Medicine, Health Care and Philosophy 3: 3–16, 2000.

© 2000 Kluwer Academic Publishers. Printed in the Netherlands.

Scientific Contribution

Das unheimliche – Towards a phenomenology of illness

Fredrik Svenaeus
Department of Health and Society, University of Linkōping, Linkōping, Sweden (E-mail: fres@tcma.liu.se)

Abstract. In this article I aim at developing a phenomenology of illness through a critical interpretation of
the works of Sigmund Freud and Martin Heidegger. The phenomenon of “Unheimlichkeit” – uncanniness and
unhomelikeness – is demonstrated not only to play a key role in the theories of Freud and Heidegger, but also to
constitute the essence of the experience of illness. Two different modes of unhomelikeness – “The mind uncanny”
and “The world uncanny” – are in this connection explored as constitutive parts of the phenomenon of illness. The
consequence I draw from this analysis is that the mission of health care professionals must be not only to cure
diseases, but actually, through devoting attention to the being-in-the-world of the patient, also to open up possible
paths back to homelikeness. This mission can only be carried out if medicine acknowledges the basic importance
of the meaning-realm of the patient’s life – his or her life-world characteristics.

Key words: attunement, being-in-the-world, Freud, Heidegger, phenomenology of health and illness, trauma, the
uncanny, unhomelikeness

Introduction The article consists of three parts. In the first part I

What is it like, from the patient’s perspective, to suf-
fer from illness? Answering this question is crucial to
make sense of medicine as an endeavour struggling
with other problems and having other aims than merely
those of an applied biology. It is in addressing ques-
tions like this one that philosophy could be of value
to health-care professionals providing future doctors,
nurses and other health-care personnel with theories
that will make it possible to focus attention on the
patient as an ill person and not only as a diseased
organism.
To be ill, as we all know, is generally something
bad: we suffer from our illness and we want to get well
again, or at least we want to be able to live better with
our symptoms.1 This is indeed where we look to medi-
cine for help. What is the nature of this suffering and
of this wish to get well again? Is it possible through
philosophical reflection to find any general character-
istics that can help us to understand what it is like to be
ill? I would like to suggest in this article that the Ger-
man concept “unheimlich” could be useful in outlining
a general phenomenology of illness. “Unheimlich” is
normally translated into English as “uncanny”, but as
we will see in the following the German term also
carries other important connotations. To be ill is some-
thing uncanny: “es ist dem Kranken unheimlich”. This
is the idea that I will elaborate upon in what follows.
focus upon mental illness and a possible
phenomenological interpretation of the theories of
Sigmund Freud, proceeding from his own thoughts in
the essay Das Unheimliche. The second part will take
its starting point in Martin Heidegger’s Sein und Zeit,
examining his concept of existential, authentic anxiety
versus illness as two different forms of uncanny, or
“unhomelike” ways of being-in-the-world. Finally in
part three I will conclude my explorations by dealing
with some concrete cases of how life can turn alien
and uncanny in illness and how health-care person-
nel could profit from a phenomenological approach in
their meetings with patients.
My aim here is to find a general characteristic of
illness through the concept of “Unheimlichkeit”, as it
can be developed starting off in the works of Freud and
Heidegger. My readings and interpretations, however,
as will become obvious in what follows, are far from
orthodox, but rather aim at finding thoughts to be fur-
ther explored in an independent manner. Consequently,
the test of the soundness of the phenomenology of
illness which I outline below is not whether it does
justice to the philosophies of Freud and Heidegger.
In many ways it does not, and indeed cannot, since
the theories of these two thinkers are incompatible on
quite a number of points. Instead, the ultimate test
of my phenomenology of illness must be the extent
to which it does justice to the different forms of ill-
4 F REDRIK S VENAEUS
ness afflicting the individuals encountered each day
by doctors, nurses and others working in the clinic.
Thus the way to a phenomenology of illness must
follow the well-known injunction of the founder of
phenomenology Edmund Husserl: “back to the things
themselves”. In this case this will mean: back to the ill
persons themselves, back beyond theories of disease
to the experiences of the persons suffering from these
diseases. Therefore, although this article is not based
on case studies, but rather consists in the philosophical
explication of essences characteristic to illness through
interpretations of the works of Freud and Heidegger, it
is nonetheless intended to inspire empirical challenge
and confirmation.
The mind uncanny
In his essay from 1919, Das Unheimliche, Sigmund
Freud tries to isolate the phenomenon of uncanniness
as a delimited zone “within that which is fearful (inner-
halb des Ängstlichen)” (p. 368).2 The uncanny gives
rise to anxiety, but, as Freud says, not everything that
causes dread and fear is uncanny. Freud proceeds in
his analysis on two main paths: the first being an his-
torical, etymological analysis of the meaning of the
word “unheimlich”; and the second, what one might
call an aesthetic analysis, by which Freud makes use of
art in order to get a grasp of the phenomenon in ques-
tion. In addition to this, in characteristic manner, Freud
intersperses the essay with a variety of examples from
psychoanalysis. Therefore, the essay not only contains
interesting reflections upon the nature of the uncanny,
but also, in its richness, provides a point of entry into
most themes of Freud’s meta-psychological theory.3
The structure of Das Unheimliche is however far from
clear and simple; most themes are only hinted at, some
will not be further elaborated upon until Freud’s later
work, and the essay progresses from theme to theme by
leaps and bounds, first sketching solutions to problems
that are, in the next moment, abruptly abandoned. This
very richness and work-in-progress structure seem to
me to support the assumption that the phenomenon of
Unheimlichkeit is really a key concept in Freud’s the-
ory, even though he did not come to fully appreciate
this insight himself.
In German there is a phonetic similarity between
“unheimlich” and “unheimisch” – which would mean
“unhomelike” – that is lost in the English transla-
tion of the former to “uncanny”. Freud, by consulting
etymological dictionaries, shows how this similarity
is explained by the common roots of the two words
“heimlich” and “heimisch”. “Heimlich” indeed comes
from “heimelich” – meaning homelike or that which
belongs to the home, “zum Haus” – and still means
this in modern German. But this aspect of keeping
within the walls of one’s own house also produced a
second meaning of “heimlich” – that of “geheim”, sig-
nifying that which is hidden from the stranger. Thus
the two meanings of “homelike” and “secret” were
combined in “heimlich”, rendering it an ambivalent
concept, or, if you will, a concept allowing two differ-
ent perspectives: what is at home for me is strange and
unknown to you who are not allowed into my house.
The second meaning of “heimlich” – “secret” – also
came to take on the meaning of something uncanny in
the sense of incomprehensible, something that is dan-
gerous and strange and ought to remain hidden. In this
process the word acquired a meaning exactly opposite
to “homelike” and was thus adjoined with a negat-
ive prefix, transforming “heimlich” into “unheimlich”.
The phonetic similarity between “unheimlich” and
“unheimisch” is therefore a similarity of importance,
the first word bearing within itself historical traces of
the meaning of the second.
