Blackwell Science, LtdOxford, UKNUPNursing Philosophy1466-7681Blackwell Publishing Ltd 200563161173Original articleTime, Human Being and Mental Health Care

Marc Roberts

Original article
Time, human being and mental health care: an introduction
to Gilles Deleuze
Marc Roberts RMN DiPHE BA(Hons) PGCE PGCRM MA PhD(c)
Department of Philosophy, School of Humanities and Social Sciences, Faculty of Arts, Media and Design, Staffordshire University, Staffordshire, UK

Abstract The French philosopher, Gilles Deleuze, is emerging as one of the most
important and influential philosophers of the 20th century, having pub-
lished widely on philosophy, literature, language, psychoanalysis, art,
politics, and cinema. However, because of the ‘experimental’ nature of
certain works, combined with the manner in which he draws upon a
variety of sources from various disciplines, his work can seem difficult,
obscure, and even ‘willfully obstructive’. In an attempt to resist such
impressions, this paper will seek to provide an accessible introduction
to Deleuze’s work, and to begin to discuss how it can be employed to
provide a significant critique and reconceptualization of the theoretical
foundations and therapeutic practices of psychiatry, psychotherapy, and
mental health nursing. In order to do this, the paper will focus upon
Deleuze’s masterwork, and the cornerstone to his philosophy as a
whole, Difference and Repetition; in particular, it will discuss how his
innovative and challenging account of time can be employed to provide
a conception of human life as a ‘continuity’, rather than as a series of
distinct ‘moments’ or ‘events’. As well as discussing the manner in which
his work can provide us with an understanding of how life is different
and significant for each human being, this paper will also highlight the
potential importance of Deleuze’s work for logotherapy, for the recent
‘turn’ to ‘narrative’ as a psychotherapeutic approach and for contempo-
rary mental health care’s growing interest in ‘social constructionism’. As
such, this paper also seeks to stimulate further discussion and research
into the importance and the relevance of Deleuze’s work for the theory
and practice of psychiatry, psychotherapy, and mental health nursing.

Correspondence: Marc Roberts, Department of Philosophy,

School of Humanities and Social Sciences, Faculty of Arts,
Media and Design, Staffordshire University, College Road,
Stoke-on-Trent, Staffordshire ST4 2DE, UK. Tel.: 44 (0)
0786 6977781; e-mail: marcwarenroberts@aol.com

© Blackwell Publishing Ltd 2005 Nursing Philosophy, 6, pp. 161–173 161

162 Marc Roberts
Keywords: difference, logotherapy, modernity, narrative, social
constructionism, time.
Introduction
The French philosopher, Gilles Deleuze, is emerging
as one of the most important and influential philoso-
phers of the 20th century (e.g. Colebrook, 2003, pp.
1–8; Williams, 2003, pp. 1–4). His prodigious body of
work not only includes innovative reassessments of
other philosophers (e.g. Deleuze, 1988a, b, 1991,
1992, 1993, 2002a, b, 2003a), informed by and inform-
ing his own ‘philosophy’, but also includes writings –
some co-authored with his long-term collaborator,
Felix Guattari – on literature, politics, psychiatry, psy-
choanalysis, language, art, and cinema (e.g. Deleuze
& Guattari, 1986, 2002, 2003; Deleuze, 2000a, b,
2003b, 2004a). As such, there is not only a growing
body of research in these areas that can rightly be
called ‘Deleuzian’ (e.g. Ansell-Pearson, 1999; Bucha-
nan & Colebrook, 2000; Rajchman, 2000; Buchanan
& Marks, 2001; Kennedy, 2001), but his work is
also stimulating research in contemporary science
(DeLanda, 2002), cultural studies (Buchanan, 2000),
health studies (Fox, 2002), nursing theory and philos-
ophy (Drummond, 2002; Holmes & Gastaldo, 2004),
religion (Bryden, 2001), and even ‘police studies’
(Watson, 1999). However, because of the ‘experi-
mental’ nature of certain works (e.g. Deleuze &
Guattari, 2000), combined with the manner in which
he draws upon a variety of sources from various dis-
ciplines (including contemporary science, biology,
mathematics, literature, art, and the whole of the
philosophical tradition), it has been suggested that
his work can seem difficult, obscure, and even ‘will-
fully obstructive’ (Williams, 2003, p. 2); indeed, in
How Mumbo-Jumbo Conquered the World, Francis
Wheen (2004) has even suggested that Deleuze’s
work is ‘gibberish’ (p. 88).
In an attempt to resist such conclusions, this paper
will seek to provide an accessible introduction to
Deleuze’s work, and to begin to discuss how it can be
employed to provide a significant critique and recon-
ceptualization of the theoretical foundations and
therapeutic practices of psychiatry, psychotherapy,
and mental health nursing. In order to do this, the
paper will focus upon what is considered to be
Deleuze’s (2001) masterwork (Williams, 2003, pp. 1–
3), and the cornerstone to his philosophy as a whole,
Difference and Repetition – indeed, in the preface to
the English edition of Difference and Repetition,
Deleuze (2001) suggested that this was the first book
in which he tried to ‘do philosophy’, and: ‘All that I
have done since is connected to this book, including
what I wrote with Guattari’ (p. xv). In particular, the
paper will discuss how his concept of ‘discrete multi-
plicities’ can sensitize us to a certain tendency of
‘modern’ thought, and how his innovative and chal-
lenging account of time can be employed, against this
tendency of ‘modern’ thought, to provide a concep-
tion of human life as a ‘continuity’, rather than as a
series of distinct ‘moments’ or ‘events’. Moreover, by
introducing his concepts of ‘the virtual’, ‘the actual’,
and ‘continuous multiplicities’, the paper will also dis-
cuss how Deleuze’s work can provide us with an
understanding of how life is different and significant
for each human being. Finally, the paper will highlight
the potential importance of Deleuze’s work for
logotherapy, for the recent ‘turn’ to ‘narrative’ as a
psychotherapeutic approach and for contemporary
mental health care’s growing interest in ‘social con-
structionism’. It is important to note, however, that
possibly due to its depth, breadth, style, complexity,
and level of abstraction, Deleuze’s work in particular
seems to lend itself to a diversity of ‘readings’ and
applications. Therefore, in providing its own ‘reading’
of Deleuze’s work, this paper seeks to stimulate fur-
ther ‘readings’, research, and discussion of how his
work can inform, challenge, and possibly even change
the theory and practice of psychiatry, psychotherapy,
and mental health nursing.
