Какво е лудостта?

by Darian Leader, Дариън Лийдър

„...Вниманието към уникалното у всеки пациент, заложено в психоаналитичния подход, става още по-важно именно сега, когато живеем в общество, оставящо все по-малко пространство за детайла и стойността на индивидуалния живот. Въпреки повсеместното празно прокламиране на уважение към различията и разнообразието, от детската градина до коридорите на професисионалния живот, днешният човек бива заставян повече от всякога да мисли по унифициран начин. Това намира отражение и в света на психичното здраве където лечението се гледа като на някаква почти механизирана техника която се прилага на пасивен пациент, а не като на взаимно сътрудничество при което всяка от страните носи отговорност..."

Дариън Лийдър е практикуващ лаканиански психоаналитик, почетен професор по психоанализа в Роухемптън Юнивърсити, бивш президент на Колежа на психоаналитиците в Лондон, основател на Центъра за фройдистки анализи и изследвания, автор на множество публикации в сферата на психоанализата и изкуството и на над десет книги, сред които „Строго биполярно", „Ръцете: какво правим с тях и защо", „Защо не можем да спим", „Обещанията, които двойките си дават, когато вече е късно", „Защо хората се разболяват?" и издадените на български език „Новото черно. Траур, меланхолия и депресия" и „Какво е лудостта?".

Като дългогодишен колумнист във в. „Гардиън" той третира най-вече теми, свързани с психичното здраве (биполярността, депресията, лудостта, проблемите със съня и др.), критикувайки остро съвременния прибързан подход към „поправяне" на индивида и лечение на отделните симптоми. Във всички свои текстове той насочва вниманието към необходимостта от вслушване в личната история на човека и цялостното му възприемане.
В статиите и книгите си, наред със строго психоаналитичните изследвания, Дариън Лийдър проучва в дълбочина и наглед прости въпроси като "Защо жените пишат повече писма, отколкото изпращат?", "Кражбата на "Мона Лиза": какво изкуството не ни позволява да видим", „Ругатните и тяхната история" и др. като умело илюстрира сложните психоаналитични понятия с клинични случаи и примери от киното, изкуството, литературата, антропологията и други сфери.

Както самият Лийдър нееднократно подчертава, важно е придържането към въпросите, а не боравенето с готови отговори.

Genres: Psychology, Psychoanalysis, Nonfiction, Philosophy, Psychiatry, Mental Health, Ebooks

460 pages, Paperback

First published October 1, 2011

About the author

Darian Leader is a British psychoanalyst and author. He is a founding member of the Centre for Freudian Analysis and Research (CFAR).

Darian Leader is President of the College of Psychoanalysts, a Trustee of the Freud Museum, and Honorary Visiting Professor in Psychoanalysis at Roehampton University.

From Wikipedia:http://en.wikipedia.org/wiki/Darian_L...

Reviews

[Tiago F · Rating 5 out of 5]

Darian brilliantly explains the nature of psychosis, the cosmology of meaning and symbolism in any given individual. It touches on the difference between being mad and going mad, the first which is totally compatible with daily living until a specific trigger causes an outbreak. It relies heavily on Lacanian psychology for most of the book, which I personally appreciated. It gets a little bit heavy at times, and I imagine to be difficult to read if one isn't familiar with traditional symbolism and psychoanalysis, but the examples at the end of the book, try to give specific cases on how pathology is created and manifested. Certainly a useful and interesting book for anyone in the field of psychiatry.

[Nik Maack · Rating 2 out of 5]

Chapter one: Psychiatry is silly. Medications are invented and then a disease is looked for, that they can "cure". The DSM manual is written by insurance companies and focuses on superficial symptoms instead of underlying causes. The whole medical model of mental health is bogus.

Chapter two: The oedipal complex is real and it is the underlying cause of psychosis. With this established...

What the heck?

With that, we're thrown into a world of analyzing crazy from a psychoanalytic perspective. It's profoundly odd that the author carefully critiques the drugging of the crazy, but then gives psychoanalysis a free pass. His bias is writ large.

And I say this as someone who was in psychoanalytic therapy for ten years: come on, man, do you really believe all this garbage? It reminds me of the joke about the devouted Christian who believes everything in the Bible -- even the parts that contradict each other. Darian Leader is that kind of psychoanalytic fan.