Now, in what way can this insight help us in char-
acterising “das Unheimliche” as a special region of the
fearful? Freud does not immediately answer this ques-
tion but instead turns to the short story Der Sandmann
by E. T. A. Hoffmann. This work contains several fea-
tures that are “unheimlich”, the two main ones being
the characters Coppelius and Olimpia. Coppelius is a
daemonic lawyer engaged in Frankensteinesque exper-
iments involving the violent extraction of children’s
eyes, and Olimpia is a kind of automaton fashioned
by Coppelius with human eyes. Why are these figures
uncanny? Freud in citing a paper by E. Jentsch gives a
preliminary answer:
In telling a story, one of the most successful devices
for easily creating uncanny effects is to leave the
reader in uncertainty whether a particular figure in
the story is a human being or an automaton (p. 378).
The uncanniness would thus seem to relate to the pos-
sibility of something dead being alive, or conversely,
of something living being controlled by mechanical,
“dead” processes. The whole argument, of course,
depends on a dualistic position according to which the
“aliveness” of human beings consists in being anim-
ated, in having a soul, “beseelt sein”. One reason for
Freud’s reluctance to link the etymological analysis
to Jentsch’s hypothesis is undoubtedly the dualistic
position that results from discussing animate and inan-
imate beings. That the soul lives in the body as if
in a house and can be either at home or absent is
not a feasible alternative for Freud, anymore than for
any modern scientist or philosopher. But is it neces-
sary to understand the unhomelike quality belonging
to the uncanny experience in this way? I think not,
and Freud, having rejected Jentsch’s hypothesis, can-
 DAS U NHEIMLICHE
not resist returning to the phenomenon of the living
doll and the “double” – “der Doppelgänger” – in
Hoffmann’s stories. The identity of the self is ques-
tioned by the latter phenomenon and this is why it is
uncanny. Freud in the essay gives this uncanny phe-
nomenon a distinct place in the drama of castration.
The double is interpreted as a prototype of what will
later in Freud’s thinking be known as the superego:
the call of conscience which is the introjected law
and threat of the father, a self-observing instance, a
double within that watches the ego (p. 388). Interest-
ingly enough, however, immediately after offering this
interpretation of the double, he makes the following
disclaimer:
But, after having thus considered the manifest
motivation of the figure of a “double”, we have to
admit to ourselves that none of it helps us to under-
stand the extraordinarily strong feeling of some-
thing uncanny that pervades the conception; and our
knowledge of pathological mental processes enables
us to add that nothing of all this could account for
that striving of defence which has caused the ego
to project such a content (the double) outward as
something foreign to itself. The quality of uncan-
niness can only come from the circumstance of the
“double” being a creation dating back to a very early
mental stage long since left behind (eine den über-
wundenen seelischen Urzeiten angehörige Bildung
ist), and one, no doubt, in which it wore a more
friendly aspect (p. 389).
The experience of the uncanny seems to point back to
something that took place long before the ego experi-
enced and repressed castration anxiety. It points back
to something that is before the time of the ego since
“the ego had not yet sharply differentiated itself from
the external world and from other persons” (p. 389).4
We will return to this uncanny “birth anxiety” shortly,
in broadening our perspective to include other works
by Freud than Das Unheimliche, but first we need
to consider yet another characteristic of the uncanny
to which Freud next turns in the essay: involuntary
repetition.
Freud in Das Unheimliche tells us about an
uncanny experience he had while visiting a small town
in Italy. Walking around the labyrinthine, deserted
streets he suddenly came to a place where the win-
dows were filled with ladies wearing heavy make-up.
Feeling uncomfortable he rushed away, only to find
that, in his efforts to get away, he always after a brief
interlude returned to the same place, where his pres-
ence now began to excite attention. The third time he
involuntarily returned to the street a feeling of distinct
uncanniness came over him. Freud now claims that the
uncanniness in this and similar situations comes from
5
the “involuntary return to the same situation (unbe-
absichtige Wiederkehr)” (p. 390). After describing
similar instances of this strange “return to the same”,
Freud writes:
How exactly we can trace back the uncanny effect
of such recurrent similarities to the infantile life of
the mind (infantilen Seelenleben) is a question I can
only lightly touch upon in these pages; and I must
refer the reader instead to another pamphlet, now
ready for publication, in which this has been gone
into in detail, but in a very different connection.
It must be explained how we are able to postu-
late the principle (Herrschaft) of a repetition com-
pulsion (Wiederholungszwang) in the unconscious
mind, based upon instinctual activity and probably
inherent in the very nature of the instincts – a
principle powerful enough to overrule the pleasure-
principle, lending to certain aspects of the mind their
daemonic character (p. 391).
The daemonic character of repetition in Das Unheim-
liche seems to come from the compulsiveness of the
repetition itself, not from the situation or phenomenon
that is repeated. Even something innocent would, if
incessantly repeated, be uncanny if we felt that we
could not control the repetition (p. 390). The uncanni-
ness, I would suggest, comes from this feeling of lack
of control, of not being at home, of being controlled by
someone or something other than oneself. The repeti-
tion itself could be viewed as a mechanical, unfamiliar
principle regulating the self beyond its possible control
and comprehension.
The pamphlet that Freud is referring to in the quo-
tation above is Jenseits des Lustprinzips, which was
published a year later (1920). In this work the death
drive (Todestrieb) is introduced in order to account
for “daemonic” phenomena, like the one mentioned
above. Since the initial aim of this book is to focus
upon phenomena that seem to be beyond the pleasure
principle (beyond wish fulfilment) focus is placed on
the repetition of painful experiences. Traumatic neur-
osis is the name that Freud gives to the compulsive
repetition of something painful, a phenomenon which
had come to the attention of Freud and his contempor-
aries through the ailments of soldiers who had suffered
severe shocks during the First World War. In their
dreams they were repeatedly taken back to the scene of
the traumatic experience, a scene which they seemed
to have forgotten or which, at least, did not seem
to occupy their conscious, waking thoughts.5 “This”,
Freud writes, “astonishes people far too little” (p. 11).
The reason why Freud finds it astonishing is that the
primary processes that are set free in dreams should,
according to his earlier theory, serve wish fulfilment
and not bring about pain.6 Yet, a destructive instinct
6 F REDRIK S VENAEUS
(Trieb) in the psyche seems to be at work in these
dreams.
In discussing the neuroses of war veterans Freud
makes some important distinctions that will serve us
well in this paper on the uncanny:
“Fright” (Schreck), “fear” (Furcht) and “anxiety”
(Angst) are improperly used as synonymous expres-
sions; they are in fact capable of clear distinction
in their relation to danger. “Anxiety” describes a
particular state of expecting the danger and pre-
paring for it, even though it may be an unknown
one. “Fear” requires a definite object of which to
be afraid. “Fright”, however, is the name we give
to the state a person gets into when he has run into
danger without being prepared for it; it emphasizes
the factor of surprise (p. 11).
The soldiers have been exposed to fright – to a danger
which it was impossible to prepare for since it was
unimaginable, ungraspable. In their dreams they invol-
untarily return to this danger – but this time they are
prepared, i.e. in a state of anxiety. The dream seems
to be an attempt to prepare by means of anxiety for
a danger which could not be prepared for at the time
when it took place (p. 35ff.).
