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Psychological Medicine, 1984, 14, 303-313

Printed in Great Britain

Descriptive psychopathology: conceptual and


historical aspects
G. E. BERRIOS1
From the Department of Psychiatry, University of Cambridge

SYNOPSIS This paper offers a conceptual and historical analysis of descriptive psychopathology.
The first section defines it as a cognitive system constituted by terms, assumptions and rules for its
application. It traces the conceptual implications of this definition and relates them to clinical prac-
tice. The second section contains an up-to-date assessment of current historical work on descriptive
psychopathology and offers a new hypothesis to account for its development during the nineteenth
century. It is suggested that the work involved in the testing of the hypothesis should be carried
out by psychiatrists with historical training and as a separate speciality. It is concluded that the
historical calibration of psychiatric symptoms must be considered as an essential stage in the
construction of a viable descriptive psychopathology.
vulnerability to accusations of 'presentism' or
INTRODUCTION 'internalism', has been left to elderly clinicians
The fear that the history of medicine and of or confined to the introductory sections of
psychiatry may become handmaids to the clinical writings.
clinician has led some historians to over-state There is a demand, however, for this type of
their autonomy. In relation to psychiatry a study. The ethical pangs of the sixties, pro-
common expression of this preoccupation has voked by the antipsychiatry movement, have
been to over-emphasize its social aspects been replaced by the descriptive furore of the
(Dorner, 1969). In relation to medicine in general seventies. Those whose business is the calibration
some feel able to write: 'A commitment to of the nomenclature of psychiatry need the
"neutral" medical history has not merely been assistance of historians. The unenthusiastic
difficult, but can often generate nothing less than response of the latter, however, has led to a
bad history - history with the anger left out' 'do-it-yourself historical industry that struggles
(Neve, 1983). unsuccessfully against the lack of formal
While there is something to be said in favour historical training, limited access to primary
of'angry' history writing, mainly in relation to material and linguistic obstacles (Andreasen,
the socio-political aspects of psychiatry, the 1982; Rome, 1979; Munro, 1982; Kendler &
suggested change has also had undesirable Tsuang, 1981). As a consequence, standards of
consequences. Exclusive preoccupation with research in psychiatric history, which should be
macroconcepts and social questions has, on as strict as in neurochemistry, have not been
occasions, resulted in psychiatric historical maintained.
works that read like political manifestos (Castel, This paper puts forward the view that
1973; Dorner, 1969; Blasius, 1980; Scull, 1979). collaborative work between psychiatric clinicians
A casualty of this fashion has been the and historians is urgently needed and suggests as
historical enquiry into the origin and evolution the first common task the calibration of
of psychiatric symptoms. The history of descrip- descriptive psychopathology. As an initial step
tive psychopathology, because of its particular towards this rapprochement it offers an anal-
1
ysis of the conceptual structure of descriptive
Address for correspondence: Dr G. E. Berrios, Department of psychopathology and then describes a general
Psychiatry, University of Cambridge, Level 4, Addenbrooke's
Hospital, Hills Road, Cambridge CB2 2QQ. model to account for its genesis during the
303
304 G. E. Berrios

