Monday, 22 December 2008

continua

Psychologists sometimes like to state - when in idol-smashing moods - that, despite an alleged bit of conventional 'wisdom', some allegedly discrete psychopathological phenomenon is actually on a continuum with non-psychopathological versions of the same. Thus delusions, for example, might be said to be on a continuum with normal, through eccentric, beliefs.

Now I don't want to take issue with this directly. But this is because the claim seems to me to be almost entirely empty. What it needs is some fairly radical further specification - of just what the continua or discontinua are to be. And beyond that, it needs to be conclusively demonstrated that the continuum dimension is the one which was driving the original formulation of the phenomenon.

So it would, I take it, be fairly hopeless to say something like: "Delusions tend to be beliefs that are just that bit more false, tend to be a bit more unshakeable, tend to be a bit more unshared... than normal beliefs. They can therefore be understood on a continuum with normal beliefs." Because all of that might be entirely true, but touch not at all on the idea lying behind any original discontinuity thesis.

Similarly with the allegedly Jasperian idea that delusions are "un-understandable". Of course there will be all sorts of ways in which delusions are understandable, or nearly, say, as understandable as other eccentric and normal beliefs. But so what? Are we certain that the kind of un-understandability that Jaspers was after was a kind which would accrue in all contexts - be they the rational relations of the belief to other beliefs of the subject; the belief's psychodynamic / motivational character; existential aspects, etc? Jaspers seemed fairly clear, after all, that the kind of ununderstandability he was after was one of our not, as it were, being able to 'make the belief our own' - to feel our way into it from the inside - despite any amount of external or intellectual grasp we may arrive at through the deployment of whatever hermeneutic device at our theoretical disposal.

So I'd like to propose that psychologists be encouraged to just stop offering a combination of blankly empirical or 'external' (as Jaspers would have put it) criteria for some psychopathological phenomenon, and then, after having found that simply by deploying such criteria we get a nice continuum from the pathological to the normal, coming out with the claim that 'after all, the pathological phenomenon is not so pathological as we might have thought'. Maybe that final point is a good claim, maybe it isn't; whether it is or not will depend on whether the continua dimensions really do capture the essential character of the phenomenon as originally intuited by the psychopathologists.

...

A meta-psychological and historical comment: Variations of the above-described theoretical tendency are notable in other psychological contexts too. I remember as an undergraduate being asked to believe that Piaget's developmental stages (pre-operational, concrete and formal operational etc.) could be shown to have occurred somewhat earlier than the great man suggested. The moral seemed to be that careful, scientific, empirically guided research can reveal that more intuitive, theoretical, philosophical approaches can underestimate the capacities of the child (or underestimate our ability to understand what the person who is deluded is saying). But, needless to say, along the way some quite blandly empirical criteria which were not at all Piaget's had been substituted for his own (admittedly more theoretically complex ones), and the 'striking finding' that the great thinker had underestimated the capacities of children was largely an artefact of this criterial substitution. (The story of the developmental psychologists' misreading of Piaget's genetic epistemology is documented in Chapman's book Constructive Evolution: Origins and Development of Piaget's Thought.)

This sets me thinking about the relation between empiricist and (let's call them) ontological approaches in psychology. As the now-cliched adage from Kant has it, "thoughts without [experientially specifiable] content are empty; intuitions [i.e. sensory experiences] without concepts are blind". If I lived in France then no doubt I'd find myself railing against the theory-mongerers for their lack of attention to the empirical grounding or - a better word owed to Joseph Margolis - 'adequation' (i.e. specification as to what counts for or against a claim) of their theories. As it is, I live in England, and I find myself railing against the theoretical impoverishment of the 'intuitions without concepts' I encounter.

Saturday, 20 December 2008

Making up the Mind

And here's an early version of a review (published in 2009 in Philosophical Psychology, 22:3, 393-397) recently written, pulling together some of my bad-tempered Wittgensteinian criticisms, in earlier blog posts, of Chris Frith's latest book...


Imagine this: waking one morning we discover that it is not we who are in direct contact with the bed; not we who are open to our lover’s caress; the movements our bodies make are not really our movements. Such privileges of direct expressive and receptive contact with our world and companions have, we discern, been afforded not to us, but—to our brains! We must rest content, on the side of action, with mere illusions of free will and, on the side of perception, with inspecting mere models which present themselves as reality but which are really just illusions thrown together by the brain.

The consolation prize is that, were we actually in direct contact with the world, the task of making sense of its complexities would just be overwhelming. So thankfully our clever brains perform these tasks “off-stage,” supplying us with outputs in the form of simple “pictures” or “messages” clear or intelligible enough for us poor cognitive beings to grasp. As Frith says in the conclusion of Making Up the Mind: How the Brain Creates Our Mental World — a well-written and accessible book which notwithstanding fully embraces and endorses the above-described theorization of, and some might say nightmarish predicament for, the self, mind and body — all “this complex activity is hidden from us. So there is no need to be embarrassed. Just go back to the party and have fun” (p. 193). Whether this is consolation enough may be questioned. As Malcolm (1986) once wrote regarding Searle’s notion that he was the brain stuck inside his own skull: “Searle says that we can receive messages. But in that predicament, who wants messages?” (p. 186).

Unlike Searle the philosopher, Frith the neuroscientist aims to substantiate his claims not with conceptual argumentation but with empirical evidence drawn from cognitive neuropsychology. In his own words, here are the key theses Frith takes the neuropsychological evidence to support: The “distinction between the mental and the physical is … an illusion created by the brain” (p. 17). “By hiding from us all the unconscious inferences that it makes, our brain creates the illusion[s] that we have direct contact with objects in the physical world [and that] our own mental world is isolated and private” (p. 17). These unconscious “inferences can be wrong,” even in “an ordinary, healthy brain” (p. 60). Furthermore, we have no “direct contact… even with our own bodies”; this is another “illusion” created by the brain (p. 81). Our “perception of the world is a fantasy that coincides with reality” (p. 111) arising when “our brains discover what is out there in the world by constructing models and making predictions” (p. 138).

Our knowledge of the “minds of others” is created by our brains “in the same way” (p. 159). And whilst “we experience ourselves as agents with minds of our own,” this too is an “illusion created by our brains” (p. 184). Frith acknowledges that our experience of freedom, individuality and responsibility is a cornerstone of societal stability and morality, but this is simply the “final illusion created by our brains” (p. 193).

Such claims are prima facie extraordinary, and if the neuropsychological data Frith presents could substantiate just one of them, his book might cause a major revision in human self-understanding. Yet what struck this reviewer again and again was the way in which the content of the hypotheses these data supposedly evidenced, and the theoretical unity of the text, derived principally from unargued and tacit metapsychological commitments which radically constrained the way the data were interpreted.

Concerning perception, Frith cites three sorts of evidence for his claim that “even if all our senses are intact and our brain is functioning normally, [the feeling that] we have direct access [to the physical world] is an illusion created by our brain” (p. 40). First, in chapter 2, he provides evidence from various malfunctions of, and curiosities regarding, visual experience – change blindness, subliminal perception, visual illusions, synesthesia, dreams, visual hallucinations, etc. Second, in chapter 4, he cites the fact that there is no direct mapping to be had of sensory (e.g. retinal) stimulation onto the contents of consciousness. Third, in chapter 5, he notes that we are normally unaware of the vast amount of complex neurophysiological processing (the activation of motor programs, say) that subtends everyday experience, and infers that “my perception [cannot be] of the world, but of my brain’s model of the world” (p. 132).

Whilst the data are fascinating, they are also incapable of motivating Frith’s theoretical claims, which instead appear to be consistently driven by a ‘homuncular’ conception of the self constantly invoked in the data’s interpretation. By ‘homuncular’ I mean a conception of the subject’s relation to its brain which harnesses a) a mentalistic conception of the immediate contents of perceptual consciousness as ‘inner images’ or ‘internal representations’ occurring ‘in our minds’ to b) a causalist construal of such immediate contents as the final products, delivered to the mind, by a CNS which has worked over information originally received by the sense organs (Kenny, 1984). (Conceptions of consciousness as an inner stage (or ‘Cartesian theatre’; Dennett, 1991) populated by inner visibilia may not explicitly posit an actual homunculus as an audience. The philosophical concern is however not ontological but methodological (Kenny, 1984): that theories deploying the conception do not neglect to demonstrate how, rather than simply assert that, they do not reduplicate the very phenomenon (perceptual consciousness) they aim to explain.)

The following are representative examples taken from Making up the Mind. Sense organs are said to work ‘just like a video recorder [transmitting] information about the physical world … to our minds’ (p. 21). The brain is described as “showing us false information” (p. 49); as not “telling us everything it knows” (p. 42); as “not simply transmit[ting] knowledge to us like a passive TV set … [but as] actively creating pictures of the world…from the very limited and imperfect signals provided by the senses.” (p. 85). My “brain manages to create for me the experience of a constant, unchanging world through which I move” (p. 110). It also “constructs models” (p. 138) of both the physical and the “mental worlds” of others (p. 159).

Accordingly, when dreams or illusions are offered (in ch. 2) as evidence that we have no direct visual access to the world, the conception which constrains the interpretation of the data already presupposes that, if we are not witnessing the world accurately, then we must (with some kind of further and as-yet-unexplained perceptual system) be accurately witnessing inaccurate mental images of the world. Or when (in ch. 4) the facts that retinal images are inverted or two-dimensional or duplicated are cited – or when movements of these images are as it were ambiguous between movements of the perceived objects and movements of the eye or head – it is simply presupposed that, since perception is construed as input to consciousness, the work of the visual system must be understood as one of ‘undoing’ the infelicities introduced at the sensory surfaces. Or when it is pointed out (in ch. 5) that the vast complexities of the CNS’s information processing are completely unknown to us, the inference is straightway drawn that therefore what we are aware of must be neither the world around us, nor our neurological processes, but their supposed illusory upshots.

