2. The history and principles of Daseinsanalysis
At the beginning of the 20th century, several thinkers dared to express their fear that the power of natural science would overshadow and even crush the fundamental dimension of psychotherapy, which is grounded in the question “Who is a human being?”MartinHeidegger’s Daseinsanalytik laid the groundwork in his Sein und ZeitI(Being and Time) (1927). The Analytik of Da-sein (as the there of being) has the task of showing that the world is not merelythe totality of all objects facing an ego or subject, an idea posited by Cartesian thought that is fundamental for the natural sciences. Heidegger showed that the world is not accessible without a human being’s prior relatedness to it. Human Da-sein is that being-present openness to the world as always already related to the world, situated in it in such a way that it always refers to the world in carrying out any action. It follows that the human being is bodily (leiblich) present and situated in his or her world.
Heidegger’s Daseinsanalytik lives on in the thought and practice of clinicians as Daseinsanalyse thanks to the founder of Daseinsanalysis, Ludwig Binswanger (1881-1966), a psychiatrist, who using the phenomenological method carefully showed how the ideology of the natural sciences and the way of thinking based on it falls short of accounting for human experience and behavior, and misses the specific nature of human existing.
Medard Boss, a Swiss psychiatrist (1903-1990) who can be considered the first representative of Daseinsanalysisas a therapeutic method, always clearly distinguished Daseinsanalyse from the Daseinsanalytik (part of Heidegger’s fundamental ontology).It is important to repeatedly emphasize that Daseinsanalysis is not a direct application of Heideggerian concepts in the context of clinical activity. Daseinsanalysis searches for the meaning of the existence of each human being in his or her unique personal experience. The therapeutic scope of Daseinsanalysis is based on an understanding of how the phenomenon of human existence shows itself in its acceptance of what is as it is. Such understanding leads to an innovative kind of clinical activity. Boss edited Heidegger’s Zollikon Seminars which records study sessions for psychiatric physicians and medical students. The work is a milestone in the history and development of Daseinsanalysis.The seminars have as their initial question: What does it mean to exist? Other concepts discussed include empirical existence, reality, objectivity, extension as a property of space, what it means to occupy space, perception, the notion of material body (Körper), man’s body (Leib) and bodily phenomenon (Leibphänomen), and freedom.
GionCondrau (1919-2006) was the co-founder in 1971 and director of the Daseinsanalytic Institute for Psychotherapy and Psychosomatics. The institute later came to be known as the Zurich Daseinsanalytic School. Condrau was trained in psychiatry, neurology and philosophy. He became a Daseinsanalyst after his training analysis with Medard Boss and attended Martin Heidegger’s Zollikon seminars from 1959 to 1969. In his numerous publications Condrau focused on the implementation of Heidegger’s thinking in clinical and psychotherapeutic work, and developed a Daseinsanalytic theory of neurosis and psychosomatics based on the principles of phenomenology. In 1990, Condrau and the Zurich group founded the International Federation of Daseinsanalytic Psychotherapy (IFDA).
Alice Holzhey developed a new Daseinsanalytic approach to psychic suffering that is also based on Heidegger’s existential anthropology in Sein und Zeit but includes important insights of Kierkegaard and Sartre. This version of Daseinsanalysis is based on psychoanalysis but gives the crucial discoveries of Sigmund Freud an existential meaning. It approaches psychopathology by way of an existential hermeneutic that discloseshuman beings as a “suffering from our own being.” Dream interpretation is also approached in a hermeneutic way.
Theory and Method
Daseinsanalysis may be understood as a form of psychoanalysis that takes a phenomenologico-hermeneutical approach and has an ontologico-anthropological orientation. It goes beyond the scientific model of psychoanalysis that is limited to objectifications of human existence. Its basic stance demands utmost respect for the phenomena themselves(a phenomenon understood as what shows itself in itself as what reveals itself to us).
Guided by the phenomenological insight of Edmund Husserl that whatever “is” will show itself in and of itself, Daseinsanalysisfocuses on phenomena as the foundation of meaning in human life. These are revealed in the factical carrying through of a patient’s being-in-the-world as it comes into focus. The supporting foundation and core of Daseinsanalytic therapy is the other human being (Da-sein) in his or her relationship to the therapist. From the very beginning, the Daseinsanalyst and Daseinsanalysand are involved in a primordial, fellow-human relationship in which each of the two contributes his or her share. Both are implicated in a happening that determines the development of their mutual relationship, leads the Daseinsanalysand to autonomy, and showing the Daseinsanalysandhis or her place in the world.