nineteenth century. This model can be empirically variations is rarely (if ever) achieved in clinical
tested by performing, for example, regional practice, the most common situation being one
studies into the evolution of individual symptoms of mild interpretation in terms of shared systems
(Berrios, 1977, 198 la, b, 1982). of social cues. Psychopathological symptoms
have, therefore, two components: a biological
source (a dysfunction) which engenders a
CONCEPTUAL MATTERS dislocation of behaviour, and a psychosocial
Psychiatry and its language aspect which relates to the interpretation of the
Psychiatry is defined in this paper as the set of behavioural dislocation by the patient himself
consequences (cognitive and non-cognitive) that and by others. The psychosocial' noise' attached
result from the appropriate use of a psycho- to each symptom may vary from states where it
pathological language. 'Cognitive' should be is very marked, such as in interaction symptoms
taken to mean 'scientific' or clinical and 'non- like manipulation (Mackenzie et al. 1978) to
cognitive' to mean 'socio-political' (McLeod, behavioural dysfunctions which are stereotyped
1977). manifestation of hardware dysfunction such as
A psychopathological language, in turn, is disorientation proper (Berrios, 1983).
defined as a systematic collection of general The clinician's observation of the psycho-
principles, descriptive statements and of the rules pathological phenomenon is controlled by a
for their application. Regional discourses of this perceptual set (Blashfield et al. 1982; Siilz &
kind have been created by most social groups to Gigerenzer, 1982). The inevitability of this
describe forms of behaviour assumed to result observational bias has exercised philosophers of
from undesirable bodily or psychological dys- science for a long time (Hesse, 1966; Wartofsky,
function (Miller & Berrios, 1984). 1979). Another source of observer bias or
The utilization of the psychopathological inestability relates to the occurrence of periodic
language is deemed as 'appropriate' when it is 'epistemological' shifts (Bachelard, 1938; Mar-
limited to the domain where it was calibrated. chais, 1983).
Language calibration is based upon cumulative This dependence of descriptive psychopatho-
historical, clinical and statistical observation. logy upon controlling 'themata' (Holton, 1973)
Once a semantic 'steady state' has been has invited 'relativistic' interpretations and the
achieved, the clinical language endures until: (1) erroneous belief that symptoms are only' cultural'
the cognitive aims of the 'community of users' constructs. Culture-related variations in the
(Laudan, 1977) or 'thought collective' (Fleck, presentation of a symptom, however, do not
1979) change direction; or (2) the psychopatho- necessarily mean that there is no biological basis
logical object itself undergoes transformation be- to it or that, if there is, it is irrelevant to its
yond permissible limits (Hare, 1974; Marchais, understanding (Rack, 1982). Paran-Vial (1966)
1983); or (3) the controlled interaction between has shown that the facts of observation in the
object and language generates further scientific behavioural sciences are, in spite of the social
growth (Pandit, 1983). Descriptive psychopatho- noise, 'partially interchangeable'. This 'con-
logy must be considered as a conceptual stancy' should make it possible for clinicians to
institution that provides a dynamic interface ' triangulate' the symptom and make allowance
between the observer and the psychopathological for any cultural surfeit which may be masking
phenomena. the underlying dysfunction. In fact, this is the
epistemological foundation of the so-called rater
Psychopathological phenomena and the inter-reliability.
observer This 'constancy' should explain the surprising
Psychopathological behaviour consists of a estability exhibited by a number of symptoms
kaleidoscopic conglomerate of symptoms of since the nineteenth century. Since it is doubtful
varied distinctness and duration. In essence, that it is totally due to social factors, it can be
these symptoms are no more than identifiable plausibly claimed that the formal 'fixedness' of
variations in the form and the content of speech many symptoms stems, like some of the
and in the motility patterns of the patient. Hence, structural categories proposed by Kant and
pure 'phenomenological' description of these Levi-Strauss, from a limited number of hardware
Descriptive psychopathology 305

