The Contested Nature of Madness: A Historical Perspective | Study notes Health sciences

Madness or Mental Illness? Revisiting Historians of Psychiatry- Gomory

Abstract

- Are the mad because of mental, physical, or environmental vulnerabilities?

- No scientific evidence for any theory of specific causes of madness

- A view of madness as a medical disease has been received concrete and rhetorical

support from the government mental health bureau, big pharma, mental health groups,

organized professions

- Historical “fact” about madness supporting the disease model are shaped by beliefs, bias,

error or ambiguous rhetoric rather than facts of the matter

Introduction:

- Medical historian Roy Porter notes our current definitions depend on the same

terminology used in the 16th century

- Porters definition of madness:

oA generic name for the whole range of people thought to be in some way, more or

less, abnormal in ideas or behaviours

oSuggests that the word does have utility

Capture within an apparently comprehensive category all those abnormal

people who significantly disturb society or themselves

oEven today there is no consensus upon the nature of mental illness

- Is madness a medical disease? A persons misfortune? Incompetent handling or greater or

lesser problems in living? Social labelling of deviance?

- The hypothesized causes, determinants, or contributing factors are as perplexingly varied

- Neither the many theories nor the implied causes of madness have been scientifically

validated

- Groups with enormous political, economic clout have taken up one theory about madness

in particular

oThe psychiatric medical model

Supported by the government mental health division, pharma companies,

mental health lobby groups, etc.

Madness as a Word:

- Madness as a word stitched together to represent or echo something related to human

behaviour or one’s perception of the behaviour

- Thought of the same type of word as “trees”

oServes as a label for collecting many disparate type of plants judged to belong

under the category tress

oThough these plants may share few common elements other than their category

name

- Disjunctive category

oAny two of its members each uniform in terms of an ultimate criterion may jab

emo defining attributes in common

- Words and categories matter

oCategorizing is a fundamental and necessary act of human survival

Helps people make sense and perhaps to respond and control the

mysterious nonhuman noumena

Makes up the “out there”

- Words do not have any fixed meaning or direct connection to material reality

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Madness or Mental Illness? Revisiting Historians of Psychiatry- Gomory Abstract

Are the mad because of mental, physical, or environmental vulnerabilities?
No scientific evidence for any theory of specific causes of madness
A view of madness as a medical disease has been received concrete and rhetorical support from the government mental health bureau, big pharma, mental health groups, organized professions
Historical “fact” about madness supporting the disease model are shaped by beliefs, bias, error or ambiguous rhetoric rather than facts of the matter Introduction:
Medical historian Roy Porter notes our current definitions depend on the same terminology used in the 16th^ century
Porters definition of madness: o A generic name for the whole range of people thought to be in some way, more or less, abnormal in ideas or behaviours o Suggests that the word does have utility  Capture within an apparently comprehensive category all those abnormal people who significantly disturb society or themselves o Even today there is no consensus upon the nature of mental illness
Is madness a medical disease? A persons misfortune? Incompetent handling or greater or lesser problems in living? Social labelling of deviance?
The hypothesized causes, determinants, or contributing factors are as perplexingly varied
Neither the many theories nor the implied causes of madness have been scientifically validated
Groups with enormous political, economic clout have taken up one theory about madness in particular o The psychiatric medical model  Supported by the government mental health division, pharma companies, mental health lobby groups, etc. Madness as a Word:
Madness as a word stitched together to represent or echo something related to human behaviour or one’s perception of the behaviour
Thought of the same type of word as “trees” o Serves as a label for collecting many disparate type of plants judged to belong under the category tress o Though these plants may share few common elements other than their category name
Disjunctive category o Any two of its members each uniform in terms of an ultimate criterion may jab emo defining attributes in common
Words and categories matter o Categorizing is a fundamental and necessary act of human survival  Helps people make sense and perhaps to respond and control the mysterious nonhuman noumena  Makes up the “out there”
Words do not have any fixed meaning or direct connection to material reality

Trying to define what madness really is, has been a failure o It is just ideas and behaviours
Unusual and scary behaviours that attract attention and elicit powerful emotions challenge people to account for their existence
Madness is a disjunctive linguistic category label
Mad has been a universal account for disturbing behaviours for hundreds of years o Linguist black hole that sucks in all peculiar human behaviour that society cannot digest or normalize but still feels compelled to explain in order to respond to it and control it
Word serves to instruct the normal that boundaries distinguish the mad from the rest of us
Mental illness was a residual category of deviance containing diverse behaviours that appear inexplicable to observers Some Problems with Historical Messengers
In the field of psychiatric historiography is reported to be passionate, partisan and polemical
Believe that most historian of madness accept that what is contained within the category of madness is best understood as a form of illness
Illness usually is understood as a medical term and some historians fully accept that madness is brain disease
Application offers wiggle room to historians who are unsure whether madness is physical disease but still feel that mental illness is illness
Scull o Considers madness as a literary or a philosophical concept not a physical illness o The boundaries of what constitutes insanity as liable and greatly influenced by social factors o Madness an illness but is not ready to declare that it is a natural feature of the universe
Some historians saw it as a primitive ignorance eventually gave way to the development and implementation of a scientific psychiatry through the key discovery that troubling and disturbing behaviours were medical disease
Some believe that the history of our responses to madness are far from being a stirring tale of the progress of humanity and science
Szasz: o Thought psychiatry was not a medical discipline to heal sick people but a policing profession because mental patients are not diseased o Management of madness was primarily political and moral endeavor o Metaphors of medicine act to convert state-supported policing activities of socially disturbing behaviour into medical interventions for a public health problem
Historical texts on madness use words like lunatic, crazy, mental illness, illness, mental medicine, psychosis o Formal medical definitions in contemporary medicine have consequences
Medical bias shapes the historical accounts Through Metaphors Darkly:
Many subjects are only spoken about in metaphors o Mind and God

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