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Curr Psychol
and Plautus’ Amphitryo and Menaechmi prove the theme recurred in plays whose titles do not make it transparent. By writing a play whose scene he set outside familiar Athens and by making an unknown traveller arrive there, the comedian could actually create an “insane place.”
In other words, the comic poet creatively united the matrices of (1) mistaken identity and (2) fears that psychiatric diagnoses of insanity lack validity. The common element of these two concepts—we can now see—is the difficulty of telling two
or (2) the sane from the insane. 8
wordplay, is put on prominent display in Menaechmi’s prologue (18–21):
…filii gemini duo, ita forma simili pueri, ut mater sua
neque adeo mater ipsa quae illos pepererat.
Two twin sons, so much alike in appearance that their foster mother could not distinguish them, nor even their real mother who gave them birth.
Compare Rosenhan’s language once more ( 1973a ):
ï However much we may be personally convinced that we can tell the normal from the abnormal, the evidence is simply not compelling.
ï We now know that we cannot distinguish insanity from sanity. ï It is clear that we cannot distinguish the sane from the insane in psychiatric hospitals. (pp. 250, 257, and 257, respectively; emphasis added)
These are all ways of expressing in English the same theme that Plautus calls non internosse posse, “inability to distinguish.” And the connection was, I submit, more obvious in the Greek play on which Plautus’ comedy is based than it is in his Latin. That is because it is in Greek alone that the verb diagignoskein, which is the origin of the Greek and English word diagnosis, fundamentally means “to tell apart.”
(2) Let us now turn to the more sweeping critique implied by ipsi insaniunt (“are really insane themselves”) and alluded to above. In his 2008 critique of the Rosenhan experiment, Thomas Szasz ( 2008
) exposed a major flaw in its logic:
Finally, Rosenhan rediscovers psychiatry’s oldest problem, “false commit- ment”: “How many people, one wonders, are sane but not recognized as such in our psychiatric institutions?” He thus reinforces the legitimacy of depriving people of dignity and liberty, provided they really have real mental illnesses. His premise reeks of the odor of bad faith. Rosenhan identifies himself and his fellow frauds as sane pseudopatients and the other inmates in the hospital as
8 Zanini ( 1984
) nearly got this idea in identifying the two central themes of Plautus’ play as “simillimi”
(identicals) and “insania,” but missed the epistemological point that unites them. Curr Psychol
insane “real” patients, even though the latter were diagnosed as insane by the same psychiatrists whose inability to make such a diagnosis Rosenhan claims to have demonstrated. (p. 78; emphasis in even though…demonstrated added.)
This suggests that only a call for an end to coercive psychiatric treatment, rather than psychiatric reform, was an appropriate recommendation of his study. Yet Rosenhan was seemingly, or perhaps only publicly and professionally, oblivious of the double bind in which his experiment left him.
Szasz himself was so sure this was the essential problem that he later chose the extract just quoted as an epigraph for the first chapter of his polemic against the “anti- psychiatry” movement associated with R. D. Laing (1927–1989) and David Cooper (1931–1986). (Szasz 2009
, p. 9)
Did Menaechmi’s author, like Szasz but unlike Rosenhan, realize the potential extent of the problem?
My answer is yes, I think he did. Why? Because from time immemorial, popular thought in Greece and Rome attributed mental abnormality, as inferred from behav- ioral deviance, to divine intervention, just as amid the Ecclesiastical State of the middle ages and early modern period the belief reemerged that witches, possession by Satan, and Jews were responsible for mental abnormality as inferred from behavioral deviance. In the 5th century BC, Hippocrates introduced a new explanation—the medical model, which attributed mental abnormality, again as inferred from behav- ioral deviance, exclusively to natural bodily causes (Rosen 1968
). In Menaechmi, Sosicles plays on the popular model by feigning that his hallucinations come from the gods, but the comedy is ultimately concerned with the newer, medical model, and specifically whether or not it is correct.
