Madness Under Modern Capitalism

Let’s talk about madness. Schizophrenia: from the ancient Greek schizo, meaning ‘split,’ and phrene, meaning ‘mind.’ But of course, in recent history, since around the 19th century, our ways of thinking about ‘schizophrenia’ have become much more complicated: a growing function of social and psychiatric progress. The history of our understanding of this complex manner of madness boomed in around the 1980s, with a neurophysiological descriptive explosion spurred on by new research, resulting in new pharmacological treatments and an eventual explosion in subtypes. This expanding bubble of complications popped somewhat in 2013, when the DSM-5 recommended dropping all subtype classifications, leaving us with alone again with just ‘schizophrenia,’ itself.

Hanging before our psychiatric institutions, our own schizoid selves.
Hanging before its religion, policing morals and condemning to Hell.

Hanging before us, quite intimately, as a reflection on the nature of the self and the possibility of our familiarity with it. Staring at us as a phenomenology of the Other – but, is it also an othering ontology? The majority consensus on schizophrenia since as early as the 19th century has been to regard it primarily as a physical disorder: today, a mental disorder symptomatically contingent upon neurophysiology and specific patterns of neurological decay. However, as Ronny Turner and Charles Edgley argue, “only after behavior is labeled as deviant can it be identified as such & diagnosed as chemically caused.”[1] The specific causal mechanisms of schizophrenia remain elusive. The neurochemicalists put social disorder at only a brain scan away from mental disorder and pharmacological normalization. Their strict materialist conception of the disease downplays or outright denies the significance of sociocultural causes. And this conception is reflected in treatment.

Never mind that recovery outcomes for people suffering from schizophrenia have been shown across a multitude of international studies commissioned by the World Health Organization to be significantly greater for patients in developing countries, where pharmacological intervention is not the standard of care, over developed countries. “Far from being mere incidental cultural music … therapeutic benefits [appear to be] forgone under circumstances of enforced supported dependency.”[2] Never mind that male African Caribbean immigrants to the United Kingdom are as much as ten times more likely to be diagnosed with schizophrenia than young Brits, in spite of the orthodox epidemiologist’s taxonomy of environmental and genetic factors predicting deviations of rates of incidence of schizophrenia within only about a single percent across cultures[3] (similar figures exist in studies of immigrants to the Netherlands.) Even differentiation between rates of early onset in males and females, for a time thought to be one robust and well-replicated result in the tome of our largely uncertain knowledge of schizophrenia, has recently been found to be a confounded finding.[4] The data is simply not as secure as we are led to believe by psychiatry and its affiliated institutions. (Perhaps the nice old owners of the pharmaceutical firms responsible for producing antipsychotic drugs have no vested interests in these matters.)

There are many questions: why the better outcomes for sufferers of schizophrenia in developing countries? Why the increased risk for culturally dislocated immigrants? Social causes and socially structured care. Perhaps these questions jointly suggest an answer, pointing to a radical reconceptualization of schizophrenia as a socially constructed disorder. Of course, this does not detract in any way from its reality, simply put. It is just that we should consider both treatments for and causes of the disease to have a fundamentally sociological character. The mental trauma endured by child sufferers of abuse can be tracked in distinct physiological characteristics of the developmental brain later on in life. Why think that the daily traumas experienced in life within the totalizing technosphere of modern capitalism could not equally mark their tracks in the brain?

We will not lapse into full-blown dealings with Deleuze, here. However, our conception of schizophrenia is determined by several of the various institutions within Western medical science, and so it is suitable to seek answers to these questions somewhere in the framework of sociopolitical assumptions that creates the context in which said institutions lay their foundations. From Levins,

The bourgeois atomistic view of society, as applied to science, asserts that progress is made by a few individuals (who just happen to be “us”) … Individualism in science helps create the common belief that the properties of populations are simply derivable from those of the uncharged atoms (genes) of populations or societies…

The specialization of scientific labor and of command functions from research creates a model of scientific organization that is easily seen as the model for the organization of the world. Nature is perceived as following the organization chart of our company or university, with similar phenomena united under a single chairman, distinct but related phenomena united under a common dean. Thus specialization in practice joins with atomistic individualism to reinforce the reductionism that still predominates in the implicit philosophy of scientists.[5]

