Madness-as-Play

Madness-as-Play

Oct 12, 2023

The following essay was submitted in May 2023 for the first module on the MSc Mad Studies at Queen Margaret University, OM207 - Introduction to Mad Studies.


MADNESS-AS-PLAY

“The medium is the massage.” (McLuhan, 2008)

GO AND PLAY

Recent anthropological work emphasises that for most of human history “there is no single pattern. The only consistent phenomenon is the very fact of alteration, and the consequent awareness of different social possibilities'' (Graeber and Wengrow, 2021, p.115). The crucial question at an ontological level is, “If we started out just playing games, at what point did we forget that we were playing?” (Graeber and Wengrow, 2021, p.116). Whether we take this literally or metaphorically, much of this play has become the type of activity that ends up being defined as deviance, pathologized and prohibited by the psy-disciplines as “madness”.

Following Lacan, “The psychoses...correspond to what has always been called and legitimately continues to be called madness” (Lacan and Miller, 1993, p.4). Other experiences, such as autism, personality disorders etc. are crucially not problematised by societies in the same way as “individuals with a diagnosis of psychosis…or bipolar…were significantly more likely to be admitted…involuntarily than…other…diagnoses” (Walker et al., 2019). Although these other experiences are “labelled violations of social norms” (Scheff, 1966, p.7), unlike madness they do not present a challenge to consensual reality at a metaphysical level. It’s no wonder that “metaphysics was effectively declared nonsense at roughly the same time as medical psychiatry was born” (Barnes and Kusters, 2021). Psychiatry positions itself as the overlord of an episteme that objectifies reality in a way that is “more theological than scientific” (Frank, Gleiser and Thompson, 2019).

If Mad Studies is to prove “part of a wider revolutionary project” (Menzies and LeFrançois, 2013, p.17) then it must also give emancipatory new ways of approaching madness that offer “the possibility to liberate a person from personal or societal oppression…by connecting them to alternative ways of viewing experiences” (Brown, 2020, p.3, 7). One such alternative is madness-as-play.

MADNESS-AS-PLAY

Philosophy is “the art of…inventing…concepts” (Deleuze and Guattari, 1994, p.2). This is itself “‘playful’ through injecting disturbance into…common sense to produce new and exciting possibilities” (Lester, 2013, p.132). Although a convincing argument can be made this is the case, a discussion of a truth claim that madness is play avoids “the seduction of the interpretative master key” (Flexer, 2016, p.22). Rather, the reader should engage in a thought experiment, the as if characteristic of which is itself a major feature of play (Spariosu, 1989, p.37-42). Western society blindly accepts the problematic interpretation that madness is mental illness, so let’s entertain a different interpretation. This opens the discussion to focus on how “play invites new beginnings” in other humanistic inquiry (Rapti and Gordon, 2021, p.16) so too it does in approaching madness.

Due to its ambiguous core, it is not easy to pin down what is meant by play, but “we all know what playing feels like” (Sutton-Smith, 2001, p.1). Bateson explains the paradox of play: “the playful nip denotes the bite, but does not denote that which would be denoted by the bite” (Bateson, 1955, p.71). It means what it means but doesn’t mean what it means. It is precisely this certain uncertainty and uncertain certainty that makes play (doubly) paradoxical in being primarily fun but also “potentially terrifying” (Graeber, 2015); it wouldn’t be so fun if the danger of dangerous misunderstanding wasn’t present. At a metaphysical level the consequences of this paradox means that play “occupies a threshold between reality and unreality” where “players unravel in some way the accepted orthodoxies of the world in which they live” (Sutton-Smith, 2001, p,1, 166) in “a movement away from order, stability and predictability” (Lester, 2013, p.136) opening up a space “where one is exempt from life’s customs, methods and decrees” (Ackerman, 2000, p.6). This is clearly the world in which mad experiences emerge.

MADNESS IN THE METHOD

It is crucially important that “If Mad Studies achieves its objectives, it needs to have as part of its end goal the shaking up, the disturbing, of all forms of academic knowledge” (Ingram, 2016, p.17). This means maddening the message and the medium; at all levels we need to start playing again. This essay therefore draws on a new architectural approach to (mad) pedagogy (Bailey, 2022) the author invented. The model combines physical movements with critical analysis in an attempt to challenge the mind-body dichotomy. He recommends a plain piece of white paper in front of you and a pen…

LYING = PERSONAL

Looks at issues from the perspective of the individual, the feelings, choices, perceptions, and personalities of those who comprise a society.

