Jean-Paul Sartre (1905–1980) was a French philosopher, novelist, and playwright who produced one of the twentieth century’s most ambitious works of systematic philosophy: Being and Nothingness (1943), written in Paris under Nazi occupation. His central claim — that human beings are radically and inescapably free — ran against both Freudian determinism and Marxist mechanism, and it became foundational for existential psychiatry. Sartre argued that consciousness is defined by its capacity to negate what it finds: we can always say “no” to our situation, our role, our past. The refusal to acknowledge this freedom he called bad faith. His analysis of the body, the Other’s gaze, and the experience of shame gave clinicians a vocabulary for understanding what happens in the medical encounter that no diagnostic manual had provided.
Intellectual Formation
Sartre wrote Being and Nothingness during the German occupation of Paris, completing the manuscript in 1943 under conditions that made the question of human freedom anything but abstract. His two decisive philosophical sources were Edmund Husserl and Martin Heidegger, both encountered through translations and time spent in Berlin in the early 1930s. From Husserl he took the principle of intentionality — that consciousness is always directed toward something beyond itself — but he radicalized it: rather than consciousness “digesting” the world into inner representations, Sartre argued that consciousness is a “bursting forth” toward its objects, never a self-contained inner substance.(Sartre, Jean-Paul, 1943) From Heidegger he took the analysis of anxiety as the disclosure of freedom, the concept of thrownness, and the description of human reality as a “being of distances,” always beyond its current situation toward possibility.(Sartre, Jean-Paul, 1943)
What Sartre made of these sources was distinctively his own. Where Husserl retained a transcendental ego as the subject of experience, Sartre’s earlier essay The Transcendence of the Ego (1936) had already argued that the Ego is not the living subject of consciousness but a transcendent object constituted by reflection after the fact — identifying with one’s ego is itself a form of bad faith.(Sartre, Jean-Paul, 1943) Where Heidegger grounded authenticity in being-toward-death, Sartre rejected this: death is not “my ownmost possibility” but an absurd facticity that arrives from outside and simply interrupts my projects — it does not lend life its structure.(Sartre, Jean-Paul, 1943) These were not minor refinements. They changed what the philosophy meant for how one lives.
Being, Nothingness, and Consciousness
Sartre’s starting move in Being and Nothingness was to collapse the distinction between appearance and reality: the being of a thing is nothing other than the phenomenon of being — what it shows itself to be is all there is.(Sartre, Jean-Paul, 1943) This cleared the ground for his fundamental ontological distinction between being-in-itself (l’en-soi) and being-for-itself (le pour-soi).
Being-in-itself is the mode of existence belonging to objects: opaque, self-identical, massive, fully coincident with what it is.(Sartre, Jean-Paul, 1943) A stone is simply what it is. Being-for-itself is the mode of existence belonging to human consciousness: characterized by an internal distance, a nothingness at its core, a perpetual self-presence that is never quite self-coincidence.(Sartre, Jean-Paul, 1943) This internal distance — infinitesimal but real — is what makes consciousness possible at all. To be conscious is to be slightly other than what one is; to be a thing is to be nothing but what one is. Sartre further insists that consciousness is its own cause as consciousness — nothing outside consciousness causes it to arise — while remaining fully contingent in its being; this tension between spontaneity and contingency underlies his account of facticity and is foundational for his treatment of anxiety.(Sartre, Jean-Paul, 1943) He distinguishes pre-reflective from reflective consciousness: at the pre-reflective level, consciousness is non-positionally aware of itself without making itself an object, and the Ego is therefore not “of” consciousness but a transcendent product of impure reflection.(Sartre, Jean-Paul, 1943)
Nothingness, for Sartre, enters the world not as a logical abstraction but through the concrete acts of human questioning and negation. When consciousness interrogates being, holding open the possibility that something might not be there, it introduces genuine non-being into the situation.(Sartre, Jean-Paul, 1943) The world of absences, lacks, distances, and destructions that humans inhabit is sustained by this capacity for negation.
