On witch-hunts, hysteria, and modern psychiatry (an excerpt from the book “The Manufacture of Madness”)

Decided a few weeks ago to look through my books for information contained therein about “hysteria” or “histrionics” after recognizing the latter as an updated term loosely referencing the former which does indeed span back several centuries. Helps to keep in mind that one reason among many for why feminism originally sprang into existence had to do with combating that very label (hysteria) and the interventions used to “cure” witches (in this case, primarily women) of it.

Looking to Dr. Thomas Szasz’ book The Manufacture of Madness: A Comparative Study of the Inquisition and the Mental Health Movement (1970), beginning on page 69:

Perhaps unintentionally and unwittingly, the new vocabulary of psychoanalysis was thus combined with the traditional vocabulary of psychiatry, generating a rhetoric of rejection of hitherto unparalleled popularity and power. The result was that everyone’s conduct—living or dead, primitive or modern, famous or infamous—became a fit subject for the psychopathologist’s scrutiny, explanation, and stigmatization.

To be sure, by adopting this approach, psychoanalysts threw fresh light on certain important similarities between dreams and mental symptoms, the behavior of primitive man and his civilized descendant, myth and madness. In these ways, the psychopathological perspective enriched and extended our understanding of human nature and personal conduct. There was, however, a serious danger in this approach, which soon manifested itself. Because the observers and interpreters were psychiatrists, and because there were impressed by a need to make psychopathological diagnoses, all kinds of human behavior tended to be perceived and described as manifestations of mental illness; and various personalities, historical and living, tended to be seen and diagnosed as mentally sick individuals. The view that witches were mentally ill persons is an integral part of this psychiatric perspective.

The possibility that some persons accused of witchcraft were “mentally ill” was entertained already during the witch-hunts, notably by Johann Weyer. In his dedication of De Praestigiis to Duke William of Cleves, Weyer writes: “To you, Prince, I dedicate the fruit of my thought . . . none so agrees with my own [view on witchcraft] as does yours, that witches can harm no one through the most malicious will or the ugliest exorcism, that rather their imagination—inflamed by demons in a way not understandable to us—and the torture of melancholy makes them only fancy that they have caused all sorts of evil.”

Is it a coincidence that the suggestion that witches are mentally deranged comes from a physician opposed to their persecution? Or is this hypothesis itself a weapon in the struggle against the witch-hunts? The evidence strongly suggests that it is the latter: that, in other words, madness is an excuse for wrongdoing (witchcraft), put forth by an authority (Weyer) on behalf of oppressors (inquisitors) deaf to all pleas but this one (insanity). Many contemporary psychiatrists openly profess this aim. Instead of protesting against the death penalty itself, they promote the concept of insanity as a “humanitarian” protection for defendants who, without the insanity defense, might be put to death.

This ostensibly lofty aspiration of saving the defendant from execution was the motive behind the important M’Naghten decision, in 1843. Known as the M’Naghten rule, this decision has ever since provided the medicolegal basis for the insanity plea, the insanity defense, and the insanity verdict. In modern psychiatric texts the insanity defense is thus invariably attributed to the “discoveries” of “scientific” psychiatry; and its recent burgeoning popularity, in this and other Western countries, to the long-overdue legislative and judicial appreciation of the supposed “contributions” of psychiatry to the administration of the criminal law. This view is completely at odds with the facts. More than three hundred years before M’Naghten, when there was no such thing as “modern medicine,” much less anything that could even remotely be called “psychiatry,” the insanity defense was an accepted plea in witch trials before the Spanish Inquisition.

“The insane were recognized as irresponsible,” writes Lea, “and were sent to hospitals. . . . In the enlightened view taken by the Inquisition regarding witchcraft, instructions of 1537 indicate a disposition to regard reputed witches as insane . . . Barcelona at the time had on hand a witch named Juanita Rosquells, whom the physicians and consultors considered to be out of her mind; not knowing what to do they referred to the Suprema, which ordered her discharge . . .” This outcome, however, was unusual. As a rule, persons declared insane were incarcerated in a monastery or hospital.

The physicians most responsible for classifying witches as mental patients were the celebrated French psychiatrists Pinel, Esquirol, and Charcot. They were the founders not only of the French school of psychiatry but of all of modern psychiatry as a positivistic-medical discipline. Their views dominated nineteenth-century medicine.

Philippe Pinel (1745-1826) believed that witches were mentally sick individuals, but he did not dwell on this subject. In his Treatise on Insanity (1801), he asserts, without discussion or demonstration, that “In a word, demoniacs of all description are to be classed either with maniacs or melancholics.” And he dismisses Weyer as a victim of the belief in witchcraft: “The credit attached to the impostures of demoniacal possessions in the writings of Wierus [Weyer] are not to be wondered at, when we consider that his works were published towards the middle of the seventeenth century, and bear as much reference to theology as to medicine. This author . . . appears to have been a great adept in the mysteries of exorcism.”

