Nima Bassiri, "Madness and Enterprise: Psychiatry, Economic Reason, and the Emergence of Pathological Value" (U Chicago Press, 2024)
01:12:02 Share

When you get fast and reliable internet at Verizon, you can also save on the entertainment you love. Save on your favorite funny flicks, adrenaline rushes, rom-commers, and can't-miss games. Add your favorite entertainment to any BIOS Home Internet plan, like Netflix and Max, or Disney+, Hulu, and ESPN+. With Verizon, stream more of what you love and save. Call 1-800-VERIZON and get BIOS Home Internet today. 18-plus terms apply.

Are your ulcerative colitis symptoms proving difficult to manage? Tramphya, Gacelcomab, can help you manage the cycle of UC symptoms. At one year, many patients taking Tramphya achieved clinical remission, and some patients also achieved endoscopic remission. Individual results may vary. Tramphya is a prescription medicine used to treat adults with moderately to severely active ulcerative colitis. Serious allergic reactions and increased risk of infections may occur.

Before treatment, your doctor should check you for infections and TB. Tell your doctor if you have an infection, flu-like symptoms, or if you need a vaccine. Ask your doctor if Tramfiya can help you manage the cycle of UC symptoms. Call 1-800-526-7736 to learn more or visit tramfiyradio.com.

- At Sierra, discover top workout gear at incredible prices, which might lead to another discovery. Your headphones haven't been connected this whole time. Awkward. Discover top brands at unexpectedly low prices. Sierra, let's get moving. - Welcome to the new Books Network.

Hello everyone. Welcome to another episode of NewBooks Network. This is your host, Morteza Hajizadeh from Critical Theory Channel. Today, I'm really honored to be speaking with Dr. Nima Basiri about a book that is recently published with Chicago University Press. The book is called Madness and Enterprise, Psychiatry, Economic Reason, and the Emergence of Pathological Value.

Nima is an associate professor of literature at Duke University. Nima, welcome to New Books Network. Thank you so much. I'm very happy to be here. Great. Such a fascinating topic and I have lots of questions to ask you and I do want to ask you about Foucault as well and how it relates to your book. But before getting into the nitty-gritty of the book, tell us a little bit about yourself,

your expertise, you're a professor of literature, but you have also done this research on the history of madness and psychiatry. And it interlates a lot with economics. I'm interested to know how these different fields have come together or have come into your area of interest.

Yeah, of course. Yeah. So, yeah, I teach in the literature program at Duke University, which is a interdisciplinary humanities, cultural studies and cultural theory program. My own scholarship is sort of situated, I'd say, broadly between two fields, social theory on the one hand and the history and philosophy of science on the other hand.

I trained at Berkeley in a very similar kind of interdisciplinary humanities sort of critical theory program where I trained largely and I would say sort of three traditions. First is sort of the post-structural theory traditions of post-war French continental thought, French theory theory.

The second tradition was a broad kind of science studies training with a with a focus on kind of the history and philosophy of science, but but pushing into sociology of science and medical anthropology and those sorts of aligned fields. And then lastly, intellectual history. So intellectual history, conceptual histories, etc.

A lot of my work has been focused on looking at the field of the human sciences, the history of the human sciences, these knowledge fields that emerge after the 18th century and our efforts to kind of reorient.

Offer some kind of new set of discursive regimes for thinking about the nature of human nature. And this is these are fields that include everything from psychiatry to anthropology to economics, sociology. How do humans behave? Why do they make the decisions they do? And related, of course, to the human sciences, also the social sciences. These are kind of paired together often in certain ways. Why do social bodies cohere in the ways they do? How do we understand social relations?

And of course, the critical dimensions of social theory are quite broad and extended to certainly Marxist theory and other forms of kind of theoretical formations. And so, yeah, the book largely kind of comes out of this effort to bring together a number of fields, thinking about the human sciences from a kind of

sort of theoretical lens, I would say, a kind of critical, applying kind of critical theory traditions to problems that emerge within the field of the history and philosophy of the human sciences. And it's just, I guess, the question that I posed first, how you came to write about the history of psychiatry and also, in a way, also economy. That's more or less for an initiation because those who have studied English literature might know that it's, in a way,

If you get into cultural studies, it's in a way a very political area as well. You get to read critical history, you get to read Marxist history, you get to read the history of economics, and then you can see how all those concepts can interrelate with things that we normally take for granted in society, like how some of the diseases are.

conceptualized or conceived and even treated. And I guess when it comes to the history of psychiatry, especially in the past century, it's very much most of those pathological cases are affiliated with, or let's say are looked upon as a consequence of capitalism, which I'm guessing you will touch upon. But let's talk about this book. When I saw the

tied to madness and enterprise and of course history of madness I can't immediately think of Foucault and he also has yeah I'm interested to know what is the intersection between your book and his and where do you depart from the way he analyzed the history of madness because those people who were considered to be mad were not really functioning people in society and you do see traces of that kind of argument in your book as well so where do you where are you similar to him how do you depart from him yeah

It's a good question. And I and I and I can see how for a lot of people, the the entry point of Foucault is is usually very helpful to get people to sort of see where I'm coming from and kind of what I'm trying to do in the book. So I would say that the book in large measure has an indebtedness to Foucault to what I would sort of think of as a kind of Foucauldian style of thinking.

Even though at the same time, the argument of my book is much less linked to history of madness. So much less linked to that first book of Foucault's and much more linked to the kind of –

the sort of genealogies and archaeologies that sort of define a lot of Foucault's kind of middle work. And I would say, too, that in a lot of that, a lot of interviews, for instance, he will kind of resituate History of Madness within a kind of larger kind of archaeological and genealogical kind of project. So the argument of the book is less, I would say, indebted per se to Foucault and certainly less indebted to the History of Madness, the book, the History of Madness, his sort of thesis, right?

