Meaning, Madness and Political Subjectivity

A study of schizophrenia and culture in Turkey

Sadeq Rahimi

• Publisher: Routledge
• Year: 2015
• ISBN:
  9781317555506
• Edition: 1
• Topic: Psychology
• Subtopic: Psychopathology
• Index: Psychology

This book explores the relationship between subjective experience and the cultural, political and historical paradigms in which the individual is embedded. Providing a deep analysis of three compelling case studies of schizophrenia in Turkey, the book considers the ways in which private experience is shaped by collective structures, offering insights into issues surrounding religion, national and ethnic identity and tensions, modernity and tradition, madness, gender and individuality.

Chapters draw from cultural psychiatry, medical anthropology, and political theory to produce a model for understanding the inseparability of private experience and collective processes. The book offers those studying political theory a way for conceptualizing the subjective within the political; it offers mental health clinicians and researchers a model for including political and historical realities in their psychological assessments and treatments; and it provides anthropologists with a model for theorizing culture in which psychological experience and political facts become understandable and explainable in terms of, rather than despite each other.

Meaning, Madness, and Political Subjectivity provides an original interpretative methodology for analysing culture and psychosis, offering compelling evidence that not only "normal" human experiences, but also extremely "abnormal" experiences such as psychosis are anchored in and shaped by local cultural and political realities.

1
Culture, schizophrenia, and the political subject

Meaning, power, and the politicality of the subject

One could think of ‘political subjectivity’ through the interaction of meaning and power in at least two respects: the fundamental role of that interaction in the work of culture and the constitutive role of that relationship in the development of what we consider human subjectivity. In either case, however, the discussion starts with the very notion of ‘structure.’ There are a number of traditions of thinking about and conceptualizing a structure, a systematic process that presumably shapes our thoughts and guides our behavior unbeknownst to ourselves. There is Freud’s psychological notion of an individual unconscious, for example, or Jung’s metaphysical collective unconscious, or Durkheim’s sociological notion of collective conscience, not to mention Levi Strauss and his notion of a grand universal “structure.” Then there are the Marxist notions of class structure as formative of human consciousness, complete with the concepts of ideology and false consciousness, or the Hegelian idea of the Spirit. There is also the more recent idea of a political unconscious, addressed by people such as Fredric Jameson, and the cognitive psychologists’ notion of implicit knowledge – which in many ways could be understood as a rediscovery of psychoanalysis by behaviorism’s grandchild. One can certainly find many more ideas that theorize human mind and behavior in terms of implicit structures. In fact the discovery of the idea that some invisible structures are at work, fully unbeknownst to us, to shape and direct our thought and behavior deserves to be recognized as one of the greatest discoveries of social and human sciences over the recent centuries. It is something of an unfortunate fact that, rather than converging on the truly amazing notion of structure as such, each theory and school of thought has chosen its own interpretation of that phenomenon, understanding and describing it in terms of its own limited scope of interest and vision – not unlike Rumi’s famous fable of the elephant in the dark room – or its translated version, the blind men and the elephant. Insofar as this book is concerned, however, without denying the value of the models I have just mentioned, and in fact building on a synthesis of much from those, I base the discussions primarily on contemporary theories of the subject developed in the wake of the so-called linguistic turn in social and psychological theories. The most basic common idea drawn from these theories might be that the human psyche is fundamentally structured, and that the structure is informed by a ‘symbolic order,’ a system of symbols the units of which always function as signifiers, and the organization of which is closely tied to the organization of another grand instance of symbolic systems: language. It is within this tradition that I discuss, investigate, and analyze the topic of human subjectivity, culture and politics, most importantly because this model allows on the one hand to develop a model of simultaneous analysis for notions typically taken as distinct by earlier theories, and on the other to incorporate temporality and memory in a broad sense connecting collective notions of history and historic memory to psychology and personal memory.

It might be worth mentioning here that while in some sense the Marxist-psychoanalytic formulation of the political unconscious developed by Fredric Jameson (1983) may appear similar to the idea of political subjectivity that I formulate here, significant differences distinguish the two. In short, Jameson’s political unconscious is a way of approaching certain aspects of the human psyche as politically motivated. More specifically, Jameson’s interest is primarily oriented toward depicting and “liberating” repressed notions of resistance in terms of class struggle, which, he suggests, are historically encrypted within texts in ways similar to the Freudian process of repression. In other words, political unconscious as a concept primarily serves the ideological objective of Marxism, namely, resistance to capitalism and awakening a class-based sense of struggle. Text, in Jameson’s account, has buried in it an “interrupted” narrative of struggle that should be exhumed: The “function and necessity” of the “doctrine of a political unconscious,” he says, lies in “detecting the traces of that uninterrupted narrative” and “restoring to the surface of the text the repressed and buried reality of this fundamental history” (p. 20).

