The cultural construction of madness

THE CULTURAL CONSTRUCTION OF MADNESS

Beset by demons in a world of madness.

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First published in Academia.edu July 3rd 2014 as part of a larger work: ‘An Unusual Power: The rise and influence of medical doctors.’

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Abstract:

This short book examines changes in perception of mental illness from a phenomenon created by external supernatural forces to one produced by internal psychic and physical forces, gradually becoming from the 16th century the province of intellectuals and physicians.

It will also consider the effects of humanism on ideas of insanity, indicating a growing negativity amongst physicians towards the mentally ill, considered in relation to writers who perceived insanity as a way of highlighting the inadequacy of human society, as containing immense wisdom within its apparent confusion, and of dramatizing philosophical views. In this work, mental illness will be considered an urban construct with links to ideological and personality formation in earlier periods of human development, and in addition will be concerned with the essentiality of shared social reality. Accordingly, Michel Foucault’s ideas will be referenced. From the 16th century began the process of secularising the soul, along with a growing interest in human motivation and behaviour. This involved concerns on the nature and effects of folly, melancholy and madness, as belief in the extremes of religious devotion, superstition and magic declined. Margaret Pelling (1998: 29) has noted the Elizabethan obsession with mood and states of mind; of consideration only it seems if the sufferer was wealthy or useful for society, as elsewhere she notes that the distracted and mad were bodily ejected from Norwich and probably other cities too (page 96). This work will in addition look at how urbanisation, the expanding money economy and gentrification altered both the perception of madness and the way the mad were treated, changed the space they occupied, and later how definitions of madness were arrived at through professional competition and dramatic presentations of grief and guilt.

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Introduction: ‘In the early modern period, madness assumed an important role in European thought and to a certain extent replaced the obsession with death that had characterised the preceding centuries. If by the late middle ages, human vices were being satirized in the danse macbre, with the allegorical figure of Death heading a morbid parade of characters from across the social spectrum, then by the early modern period, it was Madness who was leading the procession, suggesting that nothing was what it seemed.’ Maria Tauset, CSIC Madrid. Taming Madness: Moral Discourse and Allegory in Counter-Reformation Spain.

This paper begins by analysing how perceptions of mental health changed from evidence of god and the devil, of evil and the existence of other beings and planes of existence, to conduits of wisdom and philosophy, the nature of morality and human corruption, worldly corruption of human spirituality, to the wholly negative one dimensional characterisation provided by the medical model in which force and control play such an essential part of treatment and cure. The approaches embedded within historical periods will be analysed, from Classical Greece to the 17th century, when Michel Foucault1 believes that attitudes towards the mentally ill changed. In this and other papers, the continuance of such beliefs will be examined in modern psychiatric and therapeutic jargon. The Logos of the Greeks is considered, perceiving it as an urban phenomenon. This paper will also consider how human experience changed from early medieval times until early modern times, and with it human behaviour.

Different historical periods will be reviewed, analysis of different approaches to madness, from ancient societies to the 17th century England and France. It will also attempt to consider the nature of mental illness, and whether anecdotal evidence is sufficient to decide levels of and sufferers from mental illness. Although Foucault holds that the development of a concept of reason caused mentally ill individuals to be marginalised, this essay will consider also social change, urban special manipulation and 16th and 17th century gentrification, with its values of orderliness and clarity, as crucial to concepts of mad people as occupying wildness and representing the dangerous Other. This work will review Michel Foucault’s idea of incarceration of the mentally ill, prisoners and beggars, named The Great Incarceration, during the Early Modern period, and the employment of constraint and control of the mad, doing so in part through social changes that altered concepts of the world. Foucault at certain 1 Madness and Civilisation.

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points in his career determined that madness is a social construct, developed through the power of elite groups. This paper will also consider at length the views of those who reject Foucault’s position. To widen our perceptions of the cultural construction of madness, this paper includes Shakespeare’s plays, particularly Hamlet, and Jacobean Revenge Dramas and how they presented insanity, followed by images of madness and the connection between witches and mental illness.

Foucault holds that at the beginning of the Early Modern period those who did not conform to the requirements of urban life, work, accommodation, and continuity, were subject to incarceration. While this did not immediately impact on the development of professional healers, it needs to be focused upon due to physician’s later involvement with the state and the processes of incarceration. The chaining of maniacs is nevertheless evident in Early Medieval narratives and has more to do with the excessive, extreme behaviour of some sufferers, including inappropriate emotional expression, and their perceived danger to others.2 The response of a Somalian student of mine to the chaining up of those considered mad at a time of social collapse and civil war in Somalia was that it was necessary in case they killed others, although in his locality neighbour was killing neighbour. Were the mad in this context guilty only of the individual-nature of their behaviour, while other murderers functioned within groups? The latter also exhibited a congruent or socially accepted response, even if there was madness in their behaviour. Although psychiatry strongly advances a physiological construct of mental illness, many historians of medicine adhere to the idea that mental illness is a cultural construct dependent on historical period and social power.

The second part of this paper will consider a number of ideas on the nature of mental illness, further consider its part in urban development and the gentrification of cities during the 17th century.

2 Dobbs, Penelope. B. R, Nebuchadnezzar’s Children: Conventions of Madness in Middle English Literature.

Yale University Press. 1974: 5

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Christianity and possession.

SECTION 1: ideas of madness.

Ideas of madness, where they existed at all, were varied in the past but seem to stem from urban life. Like many of our long-held beliefs, madness emanates from citylife and urban conflict and conceptual negotiation with the countryside, domesticated or wild. This review of perceptions of madness holds that it is an urban construct, the end result of human domestication that began prior to, but accelerated swiftly during, the onset of farming. This section will consider ancient and modern views.

Even though it appears commonplace in ancient societies to ascribe odd, destructive and repetitive behaviour as due to the gods or even to possession by spirits and demons, Hippocrates at times located it in the brain (The Sacred Disease) and at other times in the heart. For the Greeks of his period madness occurred in relation to Logos, meaning language,

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reason, harmony, proportion, 3 which required a direct engagement with the social world and social life. Although Hippocrates testimony suggests a separation of body and psyche, this may only be in so far as engagement with social life is concerned. Where causation of insanity is concerned, and on this Hippocrates considers mainly melancholy and delirium, the body is perceived as a container that becomes unbalanced according to the location of humours.4 While the absence of gods in human behaviour is essential for the development of the self, coupled with the identification of cause and effect, but as elsewhere I have disputed the apparent originality of this axiom, this paper will only be concerned with the creation of a relationship between interactive community values and human behaviour that threatens such values.

This may have been, with variations based on other more contingent values, likely within all or most ancient cultures. Although in ancient Mesopotamia, illness was conceived of as the god’s displeasure at human misbehaviour, subject to cultural perceptions, through the agency of demons, it was the consequence of not living a ‘well-ordered life in a wellordered society’.5 There is a consistent urban aspect to the responses to and nature of mental health, fear of social alterity emanating from alternative individual behaviour. Although Thiher (1999) perceives Greek concepts of madness as a rupture between self and the world, this concerns the social being not the inner being of modern times. The earliest ancient Greek personality to suffer from madness, as seen by Thiher (page 13), was Bellerophon, who shunned the world therefore proving his instability. For ancient Greeks the community or city-state was the ideal. Habitation of such a community was equated with balance and thereby health.

Relationships to the social world figure equally large in diagnostic exercises in the present day. Inhibited or loss of communication skills (Logos) also figures in today’s diagnosis of mental health. To be mad in Greek theatre often meant to be driven from human society, while there is no clear complement in Mesopotamian culture where responses to grief (Epic of Gilgamesh) can lead to self-neglect and unhappiness, but where the self is viewed in a more complex, many layered fashion. Although Gilgamesh is devastated by the death of his 3 Thither, Alan. Revels in Madness. Insanity in Medicine and Literature. The University of Michigan Press.

1990:14.

4 Hippocratic Writings. Ed, G.E.R. Lloyd. Penguin Books. 1978: p 231.

5 Robson, Eleanor. Mesopotamian Medicine and Religion: Current Debates, New Perspectives. Religion Compass 2/4 (2008): 455-483, 10.1111/j. 1749-8171. 2008.00082.

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companion, Enkidu, his grief also concerns loss of part of his self, the reality of his own mortality, and the development of human nature as humankind breaks away from divine control.

Hippocrates provided two explanations of madness, one to do with wind, heat and other natural forces, the other humours. For example, madness occurs when fire is dominated by water in the psyche. They become melancholic and fearful for no apparent reason. Madness is a consequence, one of several (Hippocratic Writings: 1978: 231), of an individual not maintaining equilibrium of heat and moisture that diet and exercise provide. Causation is from external factors, working with humours on different parts of a hierarchically determined body. While this can be seen as an early biological explanation it also presents a connection between body and psyche in which other properties of self, such as perception, play no part.

The identification of the brain as the source of madness6 made in The Sacred Disease, is consequent on the presence of excessive moistness within it, creating movement and agitation, or excessive bile. These properties accordingly create, as a consequence of the former, passive behaviour in the sufferer, or, in the latter, aggressive behaviour. An overheated brain causes sudden anxiety, with, it appears, volatility, caused by a rush of bile into the brain through the veins. The brain, as examined in The Sacred Disease, is equally subject to seasonal change. The above descriptions do not provide evidence of bipolar symptoms for example, one of the most favoured modern psychiatric diagnosis, but indicate separate illnesses, behaviour or states of mind. Rather than providing clear evidence for modern classifications of mental illness, Hippocrates conflates all kinds of disturbed states, from sudden violent behaviour to nightmares. He appears concerned with imbalance of temperaments, no matter what form it takes.

Opposition or possible conflict between natural phenomena on and within the body, produces psychic responses. The notion of imbalance occurs also in today’s biological ideas on the causes of mental illness. The humours, which Hippocrates described as numerous in some texts but in The Nature of Man limited to four: phlegm, yellow and black bile, and blood, appear to have been influenced by the idea that human beings are influenced by the four seasons. Certainly, all the above appear to have their roots in pre-Socratic thinkers who held that the elements were instrumental in creating and composing the substance of the world.

6 Hippocrates. W.H.S. Jones (trans) Hippocrates Vol 11. The Loeb Classical Library. London: William Heinemann, New York: G.P. Puttman and sons. 1923: 175.

