Saturday, October 02, 2010

Madness and Sanity 2


The coastline at Portrane, Co. Dublin
We use the words "madness" and "sanity" almost on a daily basis in our contacts with others.  We protest to others with such exclamations as: "Are you mad?" "That's insane," "It's a mad world," "He/she is simply insane" etc.  We are never, of course, asked to explain or define these words which we have used in an obviously pejorative sense.  It is as if we instinctively know what madness is on the one hand and what sanity is on the other.  We seem also to instinctively divine where the demarcation lines are between madness and sanity.

However, we all know that while our instincts and hunches can give us certain clues and indeed directions in our life, they are not, on balance, very reliable indicators on their own.  Intelligence and logic and commonsense are more important when it comes to getting to grips with the nature of anything whether scientific, historic and even artistic, while instincts, gut feelings and "emotional intelligence" (Daniel Goleman) do come into play, but in tandem with a more considered intellectual analysis and logical overview of the situation and further, to use a culinary metaphor, all of the foregoing recipe should be topped off with a liberal sprinkling of commonsense.

Towards a Definition of Madness and Sanity

Another section of coastline near Portrane
The brain is a delicate organ as we all know only too well.  As a fifty-two year old man I have lived long enough to have known some friends and quite a number of acquaintances who have died either from brain haemorrhages or tumours.  We are learning more and more, almost on a daily basis about the structure and complexity of this wonderful if delicate organ.  Then, we come to what is called the "mind" which we assume is somehow contained rather mysteriously within the brain somewhere.  Obviously, or perhaps not so obviously, the mind is infinitely more complex than we assume.  Once again we have made the assumption over the last several hundred years that somehow the mind or psyche is the very focal point of our personality.  That it exists at all is of course an educated guess, and indeed a most likely one.  As a philosopher one could say that it is a metaphysical reality or as a literatus that it a highly metaphorical term representing the very heart (another metaphor) of what it means to be human.  Once again as a writer one is not at all surprised that our very words are somewhat inadequate to encompass the sheer complexity and indeed mystery of the mind.

On a personal level I experienced what is commonly called a "nervous breakdown" at the age of forty - exactly twelve years ago now.  I was eventually diagnosed with clinical depression and am still on medication which has indeed kept me "sane" for the past twelve years.  In the interim, that is, since my diagnosis, I have experienced little or no adverse side effects to my medication besides feeling somewhat tired at times.  This I can live with, but certainly not with the severe existential crisis and indeed mental torment brought on by a bad bout of clinical depression.  Twelve years ago I spent some several weeks in hospital - a lovely protective private institution with all the modern conveniences, thankfully, as I was luckily fully insured.  During that existential crisis I began from the very pit of despair to ask such deep existential questions as Who am I?  What is my mind?  What is my personality at all?  Is it some fluid chemical reality in my brain?  At one stage I remember thinking that I was nothing really but a collocation of chemicals - Bertrand Russell's definition of the human being as a collocation of molecules was somewhere rattling around in my brain or "mind" - whatever that was or is.  Is my personality also so fluid as to be a mere chemical phenomenon?  Indeed, I became very sure that my very personality was such a mere chemical collocation of atoms and molecules which went to make up the various neurons in my brain.  Moreover, I became further convinced that my personality could be changed or controlled by the administration of the various medications which the psychiatrists were using to stabilise my situation, and thereby somehow stop my horrific existential crisis or my experience of severe mental pain.  Thankfully for me the medical/chemical interventions worked and are still working. Before I went into hospital I was a questioning individual who accepted such things as the stability and solidity of such commonly accepted "assumptions" as the existence of God, the existence of the mind as a virtually unassailable entity, the existence of my personality as set almost in stone and other related assumptions.  When I left hospital I was very uncertain as to any of these so-called "fixed" ideas or categories.  From my fortieth year onwards all concepts and assumptions are just that, mere concepts and assumptions, which can be traded on the market of open debate for other concepts and assumptions.  They can be knocked down and done without as their use for my own personal existence or development ceases and replaced by other more useful idaes and concepts which will always cease to be real for me when they are no longer useful in their turn.

Personal Relationships

In consequence of the above preliminary thoughts, relationships become way more fluid also.  One becomes far less set in one ways and indeed far less judgemental of others - thankfully.  One becomes less likely to make assumptions, espercially rigid ones.  I remember reading aomewhere in Eugene Gendlin's work that those patients who present as all-knowing and all-certain as to their psychological problems are the less likely candidates to succeed in effecting a change in their lives.  In the light of my own experiences this is, on reflection on that experience of course, most patently obvious.  But, I suppose everyone must experience such on the very pulses of their being (some poet of the Romantic era, whose name I have forgotten, used this lovely metaphor) to realise the truth of what Gendlin, phiulospher and psychologist, is getting at.

I spent somewhat over a year in a relationship with a woman who suffered from schizophrenia and this relationship was one of the most rewarding human encounters I have made in my life.  From it I learned to be more deeply compassionate.  I learned to appreciate what mental health and ill-health really are.  I began to read more widely in psychology, psychiatry, psychotherapy and indeed psychoanalysis.  I was not solely reading to expand my knowledge.  I was now reading to understand myself and the other person, and to understand what that relationship meant at all - or, indeed, what any relationship means.  Both from my own experience of depression and from the year-long engagement woith another "suffering" human being I began to question what we mean by the words "madness" and "sanity" anyway.  I began to realise that we are too quick to use such terms.  In fact, we use them in far too simplified and judgemental ways.  I learned on the very pulses of my own being the true import of the words of Hamlet to his great friend Horatio:  "There are more things in heaven and earth, Horatio, than are dreamt of in your philosophy."

I have spent a lot of time, and indeed money, buying books about schizophrenia, manic (or bipolar) depression (a cousin and some friends suffer from this form of depression) and on many other cognate themes within psychiatry/psychology.  This has been, and continues to be, both an interesting and rewarding passtime for me.  I have gone to lectures on these mental illnesses and heard sufferers describe their experiences.  All of this has led me to question the easy categories we as a society profess to believe in and ascribe to others of our number. 

In the next several posts I wish to comment on a short but incisive history of madness by the late great scholar and historian of psychiatry Dr. Roy Porter.  This short wee book is entitled Madness: A Brief History (OUP, 2002).

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