Theory, Madness and Membership: Some Comments on Ms. Hillier's Review Article

Abstract

In her review of my book, Approaches to Insanity ('Any man Goes Mad', Sociology , May 1975), Ms. Hillier articulates her dissatisfaction, not only with my own treatment of some of the issues raised by present research-strategies dealing with 'schizophrenia', but with ethnomethodology more generally. (She writes of the 'extreme confusion of the whole ethnomethodological paradigm' and of 'its logical flaws' (p. 326, her review)). In making these claims, Ms. Hillier restricts herself for substantiation to my own book; think it hardly reasonable to condemn a growing and heterogeneous school of thought on the basis of flaws supposedly attributable to one piece of work. However, this gives me the opportunity to widen my discussion of her review to encompass issues of a wider nature than the one of how best to investigate insanity as sociologists. Although am grateful for the thoroughness with which Ms. Hillier undertook her task, her review still fails, believe, to do justice to some of my basic arguments, and her own counter-proposals seem to me to constitute the weakest points in her discussion. To begin with, some carping objections. Ms. Hillier repeats some of the claims made by Laing and his associates, each of which took up and examined in detail in my own treatment, but she confines herself to the following observation about that treatment: 'One suspects that when he (Coulter) says of Laing and his colleagues I cannot see how they can escape from a quasietiological perspective, he regards this as sufficient argument to remove them from serious consideration*, (p. 324). Of course, do not regard this as sufficient reason, and spent some twelve pages of close argument on Laing and his associates in which a wide variety of issues were examined. ( Approaches to Insanity , pp. 84-96) am also unhappy with her paraphrase of my discussion of Bateson's 'double-bind theory of schizophrenia' ; she claims that argued 'that the analysis of such relationships (for example Bateson's famous theory of the double bind) is merely a description of the normal conventions by which actions or communications are rendered intelligible. . . .' (p. 324). cannot recognize in this anything approximating to my discussion of Bateson, and urge the reader to consult my discussion unencumbered by this inaccurate precis. My objections to the Bateson team's approach drew heavily on the work of Schuham, Watzlawick and Mishler and Waxier, and were of a predominantly methodological sort. Ms. Hillier is indeed correct to assert that my objection 'appears to be to any theory as to what causes schizophrenia, even those which do not utilize a disease model in their analysis' (p. 324). Since a large part of my initial argument in the book centres upon the problem of what 'schizophrenia' is, the unreliability of the diagnostic generation of samples of 'schizophrenics' and the consequent failure of warrantable replication, treat all claims about the 'aetiology of schizophrenia' as rhetorical at best. Moreover, since argue that the concept of schizophrenia is polymorphous, and that psychiatric diagnoses are often conversational devices not susceptible to assessment in terms of decontextualized adequacy-criteria, am not postulating remedies for the situation. Unlike most cases of physical-medical diagnoses (including diagnoses of organic psychosyndromes), where biochemical and other forms of medical screening