The point of departure of a Daseinsanalytic understanding of human suffering is the existence of the human being. Existence does not denotemerely being-at-hand as a sentient being (object) but rather to the particular way of being of humans as world-related Da-sein.
Moods are forms of attunement that immediately disclose a relationship to the world, often by one’s turning away from authentic being-himself or being-herself. For example, in anxiety (one of the basic forms of attunement), the possibility of no longer being able to be shows itself as a fear of non-being(nothingness) and fear for one’s own existence.
Dreams are an important area of therapeutic exploration in Daseinsanalysis. Unlike psychoanalysis, Daseinsanalysis does not require reinterpretation of a dream by assuming a wish at its base. The dream is taken as it shows itself as part of one’s being-in-the-world. Daseinsanalysts do not differentiate manifest dream content from so-called latent ideas.
In its method, Daseinsanalysis tries to correspond to each instance of human Da-sein. Following the insights of Heidegger, Daseinsanalysis sees the existence of the human being as an area of openness of Da-sein towards everything it encounters. Daseinsanalysis understands the being of human Da-sein in the manifold ways of its presence as openness to the world. Such presence comprehends openness for things absent as well as things present, to both what is past and what is future that taken together comprise the full temporal scope of human beings. In Daseinsanalysis, it is a matter of freeing the person from any impairment of this openness, that is, of his truth as unconcealment (Unverborgenheit) of being. This is liberating for being-oneself in being-with and being-for oneanother.
Given its basic understanding of human being, Daseinsanalysis is well suited for treating all forms of mental and psychosomatic suffering, provided the client is motivated, ready, and able to cope with his or her own existence and its conflicts.
Developmental that disturbances have prevented the complete fulfillment of the possibilities of relating that could be available to the patient manifest themselves in neurotic, psychosomatic, and psychotic disturbances. The Daseinsanalysand has the task of letting himself or herself into the “space” of a relationship that arises in order to mature further in thetherapeutic relationship.The goal of Daseinsanalytic therapy is for the person to be able to remain open in an optimal way for his world, enabling free, self-accountable existing by uncovering his Da-sein and its dynamics. Basic concerns are his or her being or non-being, life and death, but also being-oneself as well as caring for both self and others, being openly being present from the other’s point of view (being-with), and being open to the environment (Umwelt), that is,everything non-human, both animate and inanimate he encounters.
Daseinsanalytical psychotherapy understands mental and psychosomatic suffering as ways of restricted and unfree existing with regard to the environment and alsothe Mitwelt (the world with others). For Daseinsanalysis, mental symptoms have meaning, the illumination of which leads the patient to himself and to the reason of his suffering.
It is the task of the Daseinsanalytic therapist:
• to obtain insight into the lived and corporeal ways of bearing the possibilities of being (existentialia) given to each person that are constitutive for his or her existence; and
• to correspond to the developing relatedness to the Daseinsanalysand in his serenity (Gelassenheit).
At this time in the history of psychotherapy, the Daseinsanalytic approach offers the most generous approach to human existence, one that is not limited to the natural scientific attitude that has dominated the field since its inception.
Daseinsanalysis is practiced in several countries in the world. Each of them has a national association that manages the training and the supervision of practitioners. An international federation (IFDA), which is affiliated with the European Association of Psychotherapy, oversees the national associations. The purpose of the Federation is to clarify and maintain the unique features of Daseinsanalysis, to promote the creation of national associations and provide them with essential guidelines of practice, to further teaching and research in the areas of Daseinsanalytic phenomenology, anthropology, and Daseinsanalytical therapy, to organize seminars, presentations, courses, and conventions, to support scientific publications and reviews of books of Daseinsanalytic orientation, and to establish contacts with other schools of psychotherapy and philosophy.