Alarmed at his (supposed) son-in-law’s erratic behavior, the father-in-law calls a medical doctor for help. The relative attributes his son-in-law’s (mis)behavior to a (bodily) illness. It did not have to be this way. He might instead have called for an agent of the law to arrest Sosicles, or he might have called for a ritual healer. Plautus’ play itself had earlier shown that such shamanistic cures were still in use, much as in the Ecclesiastic State of fifteen centuries later holy water would be enlisted as a means of casting out demons. Arriving in Epidamnus and greeted as familiar by a stranger, Sosicles had recommended this kind of therapy (289–92):
SOSICLES Please, young man, how much do pigs cost here, unblemished pigs, for sacrifice?
THE STRANGER (mystified) A drachma each.
SOSICLES Take this drachma from me; have yourself purified at my expense: I’m absolutely certain you’re insane, you see.
Yet the father-in-law summons a physician, the kind of professional who sets broken bones (885–6) and conducts Hippocratic examinations. This suffices to show that Plautus’ soul-healer is thoroughly medicalized, just as soul-healers in contempo- rary Western societies are thoroughly medicalized. The father-in-law, too, has inter- nalized the belief that (bodily) medicine is the proper treatment of troublesome behavior, just as virtually all members of virtually all contemporary societies believe (bodily) medicine is the proper treatment of troublesome behavior. This is the point we must grasp clearly and not lose sight of. How startling Menaechmi must have
Curr Psychol
seemed to some members of Plautus’ original audience, or to Christian readers in the early modern period, when belief in supernatural causes of social deviance had reemerged and who thus sought soul therapies, not from physicians, but from priests and clerics!
Recall that Menaechmus, a lawyer, is in an unhappy marriage and has been complaining of unrewarding professional relationships. Like many modern psychia- trists, Plautus’ soul-doctor resorts to drug therapy to treat these (social) issues—the kind that Thomas Szasz regularly called “problems in living.” What is more, we must not fail to notice that the psychiatrist’s therapy entails coercion. In v. 952–6 he has Menaechmus involuntarily committed to his care, with the full approval and urging of the father-in-law, and departs to prepare the treatment. Shortly later, men arrive to forcibly carry Menaechmus off. (In the sequel Menaechmus is spared only by the surprise intervention of Sosicles’ manservant, Messenio, who in 990–1022 fights the men off.) This farcical scene is Plautus’ way of making the same point that in my opening quotation Gary Greenberg referred to as contemporary psychiatry’s “dirty secret”: “…for all their confident pronouncements, psychiatrists can’t rigorously
logical language to Rosenhan’s above, Greenberg is not saying that psychiatric diagnoses lack validity. He is saying that the medical model of mental illness is a category error. Mental anguish, loneliness, guilt, unhappiness—should these be treated with neuroleptic drugs? And should an unwilling patient be coerced into taking them?
Corollaries
Doubts in the validity of Hippocrates’ medical model of “insanity”—that is, disapproved behaviors whose origins others, usually relatives, attributed to psychic disturbance—were probably born in the same instant as the model itself. It is therefore not surprising to find a social commentary on them lagging the widespread adoption of Hippocrates’ teaching by eighty years or so, the likely approximate date of the unknown Greek play on which Menaechmi is based.
We can speculate, but no more, that the comedian took these doubts from the critique of Stoic epistemology developed by Academic Skepticism. I say this because the epistemological uncertainty engendered by the case of mistaking one identical twin for the other is one of the Skeptics’ principal objections to the Stoic belief in our ability to attain certain knowledge through ordinary perception. 9 If so, we gain additional support for the traditional hypothesis that Posidippus the comedian wrote the Greek original of Menaechmi. Posidippus was born in 316, the same year as was Arcesilaus, the founder of Academic Skepticism, and he died a decade earlier (c. 250 vs. 241/0). Arcesilaus became scholarch of Plato’s Academy c. 264 BC, after the deaths of Alexis, Antiphanes, Diphilus, Menander, and almost Philemon, who died c.
