
WHEN did mental illness become a stigma, something to hide away – even punish? There was a time when the intellectually challenged member of the village was tolerated. But that’s a far cry from the horror stories we read about in the 19th century and the condition that inmates had to endure in Bedlam. Even in the 20th century we had the terror of Electric Shock Treatment so well exposed in One Flew Over the Cuckoo Nest, and to the barbarism of lobotomies. Thankfully, things are a little more enlightened these days. However, as Dr Peter Kinderman writes in The New Laws of Psychology we still need a ‘wholesale revision of the way we think about psychological distress’. And he adds: “We should start by acknowledging that such distress is a normal, not abnormal, part of human life – that we humans respond to distressing circumstances by becoming distressed.”
So, it appears that there is still a long way to go. But it wasn’t always like this and we only have to recall Erasmus and his metaphor of the Ship of Fools in Praise of Folly to demonstrate this: “Then perhaps we shouldn’t overlook that folly finds favour in heaven because she alone is granted forgiveness of sins whereas the wise man receives no pardon.” (Of course folly is female and the wise male!). Then, of course, we have Dostoevsky’s ‘positively beautiful man’ who clashes with the emptiness of his society in The Idiot. And let us not forget the ingenious gentleman himself Don Quixote.

For Michel Foucault in his Madness and Civilization the last part of Erasmus’s tilt at the theologies and churchmen of his day is ‘constructed on the model of a long dance of madmen’. In this extraordinary book Foucault asks what it means to be mad and traces its history from the 1500 when insanity was considered part of everyday life, to a point when such people came to be seen as a threat and were locked away out of sight and out of mind. “Heavens above doesn’t the happiest group of people comprise those popularly called idiots, fools, nitwits, simpletons, all splendid names according to my way of thinking?” he writes.
According to Foucault it was the classical age that resolved to ‘silence the madness whose voices the Renaissance had just liberated’. He even identifies the moment in the 17th century when confinement became the defining element of mental disorder and combines with a ‘condemnation if idleness’. It was, claims Foucault, the royal edict of 27 April 1656 that ‘led to the creation of the Hopital General’ which set itself the task of preventing ‘mendicancy and idleness as the source of all disorder’, thus replacing leprosy as the great Other to be shunned and locked away. In this way work took on its ‘ethical meaning: since sloth had become the absolute form of rebellion, the idle would be forced to work in the endless leisure of a labour without utility or profit’.

Hence the pointless treadmill seen in 19th century prisons and here too is the start of equating poverty not with lack of resources but with idleness or the ‘weakening of discipline and the relaxation of moral’. We might also point to the late David Graeber and his identification of bullshit jobs in our own day – there just to provide work for the sake of working.
So it came to pass that where once madness and unreason ‘floundered about in broad daylight’ in less than a century it has been ‘sequestered and, in the fortress of confinement, bound to Reason, to the rules of morality and their monotonous nights’. Here we have a full frontal assault by Foucault on the Enlightenment or, as he calls it, the ‘age of reason’ which ‘confined the debauched, spendthrift fathers, prodigal sons, blasphemers…libertines’. It should be pointed out, of course, that the Enlightenment is often mis-portrayed as simply privileging Reason over all else, whereas many Enlightenment thinks were motivated by an acknowledgement that humans were often really rather irrational and it might be a good idea to introduce a little more Reason and a little less superstition. It’s interesting that Kant thought the Enlightenment was a like a coming of age for humanity. Nevertheless, this mis-characterization does not blunt Foucault’s main argument that the Lords of Misrule have been unjustly cut off from society and that too much emphasis can be placed on Reason to the detriment of our mad creativity. The mentally distressed were not seen as having any use except as a spectacle – and as late as 1815, for example, the ‘hospital of Bethlehem exhibited lunatics for a penny every Sunday’. And again: “Madness had become a thing to look at: no longer a monster inside oneself but an animal with strange mechanisms, a bestiality.”

Madness and Civilization is a paean to Unreason and the role it plays in human affairs. But Foucault is not alone. Nietzsche privileged the wild abandon of Dionysius over the cool rationality of Apollo and the former, it seems, has been dominant ever since. Nevertheless, it is possible to go to the other extreme – to over objectify and place too much emphasis on Reason. This was a problem explored by Iain McGilchrist in his classic The Master and His Emissary (which featured in a previous blog) in which he argues that the alienation and abstraction of the left hemisphere of the brain is seen in some circles as being superior to the worldly engagement of the right hemisphere. The answer seems to be not that we should privilege one side over the other but that we should try to unite the two. As McGilchrist writes: “Ultimately, what I have tried to point to is that the apparently separate ‘functions’ in each hemisphere fit together intelligently to form in each case a single coherent whole.”