g knifelike i n t h e vicinity. T h e s y m p t o m had passed f r o m illusion i n t o t r u e h a l l u c i n a t i o n . K n i v e s w e r e s e n s e - p e r c e p t i b l e t o h e r i n places w h e r e for o t h e r s t h e r e w a s o n l y air. A n d R e g u l a Z i i r c h e r s u c c u m b e d as well to t h e s e h a l l u c i n a t e d k n i v e s . J u s t like t h e real k n i v e s , the h a l l u c i n a t i o n s left h e r n o c h o i c e b u t t o g r a b t h e m and s t a b wildly. T h e r e i s n o point i n a r g u i n g h e r e w h e t h e r t h e s e p h e n o m e n a should b e called h y s t e r i c a l o r already s c h i z o p h r e n i c . T h e phenomenological view attaches great importance, however, to t h e o b s e r v a t i o n t h a t t h e knife h a l l u c i n a t i o n s c a m e t o t h e p a t i e n t a t t i m e s w h e n t h e scope o f h e r life w a s a t its m i n i m u m and h e r e x i s t e n t i a l a t t u n e m e n t t o a n x i e t y and c o n f i n e m e n t a t its m a x i m u m . A l s o , i t had b e c o m e a p p a r e n t t h a t t h e p a t i e n t ' s m a t u r i n g had b e e n a r r e s t e d at a s t a g e of helpless, childish d e p e n d e n c e on t h e p a r e n t s . S h e w a s still far f r o m a selfhood o f significant a u t o n o m y and e n d u r a n c e . I n this s t a t e , h e r e x i s t e n c e w a s reduced, w h e n e v e r t h e u r g e s o v e r c a m e h e r , a l m o s t e n t i r e l y to a single r e l a t i o n s h i p c o n s i s t i n g in a v i o l e n t a t t e m p t to t e a r d o w n b a r r i e r s and b r e a k free o f t h e s u f f o c a t i n g c o n f i n e m e n t o f h e r world. As long as h e r selfhood w a s so fragile and u n r e s i s t i n g it w a s inevitable t h a t she fall p r e y t o t h e o n e m o d e o f b e h a v i o r still r e m a i n i n g o p e n t o h e r : blind, r e f l e x i v e s e l f - d e f e n s e . T h e l o n g e r t h e c o n f i n e m e n t p e r s i s t e d — t h e s m a l l e r and m o r e l o n e l y h e r w o r l d b e c a m e — t h e m o r e c o m p l e t e l y w o u l d she s u r r e n d e r t o this m o d e and b e c o m e a b s o r b e d i n t o it. W h e n it had r e a c h e d a c e r t a i n i n t e n s i t y , this w a y of c o n n e c t i n g w i t h the w o r l d gave rise o u t of i t s e l f to h a l l u c i n a t e d t h i n g s t h a t could be used for d e f e n s e and escape. S h e could s e e and feel t h e m , t h e r e , w h e r e h e a l t h y h u m a n b e i n g s could see n o t h i n g . S h a r p k n i v e s c o r r e s p o n d e d m o s t e x a c t l y t o t h e w a y o f b e i n g i n w h i c h s h e e x i s t e d , h e r selfhood totally lost, outside h e r s e l f . A knife could free h e r from t h e m o s t s t r a n g l i n g , c o n f i n i n g — m o s t , b e c a u s e it w a s t h e c l o s e s t — b o n d of all, t h e child she loved. THE PSYCHOSOMATIC AND SOMATOPSYCHIC SYMPTOMS

The hysterical paralysis of the leg I n t h e middle o f t h e c o u r s e o f h e r d a s e i n s a n a l y t i c t r e a t m e n t , R e g u l a Z ü r c h e r w a s s t r i c k e n w i t h h y s t e r i c a l paralysis o f t h e legs. S h e collapsed w h e n s h e s a w a p p r o a c h i n g on t h e o t h e r side of the s t r e e t a m a n she had met a few days b e f o r e at a c o c k t a i l p a r t y . At first sight, he waked s t r a n g e , e x c i t i n g feelings in h e r . S h e w a s taken by an a n x i e t y by no m e a n s mild and was glad to flee to t h e s a f e t y of her own tour walls.

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T o a k n o w l e d g e a b l e p e r s o n , this n e w r e s p o n s i v e o p e n n e s s t o t h e y o u n g m a n and h e r fear of his a p p r o a c h w o u l d signify an early p s y c h o t h e r a p e u t i c s u c c e s s , for b o t h r e a c t i o n s r e v e a l a c e r t a i n b r o a d e n ­ ing of R e g u l a Z i i r c h e r ' s e x i s t e n c e . S h e w a s n o w a b l e , if o n l y in a r e m o t e w a y , to perceive a m a n as a m a n ; t h a t is, as a possible p a r t n e r in s e x u a l love. T h e m a n would o t h e r w i s e n e v e r h a v e affected h e r i n such a n e x c i t i n g and f r i g h t e n i n g w a y . O n l y briefly in e a r l y p u b e r t y had s h e e x p e r i e n c e d a similar o p e n i n g and been able to e n t e r f o r a s h o r t t i m e i n t o r e l a t i o n s h i p s w i t h m a l e p e e r s t h a t w e r e t a n t a l i z i n g and e r o t i c a l l y tinged. B u t h e r p a r e n t ' s r e p r e s s i v e m e a s u r e s , applied w i t h r e d o u b l e d e f f o r t , quickly and c o m p l e t e l y buried all o f t h e p a t i e n t ' s e m e r g i n g possibilities for l o v e . T h u s i t c a m e a b o u t t h a t , from p u b e r t y until t h e birth o f h e r child, m e n could n o t b e p r e s e n t i n h e r w o r l d a s w h o l e m e n . All o f t h e m , including h e r h u s b a n d , s e e m e d t o h e r t o b e m a d e o f i n a n i m a t e m a t t e r from t h e w a i s t d o w n . W h e n e v e r m e n p r e s s e d h e r w i t h t h e i r u r g e s for s e x u a l c o n t a c t , t h e y s e e m e d like w o o d e n puppets w i t h o u t s e x u a l o r g a n s . I n t h e r a p e u t i c s e s s i o n s a f t e r t h e paralysis o f h e r legs, t h e p a t i e n t b e c a m e m o r e deeply a w a r e t h a n e v e r o f h o w e n s l a v e d she r e m a i n e d t o her mother's mentality. S h e recognized that her dependent imprison­ m e n t w i t h i n this alien life style forced h e r to misidentify m e n as e x t r e m e l y i n d e c e n t , forbidden, d a n g e r o u s , and sinful c r e a t u r e s . T h u s she could r e s p o n d t o t h e y o u n g m a n w h o a p p r o a c h e d h e r and called o u t for h e r t o c r o s s t h e s t r e e t t o h i m o n l y b y holding b a c k and r e t r e a t i n g f r o m his a t t r a c t i o n . T h e i n s t a n t she c a u g h t s i g h t o f h i m , i n o t h e r w o r d s , R e g u l a Z i i r c h e r ' s e n t i r e e x i s t e n c e fell i n t o a c o n t r a d i c t o r y r e l a t i o n s h i p m a d e u p o f a n u r g e o v e r t o h i m and o n e a w a y from h i m . T o b e s i m u l t a n e o u s l y d r a w n t o w a r d and also pulled a w a y from s o m e t h i n g m e a n s t o b e u n a b l e t o m o v e f r o m t h e spot, t o b e paralyzed. O n l y something that can perceive a meaningful address from a n o t h e r being and—depending on t h e r e s p o n s e or lack of it to this a d d r e s s — e i t h e r be m o t i v a t e d to m o v e t o w a r d or a w a y f r o m its s o u r c e is in a position to be paralyzed. A rolling s t o n e t h a t is s u d d e n t l y s t o p p e d c a n n o t be called paralyzed. B u t w h y did t h e p a t i e n t ' s s i m u l t a n e o u s a t t r a c t i o n and r e p u l s i o n t a k e t h e form o f a physical, h y s t e r i c a l p a r a l y s i s ? W h y w e r e t h e y n o t c o n s i d e r e d freely i n a n o p e n and c o n s c i o u s d e l i b e r a t i o n ? T h e h y s t e r i c a l paralysis o f t h e legs had t o o c c u r b e c a u s e t h e p a t i e n t was still totally u n f r e e and d e p e n d e n t i n r e l a t i o n t o b o t h o f t h e s e c o n t r a d i c t o r y m o d e s o f c o n d u c t t o w a r d t h e y o u n g m a n . S h e had not appropriated t h e s e possibilities a s h e r o w n ; t h e y w e r e n o t u n d e r h e r c o n t r o l R a t h e r , she w a s so c o m p l e t e l y ruled by t h e c o n t r a d i c t o r y r e l a t i o n s h i p to the y o u n g man

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t h a t s h e w a s w r e n c h e d i n t o it w i t h o u t willing it, w i s h i n g it, or t h i n k i n g it. S h e could c a r r y o u t this r e l a t i o n s h i p o n l y dully and u n t h e m a t i c a l l y in t h e bodily r e a l m o f h e r e x i s t e n c e . T h i s e x p l a i n s w h y s h e did n o t simply stand h y s t e r i c a l l y r o o t e d to t h e s p o t . S u c h a spastic paralysis w o u l d c o r r e s p o n d t o t h e n e u r o t i c bodying f o r t h o f a m u c h m o r e v i g o r o u s and less n e u r o t i c a l l y r e d u c e d r e l a t i o n s h i p t o the w o r l d t h a n t h a t o f R e g u l a Zürcher. Her surrender to the conflicting urges regarding the young m a n held h e r e n t i r e e x i s t e n c e s o s p e l l b o u n d t h a t s h e w a s r o b b e d o f a n y ability to s t a n d on h e r o w n . S h e lived o u t this loss as t h e physical collapse. T h e paralysis involved h e r l e g s b e c a u s e t h e y are w h a t c a r r y o u t bodily a n a p p r o a c h t o , or a flight f r o m , s o m e t h i n g . W h a t i s o f decisive i m p o r t a n c e i s t h a t t h e c o n t r a d i c t o r y r e l a t i o n s h i p t o t h e y o u n g m a n , and j u s t t h a t , w a s carried o u t directly in and as the h y s t e r i c a l paralysis. T h e r e i s n o t h i n g t o s u p p o r t t h e m e t a p s y c h o l o g i c a l introduction of an endopsychic conflict between an unconscious, erotic desire f o r t h e m a n and a n equally u n c o n s c i o u s , p s e u d o m o r a l p r o h i b i t i o n o f this d e s i r e . A s w i t h t h e u r g e s t o s t a b and s t r a n g l e , t h e r e w a s n e v e r a n y e v i d e n c e in t h e h y s t e r i c a l paralysis to s u g g e s t an a c t u a l wish to a p p r o a c h t h e m a n or a compunction to flee f r o m his p r e s e n c e . I n s t e a d , t h e p a t i e n t ' s contradictory relationship to the young man occurred from the b e g i n n i n g o n l y w i t h i n t h e bodily s p h e r e o f this n e u r o t i c a l l y r e d u c e d e x i s t e n c e as t h e h y s t e r i c a l paralysis of t h e legs. It w a s ifse//the i m m e d i a t e fulfillment o f h e r p a t h o l o g i c a l r e l a t i o n s h i p t o h i m . S h e e v i d e n c e d n o prior o r s i m u l t a n e o u s p s y c h i c d e s i r e s o r c o m p u n c t i o n s w i t h r e g a r d t o t h e y o u n g m a n . In fact, as we p o i n t e d o u t in o u r d i s c u s s i o n of c o m p u l s i v e p h e n o m e n a , it is f u n d a m e n t a l l y i m p o s s i b l e for h y s t e r i c a l s y m p t o m s to appear w h e n a p e r s o n is g e n u i n e l y able to wish, to will s o m e t h i n g , or to judge. T h e m e r e fact of w i s h i n g or i m p o s i n g a m o r a l j u d g m e n t implies a c e r t a i n a m o u n t o f f r e e d o m w i t h r e s p e c t t o w h a t i s w i s h e d for o r judged; and this f r e e d o m is n o t p r e s e n t in any h y s t e r i c a l s u c c u m b i n g to t h e e n t i t i e s in q u e s t i o n . T h i s fact would n o t be a l t e r e d in t h e least e v e n if t h e paradoxical u n c o n s c i o u s d e s i r e o r m o r a l c o m p u n c t i o n really did e x i s t . T o the c o m m o n m e t a p s y c h o l o g i c a l s u p p o s i t i o n t h a t h y s t e r i c a l s y m p t o m s o r i g i n a t e w h e n e v e r e n d o p s y c h i c conflict has b e e n r e p r e s s e d into the u n c o n s c i o u s , w e m a y apply t h e s a m e c r i t i c i s m w e m o u n t e d i n o u r discussion o f t h e p a t i e n t ' s u r g e s t o stab. S u c h e n d o p s y c h i c e n t i t i e s are nothing m o r e than undemonstrable, arbitrary inventions. A n e x i s t e n t i a l e x a m i n a t i o n o f t h e facts o f h y s t e r i c a l p h e n o m e n a r e q u i r e s a scientific w a y o f t h i n k i n g t h a t can m a k e s h a r p d i s t i n c t i o n s a m o n g t h e m a n y m o d e s o f h u m a n r e l a t i o n s h i p s t o t h e world. First o l all, we should r e m a i n c o n s t a n t l y a w a r e t h a t bodying f o r t h , l o n g i n g for, and w a n t i n g a r e t h r e e f u n d a m e n t a l l y d i f f e r e n t , yet equally p r i m a r y , m o d e s

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of realizing possibilities of r e l a t i n g to w h a t a p e r s o n e n c o u n t e r s in his world. F o r i n s t a n c e , R e g u l a Z i i r c h e r ' s r e s p o n s e t o t h e a t t r a c t i o n she felt to t h e y o u n g m a n w o u l d h a v e b e e n o n l y bodily if she had u n t h i n k i n g l y and u n t h e m a t i c a l l y h u r r i e d o v e r t o h i m . ( T h i s p r e s u p p o s e s t h a t t h e attraction was not opposed by the neurotic misperception of the man as s o m e t h i n g sinful a n d t h e r e f o r e to be avoided.) If, on t h e o t h e r h a n d , the relationship to the young man remained nothing other than a wishing for him t o b e n e a r , t h e n his a p p r o a c h would o n l y b e r e c k o n e d w i t h , o r visualized. T h e r e can c l e a r l y b e w i s h e s t h a t f r o m t h e o u t s e t c a n n o t b e fulfilled; a r e l a t i o n s h i p can r e m a i n in t h a t s t a t e . Wanting s o m e t h i n g , h o w e v e r , is a r e l a t i o n s h i p to t h e w o r l d t h a t is d i r e c t e d t o w a r d s o m e t h i n g c o n s i d e r e d a t t a i n a b l e , s o m e t h i n g t o w a r d w h i c h t h e w a n t i n g p e r s o n has already set o u t — w h e t h e r in t h i n k i n g and p l a n n i n g or in bodily a c t i v i t y — but n o t yet r e a c h e d . S u c h f u n d a m e n t a l d i f f e r e n c e s in individual possibilities of b e h a v i o r and relating t o t h e world preclude their b e i n g simply m e r g e d o r t r a n s f o r m e d i n t o o n e a n o t h e r . All w e can a s c e r t a i n i s t h a t n o w o n e , n o w a n o t h e r , can b e c a r r i e d o u t o r inhibited. If it is t r u e , t h e n , t h a t e n d o p s y c h i c , u n c o n s c i o u s d e s i r e s and acts of will a r e as little e v i d e n t in h y s t e r i c a l g e s t u r e s as in h e a l t h y b e h a v i o r , we can safely c o n c l u d e r e g a r d i n g t h e h y s t e r i c a l paralysis o f o u r t e s t s u b j e c t t h a t w h a t s h e fled f r o m and w a s also d r a w n t o w a s n o t a n e n d o p s y c h i c r e p r e s e n t a t i o n o f t h e y o u n g m a n . I t w a s n o r e p r e s e n t a t i o n , b u t the m a n h i m s e l f , f r o m t h e place i n h e r w o r l d w h e r e h e w a s seen w a l k i n g , w h o m o v e d h e r t o stop s h o r t and collapse. T h e o n l y r e a s o n R e g u l a Z i i r c h e r h e r s e l f did n o t r e c o g n i z e w h a t w a s h a p p e n i n g to h e r is t h a t she had not yet become herself. It was not her self that commanded her not to a p p r o a c h t h e m a n and t o r e h e r a w a y f r o m h i m . R a t h e r , s h e w a s ' d i r e c t e d from outside h e r self, like a m a r i o n e t t e . T h e s t r i n g s w e r e b e i n g pulled by t h e alien m e n t a l i t y o f h e r m o t h e r . T h e organic neurotic disturbances L o n g b e f o r e h e r h y s t e r i c a l paralysis, R e g u l a Z i i r c h e r had b e e n tormented by organic neurotic disturbances of the alimentary canal. T h e s e first b e c a m e n o t i c e a b l e during p u b e r t y . Initially, t h e r e w a s nothing more than stubborn constipation. But after her marriage, s t o m a c h pains and i n t e s t i n a l c r a m p s o c c u r r e d m o r e and m o r e f r e q u e n t l y a s well. W h e n p s y c h o t h e r a p y w a s b e g i n n i n g , t h e s e latest s y m p t o m s had b e g u n to be followed in t u r n by a t t a c k s of bloody, viscous d i a r r h e a . T h e patient's o r g a n i c n e u r o t i c d i s t u r b a n c e s had n o w a s s u m e d a m o s t t h r e a t e n i n g a s p e c t . S h e could barely take any noui i s h m e n l at all and had b e c o m e horribly e m a c i a t e d .

Testing and Research on Pathological Phenomena Traditional medicine would ascribe the patient's intestinal symptoms t o a d y s f u n c t i o n o f t h e a u t o n o m i c s y s t e m . P s y c h o s o m a t i c medicine would t a k e this idea f u r t h e r t o t r a c e t h e real c a u s e o f t h e d i s t u r b a n c e t o t h e a c t i o n s o f depressive a f f e c t s upon t h e a u t o n o m i c c e n t e r s o f the c e r e b r a l c o r t e x . Finally, a p s y c h o a n a l y t i c i n t e r p r e t a t i o n w o u l d o f f e r as e x p l a n a t i o n the r e g r e s s i o n o f t h e p a t i e n t t o a n a n a l - s a d i s t i c s t a g e o f libidinal d e v e l o p m e n t ; t h e s t o m a c h and i n t e s t i n a l s y m p t o m s would b e s e e n i n g e n e r a l a s e f f e c t s o f a n a l - e r o t i c drives o n t h e i r t e r m i n a l o r g a n s . R e g u l a Z i i r c h e r ' s case h i s t o r y r e v e a l s o n l y o n e c o n n e c t i o n b e t w e e n t h e pathological i n t e s t i n a l s y m p t o m s and t h e w a y i n w h i c h she w a s a p p a r e n t l y related a t this t i m e t o t h e w o r l d a r o u n d h e r . T h e time a t w h i c h h e r s u f f e r i n g s b e g a n p r o v i d e s a clue h e r e . S y m p t o m s o f i n t e s t i n a l disorder first b e c a m e v e r y p r o n o u n c e d j u s t w h e n y o u n g g e n t l e m e n began to n o t i c e this beautiful girl and ask h e r o u t to d a n c e s . In h e r circle of friends, it w a s c u s t o m a r y for t h e s e affairs to t u r n quickly i n t o p e t t i n g parties. Y e t R e g u l a Z i i r c h e r w a s still s o totally d o m i n a t e d b y p a r e n t a l d i r e c t i v e s t h a t she denied b o t h h e r s e l f and t h e y o u n g m e n a n y bodily c l o s e n e s s and t e n d e r n e s s . W h e n e v e r t h e o p p o r t u n i t y for p e t t i n g a r o s e , she could feel h e r b o w e l s t i g h t e n . O n days following t h e s e parties periods o f c o n s t i p a t i o n first a p p e a r e d . T o h e r already e x i s t i n g r e s e r v e c o n c e r n i n g t e n d e r , bodily c l o s e n e s s t o w a r d o t h e r s was n o w added this c o n s t r a i n t i n t h e face o f a n e w l y a r i s e n s e x u a l a t t r a c t i o n t o w a r d y o u n g men. A s w e h a v e h e a r d b e f o r e , t h e p a t i e n t ' s i n t e s t i n a l c r a m p s and d i a r r h e a disappeared quite suddenly, a s i f o f t h e i r o w n a c c o r d , s o o n a f t e r t h e s t a r t o f h e r t h e r a p y . All o f h e r s t o m a c h pains had stopped long b e f o r e t h e f u n c t i o n i n g o f h e r i n t e s t i n e s and h e r r e l a t i o n s h i p t o feces w e r e d i s c u s s e d . T h e i n s t a n t t h e p a t i e n t o v e r c a m e h e r initial r e s i s t a n c e and e n t e r e d i n t o a t r u s t i n g d a u g h t e r - f a t h e r r e l a t i o n s h i p w i t h h e r physician, the s y m p t o m s c e a s e d . It w a s as if t h e y simply b l e w a w a y o n c e s h e gave up trying to play t h e role of a h a u g h t y , g r o w n - u p lady and f o u n d r e l e a s e in the i m m a t u r e , childlike b e h a v i o r t h a t actually allowed h e r t o b e h e r s e l f . Up to this t i m e , g a s t r o i n t e s t i n a l specialists had forbidden h e r o n e food a f t e r t h e o t h e r and placed h e r o n m o r e and m o r e s c a n t y diets. S h e had barely b e g u n h e r p s y c h o t h e r a p y , h o w e v e r , w h e n s h e w a s again able t o eat a n y t h i n g she d e s i r e d . E v e n milk, c o n s i d e r e d t h e t r i g g e r i n g a g e n t for g a s t r o i n t e s t i n a l allergies and e c z e m a , she could n o w c o n s u m e w i t h o u t difficulty, as well as c e r t a i n fats and c a b b a g e s t h a t had p r e v i o u s l y been indigestible. N o t o n l y did t h e u n b e a r a b l e s t o m a c h c r a m p s disappear; t h e patient n o l o n g e r n e e d e d t h e p o w e r f u l l a x a t i v e s she had, with only m o d e s t results, taken daily f o r o v e r a decade. S h e was soon able to take for g r a n t e d d a i l y , s p o n t a n e o u s , and c o m p l e t e l y n o r m a l b o w e l m o v e m e n t s .

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N o n e o f t h e t r a d i t i o n a l medical t h e o r i e s are able t o explain this a p p a r e n t and i m p o r t a n t c o n n e c t i o n b e t w e e n t h e p a t i e n t ' s o r g a n i c n e u r o t i c d i s t u r b a n c e s and t h e particular b e n t o f h e r h u m a n r e l a t i o n ­ ships. N o t o n e o f t h e s e t h e o r i e s e v e n a p p r o a c h e s t h e issue o f h u m a n r e l a t i o n s h i p s , in fact. N e i t h e r a d y s f u n c t i o n of t h e c e r e b r a l c o r t e x , n o r t h e s u p p o s i t i o n o f s o m e e n d o p s y c h i c affect o r o f e n e r g i e s and i n s t i n c t s has a n y t h i n g to do w i t h ability to p e r c e i v e fellow h u m a n b e i n g s as c r e a t u r e s to be t r u s t e d or feared, but it is i m p e r a t i v e t h a t we u n d e r s t a n d this p h e n o m e n o n i f w e are t o learn a n y t h i n g a b o u t m o d e s o f b e h a v i o r like o p e n i n g o n e s e l f up to t h e world, or closing o n e s e l f o f f from it. If it is t r u e t h a t t h e w a y s i n w h i c h people b e h a v e t o w a r d w h a t s u r r o u n d s t h e m a r e i n a c c e s s i b l e t o o r d i n a r y medical t h e o r i e s , t h e n t h e s e t h e o r i e s c a n n o t e x p e c t t o elucidate t h e c o n n e c t i o n b e t w e e n d i s t u r b e d h u m a n r e l a t i o n ­ ships and o r g a n i c , physical d i s t u r b a n c e s . O n e thing immediately apparent in our test subject was that horrible i n t e s t i n a l c r a m p s w e n t along with a forced and c r a m p e d r e s t r i c t i o n of h e r e x i s t e n c e w i t h r e s p e c t t o the w o r l d a r o u n d h e r . W h e n e v e r she w a s o v e r w h e l m e d by a b o t t o m l e s s fear of this w o r l d in w h i c h she had no t r u s t w h a t s o e v e r , h e r c r a m p s would give w a y t o v i s c o u s , bloody d i a r r h e a s . Y e t as s o o n as s h e dared e n t e r i n t o a t r u s t i n g d a u g h t e r - f a t h e r r e l a t i o n s h i p w i t h h e r t h e r a p i s t , t h e s e p o t e n t i a l l y lethal p a t h o l o g i c a l s y m p t o m s gave w a y t o n o r m a l g a s t r o i n t e s t i n a l f u n c t i o n i n g . J u s t i c e i s d o n e t o t h e s e facts only if the p a t i e n t ' s i n t e s t i n a l vicissitudes a r e s e e n as t h e bodying f o r t h of h e r overall r e l a t i o n s h i p t o the world. T h e s e e m i n g l y m o r e c a u t i o u s and less prejudicial d e s i g n a t i o n o f s i m u l t a n e i t y o f p s y c h i c and o r g a n i c e v e n t s o r o f t e m p o r a l c o r r e l a t i o n actually prejudices m u c h m o r e . B o t h t e r m s p r e s u p p o s e t h e division of h u m a n e x i s t e n c e i n t o a p s y c h e and a s o m a , t h o u g h in an u n p r e j u d i c e d o b s e r v a t i o n — e x i s t i e n c e a l w a y s a p p e a r s as a unified w h o l e . O n l y t w o primarily s e p a r a t e e n t i t i e s can b e c o r r e l a t e d o r act s i m u l t a n e o u s l y . B u t , a t a n y r a t e , t h e p a t i e n t ' s i n t e s t i n a l s p a s m s w e r e only o n e — a l b e i t t h e m o s t d a n g e r o u s — f o r m i n w h i c h h e r e x t r e m e r e s e r v e vis-a-vis t h e world was bodied f o r t h . T h i s r e l a t i o n s h i p also m a n i f e s t e d i t s e l f in h e r aloof and d i s t a n t m a n n e r of speaking, in h e r stiff m i m i c r y , and in t h e affected, b r o k e n r h y t h m o f h e r bodily m o v e m e n t s , w h i c h w e r e c h a r a c t e r i s t i c s o f h e r b e h a v i o r during t h e t i m e s h e w a s s u f f e r i n g f r o m g a s t r o i n t e s t i n a l d i s t u r b a n c e s , and w h i c h yielded t o n o r m a l f e m a l e w a y s o f m o v i n g a t the s a m e time t h e i n t e s t i n a l s p a s m s and i r r i t a t i o n s w e n t away. A s t o w h y t h e p a t i e n t ' s pathological r e l a t i o n s h i p t o a y o u n g man s h e m e t during the c o u r s e o f h e r p s y c h o t h e r a p y was b o d i e d I 0 1 1 h n o t as an o r g a n i c n e u r o t i c s y m p t o m , b u t as an h y s t e r i c a l paralysis l t h e leg, we

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r e f e r t h e r e a d e r to an e a r l i e r publication dealing w i t h this precise question. 2

Periodic swelling and pain i n t h e b r e a s t s w e r e also part o f t h e patient's p s y c h o s o m a t i c p a t h o l o g y . H e r b r e a s t s would b e c o m e h a r d a s s t o n e s during t h e s e c o n d h a l f o f e v e r y m e n s t r u a l cycle and s o s w o l l e n t h a t h e r c h e s t m e a s u r e m e n t w a s i n c r e a s e d b y a t least a n inch a t t h e o n s e t o f menstruation. H e r g y n e c o l o g i s t was n o d o u b t c o r r e c t i n c o n n e c t i n g t h e s e s y m p t o m s t o o v e r p r o d u c t i o n o f e s t r o g e n , y e t t h e r a p e u t i c m e a s u r e s b a s e d o n this a s s u m p t i o n failed to h a v e e f f e c t . T h e p a t i e n t w a s for a long time given i n j e c t i o n s of m a l e h o r m o n e s , and while this m e a s u r e did succeed in r e d u c i n g t h e swelling s o m e w h a t , i t also p r o d u c e d s u c h s e v e r e irritability and r e s t l e s s n e s s t h a t it a l w a y s had to be d i s c o n t i n u e d quickly. Application o f a l c o h o l c o m p r e s s e s t o t h e b r e a s t s g a v e h e r s o m e relief, but a p h y s i o t h e r a p i s t ' s a t t e m p t to e a s e t h e painful swelling and h a r d n e s s by light m a s s a g e failed e n t i r e l y . T h e pain and t e n s i o n i n t h e p a t i e n t ' s b r e a s t s disappeared f o r e v e r , w h e n s h e , i n t h e c o u r s e o f h e r t h e r a p y , had d i s c o v e r e d and accepted h e r w o m a n h o o d so, t h a t she could fall " b o d y " and " s o u l " in love w i t h a m a n and joyfully w e l c o m e his t e n d e r c a r e s s e s — t h o u g h , from a purely physical s t a n d p o i n t , h e r l o v e r ' s c a r e s s e s did n o t differ g r e a t l y from t h e e a r l i e r m a s s a g e s given h e r b y h e r p h y s i o t h e r a p i s t . T h e c u r e b r o u g h t a b o u t b y t h e g e n t l e t o u c h o f a m a n she loved h a p p e n e d well b e f o r e she w a s able t o e x p e r i e n c e s e x u a l o r g a s m w i t h him, s o t h e d i s a p p e a r a n c e o f h e r b r e a s t pains c a n n o t b e a s c r i b e d t o a n y physiological change brought on by sexual intercourse. Faced w i t h o r g a n - n e u r o t i c p a t h o l o g y like t h i s , p h y s i c i a n s can n o l o n g e r be satisfied w i t h t h e p s e u d o e x p l a n a t i o n t h a t a s e x u a l l y a r o u s e d p s y c h e had a c t e d t h r o u g h t h e p i t u i t a r y gland, c a u s i n g t h e o v a r i e s t o b e c o m e h y p e r a c t i v e until, finally, p s y c h o g e n i c b r e a s t pain a r o s e . T r u e , t h e r e can b e n o d o u b t t h a t i n this c a s e o v e r a c t i v i t y o f t h e p i t u i t a r y gland and t h e o v a r i e s did play a n e c e s s a r y role. B u t j u s t as p s y c h i c e f f e c t on t h e i n t e s t i n e is n o t scientifically definable, i.e., in t e r m s of e x a c t l y m e a s u r a b l e , c o m p a t a b l e and c a u s a l l y related c o n c e p t s , so all t h e o r i z i n g a b o u t an e f f e c t i v e c o n n e c t i o n b e t w e e n an indefinable p s y c h e and a s o m a t i c p i t u i t a r y , o v a r i e s , and m a m m a r y glands is c o n c e p t u a l l y u n c l e a r . R e g u l a Z i i r c h e r ' s b r e a s t p h e n o m e n a can b e d e s i g n a t e d o n l y a s the bodying f o r t h of a s e v e r e l y d i s t u r b e d w a y of relating to o t h e r s , in p a r t i c u l a r of bodying f o r t h a l o v e - r e l a t i o n w i t h a m a n . T h e e x i s t e n t i a l d i s t u r b a n c e e x p r e s s e d t h e p a t i e n t ' s lack o f freedom t o realize her potential for loving a m a n . S h e w a s far from able to fulfill these possibilities in a decisively w a n t e d and active b e i n g - t o g e t h e r with a man in a s h a r e d world.

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FOUNDATIONS

T h e leg f r a c t u r e T h e leg f r a c t u r e R e g u l a Z i i r c h e r suffered s o m e t i m e a f t e r t h e finish o f t h e r a p y kept h e r in bed for s e v e r a l w e e k s and, since she w a s in t r a c t i o n , literally nailed h e r to it. S h e w a s n o w as u n a b l e to take a step as she had b e e n i m m e d i a t e l y a f t e r h e r e a r l i e r h y s t e r i c a l paralysis. B u t t h e r e is a d i f f e r e n c e b e t w e e n t h e f o r m e r paralysis and t h e leg f r a c t u r e . N o o n e w o u l d b l a m e this f r a c t u r e on a faulty a t t i t u d e on t h e p a t i e n t ' s part, s o m e n e u r o t i c a c c i d e n t p r o n e n e s s , for i n s t a n c e , t h a t r e s u l t e d in a m i s h a p for which she was ultimately responsible. T o g e t h e r with a number of other people, s h e had b e e n r u n d o w n from b e h i n d o n t h e sidewalk b y t h e a u t o m o b i l e of a t o t a l s t r a n g e r . T h u s h e r f r a c t u r e can be c h a r a c t e r i z e d as clearly physical in o r i g i n . It could be said t h a t a f r a c t u r e of t h e tibia p r e v e n t s a p e r s o n f r o m u s i n g t h e leg as an a m b u l a t o r y tool. B u t did R e g u l a Z i i r c h e r e v e r u s e h e r leg as such a tool? If she examined what happened w h e n she was hurring across t h e s t r e e t t o h e r l o v e r , she could n o t h o n e s t l y say t h a t she had used h e r legs a s i n s t r u m e n t s for t h e purpose o f c r o s s i n g t h e s t r e e t . A s w e h a v e n o t e d b e f o r e , she did n o t p e r c e i v e h e r s e l f t h e n as a p s y c h e t h a t s o m e h o w seized t h e body as an i n s t r u m e n t for t r a n s p o r t i n g it a c r o s s t h e s t r e e t . W h a t actually o c c u r r e d w a s s o m e t h i n g v e r y d i f f e r e n t . F a c t u a l l y speaking, all t h a t t h e p a t i e n t e x p e r i e n c e d t h e n w a s h e r l o v e r ' s u n e x p e c t e d e n t r a n c e i n t o h e r field o f vision. S h e i n s t a n t l y r e c o g n i z e d him a s h e r lover, a t t h e s a m e t i m e felt a t t r a c t e d t o h i m " b o d y " a n d " s o u l , " and in a c o r r e s p o n d i n g r e s p o n s e to this a t t r a c t i o n h u r r i e d o v e r to h i m as t h e w h o l e , e x i s t i n g p e r s o n s h e w a s , undivided i n t o s e p a r a t e physical o r psychic c o m p o n e n t s . T h i s e x p e r i e n c e d e m o n s t r a t e s clearly h o w directly t h e bodily s p h e r e o f a h u m a n e x i s t e n c e i n h e r e s in a loving r e l a t i o n s h i p to a n o t h e r h u m a n being c o e x i s t i n g in a s h a r e d w o r l d , even t h o u g h s o m e part of t h e body—a leg, for i n s t a n c e — m a y also be d e s i g n a t e d as a distinct physical component. T h e car accident, n o less t h a n t h e h y s t e r i c a l paralysis, s t r u c k n o t s o m e m e r e i n s t r u m e n t , and it w a s n o t j u s t a piece of t h e s k e l e t o n t h a t w a s broken. This something, even as a broken something, belonged to Regula Z i i r c h e r ' s dwelling in h e r r e l a t i o n s h i p s to t h e w o r l d . In p a r t i c u l a r , h e r leg c a n n o t be u n d e r s t o o d p r o p e r i y as t h e h u m a n limb it is u n l e s s we see in it the bodying f o r t h o f t h e possibilities o f a p p r o a c h i n g o r r e t r e a t i n g from s o m e p r e s e n c e . In b r i e f , t h e c a r e l e s s d r i v e r did n o t simply s h a t t e r a physical leg w h e n he ran i n t o R e g u l a Z i i r c h e r ; it was a b o v e all h e r potential for bodily a p p r o a c h i n g o t h e r p h e n o m e n a that was d e s t r o y e d w h e n h e r b o n e was b r o k e n .