And far more indebted to, yeah, Foucauldian style of thinking. So the way I approach the category of madness, the one I would say the one thing that I do draw out that I think is quite a bit more tacit in History of Madness, particularly towards the end of that book.

And this is one of I mean, I would say, you know, many books have multiple kind of arguments, I suppose. And one of the arguments of Madison Enterprise is to try and think about psychiatry less as a medical field and a little bit more as a theory of the social, a social theory, like, let's say, avant la lette.

So in a way, their efforts on the part of psychiatrists to try – like tacitly what's going on in a lot of what I talk about in the book is not merely the kind of medical aim of categorizing illnesses with the hope of trying to develop therapeutics. But trying to make sense of what it means to think about the social body as a coherent form, what it means for people to –

to abide by norms, tacit sort of behavioral norms, affective norms, social norms. In other words, imperatives that keep the social body intact, that keep it sensible, that keep it intelligible. And what happens when people deviate from social norms, when they can't seem to replicate them, when they can't seem to abide by them?

I think a tacit kind of argument to this book, and it's something that I do talk about in the conclusion, is that part of how we should understand psychiatry coming into formation in the 19th century is in a way trying to make sense of this very strange thing that we call the social and the ways that we find ourselves in.

You know, incited or compelled to act in certain ways within social contexts and perhaps to wonder why people deviate in the ways that they do. Yeah.

So that is a very largely kind of Foucauldian kind of orientation, I would say. So there's not a real replication of a Foucauldian argument per se, but again, a kind of a tenor or an ethos that's quite Foucauldian and very intentionally so. Thank you. You're right. Maybe I didn't pose a question right because it's in a way quite different. We'll get to that one. It's...

Let me ask you about your methodology. That I found really interesting myself. That style of reasoning you used to discuss how matters was turned into an economic condition. It was, I think, into an economized condition, as you mentioned it in the book, and it came to be evaluated as an economic form. Just to lay the groundwork for the listeners, can you talk about that argument and also the methodology? Sure.

Yes. Okay. So let's say there's a kind of a narrow argument in the book, a very kind of like literal argument in the book. And I can talk a little bit as well later on about what the stakes of that argument are in a broader, let's say, conceptual or philosophical vein. But

One of the things that I describe in the book is that coming into being the field of sort of psychiatry, there were sort of in the early 19th century up until like the middle of the 19th century, the field encountered what I describe in the book as a hermeneutic dilemma.

One of the things you have to understand about psychiatry is that it had it's not just an epistemic field, but it's also an important profession. And it was a profession that in the early parts of the 19th century had to establish its legitimacy. And one of the ways that it had to establish its legitimacy was to say that psychiatrists are able to or have access to psychiatrists.

sort of diagnostic capacities that not every member of the laity also had. So if something like madness was identifiable by any one of us, right, in a sense, you wouldn't necessarily need a psychiatrist to be there to identify a person as mentally ill or not.

So in a certain way, it was it was important for psychiatry to develop conceptions of mental illness that were not always clearly identifiable. So the idea I mean, when you look at prior conceptions of madness before the 19th century, the boundary between illness and health was pretty stark.

It was sort of clear-cut cases where mental illness was essentially defined by some kind of delusional disorder or a hallucinatory disorder or major problems in cognitive capacities. And what you begin to see throughout the 19th century is formulations, and this is what I describe in the book as sort of what I call borderland figures. So genres of illness which were not actually illness per se. These were types of individuals who were not

clearly sane or insane, they pose this sort of problem, a kind of interpretive problem for medical evaluation. So and these were actually essentially figures that had to be constructed in order for psychiatry to be able to step in and say, no, but we know the difference between what's healthy and what's sort of unhealthy. Right.

And one of the arguments that I make in the book is that at a certain point, that that borderland figure became so inscrutable, so kind of hard to identify that psychiatry had to turn to other, let's say, lenses, other sort of evaluative tools.

are sort of interpretive styles or interpret modes of interpretation to be able to adjudicate whether a person who's acting a little bit oddly so we can't quite tell if they're healthy or not right because they're not on any one of these sort of clear-cut boundaries of sanity or insanity

There had to be other metrics that we had to deploy, these sort of psychiatrists were essentially saying. And what they ended up using, the book argues, and they use it in a variety of different ways, are tacit economic parameters, economic benchmarks, right?

And the reason that economic benchmarks were effective to basically adjudicating whether a person who's acting bizarrely was normal or abnormal is because economic benchmarks are reducible to essentially a kind of an arithmetic. Is money being or wealth being maintained? Is it being accrued or is it being lost? So a person might be acting a bit strangely, but

And if in the course of their bizarre behaviors, they're, you know, spending money they don't have or making investments that are very troubling or selling their furniture, all these various things. We might say that their odd behavior is translating into a kind of financial loss. And so we might therefore adjudicate this otherwise difficult to interpret behavior as a form of illness.

But conversely, if this odd behavior actually translated into something that was otherwise remunerative, so they were making money, right? They or at least money wasn't being lost. Then we can say, well, you know what? They're actually fine. They're sort of healthy.

Now, the question becomes, where does one identify this turn to what I call an economic style of psychiatric reasoning? And this is one of the methodologies that I deploy in the book. And there are a number of names for this methodology. And just for the sake of maybe this conversation, I'll say, and just going back to the Foucault thing, a kind of an archaeological excavation of what I sort of describe as patterns of reasoning that

that you might see across a broad swath of North Atlantic psychiatric thought. So rather than focusing on one particular nation state or one particular institution or hospital, I look at how you could sort of think about psychiatric thought as a kind of constellating pattern or a series of tendencies.

