A Pattern of Madness [Paperback]

Neville Symington (Author)

Book Description

Publication Date: April 2002

Born of wide-ranging scholarship, a lifetime's psychoanalytic practice and deep personal commitment and struggle, this book will challenge professional practitioners in the field and all those who take a serious interest in understanding the human psyche.

Editorial Reviews

About the Author

Neville Symington is the author of established psychoanalytic classics including Emotion and Spirit; Narcissism: A New Theory; The Making of a Psychotherapist; The Spirit of Sanity; A Pattern of Madness and How to Choose a Psychotherapist. He works as a psychoanalyst in private practice in Australia.

Product Details

• Paperback: 248 pages
• Publisher: Karnac Books (April 2002)
• Language: English
• ISBN-10: 1855752794
• ISBN-13: 978-1855752795
• Product Dimensions: 9.2 x 5.8 x 0.7 inches
• Shipping Weight: 12.8 ounces (View shipping rates and policies)
• Average Customer Review: 3.8 out of 5 stars  See all reviews (5 customer reviews)
• Amazon Best Sellers Rank: #818,203 in Books (See Top 100 in Books)

Customer Reviews

Most Helpful Customer Reviews

14 of 14 people found the following review helpful:

5.0 out of 5 stars important contribution to Psychiatry and Clinical Psychology, August 3, 2002

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Princeton Reader "Princeton Reader" (Princeton NJ) - See all my reviews

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This review is from: A Pattern of Madness (Paperback)

This book is a very important contribution to Psychiatry and Clinical Psychology. Symington has been developing his concepts since"Narcissism: A New Theory ",but this book is by far better. I have read the old masters theorizing on narcissism. These have traditionally included Freud,Kohut Kernberg and Jim Cooler(1961). Elements like Grandiosity, envy, paranoia, inferiority and dependency/merging have been described before but in fragmented and meaningless ways. Symington connects them all together in his model. In this sense he is like Galileo looking at the same elements but in a new startling perspective. Symington draws from Wilfred Bion and John Macmurray but develops his own original concept that describes the essence of madness and its narcissistic core. It had profound impact in understanding personality disorders and other severe psychopathology. The test of the theory is that it holds in clinical practice. I have tested the validity of the Madness model in my daily clinical practice of psychiatry. The Model has deeply changed my vantage point of the meaning of what I see and hear from patients. All seems to make new sense. I am very grateful for this book. I suspect it will take a while till the importance of this contribution is appreciated by the Mental Health community. The main reason being the difficulty of unlearning of old useless theories, as well as our own blindness to our own narcissism.Symington recommends reading his book twice knowing how difficult it is to go through the unlearning process.In addition, I have been rereading the book daily spending 20 minutes a day on a regular basis. I recommend this approach to the serious reader.

9 of 9 people found the following review helpful:

5.0 out of 5 stars Deeply Challenging, March 30, 2005

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John Skinner "Amor Fati Skindoggy" (Palo Alto CA) - See all my reviews
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This review is from: A Pattern of Madness (Paperback)

As a layman, not a clinician, I was offered this book by my analyst sister. After the third read, and slow ingestion, it continues to plow into my world view, asking me to define my spiritual underpinnings, and take responsibility for the authorship of my life. More painfully perhaps, but richly appreciated, it's helped identify my own brand of madness as it fits into Symington's structure of the narcissistic complex. He develops his theory with some compassion, while he uses examples that cut to the chase. I will be facinated to see how this overarching and bold theory hits the psychology profession. I am deeply grateful for his effort, and his willingness to confront his own narcissism in a profession of wounded healers. There is much to be learned here toward the world's healing. Dare I say, I won't be delivered in the rapture, and this life alone will be my legacy. Symington asks for my courage to be.