Perhaps I should confess that I am convinced that what Kenny calls the “homunculus fallacy” is indeed a fallacy, and that Dennett is right to deconstruct the “Cartesian theatre”. Whilst in confessional mode I might also relate that Frith’s description of the mere brain as engaged in personal-level activities (knowing, believing, interpreting, deploying Bayesian inferences, etc.) strikes me as implicating him in another (‘mereological’) fallacy – that of ascribing to a part what can only coherently be ascribed to the whole (Bennett & Hacker, 2003).1 Yet my intent is not to foist my Wittgensteinian sensibilities onto the reader, but merely to relate that Frith’s striking theses regarding the allegedly illusory nature of our experience of the world are quite simply not a function of the data he presents, but rather of the homuncular framework used to interpret them – whatever we make of that framework. Perhaps it is a set of harmless metaphors – and if so this may also be the best way to take Frith’s theories.

Similar presentations of interesting data recruited by tacitly homuncular theorizations of the self arise throughout the book, whether we are considering perception (ch. 1, 2, 5), interpersonal understanding (ch. 6, 7), planning (ch. 4), or action (ch. 3, 6). For example, chapter 6 relates that an alleged everyday “experience of agency”— of being in control of our actions, making decisions to act, and acting on these decisions — is actually an illusion created by the brain. In truth, we are told, the brain distinguishes between intentional and non-intentional movement by measuring sensorimotor timing differences. These differential responses to the timings of causes and effects in perception and action are, it is said, translated for us into experiences of agency, providing an illusion of free will.

The experimental data (pp. 151-155) are again fascinating. But it is instructive that Frith appears to take his phenomenology of intentional action from cases such as (that which he quotes:) Ian McEwan’s marvelous description, in his novel Atonement, of Briony’s contemplation of her relation to her moving body:

She raised one hand and flexed its fingers and wondered… how this thing, this machine for gripping, this fleshy spider on the end of her arm, came to be hers, entirely at her command. Or did it have some little life of its own? She bent her finger and straightened it. The mystery was in the instance before it moved, the dividing moment between not moving and moving, when her intention took effect. It was like a wave breaking. If she could only find herself at the crest, she thought, she might find the secret of herself, that part of her that was really in charge.

What Frith seems to miss is that such descriptions are precisely not of everyday intentional action — but rather of an extremely alienated state of mind. Briony has dissociated from her lived bodily experience, becoming a disembodied homuncular spectator consciousness experiencing the body as merely a distant mechanism or “fleshy spider.” Our actual everyday experience of agency is rather characterized by the immanence of intention in action. Accordingly, the striking conclusion Frith draws – that the timing experiments reveal a genuine aspect of our self-conception to be illusory – is misplaced, for the conception of agency on offer here is drawn not from everyday experience but from an alienated theorization of it presupposed by his interpretation of the data.

The very idea that we have control over our actions is taken by Frith, in a curious Epilogue, to entail that there is supposed to be an inner homunculus enjoying a direct causal impact on a merely mechanical outer body:

For me it seems as if I am fully in control of my actions. This is why it is so hard to get rid of the idea of a homunculus. It is the dominant part of my experience that I am in control. … This is the brain’s final illusion: to hide all those ties to the physical and social world and create an [illusion of an] autonomous self. (pp. 188-9)

But what I suggest is the real reason for Frith’s struggle to rid himself of the homunculus is the unacknowledged homuncular conception of the relation between subject and body constantly inscribed within his theories.

Early in the book Frith tells us that he is “not a philosopher”, that he does “not expect to persuade people of truth by the power of argument”, and that the “only arguments [he] accepts] come from practical experiments” (p. 15). What Making up the Mind reveals, however, is one of the principal risks of eschewing philosophical reflection: that one’s theories will then be even more driven, and potentially vitiated, by tacit philosophical commitments which no amount of experimental data can evidence, challenge or extirpate.

References

  • Bennett, M. R. & Hacker, P. M. S. (2003). Philosophical foundations of neuroscience. Oxford: Blackwell.
  • Dennett, D. (1991). Consciousness explained. London: Penguin.
  • Kenny, A. (1984). The legacy of Wittgenstein. Oxford: Blackwell.
  • Malcolm, N. (1986). Nothing is hidden: Wittgenstein’s criticism of his early thought. Oxford: Basil Blackwell.

1 Both Kenny (1984) and Bennett & Hacker (2003) run together two conceptually distinct alleged ‘fallacies’: the ‘homunculus fallacy’ of tacitly reduplicating our relation to perceptibilia on a mental stage, and the ‘mereological fallacy’ of ascribing psychological properties to the brain.

what are delusions?

Having been too busy to publish blog posts, I thought I'd cheat and post some draft versions of what I've been working on recently. In this post an encyclopedia entry on 'delusion'.

Delusion

1. Introduction


Delusions are often described in textbooks as being defined, since Karl Jaspers, as false, subculturally atypical beliefs, strongly maintained in the face of counterargument. Yet such definitions fail to capture either the rich diversity or key features of delusion, and would -were it not for their prevalence - be in danger of meeting their own desiderata.

Common delusions include persecution (there is a plot or conspiracy against the subject; these are the most common delusional beliefs); grandiosity (the subject is an important personage); erotomania (the subject delusionally believes someone is deeply in love with them); and control (the belief that one’s actions, thoughts or feelings are being controlled by others). The majority of delusions concern the subject’s position in the social world, or reflect central existential issues in their lives, and they are indeed often false, atypical and strongly maintained.

It is however possible that a delusion (such as that of one’s partner being unfaithful) be accidentally true. Levels of conviction in delusions may also vary with time. Some delusions may be paradoxically true rather than false (e.g. the delusion that one is mental ill), and others may be not beliefs but rather delusional value judgements, thoughts, perceptions, memories, inner experiences and moods (Sims, 2003). The ‘delusionality’ of delusions of control, for example, arises directly from a disturbed experience of one’s own agency, rather than with beliefs about such experiences.

As Jaspers himself reported, to ‘say simply that a delusion is a mistaken idea which is firmly held by the patient and which cannot be corrected gives only a superficial and incorrect answer’ (Jaspers, 1913/1997, p. 93). Delusions rather reflect a fundamental disturbance in our relation to reality and the integrity of the self which is hard to pinpoint in a definition. Jaspers distinguished between primary delusions – which arise in an ultimately 'un-understandable' way in our contact with reality itself – and secondary delusions, which are intelligible attempts to understand baffling experiences. Whilst Jaspers’ doctrine of the un-understandability of primary delusions has often been criticised, it is important to recognise that his point is not to preclude a reflective understanding of what the deluded person says, what psychodynamics underpin it, what symbolism it expresses, etc. It is rather that we always fall short of inhabiting such beliefs or experiences from a first-person perspective.

2. Psychoanalytic Perspectives

Sigmund Freud described delusions as ‘applied like a patch over the place where originally a rent had appeared in the ego’s relation to the external world’ (Freud, 1924/1981, p. 215). He distinguished between neurotic and psychotic conditions as follows. In the neuroses the subject attempts to adapt to an incompatible reality by defending against their own feelings. The symptoms which result are the product of the internal conflicts within the patient when they try to remodel their desire. In the psychoses, by contrast, the subject attempts to solve their conflicts with reality not by altering their feelings, but by withdrawing from or ‘disavowing’ reality and replacing it instead with fantasies which are treated as realities.

In the 1960s the psychiatrist Thomas Freeman extended the psychoanalytic understanding of delusion (Freeman, Cameron & McGhie, 1966). Whilst some delusions can be understood as fantasised replacements for lost relationships, others consist of misinterpretations of experiences with others from whom the subject has not become completely detached. Accordingly the delusional subject attempt to bend or exaggerate reality to make it more tolerable and less threatening of the subject’s sense of himself or herself, rather than completely substitute for it, and the delusions are the outcome of such defensive manoeuvres.

More recent psychoanalytical thinking on psychosis has been organised, not around the concept of delusion, but rather by attempts to understand the nature of omnipotent fantasy, including the mental mechanisms of splitting, projection and projective identification, minus K, attacks on linking, and symbolic condensation. All of these processes may be implicated in the formation of delusion, but none are specific to it.

3. Phenomenological Perspectives

Phenomenology aims to elucidate the lived, non-reflective and immersed experience of being a self in relation to a meaningful environment including other selves. Accordingly, the phenomenological understanding of delusion – in particular of schizophrenic delusion – views what is specific to it as already contained in germ in a specific pre-delusional disturbance of immersed participation. More specifically, most phenomenological psychiatrists track this disturbance back to fragile temporal and corporeal processes which underpin the constitution of the self. Phenomenologists view the delimitation of self from other as arising out of an organism’s non-reflective interactions with its social and physical environment. Disturbances of that process result in disturbances in the boundary between self and world, and delusional beliefs and experiences carry this fundamental disturbance in reality contact inscribed within them.

Most phenomenological accounts take their lead from the first two stages of Klaus Conrad’s (1958) developmental account of delusion in paranoid schizophrenia. In the initial pre-delusional ‘trema’ stage, the subject starts to vaguely feel that all is not well with himself and/or the world. He may complain of an unspecific groundlessness, confusion about or lack of a sense of his own identity, diminished sense of aliveness, and lost automatic connection with reality. The body may become experienced as an object rather than as a living subject, self and other may start to become confused, the objective character of reality may be lost, and the delusional experience of reference – a sense that everything seen has been constructed for the sake of the subject – may begin (Parnas & Sass, 2001).

In Conrad’s second stage – ‘apophany’ – delusions proper arrive. Now the trema is intuitively resolved into one particular revelatory meaning, and the subject takes themselves to now ‘understand’ what had previously only been confusingly signalled. Relief is experienced from the diffuse tension and terror of the trema, and a monothematic reflective grasp of what is happening (e.g. there is a government plot against me) takes the place of the pre-reflective but destabilised grasp (‘something is up’) the subject had on their situation.