The “warfare-electro-economic” explanation of the
trauma that Freud gives in Jenseits des Lustprinzips
cannot concern us in detail here. It operates on the
level of stimuli or energy breaching the protective
shield of the organism in a manner which makes it
impossible to control or bind the energy. An explic-
ation of the language and theory of instinctual repres-
entative (Triebrepräsentant) cathexis (Besetzung) and
discharge (Abfuhr) would require a lengthy discussion
which, in my judgement, there is no room for here.7
I will not, however, deny that one of my reasons for
not focusing on this central part of Freud’s theory is
that I find it hard to defend, especially when it comes
to the phenomenology of feelings. The feeling of the
uncanny, I think, cannot be grasped in a quantitat-
ive language of pleasure and pain modelled mainly
on neuro-physiology and the male sex drive.8 Action
potentials of neurones and ejaculation seem to be the
two main sources for Freud’s electro-economic theory
of the psyche. Given Freud’s reduction of Thanatos
to the mere economic play of energies, I doubt that
his theory of the death drive can provide us with a
satisfactory explanation of the uncanny.
We have come to discuss the uncanny in terms
of trauma and anxiety. Freud himself incited us to
make this transition by interpreting the uncanny in
terms of involuntary repetition. The uncanny anxi-
ety “comes from something repressed which recurs”
(p. 394). What is it then that recurs? Given that we are
all more or less sensitive to things that evoke uncanny
feelings, it must be some kind of universal trauma.
Yet that which returns in the feeling is something
unknown, a threat coming from “nowhere”, or at least
from a “place” we do not know in our selves.9 What
if the repressed which recurs in uncanny anxiety is
something that was once the most familiar and which
has now through the process of repression become the
most estranged? What if it has to do with the most
basic loss there is – the loss of the first object, the
mother, or rather the loss of that stage in existence dur-
ing which there was not yet an ego but only a symbiosis
with her?10 A passage from Das Unheimliche confirms
this interpretation:
It often happens that male patients declare that they
feel there is something uncanny about the female
genital organs. This unhomelike (unheimlich) place,
however, is the entrance to the former home (heim)
of all human beings, to the place where everyone
dwelt once upon a time and in the beginning. . . . the
unhomelike (unheimlich) is what was once home-
like (heimisch) and familiar; the prefix “un” on this
world is however the token of repression (p. 399).
What I find remarkable in this passage is exactly the
absence of any reference to castration anxiety.11 One
would imagine, given Freud’s earlier interpretation
of the uncanny in the essay, that the female genitals
would offer a perfect opportunity for yet another inter-
pretation of the uncanny in terms of castration. Yet
Freud resists this and I think he is perfectly right in
doing so. Rather than interpreting all fears of loss in
terms of fear of castration – as Freud often does –
it would be more reasonable to regard castration as
one possible loss among others, the most primitive and
important loss being rather the loss of the mother. This
is, of course, my own, unproved claim. Freud obvi-
ously thought that analytical experience taught him
otherwise. Yet I think that the uncanny (unhomelike)
quality of some neurotic anxiety (as well as other “nor-
mal” instances of the uncanny) is a sign pointing in the
direction of the mother’s lap rather than the father’s
knife.
The different characteristics and sources of the
uncanny which Freud enumerates in Das Unheimliche
are never brought together in any coherent way in the
essay. My attempt has been to find unity by stressing
some of the points he makes more than others and
providing supporting evidence from other works. The
very last lines, which follow a lengthy discussion of the
techniques of evoking the uncanny in literature, brings
the essay to a rather abrupt conclusion:
Concerning the factors of solitude, silence and dark-
ness (which can evoke the uncanny), we can only
say that they are actually elements in the produc-
 DAS U NHEIMLICHE
tion of that infantile morbid anxiety from which
the majority of human beings have never become
quite free. This problem has been discussed from
a psycho-analytical point of view in another place
(p. 407).
I do not know which work Freud is referring to here.
The book by Freud himself which would best fit the
description was not published until seven years later. I
am thinking of Hemmung, Symptom und Angst which
bears resemblance to Das Unheimliche in terms of a
rather undisciplined structure.
One of the themes brought up in Hemmung, Symp-
tom und Angst is birth anxiety. Freud criticizes a work
by Otto Rank claiming that the trauma of birth is
the origin of neurosis (pp. 82–89).12 This hypothesis,
Freud says, lacks empirical grounding, and, what is
worse, it “contradicts the aetiological importance of
the sexual instincts as hitherto recognized by psycho-
analysis” (p. 85). But in discussing the anxiety of small
children in the book, Freud nevertheless stresses the
importance of what one might term a second birth
– the birth of the ego out of a symbiosis with the
mother (pp. 66ff., 105ff.). The pain of being left alone
(silence, solitude, darkness) is equivalent to the trauma
of uncontrollable fright (suffered for instance in war
neurosis). This a priori trauma not only brings about
repetition in the sense that a similar situation will again
give rise to anxiety as an attempt to prepare for the
danger; it also actually gives birth to the ego, since
the child comes to recognize its dependence of the
mother through this process. The mother will be con-
stituted, “cathected” in Freud’s terms, as something
other than the child – something which most often
satisfies the wishes of the child but which can also
desert it.13 The radical “Unheimlichkeit” of this situ-
ation (in the double sense of uncanny and unhomelike)
is the very quality that makes the child into an ego –
an ego that will never be (and indeed as an ego never
was) quite at home.14 The child will forever be sens-
itive to this a priori homelessness of existence which
will announce itself in the uncanny. This uncanniness,
which we all share, most often lurks in the background,
in what Freud would call the unconscious. The home-
lessness will, however, on certain occasions, break
through and make us shiver. Reading E. T. A. Hoff-
mann may be one such occasion, traumatic neurosis
another.
We might here be interpreting Freud against his
own wishes and beyond his own horizons. We will
soon move to another thinker who will provide us with
clues about how to conceptualize the homelessness of
human existence and illness. In Freud this homeless-
ness is thought of in terms of processes working in our
mind beyond conscious control. No one will ever fully
7
know himself, since the mind is an opaque region –
and necessarily so. To become a human being means
to be born to homelessness. This homelessness in itself
does not make us ill – it rather makes us human. If it
becomes too obtrusive, however, we will end up in ill-
ness. In following the track from uncanny literature to
trauma we have uncovered one such example in Freud.
The world uncanny
The leap from Sigmund Freud to Martin Heidegger
might seem a very long one. Although Vienna and
Freiburg are rather close geographically, an abyss sep-
arates the discourse of Freudian meta-psychology from
Heidegger’s existential analytic. Two very different
concepts of “Wissenschaftlichkeit” are at work here.
In spite of this I will try to show that in the end these
two philosophers – yes, I will use that term for both of
them despite their own reluctance or, as in the case
of Freud, even resistance towards philosophy – are
trying to uncover the same phenomenon – the home-
lessness, Unheimlichkeit, of human existence. Anxiety
is a prime candidate for helping us conceptualize this
homelessness in Heidegger just as it was in Freud. Let
us turn to his first main work Sein und Zeit:
In anxiety one has an “uncanny” feeling. (In der
Angst ist einem “unheimlich”.) Here the pecu-
liar indefiniteness of that which Dasein finds itself
involved in with anxiety initially finds expression:
the nothing and nowhere. But uncanniness means
at the same time not-being-at-home. In our first
phenomenal indication of the fundamental constitu-
tion of Dasein and the clarification of the existential
meaning of being-in in contradistinction to the cat-
egorical signification of “insideness”, being-in was
defined as dwelling with . . . , being familiar with
. . . (p. 188).15
The being-at-home, being-in-the-world of human
being-there (Da-sein) is always also a not-being-quite-
at-home in this world.16 The familiarity of our life-
world – the world of human actions, projects and
communication – is always pervaded by a homeless-
ness: this is my world but it is also at the same time
not mine, I do not fully know it or control it. This is not
a deficit, but a necessary phenomenon: I am delivered
to the world (geworfen) with other people and being
together with them (Mitdasein) is a part of my own
being (p. 117ff.). (Indeed one would like to say with
Freud it is the way to myself.) Thus the world I live
in is first and foremost my world (and not the “object-
ive” world of physics), but to this very “mineness” also
belongs otherness.
