'Madness and Modernism: Insanity in the Light of Modern Art, Literature, and Thought' by Louis Sass (1992)

Giorgio de Chirico, The Seer, 1915

A selection from Louis Sass's Madness and Modernism: Insanity in the Light of Modern Art, Literature, and Thought (1992).[Work in Progress]
Prologue: The Sleep of Reason

The madman is a protean figure in the Western imagination... . He has been thought of as a wildman and a beast, as a child and a simpleton, as a waking dreamer, as a prophet in the grip of demonic forces. He is associated with insight and vitality but also with blindness, disease, and death; and so he evokes awe as well as contempt... .

Madness is irrationality, a condition involving decline or even disappearance of the role of rational factors in the organization of human conduct... : this is the core idea that, in various forms but with few true exceptions, has echoed down through the ages ['persisted through nearly the entire history of Western thought'].

...Plato... imagined insanity as the condition in which the rational soul abdicates its role as charioteer or pilot of the self, failing to exercise harmonizing dominion over the "appetitive soul"... .

Many writers and theorists have understood this condition of unreason in almost entirely negative terms: as an intrinsic decline or collapse of the rational faculties, a deprivation of thought that, at the limit, amounts to an emptying out or a dying of the human essence-- the mind reduced to its zero degree. [...] ...Philo Judaeus of Alexandria... asked why we should "not call madness death, seeing that by it mind dies, the noblest part of us?"
Sometimes... not the weakness of reason per se but the power of its opposing forces receives the primary emphasis. For the philosopher Thomas Hobbes... madness was a matter of "too much appearing passion," while Francois Boissier de Sauvages, a French alienist of the eighteenth century, described this "worst of all maladies" as a "distraction of our mind" resulting from "our blind surrender to our desires, our incapacity to control or to moderate our passions." This view has ancient roots... in The Republic, Plato speaks of madness as a "drunken, lustful, passionate" frenzy, a giving in to one's "lawless wild-beast nature."
We find insanity being conceived of in much the same terms in the nineteenth and twentieth centuries.... as "primitive and archaic drives returning from the depths of the unconscious in a dramatic manner." The traditional models and metaphors persist after 1800, but filtered through the more sophisticated evolutionist/developmental and mechanistic perspectives that have continued to dominate psychology and psychiatry up to the present day... .
Here, then, are the poles around which images of madness have revolved for so many centuries: on the one hand, notions of emptiness, of defect and decrepitude, of blindness, even of death itself; on the other, ideas of plenitude, energy, and irrepressible vitality-- a surfeit of passion or fury bursting through all boundaries of reason or constraint.

The faith in reason that underlies this conception of insanity is central to Western thought, as basic to Plato and Aristotle as to Descartes and Kant, but it has not gone entirely uncriticized, especially in the nineteenth and twentieth centuries. Various writers in the romantic, Nietzschean, surrealist, and poststructuralist traditions have pointed out dangers in this enshrining of reason, such as how it can splinter the unity and authenticity of the human being, stifling imagination and physical vitality while bringing on the paralysis of overdeliberation and self-consciousness.
The notion that too much consciousness might be a thoroughgoing illness (as Dostoevsky's narrator puts it in Notes from the Underground) has been, then, a common enough idea in the last two centuries, yet it has had little impact on the understanding of the psychoses: the truly insane, it is nearly always assumed, are those who have failed to attain, or else have lapsed or retreated from, the higher levels of mental life. Nearly always insanity involves a shift from human to animal, from culture to nature, from thought to emotion, from maturity to the infantile and the archaic. If we harbor insanity, it is always in the depths of our souls, in the those primitive strata where the human being becomes beast and the human essence dissolves in the universal well of desire.
Another possibility suggests itself: What if madness were to involve not an escape from but an exacerbation of that thoroughgoing illness Dostoevsky imagined? What if madness, in at least some of its forms, were to derive from a heightening rather than a dimming of conscious awareness, and an alienation not from reason but from the emotions, instincts, and the body? This, in essence, is the basic thesis of this book. Though such a view is not entirely unknown... it has seldom been developed in much clinical detail, and has certainly not been taken seriously in clinical psychology and psychiatry; in recent years, in fact, such conceptions have been almost entirely submerged by the more traditional notions of medical-model psychiatry, psychoanalysis, and the literary or antipsychiatric avant-garde.

The traditional vision is evoked in various works by Francisco Goya, such as the etching "The Sleep of Reason Breeds Monsters" and the painting known as "The Madhouse at Saragossa"... a painting of inmates in an asylum, done in an extreme chiaroscuro, so dark that we can hardly make out all the figures in its dungeonlike space.

This is a familiar enough vision, and certainly a compelling one... . [But] close attention to what many schizophrenics actually say or write may well lead, in fact, to quite a different, rather stranger impression: of a noonday rather than a midnight world, a world marked less by the mysteries of hidden depths than by the uncanniness of immense spaces and the enigmas of gleaming surfaces and brilliant light, where... silence and solitude is not broken by bestial cries so much as by the incessant murmur of inner witnesses. Often enough schizophrenics feel not farther from but closer to truth and illumination.

No less a mind than Karl Jaspers believed... that any attempt at unriddling the enigmas of schizophrenic consciousness was doomed to failure, and that we ought simply to acknowledge a fundamental unknowability... . But there would be certain dangers in adopting this attitude of interpretive nihilism, for it risks doing a double disservice: first, to the patient, who would thereby be banished from the community of human understanding; and second, to the rest of us, who would be deprived of all access to what may be an important limit-case of the human condition.

I would argue that schizophrenia does in fact involve a sort of death-in-life, though not of the kind so often imagined: for what dies in these cases is not the rational so much as the appetitive soul, not the mental so much as the physical and emotional aspects of one's being; this results in detachment from the natural rhythms of the body and entrapment in a sort of morbid wakefulness or hyperawareness. Schizophrenic individuals often describe themselves as feeling dead yet hyperalert-- a sort of corpse with insomnia.

The interpretive strategy of this book is to view the poorly understood schizophrenic-type illnesses in the light of the sensibility and structures of consciousness found in the most advanced art and literature of the twentieth century, the epoch of modernism... . Modernist art has been said to manifest certain off-putting characteristics that are reminiscent of schizophrenia: a quality of being hard to understand or feel one's way into-- what one critic calls Uneinfuhlbahrkeit [Hans Sedlmayr, Art is Crisis: The Lost Center (1958)].

I do not seek causal explanation but what Wittgenstein calls "the understanding which consists in seeing connections," the kind of explanation that uses analogy to change the aspect under which given phenomena are seen... . I certainly do not wish to glorify schizophrenic forms of madness-- to argue, for example, that they are especially conducive to artistic creativity, or to deny that they are profoundly dysfunctional and in some sense constitute a disease. Nor am I claiming there is an etiological connection between madness and modernism-- for example, that modern culture or the modern social order actually causes schizophrenic forms of psychosis. [...] This book, however, is concerned with the issue of affinities rather than influences. In the epilogue I do take up the fascinating but difficult question of possible causal relationships among modernism, modernity, and madness... .
My main goal is imply to reinterpret schizophrenia and certain closely related forms of pathology... ; to show, using the affinities with modernism, that much of what has been passed off as primitive or deteriorated is far more complex and interesting-- and self-aware-- than is usually acknowledged. I would like to think that this investigation is in the spirit of Wittgenstein, a spirit captured in the words of a former student who, some forty years later, described Wittgenstein's message in the following way: "first, to keep in mind that things are as they are; and secondly, to seek illuminating comparisons to get an understanding of how they are."

A careful comparison with modernism suggests that schizophrenic experience may have less in common with the spirit of Dionysus than with what Nietzsche, in The Birth of Tragedy, associates with the god Apollo and the philosopher Socrates: it may be characterized less by fusion, spontaneity, and the liberation of desire than by separation, restraint, and an exaggerated cerebralism and propensity for introspection. In the course of this analysis of schizophrenia-- so often imagined as being antithetical to the modern malaise, even as offering a potential escape from its dilemmas of hyperconsciousness and self-control-- may, in fact, be an extreme manifestation of what is in essence a very similar condition.

For the sake of convenience and clarity, I will be adopting something like an ideal-type approach... . As Max Weber, who first described the notion of the ideal type, noted, such an approach [accentuates] features that are "typical" of the phenomena at issue but [does] not [apply] equally well-- or in the same way-- to all instances of the type.
At the same time, it should be clear that the thesis I am proposing is by no means a modest one. I think it applies to a great many schizophrenic patients, perhaps even the majority of "true" schizophrenics, and to many of those classic symptoms of the disease that have traditionally been seen as defining characteristics or core features. I would argue, in fact, that hyperreflexivity is a kind of master theme, able to subsume many specific aspects of schizophrenic consciousness and to organize our overall picture of the syndrome.

When one looks back from schizophrenia and again at modernism , one may well wonder whether one is seeing quite the same modernism as before. Indeed, I think this comparison [between schizophrenia and modernism] can help illuminate, if not the modern condition in general, at least certain of its more disturbing potentialities-- as these are refracted through the most exaggerated or pathological of examples.


Chapter 1: Introduction

The fact of the psychoses is a puzzle to us. They are the unsolved problem of human life as such. The fact that they exist is the concern of everyone. That they are there and that the world and human life is such as to make them possible and inevitable not only gives us pause but makes us shudder. Karl Jaspers, General Psychopathology

Schizophrenia is, at the same time, the most severe and the most enigmatic of mental disorders. Though not conceptualized as a diagnostic category until the 1890s, surprisingly late in the long history of theorizing about the abnormal mind, this illness or set of illnesses quickly became psychiatry's central preoccupation... . The history of modern psychiatry is, in fact, practically synonymous with the history of schizophrenia, the quintessential form of madness in our time [authors note: See I. Macalphine and R. A. Hunter, "Translator's introduction," in D. P. Schreber, Memoirs of My Nervous Illness].

Schizophrenia's elusiveness makes itself felt... in the intense yet indescribable feelings of alienness such individuals can evoke. ...the schizophrenic seems to inhabit an entirely different universe; he is someone from whom one feels separated by "a gulf which defies description." European psychiatrists have labeled this reaction the "praecox feeling"-- the sense of encountering someone who seems "totally strange, puzzling, inconceivable, uncanny, and incapable of empathy, even to the point of being sinister and frightening."

Like death and ecstasy..., schizophrenia has often seemed a limit-case or farthest borderland of human existence, something suggesting an almost unimaginable aberration: the annihilation of consciousness itself.
...some psychiatrists and psychologists have argued that the condition is totally incomprehensible, closed to the very possibility of human empathy. But others disagree, and, as we shall see, they have most commonly likened schizophrenia's characteristic modes of consciousness to those of people who have lost, or never attained, the higher and more socialized faculties of the mind-- including patients with diffuse brain damage..., infants or very young children, or else some imagined instance of an utterly unsocialized being, such as the mythical (and sometimes glorified) figure of the Wildman.
Given the prevalence of these traditional models-- Wildman, child, or broken brain-- it may be surprising to discover that, in many crucial respects, schizophrenia bears a remarkable resemblance to much of the most sophisticated art, literature, and thought of the twentieth century, the epoch of "modernism."


Traditional Twentieth-Century Views of Schizophrenia

The Doctrine of the Abyss and the Broken Brain

Oddly enough, schizophrenia's ineffable yet distinctive aura of strangeness has sometimes been made the basis of a crucial diagnostic criterion-- thus raising our very bafflement to the status of an essential ordering principle.

Karl Jaspers... describes the "most profound distinction in psychic life [as] that between what is meaningful and allows empathy and what in its particular way is ununderstandable, 'mad' in the literal sense, schizophrenic psychic life... ."

It is odd that Jaspers, of all people, should have insisted so adamantly on the utter incomprehensibility of this condition; he, after all, ws the most important champion of a verstehende psychiatry-- one of interpretation or understanding-- and he believed that psychiatry's need to study meanings and modes of experience made it as much one of the humanities as a biological science.

Kraepelin's use of the term dementia praecox for what we now call schizophrenia revealed his conception of the illness as a premature form of senile dementia... .

Many psychiatrists and psychologists in this century have followed along these lines... . Such accounts have usually had a mechanistic cast, with schizophrenic consciousness being conceived on the analogy of a malfunctioning computer or machine... .

Such approaches can have the unfortunate effect of legitimating a contemptous and dismissive attitude: when human beings are viewed as malfunctioning cerebral mechanisms, incapable of higher levels of purposefulness and awareness, it will naturally be assumed that they are not only difficult to interpret but in some sense beneath interpretation... . [...] ...those who adopt either Kraepelin's notion of dementia or Jaspers's "doctrine of the abyss" have assumed that the essential features of the schizophrenic disorder are the result of some unknown organic cause-- a biological factor that intrudes itself into the psychological sphere and thus cannot be understood psychologically.

The schizophrenic, it would seem, is psychiatry's quintessential other-- the patient whose essence is incomprehensibility itself.

The Original Infantile Story

We are victims of a subjective illusion... . In the normal course of things, customs varying greatly from our own always seem puerile.
Claude Levi-Strauss, The Archaic Illusion.

Bleuler, a man who coined the term schizophrenia and spent most of his life living with and treating schizophrenics, once remarked that when all was said and done, they remained as strange to him as the birds in his garden.


In 1911 Sigmund Freud described schizophrenia as a profound regression to the most primitive stage of "infantile auto-eroticism,"... . They [nearly all psychoanalytic writers] see the structures of schizophrenic consciousness as a return to an archaic mode of experience dominated by illogical primary-process thinking, by hallucinatory wish-fulfillment fantasy and raw, untamed instincts, by a state of primal fusion with the world, and by an absence or severe attenuation of "observing ego" (the capacity for self-conscious reflection and ironic distance from experience).

...the stage to which one returns (or whcih one is fixated) is sometimes conceptualized as being akin to the normal infantile condition, at other times as involving deviations from the developmental norm.

Not only in psychoanalysis but also in other schools of psychological thought... the strategy of explanation often assumes something like a modern and developmental version of the Great Chain of Being: the idea, prominent in Western thought through the Renaissance, of a single hierarchy of being with ascending degrees of perfection, rising "from the dark, heavy and imperfect earth to the higher perfection of the stars and heavenly spheres," [ ] from the domain of ignorance and the body to the bracing heights of rational self-awareness. All these schools accept some version of the grand and optimistic Western narrative of progress toward higher levels of consciousness and self-consciousness, and all presuppose a single, unilinear dimension along which all psychological phenomena can be located. At the very top are the reality-adapted, pragmatic, quasi-scientific modes of consciousness presumably obtained by normal socialized adults in modern culture. And, by what seems an inexorable logic, any deviation from this condition is assumed to correspond to an earlier and lower developmental stage.

This view has often led to the rather condescending assumption that schizophrenics need to be brought up or socialized, and that a therapist should play the role of a benign and wise parent who gives the patient a second chance to be nurtured toward maturity.

The Wildman: Hero of Desire

As the most severe and prototypical type of madman, the schizophrenic has also been a central figure in the twentieth-century literary, intellectual, and artistic avant-garde... .

In The Politics of Experience [and the Bird of Paradise], R. D. Laing describes madness as a release from constraint and a return to "primal man" that may even have the power to heal "our own appalling state of alienation called normality." In works like Andre Breton's "Surrealist Manifesto" of 1924 as well as in more recent books such as... Gilles Deleuze and Felix Guattari's Anti-Oedipus: Capitalism and Schizophrenia, the schizophrenic is celebrated as a "true hero of desire," a Wildman figure who "is closest to the beating heart of reality" and "the vital biology of the body"; and he is sometimes sen as an "emblem of creative insurrection against rationalist repression linked to social power." Here the prevailing image has been the "Dionysian madness" described in Nietzsche's Birth of Tragedy, where ecstatic surrender of self-control obliterates all doubt and hesitation, making way for the raptures of unrestrained instinct and "primordial unity." Since such a condition is generally assumed to be more characteristic of early stages of development or evolution, there is a certain affinity between the Dionysian and primitivity models. The avant-gardists and antipsychiatrists have emphasized the positive sided-- excesses of passion, vitality, and imagination-- yet they, no less than the traditional analysts, assume that the schizophrenic lacks the self-control, awareness of social convention, and reflexivity of "civilized" consciousness.

