Madness and the limits of recognition

This chapter, “Madness and the limits of recognition,” explores ways of bringing madness within the scope of recognition. This can be achieved by resolving the impairments to identity formation that remove madness from this scope. Resolution is to be understood in dialectical terms as a process governed by two requirements: (1) Preserve something of the phenomenology of madness; (2) resolve the impairments to identity formation. The chapter explores a range of narratives that appear relevant to this task, in each case assessing whether it can satisfy these two requirements: subjective narratives, professional narratives, and Mad narratives. The latter include the following: spiritual transformation, healing voices, and dangerous gifts. The chapter demonstrates how Mad narratives can play a role in resolving disunity of self and discontinuity of self, and hence at bringing madness within the scope of recognition.

Conclusion: Pathways to reconciliation

Chapter 11, “Conclusion: Pathways to reconciliation,” outlines two pathways to reconciliation based on the arguments of the book. The first pathway is for reconciling skeptics and supporters of Mad activism (respectively, those who unconditionally reject and those who unconditionally accept the claims and demands of Mad activism). This is achieved by addressing two key points that divide skeptics and supporters: the first pertains to the possibility for madness to constitute grounds for identity, and the second pertains to the scope of Mad activism. The second pathway is for reconciling madness and society. The chapter summarizes the arguments for the normative force of the demand for recognition of Mad identity, and outlines a framework for responding to this demand.

Responding to the demand for recognition of Mad identity

This chapter, “Responding to the demand for recognition of Mad identity,” addresses the following question: Does the demand for recognition of Mad identity possess normative force and, if it does, how should society respond to it? It begins by outlining the normative force of demands for recognition in general, and proceeds by applying this to the specific case of Mad identity. It explores three features of identities that can deflate a demand for recognition of its normative force: the identity for which recognition is demanded is trivial, morally objectionable, or irrational. The chapter then outlines a framework for responding to the demand for recognition of Mad identity, a framework informed by a range of political responses and attempts at reconciliation. Finally, the chapter develops the idea that Mad narratives are a broadening of our cultural repertoire as it pertains to madness, and that they can constitute a cultural form of societal adjustment—a cultural adjustment.

Mad identity II: Unity and continuity of self

Chapter 8, “Mad identity II: Unity and continuity of self,” examines two objections to Mad activism. Certain mental health phenomena are considered to undermine unity and continuity of self and hence to undermine two requirements for identity formation. This chapter explores the nature and extent of these problems, and whether or not they are fatal to the claim that madness can be grounds for identity. With regard to disunity of self, the chapter investigates passivity phenomena with a focus on thought insertion. It uncovers the cultural psychological basis of judgments of disunity, and offers a more complex appraisal of passivity phenomena. With regard to discontinuity of self, the chapter investigates patterns of discontinuity in spirit possession, dissociative identity disorder, schizophrenia, and bipolar disorder. It notes similarities and differences in these patterns, and ways of overcoming discontinuity. In pursuing this, the chapter engages with key arguments by Jennifer Radden and Christine Korsgaard.

Mad culture

This chapter examines the viability of the notion of “Mad culture” as an alternative to the formulation of madness as a disorder of the mind. The chapter addresses the following questions: What is culture? Can madness constitute a culture? What are the justifications for cultural rights? Do people have a right to their culture or to any culture? In the process of answering these questions, the chapter compares and contrasts Mad culture and Deaf culture. It also engages with Will Kymlicka’s theory of cultural rights as civil rights, which centers on the idea of culture as a “context of choice.”

Misrecognition: Political reform or reconciliation?

Chapter 5 “Misrecognition: Political reform or reconciliation?” interrogates two possible responses to demands for recognition. It begins by outlining the harms of misrecognition and the way in which they are social harms (i.e., collectively generated). Having identified some possible harms, the chapter asks whether misrecognition should be addressed through political reforms (bringing in considerations of human flourishing and social justice) or through cultivation of interpersonal reconciliation (bringing in attitudes and practices aimed at mutual acceptance). After examining both possibilities, it concludes with an argument for a dual perspective in which both institutional responses and the attempt to seek interpersonal reconciliation are required for addressing demands for recognition. In pursuing this, the chapter engages with key arguments by Nancy Fraser, Axel Honneth, and Richard Rorty.

The concept of recognition and the problem of freedom

This chapter, “The concept of recognition and the problem of freedom,” reconstructs the concept of recognition by tracing its dialectical development in Hegel’s Phenomenology of Spirit. The chapter offers a reading of the dialectic in which the central animating problem is the nature of freedom: how can a subject affirm its independence in the midst of other subjects; can it do so alone without taking account of anyone outside of it, or is dependence on the recognition of others a condition of its freedom? In addressing this question, the chapter contrasts Kant’s and Hegel’s views on autonomy and freedom. It explores various interpretations of Hegel’s idealism in the course of seeking an account of the concept of recognition that can be acceptable for us today. It argues that recognition is a concept that we ought to employ in thinking about freedom and social relations.

Mad identity I: Controversial and failed identities

This chapter, “Mad identity I: Controversial and failed identities,” examines the viability of Mad identity as a route to recognition. It develops a distinction between “controversial” and “failed” identities; the former are cases where subjects are wrong about who they think they are but where this can potentially call for revision of the collective category with which they identify, and the latter are cases where subjects are wrong about who they think they are but where this cannot call for such revision. Only identity claims that are judged to be “controversial” can be considered within the scope of recognition. Using four examples of “delusional” identities, the chapter develops an epistemological framework for distinguishing failed from controversial identities, a framework where the notion of “truth value” plays a key role.

The problem of distress and disability

This chapter, “The problem of distress and disability,” responds to common objections that madness is inherently distressing and disabling. These objections are seen to undermine positive constructions such as Mad Pride. On the question of disability this chapter responds by developing two bulwarks against the tendency to assume too readily the medical view that madness is inherently disabling: the first arises from the normative nature of disability judgments, and the second from the implications of political activism in terms of being a social subject. The chapter explores the social model of disability in light of debates on naturalism and normativism; the applicability of the social model to madness; and the difference between physical and mental disabilities in terms of the unintelligibility often attributed to the latter. On the question of distress, the chapter demonstrates that a phenomenon can be distressing and valuable, and this despite distress or because of it.

Mental health activism and the demand for recognition

This chapter, “Mental health activism and the demand for recognition,” overviews developments in mental health activism in the United Kingdom and the United States from the late nineteenth century to the present day. It begins by outlining the discourse of “mental hygiene, the “antipsychiatry” of the 1960s, the 1970s civil rights movements, and the consumer/service-user/survivor movements. The chapter continues with a focus on contemporary Mad Pride activism, describing the origins of the movement, the elements of the discourse, and the social and political demands that arise from it. It also discusses the problem of essentialism as it relates to social identities including Mad identity. The chapter concludes with an overview of philosophical engagement with Mad Pride and mad-positive activism.