Schizophrenia in history

Abstract

On first reading, the alignment of schizophrenia and history appears jarring, or even contradictory, since in the conventional psychiatric wisdom the schizophrenic is assumed to belong to a class of natural kinds that reflects the workings of causal laws and, in the words of the philosopher Ian Hacking, ‘represents nature as it is’. Expanding on the position sketched in my book Schizophrenia & Human Value: Chronic Schizophrenia, Science and Society, I draw upon my own case histories and other examples to demonstrate the limitations of an approach to mental disorder that is exclusively bound by naturalistic assumptions about what it is to think scientifically. To understand what it means to think about schizophrenia, and above all the schizophrenic agent, in history, we must grapple with the vicissitudes of the scientific project of schizophrenia and hence with the intellectual and social history in which the problem of schizophrenia emerged and was formulated. I have long been preoccupied with the schizophrenic person’s concerns with his or her own sense of worth and with the overall problem of the social worth or value of the mentally ill in modern societies. Drawing on critiques of the foundations of modern epistemology such as Richard Rorty’s Philosophy and the Mirror of Nature, Alasdair MacIntyre’s After Virtue, and Charles Taylor’s Sources of the Self, I argue that the problem of value is not by no means an incidental one, but instead is deeply entangled with the legacy of the scientific and intellectual frameworks that have underpinned the formulation and promotion of schizophrenia as a diagnosis. The history of a science such as psychiatry cannot be written in independence from a history of morals. As I argue, the most influential doctrines of late nineteenth-century psychiatry lent expression to a systematic devaluation of people with mental illness. In order to make any headway in clarifying the kind of problem that schizophrenia is, we must be willing to range across, and engage, key questions and considerations on a number of fronts, not least in the definition of what it is to be human, so as to cut through the illusions and distortions imposed by a wholehearted dependence on a naturalist picture of human life and action, and to identify buried sources of potential, both in ourselves as human scientists or health care professionals, and in the subjects whom we seek to understand. My engagement with this topic touches on many of the themes and issues that most concerned Robert M. Young such as human nature, the history of the human sciences, psychopathology and psychoanalysis.