My interest in the history and narratives of mental health and illness began very early in my research.
After finishing my undegraduate studies in Italy I moved to London to pursue a PhD in Greek literature at King’s College London. I decided I wanted to work on Euripides’ Bacchae, the last play of the youngest of the three great tragedians of the fifth century, precisely because madness, and what it means to have a sound mind is such an important topic in this play.
After obtaining my doctorate (2004) and publishing it (2007) I taught and researched a few more years in London, and kept exploring the topics of mental life and view of self, and to reflect on how ancient poets and writers choose to depict subjectivity, „mind“ and mental suffering in their work.
In 2010 I had a unique opportunity that changed my perspective in a fundamental way: I was offered a post within a research group on history of ancient medicine at the Humboldt University in Berlin („Medicine of the mind, Philosophy of the body“, directed by Ph. Van der Eijk).
I have worked on ancient medical ideas about the relationship between body and soul, bodily and mental/spiritual health and mental disorder ever since. I find the way in which ancient thinkers framed the challenges of psychopathology and the possibility of a 'psychiatry' as caring practice still extremely valuable, often sophisticated and at times more insightful than our own. Whether one shares this view or not, the terms of discussion offered by ancient thinkers remain fundamental in the way we discuss these topics nowadays. In many respects, this value still awaits exploration and recognition in current scholarship.
After five years based in the Humboldt University in Berlin, since 2015 I am a Research Fellow at Warwick University, where i hold a Wellcome Trust grant in Medical Humanities. I am part of the department of Classics, joining a group of experts in ancient Greek and Arabic medicine (Simon Swain, Caroline Petit and Uwe Vagelpohl) directed by Simon Swain.
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My main research questions are historical, but also have to do with how we - as historians and modern readers - understand mental health and illness, the curability of mental disorders, and their status in society:
- When, and how did ‚mental disorders’, or 'madness' begin to be considered a separate category, a particular kind of pathology in western medicine and culture?
- What is the relationship of disorder to health? What about a consideration for mental life in the positive as object of care rather than in the negative, needing remedy when things no longer function?
- What signs – bodily and psychological – were associated to insanity in the ancient world? Can we relate our own human experience of mental health to these ancient ‚stories’ of madness?
- What is the status of madness after all in ancient medical thought (and in general)? A bodily dysfunction, a depravity of character, or the prevailing of irrationality and emotions over the sound and well-reasoning parts of our ‚soul’? These three possibilities are still at the center of how mentally ill individuals may be judged nowadays. What can ancient discussions contribute in this respect?
- Ancient medicine was consistently ‚materialistic’, not offering a sharp opposition of body vs. ‚soul’, or 'mind'. In this frame, different models of mental-life-in-the-body emerged. What are the significant patterns of localisation in the ancient world ('mind' is in the brain, in the heart, in the blood...)? What other modes of mental functioning, alternative to localisation, can we trace in ancient medicine? How do these representations relate to the modern history of neuro-psychiatry, and to how our body and mind ultimately 'feel like'?
For five years i explored these questions with reference to the works of the Hippocratic Corpus (a body of Greek medical texts whose earlier nucleus dates to the fifth century BCE). My monograph with the results of this exploration is in press.
MY CURRENT PROJECT
Currently, I am in the initial phase of a new project, entitled ‚Ancient Histories of Phrenitis’ (Wellcome Trust funded, based at Warwick University). This project aims to look at the vicissitudes of an ancient disease that was from its beginnings – 2500 years ago or so – considered to impair the mind. Phrenitis is established in the Hippocratic texts as a high fever with derangement, displaying a set of rather fixed symptoms, and remains throughout the ancient world a key mental disease all notable physicians debated and diagnosed. Different details and observations were made through the centuries, different localisations proposed, but what remained constant was the acute and often mortal quality of the disease, and its important place in the study of human pathology. From the place it occupies in medical writings, in other words, we can only conclude that phrenitis must have been (in the perception of physicians, of course) a very frequent disease, and an impressive one for its severity and mortality.
After the end of the ancient world, the disease did not disappear. It is however with the beginning of the modern era that phrenitis began to receive fresh attention and new impetus, through the work of anatomists such as Giovanni Battista Morgagni (17th/18th century) or the Dutch physician Gerard van Swieten (18th century), to cite two prominent examples. The prominent French psychiatrist Pinel inserts it in his Nosographie Philosophique (1798), classifying it as ‘inflammation of the membranes of the brain’. Official diagnoses of phrenitis by medical authorities are documented as late as the nineteenth century.
That of phrenitis always striked me as a great case of both continuity of a disease entity (named and described for 2500 years!) and of adaptation through history, cultural as well as scientific, to the point of complete disfiguration.
