Madness: A Very Short Introduction First Edition

I highly recommend this study, which concentrates a larger historical scope, from the origins of the treatment of madness in Biblical times right up to the present, than one would normally expect to find between the covers of such a short book. The Oxford "Very Short Introduction" series is generally very good, but a number of the authors have deliberately limited their scope in order to write their books; the nevertheless very fine Peter Singer book on Hegel is a perfect example of this. Andrew Scull's main madman's progress is from the Eighteenth Century, the era of the roomfuls of shrieking mad in "Moral Lazar Houses," such as famous Bedlam, that we see in the movies, for example (anachronistically) in The Nun's Story with Audrey Hepburn, (though the nun does not guess what she is doing), to our time, when the "Reagan Revolution" has substituted drugs for treatment centers, or even therapy, and left masses of homeless on the streets of San Francisco and thereby created so much resentment of that man - a sense of which author Scull does not lack - who ruined life on the streets for sane and madmen alike. People who have never lived in the fair-weather capital of the homeless, yet can accuse us of being "San Francisco liberals," cannot understand how we feel as a result of what we are looking at on the streets every day. Though only a boy in the 1960s, two of the men in my family worked at DeWitt Mental Hospital in Auburn, California, and, fascinated and repulsed, I reluctantly joined my father a time or two while he drove the inmates around the campus, giving the more capable of them a chance to work. My uncle was a male nurse there, and then Reagan's "decarceration" movement (horrid term!) shut the place down. At the time the argument on the lips of the masses was that these institutions were abuses, where people did dreadful things to disenfranchise their own family members. Much later, hearing this same argument after decades, having endured hundreds of situations with Reagan's "sidewalk psychotics" I realized that there is a reply to this claim... now I ask "You mean there was a time when mentally ill people went from the safety of their family home, to the safety of an institution, without ever having to live on the street for a time in between?" But the Repugs just repeat their political catechism. In San Francisco there is probably no single political issue on which the populace is more in agreement than about the apocalyptically tragic effects of Reagan's "decarceration" of the insane.Scull observes that biobabble has replaced psychobabble (for just another moment "bipolar" might still be with us, but I loved it that Scull's "Further Reading" hints at the way this term plays into the designs of the psychopharmacology industry). Informed people will find it no surprise that the culmination of the book is Big Pharma, called that by Scull, which is now the most profitable industry of all time, and which, as Scull clearly and succinctly outlines, dictates far more medical and even governmental policy than is good for anyone except its own greedy self. For in psychotherapy as in every other kind of medicine, American doctors have allowed their discipline to let the treatment of symptoms suffice where once there was an actual search for a cure. Big Pharma and even the doctors are now in a clear conflict of interest: they are motivated merely to treat the symptoms of the sick, not to cure them. Or, maybe it is naïve to think that Big Pharma is really in any conflict about its interest. The American masses are arguably more betrayed in that trust in their healers than in any other walk of life. The argument that the cure will somehow fall into place if the psychological state of the patient is normalized through drugs is still evidently carrying the day, even though it renders quite glaring the hard-hearted Republican notions of "let the sick show some character and heal themselves." The task is no easier, even though certain illnesses such as hysteria and homosexuality have been "disappeared" from "the official lexicon" during the last two decades of the 20th century, though nevertheless "the number of psychiatric illnesses [has] metastasized." I would like any person in America to walk the streets of the San Francisco Mission or Tenderloin (or the "Soma") after ten o'clock any night to see whether they wouldn't apply the term "hysteria" to much of what they witness, and whether they wouldn't think it merits psychiatric treatment.Scull's mastery of the material seems to me admirable, for it is not merely historical or academic. He describes the way the treatment of the mad has morphed over the centuries right into our own time, how the houses of screaming mad have been transformed into a steady state of public and private madness absorbed into our very lifestyles, when government policy affecting many disciplines, not just psychotherapy, make it possible to infer that our world is far more shepherded and narcotized and pandered and "entertained" than very many of us are willing to realize, and how the nation has been driven into a political and cultural limbo where more and more people are affected and less and less is overtly done, until the fabric of our society is one big low-security mental institution. J.S. Bach may have been correct when he said in his Cantata 25 that "Die ganze Welt ist nur ein Hospital," but we shouldn't accept this state of things.Reading this book you may get some sense of how your own job or profession fits into the general picture of America as a hospital. I came to this shocking realization years ago, for just as my father drove patients around to participate on the campus, I now drive people around in my cab, and hear the varieties of genuine psychosis they express, to which I can only respond with distracting humor. This book helped me realize I am not wrong to believe that not only have we not gotten anywhere, the problem has spread everywhere, and I meet very few people in a week who aren't politely insane. Scull says "In California... prisons and jails have become the single largest purveyors of mental health care." And the morphing of professions within my own observation is consistent with this: that uncle of mine, who had been a male nurse at DeWitt, became a career guard at Folsom Prison. In practice, while we have told ourselves we have "decarcerated" the mad, we have only incarcerated some of them, and live elbow-to-elbow with the rest of them every day.I'm not just making some kind of "personal message" here. You will understand America a lot better if you read this book. As a people we really are in bad shape mentally, and we all need to be able to witness the situation from as great a degree of awareness as we can achieve.

