I very much admire Stephan Heckers’ framing of ‘four forms of scientific reductionism in psychiatry’ and their relation to the autonomy of the patient.Stephan seems to be using ‘reductionism’ in a legitimate, but perhaps non-standard way.‘Reduction’ in his sense has to do with loss of information.There is, first, the ‘clinical encounter’ in which the patient’s lived experience is translated into the third-person account given by the therapist.Then there is classification, identification of a biological problem, and causal implications.Each of these steps misses out something about the ‘lived experience’ of the patient.I find the discussion somewhat tantalizing, and suggest the real reason for acknowledging autonomy may be the need for a ‘Jaspersian engagement’ with the patient, which identifies the one-off idiosyncracies of the patient’s mental life, rather than merely those aspects that fall under generalizations.