"Madness was finding oneself
permanently in an all-embracing unreality. I called it the Land of Light because
of the brilliant illumination, dazzling, astral, cold, and the state of extreme
tension in which everything was, including myself. It was if an electric current
of extraordinary power ran through every object, building until the whole blew
up in a frightful explosion."
Renee, Autobiography of a Schizophrenic Girl
When I use the words 'madness' or 'psychosis' I am not seeking to encapsulate in a rigidly descriptive form those sets of behaviours and ways of thinking which have come to be regarded as at odds with what may be loosely described as 'consensual reality'. Rather, in a more phenomenological spirit of enquiry we should regard these terms as open-ended entities replete with interpretive possibilities. To begin with then, we must put forward what we regard as the common ground. All experients share one thing in common, of which we can be sure; the body. The primary phenomenon in psychosis as it appears to me has already been identified by Lacan but as is so often the case his followers, unaware it seems of the riches bequeathed them have inexplicably relegated it to the peripheries. I'm speaking about the so-called 'invasion of jouissance' that in most perceptive accounts, such as Renee's above, is experienced as altogether overwhelming and literally 'electrifying'.
From the point of view of the experient the 'invasion of jouissance' is nothing other than an immensely powerful feeling and like all feelings it will, if allowed, run its natural course. Deleuze and Gauttari define the task of schizoanalysis as facilitating the process not arresting it, 'not making it turn about in the void, not assigning it a goal'. They warn against the reterritorializations that arrest the process or assign it goals, for the 'new earth' they argue coincides with the completion of the process of 'desiring-production'. It will obviously be registered by the corporate controlled inscriptive machinery of biomedicine as entirely endogenous but it's ultimate source has come from the steady incorporation of impressions from without.
Psychiatry has, in its own way, placed it at the forefront of their intervention strategy and has developed a veritable battery of weapons with which to confront it. This is not to say however that any attempt has been made to interpret this alteration in bodily chemistry outside of a strictly circumscribed biochemical framework. What is more when the attempt to give meaning to these undoubted alterations is fashioned and put forward it is done so predominantly in a highly negativised form; that is to say it has been medicalised. The functional changes observed in the PET and MRI scans are assumed to be debilitating because the patient being screened has been diagnosed with schizophrenia or bipolar disorder which, as everybody knows, are 'illnesses' and thus whatever differences are shown to be present must be 'pathological'. In point of fact, what the phenomenon of psychosis indicates more than anything else is the presence not of a debilitated organ but of a highly functional apparatus of perception whose component parts seem to be operating too well.
In the most cited functional neuroimaging studies that have been carried out on 'manic' patients activity is shown to be; 'increased in left anterolateral' (of frontal lobe and in comparison to depressed patients), increased in right ventral anterior cingulate' (of frontal lobe), increased in right ventral striatum (of basal ganglia)', increased in frontal lobe' (in 7 of 11 subjects), increased in temporal lobe' (11 out of 11 subjects), increased in ventral anterior cingulate' (of frontal lobe), and increased in dorsal anterior cingulate' (of frontal lobe). I only found two studies on 'manic' patients where a decreased level of activity was registered; Rubin et al (1995) and Blumberg et al (1999). In both these cases, however, all subjects were under medication and in the former it was still noted that there was 'greater left hemisphere regional cerebral blood flow (rCBF) in mania compared to depression in the inferior prefrontal cortex'. (1)
This increased functionality is interpreted by the meaning-making apparatus of psychiatric intervention as indicative of 'defect' or 'disease' as though there was an eternal blueprint of the mind given to us by a Creator from which deviations constitute the sign of a defect or faulty functioning. Well, there was and is no blueprint; no original template from which we can say with confidence that the functional changes observed in the brain's metabolism is indicative of a fault or defect let alone an illness or disease. The fact of the matter is that the brain has evolved like the rest of the body and it's organs according to the often arbitrary and haphazard selection pressures induced upon the organism by the external environment. The current thinking, in fact, attributes the massive growth of the cerebral cortex as a result of the benefit obtained by our hunter-gatherer forebears in having a spongy insulator to preserve them from the heat of the mid-day sun whilst foraging in the savannah.
These same evolutionary principles have seen fit to leave some 2% of the population prone to recurrent 'psychoses' and I think its about time mental health professionals began to give serious consideration as to what the likely reasons for this may be. What we have before us in fact, from the evolutionary perspective, is an organism that on a cyclical basis and presumably in response to a perceived threat has evolved the obviously beneficial adaptive capacity to accelerate its own metabolism thereby providing copious amounts of energy to both a primed musculature and the organ in charge of its successful coordination; the brain. So let us be clear on this point; the alteration in bodily chemistry is simply the phenomenon whereas the immense semantic apparatus marshalled in to make value attributions is the ideology. If there is a value attribution to be accorded these functional changes let us please encourage the individual concerned to make it.
