The Qualitative Historical Origins of Mad Studies in Word and Deed,1436–1914

Abstract

Periodically from the 15th to early 20th centuries, mad people left written accounts of their experiences. Originally written by upper- and middle-class White authors who had both the money and literacy skills to record their thoughts, since the late 19th century, the diversity of mad people’s writings has increased to reflect more representative experiences regarding class, gender and, to a lesser extent, race and disability. The origins of what is now called “Mad Studies” can be found among writers discussed here, though long before such a field came to formally exist. From the 18th century, there were also individuals and organized groups who challenged abusive practices and attitudes toward mad people, whose efforts are precursors to recent activist histories. This article reflects on how Mad Studies is the direct beneficiary of centuries of critical analyses and activism by mad people long before contemporary times.

Mad People’s History and Mad Studies have sought to do academia differently by challenging the sanist and ableist approaches to past and present experiences of madness. This article will reflect upon qualitative challenges to understanding the development of these fields in the academy with a particular focus on how writings by mad people provided Mad Studies’ original critical origins. Prior to the 18th century, most of this history was written about, rather than by, mad people. There were notable exceptions with Margery Kempe’s transcribed memoirs from 1436 being this article’s starting point. For several hundred years, mad people have left written accounts of experiences of what it was like to be mad and to be treated as such. Originally written by upper- and middle-class White authors who had both the money and literacy skills to record their thoughts, since the late 19th century, the diversity of mad people’s writings has increased to reflect more representative experiences regarding class, gender and, to a lesser extent, race and disability. These writers were the first proponents of what is now called “Mad Studies,” though long before such a field came to formally exist. There were also individuals and groups who would today be recognized as activists, trying to change abusive practices and public attitudes toward mad people from the 18th century onwards, whose efforts are mentioned as precursors to the modern movement.

Mad Studies arose out of the development of activism and research by people who identity as mad, along with the support of allies, who have sought to challenge dominant ways of thinking about madness by doctors, mental health professionals and their like-minded colleagues in the medico-legal-academic professions. Since the early 2000s, this field has sought to create space in the academy and wider community for the study of critical perspectives of people whose views have historically been dismissed. While work that specifically identifies as belonging to Mad Studies is a recent development, this article will advocate that the overall field is the direct beneficiary of centuries of critical analyses and activism by mad people long before contemporary times.

Who are the originators of what we now call Mad Studies? This article will advocate that it is those whose thoughts, ideas, passions, despair, critiques, and clarion calls for justice dating back hundreds of years are the originators of this field. These individuals whose accounts will be recounted here were analyzing madness in ways that have been essential to the growth of this field—with a critical lens trying to understand their own experience of madness within a context of religious and later secular interpretations that challenged contemporary views of their own experiences. These thinkers also lived, were tormented, thought, and died in a world that was generally irredeemably hostile to mad people. Not until the latter 19th century did some mad people have a supportive community of like-minded writers or peers who expressed public support of their experiences as mad people, though this support was less numerous than would be the case by the latter 20th century while prejudice was endemic and persists to this day. Mad writers and thinkers during this period often toiled alone during a time when to be mad was frequently understood as due to being possessed by devilish incarnations, or later, to be afflicted with some organic, perhaps even incurable mental disorder that left anything they wrote or said as being unworthy of serious consideration. In the pages that follow, early critics of the way that mad people were mistreated will be shown as the initiators of a reflective movement that by the early 21st century is spreading further afield, though not without challenges from within the academy (Beresford and Russo, 2022). Disability Studies provides a closely related example of the efforts to become established in academia against entrenched interests who already claim they are doing this work. As Tanya Titchkoskey notes, those who have made this claim consider disability as a “problem,” as viewed by nondisabled people, quite separate from the critically informed perspectives of disabled people (Titchkosky, 2000, pp. 198–199). Mad Studies is similarly situated—it is a newly named and organized field which is in the early days of getting formally established, even though mad people have been addressing relevant issues outside the academy for centuries.

With this in mind, it is important to know the reasons about how people were selected for this article. Part of it is due to the limits of what is available during the period under consideration: most mad people left no records due to being illiterate, impoverished, and marginalized without the ability or resources to have their thoughts set down on paper. Those who did leave records were able to do so because of their privileged status of being able to record their thoughts, which were then published and distributed to places where this documentary evidence was made available centuries later. In other words, those selected were chosen partly because there were only a few writers from which to choose whose works are available. For example, Katharine Hodgkin’s study on autobiographical accounts of mad people in 1600s England focuses on three people—Dionys Fitzherbert, Hannah Allen, and George Trosse—while also noting the existence of some other writings by people deemed mad from this period (Hodgkin, 2007, 2010). Generally, such documentary evidence from the 15th to 18th centuries is quite limited. It is not difficult to surmise that even those mad people from this period who could write, did not record their experiences at a time when doing so would win them little, if any, support from their peers.

