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Introduction

The Trials of Madness

Explorations and experiments with human lives
Baptiste MOUTAUD
Cet article est une traduction de :
Les épreuves de la folie

Résumé

In Western modernity, madness constitutes a universe of otherness and alteration that opens up the exploration and experimentation of the forms of the human being. It challenges scientific epistemologies as much as it gives access to a singular representation of reality and contributes to the construction of our common world. The contributions in this issue explore these themes on three intimately intertwined levels: experiences, experimentations, and the materialities of madness.

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1In his short story “The Quantity Theory of Insanity,” the English novelist Will Self recounts the genesis of a fictional psychopathological theory which sets up the strange postulate that there is a definite quantity of mental health in a given social group at a given time. For its inventor, the psychiatrist H. Ford, who narrates his discovery and the experiments he conducted, it means that it would be possible to evaluate the “sanity quotient” of a social group, and to observe its variations according to a principle of communicating vessels, whose flows and overflows would then have to be regulated: “If you decrease the number of social class 2 anorexics you necessarily increase the numbers of valium abusers in social class 4”; or else, “If you provide efficient medication for manic depressives in the Fens, there are perceptible variations in the numbers of agoraphobics on the South Coast” (Self 1991: 141). Ford (or rather Self) condenses the spirit of his theory into a harsh comparison: “The surface of the collective psyche was like the worn, stripy ticking of an old mattress. If you punched into its coiled hide at any point, another part would spring up – there was no action without reaction, no laughter without tears, no normality without its pissing accompanist” (ibid.).

2By postulating a certain volume of madness in the world, with a distribution that is admittedly random, yet balanced, contained and non-expansive, Self offers us a theory that is almost reassuring, counterbalancing, by way of the absurd, the unpredictability, irrationality or confusion that characterizes most of the phenomena for which it claims to account. Another interpretation, however, would be to see it as a paranoid theory that irremediably links the destiny of all individuals, run through by a continuous flow of madness. “The Quantity Theory of Insanity” is certainly Self’s most frontally satirical and acerbic text about psychiatry. He ironically mocks its claim to subject phenomena of the mind, and emotional disorders, to statistical inference and to the formal investigation of the clinical and fundamental sciences, or else to hope to treat them experimentally, as one studies the movements of chemical particles or fluid mechanics. In the course of the story, we come across animal behavioral models of anorexic armadillos and neurasthenic narwhals, whilst the character H. Ford is interested for a time in “nasoscopes,” a graphic representation of the shape of the “internal” nose inspired by phrenology and supposedly capable of providing information about a person’s character.

  • 1 Thomas Szasz and R.D. Laing are two of the leading figures of the anti-psychiatry movement, who que (...)

3It is difficult not to see in this short story the influence of Self’s reading of Michel Foucault, Thomas Szasz or R.D. Laing,1 and his own professed anti-psychiatric orientation (the quantitative theory ends up being hijacked by a liberal and fascist project to control the psychic balances between social classes in favor of the more affluent). If we are looking towards Self’s psychedelic surrealism to introduce this issue of Terrain, it is because, throughout his work, he has made the human psyche and its disorders a privileged field of exploration. Self is a disquieting and exacting observer of the irresolvable philosophical and anthropological tensions that run through experiences and worlds of madness. For example, the psychopathic hero of My Idea of Fun (1993) takes us into his hallucinatory eidetic world, to indulge his most extreme fantasies and obsessions and to question the moral boundaries of the tolerable and the intolerable, the real and the fantasized. In the novel Great Apes (1997), an individual is treated for his delusion of being human after waking up in the body of a chimpanzee, in a world of chimpanzees with chimpanzee customs. In Self’s fictional worlds, physical realities, the material environment and psychic or emotional experiences do not fold neatly onto one another; rather they intertwine to better reveal the embeddedness of psychic disorders and altered emotional states in our moral universes.

  • 2 Ballard further develops this principle of inner space in his memoirs (2008: 166).
  • 3 Martin Amis, “From Outer Space to Inner Space,” The Guardian, 25 April 2009, online: https://www.th (...)