The notion of political subjectivity, however, dramatically widens the scope of ‘politicality’ to understand the subject itself as a political event. In other words, here the subject is conceived of as political in its very subjectivity – both in the sense that it engages in an ongoing act of subjugating and conjugating the world into meaningful patterns and in the sense that the subject is continuously subjugated or conjugated by the local meaning system. Politicality, in this sense, is not an added aspect of the subject, but indeed the mode of being of the subject, that is, precisely what the subject is. And in contradistinction to the Marxist project of Jameson, the politicality of the subject (or the text, for that matter) is not limited to a struggle to decrypt hidden traces of class struggle. In fact the politicality of the subject is not limited to the concept of struggle or resistance but covers all aspects of subjectivity insofar as it recognizes the human social subject as the subject of language, or better put, the subject of the symbolic order.

The deepest sense in which the human subject is political is that ‘the subject’ comes to ‘be’ through acts of interpretation and being interpreted, or what I referred to earlier in terms of conjugation and subjugation. The moment of transformation of human infant into the social subject is therefore the political moment – and that moment is indeed the same as the developmental ‘moment’ of the formation of a sense of self/ego, according to a broad range of theories of intersubjectivity. The location of the political in this sense is therefore within the apparatus of meaning making, the process through which one makes sense and is made sense of by the other. Meaning, on the other hand, is always already political: it is fundamentally imbued with power because it is always the representation of a specific ‘interest.’ This does not have to be the interest of a specific class, as in the Marxist notion of class interests, but it is always an interest and always the interest commonly shared by a group of people – meaning is always a collective product after all.

All meaning is political in the sense that the very fundamental function of meaning is a preferential legitimization of certain associations of signifiers, or putting forward certain patterns of associations of concepts as more accurate or more truth bearing and thus more legitimate or more desirable than others. Needless to say, the combined network of signifiers as units of meaning, the broader discourses that emerge, or the broadest sense of such networks, which we would call ‘systems of meaning,’ are therefore coterminous with systems of legitimacy and power. This process is central to the general process of assignment of power. Consider the simple fact, for instance, that no societies would either give rise to and cultivate, or tolerate and sustain, a political system that does not make local sense, that does not comply with local meaning systems or the local ‘cultural logic.’ And finally another fundamental role of meaning systems manifest in culture and language is that they preserve and transfer across individuals and generations information encrypted with codes of power relations, not only in the form of implicit logical systems of legitimacy but also by molding collective memories, narratives, and fantasies such as histories, myths, folk beliefs, and other collective products.

At least three dimensions of meaning are significantly relevant in this account: (1) that, as de Saussure (1959) has taught us, meaning always exists within a network of configurations as a system of differences or negations, (2) that meaning is always vested with a kind of group interest, and, finally, (3) that, as with any good system, meaning always defends itself against alterations, innovations, and processes other to it. In turn, several interrelated conclusions may be drawn from these features. For instance, that meaning, along with power, is seated simultaneously within the individual and the group, or that the interaction between power and meaning is embedded within the work of culture, or that the relationship of power and meaning is vital to the development of human subjectivity. In a most elemental sense of the word then, meaning sustains power and translates that into ‘reality’ by making possible or allowing to ‘exist’ within the symbolic realm certain logical configurations that in turn justify certain thoughts, expressions and actions, and exclude certain others. Within such a system the individual subject gets trapped by cultural domains, by being ‘forged’ into certain possible sets of meanings and configurations of ideas – groups of associations locally permitted and available for the child to grow into. I provide a more detailed theoretic discussion of these ideas in the following and then a concrete demonstration of what this all means in real life, throughout the case analyses.

Once it is understood that meaning is basically the seat of and, as such, is always the manifestation of power, and once that premise is integrated with contemporary theories of subjectivity (such as Lacan’s) that conceive of the subject as fundamentally embedded in, sustained by, and a manifestation of the orders of law and meaning, a number of consequences follow. It follows, for instance, that the process of subjectivity is always already political, and that in order to examine subjectivity one needs to engage an analysis of the local structures of meaning – a semiotic approach, in other words. These conclusions promise new analytic methods capable of incorporating hitherto divergent lines of inquiry concerning power, meaning, desire, and memory. It is precisely toward the development of such an intricate model of subjectivity in its social contexts that I have written this book.

