An Epistemology of The Clinic: Ludwing Binswanger's Phenomenology of The Other

An Epistemology of the Clinic: Ludwig Binswanger’s Phenomenology of the Other
Author(s): Susan Lanzoni

Source: Critical Inquiry, Vol. 30, No. 1 (Autumn 2003), pp. 160-186
Published by: The University of Chicago Press
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An Epistemology of the Clinic: Ludwig
Binswanger’s Phenomenology of the Other
Susan Lanzoni
In 1913, the German phenomenologist Max Scheler pointed out that psy-
chological knowledge was intersubjective by definition because its converse,
“the oft-proposed definition of the mental as that which is accessible to one
person only,” would “put an end to all empirical psychology whatsoever.”1
Although the problem of understanding the other was not new to the twen-
tieth century, in this period in Germany the topic of intersubjectivity arose
with new vigor in the overlapping discourses of phenomenology, psychol-
ogy, and philosophy.2 Scheler and other phenomenologists in the Husser-
lian tradition sought to understand mental experience in everyday contexts
The writing of this paper was made possible by the support of an NSF postdoctoral fellowship
in Science and Technology Studies based at Boston University’s Center for Philosophy and History
of Science. I am indebted to Dr. Dieter Binswanger for giving me access to Bellevue’s patient
records and the University Archive in Tübingen, especially Irmela Bauer-Klöden, for help locating
source material. I am also grateful for critical commentary from Arnold Davidson, the members
of the editorial board at Critical Inquiry, and to Anne Harrington, Peter Galison, Alfred Tauber,
Bettina Bergo, Debbie Weinstein, and Bruce Fischl. All translations, unless otherwise cited, are my
own.
1. The passage continues, “For the mental datum present to the individual must not only be
identifiable throughout a multiplicity of acts on his own part, but by many other people as well”
(Max Scheler, The Nature of Sympathy, trans. Peter Heath [New Haven, Conn., 1954], p. 221). See
also Scheler, “Die Idole der Selbsterkenntnis,” Abhandlungen und Aufsätze, 2 vols. (Leipzig, 1915),
2: 3–168.
2. Wilhelm Dilthey and those in the hermeneutic tradition made a concerted effort to
formulate a methodological basis for the human sciences based in great part on a psychology of
understanding (Verstehen). Dilthey’s classic work on a descriptive psychology that employed the
method of Verstehen in distinction to an analytic psychology utilizing explanation was originally
published in 1894; see Wilhelm Dilthey, “Ideen über eine beschreibende und zergliedernde
Psychologie,” Gesammelte Schriften, ed. Karlfried Gründer and Frithjof Rodi, 23 vols. to date
(Stuttgart, 1961–), 5:139–240. See also Michael Ermarth, Wilhelm Dilthey: The Critique of Historical
Reason (Chicago, 1978), pp. 171–76.
Critical Inquiry 30 (Autumn 2003)

䉷 2003 by The University of Chicago. 0093–1896/03/3001–0006$10.00. All rights reserved.
160
Critical Inquiry / Autumn 2003 161
by grasping the nature of the immediately given or that which could be
directly intuited through the methods of inner perception (innere Wahr-
nehmung) and various forms of intuition (Anschauung).3 Phenomenolo-
gists coupled these intuitive methods with various affective tools such as
empathy (Einfühlung) and sympathy as a means for understanding the
other.4 By conjoining the intuitive eye with the feeling self, phenomenolo-
gists like Scheler claimed to achieve an intersubjective understanding that
could form the basis of a truly empirical psychology.5
It was also in the early twentieth century that a small but influential
group of psychiatrists in Central Europe refashioned this tradition of phil-
osophical phenomenology for the understanding of patient psychopathol-
ogy. In the face of the increasing dominance of neuropathological and
objective-descriptive models in psychiatry, phenomenology offered psy-
chiatrists working in asylums and clinics a set of tools that valorized their
3. See Franz Brentano, Psychology from an Empirical Standpoint, trans. Antos C. Rancurello,
D. B. Terrell, and Linda McAlister, ed. Oskar Kraus (1874; London, 1995); Edmund Husserl,
Logische Untersuchungen, 2 vols. (The Hague, 1900–1901). For a description of the ways in which
Brentano’s notion of inner perception was adopted by Wilhelm Wundt for experimental ends, see
William Lyons, The Disappearance of Introspection (Cambridge, Mass., 1986), pp. 3–6.
4. Husserl argued that empathic viewing of the other was an act of intuition, but was not
originary; see Husserl, Ideas Pertaining to a Pure Phenomenology and to a Phenomenological
Philosophy, trans. F. Kersten (1913; Dordrecht, 1982), §1, p. 6. Edith Stein, an assistant to Husserl,
elaborated on Husserl’s view of empathy in On the Problem of Empathy, trans. Waltraut Stein (1917;
The Hague, 1964). Stein argued that empathy was the way in which we perceived an alien
consciousness and was an act of perceiving sui generis. She disputed Lipps’s claims that one could
achieve a seamless unity with the experience of another person and argued that we possess our
own and the other’s standpoint simultaneously. In 1913, Scheler published Zur Phänomenologie
und Theorie der Sympathiegefühle und von Liebe und Haß, in which he contested Lipps’s theory of
projection, arguing that there could be a direct inner perception of another’s psychological reality,
not derived from the understanding of one’s self. Scheler’s addendum, Anhang über den Grund zur
Annahme des fremden Ich, was the focus of Ludwig Binswanger’s discussion of the other in his
Einführung in die Probleme der allgemeinen Psychologie (Berlin, 1922); hereafter abbreviated E.
Moritz Geiger published a critical review on the problem of Einfühlung in 1911; see Moritz Geiger,
“Über das Wesen und die Bedeutung der Einfühlung,” Bericht über den Kongreß der Deutschen
Gesselschaft für Psychologie 4 (1911): 29–73.
5. Other philosophers who wrote on intersubjectivity in this period, but whom I do not discuss
because they did not influence Binswanger’s early psychiatric epistemology are Martin Buber, Karl
Löwith, and Husserl in his later work, particularly the fifth meditation of his Cartesian
Meditations: An Introduction to Phenomenology, trans. Dorion Cairns (1929; Dordrecht, 1995).
S u s a n L a n z o n i is an NSF postdoctoral fellow and research associate at the

