At a conference yesterday in Bristol I several times found myself struck by an apparently widespread assumption by the presenters that psychotic phenomena can be straightforwardly understood as breakdowns in normal psychological mechanisms. I'm thinking in particular of the idea that:
Depersonalisation amounts to a breakdown in a process of personalisation. The fact that someone may say that they are no longer aware of themselves as a person is taken to indicate that there is a normal process or state in which we are aware of ourselves as people.
Capgras syndrome - delusionally taking my partner for an impostor - 'something about them feels unfamiliar' - is viewed as the absence of a putative normal feeling of familiarity we have when meeting one another.
The idea is familiar from other psychopathological theories too:
- Thought insertion - delusional experience of thoughts being put into my mind which are not my own - is viewed as a breakdown in a putative mechanism by which we ordinarily identify our thoughts as our own.
Hearing voices - similarly, our own inner speech no longer recognised as self-produced because of a disturbance in self-consciousness.
Now I don't want to deny that psychotic symptoms may result from breakdowns in normal brain processes. If someone wants to give these neurological processes psychological tags then that's fine, so long as they don't accidentally take themselves to be thereby providing psychological explanations...
But I do want to question whether these explanations really stand up. For one thing, they seem to run the risk of making too much sense of the phenomena. That is, they seem to make them highly intelligible in a way which thereby diminishes our sense of their psychotic strangeness. Whilst some might think that a good thing, I would argue that it fails to respect the person experiencing the psychosis. It incoorporates them into the kingdom of the sane, putatively discerning the meaning of their experience, but in fact failing to adequately do justice to the baffling and frightening strangeness of what they are experiencing.
For another thing, we are forced to introduce a phenomenology which appears to falsify everyday experience. For it simply isn't the case that I normally have an actual experience of my own thoughts as my own, or of my partner as familiar, or of my arm movements as my own arm movements, etc. To be sure, I don't experience my own thoughts as not my own, but this shouldn't be taken to license an inference to the idea that I do experience them as my own. An absence of an experience is not the same as an experience of absence.
More importantly, this common approach seems to cover over the real character of the 'madness' of psychotic experience. I shall consider how to characterise this in the next post.