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Who thinks that they can subdue Leviathan? Strength resides in its neck; dismay goes before it. It is without fear. It looks down on all who are haughty; it is king over all who are proud. These words inspired PJ Wehry to create Chasing Leviathan. Chasing Leviathan was born out of two ideals: that truth is worth pursuing but will never be subjugated, and the discipline of listening is one of the most important habits anyone can develop. Every episode is a dialogue, a journey into the depths of a meaningful question explored through the lens of personal experience or professional expertise.
PJ (00:02.062)
Hello and welcome to Chasing Leviathan. I'm your host, PJ Weary, and I'm here today with Dr. Neema Basiri. He is a social theorist, historian, and philosopher of the human sciences. is an assistant professor at Duke University, where he teaches in the program in literature. And we're talking about his book today, Madness and Enterprise, Psychiatry, Economic Reason, and the Emergence of Pathological Value. Dr. Basiri, wonderful to have you on today.
Nima Bassiri (00:30.825)
Thanks for having me. I'm very happy to be here.
PJ (00:32.972)
So first question I always ask, why this book? What led you to this project and why is this project important?
Nima Bassiri (00:41.151)
Hmm, yes, that's a good and big question. Maybe what I'll do is answer the second question first. Why is this important or sort of what is this sort of intervention that this book is trying to do? And then I can talk about maybe how I came to it, which is not as interesting because I think I came to it in the same way that a lot of...
academics come to a lot of projects, which is happy accidents and coincidences and sort of stumbling into something and realizing you've like, my God, what is all this I've just discovered? So, and I know that most of your readers or viewers aren't familiar with the book, so I'll just do a very quick sort of schematic account of kind what the book is, but organize it around what I think is the intervention or kind of why it's important. And I'll even say that I think...
a lot of the potential significance of the book is wrapped around this term that you mentioned in the subtitle, pathological value, which is a kind of operative concept that runs through this book. And just to give you a little sense of what that term means, I'll say a couple kind of preliminary things. And the first is that a lot of what the book tries to do is to weave together two kinds of histories, a history of madness and a history of capital or capitalism.
But in a very different way than one might expect, which is not at the level of institutions. So I'm not looking, for instance, at psychiatric clinics and hospitals and marketplaces and thinking about how, you know, sort of the kind of links between economic institutions and psychiatric institutions. Instead, I approach these twin histories according to what is sort of called
And this is sort of a slightly technical terminal to just define it, what might be called the positivity of madness. And positivity is a term that gets used sometimes in the history and philosophy of science. What it really means is thinking about how the relationship between madness and economics has transformed how madness was perceived, how it was spoken about, and even more fundamentally, how its very reality was conferred. And so,
PJ (02:43.597)
you
Nima Bassiri (02:59.869)
The book, just in terms of its sort of organization, you can kind of see this sort of entwinement of the history of madness and the history of capital, just in terms of sort of the chapter breakdown. Many of the chapters are organized around major themes in the history of capitalism, financial enterprise, wealth inheritance, the political economy of labor. And the book tells a kind of story. And it's a story that starts with what I characterize in the first couple of chapters as a kind of a
a dilemma that was discovered or whatever, encountered within psychiatry in the 19th century. And it was what we can call diagnostic dilemma. So a lot of practitioners encountered what you can think of as very ambiguous or indeterminable states of mental pathology. This is one of the major transformations that happens in the context of the emergence of psychiatry as a discipline and as a profession.
we have to understand is that prior to the 19th century, the boundary between what counted as sanity and insanity was more or less clear cut, right? It was this idea that there was this sort of the stark raving lunatic, that there was someone who was completely delusional. And in that sense, it didn't actually require an expert to be able to identify the madman. So there was a way that psychiatry in order in part to justify its very existence professionally, it had to imagine
new states of mental illness, but states of what I sort of describe as borderline mental illnesses. So things that were not quite clearly insane. And it was important to kind of generate these sort of figures, these borderland figures that I call them in the book, so that psychiatry could say no lay person would ever really be able to identify who these people are. It's incumbent on us to be able to figure out.
who truly is mad and who isn't. But the problem became that these borderland figures, their mental pathologies became so ambiguous that even psychiatrists couldn't actually figure out who in fact was mentally ill or not, or whether a person was mentally ill or not. So one of the things I argue is that practitioners, these sort of clinicians and psychiatrists and early physicians, they had to supplement a lot of their diagnostic assessments with an entirely different form of reasoning.
Nima Bassiri (05:25.277)
and they had to do it with a form of economic reasoning. There was in some ways for them a very clear cut way to tell whether a person who seemed odd, who seemed eccentric, whether or not they were actually, let's say normal, normal from the standpoint of social acceptability, right? That they could continue to operate within society. And these, the sort of reasoning that's, the economic reasoning that supplemented their diagnostic assessments, they asked questions like, are these individuals
good with money, can they work? they continue to have a job? Do their seemingly strange behaviors actually result in some kind of financial yield, right? And so we in some ways inherit some of this and we can talk about this later on, this idea of the eccentric CEO or someone who's sort of sort of slightly borderline mental illness genius creativity is actually profoundly lucrative and we measure it. We measure their as it were quote unquote mad genius.
on the basis of whether money was accrued or not. So anyway, one of the things I argue though, is that the economic reasoning that suffused psychiatry, it did so so like profoundly and for so long that it actually ended up in a way transforming in a sense, the very nature of madness itself. What I would go so far as to say the very ontology of madness, the very way in which we understand madness is existing.
And in that sense, madness was, and this is one of the kind of major arguments, and I'm gonna come very shortly to the repercussions and kind of why this is important for us now. One of the things I argue is that as a consequence of this economic reasoning that supplemented psychiatry, madness was not just a medical category. It wasn't just a kind of moral category. So something to say is healthy or unhealthy or good or bad, but it became also a fundamentally economic category, an economic form.