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C o n s e q u e n t l y , r e s t r i c t i o n o f physical m o v e m e n t was n o t the only r e s u l t o f t h e leg f r a c t u r e . I t a f f e c t e d also h e r w h o l e r e l a t i o n s h i p t o the w o r l d , t h e w h o l e w a y i n w h i c h s h e e x i s t e d . F o r o n e thing, h e r r e l a t i o n s h i p s t o h e r friends, w h i c h w e r e t o h a v e b e e n actualized the n e x t day in a b i r t h d a y c e l e b r a t i o n , w e r e limited i n s t e a d to m o r o s e r e f l e c t i o n s . T o h e r o w n a s t o n i s h m e n t , s h e o b s e r v e d h o w far i n t o t h e distance e v e r y t h i n g receded during t h e first days o f h e r hospital s t a y — n o t o n l y o t h e r people, but o b j e c t s f r o m t h e s p h e r e s o f h e r h o m e and o c c u p a t i o n . All t h a t had been claiming h e r w h o l e h e a r t e d a t t e n t i o n n o w m e a n t a l m o s t n o t h i n g t o h e r . C l a i m i n g the f o r e g r o u n d o f h e r a w a r e n e s s w a s h e r o w n b r o k e n leg, d r a w i n g h e r w h o l e e x i s t e n c e u p i n t o t h e r e l a t i o n t o it. S h e b e g a n t o s e e h e r s e l f a s a n e x t r e m e l y n a r r o w , m a s s i v e , and c u m b e r s o m e r e a l m e n d i n g a t t h e walls o f the s i c k r o o m and allowing t h e approach o f n o t h i n g but w h a t w e n t o n inside t h o s e four walls. T i m e s e e m e d t o s t a n d still for h e r . S o little h a p p e n e d t h a t w h e n she a w a k e d i n t h e m o r n i n g t h e a p p r o a c h o f e v e n i n g s e e m e d a n e t e r n i t y a w a y . T i m e had b e c o m e a n e m p t y v e s s e l . P e r h a p s , s h e t h o u g h t , t h e fear o f death s e n t suddenly c o u r s i n g t h r o u g h h e r v e i n s w a s partly a t fault. T h e a c c i d e n t had r e m i n d e d h e r , in a n y c a s e , h o w v e r y fragile the h u m a n w o r l d and all its r i c h e s w e r e . A little b u r s t of n o i s e , and suddenly all w o u l d disappear. A n d t h e n ? B u t " t h e n " and " t h e r e " would n o l o n g e r e x i s t e i t h e r . S u c h t h o u g h t s caused all o f t h e t h i n g s o f h e r e v e r y d a y w o r l d t o t a k e o n a n unwanted transcience. T h i s c i r c u m s t a n c e p e r s i s t e d for o n l y t w o o r t h r e e days, h o w e v e r . A f t e r t h a t s h e s c a r c e l y g a v e a n y t h o u g h t t o h e r b r o k e n leg. H e r days w e r e filled b y t h e visits o f h e r friends. S h e also felt a n u r g e t o w r i t e s h o r t s t o r i e s for m a g a z i n e s , and s h e f o c u s s e d a large part of h e r a t t e n t i o n on plans for t h e f u t u r e , for t h e t i m e a f t e r h e r r e c o v e r y . O n c e again, h e r f u t u r e d e t e r m i n e d h e r p r e s e n t and d r e w n o u r i s h m e n t f r o m t h e e x p e r i e n c e s o f h e r past. T h e bodily pains F r o m e a r l i e s t childhood o n w a r d , R e g u l a Z i i r c h e r had had pains o f the m o s t d i v e r s e s o r t s and i n t h e m o s t d i v e r s e l o c a t i o n s t h r o u g h h e r body. T h e first she r e m e m b e r s w e r e p r o d u c e d b y e c z e m a o f t h e l e g s . L a t e r , she c a m e t o e x p e r i e n c e t h o s e a g o n i z i n g g a s t r o i n t e s t i n a l s p a s m s and a t about the s a m e t i m e b e g a n t o s u f f e r f r o m i n t e r m i t t e n t a t t a c k s o f v a s o m o t o r h e a d a c h e s . T h e r e w a s also t h e pain t h a t w e n t w i t h t h e swelling in hei b r e a s t s . Finally, a f t e r she had l e a r n e d to o v e r c o m e all of h e r o t h e r pain,, a leg f r a c t u r e b r o u g h t h e r a n o t h e r , v e r y d i f f e r e n t , type o f pain. Each of t h e s e pains had a c h a r a c t e r all its o w n . T h e patient des< I Ibrd the pains a s s o c i a t e d w i t h e c z e m a as a superficial b u r n i n g thai lelt as II ihf

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w e r e s t a n d i n g w i t h b o t h feet on a blazing pyre. S h e e x p e r i e n c e d t h e g a s t r o i n t e s t i n a l c r a m p s a s s u r g i n g and a g i t a t e d c o n s t r i c t i o n o f t h e e n t i r e a b d o m i n a l r e g i o n . T h e h e a d a c h e s c o n s i s t e d in a painful e x p a n s i o n and c o n t r a c t i o n o f h e r skull, h e r head h u r t i n g h e r s o m u c h s o m e t i m e s t h a t s h e felt as t h o u g h s h e w e r e n o t h i n g but a head, big as a barn and filled w i t h a g o n y . S h e also d e s c r i b e d h e r b r e a s t pains a s a n u n b e a r a b l e i n n e r t e n s i o n , and t h e r e w e r e t i m e s w h e n i t s e e m e d t o h e r t h a t h e r b r e a s t s would have to e x p l o d e a n y m o m e n t . Pain from t h e b r o k e n leg did n o t begin until the p a t i e n t w a s already on t h e g r o u n d . S h e felt it first as a t e a r i n g h u r t s o m e w h e r e b e l o w and t o the r i g h t . F o r the first m o m e n t , i t s e e m e d o n l y as large (spatially) as a volley ball. A l m o s t i m m e d i a t e l y , h o w e v e r , it e x p a n d e d to i n u n d a t e h e r e n t i r e l y , an i m m e n s e sea in w h i c h e v e r y t h i n g a r o u n d h e r w a s d r o w n i n g : t h e o n l o o k e r s , t h e h o u s e s , t h e sky a b o v e , the e a r t h b e l o w , and she h e r s e l f . I n t h e end, she was n o t h i n g m o r e t h a n pain and w a s being a b s o r b e d into this pain to t h e e x t e n t t h a t she n e a r l y lost c o n s c i o u s n e s s . B e f o r e this happened, t h o u g h , she w a s able t o t e a r h e r s e l f loose from t h e a g o n y and step back t o c o n f r o n t t h e painful a r e a of h e r body. T h e pain t h e n c o n t r a c t e d to form a s p h e r e , a b o u t t w e n t y c e n t i m e t e r s in d i a m e t e r , in t h e r i g h t l o w e r - c a l f region. W h e n w e look o v e r t h e p a t i e n t ' s d e s c r i p t i o n s , w e are s t r u c k b y t h e fact t h a t this w o m a n , n o r m a l l y a m a s t e r o f o b s e r v a t i o n and e x p r e s s i o n , w a s s u r p r i s i n g l y i n e x a c t w h e r e h e r pains w e r e c o n c e r n e d . It is likely t h a t t h e p h e n o m e n o n of pain itself, r a t h e r t h a n t h e p a t i e n t , is at fault h e r e . Pain is v e r y m u c h akin t o e x p e r i e n c e s o f smell and t a s t e . N o w a n y o n e would b e hard p r e s s e d t o d e s c r i b e , f o r i n s t a n c e , t h e w o n d e r f u l a r o m a and flavor o f m a n g o t o s o m e o n e w h o n e v e r smelled and t a s t e d o n e . N o m a t t e r h o w familiar t h e s e s e n s a t i o n s a r e t o t h e n o s e and palate o f t h e p e r s o n r e p o r t i n g , he will n e v e r s u c c e e d in c o m m u n i c a t i n g to his l i s t e n e r precisely w h i c h s e n s e p e r c e p t i o n he m e a n s and will p r o b a b l y , as R e g u l a Z i i r c h e r did in h e r a t t e m p t to describe h e r pains, r e s o r t u l t i m a t e l y to metaphorical comparison. Regula Zurcher's characterizations of her pains s u f f e r from t h e s a m e lack of precision s e e n in all s u c h d e s c r i p t i o n s i n scientific t e x t b o o k s . N o a n a t o m y , o r p h y s i o l o g y , o f pain, n o m a t t e r h o w precise, can g e t t h e n a t u r e o f bodily pain. T h e bodily a r e a s r e f e r r e d t o a s pain c e n t e r s and pain p a t h w a y s , w i t h all t h e i r a t t e n d a n t biophysical p r o c e s s e s , have n o t h i n g at all in c o m m o n w i t h pain itself, n o t e v e n w h e n t h e n u m b e r o f electrical i m p u l s e s racing t h r o u g h t h e m i s raised t o ml m i l y. Pain itself is n o t biophysical in n a t u r e , for it e x i s t s only as an e x p e r i e n c e . T h e r e i s n o biophysical o b j e c t t h a t has t h e capacity t o e x p e r i e n c e , to s e n s e , o r t o perceive w h a t s o m e t h i n g i s . 3

Bodily e x pei

ICI

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u ed, w e spea

k

a l w a y s e x p e r i e n c e d as h u r l i n g , o l the perception a n d s e n s a t i o n o l

p a i n is Y e t pain is

Suue pam

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a v e r y p a r t i c u l a r s o r t of p e r c e p t i o n , f u n d a m e n t a l l y d i f f e r e n t f r o m all the o t h e r so-called s e n s e p e r c e p t i o n s . I n o u r discussion o f s i g h t , w e n o t e d t h a t t h e t h i n g " c a u g h t s i g h t o f " is o b s e r v e d and its s i g n i f i c a n c e perceived, at its location in t h e o b s e r v e r ' s w o r l d , but t h a t n e i t h e r t h e act of seeing n o r t h e e y e as t h e involved bodily r e g i o n is part of w h a t is s e e n . W h e n something is touched or tasted, on the other hand, the hand or tongue can b e perceived along w i t h t h e o b j e c t itself. R e g u l a Z u r c h e r ' s p e r c e p t i o n of pain a f t e r h e r leg f r a c t u r e did n o t include t h e a c t u a l c a u s e s of the pain. I n h e r pain t h e r e w a s n o a w a r e n e s s o f t h e a u t o m o b i l e b u m p e r that had s p l i n t e r e d h e r leg. W h a t t h e pain told h e r a t first w a s o n l y t h a t h e r e x i s t e n c e had b e e n hit hard and injured. W h e n s h e tried to stand up, the pain also let h e r k n o w i n w h a t w a y she had b e e n hit. S h e l e a r n e d t h a t h e r bodily ability t o s t a n d by, g o t o , o r a w a y f r o m , t h e t h i n g s o f h e r w o r l d had b e e n t o r n f r o m h e r . T h e special w a y in w h i c h such a r e n d i n g is felt is n o t a d i s t a n t o b s e r v a t i o n o f s o m e e n t i t y but the p e r c e p t i o n o f already e x i s t i n g d a m a g e to o n e ' s o w n e x i s t e n c e , a perceiving w h i c h i n v o l v e s t h e Da-sein, totally and a b s o l u t e l y . In the hours just after her accident, Regula Ziircher was so absorbed in t h e pain s h e w a s e x p e r i e n c i n g t h a t h e r e x i s t e n c e , w h i c h until t h e n had e x t e n d e d i n e x t r e m e l y b r o a d r e l a t i o n s h i p s t o h e r past, p r e s e n t , and f u t u r e , s h r a n k t o t h e single, p r e s e n t i n t e n t t o k e e p t h e leg still and t h e h o p e t h a t t h e d o c t o r would a r r i v e as s o o n as possible. All t h a t r e m a i n e d of h e r past w a s a m e m o r y , at t h e edge of c o n s c i o u s n e s s , of a similar a c c i d e n t s h e had s u f f e r e d as a y o u n g child. T h i s d i s c u s s i o n o f t h e p a t i e n t ' s bodily pains c o m p l e t e s t h e e x a m p l e s o f individual p a t h o l o g y w h i c h w e r e i n t r o d u c e d as a practical t e s t of t h e e x i s t e n t i a l r e s e a r c h m e t h o d . O u r n e x t t a s k will b e t o e x t r a c t f r o m t h e s e e x a m p l e s t h e principles implicit in t h e m . Explaining t h e s e principles will help us t o w a r d a g e n e r a l e x i s t e n t i a l p a t h o l o g y . NOTES 1. F o r a m o r e d e t a i l e d d i s c u s s i o n o f t h i s , s e e M . B o s s , Der Traum und seine Auslegung ( B e r n e : H a n s H u b e r , 1 9 5 4 ) a n d M . B o s s , Es träumte mir vergangene Nacht ( B e r n e : H a n s H u b e r , 1 9 7 5 ) . 2 . M . B o s s , Einfuhrung in die psychosomatische Medizin ( B e r n e a n d S t u t t g a r t : H a n s H u b e r , 1974). 3 . R e f e r a l s o t o t h e e x c e l l e n t s u m m a t i o n a n d c r i t i q u e o f e x i s t i n g n o t i o n s a b o u t pain i n a w o r k by G . C o n d r a u e n t i t l e d Psychosomatik der Frauenheilkunde ( B e r n a n d S t u t t g a r t : H. H u b e r , 1 9 6 5 ) , pp. 1 9 9 ff.

Chapter 12 GENERAL DASEINSANALYTIC

ETIOLOGY AND

PATHOGENESIS

I n looking back o v e r t h e p a t h o l o g i c a l p h e n o m e n a o f o u r t e s t c a s e , w e begin t o s u s p e c t t h a t t h e p a t i e n t m i g h t n e v e r h a v e b e c o m e ill, a t least n o t i n q u i t e t h e s a m e w a y s , had s h e n o t e n t e r e d t h e w o r l d w i t h h e r o w n specific i n b o r n p o t e n t i a l i t i e s for b e h a v i n g , and had t h e e v e n t s of h e r life n o t impelled h e r t o w a r d t h e v e r y e x p e r i e n c e s t h a t a c t u a l l y h a p p e n e d t o h e r . R e g u l a Z i i r c h e r is n o t an isolated case in this r e s p e c t . W h e r e v e r we t u r n in t h e r e a l m of p a t h o l o g y , we find a s t r o n g c o n n e c t i o n b e t w e e n p r e s e n t illness and w h a t h a s c o m e b e f o r e it. T h i s c o n n e c t i o n is described i n w h a t i s c o m m o n l y called t h e e t i o l o g y , o r p a t h o g e n e s i s , o f h u m a n illness. F o r t h e m o s t part, h o w e v e r , t h e s e d e s c r i p t i o n s fail t o give a d e q u a t e and specific c o n s i d e r a t i o n t o t h e s i n g u l a r n a t u r e o f t h e i m p o r t a n t r e l a t i o n s h i p b e t w e e n a p a t i e n t ' s p r e s e n t c o n d i t i o n and previous history. O n e i m p o r t a n t d i s t i n c t i o n in t h i s a r e a h a s already b e e n partly made in o u r discussion o f t h e u n b r i d g e a b l e g a p b e t w e e n n a t u r a l s c i e n c e ' s concept o f c a u s e and t h e e x i s t e n t i a l c o n c e p t o f m o t i v a t i o n . F r o m thai d e a l distinction it follows t h a t we m u s t distinguish s h a r p l y n o w b e t w e e n a causal and a m o t i v a t i o n a l p a t h o g e n e s i s or e t i o l o g y . Like th:" c a u s e and e f f e c t s c h e m e , t h e n o t i o n of causal p a t h o g e n e s i s is r o o t e d in thai philosophical v i e w w h i c h p o s i t s all that e x i s t s as raw material l"i i

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r e p r e s e n t i n g s u b j e c t . T h i s C a r t e s i a n - G a l i l i e a n w o r l d v i e w also s e e s all real t h i n g s j o i n e d t o g e t h e r i n t o a n i n t e g r a l w o r l d t h r o u g h t h e o p e r a t i o n of a fixed, precisely calculable c a u s a l i t y . W i t h o u t t h e s e p r e s c i e n t i f i c s u p p o s i t i o n s , n e i t h e r t h e n a t u r a l scientific principal o f causality i n g e n e r a l , n o r a n y causal g e n e s i s in p a r t i c u l a r could e v e r h a v e b e e n thought out. But this w a y o f t h i n k i n g allowed t h e n o u n s " e t i o l o g y " and " g e n e s i s " t o a s s u m e m e a n i n g s v e r y distant from t h e i r o r i g i n s . Aitia, the G r e e k w o r d for " i m p e t u s , " " o c c a s i o n , " and "guilt," n o w c a m e t o m e a n ' c a u s e . " Genesis, w h i c h had o n c e r e f e r r e d to t h e s o u r c e of an illness, w a s r e i n t e r p r e t e d as a s e q u e n c e o f c a u s e s and e f f e c t s . F r o m t h e p e r s p e c t i v e o f c o n t e m p o r a r y medicine, then, both words became near s y n o n y m s . W i t h i n a g e n e r a l p a t h o l o g y , this c a u s a l - g e n e t i c v i e w can be c o n t r a s t e d to the D a s e i n s a n a l y t i c , m o t i v a t i o n a l g e n e s i s . A D a s e i n s a n a l y t i c s t u d y of p a t h o g e n e s i s does n o t aim to t r a c e p h e n o m e n a back to c a u s e s , b u t is c o n c e r n e d w i t h d i s c o v e r i n g biographical i n c i d e n t s w h i c h t h e n m o t i v a t e d a h u m a n being to c o n d u c t h i m s e l f in a c e r t a i n w a y and w h i c h still m o t i v a t e him t o p e r p e t u a t e t h e s e m o d e s . P a t h o g e n i c , b i o g r a p h i c a l m o t i v a t i n g i n c i d e n t s a r e m o t i v e s w h i c h induce a person to r e s t r i c t , or partially blind him to, t h e a b u n d a n c e of his i n b o r n possibilities of r e l a t i n g so t h a t he fulfills o n l y a f e w n e u r o t i c m o d e s of relation to his w o r l d . We should r e m e m b e r t h a t t h e p a t h o g e n i c m o m e n t s t h e m s e l v e s c a n n o t produce, c a u s e , o r e f f e c t , t h e s e m o d e s , b e c a u s e all w a y s o f being, e v e n t h o s e we call n e u r o t i c , are g i v e n to a p e r s o n at b i r t h as possibilities of e x i s t e n c e . T h e r e i s n o n e e d for t h e m t o b e m a n u f a c t u r e d a f t e r t h e fact. B o t h a p p r o a c h e s t o p a t h o g e n e s i s , t h e c a u s a l - g e n e t i c and the m o t i v a t i o n a l - g e n e t i c , h a v e i m p o r t a n t places i n m e d i c i n e . W e h a v e already stated the value o f t h e c a u s a l - g e n e t i c o r i e n t a t i o n o f n a t u r a l s c i e n c e , u n d e r s c o r i n g its u n i q u e capacity for d i s c o v e r i n g n e w c h e m o physical t h e r a p i e s . O f c o u r s e , w e also pointed o u t t h e limited application of c a u s a l - g e n e t i c t h i n k i n g to m e d i c i n e , since it s e r v e s o n l y if h u m a n bodyhood is i n t e r p r e t e d as a physical o b j e c t . W i t h a n y t h i n g t h a t is n o t c o n c e i v a b l e i n physical t e r m s — t h e e n t i r e r e a l m o f psychic p h e n o m e n a — the c a u s a l - g e n e t i c o r i e n t a t i o n loses its s e n s e and j u s t i f i c a t i o n , n o r d o e s it r e c o v e r m e a n i n g simply b y g e t t i n g the n e w n a m e " p s y c h o d y n a m i c s . " B u t •dl t h o s e p h e n o m e n a of h u m a n Da-sein t h a t c a n n o t be c o n c e i v e d of com r c t e l y o r m a t e r i a l l y , t h o s e like u n d e r s t a n d i n g , intuition, w i s h i n g , desiring, acting (in s h o r t , all t h o s e t h i n g s t h a t m a k e a h u m a n being h u m a n ) , are inaccessible t o any b u t t h e m o t i v a t i o n a l - g e n e t i c p e r s p e c t i v e . I he pi ,n in a I medical i m p o r t a n c e of this o r i e n t a t i o n will be s h o w n w h e n w e d r . i uss | i h e n o m e n o l o g i c a l , d a s e i n s a n a l y t i c t h e r a p y . I In . r . the place, h o w e v e r , to c o u n t e r t h e c o m m o n criticism t h a t p h e n o m e n o l o g i c a l pathology does n o t a c t u a l l y r e c o g n i z e any sort o f

General

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g e n e t i c o r i e n t a t i o n , o r a t a n y r a t e w o e f u l l y n e g l e c t s it. N o description o l human nature is more aware than the Daseinsanalytic that the entire past of Da-sein p e r s i s t s in, c o d e t e r m i n e s , and t h u s r e m a i n s p r e s e n t in its p r e s e n t being. B u t it is in the f o r m of motivations t h a t t h e past a d d r e s s e s t h e p r e s e n t ; past e x p e r i e n c e s do n o t causally effect p r e s e n t b e h a v i o r in the w a y in w h i c h , in a physical s e q u e n c e of e v e n t s , specific c a u s e s n e c e s s a r i l y r e s u l t in specific e f f e c t s . B e c a u s e we h u m a n b e i n g s e x i s t in such a w a y t h a t o u r p r e s e n t is a l w a y s e n g a g e d i n c o m i n g t o t e r m s w i t h o u r past, w e a r e also b y n a t u r e d i r e c t e d t o w a r d w h a t a p p r o a c h e s from t h e f u t u r e and i n m o v i n g t o w a r d it m u s t open o u r being to it. H o w we see w h a t has b e e n and w h a t is n o w is a l w a y s r e l a t e d t o t h e w a y w e a r e a d d r e s s e d b y w h a t w e e x p e c t from the f u t u r e . F o r e x a m p l e , t h e w a y t h e w o r l d is o r g a n i z e d d e p e n d s partly on t h e p o t e n t i a l for f u t u r e a t o m i c w a r . F r o m the p e r s p e c t i v e o f this s a m e f u t u r e t h e past i s judged i n c a p a b l e r e g a r d i n g m a s t e r y o f t h e p r o b l e m s o f a t o m i c fission. F u r t h e r m o r e , i t i s o n l y b e c a u s e o f t h e t h r e a t o f a t o m i c w a r f a r e i n t h e f u t u r e t h a t w e can p r o p e r l y a p p r e c i a t e Galileo's conceptual advance. Everything that goes on in the world of human beings begins from the standpoint of the future. T h u s the future may claim t h e p r i m a c y o v e r t h e o t h e r t w o o f t h e t e m p o r a l e x t e n s i o n s o f h u m a n e x i s t e n c e , t h e e c s t a s e s o f past and p r e s e n t . T h i s fact i s o f p r i m a r y i m p o r t a n c e t o m e d i c i n e , b o t h for p a t h o g e n e s i s and t h e r a p y . W e should r e m e m b e r , t h o u g h , t h a t t h e v a n t a g e e n j o y e d b y the f u t u r e i n n o w a y d i m i n i s h e s t h e significance o f past e x p e r i e n c e s for b o t h p r e s e n t and future. I n o r d e r t o a n s w e r t h e prejudiced r e p r o a c h t h a t t h e D a s e i n s a n a l y t i c , p h e n o m e n o l o g i c a l o r i e n t a t i o n i g n o r e s t h e g e n e s i s o f pathological p h e n o m e n a , let u s look a t o n e o f t h e m o s t c u r r e n t c o n c e r n s o f e t i o l o g y . F r e u d singled o u t a l m o s t solely t h e e x p e r i e n c e s o f t h e infant a t the h a n d s of its p a r e n t s or p a r e n t s u b s t i t u t e s as t h e decisive p a t h o g e n i c motivations. Since then it has been shown that many postinfantile e x p e r i e n c e s as well can also induce a limiting f i x a t i o n on n e u r o t i c m o d e s of b e h a v i o r , t h o u g h no o n e d e n i e s t h a t all t h e older m o t i v e s are at w o r k in t h e s e l a t e r m o t i v a t i o n s as w e l l . On t h e o t h e r h a n d , m o r e a t t e n t i o n will n e e d to be paid to the fact I ha I t h e w a y p a r e n t s and l a t e r m e n t o r s b e h a v e does n o t g r o w out ol a v a c u u m , e i t h e r . T h e i r field of vision, and t h e b e h a v i o r t h a t follows I rom it, a r e f u n d a m e n t a l l y shaped b y t h e spirit o f t h e t i m e s . E v e r y age g r a n t s to h u m a n i t y a Da-sein, an e x i s t e n c e as a p e r c e p t i v e open realm, w h o s e limits a r e peculiar t o t h a t a g e . H e r e , " l i m i t " should b e u n d e r s t o o d i n its double m e a n i n g : w h e r e s o m e t h i n g ends and also as wh.it t h r o w . I In form peculiar to a thing i n t o relief. Limits, then, are w h a t allow a thing tu appear as w h a t it is, w h a t allow a being, to be what it is.

EXISTENTIAL

194

FOUNDATIONS

I t would s e e m , t h e n , t h a t w h e n a n e m e r g i n g a g e m o v e s h u m a n i t y i n t o a n e w f o r m of o p e n n e s s , a seal is placed o v e r s o m e of t h e m e a n i n g s t h a t had b e e n visible b e f o r e . T h e d e s t i n y t h a t s e t s t h e limits o f t h e possible open r e a l m of h u m a n e x i s t e n c e in a g i v e n e r a of h u m a n h i s t o r y is s e e n m o s t clearly t h r o u g h t h e w a y i n w h i c h t h e f u n d a m e n t a l n a t u r e o f p r e s e n c e s h o w s i t s e l f t o t h o s e living i n t h a t a g e . N o t o n l y individuals b u t s o c i e t y as a w h o l e a r e m o t i v a t e d by t h a t fate to specific m o d e s of r e s p o n d i n g t o w h a t h a s b e e n s h o w n t o it. R e s e a r c h i n t o t h e h i s t o r i c a l l y set b o r d e r s t h a t limit t h e possibilities for h u m a n b e i n g - i n - t h e - w o r l d f o r m s t h e basis o f e v e r y t y p e o f s o c i o l o g y and social p s y c h i a t r y . T h e s e disciplines h a v e d i s c o v e r e d t h a t s o m e w o r l d s i t u a t i o n s appear t o b e m u c h m o r e i n t u n e w i t h h u m a n b e i n g t h a n o t h e r s , t h a t at s o m e t i m e s people in g e n e r a l are allowed to fulfill t h e i r possibilities for e x i s t i n g m o r e freely and c o m p l e t e l y , and t o s t a y h e a l t h i e r , t h a n t h e y can in o t h e r a g e s . It has also b e e n found t h a t t h e p a r t i c u l a r f r e e d o m allotted to h u m a n b e i n g - i n - t h e - w o r l d in a given e r a is n o t equally favorable to all h u m a n b e i n g s . At t i m e s , the historical d e s t i n y delimiting h u m a n r e s p o n s e favors c e r t a i n kinds o f people o v e r o t h e r s , and t h e f o r m o f o p e n n e s s possible t o t h e n e x t h i s t o r i c a l period m a y b e h e a l t h i e r for t h o s e w h o w e r e s h o r t c h a n g e d b e f o r e . ( B y " h e a l t h i e r , " w e m e a n m o r e c o n d u c i v e t o t h e possibilities for e x i s t e n c e t h a t t h e s e people have brought with t h e m into the world than to those of others.) T h e Middle A g e s i n t h e w e s t , for i n s t a n c e , are usually d e s i g n a t e d " d a r k . " T h e i r abilities t o d e s c r i b e n a t u r e q u a n t i t a t i v e l y w e r e i n fact far o v e r s h a d o w e d b y t h e scientific a c h i e v e m e n t s o f m o d e r n t i m e s . I n place of t h e s e , h o w e v e r , t h e d a r k ages had a c l a r i t y of vision t h a t a l l o w e d t h e divinity and the a n g e l s to be p r e s e n t and to c o m e close in a w a y a l m o s t totally lost t o t h o s e living n o w . M o r e o v e r , t h e r e w e r e t i m e s d u r i n g w h i c h epidemics radically d e s t r o y e d t h e possibilities for e x i s t e n c e o f t h o s e living in a c e r t a i n r e g i o n , and t h e s e p a r t i c u l a r r e s t r i c t i o n s on h u m a n b e i n g - i n - t h e - w o r l d h a v e b e e n largely e l i m i n a t e d b y m o d e r n physical m e d i c i n e . O n t h e o t h e r h a n d , w e all k n o w t h a t h u m a n b e i n g - i n t h e - w o r l d faces a n e v e n g r e a t e r t h r e a t i n t h e n e a r f u t u r e f r o m t h e pollution o f air, w a t e r , and soil, n o t t o m e n t i o n t h e a t o m b o m b . B e s i d e s w h a t we h a v e said already, t h e r e is also t h e fact t h a t t h e reigning n a t u r a l scientific w a y o f i n v e s t i g a t i n g m a t e r i a l t h i n g s has s e r i o u s c o n s e q u e n c e s for 1 he h u m a n r e s e a r c h e r h i m s e l f . T h i s r e v e r s i o n h a p p e n s in such a w a y that h u m a n b e i n g s are less and less able to see t h e m s e l v e s e x c e p t as met n a n i s m s w h o s e p u r p o s e it is to f u n c t i o n s m o o t h l y and efficiently. M e a s u r e d against the g e n u i n e , rich n a t u r e of m a n , this sell image r e p r e s e n t s a m o n s t r o u s p e r v e r s i o n , an i m p o v e r i s h m e n t b o r d e r i n g on sell d e s t r u c t i o n Hy n a t u r e , the h u m a n being il a clear, open realm 1

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c o n s t i t u t e d of t h e ability to p e r c e i v e and r e s p o n d , and its t a s k is to allow t h e p r e s e n c e s i t p e r c e i v e s t o e n t e r i n t o this c l e a r n e s s , t o b e and t o unfold t h e i r m e a n i n g s and c o n t e x t s o f r e f e r e n c e . I f i t e v e r c o m e s a b o u t t h a t n o n h u m a n p r e s e n c e s a s well a s h u m a n b e i n g s a r e t h o u g h t o f simply a s m a c h i n e r y parts t h a t can b e m a t h e m a t i c a l l y d e s c r i b e d , t h e n w e will h a v e a w o r l d in w h i c h it will be less and less w o r t h w h i l e to be h e a l t h y . In t h e age o f t e c h n o l o g y , h e a l t h y people h a v e t o live and e x i s t a l m o s t e x c l u s i v e l y as cogs in a m a c h i n e r y g e a r e d to p r o d u c t i o n . T h u s , w h e n t h e y a r e well, t h e y r e c e i v e m u c h less o f t h e h u m a n and e n v i r o n m e n t a l address o f m e a n i n g f u l n e s s s o n e c e s s a r y f o r life t h a n w h e n t h e y b e c o m e ill and are cared for. B e i n g h e a l t h y , t h e y are f o r c e d to v e g e t a t e all a l o n e , at a level of h u m a n c o n t a c t and t r u s t far b e l o w t h e m i n i m u m t h e y n e e d t o e x i s t . I f t h e y are ill, t h e r e would be p h y s i c i a n s and a t t e n d a n t s , at least, to a n s w e r t h e i r h u m a n n e e d s . T h i s s t a t e of affairs is p r e s u m a b l y a s u b s t a n t i a l p a t h o g e n i c m o t i v a t i o n for t h e r e l a t i v e and a b s o l u t e i n c r e a s e in the incidence o f p s y c h o s o m a t i c illness. M e d i c i n e is t h e r e f o r e c o n f r o n t e d w i t h a r e m a r k a b l e p a r a d o x : t h e s a m e causal-genetic orientation that permits unprecedented therapeutic s u c c e s s e s b e c o m e s a s e r i o u s pathogenic m o t i v a t i o n w h e n t u r n e d back upon man. I t i s n o t o n l y t h e c a u s a l - g e n e t i c idea i n t h e t h e o r y o f h u m a n illness t h a t n e e d s t o b e put i n its p r o p e r place, h o w e v e r . T h e i m p o r t a n c e t h a t m o t i v a t i o n a l p a t h o g e n e s i s c l a i m s f o r i t s e l f m u s t a l s o b e modified. T h e i n c o n t e s t a b l e g r e a t practical s u c c e s s o f b o t h g e n e t i c i n v e s t i g a t i v e a p p r o a c h e s has seduced us i n t o believing t h a t t h e d i s c l o s u r e of a pathogenesis constitutes a way—the only way, in f a c t — o f adequately understanding any pathological phenomena we confront. But genetic i n v e s t i g a t i o n s invariably o n l y e n u m e r a t e and d e s c r i b e t h e c a u s e s , o r motivations, that have come before what is under investigation. To explain w h a t w e n t b e f o r e s o m e t h i n g i s n o t t o e l u c i d a t e t h e t h i n g itself. C a u s e s and m o t i v a t i o n s a r e a l t o g e t h e r different f r o m w h a t i s c a u s e d o r motivated. N o m a t t e r w h a t t h e f o r m a n i n v e s t i g a t i o n i n t o o r i g i n s m a y be, i t can h a v e n o claim t o t h e s t a t u s o f a r i g o r o u s l y scientific r e s e a r c h m e t h o d u n l e s s it h a s first m a d e t h e p a t h o l o g i c a l p h e n o m e n o n i t s e l f visible as it stands. A n y o n e w h o insists on taking a genetic approach without having first s u f f i c i e n t l y e x p l a i n e d t h e n a t u r e o f t h e p h e n o m e n o n u n d e r i n v e s t i g a t i o n is i g n o r a n t of t h e v e r y t h i n g w h o s e o r i g i n s he is looking for, like s o m e o n e t r y i n g to r e a c h a goal he h a s n e v e r glimpsed. A c t u a l l y , o r t h o d o x p s y c h o a n a l y t i c t h e o r y has a l w a y s set out t o w a r d t h a t i m p o s s i b l e goal. F r e u d h i m s e l f o f f e r s t h e c l e a r e s t p r o o f o f t h i s i n his opinion o n w h a t p s y c h o a n a l y s i s can, and c a n n o t , accomplish r e g a r d i n g

196

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f e m i n i n i t y . He w r i t e s : "It is n o t in t h e n a t u r e of p s y c h o a n a l y s i s to a t t e m p t to d e s c r i b e w h a t a w o m a n i s — t h a t is h a r d l y f e a s i b l e — b u t simply t o explain h o w a w o m a n b e c o m e s a w o m a n , h o w s h e develops o u t o f t h e b i s e x u a l l y disposed c h i l d . " Y e t h o w can p s y c h o a n a l y s i s even begin this u n d e r t a k i n g w h e n , by its o w n a d m i s s i o n , it h a s prejudged its s t a r t i n g point, t h e f e m a l e child, as b i s e x u a l l y disposed and is u n a b l e to u n d e r s t a n d or explain t h e n a t u r e of its end p r o d u c t , t h e adult f e m a l e ? S i n c e s u c h an e n t e r p r i s e is d o o m e d to failure f r o m t h e s t a r t , it follows t h a t t h e psychodynamic-genetic hypotheses of psychoanalytic theory must be s t a b s in t h e dark, c o n s i s t i n g as t h e y do in a s e r i e s of h i g h l y a b s t r a c t presuppositions. 2

T h e p h e n o m e n o n i t s e l f should t a k e p r e c e d e n c e o v e r any i n v e s t i g a t i o n i n t o o r i g i n s . T h i s holds n o t o n l y in t h e p a r t i c u l a r area of p s y c h o a n a l y t i c t h e o r y but in all medical t h i n k i n g . It is t h e p a r t i c u l a r d u t y of t h e p h e n o m e n o l o g i c a l o r i e n t a t i o n t o clarify t h e e s s e n t i a l m e a n i n g s i n h e r e n t in the o b j e c t of i n v e s t i g a t i o n itself. T h e following s k e t c h of a g e n e r a l p a t h o l o g y t h a t is a d e q u a t e l y h u m a n , p h e n o m e n o l o g i c a l , and scientific is based on an u n d e r s t a n d i n g w h i c h defines the p e r s o n w h o is ill in a c c o r d w i t h his n a t u r e as a h u m a n b e i n g , as Dasein, as e x i s t e n c e . O u r first s t e p s t o w a r d a g e n e r a l , D a s e i n s a n a l y t i c p a t h o l o g y a r e t h e r e f o r e directed t o w a r d t h o s e l i m i t a t i o n s o f p o t e n t i a l i t i e s w h i c h affect t h e e x i s t e n t i a l traits medicine considers most essential. NOTES 1. C f . F. W a g n e r , Die Wissenschaft und die gefährdete Well ( M u n i c h : C . H . B e c k , 1 9 6 4 ) , pp. 1 0 4 ff. a n d 4 0 1 ff. 2 . S . F r e u d , " N e u e F o l g e d e r V o r l e s u n g e n z u r E i n f ü h r u n g i n die P s y c h o a n a l y s e , " X X X I I I . Vorlesung: Die Weiblichkeil, in Ges. W., v o l . 1 5 ( L o n d o n : I m a g o , I n c . , 1 9 4 0 ) , p. 1 2 4 .

Chapter 13 A GENERAL DASEINSANALYTIC PHENOMENOLOGY OF ILLNESS

Preliminary remarks W e p r o g r e s s e d t o w a r d a d a s e i n s a n a l y t i c d e s c r i p t i o n o f o u r test s u b j e c t ' s p a t h o l o g i c a l s y m p t o m s b y repeatedly asking h e r t h e simple question: "Well now, Frau Z ü r c h e r , just what is lacking?" From time i m m e m o r i a l this i s h o w p h y s i c i a n s t h e w o r l d o v e r h a v e b e g u n t h e i r d i a g n o s e s , j u s t a s predictably, t h o u g h , t h e a n s w e r t h e y are given i s a n y t h i n g but a r e s p o n s e t o t h e q u e s t i o n . P a t i e n t s r e p o r t n o t w h a t t h e y lack, w h a t t h e y do n o t h a v e , b u t w h a t t h e y have: "I h a v e a h e a d a c h e , " "I h a v e a b r o k e n leg," "I h a v e this or t h a t c o m p u l s i v e t h o u g h t . " E v e n so, t h e p h y s i c i a n s and p a t i e n t s a r e n o t really talking past each o t h e r . B o t h a r e speaking a b o u t t h e m o d e o f being ill, t h o u g h from o p p o s i t e p o i n t s o f v i e w . I t i s t h e illness itself t h a t h a s t w o f a c e s . T h e p h y s i c i a n ' s q u e s t i o n posits illness as a lack of h e a l t h ; t h e p a t i e n t simply d e s c r i b e s w h a t h e " h a s . " H e r e p o r t s w h a t disturbs h i m , w h i c h is, thai b e c a u s e of his deficient h e a l t h he is forced to e x i s t in the form ol p a t h o l o g i c a l s y m p t o m s . His r e p o r t f u r t h e r m o r e r e v e a l s his attitude t o w a r d his c o n d i t i o n , and t h e physician m a y learn w h e t h e r the patienl has a c c e p t e d the illness as a c h a l l e n g e , revolted a g a i n s t it, tried to deny itl e x i s t e n c e , o r s u r r e n d e r e d t o it. T h e a t t i t u d e t o w a r d illness ig an i m p o r t a n t part of t h e p h e n o m e n o l o g y ol the suffering. A tuberculfll 1

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infection of t h e s a m e v i r u l e n c e and location m a y s p u r o n e p e r s o n on to a c r e a t i v e e x i s t e n c e w h i l e a n o t h e r v e g e t a t e s helplessly in a s a n i t o r i u m . If all illness is in fact t h e lack of t h e c o n d i t i o n of h e a l t h , t h e n illness is n e c e s s a r i l y a l w a y s r e l a t e d to, and u n d e r s t a n d a b l e o n l y in t e r m s of, t h e state of health. T h e reverse is never true, for health cannot be c o n s t r u c t e d f r o m w h a t i s its o w n deficient s t a t e . T h i s principle has b e e n f u n c t i o n i n g all along in o u r D a s e i n s a n a l y t i c i n v e s t i g a t i o n i n t o t h e patient's pathological symptoms. T h e results of our step-by-step testing o f t h e p h e n o m e n o l o g i c a l r e s e a r c h m e t h o d a g a i n s t individual p a t h o l o g i c a l s y m p t o m s of a p a r t i c u l a r p e r s o n s h o w e d u n e q u i v o c a l l y t h a t this a p p r o a c h could elucidate t h e p a t h o l o g i c a l p h e n o m e n a in t h e i r actual aspect, as m o d e s of a h u m a n b e i n g - i n - t h e - w o r l d , w h i l e the traditional s o m a t o - and p s y c h o p a t h o l o g i c a l e x p l a n a t i o n s o f medical s c i e n c e could gain no a c c e s s to h u m a n e x i s t e n c e as a r e a l m of w o r l d - o p e n n e s s . F u r t h e r m o r e , t h e p h e n o m e n o l o g i c a l approach did n o t n e e d to rely on a n y h y p o t h e t i c a l e n t i t e s supposedly o p e r a t i n g u n d e r t h e s u r f a c e . S o m e t h i n g else b e c a m e a p p a r e n t , a s well, a s w e w e n t t h r o u g h this p r o c e s s . B e f o r e looking i n t o t h e s y m p t o m s , w e a r r a n g e d t h e m a c c o r d i n g t o o n e o r a n o t h e r o f t h e m a n y classification s y s t e m s o n w h i c h traditional p a t h o l o g i e s h a v e b e e n based. First c a m e t h e division o f t h e illnesses i n t o t h e primarily o r g a n i c and primarily p s y c h i c . B e t w e e n t h e s e e x t r e m e s , w e located t h e c a t e g o r i e s o f p s y c h o s o m a t i c o r p s y c h o g e n i c , and s o m a t o p s y ­ chic o r s o m a t o g e n i c , illness. W e m i g h t a s well h a v e t a k e n r e f u g e i n a n y o t h e r c o m m o n s y s t e m o f classification. W e m i g h t h a v e classified pathological p h e n o m e n a a c c o r d i n g t o w h i c h o r g a n o r o r g a n i c s y s t e m i s first affected b y t h e d i s t u r b a n c e , o r a c c o r d i n g t o t h e w a y i n w h i c h t h e p r o g r e s s o f t h e disease a f f e c t s a n o r g a n , o r a c c o r d i n g t o t h e i r e t i o l o g i e s and p a t h o g e n e s e s . B u t w h a t e v e r classifications we did u s e , a v e r y d i f f e r e n t o r d e r a l w a y s emerged through our descriptions of symptoms, an orientation around the fundamental traits of human existence. T h i s insight is unavoidable, in fact, if illness is s e e n c o r r e c t l y as s o m e kind of deficiency in h e a l t h , and if the n a t u r e of this s t a t e of h e a l t h can be d e t e r m i n e d a d e q u a t e l y o n l y t h r o u g h e n u m e r a t i n g t h e w a y s i n w h i c h t h e e x i s t e n t i a l t r a i t s can b e carried out. W e shall n o w s y s t e m a t i c a l l y explain this p h e n o m e n o l o g i c a l r e s e a r c h m e t h o d , e v e n if at this point we can o n l y g e t as far as t h e r u d i m e n t s of a g e n e r a l p a t h o l o g y t h a t is a d e q u a t e to h u m a n n a t u r e . A s y s t e m a t i c e x p l a n a t i o n would n e e d t o e x a m i n e t h e w h o l e r a n g e o f possible pathological m a n i f e s t a t i o n s to d i s c o v e r for each particular i n s t a n c e w h i c h of the basic e x i s t e n t i a l t r a i t s h a s been impaired m o s t deeply a n d directly, and h o w . T h e s e a r e t h e only c r i t e r i a t h a i a l l o w us t o M ' i o g n i / e 11 te e x i s t e n t i a l n a t u r e o f pathological p h e n o m e n a a n d o r g a n i z e I h e m appropi lately Foi the time being, w e m a y h a v e 111 h e '.a I i'. I l e d w i t h

