Subjectivity: Ethnographic Investigations

PART III. MADNESS AND SOCIAL SUFFERING

part iii Madness and Social Suffering • • • • • Madness or psychotic illness fundamentally challenges local understandings of human nature, as well as the theorization of subjectivity. Societies and individuals understand madness in various ways: as possession by haunting spirits, a flight from reason, a regression to childlike or primitive states, an essential mode of being in the world and a distinctive form of human subjectivity,the entry into an alternative world,or a mode of deeply disturbed and pathological subjectivity reflecting disordered brain chemistry . Whatever the interpretation, the chaotic and disturbing qualities of psychosis are deeply threatening to those undergoing the experience as well as to their families and communities. Those in the social environment of persons who are psychotic often feel threatened, fearing physical violence; feeling uneasy and anxious about the uncanny qualities or shocking behaviors of those who are psychotic, as well as their disregard for propriety and morally sanctioned order; or harboring a broader sense that madness represents a fundamental cosmological threat. These feelings lead to powerful social responses, often in the name of healing , restoration of order, or the protection of those who are ill. These responses in turn can redouble suffering, constituting madness as a social threat and redirecting violence to the vulnerable individual. At the same time, the language of madness is widely used to represent and respond to everyday forms of impropriety—are you crazy?!—or to articulate and analyze larger modes of social action that suspend ordinary social or moral rules, or permit forms of mass consciousness or “mob behavior ” to overtake everyday forms of rationality. These actions include the orgiastic or pleasurable, present in the liminal moments of ritual or celebration , but also mass violence, in which participants may commit unspeakable horrors. Such irruptions of violence or urges to act out the for237 238 / Madness and Social Suffering bidden evoke questions about the part of subjectivity that is normally repressed , the “primitive” qualities of human nature, and ultimately the essence of human nature. The fluid movement of references to madness across these terrains—the disordered experience of individuals in psychotic states or with major mental illnesses and the forms of violence (or pleasure) that dislocate ordinary assumptions about the rational or moral bases of human nature—make theorizing about madness or psychoses important to our thinking about subjectivity. And the illusive, disorienting quality of psychotic experience and utterances—at once fragmented and incoherent but subject to moments of brilliant insight that reveal normally hidden aspects of the psyche and the social world—challenges theories of subjectivity that rest on everyday assumptions about normal psychology. We should not be surprised that fundamental assumptions about human nature, social order, and human diversity permeate, often surreptitiously, medical theorizing about psychosis or psychotic experience.Emil Kraepelin, who is often considered the founder of descriptive psychiatry, developed a mode of psychiatric theorizing that he claimed was theoretically neutral. However, Kraepelin’s assumptions about the genetic and physiological bases for mental diseases (plural) produced a deeply biological vision of the subject and subjective experience—casting the mentally ill as a medicalized subject—that remains powerful in much of psychiatry today. Hidden in Kraepelin’s work are assumptions about disorders of the will and basic assumptions about degeneracy that are less obvious (Barrett 1996;Good 2003; Pick 1989). Kraepelin came to believe that dementia praecox, or schizophrenia , is a permanent, deteriorating condition, leaving the sufferer little or no chance for recovery. This view, which turns out to be empirically wrong,is rooted in an old understanding of schizophrenia as a disease of degeneracy , the end of a genetic decline causing “degenerate” families, ethnic groups, and whole societies to have clusters of alcoholics, criminals, mentally retarded people—and persons with schizophrenia. This view, based in colonial theorizing about human evolution, provided the rationale for notorious laws permitting sterilization of persons with schizophrenia or mental retardation and led to deep pessimism about schizophrenia among psychiatrists and the public alike, a view that persists to this day. But not only among biological psychiatrists, of course, have social ideologies and medical theories commingled in the analysis of psychotic disorders . Psychoanalysis and neurobiology share a language of primitivism, pointing on the one hand to forms of “regression” and the emergence of “primitive” impulses or affects and, on the other, to “primitive” aspects of the human brain (Lucas and Barrett 1995). Although offering data on [3.140.185.147] Project MUSE (2024-04...