Teaching a course on Mad People’s History since 2000 has given me a lot of time to reflect upon such writings as are available, as well as about the history of mad activism which long pre-dates our own times. With this background, I have selected these historical examples for another reason: to underline the need for appreciating the long period in our history that pre-dates more recent activist developments since the latter part of the 20th century. We are not the first (or second or third or fourth. . .) generation(s) to publicly critique concepts of madness and power relations as identified herein. Mad Studies exists because of hundreds of years of work by people deemed mad who laid the foundations for critical interpretations of our experiences long before any of us were alive. With this in mind, these historical examples have been selected in particular to represent certain critical views that writers and activists held which resonate today with Mad Studies:

• Affirming their sense of self by trying to understand what they experienced amid social prejudices against mad people;

• Critiquing the ways in which they were mistreated by contemporaries;

• Wanting to “do” something about it, in the sense of publicly recounting their experiences at a time when it was difficult to do so due to social intolerance, while also, within the context of the time they lived, offering some lessons to those who learned of their experiences about what was the relevance of mad experiences to the wider community in which they lived.

In reflecting upon these writers and activists, it is important to note that not all of them viewed themselves as mad—it is their treatment as being mad by contemporaries which enables their accounts to be recognized as belonging to this history. It is also essential to note that western concepts of madness have changed significantly during the period studied here. Religious beliefs were particularly dominant during the earliest writing considered from the 15th century; however, this belief system evolved with increasing medical explanations, along with religious ideas, among the elite in particular, during the 17th century and well into the 18th century in western Europe (Hodgkin, 2007; Lederer, 2006). By the 19th and 20h centuries, the medical model became dominant among western officials who determined who was mad, though religious views remained important for some people in explaining and treating madness (Porter, 1987, pp. 172–182; Scull, 2015, pp. 328–329). Some of the authors and activists discussed here reflect a mixture of these experiences in which religious and medical ideas intermingle over time. The people recounted here, and many others not discussed from this time period, were the predecessors of today’s mad scholars and activists, having been the original critical Mad Studies writers of their day, even if such a designation in the 2020s would make no sense to people who lived centuries ago. In seeking to describe their qualitative analyses, this article re-affirms the insights and contributions of those whose efforts have laid the groundwork for what is today a burgeoning field of study.

It needs also to be said that there is no attempt here to claim that any one historical figure is the originator of what is now called “Mad Studies.” Indeed, the person credited with coining this term in the early 2000s, Richard Ingram, eloquently makes this point when he writes:

Everyone in the Mad movement has contributed to shape the social context out of which the term Mad Studies has emerged. Within such a context, there are elements of chance to the circumstances in which the initial articulation of a new concept takes place. (Ingram, 2016, p. 12)

Similar to Ingram’s point, there is a great deal of chance to not only whose work is included in this particular article, but whose work still exists today, long after it was written. Margery Kempe’s transcribed memoir, after all, was lost for hundreds of years before it was rediscovered in 1934 in an English country house (Atkinson, 1983, p. 18). How many other mad people’s writings have been lost to posterity, or are awaiting rediscovery somewhere? While this question is impossible to answer, it is possible to claim that the “originator” of Mad Studies belongs to all those people who are mentioned here and countless others whose critiques have populated this history since the initial first-person accounts of madness began. That includes voices unknown today but who spoke up at some point in their own lifetimes but have been silenced forever by the passage of time. Yet, their cumulative efforts, known and unknown, continue to have an impact.

Mad People’s Writings and Religious Qualitative Challenges, 1436 to the Early 1700s

The first thoughts put into print by people deemed mad in western Europe were suffused with devoutly religious ideas and images between the 15th to 18th centuries. This is to be expected since western Europe during this time was, for the mass of humanity, a deeply religious world with Christian theology and practice dominating the lives of people beyond anything we can imagine today in our secular society (Lederer, 2006). Mad people who publicly expressed their experiences in print did so as a way of gaining wider understanding of what madness meant to those who experienced it. Their writing would have been read by a small group of literate peers initially as a wider reading public only grew with the rise of mass literacy in the latter part of the 19th century and early 20th centuries (Vincent, 2000). Most people up to the second half of the 1800s, mad or otherwise, were poor and illiterate, so the original audience for these writings was extremely small. Nevertheless, the historical importance of these sources is important to reflect upon for how these earliest mad authors in the English language speak to Mad Studies today. One of the most well known examples of this form of advocacy was herself an illiterate woman in late medieval England. Margery Kempe (ca. 1373–ca 1438) was a devoutly Catholic mother of 14 children whose thoughts were dictated around 1436 by her to two scribes; they were likely her son and a priest since she could neither read nor write, in common with most women of her time (Peterson 1982, pp. 6–7; Porter, 1987, 105). In what is viewed as the first autobiography in English, Kempe recounts various aspects of her life within the context of her religious beliefs in the course of which she describes her bout of madness which she experienced after the birth of her first child in the 1390s. Her reflections were therefore recorded some 40-odd years after the events occurred (Peterson, 1982).