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tentative explorations. Given the newness of the phenomenological a p p r o a c h in m e d i c i n e , e v e n t h e f o r m u l a t i o n of a f e w appropriate q u e s t i o n s w o u l d b e n o small a c c o m p l i s h m e n t . W e m u s t also b e a r i n mind t h a t t h e f u n d a m e n t a l t r a i t s o f h u m a n being a r e n o t j u s t s o m a n y b r i c k s w i t h w h i c h Da-sein i s put t o g e t h e r . T h e y c a n n o t simply be a n a l y t i c a l l y t a k e n a p a r t and o b s e r v e d o n e by o n e . All are i n s e p a r a b l e , equally p r i m a r y , m e m b e r s o f t h e unified s t r u c t u r e t h a t i s h u m a n b e i n g - i n - t h e - w o r l d , and w h e n e v e r t h e fulfillment o f a n y one e s s e n t i a l trait is d i s t u r b e d , e v e r y o t h e r trait as well is a f f e c t e d to s o m e e x t e n t . C o n v e r s e l y , n o m a t t e r h o w s e v e r e t h e illness, a s long a s a p e r s o n still e x i s t s , it is i m p o s s i b l e for e v e n o n e of t h e s e t r a i t s to disappear a l t o g e t h e r . Illness involves t h e a s c e n d a n c y o r r e t r e a t o f s o m e trait w i t h r e s p e c t t o the o t h e r s , b u t e v e n w h e n t h e i r abilities t o b e a r e c o v e r e d up, all t h e t r a i t s still p e r s i s t as p o t e n t i a l i t i e s . W h a t is a c t u a l l y impaired in a g i v e n illness is t h e ill p e r s o n ' s ability to e n g a g e in c a r r y i n g o u t t h e s e p a r t i c u l a r p o t e n t i a l i t i e s a s free b e h a v i o r t o w a r d w h a t h e e n c o u n t e r s i n his w o r l d . I n b e g i n n i n g t h e a t t e m p t t o describe t h e c h a r a c t e r o f possible m o d e s o f illness as d i s t u r b a n c e s in fulfilling basic f e a t u r e s of h u m a n b e i n g - i n - t h e w o r l d , w e list o n c e m o r e t h o s e t r a i t s o r E x i s t e n t i a l s m o s t i m p o r t a n t for m e d i c i n e . T h e y a r e t h e s p a t i o - t e m p o r a l c h a r a c t e r o f Da-sein, its a t t u n e m e n t , its b o d y h o o d , its c o e x i s t e n c e o r being t o g e t h e r w i t h o t h e r people in a s h a r e d w o r l d , its o p e n n e s s and, finally, t h e unfolding of i n h e r e n t p o t e n t i a l i t i e s i n t o e x i s t e n t i a l f r e e d o m . W e h a v e a l r e a d y said all w e can a b o u t i m p a i r m e n t i n c a r r y i n g o u t t h e u l t i m a t e e x i s t e n t i a l trait o f mortality. A n y attempt to formulate a general Daseinsanalytic pathology must begin b y i n v e s t i g a t i n g t h e d i f f e r e n t m o d e s o f illness and t h e c o r r e s p o n d ­ ing d i s t u r b a n c e in fulfilling t h e E x i s t e n t i a l s o n — a n d on n o t h i n g b u t — t h e basis o f definite, c o n c r e t e , p a r t i c u l a r d i s t u r b a n c e s o f h e a l t h . F o r t h e basic f e a t u r e s o f h u m a n e x i s t e n c e a r e a n y t h i n g b u t a b s t r a c t and t h e o r e t i c a l , and t h e y a r e c e r t a i n l y n o t s u p p o s i t i o n s e x t r a n e o u s t o t h e o n t i c , s e n s o r i l y o b s e r v a b l e , p a r t i c u l a r p h e n o m e n a o f h u m a n e x i s t i n g . T h e y a r e n o less c o n c r e t e t h a n t h e d i s c r e t e , o b s e r v a b l e , o n t i c p h e n o m e n a o f h u m a n being itself. R a t h e r , t h e s e t r a i t s , w h o s e fulfillment is d i s t u r b e d in illness, a r e t h e m o s t c o n c r e t e o f all: T h e y a r e t h a t i n w h i c h all t h e s e n s o r i l y a s c e r t a i n a b l e p h e n o m e n a o f h u m a n c o n d u c t c o a l e s c e t o a unity. T h e y c o n s t i t u t e t h e basic n a t u r e o f t h e s e p h e n o m e n a , and a s t h e i r all pervading m e a n i n g f u l n e s s o r s i g n i f i c a t i o n s , m a k e t h e m t o t h e p h e n o m e na which they are. Add to this w h a t we h a v e already said in o u r c h a r a c t e r i z a t i o n ol u n d i s t u r b e d h u m a n Da-sein a b o u t h e a l t h as f r e e d o m , and the basil q u e s t i o n of a D a s e i n s a n a l y t i c g e n e r a l pathology a s s u m e s a tripartita

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aspect: ( l ) H o w is a p e r s o n ' s f r e e d o m to c a r r y o u t his p o t e n t i a l i t i e s impaired a t a n y g i v e n t i m e ; ( 2 ) W h a t a r e t h e s e p o t e n t i a l i t i e s ; and ( 3 ) W i t h r e s p e c t t o w h i c h e n t i t i e s o f t h e p e r s o n ' s w o r l d does this i m p a i r m e n t occur? In order to maintain some connection to traditional general patholo­ gies, we shall begin by discussing illnesses t h a t m a r k e d l y d i s t u r b t h e bodily being of h u m a n Da-sein. B o d y h o o d does n o t in and of i t s e l f m e r i t first place in t h e unified s t r u c t u r e of D a - s e i n . M e t h o d o l o g i c a l l y , it w o u l d p r o p e r l y c o m e last, for b o d y h o o d p r e s u p p o s e s b e i n g - i n - t h e - w o r l d . B o d y h o o d i s n o t h i n g b u t t h e bodily s p h e r e o f t h e fulfillment o f h u m a n e x i s t e n c e . It t a k e s first place o n l y in t h a t it is directly and i m m e d i a t e l y accessible to the senses. We k n o w already t h a t traditional m e d i c i n e , s u n k as it is in t h e c o n c e p t u a l w o r l d o f n a t u r a l s i c e n c e , has declared t h e body t h e sole reality of h u m a n b e i n g s . It had no o t h e r c h o i c e , since the body is the only easily m e a s u r a b l e and calculable p h e n o m e n o n of h u m a n Da-sein. And n a t u r a l s c i e n c e , g i v e n its c o n c e p t i o n o f n a t u r e , has n o a c c e s s t o w h a t c a n n o t b e m e a s u r e d and calculated. M o d e s of i l l n e s s s h o w i n g e v i d e n t i m p a i r m e n t of t h e b o d y i n g f o r t h of human existence W e h a v e already s e e n t h a t t h e b o d y h o o d o f h u m a n b e i n g s i s n o t t o b e t h o u g h t of as simply a physically p r e s e n t , m e a s u r a b l e body, n o r as s o m e s e l f - c o n t a i n e d t h i n g sufficient u n t o itself. W h i l e e v e r y t h i n g h u m a n i s bodily, this is b u t the bodying f o r t h of a p e r s o n ' s r e l a t e d n e s s to t h e w o r l d at a given m o m e n t , t h e r e l a t e d n e s s as w h i c h he e x i s t s . W h e n illness impairs t h e body, t h e r e are t w o q u e s t i o n s w h i c h a n y h u m a n l y a d e q u a t e t h e o r y will ask: J u s t h o w is t h e bodily s p h e r e of Da-sein d i s t u r b e d P and W h a t w a y of relating to t h e w o r l d is it t h a t is d i s t u r b e d ? O f all f o r m s o f illness w h i c h s h o w m a r k e d d i s t u r b a n c e s w i t h i n t h e bodily s p h e r e , t h e m o s t p r o m i n e n t are t h o s e traditional p a t h o l o g y classifies a s primarily o r g a n i c , o r s o m a t o g e n i c . T h e p r o t o t y p e s o f this c a t e g o r y are d i s e a s e s t h a t a r e i n h e r i t e d and t h o s e t h a t a r e c o n t r a c t e d in ulero, like H u n t i n g t o n ' s C h o r e a , c o l o r b l i n d n e s s , c e r t a i n f o r m s of diabetes, m o n g o l i s m , and e m b r y o n i c d a m a g e c a u s e d b y thalidomide. N a t u r a l scientific r e s e a r c h can d e m o n s t r a t e specific g e n e t i c d e f e c t s w i t h regard t o m a n y such i m p a i r m e n t s . M o l e c u l a r biology has d i s c o v e r e d c h a n g e s in the n u m b e r and type of c h r o m o s o m e s in a cell and d e v i a t i o n s in the a r r a n g e m e n t of t h e four basic u n i t s of the D N A m o l e c u l e s within the c h r o m o s o m e s . As o n e m i g h t e x p e c t , the natural scientific: way ol t h i n k i n g immediately t r a n s f o r m s t h e s e c h a n g e s into the cau$es ol the diseases,

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Phenomenology

201

while t h e simple, old c o n c e p t of c a u s e is being supplanted by t h e c o n c e p t s of c y b e r n e t i c s and i n f o r m a t i o n t h e o r y . In o u r critical evaluation ol i n f o r m a t i o n t h e o r y and its application t o h u m a n b e i n g s , w e e m p h a s i z e d t h a t its o n l y n o v e l t y w a s a r e f i n e m e n t of t h e c o n c e p t of c a u s e - a n d - e f feet. A t t h e s a m e t i m e , t h e old c o n c e p t o f causality w a s shifted c o n s i d e r a b l y t o w a r d t h e a n t h r o p o m o r p h i c and r o m a n t i c w i t h e x p r e s s i o n s like " i n f o r m a t i o n , " " w r i t i n g , " and " l a n g u a g e , " b o r r o w e d f r o m t h e realm o f i n t e r p e r s o n a l c o n t a c t . F u r t h e r m o r e , w e pointed o u t t h a t i n f o r m a t i o n t h e o r y has b e e n applied t o h u m a n p a t h o l o g y only a t t h e c o s t o f e x t e n d i n g t h e c o n c e p t of i n f o r m a t i o n to t h e p o i n t of e x t r e m e a m b i g u i t y . In a strict, scientific s e n s e , it is n o t possible to i m a g i n e w h a t h a p p e n s w h e n the m o l e c u l a r c h a n g e s w h i c h are p r o d u c e d in h e r e d i t a r y or primarily physical d i s t u r b a n c e s and can b e r e c o r d e d c h e m o p h y s i c a l l y o r c y b e r n e t i cally are s t a m p e d as c a u s e s , as i n f o r m a t i o n s o u r c e points, w h i c h o u t of t h e m s e l v e s supposedly e f f e c t w a y s of being ( w h i c h , as we h a v e said, always r e q u i r e a p e r c e p t i o n of w h a t is t h e r e and of m e a n i n g f u l n e s s ) . T a k e , for i n s t a n c e , c o l o r b l i n d n e s s , w h i c h is supposed to be primarily h e r e d i t a r y - o r g a n i c . If we w a n t to u n d e r s t a n d w h a t it really is, we will h a v e to find o u t f r o m t h e afflicted p e r s o n e x a c t l y h o w his ability to r e l a t e h i m s e l f t h r o u g h p e r c e p t i o n t o w h a t r e v e a l s i t s e l f t o h i m i n his w o r l d h a s b e e n impaired. W e will d i s c o v e r t h a t h e c a n n o t r e s p o n d t o t h e m e a n i n g s " r e d " and " g r e e n . " Y e t t h e p o t e n t i a l i t y i n u n d e r s t a n d i n g " r e d " for w h a t i t i s c a n n o t b e u n d e r s t o o d o n t h e basis o f a n y m o l e c u l a r s t r u c t u r e . Like c o l o r b l i n d n e s s , all of t h e o t h e r so-called primarily o r g a n i c - h e r e d i t a r y illnesses are b y n a t u r e n o t h i n g m o r e t h a n deficiencies i n t h e ability t o freely c a r r y out p o t e n t i a l w a y s o f being w h i c h are usually t h e r e for people. A m o n g m o d e s o f illness t h a t s h o w evident i m p a i r m e n t i n t h e bodying f o r t h o f b e i n g - i n - t h e - w o r l d w e can also c o u n t supposedly s o m a t o g e n i c h e a l t h d i s t u r b a n c e s t h a t arise in utero or a f t e r b i r t h . F o r i n s t a n c e , a child w h o has s u f f e r e d p r e n a t a l t h a l i d o m i d e d a m a g e and c o m e s i n t o t h e w o r l d w i t h o u t a r m s , is, for o n e t h i n g , directly affected in his ability to g r e e t people. H e c a n n o t s h a k e h a n d s ; h e i s cut o f f f r o m this w a y o f relating w i t h o t h e r s . T h e Da-sein of a child b o r n w i t h a r m s b u t u n a b l e to use t h e m b e c a u s e of paralysis at b i r t h h a s b e e n r o b b e d j u s t as e f f e c t i v e l y of its ability t o body f o r t h t h e g r e e t i n g r e l a t i o n s h i p . I n f e c t i o u s diseases should b e u n d e r s t o o d similarly. F o r i n s t a n c e , w h e n polio paralyzed s o m e o n e ' s a r m s , it is n o t simply his spinal cord and physical limbs t h a t are affected; m u c h of his e x i s t e n t i a l potential is d e s t r o y e d , e.g., t h e possibility of bodying f o r t h g r e e t i n g with a h a n d s h a k e . T h e virus h a s d e s t r o y e d t h a t s p h e r e of t h e p e r s o n ' s pot en t i.d m o d e s of b e i n g w h i c h is called, in t h e i n a d e q u a t e , a b s t r a c t , o b j e c t i f y i n g c o n c e p t u a l i t y of n a t u r a l s c i e n c e , t h e a n t e r i o r h o r n cells of t h e spinal ( o r d

202

EXISTENTIAL FOUNDATIONS

A n a c u t e r h e u m a t i c i n f l a m m a t i o n o f t h e right e l b o w and s h o u l d e r j o i n t could also m a k e it impossible to body f o r t h a g r e e t i n g r e l a t i o n s h i p . T h e n it would be t h e pain t h a t i n t e r f e r e d , t h o u g h such an i m p a i r m e n t would presumably be temporary. B r a c h i a l paralysis o c c a s i o n e d b y h y s t e r i a , s o m e t i m e s misleadingly called p s y c h o g e n i c p a r a l y s i s , r e p r e s e n t s still a n o t h e r w a y in w h i c h the bodying f o r t h of a g r e e t i n g m a y be impaired. T h a t this t o o should be s e e n a s a n i m p a i r m e n t o f t h e free c a r r y i n g o u t o f h u m a n b e i n g - i n - t h e - w o r l d does n o t need t o b e discussed h e r e , given d i s c u s s i o n s o f o u r t e s t s u b j e c t ' s h y s t e r i c a l leg paralysis. T h e s a m e p o t e n t i a l i t y for g r e e t i n g can also be impaired by a s e v e r e head w o u n d . F o r i n s t a n c e , s o m e o n e m i g h t b e s h o t t h r o u g h t h e head, s o t h a t h e a f t e r w a r d s s u f f e r s from a c u t e , p o s t t r a u m a t i c d e m e n t i a . T h e n i t m a y happen t h a t t h e affected p e r s o n n o l o n g e r r e c o g n i z e s t h e m e a n i n g f u l n e s s of a g i v e n s i t u a t i o n as an e n c o u n t e r t h a t calls for a g r e e t i n g . To him, n o w this s i t u a t i o n m i g h t m e a n n o t h i n g at all, or it m i g h t be e x p e r i e n c e d as s o m e t h i n g from w h i c h it is b e s t to flee. In e i t h e r c a s e , the injured p e r s o n will not be able to body f o r t h a friendly g r e e t i n g with a handshake. E v e n for this type of being ill, t h e d e s i g n a t i o n " p r i m a r i l y o r g a n i c " m i s s e s the point. It p r e j u d g e s t h e h e a d injury as s o m e t h i n g t h a t c o n s i s t s solely i n t h e d e s t r u c t i o n o f o r g a n i c brain m a t t e r . O n c e i t h a s b e e n s o m i s c o n s t r u e d , t h e r e is no l o n g e r any w a y to r e e s t a b l i s h a c o n n e c t i o n b e t w e e n this d a m a g e d o r g a n i c m a t t e r and t h e p a t h o l o g i c a l b e h a v i o r o f the person suffering from the traumatic dementia. T h e one way to u n d e r s t a n d this b e h a v i o r is t h r o u g h seeing t h a t t h e injury to t h e brain is directly and p r i m a r i l y a n i m p a i r m e n t o f the p e r s o n ' s ability t o c a r r y o u t e s s e n t i a l h u m a n w a y s of relating to t h e w o r l d , t h e brain being b u t a bodily s p h e r e o f t h e w h o l e e x i s t e n c e . W h a t h a p p e n e d w a s t h a t his ability t o g r e e t o t h e r people i n t h e m o d e s o f s h a k i n g h a n d s w a s also w o u n d e d . A n equally s e v e r e i m p a i r m e n t o f t h e ability t o body f o r t h g r e e t i n g can o c c u r in idiotia phenylpyruvica. H e r e t h e d a m a g e to t h e brain r e s u l t s f r o m the presence in the metabolism of poisonous substances which intervene d e s t r u c t i v e l y in t h e i n t e l l e c t u a l possibilities of t h e affected children by damaging w h a t s c i e n c e c o n c e p t u a l i z e s as t h e c e r e b r u m . W h i l e it can be p r e v e n t e d simply by w i t h h o l d i n g t h e foods t h a t , in t h e v a c u u m left by an i n n a t e e n z y m e deficiency, b e c o m e t h e r a w m a t e r i a l s for t h e m e t a b o l i c poisons t h a t d a m a g e t h e brain, t h e availability of a purely m a t e r i a l therapy does not diminish t h e validity of saying t h a t , even h e r e , w h a t is a l l c c l e d directly and i m m e d i a t e l y are w a y s of b e i n g with o i l i e r people. I h e c o r r e s p o n d i n g p h y s i o c h e m i c a l pathological i m p a i r m e n t s c a n b e e l u c i d a t e d by natural scientific i n v e s t i g a t i o n within the p h e n o m e n a l

A

General

Daseinsanalytic

Phenomenology

2(U

region split o f f from t h e h u m a n e x i s t e n c e and c o n c e p t u a l i z e d as c e r e b r a I and m e t a b o l i c . T h i s p r o c e d u r e s e p a r a t e s the d e s t r u c t i o n o f h u m a n p o t e n t i a l for r e l a t i o n s h i p from t h e u n i t y of t h e Da-sein and reduces it to m e r e m e t a b o l i c and c e r e b r a l d i s o r d e r s . N o w a d a y s , m o n g o l o i d idiocy can be diagnosed p r e n a t a l l y by o b s e r v a ­ tion of c h r o m o s o m e d a m a g e in fetal cells in placental fluid. T h i s priority i n t i m e d o e s n o t j u s t i f y t h e e l e v a t i o n o f this c h r o m o s o m a l finding t o the r a n k o f p r i m a r y c a u s e , basis, o r s o u r c e o f i n f o r m a t i o n for the later d e v e l o p m e n t o f p o s t n a t a l , s t r u c t u r a l bodily c h a n g e s and b e h a v i o r a l a b n o r m a l i t i e s of this disease unless t h e m e a n i n g of c a u s e is limited to d e s i g n a t e w h a t can b e r e g u l a r l y d e m o n s t r a t e d t e m p o r a r i l y t o precede t h e s u p p o s e d effect. W h a t is of first i m p o r t a n c e is the specific i m p a i r m e n t o f t h e ability t o fulfull definite possibilities o f r e l a t i o n s h i p w h i c h are o p e n t o t h e a v e r a g e p e r s o n . T h i s i s a n i m p a i r m e n t o f w h a t constitutes human existence. T h e chromosomal changes in the i n t r a u t e r i n e fetal cells a r e j u s t t h e first a s c e r t a i n a b l e p a t h o l o g i c a l p h e n o m e n a in t h e bodily s p h e r e of a b e i n g - i n - t h e - w o r l d t h a t is disturbed from its b e g i n n i n g . J u s t a s t h e bodily findings o f n a t u r a l s c i e n c e lose n o t h i n g o f t h e i r s i g n i f i c a n c e for m o n g o l o i d idiocy in a D a s e i n s a n a l y t i c a p p r o a c h , so t o o w i t h findings for o t h e r d i s e a s e s . Indeed, t h e s e findings can b e r e c o g n i z e d as t h e i n d i s p e n s a b l e condition of directed physical and c h e m i c a l t h e r a p e u t i c m e a s u r e s only w h e n t h e y are v i e w e d d a s e i n s a n a l y t i c a l l y , s e e n i n t h e t o t a l i t y o f t h e i r m e a n i n g f u l n e s s and c o n t e x t o f r e f e r e n c e s . S u c c e s s i n t w o scientific a c h i e v e m e n t s o f t h e h i g h e s t o r d e r d e m a n d s the c o n s t a n t e f f o r t t o b e a w a r e t h a t all pathological findings o n t h e body o f t h e h u m a n being w h i c h can b e scientifically a s c e r t a i n e d are b u l p h e n o m e n a of the disturbed bodyhood of human being-in-the-world. F i r s t , o n l y a d a s e i n s a n a l y t i c p e r s p e c t i v e can keep t h e pathological bodily p h e n o m e n a o f t h e e x i s t i n g h u m a n being f r o m b e c o m i n g i n c o m p r e h e n s i ­ ble a s w h a t t h e y factually are. S e c o n d , this p e r s p e c t i v e keeps medical u n d e r s t a n d i n g from losing t h e c o n n e c t i o n o f t h e s e p h e n o m e n a t o the c o n t e x t of t h e w h o l e bodily lived e x i s t e n c e of t h e ill p e r s o n . W h e n a scientific a p p r o a c h w h i c h h a s lost a s e n s e of its c o n d i t i o n a l i t y and r e l a t i v i t y applies a b s o l u t i z e d c o n c e p t s h e r e w h i c h r e d u c e a patient's p a t h o l o g i c a l bodily s i m p t o m s to isolated p r o p e r t i e s of a m a t e r i a l body, u n d e r s t a n d i n g of t h a t c o n t e x t is i n e v i t a b l y lost. T h e y w e r e m a r k e d l y bodily d i s t u r b a n c e s o f b e i n g - i n - t h e - w o r l d , l o o , t h a t B o n h o e f f e r classed t o g e t h e r i n 1 9 1 2 a s " a c u t e exogenic reaction t y p e s . " H i s d e s i g n a t i o n w a s u n f o r t u n a t e . It is impossible to ascei l a i n thai h u m a n b e i n g - i n - t h e - w o r l d is factually divided i n t o i n t e r n a l and e x t e i rial r e a l m s . T h u s , w h e r e v e r t h e y a r e used i n m e d i c i n e , the t e r m s " e x o g e n l i and " e n d o g e n i c " c o n f u s e m o r e t h a n they clarify.

204

EXISTENTIAL FOUNDATIONS

W e can safely let this p r o b l e m o f labelling b e for t h e m o m e n t , for m u c h m o r e i m p o r t a n t are t h e findings t h a t r e c e n t l y led r e s e a r c h e r s t o r e h a b i l i t a t e and e x p a n d c o n s i d e r a b l y B o n h o e f f e r ' s classification o f a c u t e , e x o g e n i c r e a c t i o n t y p e s . T h e i r i m p r e s s i v e e x p e r i m e n t a l r e s u l t s leave n o r o o m t o d o u b t t h a t all supposedly primarily physical d i s t u r b a n c e s , n o m a t t e r h o w d i f f e r e n t t h e y m a y be, are a c c o m p a n i e d b y similar, o r identical, p s y c h o p a t h o l o g i c a l b e h a v i o r . It is j u s t as c e r t a i n , t h o u g h , t h a t t h e s a m e h a r m f u l c h e m o p h y s i c a l c o n d i t i o n will b e followed b y d i f f e r e n t d i s t u r b a n c e s in t h e p e r c e p t i o n and b e h a v i o r of each p e r s o n it a f f e c t s . T h i s p r o v e s t h a t , a t least w i t h i n t h e b r o a d area o f a c u t e , e x o g e n i c reaction types, the apparent chemophysical, neuropathological causes are not at the base of the psychopathological behavioral phenomena; that is, t h e y are n o t g e n u i n e c a u s e s o f t h e s e afflictions. T h e l a t e s t findings, i n fact, point a w a y from s o m a t o g e n i c n o t i o n s a b o u t such d i s t u r b a n c e s . T h e y indicate r a t h e r t h a t t h e m o s t direct d e t e r m i n a n t o f any such illness is t h e p a r t i c u l a r w a y in w h i c h the p a t i e n t ' s b e i n g - i n - t h e - w o r l d e x t e n d s i n t o his life h i s t o r y and i n t o his h o p e s , desires, and fears for t h e f u t u r e . T h e ideas o f t r a d i t i o n a l p a t h o l o g y could n o t g r a s p this t h o r o u g h l y significant fact, and t h e s e r e s e a r c h e r s w e r e t h e m s e l v e s painfully a w a r e o f this. T h e y tell u s t h a t t h e y did n o t k n o w w h e t h e r t h e i r f o r m u l a t i o n s a b o u t a c u t e , e x o g e n i c r e a c t i o n types would t o u c h o n t h e n e u r o p a t h o l o g i ­ cal facts o f the m a t t e r o r m e r e l y e c h o f a n t a s i e s . 2

In m a k i n g a t r a n s i t i o n to a m o r e h u m a n l y a d e q u a t e , p h e n o m e n o l o g i cally o r i e n t e d g e n e r a l p a t h o l o g y , it is all t h e m o r e i n s t r u c t i v e to c o n s i d e r so significant a failure of t h e old w a y of t h i n k i n g a b o u t a form of illness as t h e a c u t e , e x o g e n i c r e a c t i o n type. A t t h e v e r y edge o f t r a d i t i o n a l p a t h o l o g y ' s c o n c e p t u a l h o r i z o n , B l e u l e r w a s able t o divide a c u t e , e x o g e n i c r e a c t i o n t y p e s i n t o t h r e e g r o u p i n g s . I n t o t h e first g r o u p i n g h e placed p a t i e n t s suffering f r o m a " g e n e r a l dimming, or dimunition, of c o n s c i o u s n e s s . " T h e s e c o n d g r o u p i n g is c h a r a c t e r i z e d by an alteration of c o n s c i o u s n e s s , i n w h i c h t h e individual b o n d s t h a t g u a r a n t e e t h e o r d e r and u n i t y of psychic life a r e disturbed, o p e n i n g up t h e w a y to s t a t e s of c o n f u s i o n a c c o m p a n i e d b y h a l l u c i n a t i o n s . T h e third g r o u p i n g , finally, involved a " m o r e simple o r d e r i n g " of c o n s c i o u s n e s s . T h e s e t h r e e g r o u p i n g s a r e t h e n c o m p a r e d w i t h t h e activity o f a t r o o p o f soldiers o f w h i c h B l e u l e r says: " I t s f o r c e i s e x t i n g u i s h e d w h e n each individual's s t r e n g t h g o e s ; if t h e c o m m a n d e r fails, it b e c o m e s d i s o r d e r e d , aimless and i n e f f e c t i v e , e a c h m e m b e r a c t i n g as he t h i n k s b e s t ; it r e g a i n s its order, but not its spirit or skill, w h e n s o m e o n e of less ability replaces the fallen c o m m a n d e r , e v e n t h o u g h each m e m b e r is slill capable of ai I i n ) ; " ( 0 1 responding to this a n a l o g y , B l e u l e r i m a g i n e s diminution o f i O H M iousness as affecting c e r e b r a l f u n c t i o n i n g as a w h o l e , a l t e r a t i o n o f

A

General

Daseinsanalylic

Phenomenology

205

c o n s c i o u s n e s s a s injury t o t h e i n t r a c e r e b r a l c o n n e c t i v e p a s s a g e w a y s ; and ordering on a more simple level as a reduction of t h e s e possibilities for connection. In so far as this a n a l o g y to a t r o o p is i n t e n d e d to i l l u s t r a t e a t h e o r y t r a c i n g t h e p a t h o l o g y o f t h e a c u t e , e x o g e n i c r e a c t i o n type b a c k t o t h e n o t i o n of a physical brain w i t h its manifold l e s i o n s , it h a s o v e r r e a c h e d its p o w e r s . W h a t w e h a v e said b e f o r e a b o u t t h e impossibility o f deriving any h u m a n m o d e s o f b e h a v i o r f r o m p h y s i c a l - n e r v o u s s t r u c t u r e s and p r o c e s s e s n a t u r a l l y applies also t o p a t i e n t s suffering f r o m a c u t e , e x o g e n i c r e a c t i o n types. H e r e , t o o , o n e can o n l y d e m o n s t r a t e t h a t certain c e r e b r a l p r o c e s s e s and h u m a n w a y s o f being are s i m u l t a n e o u s . B u t a b o v e all, w e h a v e p o i n t e d o u t t h a t t r a d i t i o n a l p s y c h o l o g y has found n o h a r d e v i d e n c e for t h e e x i s t e n c e , n a t u r e , o r c o n t e n t s o f the c o n s c i o u s n e s s it posits, n o r h a s it b e e n able to d e m o n s t r a t e h o w a p e r s o n , o r s u b j e c t , can " h a v e " c o n s c i o u s n e s s . A s long a s t h e t h i n g i t s e l f r e m a i n s u n k n o w n , supposed a t t r i b u t e s like " d i m m i n g , " " d i m i n u t i o n , " and " a l t e r a t i o n " can m e a n v e r y little. S i m i l a r l y , t h e idea of a d i s t u r b a n c e of o r d e r and u n i t y a m o n g individual t h o u g h t p r o c e s s e s and a s s o c i a t i o n s in the p s y c h e h a s no factual basis. As we h a v e said again and again, it has n o t b e e n possible to u n c o v e r a single piece of e v i d e n c e to p r o v e t h a t s u c h e n d o p s y c h i c e n t i t i e s e x i s t . T h u s , i t should b e c l e a r e n o u g h t h a t t h e c o n c e p t u a l a p p r o a c h of t r a d i t i o n a l p a t h o l o g y is i n a d e q u a t e to explain the p h e n o m e n a o f t h e a c t u e , e x o g e n i c r e a c t i o n type. W h a t p s y c h o l o g y h a s falsely t e r m e d t h e d i m i n u t i o n , a l t e r a t i o n , and d i m m i n g o f a n e n d o p s y c h i c c o n s c i o u s n e s s can b e h u m a n l y u n d e r s t o o d o n l y i f w e finally discard, o n c e and for all, t h e p s y c h o l o g i c a l n o t i o n o f c o n s c i o u s n e s s and learn to r e c o g n i z e t h a t t h e Da-sein e v e n of ill p e r s o n s is a p r i m a r y b e i n g - i n - t h e - w o r l d . O n l y t h e n will we finally be able to see the so-called p s y c h o p a t h o l o g i c a l s y m p t o m s o f t h e a c u t e , e x o g e n i c r e a c t i o n type f o r w h a t t h e y t r u l y are, a s a n i m p a i r m e n t o f t h e b r e a d t h and c l e a r n e s s of t h e w o r l d - r e a l m w h i c h t h e Da-sein of t h e afflicted p e r s o n can hold open. F u r t h e r m o r e , the usual e x p l a n a t i o n o f so-called hallucina­ t i o n s g i v e s o n l y t h e a p p e a r a n c e o f u n d e r s t a n d i n g . N o m a t t e r w h a t the u n d e r l y i n g illness, t h e r e h a s n e v e r b e e n s u b s t a n t i a l e v i d e n c e o f a n actual a l t e r a t i o n in an equally u n s u b s t a n t i a t e d e n d o p s y c h i c c o n s c i o u s n e s s , or of a l o o s e n i n g of e n d o p s y c h i c ties or a disruption of a s s o c i a t i v e t h o u g h t p r o c e s s e s . All w e m a y l e g i t i m a t e l y s a y o f people h a l l u c i n a t i n g w i t h i n the c o n t e x t of an a c u t e , e x o g e n i c r e a c t i o n type is t h a t t h e y a r e being e n c o u n t e r e d and e n g a g e d by t h i n g s of their w o r l d o t h e r t h a n , and in o t h e r w a y s t h a n , t h e h e a l t h y people a r o u n d t h e m . W h a t e v e r n o x i o u s i n f l u e n c e is p r e s e n t directly affects t h e f u n d a m e n t a l e x i s t e n t i a l trait thai is the ability to e n g a g e in spatial r e l a t i o n s h i p s to the t h i n g s of a shai ed

206

EXISTENTIAL FOUNDATIONS

world and t o live o n e ' s t i m e w i t h i n t h o s e r e l a t i o n s h i p s . T h e s a m e applies, finally, t o t h e third s u b g r o u p i n g o f t h e a c u t e , e x o g e n i c r e a c t i o n type, usually p o r t r a y e d as a r e d u c t i o n , or simplification, in the o r d e r i n g of t h o u g h t p r o c e s s e s and a s s o c i a t i o n s w i t h i n t h e psychic realm o f t h e a f f e c t e d p e r s o n . T h e v e r y idea o f n o r m a l e n d o p s y c h i c t h o u g h t p r o c e s s e s and a s s o c i a t i o n s c o n n e c t i n g t h e c o n t e n t s o f c o n s c i o u s n e s s t u r n s o u t t o be a factually g r o u n d l e s s supposition. A g a i n , all t h a t can be factually o b s e r v e d in p a t i e n t s w h o c o m e u n d e r this third g r o u p i n g is t h a t t h e o p e n w o r l d - r e a l m of p e r c e p t i o n as w h i c h t h e y e x i s t is, u n d e r c e r t a i n c o n d i t i o n s , r e d u c e d to an o p e n n e s s only for v e s t i g e s of t h e m e a n i n g s and c o n t e x t o f r e f e r e n c e s m a k i n g u p t h e i r world. T o t h e c a t e g o r y o f m a r k e d l y bodily illnesses b e l o n g n o t o n l y all o f t h e h e a l t h d i s t u r b a n c e s until n o w w r o n g l y labelled s o m a t o p s y c h i c , b u t also, n o t w i t h s t a n d i n g t h e i r supposed origin in t h e p s y c h e and t h e i r a s s u m e d p s y c h o g e n i c d e v e l o p m e n t , all t h e so-called p s y c h o s o m a t i c illnesses. In c o n n e c t i o n w i t h o u r t e s t s u b j e c t ' s h y s t e r i c a l and o r g a n i c - n e u r o t i c s y m p t o m s , w e discussed a t l e n g t h t h e precise w a y i n w h i c h t h e s e illnesses are to be seen as i m p a i r m e n t s in bodying f o r t h specific w a y s of relating t o t h e world. O n e c a t e g o r y o f illness m a r k e d b y i m p a i r m e n t i n t h e bodily s p h e r e o f e x i s t e n c e w h i c h has b e c o m e e x t r a o r d i n a r i l y i m p o r t a n t i n m o d e r n t i m e s i s t h e c o n d i t i o n k n o w n , since S e l y e ' s studies, a s t h e s t r e s s s y n d r o m e . S t r e s s m e a n s t e n s i o n , b u r d e n s o m e n e s s , e f f o r t . W h e n w e speak o f s t r e s s syndrome, we mean the consequences of the overstraining or overbur­ dening of a p e r s o n w h i c h a p a r t i c u l a r life s i t u a t i o n m e a n s for h i m . B e c a u s e e v e r y t h i n g d e p e n d s on t h e p a r t i c u l a r m e a n i n g e x p e r i e n c e d in a particular s i t u a t i o n , t h e r e can be no such t h i n g as an o v e r e x e r t i o n t h a t is, in itself, a b s o l u t e and u n i v e r s a l . W h a t a p p e a r s f r o m t h e o u t s i d e as t h e v e r y s a m e kind o f s i t u a t i o n can p r e s e n t a n e a s y t a s k t o o n e p e r s o n , w h i l e for a n o t h e r i t m a y involve s e v e r e l y p a t h o g e n i c s t r e s s . O n e i n s t a n c e o f t h e bodying f o r t h o f a n o v e r s t r a i n e d r e l a t i o n s h i p t o t h e world is found in t h e illness w h i c h m o d e r n m e d i c i n e has n a m e d " v e g e t a t i v e d y s f u n c t i o n . " T h i s is defined as disorder of the a u t o n o m i c n e r v o u s c e n t e r ' s r e g u l a t o r y s y s t e m , w i t h all o f its c o u n t l e s s n e u r e s t h e n i c s y m p t o m s . Its victims are p r e d o m i n a n t l y middle-class h o u s e w i v e s and executives, the former burdened beyond their powers with responsibili­ ty for a high s t a n d a r d of d o m e s t i c and c u l i n a r y e x c e l l e n c e w i t h o u t t h e d o m e s t i c help this would r e q u i r e , t h e l a t t e r o v e r t a x e d b e c a u s e m o d e r n industrial s o c i e t y , f o c u s s e d e x c l u s i v e l y on an e v e r i n c r e a s i n g d o m i n a t i o n of the world, holds t h e m in a m e r c i l e s s and n e v e r - e n d i n g c o m p e t i t i o n that n e v e r lets t h e m c a t c h t h e i r b r e a t h . W h e n the people w h o e x i s t in t h e m e x p e r i e n i c s i n h w a y . ol i elating to 3

A

General

Daseinsanalytic

Phenomenology

207

t h e w o r l d a s p e r m a n e n t s t r e s s s i t u a t i o n s , t h e i r bodying f o r t h can g o far b e y o n d m e r e v e g e t a t i v e d y s f u n c t i o n s t o s e v e r e l y d a m a g e d bodily s t r u c t u r e s . T a k e , for i n s t a n c e , e s s e n t i a l o r idiopathic high blood p r e s s u r e ; c o r o n a r y i n f a r c t i o n ; g a s t r o i n t e s t i n a l u l c e r s ; c h r o n i c colitis; and accident p r o n e n e s s . S o m e o f t h e s e have g r o w n i n t o plague p r o p o r t i o n s for m a s s e s o f people, r e a s o n e n o u g h for p h y s i c i a n s t o look i n t o t h e i r natures, right down to their existential meanings. I f w e a r e really t o u n d e r s t a n d t h e s e s t r e s s d i s e a s e s , w e m u s t first b e able to explain w h a t s t r e s s , as n o r m a l day-to-day s t r a i n and e x e r t i o n in t h e r e a l m of Da-sein, actually m e a n s . C o n t e m p o r a r y m e d i c i n e s e e s the u n v a r y i n g t h y m o l y m p h a t i c r e a c t i o n s , also called physical adaptation s y m p t o m s , a s t h e c o m m o n basis for t h e g r e a t d i v e r s i t y o f physical and psychic s t r e s s e s . I n t h e biological v i e w o f t h i n g s , m o r e o v e r , s t r e s s i s r e g u l a r l y c o n c e i v e d of as being a s t i m u l u s . B i o l o g i s t s o f t e n speak n o t only o f s t r e s s e s , b u t o f s t r e s s stimuli. T h e i n t e n t b e h i n d t h e t e r m m a y b e to unify t h e e x t e r n a l and t h e i n t e r n a l in p h y s i o l o g y and biology, but the e x p r e s s i o n " s t r e s s s t i m u l u s " simply says t h e s a m e t h i n g m o r e t h a n o n c e . B o t h w o r d s are being used h e r e i n t h e p s y c h o l o g i c a l s e n s e o f w h a t e n g a g e s and a f f e c t s a p e r s o n . B u t e v e n in its older u s a g e , Reiz ("stimulus") c a n m e a n m a n y t h i n g s , depending o n t h e p a r t i c u l a r r e g i o n i n w h i c h t h e s t i m u l u s o c c u r s . T h e t e r m i s m i g h t i l y lacking i n t h e s o r t o f u n e q u i v o c a l precision demanded in natural science. In the abstract dimensions of p h y s i o l o g y , w i t h its n o t i o n s o f isolated s e n s e p e r c e p t i o n s , s t i m u l u s — a s , for e x a m p l e , a s t i m u l u s initiated by s o u n d w a v e s — m e a n s s o m e t h i n g v e r y d i f f e r e n t t h a n in t h e a r e a of a p e r s o n ' s e v e r y d a y dwelling in his w o r l d . It is possible for, say, a " s t i m u l a t i n g " {reizende: " c h a r m i n g " ) landscape to " s t i m u l a t e " (reizen: " i n v i t e " ) us to t a k e a w a l k t h r o u g h it. We also n o t e d t h a t " s t i m u l a t i o n " (Reizen: " e x c i t a t i o n ) h a p p e n s as well in the c o e x i s t e n c e o f people, w h o can o f t e n e n o u g h " s t i m u l a t e " {reizen: " e x c i t e " ) e a c h o t h e r t o love o r fury. 4

5

T h i s diversity o f stimuli r e v e a l s different m o d e s o f e n g a g e m e n t , t h a t is, o f so-called s t r e s s . Y e t t h e fact t h a t s t r e s s m a y h a v e m a n y m e a n i n g s should n o t be t a k e n to indicate s o m e deficiency in t h e w o r d itself, or in w h a t i t r e f e r s to; this multiplicity o f m e a n i n g s i n h e r e s i n w h a t t h e w o r d designates. O n l y in the natural sciences, which are wholly oriented t o w a r d calculability, is a m b i g u i t y — m o r e t h a n o n e m e a n i n g for a d e s i g n a t i o n o r d e s i g n a t e d t h i n g — n o t admissible. T h e n a t u r a l s c i e n c e s can do n o t h i n g but c a l c u l a t e , and it is impossible to p e r f o r m calculations o n t w o t h i n g s t h a t are n o t a b s o l u t l e y free from a m b i g u i t y . T o suit this peculiar r e q u i r e m e n t , and n o t o u t o f r e g a r d for t h e o b j e c t o f study itsell, i m m e n s e e f f o r t is e x p e n d e d in t h e n a t u r a l s c i e n c e s , including medicine, to get rid of t h e i n h e r e n t a m b i g u i t y of p h e n o m e n a and r e d u c e t h e m to a c o n d i i i o n o f u n a m b i g u o u s calculability.