262 at the age of 100. In other words, when Arcesilaus came to prominence, Posidippus was the only major Greek comedian still alive.
9 Sextus Empiricus Adv. Math. 7.408–410, Cicero Acad. 2.54–8 and 2.84–7. I am grateful to my colleague Charles Brittain for help on this point.
Curr Psychol
To go a step further, I would like to suggest that Posidippus’ Metapheromenoi was the model of Menaechmi. The title is usually interpreted as Men Transported but could equally mean Switcheroos, and a fragment of it (fr. 16 Kassel-Austin = Diogenes Laertius 7.27 [Zeno]) features some sort of soul therapist—perhaps philos- opher, perhaps paedagogus, perhaps physician—confidently predicting that a charge or patient will attain supreme temperance in ten days (possibly a round number):
ὥστ’ ἐν ἡµέραις δέκα
εἶναι δοκεῖν Ζήνωνος ἐγκρατέστερον. So that in ten days he’ll be more enkrates than Zeno.
promitto fide (quoted in context and translated above in §5). If, as I suspect, in a twist of a current proverb the word enkrates (= Latin compos) here plays on the meanings “temperate” (like Zeno) and “sane,” then the words would suit a psychiatrist speaking of his patient perfectly.
However that may be, I do maintain that Menaechmi’s dramatization of the Rosenhan experiment constitutes the first and perhaps only indication that there was a debate in antiquity over either the validity of diagnoses of mental illness or the validity of the medical model of mental illness itself.
So far I have spoken of Greece. What of Rome? In Plautus’ lifetime some forward- thinking Romans were controversially abandoning traditional Roman cures for de rigeur Hellenistic medicine. Pace several scholars (e.g. Stok 1996
), I see no particular satire in this play of the Hellenistic surgeon Archagathus of Laconia, who arrived in Rome in 219 BC. But if Romans were as anxious about Greek medical treatment of the mind as they were with other aspects of medicine, it may well explain why Plautus dusted off this old play and refreshed it for a new audience.
Of course, that brings us back into the realm of speculation and epistemological uncertainty. Instead of indulging myself in them, I had hoped to close this paper with a short commentary on my argument by Professor Rosenhan himself. Sadly, he passed away shortly before I could complete it. Although he was seriously ailing and living in assisted care, in the months before his death I contacted him through his friend and caretaker, Linda Kurtz, and managed to share my inchoate ideas with him. Through her I learned that David had hoped and planned to comment on the completed paper. Since death cheated that possibility, I therefore close by quoting for posterity her message to me of November 14, 2011:
recognized right away the obvious differences between his well-planned and scripted experiment (deceive to gain admission by complaining of hearing voices and deceive re[garding] the (non) pill-swallowing but otherwise behave authentically) and the fictional play by Plautus where the twins are unaware of each other’s activities, and even existence in the case of Menaechmus 1, with all the attendant consequences of mistaken identities and with an abundance of strategic feigned abnormal behavior. In the Rosenhan experiment, the pseudopatients never had to feign abnormal behavior, even to get admitted.
Curr Psychol
Despite the obvious differences between fact and fiction, David is eager to comment on how Plautus did anticipate his work and how it illustrates some of the most important points of his study. He has visual problems so it will be slow going but I’m certain I can get some good comments from him in time for your paper. He loved your title: ‘On Being Sane etc.–The Laboratory of Epidamnus.’ That brought a big smile to his face.
Added September 22, 2012
92. Seven months and two days later, Death has won a second time.
On November 8, 2011 I had sent Dr. Szasz the same conference abstract and passages from Menaechmi (in English and, at his subsequent request, in Latin) that I sent Professor Rosenhan. I asked whether he would be interested in supplying any thoughts or comments for publication. A prompt and courteous correspondent, he wrote me back the following day (11/9/2011):
story, but also important differences between them. Do you have a deadline for when you want my comments? (At the moment I am busy with two other small projects.)
