Abstract
James Frame was a nineteenth century Scotsman, psychiatric patient, and author. He published two books during his lifetime, the Philosophy of Insanity and the Asylum Diaries, which detail his lived experience as a patient at the Glasgow Royal Lunatic Asylum. This book review-essay engages with recent scholarship on Frame to argue that these recently re-published writings offer more than historical curiosity: they articulate a consistent philosophy of madness and a political theory of care that continues to be relevant for contemporary psychiatry. Frame’s testimony provides a rare first-hand account of the Scottish “no-restraint” movement, prefiguring both anti-psychiatry and patient-centered care, while foregrounding the therapeutic significance of environment, community, and the relational dynamics they foster. At the same time, Frame’s work develops a singular ethics, epistemology, and ontology of madness, insisting that reason and unreason are not opposed but entwined, thus demonstrating that the ontological impropriety of any singular life—what the Italian philosopher Giorgio Agamben calls its “exemplarity”—is what makes it most common. By analyzing Frame’s synthesis of testimonial combined with practical, philosophical, and political insight, as well as recent historical and clinical scholarship on his works, the review-essay shows how his writings anticipate both psychoanalytic concepts such as transference, as well as ethical critiques of profit-driven health systems. The piece concludes that Frame’s work remains a conceptual resource for rethinking the intertwined epistemological, ethical, and political dimensions of psychiatry in the 21st century.
Introduction: An unheard figure of the history (and philosophy) of psychiatry
As the psychoanalyst and historian of psychiatry David F. Allen (2025: 3) recalls, “James Frame, was, in his own lifetime, what one could call at least a local, if not national celebrity.” And yet today, few, if any, know of his name; it has become, as the French philosopher and sinologist François Jullien might say, “unheard (of)” (Jullien, 2019; Schwalbe, 2023). A new reedition of his works helps remedy this oversight and “unhearing” of Frame’s name, ideas, and legacy, offering an important clinical contribution to the budding historical scholarship dedicated to his works (Andrews and Philo, 2017). Comprised of Frame’s two major texts, The Philosophy of Insanity and The Asylum Diaries, which had not been in print since its original publication in 1865, augmented with an introduction by Allen, a series of scholarly and clinical essays by the historian Laurence Dubois, the clinical psychologist Fanny Hercouët, and the psychiatrist and psychoanalyst Patricia Janody, as well as an index and appendices, this reedition offers an immediate point of entry into a body of work that, despite having first been published over 160 years ago, remains uncannily relevant today. 1 This review-essay is intended less as a critical evaluation of the claims advanced in the scholarly articles of this new reedition than as an elucidation and extension of the dialogue they open with Frame’s writings themselves. In doing so, it aims to make Frame’s own words resonate through—and be refracted by—contemporary historiographical, clinical, and philosophical perspectives.
At first glance, it may seem counter-intuitive to turn to nineteenth-century historiographical and clinical writings about a nearly forgotten psychiatric patient in an age of digital connection and artificial intelligence. Yet the legitimate question “Why read Frame today?” is answered precisely by the enduring force of his works. Indeed, Frame’s writings offer a vivid first-hand account of the Scottish “no-restraint” movement that prefigured anti-psychiatry and patient-centered care, as well as an unparalleled testimony of lived madness and healing through relational, social, and narrative processes. Perhaps above all, they undertake an urgent political critique of profit-driven care and of the neglect of frontline staff that still mirrors public health challenges today. While such concerns have been extensively explored by historians of psychiatry—from patient-authored histories of madness to historical, socio-political and economic analyses of nineteenth century British “moral therapy” (Digby, 1985; Parry-Jones, 1972; Peterson, 1982)—Frame’s writings remain distinctive in the way they gather these issues into a first-person clinical, philosophical, and political testimony. Frame’s importance is thus neither strictly historical nor merely anecdotal: his writing advances a philosophy of madness that forces us to reconsider the relationship between reason and unreason, singularity and universality, medicine and metaphysics. His aim, as he himself writes, was not to “arrive at a definitive truth,” but rather to “shed even the faintest ray of light into the deep gloom which droops around the wounded spirit” (p. 17). His writings, I argue, offer a resource for rethinking the status of the common(s) in psychiatry today.
