In Going Sane, Phillips, a psychoanalyst and prolific writer, covers what philosophers, psychologists, economists, and poets have contributed to our collectively held idea of sanity in a book that feels like an extended essay. His prose is riffy, and lyrical.
First used by physicians in the seventeenth century to refer to "health in body and mind," its more familiar modern connotation as the opposite of or antidote to madness only really developed, as we shall see, in the nineteenth century. It was a word taken up by the new mind-doctors and mental hygienists, but never systematically studied or defined. Even though people never collected example of it, or scientifically researched it, or found it in foreign countries, even though it was rarely described, unlike madness, with any great gusto or commitment, and as a word was (and is) rarely found in poems, titles, proverbs, advertisements or jokes; even though it is a word with virtually no scientific credibility, and of little literary use, it has become a necessary term...
If sanity were a game, how would you learn to play it if the authorities could tell you only when you had broken the rules, but not what the rules were? It would be enough to drive anyone mad. It is as though our commonsense assumption is that if we look after the madness, the sanity will take care of itself. And that because we know what madness is, we must know what sanity is; as though if you knew the color white, you would automatically know what black was.The upshot, Phillips hopes aloud in his preface, is that this book will offer sanity, once we can establish what it is, as an alternative to wealth, happiness, security, and long life as the necessary ingredients to a "good life." Phillips sees the antipsychiatrists of the 1960s like R.D. Laing as a product of their era. If culture was driven by commerce on the one hand and fears of apocalypse on the other, then sanity was an expression of that mainstream, and madness a rational response to the horrors of modern life. Adaptation to ones environment became a negative construct for thinkers like Laing, as these supposedly sane people had no business thriving in an "inhospitable" universe. The famously mad men of their eras - Rimbaud, Van Gogh, and Nietzsche - transformed the world so that they could preserve their visions. "These artists were truly sane," Phillips tells us, "because they never sold out."
Phillips is broadly read and uses texts to both build up and knock down the expectations of his reader. Sometimes it is Lamb, sometimes Dickens or Shakespeare. With their help, he constructs richly evoked frames of mind vis-a-vis sanity and, once he has us there, he challenges the assumptions he has built. At other times, he takes our conventionally held notions, for example that sanity is characterized by "capacity," that is, an ability to understand what is happening around us, and then wields, for example, George Orwell's 1984 as the battering ram that topples our expectations. Orwell's famous dystopia, sees survival in the context of individuals' suppression by the Party, as accomplished by failing to notice what was happening,
...it is as though knowing or acknowledging certain things that are going on around you might drive you mad, might destroy your hard-won equilibrium. What is called sanity then become a strategy to manage a mad and maddening world. Sanity in 1984 is another word for consenting to one's own oppression.
He also offers provocative examples in the realm of human development, citing Winnicott's suggestion:
...not that children are mad, but that what adults feel is mad, is normal for the child. Our earliest lives are lived in a state of sane madness - of intense feelings and fearfully acute sensations. We grow up to protect ourselves from these feelings; and then as adults we call this defense "sanity." Looked at this way, sanity begins to sound like a word we might use for all adult states of mind in which we are not children, in which we do not experience things intensely. We are poor indeed though if this is our only idea of sanity.
For Winnicott, the question was not what can we do to enable children to be sane, but what can we do, if anything, to enable adults to sustain the sane madness of their young minds?
I was disappointed by Phillips's chapter on schizophrenia, autism (the area of my research), and depression. I particularly found the examples of autism as metaphor too poeticized to be human and the psychoanalytic imagining of autism as reaction to the trauma of separation ridiculously antiquated. There were times I couldn't tell whether autism was being offered as an example of insanity or sanity.
Phillips is much stronger on sanity in the context of sexuality, suicide, and his chapter on commerce is particularly insightful and of contemporary relevance. He rightly questions how, in a culture so marked by individuality and worshipful of enterprise, we can still define sanity as a quality bereft of individuality, quirkiness and passion.
Phillips concludes with an attempt to codify a contemporary notion of sanity, but I was more content with the journey of Going Sane than with the destination since, as he writes, if there are varieties of madness then there should be a varieties of sanity. Indeed, Phillips spent the entire book convincing us that "sanity is more divided against itself ...than it is with madness."