Preface to Going Sane
When the reported in 2003 that “a US court of appeal has ruled that a death row prisoner be forcibly treated for psychosis which would make him sane enough to be executed” (Guardian Feb. 12, 2003) on-one reading the report would have been too baffled by the intended meaning. Charles Singleton, the report continued,
‘who stabbed a shopworker to death in 1979 believes his prison-cell is possessed by demons, that a prison doctor implanted a device in his ear and that he is both God and the supreme court’
“Sane enough to be executed” presumably means in this context sentient enough, responsible enough, guilty enough to experience the punishment as punishment rather than something else; if Singleton does believe that he is God and the supreme court he could, for example, see himself as having taken justice into his own hands, as having redeemed himself. His sanity, should the treatment work, would be reflected in his being more in touch with consensual reality; able to acknowledge both what he had done, and that what he had done was punishable. In an extreme case such as this madness being referred to – “Singleton was diagnosed as a paranoid schizophrenic in 1983” – seems no more contentious that the sanity that is being appealed to. And yet the phrase “sane enough to be executed” serves to remind us just what we might lose if the word sanity no longer made sense to us. It gathers up, in its own furtive way, a vast number of mostly tacit preferences and assumptions, of prejudices and ideals about what we think we should be, or should be like when we are at our best; and it assures us at the same time that there is a “we” that exists by virtue of its commitment to this value (”we” know what the phrase “sane enough to be executed” must mean). That we can be agents of intentions and motives that can be understood by others and ourselves; that we can take responsibility for our actions and their (often unknowable) consequences; that we can consent to being governed by certain laws and rules and regulations; that we can be realistic about our needs, and meet them without doing too much harm to other people. This might be the kind of sanity that Singleton needs in order to be properly executed. But it is rare, as we shall see, for sanity to be defines; more often than not it is referred to without ever being spelled out. Charles Singleton may be “psychotic”, a “paranoid schizophrenic”, but what would it really mean for him to be sane enough to be executed? What, in essence, is sanity?
A word with few synonyms, ‘sanity’ has always been an unfashionable word that has never quite gone out of fashion. First used be physicians in the seventeenth century to refer to “health in mind and body”, its more familiar modern connotation as the opposite of, or antidote to madness only really developed, as well shall see, in the nineteenth century. It was a term taken up by the new mind-doctors and mental-hygienists, but never systematically studied or defined. Even though people never collected examples of it, or scientifically researched it, or found it in foreign countries; even though it was rarely described, unlike madness, with any great gusto or commitment, and as a word was (and is) rarely found in poems, or titles, or proverbs, pr advertisements, or jokes. Even though it is a word with virtually no scientific credibility, and of little literary use it has become a necessary term. Exactly what it has been necessary for – and, indeed what, if anything, it might be necessary for in the future – is the subject of this book.
By the late 1970’s, when I began my psychoanalytic training, the glamorisation of madness – the promotion of madness as a revelation, as political protest, as the higher sanity – was rarely spoken of. The anti-psychiatrists of the sixties, with their commitment to the therapeutic communities rather than the mental hospitals, and their understanding of mental illness as existential crisis rather than malingering or neurological disorder, had seen madness as a quest for personal authenticity. Their therapeutic project was not to get people back to normal, but to show them hoe the need to be normal had driven them crazy. But the libertarian hopes of these radical therapists, like so many of the fresh hopes of the sixties, proved to be short-lived. The casualties of the anti-psychiatry movement were now often more vocal, and more poignant, than its defenders. What the anti-psychiatrists – most notably R.D. Laing and David Cooper in practise, and Michel Foucault and Sartre in theory – were rightly promoting was that the so-called mad had something to say, and that it was worth listening to and taking seriously. Instead of incarcerating disturbing people in diagnoses and institutions, they suggested that we should start wondering where we had got our ideas about normality from. The very word ‘mad’ needed to be rescued from the cruelty that was invested in its pejorative connotations. The villains of the anti-psychiatry world view were those all-too scientific psychiatrists who were committed to the militant cure and control of all those people who behaved frighteningly badly; the heroes and heroines were those who took the mad on their own terms, and who understood the language of the mad as anguished, accurate personal (and therefore political) history. The question was: who was most worth listening to, the experts on insanity or the insane themselves? And, of course, what was it that they had to tell us about – the human condition (albeit at its most extreme) or just.