In my last post I quoted from Loren Mosher’s resignation letter from psychiatry without saying much about it. Mosher was the man who founded the Soteria Model of care for the mentally ill. Mosher was born and raised in the sun drenched world of California that would suffuse his essentially optimistic take on mental health care. Mosher died in 2004 after having made significant contributions to our understanding of the care for the mentally ill. His most crucial intervention was Soteria.
Imagined as an alternative to psychiatric hospitalization the soteria model remains one of our only well thought out non-psychiatric options. Mosher’s career was distinguished and impressive reaching the kind of heights a nurse-prole like me will never reach. Among the most transformative of these must have been the time he spent with RD Laing in the Tavistock Clinic. Whilst there he had the chance to work with Laing and to observe, participate and learn from the experience of the infamous Kinsley Hall experiment.
Soteria House opened in San Francisco in 1971 with the explicit purpose of seeing what would happen if one provided a supportive environment for people diagnosed as schizophrenic that did away with any and all psychiatric drugs. In 1971 psychiatry had already been more or less fully converted to the biological orthodoxy that is only beginning to crumble today. Biopsychiatry continues to be dominant despite the fact that it is moribund and that such alternatives exist.
Two years after admission to Soteria House the residents were assessed and compared with baseline measures and a “treatment as usual” group. Astonishingly even to Mosher the two year follow ups revealed that residents who has received no medication and who had been expected to deteriorate at admission had done better than either their peers in the House or in the treatment as usual control group. The control group was composed of people receiving psychiatric drugs on a psychiatric ward as almost every other schizophrenic would.
If evidence-based psychiatry was all it was cracked up to be then the biopsychiatric orthodoxy would have vanished right at the moment that it was coming into ascendence. Instead the neoKraeplinian orthodoxy steamrolled over Mosher’s discoveries. The reasons aren’t difficult to speculate on when one considers what Mosher thought his experiment did to the very category of schizophrenia. In his view Soteria had conclusively
demedicalized, dehospitalized, deprofessionalized, and deneuropoliticized what Thomas Szasz has called “psychiatry’s sacred cow” schizophrenia.
As Phil Barker and Poppy Buchanan Barker hold in their work The Tidal Model, Mosher had taken the experiments conducted by Laing and others through the Philadelphia Association, at Kingsley Hall and other sites, and effectively institutionalized them into an astonishing machine for compassionately caring for those driven mad by the experienced structural realities of capitalism exacerbating the traumas of consciousness itself. In an analysis of Soteria House Mosher and his colleague John R Bola identified that
a relationally focused therapeutic milieu with minimal use of antipsychotic drugs, rather than drug treatment in the hospital, should be a preferred treatment for persons newly diagnosed with schizophrenia spectrum disorder.
Yet we can argue what the Soteria model actually aims for to ascertain whether it is a viable mode of withdrawal for us. In their analysis Mosher and Bola make clear that much of their success came from the development of a therapeutic milieu that operated as ‘a surrogate family for clients in residence’. This leaves the Soteria model open to the critique of Oedipalisation that merely returns the schizophrenic to the egoic personological structure that the schizophrenic break is a rupture in and away from. From the perspective of Oedipus-critique the familial model of the House would return the schizophrenic to the conditions from which his symptoms enact an extreme psychic escape. If he survives he will simply be reinserted into the capitalist machinery and expected to go back to his functioning as a piece of the living anatomy of the machine. Such is the critique of Deleuze and Guattari of the personological “coming back to oneself” that RD Laing had envisaged in Kingsley Hall and wrote about consistently in his work.
Yet one wonders if it was Laing’s hand-on approach that allowed him to talk of a return to the personological structure. As Mosher himself says of the Kingsley Hall experience
The deconstruction of madness and the madhouse that took place there generated ideas about how a community-based, supportive, protective, normalizing environment might facilitate reintegration of psychologically disintegrated persons without artificial institutional disruptions of the process.
The idea that the personological structure is disintegrating in the schizophrenic process is crucial when our own society is increasingly marked by a generalized state of post-traumatic depresonalization and derealization. We are all coming apart at the seams here. As survivalism grips us we become more groupish and turn to mutual aid to survive. At the same time there are those who engage in the parasitic psychopathic function of getting all they can without any effort or risk. These heightened individualists look groupish and seem to be engage in mutual aid but it’s all feigned in order to get what they can while the going is good. Some people have suggested that the psychopathic strategy is one incredibly well suited to capitalism (cf Robert Hare in Snakes in Suits). So even if we’re not “all schizophrenic now” we may well be witnessing an increase in psychopathic traits. Schizophrenia and psychopathy have very little in common besides divergences in embodied experience and disassociation but with that said they are both fundamentally departures from the integration of personological structure.