Meaning as method in studying psychosis

My attention to the delusional networks of psychotic discourse builds on the insights of researchers of subjectivity in general and of schizophrenia in specific, such as Ellen Corin, Byron Good, Louis Sass, and Janis Jenkins. Sass and Corin, for example, speak of the interest of European phenomenological psychiatrists in what has been termed ‘natural evidence’ and its loss in psychosis (see, e.g., Corin, 1990, 2004; Sass, 1994, 2004). “Close observation of a certain number of psychiatric patients,” wrote Corin and Lauzon (1994), “led clinicians, such as Binswanger and Blankenburg, to conclude that these patients live in a world different than ours” (p. 6). The case studies I describe here have in fact allowed me to ask whether in their delusional associations the basic ideas psychotic individuals fall back on and hold on to might not be those same building blocks as used by their society at large, albeit arranged in unfamiliar forms.

In the pursuit of similar questions scholars have begun to call on interactional models to refine and promote a meaning-oriented ‘cultural psychiatry’ that would further challenge the traditional psychiatric view of the subject as limited to the individual (Jenkins, 2004; Kirmayer, 2001). Corin and her colleagues (2004) outline an essentially meaning-oriented approach to the study of psychosis and culture, in which the researcher’s task is to “identify the range of possible signifiers available in particular cultures” and then to determine the “relative weight” of those signifiers within the culture and within the subject’s discourse, and finally “to bring out the interplays of cultural signifiers, by observing their use in concrete cases” (p. 141).

More recent literature in cultural psychiatry, medical anthropology, and social medicine is in fact rich with ideas and findings that support such a decentered view of the person and meaning-oriented interpretation of narratives and behavior in mental illness (e.g., Corin, 1990, 1998, 2012; Corin and Lauzon 1992; Corin et al., 2004; Good, 1994, 2012; Good and DelVecchio Good, 1981; Good and Subandi, 2004; Jenkins, 2004; Klein-man 1995, 1999; and Obeyesekere, 1985, 1990, among others). Beyond the general agreement on the theoretical basics of the approach, however, the question that has persisted is how best that theoretical stance can be translated into a methodology for analytic interpretation. Developing a clear and theory-driven analytic methodology for examining the relationship among culture, politics, and subjective experience of psychotic illness from a meaning-oriented point of view is therefore an important secondary goal – and hopefully an achievement – of this book.

Jacques Lacan (1993) speaks of a psychotic patient of his to whom “everything has become a sign.” To the extent, he describes, that “not only is he spied upon, observed, watched over, not only do people speak to, point, look, and wink at him, but all this [also] invades the field of real, inanimate, nonhuman objects” (p. 9). Not only does this patient attribute specific intentions to other subjects’ actions and speeches, but objects as well have now developed nonconsensual properties: “[I]f he encounters a red car in the street … it’s not for nothing, he will say, that it went past at that very moment” (p. 9). One may argue that what is problematic in this patient’s reality system is not simply that ‘everything has become a sign,’ because everything is already a sign before it can be a ‘thing.’ The difficulty for this patient is that the system that gives sense to his reality does not sufficiently coincide with the consensual one. He interprets the red car visual data according to an idiosyncratic system of associations and significations that does not coincide exactly with the dominant sign system. This same notion is also reflected in the far less sophisticated ideology of Benjamin Rush (1948), the founding figure of North American psychiatry, when he defines madness as “departure” from the “aptitude to judge things like other men” (p. 350). One such ‘departure’ is what happens in schizophrenia psychosis. From the phenomenological point of view, this is the process that leads to what can be understood as structural differences between the lifeworld of the psychotic and the nonpsychotic, who, while living in ultimately continuous worlds, become almost inaccessible to each other due to differences in basic “orientations” of the subject in time and space.