Jean Etienne-Dominique Esquirol (1772-1840), Pinel’s student and intellectual heir, did more than any other man to establish the view that witches were mentally deranged persons. The most influential psychiatrist of his age, Esquirol believed not only that witches and sorcerers were mentally ill but also that (all or most) criminals were similarly afflicted; and he advocated that lawbreakers be treated by incarceration in mental hospitals rather than prisons. Modern psychiatric historians and forensic psychiatrists have borrowed these ideas from him. “These conclusions,” writes Esquirol in 1838, “may appear strange today; some day, we hope, they will become popular truth. Where is the judge today who would condemn to the bonfire a deranged man or gypsy accused of magic sorcery? It has been a long time now that the magistrates have sent the sorcerer to an insane asylum; they no longer cause them to be punished as swindlers.”

Esquirol’s views on witches were widely accepted by nineteenth-century scholars. Thus, Lecky, his his classic History of European Morals, repeats Esquirol’s diagnoses as if they were self-evident truths. He characterizes witches as “decrepit in body and distracted in mind,” and attributes their frequent suicide to “fear and madness [which] combined in urging the victims to the deed.” Describing a victim of the Spanish Inquisition in 1359, Lecky writes: “The poor lunatic fell into the hands of the Archbishop of Toledo and was burnt alive.” Commenting on the witch mania and on “epidemics of purely insane suicide,” such as occurred sporadically in Europe between the fifteenth and seventeenth centuries, even Lecky blandly asserts that these problems “belong rather to the history of medicine than to that of morals.” Nothing, in my opinion, could be further from the truth.

In the hands of Jean-Martin Charcot (1825-1893), witchcraft became a problem of “neuropathology.” In his obituary of his great teacher, Freud writes: “Charcot . . . drew copiously upon the surviving reports of witch trials and of possession, in order to show that the manifestations of the neurosis [hysteria] were the same in those days as they are now. He treated hysteria as just another topic in neuropathology . . .” Like Esquirol, Charcot took the witches as he found them defined by their tormentors, and proceeded to study their “neuropathology.” And so did Freud. In his hands, however, witchcraft becomes a problem of “psychopathology.”

In his obituary of Charcot, Freud proposes “the theory of a splitting of consciousness as a solution to the riddle of hysteria,” then reminds his readers that “by pronouncing possession by a demon to be the cause of hysterical phenomena, the Middle Ages in fact chose this solution; it would only have been a matter of exchanging the religious terminology of that dark and superstitious age for the scientific language of today.” This is an astonishing admission: Freud acknowledges that the psychoanalytic description of hysteria is but a semantic revision of the demonological one. He thus tries to legitimize his metaphors by claiming that they form a part of the language of science when, in fact, they do not.

The demonological conception of hysteria, and Charcot’s quasi-medical reinterpretation of it, made a profound impression on Freud. He returned repeatedly to this theme. “What would you say,” he asks Fliess, in a letter dated January 17, 1897, “. . . if I told you that the whole of my brand-new primal theory of hysteria was well-known and had been published a hundred times over—several centuries ago? Do you remember how I always said that the medieval theory of possession, held by the ecclesiastical courts, was identical with our theory of a foreign body and a splitting of consciousness? . . . incidentally, the cruelties make it possible to understand some symptoms of hysteria which have hitherto been obscure.”

We see Freud here taking the decisive leap into psychopathology: he accepts the officially identified patient as a patient and proceeds to examine her for symptoms. First, he lays proprietary claims on the psychopathological interpretation of possession developed by the French school of psychiatry; then, he proceeds to disregard the cruelties inflicted on the witches as indications of the human character of the persecutors, and of the social nature of the times, and interprets them instead as part of the symptoms exhibited by the “patients.”

Thirty years after publishing his obituary of Charcot, Freud returns to the similarities between the demonological theory of possession and the psychoanalytic theory of hysteria. “We need not be surprised,” he writes in his essay on “A Seventeenth-Century Demonological Neurosis,” “to find that that, wheras the neuroses of our own unpsychological modern days take on a hypochondrical aspect and appear disguised as organic illnesses, the neuroses of those early times emerge in demonological trappings. Several authors, foremost among them Charcot, have, as we know, identified the manifestations of hysteria in the portrayals of possession and ecstasy that have been preserved for us in the productions of art. . . . The demonological theory of those dark times has won in the end against all the somatic views of the period of ‘exact’ science. The states of possession correspond to our neuroses . . . In our eyes, our demons are bad and reprehensible wishes, derivatives of instinctual impulses that have been repudiated and repressed.”

Here Freud asserts that the cultural climate in which people live determines the overt symbolic form of the “neuroses” they develop; but he stops short of entertaining the possibility that they also determine which persons assume dominant roles as persecutors, and which are cast into submissive roles as victims. He thus shuts the door on a broader, cultural-historical perspective, not only on “mental illness,” but on psychiatry itself; and on the view that society not only shapes the symbolic forms of the madness it creates, but determines the very existence, direction, force, and output of this manufacturing process itself.

[Italicized emphases his; bold mine. Footnotes omitted.]

Stopping there on page 75 today.

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