Because madness was not, I argue, something that was seen as a threat, was seen as something that had to be gotten rid of, was seen as something that had to be excluded from a social order. It was something that had to first and foremost be appraised. Is there some value that can be generated from this apparent abnormality? And if the answer is yes, then it was actually acceptable. We could call it something like an eccentricity or a form of genius or whatever. And if the answer was no, if it was seen to be costly,
PJ (07:27.117)
Okay.
Nima Bassiri (07:53.937)
in some fashion, then it was a pathology that had to be gotten rid of. And so in that way, the term pathological value refers to the idea that madness has an underlying economic worth that is the primary metric or benchmark by which it's assessed. Now, the repercussions, I would say there's sort of three repercussions to this idea of pathological value. And I would add too that there should be something paradoxically, paradoxical sounding about the term pathological value.
because value is theory something we like, and pathology is in theory something we don't like. So that was very intentional to put these things together. And you see this, the sort of why this paradoxical nature of that term, it plays out in the kind of, let's say three repercussions that I would sort of draw out. And you really see this in particular in the conclusion of the book is where I really kind of come down on this. The first idea, the kind of first repercussion is that I would argue that
economic reasoning or one of the takeaways of this book is that economic reasoning has suffused virtually every aspect of our lives and every aspect of our conduct, normal and aberrant alike. So there's no place where the economic has not permeated because if economic norms and economic reasonings can actually suffuse something as profoundly irrational as madness itself, there's nothing off limits.
There's nothing off limits anymore. So that's the first, let's say, cautionary takeaway. The second, and this sort of just immediately follows, is that one of the things I try to do in this book, and one of the things I try and do or have been trying to do in my research for the most part, is to about a category like the irrational and analog concepts, like the abnormal, the pathological.
as actually being incredibly productive and prolific categories. We have a tendency to wanna say something is abnormal or irrational and therefore it's not worth thinking about and should simply be excluded. We should just get rid of, know, a healthy society is one in which irrationality is removed. And what I wanna say is that point of view fundamentally like underestimates how prolific and productive
Nima Bassiri (10:21.469)
and how in a sense valuable the very category of irrationality has long been. And so getting rid of the rationality from let's say the social order is all the more difficult because we actually want it. We need it in some ways. We have come to rely on it in very profound ways. And so related to this, the idea of the irrational as productive, as prolific in that sense as valuable. And
And so in a related kind of takeaway of the book is not only to think about how productive the irrational is, but how broad this concept of value is. That value itself is an incredibly diffuse, incredibly nebulous concept. can mean value signifies economically, right? We understand economic value, but it also signifies morally, moral value. And it signifies also medically, like there's a sense of medical values.
And so the book is actually folding together all these senses of value to kind of draw out actually how maybe in a way we don't really understand the value of value. If I can sort of speak in that sort of vague terms like that. Okay, the final point and then can just sort of stop is the final takeaway has to do a lot with forms of scholarship that I'm connected with, forms of sort of social theory and critical theory that are organized around critiques of capitalism.
And it's not uncommon within critiques of capitalism. And this is a kind of a pattern that we've seen from the Frankfurt School scholars in the 1930s and 40s, really up until the present, which is to think about capitalism as a kind of deep irrational form, right? It's contradictory, it's irrational, it's a form of madness. And then to sort of say, because it's so irrational, it will bring itself to its own demise, right? As if to suggest that pointing out the irrationalisms of capital
is a sufficient critique. And so my response to this is that actually we don't fully appreciate how productive the entwinement between the economic and the irrational actually is. So that calling capitalism irrational is not gonna do anything because I think the one way I put it in the book is that madness and capitalism have been, you know, entwined in a kind of morbid dance since the 19th century. So capitalism,
PJ (12:30.582)
You
Nima Bassiri (12:44.317)
is fueled by madness in a certain way, which isn't intuitive, but also I feel like it's not just a kind of like figurative statement I'm making. Actually, if you look at this connection between the history of madness and the history of capital, you see how kind of profoundly they're kind of interlocked. Okay, I'll stop there. think I said a lot.
PJ (13:04.982)
No, it's awesome. So that last part, are you familiar with the classic joke? Guy goes into his therapist and says, hey, I'm worried about my brother. He thinks he's a chicken. the therapist says, well, why don't you bring him in to and I can help him. He's like, I would, but I need the eggs. know, like this, like, I don't know, you're talking about the irrational and how productive it is.
Nima Bassiri (13:33.405)
Yeah, yeah, yeah, yeah.
PJ (13:35.446)
Yeah, but anyways, sorry, a little bit of a, you know, hair turn there.
Nima Bassiri (13:42.259)
No, that's perfect. I it's perfect because I feel like, you know, the book covers a lot of ground and lot of the chapters are very different, but one of the things that it does, there's a kind of kind of leitmotif that runs through and it has something to do with the fact that like anything that can function as a source of remuneration is an asset. And so it doesn't matter in a way whether you're delusional. If you're making money, even if it's because of your delusions, then that's good.
if you're making money irrespective of your delusions, then that's good too, right? And so.
PJ (14:16.632)
I don't know if I like this. It's way too close to home right now. That's...
Nima Bassiri (14:20.403)
Yeah. There's a, I mean, there's a chapter, mean, there's a, third chapter of the book is called From Disorders of Madness to Entrepreneurial Pathology. And it actually looks at the history of the 20th century concept of the entrepreneur and the way in which this chapter, looks at kind of three kind of interwoven themes in the history of psychiatry. And the first theme is a very familiar motif, which is that
PJ (14:31.032)
Mm
Nima Bassiri (14:50.077)
Modern commercial life is pathogenic. It causes, it's very traumatic. It causes people to kind of lose their minds. And that's a very common kind of claim that had been made within psychiatric medicine for, since the 19th century. But there are these two added kind of supplementary positions that we can also draw out from the psychiatric tradition. And they, in a way, they kind of neutralize that initial premise that commercial life can drive you crazy.