What today would be viewed as supernatural imagery was then accepted as part of the intellectual cosmology of the times—religious visions, transformative thoughts couched in sacred imagery, sacrilegious threats to one’s spiritual integrity—all were part of what was understood to be a world where conflict between heaven sent good was battling with hell sent evil. That Margery thought in the language of the times goes without saying, but what is more is that her thoughts were critical of those around her, and not least herself, when trying to understand what was happening to her as she struggled to come to terms with demonic possession interpreted through the voice of a woman experiencing mental distress after her first child’s birth when she “despaired of her life, weening she might not live” (Kempe, 1982, p. 8). What bothered her further was that “the devil, evermore saying to her that while she was in good health she needed no confession” (Kempe, 1982, p. 8). Instead of the guidance of a priest she should ask God’s forgiveness on her own. After a priest criticized her for this approach, Margery, whose thoughts were recorded in the third person, spoke of

the dread she had of damnation on the one side, and his sharp reproving of her on the other side, this creature went out of her mind and was wondrously vexed and laboured with spirits for half a year, eight weeks and odd days. (Kempe, 1982, p. 9)

Margery then proceeded to vilify loved ones, including herself, after abandoning her faith, as well as engaging in self-harm, including not eating. This was followed by her being “bound and kept with strength day and night” (Kempe, 1982, p. 9) after which Jesus appeared at her bedside to beseech her to return to her faithful ways. After what she viewed as a holy vision of Jesus, Margery spoke of feeling better and eating more, but this was a brief interlude of calm after which further mental torment returned. Her mental state was not helped by the men around her, including her husband, as well as monks and priests who asked if she was a heretic—a potential death sentence during those times. She escaped only by being rescued by two unidentified men after she prayed for God’s intercession. Margery being denounced as too vain for a woman who did not know her place in a strictly patriarchal society could be read as an account of a woman denouncing male domination of female lives to the point of threatening their physical existence and how this gender-based abusiveness contributed to her distressed mental state. Here is clear evidence of the earliest known account by a woman denouncing male violence against females and the impact that this had on a woman’s mental state, already distraught, as was Margery, from childbirth. She credits the Almighty with protecting her during these and other travails with “ghostly comforts” (Kempe, 1982, p. 14). This included angels and spectral images from on high. For Margery, God’s protection would burn away her sins, in effect burning away her madness which she equates with profanity. Madness was punishment for wicked thoughts brought on by the devil, with the culmination being 12 days of horrific torments after which Margery says God returned her to an obedient faithful servant. Religious guilt and misogyny thus combine as a form of madness, for Margery, only to end with a reconciliation to the one and true faith and rejection of devilish temptations.

Margery’s tone is, for the most part, passive though this may be due to the male recorders. The psychological distress after her first child was born which Margery expressed in her writing, has more recently been called postpartum psychosis, and thus it is now placed within medical terminology (Lowry, 2002). While the devil is largely blamed for her madness, which is equated as badness, the point of Margery’s recollection is a sort of self-blame for causing her mental distress due to doubting God and so she was punished by thoughts which drove her to such despair. At one point in her story, Margery is depicted as vain, a sure sign of sinfulness, especially among women in a male-dominated religious world, where she was expected to know her place. By returning to obedience, this signals a return to piety, to no longer being mad. Religious guilt and misogyny combine into a form of internalized madness externalized through beliefs in blasphemous thoughts and scornful treatment from male figures around her. Yet, there is a clear sense in this account as to how much her social isolation and being threatened with punishment on earth and in the hereafter were enough to drive her mad while coping with being a mother for the first time. Margery Kempe thus mixed her religious beliefs with down-to-earth realities in describing what happened to her and why, an example of how what later Mad Studies proponents would argue is a critical social analysis of the world in which she lived and its impact on her mind.

Hannah Allen (born ca. 1638) is singularly unique of the qualitative accounts of madness referenced here as she was a literate woman in 17th century England who left her own account of madness. Hannah is even more unique compared to all of the other writers considered here prior to the later 19th century, in that she wrote parts of her account while experiencing depression, rather than the more common practice of writing one’s own personal account of madness long afterwards, in which an author reflected back on their youth, as did Margery Kempe. Allen’s work was published in 1683 two decades after her account of intense despair took place. Like others considered during the premodern period, she wrote in religious terms addressing her words to any “Christian Reader” as a warning to be obedient unto God lest the torments she endured be visited upon thine (Allen, 1997, p. 4). Her writings begin in London on February 3, 1681, when she became convinced that “I had sinned the Unpardonable Sin”—blasphemy against the Holy Ghost (p. 5). While much of her account was written reflectively, she describes early on in her account how she had for some years beforehand been writing religious thoughts in a book “which practice I continued till I was overwhelmed with despair, some few passages whereof are here inserted as they were written in my distress”(p. 7). This is the first known example of an author keeping an ongoing account of their experiences of madness and then later publishing portions of these thoughts, a practice which much later would become increasingly common among mad authors (Chamberlin, 1978; Kaysen, 1993; Millet, 1991).

