luke wilson
The Living Force
I'm one of those people that finds it hard to stick with a book until the end, but I did with this one. I'm also one of those that can't break down a book into a blurb. Nonetheless, here is my take.
The book is about madness. It talks mainly about psychosis and schizophrenia but also touches about other forms of madness and their various manifestations. More than that, the main thread running through the book is one challenging how we perceive the above phenomena. It challenges many concepts of perception and this is one particular thing that made me stick with it, there is a novelty to it.
For example, in general, people who go to therapy may fall into the trap of being told how they should adjust to society, adjust to what is normal, adjust to how they should think etc, but the author challenges the therapist imposing their own conception, their own view on their patient.
He offers a view that is interesting in my eyes
Another tidbit,
It also perception of being able to distinguish between sane & insane people
Beyond the above, it goes deeper into a criticism of the modern focus on external behaviour in terms of mental health, that the distinction between surface and depth has been obliterated and that this naturally generates more and more clinical categories: every aspect of the human condition can now become a disorder. Conversely, conformist surface behaviour can hide a serious underlying problem: think for example, the case of Harold Shipman. He murdered more than 250 people, yet worked for years as a respected GP, earning the admiration of the community he served. He was kind, considerate and an excellent listener, yet at the same time, he was carefully killing off many of his patients. When psychiatrists examined him, they could find no clear indication of 'mental illness.' It is the very absurdity of this result that should make us realize that the DSM system of mental health diagnosis is totally off the rails.
The books goes on and on about many things I personally found quite interesting, that to me truly introduced new things into my mind. So much so that I'll have to explore some of the things further as I truly think the author touched upon some things that were truly profound. However, it also had things that didn't resonate with me so for this reason, I recommend it at your own discretion.
It's also a shame that he didn't touch upon what we call the psychopath as a category of its own (as many people would see Shipman as a psychopath for example) as it'll have been interesting to know exactly what goes on in the depths of their being and why for example some commit homicidal acts that brings them to the attention of the law whilst others terrorise society through institutions and function within the law. The whole book is essentially about 'understanding' madness.
The book is about madness. It talks mainly about psychosis and schizophrenia but also touches about other forms of madness and their various manifestations. More than that, the main thread running through the book is one challenging how we perceive the above phenomena. It challenges many concepts of perception and this is one particular thing that made me stick with it, there is a novelty to it.
For example, in general, people who go to therapy may fall into the trap of being told how they should adjust to society, adjust to what is normal, adjust to how they should think etc, but the author challenges the therapist imposing their own conception, their own view on their patient.
The emphasis on social adjustment carries many dangers, as it risks neglecting the unique and idiosyncratic formulae for living that many psychotic subjects have developed. Rather than telling someone how to live, what matters is to find what it is in their own history that has helped them, what points of identification or idealization, what activities or projects: what is there in their delusion, perhaps, or in their family history that is reliable and stable, what 'good objects' are there that could be encouraged and supported? Social adjustment, indeed, can lead to catastrophe if the therapist pushes the subject to engage in some activity or relationship that is socially valorized, yet, because it introduces a symbolic position, has nothing to support it.
Suggesting that someone take a job, or go on a date, for example, may be unproblematic in some cases, but in others may trigger or exacerbate pyschosis. In these instances, the subject is being pushed by the desire of the other - to be a boss for employees, to be a man for a woman - and may not be able to cope with the symbolization that this entails. Likewise, the social imperatives to 'achieve' and to 'act' may lead the therapist to encourage the subject to undertake some activity when in fact it is essential to them that it remain forever unrealized, always situated in the future.
He offers a view that is interesting in my eyes
Likewise, anyone undertaking such work would be well advised to question their own fantasies of helping or curing others. As Lewis Hill pointed out, 'The phrase, 'to help human beings' can both conceal and indicate motives motives to set oneself up as superior to and condescending towards patients, motives to dominate and control and force patients into preconceived patterns of behaviour, and even motives to achieve distinction by way of morbid self sacrifice and self punishment.' A psychotic subject can understand this very swiftly and quite rightly, show scepticism. As a schizophrenic woman objected to her therapist at the end of their first consultation, 'How can you claim to care about me if we've only just met?' And if the therapist just cared about all distressed human beings, how could she recognize the particularity of the patient in front of her? Her work would be sustained by rescue fantasy that would effectively block her from hearing her patients
Another tidbit,
Taking seriously the theory of ordinary madness has radical consequences for the society we live in. If we accept that there is a fundamental difference between being mad - which is perfectly compatible with everyday life - and going mad - which will be triggered by certain situations - we can learn to respect the different practices that individuals invent to stabilize their lives. Sometimes, these fit in well with accepted social practices, and sometimes they don't. But once we recognize that they are attempts to create solutions, we can hopefully question any project to bring them back to a normative set of beliefs and values.
