This Way Madness Lies: Mike Jay on Madness

Mike Jay’s work is concerned with the history of drug consumption, alternative mental states and madness. In the past years, he has written about the medical origins of laughing gas; the life of a revolutionary schizophrenic, James Tilly Matthews, and how political regimes influenced the asylum system. He has curated two shows at the Wellcome Collection: the 2010-2011 High Society and the 2017 Bedlam: asylum and beyond. We sat down to chat with him about the prevalence of mental health in pop culture this year, curating for the Wellcome Collection, and the validity of diagnoses. 

Tell me about your 2012 book, The Influencing Machine.

The text originally ran under the title, Air Loom gang. This was the name of the group James Tilly Matthew’s delusions revolved around. He was convinced that the gang operated this extremely elaborate machine that would churn out poisonous gases. The gases infiltrated the mind of politicians. Matthews himself was a political campaigner before he was admitted to an asylum. His story represents perfectly the relation between politics and madness. In his psychotic states, he saw how people in power lost control, how the discourse was slowly taken over by forces beyond anybody’s grasp. Of course, he was mad. It just happens that his madness involved a sombre and sane way of thinking about his time.

How did you set out curating the Bedlam: the asylum and beyond exhibition?

We began by looking at Matthew’s plans for the new building of the Bethlem Hospital. He created these whilst he was a patient. We wanted to go beyond the usual narrative, to offer more than just a sanitised, official image of hospitals. We included objects that revealed how the patients saw their environment, items that represented what their experiences entailed. We wanted to demonstrate the difference between how hospitals are perceived and how a patient experiences a hospital. It is important to draw a contrast between what an institution is for the world outside and how it is seen by its inhabitants.  Matthews’ figure was perfect. His drawings convey the Bethlem the patients dreamed of.

We dedicated each gallery space of the Wellcome Collection to the three buildings Bethlem was located in. In each incarnation, you’d find a different set of treatments. They embodied different ways of thinking about the role of psychiatry in treating mental illness. The architectural design of the three building was conceived in accord with the way the institution wanted to represent itself at a given time for a given people, the kind of purpose it had within the healthcare system and the value it had for the patients who were housed there.   [The Royal Hospital of Bethlem was relocated from its initial location in Bishopgate to the St. George’s Fields in Southwark in the 19th century. It was then again relocated to its current location at Monks Orchard in West Wickham in 1930.]

 Could you walk me through the brief history of the diagnosis?

The pre-modern and early-modern concept of homeostasis rested on the idea that everybody has their own balance which can be reinstated in a number of ways. Then emerged the concept of the ‘diagnosis’, which is tailored to achieve the universally applicable ideal of health. From then on, people were not considered on an individual basis but in terms of how much they diverged from the standard. Diagnosis assigns a model of management. Although this is often overlooked, it does not grow out of the body of the patient. It does not represent the full magnitude of the symptoms. At best, it renders them comprehensible for a specific discourse.

And what about the concept of mental illness?

The term mental illness was officially adopted about a hundred years ago. It was an extremely progressive innovation. It indicated that this can happen to anybody. It signalled that it is possible to recover from it the same way one might from a flu. We now acknowledge that mental illness has a lot of dimensions: medical; psychosocial; environmental; spiritual dimensions, and questions of values. This wouldn’t have happened had the term ‘mental illness’ not been coined. But since culture is always moving on, the term became a lot easier to use these days. It no longer suffices. It flattens down a large array of new ideas. It impedes us from thinking differently about various conditions. It served its task for a while. But now it’s time to move beyond and re-conceptualise it again.

In the Introduction of This Way Madness Lies, you refer to John Locke’s An Essay Concerning Human Understanding. Although it seems that madness is indirectly related to larger political tendencies, there is little discussion of the role it has been granted in philosophical and political discourses. Leibniz, Kant, Hobbes and Rousseau are known to struggle with incorporating the mad subject into their vision of the ideal arrangement of the political domain. How come these were not mentioned in the book? Is there such thing as a ‘mad enough madness’ a sort of normative understanding of it, and if so, what characterises it?

The legal system tries to manage the question of madness. It cannot do so sufficiently. A lot of judgment about madness is functional. Some people possess utility, some are functionally disabled. This is contingent on the social world around them, which could be engineered in different ways. Legal definitions can yield to some insight, but they should be taken into account in correlation with the type of world in which they are used.

How do you see the relationship between the different kinds of madness and the society in which they emerge? How do you set out the cultural phenomena that can represent the dialectical tensions between the two? Could your method be implemented more broadly, as a social enquiry?

The signature condition of our age is depression, which wasn’t even a thing up until relatively recently. The closest to it is perhaps the 17th century diagnosis of melancholy, which had different connotations back then. I think we’re broadly in an age where we’ve lived and have chosen for ourselves a very loose social contract. People are alienated. At the same time, they are given better possibility for solipsism than ever before. The occupational hazard is that there is a glass wall coming down between you and the world and everything seems meaningless. The system is eroding very fast. What was keeping it in place was the kind of life you spent living with your family on the farm, a life nobody wants anymore. Although this type of thing is enormously attractive to people now, I’m not convinced that we are actually prepared to do what it takes to re-establish the commons in the form we need to. I’ve got an enormous amount of interest in writing about Geel, Belgium, which is an example of an alternative society where that network has always been in place. The patients of the psychiatric care unit are encouraged to stay with the inhabitants of the city, with average families. They receive a daily stipend which allows them to live a comfortable, healthy life. Some choose to help out on the nearby farms, others follow the old tradition of visiting the church regularly. Nonetheless, it must be noted that Geel is subject to the same cultural stresses as the rest of the Western world.