The first premise that follows this is that many psychiatrists observe that actually a person can be quite mentally ill, but still perfectly fine as far as being a kind of economic agent. They can still pay their bills, they can still go to work, that there's actually not an incompatibility. So even if capitalism makes you go crazy, that's fine. You can still be a good economic citizen. And then the third premise, which is also something, it's all in the book there,
The third premise is that actually sometimes a little bit of madness is actually good for business. So in a way, there's a balancing act between commercial life makes you crazy, but sometimes you need a little crazy to be good at commercial life. And in that chapter, I posed this question about, is this not a contradiction, right? A kind of like, well, commercial life is pathogenic, but pathology is good for commercial life. How do you balance this out? How do you make sure that the
pathologies that are good for commerce aren't the pathologies that are going to like basically make you succumb to the tumult of commercial life. And one of the things I argue in this chapter, it's another kind of motif that runs through the book, is this is where the question of gender and race come in. There's a term I developed in the book called pathological privilege, which is that some people have the entitlement to partake in pathologies.
that are deemed remunerative. And so it was in a sense, I discussed this in detail in the chapter, but the kind of combined category of masculine whiteness that allowed some people to enjoy the privilege of being, as it were, insane, but lucratively insane. And without that privilege, others who tried to simulate it. And so I talk about this in the history of the United States, particularly non -white economic actors.
PJ (16:52.447)
you
Nima Bassiri (17:17.661)
they couldn't in a sense utilize that pathological privilege. And so every time they tried to partake in entrepreneurial behaviors, they ended up succumbing to the madness of capital itself. And so there's a complex sort of discussion there, but then that's just one chapter. mean, there's all these other, right? Yeah, anyway, so sorry.
PJ (17:33.283)
Yeah, yeah.
No, no, it's great. I just wanted, just for clarification sake, and this might just be a longer discussion, I'm happy to hear that. When you talk about pathological being productive, are you talking about that pathological as the category or pathological as its use and practice in individuals? So it's useful for individuals to be pathological or it's useful for capitalism to have this idea.
Nima Bassiri (17:48.222)
Yeah.
PJ (18:04.071)
of pathology that it puts on people, or is it a combination of those two?
Nima Bassiri (18:08.637)
Right? I would say it's the latter first so that pathology has prolific possibilities. And so it's like, if there's an operative dichotomy in my book between how we think of something, how certain states of mind can be remunerative or lucrative, the dichotomy isn't whether the mind is healthy or whether it's disordered. The dichotomy is between two styles of being disordered.
Is it disordered in a way that's considered an asset or disordered in a way that's considered a liability? In that sense, I would say it's pathology as it's applied in particular cases, but I do want to then think about in a more deeper sense, whether category of, in what ways pathology is such as a concept has always been sort of underlyingly productive. And I'll add to this too, that that concept itself is not
that old. I it's as old as a kind of modern biomedical worldview is. I I subscribe to a particular genre of the history of philosophy of science, which would propose that the very idea of pathology as we understand it now doesn't really come into being until just the beginning of the 19th century, that one could understand pathology as a way in which organisms can be, right? And so in it,
corresponds to just when psychiatry comes into being. And it also corresponds to when more mature forms of capitalism come into being. if you want to look at this in a larger kind of historical light, have pathology that... The thing is pathologies are seen as like inevitabilities of the living being. And this is the thing we have to understand, right? mean, pathology or some kind of pathological state, whether it's a cold or a disease or a broken bone, these are...
These are inevitabilities, right? These are not things that we can just remove. I mean, I think within the past maybe 40 years in the context of North Atlantic biomedicine, we've seen the rise of what's called preventative care. And preventative care tries to suggest that actually the healthiest way of being is to never succumb to an injury or to an illness, to just take some kind of medication and just never have anything at all, as opposed to thinking about pathology as a perfectly normal state.
Nima Bassiri (20:33.863)
Being healthy doesn't mean never falling ill. Being healthy means falling ill, but then recovering. So pathology, it's sort of sutured into what it means to be a living being. So it's become a profoundly sort central way of existing in the modern world. And I talk about this a little bit in the book, but there's a way that the concept of pathology and all these other related concepts that really define the modern era go hand in hand.
So what does it mean to think about a society, not an organic being, but a society is also having inevitable pathologies, right? That pathology is inevitability of social life and political life, as is something like politics and capital. Like, how do we intertwine these things? And so in that sense, I would say it's not just some instances of pathology that can be seen as valuable, but that pathology is such. Another way putting this too is if you were to say that
Pathology is inevitable.
But then every time it happens, it's dangerous. mean, that's really troubling world we suddenly live in. Rather than to say something like, if we can assign some value to pathology, given how inevitable it is, that's actually a better way of framing something like. So does that make sense?
PJ (21:56.422)
So the assigning value to pathology is not necessarily a bad thing. In fact, it depends on what value you're giving it.
Nima Bassiri (22:01.043)
I mean, that's what I.