EXISTENTIAL

208

FOUNDATIONS

O n c e this h a s b e e n d o n e , t h e n a t u r a l s c i e n c e s d o n o t c o n s i d e r i t i m p o r t a n t t o i n q u i r e w h e t h e r the u n a m b i g u o u s n o t i o n o f s t r e s s t h a t r e s u l t s still c o r r e s p o n d s at all to w h a t it w a s m e a n t to d e s c r i b e . N o r is sleep lost o v e r t h e fact t h a t in reality t h e r e a r e no such t h i n g s as unspecific or s e l f - c o n t a i n e d stimuli. T h i s f r e q u e n t l y e m p l o y e d idea is r o o t e d in an u n r e a l i s t i c a b s t r a c t i o n . In c o n t e m p o r a r y p s y c h o s o m a t i c medicine, for i n s t a n c e , t h e t e r m " s t r e s s s t i m u l u s " i s o f t e n applied reductively t o clearly q u a n t i f i a b l e m e a s u r e s o f s o u n d , light, o r p r e s s u r e . Y e t s o m e sound s t i m u l u s , m e a s u r e d i n decibels and credited w i t h t h e p o w e r to p r o d u c e a c e r t a i n i n t e n s i t y of s e n s e p e r c e p t i o n in the h u m a n n e r v o u s s y s t e m , h a s l o s t all c o n n e c t i o n t o t h e o b j e c t o f study. I n fact, such t h i n g s as s o u n d stimuli do n o t e x i s t for a p e r s o n w h o is e x p o s e d and asked t o r e s p o n d t o s t r e s s . T h e y e x i s t o n l y a s h y p o t h e t i c a l c o n s t r u c t s and a b s t r a c t i o n s from t h e t h i n g s t h a t e n g a g e u s according t o the m e a n i n g s they allow us to p e r c e i v e . E v e r y s t r e s s , as s t r e s s , is c o n s t a n t l y o r i e n t e d to a p e r s o n ' s m o m e n t a r y relation to w h a t he p e r c e i v e s as it appears in o n e significance or a n o t h e r . B u t a h u m a n b e i n g ' s r e l a t e d n e s s to t h e w o r l d is n o t s o m e t h i n g t h a t h a p p e n s o n l y from t i m e to t i m e . He is, by n a t u r e , a l w a y s in o n e or a n o t h e r e c - s t a t i c , i.e., o p e n , perceptive, w o r l d - s p a n n i n g , r e l a t i o n s h i p t o w h a t e n g a g e s him. He e x i s t s as such r e l a t e d n e s s . T h i s r e l a t e d n e s s is n o t , like t h e h y p o t h e t i c a l e x p l a n a t i o n s of n a t u r a l s c i e n c e , posited for the p u r p o s e of i n t e r p r e t i n g h u m a n being. A h u m a n being can a l w a y s be s e e n directly as a b e i n g - i n - t h e - w o r l d , a p e r c e p t i v e being o p e n to t h e m e a n i n g f u l address o f p h e n o m e n a t h a t a r e n o t himself. W i t h o u t this m e a n i n g f u l address from e x i s t i n g t h i n g s , t h e h u m a n being could n o t exist. H u m a n s t r e s s , t h e n , a d e q u a t e l y u n d e r s t o o d , b e l o n g s t o t h e f u n d a m e n t a l c o n d i t i o n of t h e h u m a n being; it is an E x i s t e n t i a l . S t r e s s or b u r d e n i n g , as this indispensable m e a n i n g f u l address, s u p p o r t s and p r o m o t e s life. S t r e s s c a n also be healing. It is n o w well k n o w n t h a t i n t e n s e e m o t i o n a l s t r e s s does n o t n e c e s s a r i l y p r o v o k e d e p r e s s i o n ; i t can e v e n c u r e o n e . T h a t s t r e s s i s n e c e s s a r y f o r life r e m a i n s o b s c u r e a s long as the h u m a n being is w r o n g l y s e e n as a primarily w o r d l e s s e g o or s u b j e c t w h o s e life h i s t o r y is objectified as a s e q u e n c e of e v e n t s and p r o c e s s e s . 6

T h e n o t i o n of a p e r s o n as a f u n d a m e n t a l l y w o r l d l e s s s u b j e c t also p r e v e n t s a n u n d e r s t a n d i n g o f h o w i t i s t h a t m a n y people e x p e r i e n c e relief—the ending o f s t r e s s — a s b u r d e n s o m e , e x h a u s t i n g , and d e p r e s s ­ ing. O n e w o u l d e x p e c t , for i n s t a n c e , t h a t e x a m i n e e s , o n c e t h e y h a v e passed an e x a m , w o u l d feel relieved of all b u r d e n s and feel f r e e r and e a s i e r than e v e r b e f o r e . T h e s t r e s s o f t h e i m p e n d i n g e x a m i n a t i o n , w e a r g u e , is n o w o v e r and all r e a s o n s for feeling o p p r e s s e d should have disappeared. Y e t m a n y people fall i n t o d e e p d e p r e s s i o n jus 1 artei passing

A

General

Daseinsanalytic

Phenomenology

2 0

an exam. In 1 9 5 1 , Schulte warned, not without justification, that "Far m o r e a t t e n t i o n o u g h t t o b e g i v e n , i n o u r opinion, t o t h e i m p o r t a n c e o f relief as a m o t i v a t o r of d e p r e s s i o n . " Y e t S c h u l t e h i m s e l f later had t o a d m i t t h a t , "in t h e face o f myriad c o n v o l u t i o n s and o v e r l a p p i n g s , w e c a n n o t g e t past t h e b u r n i n g q u e s t i o n of w h a t it is t h a t really m a k e s this period of relief so dangerous and susceptible." I f w e look, h o w e v e r , a t t h e e s s e n t i a l p e r c e p t i v e r e s p o n s i v e n e s s o f h u m a n being to b e i n g e n g a g e d , we can s e e at o n c e h o w r e l i e f can h a v e a b u r d e n s o m e aspect. If h u m a n being is in fact p e r c e p t i v e r e s p o n s i v e n e s s to w h a t e v e r is present, then human being is existentially dependent on w h a t a d d r e s s e s o r b u r d e n s it. I n t h a t case, r e l i e f from s o m e t h i n g t h a t e n g a g e s a p e r s o n is an e x t i n c t i o n of his h u m a n b e i n g as t h e p e r c e p t i v e r e s p o n s i v e n e s s he is. W h e n this b u r d e n falls a w a y , w h a t is left is n o t j u s t s o m e n e g a t i v e , a n o n b u r d e n , b u t t h e e n d of a life-giving e n g a g e m e n t on the part of w h a t is r e l e a s e d . If a h u m a n being is deprived e n t i r e l y of s u c h e n g a g e m e n t , totally u n b u r d e n e d , h e i s r o b b e d o f t h e possibility o f c o n t i n u i n g to b e - t h e r e as a h u m a n being. A d e p r e s s i n g relief s i t u a t i o n is m o s t likely to happen w h e n e v e r a p e r s o n h a s allowed h i m s e l f to be a b s o r b e d totally b y s o m e t h i n g , w h i l e o t h e r t h i n g s t h a t m i g h t h a v e e n g a g e d a n d used him as a h u m a n b e i n g - i n - t h e - w o r l d h a v e in t h e m e a n t i m e r e c e d e d far i n t o t h e b a c k g r o u n d . I f t h e o n e r e m a i n i n g b u r d e n t h e n disappears, t h e p e r s o n n o l o n g e r h a s a n y t h i n g t o w h i c h h e can r e l a t e and w i t h w h i c h he is e n g a g e d ; t h e r e is no r e l a t e d n e s s in w h i c h and as w h i c h h e can dwell. H e can n o l o n g e r b e - t h e r e , n o l o n g e r e x i s t . S e e i n g this, S c h u l t e w r o t e , again i n 1 9 5 1 : " U n d e r the i m p r e s s o f t h e s e findings w e m u s t a d m i t , against t h e grain o f p r e s e n t practice, n o t o n l y t h a t a n o r g a n i s m ' s c a p a c i t y of being b u r d e n e d is a m e a s u r e of its h e a l t h , b u t t h a t a h u m a n being can be described as t r u l y healthy if we can d e c l a r e him capable of a c c e p t i n g and r e l i n q u i s h i n g b u r d e n s . " 7

8

9

T h e r e f o r e , the a p p a r e n t relief b r o u g h t a b o u t i n l a b o r a t o r y s i t u a t i o n s designed for m a x i m u m e x c l u s i o n o f all tactile, a c o u s t i c a l , a n d optical e n v i r o n m e n t a l stimuli are actually n o t h i n g m o r e t h a n e x t r e m e o v e r b u r d e n i n g . M a n y o f t h e s u b j e c t s living for days i n l i g h t - and s o u n d p r o o f r o o m s b r e a k d o w n u n d e r this s t r e s s and begin t o h a l l u c i n a t e — w h i c h m e a n s i n this c o n t e x t t h a t i n o r d e r t o b e able t o c o n t i n u e e x i s t i n g a s h u m a n b e i n g s , t h e y are forced t o g r a s p a t the p r e s e n c e s and e n g a g e m e n t s o f p h e n o m e n a t h a t d o n o t reveal t h e m s e l v e s to t h e h e a l t h y w a k i n g h u m a n b e i n g s w h o live in t h e e v e r y d a y world around them. T h e varied m e a n i n g s o f s t r e s s and t h e beneficial and pathological c o n s e q u e n c e s of s t r e s s s i t u a t i o n s in life are far m o r e a c c e s s i b l e t h r o u g h D a s e i n s a n a l y t i c insight t h a n t h r o u g h the c o n c e p t s o f s c i e n c e 0 1

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psychology. We have seen that Daseinsanalytic understanding shows the primary nature of human being-in-the-world to consist in maintaining an o p e n r e a l m of r e s p o n s i v e n e s s and p e r c e p t i o n , a r e a l m in w h i c h w h a t e v e r r e v e a l s i t s e l f to a p e r s o n can address him. It follows from this t h a t a h u m a n b e i n g always finds h i m s e l f e n g a g e d in s o m e s i t u a t i o n or o t h e r , and is t h e r e f o r e always u n d e r s o m e b u r d e n . No h u m a n s i t u a t i o n can b e r e p r e s e n t e d , c o n s e q u e n t l y , a s i f i t w e r e s o m e c o m p o s i t e m i x t u r e of s e p a r a t e i n g r e d i e n t s like t h e e g o , t h e body, and a w o r l d . S u c h i n g r e d i e n t s can f u n d a m e n t a l l y b e c o n c e i v e d o n l y a s p a r t s o f t h e u n i t y t h a t is b e i n g - i n - t h e - w o r l d . O n l y b e i n g - i n - t h e - w o r l d is c o m p r e h e n s i v e enough to submit to diverse articulations. B u t even the observations that a h u m a n b e i n g c a n n o t be s e p a r a t e d from his world fails to r e a c h t h e m a r k , since it t o o r e s t s upon t h e puzzling n o t i o n of a u n i o n of h u m a n being and w o r l d . If t h e specific m o d e of h u m a n b e i n g - i n - t h e - w o r l d is a d e q u a t e l y c o n s i d e r e d , h o w e v e r , this m a t t e r o f separability b e c o m e s i r r e l e v a n t for h u m a n Da-sein and can be dispensed w i t h from t h e o u t s e t . A s t h e final p h e n o m e n o n b e l o n g i n g t o the g r o u p o f s e v e r e bodily i m p a i r m e n t s o f b e i n g - i n - t h e - w o r l d , physical pain n o w d e s e r v e s m e n t i o n . T h e t e n d e n c y t o label pain a n e x c l u s i v e l y pathological s y m p t o m s o m e w h a t c o n t r a d i c t s its f u n c t i o n , w h i c h i s t o w a t c h o v e r h e a l t h b y w a r n i n g a p e r s o n of i m m i n e n t d a m a g e to his i n t e g r i t y ; b u t e v e n in its role as guardian, t h e p h e n o m e n o n of pain is c o n c e r n e d w i t h injury. In dealing w i t h o u t t e s t s u b j e c t , we l e a r n e d to see h e r bodily pains as m o d e s of o p e n n e s s t h a t allowed h e r t o r e c o g n i z e t h a t o b v i o u s injury w a s b e i n g done, o r had b e e n done, t o o n e o r a n o t h e r o f h e r p o t e n t i a l i t i e s for relating bodily to w h a t is in h e r world. To bring in a n o t h e r i n s t a n c e , let us say t h a t I am r e l a x i n g in my g a r d e n , s t r e t c h e d o u t c o m f o r t a b l y on a chaise l o u n g e , t h i n k i n g at l e i s u r e a b o u t t h e f o u n d a t i o n of c o n t e m p o r a r y m e d i c i n e . As I do this, I am b e i n g - i n - t h e world in s u c h a w a y t h a t , bodily at e a s e in k e e p i n g w i t h my p r e s e n t m o o d of o p e n r e l a x a t i o n , I am s i t u a t e d in the familiar c o n f i n e s of my o w n g a r d e n . At t h e s a m e t i m e I e x t e n d , as t h e o p e n and p e r c e p t i v e r e a l m I a m , o v e r the e n t i r e r a n g e of t h e w o r l d t h a t is a c c e s s i b l e to m e . I p e r m e a t e t h a t world, e x i s t i n g as a w o r l d - s p a n n i n g r e s p o n s i v e n e s s . W h i l e I lie in my g a r d e n , e n g a g e d i n visualizing t h e topic o f c o n t e m p o r a r y m e d i c i n e , m y b e i n g - i n - t h e - w o r l d e x t e n d s t h r o u g h space at least as far as A m e r i c a and Indonesia, and t h r o u g h t i m e t e n y e a r s i n t o my past. F o r as relax in t h e g a r d e n , I visualize t h e c o n v e r s a t i o n s I had back then, with P r o f e s s o r Allport at H a r v a r d U n i v e r s i t y and w i t h P r o f e s s o r S l a m e t in [akarta. No less f u n d a m e n t a l l y , my b e i n g - i n - t h e - w o r l d e x t e n d ' , .it I hr. m o m e n t i n t o my future. M y r e m i n i s c e n c e o f t h i n g s p a s t , my p r e s e n t p i . i c e in the garden, m y reflections o n m e d i c i n e — e a c h a n d all o l t h e t e I N d e t e r m i n e d

A

General

Daseinsanalytic

Phenomenology

by a l e c t u r e I am to give this c o m i n g s e m e s t e r , in t h e f u t u r e . My w a y . ol r e l a t i n g t o m y past and p r e s e n t are f o r m e d b y t h e fact that, h a v i n g decided to give this l e c t u r e , I am already e n g a g e d by this f u t u r e e v e n ! B e i n g - t h e r e as an o p e n r e a l m of t i m e and space, my e x i s t e n t i a l p o t e n t i a l i t i e s are realized in t h e w a y m o s t p r e c i s e l y suited to m e , and my e x i s t e n c e a s a n open p e r c e p t i v e r e s p o n s i v e n e s s r e a c h e s its g r e a t e s t r a n g e and f r e e d o m . As a c o n s e q u e n c e , my Da-sein is at this m o m e n t a t t u n e d to a m o o d of c o m p o s e d , r e l a x e d s e r e n i t y . A Da-sein is a t t u n e d to happiness il it is able to realize t h e p o t e n t i a l i t i e s e s s e n t i a l to it. B u t suddenly, i n t h e v e r y m i d s t o f m y happy and o p e n r e l a t e d n e s s t o t h e w o r l d , m y old c h a i s e l o u n g e collapses u n d e r m e , a s s u c h t h i n g s are w o n t t o do, and the ring f i n g e r o f m y r i g h t h a n d i s j a m m e d b e t w e e n the w o o d e n slats of t h e chair. G o n e in a flash is t h e wide e x p a n s e of my f o r m e r , happy c o n n e c t i o n t o t h e world, g o n e t h e r e w a r d i n g t h e m e o f p r e s e n t - d a y m e d i c i n e ; b o t h h a v e r e t r e a t e d t o a n e x t r e m e l y undefined, u n t h e m a t i c d i s t a n c e . T h e b r o a d e x t e n s i o n o f m y b e i n g - i n - t h e - w o r l d into its past and f u t u r e h a s s u d d e n l y s h r u n k , a t t u n e d as I am to a t h r o b b i n g pain, t o the m e a g e r p r o p o r t i o n s o f a c o n n e c t i o n t o m y injured fingertip. My f u t u r e is limited to a plan for ending this awful pain as quickly as possible. N o w , n o o b j e c t - p s y c h e h a s b e e n altered i n this p r o c e s s , n o r a n y t h o u g h t p r o c e s s e s o r a f f e c t s w i t h i n such a n o b j e c t - p s y c h e . W h a t has b e e n c h a n g e d and r e a t t u n e d is, r a t h e r , the p e r c e p t i v e o p e n n e s s o f the b e i n g in space and time t h a t is t h e e s s e n c e of my Da-sein. T r a d i t i o n a l m e d i c i n e m i g h t h a v e i n t e r p r e t e d this e v e n t as a s o m a t o ­ psychic disturbance, or an acute, exogenic reaction. If we intend to d e m y t h o l o g i z e such i n a p p r o p r i a t e n o t i o n s a b o u t p r i m a r i l y o r g a n i c h e a l t h d i s t u r b a n c e s , w e m u s t carefully avoid t h e all t o o f r e q u e n t m i s i n t e r p r e t a t i o n t h a t t h e p i n c h e d fingertip is a physical o b j e c t in itsell w h i c h , w h e n injured, a c t u a t e s , e v e n c a u s e s , a n a t t e n d a n t p s y c h o p a t h o logical p h e n o m e n o n . T h i s i s n o t so. S e e n o b j e c t i v e l y — t h a t is, scientifical­ ly and in a w a y t h a t is a p p r o p r i a t e to h u m a n b e i n g s — t h e pinching of my fingertip, i.e., a bodily s p h e r e of my e x i s t e n c e , a f f e c t e d my w h o l e being, i n - t h e - w o r l d directly, w i t h o u t t h e i n t e r v e n t i o n of a n y e x o g e n i c physi< a I o b j e c t , t o such a n e x t e n t t h a t m y e n t i r e w a y o f r e l a t i n g i n space and time to t h e w o r l d w a s r e a t t u n e d , e x a c t l y as it w a s described a b o v e . T h e r e appears t o b e q u i t e s o m e discrepancy h e r e b e t w e e n a relatively m i n o r injury t o t h e bodily s p h e r e o f m y e x i s t e n c e , t h e pinching o l one finger, and t h e s e v e r e i m p a i r m e n t visited o n m y e n t i r e being-in the w o r l d . P e r h a p s it is by v i r t u e of t h e fact t h a t t h e f i n g e r is t h e most h i g h l y s o p h i s t i c a t e d r e a l m o f m y ability to r e l a t e t o t h i n g s bodily that the lone of this painful e x p e r i e n c e could so powerfully affect t h e e x t e n s i o n ol my b e i n g - t h e r e in space and t i m e . T h r o u g h his fingers, a person can c a r r y

212

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out w i t h m a r v e l o u s d e x t e r i t y his e c - s t a t i c w a y s o f relating t o t h e w o r l d . C o n s i d e r t h e d e x t e r i t y o f t h e v i r t u o s o pianist, w h o s e f i n g e r s give h i m a highly refined w a y o f r e l a t i n g t o his a u d i e n c e and t o t h e m u s i c h e i s playing. M o r e p r e c i s e p h e n o m e n o l o g i c a l r e s e a r c h m a y s o m e d a y b e able to find a close c o r r e l a t i o n b e t w e e n t h e function and s o p h i s t i c a t i o n of an injured bodily r e g i o n and t h e r e l a t i v e f o r c e and quality of t h e pain t h a t is e x p e r i e n c e d . It m a y be a r g u e d t h a t t h e brain, w h i c h is t h e m o s t s o p h i s t i c a t e d a r e a o f t h e bodily r e a l m o f h u m a n e x i s t e n c e , i s also t h e m o s t i n s e n s i t i v e t o pain, b u t w e should k e e p i n m i n d t h e g r e a t s e n s i t i v i t y o f t h e m e n i n g e s . A n y i n j u r y w h i c h t h r e a t e n s t h e brain from t h e o u t s i d e , and m i g h t possibly t h e r e f o r e b e a v e r t e d , can h a p p e n o n l y a f t e r this p r o t e c t i v e m e m b r a n e h a s s u f f e r e d a n e x t r e m e l y painful lesion.

s

W h a t is i m p o r t a n t to glean from o u r e x a m p l e is t h e fact t h a t bodily pain a l w a y s i n h e r e s in s o m e injury done to a p e r s o n ' s r e l a t e d n e s s to t h e w o r l d — t h a t is, t o t h e p e r s o n ' s v e r y e x i s t i n g . B o t h are s o closely r e l a t e d t h a t bodily pain actually m a k e s it possible for a p e r s o n to perceive injury to Da-sein. In this p r o p e r t y of pain lies t h e a n s w e r to a q u e s t i o n t h a t h a s u p t o n o w r e m a i n e d open. T h e r e has b e e n g r e a t u n c e r t a i n t y a b o u t t h e n a t u r e o f t h e r e l a t i o n s h i p b e t w e e n bodily and m e n t a l pain. W e did m a n a g e to define m e n t a l pain, in t h e f o r m of s o r r o w , as an E x i s t e n t i a l . W s a w t h a t t h e e v e r p r e s e n t p o t e n t i a l for a p p a r e n t l y g r o u n d l e s s s o r r o w i s in reality an a t t u n e m e n t w h i c h o p e n s us to perceiving t h a t o u r Da-sein h a s b e e n t o r n l o o s e f r o m t h e u n c o n d i t i o n a l a b s o l u t e . B u t bodily pain is a v e r y specific kind of m e s s e n g e r . It heralds e x c l u s i v e l y injury to o u r ability to body f o r t h o u r r e l a t e d n e s s t o t h e w o r l d . S o r r o w , t h e r e f o r e , i s t h e o n l y basis for fully g r a s p i n g t h e m e a n i n g of bodily pain. S o r r o w c a n n o t be a p p r o a c h e d from t h e s t a n d p o i n t o f physical pain, h o w e v e r . T h e p s y c h i c pain of s o r r o w r e v e a l s t h e f u n d a m e n t a l , e x i s t e n t i a l l a c e r a t i o n of Da-sein; physical pain o n l y p e r m i t s us to p e r c e i v e partial i m p a i r m e n t s in t h e bodily s p h e r e o f w a y s o f being. S e e i n g i n t o t h e affinity b e t w e e n bodily pain and o u r e c - s t a t i c relatedness to the world brings us closer to understanding two extremely puzzling pain p h e n o m e n a . T h e first is t h e p h a n t o m pain e x p e r i e n c e d in limbs t h a t h a v e b e e n a m p u t a t e d ; t h e s e c o n d , t h e fact t h a t w h e n pains e n s i t i v e n e r v e s a r e s t i m u l a t e d , t h e r e s u l t i n g pain is felt o n l y at t h e o u t e r m o s t ends o f t h e s e n e r v e s . W e m a k e o u r first step t o w a r d understanding these phenomena w h e n we extend our narrow picture of s e p a r a t e n e r v o u s o r g a n s t o e n c o m p a s s o u r e x i s t e n t i a l w a y s o f relating t o the world, t h e t r u e dwelling place o f all bodily p h e n o m e n a . W e have pointed out that t h e s e w a y s o f relating r a n g e far be v e n d I h e v o l u m e o f space hounded by the skin. F r o m t h e r e , it lake', no great leap to under.land both p h a n t o m pain and what h . e . b e e n i a i l e d in e r r o r

A

General

Daseinsanalytic

Phenomenology

213

" p r o j e c t i o n i n t o the n e r v e e n d i n g s . " A f o u n d a t i o n of m e d i c i n e is not the place t o t h o r o u g h l y e x p l i c a t e t h e s e p h e n o m e n a , h o w e v e r — a m a t t e r m o r e f o r a specialized, p h e n o m e n o l o g i c a l l y o r i e n t e d p a t h o l o g y . L o o k i n g back o v e r o u r c a t a l o g o f bodily i m p a i r m e n t s o f b e i n g - i n - t h e world, w e can clearly see t h a t i t i n c o r p o r a t e s m o d e s o f illness w h i c h traditional g e n e r a l p a t h o l o g i e s h a v e s c a t t e r e d a c r o s s t h e w h o l e s p e c t r u m o f classification, and i t e x p l o d e s t h e h i e r a r c h y w h i c h o n c e provided t h e only f r a m e w o r k for t h e p a t h o l o g i c a l s y m p t o m s o f o u r o w n t e s t c a s e . F o r h o w could we p r e s e r v e a h i e r a r c h y t h a t b e g i n s w i t h a c a t e g o r y of s o called primarily o r g a n i c physical i l l n e s s e s o n c e w e r e c o g n i z e d t h a t , given t h e n a t u r e o f h u m a n n e s s , such illnesses simply c a n n o t e x i s t .

Modes of illness showing severe impairment in the spatiality and temporality of human being-in-the-world T h e m o s t e v i d e n t i m p a i r m e n t o f t h e basic e x i s t e n t i a l t r a i t s o f spatiality and t e m p o r a l i t y in r e l a t i n g to t h e p h e n o m e n a of t h e w o r l d h a p p e n s in t h o s e i l l n e s s e s t h a t p s y c h i a t r i s t s classify as o r g a n i c p s y c h o s e s . In p a t i e n t s w h o s u f f e r f r o m p r o g r e s s i v e paralysis, for i n s t a n c e , o r senile d e m e n t i a , i t is n o t m e r e l y t h e v o l u m e of t h e p s y c h e t h a t is reduced, b u t t h e size of t h e s p a t i o - t e m p o r a l w o r l d held o p e n by t h e s e people's Da-sein. T h e r a n g e of t h i n g s and people to w h i c h such a p a t i e n t m a y still r e s p o n d h a s s h r u n k to t h e d i m e n s i o n s o f t h e i m m e d i a t e p e r c e i v a b l e e n v i r o n m e n t , and even h e r e t h e r e is such a closed d o o r b l i n d n e s s to t h e m e a n i n g of w h a t is perceived t h a t spatial d i s o r i e n t a t i o n often r e s u l t s . O f t h e t h r e e t e m p o r a l e x i s t e n t i a l e x t e n s i o n s o f past, p r e s e n t , and f u t u r e , the first and third a r e n e a r l y totally c o v e r e d up in s u c h p a t i e n t s , so m u c h so t h a t t h e i r e x i s t e n c e i s practically reduced t o t h e p r e s e n t . E v e n older people w h o are h e a l t h y are far less likely t h a n t h e i r y o u n g and middle-aged c o u n t e r p a r t s to be c o n c e r n e d w i t h plans for t h e f u t u r e and a r e apt t o focus r a t h e r s t e a d f a s t l y o n t h e p r e s e n t . T h e y m a k e u p for this b y h a v i n g g r e a t e r access to their pasts. T h e events of their youth draw nearer to them than e v e r b e f o r e , and t h e i r Da-sein g o e s o u t to r e m e m b r a n c e of t h i n g s past. T h u s t h e r e i s a t least o n e t e m p o r a l e x t e n s i o n t h a t r e m a i n s open, from t h e i r p r e s e n t to t h e i r past, for t h e y do realize t h a t t h e y a r e dwelling in w h a t has b e e n . N o w , w h e n w e h e a r t h a t people s u f f e r i n g from s e v e r e senile d e m e n t i a i m a g i n e t h a t t h e y a r e actually children again and m i s t a k e a n y o n e in t h e i r i m m e d i a t e p r e s e n c e for a f o r m e r p l a y m a t e , we say t h e s e people a r e " l i v i n g in t h e p a s t . " B u t this is n o t so. To say this a s c r i b e s to the illness s o m e t h i n g e x t e r n a l and s u p e r f l u o u s , s o m e t h i n g taken from the s t a n d p o i n t of an o b j e c t i v e o b s e r v e r , but t h e p h e n o m e n o n itsell reveal* t h a t t h e s e senile people do n o t live in relation to t h e i r past as the pail, the s p a c e - t i m e r a n g e of t h e i r b e i n g - i n - t h e - w o r l d does not go from the

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p r e s e n t b a c k i n t o t h e p a s t a n y m o r e . T h e i r t e m p o r a l i t y has b e e n r e d u c e d a l m o s t e x c l u s i v e l y t o t h e p r e s e n t . B u t t h e y live i n t h e p r e s e n t r e l a t i o n s h i p s to t h e people and t h i n g s of t h e i r childhood. E v e r y t h i n g a h e a l t h y p e r s o n would e x p e r i e n c e in t h e p r e s e n t is a b s o r b e d in t h e s e r e l a t i o n s h i p s and c o r r e s p o n d i n g l y m i s p e r c e i v e d . I n discussing t h e s e e x t r e m e illnesses, w e h a v e s t u d i o u s l y avoided claiming t h a t t h e t e m p o r a l e x t e n s i o n s are e v e r actually lost, saying r a t h e r t h a t t h e y a r e m a s k e d , o r c o v e r e d up. H u m a n t e m p o r a l i t y c o n s i s t s o f all t h r e e e x t e n s i o n s — p a s t , p r e s e n t , and f u t u r e . B e i n g e s s e n t i a l t o h u m a n n a t u r e , n o n e of t h e m can simply disappear and still leave a h u m a n Da-sein b e h i n d . N o w , c h i l d r e n a r e said to live e n t i r e l y in t h e p r e s e n t , n o t y e t having a c c e s s to a past or a f u t u r e . B u t this living in the p r e s e n t is v e r y d i f f e r e n t from t h a t of senile p a t i e n t s , for it is n o t t h a t children do n o t live t h e d i m e n s i o n of t h e past b u t t h a t t h e r e is n o t yet e n o u g h past to e f f e c t i v e l y d e t e r m i n e t h e i r p r e s e n t . As for the f u t u r e , it b e g i n s to s t a m p t h e p r e s e n t w i t h i n c r e a s i n g force for children a s t h e i r c u r i o s i t y g r o w s , w h i l e in old people this f u t u r e - d i r e c t e d n e s s m o r e and m o r e declines. P s y c h i a t r y has m a d e it all t h e m o r e difficult to a c h i e v e a D a s e i n s a n a l y t i c v i e w o f o r g a n i c p s y c h o t i c s t h r o u g h the v e r y c h o i c e o f this p h r a s e t o d e s c r i b e s u c h p a t i e n t s . S u c h illnesses a r e n o t c a u s e d b y biophysical, functional, and s t r u c t u r a l d i s t u r b a n c e s in a brain organ. E v e r y o n e h a s from birth t h e p o t e n t i a l for e x i s t i n g in t h e p a t h o l o g i c a l m a n n e r a s c r i b e d t o o r g a n i c p s y c h o t i c s . W e m a y see this b y t h e fact t h a t h e a l t h y people, while d r e a m i n g , can c o n d u c t t h e m s e l v e s i n t h e v e r y s a m e w a y a s o r g a n i c p s y c h o t i c s , a l t h o u g h t h e y r a r e l y e n g a g e in and c a r r y o u t this p o t e n t i a l in t h e i r w a k i n g lives. If t h e s e p s y c h o t i c p o t e n t i a l i t i e s h a v e a l w a y s b e e n t h e r e , t h e r e is no c a u s e to p r o d u c e t h e m in o r g a n i c p s y c h o t i c s t h r o u g h l a t e r biophysical c h a n g e s in the brain. T h i s would hardly be possible, in fact. N o m a t t e r h o w a p e r s o n ' s w a y s o f being m a y b e pathologically c h a n g e d i n r e l a t i o n t o w h a t h e e n c o u n t e r s , t h e v e r y fact t h a t t h e s e are w a y s o f being m e a n s t h e y c a n n o t h a v e o r i g i n a t e d i n biophysical p r o c e s s e s . T h e r e i s t h e r e f o r e n o o r g a n i c e x p l a n a t i o n for t h e illness o f supposedly o r g a n i c p s y c h o t i c s . E v e n t h e i r w a y o f b e h a v i n g i s g r o u n d e d in ability to p e r c e i v e w h a t t h e y e n c o u n t e r in t h e i r world as m e a n i n g f u l things or people. N o ability t o p e r c e i v e m e a n i n g f u l n e s s , n o m a t t e r h o w impaired i t has b e c o m e , can e v e r be derived from biophysical p r o c e s s e s . F o r e x a m p l e , if w e tried t o explain the m o n o m a n i c b e h a v i o r o f a p r o g r e s s i v e paralytic o n t h e basis o f the biophysical p r o c e s s e s a c c e s s i b l e to natural s c i e n c e , we w o u l d reach u t terly absurd c o n c l u s i o n s . W e m i g h t h a v e t o a t t r i b u t e the l a c I thai t h e m o n o m a n i c n o t i o n s o f paralytic s t h e s e d a y s a r e SO m u c h less a m b i t i o u s than t h o s e o f their p r e d e c e s s o r s t o a n n u l e a s i n g e n n u i i n

A

General

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Phenomenology

215

p r e s e n t - d a y s p i r o c h e t e s , w i t h t h e r e s u l t t h a t t h e d i s t u r b a n c e s in the n e r v e cells o f t h e f r o n t a l lobe a r e less t u r b u l e n t t h a n t h o s e caused b y the a n c e s t o r s of t h e s e s a m e s p i r o c h e t e s . S o m e t h i n g t h a t is biophysical in n a t u r e c a n p r o d u c e o n l y s o m e t h i n g else t h a t is b i o p h y s i c a l in n a t u r e . T h u s , i t m a t t e r s v e r y little w h e t h e r n a t u r a l s c i e n c e d i s c u s s e s a p a r t i c u l a r i n s t a n c e of p r o g r e s s i v e p a r a l y s i s in r e l a t i o n to an i m m u n e biologicr e a c t i o n , or a c h r o n i c e n c e p h a l i t i c r e a c t i o n , or a d e g e n e r a t i v e p r o c e s s , or a n y o t h e r m a t e r i a l p r o c e s s i n t h e brain o f t h e p a t i e n t . W h a t e v e r t h e particular e x p l a n a t i o n m a y b e , it is basically akin to m a g i c if, f o r i n s t a n c e , it tries to explain t h e b e h a v i o r of a paralytic w h o m i s t a k e s h i m s e l f and his s u r r o u n d i n g s for t h e b e i n g - i n - t h e - w o r l d of a C h i n e s e e m p e r o r as deriving f r o m injury to s o m e bodily r e a l m c o n c e p t u a l i z e d as a brain organ. W e m a i n t a i n t h a t t h e r o l e o f p h y s i c a l i t y i n o r g a n i c p s y c h o s e s can b e described a t b e s t t h r o u g h t h e f o l l o w i n g p r o p o s i t i o n s . T h e m o s t w e can say is, first, t h a t t h e r e is a r e g u l a r s i m u l t a n e i t y b e t w e e n p a t h o l o g i c a l b e h a v i o r in paralytics and a c e r t a i n c o n d i t i o n of t h e brain. S e c o n d , w h a t n a t u r a l s c i e n c e i n t e r p r e t s a s f r o n t a l lobe d a m a g e c a u s e d b y lues s p i r o c h e t e s is actually p r i m a r y and direct injury to t h e b e i n g - i n - t h e w o r l d o f a n e x i s t i n g h u m a n b e i n g w h i c h d e s t r o y s t h e bodily c a p a c i t y for carrying out most of the normal, appropriate ways of responding to what a p e r s o n e n c o u n t e r s . It f o l l o w s , third, t h a t a p e r s o n so a f f e c t e d h a s at his disposal o n l y an e x t r e m e l y s e l f - c e n t e r e d , r e s t r i c t e d m o d e of h u m a n Dasein. S t r i c t l y speaking, t h e s u b s t r a t u m of o r g a n i c illness is only t h a t s p h e r e of t h e r e d u c e d spatiality and t e m p o r a l i t y of paralytically ill h u m a n b e i n g s w h i c h m a y also be i n t e r p r e t e d , t h o u g h i n a d e q u a t e l y , as d e f e c t s in biophysical brain m a t t e r at a specific location in s p a c e . Psychiatry further misinterprets the nature of organic psychotics w h e n i t s e e s a s o n e o f t h e i r crucial s y m p t o m s a n i m p o v e r i s h m e n t o f t h o u g h t p r o c e s s e s , defined as a deficiency of a s s o c i a t i o n s in t h e brain or a s a disruption o f t h e p r o c e s s o f r e t r i e v a l o f c e r e b r a l e n g r a m s . W e h a v e r e p e a t e d l y indicated, h o w e v e r , t h a t t h e r e is no real e v i d e n c e for the e x i s t e n c e o f e n d o p s y c h i c t h o u g h t p r o c e s s e s and a s s o c i a t i o n s , disturbed or u n d i s t u r b e d . S o - c a l l e d i m p o v e r i s h m e n t of c o n s c i o u s n e s s is actually a s h r i n k i n g o f t h a t r e a l m o f p e r c e p t i v e o p e n n e s s and r e s p o n s i v e n e s s a s w h i c h t h e p a t i e n t e x i s t s . T h e r e s u l t i s t h a t a n y t h i n g t h e patient e n c o u n t e r s r e v e a l s o n l y a p o r t i o n of its c o n t e x t s of meaning, and r e f e r e n c e c o m p a r e d w i t h w h a t i t r e v e a l s t o h e a l t h y people. N o r a r e t h e w e a k m e m o r i e s o f t h e s e p a t i e n t s c a u s e d b y ini reased difficulty in r e t r i e v i n g r e p r e s e n t a t i o n s f r o m o r g a n i c a l l y s t o r e d c ei e b l >l e n g r a m s . R a t h e r , t h e presences o f w h a t w a s o n c e perceived in the o p e n realm of t h e p a t i e n t ' s e x i s t e n c e fall out of t h e o p e n n e s s ol his I >ii *eln l.n

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m o r e readily t h a n from t h e Da-sein of a h e a l t h y p e r s o n . I m p a i r m e n t of the ability to retain f o r m e r l y e n c o u n t e r e d p r e s e n c e s in o n e ' s w o r l d is an i n h e r e n t part of a n y p a t h o l o g i c a l r e d u c t i o n of a p e r s o n ' s ability to e x i s t e c - s t a t i c a l l y in a s h a r e d h u m a n world. Another instance of extremely severe impairment in the existential t e m p o r a l i t y of a Da-sein is s e e n in t h e m o d e of b e i n g - i n - t h e - w o r l d t h a t epileptics m a n i f e s t . T h e s p a t i o - t e m p o r a l a r e n a o f t h e i r Da-sein m a y b e subject to an overwhelming expansion. In the aura of their seizures, their Da-sein often e x p e r i e n c e s s p a c e - t i m e t r a n s p o r t i n t o u n f a t h o m a b l e r e a l m s . I f t h e a c c o u n t s o f t h e epileptics t h e m s e l v e s are believed, the w o r l d - o p e n n e s s t h e y are e x i s t i n g i n t h e t i m e b e f o r e t h e i r s e i z u r e b e c o m e s infinite in r i c h n e s s and e x t e n t . It is n o t u n c o m m o n to h e a r t h e m describe their e x p e r i e n c e as a t r u l y celestial bliss. In an i n s t a n t , h o w e v e r , this e x i s t e n t i a l w o r l d - o p e n n e s s o f infinite g r a n d e u r m a y collapse i n t o t h e blackest o b s c u r i t y o f p r o f o u n d u n c o n s c i o u s n e s s . W h i l e the o r i g i n s and n a t u r e o f t h e s e d i s t u r b a n c e s a r e v e r y d i f f e r e n t from t h o s e of t h e o r g a n i c p s y c h o s e s , t h e r e is also an o b s t r u c t i v e i m p a i r m e n t i n t h e spatiality o f people w h o a r e a g o r a p h o b i c o r c l a u s t r o p h o b i c . T h e a g o r a p h o b i c p e r s o n can find s u p p o r t and e x i s t in a c o m p a r a t i v e l y free w a y o n l y in r e l a t i o n to a n a r r o w circle of familiar t h i n g s and people. O p e n spaces and b r o a d a v e n u e s e n g a g e e v e r y o n e i n such a w a y t h a t o u r Da-sein h a s to m a t c h t h e i r d i m e n s i o n s , to e x t e n d to r e l a t i o n s h i p s t o t h i n g s o n t h e b o r d e r s o f t h e s e places. T h u s w e p e r v a d e t h e open spaces w i t h o u r o w n e x i s t e n t i a l p e r c e p t i v e o p e n n e s s . S u c h spaces also d e m a n d t h a t a n y o n e w h o p e r c e i v e s t h e m s u s t a i n all t h e unfamiliar and u n c e r t a i n t h i n g s t h a t m a y e n t e r t h e i r wide b o r d e r s f r o m t h e outside. Y e t t h e v e r y t h i n g t h a t c h a r a c t e r i z e s the Da-sexn o f a g o r a p h o b i c people is a lack of i n d e p e n d e n t f i r m n e s s , so t h a t it is impossible for t h e m t o m e e t t h e d e m a n d s o f large, o p e n a r e a s b y expanding t h e i r e x i s t e n c e s accordingly. I n s t e a d , t h e s e areas o v e r t a x and o v e r w h e l m t h e m . C o n s e q u e n t l y , a g o r a p h o b i c s e x p e r i e n c e open space a s s o m e t h i n g o v e r p o w e r i n g , s o m e t h i n g t h a t a b s o r b s and a n n i h i l a t e s t h e i r Da-sein. W h e n c o n f r o n t e d w i t h such spaces, t h e y t h e r e f o r e f e a r bodily collapse and loss of c o n s c i o u s n e s s , i.e., t h a t bodying f o r t h of t h e i r e x i s t e n t i a l inability to s t a y firm as an a u t o n o m o u s selfhood in t h e face of the meaningful but overwhelming address of what is present. C l a u s t r o p h o b i c s , o n t h e o t h e r hand, e x p e r i e n c e a n y e n v i r o n m e n t a l limitation as s u f f o c a t i o n c o n f i n e m e n t . T h e y panic in t h e middle ol closed, c r o w d e d r o o m s w h i c h o b s t r u c t the possibility of i m m e d i a t e escape at any m o m e n t . W e h a v e l e a r n e d from o u r test case, with its o b v i o u s c l a u s t r o p h o b i c traits, t h a t t h e ability of such people to r e l a t e to w h a t is in I h e n world i s severely reduced t o only o n e , o r a t m o . l a l e w , m e a g e r

A

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Daseinsanalytic

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217

h u m a n c o n t a c t s . T h e n a r r o w dwelling space a s w h i c h t h e y e x i s t c o n f i n e s t h e i r Da-sein to an a t t u n e m e n t of c o n s t a n t fear of s u f f o c a t i o n . F r o m the p e r s p e c t i v e o f this pervasive a t t u n e m e n t t h e y see e v e r y c o n t o u r o f e v e r y o b j e c t in t h e i r vicinity as an u n b e a r a b l e i m p r i s o n m e n t or c o n s t r i c t i o n . In all t h e s e e x a m p l e s of illness in w h i c h t h e r e is s e v e r e i m p a i r m e n t of spatiality (the h u m a n being's dwelling a l w a y s , f r o m t h e b e g i n n i n g , and n e c e s s a r i l y , in relation to close and d i s t a n t b e i n g s ) and t e m p o r a l i t y (the h u m a n being's living o u t his t i m e in c a r r y i n g his possibilities of relating to fulfillment at t h e appropriate t i m e ) , it is n o t j u s t t h e s e t w o traits of h u m a n b e i n g - i n - t h e - w o r l d t h a t a r e disturbed. C l e a r l y , t h e r e is also a d i s t u r b a n c e o f the E x i s t e n t i a l o f a t t u n e m e n t o r m o o d i n p h o b i c illnesses, in epilepsy, and in t h e o r g a n i c p s y c h o s e s . W h e r e t h e l a t t e r a r e c o n c e r n e d , i n fact, t h e d i s t u r b a n c e o f a t t u n e m e n t r a n k s w i t h t h e i m p a i r m e n t s o f spatiality and t e m p o r a l i t y as a third cardinal s y m p t o m .