Such notions of schizophrenia are, in fact, remarkably reminiscent of the evolutionism that once prevailed in cultural anthropology, in which tribal man was assumed to be ruled by rampant instinct and to lack the capacity for abstraction and self-awareness attained in later stages of development or evolution.

Though such assumptions about madness and mind can be traced back to the ancient world, it was the rationalism of the seventeenth and eighteenth century Enlightenment that gave them their modern stamp. Once human consciousness came to be defined by the self-awareness of its mental essence, as in Descartes's famous arguments about the certainty of the Cogito ("Cognito ergo sum"), it seemed especially evident... that thought and madness must somehow be profoundly antinthetical [editors note: See Foucault on Descartes in Historie de la folie]. At the deepest level, then, all three of these models-- psychiatric, psychoanlytic, and avant-gardist-- share the assumption that schizophrenic pathology must involve a loss of what, in the West, has long been assumed to be the most essential characteristics of mind or subjectivity: the capacities for logic and abstract thinking, for self-reflection, and for the exercise of the will.

Through taking a closer and, I hope, less biased look at the lived world of schizophrenic patients, I will present a very different interpretation of their modes of being. For the moment, however, we need to hold all explanations in abeyance and examine the phenomena at issue.

Anomalous Features of Schizophrenia

The first feature conflicts most blatantly with the Dionysian image of schizophrenia. This is that schizophrenic persons can often seem nearly devoid of emotion and desire (they display "flatness of affect")... . Also, such persons often display a more deliberative and ideational rather than intuitive or emotional style of acting and problem solving. A schizophrenic... could hardly have been more different from the id incarnate postulated by the primitivity and Dionysian models; this patient was, in fact, so devoid of any real sense of physical grounding or spontaneity that he once described his body as a photocopy machine... . Many such patients report feeling profoundly distant and lonely-- "like a zombie living behind a glass wall," as one put it.

[Another] feature of schizophrenia that seems inconsistent with the traditional models is of a somewhat different order, for it concerns not any single symptom but the daunting heterogeneity of the entire syndrome.

Here the characteristic symptoms cannot easily be ascribed to disturbance of a single psychological function... . Nor can schizophrenia be described in terms of a single theme... .

The illness therefore defies all attempts to bring its features within the grasp of any overarching theory or model, or to discover an underlying essence... .

We must recall... that in Jaspers's view any discoveries about the nature of schizophrenia would have to come from fields such as psychophysiology and genetics, since the "psychology of meaningful connections" could not be applied to this most alien of mental illnesses.

Having introduced the main object of this comparative study, schizophrenic symptoms, suggested their problematic nature, and questioned traditional interpretations, I now turn to the other side of the comparison: the domain of modernist art and thought. [...] ...if schizophrenia is to be comprehended psychologically, I would suggest that its interpretation must be intimately tied to its very diversity and incomprehensibility; what better place, then, to seek analogies than in the culture of modernism/postmodernism-- that "tradition of the new" where bafflement and pluralism are the rule?

A Bizarre Tradition and a Tradition of the Bizarre

Virginia Woolf's famous statement, "In or about December 1910 human nature changed," is not, of course, to be taken literally; but it does capture a widespread sense that some profoundly new developments were occurring shortly after the turn of the century... . C. S. Lewis... spoke for many when he wrote that no "previous age produced work which was, in its own time, as shatteringly and bewilderingly new as that of the Cubists, the Dadaists, the Surrealists, and Picasso has been in ours." Along with such critics as George Steiner and Roland Barthes, he saw the decades preceding World War I as marking the greatest rupture in the entire history of Western art and culture; indeed, he considered modern poetry "not only a greater novelty than any other 'new poetry' but new in a new way, almost in a new dimension."

Herbert Read saw the modernist revolution as unique in kind precisely because it did not establish a new order; rather, he said, it is "a break-up, a devolution, some would say a dissolution. Its character is catastrophe."

Avant-Gardism, the Adversarial Stance

The first characteristic of modernism is the one most obviously associated with the heterogeneity just described, and this is its negativism and antitraditionalism: its defiance of authority and convention, its antagonism or indifference to the expectations of its audience... . Though precursors can certainly be found, notably in romanticism, it is in the twentieth century that these tendencies seem to have moved from an epidemic to an endemic state... .

Perspectivism and Relativism

A related characteristic of many modernist and postmodernist works is the uncertainty or multiplicity of their point of view. We find works that draw attention to the presence of a particular perspective, thereby displaying a recognition of the inevitable limitedness of that perspective as well as works that attempt to transcend such limits by inhabiting a variety of perspectives, simultaneously or in quick succession.

Both tendencies are inspired by the modern realization of the observer's role in both creating and curtailing the world of perception, a realization usually traced to Immanuel Kant's demonstration, at the turn of the nineteenth century, of the central role of the human subject, in particular of the... "categories of understanding," in the constitution of all knowledge. (The critic Clement Greenberg identifies modernism with "the intensification, almost the exacerbation, of this self-critical tendency that began with the philosopher Kant.") This can lead to what Nietzsche called "the most extreme form of nihilism": the view that there is no true world, since everything is but "a perspectival appearance whose origin lies in us."

Dehumanization, or the Disappearance of the Active Self

...a certain fragmentation and passivization,... loss of the self's sense of unity and of its capacity for effective or voluntary action [editors note: see Victor Branford and Lewis Mumford on 'addled subjectivity', and Baudrillard, who wrote that the individual has now become "only a pure screen, a switching center for all the networks of influence."]... .

One variant of this tendency [we see in the twentieth century] might be termed an impersonal subjectivism or a subjectivity without a subject. In this form of dehumanization (common in novels by Ford Madox Ford, Virginia Woolf, and Nathalie Sarraute, among others), there is a fragmentation from within that effaces reality and renders the self a mere occasion for the warming of independent subjective events-- sensations, perceptions, memories, and the like.

Derealization and the "Unworlding of the World"

This feature, closely bound up with the dehumanization I just mentioned, could be termed the "loss of significant external reality."

...eternal reality loses... its substantiality and otherness [or, in another mode] its human resonance or significance.

...the subjectivism and objectivism associated with both dehumanization and derealization are so closely linked that they can actually coexist at the same time, as complementary facets of a single though highly paradoxical mode of existence.

"Spatial Form"

In the classic article "Spatial Form in Modern Literature," the literary scholar Joseph Frank describes some of the ways modernist fiction attempts to deny its own temporality and approach the condition of the poetic image, defined by Ezra Pound as "that which presents an intellectual and emotional complex in an instant of time." [...] These include: the overwhelming of plot by mythic structures used as organizing devices (as in Joyce's Ulysses), the movement from perspective to perspective instead of from event to event (for example, Faulkner's The Sound and the Fury), and the use of metaphoric images as recurring leitmotifs to stitch together separate moments and thereby efface the time elapsed between them (for example, Djuna Barnes's Nightwood).

Aesthetic Self-Referentiality

Many of the motives and purposes that animated earlier forms of art have lost their force in the twentieth century. Mimesis of external reality, evocation of a spiritual beyond, the conveying of an ethical or intellectual message... [etc.,.].

Irony and Detachment

Irony and detachment were certainly far from unknown in earlier periods of art, but prior to modernism these qualities seem not to have been all-encompassing [and pervasive as Ortega y Gasset, in his The Dehumanization of Art, regards the modern period, "doomed to irony"], but qualified by an underlying seriousness of purpose and positive thrust.

Modernism : Hyperreflexivity and Alienation

One could ask the same question I posed earlier about schizophrenia: Might "modernism" by only a negative category, an utterly diverse collection of styles and attributes, linked by nothing more than that most elusive of attributes-- the sheer fact of deviating from a norm (in this case, from the aesthetic conventions of preceding generations)? ...one can in fact discover a loose sort of unity here-- not a single underlying essence, perhaps, but at least a common thread or two. These have to do with the presence of intensified forms of self-consciousness and various kinds of alienation.

And all these tendencies have only been intensified in that further turn of the screw of self-consciousness called postmodernism-- for it is there that one finds the most [emphatic] expressions of skeptical disengagement, self-referentialilty, [etc.,.].

In my portrait of modernism, I am clearly emphasizing what Nietzsche called the Apollonian and Socratic aspects of art: namely, the... tendencies toward a form -seeking and contemplative self-control, toward separation of self from world and from other selves, and toward fragmenting hyperawareness and a kind of cerebral self-interrogation. [...] ...it has sometimes been alleged that modern art, perhaps especially in its postmodernist forms, is really a Dionysian phenomenon, its central characteristic being surrender to impulse and pleasure, an eclipse of all forms of distance... and a regression to early, inchoate forms of psychic organization. If so, the analogies between schizophrenia and modernism, no matter how apt, would hardly contradict tradition interpretations of schizophrenia.
In later chapters I will argue that certain aspects of modern art and consciousness (and also of schizophrenia) that have often been assumed to indicate primitivist or Dionysian trends (such as the dissolution of active, unitary selfhood) may actually result from more Apollonian, Socratic, or hyperconscious forms of experience. Still, it would be foolish to deny the existence of certain truly primitivist or Dionysian inclinations in twentieth century art-- for example, in the work of such figures as Rimbaud, Lautreamont, Antonin Artuad, D. H. Lawrence, and Jean Dubuffet. But I would maintain that the boundary-dissolving, spontaneity-inducing instinctualism they sometimes advocate constitutes only a peripheral trend in modernism. [...] ...the primitivist expressions that do occur frequently have a strong reactionary quality, as if their real motivation were a desire to escape a more fundamental hyperreflexivity-- that condition Ortega described as the "increasing insomnia of civilized man, the almost permanent wakefulness, at times terrible and uncontrollable, which affects men of an intense inner life." [...] Fredrich von Schiller believed that the feeling for nature and the spontaneous did not come naturally to his age but, rather, was akin to "the feeling of an invalid for health."

...we find [in the twentieth century], on the one hand, the expression of a fundamentally Apollonian or perhaps Socrateic sensibility and, on the other, occasional reactionary lunges toward the most unrestrained Dionysianism. Such trends have resultsed in artworks that... can seem as difficult to grasp, as off-putting and alien, as schizophrenia itself.
This, in any event, is my modernism, the modernism I shall use as a beacon for exploring the forms of madness at issue in this book.

[In the following chapters] I follow the sequence of an ideal-typical schizophrenic process, beginning with the first disturbing encroachments of an alien world and ending in the more bizarre reaches of insanity

Let us turn, then, to our first topic: the uncanny dawn that heralds the onset of a schizophrenic break.

Chapter 2: The Truth-Taking Stare

As is the case with epileptic seizures, schizophrenic breaks are often proceded by an aura. Klaus Conrad... named this preliminary stage the Trema, a term of theatrical slang referring to the stage fright an actor feels before the performance begins. At these moments the patient will be suspicious and restless, often filled with anticipation and dread. [...] Reality seems to be unveiled as never before,... peculiar and eerie... .
Fascinated by this vision, the patient often stares intently at the world, demonstrating that early sign of illness German psychiatry has named the "truth-taking stare" (die Wahrnehmungstarre). [...] Usually the person becomes quiet and withdrawn.

...a strange and enigmatic atmosphere... infuses everything yet eludes description almost completely. [...] ...the fabric of space seems subtly changed; the feeling of reality is either heightened, pulsing with a mysterious, unnameable force, or else oddly diminished or undermined-- or, paradoxically, things may seem (as one patient put it) both "unreal and extra-real at the same time."

The experience can involve a kind of conjoint and rather contradictory sense of meaningfulness and meaninglessness, of significance and insignificance, which could be described as an "anti-epiphany"-- an experience in which the familiar has turned strange and the unfamiliar familiar, often giving the person the sense of deja vu and jamais vu... .

The surrealists were... profoundly inspired by de Chirico's evocations of this vision, and they actually made a practice of cultivating such a mood or state of mind...-- the feeling of living in a vast museum of strangeness that they considered to be the essence of aesthetic inspiration.

De Chirico borrowed from Nietzsche the untranslatable German term Stimmung to refer to this mood or state of mind that accompanies the truth-taking stare. (I will use Stimmung to refer to the perceptual and emotional experience in question, and "truth-taking stare" to refer to... a particular way of looking that goes along with it). As we shall see, the Stimmung is a key symptom of schizophrenia: it contains, in nuce, many of the qualities that persist throughout the entire course of the illness. 

Most clinicians who work with schizphrenic patients will have encountered these important but subtle symptoms which often dominate the incipient phases of a psychotic break and can give rise to the famous "praecox feeling"-- the sense of radical alienness that some European psychiatrists have considered the best diagnostic indicator of schizophrenia.

The Stimmung in Schizophrenia

Perhaps the best descriptions of the schizoid and schizophrenic Stimmung can be found in The Autobiography of a Schizophrenic Girl, a personal memoir written by "Renee"... . ...it is possible to distinguish at least four aspects of her Stimmung experience: what I shall call the visions of Unreality, Mere Being, Fragmentation, and Apophany.


Renee describes "a disturbing sense of unreality"... . [...] Like many of de Chirico's paintings, Renee's world of Unreality lacked the chiaroscuro of normal forms of perception... .

For me, madness was definitely not a condition of illness; I did not believe that I was ill. It was rather a country, opposed to Reality, where reigned an implacable light, blinding, leaving no place for shadow; an immense space without boundary, limitless, flat; a mineral, lunar country, 'cold as the wastes of the North Pole. In this stretching emptiness, all is unchangeable, immobile, congealed, crystallized. Objects are stage trappings, placed here and there, geometric cubes without meaning.
People turn weirdly about, they make gestures, movements without sense; they are phantoms whirling on an infinite plain, crushed by the pitiless electric light. And I-- I am lost in it, isolated, cold, stripped, purposeless under the light. A wall of grass separates me from everybody and everything... . This was it; this was madness, the Enlightenment was the perception of Unreality. Madness was finding oneself permanently in an all-embracing Unreality. I called it the "Land of Light" because of the brilliant illumination, dazzling, astral, cold, and the state of extreme tension in which everything was, including myself.

...the experiential mutation Renee experienced did not involve gross perceptual errors or confusion about the real identity of people or objects, but something more subtle and pervasive:

During the visit [at the psychiatric hospital] I tried to establish contact with [my friend], to feel that she was actually there, alive and sensitive. But it was futile. Though I certainly recognized her, she became part of the unreal world. I knew her name and everything about her, yet she appeared strange, unreal, like a statue. I saw her eyes, her nose, her lips moving, heard her voice and understood what she said perfectly, yet I was in the presence of a stranger.

In other descriptions of so-called Unreality, Renee places less emphasis on the feeling of illuminated emptiness, strangeness, or devitalization and more on some flimsy, false, or doubled quality inherent in things. At these moments, objects could take on the look of "stage accessories" or "pasteboard scenery," and people seemed mere "puppets," "mannikins," or "automatons," or else somehow "in disguise." Patients will sometimes express Unreality by stating that everything seems distant, or as if behind plate glass.

Mere Being

...such experiences can be akin either to the exalting feeling of wonder, mystery, and terror inherent in what Heidegger considers to be the basic question of metaphysics-- Why is there something rather than nothing?-- or else to the vertigo, nausea, or sense of utter arbitrariness that made Roquentin, hero of Sartre's philosophical novel Nausea, reel before the brute fact of existence itself [editors note: in the form of a root of a tree in a park]. To Renee, things looked

smooth as metal, so cut off, so detached from each other, so illujinated and tense that they filled me with terror. When, for example, I looked at a chair or a jug, I thought not of their use or function-- a jug not as something to hold water and milk, a chair not as something to sit in-- but as having lost their names, their functions and meanings; they became "things" and began to take on life, to exist."
Their existence accounted for my great fear. In the unreal scene, in the murky quiet of my perception, suddenly "the thing" sprang up. The stone jar, decorated with blue flowers, was there facing me, defying me with its presence, with its existence. To conquer my fear I looked away. My eyes met a chair, then a table; they were alive, too asserting their presence. I attempted to escape their hold by calling out their names. I said, "chair, jug, table, it is a chair." But the word echoed hollowly, deprived of all meaning; it had left the object, was divorced from it, so much so that on one hand it was a living, mocking thing, on the other, a name, robbed of sense, an envelope emptied of content. Nor was I able to bring the two together, but stood rooted there before them, filled with fear and impotence. [Editors note: see also quotes from Renee's book reproduced in Foucault's 'Mental Illness and Psychology', in the section on 'Mental Illness and Existence.']


