Shakespeare and Mental Illness

Alan A. Stone, Touroff-Glueck Professor of Law and Psychiatry in the faculty of law and the faculty of medicine at Harvard University, in Psychiatric Times, March 12, 2013:

The ancient Greek dramas of Aeschylus, Sophocles, and Euripides gave Western civilization its foundational myths: Prometheus, Oedipus, Antigone, and the Oresteia. Two thousand years passed until Shakespeare arrived and, according to literary critics, achieved something perhaps more important: he “invented the human!”1 I think of this invention as the secular conception of the human condition. Yes secular! it is a vision of the moral adventure of life constrained by no religious orthodoxy.

Scholars debate whether Shakespeare was Catholic or Protestant. He often draws on both the Old and New Testaments of the Bible and the Book of Common Prayer, but God is missing from his greatest plays. Nonetheless, to paraphrase Simon Russell Beale, the great British actor, to perform in those plays is to experience “redemption and transcendence.” Shakespeare’s understanding of the human condition miraculously transcends his culture, time, and place…    

I have revisited the trial of Hamlet in a class I teach with Professor Alan Dershowitz—Justice and Morality in the Plays of Shakespeare. Again in a mock trial, I testified that Hamlet was sane. On this occasion, however, I saw the basis for my testimony in a completely different light than I had in the several previous public trials. Hamlet has 7 soliloquies in which he shares his innermost thoughts and feelings with the audience. It suddenly occurred to me that those soliloquies were as good or better than the information I or any other psychiatrist could obtain in prolonged anamnestic interviews. The soliloquies reveal the kind of insight, judgment, and reality testing we do not expect from patients with serious mental disorders. My friend, Fuller Torrey,15 likes to use the term “anosognosia,” suggesting a neural mechanism for the cardinal symptom of serious mental disorder. Whatever term psychiatrists use to indicate lack of insight, it clearly does not describe the Hamlet of the soliloquies.

Despite all this, I now consider my certitude about Hamlet an example of hubris. A mock trial it now seems to me is an invitation to narrow one’s perspective both on Shakespeare and on Hamlet. I recognized my failings in another defining performance of Hamlet. This one starring Michael Sheen and directed by Ian Rickson at the Young Vic in London. It was the first Shakespeare play Rickson had directed and his intentionally radical interpretation went against everything I believed. Denmark was a secure psychiatric hospital, Claudius was the nefarious superintendent, Polonius was a bumbling psychiatrist, and Hamlet was a disturbed mental patient. In the ghost scene, Hamlet lies down on the floor and out of his mouth comes the sepulchral voice of his dead father. Rickson had gone back to the psychological Hamlet, this time inspired by RD Laing16 and The Politics of the Family.

And Rickson’s idea of what is “rotten in the state of Denmark” is inspired by the 1975 film One Flew Over the Cuckoo’s Nest. Hamlet is being tormented under the aegis of psychiatry. Sheen and Rickson spent months brainstorming about the play, opting to abandon the “revenge Hamlet” and creating a new family dynamic conception. Their Hamlet hates his dead father but is locked in grief and projects his hatred onto his Uncle Claudius. They brought in psychoanalysts to help them think through all of the characters and their dynamic interactions.

It is tempting to simply dismiss this Young Vic version of Hamlet as aberrant, and many critics did. And I was certainly inclined to do the same. The production both attacked my understanding of the play and made psychiatry the evil force of oppression. But Sheen was brilliant as a mad Hamlet, and the soliloquies took on a new and different meaning. It was a stunning performance. This 21st century Hamlet demonstrated, once again, that there is no ultimate truth of the matter in Shakespeare. Hamlet says of Yorick, “A man of infinite jest.” Perhaps we can say of Shakespeare, a man of infinite human understanding and empathy.

