Badiou, the Event, and Psychiatry, Part 1: Trauma and Event

Editor’s note: This is the first of a two-part series on Evental Psychiatry.  The second part can be found here.

 

By Vincenzo Di Nicola

Philosophy is either reckless or it is nothing.

—Alain Badiou, Second Manifesto for Philosophy (2011, p. 71)

Instead of being reckless, as Badiou demands of philosophy, by which he means a bold and fearless program of innovation and change, psychiatry has become feckless, lacking courage, retreating into scientism and methodolatry, with no clear program or way forward.

In this atmosphere, already a full professor of psychiatry with classical training in psychology, psychiatry and psychoanalysis, I decided that psychiatry could not resolve its issues through more empirical research and sterile debates, so I turned to my first love, philosophy, inspired by psychiatrist-philosopher Karl Jaspers’ admonition in his re-visioning of psychiatry based on Edmund Husserl’s phenomenology (1970). At the end of his magisterial General Psychopathology that defined modern clinical psychiatry a century ago, Jaspers (1997) warned:

If anyone thinks he can exclude philosophy and leave it aside as useless he will be eventually defeated by it in some obscure form or other (p. 770).

Let’s look at this malaise from both sides—psychiatry and philosophy. Psychiatrists are living the curse of the best of times and the worst of times! We have never had so much diversity of clinical approaches, so many promising research projects along different lines, and yet there is malaise within the profession and mixed reactions from colleagues in the humanities. This malaise is captured in the resonant title of a volume on health care in the US—“doing better and feeling worse” (Knowles, 1977).

Why? Besides the debate about funding health care, which is at a boiling point in the USA and simmers elsewhere as well, there is within the profession of psychiatry a schism as to how to conceive of “psychopathology,” or how we conceive of mental illness. One way that Western academic psychiatrists are casting this debate is whether to persist in refining clinical criteria for defining “psychiatric disorders” with the Diagnostic and Statistical Manual (DSM) of the American Psychiatric Association, now in its fifth iteration, or the Research Domain Criteria (RDoC) of the National Institute of Mental Health, until recently led by Thomas Insel, based not on clinical descriptions but on putative genetic and neuroscientific factors (Insel & Landis, 2013).

Among philosophers, there is a great divide as to questions about psychiatry, the mind, and related matters. Theorists in the “Continental” or critical theory tradition have largely addressed psychiatry through psychoanalysis, notably Lacanian psychoanalysis (e.g., Alain Badiou and Slavoj Žižek), or phenomenology, including Michel Foucault who trained first as a psychologist and translated Ludwig Binswanger’s Dream and Existence (1993) from German into French, adding a lengthy introduction. Much of Foucault’s later project, investigating aspects of the history of psychiatry and the deployment of “psychiatric power” is already on evidence there.

Theorists in the Anglo-American “analytic” or linguistic tradition, on the contrary, basically declared psychoanalysis a pseudo-science, including Karl Popper and Roger Scruton, and the attention to psychiatry, psychology and related disciplines including psychoanalysis has been via philosophy of science and is now focused on cognitive neuroscience by such stalwarts as Jerry Fodor, Daniel Dennett, and Patricia Churchland. This approach often combines with a narrow and highly selective view of the “progress of science.” This positivistic notion, reflecting Auguste Comte’s famous dictum, “Order and progress,” has been at the heart of trenchant critiques in the philosophy of science (Paul Feyerabend, 2010, 2011), the humanities (Christopher Lasch, 1991), and even within the paradigm of the life sciences (Stephen Jay Gould, 1996).  The Continental tradition sees this paradigm at best as mere empiricism (or observation) and at worst as scientific positivism.

There are, of course, many crossovers between and among these schools of thought, including one of my professors, Catherine Malabou (2012) who was a student of Derrida and now focuses her philosophical work on plasticity in experimental and clinical neuroscience.

I decided to examine nothing less than the history of modern psychiatry and its relationship to philosophy by investigating trauma. During my seminars with Alain Badiou (2005, 2009a), I was struck by the symmetry between his description of the event as an opening and my emerging understanding of trauma as a rupture. When I consulted him, Badiou immediately recognized trauma/event as a fresh and innovative pairing and contrast.

