The Rudolf Steiner Archive

About Psychiatry

[ 1 ] Of course, it is no longer possible today to discuss this topic—which would require an exhaustive treatment if one were to address it at all—in any way other than with a few brief remarks at most, for psychiatric education certainly requires the most far-reaching reforms, especially in our time. Even if one merely considers how impossible it actually is today to properly frame the questions that must be addressed in psychiatry, one will realize just how necessary such a reform of psychiatric education is. However, such a reform will not be possible—as seemed clear to me from Dr. Husemann’s lecture itself—unless Spiritual Science first truly enriches the individual specialized disciplines. For that development—which Dr. Husemann has so beautifully described today, a development that began around the time of Galileo and then culminated in the 19th century—this scientific development has, in fact, driven the entire human life of thought apart into two sharply opposing currents of thought. On the one hand are the mental images we have of the material world and its processes; on the other hand is the life of thought itself, which, I would say, has taken on an increasingly purely abstract character. Since abstractions cannot be forces in the world—and therefore cannot be forces within human beings that bring about effects—there is no possibility for human beings to comprehend the material and the physical from the perspective of the soul, nor to build any bridge from the psychological to the material.

[ 2 ] After all, when people speak of the soul today, they have at most a mental image of a sum of abstractions or of abstract sensations themselves and the like. This sum of abstractions, of course, cannot set an organism in motion; it cannot in any way build a bridge to the organism. Therefore, one cannot claim that by influencing the life of the soul—which is, after all, merely a sum of abstractions—one can in any way influence the external, physical, real organism. On the other hand, there is what science has established about the physical organism; for it has been posited that mental phenomena are merely parallel phenomena or even effects of the physical organism. The concrete mental images we form about this physical organism are not suited to allowing us to extract anything at all from these images regarding the psychological.

[ 3 ] And so today, in fact, we find side by side a view of spiritual life—regardless of whether one is more or less of a materialist—that focuses solely on abstractions, and a view of material life, including organic life, from which nothing spiritual can be extracted in any way.

[ 4 ] It is, after all, quite obvious that, particularly in the field of psychiatry, one cannot easily find any method that is even remotely viable. This is precisely why, in recent times, scholars have moved away from speaking at all about the connection between the physical-organic aspects of the human being and the psychological processes that unfold in consciousness.

[ 5 ] And since, in reality, one is constantly caught between these two stools—between the physical-material and the abstract-psychic—and is actually in constant danger of falling down to earth, it is necessary to invent a completely unconscious world, a strange and unconscious world. And this has indeed been done extensively in psychoanalysis and analytical psychology—a scientific subject that is actually extraordinarily interesting. For once psychiatry has been reformed—so that we once again have a proper psychiatry—this scientific subject will, above all, have to be thoroughly examined from this new psychiatric standpoint, since it is, in fact, a subject for psychiatry.

[ 6 ] So, in order to avoid being caught between these two stools, people have tried to imagine an unconscious world. I have nothing against the unconscious world, of course, but it must be explored; it must be truly understood through what Spiritual Science introduces as “insight”; it cannot be fantasized about in the way that Freudians or similar people do.

[ 7 ] Spiritual Science will contribute to a reform of psychiatry by leading it away from merely abstract concepts—which have no inner life—toward concepts that correspond to reality, concepts that already exist in the world as such and are gained by immersing oneself in reality through its methods. Then, by rising to such spiritual methods—which in turn yield concepts grounded in reality—one will find, through these concepts that are no longer mere abstractions, the transition to what is reality. That is to say, one will be able to build a bridge between the psychological and the physical in the human being. If one is serious about psychiatry, the psychological and the physical must appear differently in our mental image than they do today.

[ 8 ] Today’s sum of abstractions—including the one that encompasses the abstract laws of nature (for these laws of nature are, after all, becoming ever more and more filtered)—this sum of abstractions is incapable of immersing itself in a real process.