And so there were these tendencies to essentially turn in many different ways to economic metrics and economic benchmarks in order to adjudicate the kind of mental state of a person who is otherwise acting oddly and for whom psychiatry on its own didn't present the available tools to finally determine whether they were healthy or not. Right.

So there's no there's no litmus test. Even even today, there's no litmus test. There's no brain scan. There's no blood tests where it comes back positive or negative that we have to deploy a lot of kind of interpretive tactics. I mean, even today, the idea of whether a person is ill or not ill is.

is determined by a number of mitigating factors, many of which are how we interpret their behavior in the backdrop of other social metrics. And economic metrics have long functioned, I argue and would continue to argue, long functioned as a go-to interpretive lens, in part because it's

trying to decide whether something is healthy or unhealthy, yeah, that leads to a lot of interpretive vagary. Like what is health, right? What is unhealth? It's open to a lot of interpretation. But economic metrics, it's mostly, it's an arithmetic. Is wealth being lost or not? And so in that sense too, I should add that in a way, I approach the very category of economic reasoning as something akin to a social logic.

It is a way that in the kind of post-18th century world, when we look at people and we try to make sense of their behaviors, we, I would say, tacitly deploy a kind of economically infused social logic just to assess whether or not

what we think they're doing is good or productive or profitable. And the same was done with respect to mental illness.

They're called Monday.com, and it was love at first onboarding. They're beautiful dashboards. They're customizable workflows that is floating on a digital cloud nine. So no hard feelings, but we're moving on. Monday.com, the first work platform you'll love to use.

This episode is brought to you by Progressive Insurance. Do you ever find yourself playing the budgeting game? Well, with the Name Your Price tool from Progressive, you can find options that fit your budget and potentially lower your bills. Try it at Progressive.com. Progressive Casualty Insurance Company and affiliates. Price and coverage match limited by state law. Not available in all states.

So this sort of idea of a style of reasoning is to sort of try and excavate patterns of thinking within –

sort of the system of psychiatric thought broadly construed and to see how the various permutations of these, as it were, economic styles in a number of different disputes. And so the chapters in the book are divided according to sort of motifs and themes that take on particular ways in which a particular, let's say, disorder was reasoned through by way of economic benchmarks.

Does that make sense? Yeah. If I may just summarize it. So previously, psychiatrists turned into something internal, which was the mind to analyze it. But these figures, they didn't come under that. I mean, they were not easily, let's say, diagnosed. So instead of turning attention to something external, which was...

their external behavior and economics or economy was a good measure of that behavior. And that's how they were sort of pathologized. When you were speaking about economics being a good arithmetic measure, I'm deviating from the book, of course, here, but I'm keen to know your thoughts. You know, social media or people usually comment a lot about politicians, especially these days that a lot of politicians, I'm talking specifically about the United States, are highly rich people.

Right. They look at the behavior, but some of them, of course, they look at their behavior and say, well, he's a businessman. Trump is a businessman. He knows what he's doing or Elon Musk. But at the same time, all the money that is being wasted, I said, these guys are crazy. And they use madness, not, of course, in a psychiatrical sense, but in a more layman's language. Yeah.

And I think in the public sphere, you can see or public domain, you can see how madness and economy are interrelated in terms of how people categorize some as mad or genius based on their economic performance. Absolutely. I think that's quite right. And that's...

In fact, that very point is something that I'm not sort of approaching in an incidental way. I actually want to argue in the strongest terms that that social normalcy and also social virtuosity is often a very tacit economic appraisal, even if actual explicit languages of, you know, financial remuneration are not being invoked.

And I would say that that's the case even, I think, you know, whether it's politicians behaving poorly or people behaving well. There's a certain way that a kind of...

economic logic has suffused, and that's kind of the strong argument, a substantial portion of a lot of our social conduct. And so one of the arguments, I mean, I guess one of the purchases of the book or the payoffs is to say that if something is marginal, let's say, marginal in the sense of like we tend to posit it as the margins of social behavior or something like madness, which is like the truest form of rationality,

can be economically recuperated or economized in a certain way. What can't be, right? Surely almost anything can be kind of suffused with an economic form of reasoning. And so that's one of the kind of major cautionary points that I want to make at the end of the book, especially around

an intervention into sort of like critical theory broadly concerned around critiques of capital to say something like, well, you know, if one organizes a critique of capital around the fact that capital is irrational and its irrationality is the source of its sort of failing, one of the arguments of the book is to say, well, actually, you know,

The category of the irrational is incredibly productive and prolific and value-laden. And we underestimate, indeed, how fecund the category of rational is, how valuable it has been historically. And that's part of what this sort of notion of pathological value means, is that something like irrationality, or what I use as a kind of synonym for madness...

Irrationality is itself a kind of economic form because we decide whether we want to accept irrationalisms or reject them based on how productive, as it were, they are. So like this is why the whole discussion. I mean, I don't want to jump ahead too much, but around the entrepreneur and the idea of an entrepreneur as an expression of profitable irrationality. Right. And the boundary really between the entrepreneur and the madman is.

is that entrepreneurialism is what we call an irrationalism that makes money, and madness is an irrationalism that loses it. And that's not a...

superficial relationship i'd say i think that's a kind of essential relationship that defines an important substance of the book and and again when when people talk about money they use a lot of words that again come close to psychiatry or mental health is money wise and i think even during the rise of neoliberalism in the 1980s late 1970s and

a lot of policymakers use that kind of language, measures, economic measures and numbers to

to determine the health of society or how well the society functions and if it was not functioning they used words that had to do with uh illness or or or or even madness uh yeah yeah which was again that rigid economic way of looking at society which well in my view didn't work uh but of course if somebody comes from neoliberal perspective we would disagree with um

Right, right. Yeah.