8 F REDRIK S VENAEUS
The unfamiliarity with other people and things in
the world is a constant possibility, a challenge for
human beings. This attempt to make sense of life is
driven by a feeling of wonder toward that which we do
not understand. This wonder can turn into a threat or
even terror if something is too unfamiliar or uncontrol-
lable (p. 142). Our understanding can also be attuned
in other feelings like joy, boredom or sorrow – but it
will always be attuned in some way (p. 335). What the
attunement of every situation generally explains is why
things matter in life, why we are open to the world as
a possibility for ourselves (p. 137).
If we, at the bottom of Freud’s theory of the psyche,
found desire as the motivating power in life, in Heideg-
ger’s philosophy, as the basis of human understanding,
we find attunement (Befindlichkeit). But in Freud the
desire itself was merely analysed as an economy of
pleasure and pain “loading” the ideas as pregiven entit-
ies. In Heidegger the feelings are part of the ideas:
the feelings form the way we understand and articu-
late the phenomena in the world, and also, ultimately,
the way we understand ourselves and others. The
world of human beings is opened up in a mood: “The
moodedness of attunement constitutes existentially the
openness to world of Dasein” (p. 137).
As we have seen in the quotation above, for Heide-
gger, uncanniness is not analysable in terms of fear
of certain things in the world: the uncanny comes
from “nothing and nowhere”. This is analogous to the
uncanny anxiety we traced in Freud: anxiety is fear of
something unknown:
When anxiety has quieted down, in our everyday
talking we are accustomed to say: “it was really
nothing”. This way of talking, indeed, gets at what
it was ontically. Everyday discourse aims at tak-
ing care of things at hand and talking about them.
That about which anxiety fears is none of the inner-
worldly things at hand. But this none of the things
at hand, which is all that the everyday circumspect
discourse understands, is not a total nothing. The no
of things (Das Nichts von Zuhandenheit) is based
on the primordial “something”, on the world. The
world, however, ontologically belongs essentially
to the being of Dasein as being-in-the-world. So if
what anxiety is about exposes nothing (das Nichts),
that is, the world as such, this means that that about
which anxiety is anxious is the being-in-the-world
itself (p. 187).
This is not a “birth trauma” (as in Freud), but it is
indeed something similar. What surfaces in anxiety is
human existence as such: every “thing” in the world
– every project – reveals itself as empty against the
backdrop of a basic meaninglessness – a homeless-
ness of life. The world is revealed in anxiety, not as
a collection of things with different characteristics, but
as a meaning-structure of human understanding which
has no meaning in itself. Things have meaning because
they belong to a lifeworld of human projects, but how
could this world in itself have any meaning? In relation
to what? Human existence has no meaning in itself, it
is only given meaning through the being-in-the-world,
and this is what uncanniness reveals.
If uncanniness is not limited to a feeling in the
presence of a certain phenomenon in the world, it
could nevertheless be triggered by such phenomena.
We remember Jentsch’s analysis of the uncanny in
terms of an uncertainty regarding life and death. A
corpse or a machine could give rise to this feeling of
uncertainty, or rather “doubleness” of life and death.
In Heidegger the basic sense of Unheimlichkeit is tied
rather to a certainty than an uncertainty about death –
to the certainty that I will die and that nobody else can
die in my place (p. 240). This death is however not a
death coming after life, but a death within life itself, a
finitude of human existence giving it its basic character
of unhomelikeness.
There is always something more to come in the
future, something that I live towards and that I do
not yet know. This is, according to Heidegger, the
openness of life, a positive homelessness of wonder, if
you will. But to this openness, to this being towards
the future, also belongs uncertainty, since the next
moment could always be my last. The future will not
be for ever, I will die and I am dying in every moment
in the sense of being towards my own death:
The ending that we have in view when we speak of
death, does not signify a being-at-an-end of Dasein,
but rather a being towards the end of this being.
Death is a way to be that Dasein takes over as soon
as it is. “As soon as a human being is born, he is old
enough to die” (p. 245).
Human finitude in Heidegger’s philosophy has two
sources, or, if you will, two “ends”. The first is the
being delivered to the world by somebody else. Human
being is not its own source, it has not laid its own
groundwork (how, indeed, could it?):
Dasein exists as thrown, brought into its there not
of its own accord. It exists as a potentiality of being
which belongs to itself and yet has not given itself
over to itself . . . . But throwness does not lie behind
it as an event which actually occurred, something
that happened to it and was again separated from
Dasein. Rather, as long as it is, Dasein is constantly
its “that” as care . . . . Because it has not laid the
ground itself, it rests in the weight of it, which mood
reveals to it as a burden (p. 284).
 DAS U NHEIMLICHE
This comes very close to that which we have ana-
lysed as a “second birth trauma” in Freud. We are
delivered to the world, born to the world as selves in
a basic dependency on the other. We are finite since
we have not given rise to ourselves. The basic trauma
of human finitude is however not interpreted in this
manner by Heidegger. Rather than maintaining focus
on our beginnings, he shifts his emphasis to the other
“end” of human existence – death. The uncanniness of
human existence in Heidegger announces itself in what
you might term a “death-” rather than a “birth-trauma”.
The emptiness of the meaning-structure of the world in
itself is revealed in the finitude that belongs to all my
projects of being-in-the-world:
What anxiety is about is the being-in-the-world
itself. What anxiety is about is the potentiality of
being of Dasein on the whole. Anxiety of death must
not be held as identical with a fear of one’s demise.
It is not an arbitrary and chance “weak” mood of
the individual, but, as a fundamental attunement of
Dasein, the disclosedness of the fact that Dasein
exists as a thrown being-towards its end (p. 251).
In Heidegger’s outline in Sein und Zeit human
beings are awakened to the basic homelessness of
being-in-the-world by a phenomenon that has a long
history in philosophy and theology: the call of con-
science (der Ruf des Gewissens).17 This call of anxiety
rises in yourself, from yourself, as a reminder of the
uncanniness of existence:
Uncanniness (Unheimlichkeit) is the fundamental
kind of being-in-the-world, although it is covered
over in everydayness. Dasein itself calls as con-
science from the ground of this being-in-the-world.
The “it calls me” is an eminent kind of discourse of
Dasein. The call attuned by anxiety at first makes
possible for Dasein its project (Entwurf) upon its
ownmost potentiality-of-being (p. 277).
The project referred to here is the understanding of
the meaning-structure of the world itself as a basic
homelessness, what Heidegger calls authentic under-
standing or resoluteness (das eigentliche Verstehen, die
Entschlossenheit). It is indeed a form of understanding
that is of the same kind as the one Heidegger him-
self carries out in practice in the book Sein und Zeit,
a form of understanding that is not caught up in the
business of life, but rather is about existence as such.
