Wednesday, 18 June 2008

Aporiae of Apophany 2: Do the Mad Live in Another Country?

In this second post I'm asking the question: Wherein or whence the psychotic strangeness of certain psychotic experiences? If depersonalisation and made feelings, for example, are not to be understood as a loss of personalisation or of self-made feelings (since there's no such things), then what do they consist in?

To start to understand this I want to turn in what might seem an unusual direction - to certain debates in Wittgenstein interpretation - in particular, between transcendentalist and resolute readers of the Tractatus. A good place to start is Cora Diamond on what nonsense might be. Diamond draws a distinction between two views of nonsense. To put these far too crudely:

  • On the first view, an expression is to be thought of as nonsensical if it expresses an idea which is nonsensical.

  • On the second view, an expression is to be thought of as nonsensical if it does not express an idea.

On the first view there is something that the expression expresses, and what it expresses is (to put it in an uncharitable formulation) a meaningless meaning, a meaning that cannot be thought, a thought which cannot be understood. We have here a something which cannot be said. One way of making sense of this (familiar enough) idea would be through something like this: the logical structure of our language or of our thought or of the world in some way constrains what can be said or thought. As if, were it not for these limits, we could have further and other thoughts.

On the second view this is all really quite hopeless. Something is meaningless not because it expresses as it were a meaning which is meaningless, but because it fails to say anything. It does not say something which is impossible - it just doesn't express anything. We have no use for those words in our language. We don't know what to do with them. Give them a meaning, build a practice around them, and we come to know what to do. Leave them as they are, and they are simply idling. Language gone on holiday, as Wittgenstein put it. Not language doing an impossible job, but language not doing a job at all.

Now what I want to suggest is that many attempts to 'understand madness' do so by creating a spurious metaphysical geography, positing lands beyond those known by those of us who are limited by being trapped within the bounds of sanity. As if we are constrained by our sanity - as if sanity, rather than being synonymous, as it were, with meaning itself, were just one form it takes. As if there are unthinkable ('for us' - for the 'transcendental we') thoughts which the person who is insane is thinking.

Delusional beliefs are accordingly thought of as species (delusions) within a general type (belief). The delusionality is not held to start to impair the very status of the beliefs as such. Thought disorder is thought of as a disorder between thoughts - rather than as something which starts to challenge the very aptness of talk of thought at all.

In short, a disturbance with reality contact is seen as contact with a different reality than 'real' ('consensual') reality.

But what is striking is that delusion, depersonalisation, hallucination, made action, thought insertion, etc., present themselves as real presences and not as absences. The person who is psychotic uses certain words and we view these as descriptions of possible experiences - just not of experiences which are possible for us (although perhaps if we take LSD etc...). And this sounds so absolutely reasonable as the best description of their experience that it becomes hard to think of any other.

At this point we need to tread very carefully to not do a disservice to the person experiencing psychosis. I want to make it very clear that I am not intending to say that they are not having disturbing experiences. That goes without saying. What doesn't - I am claiming - go without saying are the common characterisations of these.

For example, someone says that they are having the experience of thoughts being removed from their head. Now let us accept as true that they are having that experience which is aptly described using the phrase 'having thoughts removed from one's head'. What I am questioning is whether the content of their experience is that they are having thoughts removed from their head. Because I am questioning whether that is a possible content of any experience. What I am claiming, in fact, is that we lose sight of the very strangeness of the experience, fail to do it justice, when we accept as unproblematic the idea that they are describing a possible experience.

What is certainly true of course is that the person with psychosis is having experiences which are aptly described as of voices that aren't there, thoughts being put into their head, etc. But, you ask, how can I say this if I am also denying that these are possible contents of experience? The answer I wish to give is that: What makes it the case that the right description of the psychotic person's experience is of thoughts being put into their head that are not their own is just that this is the description which they are inclined to give. It is very tempting for us to try to describe some feature of their experience which would justify this description of it. A typical deficit account would do just this: We posit a mechanism by which we recognise thoughts as our own (whatever the evolutionary point of such a mechanism would be, given that we (even the psychotic person) only ever does have their own thoughts, is deeply unclear to me), and we posit that the person who suffers thought insertion has suffered a breakdown in this mechanism. But this is just the temptation which, I am claiming, we need to try our very best to resist.