© Blackwell Publishing Ltd 2005 Nursing Philosophy, 6, pp. 161–173

Modernity, analysis, and discrete
multiplicities
In order to begin to gain an understanding of
Deleuze’s philosophy, it is productive to see his work
as providing a critique of a specific way of seeking to
understand and explain certain phenomena; in partic-
ular, his work can be seen as a critique of the attempt
to analyse phenomena in terms of ‘discrete multiplic-
ities’. Taken from the physicist and mathematician
Bernhard Riemann, Deleuze (2002a) employs the
term ‘discrete multiplicity’ to refer to a ‘collection’ of
distinct ‘parts’ or ‘units’ (pp. 38–39). For example, a
collection of people, a collection of atoms, a collec-
tion of days or a collection of seconds can all be
understood as discrete multiplicities in so far as they
are a collection of distinct ‘parts’ or ‘units’. As can be
seen from these examples, many so-called ‘unities’ or
‘wholes’ are commonly understood as discrete multi-
plicities, as a collection or a multiplicity of distinct
parts; thus, a society can be understood as a collection
of people, a molecule a collection of atoms, a week a
collection of days, and a minute can be understood as
a collection of seconds. Deleuze (2002a) suggests that
such discrete multiplicities, or what we might call
‘composite unities’, are characterized by ‘juxtaposi-
tion, order, quantitative differentiation, and differ-
ence in degree’ in so far as they are ‘numerical
multiplicities’ (p. 38), i.e. they possess distinct parts
or units that can, in theory at least, be separated,
counted, quantified, and therefore reduced to
numbers.
It has been suggested that this type of ‘analysis’, the
attempt to understand and explain phenomena in
terms of discrete multiplicities, is characteristic of
‘modernity’ (Haase & Large, 2001, p. 107) – that
unique form of civilization that emerged in Europe
and North America over the last several centuries,
and which became fully evident by the beginning of
the 20th century (Cahoone, 1997, p. 11). Indeed, one
of the clearest expressions of this type of analysis can
be found within the so-called ‘analytical’ tradition of
20th century philosophy, and in particular within the
work of Bertrand Russell. While the details of Rus-
sell’s philosophy cannot be discussed here, he sug-
gests that the general aim of philosophy should be to
© Blackwell Publishing Ltd 2005 Nursing Philosophy, 6, pp. 161–173
Time, Human Being and Mental Health Care 163
‘get down in theory, if not in practice, to ultimate
simples, out of which the world is built’ (Russell, 1994,
p. 26), for one’s understanding is said to be more
‘secure’, more ‘certain’, if one can discover ‘the small-
est number of simple undefined things at the start’
(Russell, 1994, p. 27). Although this endeavour can
be discerned throughout the philosophy of modernity
(e.g. Cottingham, 1997), this type of analysis is not
simply confined to that discipline. Both the Human
Genome Project and modern physics can be seen to
understand their subject matter by breaking it down
into distinct parts (Haase & Large, 2001, p. 107),
while the ‘atomistic’ liberal–democratic theory of
modern politics understands society as a discrete mul-
tiplicity, as a collection of distinct ‘atoms’ or individ-
uals (Heywood, 1997, p. 397). As such, Deleuze &
Guattari (2000) suggests, somewhat enigmatically,
that: ‘We live today in the age of partial objects, bricks
that have been shattered to bits, and leftovers’, and
while these ‘bits’ or distinct parts can be understood
as ‘unities’ or ‘wholes’, ‘it is a whole of these various
parts but does not totalize them; it is a unity of all of
these particular parts but does not unify them’ (p. 42).
As can be seen from the above examples, however,
this type of analysis can be profoundly productive in
furthering our understanding of human beings, of the
world, of human existence within the world, and of
the very nature of the universe itself. However, it has
also been suggested that the dominance of this type
of analysis throughout modernity, the characteristic
tendency of modernity to seek to understand and
explain things as discrete multiplicities, can also pro-
foundly distort our understanding (e.g. Husserl, 1964;
Laing, 1990; MacIntyre, 1997; Heidegger, 2000). For
example, MacIntyre (1997) suggests that the manner
in which modernity analyses human life in terms of a
discrete multiplicity, partitioning each human life into
a variety of distinct segments, has meant that leisure
time has been divided from work, private life from
public and that both ‘childhood and old age have
been wrenched away from the rest of human life and
made into distinct realms’ (p. 204). Highlighting this
type of analysis within modern philosophy and soci-
ology, particularly Jean-Paul Sartre (1996) and Irving
Goffman’s (2004) attempts to understand a human
life as an enactment of distinct roles, MacIntyre
164 Marc Roberts
(1997) suggests that a human life, analysed as such,
results in the ‘fracturing’ of a person’s past, present,
and future so that ultimately ‘life comes to appear as
nothing but a series of unconnected episodes’ (p.
204).
Of particular importance for Deleuze, and of par-
ticular relevance to his conception of human life as
a ‘continuity’ is the attempt to understand and
explain time in terms of a discrete multiplicity, i.e. in
attempting to understand its past, present, and
future ‘aspects’, time is commonly analysed in terms
of a series of ‘units’ or ‘nows’, where the present is
understood as ‘now’, the past as ‘no longer now –
but earlier’ and the future as ‘not yet now – but
later’ (Heidegger, 2000, pp. 374–375). Within such
an analysis of time, an analysis that understands
time in terms of distinct ‘units’ or ‘nows’, the past is
said to have gone, the future is yet to come and so
only the present exists, thereby assuming the posi-
tion of a ‘boundary’ that separates or divides the ‘no
longer existing’ past from the ‘yet to come’ future
(Durie, 2000, p. 153). However, the difficulty with
such an analysis of time is that it conflicts with what
would appear to be one of the most fundamental
human experiences of time. That is, time is not
experienced in a ‘discontinuous’, ‘punctuated’ man-
ner in which ‘now’ or the present is sharply distinct
from the past and the future; rather, this present
‘now’, while distinguished from the past and the
future, is experienced as maintaining a continuity
with the past and the future so that the future, as it
were, ‘runs into and through’ the present and ‘into’
the past without any ‘breaks’, thereby constituting
what is commonly referred to as ‘the flow of time’
(Durie, 2000, p. 153).
