history, the real world today

Borderlands of madness

Demi-fous. Mazeland. Dazeland. Driftland. Incipient lunatics. Hysterics. Neurotics. Carriers of latent brain disease. Neurasthenia. Sufferers of high prevalence disorders. People with shattered nerves. Stressed out kittens. The traumatised. The burnt ones. Melancholics. The worried well.

There are so many names designating those who prowl in the borderlands between madness and reason. Some of these names are drawn from Andrew Scull’s Madness in Civilization: a cultural history of insanity from the Bible to Freud, from the madhouse to modern medicine (2015). Scull gives some account of the emergence of concern with this class of people during the nineteenth century. Numbers in the asylums swelled both because its cures did not work so well for many of the inhabitants who found themselves there for an enduring time, and perhaps also lived longer lives, as life expectancy grew during the nineteenth century. But also more people were drawn into the asylum, with the less extreme, less disturbed forms of illness.

Scull comments that there is debate on what lay behind this growth in numbers. Was it a real secular trend, possibly in response to forms of virus? Or was it merely an expanding diagnostic category that swept more and more into a category of concern. Another possibility that Scull does not consider is that perhaps it was a response to changing mental conditions through the nineteenth century, which placed a new strain and new premium on the soundness of the mind.

In any case, the culture and the world of medicine responded to the growth in numbers by devising new forms of treatment that would separate the severe and the moderate or even the mild. They developed sanitoriums, which Thomas Mann portrayed so ironically in The Magic Mountain, and rest cures, which the great Virginia Woolf was put on, and ultimately Freud’s own psychoanalysis for the hysterics and neurotics, who “suffer mainly from reminiscences” (Freud and Breuer Studies on Hysteria). They also raised a permanent mental  wall , at least in the mind of many health practitioners, between the experiences of the severely ill, those with serious mental illness, in the phrase that is still reserved for some, the psychotic, those with low-prevalence disorders and the troubled waifs who are worried, anxious, but do not have an organic problem.

Scull does not succeed in telling us about the experience of those banished from serious madness, always to wander the world uncertain of the name, the profundity, or the seriousness of their troubles. He tends, on my reading, to attribute the rise in diagnosis to the interests of the new profession, and behind that there is the old and odd implication of malingering weakness for the half-mad. Too weak to cope with life, they find a form of redemption in the false promises of cures from a new breed of therapies.

Still, however, he does see that Freud’s enormous cultural impact lay less in the specifics of his theories or the mixed success of his treatments, which were only ever accessible to a few, but in the fact that Freud:

“denied that madness was simply the problem of the Other. It lurked, it would seem, in all of us, at least to some degree. The same forces that led one to mental invalidism allowed another to produce accomplishments of surpassing cultural importance. Civilization and its discontents Freud proclaimed, were inevitably and irretrievably locked in an indissoluble embrace.” (Scull, p 289)

Madness and reason exist together in a misty fog of war. I was going to say they exist along a continuum, but I do not think they are so neatly arrayed, nor that anyone can be very certain at what degree of latitude their madness sits. And it is perhaps the scientific will to explain that keeps us from best knowing the the borderlands of insanity (a section heading from Scull’s chapter on the demi-fous, which  describes hysteria and the “complaints of those who crowded their [neurologists who preferred serious cases] waiting rooms …but [were] hard to pin down.” (Scull, p 274))

The will to explain breeds determinism, and all kinds of determinism have a difficult time with uncertain madness. Freud’s determinism drove him to find a royal road to the unconscious, and to invent an increasingly fanciful set of theories that pinned psychic life down to its earliest memories. Biological determinism has sought all sorts of organic explanations of the defective constitutions of the mad, and generated a murder of cruel treatments – lobotomies, insulin comas, leucotomies, teeth extractions and so on and so on. Neuroscientific determinism, currently fashionable, mistakes its pretty pictures of the brain for fixed events in a chain of causation. Social determinism finds all kinds of excuses in the social determinants of health, but only ends up nagging the poor mad to give up smoking in their cells.

So chance and indeterminacy are the madman’s friend. They do, after all, relieve the terrible burden of the genetic curse, and so free the self to live as if it were not who it is told and fears it must be.


Image credit: Antonin Artaud and his doctors – Les médecins Regis, Ferdière (les électrochocs) et Dequeker entourent Artaud à Rodez en 1946 – Artaud ce Mômo blog

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