Psychotherapy Case Studies of the 18th Century: Das Magazin zur Erfahrungsseelenkunde

Karl Philipp Moritz‘s (1756-1793) das Magazin zur Erfahrungsseelenkunde (translated as the Magazine for Empirical Psychology)  could be the first published books (or journal) of modern psychotherapy case studies. The magazine is unfortunately, still not translated into English.

100 Years before Freud…

When we think of the dawn of psychotherapy, we think of Sigmund Freud, the father of psychoanalysis.  Freud’s writings are filled with case studies of people’s lives, narrated by the persons themselves or by people who are in contact with them (e.g. family, doctors, etc.). Psychotherapy (and psychoanalysis) was born out of the realization that through the talking about, the narration of one’s inner life stories, the narration one’s experiences in relation to one’s society / culture / beliefs etc., one achieves and awareness of the self through the sharing of these “stories” with another. Therefrom comes a process of psychological healing. The term “talking cure” is coined by Freud’s first documented psychoanalytic patient, Bertha Pappenheim (Freud et.al 2009 /1895). Freud’s writings were, however, created more than a century after Moritz’s Magazin. 

The Magazin, das Magazin zur Erfahrungsseelenkundewas published in the years 1783-93. Edited by Karl Philipp Moritz, it is thought to have also anticipated the 19th century development of fields of psychology, pedagogy, criminology, etc.  Each Magazin was published triennially and was roughly 125 pages long. There are in total 10 volumes, each in 3 parts.

18th century crowd-sourced material

Somewhat like the Wikipedia of today, das Magazin is also (to a certain extent) a crowd-sourced. There is no one author to this journal. The readers were encouraged to make public “the secret history of own thoughts”, record behavior of neighbors, students, and friends, publish their earliest childhood memories and write case histories of criminals, madmen and other misfits. It was a collaboration of lay people which included also educators, judges, etc.

Interest in the Individual’s uniqueness

Moritz’s project was driven by the question: how can we find a mode of writing that does justice to the idiosyncrasies and detours of the individual’s life? How do we describe the individual-ness / uniqueness of the self?

Interest in the Individual in relation to society

Moritz’s interest was also in social deviants, and case studies from the judicial system (criminal cases). Theses case studies forces us to think about how the individual responses to societal influences. The “cases” are in fact the link between the individual’s soul and the socio-political power that is imposed on it.

In other words, the work is an initiation of the notion of psychopathology, which is actually a symptom in which a person develops as a result of negative reaction to his environment. This environment can be physical or social.  With such an attitude, Moritz’s concept mirrors the gestalt therapy approach of seeing the client in a holistic manner.

Description of cases without making judgement

The premise behind das Magazin was to portray these case studies as it is. There was interpretation or judgement of the cases presented. This is of course, different from Freud’s work.

In 1798, influential psychiatrist, Alexander Crichton, described the magazine to be a kind of publication he has not before come across since it was filled with “well-authenticated cases of insane aberration of mind”, narrated in a full and satisfactory manner, “without a view to any system whatsoever”. This means no added interpretation from higher order.

This was and still is a unique concept in writing. It is a way of sharing knowledge without controlling the reader.

These cases are narrated and described, providing as clear and complete information as possible, so that the reader gets a full as possible picture of the subject. The reader is also able to freely make his own interpretations and associations.

Moritz’s motivation

The Erfahrungsseelenkunde raises the ancient injunction to know thyself to the level of a public scientific project. Just as an individual, through self awareness can mature and live fully, so would the collective awareness bring about positive social change. Moritz says:

“If only there existed moral doctors who, like the physical doctors, were more concerned with individuals, and would publicly report of their cures, to the betterment of all…” Moritz

Moritz alludes to the need for a profession that works with the individual in the way of guidance through unique personal issues. He uses the word “moral”, which is not meant to be the same a morality imposed by culture or religion. Moritz belonged to the radical enlightenment movement that was against religious control. What “moral doctor” likely means is the healer to bring the individual to a point where he can integrate peacefully with society. This is a good goal to make in psychotherapy.

“On the basis of the combined accounts of many careful observers of the human heart one could build an empirical psychology which in practical use would exceed anything our ancestors have done on this field.” Moritz

We have many examples of psychotherapists (like Irwin Yalom who writes amazing books) who have done this: studying their patients and sharing their observations with the world. From them we have learned a great deal about our society as it unfolds.

We also gain much from people who write honest memoirs, or share their lives with others on the internet.

“In the beginning, all these observations must be collected in magazin under certain rubrics, without reflection until a sufficient amount of facts is there, and then at the end all of this must be ordered into a purposeful whole. What an important work for humanity this would be! This would be the only way how the human ace would com to know itself, swing itself to a higher level of perfection, as a single man can perfect himself through self-knowledge.” Moritz (Galius 2000)

Moritz was very careful to leave out any form of premature theorizing or moralizing in the magazine. This was to offer a moral- and censor-free space for people to learn about being a person.

