Phronesis as therapy and cure

In March 2020, our new edited volume Forms of Knowledge: Developing the History of Knowledge (Nordic Academic Press) will be published. The book is a product of the newly established Lund Centre for the History of Knowledge (LUCK) and brings together some twenty historians from different scholarly traditions to develop the history of knowledge. In the weeks to come, we will publish a series of samples from the book.

 

In my essay, I explore the concept of knowledge in early Swedish psychotherapy. When it comes to describing mental illness and its treatment there has never been much consensus, but the early twentieth century was particularly marked by heated debates and conflicting views, as very different ways of conceptualizing mental illness evolved at the same time. I examine how leading psychotherapists defined their method in opposition to other forms of treatment. What kind of knowledge was considered relevant in the clinical encounter, in order to successfully treat a patient? How was this knowledge different from other forms of knowledge? And, crucially, how was knowledge to be defined in the first place?

I am inspired by the hermeneutics of medical encounters developed by the philosophers Hans-Georg Gadamer and Fredrik Svenaeus. Thus, I regard the clinical encounter as much more than just a doctor treating a patient—it is a relationship between two individuals with their own personal beliefs and experiences. In order to get a genuine dialogue going, so making a successful treatment possible, the practitioner needs certain skills that are not just applied scientific or theoretical knowledge. Rather, scientific knowledge is always applied in the dialogical meeting. Practical knowledge is a key concept. It closely corresponds to Aristotelian phronesis, which can be described as practical wisdom gained through long experience of practical matters in life. Focusing on early psychotherapy, my aim is to see how the role of the practitioner can be interpreted from a hermeneutical perspective, and in what way it relates to the concepts of practical knowledge and phronesis.

By the early twentieth century, psychiatry had been established both as an academic subject and as a clinical profession in the asylums. It was, however, a rather new and shaky enterprise. Psychiatrists struggled to prove themselves as scientists and to achieve the same status as other physicians. One way of doing this was to promote a forceful biological model when it came to the origins of mental illness. At the same time, another approach to mental illness was gaining ground. Rooted in hypnotic treatment, early psychotherapy now saw the light of day. In Sweden, the famous physician and hypnotist Otto Wetterstrand gained an international reputation as a healer of all sorts of ailments in the 1880s and 1890s. One of his pupils was Poul Bjerre, who became the most industrious promoter of psychotherapeutic treatment in the early twentieth century. Other psychologically oriented physicians also endorsed a treatment based on suggestion, hypnotic sleep, and a close and intimate relationship between patient and practitioner.

There was a heated discussion among physicians as to the value and effectiveness of psychiatry and psychotherapy. At the core of the conflict lay the concept of knowledge itself. In my essay, I approach early Swedish psychotherapy from three different viewpoints: the relationship between theory and practice; the concept of practical knowledge; and the limits of knowledge.

 

Cecilia Riving

Researcher, Lund University

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