Mohammed Abouelleil Rashed reviews A Philosophy of Madness: The Experience of Psychotic Thinking (The MIT Press, 2020) by Wouter Kusters (translated by Nancy Forest-Flier).
This is Part Four of a Book Forum on A Philosophy of Madness. The Forum consists of four reviews and a reflection from the author.
For Part One by Jeremy Spandler, click here.
For Part Two by Emma McCabe, click here.
For Part Three by Becki Smith, click here.
For Part Five by Wouter Kusters, click here.
It is often observed that language fails before the ineffability of madness and mysticism. Kusters makes this point in different ways throughout A Philosophy of Madness, for example: “Just like mystics, madmen [sic] consider language too imprecise to do justice to “what’s going on.” It seems like sacrilege to render the perplexity of madness in the language of everyday life” (2020: 217; see also 165, 281). One finds in Kusters’ vision an inversely proportional relation between language and mad mysticism: the more the person proceeds along the mystical path, the less adequate words are until language becomes mute and “falls silent altogether” (2020: 213, 215). But mad people and mystics do, of course, speak, and Kusters outlines an original formulation of several paths that can be taken once the “dams are broken” and the silence ends (2020: 217-231). The mad person’s interlocutor then comes to face “language without borders … no longer restrained or limited by the stifling ties that connect symbol and meaning” (2020: 219). In that sort of linguistic encounter “anything and everything can be said, which leads to the minimalization of conventional meanings” and, one must add, leads to difficulties in understanding madness (2020: 220).
These difficulties constitute a key theme in philosophy of mental health, where it is recognised that ‘psychotic’ and ‘schizophrenic’ phenomena present a challenge to understanding; they cannot be accounted for in the way we ordinarily make sense of each other’s behaviours and beliefs through empathy. So significant was the challenge that the first philosopher to pay proper attention to madness declared certain phenomena, e.g., primary delusions, to be “un-understandable” (Jaspers 1963: 376; 1st ed. 1913). Decades later, Jaspers’ view was challenged. Phenomenological psychopathology, in particular, produced detailed, scholarly interpretations of madness underpinned by the philosophical phenomenology of 20th century Germany and France. These philosophers turned our attention away from the everyday, naive experience of the world and towards an appreciation and description of its conditions of possibility. In everyday experience, we exist in what Edmund Husserl called the “natural attitude”: the ordinary state of waking consciousness in which we find ourselves “living naturally, objectivating, judging, feeling, willing” (Husserl 1982: 52). We go about in the natural attitude with an implicit certainty in the reality of the world around us. On the basis of this prior certainty and embeddedness in the world, we conduct our everyday business of engaging with people and objects. Phenomenological psychopathologists incorporated these views into their accounts of madness. We can only begin to understand madness, they argue, once we consider the global alterations in the background dispositions and structures that underpin experience and constitute that person’s lifeworld, such as the “general sense or feeling of reality, the experience of time, or the implicit sense of ipseity or selfhood” (Sass 2013: 102).
Kusters and I are both dissatisfied with phenomenological psychopathology (see Rashed 2015). For Kusters, the approach does not go far enough: “the concepts it uses and the observations it makes remain, in a certain sense, remote and impassive” (Kusters 2020: 8). And while this might be a starting point for understanding madness, those who want to “delve deeper will have to abandon the safe shores of impassive observation.” (ibid.). Continuing with similar imagery, he writes:
“As long as the phenomenologist stays on the riverbank, he will not know what swimming is – or drowning, either. He may observe people swimming in the distance, snorkelling, deep-sea diving, and sometimes even drowning. His [sic] reports, however, will remain couched in the sturdy, well-defined language of observation and analysis” (ibid.).
Later he talks about “plunging into the ocean of madness” and breaking through its thin ice (ibid.). We are left with a sense that, for Kusters, understanding madness requires much more than interpretation and armchair analysis; it requires that we engage in activities by which we can venture beyond the safe and conventional and so experience something of madness.