[ 9 ] Just imagine for a moment how, using the abstractions that feature in the sciences today, one might discover something like the two important, I might say, facts—for they are facts—that I cited in the first lecture of this series: the theory of the heart based on Spiritual Science, and the theory of the inverse biogenetic law governing the historical course of events on Earth.

[ 10 ] From such examples, you can see that the methods of Spiritual Science are truly capable of finding a path from inner spiritual life into the world of facts, building a bridge between the so-called psychological and the so-called physical.

[ 11 ] But this is necessary above all for psychiatry, because it will only begin to thrive when it is able to correctly observe the relevant facts. And the facts of psychiatry are, in essence, even more difficult to observe, because they require a greater degree of impartiality than the facts of physical laws. For in human life, as soon as one moves from the so-called healthy—or relatively healthy—to the relatively ill, there is, in essence, almost no possibility of completely isolating the individual. The human being certainly develops into a complete individuality, into an isolated life. They do so precisely through their psyche—but through that aspect of the psyche which deviates from linear development. This is not the case with physical deviations from linear, so-called normal development. I can only hint at this, of course; otherwise, one would have to spend hours explaining it in detail if one wanted to substantiate it point by point. It is not the case that one can view it in isolation; human beings are, even in the deepest sense, far more social beings than is commonly believed. And in particular, mental illnesses can actually be assessed—in the rarest of cases—solely on the basis of, let’s say, the biography of the individual, in isolation. That is almost entirely impossible.

[ 12 ] I would rather use a hypothetical example than theories to illustrate what I actually mean. You see, it is possible, for example, that in any community—be it a family or any other kind of community—two people live side by side. After some time, one of them has the misfortune of suffering an episode that is thus classified as a psychiatric condition. Of course, one can treat this person in isolation. But if one does so—especially if one forms an opinion based on an isolated observation of this person—then in many cases one will actually fall victim to nothing more than a mental construct. For it may well be the case—and in numerous instances it is—that another person living with the one who has become ill, the one who has developed a mental illness, say, within the family or in some other community, actually possesses within themselves the—let’s call it—complex of forces that led to their fellow human being’s mental illness. So let us start with these two people: Person A is having—from a psychiatric perspective—an episode; Person B possesses within themselves a complex of forces of a psychically organic nature that, if considered in isolation, might exhibit to a much greater degree what is identified as the cause of Person A’s illness. In other words, Person B, who is not mentally ill at all, actually possesses this cause of mental illness to a much greater degree than Person A, who had to be admitted to a sanatorium.

[ 13 ] This is something that certainly lies within the realm of reality, not merely of possibility. For it is based on the fact that Person A, apart from the complex of forces identified as the cause of his mental illness, has a weak constitution and cannot tolerate this complex of forces. The other person, B, who also possesses this complex of forces—perhaps even more strongly—has, apart from this complex, a substantially stronger constitution than the other; it does not harm him. Person B can tolerate it; person A cannot. However, person A would not have developed the illness at all if he were not constantly under the psychological influence of person B, who lives next to him—an influence that can be exceptionally significant in this case because person B is more robust than person A.

[ 14 ] Here is an example—one that is, in fact, a reality in numerous cases—from which you can see just how important the psychiatric perspective is if it is to seriously address reality, rather than engaging in the kind of pretense that is so often seen in this field today. The point is really not to view a person in isolation, but to view them within their entire social context.

[ 15 ] However, what I mean here will have to be placed on a fairly broad foundation. After all, the same is true for the rest of the field of medicine: there is a big difference between whether a weak individual or a strong, robust individual is affected by a particular condition. Let’s assume that two people live side by side from a certain age onward and interact with one another. One, however, still possesses a robust peasant constitution due to his youth and ancestry, while the other descends from three generations of city dwellers. In such a case, the one who possesses this healthy peasant constitution and can withstand some internal damage may, under certain circumstances, harbor a much more severe form of the complex within himself, yet he can tolerate it and does not become ill. The other person, who actually possesses this nature only through psychological contagion, through imitation, through whatever is always present from person to person, cannot even tolerate the effect.

