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Madness and Literature: Report from International Health Humanities Conference

Throughout history, numerous links have been made between literature and madness. Aristotle linked genius and melancholy, contending that many great men suffered from what later centuries would refer to as 'morbid' states of mind, linked to creativity in such works as Robert Burton's Anatomy of Melancholy (1621). But in what ways should we connect madness and literature in the 21st century? Many and varied methods were suggested in a diversity of papers at the first International Health Humanities conference at the University of Nottingham last weekend.

Attended by a broad group, from clinicians to historians, literary critics to carers and service users, participants posited the general suggestion that engagement with literature can help us to understand and appreciate - and thus better treat - madness: a term chosen in preference to 'mental illness' in order to incorporate social and cultural, as well as biomedical, dimensions. While advances in biomedicine have aided treatment of a variety of mental health issues over the last few decades, many questions remain unaddressed. Mary Elene Wood, of the University of Oregon, indicated, in her review of patient narratives of illness in The Schizophrenia Bulletin, that the complaint of many service users is that the content of their delusions and hallucinations can be ignored by biomedical practitioners. Patients assert their need to make sense of these symptoms, incorporating them into their sense of 'self.' Indeed, approaches to the slippery concept of selfhood were those most often highlighted over the weekend. Dr Javier Saavedra, of the University of Seville, suggested that the assumption that the 'self' must be a single, stable and consistent entity might not always be beneficial, while keynote speaker Dr Kay Redfield Jamison, Professor of Psychiatry at the Johns Hopkins University School of Medicine, indicated the hugely variable ways in which others might respond to madness, and how attitudes might reinforce or problematise the individual’s sense of self.

Other speakers illustrated the ways in which literature can highlight the social construction of madness. Keynote speaker Professor Elaine Showalter, of Princeton University, detailed some interesting trends in the frequency of certain diagnoses, relating these to contemporary social fears and obsessions. For Showalter, Capgras Syndrome may be the disease of our time. Sufferers of Capgras Syndrome present the delusion that people, animals and objects around them have been stolen or abducted, only to be replaced by an identical imposter. Initially regarded as a form of hysteria, current explanations for Capgras Syndrome tend towards the neurological, focusing on damage to certain areas of the brain. According to Showalter, this approach cannot explain certain patterns in the way in which delusions present, suggesting that cultural influences - in an era of surveillance, global paranoia and conspiracy theories - may remain relevant.

In his closing remarks, co- organiser Professor Paul Crawford of the University of Nottingham spoke of the conference aims, and their hopes for a future in which biomedical, psychological and cultural approaches to mental illness can exist side by side, complementing each other. While scientific research undoubtedly has great worth, the challenges encountered in diagnosis, stigmatisation and areas of therapeutics indicate that no one form of understanding mental health should be privileged at the exclusion of all others.

The conference was organised by Charley Baker, Dr Brian Brown, Dr Maurice Lipsedge, Professor Ron Carter and Professor Paul Crawford. For more information on the Madness and Literature Network, and details of future events, visit: www.madnessandliterature.org