This review-essay therefore situates Frame’s writings at the intersection of historical psychiatry, psychoanalysis, ethics, epistemology, and political theory. It begins by outlining the principles and historical significance of the Scottish “no-restraint” movement, as well as its influence on twentieth century anti-psychiatry. It then focuses on Frame’s first-person testimonial of his lived experience of madness to bring to light the therapeutic resources of what psychoanalysts call “transference” (Freud, 1905), and of what the French psychiatrist and psychoanalyst Janody (2025: 166) specifies as Frame’s singular creation of an “asylum within language.” Finally, taking cues from the Italian political theorist and philosopher Giorgio Agamben, the piece draws on the political and philosophical implications of Frame’s critique of institutional neglect and for-profit care, showing how his ethical and epistemological vision of care as a usage of the common(s)—where singular lives can become exemplary and inspiring—remains urgent for contemporary psychiatry and public health. In this regard, the present review-essay may be read as a complement to recent work that mobilizes Agamben to aptly question the production of abandonment and brokenness in asylum spaces (McGeachan and Philo, 2023). Rather than focusing on the reduction or suspension of political life in the asylum, it leverages Agamben’s use of medieval philosophy to show how Frame’s writings foreground the therapeutic and political stakes of what could be called (a) life-lived-in-common.
Historical context: The Scottish “no-restraint” movement and “anti-psychiatry”
A firsthand witness of the “slight craze” and anomaly of Scottish “no-restraint”
In her scholarly essay offering a historical contextualization of the “no-restraint” movement, the historian Dubois (2025) details the ways in which a Scottish asylum like Gartnavel expanded upon the methods that had been used in England in places like the Hanwell Asylum, the York Retreat or the Lincoln Asylum. Re-inventing the ideals of “moral treatment” set forth by the French alienist Philippe Pinel at the beginning of the nineteenth century and developing upon innovations of the “moral therapy” pioneered by William A.F. Browne and John Connolly (Scull, 1989, 1990), these institutions abandoned the use of “mechanical restraint,” that is to say the use of physical machinery meant to constrain the “liberty of motion” of the psychiatric patients, setting a precedent that would, in the brief span of 15 years, durably alter the landscape of psychiatry in Great-Brittan (Dubois, 2025: 139). As Dubois (2025: 149) states, these places invented a “very new kind of therapy” that “insisted on the idea of the therapeutic environment and a way of life for the patients so that many forms of entertainment were available: games, Christmas celebrations, open air parties, lectures, music, sport, and dancing.” Frame’s “Address Delivered at One of the Asylum Concerts,” included in the Diaries, offers a vivid testimonial of the free-spirited atmosphere that seemed to reign in the asylum during these moments: “There is the appearance of slight craze here, ‘the mind’s pulse does not very temperately beat time,’ though, like some folks’ failings, their craziness leans to ‘virtue’s side.’” (p. 122). Frame was, as Dubois (2025: 153) puts it, “not only a peer witness, but also a prime mover of his day.” As the historian unfortunately reminds us, this carefree atmosphere in psychiatric asylums was short lived: not long after the departure of Frame’s beloved Dr Mackintosh in 1874, it “faded away for a very long time”; the customary usage of violence and force against patients was to become the norm in psychiatry once more.
Nonetheless, it should also be noted that historiographical research has shown that Gartnavel Royal Asylum occupied a distinctive and complex position within nineteenth-century Scottish psychiatry: as Jonathan Andrews and others have demonstrated, the institution’s reformist ambitions ran into persistent structural constraints, notably chronic overcrowding and sharp class divisions between private and pauper patients (Andrews, 1993; Andrews and Smith, 1993). By the mid-nineteenth century, both houses at Gartnavel were frequently over capacity, with some patients obliged to sleep on gallery floors and pauper admissions periodically suspended (Andrews, 1998; Andrews and Philo, 2017). While these historiographical considerations are important to keep in mind, they do not diminish the important therapeutic and ethical advances that were pioneered and achieved at Gartnavel under the auspices of “no-restraint.” In a sense, one would have to wait until the emergence of “anti-psychiatry” in the twentieth century to fully appreciate the historical, political, and therapeutic significance of the Scottish “no-restraint” movement.
