I read some Hegel in a reading group a few years ago and was bowled over by it. So I was excited to find a book that analyses Hegel’s ideas about the nature of madness, and wanted to review it even though it was written 20 years ago.
Hegel may not have been the first to have made this point, but for me his writing brings home, more clearly than any other thinker, the intrinsically social nature of human thought and existence. For Hegel, we come to be the fully formed and self-conscious beings that we are through our interaction with the external world, an interaction that we make sense of through the concepts (language) we inherit from our social community. Only when we recognise the independent existence of something outside of ourselves do we begin to fully comprehend our own individual existence. We recognise ourselves as ourselves only in as much as we stand face to face with the world, and especially with other beings like us. And we derive the tools for this learning from the society we are born into.
Hegel’s great book the Phenomenology of Spirit traces the journey of human consciousness from a kind of ‘state of nature’ in which we can barely differentiate ourselves from the world around us, to the mature, rational human consciousness of the modern era that recognises itself simultaneously as a self-determining individual and as a part of the collective human ‘spirit.’ In Phenomenology of Spirit, the journey takes place in part through history, with successive historical periods producing ever more evolved forms of consciousness, but it is also to some extent a journey that each individual embarks on from infancy to adulthood. The social and historical circumstances into which someone is born may determine the ultimate state of rationality they can reach, but for everyone there is development from an infantile state of undifferentiated self-absorption and dependency to a self-reflective state in which the individual is able to differentiate between the self and his or her world.
Hegel was a rationalist and an optimist. He was writing in the first half of the 19th century, when the French revolution, industrialisation and the beginnings of modern science held out the promise that people could radically transform their natural and political environment for the better. Widespread disillusionment with modernity, of the sort Nietzsche expressed later in the century, had not yet set in. Despite his criticisms of the French revolutionary Terror, and of the poverty inherent in the emergent capitalist system, Hegel was enthusiastic and optimistic about the process of development of human thought. Hegel is aware, however, that the path of this development is not easy. It is riddled with contradiction and dissatisfaction. It is only through overcoming these obstacles that humankind can reach its full potential, and come to exist in a state of harmony with the world.
Daniel Berthold-Bond’s book, Hegel’s Theory of Madness was published in 1995, and summarises Hegel’s views on madness as set out in various works. Essentially, Hegel views madness as a return to a pre-rational state of being. The self tries to cut itself off from the social world of shared meaning and rationality, and entrenches itself in a private internal world, the “life of feeling” (Hegel, 1978, section 408). This retreat is a response to the inevitable sense of alienation that the self encounters as it tries to grapple with the ‘otherness’ of the world. For Hegel, therefore, madness is a possibility that is inherent in the development of consciousness, because of the pain and frustration involved in its evolution towards a fuller, more developed state.
Berthold-Bond brings out the similarities between Hegel’s view of madness as a retreat to a pre-rational state, and Freud’s concept of the ‘unconscious.’ Both are realms dominated by instincts and feelings, in which the norms of rational thought are forgotten and discarded. For Hegel and Freud, withdrawal into this mode of thought is pathological and undesirable. In contrast, for Nietzsche, the world of private feeling is the more genuine state of being, and the civilised world of conventions only represses the unique creativity of the human spirit.
Freud also believed that the repression of instincts necessary for harmonious social existence, meant that humanity was doomed to unhappiness and dissatisfaction. For Hegel, although the path of the development of consciousness is challenging, the endpoint is a state of greater fulfilment, in which drives and feelings remain present but are successfully sublimated. For Hegel, each successive mode of rational thought incorporates but surpasses its previous forms, and hence the characteristics derived from our basic biological nature are not repressed as Freud and Nietzsche would have it, but become more socially integrated.
Thus Hegel presents madness as a state of social withdrawal from an alienating environment, which plays an integral part in his overall description of the trajectory of human thought. Hegel has little to say about the causes of madness in individuals – that is why some individuals should succumb to this state while others do not – but much to say about why madness should exist in the first place. The contradictions and challenges inherent in the evolution of thought create a constant desire for a simpler world of internal unity and certainty. Madness is therefore in Berthold-Bonds words “a logically necessary potentiality of spirit” (Berthold-Bond, p 50).