dislocations. This would confer upon some to the next. It is suggested in this paper that
symptoms their stereotyped and monotonous 'rejection' rules are therefore contained in the
quality, in spite of the marked variations in deep grammar of the clinical language. By the
content and severity. same token, it must be assumed that transfor-
mational rules must also exist so that attenuated
Descriptive psychopathology symptoms can be magnified or brought to focus
The avowed task of descriptive psychopathology in spite of contextual masking or 'pathoplastic'
since the early nineteenth century has been the noise.
identification of classes of abnormal mental acts. A similar analysis can be offered of the
In accordance with the then current theory of 'compatibility' criterion. Nineteenth-century
'signs', a name had to be given to each class descriptive psychopathology developed, in spite
(Franck, 18756). The emerging' units of analysis' of its multiple taxonomic systems, 'permis-
became the official templates in terms of which sible' symptom-combinations and symptom-
generations of psychiatrists proceeded to 'break hierarchies. Classificatory systems which pre-
off' the behaviour of their patients into discrete served these combinations were more likely to
symptoms. This descriptive procedure was survive than those which offered radical depar-
considered less a 'fracturing' than a proper tures. It is well known, for example, that
'disarticulation' of abnormal behaviour for it a classification of the psychoses, based on
was believed, based on a version of the 'natural markedly different symptom-descriptions, was
kinds' ontology, that 'joints' existed in the put forward around the same period as
stream of behaviour. The resulting parts Kraepelin's (Leonhard, 1957; Burckard, 1931).
Griesinger (1867) called the 'elementary dis- The lack of success of Wernicke's system cannot
orders of mental disease' (p. 60). Since this be totally explained as a scientific failure because
period, only minor calibrations in the ter- no crucial comparative study was ever carried
minology have been required. out. It is more likely that the Kraepelinian system
The accuracy of the original calibration can be expressed better whatever distinctions and
tested in two ways. On the one hand, each permutations were implicit in nineteenth-century
description should apply to the majority of descriptive psychopathology.
members of its relevant class (extensional force);
this is at the basis of the notion of validity. On Descriptive psychopathology as a cognitive
the other, its name should evoke in the mind of system
each trained observer the same 'symptom', A cognitive system can be defined as a device to
'form' or 'image' (intensional force); this is the organize knowledge. Originally, the term system
essence of reliability. applied only to a collection of physical items but
The usefulness of the calibration can also be since the sixteenth century it has also referred
tested. The simplest way is to examine the to the categories themselves (Franck, 1875a;
efficiency of the rules that decide on whether or Rescher, 1979). The concept of a system relates
not a symptom is present. Since the nineteenth closely to the 'correspondence theory of truth':
century these rules have been based on tacit its validity depends upon the success with which
cut-off points for intensity, duration and its configuration 'portrays' the objects it
frequency of the putative symptom, and also on describes.
'plausibility' criteria which help to evaluate the Since the eighteenth century a number of
reporting of the phenomenon and its 'compati- features have been recognized as character-
bility' with other symptoms. For example, in izing a system. Rescher (1979) lists wholeness,
the historical literature cases can be found where completeness, self-sufficiency, cohesiveness, con-
the 'genuineness' of a symptom is called into sonance, architectonic, functional unity, func-
question, in spite of the fact that prima facie it tional regularity, functional simplicity, mutual
had met all criteria. supportiveness and functional efficacy. These
So it must be assumed that a 'plausibility' 'parameters' influenced the construction of
criterion is in operation at some level and that descriptive psychopathology during the nine-
its effectiveness depends upon the fact that it is teenth century.
passed on from one generation of psychiatrists Condillac (1947), whose influence on Pinel
306 G. E. Berrios

(Riese, 1968) and French nineteenth-century some bizarre symptoms found no counterpart in
psychiatry has been well attested (Le Roy, normal behaviour led to the development of a
1937), identified 'speculative' and 'experimen- 'discontinuity' model, i.e. of a 'psychological
tal' systems. The latter, according to him, pathology'. Griesinger (1867, p. 62) put it thus:
generated knowledge about the world because 'we find other psychological anomalies in the
they were based on the facts of observation. His insane to which there is nothing analogous in the
view led to considering 'psychopathology' as a state of health'.
'cognitive system' during the nineteenth cen- Descriptive psychopathology during this
tury; indeed, this belief has never completely left period also acted as an interface between
France, as a recent plea for a 'methode philosophy and clinical psychiatry. The new
systemale' indicates (Marchais, 1977). medicine since the early nineteenth century had
Systems are dynamic entities and vary in demanded fine-grain descriptions of the mani-
structure according to their subject matter. festation of disease (Lain Entralgo, 1978;
Rescher (1979, p. 11) states that: Ackerknecht, 1967; Foucault, 1972 a); the avail-
able terminology of insanity was unable to
Systematicity, has vis-a-vis its components, the
character of a profile (rather than an average). Just as provide these descriptions. Hence writers like
the health of a person is determined by a plurality of Griesinger (1875) rejected the old terms as being
constituent factors so the systematicity of a body of too general. Language began to be considered as
knowledge is determined in terms of a wide variety of relevant not only to the description of symptoms
separable albeit inter-related considerations. And but also to the analysis of subjective pathological
there will be trade-offs as between the various experience (Starobinski, 1974). To cope with the
'parameters of systematicity'. ensuing conceptual problems a theory of
knowledge was required and some alienists
It is of the utmost interest to the historian to provided their own (Falret, 1864). This was not
identify the 'trade-offs' that took place in the always acceptable to philosophers who pointed
shaping of nineteenth-century descriptive psy- out that alienists, in their effort to develop a
chopathology. These may have been required descriptive system, tended to opt for one of the
both to secure the survival of the system as a Cartesian terms (mechanic physiology) to the
whole and to comply with the practical needs of detriment of the other (i.e. psychological data)
coping with the heterogeneous asylum popula- (D'Amiens, 1875). Collaborative studies had
tion. For example, as Rescher has pointed out been attempted early in the century to bridge the
(1979, p. 14):' greater completeness may threaten gap; for example, Antoine Royer-Collard invited
consistency... greater connectedness may re- Maine de Biran to compose a monograph on the
quire the insertion of disuniform elements'. relationship between psychology and biology
(Royer-Collard, 1843; Maine de Biran, 1841;
Types of descriptive psychopathology during the Swain, 1978). A similar intermediary role has
nineteenth century been claimed for psychopathology during the
Two complementary definitions of descriptive twentieth century (Deshaies, 1967; Thuilleaux,
psychopathology originated during the nine- 1973).
teenth century. The belief that all morbid
phenomena could be accommodated within the Psychopathology and quantification
then current classifications of mental functions The fact that nineteenth-century descriptive
led to a 'continuity' model. Carpenter (1879) felt psychopathology was only marginally influenced
able to write towards the end of the century: 'It by the introduction of measurement into
may be unhesitatingly affirmed that there is medicine (Shryock, 1961) and the behavioural
nothing in the psychical phenomena of insanity sciences (Boring, 1961; Zupan, 1976) requires
which distinguishes this condition from states explanation. The normative correlations estab-
that may be temporarily induced in minds lished between certain associationistic psycho-
otherwise healthy' (p. 658). Psychopathology in logical notions (e.g. 'just noticeable difference';
this sense was only a branch of psychology reaction time) and physical parameters (Boring,
('pathological psychology'). 1942) were never matched by similar studies in
On the other hand, the gradual realization that the mentally ill (Ziehen, 1909; Whitwell, 1892).
Descriptive psychopathology 307

