A Visionary Madness: The Case of James Tilly Matthews and the Influencing Machine (My Review)

 

Mike Jay is the author of A Visionary Madness: The Case of James Tilly Matthews and the Influencing Machine (2003/2014), an in-depth case study of one of the first and best documented cases of what the Diagnostic and Statistic Manual of the American Psychiatric Association (DSM) would eventually name paranoid schizophrenia.

[NOTE: This post goes with an earlier post of a BBC documentary on the history of "madhouses" that appeared here earlier today.]

Here is the ad copy for the book from Amazon:

Confined in Bedlam in 1797 as an incurable lunatic, James Tilly Matthews is one of the most bizarre case studies in the annals of psychiatry. Often cited as the first thorough case study of what we would today call paranoid schizophrenia, Matthews drew intricate diagrams of the "influencing machine" that he believed to be reading and controlling his mind. But his case was even stranger than his doctors realized: many of the incredible conspiracies in which he claimed to be involved were entirely real.

A Visionary Madness traces the story of antiwar advocate James Tilly Matthews through the political and social upheaval of the late eighteenth century, providing a vivid account of the unraveling of Matthews's mind, a snapshot of late eighteenth-century psychiatry, and its relevance to current narratives of madness, conspiracy theories, mind control, and political manipulation. Digging deep into historical records and primary sources, author Mike Jay carefully untangles truth from delusion, providing evidence that Matthews was a political prisoner as much as a madman: he had been working as a double agent in the French Revolution and was privy to political secrets the British government feared he might expose. In the process, Jay illuminates the murky revolutionary politics of the 1790s and situates Matthews' visionary madness within the wider cultural upheavals of a world on the brink of modernity. The details of Matthews' treatment in Bedlam reveals the birth-pangs of early psychiatry and its struggle to free its patients from the harsh regimes of the eighteenth-century madhouse. A fascinating and fast-paced narrative history, A Visionary Madness raises profound questions about the nature of madness and the birth of the modern world.

Matthews had believed he was brokering a peace treaty between England and France, and went to France in 1793, but the Girondists he was speaking with were removed and frequently executed by the Jacobins. Matthews quickly fell under suspicion for his Girondist associations and was suspected of being a double agent. 

Matthews suffered three years of confinement in France following the Jacobin coup d'etat (during what would later be known as "The Reign of Terror"). The French released him in 1796 believing him to be a harmless lunatic. By the point, after three years of nearly constant pleading for his release, which was generally met by silence, he was well on his way to losing his mind (and in fact, it was during this confinement that the first obvious symptoms began to appear).

When he returned to England in 1796, he was locked up in Bethlem Hospital, commonly known as Bedlam, after disrupting a debate in the House of Commons. He was committed as an incurable "lunatic."

Not long after his admission, and as part of a review process in which he sought his release, Matthews became forever entwined with Dr. John Haslam, a physician with an interest in the "insane," and a younger man with a lot of ambition. After the hearing for Matthews' release ended, Haslam saw in his patient a unique opportunity for a case study.

In 1810, Haslam produced the book, Illustrations of Madness (original title: Illustrations of Madness: Exhibiting a Singular Case of Insanity, And a No Less Remarkable Difference in Medical Opinions: Developing the Nature of An Assailment, And the Manner of Working Events; with a Description of Tortures Experienced by Bomb-Bursting, Lobster-Cracking and Lengthening the Brain. Embellished with a Curious Plate." Haslam's book grew out of the release hearing and from his need to dispute the two doctors who testified to Matthews' sanity. The book contains verbatim accounts of Matthew's beliefs and hallucinatory experiences and is the first full study of a single psychiatric patient in medical history.

The special brilliance of this book is that Jay, more than 300 years after the events described took place, is able to contextualize Matthews' life and experience in such a way that we can see how the events he lived through helped shape and define his particular and unique form of mental illness. For those of us who work in the field, the way we understand psychosis could be completely reframed by this book.

