‘Writing Off’ Psychosis

If there is one thing we are very bad at understanding – in this super-rational culture of ours – it is psychosis. Our attempts to understand psychosis (inasmuch as we ever do make the attempt) are very lame indeed. For the most part we don’t seek to understand it at all, we simply write it off. It’s as if my computer screen suddenly starts showing me a whole bunch of incomprehensible (but nevertheless very interesting) symbols and so I just dismiss it as ‘the computer malfunctioning’ and don’t look at into it any further. That’s how much interest we have in the phenomenon of psychosis itself; as ardent rationalists we very much don’t want to believe in anything that we consider as ‘strange’. We have maximal resistance to anything of that sort…

The lay-person – it’s true – may have a passing interest in the content of psychosis (to a point) but the general rule is that the more professional we are the less interest we’re going to have in the actual content of what the person diagnosed as with psychosis is actually saying. A very professional healthcare specialist will have no interest at all! It’s actually a badge of honour for us to have no curiosity on this score; we’d show ourselves up big time otherwise and consequently lose credibility in front of our colleagues. The only interest we have is in ‘classifying the content’ and what this obsession with labels shows is that we are in fact perfectly uninterested. We have a perfectly closed mind on the subject and this – it appears – is what is required of us to be a professional in the world of mental healthcare, in the world of psychiatry.

If this were not so – if you are the type of person who finds what a psychotic patient says as being fascinating in its own right (rather than being interested only in the labels which we impose on it) then this would be a black mark against you. If you happen to be the sort of person who is constantly trying to look at psychosis or schizophrenia in new ways, rather than being content to operate purely on the basis of accepted wisdom, purely on the basis of ‘the orthodox view of things’, then this would make you something of a loose cannon. That would be rather like a clergyman who suddenly starts offering novel interpretations of the gospels in the pulpit – this is in no way going to endear them to their superiors. The Church has no more interest in radically new interpretations of what Jesus was actually saying than the medical hierarchy has in new ways of trying to understand the schizophrenic-type disorders.

The profession of psychiatry – and the world of mental healthcare in general – is marked by extraordinary conformity to the established way of thinking, not by the restless questioning of the accepted truths. We all know very well that ‘too much questioning’ (or even any questioning at all) can only lead to one thing and that is ‘exclusion from the club’. This is a fail-safe way to ensure that our career goes into a steep nosedive! We may not necessarily like to admit this that this is the way things are, but we all know it just the same – we are not paid to question the sacred dogmas. We’re not paid to think for ourselves.

And yet ‘restlessly questioning whatever what everyone assumes to be true’ is the very hallmark of science. This is what the scientific approach is all about, this is precisely what distinguishes it from all other ‘ways of knowing’. This is what makes science different from ‘blind belief’, which is the default mode that we all fall back into when we lose our curiosity, when we lose our courage to question. The true scientist is a person who never lets anything go, no matter how much societal pressure might be brought to bear on them to do so. Science isn’t about conforming to societal pressure! The philosophy of science is a revolutionary one, in other words – without people having had the courage to question orthodoxy, there would be no science.

Another, related, irony here is to be found in the readily observable fact that most of us who are dealing, in a professional way, with people suffering (or otherwise) from what we call psychosis tend to be drawn from the ranks of the more ‘conventional-minded’ members of society . This isn’t meant as an insult, it just seems to be the way things are. This is – for whatever reason – how it appears to work. Human beings range of course across the full spectrum of ‘very closed-minded’ to ‘very open-minded’ and selective pressures mean that it is generally the more conservative folk who tend to provide successful candidates for the role of ‘mental health professional’, of whatever type. This job falls to those of us who are – for whatever reason – inclined to protect and preserve the status quo rather than those of us who can’t help challenging the rules, who can’t help challenging the conventions. The reason the anti-psychiatrists are as reviled as much as they are in the profession is because they have left the side down and as far is ‘group think’ is concerned there is no greater sin than this. It’s all about loyalty…

