Ludwig Binswanger

• 1. Introduction

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  Ludwig Binswanger, a Swiss psychiatrist, was born on the 13th of April 1881 and died on the 5th of February 1966. He is described as the most prominent phenomenological psychologist. He is also the figure who did the most to make existential psychology known in Europe and the United States.

  Binswanger's starting point was unusual for a doctor. Instead of asking what had gone wrong inside a patient, he asked what kind of world that patient was living in. That shift in question runs through everything he wrote.

  This documentary follows the questions the shift raised. How did a man trained alongside some of the great psychiatrists of his era come to build something of his own? What does it mean to treat a troubled mind as a world? And why do some of his most famous conclusions still draw doubt from later psychiatrists?

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• 2. Family Inheritance

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  In 1857, in the town of Kreuzlingen, a German-Jewish doctor named Ludwig Binswanger, known as Elieser, founded the Bellevue Sanatorium. He lived from 1820 to 1880, so he died the year before his grandson and namesake was born.

  The grandson's parents were Robert Johann Binswanger, who lived from 1850 to 1910, and Bertha Hasenclever, who lived from 1847 to 1896. Medicine ran through the wider family as well. Robert's brother Otto, who lived from 1852 to 1929, became a professor of psychiatry at the University of Jena.

  Ludwig received his medical degree from the University of Zurich in 1907. In 1911 he became medical director of the Kreuzlingen sanatorium, and he held that post until 1956. That is forty-five years at the head of the institution his grandfather had begun.

  In 1932 he wrote a history of the place, titled Zur Geschichte der Heilanstalt Bellevue, covering the years 1857-1932. Sigmund Freud, whom Ludwig would visit in 1907, had already cited his uncle Otto's work on neurasthenia.

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• 3. Friendship With Freud

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  In 1907, Binswanger travelled to meet Sigmund Freud alongside Carl Jung. He came away approving of his host, noting Freud's "distaste for all formality and etiquette, his personal charm, his simplicity, casual openness and goodness". Around this time he was also studying and working with Jung and with Eugen Bleuler.

  Binswanger joined the early Freud Group that Jung led in Switzerland. Yet he wrestled all his life over where psychoanalysis belonged in his own thinking. His 1921 article on psychoanalysis and clinical psychiatry marks only one stage of that long struggle.

  The friendship with Freud outlasted the argument. The two men remained friends for life, and Freud found Binswanger's illness in 1912 "particularly painful". In 1936 Binswanger gave an extended lecture in honour of Freud's 80th birthday, at the Academic Association for Medical Psychology. Its title was Freud's conception of man in the light of anthropology.

  In 1938 Binswanger offered Freud a refuge in Switzerland. In 1956, the year his directorship at Kreuzlingen ended, he published a book of recollections titled Erinnerungen an Sigmund Freud.

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• 4. Philosophers Enter

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  After World War I, the writings of Martin Heidegger, Edmund Husserl and Martin Buber began to shape Binswanger's thinking. Out of that influence he developed his own distinctive existential-phenomenological psychology.

  In 1942 he published Grundformen und Erkenntnis menschlichen Daseins, or Basic Forms and Knowledge of Human Existence. He is considered the first physician to combine psychotherapy with existential and phenomenological ideas. In this book he presents existential analysis as an empirical science, using an anthropological approach to the essential character of each human being.

  Heidegger became a direct subject of his writing. A 1949 work examined what Heidegger's analysis of Dasein meant for psychiatry's understanding of itself. A 1954 text, Martin Heidegger and psychiatry, was written for the 350th anniversary of the Heinrich Suso Gymnasium in Konstanz.

  From Buber, Binswanger adopted the importance of dialogue. For that reason he can be seen as an ancestor of intersubjective approaches to therapy. He stressed mutual recognition, set against the counterdependency of destructive narcissism that Herbert Rosenfeld described.

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• 5. Illness as a World

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  Husserl's concept of the lifeworld became, for Binswanger, a key to the subjective experience of his patients. In his words, "in the mental diseases we face modifications of the fundamental structure and of the structural links of being-in-the-world". Mental illness, for him, meant the remaking of a world. It altered the lived experience of time, space, body sense and social relationships.

