1. What are some of the author’s charges against diagnostic models of mental illnesses?
Through the course of recorded history no other domain of illness has underwent such frequent theoretical upheavals and revisions as had mental illness. This is best borne by the fact that the Diagnostic and Statistical Manual of the American Psychiatric Association (considered the prevailing authority on classifying psychiatric conditions) is constantly revising its manual. In a manner similar to how software companies release updates to their applications on an annual basis, the same set of symptoms could lead to different diagnostic conclusions on two different years. This is a statement on the confusion within the profession rather than making case for the rapid evolution and metamorphosis of the human mind. For centuries, if not millennia, the elements of human psychology have remained the same. As we learn from ancient through recent history, humans are possessed of the same set of emotions such as envy, jealousy, love, hatred, anger, fear, lust, compassion, etc. In this regard, the frequent periodic revision to the diagnostic manual betrays the immaturity of modern psychiatry as a rigorous scientific discipline.
2. How does Roy Porter illustrate the ambiguity surrounding the idea of madness?
An important message contained in the book is how one man’s madness might be another man’s conception of genius. Employing an anecdotal style, Roy Porter recounts several historical instances of designated ‘madness’ which turned out to be either feigned or misunderstood. Moreover, when the same set of symptoms enlisted in each case are evaluated using dominant diagnostic models from various eras, the interpretive outcomes turn out to be very different. This can either be taken as a critique of the profession of psychiatry or the complexity of the human mind. Porter presents arguments for both points of view, which only heightens the aura of ambiguity surrounding psychiatric disorders. Porter also treats the perennial contrarian viewpoint that psychiatry is a grand conspiracy by the political establishment to keep people under control.
3. Which literary and stylistic devices does the author use to make palatable an otherwise gloomy subject of mental illness?
One of the primary devices through which Roy Porter grabs the attention of the reader is humor. It also helps that mental disorders’ association with social taboo lends itself to humorous, embarrassing or confounding situations. Employing an anecdotal style that is natural Porter conveys the most depressing of events and cases with an element of dry irony. For example, we read about the story of a Parisian tailor who got sent to an asylum during the tumultuous days of the French Revolution. His was a case of mental disintegration, all based on a rumor he heard about the execution of Louis XVI. The doctor attending to him, understanding the untrue nature of the news that caused his delirium, designed an elaborate staging (re-enactment) of the original event to bring the tailor out of his madness. The book has plenty of such gripping narratives, some of which are even stranger than fiction. It is these components of the fantastical or the bizarre which make accessible the rather forbidding task of reading about mental illness.
Porter, Roy. Madness: A Brief History, Oxford: New York, Oxford University Press, 2003