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An important trend in current psychiatric thinking has been a growing interest in existentialism and phenomenology. This has been more intense in Europe than here; witness that the Fourth International Congress of Psychotherapy at Barcelona devoted itself entirely to these subjects. There are many understandable reasons for such interest. Our concept of neurosis (and of psychosis, likewise) has changed from a more circumscribed symptomatological one to a more general characterological one, from the person with a sickness to the sick person. The type of illness we see in psychoanalytic practice has changed from a predominance of the more or less clear-cut neurosis to an increasing percentage of the more schizoid or borderline case. We are realizing more and more that no one currently held psychological theory explains all the human phenomena we see, though some may account for more observations more satisfactorily than others, and so may better serve as working hypotheses.
That there has been such a lag in enthusiasm and interest in this country in spite of these awarenesses seems to be due to two related groups of causes; one inherent in the nature of psychiatric development here, the other inherent in existential theory itself. On one hand, the search for more comprehensive approaches to psychic pathology has taken other roads during the past three decades (while Existentialism was evolving in Europe). We have tended to organize new psychological ideas into “schools,” some of which have shifted emphasis while retaining their major tenets, for example, the Freudian from instincts to ego psychology. Others have grown de novo around each new theory or psychogenic factor found to play a part in mental illness.
On the other hand, there has been a paucity of comprehensible literature available to the psychiatrist here. Original European work has been written in extremely complex terminology, the meaning of which is often difficult to grasp. This complexity may be inherent