economic reasoning should suffuse actually well precedes the neoliberal era. And it's not into just random parts, like, you know, random expressions of human behavior in the sense of human capital that you see in like the writings of Becker or whoever, but actually it's madness itself, which is economized. So the madness itself can be seen as,

as something which could be socially accepted or rejected based on the perceived economic worth that it has. And so one of the arguments to the book is that madness is not something that was simply rejected or removed from the scene of economic domain as if it was somehow antithetical. Right. Madness is also not removed from the social domain as something that was antithetical to it.

that in fact, its place within the social and within the economic was actually largely predicated on whether or not forms of madness could be seen as, in a sense, lucrative or non-lucrative. So in fact, madness was always present within the social and the economic domain. And I mean madness here in the fullest sense, too. I'm not talking in a metaphorical sense. I'm talking like

You know, so so that's that's the strong argument is that we we we underestimate the the dangers of categories like social and political irrationalisms when we simply remove them and say they have no place in society. When, in fact, they they've always been seen as quite central to society insofar as they're often seen as engines of societal innovation or economic innovation.

However dangerously that may be the case, right? So, and again, this gets back to the idea of psychiatry as a kind of social theory. It was psychiatrists were actually describing very tacitly how psychiatry

and structures of meaning actually happen within the social domain. And it was never as simple as simply removing madness. It was actually giving madness a place within society, in part because many psychiatrists, I mean, Freud is the pinnacle, but many psychiatrists recognize by the end of the 19th century, you cannot get rid of psychopathologies. Every single person is

has some kind of porous relationship to some kind of pathological condition. So if you were to remove all the mentally ill people, even like minimally mentally ill from the scene of social life, you've essentially removed virtually everyone. And so you have to come up with justifications for how madness or even just the sort of slightest forms of psychopathologies

how they can still have a presence within the social domain and not merely as something which disrupts it, right? And you mentioned entrepreneurship. It's always a difficult word for me to get my math right, but anyhow. But before getting to that, you talk about three viewpoints that you try to describe the relationship between madness and enterprise. Right.

I know that you've written a whole chapter on that. It's a very broad question. But if you could give us an overview and then we'll talk about entrepreneurial madness, what it means there in the context of your research that you did. Sure, sure. So, I mean, just for listeners, this is the third chapter of the book, which is called From Disorders of Enterprise to Entrepreneurial Madness.

And that chapter explores essentially three interrelated motifs. And it's a chapter. So each of the I mean, not all, but several of the core chapters are thematically organized around concepts in the history of capitalism. So business enterprise being one of them. And that's what this chapter is about. Inheritance is one of the chapters that I also talk about in the book.

And labor is another chapter that I also explore in the book, among other chapters. But in this particular chapter, I look at three motifs that have been typically kind of ways in which –

economic enterprise has been sort of theorized in relation to psychiatric health and unhealth, specifically within psychiatric discourse. And the first motif is one that I think many of us are very familiar with, which is this idea that commercial life is pathogenic, right?

that the hustle and bustle of capital, of the life of the businessman or whoever, the agent of commerce, the kind of losses, the financial losses, and even the financial gains can be...

excessively sort of traumatic for the person's sort of psyche. And so there's a way that people who engage in too much commercial life are going to suffer from some kind of psychopathology. And there are various accounts of this, whether it's neurasthenia or other forms of kind of psychiatric distress. And the thing is, that sort of familiar motif, which we've seen a lot of writings and we're almost sort of culturally very familiar with,

That motif is actually offset with two additional motifs that we also see within a kind of pattern of psychiatric thought around this particular subject. And the second motif, which is sort of strange if you think about it, is that in some ways, although let's say commercial life capitalism is pathogenic and can cause people as it were to lose their minds.

Being insane was not actually antithetical to being a good economic actor. And so there are many accounts that are very surprising during this period in which psychiatrists recount patients suffering from major psychiatric disorders.

were actually quite shrewd financially. They were quite good with their money. And in odd ways, the one place in their lives where they did not display any kind of pathological abnormality was in their economic life. So their, you know, affective states were troubled. Their relations with friends and family were broken down. But they somehow were still working and making money and doing all these various things.

And so and there are various other permutations that I described throughout the book about how it could possibly be the case that one could be fundamentally irrational. That is to say, suffering from a major psychiatric disorder while simultaneously being a perfectly reasonable economic actor. So a kind of rational economic actor who was also, as it were, irrational.

The third motif sort of extends from the second one, which is not simply the case that madness could be commensurate with perfectly reasonable economic action.

But then in some cases, a little bit of madness was actually good for business. It was good for making money. It was a way by which innovative possibilities could emerge.

And this is where you see the idea of the entrepreneurialism, the concept of entrepreneur. And in this chapter, I actually kind of interweave discussions around economic theory, Schumpeter and others, with remarkably analogous discussions that were happening within psychiatric medicine around this idea that in order to create novelty within the social sphere, the social or economic sphere, in order to create something new,

You had to have a slightly abnormal mind. There had to be something where you saw in the world things that were not there.

And that's what essentially an entrepreneur does. This is the idea of economic innovation is that you create new markets. You create new demands. You create new objects. They weren't there. So you're seeing things, as it were, that are not there. But, of course, the idea of seeing something which is not there is also definitively what insanity is. It's a delusional disorder, right? And so the question then becomes what's the boundary there?

Between the entrepreneurial, the virtuosic entrepreneurialism and just madness. What is the innovation that defines one versus versus the other? And this is where I say it really comes down to a kind of retro retrospective economic appraisal.

So that if the novelty that you're creating is profitable, is remunerative, then you are in a sense an entrepreneur, a genius, a virtuoso. But if it's not, if it's not profitable, if it loses money...

