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domenica 20 maggio 2012

Podvoll: Percival's courage


Chapter 1 
Percival’s Courage 
I open my mouth for the dumb . . . I entreat you to place yourself in the 
position of those whose suffering I describe, before you attempt to discuss 
what course is to be pursued toward them. Feel for them; try to 
defend them. Be their friends—argue not hostilely. 
H E R E S Y 
Walking in the rain on the fogbound beach of Port Glasgow, he knew he 
was converted. He got what he had come for, but he never expected it 
would be so sensible. From the top of his head, running downward 
through his whole body, he felt a “spirit” or a “humor” infusing him, 
washing him with a benign influence. Its effect caused the most “cheerful, 
mild, and grateful peace and quiet” that he had ever experienced. 
How could he have doubted this gift? He did, and then he didn't; he 
went back and forth in an intense agony of indecision. But he wanted it to 
happen. He had come to this coastal town

in northern Scotland in dreary September weather to explore extraordinary 
psychic occurrences that were widely rumored to have been happening 
here. It was a scandal to the church, known as the Row Heresy. At Port 
Glasgow, and just across the ferry in Row, a small congregation of evangelical 
Christians were “speaking in tongues.” After leaving the university 
at Oxford, it had taken Perceval three months of traveling to get here. 
Now, among them, in their inspired presence, he wanted this divine gift of 
the Holy Spirit that the others seemed to have. When it came to him, it 
came in great surges, it undermined his nervous system and disordered 
his mind, and for the next forty years he would struggle with the experience 
of insanity. 
John Thomas Perceval (1803-1876) was a Victorian English nobleman, 
and even though he was the son of a beloved prime minister of England he 
was confined to an insane asylum against his will at the age of twentynine. 
He largely recovered from psychosis during the first year of hospitalization 
but was not released until two years later, at which point he 
began to devote his life to telling the hard-won truths of his experience: 
that recovery is possible, and how it is possible. It was with this confidence 
that Perceval saw through the mechanisms of insanity, and cracked 
the code of his bondage to psychosis. 
Interest in, even fascination with, the mind of psychosis never seems to 
end. Its origin and intriguing peculiarities have been discussed and written 
about by madmen and healers since the beginning of time. Philosophers, 
psychologists, scholars, and saints of all kinds continue to 
speculate about it. Yet, the experience of psychosis maintains an ageless 
impenetrability. Always, there are hints and suggestions that in knowing 
the mind of psychosis one will come to understand some of the mind's 
most fundamental and powerful energies. But psychosis is an endlessly 
interesting dark corner of the mind, which, when once illuminated, might 
change one's vision of the whole room. This was the experience of John 
Perceval, and of every other character of this book. 
The outward story of Perceval's psychosis is quite familiar and surprisingly 
up-to-date. He was a college student who gradually turned all his 
attention to his spiritual development because it added a richness and 
meaning to his otherwise dull and constricted life. He became an enthusiast 
and follower of a religious sect that practiced exercises in “transcendence,” 
or enlightenment. In a short time, he became covetous of spiritual 

experiences. He was insistent on trying to intensify the altered states of 
consciousness that different mind-altering practices brought about in 
him. Eventually, he came to endure oscillations between the ecstatic and 
terrifying experiences of living in heaven and hell. 
He was immediately hospitalized by his family and treated for almost 
three years under court order at two prestigious hospitals. His condition 
worsened for some months, and he alternately lived in a state of complete 
compliance to, or else in defiance against, “command hallucinations.” 
During the last year of his hospitalization, he became single-minded in 
obtaining his release from the hospital, and he vehemently opposed all 
attempts made to treat him. Finally, he gained his release “against medical 
advice,” only after threatening just about everyone connected with his 
treatment with negligence and malpractice prosecution. 
Similar stories can be found among the medical records of countless 
young people who have lost control of their minds. In this way, the story 
of John Perceval becoming insane is a parable of madness. 
But, the inner story of John Perceval is unlike most others. Singlehandedly 
he accomplished a dangerous path through recovery from psychosis, 
and in his great energy of determination to document his return to 
sanity he kept a daily journal. Then he published it against the bitter 
objections of his family and the medical authorities. After 150 years of 
obscurity, Perceval's writings were unearthed by Gregory Bateson, and 
they are as fresh and urgently relevant to our times as when they were 
first written.1 
In Perceval's time, psychosis was believed to be incurable, or beyond 
anything but minimal repair; in any case, one was lost to the world. Perceval's 
indomitable hope was that the destructive beliefs about psychosis 
could be undone by a true, in-depth understanding of psychotic mind. Yet 
learning from Perceval's experience brings one to the border of heresy; 
one has no choice but to become involved with what he called the “magical” 
and “miraculous” dimensions of psychosis. 
This degree of inquisitiveness into psychosis is not the same for everyone. 
Many authorities in the field of treating highly disturbed people do 
not want to know of the vivid, brilliant, and often majestic moments of 
psychotic mind. They feel that there is nothing to learn from the psychotic 
mind, from its endless

seduction, from the intimate process of delusion, not even when it 
points—as it often does—to how to relieve psychotic suffering. Some even 
feel that such a study may be dangerous to one's health. Because of this, 
there has been a long history of ignoring the existing knowledge of how to 
recover from psychosis. This ignorance is the origin of the despair in the 
modern world about the possibility of recovery at all. 
John Perceval was raised among the aristocracy and wealth of his country 
and, he said, “educated in the bosom of peace and plenty, in principles of 
delicacy and decorum, in modest and temperate habits, and in the observance 
of, and real veneration for, the religion of my country.” Until his illness, 
he lived the conventional life of a gentleman of the upper class. But 
he did this with a growing discomfort. 
Educated at Harrow, and by private tutors, he was a respectable member 
of the landed gentry, with all the decorum of those who, in their 
hearts, truly believed themselves to be the leaders and caretakers of 
England. His love and loyalty to the English promise of justice, liberty, 
and fairness, and especially to the legendary English respect for individual 
rights—all of which Perceval felt were the great and noble British mandate—
never left him for an instant: from his youth, through his psychosis 
and recovery, until his death. In a sense, he was one of the truest Englishmen 
of his age. 
He was handsome, and like his father, Spencer Perceval— prime minister 
to George III—he had large and sad brown eyes. His father died when 
he was nine years old, leaving his mother to care for John's five brothers 
and six sisters. John was strong and athletic, and since boyhood he had 
been accustomed to several hours a day of strenuous exercise. There was 
nothing he loved more, he said, than “good discipline.” Although his intellect 
was formidable (he could read and write easily in Greek and Latin), he 
decided to leave school in search of a more earthy life. He was naturally 
attracted to the discipline of the military, and at the age of eighteen, 
through family connections, he received a commission in the cavalry and 
later held the rank of captain in the First Foot Guards. This transition was 
easy for him: “I had

been nursed in the lap of ease and scrupulous morality; I now entered the 
school of polite and gentlemanly behavior.” This term, scrupulous morality, 
runs through Perceval's life, as if it were the signature of his character. 
There was a problem: Perceval was very strict with himself and others. 
It was his idea of integrity. At the same time, he wondered about the 
strength of his character, and doubted his courage if his company was 
ever called into battle. He was known for his “gravity and silence when the 
levity of my companions transgressed the bounds of decorum, and made 
light of religion, or offended against morality. I was firm also in resisting 
all attempts to drive me by ridicule into intemperance.” His very sincerity 
manifested as a kind of overintensity in his character. Certainly, he must 
have appeared humorless. Around the camp-fire on bivouac, he might 
have looked like a prudish eccentric, given to arrogance about his own virtue. 
But, in fact, the austerity of his character tortured him: 
In private I had severe conflict of mind upon the truth and nature of the 
Christian religion, accompanied with acute agony at my own inconsistency 
of conduct and sentiment with the principles of duty and feeling 
taught by Jesus and His apostles; and mingled with astonishment at the 
whirlpool of dissipation, and contradiction in society around me.2 
A personal revulsion gathered within him. The pressure to exert himself 
toward a more meaningful existence was reaching a breaking point, 
like a harshly disciplined horse who would someday bolt to run free and 
So began a spiritual crisis. Perceval felt that he lived with secret impulses 
toward dignity, grace, and compassion, but at the same time, his own egoism 
and the self-centeredness of the culture around him filled him with 
profound disgust. This revulsion fueled his tendency toward renunciation 
and ascetic activity, and he further turned the screws of his discipline. All 
his prior disciplines and efforts he now saw in a new light; they had been 
devoted only to the conventional moralities of desire for power, greed, 
and wealth. 
He prayed for guidance. He studied the Bible, particularly the Prophets. 
In his predicament, he felt increasingly drawn to those who had lived 
through similar struggles to become more thoroughly human: the desert 
fathers and the hosts of “spiritual

warriors” who risked their bodies and minds in search of a solution. He 
began to fast. Then he “added to this discipline, watching accompanied 
with prayer.” As he had read about King David, he would often awaken 
and pray through the night. And then visions occurred, “each of which 
shortly after I found were pictures of what came to pass in reality!” 
Increasingly he felt called to religious service, and sometimes visited 
with poor families and attended to people who were dying. He was drawn 
to intimate conversations about the doctrines of evangelical Christianity 
(just as his father had been), especially the teachings of “direct contact” 
with an immanent Christ. But his mind was becoming feverishly obsessed 
with points of religious doctrine. Everything he read about and saw 
around him revealed that the world was in a downhill spiral of moral degradation. 
Secretly, he was convinced that he could foresee the coming 
“destruction of the world,” and sometimes it felt near at hand. This caused 
him fits of depression. Gradually, a decision became obvious to him. After 
nine years in the military, Perceval resigned his commission and went to 
Oxford (Magdalen College) to immerse himself in religious studies. 
Conversion: Tranquility 
He rejoiced in his happiness at having made the right decision, and he 
took every opportunity to listen to the evangelical preachers of the “new 
doctrines” who routinely passed through Oxford. He was tremendously 
stimulated by their teaching that proclaimed that the “direct presence” of 
the Holy Spirit was immediately available: 
I felt endued with a new nature, and with power to overcome all those 
habits which had most vexed me during my life. In boldness of conduct— 
and of speech—in activity—diligence, and in purity of mind, I conceived 
I saw the fruits of a new life, the evidences of the gifts of the Holy Spirit. 
My mind and conduct were for the first time consistent with each other.3 
Knowing of the tragic years to come in Perceval's life, one cannot help 
but be pleased—as he was—in this joyful and longed-for change in his otherwise 
dreary character. It can be called a “conversion” experience. When 
William James 

cataloged the universal qualities of such conversion experiences, he found 
that they all occurred when there was a great pressure in one's life and 
mind; and some kind of mental implosion occurred, revealing a vast and 
“subliminal field of consciousness.”4 Perceval called them experiences 
that “astonish the heart.” In our current day and age, these events in one's 
life are sometimes called “transformative experiences,” or “transformations 
of consciousness.” Such experiences are of the utmost importance to 
people who have been in psychosis. In fact, they are the treasured possessions 
of the psychotic experience, jewels within the psychotic debris. 
The Transformative Experience 
Among the many thousands of experiences called “transformative,” 
there appears to be a great and seemingly limitless variety, and also varying 
degrees of effect on one's life. They range from the corny to the miraculous. 
But three groupings stand out: ordinary transformative 
experiences, conversion experiences, and psychotic transformations. 
John Perceval experienced all three, and in a cumulative way. 
Some were ordinary “transformative” experiences: sudden awakenings 
as to his spiritual nature, to his spiritual calling, to a world of mystery, to 
the appearance of heavenly powers on earth. On the other hand, Perceval's 
“conversion” experiences were felt at a much deeper level. With 
these, he felt he had “awakened to a new life,” a new being, perfected in 
qualities, “endowed with a new nature,” filled with the “life of the spirit,” 
and sometimes accompanied by ecstatic physical and mental sensations. 
Perceval's own understanding of these experiences was similar to the way 
Søren Kierkegaard experienced and described them: 
A change takes place within him like the change from non-being to being. 
But this transition from non-being to being is the transition we call birth 
… Let us call this transition the New Birth, in consequence of which [he] 
enters the world quite as at the first birth, an individual human being 
knowing nothing as yet about the world into which he is born, whether it 
is inhabited, whether there are other human beings in it besides himself.5

Many religions and spiritual traditions, since their origin, have known 
of the lust that can develop for such experiences of spiritual transformation, 
and many traditions warn against the development of spiritual materialism. 
In the Vajrayana tradition of Buddhism in Tibet—where 
miraculous spiritual transformations were the legends and teachings with 
which children were raised—both the ordinary transformative experience 
and the conversion experience are considered to be transient events that 
one may easily misinterpret, and misuse. The Tibetan term for them is 
nyam, meaning “temporary experience.” They are well known to occur in 
the course of intensive meditation practice, and they are given several 
classifications. But the main point is this: They should not be seized as 
one's personal accomplishment or of any particular spiritual achievement. 
No credential can be taken from them. The slightest sense of selfindulgence 
or of aggression by trying to court such experiences leads to a 
wildness of mind, and a distraction from one's journey. One might have 
such temporary experiences again and again; one doesn't go through 
them once and get it over with. 
The “psychotic transformative experience,” or the one that has the 
most potential for leading one into psychosis, is said to happen when 
direct contact is made with “powers” outside of human control—powers 
that act for good and others that act for evil. Such powers have been 
described since ancient times by shamans and spiritual teachers as being 
dangerous to one's health. There are stories even among Native American 
healers that tell of gifted healers who have become casualties of working 
with powers. This is so because the experience may also involve oneself 
becoming powerful. And who among us has the equipment and discipline 
to handle such power? 
Perceval's first conversion experience was ordinary enough, and 
although it did not last for very long, he became confirmed in his expectation 
that supernatural things could happen to a person who longed for 
them enough. He felt himself becoming capable of a subtle but direct contact 
with a world “beyond the visible.” Soon, like a dream come true, he 
learned of the latest heretical doctrines and supernatural phenomena that 
were being demonstrated at Port Glasgow, and he felt impelled to investigate 

