Religious Madness and the Logic of Contagion

A year or so ago, I began working on a new book project about the psychiatric diagnosis religious madness. I was struck then by how deeply the logic of contagion runs through the twin histories of psychiatry and the academic study of religion. It also struck me as one way of telling a larger and more familiar story about how ‘religious experience’ came to mean much less by the twentieth century than it had meant in the eighteenth. It seemed to me, when I began this work, that I was writing about an idea that I, and my readers, would find inherently ridiculous. The point of the work was to show how this self-evidently ridiculous idea is, in fact, built into our academic fields and our systems of governance. But here we are. There is a new disease, which no one on earth claims to understand, which, beyond the death it brings and will continue to bring, appears to leave the brains of some of those who survive it damaged, perhaps irreparably. That is precisely what “religious madness” was supposed to be. I used to do this work with ironic detachment. No more. Perhaps it is because of our ongoing epidemic, but I am far more afraid of this idea than I was before.  I’d like to tell a story about why I think the logic of contagion is dangerous.

By the first decade of the nineteenth century, a new idea had entered the Western world. Psychiatrists, naturalists, politicians, and theologians throughout Europe and North America came to believe that there existed a form of insanity that caused its victims to express false religious opinions, to hold clearly unreasonable religious beliefs, or to dwell too deeply on religious issues. This form of insanity, called religious madness, religious melancholia, and religious monomania in English, was believed to be a somatic disease of the brain—what today might be called a biologically rooted mental illness. Building on generally accepted scientific theories of the day, scientists of the mind theorized that religious madness presented when patients absorbed false religious ideas into their bodies. It was believed that these false religious ideas generated an emotional response which resulted in physical changes to the human body. These physical changes, they believed, resulted in madness. 

The greatest theorist of religious madness was the French psychiatrist Philippe Pinel. In August 1793, he was named physician at the Asylum at Bicêtre, and a year later he was also appointed professor of internal pathology at the newly created Revolutionary Paris Health School. At Bicêtre, Pinel was assigned to care for the inmates housed in the ward reserved for insane men.^[1]

After the Revolution, Pinel found that religious madness was suddenly rampant in Paris. One patient felt as if he were constantly surrounded by devils. Another was confined to Bicêtre because he frequently “invoked his guardian angel” and believed in the efficacy of mortification, fasting, and prayer. Another sufferer prostrated himself before the rising sun. As was his method, Pinel observed these patients in minute detail, taking note of the times of the year, atmospheric conditions, and dietary patterns that corresponded with increased symptoms.

Pinel published his fullest theory of religious madness in his 1800 Treatise on Insanity. Pinel explained religious madness as an injury of the mind’s ability to imagine caused by the introduction into the brain of false religious ideas. Those suffering with religious madness are “swelled up with morbid pride,” or may think themselves “a privileged being, an emissary of heaven, a prophet from the Almighty, or even a divine personage.” These false ideas make it particularly difficult to treat the disease, for “what measures are likely to counteract the influence of mystic vicions or revelations, of the truth of which he deems it blasphemy to express a doubt?”^[2]

Pinel’s first effort at healing religious madness ended terribly. One of the most severely afflicted patients at Bicêtre was once an “ignorant vine dresser.” His disease began when a visiting missionary convinced him that he was “irrevocably condemned to everlasting perdition.” Despairing, the vine dresser reasoned that he and his family would be better off dead as martyrs, assured of salvation, than to risk eternal damnation. He murdered his two children, but his wife managed to escape. While awaiting trial, he immolated a fellow prisoner. He wound up at Bicêtre where Pinel diagnosed him with religious madness. On every subject except religion, he seemed entirely rational. The false impression at the root of his madness was a religious one: the irrational, too-keen belief in eternal suffering of sinners. The patient could only be treated, Pinel reasoned, if that false impression were removed. Pinel instructed an asylum keeper to read the work of Racine or Voltaire to the religious maniac. After hearing Voltaire on natural religion, the patient “could no longer contain his rage.” The patient appealed to God to rain down fire upon the blaspheming attendant. When this proved ineffectual, the patient retreated to his room. Pinel considered the treatment a failure and did not repeat it, “as it appeared more calculated to aggravate than to moderate his maniacal impressions.” Later, that patient launched what Pinel called a “baptism of blood” in the asylum. He stole a shoemaker’s knife and began stabbing staff and patients. He nearly killed Pinel’s collaborator, striking a rib near the heart. He killed two other patients before he was finally restrained. He spent the rest of his life in chains.

Clearly, treating religious madness—which to Pinel meant replacing religious ideas with secular ones—would require a more systematic approach. If resources were no object (and they were, he makes clear) Pinel would have like to separate the religious maniacs from other insane within their own wing. There, “every object pertaining to religion” could be removed from their sight, as “to divert their minds from the peculiar object of their hallucination.” They would spend most of their day working a patch of land. A few hours would be reserved for “philosophical reading.” The task of the asylum keepers would be to “seize every opportunity” to draw distinctions between the “distinguished acts of humanity and patriotism of the ancients, and the pious nullity and delirious extravagances of saints and anchorites.” Ideally, the wing of the asylum for those suffering from religious mania would be a sort of secular reeducation camp.