Authentic understanding is awakened by, and attuned
in, the anxiety that arises in human being through
a call of conscience. The call that comes from my
own being does not have any other message than this
basic homelessness. It is a call about my own finitude,
about the death always already at work in me, and it
9
is an uncanny call. To listen to this call and not flee
from its message of a basic uncanniness is a “want-
ing to have conscience”, it is “authentic thinking about
death” (p. 309).
Even though it is Dasein itself as a being-in-the-
world that is really uncanny (not at home) in Sein und
Zeit, one could, as I suggested above, imagine this
feeling being triggered by some phenomenon in the
world (some memento mori), or by uncanny literature
like the stories of Hoffmann.18 Corpses and automata
might awaken the uncertain certainty of my own life
and death, the aporia of the impossible all-pervasive
possibility of death. Impossible because it would mean
the end of me as being the very possibility of the future,
all-pervasive possibility since the next moment could
always be the last one.19
The death in myself, the basic homelessness of
myself in my world is not only something which
emerge in authentic understanding. It is also an exper-
ience of being-in-the-world that is emphasized in ill-
ness. Heidegger hints at this in Sein und Zeit without
actually carrying out any analysis of illness: “Or
must sickness and death in general – even from a
medical point of view – be conceived as existential
phenomena?” (p. 247).20 Since Heidegger’s analysis
in Sein und Zeit is aimed at providing an authen-
tic understanding of the being-in-the-world of Dasein,
he does not pay much attention to different “inau-
thentic”, everyday ways of being-in-the-world. His
analysis of everyday existence seems to me heavily
biased by the pejorative presentation of “das Man” as
a public way of life in the world that conceals and
precludes the possibility of authentic understanding.
This tendency of everyday understanding to interpret
itself in terms of things in the world rather than as a
being-in-the-world (Verfallensein) leads Heidegger to
withhold from offering it the attention it deserves in
itself. Heidegger himself never wanted his philosophy
to be reduced to mere anthropology. The phenomen-
ological analysis he began in Sein und Zeit had as its
goal the uncovering of the meaning of being itself, and
not only the being of Dasein – of human “being there”
in the world.
It seems to me, however, that we could use
Heidegger’s phenomenology of being-in-the-world to
understand how illness is experienced precisely as a
not being at home in my own world. The general
opacity of the self is not limited to an opacity of
the psyche as in Freud, but could rather be under-
stood as an unfamiliarity within the world – that very
world that is a part of my own being as a being-
in-the-world. Anxiety is not only a general trauma
of homelessness, in the sense that it makes authen-
tic understanding possible for everyone; it can also
become pathological if it takes control of one’s whole
10 F REDRIK S VENAEUS
being-in-the-world, engaging too much of one’s every-
day understanding. If anxiety is constantly opening up
(or rather closing down) the world in an atmosphere
of paralysing fear, this means that the general death-
trauma (or birth-trauma as in Freud) has evolved into
illness:
Factically the mood of uncanniness (die Stim-
mung der Unheimlichkeit) remains for the most part
existentially uncomprehended. Moreover, with the
dominance of fallenness and publicness “authen-
tic” (“eigentliche”) anxiety is rare. Often anxiety
is “physiologically” conditioned. This fact is an
ontological problem in its facticity, not only with
regard to its ontic causes and course of development.
Physiological triggering of anxiety is only possible
because Dasein is anxious in the very ground of its
being (p. 190).
Where to draw the line between authentic and patho-
logical anxiety might indeed not always be easy to
determine. We recall here Freud’s unclear dividing-
line between normal and neurotic life. We are all to
some extent neurotics, we are all marked by a “not
being at home in ourselves”.
In interpreting Heidegger’s as well as Freud’s
thoughts on the uncanny I do not think we need to
stop at anxiety. Illness would generally be character-
ized by an attunement of unhomelikeness, which need
not be the one of anxiety; and since attunement in
Heidegger always means attuned understanding as a
being-in-the-world, we would here find an outline for
conceptualizing illness not only as a feeling, but at
the same time as a mode of understanding. To be ill
would mean to experience a constant sense of obtrus-
ive unhomelikeness in one’s being-in-the-world. Let us
now, in order to further explore such a general phe-
nomenology of illness, turn to some concrete cases in
the clinic.
The unhomelikeness of illness
As we now turn to clinical explorations of the results
reached on our philosophical odyssey, we will begin
with the example of anxiety since it is the phenomenon
that we with Freud and Heidegger above have used as a
point of entry to the dimension of the unhomelike and
uncanny. The case that follows below is made up, but,
nevertheless, I think, neither unlikely nor exceptional.
A woman in her forties – Susan – visits a health-
care centre and meets with a general practitioner –
Dr. V. She tells the doctor that she is unable to sleep
at night because of severe attacks of anxiety. She lies
awake in a cold sweat and broods on her present situ-
ation in life. She has lost her job and, as a consequence
of this, most of her social life. Her days are spent read-
ing newspapers and watching television; she hesitates
to go out and meet with people since she is ashamed
of herself. This is not only related to the fact that she
thinks that her life “is a failure and disaster”, but also
due to her present appearance – her face is covered
with an eczema that she started to get three years ago.
She thinks she is allergic, but the doctors have not been
able to find the cause. The last two months her nightly
anxiety has prevented her from sleeping and she feels
awfully tired and on the verge of losing control of her
life and falling into a depression. She tells Dr. V that
if this does not stop she thinks she will go mad or even
kill herself.
Now, what should Dr. V do in this situation? He
will probably prescribe sleeping pills, possibly also an
antidepressant such as Prozac, to relieve Susan of her
sleeping problems and to mitigate her anxiety. Some
kind of immediate medical treatment indeed seems
necessary to deal with the acute situation. Is this all
he can or should do to help the patient? The image of
clinical medicine as a form of applied biology would
tend to support this restrictive view. But if the mission
of health care is to deal with the unhomelikeness of
the patient’s life and open up possible ways back to a
homelike being-in-the-world, the medication is prob-
ably only a start. In addition to manipulating Susan’s
biology, her situation in life must be examined and
changed in order to help her in an effective and last-
ing way. Such an approach always starts out by paying
close attention to what the patient says in the clinical
meeting.21 What is the patient telling the doctor about
her symptoms and situation? In what way can this
story and the way it is told be related to the patient’s
illness?22
Through asking some questions Dr. V finds out that
Susan’s eczema started immediately after the divorce
from her husband three years ago. She did not feel
any anxiety then, but merely a kind of inner “dead-
ness” and meaninglessness when he left her for another
woman. The eczema got even worse after she lost
her job a year ago. Dr. V naturally starts to suspect
that the eczema is “psychosomatic” – that is, related
to psychological problems rather than to biological
defects. He also sees a possible connection between
the anxiety and the divorce as a kind of delayed reac-
tion to this traumatic event in Susan’s life, which she
was not able to deal with at the point it occurred
but instead “repressed”. Dr. V now has to make an
important choice: should he try to deal with Susan’s
problems himself or should he refer her to a special-
ist – a psychiatrist? If this psychiatrist works within a
Freudian, psychoanalytical framework he or she will
carry on the dialogue with Susan and begin a journey
back through Susan’s life trying to uncover repressed
 DAS U NHEIMLICHE
uncanny events which they together will then need
to address in order to relieve her of the anxiety and
other symptoms. This journey will go back far beyond
Susan’s divorce to the events of her early childhood.