Some excerpts from these thoughts follow to highlight Hannah’s qualitative work in shining a light on first-person accounts of madness while living these experiences. This is an approach which, more than 300 years later, historians and mad studies proponents would promote for their authenticity beyond third-party interventions:

This being the 20th Feb 63 is a time of great trouble and bitter Melancholy, and one great cause is for want of the light of God’s Countenance; and for fear that if I should have any mercy shewed me, I should abuse it; and my wretchedly deceitful heart be drawn aside from God . . . (Allen, 1997, p. 7)

The sixth of April 64. The truth is I know not well what to say, for as yet I am under sad Melancholy, and sometimes dreadful Temptations, to have hard thoughts of my dearest Lord . . . Besides, my Melancholy hath bad effects upon my body, greatly impairing my Health . . . (p. 8)

The 12th of May 64 . . . every day at present seems a great burthen to me; My earnest Prayer is, “For the Lord’s sake, that if it be thy hold will, I might not perish in this great affliction which hath been of so long continuance . . .” (p. 8)

May 26th 64 . . . these dreadful trials and temptations which do yet continue and have been woeful unto me, for almost four Months together; For Christ’s sake pity my case, or else I know not what to do. . . but blessed be my God, that he doth not lay upon me all afflictions at once; that my Child is so well, and that I have so many other mercies, which the Lord open my eyes to see. . . (p. 9)

Then she wrote: “After this I writ no more . . .” while in a state of madness (p. 9).

Instead, the rest of her account is from years later with retrospective reflections, including her self-hatred, suicide attempts by self-starvation, and various efforts to harm herself, concluding: “By these and several other ways I thought to put an End to my Life; but the watchful Eye of the Lord always graciously prevented me” (p. 14). She also wrote of contradictory feelings both rejecting the efforts by friends and family for support while at the same time wanting visitors. This is evident when Hannah wrote that she “would do what I could to discourage ‘em from coming; yet if at any time I thought they neglected me, I would be secretly troubled; as afterward I said” (p. 15). Her self-loathing presaged much of the criticism feminists had of women’s experiences of madness in a male-dominated world where the internalized hatred women like Hannah expressed was later understood as part of their social location under patriarchal oppression (Chesler, 1972; Ussher, 1991, 2011). “I must Confess I am not to be pitied for did you know me, you would abhor me, and say Hell was too good for me. . .” (Allen, 1997, p. 15). Another time she refers to herself as “the vilest Creature upon Earth” (p. 18). The ultimate expression of her self-loathing was her description of what would now be recognized as anorexia: “Towards Winter I grew to Eat very little, (much less than I did before) so that I was exceeding Lean; and at last nothing but Skin and Bones” (p. 18). It was not until the spring that her appetite slowly returned.

Hannah’s recovery from madness was gradual over several years, as was her original experience of mental torment. While support from those nearest to her is credited for her no longer being mad, she ultimately equated lack of religious faith with subsequent devilish temptations as equaling melancholy and despair while a return to devotion in God equals good health and hope for the future. In effect, her writing focusing on naturalistic and spiritual supports presages the recovery movement by several centuries (Tang, 2022). Hannah Allen was practicing “alternative” wholistic treatments long before they were deemed as such by later activists. Whereas both Margery Kempe and Hannah Allen recorded their experiences of madness in community settings, the next author wrote about what would increasingly become a common theme in mad people’s writings, and a common critique of the mental health system centuries later: forced confinement outside of one’s home.

Reverend George Trosse (1631–1713), an English Presbyterian minister, wrote about experiences of madness which took place while in his twenties during the 1650s which was published posthumously in 1714 a couple of decades after he wrote these words (Peterson, 1982, p. 26). His thoughts raise issues about how an older person entering the last part of his life employed his own personal qualitative inquiry into retrospectively coming to terms with what happened to him decades earlier in bouts of madness that he frames within religious interpretations of the need for personal reformation in a sinful world. This is especially clear where he writes about living in an environment full of devilish temptations while hearing a voice beckoning him to be “Yet more humble; Yet more humble” (Trosse, 1982, p. 30). Was this the devil trying to play a trick by speaking the language of Christian humility? Tormenting thoughts like these overwhelmed Trosse, such that he was “haunted with horrible distracting Temptations to Self-Murther . . .” (p. 32) Distraught at this inner turmoil, he withdrew to his bed where he stopped eating at the direction of the devil in the false belief that this would save his soul—perhaps the earliest recorded biographical account of male anorexia. Eventually “my friends determined to remove me” to a doctor’s house but Trosse would have none of it: “I stoutly resisted them, with all my might and utmost Efforts . . .” (p. 34). To no avail, however, as Trosse (1982) said these agents of the devil “exerted all their Power to carry me away into a Place of Torment” eventually tying him to like a sack atop a horse where a strong man took him to the doctor’s house (p. 35).