4More precisely, this writer, who can be described as the heir of authors such as J.G. Ballard and William Burroughs, haunted by the specter of Lewis Carroll, has taken up Ballard’s proposal to colonize and explore “inner space,” defined as “that nodal point in the mind [...] where external reality and the mental universe meet and fuse into a single vibration” (1974: 8). This quote concludes the preface to the French edition of Ballard’s novel Crash! (1974),2 in which this British writer of speculative dystopias returns to literature and science fiction as sites of philosophical and metaphysical reflection on our modes of existence. Martin Amis brilliantly summarized Ballard’s major shift in the title of a 2009 tribute: “From Outer Space to Inner Space.”3 This shift was constructed in a twofold movement: a critique, on the one hand, of science fiction, which he reproached for its compulsive attachment to “outer space” and the distant future (the conquest of space and the future, broadly speaking); a fascination, on the other hand, not only with surrealism but also with the “strange almost mentalised world of science labs and research institutes” of psychology (Ballard 2008: 196) that make altered states of mind sites of the production of a “heightened or alternate reality beyond and above those familiar to either our sight or our senses” (Ballard 1966).

  • 4 Western modernity is characterized, for our purposes, in three ways: (1) as a naturalistic ontologi (...)

5The starting point of this issue is precisely that madness, hallucinations, obsessions, delusions and other disturbed psychic and emotional states open up the exploration of, and experimentation with, forms of the living human being within Western worlds. More precisely, the idea defended here is that in Western modernity4 (to which this volume is restricted) madness, and the variety of phenomena and social worlds that the term covers, is one of the main sites of production of knowledge about the human. For madness confronts us with an increasingly intense experience of our world (this “heightened or alternate reality”); we constantly observe it with a feverish gaze in the hope of detecting a truth that escapes us (cf. Steeves Demazeux in this issue). It constitutes a universe of otherness and distortion that is as close to us as possible, which gives it a singular place in the economy of knowledge production in the Western sciences. As such, the experience of a radical otherness induced by madness arises without the need for a detour through anthropological comparison (nor through fictional narrative: Déléage & Grimaud 2019).

6If the borders of madness are porous and brittle, Folies?/Madnesses? looks at the incessant work of stabilization, characterization and exploration of the phenomena and experiences the term covers. The plural and interrogative form of the title marks the will to emphasize the indeterminacy that characterizes madness, an indeterminacy whose heuristic scope animates this issue. To enter Folies?/Madnesses? is above all to observe, as in “The Quantity Theory of Insanity,” a world saturated with points of view and theories about phenomena that are, moreover, difficult to qualify, identify and contain, and whose limits remain so delicate to draw. This is the subject that Steeves Demazeux takes up in his text, in which he returns, with great finesse, to the fruitless search for absolute indices of madness, and sets out the epistemic mainspring of psychiatric semiology, to reveal its distinctive fragility. He summarizes this epistemic fragility in the following way: “The intelligibility of this hidden totality that is madness is the core object of dispute, within psychiatry and without: is it a cerebral dysfunction, a hereditary defect, a psychological blockage or conflict, an existential misfortune, a social deviance disguised with a medical veneer?”

7This issue aims to give an account of the study of madness, both as a way of putting to the test the understanding of human life and scientific epistemologies (whether biological, psychological, medical or social), and as a means of accessing a singular representation and experience of reality, which nevertheless participates in the constitution of our common world.

At the limits of forms of life

8Here the term “madness” refers to perturbations, disorders, disorganization and disturbances of affects, emotions and bodily sensations felt by individuals. That being said, these experiences are not exclusively thought of as being situated “at the limits” of forms of human life, a point of view that would emphasize the precariousness and vulnerability of people, or their relegation to the margins. This issue thus also seeks to account for the multiplicity of forms of life engendered by madness in order to highlight the way in which they contribute to shaping and constructing our common world, as much symbolically as materially.

  • 5 Wittgenstein’s concept of “form of life” is used here in continuity with Sandra Laugier’s (2002, 20 (...)

