What is it to become mad, to lose touch with reality, to suffer the torments of a mind lost in waking dream, to disintegrate? The question troubles us. Madness terrifies, regardless of our degree of sanity. We try to run from it. Perhaps we even try to run from it by 'understanding' it. Either we 'understand' it as a non-predicament (it becomes a meaningless breakdown of biological function), or we 'understand' it by recasting its predicaments in a normalising manner (its dementing terrors are overlooked).

Such flight to allegedly comprehending stances was not always the norm. For there was a time when psychiatry was in part taught and practiced through immersion in sufferers' inner predicaments and, more importantly, in the actual lives of long-stay ward patients. Talking with the disintegrating, tolerating their madness, offering acknowledgement where possible, patience: this standing-by might count far more than any standing-under. Or, in other terms, understanding shown might be valued more than understanding deployed. With such an immersion, even if the trainee had little by way of a conceptual apparatus to adequately theorise what was being talked about, she could at least be hopeful of developing a sensibility for, pick up a felt sense of, the character of these suffering minds. Such a sensible immersion thereby gives viable anchorage for, and access to the objective correlate of, the diagnostic concepts.

Today, however, many psychiatric and psychological texts and trainings eschew the attempt to encounter or describe in any emotional or ethnographic or phenomenological depth the actual experience of living in a mad mode. The ready and prolonged use of major tranquillisers also suppresses the visage of madness. And today we so often meet with the assumption that either a straightforwardly medical terminology of conditions, signs and symptoms, or an everyday psychological vocabulary of beliefs and perceptual experiences and emotions, will be apt for capturing all that here needs acknowledgement. Thus on the one hand we are offered a merely biological psychiatry that pretty much ignores the lived experience of the sufferer or, on the other hand, a merely normalising psychological approach which sees only the eccentricities in the contents, rather than the derangements of the form or structure, of the psychotic mind.

Even many of today's autobiographical accounts focus mainly on what it is for an individual or their family to live 'with' psychosis, rather than give any expression of what it is for psychosis itself to 'live'. Having a tin ear for the derangement of the psychotic music no longer strikes anyone as a problem.

Existential philosophers and depth psychologists are naturally impatient with such reductive or banalising descriptions of psychotic experience. They want to know what it really amounts to to labour under a delusion, for one's world to collapse, to break down, to become clinically paranoid, and so on. But when we turn to much of today's academic literature, what we find is all too often an inquiry which is shaped by a focus on a narrow range of examples which have already been shorn of their constitutive derangement. Obscure conditions (Capras, Cotard etc.), very rarely met with in clinical experience, which conditions are supposedly characterisable in simple psychological terms (he believes he is dead, she thinks her spouse is an impostor) populate the pages of such philosophical and psychological inquiry; widespread disturbances to being-in-the-world as collected under labels such as 'schizophrenia', 'schizoaffective disorder', 'bipolar disorder' - and the phenomenological character and meaning of such disturbances - are, by contrast, now overlooked or reduced to collocations of 'symptoms'. Or we are merely offered psychological investigations into, say, the reasoning or perceptual or doxastic prowess of the psychotic subject. That such banal accounts seem apt to their object (the psychotic mind) is not surprising given the banalised characterisations of the object (that mind as described in contemporary psychiatric, psychological and certain biographical works) they've already offered up. The result, however, is that we barely even scratch the surface lying above the terrifying depths of the psychotic disturbance.

One result of much of the perfectly well-meaning and internally valid work in cognitive science, psychology, the philosophy of psychiatry, and cognitive neuropsychiatry, especially in its remove from the existential disturbance of the psychotic subject, is that the original impulse to find one's bearings in the encounter with that subject, the original impulse that inspired the work in the first place, gets obscured. It is as if we went into the Sistine Chapel at the beginning of the week with the desire to deepen our acquaintance with the sublime, only to exit at the end of the week with a colour chart and a system of pigment analysis. We've forgotten why we ever went in, but emerge pleased with a safe yet worthy new hobby. So the cognitive scientist now starts to think it is his job to, say, 'provide a new model of the processes underlying delusional belief formation'. One can tell from the breezy tone of this ambition's formulation that its object - the profound terror, emotional jarring and derangement of living meaning of the psychotic mind - is already utterly obscured.

The work required of us here is, then, primarily one of retrieval - retrieval of the meaning of the question 'what is madness?', and retrieval of such glimpses we have had of that meaning in the writings of and about those whose minds have fallen apart. It's not always easy to find willing and articulate sufferers from psychosis. Why, in any case, should many of those who suffer thus wish to share with strangers their painful personal experience? And, from the other side, it's doubtless reassurring to forget about the disturbing project of truly encountering a self in terrified dissolution, and substitute for it more manageable projects of cognitive modelling. Here though I aim for the next best thing to a living personal encounter, which is to point the reader to relevant literature which, as I see it, presents its object under a non-falsifying light. We are lucky in the English-speaking world that many phenomenologically rich autobiographical accounts of psychosis were written in the middle decades of the 20th century. Today a large number of these are already largely forgotten; their recollection is the project of this blog.