Horst-Eberhard Richter: The pain in phenomenological classification

Reviewed by Prof. Dr. med. Hartmut Göbel , 20.12.2024

Background

Horst-Eberhard Richter was only enrolled in medicine at the Humboldt University in Berlin. Richter had the desire to do a doctorate in philosophy. He therefore had to make an application for admission to the doctorate. As a reason, he stated that philosophical work was a central question of life for him. He did not see the philosophical doctorate as a formal conclusion that has only external importance for his future as a doctor, but as the basis for the further development of his philosophical activity. He had a connection between medicine and philosophy. He later realized this connection in his life in diverse writings, in particular on psychosomatic medicine and social philosophy. His philosophical examination of his dissertation on the phenomenology of pain was based on his personal experience of physical and mental suffering. He learned about the murder of his parents from captivity and subsequently fell ill with pneumonia. Lonely, without people nearby, he felt suffering as a saving repression. She led to people to catch and care for him until he had strength again. Afterwards he wrote about his philosophical thesis on the pain in which he dealt with himself about his misery and his guilt. He tried to deal with his personal depression, but at the same time with the ideology of Nazi heroism and its version of the sacrificial myth.

Richter wrote his philosophical dissertation in 1946 at the age of 23 and ended it for 25 years in 1948. According to the publisher Hans-Jürgen Wirth and Wilhelm Rimpau , this work is a central key to his entire work in the foreword to the dissertation Both his journalism as an author of numerous books and articles, as well as his commitment as the initiator of social therapy projects and the initiatives of peace policy. In the afterword by Wilhelm Rimpau, the detective search for a copy of the philosophical dissertation script by Richter described. An indication of their existence resulted from the curriculum vitae, which judges added to his medical dissertation. There is the remark that on August 16, 1948 phil. received her doctorate and took off his medical state examination on May 31, 1949. The reports on the dissertation, which was evaluated with Magna Cum Laude. In the university archives, however, the writing was not found. It did not appear in print form because the publisher, who had already prepared the publication up to the pressure flags, suddenly became insolvent. Another publisher then no longer offered the manuscript. By chance there was a copy of the dissertation script in the office of the German section of the international doctor: inside for the contraception of the nuclear war, doctor: in social responsibility eV the editors Hans-Jürgen Wirth and Wilhelm Rimpau enable the work that has now been published for the first time Richter 's thoughts are incorporated into the current scientific and political discussion, which is characterized by the endangerment of the existence of mankind through the climate catastrophe and wars.

author

Judge was born in 1923 as the son of an engineer in Berlin. There he studied medicine, philosophy and psychology. In 1962 he was appointed psychoanalyst at the University of Gießen on the newly established chair for psychosomatics. There he built up a interdisciplinary center for psychosomatic medicine and led this 30 years. Richter was retired in 1992 and then switched to the Siegmund Freud Institute in Frankfurt as a director. He headed this until 2002. The judge was voice of the peace movement in the 1980s. He campaigned against the Iraq war and was committed to peace and the environment. He ran against globalization, financial crises and pollution. The author was, among other things, co -founder of the German section of the doctor: inside against the nuclear war, which was awarded the Nobel Peace Prize in 1985. Judge was considered an important personality of psychoanalytic family research. "Parents, Child and Neurose" (1963) and "The Complex God" (1979) include important works. In the latter work, Richter up pain and suffering again. He analyzes how modern man tries through science and technology to overcome illness, age, pain, suffering and death and maintain a terrific self -image. He argues that the denial of suffering and fainting leads to an "illness not to be able to suffer" in which negative feelings are projected onto scapegoats. He sees these mechanisms as the central challenges of modern society, the overcoming of which becomes the question of survival of humanity. The connection between social engagement and science attributed judges to his experiences in the Nazi era in which science was exploited. Science, thinking and research on the one hand are directly connected to social engagement on the other.