We learn of Moritz’s political aspiration for creating this project in his statement  in which he implies that criminals should be studied, and not simply judged and executed (Galius 2000, p. 81):

We witnessed the execution of a thousand criminals, without considering worthy analysis the moral damage of these limbs, which were cut off from the social body. But these limbs are as important for the moral doctor as they are for the judge, who must perform this sad operation.//

He alludes to the fact that it is important for society to understand what led to deviant behavior, how to prevent it, how is society responsible for this behavior, and how could the process that had led to it have been overlooked. Moritz writes metaphorically:

How did the inflammation of the damaged limbs slowly increase? Was it possible to prevent the growth of the evil, to cure the damage? What negligence in observing or dressing this wound caused it to spread until all antidotes (Rettungsmittel) were ineffective?

Moritz also makes clear his stand on the concept that people are born healthy but become deviant as a result of life experiences. This is a controversial idea, since at the time, the belief was aligned with the Judeo-Christian doctrine that man was created sinful.

On which thorn did the healthy finger scratch itself, which little unnoticed splinter remained in it, inflamed, and gave rise to such a dangerous tumor?

The parallel of Moritz’s ideas to the work Psychotherapy

From the above quotation of Moritz, we see how he uses the metaphor of the splinter, which is something very small and often overlooked. He encourages society to pay attention to details without judgement. To observe like this allows one to see beyond pretenses of society, and to observe the underlying human condition / “secrets”– which one can say, alludes to the conceptualizing of the term, “the unconscious”.

The emphasis on “thinking in cases” is very much the foundation of the psychotherapeutic profession, in particular Gestalt therapy:

  • *to see a case study as an individual phenomenon;
  • *to unearth the hidden chain of events in an individual’s life history that leads to the symptoms;
  • *to see the individual not in isolation, but as part of a whole (including his society, status, life-cycle, biological and psychological etc);
  • *to avoid making generalized diagnosis;
  • *to share and listen to one’s stories without theorizing or moralizing;
  • *to tolerate the tension of situations that are unsettling to the society, so as to achieve awareness,
  • *to be able to integrate this knowledge.

 

Bibiliography

Breuer, J., & Freud, S. (2009). Studies on hysteria. Hachette UK.

Gailus, A. (2000). A Case of Individuality: Karl Philipp Moritz and the Magazine for Empirical Psychology. New German Critique, (79), 67-105.

Moritz, K. P. (1978 /1783). Gnothi Seauton. Magazin zur Erfahrungsseelenkunde. Berlin 1783-1793. Retrieved from:  http://telota.bbaw.de/mze/

Pinel 1754-1826 on Treatment of Illness from “Moral Causes”

Out of the era of the post French Revolution, we learn about Philippe Pinel (1754–1826), one of the founding fathers of what would later become psychiatry and psychopathology.

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“Pinel is important because of his method: he was the founder of the clinic, that is to say, of the determined and systematic approach through which mental illness acquired its distinctive status, institutions, and treatment.

With regard to theory, he took a rather peculiar stance: he remained skeptical of any form of theory that, as far as he was concerned, moved too rapidly away from observation. Hence one cannot talk about Pinelian theory. Rather, he proposed a pragmatic approach, a form of know-how (savoir-faire) that enters history under the name of the “moral treatment” (traitement moral). This approach accords with his views on etiology. (Verhaeghe, 2008. p 93)”

He distinguishes between three groups of pathogenic factors / causes of illnesses:

  • • Physical causes (trauma, organic diseases);
  • • Hereditary causes (debility);
  • • Moral causes.

Deeming the first two practically incurable, he concentrates on the third group, which can be inferred to as describing psychological pathology. His ensuing treatment model recalls the Hippocratic idea of illness, in which illness is the body’s healthy defensive reaction to an imbalance, and whose normal result is health. This is not unlike much of the philosophy of traditional medicine which we also embrace today.

It is clear that such a conception of illness has important repercussions for the way the person who was then called the “alienist” responds. Pinel sums this up in three basic rules:

  • • He has to wait;
  • • He has to avoid any intervention that disturbs the natural course of the illness (because its ultimate goal is health);
  • • He must help the illness progress.

It is precisely this last that constitutes the “moral treatment.”

This principle of “waiting” instead of leaping immediately into trying to “cure” or “treat” or solve a problem” or to “eliminate the pain”, with regards to working with mental issues was also clear in the decades prior to Pinel. The creation of the 18 century Magazin by Moritz, das Erfahrungsseelenskunde, centered also around the same premise of observing without premature judgment, or looking for explanation. Moritz also wrote about the need for “moral doctors” to work with individuals seen as societal deviants.

This is also in line with the principles of the Paradoxical theory of Change in Gestalt Therapy, written by Arnold Beisser in the 1970s.

With regards to psychological health and working with patients with psychological and psychosomatic issues, this attitude of being patient, of observing and understanding the client’s symptoms, and allowing the client to understand his/her situation in order to support the change process, without premature intervention is crucial for therapeutic change in psychotherapy.

The magic pill that solves the problems immediately, does no magic in helping the client work through with the goal of dealing permanently to alleviate the symptoms of depression, anxiety and other inter- and intra-personal issues.

Bibliography

Verhaeghe, P. (2008). On being normal and other disorders: A manual for clinical psychodiagnostics. Karnac Books.