According to this Freudian perspective, illness (men-
tal and psychosomatic) is due to previous experiences
of unhomelikeness of traumatic nature which by the
indirect way of repression make the present life of
the patient unhomelike. The patient needs to return to
these experiences in order to understand the predica-
ment of her life, be able to think and feel differently
about it and thus change her situation.
Regardless of whether Dr. V refers Susan to a psy-
chiatrist or tries to help her himself, and regardless
of whether the medical help which Susan is given is
mainly biological or based on psychotherapy, another
important question also needs to be addressed at this
point. It regards the nature of Susan’s unhomelikeness
and the limits of the mission of medicine. As I stressed
in the section on Freud’s philosophy above, to become
a human being means to be born to homelessness. This
homelessness in itself does not make us ill – it only
does so if the unhomelikeness becomes too obtrusive.
Is Susan’s anxiety in fact an example of an existen-
tial crisis: that is, a dwelling on the homelessness that
is part of the a priori human condition, rather than a
pathological state that should be addressed by medi-
cine? Doctors are not necessarily experts in dealing
neither with existential matters, nor with various other
kinds of psychological, social and political factors that
might make life unhomelike. How far should Dr. V go
in addressing and trying to change Susan’s situation in
life and her understanding of this situation?
There are no easy answers to be found here. If,
on the one hand, the “medicine as applied biology”
paradigm is clearly too narrow, the view of medi-
cine, on the other hand, as dealing with all kinds
of unhomelikeness in life – including the modes of
unhomelikeness directly related to our existential pre-
dicament and to social and political matters – faces
the opposite danger of a total medicalization of life.
Medicine should deal with the unhomelikeness of ill-
ness, and this unhomelikeness, although related to the
a priori unhomelikeness of being delivered to the world
as a human being, as I have tried to show above, is
indeed not identical with existential anxiety. In most
cases the unhomelikeness of illness is not triggered by
an experience of the a priori unhomelikeness of life –
“das Unheimliche an sich”, so to say – but rather by
some biological defect (disease). This disease leads to
an unhomelikeness of existence, which in turn might
let loose feelings and thoughts on the ultimate meaning
of life.
But that illness is often causally related to a bio-
logical defect – a disease – does not mean that the
11
only kind of attention which the unhomelikeness of
the patient’s life needs is biological investigation and
treatment. Diseases are always lived in particular, con-
crete situations by individual persons and thus attain
meaning as different kinds of unhomelikeness in the
persons’ being-in-the-world. Many illnesses in addi-
tion to this are chronic in nature – they cannot be
“fixed” – and the desired goal of changing the present
unhomelikeness of the patient’s being-in-the-world
into something more homelike is therefore even more
clearly dependent on getting to know the patient’s situ-
ation in life. Let me try to illustrate how the healthy,
homelike attunement of being-in-the-world gradually
can be transformed into the unhomelike attunement of
illness through giving another clinical example.23
Jane is telling us about the onset of her diabetes: I
guess I was sick for a year before I knew I had dia-
betes. It came on when I was about 55, five years ago
and I had a classic case but it was a long time before
I knew what was happening to me. I would get ter-
rifically thirsty and was not able to satisfy my thirst. I
could be watching television, get up and drink a glass
of water and be thirsty again before I sat down. And, of
course, this meant that I had to go to the bathroom all
the time, which was embarrassing, but what was worse
was that I could not hold it back. When the urge hit me
I knew I had about a minute to get to the bathroom.
This was not too bad at home or at work but it could
be a problem when I was downtown. I bet I have been
in every bathroom in every store downtown. Then I
began to have blurred vision. One time when I was
driving to work – I work as a lawyer in an office down-
town – my eyes began to blur and I could not read the
billboards along the way. This prompted me to see an
ophthalmologist but because this condition of blurred
vision came and went, and I could see all right when
I was in the doctor’s office, he could not find anything
wrong and, for some reason or other, he did not think
of the possibility that I might have diabetes and, of
course, I did not either. Well, I kept getting worse. I
lost weight and my legs felt stiff and painful just from
walking around at home and in the office. I have never
been much for exercise, but now just the thought of
my weekly Sunday walk was too much. I felt tired and
irritated most of my waking time – at work and at home
with my husband. Did not feel like being with people,
did not have the energy. Also, my memory started fail-
ing me, I forgot things at work, I forgot what people
had told me the day before. I suspected something was
wrong of course, but at the same time I kept reassuring
myself that all I really needed was a long holiday. I was
working really hard at this time and I thought maybe I
was simply getting too old to carry on like this. But to
change your way of life is not an easy thing, you are
caught up in old habits and it is hard to tell your boss
12 F REDRIK S VENAEUS
that you are getting old and weak. Finally one evening
my husband managed to persuade me to go out with
him and have dinner with an old friend of ours. As
I mentioned I had not felt like going out and seeing
people the last year – too tired after work. Well our
friend is a doctor and at dinner I started telling him
about these strange things that had happened to me
lately. He just took one look at me and said: “You be
in my office Monday morning”. I could tell by the way
he said it that he suspected what was wrong with me.
He did. He told me later that he felt he knew already
then, but he wanted to run some tests before he said I
had diabetes.
Jane’s life – her being-in-the-world – is gradually
transformed in a way that bothers and worries her. The
taken-for-grantedness, the transparency of her normal
activities is changed into an effortful striving just to get
done that which she used to perform easily; life now
offers severe resistance. She feels transformed: Is this
still me? Why do my mind and body no longer work as
they used to do? Why have they got out of my control?
Life is gradually getting “out of tune” – she feels dizzy,
tired, irritated, painstricken24 – but these “feelings”
are, in fact, part of her pattern of understanding and
are not only isolated states of mind. Jane’s being-in-
the-world is gradually becoming unhomelike; where
there was earlier a homelike attunement, there is now
the growing despair of uncanniness.
Being-in-the-world, as we laid out in the section on
Heidegger’s phenomenology, consists in being thrown
into the world as attuned and in projecting oneself
into an individualized understanding. Heidegger in
Sein und Zeit names this act of going outside of itself
and into the world, performed by human being-there
(Da-sein), transcendence (pp. 363–364). The unhome-
like attunement of illness colours and determines our
transcendence into the world. In choosing attunement
instead of understanding, thrownness (Geworfenheit)
instead of projection (Entwurf), as our starting point
for explicating illness phenomenologically through the
phenomenon of Unheimlichkeit, we did not mean to
develop a theory of illness based in feelings as opposed
to thinking and acting. To be attuned is always also
to be understanding and this understanding is, in the
case of illness, “out of tune” – that is, unhomelike.
The dizziness and weakness experienced by Jane, suf-
fering from incipient diabetes, is an example of this.
It is an attunement of unhomelike being-in-the-world,
by which the understanding transcendence – taking
part in meaningful activities in the world like talk-
ing with others, getting up in the morning, going to
work, thinking about what to do at the weekend, and
so on – is gradually diminished and emptied. The
dizziness, pain and annoyance colour and determine
the understanding of the ill person, who is thrown
back on himself as an obtrusive burden, rather than
thrown into the world of the others. The openness
of the self towards the world is gradually eclipsed in
illness.
It is not simply the case that ill being-in-the-world
possesses less transcendence than its healthy coun-
terpart. Indeed transcendence cannot be quantified or
measured. Rather, ill being-in-the-world is character-
ized by defective transcendence, in the sense of the
transcendence not being coherent – that is, not offering
comprehensibility, sense of order and meaningfulness.
