Wrong thinking? Time to rethink. Psychiatry is not a science but a construct!

On the 30^th of March 2017 the American Academy of Religion (AAR) accepted my proposal for their next conference – this is it:

Acute Religious Experiences – Disability or What?

“Mad Studies” is an emerging field within the Academy, originating in Canada in the work of scholars such as Robert Menzies, Geoffrey Reaume and Brenda LeFrançois who edited Mad Matters: A critical reader in Canadian mad studies. (Menzies 2013); Richard Ingram at the Simon Fraser University in Vancouver and David Reville, Kathryn Church and Jiji Voronka at the School of Disability Studies at Ryerson University. Developments can also be found at UK Universities, including Bridgit McWade, Damian Milton and Peter Beresford who co-authored Mad studies and neurodiversity: A dialogue. (McWade 2015).

Mad Studies acknowledges its debt to Disability Studies, Feminism, Critical Race Theory and LGBT+ studies and, similarly, privileges the relevant experiences of researchers. Mad Studies is the successor to Antipsychiatry (Laing 1967, Cooper 1970) and Critical Psychiatry (Double 2006, etc.). Mad Studies has an evolving relationship with Disability Studies but Beresford (2016) situates Mad Studies within the ambit of Disability Studies.

Much of the current effort in Mad Studies engages particular explorations of Madness as the subject of historical, psychological, sociological, political, legal and medical research and investigation.  But the, non-exclusive, alternative is as an intellectual infestation which seeks to engage, inform and reorientate any acadmeic orthodoxy which currently excludes Madness from its curriculum. It is this latter approach which this paper pursues.

I argue that Madness provides a bigger category which can exceed the need to pathologize which characterizes the domain of Psychiatry. The nosological classifications of the DSM, the ICD and the CCMD find their power in what Max Müller once dubbed ‘Classify and Conquer’. The self-fulfilling completism, which makes Not Otherwise Specified into a major diagnostic category (more than half the morbidity of Schizophrenia) flows from a way of organising knowledge which privileges reification over life experiences. Whilst this flows naturally from Psychiatry’s comorbidity with rise of Modernity and Medicine, Psychiatric classification has become a liability to thinking about extraordinary experiences and practices in a postmodern world.

The bigger picture of Madness is not in opposition to Psychiatry, that would be a return to antipsychiatry and critical psychiatry. Rather it is a different way of seeing which recognises that Schizophrenia is just a metaphor and which returns with metaphors of its own. For example, in the English language there is no name for the dark part of the crescent moon. So, metaphorically, psychiatry can be characterised as speaking to the shiny crescent, but it loses its way in the less visible hinterland of extraordinary experiences. Madness is the whole of the moon.

If Psychiatry is conceptualised as addressing a subset of Madness, Mad Scholars can draw on existing psychiatric theory rather than simply stand against it. For example, in psychiatric epistemology, Schizophrenia is found to be prevalent across the whole human population (WHO 1977) and it involves heritable gene variations (Ripke 2014). As gene variations cannot be retrojected, the only realistic way of explaining these two facts is found in the work of evolutionary psychologists (e.g. Burns, Crow, Nichols) who propose that the heritable gene variation required for Schizophrenia occurred in Homo Sapiens prior to the Diaspora from sub-Saharan Africa more than 100,000 years ago.

From a Mad Studies perspective, the idea of Schizophrenia prior to Eugene Bleuler’s conception of it in 1908 (Bleuler 1911) is an absurd anachronism involving a dubious process of retrospective diagnosis. However, the idea that heritable gene variation took place prior to the Diaspora is of immense value to a bigger theory of Madness. If this is taken seriously (and psychologists who deny all biological argument don’t.) then Madness is a foundational part of Human Diversity. In this new perspective, the susceptibility to Madness is in the World but reconceptualised as no longer necessarily pathological.

The non-ordinary, the extra-ordinary and the incomprehensible continue to present challenges to Modernity, which privileges reason and the repeatability of science. In a Mad Studies world, the objectivity of the criteria of pathology turn out to be the externalisation of presuppositions of a normative theory of the abnormal. This doesn’t eradicate the pathological, but it does cast new light on Psychiatric traditions. The reason why Socrates, Jesus, Mohammed and a host of individual saints; not to mention whole traditions of Shamans, Sufis, Sadhus and Spirit Possessed have been treated as mentally disordered by Psychiatrists is the result of an epistemological struggle of Modernity grounded in a colonial world view against the practices of the supernatural. The pathologization of the spokespeople of extreme non-ordinary states leaves their narrative accounts of Angels, Jinn, Spirit Flight and the direct experiences of God, Spirit, Reality or the Ancestors discredited.

The consequence of removing the myopic Psychiatric need to pathologize frees up the greater category of Madness allowing it to come into view. The application of the term Madness to a prehistoric context is still an anachronism, but a lesser one, grounded in texts from the 14^th rather than the 20^th century. It might seem to be a small gain for those who have seen God to be dubbed Mad instead of Mentally Disordered, but the difference is resolved by the introduction of “Acute Religious Experiences” as a category, a descriptor, a diagnosis. Did Jesus have an Acute Religious Experience during the Transfiguration? Did he see visions, hear voices and undergo all of the manifestations of a Psychotic break? In conventional terms these two questions are incommensurate, unresolvable. In a Mad Studies perspective, the dichotomy between the experience and its explanation dissolves because the pathological presupposition of the word ‘Psychotic’ can be erased.

This erasure operates against the sui generis constructions Religious Scholars have built to defend the weirdness of their subjects against the accusations of the Psychiatrists. In a world where Madness is not a crime and not a means of silencing the strange, I propose that it is time to have a more mature conversation as to whether Acute Religious Experiences are an ability or a disability.