Get out of your seat. Go on. Stand up. Move around. Find some floor space. Lie down. Relax. Madness-as-play. What does it mean to you from this position? Put some thoughts down on your paper. Words. Drawings. Connections. Then read this…

Bulkeley, a leading researcher in dreams, integrates evidence from biology, the social sciences, and the humanities to argue that “the most consilient theory of dream function” is that “dreaming is imaginative play in sleep” (Bulkeley, 2019). Surely if dreams can be best understood as play then why not madness? It’s even less of a push – play, like madness, is primarily part of the waking condition. Jung famously pointed to the similarities between the psychotic and dream states: “If we could imagine a dreamer walking around and acting his own dream as if he were awake, we would see the clinical picture” (Jung, 2014). Indeed, “recent psychological, tomographic, electrophysiological, and neurochemical data appear to confirm the functional similarities” (Scarone et al., 2008). If the dreamer is playing, then so is the madman.

Bulkeley points out that a major issue of debate in dream research is “how to account for aspects of dreaming that seem strange, unrealistic, impossible, or bizarre” (Bulkeley, 2019). It is this cognitive bizarreness which is much of the time precisely what seems to concern psychiatry most with respect to those experiencing madness – the “gulf which defies description” (Jaspers, 1997, p.447). Bulkeley argues that

thinking of dreaming as imaginative play in sleep has the benefit of reframing this issue and opening up another possibility…[that] bizarreness is a feature, not a bug, of both playing and dreaming…[it is] evidence of how far our minds can be stretched, how widely our imaginations can range across multiple possible realities

Bulkeley never makes the obvious point: exactly the same can be said of madness. Bizarreness is the primary feature, not a bug, of madness. Bulkeley contends that dreaming and play are “innate behaviors…that have the adaptive, survival-enhancing effect of stretching our minds beyond what is to imagine what might be” (2019). This resonates with the view that we can just as easily see that “the delusions of schizophrenia could stem from mechanisms that are performing their evolved functions perfectly well” (Garson, 2022) rather than as dysfunction. Thinking of madness as imaginative play whilst awake has the benefit of reframing this issue, moving us away from pathology to positivity. Rather than seeing psychosis as illness we move to awe at the organic ability such individuals demonstrate in radically transforming their experiences of reality.

SITTING = COMMUNITY

…from the perspective of the local community, defined by those who live there and their practices, and so can represent a geographic space as small as a street or as large as a city.

Sit up. Cross your legs. Ideally find someone else to join you. What does madness-as-play mean to you from this position? Put some thoughts down on your paper. Then read…

One would hope that a playful understanding of out-of-the-ordinary experiences or behaviours would move us to reconsider the dangerousness we attach to them. As Foucault argues “the notion of "danger" is still the guiding thread” of psychiatry. However, “to be dangerous is not an illness…it is not a psychiatric notion” (1988 p.188, 191) rather it is the primary “device for neutralizing difference and for policing what [is] socially undesirable” (Arrigo and Williams, 1999, p.181). The largest study suggests that when accounting for comorbid substance abuse, the risk of violent crime in schizophrenia is only slightly increased (Fazel et al., 2009). But “members of the public exaggerate both the strength of the association between mental illness and violence and their own personal risk” (Stuart, 2003), which is unsurprising when the “media’s…emphasis on interpersonal violence is highly disproportionate to actual rates of violence” (McGinty et al., 2016). Overall “people with mental illness are more likely to be a victim of violent crime than the perpetrator” (Ghiasi and Singh, 2018). More importantly, “empirical research repeatedly demonstrates that mental health professionals remain unable to predict accurately the dangerousness of any one individual” (Arrigo and Williams, 1999 p.188), consequently there really “is no scientific basis whatever for preventive psychiatric detention” (Szasz, 2003). Even if there were, the obvious candidate for such detention is psychopathy, which remains benignly neglected by the law and formally resisted by psychiatry – it isn’t recognised by the DSM despite its enormous cost to society and relationship to violence (Kiehl and Hoffman, 2011). This emphasises that our perception of what constitutes danger is greatly distorted anyway; we appear to see those that play with reality as more dangerous than those who play with morality.

