The Annihilation of The Annihilation of Subjective Subjective Experience.Experience.Dr. Alastair MorganDr. Alastair Morgan

Dr. Tim CaltonDr. Tim Calton

University of Nottingham, UK.University of Nottingham, UK.

Whither Subjective Whither Subjective Experience ? Trends in Experience ? Trends in International schizophrenia International schizophrenia Research. Research.

Aim: to evaluate trends in research Aim: to evaluate trends in research presented at two international presented at two international schizophrenia research fora between schizophrenia research fora between 1988 and 2004, including an 1988 and 2004, including an assessment of patient-centredness.assessment of patient-centredness.

Conclusion: of the 9284 abstracts at both Conclusion: of the 9284 abstracts at both conferences ( International congress on conferences ( International congress on Schizophrenia Research and the Biennial Schizophrenia Research and the Biennial Winter workshop on Schizophrenia), only 2% Winter workshop on Schizophrenia), only 2% had any focus on subjective experience. had any focus on subjective experience.

Calton, T, Cheetham, A, D’Silva, K, and Calton, T, Cheetham, A, D’Silva, K, and Glazebrook, C. “International schizophrenia Glazebrook, C. “International schizophrenia research and the concept of patient-research and the concept of patient-centredness – an analysis over two centredness – an analysis over two decades”, in Alanen et al (2006).decades”, in Alanen et al (2006).

““. . . anti-psychiatry was based on an a priori . . . anti-psychiatry was based on an a priori philosophical position that elevated to philosophical position that elevated to maximum importance the category of maximum importance the category of subjectivity . . . It entails a reduction of subjectivity . . . It entails a reduction of politics to a philosophical first principle politics to a philosophical first principle according to which power is evidenced by according to which power is evidenced by the suppression of subjectivity”.the suppression of subjectivity”.

Peter Miller, “Critiques of Psychiatry and Peter Miller, “Critiques of Psychiatry and Critical Sociologies of Madness”, in Miller Critical Sociologies of Madness”, in Miller and Rose (eds). and Rose (eds). The Power of Psychiatry, The Power of Psychiatry, (1986).(1986).

Critique of “anti-Critique of “anti-psychiatry”.psychiatry”.

The anti-psychiatry critique is outmoded – based The anti-psychiatry critique is outmoded – based around the triptych of institutions, madness and around the triptych of institutions, madness and medicalisation.medicalisation.

Madness/subjectivity is wrongly emphasised as the Madness/subjectivity is wrongly emphasised as the privileged site for understanding in the critique of privileged site for understanding in the critique of psychiatric practice.psychiatric practice.

The account of power as domination leads to a The account of power as domination leads to a negative and undifferentiated understanding of the negative and undifferentiated understanding of the effects of power.effects of power.

A Copernican turn from madness to the practices A Copernican turn from madness to the practices and discourses of psychiatry and associated and discourses of psychiatry and associated disciplines.disciplines.

Concept of Biopower Concept of Biopower

Inspired by Foucault’s development of Inspired by Foucault’s development of the concept of power as biopower, in the concept of power as biopower, in the Collthe Collège de France lectures of ège de France lectures of mid-seventies and first volume of mid-seventies and first volume of History of Sexuality (1981).History of Sexuality (1981).

Replacement of sovereign power with Replacement of sovereign power with biopowerbiopower

““. . . the ancient right to take life or let . . . the ancient right to take life or let live was replaced by a power to live was replaced by a power to foster life or disallow it to the point of foster life or disallow it to the point of death”. Foucault (1981). death”. Foucault (1981).

““To make live and let die”.To make live and let die”.

Two Poles of Biopower.Two Poles of Biopower.

One centred on the individual body – an One centred on the individual body – an “anatomo-politics of the human body”. . . “anatomo-politics of the human body”. . . “centred on the body as a machine: its “centred on the body as a machine: its disciplining, the optimisation of its disciplining, the optimisation of its capabilities, the extortion of its forces . . .”capabilities, the extortion of its forces . . .”

The other focuses on the population – a The other focuses on the population – a “biopolitics of the population”. . . “biopolitics of the population”. . . “propagation, births and mortality, the level “propagation, births and mortality, the level of health, life expectancy and longevity”.of health, life expectancy and longevity”.

Foucault, Foucault, History of Sexuality, vol.1.History of Sexuality, vol.1.

Those movements that attempt to Those movements that attempt to resist these forms of biopower do so resist these forms of biopower do so on the very same terrain - that of the on the very same terrain - that of the concept of life.concept of life.