Acknowledging this fact will have a crucial clinical consequence. As we have seen, many of the strange and seemingly bizarre practices of psychotic subjects are efforts to find a cure for the primary experiences of terror, fragmentation and invasion. Any treatment plan that confuses these two sets of phenomena will be hazardous, and undermining the person's attempt at self cure can have catastrophic effects. Psychotic subjects are always busy here, naming, creating, assembling, inventing and documenting, and to question or try to excise such activities risks depriving the subject of what is most vital to them. The fruits of such activities do not have to be of any social use or even to make sense: they can be quiet or noisy, private or public, communicative or contained.
Campaigns to destigmatize so-called 'mental illness' often take a wrong turning here. They try to demonstrate how sufferers of some condition have made amazing contributions to the sciences or the arts. Trying to destigmatize the diagnosis of autism, for example, we read how Einstein or Newton would have received that diagnosis today, and yet made fabulous discoveries in the field of physics. Even if they are acknowledged to have been 'different', their worth is still reckoned in terms of how their work has impacted on the world of others. However well intentioned, such perspectives are hardly judicious, as they make an implicit equation between value and social utility.
Taking this step is dangerous, as the moment that human life is defined in terms of utility, the door to stigmatization and segregation is opened. If someone were found to be not so useful, what value then, would their life have?
It also perception of being able to distinguish between sane & insane people
By the late 1970s, madness had become increasingly equated with its visible symptoms, those that drugs took as their targets.
In his famous study, David Rosenhan arranged for 8 'sane' people - 3 psychologists, a paediatrician, a psychiatrist, a painter, a housewife and psychology professor Rosenhan himself - to seek admission to 12 different American hospitals. None of them had any reported symptoms, yet they were instructed to complain, when seeking admission, of hearing voices that said the words 'Empty', 'Hollow' and 'Thud'. After this, if admitted, they were to simply conduct themselves as usual and report no further occurence of the voices. This all proved even easier than expected. All but one were admitted with the diagnosis, 'schizophrenia', and all of them were discharged with the diagnosis, 'schizophrenia in remission' after stays of between a week and 2 months. They were prescribed nearly 2100 pills, from a wide variety of different drugs. Remarkably staff seemed to have no awareness that these were 'pseudo-patients', but inmates were often suspicious: 'You are not crazy. You are a journalist.' as one patient said.
After reporting these initial findings, Rosenhan then told the staff at an important research and teaching hospital that he would be conducting the experiment again at some point during the next 3 months. Staff were asked to rate admissions according to a scale of probability that they were pseudo patients. 83 patients were deemed pseudo by one or more members of staff, when in fact, Rosenhan in a double bluff, had not dispatched a single one of his recruits to the hospital. Yet, despite this, all these diagnoses had been made. Without wishing to deny the gravity of mental distress, his study had challenged the assumption that the sane and the insane could be distinguished so clearly.
Beyond the above, it goes deeper into a criticism of the modern focus on external behaviour in terms of mental health, that the distinction between surface and depth has been obliterated and that this naturally generates more and more clinical categories: every aspect of the human condition can now become a disorder. Conversely, conformist surface behaviour can hide a serious underlying problem: think for example, the case of Harold Shipman. He murdered more than 250 people, yet worked for years as a respected GP, earning the admiration of the community he served. He was kind, considerate and an excellent listener, yet at the same time, he was carefully killing off many of his patients. When psychiatrists examined him, they could find no clear indication of 'mental illness.' It is the very absurdity of this result that should make us realize that the DSM system of mental health diagnosis is totally off the rails.
The books goes on and on about many things I personally found quite interesting, that to me truly introduced new things into my mind. So much so that I'll have to explore some of the things further as I truly think the author touched upon some things that were truly profound. However, it also had things that didn't resonate with me so for this reason, I recommend it at your own discretion.
It's also a shame that he didn't touch upon what we call the psychopath as a category of its own (as many people would see Shipman as a psychopath for example) as it'll have been interesting to know exactly what goes on in the depths of their being and why for example some commit homicidal acts that brings them to the attention of the law whilst others terrorise society through institutions and function within the law. The whole book is essentially about 'understanding' madness.