on A Pattern of Madness
Research into attachment has thrown light on insecure attachment; there has also been clinical investigation into autism and there is now an annual conference in honour of Frances Tustin. Knowledge of these conditions has grown considerably. Then there are the states of mind which have been familiar for a longer period: like the paranoid-schizoid position widely known through the researches of Melanie Klein and her followers. The schizoid state was elucidated by Ronald Fairbairn and the True and False Self by Winnicott. The significance of beta elements first explored by Bion but further elaborated more recently by Ferro who has developed balpha elements. Borderline and narcissistic states have also engaged many clinicians and thinkers both within psychiatry but regretfully within psycho-analysis also.
It is my contention that there is a more basic malaise of which all the above conditions are manifestations. My purpose in writing A Pattern of Madness was to describe this malaise and try to show how it is the core condition which generates these stataes which are so readily described as pathological. These states are all symptoms of a deep-seated malady. Psycho-analysis is concerned to understand the depths which beget these 'diseases of the mind'. It it the belief that if these depths are understood then a healing occurs not just in autism or in insecure attachment, or in paranoia but in many other manifestations such as addiction, psychopathy or bi-polar disorder. Insecure attachment, autism, paranoia, schizoid states, acting out, borderline and narcissistic conditions are all symptoms but they are often treated as 'ultimates' as 'things-in-themselves'. We expect this from psychiatry, one of whose roles is to decribe the mental phenomena in such a way that it can be categorized as a mental illness and therefore treated by psychiatry. Psycho-analysis, from its very beginning, has been concerned to probe beneath the surface to what lies hidden and to discover what it is at fault in these foundations. When the fault-line is understood then it has in that very act of understanding become transformed. It is a tragedy that much of psycho-analysis has been 'colonized' by psychiatry. What I mean by this is that psycho-analysis has accepted the psychiatric categorization in the belief that there is then a ready remedy. I have come more and more to see in recent years that persons come to see me to solve a personal problem which I have to listen carefully in order to understand. As soon as I categorize then I believe I can treat in a particular manner. So, for instance, Dorothy Rowe says:
" I have often observed that psychiatrists and therapists prefer to diagnose
their patients as having a disorder that they can treat rather than a disorder
that reflects what is actually going on."
A borderline state is often described as a 'thing-in-itself' rather than a phenomenon whose source needs to be looked for and then described as accurately as possible. This way in which psychiatry has 'colonized' psycho-analysis is a resistance to psycho-analysis and it may be that psycho-analysis which is under attack to-day is not being attacked for its essential nature but for the psychiatric débris that it has accumulated. This resistance is deceptive because so many psycho-analysts, with their psychiatric training, do not think of these states as symptoms. So in A Pattern of Madness what I try to do is to describe the noumenon. So, for instance, at one point I try to demonstrate that the narcissistic and borderline states are different vertices upon one single state but that this in itself is not the noumenon. Dorothy Rowe, for intance, has with some courage declared that the borderline state is not a mental entity at all but merely a fictitious construction.
I have been disappointed that this book has not attracted any general interest and it may be that, because it challenges some treasured assumptions within the professional world of psycho-analysis that it is hated. There are though other reasons which can be attributed accurately to my own deficient descriptions. Nevertheless, like Narcissism: A New Theory it has inspired a few individuals scattered around the globe. I have had letters and e-mails from these few which have made quite extravagant claims for the effect that these books have had on them. One person wrote saying that her marriage and clinical work had been transformed by A Pattern of Madness. This is very gratifying. Another colleague however was angry at the new terms which I introduced in A Pattern of Madness. I use terms like the jelly, the worm, glue-like attachment and god. Why on earth wasn't I satisfied with the terms more familiar to psycho-analysts like borderline, inferiority complex, adhesive identification and omnipotence ? I used these words because they are emotionally more evocative than the more familiar psycho-analytic terms. Jelly conjures up the inner state with an emotional immediacy more adequately than borderline; the worm describes the inner state of worthlessness more succinctly than inferiority complex. Glue-like means more to me than adhesive and god is a more powerful metaphor than omnipotence; it can also be the subject of a sentence. I also used these terms because I found that patients, especially patients unfamiliar with psycho-analytic literature used exactly these words. I have also always had an instinctive preference for words and images which can be understood by any Cockney cab driver or a working-class housewife from Stepney. Again to quote Dorothy Rowe:
" The experts in mental disorders do not like plain and simple speaking
because that would reveal how little they actually know."
