Narcocapitalism

Life in the Age of Anaesthesia

Laurent de Sutter, Barnaby Norman

• Publisher: Polity
• Year: 2017
• ISBN:
  9781509506873
• Edition: 1
• Topic: Philosophy
• Subtopic: Philosophy History & Theory

What do the invention of anaesthetics in the middle of the nineteenth century, the Nazis' use of cocaine, and the development of Prozac have in common? The answer is that they're all products of the same logic that defines our contemporary era: 'the age of anaesthesia'. Laurent de Sutter shows how large aspects of our lives are now characterised by the management of our emotions through drugs, ranging from the everyday use of sleeping pills to hard narcotics. Chemistry has become so much a part of us that we can't even see how much it has changed us. In this era, being a subject doesn't simply mean being subjected to powers that decide our lives: it means that our very emotions have been outsourced to chemical stimulation. Yet we don't understand why the drugs that we take are unable to free us from fatigue and depression, and from the absence of desire that now characterizes our psychopolitical condition. We have forgotten what it means to be excited because our only excitement has become drug-induced. We have to abandon the narcotic stimulation that we've come to rely on and find a way back to the collective excitement that is narcocapitalism's greatest fear.

Chapter 1
Welcome to Prozacland

§1. From symptom to syndrome. When Emil Kraepelin published the sixth edition of his Lehrbuch der Psychiatrie in 1899, he had for some time already been a model of scientific success – a model, that is, according to the standards of German science of his day.¹ At the age of thirty, he was made Professor of Psychiatry at the University of Dorpat (today Tartu), in what is now Estonia, quickly becoming head of his department, and then of the hospital attached to it, which he led with strict discipline. From the publication of the first edition of the Lehrbuch, in the same year as his habilitation,² Kraepelin articulated his programme in a way that left no room for doubt: psychiatry must join the ranks of the experimental sciences, and aspire to become a branch of medicine. To do this, it would have to give up the metaphysical preoccupations that had marred the development of psychology, to concentrate on what was most important – understanding the physical causes of mental illnesses.³ Of course, Kraepelin was not the only one to claim to have brought the field of the medicine of madness into line with the most robust sciences – his teacher, Wilhelm Wundt, himself belonged to what was already a long tradition of psychiatrists who had dreamed of hard knowledge.⁴ But there was at least one respect in which he set himself apart from his predecessors: his desire to establish a complete clinical picture of the main forms of mental illness, with a view to providing, at last, a system of classification. By turning to the observation of their physical causes, it became possible, he believed, to resolve the difficulties created by the analysis of isolated symptoms, which he grouped together into large families of what he called ‘syndromes’.⁵ With the publication of each new edition of the Lehrbuch, the nosographic designations and the classificatory networks proliferated from his pen, introducing numerous categories destined for great success. One of the most important amongst these, introduced in the fourth edition of the treatise in 1893, was certainly ‘dementia praecox’, which covered every case in which the development of a ‘mental weakness’ at an inappropriate age was observed. Even though it had been decisively reformulated, it was not, however, this category that made the greatest impression in 1899, but the appearance of a new one, whose sophistication came from the most brutal of short-circuits: ‘manic-depressive psychosis’.⁶