Trosse thought that the doctor was Satan; under this person, he was confined against his will for several months in a place he compared to hell on earth. When Trosse (1982) resisted being physically restrained

then would they throw me upon the Bed, and thus put Bolts upon me; and there should I lie in great Pain and Weariness ‘till I could well endure it no longer; then should I desire to be releas’d and promise to be quiet. (p. 36)

Blaming himself for being “a foolish Gallant” and thus a sinful cad, Trosse was released a chastened soul (p. 38). Trosse’s self-hatred is evident but so too is his critical views of the violent way in which he was treated which he clearly linked to the exacerbation of his mental and physical agonies; he also linked this violent treatment to ultimately acquiescing to the more powerful forces that quite literally surrounded him. In this respect, Trosse was a forerunner of much later critics 300 years later who denounced forced treatment in a medical environment, as was the case with this doctor’s house where he was confined for several months. Just as significantly, Trosse is the earliest recorded example of how “playing the game” by becoming a compliant mad person who does not resist “treatment”—in this case restraints—will cause him to be viewed as improved enough to be released from the cruel fetters of those who kept him physically and mentally tied down. Manipulating the system of forced confinement to get released was a common theme of much later writers who share these centuries earlier critiques written by Trosse (Weitz, 2004).

Trosse’s work, while overwhelmingly religious in tone, also presaged the increasingly common criticism during the 18th and 19th centuries of protest literature about being confined against one’s will for expressions deemed mad—an enormously influential part of the work that grew into what is now called Mad Studies. These writings crossed over from religious to secular to back and forth, depending on the author, but all reflected the fear people had of the mad house, and then the insane asylum, as places of incarceration began to populate the physical and mental landscape (Porter, 2002; Reaume, 2017; Scull, 2015). As the following section will show, as confinement gradually increased mad people raised issues around arbitrary confinement, power relations of who decides what madness is and how people are treated, as well as efforts to organize collectively to improve conditions for contemporaries in what would now be called the mad movement. All of these historical developments from the 1700s to early 1900s have direct resonance with Mad Studies in the early 21st century.

Mad People’s Published Writings and Activism From the Early 1700s to 1914 as Precedents for Mad Studies

The extent to which the critiques of forced confinement of mad people picked up during the 18th and 19th centuries reflects the gradual increase in mad houses and insane asylums during this time period, first in western Europe and later in North America. This article is not going to discuss the debates over Foucault’s long-critiqued claims of the “Great Confinement” in France between 1656 and 1793, which has often inaccurately been conflated to other countries after this period and is doubted as having happened within France itself (Foucault, 2006; Midelfort, 1980; Scull, 2020). It is clear, however, that by the mid-to-late 19th century, a body of publicly known work had developed, written by mad people or those deemed as such, which critiqued how they were mistreated in private and public mental institutions, first in mad houses and later in large-scale asylums. As such, these accounts can be accurately characterized as providing qualitative examples of a prequel to organized Mad Studies through the accumulation of such writings which came into increasing public awareness as forming mad people’s protest literature (Brückner, 2021; Hornstein, 2011).

It is also not surprising that this documentary evidence comes from the most privileged group of mad people who had the social capital and sense of entitlement to protest what was happening to them. Privileges due to class, race, gender, and ability all factored into whose public accounts of forced treatment exist for this period and whose do not. These accounts are uniformly by White able-bodied people of European descent, often by men, though as the 19th century proceeded more writings were published by women. Published mad authors from this period were nearly all from the upper and middle class who had access to education and resources that the vast majority of poor mad and disabled people of all races did not have. Given this context, the first writers of Mad Studies were unrepresentative of their peers in the same way that a professor like myself is unrepresentative of 21st century mad people who live in boarding homes or on the street. At the same time, it needs to be stressed that mad people in privileged positions, as were those whose writings exist from this period, used their privilege to critique practices, structures, and attitudes that affected all mad people, however varied their experiences. In this sense, the authors being discussed here added much to our history at a time when few others beyond mad people were critiquing the prejudices and oppression experienced by mentally disabled people as a group. There were some doctors and print journalists in the 19th century who did critique some of the diagnostic labels promoted by their contemporaries in the medical profession (Degerman, 2019; Murat, 2014). This came from a place of wanting to preserve the medical profession’s credibility over absurd labeling, more than anything else, rather than empathy with the experiences of those deemed mad. Mad writers, however, including those who denied they were mad but had been confined as such, were the most vociferous and insightful of all the critics of what was happening to them in this period, given what is now called their critical analyses of “lived experiences” inside places of confinement. This is another example where Mad Studies was being done long before it was called as such.

Alexander Cruden (1699–1770) was one of the earliest writers in the English language to write about being abused in a confined space for people deemed mad. A member of the Anglican elite, as well as a biblical scholar, proof-reader and bookseller to the royal household, he circulated among the loftiest circles in British society (Keay, 2004). As a result of interpersonal disputes when he was in his thirties, Cruden was confined in a private madhouse at Bethnal-Green, London, about which he published an account in 1739. In this account, he denied that he was mad and stated he was lied about as being an arsonist and mentally disturbed person by vengeful associates who wanted him out of the way. He provides what is probably the first account of being restrained in what would later be called a straitjacket, which he referred to as a “Strait-Wastecoat” (Cruden, 1997, p. 31). Cruden (1997) wrote in the third person of demeaning treatment when he was forced to “eat his supper with his mouth like a Dog, as he did his breakfast and dinner the next day . . .”; being confined in a “Strait-Wastecoat” also made it difficult to relieve himself and sleep (p. 31).