Perceval stayed three months with the heretics at Row, and during that 
time they were being prosecuted and condemned by an outraged synod of 
Presbyterian elders. At the time of the hearings, one of the Macdonald 
brothers, an originator of the new doctrines, rushed from the church 
screaming, “Come out of her, come out of her, my people!” As with all the 
other episodes of spontaneous speaking in tongues that he witnessed 
(some of which he felt were utter gibberish), Perceval was enthused by the 
man's faith, but he doubted the wisdom of giving 
utterance to it. 
In fact, among the congregation at Row, Perceval almost always found 
himself on the edge of doubt. He felt tormented about whether he should 
abandon himself to the religious belief he saw around him. In this indecision, 
his former “tranquility” dissolved. But he tried vigorously to hold 
onto it in the only way he knew: by accelerating his spiritual ambition. 
Thus began a second type of conversion experience, the one that set the 
stage for his psychosis. 
Conversion: Power 
He envied the others in the congregation who could speak “in tongues” 
during religious services—the sounds he heard being “beautiful in the 
extreme”—and he longed to “take an active part.” One evening in a tavern, 
Perceval was joined at his table by a young man, and inevitably they 
talked about religious subjects. The young man soon confessed his 
depression and broken heart at being disconnected from Christ. This 
moved Perceval deeply, it was so close to home. He wanted to do something: 
I suffered a deep internal struggle—I seemed guided to I knew not what: 
at last, I flung myself back, as it were, in the arms of the Lord; and opening 
my mouth I sang without premeditation in beautiful tones . . . ‘kindred 
with Christ! bone of his bone, and flesh of his flesh!’ . . . it was not 
my doing—the words, the ideas even, were wholly unthought of by me, or 
at least I was unconscious of thinking them.6

There were several more instances of this kind, when Perceval felt the 
“power of the Spirit” enter him, and he could speak, even sing, “in beautiful 
tones words of purity, kindness, and consolation.” Fling himself back— 
that, he discovered, was how he could open his body, his voice, and his 
mind into deeper surrender and transformation. Then he took it one step 
further. He began to take risks. He would feel “guided” to speak at inopportune 
times, and although he struggled against doing this he could not 
hold himself back. Members of the congregation chastened him for misusing 
the power, but for Perceval, his body and mind had become an 
“instrument” that was being played for holy purposes. There were other 
omens. He consulted the Bible by randomly opening it (or rather, “was 
made to open” it) and in front of him he read menacing warnings that 
threatened him with confusion: “And the Lord shall smite thee with madness 
and blindness and astonishment of heart.” 
He could neither use the inspiration for his own willfulness nor hold 
back on giving utterance to the gift. He was conscious of the danger, he 
says, but he decided to risk the folly of false zeal, rather than risk disobedience 
and ingratitude to the power that guided him. He could only hope 
that “what had begun without me, would be perfected in me, despite even 
of myself.” 
The powers began to multiply. He acquired another power: an ability to 
discern the existence and quality of the spirits that he found to be secretly 
speaking through other people. He could tell this just by their tone of 
voice, and also by the differing effects each produced in his body, particularly 
by strange sensations in the back of his throat. Eventually, when his 
friends became suspicious of his tormented “inspiration,” they asked him 
to leave the congregation, feeling that his health was in danger. Some of 
them even suspected that he might be “.possessed by a devil.” He tried to 
tell them that his inspired powers were only just beginning. He left Scotland: 
in my own imagination, a living instance of the Holy Ghost operating in 
man—full of courage, confidence, peace, and rapture, like a glowing 
flame, but still and submissive.7 
The first conversion of tranquility revealed to Perceval a quality of 
power in the world. The second conversion was more personal—he took 
the power to be his own. He felt that hidden resources of his mind were 
being tapped, or opened up, by the

power of the Holy Spirit. At Row, the heretics had practiced speaking in 
tongues with the intention of dissolving the solidness of the willful personality, 
or self-centeredness, which alone stood between themselves and 
supernatural powers. But it was having the opposite effect on Perceval: As 
he was drawn deeper into a struggle of making sense out of his mind, he 
felt the powers were directed toward him alone. 
By the time Perceval left Scotland and sailed to Dublin to visit family 
friends, the powers had begun to move his limbs and direct his hands. To 
test out his own power—and in his mind, to manifest and thus glorify the 
power operating within and through him—he had to take further risks. He 
put himself into the pathetic situation of trying to create minor miracles; 
and when they did not work he despaired and was tormented by voices of 
vicious “internal rebuke.” He became unable to sleep and wandered the 
streets of Dublin throughout the night. Exhausted, weary, and brokenhearted, 
he thought of abandoning all religious quest. In this mood he 
stayed with a prostitute (not before lecturing her on spirituality) and 
quickly contracted a venereal disease. An acute fever, noxious medicines, 
and a mind tortured by a sense of sin all combined to “lead me to my 
Sitting around a fireplace while recuperating at a friend's house, he 
heard a voice say, “Put your hand in the fire.” His friends held him back, 
but when given a red handkerchief, he believed that it was soaked in 
blood. He heard voices commanding him to sing out loudly during the 
night and to place himself into contorted positions so as to break his neck: 
A spirit came upon me and prepared to guide me in my actions. I was 
lying on my back, and the spirit seemed to light on my pillow by my right 
ear, and to command my body. I was placed in a fatiguing attitude, resting 
on my feet, my knees drawn up and on my head, and made to swing 
my body from side to side without ceasing. In the meantime, I heard 
voices without and within me, and sounds as of the clanking of iron, and 
the breathing of great forge bellows, and the force of flames.8 
He could hardly talk when his eldest brother came to Dublin to be with 
him. His brother was frightened and confused and could only treat him as 
an irrational child. A “lunatic doctor,” as they were called, was promptly 
sent for and declared Perceval

insane. He was kept in a small room with a guard outside the door. When 
he became too active he was put in a straitjacket, and when he tore 
through that (with the “power of an elephant” granted to him by the spirits) 
he was placed with his arms crossed over his stomach, in two heavy, 
hot, leathern arm pieces, which were not taken off until he arrived in 
England two weeks later. With each day in forced restraints, his condition 
steadily worsened. 
It would take him years to forgive what he saw as cruel and unnecessary 
treatment. He felt he was being treated like an animal and was bound 
to resist, not only for his sense of honor but under the command of his 
voices who threatened him with eternal torture if he did not fight against 
his oppressors. He came to believe that his psychosis would have dissipated 
quickly if he had been treated with understanding. 
It may be asked me, what course I would have had pursued towards me, 
seeing there was such evident danger in leaving me at liberty? I answer, 
that my conduct ought to have been tried in every situation compatible 
with my state; that I ought to have been dressed, if I would not dress 
myself; that I should have been invited to walk up and down my room, if 
not quietly, in the same confinement as in bed; that whilst implements 
that might do me hurt were removed, pens, pencils, books, &c., should 
have been supplied to me; that I should have been placed in a hackney 
coach, and driven for air and exercise, towards the sea shore, and round 
the outskirts of Dublin. Few can imagine the sense of thirst and eager 
desire for freshness of air, which the recollection of that time yet excites 
in me.9 
In January 1831, Perceval was brought in manacles by steam packet 
and coach to Brisslington, England, where he entered the well-respected 
private “madhouse” establishment of Dr. Edward Fox. Throughout this 
time Perceval believed he was entering a prison of hell for the crimes he 
had committed by not acting in accordance to the holy words uttered to 
him, and for lacking the courage to purify and redeem himself. 
It was a sordid time in English medical history. A host of scholars, historians, 
and sociologists have documented the madness that surrounded 
madness.10 A whole culture had become confused about insanity and left 
the treatment of highly disturbed people in the hands of a growing middle 
class of medical

specialists. “Private madhouses” were proliferating throughout England 
(150 during Perceval's confinement) and they were given enormous powers 
over their patients' lives. As was customary, Perceval's family yielded 
their own judgment to the authority of the lunatic specialists, even when 
they were ordered not to visit him in the hospital because his condition 
might worsen or that he might become violent. It has been argued that 
just at that time an arrogance of power developed within the medical specialty 
of insanity, which even to this day bears its imprint on the modern 
treatment of people in psychosis. At present, we are the inheritors of 
those same beliefs, superstitions, and delusions about treatment, and they 
make their subtle appearance each time we are suddenly confronted by 
the psychotic mind. 
It is impossible to describe the “treatment” Perceval endured within 
the walls of the Brisslington madhouse. His own words about it are 
extremely painful to read. One outrage followed another. He was treated 
with shockingly cold ice baths and forced dunkings, cold vapor baths, and 
medicines that he called “noxious fumigations,” and twice he experienced 
the treatment called “bloodletting.” 
For nearly eight months I may say that I was never out of a strait-waistcoat; 
I used to be tied up in it, in a recess the whole day, on a wooden seat, 
for months and months, with my feet manacled to the floor, and in the 
presence of fourteen other patients . . . I twice required two severe operations, 
or was supposed to require; one, bleeding at the temporal artery; 
the other, having my ear cut open to let out extravasated blood . . . that 
day [when his artery was cut] I was bled till I fainted! I saw my blood 
taken away in basins full, and I did not know what to anticipate.11 
It is ironic that his own father was involved in allowing just such treatments 
when they were being administered to George III during his last 
bouts with madness. At that time, Spencer Perceval had thought such 
treatment inhuman and ruinous but, like his son, was powerless and 
lacked the allies to prevent it from happening.12 
Yet the worst that Perceval endured was the brutality of the staff who 
surrounded him. It was physical brutality, such as when one of the staff 
impatiently wiped food from Perceval's mouth so roughly that it drew 
blood. What was even more of a daily

occurrence was the moral brutality, as when he was mocked or knowingly 
provoked into violence. He was especially abused when he insisted upon 
respect for his “royal blood.” The doctors always thought this claim to be a 
banal symptom of megalomanic pretentiousness; only much later did it 
become known that his family line descended from the early Irish kings 
who fought for liberation from English rule. Probably, some amount of his 
poor care was due to his being discriminated against by the lower-class 
attendants at the hospital, whose class hatred was being inflamed by the 
Bristol Riots, the uprisings just then occurring nearby. When, over the 
next year, he was not lashed to his bed, manacled to the wall, or secluded 
in a pigsty, Perceval could sometimes see through the bars of his asylum 
window a red glow on the horizon from fires burning in the streets of Bristol. 
The severe conditions of treatment and the terror to which he felt 
himself subjected clearly drove him further into psychosis. 
How can one describe the desolate scenes that leap from Perceval's 
writings, like Hogarthian life in a madhouse? But they are not at all unlike 
visits to the back wards of today's state-run asylums: These scenes remind 
us of nothing so much as the letters written by inmates, underground 
news reports, pictures, and movies that have been smuggled from those 
forsaken wards. These images leave one speechless. Only by imagining 
oneself living under those same conditions can one glimpse how such 
utter hopelessness and despair may disorder the mind. For almost nine 
months Perceval did not understand what was happening to him; finally 
he came to discover the secret treatment design of the lunatic doctors. 
Incredibly, they had an unspoken and sometimes subconscious treatment 
philosophy, meant for him and for everyone else: to drive mad people to 
their knees, to dominate them by humiliating them. They truly believed 
that “harsh treatment is necessary.” 
But until Perceval made this discovery, he felt that everything done to 
him was the result of divine intervention. Everything was meant to punish 
him, to test him, and to eventually purify him of all his sins. Then, he 
would not only save himself and many others from the eternal fires of 
hell, but he might also receive an ultimate salvation, whispered to him 
and promised to him by his voices. Every event, every coincidence, however 
small, fitted into this master plan of delusion through which he interpreted 
his entire world.

