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The madness taboo

Tove K delivers a harrowing, first-person indictment of a psychiatric system that allegedly prioritizes political comfort over clinical reality. The piece's most startling claim is not that a specific treatment failed, but that the entire profession is structurally designed to deny the existence of "madness" to protect the public from the uncomfortable truth that human nature is often delusional. For busy readers navigating complex family crises or policy debates, this is a disturbing look at how institutional inertia can actively harm the very people it claims to save.

The Failure of Professional Insight

K begins with a visceral account of her sixteen-year-old daughter, Alma, whose behavior—fabricating professional careers, breaking ties with grandparents over non-existent jobs, and hiding notebooks in the ground—paints a picture of severe delusion. Yet, the author notes a baffling disconnect: "Everyone who needs to deal with her for extended times finds that obvious... Everyone, except her psychologists and psychiatrists." The narrative suggests that while family and social workers see the pathology, the medical establishment refuses to acknowledge it.

The madness taboo

The author describes a cycle of failed interventions where professionals validate the patient's delusions rather than challenging them. K writes, "The new ones were even worse. They totally played along with whatever Alma said." This dynamic, she argues, isolates the patient further. Instead of grounding Alma in reality, the psychiatric care facilitated her verbal attacks on her parents and foster parents, effectively severing her support network. The author's frustration is palpable when she notes, "I don't say that all psychologists are worse than the average person - a few are brilliant. But I wouldn't be the least surprised if the average psychologist is worse than the average person at understanding humans."

Critics might argue that the author's anecdotal experience, while powerful, lacks the nuance of clinical diagnostics which often require observing patients over time and may view family reports as biased. However, K's central point is that the system's refusal to seek outside verification creates a dangerous echo chamber.

The Political Function of Psychiatry

Moving from the personal to the systemic, K posits that psychiatry's failures are not accidental but functional. The core of her argument is that the field is "political as much as scientific," tasked with answering the politically sensitive question of "How are humans?" If society admits that delusion is common, it risks a collapse of trust where everyone accuses everyone else of being irrational. K suggests that the profession actively obscures the complexity of human nature to maintain social order.

"Psychiatry's function is not to treat all its patients the best way possible. Its main function is to talk about human nature in a way that appeals to the public as a whole."

This reframing is provocative. K argues that the "madness taboo" serves a protective role for the sane by preventing the weaponization of insanity labels against political dissidents. She illustrates this with a case where a girl was dismissed as unreliable simply for challenging a narrative. While this defense of the taboo protects the vulnerable from false accusations, K contends it comes at a horrific cost to those who are genuinely ill. The system, she claims, forces families into a position where they must be the villains in the story to be believed, while the patient is shielded from reality.

The Human Cost of Denial

The most chilling section of the piece details Alma's deterioration under care. K observes a correlation between a new psychologist and the onset of severe anorexia, noting, "It is not that I wasn't warned... But in spite of her weird behavior around food, she remained normal weight. In April 2025 Alma started to see a new psychologist. And at the same time, she started to lose weight very rapidly." The author suggests the psychiatric environment inadvertently rewards the delusion, offering a sanctuary where the patient's worldview is accepted, provided they maintain a state of near-starvation.

K describes a closed ward where staff refuse to gather information from anyone but the patient, effectively silencing the family's concerns. "Month after month, psychiatry staff repeat the same mantra: Now we need to focus on getting Alma to eat. Every other investigation needs to be postponed," she writes. This delay allows the delusion to fester. The author concludes with a grim assessment of the system's priorities: "The one who pays the great price is Alma herself, who seems more likely to die from any of the self-harm disorders she develops under psychiatric care than to ever become fit for a life in freedom."

"Alma and psychiatry quite obviously have a goal in common: To deny that Alma is crazy. Together they are exploring alternative explanations... The one who pays the great price is Alma herself."

This section highlights the tragic irony where the "cure" becomes the mechanism of destruction. By refusing to name the madness, the system forces the patient to prove their illness through self-destruction. A counterargument worth considering is that the focus on eating disorders is a standard medical triage protocol, and that confronting a patient's delusions prematurely can be dangerous. Yet, K's account suggests that the refusal to address the underlying delusion renders the physical treatment ineffective.

Bottom Line

Tove K's piece is a searing critique of a system that values social stability over individual truth, arguing that the "madness taboo" has become a barrier to effective care. Its greatest strength is the raw, unfiltered evidence of how institutional denial can accelerate a patient's decline. However, the argument's vulnerability lies in its sweeping generalization of an entire medical field based on a single, albeit devastating, family tragedy. Readers should watch for how this tension between protecting the public from stigma and treating the individual's reality plays out in future policy debates regarding mental health reform.

Sources

The madness taboo

by Tove K · · Read full article

I have a persistent problem: My 16-year-old daughter is mad. She makes up stories about herself and believes in them. Sometimes she is going to be a professional figure skater. Sometimes a photo model: When she was 15 years old, she broke up with her grandparents because they wouldn't lend her their apartment in Stockholm, where she needed to live to take (non-existent) modelling jobs. She is oblivious to social facts. For example, she holds a persistent idea that she is going to save her younger siblings, especially a toddler brother she adores, from their substandard parents. When she encounters a person of authority, she constantly tries to negotiate with them, wringing out every possible advantage. She almost completely lacks any theory of mind: For example, she does things like meticulously hiding a carefully packaged bunch of notebooks in the ground and then leaving a digging spade next to the hiding place. She runs away and hides from all people she doesn't feel at ease with, including her social worker. In general, although her IQ level is very high, she seems to completely lack imagination of what people might be thinking of her.

I could go on and on and make the list longer. The point is, to the naked eye, Alma is crazy. You just need a little information about her behavior to agree that she most likely is delusional. Everyone who needs to deal with her for extended times finds that obvious: Her parents, the social workers, her foster parents.

Everyone, except her psychologists and psychiatrists. Yes, this is really perplexing. A psychologist I know says that a personality disorder should only be diagnosed if it is obvious enough for a bus driver to see it. But what do we call a case of madness that every bus driver could see, but psychologists fail to detect?

Almost two years ago, when Alma's first psychologist failed to see that she was dealing with an unusually mad patient, I believed I had just encountered an unusually stupid psychologist. When I asked the psychologist to help Alma fight her madness, the psychologist decided that I was the mad one and helped Alma to move into foster care. The foster parents then discovered rather quickly that Alma was actually mad. I did my very best to lobby to get the oblivious psychologist out of the picture. Eventually that succeeded and Alma got ...