“No-restraint,” or the ethical premises of anti-psychiatry
It is indeed only in the aftermath of World War II and in reaction to the German psychiatrist of Emil Kraepelin that some of the essential ideas of “no-restraint” were revived in what would be called “anti-psychiatry.” Anti-psychiatry, as Allen (2025: 6n8) reminds us, represents, above all, “a rejection Kraepelinian psychiatry” and of its theories of mental degeneration, as well as of all forms of physical and institutional “violence against patients.” In this regard Frame’s works anticipate the clinical, philosophical, and political works of psychiatrists like Harry Stack Sullivan and Ronald David Laing, who denounced the use of psychiatric diagnoses as a means of social repression, as well as the physically coercive practices of lobotomy and insulin shock therapy (Allen, 1994).
Defined not only in negative terms, anti-psychiatry can also be characterized as the ethical valorization of first-person testimonials of psychiatric patients; not only of illness and stigmatization, but also of hope and recovery. If anti-psychiatry has indeed taught us anything, it is that the testimonials of those who have a first-person experience of madness matter at least as much as whatever doctors and scientists might have to say about it from a third-person perspective. The power of books like the Philosophy of Insanity or the Asylum Diaries thus resides not in their objective and scientific evaluation of a clinical phenomenon, but rather in their capacity to convey to readers, as Frames eloquently writes, “things which no one but a sufferer could ever tell” (p. 17) Frame’s writings indeed testify that he felt that his position as a “sufferer” was treated with the utmost respect and care by his psychiatrist, Dr. Mackintosh, to whom he attributed his recovery and dedicated both of his written works.
Testimonial, knowledge, healing, and transference
Frame’s recovery as transference: A psychoanalytic reading
As the clinical psychologist Hercouët (2025) suggests, Frame’s recovery can in large part be explained by the psychoanalytic concept of transference. Simply put, transference refers to the patient’s capacity to “transfer” or to replace a set of unconscious feelings and representations to the therapist. If the transference functions as intended, positive feelings and representations are transferred and unloaded onto the therapist, who is then viewed as an unconditionally benevolent being, even when exerting some kind of authority or restraint. Freud (1905: 116) states that the mechanisms of transference can be likened metaphorically to “new editions (Neueauflagen) or facsimiles (Nachbildungen) of the impulses (Regungen) and phantasies which are aroused and made conscious during the progress of the analysis; but they have this peculiarity, which is characteristic for their species, that they replace some earlier person by the person of the physician.” For the founder of psychoanalysis, transference revives past “psychic experiences (psychischer Erlebnisse)” as if they belonged to the present relationship with the analyst. Some transferential dynamics appear as straightforward “reprints (Neudrucke)” of earlier relationships, while others take the form of “reworked editions” (Neuarbeitung), when their content becomes modified through “a sublimation (eine Sublimiering),” and then reshaped when they attach themselves to “particular traits (Besonderheit)” or “circumstances (Verhältnisse)” of the physician.