Modes of illness showing severe disturbances in actualizing the existential of attunement or mood T h e disturbance of a t t u n e m e n t in the organic psychoses is k n o w n in p s y c h i a t r y a s affective i n c o n t i n e n c e . T h i s t e r m t a k e s a n idea from t h e r e a l m o f physical p a t h o l o g y , n a m e l y , u r i n a r y i n c o n t i n e n c e , and puts i t i n t o t h e p s y c h i c r e a l m . A c c o r d i n g l y , p s y c h i a t r y ' s n o t i o n o f affective i n c o n t i n e n c e is based on t h e a s s u m p t i o n t h a t t h e r e is in people a kind of psychic c o n t a i n e r w h i c h holds, a m o n g o t h e r t h i n g s , a psychic s u b s t a n c e in the n a t u r e of an affect. In t h e case of o r g a n i c p s y c h o t i c s , it is i m a g i n e d t h a t this c o n t a i n e r loses its i n t e g r i t y , s o t h a t e v e n t h e s l i g h t e s t p r e s s u r e is e n o u g h to m a k e its c o n t e n t s spill o u t . I n c o n t r a s t t o this u n r e a l i s t i c p s y c h i a t r i c h y p o t h e s i s , p a t i e n t s o f this c a t e g o r y are actually s p e l l b o u n d by w h a t t h e y e n c o u n t e r . A h e a l t h y p e r s o n m a y t o a g r e a t e x t e n t decide w h e t h e r t o e n g a g e i n t h e a t t u n e m e n t p r e s e n t l y d o m i n a n t in his e x i s t e n c e and to c h o o s e h o w he will or will not c o n d u c t h i m s e l f t o w a r d w h a t a p p e a r s t o him i n this a t t u n e m e n t . A f f e c t i v e l y i n c o n t i n e n t o r labile p a t i e n t s h a v e lost this f r e e d o m o f c h o i c e . W h a t e v e r t h e y e n c o u n t e r s u b j u g a t e s and i m p o s e s a n a t t u n e m e n t w h i c h c o r r e s p o n d s t o t h e m e a n i n g i t r e v e a l s . T h e y c a n n o t decide w h i c h o f t h e p h e n o m e n a t h e y e n c o u n t e r t o dwell by, for t h i n g s e x e r t s u c h g r e a t p o w e r o v e r t h e m t h a t e a c h n e w p h e n o m e n o n d r a w s t h e m a w a y from the o n e b e f o r e , quickly r e a t t u n i n g t h e m i n t h e p r o c e s s . P e o p l e w i t h a n epileptic d i s t u r b a n c e a r e v e r y d i f f e r e n t . W h a t e v e r t h e y e n c o u n t e r t h e y s t a y w i t h , and t h e y p e r s i s t i n t h e m o o d t h a t c o r r e s p o n d s t o its m e a n i n g . M o r e s t r i k i n g l y d i s t u r b e d i s t h e a t t u n e m e n t o f p a t i e n t s s u f f e r i n g from e n d o g e n o u s , m a n i c - d e p r e s s i v e p s y c h o s e s . P a t i e n t s w h o a r e m a n i c inslsl

218

EXISTENTIAL

FOUNDATIONS

t h a t t h e y h a v e n e v e r b e f o r e felt s o h e a l t h y , s t r o n g , and happy. Life s e e m s o n e big c a r n i v a l t o t h e m . O n c l o s e r i n s p e c t i o n , h o w e v e r , this h a p p i n e s s looks v e r y d i f f e r e n t from t h e open, c h e e r f u l c a l m o f h e a l t h y people w h o h a v e m a t u r e d e n o u g h to c a r r y o u t t h e i r i n h e r e n t p o t e n t i a l i t i e s in a g e n u i n e l y free and i n d e p e n d e n t w a y . In t h e middle of t h e last c e n t u r y , Griesinger, an acknowledged expert on manic-depressive insanity, o b s e r v e d t h a t "during t h e w h o l e m a n i c p h a s e , m e l a n c h o l y v e r y o f t e n s h o w s t h r o u g h t h e wildest a r r o g a n c e , like a dark b a c k d r o p . " In t h e m a n i c s t a t e , p a t i e n t s h a v e available a s t h e i r w o r l d o n l y t h e m o s t n a r r o w r e a l m o f t i m e - s p a c e . T h e y k n o w n o open free e n c o u n t e r w i t h t h e p h e n o m e n a o f t h e i r w o r l d . T h e y c a n n o t m a i n t a i n w h a t t h e y e n c o u n t e r i n space a n d t i m e w h e r e it is n o r let it c o m e i n t o being as w h a t it has to be. T h e p e r c e p t i o n of t h e s e p a t i e n t s is so s e v e r e l y r e s t r i c t e d t h a t in e a c h t h i n g t h e y e n c o u n t e r t h e y s e e a l m o s t n o t h i n g b u t a single s i g n i f i c a n c e G e v e r y t h i n g a d d r e s s e s t h e m only as s o m e t h i n g to be seized and g o b b l e d up. B u t a s n e a r t o t h i n g s a s t h e y i m a g i n e t h e m s e l v e s , t h e y can n e v e r c o m e close t o a n y p r e s e n c e , n e i t h e r t o w h a t t h e y t h e m s e l v e s are, n o r t o w h a t i s n o t t h e m . T h e y are g r a n t e d n o s e r i o u s e n g a g e m e n t i n w h a t t h e y h a v e greedily looted but i m m e d i a t e l y fall prey to w h a t e v e r it is t h a t n e x t m e e t s t h e i r e y e s . T h e y m u s t t h e n t r y t o bring t h e n e w thing u n d e r t h e i r p o w e r , and in t h e m e a n t i m e lose t h e first. It h a s n o t , as w i t h o r g a n i c p s y c h o t i c s , e n t i r e l y dropped o u t o f t h e i r o p e n r e a l m o f p e r c e p t i o n , b u t t h e m a n i c p e r s o n does lose h i m s e l f and t h e b e i n g s of his w o r l d in a dizzying spiral o f s n a t c h i n g a t a n y t h i n g t h a t c o m e s his w a y . T h i s w h i r l w i n d s w e e p s his w h o l e past and f u t u r e i n t o t h e p r e s e n t i n s t a n t , swelling o u t o f p r o p o r t i o n for him t h e i m p o r t a n c e o f t h e e x i s t e n c e o f t h e m o m e n t . T h i s inflation is m a n i f e s t e d in a feeling of o m n i p o t e n c e t h a t is b o u n d l e s s and a b s o l u t e l y s e l f - c e n t e r e d , t h o u g h also e m p t y and u n ­ grounded. W h a t psychiatry found most arresting in the characteristic manic way o f relating t o t h e w o r l d w e r e t h o s e p h e n o m e n a w h i c h its s u b j e c t i v i s t i c theory saw as disturbances of two separate psychic functions. Psychia­ t r i s t s s p o k e o f typically m a n i c c o m p u l s i v e activity and o f t h e m a n i c flight o f ideas. W h e n w e look a t w h a t h a p p e n s , h o w e v e r , t h e r e i s n o e v i d e n c e t o indicate t h a t ideas o r r e p r e s e n t a t i o n s r a c e a r o u n d i n t h e heads o f t h e s e p a t i e n t s , n o r t h a t t h e r e is a c o m p u l s i o n driving t h e m f r o m s o m e w h e r e inside t o c e a s e l e s s activity. O n c e again, w e m u s t explode t h e traditional m y t h o f a n e n c a p s u l a t e d p s y c h e and learn t o r e c o g n i z e manically disturbed Da-sein as a deficient m o d e of f u n d a m e n t a l being,-in I h e - w o r l d . T h e p h e n o m e n a t h e p a t i e n t e n c o u n t e r s i n his world have irresistible p o w e r to seduce h i m i n t o s u r r e n d e r i n g greedily to I hem M a n n p a t i e n t s o v e r r u n t h e past and p r e s e n t , and o v e r s h o o t a n y p l a n n e d future a s well.

A

General

Daseinsanalytic

Phenomenology

219

T h i s s t e a m r o l l e r e f f e c t g i v e s t h e i m p r e s s i o n o f a truly p o w e r f u l s e n s e o f self, b u t this is an illusion, b o t h to t h e p a t i e n t h i m s e l f a n d to t h e o u t s i d e o b s e r v e r . T h a t this is so is e v i d e n t from t h e false, f o r c e d e u p h o r i a t h e s e p a t i e n t s e x p e r i e n c e ; it is still m o r e a p p a r e n t f r o m t h e p o w e r in any obstacle to their self-glorification. T h e slightest opposition is enough to d e s t r o y t h e i r e q u a n i m i t y , c a u s i n g t h e m to b r e a k o u t again and again in blind, d e s t r u c t i v e r a g e s . T h e melancholic disposition is l i k e w i s e a m o d e of fulfilling t h e E x i s t e n t i a l o f a t t u n e m e n t w h i c h i n v o l v e s r e d u c t i o n i n t h e p e r c e p t i v e o p e n n e s s and responsiveness to the address of w h a t is encountered. T h i s reduction is v e r y d i f f e r e n t from t h a t p r e d o m i n a t i n g i n t h e m a n i c p h a s e . Like m a n i c s , m e l a n c h o l i e s can see o n l y t h e m s e l v e s , and t h e w o r l d a r o u n d t h e m t h e y s e e o n l y as far as it is directly r e l a t e d to t h e m in a p a r t i c u l a r w a y . B u t w h i l e t h e m a n i c s e e s h i m s e l f a s a n o m n i p o t e n t , godlike c r e a t u r e for w h o m e v e r y t h i n g e x i s t s o n l y a s m a t e r i a l t o c o m p l e t e his o w n e x t e n d e d dimensions, the melancholic sees in himself nothing but emptiness, i n f e r i o r i t y , w o r t h l e s s n e s s , and culpability. A n y t h i n g t h a t m a y r e m a i n o p e n to his limited p e r c e p t i o n is e x p e r i e n c e d as an a c c u s a t i o n and a p r o o f o f his w o r t h l e s s n e s s . H e o f t e n l a t c h e s o n t o o t h e r s t h e w a y d r o w n i n g people lock o n t h e life p r e s e r v e r s t h a t a r e t h r o w n t h e m . M e l a n c h o l i e s can discover no thing of worth in their existence because their modes of r e l a t i n g t o t h e w o r l d (as w h i c h t h e y e x i s t ) are n o t t h e i r o w n . T h e y will c o m p l a i n m o n o t o n o u s l y t h a t n o t h i n g i n t h e i r lives w o r k s a n y m o r e . T h e r e a s o n n o t h i n g w o r k s a n y m o r e i s t h a t for t h e m t i m e h a s stopped. T h i s a l o n e c o n s i g n s t h e m t o a n e m p t i n e s s t h a t i s b e n e a t h h u m a n dignity, for h u m a n being can h a p p e n o n l y in living o u t its t i m e , c a r r y i n g to fulfillment its i n b o r n possibilities f o r r e l a t i n g to w h a t e v e r a d d r e s s e s it. M e l a n c h o l i e s are b a r r e d f r o m this kind o f r e s p o n s e t o w h a t a d d r e s s e s t h e i r Da-sein. N o t h i n g is p r e s e n t to t h e m e x c e p t w h a t t e s t i f i e s to t h e i r guilt, and t h e f u t u r e , no less d o o m e d , is r e s t r i c t e d to t h e fearful e x p e c t a t i o n of t h e i r o w n , and t h e w o r l d ' s , a n n i h i l a t i o n . S u c h a f u t u r e is b o u n d up e n t i r e l y w i t h t h e past. M e l a n c h o l i e s are e n t a n g l e d in a n e t of e n d l e s s c o m p l a i n t s a b o u t s o m e m o r t a l sin t h e y c o m m i t t e d i n t h e distant past. M i n i s t r a t i o n s f r o m t h e o u t s i d e w o r l d , n o m a t t e r h o w well i n t e n t i o n e d o r p e r s i s t e n t , c a n n o t free t h e m f r o m t h e m e s h e s o f t h e long a g o . T h e r a p y along t h e s e lines m u s t i n e v i t a b l y fail, b e c a u s e t h e p a t i e n t s are c o r r e c t in e x p e r i e n c i n g feelings o f guilt. T h e p r o b l e m i s t h a t w i t h o u t proper g u i d a n c e t h e y s t u b b o r n l y single o u t s o m e m i n o r y o u t h f u l folly a s the i r r e p a r a b l e o f f e n s e t h a t is t h e s o u r c e of t h e i r u n h a p p i n e s s and guilt feelings. Clinical psychiatry's m e t h o d of routine questioning is equally b a r r e d from d i s c o v e r i n g t h e t r u e n a t u r e of t h e guilt t h a t s e t t l e s so e.u ly

220

EXISTENTIAL FOUNDATIONS

on m e l a n c h o l i e s . In p s y c h o t h e r a p e u t i c t r e a t m e n t s e x t e n d i n g o v e r a period o f y e a r s , h o w e v e r , w h e r e t h e patient i s led t o c o n f r o n t h i m s e l f w i t h r e l e n t l e s s s e l f - h o n e s t y , t h e t r u e n a t u r e o f his individual m o r t a l sin becomes apparent. All e n d o g e n i c m e l a n c h o l i e s w h o h a v e u n d e r g o n e r i g o r o u s , a p p r o p r i a t e analysis h a v e r e v e a l e d t h e s o u r c e for t h e i r illness. E a c h b e g a n b y l e a r n i n g t h a t the m e a n i n g of h u m a n being i n h e r e s in r e s p o n d i n g , w i t h all of o u r i n b o r n possibilities, t o w h a t w e e n c o u n t e r , t h e r e b y allowing w h a t i s e n c o u n t e r e d to unfold i t s e l f in o u r o p e n r e a l m of p e r c e p t i o n . It is precisely t h i s , h o w e v e r , t h a t proved i m p o s s i b l e for e v e r y f u t u r e m e l a n c h o l i c w h o has b e e n t h o r o u g h l y e x a m i n e d . T h e y had, i n fact, always p e r c e i v e d t h e m e a n i n g f u l appealing a d d r e s s o f t h i n g s and had n e v e r c e a s e d t o h e a r this appeal, n o t e v e n during t h e i r t i m e s o f m e l a n c h o l i a . W e r e this n o t so, t h e y would n o t h a v e had t o s u f f e r a s f e w o t h e r h u m a n b e i n g s e v e r m u s t . R e m a i n i n g painfully open t o this appeal, yet unable to respond with authentic behavior of their own, they grew daily m o r e i n d e b t e d to t h e i r Da-sein. T h e y e x p e r i e n c e d this g r o w i n g debt to t h e i r unfulfilled i n b o r n possibilities for e x i s t i n g a u t h e n t i c a l l y as t h e t r u e basis o f t h e i r i n c e s s a n t s e l f - r e c r i m i n a t i o n s a b o u t the past, despite t h e fact t h a t t h e s e r e c r i m i n a t i o n s o f t e n a s s u m e d a b s t r u s e , delusional forms. F u r t h e r m o r e , all e n d o g e n i c m e l a n c h o l i e s q u e s t i o n e d a p p r o p r i a t e l y h a v e s h o w n a similar p a t t e r n in t h e d e v e l o p m e n t of t h e i r " s i n f u l " b e h a v i o r . F r o m a v e r y e a r l y age, e a c h o f t h e m r e l e g a t e d t h e significance o f his o w n i n b o r n possibilities s o far b e l o w t h a t o f t h e d i c t a t e s — a c t u a l o r i m a g i n e d — o f t h e s u r r o u n d i n g w o r l d t h a t t h e y w e r e n o t able t o g a t h e r t h e i r e x i s t e n c e i n t o a reliable, g e n u i n e self and c a r r y it to fulfillment. Instead, t h e y p e r s i s t e n t l y denied t h e i r selfhood, afraid to risk losing t h e f a v o r a b l e r e g a r d of o t h e r s , practicing this lifelong s e l f - a n n i h i l a t i o n on a scale far e x c e e d i n g t h a t of t h e self-violation s h o w n in people s u f f e r i n g f r o m h y s t e r i c a l o r c o m p u l s i v e illnesses. T h e i m p o r t a n t q u e s t i o n n o w arises o f precisely h o w t h o s e w h o will b e m e l a n c h o l i e s a c q u i r e a d e p e n d e n c y and n e e d for love so s t r o n g t h a t it can c o m m a n d t h e m to p r a c t i c e such a c o m p l e t e self-denial vis-a-vis t h e world. T h e r e a r e , for e a c h case, a t least t w o distinct possibilities. F i r s t , t h e r e m a y be s o m e i n n a t e deficiency t h a t p r e v e n t s a person from developing early e n o u g h i n t o a n a u t o n o m o u s self and, a s such, w i n n i n g distinction as an i n d e p e n d e n t being. O r , s e c o n d , p o s t n a t a l i n f l u e n c e s m a y i n t e r v e n e to disrupt t h e realization o f i n d e p e n d e n l sell h o o d In o n e case, t h e n e g a t i v e a t t i t u d e o f t e a c h e r s and p e e r s might m o v e a pel son to p a t h o g e n i c self-denial; i n a n o t h e r , c h e m i c a l t o x i n s , endo 0 1 e x o g e n i c , m i g h t affect his m a t u r i n g t o an independent s e n s e ol gel!

A

General

Daseinsanalytic

Phenomenology

O n e t h i n g a b o u t the p a t h o g e n e s i s o f e n d o g e n i c m e l a n c h o l i a , h o w e v e i , is c e r t a i n from t h e s t a r t . E v e n if it w e r e d e m o n s t r a t e d that c e r t a i n m e l a n c h o l i e s e x h i b i t m e t a b o l i c d y s f u n c t i o n s o r toxicity during then periods o f d e p r e s s i o n , this w o u l d still n o t explain t h e i r illness a s the h u m a n e x i s t e n t i a l p h e n o m e n o n it is, and even if f u t u r e discoveries produced a c o m p l e t e l y reliable p h a r m a c e u t i c a l t h e r a p y , we would not t h e r e b y h a v e a real u n d e r s t a n d i n g of t h e p h e n o m e n o n itself. B e y o n d the fact t h a t it is difficult to k n o w w h e t h e r physical e v i d e n c e in m e l a n c h o l i e s is simply a c o n s e q u e n c e of b e h a v i o r a l d i s t u r b a n c e s , t h e t r u e n a t u r e of m e l a n c h o l i a can only b e u n d e r s t o o d i n t e r m s o f loss o f freedom o v e r m o d e s o f a t t u n e m e n t and o f d i s t u r b a n c e s i n actualizing t h e o t h e r basic e x i s t e n t i a l traits. W h e r e e n d o g e n i c m e l a n c h o l i a i s c o n c e r n e d , t h e t e r m " e n d o g e n i c , " implying a bodily c o n t a i n e r , is as m e a n i n g l e s s as it is in relation to any other pathological h u m a n p h e n o m e n o n . No m a t t e r what m e t h o d is u s e d in e x a m i n i n g t h e b o d y h o o d of m e l a n c h o l i c p a t i e n t s , t h e ruling principle of t h e D a s e i n s a n a l y t i c p a t h o l o g y r e m a i n s valid. All bodily p a t h o l o g i c a l s y m p t o m s a r e t o b e s e e n e x c l u s i v e l y a s impaii m e n t s , i n n a t e o r acquired, o f t h e ability t o body f o r t h specific h u m a n w a y s o f being.

f

O n l y o n e e s s e n t i a l possibility r e m a i n s o p e n t o m e l a n c h o l i e s — t h e m o s t e x t r e m e , m o s t a u t h e n t i c , and u n s u r p a s s a b l e e x i s t e n t i a l p o t e n t i a l i t y : dying. T h i s i s w h y m e l a n c h o l i e s a r e s o p r o n e t o suicide. T h i s m a y c o m e a b o u t i n t w o w a y s . I t h a p p e n s , o n t h e o n e hand, w h e n m e l a n c h o l i e s are d r a w n i r r e s i s t i b l y t o w a r d it as t h e o n l y w a y o u t of t h e i r u n e n d u r a b l e n u m b n e s s . Q u i t e o f t e n , h o w e v e r , a m e l a n c h o l i c will c h o o s e suicide as the last available act o f f r e e will. K n o w i n g t h i s , w e can u n d e r s t a n d w h y s o m e m e l a n c h o l i e s e x p e r i e n c e t h e t i m e b e t w e e n t h e decision and the act o f suicide as o n e of joyful fulfilling liberation. In t h e t e s t a m e n t s t h e y leave behind, m a n y o f t h e s e suicides r e p o r t t h a t being able t o c h o o s e death w a s like a leap o u t of a t o r t u r e d d e s p e r a t i o n and a d e v a s t a t i n g isolation into a comforting embrace. It is possible t h a t t h e suicides of m e l a n c h o l i e s r e p r e s e n t t h e s a m e a t t e m p t t h a t leads to feelings of godlike o m n i p o t e n c e in t h e f r e n e t i c selfinflation o f m a n i c s . I n fact, o n e o f t h e e a r l i e s t c o m p l a i n t s o f m e l a n c h o l i e s m a y h i n t a t s o m e t h i n g s t r i v e n for i n b o t h kinds o f illness. N o s o o n e r has m e l a n c h o l y cast its first s h a d o w s o v e r t h e m than e v e n t h e m o s t devout b e l i e v e r s find t h e y can n o l o n g e r pray. T h e y a r e h o r r i f i e d t o d i s c o v e r t h a I t h e y h a v e suddenly b e e n t o r n l o o s e from G o d . All h u m a n beings are f u n d a m e n t a l l y m o r e or less cut o f f from the a b s o l u t e and reduced to individual limited e x i s t e n c e s ; s o r r o w is g r o u n d e d in this condition M e l a n c h o l i e s s e e m to be e x c e e d i n g l y s e n s i t i v e to this schism. I hell s o r r o w is o f such i n t e n s i t y t h a t it o f t e n involves the bodily s p h e r e ol t h e n

222

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e x i s t e n c e . F o r i n s t a n c e , it is n o t r a r e for m e l a n c h o l i e s to feel pain at the back o f t h e i r e y e s o c k e t s , and t h e y a r e p r o n e t o c h e s t pains t h a t s e e m t o t i g h t e n a r o u n d t h e i r u p p e r t o r s o s like i r o n b a n d s . T h e s e s u f f e r i n g s o f m e l a n c h o l i e s t e s t i f y c l e a r l y t o t h e e s s e n t i a l c o n n e c t i o n b e t w e e n physical and m e n t a l pain w e indicated earlier. P s y c h i a t r y c o m m o n l y d i s t i n g u i s h e s b e t w e e n e n d o g e n o u s and r e a c t i v e d e p r e s s i o n s . R e a c t i v e , u n l i k e e n d o g e n o u s , d e p r e s s i o n s , display sufficient m o t i v a t i o n in t h e p a t i e n t ' s situation at a g i v e n t i m e . B u t we m u s t e m p h a s i z e o n c e again t h a t n o e t i o l o g y suffices t o explain pathological h u m a n b e h a v i o r a s t h e e x i s t e n t i a l p h e n o m e n o n i t is. T h i s applies t o b o t h e n d o g e n o u s and r e a c t i v e d e p r e s s i o n . F u r t h e r m o r e , t h e value o f any distinction m a d e b e t w e e n t h e t w o types of d e p r e s s i o n is dubious in any e t i o l o g y . A n e x p e r i e n c e d clinical r e s e a r c h e r will freely c o n c e d e t h a t e n d o g e n o u s and r e a c t i v e d e p r e s s i o n s c a n n o t b e s e p a r a t e d p h e n o m e n a l l y , but only a c c o r d i n g t o t h e i r r e s p e c t i v e c a u s e s . S i n c e the c a u s e o f e n d o g e n o u s d e p r e s s i o n is admittedly u n k n o w n , this distinction is on s h a k y footing. M o r e a t t e n t i o n should also be paid in t h e f u t u r e to the s t a t e m e n t s o f clinical r e s e a r c h e r s a s e x p e r i e n c e d a s W . S c h u l t e , w h o has said t h a t " e n d o g e n o u s d e p r e s s i o n is n o t n e a r l y as devoid of e x t e r n a l influence as is generally supposed." But the greatest reason to doubt t h e distinction is t h e fact t h a t h i g h l y successful p s y c h o t h e r a p e u t i c c u r e s h a v e b e e n e f f e c t e d e v e n o n p a t i e n t s w h o had b e e n clearly diagnosed beforehand as endogenous melancholies. T h e s e cures came about in c a s e s w h e r e t h e p s y c h o t h e r a p i s t w a s able t o give his e n d o g e n o u s d e p r e s s i v e p a t i e n t t h e c o u r a g e t o radically c h a n g e t h e w a y h e lived, s o t h a t he no l o n g e r practiced n e g a t i o n of his selfhood as a d e f e n s e a g a i n s t loss o f love b u t i n s t e a d s t a y e d t r u e t o his i n n e r m o s t n a t u r e i n e v e r y t h i n g he did, especially in his h u m a n r e l a t i o n s h i p s . 10

T o d a y , g e n u i n e m e l a n c h o l i e s a r e far o u t n u m b e r e d b y people suffering from t h e p r e s e n t r e p r e s e n t a t i v e f o r m o f n e u r o s i s . I f h y s t e r i c a l p h e n o m e n a c o m m a n d e d t h e field o f n e u r o s e s from t h e t i m e o f C h a r c o t and F r e u d u p t o t h e end o f t h e F i r s t W o r l d W a r , from t h e n o n o r g a n i c n e u r o t i c d i s t u r b a n c e s quickly gained a s c e n d a n c y . T h e t e n d e n c y today i s i n c r e a s i n g l y t o w a r d d e p r e s s i v e illnesses. S u r v e y i n g old case h i s t o r i e s o f m e n t a l i n s t i t u t i o n s w e find t h a t , a m o n g p a t i e n t s w h o w e r e hospitalized r e p e a t e d l y , t h e d i a g n o s e s often c h a n g e d w i t h t i m e from m o o d d i s t u r b a n c e to s c h i z o p h r e n i a . N o w a d a y s , p a t i e n t s initially classified as s c h i z o p h r e n i c lose t h e i r specifically s c h i z o p h r e n i c s y m p t o m s o v e r the y e a r s , finally falling into simple d e p r e s s i o n . E v e n a m o n g n o n h o s p i t a l i z e d p s y c h o n e u r o t i c a l l y disturbed people, m o s t w h o seek help today are people h o r r i b l y d e p r e s s e d by t h e m e a n i n g l e s s n e s s and tedium ol t h e n lives. S i n c e n e i t h e r definitive e m o t i o n a l n o r psyi h o i o m a t i i s y m p t o m s

A

General

Daseinsanalytic

Phenomenology

223

p r e d o m i n a t e , t h e s e p a t i e n t s and t h e i r physicians a r e at a loss. In the c o n v e n t i o n a l s e n s e , t h e y are n o t sick. T h e m o d e r n c l e r g y m a n , t o o , is at a loss to help. S u f f e r i n g as t h e y do, t h e s e people often try to d r o w n o u t t h e i r d e s p e r a t i o n t h r o u g h addiction t o w o r k , p l e a s u r e , o r d r u g s . W h e n this fails, t h e depressive a t t u n e m e n t o f b o r e d o m and m e a n i n g l e s s n e s s t h a t prevails in this age s h o w s clearly, and we s e e d r a m a t i c a l l y t h e i m p a i r m e n t o f p e r c e p t i v e o p e n n e s s w h i c h b o r e d o m is. It is in t h e n a t u r e of b o r e d o m to let p h e n o m e n a be p e r c e i v e d as t h e y r e v e a l t h e m s e l v e s to a p e r s o n only to the e x t e n t t h a t all o b j e c t s and o t h e r people are r e v e a l e d a s u n i f o r m l y m e a n i n g l e s s e n t i t i e s . A n e s s e n t i a l l y b o r e d and depressed p e r s o n can b e w h o l e h e a r t e d l y e n g a g e d b y n o t h i n g . W h a t e v e r does r e v e a l i t s e l f t o him i m m e d i a t e l y r e t r e a t s — n o t e n t i r e l y o u t of his world, b u t far e n o u g h so it hardly c o n c e r n s t h e afflicted p e r s o n a n y m o r e . N o t o n l y p a r t i c u l a r t h i n g s b e c o m e b o r i n g , w e a r i s o m e , and tedious; t h e sick p e r s o n in his e n t i r e t y is b o r e d and w e a r i e d . In the m o d e r n n e u r o t i c w h a t is m o s t deeply affected is his ability to actualize h i m s e l f i n time a t t h e r i g h t t i m e . T h e r e is no genuine future, no s u p p o r t i n g past, only a m e a n i n g l e s s p r e s e n t . T h e t h r e e t e m p o r a l d i m e n s i o n s a r e voided i n t o m e a n i n g l e s s c o n n e c t i o n t o w h a t has b e e n , w h a t is, and w h a t is e x p e c t e d . 1 1

O v e r t i m e , a v a g u e , i n t a n g i b l e a n x i e t y usually t a k e s hold of people s u f f e r i n g f r o m n e u r o s e s o f b o r e d o m and m e a n i n g l e s s n e s s . W e h a v e already described a n x i e t y a s a n a t t u n e m e n t t h a t limits t h e p e r c e p t i v e r e s p o n s i v e o p e n n e s s of t h e Da-sein to perceiving t h e o n e possibility t h a t it can lose all r e l a t e d n e s s to t h e w o r l d . In a n x i e t y , t h e t h r e a t is n o t m e r e l y t h a t p r e s e n c e s recede i n t o an i n d i f f e r e n t d i s t a n c e , as t h e y do in b o r e d o m , for n o m a t t e r h o w far o f f s o m e t h i n g m a y g e t , i t still r e m a i n s w i t h i n the w o r l d of t h e o n e w h o is b o r e d . B u t in a n x i e t y , Da-sein f e a r s t h e total r e m o v a l of all t h a t s u p p o r t s it. At t h e s a m e t i m e , a n x i e t y i n t r o d u c e s Dasein to t h e possibility of its o w n ending, of its n o t b e i n g - t h e r e a n y m o r e . Da-sein f e a r s t h e approach of an e m p t i n e s s , an all-annihilating void. In the a n x i o u s e x p e c t a t i o n o f i m m i n e n t a n n i h i l a t i o n o f its b e i n g - i n - t h e - w o r l d , all t h e o t h e r possibilities of relating to past, p r e s e n t , and f u t u r e a r e b l a n k e t e d in d a r k n e s s . In s u c h a n x i e t y a h u m a n being finds no support in his fellows n o r in t h e t h i n g s of his world.