By carefully analysing the different stories attached to this disease label, I hope to learn something more about how ideas of mental disorder, the human body and our knowledge of it, and individual subjectivity contribute to the creation of those biological and anthropological entities we call ‘Mental Diseases', ‘Mental Disorders’ and the like. This is an exploration of history of medicine and history of science; its implications (social, political and personal) for human existence, however, are very evident; and they often have huge consequences for the life of many.
MONUMENTS TO MENTAL HEALTH
Any expression through which human beings reflect on something and want to share ideas or stories may be called a monument.
A monument to mental health and mental life, in a broad sense, could be an artefact or place but also a poem, as much as an image or a musical composition: anything human beings do, ultimately, has to do with the mind.
What i am especially interested in, however, is human attempts to celebrate mental health in a self-reflective, organised, historical way.
To speak of mental illness and recovery, and of ideals of normality or happiness as natural experiences of humans as animated beings, and as members of societies of different sorts. I want to present here a selection of museums, events, performances; but also films, documentaries, narratives that i found especially enriching (or flawed) for how they explore the theme of mental health.
MENTAL LIFE AND MENTAL DISORDERS IN FIFTH- AND EARLY FOURTH-CENTURY MEDICAL THOUGHT. Cambridge: Cambridge University Press (2017)
HIDDEN PATHS. NOTIONS OF SELF, TRAGIC CHARACTERISATION AND EURIPIDES' BACCHAE. (BICS Suppl. 99, London 2007).
- MENTAL ILLNESS IN ANCIENT MEDICINE. FROM CELSUS TO CAELIUS AURELIANUS (co-edited with P. SINGER). LEIDEN: Brill (forthcoming).
HOMO PATIENS. APPROACHES TO THE PATIENT IN THE ANCIENT WORLD (co-edited with G. PETRIDOU). Leiden: Brill (2015).
- EROS IN ANCIENT GREECE (co-edited, with C. Carey, N. Lowe, and E. Sanders). Oxford: Oxford University Press (2013).
Articles and Chapters
‚The Hippocratic Patient‘. In P. P (ed.) Cambridge Companion to Hippocrates. Cambridge: Cambridge University Press (2017).
- ‘The view of madness in the Ancient Greek and Roman tradition’. In G. Eghigian (ed.) The Routledge History of Madness (2017). London: Routledge.
- ‘The tragic prosopon and the Hippocratic facies: face and individuality in Classical Greece’. Maia. Rivista di Letterature Classiche (2016).
‘Mental disability? Galen on mental health’. In C. Laes (ed.) Disabilities in Antiquity. London: Routledge (2016).
‘Fear, Hope and the definition of Hippocratic Medicine’. In W.V. Harris (ed.) Popular Medicine in the Graeco-Roman World: New Approaches. (Columbia Studies in the Classical Tradition 42). Leiden: Brill (2016).
'Grief and Cheerfulness in early Greek medical writings'. In Bosman, P.R. (ed.) Ancient Routes to Happiness. Acta Classica Supplement 7. Pretoria: Classical Association of South Africa (2016) 95-116.
- (with Ph. van der Eijk and Orly Lewis), ‘Gradualism and mental health in ancient medicine’. In G. Keil, and L. Keuck and R. Hauswald (eds.) Gradualist Approaches to Mental Health and Disease. Oxford: Oxford University Press (2016).
‘Patient function and physician function in the Epidemics cases’. In G. Petridou and C. Thumiger (eds.) Homo Patiens. Approaches to the patient in the ancient world. Leiden: Brill (2015) 107-37.
‘Introduction.’ In G. Petridou and C. Thumiger (eds.) Homo Patiens. Approaches to the patient in the ancient world. Leiden: Brill (2015) 1-22.
‘Animals in tragedy’. In G. Campbell (ed.) Oxford Handbook of Animals. Oxford: Oxford University Press (2014) 84-98.
- ‘Metamorphosis: human into animal’. In G. Campbell (ed.) Oxford Handbook of Animals. Oxford: Oxford University Press (2014) 384-413.
‘Mental insanity in the Hippocratic texts: a pragmatic perspective’. Mnemosyne (2015) 210-233.
‘The early Greek medical vocabulary of insanity’. IN W.V. Harris, (ED.) Mental Disorders in the Classical World. Leiden: Brill (2013) 61-95.
‘Vision and knowledge in Greek drama’. In D. Cairns, N. Rabinowitz, S. Blundell (eds.) Vision and Viewing in Ancient Greece. Special Issue of Helios 40 (2013), 223-46.
Entries ‘Ancient and modern views on character and personality’, ‘Madness’, ‘Concept of Mind’, ‘Animals and animal imagery’, ‘Vision and knowledge’, ‘Bacchae’. In H. Roisman (ed.) Blackwell Encyclopedia of Greek Tragedy. Oxford: Blackwell (2013) 206-12; 785-7; 849-51; 112-4; 1466-7; 353-9.