The injurious treatment Perceval received at Dr. Fox's asylum obviously 
intensified and prolonged his insanity, but it was also the wound 
that he caused to himself that actually sealed him in illness. In this case, it 
was a psychological wound that upset the balance of a delicate mental 
mechanism. This kind of wounding occurs in stages; one mental dilemma 
builds upon another and moves one through an archetypal cycle of psychosis. 
Thus, the inner journey of Perceval's stepwise descent into psychosis 
began with an attack on his own mental functioning. 
Ignoring Intelligence 
For over a century, psychiatrists have tried in vain to identify the defect 
operating in the mind of people in psychosis, the aberration ultimately 
responsible for the peculiar “psychotic logic” that induces their hallucinations 
and delusions. Perceval announced his own conclusion as to the 
nature of this psychotic defect on almost every page of his writings: a disturbance 
of the normal and intelligent function of Doubt. 
He studied the natural function of doubt and all its permutations from 
the beginning to the end of his psychosis. This is not the doubt of indecision, 
hesitation, or ambivalence. Starting from his conversion to “power,” 
he had begun to blind himself to a reflex, or a natural instinct, inherent in 
his own intelligence, what he called a flash of “doubt” that spontaneously 
interrupts a belief in the most solid perceptual world. It is a moment of 
clarity that happens in microseconds. It is a moment of freshness of mind. 
In anyone, in an instant, it can spark even in the midst of a riveting nightmare, 
revealing it to be only an insubstantial drama of the mind. For Perceval, 
it would appear and disappear during the most savage 
hallucinations. A quick cut through the thickness of rampant thinking— 
revealing a gap, a question, or a feeling of doubt. At every stage of losing 
his mind Perceval jokingly asked himself, “Am I only dreaming?” And in 
that moment, his insanity was interrupted. 
At the very first discernible moments of his insanity, during a gathering 
feeling of purity and power, Perceval “doubted”: “I felt it was either an 
awful truth or a dreadful and damnable delusion,” and even when he was 
feeling suffused with a kind of liquid bodily pleasure he suddenly wondered, 
“Am I yet only imagining even when I am happy?”

Almost every day, he experienced a moment of this dilemma: Is this a 
dream or not a dream; am I becoming insane or am I being transformed 
into spiritual perfection? He had a sudden suspicion of the truth of his 
uncanny experiences. Then, all of “reality” was called into question and 
his whole system of spiritual belief would crash in an instant. It was a 
chasm of doubt flickering in the midst of chaos, an, eruption of a primeval 
intelligence or awareness that threads through every stage of Perceval losing 
his mind. In fact, it is a universally recognizable event in the experience 
of anyone who is losing his mind. 
How can one still lose control of his mind in the face of such powerful 
flashes of intelligence? One reason is that somehow this intelligence may 
simply not take hold: “I had a species of doubts; but no one who has not 
been deranged can understand how dreadful a lunatic's insane imagination 
appears to him, how slight his sane doubts.” Even in the grip of 
“miraculous powers” he had doubts about whether he was becoming sane 
or super-sane: 
And if I doubted my doubts were overwhelmed if not dissipated by compunction 
at attributing what was so kind, so lovely, so touching to any but 
the divine nature, and by fear of committing the sin against the Holy 
Ghost. Whatever then appeared contradictory, or did not turn out as I 
expected, I attributed to my disobedience or wont of understanding, not 
to wont of truth in my mediator.13 
“Something is wrong” characterizes the first moment of doubt, an 
uneasiness that naturally punctures any experience of oneself transforming 
into a higher or lower order of being. It is actually a quality of inquisitiveness 
or intelligence that is not really questioning for any purpose. It is 
purely questioning, not in the service of ego or non-ego; it is just a process 
of critical view that goes on all the time.14 In classical Buddhist psychology, 
this spontaneous critical flash is virtually indestructible. It is functioning 
all the time and is always recoverable. But although it never 
actually disappears, it can be gradually eroded. 
If this instinct to clarity becomes obscured, it is a great loss, one that 
may alter the balance among all the other intelligent functions of mind. 
That is what happened to Perceval's mind. But it was more than just a 
covering up of doubt that led to its

loss, he took a more active part; he violated his own mind by almost systematically 
reversing the critical moment of doubt. 
Manipulating Intelligence 
Perceval began to reason that the moment of doubt was his greatest 
obstacle to spiritual success. Doubt, in this sense, meant a critical 
moment of not knowing if he was becoming insane, not knowing whether 
he was involved with a gathering delusion or truly receiving extraordinary 
and supernatural guidance. Perceval said that this shock of doubt always 
made him hesitate in going along with delusion. He accused himself for 
this doubt, feeling that it might be the origin of his spiritual failure: 
“Receiving voices as commands of my God, nothing could prevent me 
attempting to obey those commands, however absurd they may have 
appeared to myself or others, or dangerous to myself.” 
He saw doubt as a willful “procrastination,” a mental stammer of indecision, 
which then caused all the actions he was commanded to make to 
be incomplete and lacking in the purity of intention being demanded of 
him by the Holy Spirit. Because of doubt and hesitation, he found himself 
unable to act according to the letter of the commands he received from 
the voices: “It made me prevent or lag behind the instant of execution.” 
Thus, each action he attempted ended in error, failure, and a sense of 
guilt, while the voices that shadowed and commented upon his every 
movement accused him of weakness and lack of courage. Even anything 
he willed on his own was subject to the trap of doubt. And for this, his 
voices punished him with severe physical and mental pain and threatened 
him and his family with eternal torture. 
Since doubt had undermined every intention, whether it was in submission 
to or rebellion against a delusion, Perceval became determined to 
overcome doubt, to suppress it. 
Doubt, his own mental instinct, became his enemy. He declared an 
open warfare on doubt, and he developed a strategy to subdue it by turning 
doubt into its opposite: wild hope and faith. He put this into practice 
by tuning himself to become hypersensitive to the very first and almost 
subliminal moment of doubt. Sometimes, it was to the first “taste” of 
doubt, which he could feel in the back of his throat, even before it became 

idea. This he used as a subtle “signal,” or a springboard by which he could 
leap further into a delusion. In this way Perceval engineered a selfinflicted 
mental wound, and as he practiced it he became progressively 
more insane and sometimes violent. Perceval discovered that turning 
doubt around into a blind faith in delusion is possible only because it is 
built upon another inherent mental mechanism. When his mind was most 
disordered, he noticed that every idea was immediately coupled with its 
opposite idea, and he felt that this contradictory action of turning anything 
into its opposite was latently available in the human condition and 
could even be used to oppose the functions of one's own intelligence. He 
called it a natural human “perversity,” an always-available contrariness 
that becomes highly exposed and intensified during any deranged state of 
mind. Thus, the clarity of mind that can discriminate between delusion, 
dream, and reality could be relinquished. 
Just as any of the five senses can be manipulated or conditioned in 
order to ignore, distort, or superimpose a mental image over an external 
perception, so the same could be done with internal perceptions and 
images. For Perceval, as it was for St. Paul, this perverse manipulation of 
doubt was the real meaning of “original sin.” 
Dilemma of Spiritual Submission 
If spirituality had not existed, people in psychosis would have invented 
it. The havoc of mental mechanisms experienced in psychosis seems to 
beg for spiritual or supernatural explanation. One's difficulties are then 
compounded; not only is one struggling to make sense of an external 
world, but one feels in constant conflict with an invisible world. 
This conflict first manifested for Perceval in the realm of language. 
When he spoke under what he felt to be divine guidance, he would often 
speak only gibberish, and thus incite ridicule for his presumptuousness 
and arrogance. Also, the guidance to his speech might abruptly stop, leaving 
him stammering in despair and appearing to be insane. However, if he 
held his tongue and refused to speak as guided, he would find himself 
mute and helpless. This also would make anyone around him suspect his 
sanity. Even when he tried to reply to an innocuous question, he felt an 
extreme bodily discomfort because physical pain accompanied any words 
that were uttered without spiritual guidance.

Like many others in the grip of psychosis, Perceval was in continual 
torment as to whether to obey the powers, whether to risk ingratitude for 
the gift of power, or risk the fear of human censure. He called this 
dilemma of either restraining his speech, speaking with guidance, or 
speaking his own thoughts “the most active inward cause of all my misfortunes. 
But as hope replaced doubt, he reinterpreted this paralysis of speech as 
being still another spiritual means given to him in order to discern and 
cleanse himself of all evil or unsubmissive thoughts. While feeling in mortal 
danger for doubting his divine inspiration, he once again randomly 
opened the Bible and found words that he could only assume were 
instructions for personal action: 
Brace yourself, Jeremiah; stand up and speak to them. Tell them everything 
I bid you. Do not let yourself break at the sight of them or I will 
break you before their eyes. 
Coincidences, messages, and perceptions pregnant with meaning 
began to fill his world. Nevertheless, in spite of all his efforts, doubt spontaneously 
reasserted itself and he rapidly began to oscillate between feeling 
himself to be in heavenly places and tortured in hell. Voices told him 
that his descent from spiritual glory was complete and that his only hope 
was to die and be reborn into a spiritual body, fully transformed beyond 
the defilement of doubt. He resolved to kill himself: “My body, being the 
last hope for spiritual perfection.” 
While restrained in his bed with leather straps for sometimes weeks at 
a time, he found that “the idleness of mind and body left me at the mercy 
of my delusions. I began to lose all command of my imagination.” At first, 
it was a growing inability to control and check rapidly streaming 
thoughts, but then they intensified into a wildly running nightmare. 
The inner mechanism of a nightmare became clear to Perceval. Day 
and night he would stare at the ceiling and wildly hallucinate: “I expostulated 
with the voices communing with me, in me, or without me, to allow 
me to exercise as the only means of saving me.” All his mental processes 
became solidified.

Words and thoughts turned into sounds. The sounds were animated into 
voices, and they demanded his attention. The voices were personified and 
identified as “spirits.” The spirits became enlivened with particular personalities, 
and all appeared to “buzz around my head like bees.” In this 
way, in material form, thoughts turned upon the thinker. Some spirits 
assumed visual form and were felt as visitations, both outside and inside 
his body, from a world beyond man. They all demanded his self-sacrifice. 
Each “restraint” experience led to the abrupt appearance of an organized 
delusion (“I was the one and only being to be eternally damned, 
alone, in multiplied bodies, and in torments.”). As terrifying as the delusions 
were, they at least indicated to him a direction for action. He was 
told by the spirits that if he acted bravely, he could yet be reunited with 
his family (the lack of whom he deeply and constantly lamented), to be 
hailed by them as a heroic and willing martyr to the glory of Christ. In this 
delusion, he alone was responsible for warding off the impending 
“destruction of the world,” the vengeance of the spirit world. It was both a 
representation and a premonition of an even more complete break with 
reality, the way a dream might portray the drama of insanity. This began a 
countdown to the final moment of his loss of mind. 
The delusion continued: In a vision, he saw that his sisters had the 
courage to sacrifice their own lives because he had been unable to end his 
own. They did this to help him, and to save the world that he could not 
save. Everyone mocked him for his lack of courage, and under this humiliation 
his mind became unhinged from his body and the environment. 
At last one hour, under an access of chilling horror at my imagined loss of 
honor, I was unable to prevent the surrender of my judgement. The act of 
mind I describe was accompanied with the sound of a slight crack and the 
sensation of a fibre breaking over the right temple. It reminded me of the 
mainstay of a mast giving way. It was succeeded by a loss of control over 
certain muscles of my body and was immediately followed by two other 
cracks of the same kind, one after the other, each more toward the right

ear followed by an additional relaxation of the muscles and accompanied 
by an apparently additional surrender of the judgement. In fact, until 
now I had retained a kind of restraining power over my thoughts and 
beliefs; I now had none; I could not resist the spiritual guilt and contamination 
of any thought, of any suggestion. My will to choose to think 
orderly was completely gone. I became like one awake yet dreaming, 
present in the world in body [only].15 
There was a sudden release from mind intensification and body rigidity: 
crack, relaxation, surrender of will, and the uncontrolled passage of 
thoughts into visions. At that point, Perceval “was assailed from every 
quarter” by spirits, visions, and voices. There followed an almost complete 
shift of allegiance and absorption into another world. 
With his mind adrift in an ocean of its own projections there was now 
no space for intelligent doubt. He was in status hallucinosis, or uninterrupted 
hallucinations. His mind was no longer his own, it was merely the 
plaything of the spiritual world. He felt he was “possessed,” and he looked 
only to the invisible world for clues, coincidences, and messages as to how 
to behave and how to proceed. 
Now completely desynchronized from the world outside his mind, 
everything he did or did not do was in utter servitude to his delusionary 
world. It plagued him, and at times he fought against it, like a relentless 
struggle between master and slave. 
From the first available personal accounts of psychosis appearing in 
the Middle Ages, up to the present day, there appear similar descriptions 
of “possession.”16 It is not that all such descriptions have unknowingly 
unearthed and embraced a common and unconscious belief in a primitive 
and naive explanation; rather, they are describing the same vivid experiences 
that feel as if one were under alien control. Whatever possession 
might ultimately be, according to Perceval it clearly involves unseen 
forces that act by seizing control of the latent mechanisms of one's natural 
contrariness and perversity, and thereby create confusion in one's mind 
and chaos in all one's behavior.

