In the short space between one half minute and the next I … lost my reason and become insane… A man of flesh and blood fell into step with me. We walked in silence; I felt no need to talk; I knew I had at last met my special messenger. … He ran away…  after that the solar system started to fall apart… The running man, as he went out of sight, could be seen now as four different men all present in one body at the same time. … I retired to my flat. … The super-human personage was in blind flight and racing round the planets widdershins. ... I knew also, as the racing figure did not, that at one point one of them was missing and he would fall through and disrupt the equilibrium of the others in his fall. ... If I could provide some kind of counterpoise, all might be well. I stood in a passage swinging my arms like pendulums until the danger point had passed and all was well. ... I was found soon afterwards, dancing naked in front of a mirror.

(Morag Coate, Beyond All Reason)

How are we to meet with Morag in her madness? One story goes something like this: In his General Psychopathology, psychiatrist and philosopher Karl Jaspers proclaimed psychosis sufferers like Morag to be un-understandable. We psychologists, however, can undo Jaspers’ addition of clinical insult to psychotic injury by showing how her delusions reflect her sense of herself and her life, allow her to escape from intolerable predicaments, and constitute attempts to make sense of aberrant experiences. In these ways Jaspers’ pessimism can be shown up as misplaced and inhumane, and Morag may be brought back within the community of humanly meaningful subjects.

That story is popular today, but it’s deeply misleading. Read his textbook and you’ll find plenty of examples of Jaspers stressing how delusional thought can indeed be understood in just the ways psychologists suggest. Even so, though, he still proclaims its ‘empathic un-understandability’. The remaining question, then, is what do Jaspers - and Morag - mean by saying she’s ‘beyond reason’?

It’s here that a little philosophy can help us - by distinguishing between the many different kinds of understanding that exist. Perhaps I’m a psychologist who understands how Morag’s delusions are motivated - not by the pursuit of truth but by how they make her feel better about herself. Or perhaps I’m a neurologist who understands the causal underpinnings of her thoughts in her brain. Or maybe I’m a psychoanalyst who understands her delusions as metaphorically expressive of her predicament - rather as dreams obliquely portray emotional struggles or children’s conflicts manifest spontaneously in their play. Or maybe I'm a visitor who shews understanding to Morag in my moral sensitivity. Finally, maybe I’m just trying to make sense of what Morag is saying or doing. In all these cases we encounter not just different objects of understanding; rather, what it is to understand each such object is different.

Now, it’s the final above-listed form of understanding - i.e. our ordinary grasp of what someone is saying or doing - that Jaspers styles ‘empathic’. And it’s ordinary empathic understanding that we struggle to achieve with Morag. This idea that arm swinging prevents universal destruction: it just makes no sense. We’d ‘have to be mad’ to think it (which doesn’t mean that, if only we were, we could then succeed at something which otherwise must result in failure!) Having separated out these different forms of understanding we can now reconcile Jaspers and Morag with the psychologists. Sure, Morag can’t be ‘empathically’ understood; her thoughts and actions just don't make rational sense. As she says ‘I … became insane and … forgot immediately and completely my normal, rational view of life.’ Even so, we may well still understand why she’s motivated to become delusional, understand what conflicts find symbolic expression in her delusional experiences, and perhaps even understand how her neuropsychological development made her vulnerable to breakdown.

As we read in her book, Morag had found intolerable the predicaments of having had an unlovable mother incapable of providing emotional containment, powerful sexual and religious conflicts, and of overwhelming unrequited passions. In fact her rational collapse itself makes visible the depth and power of her suffering. Far from extending the hand of human connection to her, denying this collapse by pretending to the ongoing possibility of everyday (‘empathic’ or ‘rational’) understanding instead deflects from her intolerable pain. In effect it’s itself a failure to engage that (‘moral’) form of understanding we shew one another.

Might it not be said though that, humans being essentially rational animals, we dehumanise Morag by seeing her as ‘beyond reason’? Must our retort here be that it’s mere prejudice to privilege rationality in this way? A more considered response highlights how its only such creatures as are essentially characterised by reason that may suffer its loss in delusion. We might say then that, far from impugning her humanity, acknowledging the fact of her delusion instead reinforces our appreciation both of it and of her essentially human vulnerability.

Dr Richard Gipps is a Chartered Clinical Psychologist, Associate of Faculty of Philosophy and Fellow of Blackfriars Hall, University of Oxford, and author of On Madness: Understanding the Psychotic Mind (Bloomsbury, 2022).