Wednesday, 18 June 2008

Aporiae of Apophany 3: The Groundlessness of Psychotic Avowal

In the last post I claimed that avowals of psychotic experiences are not apt because they aptly describe intelligible possibilities. Rather, they are apt ('necessarily apt', as it were - which is of course just to doubt the very aptness of 'aptness' here) because such avowals themselves individuate the experiences in question. We cannot, as Wittgenstein put it, use language here to 'get between thought and its expression'. It is of course often possible to ask whether a description really does do justice to something which is experienced. We say: 'That was a good, or a bad, description of the bird seen through the binoculars'. This is what I am claiming is not the case in cases of psychotic experience. Do we have a model for this kind of 'groundless relation' between experience and language?

The two models that comes to my mind are those of secondary sense and of the avowal of sensation. Secondary sense first: We use a word in one primary context, and it is in virtue of our mastery of such uses that we can then deploy it freestyle in a secondary context. We talk of people being thin and fat, and now we say that tuesday is thin and wednesday is fat (most people say this, rather than the reverse, if they are asked to choose). Or we learn to use words (up, down) in one (physical) context, then go on to deploy them, or spoontaneously understand deployments of them, in another (psychological) context (feeling up, high, low, down, etc.). Here nothing justifies our emotional use of 'up'. There is, we might imagine, a causal connection - something to do with the way the brain is wired, or to do with the way that culture is 'wired' - that explains the usage. But this causal explanation is no sort of justification.

Now avowal: When I say 'there's a sharp pain in my thumb' (thereby also presumably employing a secondary-sense use of 'sharp'), I do not say this on grounds. It's not obvious that, so long as I know the meaning of my words and I am being sincere, these words could fail to express a truth. 'What makes it the case that' my experience is of a sharp pain is just that these are the words in terms of which the experience voices itself. If I'm sincerely inclined to describe it as a sharp pain then this is just what it is.

Yet if there is something akin between psychotic experience and avowal and/or secondary sense, there had also better be something different. For first, it seems to not be extrinsic to our everyday capacity to use secondary sense that we know - have the ability to recognise - that it is not primary sense. Second, we rightly do not treat avowals as psychotic. As Manfred Spitzer (I think) once said, it is as if the person with psychosis has somehow conflated first person infallibility and third-person judgement. They are offering descriptions of impossible scenarios with a quasi-first-person authority ("I know that they are after me...") whilst maintaining a third-person descriptive stance.

Third, and relatedly, avowals purchase their inalienable authority at a high conceptual price. It is only because I can be said to have mastered the second- and third-person applications of folk-psychological predicates that I am afforded the logical luxury of groundless self-application in my own case. Yet aside from diagnostic usages there is no legitimate third-person application of 'he is having thoughts taken out of his head...'. The only grounds for ascribing that experience to someone would be their own avowal of it.

Nevertheless, the analogies with secondary sense and avowal do give further clues as to how to understand the nature of delusional experience. As per Spitzer's account, the way in which delusions are placed outside of the zone of potential refutation may be partially explicated through the analogy with the similar logic of avowals. (The other idea, owed to John Campbell, has it that this immunity to falsification comes from a delusion constituting the framework, rather than one of the empirical details, of someone's epistemological economy.) This is a concern about the form of delusions. The analogy with secondary sense by contrast gives us a clue as to the question of the content of delusional experience. (In all three cases (secondary sense, avowal, delusion) there seems to be no viable appearance/reality contrast either.)

Le me explain that I am not saying that secondary sense or avowal are to be taken as the model for understanding the individuation of psychotic experiences. For secondary sense and normal avowal presuppose a background sanity which is precisely what is lacking here. These phenomena rather serve a negative role - to remind us that we are cognisant of phenomena for the ascription of which it is decidenly un-apt to request certain justifications beyond what the subject is disposed to say. (Spitzer's suggestion, as with many other philosophical and psychological accounts of madness, risks making too much sense of the phenomenon.)

Notwithstanding this, secondary sense does perhaps provide the model for an outline of a causal explanatory account of psychotic self-reports (of thought insertion, made action, etc.). Whilst it may be thoroughly inapt to ask what adequates such a self report, we can still ask what causally explains the phenomenon. We just are, say, inclined to view the 'tue' of 'tuesday' as sounding thinner than the fatness of the 'wednes' of 'wednesday'. This may be due to the way our brains our wired up. So too we do naturally extrapolate - in what Mark Johnson calls 'conceptual metaphors' - from a vast array of the structural grammar of interactions between and within bodies when constructing our discourse around the self. Communicating an idea is viewed as transiting it from one person to another. Certain emotions are thought of as hot, others cold - and our experience of blood flow in the body may explain this.

Now the person with psychosis just is disposed to experience and report such experience in terms which are not apt for understanding by others - which do not conform to, or better do not constitute, the tacit canons of sanity. We tend to 'go on' in certain ways, use certain conceptual metaphors but not others, and so on. It is important to recognise that these ways of 'going on' do not correspond to the actual structure of the world or to some hypostasised 'rules of sanity'. Rather, they themselves form the bedrock for, they constitute, sanity itself.

Someone who is not disposed to talk and act as do the sane is not living in another country. They are not just going on differently. They are slipping away from living itself.

The difficulty we have in acknowledging the groundlessness of psychotic self-reports (i.e. the difficulties we have in giving up the idea that they are apt representations of inner experiences without slipping into the reductive psychiatric position that they are therefore contentless) may ultimately represent nothing other than the terror we feel in acknowledging the groundlessness of sanity itself.