Cruden’s account of the violent abuse he endured also included the first account of an inmates’ letters being confiscated. He wrote regarding a letter to his father that “it seems this letter was intercepted, as many were afterwards,” while the absence of any response to later communications led him to believe “the letters were all intercepted” (pp. 36–37). Only a letter written by two doctors was ever received by Cruden (1997) while confined; he realized other letters had been turned over to the madhouse keeper, an issue which comes up repeatedly in his account (pp. 42–44, 45, 46, 49, 51, 52–53, 56, 58, 59, 67). For a man as literate as was Cruden, having his letters censored was an act of particular offensiveness, particularly given his upper class, racial, and gendered sense of entitlement to being listened to and taken seriously by those around him. At a time when the mass of people in Britain, like everywhere else, were poor and illiterate, Cruden’s privileged status in society made his predicament all the more grating to him. He was, in a small measure, getting a slight taste of what it was like for the most underprivileged people in British society who endured daily humiliations and degradations due to their lower class status. It also presaged the more widespread censorship and confiscation of inmate letters as literacy rates rose among a more diverse population of mad people confined in institutions by the late 19th and early 20th centuries (Reaume, 2000, pp. 88–91). Thus Cruden’s critique was very much an early example of what later mad activists would present as the silencing of voice among authorities in charge of those deemed mad (Burstow and Weitz, 1988).

Samuel Bruckshaw’s 1774 pamphlet denouncing the “Iniquitous Abuse of Private Madhouses” provides further testimony from a privileged confined 18th-century man about the cruelties endured in such places (Bruckshaw, 1997, p. 75). His account also underlines the prejudice toward those confined in such places, as when Bruckshaw (1997) writes about being “totally ruined in both his property and character, besides laid open to the prejudiced censure of the public . . .” (p. 114). His words, while making no references to newspapers, nevertheless provides an early effort to reclaim a mad person’s perspective from hostile public representations which later Mad Studies writers would advocate in regard to the media (Wipond, 2013).

William Belcher, confined for 17 years in a madhouse published a short account in 1796 in which he poignantly wrote, perhaps for the first time by any ex-inmate, of “the disabilities of real insanity” (Belcher, 1997, p. 130). By linking madness and disability, Belcher would provide a crucial link that Mad Studies writers, over two centuries later, would expound upon by connecting both concepts as intertwined in so many important ways (Morgan, 2022). In his case, Belcher clearly believed he was not mad at the time of confinement but that he went mad after being locked away and abused for so long. In other words, Belcher (1997) was disabled by his environment as can be understood when he describes what happened to him:

I was driven to the verge of desperation and real lunacy through want of sleep . . . whereby I was disturbed by night with snoring and coughing, and by day with ranting and raving; so that I know not what I would have given for an hour’s peace, and am now astonished that I survived it at all . . . I have been bound and tortured in a strait waistcoat, fettered [physically restrained with chains], crammed with physic with a bullock’s horn [force-fed with medicine], and knocked down, and at length declared a lunatic by a Jury that never saw me; and, what would make a man tear his flesh from his bones, all through affected kindness. (p. 131)

He further writes:

Of rapacity and brutality, all that is shocking to human feelings, a mad-house, that premature coffin of mind, body and estate. . . Yes, on this subject I have an especial right to speak—I owe it to God, my country, and humanity to speak, and I will speak, and, if possible, make my hearers ears. [italics in original] (Belcher 132)

Belcher’s reference to “ranting and raving” indicates the despair of fellow inmates and the impact such an environment had on all who were confined therein. The physical and mental abuse, purportedly done “through affected kindness” is an early critique of the paternalistic cruelty of those who had charge of mad people claiming they were (mis)-treating them “for their own good.” Denouncing the place of confinement as a “premature coffin of mind, body and estate” is a further indication of the utter social exclusion inflicted on inmates which impacted their physical and mental condition, how being publicly identified in this way was socially devastating; it was an early form of denouncing what is now called “sanism” (Perlin, 1992).

