Abstract

In lieu of an abstract, here is a brief excerpt of the content:What, Exactly, Does the Madperson Lack?Sofie Jeppsson, PhD (bio)Justin garson has already received well-earned recognition for his Madness: A philosophical exploration (2022), in which he distinguishes the view of madness as a dysfunction from madness as a strategy—a distinction that cuts across traditional distinctions between, for example, biological/neurological and psychological/social views. On the dysfunction view, going mad might be comparable to something like having an asthma attack or, more long-term, developing type 1 diabetes. If the trachea closes up and prevents air from passing through, that is a dysfunction in the breathing apparatus. If the islets of Langerhans in the pancreas cease to produce insulin, making the person dependent on insulin shots to stay alive, that is a dysfunction. On the strategy view, going mad is rather like getting a fever when already infected with some pathogen. Given that you have the pathogen reproducing inside you, a rising body temperature provides a strategy (although not, of course, something the ill person chose) to keep the reproduction rate down, thus giving the immune system a better chance at vanquishing the infection. That does not mean that fevers are harmless—if a fever becomes high enough, it might itself do damage to the body. Still, it is a strategy, not a mere dysfunction. Analogously, on the Madness as strategy view, going mad might help a person deal with old traumas or an ongoing terrible situation, even as the madness may also be damaging in itself.In this paper, Garson introduces us to another interesting distinction: between seeing madness as a lack of reason, or as a perversion of or difference in reason. Garson writes that present-day psychiatry tends to see madness as a lack, whereas the late modern thinkers conceived of it as a perversion of reason. The late moderns clearly saw madness as something negative, but if we retain something like their basic view, merely change our evaluation from the negative perversion to the more neutral difference, we have a better basis for regarding Madness as a complicated and problematic but still cherished identity, and for Mad Pride.This is another interesting distinction well worth calling attention to. I’m uncertain how well the J.C.A. Heinroth example works—the text cited seems to show that he had a Madness as strategy view, but is it a Madness as a different kind of reason view?—but the other examples work better. Nevertheless, I want to push back a little against the claim that present-day psychiatry and philosophy of psychiatry tend to regard madness as a lack of something whereas the early moderns saw it as a difference. (Just a friendly little push, mind you, but still.)Arthur Wigan’s description of two brains, one functional and one dysfunctional, still seems to posit a lack of proper function in one of them. Sure, he does not say that the madperson lacks as much as the [End Page 313] idiot, who has two dysfunctional brains whereas the madperson has one functional and one dysfunctional. Still, there’s a lack. This two-brain picture also has its modern analogues: It brings to mind (albeit in a less biologically concrete and reified form) much psycho-educational material on, for example, how to live with bipolar disorder, according to which a supposed sane and rational part of the psychiatric patient’s mind should learn to handle and control the other, mad part (e.g., Miklowitz, 2012).According to John Locke, madpeople reason just fine, but they start from false premises. Is not this, too, something that madpeople are supposed to lack? Correct and realistic premises to start from? Locke writes that madpeople have “taken their fancies for realities,” but “make right deductions from them.” Moreover, Locke’s theory is reminiscent of modern bottom-up theories like Brendan Maher’s (1999)—madpeople have bizarre experiences on the basis of which they form bizarre beliefs, but we need not postulate that they suffer from any problems with, for example, reasoning and drawing inferences to explain why they believe what they do. Theorists who instead argue for a top-down or two-factor account of why madpeople stick...