 

Badiou’s Four Conditions

One of Badiou’s (2008) seminal contributions is to delineate the four conditions of philosophy—art (aesthetics), love (which includes psychoanalysis, or in my view, all that is relational and contextual, what Badiou calls the multiple), science (mathematics, physics), and politics (broadly conceived as ways of communal living).

Philosophy itself doesn’t generate truth but serves as the rubric under which the conditions present the truth through their truth procedures. A key consequence is that philosophy cannot be “sutured” to its conditions. Philosophy cannot be simply reduced to one or another truth procedure. Philosophy is not merely political philosophy or aesthetics or ethics or logic, say. So, for example, Badiou would not agree with Emmanuel Levinas’ stance that “ethics precedes ontology” or ethics as a “first philosophy,” suturing philosophy to ethics.

Psychiatry has its own conditions or, to communicate with colleagues in my community of practice, I would refer to psychiatry as a discipline with sub-disciplines. Psychiatry has many sub-disciplines, whose salience and impact change over time, depending on the contemporary problems that the discipline addresses, and they range from the social determinants of health and epidemiology to genetics and neuroscience. Along the way, psychiatry has benefitted from sub-disciplines as diverse as psychoanalysis and social and transcultural psychiatry.

My argument is that like philosophy, psychiatry cannot resolve its truth claims on its own. It can only use its sub-disciplines to generate truth claims. But psychiatry’s current crisis is that it is precisely sutured to one approach to truth, represented today by genetics and neuroscience using its chosen “gold standard” of evidence-based medicine (EBM). Yet, while neuroscience is a potentially valuable sub-discipline (notwithstanding it’s inflated claims and oversold promise—as one leading psychiatrist told me, it’s “aspirational”), EBM is hollow. It’s just a rhetorical restatement of the positivistic paradigm, elevating the notion of objective data as the “gold standard” for truth.

My two fundamental critiques of EBM address the scientism and methodolatry of psychiatry and the social sciences today by posing the questions: How can we evaluate the salient evidence in psychiatry? More critically, just what evidence is salient?

Evaluating the evidence. In the first critique, EBM isn’t so much scientific as scientistic, mimicking the practices of sciences rather than its spirit of inquiry. For example, the Society for the Study of Psychiatry and Culture, which straddles psychiatry as a medical discipline and the study of culture as a social science, demands that submissions be organized by the experimental model of hypothesis, methods, results; this is clearly not an adequate model for qualitative studies in psychiatry, not to mention the narrative and participatory approach of cultural studies.

Now, even if we grant EBM its premises, my mathematical metaphor is that EBM places us at an asymptote. EBM simply puts some selected studies on the table for consideration and while this is valuable and useful in a limited way, it does not get us all the way there. In the best case, even if we accept its truth procedures to arrive at the evidence, EBM takes us closer to the crucial point, but never breaches the chasm from observation to truth.

Clarifying the available information in a critical way, the clinician can then confront the clinical dilemma: How to diagnose the problem and what interventions are indicated based on a critical review of the available evidence? Here is where we reach an asymptote—at a certain point, no matter how close EBM gets us, we still have to make a subjective judgement using all the complex processes involved in human judgments. And that is the corollary of how to evaluate the evidence: the psychology of human judgments.

The notion that these can be reduced, explained, or revealed somehow is ephemeral. While EBM offers a procedural method, genetics and neuroscience offer seductive sub-disciplines (even though they only indirectly address psychiatry’s core concerns), and cognitive psychology pretends to offer the gold standard for how humans think (Pinker, 1997) and solve problems [or are bedeviled by such problems, as both Ludwig Wittgenstein (1953) and Daniel Kahneman (2011) would have it], we cannot breach the gap. Even if we grant EBM all that it claims (and to be clear, I do not), it only highlights the crucial point that clinical judgements are inescapably human, that is to say, subjective. “Subjective” here not only means subject to error but, even more importantly, that it is a human construction. What cognitive science has done, at its best, is to outline the parameters of that construction, notably in the brilliant work of Nobelist Daniel Kahneman (2011) and his associate Amos Tversky.