There are some really great chapters about how people struggling with psychosis can adapt, creating new structures for their thought. Is a delusion an attempt at saving oneself? Is a lack of identity the core, and the delusion is an attempt to protect that?

But the author says, you're one with mom, then you notice you can't satisfy her alone, something else has her interest, and then you realize dad exists. And somehow, not working through this properly (he seems to be saying) can make you psychotic. Not as a baby, but it will be triggered later in life.

While I fully believe early experiences in our childhood shape our entire lives, some of the stuff in this book just goes way beyond belief.

I love case studies. Which is why it's ironic that I quit reading this book in the middle of one (somewhere after 200 pages of reading). With all the psychosis in the world, why focus on dusty old cases analysed by Freud? The Wolf Man? Really? No wonder psychoanalysis gets accused of being a literary practice, and not a medical one.

Freud speculates (with zero evidence) that the wolf man saw his parents having sex when he was one and a half (!) and this leads to his problems later in life. Does anyone really remember anything from when they were one?

I couldn't take this seriously, and at this point I walked away from the book.

Reading the text, I can agree with a lot of it. Maybe psychoanalytic processes can work with psychosis. Sure, it takes way more time and effort -- okay. Maybe delusions are dreams, and can be worked as dreams. But tracing all of this back to the oedipal complex seems insane. And the author's dogmatic certainty in the theory is embarrassing -- particularly after he takes the time to carefully debunk the medical model.

I have bad news, sir: many people have tried to debunk psychoanalytic theory. Perhaps instead of presenting it as factual, you could admit you're living in a glass house with a lot of broken windows.

[nemėgstu filosofijos · Rating 5 out of 5]

Apie Darianą Leaderį išgirdau 2014 metais, pažiūrėjus filmą "20000 Days on Earth", kuriame jis vaidina Nicko Cave'o psichiatrą. Sužavėjo, kaip jis neaistringai linksi reaguodamas į Cave'o sapaliones, o vėliau, po 6 metų, išgirdau, kad leidykla "Jonas ir Jokūbas" (dabar Phi knygos) išleido jo knygą "Kas yra pamišimas?", nedelsdama pagriebiau ir per kelias dienas surijau. Žinodama tik Freudo teorijos pagrindus, o apie Lacaną -- nieko, dėl knygoje pasitelkiamų įvairių šaunių empirinių pavyzdžių kaip, pavyzdžiui, Shipmannas išžudo galybę žmonių, galėjau užčiuopti minėtųjų filosofų teorijų pulsą, nes pavyzdžiai ir teorija puikiai koreliavo, vienas kitą papildė. Laukiu leidžiamų kitų autoriaus knygų (kaip "New Black", "Strictly Bipolar") bei, galbūt pandemijai atslūgus, pačio autoriaus Lietuvoje.

[Kaya · Rating 4 out of 5]

An interesting psychoanalytic account. Only for those with a backbone for Lacan.

[Monika Bertašiūtė · Rating 5 out of 5]

Manau, kad tai labai gera ir naudinga knyga žmonėms, norintiems suvokti arba bent pamėginti suvokti psichozės fenomeną. Dorian Leader aprašo pamišimo priežastis bei etapus. O labiausiai atveriančiu faktu tapo tai, jog kartais žmonės savo psichozės net nepastebi. Nors knygos leksika ir nėra iš lengvųjų, manau, kad apie psichikos sveikatą reikia skaityti iš esmės, mat pavieniai straipsniai dažnu atveju neatskleidžia problemos kompleksiškumo.

[Vicky · Rating 2 out of 5]

If you are already very interested in psychoanalytic theory then this book will be good for you. It's not an easy read and requires an acceptance of some of the most convoluted elements of psychoanalytic thinking to really get 'past go'. The chapter on Shipman I found the most accessible and interesting.

[Rowan · Rating 3 out of 5]

I this was useful background reading, but not being used to psychology books, I found the explanations through case histories voyeuristic and deeply saddening.

[Dmitrij · Rating 3 out of 5]

Puiki knyga, siaubingas vertimas.

[Nora · Rating 5 out of 5]

"...la gente puede "estar" loca sin "volverse" loca."