9What we mean by “form of life” refers to the concept developed by the Austrian philosopher Ludwig Wittgenstein, as reinterpreted by the American philosopher Stanley Cavell. Cavell distinguishes between two dimensions of human forms of life (Cavell 1988: 255): the first he describes as the “horizontal sense,” referring to the conventions governing the relationships between individuals (the “horizontal sense” of form of life); the second he describes as the “vertical sense,” referring to the biological basis, the organic depth of human life (the “vertical sense” of form of life). On the horizontal level, the emphasis is on sociality, on the cultural forms of collective life, on social institutions in the Wittgensteinian sense of the conventions and rules shared by human groups and which enable them to experience a world of common understanding. For the Austrian philosopher, the most fundamental of these conventions is the troubling experience of language: “[I]t is in their language that human beings agree. This is agreement not in opinions, but rather in form of life” (Wittgenstein 2009: §241). The second dimension, the vertical sense, refers for Cavell to the form of lives, i.e. the natural or biological dimension of all human existence and all life forms. This dimension makes it possible to think about the variations and emerging forms of human life: the corporeal or organic plurality of human existences, their manipulation and transformations, the heterogeneity of individual capacities and the modalities of action and control that are imagined, whether political or private, or what characterizes the human and the non-human, for example. For anthropology, to enter into this notion of forms of life is to recognize the fragility of the agreements on which they are based as well as their creative dimension. The interest is in identifying how these two dimensions come into tension, to bring out the multiple forms of the living human.5

10Madness and disorders of the mind open up the study of the interdependence and overlap of these two dimensions of human life. Anne Lovell and Alain Ehrenberg, in the introduction to their reference work on contemporary transformations in the worlds of mental health, identify the particularity of psychological disorders as stemming from a double specificity. First, they affect the individual in his or her subjectivity: “The difficulty lies in the fact that mental pathology affects what constitutes the properly human dimension of living animals: intentionality (desires, wills, beliefs, reasoning and rationality, etc.). Mental pathology designates the disorganization of this intentionality” (Ehrenberg & Lovell 2001: 10). Mental disorder challenges one’s ability to interact with others, to access an understanding of what another person is experiencing or to share a common world. It is then the life of relationships that is disrupted. The “madman” breaks conventions and challenges rules (from an interactionist perspective, he is socially sanctioned for this and subjected to medical judgment). Second, disorders of the mind, emotions and behavior retain an epistemologically ambiguous status: although they are part of the often intense bodily experience of individuals, they remain invisible, partly unobservable. Biological markers are today still difficult to objectify and are not very specific. This does not, however, prevent mental disorders from being the target of various chemical or technological interventions that intend to act on the bodies of individuals. Moreover, as recent work in the social sciences indicates, some people rely on this knowledge (even though it is still uncertain) to claim recognition of the specificity of their altered experiences as new capacities (cognitive, psychic, emotional, for example), which enable them to interact with the world, or to perceive it, differently. On these two levels, madness imposes the reconfiguration of the links and interactions between the social and biological dimensions of our lives, giving rise to alternative forms of existence.

11The contributions to this issue explore these themes on three closely intertwined levels: experiences, experiments and the materialities of madness. The quantity theory of insanity is perhaps not the most disconcerting approach to disorders of the mind that you will encounter.

Experiences

12In his review of Will Self's novel Great Apes, writer Gary Krist compares the recurring character in Self’s novels, the psychiatrist Zack Busner – a sort of fictional double of the author – with the neuropsychiatrist and writer Oliver Sacks. The title of Krist’s review, “The Ape Who Mistook Himself for a Man” (1997), is a play on the title of one of Sacks’ most famous books, The Man Who Mistook His Wife for a Hat, published in 1985. In his best-selling books, Oliver Sacks portrays neuropsychiatric patients with unique neurological, cognitive, emotional or affective symptoms and syndromes. Their stories read like case studies of traditional objects of philosophy or psychology such as imagination, identity, consciousness, intention or memory. As with Self, neuropsychiatric disorders and the people who experience them function for Sacks “as a totem that forges the physical and metaphysical worlds together into a comprehensible, coherent order” (Jacyna & Casper 2012: 7).