The Miracle: Two Places at Once 
In the grip of delusion Perceval noted how thoughts became reality at 
once, in the time it takes to blink an eye. Pictures jumped to life. Memories 
became vivid, present realities. Suddenly, his mind was transported 
to another place and another time: 
Although I was in the house of Dr. Fox upon earth, I was at the same time 
present in Heavenly places (or in Hell): and capable of being conscious of 
both states of existence, and of directing my conduct in each, in rapidly 
succeeding intervals of time, according to what was passing around me in 
A “previous lifetime” was unveiled to him in a vision—years revealed 
and experienced in a moment. The story line of that other lifetime is as 
follows: He had lived as a young orphan in Portugal (where he had once 
served in the military) and was raised by a kindly old man. But he was 
ungrateful to those who loved him, and out of greed for material possessions 
he had murdered his protector. The vision continued: He was 
apprehended, enslaved, and tortured. Whereas in previous visions he was 
to be the last hope of the nation if he acted correctly, in this new vision of 
his former lifetime it was demonstrated to him why he was now unable to 
act purely and courageously. Here was the miraculous and complete 
explanation of his fundamental contrariness, negativity, and selfishness: 
He had been stained to such an extent in a prior existence that his current 
life would, necessarily, be filled with yet-unpaid-for suffering. His former 
sin would forever be an obstacle to his redemption, or even humanness. It 
confirmed to him that he needed some kind of great leap into spiritual 
perfection, and he became vigilant for any opportunity to make that leap. 
All his senses were in disarray, “mocked at and deceived.” Apparitions 
appeared and then suddenly disappeared. Faces changed even as he 
looked at them. “My sense of feeling was not the same, my smell, my taste, 
gone or confounded.” Voices competed for his attention: “Eat!—don't 
eat!” He said, “I could seldom refuse one without disobeying the other.” 
Miraculous beings from various dimensions controlled every movement 
of his mind and body. He explained it all to himself: If everything that 
exists in the mind in its present appearance is merely the

action of invisible forces, “why may not my individual character, and the 
character of all objects now reflected on the mirror of mind be changed in 
a minute” by those same invisible forces? It was these “miracles of the 
imagination” that created the delusion of being in two, or even three, 
places at once. 
Feeling in “two places at once” was the full consequence of the disconnection 
or desynchronization between his mind and body, and its effects 
continually led to even more awkward and impulsive actions. It could be 
compared to falling asleep and being on the verge of dreaming and then 
being interrupted by someone asking a question. That interruption is 
engulfed by the dream. In spite of one's best efforts, and because of a 
divided loyalty, one's response is incomprehensible or ridiculous, 
although perfectly logical to the dream. It is an embarrassment, and one 
either awakens or turns further into the dream. Perceval's delusions created 
just such a false logic. Like a palpable dream, it magnetized, 
ensnared, and integrated all sensory experience. It spawned and cloned 
further delusions, and it clothed the world with visions and voices. All 
background noise and any indistinct sensation of sight, sound, smell, or 
taste became the 
foundation of speech: the sounds usually clothed with speech are not 
always loud sounds, but minute and intense, and generally so; but by 
comparison and by resemblance they suggest the ideas of shouting, crying 
out, laughing, bewailing, weeping, expostulation, and the like, and the 
effect is extremely beautiful, extremely delicate, and to a sensitive frame 
of mind enchanting; so that I would willingly be able to lead an idle life, to 
enjoy the delirium of happiness and joy produced by these sounds.18 
Within that delusion and for many months, he said “he never spoke, 
hardly acted, and hardly thought, but by inspiration or guidance.” 
The diagram on page 34 is a summary of the different experiential 
domains through which Perceval passed in the course of losing his mind. 
Though Perceval was a unique person, the phenomenon of his losing his 
mind was not unique. There is a


generic cycle to psychosis, and most aspects of it are recognizable to anyone 
who has been insane. It is a cycling and recycling of chain-linking 
The complete cycle can be described in terms of a passage through six 
distinctive states of mind, each being characterized by a predominant 
emotion and a world seen through different colored glasses. Each involves 
a way of perceiving the world— has its own needs, logic, associations, 
symbols, iconography, and bodily sensations. In this sense, they are not 
so much states of mind as they are “realms” of being, or existential 
realms.19 In no way are these realms unique to psychosis; each can be recognized 
within one's ordinary life as more or less a transient state of 
being. In various heightened states of neurosis, one or another of these 
realms can clearly be seen in an intensified form. But in the gathering of a 
full-blown psychosis, the realms are tremendously exaggerated and 
strung together to create a complete and tortuous experience of insanity. 
The driving energy that begins the movement from one escalating 
realm to the next is the hope of getting somewhere or of achieving some 
kind of spiritual fulfillment. Hope, in this sense, refers to a particular psychological 
and spiritual materialism. Beginning with the realm of Desire, 
Perceval was under a great pressure to be free of the revulsion and disgust 
that he felt for himself and the world around him. From this, a motivation 
and desire to become a better, or a “higher,” more spiritually perfect person 
developed. This possibility actually dawned when he experienced his 
first conversion to tranquility and inner peacefulness. Everything in his 
life seemed to point in this upward direction toward happiness. 
When these sensations increased, or when they were fractured by 
doubt, he wanted more of them and he entered the realm of Greed. This is 
experienced as wanting something more, and yet as an inability to 
become fully satisfied, like having had a taste of spiritual grace and then 
becoming more hungry for it. But every time Perceval approached the 
spiritual peace that he craved, it turned into an illusion, or he could not 
use it, or it aggressively turned against him. He was at the height of 
impoverishment: He was arrogant with what he had, yet continually 
unfulfilled. Any doubt of whether he was getting anywhere spiritual was 
countered by his pride of having tasted something. At this time, beautiful 
voices beckoned him to a point of spiritual voracity with poetry of unrequited 

He strengthened his determination to push forward—almost blindly, 
ignoring all warnings, brushing aside and overturning doubt. He pushed 
himself more forcefully to protect his territory, to pry the final mercy from 
holy powers. This is the realm of Compulsion, an animal-like driveness to 
go further, to exert power. It takes the form of a spiritual “do or die.” But 
in this realm one can become dreamy and confused, feeling somewhat 
drugged, but pushing forward, simply hoping that something will come of 
Perceval broke into a spiritual promised land, the pinnacle of the psychotic 
achievement, for short periods when he would feel “transported to 
heavenly places.” In this realm of the Gods, he felt he experienced eternity 
and that he lived beyond birth and death. He sensed a separation between 
his consciousness and his physical being. Doubt was almost completely 
gone, but when it flashed he saw what he called the realm of pure imagination, 
or the divine mind. It led to a kind of numbness in which he 
became absorbed, fascinated in spiritual pleasure. But at times it wavered 
like a mirage, and a fear was sown—that he might lose it. 
Fear became a rush of energy. He looked back in envy at the height of 
his spiritual bliss and knew that it had gone. He became more aggressive 
in his attempt to win spiritual success from the powers. He overturned 
doubt easily, and any moment of it he saw as a demonic influence. The 
voices continually issued conflicting commands, but always they 
demanded further spiritual submission from him. He was in the realm of 
Paranoia, where he had to protect himself “against attacks from all directions.” 
He felt that only the exertion of greater energy, speed, and efficiency 
could save him from the nightmarish world that was coming. 
On entering the realm of Hell he experienced the full fury of his own 
projections. He could not tell if he was committing acts of destruction or 
creation. His speed of mind was tremendous and in a constant momentum 
of change between giving birth and dying. He was given to feelings of 
hatred and of being hated, and, while fighting against the projections, he 
began to strike inward. Voices now ordered him to destroy himself. When 
the “crack” occurred he was at a peak point of being overwhelmed, alternately 
burning or being frozen in an environment of terror. 
When Perceval first became ill he went through this cycle in

about three months. After that, he recycled through it many times. In the 
last stages of his illness, he would recycle through the six intensified 
realms in a matter of minutes. It seems that, once done, it became progressively 
easier to do. He might have a moment or two of rest, or even 
clarity—particularly during his most despairing moments of the Hell 
realm—and then it would begin again. There appears to be a significant 
natural gap, or break, in the Hell realm, where one is open to learning 
things, to seeing things in a new light—and most importantly, where one 
is open to human intimacy and friendship. All those possibilities, of 
course, were absent in Perceval's dismal life at the madhouse. 
In his loneliness he often thought of biblical Prophets and many other 
mystics and saints. They might understand his suffering, he believed, for 
they had lived through similar experiences; they also had been commanded 
about, and had been cast from the bliss of heaven into the abyss 
of the “dark night of the soul.” As do many people in psychosis, Perceval 
struggled with the ageless question of the subtle distinction between a 
tempestuous spiritual journey and true madness, and he was certain that 
he was being acted upon by the same power that had influenced the 
Prophets and the Apostles. 
There is a silent despair in the modern world about the possibility of 
recovery from psychosis. Only occasionally is the despair publicly 
acknowledged, but privately, for the vast majority of psychiatrists and 
psychologists, recovery does not exist. They have become accustomed to 
seeing patients “relapse”—make a temporary adjustment to life and then 
fall apart under the pressures of life into the same psychotic world as 
before. They have seen this so often that they have come to believe that 
relapse is inherent in the illness, the expectable natural history of the disease. 
This professional belief system has been accepted and has passed 
into the general culture. Most people have become acclimatized to a belief 
that psychosis is a terminal illness, and have thus become unconscious 
and numb to their own despair. When Perceval declared himself recovered, 
he was met with tremendous scorn. He had been in the madhouse 
many months

by then, and everyone around him believed he was still dangerous to himself 
and others. The miseries of his treatment persisted. In the course of 
proclaiming his recovery, he wrote over a hundred letters (some of which 
the hospital never sent), petitioning his mother, brothers, sisters, friends, 
lawyers, and the courts for his release from strict confinement and to be 
given a freedom commensurate with the abilities he had recovered. At 
first he addressed his mother; she, as his legal guardian, held the key to 
his confinement. He tried to explain his improvement and his wish for 
freedom: “After I began to recover from my frightful dream . . . I understood 
both things and persons to be really what they were—though not 
always, nor for sometime . . . though in a dream my behavior was still 
more moderate.” But all of his petitions were denied. He once tried to run 
away but was caught and restrained. Several famous psychiatrists of the 
time visited him and prescribed continued asylum treatment. One of 
them refused his petition, stating that because he wore his hair long and 
in ringlets (which Perceval called “natural and manly”) in knowing defiance 
of the hospital code of behavior, and because he refused to simply be 
a good patient and do what might be necessary for his quick release (like 
being kinder to his worthy family and less accusatory of his physicians), 
his judgment was obviously impaired and his mind required continued 
How he longed to be away from the excitement and provocation of asylum 
life and to be in a more simplified environment where he might work 
at stabilizing his mind. Although he was held in confinement for another 
two years, he kept his longing for freedom alive. 
Almost incredibly, during this time and while utterly alone Perceval 
was discovering a pathway to recovery from psychosis. It is difficult for us 
to know just how unique that discovery was or to appreciate how often 
and silently such an event may currently be happening in our hospitals 
and asylums. Clearly, Perceval had no scheme to do it, at least at first. 
Recovery was an evolution in process: He had decisions to make at each 
step of the way, and there were many side roads and environmental 
obstructions. Although it is now popularly believed that recovery is 
improbable for people who are as ill as Perceval, not only did Perceval 
fully recover—and only the course of his life can demonstrate that—but he 
did so under the conditions of madhouse care!

The hectic course of his recovery reveals some basic principles, which 
apply to anyone during the cyclic journey of psychosis. When these 
insights made it clear to him just what he had to do to recover, he set an 
iron determination in that direction. It is through these principles that the 
story of Perceval's recovery can best be told. 
The Wisdom of Recovery 
There are experiences of sudden “shock” or “astonishment,” momentary 
“islands of clarity” and awakening. At such a moment Perceval said 
“scales fell from my eyes.” Often these moments are accompanied by horror 
at the self-deception in which one has been immersed. 
There is also a more gradual awakening that occurs in the intervals 
between the sharp points of clarity. This happens bit by bit, sometimes 
agonizingly slowly, sometimes bitterly. But it also includes moments of 
delight and confidence. Although this sequence happens over and over 
again and its progression is cumulative, an active, continuous effort is 
required on the part of the one recovering from psychosis. 
Each stage of recovery has its own particular danger. The danger of 
being drawn back into the whirlpool dream of psychosis is powerful, beckoning, 
and even irresistible. One can become enamored with the sudden 
awakenings and easily miss the point by turning them into self-aggrandizements 
or by attempting to create them at will. And during the periods 
of gradual awakening, one sometimes feels exquisitely precarious, combining 
what Perceval called a “child's sensitivity and an imbecile ability 
to control wild thoughts.'' There is a continual undertow of grief and nostalgia 
to relax back into the dream. Compared to the vivid display of losing 
one’s mind, recovery feels boring and hopeless. One’s intention and 
effort may give way. There is no other way to describe what is needed to 
accomplish the dangerous journey of recovery other than calling it courage. 
Recovery is neither a distinct event nor a border to cross over. 
Moments of recovery are happening all the time, even in the midst of losing 
mind. Insanity and sanity are occurring together. Wildness of mind 
and clarity of intelligence are arising side by side. Spontaneous insights 
about how to recover actually pre