4. Cognitive Science Perspectives

Unlike psychoanalytical and phenomenological theories, cognitive psychological theories are driven by a psychological understanding of the human being as constantly and actively attempting to interpret, or make reflective sense of, their personal situation. Thus Brendan Maher (1974) suggested that delusional beliefs represent rational attempts to make sense of abnormal experiences (e.g. hallucinations or passivity experiences). Phillipa Garety by contrast has suggested that abnormal processes of reflective sense-making may be implicated in delusion formation (Garety & Freeman, 1999). She found, for example, that patients with delusions tend to jump to conclusions on the basis of surprisingly little evidence.

Several difficulties confront such cognitive psychological accounts. First, delusions – especially primary delusions – do not present themselves as active interpretative products, but rather as spontaneous and passive revelations in thought, feeling, or perception. Even the delusional ‘explanations’ that patients offer appear to be more post-hoc rationalisation than genuine justification. Second, Garety also found that the hasty reasoning style of delusional patients makes them equally likely to quickly give up their beliefs, which makes it hard to understand the typical intransigence of the delusional subject. It is also important to recognise that the explanatory task, in understanding delusional intransigence, is not merely how unshakeable beliefs arise, but how unshakeable beliefs with the face-value implausibility of delusions could arise. Finally, Maher’s theory does not explain why the patient fails to accept the obvious explanation that they are hallucinating or experiencing passivity experiences.

Cognitive neuropsychological – as opposed to cognitive psychological – perspectives, are typically not governed by an understanding of the individual as an active reflective sense-maker, and so are not restricted to theorising delusion in such terms. Hemsley (2005) provides a good example with his speculative model of schizophrenia as due to a deficiency in the influence of background context on current task performance. The model ties together the neurological (e.g. frontotemporal functional disconnections), the information processing (e.g. sensory and motor program disturbances), and the psychological (a range of symptoms including delusional beliefs and experiences) levels of explanation.

Primary delusions are accordingly theorised by Hemsley as due to a mismatch between tacit and automatically deployed frames of reference and the sensory inputs to which they are applied. Delusional experience in the trema is also understood as due to a breakdown in gestalt or context perception. Decontextualised stimuli, including those normally screened out as irrelevant, may appear equally salient – and secondary delusional beliefs may reflect a search for the meaning of stimuli which would not normally have come to conscious attention. Hemsley speculates, for example, that delusional thinking about causal relationships may result from a failure of context to constrain judgements about the relevance of the co-occurrence of stimuli.

5. Conclusion

Future work on delusion will need to weave together the above approaches. From epistemology we require adequate understandings of what it is that grounds our relation to reality (e.g. reflective thought, or bodily praxis), and what it is to lose that relation. From psychoanalysis we require an updating of the theory of delusion in the light of post-Kleinian understandings of the nature of unconscious fantasy. From phenomenology we require a precise understanding of how delusional distortions to reality contact manifest in the various (linguistic, corporeal, behavioural, intersubjective, and reflective) dimensions of human existence. And from cognitive neuropsychology we require theories aptly constrained by the above psychological domains, but informed by the latest neuro-imaging research.

Key Words

psychosis, paranoia, phenomenology, psychoanalysis, cognitive science

References

Conrad, K. (1958). Die beginnende Schizophrenie. Versuch einer Gestaltanalyse des Wahns. Stuttgart: Thieme.

Freeman, T., Cameron, J. L., & McGhie, A. (1966). Studies on psychosis: Descriptive, psychoanalytic, and psychological aspects. New York: International Universities Press.

Freud, S. (1981). On psychopathology. Harmondsworth: Penguin Books.

Garety, P. & Freeman, D. (1999). Cogitive approaches to delusions: A critical review of theories and evidence. British Journal of Clinical Psychology, 38, 2, 113-154.

Hemsley, D. R. (2005). The development of a cognitive model of schizophrenia: placing it in context. Neuroscience and Biobehavioral Reviews, 29, 977-988.

Jaspers, K., (1913) Allgemeine Psychopathologie. Berlin, Springer-Verlag. (trans. J. Hoenig, and M.W. Hamilton (1963) General Psychopathology. Chicago: University of Chicago Press. New edition (two volumes, paperback), with a Foreword by Paul R McHugh, (1997) Baltimore: The Johns Hopkins University Press.

Maher. B. (1974). Delusional thinking and perceptual disorder. Journal of Individual Psychology, 30, 98-113.

Parnas, J. & Sass, L. (2001). Self, solipsism, and schizophrenic delusions. Philosophy, Psychiatry, & Psychology, 8, 2/3, 101-120.

Sims, A. (2003). Symptoms in the Mind. 3rd edition. London: Elsevier.

Reading Suggestions:

Berrios, G. (1996). Delusions. In G. Berrios, The history of mental symptoms: Descriptive psychopathology since the 19th century (ch. 6). Cambridge: Cambridge University Press.

Munro, A. (2008). Delusional disorder: Paranoia and related illnesses. Cambridge: Cambridge University Press.

Freeman, D., Bentall, R., & Garety, P. (2008). Persecutory delusions: Assessment, theory and treatment. Oxford: Oxford University Press.

Sunday, 30 November 2008

sense and nonsense in psychology

Well, I don't have an example to hand. But haven't you ever noticed how frequently psychologists tell themselves things like "In psychology what we are interested in is the meaning of the phenomena. It's all very well (being a biologically minded psychiatrist and) developing a causal understanding of the thought or behaviour in question, but we mustn't treat the subject as merely a broken mechanism, etc etc"
And that's fine, I guess - for a certain range of psychological phenomena. But why on earth curtail one's psychological remit so grossly in advance of examining what it is that (competent) psychologists might actually do, within their job description, in practice? For several different modes of negotiating with meaning and with the apparently senseless come to my mind right now, and only one or two of them appear to be adequately constrained by the above-caricatured simplistic self-understanding.
  1. So, yes sure, it does sometimes - often? - happen that myself and the client are engaged in a process of making sense of the apparently senseless. The client may come along not really knowing why they are doing what they are doing. Why they can't get over the loss of their dad (we explore the ambiguities in their relationship with their dad and it soon becomes clear), why do they keep feeling this compulsion to clean (well, they haven't been adequately trained in anxiety-tolerance as a child, and so get caught up in short-term attempts to manage distressing obsessions by compulsively neutralising them; or they are symbolically attempting to wash away feelings of emotional 'contamination'), why do they keep getting agitated and unable to study (becase they are rebelling against a harsh parental introject whose only way of self-parenting is through the use of the stick rather than the carrot).

  2. But what about those times when what is driving the psychopathology is the very idea that there must be a meaning, a reason, a purpose - when perhaps there just isn't one? (And why in any and every case should there be one? What kind of a metaphysical prejudice is that?) I'm thinking principally here of cases of severe depression. The depressed person keeps trying to find a reason for why they did what they did, why something happened to them, and so on - but they are trying to answer an impossible question (there was no reason). Far more helpful, here, it seems to me, to help the patient 'externalise' their depressogenic thinking, and to see it as a kind of centripetal vortex that constantly grips their mind, spinning a web of attempted reason around a pseudo-cognition. (When subjects recover from psychotic depression, do they tell us that they have now made sense of why they felt just so guilty, or why they had the delusion that ...?)

  3. And what about those other times where sense must be developed rather than recognised? Or when an existing sense has developed which constrains too tightly the pre-reflective meanings organised within it? I'm thinking here about child development and about psychosis. So: children gradually learn to articulate their desires according to the narratives available to them in their home environment. This is often not a matter of correctly labelling or recognising nicely pre-individuated desires, but rather of the in-form-ing of desire itself. What was at first a fairly inchoate feeling, a very loose set of dispositions, now becomes tightened up, structured: the desire gains shape. But sometimes if the environment has not been apt for individuation, then narratives of the self may have developed which crack and strain at the scenes, and cannot be maintained through any amount of narrative work without an enormous (perhaps intolerable - hence psychosis?) amount of psychological effort. Here - just as with the development of symbolic capacities in, say, play therapy - desires are born afresh, out of the ashes of the old psychological structures. This is not a matter of making sense of something, but making sense out of something.

  4. And what about all of our behavioural interventions, our mindfulness interventions, and the rest of it? Behavioural activation is hardly a matter of sense-finding, but is surely none the less psychological for all that. Hypnotic interventions are not sense-finding either, but are still (surely?) psychological. Mindfulness interventions are about becoming aware of thoughts and feelings per se, as they are - and not about 'making sense of them'. Doubtless the list could go on and on.
So next time you see a psychologist describing what they do as 'making sense of the apparently senseless', you can ask why they restrict themselves to such a limited portion of psychological activity. And why, too, they restrict themselves to such a limited (merely recognitional) theorisation of the relation between sense and its articulation.

Tuesday, 4 November 2008

temporality and happiness, mindfulness and metaphysics

Last night I went to a talk in Oxford by John Cottingham - which was on - amongst other things - nachträglichkeit, and in particular on the temporality of human happiness. One of his basic claims - surely plausible - was, if I understood him right, that our happiness (unlike, say, a sensation of pleasure) is not to be understood merely episodically. Rather, it is bound up with the meanings of our lives, and these meanings extend from any moment far into the past and the future. We are continually reinterpreting, or discovering more about, or becoming, ourselves. Thus, for example, how we die may itself have a profound impact on the quantity or quality of happiness which can be said to accrue to our life as a whole. 'Call no man happy until he is dead' is one Greek aphorism (attributed by Heroditus to Solon) cited by Cottingham, which seems to give - if albeit in an extreme form - us a clue about the essence of what we could call 'happiness holism'.