Objects normally perceived as parts of larger complexes may seem strangely isolated, disconnected from each other and devoid of encompassing context.

Another schizophrenic likened his vision of Fragmentation to being "surrounded by a multitude of meanginfless details." "I did not see things as a whole," he said, "I only saw fragments... . They did not stand together in an overall context, and I saw them as meaningless details."

Unreality, where the world is devoid of feeling or authenticity; Mere Being, where the sheer fact of existence defies speech and understanding; Fragmentation, where details or parts overwhelm the synthetic whole: each of these phases or aspects of the Trema challenges the capacity of words and concepts to capture lived experience. [...] ...language and the world shed their normal symbol-referent relationship; objects seem to be stripped of the usual meanings by whcih they are unified and placed in the human world (in Sartre's vocabulary, essences recede while existence obstrudes). To speak of things as "alive" was Renee's way of capturing the fact that objects no longer seemed to have the subservience of tools, as if they were rebelling against their normal role as dutiful exemplars of the various categories of human thought and language. And, at the same time, words and syllables themselves will come to seem objectlike: no longer the transparent signifiers of meanings lying beyond themselves, they may turn opaque or come alive-- flaunting their immanence and independence, demanding to be paid attention to for their own sake.

...in normal modes of experience, focusing on standard functional meanings of objects tends to suppress awareness of the sheer fact of their existence as substances, and also to ensure their discreteness and integrity as perceptual forms; it makes sense, therefore, that a fading away of pragmatic and conventional meanings (Unreality) might lead to the experience of Framentation or Mere Being (or the reverse: that a focus on Mere Being might erode awareness of conventional meanings).


...a certain abnormal awareness of meaningfulness or of significance that has been termed the apophanous mood (from the Greek word apophany, meaning "to become manifest"). (The Stimmung, then-- a mood, which is accompanied by the truth-taking stare-- can be thought of as consisting of the Trema, whose three aspects are Unreality, Mere Being, and Fragmentation, and the Apophany, often occurring slightly later.)
Once conventional meanings have faded away (Unreality) and new details or aspects of the world have been thrust into awareness (Fragmentation, Mere Being), there often emerges an inchoate sense of the as yet unarticulated significances of these newly emergent phenomena. In this "mood,"... the world resonates with a fugitive significance. Every detail and event takes on an excruciating distinctness... -- some definite meaning that always lies just out of reach... where it eludes all attempts to grasp or specify it.

The mood, in either case, is such that no object or occurrence can seem accidental... .

So freighted with the presence of meaning, yet simultaneously so devoid of any particular, specifiable meaning, the symbols experienced during the Apophany might be called "symbol symbols," for the sole referent of these ubiquitous semiotic pointers seems to be the sheer presence of meaningfulness itself.

The Anti-Epiphany in Modernism

Since the turn of the century, the revelation of the inadequacy of standard meanings and habitual constructions of reality, including conventional language, and the looming up of previously suppressed aspects of the world have become prominent themes.

Such revelations and anti-epiphanies seem to be symptomatic of a culture in crisis, one no longer comfortable within the armature of its own categories; though virtually unknown before 1900, they are found in numerous works of both early and later modernism.

An unsettling mood of Apophany pervades Musil's autobiographical novel of 1906, Young Torless, in whcih the hero is preoccupied with the "double-face" of the world: he is constantly aware of the illusoriness of everyday appearances, and everything around him resonates with mystery, as if harboring some specific, horrible, yet unspecifiable essence. Torless even feels assailed "by inanimate objects, by mere things, as by hundreds of mutely questioning eyes." [...] Like the schizophrenic in the Stimmung, all of these central modernist writers describe objects that seem alien and incomprehensible-- stripped of familiarity and reality, and of any sense of coherence or connectedness, yet bursting with some profound inner significance that always lies just beyond the reach of one's comprehension.

The literary scholar Erich Kahler, who has offered what is perhaps the most detailed examination of the modernist anti-epiphany, speaks of "schizaesthesia" and "lucid indifference": far from resonating in affective concert with an animate or magical external world, the modernist observer seems profoundly disengaged; and, accompanying his emotional detachment there is a fractioning focus on details, an unremitting "mental microscopy" that fragments and negates the larger coherencies of human meaning by concentrating too sharply on isolatable elements. This detached hyperconsciousness decomposes all unities... .

Obviously, this is a far cry from the oceanic feelings, the dynamic primal oneness of infancy. Though this modernist anti-epiphany has been described as a "mysticism of a new kind," it might better be labeled an antimysticism. [...] Instead of a gathering in of all things or a transcendence to some incorporeal plane, we find the several varieties of alienation so familiar to the modern sensibility: deadness, increased sense of distance between self and world, and a decomposition of all the organic unities of human action and perception.


"Tacit Intimations": on the Formation of Delusions

In this state of pulsing significance, the very ineffability, uncanniness, and precision of everything seem nearly intolerable, as if the human need for meaning and coherence were being titillated only to be frustrated on the brink of its fulfillment.

Indeed, paranoid thinking an be viewed as, in some sense, an almost obvious, logical development-- in a world where everything seems cryptic,... illusory... ; a world where all events feel interpretable, so that nothing can seem accidental and everything therefore appears to be somehow consciously intended. (Believing in a conspiracy might help to explain why, for example, everyone seems false, as if play-acting for the patient's benefit.)

The most important feature of a given delusion may not be its specific content but its ability simply to offer some meaning, thereby to resolve the abstract tension of the Apophany. The early and often neglected "prodromal" experiences of the Stimmung and the truth-taking stare (Unreality, Mere Being, Fragmentation, and Apophany) may therefore play a much larger, perhaps even foundational role in the development of the more striking and overtly psychotic symptoms of delusions and paranoid thinking.

Futurism, Surrealism, and the Modernist Stare

Pursuit of a state very like the Stimmung was, for [French surrealists and Russian formalists], a conscious goal; and for this reason their aesthetic philosophies and techniques offer special insight into this mode of experience, particularly into the existential attitude or stance that seems to underlie it.

They suspended the normal trust in words and concepts in order to provide release from contamination by abstract categories, by pragmatic, goal-orientated concerns, and by all conventional patterns of meaning-- thus to bring about a fuller appreciation of things in all their concreteness and wonderous particularlity.

Viktor Shklovsky, the leader of the Russian formalists, defined art as defamiliarization ("making it strange"), while the Czech critic Jan Mukarovsky spoke of deautomatization.

Shklovsky describes several techniques for doing this-- such as taking a very distant or else fragmentingly microscopic perspective on an object, avoiding standard causal/narrative schemas of meaning, and describing an object in terms of its mere existence or geometrical form (that is, by avoiding use of its name and suppressing all references to its usual functional role in human life).

Like the futurists, the surrealists also strove to jolt their audience out of complacency and unconsciousness. Their works of art were intended to lay bare what the surrealists saw as the essentially discontinuous nature of existence and the inadequacy and absurdity of the rational systems human beings use to give themselves the illusion of coherent understanding. ("Reality," said the surrealist poerty Louis Aragon, meaning conventional reality, "is the apparent absence of contradiction. The marvelous [meaning "true" reality] is the eruption of contradiction within the real.") It is within the surrealists tradition, in fact, that we find images and objects most reminiscent of the schizophrenic Stimmung.

[Breton's Nadja (1928)] can... be read almost as a manual for achieving the surrealist vision of inspired alienation.

In an essay on modernist aesthetics, Susan Sontag contrasts this kind of staring with the mode of attention appropriate to more traditional art, as well as to normal pragmatic perception: "Consider the difference between looking and staring. A look is voluntary; it is also mobile, rising and falling in intensity as its foci of interest are taken up and then exhausted. A stare, has, essentially, the character of a compulsion; it is steady, unmodulated, 'fixed.' Traditional art invites a look. [Modernist avant-garde art] engenders a stare."
The "look" [emanates] from a secure base (and rooted in the lived body), it moves always within stable horizons... . [...] The "stare," on the other hand, is rigid and fixed... ; it bores through, breaks up, or withers its object, dissolving the physiognomy of the everyday world and bringing on the various aspects of the Trema.

Particularly revealing examples of this compulsory stare... can be found in Jean-Paul Sartre's philosophical novel Nausea (1938). The narrator, Roquentin... becomes aware of certain disquieting alterations in the perceptual world... . Though Roquentin's scrutinizing gaze is inspired by his desire to get to the bottom of those subtle perceptual changes, it actually has the effect of exacerbating these changes-- which he nevertheless watches as if they were happening independently of him, compelling his stare. ...Roquentin goes through virtually all of the modernist experiences I have described: objects lose their normal functional meanings; they begin to seem absurdly substantial; they fragment into parts; they take on curious meanings. Everything that usually links us with our embodied selves... and all the memories and channeled expectations that normally connect us to the social and practical world-- all this seems to have disappeared, reducing the protagonist to a state of ontological anxiety, a sort of abstract nausea in the face of the sheer existence of things.
Eric Kahler (writing in the 1940s and 1950s) considers Nausea to be the ultimate, culminating example of the drama of the crumbling of normal sensory and emotional reality; he views this drama of "schizaesthesia" and "mental microscopy" as quintessentially modernist-- hardly known before 1900, though a virtual commonplace in the twentieth-century avant-garde. And he sees the emergence of these experiences of perceptual uncanniness as demonstrating not regression but a certain progression-- cruel consequences of a "steady growth of man's self-reflection and psychological introspection," which leads to "utmost detachment" and to "that second, coldest consciousness... objectification of life."

He describes "how the indiscreet, all too imaginative look disintegrates the organic figuration and texture of surface reality, and how, under its animistic vivification, parts and segments assume an independent, swarming life. This happens as if under a compulsion, and the man who looks seems himself to be just an instrument, or victim, of this irresistible seeing." A passage from Renee's memoir evokes exactly this sort of experience....:

I remained quiet, unmoving, my gaze fixed on a spot or a gleam of light.
But behind this wall of indifference, suddenly a wave of anxiety would come over me, the anxiety of unreality. My perceptions of the world seemed to sharpen the sense of the strangeness of things. In the silence and immensity, each object was cut off by a knife, detached in the emptiness, in the boundlessness, spaced off from other things. Without any relationship with the environment, just by being itself, it began to come to life. It was there, facing me, terrifying me.

Act or Affliction?

The patient, it seems, is plagued not so much by diminished awareness or ability to concentrate as by hyper-awareness, a constant, compulsive need to exercise his own consciousness. Thus the illness of the famous schizophrenic Dr. Schreber began with a torturing sleeplessness, and Schreber maintained that there was a "more or less definite intention," emanating from somewhere, to bring about his mental collapse by forcing him always to be awake and aware. Another schizophrenic said, "It's as if I am too wide awake-- very, very alert. I can't relax at all."

What burgeons out of control here is the process of awareness itself. [...] Patients like this might be said to be condemned... to a kind of hyperconsciousness and compulsive deliberation... .

We see, then, that, like the modernist anti-epiphany, the schizophrenic Stimmung involves not a lowering but a heightening of conscious awareness.

It is significant that Renee should describe her insanity not only as the Land of Unreality and the state of Madness but also as the Land of Enlightenment and Light. [...] We might interpret the "implacable light" that irradiates the bright surfaces and sharp edges of Renee's Land of Madness as a quasi-symbolic manifestation of the central element of her illness: her own unrelenting and disengaged consciousness.
Madness, however, has nearly always been associated with images of primitivity and wildness, with peremptory urges emerging from some dark and subterranean place. The "remoreseless light" of the Stimmung suggestions the existence of other types of madness. Apollonian or even Socratic illnesses whose central features are hypertrophy of consciousness and a concomitant detachment from instinctual sources of vitality. It is in modernist and postmodernist culture that this detachment and heightened awareness have been most extensively explored, so let us end with the words of the poet Octavio Paz, describing, in The Labyrinth of Solitude, a "truly modern consciousness"... . Paz speaks of a consciousness "turned in upon itself, imprisoned in its own blinding clarity."

Chapter 3: The Separated Self

...to know my own self is, inevitably, to multiply or fractionate myself; it is to create a division between my knowing consciousness and my existence as a perceivable individual who interacts with others or subsists as a body of flesh and blood.
This, at least, is one vision of the human condition, a vision rooted in the philosophy of Descartes but whose more extreme implications were not elaborated (or lived out) until the era of modernism...-- a time when engagement in the world can no longer be taken for granted and the mind withdraws, or turns in upon itself. No one states this view more clearly than... Paul Valery. In "the final analysis," Valery writes, "it is the doubling which is the essential psychological fact." He speaks of a brain "too much occupied internally, [and that] deals brutally with external things... but also of a brain whose "prime function" is "to take its [own] acts, its modifications as strange and independent things."[...] In The Divided Self, R. D. Laing describes the schizoid person as an individual whose being is split in two main ways: in the relationship to external reality and in the relationship to the self.

Schizoid Personality

The most prominent characteristics of schizoid persons are an apparent asociality and indifference, often combined with introversion. Seldom do such people feel in harmony with their bodies or with the environment, and typically, their emotions do not flow in a natural and spontaneous way; instead they seem forced or stiff, and others may find them cold and unfeeling, perhaps overly cerebral or calculating. Often they will seem detached, "as if something unnatural and strange divided them from the world." [...] They have, in any case, an aloof, vaguely mysterious air, suggestive of a realm of experience hidden away from others. Though they may seem circumspect and inordinately controlled, perhaps overly formal or mannered, this can be interrupted by occasional bouts of impulsive... extroversion that smacks of overcompensation... .

Commonly, such individuals are obsessed with abstract, metaphysical, or technical concerns... .

Most schizoid persons are well aware of their own detachment. "There is a plane of glass between me and mankind" is a typical remark. [...] ...one schizophrenic (Lawrence), recalling his earlier life, described himself as having long had the feeling of living "suspended in the plasma" of his own thoughts.

Theories and Subtypes of Schizoid Personality

...in medical-model psychiatry, the schizoid's apparent asociality and emotional flatness are taken more or less at face value... . Just the opposite tack is taken by the psychoanalysts most interested in schizoid conditions, the British object-relation theorists, for they interpret the apparent insensitivity and asociality as a defense, a way of protecting and masking a deep-lying hypersensitivity and neediness.

The subtlest and most reasonable account is... the one offered in Physique and Character, a book published in 1921 [by Ernst Kretschmer]. [...] ...schizothymia-- the propensity to shift between hypersensitivity and insensitivity or coldness in one's reactions to the world.

...those individuals... who seem predominantly cold or poor in affective responce: "as soon as we come into close personal contact with such schizoids, we find, very frequently, behind the affectless, numbed exterior, in the innermost sanctuary, a tender personality-nucleaus with the most vulnerable nervous sensitivity which has withdrawn into itself, and lies there contorted."

Kretschmer notes... the high number of schizothymic individuals to be found in the movement of German idealism and romanticism-- among them Immanuel Kant, Friedrich Holderlin, Johann Gottlieb Fichte, and Friedrich von Schiller.
But if the schizothymic disposition has some affinities with romanticism, it would seem to be even more strongly linked with the modernist movement... . [...] ...we might regard the artist as an emblematic as well as ambivalent figure-- his inward turn providing an image of nonconformist escape or of rebellion against modern society while at the same time illustrating, in exaggerated form, tendencies that pervade this same society.