The fact is, however, that despite our common understanding that in the event of psychosis something happens to the way things mean what they mean, we do not seem to know why exactly such semiotic transformation takes place. One may well imagine, for example, that certain biological changes in the brain may lead to disturbances of learned structural functions of culture by reformatting associative patterns. Whatever explanatory model one might opt for in the current absence of a convincing scientific alternative, the ‘transformation’ itself remains largely indisputable. Schizophrenia psychosis, in other words, is generally identified with an alteration of associative patterns and meaning systems – an alteration of such depth that it affects not simply the individual’s interpretation of the external world but indeed his or her very sense of selfhood and being in the world. Such ‘associative’ level of impact can be observed in the fact, for instance, that in schizophrenia two basic and intensely related aspects of the ‘mind’ are commonly altered: the sense of self and self-identity and the sense of meaning or ‘reality’ that we normally conceive to lie ‘outside’ the self. That is why Fabrega (1989), for example, describes schizophrenia as a disease of the self, one that “erodes and undermines the organization and functioning of the self” (p. 277), or why Estroff (1989) calls it “an I am illness” (p. 189). It is that systemic shift that has made schizophrenia famed as the illness that renders its victims perplexing and incomprehensible, a shift already considered essential to the diagnosis of schizophrenia by Bleuler (1924), who described it in terms of a deterioration of associative processes (e.g., p. 373). For Bleuler, the problem of inaccessibility was produced by the “fact” that the new state of associations was basically a nonsystem, so that the non-psychotic observer would not find any ‘meaningful’ links between the chain of utterances of a psychotic subject. “The normal associative connections suffer in strength,” he explained, “so that the links of association following one another in sequence may lack all relation to one another so that thinking becomes disconnected” (Bleuler, 1924, p. 373). The argument of meaning and non-meaning in psychosis is an old debate, and my interest at this point is not to argue whether schizophrenia psychosis is or is not intelligible. I want to point out, however, that what most parties in this debate have in common is a concern with ‘meaning’ and a notion of a system or systems of meaning with which the psychotic subject appears to be squarely at odds once he or she ‘crosses’ a presumed threshold.

Once one consents to the idea that the psychotic subject has crossed a boundary, exiting a realm to enter one ‘other’ to that of the nonpsychotic, then what begs the question is what exactly leads these patients to switch worlds, and how exactly such a ‘departure’ takes place. As I hinted earlier, there are no final answers to either question: the question of why is, more often than not, deferred to biology in today’s scientific discourse, and here I have opted to bypass that question altogether. It is for an examination of the how of that departure, however, that I propose to draw on the notion of sign systems and their transformation within the tradition of meaning-oriented, culturally informed theories of psychosis and subjectivity. This, of course, is not a novel idea. The concept has long been around and debated, with proponents ranging from those who consider psychotic discourse “empty speech acts whose informational content refer to neither self nor world” (Berrios, 1991) to those who consider the major distinction between psychotic and nonpsychotic discourse in terms of “cognitive biases” (Bentall, 1996) and others who attribute deep or even universal meanings to psychotic discourse and symptoms (as in Jungian psychoanalytic traditions, for instance).

In early works addressing “the meaning of symptoms” (e.g., Good, 1977; Good and DelVecchio Good, 1981), Byron Good and Mary-Jo DelVecchio Good (1981) made a strong case for reconsideration of the place of ‘meaning’ in culturally informed assessments of mental health issues. Their discussion of semantic networks of associations and the significant role of these networks in the construction of clinical accounts made concrete a powerful contemporary trend of investigation in culture and mental health. Corin (1980, 1990) in developing such a method further raises two concerns, however, that are relevant here: that “this could be difficult with schizophrenia patients who may be unable, or reluctant to give such an analytical account of their experience,” and that “[their] experience often appears as fractured, contradictory, difficult to face in a verbal account, if one is not engaged in a clinical encounter” (Corin, 1990, p. 158). In what follows I examine the theoretic contours of an analytic model that can address and accommodate these challenges.

The Russian connection: salvaging temporality

In pursuit of a method capable of addressing the delusional narrative of schizophrenia patients in its semiotic and temporal context, I would like to present here intellectual developments that originated and evolved, in dialogue with de Saussure’s theory of signs and meaning, most coherently in some of the 20th-century Russian schools of literary criticism and semiotic analysis. This particular trend of semiotic analysis and criticism corresponds to the interests of this project in a number of significant respects, including but not limited to the following three. First, having flourished into a rich tradition of “cultural semiotics” associated with such f...

Table of contents

• Cover
• Title
• Copyright
• Dedication
• Contents
• Preface
• Acknowledgments
• Introduction
• 1 Culture, schizophrenia, and the political subject
• 2 Old peoples, new identities: the story of Turkey
• 3 Vicissitudes of political subjectivity: the story of Emel
• 4 Power, faith, and the politics of identity: the story of Senem
• 5 Love, loss, and a language for madness: the story of Ahmet
• 6 Conclusion
• Bibliography
• Index