[Berna Labourdette · Rating 4 out of 5]

Otra obra maravillosamente bien explicada de Leader sobre la locura (acá destaqué las otras que he leído, todas excelentes: Estrictamente bipolar y La moda negra: Duelo, melancolía y depresión donde hace un análisis principalmente sobre la neurosis y la psicosis, con muchos ejemplos clínicos e información sobre autores que han tratado el tema como Lacan, Freud o Jaspers.

[Lindsay Cornette · Rating 4 out of 5]

Wat is waanzin? Onbegrijpelijk wat er in het hoofd afspeelt van een persoon geconfronteerd met waanzin.

[Rajlakshmi Upadhyaya · Rating 5 out of 5]

Truly eye opening

[Bere Tarará · Rating 5 out of 5]

Excelentemente documentado con decenas de ejemplos. De lenguaje accesible y presenta una interpretación diferente a la actualmente imperante con respecto al desorden mental

[Fernanda · Rating 3 out of 5]

“A pressão para que muitos profissionais de saúde mental de hoje simplesmente monitorem a medicação agrava essa situação. Garantir que o paciente tome seus remédios e ficar atento aos efeitos colaterais das drogas antipsicóticas podem convencer os clínicos de que, efetivamente, há um tratamento sendo feito, e de que, portanto, as horas adicionais de contato não são essenciais. O efeito colateral mais grave da medicação, nesse caso, é a tentação, para o médico, de deixar que os remédios sejam suficientes.
Isso não significa que, em algumas situações, os medicamentos não possam ser úteis. Não há dúvida de que, em certos casos, eles podem atenuar a intensidade dos fenômenos psicóticos, mas também devem servir para estabelecer uma plataforma para o diálogo. Quanto maior o espaço fornecido para a terapia regular, mais esse uso de medicamentos poderá diminuir, e vale a pena pensar na prescrição de tranquilizantes mais leves, e não no recurso imediato aos neurolépticos, que comumente ocorre no início do tratamento. Sem isso, graças aos efeitos difundidos e nocivos do uso prolongado de drogas, a ideia da psicose como uma doença cerebral crônica e irreversível torna-se uma profecia autocumpridora.”

[Sam Eccleston · Rating 3 out of 5]

An intriguing account in which classical psychoanalytic categories are favourably compared with contemporary ‘medical model’ approaches to the understanding and treatment of psychosis. While sympathising with his critique of the medical model, and finding his contentions about the nature of psychosis and it’s relationship to a (somewhat modified) Oedipus complex interesting, I was nevertheless struck by the somewhat ad-hoc nature of much of the theorising. Connections were drawn to be sure, sometimes convincingly, but too often I wondered how such contentions would be falsified or shown to be preferable to similar alternatives. This is not to condemn Leader, it may simply be that given the obscurity of the inner lives of others, this is the best we can do. However, I do feel that an equally interesting and compelling account could be made by a relevantly placed professional arguing for the opposite conclusions. Where does that leave treatment and intervention, or indeed theory? Hard to say.

[Aivaras Žukauskas · Rating 3 out of 5]

Labiau 3,5. Geras (ir svarbiausia - paskaitomas) intro į lakaniškąją psichoanalizę, kuris kartu yra ir neblogas argumentas prieš medikamentinį psichozės gydymą, kuriuo taip mėgstama remtis šiandien. Na, ir aišku, visada smagu suvokti, jog ir pats esi kiek išprotėjęs. Tačiau, kaip teigia pats Leaderis, išprotėjimas yra visiškai normaliai suderinamas su kasdieniu gyvenimu - problemos prasideda, kuomet einama iš proto. Aktuali ir vertinga knyga mūsų visuomenei.

Grammar nazi pastaba lietuviškam vertimui: pasirinkta autorių ir atvejų vardų ir pavardžių vertimo sistema yra tiesiog didingas "bardakas".

[Augustus · Rating 4 out of 5]

Very interesting and informative about the way the mind works
Explains the way I feel

But strange that these psycho-analysts have no cure. Their efforts seem to have no help for their patients at all.

[Rodrigo Sanesc · Rating 5 out of 5]

It's a great book it really opens the perspective of the view of psychopathology . It was a bit too lacanian for my style, never the less is a brilliant book.

[Mikael · Rating 4 out of 5]

unlike many other reviewers, i quite like the far-fetched lacanian psychoexploratory hypotheses.

[Darci Marcondes Filho · Rating 5 out of 5]

Excelent book. Thank you Darian Leader. Obrigado Vera Ribeiro pela tradução perfeita.