sent themselves as veiled messages within a delusion itself, and they are 
either recognized or lost. 
If any stage of the natural unfolding of recovery is thwarted, frustrated, or 
actively opposed by the environment, the effort is either abandoned completely 
or it becomes as it did with Perceval, a grim struggle for survival. 
The implication of these principles is enormous, for it means that 
everyone has the capacity to recover from psychosis and that it might be 
done in similar stages: a virtual unwinding of psychosis. The following 
stages are described from the point of view of Perceval's experience. Each 
stage involved a recognition or insight into the nature of his own psychosis. 
Each stage is a quality of mind, not in the sense of an intensified realm 
but a particular moment of sanity within a realm, having its own emotions, 
logic, and serious dilemmas. Although they do not always follow in 
sequential order, they can be something of a guide through the predicaments 
inherent to the recovery process. 
Detachment From Delusion 
Within the first months in the madhouse, Perceval admitted to himself 
that nothing could deter him from attempting to comply with the commands 
of his delusion short of his own death. All his determined efforts at 
spiritual submission in the past had only led to this. He now openly 
acknowledged his total enslavement. 
But then, as early as one month after the “crack,” he had startling 
glimpses of recovery: 
A kind of confidence of mind came in me the evening after I had been 
threatened (by voices), and saw the thunderbolt fall harmlessly by my 
side . . . nothing ensuing, confidence again came in me, and this night a 
change took place in the tone of the voices.20 
Then, this kind of event happened several more times. That is what it 
took. He said that only “repeated experience of the falsehood of the promises 
made to me in delusion could succeed in making me relinquish altogether 
my attempts to comply.” Whatever this “confidence” was, it had 
the effect of also altering the delusion itself. 
Doubt was returning. It spelled the beginning of the end of his bondage 
to delusion. But recovery beyond this point he said was “long in coming,” 
taking six months to complete, because

soon after the episode of the failed thunderbolt Perceval was strapped to 
his bed and “became here again a sport of the wildest delusion.” 
The shock of doubt allowed doubt to gain a foothold. Memories and 
reminders of that doubt lingered. But each moment of clarity was 
opposed by a recoil or aftershock, a rapid alternation between clarity and 
delusion. Gradually, the delusion itself was affected; with each moment of 
clarity there appeared a new edition of the delusion—a compromise delusion—
which took into account his increased awareness and still exhorted 
him to maintain an allegiance to miraculous powers. 
I have so long been deceived by my spirits that I now did not believe them 
when they told the truth. I discovered at last that I was on earth, in natural, 
although very painful circumstances, in a madhouse . . . and I knew I 
was looked upon as a child.21 
He slowly concluded, from the incessant contradictions within the 
commands of the voices, that the voices were as confused as he was. In 
this way, the voices were gradually weakened and eventually terminated— 
and Perceval makes a point of this—one at a time. 
Discipline And Effort 
Frustratingly, shortly after each successful “disobedience” to the spirits, 
he would again unconsciously relapse into reckless obedience. Only 
further discipline and effort could counteract that kind of deterioration of 
his willpower. 
Voices sporadically occurred (at first making no sense) that urged him 
to “recollect” himself; that is, to become more aware of his situation and 
prevent “going into a wrong state of mind . . . by keeping my head to my 
heart and my heart to my head.” He repeated this slogan to himself over 
and over again throughout his recovery as a means of reminding himself 
to keep his body and mind together: “Without that, my head wandered 
from my heart and my heart turned from my head all through the day.” 
Voices told him he was “ruminating all day long,” and a “moving white 
light appeared as a guide” and would indicate to him when he was lost in 
A distinct kind of effort was required to recollect himself and bring 
himself back to the details of his physical world. When he

could do that there came a synchronization of body and mind that 
strengthened his ability to resist the temptations of delusion. For example, 
on attempting to write letters, 
every syllable of these letters I saw by illusion before I wrote them, but 
many other sentences also appeared besides which those I chose; and 
often these sentences made light of or contradicted what went before— 
turning me to ridicule and that ridicule goading me to anger and madness, 
and I had great labor and difficulty to collect myself to seize those 
that were at all consecutive—or not too violent—or not too impassioned. 
This was extremely painful.22 
Any sudden bursting of an illusion or of a glaring self-deception would 
“stupefy” him. At that moment his wild thoughts would cease and allow 
him to see things clearly. It took an effort to utilize that moment and not 
be distracted from it: 
I caught the reflection of my countenance in the mirror. I was shocked 
and stood still; my countenance looked round and unmeaning. I cried to 
myself, ‘Ichabod! my glory has departed from me’; then I said to myself 
what a hypocrite I look like! So far, I was in a right state of mind; but the 
next thought was, 'How shall I set about to destroy my hypocrisy'; then I 
became again a lunatic.23 
Puncturing a delusion, he realized, might come from simple sensations 
or even a scattered fact, and he began to seek them out. Once, he wrote to 
his brother to check out a memory as to the correct date of the death of his 
dog (which figured largely in one of his delusions), and its contradiction 
to the delusion once again “astonished” him. Another time, by requesting 
a copy of his baptismal certificate, he instantly dissolved his belief in the 
spirit voices who told him that he was not really his mother's son. “To 
confirm the suspicion I had of being deluded my mind needed these circumstantial 
evidences to be corrected entirely of its errors.” He noticed 
that there were perceptions whose sudden impact he had been avoiding, 
as if by a reflex. When he saw his face: “I observed on catching my face in 
the pane of glass that my head involuntarily turned away and I turned 
back to observe what had struck me.” It looked disfigured and moronic, 
and it “recollected” him. After this event, Perceval always carried a pocket 
mirror with him, so that he

could quickly check and see if he looked like a madman or not. Finding 
“errors” everywhere within his delusions, a defiance against the voice of 
delusion rose up in him. He would hold himself back from action: “I 
began to hesitate before I acted and joked inwardly at the absurdities of 
my delusions.” Then, he habitually disobeyed the voices: “It was usually a 
reason now for me to do anything, if I heard a spirit forbid it. I was sorry I 
had not done so before, being prevented by superstitious fear, for it 
seemed to bring me to my senses and make me calm and reasonable.” But 
even as his conviction in the delusions was eroding, “new delusions succeeded 
those that were dissipated.” The effort had to begin again. 
His loneliness was profound. While living in a split world, where delusion 
existed side by side with reality, his sense of detachment from people 
was alarming: “They were dead to me, and I dead to them, and yet with 
that painful apprehension of a dream, I was cut off from them by a charm, 
by a riddle I was every moment on the point of guessing.” 
His curiosity was engaged. The presence of other people called him out 
from self-absorption, even when this put him at the risk of being punished 
for it by the voices. “A beautiful servant girl whom I called Louisa” had 
such an effect: 
The sight of a female at all beautiful was enchanting to me. I now began to 
recover my reflection rapidly and to make observations upon character 
and people around me.24 
The spirit voices themselves “directed my attention with greater rapidity” 
to the “variety of situation and ornament.” Then he could make many 
distinctions and discriminations between reality and that which took 
place within the thick veil of illusion: “As I came gradually to my right 
mind I used to burst into fits of laughter at the discovery of the absurdity 
of my delusion.” 
He “experimented” and played with his delusory perceptions. What he 
discovered intrigued him, and he began to further examine the nature of 
his strange perceptual processes. He discovered that he had an exaggerated 
tendency to “dream” even while awake; that is, to pull back from seeing 
outward sensations

and to see instead the images of memory. 
These “investigations” were carried out during brief periods when he 
pushed himself to stand at the mental precipice between dream and reality, 
a precarious position. Such an episode might begin by accident: He struck by the sudden appearance of a voice or a vision, and then 
quickly decipher it down to its component parts, as one can sometimes do 
on awakening from a night dream. In doing this, Perceval first saw a simple 
“illusion,” like an afterimage, echo, or misperception. Built upon that, 
a hallucination rapidly took form by an elaboration on the ordinary illusion, 
which had only been a “trick” of the eye or ear: “I saw and discovered 
the slight that was played upon me. A trick, which until I became stronger 
in health, made me doubt that the objects around me were real.” 
Immediately upon that, he noticed a second trick, which changed the 
meaning of the perception. This second overlay was caused by what Perceval 
called the “power of resemblance.” This function reshaped the illusion 
to the likeness of a memory. Then a third trick created a sense of 
conviction, by a power to personify the illusion or grant it the privilege of 
independent existence. When a newly created existence arose it would 
begin to act for, against, or indifferent to him. The delusion became solidified 
beyond doubt when he engaged it in dialogue. 
As Perceval's discipline of self-observation became sharpened, he saw 
that all these steps occurred very quickly and outside his awareness. He 
was astonished by the speed at which a delusion could be put together and 
that he could even track that degree of speed. In short, he discovered that 
wildness of thought and disordered sensations together create hallucination, 
but only when one enters into dialogue with it does one become truly 
This self-observation and many of Perceval's further observations 
about the nature of psychotic perception are some of the most insightful 
ever made and are central to understanding the process of recovery. The 
examples that follow demonstrate an accumulation of insight about his 
own wildness of mind, all of which he needed in order to cut through his 
intoxication with delusion. They are presented in the same order as they 
occurred to him. 
1. I discovered one day, when I thought I was attending to a voice that 
was speaking to me, that, my mind being suddenly

directed to outward objects—the sound remained but the voice was gone; 
the sound proceeded from a neighboring room or from a draught of air 
through the window or doorway. I found, moreover, if I threw myself 
back into the same state of absence of mind, that the voice returned, and I 
subsequently observed that the style of address would appear to change 
according to the mood of mind I was in; still later, while I was continuing 
these observations, I found that although these voices usually come to me 
without thought on my part, I had sometimes a power, to a certain extent, 
to choose what I would hear.25 
2. The thunder, the bellowing of cattle, the sounds of a bell, and other 
noises, conveyed to me threats, or sentences of exhortation and the like; 
but I had till now looked at these things as marvelous and I was afraid to 
examine into them. Now I was more bold.26 
3. Prosecuting my examinations still further, I found that the breathing 
of my nostrils also, particularly when I was agitated, had been and was 
clothed with words and sentences. I then closed my ears with my fingers, 
and I found that if I did not hear words—at least I heard a disagreeable 
singing or humming in the ears—and that those sounds, which were often 
used to convey distinct words and sentences, and which at other times 
seemed to the fancy like the earnest cries, or confused debating, or expostulations 
of many spirits, still remained audible; from which I concluded 
that they were really produced in the head or brain, though they appeared 
high in the air, or perhaps in the cornice of the ceiling of the room; and I 
recognized that all the voices I had heard in me, had been produced by 
the power of the Deity to give speech to sounds of this nature produced by 
the action of the pulses, or muscles, or humours, &c. in the body—and 
that in like manner all the voices I had been made to fancy outside of me, 
were either formed from or upon different casual sounds around me; or 
from and upon these internal sounds.27 
4. Upon discovering the nature of an illusion caused by the projection of 
an afterimage; I drew from this the following inferences: that neither 
when I had seen persons or ghosts around me—neither when I saw 
visions of things—neither when I dreamt—were the objects really and 
truly outside of my body; but that the ghosts, visions, and dreams are 
formed by the power . . . in reproducing figures as they had before been 
seen on the retina of the eye—or otherwise to the mind—or by arranging 
minute particles in the visual organs, so as to form a resemblance or picture 
of these figures—or by combining the arrangements of

internal particles and shades with external lines and shades and etc. so as 
to produce such a resemblance and then making the soul to conceive, by 
practicing on the visual organs, that what it perceived really within the 
body exists outside, throwing it in a manner out as the specter is thrown 
out of a magic lantern.28 
5. Though I still occasionally heard these voices and saw visions, I did 
not heed them more then I would my own thoughts, or than I would 
dreams, or the ideas of others. Nay, more than that, I rather acted diametrically 
opposed to them.29 
The strength to face one's delusion comes from all such insights into 
the simple deceptions that go into creating a psychotic perception. Once, a 
magnificent vision of a naked woman, said to be his eldest sister, suddenly 
arose before him from the bushes in the garden and beckoned him. Just 
choose her, the voices told him. Recollecting how he had been so deceived 
by visions, he turned away, saying, “She might come up if she would, or 
go down if she would—that I would not meddle with the matter! At this 
rude reply the vision disappeared.” This response to a vision became Perceval's 
second most important slogan for recovery. It became his mental 
practice for recovery: a way of saying no to internal fascinations. 
Anyone awakening from a night dream, a daydream, or even a moment 
of absentmindedness “comes to.” This is usually a moment of sudden 
expansion of awareness into one's environment. It is this kind of environmental 
awareness that Perceval tried to cultivate in himself. He studied 
the mechanism in himself: “Having to recollect myself, I became more 
aware of my real position, my thoughts being called out from myself to 
outward objects.” He pinpointed the sensation of being “called out” from 
delusion as being a kind of passionate energy toward the world—shot out 
like an arrow to sensory objects—and he tried to train himself to recognize 
it more quickly. But there was a major obstacle. He found that this sudden 
openness to his sensory environment was chronically being interrupted 
and covered over by a mechanism that felt like a “film,” or a fog, insidiously 
descending over his mind and clouding his awareness. Inevitably, 
he found himself projecting images onto this film, images that became 
animated, thus cutting him off from external sensory awareness. He 
finally solved this riddle by practicing at becoming quick enough to recognize 
the subtle sensation of the film as it first came to him, and then cutting 
through it. Thus,

the sensation of the film itself became his moment of “recollection,” the 
reMinder To Wake Himself Up. 
Each time Perceval woke up to the “barbarous circumstance” of asylum 
life, he became morbidly dejected with guilt, grief, and “a deep sense of 
self-disgust and degradation.” He noted that when this happened to himself 
or any of the other inmates, the response was to “become wild or apathetic.” 
He tells of “the gradual destruction of a fine old man who was 
placed in exactly similar situations as my own.” He watched how the old 
man's behavior became progressively more slovenly until he became 
unconcerned with even the slightest dignities of living. The elderly man 
had been stripped of humanity. Then, with amazement, Perceval saw all 
his own behavior in the same light. He, too, was deteriorating, was 
becoming animal! At this point he knew fully that he was as much a victim 
of his malignant environment as he was of his delusions. He called this 
shock of awareness “a mercy”; for the old man it was a tragedy, but for 
Perceval it was an insight that had been mercifully granted to him. 
A dreadful sympathy awakened in him, for himself and for all the other 
patients around him. He was filled with an energy of compassionate outrage. 
For the first time, Perceval committed himself to follow a plan of 
action: He would direct himself toward “health” in every aspect of his life. 
He then devoted himself to becoming well, to being strong enough to 
speak for all the others who would never leave the asylum—to tell the 
truth about the horrors of their treatment. He took a vow: 
I resolved—I was necessitated—to pit my strength and abilities against 
that system, to fail in no duty to myself and to my country; but at the risk 
of my life, or my health, and even my understanding, to become thoroughly 
acquainted with its windings, in order to expose and unravel the 
wickedness and the folly that maintained it, and to unmask the plausible 
villainy that carries it on.30 
This singular event of the awakening of compassion was a quantum 
leap in Perceval's course of recovery from psychosis. It is the case for 
many other people as well; a compassionate interest and even a dedication 
to be of service to other people is crucial to the later stages of recovery.