What evidence? My second critique is more trenchant. Since it is purely procedural and cannot account for how proper research questions are generated or how they become dominant (the domains of Karl Mannheim’s “sociology of knowledge,” 1936), I do not grant that EBM can answer the question about what is to be construed and accepted as evidence. And, as Wittgenstein (1953) observed about psychology, the truth claims of psychology and psychiatry are not easily resolved by experimental methods:

The existence of the experimental method makes us think we have the means of resolving the problems that trouble us; though problem and method pass one another other by (p. 232).

Believing that the questions of the definition and tasks of psychiatry can be resolved by the experimental or any other method or procedure is methodolatry. Even before we consider methods, we must define in a philosophical sense what psychiatry is, what its concerns are, independent of the current tools at hand. That is what refusing to suture psychiatry to its sub-disciplines really means. And today’s temptation for suturing psychiatry to one of its sub-disciplines isn’t science, it’s scientism and methodolatry. As Jaspers (1997) concluded in his textbook of psychiatry, the effort to avoid philosophy will only result in its coming back to haunt us in some way or other.

All of this brings us to clarify psychiatry’s central task which requires three things:

  • a general psychology as a science of human being;
  • a coherent theory of psychiatry as a discipline; and
  • because it proposes to help people, it needs a theory of change.

To state this more broadly, any helping profession, any approach to human problems, needs to explain three things:

  • How people function [normal psychology—cognitive scientist Steven Pinker (1997) calls it “how the mind works,” but I would not limit it to “mind,” I would minimally address mind, brain, behavior and relations—these four domains are not reducible one to the other; philosophically we can ask what is a person or what is a subject? One of Pinker’s critics, philosopher Jerry Fodor (2000), wrote a rejoinder called, The Mind Doesn’t Work That Way].
  • How problems arise (a theory of psychiatry beyond clinical descriptions or “phenomenology,” as it has come to be known in psychiatry).
  • What the conditions of change are (including what is change and how does novelty arise in human experience?).

So, Badiou offers three profound things to psychiatry:

  • first, he offers a theory of the subject (Badiou, 2009c), essential in any human psychology;
  • second, his theory of how philosophy works (Badiou and Tarby, 2013), with its conditions and truth procedures (Badiou, 2008), offers a way to clarify what is proper to the discipline of psychiatry and what are its sub-disciplines;
  • third, he offers a theory of change based on the event (Badiou, 2005, 2009a), which is sorely lacking in psychiatry.

In Badiou’s work, these issues are connected. In my reading of Badiou, the three conditions for an event are: To encounter an event (which is a purely contingent encounter), to give it a name, and to be faithful to it. The subject emerges through the event. By naming it and maintaining fidelity to the event, the subject emerges as a subject to its truth. It is not mere change: what was contingent becomes a necessity (Žižek, 2104). “Being there,” as subjective phenomenology would have it, is not enough.

 

Phenomenology and Psychiatry

Badiou offers a new, objective phenomenology to replace the phenomenological epoché that is at the heart of Husserl’s subjective phenomenology. Now this is a rather far-reaching project. To understand how far, let’s examine how some major streams of European philosophy and psychiatry flowed into each other.

In every generation since Edmund Husserl (whose own teacher Franz Brentano was also Freud’s teacher), there has been a rich dialogue between philosophers and psychiatrists:

  • Edmund Husserl (2012) influenced/was influenced by Karl Jaspers’ General Psychopathology (1997).
  • Martin Heidegger’s Being and Time (2008) influenced/was influenced by Ludwig Binswanger’s “The Case of Ellen West” (1958) and Dream and Existence (1993).
  • J.-P. Sartre’s Being and Nothingness (1956) influenced/was influenced by R.D. Laing’s The Divided Self (1960), The Self and Others (1961), and Reason and Violence (1964); as well as Frantz Fanon’s Black Skins, White Masks (1967) and The Wretched of the Earth (1963).
  • Alain Badiou’s Being and Event, I &II (2005, 2009a), influenced/was influenced by Di Nicola’s A Stranger in the Family (1997), Letters to a Young Therapist (2011), and Trauma & Event (2012).

