Keeping in mind the constrictions and limitations that have marked the development of Spanish psychiatry during a good part of the 20th century, it is not surprising that its contributions to the epistemological and methodological foundations of psychopathological knowledge have been relatively scarce if compared with other countries and national traditions. Nevertheless, the writings of some outstanding authors include valuable reflections and theoretical insights that go beyond the mere reception of foreign ideas. Apart from the intense concern for anthropological questions or for the problems of existential analysis which were so typical during the central decades of the century, there have been a series of notable contributions related to the concept of understanding in psychiatry, to the development of psychopathology as an objective hermeneutics, to the historical and empirical calibration of the mental symptom and to the theoretical implications stemming from the nature of the psychiatric experience which will be presented and reassessed in the course of this presentation.