Category Archives: Mental Ilness History

The Modern Mental Disease

By Liah Greenfeld

Modern humans—that is, people who live in societies such as ours, democratic, prosperous, relatively secure, and offering its members numerous life-choices, people like you and me, in other words—are different from humans who lived or live in other types of societies. We experience life differently from them: perceive reality differently and feel emotions that other humans did not have.

Human experience was revolutionized in the 16th century England. In the previous posts we have already discussed such new emotions as ambition, love, happiness, and their connection to the new form of consciousness, which came to be called “nationalism” and formed the cultural framework of modernity. Nationalism implied a special image of society as a sovereign community of equal members (a “nation”) and of reality in general. In its original, English, form it was essentially democratic. As it spread, it carried the seeds of democracy everywhere. Considering a living community sovereign (the source of all laws), it implicitly but drastically reduced the relevance of God and, even when combined with religion and presented in a religious idiom, which happened often, was to all intents and purposes secular. It was dramatically different, in other words, from the fundamentally religious, hierarchical consciousness which it replaced, and it shaped the way we live today. Among other things, the new consciousness made the human individual one’s own maker: it implied we had the choice to decide what we want to be; it dramatically increased the value of human life, encouraging us to realize it to the fullest extent—in other words, it gave us dignity and freedom. The society built on its premises of equality and popular sovereignty was an open society, in which the individual had the right to define one’s own identity, a society which made one’s identity one’s own business.  It is not coincidental that the new emotions discussed in previous posts, which emerged when the English society was redefined as a “nation,” were in some way connected to the individual’s ability to define oneself and that the two great modern passions—ambition and love—in fact answered a new need which this ability created: the need for help in identity-formation.

Unfortunately all these benefits of nationalism—the dignity, freedom, and equality, both empowering and encouraging the individual to choose what to be – did not come unaccompanied by costs, and for all the enrichment of our life experience contributed by love and happiness, these costs would be impossible to disregard.  The liberty to define oneself has made the formation of the individual identity problematic. A member of a nation cannot learn who or what s/he is from the environment, as would an individual growing up in an essentially religious and rigidly stratified, non-egalitarian order, where everyone’s position and behavior are defined by birth and divine providence. Beyond the very general category of nationality, a modern individual must decide what s/he is and should do, and thus construct one’s identity oneself.  Modern culture cannot provide individuals within it with consistent guidance, with which other cultures provide its members. By providing inconsistent guidance (for we are inevitably guided by our cultural environment), it in fact actively disorients us. Such cultural insufficiency is called anomie. Already over a century ago, it was recognized as the most dangerous problem of modernity. For many people, the necessity to construct one’s identity, to choose what to make of oneself, became an unbearable burden.

At the same time as the English society was redefined as a nation, and ambition, happiness, and love made their first appearances among our emotions, a special variety of mental illness, different from a multitude of mental illnesses known since antiquity, was first observed. It expressed itself in degrees of mental impairment, derangement, and dysfunction, the common symptoms of which were social maladjustment (chronic discomfort in one’s environment) and chronic discomfort (dis-ease) with one’s self, the sense of self oscillating between self-loathing and megalomania and in rare cases deteriorating into the terrifying experience of a complete loss of self. Some of the signs of the new disorder were similar to the symptoms of familiar mental abnormalities. In particular, the new illness, like some previously known conditions, would express itself in abnormal affect—extreme excitement and paralyzing sadness. But, in distinction to the known conditions in which these symptoms were temporary, in the new ailment they were chronic and recurrent. The essence of the new disorder, however, was its delusionary quality, that is the inability to distinguish between the inner world and the outside, which specifically disturbed the experience of self, confusing one regarding one’s identity, making one dissatisfied with, and/or insecure it, it, splitting one’s self in an inner conflict, even dissolving it altogether into the environment. Sixteenth-century English phrases such as “losing one’s mind,” “going out of one’s mind,” and “not being oneself” captured this disturbed experience, which expressed itself in out-of-control behaviors (that is, behaviors out of one’s control, out of the control of the self), and, as a result, in maladjustment and functional incapacitation.

None of the terms in the extensive medical vocabulary of the time (which included numerous categories of mental diseases) applied to the new mental illness; neither could it be treated with the means with which the previously known mental illnesses were treated. It required a new term—and was called “madness.” It also called into being the first hospital in the sense in which we understand the word (the famous Bedlam), the first medical specialization, eventually named “psychiatry,” and special legislation regarding the “mad.”  It is this clearly bipolar and delusional disease which would be three centuries later classified as distinct syndromes of schizophrenia and affective (depressive and manic-depressive) disorders.

We shall follow the history of this modern disease and analyze it in the following posts.

[Originally published on Psychology Today]

Love, Madness, Terrorism: Connected?