Modes of illness encroaching primarily on the openness and freedom of the da-sein All f o r m s of illness described so far e n c r o a c h on t h e possibility ol realizing t h e basic o n t o l o g i c a l n a t u r e o f h u m a n e x i s t e n c e : freedom and o p e n n e s s t o w a r d o t h e r h u m a n b e i n g s and t o w a r d all the o t h e i b e i n g s e n c o u n t e r e d . T h e m o s t salient c h a r a c t e r i s t i c o f s c h i z o p h r e n i a l l this

224

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FOUNDATIONS

e n c r o a c h m e n t , a d i s t u r b a n c e so s e r i o u s t h a t it is of c o n c e r n not only to p s y c h i a t r i s t s and s c h i z o p h r e n i c s , but to h u m a n i t y as a w h o l e . Indeed, s u c h illness lends i t s e l f to e x p l o r a t i o n of t h e fragile f r e e d o m t h a t is peculiar t o h u m a n e x i s t e n c e . U n f o r t u n a t e l y , s o c i e t y i t s e l f often p r e v e n t s s u c h r e s e a r c h by d i s a v o w i n g and locking a w a y people suffering from s c h i z o p h r e n i a . N o t only a r e t h e s e people t h e n deprived o f t h e loving h u m a n a t t e n t i o n t h e y s o s t r o n g l y r e q u i r e , b u t t h e i r j a i l e r s , w h o are their fellow h u m a n b e i n g s , t h e r e b y a b a n d o n a w a y to a c h i e v e a w a r e n e s s and insight into t h e i r o w n n a t u r e . T h e r e are i m p o r t a n t r e a s o n s to include a d i s c u s s i o n of s c h i z o p h r e n i a in a D a s e i n s a n a l y t i c approach to m e d i c i n e . F i r s t , s c h i z o p h r e n i a is o n e of the c o m m o n e s t o f h u m a n illnesses. I t d o m i n a t e s p s y c h i a t r i c r e s e a r c h . O n the o t h e r hand, medical s c i e n c e h a s so far failed to u n d e r s t a n d it in scientific t e r m s . R e s e a r c h into its g e n e s i s and e t i o l o g y in h o p e of finding c o n c r e t e , causal, g e n e t i c a l l y d e t e r m i n e d f a c t o r s h a v e had n o c o n v i n c i n g result. Equally fruitless have been a t t r i b u t i o n s of m e t a b o l i c d i s t u r b a n c e , specific f o r m s o f e m o t i o n a l t r a u m a , o r family p a t t e r n s a s u n e q u i v o c a l c a u s e s o f modes of schizophrenia. E v e n if definite s o m a t o g e n e t i c or p s y c h o g e n e t i c f a c t o r s had been discovered and e s t a b l i s h e d b e y o n d a n y d o u b t , h o w e v e r , t h e y would n e v e r in principle h a v e led to a clarification of s c h i z o p h r e n i c b e h a v i o r as w h a t it is in itself. O n l y a t r u e p h e n o m e n o l o g i c a l a p p r o a c h can clarify a h u m a n p h e n o m e n o n a s such. I f t h e p h e n o m e n o l o g i c a l definitions o f s c h i z o p h r e n i a have up to n o w failed, t o o , it is b e c a u s e t h e y have g e n e r a l l y outlined in less t h a n scientifically a d e q u a t e t e r m i n o l o g y the following s y m p t o m triad: (a) l o o s e n i n g and d i s i n t e g r a t i o n of t h o u g h t p r o c e s s e s ; (b) d i s t u r b a n c e of affect; and (c) s u b j e c t i v e d e p e r s o n a l i z a t i o n of t h e e g o . All t h r e e o f t h e s e supposedly p r i m a r y s y m p t o m s a r e r e g a r d e d a s the expression of a disturbance of the whole personality. T h e alteration of single d i s c r e t e psychic f u n c t i o n s , such a s t h e a p p e a r a n c e o f hallucina­ t i o n s o r delusions, i s n o t c o n s i d e r e d t o b e s c h i z o p h r e n i a . O n t h e c o n t r a r y , it is believed t h a t c h a n g e s in t h e individual psychic f u n c t i o n s appear w h e n the p e r s o n a l i t y as a w h o l e is sick. T h e scientific value of this p s y c h i a t r i c c o n c e p t of t h e p e r s o n a l i t y is in q u e s t i o n , h o w e v e r . C u r r e n t p s y c h i a t r y , even i n its s t a t e m e n t s o n s c h i z o ­ p h r e n i a , tends to use v a g u e c o n c e p t s . P e r s o n a l i t y is r e g a r d e d w i t h o u t e x c e p t i o n as a p r i m a r y i n n e r life, and t h e illness of s c h i z o p h r e n i c p a t i e n t s is t h e n v i e w e d as an e x t r e m e d i s i n t e g r a t i o n and discord a m o n g the i n t r a p s y c h i c a s p e c t s t h a t m a k e up t h e p e r s o n a l i t y . Y e t t h e r e is a g r e a t deal of c o n v i n c i n g e v i d e n c e , a m a s s e d by p s y c h o a n a l y s i s w h o treat s c h i z o p h r e n i a , t h a t levels of i n n e r d i s i n t e g r a t i o n and opposition b e t w e e n c o n t r a d i c t o r y i n n e r d e v e l o p m e n t a l t e n d e n c i e s , whu h . 1 1 fl sein may persist into adulthood, unable to p e r c e i v e or respond to Other adults

The "Locus" of the Therapeutic Interaction

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e x c e p t in t h e f e w r e s t r i c t e d m o d e s t h a t his p a t h o g e n i c elders had p e r m i t t e d him during childhood. A p e r s o n w h o s e e x i s t e n c e h a s b e e n r e s t r a i n e d t h u s from childhood will, w i t h o u t help f r o m p s y c h o t h e r a p y , g o t h r o u g h his w h o l e life s e e i n g i n o t h e r adults o n l y t h o s e c h a r a c t e r i s t i c s t h a t fit t h e limited p e r c e p t i o n h e w a s p e r m i t t e d i n childhood. T h i s m e a n s , a m o n g o t h e r t h i n g s , t h a t t h e t h e r a p i s t , like a n y o t h e r adult, will appear in t h a t s a m e , original, childishly limited light; t h e r e can b e n o q u e s t i o n o f transference into an earlier mode of perception, because the earlier mode has never given way to any other. F r e u d ' s third a r g u m e n t for t h e d e c e p t i v e n e s s o f t h e p a t i e n t - p h y s i c i a n r e l a t i o n s h i p r e s t s , like t h e o t h e r s , o n a m i s i n t e r p r e t a t i o n o f w h a t h a p p e n s i n t h e r a p e u t i c b e i n g - t o g e t h e r . His t h e s i s b e g i n s w i t h t h e false p r e m i s e t h a t the patient is an adult and t h e r e f o r e able to love in a m a t u r e , generous way. But neurotics would never have become neurotic in the first place if t h e y had b e e n able to develop t h e i r i n h e r e n t p o t e n t i a l for relating t o o t h e r s t o s u c h a s t a t e o f m a t u r i t y . T h e p r i m a r y c h a r a c t e r i s t i c of an infantile, i m m a t u r e love r e l a t i o n s h i p is its o v e r r i d i n g d e s i r e to take,, t o suckle. I n d e m a n d i n g c o n s t a n t p r o o f s o f love, t h e r e f o r e , t h e so-called t r a n s f e r r i n g patient is e x p r e s s i n g love. T h e f o r m of t h e love is childish, but it is t h o r o u g h l y g e n u i n e , and it is e n t i r e l y c o n s i s t e n t w i t h t h e p a t i e n t ' s p r e s e n t m a k e - u p and t h e t h e r a p e u t i c s i t u a t i o n w h i c h his participation is helping s h a p e . T h i s is so p a t e n t l y t r u e t h a t e v e n F r e u d c o n t r a d i c t e d o n e o f his o w n s t a t e m e n t s o n t h e m a t t e r . H e o p e n l y a d m i t t e d t h a t applying t h e t h e o r y o f t r a n s f e r e n c e i n analysis m i g h t b e n d the t r u t h s o m e w h a t , for w h a t r i g h t had t h e a n a l y s t to c o n c l u d e t h a t a p a s s i o n a t e l o v e developing i n t h e r a p y could n o t b e g e n u i n e l o v e ? 2

O u t o f t h e v e r y n a t u r e o f h u m a n e x i s t e n c e a p a t i e n t and his f u t u r e t h e r a p i s t a r e already, f r o m t h e first m o m e n t t h e y k n o w s o m e t h i n g a b o u t e a c h o t h e r , e n g a g e d in a h u m a n r e l a t i o n s h i p . B o t h c o n t r i b u t e to this r e l a t i o n s h i p . It is a fact t h a t m a n y p a t i e n t s w h o c o m e to t h e i r family d o c t o r s o r specialists for s o m e p u r e l y physical a i l m e n t e x h i b i t b e h a v i o r e v e r y bit as i m m a t u r e as t h e t e s t s u b j e c t ' s early d e m a n d s on h e r physician. T r e a t i n g such b e h a v i o r o n t h e basis o f t h e t r a n s f e r e n c e t h e o r y can b e j u s t a s d e s t r u c t i v e o f o u t c o m e s o f physical a s o f p s y c h o a n a l y t i c therapy. Since proper guidance of the human being-together between physician and p a t i e n t has such i m p o r t a n c e for t h e w h o l e realm o f m e d i c i n e , let u s look a t t w o a n a l o g i e s t h a t f u r t h e r i l l u s t r a t e t h e d a n g e r and u n t e n a b i l i t y o f t h e t h e o r y o f t r a n s f e r e n c e . A s s u m e t h a t a little girl is playing w i t h a b u r n i n g c a n d l e . S h e is s q u i n t i n g a t t h e candle and s e e s , r a t h e r than t h e usual c o n e - s h a p e d flame, a r a d i a n t s t a r . N o w a s s u m e t h a t while s h e is playing with the candle t h e child b u r n s b o t h eyelids s e v e r e l y and t h a t t h e r e s u l t i n g seal

270

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t i s s u e p e r m a n e n t l y r e d u c e s h e r vision t o w h a t can b e s e e n t h r o u g h t w o n a r r o w slits. W i t h o u t s u r g i c a l i n t e r v e n t i o n , t h e injured child will perceive t h e flame o f a n y c a n d l e she e v e r s e e s , f r o m this t i m e until t h e end of h e r days, as a s t a r - s h a p e d r a d i a n c e . W h o w o u l d dare claim t h a t this child is m e r e l y p r o j e c t i n g — t r a n s f e r r i n g — a n a b n o r m a l flame i m a g e t h a t had b e e n f o r m e d long a g o i n h e r p s y c h e , s o t h a t w h e n e v e r a f t e r w a r d she looked a t f l a m e s s h e w o u l d see n o t t h e s e p r e s e n t f l a m e s t h e m s e l v e s b u t a l w a y s , i n e s s e n c e , t h a t o n e f l a m e w h i c h had originally b u r n e d h e r eyelids while s h e w a s s q u i n t i n g at it. F o r o u r s e c o n d case let us say t h a t a m a n d r o v e i n t o his g a r a g e a f t e r w o r k and a c c i d e n t a l y r a n i n t o his son, w h o s e leg w a s b r o k e n b y t h e collision. T h e b o n e w o u l d n o t m e n d properly, and t h e child had w a l k e d w i t h a limp e v e r s i n c e . He is still limping w h e n , at t h e age of t w e n t y - f o u r , he u n d e r g o e s as part of his t r a i n i n g a didactic a n a l y s i s . He always g e t s to the a n a l y s t ' s office on foot. No o n e would s e r i o u s l y c o n t e n d in this c a s e t h a t this p a t i e n t w h o is limping to his a n a l y s t does n o t really w a n t to go to his a n a l y s t . Still less could it be a r g u e d t h a t t h e p r e s e n t limping o n c e caused by the patient's father constituted unequivocal proof that the c u r r e n t walks t o t h e a n a l y s t e x p r e s s e d a n i n t e n t i o n — d i s p l a c e d and transferred—to seek out the father. Y e t t h e s t o r i e s o f t h e s e t w o children are n o t e s s e n t i a l l y d i f f e r e n t f r o m t h o s e w h i c h are t a k e n w i t h o u t q u e s t i o n a s o v e r w h e l m i n g d e m o n s t r a ­ tions o f t r a n s f e r e n c e i n adult n e u r o t i c s . B o t h p e r s o n s s u f f e r e d g r e a t injury t o t h e i r e x i s t e n t i a l f r e e d o m o f m o v e m e n t i n t h e i r childhood. B u t t h e s a m e i s t r u e for all children w h o l a t e r b e c o m e n e u r o t i c s . F o r t h e s e , h o w e v e r , t h e p a t h o g e n i c b e h a v i o r o f p a r e n t s has d a m a g e d " m e r e l y " t h e mind's eye, or t h e child's ability to dispose freely o v e r his e x i s t e n t i a l p o t e n t i a l for e m o t i o n a l l y a p p r o a c h i n g , o r w i t h d r a w i n g from, t h i n g s . P e o p l e w h o are n e u r o t i c a l l y ill s h o w as little e v i d e n c e of a n y t r a n s f e r e n c e as t h e physically h u r t people in o u r i l l u s t r a t i o n . L a t e l y , a third u s a g e of t h e t e r m transference h a s b e g u n to push t h e older, classical definitions i n t o t h e b a c k g r o u n d . T h e original n o t i o n o f hidden d i s p l a c e m e n t plays hardly a n y part in this n e w e s t v e r s i o n . P r o f e s s i o n a l s n o l o n g e r speak o f t r a n s f e r e n c e d r e a m s i n w h i c h c e r t a i n f e a t u r e s o f t h e p a r e n t s a r e shifted first o n t o the a n a l y s t and t h e n o n t o d r e a m i m a g e s o f still o t h e r people. N o r is t h e w o r d transference used a n y l o n g e r to indicate t h e d i s p l a c e m e n t o f feelings from e n d o p s y c h i c p a r e n t - i m a g e s o n t o t h e a n a l y s t . N o w a d a y s , t h e w o r d is used by m o s t p h y s i c i a n s and p s y c h o l o ­ gists t o r e f e r e x c l u s i v e l y t o t h e i m m e d i a t e feelings o f the m o m e n t t h a t t h e patient e x p r e s s e s t o w a r d the physician. B u t even this w a t e r e d - d o w n n o t i o n o f t r a n s f e r e n c e c o n s i d e r a b l y d i s t o r t s t h e puzzling p h e n o m e n o n ol h u m a n e x i s t e n c e .

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t h e e n d o f s o m e e m o t i o n a l tie, c a r r y i n g i t t o his n e i g h b o r , and t h e n transferring it to the other, securing it there. This would be necessary o n l y if e a c h p e r s o n w e r e t h e r e initially as an isolated s u b j e c t , an e g o - p o l e . B u t i f t h a t w e r e really so, t h e n e v e r y p s y c h o l o g i c a l a b s t r a c t i o n , including a f f e c t s and e m o t i o n s , w o u l d h a v e t o b e c a r r i e d b a c k and f o r t h s o m e h o w b e t w e e n t w o s u c h h u m a n polarities for t h e r e t o b e a n y c o m m u n i c a t i o n b e t w e e n t h e m . Y e t all o u r e x p e r i e n c e t e a c h e s u s t h a t h u m a n c o m m u n i c a ­ tion p r o c e e d s in a w h o l l y d i f f e r e n t w a y , t h a t t w o people a r e already w i t h each o t h e r f r o m the v e r y i n s t a n t t h e y e n c o u n t e r and p e r c e i v e each o t h e r directly o r indirectly (for e x a m p l e , b y h e a r i n g o r reading o f t h e o t h e r ) . S u c h b e i n g - t o g e t h e r is a basic trait of h u m a n b e i n g - i n - t h e - w o r l d w h i c h can be c h a r a c t e r i z e d as an i n h e r e n t , s h a r e d e n g a g e m e n t in t h e o p e n r e a l m o f p e r c e p t i o n and r e s p o n s i v e n e s s a s w h i c h m a n f u n d a m e n t a l l y e x i s t s . A c c o r d i n g l y , h u m a n b e i n g s i n h e r e n t l y dwell t o g e t h e r " o u t t h e r e " in a s h a r e d w o r l d . We c a n n o t p e r c e i v e s o m e t h i n g u n l e s s o u r s e e i n g , in its b r o a d e s t s e n s e , i s already b y it, and h o w could w e e v e r g r a s p s o m e t h i n g u n l e s s w e w e r e already b y it? " O u t t h e r e " i s i n q u o t a t i o n m a r k s t o e m p h a s i z e t h a t this e x p r e s s i o n a l w a y s p r e s u p p o s e s a s e p a r a t e " i n n e r " r e a l m a s well. T h e r e a d e r will recall, h o w e v e r , t h a t w e h a v e s h o w n t h e r e is no e v i d e n c e for t h e actual p r e s e n c e in people of t h e kind of i n t e r n a l i t y represented in the container concepts of ego, consciousness, psyche, s u b j e c t , o r p e r s o n . I n s t e a d , h u m a n b e i n g s are i n h e r e n t l y e n g a g e d i n r e l a t e d n e s s t o w h a t e v e r p h e n o m e n a address t h e m f r o m t h e i r l o c a t i o n s i n t h e h u m a n w o r l d and e x i s t a s t h e s e p e r c e i v i n g and r e s p o n d i n g r e l a t i o n s h i p s . B u t t h e h u m a n m o d e o f dwelling i n t h e w o r l d i s c o n s t a n t l y a t t u n e d t o o n e m o o d o r a n o t h e r , a t t u n e m e n t b e i n g o n e o f t h e basic f e a t u r e s , o n e o f t h e E x i s t e n t i a l s , o f h u m a n n a t u r e . I f people a l w a y s s h o w and e x p e r i e n c e a p a r t i c u l a r a t t u n e m e n t , a special e m o t i o n a l a c c e n t in t h e i r e n c o u n t e r s w i t h a n y p h e n o m e n a , t h e y m u s t d o this i n t h e i r e n c o u n t e r s w i t h fellow h u m a n b e i n g s a s well, n o m a t t e r w h e r e this b e i n g - t o g e t h e r t a k e s place. T h i s m e a n s , in t u r n , t h a t all e m o t i o n a l r e l a t i o n s h i p s b e t w e e n p h y s i c i a n and patient are n o t h i n g m o r e t h a n particularly attuned e n g a g e m e n t s of two h u m a n beings in their c o m m o n dwelling b y t h e s a m e p h e n o m e n a o f t h e i r s h a r e d world. T h e s e p h e n o m e n o l o g i c a l i n s i g h t s g u a r d t h e p h y s i c i a n - p a t i e n t rela­ t i o n s h i p a g a i n s t all t h r e e o f t h e m i s i n t e r p r e t a t i o n s c u r r e n t i n t r a n s f e r ­ e n c e t h e o r y . F r o m t h e n e w p e r s p e c t i v e , w e can r e c o g n i z e this r e l a t i o n s h i p o n c e again, m o r e fully t h a n e v e r b e f o r e , a s t h e p h e n o m e n o n F r e u d s a w as t h e focal point of t h e r a p y , t h e actual basis of all medii al t r e a t m e n t . N o m e r e t h e o r y can a l t e r this i n t h e least, for the h u m a n r e l a t i o n s h i p of physician and p a t i e n t r e m a i n s t h e v e r y c o r e ol I hei apeul 1( a c t i o n , its basis and a r e n a , w h e t h e r or not the people taking, pal t In it are a w a r e o f its t h e r a p e u t i c s i g n i f i c a n c e .

EXISTENTIAL

272

FOUNDATIONS

I g n o r a n c e o f t h e t r u e n a t u r e o f t h e b e i n g - t o g e t h e r o f p h y s i c i a n and patient m a y not always necessarily reduce the effectiveness of medical t h e r a p y , b u t v e r y o f t e n it d o e s . It is a fact, also, t h a t k n o w l e d g e a b o u t t h e t h e r a p e u t i c e f f e c t i v e n e s s o f t h e p h y s i c i a n - p a t i e n t r e l a t i o n s h i p , a s well a s all p r a c t i c a l a t t e m p t s t o t a k e a d v a n t a g e o f this k n o w l e d g e i n a c t u a l t h e r a p y , c o n s t i t u t e e x i s t e n t i a l m a n i f e s t a t i o n s o n t h e part o f t h e therapeutically active person. So diverse are these ways of existing of different physicians and their therapeutic successes, that the m a t t e r deserves separate consideration. NOTES 1. S. F r e u d : " R a t s c h l a g e , fur den A r z t bei d e r p s y c h o a n a l y t i s c h e n B e h a n d l u n g " ; " B e m e r k u n g e n ü b e r die U b e r t r a g u n g s l i e b e " ; " Z u r E i n l e i t u n g der B e h a n d l u n g " : i n Gesammelte Werke ( L o n d o n : I m a g o , I n c . , 1 9 4 1 ) , v o l . 8 , p . 3 7 7 ; v o l . 1 0 , p . 3 1 8 ; v o l . 8 , pp. 4 5 8 a n d 464-65. 2. S. (London:

Freud, 1949),

"Bemerkungen pp.

315-17;

über and

die

Ubertragungsliebe,"

"Wege

der

Werke, vol. 1 2 ( L o n d o n : I m a g o , 1 9 4 7 ) , p . 1 8 9 .

Gesammelte

psychoanalytischen

Werke,

Therapie,"

vol.

10,

Gesammelte

Chapter 17 THOSE WHO ARE THERAPEUTICALLY ACTIVE

In a therapeutic situation, there are, on the one hand, those being acted upon and, on the other, those w h o are therapeutically active. N e v e r is it only t h e t h e r a p i s t w h o a c t s . T h e p a t i e n t a l w a y s a c t s t h e r a p e u t i c a l l y w i t h t h e p h y s i c i a n . T h i s i s t r u e e v e n i n c a s e s a t t h e e x t r e m e s o f medical therapy: from analytic psychotherapies to surgery performed under general anesthesia. In the sort of psychotherapy we have in mind, the a n a l y s t m a y r e s t r i c t his role t o t h a t o f l i s t e n e r ; t o all a p p e a r a n c e s h e sits p a s s i v e l y w h i l e t h e p a t i e n t i n i t i a t e s w h a t e v e r talk o r a c t i v i t y m a y o c c u r . C o n v e r s e l y , t h e w h o l e b u r d e n o f t h e r a p y s e e m s t o fall o n t h e s u r g e o n w h o i s r e m o v i n g a n i n f l a m e d appendix f r o m a n a n e s t h e t i z e d p a t i e n t . Y e t in e i t h e r c a s e , physician and p a t i e n t alike a r e i n v o l v e d in t h e t h e r a p e u t i c p r o c e d u r e . F o r e v e n w h e n a p s y c h o a n a l y s t a p p e a r s t o b e passively l i s t e n i n g h e h a s a c t i v e l y o p e n e d his p e r c e p t i o n t o t h e p a t i e n t , allowing h i m t o a p p e a r , t o c o m e t o b e i n g i n t h e light o f his healing u n d e r s t a n d i n g a n d b e h a v i o r . T h e healing r e s p o n s e o f t h e a n a l y s t t o t h e appealing a d d r e s s of t h e p a t i e n t is to e n a b l e h i m to a p p r o p r i a t e as his o w n the i n n a t e h u m a n p o t e n t i a l i t i e s w h i c h u p until t r e a t m e n t had been hidden, d i s t u r b e d , o r d i s t o r t e d . I n o u r o t h e r e x a m p l e , t h e patient must have a c t i v e l y a g r e e d to allow t h e o p e r a t i o n and to place h i m s e l f in the s u r g e o n ' s h a n d s b e f o r e he is a n e s t h e t i z e d for s u r g e r y . W i t h o u t the.

274

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a g r e e m e n t o n t h e p a t i e n t ' s part, surgical i n t e r v e n t i o n would n o t b e possible. S i n c e t h e a g r e e m e n t is based on a p e r c e p t i o n and u n d e r s t a n d i n g of p h e n o m e n a t h a t h a v e b e e n e n c o u n t e r e d , as well as a r e s p o n s e to t h e s e p h e n o m e n a , t h e b e h a v i o r of this p a t i e n t is no less a g e n u i n e h u m a n act t h a n i s the a n a l y s t ' s a t t e n t i v e n e s s i n t h e o t h e r c a s e . T h e s a m e applies t o all t h e r a p e u t i c m e t h o d s t h a t lie b e t w e e n t h e s e t w o e x t r e m e s . T h e p a r t n e r s w h o a r e acting t o g e t h e r i n t h e s e w a y s can b e v e r y different kinds o f people. A b o v e all, t h e i r a t t i t u d e s t o w a r d t h e r a p y and t h e being ill m a y v a r y g r e a t l y . In o u r t e s t c a s e , f o r e x a m p l e , b o t h t h e active p s y c h o t h e r a p i s t and t h e a c t e d u p o n p a t i e n t realized f r o m t h e o u t s e t t h a t t h e goal o f t h e r a p y w o u l d b e t o l i b e r a t e t h e p a t i e n t f r o m h e r n e u r o t i c a l l y r e s t r i c t e d w a y s o f r e l a t i n g t o t h e people and t h i n g s o f h e r world. T h e physician therefore deliberately challenged each of her a t t e m p t s t o r e s i s t g r e a t e r f r e e d o m for h e r s e l f . B u t t h e s u r g e o n she l a t e r c o n s u l t e d for h e r leg f r a c t u r e had n e v e r b o t h e r e d t o c o n s i d e r t h e n a t u r e o r p u r p o s e o f h u m a n b e i n g - i n - t h e - w o r l d . H e t o o k for g r a n t e d t h e overall validity o f t h e n a t u r a l scientific t h i n k i n g t h a t pervaded m e d i c i n e . T h e only m e t h o d of t r e a t m e n t he k n e w did n o t r e c o g n i z e t h e p a t i e n t as a h u m a n Da-sein. His medical r e l a t i o n s h i p to h e r c o n c e r n e d n o t h i n g b u t t h e repair o f s o m e b o n e s y s t e m t h a t could b e located, d a m a g e d , s o m e w h e r e in a physical space. T h e fact t h a t t h e a c c i d e n t had n o t o n l y b r o k e n a b o n e b u t s e v e r e l y a f f e c t e d t h e p a t i e n t ' s e n t i r e b e i n g - i n - t h e - w o r l d and r e d u c e d it to t h e s m a l l e s t spatiality and t e m p o r a l i t y i m a g i n a b l e did n o t t r o u b l e t h e s u r g e o n i n t h e least. N o t w i t h s t a n d i n g his e x t r e m e l y limited r e s p o n s e , however, no other therapist—certainly not a psychotherapist—could h a v e d o n e a m o r e t h o r o u g h and speedy j o b o f r e s t o r i n g h e r h u m a n f r e e d o m t h a n this s u r g e o n w i t h his skillful t e c h n i c a l m i n i s t r a t i o n s t o w h a t he i n t e r p r e t e d as a b r o k e n shin. E v e n in t h e case of i n t e r n a l d i s o r d e r s , t h e r e is o f t e n small h a r m d o n e in m i s i n t e r p r e t i n g t h e a c t u a l n a t u r e of t h e a i l m e n t , and t h e r e is a p r o m p t r e c o v e r y i n spite o f t h e fact t h a t t h e physician s e e s a s his t a s k o n l y t h e c r e a t i o n of a c h e m o p h y s i c a l i n t e r a c t i o n b e t w e e n t w o o r g a n i c s y s t e m s , a bacterial c o l o n y and a h u m a n being r e i n f o r c e d w i t h a n t i b i o t i c s . W h e r e practical t h e r a p e u t i c o u t c o m e s a r e c o n c e r n e d , t h e n a r r o w s o m a t i c c a u s a l - g e n e t i c a p p r o a c h o f t e n suffices, and r e m o v i n g w h a t is seen as t h e causal a g e n t o f t h e illness usually does a w a y w i t h t h e illness i t s e l f and t h e resulting impairment of human freedom. O n t h e o t h e r hand, t h e s a m e a p p r o a c h t o t h e r a p y p r o v e s d e f i c i e n t , e v e n in purely practical t e r m s , w h e n it is applied to a n u m b e r of o t h e r health d i s o r d e r s t h a t look like simple physical a i l m e n t s — w h e n e v e r , for i n s t a n c e , a f r a c t u r e or i n f e c t i o n afflicts a h u m a n e x i s t e n c e that, as Da-sein, is already u n h e a l t h y and i m m a t u r e . H e r e t h e t h e r a p i s t pays bitterly for

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his i g n o r a n c e of t h e e x i s t e n t i a l basis t h a t u n d e r l i e s all t h e r a p y . If he does n o t c o n s t a n t l y k e e p s i g h t of t h e fact t h a t all medical i n t e r v e n t i o n — b e it surgical, c h e m i c a l , o r p s y c h o t h e r a p e u t i c — a i m s a t r e s t o r i n g t h e u s e o f all i n n a t e e x i s t e n t i a l p o t e n t i a l i t i e s t o t h e p a t i e n t , his b l i n d n e s s m a y h a v e o n e o f t w o c o n s e q u e n c e s . A t t h e v e r y least, t h e f r a c t u r e o r i n f e c t i o n heals m o r e slowly t h a n usual. B u t t h e far g r e a t e r d a n g e r f r o m this m y o p i a o f therapists is that in modern welfare states, with their strong tendencies t o infantilize t h e i r m e m b e r s , w h a t m a y first look like simple physical a i l m e n t s , a m e n a b l e t o t h e i n t e r v e n t i o n o f s u r g e r y o r m e d i c a t i o n , all t o o often d e g e n e r a t e i n t o i n t e r m i n a b l e c h r o n i c n e u r o s e s o r h y p o c h o n d r i a chal i l l n e s s e s . T h i s d o e s i m m e a s u r a b l e h a r m t o t h e p a t i e n t , t h e physician, and, last but n o t least, to h u m a n s o c i e t y as a w h o l e . I n light o f t h e v a s t n u m b e r s o f people w h o are e x i s t e n t i a l l y i m m a t u r e and d i s t o r t e d b e f o r e t h e y are affected b y s e e m i n g l y bodily illness, t h e r e would seem to be only one workable way to control the development of e v e n m o r e s e v e r e n e u r o s e s , and t h a t is to h a v e , in e v e r y a r e a of medical specialization, m a n y m o r e d o c t o r s a w a r e t h a t s u c h t h i n g s a s t h e s e t t i n g o f a b o n e , o r t h e i n t r o d u c t i o n o f a n t i b i o t i c s i n t o t h e body, o r a n y o t h e r a p p a r e n t l y purely physical i n t e r v e n t i o n , does n o m o r e t h a n p r o m o t e p r o p e r callous f o r m a t i o n , o r t h e d e s t r u c t i o n o f p n e u m o c o c c i i n t h e body. T h e process of genuine healing involves the way the patient is e x i s t e n t i a l l y related t o t h e w o r l d a t t h e t i m e , his w h o l e e x i s t e n c e . T h i s i n s i g h t will n o t c o m p e l s u r g e o n s and i n t e r n i s t s t o c h a n g e t h e i r t h e r a p e u t i c t e c h n i q u e at all, e x c e p t in r a r e i n s t a n c e s , b u t in t h e long run, w h e t h e r o r n o t t h e m a n i p u l a t i o n s o f s u r g e o n s and i n t e r n i s t s a r e r o o t e d in an a d e q u a t e u n d e r s t a n d i n g of h u m a n being, will be decisively i m p o r t a n t . W i t h o u t this u n d e r s t a n d i n g , the physician will n o t realize t h a t his m a n i p u l a t i o n of t h e p a t i e n t ' s bodily s p h e r e is no m o r e t h a n a prelude t o t h e r e c o v e r y o f t h e w h o l e h u m a n e x i s t e n c e . N o p a t i e n t i s g e n u i n e l y h e a l e d , n o m a t t e r w h a t his p a r t i c u l a r a i l m e n t , until h e h a s r e c o v e r e d full u s e of all t h e p o t e n t i a l i t i e s n a t i v e to his Da-sein. N a t u r a l l y , t h e r e a r e sick people w h o , as Da-sein, a r e r o b u s t and h e a l t h y e n o u g h b e f o r e t h e i r surgical o r medical t r o u b l e s t o b e able t o o v e r c o m e the i n e v i t a b l e afflictions of t h e i r Dasein w h i c h a n y illness leads t o . B u t this does n o t c h a n g e t h e basic s h a p e o f t h e p r o b l e m . To s e e t h a t p a r t i c u l a r t h e r a p y is m e r e l y a p r e p a r a t i o n is n o t to criticize t h e t h e r a p y itself. T o t h e d e g r e e t h a t t h e y c o n t r i b u t e t o the s u c c e s s o l a n e n t e r p r i s e , p r e p a r a t i o n s a r e t o b e valued and c a r r i e d t h r o u g h w i t h greal c a r e . T h e y d o h a r m i n t h e r a p y o n l y w h e n t h e y t r y t o pass t h e m s e l v e s o l I as t h e be-all and end-all in medical p r o c e d u r e . To c o n c e i v e of t h e p a t i e n t as a purely physical o r g a n i s m only s o m e t i m e s r e s u l t s i n h a r m c o n c e r n i n g health disorders like t h o i t u i

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h a v e been discussing. B u t t h e e f f e c t s o f this o r i e n t a t i o n a r e m o r e predictably h a r m f u l in t h e c a s e , let us say, of a m a n i n f e c t e d w i t h syphillis. A h u m a n l y a d e q u a t e t h e r a p y would n e e d to go b e y o n d t h e approach o f n a t u r a l s c i e n c e and take i n t o a c c o u n t t h e likelihood t h a t t h e w h o l e e x i s t e n c e of t h e syphillitic h a s u n d e r g o n e a s e v e r e p a t h o l o g i c a l r e s t r i c t i o n , o r h e w o u l d h a r d l y h a v e had t o m a k e t h e m o s t i n t i m a t e o f his h u m a n c o n n e c t i o n s i n t h e seedy, disease-ridden a m b i e n c e o f a b r o t h e l . S u c h e x i s t e n t i a l d e m a n d s o n t h e physician will d o u b t l e s s face t h e usual o b j e c t i o n , t h a t t h e specialist in v e n e r e a l d i s e a s e s w o u l d be o v e r t a x e d by t h e added b u r d e n o f t e n d i n g t o d i s t u r b e d h u m a n w a y s o f r e l a t i n g t o t h e w o r l d . Of c o u r s e he w o u l d h a v e a lot to do. B u t o n l y by o p e n i n g his m i n d to this pressing t h e r a p e u t i c c o n c e r n can he b e c o m e a t r u e healer, able to do m o r e t h a n sit idly b y until t h e patient r e t u r n s w i t h a n o t h e r v e n e r e a l i n f e c t i o n . He w o u l d no l o n g e r h a v e to be like a f i r e f i g h t e r w h o can do n o t h i n g b u t put up s m o k e s c r e e n s a r o u n d t h e wall of a b u r n i n g h o u s e . T h e physician's d u t y t o c o u n t e n a n c e a n e x i s t e n t i a l , D a s e i n s a n a l y t i c approach b e c o m e s e v e n c l e a r e r w i t h t h a t g r o u p o f h e a l t h d i s o r d e r s w h i c h , since J o r e s , h a v e b e e n called specifically h u m a n a i l m e n t s . T h e y m a n i f e s t t h e m s e l v e s m o s t f r e q u e n t l y t h e s e days a s e s s e n t i a l h y p e r t o n i a , a n u m b e r o f c h r o n i c g a s t r o i n t e s t i n a l d i s o r d e r s , a s t h m a , and a c c i d e n t p r o n e n e s s . N o n e o f t h e s e steadily i n c r e a s i n g diseases h a p p e n s o u t s i d e t h e r e a l m o f h u m a n b e i n g - i n - t h e - w o r l d . Identical s y m p t o m s m a y b e produced in l a b o r a t o r y a n i m a l s , b u t t h e a i l m e n t s a r e still u n i q u e l y h u m a n , for t h e a n i m a l s w o u l d n e v e r h a v e b e c o m e sick i n quite t h a t w a y i f people had n o t had a h a n d in it. C o n s e q u e n t l y , little s e r i o u s d o u b t remains that the incidence of these unique ailments is connected to particular d i s t u r b a n c e s i n t h e w a y t h e s u f f e r e r r e l a t e s t o the w o r l d . A n d if to be a t h e r a p i s t m e a n s to offer f u n d a m e n t a l help, t h e y m u s t c o n s c i o u s l y focus t h e i r t h e r a p i e s o n r e a t t u n i n g t h e p a t i e n t ' s p a t h o g e n i cally reduced w a y s of b e i n g in relation to t h e p h e n o m e n a of his w o r l d . 1

T h e s a m e u n d e r s t a n d i n g o f the basis o f all t h e r a p y i s r e q u i r e d o f t h e physician t r e a t i n g " p u r e p s y c h o s e s " and " c h a r a c t e r n e u r o s e s . " T h e s e illnesses differ from t h e "specifically h u m a n , o r p s y c h o s o m a t i c , " a i l m e n t s in t h a t t h e d i s t u r b e d r e l a t i o n s h i p s to t h e world are less s t r i k i n g l y evident w i t h i n t h e i r bodily s p h e r e s . T h e diseases k n o w n a s p s y c h o n e u r o s e s m o s t directly affect p o t e n t i a l i t i e s i n t h e r e a l m s o f t h i n k i n g , feeling, and a c t i n g . I n order t o heal w h e n t h e s e areas are a f f e c t e d , t h e physician m u s t often explode t h e a s s u m p t i o n s o f classical p s y c h o a n a l y t i c t h e o r y , according to w h i c h t h e w h o l e p r o b l e m is to r e l e a s e libido that h a s b e e n fixated o n infantile e n d o p s y c h i c c o n t e n t s b y m a k i n g t h e s e c o n t e n t s c o n s c i o u s . It has been pointed o u t o f t e n e n o u g h , h o w e v e r , thai libido and

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endopsychic contents are things for whose existence there is no proof at all, and t h a t e v e n if s u c h a t h i n g as libido did e x i s t it could n e v e r of its o w n a c c o r d p r o d u c e a h u m a n w o r l d of p e r c e i v e d m e a n i n g s . F a r less could it c h a n g e o r heal t h a t w o r l d . N o kind o f e n e r g y o r f o r c e can p e r c e i v e s o m e t h i n g in its s i g n i f i c a n c e . B u t this is an ability w i t h o u t w h i c h h u m a n b e i n g s could n e v e r live in t h e w o r l d as t h e y do. H o w t h e n does i t h a p p e n t h a t p h y s i c i a n s w h o a r e e n s l a v e d t o the libido t h e o r y and o t h e r s p e c u l a t i o n s o f p s y c h o a n a l y t i c m e t a p s y c h o l o g y can o f t e n free p a t i e n t s o f t h e i r p s y c h o s o m a t i c s y m p t o m s ? S i m p l y b e c a u s e t h e s e p a t i e n t s r e c o v e r n o t because of faulty t h e o r y b u t in spite of it. T h e r e a r e a t least t h r e e w a y s t o explain h o w c u r e s can t a k e place u n d e r such c i r c u m s t a n c e s . F i r s t , F r e u d h i m s e l f did n o t allow his t h e r a p e u t i c m e t h o d s to be ruled e n t i r e l y by his t h e o r e t i c a l findings. At decisive p o i n t s , in fact, h e a c t e d i n radical o p p o s i t i o n t o h i s o w n m e t a p s y c h o l o g y . T h i s can b e s e e n i n t h e striking c o n t r a d i c t i o n s t h a t e x i s t b e t w e e n his papers o n t e c h n i q u e and his w o r k s o n t h e s u b j e c t o f m e t a p s y c h o l o g y . T h e t h e o r e t i c a l s u p e r s t r u c t u r e m e a n s to be a n a t u r a l scientific s y s t e m and t h e r e f o r e c o n f o r m s s t r i c t l y t o t h e d e t e r m i n i s t i c principle o f c a u s a l i t y . B u t in F r e u d ' s practical advice for c o n d u c t i n g p s y c h o t h e r a p y , t h e r e is m u c h d i s c u s s i o n o f t h e m e a n i n g o f s y m p t o m s and o f t h e g r e a t e r f r e e d o m t o w h i c h p a t i e n t s can b e led t h r o u g h p s y c h o a n a l y t i c t r e a t m e n t . N o w , n e i t h e r m e a n i n g n o r f r e e d o m h a s a n y place in a s t r i c t l y d e t e r m i n i s t i c t h e o r y . T h e causal i m a g i n a t i o n beholds o n l y rigidly c h r o n o l o g i c a l sequences of events meaningless in themselves. T h e s e c o n d r e a s o n for t h e s u c c e s s o f such c u r e s i s t h a t , e v e n w h e n t h e physician i s t h e m o s t t h e o r e t i c a l l y o r t h o d o x p s y c h o a n a l y s t , infinitely m o r e h a p p e n s during t h e r a p y t h a n the m e r e r e p o r t a g e o f libidinal t h e o r i e s t o t h e p a t i e n t . W h a t h a p p e n s has m u c h m o r e t o d o w i t h that decisively i m p o r t a n t a s p e c t of t h e r a p y t h a t can o n l y be g r a s p e d by a D a s e i n s a n a l y t i c a p p r o a c h , and not by a p s y c h o a n a l y t i c o n e . We have pointed o u t a b o v e t h a t v e r y f e w adults indeed e v e r e x p e r i e n c e from a n o t h e r adult the kind o f e n d u r i n g , u n s h a k a b l e , b e n e v o l e n t , and tactful d e v o t i o n t h a t a p a t i e n t r e g u l a r l y r e c e i v e s from a n a n a l y s t , w h a t e v e r h i s s c h o o l o f t h o u g h t . F o r m a n y people w h o have b e c o m e n e u r o t i c t h r o u g h l o n e l i n e s s , such b e i n g - t o g e t h e r is in itself a v e r y e f f e c t i v e therapeutic tool. T h i r d , e v e n i n c o n c e p t u a l l y o u t m o d e d p r o g r a m s o f psychoanalytit t r e a t m e n t t h e p a t i e n t o f t e n g a i n s at least a foggy a w a r e n e s s o f t h e r e a l m . of p h e n o m e n a from w h i c h his e x i s t e n c e has so far been cul oil An a result o f this being cut off, which i s largely due t o i n a d e q u a t e a n d i n a p p r o p r i a t e upbringing, h e b e c a m e n e u r o t i c . B u t b e c a u s e t h e analysl | g m o r e open and c o u r a g e o u s than t h e p a r e n t s , close h u m a n c o n t a c l with

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him gradually t e a c h e s t h e p a t i e n t to e n g a g e i n d e p e n d e n t l y in r e l a t i n g m o r e freely t o r e a l m s o f p h e n o m e n a h e had b e e n avoiding. S o s u c c e s s can b e g a i n e d i n spite o f t h e fact t h a t n o e v i d e n c e e m e r g e s i n the course of therapy to support the theoretical statements of the o r t h o d o x p s y c h o a n a l y s t . B u t t h o s e p a t i e n t s w h o are n o t able t o see e v e n t h e dim o u t l i n e s o f w h a t lies b e y o n d t h e c o n c e p t u a l f r a m e w o r k o f o r t h o d o x p s y c h o a n a l y s i s usually w i n d u p trading t h e i r first n e u r o s i s for a n e w one: "psychoanalysitis." T h e y begin suffering from a compulsive u r g e to drill t h e m s e l v e s in t h e i n t e l l e c t u a l a c r o b a t i c s of p s y c h o a n a l y t i c t h e o r y . O b v i o u s l y , this kind o f m o n o m a n i a p r e c l u d e s t h e d e v e l o p m e n t o f r e l a t i n g m o r e freely t o t h e w o r l d . Q u i t e a f e w o f t h e s e p a t i e n t s can n e v e r t h e l e s s b e m a d e g e n u i n e l y h e a l t h y , i f t h e y a r e willing and able t o c h a n g e p h y s i c i a n s . W h a t t h e y n e e d i s a n a n a l y s t w h o s e h u m a n u n d e r s t a n d i n g a l l o w s h i m t o m a k e t h e leap f r o m a b s t r a c t ideas, like p s y c h e or psychic c o n t e n t s , to a m o r e a p p r o p r i a t e g r a s p of h u m a n Da-sein as b e i n g - i n - t h e - w o r l d . S u c h a physician e x c h a n g e s t h e t e c h n i q u e s o f a p s y c h o a n a l y t i c t h e r a p y o f r e s i s t a n c e for a D a s e i n s a n a l y t i c t r e a t m e n t of t h e c o n s t r i c t i o n s of t h e Dasein. T h e t h e r a p i s t s e e s t h e " D a - " of his p a t i e n t ' s Da-sein as t h a t o p e n r e a l m o f p e r c e p t i o n and r e s p o n s i v e n e s s t o t h e p r e s e n c e o f b e i n g s , w h i c h i s b o r n b y his, and t h a t o f all o t h e r h u m a n b e i n g s , e x i s t e n c e . A t o n e w i t h t h i s , t h a t for t h e sake o f w h i c h , for w h a t and t o w h a t end, t h e Da-sein o f his p a t i e n t is claimed as t h e " D a - " will be c o n s t a n t l y p r e s e n t for t h e D a s e i n s a n a l y t i c t h e r a p i s t . H e will t h e r e f o r e guide e v e r y p a t i e n t t o w a r d t h e s a m e goal of r e n d e r i n g t h e Da-sein of e a c h as p e r c e p t i v e l y o p e n and r e s p o n s i v e a s i t can b e t o t h e p r e s e n c e s o f e v e r y single p h e n o m e n o n t h a t a d d r e s s e s him w i t h t h e appeal to e n t e r i n t o t h e light of his fully freed e x i s t e n c e , and s o c o m e t o b e . D a s e i n s a n a l y t i c t h e r a p y can heal p a t i e n t s s u f f e r i n g f r o m p s y c h o n e u r o s e s , c h a r a c t e r n e u r o s e s , and p e r v e r s i o n s b e c a u s e t h e s e people c a n , w i t h an a d e q u a t e l y t h e r a p e u t i c a l l y active a n a l y s t , l e a r n to live purposeful lives o f t o t a l a u t o n o m y and f r e e d o m . T h e goal o f D a s e i n s a n a l y t i c t h e r a p y t h u s c o i n c i d e s e x a c t l y w i t h t h e m o s t s u i t a b l e definition for a h e a l t h y Da-sein. I n his p u r s u i t o f t h e u n i v e r s a l goal o f D a s e i n s a n a l y t i c t h e r a p y , t h e physician can n e v e r r e m i n d h i m s e l f t o o o f t e n t h a t his t a s k i n t h e r a p y does n o t c o n s i s t a n y l o n g e r m e r e l y i n dredging u p i n t r a p s y c h i c i m a g e s o f e x t e r n a l - w o r l d o b j e c t s , painful o r forbidden p o r t r a i t s t h a t w e r e supposedly r e p r e s s e d a t o n e t i m e i n t o t h e n e t h e r m o s t l a y e r o f a n e n c a p s u l a t e d p s y c h e . His duties are far m o r e p r o f o u n d . F o r t h e D a s e i n s a n a l y t i c t h e r a p y o f r e s i s t a n c e does m o r e than simply help p a t i e n t s find the c o u r a g e to face s h a d o w y i m a g e s supposed to exist inside

