The Psychopathology of K. Jaspers and K. Schneider as a Fundamental Method for Psychiatry

Abstract

Summary: The paper is intended to answer the question whether and to what extent the psychopathology in the direction of Karl Jaspers and Kurt Schneider is still meaningful for contemporary psychiatry. K. Schneider developed gradually his “Clinical Psychopathology”, proceeding from Jaspers' 4th edition of the “General Psychopathology” (1946). The Jaspersian-Schneiderian approach, aiming more at the elucidation of the patient's own inner experiences than at the observation of behaviour, has overcome the overly objectifying psychiatry of Kraepelin. The history and bearing of Jaspersian-Schneiderian psychopathology on psychiatry, its tenets, positions and concepts, as well as findings and results obtained with the approach are outlined. Recent developments in psychiatry, underestimating or even neglecting the psychopathological approach, are in danger of resulting in a loss of psychopathological competence in research and practice. The essay shows that this psychopathology is far from over, but remains relevant for clinical and biological psychiatry and should lead now, as ever, all other special and basic sciences in psychiatry. The critical methodological reflection and the fundamental psychopathological framework, created by Jaspers and modified and adapted to the requirements of clinical psychiatry by K. Schneider, are also today practically useful and heuristically fruitful. That we need psychopathology for diagnostics, therapy and primary and secondary prevention of schizophrenic psychoses, and also for biological psychiatric research, has been demonstrated by means of a long string of contributions of the last decades. The Jaspersian-Schneiderian approach does not mean definite conclusion and codification, but leaves enough room for new developments, completing, correcting and changing many aspects of classical and present psychiatric views. It ensues that the view of European psychiatrists that we need psychopathology, according to the axiom: “First things first” (Gross and Huber 1993a, 2000a), and the call of Andreasen (Andreasen 1998) for a serious investment in training a new generation of psychiatrists in psychopathology, seem to be well founded and entirely justified.