So God created man in His own image; in the image of God He created him; male and female He created them. Genesis 1:27

Introduction

Madness as a topic has been a contested area which to this date remains without an agreed definition in both scientific arenas and non scientific arenas. It is from this epoch that there is no agreement in the aetiology of mental disorders and also followed by disagreements in how to care either as in psychotherapeutic approaches and or bio-centric approaches.
Whilst there is heated debate in both aetiology and therapeutic arrangements its is of interest to note that those people with madness, have never found sound relief of their issues and majority suffer in disproportionate sense, if suffering could be measured. Madness has the ability to shutter lives in (Expert answers, 2018) Lady Macbeth and Macbeth’s lives are shuttered to death by madness.
In the Holy Bible Legion a madman possessed with demons was shuttered and left in the tombs wandering and self harming only to be saved by the Messiah Jesus Christ and returned to the best functional levels, preaching to ten cities in Decapolis. Essays UK (2013) cites C Erik Midelfort opining that Christian faith dominated explanations of madness with views demonology taking centre stage.

Mamhepo Phenomena

It is also important to note that from antique thus as far as 1600 there was no understanding of madness. This was brought to the fore by Shakespeare in Macbeth as the doctor attending Lady Macbeth in line 72 in Act 5, scene i that the situation warranted for Heavenly attention than a medical doctor (Expert Answers 2018). It is also interesting that those also in ancient Rome viewed those with madness as struck by the goddess of the moon Lunar hence the term lunatic. In Zimbabwe people found with madness are often thought as being haunted by spirits of avengers commonly known as “mamhepo” (bad spirits). Incidents such as when Macbeth saw people he had killed on the dinner table such as Banquo could have easily explained by the Shona people as “mamhepo” with remedies to that often suggesting the appeasement of ancestral spirits via a “n’anga”(traditional healer) to abate the madness or consultation to a spiritualist popularly known as ‘madzibaba’ even without help. It is important at this juncture to state that such explanations of “mamhepo” added nothing in the improvement of the welfare of the person with madness.
It is interesting and sad to note that with explanations of mamhepo being the conception of madness therapeutic measures such as blood letting , trephining and lashing of those people with madness were often given as remedy to the malady in which they were found with. In antique times in the western world mad people were often put in ships and driven away into far away places on the sea. The belief was that they will heal on those journeys, which places were far from their families and impossible for them to retrace their way back.

Mental Asylums
The construction of Bethlehem which degenerated into Bedlam being the first asylum centre in England (Essays UK, 2013 Nov) brought no relief in the suffering of those people living with madness. People living with madness in these asylum centres were subject to dire inhuman and subjugatory treatment and what made matters worse was the absence of therapists and psychologists at that time (Essay UK.Nov2013). Evelyn B Kelly commenting on “Bedlam” echoed that approaches to madness at that time resulted in iatrogenic injury.

Euthanasia

In Germany during the T4 program which was manned by psychiatrists such as Ernst Rudin from 1939-1941and funded by thoughts of Eugenics works of Kraeplin (a psychiatrist) people living with madness from an estimated 80000 to 100000 lost their lives and mostly they were subjected to gas chambers and their death certificates were faked. Approximately 400000 people sterilized forcibly as they were viewed as threat to any stronger race (Breggin 1998). It is not surprising that such acts have been directly supported through commemorations done to remember “Emil Kraeplin” (ideological forerunner of psychiatric mass murders) in 2006 by Dr Gold and with Mayor Andreas Grand (Discher 2018, 12 July). In honouring such nefarious and malicious personalities it is clear that lives of those who live with madness are still far from being recognised as ‘worthylives’.

Electroconvulsive Therapy

In the 1930s to 1938 use of the malicious electroshock was conceptualised and put within the praxis so as to aid in dealing with resistant depression. A Hungarian psychiatrist came with an approach which was used in swine in passing electricity in them so as to slaughter them. This however paradoxically went on to be employed in humans living with problems of living. Its administration has been more harmful and an ethical dilemma as it has resulted in severe damages on the Anterograde, retrograde memory. It also resulted in death.

Nosological Systems

It is from this dilemma that in 1952 the introduction of the DSM. Nosological systems had certain categories which from earlier times were controversial and dubious such as draptomania and clitoridectomy. Such classification system has helped in the incarceration of those with political dissent. It also allowed claims for insurance fees by practing health personnel with little help or even diverse effects to those with madness. The DSM success can only be noted in its achieving its goals of disease mongering and with little to non effect in explaining the cause and cure to such phenomena which it has created.

Neuroleptic Drugs

The introduction of neuroleptic drugs for example chlorpromazine in 1953 in the market with trade name Largactile by Rhone-Poulenc, has seen the outcomes of people with disability as a result of madness rising in leaps and bounds. Disability rates due to what has now been viewed as “mental illness” has risen to alarming levels with depression topping the list. It is from this approach that explanations and interventions proffered to madness have never comported or upheld the interest of those living with madness. Approaches such as those of spirituality like the “mamhepo” phenomena, asylums, ECT, Drug therapy among others have never alleviated the dilemmas of those living madness but rather served for the worst.

Conclusion
It is my ever wish that as practioners and researchers seek for remedies and understanding of the phenomena which in this case is madness, such inquiry and praxis be pro-lives of those living with madness, not their beloved professions or other personal or political interests.
I hope for a madness oriented approach within the health professions in dealing with madness and even its research to capture more of the voices of those living with madness than that of professionals.

Prosper K Mushauri
Intern Counselling Psychologist