Center for Philosophy and History of Science at Boston University. This essay
originated from her dissertation, “Bridging Phenomenology and the Clinic:
Ludwig Binswanger’s Science of Subjectivity,” completed at the history of science
department at Harvard University. She is presently working on a history of
empathy.
162 Susan Lanzoni / An Epistemology of the Clinic
clinical and interpersonal skills. In particular, the doctor-patient relation-
ship, understood phenomenologically, was seen as a source for an intimate
psychological knowledge of the other. In the company of psychiatrists such
as Karl Jaspers, Kurt Schneider, and Eugène Minkoswki, the Swiss psychi-
atrist Ludwig Binswanger (1881–1966) sought to establish a psychological
epistemology rooted in the encounter between psychiatrist and psychotic
patient.6 Although Binswanger’s name is most closely associated with ex-
istential analysis (Daseinsanalyse), an approach he developed in the 1930s
based on Martin Heidegger’s existential analytic of Dasein, in this essay I
focus on his early and largely unexamined epistemology of the clinic de-
veloped between 1911 and 1925.7
Binswanger’s phenomenology of the clinical encounter stressed the role
of the clinician as the epistemological instrument of perception and feeling
and offered a striking alternative to the patient-psychiatrist encounter as
described by psychoanalysis. Binswanger’s work thus stands in a phenom-
enological psychotherapeutic tradition that departs significantly from
Freudian psychoanalysis and that has had profound influence in Central
6. Also included in this group are the psychiatrists Franz Fischer and Emil Freiherr von
Gebsattel and the neurologist Erwin Straus, to name a few. As to Binswanger’s role, the
phenomenologist and historian Herbert Spiegelberg wrote, Binswanger “was chiefly a trail-blazer
for a new approach in phenomenological psychopathology, and there is little doubt that thus far
he is the major one. Certainly, for better or worse, none of his potential rivals in this enterprise has
made so much use of philosophical phenomenology” (Herbert Spiegelberg, Phenomenology in
Psychology and Psychiatry: A Historical Introduction [Evanston, Ill., 1972], p. 232).
7. In 1942, Binswanger published an extensive phenomenology of intersubjectivity, a
celebration of we-hood (Wirheit) and love: Grundformen und Erkenntnis menschlichen Daseins
(1942), vol. 2 of Ausgewählte Werke, ed. Max Herzog and Hans-Jürg Braun, 4 vols. to date
(Heidelberg, 1992–). As this work appears twenty years after the scope of this paper, it will not be
discussed here, but certainly Binswanger’s early attempts at understanding intersubjectivity
formed the foundation for this later project. For more on this part of Binswanger’s oeuvre, see
Roger Frie, Subjectivity and Intersubjectivity in Modern Philosophy and Psychoanalysis: A Study of
Sartre, Binswanger, Lacan, and Habermas (Lanham, Md., 1997), and Michael Theunissen, Der
Andere: Studien zur Sozialontologie der Gegenwart (Berlin, 1977), pp. 439–76. Jan Holthues does
discuss Binswanger’s early work, but does not pair his insights with a discussion of psychiatric
practice; see Jan Holthues, Kritik der Psychologie: Anthropologie und Wissenschaftstheorie bei
Ludwig Binswanger (Heidelberg, 1999). Recent work on Binswanger includes William Alan Sadler,
Existence and Love: A New Approach in Existential Phenomenology (New York, 1969); Torsten
Passie, Phänomenologisch-Anthropologische Psychiatrie und Psychologie: Eine Studie über den
“Wengener Kreis”: Binswanger, Minkowski, von Gebsattel, Straus (Hürtgenwald, 1995); Heinz-Peter
Krienen, Ludwig Binswangers Versuch einer existentialontologischen Grundlegung des
psychopathologischen Daseins: Geschichte und aktuelle Situation (Frankfurt, 1982); Alice Holzhey-
Kunz, Leiden am Dasein: Die Daseinsanalyse und die Aufgabe einer Hermeneutik
psychopathologischer Phänomene (Vienna, 1994); and Klaus Hoffman, “Ludwig Binswanger—
Begegnung von Psychoanalyse und Philosophie,” Jahrbuch der Psychoanalyse 37 (1996): 248–64.
See also the recent issue of Luzifer-Amor 29 (2002), with essays on Daseinsanalyse by Klaus
Hoffmann, Albrecht Hirschmüller, Alice Holzhey-Kunz, Gion Fidel Condrau, Roger Frie, and
Gerlinde Angelika Schopf.
Europe, as well as in England and the United States.8 In the years following
World War II, Binswanger’s rendering of the phenomenological vision
would inspire Maurice Merleau-Ponty as well as the young Michel Fou-
cault.9 As a source of intersubjective and social definitions of mental dis-
order, it would also provide philosophical fuel for the antipsychiatry
movement.10 In formulating a hybrid science melding the domains of phi-
losophy and psychiatry, Binswanger went further than most in demonstrat-
ing the potential of phenomenology to bridge intellectual and practical
worlds: from European psychiatric asylum practice, to critiques of psycho-
analysis, to philosophical discourse on intersubjectivity.
It is perhaps obvious that a clinical psychiatrist, especially the director
of a psychiatric asylum, would take an interest in intersubjectivity as it
pertained to the clinical encounter. New therapeutic practices—suggestion
and hypnosis in the late nineteenth century and psychoanalytic transfer-
ence in the early twentieth—had focused attention on the healing possi-
bilities of doctor-patient contact. For the majority of Binswanger’s asylum
patients, however, who suffered from psychotic disturbances such as ma-
nia and schizophrenia, these therapeutic techniques had limited value. For
such cases, the more basic challenge to the practicing psychiatrist was
merely to understand schizophrenic experience, which seemed so unlike
the normal, both cognitively and emotionally. Jaspers, one of the pioneers
8. It is only recently that scientific psychologies with debts to phenomenology have become a
research topic for historians of psychology and psychiatry. The classic work is Spiegelberg’s
Phenomenology in Psychology and Psychiatry. See also Max Herzog, Phänomenologische
Psychologie: Grundlagen und Entwicklungen (Heidelberg, 1992). Mitchell G. Ash chronicles the
history of Gestalt psychology, with attention to its phenomenological roots, in Gestalt Psychology
in German Culture, 1890–1967: Holism and the Quest for Objectivity (Cambridge, 1998). See also
Anne Harrington, Reenchanted Science: Holism in German Culture from Wilhelm II to Hitler
(Princeton, N.J., 1996), for a discussion of holism and phenomenology in the work of the
neurologist Kurt Goldstein and psychologist Max Wertheimer. Martin Kusch discusses
phenomenology and life-philosophy in the history of disciplinary disputes between philosophers
and psychologists in Germany in Psychologism: A Case Study in the Sociology of Philosophical
Knowledge (London, 1995). Kusch also examines the Würzburg school of thought-psychology,
which made use of Husserlian ideas, in Psychological Knowledge: A Social History and Philosophy
(London, 1999). Katherine Arens explores developments in conceptual psychology, focusing on
Franz Brentano, Dilthey, and Husserl, in Structures of Knowing: Psychologies of the Nineteenth
Century (Dordrecht, 1989). Louis Sass discusses three phenomenological approaches to
schizophrenia in Louis Sass, “Self and World in Schizophrenia: Three Classic Approaches,”
Philosophy, Psychiatry, and Psychology 8 (Dec. 2001): 251–70.
9. Binswanger’s first existential essay, “Dream and Existence,” was famously introduced to a
French-speaking audience by Michel Foucault in 1954. See Michel Foucault, “Dream, Imagination,
and Existence,” in Foucault and Binswanger, Dream and Existence, ed. Keith Hoeller (1954;
Atlantic Highlands, N.J., 1993). Maurice Merleau-Ponty, Phenomenology of Perception, trans. Colin
Smith (London, 1989) cites Binswanger’s work on hysteria and the body; see p. 160.
10. R. D. Laing is a major figure in the antipsychiatry movement (along with Foucault) with