Deleuze and the passive synthesis
of time
Against time understood as a discrete multiplicity, as
a discontinuous series of ‘units’ or ‘nows’, in which the
present is sharply distinct from the past and the
future, Deleuze provides an account that attempts to
accommodate the experience of time as a continuity
in which the future ‘flows into and through’ the
present and ‘into’ the past. For those unfamiliar with
the philosophical tradition, however, the manner in
which he argues for that account may appear unusual,
and so it is necessary to briefly outline the form of the
argument that he uses, an understanding of which is
essential in order to grasp other important aspects of
his work. In terms of classical arguments from the
philosophical tradition, Deleuze provides what are
referred to as ‘transcendental deductions’ – although
it should be noted that he employs such arguments in
challenging and innovative ways (Williams, 2003, p.
17). Broadly speaking, transcendental deductions are
arguments that begin from a given ‘thing’ and seek to
discover what the conditions, or the preconditions,
have to be for that given thing to be given or to
appear as it is. That is, transcendental deductions, tak-
ing a given thing as their starting point, attempt to
‘deduce’ the conditions for that given thing, which
(because they are the conditions for that given thing)
are not given but ‘transcend’ that given thing. In this
way, transcendental deductions attempt to contribute
to knowledge by enabling us to know more about
how a given thing must be given or appear as it is, and
by doing so can radically challenge our common sense
notions. As will be seen, once a transcendental deduc-
tion has been carried out, we may discover counter-
intuitive truths about a given thing and how we are
to think about it in light of its transcendental condi-
tions (Williams, 2003, p. 17).
It is through the use of a transcendental deduction
that Deleuze argues for and presents his account of
time, where the given ‘thing’ that he takes as a starting
point for his deduction is the ‘lived, or living present’
(Deleuze, 2001, p. 70). However, as highlighted
above, how we are to think of the ‘lived, or living
present’ can only be fully explored in the light of its
transcendental conditions, and so provisionally it can
be taken to refer to ‘this very moment that is given to
us’ and which we are presently ‘living through’. In
contemplating the living present, Deleuze (2001)
observes that it is always characterized by an orien-
tation towards the future, an orientation that takes
the form of ‘expectation’ (p. 70). While we may be
familiar with the experience of expectation, however,
we may be unfamiliar with the extent to which expec-
tation characterizes experience, and which may only
manifest itself in those moments of ‘shock, disquiet
© Blackwell Publishing Ltd 2005 Nursing Philosophy, 6, pp. 161–173

or stumbling’ when something that was expected is
not there or does not occur, or when something else
replaces what was expected (Williams, 2003, p. 86).
Highlighting the extent to which expectation charac-
terizes experience, Deleuze takes Hume’s (1993)
example of the repeated series of couples of events:
AB, AB, AB, A . . . , in which whenever A occurs we
expect B to follow; for example, whenever we hear
the ‘tick’ of a clock in the present we expect a ‘tock’
to follow. Importantly, in questioning how it is possi-
ble for us to always have this orientation towards the
future, Deleuze suggests that in this living present,
there is always a ‘contraction’ or a ‘synthesis’ of all of
the previous instances of AB so that: ‘When A occurs,
we expect B with a force corresponding to the quali-
tative impression of all the contracted ABs’ (Deleuze,
2001, p. 70). So, for example, when in this living
present the ‘tick’ of a clock occurs, we expect a future
‘tock’ because in this living present there is also a
synthesis or a contraction of all the past instances of
experiencing a ‘tock’ following a ‘tick’.
Thus, Deleuze suggests that the living present, the
present moment that we are living through, always
possesses an orientation towards the future, an orien-
tation that takes the form of expectation. This orien-
tation towards the future in the living present is said
to only be possible in so far as there is also a synthesis
of the past within the living present. As such, the past
and the future are not to be thought of as sharply
distinct from the present; rather, the past and the
future must be thought of as ‘dimensions’ of the
present. As Deleuze (2001) suggests: ‘To it belong
both the past and the future: the past in so far as the
preceding instants are retained in the contraction; the
future because its expectation is anticipated in this
same contraction’ (pp. 70–71). Therefore, in seeking
to uncover the transcendental conditions, the precon-
ditions, for the living present, Deleuze suggests that
the past must always be synthesized or contracted
into the living present, thereby opening up a future
for us in the form of expectation. Importantly for
Deleuze, this synthesis of the past in the present is
‘passive’ or ‘unconscious’, i.e. it is not something that
we have to ‘actively’ or consciously think about for it
to occur. As Deleuze (2001) suggests: ‘It is not car-
ried out by the mind, but occurs in the mind . . . prior
© Blackwell Publishing Ltd 2005 Nursing Philosophy, 6, pp. 161–173
Time, Human Being and Mental Health Care 165
to all memory and all reflection’ (p. 71). Thus, in
hearing the ‘tick’ of a clock in the living present, we
do not expect to hear a ‘tock’ by consciously reflect-
ing upon or remembering all of the past occasions
when we have heard a ‘tock’ follow a ‘tick’; rather, all
of those past occasions are passively synthesized into
the living present to create the unconscious, future-
orientated expectation that a ‘tock’ will follow a
‘tick’.
