Background Experience as the Shared Cultural Context

Foucault refers to Ludwig Binswanger’s (1881–1966) existential analysis in his search for a method that would allow the grasping of experience without explaining it in terms of causes or classifications. He does not follow Binswanger faithfully, which is typical of him, but he acknowledges that the strength of Binswanger’s work is his attempt to operate on the concrete level of existence by treating patients as persons and trying to understand the ways in which they experience their own being (DEI.1, 93–94; 96–97; Basso 2012, 160). Binswanger distinguishes his existential analysis from philosophy because of its practical, therapeutic context, hence he refers to it as “phenomenological anthropology” (Binswanger 1962; Brencio 2015, 282).

I argue above that mental disorders become manifest and are expressed in relationships with others according to Foucault: even if experience is understood as something the individual lives through, it does not mean that mental disorders should or could be reduced to individual minds. In referring to Binswanger and the tradition of phenomenological anthropology, Foucault positions his study as an analysis of intersubjectivity (MIP, 45). The emphasis on intersubjectivity stems from Binswanger’s indebtedness to Heidegger and his

“intentional misreading” of Heidegger’s Being and Time. Heidegger characterises Dasein as a mode of being, and he deliberately distinguishes the concept from that of a “human being”—

he explains that in the case of Dasein, being itself is at issue (Heidegger 1978, §10). He further defines Dasein as being-in-the-world, which means that Dasein is profoundly relational and embedded in the practical social world rather than an entity amongst other entities (Heidegger 1978, §12). Binswanger stresses the relationship between the psychiatrist and the patient in his formulation of Daseinsanalyse for therapeutic purposes: patients should not be defined by their symptoms but should be understood as they are situated in the world in their entirety (Brencio 2015, 282). From this perspective, psychoses, as specific forms of being-in-the-world, can be understood only in terms of a certain world design (ibid.).

Foucault uses the concept background experience (expérience fondamentale) with reference to psychosis as an intersubjective experience in which relationships with others are altered (MIP, 45). This raises the question of what background experience means in this context. Foucault argues that it “dominates all pathological processes”, and that practitioners should reconstitute the pathological world, the world that the patient experiences, by means of direct contact (MIP,

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45–46). Dreyfus provides a Heideggerian reading of Foucault’s Mental Illness and Psychology, arguing that directing and orienting oneself towards the world always presuppose a context, a background understanding, even though one does not consciously reflect upon it (Dreyfus 1987, xviii). In familiar surroundings, one instantly knows how to operate with objects and entities without paying attention to or questioning the ways in which they embody an understanding of the meaning of being (ibid.). In other words, language, tools and institutions of the concrete environment embody the ways in which background contexts respond to the question of “what it means to be” (ibid.). Foucault does not thematise or address the question of being in this Heideggerian sense, but throughout his work he focuses his inquiry on actual statements and expressions, concrete techniques, practices and architectural arrangements.

This emphasis on concrete statements and material arrangements represents a strong philosophical commitment: the idea is that concrete phenomena such as bodily expressions, daily routines and spatial orchestrations embody a comprehensive background experience of the world.

However, in Zollikon Seminars Heidegger rejects Binswanger’s objectives of developing Daseinsanalyse for psychiatric purposes.¹² He argues that Binswanger’s approach remains on the anthropological (ontic) level, which means that his analyses only provide descriptions of human beings as reduced to subjects of human-scientific or anthropological knowledge (Heidegger 2001, 115; 190). He further claims that even if Binswanger takes the concept of being-in-the-world as the starting point of the method he uses in psychiatry, he does not take seriously enough the fundamental ontological project of Being and Time and the constitutive dimensions of the viewpoint of the one who is present in the world—the patient (Heidegger 2001, 188–189).¹³

Foucault, for his part, defends the way in which Binswanger combines Heidegger’s conceptual apparatus with the analysis of patients’ everyday experience. As he explains, the anthropological aspect of Binswanger’s method involves approaching and treating patients as subjects of experiencing, whereas the ontological task is to investigate the ontological structures of existence—such as temporality, spatiality, sociality and corporality—as they are