Franz Kafka: A Hypersensitive Sensibility

Kafka's introversion does seem largely a responce to hypersensitivity, a defensive drawing back... . [...] Kretschmer describes "a cramping of the self into itself," an attempt "as far as possible to deaden all stimulation from the outside"; such people "close the shutters of their houses, in order to lead a dream-life, fantastic, 'poor in deeds and rich in thought' [the quotation is from Holderlin] in the soft muffled gloom of the interior."

Kafka himself stated the dilemma very well: "You can hold yourself back from the sufferings of the world, this is something you are free to do and is in accord with your nature, but perhaps precisely this holding back is the only suffering that you might be able to avoid." [...] ...he wrote to a friend of wanting to read only "
the kind of books that wound and stab us. ... A book must be the axe for the frozen sea inside us."

Charles Baudelaire: A New Aesthetics of Disdain
Baudelaire's persistent scorn has two main objects, the first being the natural world and all the organic, spontaneous processes that it sustains. Nature, he says, is hideous and corrupt: a "swamp of blood, an abyss of mud" whose relentless flourishing and self-renewal strike him as shameful and distressing. His own preference is for "la majeste superlative des formes artificielles," and he insists that "everything that is beautiful and noble is the product of reason and calculation... ."
The other object of Baudelaire's disdain is the ordinariness and predictability of both the masses and the bourgeoisie.... . The problem with the average man, as Baudelaire sees it, is his sociability: his desire to be just like the others, to conform to their expectations, and, worst of all, to lose his separateness by melting in with the crowd. The man of genius, by contrast, always "wants to be one, and therefore solitary," for he knows that "to be a great man and a saint by one's own standards... is all that matters"... .
The mood of Baudelaire's solitude and withdrawal is, then, less a matter of threat than of gnawing dissatisfaction... .

The true antithesis of nature and society is that glorious figure, the dandy, whom Baudelaire defined as "the man brought up in luxury... who has no other profession but that of elegance, [and who] will always have a distinctive appearance, one that sets him utterly apart." [...] The way of the dandy... requires him to be "sublime without interruption; [to] live and sleep before a mirror," always cultivating an "air of reserve, which in turn arises from his unshakeable resolve not to feel any emotion."

Behind such cold and arrogant surfaces, however, there will, as Kretschmer pointed out, usually be indications of a tender core: a "most vulnerable nervous sensitivity which has withdrawn into itself, and lies there contorted."

Displeased with everybody, displeased with myself, I should like to regain a little self-redemption and self-pride, amidst the silence and solitude of night... . O Lord my God, give me grace to produce a few lines of good poetry, so that I may prove to myself that I am not the most abject of men, that I am not inferior to those whom I despise.

Parallels with Modern Culture: Disconnection

Both Kafka and Baudelaire wrote from a position of estrangement from society-- a society seen, in the first instance, as callous and threatening and, in the second, as... banal. Yet it would be wrong, for this reason, to ignore how their attitudes and modes of experience, so typical of the schizoid individual, can also reflect the culture of which they were a part, a culture whose signature can be most apparent precisely in those who criticize or reject it [editors note: compare this with Foucault's statement that a culture positively expresses itself through the very phenomena, or people, it rejects].
The issue of the affinities between culture and the schizoid attitude has received remarkably little attention in mainstream psychiatry... .

...the most characteristic features of the schizoid lived world, bear a remarkable resemblance to the modern or modernist sensibility; of all personality types, the schizoid most clearly epitomizes the distinctive elements of the modern condition.

It seems clear that one of the most distinctive and pervasive features of modernity is the intense focus on the self... . The modern cultural constellation obviously has certain strengths-- allowing as it does for freedom of movement and thought, and encouraging individual initiative and self-expression. But, of course, it also has a dark side, forms of alienation summed up in the following list: "isolation, loneliness, a sense of disengagement, a loss of natural vitality and innocent pleasure in the givenness of the world... ."
Interiorizing Trends

The social historian Norbert Elias speaks of "the extraordinary conviction carried in European societies since roughly the Renaissance by the self-perception of human beings in terms of their own isolation, the severance of their own 'inside' from everything 'outside.'" This aspect of modern existence is manifest at many levels of cultural reality... . For its clearest expression, however, we might look to the doctrines of the two most influential philosophers of the modern era, Rene Descartes and Immanuel Kant.

Descartes..., generally acknowledged as the father of modern philosophy, could be said to have [given] the modern concept of mind [its] decisive formulation. […] Consciousness in the Cartesian scheme is conceived of as radically distinct from the material plane of extended substances, a plane that includes the body in which this consciousness is mysteriously housed, rather like a ghost in a machine (in Gilbert Ryle’s famous phrase). […] Further, consciousness is assumed to have direct access not to the external world but only to inner “ideas” that somehow represent this world… . Both these aspects of Cartesianism are by now so deeply embedded in prevailing modes of understanding as to seem self-evident and inevitable. We may need to be reminded that very different visions are quite possible, and have in fact prevailed in other cultures and other eras… .
The essential implications of Cartesianism for the modern self might be summed up in two words: disengagement and reflexivity.

Kant’s philosophy, which… is sometimes viewed as initiating modernist thought, could be seen as a radicalization of Cartesianism, since it places an even more intense emphasis on reflexivity and disengagement. […] Consciousness for Kant is not just a touchstone of certainty [as it was for Descarte’s]; now its structures—in the form of the (human) categories of time, space, causality, and materiality—are said to constitute, in a sense to create, the world of our experience. […] In Descartes’s scheme, the ideas we experience were certainly inner phenomena, yet nevertheless were assumed to be linked (albeit uncertainly) to an external world. Kant, by contrast, draws an absolute distinction between the realm of all possible human experience (the “phenomenal” realm, as he called it) and that of actual existence or being (the “noumenal”), thus implying an unbridgeable gap that sunders us eternally from the real—leaving us “lonely and forsaken amidst the world, surrounded everywhere by spectres.”

Particularly telling illustrations of a growing self-consciousness, and of an increasing interiorization and privatization of daily life, are offered by the historical sociologist Norbert Elias’s vivid studies of the history of manners. Elias describes, for instance, how eating came, in Western society, to be the object of increasing strictures that had the effect of… disguising or even denying [peoples] natural or animalistic side. […] The new forms of etiquette that were developing required the restraint of emotion and spontaneous impulse by internal controls and an increasing dominance of the cerebral over the affective or instinctual side of life. They also led to an ever-growing self-scrutiny and insistence on self-control, which necessarily lowered the threshold of what was felt to be shameful and offensive. Elias suggests that this necessity to restrain the spontaneous expression of affect and impulse led to a feeling of being separated from the external world by an invisible wall, a “self-perception in terms of one’s own isolation” that is expressed in the modern philosophical leitmotif of homo clausus, the image of a “self in a case” that is so important in the thought of Descartes, Kant… .
The spread of literacy may also have contributed to these interiorizing trends. As the scholar Walter Ong has pointed out, both writing and reading (especially silent reading, a practice that only gradually came to be the norm) allow—even force—a person to think or to encounter thought alone, with a sense of isolation from the group… . The written word could also be said to freeze thought, by organizing and preserving it in a visual space; it thereby offers a new image of an independent mental universe… . By the eighteenth century in the West, Ong argues, the commitment of sound to space that is inherent in alphabetical writing had had a noticeable effect on our sense of the world, gradually making possible what Ong calls a new kind of “schizoid” withdrawal—a remoteness from sensory actuality and social interaction that allowed for escape into… the interior of one’s own mind.
Schizoid individuals seem to have a special affinity for modes of inwardness and withdrawal akin to those of the modern age.

Parallels with Modern Culture: Uncoupling

Disconnection-- the sense of being cut off from external objects and other people-- is not the only form of separation experienced by the schizoid individual. Typically, such a person's existence is also riven in a second major way, along fault lines running through the self rather than between self and world. And this is often associated with a second major form of self-consciousness: where consciousness focuses no the self not as a knowing center... but as an actor in the world and a potential object of awareness for others. The "uncoupling" this entails... sets up a division between different selves: a hidden, "inner" self that watches or controls, usually associated with the mind, and a public, outer self that is more closely identified with bodily appearance and social role and that tends to be felt as somehow false or unreal.

Role Distance

The term role distance, introduced by the sociologist Erving Goffman, captures this phenomenon: one scrutinizes and judges one's behavior from within as well as from the standpoint of an imaginary other, whose reactions one attempts to anticipate and control. And, as Goffman points out, role distance is not so much a denial of the role itself as a rejection of the "virtual self" that is normally felt to animate or inform one's public performance. As with other features of schizoid personalities, this phenomenon seems to have particular prominence in the modern world; let us now consider some of its cultural manifestations and sources.
One of the most fundamental presuppositions of contemporary Western society and thought is that each individual has some kind of inner being or personhood existing apart from or prior to his or her actions or social roles. Historical and anthropological research suggests, however, that this notion is far from universal, being absent not only in traditional societies of the non-Westernized world but also in the West prior to the modern age.

...[an] absence of the concept of experience of an inner self prevailed in European culture until the end of the Middle Ages, for it is only in the sixteenth century that one begins to find literary evidence of a modern awareness of inwardness and role distance; and philosophical conceptions of the individual person as independent of roles do not come to prominence until the eighteenth century. Historians and sociologists have viewed these as "inner deep-seated changes in the psyche" that betoken "the emergence of modern European and American man."

The polarization of inner from outer or public man has strong evaluative implications, for there is an increasing tendency to value the inner self above its "mere" social roles. We can trace this development in the process whereby the sixteenth century ideal of sincerity came [editors note: recall the severity of the crime of 'bearing false witness'], by the nineteenth century, to be replaced by an emphasis on a rival ethic-- authenticity. Sincerity-- the congruence between actual feeling and avowal-- does not yet imply an overvaluation of the inner... . But, as Lionel Trilling shows, this concept of virtue has been displaced over the course of the last two hundred years-- to the point where the term sincerity has come to have a quaint... ring to it. For some time now we have lived in a postromantic climate that... stresses instead authenticity-- where the point is not so much to be true to other human beings as to be true to oneself... . Similar developments are suggested by the gradual eclipse of the Renaissance category of passion-- which implied some overt, often violent accompanying action-- by the far more "inner" or "subjective" concept of emotion... .
One consequence of this inward turn has been a draining of value from public action... .

Abdication of the Public Self

The first way of responding to this devaluation of the public self is to attempt to abdicate the public self entirely... .

For [Sarraute],... it is the "unceasing play" of inner phenomena... that constitutes "the invisible woof of all human relationships and the very substance of our lives." An authentic life is one that attends to this inner stuff, and avoids dissipating itself in the distractions of action and the public life [editors note: notice the similarities with the kind of asceticism we find in the early church].
This kind of inwardness and alienation from the public self is very common in certain kinds of schizoid patients.

...Mary MacLane [in her autobiographical book I, Mary MacLane] is a clear example of... the kind [of schizophrenic] who turns inward and develops a layer of indifference largely as a means of self-protection. [...] ..."I never disclose my real desires or the texture of my soul," she explains. "And so every day of my life I am playing a part; I am keeping an immense bundle of things hidden under my cloak." "My inner life is never touched." But this extreme dissociation from the outer persona exacted its price, in the form of painful feelings of fraudulence: "When one has played a part--  a false part-- all one's life, for I was a sly, artful little liar...; then one is marked." "[I am] in no small degree, I find, a sham-- a player to the gallery," she insists; there was always "a spirit of falseness that rose and confronted me and said, 'hypocrite,' 'fool.'
Such preoccupations were especially intense for another of Laing's schizoid patients... . Generally, James would try to protect his inner being by appearing like everyone else, falling in step with them and copying their behavior. The result, however, was that nearly everything he did felt inauthentic... . [...] ...the outer self, instead of feeling under the actor's control, came to seem increasingly independent and removed, taking on a mechanical life of its own. [...] Eventually such persons may come to sense they have no self at all... : "I am only a responce to other people," James said. "I have no identity of my own... no self... I am only a cork floating on the ocean."

Not surprisingly, perhaps, patients like these will often assume that other people's behavior is just as contrived or mechanical, in any cases as devoid of spontaneous involvement, as their own.

Unconventionality and Inauthenticity

There are other, more active modes of being that also stem from the modern emphasis on individuality and the separation between inner and public selves. Instead of shrinking back from overt action, as from something inevitably contaminating, one may seek to act in ways that display the sovereignty of the inner person or unique self.

The Path of Most Resistance: Schizoid Traits in Overt Schizophrenia

The "Famous Empty Smile"

No one who has interviewed schizophrenics will have failed, at times, to have the sneaking suspicion that the whole interaction is, to the patient, something of a joke. Often this tone is quite subtle, and the interviewer is left wondering whether the patient is really involved in the conversation, or is essentially detached, watching and mocking the whole event as if from somewhere far above.
Given how common this disconcerting and ambiguously ironic posture can be, it is surprising it receives so little attention in the literature on schizophrenia.

Significantly, irony is one of the salient features of modern art and consciousness. In 1800 Friedrich Schlegel spoke, very presciently, of "such a quantity of great and small ironies of different sorts" that seemed to be springing up recently, and he warned of the dangers of these tendencies he saw burgeoning all around him, asking: "What gods will rescue us from all these ironies?" But... what seems fairly distinctive about the schizophrenic variety... is, first, its totalizing character-- ... it is all-encompassing, not a criticism of one thing in favor of another but a universal mockery.

Certainly the schizophrenic's irony lacks the infectious quality of a manic person's hilarity; and it is hardly the sort of good-natured belly laughter that builds a sense of solidarity.

While this kind of irony may provide a bizarre form of satisfaction [for the patient], not surprisingly its usual effect is further to alienate the patient from the possibility of a satisfying intimacy with others.

...one must question whether these qualities of alienation, irony, and masquerade are really so peripheral to the schizophrenic condition as is often assumed.


Chapter 4: Cognitive Slippage

Relativism and Perspectivism: "Vertigo of the Modern."

Nietzsche's own perspectivism is apparent in his persistent opposition to Platonism and all forms of essentialism... .

One might contrast this condition, which the poet Louis Aragon called "the vertigo of themodern," with that of premodern, traditional, or (so-called) primitive ssocieties, where one seldom finds this kind of relativism, the sense of arbitrariness that accompanies the recognition that one's world view is but one possibility among many.

One of the clearest illustrations of modernist relativism, and of the weakening of personality it can cause, is Ulrich, the antihero protagonist of the novel The Man Without Qualities, a character whom Robert Musil... created both as an alter-ego figure and a sort of representative modern man.
Ulrich is plagued with excessive rationality and self-consciousness, and unusually open to alternative possibilities and modes of experience. A "possibilitarian,"... .

Nothing is stable for him. Everything is fluctuating, a part of a whole, among innumerable wholes that presumably are part of a super-whole, which, however, he doesn't know the slightest thing about. So every one of his answers is a part-answer, every one of his feelings only a point of view.... .

It is understandable, then, that Ulrich should no longer experience commonsense reality, that "utopia of the status quo" within which normal people go about their daily lives, as an inevitable terrain to which one simply opens one's eyes. ...it is only by

exercising great and manifold skill [that] we manage to produce a dazzling deception by the aid of which we are capable of living alongside the most uncanny things and remaining perfectly calm about it.... . We know that life ebbs away both out into the inhuman distances of interstellar space and down into the inhuman construction of the atom-world; but in between there is a stratum of forms that we treat as the things that make up the world, without letting ourselves be in the least disturbed by the fact that this signifies nothing but a preference given to the sense-data received from a certain middle distance. Such an attitude lies considerably below the potentiality of our intellect... . But if one looks into it more closely one sees that it is nevertheless an extremely artificial state of mind that enables man to walk upright between the circling constellations and permits him, in the midst of the almost infinite terra incognita of the world around him, to place his hand with dignity between the second and third buttons of his coat.

Schizophrenics often have a similar sense of the absurdity of things... . And, frequently, they will also experience an analogous feeling of being overwhelmed by endless possibilities. A patient... said that whenever she wrote something, she couldn't help but think about what she was not writing; and this, she explained, made her feel as if she were living inside some kind of endless hologram.

