The Witch as Mental Patient

Although Freud recognized some of the dangers inherent in the 

Perhaps unintentionally and unwittingly, the new vocabulary of psychoanalysis was thus combined with the traditional vocabulary of psychiatry, generating a rhetoric of rejection of hitherto unparalleled popularity and power. The result was that everyone s conduct—living or dead, primitive or modern, famous or infamous —became a fit subject for the psychopathologist s scrutiny, explanation, and stigmatization. 

To be sure, by adopting this approach, psychoanalysts threw fresh light on certain important similarities between dreams and mental symptoms, the behavior of primitive man and his civilized descendant, myth and madness. In these ways, the psychopathological perspective enriched and extended our understanding of human nature and personal conduct. There was, however, a serious 

This ostensibly lofty aspiration of saving the defendant from execution was the motive behind the important M Naghten decision, in 1843. Known as the M Naghten rule, this decision has ever since provided the medicolegal basis for the insanity plea, the insanity defense, and the insanity verdict. In modern psychiatric texts the insanity defense is thus invariably attributed to the discoveries of scientific psychiatry and its recent burgeoning popularity, in this and other Western countries, to the long-overdue legislative and judicial appreciation of the supposed contributions of 

The physicians most responsible for classifying witches as mental patients were the celebrated French psychiatrists Pinel, Esquirol, and Charcot. They were the founders not only of the French school of psychiatry but of all of modern psychiatry as a positivisdc-medical discipline. Their views dominated nineteenth-century medicine. 

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Finally, as we have noted earlier, once the roles of witch and mental patient become established, occasionally people will seek,... 

Deutsch gets caught here in the same trap that ensnares all who treat the rhetoric of oppression as if it were a dialogue between equals. The accused—witch, Jew, mental patient—must be at fault or guilty, or else he would not be accused by honest men. What such reasonable critics of mental health practices as Deutsch fail to see is that in a relationship where one party controls another by brute force, the former forfeits all possibility of a dialogue with the latter and, before a critical observer not subject to his power, he forfeits all claim to credibility as well. 

It is necessary to keep in mind here that most people diagnosed as physically ill feel sick and consider themselves sick whereas most people diagnosed as mentally ill do not feel sick and do not consider themselves sick. Consider again the homosexual. As a rule, he neither feels ill, nor considers himself ill. Hence, he usually does not seek the help of a physician or psychiatrist. All this, as we have seen, parallels the situation of the witch. As a rule, she, too, neither felt sinful, nor considered herself a witch. Hence, she did not seek the help of the inquisitor. If, then, a psychiatrist is to have a patient of this kind, or a priest such a parishioner, each must have the power to impose his care on an unwilling subject. The State gives this power to the psychiatrist, just as the Church gave it to the inquisitor. 

This intolerance is understandable. Doubt about the existence or dangerousness of mental patients would limit the methods permitted to institutional psychiatrists in combating mental illness, just as doubt about the existence or dangerousness of witches would have limited the methods permitted to inquisitors in combating witchcraft. The Inquisition thus flourished so long as its agents were entrusted with special powers by the society they served. Institutional Psychiatry now flourishes for the same reason. Only when these powers are curbed does such an institution wither away. 

To be sure, men like Galileo and Darwin were opposed by clerical authorities. And so were heretics and witches. But men like Semmelweis and Freud were opposed by clinical authorities. And so are the men and women we treat as involuntary mental patients. This is not surprising. In medieval society, the Church supplied the ideology, the State the power. Today, the Scientific Establishment supplies the ideology, the State the power. Formerly, the inquisitor accused the citizen of witchcraft and proved him to be a witch he then relaxed the witch to the secular arm —that is, the State— and he was burned at the stake. Today, the institutional psychiatrist accuses the citizen of mental illness and diagnoses him as psychotic ... 

The second section of Part I of the Malleus is entitled Whether it be a Heresy to Maintain that Witches Exist. The peculiarly inverted phrasing of this sentence should be noted. Sprenger and Kramer ponder whether the belief in witchcraft is a mistake—only to conclude that to disbelieve it is a grave sin. The question arises, they ask, whether people who hold that witches do not exist are to be regarded as notorious heretics. . They answer yes. This is as if modern psychiatrists were to ask whether mental patients exist, and would answer that to believe otherwise is a serious error and a grave offense against the psychiatric profession. Since I have dubbed mental illness a myth, precisely this argument has been advanced by several psychiatrists critical of my views. ... 

It is clear that psychiatrists have a vested interest in diagnosing as mentally ill as many people as possible, just as inquisitors had in branding them as heretics. The conscientious psychiatrist authenticates himself as a competent medical man by holding that sexual deviants (and all kinds of other people, perhaps all of mankind, as Karl Menninger would have it) are mentally ill, just as the "conscientious inquisitor authenticated himself as a faithful Christian by holding that homosexuals (and all kinds of other people) were heretics. We must realize that in situations of this kind we are confronted, not with scientific problems to be solved, but with social roles to be confirmed. Inquisitor and witch, psychiatrist and mental patient, create each other and authenticate each other s... 

The evidence presented thus far establishes, I believe, the basic similarities between the social situation of witches and involuntary mental patients. At the same time, although, as scapegoats and victims, witches and madmen resemble Jews and Negroes, there are also some important differences between them which deserve some brief remarks. 

In many African animist cultures, Western medicine may cure the disease but not the patient, who continues to languish. Western medicine is regarded in Africa in the same way that the Western world regards naturopathy - as ineffective, and this can cause the reverse placebo effect. This can be seen to the extreme in the severe mental function and physiologic systemic shutdown produced by a witch doctor s curses, which seem totally unresponsive to antidepressant medication (Cannon, 1957), and the first author of this chapter has witnessed and successfully treated such an episode but had to use unconventional methods. 

Common justice demands, say Sprenger and Kramer in the Malleus, that a witch should not be condemned to death unless she is convicted of her own confession. 2 According to Robbins, Once accused, the victim had to endure torture and inevitably make a confession of guilt. Every witch trial had its confessions. Similarly, every sanity hearing has its psychiatric self-incrimination the state-employed psychiatrist demonstrates to the court, from statements made by or attributed to the victim, that the patient is suffering from mental illness. The records of witch trials are as full of documented confessions of pacts with the devil and other evidences of witchcraft, as are the records of modern Institutional Psychiatry of hallucinations, delusions, and other evidences of insanity. One example of this should sufi ce here. ... 

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