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This paper is a superb exposition of the development of existential psychiatry and its current rationale and technique. In an area notoriously short of explanations and perhaps overloaded with philosophical statements, it makes an important contribution in terms of the similarities and differences between existential therapy and psychoanalysis.
Jaspers pointed the way from descriptive, objective psychiatry to phenomenology. The focus became the patient's experience seen from within. He stressed the forms of inner experience, while psychoanalysis explored the content of inner life. With the concept of 'two melodies being played simultaneously; although these two melodies are as dissonant as can be', Havens passes to the work of Minkowski—the realm of existential encounters. Minkowski compared the patient's psychic life with his own. This involved elevating the doctor's emotional response to a principle of investigation and treatment. Thus the subject matter of existential psychiatry developed from individual phenomena discussed by willing informants with objective physicians into whole inner states now experienced in explosive contact between people not always recognizably physician and patient. Binswanger's contributions stressed an empathy with what is sick, i.e., a rapport with what might arise as a barrier to communication. Binswanger attempted to come unencumbered into the clinical situation to allow for the 'engagement of feelings' which would result in a change in both parties. Within such a setting the dissociated elements might be changed or led back into a newly integrated personality. This is accomplished by virtue of the therapist's allegiance to the dissociated elements, not merely an alliance with the normal personality.