Construction

The book is initiated by a foreword by publisher Hans-Jürgen Wirth and Wilhelm Rimpau . The three main chapters bear the heading "The Physiology of Pain", "The History of the Psychological Classification of Pain" and "The Experience Contributions to Pain in Phenomenological Conservation": The literature, an appendix and an afterword by Wilhelm Rimpau . In a final appreciation of Hans-Jürgen Wirth, the life and work of Horst-Eberhard Richter as a psychoanalyst, family therapist, social philosopher and politically committed citizens from various perspectives is considered and evaluated.

Contents

In the introduction Richter explains that the term pain in Indo-European development ex ante was based on the expression of both the physical sensation and a mental-spiritual function. In general, however, there would be no doubt that there is an original phenomenal difference between a bodyy hurt and purely mental suffering. On the other hand, emotional sadness could sometimes even cause violent physical pain, so that experience of experience occurs in which the sadness and physical pain have been inseparably merged. Organ sensations have to be distinguished from feelings and affects. Richter 's output hypothesis is that the phenomenon of physical pain should be treated separately from the outset. The task is to make the phenomenological difference to that experience of the "painful heartbeat" in contrast.

In the chapter on the physiology of the pain, the author describes the current state of physiological knowledge about pain at that time. The purpose is to provide an orientation through the physical foundations of the pain sensation. He examines whether it is possible to grasp the phenomenon of experience itself from the basic fund of the pain. This analysis emphasizes that the insights are limited to the physical basis of the pain sensation. Psychology and philosophy could therefore hardly rely on their views of the nature, form and meaning of pain on the knowledge of pain physiology at that time.

Judge complains about the lack of knowledge of his time about the physiology of pain. He asks three central questions: (1) What is the exact anatomical surface of the pain sensation? (2) What somatic conditions must be given so that pain is triggered? (3) How is the pain process in physiologically obtained?

Richter answers the first question with the statement that Viktor von Weizsäcker met in his lecture "On the Clinic of Pain": "It is not good for ensuring our basic neuroanatomical ideas in pain theory". Richter specifically attacks the Descartesche paradigma, according to which harmful stimuli in the periphery is a prerequisite for the sensation of pain. According to this approach, the mind and body are two fundamentally different objects that could exist independently of one another. This thinking led to a mechanistic understanding of the physical world, while the spirit was regarded as an intangible authority. Judge criticizes this idea, based on clinical experiences, according to which serious damage to the lungs, skin or brain is painless, while that could cause severe pain in connection with trigeminal neuralgia without tangible anatomical damage. A somatic pain stimulus is therefore not premise for a sensation of pain. Judge points to a classifical distinction between real "legitimate" pain made in medicine, which is understood as actual suffering perceptions and "illegitimate" pain without an capable peripheral pain stimulus. He asks the question of whether the pain is different in the first case than in the second and the latter a mere fantasy product, which can be ruled out from the field of physiological consideration, as is often done. He answers this question himself by depending on the fact that the so -called "pain hallucination" is a legitimate, real sensation of pain like any other. It is not adequate to measure a minor physiological basis for this pain.

In response to the third question judge points out that one is not aware of whether the course of the pain process is exclusively affected by the periphery of receptive centripetal, or whether an efferent, centrifugal modulation of the pain must also be added. While in the former case the pain is purely passive, clinical observation in medicine makes it clear that the pain is an active event, which is modulated by centrally modulating peripheral. As an example, it leads the effect of local anesthesia with the result of a sudden improvement or even healing local physical diseases. Accordingly, pain is not the result of a damaging stimulus, but vice versa - the pain can also cause and maintain physical damage. Pain is therefore not a centripetal side symptom, which would be irrelevant for the expiry of the disease. Rather, pain is a factor that actively affects the physical processes. Richter notes that the idea based on the Descartesche pain model is shaken by clinical observation. The "objective meaning" of the pain, which is regarded for a matter of course, to point out damage in the area of ​​sensation localization, does not experience any general confirmation. Somatic physiological research cannot therefore explain the experience phenomenon of pain.

