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Philosophy of Madness overlaps with several other fields, such as disability studies and Mad studies. Perhaps most notably, it overlaps with—and to some extent grew out of—philosophy of psychiatry. The term “Madness” does not have a single use or definition. A few examples of how it is used are: the term can denote unusual mental states and experiences in phenomenology; scholars discuss the socially constructed difference between Madness and eccentricity; and activists regard “Mad” as a political identity. “Madness” overlaps with concepts such as “mental illness” and “neurodivergence,” but it does not have the negative value-laden connotation of “illness” and is not necessarily as inborn or permanent as “neurodivergence.” Philosophy of Madness, understood as philosophy that is about Madness, differs from philosophy of psychiatry by centering Mad people’s own experiences. In a narrow sense, philosophy of Madness is done by openly Mad philosophers; in a wider sense, it can be done by sane people too, as long as it still centers Mad people’s experiences and methods and avoids the “othering” one frequently sees in traditional philosophy. This mirrors the “nothing about us without us” approach in disability and neurodiversity studies and activism. In the wider sense, Philosophy of Madness may also concern itself with topics other than Madness itself; philosophers of Madness apply Mad insights to topics such as agency and epistemology. Finally, the article discusses the possibility of doing philosophy madly.

In this paper, I will argue for two interrelated theses. First, if we take phenomenological psychopathology seriously, and want to understand what it is like to undergo various psychopathological experiences, we cannot treat madpeople’s testimony as mere data for sane clinicians, philosophers, and other scholars to analyze and interpret. Madpeople must be involved with analysis an interpretation too. Second, sane clinicians and scholars must open their minds to the possibility that there may be experiences that other people have, which they nevertheless cannot conceive of. 

I look at influential texts in which philosophers attempt to analyze and understand depersonalization and thought insertion. They go astray because they keep using their own powers of conceivability as a guide to what is or is not humanly possible to experience. Several experiences labelled inconceivable and therefore impossible by these philosophers, are experiences I have had myself. 

Philosophers and others would be less likely to make this mistake if they would converse and collaborate more with the madpeople concerned. When this is not feasible, they should nevertheless strive to keep an open mind. Fantastical fiction may have a role to play here, by showing how bizarre experiences may nevertheless be prima facie conceivable. 

People are morally responsible agents when they are sufficiently rational and in control of themselves. Morally responsible agents may or may not be morally responsible for particular actions, depending on whether they had sufficient control and the information needed in the situation at hand. We can be morally responsible for good, bad, or morally neutral actions. This chapter focuses on culpability – responsibility for bad actions. In cases of mental disorder, rationality and/or control may be diminished, and people might be unable to avail themselves of important information. Nevertheless, the exact difficulties that people struggle with vary, not only between diagnostic categories but within them as well. Culpability assessments are therefore complicated, and must ultimately be done on a case-by-case basis. Psychiatric patients who are exempted from culpability altogether, considered too irrational or out of control to be morally responsible agents at all, may feel dismissed and isolated. Moreover, culpability judgments in clinician-patient relationships are naturally quite fraught. Hierarchical relationships often result in one-sided responsibility practices. In these cases, a person in power holds another person culpable and, at the same time, dismisses attempts to be held culpable by others, most notably people subjected to their power. Finally, it is important to recognize that actions that seem strange and disturbing need not be culpable; they may be excused or even justified. 

Justin Garson introduces the distinction between two views on Madness we encounter again and again throughout history: Madness as dysfunction, and Madness as strategy. On the latter view, Madness serves some purpose for the person experiencing it, even if it’s simultaneously harmful. The strategy view makes intelligible why Madness often holds a certain allure – even when it’s prima facie terrifying. Moreover, if Madness is a strategy in Garson’s metaphorical sense – if it serves a purpose – it makes sense to use consciously chosen strategies for living with Madness that doesn’t necessarily aim to annihilate or repress it as far as possible. In this paper, we use our own respective stories as case studies. We have both struggled to resist the allure of Madness, and both ended up embracing a kind of Pyrrhonian scepticism about reality instead of clinging to sane reality.

