It’s not so much thinking out what to do, it’s the doing of it that sticks me

Iain McGilchrist

  • The Paradoxes of Delusion: Wittgenstein, Schreber, and the Schizophrenic Mind by Louis Sass
    Cornell, 177 pp, £23.50, June 1995, ISBN 0 8014 9899 6
  • Madness and Modernism: Insanity in the Light of Modern Art, Literature and Thought by Louis Sass
    Basic Books, 593 pp, £18.99, November 1993, ISBN 0 465 04312 7

The pianist is stopped mid-cadenza as he suddenly remembers his fingers. The lover is recalled from ecstasy by a fractionally too great awareness that he needs to consult an erotic zone. The poem grinds into prose. The Goddess of Nature cedes to the Department of the Environment. It might be called a modern affliction: an excess of self-consciousness, a doing of things by rules, a misplaced hungering for certainty. In every sphere of life we find a new kind of attention imposed, drawn out from within the experience and directed at the idea of the experience. Nothing is spared.

The growth of excessive consciousness has profound consequences for the way we experience ourselves and the world. These consequences have been explored or expressed in much of the art and philosophy of the late 19th and 20th centuries, in what might be gathered together under the names of Modernism and Post-Modernism. The cult of the ironic, distanced observer, aware of his own awareness, unable to break out of his solipsistic construction of himself and his world, has displaced what is now seen to be the naive, immediate relationship with reality as it is felt. This point of view has developed its own orthodoxy, even if most of us go about our lives as though we were actually involved with things, events and people not entirely of our making.

Most of us – but not all. Imagine being so constructed that this excessive consciousness pervaded everything. The most intuitive acts become the object of exhaustive scrutiny. One’s own thought processes start to appear alien and bizarre. In the extreme case both feeling and acting eventually become impossible. About 1 in 100 people world-wide lead lives shaped by this strange affliction: schizophrenia.

I am not sure of my own movements any more. It’s very hard to describe this but at times I’m not sure about even simple actions like sitting down. It’s not so much thinking out what to do, it’s the doing of it that sticks me.

People just do things but I have to watch first to see how you do things.

I have to do everything step by step, nothing is automatic now. Everything has to be considered.

Schizophrenia has nothing to do with split personality. The phrase might be better rendered as ‘shattered mind’. Indeed, the word ‘shattered’ picks up well one of the condition’s cardinal features: the loss of the faculty of seeing things as a whole – the loss, to use the old psychological term, of the Gestalt – so that the whole of reality becomes, like Coleridge’s description of the cosmos, ‘an immense heap of little things’. Everything has to be broken down into parts. Thought processes lose their coherence; emotions are absent altogether or, similarly, fail to cohere. Most strikingly, there is an altered relationship with external reality, characterised by delusions and hallucinations: what is ‘real’ becomes uncertain, nothing can be trusted, the world becomes frightening and alien.

What schizophrenics experience might, then, be viewed as an extreme version of the mental world of the alienated intellectual. To understand quite how extensive, and how important, the comparison is, you need to read Louis Sass’s wholly fascinating Madness and Modernism: Insanity in the Light of Modern Art, Literature and Thought, and The Paradoxes of Delusion: Wittgenstein, Schreber, and the Schizophrenic Mind.

Sass is a professor of clinical psychology and Madness and Modernism is rooted in a thorough knowledge of the psychological literature, but he also draws on an extensive acquaintance with 19th and 20th-century art, literature and philosophy. Both books are powerful, lucid and original, and they should revolutionise our thinking about the workings of the human mind.

The Paradoxes of Delusion is the shorter and, in the technical sense, more philosophical work. In it Sass explores the idea that ‘madness ... is the end-point of the trajectory [that]consciousness follows when it separates from the body and the passions, and from the social and practical world, and turns in upon itself.’ To Sass, as to Wittgenstein, there is a close relation between philosophy and madness. Sass argues that the philosopher’s ‘predilection for abstraction and alienation– for detachment from body, world and community’ produces a type of seeing and experiencing which is, in a literal sense, pathological. His concern is the transformations which come over our understanding of the world when we cease to be involved and instead become passive, disengaged, self-conscious, ‘objective’.

Throughout this book, like the interwoven strands of some counterpointed duet, run the introspective reflections of two highly intelligent individuals, one a philosopher, the other a certified madman. The philosopher is Wittgenstein. The other is Daniel Paul Schreber, an appellate judge in late 19th-century Dresden whose detailed accounts of his experience of paranoid schizophrenia became the focus of Freud’s only major study of a psychotic illness, and were extensively explored by Bleuler and Jaspers. Schreber was mad in the recognised sense: as with many other schizophrenics, his actions appeared to him to be controlled by rays, often people were cunning simulacra of human beings, it seemed that he was turning into a woman, and so on. But, Sass maintains, even these phenomena make sense if we come to understand the excessive consciousness which characterises schizophrenic thinking.

Sass does not see madness as the simple malfunctioning of reason, nor does he strive, as some have done, to glamorise it as an inspired alternative to reason. The delusions of schizophrenics are not failures of reasoning, but of appropriate feeling. ‘I used to cope with all this internally, but my intellectual parts became the whole of me,’ says one patient. Madness, in Sass’s view, is ‘to be sure, a self-deceiving condition, but one that is generated from within rationality rather than by the loss of rationality’.

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