As he lived only an hour away, I paid Dr. Szasz a visit on November 29, 2011. He was a tremendous conversationalist, but our talk never made it around to Menaechmi, and despite the dozen subsequent messages we exchanged I never did learn his thoughts about the play. Just before departing Ithaca to deliver an oral version of this paper in Berlin, however, I sent him a final email about the Anders Breivik trial in Norway. I wrote (my email to him of 6/22/2012):
sions about Breivik’s mental health. The first team diagnosed him with ‘para- noid schizophrenia’, a serious mental illness. The second team found him legally sane, saying he suffers from a dissocial and narcissistic personality disorder, but is not psychotic.’ … Among many thoughts that come to mind, I note that ‘paranoid schizophrenia’ was the particular diagnosis to which Rosenhan had so strenuously objected as a meaningless label all those years ago. I imagine you’d go further than him, of course, but it’s remarkable to watch history repeating itself.
Sixteen minutes later he replied with the last message I would receive from him: Thanks, Mike. I have been following this story. Attributions treated as phe- nomena. The show goes on.
Have a great time in Berlin. Best wishes,
Tom Curr Psychol
References
Lecturae plautinae sarsinates X: Menaechmi (pp. 11–19). Urbino: QuattroVenti.
Fantham, E. (2007). Mania e medicina nei Menaechmi e in altri testi. In R. Raffaelli & A. Tontini (Eds.), Lecturae plautinae sarsinates X: Menaechmi (pp. 23–46). Urbino: QuattroVenti.
Fantham, E. (2011). The Madman and the Doctor. In E. Fantham (Ed.), Roman readings (pp. 15–31). Berlin: De Gruyter.
Gratwick, A. S. (Ed.). (1993). Plautus Menaechmi. Cambridge: Cambridge University Press. Greenberg, G. (2010). “Inside the battle to define mental illness”, Wired Magazine. Retrieved from http://www.wired.com/magazine/2010/12/ff_dsmv/all/1 .
Leo, F. (Ed.). (1895). T. Maccius Plautus Comoediae. Berlin: Weidmann.
Nixon, P. (1917). Plautus: With an English translation (Vol. 2). London: William Heinemann, New York: G. P. Putnam’s Sons.
Rankin, K. (1972). The physician in ancient comedy (Unpublished doctoral dissertation). Chapel Hill: University of North Carolina.
Rosen, G. (1968). Madness in society. Chicago: University of Chicago Press. Rosenhan, D. L. (1973a). On being sane in insane places. Science, new series, 179(4070), 250–258.
Rosenhan, D. L. (1973b, April 27). “Psychiatric diagnosis.” Correspondence section in Science, new series 180(4084), 356+358+360–369.
Rosenhan, D. L. (1975). The contextual nature of psychiatric diagnosis. Journal of Abnormal Psychology, 84, 462–474.
Segal, E. (1996). Four Comedies: Plautus. Oxford and New York: Oxford University Press. Spitzer, R. L. (1975). On pseudoscience in science, logic in remission, and psychiatric diagnosis: a critique of Rosenhan’s ‘On being sane in insane places’. Journal of Abnormal Psychology, 84, 442–452.
Stok, F. (1996). Follia e malattie mentali nella medicina dell’età Romana. Aufstieg und Niedergang der römischen Welt, 2.37(3), 2282–2410.
Szasz, T. S. (2008). Psychiatry: The science of lies. Syracuse: Syracuse University Press. Szasz, T. S. (2009). Anti-psychiatry: Quackery squared. Syracuse: Syracuse University Press.
Szasz, T. S. (2010). The myth of mental illness: Foundations of a theory of personal conduct. New York: Harper Perennial. (Original work published 1961.)
Zanini, M. C. (1984). “Simillimi ed insania nei Menaechmi,”Eos 72, 87–94.
Erich Segal ( 1996
) and Paul Nixon ( 1917
). The corresponding Latin text (which I have independently checked) is basically that of Friedrich Leo ( 1895 ).
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