- ‘Hallucination, Drunkenness and Mirrors: Ancient Reception of Modern Drama’. In A. Bakogianni (ed.), Dialogues with the Past 1: Classical Reception Theory and Practice. BICS Supplement 126-1. London (2013) 39-60.
‘Mad Eros and eroticized Madness in Tragedy’. In E. Sanders, C. Thumiger et al. (eds.) Eros in Ancient Greece. Oxford: Oxford University Press (2013) 27-40.
‘Introduction’. In E. Sanders, C. Thumiger et al. (eds.) Eros in Ancient Greece. Oxford: Oxford University Press (2013) 1-8.
‘Metatheatre in modern and ancient fiction’. Materiali e Discussioni per l’Analisi dei Testi Classici 63 (2009) 9-58.
‘Epidemia tra le Baccanti di Euripide, Tucidide e il Corpus Hippocraticum’. Studi Italiani di Filologia Classica 7(2) 2009, 176-200.
‘anagkês zeugmat’ empeptôkamen: Greek Tragedy between Human and Animal’. Leeds International Classics Seminar (2008).
‘Personal Pronouns as Identity Terms in Ancient Greek: The Surviving Tragedies and Euripides’ Bacchae’. Harvard Studies in Classical Philology 104 (2008).
- ‘Visione e identità nelle Baccanti di Euripide’. ACME II (2007) 3-30.
‘Animal World, Animal Representation, and the “Hunting-Model”: Between Literal and Figurative in Euripides’ Bacchae’. Phoenix 60.3-4 (2006) 191-210.
- ‘The professional audiences of the Hippocratic Epidemics. Patient cases, in ancient scientific communication’. In The Greek Medical Text and its Audience: Perception, Transmission, Reception, ed. by P. Bouras-Vallianatos and S. Xenophontos. Tauris (forthcoming).
‘A most acute, disgusting and indecent disease’: Satyriasis in ancient medicine’. In Mental Illness in Ancient Medicine. From Celsus to Caelius Aurelianus (edited by c. THUMigER and P. Singer). Leiden: brill (2017).
‘Stomachikon, Hydrophobia and eating disorders: volition and taste in late-antique medical discussions’. In Mental Illness in Ancient Medicine. From Celsus to Caelius Aurelianus (edited by C. Thumiger and P. Singer). Leiden: Brill (2017).
(With L. Graumann) ‘Children And The Art Of Medical Storytelling: Contemporary Practice And Hippocratic Case-Taking Compared’. In Cases and Anecdotes, ed. by M. Asper et al. (forthcoming)
- Chapter on ‘Animals’. In L. Totelin (ed.) The Berg/Bloomsbury Cultural History of Medicine. Volume on Antiquity. London: Bloomsbury (2018)
DISCUSSIONS ON DISABILITY
“Disabilities is an umbrella term, covering impairments, activity limitations, and participation restrictions. An impairment is a problem in body function or structure; an activity limitation is a difficulty encountered by an individual in executing a task or action; while a participation restriction is a problem experienced by an individual in involvement in life situations.
Disability is thus not just a health problem. It is a complex phenomenon, reflecting the interaction between features of a person’s body and features of the society in which he or she lives. Overcoming the difficulties faced by people with disabilities requires interventions to remove environmental and social barriers.
People with disabilities have the same health needs as non-disabled people – for immunization, cancer screening etc. They also may experience a narrower margin of health, both because of poverty and social exclusion, and also because they may be vulnerable to secondary conditions, such as pressure sores or urinary tract infections. Evidence suggests that people with disabilities face barriers in accessing the health and rehabilitation services they need in many settings”
(WHO, accessed 17.07.2016, http://www.who.int/topics/disabilities/en/)
The WHO definition emphasizes impairments, activity limitations, and participation restrictions as part of the human experience of disability, focusing thus on the body, on society's reactions to certain conditions, and on the need for interventions to remove respective barriers. This definition – the standard in our world - covers mental impairments only in a derivative way. At the centre are the physiology and structures of the human body and their variations, framed within the activities and interactions of life.
Mental disability is only a particular case within this whole, and notably one which ancient medical literature barely consider in ways on which we could superimpose our own modern constructs, (e.g.) discussions of what used to be called 'retardation' in modern or contemporary medicine – 'mental disability'. In this sense we are setting ourselves out onto an anachronistic path as we inquiry mental disability in ancient sources, and both the correspondences and the differences between us and the ancient can be only partial.
Nonetheless, to search for the antecedent of modern ableism and dis-ableism (on these see F.A. Kumari Campbell, Contours of Ableism: The Production of Disability and Abledness, London, 2009) is an important critical exercise to both challenge our own prejudices and the polices and institutions of our societies, and to better understand ancient social organisations and thought systems.