8 of 10 people found the following review helpful:

4.0 out of 5 stars A good clinical tool, but problematic as theory., December 31, 2007

By 

Robert Bezimienny (Sydney, NSW Australia) - See all my reviews
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This review is from: A Pattern of Madness (Paperback)

The ideas contained in this book are informed by the work of many distinguished thinkers in the field of psychology, most notably Klein, Winnicott, Jung and Bion. The content of the book is difficult to comprehend without some acquaintance with the thought of these figures. Symington's postulated structure for the psyche is novel in its detail, yet its broad pattern is founded on assumptions elaborated by his predescessors.

Perhaps the presiding assumption is that a person's psyche can be conceived as being either unified or fragmented. Unification of the psyche is considered the ideal, and so is equated with sanity. Fragmentation of the psyche is pathologized, and is hence allied with madness.

Unification is a term that can imply an undifferentiated cohesion, but here the cohesion is conceived as structured. Symington uses the term `intergration', which was also used by Winnicott (and no doubt others). Thus the psyche can be conceived as having parts, but these parts cooperate harmoniously, and from their cooperation, or integration, a unified sense of self emerges. What is more, the self can then act, and conceives of itself as a willful agent.

In contrast, when the psyche sequesters a part of itself, then this prevents unification; and furthermore, Symington sees the presence of this isolated fragment as preventing the remainder of the psyche from functioning adequately. The psyche loses its ability to initiate action and to feel authentic. The idea of the psyche splitting in some way is found in Jung, Klein and their successors, and Symington's formulation appears to be a variant of these conceptions. He too sees such splitting as pathological, and in keeping with this premiss he sees fragmentation as being caused by traumatic events; while he does not dwell on this point, he situates the trauma in infancy. More cryptically still, he suggests that confronting reality is difficult per se, and that humans resist doing so - thus the recourse to fragmentation might well be `easier' than integrating more of reality into one's experience.

The terms `sanity' and `madness' have an implied prescriptive quality, in that it is implied that sanity is preferable to madness. Symington goes further with his normative prescriptions, suggesting that a person's development should be seen as a struggle to recognize and then overcome the `bad' elements in the person's constitution, and that this struggle `creates' character. Unifying, or integrating, the psyche requires the recognition of what amount to traditional sinful tendencies (greed, envy, jealousy, hatred), and then choosing to act, think, and feel in ways that foster the traditional virtues (love, kindness, courage, gentleness). There is a less explicit encouragement to engage with the external world in these positive ways, and so integrate (in some loose sense) more of the world into one's experience.

Symington overtly states that he has chosen a terminology derived from ordinary language. He justifies this choice by citing the alleged emotional force of the terms. Thus, he calls the fragmented elements in the psyche `the crust', and the poorly functioning remainder of the psyche `the jelly'. Following the logic of his terms, what produces a `crust' is called a `petrifier', while what produces `jelly' is called a `liquifier'. However, the very fact that he has two terms is misleading. For it turns out that whenever petrification occurs, then so too does liquification. They are two aspects of the one process. The same forces are responsible for both. These forces are called `intensifiers'.

Frankly, I found this nomeclature awkward and confusing. The terms `crust' and `jelly' bear associations with foodstuffs, and these associations make little sense in the context of the psyche. As far as the pictorial representation derived from the terms, this too is confused, as Symington would like the `crust' to be seen as `bits' in the `jelly', but he would also like the `crust' to be viewed as a shell around the `jelly', although he qualifies the latter as being a ragged, porous shell. `Liquifier' and `petrifier' are Latinate terms that, at least to me, do not sound especially `ordinary', and carry no useful emotional weight. What is worse, one term would be more appropriate than two, as they reference only one process, as mentioned above. Overall, I do not see what advantage is gained by the proposed terminology, over a view of the psyche containing fragments, or sequestered parts, and the process of sequestration being identified by a single term.

