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.