And I think that that's something to really sort of take seriously. but you see instances of this, right? mean, so it's like one of the differences between, let's just say sort of psychoanalysis and psychiatry. And I always vary in terms of like how strongly I wanna lean into there being a stark difference between these two kind of fields. But at least for Freud, there was a stark difference, at least between
psychoanalysis and least some normative psychiatry. One way of describing this is that a psychiatric standpoint would imagine that any kind of abnormalities
Whereas a psychoanalytic standpoint would say that abnormalities are inevitable. There is no such thing as a normal person. There's always some kernel of pathology, right? Whether it's like these ordinary psychopathologies of everyday life, right? There's never not, I mean, this is like a Freudian claim, like we are all in a way neurotics. No one's not neurotic to some degree. And so there's instances in which, but you also, by the way, I should add to that for,
For Freud, he wants to make a stark distinction between what he's doing, what all of psychiatry does. And that's actually not entirely true. There's a lot of other psychiatrists who are making similar claims at around the same time. But of course he has to speak in these sort of of stark terms. But that's one instance of somebody saying, look, the pathological is inevitable and it's everywhere. It's just, haunts every aspect of our life. And so it makes sense to me that it would then be suffused with a value function. Because if it's everywhere, why not try and profit off
Nima Bassiri (23:47.145)
Does that make sense, right?
PJ (23:48.718)
So a couple questions. But the first one, I was going to ask you this anyways, and then the way you said, subscribe to a certain view of the history of science. How much of an influence, if it was, perhaps it wasn't, but how much of an influence was Foucault's history of madness on your work?
Nima Bassiri (24:08.765)
Yeah, mean, it's, I, it's, no, no, I mean, what's funny is it's not so much actually that book, weirdly. It's later Foucault that is much more present. I would say later Foucault and a certain tradition of French, what's called historical epistemology that kind of runs through the book.
PJ (24:10.981)
I like it. Yeah, sorry. Go ahead.
PJ (24:16.246)
and
PJ (24:20.706)
That makes sense. Yeah.
Nima Bassiri (24:36.765)
I mean, I make it quite known. I I describe methodologies and introduction. And so, you know, I'm not hiding anything. It's definitely there. there's a longer conversation I could have about how much and kind of a late Foucault is present in the book, especially kind of in the conclusion of the book. So, no, Foucault is a very formative thinker as are other...
maybe less known, I don't know, kind of less known figures. Another philosopher of science, historian philosopher of science from the French tradition is Georges Conguien, who wrote this book in the 40s called The Normal and the Pathological. And he was a major kind of figure and was also a mentor to some degree for Foucault when he was writing History of Madness. The way that Conguien will describe pathology and pathological forms.
is profoundly formative for me. And again, I don't hide it in the book. It's quite present and I go into quite a bit of detail about it. Yeah, it's funny, because when I talk about this book to people who aren't necessarily in the kind of history of the human sciences or psychiatry, the frames of reference that people tend to have with respect to psychiatry, it's either Freud or Foucault. And so I always say, where's Freud? Because it's like they want a position from which to understand the book.
PJ (25:55.854)
Yeah.
Nima Bassiri (26:02.107)
And so I'm used to it. It's good that you ask.
PJ (26:04.494)
And then, yeah, even as you're kind of talking through all this.
How important is it that I kind of at the start of this, you know, in the first chapter, you're kind of talking about how a lot of this work in providing economic value to pathology comes from a provisional economic hermeneutic. How influential do you think it was that it kind of from the beginning, at least from what I'm reading and maybe I'm incorrect here, but that it's provisional, that they're kind of, a little, it feels a little bit on the fly that they're, they're feeling this gap. And so they're filling it instead of.
Nima Bassiri (26:37.193)
Yeah.
PJ (26:43.19)
providing a systematic analysis that then does that make sense?
Nima Bassiri (26:46.515)
Yeah, it makes total sense. And I actually think, I mean, you're hitting something quite right on the mark here, which is that it was really important for me to describe what's happening as not a concerted effort to take ideas from economics and transplant them into psychological medicine, but to suggest that there is, this is a strange way putting it, but there was some, possibility of making sense of the social world.
which was underlyingly economic in nature. So when psychiatrists were reaching for some interpretive frame, they inevitably reached for an economic frame because the question that they were asking, and I think this is really key.
Asking about whether or not a person is sane is a very tricky kind of question to ask because it does result in this, well, what do you mean exactly by sane? And I actually think that the answer of like, well, are their minds rational was not actually that important. And I know this sort of sounds kind of weird, but rationality is not actually what we demand of one another in social life.
What we demand is propriety. Are your behaviors proper? Are they conventional? Are they acceptable? And so the question becomes, if I were to grasp, like, what are the benchmarks for propriety? It's not about treating people well. You don't have to treat people well. You just have to not envy them, right? How do I know if someone is acting correctly? One of the things I talk about in the book is
Economic benchmarks are so interesting because unlike other benchmarks to appraise social propriety, economic benchmarks are reducible almost to a kind of arithmetic calculation. Is money being lost or not? Right? Are you accrued, are you able to work? And that's a, that's a, that's a question that means is money being produced? Right? Are you, are you spending money you don't have or are you making it?
Nima Bassiri (29:05.659)
So in a way, using an economic benchmark has this remarkable efficacy where you can ask this question. When you ask the question, is this person sane? What you're really asking is, are they a problem for society? Are they a problem? And what's interesting is like, there's a, think in the introduction, I cite a very well -known British late 19th century, mid to late 19th century British psychiatrist, Henry Maudsley.
And one of his, and he wrote these often these very sort of public, not public, but sort of popular science books. And in one of them in 1895, he has this, the first chapter is called, What is Insanity? And you'd think he had, he would have some kind of hyper physiological or medicalized definition of it. And I talked about it in the introduction, but one of the things he says, which is so remarkable is he says, insanity is when somebody is no longer in harmony with the rest of society. They're off somehow. They're not in sync somehow.