In Deleuzo-Guattarian territory we might celebrate this dissolution of the ego as a promising development towards the liberation of molecular schizoflows of creativity. All of which is good because
schizophrenia is the exterior limit of capitalism itself or the conclusion of its deepest tendency, but that capitalism only functions on condition that it inhibit this tendency, or that it push back or displace this limit… Hence schizophrenia is not the identity of capitalism, but on the contrary its difference, its divergence, and its death (246).
I don’t wish to position some banal dualism here. I am not going to say schizophrenia=good/psychopathy=bad. The breakdown of the semiotic chain in the schizophrenic speech is evidence of some kind of liberation from the imposition of the master signifier that structures psychic development and therefore plays an integral role in subjugation under capitalism. The schizo refuses to be Oedipalized and as such frustrates capitalism and the psychoanalyst. Escaping from the paternal function the schizo has no commanding anchor that can serves as the cornerstone of psychic organization. Essentially, there is no organizing function that can tie all the information with which the schizophrenic brain is bombarded and therefore no ego develops. Here is an image of freedom. Of course Deleuze and Guattari caution not to go too far but they never suggest that we should come back either.
If countless neuroscientists are correct then the personological structure is an informational illusions generated to orient the organism to its environment. This is an adaptive feature of the organism that has developed in relation to the physical and increasingly the semiotic environments. As Farah and Heberlein have contended in their survey of the neuroscientific evidence the entire illusion of personhood (the personological structure) evolved in order to assist a highly social species in mapping, predicting and navigating those environments with the sole purpose of the survival of the organism and successful genetic transmission. Farah and Heberlein swing close to psychology’s attribution theory when they suggest that the personological was fabricated by the successes of ancestral early adopters in attributing agency to other bodies. In order to do this they suggest that those ancestors attributed beliefs, desires, motivations to other humans and nonhumans. The entire tradition of animism appears as the accident of the mis-attribution of aspects of personhood to nonpersons. If this thesis is correct it is also necessary that we say (in a paraphrase of Lacan) that every attribution is a mis-attribution. This includes all attributions that are organizationally anchored to a self/ego/person at the core of our own experience of ourselves. In the view of things elaborated by Thomas Metzinger
The illusion is irresistible. Behind every face there is a self. We see the signal of consciousness in a gleaming eye and imagine some ethereal space beneath the vault of the skull, lit by shifting patterns of feeling and thought, charged with intention. An essence. But what do we find in that space behind the face, when we look? The brute fact is there is nothing but material substance: flesh and blood and bone and brain…You look down into an open head, watching the brain pulsate, watching the surgeon tug and probe, and you understand with absolute conviction that there is nothing more to it. There’s no one there.”
For the anti-Oedipalism of Deleuze and Guattari the schizophrenic is coterminus with capitalism. The schizo-flows and processes are the same as those of capitalism understood as a tendential movement of decoding and/or deterritorialization. In their rush to escape the individualism of psychoanalysis and its adherence to the dominance of the symbolic order, Deleuze and Guattari eschew the phenomenological illusion of personhood as the outcome of pre-personological processes of subjectivation. In this they are no different from any of the other theorists of French Theory. It is only in their insistence on some impossible amount of schizophrenic liberation that doesn’t collapse into the black hole of a psychotic despair that they differ from the others. It sounds radical: the schizo is the liberation of the subjective processes from the egoic and familial prisons that always suffocate them.
Yet how does one achieve the goal? They will give all kinds of operative guides on how to become a body without organs but it is almost as if the pair have never met a schizophrenic. Of course there are good psychotic experiences, desirable and sought after, but these tend not to be those that come to the attention of a psychiatrist like Guattari. It is baffling that he could be party to the deployment of metaphorical schizophrenia intended to destroy metaphor whilst forgetting the suffering of the real schizophrenics he worked with at La Borde.
The phenomenological personological illusion is already itself an hallucinatory experience generated by ancestral need and the glitch in the system that creates a depth interior when confronted with a surface arrangement “like me”. There is in fact no ego except the false appearance of the ego.