Then you are in a sense, it's not innovation that you've instituted. It's aberration. It's some kind of, it's novelty, but in the form of an abnormality, which is also a kind of conception of novelty, right? The abnormal, the mutation, it's a discrepancy, but it's still a form of novelty, right? And so, and it's this interesting proximity between a form of pathology that's lucrative, right?

Right. That we then call entrepreneurial and virtuous, virtuosic and a pathology that I call or which can be called pernicious. So pathology that actually doesn't produce something and produce something in terms of like what would be socially and economically defined as valuable pathology.

versus a pathology which does. And so this is an interesting kind of boundary between the lucrative and the pernicious pathology. So in a way, what I'm trying to describe in the book is not that it's not the dichotomy between health and illness, that health is productive and illness is unproductive. It's actually saying, no, no, no, it's illness that has to be dichotomized into productive illnesses, productive and prolific irrationalities and unproductive ones. Mm-hmm.

It's quite interesting that this way of thinking is still, I guess, very much present in, I don't know, my businessmen, among some economists, this idea of being a mad genius, let's say, as you mentioned, to come up with new ways of selling things or creating new markets. Yeah.

No, I mean, it's true. And in that sense, and I just quickly say, too, I mean, I'm the book is an effort to try and understand why we even come to think in this way, like why we would come to think about the idea of a kind of creative genius or creative madman. What was what were the kind of genealogical impulses that kind of animate that form of thinking? That's largely what that chapter I mean, and also the book is about. And

Not to push too far onto it, too, but just back to the Foucault thing, of course, you know, I don't really say it explicitly, though I do think it does seem clear and you have yourself identified. This is very much a book which you can call a kind of history of the present. I don't really talk about contemporary things, but clearly the shadow of our moment is cast throughout the book. And that's really what the book is trying to do, is trying to understand why, you know, why do we have...

Why do we think in these ways that we do? You're right. Because when I was going through the world, I was constantly making connections with what's happening these days or what's happening in the past four decades in terms of economy. Yeah. Yeah. Yeah.

Don't miss your window of opportunity. Upgrade your space now during Blinds.com's anniversary sale and save up to 50% site-wide. Our design experts can help schedule a professional measure and installation, plus guidance for DIYers too. With over 25 million windows covered and our 100% satisfaction guarantee, you can count on Blinds.com to deliver results you'll love. Shop Blinds.com's anniversary sale now for up to 50% off site-wide. Save up to 50% site-wide at Blinds.com. Rules and restrictions may apply.

The land has been thrown into disorder. As Trump rips up the rule books, Musk breaks apart the government, and Vance offends allies, it's official. We're living through the era of the global enduring disorder. My name is Jason Pack. I'm a podcast fellow for the New Books Network and host of the Disorder Podcast.

I've seen a fair amount of disorder in my day. I lived in Libya in the late Qaddafi period. I worked in Syria and in Iraq. I've been kidnapped twice. But this is the worst I've seen. The rules-based international order that has reigned for 80 years no longer applies. So I want to bring a nerdy new books network kind of approach to understanding how did we get here?

And what can we do to restore a semblance of order to our mad, mad, mad, mad world? We will fight those powerful and nefarious forces of neoliberalism and oligarchy. We will overthrow them and restore harmony to the land. We need you, the mega orderer, to listen and help us order the disorder. So search Disorder in your podcast app to listen right now.

This is a very interesting way of looking at the idea of madness and entrepreneurship. But I have another question here. I've read a couple of books on the history of madness and how it was pathologists, how they tried to diagnose or even treat this condition. But there's always been a difference the way madness has been viewed between men and women. So there was always a sexist element to it as well.

And here and you were talking about economy. So I'm wondering if this idea of entrepreneurial madness, if there was any, first of all, racial and also a sexist element in terms of was it a white masculine phenomenon? Did the blacks have that answer? I mean, did where they did they have that privilege of being, let's say, entrepreneurially mad?

for that sake as well? Right, right. Yeah, that's a great question. And it's a motif that I describe throughout the book and a couple of chapters closely in particular.

So I just described a moment ago about how the dichotomy that I'm really trying to draw out in this book is less about the dichotomy between health and madness or health and illness as if health is the productive and illness is the nonproductive side of the binary, but rather sort of dichotomizing madness itself. So dichotomizing pathology itself.

into lucrative forms of pathological states and, and pernicious forms, uh, costly forms. And, um, one of the arguments that I make in the book is that the boundary, um,

between lucrative pathologies and pernicious pathologies were largely regulated on gendered and raced terms. And the category of both whiteness and masculinity, in particular white masculinity, is one of the ways that I understand how that boundary between the lucrative and the pernicious pathology is largely kind of normalized.

And what I mean by this is that, I mean, one of the things I talk about in the book is that the idea of pathological value in many respects is a form of entitlement, an entitlement largely hinged on white masculinity. So that it tends to be the case. And I'm going to be a little bit schematic because it's a discussion I go into in quite a amount of detail in the book.

Basically, thinking about the way pathological value is itself linked to a history of racial capitalism and the idea that for certain forms of value to be accrued, certain kinds of expropriations of value have to also take place. And so when I talked a little bit a moment ago in this sort of chapter about how you have this idea that in commercial life, there are these constant risks that

that businessmen run into of potentially suffering some kind of like traumatic disorder as a consequence of business life. Right. So so commercial life is incredibly pathogenic. And yet you also need to be a little bit mad in order to be profitable. So how do you balance the necessity of madness against the constant sort of traumatizing risks of economic life?