[ 16 ] Here you can see everything that comes into play when you want to talk about psychiatry not from the perspective of theory and programs, but from the perspective of reality—as is indeed the case today, when people are already turning their attention to the gravity of the situation that arises from the realization of how, fundamentally, ever since the time of Galileo, our scientists have become so one-sided, and how necessary it is to embrace new ideas in a fruitful way in all fields. Otherwise, human knowledge—especially in those fields intended to lead into practice, into the practice of life—will fall into complete decadence.

[ 17 ] So I could say: Essentially, the same principle applies in psychiatry as what we say about the art of education when we speak of the Waldorf school—that one should not merely come up with some new theoretical formulations, but rather bring living Spiritual Science itself into this field. What needs to be said in the field of education must also be said in the field of psychiatry. One can never take a one-sided approach by saying, “This or that needs to be improved in the field of psychiatry.” Rather, one must familiarize oneself with the idea: Either one adopts the foundation of Spiritual Science in the realm of cognition as a whole; in that case, this foundation of Spiritual Science will already transform psychiatry, and it will make psychiatry into something quite special—something that is actually longed for by many people today, but which cannot exist at all through the latest scientific methods, which have been sufficiently explained to you yesterday and today.

[ 18 ] You see, what must ultimately emerge above all else from—let me use this trivial word—the popularization of Spiritual Science is a much, much better understanding of human nature than you can find today. People face one another today in such a way that one cannot even speak of an understanding of human nature. People pass each other by; everyone lives only within themselves. Spiritual Science will open people up to one another. And then, above all, much of what is perhaps still believed today to lie in the realm of psychological pathology will, precisely because of this, be shifted over into the realm of psychological hygiene. For the situation is precisely such that—I would say—straightforward lines can be drawn everywhere from the symptom complexes of disturbed psychological life to the very notions that are commonplace in public life today, notions that are not at all considered pathological but are simply generally accepted. And if one were to trace certain widely accepted concepts, one would find that, albeit more slowly, the same path has ultimately been taken as that evident in the progression of a psychologically abnormal symptom complex—a process that, admittedly, proceeds rapidly in someone whom we today consider psychologically abnormal.

[ 19 ] All these things show that, in the end, all this talk about the details of reforms in the individual sciences leads to very little; but that if one resolves—though today many souls are many souls are too drowsy—to seek a revitalization of scientific life in the spirit of Spiritual Science, then the most diverse fields of science—but especially that field of science which deals with the various deviations from normal psychological life, namely psychiatric medicine—will thereby undergo a necessary, I would say, self-evident reform. Even if these cases go as far as extreme rebellion, mania, mental retardation, and so on: only then will we discover what these psychological deviations from normal life actually signify within the overall context of normal development. And in many respects, we will find that as our worldview becomes increasingly healthy, much of what shines forth from public error will heal the pathological aberrations of the mentally ill.

[ 20 ] After all, it is quite strange how difficult it is to draw a clear line between so-called normal life and psychologically abnormal life. For example, it is hard to say whether a state of psychological normality exists—take, for instance, the case that occurred not far from here, not too long ago in Basel, where a man bequeathed a large sum of money in his will to anyone who would isolate themselves in complete solitude until they succeeded in truly proving the immortality of the soul. This was stipulated in the will of a man in Basel, and I do not know what became of the matter. I believe the heirs objected to it and at the time—though not from a psychiatric perspective, but rather a legal one—attempted to determine to what extent it involved psychiatric issues or not. But if each and every one of you were to set out to investigate whether this should be assessed from a psychiatric perspective, or whether it is a mental disorder, or whether it is in fact an excessive religiosity, or whatever else—you would hardly be able to arrive at a completely precise conclusion.

[ 21 ] The fact is that our concepts have gradually become weak in the face of reality; they must become strong again. But they can only become strong through Spiritual Science. And among many other fields, psychiatry in particular will feel the effects of this.