It becomes clear as we read that psychosis is not random, is not purely organic (genetics), and is not lacking an internal logic. Matthews was "driven crazy" by circumstances and temperament, and even in the depths of paranoid delusions about "influencing machines," he comes across as rational and lacks the thought disorder characteristic of schizophrenia. After all, he was able to convince family and friends, as well as the two doctors who testified that he was completely sane.

Perhaps the most interesting aspect of this case study is that it marks a transition in how mental illness is experienced by the individual. Until this case, most if not all records of psychosis involve influence and control by God, demons, spirits, and other supernatural forces. But Matthews, and millions of people after him, there is now the influencing machine. The rise of science in the Enlightenment created a new source for fear and paranoia - technology.

Jay does a remarkable job of explicating the "air loom" that Matthews believed was controlling him and many other people (if not all people). Here is a brief description of the "air loom" from Wikipedia:

Matthews believed that a gang of criminals and spies skilled in pneumatic chemistry had taken up residence at London Wall in Moorfields (close to Bethlem) and were tormenting him by means of rays emitted by a machine called the "Air Loom". The torments induced by the rays included "Lobster-cracking", during which the circulation of the blood was prevented by a magnetic field; "Stomach-skinning"; and "Apoplexy-working with the nutmeg grater" which involved the introduction of fluids into the skull. His persecutors bore such names as "the Middleman" (who operated the Air Loom), "the Glove Woman" and "Sir Archy" (who acted as "repeaters" or "active worriers" to enhance Matthews' torment or record the machine's activities) and their leader, a man called "Bill, or the King".

Matthews' delusions had a definite political slant: he claimed that the purpose of this gang was espionage, and that there were many other such gangs armed with Air Looms all over London, using "pneumatic practitioners" to "premagnetize" potential victims with "volatile magnetic fluid". According to Matthews, their chief targets (apart from himself) were leading government figures. By means of their "rays" they could influence ministers' thoughts and read their minds. Matthews declared that William Pitt was "not half" susceptible to these attacks[3] and held that these gangs were responsible for the British military disasters at Buenos Aires in 1807 and Walcheren in 1809 and also for the Nore Mutiny of 1797.

In 1814 Matthews was moved to "Fox's London House", a private asylum in Hackney, where he became a popular and trusted patient. The asylum's owner, Dr. Fox, regarded him as sane. Matthews assisted with bookkeeping and gardening until his death on 10 January 1815.[4]

Here is Matthews' incredibly detailed illustration of the "air loom":

Interestingly, in addition to the notes Haslem kept on Matthews, Matthews kept notes of Haslem and how he conducted himself, as well as his treatment in Bethlem. These notes became evidence looked at by a Select Committee of the House of Commons in 1815, following Matthews death. The hearings led to Haslam's dismissal and to reform of the treatment of patients in the Bethlem Hospital.

It's a fascinating and captivating narrative, and it is told without a lot of jargon. This books is highly recommended for therapists and for those who know someone suffering from psychosis. 

Mental: A History of the Madhouse (BBC Documentary)

Most people have heard the word bedlam, and know that it refers to a chaotic, noisy, and disorganized state of being. The origin of the word is the Bethlem Royal Hospital in London, originally founded in 1247, making it likely the oldest psychiatric hospital in Western Civilization. The city of London took over the asylum in 1546-47.

Conditions in Bethlem were often horrid at best, thus the term bedlam - from the fourteenth century, Bethlem had been referred to colloquially as "Bedleheem", "Bedleem" or "Bedlam."

Typically, the hospital appears to have been a receptacle for the very disturbed and troublesome and this fact lends some credence to accounts such as that provided by Donald Lupton in the 1630s who described the "cryings, screechings, roarings, brawlings, shaking of chaines, swearings, frettings, chaffings" that he observed therein.

At various times in its early existence, the doors were opened to citizens of the city to come and observe the people kept there (likely beginning in 1598 as a way to create income) - its proximity to two playhouses made it part of a night out for some people.

