‘To Define True Madness,’ the first episode in the BBC series MADNESS, traces the origins of our ideas of madness back to the belief in divine possession that is to be found in a wide range of mythologies. With the advent of Christianity, the idea of invisible forces became visualized in terms of a struggle between the forces of Good and Evil competing for control of individual human souls. The Christian belief that one would be held accountable in the afterlife for one's deeds in this life contributed to the processes of growing introspection that were already underway, and to the development of a notion of personhood as self-consciousness. In the nineteenth century, theologians and doctors competed with one another as they tried to explain the origin of madness as either supernatural or natural, the work of the devil/witchcraft or a physical condition. Although theological views became less and less influential, until they were eventually discredited by late nineteenth-century French neurologists who retrospectively diagnosed cases of possession as cases of hysteria, our postsecular world still retains traces of pre-secular ideas of madness (such as psychic readings, for example).

The numerous physiognomic studies of the insane that emerged in the second half of the nineteenth century were all based on the assumption that temporary facial expressions leave permanent traces on the face that can be categorized and used for diagnostic purposes. Thanks to its assumed ‘objectivity’, the new medium of photography was considered the most appropriate diagnostic and descriptive tool in the study and treatment of the insane. In an interview included in ‘In Two Minds’, another episode of the Madness series, Sander Gilman (author of the 1996 study, Seeing the Insane) observes that what is striking about this period is not so much the representation of insanity, but ‘the repertoire, recurring and consistent, of art historical traits ‒ the style, the conventions, not the subject.’ The blossoming of psychiatric illustration contributed to the creation of a taxonomy of mental illnesses and of types of people ‘most likely’ to suffer from them. Physicians were trained to see their patients through the prism of such conventionalized visual representations. With the rise and spread of psychoanalysis, visual representations of madness and mental illness lost their initial appeal.