PART ONE
PARABLES OF
MADNESS
11
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.
—JOHN THOMAS PERCEVAL
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
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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
PERCIVAL’S COURAGE [13]
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
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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.
B R EA K O U T
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
PERCIVAL’S COURAGE [15]
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
wild.
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
[16] PARABLES OF MADNESS
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
PERCIVAL’S COURAGE [17]
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
[18] PARABLES OF MADNESS
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
them.
PERCIVAL’S COURAGE [19]
L O S I N G M IN D
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
[20] PARABLES OF MADNESS
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
PERCIVAL’S COURAGE [21]
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
destruction.”
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
[22] PARABLES OF MADNESS
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
PERCIVAL’S COURAGE [23]
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
[24] PARABLES OF MADNESS
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.
PERCIVAL’S COURAGE [25]
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?”
[26] PARABLES OF MADNESS
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
PERCIVAL’S COURAGE [27]
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
an
[28] PARABLES OF MADNESS
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.
PERCIVAL’S COURAGE [29]
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.”
Nightmare
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.
[30] PARABLES OF MADNESS
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.
“Crack”
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
PERCIVAL’S COURAGE [31]
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.
Possession
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.
[32] PARABLES OF MADNESS
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
each.17
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
PERCIVAL’S COURAGE [33]
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.”
T H E C Y C L I C J O U R N E Y O F L O S I N G MIN D
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
[34] PARABLES OF MADNESS
PERCIVAL’S COURAGE [35]
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
experiences.
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
love.
[36] PARABLES OF MADNESS
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
it.
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
PERCIVAL’S COURAGE [37]
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.
S TA G E S O F R E C O V E RY
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
[38] PARABLES OF MADNESS
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
treatment.
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!
PERCIVAL’S COURAGE [39]
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
[40] PARABLES OF MADNESS
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
PERCIVAL’S COURAGE [41]
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
thought.
A distinct kind of effort was required to recollect himself and bring
himself back to the details of his physical world. When he
[42] PARABLES OF MADNESS
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
PERCIVAL’S COURAGE [43]
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.
Discovery
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
[44] PARABLES OF MADNESS
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
would.be 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
insane.
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
PERCIVAL’S COURAGE [45]
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
[46] PARABLES OF MADNESS
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,
PERCIVAL’S COURAGE [47]
the sensation of the film itself became his moment of “recollection,” the
reMinder To Wake Himself Up.
Courage
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.
[48] PARABLES OF MADNESS
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,
PERCIVAL’S COURAGE [49]
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
him.
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.
R E E N T RY
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
[50] PARABLES OF MADNESS
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
care.
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
PERCIVAL’S COURAGE [51]
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?
32
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
[52] PARABLES OF MADNESS
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
life.
Outrage
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
PERCIVAL’S COURAGE [53]
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
discharge,
[54] PARABLES OF MADNESS
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
violent.
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.
PERCIVAL’S COURAGE [55]
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
themselves.
They were relentless in their bombardment of successive home secretaries
with their advice, petitions, exposes, and
[56] PARABLES OF MADNESS
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
read:
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
PERCIVAL’S COURAGE [57]
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
[58] PARABLES OF MADNESS
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
PERCIVAL’S COURAGE [59]
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
inspection:
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
[60] PARABLES OF MADNESS
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,
PERCIVAL’S COURAGE [61]
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
A S Y L U M AWA R E N ES S
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
aggression.”
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.
[62] PARABLES OF MADNESS
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
PERCIVAL’S COURAGE [63]
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
children.44
[64] PARABLES OF MADNESS
• 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
means.45
• 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.
PERCIVAL’S COURAGE [65]
• 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
[66] PARABLES OF MADNESS
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
PERCIVAL’S COURAGE [67]
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
wrote:
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—
[68] PARABLES OF MADNESS
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.
