Madness: A Brief History (8 page)

The truth on’t is, my Brain’s well fixt condition

Apollo better knows, than his Physitian:

’Tis Quacks disease, not mine, my poetry

By the blind Moon-Calf, took for Lunacy.

But Dr Allen (here dubbed ‘Mad-quack’) had informed him ‘that till he left making Verses, he was not fit to be discharg’d’. What did this prove but Dr Mad-quack’s folly? For poetry was neither the source nor a symptom of madness, but therapeutic; after all, wasn’t Apollo the god of both poetry and healing?

In Augustan culture, madness remained a favourite metaphor. By Swift, Pope, and other Tory poets and critics, the outpourings of Grub-Street hacks and ‘dunces’ were damned as deranged—they had no touch
of the divine about them, precisely because, far from being a gift from on high, their ‘inspiration’ welled up from their bowels. Their much-prized ‘afflatus’ was mere flatulence, issuing from diseased guts, or it came from what Pope called ‘a morbid secretion from the brain’. ‘The corruption of the senses is the creation of the spirit’, pronounced Swift in a dark aphorism. It was, in other words, only
false
and
contemptible
versifiers who were deranged: true poetry by contrast flowed from healthy minds: the Dean prided himself on being ‘a perfect stranger to the spleen’.

Great writers were cast as sane by an Augustan aesthetics which construed the artist not as a visionary but as a supreme craftsman. The mad poet lost his licence to conjure with words, and the Aristotelian trope of poetic melancholy was parodied in Pope’s
Dunciad
nightmare of Grub Street hacks skulking in their Cave of Spleen infected with the
cacoethes scribendi
and obsessed by ‘the power of noise’. Swift’s anti-heroes— the first-person unreliable narrators of
Gulliver’s Travels
and
A Tale of a Tub
—were garrulous windbags, full of themselves, compulsively and solipsistically digressing and lacking true self-awareness. The
Tale's
hero expresses the demented hope that he will eventually be able ‘to write upon nothing’. In his satires, Swift saw lunacy infecting Dissenters and free-thinkers, scientists and projectors, and his notorious
Modest Proposal
(1729), suggesting as it did that Ireland’s economic and demographic problems could be solved at a stroke by serving up babies for dinner, could have been written by a Lockean madman reasoning correctly from false premises.

Madness and genius

As if taking the hint, the poets of the age of reason generally did not seek to don the mantle of madness. The age held genius in esteem, to be sure, but found it in balance and good sense. While prizing originality, William Sharpe’s
A Dissertation upon Genius
(1755) and Edward Young’s
Conjectures on Original Composition
( 1759) read creativity as the outpourings of the healthy psyche, analogous to the growth and flowering of plants.

In their turn, Romantic poets worshipped the imagination as the noblest work of man. Denouncing the empiricist model of the mind identified with Locke as grossly mechanistic, William Blake pronounced that ‘art is the tree of life’. That visionary engraver and poet gloried in the idea of the mad artist, recording a dream in which the poet William Cowper ‘came to me and
said: “O that I were insane always. I will never rest. Can you not make me truly insane? ... You retain health and yet are as mad as any of us all—over us all—mad as a refuge from unbelief—from Bacon, Newton and Locke.” ’ But Blake was exceptional. Staking their claim for the poet as the legislator of humanity, the Romantics as a whole saw the writer not as psychologically peculiar but as truly healthy—indeed, Charles Lamb wrote an essay entitled ‘The Sanity of True Genius’.

This Romantic ideal of the heroic, healthy genius was later daringly or recklessly abandoned in
fin de siècle
degenerationism. Associating mental disturbance with various other illnesses (syphilis, tuberculosis) and vices (drinking, drug-taking), the avant-garde, notably in the Paris of Flaubert, Baudelaire, Verlaine, and Rimbaud, held that true art—as opposed to the good taste favoured by the bourgeoisie—sprang from the morbid and pathological: sickness and suffering fired and liberated the spirit, perhaps with the aid of hashish, opium, and absinthe, and works of genius were hammered out on the anvil of pain.