For example, in the WHO definition the terms ‘impairment’, ‘activity limitation’ and ‘restriction’ indicate a permanent or long-lasting state of things that characterize an individual in his or her life and interactions with the world outside. This enduring quality of a disability, mental or physical, by which health is deeply embedded into the nature of each individual find a match with several ancient ideas: for example, that of hereditary defilement, ‘family guilt’; or the correspondence between bodily excellence and moral character (the so called kalokagathia, ‘to be good and handsome’). All these characteristics cannot be changed through therapy or good will.
On the other hand, to these impairments qualities of excellence are sometimes associated. The god Hephaistos is famously represented as lame, as well as being an extraordinarily skilled artisan:
...as well as there is a pattern of representing figures of wisdom and artistic greatness as as blind, like famously the poet Homer or the Theban seer Thyresias.
On the other hand Archilochus, the iambic poet of the 7th century BCE, went as far as clearly pointing out that an imperfect bodily appearance had nothing to do with a man’s qualities; a crooked, but strong-hearted soldier is of much more value than a brainless and cowardly macho:
‘I love not a tall general nor a straddling,
nor one proud of his hair nor one part-shaven;
for me a man should be short and bowlegged to behold,
set firm on his feet, full of heart’
οὐ φιλ<έω> μέγαν στρατηγὸν οὐδὲ διαπεπλιγμένον
οὐδὲ βοστρύχοισι γαῦρον οὐδ' ὑπεξυρημένον,
ἀλλά μοι σμικρός τις εἴη καὶ περὶ κνήμας ἰδεῖν
ῥοικός, ἀσφαλ<έω>ς βεβηκὼς ποσσί, καρδίης πλέως.
All these sparse, and well-known examples – many more could be mentioned – illustrate the existence of both a prejudice on ‘disabled bodies’ – whether positive or negative prejudice - and of a challenge to it from very early in Western culture.
Still, the ancient lacked a clear categorization of ‘disability’ as general experience and could be said, in some respect, to have held a less normative view of what it means to be a human being worthy of this name. This does not mean that the life of the mentally of physically impaired would have been necessarily less difficult, and sometimes tragic than it is in many places and contexts nowadays. A clear classification of able vs. dis-abled was not there, however: and it is precisely classifications, rather than the recognition of innate differences and degrees of strength among individuals per se what notably brings in rigid social divisions, margialisation and devaluation, and the ultimate call for a homogenisation of humanity based on a set of given measurable values.
Much work has been done in disability studies to reflect critically on what ‘(dis)ability’ means, and to uncover different human attitudes to this aspect of human difference in other historical periods. Still much works has to be done, especially in the area of mental disability in its various forms, notably more problematic to reconstruct than bodily particularity. Here are some studies on the ancient period:
Breitwieser, Rupert 2012. Behinderungen Und Beeintrachtigungen / Disability and Impairment in Antiquity. Oxford, Archaepress.
Francis, Sarah 2017. ‘From private disabilities to public illnesses: placing the mentally incapacitated in Roman society’, in Thumiger and Singer (eds.).Mental Illness in Ancient Medicine. From Celsus to Caelius Aurelianus. Leiden, Brill.
Garland, Robert. 2010. The Eye of the Beholder: Deformity and Disability in the Graeco-Roman World. London, Bristol Classical Press.
Goodey, Christopher F. 2011. A History of Intelligence and ‘Intellectual Disability’: The Shaping of Psychology in Early Modern Europe. Ashgate, Routledge.
Hubert, Jane 2000. Madness, disability and social exclusion: the archaeology and anthropology of ‘difference’. London, Routledge.
Kellenberger, Edgar 2011. Der Schutz der Einfältigen. Menschen mit einer geistigen behinderung in der Bibel und in weiteren Quellen. Zürich, TVZ Theologischer Verlag Zürich.
Kellenberger, Edgar 2013. Children and Adults with Intellectual Disability in Antiquity and Modernity: Toward a Biblical and Sociological Model, CrossCurrents 63.4: 449–472.
Laes, Christian 2013. ‘Approaching disabilities a Capite ad Calcem: hidden themes in Roman Antiquity’, in Laes et al. (eds.), pp. 1–15.
Laes, Christian 2014. Beperkt? Gehandicapten in het Romeinse Rijk. Leuven, Davidsfonds Uitgeverij.
Laes, Christian 2016. Disabilities in Antiquity. London, Routledge.
Laes, Christian, Goodey, Chris F. and Rose, M Lynn (eds.) 2013a. Disabilities in Roman Antiquity. Disparate Bodies a Capite ad Calcem. Amsterdam, Brill.
Rose, Martha L. 2003. The Staff of Oedipus. Transforming Disability in Ancient Greece. Ann Arbor, University of Michigan Press.
Thumiger, Chiara ‘Mental disability? Galen on mental health' In C. Laes (ed.) Disabilities in Antiquity. London: Routledge (2016).