Rather puzzlingly, in the last chapter Berthold-Bond equates this view with the idea that madness is a bodily disease, and so contrasts Hegel’s theory of madness to the views of Thomas Szasz and Michel Foucault. He characterises the latter as ‘labelling’ theorists, and appears to believe they both viewed madness as a phenomena that is entirely socially constructed. It is the notion of madness as a disease that is socially constructed, according to these thinkers, however, not the phenomena itself. Szasz referred to the various states that are labelled as mental illness as ‘problems of living,’ but he paid little attention to their phenomenology, and Foucault too was interested in the history of the silencing of madness, rather than its content.
As now, there were contrasting views on the nature of madness in Hegel’s time, with empiricists and somatists arguing for the bodily nature of the condition, psychics arguing for the autonomous existence of the psyche and Romantics, presaging Nietzsche, seeing madness as a return to a privileged state of nature. As might be expected from a philosopher of unity, Hegel did not come down on any one side of these debates, but tried to incorporate elements from all. He was keen to stress the interdependence of body and mind and that nature, or the body, is the “presupposition” of the mind (Hegel, 1970, Introduction). He referred to madness as a “disease of body and mind alike” (Hegel, 1978, section 408), and drew comparisons between the way the mind becomes deranged in madness and what he saw as the essential nature of bodily disease.
It is difficult to reconcile Hegel’s ‘ontology’ of madness as Berthold- Bond calls it, and a simple disease theory of mental disorder, however. A withdrawal from the alienating world of otherness, with which we must struggle to develop our full human identity, is an understandable reaction, a meaningful, if in Hegel’s view, self-defeating response. Indeed, in many ways, Hegel’s views prefigure the phenomenology of madness that R.D. Laing presents in The Divided Self. For Laing too, madness was a meaningful response to the ‘ontological insecurity’ or anxiety produced by interaction with other people. Madness occurs when there is a failure to integrate the social self with the private internal self, leading the ‘real’ self to split off into the world of fantasy, increasingly disconnected from the external world. Laing certainly did not see this view as compatible with the idea that madness is a bodily ‘disease’ in the way we normally use and understand that term.
Hegel’s view of the treatment of madness is also hardly consistent with a straightforwardly medical approach. Although he did not disapprove of physiological interventions entirely, he was convinced that only psychological strategies could address the fundamental basis of madness. The ‘therapist’ must engage with the remnants of shared rationality that persist despite the retreat into madness, and lead the person gently back into contact with the “real world” (Hegel, 1978, section 408).
Hegel’s ideas on therapeutics were strongly influenced by Pinel’s ‘moral treatment,’ and anticipate modern movements such as the Soteria model of the treatment of psychosis (http://www.moshersoteria.com/articles/). His idea of the essentially asocial nature of madness seems to me to make good sense for the most severe problems, at least. It also provides a philosophical basis for a truly humanistic approach to helping those who, for whatever complex combination of reasons, sink into a state of mental estrangement.
With thanks to Meade McCloughan for advice on aspects of Hegel’s work and ideas.
Berthold-Bond, D. 1995, Hegel’s Theory of Madness State University of New York Press, New York.
Foucault, M. 1965, Madness and Civilisation Random House Inc., New York.
Hegel, G. W. F. 1970, Hegel’s Philosophy of Nature (Tr A.V. Miller) Oxford University Press, Oxford.
Hegel, G. W. F. 1978, Hegel’s Philosophy of Mind (part III Encyclopaedia) (Tr W. Wallace) Oxford University Press, Oxford.
Hegel, G. W. F. 1979, Phenomenology of Spirit (Tr A.V. Miller) Oxford University Press, Oxford.
Laing, R. D. 1965, The Divided Self Pelican Books.
Szasz, T. 1970, Ideology and Insanity; essays on the psychiatric dehumanization of man. Anchor Books, New York.