Epistemology of Psychopathology

Pierre Fédida and Daniel Widlöcher, who were the editors of the Revue Internationale de Psychopathologie, in the famous preface of the journal’s 1990 inauguration issue, presented the epistemological challenge that is constitutive of psychopathology as a field of knowledge on psychic suffering: “Situated at a crossroad of multiple epistemological and methodological perspectives, psychopathology constitutes a heterogeneous discipline from the point of view of the definition of its object of study, as well as its theoretical-practical approaches” (Fédida & Widlöcher, 1990, pp. 3-4). In fact, the heterogeneity of perspectives and the constant effort toward formal delimitation of its object constitute the founding and irreducible complexity of psychopathology and, in a certain way, the raw material for its rationality efforts.

Such a problem was explicitly expressed in Allgemeine Psychopathologie by Karl Jaspers. In his first pages, the great German psychiatrist-philosopher states: “In Psychopathology, there is a series of manners for consideration, a set of parallel pathways, which are, in themselves, legitimate, and which compete and do not detract from one another. My efforts aim at distinguishing, sharply separating pathways and at exposing the multidimensionality of Psychopathology” (Jaspers, 1913/1979, p. 8). The “generality” sought in his Treatise referred to the multiplicity of methods in psychopathology assigned to appropriately examine the different dimensions of the morbid phenomena of mental life, as well as, to the necessary ethical and propaedeutic care of the discipline in not giving in to the temptation of going through methodological reductionisms that are indispensable to each science, to an unacceptable explicative reductionism of the suffering peculiar to the psychic life.

Jaspers’ contemporaneousness arises mainly from promoting a critical attitude that would be constitutive of any psychopathological project. Besides the cited anti-reductionism, expressed in the refusal of a psychopathology without a psyche, he defends a stance that is perspectivist (refusal of a project of totality), anti-dogmatic, with a fully methodological conscience (“... fact and method intimately dependent on one another. We only have the fact through the method”) (Jaspers, 1913/1979, p. 59), and lastly empiricist (focused on the actual, concrete experience), with an important disclaimer that it is an empiricism that does not ignore its assumptions and limits.

In this context, two fundamental aspects of the psychopathological tradition become clearer. On the one hand, the Jasperian methodological distinction, inspired by Dilthey, between understanding a mental phenomenon (verstehen) and explaining it (erklären) corresponds to the epistemological respect to the rationality plan proper to each different aspect of the object of study of psychopathology. Here we may situate the efforts of Kurt Schneider (1948/1976), or equally those of Roland Kuhn (1991), into establishing a strict definition of the scope of phenomena susceptible to a psychopathological approach from the perspective of natural sciences, in such a way as to assure the irreducibility of human suffering to scientific explanation.

On the other hand, there is the endeavor to constitute a philosophical anthropology capable of situating the psychopathological phenomena in their proper human specificity. Here, the methodological and epistemological precautions need to be intensified, in such a way as to avoid the risks of a metaphysical objectivity of what would be an ideal completely fulfilled human existence (the Greek “eudemonia”) or, in a correlative manner, of an imaginary formalization of the specifically linguistic-symbolic dimension of human pathos. It is thus, for example, that Heidegger in his Zollikon Seminars, addressed to physicians and psychiatrists, began exactly by this explicit warning, seeking to assure ethically and methodically the dimensions of openness and incompleteness of existence, in the efforts of theorizing human suffering through psychopathology:

human existence in its essential ground is never only an object present in a random place, and, much less, a self-enclosed object. Contrary to that, that existence consists of the “mere” possibilities of apprehension that are directed to what is delivered to it in a meeting, and that cannot be conceived by sight or by touch. All the objectifying capsular representations of the psyche, a subject, a person, an I, a conscience, used until the present moment in psychology and psychopathology, must disappear... (Heidegger, 2009, p. 33)

Thus, the constitution of a philosophical anthropology or the preparation of a conceptual epistemological reference for appropriately settling the specifically human dimension of a psychopathological happening are grounded precisely on the challenge of escaping all manners of objectifying moral representation of psychic suffering in the encounter of psychopathology with the impasses of the subject (Pereira, 2014 and Pereira, 2019, in the section “Epistemology of Psychopathology”, in this issue of the Journal).

Thus, we have found some of the fundamental tensions, constitutive of the psychopathological field (Banzato & Pereira, 2014): the irreducibility of human pathos to the natural plan of nosology or to a systematizing diagnostic register; the insolubility of the singular suffering in the general descriptions of the pathological phenomenon, as targeted by science. And it is also like that that the category of “subject,” now reread in a manner to give an ethical and epistemological account of the specificity of human suffering, may be thought of as both a reference and an insurmountable challenge for contemporary psychopathology (Costa, Bezerra Jr. & Gama, 2019).

The section on the “Epistemology of Psychopathology” in the Revista Latinoamericana de Psicopatologia Fundamental (Latin American Journal of Fundamental Psychopathology), beginning in this issue, is focused on these founding marks of rationality in the psychopathological field. It is constituted as a space for presenting original and stimulating contributions that provoke the amplification of the horizons constitutive of this discipline: the complexity of its object of study, its concepts and values (explicit or not, perceived or inadvertent), the heterogeneity of methodological approaches, the irreducibility of human suffering to the discourses of all-encompassing pretention. These are the broad but precise parameters that the section offers to the readers of the Journal, inviting everyone to engage effectively in further developing our debates.

Referências

• Banzato, C. E. M., & Pereira, M. E. C. (2014). O lugar do diagnóstico na clínica psiquiátrica. In R. Zorzanelli, B. Bezerra Jr., J. F. Costa (Orgs.), A criação de diagnósticos na psiquiatria contemporânea (pp. 35-54). Rio de Janeiro, RJ: Garamond.
• Costa, J. F., Bezerra Jr., B., & Gama, J.A. de (2019). The Subject of Psychopathology: Of What Plural is it Made? Philosophy, Psychiatry, & Psychology, 26(2), 89-97. [Special issue: Brazilian Philosophy of Psychiatry, Guest Editors: Claudio Banzato & Guilherme Peres Messas. Johns Hopkins University Press.]
• Fédida, P., & Widlöcher, D. (1990). Présentation. Revue Internationale de Psychopathologie, 1, pp. 3-4.
• Heidegger M. (2009). Seminários de Zollikon (2ª ed. rev.). Petrópolis, RJ: Vozes; Bragança Paulista: Editora Universitária São Francisco.
• Jaspers, K. (1979). Psicopatologia Geral Rio de Janeiro, RJ: Atheneu.(Trabalho original publicado em 1913).
• Kuhn, R (1991). Existence et psychiatrie. In P. Fédida, & J. Schotte. Psychiatrie et existence Grenoble, França: Millon.
• Pereira, M. E. C. (2014). A crise da psiquiatria centrada no diagnóstico e o futuro da clínica psiquiátrica: psicopatologia, antropologia médica e o sujeito da psicanálise. Physis: Revista de Saúde Coletiva, 24(4), 1035-1052.
• Pereira, M. E. C. (2019, dez.). Projeto de uma (psico)patologia do sujeito. Revista Latinoamericana de Psicopatologia Fundamental, 22(4), 828-858.
• Schneider, K. (1976). Psicopatologia clínica São Paulo, SP: Mestre Jou. (Trabalho original publicado em 1948).

Edited by

Editoras/Editors: Profa. Dra. Ana Maria Galdini R. Oda e Profa. Dra. Sonia Leite

Publication Dates

• Publication in this collection
  17 Jan 2020
• Date of issue
  Oct-Dec 2019

History

• Received
  30 Oct 2019
• Accepted
  31 Oct 2019