Schizophrenia. Orna Ophir
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Terms such as “madness,” “lunacy,” or “insanity,” together with descriptions of people who, in the eyes of their contemporaries, displayed disturbances in their habits and conduct that indicate the loss of a shared reality or common sense, can thus be used to write a history that predates the term schizophrenia. In other words, our story begins in the period well before the term schizophrenia was coined and its presumed “proper history” can be studied. The numerous (and often remarkable) ancient and medieval descriptions of the transformation of individuals who have “gone mad” show how previous eras dealt with the perennial difficulty of characterizing perceived deviant mentality and behavior, as being either at the extreme end of normal human experience or as a discrete form, to be diagnosed by experts and treated by specialists as isolated phenomena.
Yet, in studying the understanding of madness before modern psychiatry established the diagnosis of schizophrenia, we should avoid presentism and retrospective projections. Especially, we should not assume that “madness,” “madmen,” and “mad-doctors” (as they are described in these earlier texts) can be easily translated into the modern idioms of “schizophrenia,” “schizophrenics,” and “psychiatrists,” respectively. Instead, the meaning and interpretation, the explanation and understanding of madness, depend on how the term is understood in its different historical, geographical, cultural, theological, and philosophical contexts. We would even contend that what constitutes “mad” people is determined by themselves and/or according to their contemporary witnesses and experts.
Prophets or Beasts? Madness in the Bible
And the Spirit of God came upon him, and he prophesied among them. And it came to pass, when all that knew him beforetime saw that, behold, he prophesied among the prophets, then the people said one to another, what is this that is come unto the son of Kish? Is Saul also among the prophets? (1 Samuel 10:10–11)
Although schizophrenia is a diagnosis used in psychiatry, the term “madness” was not always understood, or used, as a medical concept. In fact, as Madalina Vârtejanu-Joubert, an expert on madness in Ancient Near East History and the Hebrew Bible, argues, when it comes to the early Hebrew tradition, madness is not part of the history of medicine but of political, religious, and legal anthropology.13 In the Hebrew Bible, madmen are characterized either as human beings who have been degraded to the level of beasts, or as select individuals who are elevated towards the presence of the divine. In both cases, men who behave in strange ways seem incomprehensible to their fellow human beings, having become something other than merely recognizably human. Whether they belong to the animal kingdom or the divine realm, mad people are deemed to be, so it seems, of an entirely different, unique kind.
The first time the word “madness” appears in the Hebrew Bible, in the Book of Deuteronomy, it is presented as a form of divine punishment. As Moses delivers the Lord’s words to the people of Israel (recounting all the blessings He shall grant them should they follow His words, and listing the numerous curses He will bring upon them should they not hearken to His voice), he says: “The Lord will smite you with madness and with blindness and with bewilderment of heart.”14 As Vârtejanu-Joubert shows, the Hebrew word for madness, “shigaon” resembles expressions with a similar root in other ancient Semitic languages, implying that to be mad is to be “like a bear with a sore head,” or “to squeal like a pig.”15 In fact, in the later story of Nebuchadnezzar, the king of Babylon, who is punished with madness for his pride, we clearly see this degradation of the monarch to a bestial, lower form of life. Nebuchadnezzar’s human heart (which was considered the seat of the higher faculties of reason, will, and judgment) is changed into that of an animal; he “eats grass as oxen, and his body is wet with the dew of heaven, until his hairs were grown like eagles’ feathers, and his nails like birds’ claws.”16
Another depiction of madness as a degradation of the human spirit can be found in the gospels, in the New Testament. In Mark 5, Jesus is reported to visit the country of the Gerasenes and is confronted by “a man with an unclean spirit.”17 Here as well, the madman is compared to the wolves and the dogs that roam around naked, without shelter or clothing, screaming at the graveyard. The fearful villagers try to restrain the madman with chains and fetters, and feed him as if he were an animal. When Jesus is called to intervene and asks him for his name, the man replies: “My name is Legion; for we are many.”18 Jesus then sends the “legion,” the “unclean spirits” into a passing herd of swine which, having been transformed, run into the water and drown. As a result of this miracle, the demoniac (the man who had been possessed by demons) conducts himself as a human once again, “sitting and clothed and in his right mind.”19
In these early traditions, however, madness does not always involve changing into a lower form of life. The word “mad” or meshuga is also used to designate the transformation into a higher form of being, namely that of the prophet, the navi. For example, in the famous case of King Saul’s bizarre gestures and nudity, the question arises of whether Saul should be counted “also among the prophets?”20 Indeed, in Hebrew, “to behave like a prophet” can also mean “to rave,” “to act like one who is beside himself,” or “to behave in an uncontrolled manner.”21 People who displayed behavior such as King Saul’s were seen as strange. As we saw in the words from 1 Samuel, cited in the epigraph to this section, those who knew him before noticed that he had changed:
And he stripped off his clothes also, and prophesied before Samuel in like manner, and lay down naked all that day and all that night. (1 Samuel 19:24)
They thus had to ask themselves what had happened to him and, indeed, whether he had become a raving prophet, from then on belonging to a different category of humans.
Yet not only bystanders or contemporaries, who all too often mocked and isolated those who were thus afflicted, questioned the transformation of those who, in fact, behaved like prophets. The latter themselves also acknowledged their alteration. Such individuals clearly experienced themselves as being different from the rest of society, with its firmly established customs and well-circumscribed, sanctioned forms of conduct.
That said, the prophets of the Bible are depicted in ways that make it difficult, even for their contemporaries, to know whether they are divinely inspired or, on the contrary, gravely deluded. Indeed, the prophets claimed that when the divine spirit seized them, they had visions and could not help but behave strangely. As emissaries of the divine, Hebrew prophets such as Isaiah, Jeremiah, Elijah, and Ezekiel are said to conduct themselves in eccentric and irrational ways. In fact, Ezekiel, more than others, has been retroactively diagnosed as a schizophrenic.22
In these ancient depictions, madness is defined as a different spiritual quality that opposes the mad individual to those considered sane. Madness is seen as the result of possession (having an unclean spirit or being haunted by demons), as a consequence of “in-spiration” (that is, of being in the spirit of God that came “mightily upon” the individual in question) or as a departure of the good spirit, followed by torment by an evil substitute:23
Now the spirit of the Lord departed from Saul, and an evil spirit from the Lord tormented him. (1 Samuel 16:14)
In Saul’s story, madness is a matter of “another heart,”24 while in the punishment of King Nebuchadnezzar, it is a change from a “man’s heart” to a “beast’s heart.”25 In these ancient texts, a qualitative, rather than quantitative, difference thus exists between the mad and the sane. If the work of the prophet is to communicate the word