A Brief History Of Madness

In the previous post, The Narcissistic Personality of Our Time, I discussed the trade-off that the modern individual must face when isolating himself from his cultural roots.

The critique that Lasch presented in A Culture of Narcissism is not towards isolated behaviors that aim to better oneself, but the belief that the combination of multiple autophile behaviors will be an inadequate substitute for traditional communities and social contracts (that asked the individual to direct their libidinal energy outwards, away from the ego).

When this was done in the past, it grounded people and gave them a sense of humility. Today’s self-centered society believes that it is the community that owes them something. And unwittingly, the modern narcissist worships new forms of religion. In the modern world, as Harari points out in Homo-Deus, it is not so much the cult leaders or religious leaders that are worshipped, but the technologists in Silicon Valley that are promising the next big breakthrough that will be the cure of all cures.

In the end, people must worship something. The self is a poor candidate, since too much self-love can lead to megalomania and delusional ideas (Secondary Narcissism). Self-love does not perform the function of a drug, it does not give people a sense of security. So when people turn their attention on something else to worship, or perhaps someone else, they are in a way, protecting themselves from psychological harm. They are blocking energy from flowing towards the self, they are standing in the way of their own narcissism.

The unfortunate truth is that human beings cannot choose to worship nothing and have a healthy sense of self. At least that is the suggestion behind Freud’s theory of narcissism. And the problem that no choice of worship is not without its problems. In the culture of the therapeutic, the problem is propagated as more people become convinced that the cure to their problems is self-understanding; they debilitate themselves.

Psychology makes the claim that you should understand yourself, or in ancient philosophy speak, “know thyself”. Yet no psychologist has not admitted to the complexity of the self, its dynamism, and elusiveness. This is a clear double-blind.

Nietzsche, long before the advent of psychotherapy, understood the importance of the religious instinct. That is why he created Zarathustra, a Zoroastrian prophet, who came to preach the doctrine of no divinity, in Biblical style. After Freud psychoanalyzed away the idea of God, his disciples, Jung and Adler, went on to establish their own pseudo-religious organizations, as detailed in The Triumph of the Therapeutic.

One of the features of this new world that we occupy is that each individual is somehow broken. If they are not being as “effective” as they can be, or capable of “relating to others” well enough, or buying into social fictions willingly, then they are “sick.” The reality is that they are not docile enough to be considered normal.

In the West there are many therapists who handle these problems professionally. And they take a fat fee for their services. In other parts of the world, therapy isn’t even an idea that people entertain. But slowly, thanks to globalization, most nations are beginning to embrace therapy. You would think that the countries that have the most therapists would have the highest percentage of psychologically “healthy” people.

Which countries have the highest rates of mental illness? You can see very quickly how difficult it is to answer such a question, not least of all because simply defining “mental illness” is highly subjective — as Szasz would point out.

In a study being conducted by the World Health Organization the highest prevalence of mental illness (which include anxiety, mood disorders, impulse control, and substance abuse) was found among the “United States, Colombia, the Netherlands and Ukraine tended to have higher prevalence estimates across most classes of disorder, while Nigeria, Shanghai and Italy were consistently low, and prevalence was lower in Asian countries in general.” — Source

Can we extrapolate that the US indeed has the highest number of mentally ill individuals, or are these results simply reflective of a society that has embraced therapeutic definitions? In which case, the data we have is based on what is self-reported.

How to resolve this paradox?

An answer can be found in The Myth of Mental Illness, the first point Szasz makes is that psychological diseases keep changing over time. Szasz recalled that not long ago, there were less than 20 psychological illnesses — then, during his lifetime there were hundreds. It is not that change itself is indicative of foul play — without change, there is no evolution or advancement, but the point is that we have not really discovered new illnesses, as much as we have re-categorized old behaviors. The role of the therapist is essentially to socialize the individual into the normal functions of society.

In Madness and Civilization, Foucault details the history of madness.

There was a time when the mad were mobile, where they interacted with society, and people heard them speak. There was a time when it was those who knew too much that went mad — Don Quixote went mad because of too much reading, so his priest burnt a selection of his books to cure him. There was a time when to be mad meant to be unproductive, thus the vagabonds, the idle, and the youth who had squandered the family fortune were labelled as mad. There was a time when the remedies to curing the mad was in throwing cold water at them. But confinement was the most popular tool.

Madness was recognized as non-reason, or the negation of reason — that is, non-being — insofar as it is cut off from external stimuli. In fact, doctors prescribed travel and ocean waves to restore movement, and thus the correct flow of thoughts in the mind. To cure madness, by language, for example, was to follow the madman in their illusion, or to force them to come out of their condition out of necessity (the need to work and survive).

Eventually, the mad were no longer allowed to be mobile and were locked up in prisons to make sure they were productive and not just a drag on society, they were forced to work. Ironically, this had the effect of displacing “normal” people in society from jobs, and then those people were labelled as “mad” and the cycle continued.

Then in the 19th century, it was only the unproductive mad people that were considered “mad” — this marked the beginning of the asylum.

