Scientific Contribution Catharsis and Moral Therapy II: an Aristotelian Account
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Medicine, Health Care and Philosophy (2006) 9:141–153 Ó Springer 2006 DOI 10.1007/s11019-005-8319-1 Scientific Contribution Catharsis and moral therapy II: An Aristotelian account Jan Helge Solbakk Section for Medical Ethics, Faculty of Medicine, University of Oslo, 1130, Blindern, NO-0318, Oslo, Norway (Phone: +47- 22844641; Fax: +47-22850590; E-mail: [email protected]) Abstract. This article aims at analysing Aristotle’s poetic conception of catharsis to assess whether it may be of help in enlightening the particular didactic challenges involved when training medical students to cope morally with complex or tragic situations of medical decision-making. A further aim of this investigation is to show that Aristotle’s criteria for distinguishing between history and tragedy may be employed to reshape authentic stories of sickness into tragic stories of sickness. Furthermore, the didactic potentials of tragic stories of sickness will be tried out. The ultimate aim is to investigate whether the possibilities of developing a therapeutic conception of medical ethics researched in a previous article on catharsis and moral therapy in Plato may be strengthened through the hermeneutics of the Aristotelian conception of tragic catharsis. Key words: Catharsis, emotions, error, fallibility, fear, guilt, hamartia, therapy, tragedy Introduction in their teaching, i.e. on conceptual clarifications and purifications, on methodological case study The present article aims at investigating Aristotle’s analyses and on rational strategies and theories for controversial treatment of the notion of tragic resolving moral dilemmas, while neglecting the catharsis in the Poetics. There are three reasons for cathartic role that pity, fear and other painful limiting the scope to the Poetics. For a first, there emotions, such as e.g. anger and embarrassment are reasons to believe that Aristotle’s conception of may play in the process of moral discourse and poetic catharsis represents ‘‘some sort of response learning. In this way I also hope to show that the to Plato’’ (Nussbaum, 1992, p. 281). Second, in his possibilities of developing a therapeutic conception definition of tragedy in the Poetics, Aristotle makes of medical ethics demonstrated in a previous article a controversial connection between catharsis and on Plato’s conception of cathartic treatment and the emotions of pity (eleos) and fear (phobos).1 moral regimen may be strengthened through the Third, there are reasons to believe that an inves- hermeneutics of the Aristotelian conception of tigation of the emotional potential of Aristotle’s tragic catharsis. poetic conception of catharsis may lead to a more accurate diagnostics of the particular didactic challenges involved when training medical students Aristotle’s poetic account of cathartic treatment to cope morally with complex or tragic situations of medical decision-making; these are situations One argument that will be substantiated in this where one is forced to make decisions with paragraph is that Nussbaum is right in her claim potentially disastrous consequences for one or that Aristotle’s conception of poetic catharsis several of the parties involved, while at the same represents a response to Plato, notably to the time one is faced with the fact that the possibility of purist view of catharsis advocated in the Phaedo abstaining from making a choice or of making a and the Republic. On the other hand, by limiting choice not contaminated with some sort of error or her scope to the two most idealistic dialogues of guilt (hamartia) is non-existent.2 Plato, i.e. the Phaedo and the Republic, she fails to My claim is that lecturers in medical ethics acknowledge that the conception of cathartic mainly focus their attention on instrumental issues treatment suggested in the Charmides and the 142 JAN HELGE SOLBAKK Sophist is fully compatible with Aristotle’s concep- moral interpretations, including interpretations of tion of tragic catharsis introduced in the Poetics. catharsis as an education of the emotions, According to J. Hardy (Hardy, 1932, p. 16) catharsis conceived of as the experience of emo- there is no passage in Greek literature more tional relief, famous than the ten words of the Poetics where aesthetic interpretations or interpretations of a the notion of catharsis is dramatically depicted as dramatic or structural nature, and finally interrelated with the painful emotions of pity complex or ‘holistic’ interpretations of catharsis. (eleos) and fear or terror (phobos). The passage In my analysis I nourish no ambition of being which throughout the centuries has given rise to able to settle the old controversy and determine such ‘‘a deluge of works’’ (German: ‘‘Flut von which of the interpretations of catharsis mentioned Schriften’’, Gudemann, 1934, p. 167), reads as best complies with Aristotle’s definition of tragedy. follows:3 My aim is of a rather different and more modest Tragedy is a representation of a serious, complete nature: to investigate the didactic potential of each action which has magnitude, in embellished interpretation in illuminating the process of med- speech, with each of its elements [used] separately ico-moral discourse and learning. In other words, in the [various] parts [of the play]; [represented] by what I hope to achieve is to demonstrate how the people acting and not by narration; accomplishing different interpretations of the notion of tragic by means of pity and terror the catharsis of such catharsis may be used to uncover and substantiate emotions. By ‘embellished speech’, I mean that the variety of forms of clarification and cleansing which has rhythm and melody, i.e. song; by ‘with involved in the process of medico-moral discourse its elements separately’, I mean that some [parts and learning. In doing this, I also hope to make of] are accomplished only by means of spoken clear why tragic stories of sickness should be verses, and others again by means of song. considered as the most prominent teachers and sources of medical ethical wisdom. In the secondary literature no substantial consen- sus has been reached as regards the exact meaning Medical interpretations of ‘tragic catharsis’ Aristotle attributes to ‘catharsis’ in his definition. On the contrary, a whole range of seemingly One of the most medically minded interpretations of disparate interpretations have been suggested, tragic catharsis, still vividly debated in the literature which I shall turn to in a short while. The notion was launched by J. Bernays, an uncle by marriage of as such, however, belongs, as mentioned in the Sigmund Freud. In an influential essay published in previous article, to a family of words (catharos, 1857 Bernays advances the argument that attending catharsis, catharmos) that were in use in many a tragic play may have a direct therapeutic effect on different contexts (Nussbaum, 1992, p. 280–281): the spectator, in the sense that it may clear and ‘‘everyday practical, educational, medical, reli- alleviate him from build-ups of undesirable emotions gious, literary’’. According to Nussbaum, there of pity and terror. Bernays draws support for his are no indications to suggest that ‘catharsis’ ever ‘‘pathological standpoint’’ (German: ‘patologischer became separated from its original family and Gesichtspunkt) from Politics VIII 7.1342a4-16 took on a different meaning. On the contrary, the (Bernays, 1857/1979, p. 158).4 In this passage, which ordinary meaning – i.e. ‘cleaning’ or ‘clearing up’ is quoted in the preceding note, Aristotle explains the – seems to have prevailed throughout. The meaning and role of catharsis in relation to pity and disagreement about ‘catharsis’ in Aristotle’s def- terror by making a comparison with the psycholog- inition of tragedy does not therefore relate to the ical healing process which people affected by hyster- formal meaning of the word, but to what kind of ical outbreaks of emotion (enthousiasmos)undergo ‘cleaning’ or ‘clearing up’ Aristotle actually had in when cathartic songs are used as therapeutic devices. mind. Bernays takes this comparison to mean that Aristotle In the secondary literature it is possible to conceived of tragic catharsis as a therapeutic device distinguish between at least six different groups of in the treatment of pathological emotions: interpretations: medical interpretations and interpretations of Catharsis then becomes a special type of iatreia catharsis as a natural process of discharge/release (which is why that term [meaning ‘healing’] is or outlet of emotions, used before it): ecstasy turns to calm through catharsis conceived of as emotional and intellec- orgiastic songs as sickness turns to health tual clarification, through medical treatment – not through any CATHARSIS AND MORAL THERAPY II 143 treatment, but through one that employs cathar- without turning tragic catharsis into a therapeutic tic means to fight off illness. Thus the puzzling device reserved for emotionally unbalanced people, piece of emotional pathology is explained: we can has been suggested by H. Flashar (Flashar, 1956, pp. make sense of it if we compare it with a patho- 12–48). His alternative is to unravel the medical logical bodily reaction ... basis of Aristotle’s understanding of pity and terror ... operative in both clauses. Flashar finds that in prevalent pre-Aristotelian views of the effect of ...catharsis is a term transferred from the physical poetry (in particular those of Gorgias and Plato), to the emotional sphere, and used of the sort of pity and terror are always associated