Janusz Rybakowski: Emil Kraepelin´s dchotomy of "endogenous psychoses" in histoical prspective


Nassir Ghaemi’s comment on Carlos Morra’s comment


         I often hear colleagues invoke Kraepelin’s last edition of his textbook, or other articles in the last years of his life in the 1920s, and use those writings to contradict his earlier statements.  They feel that such reference is sufficient to prove their point. In fact, it isn’t.

         Just because someone says something when he is older doesn’t mean that he is more correct than what he said when he was younger.

         This phenomenon is common especially with great thinkers, in whom there always is an Early, Middle, and Late thinker.  The assumption in these critics of the Kraepelinian system often is that the Late Kraepelin is the Right Kraepelin, or the Best Kraepelin. But how do we know that?

         Is the late Marx the best Marx?  Or is the early Marx, who was much more liberal and humanistic, a „better” Marx? Is the late Freud the best Freud?  Or are his early works on sexual repression more meaningful and closer to clinical reality? Is the late Heidegger the best Heidegger? Or is the early Heidegger of Being and Time much more original and influential? The late Sartre vs the early Sartre?  The late Jaspers vs the early Jaspers? The late Einstein vs the early Einstein?  The late Nietzsche vs the early Nietzsche? 

         I personally think that if one had to generalize, the best phase of a thinker is his or her most mature phase, which usually is in the middle of one’s life. The middle Marx who wrote Kapital is the mature Marx. The middle Freud who wrote Ego and Id is the mature Freud. The middle Heidegger, the middle Jaspers, those are the core thinkers.  The middle Kraepelin of 1896 to about 1910 is the mature Kraepelin.

         Later is not necessarily better.

         So turning to the clinical question raised by my colleague I don’t know if paraphrenia is legitimate, but unless there is good scientific evidence that is collected for it, I wouldn’t give it any special prestige just because it was part of Kraepelin’s later works.


July 30 2020