This failure may have resulted from the fact that specific regional accounts. The clinical historian
most of the morbid symptoms recognized by the wants to know, for example, how to recognize
alienists found their origin in faculty psychology the early or critical signs of an 'epistemological
and constituted 'packets' of disturbance which break' in his own discipline. More important,
cut across the abstract units of analysis of the he wants to know whether this crisis stems from
associationists. Notions such as stupor, con- language failure or object change (Marchais,
fusion or delusion were far too complex for the 1983). This paper states that the last 'break' in
new experimental psychopathology to handle. the psychopathological language occurred
Furthermore, any development in the 'experi- during the former half of the nineteenth century.
mental psychopathology' of mental illness was It also suggests that the process by means of
to suffer a blow towards the end of the century which the new psychopathology was constructed
by the appearance of the psychodynamic was first completed in France, soon after the
models. middle of the said century.
Psychopathology and the new dynamic The state of the historical art
psychology The Yale Symposium on the History of
The psychodynamic models exploited the Psychiatry took placefifteenyears ago (Mora &
distinction between 'form and content' and Brand, 1970). Its proceedings offer a fair
made it their business to develop a conceptual evaluation of the fruits of traditional historio-
machinery to account for the latter. Descrip- graphy and are more than ' an informative book
tively, however, psychodynamic theories re- for neophytes' (Braceland, 1970). The same in-
mained surprisingly close to nineteenth-century novatory spirit led Marx (1970) to state in a
psychopathology, as a perusal of the early work classical paper that historical writing in this area
of Janet and Freud shows. The gradual shift required 'a view of history, a definition of psy-
towards 'content' had already been implicit in chiatry and a precept of what psychiatry should
Brentano's work (Fancher, 1977). This author, be' (p. 603); he later expanded on this
like Freud later on, emphasized the retrospective Lakatoshian view of history as a 'tentative
analysis of subjective experience (Ellenberger, construct' (Marx, 1977). Similar views have been
1970). The 'hypnotism' tradition also contri- expressed with respect to the history of the
buted to the creation of an 'internal space' or behavioural sciences (Young, 1966) and of
'discourse' by searching for non-conscious medicine (Clarke, 1971).
mechanisms (Barrucard, 1967). In Janet (Pre- Since those halcyon days the history of
vost, 1973) and later in Freud (Bercherie, 1983) psychiatry has become well populated. The
these trends converged and the new 'dynamic post-Foucaultian industry shows no signs of
psychopathology' brought together 'content', abating, and the generalizations of its mentor
'form' and 'mechanism' in a unified theoretical (Foucault, 1972ft)have undergone progressive
model. correction (Sedgwick, 1981; Castel, 1977; Swain,
1977; Gauchet & Swain, 1980). On a different
THE GENERAL CONTEXT stream, senior French writers such as Ey, Baruk,
Lanteri-Laura and Postel have published over
Languages (of various degrees of resolution) the years first-rate historical papers which, alas,
have been generated by most societies and during remain mostly unknown in the English-speaking
most historical periods to describe the insane and world.
their study leads to transcultural (Rack, 1982) Social historians have of late also made
and historical psychopathology, respectively. important contributions to the history of
Periods of descriptive stability and conceptual psychiatry (Scull, 1981; Alexander, 1976; Castel
breaks (Bachelard, 1938) can be discerned in the et al. 1979; Blasius, 1980; Dorner, 1969). Their
longitudinal analysis. It is incumbent upon the frequent emphasis on the application of social
historian to identify the mechanisms responsible control theory to the understanding of insanity
for these processes. Models of scientific change has, on occasions, led to the neglect of its
(Hacking, 1981; Laudan, 1977; Pandit, 1983) biological aspects. These works therefore can be
may assist him in a general way, but he needs said to be less relevant to the understanding of
308 G. E. Berrios

