BINSWANGER, LUDWIG (1881-1966)

Ludwig Binswanger, a Swiss psychiatrist, was born on April 5, 1881, in Kreuzlingen, Thurgau, Switzerland, where he died on February 7, 1966. In Kreuzlingen he was director of clinical psychiatry at Bellevue Sanatorium, an internationally renowned institution founded by his grandfather. Binswanger took over responsibilities in 1910 from his father, passing them on to his own son in 1956.

He spent his school years in Constance, Germany, and studied medicine in Lausanne, Heidelberg, and Zurich. In 1906 he obtained the position of assistant at the Burghölzli Psychiatric Clinic in Zurich, directed by Eugen Bleuler. In 1907 he defended his doctoral dissertation on association tests before Carl Gustav Jung.

Binswanger devoted his life to psychiatry and the search for new therapeutic treatments. His father had introduced a revolutionary method for running the clinic, according to which the "doctor's family will also assist in treating the patient." The entire institution became, in effect, an extended family presided over by a patriarch. Ludwig Binswanger was raised in a world where "the father's teachings were the absolute law." He developed an interest in psychoanalysis at the Burghölzli Clinic, where the medical staff included some of the leading psychoanalysts of the time (Karl Abraham, Max Eitingon, Franz Riklin, and Hermann Nunberg). Jung was the director. In 1907 he met with Freud ("his most important human experience") in the company of Jung. This led to other meetings and a thirty-year friendship, as shown by their lengthy correspondence. Although Freud had difficulties, recognized by Freud himself, in maintaining friendships with people who did not share his ideas, and although they had different attitudes toward fundamental aspects of psychoanalysis and its potential uses, they enjoyed an extended friendship. This friendship was based on an understanding of mutual expectations: Freud hoped to break down the wall separating official psychiatry and psychoanalysis, and Binswanger sought to fight for the acceptance of a new theory under Freud's paternal control.

Binswanger wrote nearly a hundred articles and books. He wrote reports of analyses ("Versuch einer Hysterie Analyse," 1909; "Analyse einer Hysterischen Phobie," 1911) and methodological criticisms of psychoanalysis like Die drei Grundelemente des wissenschaftlichen Denkens bei Freud (The three fundamental elements of Freud's scientific ideas; 1921). In Grundformen und Erkenntnis menschlichen Daseins (Fundamental forms and the recognition of human being-in-the-world; 1953), Binswanger attempted to define existential analysis as an empirical science involving an anthropological approach to the individual essence of being human.

Over the years Binswanger's contributions to psychoanalysis were marked by an increasing reserve, as shown in his introduction of psychoanalytic therapy as an element of institutional care. In 1907 his uncle, Otto Binswanger, a professor of psychiatry in Jena, presented him with a hysterical patient, Irma, for analysis, which he undertook on the basis of his reading alone. He treated a number of other patients who required institutional care, including some of Freud's patients. His beginner's enthusiasm was soon subject to setbacks as a result of his lack of rigor. He concluded, "Ten years of effort and disappointment have been the price to pay to be able to recognize that only a select number of our institutional patients can benefit from analysis."

Binswanger began to subject psychoanalysis to a methodological and critical analysis. He began by attacking the methodology of general psychology and then attempted an epistemological criticism of psychoanalysis itself. He made use of Edmund Husserl's phenomenology and the hermeneutics of Wilhelm Dilthey and Friedrich Schleiermacher. For him, the link between Freud's scientific method and clinical psychiatry is a shared reduction of human existence to a schema or system. In his new approach, human existence is necessarily human, and the task for existential analysis is to describe the fundamental orientations of that existence.

After Martin Heidegger's Being and Time, Binswanger underwent a second transition from phenomenology to phenomenological ontology and switched from a methodological approach to an anthropological approach. For Heidegger, Daseinanalytik (existential analysis of being in the world) consists in describing the structure of human existence as such. Binswanger's Daseinanalyse attempted to contrast the natural sciences, which treat the human being as a "system of organic functions," with a phenomenological methodology that attempted to explore humanity's subjective existence in its totality and that looked at the individual as a being present in the world, a being responsible for its own existence from within. To help the patient, the therapist engages with the patient's primal world and how the patient is present in the world. Mental illnesses are "modifications of the fundamental structure and structural bonds of the being-in-the-world as transcendence." Therapy does not consist in "an attempt, starting with the ego, to enable the organism to connect with another through language, but makes language itself its starting point."