strong connections to existential psychiatry; see R. D. Laing, The Divided Self: An Existential Study
in Sanity and Madness (1959; New York, 1990), pp. 17–38.
of phenomenological psychiatry, found phenomenological methods useful
for understanding individual psychotic symptoms but did not think they
could lead to a comprehensive understanding of psychosis.11 Binswanger,
in contrast, boldly claimed that phenomenological intuition and empathy
could provide a direct pathway to understanding the psychotic person ho-
listically.
As the director of the elite, family-based Bellevue asylum on the shores
of Lake Constance in Switzerland from 1911 to 1956, Binswanger was an early
adherent of psychoanalysis, a lifelong friend of Freud, and one of the first
European psychiatrists to introduce psychoanalysis into an asylum context.
Freud sent many of his more intractable patients to Binswanger’s asylum
for inpatient care. During the first decades of his asylum tenure, Binswanger
began to transform the Freudian psychoanalytic model of patient-doctor
interchange based on transference, countertransference, and projection,
with a phenomenological and existential outlook.12 Mining the psycholog-
ical and aesthetic literature on empathy, he came to understand emotional
resonance as an epistemological tool useful in the clinic. Although Ein-
fühlung had been originally coined as an aesthetic term by Robert Vischer
in 1873,13 in 1903 Theodor Lipps described Einfühlung as a method useful
not only to aesthetics but for the psychological understanding of another
11. See Karl Jaspers, Allgemeine Psychopathologie: Für Studierende Ärzte und Psychologen (1913;
Berlin, 1923). In a letter to Jaspers, Binswanger said that despite his criticism of Jaspers’s methods,
they were united in the attempt to turn psychology in the direction of subjectivity; see Binswanger,
letter to Jaspers, 1 Nov. 1922, Binswanger Archive 443/17, Tübingen University Archive, Tübingen,
Germany; hereafter abbreviated UAT.
12. Binswanger’s understanding of the doctor-patient relationship places him alongside other
early critics of psychoanalysis such as Sándor Ferenczi in promoting a therapeutic relationship
modeled on a more intimate connection than that of psychoanalytic transference; see Sándor
Ferenczi, The Clinical Diary of Sándor Ferenczi, ed. Judith Dupont (Cambridge, Mass., 1988), and
chapters on Ferenczi in Ruth Leys, Trauma: A Genealogy (Chicago, 2000). In the 1950s,
psychoanalysts such as D. W. Winnicott and Michael Balint began to look favorably on a more
direct relationship between patient and doctor. See also André Haynal, The Technique at Issue:
Controversies in Psychoanalysis (London, 1988), and Ralph Greeson and M. Wexler, “The Non-
Transference Relationship in the Psychoanalytic Situation,” International Journal of Psychoanalysis
50 (1969): 27–39. Hoffman points out that Binswanger saw his later existential analysis as a
foundation for psychoanalysis and not as an independent, therapeutic method; see Hoffman,
“Ludwig Binswangers Einfluß auf die deutsche Psychoanalyse nach 1945,” Jahrbuch der
Psychoanalyse 41 (1999): 191–208. On the relationship of Binswanger’s approach to psychoanalysis,
see also Gerald Izenberg, The Existentialist Critique of Freud: The Crisis of Autonomy (Princeton,
N.J., 1976), and Leston Havens, Approaches to the Mind: Movement of the Psychiatric Schools from
Sects to Science (Boston, 1973).
13. See Empathy, Form, and Space: Problems in German Aesthetics, 1873–1893, ed. Harry Francis
Mallgrave and Eleftherios Ikonomou (Santa Monica, Calif., 1994). For Vischer, empathy was the
projection of one’s ego onto the object. Other aesthetic theorists of Einfühlung included Johannes
Volkelt, Der Symbol-Begriff in der neuesten Aesthetik (Jena, 1876); Paul Stern, Einfühlung und Association
in der neuren Ästhetik (Hamburg, 1898); Theodor Lipps; and Wilhelm Worringer, Abstraction and
Empathy: A Contribution to the Psychology of Style, trans. Michael Bullock (New York, 1953).
person.14 For Binswanger, the psychiatrist was to use his or her capacity for
empathy to become an active participant in the clinical encounter rather
than an unemotional recorder of patient experience.
The psychiatrist could also use intuitive methods to understand the inner
experience of his patients, according to Binswanger. The epistemological
tools of inner perception, outlined by Scheler, and essential intuition (Wes-
ensschau), described by Edmund Husserl, were harnessed for this task. The
perceptual task was parallel to an aesthetic one, as Binswanger outlined in
a lecture to practicing psychiatrists in 1922. Husserl’s intuition of essences
could reveal the truths of expressionist painting, Binswanger maintained,
just as it could be directed towards patient utterances for grasping the es-
sences of psychological disorder.15 Empathy and essential intuition were
thus pathways to the inner experience of psychosis, in a way similar to the
artist’s comprehension of the truths of nature.16
As an account of the intersubjective foundations of psychiatric knowl-
edge, it is no surprise that Binswanger’s work placed a premium on the skills
of practicing psychiatrists. The empathic model required a storehouse of
experience on the part of the psychiatrist with which he or she could make
connections with the patient, and Wesensschau relied on the special ability
of the psychiatrist to intuit essences. These methods fashioned the psychi-
atrist into an epistemological agent who needed no special equipment but
his or her own capacity to feel, empathize, and intuit. Psychiatrists at asy-
lums and clinics could thus utilize a research tool dependent on refined
skills but far different from the techniques popularized by the new exper-
imental psychologies.17 In a cultural setting where the value of the purely
14. See Theodor Lipps, Ästhetik: Psychologie des Schönen und der Kunst, 2 vols. (Leipzig, 1903–6)
and Leitfaden der Psychologie (Leipzig, 1903).
15. Binswanger focused on the expressionist collective of the Blaue Reiter, particularly the work
of Franz Marc; see Der Blaue Reiter, ed. Wassily Kandinsky and Franz Marc (1912; Munich, 1984).
16. Binswanger found himself in accord with Marc’s declaration that he was searching for “a
feeling [Empfinden] of the organic rhythm of all things, a pantheistic feeling-into
[Sichhineinfühlen] the tremble and flow of the blood of nature, in the trees, the animals, in the air”
(Marc, letter to Reinhard Piper [the publisher of Der Blaue Reiter], 20 Apr. 1910, quoted in Claus
Pese, Franz Marc: Leben und Werk [Stuttgart, 1989], p. 61).
17. The larger cultural debates of this period reflected this elevation of the purely intellectual
over that of the technical, especially as evidenced in the struggle over epistemological issues in the
new discipline of psychology. See Ash, Gestalt Psychology in German Culture, pp. 42–50, and Fritz
Ringer, The Decline of the German Mandarins: The German Academic Community, 1890–1933
(Hanover, N.H., 1990), pp. 102–13. In this vein, G. E. Berrios asserts that Jaspers’s adoption of
Husserlian phenomenology amounted to a strategic labeling of the older descriptive method as
phenomenological, which was merely a way to shore up the decaying authority of classic
nineteenth-century descriptivism; see G. E. Berrios, “Phenomenology, Pychopathology, and
Jaspers: A Conceptual History,” History of Psychiatry 3 (1992): 303–27 and “Phenomenology and
Psychopathology: Was There Ever a Relationship?” Comprehensive Psychiatry 34 (Jul.–Aug. 1993):
213–20.
intellectual was privileged over the technical, empathic and intuitive meth-
ods promised not only a new look at psychiatric disorder but also ensured
the status of the psychiatrist as a member of the cultured elite, practicing a
profession that engaged the most elevated humanistic, aesthetic, and intel-
lectual resources.
The Contours and Limits of the Psychoanalytic Model