Human rights are increasingly Human rights are increasingly conceived as rights to life, health, and conceived as rights to life, health, and control over the making and shaping control over the making and shaping of bodiesof bodies

Hannah Arendt’s Hannah Arendt’s analysis of biopower.analysis of biopower.

In In The Human ConditionThe Human Condition, Arendt , Arendt articulates a paradoxical combination articulates a paradoxical combination in the politics of life.in the politics of life.

On the one hand the belief that On the one hand the belief that “everything is possible”.“everything is possible”.

On the other, the belief that human On the other, the belief that human beings are merely animals governed beings are merely animals governed by the laws of nature.by the laws of nature.

““The social realm where the life The social realm where the life process has established its own public process has established its own public domain, has let loose an unnatural domain, has let loose an unnatural growth, so to speak, of the natural”.growth, so to speak, of the natural”.

Hannah Arendt. Hannah Arendt. The Human Condition The Human Condition (1958).(1958).

Critical Psychiatry and Critical Psychiatry and Biopower.Biopower.Three Elements.Three Elements.

Knowledge of vital life processes – Knowledge of vital life processes – conducted largely in the name of conducted largely in the name of neuroscience but blurred in the neuroscience but blurred in the transformation of vital life processes in transformation of vital life processes in the very formation of knowledge itself. the very formation of knowledge itself.

Strategies for intervention upon Strategies for intervention upon collective existence in the name of collective existence in the name of mental health, even happiness.mental health, even happiness.

Modes of subjectification- in which the Modes of subjectification- in which the individual is enjoined to work on him individual is enjoined to work on him or herself in the name of an or herself in the name of an understanding of mental health.understanding of mental health.

Nikolas Rose and Paul Rabinow, “Biopower Today”, in Nikolas Rose and Paul Rabinow, “Biopower Today”, in BiosocietiesBiosocieties, (2006), 1:195-217., (2006), 1:195-217.

Two forms of Two forms of subjectification.subjectification.

The move in a risk politics of life from group risk The move in a risk politics of life from group risk to a “biological susceptibility”, which is inherently to a “biological susceptibility”, which is inherently probabilistic and indeterminate.probabilistic and indeterminate.

The move towards the assumption of a The move towards the assumption of a responsibility to producing one’s own mental responsibility to producing one’s own mental health, in terms of an understanding of one’s health, in terms of an understanding of one’s individuality as defined by belonging to a biological individuality as defined by belonging to a biological classification – Rose terms this “somatic classification – Rose terms this “somatic individuality”.individuality”.

Nikolas Rose “The Politics of Life Itself”, in Nikolas Rose “The Politics of Life Itself”, in Theory, Theory, Culture and Society, (2001), vol.18 (6): 1-30.Culture and Society, (2001), vol.18 (6): 1-30.

A new form of biological citizenship, A new form of biological citizenship, creating new forms of human rights.creating new forms of human rights.

This takes place in a moral economy of This takes place in a moral economy of hope, focussed on life.hope, focussed on life.

Biological citizenship is a matter of Biological citizenship is a matter of biosociality as well as somatic individuality.biosociality as well as somatic individuality.

Rose and Novas, “Biological Citizenship”, in Rose and Novas, “Biological Citizenship”, in Ong and Collier (eds.). Ong and Collier (eds.). Global Anthropology, Global Anthropology, (Blackwell, 2003).(Blackwell, 2003).

A new form of critique?A new form of critique?

““The melancholy refrain of those who The melancholy refrain of those who condemn the arrogance of biomedicine for condemn the arrogance of biomedicine for meddling in such areas, who convict all meddling in such areas, who convict all references to the biological of reductionism, references to the biological of reductionism, individualism and determinism . . .are of little individualism and determinism . . .are of little help to us in understanding the issues at help to us in understanding the issues at stake here…We have entered the age of stake here…We have entered the age of vital politics, of biological ethics and genetic vital politics, of biological ethics and genetic responsibility”.responsibility”.

Nikolas Rose “The Politics of Life Itself”.Nikolas Rose “The Politics of Life Itself”.

““Critical evaluation would have to take other Critical evaluation would have to take other forms than denunciation of reductionism, forms than denunciation of reductionism, individualism and rejection of the social. . . If individualism and rejection of the social. . . If in fact we are in an emergent moment of in fact we are in an emergent moment of vital politics, celebration or denunciation are vital politics, celebration or denunciation are insufficient as analytical approaches”.insufficient as analytical approaches”.

Nikolas Rose and Paul Rabinow. “Thoughts Nikolas Rose and Paul Rabinow. “Thoughts on the Concept of Biopower Today”.on the Concept of Biopower Today”.