Given the small space of these short introductions, the history of madness presented in this book feels thorough and cohesive, especially with regard to perspectives on madness, and the history of the insane asylum. However, I give it 4 out of 5 stars because it spends almost no time discussing what "madness" in all its forms actually is. For example, it mentions schizophrenia in a few "case studies," but doesn't go into detail about the condition itself. As mentioned above, this book focuses more on the history of madness and its cultural and scientific perception.However, I did enjoy the material presented, and felt that it was written in an organic, understandable, and interesting way. I only wish the book discussed madness itself in greater depth, and discussed what constitutes a "mad" individual more than just in passing, vague terms.

This book is an excellent examination of how mental maladies have been perceived and treated in western culture over the past 400 years. It describes how mental illness has been portrayed in the arts and the social stigmatisation of sufferers over that time.Of particular interest to me was the evolution of proposed causes and treatments as understanding of the body developed over the years. The underlying assumptions with respect to the cause of mental illness has links to religious beliefs which I found particularly fascinating. It also takes a brief but critical look at the financial incentives behind proposed pharmacological treatments in the last few decades.I would certainly recommend this book to anyone with an interest in the history of western culture.

I'm pretty fussy when it comes to books. Sorry if this sounds arrogant: but being fairly well read - I don't like wading through a lot of rhetorical fluff. This book only has about 2 chapters of it (insane people had it so hard, here's a bizillion examples to oversell the point), but the rest is substance describing the world view/mental framework under which madness (or mental illness) was viewed. Well worth reading.

The Very Short Introductions are just short enough to be a quick read and cover just enough information about the topic to keep it interesting. I recommend these titles.

It is more than an introduction to a part of our culture usually clouded by fiction.

Verk good

Andrew Scull approaches an enormous and compelling subject with remarkable clarity and concision without ever slipping into perfunctory analysis. That he is a leading scholar in the history and sociology of mental illness is immediately apparent, yet his account is wonderfully accessible and engaging for all. He is adroit in his articulation of the many paradigmatic shifts that have occurred in the understanding and treatment of mental illness. Nor is this a Whiggish account of uniform progress. He is appropriately robust in his handling of the pseudo-scientific Freudian mumbo-jumbo that engulfed psychology and psychiatry for far too long. The current hegemony of pharmacological approaches is also treated to a far from eulogic assessment. Perhaps the most appealing quality of Andrew Scull's excellent book is that it is mercifully free from the jargon and depressingly mechanistic theory-laden approaches that have frequently infected studies in the history of medicine.

