Yeisley Rusk, George

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IS IXSA^IT^• I'XSOCIAL?BY C.I'.OKCI". YI.ISLr.V RUSKIN a recent number of The Socioloijical Rcx-icw Dr. Alice Ravenenumerated the chief characteristics of various sorts of insanitx.These, she held, can easily be detected, and the persons afflicted,by immediate detention and treatment in hospitals, can be savedfrom crime. W ith the article in general I am in cf)mplete ajjree-ment. I wish to raise a question about only one statement made init although it is substantially rejieated several times. The statementis this: "In all his thinking he (the insane man i has himself andhis own advantage as the centre." (i).287) Uut is insanity alwaysand in all respects unsocial in the thought of the i)erson afflicted?My observation would suggest that it is not—as we shall now ])ro-ceed to show.( 1 ) In some cases the insane man blames himself—j)ossiblyfor deeds which he has done, and is grateful to society for search-ing him out and trxing to redeem him—possibly in larger waysthan society' has done. One patient, on arriving home in a deludedcondition, cried out to his family: "O love that wilt not let me go."lie thought that his family had been seeking to redeem him fromimagined sins all his life. It is true that even in this case thepatient was thinking of his own advantage—but not in oppositionto the advantage of society, ^'et it is in the sense of in-opposition-to-the-advantage-of-societ\' that Pr. Raven used the term '"his ownadvantage." I'or earlier she had referred to the "anti-social ten-dencies which mark all per-ons of al^iormal ])sychology."(2) In some cases the chief comfort that the insane man hasin his terrors is that no other human being has ever been calledui)on to go through worse tortures than he is experiencing. Heidentifies himself with all the most unfortunate of his fellow men—IS INSANITY UNSOCIAL? 245"even these least." Life in a hospital is helpful to him becausehere he can most easily make such an identification.( 3 ) In some cases the insane man is interested in himself toan unusual degree only as a servant of a real truth which societyneeds but will not accept. Even when his truth is an obviousdelusion, his attitude is not anti-social. Jesus thought of himselfas a martyr for truth. Would the author say that therefore he wasanti-social? Dr. J. H. jowett once declared that Jesus was either(jod-man or mad-man. Would Dr. Raven insist upon the latteralternative?(4) And in some cases a man remains amid circumstancesof great stress for those who will not compromise, with the purposeof serving society, and so goes insane, with the more or less con-scious realization that thus he will reveal to society that it is notgiving a square deal even to its devoted members. And any societywhich allows some members—perhaps through the mere fact ofhaving inherited a fortune—to live in wanton kixury while it refuseswork to many eager to work at anything at all equal to their intelli-gence and training is essentially unjust. The ten percent of thepeople who control ninety percent of the wealth of the country, donot possess ninet}- percent of the abilit}'. Even when perfectlyadventitious causes do not determine the financial status of a man,and when no unfair control of the means of wealth has beenresorted to, men are rewarded for their special commercial ability,not absolutely, but geometrically. A slight initial superiority, be-cause of the wa\' modern society is organized, receives a constantlyincreasing reward. There is no essential justice in such a society.It is true that a man in need can generally get some help fromcharit}', but he may be too socially sensitive to seek it—till afterhe has gone insane and so cannot help himself.Or perhaps the work offered a man would prevent his carryingout a purpose which he, at least, thinks of as valuable for society.Or prospective employers may encourage a man to wait, and stillwait, for the position in which he can serve society as he desires—but never actually offer him the position. In any of these cases aman may let his mind fall to pieces to get the help of society to geta proper position and to reveal to society its essential injustice andso aid it to reform. If the gentleness of the little child of Biblical246 Tin: OlMN COLRTvision cannot lead -ociety to the place of rc(kni])lion. ])c-iha])s theexpense and terror of the gro\\in<,^ multitude of the insane will.l')Ut perhaps it may he replied that a man can li\e utterly trueto his ideals in the service of society without ha\inj,f to jtay theprice of insanity— simply b\ remaininj; level-headed. I Jut he can-not. Perhaps the modern LaKinist, to take one extreme, thinksthat he does so, strong in his faith in the final triumjjh of hi:- ( iod.Iiut with all his consistency, no Calvanist has ever dared to thinkthrough the cjuestion of Ciod's decrees, and all of them after assign-ing an untold section of mankind to eternal torment, are quite readyto go home and eat tenderloin beefsteak smothered in onion>. ( )r.to take the other extreme, the modern socialist. The socialist can-didate for president, Xorman Thomas, said in a i)uhlic speech on ahot summer day that increasingly he realized the compromises thathe made, and so increasingly was tolerant of those that others made.It is the insane alone who have been utterly sincere in devotion tosome truth which, in some asi)ect at least, the\' beliexc might be ofservice Xo societ\. Ihe rest of us either compromise unwittinglywith our holiest visions, and struggle blindly on under their waninglight, and still hoj)e: or. in the full glare of consciousness we rec(jn-struct for our guidance i)hilo>o])hies which contain no absolutevalues unmediated by their oj)])()sites.Even when personal complexes must share with society theresponsibility for