What Is Madness?

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.