This free-floating mode of cerebration can be expressed in an all-encompassing doubt... . [...] As some schizophrenics have said: ... "my thoughts are so confused, everything is wavering, nothing is fixed-- one cannot hold fast to anything."
Though such patients will usually have an intellectual awareness of where they are located, they may not feel as if they are in that place and time, for they lack that all-important source of orientation and stability: the sense of grounding in the lived body. (Perhaps Judge Schreber, the famous paranoid schizophrenic, was responding to this feeling of rootlessness when he complained that the "rays [he had delusions of being influenced and tormented by divine rays] did not seem to appreciate at all that a human being who actually exists must be somewhere.")

The psychotic murderer Moosbrugger, the central figure in one of the major subplots of Musil's The Man Without Qualities... experiences certain classic schizophrenic symptoms, and has been diagnosed as having dementia praecox.

The normal citizens of Kakania, the fictional society of Musil's novel, imagine this murderer as a pure incarnation of all that is primitive and instinctual... . But Musil's description of Moosbrugger's inner life differs sharply from this image (suggesting, interestingly, that Musil may have had some inkling not only of the parallels between modernism and this kind of madness but also of the ironic error implicit in the standard Wildman image of the latter).

Moosbrugger is no intellectual, but his alienated, rather inchoate, insights into the nature of words and concepts are remarkably reminiscent of various modern forms of perspectivism.  Thus... he seems to realize.... that human concepts work through their relationships with each other (everything "hangs together") more than by any direct connection with the real. [...] ..."life," he realizes, "forms a surface that pretends it has to be the way it is, [while] under its skin things are thrusting and jostling."

Even Moosbrugger's murderous violence, the most obvious expression of his supposedly bestial or Dionysian nature, actually takes place in an atmosphere of surrealistic alienation-- motivated, it would seem, by a desire to erase his disconcerting sense of fragmentation, arbitrariness, and the absurd.

Chapter 5: Disturbances of Distance

The play with time was so uncanny... an alien time seemed to dawn. -- Schizophrenic patient, In Karl Jaspers, General Psychopathology.

Verbal Concepts and Nietzschean Dualism

...Nietzsche would speak of the importance of escaping from instrumental convention and abstract ideas into the world of sensations, of immediacy, and of becoming-- into a realm of "sudden impressions"... . He would fault abstract concepts for distorting the actual nature of the world.

Roland Barthes's express desire to escape the "disease of thinking in essences" by adopting "ephemeral concepts, linked to limited contingencies."

Narrative Understanding

Narrative Form and Schizophrenia

Schizophrenic discourse has often been observed to display similiar characteristics: the lack of a cohesive theme or narrative line, of conventional space-time structure, of comprehensible causal relations, and of normal regulation of the symbol-referent relationship.

These various distortions of normal time and space, of symbol-referent relations, and of frame of reference have nearly always been interpreted as indicators of cognitive incapacities or else the collapse of ... structures brought on by regression. The tendency to focus on the medium of representation-- has often been seen as a sign of... an inability to transcend the literal, physical presence of a stimulus-object by perceiving it as representative of some meaning or some hypothetical world existing beyond itself. [...] It is interesting to discover, therefore, that virtually the same characteristics can be found in some of what might be considered the most sophisticated narratives... of our time.

Spatial Form in Modern Literature

...the characteristics that make schizophrenic stories unlike the standard narrative form are much the same as those that differentiate traditional from modernist literature in general... . The classic statement of the relevant view regarding modernism is Joseph Frank's seminal essay of 1945, "Spatial Form in Modern Literature," which describes a widespread attempt in modern literature to deny time and thereby to achieve a sense of simultaneity... .

Escape from Time

At the end of a book on the turn-of-the-century origins of the twentieth century avant-garde, the literary scholar Roger Shattuck suggests that a time machine fantasized by the playwright Alfred Jarry could stand as a symbol for the consciousness of the modernist age. Jarry's time machine, a kind of gyroscope, achieves absolute immobility via controlled motion. By an elaborate pseudophysical (he called it "pataphysical") conceit, Jarry "proves" that if one could achieve such spinning immobility in space, one would also escape from the bounds of normal time. And since the imaginary machine, like a gyroscope, achieves its stasis-cum-motion by turning around its own center, its escape from chronology is achieved by means of a kind of involution or self-reference.
This fantasy machine-- conceived by a schizoid and typifying modernism-- echoes with uncanny accuracy certain statements made by schizophrenics that have been collected by the psychiatrists Eugene Minkowski, Franz Fischer, and others. One patient, for example, described himself as "like a machine that runs but does not move from its place. It goes at full speed, but remains in place." Another made explicit reference to the connection between introversion and his disturbed sense of time, describing an "intense cerebral activity in which inner experiences took place at greatly increased speed, so that much more than usual happened per minute of external time. The result," he said, "was to give an effect of slow motion. ... The speeding up of my inner experiences provided in this way a slowing down of the external world."
A third patient’s statement is richer still:

I look for immobility. I tend toward repose and immobilization. […] I will try… to make circular movements so as to not move too far away from the base in order not to be uprooted.

…it seems reasonable to ask whether… [schizophrenic spatialization’s] motivation might be akin to that of the spatial form found in modernism.
Drawing on certain classic arguments made by the art historian William Worringer, Joseph Frank proposed that spatial form could be understood as a way of escaping what is felt… to be the intolerably anxiety-provoking nature of external reality. By rendering reality as a timeless present, its unpredictability, dynamism, and mystery—in fact, its very otherness—are denied.

A… gradual progression toward flatness is clearly visible in the work of one schizophrenic man, Louis Wain,… whose paintings of cats gradually lost the dimensions of both depth and time and, with the progression of his illness, increasingly took on the “morbid geometrism” that is particularly characteristic of chronic forms of schizophrenic psychosis.

Lesage, ‘Composition Symbolique sur le Monde Spirituel’

…the focus on words or paint can also undercut the reality of the world: to the extent that one focuses on the way in which reality is rendered, reality’s status as something independent and apart is denied. And, in this sense, the words or paint function not so much as tokens of materiality as… of the dependence of the world on the mind that represents it.

These forms of reflexivity can, then, be a source of feelings of security of various kinds. //The critic Celement Greenberg… identified modernism with “the intensification, almost the exacerbation, of [the] self-critical tendency that began with the philosopher Kant,”… .

The Visual Arts

The sculptor Bruce Nauman… said he felt dissatisfied with his own sculptures because “they seemed to have too much to do with sculpture and not enough to do with his own thought processes.” This expresses a widespread aesthetic attitude, one source of which is Marcel Duchamp’s influential attempt to replace a merely “retinal” painting with something more purely conceptual, more directly an expression of the mind.

Heller [in his essay on Nietzsche and Wittgenstein] speaks of the predicament modern philosophy has entered, along with poetry and painting: “the stage where every act of creation is inseparable from the critique of its medium, and every work, intensely reflecting upon itself, looks like the embodied doubt of its own possibility.” This is a quandary Nietzsche anticipated in “A Fragment from the History of Posterity,” in his portrait of “The Last Philosopher”: “Nothing speaks to him any more—except his own speech; and, deprived of any authority from a divinely ordered universe, it is only about his speech that his speech can speak with a measure of philosophical assurance.” Here is a person undermined from within: confounded by ambiguity and paralyzed by indecision, he finds himself shuttered inside his own self-consciousness and devoid of all belief in a communicable world.

Chapter 6

Language of Inwardness

Parallels with Modernism

It is widely acknowledged that the last decades of the nineteenth century saw a major shift in prevailing attitudes toward language. […] As with the language of schizophrenia… several central underlying tendencies can be identified.

The first tendency is a new preoccupation with the uniqueness and particularity of unverbalized experience, and with the sense of ineffability this invariably evokes. The second is a move toward a kind of inner speech that is felt to be more authentic than conventional language. And the third is a new recognition of the independent nature of language, an acknowledgment of its existence as a system imbued with its own inherent mysteries and forms of productiveness… .

An investigation of these parallels should expose the inadequacy of certain popular notions regarding differences between creativity and madness-- notably, the oft-expressed view that whereas "the poet is a master of language, the schizophrenic is a slave to it." [...] For, in reality, more than a few modern poets and other writers have felt unable to master language, and some have even made this experience into a central theme of their work.

Impoverishment and Ineffability

I shall call modern the art which devotes its “little technical expertise”… to present the fact that the unpresentable exists. –Jean-Francois Lyotard The Postmodern Condition

To some important critics, the principle turning point in the history of Western literature occurred in the last decades of the nineteenth century and the beginning of the twentieth; these were the years when, for many writers, language ceased to feel like a natural organ of expression and came instead to be experienced as a constraining force, a devitalizing or banalizing medium incapable of capturing the unique nuances and particularities, or the deepest truths, of either the internal or the external world.

…Rilke, Musil, T. S. Eliot, and many other writers,… shared the malaise and frustration expressed in Eugene Ionesco’s lament: “there are no words for the deepest experience… . Of course, not everything is unsayable in words, only the living truth.” A passage from Sartre’s Nausea (1938) offers what is perhaps the most vivid and revealing portrayal of this modernist experience of ineffability and alienation.
In this famous climactic scene, the protagonist and narrator, Roquentin, is sitting in a park, staring fixedly at the root of a chestnut tree and feeling overwhelmed by the individuality and sheer actuality of what he sees before him. […] In this moment… all words—root, tree, leaf—seem to have “vanished and with them the significance of things, their methods of use, and the feeble points of reference which men have traced on their surface,” he writes. As Roquentin sits… he struggles vainly to regain his normal sense of orientation in a meaningful and categorizable world by repeating words to himself, yet finds himself only sinking further into the infinite uniqueness of this object before his eyes:

Knotty, inert, nameless, it fascinated me, filled my eyes, brought me back unceasingly to its own existence. In vain to repeat: “This is a root”—it didn’t world any more. I saw clearly that you could not pass from its function as a root, as a breathing pump, to that, to this hard and compact skin of a sea lion… . This root, with its colour, shape, its congealed movement, was… below all explanation.

In Autobiography of a Schizophrenic Girl, in fact we find an almost identical scene—a moment when Renee, caught up in her truth-taking stare and overwhelmed by the sheer presence and actuality of physical objects, tries to escape their hold by calling out their names: “I said, ‘chair, jug, table, it is a chair.’” She, however, is no more successful than Roquentin: as she says, words feel “deprived of all meaning,” like mere “envelope[s] emptied of content”; they seem to echo hollowly and are no longer capable of subduing the defiant and mocking presence of the objects with which they were once connected.

Many schizophrenic persons will also become preoccupied with the impossibility of describing experiences that are felt to be inner and private.

…a schizophrenic woman.. describes the “agony in not being able to communicate one’s mind”: “My own inadequacy to use language to express what lies buried so deeply inside me, even when I am lucid, makes words a curse… . There are things that happen to me that I have never found words for.”

Acute experiences of the inadequacy of language might elicit a variety of responses… . One possible reaction is simple refusal, a (sometimes ostentatious) lapsing into silence in order to escape entirely the contaminating or diluting forms of speech or writing. Robert.... had remained silent during a week of semi-catatonic torpor;... he explained this long period of muteness ("poverty of speech") as resulting from his sense of the unutterable complexity and profundity of existence: he had been unable to talk, he said, because there were just "so many echelons of reality... so many innuendos to take into account."

...so-called poverty of content of speech ['poverty of speech']... can also result from several different underlying processes-- including simple indifference to one's audience, the wish not to be understood too precisely, pretentiousness, [etc.,]... . Still, the phenomenon of ineffability does seem a particularly central issue, as indicated by how frequently schizophrenics themselves complained of the inadequacy of language.

The two major philosophers of the twentieth century, Wittgenstein and Heidegger, have written... that some issues are of such great generality and foundational significance that they cannot be spoken about, at least not in anything like normal modes of speech. As they point out in their very different ways, such issues-- which pertain to metaphysical or ontological questions concerning the ultimate nature of Being and the relationship between mind and world or language and world-- are already embedded in or presupposed by our forms of experience and of speech; and this makes it extremely difficult to detach ourselves from these all-encompassing matters in order either to describe them or to call them into question.
Many schizophrenics do seem to be highly preoccupied with experiences involving revelations of such cosmic or totalistic proportions-- about the nature of existence in general or its fundamental relationship to the self.

The preoccupation with general ontological or epistemological concerns, with issues pertaining to the nature of reality in general and to the general structure of self-world relations... resulted in speech unlikely to seem meaningful to the person not attuned to such issues.

At least some of the statements that strike observers as woolly or empty philosophizing... may thus be attempts-- sometimes inept but sometimes not-- to express concerns that are just too all-encompassing or too abstract to be stated in clear and specific terms, even by the most clear-minded of speakers.

One might, in fact, compare the hostile or contemptuous responses to Heidegger of such empirically orientated analytic philosophers as A.J. Ayer and Rudolph Carnap, who claimed that most of Heidegger was devoid of cognitive significance, to the way many psychiatrists dismiss what they see as the poverty of content of some schizophrenic speech. In both cases we note a similar impatience, verging sometimes on revulsion and contempt, for an attitude of mind that turns away from the noonday world of social and practical reality toward the elusive one of ontological speculation. But anyone who has indulged in such musings, whether during adolescence or since, will know that anything said on such ultimate and totalistic topics can easily seem, even to the speaker, to waver between profundity and utter meaninglessness.

Inner Speech
A second feature of the new literature emerging around the turn of the century was its reliance on juxtaposition rather than transition, on the technique of setting elements beside each other without explicit causal, logical, or narrative connectiveness.

…in his surrealist manifesto of 1924 Andre Breton rejected the view that thought is somehow too subtle or too rapid to be captured in language. The technique of automatic writing that he advocated would be… “a monologue spoken as rapidly as possible, on which the subject’s critical spirit brings no judgement to bear, which is subsequently unhampered by reticence, and which is, as exactly as possible, spoken thought”; it would thereby provide “a true photograph of thought.” The crucial requirement [is] a freeing of words from the constraints of rationality and public communication.

The linguistic characteristics of this inner murmuring are presented in Thought and Language (1934), a classic study by the Russian psychologist Lev Vygotsky… . Vygotsky asserts that the structure or skeleton of normal adult thought is provided by a kind of “inner speech.” As he explains, the form of this speech derives from its function, its role as a medium of expression rather than communication, a way of symbolizing thoughts for oneself. It follows that all that is obvious to the speaker can be omitted. And so, in inner speech, language becomes abbreviated or telegraphic: syntax is simplified, explicit causal and logical connections are omitted, and there is an absence of framing devices such as those normally used to distinguish metaphorical from literal meanings of verbal images.

The features of inner speech that Vygotsky describes are also found in much of the literature of the twentieth-century avante-garde and are central, too, in the desocialized speech so characteristic of schizophrenia.

It would be a mistake to assume that rejecting the social domain necessarily means immersing oneself in a realm of irrationality, instinct, or the passions—as if the only alternative to conventional, secondary-process thought and language were regression to the primary process.

…the desocialization of schizophrenic speech is not—at least primarily—the consequence of a move backward to childhood or downward toward the instincts and emotions. Like modernism, it seems to involve a turning away from the human community, and a focus instead on expressing the inner life.

The Apotheosis of the Word

…in Writing Degree Zero… Roland Barthes articulated… the notion that modern literature originates when the Word sheds its transparency and begins to shine forth as an independent object of attention and source of meaning.

The poet leaves the initiative to the words, to the clash of their mobilized diversities. The words ignite through mutual reflexes like a flash of fire over jewels. [Mallarme, 1880’s]

This Mallarmean withdrawal, this ceding of initiative to words, effects a profound transformation in one’s experience of language. The very possibility (and the worth) of referring to stable meanings or to realities external to language comes into question.