While he didn’t outline a psychology let alone a psychiatry, Heidegger closely followed the work of his psychiatric interlocutor, Ludwig Binswanger, with whom he maintained a lengthy and detailed correspondence.

Sartre offered an explicit psychological theory (see his Sketch for a Theory of the Emotions, 2002) and influenced R.D. Laing’s call for a “social phenomenology” in his critiques of psychiatry (while his colleague David Cooper coined the term “anti-psychiatry,” Laing specifically refuted this term). Laing and Cooper (1964) produced a précis of Sartre’s work in English with a laudatory preface by Sartre welcoming the advent of a “truly human psychiatry.”

Until I worked with him, no one in my field had really paid attention to the import of Badiou’s event for psychiatry.

This line of investigation in philosophy with its applications to psychiatry has reached an asymptote, the point of diminishing returns (see Tom Sparrow, The End of Phenomenology, 2014). We may call it, from Husserl to Sartre and their epigones in both philosophy and psychiatry, “subjective phenomenology.” With his key philosophical works, the foundational texts for a new ontology—Theory of the Subject (2009c) and Being and Event, I and II (2005, 2009a)—Badiou sets out a new “objective phenomenology.”

Deep into my philosophical investigations, Badiou offered this crucial assessment and challenge: “You are at a crossroads, either you will abandon psychiatry as such or announce a new, perhaps, evental psychiatry.” It was an accurate philosophical diagnosis! This added another year and another hundred pages to my doctoral dissertation which I called with Badiou’s approval, “Trauma and Event” (Di Nicola, 2012).

My turn to philosophy was confirmed by Badiou’s assessment, echoed Jaspers admonition of a century earlier, and reflected the critical insight of the founder of the modern scientific approach to knowledge, Francis Bacon who in his Novum Organum (1620) distinguished “experiments of light” from “experiments of fruit” (or profit):

[W]e must first, by every kind of experiment, elicit the discovery of causes and true axioms, and seek for experiments which may afford light rather than profit. Axioms, when rightly investigated and established, prepare us not for a limited but abundant practice, and bring in their train whole troops of effects (Aphorism 70).

I tasked a triumviri of philosophers for my investigations: Foucault (1972), the philosopher of discourses and apparatuses; Agamben (2009), who adapted Foucault’s work on the apparatus and paradigm to forge a method of inquiry called “philosophical archaeology,” is our philosopher of the threshold; and Badiou (2005, 2009a), our contemporary Platonist, is the philosopher of the exception and of the event. By seizing on the profound symmetry between Badiou’s ontology based on the event and the rupture that precedes trauma, I was able to re-read the history of psychiatry, psychology and psychoanalysis through the apparatus of trauma to make it contemporary. This method is Agamben’s philosophical archaeology (2009).

Rupture is a breach that suspends the past and interrupts the world. Radically contingent, hence unpredictable and uncontrollable, it can lead to novation, an opening for new possibilities that leads to an event, or shut down into trauma, closing down possibilities. Ultimately, this allows us to see a psychiatry of trauma (that not only concerns itself with trauma but can also be traumatizing) and a psychiatry of the event (that not only studies the event but is radically open to recognizing radical change and being faithful to it in the construction of new forms of human relations).

And, as Freud observed, everywhere we go we find that a poet has been there before us. Amichai grasped this dichotomy of being in his poem inspired by the Babylonian Talmud:

Open closed open. Before we are born everything is open
in the universe without us. For as long as we live, everything is closed
within us. And when we die, everything is open again.
Open closed open. That’s all we are.

—Yehuda Amichai, Open Closed Open (2000, p. 6)

 

Vincenzo Di Nicola, MPhil, MD, PhD, FRCPC, DFAPA, is a tenured Full Professor of Psychiatry at the University of Montreal, where he works as a Child & Adolescent Psychiatrist. Trained in psychology, psychiatry and philosophy, Professor Di Nicola completed his doctorate in philosophy at the European Graduate School, where he worked with Giorgio Agamben, Alain Badiou and Slavoj Žižek. His 2012 dissertation, “Trauma and Event: A Philosophical Archaeology,” was granted Summa cum laude and inspired his call for an Evental Psychiatry. He is now working with fellow psychiatrist and philosopher Drozdstoj Stoyanov on a volume called, Psychiatry in Crisis: At the Crossroads of Social Science, the Humanities, and Neuroscience, to be published by Springer International.