This reminds me of something that Arthur Bryant said about lawyers:
" For the lawyers, who in the days of universal illiteracy had secured their craft monopoly by the simple device of being able to read and write, had learned to preserve it, as the nation became literate, by ingeniously constructing a wordy jargon which no man but themselves could understand and which they ever expanded as the march of human reason toiled vainly after them."
But psycho-analysts have fallen into the same professional trap. I believe that jelly, worm and glue-like attachment can be understood by the man-in-the-street. The malady that underlies all the psychiatric categories is something that is part and parcel of the normal human condition.
However this same woman who was inspired passionately by A Pattern of Madness also told me that it was a difficult book and that of five people to whom she had recommended it only three persevered, the remaining two giving up because they found it too difficult. There is no doubt that Narcissism: A New Theory is an easier book to read. Its main argument is clear: that an act refusing what is lifegiving lies at the heart of narcissism rather than the classical definition: that it consists in taking oneself as love object. The simplicity of the argument and the clinical examples illustrating it have given the book considerable appeal and, apart from The Analytic Experience, it has sold much better than any of my other books. A Pattern of Madness is however a deeper book. My book on Narcissism has a moralistic tinge in its tone. A Pattern of Madness sees the narcissistic condition as one aspect of a more fundamental disorder, a mental outlook which leads to great human suffering. I try to describe the discrete elements but in such a way as to show that they are all one state but that our inability to see it this way is due to the limitations of our minds. Narcissism: A New Theory can be read straight through and understood without too much difficulty but A Pattern of Madness requires meditation. There are some books both within the psycho-analytic corpus and outside of it that require slow meditative reading – sometimes line by line. I have been reading recently a book, short in length, but which is pregnant with meaning and startling in its vision and, at the end of six months, I am only a third of the way through the book. It will, I am sure, take me more than a year to finish it. Bion's great works Learning from Experience, Elements of Psycho-Analysis and Transformations are, for me, also books of this nature. I know that I do not have the emotional wisdom nor the depth of intelligence of these great authors. When writing A Pattern of Madness I kept being confronted with the clear knowledge of my intellectual and emotional shortcomings. I was never confronted with this when writing Narcissism: A New Theory. Writing the latter boosted my ego; writing the former humbled me. There is one person I know who has learned and developed through writing A Pattern of Madness – that is myself. A priest once told me that the sermons which were his best were those which spoke to him himself and transformed him.
A Pattern of Madness starts by going to the roots of existence and that is why I start the book with a chapter on Ontology. Ontology is the study of Being. Why on earth start there ? There is a problem which has beset the thinking person from the dawn of history: the powerful human need to establish certainty. It has guided all great thinkers: Parmenides, Plato, Aristotle in classical times; Moses Maimonides, Thomas Aquinas and Avicenna in the Middle Ages and Spinoza, Descartes and Kant in the modern era. They have all known that only against a background of absolute certainty can other thoughts, judgments and conditions of mind be measured and given an appropriate value. They have also known that when this absolute is wrongly placed upon something that is particular, upon something that is just a fragment of the whole but not the whole itself, then our whole mental world becomes distorted. This is why I start with Ontology which is the contemplation of Being. Psycho-analysis has been at fault because, together with Psychology and Sociology, it has made absolute the struggle for survival but this is not the whole but a fragment of the whole and it has led to a distortion which in itself is a madness and which obscures what is mad and prevents us from differentiating clearly the sane from the insane.