the wrecking of a man's life, these can be readas the result of the insupportable burdens which society has ])lacedupon him. At last, as the result of his life in society, a man b\ amultitude of at least partly conscious mental acts ma\- give in andgives uj). He may let society have its way—but not while he issane. Thus he is enabled to declare emphatically what society isby the very going insane and permits her to begin her own redemj)-tion by saving him.I5\' carrying cnit such a ])rogram. a man can lia\e a ])rofoundinfluence upon societ\. .Ml of the modern study of the mind, andthe consequent construction of the true laws of hap])y thought (asop[)osed to the dogmas of religion through which formerly menhoi)ed to find peace) may be said to have been forced ui)on societyby those who went insane rather than give up j)urposes which theyrightl\ held as worthy and wholesome. Of course it would haveIS IXSAXITY UNSOCIAL? 247been better if all men had always been happ}' and good, and so ifit had never been necessar}- to study the psychology of the abnormal.But at any gi\en time, with most men miserable, the man who goesinsane, and so forces societ\' to study the nature of the human mindand discover the laws of happiness for the benefit of all men, andto correct its irrational industrial awards and moral standards, maybe conceived of as a social benefactor and in his own characteras profoundl}- social—partl\- unconsciously, but parti}- consciously,in so far as he has remained true to his ideals and would not adjusthimself to life as it now is. The longest way around is sometimesthe shortest wa_\' home.An excellent illustration of how effective such la}ing down ofone's life ma\- be is supplied by those whose lives were ruined bythe old methods of education. The observation of the ruin thuswrought has caused the introduction of the project method ofinstruction into man\- schools. Even this method will be greatlyimproxed as its failures are noted. The lives ruined by the oldmethod were, indeed, ruined. Those ruined, in turn, were cruelor unwise to others. They would not make pleasant companions.Yet in a profound sense they have served the progress of education.By the sacrifice of such lives society has been progressivelyredeemed. In this knowledge, when even vaguelv grasped, is theirpeace. In this service is their .atonement—the onl\' atonementwhich is morally defensible.Insanity ma\', we must then conclude, in ver\- important respectsbe social. Therefore it is not necessary to tell a patient—as thewhole truth—that his failures have been due to his own deficiencies,that his whole past life has been so mistaken that society has beenjustified in rejecting him, that his labors have had no value, hisbitter sacrifices have been useless, his feeble protests against societyhave had no objective justification, that at best he is a victim ofhis infantile histor\', and not at all the martyr of his true ideals.Yet psychiatrists, perhaps inadvertently, sometimes condemn bv im-plication the entire past life of the patient, when trying to teardown the patient's idea of himself and of society so that they canbe rebuilt in such wise that the patient will be willing to accept lifeas it is.Now, I do not believe that societv has as vet so fullv become the248 Tin-: ()Pi:n court"beloved community" that such a view of the past hfe of a jiatientcan be held in any case to be absolutely true. Insistence upon itstruth naturally retards the reviving confidence of a patient in hisdoctor, and so in society, whose representative the doctor is to thepatient. A patient may rightly believe that as a result of his tragicexperiences, and his deej) ponderings, he has come upon profound,revolutionary truths, which society is not ready to accept, and thatit rejects him because he is "a voice crying in the wilderness." Thepossibility of all this being the case I believe that the psychiatristcan safely acknowledge, and so win the patient to reconciliationto society far more quickly than by the present denials, confusionsor evasions in the matter. ( For a single illustration of the un-certainty which now prevails in psychiatry about this matter, con-sult : Understanding Human Nature by Alfred Adler. ) Imj^ly thatan insane person is anti-social until converted by the particularevangelist in charge, that at present there is nothing of sacrificialworth in his life ("Nothing in my hand I bring, simply to thy zvordI cling"), and he will remain unconverted for some time, ikitmake clear that psychic health does not demand a denial of thevalue of devotion to individually formulated truth, and a ]:)atientwill be reconciled quickly to his doctor and to societ\'—in an\'respect in which he is not so already.Freudianism, which views insanit)- from the standi)oint of itsorigin in the initial experiences of those afflicted by it, and Adlerism.which views insanity from the standpoint of the efiforts of the in-dividual to master his environment, should be supplemented by atheory of insanity, and by a technique for its analysis and cure,based on its .social implications—both the failures of society to meetthe normal needs of the natural human being and the social idealsin the service of which the patient has assumed burdens which havecrushed him. I'ntil this has been done, our treatment of insanit\will be unstable, ever defeating its own efforts, inadequate.Any tendency on the part of a i)atient toward vindicative bit-terness against society because of what he has endured, may be over-come by revealing all the members of society as the victims of com-plexes and unfavorable conditions as well as the patient, and so asworthy of the same respect (altho perhaps in varying degree ) thathe asks for himself. -At length he will see society as a drama ofconflicting forces out of which is slowly being evolved "the belovedIS INSANITY UNSOCIAL? 