Understanding madness?

Irrationality, usually in the form of self-deception or weakness of the will, is an issue which has been much debated in philosophy in recent years. The kinds of cases discussed, however, are almost always of a limited nature, isolated episodes in the lives of otherwise normal, rational people. The question of madness, of a large-scale breakdown in rationality, by contrast, has received little or no attention. The apparent problem posed by madness is one of understanding. In the third part of this paper, I will develop a more technical notion of understanding, but until then, we can use the concept quite informally and intuitively. The insane seem to have beliefs and desires which, for various reasons, we find it hard to see the justification for, or the point of. How can someone really believe of himself that he is a gourd, or that he is made of glass? How can someone really have the desire to eat up the world? There may also be phenomena which are even more difficult to understand, such as belief in an apparent contradiction, or non-transitive patterns of preference. In this paper, I propose to look at two suggestions which have been made by philosophically inclined psychiatrists about how to understand the psychotically insane. I will argue that the methods proposed are unsatisfactory, though for different reasons. Finally, I will say something about how a particular philosophical approach to the topic of mental content might have something useful to say about the problem of understanding madness. Before I begin, a brief caveat: in what follows, I use the term “psychosis” and its cognates interchangeably with “madness” and insanity” and their cognates. And I use none of these in any clinically defined sense. Indeed, whether or not these terms can be given any precise clinical sense is largely an irrelevance here since I am happy for my remarks to apply to any cases which present the difficulties for understanding which I take as the sign of madness, regardless of whether they match any proposed clinical definition. < < .