While it is clear that Frame’s transference with Dr Mackintosh relies on the former’s manifest idealized sublimation of the latter, Hercouët rightly suggests that the transferential process of idealization that made possible Frame’s healing goes beyond the doctor’s mere person. Indeed, Frame idealizes the place of Gartnavel itself, as is made quite clear in the Philosophy of Insanity. There Frame writes: In Gartnavel, not the slightest appearance of restraint, the place and the patients scrupulously neat and clean – good looking women walking about quietly and cheerfully among them, these are nurses evidently selected with skill and care, and whose appearance and demeanor are the very reverse of what a novelist would represent female servants in a lunatic asylum to be. Nothing offensive to be smelt or seen. The other side of the canvas we will leave untouched, in the belief that the picture would be more disgusting than beneficial. (p. 65)
Even though it is obvious that Frame’s amusing evocation of “good looking women” paints an idealized picture of the asylum (indeed Dubois’ essay reminds us that physical restraint was in fact still practiced with non-paying patients during Frame’s time), it is also evident, as suggested by the irony of the last sentence (“The other side of the canvas we will leave untouched, in the belief that the picture would be more disgusting than beneficial”), that Frame displays some degree of awareness when it comes to his own idealized view of Gartnavel. As Hercouët’s (2025: 169 and 173) clinical reading of Frame’s testimonial suggests, his idealization of Mackintosh represents the first step of his healing through transference, while the idealization of Gartnavel represents the second, which “allows him to be part of something bigger; a possibility of social connection which thus supports and defines the walls of his existence.” The third and final step of the transferential process identified by Hercouët comes when Frame is accepted as a spokesperson of “no-restraint” psychiatry and recognized as an author.
Frame’s name: Both noun and verb, or the invention of an “asylum within language.”
The psychiatrist, psychoanalyst, and author Janody (2025) rightly insists upon and furthers Hercouët’s discussion and clinical analysis of Frame’s recovery. Janody even articulates how the transferential process at play in Frame’s treatment and writing involves a subjective reappropriation of his own name. As the following sentence from the Philosophy of Insanity clearly suggests, Frame’s singular usage of the common noun “frame” literally frames the powerful process of metaphorization at the heart of his experience of healing: A general knowledge of the structure of our own frame, and more particularly of any particularity which attends upon our own individual constitution, is imperative upon all who feel it to be their duty and their interest to keep their minds and their bodies in a state of efficiency, so far as doing so lies within the scope of their own exertions. (p. 49)
The power and performativity of this sentence, and of Frame’s metaphorized usage of the noun “frame,” should not be underestimated. The term itself functions as the nodal point of Frame’s own philosophical theorization of mind and body as two “entwined” and “incorporated” entities (Janody, 2025). In other words, through a metaphorized usage of the term “frame,” James, the patient and “lunatic,” establishes a link with Frame, the author and philosopher, to regain a subjective position of initiative.
Given that Frame’s delusions involved his own body (during his manic outbreaks he was convinced that a Devil inhabited his stomach), one might be tempted to dismiss as delusional his usage of his surname as a common name in his theorization of insanity. And yet, as Janody (2025: 163) suggests, the ambiguity of Frame’s metaphorized usage of the noun “frame” plays a decisive role in his healing and in his capacity to distance himself from the very delusions that led to his hospitalization in the first place. “James Frame,” Janody writes, “[. . .] makes his name into something ordinary, and lets it slide between a proper name and an ordinary noun. [. . .] His writing unfolds the enigmatic nature of his name under the gaze of the enigmatic nature of madness.” Frame’s capacity to construct a “textual place” through a metaphorized usage of his name thus appears to have played a central role in his healing. His ability to metaphorize his own name demonstrates how the treatment and care he received at Gartnavel, as well as the sense of community and belonging he found there, provided him with a supportive environment that not only tolerated his singularity, but actively encouraged it. Frame, as Janody (2025: 166) argues, “invents a way of saying I by the decentering of the places which he uses to name himself [. . .].” By relating his experiences at the asylum and by offering his own singular theorizations of them, Frame, as the psychiatrist and analyst writes, “builds an asylum within the hospital, an asylum within language.”
The politics of care, then and now
An ethical critique of for-profit healthcare, a political defense of public health policy
While it might be tempting to dismiss Frame’s testimonial as an isolated, anecdotal experience, doing so would lead us to neglect the essential political teachings that his writings still carry today. The seventh and eight chapters of the Philosophy of Insanity are indeed full of such insights that remain more-than-relevant today. Entitled “Lunatic Asylums and Attendants” and “Labor and Amusements Considered as Curative Agents,” they offer an unequivocal condemnation of any psychiatric institution that does not make at least a minimal effort to provide “small, snug, home-looking places” for the patients that could benefit from them (p. 52).