249community," which is the Kingdom of God. In this evolution hisstruggles have an essential place. This is the teaching of religion,for "the things that are despised did God choose." And it is theteaching of science, for in science nothing that is can be denied itsplace in the final ordering of experience. In the physical sciences,we must in all formulas take account (implicitly) of every quantumof matter and force. And if we are to develop a social science, wecannot permit ourselves to regard any state of consciousness of an}'soul as of no ultimate significance, which the totally invalid cannothave.All detention of a patient in a hospital as too unsocial to be atlarge for his own good or that of society, till he renounces faithin himself and accepts the conditions prevailing in the hospital—forinstance, continuous immoralities, as willingly as he would the trulynecessary injustices out in the world; or until he becomes as docileto superiors as is a hundred percent American, is unjustified. Xolover of mankind has ever been so. Anna Freud in the Januarynumber of The International Journal of Psychoanalysis (p. 37)supports the former of the two points which I have just made, andso by implication the social theory of insanit}' which I am advo-cating. She seems to disapprove of insistence by authorities uponprolonged hospital life for a patient wdiose super-ego under theconditions of hospital life increases its demands as it would not innormal life. Therefore she seems to believe that the actual good ofthe patient should guide his treatment, that he is not to be a pawnin the hands of his doctors, to be made over into a creature whosimply accepts his environment. She regards the patient's idealsas the factor which should determine his environment, not viceversa. Therefore she seems not to regard insanity as unsocial, assomething to be rebuked, stamped out. Rather, she seems to belaying the grounds for its recognition—at least in one aspect—associal because a constituent part of a personality not essentially atwar with society, and for its treatment as such. She writes:"By the kindness of Dr. Ferenczi I have had an opportunity ofseeing the notes of a mistress at one of the modern Americanschools, the W'alden School. This mistress, who has had a psycho-analytical training, describes how neurotic children whose home-standards are strict, and who comes to her school while still in thekindergarten age. after a longer or shorter period of holding back250 THI-: ()pi:n col'rtill amazement, j^row accustomed to the extraordinarily free atmos-phere and gradually lose their neurotic symptoms, most of whichare reactions to breaking the habit of onanism. We know that withan adult neurotic it would be impossible to produce a similar effect.The freer the environment into which he finds himself transplantedthe greater is his dread of the instinct in question and, therewith,the more marked the accentuation of his neurotic defence—reactions,i.e.. his sNmptoms. The demands made on him by his super-ego areno longer susceptible to influence from his enviniument. .\ child,on the contrary, once lie begins to modify his standards, is inclinedrather to go a long way in tlii^ direction and allow himself morelatitude than even the freest surroundings could permit him."l>ut of course the outstanding author and advocate of a socialinterpretation of insanity is Trigant lUirrow in his The Social Basisof Consciousness. .\nd perhaps we shall not do justice to thisaspect until we employ "group analyses"—such as he suggests. Buteven if we never go so far as that, we ought to give much thoughtto this aspect of the matter and recognize it in our treatment ofpatients—as some private psychiatrists are already doing largel\'empirically.Yet even Freudianism approaches close to the .social interpreta-tion of insanity when it traces the origins of psychoses past theexperience of the individual to that of the race, .\dlerism does solikewise when it views insanity from the standpoint of the purposesof the individual. Perhaps these—at present inimical theories—willfind their conscious reconciliation in a social theory of insanity—as thesis and antithesis in their synthesis. And perhaps thru asocial theory of insanity, psychiatry will be brought into a fruitfulrelation to social reform—to the unlimited benefit of mankind.Perhaps in psychiatry we shall secure an exact knowledge of theplaces where society presses with too great a pressure upon theindividual and how to reward the dreamer of dreams with reason-able means of self-expression before he turns his back upon realityin discouragement, thus at once making unnecessary the stern sacri-fice of the insane for society and causing its mental health to be-come sound to the core.I'ntil we come to acknowledge that the insane are not necessarilyanti-social beings, (1) we shall not deal v^ith them wisely; (2) weshall not deal wisely with reformers who are not adjusted to societyIS INSANITY UNSOCIAL? 251as it is. yet who have not yet broken clown ( for instance, JohnRuskin before his break-down) : and so (3) we shall not be able toinduce them to turn to psychiatrists for help before a crisis hasovertaken them. To induce people to turn to mental doctors foraid in carrying- their purposes into efifect as readil\- as people nowturn to physical doctors for the re-establishment of their bodih-health—without an\' sense of shame or inferiorit\"— is the great needof our contemporary life. It should be the final aim of all psvchiat-rists. Hut, let me insist, this they cannot do until thev have di-vorced in the public mind mental sickness and fundamentalK- un-social attitudes.

Is Insanity Unsocial?

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Is Insanity Unsocial?

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