Liah Greenfeld in Chapter 5 of Mind, Modernity, Madness:

It is… clear that Shakespeare regarded madness as a common enough aberration to juxtapose the truly mad Lear to Edgar pretending to be mad and both to the Fool, to have both Hamlet and Ophelia succumb to it, and to justify his frequent attention in other plays. It was an abnormality which was by his time becoming quite normal in England; the quip in Hamlet (Ham.:Ay, marry, why was he [Hamlet] sent there? 1 Clo.: Why, because he was mad: he shall recover his wits there; or, if he do not, it’s no great matter there. Ham.: Why? 1 Clo.: ‘Twill not be seen in him there; there the men are as mad as he) can be taken as evidence that Shakespeare, at least, thought so. It was, in fact, becoming the characteristic form of suffering, and he believed it to be related to the current state of society.  The time, as Hamlet put it, was out of joint. The instability of social relations, the unpredictability of personal ties which nothing seemed to hold together and which, therefore, rendered everyone insecure and unable to gain a firm foothold in society – in other words, anomie – are at the root of both Lear’s and Hamlet’s tragedies (as they are, too, in Macbeth and Othello). Remarkably, the one true villain, the one evil person in both (in distinction to the many ordinary people who are simply not good) — Edmund in King Lear and Claudius, Hamlet’s uncle, in Hamlet – is the product and the beneficiary of an anomic society. It is the self-made man, acutely conscious of his natural equality to those above him, whose place he ambitiously craves, and resentful of the social conventions that hold him to his place. He would not be so bound: resourceful, intelligent, and self-confident, but characteristically not particular about his choice of means, he breaks these conventions. Unprincipled ambition is not the cause of madness in either King Lear or Hamlet, but in Macbeth, for instance, it is, and, whether or not this passion for self-realization is directly responsible for unhinging men’s minds, it is always indirectly involved in this, for it is in a society which encourages ambition that madness thrives. Love thrives there too; it also must be free of social conventions and is focused on the self. Is it a wonder, then, that so often madness begins in it? The characteristic disease of the age, connected to its two governing passions and to the very nature of its society, madness is a factor whose interference in the course of human action an historian would be wise to suspect. Acutely attentive to historical forces, Shakespeare clearly considered it one. Both King Lear and Hamlet offer proof of this. It is Lear’s madness which leads to the war between Britain and France; it is the madness of Hamlet, moreover, the specific form of Hamlet’s madness, which, in the final analysis, delivers Denmark into the hands of Fortinbras.

Early American psychiatrists, of course, were not aware of the historical implications of Shakespeare’s treatment of madness. They did not know about the tremendous revolution which occurred in England in the 16th century, as a result of which God was banished and Man enthroned in His position. At least insofar as they were concerned, He was safely back in 19th century’s America and presided over history. They could not regard the human mind as the seat of historical forces. Thus they could not appreciate Shakespeare’s contribution to psychiatry fully. The fact that they were full of appreciation, nevertheless, allows us to treat his representations of mental disease in plays as clinical descriptions of it, which, since we have no clinical material dating to the late 16th century, is of no small importance. But Shakespeare’s work provides evidence of much more than the existence in England of the 16th century of precisely the kind of mental disorders that were observed in 19th century United States. It provides evidence that this kind of mental disease – madness – was a remarkable and yet unstudied, therefore recent phenomenon, that, however common already, it was spreading further, and that it was somehow correlated with other recent changes in the existential experience brought about by nationalism. Of course, we have plenty of other evidence for this: the changes in vocabulary; the introduction of legal provisions for the insane; the foundation and constant expansion of Bedlam; the growing preoccupation with madness in legal, religious, and especially medical discourse; the “epidemic” among Elizabethan intellectuals and the “abnormally extensive” use of insanity on the Jacobean stage. But, were Shakespeare not to focus on madness, all these data would have been palpably insufficient.  Shakespeare was, unquestionably, the greatest genius of the age, thus its keenest observer, capable of perceiving and assessing the true significance of the least conspicuous phenomena. Moreover, the purpose of his work, as he told us himself, and specifically of his work for the stage, was “to hold, as ‘twere, the mirror up to nature” and show “the very age and body of the time his form and pressure” – i.e. the understanding of his society. His neglect of, paying less attention to, or even different timing of his dramatic preoccupation with, madness would have been jarringly inconsistent with the rest of our case. The fact that the subject occupied him to the extent that it did and that it came to occupy him more in the last two decades of his life, after he had already considered at length national commitment and pride (in his historical plays, such as Richard II, Henry IV, and Henry V), ambition (in Richard III, Julius Caesar), and the new idea of love (in Romeo and Juliet) strengthens and completes this case, making it, in effect, incontrovertible. Shakespeare thus provides us not simply with important additional evidence, but with evidence that is crucial.


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