The Freudian topic of nachträglichkeit was particularly and personally apt because the discussion caused me to rework and unfold some of my own reflections, earlier that day, on the kinds of spurious (usually idealist) metaphysics that get implicated in the interpretation of simple Buddhist or CBT Mindfulness Techniques. Here's what I have in mind:

We are invited to cultivate an ability to move from a 'doing' to a 'being' mode. To just notice the sensations, for example, that come up in our body, as they arise. To notice when our mind wanders - off into the past, or the future, or some present concern, and gently bring it back to the meditative object (e.g. the body, or the breath, or a candle, or what have you). We may notice as we do this that a sense of happiness wells up from within - contentment, bliss - not about anything in particular, but just through settling into ourselves and gently relinquishing the urge to fantasise, fret or ruminate.But what sometimes frustrates me is the way in which the 'being' mode gets presented as a kind of engagement in a temporal pointilism. As if just 'being here now' meant a relinquishment of temporality. As if I could really be said to be existing as a human being, living a meaningful, rewarding, happy, life, if I were to pursue an existence self-contained at every moment. As if my being - my dasein - were not itself constitutively temporal.

Why is it that a straightforward psychological or spiritual technique so readily gets caught up with a particular metaphysics - in this case a metaphysics which seems to want to deny the kind of temporal happiness holism described by Cottingham as constitutive of the human condition? Well, I think the answer is clear when we think about it. It is because we have not adequately distinguished between the neurotic temporalisation of the mind which flees from being into the imagined future (or past), and the constitutive temporality of human existence - dasein - which knits us essentially into our personal-historical contexts. A perfectly decent psycho-spiritual claim gets dressed up in metaphysical garb, perhaps to make it appear more philosohpically respectable - but the result is just implausibility.

To conclude, let me just make the distinction as clear as I can. Sure - when I'm depressed I may just be thinking about the past, or when I'm obsessional I may just be ruminating over what I said or did earlier, or when I'm neurotically anxious I may just be desperately trying to figure out what might happen next. Perhaps in part I am trying to flee from a present which I fear will be overwhelming. In all such cases I am showing an unwillingness to simply experience what is 'in my mind' - to accept my experience for what it is. It is this neurotic temporalisation which therapies or practices relying on mindfulness attempts to dispel - and to return the subject to stimulus-governed (rather than rule-governed) contingencies, as the behaviourist might put it.

But it is not only - not even primarily - through such neurotic temporalisation that my life gains temporal structure. Rather, the meanings which are necessarily distributed throughout the historical texture of my being arise not just in anxious reflective thought, but in my reposed moral reflection, in my gradually unfolding self-understanding, and primarily in the mainly non-reflective practices which occupy me each day. Lived temporality looks after itself, we might say, putting the claim in a rather extreme way, with no need of such a helping hand from thought. My life has its temporal contours, and the meanings of it stretch right out through the unfolding activities and practices of my existence. Neurotic temporalisation would in fact be most likely to stifle, rather than promote, any such temporal unfolding, keeping being locked into static (situation/contingency non-governed) and predictable patterns of action and reaction.

Being, then, is not aptly opposed to Doing, when making a contrast between a mind which is anxiously projecting itself into possibilities, and a mind which is reposed in the present yet constructed by its temporal ties to past and future. Being is doing, Doing is being. Some forms of being, because of their infatuation with projection-ahead-of-itself modes of fantasy, are profoundly limited. The question is not: Can I reside in the present moment? (Now that often really would be banal!) The question is: Can I reside in my Being, as it unfolds, through time, with all of its rich temporalities and episodic uncapturability? Can I be on-the-way-to with no hurried pace faster than my existence can carry me?

Saturday, 1 November 2008

words were originally magic

Solution-focused therapist Steve de Shazer tells us that 'words were originally magic'. He himself is quoting Freud who, in both the Question of Lay Analysis, and in his Introductory Lectures, discusses in passing the idea that

Nothing takes place in a psycho-analytic treatment but an interchange of words between the patient and the analyst. The patient talks, tells of his past experiences and present impressions, complains, confesses to his wishes and his emotional impulses. The doctor listens, tries to direct the patient’s processes of thought, exhorts, forces his attention in certain directions, gives him explanations and observes the reactions of understanding or rejection which he in this way provokes in him. The uninstructed relatives of our patients, who are only impressed by visible and tangible things ... never fail to express their doubts whether ‘anything can be done about the illness by mere talking’. That, of course, is both a short-sighted and an inconsistent line of thought. These are the same people who are so certain that patients are ‘simply imagining’ their symptoms. Words were originally magic and to this day words have retained much of their ancient magical power. By words one person can make another blissfully happy or drive him to despair, by words the teacher conveys his knowledge to his pupils, by words the orator carries his audience with him and determines their judgements and decisions. Words provoke affects and are in general the means of mutual influence among men. Thus we shall not depreciate the use of words in psychotherapy and we shall be pleased if we can listen to the words that pass between the analyst and his patient.

But what does this mean: 'words were originally magic, and to this day have retained much of their magical power'? Is it really to be understood simply in terms of the idea that words 'provoke affects and are in general the means of mutual influence among men'? Or was Freud here trying to unpack an intution or insight using a theoretical framework which could not possibly contain it?

That, at any rate, is my conjecture, and in this post I want to explore what it might mean to still want (as I do) to describe words as somehow 'magical' if we eschew any idea that they have (or have been believed to have) any astonishing causal powers. Along the way I shall touch on Freud, Frazer, Adorno and Wittgenstein. The aim is to develop (clear the conceptual space for) an idea, rather than to achieve ultimate demonstration of the validity of the case being offered.

So, to reiterate: The sense of 'magical' that I am after here is not one which accrues only to extraordinary uses of words (in spells, say). The traditional notion of the spell (although even here we must be careful in our anthropology, as Wittgensteinian readers of Pagan faiths remind us) would appear to be one of 'action at a distance'. And this causal notion is precisely not what I am going to be articulating. Words are to be understood as magical, it might be said, in their suchness, and not in their causally functioning as talismans.

The topic most naturally invites a Heideggarian analysis, but it has also received consideration by the Frankfurt School scholars Horkheimer & Adorno in their Dialectic of Enlightenment, and a Wittgensteinian treatment from the intriguing philosopher Viktor J. Krebs in his papers Mind, Soul, Language in Wittgenstein - and The Subtle Body of Language and the Lost Sense of Philosophy.

Here is my first stab at an outline.

Words have both expressive and descriptive functions. Yet we are constantly tempted to construe the expressive as the descriptive (for example, treating our avowals of our feelings as if they were descriptions of what a putative faculty of introspection finds within).

Furthermore, we all too readily fall pray to a phantasy of having, or of attempting to achieve, a purely descriptive discourse. (Adorno and Horkheimer are particularly good - albeit in their stylistically atrocious manner - at expounding the ways in which unconscious (fascist) desires get smuggled into a discourse which presents itself as merely reportative, and which thereby covers over the appalling values it embeds and expresses.) But our grasp of language 'bottoms out' not in a mythically self-interpreting, nor alternatively in a hopelessly infinite regress of, rule and representation - but in the diverse range of our instincts embedded in the diverse range of our language games.

Language, we might say, is always 'driven by and embeds desire', and if we attempt to cover this over, we all-too-readily just disguise from ourselves our own (ethical, political) desires or values, imposing them uncritically onto the structure of the social world.

Finally, what drives our blindness to the magical (in the 'good' sense) quality of words, and what drives the view that our sense of the magical must be explicated in terms of the talismanic, is our alienation from our own life-with-language and the allegedly obligatory pseudo-explanatory agendas which that alienation births. (It is also true that the appearance of any genuine content to the (my) philosophical notion that words are magical (in the 'suchness' sense) is itself an illusion - a kind of residual shock surprise and an associative residual post-enlightenment carry-over-disposition-to-say-that that things can be just as they are - surprise that (vacuously) they 'just are' as they are - a residual shock amazement that we are not in fact called on to entertain the explanatory agendas which the alienated stance seemed to promote as an intellectual necessity for any responsible philosopher.

Cioffi on Freud  and FrazerHere is Frazer and Freud's idea of what magic is: When the 'primitive' person, dominated by a mythic consciousness, acts mimetically in behaviour or speech, they are allegedly trying to effect a causal impact on the world merely using their mind. But here's Adorno or Wittgenstein's riposte: rituals are not (always) best thought of as superstitious attempts at instrumental control of the world through the power of thought. Krebs' example of a modern parallel is kissing our lover's photograph: we don't typically do so on the basis of a belief in the causal power of our action. The kiss is, rather, expressive of my desire, it is part of its 'body'.

Wittgenstein notes that ritual practices cannot be understood in [Frazer's] way, for their purpose is none other than the spontaneous expression of an inner need that is as important as it is different from intellectual articulation. [Krebs, MSLW, p. 1]
What is 'magical' can, I believe, best be brought out by an investigation of common, unhelpful, alienated, Augustinian, phantasies of language learning and language production. Such phantasies invite us to take it that when we articulate our responses to what we see or hear, or when we articulate our feelings ("Here's my brother coming back home!"; "I feel exhausted!"; "That is a lovely, yet haunting, tune you are playing!") then what we do is, say, pick the best description of what is encountered in experience. Visual avowal, then, becomes thought of as predicated on matching or representing. I represent something in the world, or represent something in my mind, in my language. Perhaps the matching procedure, which is thought to ground my sense of what is apt to say on some or other occasion, is said to be a function of my grasp of some rule. I apply the rule, and so see whether or not the description is or is not apt in some situation.

The fallacy is obvious: The person who is performing this putative 'matching' or 'representing' must know how to wield these representations or rules. But what does my grasp that this X word is an apt representation for that X object or that X thought consist in? And what grounds it? Are we to allow that it is intuitive, and also that it is groundless? If not, then must we posit a further rule which guides the interpretation of the first? Yet if so, then why cannot the same be said of our bald articulation of our affects, thoughts, and perceptual experience? So: What if I am simply voicing my desires - if my verbal articulations of them are no more representations of desires than my pre-verbal expressive behaviour (grunts, groans, sighs) - themselves? The sound the bow makes when drawn over the string does not report on the tone which it voices, nor report on the state of the violin.