This linguistic vision is well illustrated by Derrida’s own reading of Plato’s Phaedrus, a work that happens to contain one of the earliest philosophical discussions of speech and writing. […] The “intentions of an author who goes by the name of Plato” are not his concern, Derrida explains; what interests him are the infinitely ramifying associations occasioned by “the play of language”—and these links “go on working of themselves,” regardless of the author’s intent or awareness.

Most previous theories of language, Derrida points out, have held that the essence of language lies in speech, and they have relegated the written word to a secondary status, merely an encoding of the more fundamental, face-to-face acts that occur in oral communication. Derrida himself, however, prefers a conception of language that would put writing at the center; for this brings out the two features of language that he considers so important: the independence and the ambiguity of the signifying medium. After all, written marks exist apart from their author or their reader in a most literal way: at a distance and in a physical space distinct from any intention to signify. And, instead of dying out along with an accompanying inner experience [“disappearing along with the act which gave rise to them”], written marks obviously persist in time and space, and can be transported far away from the locus of the original signifying act.

..the schizophrenic’s focus on the word’s sound or graphic appearance often involves… something [close] to a Derridean attitude.

Intention and Meaning in Schizophrenic Speech

As with modernism, so in the case of schizophrenia, we can speak of a “discovery and colonisation of inwardness,” of “a little cosmos of inwardness salvaged from the devaluation of the world.” [Heller, The Disinterested Mind, 197-]

The old ideal of a relationship with the world or with others that is mediated by words is replaced by an isolating relationship with language alone—and with a language that, in its… self-sufficiency has itself come to stand as an epitome of isolation and self-involvement.

Chapter 7: Loss of Self

The instinct for knowledge is malicious (something murderous, opposed to the happiness of mankind)… the will to knowledge… dissolves the unity of the subject;… it creates a progressive enslavement to its instinctive violence. Michel Foucault, Nietzsche, Geneology, History.

Normally, one [has] the sense of living one’s perceptions, thoughts, and actions as if from within, with an implicit or semiconscious sense of intention and control; one generally feels that one’s own consciousness belongs to oneself, and that unless one communicates the inner life through word or gesture, it will remain private. These presuppositions are, in fact, so deeply embedded in our general outlook and mode of existence that to state them has the ring of tautology—as if any alternative were simply impossible to conceive. […] But, strangely enough, with the development of a schizophrenic psychosis, these very assumptions can no longer be relied upon… .

For Descartes, the sense of possessing one’s own consciousness and inhabiting one’s acts (the essence of the Cartesian cogito) served as an Archimedean point, a fulcrum of certitude… . But, far from providing a solid base, in schizophrenia the cogito may come to seem the most dubious or evanescent of phenomena, and, with this loss of the awareness of one’s own subjectivity and… will, there may occur a more general fragmentation, a dissolution of all sense of one’s own cohesiveness, separateness, or continuity over time.

Clearly, such peculiar experiences are at odds with some of the most fundamental assumptions of our culture—described by the cultural anthropologist Clifford Geertz as our “Western conception of the person as a bounded, unique, more or less integrated motivational and cognitive universe, a dynamic centre of awareness, emotion, judgement, and action organized into a distinctive whole and set contrastively both against other such wholes and against its social and natural background.” It is understandable, then, that Karl Jaspers should have considered such experiences to be beyond the pale of any normal person’s empathetic capacity, and… should offer these symptoms as the primary illustrations of schizophrenia’s unsurpassable alienness and incomprehensibility. But, though the view sketched out by Geertz has certainly been the dominant one in mainstream Western culture over the last several centuries, in philosophy as well as in everyday life, it is not in fact the only one. Other views—and other modes of being—contradict the universality and perhaps even the validity of this Cartesian vision of a controlling or inner self, and may provide insight into the privations of agency and self-possession experienced in schizophrenia. “What gives me the right to speak of an ‘I,’ and even of an ‘I’ as cause, and finally of an ‘I’ as cause of thought?” asked Friedrich Nietzsche. “A thought comes when ‘it’ wants, not when ‘I’ want… It thinks: but that this ‘it’ is precisely that famous old ‘I’ is, to put it mildly, only an assumption, an assertion, above all not an ‘immediate certainty.’”

Such statements have become increasingly common in the course of the twentieth century; indeed, in the postmodernist art and poststructuralist thought of the last couple of decades, they came to be accepted almost as a kind of orthodoxy.

Psychiatric, Psychoanalytic, and Avant-Gardist Views

The psychoanalytic view of such self-disturbances was originally worked out in a famous paper [On the Origin of the 'Influencing Machine' in Schizophrenia, 1919] by Victor Tausk... who first introduced the phrase "loss of ego boundaries."

The patient is Miss Natalija A., thirty-one years old, formerly a student of philosophy. She declares that for six and a half years she has been under the influence of an electrical machine made in Berlin... . It has the form of a human body, indeed, the patient's own form. [...] The outstanding fact about the machine is that it is being manipulated by someone in a certain manner.

To Natialija, all that would normally be felt to be purposive or purposeful-- the movement of an arm or the semi-controlled play of attention across a set of thoughts-- feels imposed upon her.

Coming Apart: modern Culture and the Self

William James: Searching for the Self

In the Philosophical Investigations, Wittgenstein... addresses William James's claim that the self consists mainly of "peculiar motions in the head and between the head and throat," suggesting that this "discovery" is a function of the introspector's attitude: "And James' introspection showed, not the meaning of the word 'self' (so far as it means something like 'person,' 'human being,' 'he himself,' 'I myself'), nor any analysis of such a thing, but the state of a philosopher's attention when he says the word 'self' to himself and tries to analyze its meaning."
Wittgenstein wrote of the unnaturalness of a mode of... thought that would put states of consciousness or of willing at a remove... . It is not that such an inner division is impossible but that, when it does occur, it sets up an aberrant state of mind. After all, notes Wittgenstein, "I cannot observe myself unobserved"; hence a sentence like "I perceive I am conscious" describes an abnormal way of disposing one's attention. [...] What underlies such forms of illusion is a paradoxical condition: a failure to be sufficiently self-conscious about the effects of one's own self-consciousness, to distance one-self adequately from distanciation itself.

Self-Disorders in Schizophrenia

The Influencing Machine

As we saw in our discussion of William James, the person who stares intently at his own stream of experience... his own bodily sensations will seem separate from him, since the very fact of scrutinizing will make them seem out there, apart. To experience one's own sensations as having their original locus in another version of one's own body, in an influencing machine not under one's own control, would seem an appropriate way of symbolizing such an experience (and of providing a subjective explanation for it).

I am suggesting that we might see the influence machine as a late-stage symptom of a certain introversion, a crystallization of a phenomenological world in which explicit attention fixes on the inner sensations and body-image experiences that would usually be transparent and unthematized, that would normally remain latent while the external world occupies the focus of awareness.
According to this interpretation, the influencing machine would be a projected image not of the physical body but of the subjective body—a lived body that is, so to speak, turned inside out and solidified, reified by the intensity of a self-directed gaze. And this inside-out body nearly fills the universe, reducing the world to a room located in some vague elsewhere and other people to phantoms whose only function is to manipulate and discuss the Natalija machine lying before them.
In many cases, the progression of the disease is quite consistent with such an interpretation. […] In one autobiographical account, a schizophrenic who eventually developed delusions of influence describes himself as having been from “very early in life an observer of my own mental peculiarities… .” As Tausk himself pointed out, the illness of patients like Natalija often begins with mild experiences of estrangement. […] Such experiences tend to feed upon themselves. As the patient’s own strange sensations and thoughts attract his attention, this attention itself makes the sensations seem all the more distant, external, and concrete.

Whatever its sources, a relentless kind of introspection is clearly a central element of schizophrenic experience… .

We can understand, then, how a person who steps back from his own experience might begin to feel as if his sensations and thoughts originated somehow outside his own body or mind, how he could begin to hear his own thoughts as words spoken outside his head, or even to feel his actions, sensations, or emotions as being imposed upon him from without.

This progression of simultaneous involution and externalization may end in the formation of a systematized delusion that can alleviate a frightening sense of chaos and disintegration. Thus the notion of some kind of influencing machine, one of the classic delusions of schizophrenia, may stabilize the world by filling it with a quasi-external symbol of the subject’s own hyper-reflexive consciousness, and by providing some way of accounting for the distorted, passivized experiences being undergone.

According to the traditional primitivity view, the attenuation of “reflective thinking” or “observing ego”… and the loss of “self” (of the sense of the reality, discreteness, and cohesiveness of one’s being) are complementary… . Accordingly, many psychoanalysts have recommended psychotherapeutic approaches whose main purpose is actually to encourage introspection and the development of an observing ego. This assumption of the interdependence of ego boundaries and of reflective awareness, and of the weakening of both in schizophrenia, is, in fact, made by virtually all those who have attempted to interpret these aspects of the schizophrenic condition—including nonpsychoanalytic psychologists as well as members of the literary avant-garde.

But by now we have seen that an alternative interpretation of this erosion is possible: rather than sustaining a sense of self, certain forms of self-observing may actually serve to undermine it.


Like some other advocates of the primitivity interpretation, Julian Jaynes suggests that the quintessential example of auditory hallucination in schizophrenia is the “command hallucination,” obeyed without hesitation or conscious reflection. In fact, however, the auditory hallucinations most characteristic of schizophrenia, those listed by Schneider as First Rank Symptoms, do not fit this description at all. Schneider lists three specific types, and in two of them the role of hesitation or self-monitoring is particularly obvious: first, a voice mocking, criticizing, or commenting on what the schizophrenic person is doing or thinking… ; and second, two or more voices discussing or arguing about the individual’s ongoing activities.

Auditory hallucinations have often been thought to express primitive urges or archaic memories that have somehow pushed their way upward, bursting suddenly into the more rational chambers of the mind. […] One might better think of the hyperrationalism Nietzsche criticizes in The Birth of Tragedy: what he describes as the condition of that “monstrosity,” the “non-mystic, in whom the logical side has become, through superfetation, as overdeveloped as has the instinctual side in the mystic,” and where consciousness, the “dissuader and critic,” replaces instinct as the dominant motivating force. (In The Birth of Tragedy, Socrates epitomizes this aberrant condition that Nietzsche believed was increasingly becoming the norm in Western civilization; and Socrates is described as hearing a quasi-divine voice that speaks to him as if from without—a voice that, as so often in schizophrenia, is a “purely inhibitory agent”: it “always spoke to dissuade.”)

"Dispossession" and "Furtive Abductions"

Schizophrenic individuals often believe or sense that they are being watched. In his diary, a young artist named Martin,… wrote of “being examined throughout my life—secret cameras and microphones the whole James Bond Ian Fleming trip is whirring in my head,” and another schizophrenic patient described being monitored by a “Watcher-Machine” that protectively oversaw her daily activities.

…the feeling of being watched typically involves an acute awareness of the presence of other consciousnesses, and this too is foreign to any conception of infantile experience.

Such manifestations of hypertrophied self-consciousness are not likely to facilitate normal forms of pragmatic and social activity, which may help to explain why some schizophrenics seem to move in such a stiff or awkward way. One schizophrenic patient complained, “None of my movements come automatically to me now. I’ve been thinking too much about them, even walking properly, talking properly and smoking—doing anything. Before they would be able to come automatically.”

Silvano Arieti describes a patient, John, whose catatonic paralysis evolved out of this kind of alienating hyperconsciousness. […] …he feared he might commit some crime or do something that would cause disaster… . The terror soon became intense enough to inhibit all movement, causing a petrification; in his own words, he saw himself “solidifying, assuming statuesque positions.”

It is ironic… that the schizophrenic loss of self should have been taken, in antipsychiatry and in the artistic avant-garde, as some sign of liberation into the free play of desire. Actually some such patients gradually cease to have any sexual feelings at all… .

…the schizophrenic often seems to be caught in an insoluble dilemma, driven to search for the self yet likely to destroy it in the act of searching. One patient was afraid of forgetting herself: “When I suddenly realized I hadn’t been thinking about myself I was frightened to death. The unreality feeling came. I must never forget myself for a single instant.” Another patient sought the experiential centre of her own consciousness but became confused when, like an infinitely receding horizon, it continually eluded her attempts to grasp it; she ended by not being able to be sure that her thoughts were really her own… . […] The literary mise en abyme has been described as a paradoxical combination of self-constitution and self-cancellation… . …her frantic attempts to constitute the self actually undermine it—as if the exigent searching, the desperate attempt to locate a self as solid as a thing, were part of what tears it apart.

…the most constant theme of Artaud’s writings is… what he himself describes as “an absence of mental fire, a failure of the circulation of life,” or “a disembodiment of reality.” […] …the sensual excesses of his “theatre of cruelty” may be better understood not as expressions of a naturally overflowing vitality but as defences against the devitalization and derealization that pervaded his being. …”I wanted a theatre that would be like a shock treatment, galvanize, shock people into feeling,” he said.

Artaud did desire to eclipse the mind through ecstatic sensation and fusion with the ambient world; yet, far from being his primordial condition this was an escape he never achieved. […] …Artaud’s persistent misery, and the most powerful motivation for the extreme antimentalism of his aesthetic philosophy, lay in the fact that the loss of self he actually experienced… had a far more cerebral character, one closer to the mise en abyme of self-alienating introspection. As he puts it in The Theatre and Its Double, “If our life lacks brimstone, i.e., a constant magic, it is because we choose to observe our acts and lose ourselves in consideration of their imagined form instead of being impelled by their force.” … “We are of the inside of the mind, of the interior of the head”’ “I suffer because the Mind is not in life and life is not the Mind; I suffer from the Mind as organ, the Mind as interpreter, the Mind as intimidator of things to force them to enter the Mind.”

…he describes having experienced his physical being as a sort of vast and fragile body-universe disintegrating beneath his watchful eye: “This cataclysm which was my body… this dislocated assemblage, this piece of damaged geology… this ill-assembled heap of organs which I was and which I had the impression of witnessing like a vast landscape on the point of breaking up.”

What prevents them from returning to a more normal existence is no simple failure of will but, in a sense, an inability to desist from willing—an inability to let themselves be caught up in and carried along by the ongoing flow of practical activity in which normal existence is grounded.

…what seems to be alienating about schizophrenics like Natalija… cannot be separated from the self-alienation felt by the patients themselves. But if this is so, it has the odd implication that the observer’s alienation may not, in fact, indicate a total failure of empathy: it may be a shared alienation, a feeling evoked by accurate intuitions of what the patient is actually going through. Could it be, then, that the dizzying abyss we feel in the presence of certain schizophrenic patients is connected with the mise en abyme into which they themselves are falling?

Chapter 8: Memoirs of a Nervous Illness

I have decided to apply for my release from the Asylum in the near future in order to live once again among civilized people and at home with my wife. It is therefore necessary to give those persons who will then constitute the circle of my acquaintances an approximate idea at least of my religious conceptions, so that they may have some understanding of the necessity which forces me to various oddities of behaviour, even if they do not fully understand these apparent oddities.
This is the purpose of this manuscript... . I cannot of course count upon being fully understood because things are dealt with wchih cannot be expressed in human language; they exceed human understanding. Nor can I maintain that everything is irrefutably certain even for me... . But one thing I am certain of, namely that I have come infinitely closer to the truth than human beings who have not received divine revelation.

So begins Memoirs of My Nervous Illness, the most influential account of a psychotic disorder ever produced by a psychiatric patient. This book, published in 1903, is the work of one Daniel Paul Schreber,... who suffered his first psychotic break in 1894, the year after he was appointed to the position of presiding judge... in the Superior State Court in Dresden... .

...many of his themes and concerns coincide remarkably closely with what the philosopher/historian Michel Foucault (in his influential Discipline and Punish) describes as the central and defining feature of the modern self.

Freud... made it [Schreber's Memoirs] the subject of the most extensive paper he ever wrote on psychosis, the famous "Psychoanalytic Notes upon an Autobiographical Account of a Case of Paranoia (Dementia Paranoides)"... . Schreber's words were also read by most of the classic early writers on schizophrenia, including Eugen Bleuler, Adolf Meyer, Carl Jung, and Karl Jaspers, among others, and he was frequently cited as an example of schizophrenia in major psychiatric monographs and textbooks. Several passages from the Memoirs appear in Japsers's General Psychopathology-- as illustrations of the... experiences Jaspers considered to be the epitome of schizophrenic bizarreness and incomprehensibility.