In the second chapter on the history of the psychological classification of the pain, the historical change in views about the pain is analyzed. The discussion focuses on a historically critical overview of the various developments in psychological classification. In pre -Kartesian psychology, people are considered a unity of body, mind and soul. The pain is understood as the condition of the desire. Thomas Aquin grabs back to the platonic assumption of the soul as an immortal, intangible substance that exists regardless of the body and a coveted part of the soul. Out of love and hatred, a drive arises on the objects or away from them. This would result in gaudium, pain or Tristitia.

In the psychology of the Enlightenment, the pain changes to cognitive function. He is classified from the affect, the Tristitia, and placed in a row with other body sensations, which you can feel in the limbs. Pain and sadness have to be distinguished from the sensual tickle and the joy. A cognitive function is awarded to the pain. Through it, the soul is aware of a certain unpleasant physical change, an evil. Pain is expressly placed in a row with the sensory sensations. The difference is that, for example, a external object is recorded in the case of color perception, a part of the body is captured.

In the 18th century, the idea of ​​pain developed as a feeling. For example, Moses Mendelssohn in 1776 placed the theory of the three basic assets of the human soul. These would form from the knowledge of knowledge, the desire for desires and sensitivity. It could cause a matter of lust or displeasure that you can cheap, approved it, feel comfortably or disapprov, blame and experience uncomfortably.

In Herbar's theory, physical pain is seen as a sensory impression, which is inseparable from ideas. He is felt regardless of how much you take care of how patient you can stand. The pain has grown into the most intimate with the sensory sensations. While Kant sees feelings as modified judgments to distinguish things, Herbart works out two important psychological provisions of pain: on the one hand, the inseparability of the sensual sensations that accompany him. On the other hand, the external and independence with regard to the emotional center.

With the progress of physiology, the connection between sensual ideas and their physical foundations had become concise. For this, the name "sensations" has become natural. Findings are related to sensory processes associated with certain nerve objections. From now on, the other phenomena would be called "feelings". Physiological work has become clear that the peripheral pain was bound to the anatomical foundations of the nerve fibers. However, since the sensations are sensorically conveyed by processes by processes in the peripheral nerves, the question arises as to whether physical pain is not a feeling instead of a feeling. Accordingly, the sensory physiologist Johannes Müller subsumed the pain in addition to the sense of touch, cold and warmth to the qualities of the 5th sense.

Lotze contradicted this . This attempts to explain the mechanical and physical processes in the body without losing sight of the spiritual and ethical dimensions of life. The pain belongs to the feelings of reluctance and should be separated from the sensations. The sensations would only provide interesting perceptions. Only the feeling that the pleasure of the pleasure would bring the perception content into contact with our minds. It does not happen that the feelings are originally subjective, the sensations are objective.

The basic question of the classification belonging to the pain relates to the boundary between pain as a sensation and pain as a feeling. As a difficulty, it turns out that all sensations have always been accompanied by feelings. Accordingly, for Wundt, pain, painful sensation and a painful feeling are part of the development of the overall experience. Brentano, in turn, integrates the pain into his basic class of "love and hatred", its emotional nature is thus sharply separated from the cognitive sensation pad. According to Geyser, all sensation content would have to be intended as objective truths that exist in themselves. In contrast, feelings of pleasure and reluctance, on the other hand, are basically phenomena of wise of mental being. This means that they could not be presented in themselves. The result is: feelings are subjective, sensations are objective.

In the light of the modern view, pain is viewed as a sensation of emotions. Stumping clubs the previous separation to the new class with the term "emotions". He expresses that sensations would be based on the feelings and would be in a close relationship to feelings. One is forced to consider the purely sensual pain phenomenon despite its particularly close relationship to reluctance to reluctance than a pure sensation. It is undoubtedly that the phenomenon is already as painful and completed, before and without the mind, the feeling of me, somehow takes care of it. Pain is to be differentiated from the ordinary sensory sensations. He can be put together with the localized sensual wool lust or coordination states into a special group of sensations that would be titled "sensory sensations".