You can find more about his work on these sites: 

https://philoshrink.blogspot.ca/
https://www.researchgate.net/profile/Vincenzo_Di_Nicola3
https://umontreal.academia.edu/VincenzoDiNicola

12 thoughts on “Badiou, the Event, and Psychiatry, Part 1: Trauma and Event

  1. “I welcome you engagement with Badiou, Foucault, Agamben oriented toward a broad redefinition of psychiatry. Starting in 1997 Badiou, Foucault, Jean-Luc Nancy and also Agamben and others were my main references for a reconceptualization of change in psychotherapy, understood as poetic events that can interrupt dominant micropolitics that organize everyday life situations including therapeutic models and interventions. These poetic events could be integrated to our everyday life through a work of imagination understood not as the individual production of fictional images but as the work with images conceived as apparition of worlds under different modes. This work has been published so far in Spanish in two books: “Palabras que permanecen, palabras por venir. Micropolítica y Poética en psicoterapia” (2011), Barcelona, Gedisa. And “Texturas de la imaginación. Más allá de la ciencia empírica y del giro lingüístico” (2014), Barcelona, Gedisa, the fist volume of the trilogy “El espectro y el signo” whose second volume is now in preparation.
    Thanks so much and looking forward to the second part of your presentation and of the book you are writing in collaboration. Best regards!”

    • Querido Marcelo,

      I appreciate your comments and look forward to engaging your texts which you kindly forwarded to me. We do need a more encompassing theory of change in psychotherapy – and in all the domains of the psyche, from psychology to psychiatry to psychoanalysis and all the psychotherapies. What we have are descriptions of change or theories of how those changes come about. Psychoanalysis comes closest in articulating a theory of mind, of insight as the vehicle of change, and of insight as a characterological change in itself. What is missing is a broader theory of how “novation” as Badiou calls it – novelty and innovation – come about at all. That is an ontological task and not a methodological one, so we cannot subcontract it to one of our subdisciplines – philosophy itself will have to take on this Herculean task, and that is precisely what I am doing using Badiou as my platform.

      As for poetry, I hold by what Dylan Thomas said about the task of the poet:

      “No honest writer today can possibly avoid being influenced by Freud through his pioneering work into the Unconscious and by the influence of those discoveries on the scientific, philosophic, and artistic work of his contemporaries: but not, by any means, necessarily through Freud’s own writing.”

      Here, Thomas was acknowledging but not bowing to psychoanalysis and privileging the larger burden and task of the poetic imagination to document and refresh our sense of humanity.

      The conversation continues …

      Abrazos,

      Vincenzo Di Nicola

  2. These thoughts are a needed reminder of the limitations of the empirical method within the so-called human sciences and especially psychiatry, which presumably has to do with “how to live,” whether as a discipline it acknowledges this question directly, grappling with it as an aporia, or allows it to fade into the background. When the discipline allows a conscious approach to this question, it has entered the realm of philosophical thought, unless in takes a detour into an onto-theological perspective of whatever particular religious practice. And the latter would raise another needed critique. When the question of “how to live” is disavowed as a part of psychiatric practice — or all medical practice, for that matter — then one risks ending up with unacknowledged and uncritical ideas about life in general that easily morph into a presumed but unconscious ideology about what constitutes normality for humans. I fully agree that most empiricist approaches in this arena end up being “scientistic” rather than scientific. I particularly like your term “methodolatry.” However, I would want to add the concern that this fetishization of approach is not limited to psychiatry but also is a risk in philosophy. As an example, Heidegger’s concept of “authenticity” had much appeal in the humanities in general and more specifically in the therapeutic arts over much of the last century. However, too few people at the time heeded Adorno’s critique of Heidegger in general and authenticity in particular. This is not intended to discount Heidegger’s thinking and its almost limitless impact on the next generation of philosophers, whether in affinity or in separation, but is meant as a reminder that any philosopher — however much her body of thought may seem to transcend its immanent embeddedness — is to some extent ensnared in the socio-political contingencies of their time. And, as we now know all too well, such politics can be quite concerning and raises the difficult and unceasing question of how intertwined thought is with its situation. The latter is, as you know, something that Badiou thinks head on, so to speak, especially in Logics of Worlds, and certainly his radical left politics appeal to me much more than Heidegger’s more than flirtation with fascism. Yet, I fear there is still a needed critique of the proximity of the evental with its forerunner of authenticity, despite their obvious distinctions. The critical theory lineage within continental philosophy has helpfully demonstrated quite clearly the proximity of and the quick shifts among left radical politics of the common, liberal and neoliberal governance of presumed democracies, and neo-conservative fascisms. I say this merely to underline that there must also be vigilance about methodolatry in philosophy, intimately related as it is to the ideologies of political economies, which are in many ways the defining strictures of “how to life” that must be continually critiqued and resisted.