People are morally responsible agents when they are sufficiently rational and in control of themselves. Morally responsible agents may or may not be morally responsible for particular actions, depending on whether they had sufficient control and the information needed in the situation at hand. We can be morally responsible for good, bad, or morally neutral actions. This chapter focuses on culpability – responsibility for bad actions. In cases of mental disorder, rationality and/or control may be diminished, and people might be unable to avail themselves of important information. Nevertheless, the exact difficulties that people struggle with vary, not only between diagnostic categories but within them as well. Culpability assessments are therefore complicated, and must ultimately be done on a case-by-case basis. Psychiatric patients who are exempted from culpability altogether, considered too irrational or out of control to be morally responsible agents at all, may feel dismissed and isolated. Moreover, culpability judgments in clinician-patient relationships are naturally quite fraught. Hierarchical relationships often result in one-sided responsibility practices. In these cases, a person in power holds another person culpable and, at the same time, dismisses attempts to be held culpable by others, most notably people subjected to their power. Finally, it is important to recognize that actions that seem strange and disturbing need not be culpable; they may be excused or even justified. 

Philosophers traditionally distinguish between excuses and exemptions. We can excuse someone and still see them as a participant in normal human relationships, but when we exempt, we rather see them as something to be managed and handled: we take an objective attitude to them. Madness is typically assumed to ground exemptions, not excuses. So far, the standard philosophical picture. Seeing other people as objects to be managed and handled rather than persons one can have relationships with is already ethically problematic; if I am mad myself, consistently seeing myself this way becomes downright unsustainable. A better option is to fully appreciate my own difficulties and learn to show myself compassion and understanding; I can then excuse myself on those grounds. A compassionate self-excusing attitude furthermore leaves room for both nuance and improvement in a way that total exemption does not. Finally, I argue that many mad actions ought to be considered justified rather than in need of exemption or excuse. 

It has been argued that a retributivist criminal justice system treats offenders with a respectlacking in alternative criminal justice systems; retributivism presumably recognizes that offenders are fellow members of the moral community who can be held responsible for their actions. One version of the respect argument builds on P.F. Strawson’s moral responsibility theory. According to Strawson, we may take either a participant or objective attitude toward other people. The former is the default attitude when interacting with other adults, whereas the latter is fit for children and the mentally disabled or ill, whom we merely try to manage and handle as best we can. The participant attitude also involves holding people responsible when they do wrong. Supposedly, a retributivist criminal justice system functions as a natural continuation of our everyday, participant, and responsibility-holding practices, unlike alternative systems that adopt an objective attitude toward offenders. I argue that this is wrong. The participant atti-tude requires reciprocity and, usually, some level of equality too. Even an idealized retributivist system has little room for this, not to mention the flawed versions of this system we see in reality. 

Filosofer och andra debattörer hänvisar ibland till skepticism om moraliskt ansvar när de argumenterar för en mer rehabiliteringsinriktad kriminalvård och ett tryggare välfärdssamhälle. Om vi underminerar tron på moraliskt ansvar, resonerar de, så underminerar vi därmed tron på förtjänta bestraffningar och förtjänt fattigdom. Skepticism-baserad argumentation för samhällsreformer lider dock av flera problem. Påvisade skillnader i hjärnan mellan olika grupper bevisar inte frånvaron av moraliskt ansvar hos vissa. Total skepticism om moraliskt ansvar innebär att rika och mäktiga saknar ansvar de också. Filosofiska argument både för och emot existensen av moraliskt ansvar bottnar i slutändan i intuitioner, som skiljer sig från person till person. Det är bättre att fokusera på empiriskt grundade argument som visar att människor har begränsad kontroll över sin situation. Sådana argument övertygar förstås inte alla, men det finns inga magiska argument som gör det.

The medical and social model of disability is discussed and debated among researchers, scholars, activists, and people in general. It is common to hold a mixed view, and believe that some disabled people suffer more from social obstacles and others from medical problems inherent in their bodies or minds. Rachel Cooper discusses possible 'test environments', making explicit an idea which likely plays an implicit part in many disability discussions. We place or imagine placing the disabled person in a range of different environments; if there is a relevant test environment in which they do fine, their problem was societal/external, if there is not, it was medical/internal. Cooper admits that deciding on the appropriate range of test environments is an ethical and political question. In this chapter, I argue that we often ought to widen our scope when discussing psychiatric disabilities.