The Concept of LifeThe Concept of Life

““For anyone undertaking a genealogical study of the For anyone undertaking a genealogical study of the concept of “life” in our culture, one of the first and concept of “life” in our culture, one of the first and most instructive observations is that the concept most instructive observations is that the concept never gets defined as such. And yet, this thing that never gets defined as such. And yet, this thing that remains indeterminate gets articulated and divided remains indeterminate gets articulated and divided time and again through a series of caesurae and time and again through a series of caesurae and oppositions that invest it with a decisive strategic oppositions that invest it with a decisive strategic function in domains as apparently distant as function in domains as apparently distant as philosophy, theology, politics, and – only later – philosophy, theology, politics, and – only later – medicine and biology”.medicine and biology”.

Giorgio Agamben, Giorgio Agamben, The Open: Man and Animal (2002).The Open: Man and Animal (2002).

Giorgio Agamben and Giorgio Agamben and Bare LifeBare Life

The distinction between zoe and bios.The distinction between zoe and bios. Sovereign power is already based on the inclusive Sovereign power is already based on the inclusive

exclusion of life, it is already biopower.exclusion of life, it is already biopower. Sovereign power incorporates life through the limit-Sovereign power incorporates life through the limit-

figure, who can be included only on the basis of figure, who can be included only on the basis of his or her exclusion.his or her exclusion.

The state of exception in which sovereign power The state of exception in which sovereign power confronts bare life in the form of an inclusive confronts bare life in the form of an inclusive exclusion is increasingly becoming diffused though exclusion is increasingly becoming diffused though different practices and spaces of political life.different practices and spaces of political life.

Giorgio Agamben:Homo Sacer: Sovereign Power and Giorgio Agamben:Homo Sacer: Sovereign Power and Bare Life, (1999).Bare Life, (1999).

What is produced at the centre of a What is produced at the centre of a biopolitics of the individual is a dead biopolitics of the individual is a dead space, a form of “life that does not space, a form of “life that does not live”. live”.

A politics of life reverts to a death-in-A politics of life reverts to a death-in-life.life.

Early Intervention in Early Intervention in PsychosisPsychosis

Susceptibility to develop psychosis is Susceptibility to develop psychosis is based on a probabilistic notion which based on a probabilistic notion which has no biological basis.has no biological basis.

The duration of untreated psychosis The duration of untreated psychosis hypothesis leads to the potential for hypothesis leads to the potential for earlier and earlier intervention in the earlier and earlier intervention in the name of something only minimally name of something only minimally apparent.apparent.

Psychosis itself is an uncertain and Psychosis itself is an uncertain and indeterminate label, which may or may indeterminate label, which may or may not develop, but into what ? not develop, but into what ?

How can the individual situate him or How can the individual situate him or herself in relation to such a form of herself in relation to such a form of biopower ?biopower ?

Fate and BiologyFate and Biology

““Biology is no longer blind destiny, or Biology is no longer blind destiny, or even foreseen but implacable fate. It is even foreseen but implacable fate. It is knowable, mutable, improvable, eminently knowable, mutable, improvable, eminently manipulable”, Rose and Novas,(2003).manipulable”, Rose and Novas,(2003).

““Fate as the definite ineluctability that Fate as the definite ineluctability that springs from an essential indefinability”, springs from an essential indefinability”, Alexander GarcAlexander García Düttmann, ía Düttmann, The Memory The Memory of Thought, (2002).of Thought, (2002).

The process of self-The process of self-formationformation

What is not allowed into discourse What is not allowed into discourse and recognition by biopower.and recognition by biopower.

What is the process of self-reflection What is the process of self-reflection through which subjectification takes through which subjectification takes place. place.

There is an experience of loss and There is an experience of loss and domination at the heart of a domination at the heart of a subjective experience that is identified subjective experience that is identified through a reduction to its biological through a reduction to its biological life and supposed potential.life and supposed potential.

CritiqueCritique

Any critique of the biopower of psychiatry Any critique of the biopower of psychiatry needs a concept of individual suffering, of needs a concept of individual suffering, of what is lost through the formation of a what is lost through the formation of a somatic individuality.somatic individuality.

The subjective experience of madness is The subjective experience of madness is not exhausted by an analysis of the not exhausted by an analysis of the discourses and practices of psychiatry.discourses and practices of psychiatry.

We need an understanding of power as We need an understanding of power as domination and exploitation as well as of domination and exploitation as well as of the productivity of power.the productivity of power.