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I have described ancient Greek ideas on madness as being part of a social construct, the Logos, being that which forms and regulates human society. This may have been common to many early urban societies, including Mesopotamia. It is also one definition of madness commonly used today by laypersons and physicians. Here, Logos, integral to concepts of modern rationality and thereby sanity, will be considered as based upon discourse, the ability to employ language to construct reality, correct decision making, both domestic and political, providing balance/proportion/equilibrium/reciprocity (Johnstone, 2009). It is a specifically literate construct occasioning synthesis of different and differing viewpoints over time. When Robert Burton considers the opposing conditions of reason and Melancholy: ‘We, as long as we are ruled by reason, correct our inordinate appetite, and conform ourselves to God’s word, are as so many living saints: but if we give reins to lust, anger, ambition, pride, and follow our own ways, we degenerate into beasts, transform ourselves, overthrow our constitutions, provoke God to anger, and heap upon us this of Melancholy…..’

He equates reason with balance and order, community virtues, not with empirical judgement. Madness involves a failure to be involved in the community, reason a healthy capacity to engage with others through God. Christopher Lyle Johnstone7 demonstrates the appearance of Logos in Western culture but perhaps erroneously perceives only its Western antecedents not those of middle-eastern and North African wisdom literature based upon the literary presentation of alternative viewpoints. Discussions on the nature of God, often preceding ancient Greek intellectuality, perhaps form the roots of ancient Greek thinking. Surely, the envelopment of Greek Asia Minor, the exposure of the Greeks to other ideas from distant lands, caused the formation of Greek wisdom, the supposed miracle of Greek natural philosophy?

The achieving of Logos is done through at least two groups imbued with abstract language establishing common procedure and perception prior to or on completion of an act or series of acts. It is society in which happiness is best produced in, and for which a state of conflict is the alternative. In such a worldview, excessive acts or series of actions, are held as destructive and destabilising, in other words ‘mad’. It affects civic life and the common good (Johnstone, 2009, chapter 5, Civic Wisdom, Divine Wisdom). In ancient Western writing on insanity, causation comes from a physical, external source. Through the ideas of Late 18th 7 Listening to the Logos. Speech and the Coming of Wisdom in Ancient Greece. University of South Carolina Press. 2009.

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century Enlightenment thinkers, such as Voltaire and Rousseau, reason and rationality began to be formulated as: secularism, whereby society is no longer ruled by elites interpreting sacred texts: personal autonomy, with emphasis upon individual good judgement: humanism, whereby human beings and the environment they create are at the centre of society’s endeavours and curiosity. Jon Elster8suggests also in understanding reason: impartiality with regard to persons, temporal impartiality, and rational and well-founded beliefs. Rationality feeds from other roots, according to Elster, although the two are normally twinned, providing opposition to passion and self-interest, within a subjective belief system not within a financial system. Elster includes appropriate action and aims directed towards the common good. All these notions, while not essential to 17th century views of madness, are essential to modern views. The rationality and reason of the ancient world appears to have been based on community, while recent European developments have generally based them on the individual.

While ancient Greece believed in community and its theories evolved from the idea of the supremacy of the community, Rome from early in its history conceived of the city state as occupying a community/power nexus, with later emphasis on the individual, therefore, although Galen structured his ideas on Hippocrates, there would be differences in his approach. 9At this point I will reference the sociological concepts expressed by Klaniczay (1990) in an effort to accentuate differences between Galen and Hippocrates. While on the surface Classical Greeks pursued ideologies of communitas10, stressing equality through citizenship values based upon ethnicity and gender, Rome concentrated on structure, based upon rank and wealth. Although born a Greek, Galen practised in Rome in the second century AD. He appears to have competed vigorously with other doctors, subject to boasts and power-play.11 He attacked the skills of other doctors and may have gained notice through his diagnostic ability and the extent to which he provided titles for conditions. This is a process visible today, in that conditions are provided, named and after being described at length, separated from other conditions and provided with treatments. His competitiveness, need to 8 Reason and Rationality. Trans. Steven Rendall. Princeton University Press. 2009.

9 Although this statement is useful for the city-states of southern Greece and many of their colonies, it does not reflect all of ancient Greece. Sappho’s poetry would perhaps only have been written by someone outside of the largely exploitative and patriarchal world of Classical Greece.

10 Klaniczay, Gabor. The Use of Supernatural Power, 400-1500. The Transformation of Popular Religion in Medieval and Early-Modern Europe. Trans. Singerman. Ed. Margolis.Polity Press. 1990: page 32.

11 Gill, Whitmarsh, Wilkins (ed.) Galen and the World of Knowledge. Gill, Whitmarsh, Wilkins Introduction.

Cambridge University Press. 2009.

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be in control and belief in his superiority to other physicians might have had to do with the environment in which he practised. A scholar as well as a physician he integrated Aristotle’s and Plato’s ideas into the medical concepts of Hippocrates.

In Shock and Awe, Maud W. Gleason describes Galen’s anatomical demonstrations, done on those lowest in the social order and animals, and rightly she connects these to the public shows of the coliseum. They served also to confirm the order of things. In essence, Galen was concerned with his authority, Hippocrates with his healing of others.12 Medieval madness: definitions.

12 This concerns power and its use.

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Peter Breughel the Elder’s ‘Dulle Grete’ c 1562 (Mad Meg). The ship of fools is situated at the picture’s centre, but is too small to contain all the world’s madness, demonstrated through images of war and anarchy. Mad Meg runs across the painting, an icon of madness through her dishevelled appearance and tattered clothing, towards the mouth of hell. Sinful behaviour, profligacy and gluttony, mix with symbols of lunacy and demons. From the time of the Enlightenment onwards, such paintings as this would be immediately considered products of lunacy.

The medieval world, according to Thiher (1999), by contrast did not clearly differentiate the mad and the nonmad, sanity and insanity, but in fact evidence of this separation can be found in matters of law and through developments in concepts of possession. Possession as the chief understanding of ‘madness’ belongs to the early medieval period. Extreme expressions of Christian piety were the norm, with self-torture, self-abasement not only tolerated, but venerated. Madness was attributed to the committing of sin, as much a metaphor as a condition.13Golem in Lord of the Rings is a modern version of this type.

Many behaviours of the Early and Late Medieval world would now be classified as mental illness. Saint Cecilia, venerated from the 4th century, upon marriage clothed her body in haircloth, fasted, preyed and wept out of fear of intercourse. In a secular society, standing on top of a styloi for decades would be judged insane and likely to result in incarceration and forced infusions of drugs as recommended by a bevy of drug companies and psychiatrists Simeon’s rationalisation for his odd behaviour is legitimised by its historical context, concepts of Self and of life. Self-flagellation, common amongst the very powerful, if carried to extremes, would also be a candidate for psychiatric treatment and not evidence of saintliness or of a strong conscience. Other attitudes would solicit a worrying response, such as on occasion, while a female virgin was often employed as a symbol of holiness, a sexually active woman was used to symbolise sin and depravity. Although the latter can be found in societies around the world, it remains irrational in that it conforms to an internal logic and not to an external one, attached to untraceable religious commands. We usually consider all such notions irrational. In fact, behaviour has been constrained and fulfils, in the present day, notions of domestication. Sedgwick,14 in his repost to Foucault and Szasz, declares that there is a normative framework to mental illness that exists within all contexts, and therefore St. 13 Doob. Nebuchadnezzar’s Children. Conventions of Madness in Middle English Literature. Yale University Press, 1974.

14 Psycho Politics. Pluto Press Ltd. 1982.

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Simeon, one imagines, would be judged sane now no matter how extraordinary his behaviour, or that his behaviour anyway would be modified. As with the others illustrated here. But immediately, with Sedgwick’s reasoning, we have still the problem of who decides who is mad, which will be considered later.

Excess in behaviour or mood was often the deciding factor. Wild men often represented bestiality, and can be connected to the raving lunatic. Removed from the public world largely inhabited by men, women who were sexually highly active, through too often occupying the public domain, were also considered beastly. Were the voices of St. Joan examples of spiritual exclusivity or of schizophrenia? Perhaps, they were the only way a young woman of humble origins could communicate her perceptions and be listened to in a hierarchal world, with God as its supreme authority. In a world as different from our own as the medieval world, perhaps we should not and cannot employ the same classifications.

The law early became involved in definitions of insanity. Wendy J. Turner has edited an insightful volume on medieval madness and the law, referenced here, but the book fails to distinguish between different kinds of mental illness and demonstrates complete acceptance of the supposed generic condition of mental illness as fact.15 Her occasional case studies involve anecdotal evidence, and might simply reference temperamental unsuitability for business or other worldly transactions of the time. She also concentrates on the Late Medieval period when group perceptions were probably undergoing change from a reliance upon religious conviction and communal understanding to one on book learning based upon the authority of ancient sources and caste-bound commentators. Nevertheless, she demonstrates an early involvement of the law with madness, consequent to matters of inheritance and property possession. Many of the examples provided appear to refer to the cognitively limited. In her piece Silent Testimony she describes exaggerated emotional incongruence (upon the enacting of a criminal offence) and memory tests (possible idiocy) as providing evidence of mental instability. Evidence of inappropriate emotion often appears linked to dementia. As Turner points out, incarceration or constraint only occurred when the sufferer was in a position of responsibility. Johann Weyer (1998), in the 16th century denied the reality of witchcraft and asserted that witches were mentally ill, employing legal judgements in his arguments. By the late 16th century in parts of Europe, physicians were 15 Madness in Medieval Law and Custom. Brill. Leiden/Boston 2010.

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consulted when witches were tried. Weyer’s work is seen as a forerunner of insanity defence, whereby he declared old women merely imagined those matters they confessed to, driven into incompetence by excesses of melancholia.16 Turner also includes consideration of changes to understanding of emotion and how it defined personality and intentionality. By the end of the medieval period, passion, if it results in inappropriate action, has become a form of temporary madness. Thiher too makes note of how emotional expression was viewed, from humoral determination, supernatural possession and Stoic concepts of emotional excess as a form of madness. Two of these perceptions we have retained, although descriptions of both have suffered alterity to fit in with modern ideologies.