And what does that mean to be insane, Cor? What does it mean to be harmonious with the social order and the social good? It means doing the things that are conventionally asked of you. And what are the things that are conventionally asked of people within civil society? Well, economic things tend to be the most prominent ones. So when I describe it as sort of provisional, what I really want to say, psychiatrists were like, well, our medical...
interpretations are not sufficient. What else are we going to use to assess whether they're being social, whether their social propriety and these behaviors, these potentially odd behaviors? Well, let's just use the economic ones. And they use them so fundamentally that almost in a way, the very nature of madness transformed to facilitate this, these economic benchmarks are sort of put upon them. And they were doing this like in the first several decades where modern psychiatry is coming into formation. In other words, when
modern categories of madness were coming into formation. So in a sense, there's a kind of co -production here of psychiatry as a profession that made use of economic benchmarks as essentially the right forms of social interpretation that were in the ether, right? And madness as a concept as it was developing. You know, it's a funny thing I often say to, I mean, I'll say this to my students in class. When we talk about a person,
Nima Bassiri (31:24.721)
and say of such a person that they are successful. This is a successful person. We always mean it with respect to money and financial and professional success. If I say so -and -so is successful and your first question is gonna be, what do they do? And I'm gonna say, they do. I would say, they do virtue. They're morally successful.
PJ (31:42.515)
Yeah.
Nima Bassiri (31:49.149)
Like I'm a acquaintance to something. I'm like, they're morally successful. They've cultivated a philosophical spirit. You would say that's not what successful means. Successful is a certain. So already in that kind of like, that reflexive way of understanding success, ultimately about professional and economic success, I think this just sort of, it has the imprint of the extent to which the kind of most substantive form of social propriety is economic.
And so that was really important for me to sort of draw this out. It's like, assume in the background of the way psychiatrists are thinking, are social norms that have become entrenched in the 19th century that are deeply economic in nature.
PJ (32:36.278)
And so I want to be clear because it could sound like I'm critiquing psychiatry as a discipline and I don't that's not my goal here. My goal is to talk about why the work that you're doing the work that even Foucault did is important, which is to evaluate psychiatry in light of philosophical frameworks because you can't learn all psychiatry and all of philosophy, right? Like, you know, sometimes when I'm talking on this show, people are like, you should
Learn more about this, learn more about this. And I'm a nerd and I'm enjoying learning about all the different things, but most people don't have this amount of time. Right. And so, so what we see the psychiatrist that idea that you talked about where you have harmony and out of sync. Well, this is where you get the idea of genius and madness. And it's hard to know until you can evaluate it much later because like, when is, when is society rock?
Nima Bassiri (33:12.991)
right right now.
PJ (33:34.166)
Right. That's kind of, mean, that's what made me think of history of madness. Right. Like it's like, wait, wait, wait, wait, like he's not wrong. Like that's like, everyone's just blind to this. And from the psychiatric standpoint, if their goal is just to stay with stable frameworks, cause that's what we're talking about here. They're just going to go generally go with the status quo. Cause they're not looking to push. could you, I mean, I'm trying to imagine someone who is a psychiatrist who also was like trying to like.
make deep ethical changes to the society. Like, you're like, he's going and like people are getting stranger. like I don't think. Yeah.
Nima Bassiri (34:11.591)
Nina, no. So, and I'm not, it's not a criticism, although I will say I have given book talks to clinicians and they haven't accused me, but there have been sort of like, are you actually saying madness isn't real? Like I'm like, well, that's not what I'm saying at all. In fact, I'm describing how the reality of madness has transformed over time. Madness, mental illness is profoundly real, but what do we, there are many ways in which something can be.
real. And this is a standard premise within philosophy of science, right? We can think of something, it doesn't have to be real only insofar as it's biologically real or real only as it's socially constructed. There are various permutations of real in the sense that like the economic appraisals of madness and how madness operates as an economic form had real effects on people's lives. And that is a measure of its reality. I will say something about
PJ (34:53.644)
The real, yes.
Nima Bassiri (35:08.831)
And as I say, it's not a criticism of psychiatry, but it is an important observation to make about, and it's not an observation I'm starting. mean, it is an observation that is right there at the end of history of madness. So 1961, and then many, psychiatrists, historians of psychiatry, excuse me, have talked about this, which is that, apropos of this thing that I mentioned earlier, to the extent that it was very important for psychiatry to justify its professional existence,
by virtue of saying mental illness is not something just anyone can identify. Because if it were, you wouldn't need us. And so it had to be subtle. It had to be buried. It had to be ingrained in ways that were largely invisible. But insofar as it was this, psychiatry, order to identify that boundary between normality and pathology, it had to be able to make claims
about the sort of deepest recesses of human conduct. And so in that sense, it wasn't just about assessing whether or not delusions or delusional states were abnormal, but became assessing the normalcy or the health of what you might think of as more ordinary states of interiority, like emotional regulation, for instance, or the extent to which, I mean, what I'm suggesting here is that psychiatry,
or psychiatric reasoning has come to pervade every aspect of our interiorities because our interiorities are like nothing's off limits in that sense. And so, I mean, you know, there's a reason why, you know, something like the duration by which or the duration which one grieves for a loss, right? There is a right amount of time to grieve. If you grieve beyond this time, now you're in a pathological state.
And if you don't grieve at all, that's a pathological state. every aspect of our emotional, right? And so it's a consequence, it's inevitable. And I'm not saying it was some kind of evil genius, it was just an inevitability that psychiatry ended up becoming in large ways, the moral arbiter of the right ways of behaving and the right ways of acting and the right ways of feeling and thinking and so on. And this is why there are psychiatrists who write books about why Donald Trump is mentally ill or what, right?
