Our thinking about madness is highly dependent on context. In a schizophrenic relative we think of it as a treatable disease, in a bum on the street perhaps a threat, in an artist it seems a risky by-product of his creativity or even a necessary condition for great achievements. Wouter Kusters wonders how we can understand this diversity of views.
When it comes to madness and psychiatry, we live in a time full of contradictions. There is a romantic haze of genius about the madness, but at the same time everything that hints at psychiatry is feared and shunned. Everyone knows that photo of Albert Einstein with his tongue sticking out. Knowing that this is a famous and respectable physicist, we see the strange facial expression as befitting a scientist of genius.
Creativity and madness
Behavior that we often judge as problematic, psychologically disturbed or even 'sick', we find acceptable and perhaps even desirable for people with 'creative professions'. This also applies to famous philosophers. Wittgenstein's peculiar outbursts to his pupils and friends and his erratic conversation are benevolently written as belonging to his wisdom.
We even expect a certain degree of madness from artists. ADHD-like hyperactivity, obsessive fixation at work and manic-depressive mood swings seem to be typical of the artist's life. An artist who is completely normal on the inside, raises the suspicion that his artworks will not be that 'deep' either – rightly so, studies show time and again that there is a relationship between creativity and madness (see for example the work of Kay Redfield Jamison).
In our time, this admiration for the ingenious-madness is accompanied by massive suppression of everything that has to do with insanity. Today, from a very early age, observations and assessments are performed to diagnose mental disorders – with the criteria for what constitutes a disorder broadening every year. At primary school age, the ADHDers and autistic children are fished out of the population, followed a little later by the bipolar adolescents and still later the psychosis-prone young adults.
There are more models of normality circulating in psychology and the media than ever. Medicines that pretend to correct our minds are now among the most sold pharmaceuticals. In addition, we still admire the extreme, maladaptive sides of the mind immensely. We can only understand this diversity of views if we look at how it has evolved over time.
In the positive view of madness, it is a source of inspiration from which you can learn something about your own deepest motivations, essential patterns in the cosmos or even knowledge beyond life and death. Insanity is then related to dreams and other states of consciousness. Among the shamans, who appear in many ancient cultures in Northern Asia, we see for the first time such a positive appreciation for other kinds of consciousness. Shamans put themselves into a trance and thus made contact with a world of benign and evil demons to avert evil influences on ordinary life.
Shamanic practices and the associated worldview have had a strong influence on how people in trance were viewed later in Western history. To this day, studies appear that argue that people with severe psychosis are actually a kind of shamans, lost in time.
The Greeks also liked to contact another world for support in adversity. Well known is the oracle of Delphi that spoke in gibberish, nowadays associated with psychosis, but then regarded as messages from the beyond that were valuable if properly interpreted.
Among the Greeks, on the other hand, we also find the first theories about madness as a threat to orderly, harmonious life. Medics in the Hippocratic tradition rejected the idea that madness had to do with the world of the gods. They believed that madness – and disease in general – disrupted the balance of the four body fluids:blood, mucus, yellow and black bile. Too much black bile led to biliousness or melancholy, while too much blood was linked to mania. It was here that the foundations were laid for what two millennia later would be called a 'bi-polar disorder', a sickly mood swing.
Middle Ages:The Jester
Another precursor of today's madness is clearly visible in the Middle Ages, in the colorful variety of fools and jesters. These roamed freely; there were hardly any institutions where they were gathered. Sometimes they worked just like others, sometimes they ended up at the fair or in begging.
For some, a career as a jester was possible. In that role, they penetrated the homes of the clergy and the medieval courts and were seen at fools' parties and the upcoming carnival. They served for entertainment and sometimes also for teaching when they held up the proverbial mirror to people.
Folly was used to criticize an over-regulated society. For Erasmus in his Praise of Folly it was a necessary counterbalance to reason. Without folly there is no pleasure, no love, no passion and not even a religious ecstasy. To this day, madness in the form of ridicule and criticism of morals and customs is a source of inspiration for poets, artists and comedians.
Middle Ages:the witch
Not every madman was a comedian avant la lettre. From the end of the Middle Ages, Western societies changed radically:industry rose, religious disputes spread and the urban population increased sharply. A part of what used to be the (female) fools, mystics and fools, now got the negative label witch on itself. They would become involved in the devil and sorcery and were severely persecuted.
The newly emerging (medical) science jumped into the breach for them and appealed to reason and humanity to free these victims from ignorance and religious madness:witches were not possessed, but sick. Initially, this brought them down from the rain. The 'Great Burning' was over, but the time of the 'Great Incarceration' (Foucault) had arrived, often in brutal circumstances.
At the beginning of the nineteenth century, ideas about madness change radically. The medical profession entered the asylums and for the first time a category of psychiatric patients was distinguished. Under the guidance of neurologists, the triumphal march of the image of madness as an individual physical abnormality began from the asylums. The therapies initially consisted of rest, alternating baths, insulin therapy and even lobotomy and electroshocks to control that unwilling mind via the brain.
Over the past half century, the use of psychotropic drugs to suppress insanity has grown enormously, both inside and outside the institution. The fact that these drugs do have some effect – although rarely just the desired effect – has led to the idea that insanity is primarily a neurological problem. The image of madness in contemporary psychiatry has thus become particularly one-sided, but very popular.
However, people have also remained fascinated by the people who are in the asylums. Besides the fear of the strange and incomprehensible, we believe we can still find heavenly inspiration, ecstasy and creativity in madness.
We feel pity or disgust for the madman laughing to himself, but sometimes we suspect that he is grasping something that eludes us. Thus madness in all times remains admired as well as feared and reviled.