Opoet, playwright, biographer, and scholar, the greatest literary figure of his age, Samuel Johnson (1709—1784) once wrote, “Disorders of the intellect happen much more often than superficial observers will easily believe. Perhaps if we speak with rigorous exactness, no human mind is in its right state.” His interest in the subject was due to concern for his own sanity. In Young Sam Johnson, James Clifford writes that Johnson “would become oppressed, again and again, by the morbid obsession that he was losing his mind.” Johnson was a great admirer of John Bunyan. Historian W. HaleWhite notes that Johnson was “haunted by Bunyan’s specters.” That is not surprising, as Johnson, like Bunyan, clearly had obsessive-compulsive disorder.James Boswell, Johnson’s famous biographer, notes that his subject had “queer habits which amazed all beholders,” habits we now recognize as touching and repeating compulsions. Johnson “sometimes seemed to be obeying some hidden impulse, which commanded him to touch every post in a street or tread on the center of every paving-stone. He would return if his task had not been accurately performed.”Johnson also performed compulsive rituals before entering houses: “I have upon innumerable occasions,” writes Boswell, “observed him suddenly stop, and then seem to count his steps with a deep earnestness; and when he had neglected or gone wrong in this sort of magical movement, I have seen him go back again, put himself in a proper position to begin the ceremony, and, having gone through it, break from his abstraction, walk briskly on, and join his companion.” Similar compulsions are described by another Johnson biographer, Miss Frances Reynolds, who writes that upon entering a house Johnson “whirled and twisted about to perform his gesticulations; and as soon as he had finished, he would give a sudden spring and make such an extensive stride over the threshold, as if he were trying for a wager how far he could stride.”Johnson frequently suffered a nervous tic disorder, not uncommon with OCD sufferers. Sometimes, his compulsions and tics were the object of ridicule. Boswell writes: “Once Johnson collected a laughing mob by his antics; his hands imitating the motions of a jockey riding at full speed and his feet twisting in and out to make the heels and toes touch alternately.”*16/338/2*
The more our perception improves, the less we will need to use terms such as ‘disorder’ and ‘chaos.’ In what follows, except where I need to differentiate process thinking from medical paradigms, I shall refer to mental disorders as extreme states.
The word ‘state’ means for me a momentary picture of an evolving process. The term ‘extreme’ refers to the frequency with which these states are met with by the ordinary person during everyday conditions outside of the psychiatric milieu. Thus, they are rare only in terms of occurrence; the majority of their content and structure is experienced by all of us. These extreme states show a chronically missing ‘metacommunicator,’ that is, someone who is able to talk about the states as if they were occurring in another person.
This definition of psychosis frees me to study these states as static momentary or cyclical processes which are evolving, have a purpose and an implicit order and direction. Furthermore, I am removing them from the ordinary categories of cause and effect, medical disease and cure, and placing them in the realm of phenomenology, which connects psychiatry to psychology, physics, medicine and sociology.
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