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

The historical debates surrounding the nature of madness, questioning whether it is a medical disease or a social construct. The author discusses how the word 'madness' functions as a disjunctive category label, collecting various abnormal behaviors, and how historical accounts have been influenced by metaphors and biases. The document also touches upon the role of historians in shaping our understanding of madness.

What you will learn

  • How has the word 'madness' been used throughout history?
  • What is the historical perspective on the nature of madness?
  • What role have metaphors and biases played in shaping historical accounts of madness?

Typology: Study notes

2020/2021

Uploaded on 04/08/2021

juliana-mirkovic
juliana-mirkovic 🇨🇦

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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:
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