There was a shift of allegiance toward health in everything he did, and 
he resolved to “follow a plan calculated to compose and strengthen me, to 
arouse and cheer me—if I had not had resolution to adhere to such a plan, 
there might have been risk of return of illness, perhaps of insanity . . .. I 
braced up my mind also to courageous and virtuous efforts.” 
He experimented with new efforts at bringing his body and mind into 
harmony to overcome the physical and mental torpor of asylum life: 
“Whenever my thoughts and hands were most occupied I became, I suppose, 
nearest to sound state of mind, and consequently more aware of my 
situation,” and he also remarked “that all, or many of the faculties of mind 
and body should be called into play at one time, and above all things that 
the body should be occupied.” He also experimented with his breathing 
and discerned a peculiar interdependence of mind and breath, finding 
that his mind could be calmed and controlled by “regulated respirations.” 
He tried to watch more closely how he ate his food, finding that the rate 
at which he ate and the qualities of food and their effect on him were all 
interrelated to his state of mind. He tested his ability to exercise by walking 
fast and was overcome with grief at the extent of his physical deterioration. 
He became concerned with his general health, and wrote to his 
mother to send him (which she did) the “dental materials” he needed to 
care for his teeth. He fought the hospital authorities to the end and finally 
was allowed to have some religious books sent to him. 
Whenever he could be alone in his hospital room he stealthily wrote 
about these efforts and kept his journal hidden from the staff. He knew 
that they were especially interested in his notations about abusive treatment 
and his eventual plans for malpractice accusations. Because they 
would sometimes find his notes, he often wrote sensitive material in Portuguese. 
Only after many letters, and what the legal establishment called his 
relentless badgering, did Perceval gain his release from Dr. Fox's asylum. 
His aged mother and his brothers gave in, and two of his elder brothers 
came for him. All the time while riding away in a coach from the asylum, 
he thought they were bringing him home. It was not until they got to the 
doors of Dr. C. Newington’s madhouse at Ticehurst, in Sussex, did Perceval 
realize what had happened. The new madhouse turned out to be 
more humane, and at least allowed him to take walks in the enclosed garden. 
His treatment here was not nearly as harsh,

but he resisted it as best he could, and he continued his letter writing! 
Now, more often, he wrote to the Metropolitan Commission of Hospitals, 
to certain judges and members of Parliament, and in all the letters he 
demanded an immediate examination of his sanity. 
He insisted to his family that they remove him from the madhouse and 
place him in a private home with a family or with attendants to care for 
I needed quiet, I needed tranquility; I needed security, I needed even at 
times seclusion—I could not obtain them. At the same time I needed 
cheerful scenes and lively images, to be relieved from the sad sights and 
distressing associations of a madhouse; I required my mind and my body 
to be braced, the one by honest, virtuous, and correct conversation, the 
other by manly and free exercise; and above all, after the coarse and brutal 
fellowship I had been reduced to, I sighed for the delicacy and refinements 
of female society.31 
At the same time that he was becoming more outwardly defiant of the 
hospital authorities, he was also mentally rejecting and just saying “No!” 
to visionary commands. The hallucinations became forgiving, softer, and 
at times encouraged him toward health. But he painfully discovered that 
he had to stand fast even against voices that called themselves friends. He 
had to forcibly take command of his own thought processes. This, he said, 
was the greatest effort of all. It meant assuming the power to direct his 
thinking—the very same power that, when he was losing his mind, he had 
attacked and abandoned. His previous practices of turning away doubt, 
spiritual submission, and nonhesitation had to be reversed. He did this by 
actively renouncing his emotional attachment to the voices—neither fearing 
threatening voices nor taking pleasure in hopeful voices. Soon, his fascination 
with the presences, voices, and spirits ceased. 
Soon after Perceval was transferred to the second asylum he wrote to 
his mother and her attorney to inform them that he held them legally 
responsible for their having submitted him to

abusive treatment, and for holding him in the hospital against his will; he 
wished to be immediately released to a family lodging. He had heard that 
this method of treatment was being done by two doctors in London, and 
he requested that he be put under their supervision. Again, there was a 
round of visiting doctors and inane interviews. Once again, they urged 
him to remain at the Ticehurst madhouse and not to cause further grief to 
his family, who had suffered enough by his illness. 
But something new was apparent in the behavior of the examining doctors 
and magistrates—they were fearful of his being released. He saw their 
professional greed at wanting to keep him as a patient. He saw their fear 
at his potentially exposing them to investigation. He suspected that they 
were also under the influence of his family, who wanted him to remain in 
the hospital. But he came to the conclusion that the greatest influence on 
their rejection of his appeal was that they were unworldly people, conventional 
and deeply prejudiced—merely “exceedingly simple” and fearful. 
Finally, at the age of thirty-one, after three years in the madhouses, 
Perceval's intimidation of his family and the doctors forced his discharge. 
Physically ill, mentally exhausted, and vulnerable to becoming quickly 
overexcited, he moved to London and spent some time recuperating at a 
home-care lodging in Seven Oaks. He needed a great deal of rest! 
In the following year, he married a woman named Anna Gardner, and 
two years later the first of their four daughters was born. They lived 
mostly in a home in the Kensington area of London, and it was there that 
Perceval made his fateful decision to write a book describing his experience. 
The book was to contain all the notes and letters that he wrote while 
in the asylums, including his accusations against his doctors and his own 
family. His friends argued against it; they said he would be bitterly 
attacked for such an expose, that it would only harm himself and his family 
and children, and that he should put those terrible years behind him. 
He recalled the vow he had made to himself to speak in the name of the 
other inmates and how it had been the mainstay of his recovery: to use all 
his energy and his sanity to expose and break the system of madhouse 
I reflected how many were in the same predicament as myself . . . and I 
said, who shall speak for them if I do not—who shall

plead for them if I remain silent? How can I betray them and myself too 
by subscribing to the subtle villainy, cruelty, and tyranny of the doctors?
He moved to Paris for the next year and during that time, largely from 
memory, wrote of his illness and his confinement. The writing itself 
frightened him. He feared that by vividly bringing back all his memories 
he might once again put himself on the verge of madness. He was also 
rightly apprehensive that he might overwhelm his readers in his flood of 
painful and accusatory words. While writing, he sometimes felt a return of 
insanity—an upsurge of a living memory, like the voracious eating of 
chained madmen—but then he would clear his mind “by pausing and 
drawing a deep breath, sobbing or sighing, as the cloud of former recollections 
has passed over me.” On the front page of the book he added a quote 
from the Aeneid. An aged warrior is requested to recount the siege and 
rape of Troy: 
Oh Queen—too terrible for tongues, the pain you ask me to renew, the 
tale of how the Damaians could destroy the wealth of Troy, that kingdom 
of lament: for I myself saw these sad things, I took large part in them. 
While still in Paris, he met at the Salpetriere Hospital with Dr. Jean- 
Etienne Esquirol, a giant of French psychiatry and soon to become a leading 
figure in the reform of asylum abuses. Esquirol helped Perceval and 
advised him as to the political actions he might take in England. But he 
was disturbed by the extremity of Perceval's conviction that all private 
madhouses should be abolished, feeling that the only innovations possible 
within psychiatry would come from the private sector. 
Without realizing it, Perceval had stepped into the great debate then 
taking place in French psychiatry, one that repeats itself right down to our 
present time: Is psychosis a disorder of the intellect and will, as Esquirol 
argued, or is it a hereditary and degenerative brain disease, as championed 
at the Rouen asylum (which Perceval also visited) by Dr. Jacques 
Joseph Moreau? 
Back in London, Perceval felt he also had something to say about this 
issue. He concluded that the study of a mystery like that of insanity—a 
study that to him was the “most grand and terrible”—was too important 
and instructive to be left in the hands of the physicians. He titled his book 
A Narrative of the

Treatment Experienced by a Gentleman, During a State of Mental 
Derangement: Designed to Explain the Causes and the Nature of Insanity 
(and to Expose the Injudicious Conduct Pursued Towards Many 
Unfortunate Sufferers Under that Calamity). He published it anonymously 
in 1838, and it had immediate consequences on the course of his 
Living with barely controlled outrage is the experience of many people 
who return from the asylums. As for Perceval, he felt himself to be a lonely 
survivor and witness to an atrocity, one that was continuing without public 
awareness and that would continue far into the future. There were few, 
he believed, who could genuinely speak for the insane other than himself. 
“And yet who is on my side? where shall I find the energy to reform these 
abuses?” His situation was not unlike those early escapees from the concentration 
camps who told of what was being done but were met with criticisms 
of “exaggeration” and hysteria.33 Perceval always seemed to 
provoke the criticism of being too “excessive, intemperate, or over-indulgent” 
in describing his experiences. To this he answered: 
I consider this one of the cruellest trials of the lunatic—that on their 
recovery, by the formality of society, they are not allowed to utter their 
sentiments in the tone and manner becoming their situation... in expecting 
from such as have been insane, and are sensible of their misfortune, 
the same tone, gesture, cadence, and placidity, that meets them in persons 
who have not been through any extraordinary vicissitudes.34 
When Perceval learned that one Richard Paternoster, a civil service 
clerk, was being unjustly confined at Dr. Finch's madhouse in Kensington, 
he helped to create the public pressure that led to Paternoster's discharge. 
When he was freed from confinement, Paternoster advertised in the 
Times of London “for fellow sufferers to join him in a campaign to redress 
abuses in the madhouse system.”35 Perceval joined him immediately, and 
together they began to petition the city magistrates for an investigation 
into asylum treatment. They were soon joined by William Baily (an inventor 
and veteran of five years in a mad

house), Richard Saumarez (a surgeon who had two insane brothers), and 
Dr. John Parkin (another former patient). 
In 1840 Perceval published a second, expanded volume of his Narrative, 
and this book was even more clearly dedicated to social action. One 
of the spearheads of action was to be his legal prosecution of his mother 
and Dr. Fox. No action of Perceval's met with so much suspicion of his 
judgment, doubt about his sanity, and accusations of his being a traitor to 
his class and country than his declaration to prosecute his own mother. 
Could this be outrage running wild? Many people recovering from psychosis 
have been known to get stuck in a sense of justifiable outrage, feeling 
the energy of outrage to be an essential ingredient of their health. 
Certainly, Perceval felt this way. He especially became impatient with 
people who could not see, or would not see, the abuse of power taking 
place in the asylum and the world around them. 
The Assassination 
He understood that it could happen again at any time. He might be 
labeled insane by his family or the lunatic doctors, and he might once 
again fall into the snare of the madhouse. He was already under suspicion 
by the Home Office for distributing literature that they said was calculated 
to inflame the lower classes. Paternoster himself had been whisked 
away by the police in the middle of the night following a financial dispute 
with his father. Perceval and his group of former patients worked in an 
atmosphere of potential violence; the age of Victoria was also the age of 
wrongful confinement. 
Perceval's immediate family, which included a number of prominent 
gentry in politics and the ministry, was appalled at the public exposure of 
his insanity, but much more so at the legal action he was directing against 
his mother. To them, it was surely an act of uncalled-for revenge. To him, 
it was the most precise and cutting action possible to present his case: His 
mother, just like the public, was being duped into believing the heartless 
advice of the lunatic doctors. Only later did Perceval find out that, from 
the beginning, one of his brothers had wanted to have him released from 
the asylum and brought to a private lodging next to his brother's home; 
but his mother (on the advice of the asylum) vetoed this plan. Before his 

he asked his mother to join with him in a suit against Dr. Fox; she refused. 
Now, he felt he had no choice but to proceed alone. The malpractice prosecution 
might arouse public attention to asylum treatment, help provoke 
investigative hearings, and reduce the plight of those wrongfully confined. 
Also, he hoped this legal action would secure the rightful inheritance from 
his father, which his mother had withheld from him since his internment. 
It is a strange irony that Perceval must have come to appear to his family 
as a haunting replica of the man who, many years before, had murdered 
his beloved father. The story is as follows: In 1812, when John was 
nine years old, his father was shot to death in the lobby of the House of 
Commons. The assassin, John Bellingham, was noted to be insane (as 
Bellingham's father had been) and was summarily hanged one week after 
the event. One report said: “It was one week from homicide to homicide. 
This trial was called a case of judicial murder of an insane man and was 
explicitly rejected as having no legal precedential authority.”36 Bellingham 
had lived a life of misfortune and bankruptcy and had been imprisoned 
for embezzlement. After that, he never ceased to petition and harass 
members of the government for compensation for what he felt was a 
wrongful imprisonment. He began to feel that he had to kill someone in 
order to bring his grievances to public attention, and Spencer Perceval—a 
man known for his generosity and aid to the poor—was the one. When 
John Perceval, twenty-six years later, began his incessant letters and petitions 
for asylum reform, his family heard echoes and rumors of a dangerous 
person, a chronic complainer against the system, an avenger, possibly 
Throughout this his mother pleaded ignorance. She had no idea how 
badly he was being treated. In any case, she felt that the doctors knew 
what they were doing. They told her that John might become violent if he 
were removed from their treatment. That was enough for her, she had 
experienced enough violence in her family. 
Soon after the publication of his second book, Perceval abandoned his 
threats of prosecution, possibly because his writings and activities were 
already achieving his goals.