From the psychiatric viewpoint, the Italian Cesare Lombroso held that, as a breed, artists and writers were disturbed and perhaps in need of treatment. Along similar lines, J. F. Nisbet’s
The Insanity of Genius
(1900) offered a backhanded celebration of ‘men of letters
lapsing into or approaching insanity—Swift, Johnson, Cowper, Southey, Shelley, Byron, Campbell, Goldsmith, Charles Lamb, Walter Savage Landor, Rousseau, Chatterton, Pascal, Chateaubriand, George Sand, Tasso, Alfieri, Edgar Allen Poe’.

In his own way Freud perpetuated this
fin de siècle
stigmatization by deeming art the child of neurosis, which made Virginia Woolf fearful of his designs: psychoanalysis, if it worked, would toll the knell of the novelist. And the American poet Ezra Pound later accused the public:

It has been your habit for long to do away with good writers,

You either drive them mad, or else blink at their suicides,

Or else you condone their drugs, and talk of insanity and genius,

But I will not go mad to please you.

The breakdowns (sometimes followed by suicide) of such creative figures as Antonin Artaud, Nijinsky, Woolf, Sylvia Plath, and Anne Sexton further fuelled the mad/genius debate. ‘As an experience’, declared Woolf, ‘madness is terrific I can assure you, and not to be sniffed at; and in its lava I still find most of the things I write about. It shoots out of one everything shaped, final not in mere driblets, as sanity does.’ In our own time Kay Redfield Jamison’s
Touched with Fire:

Manic-Depressive Illness and the Artistic Temperament
(1998)—the reflections of a manic-depressive academic psychiatrist—and the writings of the neurologist Oliver Sacks show there is still much life in the ‘creative malady’ controversy.

Nerves

Meantime the cultural stereotype of the melancholic also underwent many modifications. Through such works as Richard Blackmore’s
Treatise of the Spleen and Vapours
(1725) and George Cheyne’s
The English Malady
(1733), the nervous, narcissistic valetudinarian became a fashionable if absurd Enlightenment figure. The Scot Cheyne identified his ‘English malady’, a form of depression, as the disorder of the elite in an advanced, prosperous, competitive nation: the pursuit of affluence, novelty, and elegance, and the enjoyment of the ‘good life’— excessive eating and drinking—exacted a heavy toll.

Doubtless with his own ‘case’ in mind—gormandizing at one point blew him up to 450 lbs— Cheyne noted that ‘
Great Wits
are generally great
Epicures,
at least, Men of
Taste'
. If the stimuli of the bottle and the table were needed in order to shine, no wonder the nerves became damaged.

13
A depressed scholar surrounded by mythological figures, representing the melancholy temperament. The main image shows a scholar with a knife behind him and a goddess with an apple (fruit of knowledge) before him. In the bottom left-hand corner is Minerva, goddess of wisdom, and at the top is an owl, one of her attributes. The price of wisdom is melancholy.

Sickness, held Cheyne, made terrible inroads into the sensibilities of those fine spirits blessed, or cursed, with exquisite feelings and hyperactive brains. The highly strung were spinning dizzyingly downwards. Fleeing
‘Anxiety
and
Concern',
they sought diversion in dissipation—
‘Assemblies,
Musick Meetings, Plays, Cards, and
Dice'
, which jeopardized their health. The irony (or cosmic justice), in short, was that it was the Quality, the social and literary elite, who were chiefly doomed to suffer: just as melancholy had once been ‘the courtier’s coat of arms’, now clodhopping peasants alone were spared the English malady.

In his
Treatise of the Hypochondriack and Hysterick Diseases
(1730), the Dutch-born practitioner and satirist Bernard Mandeville examined the kind of modish melancholy with which the elite liked to flirt, by means of a fictitious dialogue between a physician and a gentleman patient who explained how reading about illness had reduced him to hypochondria.