During what historian Wolfram Schmitt has called a period of meth-
odological reflection in psychiatry from 1890 to 1920, Binswanger under-
went training in a range of psychiatric methods but cast a critical eye on
most of them.18 In 1904, Binswanger studied with the clinician Karl Bon-
hoeffer in Heidelberg, whose research on exogenously caused psychoses
found that despite a wide variety of organic insults, including fever, infec-
tion, and noxious stimulants, nearly identical psychological clinicalpictures
resulted. To Binswanger, this research, along with that of Alfred Hoche, had
punctured a simple psychophysical parallelism, the linking of specific phys-
iological correlates to specific psychiatric diseases.19 Binswanger’s training
at the Burghölzli Hospital in Zurich from 1906 to 1907 in descriptive psy-
chopathology under Carl Jung and Eugen Bleuler profoundly influenced
his work but did not escape his criticism. Bleuler’s understanding of autism,
as Binswanger put it, provided merely a framework for understanding,
rather than an inhabitable (wohnlich) structure, because it simply did not
capture the psychiatrist’s experience in encountering an autistic patient.20
Binswanger’s enthusiastic embrace of psychoanalysis after his first meet-
ing with Freud in 1907 led Binswanger to proclaim psychoanalysis as one of
the best empirical methods for understanding patient experience. He pub-
lished two psychoanalytic case studies of hysterical patients in 1909 and 1911,
the first conducted while an assistant for his uncle Otto Binswanger at the
18. Schmitt’s term is methodologische Selbstbesinnung, a reflective period in which the

epistemological claims of psychiatric expertise were open for debate; see Wolfram Schmitt, “Das
Modell der Naturwissenschaft in der Psychiatrie im Übergang vom 19. zum 20. Jahrhundert,”
Berichte zur Wissenschaftsgeschichte 6 (1983): 89–101. Others have said that it was more of a crisis
than a period of methodological reflection; for instance, Karl Bühler in Die Krise der Psychologie
(1927; Stuttgart, 1965) argues that the crisis was prompted by a lack of a unifying method in a field
with a plethora of approaches.
19. See Alfred Hoche, “Die Bedeutung der Symptomenkomplexe in der Psychiatrie,” Zeitschrift
für die gesamte Neurologie und Psychiatrie 12 (1912): 540–51; Schmitt, “Das Modell der
Naturwissenschaft in der Psychiatrie im übergang vom 19. zum 20. Jahrhundert,” p. 96; and Karl
Bonhoeffer, “Exogenous Psychoses,” trans. H. Marshall, in Themes and Variations in European
Psychiatry, ed. Steven R. Hirsch and Michael Shepard (Charlottesville, Va., 1974), pp. 47–52 and
Die symptomatischen Psychosen im Gefolge von akuten Infektionen und inneren Erkrankungen
(Leipzig, 1910).
20. See Binswanger, “Über Phänomenologie,” Ausgewählte Werke, 3:35–69; hereafter
abbreviated “ÜP.”
university clinic in Jena.21 In his 1914 lecture on “Psychological Issues within
Clinical Psychiatry” to the Swiss Society for Psychiatrists, Binswanger
placed psychoanalysis within the larger tradition of an interpretative ap-
proach in the human sciences as laid out by the philosopher Wilhelm Dil-
they and practiced by Binswanger’s colleagues, the Swiss philosopher Paul
Häberlin and the psychiatrist Jaspers.22
In this period, Binswanger adopted a psychoanalytic model of the clinical
encounter; the analyst acted as an unbiased receiver of the impulses of the
patient by stripping his unconscious of its own concerns so as to attune it
to the unconscious of the patient. Freud had modeled this process on the
mechanism of the telephone, whereby the analyst’s unconscious functioned
as the receiver of the telephone by transforming electrical signals, in this
case the derivatives of the unconscious transmitted by the patient, back into
sound waves or their original unconscious form.23 This mechanical model
accounted for the ways in which the patient’s pathological experiences
could be imprinted upon and deciphered by the therapist’s unconscious.
As Freud had put it, the therapist’s unconscious was the instrument of the
analysis.24
The unconscious was not only critical to the success of therapeutic inter-
action but was also the source of psychological causality, according to Bin-
swanger. He argued that the positing of causal relationships within the
confines of the psychological realm was the critical element in constructing
an independent science of psychology, which would not rely on a psycho-
physical model of causation. He thus took issue with the strict divisionJaspers
made in 1913 between causal and interpretative methods in the understanding
21. See Binswanger, “Versuch einer Hysterieanalyse,” Jahrbuch für psychoanalytische und
psychopathologische Forschungen 1–2 (1909–10): 174–356 and “Analyse einer hysterischen Phobie,”
Jahrbuch für psychoanalytische und psychopathologische Forschungen 3 (1911): 228–308. Binswanger
also served as president of the Zurich Psychoanalytic Society from 1910 to 1914 and became an
important player in the political machinations between the Vienna psychoanalytic school and the
independently minded Zurich school; see Binswanger, letter to Eugen Bleuler, 12 Nov. 1914, UAT
443/1.
22. See Binswanger, “Psychologische Tagesfragen innerhalb der klinischen Psychiatrie,”
Zeitschrift für die gesamte Neurologie und Psychiatrie 26 (1914): 574–99; hereafter abbreviated “PT.”
This Swiss Society for Psychiatrists was founded in 1895 and composed mainly of asylum
psychiatrists. It was dedicated to both promoting the science of psychiatry and contending with
the practical matters of the asylum care of patients.
23. Binswanger cited Freud here (“PT,” p. 595); see Sigmund Freud, “Ratschläge für den Arzt
bei der psychoanalytischen Behandlung,” Zentralblatt für Psychoanalyse 2 (1912): 486. Some writers
on empathy discuss Freud’s concept of identification as an unconscious form of empathy; see
Robert Katz, Empathy: Its Nature and Uses (New York, 1963), pp. 71–76. The elements of
identification include introjection, imitation, and regression. This was not understood as a
therapeutic/scientific tool, however, as was the above description of the analytic encounter.
24. See Freud, “Ratschläge für den Arzt bei der psychoanalytischen Behandlung,” p. 486.
of schizophrenia.25 For Jaspers, causal agents were restricted to that which
was extraconscious: bodily or physical processes that included hereditary and
dispositional factors.26 In support of unconscious psychological causes, Bin-
swanger called to his aid the work of Lipps, a professor of philosophy in Mu-
nich since 1894, and cited approvingly Lipps’s 1897 declaration that the
unconscious was the question of psychology, for only it could account for the
causal gaps in psychological experience (see “PT,” p. 597).27 Binswanger ar-
gued that Freud had empirically demonstrated the operations of such an un-
conscious and in doing so had made lawful sense out of what had seemed to
be chaotic psychological processes. Indeed, in Binswanger’s own psychoan-
alytic case study of Gerda, published in 1911, a causal psychological relation
was critical in explaining that the development of Gerda’s phobia was caused
by the traumatic experience of the birth of her brother.28
Despite Binswanger’s early acceptance of psychoanalysis, he was also
aware of its therapeutic limitations in his asylum practice. In a 1913 letter to
the Berlin psychiatrist and opponent of psychoanalysis Hermann Oppen-
heim, Binswanger firmly delimited the applicability of psychoanalytic ther-
apy to a small portion of his clientele; only those with an intact moral
makeup, a good degree of intelligence, and who were under the age of thirty-
five would qualify. This reduced the eligible number to only four or five
among approximately eighty patients at the asylum.29 In addition, Bin-
swanger confessed to Bleuler in 1916 that his training with Freud and Paul
Dubois, the Swiss practitioner of a suggestive or persuasive therapeutic
method, had led him to expect much more from psychological therapeutic
methods than they actually could accomplish.30 Binswanger noted later in
25. See Binswanger, “Bermerkungen zu der Arbeit Jaspers: Kausale und verständliche
Zusammenhänge zwischen Schicksal und Psychose bei der Dementia praecox (Schizophrenia),”
Internationale Zeitschrift für ärztliche Psychoanalyse 1 (1913): 383–90. Jaspers’s original article was
“Kausale und verständliche Zusammenhänge zwischen Schicksal und Psychose bei der Dementia
Praecox (Schizophrenie),” Zeitschrift für Neurologie 14 (1912): 158–263.
26. Jaspers argued that psychoanalysis could offer psychological explanations of the
unconscious or what he called unnoticed (unbemerkte) conscious events, but not causal
explanations. The latter were only possible within the bounds of a natural scientific approach.
27. Without causality, Binswanger wrote that scientific psychology would receive its
“deathblow” (Todesstoß) (“PT,” p. 592).
28. See Binswanger, “Analyse einer hysterischen Phobie.” See also Binswanger, letter to Paul
Häberlin, 5 Feb. 1913, in Paul Häberlin-Ludwig Binswanger Briefwechsel 1908–1960, ed. Jeannine
Luczak (Basel, 1997), p. 107.
29. See Binswanger, letter to Hermann Oppenheim, 9 Sept. 1913, UAT 443/34. See also
Binswanger, letter to Christian Müller, 26 Nov. 1918, UAT 443/34.
30. See Binswanger, letter to Bleuler, 18 Feb. 1916, UAT 443/1. Christian Müller describes
Dubois’s method as one situated between hypnosis and psychoanalysis, which included the
Socratic method of questioning patients. Dubois employed the term psychoneurosis
(psychonévrose) to indicate a psychogenic origin of neurosis; see Müller, De l’asile au centre
psychosocial: Equisse d’une histoire de la psychiatrie suisse (Lausanne, 1996), pp. 150–53.
f i g u r e 1. Interior of Bellevue Sanatorium. From Sigmund Freud, Ludwig Binswanger: Briefwechsel