Nima Bassiri (37:35.955)
they see themselves as curators of the health of society in a way that no other medical expert does. You don't have cardiovascular specialists writing off heads about, I mean, they do about the kind of state of heart disease, so the heart disease as a public health issue, but not about sort of pathologizing figures and like having someone who is pathological or something will be dangerous, right? So there is a certain way that psychiatry has come,
just invariably to operate in this way as a kind of custodian, right? The custodian of healthy ways of behaving. Is that a criticism? I don't think it's a criticism. What I actually say in the conclusion of the book is that we have to begin to see how psychiatry was more than just a medical field. Psychiatry, or at least, and I'm not saying every psychiatrist, but I'm saying there are elements within psychiatric discourse that make psychiatry
And this is not a critique that makes psychiatry actually very close to what we might call a social theory. It's a theory of society, right? And theories of society or social theories are deeply normative. They make claims about how society should exist and how it shouldn't exist, right? mean, whether or not we think of capitalism as a problem, whatever it is, psychiatry in some sense, I'm not criticizing, there's no anti -psychiatry stuff here. It's actually to say, what's fascinating about psychiatry is that without realizing it, it had been a social theory all
And these are the ways that it operates the social theory. So in large part, this book is about, let us assume psychiatry is a social theory. How is it understanding this relationship between pathology and value? And this is why throughout the book, very, very intentionally, when I talk about psychiatrists, often, at least in terms of like introductory and concluding sections, but I do it throughout the book, I will pair up or kind of put into a kind of constellation psychiatric claims and claims from like turn of the century social thought.
Georg Zimmel, Durkheim, Nietzsche, right? They come to us with Freud, like Freud, know, Freud and Talcott Parsons describes Freud and Durkheim and Weber as the kind of preeminent social thinkers of the turn of the century. And I'm like, well, I think you could make psychiatry as such a kind of social theory. in that sense, right, so I'm actually trying to think about what psychiatry is as a way of thinking about us. Does that make sense? Yeah.
PJ (40:01.634)
Yeah. Yeah. And, you start off with John Stuart mill, right? Like, and then you immediately follow with kind of arguments from, from the psychiatric side of things. and I, you've kind of touched on this, but, if you don't mind kind of expounding a little bit, or I just make, maybe this is just me clarifying, making sure I'm the right track. Economics tend, to dominate the discourse versus moral versus.
Nima Bassiri (40:10.769)
Exactly,
PJ (40:31.274)
Medical because it is because economics is susceptible to quantification. It's susceptible to mathematical analysis in a way that Moral and economic it's it's susceptible to hard and fast Metrics in ways that moral medical are really not and the reason that matters and you start off with this and I wrote this down is Psychiatry is trying to wrestle with the radical
ambiguity of human conduct.
Nima Bassiri (41:04.361)
think that's right. I think that's exactly right. That's the starkest way of putting it. would say psychiatry found itself embroiled in a bigger problem. They bit off more than they could chew. It was no longer about the raving lunatic. It was like, how do we assess the normalcy of conduct in general? And in that sense, the boundaries between health and illness, given what I just described around the inevitability of pathology.
The boundaries between health and illness are porous. They're really hard to identify. The boundary between moral right and wrong is also incredibly porous. mean, just we read Nietzsche, it's like genealogy of moralities 1884. It's like right at the same time. It's like really hard to identify when something.
can be morally appraised positively versus negatively. I'm not talking about like obvious acts of like goodwill or obvious heinous acts. I'm talking about everyday conduct. in what, you know what I mean? It's very hard, but the question, it's not even about the mathematizability. It's the kind of hard and fast appraisability of something economic. You have X amount of money. Did it go up or down? it stay the same? Right? It's easier. It's a quicker mechanism.
And I think, and I'm by the way not making a claim about economics as such, because a historian of economics might say, well, actually economics doesn't operate that way. And that's good and fine, but it does operate that way as a social logic. And so when I talk about economics, I'm talking about economics the same way I'm talking about psychiatry, as a social logic, as a kind of social theory. So economics is a social theory, psychiatry is a social theory, and as social theories,
they interweave and they produce these remarkable consequences that I think bear into both psychiatry and also into economics. I have whole discussion around Joseph Schumpeter's conception of the entrepreneur. And he's not really reading, I don't think as far as we know, any psychiatric writings, but I show the remarkable, like there's this like shocking mirroring between how he's describing the early 20th century entrepreneur
PJ (43:12.106)
okay. Yeah.
Nima Bassiri (43:21.319)
as this creative demonic genius who's actually, as he says, irrational, productively irrational, and claims that are drawn right out of sort of psychiatric thought. So there's this kind of historical correlation. So it's as social logics that I'm interested in thinking about these things, because I think economics and psychiatry have more of a bearing on you and I as social logics, rather than in terms of the actual nuances, right, of psychiatric thought or economic thought.
PJ (43:52.174)
Can you expound on that a little more? And I understand this might be beyond the bounds of your book. And if you're not comfortable answering it, that's fine. Can you talk a little bit about this kind of the history of the entrepreneur? Kind of this, you have this title disorders of enterprise to entrepreneurial. I own my own business. so I mean, the algorithm bombards me with like hustle culture stuff. My wife loves watching Shark Tank.
Nima Bassiri (44:05.342)
Yeah.
Nima Bassiri (44:09.982)
Yeah.
Nima Bassiri (44:17.831)
Yeah, yeah, yeah.
PJ (44:20.524)
which drives me crazy. So I'm really interested in this particular thread.
Nima Bassiri (44:20.856)
yeah.
Nima Bassiri (44:27.507)
So, mean, it's not beyond the remit. In fact, that chapter goes into it in a great sort of, in a lot of detail. And I almost, I'll say, I'll be very schematic while performing the function of plugging the book and hoping people would read the book. there's the detail there and it's a lot of material that I think is really helpful to kind of think about a lot of this. So there's a number of threads here. And one of the threads,
PJ (44:43.512)
Yes.
Nima Bassiri (44:56.531)
is the extent to which, so you have sort of a couple of things happening all at once. Within the context of psychiatry in the late 19th century, you have a number of thinkers dealing with what the philosopher William James called the genius problem in psychiatry, which is thinking about forms of abnormal, like abnormal mentation as potentially like beneficial.
