‘I like him,’ said D ‘He’s a proper 1970s schizophrenic. Old-school mad.’
D is a psychiatric nurse, and his words seem to confirm the idea that ‘madness’ (or the way ‘madness’ is expressed) is culturally determined. The patient he is talking about lives in a world of his own,
but unlike many of the other patients his world is not populated with devils and demons, he is not persecuted and pursued by shadowy Government agents or tormented by hateful voices. In his world he is famous, with responsibilities towards his fans and marketing, and this can be stressful in its own way.
If the expression of ‘madness’ is culturally determined, the number of devils stalking this in-patient unit is surprising. These things have followed men since the Dark Ages. Here in the unit, they are dispelled with drugs; Chlorpromazine, Haloperidol for the old-school, Quetiapine, Risperidone for the newer patients; Clozapine for the die-hards. The side-effects are well-documented, (‘his eyes are fucked,’ says D of a 60-year-old, long-time patient ‘He can’t see now, because of all the Clozapine’) but here in the unit the law is clear. Most of these men have committed crimes while unwell, and thus their rights over their own body are secondary to the rights of Society. Society/people have the right to be protected from the devils which take over their minds and bodies. We vanquish the demons with chemicals, and their bodies are the battleground.
Poverty and drugs feature heavily in the histories of most of these men. As I process their records, their home addresses are familiar to me, from my days of shared houses and damp flats. Madness can strike women and men of all ages and backgrounds, but the type of madness which is considered dangerous most often seems to strike young men, who live in council flats and self-medicate.
This wasn’t always the case. The old asylums used to be full of women, women who threatened the very morals and fabric of society by having babies, or refusing to have babies; most of all by not getting married and becoming economically dependent upon others. Nowadays, a man brandishing a meat cleaver is generally considered more dangerous. Rape is seen as a crime. With the result that many more men are locked up than women.
Yet the violence, if not the sexual crime, is decreasing.
‘You don’t have to fight like you used to,’ says D nostalgically ‘they’re all so much calmer now. And they get tellies in the communal area and a choice about whether to have sugar in their tea. It’s not like it was in the old days. It’s all about personality disorder now.’
Personality disorder, or psychopathy as it used to be called, is the new madness, and so much harder to put your finger on. It’s the consequence of a loveless childhood, leaving the child prone to violence and cruelty, lacking in feeling and unable to form relationships. Unable to get along with anyone in any situation. Unable to get a job, and thus economically dependent upon the State.
Money and madness, it seems, are linked. There are drugs to make you ill and drugs to make you well, and drugs that do both. Love can be the prevention and the cure, but only if it’s administered in time.