[Michael Pennington · Rating 2 out of 5]

Problematic. Marketed as popular science : it isn't. It's an academic treatise and far too technical for the layman. It just went over my head for the most part and I couldn't wait to finish...

[Gailė Ne · Rating 2 out of 5]

Totally not what I expected. Extreme psychoanalysis is not my cup of tea.

[Andrew Diamond · Rating 3 out of 5]

Leader writes of Western Culture's current failures to define and treat madness. Western nations currently aim to treat the symptoms of psychosis and to bring the patient's behaviors into line with social norms without understanding or treating the roots of the disease.

Many "symptoms" of psychosis, Leader argues, are actually not symptoms of the underlying disease but adaptations the patient makes to try to adjust their understanding of the world to how the world actually works. The disorders listed in the DSM and the symptoms that define each disorder seem to be defined by the pharmaceutical companies that have a drug to treat each symptom.

Leader distinguishes between going mad and being mad, remarking that some psychoses have no symptoms until something triggers them. The symptoms can go into remission once the triggering event has passed, but that does not mean the psychosis has disappeared. It just continues to exist in a form that doesn't alarm the neighbors.

Leader examines three famous cases of psychosis, or potential psychosis, including Lacan's Aimee, Freud's Wolf Man, and the British serial killer physician, Harold Shipman, who murdered 250 of his patients. The case of Aimee is especially interesting and makes me want to read Lacan's original writing on the subject. I found the entire Wolf Man chapter annoying because I find Freud annoying. How can such an astute observer as Freud insist on bending all interpretations to his pet theories? The final case, Shipman, is simply baffling. He seemed to want to take his secrets to the grave.

The final chapter, Working with Psychosis, is fascinating for its description of what it's actually like to work with psychotic patients. The author reiterates that one of the most important aspects of treating psychosis is to understand what symbols, events and ideas actually mean to psychotics, and to help them build meaning that they often can't seem to build for themselves. This is a task that requires years, if not decades of work. It's not profitable to the drug companies or to insurers or hospital chains, so it's not a type of treatment we pursue.

The afterword is also interesting for its summary of recent Western attitudes toward mental illness. In the US, in the early twentieth century, many states prohibited the mentally ill from ever marrying. Some wanted to forcibly sterilize the mentally ill. There was even a movement in the US to exterminate the insane, in the name of eugenics, to improve the human gene pool. That plan didn't quite take off in the US, but the Nazis picked it up, just as they picked up toxic rhetoric and discriminatory laws against American Blacks and applied them to European Jews.

I sometimes think we live in a unique age of social and political insanity, but Leader's afterword these strains of nastiness have run through Western civilization for quite some time.

[uglygooseling · Rating 5 out of 5]

This book sets out to explain what madness, or psychosis (these words are used interchangeably by the author), is, in a uniquely accessible way. Starting from rejection of multiplying diagnoses of the modern day and time, Leader asks questions about underlying structures of psyche as well as places of their possible breakdowns, and posits madness as a question of failure to integrate or interpret meaning.
He dedicates a fair share of the book to discussing “quiet”, everyday madness that has not erupted – or potentially will never erupt – and hence has not acquired a plethora of loud, noticeable symptoms. Madness, he says, is usually compatible with “normal” life (analysing, among others, the case of Harold Shipman, british serial killer), and understanding this helps us understand how to proceed and care for those, whose psychosis has been triggered. Interestingly (and contrary to general knowledge and common sense), Leader states that the noticeable, “loud“ symptoms of a triggered psychosis usually point to the attempts of psychotic subject to cure themselves, and not to the root of the illness.
The book is full of case studies and examples of direct speech – something, Leader says, is missing from the majority of modern psychiatric literature or therapy reports. Instead of seeing the therapist as a figure of authority, as an expert, who aims to provide their patient with one-size-fits-all algorithmic treatment, he believes that patient and therapist must be working together, as colleagues, on mending the breakdown of meaning. It was Lacan who said that therapists must be “secretaries to the insane”. And after reading this account of what madness is, I incline to agree on this with both Lacan and Leader.