12 On Heidegger and Binswanger see Brencio 2015; Askay & Farquhar 2013.

13 Heidegger criticises anthropology in Being and Time and in the Zollikon Seminars, and the critique is targeted explicitly towards Binswangers’s psychiatric Daseinsanalyse (Heidegger 2001, 115; 188–189; 190). In Being and Time, Heidegger distinguishes his existential analytics from anthropology, psychology and biology: they do not address the question of being, because they only focus on the objects of knowledge as things. Anthropology, as Heidegger knows it, takes for granted concepts such as “man” and “life” without analysing them philosophically (Heidegger 1978, §10).

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manifest in experience.¹⁴ Anthropology in this context raises the question “What is it like to be a human being?”, whereas ontology addresses the question of the singular who that is announced at certain “structural moments” (Binswanger 1993, 84).

Thus, in Mental Illness and Psychology Foucault gives examples of pathological distortions in the structures of experience: these include disturbances in temporality (such as the fragmentation and discontinuity of time, and hyper-reflective awareness of eternity), spatiality (shattered and disconnected surroundings and objects), the social world (becoming profoundly the other, losing things that are shared, such as language and expressions), and one’s own body (the strangeness of sensing it or disturbed ideas about its constitution, location in space and so on) (MIP, 50–54).¹⁵ One example of these structural distortions is the notion of “falling”, which Binswanger picks out from patients’ descriptions of their emotional collapses. He argues that these expressions should not be perceived merely as figurative speech: after a severe disappointment or a state of shock one might experience falling even though there is no physical aspect of collapsing (Binswanger 1993, 81–82).¹⁶ The concept of falling depends on a matrix of meaning in which the movement from above to below has existential significance to the subjects who experience it (Binswanger 1993, 82).

Foucault explains in Mental Illness and Psychology that the task of his analysis is to grasp “the radical alteration of the living relationship with others” (MIP, 45). In other words, his point in arguing that the experience of illness or distress covers much more than mere symptoms is that awareness of one’s own situation becomes manifest in the intersubjective sphere. The different ways in which patients try to reject or accept their condition and give meaning to it are integral to the experience of mental distress, and such conditions require constant activity in terms of adjusting and re-orientating oneself in the natural and social world. In Dream and Existence, Binswanger describes a patient who wishes to withdraw entirely into a subjective realm, but he argues (for structural existential reasons) that there is no possibility of a complete dissolution into subjectivity, not even in psychotic cases (Binswanger 1993, 91).

14 The distinction between anthropology and ontology is without doubt Kantian (see Chapter 1.3). Foucault argues in “Dream, Imagination and Existence” that the distinction between anthropology and ontology only has an operational function in Binswanger’s work, and that in practice it is difficult to draw such a line (DIE, 32). He describes how Binswanger moves “back and forth between the anthropological forms and the ontological conditions of existence” (ibid.). Foucault is well-known for his critique of the anthropological structure of knowledge, especially in The Order of Things. He also describes anthropology as “a problematic structure of philosophizing” in other early essays from the 1960s in that it addresses all philosophical questions from the first-person perspective and objectivises the others (DEI.30, 467).

15 These structures of experience have been studied extensively in later phenomenological research on mental disorders and psychopathologies. See Heinämaa & Taipale 2018..

16 In a more recent debate on existential psychiatry, Thomas Fuchs analyses the experience of falling into a depression. See Fuchs 2002.

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In Mental Illness and Psychology, Foucault gives examples of the different ways in which patients can be aware of their mental disorders: they may, for instance, create a maximum distance from their own condition and perceive it only as an organic process, or they may acknowledge a change with respect to their previous life and feel that its meaning has profoundly altered. Alternatively, they may fully accept hallucinations but also recognise (at times in a minimal sense) that in doing so their world seems radically solitary and separate from the world of others; they might also describe their experience as a dreamlike state that is different from the world of those who seem to be awake (MIP, 47–50). The point is that most of these examples manifest not only a clear awareness of change, but also an altered relationship with the world and with others.