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s o m e s o r t o f psychic s t r u c t u r e ; t h e y m u s t e s t a b l i s h o p e n r e l a t i o n s w i t h each one of the phenomena that inhabit their world, no m a t t e r w h e r e in t h e i r o p e n realm of p e r c e p t i o n it c h o o s e s to appear. A n d this bold act m u s t b e t a k e n o n n o t o n l y i n r e l a t i o n t o i n a n i m a t e o b j e c t s b u t for e v e r y living c r e a t u r e , e v e r y o t h e r p e r s o n , and for t h e p o t e n t i a l i t i e s o f o n e ' s o w n e x i s t e n c e : i n s h o r t , for e v e r y t h i n g i n h e a v e n and e a r t h f r o m w h i c h t h e p a t i e n t has e v e r fled, e v e r y t h i n g t h a t , for r e a s o n s o f s h a m e , o r disgust, o r injured pride, o r s o m e p s e u d o m o r a l i t y , h e w o u l d n o t face a t a n y c o s t . R e p e a t e d q u e s t i o n i n g o f t h e p a t i e n t ' s a t t e m p t s t o flee f r o m s u c h p h e n o m e n a e n c o u r a g e s h i m t o p e r c e i v e , and c a r r y o u t , t h e g r e a t t a s k t h a t is placed b e f o r e h i m as a h u m a n b e i n g - i n - t h e - w o r l d , t h e t a s k of facing u p t o e v e r y t h i n g t h a t a d d r e s s e s him f r o m t h e o p e n r e a l m o f his b e i n g - t h e r e , and o f r e s p o n d i n g t o t h a t call a p p r o p r i a t e l y . S u c h t h e r a p y can r e m o v e t h e f o u n d a t i o n o f t h e illness. N e u r o s i s develops o n l y through ignoring, turning away from the existential task of committing o n e s e l f i n p e r c e p t i v e , r e s p o n s i v e r e l a t i o n s h i p w i t h w h a t r e v e a l s itself. W h a t allows t h e D a s e i n s a n a l y t i c t h e r a p i s t t o e x p e c t s o m u c h o f his p a t i e n t s i s his o w n w i l l i n g n e s s t o provide t h e m w i t h t h e dwelling place o f t h e p h y s i c i a n - p a t i e n t r e l a t i o n s h i p t h e y n e e d and c a n rely on. T h i s h u m a n t w o - n e s s s e r v e s a s t h e firm f o u n d a t i o n for t h e p a t i e n t ' s n e w l y l i b e r a t e d Da-sein u n t i l h e n o l o n g e r n e e d s t h e p r o t e c t i o n o f t h e s a f e m i n i a t u r e t e s t w o r l d . T h i s m e a n s , a s far a s practical t h e r a p y g o e s , t h a t t h e physician m u s t i m m e d i a t e l y d i s p e n s e w i t h t h e old w h y - q u e s t i o n s o f p s y c h o a n a l y ­ sis. All t o o o f t e n it h a s b e e n s e e n t h a t p a t i e n t s i n t e r p r e t such q u e s t i o n s as t h e r a p e u t i c a l l y u s e l e s s c o m m a n d s to dredge up s o m e i n f a n t i l e c a u s e f o r a p r e s e n t a i l m e n t , a s its e f f e c t , w i t h o u t e v e r l e a r n i n g t o u n d e r s t a n d t h e present pathological modes of relationship as they actually are. For a n o t h e r t h i n g , n e u r o t i c a l l y ill people f r e q u e n t l y m i s t a k e w h y questions—contrary to the analyst's intent—for prohibitions. T h e a n a l y s t s e e m s t o b e asking t h e m : " W h y are y o u still doing t h i s , w h e n y o u should h a v e given it up as i n a p p r o p r i a t e long a g o ? " In t h e v o c a b u l a r y of t h e D a s e i n s a n a l y t i c t h e r a p i s t , " w h y ? " i s replaced a s t h e m o s t i m p o r t a n t w o r d by t h e q u e s t i o n , " W h y in t h e w o r l d not?" At e v e r y available o p p o r t u n i t y , the D a s e i n s a n a l y t i c t h e r a p i s t will ask t h e p a t i e n t w h y i n the w o r l d he h a s n o t dared to p e r c e i v e and r e s p o n d to s o m e t h i n g in his world f r o m w h i c h he has c o n s t a n t l y b e e n looking a w a y . W a s it really n e c e s s a i y t o flee and hide f r o m t h i n g s t h a t r e v e a l e d t h e m s e l v e s t o h i m ? S u c h " w h y n o t " questions are particularly indispensable whenevei there is a barrier to the honest, open verbalizing of the patient's hum.in r e l a t i o n s h i p to t h e t h e r a p i s t , c o n c r e t e e x a m p l e s of w h i c h a b o u n d m the p r e c e d i n g description of o u r t e s t c a s e . In fact, " W h y in the world nol la ;

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really a t t h e h e a r t o f a n y c o m p r e h e n s i v e p s y c h o t h e r a p y . B u t i f t h e t h e r a p i s t u s e s this q u e s t i o n a s j u s t a n o t h e r t e c h n i c a l tool, h e will s u r e l y apply it at t h e w r o n g t i m e s and places. He can u s e it successfully in t h e r a p y o n l y i f h e k n o w s well e n o u g h t h e o n t o l o g i c a l s t r u c t u r e o f h u m a n b e i n g - t o g e t h e r i n a s h a r e d w o r l d . T h e t h e r a p i s t m u s t realize t h a t t h e real r e a s o n for c o n f r o n t i n g p a t i e n t s w i t h such precisely f o r m u l a t e d , specific o n t o l o g i c a l q u e s t i o n s i s t o rid t h e m o f t h e n o t i o n t h a t t h e y a r e n o t h i n g t o him b u t n u m b e r s and t h i n g s , and to h a v e t h e m gradually e x p e r i e n c e a genuine human relationship shared by both. W i t h o u t the potentiality of such an insight into the ontological structure of human being-in-thew o r l d , t h e t h e r p i s t w o u l d h a v e n o o t h e r w a y b u t t o g r o p e i n t h e dark. W i t h it, he can s y s t e m a t i c a l l y s h o w his p a t i e n t s t h a t he is c o m m u n i c a t i n g w i t h t h e m in t h e r e a l m of a h u m a n b e i n g - t o g e t h e r . It s e e m s to be a p r e r e q u i s i t e for s u c c e s s in t h e r a p y t h a t in t h e c o u r s e of t r e a t m e n t t h e p a t i e n t b e s h o w n this v e r y t h i n g d o z e n s and h u n d r e d s o f t i m e s . It is n o t n e c e s s a r y t h a t the patient h i m s e l f learn to r e c o g n i z e thematically the ontological, existential structure of human being-int h e - w o r l d . His insight need n o t e x t e n d b e y o n d t h e limits o f his individual, directly p e r c e p t i b l e o n t i c w a y s o f r e l a t i n g t o t h e t h e r a p i s t . B u t it is t h e d u t y of t h e l a t t e r to b e c o m e t h o r o u g h l y a c q u a i n t e d w i t h , and clearly a w a r e of, t h e o n t o l o g i c a l n a t u r e o f b e i n g - t o g e t h e r i n o r d e r t o give his t r e a t m e n t a scientific f o u n d a t i o n . G i v e n this s o r t o f f o u n d a t i o n , i t m a y o n t h e s u r f a c e appear n o n s e n s i c a l to apply t h e label " a n a l y s i s . " It w o u l d s e e m r a t h e r to be a " s y n t h e s i s , " in t h a t the p a t i e n t is c o n s c i o u s l y guided i n t o t h e w h o l e n e s s of a free and a u t o n o m o u s e x i s t e n c e . B u t t h e w o r d analysis is o b j e c t i o n a b l e in this c o n t e x t o n l y if it keeps t h e m e a n i n g it has t a k e n on in t h e m o d e r n t e c h n i c a l age, of s e p a r a t i n g c o m p o n e n t s , b u t n o t w h e n it is u n d e r s t o o d in its original s e n s e of r e v e a l i n g t h e a r t i c u l a t i o n of a w h o l e . S t r i c t l y s p e a k i n g , t h e w a y in w h i c h a p h y s i c i a n heals t h e Da-sein of his p a t i e n t t h r o u g h " w h y n o t " q u e s t i o n s i s m o r e radical i n its e f f e c t s t h a n a n y h e a r t t r a n s p l a n t could e v e r be. T h e l i b e r a t i o n o f a p a t i e n t f r o m n e u r o t i c and p s y c h o s o m a t i c captivity b r o u g h t a b o u t w i t h t h e aid o f t h e s e q u e s t i o n s a l w a y s h a s to be, quite literally, a w o r l d - s h a k i n g e x p e r i e n c e for physician and p a t i e n t alike. It lacks o n l y t h e s p e c t a c u l a r m a t e r i a l e x p e n s e of a physical h e a r t t r a n s p l a n t and t h e r e s p e c t t h a t m o s t people a c c o r d to physical m a t t e r t h e y can see w i t h t h e i r o w n e y e s . A D a s e i n s a n a l y t i c t h e r a p i s t can e v e n g e t t h r o u g h to t h a t m o s t difficult class o f p a t i e n t s , m o s t o f t h e m y o u n g , w h o a r e n o t medically ill a t all. T h e y e x h i b i t n o specific medical s y m p t o m s , y e t t h e y d o suffer, filling t h e w a i t i n g r o o m s o f physicians i n i n c r e a s i n g n u m b e r s . W e h a v e already said that t h e s e y o u n g people suffer o n l y from g e n e r a l b o r e d o m , t h e

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m e a n i n g l e s s n e s s o f h u m a n e x i s t e n c e i n g e n e r a l and t h e h o p e l e s s n e s s o f t h e i r o w n lives i n particular. T h e i r f a v o r i t e e x p r e s s i o n s e e m s t o be, "It d o e s n ' t m a t t e r . " T h e y say this e v e n a b o u t t h i n g s t h e y have j u s t c o m p l a i n e d of. N e v e r t h e l e s s , m o r e and m o r e , physicians w h o t r y t o t r e a t such p a t i e n t s e x i s t e n t i a l l y h a v e c o m e u n d e r h e a v y c r i t i c i s m f r o m influential sectors of society. Certainly, these critics are correct in pointing out that t h e p h y s i c i a n and his p a t i e n t do n o t e x i s t in a v a c u u m b u t w i t h i n t h e l a r g e r , d a y - t o - d a y reality o f m o d e r n industrial s o c i e t y . T h e r e are m a n y leading p h y s i c i a n s , t o o , w h o a r e o p p o s e d from t h e s t a r t t o a n y t h e r a p y t h a t dwells o n s u c h t h i n g s a s h u m a n o p e n n e s s t o p h e n o m e n a l p r e s e n c e s and t h e o p e n space o f p h y s i c i a n - p a t i e n t b e i n g - t o g e t h e r . T o t h e s e critics, s u c h a f o u n d a t i o n for t h e r a p y s h a r e s m o r e w i t h p o e t r y t h a n w i t h practical s c i e n c e . W h e t h e r D a s e i n s a n a l y t i c t h e r a p y is poetic is i r r e l e v a n t . T h e c h a r g e o f u n s c i e n t i f i c n e s s , h o w e v e r , i s valid o n l y o f s c i e n c e a r b i t r a r i l y r e s t r i c t e d to n a t u r a l scientific o r i e n t a t i o n , a r e s t r i c t i o n m a d e w i t h i n c r e a s i n g f r e q u e n c y t h e s e days. F u r t h e r m o r e , i t s h o u l d first b e demonstrated that Daseinsanalytic therapy involves an approach that is less s t r i c t and less o b j e c t i v e , w i t h r e g a r d t o t h e m a t t e r a t h a n d , t h a n n a t u r a l scientific o r i e n t a t i o n . B u t s o far n o critic h a s b e e n able t o p r o v e such statements. It is a b s u r d , in any c a s e , t h a t t h e v e r y p h y s i c i a n s w h o t r y to s u m m o n t h e i r D a s e i n s a n a l y t i c c o l l e a g u e s b a c k i n t o t h e fold o f n a t u r a l s c i e n c e should b e t h e o n e s w h o fight, t h r o u g h t h e i r p r o f e s s i o n a l o r g a n i z a t i o n s , a g a i n s t t h e socialization o f m e d i c i n e . F o r t h e m o r e t h e y think o f t h e m s e l v e s e x c l u s i v e l y a s p r e c i s e , n a t u r a l , scientific h e a l t h e n g i n e e r s , t h e m o r e t h e y a b a n d o n all claim to i n d e p e n d e n t p r o f e s s i o n a l standing. M e m b e r s o f all e x i s t i n g t e c h n i c a l p r o f e s s i o n s h a v e w o n t h e s t a t u s o f e m p l o y e e s on fixed salaries; this fact gives a h o l l o w s o u n d to t h e cries for i n d e p e n d e n c e issued b y w o u l d - b e t e c h n i c i a n s a m o n g t h e medical p r o f e s s i o n . T h e d o c t o r s ' fight a g a i n s t socialization w o u l d be justified, in t h e l o n g r u n , o n l y if a m a j o r i t y of t h e m w e r e able to s t r u g g l e t h r o u g h to a b e t t e r e x i s t e n t i a l u n d e r s t a n d i n g o f t h e healing art. O n l y t h e n could t h e y p r o c l a i m t h e f r e e d o m and o p e n n e s s c h a r a c t e r i s t i c of a h e a l t h y h u m a n e x i s t e n c e . O n c e t h e y h a v e this u n d e r s t a n d i n g , t h e y will h a v e a they will h a v e a c o n v i n c i n g a r g u m e n t for t h e n e c e s s i t y of an i n d e p e n d e n t medic al p r o f e s s i o n . F o r no o n e will d e n y t h a t , if h u m a n h e a l t h c o n s i s t s in I In­ c a p a c i t y to e n g a g e freely in i n n a t e e x i s t e n t i a l p o t e n t i a l i t i e s , this health can be realized o n l y in an a d e q u a t e l y free p h y s i c i a n - p a t i e n t r e l a t i o n s h i p S u c c e s s f u l p r e v e n t i v e m e d i c i n e relies, for the s a m e r e a s o n s , o n the i n d e p e n d e n c e o f t h e physician. C e r t a i n p h y s i c i a n s , and m a n y leading industrialists as well, want no dealings with a t h e r a p e u t i c m e t h o d thai aims at freeing the paticnl f r o m

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FOUNDATIONS

t h e p a t h o l o g i c a l i m p a i r m e n t of his p o t e n t i a l i t i e s and i n t r o d u c i n g h i m to a f r e e , a u t o n o m o u s b e i n g - i n - t h e - w o r l d . It w o u l d be difficult, t h e y say, to i m a g i n e a t h e r a p y less s u i t e d t o t h e p r e s e n t a g e o f t h e c o m p u t e r . F o r people s e l d o m t h i n k o f t h e m s e l v e s a n y m o r e a s d i s t i n c t individuals. T h e y r a r e l y s a y " I . " T h e y say " w e " i n s t e a d , m e a n i n g t h e s u m t o t a l o f e m p l o y e e s a t " t h e i r " g i a n t industrial c o n c e r n . All t h e e m o t i o n s , t h o u g h t s , and a c t i o n s o f t h e s e w o r k e r s a r e d i r e c t e d t o w a r d m a x i m u m p r o d u c t i o n and g r o w t h for " t h e i r " c o r p o r a t i o n . T h e i r life goal c o n s i s t s , a c c o r d i n g l y , i n a t t a i n i n g t h e m o s t efficient and p e r m a n e n t c o o p e r a t i o n possible a m o n g fellow w o r k e r s , w h o a r e all i m a g i n e d as cogs in a w h e e l . T h e aforementioned physician-technicians argue that, in the vast m a j o r i t y o f c a s e s , individual and g r o u p t h e r a p i e s a r e c o u n t e r p r o d u c t i v e i n c o n t e m p o r a r y s o c i e t y . T h e physician can o n l y h a r m his c h a r g e s b y helping t h e m a t t a i n a n i n d e p e n d e n t and free s e l f h o o d , w h i c h o n l y m a k e s it h a r d e r for t h e m to fit i n t o t h e m a s s s o c i e t y of i n d u s t r i a l e m p l o y e e s . T h e y would h a v e m o r e c o n f l i c t s w i t h c o w o r k e r s and s u p e r v i s o r s . Anyone coming out of Daseinsanalysis, therefore, would be sure to lose his j o b , be d i s m i s s e d , and u l t i m a t e l y be h a n d e d o v e r to social and physical ruin. O u t o f c o n s i d e r a t i o n for t h e s e c o n s e q u e n c e s , s o m e d i r e c t o r s o f i n d u s t r y h a v e already t a k e n i t u p o n t h e m s e l v e s t o forbid t h e i r e m p l o y e e s to undergo programs of analytic therapy. C e r t a i n scientific p u b l i c a t i o n s , l a r g e l y o f A m e r i c a n origin, imply t h a t this a t t i t u d e i n i n d u s t r i a l l e a d e r s h i p h a s i n f l u e n c e d p h y s i c i a n s t h e m s e l v e s , h a s c a u s e d t h e m t o allow p s y c h o t h e r a p y t o slip m o r e and m o r e out of their hands. According to these articles, physicians have delegated t h e i r p s y c h o t h e r a p e u t i c a c t i v i t y m o r e and m o r e t o s o c i o l o g i s t s , w h o c a r r y o u t a psychic i n d o c t r i n a t i o n o f t h o s e e n t r u s t e d t o t h e i r c a r e . T h e s e s o c i o l o g i s t s , p r a c t i c e a b r a n d of m a s s t h e r a p y aimed at e x t e r n a l p s y c h o l o g i c a l c o n t r o l of all p e r s o n n e l . A s t a t i s t i c a l description of all Americans undergoing some form of psychological t r e a t m e n t would s h o w t h a t t h o s e b e i n g s h a p e d to a s m o o t h fit in i n d u s t r y e x c e e d t h o s e being guided to a t t a i n m e n t of an i n d e p e n d e n t f r e e selfhood by a r a t i o of a b o u t a t h o u s a n d to o n e . 2

T h a t this is so already in A m e r i c a , and will be s o o n all o v e r t h e w o r l d , is n o t s u r p r i s i n g . D e v e l o p m e n t s i n t h e r a p y t a k e t h e i r lead f r o m t h e l a r g e r v i e w o f h u m a n n a t u r e t h a t p r e d o m i n a t e s today. Y e t i t i s doubtful w h e t h e r i n t h e long r u n this a p p r o a c h t o t h e r a p y will p r o m o t e e v e n s u c h a n a r r o w goal as i n c r e a s e d p r o d u c t i v i t y in i n d u s t r y . B e c a u s e h u m a n Dasein is i n n a t e l y disposed to an e x t r e m e l y b r o a d e x p e r i e n c e , it is m o r e likely t h a t the m a s s e s o f industrial w o r k e r s will r e a c t t o t h e a t t e m p t t o r e p r e s s their unique n a t u r e s by s h o w i n g s e v e r e l y p a t h o l o g i c a l b e h a v i o r apt to n i p p l e even the l a r g e s t industrial g i a n t s . T h i s pathological r e s p o n s e t o

Those

Who Are

Therapeutically Active

283

d e p r i v a t i o n is taking s h a p e as m a s s c r i m i n a l i t y and m a s s addiction, and o n a scale t h a t c h a l l e n g e s t h e i m m e n s e r e s o u r c e s o f t h e s t a t e itself, n o t t o s p e a k o f t h e fragile i n s t r u m e n t a r i u m o f t h e p h y s i c i a n s w h o , a s a body, a r e t h e m s e l v e s o r i e n t e d t o t h e f u n c t i o n i n g o f t h e i r c h a r g e s and o f a n i n d u s t r i a l s o c i e t y . A rapid i n c r e a s e in c r i m e and addiction, m u c h l a m e n t e d t h o u g h i t b e t h e s e days, i s n o n e t h e l e s s t h e i n e v i t a b l e r e a c t i o n t o t h e g r o w i n g c r i m e s p e r p e t r a t e d upon t h e h u m a n soul b y the a p o t h e o s i z e d spirit o f t e c h n o l o g y . Addiction, w h a t e v e r its f o r m , h a s a l w a y s b e e n a d e s p e r a t e s e a r c h , on a false and h o p e l e s s path, for t h e fulfillment of a h u m a n f r e e d o m . O u r d i s c u s s i o n o f h u m a n p a t h o l o g y b r i n g s u s face t o face again w i t h t h e fact t h a t h u m a n illness and its t r e a t m e n t a r e b o t h peculiarly r o o t e d i n f u n d a m e n t a l h u m a n n a t u r e , i n m a n ' s b e i n g - i n - t h e - w o r l d and his i n h e r e n t b e i n g - t o g e t h e r w i t h o t h e r s in a s h a r e d world. O n c e again we s e e t h a t all illness and t r e a t m e n t develops o u t o f t h e p a t i e n t ' s disturbed h u m a n r e l a t i o n s h i p s ; in o t h e r w o r d s , social b e h a v i o r is n e c e s s a r i l y i n v o l v e d i n illness. C o n s e q u e n t l y , a n y p r o g r a m o f t h e r a p y , e v e n t h e m o s t trifling, is e s s e n t i a l l y an i n s t a n c e of social m e d i c i n e . NOTES 1. A . J o r e s , Vom kranken Menschen ( S t u t t g a r t : T h i e m e , 1 9 õ 6 ) ; Menschsein als Auftrag ( B e r n a n d S t u t t g a r t : H . H u b e r , 1 9 6 7 ) ; a n d Urn eine Medizin von morgen ( B e r n a n d S t u t t g a r t : H . Huber, 1 9 6 6 ) . 2 . S t . L e s s e a n d W . W o l f , Proceedings of lhe Vlllh International Congress of Psychotherapy, 1 9 6 7 (Basel and N e w Y o r k : S. K a r g e r , 1 9 6 9 ) , 2: 2 7 - 5 4 ; and J. R e u s c h , " P s y c h o t h e r a p y in the C o m p u t e r A g e , " ibid., 2 : 3 2 - 4 6 .

Afterword THE FOUNDATIONS

OF A DA-SEIN-BASED

SOCIAL PSYCHOLOGY AND SOCIAL PREVENTIVE MEDICINE IN MODERN INDUSTRIAL SOCIETY

T h e medical s c i e n c e s o f social p s y c h i a t r y and social p r e v e n t i v e m e d i c i n e , t h o u g h still v e r y y o u n g , h a v e already r e g i s t e r e d a s t o u n d i n g s u c c e s s e s . T h e i r m o s t i m p o r t a n t a c h i e v e m e n t s are limited p r i m a r i l y t o the struggle against bacterial disease, the accidents that are always t h r e a t e n i n g t h e i n d u s t r i a l w o r k e r , t h e pollution o f o u r e n v i r o n m e n t , t h e c o n t a m i n a t i o n o f o u r food, and a n u m b e r o f a n a l o g o u s e n c r o a c h m e n t s on people's h e a l t h . M a n y of t h e s e e f f o r t s in social m e d i c i n e are still in t h e i r first p h a s e s , and t h i s i s s o p a r t i c u l a r l y f o r t h e e n o r m o u s e f f o r t s o f t h e field o f m e n t a l h y g i e n e . In t h e s e t i m e s , it is p r e c i s e l y t h e field of m e n t a l h y g i e n e w h i c h is e s p e c i a l l y i m p o r t a n t . Its t a s k i s t o w o r k out a p p r o p r i a t e m e a s u r e s t h a t c a n c h e c k , o r e v e n w h o l l y p r e v e n t , t h e kinds o f d i s t u r b e d social b e h a v i o r t h a t h a v e spread like s o m e e p i d e m i c a m o n g t h e y o u n g people w h o n o w s t a n d f o r t h e f u t u r e o f h u m a n i t y . T h e s e u n h e a l t h y f o r m s o f social b e h a v i o r , w h i c h i n t h e last c h a p t e r w e called n e u r o s e s o f m e a n i n g l e s s n e s s and b o r e d o m , a r e n o w m o r e c o m m o n t h a n t h e o l d e r f o r m s o l h y s t e r i a and o r g a n i c n e u r o s e s . P r e c o n d i t i o n s f o r s u c c e s s f u l t h e r a p y and p r e v e n t i o n o f social u n r e s l a m o n g t h e y o u n g a r e , as t h e y a r e f o r a scientific art of healing in a n y area, c o r r e c t d i a g n o s i s and a p p r o p r i a t e i n s i g h t i n t o t h e basic n a t u r e ol what Is

286

EXISTENTIAL

FOUNDATIONS

g o i n g o n . T h e r e i s n o lack o f p s y c h o l o g i c a l , sociological, t h e o l o g i c a l , political, and f u t u r e studies. B u t t h e u s e f u l n e s s of such i n v e s t i g a t i o n is n e c e s s a r i l y d e t e r m i n e d b y t h e quality o f u n d e r s t a n d i n g a b o u t w h a t n e e d s c h a n g i n g , and i t w o u l d appear t h a t this g r o u n d w o r k h a s s c a r c e l y received its due a t t e n t i o n . I t o f t e n h a p p e n s t h a t t h e b e h a v i o r a l d e f e c t s o f people s u f f e r i n g f r o m n e u r o s e s o f b o r e d o m and m e a n i n g l e s s n e s s a r e a t t r i b u t e d t o s o m e a b s t r a c t c o n c e p t like " t h e malaise o f t h e t i m e . " B u t t h e n i t b e c o m e s difficult t o decide w h e t h e r t h e fault lies w i t h t h e y o u n g people t h e m s e l v e s or t h e t i m e s t h e y live in. A d i s c e r n i n g c o n v e r s a t i o n w i t h a n y typical o n e o f t h e s e m e m b e r s o f o u r s o c i e t y s h o w s t h a t t h e y all suffer—whether they consider themselves healthy or disturbed—the fate of the times, their times. I t e a t s a t t h e m t h a t this fate o f t h e i r s p r e s s u r e s t h e m t o r e g a r d e v e r y t h i n g in t h e w o r l d and u n i v e r s e , e v e r y t h i n g and all t h a t l i v e s — plants and animals and e v e n h u m a n b e i n g s t h e m s e l v e s — m o r e and m o r e as n o t h i n g b u t i n t e r c h a n g e a b l e parts of a p l a n e t a r y m a c h i n e t h a t t a k e s in t h e w h o l e w o r l d . T h e y k n o w t h a t c o m p o n e n t s e x i s t only t o b e m e s h e d i n t o p r o d u c t i o n a p p a r a t u s e s w h i c h m u s t yield m o r e e n e r g y and m o r e g o o d s purely for t h e sake o f i n c r e a s i n g p r o d u c t i o n , and t h a t t h e particular kind and p a r t i c u l a r m e a n i n g of t h e p r o d u c t is a m a t t e r of diminishing s i g n i f i c a n c e . T h e d e s t i n y t h a t arises f r o m such a w o r l d v i e w r e c o g n i z e s o n l y t h e single goal o f m a x i m u m e x t e n s i o n o f p o w e r o v e r all t h i n g s t h a t can b e useful and s e r v i c e a b l e , t h i n g s w h i c h i n t h e m s e l v e s h a v e b e e n d r a i n e d o f m e a n i n g , t h i n g s t h a t can o n l y b e a m a s s e d — t h e h u m a n being included. T h i s d e s t i n y c e r t a i n l y d o e s bring the Biblical m a n d a t e o f h u m a n d o m i n i o n o v e r h e a v e n and e a r t h c l o s e r t o realization, and i n this n o d o u b t lay its passing f a s c i n a t i o n for t h o s e w h o a r e n o w t h e g e n e r a t i o n o f p a r e n t s and g r a n d p a r e n t s . B u t for t h e y o u n g w h o are p e r c e p t i v e , a g h a s t l y b o r e d o m and e m p t i n e s s g a p e s in this w o r l d v i e w , and the l o n g e r i t g o e s o n , t h e w o r s e i t b e c o m e s . T h i s s e l f - a l i e n a t i o n — t h e oblivion i n t o w h i c h t h e c h a r a c t e r i s t i c t r a i t s o f h u m a n being h a v e s u n k , and t h e h u m a n i s o l a t i o n t h a t follows f r o m it—has heavily i n f e c t e d t h e r e l a t i o n s h i p o f m o s t c o n t e m p o r a r y p a r e n t s w i t h t h e i r c h i l d r e n , and for the y o u n g this is p a r t i c u l a r l y d e v a s t a t i n g . T h e r e h a v e b e e n m a n y sociological i n v e s t i g a t i o n s w h i c h appear t o c o n t r a d i c t this and t o d e m o n s t r a t e t h a t m a n y y o u n g r e b e l s and t h e i r p a r e n t s have g e n e r a l l y g o o d , o r a t least a c c e p t a b l e , r e l a t i o n s h i p s . B u t t h e value o f t h e s e studies depends o n t h e c r i t e r i a b y w h i c h t h e s o c i o l o g i s t s a s s e s s t h e people t h e y i n v e s t i g a t e , and t h e s e criteria g e n e r a l l y c o r r e s p o n d t o t h e m e a g e r n o r m o f the c o n t e m p o r a r y p a r e n t - c h i l d r e l a t i o n s h i p . F u r t h e r m o r e , t h e i n v e s t i g a t i o n s w h i c h lead to such c o n c l u s i o n s regularly use the t e c h n i q u e of the q u e s t i o n n a i r e , a

Afterword

287

methodology that is inherently unreliable regarding any matters c h a r a c t e r i s t i c of and basic to h u m a n b e i n g s . In talking a b o u t t h e i r lives w i t h s o m e o n e t h e y can t r u s t , t h e v e r y s a m e y o u n g people m u s t often reverse the judgment they recorded in the questionnaire response. It is no w o n d e r t h a t u n d e r s u c h family c o n d i t i o n s m a n y a d o l e s c e n t s today n o l o n g e r grasp w h y s o m e o n e should e v e r d o s o m e t h i n g simply t o oblige s o m e o n e e l s e . An u n r e a s o n a b l e d e m a n d of this kind is usually a n s w e r e d w i t h a n u n c o m p r e h e n d i n g , " W h y ? " H o w could a g r a t e f u l love b e e x p e c t e d o f y o u n g people w h o t h e m s e l v e s h a v e n e v e r r e c e i v e d f r o m their o w n p a r e n t s t h e f u r t h e r i n g help t o w h i c h t h e y a s children had e v e r y r i g h t ? T h e y h a v e b e e n s o shaped i n t h e h o m e s o f t h e i r p a r e n t s ; h o w could t h e y h o n o r and r e s p e c t s u c h e l d e r s ? T h e p a r e n t a l g e n e r a t i o n in the industrialized c o u n t r i e s h a s largely forfeited its l e g i t i m a t e claim to love. L o v e and r e s p e c t a r e i n t i m a t e l y b o u n d up w i t h e a c h o t h e r . In t h e original n a t u r e o f h u m a n b e i n g s t h e y o u n g always d o g e n u i n e l y love and r e s p e c t p a r e n t s and a u t h o r i t i e s as l o n g as t h e s e elders s t a n d by t h e m in w a y s w h i c h help t h e m a s t h e y e n d e a v o r t o g r o w i n t o the free, a u t o n o m o u s b e i n g s - i n - t h e - w o r l d t h e y are m e a n t t o be. O n e i s a l w a y s h e a r i n g t h e s e days t h a t t h e y o u n g are h o s t i l e t o w a r d a u t h o r i t y . B u t w i t h e v e r y single o n e o f t h e s e r e b e l l i o u s y o u n g people ( w h o is n o t c o n s t i t u t i o n a l l y impaired) t h e e x a c t o p p o s i t e h a p p e n s as s o o n a s t h e r e i s s o m e o n e t h e y can c o m e t o t r u s t , w i t h w h o m t h e y can b e o p e n . T h e y w o u l d like n o t h i n g b e t t e r t h a n finding a u t h o r i t y w o r t h y o f t h e n a m e . T h e w o r d i t s e l f c o m e s f r o m t h e Latin augere, w h i c h m e a n s " t o i n c r e a s e or m u l t i p l y . " F o r t h e y o u n g , t h e n , a g e n u i n e a u t h o r i t y is o n l y s o m e o n e w h o can e x i s t e n t i a l l y e n r i c h t h e i r Da-sein, w h o k n o w s h o w t o help t h e m b e c o m e the h u m a n b e i n g s t h e y could, a c c o r d i n g t o t h e i r o w n i n b o r n p o t e n t i a l , b e . T h e best a m o n g the rebellious y o u n g despair, g r o w o u t r a g e d and d e s t r u c t i v e , o n l y b e c a u s e t h e i r s e a r c h for s u c h a u t h o r i t y is fruitless and t h e y m u s t e x p e r i e n c e again and again t h e fact t h a t t h o s e adults w h o would b e t h e i r a u t h o r i t i e s are h i n d e r i n g i n s t e a d o f f u r t h e r i n g t h e i r e f f o r t s to lead m e a n i n g f u l lives. T h e y o u n g o v e r s h o o t t h e m a r k , h o w e v e r , w h e n t h e y m a k e t h e s e adult pillars of s o c i e t y p e r s o n a l l y r e s p o n s i b l e for t h e i r o w n failure as a u t h o r i t i e s . For t h e m o s t part, adults t h e m s e l v e s d o n o t k n o w w h a t has h a p p e n e d and still is h a p p e n i n g to t h e m . T h e y h a v e hardly a clue that t h e y are p r i s o n e r s o f t h e t e c h n o l o g i c a l spirit o f t h e t i m e s . And s o they are e v e n less a w a r e t h a t t h e w a y t h e i r w o r l d v i e w has b e e n blocked out t o s o e x t r e m e l y n a r r o w a vision follows n o t from t h e i r o w n dealings and i n t r i g u e s but, r a t h e r , from this e r a ' s d e s t i n y . W i t h t h e s e b l i n d e r s t h e y can s e e , of all t h e w a y s to be in relation to the world, o n l y t h e increase ol

288

EXISTENTIAL FOUNDATIONS

p o w e r o v e r t h i n g s for t h e sake o f c o n t r o l and for t h e c o n s e q u e n t i a l i n c r e m e n t of p o w e r for w h o is in c o n t r o l . It is n o t h i n g s h o r t of impossible for this g e n e r a t i o n t o fulfill t h e d e m a n d o f t h e y o u n g t h a t t h e y b e t r u e authorities, furtherers, "increasers" of their existence. But when the elders no l o n g e r h a v e m u c h to say t h a t is h u m a n l y useful, or h u m a n l y m e a n i n g f u l , s u r e l y t h e y o u n g c a n n o t b e faulted for w a n t i n g t o have t h e i r w a y and take t h e i r part in shaping society and t h e i r o w n lives. M o r e t h a n a c e n t u r y a g o , M a r x o f f e r e d alienation as an e x p l a n a t i o n for t h e malaise o f t h e people i n m o d e r n industrial s o c i e t y . H e t o o k t h e c o n c e p t from t h e p h i l o s o p h y o f H e g e l , w h o used alienation t o m e a n t h e not yet accomplished coming-to-be-itself of the absolute subjectivity. B u t in his e a r l i e s t w r i t i n g s , t u r n i n g Hegel's p h i l o s o p h y on its h e a d , M a r x t r a n s f e r r e d t h e n o t i o n of a l i e n a t i o n from a b s o l u t e spirit to individual w o r k e r . H e s a w t h e r o o t s o f self-alienation i n t h e c i r c u m s t a n c e t h a t t h e good a m a n p r o d u c e s at w o r k in t h e f a c t o r y is no l o n g e r directed t o w a r d a n o t h e r person w h o stands in an immediate relationship to him. What he produces is degraded to a purely m a t e r i a l saleable c o m m o d i t y . W i t h t h e degradation o f w h a t h e p r o d u c e s , t h e w o r k e r ' s w o r k and t h e w o r k e r h i m s e l f are degraded, t o o , from s o m e t h i n g h u m a n t o a c o m m o d i t y w h i c h is alien to h u m a n being. M o d e r n M a r x i s m , w h i c h i s allegedly based o n M a r x ' s p h i l o s o p h y , believes t h a t it already h a s t h e t e c h n i q u e s of social t h e r a p y n e e d e d to a n n u l t h e d e s t r u c t i v e c o n s e q u e n c e s o f t h e n e w age's t e c h n o l o g i c a l destiny. B u t i n t h e m e a n t i m e , t h e c o n t i n u i n g disquiet, r e s t l e s s n e s s , and r e v o l t o f t h e y o u n g t o d a y s p a r e s n e i t h e r liberal n o r M a r x i s t social f o r m s . T h e ubiquity o f this social u n r e s t raises t h e likelihood t h a t M a r x i s m ' s f u n d a m e n t a l idea is all t o o closely b o u n d to t h e p h i l o s o p h y t h a t already s p a w n e d the alienating, t e c h n o l o g i c a l , m o n o p o l i s t i c capitalist f a n a t i c i s m t o a c h i e v e . O f s u c h i n d i c a t i o n s , not t h e least a r e t h e dead s e r i o u s style and violent c o n d u c t o f M a r x i s t p r o g r e s s i v e s a m o n g s t u d e n t s t h e m s e l v e s . In fact, t h e capitalist and M a r x i s t industrial s o c i e t i e s h a v e a close kindred c o n n e c t i o n indeed. M a r x i s m simply c a r r i e s t h a t C a r t e s i a n s u b j e c t i v i t y w h i c h i s t h e m o t h e r e a r t h o f W e s t e r n industrial s o c i e t y t o its m o s t e x t r e m e f o r m . M a r x i s m e x p a n d s D e s c a r t e s ' s old s u b j e c t t o h u m a n i t y as a collective b u t faithfully p r e s e r v e s all t h e c h a r a c t e r i s t i c f e a t u r e s of t h e t h i n k i n g s u b s t a n c e as D e s c a r t e s applied it to t h e individual s u b j e c t . M a r x ' s collective s u b j e c t is u n c o m p r o m i s i n g l y c o n c e p t u a l i z e d as t h a t s u b j e c t i v e being w h i c h u n d e r l i e s and s u s t a i n s all o t h e r b e i n g s , i s literally " s u b - j e c t e d , " t h r o w n u n d e r t h e m . A s s u c h , M a r x ' s s o c i e t y - s u b j e c t arbitrarily d e t e r m i n e s t h e m e a n i n g and signifi­ c a n c e of e v e r y t h i n g else and h o w it is to be e x p l o i t e d to a u g m e n t the s u b j e c t ' s p o w e r . In his a t h e i s m , M a r x w e n t a step f u r t h e r than

280

Afterword

D e s c a r t e s ' s s u b j e c t i v i s m and a t t r i b u t e d t o t h e collective h u m a n subject w h a t had f o r m e r l y been r e g a r d e d a s t h e c r e a t i v e p o w e r s o f divinity. N o w this s u b j e c t had t o m a k e e v e n itself. T h e y o u n g M a r x w r o t e : A being is an i n d e p e n d e n t being o n l y w h e n it stands on its o w n f e e t , and it s t a n d s on its o w n feet o n l y w h e n it r e c e i v e s its D a s e i n f r o m itself. A h u m a n being w h o lives by t h e g r a c e of a n o t h e r r e g a r d s h i m s e l f as a d e p e n d e n t being . . . and my life n e c e s s a r i l y has s u c h a s o u r c e outside itself when it is not of my own making. 1