Passive synthesis, continuity, and
human being
Following his transcendental deduction of the living
present, Deleuze can be understood as providing an
account of time as a continuity of the past, present,
and future. Rather than understanding time as a dis-
crete multiplicity, as a discontinuous series of ‘units’
or ‘nows’, he suggests that the past is passively syn-
thesized into the present, thereby opening up a
future for us in the form of expectation. As such, the
present is no longer thought of as a ‘boundary’ that
separates or divides the ‘no longer existing’ past from
the ‘yet to come’ future; rather, the past is said to
coexist or to be contemporaneous with the present,
thereby opening up a future for us, in this living
present, that takes the form of expectation. Upon
considering the implications of this, Deleuze’s (2001)
account of time may strike us as paradoxical, and he
is keen to stress that his account does reveal the
inherently paradoxical nature of time (pp. 81–82).
Against our ‘everyday’ understanding of time,
Deleuze’s account suggests that the past is not ‘gone
for good’ or ‘no more’, but always coexists with each
and every living present – strictly speaking, and as
will be discussed in more detail below, Deleuze
(2001) suggests that the past ‘does not exist, but it
insists, it consists, it is’ (p. 82). Similarly, his account
suggests that the future must not be thought of as
distinct from the present; rather, each and every liv-
ing present, in so far as it is always characterized by
expectation, is already ‘outside of itself’, as it were,
and therefore ‘extended’ or ‘projected’ into the
future (Boundas, 1997, p. 93).
In attempting to understand how the present is
distinguished from the past and the future while the
166 Marc Roberts
past and the future are not sharply distinct from the
present, but form a continuity with it, Deleuze (2001)
suggests that ‘instead of something distinguished
from something else, imagine something which distin-
guishes itself – and yet that from which it distin-
guishes itself does not distinguish itself from it’ (p.
28). Memorably, he attempts to encapsulate the man-
ner in which the present is distinguished from, and
yet maintains a continuity with, the past and the
future by employing the image of a streak of lightning
across the night sky: ‘Lightning, for example, distin-
guishes itself from the black sky but must also trail it
behind, as though it were distinguishing itself from
that which does not distinguish itself from it’
(Deleuze, 2001, p. 28). Importantly, when we employ
Deleuze’s account of the passive synthesis of time to
achieve an understanding of human life, his work sug-
gests that we never exist within some isolated present
moment that is sharply distinct from the past and the
future. Rather, his account suggests that each and
every one of our present moments always occurs, as
it were, ‘against a background’ of past and future
‘horizons’, ‘background temporal horizons’ that we
may, in this present moment, remain largely unaware
of. Thus, in order to account for the ‘flow of time’, for
the human experience of time as a continuity rather
than as a ‘discrete multiplicity’ or as a discontinuous,
‘punctuated’ series of ‘units’ or ‘nows’, Deleuze sug-
gests that the past is passively synthesized into, and
therefore contemporaneous with, the living present,
which ensures that the living present, in the form of
expectation, is already ‘outside of itself’, and thereby
‘extended’ into the future.
Moreover, it is important to note that it is not sim-
ply some past events that are passively synthesized
into the living present; rather, the whole of the past
is said to be contemporaneous with each and every
present moment. That is, the totality of past events –
what Deleuze (2001) refers to variously as ‘the pure
past’ and ‘the past in general’ (p. 80) – including
those that have ‘sunk without a trace’, always pas-
sively coexist with the living present (Williams, 2003,
p. 94). For example, while all of our past experiences
of hearing a ‘tock’ follow a ‘tick’ are always passively
synthesized into and therefore contemporaneous
with the present, that particular synthesis only
‘comes into play’, as it were, and creates the future
expectation of a ‘tock’, when a ‘tick’ is experienced in
the living present. To support the suggestion that the
whole of the past is contemporaneous with the
present, Deleuze (2001) highlights our ability, in
the present, to actively ‘pick out’ or remember par-
ticular events from the past (p. 80). That is, in order
to ‘pick out’ a particular event from the past and
represent it to ourselves and others in the present
moment, then the whole of the past must be contem-
poraneous with the present; if the past did not pas-
sively coexist with the present, if the past was sharply
distinct or independent from the present, then there
would be no way for us to ‘move beyond’ the present
in order to ‘pick out’ a particular event from the past.
Thus, Deleuze (2001) suggests that: ‘The past is not
the former present itself but the element in which we
focus upon the latter . . . The past in general [the
whole of the past] is the element in which each
former present is focused upon in particular and as a
particular’ (p. 80).
Importantly for Deleuze, it is the passive synthesis
of all past events in the present, and therefore the
passive coexistence of the whole of the past with the
living present, which ensures that for a human being
‘a single life is played out’. That is, it is the passive
synthesis of time that ensures that ‘however strong
the incoherence or possible opposition between suc-
cessive presents, we have the impression that each of
them plays out the same life’ (Deleuze, 2001, p. 83).
Thus, even though a human being may have experi-
enced an innumerable number of heterogeneous
moments, had an innumerable number of different
thoughts and feelings, carried out a variety of ‘roles’,
and quite literally been different ‘selves’ (Deleuze,
2001, p. 78), it is the passive synthesis of all those into
the living present that ensures that a single life is
being ‘played out’. This passive synthesis ensures that
all of the past moments of a human being’s life are
‘carried into’ and ‘along with’ each and every one of
their living presents, as well as creating the expecta-
tion that each and every future moment, no matter
how different, will also be ‘carried into’ and ‘along
with’ each and every living present, thereby creating
the sense that a single life is being, and will continue
to be, ‘played out’.