The transcendence of the person with incipient dia-
betes is in the process of losing its transparency and
ease; it is obstructed in a mood of fatigue and worry
– What is happening to me? Why am I so tired?
The being-in thus has taken on a specific quality of
unhomelikeness characteristic of illness.
How is it possible in principle to separate such
an attunement of illness from the tiredness some
of us always experience getting up in the morning?
The answer would generally be given by the lasting
unhomelike character of the illness mood. A lasting
fatigue is indeed called “chronic fatigue syndrome”
and considered an illness, even though one cannot find
any disease responsible for it. I would thus at this
point also like to stress that a phenomenological theory
offers new possibilities for understanding illness pre-
cisely because it takes as its starting point, not disease,
but lived experience.25 The lasting character of Jane’s
tiredness amplifies the unhomelikeness of her attune-
ment. As Gadamer has pointed out in his recent book
Über die Verborgenheit der Gesundheit health seems
to be a rhythmic phenomenon:
Health is not a condition that one introspectively
feels in oneself. Rather it is a condition of being
there (Da-Sein), of being in the world (In-der-Welt-
Sein), of being together with other people (Mit-den-
Menschen-Sein), of being taken in by an active and
rewarding engagement with the things that matter in
life . . . . It is the rhythm of life, a permanent process
in which equilibrium re-establishes itself (Gadamer,
1993, pp. 144–145).
Sleepiness belongs to healthy life as a phenomenon
occuring daily that frames our being-in-the-world. The
unhomelikeness of illness in the example above, how-
ever, means a lasting, never-ending tiredness, trans-
formed into an alien attunement, which has gone out
of rhythm.
The healthy as well as the ill life has a time-
structure built into it. To be-in-the-world means to be
open to the future as a possibility of the past (Heide-
gger, 1986, p. 325). Being-in is a being-towards the
future in relation to the past in the moment of presence.
Homelike being-in-the-world is thus to be understood
 DAS U NHEIMLICHE
as a dynamis rather than as a stasis; or, in the termino-
logy of Sein und Zeit, as an ek-stasis – a standing-out
of the self towards the future and the past in the
moment of presence. Openness of the self towards the
future in developing given possibilities of the past is
that which is maintained in health and gradually lost in
illness.
Drew Leder, in his book The Absent Body, has
pointed out that health is not an unchanging state but a
process:
Phenomena such as ageing, puberty, menstruation
and pregnancy are a normal and necessary part of
the life cycle. They are not in themselves dysfunc-
tional and alienating. As such they should not be
associated with the notions of “bad” or “ill” that
comprise part of the Greek meaning of dys (1990a,
p. 89).
As Leder makes clear, referring to studies of men-
struation, pregnancy and menopause, this rhythmic
character of health seems to be specially prevalent
for women, given their form of embodiment. As long
as these changes have a rhythmic, homelike charac-
ter they will not mean unhomelike being-in-the-world,
not eclipse the openness towards the future and the
world, but merely indicate different tempos, differ-
ent rhythms. To the rhythm of a healthy being-in-
the-world during a life span normally belongs tem-
porary sadness and despair. Very much analogous
to the difference I have explicated between different
forms of tiredness is the difference between the grief
one experiences after the loss of a loved one and
an endemic depression (compare the case of Susan
above). Indeed, an attunement of sadness need not at
all be an unhealthy mood, if it merely colours, but
does not prevent one’s understanding in transcending
in a coherent way. The border between health and
illness can thus only be drawn by studying the being-
in-the-world of the person in question and its temporal
dimension.26
The doctor who is to help Jane in the example
above cannot restrict his mission to the activities
of performing labtests and providing insulin therapy.
Since diabetes is a chronic disease Jane will have to
be taught to live with her changed biological con-
dition in the best possible way. She has to learn
to measure and watch her blood sugar, regulate her
diet and exercise, abstain from alcohol and tobaco,
take her medication, possibly insulin shots, and so
on. Jane’s illness regards a whole pattern of being-
in-the-world, which has to be changed in order to
minimize the unhomelike experience of living with
diabetes. Jane has to attain knowledge of the biomed-
ical processes involved in diabetes and the way they
are connected to the everyday patterns of life. She has
13
to change her life style. If the doctor is going to be
successful in his encounters with the patient he must
consequently focus upon Jane’s thoughts and feel-
ings about herself and her changed conditition, upon
Jane’s habits, attitudes and character in addition to her
biology.
As Jane’s story of her experience of an incipi-
ent diabetes above makes clear the unhomelikeness
of illness is typically in some way related to changed
conditions of embodiment. There are indeed cases of
illness which do not directly involve somatic symp-
toms (mental illness) but even here the embodiment
of the ill person is often changed in different ways.
From the phenomenological perspective no illness is
exclusively mental or somatic but always both. Dia-
betes involves changed processes of one’s mind, just
as depression affects one’s embodiment. Illness –
unhomelikeness – means an attunement (Befindlich-
keit) lived through every aspect of the being-in-the-
world of Dasein, from body to language, and thus
penetrating the entire understanding of the ill person.
In this article I have mainly dealt with the mental
aspects of illness. In a second article to be published
in this journal – The Body Uncanny – Further Steps
towards a Phenomenology of Illness – I will focus my
attention on the lived body as another important aspect
of the unhomelikeness of illness.
Conclusion
We began our analysis of the feeling of the uncanny
by considering certain features of a short story by E. T.
A. Hoffmann. An hypothesis, initially raised by Freud
by way of Jentsch, was that this feeling stemmed from
an uncertainty regarding the aliveness or deadness of
a literary character. We have now traced the uncanny
in Freud and Heidegger and discovered that it refers
to a universal trauma of homelessness in life which
emerges in anxiety – due to a birth-trauma in Freud
and a death-trauma in Heidegger. In both cases the
trauma refers to the presence of deadness or otherness
in life, to the presence of something alien in myself
– in myself as mind and in myself as being-in-the-
world. Pathological anxiety, we found, is only possible
against the backdrop of this a priori homelessness.
A more general outline of illness as homeless-
ness was then attempted through an exploration of
some clinical examples. Pathological anxiety is thus
only one example of the unhomelike quality of ill-
ness. Through its general tie to the uncanny as such,
however, it makes it possible to understand how ill-
ness is played out against the background of the gen-
eral homelessness of human existence – the general
trauma of life and death. Medicine would thus not only
14 F REDRIK S VENAEUS
encompass the sciences of biology and pathology, but
also the art of providing of a way home for the patient.
Human life (bios) suffers (pathe) from a basic home-
sickness that is let loose in illness. If this unhome-
likeness is taken as the essence of illness, the mission
of health care professionals must consequently be not
only to cure diseases, but actually, through devoting
attention to the being-in-the-world of the patient, also
to open up possible paths back to homelikeness. This
mission can only be carried out if medicine acknow-
ledges the basic importance of the meaning-realm of
the patient’s life – his or her life-world characteristics.
As I hope to have shown in this article, phenomen-
ology provides possible ways to go in exploring this
realm.
Notes
1. On this theme see Mordacci (1998), an article which fur-
thermore gives references to some earlier attempts to ana-
lyse health and illness phenomenologically. See also Drew
Leder (1995) for a survey of the fragmentary but interesting
attempts that have been made to develop a phenomenology
of illness, mainly by Kay Toombs, Richard Zaner and Leder
himself.