Richter sees two open questions. On the one hand according to the type of specific being of pain sensation towards the other sensations of emotions. The qualitative "so being" of the pain, which causes it to hurt us, is no longer accessible in any other way as the current experience itself. The second question is that of the relationships that are subject to pain sensation in connection with the overall life. Especially the experience relations of the pain would include the totality of the personality with all their layers in the event.

In the third chapter on the experience of the pain in a phenomenological view, Richter developed a differentiation of the being of the pain. He asks the question of the functional relationships in which the sensation phenomenon of pain can occur within the psychological whole. He separates the pure sensation of the sensory perception content from the secondary experience components, which already affect the processing and evaluation of the content of consciousness. The aim is to first emphasize and differentiate the component of the pain, what makes pain into pain without inducing the emotional consequences of the sensory experience. On this basis, in the next step, the influence of this sensory sensation into the overall life is shown. Richter makes these experience of pain in the overall consciousness of the central center of his dissertation. It is the question of nature and forms of the functional references of pain within the psychological whole. From this he develops a comprehensive phenomenology of pain life for the first time. He differentiates the wise of pain life into different components. On the one hand in those who instinctively process themselves in the so -called "vital sphere" and on the other hand into those that contain their imprint from the custodian through an active intervention. He divides these main components of the pain into further forms of experience. judge differentiates the pain phenomenologically into different dimensions, knowing that the experience of pain includes a diverse lively diversity in terms of consciousness content and behaviors. Knowing about these limits, he limits the phenomenological delimitation of pain components to divorce lines, which already seem to be prescribed in the nature of phenomenal contents of consciousness. In this way, he prefers a gross but continuing structure of the phenomenon pain in order to create a practical basis for the scientific understanding of pain life. The author outlines relatively shortly the possibilities of exposure to emotions and person central interventions on pain life. He sees the conditions of so -called psychogenic pain in this. His goal is less to describe the physiological foundations of these sensations than to point out these relationships at all.

Richter develops a layer scheme of localized sensations of emotions and the pain -related vital effects. Judge categorizes them. The vital damping goals on moods that are expressed in words like "I feel bad, bad, misery". The expectation experienced, the feeling of weakness expresses the only rarely used word "Siechen", related to the English term "seinging". This vital damping is accompanied by a drop in blood pressure and slowing down the heartbeat.

The vital excitement, on the other hand, leads to vital turmoil, tension of all forces and lively discharge. Sweat, reddening of the face, pulse acceleration, muscle tension are visible signs of organic turmoil. They are signs of pain work. So the experience of pain seems more a painful, unsuccessful activity than a mere suffering. This vital pain experience makes a change in the behavior of the individual to society and the environment. On the one hand, a cry for help. The pulse of pulses would master hatred, pride, selfishness and all anti -social tendencies. However, insulation tendencies have a contrary. Pain makes people selfish. He tears people out of all supporting covers to his fellow human beings.

Furthermore, the sensation of pain is impaired by vital feelings. The pain does not remain the same when it comes into the vital feelings, but assumes that it depends on them. Relaxation led to pain reduction, but anxious concentration on the pain to increase pain. Want to get healthy is part of healing.

After all, pain can be generated by vital emotional “imagination” or this can also lead to sensitivity to pain. These are suggestive, fully illicit imaginations of pathological, pain -related physical changes, which are experienced with severe affective sympathy. Richter describes this with the concept of hysteria. It is not a single pain, but its imaginable substrate. Richter describes "autogenic training" as an example. With its help, the influence of pain and other body sensations as well as somatic functions is possible.

The central lifestyle of the pain would structure themselves into those in which the center of personal center encounters pain as such in its sense of vital, to follow him as an external state of herself. However, he could also be kept with himself that the core of the person could absorb the pain entirely, remove it from his natural reference through an act of identification and become one with him.

Pain is also expressed in the external argument. This includes accepting with the pain and wearing the pain. The stoic objectifying of the pain aims to keep free from all shattering effects through the pain and to refer it back to his pure sensation. The thesis that the pain is not evil means the request to remove the pain of the bad, namely the affective disgrace by one's own deed. If the pain is an evil, it is the guilt of the person concerned who makes him. Through his mentally central self -control, people have given people to refuse to pain any emotional tribute.