Bion said that he thought psycho-analysis was a poor instrument for the investigation of the mind but that he did not know a better one. This is the perspective of someone who knows that psycho-analysis is a fragment, a limited instrument of research. He could only speak like this because he knew there is a something that is not limited. He referred to this as O which I believe he meant to stand for Ontos which is the Greek for 'being'. I don't this it denoted origin as has been suggested by various authors. Bion used Greek letters such as alpha and beta to describe realities and I think O stood for Ontos. Bion, probably wisely, rarely wastes time on demolishing idols but spends his energies in describing what is real, what matters. It has had an unfortunate consequence, however, in that those who have been schooled in the Freudian aula have, as their unquestioned assumption, the belief that the struggle for existence is the overarching tool that explains all motivation and is why instincts, which are the servants of survival, have had pride of place in psycho-analysis. So psycho-analyis has fallen prey to that ancient error, which those great thinkers mentioned above strove so hard to avoid. And Bion's vision has been pressed into this fragmentary slice of the truth and therefore distorted.
Madness is that state where we make absolute, endow with supreme and unquestioned value something which cannot sustain such a faith. There are delusional systems which govern our thinking and beliefs. We usually recognize the crazier ones but swallow whole those that sound alright because we have heard them so often. So I start A Pattern of Madness by placing absolute certainty where it belongs. I claim that when we have done this we have done a great service to ourselves and others. We have laid the foundation-stone of sanity. My own individual existence is a fragment of the whole. When I try to make that fragment into the whole then I plunge into madness in one of its many forms. The epistemological method that brings me to an understanding of Being is profoundly different from say the belief that the struggle for existence is the overarching principle of explanation. The latter is embraced as a received dictum; the former can only be arrived at through a personal creative act. I can be taught the latter; I cannot be taught the former. The enlightenment that accompanies the personal act of understanding in the realization of Being permeates all reality while respecting all individual variations. What however is embraced as a received dictum ruthlessly destroys all reality that does not conform to its dictatorial force.
So what I was trying to do in A Pattern of Madness was to transplant psycho-analysis from a certainty which is delusional into one that is real. If someone reading this piece is moved to read, or re-read, A Pattern of Madness, and to be moved to a new understanding through reading it then I know that this article will have achieved its purpose.
It is my contention that there is a more basic malaise of which all the above conditions are manifestations. My purpose in writing A Pattern of Madness was to describe this malaise and try to show how it is the core condition which generates these stataes which are so readily described as pathological. These states are all symptoms of a deep-seated malady. Psycho-analysis is concerned to understand the depths which beget these 'diseases of the mind'. It it the belief that if these depths are understood then a healing occurs not just in autism or in insecure attachment, or in paranoia but in many other manifestations such as addiction, psychopathy or bi-polar disorder. Insecure attachment, autism, paranoia, schizoid states, acting out, borderline and narcissistic conditions are all symptoms but they are often treated as 'ultimates' as 'things-in-themselves'. We expect this from psychiatry, one of whose roles is to decribe the mental phenomena in such a way that it can be categorized as a mental illness and therefore treated by psychiatry. Psycho-analysis, from its very beginning, has been concerned to probe beneath the surface to what lies hidden and to discover what it is at fault in these foundations. When the fault-line is understood then it has in that very act of understanding become transformed. It is a tragedy that much of psycho-analysis has been 'colonized' by psychiatry. What I mean by this is that psycho-analysis has accepted the psychiatric categorization in the belief that there is then a ready remedy. I have come more and more to see in recent years that persons come to see me to solve a personal problem which I have to listen carefully in order to understand. As soon as I categorize then I believe I can treat in a particular manner. So, for instance, Dorothy Rowe says:
" I have often observed that psychiatrists and therapists prefer to diagnose
their patients as having a disorder that they can treat rather than a disorder
that reflects what is actually going on."