2. All page references in this text are to the English transla-
tions of Freud’s works – most often the Standard Edition.
All translations have however been checked against the
German originals and have also often been revised.
3. The essay Das Unheimliche interestingly enough is situated
at a point in Freud’s thinking when he was reworking his
theories on the economics of the psyche. This change was
not to be completed until Freud had introduced the concept
of the death drive (Thanatos) in Jenseits des Lustprinzips in
1920, added the new topography of the agencies ego, id and
superego to the earlier one of the systems of the conscious,
the preconscious and the unconscious in Das Ich und das
Es in 1923, and discussed trauma, the nature of defence
and anxiety in 1926 in Hemmung, Symptom und Angst.
Precursors of many later themes are, as we will see, already
present in Das Unheimliche. One could indeed claim that
the analysis of the phenomenon of uncanniness itself tends
to disrupt the coherency of his earlier views and pushes him
towards his later thinking.
4. The German term “Ich” can be translated both as the every-
day “I” and as the more technical “ego”, which has been
used in English translations to indicate a topographical
meaning of the term in Freud’s writings which I have not
discussed here. This theory of the ego was already present,
inchoately, in Das Unheimliche, but it was not formu-
lated explicitly until four years later in Das Ich und das
Es.
5. In Das Unheimliche Freud makes a reference to dreams
as a basic source of the uncanny due to the helplessness
sometimes experienced in them (p. 389).
6. See Die Traumdeutung.
7. See above all Triebe und Triebschicksale.
8. See Aus den Anfängen der Psychoanalyse published
posthumously, but written as early as 1895 and containing
the origins of Freud’s model of the mind.
9. The unconscious cannot, of course, be though of as an area
– a special part of the brain or even another “mental” area.
It is rather another mode of thinking at all times at work
within us. See Das Unbewusste and Die Verdrängung.
10. A possible path on which to continue this critical reading
of Freud are the works of Melanie Klein, as well as other
works from the analysts of the so called object-relationship
schools. Psychoanalysts have indeed criticised Freud on
most of the points I call attention to in this paper. My claim
for originality concerns only the way I use Freud to find a
way towards a phenomenology of mental illness proceeding
from Unheimlichkeit.
11. This tie between the uncanny and castration anxiety is
found in other places. Regarding the Jews and their tra-
dition of circumcision, Freud writes in Der Mann Moses
und die monotheistische Religion that the rite “made a dis-
agreeable, uncanny (unheimliches) impression on others”
(p. 116).
12. Actually another book by Rank figures quite heavily in Das
Unheimliche: Der Doppelgänger.
13. My use of the phenomenological term “constitution” here is
quite deliberate. Freud’s choice of the economical language
of cathexis seems to me, as stated above, highly problem-
atic and insufficient when it comes to feelings. One may
ask oneself if this quasi-quantitative electromechanics is
indeed not on the verge of breaking down in Hemmung,
Symptom und Angst and other late works. On page 107
and 108 Freud writes of the “home-longing” (sehnzüchtig)
cathexis of child anxiety. But how could a “Besetzung” of
an object with energy be “longing”? In contrast to what
other cathexis and in terms of which quantitative relation-
ships? It seems like the only thing a quantitative scale
of energy could explain would be different intensities of
“wanting” an object. The quality of different kinds of want-
ing like longing and loving would hardly be expressible
therein. Freud’s own attempts to add qualities to the neutral
energy by means of Eros and Thanatos is hard to grasp (Das
Ich und das Es, p. 42). If tension is pain and discharge is
pleasure how could hate and love be added to this mechan-
ism? To love is not only to be satisfied and to hate is not
only to avoid pain as Freud himself is acutely aware of in
this book.
14. Freud does not use the term “unheimlich” himself here.
However, he uses the term “sehnzüchtig“ – “home-longing”
– cathexis (translated only as “longing” in the Standard
Edition, p. 107).
15. Martin Heidegger, Sein und Zeit (1986 16th ed. [1927]).
All page references here are to the German original. I
have, however, for the translations consulted the new Eng-
lish translation (1996) of this work by Joan Stambaugh
(without always following her suggestions). Just as in the
case of Freud’s meta-psychology I do not see any possibil-
ity here of providing a general introduction to Heidegger’s
philosophy, where concepts like Fundamentalontologie,
existenziale Analyse, Dasein, In-der-Welt-sein, Befindlich-
keit, Verstehen, Sorge etc. would need a lengthy introduc-
tion. The vocabulary might for a reader unfamiliar with
 DAS U NHEIMLICHE
Heidegger (just as is the case with Freud) sometimes seem
esoteric. Although my dealings with Heidegger here might
be unorthodox and incomplete I think and hope I will
stay true to some of his important insights considering
Unheimlichkeit.
16. Erwin Straus’ idea of an I-Allon (I-other) relation as the
basis of our being-in-the-world is helpful here. See Straus
(1969).
17. Fear of conscience (Gewissenangst) has, according to
Freud, its source in the repressed fear of castration (Kas-
trationsangst) (Das Ich und das Es, p. 60). It is interesting
that although the interpretation of conscience in terms of
infantile sexuality seems light-years away from Heideg-
ger’s fundamental ontology, the two philosophers share a
tendency to interpret ethics in terms of anxiety in response
to a basic homelessness. The voice of the superego in Freud
is just as in Heidegger a call that comes from the depth
of Dasein itself and one which does not offer any laws of
behaviour, but only a constant feeling of guilt and loss tied
to existence as such.
18. After 1930 (which is usually referred to as “the turn” – “die
Kehre” – in Heidegger’s thinking) Heidegger will turn to
literature as a type of authentic understanding or source of
truth. It will be Hölderlin and not Hoffmann though, that
will be the main messenger of the uncanniness of human
existence in Heidegger’s philosophy.
19. See Jacques Derrida (1993).
20. Others have after him tried to use his philosophy in psychi-
atry and psychology (often together with some of Freud’s
insights). For a survey see Spiegelberg (1972).
21. For an attempt to understand clinical medicine as a form of
applied hermeneutics – an interpretive dialogue and meet-
ing of the lifeworld horizons of doctor and patient – see Part
3 of Svenaeus (1999). Regarding phenomenological and
hermeneutic theories of clinical medicine, see also Leder
(1990b), Toombs (1992) and Zaner (1994).
22. The specific qualitites of spoken language and the language
of the body are indeed very important aspects of the clinical
dialogue. See Cassell (1985).
23. This example is taken from Hardy (1978, pp. 232–233). It
has however been slightly altered.
24. Pain would here not be restricted to a sensation in the body,
but would consist in an atmosphere, a “pain-mood” disrupt-
ing understanding. See Leder (1984–85). See also Heideg-
ger (1989, pp. 118–119): “Eine Magen ‘verstimmung’ kann
eine Verdüsterung über alle Dinge legen.”
25. For an interesting study of normal and pathological
physiology from a phenomenological perspective, see
Buytendijk (1974). The following remark by Buytendijk
fits in nicely with my attempt at a phenomenological theory
of illness: “Being ill is above all alienation from the world”
(p. 62, italics in original).
26. Regarding further explorations of the phenomenology of
illness as unhomelike being-in-the-world I refer the reader
to the second part of my thesis: The Hermeneutics of Medi-
cine and the Phenomenology of Health: Steps towards a
Philosophy of Medical Practice (1999).
15
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