Healing: prayers, sacrifices to Asklepios, god of healing
Drama
Aeschylus, Sophocles, Euripides
Madness often results as “Psychic civil war becomes endemic to the human condition” and introspection begins to dominate drama
Medea
Greco-Roman custom
Violence, cannibalism, grief seen as markers
No asylums; family responsibility for care
Fear of contagion from evil spirits (keres)
Cure for hysteria (“wandering uterus”): marriage
Idea of “melancholy genius”
Plato, Aristotle
Early Medicalization
Hippocrates (ca. 460-357 BC): natural explanation for epilepsy
“naturalization of madness”
“…the sacred disease appears to me to be no more divine nor more sacred than other diseases, but has a natural cause from which it originates like other afflictions. Men regard its nature and cause as divine from ignorance and wonder, because it is not like other diseases.”
Mania and melancholia: excitement/depression
Humoral theory (usually choler, black bile)
Melancholy madness sometimes seen as genius (i.e. modern ideas of bipolar creativity)
Plato
Timaeus, 375 B.C.E: Physiological cause of madness, therefore
possibility of treatment by medical means
Also, concept of “madness as a transcendental divine fire with
the power to inspire”
“Naturalistic Notions”
Galen!!
Mania: disease of yellow bile (the heart)
“hot” disease called for cooling treatment
Soranus
Mental illness caused by: “continual sleeplessness, excesses of venery, anger, grief, anxiety, or superstitious fear, a shock or blow, intense straining of the senses and the mind in study, business, or other ambitious pursuits”
Arataeus of Cappadocia (contemporary of Galen, 150-200 C.E.)
Descriptions of mental disorders (depression, mania, melancholy, bipolar disorders) and epilepsy
“one believes himself a sparrow; … or they believe themselves a grain of mustard, and tremble continuously for fear of being eaten by a hen.”
Criticized Dionysian frenzies as disgraceful
Greek ideas dominated medical thought for centuries, providing basis for medieval European and Islamic thought
Biblical Examples
Madness as divine punishment: Deuteronomy 6:5, “The Lord will smite thee with madness”
King Nebuchadnezzar
New Testament examples of Jesus healing demonic possession
Non-Western Antiquity
Hinduism
Goddess Grahi (“she who seizes”)
India
Dog-demon
Mesopotamia and Babylon
Spirit invasion, the evil eye, demonic power, breaking of taboos led to mental disorder
“If at the time of his possession his mind is awake, the demon can be driven out; if at the time of his possession is not so aware, the demon cannot be driven out.” ~Assyrian text, 350 B.C.E.
Early Christianity: “Holy Madness” vs. Diabolic Possession
Supernatural forces battled for possession, leading to despair, anguish, etc
“Madness of the Cross”- “ecstatic revelations of
saints and mystics”
But cause usually diabolic, spread by heretics,
witchcraft
Anatomy of Melancholy (1621): Richard Burton (Oxford): sick people particularly susceptible to Devil, “true author of despair and suicide”
Religious Treatments
Spiritual treatment for unclean spirits: masses, exorcism, pilgrimages (Catholicism)
Insane cared for in religious hospitals, houses
Prayer, counsel, Bible reading (Protestantism)
Madness as Heresy
Reformation and Counter-Reformation
Political purposes of diagnosis
“False doctrine and delusion formed two sides of the same coin: the mad were judged to be possessed, and religious adversaries were deemed out of their mind.”
Discovery of bacteria led to cures of syphilis, which caused mental illness
1920s: dubious trends
Electric shock therapy
Barbiturates and prolonged-sleep
Insulin coma (schizophrenia)
1930s: psychosurgery
Leucotomy: separation of frontal lobes and rest of brain
Lobotomy
18,000 by 1951
Often made patients submissive; some able to re-enter society
Well-meaning doctors, but criticized as overly aggressive
Methamphetamines came into use
1940s: penicillin!
1940s: penicillin!
Led to rise of pharmacology
1949: first psychotropic (mood-
influencing) drug introduced for
bipolar disorder
1950s
Anti-psychotic and anti-depressant drugs
Many could leave asylums under medical regimens with new drugs
Valium introduced 1960s
Prozac 1987
Increased serotonin created “feel-good” sensation
Within 5 years, 8 million people tried
Karl Menninger
Karl Menninger
“Gone forever is the notion that the mentally ill person is an exception. It is now accepted that most people have some degree of mental illness at some time.” (1956)
More attention on milder cases
Anti-psychiatry movement,
1960s and 1970s
Supported deinstitutionalization
Sources:
Roy Porter. Madness: A Brief History. Oxford, Oxford University Press, 2002.
