What is Madness?


This is not to say the pharmacopoeia of modern psychiatry is not of enormous value in the controlling of psychotic symptoms but that the medical community’s increasing reliance on using chemicals tends to obscure a deeper understanding of what is actually causing these conditions and perhaps addressing them.
Parallel with this is an increased emphasis in psychiatry and science in general to look for biological reasons for psychotic behaviour, particularly genetic explanations. Though couched in the language of cutting edge science this is a rather worrying trend, leading in the direction of eugenics and all its baggage. Indeed despite the insistence of the geneticists there is remarkably little evidence for hereditary explanation of psychosis and certainly no specific genes have been isolated
the social contexts for madness

the social contexts for madness

More to the point, what is often ignored nowadays is the enormous amount of evidence for a large environmental component in the condition. This was collected by the pioneers studying these conditions in the late nineteenth and early twentieth century but is now virtually ignored as all the emphasis is on controlling the symptoms rather than understanding the causes. Alas individual case histories do not make good fodder for statistical surveys of patient outcomes and thus do not lend themselves to the mechanics and, more importantly perhaps, funding of modern medicine.

What many people also do not realize is many so called “mad people” often go through life with no one realizing their condition or at most thinking them a little eccentric. For instance Harold Shipman was hardly a paragon of sanity yet many of his patients said they would be happy to be treated by him even after his multiple murders were revealed. Equally we would assume that someone who thought the police were constantly watching them was possibly delusional. But if the police really did start watching such a person would it still be a delusion?  A man might believe himself the new messiah but if he can get enough people to believe him he might be the perfectly happy leader of a cult rather than institutionalized. So the line between sanity and madness is not an easy one to draw.
A wonderful book that examines all the above in more detail and much else besides is  What is Madness? by Darian Leader, a psychoanalyst practising in London. He is a member of the Centre for Freudian Analysis and Research and of the College of Psychoanalysts – UK. He is also the author of Why Do Women Write More Letters Than They Post?Promises Lovers Make When It Gets LateThe New Black: Mourning, Melancholia and Depression and Stealing the Mona Lisa.

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