We have been talking about the manner by which a particular experience has had its meaning shaped and interpreted for us by the institution of psychiatry. I have attempted elsewhere to show that the dogmatic assertion of this meaning has led to and continues to lead to basic human rights infringements. Most of all what I have tried to get across is that our understandings of what 'psychosis' constitutes, what it is as an experience, are derived almost entirely from the hegemonic narratives emanating from a particular institutional form. What William James, in particular, has highlighted in his work is the similarity if not identity that prevails between the powerful experiences that occasioned the birth of the major religions and the present day designation of psychosis. Data emerging from MRI scans on experients show what they themselves already know; there is more activity, more energy, there is a perceptual overload.
In the past, what was perceived during the ecstasy of engagement gave sufficient impetus and conviction to change the course of history. We have today received notions as to what God and religious faith mean. Today these notions have been seemingly dismantled by the 'advance of science'. In the earliest times these matters were raw and their practice embedded in people's daily lives. It is clear that we have lost what religion meant. We are jaded today not with what it originally meant but with what it has become. Let us allow the possibility that in this condition of heightened functionality the bodily apparatus is perceiving something that is ordinarily veiled from perception.
Let us further propose that 'psychosis', the medical understanding of the term, is certainly real and possesses all those characteristics that are normatively attributed to it, but yet, let us also allow that these symptoms (delusions, voices, sleeplessness, agitation, increased sensitivity) are the inevitable result of the mind's attempt to account for what it cannot explain. It is a condition marked by an encounter with the Real; an encounter moreover that cannot be properly symbolised. A heightened perceptual apparatus imbued with an abundant store of energy far more than is normally required to sustain itself is found too, among other members of the animal kingdom, such as the lepidoptera - which is why we are justified in referring to the metabolic changes wrought by psychosis as instead an instance of a 'Chrysalis of the Foreclosed', that is to say, a contemporary Lamarckism.
(1) Increased Anterior Cingulate and Caudate Activity in Bipolar Mania, Hilary P. Blumberg et al, Biol Psychiatry 2000;48 1045-1052.
Renee, Autobiography of a Schizophrenic Girl
When I use the words 'madness' or 'psychosis' I am not seeking to encapsulate in a rigidly descriptive form those sets of behaviours and ways of thinking which have come to be regarded as at odds with what may be loosely described as 'consensual reality'. Rather, in a more phenomenological spirit of enquiry we should regard these terms as open-ended entities replete with interpretive possibilities. To begin with then, we must put forward what we regard as the common ground. All experients share one thing in common, of which we can be sure; the body. The primary phenomenon in psychosis as it appears to me has already been identified by Lacan but as is so often the case his followers, unaware it seems of the riches bequeathed them have inexplicably relegated it to the peripheries. I'm speaking about the so-called 'invasion of jouissance' that in most perceptive accounts, such as Renee's above, is experienced as altogether overwhelming and literally 'electrifying'.
From the point of view of the experient the 'invasion of jouissance' is nothing other than an immensely powerful feeling and like all feelings it will, if allowed, run its natural course. Deleuze and Gauttari define the task of schizoanalysis as facilitating the process not arresting it, 'not making it turn about in the void, not assigning it a goal'. They warn against the reterritorializations that arrest the process or assign it goals, for the 'new earth' they argue coincides with the completion of the process of 'desiring-production'. It will obviously be registered by the corporate controlled inscriptive machinery of biomedicine as entirely endogenous but it's ultimate source has come from the steady incorporation of impressions from without.
Psychiatry has, in its own way, placed it at the forefront of their intervention strategy and has developed a veritable battery of weapons with which to confront it. This is not to say however that any attempt has been made to interpret this alteration in bodily chemistry outside of a strictly circumscribed biochemical framework. What is more when the attempt to give meaning to these undoubted alterations is fashioned and put forward it is done so predominantly in a highly negativised form; that is to say it has been medicalised. The functional changes observed in the PET and MRI scans are assumed to be debilitating because the patient being screened has been diagnosed with schizophrenia or bipolar disorder which, as everybody knows, are 'illnesses' and thus whatever differences are shown to be present must be 'pathological'. In point of fact, what the phenomenon of psychosis indicates more than anything else is the presence not of a debilitated organ but of a highly functional apparatus of perception whose component parts seem to be operating too well.