Individualism and reductionism: sever the individual from society, reduce the cause of the patient’s condition to something entirely material, or physical. Correct neurological imbalances with powerful dopamine reuptake inhibitors, enforcing treatment within the confines of special types of prisons called mental health hospitals. In India, greater health outcomes for schizophrenics have been attributed to a highly attentive family based care model, based on the specific needs of the suffering individual and typically carried out in the home. Pharmacological interventions are significantly less common.  A recent sixteen month ethnographic study on the standards of psychiatric treatment for schizophrenics in ‘developing’ India finds that “a model of medical care that deemphasizes patient autonomy [i.e., individualization] and the rational understanding of pathology [i.e., reductionism] benefits those diagnosed with schizophrenia.”[6]

It is not that all scientists in the West are themselves bourgeois, but they are largely the ideologues of the ruling class. An inter-institutional struggle between the old Enlightenment ideals for science and its unending search for Truth, and the post-positivistic research cartels racing to some finish line just to finally get it right and to get the last word (and more often than not, to patent it as intellectual property) has created a rift between the laborers of science based on their support or repudiation of commoditization. The poor outcomes of Western medical science with respect to schizophrenia points to a point of contradiction, where the values imposed from the top-down through enforced institutional arrangements that benefit the ruling class might be exposed as oppressive. To root out these oppressive values, we must take aim at the commoditization of science. And this, in turn, will lead us squarely to a critique of the great modern romance between science, technology, and capitalism.

[1] See “From Witchcraft to Drugcraft: Biochemistry as Mythology,” in The Social Science Journal 20.4 (1983).

[2] Hopper and Wanderling, “Revisiting the Developed Versus Developing Country Distinction in Course and Outcome in Schizophrenia,” in Schizophrenia Bulletin 26.4 (2000).

[3] Jones and Fung, “Ethnicity and Mental Health: The Example of Schizophrenia in the African Caribbean Population in Europe,” in Ethnicity and Causal Mechanisms (2005), 227-61.

[4] Jablensky and Cole, “Is the earlier age at onset of schizophrenia in males a confounded finding?” in British Journal of Psychiatry 170 (1997).

[5] Levins & Lewontin, “The Commoditization of Science,” in The Dialectical Biologist (1985).

[6] Sousa, “Pragmatic ethics, sensible care: Psychiatry and schizophrenia in north India,” available in Sociological Abstracts.

Dialectical Biology // Cognitive Maoism

Modified from my forthcoming, ‘Epistemic Dynamics of a Revolutionary Science.’

Of course the speed of light is the same under socialism and capitalism, and the apple that was said to have fallen on the Master of the Mint in 1664 would have struck his Labor Party successor three-hundred years later with equal force. But whether the cause of tuberculosis is said to be a bacilus or the capitalist exploitation of workers, whether the death rate from cancer is best reduced by studying oncogenes or by seizing control of factories – these questions can be decided objectively only within the framework of certain sociopolitical assumptions (Levins & Lewontin 1985, 4-5).

By ‘science,’ we speak of variously many things.  There are scientific theories – explanatory hypotheses about the natural world – and even technological commodities, which are the products of science.  Then, there is a network of social actors, orthodoxically thought to consist primarily or even exclusively of ‘scientists,’ the fruits of whose collective efforts constitute the social production of these products.  Finally, there is a third respect in which we speak of science; in this sense, there is a worldview, approximately but not exclusively defined by the socially productive modes and products of science, which presents the manifest image of reality as the scientific image (see Bas Van Fraassen, The Scientific Image (1980) on the distinction between the manifest vs. the scientific image of reality.)  I do not mean to suggest that there is a single ‘worldview’ that is consistent across the endless spectrum of scientific disciplines and subdisciplines; worldviews differ significantly between Mendelian and molecular genetics, between Newtonian mechanics and relativity theory; indeed, historical cases abound in which some such cases of collisions between worlds had significant sociopolitical consequences.  Here, I mean only to articulate the relation between the historically contingent social worldview and the productive modes of science.  The mode of this scientific worldview is primarily ideological; by understanding this ideological mode in an Althusserian vain, we see that social relations of knowledge production in science are both materially and ideologically productive; in this sense, both the theoretical products of the first, and the scientific worldview of the third senses in which we speak of science are essentially ideological.  The dominant Western scientific ideology operating in and between each of these layers has been variously critiqued by philosophers of the Left: for its deeply methodologically entrenched oppressive patriarchal values, exposed by feminist philosophers of science; for its bourgeois Capitalist values and culturally imperialistic violence, decried by epistemological anarchists and Marxist scientists alike.  Arguments for the value-ladenness at each of these levels abound.  The Mertonian myth of value-free objectivity of the early twentieth-century has only served to engender a certain disinclination among interested parties of scientists and stakeholders to challenge (or even to see) the framework of sociopolitical assumptions in which these social and material relations of knowledge production are arranged.

