Approaches to Insanity: A Philosophical and Sociological Study

Approaches to Insanity

Approaches to Insanity A Philosophical & Sociological Study JEFF COULTER

Martin Robertson

©Jeff

Coulter 1973

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of the copyright holder First published in 1973 by Martin Robertson & Co. Ltd., 17 Quick Street, London N1 8HL ISBN 0 85520 049 ISBN 0 85520 048

9 (case edition) 0 (paperback)

Printed in Britain by The Pitman Press, Bath.

Contents Introductory Remarks

Vll

PART ONE

THEORETICAL ISSUES IN FORMAL PSYCHOPATHOLOGY

CHAPTER ONE

Schizophrenia as a Disease

CHAPTER TWO

Schizophrenia as an Experiential Product

36

CHAPTER THREE

Phenomenological Conceptions of Schizophrenia

79

PART TWO

CULTURE AND PSYCHOLOGICAL ASCRIPTION

CHAPTER FOUR

Insanity Ascription

3

112

SECTION ONE: Introduction; SECTION TWO: Hallucinations; SECTION THREE: Disordered Thought; SECTION FOUR: Delusions

CHAPTER FIVE

Transcultural Psychopathology

145

CONCLUSION

Cognition as a Moral Order

152

Name Index

165

Subject Index

169

Dedications & Acknowledgements I should like to thank my wife, Lena, for enduring my extra-curricular academic obsessions over the months during which this work was undettaken and revised, for her continuing critical contributions, and for her inspiration. I should also like to register my thanks to my parents whose many sacrifices have enabled me to pursue learning at two universities. To my wife and parents this work is most affectionately dedicated. On the formal, academic level I have to thank Dr Robert Ferguson, former Consultant Psychiatrist and now Senior Lecturer in Sociology, University of Salford; Dr. W. W. Sharrock, Lecturer in Sociology, University of Manchester (currently Visiting Assistant Professor, University of British Columbia, Canada); Dr Hassan Taufiq, Consultant Psychiatrist, Khartoum Hospital Psychiatric Section, Sudan; and the staff of a large Mental Welfare Department in the United Kingdom who kindly facilitated my research and put up with many niggling questions. None of these colleagues and associates will necessarily agree with the theses defended in this work, but the impetus to write it derived in large measure from discussions with them.

Introductory Remarks This book is neither a textbook in psychopathology, nor an attempt to popularise that subject. Its purpose is to engage in a debate which currently straddles several disciplines whose theoreticians and researchers have been involved in work on 'the schizophrenias' : psychology, sociology and biology. The inverted commas around the term schizophrenias point up the present controversies and disputes that pervade the areas of research to be examined in this work. I have chosen to treat the available materials selectively, picking out what I consider to be the best work representing the various styles of theorizing and research. For much of what I have omitted, I have to claim that the recurrent methodological and conceptual troubles isolated here can be found there also. Essentially, what follows is a series of related chapters grouped into two parts. the first focusing upon the substantive literature on 'schizophrenia', and the second establishing a complete break from such an orientation and focusing instead on the natural logic of insanity ascription. The disjunction is perhaps most adequately summarised by stating that the first section deals with what somaticists, psychologists, sociologists and phenomenologists have made of 'the schizophrenias', whilst the second section leaves that focus behind and the second-order psychiatric taxonomy along with i~, seeking to deal with Anyman's ways of C