In these two chapters, Frame details how the proper training of attendants and how the construction of a nurturing and nourishing atmosphere for the patients constitute the cornerstone of effective treatment. Frame’s critique of the private asylums and of the “poor-houses” of his time remains particularly salient: ‘It is our interest to let them die – yours to keep them living’ said a poor-house attendant upon the insane to an attendant upon the insane [. . .] in a public asylum. The remark was literally true, and proves more powerfully than all the reports off all the committees of inquiry that ever existed that poor-houses should not be entrusted with the keeping of lunatics. Besides, they have the power, and they use it, of sending their most troublesome and expensive cases to public asylums, thereby burdening these far from profitable establishments with the most oppressive part of a burden which, if divided at all, should be divided fairly. (p. 56)
One cannot help but be struck by the actuality and insightfulness of Frame’s remarks today. More than ever, the proliferation of for-profit medicalized facilities seems to exhibit the logic of destruction and neglect described by Frame. In France, the recent scandal detailing the negligence and mistreatments carried out in the for-profit nursing homes of private companies like Orpea and Korian gives Frame’s writings an almost prophetic tone (Castanet, 2022). 2 While the picture of both public and private mental healthcare in nineteenth-century Scotland might have been more complex than Frame painted it be, as Andrews and Philo (2017) have rightly suggested, his social critique of poor labor conditions in psychiatry and for-profit healthcare remains undeniably relevant today, especially because it insists on the key therapeutic role of “attendants,” the non-medical staff who work directly with patients.
The essential “status, role, and function” of care workers
Frame’s critique of private healthcare facilities also brings into focus another key political lesson of his writings: the importance of what Jean Oury, a central figure of French institutional psychotherapy (psychothérapie institutionnelle), called the “status, role and function” of “attendants,” who often provide the most immediate forms of care and support to psychiatric patients. For the French psychiatrist, status designates their institutional position within a hierarchy, role the responsibilities formally expected of them within a system, and function the unique way or manner in which their presence and actions actively shape the collective atmosphere of the psychiatric milieu (Oury, 2024: 83–88). From Frame’s perspective, attendants deserve the utmost attention and care, just like patients, as well as proper pay. “So long are these men are paid less than day laborers, and perhaps often required to work as such,” Frame writes, “nothing but necessity can cause anyone fitted for the trying task to accept it, and nothing short of necessity can compel them to keep it” (p. 56). For Frame, offering low wages to healthcare workers to maximize profit can therefore, by virtue of the logical and philosophical laws of “necessity,” only lead to poor patient outcomes.
Frame’s insistence on the crucial importance of non-medical staff in psychiatric facilities, and in healthcare institutions in general, thus remains of the utmost importance today. “A good attendant,” as Frame reminds us, “is a most valuable person, and is capable of doing, in many cases, a vast amount of good to those under his care. [. . .] A good attendant,” Frame continues, “male or female, should be treated with respect, and met with reward and encouragement” (p. 57). Clinicians and policy-makers alike therefore have much to learn from Frame’s assessment of the moral value that non-medical staff provides to patients in healthcare institutions. Although their labor most often remains unheard and unseen because of its ordinariness, they play a decisive role in fostering the overall atmosphere that will lead to positive treatment outcomes. Offering decent wages, recognizing the perspective of caregivers, and involving them in decisions regarding the daily life of the institution are, from Frame’s philosophical standpoint as well as from the perspective of the contemporary ethics of care (Laugier, 2020; Molinier, 2020), immediate and concrete ways to improve treatment outcomes, even in severely resource-deprived healthcare settings.
Madness and reason “entwined”: Frame’s ethics, epistemology, and ontology
Frame’s humanist ethics of “insanity” and the advent of “patient-centered medicine”
Frame’s aim in writing his book was not so much to arrive at a definitive truth on the matter of madness and insanity. Instead, his hope was that it could “[. . .] shed even the faintest ray of light into the deep gloom which droops around the wounded spirit [. . .]” (p. 17). In other words, Frame’s text and philosophy seek to offer preventive rather than curative care to the individuals and families who become afflicted by “that insane spark which, smoldering, lies in the breast and brain of everyone endowed with reason and with life [. . .]” (p. 18). In stating that insanity is a matter that concerns “everyone,” Frame explicitly reaffirms the age-old humanist view that madness and reason are not to be thought of as two categories that mutually exclude each other, but rather as two consorts bound by the philosophical and logical laws of necessity. In this regard, Frame’s sentence appears to follow the logic of the seventeenth century French physicist, mystic, and moralist Pascal (1995) who stated that: “All men are so necessarily mad that it would be mad through another twist of madness to not be” (Pensées, fragment 414).
