Tag Archives: mental health

An imaginary connection to the post office

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Reading Troubled By Faith by Owen Davies, 22 November 2023

Readers of this magazine may recall how, in early 2020, 5G mobile technology got caught up in a conspiracy theory that saw cellphone towers being set on fire across Europe. But how many of us knew just how dated this delusional belief really was?

A medical note from 1889 reports on the plight of one Henry Staples, 59, who ”fancies telegraph wires are over his head” and “that messages are being sent to people as to his character”. A year later, 56-year-old Janet Sneddon from Glasgow presented with an imaginary wire “connecting her to the post office”.

Owen Davies is an historian of magic. Troubled by Faith is his account of how early clinicians met with, understood, and dealt with irrational belief.

In a book that never lets the big ideas get in the way of the always entertaining fine detail, he builds a cast-iron defence of the movement that saw asylums springing up across western Europe in the 1830s. There were certainly abuses — there still are — but asylums were also places of compassion and sensitivity. Nor, by the way, were you ever just dumped there. Half of all “incarcerated” patients left after less than a year, and most within two years.

19th-century asylum records have serious limitations — the patients’ own words are rarely recorded directly — but Davies’s examination reveals what he calls “an extraordinary cultural space where under one roof prophets, messiahs, the bewitched, and the haunted, wrestled with angels, devils, imps, and witches.”

Troubled by Faith is a complex, sometimes tragic and ultimately uplifting story of how intelligence, sympathy and good-will triumphed over clinical ignorance. Growing up imbued with the values of the Enlightenment, doctors like the pioneering French neurologist Jean-Martin Charcot and his pupil Sigmund Freud believed that magic was “a diseased survival of a benighted mediaeval past”, and that “madness” was therefore largely determined by history. Ignorance had spread superstition; superstition had fertilised irrational beliefs; and irrational beliefs were driving people into manias and insanias of one sort or another. If you could educate people into thinking rationally, mental wellbeing was bound to follow.

But irrational beliefs were not irreconcilable with modernity after all, Owens explains. Magical thinking, which ruins lives, is just a species of rule-of-thumb thinking, without which day-to-day life is impossible.

These have been humbling lessons for a discipline that, when it started, imagined the problems and mysteries it confronted could be cleared up in a generation.

Troubled by Faith is hardly the first book to be written about the very early years of psychology. But while most of these tend to plash about in the shallows of developing theory, Owens does everyone a tremendous favour by rolling up his sleeves and diving into the lived experiences of distressed and delusional people.

Owens explains how insanity diagnoses spread from behaviour to belief — in witches or fairies or ghosts, in divine or infernal visitations, or in new technologies operating in supernatural ways — and he explains how, by listening to and caring for patients, this diagnostic overreach was eventually corrected.

Many a contemporary observer found such a muddle infuriating, of course. In a long section about the legal culture around insanity, we meet the judge Baron George Bramwell who, we are told, “became something of a bogey figure in the psychiatric community as he routinely critiqued and dismissed medical expert witnesses and scoffed at the notion of moral insanity.”

With hindsight, and thanks to works as insightful as this one, we can afford to be more admiring of the effort to understand the mind, that enjoys reason, but does not need reason to be right.

“Crude to the point of vulgarity, judgmental in the extreme, and bitterly punitive”

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Reading The Age of Guilt by Mark Edmundson for New Scientist, 5 July 2023

In his Freudian analysis of what we might loosely term “cancel culture”, Mark Edmundson wisely chooses not to get into facile debates about which of the pioneering psychoanalyst’s ideas have or have not been “proved right”. What would that even mean? Psychology is not so much science as it is engineering, applying ideas and evidence to a purpose. Edmundson, an author and literary scholar, simply wants to suggest that Freud’s ideas might help us better understand our current cultural moment.

In the centre of Freud’s model of the personality sits the ego, the conscious bit of ourselves, the bit that thinks, and therefore is. Bracketing the ego are two components of the personality that are inaccessible to conscious awareness: the id, and the super-ego. The id is the name Freud gives to all those drives that promote immediate individual well-being. Fancy a sandwich? A roll in the hay? A chance to clout your rival? That’s your id talking.

Much later, in an attempt to understand why so many of his clients gave themselves such a hard time (beating themselves up over trivia, calling themselves names, self-harming) Freud conceived the super-ego. This is the bit of us that warns us against misbehaviour, and promotes conformity to social norms. Anyone who’s spent time watching chimpanzees will understand why such machinery might evolve in an animal as ultra-social as Homo sapiens.

Casual descriptions of Freud’s personality model often characterise the super-ego as a sort of wise uncle, paternalistically ushering the cadet ego out of trouble.

But this, Edmundson says, is a big mistake. A power that, in each of us, watches, discovers and criticizes all our intentions, is not a power to be taken lightly.

Edmundson argues that key cultural institutions evolved not just to regulate our appetites; they also provide direction and structure for the super-ego. A priest might raise an eyebrow at your gluttony; but that same priest will relieve you of your self-hatred by offering you a simple atonement: performing it wipes your slate clean. Edmundson wonders what, in the absence of faith, can corral and direct the fulminations of our super-ego — which in this account is not so much a fount of idealism, and more a petulant, unrelenting and potentially life-threatening martinet, “crude to the point of vulgarity, judgmental in the extreme, and bitterly punitive.”