A borderline state is often described as a 'thing-in-itself' rather than a phenomenon whose source needs to be looked for and then described as accurately as possible. This way in which psychiatry has 'colonized' psycho-analysis is a resistance to psycho-analysis and it may be that psycho-analysis which is under attack to-day is not being attacked for its essential nature but for the psychiatric débris that it has accumulated. This resistance is deceptive because so many psycho-analysts, with their psychiatric training, do not think of these states as symptoms. So in A Pattern of Madness what I try to do is to describe the noumenon. So, for instance, at one point I try to demonstrate that the narcissistic and borderline states are different vertices upon one single state but that this in itself is not the noumenon. Dorothy Rowe, for intance, has with some courage declared that the borderline state is not a mental entity at all but merely a fictitious construction.
I have been disappointed that this book has not attracted any general interest and it may be that, because it challenges some treasured assumptions within the professional world of psycho-analysis that it is hated. There are though other reasons which can be attributed accurately to my own deficient descriptions. Nevertheless, like Narcissism: A New Theory it has inspired a few individuals scattered around the globe. I have had letters and e-mails from these few which have made quite extravagant claims for the effect that these books have had on them. One person wrote saying that her marriage and clinical work had been transformed by A Pattern of Madness. This is very gratifying. Another colleague however was angry at the new terms which I introduced in A Pattern of Madness. I use terms like the jelly, the worm, glue-like attachment and god. Why on earth wasn't I satisfied with the terms more familiar to psycho-analysts like borderline, inferiority complex, adhesive identification and omnipotence ? I used these words because they are emotionally more evocative than the more familiar psycho-analytic terms. Jelly conjures up the inner state with an emotional immediacy more adequately than borderline; the worm describes the inner state of worthlessness more succinctly than inferiority complex. Glue-like means more to me than adhesive and god is a more powerful metaphor than omnipotence; it can also be the subject of a sentence. I also used these terms because I found that patients, especially patients unfamiliar with psycho-analytic literature used exactly these words. I have also always had an instinctive preference for words and images which can be understood by any Cockney cab driver or a working-class housewife from Stepney. Again to quote Dorothy Rowe:
" The experts in mental disorders do not like plain and simple speaking
because that would reveal how little they actually know."
This reminds me of something that Arthur Bryant said about lawyers:
" For the lawyers, who in the days of universal illiteracy had secured their craft monopoly by the simple device of being able to read and write, had learned to preserve it, as the nation became literate, by ingeniously constructing a wordy jargon which no man but themselves could understand and which they ever expanded as the march of human reason toiled vainly after them."
But psycho-analysts have fallen into the same professional trap. I believe that jelly, worm and glue-like attachment can be understood by the man-in-the-street. The malady that underlies all the psychiatric categories is something that is part and parcel of the normal human condition.
However this same woman who was inspired passionately by A Pattern of Madness also told me that it was a difficult book and that of five people to whom she had recommended it only three persevered, the remaining two giving up because they found it too difficult. There is no doubt that Narcissism: A New Theory is an easier book to read. Its main argument is clear: that an act refusing what is lifegiving lies at the heart of narcissism rather than the classical definition: that it consists in taking oneself as love object. The simplicity of the argument and the clinical examples illustrating it have given the book considerable appeal and, apart from The Analytic Experience, it has sold much better than any of my other books. A Pattern of Madness is however a deeper book. My book on Narcissism has a moralistic tinge in its tone. A Pattern of Madness sees the narcissistic condition as one aspect of a more fundamental disorder, a mental outlook which leads to great human suffering. I try to describe the discrete elements but in such a way as to show that they are all one state but that our inability to see it this way is due to the limitations of our minds. Narcissism: A New Theory can be read straight through and understood without too much difficulty but A Pattern of Madness requires meditation. There are some books both within the psycho-analytic corpus and outside of it that require slow meditative reading – sometimes line by line. I have been reading recently a book, short in length, but which is pregnant with meaning and startling in its vision and, at the end of six months, I am only a third of the way through the book. It will, I am sure, take me more than a year to finish it. Bion's great works Learning from Experience, Elements of Psycho-Analysis and Transformations are, for me, also books of this nature. I know that I do not have the emotional wisdom nor the depth of intelligence of these great authors. When writing A Pattern of Madness I kept being confronted with the clear knowledge of my intellectual and emotional shortcomings. I was never confronted with this when writing Narcissism: A New Theory. Writing the latter boosted my ego; writing the former humbled me. There is one person I know who has learned and developed through writing A Pattern of Madness – that is myself. A priest once told me that the sermons which were his best were those which spoke to him himself and transformed him.