    • Dear Randall,

      This is a nuanced and sophisticated engagement with my text!

      There is so much there and I want to think more about it, but I do want to comment on your take on “how to live.” When I read Peter Sloterdijk’s “You Must Change Your Life,” a number of things crossed my mind. First, the title, invoking Rainer Maria Rilke riveted me (Rilke is a great inspiration not least because of the boldness of his life and thought, in spite of certain lapses). From the title, I expected something about meaning and transformation. In fact, it’s about the return to religion with Sloterdijk’s unique way of ironizing and reframing. It could also be an ironic take-down of the self-help and recovery moment of pop psychology. And when I read these things, it always makes me smile, remembering that, as you invoke, philosophy was the original self-help – cf. “Consolatio Philosophiae” by Boethius.

      I can appreciate what you intimate – the impossibility of a value-free, supposedly scientific psychiatry – and hold by a psychiatry of meaning. Yet, as you say, we must be careful about fetishizing our values. Ivan Illich, who was one of the truest and yet most critical voices of the Catholic Church in the 20th century, cursed the Church’s fetish of life (notably in being against abortion and euthanasia) – something reflected in the teachings of the current Pope Francis. (Monty Python had a go at this one with their song, “Every Sperm Is Sacred.”)

      Psychiatry cannot be divorced from meaning but we also cannot be too partisan in prescribing “how to live.” A century ago, paediatric texts were filled with injunctions about masturbation in children, and not too long ago, psychiatry saw homosexuality as deviant. We must avoid becoming ensnared, as you state so felicitously, in the “socio-political exigencies” of our time.

      Now, as for authenticity. The reach for authenticity is a sure sign – in the hands of most people – of its opposite. I eschew preaching and righteousness of any kind. As soon as I heard Hillary Clinton mouth the word “deplorables,” I was sure who was deplorable – the signifier, not the signified. I cannot fathom the followers of Heidegger who was deeply inauthentic in his personal, professional, and political life. He was a venal man, interpersonally manipulative and small-minded, notably toward his teacher Edmund Husserl. Karl Jaspers, who was his intellectual equal and certainly his moral superior, judged him harshly. Heidegger’s incomprehensible affair with Hannah Arendt is not just a question for intellectual history but a whole school of psychoanalysts. She herself showed parallel lacunae in her moral and political judgments and could not be brought to reason on the Jewish response to her provocative and deadly wrong arguments about Eichmann in her meretricious treatment of his trial, despite the great pain she knowingly inflicted on her co-religionists. As for Heidegger himself, his was not a mere flirtation with Nazism. One cannot argue that he was a major thinker and accept these measly ex culpas that it was a flirtation or merely politically expedient. As for expediency, Jaspers chose to leave Germany, as did Thomas Mann, and many others who had the chance to flee; Enrico Fermi and Arturo Toscanini also left Fascist Italy. Heidegger was a fully engaged thinker who knew exactly what he meant and lacked the courage to say it openly as the newest revelations about him unequivocally attest. Physicist-philosopher Mario Bunge’s dictionary cites “H” as the most dangerous letter in the German language. One of my professors of philosophy at the European Graduate School, Martin Hielscher, agreed, citing Heidegger, Hitler, and Himmler. Hielscher himself, a man of refined sensibilities and a scholar of Adorno, is certainly not on that list!

