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Karl Theodor Jaspers was born 1883 in Oldenburg in Northwestern Germany, as the oldest child of a well-to-do lawyer and director of a bank. From childhood Jaspers developed a spirit of independent and critical thinking, which set him apart from his schoolmates and under suspicion from his teachers. He suffered from delicate health with frequent infections which resulted in chronic bronchiectasy and cardiac decompensation with shortened life expectancy. This prevented him from taking part in physical activities, and failing health with recurring infections and fatigue, became a lifelong handicap, but it did not impede his clarity of thinking or his will to live a meaningful life. After finishing gymnasium, 1901 he chose a university study leading to a position in practical life instead of his favorite interest, philosophy. He began studying law, but after three semesters he changed to medicine in order to obtain best possible knowledge about nature and human beings, hoping to be able to work as psychiatrist or psychologist. He completed his study 1908, and the following year his dissertation for doctor of medicine [1].

In 1909, he obtained a position at the psychiatric hospital in Heidelberg under the brain histologist Franz Nissl, at first as intern, but after a few months he was allowed a voluntary part-time position as research assistant, because of his failing health. He participated in ward rounds, staff meetings, patient demonstrations and scientific discussions in the inspiring and encouraging atmosphere of an intellectual fellowship of distinguished psychiatrists in the Heidelberg clinic. He became engaged in the study of psychopathology, read extensively and was allowed to select patients for intensive study, from which he published papers on various groups of symptoms, with detailed case stories. In 1911, he accepted an invitation from the deputy chief of the clinic, Carlos Wilmanns, and the publisher Ferdinand Springer to write a textbook on general psychopathology to provide a survey of the extensive and confusing variety of the literature in the field. His own studies had led him to adopt the philosopher Husserl's Phenomenology, the investigation and description of conscious experiences, as a reliable research method for assessment and proper descriptions of psychopathological symptoms by careful empathic listening to and feeling oneself into the patient to comprehend his experiences [1, 2]. He further adopted an approach of ‘understanding psychology’ to comprehend meaningful connections and motives for the symptoms in relation to circumstances in the lives of the patients, such as the ‘genuine reactions’ to traumatic stress, described with guidelines for their excessive development into reactive psychosis. He contrasted this to a complementary ‘explanatory psychology’ for causal connections from factual data obtained from objective, external observation. His classification of disorders was hierarchical, stressing that classifications are but fictions serving their purpose when most appropriate for the time being. In two years he managed to produce a systematic, comprehensive compilation, and carefully balanced evaluation of the validity of the various theories, methodologies and observations in psychiatric literature, the ‘Allgemeine Psychopathologie’, published in 1913, when he was aged 30. It was used for his habilitation, not in psychiatry, but in psychology. In this way he entered into the philosophical faculty in Heidelberg, where he eventually became professor in psychology and from 1921 in philosophy, never to return to psychiatry [1, 3, 4].

‘Allgemeine Psychopathologie’ was received as a landmark in psychiatry, a scientific psychopathology, with well-ordered and clear descriptions of symptoms and types of disorders, in a uniform terminology taken from normal psychology. The book, however, did not have the expected influence it deserved, not even within Germany, where it was considered of limited relevance in the daily clinic and suspected of too extensive and speculative understanding [5]. It appeared in several editions, the 4th from 1946 with a major revision and update, adding another 300 pages, written during the Nazi-period, when he was not allowed to work or publish because of his critical thinking and his Jewish wife. The book was not translated into English before in 1963, until then unknown in the United States, and is still with the latest edition, 1973, not much known outside Germany.

All the same, the influence on present day psychiatry is evident. Jaspers’ hierarchical order of classification of mental disorders has been retained in ICD-10 [6], whereas DSM has preferred a horizontal classification with all Axis I disorders on equal level [7], opening for extensive comorbidity. The reactive psychoses has survived in ICD-10 as ‘Acute and Transient psychotic Disorder with associated acute stress’ [6], and in DSM-IV as ‘Brief Psychotic Disorder with marked stressor(s)’ [7]. The phenomenological approach has been continued and evolved in the Present State Examination in its 10 revisions [8, 9] with specified definitions in the SCAN Glossary of Definitions [10], a WHO authorized psychopathology, for a common language in psychiatry, if ever possible.

References

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  2. References
  • 1
    Jaspers K. Philosophical autobiography. In: Schilpp PA, ed. The philosophy of Karl Jaspers, 2nd augmented edition, La Salle, Illinois: Open Court Publishing Company, 1981.
  • 2
    Jaspers K. Die phänomenologische Forschungsrictung in der Psychopathologie. Z Neur U Psych 1912;9:391408 (Translation: The phenomenological approach in psychopathology. Br J Psychiatry 1968;114:1313–1323).
  • 3
    Jaspers K. Allgemeine psychopathologie. Heidelberg: Springer Verlag, 1913, Neunte Auflage, 1973 (Translation: General psychopathology, 7th edn. Manchester: Manchester University Press, 1963).
  • 4
    Kolle K. Karl Jaspers. In: Kolle K (ed.) Grosse nervenärtzte. Stuttgart: Georg Thieme Verlag, 1956.
  • 5
    Schneider K. 25 Jahre “Allgemeine Psychopathologie” von Karl Jaspers. Der Nervenarzt 1938;11:281283.
  • 6
    World Health Organization. The ICD-10 Classification of Mental and Behavioural Disorders. Clinical descriptions and diagnostic guidelines. Geneva: WHO, 1992.
  • 7
    American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 4th edn. Washington, DC: American Psychiatric Association, 1994.
  • 8
    Sims A. Symptoms in the mind. An introduction to descriptive psychopathology. London: Baillére Tindall, 1988.
  • 9
    Wing JK, Sartorius N, Üstün TB (eds.) Diagnosis and clinical measurement in psychiatry, a reference manual for SCAN. World Health Organization. Cambridge: Cambridge University Press, 1998.
  • 10
    World Health Organization. Schedules for Clinical Assessment in Neuropsychiatry, SCAN, interview and glossary of definitions, Version 2.1. Geneva: WHO, 2000.