The scientific worldview sets epistemological boundary conditions that narrow and define our conception of ‘truth.’  When this feedback loop is allowed to continue, the result is a paradigmatic period of Kuhnian ‘normal science’; for many, this is not a vicious circle, but rather a precondition of scientific progress.  I hardly need to state that the story of stable progress along the lines projected by the status quo characteristically fails to convince those who detect oppression in the orthodoxy.  Epistemic features of theories are designed to aim at ‘truth’; however, minimally insofar as our conception of ‘truth’ is refined by ideological production and for the sake of ideological reproduction (a further Althusserian notion), we should expect that the idea has a material existence that exerts its force on the social means of knowledge production.  The ‘framework of sociopolitical assumptions’ raised by Levins and Lewontin is an idea which directly challenges the question of ‘truth,’ by challenging the proper construal of standard epistemic features in biological theories.  They reject Cartesian reductionism as a manifestation of oppressive ruling class values being insinuated into scientific methodology as a guiding epistemic principle, presenting work from across the fields of evolutionary and population sciences, molecular biology and zoology, to demonstrate the value in adopting a dialectical ‘truth-concept’ as an epistemic aim in the sciences.  The selection of truth-concept is established with express political motivation.

An epigraph is set in the beginning of The Dialectical Biologist (1985); it reads,

To Frederick Engels,

who got it wrong a lot of the time

but who got it right where it counted

So too did Levins and Lewontin get ‘it right where it counted.’  The form of ideological revolution presupposed by dialectical biology amounts to scientific or cognitive Maoism; it is thereby ill-equipped to fulfil its mandate, to be an ideologically emancipatory science, counterposed to the dominantly Cartesian orthodoxy.  We can conceive of an alternative view – with a Trotskyist spirit – in Longino’s contextual empiricist approach to the study of the social relations of knowledge production.  Longino’s view pushes for greater diversification among practitioners of science, to maximally widen the array of background beliefs employed in the production of knowledge; however, diversification within the constraints of Western science is effective only up to a point.  Barring the revolutionary abolition of class antagonisms, the material reality of Western science is such that oppressed beliefs remain alienated from the centralized, sanctioned body of permissible bourgeois-ified background beliefs.  Thus, the ideological erosion of the scientific worldview on a material basis must serve as a precondition for ideological emancipation; furthermore, this erosion must proceed from the bottom-up, under the unity of an educational program, rather than from the top-down, under the forcible instilment of dialectics.  As is so often seen in the realpolitik of emancipation, spontaneous solidarity builds between sectarian pockets of the revolutionary Left.  Likewise, my predominantly Marxist analysis benefits here from the groundwork laid by Feyerabend’s epistemological anarchism.

The question may arise as to what sorts of concrete results we might be entitled to expect as a result of the program of ideological erosion, and of the transitional program of a subsequent dialectic reconstitution of science in society.  Feyerabend argues that separate and distinct traditions of knowledge are likely to be mutually enriched as a result of open theoretical discourse.  If correct, then epistemic enrichment is a beneficial consequence of the ideological erosion of the scientific worldview on the material basis of the elevation of the intellectual and cultural authority of non-scientific worldviews.  But however serendipitous, the matter quite misses the point.  My argument proceeds on the basis of the view of sociopolitical emancipation as historical necessity, in a Hegelian sense.  What would it mean, say, to have one’s body of theories epistemically enriched in the sense that they now more reliably produce justified true beliefs, when epistemological reliabilism is fed back into science methodologically as an epistemic aim inspired by evolutionary biology and psychology? – only that we have successfully reinforced the status quo, ‘progressing’ in a dull Lakatosian vain.  While I do consider enrichment of this sort to be likely, it is merely a coincident to the final emancipatory cause.

