Portrait of Kant, 1768
I've been thinking lately about overlaps between philosophy and mental illness. But what does this mean? Philosophy tends to involve an activity of thinking, while mental illness tends to lend itself to characterizations involving the absence or abeyance of thought. So why unite the two together?
Typically when we do think of madness, for example, what comes to mind is some Dionysian lunatic, with frenzied energy, shouting nonsensical things in the street. This person looms, is threatening, dangerous; they are not capable of rational, deliberate thought; they are the anti-philosophical, if by philosophical we mean something like an illuminating activity of thinking. But research by scholars like Louis Sass and Josef Parnas have shown that, in reality, mental illness is not a regression towards some primal instinctual state, but actually often takes the form of hyperreflexivity, meaning too much rationality, so that people with schizophrenia-spectrum illnesses, for example, might often feel painfully self-conscious and hypervigilant.
If madness is a form of hyperreflexivity, what does this have to do with philosophy? There is something about madness that lends itself, I think, to speculation, and therefore to philosophy, because madness in the form of psychosis can often involve what the scholar Clara Humpston has called "ontologically impossible experiences." By this she means that when a mad person, in the grips of their madness, believes they are telepathic, say, what is happening to them - what their senses show them - is an experience that is impossible. To experience the impossible is then to be forced to ask questions about reality. And when we begin to wonder about what is real, immediately behind the question comes trundling wholes areas of philosophy, like epistemology, ontology, aesthetics, and ethics.
What is real? Is that even a helpful question? Richard Rorty wanted to replace such metaphysical questions with with thickly textures questions like "What is it like to inhabit a twentieth century democratic country?" But when we have experienced mental illness, I think this question comes up honestly and naturally, and is worth talking about.
If we talk about philosophy and what is real, we are going to get radically different answers depending upon the philosopher and philosophy we are investigating. But if we start with Plato, for example, it seems like the real for him - the truth for him, if not the real - was the supersensuous. What is true, what is real, is the world behind this world, the world of reality behind the appearances. What are the implications for this in the context of mental illness?
There is a kind of bizarre and even dangerous overlap between this aspect of Plato's philosophy and the experience of mental illness. Because we could say, with some hesitation, that psychosis is a kind of Platonic disease, where what is attributed to reality is something that is not there. When you are psychotic, you doubt your senses; better put, you leave your habitual sensemaking, including the world of the sensuous, for something that stands between you and the perceptual world - namely, delusions and hallucinations. The perceptual world is erased, wiped away, substituted by one's delusions and hallucinations, and these become real. One then begins to think, phantasmagorically, that the world itself has something missing in it, that one's psychosis fills in. One then may think that one is a prophet, for example, or a healer or a sage, and a kind of false but intense morality start churning in the sick person's mind.
Mental illness is like a form of philosophy turned on its head, where associational logic - in mania, for example - replaces logic. The madman is a Platonist seeking - experiencing - the "reality behind the appearances," though in reality he is really chasing after the appearances behind the reality. But what is the reality, when the reality experienced can be so transfigured?
It seems like the Real, in true Kantian colors, can never be experienced, that we can only know the limits of our world. Meaning, the world occurs, there is no doubting that, but there is no way to say that our interpretation of the world, the way the world becomes intelligible to us, is the way of interpreting the world. There is no way out of our interpretation of the world. The world has a causal influence on us, but we can only see it through the blinds of our norms. Even in science, where we view the world, in Heidegger's terms, as a present-to-hand, the backdrop for our ability to even do science is our ability to make the world intelligible, which is also intepretive. If this is the case, then that means that we can never wholly know the Real, because interpretation is infinite and fallible.
What are the implications for this for madness? If we cannot know the thing-in-itself, if we are constrained ultimately by the ontology of the social, then madness can only be healed by solidarity and community, including things created by the community, like medication. Madness is a kind of interpretation, but it is an involuntary one. It is also - and this is important to say, without judgment or denigration - an incorrect interpretation, meaning that what the mad person is reporting is not real, even though every ounce of their senses, because of their hallucinations and delusions, say that it is real. This means, or seems to mean, that there are two realities, which seems quite Kantian - the reality of the thing-in-itself, which we cannot know, and shared human reality, which madness obscures. Madness is like a third interpretation, that exists in a no-man's land. For shared human reality requires notions like fragility and luck, though madness tends to ignore these realities for grandiose convictions all out of keeping with what is actually going on, with what is actually possible. People who are mad are often idealists in the most extreme manner. And in a way, their madness claims to know the thing-in-itself. In this sense, to be mad is the opposite of being humble, for to be mad often means claiming to possess some answer, some secret, some insight that solves all the problems of the world. I suppose one aspect of coming back to consensual reality is remembering how fallible we are as human beings, and therefore coming back to a kind of sensible humility.
Healing from madness can often take the form, then, of what Nietzsche spoke of as an inverted Platonism. We come to our senses, and we begin to realize that it is the sensuous that is real, and not anything supersensuous. We begin to shuck off any distinction between reality and the appearances. This then seems to be health - where the true is the sensuous, where art is a configuration of the sensuous, and where what is just is not only some legal term, but related to how we concretely lives our lives everyday.
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