A Pattern of Madness starts by going to the roots of existence and that is why I start the book with a chapter on Ontology. Ontology is the study of Being. Why on earth start there ? There is a problem which has beset the thinking person from the dawn of history: the powerful human need to establish certainty. It has guided all great thinkers: Parmenides, Plato, Aristotle in classical times; Moses Maimonides, Thomas Aquinas and Avicenna in the Middle Ages and Spinoza, Descartes and Kant in the modern era. They have all known that only against a background of absolute certainty can other thoughts, judgments and conditions of mind be measured and given an appropriate value. They have also known that when this absolute is wrongly placed upon something that is particular, upon something that is just a fragment of the whole but not the whole itself, then our whole mental world becomes distorted. This is why I start with Ontology which is the contemplation of Being. Psycho-analysis has been at fault because, together with Psychology and Sociology, it has made absolute the struggle for survival but this is not the whole but a fragment of the whole and it has led to a distortion which in itself is a madness and which obscures what is mad and prevents us from differentiating clearly the sane from the insane.
Bion said that he thought psycho-analysis was a poor instrument for the investigation of the mind but that he did not know a better one. This is the perspective of someone who knows that psycho-analysis is a fragment, a limited instrument of research. He could only speak like this because he knew there is a something that is not limited. He referred to this as O which I believe he meant to stand for Ontos which is the Greek for 'being'. I don't this it denoted origin as has been suggested by various authors. Bion used Greek letters such as alpha and beta to describe realities and I think O stood for Ontos. Bion, probably wisely, rarely wastes time on demolishing idols but spends his energies in describing what is real, what matters. It has had an unfortunate consequence, however, in that those who have been schooled in the Freudian aula have, as their unquestioned assumption, the belief that the struggle for existence is the overarching tool that explains all motivation and is why instincts, which are the servants of survival, have had pride of place in psycho-analysis. So psycho-analyis has fallen prey to that ancient error, which those great thinkers mentioned above strove so hard to avoid. And Bion's vision has been pressed into this fragmentary slice of the truth and therefore distorted.
Madness is that state where we make absolute, endow with supreme and unquestioned value something which cannot sustain such a faith. There are delusional systems which govern our thinking and beliefs. We usually recognize the crazier ones but swallow whole those that sound alright because we have heard them so often. So I start A Pattern of Madness by placing absolute certainty where it belongs. I claim that when we have done this we have done a great service to ourselves and others. We have laid the foundation-stone of sanity. My own individual existence is a fragment of the whole. When I try to make that fragment into the whole then I plunge into madness in one of its many forms. The epistemological method that brings me to an understanding of Being is profoundly different from say the belief that the struggle for existence is the overarching principle of explanation. The latter is embraced as a received dictum; the former can only be arrived at through a personal creative act. I can be taught the latter; I cannot be taught the former. The enlightenment that accompanies the personal act of understanding in the realization of Being permeates all reality while respecting all individual variations. What however is embraced as a received dictum ruthlessly destroys all reality that does not conform to its dictatorial force.
So what I was trying to do in A Pattern of Madness was to transplant psycho-analysis from a certainty which is delusional into one that is real. If someone reading this piece is moved to read, or re-read, A Pattern of Madness, and to be moved to a new understanding through reading it then I know that this article will have achieved its purpose.
By Neville Symington
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