For Frame, it is thus the ubiquity and necessity of insanity itself that justify that we strip ourselves of our moral prejudices when we approach it: No doubt it is a dreadful disease, but not so universally dreadful as is generally thought. In the great majority of cases, provided proper treatment is resorted to at the commencement of the attack, it is curable, and where we find it incurable the brain is often benumbed, and consequently the day of suffering forever past; while in many other cases of confirmed insanity we see the manifestations of an intensity of enjoyment that no sane person can properly appreciate or know. (p. 23)
In arguing that insanity can in fact be “curable,” Frame fights the prejudice of those who assimilate madness to damnation. He reminds us that even in cases that could be considered “incurable,” what causes “suffering” can, in fact, become “benumbed” by the “brain,” and thus be cast away into the “past.” Far from being incapable of “enjoyment,” many of those who are deemed mad or insane may experience it on a level of “intensity” that remains, for the “sane person,” impossible to “appreciate or know.” Frame therefore invites his readers not to dismiss the experience of the “incurable” as a cesspool of misery, but rather to respect the “benumbed” tranquility and/or “intensity of enjoyment” of their experience of living. Writing prior to the emergence of the scientific paradigm of organic and biological “degeneracy” and its therapeutic pessimism, famously championed by figures such as Emil Kraepelin and radicalized through the rise of the eugenics movement (Allen, 1996), Frame articulates a conception of madness that resists the reduction of patients to defective or unworthy lives. In doing so, he anticipates ethical orientations that would only (re)emerge more explicitly in the twentieth century under the auspices of “patient-centered medicine,” a paradigm in which the physician, “in addition to trying to discover a localizable illness or illnesses, [. . .] also has to examine the whole person in order to form [. . .] an ‘overall diagnosis’” so as to understand the patient as a “unique human-being” (Balint, 1969: 269).
Frame’s “entwined” physiology, epistemology, and poetics
Even though it is clear that Frame’s Philosophy of Insanity finds its deepest rooting and impetus in ethics, it also invents a singular and relevant epistemology of madness. Frame seeks to anchor his philosophy in a “knowledge” derived from the observation “of the internal structure of the body – of what constitutes the use and abuse of the different organs thereof [. . .]” (p. 46). Much like the Epicurean philosophers of Greek Antiquity who sought to approach ethical and psychological matters based on a physiological understanding of observable phenomena (Konstan, 2010), Frame aims to found his philosophy upon “a knowledge of the nature of the body” deemed to be “indispensable” (p. 47).
Seeking to arrive at “any practical, that is to say at any useful result,” Frame states from the outset of the Philosophy of Insanity that “the entire question of insanity must be stripped of metaphysical drapery. Whatever may be the theoretical belief,” he adds, “the mind must be practically looked upon as a material substance, capable of being healed and hurt – subject to disease, to decay, and to death” (p. 18). While he readily admits in his physiology and psychology that the “brain is universally allowed to be the seat of intellect,” his own lived experience of madness precludes him from dogmatically conceding to a materialist theory of the brain as the seat of the psyche; it forces him to recognize that “other organs besides the brain are powerfully painfully acted upon by the mysterious agency named soul, spirit, intellect or mind. In wild anxiety or deep grief,” Frame writes, “the pain lies immediately below the diaphragm; and the mad agony of that despair which impels the maniac to plunge into the black billows of an unknown, shoreless sea, does not feel as if proceeding from the brain” (p. 47). The combined usage of images, metaphors, and physiological terms to evoke a lived experience of “mad agony” produces a poetic re-invention of the philosophical and theological categories of “soul, spirit, intellect or mind” that form the metaphysical heart and “mysterious agency” of Western ontology, psychology, and psychopathology (Jullien, 2007; Schwalbe, 2023: 37–41). In this moment of poetic invention, Frame exposes what the Italian philosopher Agamben (1990, 1993) might call his exemplary singularity.
