A Different View

By Kevin Murphy, M.Sc.,
Psychoanalytic Psychotherapist,
Dublin, Ireland.

It was coincidental that my last blog happened to be on the subject of madness while at around the same time Dr Paul Williams, a leading UK psychoanalyst and a former co-editor of the International Journal of Psychoanalysis was in Dublin giving a lecture on the topic ‘Madness in Society’. He was the guest speaker at the Irish Psycho-Analytical Association’s annual public lecture.
He covered many topics, including a historical perspective of how madness has been viewed by different stages of developing society. And as he steadily built up his argument about the current place of madness in modern society, he made the interesting point that psychoanalytic therapy does not set out to ‘cure’ in the bio-medical sense. That was why there are so many healers and so few effective psychotherapists. This was because psychotherapists, the good ones, that is, understand that successful therapy is only possible if there is ‘immersion in’ and not ‘control of’ uncertainty, contradiction and paradox.
People have problems, he said, not only because of the social conditions under which they operate, or what we know broadly as the civilized world. But added to this, each of us has to deal from infancy with an inheritance, as he called it, of powerful and contradictory capacities. A particular line I liked was his statement that our human instincts, strength and intelligence exceed our capacity for judgment and that is why we require a longer period of maturation of any primate. In other words, we come into the world as possessors of powerful engines that can take us a long time to figure out how to harness and drive in the direction we want to go. And usually we want to go in the direction of being successful in our human relations, in connecting with those around us, in finding our desire in and through others.
In addition to what he termed the impact of modernization of society and its ever growing need to control every aspect of people’s lives, we each have our own personal endowment of sexuality. Each of us has to come to terms with our sense of sexuality and often society, because that is what it does, tends to understate the impact of this. The passage from boys and girls to men and women can often be a difficult one and that has to be continually recognized.
On top of that we have the impact of the twin psychical forces of aggression and narcissism as we make our way along the path to becoming the individuals we would like to be. All in all it adds up to a busy and complex process that is rarely given much credence by social commentators. And so this brings us to the concept of madness.

According to Dr Williams, the individual suffering from psychosis (or madness in plain English) suffers both a fracture and dissolution of their thinking so that their dependence on human relations, the one most of us learn to accommodate, is ‘abolished’. In its place comes a seriously skewed relationship to fellow humans, often to the point of non-relationship. Or indeed, instead of human relationships, fantasy relationships are substituted which keep the person ‘preoccupied, isolated and ill’, as he put it.
So, he asked, is it any wonder that our caring agencies behave defensively when faced with such a task. Nor are they the only ones. Patients who are deemed mad are put in hospital as part of a collusion between family and doctors because the family cannot deal with the behaviour any more. So now the caring agencies take on a responsibility that is beyond their capacity to resolve. And to defend themselves against the anxiety that this produces, they introduce ‘devices’ such as work routines and division of tasks that preclude them relating ‘as a whole person, to the patient as a whole person’, Dr Williams said.
On this point it is interesting to note in my last blog on the madness experienced by London-Irish poet John O’Donoghue, that it was not the electric shock treatment or the drugs or the psychiatrists that he said cured him. It was the unexpected experience of going to university where he discovered poetry and, also, where he met the lady who was to become his wife.
And I am also reminded of a particularly evocative lecture given by Dublin psychoanalyst Dr Helen Sheehan at a conference on Schizophrenia last December at St. Vincent’s Hospital, Elm Park, Dublin organized by the Irish School for Lacanian Psychoanalysis. She spoke eloquently about the place of the psychotic person in our Celtic heritage and consciousness and reminded us that even in mythical times there was a place for them, not behind high walls but somewhere radically special. And it is still there today.
Gleann-na-nGealt is a valley in the Dingle peninsula, Co. Kerry and in English it means the Valley of the Mad, because of a belief that a cure for insanity exists in a well which is situated in the valley. Legend has it that the name is associated with Gall, who was king of Ulster and was cured of madness when he drank from the well and ate the watercress growing in its waters. Ancient history also tells of "Bolcan" King of France who was also restored to full health when he drank from the well fleeing from the battle of Ventry harbour. In the 12th. century tale of "An Bhuile Shuibhne", Gleann-na-nGealt is said to be the place where Mad Sweeney found peace when he was banished to wander Ireland for a year and a day. Mad Sweeney was one of the early kings of Munster and recent historians link him with King Arthur’s Merlin the Magician.
So our own history tells us that there once was a place for those who were deemed mad, but it was a natural setting, in relative harmony with the world at large where they could recover and come back again.
Dr Williams in his lecture said the madness that exists in society is created within us and within society itself. It is partly a result of living in a complex, confusing, contradictory and very often de-stabilising world. He acknowledged that the work of caring agencies is a difficult one because the nature of the work is undoubtedly difficult and the demands placed on care workers at the coal face is quite often unrealistic, as is the caseload of most public sector psychiatrists. But he ended by saying that, difficult and painful as it can be, the only chance for improvement is to pay close attention to the individual who suffers, to the personal and social contradictions that created them and to do so in the context of authentic therapeutic relationships.