      Somewhere between an impossibly value-free science or medicine and partisan ideologies, we need to find an interstitial space of deep engagement, immersed in the subjectivity of human being, without any pretence to objectivity, always imbricated with a critical regard, to re-invent psychiatry as a science of persons. Any real science could never become arrogant and certain, it should always be open to being improved, maintaining only a provisional status of truth.

      The next part of my blog will outline a brief sketch of what that could look like, inspired by the work of Alain Badiou.

      Please join me this Thursday, won’t you?

      Warmly,

      Vincenzo Di Nicola
      Université de Montréal & The George Washington University

  3. I’m very much delighted to have read Vincenzo de Nicola’s groundbreaking work that has a Badiouian twist to it. His pioneering work in the behavioral studies (the customary Behavioral Trinity comprised of Psychiatry, Psychoanalysis and Psychology) critically addresses what Slavoj Žižek
    has recently termed in his last book “‘Incontinence of the Void: Economico-Philosophical Spandrels” spandrels – “the interspaces between fields” that were mostly left in the shadows outside the spotlight of a ongoing intellectual debate.

  4. I’m very much delighted to have read Vincenzo de Nicola’s groundbreaking work that has a Badiouian twist to it. His pioneering work in the behavioral studies (the customary Behavioral Trinity comprised of Psychiatry, Psychoanalysis and Psychology) critically addresses what Slavoj Žižek has recently termed in his last book “‘Incontinence of the Void: Economico-Philosophical Spandrels” spandrels – “the interspaces between fields” that were mostly left in the shadows outside the spotlight of a ongoing intellectual debate.

  5. Dear Vincenzo it is very welcome this approach to profound contradictions of contemporary medicine and psychiatry, psychopathology is still a major mystery in the middle of the mental health global crisis, it is essencial remember Jaspers and so many genial people that have generated original and useful interpretations that help us in clinical work and public policy. May the debate flourish.
    Abraço,
    Vitor

  6. I would love to deconstruct this article and remove all the associations and references. What would be left. Incoherent sentences and obscure acronyms.
    Philosophy has long been a private conversation within an elite and has lost relevance to all outside its inner sanctum. Frustrated is how I feel after reading this article- even though I have just read a critique of inflationary theory in cosmology. The latter for all its multiverses reads as being of more value.

    • Des Greene,

      You complain that my article is incoherent!

      So we are reliving a moment in pre-modern philosophy where you are reprising the role of al-Ghazali in the “Tahāfut al-Falasifa” (The Incoherence of the Philosophers) and my answers were already prefigured in the work of one of my heroes, ibn Ruchid known to us by his Latinate name, Averroes, “Tahāfut al-Tahāfut” (The Incoherence of the Incoherence).

      Now, let me point out that my article is for an audience of philosophers and the educated public, not an op-ed piece in the Sunday paper. It is neither recondite nor very specialized and I went to some lengths to explicate ideas that are in fact quite dense and complex. As for “obscure acronyms,” there are precisely three – “DSM” has been in the news, and when the new version (DSM-5) was launched in 2013, the controversies surrounding it were splashed on the pages of current news all over North America. “EBM” (Evidence Based Medicine) is somewhat more specialized, but I explain that clearly, as I do with “RDoC” (Research Domain Criteria), precisely to critique them.

      As for larger matters, many people in the academy, including some philosophers, are unhappy with the “private conversation” you allude to, especially in technical papers in the field. Santiago Zabala and Creston Davis addressed this recently, in response to Stephen Hawking declaring philosophy dead. They ask, which philosophy is dead?, and finger Anglo-American philosophy as not only very technical but also having painted itself into a corner and I agree with that judgment.