If we assume that the mad are predominantly engaged in play then we can approach their activity in a similar way to the risky play of children rather than as the dominant image of the terrifying maniac (Owen, 2012). “To play is to risk: to risk is to play.” (Ackerman, 2000, p.7). Of course play can get out of hand but when it does our response tends to affirm rather than deny agency. Players are usually encouraged to take responsibility for their action, whereas the mad are denied that their intentionality is at work in this process at all, which “is found in the fact that so many ‘psychotics’ are detained rather than voluntarily seek psychiatric assistance” (Saville-Smith, 2023). It has been stressed that those experiencing psychosis have an active role in their delusions, which “should be viewed as agentic in nature” (Hook, 2020). In other words, “poor-reality testing” is misunderstood as the “quintessential sign of madness” as many schizophrenic patients actually “seem to have a surprising, rather disconcerting, kind of insight into their own condition” to the extent that “one may even begin to suspect…they are somehow only playacting” (emphasis added; Sass, 1995, p.1-4). As Unger argues, this moves us to viewing lack of insight in a very different frame, seeing psychosis as “caught up in imagination and play without enough awareness that it is play” (Unger, 2013). This encourages us to reject the

better safe than sorry climate of the medical community [which] is responsible for ceaseless numbers of perfectly harmless individuals routinely being diagnosed as "dangerous" and consequently subjected to involuntary confinement (Arrigo and Williams, 1999, p.190)

It is utterly unacceptable that individuals are unjustly deprived of their liberty despite having not committed any offence; a clear act of discrimination. Instead by seeing madness-as-play we must, as is emerging in approaches to the risky play of children, promote the idea in our communities of “safe as necessary, not as safe as possible” (Brussoni et al., 2012).

CHAIR = NATIONAL

…from the perspective of the nation state where events and trends have an impact within the geographical boundaries of a particular country or between countries.

Move to a chair. Get as comfortable as is possible in this artificial imposition. What does madness-as-play mean to you from this position? Put some thoughts on paper. Then read…

Without psychiatry it is hard to see how the modern state could claim the sovereignty necessary to its very existence. It is crucial in providing a permanent state of exception which gives it the essential power to detain and “correct” individuals who have not committed a crime but “pose offences grave enough to the social order to warrant…special treatment” outside of the legal-moral order (Ashe, 2019). This function was of course politically crucial to the Soviets and Nazis, but as Cooper argues

It is an impertinence of western psychiatrists to try to absolve their own practices by accusing their true brothers in the Soviet Union of the abuse of psychiatry for political ends: it is psychiatry that is the abuse of humanity for political ends. (Cooper, 1978, p.177)

Anthropologically speaking, it’s been argued more fundamentally that “perhaps this is what a state actually is: a combination of exceptional violence and the creation of a complex social machine, all ostensibly devoted to acts of care and devotion” (Graeber and Wengrow, 2021, p.408). Derrida argues that “oppressive structures are identified solely in terms of their attempts to instantiate presence” (Jun, 2007) and “play is the disruption of presence” (Derrida, 1978, p.292). The state imposes stasis, play insists on change. It is this play element in the destructuring dis-course of madness that makes “all madmen…political dissidents” (Cooper, 1978, p.23). Like freedom, play and madness has to be in tension with something or its just randomness (Graeber, 2015). This “to-and-fro movement” of play (Gadamer, 2004, p.93) is reflected in the twofold process of (mad/playful) deterritorialization and (violent/bureaucratic) reterritorialization, which is the very foundation of the capitalist-state (Deleuze and Guattari, 1983, p.34-5). Reframing madness-as-play encourages us to (re)politicise psychiatry in a new way, seeing it as ultimately anti-play. By pathologizing play, psychiatry represses the necessary (dis)order play brings about, “as though it saw in this process the image of its own death coming from within” (Deleuze and Guattari, 1983, p.245), forcibly muting “the possibility for any liberating social transitions to occur” (Arrigo and Williams, 1999). This is “what all societies dread absolutely as their most profound negative: namely, the decoded flows of desire…[that] deliberately scrambles all the codes” (Deleuze and Guattari, 1983, p.161, 15); re-creation. In other words, “what ultimately lies behind the appeal of bureaucracy is fear of play” (Graeber, 2015). In order to support experimentation within a society we must move towards “a more tolerant and playful approach to “mad” perspectives of many kind” (Unger, 2013). But as Cooper rightly points out – and to which the framing of play helps to reveal – is that "it is not a question of obtaining a tolerance for madness, but rather of making it understood that madness is the expression of social contradictions against which we must struggle as such." (Cooper, 1978, p.166). Namely, against the state itself.