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§2. When being errs. Unexpectedly, for those unfamiliar with his work, Kraepelin did not provide a definition of ‘manic-depressive psychosis’ (or manisch-depressiven Irresein in German), contenting himself with describing the features grouped under this name. These were of either a physical or psychic type, with the latter – present in greater number in Kraepelin’s description – including ‘sensory disorders’ and ‘delusional disorders’, ‘avolition’ and ‘logorrhea’.⁷ Taken in isolation, none of these symptoms would have seemed new; it was their grouping together, and their singular mode of temporal extension, even across generations, that justified the invention of the ‘manic-depressive psychosis’ category. That ‘melancholic’ states could sometimes alternate with ‘manic’ states bordering on possession was actually something that observers of the human soul had noted since antiquity – it had become a platitude. From Aretaeus of Cappadocia, between the first and fourth centuries CE, to Robert James’ Medicinal Dictionary in the middle of the eighteenth century, it was understood that, despite their differences, melancholia and mania were two sides of the same illness.⁸ In a sense, Kraepelin had been happy simply to synthesize this history into a single nosographic category, which he went on to describe in greater depth than anyone before – anchoring it decisively in the physical domain. For him, the only interest of ‘manic-depressive psychosis’ was that it gave rise to notable signs – signs whose composition would indicate with certainty the treatment that needed to be prescribed, if indeed there was one. On this point, Kraepelin was hardly an optimist; as he got older, his insistence on the physical dimension of mental illnesses had brought him to defend positions that increasingly leant towards eugenics, and the genetic control of races.⁹ Once it had been accepted that physical characteristics were transmitted from generation to generation, it seemed certain to him that mental illnesses, or at least the predisposition to develop them, were also transmitted, with no hope of recovery or redemption. Madness was not an accident that it was possible to survive; it was part of the very being (Sein) of the sufferer, whose erring (Irre) must continue inevitably, even beyond itself.

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§3. What is excitation? Even though he did not risk a definition of ‘manic-depressive psychosis’, a disturbing element kept cropping up as Kraepelin went through the symptoms of the illness: ‘excitation’. Whatever the symptom described, it was differentiated according to the ‘state of excitation’ of the patient, which could refer to a physical or psychic agitation, could be positive or negative, and could relate to the ‘manic’ or the ‘depressive’ phase. More than the symptom itself, it was its intensification by ‘excitation’ that should hold the observer’s attention, and that, combined with other symptoms of the same order, would allow for the classification of the patient as a victim of ‘manic-depressive psychosis’.¹⁰ At one point, as he describes the patient’s ‘urgent need for activity’, he admits it himself: the ‘increase in excitability’, intensifying excitation as such, should ‘perhaps’ be considered the ‘essential symptom’.¹¹ The capacity to be excited, more than the ‘excitation’ it was possible to observe, constituted the essential core of the manic-depressive syndrome as Kraepelin understood it – the fact that someone afflicted by the illness could not stand still. The erring of the sufferer’s being was neither linear nor planar; it took the form of an oscillation whose movement and amplitude were entirely unpredictable, except in that it was unlikely to stabilize at any point. The manic-depressive was more likely than others to climb aboard the ontological roller coaster, and to abandon being’s stable state for a disequilibrium as extreme as it was permanent. In other words: ‘manic-depressive psychosis’ was being’s extreme state, once it had given up on its own constitutive principles – it was extreme désêtre, the disorder of being as irresistible temptation. That was what troubled Kraepelin: excitation, for him, meant a rupture in the world order – a regime of intensity challenging the way in which being orientates itself so that it can be qualified as sane. To get rid of the illness, therefore, you would have to attack the capacity to be excited – which is to say, the bodily element that carried being away into extreme regions that no normal human should be allowed to frequent.

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§4. Enter chloral. Kraepelin’s physicalism could have remained a curiosity, relegated to the margins of the history of psychiatry – but, in a few years, it had become the default setting for thinking about mental illnesses in Europe, and then, later, in the United States.¹² This delay is explained by the success that psychoanalysis enjoyed in America at the beginning of the twentieth century – a success based on the opposite hypothesis to Kraepelin’s, namely that the milieu of mental illness was the psyche, with language as its epistemological vehicle.¹³ If Kraepelin’s theory ultimately prevailed across the Atlantic as well, it was because, whatever the hypotheses, there was a point on which everyone agreed – the treatment methods for manic-depressive disorder, or, rather, its principle symptom, excitation. While Kraepelin did not provide any therapeutic advice in his observations on ‘manic-depressive psychosis’, his clinical practice, which he passed on to his successors, left no room for doubt on the subject. It must be said that the arsenal available to doctors had recently benefitted from considerable innovations in the world of ch...

Table of contents

• Cover
• Title Page
• Copyright
• Dedication
• Thanks
• Prologue: Goin’ Down
• 1 Welcome to Prozacland
• 2 Narcocapitalism Unlimited
• 3 Day Without End
• 4 Swallowing the Pill
• 5 The Politics of Overexcitement
• Epilogue: Gettin’ Up
• End User License Agreement