Retreat From the Social: a Review of Hegel’s Theory of Madness

Joanna Moncrieff, MD
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I read some Hegel in a reading group a few years ago and was bowled over by it. So I was excited to find a book that analyses Hegel’s ideas about the nature of madness, and wanted to review it even though it was written 20 years ago.

Hegel may not have been the first to have made this point, but for me his writing brings home, more clearly than any other thinker, the intrinsically social nature of human thought and existence. For Hegel, we come to be the fully-formed and self-conscious beings that we are through our interaction with the external world, an interaction that we make sense of through the concepts (language) we inherit from our social community. Only when we recognise the independent existence of something outside of ourselves do we begin to fully comprehend our own individual existence. We recognise ourselves as ourselves only in as much as we stand face to face with the world, and especially with other beings like us. And we derive the tools for this learning from the society we are born into.

Hegel’s great book the Phenomenology of Spirit traces the journey of human consciousness from a kind of ‘state of nature’ in which we can barely differentiate ourselves from the world around us, to the mature, rational human consciousness of the modern era that recognises itself simultaneously as a self-determining individual and as a part of the collective human ‘spirit.’ In Phenomenology of Spirit, the journey takes place in part through history, with successive historical periods producing ever more evolved forms of consciousness, but it is also to some extent a journey that each individual embarks on from infancy to adulthood. The social and historical circumstances into which someone is born may determine the ultimate state of rationality they can reach, but for everyone there is development from an infantile state of undifferentiated self-absorption and dependency to a self-reflective state in which the individual is able to differentiate between the self and his or her world.

Hegel was a rationalist and an optimist. He was writing in the first half of the 19th century, when the French revolution, industrialisation and the beginnings of modern science held out the promise that people could radically transform their natural and political environment for the better. Widespread disillusionment with modernity, of the sort Nietzsche expressed later in the century, had not yet set in. Despite his criticisms of the French revolutionary Terror, and of the poverty inherent in the emergent capitalist system, Hegel was enthusiastic and optimistic about the process of development of human thought. Hegel is aware, however, that the path of this development is not easy. It is riddled with contradiction and dissatisfaction. It is only through overcoming these obstacles that humankind can reach its full potential, and come to exist in a state of harmony with the world.

Daniel Berthold-Bond’s book, Hegel’s Theory of Madness was published in 1995, and summarises Hegel’s views on madness as set out in various works. Essentially, Hegel views madness as a return to a pre-rational state of being. The self tries to cut itself off from the social world of shared meaning and rationality, and entrenches itself in a private internal world, the “life of feeling” (Hegel, 1978, section 408). This retreat is a response to the inevitable sense of alienation that the self encounters as it tries to grapple with the ‘otherness’ of the world. For Hegel, therefore, madness is a possibility that is inherent in the development of consciousness, because of the pain and frustration involved in its evolution towards a fuller, more developed state.

Berthold-Bond brings out the similarities between Hegel’s view of madness as a retreat to a pre-rational state, and Freud’s concept of the ‘unconscious.’ Both are realms dominated by instincts and feelings, in which the norms of rational thought are forgotten and discarded. For Hegel and Freud, withdrawal into this mode of thought is pathological and undesirable. In contrast, for Nietzsche, the world of private feeling is the more genuine state of being, and the civilised world of conventions only represses the unique creativity of the human spirit.

Freud also believed that the repression of instincts necessary for harmonious social existence, meant that humanity was doomed to unhappiness and dissatisfaction. For Hegel, although the path of the development of consciousness is challenging, the endpoint is a state of greater fulfilment, in which drives and feelings remain present but are successfully sublimated. For Hegel, each successive mode of rational thought incorporates but surpasses its previous forms, and hence the characteristics derived from our basic biological nature are not repressed as Freud and Nietzsche would have it, but become more socially integrated.

Thus Hegel presents madness as a state of social withdrawal from an alienating environment, which plays an integral part in his overall description of the trajectory of human thought. Hegel has little to say about the causes of madness in individuals – that is why some individuals should succumb to this state while others do not – but much to say about why madness should exist in the first place. The contradictions and challenges inherent in the evolution of thought create a constant desire for a simpler world of internal unity and certainty. Madness is therefore in Berthold-Bonds words “a logically necessary potentiality of spirit” (Berthold-Bond, p 50).