13The dysfunctional and the pathological are not reduced to a modality of access to normal functioning, which would make invisible processes visible, nor to a medical view of those disorders as deficiencies, identified by the blunting or collapse of particular abilities and skills. Sacks’ subjects suffer from something that goes beyond ordinary conditions. He investigates their existence as creative ways of inhabiting the world. Between the exemplary and the singular, the ordinary and the extraordinary, they are the embodiment of new forms of life, new ways of experiencing, confronting or “feeling” reality through different capacities.

14Much work has been done to describe how “institutions” (in this case, scholarly practices, medical theories, scientific technologies, classifications and categories) shape individuals, their ways of thinking and acting (Douglas 1986), how they “affect” people and “shape” their experiences (Hacking 1983). The contributions to this issue nevertheless demonstrate, in line with other research, that people’s experiences are also characterized by their resistance, their struggles against these institutions, or the impossibility of encompassing them in a theory (Biehl 2005, Jenkins 2015). In contradiction to a view of their trajectory as static and inescapable, individuals affected by emotional, cognitive or affective disorders are able to transform the way they are viewed and treated, and even constitute alternative forms of life and identities from which they can creatively influence their paths in life and negotiate situations (e.g. the neurodiversity or hearing voices movements; see Marquis & Moutaud 2020).

15In a striking text, “The Memory Multiverse: Existential Ruptures, Familiar Faces and Brain Injury,” Denielle Elliott sets out the consequences of a head injury on her perception of reality and the feeling of depersonalization she experienced. She transforms this story into an exercise in anthropological writing, in which she questions how “to open the imagination so that the distinctions between real and unreal, fictive and non-fictive, living and ghostly, in the lives we contemplate, become blurred.” For the author thought she was “going mad” when, among the many after-effects of her trauma, she was gripped with the illusion that she knew intimately strangers whom she would happen to meet by chance. Beyond a desperate search for explanations and comfort from specialists with no answers, from this reading of these neurological imaginaries, we can grasp the construction of a narrative. The author splits herself within her writing, as if living in two distinct temporalities, before and after the trauma. She thus seeks to give an account of what is inaccessible to us from the outside, of this disconcerting experience of the “jamais vu” and of the lived confusion of the neurological and the psychological, of the emotional and the physiological.

16This tension between the incommunicability of these extraordinary experiences and their revelatory power concerning what makes up our commonality preoccupies research on madness. The ethical stance of researchers in the social sciences is to endeavor to give voice to those who often experience a precarious life, balanced on the edges (or even outside) of ordinary worlds (Biehl 2005). It is as much what they can say about what they experience as it is their perceived and embodied experience that is an object of knowledge, considered as a testing of our understanding of the world. Thus, in “Voices of Madness,” Tanya Luhrmann paints a portrait of people who have had the radical experience of psychosis: that is to say, of the “deviation” of thoughts and perception. She inquires into the way in which these people and their experiences “invite us to think differently about the very nature of the human mind.” The undertaking is perilous and often disorienting, as she confesses: “To be sure, there have been times I felt that I had a glimmer of understanding. There are moments when I have felt ajar, as if what once was real was no longer real.” She then proposes avenues of reflection inviting us to test the boundaries between perception, thought and language.

17Nicolas Marquis describes the daily life of two French-speaking psychiatric institutions in which patients and carers live together and split their days between leisure activities, household tasks and therapeutic activities. The aim of these institutions is to rehabilitate people to life in society, in particular by trying to work out a “life project” around which to link their care and their path forward. Marquis uses interviews he conducted with residents of these institutions to show their expectations about leaving institutional life. Their actions appear to be marked by perpetual impediments, all the way down to the smallest details of daily life. Their experience of illness is also shaped and haunted by the horizon of “the crisis” (the violent onset of symptoms) and by the uncertainty of the often inevitable relapse. Finally, Marquis shows that the residents’ experience is permeated by dependence on institutions: they lead a life under conditions where any action undertaken remains dependent on a multitude of discussions, authorizations and decisions, the temporalities of which are out of their control.

