states between the two. A London psychiatrist by the name of John Conolly, who in the middle of the nineteenth century did a lot for the humane treatment of the mentally ill, wrote in 1830 that very often individuals were locked up in lunatic asylums out of ignorance and failure to understand them. This could have disastrous consequences: “A man of undisturbed understanding, suddenly surprised by the servants of a lunatic asylum, with handcuffs ready, and a coach waiting to carry him off, would infallibly exhibit some signs, easily construed into proofs that he was ‘not right in his head,’” adding: “Once confined, the very confinement is admitted as the strongest of all proofs,” and visitors would tend to project (to use a modern term) certain symptoms of madness onto the persons in question — symptoms that in reality were nonexistent (Conolly,
An Inquiry Concerning the Indications of Insanity
, 4–5). Besides, he adds, those who are locked up among real madmen can easily lose their minds. And a hundred years later, at a time when systematic clinical psychiatry was gaining ground and the scientific way of looking at things was developing explosively, Freud wrote at the end of his career: “We have seen that it is not scientifically feasible to draw a line of demarcation between what is psychically normal and abnormal; so that that distinction, in spite of its practical importance, possesses only a conventional value” (
An Outline of Psycho-Analysis
, 195), and when he asserted that “a knowledge of the neurotic illnesses of individuals has been of good service in assisting understanding of the great social institutions,” then, without having traversed that path himself, he outlined the methodological horizon for dynamic psychiatry: madness is not just a cluster of physical or psychological symptoms but also an autonomous interpretation of existence.
It is understandable that the scientific frame of mind is not inclined to make that view completely its own — not only in connection with diseases in general, but even regarding mental illness. Melancholia has always been accompanied by somatic symptoms (usually described similarly from Hippocrates through Diocles of Carystus to the present day), but unlike the medical science of antiquity, the Hellenistic period, or the Renaissance, the so-called nosological trend of modern psychiatry, oriented to brain pathology — in compliance with an interpretation of reality that is mesmerized by facts — perceives symptoms primarily as symptoms of the body, in a strictly defined sense, that is, it tries to derive the disease from the body itself, not from the broader context, the study of which characterized old-style medicine and is not alien to modern dynamic psychiatry, the Daseinsanalytical school, or psychosomatic medicine. In the first half of the eighteenth century, Friedrich Hoffmann held the view that melancholia was the result of a physiological change in the brain, a kind of status frictus, whereas Anne-Charles Lorry, in the latter half of that century, attributed it to a change in the nerve fibers. In 1804, the French physiologist Pierre Cabanis posed the poetic question: “How could [physicians] soothe that ruffled mind, that soul consumed by persistent melancholia, if they did not take notice of the organic changes that may cause such mood disorders, and to which functional disturbances they are connected?” (Cabanis, Coup-d’oeil sur les révolutions et sur la réforme de la medicine, 346). By the mid-nineteenth century, Wilhelm Griesinger was claiming that every mental illness was a disease of the brain. But if one takes into consideration that he reached this conclusion before the explosive development of research into the nervous system, the suspicion arises that it was just a matter of faith, of a supposition that empirical science has been unable to prove satisfactorily down to the present day in the case of endogenous psychoses, the commonest species of psychiatric diseases. That same faith was also given expression by Kraepelin and Carl Wernicke, and Hugo Münsterberg articulated it in 1891 almost as a moral dictum for medical science: “Breaking down the totality formed by the contents of consciousness into its elements, in establishing combinatory laws and particular combinations of these elements, and in seeking empirically, for each elementary psychic datum, its concomitant physical stimulus; in order indirectly to explain by the causally intelligible coexistence and succession of these physiological excitations, the combinatory laws and the combinations of different psychic data which are not explainable from a purely psychological point of view” (quoted in Wilhelm Dilthey, Ideas concerning a Descriptive and Analytic Psychology, 49). But medical science has failed so far to find an unequivocal, demonstrable correspondence between changes in the central nervous system, the mind, and the soul, nor has it managed to reveal the relationship between physical and psychological processes. The supposition that with the assistance of the electroencephalograph it would be possible to get nearer to the riddle of so-called endogenous psychoses, which may be independent of external causes, has not been fulfilled; though certain mental abilities or changes can be localized, others (mania, depression, illusions) cannot be. And even if the ability to concentrate, the loss of memory, or disorientation could be localized, the switchover of the body “into the mind” would remain a mystery. Certain physical lesions and changes can be coupled with the melancholic-depressive symptom cluster,5 although no evaluable pathomorphological changes are detectable. A mutual change in body and soul is not regular and absolute: this is a myth that somatic-oriented medical science dreamed up in order to conceal the ultimately unexplained and inexplicable nature of the relationship of body and soul. After all, it can be in God’s power only to make definitive pronouncements about human existence, which is surpassing itself time and time again. The admission of such inexplicability would radically undermine not just nosologically aligned medical science, but also the mentality of the current time, existing as it does under the spell of a practical universe. The instrumental mind seeks instant answers, but in spite of medicine having a degree of efficacy, it is unable to answer the most fundamental question, namely, what kinds of psychophysiological processes take place within an organism under the influence of drugs. It is a self-contradiction of nosologically directed psychiatry, which is exclusively concerned with pathological forms, that it believes in matter in roughly the same way that medieval medicine believed that illness was the devil’s work. Faith in matter, especially since it has not managed to clarify satisfactorily the problem of the materiality and intellectuality of the human body, is a sort of tacit religiosity, a diabolic theology, and it is related to the modern undertaking of pushing God off his throne. This undertaking regards existence as an ultimately decipherable chain of practical connections, and believes that it is able to explain all the riddles in the world without any reference to God. Tamás Nyíri6 indicated the self-contradictoriness of this way of thinking, which could be characterized as a perverse theology:
Those who assert that all that exists is material, which in their opinion is the sole reality, ought to be asked what they mean by material. If the objects recognized by the senses are called material, then they are not talking about material but about various individual experiences, and they do not offer an answer to the question as to why they are being collected into a unified concept. Those, however, who assert that material is everything that exists objectively are doing nothing more than use the word “material” to designate whatever exists. Although that assertion is not false, it is nevertheless a nuisance, because it smuggles back the assumption that only what is perceptible to the senses exists.