3.Daseinsanalytic PsychotherapyBy Pr. Dr. Gion Condrau
Daseinsanalysis owes its origin and development to the spiritual renewal in the wake of the two world wars. In the realm of psychiatry, a movement began in the twenties which was partly triggered by the discussions around Freudian psychoanalysis, partly by a scientific unease with regard to the traditional, systematizing, clinical psychopathology, and which was searching for a new understanding of the basics of human existence and its disturbances. The one-sided, natural-scientific orientation of psychiatry and psychotherapy, in particular, was the subject of heated criticism. This gave rise to the so-called “anthropological” psychiatry, initiated by renowned researchers such as Ludwig Binswanger, Viktor von Weizsäcker, Viktor von Gebsattel, Eugene Minkowski, Erwin Straus, Rollo May, R.D. Laing, and others.
Ludwig Binswanger (1881-1966) is considered the actual initiator of daseinsanalytical psychiatry. In the beginning, however, subsequent to his intense studies of Husserl’s phenomenology, he called his research orientation “phenomenological anthropology.” From 1941 onwards, he preferred “Daseinsanalysis” for his new scientific approach. At that time, Binswanger had already been decidedly influenced by Martin Heidegger’s work, especially by the latter’s book “Being and Time,” published in 1927. Ludwig Binswanger’s main oeuvre “Grundformen und Erkenntnis menschlichen Daseins” (basic forms and perception of human Dasein) was published in 1942. This was followed by a whole series of publications on Daseinsanalysis, the language and behavior of schizophrenics as well as studies on melancholy and mania. It has to be mentioned that Binswanger was also influenced by Sigmund Freud with whom he maintained a life-long friendship, even though he disagreed with the main issues of psychoanalytical theory.
After World War II, a School of Daseinsanalysis that differed from Binswanger evolved in Zurich. Its primary concern was the practical application of Heidegger’s phenomenology to the theory of neuroses and psychotherapy. Medard Boss (1903-1990) had managed to interest Heidegger personally for the concerns of psychotherapists, and to make him participate in the corresponding training program. To begin with, this led to a discussion and critique of the metapsychology of Freudian psychoanalysis and C.G. Jung’s analytical psychology. While Boss, in his first daseinsanalytical publications was clearly under the influence of Ludwig Binswanger, he quite abruptly distanced himself from the latter. In 1957, after a conference in Madrid, Boss published a decisive critique of Freud, Jung, and Binswanger which, unfortunately led to a split between the two scientists. Binswanger felt betrayed by Boss as well as by Heidegger, and from then on referred more to Husserl, while Boss was sponsored by Heidegger, with whom he developed a personal and scientific friendship. While Binswanger overtly refused to institutionalize his “psychiatric Daseinsanalysis” and concentrated on basic research (rather than on psychotherapeutic values), Medard Boss, together with Gion Condrau, founded the Swiss Society for Daseinsanalysis in 1970 and the Zurich Institute for Daseinsanalytic Psychotherapy and Psychosomatics in 1971, later known as Medard Boss Foundation. From 1959 to 1968, Heidegger visited Boss in Zollikon where he held the famous, world-renowned “Zollikon Seminars.” In 1984 the Swiss Professional Federation for Daseinsanalysis has been founded in Zurich.
Consequently, Daseinsanalysis as psychotherapy is based on Martin Heidegger’s ontology and on his phenomenological view of the human being’s existence as the area of openness of Dasein to everything it encounters. This means that human Dasein is, on principle, open and free to perceive everything undistorted which discloses itself naturally from its meaning-content. In this aspect, phenomenology differs from the dualistic world view of natural sciences which ultimately are based on the philosophy of René Descartes according to which an aseinsanaly chasm exists between the human mind and measurable matter.
Such a view of the nature of human being necessarily leads to a new anthropology, i.e. a science detached from a purely natural-scientific reduction, but equally so from metapsychological speculations. Whereas biology can only grasp a partial aspect of human existence, metapsychology of the positivistic school – according to the daseinsanalytical view – relinquishes the ground of visible reality.
This has consequences for therapy. In a certain sense, Daseinsanalysis can be seen as a further development of psychoanalysis. The extemal setting has been kept more or less unchanged. There are, however, substantial differences concerning the interpretation of symptoms, aseinsa, and dreams. In those areas, Daseinsanalysis proceeds phenomenologically; it does without causal-genetic interpretations and, instead, inquires more intensely into the meaning and meaning-content of the observed phenomena. The concem of Daseinsanalysis is to see (sehen), not to explain (erklären). The importance and meaning of this “Seeing” becomes manifest in the theory of neuroses and psychosomatic diseases.
