top of page
Search

A Philosophy of Psychosis

Writer's picture: Andrew FieldAndrew Field

"Miracle Shepherd" by August Neter, from Artistry of the Mentally Ill, by Hans Prinzhorn
"Miracle Shepherd" by August Neter, from Artistry of the Mentally Ill, by Hans Prinzhorn

1.

What does it mean to unite the terms "philosophy" and "psychosis"? Well, for starters, it means, or assumes, that there is a connection between psychosis and philosophy, a meaning or assumption that I think is sound and correct. That does not mean that we are smothering psychosis under the blanket of philosophy, nor are we doing the inverse, and losing the lineaments of philosophy, by which I mean in some sense the Western philosophical tradition, through the investigation into psychosis. What I am saying is that, in my understanding, philosophy is largely, in William James's words, "our more or less dumb sense of what life honestly and deeply means." (7, James) Philosophers tend to make explicit this dumb sense, massaging it into various stances; but generally speaking, we all carry around a tacit philosophy, and if we have also experienced psychosis, that is going to impact our Jamesian dumb sense.


Why and how does psychosis impact our philosophy? By psychosis I mean a set of symptoms that indicate a loss of contact with reality. I suppose our definition carries within it certain implications that can suggest some answers. First, if we have lost contact with reality, then when and if we return to reality, (or even before we return to reality, if we are in the grip of hallucinations and delusions), we might sensibly ask "what is reality?" (Whether this is a helpful question, in its abstraction and lack of much context, is another question, but the need to answer it comes honestly.) When we ask "what is reality?" other questions present themselves, like "what is real?" or "what is the world?" or "who am I?" And suddenly our instinctive questioning, and our need for answers, enters a side door and finds itself in some hallway of a college building, where things like ethics, epistemology, ontology, and aesthetics are taught in classrooms. So what I'm saying is that the questions that an experience of psychosis can raise are oftentimes philosophical questions, and therefore they require, in some sense, philosophical answers.


But what would a philosophical answer look like? To what would we be responding or replying? And to whom do we turn for a philosophical response? For of course, if we asked our question about psychosis to Plato, for example, we would receive a different answer (and most likely not a kind answer, for Plato does not seem to have liked mad people) than if we asked it of Martin Heidegger or Ludwig Wittgenstein, the philosophers who in fact I think can provide some interesting answers to our questions.


If psychosis means a loss of contact with reality, I do think we first have to define reality. And Heidegger is good for this reason. Why? In Heidegger's magnum opus, Being and Time, we are given a vision of things that represents how we experience the world phenomenologically. By phenomenology I do not mean the phenomenology of Husserl, which also sought to explore, however, our consciousness of the world more than the world. Husserl wanted to put to one side science, common sense, and metaphysics, in order to focus on our conscious experience, and more specifically the object of consciousness as it presents itself to our conscious experience. This led Husserl to posit that the object of consciousness is value-neutral, though we assign value to it, like an add-on, when we see or reflect on it. This definition of reality, according to Heidegger - the Husserlian version - is deeply misguided, and it represents, furthermore, the kind of problem that is endemic to the Western philosophical tradition as a whole, which is the problem of staring versus looking. In this reality, where objects are value-neutral, we do not move through places, but through a kind of space built on coordinates. A hammer is not something you use to hammer, but a piece of wood and metal. A Husserlian world is a disembodied world. It is a world of theory, not practical activity; staring, not looking; a world that is not the world we live in - an unfamiliar world.


What does it mean, then, to live in a familiar world, and what does this have to do with psychosis? William Blattner writes that Heidegger


argues that our fundamental experience of the world is one of familiarity. This familiarity enables us to be absorbed in our world,, fluidly navigating it to complete tasks, pursue our ambitions, and act in the world. We do not normally experience ourselves as subjects standing over against an object, but rather as at home in a world we already understand. (15, Blattner)


We care about this world that we understand, in part because we understand it. It is our world. We are free in this world, not to do whatever we want, but to listen to the summons of our conscience, and act resolutely in and on this freedom. Good. But what happens when we throw psychosis into the picture, where a human being, or Dasein, to use Heidegger's term, loses contact with reality, and therefore loses contact with the familiarity of the world or, to put it differently, enters a different kind of world?


One way to conceptualize this experience is through Heidegger's notions of significance, worldhood, and un-readiness-to-hand. Throughout Being and Time, we are often given images that suggest an absorption in a practical activity or task, what Heidegger calls "circumspection." When we are absorbed in a task, like hammering or writing, we are not aware of the equipment we are using to perform the task. As I am typing right now, I am not focusing on the hardware or software of the computer at which I type. If the computer broke down, then the machine would no longer be "ready-to-hand" - it would not longer be available - but instead unavailable, or "un-ready-to-hand." In the situation of this breakdown, what had remained inconspicuous - the hardware and software of the computer - suddenly becomes, to use Heidegger's terms, conspicuous, obtrusive, and obstinate. We change our focus; our absorption is broken. Yet this change of focus is not exactly normal, for Heidegger represents our absorption in tasks as a kind of defining feature of our lives.


Psychosis, of course, is a kind of breakdown, where what becomes conspicuous, obtrusive, and obstinate is our mental functioning itself. This analogy isn't totally correct, because I don't think the mind should be thought of as a form of Heideggerian equipment, and oftentimes when we don't have insight into our psychosis - when we totally lose contact with reality, and think that our psychosis is real - then our mental functioning is not conspicuous but the opposite. We become absorbed, not in practical activities, but in the psychosis itself. The world as defined by Heidegger, made by the totality of our involvements and the structure of our significances, then becomes invisible, and the psychotic world takes over.