By Liah Greenfeld

In the 16th century, in England, several remarkable things happened:

Social mobility, inconceivable before, became legitimate and common;

The ideal of Romantic love between a man and a woman emerged and “true love,” as we understand it today, was added to the human emotional range;

The word “people,” which earlier referred to the lower classes, became synonymous with “nation,” which at the time had the meaning of “an elite”;

Numerous new words appeared, among them “aspiration,” “happiness,” and “madness”;

The English society, previously a society of hierarchically arranged orders of nobility, clergy, and laborers under the sovereignty of God and his Vicar in Rome, was redefined as a sovereign community of equals;

The nature of violent crime, personal and political, changed, with crime that was not rational in the sense of self-interested becoming much more common;

The attitude to pets, especially dogs and cats, changed, transforming these animals in many cases from living multi-purpose tools to our friends and soul-mates;

The pursuit of growth — rather than survival, as was the case before – became the goal of the economy;

Mental diseases which were later to be named “schizophrenia,” “manic-depressive illness,” and “depression” were first observed, shifting the interest of the medical profession, in particular, from other, numerous, mental diseases that were known since the times of antiquity.

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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…     Continue reading

The Cradle of Madness

By David Phillippi

In the same 16th century England which brought the world ambition and love (see Madness: A Modern Phenomenon), a new form of mental disease—madness—appeared. While previously known forms of mental illness were temporary, related perhaps to an infection, an accident damaging the brain, a pregnancy, a bodily illness like “pox” (syphilis), or old age, madness was chronic—usually appearing at a fairly young age (without evidence of an organic cause) and lasting till death. Another of its names, lunacy, reflected the suspicion of a physical cause—specifically implicating the waxing and waning of the moon in the periodic alterations in the character and symptoms of the sufferers. The word insanity entered English at that time too, apparently referring to the same phenomenon as madness and lunacy.

The chronic nature of madness made it a legal issue from the very beginning; the first provision in English law for mentally disturbed individuals—referred to, specifically, as “madmen and lunatics”— dates back only to 1541. Also in the middle of the 16th century, Bethlehem Hospital—more commonly known as Bedlam, the world’s first mental asylum—became a public institution, transferred to the city of London in 1547. While there was probably little to be praised in terms of humane treatment and comfortable accommodations, Bedlam continued to expand into the 17th century to meet what seemed to be a growing need to house the severely mentally ill.

Physicians of the day sought to describe and understand this new phenomenon, but their methods, sources, and interpretations were thoroughly mixed. Their reliance on classical Greek and Latin terms of mental disturbance resulted in a liberal blend of (their interpretation of) the old ideas with the new reality, and though they attempted to draw distinctions between conditions, they were far from clear. The cause was usually assumed to be organic. The common attribution of madness to an imbalance of the four humors shows the strong influence of the classical medical understanding. (The use of the term melancholy as a name for mental illness in general or a particular variety of it is a prime example). Insanity might also be explained by the stars under which one was born. Some authors distinguished between organic madness and spiritual madness caused by demonic influence. Still others focused on mental states that could in turn affect the body.

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Madness: A Modern Phenomenon

By David Phillippi

For most of human history, in most societies, identity was not something one had to go searching for – it was given at birth. For most individuals, the socio-cultural space relevant to their lives was easy to map out, and directions for proper navigation were well understood from a young age. Life may have been extremely difficult in the physical sense, but at least it was not confusing – people knew their proper place.

As Greenfeld has demonstrated in her first major work, Nationalism: Five Roads to Modernity, this changed in 16th century England following the War of Roses, which wrecked the nobility and left the rigidly stratified society of orders in disarray. In its place, a new consciousness emerged–nationalism–the modern consciousness, which redefined the possibilities for life in England and in the other societies to which it soon spread. We call this new consciousness nationalism simply because “nation” was the name given to the society in which it emerged by those 16th century Englishmen who first experienced its dignifying effects.

Nationalism is a fundamentally secular and humanistic consciousness based on the principles of popular sovereignty and egalitarianism. (Three distinctive features which most often take shape along with this consciousness are an open class structure, the state form of government, and an economy oriented towards sustained growth). At the beginning of the 16th century, someone among the newly elevated English aristocracy began equating the word “nation,” which had formerly referred to as a political and cultural elite, with the word “people,” which referred originally to the lower classes. This equation of “nation” and “people” both reflected and reinforced the new reality of English society, where the principles of popular sovereignty and egalitarianism made the nation and all its members an elite. No longer confined to a particular station in life by a closed societal structure ordained by Divine Providence, man became his own ruler, the maker of his own destiny. This elevation in dignity for every member of the nation meant that life in the here and now gained much greater importance–eternity was no longer the realm of the meaningful. This is the source of the secularism of modern society–God was not consciously abolished, but was essentially replaced by man.

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