You Must Be Crazy to Read This
I heard that the difference between neurotic and psychotic is this: if someone believes they have a problem, and we don’t, they’re neurotic. If we believe they have a problem, and they don’t, they’re psychotic. This tongue-in-cheek remark (I forget the source) points us in the direction of the problems we are facing when attempting to understand mental illness.
The more serious issues have been under discussion for over half a century. Amongst the ‘big guns’ who began to challenge the concepts of madness in our society were R.D Laing and Thomas Szasz. They were already questioning the methods and morality of our contemporary Western approach to dealing with people with emotional or social difficulties in the 1950s. Remember that psychiatry as a separate discipline within medicine and psychotherapy as a self-proclaimed ‘science’ are only a little over 100 years old. So for at least half of that time, prominent and properly trained doctors, psychiatrists and other qualified individuals have questioned and offered serious and well considered challenges to the very premises on which the modern attitude towards mental illnesses claims to rest.
Books have been published, seminars held and opinions disseminated. But we are preaching to the choir and we are not really a whole lot closer to changing the dominant approach held by conservative science and medicine, which is still taught in universities and supported by government funding and state-run institutions around the world. And the vast array of modern ‘new age’ and holistic health movements notwithstanding, it seems that the traditional views of classifying all mental conditions, including emotional disturbances and eccentric behaviours as ‘illnesses’ and thereby legitimising their treatment by doctors with chemicals and other biological means like shock-treatment or even brain surgery, is increasing, rather than diminishing. The Prozac revolution and the billions spent on the chemical treatment of depression would support the view that more ground has been lost than gained even in the past 15 years. James Hillman is one of several prominent contemporary writers who is outspoken on this matter. As he reminds us, “Depression is still the Great Enemy. More personal energy is expended in manic defences against, diversions from, and denials of it than goes into other supposed psychopathological threats to society: psychopathic criminality, schizoid breakdown, addictions.” (Cf. Hillman, A Blue Fire, p153)
In truth, these questions were raised long before modern times. Otto Rank and others in the early part of the 20th century questioned the legitimacy of the methods used to treat people with emotional difficulties or behavioural differences, and these challenges go all the way back through the history of the Western approach to mental illness. It is, for example, disturbing to read the views of Benjamin Rush, the so-called ‘Father of American Psychiatry’ and his ‘treatment by fear’ methodology, in the early 19th century, or the views and treatment methods of Charcot in France in the late 19th century. We can only wonder how these men could have been allowed to promote and encourage others to follow views that are so inconsistent with any concept of basic human dignity and respect. Both of these men wielded considerable power and influence and their opinions have continued to influence even contemporary views on the subject. There were always individuals who challenged these views, but these were in the minority and they were either tolerated or marginalised within their communities. Of course, the main stream opinion makers were not able to accomplish their dominance single-handed and they were very ably assisted by hoards of medical sycophants, who, like civil servants agreeing to whatever bad decisions their boss made so as to secure their own livelihood and to further promote themselves, went along with the ‘discoveries’ made by their seniors. Even Freud, obviously a heavy-weight in his own right, was somewhat under the Charcot spell and parts of the interaction between these two men is dealt with in Thomas Szasz’s important book, The Myth of Mental Illness.
What Szasz argues is that mental illness is an artificially constructed category designed to contain, limit or render impotent any person whose behaviour or moral values are perceived by their peers as being disruptive, confusing or simply uncomfortable. Laing’s main argument is that the ‘insane’ person is actually the only sane member of an insane family, who develops their behaviour precisely as a survival mechanism, to escape being drawn into what Camille Paglia would later call ‘the family romance’. In fact, as Szasz, Laing and many others before and after have argued, most of the individuals diagnosed with ‘mental illness’ are simply men and women going though life’s inevitable difficulties, who, if properly understood and offered containment and support for a period of time, would likely recover and be able to resume useful lives. Obviously, this might necessitate that the ‘patient’ lives under different circumstances to what had been before, and so that is not likely to attract the support of those who prefer to contain, rather than free, those over whom they previously exercised control. Labelling and consequently stigmatising people, by classifying conditions like ‘hysteria’ (the catch-all description in the late 19th and early 20th century for any woman who behaved other than what was expected of her), schizophrenia, manic-depression (now called bi-polar), obsessive-compulsive behaviours, major or minor depressions and a whole range of increasingly subtle sub-categories and variations of so-called ‘illnesses’, often with grandiose Latin names, are in reality an increasingly complex smoke screen that allows medical doctors, who at most should deal with brains, to legitimise their hostile take over of the territory of minds and souls. Szasz reasons, “I hold that mental illness is a metaphoric disease; that, in other words, bodily illness stands in the same relation to mental illness as a defective television receiver stands to an objectionable television programme.. When we call minds ‘sick’ we systematically mistake metaphor for fact, and send the doctor to ‘cure’ the illness. It’s as if a television viewer were to send for a TV repairman because he disapproves of the programme he is watching.” (Szasz, Myth, p11)
It is important to understand at this point that we are not discussing those behaviours that have an organic origin, that is, where there is some disease of the brain which affects and consequently impacts on thinking and behaviour. Everyone is agreed that in these circumstances, we are rightly talking about ‘mental illness’ and under these circumstances, modern medicine has made enormous breakthroughs and is of tremendous value. Furthermore, it is also accepted that medical science, like all science, is constantly making new discoveries and so behaviours that are unexplained today may be explained by medicine tomorrow. But this ‘grey area’, of supposed diseases, with ‘as yet undiscovered’ origins, is not a blank cheque for the medical fraternity to label any and every emotional or behavioural disturbance as ‘mental illness’ which would then, like physical illness, fall in the arena of medicine and consequently be legitimately treated by doctors as a special type of medical disease.
