Madness Is a Human Phenomenon

Madness¹ is a human phenomenon. So are depression, mania, social anxiety, and other phenomena classified as mental disorders. After many years in which we have been accustomed to treating these mental states as organic illnesses, as medical conditions parallel to other medical conditions like diabetes or heart disease, this basic claim that it is a human phenomenon requires explanation and justification. Consequently, the claim that the treatment of mental health problems should be a treatment unique to human beings is also not self-evident in our time, and I will also give it space here.

First, the clear facts — most of what is defined as mental disorders does not exist in animals. Exceptions are phenomena at a basic level, such as what appears to be anxiety in response to stress or when animals are abused to the point of learned helplessness. This is of course not true for most diseases, most of which occur quite similarly in animals, and therefore it is easy to conduct experiments in which drugs or interventions are tested on animals. Cancer in a dog and cancer in a human are similar, as are various infections or arterial stenosis.

The most reasonable and immediate explanation for the difference mentioned between animals and humans is language. No animal thinks it is the Messiah, asks itself if it has a reason to get out of bed in the morning, and looks at its reflection in the mirror again and again and thinks it is too fat. All these phenomena are mediated by language, mediated by the effect of meaning and self-observation that language produces.

Mental development is also unique to humans. In the development of animals, we mainly talk about maturation, stages in which animals acquire abilities according to the development of their body and brain. As long as we create suitable conditions, there is no reason why a wolf, a crocodile, or a dolphin should not be “normal.” In a romantic view, one might think the same about people, that if only we give them a suitable environment that does not interfere, they will develop correctly. But even without particularly traumatic experiences, human development becomes complicated in a certain way for almost everyone. It is impossible to describe human development without a linguistic and cultural context.

See how complicated it is to define what is healthy and normal development, and accordingly to think about what abnormal development is. To begin to do this, we will already need to move away from simply relying on biological terms like maturation. In the description of mental development, we usually talk about developmental stages, stages within which our biological potential takes on a certain character and completes or does not complete certain achievements.

I will describe a few such theories, mainly psychoanalytic ones, with an attempt to understand the milestones and the desired and undesirable outcomes on the way to the coveted “normal.” We will mainly see how there is no paved path for humans on the way there.

Attachment theory emphasizes the early bond between the child and the mother or primary caregiver, and it claims that the attachment pattern of the infant and child — secure, avoidant, and insecure – has significant implications throughout life. This theory still has parallels in the animal world, as it has been shown that monkeys are also greatly affected by closeness and feeding in conditions of proximity. Erik Erikson described stages in human development — from trust versus mistrust in the first year, autonomy versus shame and doubt in the next two years, to integrity versus despair in the final stage of life. Each stage involves a complex drama and not a simple question, with a spectrum of possibilities for how the drama is resolved.

Freud emphasized how complex the development of human sexuality is and how deeply it affects all mental development. Freud emphasized the importance of recognizing the difference between the sexual aim (the action to which the drive is directed, such as gratification in a particular area) and the sexual object (the one to whom one is attracted), each of which can move on a very wide spectrum, so that the encounter between them is complex and creates an infinite range of variations of sexuality, attraction, and difficulties. Here too, the attempt to define normality is complex and almost impossible, as a person can experience themselves across a wide spectrum of sexual satisfactions and sexual identities, and also be attracted to a wide spectrum of genders and objects.

What is called sexual perversions is extremely complex, since the entire human sexual pattern is one big deviation from what in the animal world looks like normal sexual behavior: from stimulation by looking, touching, and kissing, to the multitude of stimuli that come with the exercise of power, voyeurism, pleasure from control or submission, etc., these are all behaviors unique to humans but deviate from the union of the genitals for the purpose of reproduction. One might think that these things are not related to the discussion of madness, but they are critical to understanding that the spectrum of the human mental field goes far beyond the biology of animals, and to understand it we need to delve into the fields of words and meaning and their complex interface with biology.

Further to understand the winding path towards normality, we will use another Freudian concept — the Oedipus complex. In a slightly exaggerated simplification, I will describe it as follows: the small child has strong impulses towards their parents, and even more typically towards the parent of the opposite sex. He wants all of them, only for herself or himself, all the time. Within this, the child feels herself, at least for a while, as the most perfect thing there is, as the one who brings complete happiness to the parent, as the one whose every movement excites and satisfies the parent.

