The British Journal of Psychiatry
The Sublime Object of Psychiatry: Schizophrenia in Clinical and Cultural Theory
Femi Oyebode
The Sublime Object of Psychiatry: Schizophrenia in Clinical and Cultural Theory By Angela Woods. Oxford University Press. 2011. £34.99 (pb). 272pp. ISBN: 9780199583959

Woods is very clear at the outset of this book what her aims are: ‘a study of schizophrenia in theoretical texts... of how the concept of “schizophrenia” is represented in specific disciplines, and of how, at the meta-discursive level, these representations reveal some of the complex relations between the disciplines’ (p. 2). For this purpose, the term ‘sublime’ refers to ‘something that exceeds or exists beyond our capacity for comprehension and representation’ (p. 8), and ‘because it threatens to overwhelm our sense of self, the sublime initially inspires in its subjects feelings of awe and terror, but these... are then superseded by the sense of delight that comes from mastering the perceived threat’ (p. 8).

The first section of this book deals with clinical theories deriving from Kraepelin and Freud. Woods correctly sums up the position with regard to our understanding of the pathophysiology and treatment of schizophrenia, namely that there is much yet to learn and that no cure exists at present. But, she understates the progress in knowledge since Kraepelin’s day. For one, treatments are by any definition better, even if there are troubling side-effects and incomplete benefit. The main issue is that while correctly summing up, although correct in her summing up, Woods tends towards exaggeration. For instance, she says that within psychiatry schizophrenia is ‘framed as an opaque and bizarre disorder of unknown or unknowable aetiology, it exceeds and thus marks disciplinary limits as a form of unreason which can be neither adequately represented nor analytically mastered’ (p. 63).

Central to her examination of the psychoanalytic understanding of schizophrenia are Freud and Lacan’s analyses of Daniel Schreber’s Memoirs of My Nervous Illness. Woods’ point is that these analyses are dependent on text, indeed a particular and singular text, and that, like all literary texts, Schreber’s Memoirs supports manifold interpretations and is seemingly symbolically inexhaustible. She deems it a sublime text within psychoanalysis.

The second section deals with cultural theory starting off with the antipsychiatry movement, focusing on Szasz, Laing, and the duo of Deleuze and Guattari. These writers serve only as a prelude to Woods’ exploration of the works of Louis Sass and Baudrillard. She expends considerable time on Bret Easton Ellis’ novel Glamorama. There is a growing body of work that equates modernity and/or postmodernity with schizophrenia. It is never clear whether these cultural analyses are using schizophrenia as a metaphor, that is, are taking aspects of the experience of patients who experience schizophrenia and carrying these over to describe features of modern or postmodern society. Sometimes, the arguments veer in the direction of merging the tenor with the vehicle, a form of concretisation of a poetic image. At other times, the arguments assert that modern or postmodern society causes schizophrenia because of the similarities that have been identified. In all this, what is lost is the distinction to be drawn between objects being similar and being identical. Or, the distinction between a lion in the Serengeti and an image of a lion emblazoned on a football jersey. Discussions about the one and the other may have points of intersection but are distinguishable.

This is a compelling book. It draws widely and is full of novel ideas and interpretations. It definitely shows how varied and disparate are the uses and understandings of the term ‘schizophrenia’. It ought to be read, if only to appreciate the cultural history of the term ‘schizophrenia’.