Belcher’s words resonate with the point that Hannah Morgan makes when discussing Mad Studies and Disability Studies when writing about how “disablement is the outcome of a range of structural, social, cultural and political forces which are disabling . . .” (Morgan, 2022, p. 109) along with how the “psycho-emotional impact of living in an increasingly hostile environment becomes intensified when the problem is returned to one of individual agency and resilience” (p. 116). Belcher’s description of “the disabilities of real insanity” meant that he was driven mad by the forces arrayed against him who locked him up and, especially, by the physical and emotional abuse he endured while confined—a late 18th century critical analysis employing concepts that are now familiar under the Social Model of Disability (Morgan, 2022). The emotional impact of writing such an account, making it public and reliving traumatic experiences through his writing, may also have been experienced as mentally exhausting given his social isolation and insisting on wanting to “make my hearers ears”; the implication is that his views were being ignored up to this point. We do not know whether Belcher’s words, and what would today be called self-advocacy, had the impact he wanted. His pamphlet was also an early account of using historical examples to compare what happened to him get his point across by evoking popular knowledge of the past, from both distant and recent events, at the time of writing. This is evident when Belcher denounced the violence inherent in being forcibly confined in a madhouse as when he referred to this experience as “one of the graves of the mind, body, and estate, much more dreadful than the Bastille and Inquisition” (Belcher, 1997, p. 134). This form of critical historical comparison, whether to a place of confinement or repressive legal practices against people deemed mad, would be common among mad writers and activists in the generations to follow. Sometimes, such comparisons would hit the mark, other times they would not, as will be mentioned below.

While protest writings from people confined in madhouses would continue well into the 19th century, the 1800s would also see the widespread expansion of writings by mad people confined in increasing numbers in insane asylums as well as the organization of the first advocacy groups by ex-inmates of places of confinement. While most of these published writings continued to be from upper and middle class White people, there were far more women writing accounts at a time of expanding literacy skills and feminist activism.

In the 19th century, writer-activists like Elizabeth Packard helped to bring to the fore the plight of women asylum inmates being confined by a patriarchal society in which husbands, fathers and male authority figures could determine whether or not a female would end up being confined (Carlisle, 2010; Sapinsley, 1991). While Packard was herself confined in an Illinois asylum from 1860 to 1863 due to the collusion of her husband and a compliant doctor, she did not challenge the existence of asylums as did some later writers. She did, however, challenge who is defined as mad and why including how “insanity is treated as a crime, instead of a misfortune” (Packard, 1994, p. 61). In making this point, Packard provided an early example of how mad people were criminalized in ways that later Mad Studies writers would denounce, particularly in regard to the nature of pathologizing race, madness, and criminality (Ben-Moshe, 2020). Yet, Packard also made comparisons between the situation of White middle class women like herself and enslaved Black people that, then as now, are insensitive, to say the least. For example, when she wrote in 1866, the year after the American Civil War ended,

the insane are permitted to be treated and regarded as having no rights that any one is bound to respect—not, not even so much as the slaves are, for they have the rights of their master’s selfish interests to shield their own rights. (Packard, 1994, p. 62)

Packard’s work to ensure White women were not confined by abusive husbands by stating they were worse off than Black slaves was an example of the thoughtless and, in this case, racist, idea of slaves being “protected” by slave-owners. This presages the, at times, inappropriate comparisons that some mad activists have used over the years when engaging in critiques and the tensions between White and racialized activists (Bruce, 2021; Gorman, 2013). Thus, not all such precedents in this history are praiseworthy.

While many of the precedents set by preceding centuries’ writers were amplified by 19th-century asylum ex-inmates, including over-bearing medical and legal authority, forcible confinement, suppressed communications, patriarchal oppression, and a radical change in power relations upon being declared mad, one aspect of 1800s Mad People’s History presaged developments which later Mad Studies proponents would engage in: organized group activism. Elizabeth Packard tried to set up a group called the Anti-Insane Asylum Society in the late 1860s but not much is known about it (Carlisle, 2010, pp. 153–154). It was in western Europe where the first well-organized network of groups run by ex-asylum inmates became active and thrived for decades. Many of the legal rights advocated by activists and later Mad Studies proponents were first put forward in the mid-19th century by the Alleged Lunatics’ Friend Society (ALFS) which was founded in London, England, and was active from 1845 to 1863. Organized mainly be ex-inmates of madhouses and asylums, including author John Perceval, the ALFS critiqued the wholesale confinement of both mad and mentally disabled people more generally at a time when no other groups did so, and made cross-disability connections that only gradually developed in the Disability Rights Movement over a century later. The ALFS also advocated for inmates’ rights to be posted on the wards of asylums; for the right of inmates to mail and receive letters without staff interference; advocated rigorous inspections and oversight of asylums; denounced what would later be called the infantilization of mad people and argued that they should be treated with respect as adults; promoted less power for doctors to certify people; promoted various legal safeguards; organized media campaigns; wanted half-way houses in the community for ex-inmates to transition back into society; advocated for a mandatory coroner’s inquest into the deaths of people in asylums; and argued for the recording of patients’ views of their treatment in medical records, including if they disagreed with the contents therein (Hervey, 1986). The ALFS, like later groups, also had tensions between organizers, including class differences. Co-founder John Perceval, who was from a highly privileged background, argued that “gentlemen” like himself should have their own separate rooms with servants when in an asylum, a point with which other members strongly disagreed (Hervey, 1986, pp. 255–256). This sort of class snobbery was counter-productive and insensitive, particularly since the mass of public asylum inmates were poor people in need of support which the ALFS did indeed try to provide for them. By the later 20th century, people who became involved in what would later be called the consumer/survivor/ex-patient movement came from more diverse class backgrounds where class snobbery was less pronounced (Morrison, 2005).