The reason this closed-mindedness of ours when dealing with issues of mental health constitutes an irony is because psychosis occurs as a result of us being unusually open-minded, unusually open to ‘novel ways of seeing the world’ – ways of seeing the world that most of ours would dismiss immediately, without even giving the matter a moment’s consideration. When most of us meet someone who is open in this way it is usually the case that we see what they are saying as ‘silly’ or ‘nonsensical’ or ‘daft’, or whatever. This is what we say – or at the least what we privately think – that the person is ‘away with the fairies’, and that no right-thinking person should listen to them. In short, we automatically dismiss what they’re saying just as we automatically dismiss anything else that doesn’t agree with our established worldview. We write it off ‘by reflex’, and this is our standard modality for getting through life. This is our ‘coping strategy’ when it comes to dealing with all the strange, unaccountable things that happen in life.

This is how rationality itself works – the type of rational statements the thinking mind operates on the basis of – can only be as definite in their nature as they are because all competing viewpoints on the matter have been very thoroughly excluded. The mind is a ‘reducing valve’, as Aldous Huxley has famously said. When we suggest that psychosis can be associated with what we might call ‘radical open-mindedness’ this is not by any means a trivial thing to say – if the thinking mind’s operation is based upon the thorough exclusion of competing viewpoints (if rationality works operates by being one -sided, as Jung says it does, then the suggestion that psychosis is a sign of the failure of this ability that the mind has to exclude competing viewpoints (i.e., the failure of the reducing valve to reduce the full sweep of possibilities down to a single ‘official’ one) can hardly be dismissed as whimsical or trivial. Rationality creates an ‘artificial view of the world’ that has to be constantly maintained against all those forces which would fatally compromise it and it is this unacknowledged defensiveness that lies at the root of our zealotry.

The trouble is that when we go down the road of seeing everything in terms of ‘open versus closed’ we are opening a particularly worrying can of worms. We’re opening Pandora’s Box and everyone knows that we’re not supposed to do that! In one way, therefore, it makes sense that we should send our most compartmentalised (or ‘concrete’) people into the front-line of psychiatry. They are the most impervious to ‘non-equilibrium thinking’ and so they can act as our front-line soldiers, protecting the rest of us from any destabilising influence. The original ethos behind psychiatric hospitals was not, after all, to help the unfortunates who were admitted, but to protect the wider community from having to encounter them. Psychiatry is where we send our ‘elite units’ in the war against strangeness. Rationality -as we have said – always has to defend itself against the chaos of irregularity, the chaos of the disordered, the chaos of whatever doesn’t fit into our narrow scheme of things. Our entire modality of existence in the West is based on rationality, which is to say, on ‘explaining unexplained phenomena away’. We might say that this is ‘science’, but it isn’t – science isn’t about explaining things away, as we have already said, but – rather — it’s about not being afraid to have our best theories disproved.

We explain the experience of psychosis away by saying that it is a ‘brain error’ of some sort or other. We can’t fix it but at least we can have the satisfaction of rationalising away what is actually of course both a tremendously irrational and yet at the same time incredibly potent experience. We have responded to this challenge by relegating this entire domain of human experience to a very narrow pigeonhole, the pigeonhole of psychiatry. This is what we do with everything of course – we fragment the whole domain of knowledge into innumerable specialties, none of which are particularly good at communicating with each other. This has been pointed out many times of course but that doesn’t mean anything has changed (or shows any sign of changing). Psychosis has been made the province of one such narrow specialty and the result of this is that it has become a ‘nothing but’ that no one cares about. It has been explained, it has been buried, it has been neatly removed from the public domain so that none of us ever have to think about it. Our societal duty is to shut that stuff down…

But perhaps psychosis is something rather more significant than we like think it is. Perhaps it’s not as safe a subject as we imagine it to be, perhaps we were too quick to draw a curtain over it and consign it to a bunch  of dull text books.  Perhaps we understand nothing about it at all. Can we really explain away the most existentially challenging experience it is possible to have so very easily, or is it just that we’re afraid of what we might find out if we don’t reduce it to a ‘nothing but’? Is it not perhaps the case that what we’re really worried about is discovering that our nice neat rational way of understanding the world is just a glorified evasion, and that – as Shakespeare has said – there are ‘more things in heaven and earth than are dreamt of in our philosophies’?




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