Collective denial
In the winter of 1511, a woman named Alys Hendre of Kent is recorded in a parish register as having “talked overmuch with the wind.” It was not clear if the wind replied, though one cleric noted, “She laughs when it hushes; she turns when it turns.” This is the first case I can locate of prodromal modernity disguised as witchcraft. She was burned, of course—though the word madness had not yet gained diagnostic purchase. Her behaviour existed in the porous border between natural and demonic explanation, the very zone from which psychiatry would later harvest its authority.
By the late sixteenth century, the encyclopaedist Parson Whittle (whose Brief Declarations against the Stormed Head of 1582 survives only in fragments) had already noted that “there be melancholies who think their thoughts are foreign.” My students laugh when I cite him—it seems absurd that one could attribute estrangement to the devil’s whisper. But can one entirely disentangle the voice of possession from that of obsession? I have met modern patients whose auditory hallucinations use bureaucratic tones: we will assess your compliance shortly. The devil now wears an NHS badge.
In the seventeenth century, hysteria grows fashionable. Aphra Behn’s scandalous characters, railing against propriety, mirrored the clinical fascination with women who spoke too much or not enough. One physician, Dr. Elyard, wrote in 1698 that “the womb, having wandered to the brain, excites moral indiscipline.” He was serious. His casebooks (I saw them once at St. Bartholomew’s archives) reveal less about his patients than about the early ambition of medicine—to colonise the soul under empirical pretence. Science was not the successor to religion; it was its favourite imposter.
By 1723, the language of devils had been domesticated into “nervous disorder.” The prototypical insane gentleman was not wild but mannerly, morbidly courteous in his deviation. (One thinks of Lord Dutton, whose diary mentions “a perpetual odour of guilt like vinegar in the room.” His doctor forbade him reading Pope.) The asylum at Bethlem had begun its long conversion from a theatre of punishment to a theatre of experiment. It is difficult to say when curiosity replaced cruelty; I suspect they were never distinct species.
The Victorians, predictably, transformed insanity into character. They could not resist moral taxonomy. Stevenson’s Strange Case offered dirtier pleasures than most sermons, yet its real scandal was epistemic: the respectable body contained an unlicensed tenant. Psychopathology was narrative decorum’s revenge against theology. In the consultation rooms of the 1880s, erotic deviance and religious mania became professional delicacies. “There are only so many ways one can confess,” wrote the alienist Dr. F. G. Malloy in 1891, “and the most popular is to a doctor.” He misunderstood his own irony.
The early twentieth century brought psychoanalysis—initially Austrian, embarrassingly Viennese in its velvet articulations—but by the ’30s it had acclimatised to the English damp. The analyst’s couch replaced the confessional bench: a new furniture of guilt. I suspect we enjoyed it too much. My predecessor, Professor Whinmore, boasted in 1939 that he could detect neurosis “by handshake alone.” He died later by misadventure, having interpreted his own dizziness as an Oedipal symptom rather than impending collapse.
And yet the later century—my own—revealed the final irony. Once the Church had exorcised demons; now, the doctors exorcised meaning. Every passion was a syndrome, each unconventional ardour a “cluster B tendency.” The word insanity lost its scandal; it became administrative. In the psychiatric reforms of 1983, we spoke of “Care in the Community,” a phrase that still makes me shiver. We thought we were liberating them—the disturbed, the inconvenient, the vividly alive—but what we produced was a distributed asylum, the city itself made clinical. The difference between the witch’s stake and the case manager’s file note is only procedural.
By 1995, in the debris of psychoanalytic prestige, I began experimenting with digital diagnostics. A computer at University College claimed to infer “deviant emotional profiles” from word patterns. It judged Shakespeare’s Lear schizotypal, Blake mildly manic, myself “borderline grandiose.” I congratulated it. At least the verdicts were approximate to civilisation itself.
In one of my lectures, I have said—perhaps too often—that psychosis might be the last surviving form of sincerity. Insanity persists because it must; reason’s symmetry has always required a shadow. But unlike earlier centuries, we no longer grant madness the dignity of transcendence. It used to touch the divine, or at least the tragic. Now it is treated, charted, and discarded like obsolete software.
Still, I admit—privately—that I feel an unbecoming nostalgia for the era when insanity, witchcraft, and sin formed a single unstable category. Not because I believe in them, but because they believed in themselves. The theologians and witches at least shared a language; we moderns share only metrics. “Unwellness,” as a student once called it, has become our vernacular of estrangement. You can measure a culture’s terror by the precision of its diagnostic manuals.
Occasionally I wonder—again, privately—whether my own archive of cases constitutes a record or a confession. I perceive in their multiplicity something too familiar. Each patient, from 1511 to last week’s discharge summary, behaves as if rehearsing a role I have somehow forgotten. Perhaps that is the true continuity of insanity: performance mistaken for essence, metaphor mistaken for symptom. The very desire to understand them may be the oldest delusion of all.
It is tempting to close on some professional summary—the trope of “progress,” another name for collective denial—but I must resist. The mind’s history is not linear; it circles around its own disavowed origins. We have replaced exorcism with explanation, control with comprehension, but the hum behind both is the same: an unease that someone, somewhere, is laughing at the wind again.
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