Hermeneutics, dialectics and psychiatry

Abstract

The author attempts to highlight the relationship between hermeneutics and dialectics on the one hand and psychiatry on the other, giving particular importance to the contributions of Karl Jaspers to these subjects. He first discusses the coincidences and differences between the method of understanding in the sense of Jaspers and the hermeneutic approach in the sense of Gadamer. Afterwards he describes the multiple ways in which a hermeneutic attitude can be applied in the practice of psychiatry. Thus, even before the psychiatrist try to understand a psychopathological phenomenon he finds himself needing to adopt such an attitude. The classic Rümke’s description of the “Praecox-Gefühl” (feeling of what is schizophrenic) and our description of a “Melancholie-Gefühl” (feeling of what is melancholia) represent two examples of the significance of such hermeneutic attitude in the first interview and in the diagnostic process. The importance of a strict separation between the true and the false prejudgements and/or intuitions in the preverbal moment of the encounter with psychiatric patients is emphasised. The role of hermeneutics in the verbal encounter with the patient is also analyzed by describing typical language and thought disorders in schizophrenia as well as in severe depressive states. After a brief description of the transcendence of dialectics in the history of western thought, the author tries to demonstrate the advantages of a dialectic perspective in psychiatry: to see the positivity of the negative; to question the rigidity of concepts like normal-abnormal, healthy-ill, etc.; and above all, to look at the different non organic psychopathological conditions as displayed in polarities, one side being the opposite with respect to the other and vice versa and to consider the healing process itself as movement in the opposite direction until the right balance is reached. Finally, the author attempts to show how hermeneutics and dialectics are essentially linked, because the “opening” characterizing hermeneutics is materialized in the question, whose inherent negativity is isomorph with the one of the dialectic experience. In turn, psychiatry praxis demands the ability to know how to question, how to fail and how to dialectically salvage some knowledge from this failure.