S a r t r e e m u l a t e d M a r x i n c a r r y i n g C a r t e s i a n s u b j e c t i v i t y t o its f u r t h e s t e x t r e m e . I n a n early w o r k h e w r o t e , " T h e h u m a n b e i n g i s n o t h i n g o t h e r t h a n w h a t h e m a k e s o f h i m s e l f . " L a t e r , i t w a s n o l o n g e r t h e individual person w h o m Sartre rendered absolute but the totality of historical h u m a n i t y . Calling M a r x " t h e i n s u r p a s s a b l e p h i l o s o p h e r o f o u r t i m e , " h e too proclaims, "Humanity makes itself." 2

3

T h e o u t c o m e o f this s h a r e d p r e m i s e t h a t u n d e r l i e s and s u s t a i n s t h e t e c h n o l o g i c a l world in East and W e s t alike h a s s h o w n us t h a t in t h e s o c i e t i e s shaped b y M a r x i s m , t o o , people h a v e b e e n u n a b l e t o r e e s t a b l i s h t h e i m m e d i a t e c o n n e c t i o n t o t h i n g s and o t h e r people w h i c h would r e s t o r e e a c h p e r s o n f r o m a l i e n a t i o n and m a k e h i m feel a t h o m e o n c e again o n t h e face o f t h e e a r t h . T h e failure o f all a t t e m p t s s o far t o p r e v e n t and heal social malaise o r i g i n a t e in t h i s . T h a t it r e m a i n s hidden from the M a r x i s t s t h e m s e l v e s m a y b e due t o t h e i r fascination w i t h a s t a t e m e n t o f M a r x ' s i n w h i c h h e r e p r o a c h e d p h i l o s o p h e r s for m e r e l y i n t e r p r e t i n g the w o r l d . T h e point, he said, is to c h a n g e it. B u t t h e r e can be no c h a n g e in t h e w o r l d w i t h o u t c h a n g e in h o w we c o n c e i v e of t h e w o r l d , i.e., w i t h o u t a prior t r a n s f o r m a t i o n o f h o w w e i n t e r p r e t the world. M a r x ' s v e r y call t o c h a n g e t h e w o r l d r e s t s on a definite i n t e r p r e t a t i o n of t h e w o r l d and s o c i e t y , o n t h e basis o f w h i c h h e s a w w h a t had t o b e c h a n g e d and w h a t i t had t o b e c h a n g e d i n t o . Only a shrinking remnant of modern progressives think Marx's a s s e r t i o n t h r o u g h to its end, let a l o n e first inquiring a d e q u a t e l y a f t e r the c h a r a c t e r o f h u m a n s o c i e t y , and m o d e r n industrial s o c i e t y for o n e . S t u d e n t e f f o r t s to a c c o m p l i s h e v o l u t i o n a r y social c h a n g e , as well as the a t t e m p t s o f t h e a n a r c h i s t r e v o l u t i o n a r i e s , h a v e s t a y e d b o g g e d down i n c o n t r a d i c t o r y and m u t u a l l y e x c l u s i v e c o n c e p t s . T h e r e a r e t o o m a n y y o u n g r e b e l s w h o aim at a r a s h and radical d e s t r u c t i o n of t h e e x i s t i n g social o r d e r , w h i c h t h e y r e g a r d a s t h e n e c e s s a r y revolt o f p r i s o n e r ' a g a i n s t t h e i r prison walls, w h i l e t h e y e x p e c t as a m a t t e r of c o u r s e to k e e p g e t t i n g t h e i r g r a n t s and s c h o l a r s h i p s after t h e d e s t r u c t i o n ol i n d i e . 1 1 ial s o c i e t y . T h e y do n o t r e c o g n i z e t h a t only a totally a d m i n i s t e r e d ,

290

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FOUNDATIONS

t h o r o u g h l y o r g a n i z e d , c o m p l e t e l y m a t e r i a l i s t i c , industrial s o c i e t y can m a i n t a i n large n u m b e r s o f u n p r o d u c t i v e s t u d e n t s . T h e collapse o f t h e t e c h n o l o g i c a l w o r l d w o u l d m e a n s i m u l t a n e o u s l y giving u p t h e c o m f o r t s o f affluent s o c i e t y and r e t u r n i n g t o t h e b i t t e r s t r u g g l e o f o t h e r c e n t u r i e s for s h e e r physical e x i s t e n c e . It is still n o t long since t h e lives of all h u m a n i t y — e x c e p t for t h e few w h o r u l e d — w e r e spent i n d r u d g e r y u n w o r t h y o f h u m a n b e i n g . Even t o d a y , o n l y a small part o f h u m a n i t y h a s g o t b e y o n d this s t a g e , and t h e people o f u n d e r d e v e l o p e d c o u n t r i e s will likewise h a v e t o a p p r o p r i a t e t h e t e c h n o l o g i c a l w o r l d v i e w t o free t h e m s e l v e s f r o m t h e b o n d a g e o f physical h u n g e r . To e x i s t in a t e c h n o l o g i c a l w o r l d v i e w m e a n s t h a t o n e uses all t h i n g s he e n c o u n t e r s as e f f i c i e n t l y as possible so t h e y yield all t h e i r e n e r g i e s to h i m , w h o t h e n h a s t h e m a t his disposal for f u r t h e r i n g his p o w e r o v e r m a t e r i a l g o o d s . F o r this r e a s o n , W e s t e r n m a n h a s s o u g h t t o e x p o r t his achievement motive to underdeveloped countries, thereby running into g r e a t difficulties. E x p o r t i n g single m o t i v e s is a p r o f o u n d l y t h o u g h t l e s s b u s i n e s s . T h e t o t a l i t y o f t h e w o r l d v i e w s i n w h i c h the people o f t h e s e u n d e r d e v e l o p e d c o u n t r i e s a r e still dwelling, and f r o m w h i c h all t h a t m o v e s t h e m c o m e s , m u s t first b e t r a n s f o r m e d f r o m t h e g r o u n d up. B u t t h e m a s s e s of people in t h e s e places prove to be r a t h e r r e l u c t a n t in yielding to such a c o m p l e t e c h a n g e . W e s t e r n p s y c h o l o g i s t s and f a c t o r y m a n a g e r s s e e m t o h a v e a hard t i m e m a k i n g t h e w h o l e vision o f t h e s e people s h r i n k t o t h e point t h a t w h a t discloses i t s e l f t o t h e m o f t h e i r w o r l d is o n l y w h a t can be p r e c i s e l y calculated and t i g h t l y o r d e r e d i n t o flawless c h a i n s o f c a u s e and e f f e c t . T h i s s h r i n k i n g i s t h e e s s e n c e and basis o f t h e spirit o f m o d e r n t e c h n o l o g y . W h a t d o m i n a t e s i n t h e c o m i n g s and g o i n g s of t h e p o p u l a t i o n s of t h e u n d e r d e v e l o p e d c o u n t r i e s is still a far c r y f r o m t h e W e s t e r n goal o f t h e m o s t efficient possible e x p l o i t a t i o n o f w h a t t h e y e n c o u n t e r . T h e i r o w n a c h i e v e m e n t m o t i v e is o p e r a t i n g , b u t in a v e r y different r e a l m from t h a t o f m a t e r i a l w e a l t h and t e m p o r a l p o w e r . 4

L e a s t able t o heal t h e pathological o u t c o m e s o f m o d e r n industrial s o c i e t y is s o m e h a r k i n g b a c k to t h e good old days to appeal for d e r a t i o n a l i z i n g and d e m a t e r i a l i z i n g today's t o t a l l y a d m i n i s t e r e d p r o f e s ­ sional w o r l d . R a t i o n a l i s m , m a t e r i a l i s m , and d e p e r s o n a l i z a t i o n a r e c h a r a c t e r i s t i c s of t h e p r e s e n t d e s t i n y of a t e c h n o l o g i c a l w o r l d v i e w . J u s t a s o n e can h a r d l y r e v e r s e t h e e r o s i v e s p r e a d o f t h e industrial s y s t e m , s o o n e could hardly c a n c e l o u t t h e i n c r e a s i n g l y p e r f e c t e d a d m i n i s t r a t i o n o f things from the technical worker up to the general manager. C l e a r l y , it is n e c e s s a r y to t r a n s f o r m the m o d e s in w h i c h it is possible to b e c o m e a w a r e of t h e world's p h e n o m e n a and to t r a n s f o r m the world, in a w a y far m o r e radical t h a n w h a t v a r i o u s intrinsically s e l f - c o n t r a d i c t o r y social d o c t r i n e s could e f f e c t . S u c h a t t e m p t s , allegedly so r e v o l u t i o n a r y ,

Afterword

2^1

retain fundamentally unchanged the subjectivistic, possessive relation­ ship w i t h t h e world o n w h i c h t h e social o r d e r t h e y w o u l d c h a n g e i s based. T h e p h e n o m e n o l o g i c a l o r D a s e i n s a n a l y t i c a p p r o a c h i s available t o t h e s c i e n c e s of social p s y c h i a t r y and p r e v e n t i v e medicine as a g e n u i n e l y r e v o l u t i o n a r y w a y o f s e e i n g . H o w i t stands u p t o s c r u t i n y i n t h e s e s p h e r e s of m e d i c i n e , as well as in t h e healing a r t s we h a v e already discussed, can b e illustrated t h r o u g h o n e o f m o d e r n industrial s o c i e t y ' s m o s t positive a c h i e v e m e n t s , t h e h i t h e r t o u n k n o w n a m o u n t o f available time o u t s i d e w o r k i n g h o u r s . It is called " r e c r e a t i o n t i m e , " and in t h e f o r e s e e a b l e f u t u r e m o s t people will h a v e a c c e s s t o m o r e h o u r s o f r e c r e a t i o n t i m e t h a n t h e y h a v e t o spend o n t h e j o b i n offices and f a c t o r i e s . S o m e heads o f i n d u s t r y a r e already s e r i o u s l y c o n s i d e r i n g actually paying t h e m a j o r i t y o f t h e i r e m p l o y e e s n o t t o appear for w o r k . People do incomparably m o r e damage at work with their mistakes than t h e far less fallible a u t o m a t e d m a c h i n e r y . A c c o r d i n g t o t h e industrialists, i t w o u l d b e s i g n i f i c a n t l y c h e a p e r t o c o m p e n s a t e m o s t o f t h e w o r k e r s for not working than to repair the mistakes they make. H o w e v e r t h a t m a y b e , p l a n n i n g for r e c r e a t i o n t i m e h a s b e c o m e a n e x t r a o r d i n a r i l y s e r i o u s i s s u e for t h e f u t u r e o f h u m a n i t y . F u t u r e o r i e n t e d leaders a m o n g p s y c h o l o g i s t s , s o c i o l o g i s t s , e d u c a t o r s , city p l a n n e r s , a r c h i t e c t s , and i n d u s t r i a l i s t s have c e r t a i n l y n o t i c e d its g r o w i n g s i g n i f i c a n c e , and t h e r e is an I n t e r n a t i o n a l R e c r e a t i o n A s s o c i a t i o n already at w o r k w i t h t h e a v o w e d p u r p o s e of c o o r d i n a t i n g a w o r l d w i d e policy for r e c r e a t i o n t i m e . T h o s e w h o specialize i n p r e v e n t i v e m e d i c i n e are called on, n o less t h a n t h e s e o t h e r specialists, t o c o l l a b o r a t e i n this e n o r m o u s task. B u t in fact all t h a t m a t t e r s is w h e t h e r such an e m i n e n t panel s u c c e e d s in r e n d e r i n g t h e ample t i m e for re-creation, w h i c h a p e r s o n m a y spend w i t h family and friends, as a h e a l i n g c o u n t e r b a l a n c e to t e c h n i c a l o c c u p a t i o n s , w h i c h a r e involved m o r e deeply t h a n e v e n in t h e n a t u r a l scientific world v i e w — a m o d e w h i c h t h e t h e o r e t i c a l physicist H e i t l e r has called f u n d a m e n t a l l y hostile t o l i f e . R e c r e a t i o n a l planning t h a t c o m p e n s a t e s for this, w h i c h f u r t h e r s life, will s u c c e e d o n l y w h e n t h e s o c i e t y of days to c o m e l e a r n s to r e g a r d its r e c r e a t i o n a l i n s t r u c t o r s as h a v i n g a significance equal to t h a t of p r o f e s s i o n a l i n s t r u c t o r s . All is in vain, h o w e v e r , if t h e s e r e c r e a t i o n a l p l a n n e r s allow t h e m s e l v e s t o b e engulfed b y t h e t e c h n o l o g i cal v i e w o f t h e w o r l d . T h e d a n g e r e x i s t s from t h e o u t s e t t h a t t h o s e w h o have t h e first say i n t h e d e l i b e r a t i o n s o f t h e I n t e r n a t i o n a l R e c r e a t i o n A s s o c i a t i o n will be t h e i n d u s t r i a l i s t s , city p l a n n e r s , and a r c h i t e i I s . and t h a t t h e y will w a n t to s t a r t building at o n c e w i t h o u t first c o n s i d e r i n g well e n o u g h t h e " f o r w h a t " o f t h e i r building. 5

T h i s " f o r w h a t " is the t i m e for r e - c r e a t i o n of h u m a n beings In im idei n industrial society. T h e primary task ol those w h o plan this recreation

EXISTENTIAL FOUNDATIONS

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t i m e is to ponder its n a t u r e in t h o r o u g h and f u n d a m e n t a l t e r m s . If t h e y n e g l e c t t o clarify t h e r e c r e a t i o n o f t h e h u m a n b e i n g and t h e f u n d a m e n t a l n a t u r e o f h u m a n t i m e b e f o r e t h e y m o v e i n t o a c t i o n , t h e y could easily b e c o m e a m e r e R e c r e a t i o n T i m e I n s t i t u t e and m a k e this field j u s t o n e m o r e technological concern in which they would incarcerate human b e i n g s w h e n t h e y are n o t o n t h e j o b . 6

It is t h e r e f o r e indispensable t h a t t h e r e c r e a t i o n t i m e i n s t r u c t o r s and all o t h e r s c o n c e r n e d w i t h t h e g r o w i n g " d i s - e a s e " i n civilization t h e m s e l v e s first win t h e f r e e d o m t h a t w o u l d m a k e t h e m able t o c o m m i t t h e m s e l v e s w h o l l y t o a n o t h e r w a y o f s e e i n g the w o r l d . I n d i s c u s s i n g t h e difficulty o f s u c h a t r a n s i t i o n e a r l i e r in this b o o k , we h a v e a l r e a d y said t h a t o n l y t h o s e w h o d a r e leap w i t h t h e i r w h o l e s e e i n g , t h i n k i n g , w i s h i n g , willing, feeling, and sensibility s u c c e e d in b r i n g i n g t h e m s e l v e s face to face w i t h t h e w o r l d in a n e w w a y . T h e y m u s t leap o u t of today's a b s o l u t e l y subjectivistic, acquisitive, t e c h n o l o g i c a l - c a p i t a l i s t / t e c h n o l o g i c a l - M a r x i s t s t a n c e t o w a r d t h e world into t h e n o l o n g e r p o w e r h u n g r y , n o l o n g e r s u b j e c t d e p e n d e n t , b u t the being and l e t t i n g - b e w o r l d v i e w i n t o w h i c h , in t h e W e s t e r n world, H e i d e g g e r ' s Daseinsanalytik s h o w e d t h e w a y . W h o e v e r s u c c e e d s in m a k i n g this leap will r e c o g n i z e t h e c h a s m t h a t e x i s t s b e t w e e n w h a t m o s t people can still see o f t h e p h e n o m e n a o f o u r w o r l d and w h a t a b u n d a n t m e a n i n g and significance t h e s e p h e n o m e n a h a v e , hidden t h o u g h t h e y are from t h e vision o f m o s t people n o w . T h o s e w h o a r e ruled b y t h e spirit o f t e c h n o l o g y have a c c e s s o n l y t o w h a t can b e m e a s u r e d and calculated a b o u t t h i n g s and people: t h e v o l u m e o f visible objects, their mass, their physiochemical composition, their cybernetically c o m p r e h e n s i b l e g e n e t i c c o d e , t h e level of selling price, and so on. T h e s e days, t h e r e is a predilection for calling such e x a c t l y m e a s u r a b l e q u a n t i t i e s t h e " p u r e " » . i lality o f t h i n g s . B u t a f t e r t h e leap i n t o t h e p h e n o m e n o l o g i cal v i e w of t h e world, t h e world's p h e n o m e n a r e v e a l t h e m s e l v e s in an actuality much more "pure"—undamaged, intact, whole, undistorted, undisguised, u n f e i g n e d . . \?e m a y illustrate t h e p a r t i c u l a r w a y in w h i c h this p h e n o m e n o l o g i c a l leap is to be followed w i t h t h e e x a m p l e of an apple t r e e in full b l o s s o m , w h i c h has j u s t c o m e i n t o v i e w . We stand in front of a f l o w e r i n g t r e e and t h e t r e e stands b e f o r e u s i n t h e m e a d o w . A n y o n e can s a y this. B u t m o s t o f u s t h e s e days would t h i n k : " W e r e p r e s e n t t h e t r e e t o o u r s e l v e s . " If, h o w e v e r , we r e m a i n t r u e to w h a t is h a p p e n i n g as it is, we m a y say only: " W e are presenting ourselves to the tree, encountering the tree." Only so do we leave t h e t r e e as t h e t r e e it is; o n l y so do we let it be t h e r e in t h e middle of a m e a d o w w h e r e it is in its actual p r e s e n c e , f r o m w h i c h place it a d d r e s s e s itself to us. And so we do n o t g o b b l e it up at o n c e , h u n g r y for p o w e r , i n t o t h e m e n t a l activity o f a h u m a n s u b j e c t . W e do not d e g r a d e it

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203

w i t h a w a v e of t h e hand i n t o a m e r e i n t r a p s y c h i c r e p r e s e n t a t i o n within an encapsulated human consciousness. W h e n w e c o n d u c t o u r s e l v e s i n this w a y , e n c o u n t e r i n g t h e t r e e with c a r e , w i t h c i r c u m s p e c t i o n , in a w a y t h a t is j u s t to t h e p h e n o m e n a , t h e n w h a t h a p p e n s i s n o t h i n g less t h a n t h a t " w e " — t h e r e p r e s e n t i n g s u b j e c t and t h e t r e e as its r e p r e s e n t e d o b j e c t — r a d i c a l l y disappear. A n d we have left t h a t o v e r b e a r i n g p o s s e s s i v e s u b j e c t i v i s m of D e s c a r t e s w h i c h , in his o w n w o r d s , a i m s a t t h e m a s t e r y and p o s s e s s i o n o f n a t u r e , and a c c o r d i n g to w h i c h a b l o s s o m i n g apple t r e e e x i s t s o n l y by t h e g r a c e of a h u m a n s u b j e c t ' s r e p r e s e n t a t i o n of it in his p s y c h e . We h a v e t a k e n in its place the h u m b l e r and m o r e r e v e r e n t p h e n o m e n o l o g i c a l w a y o f s e e i n g , i n w h i c h t h e apple t r e e in b l o o m is e x p e r i e n c e d as t h a t w h i c h is p r e s e n t t h e r e b e f o r e us. It s t a n d s b e f o r e us as w h a t — a c c o r d i n g to t h e m e a n i n g s and c o n t e x t s of r e f e r e n c e t h a t c o n s t i t u t e it as a t r e e — i t i s . And for o u r part, we n o w only put o u r s e l v e s , as e x i s t i n g h u m a n b e i n g s , at its disposal. We offer o u r s e l v e s to it as the r e a l m of w o r l d - o p e n n e s s we are, as t h e f r e e , c l e a r o p e n n e s s in w h i c h it can a p p e a r and w h i c h e n a b l e s it, in t h e light of o u r p e r c e p t i o n , t o c o m e t o b e p r e s e n t . W e h u m a n b e i n g s can d o t h e t r e e this s e r v i c e b e c a u s e we are w o r l d - o p e n n e s s ; we e x i s t e s s e n t i a l l y as a w o r l d - s p a n n i n g r e s p o n s i v e n e s s t o t h e being and m e a n i n g f u l n e s s o f w h a t has c o m e t o b e p r e s e n t . 7

If, i n t h e w a y w e c o n d u c t o u r s e l v e s t o w a r d this b l o o m i n g apple t r e e , we a c c o r d t h e t r e e its full b e i n g - p r e s e n t , t h e n it e n c o u n t e r s us as s o m e t h i n g e x t e n d i n g w i t h its r o o t s i n t o t h e r e a l m o f e a r t h and w i t h its s o a r i n g b r a n c h e s i n t o the light o f t h e h e a v e n s . Its g e r m i n a t i o n and g r o w t h r e v e a l p o w e r s o f c r e a t i o n t h a t w e r e from a n t i q u i t y called divine. T h e fruit p r o m i s e d b y its f l o w e r s e x p r e s s t h e p o t e n t i a l i t y o f s o m e d a y i n a u t u m n n o u r i s h i n g t h e h u m a n b e i n g . In this w a y t h e apple t r e e in b l o s s o m , a single t h i n g , g a t h e r s h e a v e n and e a r t h , t h e divine and the h u m a n , in t h a t fullness of its m e a n i n g and significance w h i c h a r e , by its v e r y n a t u r e , its o w n . 8

W h a t is t r u e for this t r e e is no less t r u e for all t h e o t h e r p h e n o m e n a of o u r w o r l d — i n c l u d i n g the o t h e r h u m a n b e i n g s w e e n c o u n t e r . T h e t e c h n o l o g i c a l spirit i s d o m i n e e r i n g and hostile t o w a r d h u m a n being. It w o u l d be v e r y m u c h indeed if this w e r e u n d e r s t o o d by the d o c t o r s , p s y c h o l o g i s t s , s o c i o l o g i s t s , and all o t h e r s w h o a r e called upon to t r a n s f o r m m o d e s o f t h i n k i n g and feeling w h i c h will b e t h e g r o u n d w o r k for fruitful social life in a m o d e r n industrial s o c i e t y w h i c h would be h u m a n l y just and n o u r i s h i n g . T h i s t e c h n o l o g i c a l spirit is not itsell .1 technical t h i n g . It is w h a t reveals itself as the destiny of t h i s e p o c h , o p e n i n g to us and at the s a m e time limiting us to the t i m e spat e w h i t h

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natural science conceives. Such a destiny is never the o u t c o m e of the e f f o r t s o f t h e h u m a n b e i n g a s s o m e s u b j e c t w h i c h d e t e r m i n e s all t h i n g s from n o t h i n g b u t itself. O n c e this i s s e e n , t h e a c t i v i t y o f t h e h u m a n s u b j e c t loses t h e s u p r e m a c y claimed for it n o w . At the same time, Daseinsanalytic insight into h u m a n existence frees people for a f u n d a m e n t a l l y m o r e a u t o n o m o u s s t a n c e t o w a r d t h a t t e c h n o l o g i c a l w o r l d v i e w in w h i c h m o s t people t o d a y are exiled. T h i s i n s i g h t clears t h e w a y f o r r e c o g n i z i n g t h a t t h e t e c h n o l o g i c a l a p p r o a c h t o t h e w o r l d i s o n l y o n e a m o n g m a n y possible r e l a t i o n s h i p s . T h e spirit o f t e c h n o l o g y n o l o n g e r s e e m s like a b s o l u t e , d e f i n i t i v e , u l t i m a t e t r u t h , i n s h o r t , t r u t h itself. On t h e c o n t r a r y , it can n o w be u n d e r s t o o d in a t r u l y liberating w a y as a vision of t h e w o r l d , o n e w h i c h can claim h u m a n b e i n g i n - t h e - w o r l d o n l y to a r e l a t i v e l y m o d e s t d e g r e e , and n o t for all e t e r n i t y . At the same t i m e , it is t h e p h e n o m e n o l o g i c a l w a y of l o o k i n g , t h i n k i n g , and feeling w h i c h itself b e s t u n d e r s t a n d s t h a t the t e c h n o l o g i c a l a p p r o a c h t o t h e world, a s t h e d e s t i n y o f today's h u m a n i t y , does h a v e t h e a u t h o r i t y to claim t h e m o d e r n h u m a n being to c a r r y it to fulfillment. For this r e a s o n , t h o s e w h o o n l y c u r s e o r try escaping this p a r t i c u l a r d e s t i n y i n w h i c h w e w h o live today are y o k e d , a r e a l w a y s evading t h e m s e l v e s and s h i r k i n g t h e i r destined m i s s i o n . T h e y pay for t h e i r flight w i t h a bad c o n ­ science. F o r the d r e a m t h a t people could be led—as F r e u d h o p e d to do t h r o u g h p s y c h o a n a l y s i s — b a c k i n t o t h e happy c o n d i t i o n o f a n i n n o c e n t child o r noble s a v a g e , has long since b e e n d r e a m e d t o its e n d . T h e b e i n g - g u i l t y , b e i n g - i n d e b t e d of h u m a n b e i n g s is an E x i s t e n t i a l , a b a s i c and indelible n a t u r a l f e a t u r e of h u m a n b e i n g - i n - t h e - w o r l d . It is r o o t e d in t h e c o n d i t i o n t h a t b e i n g - h u m a n is a l w a y s to be a d d r e s s e d , to be c l a i m e d or called upon. T o b e h u m a n i s t o e x i s t a s t h e m a n d a t e , a c c o r d i n g t o o n e ' s c o n s c i e n c e and b e s t k n o w l e d g e , t o s e e k o u t t h e t h i n g s o f t h e w o r l d t h a t a p p e a r in t h e light of o u r p o t e n t i a l for perceiving and u n d e r s t a n d i n g and to c a r e for t h e i r unfolding. At a n y given t i m e , h o w e v e r , a p e r s o n can c a r r y t o fulfillment o n l y o n e o f t h e t h o u s a n d f o l d p o t e n t i a l i t i e s t h a t lie open t o him. F o r t h e fulfillment o f t h e r e s t h e m u s t r e m a i n i n d e b t e d . B e s i d e s t h i s , it is i n c u m b e n t on him to fulfill t h o s e e x i s t e n t i a l possibilities w h i c h will a p p r o a c h h i m f r o m t h e f u t u r e and call upon h i m . N o w , this e x i s t e n t i a l b e i n g - g u i l t y , b e i n g - i n d e b t e d , is c o m p l e t e l y different from t h e m e r e guilt feelings o f w h i c h p s y c h o l o g y and p s y c h o p a t h o l o g y g e n e r a l l y speak. T h i s b e i n g - g u i l t y b y n a t u r e , b e i n g indebted by n a t u r e , is w h a t m a k e s all t h o s e guilt f e e l i n g s possible, t h o s e which a r e n o r m a l and i n e v i t a b l e a s well a s t h o s e w h i c h a r e p a t h o l o g i c a l and c u r a b l e . E x i s t e n t i a l i n d e b t e d n e s s h a s n o t h i n g t o d o with s o m e " p o o r

Afterword

295

s i n n e r t h a t I a m " face, h o w e v e r . Its w e i g h t and o p p r e s s i v e n e s s can be o v e r c o m e t h r o u g h o u r r e a d i n e s s t o place o u r s e l v e s w i t h o u t r e s e r v a t i o n , a s t h e c l e a r r e a l m o f o p e n n e s s t h a t m a k e s i t possible for t h e world's p h e n o m e n a t o s h i n e f o r t h i n t o t h a t c l e a r i n g , a t t h e disposal o f t h o s e phenomena. A s this p r i m a r y b e i n g - u s e d , b e i n g - c a l l e d - u p o n , o f t h e h u m a n being g r o w s c l e a r i n t h e light o f t h e p h e n o m e n o l o g i c a l v i e w , w e can s e e a t t h e s a m e t i m e t h a t a n a n t h r o p o l o g y w h i c h s p r i n g s from this p e r s p e c t i v e p o s s e s s e s , f r o m t h e v e r y n a t u r e o f its s o u r c e , a n i n n a t e e t h i c w h i c h s u s t a i n s all social b e h a v i o r . T h u s t h e D a s e i n s a n a l y t i c u n d e r s t a n d i n g o f the h u m a n being n e e d n o t look e l s e w h e r e first f o r its e t h i c a l principles T h e u n i q u e " m i n e - n e s s " o f e a c h h u m a n Da-sein, s o e m p h a s i z e d b y this w a y of l o o k i n g at e x i s t e n c e , c a n n o t be m i s t a k e n for s o m e sign of a r u t h l e s s e g o i s m . S u r e l y , it is for e a c h p e r s o n to t a k e on t h e p o t e n t i a l w a y s o f b e i n g w h i c h a r e g i v e n him and t o c a r r y t h e m t o fulfillment. B u t t o t h e fulfillment o f t h o s e p o t e n t i a l i t i e s w h i c h a r e u n i q u e l y m i n e b e l o n g t h e c h e r i s h i n g o f all t h a t i s b e y o n d m e , n o less t h a n m y o w n c a r i n g for m y s e l f , w h i c h c o m e s i n t o t h e light o f m y p e r c e i v i n g , u n d e r s t a n d i n g , being-in-the-world. All this n o t w i t h s t a n d i n g , m a n y m o d e r n s o c i o l o g i s t s flatly d e n y t h e suitability of t h e p h e n o m e n o l o g i c a l v i e w of h u m a n being as a basis for a practical social s c i e n c e . O n e can a l w a y s h e a r t h e t h o u g h t l e s s r e p r o a c h t h a t t h e D a s e i n s a n a l y t i c v i e w t a k e s n o a c c o u n t o f c o n c r e t e social r e l a t i o n s h i p s b e t w e e n people, i n q u i r i n g o n l y a f t e r a b s t r a c t B e i n g . B u t quite apart f r o m the fact t h a t B e i n g as such is a n y t h i n g b u t a b s t r a c t , u n d e r no c i r c u m s t a n c e s is it m e a n i n g f u l in a n y w a y to i n q u i r e a f t e r B e i n g w i t h o u t a t t h e s a m e t i m e i n q u i r i n g a f t e r t h e c o n c r e t e e x i s t e n c e o f people with each o t h e r in their shared world. Given this, the Daseinsanalytic approach is actually so earnestly concerned with the c o n c r e t e human being and his social r e l a t i o n s h i p s t h a t it is precisely this a p p r o a c h w h i c h , i n w o r k i n g o u t t h e c h a r a c t e r i s t i c s o f b e i n g - t o g e t h e r , w a s able t o lay o u t the f o u n d a t i o n m o s t c a p a b l e o f s u s t a i n i n g e a c h s c h o o l o f s o c i o l o g y . T h e leap o u t of a t e c h n o l o g i c a l s t a n c e i n t o a p h e n o m e n o l o g i c a l r e l a t i o n s h i p w i t h t h e w o r l d yields t w o t h i n g s , t h e n . F i r s t , in its light the phenomena of the world reveal themselves in an incomparably richer c o n t e x t o f m e a n i n g and r e f e r e n c e . S e c o n d , o u r e y e s a r e o p e n e d t o the f u n d a m e n t a l m e a n i n g and goal of being h u m a n . It is o b v i o u s that w i t h o u t s u c h a c l e a r a w a r e n e s s o f t h e goal and m e a n i n g o f h u m a n e x i s t e n c e , medical and n o n m e d i c a l t h e r a p i s t s are helpless in t h e f a c e ol t h e b u r g e o n i n g n u m b e r s o f p a t i e n t s w h o suffer from the m o d e m n e u r o s i s o f b o r e d o m and m e a n i n g l e s s n e s s . And h o w , w h e n they t h e m s e l v e s h a v e n o t found a d e q u a t e freedom in relation to the

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EXISTENTIAL

FOUNDATIONS

i m p o v e r i s h e d m e a n i n g s s e e n i n t h i n g s and people t h r o u g h t h e w o r l d v i e w o f t e c h n o l o g y , a r e t h e specialists i n p r e v e n t i v e m e d i c i n e , the s o c i o l o g i s t , and t h e r e c r e a t i o n t i m e p l a n n e r t o guide t h e e n e r g i e s o f t h o s e y o u t h , w h o are n o t sick b u t a r e rebelling a g a i n s t t h e e x i s t i n g social o r d e r , into a c r e a t i v e r e n e w a l ? T e c h n o l o g y c o m p r e h e n d s o n l y t h e p r o f o u n d l y m e a n i n g l e s s and m e a g e r goal o f t h e u n r e l e n t i n g i n c r e a s e o f p o w e r — b y a n individual o r c o l l e c t i v e s u b j e c t — o v e r n a t u r a l o b j e c t s . I n d u s t r y ' s f a s c i n a t i o n w i t h the m a d n e s s of e x p o n e n t i a l g r o w t h is r o o t e d in this s a m e goal. B u t i n all r e a l m s o f living t h i n g s w h e r e such u n l i m i t e d g r o w t h t a k e s hold, w h a t is b r o u g h t f o r t h is no h e a l t h y f o r m t h a t can g e n e r a t e a f u t u r e , but a c a n c e r o u s d e g e n e r a t i o n . G i v e n t h e h u g e a g g l o m e r a t i o n s built b y and for t e c h n o l o g y and n a t u r a l s c i e n c e , t h e r e m a y be a s e n s e t h a t a p h e n o m e n o l o g i c a l , D a s e i n s a n a l y t i c v i e w is c u r s e d w i t h f u n d a m e n t a l p o w e r l e s s for all t i m e . T h e r e will n e v e r be m o r e t h a n a handful of people capable of p e r f e c t i n g p h e n o m e n o l o g i c a l i n s i g h t i n t o t h e basic condition o f m a n and his w o r l d , and t h e o n t o l o g i c a l r e l a t i o n s h i p b e t w e e n t h e m . B u t t h e n u m b e r o f r e s e a r c h e r s w h o g r a s p t h e f u n d a m e n t a l principles o f q u a n t u m physics i s n o g r e a t e r , and yet t h e r e a r e millions o f t e c h n i c a l w o r k e r s w h o k n o w , from d e r i v a t i v e s o f t h e s e principles, h o w t o p r o d u c e c o u n t l e s s television s e t s . A n d m a s s e s o f people w h o listen t o radios and w a t c h television, s o m a n y t i m e s g r e a t e r i n n u m b e r t h a n t h o s e t e c h n i c i a n s and u n d e r s t a n d i n g so v e r y m u c h less of p h y s i c s , a r e able to o p e r a t e and u s e t h e s e devices. It is not groundless to hope, then, that the fundamental ontological i n s i g h t s of D a s e i n s a n a l y t i c p h e n o m e n o l o g y could, in t i m e , e x e r t a c o r r e s p o n d i n g l y wide i n f l u e n c e on the spirit of h o w people live in this society. W e m a y a s s u m e t h a t t h e b r e a k t h r o u g h the t e c h n o l o g i c a l f r a m e w o r k of m o d e r n industrial s o c i e t y i n t o a g e n u i n e f r e e d o m in r e l a t i o n to this t e c h n o l o g y will n o t be d o n e first by t h e W e s t . It is r a t h e r to be hoped for from t h e peoples o f t h e F a r E a s t . W h o e v e r has t h e good f o r t u n e t o b e i n close and e x t e n d e d a s s o c i a t i o n w i t h the people o f India, Japan, and C h i n a e x p e r i e n c e s h o w t h e i r b e i n g - i n - t h e - w o r l d — w i t h o u t d e t r i m e n t t o the vigor w i t h w h i c h t h e y a p p r o p r i a t e and exploit W e s t e r n s c i e n c e — i s shaped a l w a y s , c o n t i n u a l l y , and decisively by a t r a d i t i o n a l r e l a t i o n s h i p w i t h t h e w o r l d t h a t is a s t o n i s h i n g l y close to t h e vision of E u r o p e a n p h e n o m e n o l o g y j u s t n o w unfolding.

Afterword FOOTNOTES 1 . K . M a r x , Die Fruhschriften ( S t u t t g a r t : K r o n e r , 1 9 5 3 ) , p . 2 4 6 2. J . - P . S a r t r e , L'exislenlialisme est un humanisme ( P a r i s : 1 9 4 6 ) , p. 2 2 . 3. J . - P . S a r t r e , Critique de la raison dialectique ( P a r i s : 1 9 6 0 ) , p. 98 4 . S e e , f o r e x a m p l e , D . M c C l e l l a n d , J . W . A t k i n s o n , R . A . C l a r k , a n d E . L . L o w e l l , The Achievement Motive ( N e w Y o r k : A p p l e t o n - C e n t u r y - C r o f t s , 1 9 5 3 ) . 5. W. H e i t i e r , 1 9 6 2 ) , p. 2.

Der

Mensch

und die

naturwissenschaftliche

Erkenntris,

2d

ed.

(Braunschweig-

6. S e e also, R. Konig, " D i e Gesellschaft von heute zwischen g e s t e r n und m o r g e n , " Universitas: Zschr, Wissenchaft, Kunst und Literatur, 1 1 . J g . , H. ( S t u t t g a r t : T h i e m e , 1 9 6 7 ) . 7 . S e e M . H e i d e g g e r , Was heisst denken ( T u b i n g e n : K l o s t e r m a n n , 1 9 5 4 ) , p . 1 6 ; a n d K . T s u j i m u r a , Martin Heidegger denken und die japanische Philosophie, in: Ansprachen zum 89. Geburtstag (Martin Heidegger im Gesprach, K. Alber, Freiburg/Munich, 1 9 6 9 ) , p. 9. 8. M. H e i d e g g e r , " D a s pp. 1 6 5 ff.

D i n g , " in:

Vortrage

und Autsatze ( P f u l l e n g e n :

Neske,

1954)

INDEX

acute,

exogenic reaction types, 203-6 addiction, m a s s , 2 8 3 Adler, A., 3 6 , 5 2 , 5 4 affective incontinence, 2 1 7 affectivity, 1 1 0 - 1 4 agoraphobia, 2 1 6 Agrippina, 1 4 3 "Aha - experience," 6 4 - 6 5 A l e x a n d e r , F., 3 6 Allport, G . , 3 8 animal psychologies, 6 9 - 7 0 anthropological medicine, 37, 48-49, 76 anxiety, 1 1 2 - 1 3 , 129 Aristotle, 96, 1 3 1 , 1 5 1 , 163 attunement, 1 0 9 - 1 4 s e v e r e d i s t u r b a n c e s in a c t u a l i z ­ ing e x i s t e n t i a l of, 2 1 7 - 2 3 Augustine, St., 115 Bally, G., xv "basic trust," 38 b e c o m i n g , f r e e d o m and, 3 7 behaviorism, 38 B i n d e r , H., 71 B i n s w a n g e r , L., xii-xiii, 3 7 , 7 1 B l e u l e r , E., xxiii, 6 0 , 2 0 4 , 2 0 5 , 2 3 7 bodily pains, phenomenological i n v e s t i g a t i o n of, 1 8 7 - 8 9 , 210-13 b o d y h o o d , xviii, 1 0 0 - 1 5 h u m a n b o d y a s physical o r g a ­ n i s m and, 1 2 7 - 3 1 bodying f o r t h , 1 0 2 - 4 illnesses s h o w i n g i m p a i r m e n t of,

2 0 0 - 1 3

boredom, 2 2 3 brachial paralysis, 2 0 2 Buber, M„ 38, 72 calculability, 1 5 6 Charcot, J.M., 222 China, 2 9 6 claustrophobia, 2 1 6 - 1 7 c l e a r n e s s o f h u m a n space, 8 8 - 9 0 c o e x i s t e n c e i n s h a r e d space, 1 0 6 - 9 collective unconscious, Jungian, 36, 147 color blindness, 2 0 0 , 2 0 1 conditionality of psychosomatics, 73-78 Condrau, G., 1 8 9 Conrad, K., 37, 69 consciousness, fundamental open­ ness of human existence and, 1 3 2 - 3 5 countertransference, 2 5 9 - 6 0 criminality, mass, 2 8 3 cybernetics, 2 1 , 2 5 - 2 9 D a - s e i n , o n t o l o g y of, i x - x , xiii, xviii, x x i x - x x x i D a - s e i n - b a s e d social p s y c h o l o g y and social p r e v e n t i v e medi­ cine, 2 8 5 - 9 6 Daseinsanalysis c r i t i c i s m s o f medical use o l , 155-60 o f R é g u l a Z i i r c h e r case, 8 1 8 4 , 1 0 1 , 103, 1 0 7 - 0 , | , 7 8", 1 9 1 , 1 9 7 , 258-e>7 (

t ransitional difficulties in undei standing insights of, 161