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Rainald Goetz: Irre (Insanity)

There is a theory held by some people that we are all insane but those that are most insane are those responsible for curing and caring for the insane. This book, to a certain extent, supports this thesis. Goetz himself is a qualified psychiatrist so is presumably well-placed to judge the accuracy of this view.

The book is divided into three sections. In the first part, called Away, the story… well, there isn’t really a story but rather a collection of somewhat disjointed paragraphs which describe (presumably – nothing is terribly clear in this part) the activities associated with a specific mental institution. We follow the patients (generally from their point of view) as well as the staff. We see the staff with the patients, attending meetings, giving lectures and being interviewed, including for TV. They get into disputes with interested members of the public on psychiatric theory and practice.

It is often not clear who is speaking as we jump from section to section, from paragraph to paragraph. Some of it is narrated by an I narrator though it is generally not clear who this person is. Some of it is narrated in the third person. Sometimes the individuals are named. Sometimes we just get he or she though who these people are not often clear. Sometimes we just get a single initial. The use of K. is clearly a homage to Franz Kafka, who is an obvious influence on this part. The other obvious literary influence is James Joyce, perhaps Finnegans Wake as much as Ulysses. Indeed, Joyce’s daughter, Lucia, who was a schizophrenic, is mentioned more than once and it is even suggested that Joyce himself was schizophrenic. (But then, of course, everyone is insane…). The second part will clear up some of the identities.

As a psychiatrist, Goetz clearly knows his psychiatric patients and we get detailed portraits of quite a few. Walther Zarges, for example, is a former patient and has just been allowed to return home. However, he remains in bed, huddled under the blanket, facing the wall. His wife comes in and tells him to get up but, for three weeks, the miserable slob spends the whole day in bed. Mrs. Zarges is not happy about it and abuses him. He knows that she is right but, instead of examining her clearly valid motives, he wonders whether it is really three weeks and spends hours calculating the exact time he has spent in bed. It is superbly told from his point of view and there are several other examples of other cases, explained from the patient’s point of view, including the man who sees trees as the threat. We will meet Zarges later, as an inmate, and learn that he is obsessed with counting.

We see many different types of patients. There are the drug addicts for whom detox sometimes works but often does not. There are the depressives but are they endogenous depressives or reactive depressives? There are some patients, of course, who are clearly convinced that there is nothing wrong with them and they should be sent home.

But it is the staff who are perhaps most peculiar. There is the medical director who is almost obsessive-compulsive in his morning routine, who ignores the patients who are clamouring to see him. There is Raspe, who goes to his girlfriend’s party with cuts on him. The others comment on the brilliant make-up but it is not make-up and he shows them by cutting himself. Self-harming from a patient, yes, but this is self-harming from a doctor.

The doctors also argue with one other and with the public on treatment. Two of the main issues are electro-convulsive therapy (ECT) and modern psychiatry. There are those who favour ECT and those who do not and this leads to a lot of disputes, to which we are party. Similarly, there are those who support the theories of R D Laing and David Cooper (madness is revolt, man, it’s art!) and those who think their views are nonsensical (The crazies are crazy, period. They’re not artists or revolutionaries. They’re just insane.) This is, inevitably, a generational divide.

K. goes even further. K. sees psychosis as societal in origin. In psychosis, K. has stated, our society’s contradictions come undisguised to the surface. Therefore, K. considers so-called insanity to be in essence normal. It is madness, K. believes, to try and combat the truth psychosis reveals about our own reality by means of medicine. A professor takes it even further. Why is a schizophrenic chased away from his workplace? Why can’t an old woman traipse through the metro singing and praying if the mood strikes her? Why is a person who feels over the moon nevertheless forced into confinement? Why shouldn’t a person fed up with the rat race lie motionless in bed for a few weeks? Why do we forbid someone from hearing voices coming from thin air and then engaging them in conversation? Why do we call that person insane? and the madman has chosen delusion, he opts for insanity, in order to reckon with the demands of capital and state, dispensing with the criteria the bourgeois world imposes to determine its members’ validity.

The second part takes a more conventional approach, essentially recounting the career of Dr. Raspe in the institution, from his first day. Initially, Raspe does not entirely fit in. Some of the patients think he is insane and he struggles somewhat with his new colleagues, though this would be the same in any new job. We learn quite a lot about how a psychiatric hospital functions: the role of the nurses, the relationships between staff and patients and between the different patients, the various conditions as well as the disputes amongst the staff regarding the different forms of treatment. We also follow various cases, including the aforementioned Walther Zarges.

Eventually, he does get on better with his colleagues, though less so with the senior staff. However, he struggles with the patients and ends up ignoring some of them. He also finds the work trying and turns, in part, to drink and drugs (as well as the self-harming we saw in the first part). The pointlessness of psychiatry was at times simply overwhelming is one of his comments. He had come into the profession, hoping to make a name for himself as a researcher and prove that he was different but that soon fades away. Finally he comments I don’t want to become like Schlüssler, like Singer, like Reiter [his colleagues]. I don’t want to become like I am.

The third and final part, called Order is another change of direction. It is narrated by Rainald Goetz, our author. Goetz is involved in various activities but, in particular, he is making an experimental film as well as writing about various bands, primarily English punk/new wave bands. (What? No Einstürzende Neubauten?). Goetz rants and raves and struggles with his life. Every day in the morning, often for hours, he had to think away the chaos and think order into being.

Goetz, we learn, had worked with Raspe in the clinic and the pair meet up. (Raspe seems to be no longer there, either. The clinic walls are high. Within them reigns the law of Hell). Both are now struggling with their lives as a result of their work there. Goetz wants to become a novelist but publishers are not interested in New German Literature. It appears in practical isolation from the public. But he will carry on. He has hope or, as he puts it, HOPE.

This book is chaotic and anarchic but it is an amazing book. Goetz has an insider’s knowledge of psychiatry and psychiatric treatment and is clearly not too impressed by it. The idea that we are all insane but psychiatrists may be somewhat more insane than the rest of us is an interesting idea as is the idea that there seems to be limited agreement within the profession on how to treat psychiatric cases. Goetz turns to the arts and we can see some of the views of Laing and Cooper regarding the relationship between art and mental health coming to the fore.

I seem to have quite a few books on this site set at least partially in mental institutions. One Flew Over the Cuckoo’s Nest is the best-known but in the past year or so Han Kang‘s The Vegetarian, Kyusaku Yumeno‘s Dogra Magra, Sara Stridsberg‘s Gravity of Love, Igor Eliseev‘s One-Two and Cristina Rivera-Garza‘s No One Will See Me Cry have all been reviewed but none has focussed on the point of view of the psychiatrists, as this one has done nor have the others been so much a cry from the heart as this one is. It is it not an easy read, which may explain why we have had to wait thirty-four years for it to appear in English and, inevitably, it is a wonderful small publisher – Fitzcarraldo Editions – that has published it.

Publishing history

First published 1983 by Suhrkamp
First English translation by Fitzcarraldo Editions in 2017