The ALFS was not an isolated historical example from the 19th century. As Burkhart Brückner has shown, in what was then called the “lunatics’ rights” movement, from the late 1800s into the early 20th century, documentary evidence exists “from twelve European countries [which] clearly indicate that lunatics’ rights activism had its geographical hotspots in Central and Western Europe” where asylums were more prevalent than elsewhere (Brückner, 2021, p. 95). Hundreds of published accounts by ex-inmates were circulating during this time period, a full century before the formal existence of Mad Studies. Such accounts, taken as a whole, can be described as a major part of the qualitative origins of Mad Studies today through the existence of a pan-European collection of groups and individuals who were engaged in promoting the rights of, and respect for, people confined in mental institutions. In this sense, the efforts to promote rights for confined inmates and politicizing community awareness to “do something” to change an abusive mental health system is a precursor to 21st century activists and writers who have been engaged in “doing mad studies” in the academy and wider community (Ballantyne, 2019; Ingram, 2016; Reville, 2022). It is also important to address the less-than-progressive aspects of our history. As Ann Goldberg has shown in her study of “lunatics’ rights” in Imperial Germany from 1890 to 1914, activists ranged across the political spectrum from far-right anti-Semites to left-wing revolutionaries, with a sizable number being middle class men out to reassert control over their domestic life, and in particular maintain male authority in the home after being “emasculated” by being confined in asylums (Goldberg, 2003). Thus, while portions of this activism resonate with contemporary Mad Studies, other aspects do not. It does, however, reflect that contemporary analysis about prejudices within the mad and disability movement, while reflecting a higher degree of involvement by racialized people in more recent decades, is also not new; bigotry between and among mad people has always existed and can be documented in debates around race, religion, and ethnicity, as well as gender and class prejudices, as is noted above.

While these activist groups were not anti-institutional to the extent some post-1960s groups were their campaigns to call attention to what was termed “wrongful confinement” (as opposed to all confinement being wrong) were aided by media campaigns that reached out to isolated individuals in ways that later mad studies proponents would recognize (Brückner, 2021, p. 109). Ann Goldberg notes in this regard that

individual cases became public scandals widely reported in the press and the subject of parliamentary debates. This led other “mad” people to reconsider their own experiences in a new light and to contact a network of reformers and publishers specializing in asylum literature. (Goldberg, 2003, p. 170)

This widespread activism, long before the second half of the 20th century, led to a nascent form of Mad Studies whereby “lunatics’ rights” activists sought out support and provided mutual aid to each other. This mass of activity in the late 1800s and early 1900s provides qualitative evidence for the origins of organized mad activism with individual efforts to understand the situation of mad people coalescing into a critical social analysis of their place in society shared by people with similar experiences of confinement. Although some of these interpretations were extremely troubling, given the racism, sexism, and class elitism of some activists, the examples of organized efforts to promote the rights and self-directed study of mad people on a large scale underlines how the origins of both mad activism and Mad Studies goes much further back than the mid-to-late-20th century.

Conclusion

While Mad Studies is a relatively new field of study in the academy, its community and individual origins are deeply embedded in Mad People’s History to such an extent that it is not as new as it may appear. From the first published memoirs and pamphlets in late medieval and early modern England, to the increasing number of activist groups and individual accounts in Western Europe and North America during the 19th and early 20th centuries, there has long been a significant accumulation of qualitative evidence for the emergence of Mad Studies long before it was named. This includes themes which resonate today in Mad Studies: original forms of protest and advice literature from people who lived these experiences in which authors grappled with what happened to them and why; first-person accounts of madness and efforts to critique the way in which madness was defined and by whom; the increasing role of medical practitioners and the legal profession, with state support, in abrogating the rights of people deemed as having some form of madness; as well as critiques of public prejudices toward anyone deemed mad and the consequent impact on people discriminated against in this manner. Throughout these centuries, people deemed mad were, in effect, studying what happened to them and to those with whom they were confined as institutions developed. In doing so, individually, and then collectively, these authors through their writings and activist organizing provided a cumulative knowledge base and historical tradition of qualitative critiques about what happened to them and others in similar situations that has provided a solid foundation upon which the “new” field of Mad Studies is the direct heir and beneficiary. The examples cited in this article also underline how historical context is crucial to appreciating expressions of madness, in terms of wider cultural, political, and social relationships that impacted upon how people have understood their own experiences and related it to their contemporaries. This is evident in regard to supernatural thoughts in a devoutly religious society where divine symbolism was ever-present. It is evident too in secularized concepts of rights, as more privileged mad people, particularly White middle and upper class males, and increasingly more women during the 19th century, demanded their rights at a time when such concepts increasingly became a source of widespread political engagement from the late 1700s onwards for all classes and various groups of people. What madness means, to whom it applies, and why, has always been a highly controversial issue for those to whom this term has impacted most directly. Mad Studies is thus old and new thanks to those people whose efforts have provided centuries of critique and analyses of what it means to be mad in the societies in which they have lived.