The forces which cause fragmentation are greed, jealousy, and envy, conjoined to hatred, and these terms are used pretty much according to their ordinary meanings. The scenarios to which they are applied, however, are derived from previous psychoanalytic thought (The scenarios amount to imaginative reconstructions of what the infant experiences, as per Klein, Winnicott, and others.). In such scenarios the term `denial' is usually used instead of `hatred', but Symington considers the latter to properly suggest the involvement of violent emotions.

Symington places an emphasis on Narcissism. Indeed, he wishes to install Narcissism as his key concept. He goes as far as to claim that all forms of mental illness can be understood through the concept of Narcissism, and that Narcissism also structures many of the institutions and processes of everyday life in the Western world. Ironically, such grandiose claims struck me as themselves Narcissistic; nevertheless, the terminology here suddenly became evocative.

Symington's theory proposes that we have a predisposition to polarize our conception of our own psyche, along with our conceptions of other beings or entities. This polarization sees us either adopting a position of omnipotence, or one of utter worthlessness. In Symington's terms, we are either `god' or the `worm'.

Even here, there is the legacy of previous thinkers, particularly those conceptualizing the development of the psyche in children; the infant is conceived as experiencing a kind of omnipotence, if its desires are adequately anticipated by its mother or caregiver and so instantaneously, almost magically, fulfilled. Thus, in infancy, we all experience what it's like to be god. Conversely, the infant is vulnerable in the extreme when its mother or caregiver is absent or neglectful, and here we experience what it is like to be the `worm'. This template, derived from the infant's experience, is postulated to persist into adulthood, indeed into the very structures of culture, being used as a recourse when the complex task of `integrating' one's experience proves too difficult. The general strategy of Symington's argument is in keeping with the strategy of much of psychoanalytic theory, in as much as he suggests that certain dynamics allegedly present in infancy and early childhood are revisited, inappropriately, in adulthood, causing disturbances and distress. He does push things further when he suggests that predisposition to conceive experience in this polarized manner is made manifest in the form of organized idolatrous religion, and in secular structures as well (although he does not elaborate these). His use of the term `god' effectively suggests the extension of his theory to this broader realm.

This polarity embodies a rigidity of thought. It also signals a divorce from reality. Instead of dealing with the complexity of experience, where contradictory elements co-exist, the polarity seeks to artificially segregate matters into the all-good or the all-bad. The implication in Symington's theory is that it is somehow easier for us to conceive of things as homogenous and unchanging, than it is to conceive of a world as heterogenous and mutable. He almost asks us to imagine the world through the eyes of an infant, where this is taken to be a view which shifts from moment to moment, with an inability to order and relate experience serially (that is, through memory) - things simply are one way, and then they are another way, and there is no capacity to conceive of the same thing changing through time, or of containing conflicting elements simultaneously.

Part III of the book illustrates his theory through clinical cases. The cases provide a readily intelligible structure to the prose, and the value of his theory as a kind of rubric for clinical thinking is made evident.

Part II elaborates Symington's thought on the actual patterns of thought that constitute madness. The elements of the theory, that is the `jelly', `God', `The worm', are used as pragmatic headings for each of this part's sections. The prose is less of an argument than a filling out of the skeletal structure presented as a diagram on the front cover of the book. Symington asks the reader to dwell on each element in turn, and to gradually discover how each relates to each, a more or less coherent picture of the interrelationships emerging by reading's end.

Part I is very difficult to follow. Here, Symington attempts to relate this theory of Narcissism to more abstract speculations. He references philosophy, but he does so opaquely. He takes terminology from philosophy, such as the necessary and the contingent, but the established meaning of these terms is not respected; instead, he uses the terms idiosyncratically and incoherently. It is not at all clear what he means by either term. He mentions Spinoza, but again the text does not present Spinoza's thought comprehensibly. Other philosophers fare no better. He appears hostile towards Immanuel Kant, but his own implied morality (outlined above) is reminiscent of Kant's. He also references eastern religious thinking, and psychologists. Thus, the psychologist Wilfred Bion's... Read more ›