      Now, if you are one of those people who think that critical thinking should be expressed in common parlance, I don’t agree with you. We should try to be as clear as possible but we cannot be clearer or simpler than the complex subjects we try to grasp and elucidate. To use a metaphor, we can try to clean the windows or our glasses but if it’s dark outside or if there is fog, cleaning our lenses and windows won’t change that. The language cosmesis that Wittgenstein and his followers exhorted us to adopt is a lot like that. They are quite satisfied that the windows are clean but they haven’t noticed the fog or the dark and obviously haven’t found a way to clear it up.

      My guess is that you would prefer someone like Roger Scruton who enjoys shredding psychoanalysis and thinkers in the so-called Continental tradition (Jacques Derrida, for example) and Critical Theory (viz., Adorno, Benjamin, Marcuse) as did philosopher of science Karl Popper, biologist Peter Medawar and physicist Mario Bunge. They appeal to concepts that are likely congenial to you like Popper’s criterion of falsifiability. The problem is that each group of thinkers chooses or forges different tools for different tasks. Wittgenstein thought he had resolved the problems of philosophy by dismissing them as pseudo problems, only to return, again and again, usually in less assertive ways with greater and greater qualifications and limits to his philosophical vision.

      My guess is that you have fashioned and deployed tools adapted to other tasks and find philosophy and psychiatry irritating.

      But let’s be honest, what do you know about philosophy or psychiatry for that matter? As philosopher Jerry Fodor admitted decades ago, lots of people in the common sense school of philosophy think that with a free Saturday afternoon and a little effort, they can put psychology’s or psychiatry’s house in order.

      As for myself, I have been reading philosophy for the last 50 years, guided by professors of philosophy starting with Prof. Georgiadis at McMaster who taught me Greek and introduced me to the Arabic philosophers although I only belatedly took on Arabic at a basic level to at least appreciate the complexity of classical Arabic. Later, I had Charles Taylor as a mentor at McGill and went up to see him at Oxford when I did my graduate work in London. As I said in the article, I turned again to philosophy because there are no clear answers within my field, so I worked with some of the finest European thinkers like Giorgio Agamben, Alain Badiou and Slavoj Zizek. I’ll skip the details of my training in psychology, medicine, paediatrics, psychiatry, and psychoanalysis, but let’s just say that as a lifelong academic attending scholarly conferences from history to philosophy and literature to medicine, I am surrounded by strong critiques and powerful arguments from many quarters all the time. My community of practice ranges from the best researchers at the American College of Psychiatrists to philosophers who criticize positivist science to historians and artists (Vitor Pordeus who posted a comment here is a Brazilian physician and actor working with people who have been hospitalized in psychiatry).

      In other words, I am seriously engaged in this work.

      And you?

      Vincenzo Di Nicola

      • This is a very thoughtful reply to some tough objections Dr. Nicola. I would add that anyone who has tried to articulate original ideas knows how difficult it is to be clear. Natural language has its limitations, and philosophers often write at the limits of natural language. So they cannot be faulted on these grounds; it is up to readers as well as writers to engage with the subject-matter under discussion. We must take the time to do that before we judge.

  7. My colleague forwarded your blog to me and I’m so happy I found this post. I have been reading Badiou’s work for many years and trying to work out what a theory of change would mean for literary works of the early 20th century (the modernists). I started with Lacan and found that Badiou is a very discerning reader of Lacan, esp. on questions of temporality.

    I agree with your point that Badiou takes us forward when it comes to a theory of change, since Being and Event and Theory of the Subject both analyze the the subtle dialectic between anxiety and courage (esp. Theory of the Subject). The failure to see a break with established norms as a possibility is a cause for anxiety, but as Lacan pointed out, this anxiety also has a truth value. Badiou’s clearly theorizes the risks involved in holding on to a fragile encounter, and how society’s view of these risks (often celebratory) slips away from moments of decision (thinking, in hindsight, they are already decided). Badiou’s analysis gives us clarity about what a decision means — it’s an aleatory event. And his philosophy takes us pretty far into understanding why we may close off genuine change. Narrative expressions try to harness both sides of this temporal problem (anxiety and courage) and Badiou is also a great analyst of the narrative process, along with Lacan.

    I look forward to your next post.

    Janina Levin, PhD
    Writing Instructor, University of the Sciences

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