In Heresy in Transition17 Sabina Flanagan, Heresy, Madness, and Possession, demonstrates that papal attitudes to possession were changing as a consequence of wording on heresy from the Fourth Lateran Council of 1215 that conflates heresy and madness.

Although, other commentators describe the conflation of heresy and madness as a medieval topos of no great importance. Nevertheless, the writer points to the diminishment of references to the Devil as the cause of, to-the-prevailing powers, inappropriate thinking and behaviour.

Through the development of humanism and changes in society, madness was becoming increasingly subject to professional and intellectual gaze. Behaviour has changed from medieval times to the Early Modern period. Religious excess has become unusual, and when evidenced, frowned upon. The scatological communication of the educated, such as in the works of Thomas More, is disapproved of or becomes increasingly unfashionable. By the end of the 16th century responses to madness had undergone immense change, viewed below, encapsulating the negativity of the physician, and the exploration of writers. In France, Du Laurens (Thiher, 1999: p 74) presents the view that the insane cannot be regarded as human, but are bestial in nature. Worse, because they fail to live up to the perfection expected of a creature made in god’s image they are symbolic of deicide. Peter Sedgewick, 18an apparent 16Gunnoe Jr, Charles. D. The Debate Between Weyer and Erastus. Melton, James Van Horn. Ed. Cultures of Communication from the Reformation to Enlightenment. Constructing publics in the early modern German lands. Ashgate. 1988.

17 Hunter, Laursen, Nederman. Transforming Ideas of Heresy in Medieval and Early Modern Europe. Ashgate.

2005.

18 Psycho Politics, 1982. Pluto Press Ltd.

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believer in medical history as an evolutionary journey from ignorance to truth, pinpoints Johann Weyer (page 125) in 1563 producing clinical descriptions of auditory hallucinations and persecutory ideas, advising medical treatment for those accused of witchcraft and consequently being placed on the Papal index. Although in recent years, Weyer has become lauded as an exponent of early psychiatry in fact he was concerned primarily with the nature of witchcraft and the methods employed to counteract witchcraft.

Michel Foucault: Medical Power in France.

Foucault’s theories have mainly been concerned with power, knowledge and discourse, ‘The boundary of politics has changed, and subjects like psychiatry, confinement and the medicalization of a population have become political problems.’ (Foucault, cited in Macey 1994: 217).19 As an historian he emphasised a great incarceration, when people considered idle were imprisoned and made to work. Foucault perceives early psychiatry as an attempt to capture minds, patients placed under a psychiatric discourse, the result a psychological trial (Merquior, 1985: 24) that they are never released from, even when the patient accepts the psychiatric viewpoint. The moral torture that ensues becomes reason’s tyranny over madness.

The constitution of madness as an illness, broke the dialogue between reason and insanity.

According to Foucault, psychiatry has enforced: ‘a monologue of reason about insanity’ that has pushed ‘madness’ in its many forms into the margins of both society and intellectual curiosity.

Modern critics have largely attacked his research methods and research expertise, but nevertheless seem also to be attacking the threats his ideas have for prevalent and current status quo. If knowledge concerns power, historical and social positioning, than all experts must be viewed with scepticism. These critics focus upon his limited research, pointing out that he based his ideas on the literature and images of the Late Medieval, Renaissance and Early Modern Society. He did not give sufficient focus to the documents of these periods and therefore his conclusions are not justified. J. G. Merquior (1985: 44), certainly one of his sternest critics, berates Foucault for referencing Paracelsus and not more eminent figures such as Erasmus and Montaigne, forgetting, one hopes, the influence Paracelsus had on fellow physicians and that he was after all a working physician and writers and thinkers like Montaigne were not. In the end, it is what doctor’s think, not philosophers. This is more the case in the present day, when physicians have separated their ideas from the philosophical, 19 Macey, D. The Lives of Michel Foucault. London: Vintage, 1994.

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sociological and psychological viewpoints found in universities, for example. The above viewpoints suppose that images are not evidence without documentation, and that documentation provides more credible examples of reality. Unfortunately, this allows for history, especially ancient history, to become fossilised within academia, not permitting thereby the infusion of insights from elsewhere. Foucault has been as much criticised for his temerity in critiquing psychiatric mores as in his methods and for not appreciating that incarceration occurred in medieval times.

Hieronymous Bosch: late fifteenth century Ship of Fools. Icons of immorality, such as eating of cherries, mix with icons of madness, the melancholic fool with his fool’s stick. The gathering of clergy and apparently ordinary individuals indicate that this is a satire on prevailing social conditions. Although the ship is an early image of containment and

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isolation of the mad it is also a microcosm of Late Medieval/Renaissance society. The mad here still play a reflecting role to the rest of society.

In Madness and Civilisation (1967), Foucault describes how in France mad people were placed on a ship, which floated between rural authorities. Called the Ship of Fools it became later symbolic of managers of states and other institutions. Neely (2004) points out that there is no evidence of such events. Nevertheless, this may be an early urban myth that symbolises how city administrators constructed order and dealt thereby with its apparent antithesis.

Paintings of the period show a variety of fools journeying together in ships, indicating perhaps their social and mental rootlessness. Madness is now a thing apart, contained and enclosed. Merquior20 refers to how, in Foucault’s thinking, the ship of fools alludes to realms of thought beyond reason, while also showing mad people searching for their reason, the capacity to be involved in production and meaningful employment.

Foucault places madness or Folly central to the Western experience, the primacy of madness a consequence of the breakdown of medieval religious symbolism, which had pervaded everything. To the modern mind the religious world that preceded and continued during the renaissance, one of devils, fear, and Satan, is irrational: it is mad. The panoply of strange, disturbing symbolism became in a socially ordered world based upon civic commitment the irrationality of the mentally ill. According to Foucault, madness had found a place in the medieval hierarchy of vices, linked it seems to me not just to folly, ranked among ‘the wicked soldiers of the psychomachy.’ The strange creatures of the medieval supernatural had a place in the knowledge of the time, which was different to that which developed from the renaissance onwards. While modern psychology might say it concerns the outward projection of inner individual and group anxieties in fact such a view represents an unwillingness to accept alternative kinds of knowledge. Folly perhaps refers to those who cannot access the knowledge. Medieval thinking relied on image, analogy and symbolism. The horned beast, gargoyle, troll and whatever else. Such creatures are now the subject of horror films, not companions of space and time.

20 Foucault. 1985. Fontana Press/Collins.

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For Foucault the incarceration that followed the renaissance concerns the containment of this experience/imagery in a different age. The imprisonment of the mad symbolises the development of social order. He perceived madness as part of an historical process, not as universal or objective categories. He illustrated how madness, poverty and unemployment began to be seen as social problems. Meaning and ethical values attached to them determined how these phenomena were experienced. In order to fully understand this phenomena, Foucault undertook a structural study of the institutions, places of confinement, ideas, juridical and scientific constructs that framed and supported the phenomena.21 Merquior (1985) criticises Foucault for asserting that the mentally ill were confined within converted leprosaria, as leprosy died away, when many institutions also accepted the mad. He gives little space nevertheless to the attitudes towards lepers, that of sinners punished by god, or/and the walking dead and the possible wholesale transference of such attitudes to the mentally ill and the disadvantaged. Like Sedgwick (1982) he sees mental illness as inhabiting an ideal form, unchanging and unchangeable, not liable to poor diagnosis, dissembling, and context. Foucault perceived madness as an objectification that changed human beings into subjects (Tover-Restrepo, 2012), specimens for study. Since, madness has become far more widespread it seems as society has become transmogrified by medical perception and interference. As a society, our minds have become the objects of study of an autonomous body, empowered by laws and in a capitalist, consumerist alliance with pharmaceutical companies. Or at least that is one interpretation. Another is: ‘analysis shows that psychiatry is a new type of hybrid discipline, exhibiting a complex epistemological structure and philosophical language, located in the terra ignota that stretches between the old social and natural sciences.’ 22Foucault was concerned with the very nature of knowledge. In this new world of the 17th-18th centuries, humankind (man) became increasingly the focus of attention, rather than god.

Foucault perceived society as constructed upon contingent discourses that reflected group power and social stratification. He saw knowledge as bound to power, a point Plato had made several thousand years before. Madness therefore became the subject of those engaged in rational, often understood as scientific, purposes. The mad became objects of study, objects of 21 Marcela Tovar-Restrepo. Castoriadis, Foucault, and Autonomy. New approaches to Subjectivity, Society, and Social Change. Continuum Studies in Continental Philosophy. Continuum International Publish Group.

London: New York.

22 Ed. Yasmin Haskell. Diseases of the Imagination and Imaginary Disease in the Early Modern Period. Vol. 2 2011, page Xvii. Preface.

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gaze of those in power, involving containment in some form or another, as others, for example the poor and criminals became subjects of punishment as a consequence of ideas of possession and labour. In terms of mental illness, some23have questioned his apparent rejection of mental illness as a genuine, rather than cultural, phenomenon and suggested that such an approach could result in social difficulties and that it is wrong to deny other’s expressed suffering. While clearly people suffer immensely from a number of verifiable conditions, understanding of and remedies for these conditions need to be removed from power-relations. There, he was not wrong.

Foucault focuses on the establishment of the Hopital General in Paris, existing within its royal remit with absolute authority outside of ‘courts, decides, judges, and executes,’ 24 the intention being to control the city’s poor, ill and mad. Foucault points out that the original Hopital, as many were later set up in every French city, for the prevention of ‘mendicancy and idleness.’ I have previously considered a number of these issues. Foucault (page 47) asserts that many of these developments were a consequence of poor government economic policies and legislation against begging. Unemployment had risen in the early 17th century and riots had occurred in Paris, Lyons and Rouen. As we have already seen, the king took responsibility for administrating social control and citizen health in France, thereby centralising the development of medical care. In 1676 the king ordered the setting up of a general hospital in every city.

