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Rose, N. (1990). The visible invisible: Picturing madness. Free Associations, 1U(20):75-84.

(1990). Free Associations, 1U(20):75-84

The visible invisible: Picturing madness

Nikolas Rose

Seeing the Insane, by Sander L. Gilman, New York: John Wiley in association with Brunner/Mazel, 1982, xiii + 241 pages, hb

The only pictures in the twenty-four volumes of the Standard Edition of Freud's collected works are of Freud himself, his colleagues and his place of work. Likenesses of the patient do not figure in either the classical or the modern texts of psychoanalysis. The same is true of contemporary text books of psychiatry. The art of psychiatric illustration now appears limited to such technical matters as diagrams of the localization of brain functions. The image of the patient has disappeared from the documents of psychiatry. Correlatively, the visual appearance of the patient plays a minor role in the therapeutic practices of psychoanalysis and psychiatry. The talking cure is a matter of speaking and listening; it is not much concerned with looking. Modern psychiatry pays limited attention to the visible surface of the patient's body. It takes no interest in the shape of the head, the colouring of the complexion, the proportion of the parts. Posture and facial expression may be observed in diagnosis, but only to the extent that they seem to manifest the state of play in the patient's internal world. Dress and cleanliness may be scrutinized, but only in so far as they provide an indication of the capacity of the individual to cope with the requirements of living an independent life. The voice has become the privileged interlocutor of the psyche.

This subordination of the eye to the ear is recent.

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