Gerd Huber and Gisela Gross: The Development of the Psychopathology in Germany in the Last Decades (20th century) with an Introduction by Carlos R. Hojaij

Hector Warnes’ comments

        I was overwhelmed by the contributions of dozens of outstanding psychiatrists who made an impact in the development of psychopathology on a phenomenological basis. In my mind, their contributions were based on minute clinical observations of similarities and differences of patients. I must say that I read half of them and I was invariably dazzled by their writings. Professor Hojaij attempted to classify the various types and basis of the phenomenological approach to psychiatry in his usual systematic and brilliant stance.

        In order to simplify the vast theoretical and clinical contributions of the great German masters I would classify their writings into those who were closer to philosophy, particularly the writings of Hegel, E. Husserl and Heidegger; those who were closer to clinical psychiatry, e.g., Kretschmer, Mayer-Gross, Beckmann and Weitbrecht; and those who attempted to faithfully elaborate Karl Jaspers and Kurt Schneider's original writings. I must say further that Mayer-Gross, Slater and Roth wrote an outstanding textbook of psychiatry in English, obviously benefiting from Mayer-Gross’ immigration to England. And I would add that my favourite textbook is the one written by Hans Jörg Weitbrecht (1973), Psychiatrie im Grundriss, which is richly illustrated and published in its third edition. It is the book which closely reflected my clinical praxis and, unfortunately as far as I know, it was not translated.

        I would agree that most brilliant writings on the phenomenological analysis of patients often lack specificity and could easily cross clinical boundaries.

        From this point of view I would add that the excellent writings on the psychopathology from a phenomenological perspective could be classified into those that were closer to the classical authors (eg Kraepelin, Wernicke, Kleist, Leonhard), those who stayed closer to a pure and minute phenomenological anthropological analysis and those who drifted into a hermeneutical approach.

        I am still trying to integrate the manifold theoretical approaches of psychiatry. I very much liked Ludwig Binswanger at one end of the spectrum and Weitbrecht at the other. The latter, in his long career, had a clear clinical foundation not unlike K. Schneider as seen in Abnorme Persönlichkeiten (1963); Reaktionen und Entwicklungen (1963); Die körperlich begündbaren Psychosen (1963); and Psychiatrie im Grundriss 1973). A similar approach, even a more original one, was that of Ernst Kretschmer, whose contribution to the study of psychotherapy and personality, each type with its own risk factors, was paramount but unfortunately has fallen into oblivion.

        Karl Jaspers’ original distinction on the difference between understandable and causal connections have been amply used by British psychiatry. It is not the same to understand a patient during an interview that to impute that understanding to be the cause of his illness.

        I wish the authors would have elaborated on each of the most original contributions of German psychiatrists to psychopathology (Tellenbach 1983; Zutt and Kulenkampff 1958).

        Finally, would the authors elaborate on the concept of anthropology as used by outstanding psychiatrists and internists (e.g., Viktor von Weizsäcker, Thure von Uexküll) in the understanding of patients with psychosomatic or psychiatric conditions?

References:

Tellenbach H. Melancholie. Springer Verlag (Vierte, erweiterte Auflag), Berlin, 1983.

Weitbrecht HJ. Abnorme Persönlichkeiten, Reaktionen und Entwicklungen. Springer, Berlin, Heidelberg. 1963.

Weitbrecht HJ. Die körperlich begündbaren Psychosen. Springer, Berlin, Heidelberg. 1963

Weitbrecht HJ. Psychiatrie im Grundriss. Springer, Berlin. 1973.

Zutt J, Kulenkampff C, editors. Das Paranoide Syndrom in Antropologischer-sicht. Springer Verlag, Berlin, 1958.

October 3, 2019