Understanding understanding in psychiatry

Abstract

Originally put forward to defend history from the encroachment of physics, the distinction between understanding and explanation was built into the foundations of Karl Jaspers’ ‘phenomenological’ psychiatry, and it is revised, used and defended by many still working in that tradition. On the face of it, this is rather curious. I examine what this notion of ‘understanding’ amounts to, why it entered and remains influential in psychiatry, and what insights for contemporary psychiatry are buried in the notion. I argue that it is unhelpfully associated with the view that the mental is epistemologically and methodologically autonomous, but that it nevertheless highlights an important lacuna in many views of psychiatry and the scientific study of humans more generally.