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.