Freedom and Facticity
The nothingness at the core of consciousness is the ontological ground of freedom. Because the for-itself is never simply what it is — never fully coincident with its situation, its past, or its role — it cannot be determined by any of them.(Sartre, Jean-Paul, 1943) This is Sartre’s “condemned to be free”: freedom is not something consciousness possesses as a property; it is what consciousness is.(Sartre, Jean-Paul, 1943) We cannot choose not to choose.
Anxiety (angoisse) is the specific mode of consciousness in which freedom discloses itself.(Sartre, Jean-Paul, 1943) In anxiety we apprehend ourselves as the groundless source of our own choices, without any prior determination settling what we will do.(Sartre, Jean-Paul, 1943) [GAP: Explanation of why bad faith is pervasive because anxiety is unpleasant] [GAP: Claim that flight from anxiety is the default condition of human life]
Freedom does not mean freedom from circumstances. Sartre calls the complex of circumstances and responses the situation: we are always thrown into a world we did not choose — class, body, historical moment — but we are responsible for how we take it up.(Sartre, Jean-Paul, 1943) The workers of the Croix-Rousse in Lyon, living in grinding poverty, can live that poverty as simple necessity or as intolerable injustice calling for revolt; the objective facts do not settle the question.(Sartre, Jean-Paul, 1943) This concept of freedom-in-situation became directly relevant to clinical thinking about suffering: a person is not simply a product of their circumstances, even when the circumstances are severe.
Sartre’s account of temporality follows from the structure of the for-itself itself: the for-itself is always its own past (as facticity it can never simply be), its own present (as flight from that past), and its own future (as project), and these three ecstases are unified in a single temporal flow rather than existing as external containers in which events occur.(Sartre, Jean-Paul, 1943) The for-itself also exists as a fundamental lack, perpetually lacking the coincidence with itself that being-in-itself possesses; value is the impossible ideal of a being that would be both in-itself and for-itself simultaneously — the ens causa sui Sartre identifies with the traditional idea of God — and this project is constitutively incapable of fulfillment.(Sartre, Jean-Paul, 1943)
Sartre also insisted that the past cannot determine us, though we always have to reckon with it. The past is the in-itself that I am — my sedimented facticity — but I relate to it from a present that surpasses it, and I am responsible for how I take up my past, not merely shaped by it.(Sartre, Jean-Paul, 1943)
The Body: Three Ontological Dimensions
Sartre’s analysis of the body in Part Three of Being and Nothingness is one of the most clinically useful sections of the work. He argues that the body exists in three irreducible ontological dimensions.(Sartre, Jean-Paul, 1943)
The first dimension is the body-for-itself: the lived body as the point of view from which I act in the world, my facticity as embodied consciousness. I do not perceive my body from outside when I am simply living in it — it is the condition of all my perceptions, the zero-point of my experience.
The second dimension is the body-for-others: the body as it appears to another person, perceived, categorized, judged. When the doctor examines a patient, the patient’s body is in this second dimension — it becomes an object within the doctor’s field.
The third dimension is the body as I come to know it through others’ perception of me: the body I have learned to see from outside, the body given back to me through the Other’s gaze.(Sartre, Jean-Paul, 1943)
This three-part analysis explains phenomena that a purely biomedical account cannot reach. Sartre’s analysis of pain is a case in point: pain is not an object for consciousness but the mode in which the body is present to consciousness as facticity — only when I reflect on it does it become a psychic object, “the ache.”(Sartre, Jean-Paul, 1943) The difference between lived suffering and medicalized symptom turns on exactly this move from the first to a reflected, objectified dimension.
Bad Faith
Bad faith (mauvaise foi) is the structure of self-deception through which a person denies their own freedom by treating themselves as a fixed thing.(Sartre, Jean-Paul, 1943) This can take two forms. In the first, a person collapses into pure facticity: they treat their role, their past, their diagnosis, their class position as their essence, denying that they freely choose to inhabit these determinations. Sartre’s paradigmatic illustration is the waiter who “plays at being a waiter,” performing his role with excessive precision, treating his function as his essence, and thereby denying that he freely chooses the vocation and could always choose otherwise.(Sartre, Jean-Paul, 1943) In the second form, a person claims pure transcendence: they deny their facticity entirely, treating themselves as purely free spirit untouched by circumstance, evading the real constraints of their situation.