Kusters believes we can go about this in a number of ways, key among which is philosophy. Philosophers, though most of them stop at the safe shores of reason and never venture into the “ocean of madness”, share with the madperson “the source of astonishment and amazement, involvement and detachment” (2020: 15). For the madperson, however, philosophical questions about, say, the nature of time and the structure of reality are not intellectual musings, but urgent questions and matters of life and death: “madness is philosophy lived out in practice.” (ibid.). The philosopher, unlike the madperson, is able to prevent these questions from taking over their life, and is able, with varying degrees of success, to convey these ideas to their peers and, occasionally, to the public. Philosophy has been historically antithetical to madness, the latter being everything that philosophy of a certain kind ought to avoid. Kusters is correct in reminding us that philosophers tend to see madness as an “end point and not as a jumping-off point or impetus for further reasoning” (2020: 11). René Descartes famously regarded madness as the failure to represent reality, while Immanuel Kant’s philosophical system, as Kusters writes, “protects the reasonable individual from his mad counterpart” and “guards modern man from thoughts of bottomless scepticism, experiences of unfathomable depths, and the seductions of animal sensuality” (2020: 12). Kusters wants to push philosophy further and beyond the limits of reason and shared language, while at the same time finding, at its outer-reaches, protection from what he refers to as the “seduction of madness”: the risk of absorption into images and the overwhelming of awareness by what was previously tacit (2020: 202, 486).
In so far as the question of understanding is concerned, the view that emerges from my reading of A Philosophy of Madness is a sort of experiential approach to madness. How can philosophers, or anyone for that matter, push beyond the conventional and towards an experience of mad mysticism? Kusters’ book is itself an invitation to do so; it contains, as he puts it, “more formulas for going mad than for avoiding madness” (2020: 8). For example, Chapter 5 on detachment describes a key step that can place the person on the road to mad mysticism. It involves freeing oneself from earthly concerns in order to become “‘open’ to the mystery” (2020: 178). An initial aspect of this mystery is the One, a mystical intuition/experience of a notion that transcends dualities and distinctions and pervades all of life (Chapter 9). It is not itself an existent among others, but “constitutes the condition for the existence of other things” (2020: 293). It is not itself located in conventional space and time but is nevertheless always there and present (ibid.). In contrast to spiritual traditions that prescribe prayer, yoga, and restraint, arriving at the intuition/experience of the One (the Uni-Delusion) requires “deep thought”, “meditation”, “brooding”, “reflecting”, “contemplation”, all of which might appears to others as “cogitating your head off” (2020: 297).
Another aspect of the mystery, the Esse-Delusion (Chapter 10), involves astonishment at sheer being, where “everything is more intense: colours are more vivid; shapes more detailed; thoughts more acute, ponderous, and rapid; and feeling and moods more extreme and intense” (2020: 304). One possible route to the Esse-Delusion, as suggested by Kusters, is self-induced through psychomimetic substances such as LSD and mescaline. Following a discussion of Aldous Huxley’s The Doors of Perception, Kusters suggests that mental health workers and others can experiment with such substances: “whether one is afraid or, concerned about, interested in, or obsessed by madness, such psychomimetic substances can teach us a great deal” (2020: 329).
The experiential approach to madness does address one of the key shortcomings of phenomenological psychopathology, and indeed of other similarly interpretive approaches. For if shared language cannot help us understand madness, then experiencing something of madness might be our only option going forward. Nevertheless, in what follows I shall raise concerns about the experiential approach to madness, in the hope of stimulating further debate.
Radical detachment, bottomless scepticism, and other activities/experiences that take us beyond the everyday and confront us with the void and the mystery are not open for everyone to pursue. There is a constitutional limit to becoming a mad mystic, a limit determined, in part, by what Merleau-Ponty, in a different context, terms ‘operative intentionality’ and defines as follows:
“that which produces the natural and antepredicative unity of the world and of our life, being apparent in our desires, our evaluations and in the landscape we see, more clearly than in objective knowledge, and furnishing the text which our knowledge tries to translate into precise language”(1962: xviii).