18Marquis also proposes a theoretical approach to account for experiences of madness “for those who live it firsthand.” Unlike Luhrmann, however, he does not seek to explain the nature of the phenomena, but rather works to develop a pragmatist theory of madness. In this case, madness unfolds, according to him, as a particular configuration of autonomy and dependence that makes autonomy (acting on one’s own) the cardinal value, a configuration in which people in contemporary Western societies are caught. Part of this approach is a conception of madness as a significant “event,” a “rupture of intelligibility” (Bensa & Fassin 2002: 8) that brings into play much more than the organic, the biological or the psychological and reveals the social structures and modes of reproduction of a society. If we follow Marquis’ theoretical proposal, the structures, techniques, practices and knowledge aimed at taking care of people suffering from psychological disorders (in order to “return them to society in a better state than the one in which they arrived”) act as rituals of socialization that reveal conceptions of the individual.

Experiments

19Madness constitutes a privileged entry point for the insatiable desire to understand and elucidate the human mind. In the construction of Western knowledge about the human being, psychological and behavioral disorders have thus been subject to experimentation and exploration, prized as much by the medical and biological sciences as by the human and social sciences. These phenomena raise, of course, the question of the logic that governs human behavior, but above all they test the modes of knowledge and the methods of access to the otherness of the mind (what is in the mind of the other, and how it functions).

20The contributions by Lucie Gerber and Danielle Carr are particularly rich on this point. The two authors take us into laboratories of experimental psychology and neuroscience to observe practices of the scientific objectification of mental disorders. These spaces must be understood as sites of the production of naturalistic cosmologies, which open onto the analysis of reconfigurations of the relationships between physicality and interiority, but also between affects and environment, or between the human and the non-human.

21Based on unpublished archives, Lucie Gerber returns to the psychologist Harry F. Harlow’s endeavor to model depressive states in monkeys in the 1960s. In his laboratory at the University of Wisconsin, Harlow and his team developed experimental devices (such as the “pit of despair”) that aimed to disrupt the social and emotional life of young monkeys by depriving them of contact with their peers. In other words, they wanted to manipulate different environmental and social variables in order to induce, in animals, behavioral disorders similar to a depressive symptomatology. Gerber gives an account of Harlow’s unsettling inventiveness in setting up procedures of “affective dissection” in the development of young primates. In addition to chronicling the failure of an enterprise that is (at best) ethically contested and scientifically questionable, her article investigates “the reasons behind the fragility of animal models of mental disorders.” By extension, this experimentation poses several questions head-on: that of the nature of these phenomena and the way they affect people; that of the capacity to reproduce behavioral and emotional disorders in (non-human) animals; but also that of the place of these animals in the array of modes of existence of depressed humans. Can animals be mad? Or, at least, can they be in the same way as humans?

22The controversy over the validity and hence the usefulness of animal models in psychiatry is one of the most heated in the field. It turns partly on arguments concerning the artificiality of these models, and their inability to produce predictions that can be transposed to humans. The problem stems from the impossibility of determining whether there is a continuity of “interiorities” between humans and animals, whether their mental and emotional states could be compared. The experimental animal can be analyzed as a pure emanation of the naturalistic ontology of modern societies described by Philippe Descola (2013): it shares the same physicality with humans, which makes it a potential substitute for the human body whose biological functions can be experimentally manipulated, but it is devoid of interiority. This representation would be a legacy of the moderns and of Descartes’ animal-machine, incapable of feeling pain, deprived of access to language (in the sense of the capacity to institutionalize conduct). It is this denial of interiority that until recently gave animal models an inferior ethical and legal status, morally legitimizing their use in science as an object of experimentation and manipulation (Rémy 2008, Schlich et al. 2009). Yet this denial of interiority (or at least, today, the denial of the equivalence or transposability of human and animal interiorities) has become the crux of the controversy concerning its mobilization as an experimental model for behavioral disorders. The lack of recognition of a possible comparative similarity on this point invalidates the model. If an animal has no interiority (or if it is too different), how could it be a model for a human mental disorder?

23Taking animals to represent human emotions, or internal states, is therefore a source of fundamental tension, and it is sometimes better for neuroscientists to turn directly to humans. Danielle Carr looks back on the two years she spent as part of a team of neuroscientists and clinicians at a US neuroscience research center developing an experiment with a person suffering from a very severe form of depression. Carr calls the person “the Subject” to emphasize his ambiguous status, which the procedure tends to reduce to an objectifiable experimental body, ready for scientific exploration (because no non-human animals were available?). In this case, the researchers implanted the Subject’s brain with an innovative device that makes it possible to stimulate dysfunctional neuronal networks while recording cerebral activity in real time at the deepest level of matter. Their ambition is nothing less than to discover the organic substratum of a psychological disorder. It is a question of laying the foundations of a psychiatry that could do away with language as the preferred mode of access to the internal states of individuals and favor their digital quantification based on raw data drawn directly from the organism.