STANDING = GLOBAL

…from the perspective of the entire globe in which events and trends have far-reaching and long-term impacts, cutting across social identities and interests.

Stand up. Look down. Look up. Look around. What does madness-as-play mean to you from this position? Put some thoughts on your paper. Then read…

In the West, the medicalisation of human experience by the “rational” language of psychiatry is complicit in “grave over-seriousness” (Stelzer, 2022) by “reinforcing a morbid society” that refuses to take life, death and madness with a playful pinch of salt; “a medical nemesis” that pathologises the world into a hospital ward (Illich, 1982). We treat those having mad experiences with deadly seriousness, violently closing them down with incarceration and chemical strait-jacketing. We are distressed by these experiences and concurrently this becomes the way individuals frame their madness. In other words, over-seriousness becomes a form of hermeneutical injustice (Fricker, 2007). The historical and cultural record shows that it simply doesn’t have to be this way. Luhrmann describes this as social-kindling:

that the implicit and explicit ways in which a local social world gives significance and meaning to sensation (such as a hallucination) will alter not only the way those sensations are interpreted but the likelihood and the quality of the sensation itself (et al., 2015)

To take the broadest application of this, it’s been often observed that “In the East, spiritual life and experiential journeys take their practitioners across a region that, in the West, is fenced off with psychiatric barbed wire” (Kusters, 2020, p.475). Much of the time, those experiencing madness end up caught in this choice between interpreting it as sickness or as a spiritual crisis. Importantly “...which perspective is chosen not only influences how others will treat you, but also how you will treat yourself” (Taylor, 2007, p.621). Nevertheless, both responses treat the experience with utmost seriousness. The ludic perspective, on the other hand, provides an alternative “beyond the imperatives of meaning and rationality” (Taminiaux, 2021). Madness-as-play not only dispels with psychiatric pathologization but also with the demand that these experiences transform into something more: madness may or may not be meaningfully meaningless and/or meaninglessly meaningful.

Practically speaking, it’s worth remembering that in cultures

where the distinction between reality and fantasy is more flexible, people are encouraged to observe their hallucinations…and private events [and] since these experiences are positively valued, they tend to be frequently noticed and communicated to others. (al-Issa, 1995)

This concurs with the more benign trajectory of mad experiences outside the West, with the WHO consistently finding “persons clinically diagnosed…in the…West to have less favourable outcomes than counterparts in developing countries” (Hopper, 2003, p.72). Luhrmann’s research comparing voice-hearing in different cultures suggests the way we frame madness matters. Americans who uniformly interpreted voices “rationally” as symptoms of illness found them negative, violent and assaulting. Africans who tended to see them in “spiritual” terms as spirits under the authority of God reported the most positive experience emphasising their moral quality. South Asians who saw the voices as Hindu spirits in command of dead or alive humans known to them usually found them to offer useful guidance, even if they weren’t always a positive experience. Of these responses, guidance is the only emancipatory understanding of voices as they are not negatively or positively deterministic. Interestingly some of these subjects directly reported voice relationships as playful. Other research also suggests that Hindu subjects often experience psychosis as a “positive withdrawal” (Corin, Thara and Padmavati, 2003). There is also an attitude of greater tolerance of psychosis in the society (Leff et al., 1987). Although this does not escape the imperative of meaning – remaining tied to serious (but not overly-serious) soteriological demands in relation to achieving moksha (enlightenment), oneness with brahman (the divine), as the ultimate goal of existence – the Hindu divine is nevertheless considered to be fundamentally playful (lila), pointing to the way play can powerfully reframe experience.

CONCLUSION

Play is a “joyous cosmology” (Watts, 2013) that provides an “antidote to dark times” (Rapti and Gordon, 2021, p.5). Considering the continued violent nature of Western psychiatry, reframing madness-as-play constitutes a much-needed deradicalisation. At the global level, it offers a way of breaking with the over-seriousness that rational and meaning-laden approaches demand, opening a dis-course that de-stresses mad experiences. At the national level, by emphasising psychiatry’s involvement in the play of sovereignty, it encourages us to simultaneously re-politicise psychiatry and de-politicise madness. At the community level, it moves us away from risk-averse attitudes that deny mad agency, moving us towards more parental rather than policial approaches to safety. At the individual level, it puts madness back into phenomenology without sacrificing its ontological significance. At all levels, play is life-affirming, psychiatry is life-denying. Isn’t it time Mad Studies started playing?

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