© Blackwell Publishing Ltd 2005 Nursing Philosophy, 6, pp. 161–173

The virtual, the actual, and
living significance
For Deleuze (2001), reality possesses two ‘sides’ or
‘aspects’, aspects that he refers to as the ‘virtual’ and
the ‘actual’ (pp. 208–209). The actual can be taken to
mean those actual ‘entities’ or objects that we encoun-
ter every day in the living present, such as actual
books, cars, buildings; actual people, situations, or set-
tings; actual sights, sounds, smells, tastes, and the
actual touch of things. The virtual, however, should
not be understood in accordance with the phrase ‘vir-
tual reality’, where this is taken to mean ‘not real’; as
Deleuze (2001) stresses: ‘The virtual is opposed not
to the real but to the actual. The virtual is fully real
in so far as it is virtual’ (p. 208). Understood as ‘fully
real’ but not existing in the mode of an ‘actual entity’,
the virtual can be taken to refer to the ‘past in general’
or the ‘whole of the past’, a past that is contempora-
neous with every present moment of a human being’s
life. Moreover, in so far as the whole of the past
coexists ‘virtually’ with every present moment of a
human being’s life, then this ‘virtual past’ is also con-
temporaneous with every actual entity that is experi-
enced in the living present. Thus, the actual entities
that we encounter every day are not experienced in
an atemporal manner, ‘uninformed’ by the past, but
are experienced ‘against the background’, as it were,
of a past ‘horizon’. As such, it is the virtual coexistence
of the past with the actual that not only ensures that
everyday actual entities possess a living significance
for us, but that life is uniquely different and significant
for each human being (Williams, 2003, p. 8).
For example, we recognize a book or a chair in the
present precisely as a book or a chair in so far as our
past encounters with such objects are passively syn-
thesized into, and therefore coexist virtually with,
our living present, providing us with the ‘fore-
conceptions’ or pre-conceptions by which we are able
to recognize something as something (Gadamer,
2004, p. 269). More than this, however, an actual book
can have a unique living significance for us in so far
as our own individual past coexists virtually with
every moment of our lives, ensuring that actual
objects are ‘informed’ by, or occur against the ‘hori-
zon’ of, our own unique past. Thus, when we encoun-
© Blackwell Publishing Ltd 2005 Nursing Philosophy, 6, pp. 161–173
Time, Human Being and Mental Health Care 167
ter a book in the living present, not only do we
recognize it as a book, but that actual object may
evoke memories from the past that give the object a
unique significance for us in this living present; for
example, it may be the book that we enjoyed as a
child, or it may be the book that we were given by a
‘significant other’, or it may be the book that we
started to read on holiday last year, but never found
the time to finish. Alternatively, we may be more
familiar with the experience of encountering, by
chance, the actual smell of a certain perfume that
evokes or ‘actualises’, in this living present, a unique
set of past thoughts and feelings about particular peo-
ple or places. Moreover, in so far as Deleuze’s
account of time suggests that expectations about the
future are ‘informed’ by the synthesis of the past in
the present, then the virtual coexistence of the past
with every present also creates future expectations
about actual ‘entities’. Our own unique past experi-
ences of a specific person, for example, not only
‘inform’ how they are encountered by us in the
present, but also ‘inform’ our future expectations
about them. On the basis of our past we may expect
a person to continue to be unreliable and deceptive,
a person to distrust or to fear; alternatively, we may
expect a person to continue to be reliable and trust-
worthy, a valuable friend and confidant.
In so far as each human being possesses their own
unique past, a past that coexists virtually with every
present moment of their lives, then not every actual
‘entity’ will have the same significance for each per-
son. However, while each person will have his or her
own unique past, these pasts must not be understood
in terms of a discrete multiplicity, as a collection of
separate and distinct pasts. Recalling Deleuze’s
(2001, p. 28) account of the continuity of time and his
image of lightning striking across the black sky, each
person’s past can be distinguished from every other,
but those pasts should not be thought of as sharply
distinct from each other. Rather, pasts are said to exist
in a state of ‘perplication’, a ‘plexus’ of ‘interwoven’
or ‘enfolded’ pasts, pasts that exist ‘under glimmer-
ings which never have the uniformity of a natural
light . . . [and where] . . . obscurities and zones of
shadow correspond to their distinction’ (Deleuze,
2001, p. 187). Importantly, Deleuze’s (2001) work sug-
168 Marc Roberts
gests that individuals’ pasts are not only ‘enfolded’
within each other, but also ‘enfolded’ within the
whole of the past itself, forming a ‘gigantic memory’
or ‘mnemonic virtual’ (p. 212), a vast ‘continuous’
past that coexists virtually with every present
moment of an individual’s life. So, for example, when
we encounter an actual crucifix in the living present
and recognize its significance, Deleuze’s work sug-
gests that it is because the past coexists virtually with
the present; however, this is not simply our own
unique individual past, a past sharply distinct from
any other, but a past that is ‘perplicated’ or ‘enfolded’
within, and therefore ‘informed’ by, Christianity’s
past (Deleuze, 2001, p. 83). Moreover, Deleuze’s
work suggests that even if an individual does not
recognize the actual object encountered in the living
present as a crucifix, this does not mean that Chris-
tianity’s past does not coexist with that individual’s
present. Rather, that past continues to exist but exists
virtually, an unknown ‘horizon’ that will ‘invest’ the
actual object with significance for the individual once
that individual learns of that past or, to use Deleuze’s
(2001) terminology, once that past is ‘actualised’ (pp.
206–207).
Thus, in suggesting that reality possesses both a
virtual and an actual side, Deleuze (2001) is not sug-
gesting that reality is composed of two sharply dis-
tinct ‘parts’ or ‘realms’ (p. 209). Rather, the structure
of reality is said to be a ‘two-sided one’, ‘composed’
of the virtual past and actual everyday ‘entities’ in
which it never fully makes sense to speak of an actual
‘entity’ ‘divorced’ from a past, a past that coexists
with that entity (Williams, 2003, p. 8). It is in this
context that we can understand Deleuze’s (2001)
important and yet apparently paradoxical description
of his philosophical project as a ‘transcendental
empiricism’ or a ‘superior empiricism’ (p. 56). The
virtual past, in so far as it is virtual, is not actual but
‘transcends’ everyday actual entities; however, while
the virtual past ‘transcends’ actual entities, it does not
exist in some ‘transcendental realm’, but is ‘imma-
nent’ to the actual, fully real but not existing in the
mode of an actual entity (Boundas, 1997, p. 87; De
Beistegui, 2004, p. 278). Therefore, in exploring the
virtual past that ‘transcends’, but is ‘immanent’ to,
every actual entity, entities that are empirically given,
Deleuze’s work can be understood as a ‘superior
empiricism’ or a ‘transcendental empiricism’, an
enterprise that discloses that which ‘transcends’
empirically given actual entities, but remains ‘imma-
nent’ to them, namely, the virtual past.
