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German E. Berrios and Ivana S. Marková

Writing the history of mental disorders is an unfinishable task. Each historical period is expected to write its own, and in a style designed to satisfy its own conceptual and social needs. In the 21st century such a historical account seems to be one that conceives of mental disorders as natural kinds, that is, as entities that for their meaning and ontology require to be related to a brain change. However, being aware that, after all, concepts are just instruments in the hands of humans opens up the possibility of writing a more comprehensive history of mental disorders, one based on their historical epistemology, that is, on the manner in which madness has been culturally reconfigured throughout the ages. This approach should be more fruitful in regard to finding ways of helping people with mental sufferings, a task which is about the only justification for the existence of the discipline called psychiatry.

Article

Disability—whether physical, mental, or sensory—is widely represented in Early Modern literature, and as such it has been attracting attention from 21st-century literary scholars, who apply the theoretical and critical tools of disability studies to Renaissance narratives and literary characters. Literary disability in its various forms can be analyzed in the light of various models of disability, including medical, social, moral, or cultural. This helps in understanding early modern representations and experiences of disability in culture and history and making sense of reactions to disability in the period: including stigma, mockery, proud identification with the disabled identity, or also a desire for it. Physical disabilities in the Renaissance encompass anything from deformity to bodily mutilation to dwarfism or monstrosity, and they are especially prone to be emphasized, explained, or scrutinized in search of their meaning. Sensory disabilities, including blindness, deafness, and mutism, prompt interpretations that connect physical impairment with the character’s inability or surprising ability to understand reality—whether in a pragmatic or spiritual sense. Intellectual and mental disabilities have many ramifications in early modern literature, some of which, such as fools and madmen, are staple types of drama. Intellectual and mental disabilities are often described in medical terms, but literary texts tend to differentiate between them, whether in technical or narrative terms. Foolishness normally turns into comedy, whereas madness is often connected with tragic characters undergoing mental breakdowns. Renaissance disability studies are also concerned with less obvious types of disability: disabilities that were disabilities in the past but not in the 21st century, concealed disabilities, and disabilities that are not actually disabilities but do foster a conversation that excludes the character who does not embody what society regarded as the ideal physical shape. Finally, instances of counterfeited disability and disability attached to concepts rather than people help understand how Renaissance culture often viewed the nonstandard body not only as something to beware of or reject but also as an image of empowerment.

Article

Definitions of and explanations for mental illness differ between societies and have changed over time. Current use of the term arises from secular and materialist epistemologies of the body and mind, influential from the 18th century, which rejected the spiritual or supernatural as causes of illness. Since the 19th century, a specialist body of study, of law, practices, professionals, and institutions developed to investigate, define, diagnose, and treat disorders and illnesses of the mind. This was the emergence of psychiatry and of a professional psychiatric sector. With origins in the West, at a time of capitalism and imperialism, psychiatry was brought to South Africa through colonialism, and its development has been strongly influenced by the country’s economic, political, ideological, and medico-scientific histories. There have been significant continuities: the sector has always been small, underfunded, and prioritized white men. Black patients were largely neglected. Discrimination and segregation were constant features, but it is helpful to identify three broad phases of the history of the psychiatric sector in South Africa. First, its most formative period was during colonial rule, notably from the mid-1800s to c. 1918, with an institutional base in asylums. The second broad phase lasted from the 1920s to the 1990s. A national network of mental hospitals was created and changes in the ways in which mental illnesses were classified occurred at the beginning of this period. Some new treatments were introduced in the 1930s and 1950s. Law and the profession’s theoretical orientations also changed somewhat in the 1940s, 1960s, and 1970s. Institutional practice remained largely unchanged, however. A third phase began in the 1980s when there were gradual shifts toward democratic governance and the progressive Mental Health Act of 2002, yet continued human rights violations in the case of the state duty of care toward the mentally ill and vulnerable.