The first thing I notice upon entering Darian Leader’s front room is a large, chrome black couch. The second is the bookcase – filled, I assume, with names such as Lacan, Klein, Winnicott; all pioneering explorers of the psyche’s darkest corners. If you’re already thinking this sounds a bit forbidding, you might be forgiven. While platitudes of ‘pop psychology’ are becoming increasingly hard to escape, public references to psychoanalysis rarely extend beyond the odd scoff at the Oedipus complex. The image of the analyst ingrained within public consciousness is still that of the bearded academic; a glassily silent figure steeped in esoteric theories.

You might be relieved, on my behalf, to hear that Leader’s reality is very different: “analysts come from all sorts of backgrounds,” he assures me – “doctors, philosophers, social workers, hairdressers,” The variety extends to the personal level – “sometimes as an analyst I’m very talkative, sometimes very quiet. There are no rules except a constant aim: to treat the patient as the expert, generating material which will provide access to the unconscious.” When I ask which personal qualities are essential to the profession, his answer is strikingly brief: “suffering...and a curiosity about people. Just those two.”

Psychoanalytic training is, nevertheless, a necessarily complex and thorough procedure. As one part of the seven or eight year (minimum) process, trainees explore their motives with their own analyst, and Leader himself remains in analysis to this day: “if you want to continue grappling with problems in your own life, that’s what you do.” Indeed it was Leader’s desire to understand personal family events which first brought his attention to psychoanalytical ideas, eventually taking him to France to study Lacanian theory for nine years.

Critics of psychoanalysis have faulted its theoretical foundations for being unempirical but Leader remains unperturbed: “the conceptualisation aims to be scientific, but the practice is an art,” he insists. In fact he argues that this does not differ it from the NHS-sponsored, statistically-successful practice of CBT: “all the discourse about evidence-based treatment  comes from the pseudo-sciences, not the Natural Sciences,” he argues. Yet most of the mental health industry remains intent on claiming an empirical basis – “Biology and Chemistry don’t feel the need to prove that they are Sciences, so why do Neuroscientists put it in the name?” he asks provocatively. “What are they so worried about?”

These worries, Leader laments, have propagated a swathe of modern therapies which thrive on quantitative categories and unhelpful statistics, attempting to impose a normative solution on the psychotic. Their diagnostic categories constitute lists of external symptoms, perpetuating stigmatised notions of the mad as jabbering, howling, even violent. But “you can’t define madness by symptoms” argues Leader. “Anyone can have a hallucination – if you’re on certain drugs or excessively tired. The real criteria lies in how these experiences are made sense of by the person. Some will just dismiss a vision, but a psychotic person will take it very seriously. They will know it to be an extremely meaningful message sent directly to them.”

Crucial to Leader’s own methodology is the distinction between ‘primary’ and ‘secondary’ phenomena – “primary being the experience of psychic disintegration, and secondary the ways of finding solutions to this.” Delusions are located within the latter category, in which we find “the creative, positive side” of every psychosis. “A delusion is not a psychotic phenomena, but a response to one; a constructive attempt to give meaning to one’s experience. One of the sad things today is that the distinction has dissolved, so a lot of therapists mistakenly try to remove secondary phenomenon rather than respecting them.”

The real task of the psychoanalyst, as Leader describes it, is “not to get rid of the delusion, but to use it in order to create a new structure or system; to help the patient find an equilibrium using their own words, memories and histories.” The treatment offers profound hope for patients – that their own attempts at self-cure can be recognised and enabled, approached without any of the pathologising subtext underlying even many well-meaning therapies.

The process is often a long one, but Leader emphasises that it “isn’t something that can only happen in a quiet consulting room with a couch” Most important for us to remember is that “anyone can make a fruitful dialogue with the mad, if we recognise the distinction between primary and secondary phenomenon.” The role of delusions ought to be understandable to us all, for every human faces the hard task of finding meaning in existence. Where the non-psychotic create set routines and beliefs, the psychotic pursue systems with far greater zeal and seriousness. In this, perhaps, the mad are the most rational of us all.