Because in a way, what was so fascinating for a number of psychiatric thinkers, insane people, so mad men and geniuses, they shared something in common. And what they shared is they both broke with convention, right? That's what demarcates both of their minds. They both break from the conventional. And in fact, Max Weber, social, the German social sociologist,
had this interesting, and I talk about this in the chapter, had this interesting discussion around the notion of innovation in society. And for him, what is innovation? Well, innovation is breaking away from the customary flow of the social. And it demands, Weber says, some form of abnormality. So one of the things I press, and maybe I'll just keep it to this, is what really became the determining factor
to assess whether a person was a genius or a madman. And I somewhat cynically, and again, there's a lot of material, so please read it, but I somewhat cynically say it's beginning in the kind of late 19th century, it became a retroactive appraisal of whether that break from the customary yielded fiscal returns in some form.
And if it did, you were a genius. And if it didn't, you were a madman. And it kind of came down to that in part because the concept of the genius is something, and there's good intellectual history on this. It's a concept from the kind of late 18th, early 19th century. So ideas around grand figures, Napoleonic figures, and so on and so forth. And so it has a history that's disconnected from psychiatry because it sort of emerges before psychiatry. But the moment that it links up to the psychiatric,
Nima Bassiri (47:20.103)
it takes on this economic appraisal. And so as consequence, I would say even today, the notion of a genius, and I would say a virtuoso, and that proximity between the virtuoso as maybe being a little bit mentally abnormal, it always comes down to whether there's something lucrative in what they do. And I know it's very funny. I talk about, so I've talked about this in like talks and stuff, and I get a lot of pushback from people who want to retain.
the kind of like romantic conception of a genius, that it's not just about money. And I always remind them about the concept of the blue chip artists, know, like contemporary artists who like anything they produce will be worth millions of dollars. And we appraise, it's like, you could find a Picasso sketch and it's gonna be worth $20 million, right? And it's like, no one is seen as a kind of artistic genius and the work is not valuable. And so in that sense, now I would say those notions have become intertwined.
And I think it bleeds into the idea of entrepreneurialism because there is something about entrepreneurialism, we're always in the background. There is this idea that developing innovation, and this is the catch word, right? mean, every university, by the way, I should add, every university has some iteration of an innovation entrepreneurial program or certificate. We have it at Duke, they have it everywhere. There's a, there's, yeah, exactly. There's a background idea that the innovative and the creative
PJ (48:38.722)
The creative, creative side up there too, yes.
Nima Bassiri (48:46.441)
they go together and some form of out of the box thinking has to happen. Now, of course, if you are really out of the box, you are dubbed a little abnormal or a little eccentric, but it all gets redeemed based on what you produce. Do you know I'm saying? And so that's something that I think is quite interesting. And I go into a lot of detail about it. And so even the concept of the entrepreneur as it is developed with an economic theory.
I say seems to succumb to this similar kind of dichotomy where ultimately there is this, productive, this is what I mean by the productive irrationalism, right? An irrationalism that is value laden versus an unproductive irrationalism. And that's really the dichotomy between the virtuoso slash genius slash entrepreneur and the mad man. In fact, the last chapter of the book, I don't, do I have time to say this really quickly?
PJ (49:43.462)
yeah, go, no, yeah, you gotta play, yeah.
Nima Bassiri (49:44.743)
The last chapter of the book, sort of before the conclusion, is a case study. So most of the chapters are like, kind of more sort of intellectual kind of histories of concepts. The last chapter is a case study about, and it's set in America, about a Gilded Age eccentric millionaire who was like the great, great grandson. He was an aster, you know, in New York. So he had all this money. And it was a man who,
very likely had a mental illness. I mean, he heard voices, right? Except he was convinced that these voices were actually a lucrative asset. They were like some kind of mental technology that would allow him to have a certain kind of oracular or prophetic connection to business markets. And I described how he ran these tests on himself, the voices, he called the voices the ex -faculty.
I like it. like, it's 1892. And I love that it's like the ex -faculty, It's the ex -faculty, is what he calls it. It's a shocking case study because of how it's reminiscent, but in advance of things that you just read in a like way. This seems like now, but anyway, one of the early experiments of the ex -faculty that he did with the ex -faculty is the ex -faculty told him to go into the city and essentially
bet on a particular stock and that it would go up. And he like made money off of it. And he's like, no, it's real. And he tried to patent it. He tried to patent his ex faculty. It's a kind of remark. This is all happening before economic theorists are talking about entrepreneurs as these irrational, demonic, Napoleonic figures. This gentleman who I talk about, his name was John Chandler, but he changed his name because it was the more oracular version he had in mind or whatever.
He thought he was the reincarnation of Napoleon. I mean, there's all these like echoes that are quite remarkable. But what's interesting is another thing I argue is that the fact that he was incredibly wealthy from birth and white and highly educated, living at turn of the century America, gave him the entitlement to imagine that his oddities were actually financial assets.
Nima Bassiri (52:05.971)
which is not something we all have access to. So this is confluence between the entrepreneurial and the pathological privileges that underwrite it. He is a kind of entrepreneur par excellence, right? And what's funny is actually, I mean, one of the things that he invested in was in, he invested in Southern textiles in the 1890s. He was a New Yorker, but he invested. And there's a whole story, his family was really upset with him. They had him committed.
He wasn't actually able to profit off of his textiles, but the thing is they were profitable. If they had let him do it, he would have made a ton of money. He was actually one of the founders of the city of Roanoke Rapids in North Carolina. What's crazy is he wasn't wrong, which is so shocking. So it's at this perfect encapsulation. So this thematic of the entrepreneur runs throughout the book because I think it's one of the best iterations.