Here we are, talking together. I 'speak', you 'understand'. You take up the phrase where I left off. We laugh together, share a moment. An image drifts through the conversation, structuring it for a while, only to be replaced by another. Then there is a short hiatus when something happens which we call 'misunderstanding'. At least one of us cannot feel our way into the language of the other. At such times perhaps we retreat to common, agreed, shared, uncontroversial terms - perhaps we try to work our way reflectively out from these - via what we call 'definitions' or 'rules for the use of words'. Yet this reflective, descriptive, form of discourse, in which some distance opens up between our intentions and our inflections, is hardly to be taken up as the prototype. It is recognisable as an aberration, as what it is against the backdrop of the norm in which there is no such separation between thought and speech.

"Are you just saying that words are magic, then, because of the immanence of thought within discourse?" Well, that is a very thin way of putting it. It captures litle of the magic. The magic is in the fact that not only are my words immanent within my discourse, but that I am immanent in it too - and so too are the worldly situations ("That's one big mansion house", "You remember yesterday when George fell over getting out of his car? Well he could hardly...") my words articulate. Magic here is not: using thought to affect reality. The magic is rather: here where there is no room for thought to insert itself between reality and my expressive comportment. It is the immediacy, the shared spontaneity of the conversation: that is what is magical.

Sometimes at the start of a clinical session I may ask the client "Well, I'm wondering how you're feeling; what's been on your mind; what the week's held for you". And then what I often get is a report, of little therapeutic value or use in itself. But soon the real conversation gets going, and now my client is not reporting their thoughts, but rather unfolding them. Felt senses give birth to meanings, meanings that are themselves unfolded with back and forth gestures between the feeling and its articulation. All of this is witnessed by myself, the interlocutor. Thoughts of the correctness of what is said do not yet arrive on the scene. Truth and meaning have not yet gone their separate ways - and so there is no substantial opportunity here for the meaningful articulation of propositions which then may or may not be correct. Where we are at is, rather, at the site of the birth of personal meaning (or of what Christopher Bollas calls 'idiom'), the site where the self becomes itself.

Words were originally magic. But: they still are magic, although their magic quality is constantly disguised from us by the representational fantasies that thought throws up when it reflects upon itself. The sheer fact of (what Frederick Olafson, in Heideggerian vein calls) presence is lost upon us - tacitly and illicitly assumed for our relation to inner representations, utterly disguised in our perceptual relations to outer entities which now appear merely causal.

The patient talks ...The doctor listens. ... By words one person can make another blissfully happy or drive him to despair, by words the teacher conveys his knowledge to his pupils, by words the orator carries his audience with him and determines their judgements and decisions. Words provoke affects and are in general the means of mutual influence among men. Thus we shall not depreciate the use of words in psychotherapy and we shall be pleased if we can listen to the words that pass between the analyst and his patient.

The temptation is to think that the 'magic' aspect of words consists in their ability to conjur up for us what is not present, or in the power of mere sounds to alter how the other feels, to exert an influence on us. But this is not the kind of 'magic' about words which entrances myself, nor the kind which fascinated Heidegger and caused him to endlessly try to articulate it, nor the form which attracted Wittgenstein but which he found tramelled over by the barbaric culture of the twentieth century. Or - it is a shallow articulation of what they found 'magical' about discourse. We might as well say that it is the lack of any need for any such conjuration which marks out language as magical. It is the lack of the need for language to evoke images or objects 'in or to the mind' - the lack of the operation of any such mind - which best captures its magical quality. You speak, I listen and in listening understand - without the need for mental intermediaries. That is the magical.

Perception is certainly no less magical for the presence of the real object before the perceiver. What is magic is the sheer presence of the object to the perceiver. Representational theories attempt to dispel this magic by 'explaining' the perceptual act. The irony of its ultimate reduplication, and hence the preservation of the putative mystery, is typically lost on them. But in any case, magic and this mystery are two quite separate things. This 'mystery' stems not from our being confronted with an explanandum in search of an adequate explanans, but from our having, first, simply missed the fact of presence.

The magic of words is, then, not to be found in their capacity to 'exert an influence' on us. That very way of putting things covers over what is of real interest - which is that in which in the influence consists. It is not that 'mere words' somehow make way for understanding - as if the process of listening with understanding had to be understood in terms of the taking up of the mere outer sounds into an inner domain of comprehension. That words influence our feelings is no more surprising than that any other act or occurrence should influence our feelings. What is magical about words-in-use is simply their partaking of presence, their embodiment of comprehension.

The patient talks ...The doctor listens.

Hasn't enough been said already?

Tuesday, 30 September 2008

Psychosis, Humanity, Dialectics



I've been struck recently, in my clinical work, by the way in which psychosis both:
  • Challenges the humanity of the sufferer
  • Reveals the sufferer at his or her most human
often at one and the same time. Further, or so I want to suggest, only a properly dialectical understanding of selfhood allows us to appreciate just why this is so. So - first - what do I mean by dialectical?

Let's start with what I don't mean. There are, it seems to me, many conceptions, or concepts, the meaning of which can be understood simply by virtue of their place in a differentiated web of other such conceptions. Leaving aside spurious metaphysical notions of self-identity, identity conditions are typically given by "différance". Left is what is not right, right is not left, and the meaning of a term is at least in part a function of the differentiating work that this term carries out within the web of signifiers. Such meaning is not however, by itself, dialectical in the sense I wish to indicate here. For whilst we must understand what 'right' means in order to understand 'left', this is an exclusory understanding: right is just not left.

Dialectical conceptions, however, work differently. A dialectical condition cannot be comprehended simply through a grasp of the differentiating play of signifiers. It is, rather, necessary to comprehend it in terms of an irresolvable tension, back and forth, between two opposed conceptions. Dialectical conceptions really do hold us in a tension; they are necessarily undefinable; and we can find no resting place within them. They do not repose at one juncture, one antithesis, in the way that non-dialectical concepts do.

'Self' and 'other' are concepts which are defined through their mutual opposition - but this in itself does nothing to make them 'dialectical'. The dialectical character of selfhood comes out, I want to claim, in an ongoing and unresting play between identification and differentiation. But let's consider first the most famous example of dialectical comprehension provided by Hegel - in his discussion of the relations of masters and slaves - sufficiently gripping and sufficiently near the beginning of the Phenomenology of Spirit for readers (like me) who never got round to reading the whole thing to pretentiously wield around the place as if they knew what Hegel was generally all about. (Not as bad as clichéd references to Proust's madelaines (they crop up near the beginning of volume 1 of In Search of Lost Time, if my rememberances serve me right, which is also as far as I - and I suspect many others - got with that work) but, well... nearly...) As John Elster summarises the discussion in his super little book - An Introduction to Karl Marx (p. 37) -
The contradictory desire Hegel finds in the master is the desire for a unilateral recognition. The master wants to be recognized by the slave, but he does not want to recognize the slave in return. This constellation of desires is contradictory because recognition, to be worth anything, must come from someone who is worth recognizing. ... To be recognized by someone whom we pay to lavish us with praise can at most give a fleeting satisfaction; it is like transferring money from one pocket to another [cf Wittgenstein's examples in the Investigations of giving a gift from one hand to the other], not like receiving an additional income. Although strange, such strivings play an important part in human behavior.
To be recognised as a master, I must also confer recognition to the slave - otherwise they cannot count as a meaningful recogniser. But how much is enough, and how much too much? There is no answer to this: the social contract must be continually negotiated, fought over, redefined.

So too, I want to claim, with selfhood more generally. What is dialectical comes out not in the fact that 'self' and 'other' must be defined in relation to one another; there's nothing dialectical about that per se. Rather it comes out in the process by which we comprehend one another as distinct selves - which process necessarily involves identification.

To recognise the other as other, we must acknowledge their separateness, their difference from us. But to recognise them as an other self, we must be able to identify with them. Such identification demands a capacity to relinquish separation or difference. And in order to genuinely relate to others as others, we must oscillate between the two, constantly back and forth. There is no pre-defined mid-point or definition of a balance between the two extremes of an isolation which denies oneself the possibility of achieving recognition, and an identification which risks losing one's selfhood entirely in the other.

This dialectic has varied forms. Some of them are largely embedded in our self-understandings, implicit or explicit. A 'dialogical' approach is offered to us by the Lysakers in their important new book Schizophrenia and the Fate of the Self. It is important to note that by 'dialogical' they do not mean 'dialectical' (purely verbal modes of engagement), and they are concerned largely with our ability to sustain and move between various different positions of self-in-relation-to-others. Nevertheless it would be fair to say that theirs is largely a more discursive approach than is found in other psychiatric/phenomenological theories, which provide a primarily sensori-motoric or principally non-verbal affective understanding, where the principle 'positions' one is able to occupy are not those sustained through discourse-involving practices, but rather through postural, proprioceptive and exteroceptive, motoric-interactive engagements. But regardless of the particular medium, my claim here is that the condition of psychosis, perhaps in particular psychosis as it occurs in the 'schizophrenic' disorders, is precisely due to struggles with such dialectical processes. Throwing ourselves into this dialectic, we risk losing ourself in the other, being taken for granted, being the object of transference or projection, being strung along, for the sake of a chance at being and becoming. (I'm dramatising here to make the point: much of the dialectic is doubtless sustained and modulated by automatic neurobiological processes.) Removing ourselves from the dialectical process we keep safe at the expense of existing (since existing is being-in-the-world).