In 1795, Pinel was presented with an opportunity to put into place, at least partially, the kind of therapeutic, secular reeducation Pinel hoped might cure religious madness. That year—the third year of the French Republic—the governing French Directory ordered all religious artifacts including crucifixes, bibles, and stained glass with religious motifs, to be removed from France’s hospitals. An agent of the Directory arrived at Bicêtre to enforce the ruling. He gathered the insane for a meeting and instructed “those who love liberty [to] draw near and enroll themselves under the national colors.” One by one, the mad of Bicêtre stepped forward to receive a tricolored cockade: symbol of the Directory’s return to the original impulses of the Revolution, of the Revolution’s return to a modicum of moderation, and—in this context—an unsubtle reminder of the regime’s commitment to laïcité. Cockades affixed, Pussin led his insane wards to the asylum’s chapel where he instructed them to destroy its religious relics. With much “consternation and terror,” the insane at Bicêtre reluctantly tore paintings from the walls and smashed holy vessels. Some cried out to God to rain down fire from heaven upon Pinel and the government’s representative for the sacrilege being committed. Others had visions of the gates of hell opening up to them for their role in the iconoclasm. Pinel’s collaborator ordered the inmates to carry the broken relics into the courtyard. As a final act, hospital staff ordered the insane patients to crush the relics into thousands of pieces “to convince them…that heaven was deaf equally to their imprecation and prayers.” The insane—more convicts more than patients—were powerless to refuse.

How should we interpret this scene? On one hand the politics of this pageant are obvious. Foucault read the treatment of King George III as the sovereign dethroned, disrobed, and ridiculed before his new sovereign, Reason.^[3] That is what’s happening here, too: belief is equated with madness (not always wrongly), religion’s material presences become a threat. Reason is again coronated, and the psychiatrist is its agent. That is a familiar story. But Pinel’s theory of religious madness is also a theory of mind. Cleansing the hospital of relics is merely the first step in the healing process. The blasphemy was critical to the therapeutic process, but it was merely the first step. True healing occurs, over time, only if the patient is kept safe from the intrusion of religion. Once safe, the brain will return to its natural (that is, healthy) state, free of logics not grounded in Reason. The brain is, in this theory, secular by default. Its healing power returns it to stasis of non-religion. Religion doesn’t reside in the brain. It is not innate in the human body. It is an unnatural imposition, a biological threat, a virus. 

So why do I think the logic of contagion is so dangerous? Because religious madness was understood as literally contagious—as a threat to public health—the burden fell on the state to protect its citizens from harm. I think this may explain why the religions most frequently cited as causing religious madness are those that most clearly pose a challenge to the established social order—Quakerism in the eighteenth century, Methodism in the 1830s and 40s, Spiritualism in the 1850s and 60s, Charismatic Pentecostalism in the 1910s and 1920s, radical Black religions since the 1930s. I think this may explain why the academic field that today calls itself the study of New Religious Movements was founded by sociologists of deviance whose studies were funded by the National Institutions of Mental Health, which spent millions of dollars in the 1960s asking social scientists to develop theories about conversion to “cults” in hopes that these conversions might be prevented in the interest of public health. 

And I think this explains why religious madness hasn’t gone away.Consider, for example, the explanation the Chinese government has given for why their ongoing genocide against Uighur Muslims: “Although a certain number of people who have been indoctrinated with extremist ideology have not committed any crimes, they are already infected by the disease. There is always a risk that the illness will manifest itself at any moment, which would cause serious harm to the public. That is why they must be admitted to a reduction hospital in time to treat and cleanse the virus from their brain and restore their normal mind. We must be clear that going into a re-education hospital for treatment is not a way of forcibly arresting people and locking them up for punishment, it is an act that is part of a comprehensive rescue mission to save them.”^[4]

The logic of contagion has become—and is becoming—the way we understand ourselves in the world. We are learning to live within what Anjuli Raza Kolb terms “the epidemic imaginary.” We are getting comfortable thinking with, and through, this metaphor of contagion. This worries me for a lot of reasons, but chief among them is the fact that contagion is the language of genocide.

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^[1]Dora B. Weiner, “Philippe Pinel’s ‘Memoir on Madness’ of December 11, 1794: A Fundamental Text of Modern Psychiatry,” in The American Journal of Psychiatry 149, volume 6 (June 1992): 725-728.

^[2]Philippe Pinel, A Treatise on Insanity: In Which Are Contained the Principles of a New and More Practical Nosology of Maniacal Disorders than Has Yet Been Offered to the Public, trans. D. D. Davis (Sheffield : Printed by W. Todd for Cadell and Davies, 1806), 74.

^[3]Michel Foucault, Psychiatric Power: Lectures at the Collège de France, 1973-1974 edited by Jacques Lagrange, translated by Graham Burchell (New York: Picador, 2003), 20-27. 

^[4]James Millward, “‘Reeducating’ Xinjiang’s Muslims,” New York Review of Books (February 7, 2019).