When the psychotic world takes over - when someone is suffering from lack of insight, or anasognosia - what is happening phenomenologically? The social world recedes. The psychotic person becomes, to borrow Louis Sass's description, a kind of solipsist. Why? When you are psychotic and without insight, you think that your hallucinations and delusions are real. Oftentimes your hallucinations serve to cement your delusions in place, and vice versa, with each serving a corroboratory function for each other. When I was psychotic and thought I was a shaman - I have schizoaffective disorder, bipolar type - I would hallucinate colors that seemed to suggest to me spiritual experiences, which then corroborated my feeling that I was a shaman. And so on. But what happens is that these hallucinations and delusions replace the social world. There is no such thing as healthy intersubjectivity when someone is psychotic, because most times a stubborness attends psychosis without insight, an insistence that what the psychotic is experiencing is something everyone else is experiencing (and if they are not experiencing it, they are crazy). Paranoia is like that, carrying into its net enormous amounts of people to answer its hunger, and framing those people in a particular way. So are religious delusions, which find a mania in connection, like paranoia, but take it in a different direction, towards euphoria rather than fear and suspicion.


In psychosis without insight, therefore, there is really no other. There is then no "being-with," to use Heidegger's terms. It is a terrifying experience, and a profoundly isolating one.



How do you come back from psychosis? What does that look like, feel like? Do people heal, recover?


I think Heidegger's emphasis on dwelling and the everyday is helpful here, but I've written about that elsewhere. But another philosopher who is interesting in the context of recovery is Wittgenstein. Why and how?


Wittgenstein is interested in performing a kind of therapy on how we think. And one of his main emphases is that we have to be careful about falling into various forms of fixations, where we lose the fluidity of thought and concept, and therefore the fluidity of a form of life. He is therefore a great diagnostician of staring versus looking. One of the hardest aspects of returning to sanity is wondering what happened to the mad person inside, the person who had such intense convictions, the person who saw things and chased after them, the person who thought a particular way about things that now is bleeding away. And I think Wittgenstein helps us to answer this question by his emphasis on behavior and sociality rather than a private language. How do I mean?


There is a tragic dimension to psychosis that is hard to shake, and that is not talked about enough. When we have experienced psychosis, we have experienced the trauma of mental illness; and if we have been sick for a long time, then return to sanity, there is the strange sense of grieving lost time, even some time lost years, when one was sick or ill or psychotic. The tragic sense turns both ways, towards the psychosis and the trauma of experiencing or undergoing it, and towards recovery, and the need to assimilate that sense of tragedy within one's own person. Yet sometimes we hang on to certain aspects of our psychosis, because of the certainty of it. For when you are psychotic without insight, you possess a great deal of certainty, even if that certaintly is, of course, not founded on anything real. It felt like a private language, though it was no such thing.


Wittgenstein is excellent on talking about the pitfalls of certainty, and he is excellent in part because he himself had fallen for that seduction in his Tractatus. Here he is, answering his own thought:


  1. Tractatus Logico-Philosophicus (4.5): "The general form of propositions is: This is how things are." -- That is the kind of proposition one repeats to oneself countless times. One thinks that one is tracing nature over and over again, and one is merely tracing round the frame through which we look at it. (53, Wittgenstein)

Similarly, in madness, one repeats to oneself over and over the same form of the proposition: this is how things are. And the mad person believes they have stumbled upon the secrets of nature itself and are unearthing nature's secrets over and over again. But what is actually happening is that they are "merely tracing round the frame through which we look". Someone who is psychotic, without insight, loses the ability to interpret their interpretations, to assess them, to evalute their experiences in any way, shape, or form outside of the certainty of their psychotic frame. When we return to the world - for me, through medication and therapy - then we begin to interpret our interpretations again. We put one foot in front of another, relinquish the hold that our psychotic certainty had on us, and walk into the actual world we live in, the ambivalent and ambiguous and absorbing world. We remember that it is sociality that determines our role in the world, and that our roles in the world in some sense help determine sociality. We then, to use a Rortian formulation, choose solidarity over objectivity.


But recovery takes time. I felt, upon returning to sanity, that my life had been set on fire by a conflagration, and that although I had my mind intact, I had nothing else, nothing to keep me tethered to the world anymore. I struggled deeply with suicidal ideation then. I had been sick for three years. It took me time to relearn how to be in the world, in an everyday sense. It took me time to regain the familiarity that Heidegger might sometimes take for granted. And it took me time to move away from my own Hedieggerian anxiety about the world breaking down, and begin to trust in the familiar world, where the things I cared about lay in wait.


A philosophy of psychosis is important, because our lives are important, our lives are significant, and the world in which we live is, as Heidegger would say, structured out of these various significances. Being itself, Heidegger argues, is care, or concern, about and for our lives. Psychosis is a part of many people's lives. But it doesn't have to be the last chapter, and it deserves to be taken seriously, by which I mean here philosophically.


Blattner, William. Heidegger's Being and Time, Second Edition, 2024.

Heidegger, Martin. Being and Time, translated by Macquarrie and Robinson, 2008.

James, William. Pragmatism and Other Writings, Penguin Classics, 2000.

Wittgenstein, Ludwig. Philosophical Investigations, 2009.



49 views0 comments

Recent Posts

See All

Comentários


Subscribe Form

Thanks for submitting!

  • Instagram
  • Twitter
  • Youtube

©2021 by Jewish Poetics. Proudly created with Wix.com

bottom of page