On a recent Saturday afternoon, the British psychoanalyst and writer Adam Phillips delivered a talk at the Brooklyn Academy of Music titled “Acting Madness.” The event was being held in conjunction with BAM’s spring season, which features three plays about madness: David Holman’s adaptation of Gogol’s “Diary of a Madman”; Macbeth; and King Lear. In a row with plenty of other seats, a young man with a wispy beard and glasses took the place directly next to mine. He was wearing, I noticed at once, a Paris Review T-shirt. My mind leaped as though a starter pistol had been fired. It was all so obvious: The Paris Review had sent this person to check up on me.

In his essay “First Hates,” from On Kissing, Tickling and Being Bored, Phillips usefully glosses paranoia as the refusal to be left out. That is, much worse than the fear that everyone is talking about you is the fear that no one is talking about you. As the gentleman in question and I waited in silence, I performed a little Phillips-inspired self-analysis. Either The Paris Review had sent this man here to stalk me, and he was announcing his intentions with his T-shirt, or he was a Phillips enthusiast and also a reader of The Paris Review—even my paranoiac fantasy had to concede this as a likely demographic crossover. Embarrassed, I meditated, very briefly, on my own unimportance. The Paris Review would survive with or without my post. This unimportance was a fact I was going to have to live with, because living without it—believing that this man had donned an official T-shirt in order to more conspicuously surveil my blogging—was crazy.

Crazy, not mad, is the preferred casual diagnosis of the thirty-five-and-under set. Mad has literary connotations, highbrow aspirations. It’s the teensiest bit fussy. Lear and Macbeth and Poprischin are mad, just like old King George and Ludwig; madwomen populate the attics of Victorian fiction. Mad is for special cases, but crazy is how today’s people draw attention to almost any experience that is somehow charged. It means that someone has gotten your attention; he or she has become a kind of event in your life. What is memorable becomes admirable; in a distracting world of attractions, crazy stands out. It makes for a good story.

The mad person, Phillips’s talk made clear, is trying to become a good story, trying to stand out. Madness craves attention—but it isolates the sufferer. His subjects ranged from Gore Vidal’s aperçu about Reagan as the “acting president” to Lionel Trilling’s critique of the antipsychiatry movement, but the thread throughout was how the performances of mad people, on and offstage, are attended to, or not. (Our families, he reminded us, are the first audiences for our performances, and their responses are formative. Unsurprisingly, he himself has the air of a firm but patient parent.) Madness, he said, is when you can’t find anyone who can stand you. A mad person is wearying and repetitive: “being mad means always being about to lose [someone’s attention] or living as though it has been lost and can never be recovered.” A mad character must therefore find a way to be both off-putting and compelling, irritating and engrossing.

Take “Diary of a Madman,” which ends this week. In his attic chamber, Poprischin (Geoffrey Rush), a low-ranking clerk who fancies himself a gentleman, goes from imagining he can speak the language of dog to believing himself to be the King of Spain. Lighting, design, music, props and costumes, the script—all enhance his frightening, electrifying performance; they not only intensify the mood, but aestheticize the presentation, making it possible to bear. Rush’s charismatic floppiness—his arms are like those air dancers advertising deals at gas stations—is broadened by the musicians who score his moods, the angular set, his incorrectly buttoned coats. (What is it about Gogol and coats?) He plays Poprischin as a carrot-topped, louche entertainer, tossing off one-liners directly to the audience, even touching those in the front row. As he becomes madder and madder, the intermittent blackouts that separate the episodes come harder and faster, allowing Rush to pose and pop up in new positions; it’s comedy and camp to begin with, but eventually takes on something of a horror show. I half expected to find him under my seat.

Madness is embodied, physical—we know that something is terribly wrong with that deranged person on the subway because something is off about how they hold their heads, how they stand, how they shuffle. Literature may attempt to convey this literal lack of balance with long exhausting monologues or fragmented time signatures; movies showcase the stuttering or herky-jerky performances with close-ups and hysterics; but with theater, it’s simply us, the actor, and the stage. As Phillips said in response to a question about cinematic madness, “acting mad” onstage comes down to the fact of being in the physical presence of the actor, the person pretending to be mad—willingly tolerating that presence, when the usual move is to get as far away from the lunatic as you possibly can.

This is a simple point, but it’s also a fundamental one, and it gets at something fundamental about theater. Phillips stressed that there is something mad about theatricality itself insofar as actors play pretend, but I would go farther: mad people and theater are both difficult to put up with, better in small doses. There’s something a little unhinged—a little needy and attention-seeking and uncomfortable and annoying, a tad embarrassing and a lot self-involved—about live theater. It’s very uncomfortable to see actors “act”; it’s only when you forget they have your attention that you enjoy giving it to them. Putting a mad person onstage tackles the issue head-on.

Still, these days I’m finding the art of suffering harder and harder to enjoy. I’ve lost my taste for yakuza; I closed my eyes during most of Nicholas Refn’s Viking gross-out Valhalla Rising; I pushed my way out of the Marina Abramovic retrospective. This thought recurs: I don’t want to be in a place where things like this are happening. It’s only acting, I told myself, as Geoffrey Rush screamed onstage. But it didn’t help. The object-relations theorist D. W. Winnicott, Phillips said, knew that to understand a person, we must understand the environment she creates around herself. To understand Poprischin, by extension, is to understand what kind of audience he creates for himself, or drives away. To understand one’s own reaction to the madman is thus to come closer to knowing what he wants. Our symptoms are solutions to problems we haven’t identified yet. “The more disturbing something is,” Phillips sensibly pointed out, “the more ingenious are the defenses we will call up to protect ourselves from it.”

But it was the insignificance of this post, the unimportance of it, that disturbed me in the first place, wasn’t it? Before the talk began, I turned to the man in the brown Paris Review shirt and asked him why he was there. It turned out that he was a recent Adam Phillips convert, having discovered him three weeks earlier. The only interest he took in me for the next hour was to borrow my pen to jot down a few words during the talk. I snuck a peek at his paper, but I couldn’t make out what was written there. I would have had better luck talking to a dog.

Christine Smallwood, an English graduate student at Columbia, has written for The Nation, the London Review of Books, and Harper’s Magazine.