Both of our readings this week discuss schizophrenics from different perspectives but deal with similar issues. John Wray’s Lowboy represents a phenomenological approach to schizophrenia; Simon McCarthy-Jones’ Hearing Voices examines schizophrenia from the institutional framework of the “psychiatric system” (144). Lowboy places the reader within schizophrenia’s experience of the world; McCarthy-Jones investigates how the psychiatric system constitutes the lived experiences of schizophrenia when “voice-hearer” becomes the psychopathologized schizophrenic. It seems both texts are trying to complicate our understanding of mental illness.

I know that I reference Foucault a lot, and I am going to do so again here. These readings instantly made me think of Foucault’s Madness and Civilization. Foucault claims that the notion of madness as being inside the body, as constituting the individual, is part of the discursive formation of madness of the modern period. The taxonomy of illness, to define it, locate it, diagnose, treat, and relegate bodies with the illness represents a new form of productive power within modernity. (I apologize for the long quote)

“In the serene world of mental illness, modem man no longer communicates with the madman: on one hand, the man of reason delegates the physician to madness, thereby authorizing a relation only through the abstract universality of disease; on the other, the man of madness communicates with society only by the intermediary of an equally abstract reason which is order, physical and moral constraint, the anonymous pressure of the group, the requirements of conformity. As for a common language, there is no such thing; or rather, there is no such thing any longer; the constitution of madness as a mental illness, at the end of the eighteenth century, affords the evidence of a broken dialogue, posits the separation as already effected, and thrusts into oblivion all those stammered, imperfect words without fixed syntax in which the exchange between madness and reason was made. The language of psychiatry, which is a monologue of reason about madness, has been established only on the basis of such a silence” (x-xi).

McCarthy-Jones, who seeks to find space for the “voice-hearers” within modern society wherein hearing voices is not “pathological” but an inability to cope “can be labelled illness,” seems to align with Foucault against “the constitution of madness as a mental illness” (145). McCarthy-Jones appears to offer a practical solutions to undo the social and individual stigma of pathologizing schizophrenia. Nevertheless, McCarthy-Jones situates voice hearing within a schema of “recovery,” which resumes “a monologue of reason about madness” by simply establishing a new demarcation of “being a patient voice-hearer” from “a healthy voice hearing” (145). McCarthy-Jones’ good faith approach to help schizophrenics conform their condition within normative society still takes up psychology’s discourse; it still sees the condition of hearing voices as a condition to be treated. To the psychologist the schizophrenic subject’s inherent ontology is within the realm of the pathological. McCarthy-Jones’ may be working against the stigma of pathology but his analysis derives from legible categories of psychopathology: behaviors, statements, ideations, are still categorized and subjected to professional scrutiny. The subject as a “patient” must seek recovery through the psychologist’s humanized regimen. The patient continues to possess an illness that needs sterilization. Foucault’s genealogy of madness complicates this binary by arguing that the taxonomy of mental illness has a history; that before it represented a malady “within man,” madness was a link to the “subterranean,” existing outside of the body that could be accessed in order to retrieve the truth of the world (26). The discursive shift of madness occurs when the madman becomes the mentally ill, a subject in need of profession help.

Looking back at The Shaking Woman, Hustvedt has some interesting things to say about schizophrenia. In contrast to Hegel, who reasons that “our self-consciousness is rooted in relations between the self and other,” for “some schizophrenics” the concept of self-consciousness has no basis since “‘I’ and ‘you’ become confused or meaningless” (76-77). On the one hand, we can view the lived experience of schizophrenia as perversion of consciousness; on the other, the concept consciousness as existing and emanating from within the self is unsatisfactory from the perspective of the schizophrenic. The ontology of schizophrenia, in other words, expresses the limitations of “self” as a isolatable concept. Moreover, Hudstvedt brings up Ian Hacking’s proposition that psychological diagnoses “affects people” (148). Similar to McCarthy-Jones’ argument, being labeled schizophrenic will place the subject within “the subculture of psychiatry” (149). In other words, the subject is placed within the arena of psychiatric observation and induced into incessant confessions of his/her illness. The diagnosis of schizophrenia is not simply reference to a natural biological affliction. It both effects new outcomes and regimen of behaviors, which will be thoroughly researched and analyzed as well as affects how the individual thinks about him/herself. The diagnosis of schizophrenia does not elicit the truth of the subject; instead, the “schizophrenic’s” identity is subjected to the organizational, institutional, and discursive power embedded within the epistemology of schizophrenia. As a result, the possibility of escaping the bounds of the Hegelian dialectical identity is denied; that “meaningless” terrain described by Hustvedt is no longer acceptable. Instead, identity is supplanted by the psycopathological binary: the abnormal “schizophrenic” and the normal “you.”

The diagnosis of schizophrenia is not simply a symbolic supplantation of identity; it places within the body legible traits that are dangerous to society, and therefore must be medicalized and quarantined. The novel Lowboy articulates the “psychological” (and sociological, why not?) damage that the labeling of schizophrenia inflicts. The book is not about how meds or psychotherapeutic treatment improve the life of William Heller. It tells instead a tragic story of the newly diagnosed schizophrenic reentering the world as a schizophrenic. But at the same time, it Wray wants to complicate our notion of schizophrenia. After suffering what is most likely a concussion, the detective Ali Lateef hears a voice, “I’m Rufus White, he thought suddenly. The thought came to him in an odd voice, faraway but insistent, like the thoughts that sometimes visited him as he fell asleep, or the voices reportedly heard by schizophrenics” (152). What’s fascinating about this moment is the simultaneous acquisition and admission of a legible schizophrenic trait as well as Lateef’s dismissal of its existence inside of him. Nevertheless, Lateef reads his internal phenomenon as evidence of a possible alteration of self: “He’ll change me too if I allow it, he thought. Maybe he already has” (152). This moment suggests the unspoken logic for the treatment of psychosis: that madness is contagious and must be subjected to quarantined professional scrutiny so that it does not infect normal society.

The possibility to return to a world where mental illness loses its meaning as a relevant signifier seems impractical. In this light, McCarthy-Jones’ prescribed solutions for undoing the negative effects of the psychiatric system may be a step in the right direction for now. However, I can’t see how inventing euphemisms solve the problem. Substituting “voice-hearer” for “schizophrenia” does not diminish the diagnosis; rather it functions as pseudo-psychiatric sublimation, by fulfilling the suppressed urge of diagnosing. Psychiatry will not willingly self-destruct, nor will the value we place (including myself) on their role in making us more productive citizens subside. What we could do is perhaps stop inventing individuated selves, or at least recognize that the notion of a “true self” is social construct.