Time to begin with Camus

Before I come to the subject matter of this piece “An Abridged Bioggraphy of Madness let me make a bold even if controversial statement, most mad persons in the extremity of madness (whether dudgeon of depression, madness of mania or complexity of complex Schizophrenia) find life and living meaningless and contemplate Suicide and a large number of them annually die by suicide. Though suicide has complex etiology, suicide and madness are so interlinked that i call suicide the colonial cousin, rather sibling of madness.

And talking of madness, meaningless of life and suicide, takes me direct to the French Philosopher Albert Camus and his most famous essay “The Myth of Sisphus”. Camus, tells in the perface of his 1940 book “The Myth of Sysphus and Other Essays –

[The fundamental subject of “The Myth of Sisyphus” is this: it is legitimate and necessary to wonder whether life has a meaning; therefore it is legitimate to meet the problem of suicide face to face. The answer, underlying and appearing through the paradoxes which cover it, is this: even if one does not believe in God, suicide is not legitimate. Written in 1940 amid the French and European disaster, this book declares that even within the limits of nihilism it is possible to find the means to proceed beyond nihilism.. Although “The Myth of Sisyphus” poses mortal problems, it sums itself up for me as a lucid invitation to live and to create, in the very midst of the desert]

For Camus, even within the limits of nihilism it is possible to find the means to proceed beyond nihilism. And I posit even within the limits of boundaryless madness it is eminently possible to find the boundary of non-madness.

I will return to Camus and Suicide later. Ladies and gentlemen, boys and girls for now, let us visit and revisit the subject matter of – “An Abridged Biography of the Madness”. It will consume many parts of this series. Here is Part-A.

Mad in India and Their One Way Ticket to Hell

Michaux Henri Michaux a Belgian-born French poet, writer and painte renowned for his strange, highly original poetry and prose, and also for his art wrote in his 1954 book “Face aux verrous” famously “Those who hide their mad, die unspoken”. This is the true commentary on 21st century India were mad in homes or in society are ‘locked inside’ and and outside in society are made voiceless non-citizens with societal tag of mad, lunatic and insane, and with the Constitutional status of one with “Unsound Mind”. Being declared “of unsound mind” by a court in India is a one way ticket to hell, with no exit route.

Contemporary Conception of Madenss

I begin with the verbatim quote of Andrew Scull the foremost historian of Madness across civilizations. He says-

“They (the contemporary pshychatrists) dismiss these surface manifestations ( disturbed behaviours, emotions and cognitions of mad aka mentally ill) as so much epiphenomenal noise. Contemporary psychiatry has a very different view. Where an earlier generation of psychiatrists sought to disentangle and make sense of above their modern-day counterparts claim Madness, is brain disease tout court. Its origins lie in disturbances of the chemical soup that bathes our brain cells, in defects in our hereditary endowment or in some mysterious mix of the two. Breakthroughs in psychopharmacology are sought to repair these underlying somatic lesions and make the mad sane. The symptoms of madness (emphasis supplied) are of no enduring significance or interest, save as the surface manifestations of a bodily disease and the visible markers that permit the profession to identify the (very) many who need its interventions. Psychiatric treatments are resolutely directed at defective bodies, not unhinged mind”

I call the above complete biological reductionism of mad doctors turned psychiatrists completely sold out to American bible Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR current version) and in vice like grip of the pharma industry whose biggest sale and profit comes from medicines to ameliorate (or not) madness of all hues dismissing all psychological, behavioral, environmental and scoio-cultural factors as not only meaningless but utterly useless.

The Caveat once Again

Before moving further I again clarify and painfully so, I am no enemy of current genre of physiatry rather am a believer in evidenced based treatment even if not at the cutting edge they are trying to provide and without which millions mad of India would have been in a far worse state. Also, i am neither in truck with nor have any thing to do with those who dismiss mental illness as a myth or the social construction of a malevolent psychiatric profession (paraphrasing Skull) and though i have been ardent student of sociology and even the sociology of madness, I dismiss Szaszians who insist the current conception of psychiatry is the crazy calumnies of the Scientologists.

I do sincerely believe that biological and genetic factors have their own role in managing and treating madness, I firmly believe that the genesis of my own Manic Depressive Insanity, and unremitting Schizophrenia since 1990 of Richa, daughter of my friend Amrit Kumar Bakhshy (President Schizophrenia Awareness Association) have likely definitive biological connect and maker. But my bonafide informed fight is against the complete biological reduction of madness by today’s psychiatry in near total exclusion with all other determinants and influencers.

One thing with which I am in complete agreement is , the maxim that ” madness or mental illness remains “the most solitary of afflictions to the people who experience it; but … the most social of maladies to those who observe its effects” espoused by Michael Macdonald in the book “Mystical Bedlam: Madness, Anxiety and Healing in Seventeenth-Century England (Cambridge Studies in the History of Medicine, 1983)

But it was not Always the Case

Laure Murat wrote the now classic book, “The Man Who Thought He Was Napoleon
Toward a Political History of Madness”. She writes writes elesewhere about the revolutionary postulate of equality between the madman and non-madman. She writes that when Alexis de Tockville the French bureaucrat when he wrote his classic De la démocratie en Amérique ( Democracy in America) in the year 1835 it was an era  when the French passion” for equality was practiced within a society and within the context of a government (the July Monarchy) that had witnessed the triumph of a form of “alienism” based, in large part, on the revolutionary postulate of equality between the madman and the non-madman.

Talking of what biography of the madness makes me believe that once upon a time, a society was more modern than today which instead of shunning mad men and mad women believed in the now alien postulate of equality between the madman and the non- madman

Even in early 1980s when i first’ turned serious student of madness, though DSM-III that cast in iron the biological reductionism in the tautology of madness, one of the tenets of Sigmund Freud was still alive as a dominant paradigm in academic and among leading psychiatrists in America and Europe, and it believed that “Madness and meaning are intimately interconnected and intertwined” . In between the two biological revolutions in psychiatry there was a period if not of century then of decades when the psychoanalysis of Freud occupied the grandstand in the psychiatry in USA and America. Freud conceptions and doctrines of madness were fraught and had its flaws but it also had a sound basis, as Scull says ” if the origin of madness were buried in the in the recesses of human (un)conscious its cure likewise revolved around questions of meaning. It was by making the unconscious conscious and by re confronting meanings we had fruitlessly sought to repress that we could successfully overcome the demons that lurked within us. Madness was indeed all about meaning”

In part B of the Abridged History of Madness, i will talk of the influence of Freud and psychiatry’s subsequent fight with the ghost of Freud before moving back to the era of mad doctors and mad houses and the zenith of the first era of false promises of biological psychiatry.

Akhileshwar Sahay for the last five decades has been dabbling and digging beneath the history of madness across civilizations, the troubled story of madhouses, maddoctors, asylum, alienists and psychiatrists as a students and has now embarked upon the Odyssey of narratives of all that has happened. He is grateful to all the historians, sociologists, psychologists, psychiatrists and scientists who have tried to decipher madness before him..

…..To be continued , Stay Tuned for Volume 4, that will toruch upon Part- B of the Abridged Biography of Madness. Sahay can be reached out on Linkedin (Akhileshwar Sahay), his twitterhandle- @akhileshlinky and gmail id- akhileshwarsahay@gmail.com