Fighting pain offers the highest drama under all kinds of personal behaviors. The internal appropriation of the pain leads into the state of suffering. To suffer a pain, mine, allow him, to shape his implementation.

It could not make pain "blessed", rather the reverse applies: bliss would primarily be based on the pain experience. If a suffered pain has to be given an effect of the explanation and deepening, it is only the effect of increasing clarification of the core of our existence for our awareness. The suffering personalization of the pain requires intensive sinking into the depth of the personal nature, a steady update and complete updating of the m presverteness. Consciousness must withdraw from all the uninvested peripheral experience at the moment and, in this respect, be clarifying and leaning. Accordingly, Nitsche describes the great pain as a liberator of the mind.

judge examines the effects on the sensation. He distinguishes functions that affect the remark of pain and those that attack and determine the sensation process itself. For example, stoic behavior could push back the vital emotional effects of pain. Intellectual distraction could also lead to preventing pain. This has therapeutic consequences for psychotherapy. According to judges, illness -related conflicts can cause pain due to unsuccessful displacement. This could cause pain if a head worker has to despair of his intellectual task. A general characteristic of all of these conflicts is that a given strut of any kind can neither be lived out nor decidedly to be forced. The psychological reason for the development of pain is based on the fact that the personality does not succeed in coping with a decision -making task, which lies in the coercion of affirming or denied an updated intensive desire. Pain could then arise at the point where the ego will be at this decision. Be it that the desire is practically unfulfilled or that it is not allowed for reasons of conscience. No determined personnel no can be spoken. A liberating disempowering of the desire with the prevention of pathological sequence does not matter. Half, incompletely failed repression causes pain. A conflict between secret wishes on the one hand and resigning on the other. The result is a fateful indecision. The root of psychoanalytically curable pain lies in this person center. Judge concludes his dissertation with the outlook of how the conflict of pain and illness would be overdue, it must be further clarified by a technical science.

discussion

With the publication of his philosophical dissertation 75 years after his creation, judge an invaluable insight into understanding the pain in the middle of the last century. He develops this precisely from historical, philosophical, physiological and clinical view. On this basis, he describes his own phenomenological layer theory of pain knowledgeable. This leads to a new phenomenological classification. Without pronouncing it directly, he realized that pain is not to be defined "in itself". Rather, only the individual components of the pain of pain and pain can be delimited and analyzed in their nature and their relationships are recorded with each other. While medicine is usually largely based on the Descartesche pain model at its time and still today, only the pain that can be tangible by somatic causes is considered an unimodal medical enemy as "legal", judge through this limited "Ptolemaic world view" of the pain . It describes the diversity of the experience in detail and in a high -precision, virtuoso, in today's language that can hardly be found. He assumes physiological ideas and research in his explanations, which were only physiologically described and justified in the 70s and 80s of the last century. Examples are the efferent pain control and the gate control theory of pain, albeit controversial. This work is obviously made possible by the broad formation of judges in medicine, psychology and philosophy. From today's perspective, his considerations on the psychoanalytic development of pain and its therapyability must be viewed critically. In summary, the work is an invaluable treasure trove of knowledge about the pain in the course of human history. Anyone who deals with pain in science and practice should know.

Conclusion

The work "The Pain in Phenomenological Classification" by Horst-Eberhard Richter describes the knowledge of the physiology of pain in the middle of the 20th century, and the historical development of the philosophical and psychological view of pain is examined from ancient times to modern times. Building on this, the author develops a phenomenological classification of the pain in which experience, sensation, vital functions and person are differentiated in a psychological layer hypothesis. An afterword by Wilhelm Rimpau describes the history of the work. Finally, Hans-Jürgen Wirth Horst-Eberhard Richter as a psychoanalyst, family therapist, social philosopher and politically committed citizens.

Review of
Prof. Dr. med. Hartmut Göbel
Director of the Pain Clinic Kiel Specialist in Neurology, Special Pain Therapy, Psychotherapy Diploma Psychologist
Mail form