The depiction of madness has changed radically in pop-culture over the recent years. You have supported projects such as Re:create Psychiatry or Madlove, the Designer asylum, whilst you also participated in setting up the Museum of Mind at the Bethlem Hospital. Even though stigmatisation and ‘othering’ are still quite prevalent, it seems as if the younger generation’s understanding of mental illnesses would be more open-minded and perhaps less influenced by scientific categories. Do you have favourite artists who champion a better image of madness? How should madness be represented?

It’s important to realise that you aren’t fully inhabiting either the patient’s or the doctor’ perspective. It is a subject that can’t be left to a dialogue between patient and doctor: somebody needs to interrogate how it has been assembled. That has been my mission. Lately I’ve began to focus on forging the means that allow service users to speak for themselves and showcase their work. We must find a way to include those perspectives. A lot of people in mental health activism and art are doing amazing work. Neither outsider art nor patient art are sufficient terms to cover the types and forms of work being done. One of the things that I tried to do with Bedlam is to take a piece of work on its merits, to have a range of works. We had pieces from Richard Dadd who was an academic artist before things had happened to him. His path is different from somebody who only starts producing work in an occupational, therapeutic context once they are in residential care. And then, there’s James Tilly Matthews who produces in a very professional modality whilst imprisoned in Bethlem. I’m not sure if you can form a category in which they can all sit. Categories at best can only provide royal roads into each individual story.

Your work is almost like a forensic investigation into the circumstances in which the jargon of scientific treatments has been conceived and treatments have been validated. It attests to the idea that the recognition of the conditions of subordination can forge the momentum for protest/change. Can your works be considered as radical interventions?

It all comes down to the calculus of how we allocate not quite enough resources. That being the case I don’t feel like ushering in a radical intervention that can resolve the problem. It’s vital to not judge people who work in that context. I don’t have an intervention but I’d like to create a path through which it can emerge, through which it can be communicated. It’s better to take a broader cultural, historical view. The present is part of the process. It’s more viable to focus on ideas of evolution and dialectic rather than rupture and revolution. Once you get your 3D glasses in time, then you can recognise the interplay between madness and pathologies and how they developed in the course of history.

What is the role of your works?

I work for a general, commercial audience. It’s very satisfying to find a point in the narrative where philosophy becomes central and essential, so that the reader will appreciate it. I’m always on the lookout for these. I wrote a book about laughing gas, which was also about the hinge between the Enlightenment and the Romantic movement. Humphry Davy and his associates began to experiment with nitrous dioxide exactly at the same time as Samuel Coleridge returned from Germany where he was reading Fichte and Kant. Humphrey’s famous pronouncement after his first time using nitrous dioxide went: “Nothing exists but thoughts!” This captures a particular moment in the history of ideas. It represents the shift towards Kantian philosophy. It’s always satisfying when a story moves in that direction when otherwise you wouldn’t be able to present that. History and theory should be present but sublimated. If you are used to approaching this on the basis of theory, you’ll be fixated on finding the names, the secondary resources, perhaps some Foucault. However, my job is to work it into the text instead of abstracting it. It’s an interesting challenge. I enjoy working with a language the general reader can read. It’s very satisfying to find ways of taking those ideas out of the academic world which normally contains them.

What’s your new book about?

I’m writing about the history of mescaline for Yale University Press. The peyote cactus was adopted by Native American tribes in the late 19th century. It was first witnessed by an ethnographer from the Smithsonian who brought it into the purview of western science in the 1890s. Then scientists like Weir Mitchell and William James experimented with it, and mescaline was isolated from the cactus.’ Throughout the first half of the 20th century mescaline was the only psychedelic drug available. It had various uses for German psychiatry. Simultaneously, philosophers Walter Benjamin and Jean Sartre began experimenting with it. Maurice Merleau-Ponty wrote in great length about it. That’s an example of how medical questions can infiltrate the field of psychiatry and psychology, only to spill out further for philosophy to become necessary to resolve the dilemmas it leads to on the next stage. In terms of phenomenological insights, Merleau-Ponty gets much out of it in various ways. And then, mescaline begets a psychoanalytic revolution. Eventually it gets replaced by LSD, so in a way it is about telling the story of what the experience of psychedelics would have been before people knew about it.


Mike Jay is a cultural historian, writer and curator. He has written about the history of various drugs and mental illnesses. The 2016 This Way Madness Lies explores how asylums changed between the 17th century and the contemporary era. The accompanying exhibition, Bedlam: the asylum was hosted by the Wellcome Collection in 2017. His upcoming book on the history of mescaline will be published by Yale University Press next year.

Leila Kozma is currently preparing a conference paper on the Social Patient’s Collective which will be presented at the Association for Psychosocial Studies Biennial Conference in April, 2018. Her work has been published by Tank, Sleek and How to Sleep Faster.