Philosophers attempt to make sense of the human condition, and doing that entails making sense of how humans typically function. This requires specifying what the functions are that humans carry out, and how the conditions in which they find themselves play a role in influencing those functions. Even casual observation reveals that although we can identify and classify functions shared with other organisms and others which may be uniquely human, there is significant diversity among individuals in the extent to which any of these functions is present. Vision, for example, is typically present in human beings, and it plays an important role in a wide variety of human activities and pursuits, though it can be completely absent from some humans, and visual acuity can vary widely. We can determine a range of normal vision by using tests of visual acuity to sample populations.
Can we do the same for mental health? Is there a benchmark for behavior that would enable us to characterize the way humans behave as normal , as we can characterize vision as normal? One difficulty is that human behavior encompasses a very swathe of human functioning than something like vision, or other physiologically based functions, and so it is less clear what we would be trying to describe and benchmark. There are as many types of behavior as there are ways of describing what people do. Are there “normal” behaviors for each of these types? Is there normal and abnormal hunting behavior, grooming behavior, speaking behavior, and shopping behavior? Are extreme abnormal behaviors of these types forms of mental illness?
A second, related problem is that our characterizations of types of human behavior and their ranges relies on beliefs and values that we have prior to coming up with these characterizations, and those beliefs and values themselves represent behaviors that we already presuppose as normal. In short, how we understand mental health depends on what we think constitutes normal human behavior in various contexts which we take to be relevant to one’s mental health. Michael Foucault sheds considerable light on this often under-appreciated aspect of our understanding of mental health in Madness and Civilization, where he shows how our understanding of mental illness has changed from the end of the sixteenth century to the present These two complicated philosophical dimensions of our understanding of mental illness are brought to the fore in “Miniature.”
Charley Parkes is described by his boss as a “square peg,” and he is promptly fired for just that, for his failure to fit into the culture of the office where he works. He is never late and he gets his work done. But he is fired because he just doesn’t fit in, which, in the early 1960s counted as a fully adequate basis for firing someone. Nothing suggests that Charley’s unusual personality prevents anyone from doing their job. It seems merely that they don’t like his personality. Charley’s boss also comments on the fact that Charley, a grown adult, still lives with his mother. While the boss acknowledges that this is irrelevant to Charley’s work at the firm, it is clear that the boss thinks this is odd and says so. We soon learn that Charley has lost jobs in the past, and also that he has few friends and no romance in his life. This is a source of concern for Charley’s family, and they seek remedies, by presenting opportunities for both employment and romance. They are supportive and loving, and wish only the best for Charley.
Perhaps to escape from the stress of meeting the expectations of others, Charley becomes obsessed with a miniature display of the interior of a 19th century, complete with a doll of the house’s resident, seated at a harpsichord. Charley experiences first auditory and then visual illusions. He hears Mozart’s Piano Sonata in A Major, and then sees that it emanates from the “doll” playing the harpsichord in the parlor room of the miniature house on display.
Is this the description of someone who is mentally ill? Charley has a flat affect. He is a loner, and he may have certain other traits that we, sixty or more years later than the period represented in the episode, might characterize as an obsessive-compulsive or borderline personality disorder. Yet Charley’s behavior in the early 1960s, before the anti-war, civil rights, and feminist movements, is very much out of step with what was considered normal. Even before he begins to experience hallucinations, Charley is marked as a serious problem.
Unusual or abnormal behavior is called out when it creates conflict. Charley doesn’t work as a member of the “team” at work, and the solution is to eliminate him from the team. Attempts to put him on other teams by those who care about him create other conflicts, and Charley ultimately takes matters into his own hands by finding a team that he fits into, the world of the miniature house. That this isn’t a workable solution follows from the simple fact that the larger society to which Charley belongs is inescapable. His beliefs about the miniature house and its contents conflicts with the beliefs of everyone else. As his psychiatrist explains, intersubjective agreement is the test for what exists. As long as Charley makes claims about the existence of things that others don’t agree with, the conflicts will remain.
Charley figures this out, and learns how to withhold his claims about the reality of the experiences that he has that are not shared by others. He learns how to not make waves and ultimately get himself sprung from the psych ward, just long enough that he can return to full bore engagement with his miniature world, leaving “the real world” behind. Whether this is understood as psychosis or suicide hardly matters. It is the outcome of all the well-meaning interventions of his family and care-givers. As his psychiatrist said, the important thing is to figure out not what Charley saw, but why he saw it. It appears that no one came up with the answer to that important question.
Mental illness, or what used to be referred to as madness, has long been the subject of philosophical reflection. In epistemology, it has functioned to provide a way of considering whether it is possible to know anything. Descartes implicitly raises this in Meditation 1 of his Meditations on First Philosophy, when he argues that because he has sometimes been deceived by his senses, it is possible that he is always deceived by his senses. This possibility would put him in the same league as Charley, who lacks the ability to distinguish his hallucinations as hallucinations. But Descartes quickly rejects this possibility, in a beautiful passage:
And how could I deny that these hands and this body are mine, were it not perhaps that I compare myself to certain persons, devoid of sense, whose cerebella are so troubled and clouded by the violent vapours of black bile, that they constantly assure us that they think they are kings when they are really quite poor, or that they are clothed in purple when they are really without covering, or who imagine that they have an earthenware head or are nothing but pumpkins or are made of glass. But they are mad, and I should not be any the less insane were I to follow examples so extravagant. (Descartes, 1911, p. 145)
Descartes doesn’t explain why he rejects the possibility that he is mad here, though perhaps it is simply that he finds himself in agreement with others about what is real, which, as his psychiatrist suggests, provides the touchstone for distinguishing hallucinations from reality. But by the end of Meditation 1, Descartes has provided further arguments which remove whatever grounds he had for distinguishing illusions from what is real. The extreme or hyperbolic doubt of everything removes the touchstone of our agreement with others, since even that agreement may be an illusion. Descartes, like Charley, is engaged in a solitary endeavor.
Bolton, Derek, What is a Mental Disorder?
Descartes, R., Haldane, Elizabeth S., Ross, G.R.T., trans.(1911) Meditations on First Philosophy, in The Philosophical Works of Descartes, Volume 1.
Foucault, Michael, (1965) Madness and Civilization, Random House.