This state of affairs can exist and even bring happiness, but over time it runs aground. The parent has other loves besides the child. Other children, a spouse, and even, God forbid, areas of interest and a profession that they really love. The child discovers with sadness that there are limits to the parent’s love and devotion, and also that she is much less perfect and funny than she thought. She also discovers that she may be punished for unrestrained expression of her impulses and that the other parent is much bigger and stronger than her.

The descent from the narcissistic childhood paradise is accompanied by much pain, which there is no way to skip and no paved way to do it. Everyone must find their own way with different ways to compensate and try to preserve something of the so pleasant feeling of self-worth that existed. The way Freud described for finding a way out of the Oedipus complex is the way of identification — I may be small and not worth much, but I am part of a really successful and valuable culture, more so than any other culture, a fan of a worthwhile football team, and my parents are really worthwhile. Through identification with the father or with the mother (or in a certain way with each of them) and especially with what they represent, that is, the tribe or society or culture they are part of, the child finds comfort in belonging and a sense of specialness that somewhat compensates for the lost narcissism.

Identification with the parent who also represents society, which in a footnote I will say occurs much less clearly in our time, has a normalizing effect. Whoever “buys” the values and codes of the society in which they live essentially receives a compass that tells them what is good and what is bad, how to behave and what they should not do. Of course, there is nothing objective here; these codes can in themselves be cruel, illogical, and immoral, but they unite a certain society and are adapted to what is accepted in that society. The child gradually becomes one of everyone.

According to Freud’s beautiful description, culture actually plants its agency within the child, which from now on and for the rest of their life will sit inside them and give them grades and evaluations on everything they do. “A garrison in a conquered city,” that is Freud’s analogy for the superego that is established in the child’s psyche. The establishment of the superego has a great psychological cost. The child loses something of their naturalness, of their freedom to express and be what they want, and begins to be a divided creature, which in a sense is always split between impulses and desires and prohibitions and rules, prohibitions and rules that no longer come only from the outside as in early childhood but sit deep within their psyche.

In recent years, a new concept has been established, “normopathy,” which is defined on Wikipedia as a pathological pursuit of conformity and social approval at the expense of individuality. From the other pole, one can look at madness, where the person is largely freed from social codes and approvals and thinks and exists in the most individual way possible. Of course, this is a spectrum on which we all find ourselves, between normopathy and madness, or in another conceptualization, between complete loss of authenticity and extreme authenticity.

By looking at this tension between normopathy and madness, and from the understanding that this tension resides within us, we can see how complicated it is to be human and how much human suffering and what is called mental psychopathology are complex and unique human phenomena. Erich Fromm describes this tension in his famous book Escape from Freedom when he shows how man wants to be free, but is also afraid of it because being free endangers him socially and puts him at risk of rejection and ostracism. One can see a version of this tension in adolescence, where the need for belonging and social conformity explodes and is also in tension with parents, and we see children very busy looking and thinking in the way that is most adapted to what they think is the socially correct way. We also see there the children who are not drawn into this thing and to some extent remain outside.

Would you want your child not to be drawn into this whirlpool of normality? The answer here is obviously personal, but it is certainly not simple. The children who are not drawn into this whirlpool can think independently, create and do beautiful things, but may also experience rejection and feel themselves for years as a foreign element in the world. Life and literature are full of many stories about such children, sometimes as heroes and sometimes as anti-heroes.

David Grossman describes such a child in the book The Book of Intimate Grammar. Aharon, who in childhood sails with a friend in the development of a private language and sees and feels the wounded and scratched adult world around him (mainly composed of holocaust survivors), fails to integrate with the entry into adolescence in the pressure cooker of normalization like his friends, and eventually falls.

In contrast, in the description of Steve Jobs’ life, one can see a very non-normative course of a child who does not fit into frameworks but receives support from his parents for this, and in early adulthood leaves studies and immerses himself in his own ideas with what seems like indifference to money and the accepted way to advance. Many pioneers are precisely those who were not swept deep into the current of conventional thinking, scientists and artists alike, but on the unpaved road there are also many risks.

