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p. 36 “To work with the psychotic person over a long period is distressing, not so much because of their psychosis, but because of how they deconstruct the defenses crucial to our own piece of mind. Some clinicians, understandably, elect not to inhabit that realm. Those of us who do are changed by these patients through their astute challenges to our own thoughtless assumptions and systems of safety.
It is important to make a distinction between ‘psychosis’ and ‘madness’. Schizophrenics are psychotic, but they are not mad. Indeed they are generally very frightened by madness and can often be phobic about coming into contact with it.
Madness refers to the creation of a chaotic state of affairs driven by the acting out of our unconscious fantasies. A ‘mad scene,’ for example, is an episode that takes place in reality. It is considered abnormal, and it expresses the most primitive aspects of the human psyche – violence, sexuality, identifications, and paranoia.
Sophocles and Shakespeare wrote about madness, not about psychosis. They staged the madness endemic to all human families: a father’s hatred of a son, a mother’s jealousy of her husband, a child’s rage against a sibling, a group’s growing realization that it is following an illusion of coherence, defending against the reality of the incoherent. The family of origin is a launching pad for the parents and the children to engage in freelance enactments of shards of craziness – and no family escapes this madness.
Those who find themselves inside seriously mad families may sometimes opt for what we might think of as ‘the eccentric solution.’ An eccentric is a person who is odd or unusual, but who has found a way to control madness through forms of internal transformation of maddening scenes, often taming them through comedic representation. An eccentric will act outside norms of behavior. This may cause distress to the normals, but rarely violates their peace of mind because the eccentric has established reliability in the performance of limited madness.
Schizophrenics seem to have sensed the danger of participation in family madness and to have developed curious and profound defensive structures against it. Often retreating into invented systems of meaning – outside the logic of the family madness – they find ways to tiptoe through the fields of conflict. It is important to our understanding of the schizophrenic world that we differentiate it not just from the normal, but also from the mad, and the eccentric.”