James Phillips

In commenting on Hamm, Buck, and Lysaker’s “Reconciling the Ipseity-Disturbance Model with the Painful Affect in Schizophrenia”, let me first acknowledge the authors’ fine work in delineating this issue. They review very clearly the history of theoretical models of schizophrenia, including biological, psychoanalytic, and phenomenological approaches. They emphasize the need to include accounts of subjective experiences of persons with schizophrenia, and for this they underline the role of phenomenological research. In the latter, they note an emphasis on cognitive and perceptual disturbances, with an apparent neglect of painful affective experience. To demonstrate the neglect, they focus on the work of Louis..

In lieu of an abstract, here is a brief excerpt of the content:Madness of the Philosophers, Madness of the ClinicJames Phillips (bio)KeywordsPhilosophy, insanity, moral, natural, Hegel, KierkegaardDaniel Berthold's "Talking Cures: A Lacanian Reading of Hegel and Kierkegaard on Language and Madness" is an eloquent discussion of speech, silence, and the 'talking cure' in the three figures highlighted in the title. There is much to admire in this paper. The treatment of speech and silence in the thought of Hegel and Kierkegaard, with many well-chosen quotations, offers much for reflection, both with respect to these philosophers and more generally with respect to the human condition. This is a paper that deserves more than one reading. I find nothing to criticize here and intend the following as further discussion of the themes Berthold has brought to us. Taking his cue from Lacan and reading back into the nineteenth-century figures from the perspective of Lacan's emphasis on language and what he (Lacan) terms the Symbolic, Berthold explores the question of madness in Hegel and Kierkegaard. In my remarks, I connect Berthold's analysis with older traditions of madness, distinguishing what I call the madness of the philosophers and the madness of the clinic.With the phrase, madness of the philosophers, I refer to a longstanding philosophic tradition that opposes reason and passion and attributes madness to an excess of the latter. In Berthold's paper, Hegel is the representative of this position, with his description of madness as a regression into the primitive "life of feeling." As Berthold puts it:For Hegel, madness is a "reversion" or "withdrawal" or "sinking back" of the rational consciousness into the primitive world of instincts and drives, or what Hegel calls "the life of feeling" (Gufühlsleben), which he locates in "the soul," where the "mind is still in the grip of nature"... The soul is "the form of the dull stirring, the inarticulate breathing of the spirit through its unconscious individuality" (in seiner besusstlosen Individualität)... The mind becomes "mastered" by the archaic, unconscious drives of the soul: "the natural self... gains mastery over the... rational consciousness."(2009, 301)Taking off from Lacan in his interpretation of Hegel, Berthold associates reason with language—or, in Lacan's terminology—the register of the Symbolic. Hegel's "life of feeling"—or of passion—is inarticulate, primitive, and vulnerable to madness.Berthold analyzes Kierkegaard in these categories. On the one hand, Kierkegaard is driven to silence, subjectivity, and inwardness as the native [End Page 313] ground of faith. On the other hand, he recognizes something maddening in his extreme solitude, and acknowledges his need to write as a form of self-therapy: "If I stop [writing] for a few days, right away I become ill.... So powerful an urge, so ample, so inexhaustible [is my need to write], subsist[ing] day after day for... years." Kierkegaard's compromise is his "indirect communication." By Berthold's account, Kierkegaard's silence does not rate very high for Hegel and Lacan. For Hegel it represents a regression into the primitive "life of feeling." For Lacan, Kierkegaard's silent inner self is "a myth—a 'shapeless vapor,' 'absolutely nothing.'" As we shall see, Kierkegaard's ambivalence toward silence and speech (or writing) does not fit neatly into the equation of silence and madness.What, however, in contrast to this madness of the philosophers, is the madness of the clinic?1 It is madness caused by disease, whether the latter be understood in ancient terminology of humors, or more modern terminology of brain disease. For a quick review of how clinical madness has played off against the madness of the philosophers, we can turn to the philosophers themselves, invoking Plato as our first guide, because he speaks of both kinds of madness. On the one hand, with his tripartite division of the soul, he is one of the inaugurators of the philosophic vision of madness as an overcoming of the rational part of the soul by the appetitive side. On the other hand, he implicitly endorses the Hippocratic, medical view of madness with a statement like this: "A man who commits one of these crimes might be suffering from insanity, or be as good as insane either because...

Eric Craig invites us to participate in a conversation about existential psychotherapy, which I am pleased to join, and I am able to articulate my questions and disagreements only because he has provided such a clear presentation of the relevant issues. Craig argues two major points: 1) that existential psychotherapy, at least in the United States, has lost its grounding in ontology, and that it must recover that grounding; and 2) that the only adequate ontology for grounding existential psychotherapy is that of Martin Heidegger. In this commentary, I question both of these assumptions. Before proceeding to that discussion, however, we need two clarifications. The first involves..

Two central strands in Arendt's thought are the reflection on the evil of Auschwitz and the rethinking in terms of politics of Heidegger's critique of metaphysics. Given Heidegger's taciturnity regarding Auschwitz and Arendt's own taciturnity regarding the philosophical implications of Heidegger's political engagement in 1933, to set out how these strands interrelate is to examine the coherence of Arendt's thought and its potential for a critique of Heidegger. By refusing to countenance a theological conception of the evil of Auschwitz, Arendt consolidates the break with theology that Heidegger attempts through his analysis of the essential finitude of Dasein. In the light of Arendt's account of evil, it is possible to see the theological vestiges in Heidegger's ontology. Heidegger's resumption of the question concerning the categorical interconnections of the ways of Being entails an abandonment of finitude: he accommodates and tacitly justifies that which can have no human justification.

Our lives are dominated by technology. We live with and through the achievements of technology. What is true of the rest of life is of course true of medicine. Many of us owe our existence and our continued vigour to some achievement of medical technology. And what is true in a major way of general medicine is to a significant degree true of psychiatry. Prozac has long since arrived, and in its wake an ever-growing armamentarium of new psychotropics; beyond that, neuroscience promises ever more technological advances for the field. However, the effect of technology on the field of psychiatry remains highly ambiguous. On the one hand there are the achievements, both in the science and practice of psychiatry; on the other hand technology's influence on the field threatens its identity as a humanistic practice. In this ambiguity psychiatry is not unique - major thinkers have for a long time been highly ambivalent and concerned about the technological order that now defines modern society. For the future, the danger is that the psychiatrically real becomes that which can be seen, the symptom, and especially that which can be measured. Disorders and treatments might become reduced to what can be defined by diagnostic criteria and what can be mapped out on a scale. This book exams how technology has come to influence and drive psychiatry forward, and considers at just what cost these developments have been made. It includes a range of stimulating and thought-provoking chapters from a range of psychiatrists and philosophers.