And one of the things that I argue in the book is that whiteness and masculinity become certain kinds of inoculative privileges.

that in some respects shelter certain economic agents from suffering, from sort of submitting to the pathogenic virulence of economic life while still being able to, let's say, benefit from certain kinds of lucrative pathologies. So, I mean, in very just sort of schematic terms, what this implies is that there are some people in the population whose weirdness, whose aberrancies, whose potential pathologies

we tend to think of as it were...

remunerative or financially beneficial. And I think white men, as it were, tend to have that kind of privilege attached to their behaviors. So there's a certain, a greater degree of dispensation for a white masculine agents to get away as it were with certain forms of pernicious, otherwise pathological conduct that they're sort of non-white, non-masculine counter

Our parts can't necessarily take take advantage of. And this is an extended discussion I have in one of the sections of the book where I talk about black enterprisers in the history of the US and the ways in which this claim to economic prosperity as a mechanism for adjudicating racial violence, particularly in the context of racism.

black American businessmen and said extended discussion. It was it never really paid out. So it never really paid off. This idea of like economic freedom as a way of ameliorating racial violence failed. And I want to argue that actually part of the reason that it fails has to do with this way that pathological value is largely hinged on gendered and racialized violence.

lines um so yes so so in fact um in a way rather than thinking about um certain populations being pathologized negatively pathologized so women raced bodies so on and so forth i think about how um a kind of an inverse pathologization happens for around the category of white masculinity that that um

enables or allows for a certain form of, let's say, lucrative pathology to emerge. That makes sense. I'm also interested to talk about some specific examples. One example that I absolutely found fascinating was insurance law in the U.S. in 1898 where

and also the condition of sinistrosis, which supposedly has its roots in that insurance law. Can you talk about that part of the book, please? Yeah, yeah. So this is a chapter called The Pathology of Work, and it explores, let's say outwardly, this disease category called sinistrosis. It's my translation of the French term, la sinistrosis.

And it was a disease category that was essentially created and emerged right around 1907, 1908, and was a transient disorder. In other words, it sort of disappeared by the 1920s and 1930s. And it was coined by a neurologist named Edward Brissot, who was one of the students of Jean-Martin Charcot, the famous French neuropsychiatrist.

And synastrosis was this very strange condition that was attributed almost exclusively, I would say, in fact, exclusively to French industrial workers. So sort of industrial laborers. And what it was seen as was a kind of delusional psychosis that a worker suffered from,

usually after some kind of injury that they incurred on the job, where they believe that they were somehow owed some kind of recompense for whatever injury that they received. And it was this very interesting disorder because the true etiology, in other words, the source of this delusional psychosis disorder,

was posited as the 1898 worker compensation legislation, the laws that the French state instituted in order to guarantee some kind of monetary payout for injuries that were incurred in the workplace. And so it's essentially like liberal worker friendly legislation was seen as actually a virulence, like a source, a pathogenic source for some kind of a psychotic state.

And what was very interesting is that this category of sinistrosis, this was not a...

This was believed to be a real disorder. It wasn't considered some kind of like, you know, surely it was understood as kind of like being very anti worker. But they really believed that it was a real disorder and that, in fact, certain kinds of economic policies could induce forms of pathology. And essentially, because all industrial workers in France were effectively indemnified by this national legislation, they

All workers in France were perceived as susceptible to suffering from sinistrosis. And and the chapter offers a kind of genealogy of sinistrosis. So why this this disease category would emerge in the first place? And it looks at a number of sources. I'll very briefly just name them. I won't really go into detail because it's a longer chapter, too.

And so one of the ideas is that a lot of the discourse of sinistrosis comes from a long history of the problem of simulation within the history of psychiatry. So the idea that...

People were fraudulently trying to claim that they were ill for some kind of compensation by claiming that they had a psychiatric disorder, that they were essentially malingerers or they were faking it in order to not work or not get conscripted into military service or whatever it may be. What's very interesting about simulation as a problem in the history of psychiatry is

is that after the 1870s or so, when new disease categories like hysteria begin to emerge and begin to be seen as legitimate psychiatric disorders,

One of the sort of legitimate, as it were, quote unquote legitimate symptoms of disease states like hysteria is that people simulate disorders. So that simulation is actually seen as an unintentional symptom of a real pathology. So the question then becomes, how do you differentiate a real simulator from an inadvertent simulator? In other words, a person who's actually trying to deceive someone.

from a person who is just simulating some kind of a condition, like an ailment. And a simulation, an unintentional simulation might be like a psychosomatic symptom or a hysterical blindness or something along these lines. So you have the problem of simulation. And then, of course, you have another larger discourse around occupational psychopathologies. What does it mean to think about addicts?

in the workplace causing not just physical injuries, but psychiatric traumas. In fact, the origin of the very category of a traumatic disorder begins in the period of the 1860s and 1870s around the problem. And it was a it wasn't just a medical problem, but it was a legal and economic problem of how people get some kind of recompense for an injury that they sustained on

on the job or within some kind of industrial context, a factory, a railroad or something along these lines.

So so so this idea of sinistrosis emerges from these various trajectories, these vectors, simulation, the problems of occupational disorders, the problem of trauma, the entire question around litigation, the creation of insurance protocols in a way to make people.

to sort of bypass the question of liability. I mean, part of the reason why throughout Europe you have worker compensation legislation happening is because workers were largely suing the companies after they would be injured, whether it was railway companies or factories.

And and winning often. And so this sort of nationalized legislation was a way of actually creating a kind of no risk or rather no fault. Sorry, no fault orientation towards these compensation outputs. So if you were injured on the job, the state would pay you out.

And there would be no need for litigation. But it created a whole new set of problems where psychiatrists like Brousseau came to believe that actually these worker compensation laws themselves induced in workers a delusional belief that they were always owed money.