As the fashionable Bath doctor James Makittrick Adair declared in 1790,

Upwards of thirty years ago, a treatise on nervous diseases was published by my quondam learned and ingenious preceptor Dr. WHYTT, professor of physic, at Edinburgh. Before the publication of this book, people of fashion had not the least idea that they had nerves; but a fashionable apothecary of my acquaintance, having cast his eye over the book, and having been often puzzled by the enquiries of his patients concerning the nature and causes of their complaints, derived from thence a hint, by which he readily cut the gordian knot—
‘Madam, you are nervous
!’ The solution was quite satisfactory, the term became fashionable, and spleen, vapours, and hyp were forgotten.

From the eighteenth century onwards, polite society has continued to find in such ‘nervous’ disorders (the vapours, the spleen, and hysteria, now no longer viewed as uterine but as nervous in origin) a rich social idiom. While permitting display of superfine sensibilities, these complaints served as signs of social superiority, for the ailments were exclusive to truly refined temperaments. Such sufferers as himself, wrote James Boswell in the newspaper column he published under the pen name ‘The Hypochondriack’, might console themselves with the knowledge that their very miseries also marked their superiority. Far more vulnerable to ‘the black dog’ (depression) and anxious about what he deemed ‘the dangerous prevalence of imagination’, his friend and mentor Samuel Johnson thought him a silly ass for trifling with such nonsense. Soon George III was to be insisting that he was not ‘mad but only nervous’. Fashionable melancholy had a bright future ahead of
it in various incarnations. On both sides of the Atlantic, eminent Victorians sank or wallowed in hypochondria (mainly male) and hysteria (essentially for the ladies). By the
fin de siecle,
it was trendy to be ‘neurasthenic’, much as, in superior Manhattan circles, one might till very recently lose face unless engaged in ‘analysis interminable’ with a
chic
shrink. Private ‘nerve’ clinics, hydros, and spas sprang up for rich breakdown cases in Europe and America alike, paralleling the TB sanatoria in the Alps.

The glamorization of the gloomy genius had traditionally been a male preserve, as versified in John Milton’s
Il Penseroso
(1632) and Matthew Green’s
The Spleen
(1737). More recently, and perhaps as an ironic upshot of, or backlash against, the movement for female emancipation gathering momentum from the midnineteenth century, women have come to dominate the cultural stereotyping of mental disorder—and they have been disproportionately the recipients of mental treatments, both within and beyond custodial institutions. The autobiographical novels of Mary Woll-stonecraft (1759-97) developed the gothic image of the mad and/or victimized heroine; sentimental fiction popularized the Ophelia figure, the young lady disappointed in love doomed to a hysterical breakdown followed by an early and exquisite death; while the female maniac assumed prominence in Bertha Mason, the first Mrs Rochester (a ‘clothed hyena’) in Charlotte Bronte’s
Jane Eyre
(1847). Depressive, hysterical, suicidal, and self-destructive behaviour thus became closely associated, from Victorian times, with stereotypes of womanhood in the writings of the psychiatric profession, in the public mind, and amongst women themselves. Freud himself classically asked: ‘what do women want?’, and went on to diagnose penis envy. Classic hysteria, so common in Freud’s day, may also have disappeared, but it has perhaps metamorphosed into new and primarily female conditions, notably anorexia nervosa, somatization disorder, and bulimia.

The figure of Folly may have also taken her bow, but the original riddle remains: is the world mad, is civilization itself psychopathogenic?—the question, of course, posed by Freud’s
Civilization and its Discontents
(1926). And if civilized society is thus disordered, what right has it to pass judgement on the ‘insane’? Regarding his committal to Bethlem, the Restoration playwright Nathaniel Lee reputedly declared: ‘They called me mad, and I called them mad, and damn them, they outvoted me.’ The issue is still alive.

Before the asylum

The theory and practice of confining the insane in foundations designed exclusively for them came late. That is not, of course, to say that lunatics were till then exempt from regulation and control. Greek and Roman law sought to prevent them from destroying life, limb, and property, and made guardians responsible for them. ‘If a man is mad’, wrote Plato in the
Laws,
‘he shall not be at large in the city, but his family shall keep him in any way they can.’