According to Foucault, the great confinement occurred as a government policy to deal with unemployment and begging, the result of conflict and social change, forcing inmates to work. Shortly after the Royal Edict that established the Hopital General, militia connected to the Hopital hunted down beggars and forced them into the different buildings of the Hopital (Foucault, 1971: 49). Once confined, all inmates were made to work, a social construct that may have emerged from puritanism involving a precise use of time and energy. The confinement revolved upon a belief in an ill-considered economic response to idleness framed within moral paradigms, involving exclusivity and punishment. From these evolved perceptions of the mad, idle and useless, and methods of treatment. But for Foucault, of far more import it seems, is the construction of a power ethos behind treatment of those excluded from industrious, wage-bound society. In Foucault’s view, Royal power devolved down to 23 Mills, Sara. Michel Foucault. Routledge Critical Thinkers. 2003.

24 Madness and Civilisation. A History of Insanity in the Age of Reason. 1971. Page 40. Routledge.

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minor administrators engaged in the processes of confinement, and with it methods of control, constraint and punishment. These continued into the 19th century when the majority of those confined in the Hopital General were regarded as insane. During the 18th century a tenth of those arrested and confined in the Hopital Generals were regarded as insane.

Famously, Merquior (1985) and others challenge Foucault’s idea that the Enlightenment was unusual in its response to madness, and his belief that in previous ages people responded more positively to the mad. He points out that Peter Sedgwick has shown that many insane people had been in custody and made in undergo treatment, always cruel, long before the Enlightenment. Midelfort too has provided clear evidence of incarceration of the mad in late Middle Ages accompanied by extraordinary cruelty. But does this genuinely undermine Foucault’s idea of madness as the end-result of a power discourse? For Merquior’s dismissive arguments to be correct we need evidence on what the mad were suffering from, and whether the madness of medieval patients was the same as that of modern sufferers of mental illness.

While Merquior (1985) rightly points to the hospitals for the insane25 across the Rhine valley ‘prior to Foucault’s classical age’, and charitable asylums in fifteenth century Spain, with various treatments, stemming from Muslim societies, based upon physiological concepts of mental illness, he does not define the nature of that illness, whether they meet the same definitions as modern psychiatric viewpoints. Clearly, containment and incarceration of the mad was a developing paradigm, epitomised by Edward Schon’s woodcut of the cage of fools (1530), found in Gillman’s ‘Seeing the Insane’1982:48), but usually it was in relation to anxiety on morality. Incarcerating the mad, or those judged so, in the medieval world might also have concerned the containment of the larger world’s immoral behaviour. In other words, for wholly different reasons then in the Early Modern period.

While Foucault’s detractors focus on his research, they have rarely challenged the importance of central power on the evolution of French medical care nor the creation of places of confinement for the poor. Nor it is reasonable to deny the connection made between beggarly poor and idleness and moral corruption directed by powerful elites who feared the depopulation of workers from the country and social instability.26 Merquior (1985) appears again not to appreciate the evolution of one power-based view of a separate group, such as beggars, to that of another, such as the mad, and how such views can be connected allowing 25 Taken from Peter Sedgwick’s Psycho Politics.

26McHugh, Tim. Hospital Politics in Sevententh Century France. The Crown, Urban Elites and the Poor.

Ashgate, 2007.

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the officially sanctioned attributes of one group to be imposed upon another. One crucial aspect of later incarceration of the mad, up until the present, is the way in which the mentally ill symbolised poverty and material and social deprivation. It is generally accepted that the poor of the time were seen as an untapped source of wealth that required management and control (McHugh, 2007: 46).

Brockliss and Jones27(page 443) concur with Foucault that in 16th century France the mad were seen as moral symbols, not as subjects for care and understanding referencing depravity or divine wisdom. In the 17th century they were associated with irrationality and improper use of the will, socially dangerous animals who had to be excluded from human society.

Consequently, they were locked away with beggars, prostitutes and blasphemers. Today, all such groups are liable to be placed under the category of mental illness. Whatever occurred, the mad were disenfranchised and excluded, locked away in hopital general. In support of Foucault, Johann Weyer28(1515-1588), as noted, attacked the concept of witchcraft, and suggested, for example, that old women accused of witchcraft were hallucinating and crazy, and therefore should not be punished. This fitted in with the Roman legal maxim employed during that period: ‘the mad man is not punished because he is punished enough by his own madness.’ Erasmus asserts an inclusive philosophy, that all creatures are touched by god, therefore the mad are also expressions of god.

17th Century Concepts of Madness, and the impact of social change.

The 17th century witnessed changes in the approach to insanity with more engagement with problems of aberrant social behaviour. Many scholarly treatises were produced commenting on the causes and prevalence of problems of the mind, but, as yet there were few unchallenged self-appointed experts in mental health matters.

Erik Midelfort29identifies three specific notions or images of madness: folly, demonic possession and melancholia. At this period, these forms of madness also incorporated a coexisting form of irrationality that was beneficial, offering deeper sources of wisdom and insight. In ancient times, disordered senses were valued as a form of religious experience in 27 The Medical World of Early Modern France. Clarendon Press, 1997.

28 Benjamin G. Kohl, H.C. Erik Midelfort (ed) On Witchcraft. De praestigis daemonum. Pegasus Press.1998 29 A History of Madness in Sixteenth Century Germany. Stanford University Press. 1999. Page 22.

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which social controls and customs were overridden. In Dionystic rites, women, the group most subject to control in ancient Athens, were allowed complete freedom of expression, emotional and physical. Midelfort identifies Christian wisdom as a kind of madness or folly, according to St. Paul and Erasmus, which brought the believer closer to god. The leaving of the senses allows for another form of knowledge. Demonic or spirit possession also indicated alternative, or in medieval times customary, forms of knowledge, allowing access to another world beyond the material one we inhabit. The writer then demonstrates that melancholy had a positive side, being linked, as sometimes now, to creativity.

From this evidence Midelfort construes that madness was central to experience during the Renaissance, although clearly it constituted then a completely different experience from the present. These expressions of madness were closely tied to present day notions of inspiration and genius, of a god, or devil, provided view of problems unavailable to the conventional and staid. Great individuals were more likely to be possessed than their steadfast counterparts.

Theories of madness remained attached to cultural perspective. Although, as Midelfort makes clear, Paracelsus’s ideas on madness were subject to contradiction, he developed a theory based upon the triadic scheme of human nature: body, spirit, soul. He understood madness as an ignoring of the essential integrity of the individual, the sidereal body or mortal spirit, what made them human, and therefore becoming merely a beast, and the conflict over this part of individual nature caused madness.

Paracelsus divided madness into five types. The first was epilepsy, the falling sickness: 2) mania, a corruption of reason rather than the senses, produced by intrusive elements such as worms. This was treated by bloodletting, or oil of camphor, silver, mercury or lead to cool the individual: St. Vitus’ dance connected to abandon and associated with sexual thoughts and activities: a suffocation of the intellect, decision making, which again he believed had physical causes such as worms, poor diet or uterine problems: privatio sensuum, loss of the senses, including lunatics, the congenitally insane, the mad, those afflicted by witchcraft, and those by melancholy. He attributed causes to each. For example lunatics had fallen under the influence of the moon, instituting chemical disorders, while those insane from birth had their parent’s insane passion during intercourse for blame. Like a true physician, Paracelsus expanded on examples of madness to include those who disagreed with him (Midelfort, 1999, page 119) based upon a notion of astral drunkenness. All in all, he connected madness to the behaviour and cognitive capacity of beasts that many individuals intentionally acquire.

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Madness here is either achieved or the result of outside effects, and is dependent on Christian concepts of soul.

Apart from the above, in-depth evaluation of madness was limited to melancholia, seen as, according to Midelfort (1999), a disease of both genders. It was often attributed to education, the excessive reading of intelligent people. This is the accusation against Hamlet, accounting for his procrastination. While today many assume that it represents an early identification of depression, I hopefully will later demonstrate how diagnosis can be the result of interaction between involved members of the healing process, and also of rarely considered processes of interaction especially between healer, healee and those involved with both parties. Also at this time, demonic possession was seen as one determinate of madness, affecting men and women equally. Whatever the nature of mental illness, it remains, then as now, subject to cultural interpretation and design. In the modern age, it is particularly subject to the vagaries of the observer. Retarded and mentally ill people were often retained in European courts to provide both entertainment and to tell their aristocratic master’s the truth, not willingly supplied by the sane.

In essence, madness was perceived of as to do with those who behaved differently, often acting outside of social convention in physically shameful ways, or in an uncertain relationship to position and possessions. In medieval and Renaissance times it was seen as an imbalance of the humours, often viewed within a religious context, as the world’s evils, especially evils of the flesh, intruding into the purity of the soul. One popular cure for madness was music and dance that were said to work against dominance of black bile.30 Lawrence Babb31 shows that Renaissance saw mind and body as acting as one, animated by the soul, divided into three sub-sections: the vegetative, sensitive, or sensible, and the rational, or reasonable. The vegetative soul, common to plants and animals as well as human beings, was seen as located in the liver; the sensitive soul, concerned with imagination, the senses and intentionality, was perceived of as seated in the brain and heart; the rational soul, separating man from all other creatures, was seen as seated in the brain.

Renaissance people recognised, according to Babb, five external senses and three internal ones; common sense, imagination and memory, all located in the brain. Common sense gives 30 Gilman, S. L. Seeing the Insane. John Wiley and Sons. 1982.

31The Elizabethan Malady. A Study of Melancholia in English Literature from 1580 to 1642. Mitchigan State College Press. 1951.

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sensory experience form. The imagination then evaluates whether experiences are pleasant or unpleasant, and delivers these evaluations to the memory. The internal senses create emotions, divided into motions, affections, passions and perturbations. The rational soul has two divisions, intellectual and volitional, that is, reason and will. Reasons perceives the essence and appearance of matter, seeking truth through a logical train of thought, determining if something is good or bad. Will, implanted by god, desires good, not bad, promoting physical action.

As the soul, in its various forms, resides in the body, the body is seen as the principal conduit of understanding of the world and the capacity to deal with it. This was a physiological position rooted in the humours, aided by digestion, or concoction, and those elements, chyle, in the body dealing with the product of digestion. This process illuminates Hamlet’s psychological journey, from the activity of the senses to the delaying or reconsideration of the will (Babb, 108). Locating all the above manifestions within the body, although subject to external manipulation (food and weather), suggests individualism, certainly compared to the external agencies of madness, demons for example, of the medieval world. Nevertheless, in an unjust and violent world there seems no room yet for the psychological effects of that world on individuals.