At times Schreber believed he was as wide as all space, that his boundaries were coextensive with the universe. Yet he would sometimes maintain that his actions, both physical and mental, were entirely out of his control, sometimes under that of other beings or minds who imprisoned his "will-power"... .

Far from demonstrating an enslavement to impulse and stimulus or an incapacity for self-monitoring awareness, Schreber is in fact a fanatic of self-consciousness, a self-victimizing victim whose relentless awareness is both his defense and his prison. Indeed, the very symptoms that seem most obviously primitive-- such as his incontinence and his bellowing--turn out to derive from just this hyperreflexivity, a condition that is closely akin, as we shall see, to the configuration of knowledge and power in modern society described in Foucault's Discipline and Punish, a work that purports to offer a "genealogy of the modern 'soul.'" Obviously, it would be absurd to view Schreber as being in any sense a typical man of modern civilization, but there are nevertheless certain respects in whcih he could be considered an exemplary one.

...the most autistic delusional system may be uncannily reminiscent of the public world, mirroring social practices and mores in the innermost chambers of the self.

Schreber's Delusional Cosmos

"I am absolutely certain that... I command experiences which-- when generally acknowledged as valid-- will act fruitfully to the highest possible degree among the rest of mankind." [...] Schreber... was well aware of the intractability of his subject matter, which he called "the most difficult subject ever to exercise the human mind," and seemed to anticipate the praecox feeling his book would elicit. To Schreber, the "order of the World itself was out of joint," and he was aware that an audience of normal readers, having no familiarity with ehse transformations, would inevitably have difficulty imagining his experiences: "Again it is extremely difficult to describe tehse changes in words because matters are dealt with whcih lack all analogies in human experience and which I appreciated directly only in part with my mind's eye, in part only by their effects so that I may have formed but an approximate picture."

In his estimation, the central element of his "nervous illness" was that his reason was under attack. His first synmptoms involved a torturing insomnia, an uncontrollable heightening of awareness. ...afflicted with what he called the "mental torture" of "compulsive thinking."

To understand the experience of compulsive thinking and the nerve-language, it is necessary to understand the nerves and rays, for these, along with God, constitute the fundamental ontological forms of what he calls his "out-of-joint" world.

Nerves,... are the "foundation" of all human experience, since their activity, in the form of "vibrations," corresponds to the events occurring in a human being's consciousness. [...] Like an aeolian harp, the nerves vibrate in automatic response to passing influences.

The rays... are transformations of the "infinite and eternal" nerves of God, who is "only nerve, bot body, and akin therefore to the human soul."

Obviously, the relationship of rays to nerves is in some sense antagonistic, analogous to that of master and slave or spy and victim. [...] Much of the Memoirs is taken up with their problematic relationship, a relationship described in the most concrete or spatialized terms, almost as if it involved phsyical entities in a kind of delusional solar system. The rays' interest in the nerves, for instance, is frequently represented... not unlike a magnetic attraction.

[fill gap, summary of Schrebers text]


The organizing metaphor of Discipline and PUnish, its central image for describing the modern social order (and, ultimately, for characterizing modern subjectivity), is the Panopticon-- an architectural design conceived by Jeremy Bentham in 1791, at the height of the Enlightenment enthusiasm for technical rationality. [...] Its essential point was to effect a radical separation between observer and observed, and to keep the latter under constant surveillance. The Panopticon consists of two elements: a central observation tower and an encircling building containing numerous small cells. [...]... exposing the occupant to the gaze of the watcher in the central tower. In this way, those in the cells would always be within sight of the implacable tower, which itself was darkened and fitted with narrow slits so that those within could peer out without being seen.
Foucault describes the Panopticon as "a machine for dissociating the see/being seen dyad: in the peripheric ring, one is totally seen, without ever seeing; in the central power one sees everything without ever being seen." In Foucault's view, this little-known architectural fantasy cannot be dismissed as some "bizarre little utopia" or "perverse dream," for it captures the grim essence of the modern age-- pervasive characteristics of modern life that prevail even in the absence of any literal Panopticon. Whereas premodern society had been the era of the "principle of the dungeon," with the powerless hidden away in dark places and the powerful highly visible (for instance, in the spectacles of the royal court), in the modern world it is the principle of "panopticism" that dominates: now the powerless are exposed, and power lies in the relentless, invisible gaze that studies them.

If we imagine the situation of the prisoner in the Panopticon, we realize he must remain constantly aware of the observation tower looming before him; further, since the prisoner cannot know whether he is in fact being watched [at any given moment], he is never able to let down his guard. As Foucault points out, if vigilance is able to replace the severity and drama of punishment, this is because the eternal vigilance that supplants the circus of torture is ultimately an inner vigilance, an observing of the self by the self. Paradoxically enough, this situation may even give rise to a sense of freedom in the prisoner-- the freedom of a self bent on scrutinizing and subduing a "lower" or more objectified part of its own being.

...it is not difficult to imagine some of the paradoxical consequences. Such a system will force one to experience oneself both as the body that feels itself observed... and also as the watcher who feels like a pure and omniscient consciousness. But oddly enough, while the prisoner is in one sense both observer and observed, in another sense he cannot truly identify with either of these polarized roles (that is, either with a bodily self-presence or with an observing consciousness). One cannot experience one's own bodily being from within but only from without, from the imaginary position of an observer in the tower. And, insofar as one identifies oneself with the mind, one will be identifying with a being whose essence is always elsewhere-- an imagined, alien consciousness, perpetually watching from a remove.
A second paradox is that these two selves are characterized by both an absolute separation and an absolute interdepedence, an interdependence amounting to a kind of symbiosis. In this variant of the master/slave dialectic, each self-- observer and observed-- comes to be defined almost completely by its relationship with the other, a relationship whose essence is distance and difference: thus, the prisoner's body would have to be experienced by the prisoner as a body-as-perceived, a body for the distant observer; while the observer's being would be reduced to a single function, the-being-who-observes-me-from-afar. The panopticon also brings about a peculiar kind of isolation, in which one never feels alone. Though deprived of all "horizontal" relationships-- all possibility of interacting with one's equals or of shedding individuality by, say, ecstatic merging with a crowd-- one is nevertheless forced to experience, and ultimately to internalize, a "vertical" relationship with an always superior, always invisible Other. According to Foucault, this entire system culminates in the nineteenth-century penitentiary colony of Mettray, where the principle punishment was solitary confinement in one's cell, on whose walls were written these words: "God sees you."
Foucault considers the Panopticon and Mettray to be only the most concrete and blatant manifestations of a new regime of power/knowledge whose reach extends far beyond penal systems. [...] ...the "ideal point of penalty... would be an indefinite discipline: an interrogation without end, an investigation that would be extended without limit to a meticulous and ever more analytical observation... .

As we have seen, the central elements of Schreber's delusional world are the nerves, the rays, and God, while his central preoccupation is the relationship among these various types of beings. I now want to show how these strange, quasi-cosmological entities-- which suggest a kind of weird planetary system existing in a reified, external space-- must be read as symbolic representations of aspects of Schreber's own consciousness, a consciousness both rent and joined by an inner panopticism. Whereas the nerves represent the part of the mind that is observed-- self-as-object-- the rays represent the part that does the observing--self-as-subject. Further, the God who lies behind the rays (for rays, as the reader will recall, are the nerves of God) corresponds to that invisible, potentially omniscient, only half-internalized Other who is the source and grounding of Schreber's particular kind of introversion.

"Rays" and "God"

The association of rays with reflective meta-awareness is implied in many parts of the memoirs. In one passage, Schreber distinguishes human nature from that of plants according to the criterion of self-consciousness, which he associates with rays... . ...he speaks of "self-awareness" being returned to corpses "through the influence of the rays."
...the kind of self-awareness associated with rays seems to involve a characteristic combination of internality with externality, of intimacy with alienness, that is reminiscent of the prisoner of panopticism. The main characteristics of Schreber's "God" are the same as those of the observer in Benthams' tower: first, distance or hiddenness and, second, omniscience or, more precisely, a potential omniscience. [...] Schreber's feeling that the rays are both outside and inside the self-- visible, as he says, to the "bodily eye when I keep my eyes open" and to the "mind's eye when my eyes are closed"-- also seems to be an expression of the feeling of being scrutinized by a gaze that exists both outside and within, belonging to the self as well as to some distant Other.

Schreber's vulnerability is, however, even more profound than that of Bentham's ever-visible prisoner, for Schreber's is an inner panopticism; and not even the boundaries of the body provide protection against these rays that exist in a dimension beyond the physical and can penetrate to the core of his being:

...no mechanical obstacle made by man can prevent the entry of the rays. ...no wall however thick, no closed window can prevent the ray filaments penetrating in a way incomprehensible to man and so reaching any part of my body, particularly my head.

An Allegory of Innerness

By now it should be clear that Schreber's whole world of nerves and rays virtually demands to be read as a psychological rather than a cosmological vision, as a kind of allegory of the divided state of Schrber's own hyper-aware, acutely reflexive mind.

In another of those tantalizing footnotes that come so close to providing an exegesis yet never quite do, Schreber himself suggests the appropriateness of such a psychological rather than physical reading of nerves and rays: he says that the force of attraction exerted by the nerves on the rays ought not to be understood "in terms of natural forces acting purely mechanically" but as "something like a psychological motive power: the rays too find that 'attractive' which is of interest to them." Since rays and nerves evidently stand for different parts of his own mind, it seems apparent that what interests Schreber is primarily his own endless involutions, which always seem to be taking place in some distant elsewhere.
In this inner cosmos, which is neither incomprehensible nor primitive, the rays and nerves have the same interdependence, the same qualities of activity and passivity, and the same emptiness and plenitude, as would be expected of a self split into observing subject and object observed. [...] The rays... have no life of their own; their whole existence is taken up with attending to what goes on in the nerves. Like a pure, disembodied Consciousness--... a Being Without Qualities... .

The voluminous writings of the French man of letters Paul Valery, whom T.S. Eliot once described as the exemplary poet of the twentieth century, at times recall, with eerie precision, Schreber's fretfully divided existence. In Valery's alter-ego character, Monsieur Teste, the parallels are particularly obvious.... .

Valery describes this curious individual-- whose name is an archaic spelling of tete, the French word for "head"-- as "a Head: a formidable closed Implex" and as "the home of the Selves, the island of the Selves." [...] In Teste, Mind fights against Life; for, like the author of Memoirs... , he is a man "observed, watched, spied on by his 'ideas,'"... .

Though both Schreber and Teste yearn for unity within the self and communion with the world, in the end they seem doomed by self-consciousness to a disturbing inner rift and a sense of isolation.

Body and Soul

If Schreber’s relentless hyperreflexivity divides consciousness, it also ranges more widely through his entire being, disrupting the sensual and resulting in strange behaviors that have, somewhat understandably, been understood almost exclusively on the analogy of the infant or the Wildman. Yet these very behaviors—the outbrusts of loud bellowing, the seemingly mindless recitation of irrelevant or nonsensical speech, even Schreber’s incontinence—turn out to be but further ramifications of an implacable, highly cerebral, and panoptical form of consciousness.
Schreber describes his experience of the human condition as consisting of two different states, “compulsive thinking” and “soul-voluptuousness.” These two states are fundamentally opposed to each other, for, as Schreber puts it, “every mental activity… is always accompanied by a considerable decrease in bodily well-being.” It seems he cannot rest comfortably in either of the states. As Schreber explains, human beings are “not born for voluptuous pleasure,” but it is also true that “continued thinking, uninterrupted activity of the nerves of intellect without any respite, such as the rays impose on me through compulsive thinking, is equally incompatible with human nature.” Though he states that “the art of conducting my life in the mad position I find myself… consists in finding a fitting middle course” between the two, such a course always eludes him, and instead he finds himself swinging back and forth between the extremes.

As we have seen, the state of compulsive thinking involves the intense self-consciousness of a mind compelled to watch its own functioning. Most of the time, Schreber finds himself in a panoptical state of heightened awareness and reflexivity, as if this rather unnatural state were what came most naturally to him.

In Schreber’s cosmological-psychological world (which I have argued is an allegory of innerness), psychological division, introversion, and self-alienation are represented as a physical kind of distance, a spatial separation between the observing rays (or God) and the observed nerves (not unlike the distance between tower and cells in the Panopticon).

In soul-voluptuousness, by contrast, there is an absence of such self-monitoring, which in turn is experienced as a collapsing or diminishing of the distance between rays and nerves… . Such an effacement of self-concsiouness seems to occur at times of absorption… ; while at the theatre or a church service, for example, Schreber would lose himself momentarily, since “the rays, always inquisitive, were so absorbed in watching the spectacle that their tendency to withdraw [that is, to retreat to the proper distance for panoptical self-consciousness] was minimal.”
Schreber both yearns for and fears what he calls this “volumptuousness” or “union of all rays”… . On the one hand, such a state offers escape from the “mental torture” of compulsive thinking, from that state of self-torturing… . But voluptuousness also has its dangers, not of separation or fragmentation but of annihilation. After all… Schreber often requires the presence of some watcher to confirm for himself his own existence; and the state of voluptuousness, with its absence of self-division, precludes such confirmation.

We see, then, that Schreber yearned at times for a voluptuousness that could serve as an antidote to his incessant self-monitoring, though he seldom felt at home with the absence of self-consciousness this would require.

As we have seen, the self-conscious part of his mind strives always to preserve itself, and this means preventing “the union of all rays” from occurring… .

The physical inhibition they bring about is, in fact, a very clear illustration of Foucault’s generalization about the modern, panoptical age: here, quite literally, “the soul is the prison of the body.”

Certain of the other, seemingly infantile or bizarre actions Schreber engaged in can also be understood in the light of his panopticism—not, as with incontinence, as direct consequences of the self-consciousness but as ways of coping with or defending against such a mode of being. …as a way of overcoming the constipating effect of his self-consciousness… .

It is true that he craved a “union of all rays,” a dissolution of self-consciousness and self-control that might well be termed “primitive.” But such a mode of being was less the core of Schreber’s madness than its potential antidote… . […] His union of all rays plays a role akin to primitivism in modernist culture: not the expression of an inner essence but a yearned for, and always elusive, escape from a more fundamental division and self-alienation.


Chapter 11 Conclusion: Paradoxes of the Reflexive

Our knowledge will take its revenge on us, just as ignorance exacted its revenge during the Middle Ages. -- Friedrich Nietzsche


What... does it say about modernism that it should display such remarkable affinities with this most severe of mental illnesses, which some have called the cancer of the mind? [...] Can we view the alienation and self-consciousness of the modern mind as the inevitable signs of increasing degrees of complexity, subtlety, or insight, or must we see them as something far less benign--- signs of deep pathology, perhaps, of a disease or spiritual decadence corroding the style and sensibility of our age?
We might ask as well how these parallels should affect our evaluation of schizophrenia.

How... should we account for the parallels between madness and modernism?

Here, in the second half of this concluding chapter, I shall take up the... question;... concerning the possible role of modern culture or society in the etiology of schizophrenia... .

Romanticism, Modernism, Postmodernism

Is the artist sick? Is the madman creative, authentic, or wise? Such questions are hardly new, having been raised again and again since ancient times (in Plato's Phaedrus, for instance). Indeed, in the twentieth century, the resemblance of madness to specifically modern forms of art and literature has frequently been asserted...  Generally... those making such comparisons have assumed the shared element to be something either atavistic or primal, and their evaluative judgements have naturally been determined by their attitude toward this shared primitive core-- which may be admired as a source of passionate vitality or deplored as some kind of decline into bestiality and perversion. My analysis of both modernism and madness clearly differs markedly from these, and it suggests that an y evaluations would have to be based... on judgements about the forms of hyperreflexivity and detachment that I have been emphasizing. We might ask whether these qualities should be viewed as a source of insight or of illusion, of life or of deadness.