The virtual past, metastability, and
continuous multiplicities
A ‘continuous multiplicity’, one of Deleuze’s most
important concepts, stands opposed to a discrete mul-
tiplicity. As discussed previously, the latter refers to a
collection of distinct parts or units, and is character-
ized by a ‘difference in degree’ (Deleuze, 2002a, p.
38); it is a numerical multiplicity in so far as its distinct
parts can, in theory at least, be separated, counted,
quantified, and therefore reduced to numbers. In con-
trast, a ‘continuous multiplicity’ is said to be a ‘collec-
tion’ or a ‘multiplicity’ that cannot be reduced to
numbers (Deleuze, 2002a, p. 38); it is a ‘qualitative
multiplicity’, characterized by: ‘Degrees of difference
itself, and not differences of degree’ (Deleuze, 2004b,
p. 43), whose ‘parts’ are not ‘distinct’ or ‘discrete’ but
‘fuse’ into or are ‘continuous’ with one another. In
elucidating the concept of a ‘continuous multiplicity’,
Deleuze (2004b) provides the example of ‘pure white
light’, where all the colours of the spectrum are ‘con-
tained within’ ‘pure white light’ but they do not exist
separately, juxtaposed in the manner of a ‘discrete
multiplicity’ (p. 43). Of course, it is always possible to
pass ‘pure white light’ through a prism, ‘separating’ it
into the spectrum and then counting the colours, but
‘pure white light’ itself can be seen to be a ‘continuous
multiplicity’ whose colours are ‘perplicated’,
‘enfolded’ or ‘continuous’ with one another (Smith,
1997, p. 36). As Deleuze (2002a) suggests, within a
continuous multiplicity, and hence ‘pure white light’:
‘There is other without there being several; numbers
exist only potentially’ (p. 42).
Thus, in suggesting that individuals’ pasts are not
only ‘perplicated’ or ‘enfolded’ within each other, but
also ‘enfolded’ within the whole of the past itself,
forming a ‘gigantic memory’ (Deleuze, 2001, p. 212),
Deleuze can be seen to be providing a characteriza-
tion of the virtual past as an immense continuous
multiplicity.
© Blackwell Publishing Ltd 2005 Nursing Philosophy, 6, pp. 161–173

Moreover, Deleuze’s work suggests that the ‘singu-
lar moments’ and ‘events’ that make up an individ-
ual’s past must also be understood as a continuous
multiplicity that is ‘embedded’ within that larger mul-
tiplicity, the whole of the past or ‘gigantic memory’.
That is, the ‘singular moments’ and ‘events’ that com-
pose an individual’s unique past, and that coexist vir-
tually with each and every moment of that person’s
living present, do not exist as separate parts, juxta-
posed in strict temporal succession. Rather, they can
be understood as ‘perplicated into’ or ‘continuous
with’ one another, in which there are ‘non-localisable
connections, actions at a distance, systems of replay,
resonance and echoes . . . which transcend spatial
locations and temporal successions’ (Deleuze, 2001,
p. 83). For example, within an individual’s past, events
that happened many years ago may ‘connect with and
act upon’ present moments, and events that occur in
the present may ‘resonate with and echo’ moments
that happened many years ago. Thus, Deleuze’s
(2001) work suggest that an individual’s past, a past
that coexists virtually with each and every moment of
their lives, and is ‘enfolded’ within the pasts of others
as well as the whole of the past itself, is composed of
‘singular moments’ and ‘events’ that are ‘distributed
nomadically’ (Deleuze, 2001, pp. 36–37), ‘fusing’ into
one another in a manner that ‘transcends’ spatial
location and temporal succession, and can therefore
be understood as forming a ‘continuous multiplicity’.
For Deleuze (2002a), one of the most important
characteristics of a continuous multiplicity, and there-
fore of an individual’s virtual past, is that ‘it does not
divide up without changing in kind, it changes in kind
in the process of dividing up’ (p. 42). For example, a
person who is currently experiencing difficulties in
managing anger may attribute its emergence to
recent events, thinking that prior to those events it
was not a problem. Following a period of psychother-
apy, however, a person may begin to consider that
their current problems with anger can be attributed
to earlier events, possibly even events in their child-
hood. By reconsidering which events are significant
and which are not, by ‘dividing’ the past up differ-
ently, that individual’s past changes; the ‘root of the
problem’, as it were, has been relocated and the indi-
vidual may now attribute past problems to anger
© Blackwell Publishing Ltd 2005 Nursing Philosophy, 6, pp. 161–173
Time, Human Being and Mental Health Care 169
where they did not do so previously. Importantly, this
example reveals that the ‘singular moments’ and
‘events’ that make up an individual’s past are not
static; rather, ‘singularities–events correspond to het-
erogeneous series, which are organized into a system
which is neither stable nor unstable, but rather meta-
stable (Deleuze, 2003b, p. 103). Although this is a part
of Deleuze’s work that Wheen (2004) refers to as
‘gibberish’ (pp. 87–88), it can be understood as an
appropriate description of the manner in which an
individual’s past exists: neither ‘stable’ or ‘unstable’
but ‘metastable’, a term taken from physics to desig-
nate ‘a system’ that is ‘stable provided it is subjected
to no more than small disturbances’ (Pearsall, 1998,
p. 1163).