According to an interesting volume edited by Yasmin Haskell32, the Early Modern concept of madness was based upon the notion of diseased imaginations, connected to the above dynamic between sense and rationality. This survived until recently into modern thinking when more mechanistic understandings of the mind gained popularity. Instead of saying, whenever someone becomes anxious, that: ‘It is in your imagination’ we now might declare ‘you are suffering a chemical imbalance.’ In the 17th century and beyond, imagination was held to be a powerful force capable of overcoming the reasonable (reasoning) mind. This force connects madness due to disease, birth defects for example, to melancholy and fevered disruptive behaviour of, what we now call, psychosis, to St. Vitus dance and demon possession. The imagination was a force wielded by the individual that allowed, if the individual were weak-willed or infirm,33 misuse by other forces both material and supernatural.

32 Diseases of the Imagination and Imaginary Disease in the Early Modern Period. Vol.2 Brepols. 2011.

33 Having insufficient will and rationality.

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In fact, there were a number of theories on the reasons for mental disturbance, from astrology, rebellion, to passion, particularly sexual passion, fear, and principally imagination.

While Hunter (1982) records evidence of Early Modern acquaintance with hypochondria, other forms of diagnosed mental illness included Lycanthropy, Catalepsy, which Robert Bayford, writing in 1663, considered common. 34 John Graunt35constructed statistics on lunacy from the Bills of Mortality, noting how few there were, unlike the numbers today, but how many more could be found if the effort to find them was made.

In the 1664 Thomas Willis, who invented the term neurology, wrote Cerebri Anatome. In doing so he set aside, at last, Galen’s view that the anima, which dwelt within the body, explained the mind. He had, according to William Feindel,36 re-connected with Hippocrates’s original notion that the brain was the seat of all desires, emotions and thoughts. An associate of Wren and a member of the Royal Society of London, he experimented with ink injected into carotid arteries and noted how blood circulated through the brain. He described how different parts of the brain had different functions. He appears to have been influenced by Descartes, referring to animal spirits in the same explanatory fashion. Roy Porter37(page 55) describes Willis as occupying the ‘cutting edge of respectable scientific thinking’, determining that he perceived the body as a corporate soul subject only to the capacity to receive and react to stimuli. He distinguished sensory from motor functions, and separated human nature into two, the animal soul and super-rational soul. While convinced of Willis’s supreme importance, he admits that he may have had little effect on common perceptions. As with many celebrated thinkers during this period, Willis’s influence may have been limited to a small elite group, his importance mainly in hindsight.

Although Willis’s work appears to evoke present day neurological and psychiatric concerns with brain construction and chemical imbalance, most theories were concerned with moral or religious perspectives. For example, a landowner not attending to his estates would be considered mentally ill, the association made that sanity was expressive of an individual’s better self and insanity, or distemper, evidence of the baser side obtaining dominance.

34 Hunter, R. Ed. Three Hundred Years of Psychiatry. 1535-1860. Carlisle Publishing. 1982.

35 Natural and political observations mentioned in the following index, and made upon the bills of mortality, 1662.

36 Foreword. The Anatomy of the Brain and Nerves. McGill University Press. 1965.

37 Flesh in the Age of Reason. How Enlightenment Transformed the Way We See Our Bodies and Souls. Allen Lane 2003.

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Efficiency indicated sanity. Those judged insane often behave without inhibition, verbally and physically assaulting those they dislike, unclean in person and habits, and significantly attend to housework, unless carried to excess (Hunter, 1982: 103). While cleanliness was considered next to godliness, so sanity was associated with order in habits and general behaviour. Bad behaviour towards others encourages a rogue to go insane, while behaving calmly and ethically towards others encourages internal calm and balance, or sanity. In this view, the individual plays a part in whether or not they become insane.

This view that insanity was a consequence of individual responsibility and of baseness of thought or deed, gave authority to the intrusive treatments employed. Shackling in irons, beatings, induced vomiting, purges, bleeding and numerous shock treatments, apart from those already described, such as ducking. Many of these treatments would be continued into the 20th century.

Foucault’s position on the perception and treatment of madness appears predicated upon his view of the Great Confinement, the creation of institutions to deal with largely social problems, the poor, landless and unemployed. While some grew out of the medieval hospitals38 and lazar houses, by the early 17th century such places resembled the institutions of the present day. The organisation of space closely resembled and resembled monasteries, with discrete activities sectioned off. By the 17th century, according to Casella (2007), these were organised around principles of segregation with restricted and controlled access. Practices of surveillance and ordered symmetry emerged during the latter part of the 17th century. In 1647 the London Workhouse was erected, which was principally designed for the purpose of institutional confinement. Here, a central chapel connected separate wings, one for destitute children and the other for petty criminals. In the Netherlands the first male house of correction occurred in 1589 where destitute men pulverised wood for use as a textile dye, and in France the L’Hopital General was built in Paris in 1656. Here were incarcerated those members of French society deemed unproductive and ‘unreasonable’, beggars, debtors, prisoners, invalids, prostitutes, orphans, elderly and the insane. Rehabilitation consisted of enforced labour, which also had the added incentive of wealth production. Those who did not comply were severely punished. Casella, along with many other commentators, taking the line initiated by Foucault, describes these institutions as evoking a change from Christian, exploitative care of those outside of society into morally charged state repression.

38 Leanor Conlin Casella. The archaeology of Institutional Confinement. University Press of Florida. 2007, page 8.

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Of interest is who is considered mad, especially in a mad world? Is diagnosis of madness in the supreme control of the observer, especially if the observer is extremely powerful? Mentally-ill people tended to be classified as vagabonds, beggars and disorderly persons and dealt with in the same way.39 Hunter (1982) provides examples, page 6 from Thomas More’s dialogue of comfort against tribulation, in which the individual described may simply be rascally and free-thinking. As with the notion of witchcraft and madness, possession and madness, heresy-‘after that he had fallen in to ye frantike heresyres, fell soone after in to playne open fransye bysyde- is an important descriptor of the condition.

There is an element here of an individual thinking and acting outside of proscribed ways, which More was always deeply concerned with, reflected in his treatment of Tyndall.

SECTION 2: Representations of madness, from medieval period to Early

Modern period.

Images:

39 Hunter, R. Three Hundred Years of Psychiatry. Carlisle Publishing Inc. 1982.

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Dancing was employed as a therapy for lunatics, based on the effects of extreme physical activity and motion. Henricus Hondius engraving (1642) based on Breughel drawing of the pilgrimage to Molenbeek.

Images, engravings and paintings, contain perspectives and reflect a period’s thinking.

Gilman (1982) has provided extensive examination of how the mad were regarded from medieval times, referencing physiology, symbolism, posture and gesture. Mental illness is viewed, within these pages, as evidenced by darkness of skin colour and furrows on forehead aligned to astrological signs and humours. Legs crossed in a seated position, elbows on legs, and hands under chin or holding head indicates reflection and grief induced madness of the melancholic. Often the mad were shown in contorted positions, clear evidence of their internal struggles. In many paintings identifying mental illness the principal figure hides their hands, indicating ineffectuality.

Gilman notes that, certainly in early medieval times, madness is shown as the result of possession with Christ or a Saint representing the divine driving out the consequences of earthly corruption. While often cures for mania are shown as within the realm of religion, those for the melancholic are shown as belonging to the physician, of the physical

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intervention, blood-letting, cauterisation, common at the time for dealing with an excess of black bile.

As will be seen, images of confinement appear mainly from the 16th century onwards and prior to this the mad are related to activity in the countryside, often prancing or dancing. The latter, combined with music, was perceived of as a cure for mania, foolishness and melancholia. Gilman also references the cutting out of the stone of folly, the removal of real or imagined protuberances in the forehead. Paracelsus saw madness as related to the abdominal region, and others in the backside. It clearly possessed physical traits that could be subjected to surgery. Early modern society sought for physical evidence of madness: goitres or ‘black bile, black demons, black stones, black rats.’40 Gilman rightly points out the attempt to make concrete the internal drives of mental confusion.

The fool, the mad, appear to have been important Images of the mad until the 17th century tended to show them as existing amongst wild places, often seen as reflecting or connected to nature (Gilman, 1982: 8). In essence, mad people are displayed as freer than the sane until their space, water, nature, the world outside of human environments, is subjected to restrictions, incarcerated on ships, or put into cages and shackles. In Lucas Cranach the Elder’s 1532 painting Melancholy, the melancholic sits in a corner carving a stick into a bifurcated staff, an image of mental illness, half in and half out of the natural word of trees and mountains. To the left of the picture are the various humours on zodiacal beasts representing madness. The melancholic is nonetheless contained and although connected to wildness is likewise connected to order (Gilman, 1982: 8) indicating perceptual change.

Gilman demonstrates an association between mad people and witches, who employ their staffs to fly, thereby further escaping from the restrictive human environment. A further indication of the freedom of mad people is that they were often portrayed as naked, for example Cibber’s statues above Bethlam, creating an association with barbarians in the

40 Gilman, 1982, page 42.

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classical world, who too were of the wild and rejected order.

Like a grotesque in appearance, a madman is represented as physically powerful, even demonic, and therefore requiring constraint. This is less a man than a demon. Compare with the expressions and muscularity of images below. Charles Bell’s ‘Madness’, Essays on Anatomy of Expression in Painting. (London: Longman, et al.,1806).41 The rage of the madman is apparently based on internally generated fear. The demonic appearance of the grotesques below can possibly be traced back to images of Ishtar, Mesopotamian goddess of sex and war, and other early Mesopotamian deities. It is certainly an image of destructive power.

41 Gilman, Sander L. John Wiley & Sons. 1982:91.

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Hamlet: presentations of insanity.

According to Gregory J. Reid,42 tragedy and madness were always closely allied in theatre, although this does not acknowledge the role of the fool, foolish or comedic types with addled wits that appear in comedies. Reid cites Hallman43who conceives tragedy as involving the individual’s inability to achieve identity. But, surely, it is extreme external and internal events that connect tragedy and madness, the latter being an expression of the former.

Reid’s own definition provides points of interest worthy of discussion (2002, page 39): ‘madness in tragedy is a discourse resulting from the negation of the individual’s sense of reality.’