1908–1938, ed. Gerhard Fichtner (Frankfurt am Main, 1992), pp. 12–13.
his life that his enthusiasm for psychoanalysis had only abated after ap-
proximately ten years of disappointment, but its practical limitations had
become evident rather quickly.31
It was the nature of the Bellevue clinical milieu—a family-based asylum,
where the lives of staff and patients intermingled—that contributed to Bin-
swanger’s growing dissatisfaction with many aspects of the psychoanalytic
method. The Bellevue asylum was founded by Binswanger’s grandfather in
1857 and had operated according to a family model, where staff and patients
shared common living quarters and participated together in social activities
(fig. 1). During his father’s tenure as director of the asylum from 1880 to
1910, the young Binswanger often encountered patients that his father was
treating at the nearby family home. As director, Ludwig Binswanger and his
family lived on asylum grounds in the villa Harmonie until 1917 and then
moved to the garden house, also on asylum grounds.32 Binswanger repeat-
edly commented to friends and colleagues about the intensive demands of
working at an asylum; it was more taxing than undertaking psychiatricwork
in a clinic, which had more circumscribed hours.33 Indeed, his involvement
often extended to evening hours, when he attended social functions for the
patients, including performing as the musical accompanist for a patient
who gave a vocal concert at the asylum.34 In 1957, Binswanger explicitly con-
trasted his practice with Freud’s, who had a separate entry in his home for
his patients so that his family would be shielded from them.35 Rather than
31. Looking back in 1956, Binswanger wrote that in 1911 he thought almost every patient could
be analyzed; see Binswanger, Sigmund Freud: Reminiscences of a Friendship, trans. and ed. Norbert
Guterman (New York, 1957), p. 29.
32. See Binswanger, “Zur Geschichte der Heilanstalt Bellevue in Kreuzlingen,” in Ludwig
Binswanger und die Chronik der Klinik “Bellevue” in Kreuzlingen: Eine Psychiatrie in Lebensbildern,
ed. Herzog (Berlin, 1995), p. 65.
33. See Binswanger, letter to Fräulein von der Leyen, 21 May 1929, UAT 443/38.
34. See Binswanger, letter to Frau P., 1 Dec. 1934, UAT 441/2256.
35. See Binswanger, “Zur Geschichte der Heilanstalt Bellevue in Kreuzlingen,” p. 49.
advocating emotional distance from patients, Binswanger took pride in the
closeness of his own family life to his patients.
By 1925, Binswanger’s methodological criticisms of psychoanalysis had
grown, and he explicitly recorded his dissatisfaction with Freud’s telephone
analogy as an accurate representation of the way the analyst understood the
patient. For such a model to be efficacious, Binswanger now argued, one had
to posit a universal intellectual disposition, which, when operatingapartfrom
the personal biases or affective inhibitions of the analyst, would allow the
unconscious of the patient to be received automatically.36 Binswanger could
not accept the mechanical reproduction of the patient’s unconscious in the
unconscious of the analyst, but saw the process of understanding as modu-
lated by the training and experience of the psychiatrist.37 As this experience
varied from person to person, it could not operate according to rationalistic
or mechanical principles. Although Freud protested that it was more precisely
the analyst’s preconscious that was involved, Binswanger still questioned his
characterization of an understanding that functioned without much con-
scious control.
In discarding Freud’s model of unconscious communication, Binswan-
ger now aligned himself more closely with Jaspers, who had argued for the
importance of empathic listening in the clinical assessment of patients. This
meant that the psychiatrist had to actively resonate with the experiences of
the patient in order to fully understand him or her. This kind of sympathetic
understanding could reveal more about the nature of the disorder than
could an “objective” or dispassionate method of study.38 Even though Bin-
swanger had promoted Freud’s mechanical model of patient-doctor inter-
change in 1914, he never accepted Freud’s lengthy comments on the
necessity for emotional coldness (Gefühlskälte) and lack of sympathy (Mi-
tleid) on the part of the therapist.39 Binswanger had read Lipps’s work on
36. See Binswanger, letter to Freud, 15 Feb. 1925, in Sigmund Freud, Ludwig Binswanger:
Briefwechsel 1908–1938, ed. Gerhard Fichtner (Frankfurt am Main, 1992), p. 199.
37. See ibid. In his reply, Freud emphasized that he had merely intended to stress the
importance of dispelling conscious expectations in the therapeutic process; see Freud, letter to
Binswanger, 22 Feb. 1925, in ibid., p. 202.
38. Jaspers, General Psychopathology, trans. J. Hoening and Marian W. Hamilton (Chicago,
1968), p. 22. Jaspers said that this process had to be an interplay of detachment and sympathy and
that such an endeavor entailed working on oneself as much as working on the facts.
39. As Freud explained:
I cannot advise my colleagues too urgently to model themselves during psycho-analytic
treatment on the surgeon, who puts aside all his feelings, even his human sympathy [menschliches
Mitleid], and concentrates his mental forces on the single aim of performing the operation as
skilfully as possible. . . . The justification for requiring this emotional coldness [Gefühlskälte] in
the analyst is that it creates the most advantageous conditions for both parties: for the doctor a
desirable protection for his own emotional life and for the patient the largest amount of help that
empathy in 1913 and in the next year pushed clinicians to extend their ca-
pacity for empathizing with psychotic patients. Specifically, he encouraged
them to deliberately blur the lines between the normal and abnormal as a
way to decrease the emotional distance from patient to doctor.40 In addition,
Binswanger rejected attempts to causally explain his patients’ disorders by
invoking flows of libido or unconscious mechanisms, both because they did
not apply to his psychotic patients and because Binswanger questioned the
speculative quality of these explanations.41 Binswanger’s emphasis thus
shifted from articulating causal mechanisms of a hidden unconscious to a
focus on the psychiatrist’s active efforts to grasp his patients’ experienced
reality (see “PT,” p. 596). It was an extension of the empathic reach followed
by a critical and sharp conceptual clarification of the materials gained by
Einfühlung that Binswanger now touted as the groundwork for a scientific
psychology of use in the clinic.
The Uses of Einfühlung

In the preface to his 1922 Introduction to Problems of General Psychology,
Binswanger summed up his methodological reflections: “This work arises
from the endeavor to reach clarity on the conceptual foundation of what
the psychiatrist, in a psychological and psychotherapeutic respect, per-
ceives, reflects upon, and does at the bedside” (E, p. v). The question of
psychiatric epistemology as it played out at the bedside, however, was not
only of concern for psychiatrists but also had deep implications for a psy-
chology that departed from natural scientific approaches. Binswanger was
interested in developing neither a psychology rooted in physiologicalmech-
anisms nor a psychology that focused on an elementist account of cognitive
processes. Rather he was seeking a science of the person (Person-wissen-
schaft) based on the possibility of direct, intersubjective understanding.
In his Introduction, Binswanger outlined alternatives to a natural sci-
entific psychology, which included Carl Stumpf ’s functional psychology,
Franz Brentano’s theory of psychic acts, Husserl’s phenomenology of in-
tentional experience, Lipps’s theory of conscious experience, and Natorp’s
reconstructive psychology. The first three chapters of his book explainedthese
we can give him to-day. [Freud, “Recommendations to Physicians Practicing Psycho-Analysis”