Rather puzzlingly, in the last chapter Berthold-Bond equates this view with the idea that madness is a bodily disease, and so contrasts Hegel’s theory of madness to the views of Thomas Szasz and Michel Foucault. He characterises the latter as ‘labelling’ theorists, and appears to believe they both viewed madness as a phenomena that is entirely socially constructed. It is the notion of madness as a disease that is socially constructed, according to these thinkers, however, not the phenomena itself. Szasz referred to the various states that are labelled as mental illness as ‘problems of living,’ but he paid little attention to their phenomenology, and Foucault too was interested in the history of the silencing of madness, rather than its content.

As now, there were contrasting views on the nature of madness in Hegel’s time, with empiricists and somatists arguing for the bodily nature of the condition, psychics arguing for the autonomous existence of the psyche and Romantics, presaging Nietzsche, seeing madness as a return to a privileged state of nature. As might be expected from a philosopher of unity, Hegel did not come down on any one side of these debates, but tried to incorporate elements from all. He was keen to stress the interdependence of body and mind and that nature, or the body, is the “presupposition” of the mind (Hegel, 1970, Introduction). He referred to madness as a “disease of body and mind alike” (Hegel, 1978, section 408), and drew comparisons between the way the mind becomes deranged in madness and what he saw as the essential nature of bodily disease.

It is difficult to reconcile Hegel’s ‘ontology’ of madness as Berthold- Bond calls it, and a simple disease theory of mental disorder, however. A withdrawal from the alienating world of otherness, with which we must struggle to develop our full human identity, is an understandable reaction, a meaningful, if in Hegel’s view, self-defeating response. Indeed, in many ways, Hegel’s views prefigure the phenomenology of madness that R.D. Laing presents in The Divided Self. For Laing too, madness was a meaningful response to the ‘ontological insecurity’ or anxiety produced by interaction with other people. Madness occurs when there is a failure to integrate the social self with the private internal self, leading the ‘real’ self to split off into the world of fantasy, increasingly disconnected from the external world. Laing certainly did not see this view as compatible with the idea that madness is a bodily ‘disease’ in the way we normally use and understand that term.

Hegel’s view of the treatment of madness is also hardly consistent with a straightforwardly medical approach. Although he did not disapprove of physiological interventions entirely, he was convinced that only psychological strategies could address the fundamental basis of madness. The ‘therapist’ must engage with the remnants of shared rationality that persist despite the retreat into madness, and lead the person gently back into contact with the “real world” (Hegel, 1978, section 408).

Hegel’s ideas on therapeutics were strongly influenced by Pinel’s ‘moral treatment,’ and anticipate modern movements such as the Soteria model of the treatment of psychosis (http://www.moshersoteria.com/articles/). His idea of the essentially asocial nature of madness seems to me to make good sense for the most severe problems, at least. It also provides a philosophical basis for a truly humanistic approach to helping those who, for whatever complex combination of reasons, sink into a state of mental estrangement.

(With thanks to Meade McCloughan for advice on aspects of Hegel’s work and ideas.)

Bibliography:

Berthold-Bond, D. 1995, Hegel’s Theory of Madness State University of New York Press, New York.

Foucault, M. 1965, Madness and Civilisation Random House Inc., New York.

Hegel, G. W. F. 1970, Hegel’s Philosophy of Nature (Tr A.V. Miller) Oxford University Press, Oxford.

Hegel, G. W. F. 1978, Hegel’s Philosophy of Mind (part III Encyclopaedia) (Tr W. Wallace) Oxford University Press, Oxford.

Hegel, G. W. F. 1979, Phenomenology of Spirit (Tr A.V. Miller) Oxford University Press, Oxford.

Laing, R. D. 1965, The Divided Self Pelican Books.

Szasz, T. 1970, Ideology and Insanity; essays on the psychiatric dehumanization of man. Anchor Books, New York.

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This article appears also on Joanna Moncrieff.com,
Joanna Moncrieff’s personal website.

