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.