The ontological exemplarity of the singular, or the impropriety of the common(s)
Philosophically and ontologically speaking, the singularity of existence appears to stand in tension with the universality of scientific knowledge: existentia est singularium, scientia est de universalibus—“existence is singular, science speaks of the universal,” as the medieval adage of scholastic ontology commenting upon Aristotle’s (1986) De anima (417b23) reminds us. And yet, as Agamben (1990: 35) recalls, medieval theologians also argued that the singular, when conceived ontologically as an example, reveals a universal concept of “impropriety”: that which belongs to no one and, thus, logically, to everyone. “For the being that is his own [singular] manner,” Agamben continues, “this manner is not a property that determines and identifies him as an essence [. . .].” Rather, as the philosopher suggests, it is what makes that being an impropriety. From an ontological perspective, when such impropriety is “assumed and appropriated” as what makes any-being-whatsoever truly “unique,” it can become, as Agamben concludes, “exemplary.”
In this sense, Frame’s writings can themselves be read as exemplary. Indeed, the unflinching exposure of his own “being insane,” stripped of both property and essence, enacts precisely the impropriety that the theology and ontology of the scholastics described. Frame’s work thus does not merely recount an individual life. Instead, it stages singularity as that which, paradoxically, belongs to the common. On an ontological level, the impropriety of a singularity’s exemplarity defines, as Agamben (1990: 35) suggests, what constitutes “being (in) common”: “The example is the being of which it is the example; but this being does not belong to it — it is,” as the philosopher states, “perfectly common.”
Conclusion: James Frame, or the singular power of (a) “life-lived-in-common”
In conclusion, Frame’s work provides, as argued throughout this article, both a singular and exemplary account of someone who has “outgrown their madness,” to paraphrase the poet Auden ([1938] 1997), as cited by the Japanese writer Ōe ([1969] 1977). By raising the impropriety of his singular experience to the status of an example, Frame offers us both the testimonial and realization of a singular, authentic, and yet common philosophy of healing. His Philosophy of Insanity, as Janody (2025: 165) writes, “helps us at a time when the expansion of bureaucratic categories is required by official psychiatry as it destroys, in an organized manner, places of healing.” Understood via Agamben’s definition of the common as exemplary, Janody’s remark underscores the deeply political reasons why Frame’s writing remains both essential and relevant for contemporary clinicians and scholars of madness. In a world where the ideal commons of democracy are threatened by the resurgence of authoritarian rulers and oligarchies, Frame’s commitment to promoting ideals of care, freedom, and enlightenment, as well as his lucid clinical assessment of short-sighted profiteering, remain as vital as ever. His writings and ideas evoke, on an aesthetic level alone, the ideality, beauty, quaintness, strangeness, and, above all, power of (a) life-lived-in-common, i.e., life that assumes and welcomes the exemplary uniqueness of any-being-whatsoever, regardless of its measure, form, identity, status, and/or value.
To end this article with a well-spirited Freudian joke, it suffices to say that James Frame’s at once singular, common, and exemplary destiny certainly lived up to the promise of his name. More than a century after his passing, the uniqueness of his writings and story continue to provide an enduring and useful frame (of reference) to think critically about the history of psychiatry today. Frame indeed provides us with a welcome reminder that we should continue to conduct both historical, philosophical, and clinical research that values the voices and concerns of patients and caretakers, just as much as those of doctors and academics.
Footnotes
Ethical considerations
This article is based on historical and philosophical research and does not involve human participants or the use of data requiring institutional ethical approval.
Consent to participate
No consent to participate was required for the production of this article given the nature of its methodology.
Funding
The author received no financial support for the research, authorship, and/or publication of this article.
Declaration of conflicting interests
The author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Data availability statement
No datasets were generated or analysed during the current study.