23 COMMENTS

  1. From my personal experience of “madness” the retreat from the social is really the retreat from a world we have no control over that has revealed the unbearable reality of intense injustice combined with the bankruptcy of recommended coping strategies as we understand them. Along with a fearless search for truth grasping to consolidate into an integrated system a personal survival strategy that somehow saves the whole world while at the same time being badgered by psychiatric” authorities” and concerned others who don’t seem to realize whats going on and won’t allow you an unbadgered space to work things out and in fact seek to make profit out of your apparently altered state. As if smashing a caterpillar’s cocoon and definitely not allowing any chance for a butterfly to emerge. While being themselves deathly afraid of any truths that may emerge that may upset the applecart of the vested interests. And ever ready to torture you back to compliance. Ever Ready.

  2. “Essentially, Hegel views madness as a return to a pre-rational state of being. The self tries to cut itself off from the social world of shared meaning and rationality, and entrenches itself in a private internal world, the “life of feeling” (Hegel, 1978, section 408).” This retreat is a response to the inevitable sense of alienation that the self encounters as it tries to grapple with the ‘otherness’ of the world. For Hegel, therefore, madness is a possibility that is inherent in the development of consciousness, because of the pain and frustration involved in its evolution towards a fuller, more developed state.”

    This is so interesting because in the energy healing world, our ‘feeling self’ it our spirit to body communication, so it is, in essence, our inner guidance. That’s actually the goal, to connect with ourselves this way, with an integral sense of self, on a feeling level.

    Indeed, in life we are guided to be in our heads and to address life ‘rationally,’ but at the same time, our global society is filled with so many smoke and mirrors, that trying to be rational can lead to madness, because really, nothing makes sense when you look at the world rationally, because the world is not rational. It is in chaos.

    Going from a rational, intellectual, brain-centered existence to a feeling and heart-centered reality is a big jump, and takes adjustment. It’s not the same thing as retreating from society, I never retreated when I made this transition, although I did change my environment because I had outgrown my relationships with my old life, and this change was appropriate and aligned with my internal changes.

    My new environment matches my perspective and new grounding, and it is a lovely, happy, and well-integrated community, based on feeling, not judging. The idea is to feel joy, not necessarily to make sense of everything. Clarity unfolds over time, but joy is something for which we can strive every day, and that is what heals madness, to my mind, or at least, makes it a moot issue. Absolutely everyone has the capacity for madness.

    • I’m grateful, Joanne, that the decent and ethical psychiatrists are denouncing schizophrenia as a valid disease, especially since it is possible that a majority of all schizophrenia / bipolar may actually have been created via the central symptoms of neuroleptic induced anticholingeric intoxication syndrome itself.

      What causes psychosis? In my case, it was a child’s dose, .5mg, of Risperdal, which means this is not a safe dose of Risperdal for any child (I was a grown adult when made psychotic for the first time with this child’s dose of an “antipsychotic,” dealing with a medical / religious cover up of the abuse of my child and easily recognized iatrogenesis by my PCP’s husband, albeit not all involved had full information on all matters at the time, obviously myself included).

      And a super sensitivity manic psychosis is also caused by withdrawal from the psych drugs. Personally, I had the “voices” of the child abusers pumped into my head when I was on the psych drugs, and I learned the story of my hopeful dreams / subconscious via the drug withdrawal induced super sensitivity manic psychosis.

      Which is where I end up seemingly agreeing with what I think are Alex’s perspective of spiritual healing, and the belief that there is a collective unconscious or unity of souls. Which implies the common sense of humanity is that we live in societies with laws. So doctors and the clergy should not actually be utilizing what’s been confessed to me, by an ethical pastor, to be the “dirty little secret of the two original educated professions” (doctors and the clergy do not actually have a moral right to cover up their sins and malpractice by psychiatrically defaming and torturing patients via the psychiatric defamation and torture system).

      • Some societies I’ve experienced are all inclusive and some are very exclusive (and maybe the only society around at the time).

        To survive a person has got to interact with society at some level but society might be more to be humoured than to be believed in, and lot of normal people are people that just keep up appearances.

        I think for a society to support the idea of ‘rejects’ the society itself has got to be unwell, because a person can only be on the ‘outside’ in an excluding society.

        • Fiachra, this is a perfect and to-the-point comment, imo.

          “I think for a society to support the idea of ‘rejects’ the society itself has got to be unwell, because a person can only be on the ‘outside’ in an excluding society.”