This, then, is why I believe that psychosis often strikes me as both a challenge to the humanity of the sufferer, and also as itself a window into what is most human about him or her. It is in our attempts at, or our preconscious capacities for, managing our dialectical encounters that we are engaged most fully on the pursuit of being human. And it is due to a great fragility in the capacity to sustain a sense of self-in-relation-to-others that the person with schizophrenic psychosis is so vulnerable to alienation and deadening on the one hand, or to the processes which Laing so aptly characterised of implosion or petrification or engulfment on the other. If the pursuit of our own humanity - our ongoing management of our self-in-relation-to-others - were not a dialectical affair, then psychosis would simply present as a diminishment of humanity. But it is a dialectical concern: being human is not a matter of approximating to some one stable standpoint, but of continually negotiating a balance between identification and differentiation. To this extent, then, the sufferer from psychosis is not, as Sullivan had it, just 'more simply human than otherwise'.

Addendum

The Frankfurt School were suspicious of non- or anti-dialectical stances in critical thought. This, it might be suggested, is what led core members to withdraw support from Fromm's increasingly non-dialectical, ego-psychological, potentially-mythologising thought. That at least is how Martin Jay seems to understand it, in his book on The Dialectical Imagination (on the Frankfurt School). He quotes from Fromm's The Heart of Man:
This duality [of death and life instincts] is not one of two biologically inherent instincts, relatively constant and always battling with each other until the final victory of the death instinct, but it is one between the primary and most fundamental tendency of life - to persevere in life - and its contradiction, which comes into being when man fails in this goal.
Here we do not have the human condition being (partly) defined through a shifting tension between two opposites. Rather, we have one tendency posited as primary (to persevere in life) and a contrary tendency (towards death) emerging only secondarily. This is nothing to do with dialectics proper, it seems to me. Whatever one thinks of the notions of the death drive and eros, thinking which draws upon them enjoys the possibility of sustaining dialectical tensions and not slipping into mythocentric psychologised religion. (It is just this insistence on the ubiquity of the tragic, and on the sui-generis character of aggressive drives, which marks out Kleinian as opposed, say, to Fairbairnian, thought as containing the greater ethical and intellectual potential and promise (whatever the actual ethics and understandings on offer in dominant Kleinian paradigms.))

Sunday, 28 September 2008

Deriving Paranoid Delusional Content from Paranoid Delusional Form

Cognitive psychologists have rather too little to say about the relationship between delusional content (what the delusional person delusionally believes) and the condition from which the delusional person is suffering (e.g. schizophrenia.) In fact, I can put the question I wish to ask even without invoking putative conditions which might be found ontically or ontologically unacceptable by the cognitivist. So: Why is it that we find the same kinds of delusions again and again (grandiose; sexual; deadness; conspiracies; etc.); why is there not an even distribution of delusional content? Why for example are so many people with delusions paranoid? Why do they start to believe that there are plots against them?

No appeal to a bias or failure in a general cognitive or attributional mechanism would seem to have this covered. In fact, I'm not even sure of a psychodynamic explanation which has this possibility covered. So, sure, if we project our own hate into others, we may experience them as hateful. But: plots, conspiracies? Against us in particular? Perhaps with the help of an alleged regression we may attain the egocentricity; perhaps.

But the phenomenologists have the beginning of an account. Maggini and Raballo, for example, describe a phenomenological progression of obsidional delusional experience into delusional belief. We are to move, that is, from a disturbance in proprioception, to an alteration in the field of experience characterised by self-centrality, to full-blown paranoid beliefs. This is something we see in the non-delusional experience of our paranoid patients: It is as if, they tell us, the world around them appears to have been magicked up for them, just then; people have been put in place in the street just for when they walk past.

The progression is not available to the cognitivist who tends to assume that beliefs only follow perception through the content, rather than the form, of the perceptual experience. But this isn't what the experience of reference suggests to us. (Such prototypical delusional phenomena show straight away the inadequacy of the 'delusions either due to correct interpretation of faulty perception, or to reasoning problems' forced choice of empiricist psychopathology.) What it suggests is that something in the way that experience is itself meaningfully organised (people are experienced, not just interpreted, as doing things for one's own benefit (or disbenefit)) has gone awry.

So let us agree with Maggini and Raballo:

(3) SC is a cognitive BS reflecting a disturbance in the familiarity and controllability of the peripersonal space, which presents itself on a background of corporeal experience [8, 20]. Therefore BS involving bodily misperceptions are expected to be predictive of SC, and

(4) according to the BSM transitional sequences, SC is a ‘microproductive’ BS [13, 14] that precedes the delusional attribution (i.e. psychotic externalization phase) rather than a post-psychotic delusional byproduct.


Nevertheless, our original question now just moves backwards: Why has experience become referential? How does this self-centrality grow out of a disturbance of the familiarity and controllability of the peripersonal space, a disturbance which is ultimately corporeal? Maggini and Raballo do not tell us.

Bovet and Parnas have a crack at this issue too. Like Maggini and Raballo, these authors are concerned to elucidate the 'basic phenomena' which mediate between altered neurobiology and alterations in discrete symptoms (delusions, hallucinations, etc.). (Incidentally, this is a fine example of a phenomenological approach to tackling one version of the mind-body problem: identify an intermediate layer which is neither purely physiologically bodily nor having to do with particular intentional contents - but which grows out of the former and constrains the latter.) But what they say is also, in this respect, less than satisfactory.
We propose that the normal subject, always immersed in intersubjectivity, searches in himself for the main clues to his future, whereas the preschizophrenia subject, unframed by intersubjective ties, is forced to look for such guiding clues in the "outer world," rendering the latter potentially selfreferential. If such a vulnerable individual finds himself committed to a situation that threatens his autonomy beyond his capacities, the way to escape the threat is to reshape the context of his being-in-the-world, either by an "autoplastic," delusional reshaping of the experience or by a temporary, senseless "alloplastic" behavior. Such episodes may relieve the tension, and the individual may return to the status quo ante or progress
by an autocatalytic process into a long-lasting schizophrenic episode...
So, I look to the world around me for an understanding of what is going to happen to me. But, well, we all do this - and why should doing more of it render it 'self-referential' in the way that speaks not simply to the uses to which I can put what I find in the world, but to an altered structure of experience - which has now become referential, or more generally, manifesting an Ich-Storungen - itself? Bovet and Parnas nicely draw on Blankenbury to explain, by the way, how delusions of control and of omnipotence are cases where the boundary between self and world has been re-drawn in a too-close or too-far from self manner. No similar elaboration of the origins of paranoia / self-centrality is however forthcoming.

It is tempting to appeal instead to a dysfunctioning neurocognitive mechanism. We do after all seem to experience normal self-referential experiences (e.g. when we overhear people talking about us, or for that matter when we find our lives temporarily the topic of conversation at the dinner party). Or perhaps we could appeal instead to a regressed mode of psychological functioning, in which self-centrality represents an energetically easier systemic equilibrium. But these options would need serious work before they could be said to achieve any explanatory adequation.

A metaphorical explanation I have sometimes toyed with has to do with the 'reversal of the direction of intentionality'. If we imagine the intentional relation as typically moving from subject to world/other - whereby my projects and interests are 'projected out' into the world (I find in the world what conforms to my plans), then we can imagine the reverse of this being an experience of the world as bearing significance for the self. The significance function keeps going, but the direction of intentionality, due to a disturbance of an Ich-Storungen type, is reversed. However I honestly have no idea as to how to explicate further such an involution of intentionality so that it retains an explanatory rather than merely suggestive force.

how to be a duff analytical philosopher 2

I thought I'd test whether I was being prima facie unfair in my last post by randomly sampling a piece of contemporary analytical philosophy. The latest piece reviewed in the Notre Dame Reviews (excellent on-line philosophy reviewing site, with email feeds of reviews as they come in) will do just fine. Here is the text of the review which, as it happens, is of a book by Jens Harbecke called Mental Causation: Investigating the Mind's Powers in a Natural World (which, if you really want to buy it, will cost you €119.00).

To recall: What I claimed was that the ability to spin a wonderfully complex, dense, logically rigorous, theoretically-inclined, answer to a putative problem facing the serious philosophical inquirer is often a function of some astonishingly un-self-reflective assumptions regarding the decontextualised meaningfulness of the premises deployed therein. And that - question for one moment our right to feel so assured in the meaningfulness of the terms of the questions raised and hopefully answered by the philosophical project, and - both the viability, and the need, for the explanatory project, rapidly appear uncertain.

Here then is a sample of the kind of argumentative structure which the book is said by the reviewer, David Robb, to deploy:

(MC) Mental events cause physical events.

(CP) The realm of the physical is causally complete. [This is earlier glossed as, "for all physical events further physical events can be identified that figure as their sufficient causes" (p. 18).]

(NI) Mental events are not identical with physical events.

(NO) Physical events are not pervasively, or systematically, causally overdetermined.

And of course the struggle worked with in the book is that of trying to reconcile these apparently contradictory premises, or to see which is least painfully ditched.

But, and here's my concern: What kind of tin ear do we need to effect or deploy in order to get ourselves into a state of mind where we would be likely to find ourselves caught up in the above struggle? First we would need to assume that we knew how to use the term 'mental'here - assume that there was an off-the-shelf multi-purpose use available for us to know. Next, that we understand what a mental 'event' amounts to. Next that there is some kind of univocal notion of 'cause' to which we can help ourselves. And so on. The kinds of pickle we could get ourselves into thereby - which pickles, if we keep our logically rigorous hats on will start to seem extremely intriguing - can but be imagined. The only options will seem to be the accepting or rejecting of the premises. A particularly tinny tin ear will be needed to start to happily deploy a concept like 'physical' as an adjective to describe different events: mental events, physical events, etc. We will need to be perfectly happy with the idea that football matches, atomic collisions, and my raising my arm all describe 'physical events' in a relevantly similar sense of 'event', and a manageably similar sense of 'physical'.