And so this is very interesting idea that in a weird way, industrial workers were seen as constantly at risk of something, whether it was the risk of being injured on the job or the risk of being, let's say, tricked by a kind of national legislation and then coming to believe in some ways that they were always injured.

they were always injured, that they always were owed money. So it's a very fascinating kind of series of convergences. And again, to talk about more practical examples of the arguments, there's another character in the book you discuss, John Armstrong Chandler, if I'm not mistaken, and who turned his psychological condition into an economic asset.

What was his economic... Sorry, what was his psychological condition? How did that story unfold? Yeah. So, you know, I start the book in terms of what we were just talking about moments ago around these borderland figures, these figures who are sort of

Not quite saying not quite insane. And at the beginning of the book, I talk about how the category of eccentricity was always a very long standing problem for psychiatrists throughout the 19th century. And eccentric is an odd kind of characterization for a person because an eccentric is defined largely by the performance of behaviors that are inscrutable in a certain way. They're not quite normal, but they're not necessarily determinably unhealthy either.

And I end the book by doing it with a kind of case study of a very well-known or at least within the field, the kind of semi well-known eccentric person.

who was a Gilded Age New York businessman. His name was John Armstrong Chandler. He then changes his name to Challoner for reasons that I talk about in the chapter. He was an heir to the Astor family fortune. So just a wealthy New Yorker who...

um decided and this was not uncommon for a lot of wealthy new yorkers to um invest in southern text textiles um challoner was an interesting individual because he um s-s-s-

Probably suffered from a serious psychiatric disorder. He believed that he had this sort of voice or this faculty, this capacity in his mind that was a sort of separate psychological agent. He named it the X faculty. He believed that the X faculty spoke to him, that it helped him make decisions about business endeavors and these sorts of things.

And the idea is that that challoner could not help but always perceive his ex faculty as something akin to a financial asset.

He tried to copyright the ex-faculty. He described his ex-faculty as essentially a kind of oracular capacity to, you know, to partake in kind of financial endeavors. In other words, it's a story about an individual who very likely suffered from a serious abnormality, but who always perceived it as a certain kind of an economic asset. And, you know, he was a wealthy white man

a man who was very aware of his racial standing. And I, you know, I described how that's the case in the book. And so he, he essentially is a paradigmatic of what I describe as the kind of entitlements that underwrite a great deal of this, this concept of pathological value.

And so in a way, he's he's doing to himself, I argue, what psychiatrists had long been doing to madness, which is appraising these odd behaviors on the basis of their economic merits. And so in a sense, Chaloner was was essentially saying,

taking up this economic style of psychiatric reasoning, but on his own. He was using it as what's often described as a kind of technology of the self, really reimagining and refashioning himself as this sort of a kind of prophetic, oracular genius in financial affairs, but whose genius is actually fundamentally grounded in what would effectively have been seen as a morbid psychopathology. Yeah.

Make your next move with American Express Business Platinum. You'll get five times membership rewards points on flights and prepaid hotels booked on amextravel.com. Plus, enjoy access to the American Express Global Lounge Collection. And with a welcome offer of 150,000 points, your business can soar to all new heights. Terms apply. Learn more at americanexpress.com slash business-platinum. Amex Business Platinum. Built for business by American Express.

Thanks to IP.

Learn more at phrma.org/ipworkswonders.

As a final question, maybe my last question is two parts. So I might ask you just separately. Yeah. And the first one is that you've already touched upon at the beginning of the interview that the purpose of the book, why you decided to write a book. But I really like that in your last chapter, you called for an undoing, a deontologization of madness, economic rationality.

What do you mean by deontologization of madness as an economic rationality here? Maybe that's the first part of my question. So I'll let you answer this one before moving to the next. I'll try and be slightly quick, which is to say that one of the things I'm trying to do in this book is to...

go in a slightly different direction than what might intuitively be seen as the direction to go in thinking about the relationship between psychiatry and economics.

In the sense that one might be inclined to think about that relationship as being about the political economy of psychiatry as a field, as an institution, in terms of labor practices, in terms of underlying economic incentives and so on and so forth. What I argue instead is that...

To understand how madness was even theorized or imagined from the inception of modern psychiatry as a concept that was suffused with a form or style of economic reason, it meant that the very thinkability of mental illness could never be dissociated from a certain kind of economic logic. And what that implies...

I say and I say this in the strongest possible terms is that in a way, the very the very essence of madness is a kind of an economic form.

So that madness is not incidentally economic to the extent that it's also a medical and deeply moral category, that it is also a fundamentally economic concept, like sort of through and through. And this is what I mean by saying that the very ontology of madness has been transformed by the economic styles of thinking that made that gave sense to it and that shaped it.

It was essentially the very contours of madness are economic in a very fundamental way. So what does it mean then to kind of extract or remove an economic reasoning?

not just from madness, but also then from the attendant notion of mental health. Because obviously madness is a profoundly economic concept and so is psychiatric health in large ways that we can't even imagine what health and illness means in a non-economic way, right? So this is in a sense going so far as to say that

That capitalism is not merely a political economy, but it's an entire cosmology that has fundamentally transformed the nature of things, right? Including our very conception of health and illness. And so it's not enough, as it were, to remove practices of health, like medical practices, from certain political economies. That's not sufficient. That's not going to, in and of itself, change.

transform how we even conceptualize health and mental health and mental illness. And so something more, something more radical, I think may be necessary. I won't go too much into this, but I'll simply say that then I kind of invoke what's often, you know, you see it in many places too, which is that real kind of transformations, radical, let's say revolutionary political transformation. It's not enough to sort of shift infrastructures and institutions or

But that what is also demanded is a profound sort of self-transformation. And this is a certain way in which sort of Marxist thought is brought into conversation with certain post-structural strands of thinking. For instance, a kind of Foucauldianism where people actually try to bring back into conversation a kind of Marxist critique of capital, right?

with a kind of Foucauldian approach. Oftentimes these things have been pitted apart, but I think recently a lot of different kinds of scholars have been thinking about actually putting these back into conversation and saying that perhaps our very conception of subjectivity is also fundamentally suffused by the logics of capital. And so it's not just enough to change political economic institutions, but also to fundamentally transform subjectivity itself.