the genesis of descriptive psychopathology than


a number of recent historical publications The historical hypothesis
(Werlinder, 1978; Janzarik, 1979; Wallace & The sentential model (Harre, 1970) proposed by
Pressley, 1980; Simon, 1978; Sauri, 1969; this paper can be summarized as follows
Roccatagliata, 1973, 1981; Lopez Pinero & (detailed evidence can be found in Berrios,
Morales Meseguer, 1970; Clarke, 1975; Dew- 1984ft).
hurst, 1982; Lopez Pinero, 1963; Bercherie, (1) Descriptive psychopathology developed
1980; Postel & Quetel, 1983). during the former half of the nineteenth century.
General historiographic trends have also The process was first completed in France.
influenced the history of psychiatry (Brieger, (2) It established itself as a descriptive
1980). Once upon a time complex issues in the language. As such, it contained a terminology,
history of the behavioural sciences were made relational statements and rules for their
momentarily translucid by the facile application application.
of Kuhnian terms such as' paradigm',' anomaly', (3) The meaning of each term came to depend
'scientific community', 'Gestalt switch' (Kuhn, both upon its relationship with a given be-
1962). Thus, instead of attempting to develop an havioural form (sign-function) and with other
epistemology of the inexact sciences (Helmer & terms within the descriptive system (compati-
Rescher, 1959) some writers contented them- bility function).
selves with the belief that the behavioural (4) The rules for the application of each term
sciences were resting in some kind of 'pre- concerned: (a) the observer's evaluation of the
paradigmatic limbo' (Farrell, 1978; Warren, intensity, duration and experiential quality of the
1971). An earlier, and equally naive historio- symptoms as described by the patient; and (b) a
graphic view, had led others to consider number of permissible associations according to
pre-Freudian psychiatry as 'pre-historical' (Zil- which decisions on the presence of a symptom
boorg, 1941; Alexander & Selesnick, 1966). were taken in terms of the presence or absence
History and the clinician of other symptoms within a given domain.
(5) The historical origin of descriptive psycho-
There seems to be, therefore, a 'legitimate' need pathology is multi-determined: biological and
(Daumezon, 1980) for historical studies that ask social factors can be identified.
specific questions about the genesis of descriptive (6) An important social factor concerned the
psychopathological categories and about their descriptive requirement (the need to keep good
interaction with the psychological and philo- clinical records) which early alienists had to
sophical context (Bercherie, 1980; Quetel & meet. For this purpose, generic names (e.g.
Morel, 1979; Postel, 1981; Swain, 1977). mania, melancholia, phrenitis) were insufficient.
This paper proposes a research model which A fragmentation of these categories was therefore
can be best described as a nest of 'Chinese needed. This was carried out in terms of the
boxes': with the 'inner' boxes containing the principles of faculty psychology (Albrecht, 1970;
philosophical-psychological concepts, and the Brooks, 1976) and associationism (Warren,
'outer' boxes the sociopolitical context. It 1921; Hoeldtke, 1967), the two influential
further claims that the conceptual analysis of the psychological theories during early nineteenth-
'inner boxes' alone may provide an adequate century France (Boutroux, 1908; Ravaisson,
account of the formation of the psychopalho- 1885).
logical language. This 'conceptual history' is (7) An important theoretical factor was
particularly suitable for researching into psycho- represented by changes in the epistemology of
pathology and provides the clinician with medicine (Ackerknecht, 1967). The anatomo-
practical calibration techniques. The analytic clinical view, developed in France at the begin-
emphasis on the 'inner boxes' should not be ning of the nineteenth century (Lopez Pinero,
interpreted as a rejection of the 'outer boxes'. It 1983), demanded that correlations be established
only means that historical analysis of the latter between anatomical lesion and external manifes-
is not essential to the practical effects of tations of dysfunction, i.e. signs or phenomena
understanding the internal structure of descrip- (Lain Entralgo, 1978).
tive psychopathology. (8) The ensuing ' descriptivism' soon became
Descriptive psychopathology 309

