Beyond Madness and Badness: Where Angels Fear to Tread?

Abstract

Attempts to define the boundaries of forensic psychiatry typically reify ‘madness’ and ‘badness’ as pivotal and polarised concepts. In reality, though, the rigid demarcation implied by alternative and oppositional qualities is neither possible nor desirable (Bowden, 1983). Rather, the ideological territory in which Special Hospitals have been symbolically constructed is a battlefield, dissected by the barricades of law and medicine: of criminality and abnormality, free will and determinism, responsibility and gullibility. To this list of inferential medico-legal constructs which impact upon the definition, diagnosis and disposal of deviant individuals we might posit a further dimension of ‘good’ and ‘evil’. This chapter seeks to resurrect, though not in a purely theological sense, the heritage and legacy of such ideas and images — latterly disguised and dismissed — in the context of caring for offender-patients.

The end of one ideology is thus the beginning of another; where religious heresy ends, psychiatric heresy begins; when the persecution of the witch ends, the persecution of the madman begins. (Szasz, 1970)