Correlatively, a whole host of distinctions that are deployed in normal discourse - such as that between actions and events, doings and happenings - will have to be portrayed as somehow (how?) fairly insignificant compared with the allegedly far more 'deep' or 'significant' (why?) distinctions or non-distinctions drawn on or made by the philosophical theory under consideration. And strange locutions will need to be called upon (such as 'the event of my coming to believe that...') to get what at first glance appear like quite disparate phenomena (note: even 'phenomena' hardly does justice to the diversity of what we are here discussing) to fit within the one question-and-answer schematism.

Analytical philosophers often (in my experience) take 'continental' philosophers to task for their obscurantism and fanciful way of expressing themselves. What I am urging is that - logical rigour aside - the non-obscurantism of some ('duff') analytical philosophy is but a sham. The language appears crisp and familiar, but when we pause to think, we realise we are being invited to use clear-enough everyday terms radically out of context with at best a mere appeal to intuition as to what these allegedly timeless terms mean here, now, in the mouth of this analytical philosopher. At least the 'continentalist' wears his obscurantism on his sleeve.

So, to-recap:

I switched off the cooker because I thought the pot was burning.

must be taken as an exemplification of the alleged 'thesis' that:

(MC) Mental events cause physical events.

before we can get the whole discussion going. And what I am claiming is that it can hardly be innocent to suppose that any of these four words 'mental', 'events', 'cause', 'physical' have any very obvious meaning when put together in this kind of way. Sure, I know what it is for someone to have a mental illness. Sure, I know what a corporate event is. Sure, I know what physical exercise is. Sure I have some beliefs about the human causes of global warming. But do I therefore - on the basis of this contextual know-how - know what it is for 'mental events to cause physical events'?

Well, do I?

Thursday, 18 September 2008

how to be a duff analytical philosopher

Introduction

I've been turning over again in my mind the Wittgensteinian analogy of neurosis and philosophical disorder. This was prompted by my reading of the psychological literature on Chronic Fatigue Syndrome, and the curious use of the words 'reality' and 'real' that appear therein. And what this reminded me of was the curiously blithe and unconscious use of certain terms in (low-grade) analytical philosophy, and the way that such a use tacitly and illicitly sustains a debate, an interest and a focus. Let me explain.

How to be a duff analytic philosopher in 2 easy stages

So first of all it's worth reminding ourselves where we want to end up. What we want is to be able to develop a complex theory of a fairly everyday phenomenon, which it would not occur to the unitiated to even be required, and which will turn or draw not on empirical data, but on the distinctions that we can (take ourselves to) draw and track within our own minds. We want to be able to claim legitimate academic and expert status by showing the reader that we have turned up puzzles and complexities that might not have been apparent at first, complexities for which we then clearly need to solve, and which we can claim to be 'working on at the moment'. (It helps to say 'working on', since 'playing with' or 'risking being suckered by' might not quite do the job of quelling the anxieties arising within regarding the validity of our own enterprise.)

1. Take it for granted that the use of some particular term is completely unproblematic. We are to just acquiesce in this term, take it that we understand it, and take it that it can be deployed in whatever context we like without any particular interrogation. A term like 'reality' or 'real' will do. We take it for granted that we know what it is - or rather, we first take it for granted that there is some determinate thing which is thus known - for something to be 'real'. Other terms work quite well too: 'substance' is a nice one; 'entity' is another; 'mental state' does us quite nicely, and its cousin 'mental process' does the trick too. But even better is if we use a word which is just somewhat technical, but which has not been defined in terms of necessary and/or sufficient conditions. So we might use a word like 'representation' or 'intentional' (in the sense of 'intentionality'). (NB please don't let my sarcastic tone lead to the impression that I think there is, in many contexts, anything wrong with using undefined terms, or with generally taking it for granted that we know how to use our words.)

2. Next we just ask questions about whether or not the term in question obtains in some instance, or whether some instance is indeed an instance of what the term denotes. In the CFS literature, to go back to my original psychological inspiration, we are to take it for granted that we know what it is for something to be 'real' tout court, and then we can ask whether or not CFS, for example, 'is real'. Or we ask a complex series of questions which, taking for granted our grasp of the allegedly univocal meaning of the term in question, seem to take us forward to the fascinatingly rich and mind-bogglingly complex issues we can say 'we are doing work on'.

The fascinating detail and career-sanctioning complexities of 2 are accordingly purchased at the expense of the tacit, repressed, over-simplifications of 1. Take it for granted that there is - duh, obviously - some univocal meaning of 'real', try to forestall thought about this through allegiance to a micro-research-community of fellow neurotics all with the same conceptual blindspot, and then pursue the job of saying what is and is not 'real' in the universe. What we might instead call the 'kinds of reality' enjoyed by different kinds of phenomena are all typically conflated and collapsed into that kind which is enjoyed by whatever is going to function as our unconscious prototype (these days we can take it for granted that the kind of reality enjoyed by physical entities will play that part for us). As with CFS, the thought that there might be questions as to whether some condition is a real hysterical disorder or not, a real psychological disorder or not, a real neurological disorder or not, does not get asked. We are just asked 'is it real', where an assumption is made that we know what we are asking that when we ask it, in the abstract as it were. And then, with that simple assumption in place - with at best that self-confident knowingness that "of course we know what a 'representational state' is" - now we take ourselves to just have the task of figuring out 'how representational states are connected with reality' (or some other such exciting-sounding enterprise).

I notice that I have written this post in a somewhat sarcastic tone. At this stage, then, I ought to own what I recently said to a philosopher who claimed my Wittgensteinian critique of neurotic philosophy only applied to 'second-rate philosophers': 'But surely there's a second rate philosopher inside all of us'.

Monday, 1 September 2008

"sane by common consent"

In chapter 2 of The Divided Self R. D. Laing provides the following definition of what it is to be sane or insane:
when two sane persons meet, there is a mutual and reciprocal recognition of each other's identity. In this mutual recognition there are the following basic elements:
  • I recognise the other to be the person he takes himself to be.
  • He recognises me to be the person I take myself to be.
Each has his own autonomous sense of identity and his own definition of who and what he is. You are expected to be able to recognise me. That is, I am accustomed to expect that the person you take me to be, and the identity that I reckon myself to have, will coincide by and large: let us say simply 'by and large', since there is obviously room for considerable discrepancies. However, if there are discrepancies of a sufficiently radical kind remaining after attempts to align them have failed, there is no alternative but that one of us must be insane. I have no difficulty in regarding another person as psychotic, if for instance:
  • he says he is Napoleon, whereas I say he is not;
  • or if he says I am Napoleon, whereas I say I am not;
  • or if he thinks that I wish to seduce him, whereas I think that I have given him no grounds in actuality for supposing that such is my intention;
  • or if he thinks that I am afraid he will murder me, whereas I am not afraid of this, and have given him no reason to think that I am.
I suggest, therefore, that sanity or psychosis is tested by the degree of conjunction or disjunction between two persons where the one is sane by common consent.

The critical test of whether or not a patient is psychotic is a lack of congruity, an incongruity, a clash, between him and me.

I want to consider what is both profoundly right and wrong with this approach. What is both right and wrong with it seems, to me, to pervade the chapter, indeed much of the book, as a whole. (For further philosophical critique of Laing, see Eric Matthews' enlightening essay in the book Reconceiving Schizophrenia. Incidentally, what is profoundly wrong with Laing's book does not, in my mind, stop it from being the greatest contribution to philosophical psychopathology prior to the work of Louis Sass. And this is not simply because it also contains thoughts which are profoundly right; the wrongness of some of his thoughts does not, I believe, detract from their profundity.)

First, what is right with the approach? I shall not be arguing for this here, but one thing I think is right with the approach is the way it does not try to analyse or produce positive criteria for what is to count as 'insanity'. That is a demand we may often feel - to provide 'the criteria for' delusion, for example. (When they are provided (e.g. 'false, unusual, unshakeable') we can only wonder at how inadequate they are, how they fail to distinguish insanity from eccentric error, how they fail to grasp, at all, the depths of 'the schizophrenic's' disconnection from reality, at a level far below that of incorrect or unusual modes of representation.) Yet it is a hopeless demand, and Laing is right to simply cite the simple disjunction of the sane and the insane as the end of the analysis as well as its beginning.

An imaginary dialogue to explicate the point:

Laing (as I'm reading him): "That is what is called 'sanity'"; "that is what is called 'insane'".

Misguided interlocutor: "Why is that (e.g. utterance) called that (e.g. 'insane')? What makes that (e.g. behaviour) an example of insanity?"

Laing (...a la Wittgenstein): "No - we have already reached bedrock. Our psychopathological spade is turned. We call that insanity because it is not sanity. And there are no criteria for sanity. And there are no criteria for insanity. We understand what 'sanity' means through our acquaintance with our everyday modes of thought and interaction. We have no general grasp of the concept of 'the sane' which transcends our grasp of these particulars as being examples of it. They (insane ones) do not go on as we (sane ones) do."
A good way of putting this point also sets the scene for understanding just what also seems wrong with Laing's approach. Be warned ... this will require a considerable non-Laingian philosophical detour. So: Let us accept (for the sake of the argument) the idea that many of our thoughts can be understood as 'representations' of states of affairs, as right or wrong depending on whether they correspond to the way things are. For this to be the case - for it to be meaningful to talk in this way - we must, it can be argued, have access to some system of representation, some rule book as it were, by reference to which a representation can be judged as felicitous or not. Let us take Wittgenstein's eccentric shopkeeper (PI 1) as an example:
Now think of the following use of language: I send someone shopping. I give him a slip marked "five red apples". He takes the slip to the shopkeeper, who opens the drawer marked "apples"; then he looks up the word "red" in a table and finds a colour sample opposite it; then he says the series of cardinal numbers--I assume that he knows them by heart--up to the word "five" and for each number he takes an apple of the same colour as the sample out of the drawer.--It is in this and similar ways that one operates with words.--"But how does he know where and how he is to look up the word 'red' and what he is to do with the word 'five'?"--Well, I assume that he acts as I have described. Explanations come to an end somewhere.
So the (obsessional) shopkeeper has a system of representation for use of the words '5', 'red', 'apple' and so on. We can sensibly ask of him: how can he check if he is right? He can do this by making moves within his system of representation - opening the drawer, counting, looking in a table. The point is that there is room here for saying in virtue of what some action of the shopkeeper consisted in correctly responding to the demaind of the slip. He can justify himself, or correct himself, by reference to the standard.