a 'semiology' (Barthes, 1972) that is, a cognitive may help to understand the origin of the
system. This new system sought epistemological 'form-content' dichotomy.
legitimacy in a return to the Baconian view of (12) A selection process took place after the
science (Ravaisson, 1885, p. 60) as illustrated by 1850s whereby some symptoms were retained
Comte's positivistic reinterpretation of the (e.g. delusions) (Ball & Ritti, 1882) and others
Baconian' datum' (Remusat, 1857). Concerning were discarded (e.g. aural haematoma and
direct contacts between philosophers and unilateral hallucinations) (Regis, 1881). The
alienists, it is reported that in 1826 Comte mechanism and ideology that presided over this
lectured to a selected audience which included selection require further elucidation. Only a
Esquirol (Mazlish, 1967). small number of symptoms in fact survived into
(9) The fragmentation of the insanity categories the twentieth century. By the end of the
followed approximately the tripartite classifica- nineteenth century this limited number of
tion of the faculties of the mind that Kant symptoms (and of symptom-permutations) had
(Hilgard, 1980) and the Scottish philosophers proved insufficient to make reliable cross-
had redeveloped (Spoerl, 1936). In the fulness of sectional diagnoses. Fin de siecle nosologists
time both nosological and symptomatic dis- such as Magnan (Pichot, 1982) and Kraepelin
tinctions were constructed along these lines. For (Havens, 1965) attempted to solve the problem
example, hallucinations (which originally referred by introducing longitudinal or 'diachronic'
only to visual experience) became general diagnostic factors, such as irreversibility and
'disorders of perception' (Berrios, 1982) and natural history. On occasions, however, this led
monomania (a clinical condition) was classified to a relative neglect of descriptive symptoms. For
into intellectual, emotional and volitional (Linas, example, as Havens (1965, p. 23) has remarked,
1882). Kraepelin ' seldom gave delusions much impor-
(10) Two types of symptoms resulted from this tance diagnostically or prognostically'.
fragmentation. Some disorders like hallucina- (13) Towards the latter part of the nineteenth
tions could be considered as exaggerations or century the surviving symptoms reclustered into
disturbances of a normal function (continuity a number of syndromes (Bercherie, 1980; Pichot,
view). Others referred to bizarre states, such as 1982). Some of these, like delirium, were
obsessions or delusions or stupor, which found practically the same as before the fragmentation
no clear counterpart in the normal (discontinuity (Berrios, 1981 a); others, such as manic-depressive
view). This two-tier system has remained to the insanity or obsessional disorders (Berrios,
present day (Lanteri-Laura, 1968).Thecontinuity 1984 a), constituted new configurations. Some of
view can be found in the work of Freud the classical terms were also reused (mania,
(Broustra, 1975) and Eysenck (McGuire, 1973), melancholia, paranoia, dementia and stupor) but
and the discontinuity view in the work of Jaspers with a different meaning (Leibbrand & Wettley,
(1963), Weibrecht (1968), Bash (1955) and 1961; Bercherie, 1980).
Conrad (1958). These two views reflect closely (14) Early during the twentieth century
the conceptual permutations which connected descriptive psychopathology encountered pheno-
the 'normal' and the 'pathological' during the menology. This much talked-about alliance can
nineteenth century (Canguilhem, 1975). best be described as a marriage of convenience.
(11) Early in the nineteenth century descriptive Around this period the conceptual foundation
psychopathology based itself on data obtained of descriptive psychopathology had become
from the observation of 'overt' behaviour. A suspect (following the decline of classical
gradual utilization of'psychological' or 'subjec- nineteenth-century psychology) and required
tive' data started in France in the 1840s (Dubois, buttressing. Phenomenology, with its emphasis
1845), mainly with Moreau de Tours (Riese, on subjectivity and neutral descriptions, became
1960; Bollote, 1973; Pigeaud, 1980; Delacroix, the ideal partner. But phenomenology itself was
1924). Soon after, the introduction of the ' psy- also in need of empirical anchoring; this resulted
chological' notions of consciousness (Berrios, from the fact that, for all its anti-psychologism
1981ft) and of introspection (Boring, 1953) and demands for neutrality (De Boer, 1978),
legitimized the semiological value of the' contents phenomenology had developed into yet another
of consciousness'. This historical development variety of armchair psychology and was therefore
310 G. E. Berrios

