THE PILLARS OF MADNESS
There are four extraordinarily useful ideas amid the massive tangle of publications on madness, these contributed by four men of genius in the practice of studying and changing seemingly irrational human actions—
 The Temperament Base of Madness (Ernst Kretschmer)
 Distracting Automatisms (Pierre Janet)
 Role Casting Control (Jay Haley)
 Disarming Confessions (Alfred Adler)
 Disarming Confessions
The fourth idea was long in coming, appearing shortly after the turn of the 20th century. Alfred Adler, an Austrian medic, said that our absurd ritual, whatever its form, is unwittingly designed to conceal from us and our companions that we have a deep-seated and abiding sense of unworthiness. Madness, then, has a job to do, that is, to conceal our dark secret, so that we have an excuse for failing to live up to our expectations and for setting aside one or more of the tasks of life—working, communing, mating. The function of absurd rituals—madness—is thus concealment.
We are obligated to live up to our expectations. And indeed, much is expected of us from the very beginning of our lives, some of us more than others. Those of us who promise much are expected to deliver, so we feel more obligated than those who promise little. We grow up bathed in expectations, so that we feel increasingly obligated. When we near that fateful time when we are launched into a world outside our home and school, we wonder if we can deliver what is expected of us.
Paracelsus, having claimed that our choice of madness is disposition-determined, said in On the Origin and Healing of Diseases that “Insanity is brought on by the abuse of the natural strength of reason. Because of their own limited knowledge men are thrown into a confused state of mind. This leads them to doubt and to great preoccupation, together with intense fantasies (daydreaming) and eventually Insanity.”
In the early part of the 19th century Schopenhauer, a German philosopher, chimed in with Paracelsus, adding that madness works for us, works to protect us, that it is functional in protecting us, not from physical danger, but from the danger of becoming demoralized. He said it protects our pride and in so doing keeps us from feeling ashamed of ourselves. By the middle of the 19th century the shame-protection theory of madness had spread throughout Europe, sparking vigorous empirical research, especially in Austria, Germany, and France.
What Schopenhauer suggested was that people act strangely to hide their shame, thus protecting themselves from recognizing themselves as unworthy. Some people, he wrote, are ashamed of themselves and therefore feel unworthy of the care and concern of others. If they do nothing to ward off shame, they fear that they will cease to care about themselves, a circumstance making life unbearable. The job of madness, said Schopenhauer, was to conceal our unworthiness from ourselves:
How unwillingly we think of things which powerfully wound our pride…. In that resistance of the will to allowing what is contrary to it to come under the examination of the intellect lies the place at which Insanity can break in upon the mind…. If the resistance of the will against the apprehension of some knowledge reaches such a degree that that operation is not performed in its entirety, then certain elements or circumstances become for the intellect completely suppressed. Because the will cannot endure the sight of them; and then, for the sake of necessary connections, the gaps that thus arise are filled up at pleasure; thus Insanity appears. For the intellect has given up its nature to please the will; the man now imagines what does not exist. Yet the Insanity which has thus arisen is the lethe of unendurable suffering; it was the latest remedy of harassed nature, i.e., of the will.
Thus for Schopenhauer the intellect is the servant of the will, so that desire dominates belief. What would defy our desire for self-esteem, writes Schopenhauer, is suppressed and replaced with fantasy, and this protective use of imagination is madness. Our madness is not the work of evil spirits, or of the sun, moon, or planets; or the eruption of trapped or wayward fluids, or yet the failure of defective or damaged flesh. It is purposive action, outside of consciousness, protecting us from the dread experience of shame, and the anguish that comes of spoiled identity.
Our absurd ritual must be disconcerting enough to goad our companions into trying to correct us. Failing in this they wonder whether we are mad instead of bad. They are baffled. But absurd rituals are time-limited, for sooner or later our baffled companions appeal to an authority who is likely to label our absurd ritual as a form of madness. Our companions’ deference to authority enables us to confess (to a lesser crime than unworthiness) that we are indeed afflicted by the named madness. To our relief, our confession puts us in the dominant position of the “identified patient” so that we can claim that our affliction, whatever it is called, prevents us from tackling the tasks of life—working, communing, and mating.
The obvious fact that we are prevented from taking on the tasks of life disarms our companions, so that they don’t know what to expect of us—the more extreme our madness the less can be their expectations. Thus our disarmed companions provide us with an excuse for not living up to expectations, not fulfilling our promise, not taking responsibility for succeeding in life. Authority finds us, alas, mad. Safe at last, we heave a sigh of relief, our dark secret of unworthiness buried beneath our madness. What goes unnoticed in the end is that our certified and confessed affliction keeps our companions from noting that we are not worthy of their regard, so that we finally dodge being found out. Our reward is twofold—we avoid abandonment and escape from freedom.
Suppose those forms of action said to be mad that are identifiable by their unique patterns are not due to brain defect, but to a controlled scenario. Suppose that it is not an inability to control one’s own actions, rather that it is an ability to control the actions of others. Suppose it is personal un-control vs social control. Madness, as said earlier, is social arrangement, not mental derangement. Given this, then, the better the brain, the more effective the effort to keep control of reciprocal roles, and if there is brain defect, then the control of roles must be less effective. Surely we need all of our brains to adjust our absurd riutals just so to keep our companions in line. Perhaps those of us who engage in uncomplicated role alterations can get along with minor brain defect, but even we are going to be hard put to play our chosen role, however uncomplicated, with consistency, especially if our social field permits us little leeway in our role enactment. The point is that it takes brains to manage roles effectively.
If madness accompanies brain defect, its sequences are unpredictable, with little or no pattern that can be counted on to repeat itself. In contrast, the seemingly irrational actions entailed in absurd rituals is very predictable, indeed painfully predictable, having, as it does, extreme consistency of pattern, which is to say, it is a matter of habit and is painfully predictable because it is an absurd ritual that is very disconcerting to our companions. After all, presumably safeguarding roles and distracting rituals are carefully configured with an (unwitting) eye to their social consequences, while the actions presumed to be triggered by brain defect seem to be independent of and oblivious to social consequences.
Given Schopenhauer’s domination of European thought in the latter part of the 19th century, at that time Pierre Janet, a French medic, told us that self-defensive actions are automatisms, actions that are at once inadvertently motivated and involuntarily executed. What he meant by this is that in order to carry out a defensive action we instinctively enter a trance state of consciousness and remain in that altered state until the total action is completed. It is the “auto-hypnotic-trance” theory of madness that holds that defense is never done purposefully and deliberately, but always without conscious purpose and deliberation. This idea, as said, has a long history, beginning as early as the latter part of the 17th century in Scotland and a century later surfacing in France. We may wonder how much Schopenhauer was influenced by these early practices and speculations of the French somnambulists.
Also influenced by Schopenhauer, in the early part of the 20th century, was Alfred Adler, an Austrian medic, who advised that defensive behavior is nurtured in the family during early childhood, owing to insufficient parental encouragement of their children to overcome their natural feelings of inferiority. Unable to achieve enough self-esteem to play a productive role in such a barren social context, these children develop safeguarding family roles, not to achieve social success, but rather to avoid social failure and therefore shame. Thus the seminal ideas of four men—Kretschmer’s Temperament Base, Janet’s Trance State, Haley’s Role Control, Adler’s Disarming Confession—made possible, at long last, discarding mental illness in favor of method in madness.