24The enterprise is futile in this specific case, according to the author, since language is also what gives value to the data collected, what makes it possible to link the surface (the experience) of the symptoms and the organic depth of the possible causes (see also Demazeux). Moreover, the Subject (just as recalcitrant as Harlow’s monkeys) and his language go beyond the framework of the experimental set-up, to the great despair of the research team: he takes advantage of the monitoring visits to the unit to gain more time with the team (in exchange for data), to recite poems he has written and to tell his story. Nevertheless, this experimentation opens directly onto the development of an industry for the management and commodification of our psychic lives, in which everyone would become an inexhaustible source of knowledge (or, more modestly, of data) via connected devices and applications. For Carr, this prospect is as much scientific and medical as it is ideological, with the horizon of freeing individuals from the constraints of language. Such an endeavor might not resist the logic of profitability in a society of quantification, measurements and Big Data, nor the ideal of the reassuring neutrality of biology and numbers.

  • 6 Hacking claims an intellectual lineage from the pragmatist philosopher Nelson Goodman, for whom kno (...)

25The prospect of the economic capitalization of life, pushed to the excess of data about madness, runs through both Harlow’s experimental craft and the horizon of industrialized care in digital psychiatry. A further point in common is the attempt to reconsider the links between the emotional and physical, psychic and biological, environmental and social components of phenomena. The direct consequence is to establish a new hierarchy of knowledge, technologies and interventions that would be best able to explain and act on situations. The laboratory research described by Carr and Gerber therefore does not only contribute to establishing categories of thought. In this case, in line with Ian Hacking’s realist approach to the philosophy of science, scientific activity and experimentation act both as the production and manipulation of phenomena as well as the technical transformation of the world (Hacking 1983).6 It is to represent but also to intervene, to understand but also to transform. To experiment is to act on the world insofar as, for the subject that concerns us, the entities produced and the associated practices will profoundly transform the experience of individuals: “Experiences are not only redescribed; they are re-felt” (Hacking 1999: 130). It is to experiment in the sense of testing the consistency of the realities produced directly in the world, testing theories on and in bodies in order to judge how they interact very concretely with people’s lived experience. Consequently, the interest in entering the scholarly and clinical spaces of madness consists in measuring the extent of “the ontological, ethical and political ramifications” (Rabinow & Bennett 2012: 125) of discourses with hegemonic claims regarding the understanding of the mechanisms of the mind.

26This issue is at the heart of my article on the development of cognitive training practices for people with schizophrenia. This contribution can be situated – after those of Gerber and Carr – at the very end of the organizational logic, and intellectual continuum, of the production of knowledge about the human, and practices of care in biomedicine. I follow the work of a hospital team as it pertains to the case of Sylvain, a person who suffers from schizophrenia and who enters a cognitive training program. I describe how totalizing theories (“neuroplasticity,” “the neurodevelopmental hypothesis of schizophrenia”) and neuro-essentialist categories (“the schizophrenic brain,” “the vulnerable brain”) that claim to explain the nature and cause of psychic disorders are put to the test in Sylvain’s routine treatments and in his follow-up care. In the case of these cognitive optimization practices, the brain is conceived as sensitive to its social and material environment (experiences and the environment would directly influence the development and functioning of the brain), but also as a malleable and plastic organ. This representation would be the translation into neuroscientific language of an ideal of emancipation in which each person could act on his or her brain in an attempt to achieve self-fulfillment. Nevertheless, these ambitions come up against Sylvain’s daily experience. Ultimately, it is because the theories and tools of the medical team are unable to embrace the complexity of that experience that Sylvain is delegated the task of defining how to overcome the fragility and vulnerability that characterize his existence.