  A single example shows how this differed from psychoanalysis. Where an analyst might see only "an overly strong 'pre-oedipal' tie to the mother", Binswanger replied that "such overly strong filial tie is only possible on the premise of a world-design exclusively based on connectedness, cohesiveness, continuity".

  The same attention to lived experience shaped his book Dream and Existence, first published in 1930 as Traum und Existenz. Michel Foucault translated it from German into French and added a substantial essay-introduction. Binswanger urged "steeping oneself in the manifest content of the dream - which, since Freud's epoch-making postulate concerning the reconstruction of latent thoughts, has in modern times receded all too far into the background".

  Eugène Minkowski had earlier carried Binswanger's ideas into France. Through him they influenced, among others, the early work of Jacques Lacan.

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• 6. Ellen West

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  Ellen West is the patient most closely tied to Binswanger's existential studies. The source calls her deeply troubled, and her case study was translated into English for the 1958 volume Existence.

  Binswanger ascribed schizophrenia to her, and her case is included in his 1957 book Schizophrenie. Few contemporary psychiatrists would accept that diagnosis. Anorexia nervosa, too, is considered a misplaced label for her.

  What the record preserves most plainly is one detail about Ellen West herself. She felt an extreme urge for weight loss.

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• 7. Modes of Existence

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  Hunter, romantic, businessman: Binswanger used such roles to show how free a person is. Humans, he wrote, have the choice of "being a hunter, of being romantic, of being in business, and thus (we are) free to design (ourselves) toward the most different potentialities of being." Such existence "transcends the being", making a person accessible to himself in many possible outcomes. Understanding it required a whole view: "It is a question of attempting to understand and to explain the human being in the totality of his/her existence."

  He divided existence into three modes. The Umwelt is the "around world", the relationship between an organism and its environment. It applies to humans and to non-human animals alike. Animals, however, "can neither design world nor open up world nor decide independently in and for a situation". Humans rise above it by "climbing above it (the world) in care and of swinging beyond it in love."

  The Mitwelt, the "with world", is the shared world each person has with others. It means viewing a life through its relationships with other people. The Eigenwelt, the "own world", is a person's relationship with himself. It is the hardest mode to grasp because its definition is vague. Binswanger held that understanding a person fully meant accounting for all three.

  The German word Weltanschauung, or world-view, ties into these modes. It is how a person sees and opens up to the surrounding world. Binswanger wrote that it "is by no means confined to the environment of the world of things, nor to the universe in general". It reaches equally into the Mitwelt and the Eigenwelt.

  Two further concepts frame the relationship between people and their surroundings. Being-in-the-world is the ordinary, lawful interaction with the real environment. It follows three steps: identify the situation by known objects and their properties, assign general rules to it, then use logical rules to conclude what must be done.

  Being-beyond-the-world is the second concept. Here people use free will to change their circumstances and transform their world by their own motivations. Binswanger tied this to love, which, he believed, "takes us beyond the world of one's own self to the world of we-hood".

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• 8. Critics and Writings

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  R. D. Laing criticised Binswanger's phenomenology of space. In his view it did not fully recognise how far one's sense of space is structured by other people. Fritz Perls made a different objection, arguing that Binswanger's existential therapy leaned too heavily upon psychoanalysis.

  Binswanger's own list of publications begins in 1907 with a study of the psycho-galvanic phenomenon in association experiments. In 1910 came a work on the origin and prevention of mental disorders. A 1922 book introduced the problems of general psychology, and a 1933 study examined the flight of ideas.

  His range widened over the decades. In 1946 he wrote On language and thinking. In 1949 he published a study of Henrik Ibsen and the problem of self-realization in art. A 1956 book, Drei Formen missglückten Daseins, examined three forms of failed existence: extravagance, crankiness and affectation.

  Later titles turned to specific conditions. Melancholie und Manie appeared in 1960, and Wahn, a work on delusion, in 1965. In between, a 1962 preface addressed arts education under the title Der Musische Mensch.

  From 1992 to 1994 the publisher Roland Asanger of Heidelberg issued a four-volume edition of selected works. The first volume, edited by Max Herzog, gathered Binswanger's writing on failed forms of existence. A late addition to the list of his works is an Italian volume, La guarigione infinita, on the clinical history of Aby Warburg, edited by Davide Stimilli.

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