Schizophrenia and narrative in artificial agents - Narrative Intelligence - page 263

example, Erving Goffman, in his ground-breaking anthropological study Asy-
lums (Goffman 1961), argues that a major feature of psychiatric institutions
is the “programming” of each inmate “into an object that can be fed into the
administrative machinery of the establishment, to be worked on smoothly by
routine operations.” (16)
One of the signs of this mechanization is the reduction of patient to symp-
tomatology. Patients are constantly monitored, their behavior continuously be-
ing examined for and interpreted as signs of illness. The patient's actions only
function insofar as they are informational - they only act as ciphers, which it
is then the responsibility and right of the doctor to decode. Rather than being
taken seriously as such, a patient's words are used to place the patient in the
narrative of the doctor's diagnosis. “When you spoke, they judged your words
as a delusion to confirm their concepts” (Robear 1991: 19).
Understood symptomatically, the patient's subjective experience is ig-
nored. Susan Baur describes this limitation of the institutional approach to
mental illness:

I... believe that the medical model of mental illness excludes too much of the
patient. Using this model, only parts of the patient are considered, and even
when these parts are assembled by a multidisciplinary team into a manikin of a
schizophrenic or of a manic-depressive, the spirit that animates the real person
gets lost. Especially in chronic cases where mental illness and the desperately
clever adaptations it inspires have become central to an individual's person-
ality, the patient's own story and explanations - his delusions and imaginary
worlds - must be included (Baur 1991: 105-106).

The patient is formalized, reduced to a set of somewhat arbitrarily connected
symptoms. The patient is no longer a living, unique, complex individual, but
fragmented into a pile of signs: “she is autistic,” “she shows signs of deperson-
alization,” “she lacks affect.”
This fragmentation into symptoms, psychiatrist R. D. Laing argues, actu-
ally reinforces , rather than treats, schizophrenia. When mechanistic explana-
tions reduce the patient to a bundle of pathological processes, the patient as
human is rendered incomprehensible. Laing argues that institutional psychi-
atric practice cannot fully understand schizophrenia because it actually mimics
schizophrenic ways of thinking, depersonalizing and fragmenting patients.

The most serious objection to the technical vocabulary currently used to de-
scribe psychiatric patients is that it consists of words which split man up
verbally in a way which is analogous to the existential splits we have to de-
scribe here.... [W]e are [then] condemned to start our study of schizoid and