Materialities

27The tension in Ballard’s (and Self’s) work mentioned in the introduction between external (or material) reality and the life of the mind is the thread that runs through the third axis around which this issue is structured. More precisely, it explores the relationship between mental health, design, environment and architecture.

28Madness has a profound effect on bodies and experiences, as the contributions in this issue remind us. Experiences of madness are not only metaphors, alternative worldviews and the opening of new possibilities. Madness penetrates the thickness of the flesh. Experiences of it are also those of broken skulls, clumsy gestures and bodies; monkeys prostrate at the bottom of a cage, one after the other, or else curled up together; brains passed over by electric currents; somatic sensations, which are sometimes violent, associated with ingested molecules, yet also provoked by fear, hallucinations or daily despair. The worlds of madness also imply gazes, technologies and knowledge that cross these bodies, explore their depths, model them or try to make their functions and history visible, to objectify their experiences and sensations.

29Madness works more broadly on spaces and environments, it regulates their organization, just as much as the materiality of environments interacts in return with the psyche of individuals and shapes minds, affects and behavior. Situations of co-production between behavior and architecture, between mental health and design, between madness and environments are numerous in everyday life. These questions were already present in Harlow’s experiments and his psychological and behavioral conditioning devices for primates. But we can also turn, for example, to the work of Natasha Dow Schüll (2012) on the logic of the development of entertainment infrastructures in Las Vegas. The architecture and spatial organization of the casinos as well as the design of the technical devices are described there as developed with the aim of inciting or feeding the addictive, compulsive and obsessive behaviors of the gamblers and to lose them in a sensory and temporal labyrinth. And from a different ethical point of view, some supermarket chains now offer people with autistic disorders (sensitive to light and noise) dedicated time slots during which the light and sound environment is attenuated. This is not just a matter of adapting the environment to the specific capacities of people with impairments or disabilities in the interests of equality and inclusion (such as the construction of wheelchair ramps in public buildings, for example). What is highlighted in this case is the psychological and behavioral effects of our ordinary physical environment, the fact that the material world has direct consequences on our psyche.

30Everyday artifacts, spaces, natural or otherwise, in which we live are now scrutinized, sculpted, remodeled or manufactured according to this new grid of intelligibility (work spaces, mobile phones, gardens, bedrooms, entertainment, means of transport, etc.). Has the study of the relationship between design or architecture and mental well-being become a new line of experimentation in the modulation of human behavior? A new parameter to be integrated into the management of mental equilibrium? What consequences can building materials, and their layout, have on our mental health?

31In his portfolio on madness and the green city, Des Fitzgerald reflects on the relationship between the city and mental health through the contemporary development of green architecture, or green design, with restorative ambitions. He guides us from disproportionate architectural projects in Shanghai and London to Parisian colloquia on the green city, and the tree, as a salvific horizon for the urban citizen. Fitzgerald reminds us that the relationship between the city and mental health (and the fact that the city is harmful to human health) is a classic subject of urban studies, just as it is a focus of psychological research in view of the greater prevalence of mental disorders in urban environments. Indeed, for some observers and historians, urbanization was a major factor in the development of psychoanalysis and behaviorism in the West as one needed to understand and master the behaviors of one’s fellow human beings and, at the same time, save one’s personality from the impersonality of urban life (and from industrialization, see Ehrenberg 2018: 130-135). Now, if we follow Fitzgerald, the stakes are quite different: for urbanists, designers or politicians, these issues would be intertwined with that of the apocalyptic environmental destiny of humanity. “Nature” would become “the iconic substance of psychological and spiritual reparation in the twenty-first-century city.”

32The question of the interaction between architectural design features and the psyche has been raised acutely in the history of hospitals and asylums. This is the subject of Meredith Ten Hoor’s portfolio and of Claire Edington’s text. The former comments on the unpublished archives of the French architect Nicole Sonolet and her collaboration with the psychiatrist Philippe Paumelle in the construction of psychiatric institutions from the 1960s onwards (the Eau Vive clinic in Soisy-sur-Seine and the day center of the Association de Santé Mentale 13 in Paris). The striking aspect of the project presented by Ten Hoor is to show how conceptions of madness and care that permeate their approach are materialized in the walls and spatial organization of the buildings. In this case, inspired by institutional psychotherapy (psychothérapie institutionnelle), a psychiatric reform movement born in France in the aftermath of the Second World War, their architectural productions reflected the ambition to make them fully fledged technologies of care, breaking with certain dominant principles of asylums (the isolation of patients from society, segregation within the structure, etc.). Their work produced a double movement of the internal organization of the institutional space and the inscription of the institutions within the city, in order to break with the social and psychological alienation of the residents.