There is no doubt that Martin Heidegger’s thinking has influenced psychotherapeutic theory and practice to an extent that cannot be ignored (see Gion Condrau: Martin Heidegger’s Impact on Psychotherapy, New York, Vienna 1998). The Zurich school of Daseinsanalysis has explored many times the possibilities of translating the word “Dasein” into other languages, especially into French and English. We came to the conclusion that “Dasein” as such loses its intrinsic meaning by any attempt at translation. We therefore decided to keep the term “Daseinsanalysis” in order to differentiate it from the so-called existential, interpersonal, or humanistic psychotherapies since it refers uniquely to Martin Heidegger’s ontological analytic of Dasein. Of course, when we speak of theory and practice, we move on a scientific, not philosophical ground, but as Heidegger himself always maintained, and also repeatedly stated at the time of his seminars in Zollikon, every science has its roots in philosophical tenets. This is equally valid for the natural sciences, as for any other scientific approach, even if these roots are not specifically acknowledged or mentioned. Daseinsanalysis, according to its global view, tries to overcome the Cartesian dualism of subject and object, therefore also the dualism of psyche and soma. Insofar, we do not speak of psychogenetic or somatogenetic diseases, although for the sake of mutual understanding, Daseinsanalysis still keeps the term “psychosomatics.” The aseinsanalytic approach to human suffering is a phenomenological one. Phenomenology, as Heidegger defines it (unlike Edmund Husserl) is not a question of conscience but a question of insight which means that it refrains from interpretations and lets the phenomena speak for themselves. In this respect, of course, it differs from psychoanalytic or Jungian theories, although it has adopted some of the practical recommendations, especially from Freud.
Modern scientists, psychiatrists, psychologists, and doctors have mostly lost sight of the real importance of the obvious. They often overlook the richness of what can be immediately experienced, and concentrate on coming as soon as possible to an indirect, background-based, theoretical explanation of all they meet, thereby making their object of investigation calculable and thus also reproducible. In contrast to this is the phenomenological or existential analytical approach, which emphasizes a simple experience of the perceived phenomena. Lt dwells on the very matter to be explored, always trying to grasp its meaning more explicitly. It is thus in an excellent way ‘objective’ or real. The right to a special position in the field of psychiatry, psychology, psychotherapy, and psychosomatics derives from the fact that all these sciences principally have to do with the human being. Less than anything else can human being be dissolved into calculable quantities. The priority of the existential analytical scientific method in these areas has its further basis in the nature of the neurotic, psychosomatic and psychotic way of being ill. This, in its essence, is primarily not founded on countable quantities, as would be the case if natural sciences dealt with them. Lt can only be understood through insight in the incalculable qualities of the always different, disturbed, of key and unfree relationships, of the individual patient to the eventualities of his world. This, of course, does not exclude, but includes the fact that, by methods of natural science, data can be found in the existence of human beings both healthy and sick, which can be useful and somatically important. But by this method, one never finds the specifically human cause of being healthy and sick.
lt is obviously not correct – as occasionally is done – to put existential analysis as ‘philosophy’ in contrast to psychoanalysis as ‘science’. They both are sciences of the human being, both so-to-say ‘anthropologies;’ they both belong to psychiatry, psychology, and psychotherapy. This still is so in a time when the more narrow meanings of the medical terms ‘disease’ and ‘health’ have been expanded by the sociological point of view. Today, psychiatrists, psychologists, and psychotherapists are not satisfied with merely formulating theories. Increasingly, they ask about the sense and meaning of what is sick and has to be healed. To clear the relationship between body and soul, and to try to escape the blind alley of the dualistic way of looking upon life, they are forced to consult philosophers in order to perceive better the existence of the human being. Every attempt at explaining and acting of human beings, including the psychological and medical sciences, relies on presuppositions that are philosophical and pre-scientific.
By considering these philosophical presumptions, the quality of the practical work of the psychiatrist and the psychotherapist is established, because their work is certainly influenced by their way of understanding the world.