And so that's part of where I gesture at towards the end of the book. And as a second part, your book is, as you mentioned, it's more focused on the 19th century, but it constantly evokes the present. Even if we don't talk about it there, you just can't escape it. And I know that this is not an area that you particularly research in the book, but I'm keen to know your thoughts, your observations, if

this way of pathologizing madness in the 19th century, how do you see resonances in the present in terms of either, you know, in public discourse when people talk about the economy of madness or even in clinical practices or psychiatrical clinics where, do you see any, let's say, resonances of that

or maybe a marked difference or a shift in the way we think about madness and related to economic rationality? Yeah, that's a great question. I mean, I see a certain degree of continuity. I can give you a couple examples and colleagues of mine who are much more embedded within clinical work. So colleagues who are maybe historians of psychiatry, but also are psychiatrists themselves, right?

have have confirmed similarities here and and just to give you a couple examples i mean very superficial ones or at least one very superficial one i think a lot of the clinical determinations about a person's psychiatric health is often almost just tacitly i mean to the point where we don't even think it's an issue hinged on whether or not a person is capable of working

So whether or not you are productive in the workplace is oftentimes a very strong kind of guarantor of your psychiatric health. So just the very idea, and we don't even question it, like about, you know, the idea that, well, are you working right now? That's itself in large part, it determines if you're okay. Are you okay? Can you go to work? That's a very strange, you know, if you think about it, it's a very odd equivalence, but it's such a common concept.

one that I think it's very interesting. Another one that I think is quite fascinating and this will, I don't want to go too much into it because it didn't, it pushes us off in a different direction, but it is quite, you know, it's very central in the pathology of work chapter, which is, you know, the, the discourse on trauma is still very much with us today. Trauma studies is a very, you know, a very dominant, very popular conception of how people understand the state of their mental health and,

I think trauma is still very largely embedded within a kind of economic style of thinking. I think traumas are often still seen, I think, as a kind of a contractualist logic.

where a trauma is something that happened to me and I am, as it were, paying for it, paying for it going forward. So somehow traumas are kind of like they're sort of seen as kind of economic circuit. Something happened and I have to pay for it or I'm owed something. The very idea of health even...

As a kind of bank account. So, you know, for instance, like I'm investing in my health by eating healthfully, by sleeping. Oh, I didn't sleep very much the past week, so I'm making up for it. I'm adding new deposits into my bank account by sleeping more next week or something along these lines. So I think this bank account logic of thinking about health and unhealth is still relevant.

Very much with us. Not only so, not only would I say that the things that I describe in my book are still present, I think they've become so present and so diffusely present that they become almost invisible. So part of what I'm trying to do in the book is to draw out a kind of a way of thinking to try and illuminate how much economic logics go unquestioned in our conceptions of health and unhealth today. Yeah.

Yeah, it just reminded me, like, I don't know about the United States. In Australia, if you work somewhere, you're entitled to three sessions of psychologists, psychologists, if you're under stress, and that's paid by work. And I guess we owe it to the unions here. But again, I'm always very skeptic and I'm a skeptic of HR and I hope my manager is not listening to this. But the whole idea is you make sure you're right. They just want to make sure that you're okay to be economically profitable.

And I do remember a colleague of mine went through a really, really tough time. He had to see a psychologist. He had to take a few months off work. And he was very happy that the workplace was looking after him. But after he came back and said, look, you know that at the same time, the workplace was also thinking of finding a replacement in case he can't come back to work.

He didn't really give a shit about you. It was just, yeah, come back to work to make more profit. And you're right. It's so much out there, so much. Yeah. But we take it for granted that we don't even see. There's a there's a thing I talk about throughout the book as well. I mean, more on the sort of intro and the conclusion of the book, which is, you know, one of the things that I'm trying to do in the book is to reconsider the very concept of value.

And so I don't approach it from a kind of strictly Marxist sort of theory of value, but from a broader kind of – a set of broader discussions around theories of value that you see in the context of social theory. And one of the things I say is that in the context of sort of social thought, conceptions of economic value –

tend to also co-occur with conceptions of moral value and medical value. And so this idea of what's healthy and what's good and what's productive and profitable kind of go together. But because they go together, they can end up creating these very interesting inversions and transformations. So you might say, well, but of course, mental illness is not healthy. So therefore, it must be morally bad and unhealthy.

Right.

creates these mutations that are actually quite interesting and gets back to this thing that I said at the very beginning of the interview, that a lot of what this book is about is thinking about how productive the category of the irrational has become, or maybe has always been in the modern era, that we can never really get rid of irrationality in the world. And whether we understand this as like

political nefarious political irrationalisms or just medical forms of mental illness we have to make room for them we have to make sense of them we have to give them a place and oftentimes that place is um far more uh valued than than maybe they should be but anyway um so so yeah i'll just stop there but i think that's that's kind of getting to your point yeah yeah

Thank you very much, Neema. I absolutely enjoyed talking to you about the book, and I do strongly recommend the book to our listeners. As you mentioned, you go into a lot of details, fascinating details. It doesn't matter if you

come from, let's say, background in psychology or psychiatry. If you're interested in economy, intellectual history, history of madness, if you're interested in critical theory, this is a book to read, Madness and Enterprise, Psychiatry, Economic Reason, and the Emergence of Pathological Value, published by Chicago University Press. Thank you so much, Neema, for your time. Thank you. I really enjoyed this conversation.