The Couch in the Courtroom
FOR the Greeks, madness was an affliction visited on those unlucky enough to have angered the gods. The genius of this explanation lies in its association of madness with divinity-an association inferred, perhaps, from the inescapable mysteriousness that surrounds both. Modern culture has stripped this mystery of its mythological roots and given it a peculiar twist: God is no longer allowed to create madmen, but He is surely intimate with some psychiatrists. Fifteen years ago, in The Triumph of the Therapeutic, Philip Rieff described the increasingly priestly function of psychiatry in American culture. Writing of the ascendency of psychological over religious mores, he observed that “if the therapeutic [man] is to win out, then surely the psychotherapist will be his secular spiritual guide.” It is a remark that goes to the heart of contemporary debate about the insanity plea. Revered in the courtroom and reviled by critics, psychiatrists are inextricably mired in the controversy that surrounds the plea. The relation of their profession to the criminal law is one of two issues that shape the contemporary debate.