In the face of so much contemporary literature, so many prominent and respected figures taking a stand against “the liquid cosh” approach to dealing with emotional and behavioural conditions by predominantly chemical means, I suppose we should ask why main stream views have been so difficult to influence. The same arguments could be had about the state of big business and multi-national companies versus the ecological health of the planet, the corruption of political dictators versus the basic welfare of the people living in those countries or the hierarchies of religions and the manipulation of religious dogma versus the spiritual rights of all human beings. These situations are as old as the history of the world and always go back to power, greed and the desire to control others for personal gain. This paper is not the place to go into the matter further. Suffice to say that the world of modern medicine, with the personal status in society of medical practitioners on the one side, and the vast amounts of profit to be made by drug companies on the other, is no different from any other system where power and personal gain are king, and damn the damage or consequences.
Simply put, and especially so far as ‘mental illnesses’ are concerned, the fundamental issue at stake here is that the contemporary Western view followed the materialist philosophy of the late 19th and 20th century, which dismissed any spiritual values or experiences as irrelevant or nonsense. By the end of the 19th century, this anti-spiritual attitude was specifically supported by Freud’s view that any spiritual inclination was, in the final analysis, an infantile regression, an immature and childish longing for something nonexistent and nonsensical that ultimately needed to be outgrown. This view, and the Behaviourist, Rational-Emotional, Object Relations and other therapies that mushroomed around this materialist outlook, still dominates the majority of psycho-therapeutic teachings and practices in most places of the world.
The rise of Scientific Materialism, supported by the acceptance and eventual dominance of the post-Darwinian approach to nature and post-Marxists view on society, consolidated the view by the end of the 19th century that, as Nietzsche maintained, “God is dead”. The decline in spiritual awareness, consciousness and practice originally took hold as a reaction against oppressive religious and state control in the previous century. In the emerging fields of psychology and psychiatry at that time, this view was supported by pseudo-scientific opinions on the management of the insane, where socially condoned tortures and cruelty in institutions replaced the Church sanctioned work of the Inquisition. Many of the same people were targeted and for essentially similar reasons, that is, that their behaviours did not conform with the opinions of those who determined what was, and what was not, ‘acceptable social behaviour’ and who also had the power and authority to carry out their judgement. Those who were unwilling to be easily convinced of the ‘errors of their ways’ were punished and coerced until they did change and those who would not change were permanently institutionalised and, unless they had money and influence, were for the most part brutally tortured. Some of the terrifying history of all this can be read in Szasz’s The Manufacture of Madness and several other publications. The shocking history of Western medicine’s 200-year affair with sexuality, particularly the evils of masturbation, and the punishments handed out in the name of medical treatment, can be found in Alex Comfort’s book, The Anxiety Makers.
In many instances, those classified as ‘mentally ill’ were ordinary people, perhaps more sensitive that most, who were unable or unwilling to adapt to a lifestyle that was to them unacceptable. For example, countless women in sexually, physically and economically abusive relationships were diagnosed as ‘hysterical’ when they reacted against their oppression. In previous times, their strange behaviour would have seen them classified as witches and they would have been put on trial and usually killed, for being ‘odd’, for example, by not submitting to endless sexual violence without complaint. Now, in the more ‘humane’ times of the comically named “Age of Enlightenment” they were called ‘ill’ and treated in a variety of ways, from the kind village doctor’s ‘pelvic massage’ that resulted in a temporary ‘release of tension’, to the permanent incarceration of those less fortunate, whose husbands had found an easy and legal way to rid themselves of a wife no longer wanted. Any man or woman with any sort of idiosyncratic or ‘odd’ behaviour could be accused of ‘insanity’ instead of ‘heresy’. Exactly as had happened during the Inquisition, to accuse someone, it was sufficient to have as ‘evidence’ the testimony of those who had witnessed the ‘bad’ behaviour and the accused was guilty until proven innocent. Instead of the Church, through its appointed agents, the licensed priests of the Inquisition, convicting the accused, apparently for their own moral and spiritual good and punishing them if they did not renounce their evil ways (although even if they did, this did not always save them), now Society, through its appointed agents, the licenced doctors of the Scientific Community, convicted the patient, apparently for their own moral and social good, and punished them if they did not renounce their disruptive ways (although even if they did, this did not always save them.)