Reflecting On Reflection

Reflection has ever been the philosopher’s most prized capacity, thought capable of rendering clear our beliefs as a mode of second-order cognitive scrutiny.  I intuitively believe that there is a keyboard here at my fingertips, a monitor before my eyes; I may call these beliefs into question, distancing myself from the immediate cognitive impressions they form on me.  If I reflect on these beliefs aptly, I ought to find that I have good reasons to hold these beliefs.  Indeed, some have claimed that it is just this capacity which cuts between human and animal cognition.  My (sadly hypothetical) dog cannot distance himself from the belief that we will go out for a walk when I show him his leash – he cannot question whether he has good reason to hold this belief, any more than he can question whether having arrived at this belief in just the way that he did constitutes a good method for arriving at beliefs.  However, qua human beings, our beliefs are called into question constantly, from the flights of fancy of minds in vats to the complex assignment of statistical probabilities to the possible truth-values of a possible set of facts which are thought to occur in (possibly) the real world.  Just as the line between human and animal has been drawn along these lines, so too has the line of freedom and moral responsibility.  The ability to scrutinize our beliefs with some higher-order reflective capacity seems, to some, essential to explain the phenomenology or reality of human freedom and agency.  Agency is thought to imply responsibility.  Hence, we are thought able to be judged praise or blameworthy, in virtue of our freedom to chart the paths of our own actions from among a sea of possible alternatives.

However, the value of our capacity for reflection may not hold up to close scrutiny.  In On Reflection (2012), Hilary Kornblith argues that this faculty, as we have hitherto conceived of it, is not the kind of thing which could possibly enlighten our inquiries about knowledge, reason, freedom, and normativity.  Our treatment of reflection seems to be essentially phenomenological; Kornblith notes an important dissimilarity between this, and our rather more empirical orientation towards other phenomena in the natural world.  The reader should note the operative ‘other’ in the previous sentence.  Kornblith considers knowledge and related epistemological phenomena to be natural kinds – see his arguments for a naturalized epistemology in Knowledge and its Place in Nature (2002).  This phenomenological bias manifests particularly in the common tendency of philosophers in the reflectionist orthodoxy (a poor ad hoc moniker to be sure – the category is meant to include Sosa, Korsgaard, Goodman, BonJour, and many others) to use first-person language to describe features of reflection.  Naturalized epistemology can be characterized as the view that explanations of the objects of epistemological inquiry are ultimately natural explanations, rooted in the natural world.  If correct, this view provides a strong reason for scrapping our phenomenological bias, in favor of a more empirical orientation towards epistemological inquiry – including our reflections on ‘reflection’.

Kornblith’s main arguments against the received view of reflection show that, on that view, scrutinizing our beliefs always falls into infinite regress.  When I reflect on my first-order belief B that there is a keyboard at my fingertips, I form a second-order belief B’ that I do indeed have strong reasons in support of the first-order belief.  But I do not know whether I have strong reasons in support of B’ unless I reflect on those reasons, thus forming belief B’’ that I do indeed have strong reasons in support of B’; et cetera ad infinitum.  Therefore, our beliefs are never ultimately justified, and we never know what ultimately counts as having sufficient reasons for accepting a belief.  It follows that we must remain mute on normative claims about belief formation.

To infinity, not beyond.  I suspect that the severity of an infinite regress is a pain much more immediately felt by those with a naturalist suasion.  If explanations about objects of epistemological inquiry are ultimately natural explanations, and the received view of reflection leads in every case to an infinite regress, then one is at pains to devise a naturalistic explanation of infinity.  The human brain must thereby be supposed to be capable of performing supertasks, provided we are not meant to reflect on even our most banal beliefs on into eternity.  A supertask is a task consisting of a countably infinite set of calculations or operations, which occurs sequentially within a finite amount of time.  Kornblith offers no argument as to why infinite regress is to be avoided in epistemological explanations.  Presumably, it is his naturalistic aversion to something like a cognitive supertask that underwrites his argument.  Another likely assumption is that cognitive tasks in humans are not such that they can perform operations on infinities.  This is not necessarily true – the phenomenology of reflection provides good reasons to believe that at least one epistemological explanandum (reflection itself) performs operations on infinities.  Mathematicians reflect on set-theoretic proofs involving greater and smaller infinities, as Cantor did with his diagonalization argument.  On a similar vein, Roger Penrose has argued that Kurt Gödel’s incompleteness theorems – and their subsequent comprehension and acceptance by fellow mathematicians and human reasoners – provide a strong reason to consider that human cognition must contain exponentially more processing power than any possible mechanical system could (though these arguments fall quite far short of wide acceptance themselves).  Again, this assumption falls on prima facie naturalistic inclinations.  Naturalized explanations just cannot, or cannot easily, contain infinities, greater or smaller.