          I think this says it all. Snobbery, exclusion, marginalization–where you see this, you see a sick society in need of growth, expansion, and change.

          And in societies like this, which insist on their position of exclusion, which they always know how to justify and rationalize with thinly veiled, nonsensical, illogical arguments, that’s a rude awakening waiting to happen, guaranteed.

          This is where you’ll find insidious abuse and double-binding oppression, which, if complained about, they’ll turn YOU into the villain, the bully–and/or ‘the sick one’–also guaranteed. There’s a practiced formula to this. I’ve seen it repeatedly in every agency related to ‘mental health,’ here in the USA.

          I think the point you make, Fiachra, is the issue of all issues, because until this is rectified, nothing that is complained about here will change, because these communities are based on conditional inclusion, which is like conditional love, which is only oppressive and controlling.

          “Want love and support? Take your meds and don’t make waves. Otherwise you are not-deserving of our love and support.”

          Other than, as you say, to ‘keep up appearances,’ which can only go so far because it is, in reality, deceit and non-transparency, it just doesn’t fly.

          Thanks for this comment. I think it’s the bottom line truth, and the only change will which really make a difference right now, because until then, we only have control and resentment happening. I think we’re trying to graduate from ‘survival-of-the-fittest’ mentality, but that’s really hard for some people to let go of. This is going to be an interesting part of the shift, as it means a radical shift in personal beliefs, and that’s never easy to embrace. Although it is how change happens, without a doubt.

          • Thank you, I appreciate that, Fiachra. Even though physically and technically I have separated from the mental health world, I guess I still remain somewhat tied to it because those experiences continue to live inside me, they were so intense and pervasive within that culture, and marks such a big time frame of my life–in a way shaping it, but through resistance, not ease. At least now, it’s really more good information relevant to my life and work, and not lingering trauma as it had been, although it can feel a bit haunting. I felt as though I was on the other side of the looking glass, which was a really weird and helpless feeling, as though I were meant to go through it, for some “higher-purpose” reason. I wouldn’t doubt that is the case for just about all of us.

            And still, many things have left me scratching my head a bit–like, why are certain things still happening, on such a grand scale? Knowledge may have moved forward, but I don’t see practices changing, not one bit–at least not in my neck of the woods. Attitudes, maybe a little bit–maybe, but still I’d imagine not significant enough to stop or at all slow down the pervasive and insidious abuse this all adds up to, every day.

            And this is so frustrating to me, I’m trying to figure out why this is, and how to get and expand this new knowledge at work on the planet, and continuing to consider radical perspectives, because conventional ones sure haven’t been working. The mh world is notorious for high resistance and lack of transparency, so that makes it an interesting challenge.

            I appreciate having MIA to explore these while remaining somewhat distant. I most definitely always appreciate your insights, too. You got a lot of clarity on your journey like I did. It’s hard to look back, but at the same time, I feel there is more to unearth that would be of great value for us to know. So much stubborn stuckness, I’m kind of drawn to that, because that is really where the ground is most fertile for radical change, which is what I, personally, seek.

            I’m a big fan of detective shows because I enjoy solving mysteries. This one, however, is so emotionally charged, that I find my creativity and inspiration leading me, rather than convention, as there seems to be no conventional way to process these issues. Sure is a doozy.

            But the good news is that I’m sure we’ve never before in history have gotten this far in the conversation, which does make me feel hope. So I’m grateful to all the courageous souls who dare to speak their truth against the grain. That is radical change happening.

      • “Which is where I end up seemingly agreeing with what I think are Alex’s perspective of spiritual healing, and the belief that there is a collective unconscious or unity of souls.”

        Yes, Someone Else, you’re reading me correctly. We are, indeed, all connected at a soul-level, which is what we can perceive as we continue to awaken to deeper truths about our existence. As we continue to expand our awareness around this, our perspective shifts to where we can realize that when we judge, mistreat, betray, or withhold love and respect, we are merely doing this to ourselves–that is, we are self-sabotaging.

        For me, spiritual healing is about focusing on our path of growth and creativity, while treating everyone with equal regard and respect, as a reflection of our own self-regard and self-respect. When we do this, we balance the energy of our hearts, and this is healing to the soul. After that, things go much easier, including manifesting what we want, our heart’s desires.