33Claire Edington, using a photograph from the archival collection of the Musée du Quai Branly, looks back at the colonial psychiatric project of the Biên Hoà asylum in French Indochina. Far from the image of a psychiatry with universalist claims, imposed by authority, within a closed asylum structure that would have crushed subjectivities and identities in the context of the French colonial system, Edington describes the negotiations between French doctors and families in the management of patients’ trajectories. She explains how the practices of care, and follow-up, extended beyond the walls of the asylum to the community and with it the mobilization of local expertise in decision making, contributing to the co-fashioning of conceptions of deviance and illness, as well as to the insertion of the asylum into the local economy.

34From these contributions emerges the strong idea that the spatial logic of the hospital and the laboratory is spreading, expanding and becoming generalized: architecture as a technology of care and control presides over psychic destinies. The materiality of space and our mental states are mutually shaped in a series of back-and-forth movements across multiple social spaces.

35Anne Lovell’s illustrated narrative account provides us with an epilogue to these explorations of the worlds of madness. She guides us (because we can’t read the map) through the desolate landscape of post-Katrina New Orleans. Weaving through the metaphor of the river, she follows the lives of mentally ill people on the brink. For once the hurricane passed, once the water rose, these people were left to fend for themselves in a city with a ravaged health care system and infrastructure. Like a river that has left its banks, they have stepped out of the “scripts” that usually govern their destinies and find themselves navigating the everyday post-disaster world. In these extreme situations, attention and care are directed towards the psychic consequences of the trauma suffered by the “ordinary” population; Lovell, on the other hand, turns her gaze towards the forgotten and invisibilized inhabitants. These stories tell of the geographical partition of the city and its racial and economic boundaries, but also of the new forms of socialization created in a devastated world. When the water recedes, it is above all the opportunities opened up by the collapse of their environment that invite people to travel and explore new geographical, social and psychological spaces, far from the confined worlds of institutions and the static places of psychiatry.

36In this final text, madness melts into the time and movement of chaos and disaster. But it is also what allows these individuals to invent and improvise new lives, away from attempts to stabilize and contain them. Madness contributes as much here to a double movement of production and revelation of the world as it does to the flow of its collapse.

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Notes

1 Thomas Szasz and R.D. Laing are two of the leading figures of the anti-psychiatry movement, who questioned the scientific foundations and social role of psychiatry

2 Ballard further develops this principle of inner space in his memoirs (2008: 166).

3 Martin Amis, “From Outer Space to Inner Space,” The Guardian, 25 April 2009, online: https://www.theguardian.com/books/2009/apr/25/jg-ballard-martin-amis

4 Western modernity is characterized, for our purposes, in three ways: (1) as a naturalistic ontological regime that marks a distinction between body and mind, between the human as a natural being of nature and as a being of language; (2) as a regime of the objectification of bodies and experiences by a scientific and technical medicine with universal intent; (3) in terms of individualism which makes autonomy and rationality of action cardinal values in the construction of identity and subjectivity.

5 Wittgenstein’s concept of “form of life” is used here in continuity with Sandra Laugier’s (2002, 2008) and Anne Lovell’s (2013, 2018) re-reading of it following the work of Cavell (1988).

6 Hacking claims an intellectual lineage from the pragmatist philosopher Nelson Goodman, for whom knowledge was a way of ‘making worlds’ (Goodman 1978).

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Baptiste MOUTAUD, « The Trials of Madness », Terrain [En ligne], 76 | mars 2022, mis en ligne le 03 mai 2022, consulté le 20 mai 2022. URL : http://journals.openedition.org/terrain/23065 ; DOI : https://doi.org/10.4000/terrain.23065

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Baptiste MOUTAUD

CNRS-Lesc

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