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States of mind: Tom O’Bedlam & Early Modern attitudes to mental health

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Shakespeare400 is a cultural festival marking the 400th anniversary of Shakespeare’s death in 2016.  You can find listings for all the varied events on the Shakespeare400 website and also follow events on twitter @S400events.

I was lucky enough to be part of the reviewing team at King’s College London for the festival, and will be sharing a couple of my reviews on this blog.  The reviews for all the events will be shortly available online with the intention of forming an enduring archive of the amazing mix of cultural and educational events across the course of the festival.

Here is my review for an event led by Ian Noonan, Lecturer in Mental Health Nursing at King’s College London on 13/02/16.  The talk was entitled “States of mind: Tom O’Bedlam & Early Modern attitudes to mental health”.

This “states of mind” session was advertised as a “cross-discipline lecture-recital-performance-discussion” in the festival brochure, a tongue-in-cheek description which aptly fitted an event which defied simple categorisation. The strength of the event surely lay in its diverse panel, which was headed by Ian Noonan, a mental health nurse by profession as well as a musician, and also included a Shakespearean actor, an English Professor and a Patient Educator with personal experience of mental health problems.

“Tom O’Bedlam” is a historical term used to refer to a person discharged from the Bethlem hospital, who was given special dispensation to beg on the streets due to their history of mental illness. Shakespeare uses this character as a plot device in King Lear, when Edgar needs to go into hiding and so assumes the disguise of the stereotypical mad man. As a character, Tom O’Bedlam would have been familiar to Shakespeare’s audiences, as he appeared in poems and popular songs of the 16th and 17th century.  Noonan got the session off to a lively start, with a performance of the anonymous ballad of “Mad Tom”, showcasing his fine singing voice with accompaniment on traditional instruments from Shakespeare’s day.

The panel discussion began with an examination of the text of the ballad, with Noonan highlighting descriptions in the text which could be viewed as psychiatric symptoms. For example, “Hark! how the angry furies howl!” could be interpreted as a description of an auditory hallucinations, more commonly known as “hearing voices”.  This led Laura Sherlock, the Patient Educator, to comment on the different perspectives of the medical view, for example categorising certain experiences as “symptoms” indicating illness or disease, versus the view of person themselves who may not see their experiences as part of an illness. Sherlock challenged us to see people not as diagnoses, or lists of symptoms, but instead “just as people who are living their lives who have stories”.

Next up came a powerful rendition of one of Edgar’s monologues from King Lear, when he is “acting mad” as Tom O’Bedlam. I found myself trying to make sense of the seemingly incoherent ramblings, much as I do in my professional life as a mental health clinician, when speaking to a patient who is deemed to have “thought disorder”.  Even when the individual words appear nonsensical, or the narrative is jumbled, very often an underlying theme or just an emotional tone can be effectively communicated, and this can form the basis of a human connection.  For example, there was a repeated refrain of “Tom’s a-cold” in the speech, which touched me deeply and invoked my compassion for his suffering.

The final part of the session moved on to a discussion of how real vs. feigned madness is a recurrent theme in Shakespeare’s plays, and how the contrast between these two states is portrayed in scenes where characters pretending to be mad interact with characters who actually are going mad (e.g. Edgar and Lear). This led onto to an interesting debate about the benefits or gains of “playing mad” – for example, pretending to be an ex-Bethlem patient in order to get begging rights in the 17th century, or pretending to be mad as a way of avoiding detection as Edgar does.  However, given the ongoing stigma and social ostracisation associated with mental health problems, it is questionable whether any advantages of “playing mad” could ever outweigh the disadvantages. Another interesting observation Laura Sherlock made was that “insight” or acceptance of an illness model for one’s experiences is seen as essential for wellness or recovery, which is not always the case; this is yet another example of how the dominant medical paradigm can be used to invalidate the viewpoint of a person with lived experience of mental health problems.  Tom O’Bedlam may be a mythical character, a stereotype of madness and mental mayhem; but Sherlock reminded us to always go back to the “wholeness of the person”.  Sadly, the words of the “Mad Tom” ballad are as true today as they were 500 years ago:

“In vain with cries I rend the skies,

For pity is not common”

 

 

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