Consider, for example, that an individual discovers
the infidelity of a marriage partner. Prior to the dis-
covery, the individual may have understood their past
in a relatively ‘stable’ way, and possessed expecta-
tions of the future on the basis of the relative stability
of that past. The discovery of the infidelity, however,
may be experienced as a ‘large disturbance’, as a dis-
turbance that ‘challenges’ the relative stability of the
individual’s past and the expectations of the future
that are made upon it. The past, a past that coexists
virtually with the present, may now become ‘unsta-
ble’; the individual did not ‘possess’ the marriage that
they thought they did, and only once they have
‘reconfigured’ their past in the light of the revelation
will that past ‘return’ to a state of ‘relative stability’
or ‘metastability’. Importantly, this example not only
reveals the manner in which the virtual pasts of ‘indi-
viduals’ are ‘perplicated’ or ‘enfolded’ within each
other, but it also reveals the structure of a person’s
life as a dynamic relation between the virtual and the
actual (Williams, 2003, p. 8). As discussed above, the
virtual past not only acts upon actual entities, ‘invest-
ing’ those actual entities with a living significance, but
the actual entities can act upon and change the virtual
past, forming, as it were, a complex system of ‘feed-
back loops’ in which the significance of actual entities
is always liable to change (Cilliers, 2002, pp. 3–5). In
our example, following the discovery of the actual
event of infidelity, the individual’s virtual past is
‘reconfigured’, achieving a different state of ‘relative
stability’ or ‘metastability’; this reconfigured past now
170 Marc Roberts
‘invests’ actual entities and objects with a different
significance (e.g. wedding rings or anniversaries) and
changes the expectations of the future that are made
upon that reconfigured, virtual past (e.g. ‘I’ll never
marry again’).
The implications for contemporary
mental health care
Deleuze’s work would seem to have important and
far-reaching implications for contemporary mental
health care and beyond. Although it cannot be dis-
cussed here, his work not only appears to be signifi-
cant for contemporary understandings of how a
discipline’s ‘theoretical framework’ or ‘paradigm’
becomes ‘unstable’ and achieves a subsequent state
of ‘metastability’ (e.g. Kuhn, 1996; Chalmers, 1999),
but it also seems to resonate with the emerging inter-
est in ‘complex systems’ and ‘complexity theory’
throughout the social sciences and humanities (e.g.
Byrne, 1998; Cillers, 2002), as well as appearing to be
informative for contemporary health care’s recent
interest in virtue ethics and communitarianism (e.g.
MacIntyre, 1997; McKie & Swinton, 2000; Roberts,
2004). In so far as it provides a critique of ‘discrete
multiplicities’, however, Deleuze’s work can, in par-
ticular, sensitize us to the presence of that type of
analysis within modernity as well as the consequences
of that analysis for the mental health of ‘modern’
human beings. For example, it has been suggested
that modernity, in being characterized by a ‘liberal
individualism’ that understands human beings as
sharply distinct from each other and sharply distinct
from the past (Taylor, 1992, p. 40; MacIntyre, 1997, p.
222), may be responsible for the ‘existential vacuum’
that Victor Frankl (2004), the originator of ‘logother-
apy’, suggested was characteristic of the 20th century
(p. 111). That is, by separating each human being from
every other and separating each human being from
the past, modernity is said to have removed the ‘hori-
zons’ against which one can make one’s life meaning-
ful (Taylor, 1992, p. 40). The attempt to find meaning
in one’s life, to understand the overarching purpose
or telos of one’s existence, then becomes ‘frustrated’
and it is precisely this ‘existential frustration’ that is
said to result in widespread mental health problems,
including aggression, addiction, depression, and sui-
cide (Frankl, 2004, p. 112).
Rather than attempting to counter this type of
analysis, however, it has been suggested that ‘modern’
psychiatry, psychotherapy, and mental health nursing
have sought to understand human beings and their
‘mental distress’ precisely in terms of discrete multi-
plicities, separating them into a variety of ‘parts’, such
as ‘self’ and ‘other’, ‘self’ and ‘world’, ‘mind’ and
‘body’, and the ‘ego’, the ‘superego’ and the ‘id’
(Laing, 1990, p. 19). However, in so far as human
being and the nature of human being within the world
is said to be more than a composite of such parts, such
an analysis is said to be, at best, an inappropriate
abstraction and at worst, a damaging distortion
(MacIntyre, 1997, pp. 204–205). Indeed, Laing (1990)
has suggested that the attempt to understand and to
treat schizophrenia with the ‘verbal and conceptual
splitting’ that characterizes the analysis of modernity,
serves only to potentiate the ‘fragmentation’ of
the ‘schizophrenic’s’ already ‘fragmented’ sense of
‘being-in-the-world’ (p. 20).
Against this type of analysis, and with its emphasis
on the continuity and dynamic ‘evolution’ of a
human life, Deleuze’s work can be seen to bear sim-
ilarities with the so-called ‘narrative’ conception of
selfhood (e.g. MacIntyre, 1997, p. 218), and the
emerging interest in ‘narrative’ as a psychotherapeu-
tic approach (e.g. White & Epston, 1990). While the
details of this approach cannot be discussed here, it
suggests that human beings ‘story’ their existence,
wherein they attempt to integrate the ‘singular
moments’ and ‘events’ of their life into an overarch-
ing, coherent ‘story’ or ‘narrative’ (Burr & Butt,
2000, pp. 200–201). After the manner of Deleuze’s
passive synthesis of time, human beings are said to
possess, in each present moment, expectations of the
future and future goals, which are informed by and
made on the basis of the past (MacIntyre, 1997, p.
220); it is this continual synthesis of past, present,
and future that enables us to attempt to integrate the
moments and events of our lives into an overarching,
coherent ‘story’ (Deleuze, 2001, p. 83). Moreover, in
accordance with Deleuze’s description of the
dynamic interaction between the virtual past and
actual entities, and therefore the ‘metastability’ of
© Blackwell Publishing Ltd 2005 Nursing Philosophy, 6, pp. 161–173

the past, narrative approaches recognize that a per-
son’s past, rather than being fixed, can always be
‘reconstructed’ or ‘re-authored’ following actual
events in the present. As Burr & Butt (2000) suggest,
one’s past is ‘an inseparable mixture of construction
and event’, and the events of the past are ‘not like
mushrooms, waiting to be collected . . . [but] . . . are
picked out within shifting narrative searchlights’ (p.
