Traditionally, “understanding” is related to the comprehension of the particular and of individualities as historical unique; “explanation” is conversely related to the sciences of general laws, preferential expressed mathematically. Within the “Methodenstreit”, first method is related to an idiographic second to a nomothetic approach. This dichotomy was transferred by Jaspers into psychiatry.

How the understanding-explanation dichotomy could be dialectically kept, but also surmounted in contemporary psychiatry and psychosomatics in the light of a broader concept of “comprehensibility” as dialectically opposed to “incomprehensibility”.

Possible steps in development of the understanding-explanation dichotomy are rebuilt historically from Neo-Kantian and hermeneutic approaches onwards. Starting from reflections on analytic action theory as well as from a critique of Descartian dualism of substance and from the assumption of incomprehensibility, we try to state an integrative conceptual network.

Ways of comprehensibility and incomprehensibility as well as understanding and not understanding are explored by crossing epistemological and ontological perspectives. Four implicit categories of understanding and a dialectically built conceptual network of dimensional dualities are stated.

The methods of “understanding” and “explanation” maintain in contemporary psychiatry a heuristic importance, but not in a segregative manner. This epistemological dichotomy might be integrated in a network of superordinate dualities.

The author has not supplied his/her declaration of competing interest.