They were forced to work so that they did not violate one of God’s commandments. The work was a way to fix their soul, and consequently, absolve them of guilt. But that was not the only rationale. There was an idea that work was a way to cure man from his suffering. When man escapes the law of labor that nature imposes on him, he seeks a world of anti-nature, and artifice, and his madness becomes only one manifestation of such a world. In describing how he succeeded, by industrious activity in being cured, Bernadin de-Saint Pierre said:

It was to Jean-Jacques Rousseau that I owed my return to health. I had read, in his immortal writings, among other natural truths, that man is made to work, not to meditate. Until that time I had exercised my soul and rested my body; I changed my ways; I exercised my body and rested my soul. I gave up most books; I turned my eyes to the works of nature, which addressed all my senses in a language that neither time nor nations can corrupt. p.104

Madness and Civilization, Foucault

The next stage, psychiatry, is when the analyst takes the role of the priest. The patient, or the madman, confesses to them their sins. In a sense, the madman is like a child while the analyst/therapist is the adult. Merely by virtue of rationality vs non-rationality, the therapist had the upper hand and did not need to use any physical force.

That was Foucault’s contention against Freud, that one did not need to archive mountains of data on a patient to analyze them. it was sufficient to merely be the rational person in the room, and in that sense, you could hold up a mirror to the madman or the patient, and they would be able to see the errors in their thinking for themselves. This is in contrast to Jung, who preferred not to maintain this hierarchical relationship.

There are two points that are important. One, the very definition of madness is dubious, not only because it keeps changing with time to reclassify old modes of behavior, but because there are political and financial incentives to convince people that they are dysfunctional. Second, the therapist has merely filled the void that was previously occupied by the priest, the family, and traditional institutions.

My intention is not to reduce psychotherapy to an invalid mode of healing, but simply to point out its shortcomings and limitations. If we want to contextualize its position in history, we would treat it as just another human experiment (not a source of ultimate truth) that began with mesmerism and strange forms of pseudomedicine, and then evolved to psychotherapy, behaviorism, and finally cognitive science and neuroscience.

If you would like an introduction into the history of psychology, see my summary of Ellenberger’s excellent The Discovery of the Unconscious.

Psychology faces one final limitation: the subject-subject problem. That is, the scientific study of subjective experience requires a subject to be an objective observer of subjective experiences. On the one hand, it is impossible to derive an ought from an is. As Karl Popper pointed out, you cannot falsify psychological ideas. Therefore, as scientific hypotheses, psychological ideas (Adler, Freud, Jung) fail. But that would be the wrong lens to view these ideas. A better approach would be to see the ideas of psychoanalysis as a philosophy, like Epicureanism or Stoicism, no less valuable and important to the human experience.

The problem only arises when a philosophy is expressed as brute fact. In recent years, there has been an accommodation in the West to the benefits of Eastern practices that used to be considered esoteric and exotic (yoga, meditation). But a few decades ago, this was not the case.

In Altered Traits, a book by Daniel Goleman and Richard Davidson, we are told about the failure of clinical psychology in trying to cure the problems of the mind. A comparison is made between the Western and Eastern approach.

In the West, clinical psychology tries to fix a specific problem like high anxiety by focusing on that one thing, while Asian psychologies have a wider lens and offer ways to enhance our positive side. Notice that this is akin to the dichotomy posited by Ian McGilchrist in The Master and His Emissary.

Essentially, the brain is divided into two ways of thinking (left hemispheric and right hemispheric). This is a metaphorical description and not a description of the location such modes of thinking take place in.

The left hemisphere is sequential, linear, compartmentalizes the world, logical, and analytic. The right hemisphere is holistic, complex, receptive. Each hemisphere knows things that the other hemisphere does not know. The corpus callosum creates cooperation between the hemispheres, by excluding the other at the right time.

A great example given by McGilchrist is to compare the two hemispheres to a technology business consisting of a salesperson and of an engineer. The salesperson forges new relationships and brings in clients, while the engineer builds systems and technologies. The salesperson thinks that the engineer is free loading off of his talent, while the engineer thinks the same of the salesperson.

We can draw a parallel between the Eastern and Western approach in dealing with problems of the mind. The Eastern approach is holistic and right-brained, while the Western approach is linear and left-brained.

Richard, one of the authors of Altered Traits, became interested in consciousness after reading the works of Aldous Huxley, R.D Laing, Martin Buber, and Ram Dass. But these interests were driven underground during his college years in New York University, where professors were staunch behaviorists (followers of B. F. Skinner). They thought that observable behavior was the only way of understanding the mind, while looking inside the mind was a taboo waste of time. They believed that mental life was irrelevant to understanding behavior.

When French poet and Nobel laureate Romain Rolland became a disciple of the Indian saint Sri Ramakrishna near the beginning of the 20th century, he wrote to Freud about the mystical state he experienced. Freud diagnosed it as regression to infancy.

In the 1960’s, psychologists dismissed drug-triggered altered states as artificially induced psychosis.

And yet, as described in Altered Traits, there are tangible, scientifically measurable benefits to meditation.

In the past, many insights about the mind have been discovered by psychologists in the West, but it is important to not ignore the subjective experience of “I”. That is, to give priority to experiences and relationships that are positive, rather than to compartmentalize subjective experiences (anxiety, stress) and to try to only understand them in isolation.

The right-hemispheric approach to complexity is to look at the bigger picture, rather than to get lost in the details. An approach that sounds more majestic and visionary, when one gets around the negative associations we have internalized when it comes to solutions that lack scientific rigor. As Kahneman reveals in Thinking: Fast and Slow, system 2 (the deliberate brain) thinks it is playing the lead role in the movie, when in fact, it is system 1 that is the star (the automatic brain).

Originally published at https://unearnedwisdom.com.

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