Daseinanalyse, as practiced by Binswanger, Medard Boss, Henri F. Ellenberger, and Rollo May, maintained a distance from the theory and practice of Freudians. Freud himself acknowledged, "We are unable to establish a dialogue between us."

Ruth Menahem

See also: Hirschfeld, Elfriede; Phenomenology and psychoanalysis; Psychoanalytic epistemology; Schizophrenia; Switzerland (German-speaking).

Bibliography

Binswanger, Ludwig. (1920). Psycho-analysis and clinical psychiatry. International Journal of Psycho-Analysis, 1 (3), 357.

——. (1953). Grundformen und Erkenntnis menschlichen Daseins (2nd ed.). Zurich, Switzerland: Niehans.

——. (1957). Sigmund Freud: Reminiscences of a friendship (Norbert Guterman, Trans.). New York: Grune & Stratton. (Original work published 1955)

——. (1971). Introductionà l 'analyse existentielle (Jacqueline Verdeaux and Roland Kuhn, Trans.). Paris: Minuit.

Fédida, Pierre. (1986). Le contre-transfert en question. Psychanalyseà l 'Université, 11 (41), 19-30.

Freud, Sigmund, and Binswanger, Ludwig. (1992 [1908-1938]). The Freud-Binswanger Correspondence, 1908-1938 (Arnold J. Pomerans, Trans.). New York: Other Press, 2003.

Lantéri-Laura, Georges. (1963). La psychiatrie phénoménologique: Fondements philosophiques. Paris: Presses Universitaires de France.

BINSWANGER, LUDWIG
(1881–1966)

Ludwig Binswanger, the Swiss psychiatrist whose school of Daseinsanalyse, or existential analysis, is the most extensive attempt to relate the philosophies of Edmund Husserl and Martin Heidegger to the field of psychiatry, was born in Kreuzlingen, Thurgau, Switzerland, into a family line of eminent physicians and psychiatrists. After attending the universities of Lausanne, Heidelberg, and Zürich, he received his medical degree from Zürich in 1907. In 1910 he succeeded his father, Dr. Robert Binswanger, as chief medical director of the Sanitorium Bellevue, an institution founded by his grandfather at Kreuzlingen. He relinquished his directorship in 1956.

Daseinsanalyse is an original amalgam of phenomenology, Heideggerian existentialism, and psychoanalysis, the goal of which is to counter the tendency of scientific psychology to view man's being as solely that of a natural object. However, the school does not seek spheres of human existence that argue against the explanatory power of psychoanalysis. Binswanger complained of the overreductionism of natural science as applied to humankind, but in doing so he was not questioning science's ability to explain; he was, rather, urging that that which is being explained be kept in mind in its full phenomenal reality. Binswanger is a phenomenologist in that he demands a presuppositionless discipline in which the investigator can apprehend the world of the patient as it is experienced by the patient. To this end he limits his analysis to that which is actually present (or immanent) in the patient's consciousness. He seeks the essential structure of these phenomena without relying on reductive theory, his aim being to allow the phenomena to speak for themselves. As an existentialist he views the essential structures that the phenomena reveal on their own terms as "universals with power." That is, he sees them as the matrix within which the individual's world and self—his essence—are determined. He seeks in each patient a general context of meaning within which the patient exists. He calls this meaning-context the transcendental category of that patient's world design.

This notion of a general existential meaning-context must be understood as that which expresses with equal validity all aspects of the patient's life and world. The criterion of a complete expression is based on Heidegger's ontology of man and includes his orientation in space, his mode of being in time, his relation to his bodily life and to his fellow man, his way of thinking, and his fears and anxieties. For example, a universal such as continuity is equally understandable and expressive in reference to time (continuity of events versus the sudden and unexpected), space (contiguity), relationships with others (for example, oedipal ties or bonds), and the individual's own world ("inner" continuity, continuity of feelings or of affections). But such explanatory categories as aggression or libidinal energy emphasize one aspect of man's being as most real and are therefore rooted in a one-sided ontology of human existence.