Jacobean Revenge Drama involved many instances of madness, seen in Kyd’s Elizabethan exercise in revenge, The Spanish Tragedy, in which Hieronimo, the main character, and his wife, Isabella, descend into madness as a result of their son’s murder.

Often, in these dramas madness is linked to extremes of behaviour involving violence, many, if not most, involve women achieving autonomy, or asserting themselves in a world in which their feminine identity has been subverted. Babb (1951) states that Elizabethan drama (surely,

42 A Re-Examination of Tragedy and Madness in Eight Selected Plays from the Greeks to the 20 th Century.

Studies in comparative literature. Vol. 44. The Edwin Mellen Press. Lewiston-Queenston-Lampeter. 2002 43 Psychology of Literature: A Study of alienation and tragedy. New York, Philosophical Library, 1961.

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Jacobean more so) ‘is notable for its psychopathic characters’44 (whatever that means) and the number of physicians who appear on stage to provide treatment. The reasons are usually connected to remorse and love, i.e. the passions, and cured by subterfuge or simulation of passion by the physician. While essays on grief, of one kind or another, they provide a discourse on sense and reason, whereby emotions outweigh and prevent the development and employment of reason unless provoked to do so by an external agent.

Shakespeare was probably thinking of melancholia when considering the real or feigned madness of Hamlet.45 This fashionable intellectual condition suited wealthy members of the Tudor and Jacobean elite. Although Carol Thomas Neely46accepts that early modern concepts of madness drew on Galen and Aristotle and the notion of humoral constructs of illness, she nevertheless denies that the subject was viewed as a unified discourse but involved heterogeneity. She perceives drama as developing a language of madness indicating an increased interest in the matter, involving (Neely, 2004: pages 2 and 3) the secularisation and medicalization of madness, separating conditions from theology and ideas of possession. Ian Hacking named this process ‘the secularisation of the soul.’ Hamlet can, with considerable justification, be called a ‘fully fledged psychological drama which focuses at unprecedented length on the protagonist’s tortured mental condition.’47 Clearly, melancholy formed a substantial part of early perception of mental illness, distinguished from madness and variable in its effects.48 It describes conditions of dementia and of relative normality, of morose temperament and of someone subject to hallucinations.

During the Early Modern period it was associated with genius, particularly on the continent, and thereby attractive to the emerging intellectual class. Such was the faddish nature of the condition that epidemics of the illness broke out in England at the end of the 16th century, constituting a social type, malcontents. Many men of letters, for example, John Donne, Chapman, Greene and Nash amongst others, assumed or engaged with melancholy, thereby

44 Pages 114-5.

45 Lidz, Theodore, Hamlet’s Enemy. Vision Press, 1976: 34.

46 Distracted Subjects. Madness and Gender in Shakespeare and Early Modern Culture. Cornel University Press. 2004.

47Mackay, Hugh. Shakespeare and Renaissance Drama. York Press. 2010.

48 Babb, Lawrence. Sanity in Bedlam. A Study of Robert Burton’s Anatomy of Melancholy. Michigan State University Press. 1959.

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advertising their talents and their intellectual scepticism. Shakespeare, an actor, business man, and family man, appears to have been free of such mannerisms.

The illness, if that is what it was, is surveyed by Robert Burton in The Anatomy of Melancholy published in 1621. A very popular work in its day, it has its roots in the Renaissance, during which it was one of the accepted mental diseases along with madness, frenzy, hydrophobia and epilepsy.49 Burton was apparently motivated by his own intense melancholy. The disease involved fear and sorrow without external cause, varying in intensity from ‘relative normality to a dementia characterised by intense agony of mind and fearful hallucinations’ (Babb, 1959). A huge book, it dissects melancholy through the simple strategy of dealing with the condition in several sections, beginning with the consequences of original sin. Grief and guilt over human banishment from Eden and separation from god are the real reasons for human madness. This is divided into three sections, or partitions: after consideration of its causes, cures are considered, and the third part dwells on love and religious melancholy. Once this is concluded, there are digressions on anatomy, air/atmosphere, and the nature of supernatural beings. In the third book he love-melancholy, the mopping of the young lover, and religious melancholy. In lengthy passages he considers how the passions can cause melancholy, devils and learning can equally cause the condition.

Although rarely touching on the severe depression identified by modern physicians, it nevertheless conjures up the present through its popularity amongst people in general, a metaphor for every stage and event in life. Like many of his contemporaries, Burton saw human beings as the most noble of God’s creatures, that perfection whittled away by social injustice and social ills, and their own importunes behaviour. It is the act of living that largely causes the condition, and human kind’s unreasonable behaviour in acting cruelly and selfishly rather than obey God and behave rightly and righteously. Unable to achieve the perfection before the fall, human beings fall into melancholy.

Burton presents melancholy within the paradigm of medical perspective, seeing excessive or original thought and behaviour as causing or symbolic of human aberration, observed in his use of Hippocrates as the central judge of others’ thoughts and behaviour, and (page 33) employs Bedlamite insanity to weigh the credibility of both language and understanding. Melancholy has assumed the preponderant, mischievous effects of the devil, placing unhappiness and madness as central to human experience. Madness and badness, of 49 Babb, Lawrence. Sanity in Bedlam. A Study of Robert Burton’s Anatomy of Melancholy. Michigan State University Press. 1959: page 2.

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individuals and society, are exhaustively connected. The devil and his minions no longer play such a causative part in human lives, there are no longer the ancient intermediaries between humankind and god. Melancholy can only (pages 70-71) be treated when the ideal society evolves, Christian and centralised.

In essence, Burton describes the results of social change: of the effects of social mobility, anxieties explicit in individualism, and the fragmentation of belief, greater selfconsciousness and concentration on human rather than godly nature. He separated, or began the separation, of experience from human nature, implicit in modern psychology. Life, death become absorbed in metaphors of pathology.

Although Shakespeare employed several ways of analysing behaviour, witchcraft (Macbeth), in Hamlet he presented an individual’s inner world, albeit through the metaphor of feigned and actual melancholia, communicating and dramatizing his own thoughts. In Chaucer behaviour is presented without interior motivation, expressing a concrete world cheerfully mocked but not deliberated over, while Hamlet provides the language and world of thought. He possesses interiority, and changes himself through his relationship to himself. 50 A new human being is here presented, conferring with himself not with god or the devil, fundamentally concerned with understanding himself and constructing a relationship with others’ motivations. It is from that relationship with ourselves that all the abstractions of mental illness, its reflected suffering, comes from in the present world, resituated by psychiatry into an external phenomenon. Bloom (1998: page 741) examines the possibility that according to a Dutch psychiatrist, J. H. Van der Berg, the birth date of the inner self can be traced further back then Hamlet, to 1520 when Luther, in a discourse on Christian Freedom, distinguishes the inner human from the physical one.51 From the 17th century, although of course this is a hopeless generalisation, the inner self became both fundamental and functioning, exampled by Hamlet: ‘his world is the growing inner self, which he sometimes attempts to reject, but which nevertheless he celebrates almost continuously, though implicitly’ (Bloom, 1998: page 405.) Hamlet’s mind is not simply self-evident, made public to the theatre audience, offered to their gaze, and exposed to examination by the audience, but it is fetishized, the origin of many and various responses: time, hero-worship, charisma, youth (although Hamlet is not that young), lust and the gamut of relationships.

50 Bloom, Harold. Shakespeare. The Invention of the Human. Fourth Estate. 1998.

51 In fact the inner human is implicit within Christianity, as Christ insists that thought as well as behaviour must be policed. From individual conscience came the mind.

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From these clear beginnings, the mind has now become the focus of physician and lay person alike.

Neely (2004) demonstrates that the two earliest English plays dealt with madness, connecting the behaviour of important characters to their responses to loss, grief and rage, referencing the ancient Roman dramatists but not their earlier Greek counterparts in Athens who employed extreme emotions and principles, usually within outsiders such as women, as drivers for their plays. In Gammer Gurton’s Needle Diccon the main character is portrayed, according to Neely, as a trickster figure who feigns madness and to others as a wise fool bringing difficult truths about character and behaviour to light. In essence, he is an outsider, disruptive, of no social role connected to the vagrants and nomadic thieves discussed in early parts of An Unusual Power. Causing trouble amongst the leading figures of a village he then ascribes madness to each when they respond to his lies. Neely (2004: page 31) states that Diccon’s ‘bedlam’ status is a metonymy for madness that is not outside but inside the normative social categories of ‘gender, class, sexuality, locale, and profession.’ Social order representing perhaps one illusion, if a commonly accepted one, and madness another, that of chaos, the outsider and truthfulness.

In Kyd’s The Spanish Tragedy, the main character, Hieronimo, and later Isabella, his wife, have become mad, or distracted, by their son’s murder. As in ancient Greek tragedy, clear reasons are given for the subsequent excessive behaviour and emotion of a principal protagonists. Although in the original form of the play, Kyd alluded to Hieronimo’s madness only once, later additions, perhaps by Ben Johnson, make it more central to the character’s actions. His madness is represented as a failure to grief properly and accept his son’s death.

While Isabella’s grief leads to her suicide, Hieronimo’s leads finally to recovery and action against his son’s murderers. Neely sees the play as developing understanding or identification of madness by presenting it as ‘inward, secular, self- generated’ (Neely2004:39). Madness is a matter of individual responses to recognised situations and conditions not due to outside supernatural intrusion into the world of the living. It is connected to a protagonist’s character, their ability to deal with difficult truths and reality. The madness highlighted in both these early dramas illumines real motives behind the cloaking of behaviour and motive that represents the social state, particularly of the growing ranks of the bourgeoisie towards whom Jonson’s satirical attacks were often directed. In addition, the mad characters take a subversive and heroic stance against the corrupt cultures around them.

