Travels with Ian Hacking

anneliese's picture

Brought to you by The Slippery Brain Sodality

 Mad Travelers: Reflections on the Reality of Transient Mental Illnesses

by Ian Hacking

 

This book (actually, a series of lectures with supplementing documents) was mentioned in a Jan. 10, 2010 New York Times Magazine article on the Americanization of Mental Illness. Using the fugue as a case example, Hacking sets forth a framework for thinking about and understanding how it is that madness (and distress more generally) comes to be expressed in ways specific to a given time and place. His main contribution is the concept of an "ecological niche," a metaphor he argues is more useful for thinking about the ephemerality of certain disorders than, say, social constructionism. His hope is that readers will extend this framework to thinking about present-day diagnostic vogues.

From Chapter 1:

"Perhaps all our problems will be erased when we have enough objective scientific knowledge. I have a another view. We do have a limitless reservoir of ignorance, but we also have conceptual confusions that new knowledge seldom helps relieve. There are a number of reasons for this, but I am especially impressed by the way that scientific knowledge about ourselves - the mere belief system - changes how we think of ourselves, the possibilities that are open to us, the kinds of people that we take ourselves and our fellows to be. Knowledge interacts with us and with a larger body of practice and ordinary life. This generates socially permissible combinations of symptoms and disease entities." (p.10)

"I believe that most important conceptual difficulties are rather unyielding [to efforts at clarification]. This is because they result from some fundamental incoherence in the underlying organization of our ideas - ideas that we will not give up partly because they are essential to the ways in which we do think. [...] No amount of analysis makes deep confusion evaporate...[but] there are things we can do. One is to examine in some detail a manageable example in which many of the ingredients of the confusion are plainly on view. Enter Albert. Enter the fugue epidemic of the 1890s." (pp. 11-12)

Comments, reactions welcome below...

(While this page is part of an ongoing book club discussion, visitors are warmly invited to share their experiences and join the conversation.) 

Comments

Paul Grobstein's picture

From fugue to ... cultural change

Thanks, all for rich conversation this morning.  For more about the general approach to "disabilities" (mental and otherwise), see Cultures of Ability

anneliese's picture

 Ditto - and...

... am also particularly appreciative of our group dynamic. Though I tend to be (perhaps overly) skeptical/pessimistic about the possibility of successfully directing/influencing cultural change (at least on a large scale, and thinking in broad, abstract terms), the climate and experiences we create together offer tangible evidence to the contrary and make concrete the perhaps overquoted imperative to "be the change you wish to see in the world."

Along these lines, here's a link to school-based efforts presented by Maurice Elias (Rutgers) in a lecture at CHOP yesterday.

And a quote by Anaïs Nin I just encountered: "When you make a world tolerable for yourself, you make a world tolerable for others."

Paul Grobstein's picture

the role of story in mental illness

"... the two psychisms, one conscious, one unconscious, each correlated to a part of the brain: hysteria resulted when the two failed to interact with each other in an appropriate way."

Perhaps fugue too?  And dissociation?  And borderline personality disorder?  And Capgras syndrome (see Richard Power's The Echo Maker).  Maybe the key here is to recognize that "story" is "real," that both the hearing and the creation of stories is a human brain function that is inextricably involved in human brain function.  And so there is no significant distinction between what is "made up" and what is a function of the brain?  

From this perspective (see Models of Mental Health: A Critique and a Prospectus), there is nothing either mysterious or unexpected about "transient" mental illness, nor about the involvement of cultural factors in them.  And people suffering from them are no less afflicted, no less in need of/deserving of help than those suffering from problems that have no major story element in them.   One does, however, need conceptual frameworks and associated therapeutic procedures that take seriously the story involvement.      

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