Both moves are bad faith because each denies half of what the for-itself is. The for-itself is always both: facticity (what it finds itself to be, the situation it did not choose) and transcendence (the capacity to surpass that situation toward possibilities). Bad faith falsifies this ambiguity by absolutizing one pole.(Sartre, Jean-Paul, 1943) Sartre’s account of impure reflection (réflexion complice) shows how this operates introspectively: ordinary self-examination posits psychic states as objects — emotions, desires, moods as things — and thereby hypostatizes the fluid activity of consciousness into a false interior substance, producing the illusions of fixed character and personality.(Sartre, Jean-Paul, 1943)
The escape from bad faith Sartre calls authenticity — a radical conversion in which corrupted being reclaims itself — but he defers its treatment, noting only that it does not mean eliminating the ambiguity between facticity and freedom but reclaiming it honestly.(Sartre, Jean-Paul, 1943)
The Look and Being-for-Others
Sartre’s account of the Other begins from the experience of shame. When I am looked at, I do not infer another subject by analogy with myself — I directly apprehend my own being as an object for another subject, without intermediate reasoning.(Sartre, Jean-Paul, 1943) The Other’s gaze (le regard) temporarily arrests my freedom: I find myself fixed, characterized, defined from a point of view that is not mine and not at my disposal.(Sartre, Jean-Paul, 1943)
Sartre’s treatment of ereutophobia (pathological fear of blushing) illustrates how “psychotic” symptoms can be understood as modes of being-for-others gone wrong.(Sartre, Jean-Paul, 1943) The blush exposes the body as an uncontrollable signifier for the other’s gaze, making visible the ontological vulnerability of embodied intersubjectivity.(Sartre, Jean-Paul, 1943)
The Look has explicit clinical implications. Sartre notes that conditions involving irrational fear of being seen — he mentions ereutophobia, the fear of blushing — can be understood as distortions of this ontological vulnerability: the body as uncontrollable signifier in the field of the Other’s gaze.(Sartre, Jean-Paul, 1943) The clinical encounter, with its asymmetric exposure and examination, is structured by exactly the relations Sartre describes.
Sartre argues that all concrete relations with others — love, desire, hate — are characterized by irreducible conflict: each consciousness attempts to capture the other’s freedom while preserving its own, but this project is necessarily self-defeating.(Sartre, Jean-Paul, 1943) This is not pessimism about specific relationships but a structural claim about the ontology of intersubjectivity. Sartre acknowledged that a morality of deliverance might exist but insisted it could only be achieved after a radical conversion.(Sartre, Jean-Paul, 1943)
Existential Psychoanalysis
In Part Four of Being and Nothingness, Sartre proposed an alternative to Freudian analysis. Rather than seeking repressed drives in a causal-mechanistic unconscious, existential psychoanalysis seeks the original project: the fundamental free choice of being that gives unity and meaning to all of a person’s specific behaviors and choices.(Sartre, Jean-Paul, 1943) The original project is not caused; it is freely chosen and freely sustained, though it may be obscured from the person who lives it.
Sartre’s critique of the Freudian unconscious had already been mounted in Part One. The censor, he argued, must know what it is repressing in order to repress it, and must therefore be conscious of the very thing it is hiding from consciousness — which is not an unconscious mechanism but another instance of bad faith.(Sartre, Jean-Paul, 1943) The Freudian topology of id, ego, and superego does not solve the paradox of self-deception; it restates it.