What psychoanalysis takes as conditioning factors—such as instinct or childhood sensations—are regarded by Binswanger as already being representations of a basic world design. It is not that Binswanger wants to push back the causal chain beyond instincts or childhood sensations, but rather that the causal chain itself, as described in scientific depth analysis, must be viewed as a whole, without any a priori privileged reference point in terms of which all else is to be explained. Explanation in terms of a privileged reference point presupposes a theory, and a theory assumes a world outlook—in this case the world outlook of natural science. Binswanger does not, therefore, use the past to account for the present. He sees the past of a patient as existing in the present in that the entire world design—within which a particular event in the past "conditioned" a present neurosis—is the patient. Therefore, the present, or the conscious, or the manifest content of dreams and the manifest verbal expressions, all point to a unity or category(ies) that is the basis of the patient's world. In other words, because the self cannot experience a "pure" event outside of a meaning-context, even if the self be that of a child, it is that source meaning-context which Binswanger seeks to apprehend.

Binswanger does not offer his approach as a substitute for psychoanalysis; insofar as the goal of psychiatry is intervention in the patient's life—manipulation of or change in it—only a scientific approach, such as psychoanalysis or clinical psychiatry, is adequate. For Binswanger, phenomenology and reductive explanation are two complementary aspects of the Geisteswissenschaften, including psychology. Phenomenology can provide us with an essential description of the data, and phenomenological existentialism can provide a full dynamic understanding of the individual's life on his own terms. But if we are willing and find it necessary to transform and control phenomena, natural science is at present our major tool. However, whereas in the natural sciences we confer meanings, in the Geisteswissenschaften the phenomena under investigation are themselves meanings to a self, and it becomes necessary phenomenologically to receive these meanings on their own terms.

See also Heidegger, Martin; Husserl, Edmund.

Bibliography

principal works by binswanger

Wandlungen in der Auffassung und Deutung des Traumes von der Griechen bis zur Gegenwart (Changes in understanding and interpretation of the dream from the Greeks to the present). Berlin: Springer, 1928.

Über Ideenflucht (On the flight of ideas). Zürich, 1933.

Einführung in die Probleme der allgemeinen Psychologie (Introduction to the problems of general psychology). Berlin, 1942.

Grundformen und Erkenntnis menschlichen Daseins (Basic forms and cognition of human existence). Zürich: Niehans, 1942; 2d rev. ed., Zürich, 1953.

Ausgewählte Vorträge und Aufsätze (Selected lectures and essays). 2 vols. Bern: Francke, 1947–1955.

Drei Formen Missglückten Daseins (Three forms of unsuccessful dasein). Tübingen: Niemeyer, 1956.

Schizophrenie. Pfullingen, 1957. Contains Binswanger's well-known clinical studies of Ilse, Ellen West, Jürg Zünd, Lola Voss, and Suzanne Urban.

Melancholie und Manie. Pfullingen: Neske, 1960.

Traum und Existenz (with an introduction by M. Foucault). Bern: Gachnang & Springer Verlag, 1992.

Ausgewählte Werke in vier Bänden. Heidelberg: R. Asanger Verlag, 2004.

english translations

May, Rollo, Ernest Angel, and Henri F. Ellenberger, eds. Existence. New York: Basic, 1958. This and the following work contain some of Binswanger's works in translation.

Needleman, Jacob. Being-in-the-World. New York: Basic, 1963.

works on binswanger

Keen, E. A Primer in Phenomenological Psychology. New York: Holt, Reinhart & Winston, 1975.

Needleman, Jacob. Being-in-the-World. New York: Basic, 1963. A philosophical critique of Sigmund Freud and Binswanger, taking account of the background of Immanuel Kant and Heidegger.

Sonnemann, Ulrich. Existence and Therapy. New York: Grune and Stratton, 1954. Brilliant and unreadable.

Speigelberg, H. Phenomenology in Psychology and Psychiatry. Evanston: Northwestern University Press, 1992.

Van Den Berg, J. H. The Phenomenological Approach to Psychiatry. Springfield, IL: Thomas, 1955. Simple and clear.

Jacob Needleman (1967)

Bibliography updated by Thomas Nenon (2005)