Birth of the Patient Advocacy Movement 
In his books and letters to newspapers and government officials, Perceval 
had become an outspoken opponent of what was called the New 
Poor Law. It was a complicated bureaucracy of rules and regulations that 
made it increasingly difficult for poor people to receive public relief and 
much easier for them to be placed in one of the public workhouses that 
existed in every parish in England. Perceval's criticisms led to his being 
given a position as one of the overseers of the Poor Law management. He 
was named “Guardian of the parish of Kensington”—a thankless and usually 
impotent job. He visited the homes of poor people and pleaded their 
cases for public assistance before the government. He wrote to the home 
secretary (and published the letter in the Times) in support of one poor 
widow who was about to be deported to Ireland or else placed in a workhouse 
because of deficiencies in the law. He fought against the separation 
of husbands and wives who entered the workhouse and against young 
children being confined separately from their families. As a guardian, he 
was also allowed to visit with patients inside the public asylums. Sometimes 
he did this along with visiting magistrates on their tours of inspection. 
Although Perceval was becoming an irritating gadfly to the hospital 
administrators, he began to make many friends among the inmates. 
As outraged citizens (many of whom were liberal members of Parliament) 
became interested in patient rights and asylum abuses, the original 
group expanded and in 1846 formed an activist organization, which they 
called the “Alleged Lunatics' Friend Society.” Just about everyone who 
joined this group was either a former patient or, more frequently, the relative 
of someone confined to an asylum. Perceval was clearly at the helm 
of the society and was renowned for his brilliance and energy. Over the 
next twenty years, the society was indefatigable in its efforts to protect the 
civil liberties of mental patients, correct asylum negligence, expose asylum 
greed and corruption, and represent indigent patients before the 
courts. The society lawyers took up the cases of more than seventy 
patients, almost all defenseless people who could not obtain help for 
They were relentless in their bombardment of successive home secretaries 
with their advice, petitions, exposes, and 

legislative bills. In all their actions, they were fearless in exposing upperclass 
sensibilities to the conditions of lunacy, which had long been felt to 
be an extremely private and delicate matter. They held meetings, distributed 
educational material, and gave public lectures. But in almost every 
activity the society engaged in, they were bitterly opposed by the ultraconservative 
Metropolitan Lunacy Commission, the governing body that dictated 
the standards of patient care throughout England. Any patient who 
desired to leave a hospital had to submit to the decision of the commission. 
This commission was held in the iron grip of the notorious earl of 
Shaftesbury, a man obsessed with maintaining Victorian virtues and with 
fighting off every movement toward reform. He continually steered the 
commission in the interests of the medical profession and the influential 
asylum owners. Shaftesbury was the self-avowed archenemy of the society, 
and particularly of John Perceval, who had been his classmate at Harrow. 
The society and the commission were in combat, and they both vied 
for influence over Parliament. 
It seemed that Perceval thrived on this twenty-year struggle. One time, 
through his investigations, Perceval managed to free a patient from years 
of involuntarily confinement in a private madhouse and forced the commission 
to reprimand the asylum owner, who then told Perceval, “I would 
rather have the devil confined here than you!” Being the “son of his 
father,” he was at home in the corridors of power and became increasingly 
audacious in his attacks on Shaftesbury and the commission. He advertised 
a public lecture to be held at 7:00 P.M. on 1 May 1851, in the Kings 
Arms Tavern, at High Street in Kensington. The advertisement for the lecture 
On the Reform of the Law of Lunacy: When the abuses of the Law will be 
illustrated by several cases of oppression recently brought to light, and by 
the example of a Gentleman who was lately seized by the Police of the 
Metropolis under circumstances of Gross Outrage and Injustice. 
A plainclothes detective was in the audience—the kind of surveillance 
Perceval suspected but did not know of at the time— and reported back to 
the police and the commission. His report must have disappointed them. 
He said: “There were twenty-four people present, of respectable appearance.” 
He might have added what was already well known, that Perceval 
was an 

enthusiastic speaker who could rouse an audience with his clarity of documentation. 
Personal abuse and slander followed many members of the society. 
When Perceval mounted an assault (which he won) through the courts, 
press, and public lectures on the abuses at Northampton Hospital, one of 
the officials of the asylum accused Perceval of being mentally deranged 
and wrote in the newspaper that his “sympathies with the insane are of a 
very morbid character and his judgement to the last feeble and weak.” 
Even though Perceval's sanity continued to be doubted by some people, in 
these years of political action he gradually regained the confidence of his 
family. Many brothers, sisters, and distant relatives gathered to give him 
comfort, along with moral and financial support. 
The society submitted a continuous stream of new and brilliant legislation 
to change the laws regarding rules of certification, enforced treatment, 
visitation of patients, means of treatment, qualifications of doctors 
and asylum owners, inspection of hospital facilities, overcrowding of hospitals, 
education of patients as to their legal rights, and judicial hearings 
for every patient before involuntary admission. 
They challenged the adequacy of long-term care for all patients 
(whether in asylums, workhouses, or private lodgings), and they advocated 
for the system of treatment being used in Geel, Belgium, where 
patients were boarded out with families on a voluntary basis. (“I am convinced 
that the collecting of lunatic patients together is a necessity to be 
deprecated, rather than a principle to be admitted,” wrote Perceval.) The 
society proposed transitional treatment facilities for patients before 
involuntary admission to an asylum and for aftercare following discharge. 
Perceval, especially, insisted on greater involvement of the church in the 
care and visitation of the insane—an ageless function of the ministry, he 
felt, that the church had abandoned to the lunatic doctors. 
Every proposal by Perceval and the society was vehemently opposed by 
the commission and those with vested interests in the asylum. This conflict 
came to a head when the society's efforts provoked Parliament to convene 
a Select Committee of the House to hold hearings and gather 
testimony about the care of the insane. It was at one of these hearings in 
1859 that Perceval bluntly said, after being asked why he was so singleminded 
about insuring the delivery of patient's letters: “I consider my

self the attorney-general of all Her Majesty's madmen.” Perceval and the 
other officers of the society sat through days of official hearings. Perceval 
was hard-of-hearing (from wounds he received to his ear at the madhouse) 
and each night had to study transcripts of the proceedings. At 
times, attorneys for the commission prevented the society from using crucial 
testimonies and evidence. But through the proceedings, the society 
members were confident and hopeful. Even reading the transcripts today, 
one is struck by the clarity and drama with which they presented their 
program for reform. 
In the end, only a handful of the society's bills and amendments were 
passed by Parliament. But the society's educational influence was great, 
and they sowed the seeds for reform well into the next generation. Their 
demand that all patients should have a jury trial or magisterial hearing 
before involuntary confinement—a crucial element in the society's program 
for reform, and adamantly opposed by Shaftesbury—could not be 
enacted until 1890, after Shaftesbury's death. 
After twenty years of activity, the society appears to have come to a natural 
end in the mid-1860s. In those last years, two of the society's ablest street 
fighters died and Perceval lost three of his brothers. “One suspects,” writes a 
historian of the period, “that the appointment of his nephew Charles Spencer 
Perceval as the Lord Chancellor's secretary in 1866, and later as secretary 
of the Lunacy Commission, finally gave him some peace of mind.”37 
This history of the world's first—and perhaps most influential—organized 
attempt at asylum reform by former mental patients gives all of us 
who are currently involved with the issues of patient advocacy food for 
thought. In our age, grass roots patient advocacy is just now becoming a 
powerful force in determining the care of insane people. But it is beset 
with difficulties. Along with almost all of the same issues that the society 
fought for, current-day activists must add new ones, like the overuse of 
tranquilizing and “antipsychotic” medications and the right to refuse 
treatment. As current activists, we may naturally wonder what is to 
become of our own work, if as highly organized and industrious a group as 
the society failed to achieve its legislative goals and passed virtually unnoticed 
in the history of psychiatry. 
Particularly in our age, amidst the increasing appearance of organizations 
to protest human rights violations and inhumane activities of all 
kinds, the movement for mental patient advocacy does not find much 
support. Surely, Perceval would tell us not

to lose heart. He would remind us that “antipsychiatry” was not simply a 
movement toward reform that began in the 1960s, it began as soon as psychiatry 
began. He would say that there have always been tremendous 
obstacles to genuine care for the insane—every age has its Shaftesburys. 
Although the society had meager results in changing the laws of England 
and altering the course of psychiatric care, it directly benefited hundreds 
of people, and probably indirectly eased the pain of many thousands in 
the institutions. 
A commitment to patient advocacy usually happens at a very personal 
level—through one's own experience, in one's family, or with friends. 
Thus, an increasing number of us have and will have the opportunity to do 
patient advocacy. If we are not involved with patient advocacy, who is? 
Who will be? Perceval would say that it does not matter if we do it for one 
year or one day, it will still affect people in the hospitals. If we advocate 
for the improved treatment of even one patient, and do it steadfastly, it 
can have great consequences. Having the courage to visit someone in the 
hospital means something. In fact, just visiting someone may become an 
important event in that person's life! 
Perceval visited public asylums and private madhouses whenever he 
could get the opportunity. As guardian of the Parish of Kensington he 
could get into the inner wards when he accompanied official teams of 
I mixed with the patients, and stood apart from the other gentlemen, 
because more is observed sometimes in this way, than in attending to 
what is directly going on before the physicians; when a patient, who had 
been singing very loudly and very well, addressed me, and asked me how 
I liked his singing; “It is not bad,” said I, “but I observe one fault; you sing 
out of time.”—”You are the first person, then, that ever accused me of 
that,” said he. I replied, “You do not seize my meaning; I mean that it is 
out of time to sing in the presence of these gentlemen, who are here on 
the business of the hospital.” He received this with a hearty friendly 
laugh, and ceased his singing.38 
On one such visit to the infamous Bethlehem Hospital, Perceval found 
himself in the company of Dr. John Bright, the same lunatic doctor who 
had visited him at the Ticehurst madhouse and had turned down his 
appeal for freedom. A haggard, middle

aged patient stopped Perceval in the hallway and handed him a sheath of 
one hundred pages of poetry, asking him to give it to Dr. Bright. Perceval 
admired what he read, in part: 
And there the prisoners and the keepers rest 
Together, the oppressor and the oppress 'd. 
The great and small obey the same decree, 
For, as the master, is the servant, free 
Among the dead, where no distinction be. 
Arthur Legent Pearce had attacked his wife ten years earlier in a fit of 
delusional jealousy, and he had been abandoned by his family and confined 
ever since. Now, he declared his sanity and was trying to gain his 
freedom. Perceval and Pearce became friends, and on subsequent visits 
Perceval convinced him to allow the publication of the poetry, feeling that 
it would help his cause, as well as lift his spirits, and the sale might help 
pay for his legal appeals.39 
On another official visit to Bethlehem Hospital, Perceval met with Dr. 
Edward Peithman, who claimed that he had been confined for the past 
thirteen years while being of perfectly sound mind. Perceval thought Peithman 
to be one of the most distinguished and well-educated scholars he 
had ever met, and he took up his case. Peithman, a German national, had 
been a tutor in languages and a university lecturer but, following an 
absurd series of mishaps with his employer, was arrested for a “breach of 
peace” and then hospitalized. Over the years, Dr. Munro, a director of 
Bethlehem, continued to certify Peithman as insane. When the lunacy 
commission reviewed his case, Peithman was freed. But, immediately 
upon release, Peithman went to Buckingham Palace to deliver a long and 
eloquent petition that requested compensation for his thirteen years of 
illegal confinement. He was told to leave, but, when he refused, he was 
again arrested and returned to the hospital. Now Perceval gathered 
numerous testimonials from doctors, clergymen, friends, and Peithman's 
family in Germany as to his mental health. Peithman was released again, 
but only on the condition that he leave the country and return to Germany. 
Perceval accompanied him on the trip and helped him to reunite 
with his family. In Germany, his family and many doctors found Peithman 
to be perfectly sane, even something of a genius. Within months, 
Peithman— along with the German government and Baron Von Humboldt,

chamberlain to the king of Prussia—demanded immediate redress to injuries 
from the Crown of England. 
In 1854 Perceval published a full account of the story along with letters, 
certificates, and testimonials in support of Peithman's petition. Perceval 
adds this bizarre postscript: 
In conclusion, it is to be observed that Dr. Munro, on whose sole authority 
Dr. Peithman was detained in Bethlehem during thirteen successive 
years, has been proved to be in a state of insanity, and is actually confined 
in an asylum.40 
Confinement in Perceval's time was considered to be one of the unfortunate 
necessities of a turbulent society, but everyone knew that hospitals 
were dangerous places—one might never leave or might come out worse 
than when one went in. Today a relative upsurge of interest in patient 
advocacy has provided more than enough documentation that psychiatric 
hospitalization is still dangerous.41 Comparison of the litigation against 
hospitals and doctors, and of the bills of reform submitted for legislation, 
between Perceval's time and our own, reveals them to be the same. We are 
still struggling with the same problems that plagued the early asylums: 
procedures of commitment, enforced hospitalization, the right to refuse 
treatment, the inadequacy of treatment review, untrained doctors and 
staff, and un-reported hospital deaths. We are still arguing about the fine 
line between what constitutes treatment and what is “therapeutic 
Many changes have occurred since the time of Perceval. But if Perceval 
were here now to walk our wards, among heavily tranquilized patients, to 
talk with them, discuss treatment with our doctors, and to visit with the 
homeless mentally ill within the shelters, he would conclude that there 
have been changes but that not very much has improved. 
We still create our own style of madhouses and asylums. This can be 
seen at beautifully furnished private treatment centers as well as at deteriorating 
state hospitals. We seem to be inescapably drawn to re-create conditions 
of treatment that are bound to make it difficult, if not impossible, 
to recover from psychosis.