The hospital was rebuilt in a new location in 1675 and 1676, but it was shoddy work and within 200 years it would need to be rebuilt again.

Anyway, there is a lot to know about Bethlem, but it is only one of the many "madhouses" discussed in this fascinating documentary from the BBC.

Mental: A History of the Madhouse

Published on Feb 10, 2014


Documentary which tells the fascinating and poignant story of the closure of Britain's mental asylums. In the post-war period, 150,000 people were hidden away in 120 of these vast Victorian institutions all across the country. Today, most mental patients, or service users as they are now called, live out in the community and the asylums have all but disappeared. Through powerful testimonies from patients, nurses and doctors, the film explores this seismic revolution and what it tells us about society's changing attitudes to mental illness over the last sixty years.

Here is some more from the Wellcome Trust Library site - which is where the image at the top was also found.

Among the interviewees were patients, members of medical and nursing staffs, the historian Dr Peter Barham, and Dr Henry Rollin FRCP FRCPsych, emeritus consultant psychiatrist at Horton Hospital, Epsom, and former Librarian of the Royal College of Psychiatrists. Dr Rollin described the grimly low levels of medical care in many of those asylums, and of care in general. Historic film footage of crude brain surgery was shown. Of prefrontal leucotomy Dr Rollin confessed "I had the misfortune to recommend sixteen patients [for the operation] ... it was of no benefit whatsoever, and some of them had the tragedy of personality change." It seemed at times that the only escape from the tyranny of routine lay in the menace of maltreatment. A former psychiatric nurse in Newcastle told of a difficult patient being dragged away and having a bucket of cold water being poured over him by a staff member who then jammed the bucket on the patient's head. A young woman who suffered panic attacks went to one asylum and ended up staying inside for thirty-three years.

As an illustration of a classic old-style asylum, the programme focused on High Royds near Leeds (illustration top), which had all the right qualifications: a Psycho-type silhouette at twilight, miles of corridors, once fine but now decayed Victorian decoration, the indispensable looming water-tower, and of course a proposal to turn it into luxury residences when it closed in 2003.

High Royds. Drawing by Paul Digby, 2003-4. Wellcome Library no. 643245i

The Wellcome Library has a large drawing made by an artist in High Royds in 2003-2004 as part of the ritual commemorations that were felt to be required at the time of its decommissioning. It looks like drawings done by patients to describe their gloomy life in the asylum. In fact, as film of the High Royds corridors showed, the drawing is merely an atmospheric representation of the actual interior in which patients spent their "empty and repetitive asylum life". There was a "quasi-prison atmosphere" (Dr Rollin again). The film-makers found articulate people who were able and willing to describe their experiences at High Royds and other asylums, whether as patients or as staff. These interviews are priceless.

The film-makers were careful not to make High Royds seem like a scapegoat: after describing episodes of brutality towards patients, the commentary stated that there was "no evidence of this kind of treatment at High Royds" which on the contrary was "in the forefront of the drugs revolution" in therapy. Some of the reminiscences on the High Royds website are quite complimentary, though others, it must be said, recall much unpleasantness. Other asylums in Newcastle, Sussex and Buckinghamshire also featured in the narrative, often with superb historic film footage.

The film showed the long process leading to the closure of the asylums. The first real "breaking point with the Victorian period" (Barham) was the 1959 Mental Health Act. Dame Pat Hornsby Smith MP called for "sympathy and understanding" to be the principles underlying treatment of the mentally ill. In 1961 Enoch Powell as Minister of Health 1960-1963 started a war on the asylums with a remarkable speech seizing on the image of the "looming water-tower and chimney combined" as the emblem of the asylum. Powell urged "the elimination of by far the greater part of this country's mental hospitals as they are today". He lost battles but won the war when Care in the Community was introduced. But Dr Rollin was no happier about the new arrangements than about the bad old days of the asylum. "The whole concept of Community Care is a disaster: I don't think the community cares" (NIMBYism was one of the problems he had in mind).