The best place to begin our exploration of the evaluative issue is with the aesethetic philosophy and ethos of the romantic period, for this is the era when the essential criticisms of hyperreflexivity were initially formulated. Later we shall see that a range of different positions toward the problem of self-consciousness has developed in twentieth-century thought, including an essentially critical view that tends to deplore hyperreflexivity as a source of error and malaise and a celebratory one that praises it as a fulfillment of the human essence. Whereas the first position retains certain elements of the romantic view..., the second rejects romanticism almost entirely and might therefore be described as hypermodernist.

The Romantic Critique

...the romantics were the first generation to confront "the depressions of unbelief, the starvations of feeling, [and] the anemia of the doubting intelligence" that seem to occur at the higher, or later, stages of cultural development in the West. What these German and English writers of the early nineteenth century perceived as a widespread malaise and sense of dereliction was, in their view, the consequence of a growing fragmentation and overintellectualization of human existence.

In his famous sixth letter on the aesthetic education of mankind, Friedrich von Schiller (1759- 1805) described how the mental faculties came to be separated from the heat and vigor of the emotions, and how, once detached, the "all-dividing intellect" tends to effect divisions and dissociations all its own. In an obvious reference to Kant, he speaks of the "speculative spirit"... wrentching itself loose from matter for the sake of concept and form, sacrificing "fullness and warmth"... .

...von Schelling equated the true "fall of man" with the detached vision of modern, mechanistic science, which he characterized as the condition of a man "who holds that the world, which he conceives to be dead, absolutely manifold, and separated, is in fact the true and actual world."

It is understandable that the romantics' acute awareness of fragmentation, estrangement, and devitalization should have led at times, by way of reaction, to a yearning for something antithetical-- for instance, to primitivist, Dionysian, or mystical longings for self-dissolution. [...] Kleist's famous dialogue essay of 1810-11, "On the Puppet Theater." Here Kleist discusses the discoordinating effects of self-awareness, describing the physical awkwardness, the destruction of natural grace, that occurs when acts become separated from intentions and contrasting this wtih the fluid ease of lower animals, which are spared the curse of self-awareness. But his essay does not end with any simple call for a return to nature; instead, Kleist asks whether it might be possible to escape self-consciousness through self-consciousness... .

"That means," said I, somewhat amused, "that we would have to eat of the tree of knowledge a second time to fall back into the state of innocence."

What Kleist imagines... is... a state of higher innocence in which alienating self-consciousness would be transcended rather than banished altogether. ...this goal... the romantics generally conceived... not as a primal fusion... but as some kind of integration that would preserve the indepedence of each part.
Thus Schiller imagined an ideal synthesis of reflectiveness with a kind of naivete, an "intimate union" in which the dangers of detachment and uncertainty would be balanced by a robust faith and spontaneity of action. If the romantics held art and imagination tin such high esteem, it was precisely because they considered the aesethetic realm to be the privaliged domain for achieving such an integration.

Two Modernisms: Postromantic and Hypermodernist

Certainly modernism often does reject the aspirations of romanticism-- replacing the goal of a reconciliation or higher integration (of mind with nature... ) with willful veerings into states of extreme inwardness or radical objectivism. From the standpoint of a Schiller or a Schelling, this might be grounds for condemnation, suggesting as it does capitulation to the alienation, unanchoring, and spiritual dessication of modern life... . From this standpoint the striking parallels between modernism and schizophrenia would simply be further proof, if such were needed, of the essential fallenness of the modern mind, its severance from that vital organic unity that is the heart and goal of the human spirit.

Vestiges of the positive side of romanticism are... apparent in modernism's persistent desire for a kind of aesthetic bliss, a lyrical moment that might redeem the disorder and banality of modern life. [...] ...something of the romantic aspiration toward unity does persist in this idea of the wholly absorbing, wholly unitary image... .

Philosophical Positions: Postromantic and Postmodernist

Many modernist artists, and particularly postmodernists, might be viewed as expressing-- and many schizoid and schizophrenic individuals as living out-- something akin to the philosophical aberrations or distortions that emerge when one loses contact with the prereflective world that is the normal dwelling place of human existence.

...if one were to take [the] hypermodernist philosophy literally, imagining an actual living out of its claims, the existence one would arrive at might well resemble the schizophrenic condition I have been describing in this book.

In his most famous essay, "The Rhetoric of Temporality," de Man sets himself explicitly against the (in his view) self-mystifying aspirations toward organic unity and reconciliation that are characteristic of romanticism (and of the postromantic strains of modernism), and he pulls no punches about the dryly rational and distanciating nature of the "philosophy of necessary separation" to which he subscribed.

It is not that de Man would deny the malaise or the sense of upheaval and psychic unraveling that can be engendered by this kind of hyperreflexivity and alienation, but he prefers to see these as the by-products of true insight into human reality; hence the ability to tolerate such experiences comes to be viewed as a kind of paradigm of heroism. Clearly this can lead to a very different, far more positive evaluation of many of the phenomena at issue in this book, in modernism as well as in schizophrenia.

In On the Essence of Laughter Baudelaire noted the commonness of laughter among madmen, and he ascribed this to the attitude of superiority that is inherent in the absolute irony that they turn upon the most fundamental conditions of life. Adopting this view, de Man suggests that the sanity of the normal individual depends on one's ability to ignore, or one's inability to see, the fundmental duplicities of social existence and the forms of alienation that are the essence of our condition. To recognize these facts is to risk losing a conventional sense of grounding... and to be precipitated into a free-fall that is akin to insanity. Hence absolute irony, according to de Man, can be said to be "a consciousness of madness... a reflection on madness from the inside of madness itself."

Here, then, are two ways of understanding and evaluating hyperreflexivity and alienation, the postromantic and hypermodernist.

Anguish and Omnipotence

...many schizophrenics do have a special aptitude for apprehending certain facets of reality that generally go unnoticed, facets that can hardly be dismissed as trivial. Often they seem to have a special capacity for perceiving what Hegel called the "self-apprehending vanity of all reality, the way "everything [is] estranged from itself," and also for noticing the background assumptions that constitute the horizons or foundations of human activity; hence they can be acutely aware of the inauthenticities and compromises of normal social existence... . In this sense, there may be some truth to a remark that Martin, the schizophrenic artist, once made to me: "our insight into schizophrenia is insight into insight."

Epilogue: Schizophrenia and Modern Culture

My purpose has been to describe the texture and to elucidate the structure of schizophrenic experience and expression, rather than to account for these phenomena in a causal sense. […] My particular concern has been with the phenomenological dimension… .

Can schizophrenia be said to be, in any sense, a disease of modern civilization, and, if so, how can we account for this relationship? […] These issues, bracketed until now, will take us beyond the patient’s immediate experience, leading us… outward or upward to the level of social forces and cultural meanings… .

T.S. Eliot diagnosed the modern condition as a “dissociation of sensibility:” a widening rift between thought and emotion, intellect and sensation, and a general failure to achieve “unification of sensibility.” This is remarkably close to Emil Kraepelin’s and Erwin Stransky’s classic definitions of dementia praecox—as “a loss of inner unity of intellect, emotion and volition… .”

Might insanity be, in some sense, a disease of certain highly advanced forms of cultural organization, perhaps “part of the price we pay for civilization”—as was occasionally suggested in the nineteenth century?

Before we can speculate fruitfully about these questions of causality, we must first consider the issue of prevalence. Is schizophrenia, or the related spectrum of illnesses, especially common in modern Western civilization—either in comparison with other cultures in the contemporary world or with earlier epochs in the West?

The Prevalence of Schizophrenia

The Cross-Culture Dimension

Most contemporary psychiatric textbooks state, and most psychiatrists seem to believe, that schizophrenia has approximately the same prevalence in all contemporary societies, slightly under 1 percent. […] Theorists wedded to an exclusively biological account generally acknowledge the rather obvious fact that culture can affect the content of symptoms, making it, for instance, more likely that the delusions of schizophrenics in industrialized societies will concern television sets and X rays rather than ghosts and spirits; and many such theorists are willing to accept that the way a given society responds to deviance might affect the illness’s course and outcome. Aspects such as these are, however, often considered to be of secondary importance, as they are presumed to have little or nothing to do with the illness’s genesis or essential form.

Sociocultural factors… are assumed to be merely “pathoplastic”—able only to give “content, colouring and contour to individual illnesses whose basic form and character have already been biologically established.” And this means, in the words of one psychiatrist, that “cultural relativeism is of no value in explaining the psychosis”; for the “culture of a group can determine the content but not the forms of a psychosis.”
This standard view turns out to be questionable, however, on theoretical as well as on empirical grounds, as some of the more culturally orientated psychiatrists have noted. […] …the empirical claim that schizophrenia is equally common across different cultures is far from established. Both these points are best approached through a consideration of the major international research projects that have dominated discussion of sociocultural influences in the last decade or so: the International Pilot Study of Schizophrenia and the Determinants of Outcome Study, both sponsored by the World Health Organization.

[One] point to be noted about the WHO studies is that the Third World settings that were examined were all in developing societies, where the allied forces of modernization, Westernization, and industrialization had already been able to have a significant degree of influence. A full analysis of the issues of cross-cultural prevalence would require the examination of societies that are more radically different from our own, namely, preliterate, tribal, hunter-gatherer, or other so-called primitive societies that have had a minimum of contact with the modern, industrialized world.
Evidence from such cultures is very sparse and not entirely consistent, but in the main it seems to indicate that schizophrenia, at least as we know it, is in fact more rare in such contexts. Certainly this was the view of most anthropologists who worked with so-called primitive cultures during the first half of this century, before Western influence had become widespread. "We seldom meet with insanity among the savage tribes of men; not one of our African travelers remark having seen a single madman," wrote Sir Andrew Halliday in 1828. IN a 1929 article on "Temperament, Conflict, and Psychosis in a Stone-Age Population" of highland New Guidea, the anthropologist Curt Seligman wrote that he could find "no evidence of the occurrence of mental derangement, other than brief outbursts of maniacal excitement, among natives who have not been associated with White Civilization." And in 1939 the anthropologist and psychoanalyst George Devereux stated that the rarity or absence of schizophrenia in authentically primitive societies is "a point on which all students of comparative society and of anthropology agree"-- and that the illness seems to appear very quickly once such societies are subjected to acculturation.

...the evidence does seem to indicate that the most clear-cut cases of schizophrenia-- those characterized by the core symptoms of chronicity and social withdrawal, by flat and inappropriate affect, by Schneiderian First Rank Symptoms, and by unusual and abstract styles of thinking-- may well be less common in cultural settings where traditional or premodern forms of social organization prevail.

The Historical Dimension

A look at the historical dimension reinforces the impression of an association between schizophrenia and the social and cultural forms of modernity. [...] What evidence there is suggests that schizophrenic illnesses did not even appear, at least in any significant quantity, before the end of the eighteenth century or the beginning of the nineteenth.

...telling is the absence or extreme rarity of descriptions of clear instances of individual cases of schizophrenia, at lesat of the chronic, autistic form, in either medical books or general literature prior to the nineteenth century. [...] Many writers in the eighteenth century made systematic attempts to describe the known forms of mental illness, which resulted in works like Haslam's Observations on Insanity (1798) and Pinel's diagnostic system (1801). But despite the striking clinical picture that schizophrenia presents... one can find no account of it in these or any earlier works.
Also significant is the perception, widespread in Europe and America throughout the nineteenth century, of a striking increase in the incidence of insanity. By the time Henry Maudsley read his paper "Is Insanity on the Increase?" to the Medic-Psychological Association in 1871, this issue had come to be of profound concern in England... . In recent decades there has been a tendency... to discount these reports and to dismiss this apparent increase as an illusion or an artifact, resulting either from a growing awareness of insanity or else from a shift toward lengthier stays in the asylum. After carrying out a meticulous examination of the evidence, however, the medical historian Edward Hare concluded that these factors, though real, cannot explain away the apparent increase. Hare argues, in fact, not only that there was a significant rise in the incidence of insanity or lunacy in the nineteenth century but that this increase consisted largely of patients with the illness we now call schizophrenia... .

Neither the historical nor the cross-cultural evidence is beyond dispute... . Nevertheless, the bulk of the evidence is suggestive: whether considered from a historical or a cross-cultural standpoint, modern Western civilization does seem to have a statistical association with schizophrenia... . Having arrived at this (admittedly somewhat tentative) conclusion, I turn next to the still more difficult question of how one might account for this intriguing association.

Etiological Hypotheses

I begin with what is likely to seem the least plausible of the hypotheses... : the possibility that schizophrenia could in some sense be a cause of modern culture.

If one considers the cultural significance of the works of actual schizophrenic individuals such as Holderlin, Nijinsky, and Artaud... it may not seem absurd to attribute a degree of influence to this condition. [...] If one were to include markedly schizoid persons like Baudelaire, Nietzsche, van Gogh, de Chirico, Dali, Wittgenstein, Kafka, and Beckett... this thesis might even begin to seem rather plausible.

Having suggested this hypothesis, however, I must immediately qualify it: for such individuals to have much impact, it would seem that the culture would already need to be imbued with something like... a peculiar openness to all that is idiosyncratic, inward, and enigmatic... . Schizoid and schizophrenic productions and ways of being might well foster such a taste, but surely they would also depend on it for any influence they might have. [...] This brings us to the second causal hypothesis-- that modern culture contributes to the rise of schizophrenia rather than the other way around.

Torrey suggests... that the rise in schizophrenia is a consequence of a slow viral epidemic beginning in the West some two hundred years ago; the incubation and spread of this hypothetical virus was supposedly fostered by the demographic circumstances and social conditions associated with urbanism and industrialization-- conditions that are now gradually being spread, along with the virus, throughout the developing world.
There is another approach that does grant importance to the psychological aspect of culture and society, while assigning to these factors only a negative function. [...] Modern social settings are... assumed to be particularly troublesome for persons with these defects... . According to these views... the conditions of modern life-- its "complex, conflicting and potentially disorientating cognitive requirements," its harrowing assignment of individual responsibility-- are able to precipitate the occurrence of the psychosis, or to exert a detrimental effect on acute schizophrenic episodes that occur independently... ; but it is assumed that these conditions do not affect the illness's essential form.
Modern culture can, however, also be assigned a more positive role in the production of schizophrenia or in the shaping of its definitive characteristics.
Consider... the emphasis on  disengagement and self-consciousness [contained in] the ideas of philosophers like Descartes, Locke, and Kant... .

European culture over the last three centuries or so has been increasingly dominated by individualism and subjectivism, by rationalism and relativism, and a new character type has come into dominance in the twentieth century: "psychological man," who is "intent upon the conquest of his inner life" and embraces the ideal of "salvation through self-contemplative manipulation." It is easy to see how such attitudes might foster the state of permanent reflectiveness and subjectivization that the sociologists Helmut Schelsky and Arnold Gehlen see as endemic to modern consciousness.. . If schizoids and schizophrenics, like other human beings, are subject to the influences of their social milieu, it is not hard to see how a number of their core traits... might be exaggerations of tendencies fostered by this civilization... .

This interiorizing culture is certainly very different from what is found in traditional tribal societies... .

The most influential descriptions of these aspects of modernity come from the founding fathers of sociology: Karl Marx-- on the alienating consequences of certain economic structures and relationships; Max Weber-- on the growing rationalization, technologization, secularization, and bureaucratization of modern life; and Emile Durkheim-- on the juggernaut of industrialization and the growing reflectiveness that cause traditional values to lose their quasi-natural status. These changes, occurring over the last three centuries, have been as great... as any that have previously occurred... .

...schizophrenics are in a dual relationship with modernity, existing not just as a product of but also as a reaction against the prevailing social order.

In our discussion of Schreber's panoptical universe... we saw how the bizarre and seemingly chaotic inner world of madness could mirror the rationalized and alienating social order without. ...madness, at least in Schreber's case, turned out to be one of the most extreme exemplars of this civilization-- a simulacrum of the modern world in the most private recesses of the soul.

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