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The theatre’s exploration of madness may not have been the norm in a society that was still intensely religious, with a profound belief in good and bad. The views of playwright’s may have been a response to social change, urbanisation, introduction of waged employment, greater interest in social order, and the growing belief that human beings were rational and controlled their own fate. Neely details (pages 47-48) the professional history of Richard Napier, still practising in 1634, minister, doctor and astrologer, many of whose patients believed their mental problems were caused by witchcraft. Napier administered combination remedies, reflecting medical, religious, and astrological practice. While Timothy Bright in his Treatise of Melancholy (1586) tended more towards secular explanations based upon natural causes. Edward Jorden’s A briefe discourse of a Disease Called the Suffocation of the Mother (1603), distinguishes between natural causes of distraction through uterine disease and ideas of witchcraft as a factor. Neely (48) suggests that all three were intent on legitimising the expertise of licensed physicians. Reporting of possession declined throughout the 17th century in England, as the new physician-based explanation very slowly became established and over time mental illness became more the province of the physician and not of the church.

Neely identifies a new portrayal of madness through theatrical discourse, utilising a ‘peculiar language’ (page 50) rather than through physiological symptoms, stereotyped behaviour and iconographic conventions. A language that is both coherent and incoherent, playful in aspect and rarely to the point. The speaker wanders around through various aspects of commonly shared culture, employing prose and poetry and whimsicality laden with meaning. In this language of alienation, intellectual control of meaning is never entirely lost.

In Shakespeare, according to Neely, this tool allows for the presentation of melancholy, feigned madness, female distraction in Hamlet, witchcraft in MacBeth, demonic possession, dementia and guilt-caused despair in King Lear.

In Hamlet the mad speech serves not only to display distraction, but to distract others from motivations and reasons for the feigned or real distraction, putting enemies off the scent.

It, like the examples above, throws light on other’s behaviour while avoiding or delaying confrontation. It is often employed to implicate, an internal dramatic devise like the play within a play, allowing a character to indicate other’s guilt without assuming complete responsibility. In this it is connected to Alan Mercer’s more recent TV plays on theatrically presented schizophrenia: Morgan: A Suitable Case For Treatment, and on theories of the message-laden nature of mental illness put forward by R. D. Laing.

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As Lidz (1976), who in other ways takes the psychiatrist’s view of madness as anything and everything habitually and emotionally excessive is therefore insane, notes, observers of Hamlet’s behaviour do not blame the usual reasons of the time for his insanity, such as witchcraft, possession, sin or humours, but to real-life events. Ophelia’s madness exacts the same response. That Hamlet’s madness is a plot devise, a strategy of the main character, is on the one hand indisputable but on the other appears caught up in genuine indecision and gathering sadness. He thereby feigns disturbance but at the same time is deeply disturbed by his mother’s sexual iniquities. His madness concerns not his own sin it seems, but that of others.

This book has considered how the flow of populations between countryside and town/city was negotiated and the need to continue to impose order on migrating groups will here also look at changes in 16th and 17th century social order and . The constriction of the mad person’s world, their restriction into ever smaller confines, was part of this urban evolution. Like barbarians at the time of the Roman Empire, as seen through chroniclers of the time, the mad represented the threat of wildness, freedom, the unknown and anarchy as well as being a cause for amusement. In literature, madness gradually loses its foreground presence, emerging, and why will be considered later, in weakness of mind in Dickens, and in incarceration of mad relatives in Charlotte Bronte’s Jane Eyre.

Witchcraft and its connection to madness: Through symbolic representation, witches occupied a number of references employed for the insane, such as otherness, appearance, and differences in thought and behaviour from society in general. Their association with wild mountainous terrain connected them to wildness and danger.

In 1484, prior to the period under consideration, Malleus Maleficarum, 52written by Fr. Henry Kramer and Fr. James Sprenger, was published in Latin. This dealt with the discovery and apprehension of witches and sorcerers and provided a text-book on the subject for inquisitors. Aside, but connected to madness metaphors, witches were regarded as revolutionaries who attached accepted social order, undermining all religious institutions.

Witches and sorcerers were regarded as elements of organised rebellion against Lords, 52 Walter Bromberg, From Shaman to Psychotherapist, 1975. Henry Regnery Company.

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Church and the natural order of things. The tome gave authority to the idea that mental illness was the result of demon-possession. It also connects women directly with evil as a consequence of their insatiable lust (Bromberg, 1975. Page 43).

As evidence of witchcraft grew exponentially, learned doctors published diagnostic treatises, allowing for conditions to be swiftly identified. The symptoms were presented as: resistance to medical diagnosis, loss of appetite, sexual impotency, languor and sudden mania (Bromberg, 1975: 46). A further sign was the evidence of skin blemishes, indicating points of contact with Satan. These beliefs were held by medical practitioners until 1700 and beyond.

Sir Thomas Browne was an advocate of the effects of the Devil on ‘humours.’ Inquisitors, tenderly and altruistically tortured their fellow man/woman in order to drive out intrusive devils and thereby save people’s bodies and souls. Even, of course, if it killed them in the process! For many centuries after the publication of Malleus Maleficarum witchcraft and the devil’s work was seen as an established scientific fact often taught alongside the science of physical causation. In 1584, Reginald Scot published Discoverie of Witchcraft claiming that what appeared as the consequences of witchcraft often had natural courses.

Although according to Bromberg (1975) increased literacy caused cracks in the mass illusion of witchcraft and the devil’s unruly intervention, events in Northern America and Europe testify that it went on with considerable energy throughout the 17th century. William Drage, both a practitioner and teacher of medicine, wrote in 1665 Daimonomageia: A small treatise of sicknessers and diseases from witchcraft, and supernatural causes…., which detailed a woman’s possession by two devils. She was sent to a Dr Woodhouse who ‘prepared stinking Suffumigrations, over which she held her head.’ The disgusting smell of the concoction reciprocating that of the devils, thereby like for like occasioning a cure. The woman then began making animal noises. As the processes of exorcism begun, the woman’s devils began to speak. On occasion, the devils ordered the woman to choke or drown herself.

Although Drage appeared unsure of possession, noting that the patient seemed able to act normally at most times, he acquiesced in the diagnosis.

Hunter (1982) notes that this narrative appears to demonstrate double consciousness or multiple personality disorder, although clearly the patient spoke and acted within a cultural framework and appeared often in control. Drage noted that the devils spoke in a different voice to the patient and would order her to dance, which she did. Drage points out that recently an entire convent was overtaken by a similar kind of possession. While any

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psychiatric tome will claim the patient’s behaviour as evidence of mental disorder, as does Hunter in Three Hundred Years of Psychiatry-1535-1860, this can also be seen as extreme acting out in, for the patient, a possibly repressive and manipulative environment. Drage, as doctor’s today, concentrated on the patient and accepted her behaviour as subject to dynamic external agencies rather than an example of active negotiation between the patient and her environment.

A number of books spreading the philosophy of empirical thinking do not mean that such an approach was widely employed. Clearly another perspective was emerging, with emphasis on the brain as the source of mental health, most noticeable in the work of Thomas Willis (1660). In the 17th century the mind of course was rediscovered in the works of Descartes, and became then on a matter for analysis and debate.

Broomberg, in a triumphalist heat produced no doubt by the discoveries of the 1960s and 70s, believed that by the 17th century supernaturalism as a means of understanding physical and mental illness was giving way to rationalism. While on the surface this seems true, I hope to demonstrate in later books that rationalism may not be as clearly defined as imagined.

The history of madness, as I previously indicated, involves more than the history of those organisations set up to deal with the social consequences of folly, a term Foucault preferentially employs as it carries with it assumptions of reason, and attempt an understanding and cure.

Domestication and gentrification: In order to better explicate the issues involved, I will also here look at ‘domestication’, an idea formed out of an archaeological perspective of the Neolithic. It was during this period that rapid, that is over several thousand years, urbanisation occurred. Cities emerged creating human corrals or pens. Within these, spatial concepts were formed, separating the city, a completely human environment, from the world outside of the city, denoted as wild and dangerous. From these long-developed notions we acquired ideas of chaos and stability, disorder and order. In The Myth of Mind and Consciousness I suggest that many of our present psychological and social traits were formed in this period.

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Prominent in creating understanding of domestication has been Ian Hodder53 who excavated Catalhoyak in Anatolia, the earliest yet discovered town dating back at least 10000 years. Domestication involves the emergence of agriculture, thereby domestication of plants, animals and human beings. Plants were changed to provide greater stability and nutrition for humans, pigs, sheep and cows subjected to eugenics, producing often smaller versions of their wild cousins. Symbolism, painting and relief sculpture, expressed the ideas behind domestication by symbolically controlling the wild, evidenced by the portrayal of dangerous animals within Catalhoyak and the nearby site of Hacilar. Hodder (1990, page 9) suggests that the interiors of homes had, and of course have, representational values, for example: male: inner (back) death and the wild: female: outer (front) life and domestic. One consequence of this was gender roles and generic personalities. Burials take place within the dwelling at Catal Huyuk, demonstrating the need to control death. Until recently in Western societies, women have been associated with kitchens, the back of the house, while men often controlled the living room, the front of the house, symbolising domestic and public roles within society. In suburban England, the husband dealt with the front garden, although peripheral plants, such as roses, might have been within the woman’s domain. If a man attended to roses, for example, he would have been expressing female attributes. Such symbolism sustained a ‘natural order’.

Conversely, Hodder suggests that female reproduction was linked to the wild and danger.

In fact, throughout ancient history, women appear to occupy the opposites of domesticity and extreme wildness/danger. For example, Lillith and Eve, Inanna, who represented sexual love and war, and also witches. The threatening nature of women in Greek plays, can be ascribed to their identification with the wild, deep, primeval, uncontrolled and uncontrollable forces, while in epics they are often presented as wives. This of course is a considerable subject that doesn’t necessarily lend itself to simple viewpoints.

As state apparatus grew, based upon order, it was necessary to eliminate or marginalise its opposite, which was threatening to both state and society in general. Whereas in medieval times, madness, with its several variants, was probably tolerated as part of the human condition, with the growth of the state in Europe, especially France, it became subject to control and restraint. The mad began to exist outside of society, becoming un-or-non-human, part of the ‘wild’, resistant to conformity and also non-producers. Over time a distinction was 53 The Domestication of Europe. Structure and Contingency in Neolithic Societies. Basil Blackwell Inc. 1990.

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made between being normal and being abnormal, symbolised by mental hospitals. Doctors acquired, almost by default, roles constructed upon authority and order, especially in the defining and treatment of madness.