I am differently inclined.  Some kind of infinitesimal calculus sounds to me like a potentially plausible way to model our capacity for reflection.  I form a first-order belief B, which defines the limit to a probability function that models my certainty in that belief (to a max- or minimum infinity).  Reflective scrutiny is hence a process somewhat like calculating a limit with reasons for belief in B, with a max-limit providing an idealized objective certainty in B, and a min-limit its absolute refutation.  We can no more conceive of each of the elements in an infinite set than we can the requirements of absolute certainty in or refutation of B; we can, however, form a transcendent ideal of the concept at hand in order to understand some part of it.  Here, I am somewhat indebted to a colleague from during my undergraduate work in Victoria, who once described Anselm’s ontological proof to me as calculating a limit towards God’s existence.  Of course, the procedure that I propose would involve some sort of conceptual analysis, or analysis of our epistemic intuitions.  Experimental philosophers have recently raised many issues with this practice, which I haven’t the space to consider in this post – see especially Stitch’s The Fragmentation Of Reason (1990), and Alexander and Weinberg’s “Analytic Epistemology and Epistemic Intuitions” (Philosophy Compass 2/1, 2007).

Infinite regress only seems menacing if we share Kornblith’s epistemological naturalism; otherwise, his main arguments against the received view of reflection simply are not knockdown arguments.  Kornblith often takes Ernest Sosa’s epistemological views as his target in On Reflection.  Sosa is a main proponent of the use of a virtue vocabulary to describe and reflect on our standards of excellence in all matters epistemic.  I believe that the cultivation of epistemic virtue might have some import to a view modeling reflection as an infinitesimal probability calculus operating on our beliefs.  Consider the phenomenon, familiar to many and well-studied by psychologists, linguists and other researchers in the field of child development, of the explosion of explanation-seeking questions in preschool aged children.  The attitudes of many parents towards this phenomenon are neatly summed up by comedian Louis C.K. in the following routine.

Children between roughly the ages of 2.5 and 5 never seem to know when to stop asking why.  The increasingly metaphysical nature of Louis’ daughter’s questions demonstrates a certain tendency to exceed what adults typically consider to be sufficient reason for holding some belief.  The phenomenon is particularly well documented in Frazier et al, “Preschoolers’ Search for Explanatory Information Within Adult-Child Conversation” (Child Development 80/6, 2009).  They will often seek to over-explicate their beliefs, because a reasonably reliable calculus for belief acceptance has not yet been developed.  Refinement of this calculus would constitute the cultivation of an epistemic virtue, essentially inscribing on one’s cognition a sort of cut elimination theorem.  As is the case with the cultivation of virtue in general, experience is required, to establish a mean relative to the individual child between excess and deficiency with respect to explanations.  Children must become proficient in the use of explanatory language, with causal connectives and representational concepts, to add to their own epistemic intuitions.  A pre-theoretic epistemic intuition such as ‘justification’ is refined by honing in on a reasonably reliable mental probability calculus to operate on our beliefs.

If it is plausible to model reflection on our beliefs as a probability calculus – and certainly more argument is required than what little I have entertained here – then a strong counterargument to Kornblith’s naturalized epistemology exists.  I agree with Kornblith’s assumption, that natural explans cannot, or cannot easily contain infinities.  All the more reason not to consider epistemological kinds as natural kinds.  In Metamind (1990), Keith Lehrer develops a different account of the human mind: the human mind is a metamind.  It is a representation of mind.  This is to say that the human mind in some sense essentially transgresses the natural, at least as Kornblith conceives of it.  Again, for lack of space, I cannot here entertain the idea that something like a metamind might better ground the argument that reflection is a sort of (meta-)mental probability calculus.  I shall continue to reflect on these thoughts henceforth, for a time.  For now, suffice it to say that Kornblith’s main arguments against the reflectionist orthodoxy are grounded in assumptions informed by his epistemological naturalism; unmoved by this proclivity, I lean towards a view like Lehrer’s.  The burden of argument falls on Kornblith to tell us why infinite regress is a bad thing, even if we do not wish to accept epistemological naturalism.  However, I find myself more inclined towards cautiously abandoning naturalism, to test the limits of infinity as an explanatory concept in the reflective scrutiny of our beliefs.  And I suspect that this endeavour shall keep me asking, “Why?” ad nauseam; in this, the philosopher resembles the preschooler.  Perhaps, a preschooler who has grown up having poorly refined the virtue of knowing how much reflection is sufficient for the reasonable acceptance of our beliefs!