On examining our own systems of treatment, we might ask: How has it 
come to be that, in spite of our best intentions, we are haunted by the possibility 
of reproducing the environment of a lunatic asylum? Why haven't 
we learned how to run a hospital better than that? It is because creating 
an asylum stems from a particular state of mind, an asylum mentality, 
which can resurface anytime and anywhere and recapitulate the history of 
the asylum. Contact with insanity tends to provoke it: a reflex-like way of 
responding to insane people that can, in a moment, generate all the notoriously 
punishing techniques of treatment used in a supposedly bygone 
era. Even in the most benevolent of institutions, asylum mentality erupts 
as a series of self-deceptions and primitive beliefs, or superstitions, about 
what madness is and how it should be treated. Experience shows that no 
program, project, hospital, or therapeutic community can fully escape the 
spontaneous arising of asylum mentality; we are the unconscious inheritors 
of that way of trying to treat many people in one place. 
Asylum mentality is a mind of exerting power over others, in this case 
“therapeutic power.” Perceval's shocking discovery—a landmark event in 
his recovery—was the degree of power vested in the hands of people who 
were treating him and the gross therapeutic aggression that they practiced. 
In our time, the “therapeutic community” movement was designed 
to avoid this tendency to abuse of power through a program of 
democratizing treatment wards. But even this movement has failed (its 
founder, Dr. Maxwell Jones, recently said), because of the same tendency 
to abuse therapeutic power and thus create the same therapeutic environments 
of aggression.42 The facts are clear: The accusations of “oppression” 
by therapeutic power in the past are the same as those made about 
our current institutions and asylums. 
The Practice 
How can we work with this seemingly universal tendency toward asylum 
mentality? For any of us, the most important point is to become 
aware of it as it happens. No one appears to be immune to a subtle 
appearance of asylum mentality; it can appear at any time and in many 
different situations of dealing with or about people in psychosis. But, one 
can train oneself to

recognize it at an early moment and not slip further into an archaic belief 
system. In this way it is possible to cultivate a healthy doubt about how we 
are treating people whose minds are highly disturbed. To do this we need 
to become more aware of the subtle meanings of the word asylum. 
A recent analysis by the great social historian Michel Foucault of the 
so-called Age of Confinement confirms and deepens Perceval's meaning 
of asylum: a therapeutic structure or space that is required to be filled; a 
theory about treatment based on ignorance; and techniques of relating to 
people in psychosis that are ultimately punishing.43 Asylum mentality 
manifests in a variety of ways: 
• Asylum preserves what is called “nonreciprocal observation.” One 
is observed without being able to observe properly. One's state of mind— 
mistakes, awkwardness, and transgressions—is cataloged, diagnosed, and 
studied; whereas one's own observations are held in suspicion and doubt 
and are called unsound, resistance, arrogance, transference, and the like. 
An examination by the insane of their conditions, including the state of 
mind and therapeutic intentions of all their caretakers, is more or less 
prohibited. It is a situation bound to evoke paranoia. 
• Asylum mind treats madness as childhood. It relegates the asylum 
confinees to the status of minors—intellectually, morally, judicially. This 
prejudice stems from what is known as the “damage theory” of psychosis, 
that people in psychosis are undeveloped, arrested, deficient, or defective. 
It lays the foundation for a wide variety of treatment theories and beliefs 
as to what can be expected from “recovery.” Most of all, it excuses insufficient 
care. Perceval pleaded this point: 
To the custom of the courts of justice to look upon them as infants in law, 
from whence has followed the practice in asylums of treating them as if 
they were infants in fact . . . The law which, under the pretence of their 
being 'infants,' and who subjects them to the caprices and arbitrary rule 
of their guardians, should at least protect them as a parent would her 

• Asylum embodies the idea that madness must first be subjugated 
for recovery to take place. In the words of Samuel Tuke—a reformer who 
tried valiantly to break out of the asylum tradition, only to create a more 
subtle asylum called “moral treatment”—insane people need to be ^dominated.” 
The mind of insanity must learn to bow before the superior power 
of reason and logic. Perceval felt that “so rooted is the prejudice that 
lunacy cannot be subdued, except by harsh treatment,” that this belief 
would appear in every aspect of interacting with the insane. 
The glory of the old system was coercion by violence; the glory of the 
modern system is repression by mildness and coaxing, and by solitary 
confinement; but repression is the word, and that is to be obtained by any 
• Asylum manifests in an organization of people whose hierarchy is 
based on a conviction of its moral sovereignty over the insane. This 
involves a further notion of the subjugation of insanity. One is to be cured 
within a moral social order based on the principle of the bourgeoisie 
patriarchal family. The asylums that practice “moral treatment” emulate 
that structure and try to refine it into a perfected family institution. It was 
meant to be a new, ideal asylum, but it carried with it many of the restrictions 
of the old asylums. 
• Asylum is a moral domain where recovery is measured against 
many differing notions of “mental health.” Wherever there is insanity, 
issues of “spirituality” arise. In the Victorian asylums, the principles of the 
established church were the measures of sanity. Perceval observed that 
the spirituality professed by doctors was so uninformed and narrowminded 
that they hardly recognized that most people in psychosis were 
involved in a variety of life-threatening spiritual crises. When the medical 
view of sanity and psychosis came to ascendance, a seemingly ageless 
understanding of insanity as a spiritual crisis was lost. Asylum mind sees 
spirituality as “religiosity” and as dangerous to the welfare of the patient. 
Yet it does not hesitate to promote and enforce its own ideologies about 
sanity, in therapeutic environments whose various social designs incorporate 
the whole spectrum of religious and political beliefs.

• Asylum is a place of refuge. It rescues people from degraded, animallike 
environments and brings them into social conditions of a higher 
order. This principle arose from a growing understanding that madness 
springs from a diseased or problematic environment of some kind. Asylum 
mind poses itself as the rescuer, to which one should be grateful and 
obedient. It has to distinguish itself from a patient's previous life by ignoring 
and belittling the richness, energy, and seduction of insane worlds. 
• Asylum, with or without walls, views madness in all its expressions 
as a primitive arrogance, an insufferable presumption, which sporadically 
arises in the human condition. And it must be punished. Michel Foucault 
traces this therapeutic belief to the Inquisition: “His torment is his glory, 
his deliverance must humiliate him.” Such a theory justifies brutal and 
constraining treatment of all kinds, as a necessity. 
The most subtle form of asylum mind has been called the “silence that 
humiliates,” a studied interpersonal rift between doctor and patient. The 
professional separation between them creates a loneliness and silence for 
the patient in which to reflect on madness—to intensify it, so that it might 
mock itself. Asylum mind demands a confession to the error of arrogance 
and to the ancient crime of spiritual self-exaggeration; its goal is for the 
patient himself to come to believe that his suffering harsh treatment is 
deserved and necessary for recovery. A residue of guilt is meant to last far 
into the future, to be an armor and reminder against any excessive selfpresumption 
in the future. 
Many early asylum directors worked diligently with their staff to design 
ways and means of mockery, to humiliate and thus bring a patient to his 
senses. From this has come some treatment plans that prescribe the outright 
terrorizing of patients, in order to inspire a fear that might shock 
them to their senses. The asylum belief is that recovery cannot take place 
without sufficient inner self-mortification and an attitude of apology. But 
that does not occur; instead, outrage and defiance in an asylum culture 
was, and is, rampant. Perceval reported how he and many of the other 
inmates would among themselves take vows of silence and noncompliance 
to the doctors. 
This treatment was designed to insult, under the idea of quickening, 
arousing, nettling the patient's feelings! . . . my mind is

astonished at the idea of reasonable beings admitting the propriety of 
such gross mockery, arguing in so absurd a circle, to such a cruel end. It is 
as if when a jaded post horse has fallen motionless from fatigue you were 
to seek out a raw place to spur him or lash him in, to make him show 
symptoms of life.46 
• Finally, asylum is fundamentally a medical space. Somewhere at 
the turn of the eighteenth century, medical specialists took complete 
responsibility for the care of the insane. This new territory was even royally 
sanctioned when the lunatic doctors were given full authority to treat 
George III. Their status was assured. From that point on, the lunatic doctor 
assumed the privilege of deciding who was insane and could commit 
someone to an asylum merely by his signature. 
In the early 1800s it was an open and begrudgingly acknowledged fact 
that medicine itself had little to offer as treatment for the insane. The elixirs 
and the herbs, baths and bleedings, isolations and exposures, shocks of 
cold or hot, and restraints and drugs that had been handed down within 
the medical tradition just did not work. The few studies of psychotic mind 
available were deemed to be effete and even irrelevant to the conduct of a 
psychological “science.” The study of brain physiology and anatomy—the 
exalted science and the great hope of that time and ours—already showed 
signs that simplistic brain mechanics would not account for psychosis. 
Leaders of the medical schools and hospitals of the period had strong disagreements 
about that. Treatment increasingly relied on medical power 
or on the status of magic and authority that “medicine” always accrues to 
itself. The leaders relied not on competency and knowledge but on the 
power of a credential, which implied wisdom. Medicine borrowed science's 
mask of power, even as it acknowledged that its own science did 
not work. All that could be hoped for was a prescription to recover by 
moral command. Foucault, in the spirit of Perceval, claims that all medical 
psychology still bears the stamp of asylum mentality; it still continues 
to rely on a scientific authority which it has not earned. 
To soften this medical influence Perceval increasingly advocated for 
the participation of the ministers of religion in the care of the insane. He 
wanted ministers of many denominations to visit with patients in the asylums. 
This turned out to be a most unpopular request: Doctors resented 
any interference to their

treatment hegemony over the insane, and members of Parliament 
thought it might erode the separation of state and church. The ministers 
themselves felt too inadequate to be involved; although they continued to 
visit prisoners, poor people, and disaster victims, they claimed that working 
with the insane was no longer part of their tradition. Even Perceval 
had some misgivings about the idea. Many years previously he had turned 
his back on official religion, believing the ministry to be ignorant of personal 
spirituality. At the age of sixty-five, eight years before he died, he 
Much mental suffering thirty-seven years ago, accompanied with the 
experience of very extraordinary mental or spiritual phenomena which 
have continued, and have been my study to this day, has made me very 
skeptical upon the value of the Scriptures, and on many points of the 
Jewish and Christian religions.47 
However, Perceval felt that the ministers could be trained. Perhaps 
they could understand that as much as a person in psychosis is ill, he is 
also like the victim of an earthquake, in need of help. He believed that if 
anyone could inject a compassionate influence into the lives of people in 
the asylums, it would be the ministers, whose education was at least 
grounded in the teachings of compassion. 
The awakening of compassion for his fellow inmates had been the crucial 
moment of Perceval's recovery from insanity. It gave him energy; it 
gave him resolve and courage to recover his health, and in the end he dedicated 
his life to compassionate activity. A young companion once asked 
Perceval why he—a man with views far in advance of his fellow countrymen 
and so at odds with the establishment—had not emigrated to the liberal 
American colonies, as many of his character had done. Perceval 
thought this was an “ironical compliment, yet I knew that it was the case.” 
Yet the assessment of Perceval's character was mistaken; he was really not 
the colonist type. He could never turn his back on England and English 
people—that was his family heritage and honor. Almost as much as Perceval 
believed that one's sanity could be recovered, he believed that the 
health of his country could be recovered and that its national sanity could 
be restored. In all of his patient advocacy work, he tried to engage what he 
felt was the national sanity. Perceval was convinced—as had been many of 
his family and class before him—

that the English ideal of justice (with its exquisite respect for human liberty) 
was one of the world's noblest expressions of an innate human compassion. 
Justice was the true heart of England for Perceval, and he 
believed that it could always be appealed to and awakened in times of 
national madness.

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