Normality and Madness

Different ways madness is understood

• Divine punishment or possesion

• Imbalance of humors

• Moral or ritual failing (plato, aristotle)

• Ritual (e.g. the Bacchic trance — liberate selves from problems by forgetting social norms)

• Ambiguous status, respected for connection to muses/supernatural forces (creativity)

Madness in medieval period

• Understood largely according to Galenic medicine (humors) or folk medicine

• References to frenzy, mania, melancholy, lovesickness, stupor, drunkennes, stupidity

• Taken as a person was not performing “normally”

14th, 15th C. Madness

• Demonic possession was viewed as important factor

• Also, eating melancholic food, drinking strong wine, suffering of soul

16th, 17th C. Madness

• Possession becomes sole explanation of madness under extreme circumstances (e.g. when the worst witch hunts were occuring)

Madness treatments

• Medicinal plants and herbs

• Charms, holy wells, relics

• Bloodletting, trepanation

• Care of insane fell to families, monasteries, parishes

• Violent were confined to asylums or house of correction

18th C. Madness

• The rise of mad houses

• Resembled prisons, overcrowded, poorly ventilated, minimal sanitation, harsh treatment, segregated from society, vermin infested, malnourished

• Treatments — Physical restraints, straitjackets, beatings, neglected patients

Great Confinement Era (Goals of asylums)

• Curing the insane away from poor families

• Confining socially undesirable people to protect society

• Great Confinement - made possible by new spaces for madness, led to poor, homeless, criminals being confined

• Led to socially undesirable people being separated from having freely chosen these lives (prostitutes, blasphemers, vagrants)

OVERALL AIM: Social order, separating the sane and insane with no emphasis on treatment or care

Enlightenment

• King George III experienced mental illness — his experience and remission showed that mental illness could be treated

• Madness became object of study, illness to be cured/rehabilitated

• Moral treatment emerges, by treating patients with compassion (able to move freely, no restraints, well-ventilated), they could be cured

Demise of moral care

• Human institutions became overcrowded, lost funding

• Moved to state-led care, which saw people back in straitjackets, bars, etc. to try and control or calm patients in asylums

• Difficult to tell difference between prisons and asylums

Women Institutionalized

• Wrongful institution, committed by family for unfair reasons: giving their opinions, being unruly, etc.

• Diagnosis - nervous exhaustion

• Enabled families to institutionalize their own kin for any behavior that was irritating or antagonistic

• Also, wives assets passed to husband if she was institutionalized, so many men did so for financial reasons

20th C. Therapies

1910s-1930s

Schizophrenia, epilepsy - deep sleep therapy, insulin shock therapy, electroconvulsive therapy

Psychosurgery - Ice Pick lobotomy

Force sterilization - Eugenics movement led to sterilizing inmates, ~6000 disabled babies, children, teens murdered by starvation or lethal injection

Deinstitutionalization

• Shortening stays, reducing re/admission rates, discovery of psychiatric drugs, research on asylums, lack of funding

• Increase in homelessness