Madness or Mental Illness? Revisiting Historians of Psychiatry

Abstract

Is madness medical disease, problems in living, or social labeling of deviance? Does the word merely refer to behavior peculiar enough to be disturbing? Are the mad mad because of mental, physical, or environmental vulnerabilities? No one knows the answers to these questions because there is no scientific validation for any theory or specific causes of madness. Nonetheless, a view of madness as medical/bodily disease has been receiving concrete and rhetorical support from the government mental health bureaucracy, Big Pharma, mental health lobby groups, the organized profession of psychiatry, hundreds of thousands of providers of mental health services and countless books and articles. This article explores the role that medicalized language and its use by seven noted historians of psychiatry (Norman Dain, Albert Deutsch, Gerald Grob, Roy Porter, Charles Rosenberg, Andrew Scull, and Edward Shorter) might have played in shaping the contemporary view of madness as mental illness. The evidence we uncover suggests that historical “facts” about madness, much as psychiatric “facts” supporting the disease model, are shaped by belief, bias, error or ambiguous rhetoric rather than the facts of the matter.