However, there was another group of individuals whose behaviour was more than socially disruptive, in the sense implied by the above. These were individuals with unreasonable phobias such as of insects, closed spaces or physical intimacy, debilitating bouts of anxiety and depressions, episodes of mania, delusions or paranoia and any number of other conditions that, by their incapacitating nature, did legitimately require some sort of intervention by those who were concerned about and cared for those afflicted. It is to Freud’s credit that he developed a method of uncovering and interpreting information, usually suppressed memories of the experiences during childhood and early life, that held the key to explaining subsequent adult behaviours. Properly brought into consciousness, the emotions that these experiences held could then be released and the individual was then often better able to deal with their life’s circumstances. Notwithstanding the extent to which he was limited by his historical and cultural milieu, Freud’s Psychoanalysis was properly the beginning of the psychotherapeutic method as we understand it today.
What Freud and many of those who followed him had discovered was a way to access the biographical information of an individual’s life. This in turn rested on the concept of the Personal Unconscious, a vast area of the mind where memories, thoughts, feelings and desires that were uncomfortable, inappropriate or unsafe went to hide. It took the genius of Jung to add the concept of a Collective Unconscious, in addition to the personal repository, to complete the picture and lead us into the more progressive psychological understandings of the 20th century. Subsequent developments and research made us aware that, in dealing with the issue of ‘mental illness’ it was not sufficient to deal with life’s difficulties, based only on the ‘biographical’ material. There were other realms to be considered.
Based on these insights of Jung and several other original thinkers in the first part of the last century, the subsequent work of Erich Fromm, Abraham Maslow and countless other individuals, especially those associated with the Transpersonal Movement in psychology from the 1960s onwards, brought back the spiritual aspirations and desires of ordinary human beings as both valid and essential aspects of understanding human experience. For many people, their crises were in fact the outward physical expression of a process of inner transformation that could lead to spiritual healing. These ‘mad’ episodes, if properly managed, were often the potential markers of deep and profound personal growth. Stanislav Grof and others, working from the 1960s onward, also began to map out and correlate both the nature of these episodes and the outcome of these crises when properly managed. In addition to using the biographical information, that is, the actual experiences that are retrievable by conscious memory in an individual’s life, Grof helped to consolidate the work in two additional categories of experience that are relevant in understanding and integrating unusual behaviours, the Perinatal and the Transpersonal. In continuing the work of Assagioli, Wilhelm Reich and others, Grof advanced a more developed and coherent theory of perinatal experiences, that is, from conception until a period after birth, and the impact of these experiences on adult behaviour. And in continuing the work of the Transpersonal Movement in understanding the spiritual dimensions of human growth, Grof and others began the work of systematically mapping out the varieties of transpersonal experiences. Grof also pioneered a body-based procedure, Holotropic Breathwork, as a means to more easily access both perinatal and transpersonal material.
It seems unreasonable and even unfair to single out only the few individuals that I have named in the above paper. Joseph Campbell’s seminal work on archetypes and mythology generally and specifically on the Hero’s Journey motifs, added profound insights from ancient to modern traditions. Mircea Eliade, writing as a commentator on religious rather than psychological experience, made original and startling contributions to our understanding, offering us insight into universal rituals and the roots of spirituality, dealing in detail with Yoga, Shamanism and early Alchemy. Jung single-handedly recovered Alchemy as an authentic Western mystical path from the garbage dump of folk tales and superstition. By the end of the 20th century, James Hillman had almost single-handedly re-visioned psychology based on and developed out of Jung’s work, adding profound insight from his own extensive scholarship. Arnold Mindell has seamlessly merged countless body-based therapies with his own insights into Jung, classic Shamanism and Quantum physics. These are only a few of those who have opened up new ways of understanding the mind and soul.
What is significant is that every one of those mentioned above, together with the thousands of other men and women who have also made essential contributions to developing our understanding of human consciousness and its varieties, all agree that the classifications of ‘mental illness’ that are still be used by the ‘authorities’, still being taught in medical schools, still being funded by government and sponsored by large drug companies, are morally wrong and scientifically unsound. They are a few of the people who have preceded us in the type of work that we have undertaken to learn and to teach. When we stand on the shoulders of giants, we can see far.