201). As such, reflection upon one’s past is said not
to be a ‘simple matter of accuracy, but one of con-
structing afresh in the present’ (Burr & Butt, 2000, p.
201).
In suggesting that an individual’s past is not only
‘perplicated’ within the pasts of others, but also
‘enfolded’ within the whole of the past itself, forming
a ‘gigantic memory’ (Deleuze, 2001, p. 212),
Deleuze’s work can also be seen to resonate with
contemporary mental health care’s emerging interest
in ‘social constructionism’ (e.g. Fee, 2000). While
‘social constructionism’ is a general term for a multi-
farious movement within the social sciences and
humanities, it can be broadly taken to maintain that
a human being’s personal identity is ‘socially con-
structed’, ‘a product of the history of the culture, the
position of the person in society and the linguistic
resources available to the individual’ (McLeod, 2003,
p. 234). As such, what or who I am is said to be ‘in
key part what I inherit’ (MacIntyre, 1997, p. 221); it
is in this context that we can understand Gadamer’s
(2004) assertion that ‘history does not belong to us;
we belong to it’ (p. 278) and Deleuze’s (2001) sugges-
tion that ‘one is only what one has’ (p. 79). However,
while what one inherits at the familial, social, and
historical level may be beneficial, providing us with a
largely ‘positive personal identity’ that gives our lives
meaning and direction (MacIntyre, 1997, pp. 221–
222), what we inherit may provide us with a largely
‘negative personal identity’ that results in intraper-
sonal and/or interpersonal conflict which may
develop into ‘mental health problems’. For example,
it has been suggested that what ‘modern’ women
inherit in terms of body image, dieting and attitudes
to food is such a powerful, pervasive and continual
‘pressure’ that it can result in the development of
eating disorders, such as anorexia and bulimia ner-
vosa (McLeod, 2003, pp. 238–239).
© Blackwell Publishing Ltd 2005 Nursing Philosophy, 6, pp. 161–173
Time, Human Being and Mental Health Care 171
It is surrounding these issues that Deleuze’s work
can be seen to ‘resonate’ with the work of the French
philosopher Michel Foucault. Among other things,
Foucault’s work is concerned with the manner in
which a human being’s personal identity is ‘con-
structed’ and maintained by ‘historical–social–
political forces’. In particular, he suggested that the
primary objective of his work had been to provide a
history of the different ways in which ‘human beings
are made subjects’ (Foucault, 1982, p. 208); ‘made
subject’ to others by ‘control and dependence’ (Fou-
cault, 1982, p. 212) and ‘made subjects’ in the sense
that their ‘subjective identity’ is ‘constructed’ through
a ‘conscience or self-knowledge’ (Foucault, 1982, p.
212). Rather than helping clients ‘work against’ what
they inherit, and therefore what may have contrib-
uted to the formation of ‘negative personal identities’,
it has been suggested that contemporary mental
health care, characterized by the language of ‘illness’
and ‘passivity’ (Burr & Butt, 2000, p. 200), can itself
replace a client’s identity with one that stresses
‘dependence’ and ‘illness’, and which is then used to
legitimize explicit, as well as the more refined forms
of psychiatric power and control (e.g. Kay, 1999; Rob-
erts, 2005).
In contrast, Deleuze’s (2001) challenge to contem-
porary mental health care is to engage in a procedure
that he refers to as ‘vice-diction’ (pp. 189–190), a prac-
tice that amounts to enabling a client to carry out an
‘historical ontology’ of themselves (Foucault, 1991, p.
46). That is, vice-diction can be understood as that
procedure by which we enable a client to ‘work upon’
their past to reveal what they have inherited, to reveal
what has contributed to the ‘construction’ of a largely
‘negative personal identity’ that results in intraper-
sonal and/or interpersonal conflict. In doing so, how-
ever, it does not seek to ‘liberate’ an individual’s ‘real
personal identity’, ‘authentic being’ or ‘essential self’;
for Deleuze (2001), there is no such ‘real identity’,
‘authentic being’ or ‘essential self’ (p. 78). Rather, in
identifying what ‘historical forces’ have ‘constructed’
a client’s ‘personal identity’, vice-diction aims to call
into question, to ‘deconstruct’ the validity and worth
of those historical forces, and to enable a client to
‘reconstruct’ and ‘adopt’ a more ‘productive’ and
‘positive’ personal identity, a personal identity ‘con-
172 Marc Roberts
structed’ on the basis of a language that stresses ‘inde-
pendence’, ‘health’, and ‘empowerment’, rather than
a language permeated with the concepts of ‘depen-
dence’, ‘illness’, and ‘passivity’.
Conclusion
Although Gilles Deleuze is emerging as one of the
most important and influential philosophers of the
20th century, the ‘experimental’ nature of certain
works, combined with the manner in which he draws
upon a variety of sources from various disciplines, can
make his work seem difficult, obscure, and even ‘will-
fully obstructive’. Against such impressions, this
paper has sought to provide an accessible introduc-
tion to his work, and to begin to discuss how it can
be employed to provide a significant critique and
reconceptualization of the theoretical foundations
and therapeutic practices of contemporary mental
health care. In particular, it has attempted to show
how his innovative and challenging account of time
can be employed to provide a conception of human
life as a ‘continuity’, rather than as a series of distinct
‘moments’ or ‘events’. Moreover, as well as discussing
the manner in which his work can provide us with an
understanding of how life is different and significant
for each human being, this paper has also sought to
highlight the potential importance of Deleuze’s work
for logotherapy, for the recent ‘turn’ to ‘narrative’ as
a psychotherapeutic approach and for contemporary
mental health care’s growing interest in ‘social con-
structionism’. However, possibly due to its depth,
breadth, style, complexity, and level of abstraction,
Deleuze’s work in particular seems to lend itself to a
diversity of ‘readings’ and applications. Therefore, in
providing its own ‘reading’ of his work, this paper has
sought to stimulate further ‘readings’, research, and
discussion of how Gilles Deleuze’s work can inform,
challenge, and possibly even change the theory and
practice of psychiatry, psychotherapy, and mental
health nursing.
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