(1911), in The Freud Reader, ed. Peter Gay (New York, 1989), p. 359]
40. Binswanger did acknowledge that these divisions should be maintained for educational or
therapeutic (didaktischen) ends; see “PT,” p. 596.
41. Binswanger wrote that the concepts ego and libido were vague and shaky (schwankend); see
“PT,” pp. 598–99. Binswanger’s more extensive critiques of the natural science perspective of
psychoanalysis were published in 1936; see Binswanger, “Freud und die Verfassung der klinischen
Psychiatrie,” Schweizer Archiv für Neurologie und Psychiatrie 37 (1936): 177–99 and “Freuds
Auffassung des Menschen im Lichte der Anthropologie,” Ausgewählte Vorträge und Aufsätze, 2
vols. (Bern, 1947–55), 1:159–89.
approaches and their differences from the natural scientific perspective;
rather than viewing cognition as clusters of associative processes, they un-
derstood psychic life as unified and nonquantifiable. Binswanger’s fourthand
most lengthy chapter in his Introduction described the other (das fremde Ich)
and the scientific representation of the person. As Binswanger explained, a
science of the other “doesn’t originate from a generalizing, atomizing, and
mechanizing method, but rather from a individualizing, dynamizing, recon-
structive, and pure intuitive (phenomenological) method” (E, p. 355).
Binswanger’s aim, in this volume, was to lay a methodological founda-
tion for the experience of the psychiatrist in encountering the patient on
the one hand and the experienced reality of the patient on the other. Fol-
lowing Lipps, Binswanger argued that understanding the emotional life of
the other opened up a new cognitive domain:
It concerns here a third domain of knowledge [Erkenntnisgebiet] that
exists in addition to the knowledge of things outside of us and that of
our own selves, to which an entirely new and unique cognition is
needed, which we have practiced instinctively from childhood on, and
which consists in the fact that next to our own individual selves, we ac-
knowledge other individuals. [“PT,” p. 589]
This instinctive method was that of Einfühlung. With it, one could percep-
tually grasp another’s psychological processes and states (Vorgänge und Zus-
tändlichkeiten) because they engendered in the perceiver a similar feeling
or wish that he or she had already experienced. Empathy was thus a way of
taking into account both psychiatrist and patient.
Lipps had identified four different types of Einfühlung, and Binswanger
focused on the fourth, or “Einfühlung in the sensory appearances of per-
sons” in his Introduction (E, p. 230).42 Unlike the ways in which one em-
pathized with an individual feeling or with a natural object, in this case one
utilized one’s entire I in the process so that it was also called a process of
self-objectification. One’s own consciousness was bound to the grasped sen-
sory stimuli (Sinnliche) of the other, “in short, it is objectified in it” (E, p.
230). This objectified conscious experience, rooted in the perception of the
other’s body, could fasten itself to the alien I, understood to be bound to
the other’s body. Einfühlung was a special type of intentional act, then, ir-
reducible to other kinds, and involved a merging of one’s own experience
with the signs of a similar experience as perceived in the other (see E, p.
230). According to this view, one could only understand others insofar as
42. Lipps also discussed general apperceptive Einfühlung, mood empathy, and empathy in
nature; see Lipps, Leitfaden der Psychologie, pp. 187–91.
one had the capacity to experience something similar, and, for this reason,
the perceiver and the store of his life experiences was of prime importance
in the process of understanding (see “PT,” p. 590). The key to understanding
the other was understanding oneself.
Although Binswanger did not explicitly comment on the clinical matter
of how a psychiatrist could empathize with a psychotic patient in his 1922
volume, he had always declared that this was necessarily an empirical ques-
tion. There should be no a priori limits that would restrict the kind of
knowledge that could be grasped by an empathic clinician. Binswanger pos-
tulated that even a small bit of psychotic experience that could be vicariously
felt (nachfühlen) carried with it the possibility of empathizing (einfühlen)
with the psychotic patient (see “PT,” p. 596). Binswanger wrote to a col-
league in 1927 that he had always maintained that it was impossible to sepa-
rate those forms of emotional life with which one could empathize from
those that one could not.43 He even viewed the success of Bleuler’s work on
schizophrenia not as a result of a theoretical grasp of the disorder but due
to Bleuler’s personal capacity for Einfühlung in the emotional life of schiz-
ophrenics (see “ÜP,” 3:61).
Schelerian Inner Perception

But even more powerful than Einfühlung was the ability to directly intuit
the other’s psychological reality, as Binswanger was to argue. This process
of inner perception was described by Scheler, a phenomenologist of the Mu-
nich school since 1906, one of the first four editors of Husserl’s Yearbook for
Philosophy and Phenomenological Research (1913), and one of the most cele-
brated philosophers of the early 1920s in Germany.44 Binswanger and
Scheler were personally acquainted and corresponded (see UAT 443/33).
Schelerian inner perception construed the psychological reality of the other
as an empirical fact, directly perceivable in its own right and not derived
from perceptions of the body. In adopting Scheler’s views, Binswanger and
other phenomenologists extended the nature of the merely given in accord
with Dilthey’s reflection that “experience is vastly more than what the em-
piricists and Kantians have portrayed under that name.”45
43. Binswanger, letter to Heinz Hartmann (psychiatrist assistant), 22 Mar. 1927, UAT 443/37.
44. See Spiegelberg and Karl Schuhmann, The Phenomenological Movement: A Historical
Introduction, 3rd ed. (Dordrecht, 1994), pp. 268–69. See also John Raphael Staude, Max Scheler
1874–1928: An Intellectual Portrait (New York, 1967).
45. Quoted in Ermarth, Wilhelm Dilthey, p. 197. The phenomenological view of experience was
also rejected by the logical empiricists; in 1930 Moritz Schlick argued that phenomenological
descriptions of experience did not refer to actual existence or things, but rather only revealed
concepts inherent in language itself. See Moritz Schlick, “Is There a Factual a Priori?” in Readings
in Philosophical Analysis, ed. Herbert Feigl and Wilfrid Sellars (New York, 1949), pp. 277–85.
In his chapter on the constitution and knowledge of the other in his In-
troduction, Binswanger argued that Scheler’s inner perception offered a
more direct appraisal of the other than did Lipps’s empathy theory, an ar-
gument that Scheler had made himself.46 Scheler argued that Lipps’s theory
“offers no grounds for assuming the existence of other selves, let alone other
individuals. For it can only serve to confirm the belief that it is my self which
is present ‘all over again’, and never that this self is other and different from
my own.”47 For Scheler, seeing the other was a direct perception and not
dependent on one’s own self-projection or on the basis of sensory signs
provided by the other’s body. For instance, seeing the red of someone’s
cheek and understanding it to be shame was not a matter of seeing red and
then animating that sensory perception with one’s own experience of
shame, but rather a direct perception of shame in the other’s experience.48
One could directly perceive joy in another’s laughter and sorrow in tears,
and it was only in the case of misapprehensions or mistakes that one had
to draw inferences to correct an initial misperception.49 As Scheler argued,
if one engaged in acts of external perception (äußere Wahrnehmung), one
symbolized the body of another, whereas acts of inner perception symbol-
ized the other’s I. Thus, both physical and psychic signs inhered in the
other’s expressions, and different manners of perceiving decreed whether
one saw a bodily or psychic event.50
Scheler’s intersubjective understanding of inner perception gave Bin-
swanger the critical methodological piece for establishing a psychology in-
dependent from the natural sciences, but still based on empirical evidence,
as he declared in his Introduction:
Through this theory of an original, psychophysical neutrality and
unity of the object “human,” the psychology of the person first re-
ceives its self-sufficiency and independence from natural science, par-
ticularly from physiology and biology. The point of departure of this
psychology is now no longer the body and the various interpreted or
46. For Scheler’s theory of inner perception, see Scheler, Zur Phänomenologie und Theorie der
Sympathiegefühle und von Liebe und Hass: Mit einem Anhang über den Grund zur Anahme der
Existenz des fremden Ich (Halle, 1913).
47. Scheler, The Nature of Sympathy, p. 242. See also Scheler, Wesen und Formen der Sympathie,
6th ed. (Bern, 1973), p. 236.
48. Scheler questioned the circularity of Lipps’s theory; to grasp others’ bodily changes as
expressive movements was evidence that we intuited another expressive being originally and had
not secondarily connected the other’s bodily expressions with our own psychological experience.
49. See Scheler, The Nature of Sympathy, p. 206; see also Scheler, Formalism in Ethics and Non-
Formal Ethics of Values, trans. Manfred S. Frings and Roger L. Funk (1916; Evanston, Ill., 1973), p.
408.
50. See Scheler, The Nature of Sympathy, pp. 261–62.
empathized bodily changes, but rather a world of original, psychologi-
cal intuitive data [Anschauungsdaten]. [E, p. 242]
These primary psychological data, collected through the manner of intui-
tion, were to be the building blocks of Binswanger’s psychologicalapproach.
Following Scheler’s notion of inner perception, Binswanger argued that,
at base, the other’s emotional life was not given differently from one’s own
because there was an original undifferentiation of one’s own and the other’s
stream of experience (see E, p. 233). In this context, he quoted Scheler ex-
tensively:
Nothing is then more certain than that we both think our own
thoughts and those of others, that we can feel our emotions as we do
others’ feelings. Don’t we speak every day about this? Aren’t we con-
tinually differentiating “our” thoughts from those that we have read or
someone has communicated to us? “Our” feelings from those that we
only empathized with [nachfühlten] or from those we (unconsciously)
picked up as a contagion? [quoted in E, p. 235]51
What was primarily given then, as Scheler argued, was an indifferent stream
of experience, only secondarily gathered up around a particular individual
as exclusively his or her possession.52 This view did not deny the fact that
each psychological act was constituted by an individual consciousness, but
argued that the contents of such acts, their objects or things, could be
shared. Scheler argued that two people could share the same sorrow, which
was a psychological reality, but could not share the same pain, which was a
bodily sensation. For Scheler, the communal nature of thoughts and mental
experiences were at work in the phenomena of hypnosis, unconscious rem-
iniscence, and the effects of traditions imparted by parents and teachers.
Although Binswanger agreed with Scheler’s critique of Lipps’s empathy
theory, Binswanger contended that for the practical concerns of the clinic,
both empathy and direct inner perception were acts of psychological un-
derstanding (Verstehen). In the case of inner perception, one perceived psy-
chological entities in the other; in the case of empathy, one ensouled
(beseelen) through “feeling-into” the other’s bodily signs (see E, p. 261).
These were two aspects of an intersubjective dynamic, and for Binswanger
51. Slightly changed text printed in Scheler, Wesen und Formen der Sympathie, p. 239.
52. Empathy theory said that deceptions or errors in understanding others were a failure to
make the right projection onto others, but Scheler pointed out that the more common error was
that we mistakenly take others’ experiences for our own. This fact revealed that the most
fundamental understanding of others was not a function of our self-projection, but our capacity
to take on the other’s experience; see E, p. 237.
both methods necessitated training and experience on the part of the psy-
chiatrist or psychologist (see E, p. 271). Thus Binswanger instructed the psy-
chiatrist to practice both self-observation and a greater receptivity to the
other: “The more I experience myself, the better I understand the other, or
can adjust myself to him, on the other hand, the more I understand the
other, the more I get to know myself afresh, and I extend the horizon of my
experience” (E, p. 275). To train oneself in these matters was not to under-
take a theoretical calculation but to actively develop one’s powers of feeling
and perception. It involved the whole of one’s experience or what Bin-
swanger called self-experience (Selbsterleben). For instance, it was not a
matter of making note of the fact that the dilation of pupils and a pale face
were bodily indicators of another’s fear, but it was a matter of learning how
to empathize with or directly see fear in these signs (see E, p. 271).53
Although Binswanger admitted that the boundaries between a theoreti-
cal and direct grasp of another’s experience were not sharp, he did give ex-
amples of the way the psychiatrist’s own experience could function as an
epistemological tool. In another lecture on the relationship of psychology
to psychiatry in 1924, Binswanger argued that the psychiatrist’s feeling (Ge-
fühl) in the presence of the patient could deliver important diagnostic and
psychological information.54 In an encounter with a schizophrenic, the psy-
chiatrist could rely on his feeling as a type of psychological perception. A
diagnosis based on feeling (Gefühlsdiagnose) was at base an emotional per-
ception: “We diagnose in this case actually not according to, but with our
feeling, that is by means of that manner of perception, which, aside from
the name, has not the slightest in common with ‘feeling’ in the sense of
sensory or emotional feelings” (“WA,” p. 427). A feeling-diagnosis could
proceed from the perception of the schizophrenic’s characteristic glance or
way of looking; it could result from extended time spent with the patient,
where one noticed a lack of emotional rapport; or it could also result from
a single encounter. As Binswanger wrote, when the door opens and the
schizophrenic enters, his appearance and manner “can so ‘astound’ me that
I am rebounded back into myself ” (“WA,” p. 427). Binswanger differenti-
ated this reaction from a mere attraction or repulsion and further explained,
“a schizophrenic can be very likeable to me as a person, and yet I rebound
[zurückprallen] internally, I always experience a barrier of my own inner
unity with him, in the perception of his person as a schizophrenic” (“WA,”
53. This did not mean that one could not use representations and one’s intellect to further
understand the other, according to Binswanger; see E, p. 275.
54. See Binswanger, “Welche Aufgaben ergeben sich für die Psychiatrie aus den Fortschritten
der neueren Psychologie?” Zeitschrift für die gesamte Neurologie und Psychiatrie 91 (1924): 402–36;
hereafter abbreviated “WA.”
p. 427). This process, however, was not a mysterious reaction, as one could
be trained to register and utilize these perceptions for further judgements
and conclusions. Indeed, just as one could precisely and critically analyze
one’s perceptions of another’s physical body, so could one further investi-
gate this psychological method of perception. In a letter to the phenome-
nologically inclined psychiatrist Eugène Minkowski, Binswanger explained
that a Gefühlsdiagnose could be understood as an intuitive diagnosis carried
out by a gifted physician, but, more pointedly, it was a way to characterize
an inner perception in Scheler’s terms.55
The Schelerian postulation of a commonality of feeling between indi-
viduals, however, was clearly refuted in the case of schizophrenia. Although
Binswanger did not directly address this point, he did define schizophrenia
precisely as a defect in intersubjective understanding or the failure to
achieve an inner unity with the other. The schizophrenic then stood as the
limit case—one who made visible the everyday intersubjective basis for un-
derstanding the other but also whose very being denied a unitary feeling
between doctor and patient. For Binswanger, however, this lack of connec-
tion did not call a halt to the interpretative process, but was merely a first
step, to be integrated with further insights and conclusions. He did not be-
lieve with Jaspers that one could phenomenologically assess only individual
symptoms, a process Jaspers called static phenomenology. For Binswanger,
feeling was an epistemological tool, to be supplemented with other phe-
nomenological methods for the illumination of not only individual symp-
toms but, more ambitiously, the essences of mental disorder and the core
of the personality itself. These latter tasks occupied Binswanger in the latter
part of 1922, when he enrolled the work of Husserl to sketch the contours
of a clinically relevant psychopathological phenomenology based on intu-
itive seeing and illustrated by aesthetics.
Essential Intuition, Aesthetics, and the Schizophrenic

