Too Mad to Be True II — Conference Review
Josh Richardson shares highlights from a conference on the promises and perils of the first-person perspective
Josh Richardson is a Registered Psychotherapist practicing in Ontario, Canada. He studied philosophy as an undergraduate and pursued post-graduate studies in the philosophy of psychiatry. He is currently working on a manuscript on the ideas of eumania and dysmania, titled Eumania: Madness which is not Illness.
I am in a courtyard, a beached whale in front of me, voices swirling around my head in quadraphonic sound. Iron shackles, artwork, straight jackets, and psychedelic Rorschach inkblots adorn the walls. Human skulls, bizarre medical instruments, and photographs of people with pained expressions sit in display cases. A chapel stands at the entrance, as if to offer some peace for the disquiet. I am inside the walls of the Museum Dr. Guislain, a former asylum, now psychiatric museum in Ghent, Belgium. The museum’s mission is to challenge the stigma of mental illness. Its exhibitions provide space for artists to explore and comment on their own experiences of mental illness. I am here to attend and speak at the second Too Mad to be True conference, organized by clinical psychologist Jasper Feyaerts of Ghent University and the linguist and philosopher Wouter Kusters of the Foundation for Psychiatry & Philosophy in the Netherlands. Feyaerts and Kusters are a clinical-philosophical duo who have published several articles together. Their first TMTBT conference in 2021 coincided with the publication of the English translation of Kusters’s book A Philosophy of Madness: The Experience of Psychotic Thinking (MIT Press), which won the 2015 Dutch Socrates Award. The book is a philosophical exploration of Kusters’s own psychotic experience (he was twice hospitalized with psychosis), and uses a diverse range of sources from philosophy and psychiatry to mysticism and biography. It is a compelling and lucid account, which includes recollections of his own psychotic experience interwoven with philosophical analysis. After reading Kusters’s book and hearing about the conference, I applied to be a speaker at this year’s event. I myself have had such experiences and have been hesitant to speak about them, in part because I am a registered psychotherapist - internalized stigma and the fear of being alienated from colleagues has kept me largely silent. Kusters’s book showed me that a clear minded account of one’s own experience is possible and indeed may offer some valuable insight.
My talk focused on two general themes taken from Plato, which also emerged as dominant strains at the conference: the eumanic, which views madness as a ‘gift from the god’ and ‘divine release from normally accepted behavior,’ and the dysmanic, which sees madness as a ‘human illness.’ Eumanic views tend to see the experience of madness in a positive manner, as holding some value, and those with dysmanic views, tend to see mental illness as something negative, a loss, a negation of some capacity, or function. This binary is at the core of traditional thinking about madness. In my mind these categories are not fixed and absolute, but can serve as a heuristic, which can be used to show how tensions emerge in discourse regarding madness.
My talk focused on two general themes taken from Plato, which also emerged as dominant strains at the conference: the eumanic, which views madness as a ‘gift from the god’ and ‘divine release from normally accepted behavior,’ and the dysmanic, which sees madness as a ‘human illness.’
The theme of this year’s Too Mad to Be True II conference was ‘the promises and the perils of the first-person perspective.’ One can already see traces of a dialectical tension. The promises of a first-person perspective of madness lends itself quite naturally to eumanic views which see some value (divine, or otherwise) to the experience of insanity. Conversely, the perils of the first-person perspective fits well with dysmanic views which focus on the human illness of insanity and the destruction it represents.
Too Mad to Be True II
The two general tendencies in the discourse of madness are made evident in the two dominant modes of study represented at the conference: 1. Mad Studies, which grew out of the consumer survivor and Mad Pride movements. Its object of study is madness. And, 2. Philosophy of Psychiatry, which arose out of philosophy of science and phenomenology. Its object of study is mental illness. Mad studies aims at reclaiming mad identity, validating the experiences of mad people, and recognizing the value in people’s lived experience of madness. Philosophy of psychiatry on the other hand is preoccupied with questions regarding psychopathology, diagnostic classification, and the phenomenology of mental illness. It aims at clarifying the concepts of psychiatry and categories of mental illness, which presupposes a loss of mental health. It is no coincidence that many of those engaging within the philosophy of psychiatry are themselves clinicians comfortable with presupposing the negativity and loss of health in a mental disorder. It is equally unsurprising that speakers from Mad studies were often grounded in the activist community, focusing on the lives of mad people.