In the most cited functional neuroimaging studies that have been carried out on 'manic' patients activity is shown to be; 'increased in left anterolateral' (of frontal lobe and in comparison to depressed patients), increased in right ventral anterior cingulate' (of frontal lobe), increased in right ventral striatum (of basal ganglia)', increased in frontal lobe' (in 7 of 11 subjects), increased in temporal lobe' (11 out of 11 subjects), increased in ventral anterior cingulate' (of frontal lobe), and increased in dorsal anterior cingulate' (of frontal lobe). I only found two studies on 'manic' patients where a decreased level of activity was registered; Rubin et al (1995) and Blumberg et al (1999). In both these cases, however, all subjects were under medication and in the former it was still noted that there was 'greater left hemisphere regional cerebral blood flow (rCBF) in mania compared to depression in the inferior prefrontal cortex'. (1)
This increased functionality is interpreted by the meaning-making apparatus of psychiatric intervention as indicative of 'defect' or 'disease' as though there was an eternal blueprint of the mind given to us by a Creator from which deviations constitute the sign of a defect or faulty functioning. Well, there was and is no blueprint; no original template from which we can say with confidence that the functional changes observed in the brain's metabolism is indicative of a fault or defect let alone an illness or disease. The fact of the matter is that the brain has evolved like the rest of the body and it's organs according to the often arbitrary and haphazard selection pressures induced upon the organism by the external environment. The current thinking, in fact, attributes the massive growth of the cerebral cortex as a result of the benefit obtained by our hunter-gatherer forebears in having a spongy insulator to preserve them from the heat of the mid-day sun whilst foraging in the savannah.
These same evolutionary principles have seen fit to leave some 2% of the population prone to recurrent 'psychoses' and I think its about time mental health professionals began to give serious consideration as to what the likely reasons for this may be. What we have before us in fact, from the evolutionary perspective, is an organism that on a cyclical basis and presumably in response to a perceived threat has evolved the obviously beneficial adaptive capacity to accelerate its own metabolism thereby providing copious amounts of energy to both a primed musculature and the organ in charge of its successful coordination; the brain. So let us be clear on this point; the alteration in bodily chemistry is simply the phenomenon whereas the immense semantic apparatus marshalled in to make value attributions is the ideology. If there is a value attribution to be accorded these functional changes let us please encourage the individual concerned to make it.
We have been talking about the manner by which a particular experience has had its meaning shaped and interpreted for us by the institution of psychiatry. I have attempted elsewhere to show that the dogmatic assertion of this meaning has led to and continues to lead to basic human rights infringements. Most of all what I have tried to get across is that our understandings of what 'psychosis' constitutes, what it is as an experience, are derived almost entirely from the hegemonic narratives emanating from a particular institutional form. What William James, in particular, has highlighted in his work is the similarity if not identity that prevails between the powerful experiences that occasioned the birth of the major religions and the present day designation of psychosis. Data emerging from MRI scans on experients show what they themselves already know; there is more activity, more energy, there is a perceptual overload.
In the past, what was perceived during the ecstasy of engagement gave sufficient impetus and conviction to change the course of history. We have today received notions as to what God and religious faith mean. Today these notions have been seemingly dismantled by the 'advance of science'. In the earliest times these matters were raw and their practice embedded in people's daily lives. It is clear that we have lost what religion meant. We are jaded today not with what it originally meant but with what it has become. Let us allow the possibility that in this condition of heightened functionality the bodily apparatus is perceiving something that is ordinarily veiled from perception.
Let us further propose that 'psychosis', the medical understanding of the term, is certainly real and possesses all those characteristics that are normatively attributed to it, but yet, let us also allow that these symptoms (delusions, voices, sleeplessness, agitation, increased sensitivity) are the inevitable result of the mind's attempt to account for what it cannot explain. It is a condition marked by an encounter with the Real; an encounter moreover that cannot be properly symbolised. A heightened perceptual apparatus imbued with an abundant store of energy far more than is normally required to sustain itself is found too, among other members of the animal kingdom, such as the lepidoptera - which is why we are justified in referring to the metabolic changes wrought by psychosis as instead an instance of a 'Chrysalis of the Foreclosed', that is to say, a contemporary Lamarckism.
(1) Increased Anterior Cingulate and Caudate Activity in Bipolar Mania, Hilary P. Blumberg et al, Biol Psychiatry 2000;48 1045-1052.
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