The result of unmet super-ego demands is sickness. “The super-ego punishes the ego and turns it into an anxious, frightened creature, a debilitatingly depressed creature, or both by turns,” Edmundson explains, and quotes a Pew Research study showing that, from 2007 to 2017, the percentage of 12-to-17 year olds who have experienced a major depressive episode in the past year rose from 8 percent to 13 percent. Are these severely depressed teenagers “in some measure victims of the wholesale cultural repudiation of Freud”?

Arguments from intuition need a fairly hefty health warning slapped on them, but I defy you not to find yourself nodding along to more than a few of Edmundson’s philippics: for instance, how the internet became our culture’s chief manifestation of the super-ego, its loudest users bearing all the signs of possession, “immune to irony, void of humour, unforgiving, prone to demand harsh punishments.”

Half a century ago, the anthropologist Ernest Becker wrote a book, The Denial of Death, that hypothesised all manner of connections between society, behaviour and consciousness. Its informed and closely argued speculations inspired a handful of young researchers to test his ideas, and thereby revolutionise the field of experimental psychology. (An excellent book from 2015, The Worm at the Core, tells their story.)

In a culture that’s growing so pathologically judgmental, condemnatory, and punitive, I wonder if The Age of Guilt can perform the same very valuable trick? I do hope so.

The Value of Psychotic Experience

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Reading The Best Minds: A story of friendship, madness and the tragedy of good intentions by Jonathan Rosen. For the Telegraph, 3 April 2023

This is the story of the author’s lifelong friendship with Michael Laudor: his neighbour growing up in in 1970s Westchester County; his rival at Yale; and his role-model as he abandoned a lucrative job for a life of literary struggle. Through what followed — debilitating schizophrenia; law school; and national celebrity as he publicised the plight of people living with mental illness — Laudor became something of a hero for Jonathan Rosen. And in June 1998, in the grip of yet another psychotic episode, he stabbed his pregnant girlfriend to death.

Her name was Caroline Costello and, says Rosen, she would not have been the first person to ascribe everything in Laudor’s disintegration, “from surface tremors to elliptical apocalyptic utterances, to the hidden depths of a complex soul.”

It will take Rosen over 500 pages to unpick Costello and Laudor’s tragedy, but he starts (and so, then, will we) with the Beats — that generation of writers who, he says, “released madness like a fox at a hunt, then rushed after — not to help or heal but to see where it led, and to feel more alive while the chase was on.”

As a young man, the poet Alan Ginsburg (whose Beat poem “Howl” gives this book its title) gave permission for his mother’s lobotomy. He spent the rest of his life atoning for this, “spinning the culture around him,” says Rosen, “into alignment with his mother’s psychosis”. By the summer of 1968 the Esalen Institute in Big Sur was sponsoring events under the heading “The Value of Psychotic Experience”.

To the amateur dramatics of the Beat generation (who declared mental illness a myth) add the hypocrisies of neo-Marxist critics like Paul de Mann (who proved texts mean whatever we want them to mean) and Franz Fanon (for whom violence was a cleansing force with a healing property) and the half-truths of anti-psychiatrists like Felix Guattari, who hid his clinic’s use of ECT to bolster his theory that schizophrenia was a disease of capitalist culture. Stir in the naiveties of the community health movement (that judged all asylums prisons), and policies ushered in by Jack Kennedy’s Community Mental Health Act of 1963 (“predicated,” says Rosen, “on the promise of cures that did not exist, preventions that remained elusive, and treatments that only work for those who were able to comply”); and you will begin to understand the sheer enormity of the doom awaiting Laudor and those he loved, once the 1980s had “backed up an SUV” over the ruins of America’s mental health provision.

This is a tragedy that enters wearing the motley of farce: on leaving Yale, Laudor became a management consultant, hired by the multinational firm Bain & Co. Rosen reckons Laudor got the job by talking with authority even when he didn’t know what he was talking about; “That, in fact, was why they had hired him.”

By the time Laudor enters Yale Law School, however, his progressive disintegration is clear enough to the reader (if not to the Dean of the school, Guido Calabresi, besotted with the way an understanding of mental health could, in Rosen’s words, “undermine the authority of courts, laws, facts, and judges, by exposing the irrational nature of the human mind”).

Soon Michael is being offered a million dollars for his memoir and another million for the movie rights. He’s the poster child for every American living with mental illness, and at the same time, he’s an all-American success story: proof that the human spirit can win out over psychiatric neglect.

Only it didn’t.

No one knows what to do about schizophrenia. The treatments don’t work, except sometimes they do, and when they do, no-one can really say why.

Rosen’s book is a devastating attack on a generation that refused to look this hard truth in the eye, and turned it, instead into some sort of flattering sociopolitical metaphor, and in so doing, deprived desperate people of care.

Rosen’s book is the mea culpa of a man who now understands that “the revolution in consciousness I hoped would free my mind… came at the expense of people whose mental pain I could not begin to fathom.”

It’s the darkest of literary triumphs, and the most gripping of unbearable reads.