To show the method at work, Sartre analyzed Flaubert: Flaubert’s literary style, his neurotic symptoms, and his life choices can be unified under a single fundamental choice of being — to be simultaneously active and passive — not because this was caused by his upbringing but because it was the project through which he freely organized his situation.(Sartre, Jean-Paul, 1943)
Sartre drew explicitly on Jaspers’s General Psychopathology and the concept of Verstehen — comprehensible connections between mental states — while departing from Jaspers by denying that comprehensibility implies causal determination: a motive is “comprehensible” but does not explain, because the for-itself always constitutes what counts as a motive through its free project.(Sartre, Jean-Paul, 1943)
The Conclusion of Being and Nothingness synthesizes its ontological argument by showing that nothingness is not a third thing alongside being but a nihilation performed by the for-itself upon being-in-itself, making the world appear as a structured totality rather than undifferentiated brute presence.(Sartre, Jean-Paul, 1943) Sartre identifies the fundamental human project as the desire to be the ens causa sui — both in-itself and for-itself simultaneously, the traditional idea of God — a project necessarily impossible because the two modes of being are ontologically incompatible.(Sartre, Jean-Paul, 1943) The Conclusion also explicitly raises the possibility of an existential ethics of authenticity, gestured at as a consciousness that in purifying reflection “wills itself,” but immediately defers it: the work on ethics that would follow was never completed, and the Notebooks for an Ethics (1992, posthumous) remains a fragmentary approach to what Being and Nothingness promised.(Sartre, Jean-Paul, 1943) This consolidates Sartre’s anti-determinist thesis: the for-itself is always already beyond its facticity — class, body, past — so that the concept of psychological or social determination is ontologically groundless, even as the situation remains the starting point that freedom must surpass.(Sartre, Jean-Paul, 1943)
Influence on Medicine and Psychiatry
Sartre’s influence on medicine and psychiatry ran primarily through R.D. Laing, though the path was complex. Laing acknowledged his main intellectual debt to the existential tradition — Kierkegaard, Jaspers, Heidegger, Sartre, Binswanger, Tillich — while noting important points of divergence from each.(Laing, R. D., 1960) What Sartre specifically contributed to Laing’s The Divided Self (1960) was the distinction between the imaginary self and the real self, which Laing used to describe the schizoid predicament: the imaginary self “breaks in pieces at contact with reality.”(Laing, R. D., 1960) Laing’s concept of ontological security — the firm sense of one’s own and others’ reality from which an ordinary person meets the hazards of life — is in part an application of Sartre’s account of being-for-itself to clinical phenomena.
Sartre’s account of the objectifying Look also shaped Laing’s analysis of how psychiatric treatment, by treating the patient as an object for diagnosis and management, could itself contribute to the patient’s sense of unreality and non-being. This is a clinical application of the third dimension of the body.
The feminist reception of Sartre — documented in the translator’s introduction to the 2018 translation — found his account of the objectifying effect of the Other’s gaze directly useful for understanding the clinical encounter and social relations of embodiment.(Sartre, Jean-Paul, 1943)
Post-structuralist philosophers including Foucault and Derrida explicitly positioned themselves against Sartre’s existentialism, declaring the “death of man” as a rejoinder to Sartrean humanism.(Sartre, Jean-Paul, 1943) This dispute shaped the subsequent history of medical humanities, which drew on both traditions.
The Anglophone reception of Being and Nothingness was shaped from the outset by distorting lenses: British philosophers read it through empiricism, American philosophers through pragmatism, and both frameworks missed the distinctive character of Sartre’s phenomenological ontology.(Sartre, Jean-Paul, 1943) Herbert Marcuse published an unfavorable review in 1947, situating the text within competing Marxist frameworks, while Wilfrid Desan, a French native who had met Sartre during the war, produced one of the earliest Anglophone studies of the text.(Sartre, Jean-Paul, 1943) This reception history meant that the detailed philosophical engagement with Being and Nothingness as a work of systematic ontology came later, and often through continental rather than Anglophone channels.
Human Notes
Sartre wrote Being and Nothingness during the German occupation of Paris, in conditions of real political danger. His earlier novel Nausea (1938) had already dramatized the ontological discoveries he would later systematize: the sheer contingency of existence, the way the world ceases to be a familiar backdrop and becomes overwhelming brute facticity, the radical absence of any given meaning. He was 38 when Being and Nothingness appeared. He turned down the Nobel Prize for Literature in 1964, on the grounds that accepting it would compromise his independence. He had collaborated on the Resistance newspaper Les Lettres Françaises during the occupation — which gives his abstract claim that freedom is total, even in constrained situations, a particular weight. The political turn documented in the translator’s introduction — Sartre’s move toward Marxism and his abandonment of the planned work on ethics in favor of revolutionary political engagement — reflects a genuine tension between his ontology and the social world he was living in.(Sartre, Jean-Paul, 1943)