In archaeology, post-sessessonal ideas are also concerned with the symbolic meaning of artefacts, spatial symbolism and how urbanisation constructed human psychology by introduced concepts of privacy and individuality. Although psychology, as just one example, tends to perceive human behaviour as subject to interaction with other human types, this may nevertheless present a limited approach that has as much to do with structured professional learning as with the reality of human minds and motivations. From the beginning of recorded history urban landscapes have played an important role in shaping human psychology, ensuring domestication of our specie as well as segregation into classes and roles. 54An individual’s built environment can determine their behaviour. A prison, for example, predicts and encourages certain behaviour of both prisoners and wardens. Like a frame around a painting, it shapes our views. The prison, and asylum, represents state control and order.

Although functionalism is itself limited in its perspective, it should also not be ignored when attempting to understand the emergence of modern concepts of mental illness.

London, for example, substantially changed during the 17th century from a city where rich and poor often inhabited the same space, to one where the rich were segregated from the poor.55 This involved the creation of the city’s suburbs, where the well-off began to reside. In medieval times the areas outside of the walls were largely inhabited by the poor and also by criminal elements, and in urban centres, such as Norwich, the city’s boundaries emphasised different mind sets, of stability and continuance, hard work and wealth, and instability and impermanence. The Domesticity and Wild dichotomy. By this reasoning, the way to contain the wild, criminals, rebellious or mad people, was to contain them outside of urban centres or, if within, in buildings that were little more than roofed walls.

By this reasoning, it is not surprising that fairs and the theatre took place outside of the city boundaries, although of course there are equally reasonable alternative considerations such as crowd control and the Elizabethan fear of mobs. Of interest is the fact that until recently those areas to the East and South of the city, were notoriously areas of criminal activity and for immigrant, usually marginalised, groups. London’s green areas throughout 54 Hodder, Ian. Ed. The Spatial Organisation of Culture. Duckworth, 1978.

55 Carr, Gregg. Residence and Social Status. The Development of 17 th Century London. Garland Publishing.

1990.

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the 17th and 18th century became subject to increased control, with unruly elements prevented from entering Lincoln’s Inn fields, for example, and these areas became civilised or gentrified. While in London the congregation of the wealthy in the western part of the city, Piccadilly, Holborn, can be explained as due to their desire to be near the court at Westminster, it was also a consequence of the urbanisation of landed gentry, and the identification of gentility with large urban open spaces.56 In such Brave New Worlds, criminals and mad people would not be wanted, bringing into such civilised spaces wildness, disorder and fear.

Although Foucault’s major thesis concerns opposing reason/unreason, the gentrification of Europe may also have played a major role in views of and treatment of madness. Within this social and intellectual construct, wildness was placed well out of sight, and gradually, more and more, including emotional excess, was re-constructed as wild and dangerous, requiring control.

In London, during the 17th century, Gregg Carr (1990: 159) asserts that not only location constructed gentrification but also aesthetic factors such as spaciousness, newness of houses and clean air. London attracted the country gentry who often acquired one or two rooms in order to be close to money and marriage markets, establishing themselves in Westminster. Of course into this growing pool of gentry arrived professionals to tender to their needs and assume some of their behaviour and status. Although I have already considered this process, principally in the first part of An Unusual Power, I will look at it again through contemporary eyes: ‘Ordinarily the king doth make only knights and create barons or higher degrees: for as for gentlemen, they may be made cheap in England. For whosoever studieth the laws of the realm, who studieth in the universities, who professeth liberal sciences, and, to be short, who can live idly and without manual labour, and who will bear the port, charge and countenance of a gentleman, he shall be called Master, for that is the title which men give to esquires and other gentlemen, and shall be taken for a gentleman.’ 57

56 Carr, Gregg, Residence and Social Status. The Development of 17 th Century London. Garland Publishing.

1990.

57 Sir Thomas Smith, The Commonwealth of England 1912. Page 27, quoted in Gregg Carr, 1990, page 164.

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Henry Kamen58 describes the term gentry as distinct from nobility in that the latter refers to a person’s outward rank, while the former refers to interior virtues that should accompany rank. Nobility, he comments, ‘could be bought and sold, but ‘gentility’ could only be inculcated’. Kamen stresses that the difference raised political issues about right to rule, whether by virtue of birth or through personal qualities. Although throughout the 16th century the argument predominantly lay with lineage, by the 17th century education and service began to take precedence, allowing thereby a greater place in government for merchants and civil servants. Becoming part of the gentry was already a route to becoming part of the ruling classes ensuring both a countryside and urban aesthetic that demanded order and peaceful surroundings, reflecting the internal values noted above.

The assumption of gentry’ values by modern society, and also by doctors, determined the nature of normality and thereby who is judged sane and insane. Although concerned with a much later period, Japonica Brown-Saracino, as editor of The Gentrification Debates, Overview: The Gentrification Debates, Routledge 2010, states that gentry implies a middleclass with shared recreational, buying, educational and housing values. This assessment can also be justified for the rising professional classes in 17th century Britain. Added to these factors, although not significantly different from the caste alliances of modern states, are construction of self, how individuals feel about themselves, and relationship to work or money. The relationship between gentrification and insanity/mental illness has become increasingly complex due to the introduction, for example, of psychotherapy. The spatial differences between gentry and poorer elements of 17th century London already expresses differences in power, and not just because of an increased closeness to the court. Those physicians closer to the court would express a power differential from those distant from the court.

Of importance to the establishment of gentry status were appearance, possessions, habitation, looks and dress, education, deportment, and these can be compared to the wild appearance, lack of apparent concern with goods and location of the insane. The gentry affect a calm method of talking, intent on elucidation, while the insane babble and rant. The gentry are emotionally ordered, while the insane are passionate. This of course simplifies much of the modern experience, but is symptomatic of the Early Modern World.

Conclusion: 58 The Iron Century. Social Change in Europe 1550-1660. Cardinal 1976, page 140.

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This brief introduction to insanity in earlier periods and the present, views it as symbolising sexual excess and emotional excess, incongruent response, and corresponding to any behaviour that takes an individual out of the community or opposed to the community.

Since the earliest periods of urbanisation, humankind has been subject to pressures of domestication, formed by space and the attitudes suited to re-constructed space, for example how the local authorities in Norwich established human behaviour within the city by ejecting those displaying unsuitable behaviour outside its walls or how London constructed zones of behaviour within its walls, establishing preferred behaviour in the western parts of the city.

Extreme behaviour is tolerated within a dominant context or narrative, but not tolerated if the behaviour is exclusive. In many medieval stories, the mad, those not included within the dominant social ideal, exist in woods and caves: in the wild, alongside outlaws.

While Galen, a Greek working in Rome, believed that humoral imbalance caused madness, Hippocrates seems not to have utilised a separate view of madness, bracketing nightmares and excessive, erratic behaviour together. In medieval times, madness was connected to sin and penitence, and involved acceptance or recognition of God. Demonic possession and madness were seen as the same, the cure often involving various kinds of punishment. Throughout these periods, instances of modern day psychiatric typology is difficult to find, while many of the attitudes of earlier periods are evident in modern psychiatry.

Madness depicted in Early Modern literature, usually throws a light on the behaviour of others, highlighting pride and sinfulness for example. The mad often expose the corruption of society and like Hamlet point to higher ideals, better forms of behaviour and glimpses of a more evolved self. While this can be seen as one side of humanism, the other side envisions those without reason, within society, as being like beasts. The wildness of those outside of society is thereby internalised, and madness is viewed negatively. The ugliness of wildmen and witches is transferred to the insane. The emergence of widespread gentrification requires that the insane, as with the poor, dirty and criminal be removed from specific localities and situated within parts of the city away from its civilised aspects. Images of the supernatural world appear to have fed into later images of the mad, coming to agonised fruition in later asylums and modern-day tabloids, both presenting the mad as uncontrollable, lustful and violent.

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The autonomy of Hamlet expressed a psychological change that created the concept of mentality, or mental energy. Before, individuals dealt with and understood the world through a number of interrogators, such as priests, holy books and various interpretations of god.

Thereby individuality was barely present except where status occurred, usually in relation to a dominant figure, such as a king, or through the publication of written material bearing claims of authorship. Mental energies were directed outward, expressing dependence on or intentions distinct from the group. Once human beings began the long lasting internal conversation with being, the gathering resonances created self-consciousness, the relationship with oneself, and forces that became the fodder of modern psychiatry.

Archetype

Religious worship

Aristocratic elite

Community

Family

Energies are directed outward, being resolved or not by external factors and forces.

Individual

Other individuals Own future World future Creative or formal productions

The individual’s energies are not contained by external factors and forces but are engaged exponentially with life-experiences, creating thereby abstractions and greater energies.

By the later 16th century, definitions of madness involved the law, and, also, often the state. Although Sedgwick (1982) holds that madness exists within a normative frame or ideal state and is not subject to context, he assumes that there is a direct link between the concepts of medieval and Early Modern views of madness and the present. He also invests observers and treaters of lunacy with a similar ideal form. A thought experiment may help at this

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juncture. If someone in our present society, if the reader is in the same society as the writer, has a fixed fascination with balloons, buying thousands, talking of nothing else, a physician would probably define such a person as suffering from mental illness. If the individual with such an apparently compulsive fascination suddenly enters another world where balloons are valued and employed everywhere, say for currency, their behaviour will occupy a normative frame. The physician, if they cannot develop a fascination with balloons, could then be deemed mentally ill.

This paper has described madness as a consequence of paradigms of wildness, the natural world, and of urban life representing order, but that does not invalidate its actuality.

Although many of thinkers, for example Laing, Szasz and Foucault, from the 1950s until the 1990s denied the existence or suffering of mental illness, this is not really an acceptable position. It exists but perhaps not to the degree and in the manner physician’s claim. The brain can become diseased, suffer faults at childbirth or before, or simply function in one way or another differently from the norm. But otherwise, the descriptions of present day psychiatric diagnosis fit more closely cultural construction. This work focuses on physician’s power, as noted by Foucault, and colonisation of mad treatments and thereby physician’s mind models, contrasting these with present philosophical and neurological viewpoints. How did physicians’ ideas of mental illness come to be the norm, and how much truth does the medical model contain?