        • And btw, from what I’ve learned throughout all of this, and which I continue to explore and discover as life goes on daily, is that THE ILLUSION–when we talk about what is ‘real’ and what is not, and all that good stuff that permeates the mental health world and discussions around this–is the perception of ‘separation’ which we experience with each other. That’s the essence of duality, which keeps us separated and fragmented and at odds with each other within the culture of our global humanity.

          Indeed, we are individuals with our own personal spirit, process, and our preference and choices about how we do life, and we have boundaries which we develop, as a result of our interactions with the world and how that affects us.

          But at the same time, on a deep, deep layer of our existence, at the core, is a unifying field of which we are all part. The spiritual teachings around this topic say that humanity is one consciousness, with all these different aspects that form a whole–like, from 7 billion perspectives, as many people as their are on the planet. And throw into this, the aspects from nature, wildlife, vegetation, etc., which express consciousness in a different way than humans, but still, it’s consciousness.

          But to keep it simple, humanity is, on a core level, one consciousness, and we each represent a different aspect of this. This is what is taught in a variety of spiritual teachings (not ‘religious’), and which I totally trust, from my personal experiences.

          From this perspective, we are already united, although not all will perceive this, for a variety of reasons. That’s why people get marginalized, because we are taught to believe that we are completely separate from each other, therefore creating classes and the snob/victim mentality.

          Seeing past this illusion of separation and knowing that we are, in reality, one consciousness, is what is considered to be the big awakening–seeing past this grand illusion–and when it is felt, it changes how we choose to do things, because we see how our actions, thoughts and feelings affect our own reality. So it’s not about how we judge our actions as moral or immoral, nice or not nice, but more about how practical it is to our own life experience.

          So when we hate or resent others, we are not influencing them, we are only hurting ourselves. When we feel compassion, forgiveness, letting go and moving forward, it is the most practical thing we can do for ourselves, because it frees us up to create what it is we want. Burns up a lot of energy to stay angry, which could be used in a more productive and better feeling way. That affects our health, entirely.

          When it comes to our own creative potential, I think we are without limit, when we can believe in ourselves this way.

          Although there is a limit to the extent we can influence others. In that sense, as individual beings, even as aspects of one collective consciousness, we still have freedom of choice. Some choose to see their role in the collective and are humble to the reality of this natural unification, and others fight it because there is some truth they are not ready to see, that’s how I perceive that resistance.

          ‘Free will’ allows us to go with whatever feels right for us in the moment, but when we learn the cause-and-effect ripple of our own words, thoughts, and deeds, we tend to be more awake and mindful to what we put out. That’s hardy and valuable internal work that will translate to what we reality we project in the world. There is usually a middle path which cuts right through the bs and get to manifesting something better, and that has to be found.

          It’s good stuff, I was relieved and so grateful when I learned to perceive from a much broader perspective, rather than always feeling as though these issues always led to kind of a dead end, draining. That’s how it was feeling to me, until I perceived that we really are one! Turned out to the most practical information, because from that perspective, we can know how to gauge our moral compass, in a way that felt comfortable to each of us, by personal choice and preference. I think we each choose this for ourselves, based on what feels just at the time.

          I could go on and on about this, it’s an endless stream of fascinating information. Someone Else, you always inspire me to think further outside the box, which always brings clarity in a new way. Thank you.

  3. Dear Dr Moncrieff
    Thank you for the interesting article. All the good ways to recover seem to involve the same human kindness.

    I think of being disturbed as being in fear, and anxiety as being socially generated rather than real.

    Overcoming fear for me was difficult but straightforward. It was about letting go in the present. When I became calm, there was no real problem.

  4. Thanks for this summary of Hegel’s perspective. It fits with my experience, both personally and as a peer-professional for 30 years…and with my son’s altered experience eight months ago and how we tried to stay connected in any way we could until he came through it…which he did at home with meds only for a few nights to get to sleep…

  5. I’d say, in a sense, that more recent history has darkened any rosy, enlightenment, vision that Hegel might have had. Remember WWII, and that’s still before my birth? Such was not even on the horizon in Hegel’s day. Marx, among the New Hegelians, placing the old sage upon his head, and inverting his philosophy, showed what could be made of his rationalistic spiritual evolution, and that was much less. I’m not so sure your “mental estrangement” is far removed from social estrangement, and that is the point I’d make here. The scientist must come to realize that he or she is not removed from the study they are engaged in, particularly in the social realm. More infantile levels of engagement are often based on somebody’s feelings of superiority, and this feeling of superiority, in turn, is based upon a facile objectivity. Facile as in false. Denial does not eliminate any professional’s part in any relationship beyond his or her relationship with him or herself.