Madness is the complete departure from social order. It is a state in which the tension between the accepted and the right and between self-expression and inner freedom collapses to one side, to the side of absolute freedom. Why does this happen? In “Neurosis and Psychosis,” Freud describes psychosis as a result of a “disturbance in the relations between the ego and the external world” and delusional thoughts and psychotic phenomena as an attempt at healing and as an attempt to bridge this gap. That is, the real problem in psychosis is not what we see as the phenomena of madness, but that there is an unbridgeable gap between the person and society, between the person and the world that surrounds her.

This gap characterizes not only madness but also other extreme mental states in which a person finds herself alone and feels or thinks very differently from everyone around her. One can think of various reasons for such a gap – traumas, a harmful society, a person with internal structures (innate or acquired) who is unable to accept the rules of society, or various random factors in a person’s life that led them to such a collision course. What is important in my view to see is that psychosis, and I think it can be said that also quite a few other difficult mental states, is closely related to loneliness and a deep difficulty in social integration in the world. It is no coincidence that many mad people are also homeless, because the fall from society and the cessation of functioning is such a deep characteristic of psychosis.

It is worth looking at the fall from society from two directions – on the one hand, one can look at the mad person as someone who rejects society, is unwilling to accept its codes and values, and on the other hand, see society as something that rejects the special person, the person who does not behave as it expects them to.

I think that an understanding of psychosis and other extreme mental states as phenomena closely related to the fall from society helps to direct us also to therapeutic responses that treat the social aspect as central. Freud’s conception, which sees delusional thoughts as patches that come to create a connection and relationship with the external world, also helps to shift the focus from “healing” this patch, these delusional thoughts, and to put at the center the coping with the rift with the external world, which is the real problem.

The medical conception of madness, which was mainly established from the beginning of the twentieth century, tried to conceptualize these states in a similar way to the conceptualization of physical illnesses. A very great effort was made to locate mental illnesses in brain tissue and to understand their physiology, and an even greater effort was made to find substances that would cure these “diseases.”

A disease was invented, the name that was eventually established for it is “schizophrenia,” and the theory that was established is that this disease lies behind the strong states of madness. The problem is that this disease has never been found. The brain evidence for it is very weak, and it is actually a title for phenomena and not an explanation of them. That is, we see that a person is mad and meets certain criteria, so we say that they have this disease. The validity of this diagnosis, like that of most psychiatric diagnoses, is very weak, and there is no real ability to draw reasonable boundaries between the various mental disorders.

There is a wealth of research showing the serious problems of this diagnostic method and the attempt to present a scientific appearance to their existence. For example, an article published in Nature with the title “On the Spectrum” shows that there are no genetic or other biological findings that support the separation between the different diagnoses, and when there are certain genes that are identified or certain brain patterns, they go beyond a specific diagnosis, integrate with additional genes that influence, and ultimately constitute one large spectrum of states.

In general, the psychiatric diagnostic system is extremely problematic. For example, with the release of the fifth edition of the accepted American psychiatric diagnostic manual — the DSM — Jose Brunner published an article in Hebrew that presents the ongoing crisis of psychiatry. He wrote regarding the manual:

“To this day, no sufficient biological basis has been found for the definitions of mental disorders that appear in it, and the effects of psychiatric drugs do not align with its definitions either. With the release of the fifth and updated edition of the book, it is clearer than ever that it lacks the necessary scientific validity, but also stands without a real alternative.”

To emphasize this claim, he quotes the head of the National Institute of Mental Health (NIMH) in the USA, who claims that there is no biological basis and no empirical basis at all for the DSM diagnoses, and therefore he urges researchers not to rely on these diagnoses for research purposes.

Ultimately, the journey through what we term “madness” and other complex mental states reveals a truth that is far richer and more intricate than a purely medical model can capture. By stepping back from the reductionist view of mental disorders as mere organic illnesses, we recognize them as profound human phenomena, deeply interwoven with language, culture, development, and our fundamental struggles with belonging and individuality.

This understanding challenges us to move beyond diagnostic labels that lack scientific validation and instead embrace a holistic perspective, acknowledging the inherent tension between our innate desires for freedom and our societal need for connection. Approaching mental distress with this broadened lens allows for therapeutic responses that prioritize the unique human experience, focusing on bridging the gaps between individuals and their world, and fostering genuine integration rather than simply “curing” symptoms. It is in this nuanced appreciation of the human mind’s vast spectrum that we can truly begin to address suffering and cultivate well-being.