In November 1922 at a meeting of the Swiss Society of Psychiatry in Zu-
rich, Binswanger gave a lecture, “On Phenomenology,” in which he outlined
how Husserl’s notion of essential intuition could help psychiatrists to un-
derstand their patients. As Binswanger argued, the Wesensschau could pro-
vide a glimpse into the essential nature of the experience of disorders such
55. See Binswanger, letter to Eugène Minkowski, 18 Mar. 1926, UAT 443/24. See also Minkowski,
letter to Binswanger, 2 Sept. 1924 and letter to Binswanger, 15 Mar. 1926, UAT 443/24, where
Minkowski commented that he found value in Binswanger’s concept of the Gefühlsdiagnose, but
was afraid that the rationalistic nature of French psychiatry would resist the term, so had hoped
Binswanger could provide a more neutral one. It was in this context that Binswanger suggested
diagnostic intuitif for the first case and diagnostic direct or immédiate or phénoménologique or
psychologique direct for the latter.
as schizophrenia and autism. At this meeting, Binswanger was not the only
psychiatrist to express an interest in phenomenology. Minkowski presented
a phenomenological case study of a melancholic schizophrenic and argued
that it was the patient’s experience of time, specifically, the lack of a future,
which formed the basis of his delusions.56 Bleuler gave a colecture where he
praised the fruits of Binswanger’s approach, although he remained skeptical
of the use of Husserl’s Wesensschau.57 Although a number of respondents
also expressed confusion and doubt about the nature of Wesensschau and
the scientific nature of this practice, there was a great deal of interest in the
effort to capture the experience of schizophrenia.58 Many recognized that
there was a critical problem of losing sight of lived reality through the dom-
inance of concepts and theories, and one touted the work of the life-phi-
losopher Henri Bergson as a lucid presenter of these ideas.
In his lecture, Binswanger made a special point of touching upon the
pervasiveness of “theory exhaustion” (Theorienmüdigkeit) in many scien-
tific fields (“ÜP,” 3:45).59 For phenomenologists working in the Husserlian
tradition, this meant focusing on the immediate phenomena of conscious-
ness and bracketing or putting aside theoretical constructs and naturalistic
assumptions about the nature of consciousness—an approach ensconced
in Husserl’s oft-repeated phenomenological refrain: “Back to the things
themselves.”60 Binswanger first became interested in the work of Husserl
after his 1913 trip to Vienna to visit Freud with his philosopher friend Hä-
berlin.61 By 1915, Binswanger had read the first section of the second volume
of Husserl’s Logical Investigations, although it was only in 1923 that Bin-
swanger first met Husserl, following Husserl’s lecture at the neighboring
asylum of Reichenau, on Lake Constance. A few days after this meeting,
56. Minkowski had spent two months living with this patient and described the patient’s daily
delusion that at the end of the day he would be destroyed by having to imbibe all the waste in the
world. Minkowski argued that it was the patient’s sense that there was no future stretching out
before him, or a disturbance of his time sense, that formed the basis for the development of his
delusions. This interpretation was at odds with the commonly accepted one: that the patient’s
delusions caused the disturbance of his time sense; see Minkowski, “Étude psychologique et
analyse phénoménologique d’un cas de mélancolie schizophrénique,” in “Schweizerischer Verein
für Psychiatrie Protokoll der 63. Versammlung, Samstag den 25. und Sonntag der 26. November
1922 in Zurich,” Schweizer Archiv für Neurologie und Psychiatrie 12 (1923): 331–32.
57. See Bleuler, “Korreferat Bleuler,” in “Schweizerischer Verein für Psychiatrie Protokoll der
63. Versammlung,” pp. 330–31.
58. See Minkowski, “Diskussion zur Phaenomenologie,” in “Schweizerischer Verein für
Psychiatrie Protokoll der 63. Versammlung,” pp. 332–36.
59. Binswanger singled out biology as a field suffering from such exhaustion, which had
important repercussions for psychiatry, as it was its neighboring field.
60. Husserl, Logische Untersuchungen, pt. 1, §2, 2:7.
61. See Binswanger, Sigmund Freud, p. 9.
Husserl himself traveled to the Bellevue asylum for a visit, where he gave a
lecture on the “Essence of Phenomenology.”62
Given his comments against theory, it was only appropriate that Bin-
swanger introduced the notion of phenomenological intuition to his clini-
cal audience with a turn away from theory and towards perception. For
Binswanger, it was aesthetic perception, specifically embodied in the work
of the German expressionist painter Franz Marc, that could best illustrate
the workings of the Wesensschau. Binswanger argued that Marc’s paintings
of blue horses had captured the essence of horseness; his depiction had re-
vealed the horse in its generality, which went beyond the portrayal of this
or that individual horse or the depiction of a horse as a member of a zoo-
logical species (fig. 2).63 As Binswanger explained, the essence of a horse was
not identical with an individual entity or a natural class of objects but was
the ideality that inhered in a particular exemplar. The grasp of the essence
of an individual object or an idealized object, in this case Marc’s horses,
demonstrated for Binswanger phenomenological seeing in the aesthetic
mode.64 In accessing this eidos or idea of a horse, Binswanger cited Marc’s
writings on the artistic process:
When I want to represent a cube [Kubus], I can represent it, as one is
taught, to draw a cigar package or something similar. With that I give
the object an outer form as it appears to me optically—the object,
nothing further—and I can do it poorly or well. I can also represent
the cube, not as I see it, but rather according to what the cube is, its
predicate. [“ÜP,” 3:51]65
To Marc, this was also a way of getting at the nature of an object; as he
wrote in 1912, “we no longer will paint the forest or the horse, as it appears
to us, or pleases us, rather as they really are, as the forest or the horse feels
62. Husserl had travelled to Reichenau for relaxation and to visit Alfred Schwenninger,
assistant at the Psychiatrische Landesanstalt near Reichenau, Konstanz. Schwenninger had also
been a student of Lipps and was among the Munich group that went to study with Husserl in
Göttingen in 1905; see Schuhmann, Husserl-Chronik, Denk- und Lebensweg Edmund Husserls (The
Hague, 1977), pp. 271, 89. In a letter to a colleague (27 Aug. 1923, UAT 443/26), Binswanger reported
that Husserl had visited the Bellevue asylum with Schwenninger, and Binswanger enjoyed a very
animated afternoon.
63. Binswanger also discussed the intuition of essences in geometry, for example in the
perception of a triangle, but this section was rather brief in comparison to his discussion of artistic
forms. Binswanger stated that he wanted to use geometic examples to remedy what he thought
could be the misperception of phenomenology as an artistic process; see “ÜP,” 3:51.
64. Binswanger warned against characterizing this essence as simply an ideal form in a Kantian
sense or as possessing real existence, as it could not be explained by the ideal-real epistemological
opposition; see “ÜP,” 3:40.
65. The source that Binswanger cites throughout his lecture is Marc, Briefe, Aufzeichnungen,
und Aphorismen (Berlin, 1920), p. 122.
f i g u r e 2. Franz Marc, Die grossen blauen Pferde, 1911. From Claud Pese, Franz Marc Leben und Werk (Stuttgart, 1989), plate 68.
itself, their absolute nature [Wesen], that stands behind the appearance that
we see.”66 With regard to his painted horses, Marc declared that “the ob-
server should not be able to ask about the ‘type of horse’ but should feel
instead the inner, pulsing life of the animal.”67 This elevation of feeling on
the part of both artist and observer was to Marc and Wassily Kandinsky,
cofounder of the Blaue Reiter group in Munich in 1911, the means to achieve
the proper understanding of the object to be painted.68 For Kandinsky, the
artist was to give free rein to his feelings, and this feeling would pave the
way towards creating a properly spiritual art.69 The artist’s feeling could di-
rect him or her to the most spiritual and objective of truths, truths that
resided in the inner necessity or inner form of an external shape. This inner
form could be more accessible in abstract or nonrepresentational art, ac-
cording to Kandinsky, because the superficial assumptions of the natural or
the obstacles of conventional beauty were bypassed for deeper realities. For
the loosely bonded Blaue Reiter movement, then, it was the task of the artist
to paint these inner forms and the duty of the observer to perceive such
inner forms through the sensual materials. This necessitated a special re-
lationship or proper “vibration” between the observer and the work of art,
dependent on the quality of the work and on the spiritual or mental attitude
(Geisteshaltung) of the viewer.70 For Binswanger, expressionist art offered a
powerful example of the inherent ability to move beyond the perception of
mere sensations to the level where one could perceive “essences.” This abil-
ity could best be described as the gift of intuition, or as Binswanger quoted
Marc, “each thing in the world has its form, its formula, that we don’t invent,
that we can’t touch with our crude [plumpen] hands, rather that we intui-
tively [intuitiv] grasp to the degree that we are artistically gifted” (quoted
66. Marc, Briefe, Aufzeichnungen, und Aphorismen, p. 123.
67. Marc, letter to Piper, 20 Apr. 1910, in German Expressionism: Documents from the End of the
Wilhelmine Empire to the Rise of National Socialism, ed. Rose-Carol Washton Long (New York,
1993), p. 48.
68. It is generally accepted that German expressionism was not a unitary movement; Die
Brücke, led by Ernst Ludwig Kirchner in Dresden in 1905 is associated with the more conventional
understanding of expressionism as a form of personal expression. In contrast, the Blaue Reiter,
centered in Munich, was more interested in advancing a philosophy of art that tended towards
spiritual and universal themes. Tayfun Belgin calls the Blaue Reiter group practitioners of an
“expressive-spiritual” art and uses expressionism to describe the deformed, erotic human images of
Die Brücke; see Tayfun Belgin, “‘Expressionistisch’ oder ‘expressiv’? Die Kunst der ‘Brücke’ und
des ‘Blauen Reiter,’” in Von der Brücke zum Blauen Reiter: Farbe, Form, und Ausdruck in der
deutschen Kunst von 1905 bis 1914, ed. Belgin (Heidelberg, 1996), pp. 10–23. See also Roland März,
“German Romanticism and Expressionist Utopia,” in German Expressionism: Art and Society, ed.
Stephanie Barron and Wolf-Dieter Dube (New York, 1997), p. 64.
69. See Kandinsky, Über das Geistige in der Kunst (1912; Bern, 1973), p. 34.
70. Kandinsky, “Über Bühnenkomposition,” in Der Blaue Reiter, p. 192. See also Marion
Ackermann, “Kandinsky und der ideale Betrachter,” in Der Blaue Reiter: Kunsthalle Bremen 25.
Marz bis 12. Juni 2000, ed. Christine Hopfengart (Cologne, 2000), p. 35.
in “ÜP,” 3:51). Only those with the artistic ability or the capacity to intuit
could perceive the essences inhering in the object itself. Binswanger claimed
that Marc had mirrored the impulses of scholarly phenomenology in seek-
ing what was generally valid, as opposed to the personal, in his art. He had
done so, however, without knowledge of this discipline, but from the depths
of his own artistic personality (see “ÜP,” 3:51).
In his eclectic merging of ideas from aesthetic and phenomenological
sources, Binswanger went on to argue that the aesthetic perception of inner
form could best be explained according to Husserl’s concept of categorial
intuition (kategoriale Anschauung), by which one could directly access non-
sensuous contents of objects, including numbers, aggregates, totalities, and
states of affairs (Sachverhalte). Categorial intuition was a kind of supersen-
suous perception of ideal objects, which was not a symbolic process but a
direct perception or intuition. Husserl explained, “sensuous or real objects
can in fact be characterized as objects of the lowest level of possible intuition,
categorial or ideal objects as objects of higher levels.”71 Binswanger asserted
that Husserl’s categorial intuition could better account for perceptions pre-
viously explained on the basis of association, synesthesia, or vague feelings.
For instance, Van Gogh had reported that his painting of a wind-whipped
tree was similar to a human drama; likewise, his depiction of young corn
in a field touched him as something ineffably pure and gentle that he could
also perceive in a sleeping child (see “ÜP,” 3:94).72 As Binswanger explained,
the phenomenon of embattlement was common to the representation of
the tree and to a human drama, and, similarly, the phenomenon of the pure
and gentle linked the painting of the young corn and the sleeping child. Both
were examples of categorial intuition. These phenomena were “seen” by
Van Gogh in a direct way, and, although based in sensory experience, went
beyond them. Binswanger accorded this awareness or knowledge (Kennt-
nisnahme) a power of persuasion that could be more definitive than that
afforded by sensory perception; one only needed the “organ” with the men-
tal (geistiges) ability to perceive it (“ÜP,” 3:37).
71. Husserl, The Shorter Logical Investigations, trans. J. N. Findlay, ed. Dermot Moran (London,
2001), p. 350. For a brief description of Husserl’s use of categorial intuition, see Spiegelberg, The
Phenomenological Movement: A Historical Introduction (Dordrecht, 1994), pp. 104–5, and Moran,
Introduction to Phenomenology (London, 2000), pp. 118–21.