There is however a natural enough (but misguided) human urge to push the demand for a justification or explanation beyond the point at which it can cogently be answered (cf children who keep iterating 'but why?'). Wittgenstein's interlocutor above asks
--"But how does he know where and how he is to look up the word 'red' and what he is to do with the word 'five'?"--
And the answer comes
Well, I assume that he acts as I have described. Explanations come to an end somewhere.
There is, then, no answer as to how he knows how to do these things. He 'just knows'. Our spade is turned; PI 217:
If I have exhausted the justifications I have reached bedrock, and my spade is turned. Then I am inclined to say: "This is simply what I do."
(In truth, a less eccentric shopkeeper would be just as secure in his immediate grasp of 'red' and 'apple'; his spade would have been turned instantly on reading the customer's request. Or to put it more satisfactorily in terms of the order of possible justification, rather than in terms too apt to invite a merely psychological reading: an ordinary shopkeeper's grasp of the request slip is no less secure and no less fundamental than his grasp of the meaning of the samples in the table.) Nevertheless, there is just such an urge to ask 'but how do we know' beyond the point at which it can intelligibly be sustained. (We are inclined to find this mystifying if we don't allow an understanding of what was wrong with the question in the context in which it was asked to accompany our refusal to provide the kind of answer the question seems to demand from us.)

One way in which this urge gets played out in philosophy is by asking what justifies a belief that some system of representation is itself the right one, is a correct way of grasping the world. If we saw our initial justification - of some particular understanding of the use of 'red' - as a matter of making moves within our system of representation - justifying some particular interpretation of a representation of 'red' (on the customer's request slip) by reference to some other representation (the colour sample on the table), we may now feel a need to 'step outside of' these systems of representation and compare them 'with the world'.

Here is how this misleading picture can be generated so we can, for a moment, allow ourselves to be held captive by it. First we imagine that systems of representation are not part of reality, are set over against reality, and that we, our comprehension and intentionality, are as it were 'trapped' within the former. (We must, that is, forget the fact that our thought is grounded in our animal negotations of the world, that our systems of representation involve parts of the world as paradigms or samples, that language is first and foremost verbal behaviour and not disembodied symbolisation.)

Then we must imagine that when we justify ourselves, we make moves within our system of representation. (Not an unreasonable thought if one has avoided the first thought, but apt to appear so if one has not, in which case the second thought is more aptly expressed as 'we merely make moves within our system of representation'.) Finally we start to wonder about the adequacy or justifiability or correctness of our system of representation itself. So we now imagine that, in order to check it, or to be justified in cleaving it to, we must somehow stand outside of it. Perhaps we must find a meta-system of representation in terms of which our system as a whole may be compared with reality. Perhaps.

Similarly, to start to return from our detour, when it comes to asking: 'in virtue of what is that a sane, and that an insane, reaction?' 'Sanity' does not refer to some justifiable-from-the-outside way of going on, as if both the sane and the insane had access to some greater agreed on framework or table of samples of sane, rational behaviour for assessing the viability of what is said. There is no further set of exemplars of sanity, preserved in a sample book, with which we supra-rational beings may compare our conversational lives. The rule book is distributed immanently over the surface contours of our enactive lives.

It is because sanity is not itself describable as correct representation (but is rather it's presupposition) that insanity cannot be described as misrepresentation. Accordingly, we must say, when asked to justify why one person who is talking and acting in this >>> way is to be described as 'insane': "My spade is turned; that is just what is called 'insanity'".

Time to return, back from our detour, to Laing's Divided Self. I said above that Laing was to be congratulated for not providing us with an account which goes beyond the common consent of what is called 'sane' and 'insane'. But I also said that I felt there was something profoundly wrong with what he writes. What is wrong can be boiled down to the occurrence of the word 'by' in the phrase 'sane by common consent'. For Laing writes as if what makes it sane - what makes us correct in calling this utterance or behaviour 'sane', and this 'insane' - is our common consent. As if our consensus - the consensus of the sane (note) - was what made for the sanity of the sane, and for the exclusion of those judged 'insane' from this self-appointed enclave. And this just isn't right. That little word 'by' instantly takes us, it can be said, all the way over the vast unfathomable distance from a modest minimalism about the diagnosis of insanity to an untenable conventionalism or incoherent transcendental idealism regarding the foundations and core character of sanity (explication will follow). It turns an observation into an explanation.

A similar difficulty is contained in the material from the beginning of the above-quoted section from chapter 2:
when two sane persons meet, there is a mutual and reciprocal recognition of each other's identity. In this mutual recognition there are the following basic elements:
  • I recognise the other to be the person he takes himself to be.
  • He recognises me to be the person I take myself to be.
Each has his own autonomous sense of identity and his own definition of who and what he is. [Now, we are expected to be able to recognise one another.] ... However, if there are discrepancies of a sufficiently radical kind remaining after attempts to align them have failed, there is no alternative but that one of us must be insane.
But the notion of 'recognition' is coming in at the wrong conceptual juncture here. To be sure, two sane persons may be willing to offer one another recognition and, to be sure, this may not be possible for or by the insane person. Yet Laing writes as if there is some way that one person can take him or herself to be which is not how the majority who self-appoint as 'sane' take that person to be: 'Each has his own autonomous sense of identity...'. It is as if he somehow believes that intelligible talk of 'ways of being' radically transcends the recognitional capacities of sane persons. But this just isn't the case. Even on empirical grounds, the fact of the lack of an autonomous sense of identity of the person with schizophrenia is striking, and is argued for by Laing himself throughout his text. Yet on transcendental grounds, the case is even stronger: identity just is not something we have the luxury of affording ourselves, but is a precondition of our being 'afforders' in the first place.

Or consider the end of chapter 2. Laing writes:
What is required of us? Understand [the schizophrenic man]? The kernel of the schizophrenic's experience of himself must remain incomprehensible to us. As long as we are sane and he is insane, it will remain so. But comprehension as an effort to reach and grasp him, while remaining within our own world and judging him by our own categories whereby he inevitably falls short, is not what the schizophrenic either wants or requires. We have to recognize all the time his distinctiveness and differentness, his separateness and loneliness and despair.
Laing's way of writing suggests that there is some intelligible 'outside' to sanity, some other way of going on which is not, as he puts it just before the quoted passage, 'really true' in the sense of 'real' and 'true' as they are used when discussing 'grammar and the natural world', but which is nevertheless an existential possibility. (It seems to me that the same difficulties befall the word 'existential' here as they do the word 'transcendental', as it is used in articulations of the pseudo-doctrine of 'transcendental idealism' (cf Adrian Moore's Points of View.))

This, however, is to partake of the fantasy of an 'outside' to our system of representation. As if we just need to get outside of our own heads enough, expand our consciousness enough, to accommodate the putative forms of thought of the insane. But this is just what insanity brings into question: the possibility of thought at all. Laing writes as if 'the insane' simply have a different 'point of view', one which we cannot share because of our sanity. But the very idea of a 'point of view' has here been stretched beyond what is intelligible. Sanity is not a point of view, but the precondition of the possibility for having a point of view in the first place.

Similarly, the possibility of recognition by another is, as Laing himself acknowledges at other moments, a precondition of the possibility of real existence as a person.

We are, then, not 'sane by common consent', nor are the insane insane by common consent.
That makes it sound as if it is our agreement that certain behaviours are sane that makes them sane. But sanity is what makes for the very possibility of anything called genuine 'consent'.

Consider PI 241:
So you are saying that human agreement decides what is true and what is false. It is what human beings say that is true and false; and they agree in the language they use. That is not agreement in opinions but in forms of life.
Laing writes as if our mutual sanctioning as sane by common consent is an 'agreement in opinions', whereas we really ought to see it as a matter of agreement in 'form of life'. (nb this is not just a matter of agreement being in two different things; we rather have two different senses of 'agreement' here. In the former case it is a normative notion; in the latter case it is not.) Going on like this >>>, like that >>>, is called sane, is called 'offering recognition', 'acknowledgement'. This >>> is sane, as is this >>>, what he says here and what she says there; that >>> is not.

It is not that our agreement makes us sane, that our exclusion makes the insane person insane. Someone is not to be said to be sane in virtue of their going on in the right way. Someone is not sane because we agree they are. Terms like 'in virtue of' or 'because' have their sense from their explanatory applications, yet no explanation nor justification can be, is really being, offered here.

"We call him 'sane' because he goes on (talks, acts) in the same kinds of ways that sane people do" is clearly a nonsense. Compare: "We call it a hamster because it is a hamster." But to whom, in what circumstances, does this count as an explanation or justification of the use of that term ('hamster')? Perhaps we could invent a circumstance - a circumstance in which, under some radical confusion that we were in fact talking about a cat called 'Hammy', I start to wonder why you call Hammy a 'hamster'. However such circumstances aside, the 'because' does nothing in the 'because it is a hamster'; no justification occurs.

So too, when I say "Well I called him 'sane' because he went on as we do", the only cogent way to delimit the extension of the 'we' is by reference to the intension of the group of sane people. This way with 'we', however, simultaneously vitiates the 'because'. "Going on like this >>> is called sane" is something we might say to someone who seemed to be asking for justification after the point at which our spade was already turned. It is not an answer to a question, but a way of refusing one.