    Anyway, thanks for your post. It’s good to see the discussion move beyond the bounds of psychiatry, psychology, and sociology proper.

  7. Friedrich Holderlin, one of the great German poets, was a close friend of Hegel. He slipped into madness while still young and lived many years on a farm where he was taken care of by a kindly man. Whether Hegel ever visited him I do not know. Arthur Schopenhauer, who thought rather ill of Hegel, spent a great deal of time visiting asylums in Germany and getting to know the patients. Schopenhauer writes very lucidly and well and knew seven foreign languages but was not good at marketing himself — something Hegel was good at doing. I am not sure whether Schopenhauer ever formulated a theory of madness. He had various interesting ideas about mad persons. It would be worth someone’s time to research what he found out as he was a very brilliant philosopher and thinker and ahead of his time. He loved the Upanishads and the German mystics though he thought of himself as an atheist. His writing was much appreciated by persons such as Tolstoy, Proust, etc. And of course Nietzsche.

  8. “The ‘therapist’ must engage with the remnants of shared rationality that persist despite the retreat into madness, and lead the person gently back into contact with the “real world” (Hegel, 1978, section 408).”

    Presumably Hegel had seen at least some examples of how this could work in practice. Question is, why on earth should it work? Why should the person who retreated into madness in order to escape from the world suddenly be amenable to returning just because somebody leads him back?
    Maybe, it’s the simple fact of a person who cares, gently helping him.
    Maybe, it was simply the lack of someone who cares giving gentle help that led the person to despair of the world in the first place.

    • Thanks, Fred. I was just checking it out his website. Wow, looks really powerful and compelling. I read chapter one, his style is really beautiful, reminds me of the Beats. Sure does ring true to me, from what I’ve read so far.

      I do know about the sinister plan, here, and how this all ties in with the Nazis. What I’m not getting, though, is why the information which is so thoroughly discussed on here is not getting past the point to where it is being integrated, at least partially, given all the clinicians, social workers and other professionals who read this and agree that the old ways don’t work and only serve to harm.

      For all that has come to light from one groundbreaking discussion after another, my observation is that nothing really new is trickling down to the streets, these issues of mental health and social service practices continue as usual, even as the system is going into turmoil, and homelessness, extreme poverty, isolation, disenfranchisement, marginalization, and rage & violence, including suicide, are getting worse, not better. I feel this is directly related to misguided mental health practices and the perspective from the system. I’m wondering where the blocks in communication are, from in here to out there.

      Indeed, that would be part of the system, to create these communication blocks and distortions. That’s part of dire social oppression, related to what Black talks about, but I’m curious where exactly that resistance lies, between what we know to be true, and what is not getting out there. To me, that speaks of sabotage, which is not unfamiliar in mental health and social services. If this particular information would come to light, which eventually it will as everything does, then we’d more than likely get somewhere in this effort to change things for the better and just.

      • I also think the title is interesting. Not having read the book, I don’t know how he addresses this further, but to me, ‘weak’ would mean ‘un-awakened to their power.’

        Oppressors don’t want people to feel their power–which is why they resort to stigmatizing, shaming, gas-lighting, distracting, and/or avoiding when confronted, to throw those calling them out off kilter–because personal empowerment makes the oppressors vulnerable, which of course, is what is happening now in the world.

        People are, indeed, waking up and finding their voices, and using them wisely and courageously. For me, what started out as a simple desire to work ended up being years of calling out sabotage. I hadn’t expected that and had not intended to be an activist, but this is no good for any of us. So I started looking at all this, as part of my own life education, and I was blown away by what has come to light. Still trying to wrap my mind around how this system is set up to be so limiting, sabotaging, and draining for the people who ask for help, and so incredibly lucrative and empowering for those in the position to help. That just blows my mind.