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Existential Encounter in the Asylum: Ludwig Binswanger’s 1935 Case of Hysteria

Boston University, slanzoni{at}bu.edu

This paper examines the Swiss psychiatrist Ludwig Binswanger’s view of the doctor-patient relationship as a direct and trusting existential encounter in a 1935 clinical case of hysteria. Drawing upon unpublished materials from the patient record and correspondence, I show that his conception of existential encounter emerged from the Bellevue asylum context, where treatment choices were linked to maintaining order in a communal setting, and addressing a complex array of bodily and psychological symptoms. Binswanger touted the underlying, positive relationship with his patients as the critical factor in the efficacy of a wide variety of treatments, including some of the most forceful and authoritative. Sources from the patient’s perspective, however, demonstrate that, in this case, a mutual relationship of trust was not clearly achieved.

Key Words: Binswanger • existential • encounter • history • hysteria • psychiatry

History of Psychiatry, Vol. 15, No. 3, 285-304 (2004)
DOI: 10.1177/0957154X04039352


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