The first keynote speaker, Alastair Morgan, fit squarely within the philosophy of psychiatry domain defending a minimalist style of interpreting patient lived experience aimed at decreasing potential harms. It is a line of argument deftly executed in detail in his book The Continental Philosophy of Psychiatry: the Lure of Madness (Palgrave McMillan). His work draws from critical theory and the extensive body of phenomenological work in the history of continental philosophy of psychiatry. Clinical psychologist Elizabeth Pienkos also examined themes familiar to philosophy of psychiatry in her keynote presentation On the understandability of psychosis: Pushing limits of phenomenological psychopathology, arguing for the importance of the ununderstandable in clinical entities such as schizophrenia. Her work drew from Karl Jasper’s foundational work in phenomenological psychiatry and psychopathology.
Mad studies was a more explicit focus during the parallel sessions. Grietje Keller, an organizer of Stichting-Perceval, a service-user led organization in the Netherlands, defended the role of identity politics for Mad Studies and Mad activism, drawing historical and present day connections to Disability studies and Women’s studies, and other liberatory social movements in order to help form a conception of madness free of mental health systems. And Lisa Archibald’s presentation on Experiential wisdom and academic Mad Studies, drew from her experience working in peer support, arguing for the value of lived experience in informing the new academic discipline of Mad Studies.
Sam Fellowes, an autistic philosopher of psychiatry and historian of autism, balanced the eumanic value of incorporating Experts by Experience (EbE) in the research of dysmanic diagnostic categories. His was a very clear example of how these different poles may be deconstructed, allowing for more complex and novel ways of examining madness and mental illness to be formulated. The final keynote from Phoebe Friesen on Psychosis and Psychedelics: Historical Entanglements and Contemporary Contrasts also worked to pull apart the ways in which these dialectical oppositions conflict. In her presentation she argued that contemporary treatment of mental health should draw lessons from experimental psychedelic research from the 1950s and 60s, which showed the effects of set and setting on subjects under the influence of psychedelic drugs, in order to change treatment settings and help guide the intentions (mind set) of those entering them.
Not far from Ghent is the small city of Geel, Belgium. Tradition holds that the father of Saint Dymphna, the patron saint of madness, beheaded his daughter in Geel, while in the grips of his own madness. A 700 year old tradition of mental health care, ‘gezinsverpleging,’ literally ‘family nursing,’ continues in Geel to this day. For seven centuries madmen and madwomen in Geel have been placed with families, given a room and board, and employment in a system of care which draws people from around the world in order for it to be studied. When speaking with people from Belgium inside and outside the Too Mad to be True conference, they expressed pride in this ancient tradition integrating people with mental illness into the community. Such a successful tradition of integrative care brings another meaningful connection to the cultural setting of the Too Mad to be True conference; a culture with a tradition that has worked for centuries to integrate madness and mad people, breaking down polarities of madness and sanity, loss and value is an ideal setting for an event in a similar spirit.
An example that comes to mind is the keynote presentation from religious studies scholar Richard Saville-Smith, whose book Acute Religious Experiences: Madness, Psychosis and Religious Studies (Bloomsbury) was published just two months prior to the conference. A self-identified madman, Saville-Smith, clad in a suit jacket printed with brightly colored pills, very much looked the part. He took to the stage in an address which was both comical and tragic, teetering on the edge of madness, in a manner reminiscent of the puzzling wisdom proffered by a Shakespearan fool. It was a talk that I will not soon forget, and one that less daring conference organizers would not have had the gumption to program.
Feyaerts and Kusters have successfully organized and executed a happening which extends the spirit of Geel into the realm of academia, bringing together both the eumanic and dysmanic, Mad studies practitioner, and philosopher of psychiatry, for a meaningful exchange regarding madness and mental illness. One might even say they were mad for setting out to do such a thing - and that wouldn’t necessarily be a bad thing.
A full list of the presenters with abstracts of their presentations, plus video from the keynotes and some of the parallel sessions are available from the conference website: https://www.psychiatrieenfilosofie.nl/too-mad-to-be-true-ii
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