This article reconstructs Nietzsche's conception of spiritual illness, especially as exhibited in various forms of the bad conscience, and asks what positive, ennobling potential Nietzsche finds in it. The relevant concept of spirit is arrived at by reconstructing Nietzsche's conception of life and then considering what reflexive life—life turned back against itself—would look like. It distinguishes four independent features of spiritual illness: the measureless drive to make oneself suffer, self-opacity (or mendaciousness), life denial, and a self-undermining dynamic in which life exhausts the sources of its own vitality. The article ends by considering various suggestions as to how these features of spiritual illness might also be preconditions of great spiritual health, including the preconditions for erecting new “ideals.”

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