theoretically committed (Rancurello, 1968). to the identification of the epistemological


Jaspers' youthful eloquence (1968) made it structure of the language of psychopathology. In
appear as if phenomenology had been put to this context more important advances have been
work at last on a concrete problem; this belief made in Europe (Daumezon, 1957; Daumezon
remains to the present day (Shepherd, 1983; & Lanteri-Laura, 1961; Fedida, 1964; Pistoia,
Spiegelberg, 1972). 1971; Castilla del Pino, 1978; Tizon, 1978;
A careful comparison of the clinical meaning Georgin, 1980; Marchais, 1981; Lanteri-Laura,
and usage of the basic symptoms before and after 1982, 1983) than in the USA (Kroll, 1979;
1913 (Jaspers, 1963), however, shows that the McHugh & Slavney, 1982).
'phenomenological' treatment did not alter Since instruments like the DSM-III (APA,
them at all. In a way, this is not surprising for 1980) and the PSE (Winged/. 1974; Wing, 1983)
Jaspers' usage of 'phenomenology' at this early are already being widely adopted as glossaries,
stage was purely methodological:' This prelimi- the average clinician wants to know whether or
nary work of representing, defining, and classi- not his' descriptive rights' will soon be abrogated
fying psychic phenomena, pursued as an in- by a 'premature closure' (Spitzer et al. 1975,
dependent activity constitutes phenomenology' p. 1191); more importantly, he wants to know
(Jaspers, 1968, p. 1314). whether he has any rights left to try alternative
Soon after, phenomenology was to become a forms of psychopathology (Shapiro, 1975;
conglomerate of schools (Spiegelberg, 1982). Clifford & Frosh, 1982). In the face of the
Although some of these were to prove important benefits accruing from the statistical formaliza-
to the development of existential psychologies tion of descriptions, questions like these may
and therapies (Spiegelberg, 1972), phenomen- sound either candid or ungrateful. However, it
ology was too abstract and heterogeneous a is worth emphasizing that a closer acquaintance
methodological tool to have much relevance to with the history of descriptive psychopathology
practical descriptive psychopathology. Subse- may temper hawkish strivings towards reliability
quent efforts in this direction both in psychiatry and hopefully remind everyone that validity is
(De Koning & Jenner, 1982) and clinical psycho- also an important feature of the scientific
logy have been rather meagre (Merleau Ponty, language.
1945; Thines, 1977). Indeed, Ryle's prediction The history of psychopathology must be
that phenomenology was to 'end either in self- considered as more than mere comedy of errors,
ruinous subjectivism or in a windy mysticism' antiquarian exercise, or political analysis of the
seems to have come true (Ryle, 1932). social aspects of psychiatry. It is a powerful
calibration technique by means of which the
language of psychiatry is conceptually tightened
CONCLUSIONS and made ready for quantification.
A number of conclusions can be drawn. First,
conceptual-historical studies are an integral part
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