To study the relationship between empathy and psychopathology starting from Jaspers’ understanding, 100 years after the publication of the first edition of his “General Psychopathology”.
Historical and epistemological analysis of the concept. The original Jaspers’ text will be considered in detail, together with the more relevant critical debates that followed his conceptualization.
The place of the concept of understanding within Jaspers’ system is discussed. It is shown that Jaspers’ methodology is intrinsically pluralistic and that in his view explanation and understanding are both necessary for psychopathology. They are different and nonoverlapping methods that represent the proper scientific means for knowledge within their respective scientific fields (natural sciences and human sciences). In the field of the human sciences, the proper method is empathic understanding, whose distinction between static and genetic understanding is considered in detail. Static understanding is mainly related with the intuitive grasping and actualization in the listener of the experiences of the patient. Genetic understanding considers the connections between such psychic events from an “internal” viewpoint of the motivational chain (meaningful connections). The characteristics and limits of Jaspers’ understanding are fully considered. The intuition on which it is based poses an epistemological problem that is discussed throughout. In the first person perspective, empathic intuition is self-evident, but if it relies only on a idiosyncratic, personal emotional ability to empathize, then it lacks interpersonal reliability and it risks to be a sort of mystic. For this reason (of being “too subjective”), Jaspers’ understanding was similarly criticized by both naturalist-oriented and hermeneutically-oriented psychiatrists. Moreover, it is stressed that Jaspers’ understanding is not a rational understanding, but an emotionally-based empathy; that it is based on the co-presence of emotional involvement and detached description (the “right distance” position being based on their interplay); that the understanding is limited for many reasons (some of which are related to intrinsic features of the studied phenomena, but others are related to the characteristics of the psychopathologist and the context, including the setting and the duration of the therapeutic relationship); that the boundaries of understanding are not fixed but movable; that the understanding is epistemologically asymmetric because it is useful for a posteriori reconstructions of events, but it does not allow scientific prediction; that causal explanation and psychological or existential interpretation are possible ways to surmount these limits, but also that interpretation is already within Jaspers’ understanding.
Despite these limits, the concept of understanding is probably the major column of the psychopathological reasoning, and has demonstrated its usefulness over a century of clinical practice. However, it is in need of revision to take into account new epistemological and clinical challenges. Future research should clarify that being understandable or not is neither a feature of the object of study nor of subject under study, but is rather a relational property emerging from a semiotic process.