Madness and Civilization: A History of Insanity in the Age of Reason

At the end of the Enlightenment, the experience of confinement haunted the population of Western Europe. Moral judgements of the “mad,” had generated a widespread myth of “madness” as a sort of moral contagion. It was considered cruel to confine the non-”mad” alongside the “mad” because of this moral contagion. These fears mirrored medieval fears about the spread of leprosy. Amidst this fear of social deterioration via proximity to “madness,” a medical reform movement came into being aimed at revolutionizing the systems of confinement.

Physicians interested in implementing these reforms were empowered to do so, ironically, because of the widespread moralist fear that demeaned “madmen.” In other words, the need to address “madness” as an issue of medicine arose not because of an increased scientific awareness of how mental illnesses operated, but because of the misinformed belief that “madness” was contagious and would morally corrupt society. As cultural fear of “madness” increased, so did cultural preoccupation with it.

The Enlightenment world was a world undergoing massive changes, and anxieties about these changes became tied to anxieties about “madness.” Some worried that “madness” in places like England could be explained by political structures that enshrined economic liberty. Widespread skepticism about antiquated, fanatical forms of religion, led to a belief that extreme piety could also lead to “madness.