The “natural and antepredicative unity of the world” is, in part, a function of our embodiment, of the way that experiences are inscribed in our bodies. My experience of this book or that cup already contains reference to my body in that these objects solicit my intentions prior to any deliberation on my part. They offer me opportunities for action that I could avail myself of, should I wish to do so. “When I move towards a world,” Merleau-Ponty writes, “I bury my perceptual and practical intentions in objects which ultimately appear prior to and external to those intentions” (1962: 82).
Scepticism and detachment can only go as far as the point where the body takes over in its relationship with the environment. At that point, the cascade of sceptical doubts comes to a halt and our efforts at detachment come up against the opacity of the world and the density of our situated existence. I recall conversations I had with young people experiencing ‘prodromal symptoms of psychosis’. They would often raise a range of related questions for which they were unable to find satisfactory answers: Why do we have cars? Why do we have doorknobs? They were not after answers that invoked the utility of these objects or their history or production process. Having exhausted all standard answers, it seemed to me that, for these young people, cars, doorknobs, and other everyday objects no longer solicited their intentions and ceased to appear as practically meaningful possibilities for action. But from where I stood, I could not share in their scepticism and detachment, even if I understood it theoretically. Which brings me to the key point I want to make: the possibility for my sceptical doubts and efforts at detachment to be understood by others is contingent on them sharing my reasons for asking these questions, and these reasons are not always explicit and may ultimately be reducible to a basic, unanalysable bodily intentionality. Beyond a certain point of scepticism and detachment, what is being interrogated is not a shared truth or dogma, but the interrogator’s own embeddedness in the world, and which he can no longer take for granted.
The constitutional limit to detachment and scepticism poses an obstacle to the experiential approach to understanding madness. To say that this limit is constitutional is to say that the pre-reflective organisation of experience, evident in operative intentionality, is a function of personal, social, cultural, and existential imperatives that are an outcome of the path a person’s life had taken. They cannot, in any straightforward sense, be modified without this also resulting in a transformation of one’s life at its core. To be sure, I can take LSD in order to dismantle this limit; I might wish to do so out of curiosity, or perhaps for religious or ideological reasons. In the absence of such reasons, and in the context of the problem of understanding madness, transforming one’s life at its core cannot be the solution. To appreciate this, we need to apprehend the problem of understanding in its wider social dimension. The problem is pressing because lack of understanding is one of the reasons underpinning stigma and the otherness often attributed to madness. Recommendations on how to approach this problem must keep in mind their target, which is society at large, and not philosophers, therapists, or individuals curious about madness. It is difficult to construct moral arguments by which large segments of the population ought to dismantle their constitutional limit on scepticism and detachment – and with it risk their existential grounding, certainties, and values – in order to understand someone else. An alternative is to view the problem of understanding as an encounter between visions of the world, of reality, that appear incommensurable. What we need to consider are the ethical and political principles that should regulate this interaction. Whether or not understanding will emerge from it cannot be known beforehand, but at least we would have encouraged people to meet with the intention of reconciliation.
Husserl, E. (1982). Ideas Pertaining to a Pure Phenomenology and to a Phenomenological Philosophy. London: Martinus Nijhoff.
Jaspers, K. (1963). General psychopathology. Manchester: University of Manchester Press.
Kusters, W. (2020). A Philosophy of Madness: The Experience of Psychotic Thinking. London: MIT Press.
Merleau-Ponty, M. (1963). Phenomenology of Perception. London: Routledge.
Rashed, M. (2015). A Critical Perspective on Second-Order Empathy in Understanding Psychopathology: Phenomenology and Ethics. Theoretical Medicine and Bioethics 36: 97-116.
Sass, L. (2013). Jaspers, phenomenology, and the ‘ontological difference’. In One century of Karl Jaspers’ General Psychopathology, ed. G. Stanghellini, and T. Fuchs, 95–106. Oxford: Oxford University Press.
Mohammed Abouelleil Rashed is Wellcome Trust research fellow at the Department of Philosophy at Birkbeck College University of London, Visiting Lecturer in Philosophy at King’s College London, and a practising psychiatrist in the NHS. He is the author of Madness and the Demand for Recognition: A Philosophical Inquiry into Identity and Mental Health Activism (Oxford University Press, 2019).