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Questions Arising from Reading Darian Leader's What is Madness?

The Letter, Issue 49, Spring 2012, Pages 51 - 63


Barry O’Donnell

This paper examines the representation of a psychoanalytic response to madness in the recent publication What is Madness? by Darian Leader. Drawing from the comments of Christian Fierens and Guy Le Gaufey and guided by the treatment of Freud’s position on paranoia in Tom Dalzell’s Freud’s Schreber Between Psychiatry and Psychoanalysis the paper finds that the representation of a psychoanalytic response raises crucial questions for our practice and teaching as well as the constitution of our schools.

Keywords: diagnosis and practice, quiet madness, ordinary psychosis, the use of vignettes as a representative device

2011 saw the publication of two books on the question of madness which came to my attention. Tom Dalzell’s Freud’s Schreber between Psychiatry and Psychoanalysis has been recognised as a very readable, thoroughly scholarly, theoretically rigorous book. It articulates Freud’s specifically psychoanalytic account of psychosis and situates it in the context of the psychiatric theories and treatments of psychosis of Freud’s time. Furthermore, it studies the influence of Freud’s account on subsequent psychoanalytic responses to madness. Dalzell argues that Freud explains the psychosis of President Daniel Paul Schreber’s as caused by a fixation at narcissism. What distinguishes this theory from all others is that Freud invokes a theory of subjectivity which posits “the individual subject’s involvement in the origin of his or her illness, and its cure.” [2] There was, in that era, the late nineteenth, early twentieth century, vigorous debate and heated exchange between very different positions on the question: what is madness? Dalzell describes Freud’s long and difficult engagement with the views of leading psychiatrists, who, for all their own differences, rejected this Freudian thesis of a subjective aetiology of madness. Even in the psychoanalytic community Freud’s approach was not entirely followed leading Dalzell to conclude that “Jacques Lacan has received Freud’s Schreber text and its aetiology more fully than other influential figures in the psychoanalytic community.” [3]

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