On madness

‘You don’t have to be mad to work here…etc.’ It wasn’t very funny the first time round when this adage began appearing on office walls a few decades ago. But it did demonstrate the casual attitude to madness, something very few people actually encounter red in tooth and claw unless they have sufferers in their family or work professionally with people who have ‘mental health problems’.

The current euphemism ‘mental health problems’ covers a wide range of disorders from mild anxiety through to frank psychosis, in other words, ‘madness’. Described as ‘the state of having a serious mental illness’, madness has nearly 60 acronyms such as ‘insanity’, ‘mania’ and ‘derangement’ and if you have spent any time working in a psychiatric hospital you will recognise just how extreme madness can be.

A manic depressive in a manic phase can be someone out of control with an outsized estimation of their own standing, ability and energy attempting outrageous mental and physical feats and requiring constant observation. The rebound apathy, shame and despair are pitiful to watch.

In the same vein the bizarre and often terrifying delusions of a paranoid schizophrenic are almost as distressing to the observer as for the sufferer for whom these are not delusions; they are real.

Therefore, the casual way the word ‘madness’ and its related adjective ‘mad’ have slipped into everyday use is long-standing. However, these expressions have moved from being mere colloquialisms, casual or inappropriate insults to part of the currency of political exchange. I must own up to some causal use myself as in ‘the madness of lockdown’ and ‘the madness of the anti-vaccination brigade’.

Turning to our political masters, a quick check of Hansard during 2020 for the word ‘madness’ revealed 57 hits. I was not sure whether to be surprised or disappointed, but I cursorily investigated the instances when the word ‘madness’ was used and, while not its exclusive use, it was noticeable how often the term was used in relation to the United Kingdom’s then imminent departure from the European Union, ‘Brexit’.

For example, Geraint Davies MP (a repeat offender) said, in relation to Brexit: ‘This is not sovereignty; it is madness and self-harm’ thereby managing to include two aspects of mental illness in the same sentence. Ian Blackford MP was more effusive, but eventually got to the point with: ‘With the continued risk of a second wave hitting the economy and our communities in winter, the idea of the UK leaving the European Union at the same time is economic madness.’

Economic madness it may have been but in epidemiological terms it transpired to be a godsend as exemplified by the speed with which the United Kingdom was able to approve a COVID-19 vaccine compared with our former Euro-compatriots. Sir Keir Starmer MP, always keen to keep the population of the country he wishes to govern locked up longer and more severely than necessary, with reference to the global pandemic, reckoned: ‘If the infection rate is still going up on 2 December, it is madness to come out of the system back to the tiered system.’

The Scottish National Party, under the delusion that anyone south of the border cares what they have to say, never like to be excluded from a debate and Pete Wishart MP, in a typically long-winded statement included: ‘I can tell the right hon. Gentleman that the Scottish people are also scenario planning. We are planning our best-case scenario, when we get out of rogue state UK before the worst of this Brexit madness consumes our beautiful nation.’ I could not resist including his ongoing invective, thus: ‘His European counterparts must be looking forward to the next round of talks with all the relish of a vegan being served a platter of chlorinated chicken.’

Vegans everywhere should rise in indignation; just imagine the outcry if he had used the analogy of a Muslim and a pork pie. Adhering to the Brexit theme, Brendan O’Hara MP said: ‘it is beyond madness for this Government to believe that it will be possible to conduct and conclude all the necessary negotiations and implement the results within the next five months.’ This was an interesting analogy as what lies ‘beyond madness’ is sanity; perhaps O’Hara is a closet Brexiteer.

Using the term madness is not always abstract; it has also been used ad hominem and a special article in the Journal of the Royal Society of Medicine examined the former MP and journalist Matthew Parris’s assertion in 2003 that the then Prime Minister Tony Blair MP was mad. Parris, who never knowingly plays down his views, considered that Blair’s ‘grasp on reality was slipping and he was making statements that were ‘palpably absurd.’’

The author, a Fellow of the Royal College of Psychiatrists, was unable to conclude on the state of Blair’s mental health but he did warn that the casual use of the word encouraged negative stereotyping of people with genuine mental illness. After all, who would wish to be likened to Tony Blair?

The problem with the casual but directed and deliberate use of the term madness is that it labels individuals and adherents to unpopular views as not worthy of being listened to or debated with. Thus, Brexit is madness and Brexiteers are mad and that is an end to it. There is no point in engaging in argument with them and certainly no point in trying to find out why they hold their beliefs.

I have, literally, cleared a circle of people round me at a reception by announcing that I voted to leave the European Union. Donald Trump is mad, apparently, and there is no limit to the diatribe that can be aimed at him. But he is not mad. I am not a psychiatrist, but I reckon he is an incurable and spoiled narcissist which, if that is a definition of madness, would clear most of the front benches in the UK parliament. For certain, the previous Speaker of the House of Commons, the illustrious John Bercow MP would have been committed to a secure unit a long time ago.

Nevertheless, those of us considered mad, due to our countercultural views are quite lucky. In the former Soviet Union, mental health was weaponised against dissidents, and madness followed by incarceration, was diagnosed based on ‘psychopathological mechanisms’ and ‘philosophical intoxication’ for anyone disagreeing with the Communist leadership and who questioned the basic tenets of Marxism-Leninism.

Thus, were people removed from society and held, often until death, in psychiatric prisons purportedly receiving treatment for their disorder. The only acceptable cure for the disorder was to accept re-education and adherence to state doctrine and the prospect of a return visit to prison if you relapsed.

We are blessed in the United Kingdom. No matter how much our political opponents may wish to label us as mad and, I am sure, have us locked up and the keys discarded, there is nowhere to put us. Long gone are the large Goffmanesque asylums which existed on the outskirts of most major cities. We now live in the age of Care in the Community. Maybe we are all mad.

Roger Watson is a professor of nursing

Subscribe to the quarterly print magazine

Subscribe to the quarterly digital magazine