[أحمد · Rating 5 out of 5]

حضرت محاضرة لداريان ليدر عن حالات الذهان
واعجبني طريقته في فهم الأعراض وكيفية تطور الحالة حتي تصل الي الأعراض الغير مفهومة
عمل داريان ليدر يناقش من زوايا جديدة المرض الذهاني ويطرح رؤية جيدة جدا لتطور واسباب الذهان
يعرض الفارق بين الحالة الذهانية (ان تكون افكار الشخص ذهانية) وبين ان يتصرف الشخص بشكل ذهااني

يتحدي الكتاب فكرتنا السائدة عن الجنون
وهو حالة اللامعقول بالنسبة للفكر السائد
ويطرح فكرة مقابلة ان الجنون معقول جدا في إطار تطوره وظروفه
يدمج بين رؤية "بيون" لتطور الأفكار الهائمة والمجنونة نتيجة عدم احتواءها في الطفولة (Beta Elements) مع افكار لاكان عن غياب الهيكل النفسي القادر علي قولبة الأفكار
اعجبني خاصة الفصل الخاص بأسباب الذهان Causes of psychosis
وهو محاولة جادة لتطبيق اساليب التحليل النفسي علي حالات الجنون
عمل رائع وشجعني علي متابعة الكاتب وافكاره

[Fatih Ö. · Rating 5 out of 5]

As someone interested in Lacanian psychoanalysis, this book was perfect in its excesses of examples. If you have started reading Lacan like me, you will be invaded with many difficult concepts and initially relatively few examples.
Here, you will find the opposite : Darian Leader manages to use few Lacanian jargons and shows you the clinical and conceptual application of psychotic subjects.
The study of psychosis brought another aspect to understand neurotic "normal" people: You can see the contrast to the repressing neurotic subject by seeing the situations if some mechanisms did not go as intended.

[Paul Ataua · Rating 4 out of 5]

Darian leader undertakes an exploration of nature of psychosis, what most would consider to be what madness is. It is an interesting attempt in which Leader, relying heavily on the work of Jacques Lacan, tries to give a psychoanalytical explanation of psychosis that will be comprehensible to the laymen. That is, of course, an almost impossible task, which has much the same difficulty level as explaining quantum physics to the non-scientist. If you have a little background in Freud and Lacan, however, it is a good read, albeit at times it does overuse example stories where explanations might have been more appropriate.

[Yahya · Rating 5 out of 5]

Leader bu kitabında psikoz sorununu derinlemesine ele alıyor. Hem teorik olarak hem de vakalarla bana göre çok güzel ortaya koyuyor. Tabii tüm bunları psikanalitik gelenekten yola çıkarak yapıyor. Bu kitapta okuduğunuz tüm teori ve uygulamalar Freud ve ağırlıklı olarak Lacan geleneği ile ele alnıyor. Okumak isteyenler bunu bilerek okusun. Temel düzeyde en azından Lacan'ın psikanalizine biraz hakim olmak gerekiyor. Zaten kitap bizde Lacancı Bakışlar Dizisi adı altında çıkmış. Dizinin ilk kitabı bu. Ben dilini oldukça beğendim ama alana uzak olan için kavramlar ağır olabilir. Alanın içindekiler içim oldukça akıcı bir dili var.

[Joanne R. · Rating 4 out of 5]

3.5 (rounded up to 4)

The overarching message (criticizing common views of madness and the ways society fails over and over again to address mental conditions with empathy) is clear and worth thinking about, especially amidst a culture that is all too easily dismissive and superficial regarding those mental conditions. He only lost me at some parts where he would [seem to] equate some things with psychosis, such as gender dysphoria or George Cantor's theories on Shakespeare, but seeing as how sympathetic he is to these people regardless tells me that he doesn't view them as "wrong" per se. Giving him the benefit of the doubt on this one.

[sHuysmans · Rating 4 out of 5]

Eindigend met de casus van dr. Shipman (Heeft ongeveer 300 mensen vermoord) waarin Leader misschien toch iets te graag wilde aantonen dat ook dit 'Stille Waanzin' was. Het laatste stukje is eerder beschouwend: Hoe ga je nu eigenlijk met psychose om - best niet veroordelend, niet leidend en vanuit een trachten en willen te begrijpen. Mooie synthese.

Globaal wel goed boek dat de zuiver biologische psychiatrie soms terecht een spiegel voorhoudt en goede wenken aanbiedt om beter met psychose overweg te kunnen. Ook de casuïstiek is goed gekozen. (Wel iets te veel Lacan naar mijn zin.)