The lucidity of the insane: Nietzsche and others

Abstract

Lunacy has always been reflected upon by Western thinkers. The acceptance of its putative causes has varied across centuries and cultures. In all of them, it has been difficult, above all, to establish boundaries beyond which insanity is definitive. Plato considered insanity to be the manifestation of a mystic spirit that inspired but a few. Medieval and Renaissance thought admitted lunacy’s nature to be good or bad, divine or diabolic, religious, moral or health related. Early ethnopsychiatry considered culture and personality unimportant to explain lunacy. Similarly, Freud thought that lunacy lives in the subconscious. Starting in the 17th century, the Cartesian paradigm established reason’s supremacy as the mediator of knowledge, which led to Foucault opposition to Derrida’s exclusion of lunacy from this paradigm. Lack of adequate understanding of lunacy has led, in the past, to the exclusion of lunatics from social living and the adoption of violent, “curative” therapeutics. In many cases, they have worsened the condition or led to a irreversible breakdown of reasoning ability. Adequate diagnosis and treatment of lunacy require that no theoretical barriers are established between the health professional and the patient; on the contrary, patients issues must be heard and followed by an interdisciplinary team. Finally, according to Nietzsche insanity would be linked to the creative impetus.