72. Binswanger was citing examples from Van Gogh’s letters to his brother. The reference can
be found in a November 1882 letter to Theo, where Van Gogh wrote,
Sometimes I have such a longing to make landscape, just as I crave a long walk to refresh
myself, and in all nature, for instance in trees, I see expression and soul as it were. A row of
pollarded willows sometimes resembles a procession of almshouse men. Young corn has
something inexpressibly pure and tender about it which awakens the same emotion as the
expression of a sleeping baby for instance. [Vincent Van Gogh, The Letters of Vincent Van Gogh
to His Brother 1872–1886, 2 vols. (London, 1927), 2:12]
Binswanger’s audience was receptive to these aesthetic digressions; the
psychiatrist Christoffel expressed an interest in Kandinsky’s work On the
Spiritual in Art and was in accord with the view that phenomenology could
be a way to access both patient complexes and artistic creations. He had
already reported on patients’ experiences of color and form in an earlier
session of the society.73 Another respondent thought the delineation of
inner experience was the critical task and that the term phenomenology
should be altered to reflect this exclusive attention to inner reality.74
Binswanger’s discussion of aesthetics in this lecture formed the back-
ground for his demonstration of how to employ essential intuition in the
case of a schizophrenic patient who heard voices. Binswanger’s analysistook
as its point of departure the actual utterance of a patient: “No, I don’t hear
voices, but at night lecture halls are opened, which I would gladly dispense
with” (“ÜP,” 3:55). Binswanger explained that rather than pulling out con-
cepts, the phenomenologist was to settle into (einleben), immerse, or trans-
fer himself into the meanings of the words in order to clearly intuit the
experiences expressed by the utterances. Understanding the experience of
the speaking hall in its phenomenologically unique essence was a process
of moving from individual, empirical facts to the formation of ever clearer
and purer essences (see “ÜP,” 3:43). Even as he described the intuiting of
an essence as similar to an aesthetic perception, Binswanger stressed that it
was a scientific process that was to be performed in steps or stages. It was
not to be confused with a mystical or metaphysical flash of insight, nor was
it wholly dependent on an individual observer. As a systematic process, it
could be overseen and monitored by others.
When it came to identifying the essence of the speaking hall experience,
however, Binswanger only came up with a few remarks that suggested that
the phenomenon of speaking at a distance from oneself could be likened to
other schizophrenic experiences of being simultaneously present and ab-
sent. In addition, he did not invoke Husserl’s important phenomenological
concept of free variation or of attempting to view the object with a number
of different intuitive acts from which one could cull out the essence.75 In
Binswanger’s truncated account of this process, he did acknowledge that he
73. See Christoffel, “Affektivität und Farben,” in “Schweizerischer Verein für Psychiatrie
Protokoll der 62. Versammlung, Samstag den 24. und Sonntag den 25. Juni 1922 in Basel,” in
Schweizer Archiv für Neurologie und Psychiatrie 12 (1923): 158.
74. K. Graeter suggested a number of alternate terms including Enthymiologie, Esoterologie,
Endo-gnosis, and Endo-phaenomenologie; see Minkowski, “Diskussion zur Phaenomenologie,”
p. 335.
75. For Husserl, the essence of a physical object could be given one-sidedly or many-sidedly
in a sequence of perceptions, but never all-sidedly; see Husserl, Ideas Pertaining to a Pure
Phenomenology and to a Phenomenological Philosophy, §3, p. 8. In the Cartesian Meditations,
Husserl explicitly made use of the notion of free variation; see §34, p. 71.
had not made sufficiently clear the phenomenological essence of what he
understood to be a characteristically schizophrenic experience of a long-
distance connection (Fernverbindung) (see “ÜP,” 3:58).76
Binswanger’s selective use of Husserl’s Wesensschau demonstrates that he
was less able to ascertain the essence of schizophrenia than to elucidate the
meaning of the lecture hall experience for the individual patient at hand.
Binswanger invoked another Husserlian concept, the Kundgabe, to perform
this task. Binswanger argued that the patient’s utterances could be under-
stood according to their declarative or intimating function (Kundgabe), in
short, as expressions of the patient’s inner state. Binswanger had acquired
this concept from Husserl’s first volume of Logical Investigations, on ex-
pression and meaning. In general, intimation meant that along with the
meaningful content of an expression came the appreciation that there was
an experiencing being uttering such an expression. As Husserl put it, “it
consists simply in the fact that the hearer intuitively takes the speaker to be
a person who is expressing this or that, or as we certainly can say, perceives
him as such.”77 Binswanger took this to mean that the person declared or
expressed him or herself in an utterance and, conversely, through an utter-
ance one could see into the person (see “ÜP,” 3:58). The understanding of
an individual symptom, in this case the hallucination, was therefore a win-
dow onto the totality of the person for whom this symptom made sense.
Binswanger claimed that when he immersed himself in the patient’s lec-
ture hall experience, he perceived a person who had to continuously strug-
gle with dark, spiritual powers and who lived in an entirely different
psychological sphere than most others. The patient’s experience of the lec-
ture hall was his settlement of accounts with his earlier life, where he was
constantly turning over problems with a certain urgency. In fact, it was a
battlefield and marked a contrast to his earlier life, with its lack of serious-
ness and responsibility. The lecture hall was the exemplification of the pa-
tient’s personal Weltanschauung, through which Binswanger intuited an
ethically transformed person. Indeed, the understanding of this patient’s
76. Later in his lecture, Binswanger did venture a description of the phenomenological essence
or core of autism, which he identified as an altered attitude toward values. This essence stood as a
corrective to the generally accepted view of autism as a rejection of outer reality and a focus on the
inner world. Binswanger based these conclusions on evidence from a patient along with work
done by Gruhle and Jaspers; see “ÜP,” 3:63.
77. Husserl, Shorter Logical Investigations, p. 107. Kurt Danziger explains the origins of the
psychological concept of the Kundgabe in systematic experimental introspection with von Aster,
who used it as the expression of the overall quality of experience rather than the description of
parts of the experience; see E. von Aster, “Die psychologische Beobachtung und experimentelle
Untersuchung von Denkvorgängen,” Zeitschrift für Psychologie 49 (1908): 56–107. As Danziger
explains it, the study of the Kundgabe focused on personality and was picked up in the work of
Kurt Lewin on motivated behavior and clinical existential psychology; see Kurt Danziger,
Constructing the Subject: Historical Origins of Psychological Research (Cambridge, 1990), p. 46.
utterance not as an example of hallucinatory thinking but as a declaration
of self made possible not merely a grasp of the person’s cognitive capacities
but his moral makeup as well. A psychology of the expressive utterance
viewed the person as a complex of different capacities and not merely as a
deficient cognitive being. Binswanger could thus assert that
the intimating function, or declaration [Kundgabe] in its fullest sense,
extends not only to linguistic-intellectual acts, but also to aesthetic,
ethical, and religious acts and experiences, in other words, the person
can give a declaration of himself not only from logical, but also from
aesthetic, ethical, and religious regions, he can in these various ways
represent, unfold, manifest, or objectify himself. [E, p. 271]
For Husserl, understanding (Verstehen) was predominantly a matter of
grasping meanings (Sinnverstehen), but for Binswanger it was a person in
his or her complexity who was to be understood. This was the task of the
phenomenological psychologist.
Conclusion
Binswanger’s inquiry into phenomenological philosophy encompassed
a host of methods including empathy, inner perception, essential intuition,
and the analysis of expressive utterances (see E, p. 264). In the end, however,
his syncretistic bent emphasized the common root of these methods rather
than their differences; they all relied on an intuition or direct perception of
the person and not on conceptual knowledge or forms of judgement. The
goal was the understanding of the person from the immediacy of the clinical
encounter, and this process
always presupposes intuition (presentative or representative); the
hearer apperceives the speaker intuitively as a person, who intimates
this and that, or he perceives (wahrnehmen) him as such, just as he
perceives the intimation itself. The understanding of the intimation
(Kundgabe) is simply not a conceptual knowledge of the intimation,
not a judgement of the manner of the statement. [E, p. 264]
A phenomenology of the mentally ill other was carried out through the
direct apprehension of the patient’s words and expressions as manifesta-
tions of his or her personhood.
Binswanger’s focus on the patient as a person was dependent on the role
of the psychiatrist as an empathic and perceptive being—in short, as a well-
honed epistemological instrument. Those with an intellectual/spiritual
(geistiges) grasp of the complexities of experience, mixed with a good dose
of artistic and ethical understanding, were equipped to practice this new
phenomenological psychiatry. This sort of psychiatrist embodied the qual-
ities of an elite, educated middle class (Bildungsbürger), who engaged in a
complex psychological understanding of the other, rather than merely cal-
culating results from physiological or associative tests. The psychiatrist was
to mine the resources of philosophy, ethics, and even aesthetics in order to
perceive and empathize with the patient as a suffering moral entity. The
schizophrenic’s hallucination was no longer a sign of cognitive disarray or
a product of a diverted libido but was now an expression of the patient’s
moral struggle. Binswanger’s epistemology of the clinic thus transformed a
medical language into an ethical one.
This ethical language was the currency of Binswanger’s new psycholog-
ical science, which claimed to do no less than grasp the essence of the person
(das Wesen der Person) (see “ÜP,” 3:58). This science cut across the domains
of the normal and the pathological, the neurotic and the psychotic, by tout-
ing a vision of the person as a unified moral entity, in possession of a co-
herent and comprehensible Weltanschauung. The category of person was at
once narrower than psychiatric nosology, as it dealt with the individual pa-
tient, and broader, for it could apply to the normal case. Binswanger’s em-
phasis on the individual patient in this period, however, resulted in only
scattered analyses of patient experience. In the 1930s, he recast the concern
with the person as perceived in the clinical encounter to an understanding
of different styles of existence. This existential anthropology resulted in a
typology of existential styles linked to conventional psychiatric illness cate-
gories such as mania and schizophrenia.78
Yet, whether Binswanger spoke of the person or, later, an existential style,
his ambitions were not restricted to understanding the psychotic patient or
a psychiatric disease, but extended to an epistemology of personhood in gen-
eral. His work was thus an attempt to forge a new discourse of the person
and existence that straddled the disparate disciplinary terrain of philosophy,
psychology, and psychiatry and therefore easily slips through the established
disciplinary boundaries of today’s academy. Perhaps one legacy of this tra-
dition of phenomenological psychiatry that remains to be further explored
is the way in which a young Michel Foucault embraced precisely the con-
founding of disciplinary divides that Binswanger’s work reflects and de-
mands: “To reject such an inquiry at first glance because it is neither
philosophy nor psychology, because one cannot define it as either science or
speculation, because it neither looks like positive knowledge nor provides the
content of a priori cognition, is to ignore the basic meaning of the project.”79
78. Binswanger’s studies of the manic flight of ideas were published in Binswanger, Über
Ideenflucht (Zurich, 1933), and his case studies of schizophrenia are collected in Binswanger,
Schizophrenie (Pfullingen, 1957).
79. Foucault, “Dream, Imagination, and Existence,” p. 32.

An Epistemology of The Clinic: Ludwing Binswanger's Phenomenology of The Other

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An Epistemology of the Clinic: Ludwig Binswanger’s Phenomenology of the Other

Author(s): Susan Lanzoni

Critical Inquiry 30 (Autumn 2003)

S u s a n L a n z o n i is an NSF postdoctoral fellow and research associate at the

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18. Schmitt’s term is methodologische Selbstbesinnung, a reﬂective period in which the

f i g u r e 1. Interior of Bellevue Sanatorium. From Sigmund Freud, Ludwig Binswanger: Briefwechsel

The Uses of Einfühlung

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Schelerian Inner Perception

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