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["Understanding" in psychiatry-part 1 : Philosophical sources and concept analysis]
1Klinik für Psychosomatik, Neurologie und Psychiatrie, Zentrum für Psychiatrie Südwürttemberg, Weingartshofer Str. 2, 88214, Ravensburg, Deutschland. juan.valdes-stauber@zfp-zentrum.de.
Background:
The dichotomy comprehension/understanding vs. explanation has been initially developed with a legitimating intention for the humanities vis à vis the natural sciences. This investigation examines the different usages of understanding/comprehension in psychiatry and psychotherapy as well as its relevance for medical practice.
Method:
Critical discussion of the historical roots of the comprehension-explanation dichotomy and its introduction into the psychiatry by Jaspers. A propaedeutic logical analysis of the concept of "understanding" will be proposed. This investigation aims to elucidate latent dimensions in the usage of "understanding" in psychiatry and psychotherapy. In more detail the operation of assignment and attribution will be discussed as well as the elucidation of individual meaning and supraindividual significance.
Results:
The term analysis shows that "to understand" as a predicate is gradually and polysemic; its definition must take the different logically additive meanings into account. These meanings can be condensed into three dimensions: i. Rational diagnostic assignment; ii. Elucidation of meaning through individual empathetic re-experiencing as a psychological approach respectively the supraindividual elucidation of significance, and; iii. Dialogic attitude. Psychological understanding roots in Jaspers' epistemology on assignment to and alignment with supraindividual meaningful connections and not on empathetic re-experiencing.
Discussion:
"To understand" as a logical operation of assignment and as meaning elucidation takes for granted a predicate in its transitive first-person perspective ("who" should be understood, as objectified) in conjunction to a third-person perspective ("what" should be understood). This analysis should be complemented by a first-person perspective ("who" should be understood, as a subject) in conjunction with a dialogic second-person perspective ("how" should be understood, following a mutual disposition). This last approach will be discussed in an additional article.
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