Saturday, March 29, 2008

"If this be madness there is method in it"

Readers will immediately know that my title is a quotation from Shakespeare's Hamlet, the words spoken by Polonius who is commenting on Hamlet's "antic disposition."  As to what madness is no one can quite agree.  As I have outlined in my last post the demarcation lines between sanity and insanity may not be that particularly clear.  The late great Roy Porter (1946-2002) in his marvellously illuminating Madness: A Brief History (Oxford, 2002) quotes this same Polonius and praises him for his perspicacity in being unable to define madness and being content to state merely that "what is't but to be nothing else but mad." (op.cit., 1)  There are even scholarly psychiatrists (admittedly in a very small minority indeed) who doubt the existence of madness itself. (Whether these scholars doubt the necessity of their own professional specialism is not at all too clear.  I presume they are aware of the blindingly obvious contradiction).  I refer here to the likes of Professor Thomas Szasz of Syracuse University, New York who says that madness is not a disease but rather a myth promulgated by psychiatrists for reasons of professional advancement and "endorsed by society because it sanctions easy solutions for problem people." (Ibid., 2)  I can only presume he's not that popular with his professional colleagues.

Be that as it may, I have already referred to the fact that I believe in treating all human beings as human beings, just that.  One of the worst offences those of us who are not physically challenged make against our disabled brothers and sisters is to talk about them in the third person rather than addressing them in the second.  A similar offence, I believe, is to treat the mentally ill in a like fashion.  I have already not only alluded to but also quoted extensively the wonderfully humane existentialist psychiatrist R.D. Laing in these pages before.  See this link Laing for my considerations of his writings and thought.   He approached all his patients as persons with feelings, not as cases of "madness" to be "cured."

One of the greatest contemporary scholars of the subject in question here, namely madness or insanity - more kindly called mental illness - is Dr. Richard Bentall, one time Professor of Clinical Psychology at the University of Liverpool and current Professor of Experimental Clinical Psychology at the University of Manchester.  In his preface to his masterful Madness Explained: Psychosis and Human Nature (Penguin, 2004) he says the following which I deem profoundly obvious and extremely heartening and essentially positively wholesome as regards the essence of the human condition.  Read Richard P. Bentall's words below and savour them.  I'll indent them for emphasis.  Maybe after reading them you will not use such loaded words as "mad" and "fool" lightly again.

Scientists like ordinary folk and psychiatric patients, are flawed, emotional and excitable human beings who are sometimes wise and sometimes stupid, sometimes lovable and sometimes bloody irritating.  By talking about my own experiences, both positive and negative, I have attempted to highlight an important theme of this book, which is the vanishingly small difference between the "us" who are sane and the "them" who are not.  At a recent conference I was introduced as "Someone who has done more than most to move the dividing line between sanity and madness", which I think was a compliment.  In any case, in these pages I have tried to demonstrate that the differences between those who are diagnosed as suffering a psychiatric disorder and those who are not amounts to not very much.  This is an important insight because of its implications for psychiatric care.  As I hope to demonstrate in a later publication, the dreadful state of our psychiatric services is not only a consequence of muddled thinking about the nature of psychiatric disorders, but also a consequence of the way in which psychiatric patients have been denied a voice by being treated as irrational and dangerous, like wild animals in a zoo.

(Op. cit., xiv)

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