What is madness? Is it merely a colloquial term for “mental illness,” one that is alternatively reviled and reclaimed? Is it merely the lack of reason? Or is madness a distinctive style of reasoning in its own right? Is it a distinctive mode of living and acting in the world, one with equal value to our exalted image of sanity?
For that matter, what is sanity? Is sanity the towering ideal we should all strive for? Is madness merely a failure to live up to such a noble ideal? Or could madness be an alternative ideal?
We can take the question one step further. Is madness ever superior to sanity? Does madness contain the potential for insights and experiences that many of us are locked out of?
Here, I’m going to describe one alternative vision of madness, a vision I’ve encountered in my historical research and that has the potential to subvert our commonsense notions of reason and unreason.
Of course, to say that madness may have its benefits does not mean it is always useful or pleasant. Nor does it mean that the mad have no right to seek resources for managing their experiences. If it is a gift, it is, indeed, a dangerous gift, as activist Jonah Bossewitch, among others, has explored.
Crafting new visions of madness
The movement described as Mad Pride, mad resistance, or mad activism has always viewed medical psychiatry with deep, and legitimate, suspicion. By “medical psychiatry,” I mean the view that sees experiences of madness only as byproducts of a broken mind, chemical imbalances, or inner dysfunctions. I have tried to show in my academic work how this medical paradigm has burrowed itself so deeply into our collective thinking that it drowns out competing voices.
It’s true that mad activists and allies must criticize and confront the medical paradigm that dominates the public conversation. We must expose the various guises that it often adopts. Sometimes, advocates of the medical paradigm describe it in the euphonious terms of the “bio-psycho-social model,” by which is meant something like “an inner dysfunction caused by the environment.” We must be willing, like the kid detectives of Scooby-Doo, to unmask it wherever it occurs.
Yet we have an equally urgent task: crafting new visions. It’s the task of creating more empowering ways of understanding what it means to be mad. These framings must part ways from the mainstream model that sees it merely as a disease, dysfunction, or deviation from our ideal of sanity.
What are some options for this new vision? I believe that my recent historical research has shown me one such alternative.
Strangely, this alternative was extremely common in the 1700s and 1800s, at least in the West. In the last century, it has been largely forgotten or ignored. In short, many doctors and philosophers of the era, such as Immanuel Kant, Johann Christian August Heinroth, Philippe Pinel, and Arthur Wigan, saw madness not as a defective form of reason, but a distinctive style of reasoning.
This form of reasoning had, they thought, its own strengths and pitfalls—its “trade-offs,” in the language of evolution. Although I’ve written about this period in a published, scholarly symposium – and responded at length to critics of my historical and philosophical interpretations—here I want to distill the most vital element of this picture.
A distinctive style of reasoning
During the time period I investigated, from about 1700 to 1850—I call it the “Late Modern view of madness” for a convenient label—many doctors, philosophers and other theorists shared a certain belief. They thought the core puzzle of madness was not to understand how madness differs from sanity. It was to understand how madness differs from “idiocy.” (The historian Simon Jarrett has investigated this category extensively.)
Some think “idiocy” is just an archaic term for the modern concept of severe intellectual disabilities. But as a historian of ideas, I don’t believe in seamless transitions between older and newer terms. Rather, our changing words reflect far deeper changes in our collective concepts and framings. When I use “idiocy,” I don’t use it as a quaint or archaic term for an actual group of people. I think of it as a phantom of the Late Modern mind.
What fascinated me was witnessing how these early theorists, in their attempt to distinguish madness from “idiocy,” arrived at a very different way of thinking about madness—a way that clashes with our current medical model.
To begin with, for the Late Modern mind, madness was not simply the absence or failure of reason. That’s because, for them, describing madness as “the opposite of sanity” wouldn’t distinguish madness from idiocy.
Rather, what made madness different from idiocy was not the lack of reason, but the presence of reason in an unexpected or surprising form. The mad possessed a distinctive mode of seeing, navigating, and reasoning about the world. This mode was at odds with the lofty social image of sanity.
In short, these early theorists didn’t see mad reasoning as defective, but as distinctive. They wanted to understand what was so distinctive about it.
A spectrum of viewpoints
Although these theorists saw madness as a distinctive form of reasoning, they disagreed about the precise way in which madness “contained” reason.
Take for example, the forgotten physician Arthur Wigan and his 1844 treatise on insanity. He thought madness was completely unlike “idiocy” because the mad person possessed reason. The problem, he thought, was that the mad person was of two minds, and sometimes these two minds clashed with each other.
In fact, Wigan thought everybody was of two minds, but that this conflict was heightened in madness. In extreme cases, Wigan thought, this inner conflict could create distressing thoughts and experiences, or lead people to act in ways that were disturbing to others. But there was never a question of the mad person losing reason.
The physician and philosopher John Locke, who was a powerful influence on the Late Moderns, was likewise impressed by the fact that the mad person could make precise logical inferences. (Intriguingly, recent research on schizophrenia supports Locke’s impression.)
The problem, Locke thought, was that the mad person had fallen into the grip of a false premise, not unlike today’s conspiracy theorist. They didn’t lack the power of logic, but they “err as men do that argue right from wrong principles.”
Probably the best example of this Late Modern mindset is the German philosopher Immanuel Kant, whose minor works deal with madness. It’s true that Kant took up a medical viewpoint in some ways. In some respects, madness was, for Kant, a breakdown in the power of reasoning.
But Kant also glimpsed, in the most extreme form of madness, which he called Aberwitz, a fundamentally different perspective on reality, one with its own worth and significance. (In his response to my essay, the philosopher of madness Wouter Kusters does an admirable job of drawing attention to this unexpected feature of Kant’s thought.)
The stone the builders rejected
It’s true that the theorists I studied did not identify as mad. It’s also true that they accepted, in some ways, a medical framework which saw madness as a disease to be classified and treated. They never claimed that madness should be celebrated rather than managed or cured.
But there was something progressive and powerful buried in their views: they were willing to see, in madness, a distinctive style of reason, one that needed to be reckoned with in its own terms, rather than a complete breakdown of reason.
The Late Modern idea of madness as a distinctive, rather than defective, style of reasoning, has the potential to make a valuable intellectual contribution to mad activism. That’s because it reinforces the idea that the mad person is neither irrational nor infantile, but that their perceptions and reflections can carry valuable insights about the world and our place within it—a theme philosopher Sofia Jeppsson has written thoughtfully about.
In presenting this idea, I’m not trying to promote a one-size-fits-all picture of what madness is. Part of the very point of mad activism, as I see it, is to resist any narrow definitions of “madness.”
Rather, my role as a philosopher is to salvage and give voice to these forgotten visions. It’s to recover a largely unknown historical conversation—a conversation that might give us new tools for challenging medical framings of madness and building empowering alternatives.
Garson, J. 2023. “Madness and Idiocy: Rethinking a Basic Problem of Philosophy of Psychiatry,” Philosophy, Psychiatry, Psychology (link to preprint)
This article will be published in December alongside seven commentaries and my response, “Lack, Perversion, Shame: Response to Commentaries.” The commentaries were written by Wouter Kusters, Sofia Jeppsson, Jonathan Tsou, Awais Aftab, Valentina Cardella, Richard Gipps, and Konrad Banicki.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.
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