PJ (52:51.022)
Yeah.
Nima Bassiri (53:03.055)
of everything I'm kind of talking about. It's not the only one. I have whole discussion around occupational, industrial labor, industrial labor and occupational psychopathology that have a chapter on aphasia speech disorders and will writing in the 19th century, which is a very strange kind of episode in the history of, well, aphasiology. There was this question that was constantly being posed, can aphasics write wills? But it was like, it was this.
people were obsessed with this question from around 1870 up until on the First World War. But anyway, I don't know if that answered your question about.
PJ (53:35.554)
Yeah. Yeah, I know it's awesome. Yeah. First and foremost, make sure you buy the book. It's awesome book. something you talked about here in, and we've kind of pushed this all along is the, how economic became kind of the preeminent way to, interpret interiority. And what's interesting in some ways it started to even push out what we would like, not just to, to
Nima Bassiri (53:56.765)
Yeah.
PJ (54:03.402)
Exists as like a first among equals with medical and economic and I want to make sure I'm tracking with you here, but Because we see this even in just popular fiction in in movies all this kind of stuff It actually starts to push out moral it starts to push out medical because this is where you get like the tortured genius and you have this guy Who is like throwing a fit? He's throwing furniture around and stuff like this. I how many times I'm not thinking of a specific
scene like we have seen the scene so many times where this guy's being a jerk. He's a danger to those around him. but he's he makes so much money. He's a genius, right? He's a tortured genius. You're like, like you can make a lot of money without throwing lamps in people's heads. You know, I mean like.
Nima Bassiri (54:33.492)
Right.
Nima Bassiri (54:42.483)
Yeah.
Nima Bassiri (54:50.035)
Yeah. I know, it push, I would even say maybe not pushes out the moral and the medical. It reshapes the moral and it transforms the moral and the medical into, and one of the ways I think about this, you know, when I talk about the economic, it's not necessarily, it's not necessarily, let's say from a Marxist lens.
PJ (55:00.741)
yeah.
Much better.
Nima Bassiri (55:18.791)
An equally influential kind of claim is something that you see in Nietzsche's Genealogy of Morality, where he talks about how so much of our moral relations with individuals is predicated on what is effectively an economic logic. For Nietzsche, it's not around modern capitalist structures, but the economic there is the relationship between debtor and creditor, which is an economic relation.
And so it's a relation of transactionalism. So transactionalism suffuses so much of our kind of everyday lives. And so, I mean, I talk about this quite a bit too, like what does it mean when moral categories and medical categories get very surreptitiously reshaped into very subtle economic structures or economic categories? What happens to like morality when we often act in...
moral ways because we're largely trying to accumulate some sense of moral capital. I want to look like a good person. I want you to think I have a lot of moral stock. I form my morality in the same way that a wealthy person might perform their wealth. Or I might even perform my health in a way that a wealthy person performs their wealth. That there are these contaminations. So it's not so much about pushing out, but contaminating and reshaping.
PJ (56:26.52)
Yeah.
Nima Bassiri (56:47.793)
in ways that we haven't really thought about, if that makes sense.
PJ (56:51.096)
Yeah, absolutely. So I want to be respectful of your time, besides buying your book, which everyone should do.
What would you say, what would...
Nima Bassiri (57:02.175)
Please, I think it's funny that I'm also selling a book. I'm critiquing. I see the contradiction. I'll critique the concept of innovative, but my book is very innovative.
PJ (57:06.519)
Yeah, yeah.
It's a genius book.
PJ (57:16.622)
Yeah, so good. so besides buying your book, what would you tell the audience that who has listened to this episode to think or to do as they go throughout this week? What's something that they should stop and look at or stop and think about throughout the week as kind of a takeaway from today's discussion?
Nima Bassiri (57:41.417)
Ooh, that's a good question.
Nima Bassiri (57:46.077)
Well, I I would maybe put it in a very general kind of way. It's a thing I often, I'll teach courses on like social theory and ethics or whatever to a lot of students. And I often say things like, we often go through the world not realizing how much of our behaviors are profoundly routinized and habituated and kind of conventional and not realizing necessarily what underwrites that kind of the convention itself.
why we're doing the things we do. It's almost like, I guess what I would ask of your viewers and listeners is a certain ethical demand to wonder why our conduct has been shaped in the ways that they have. And maybe just a little bit more specifically related to the book, how much of that conduct is underlyingly economic in nature. It's a thing that I will tell my students too. It's like, we're in class together and we're not in class because you wanna learn and I wanna teach you. We're in class because
someone is paying me and you are paying someone. Like that's really why we're here. And it's a cynical sounding discovery, but it's not, I don't actually think it's cynical. I think it's an important and rigorous sort of self -examination. And that's actually kind of what I gesture towards at the end of the book is like, I think we need a certain kind of like suspicion on our own behaviors and our own selves.
to wonder how complicit we are in a lot of these violent structures we're in. I worry about the belief that one is sort of exempt or invulnerable to these horrific vectors. We live in societies that are structurally flawed and violent and oppressive. Am I some superhero who's not affected and hasn't been created in this society? Well, obviously I am. And there's a complicity and there's levels of complicity. may not even...
realize. And so I think there's that constant self -reflection, which is a certain self -suspicion. I think it's just important. And I don't think it's like a weekly thing. I think it may just be a general thing. And I end the book by wondering what that might entail in a rigorous way, like what that might actually, you know, this term of pathological value, the final section of the conclusion is it asks this question, what would it mean to get beyond pathological value? Is that even a legitimate form of thinking?
PJ (01:00:15.568)
Great answer, Dr. Basiri. Absolutely wonderful to have you on today.
Nima Bassiri (01:00:19.322)
Thanks so much for having me. I really appreciate it.