Reason, madness, and the like

Adam Phillips reviews Gary Greenberg’s Manufacturing Depression, along the way quoting some memorable remarks and making intriguing remarks of his own.  He mentions Alfred Adler’s practice of beginning a course of psychoanalysis by asking a patient, “What would you do if you were cured?”  Adler would listen to the patient’s response, then say, “Well, go and do it.”  Phillips points out that this practice suggests that mental illness is simply an obstacle to achieving goals that themselves need no explanation, simply a form of inefficiency.  If to you this sounds like Max Weber’s description of rationality as an instrument that moderns use to achieve goals which they cannot subject to rational  criticism, you’ll appreciate this quote from Weber:  “Science presupposes that what is produced by scientific work should be important in the sense of being ‘worth knowing.’ And it is obvious that all our problems lie here, for this presupposition cannot be proved by scientific means.”  Phillips tells us that Greenberg sees mental illness quite differently than Adler did; in the course of his explanation of Greenberg’s view, he mentions D. W. Winnicott’s definition of madness as “the need to be believed.”   

Phillips identifies Greenberg’s main interest as the way psychology and psychiatry have described depression and the economic interest this particular description serves.  Phillips summarizes Greenberg’s arguments on this point and contrasts them with the radical anti-psychiatry of earlier decades, but he himself seems more interested in deep questions about the philosophy of science.  For example, he writes:

Scientists sometimes want us to believe that the evidence speaks for itself, but evidence is never self-evident; people often disagree both about what counts as evidence and what evidence is evidence of. It is as though, now, the cult of evidence—of “evidence-based research”—is the only alternative to the cults of religion. But the sciences, like the arts, like religions, are forms of interpretation, of people making something out of their experience. And our ideas about health, mental or otherwise, are just another way of talking about what a good life is for us, what we can make of it and what we can’t.

The blurb for this review on the issue’s table of contents reads “Science can be disproved only by its own criteria; when it comes to mental illness, its own criteria are often insufficient.”  Which is a strange thing to say- if the criteria of science are insufficient to disprove theories about mental illness, then how can those theories be called scientific?  Be that as it may, the blurb is clearly not a fair summary of what Phillips is saying, or of the views he attributes to Greenberg.

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