If the neurosciences are correct then we are forced to consider that Deleueze and Guattari’s interesting but dangerous deployment of schizophrenia as the disease of capitalism is fundamentally wrong. If it is wrong then we have to ask what it is that Deleuze and Guattari are playing at. They caution- oh we don’t mean all this literally. Cool. Great. So why say it. The metaphorical purchase is lost the moment one points to, say, dementia and remarks that actually the loss of the person illusion is fucking awful. Risking the personological illusion risks the organism just shutting down. It forgets to eat, forget how to walk, and is left without a mode of structuring temporality so that each and every moment that it assembles is a new and intense horror.
There are other modes of egolessness of course. There are the mystical experiences and the psychedelic induced states. There are those experienced by people who have undergone a biological “explosion” such as UG Krishnamurti, although even he is unable to exist outside of the community of selves that language consistently induces. In fact UG would persist in all his talking that there was no person or ego or self to escape. One simply had to stop. To try to escape the self was a “self-centered activity” that only perpetuates the self.
The criticism of familialism that we began this line of thinking with might well hold in many respects, but it neglects the sociality of humans and the way that “family” might be our best metaphor for various group organizations. Is it impossible that Soteria House could have occasionally become a subject-group? It’s difficult to know from here, so long after the experiments are over.
Besides, we are interested in an implosive politics. Who gives a shit about the family and all of that? Who cares whether we’re dissolving our non-existent egos? I assume we do. And so in treating these illusions as realities, in continuing to misrecognise ourselves as something or other at all, we are perpetuating the very structures that we’re seeking to withdraw from. Our passivity is still not passive enough/still not active enough.
As our technologies progress and we become open to the shamanic and the gnostic and all these much older healing escapological protocols we might look to the evidence. Soteria seems to undo the destructive work. What if we just never left? The Invisible Asylum that one never left- the sanctuary that was one’s whole life. If the personological illusion is an illusion then the transpessimist gamble must be that we are going to be able to play with the structure of that illusion with a high degree of specificity and a high degree of potency soon. The material neurological infrastructure of our experience is the domain that must become open to us so that we can play with what might then really be an infinitely plastic personhood. Among these options will exist that state of ego-death of UG Krishnmurti and others. But it might also include borgified distributed consciousness. It might also include the final deactivation of the personological structure and its replacement by some unconscious version of the self that we would never have to be bothered by. I don’t doubt that given the option some of us would prefer to opt out of consciousness at all.
Maybe we need to stop crying over the illusions and hallucination and simulations we have always been wrapped in. The post-intentional neuropathic future offers us the shining promise that we can choose our own hallucinations. This spells the end of the human. It spells the authentic elimination and/or multiplication of the manifest image. The scientific image of man makes of man an open access interface kit that we can alter and edit. If self-consciousness causes suffering let’s stop fucking around- lets get rid of it!
In the meantime is somewhere like Soteria such a terrible place for those of us who are too far down the line of madness that none of us escape from? As for the rest of us Soteria resembles those “sane asylums” that were talked about in the previous post. Shortly before he died Mosher was asked what would happen if Soteria was tried in 2004. His answer remains our answer
if you started to do a Soteria today I think you’d get a lot more problems. They’d try to stop it or prevent its ongoing funding or, more likely, they would take the position that it’s malpractice not to treat people with neuroleptics. They’d accuse you of withholding a known safe and effective treatment.
Even without the promise of revolution we are left with the difficult question of how to effect escape. The transpessimist strategies aren’t immediately forthcoming and its lo-tech analogues such as mysticism and psychedelics and Epicurean hedonism will be met with accusation of irrationalism and irresponsibility. But who is interested in rationalism for its own sake? Rationalism can be made to serve a post-nihilistic irrationalism. And the beginnings of any kind of post-communist nonpolitics of implosion have to start from the refusal of the role of being saviors.
The word soteria means salvation in the biblical sense of deliverance from the mutilations of enemies. This is what is at stake. Are we able to find this sanctuary? If we have entered a “profoundly masochistic phase”, do we even want to? Masochism itself- the self-lacerations and self-disgusts- might themselves be what we need to accelerate. It is ourselves first of all that we need to destroy.
What Laing and Mosher did was to find a path whereby such a destruction didn’t result in total obliteration. This must be our question: do we want to be saved? or do we really want to find the oblivion of the “safe” dissolution of the self. Do we want to become living suicides, an extinct species that still walks upon the earth?