While this contains some interesting facts and images, Scull's very short introduction to madness is maddeningly adjective - not content with giving us the facts, he jerks us about all over the place with directions concerning how we should interpret the data: how to interpret the data like him. Not being Scull, this was of little use to me, and just elicited frown after increasingly irritated frown. It would have been all very well had this been Scull on Madness - but an introduction, surely, ought to be an unbiased review of the facts (or an as unbiased as possible review of the facts). Like Lacan? Scull trashes him to bits. Have views of your own pretty much at all? Best hope they agree with Scull's, or it's going to be an uncomfortable ride.

This is yet another of the many “Very Short Introduction” books from Oxford University Press that I’ve been pleased to read and review. The series offers concise overviews of a wide range of topics that are presented by scholarly experts. This particular book is a historical examination of the changing approaches to mental illness from the ancient world where such a condition might be attributed to demonic possession to more recent times in which drugs and decarceration / defunding of asylums have become the dominant approaches to mental illness. Along the way the book shines a light on the immense difficulty experts have had in understanding what mental illnesses are and how they can best be dealt with. The book not only looks at the real-world response to mental illness, but also explores how it’s been treated in fiction from “Hamlet” to “One Flew over the Cuckoo’s Nest.”The book consists of six chapters. As one would expect of a book from a historian’s-eye view, its organization is chronological, but the arrangement of time periods by chapter reflects changing approaches to mental illness. Chapter one focuses on the ancient world, during which we begin to get glimpses of madness in the written record. Chapter two, entitled “Madness in Chains,” focuses on the 16th through 18th century, during which Bethlem [Bedlam] Hospital was the cutting edge. That the institution’s nickname becoming a synonym for chaos and confusion says a lot. It was a time of brutal measures that did little to reduce the trauma of mental illness. The chapter also discusses madness in Elizabethan literature, famously that of Shakespeare.Chapter three shifts to the 19th century, an era in which incarceration became more widespread as well as coming to be thought of as the best that could be done for the insane. In Chapter four, we learn about the rise of psychoanalysis as well as the increasing employment of treatments that involved the physical body – infamously, the lobotomy.Chapter five is one of the most intriguing parts of the book. Entitled “Madness Denied” it opens with an exploration of the difficulties that arose from all the war-related cases of mental illness that came about as a result of the two World Wars (and others.) It also discusses a movement to overturn the prevailing approach to insanity, most famously and vociferously argued by the Scottish psychiatrist R.D. Laing, a clinician who had a mix of promising and disastrous results from his experimental approach which used LSD, but few other medicines. What I found most interesting, however, was the discussion of the growing recognition that there was a false front in the idea that psychiatry was beginning to really understand mental illness and its treatment. This was exemplified by the Rosenhan experiments in which sane volunteers checked themselves into asylums and, for the most part, the doctors and staff couldn’t tell that they were sane (though, interestingly, in at least some cases the other patients did call it out.) The troubles in classifying and diagnosing mental illnesses have also seen in the vexed history of the “Diagnostic and Statistical Manual of Mental Illness” [DSM,] a guide meant to get mental health experts on the same page about what’s what. [As opposed to ten psychiatrists offering ten different diagnoses of a given patient.] While a worthy attempt, the DSM has not – thus far – succeeded, though it could probably be argued that progress has been made.The last chapter brings the reader up to the current period, a period dominated by two trends – first, mental illnesses being treated overwhelmingly pharmaceutically; and second, the closing of asylums and the concurrent ill-effects that have come about, societally speaking.The book has a few graphics, mostly black and white art and photos used to enhance the reading experience. There are also appendices of references and recommended readings.If you are interested in the history of psychiatric medicine, I’d highly recommend you check out this brief guide. It may not give you all the information you’re looking for, but it’s a good first stop to organize your thoughts on the subject.

Insightful! Wonderfully written & researched! Just inspires one to read more on this very interesting topic!!

Anyone wishing to have any gumption on what Madenss is should and must read thss splendid book..

loved it