The title of this post is distinctly ideological and, I believe, holds implications for a discussion of the medicalization of madness and mental illness. In my work as a PhD student in Musicology and Cultural Studies, I have seen similarities in how madness was depicted in the arts and medical texts of the seventeenth and eighteenth centuries. This similarity centers on the characteristics of disruption and dissonance. So far I have seen these properties associated with weakness, failure, degeneracy, and subversion of social order. My focus has been on seventeenth- and eighteenth-century England, though this does echo similar sentiments from Continental Europe. In art, madness is depicted as ugly and subhuman, degenerates who either wallow in their own shit or wander the streets causing havoc. Mad characters in literature, especially women, lose their ability to act and speak clearly, think of poor Ophelia in Hamlet. In opera, madness is depicted through dissonance and shocking changes, jagged or disjunct melodies, and harmonies that disrupt the flow of music with ugly and unusual sounds. These all resemble the descriptions of madness found in the influential treatises by Timothy Bright and Robert Burton of the sixteenth and seventeenth century. My work so far has focused on Hogarth's A Rake's Progress and Handel's Orlando, both of which are morality tales instructing the viewer and listener on behaviors that lead to a man's loss of sanity. In Hogarth's print series it is licentious behavior that was a sharp critique of the middle-class libertinism encouraged by aristocratic culture. In Handel's opera the great knight Orlando is ultimately to blame for his own insanity because he abandoned his duty to Charlemagne and pursued the love of a woman. Orlando is the Italian name for Roland, the subject of numerous heroic stories.
I would argue that these similarities, which are explicit in the Hogarth and Handel examples, represent a common sentiment in England during the first half of the eighteenth century that saw madness as exhibiting and being a manifestation of disruption and dissonance. The Enlightenment man's greatest virtue was rational thought. To lose the ability to be rational was to descend into a bestial state. The above examples aren't only about madness being a sin against the whole Enlightenment project. Gender is associated with madness through the influence of women on men. Class becomes an issue because it is essential to the proper ordering of social power and the nature of a civilized society. When a man of a high status loses his mind and descends to the behaviors of beasts, than he is no better than the poor man on the street that stank and spoke poorly and was prone to violence. These are some of the many implications of these morality tales. What's more, they resemble many of the narratives we see in the media today, but I'll return to this in a bit.
While there is no direct comparison between modern psychoanalysis and the practices of medical intervention in cases of mental illness three centuries ago, I find striking similarities in some key attitudes. First, we diagnose collections of behaviors as mental illnesses and decide that these represent abnormality. The term abnormality is an ideological one that assumes there is such a thing as a universal "normal." Second is the attitude that this collection of behaviors must have roots in biology. And third, we believe we can and should impose some kind of medical treatment on people exhibiting what we diagnose as mental illness. Now, technology has advanced exponentially since the time I focus on in my research. We have studied the brain in some detail and mapped the genome. Yet, we still haven't arrived at a clear understanding of how the mind affects the body and vice versa. We still seek genetic markers for psychological disorders and to explain behaviors that are disruptive. We still lock disruptive children away into special programs or schools and adults into special hospitals or prisons, all so the "normal" people are safe from their behavior, or so we don't feel uncomfortable with their presence in our environment.
To return to the implications of these things, let's look at the gun debate and the recent Charleston shooting. It was said in the liberal media that while black violence is described as a moral failing, as somehow endemic and natural to the culture and minds of black people, mass shooters who are white are much more likely to be described as mentally ill. This represents the inability of mainstream media to grapple with the image of white men and gun violence. It also contributes to the powerful stigma associated with mental illness; despite studies showing that mentally ill people are far more likely to be victims of violence rather than the perpetrators. In addition, the association of mental illness and disruptive behavior with social class and morality dehumanizes black and poor people while reinforcing the idea that middle class or wealthy people and white people possess a higher nature or are more human because they possess a rational mind others do not. Many other groups also suffer under similar processes of dehumanization. Homosexuality wasn't taken out of the main diagnostic handbook for psychotherapists until the 1970s. We associate behaviors and subhuman natures like those imposed on black and poor people with Latinos and immigrants.
We think of our science and medicine today as advanced compared to that of three and four centuries ago. Still, despite technological advancements, we cling to some fundamental principles that have not changed in the interceding years. What's more, many of our media narratives and the ways we speak about mental illness and mentally ill people today echo those same morality tales that arose out of that philosophy and medicine of so long ago. Why is this important? Because the ways madness and mad people were described then and now contribute to the real suffering of real people. The assumptions these principles allow to form or fail to combat continue to affect our struggles with structural racism and the politics of gun violence. Music only makes up a small part of this, but is a vital source of evidence documenting the beliefs and discourses of then and now. It is important that we understand the complex ways we construct and reproduce the narratives and discourses that oppress people and inhibit progress.