The Inner Demons That Lie Behind Prison Walls

Imagine adults chained up in dark pits of a room. Innocent victims to doctor’s twisted versions of “treatment”. After not conforming to society, people who may not even been mentally ill were trapped in mental asylums and locked away from any hope of having a future outside of those bare prison walls. As a consequence for having an uncontrollable disease, patients were subjected to barbaric treatments. Mental asylums were more like a prison of hell than a place to heal and recuperate. Moreover, what leads to someone being committed to a mental asylum? Gogol’s short story, “Diary of a Madman”, tells of a man’s descent into madness and marks the transition of a sane man to an untamed beast. His utilization of point of view and metaphors, combined with the lack of treatment for schizophrenia in the 1800s powerfully reveal how damaging mental illness is to not just the patient, but also the society as a whole.

When nobody, not even doctors, knew what schizophrenia was, how was the disease depicted in literature? Gogol’s, “Diary of a Madman” answers that question: with extreme delusions and hallucinations. Schizophrenia onset begins in young adolescents, typically from ages 18-30 (Diaz). The protagonist and “madman” of this story takes the readers on a whirlwind of a journey through his psychosis with vivid hallucinations of dogs writing letters to one another and he also truly believes that he is the King of Spain. The crucial factor of this story is that our protagonist is the patient with schizophrenia; he is the case study. The only point of view that readers can analyze is his. This story requires a trained eye to comb through the diary entries in order to realize the protagonist’s symptoms and to diagnosis him with schizophrenia. His point of view is revealed through his diary entries and studied in order to mark his descent into madness. For instance, in his first diary entry he details that, “I must confess that for some time I have been seeing and hearing things such as no one has seen or heard before” (Gogol). This foreshadowing and self-realization set up the incredible shift in the madman’s point of view at the end of story when he is convinced that he is the King of Spain. In the beginning, he is skeptical of himself and is able to recognize when strange occurrences happen to him. However, at the end of the story the narrator loses all sense of reality and fails to notice that now, everyone is skeptical of him. This loss is created when he writes, “I am beginning to realize that I have fallen into the hands of the Inquisition, and that the man I first took to be the High Chancellor is in fact the Grand Inquisitor” (Gogol). The narrator reaches his mental limit at this point and is experiencing severe delusions. During his delusions, he truly believes that everyone is following his lead as King. Gogol portrays the protagonist in a stubborn manner that readers are able to acknowledge due to the short story being written in first person. We never learn what every individual in town thinks of the narrator so we must analyze every little snippet that the narrator includes in his diary entries. All together, the entries demonstrate a lack of awareness of mental illness. His point of view reveals how damaging schizophrenia can be to mentally ill sufferers, due to the lack of intervention from medical professionals, especially those who lived during the 19th century.

Gogol’s vivid incorporation of metaphors in his short story illustrates a world of confusion and illusion that both the protagonist and readers alike experience. When the protagonist is in his delusion that he is the King of Spain, he notices that in a room full of people, he is the only one to have hair. He takes note by writing, “However I realized at once that they were either grandees or soldiers, because they shave their heads” (Gogol). This was not a stylistic choice, for the protagonist has arrived to the mental asylum that he is doomed to live the rest of his life in. Still trapped in his royal delusion of grandeur, he does not realize that the shaved heads represent the loss of free will. While the patient’s heads were shaved to prevent the onset of lice, everyone appearing identical creates a sense of conformity and a lack of individualism (Gogol). This metaphor contributes to how society has continued to view mental illness: they clump all patients into a specific category of freaks that must be kept away from the town’s public eye. Even today mental illness remains a stigma that silently kills thousands every year due to the lack of treatment received. Those who deny the existence of schizophrenia only increase the negative stigma. Treatment has been a struggle for researchers, especially when their own patients deny having a mental illness. One symptom of schizophrenia is not believing that you indeed have the disease (Gupta). Those who deny the effectiveness of treatment may do so because medication has not helped them personally (McCarthy-Jones). Furthermore, there are people who challenge the entire concept of schizophrenia as a whole, calling it a “myth”. One writer that does not believe in the illness has written, “The phenomenon we call paranoia always develops (in a most understandable way) from a profound sense of failure. And the only successful treatment is regular doses of feelings of success, which can only come from actual successes” (Hickey). Due to people denying the fact that schizophrenia is a real disease and treatment is truly effective, the stigma still exists in 2018. Gogol captures this stigma through his short story’s metaphors because the comparison of the mentally ill to soldiers creates two different views of society that fall under one umbrella. Both soldiers and asylum patients follow rigorous orders and are viewed as different from the “regular” citizens of society. However, it is the mentally ill that suffer from hidden internal demons and visible external demons from society. Gogol’s metaphors in “Diary of a Madman” allow for a new development of schizophrenia to flow throughout the story that alludes to society turning a blind eye to the struggles faced by the mentally ill.

This short story was written in 1835 in Russia. During the 19th century, schizophrenia had not been diagnosed and would not be until 1910. Emil Kraepelin is credited as the first doctor to recognize symptoms of schizophrenia, which he categorized into a disorder called “dementia praecox” however Eugen Bleuler changed the name to schizophrenia stating, “…appears to be a group of diseases.” Both Kraepelin and Bleuler noted key symptoms such as catatonia, episodes of confused excitement, change of personality, hallucinations, mood changes, and loss of reality. (Jablensky). Mental illness was largely ignored during this time period, and those that did receive treatment were grouped into one style of treatment that consisted of being forced to subjected to years of torment. Patients were treated very poorly for instance they were kept chained to beds as well as unfed for ten to twenty years. Doctors “cured” mental illness by bloodletting and trephination, which was cutting into a patient’s skull, in order to let the “demons and spirits” out. Any form of behavior that was considered abnormal was attributed to a patient being possessed by demons (Diaz). Patients became more mad than sane. Thankfully, in 2018 treatment for schizophrenia has vastly improved from the horrid dungeon style torture that was implemented centuries beforehand. There are numerous medications and therapies that effectively treat the disease, for example antipsychotics such as Clozaril and Zyprexa diminish a patient’s hallucinations and loss of reality (Poor and D. Diaz). In recent time cognitive therapy has been successful and popular due to its ability to repair a patient’s inability to function (Keefe and Kraus). When comparing treatments from the 1800s to treatments today in the 2000s there is an extreme contrast. The level of treatment given to patients intertwines to how mental illness has been perceived in a specific society. Today, mental illness is discussed in public and given attention. People that have schizophrenia are not locked away from the public eye or seen as a town fool. Mental illness no longer dooms a patient to live a life ostracized from society. Although medical science has made miraculous advancements in treatment, to this day, there remains no cure and only 38% of patients have a favorable outcome. Unfortunately, patients will never return to how they were, mentally, before the onset of their schizophrenic symptoms (Diaz). Overall, treatments have remarkably overcome their difficulties and have managed to subdue the inner demons that people who suffer from schizophrenia face daily.

Those who do not have schizophrenia cannot even begin to imagine the struggles these patients fight daily. Their inability to function in society is a factor that is difficult to convey, but a factor that Gogol effectively conveys in his short story “Diary of a Madman”. In the same manner, due to his point of view through the protagonist being the case study of someone living with schizophrenia and continuous metaphors that flow between the diary entries, the audience is able to grasp a sense of utter madness that encapsulates the story. The lack of treatment that allows for the character’s hallucinations and delusions to continue to grow serves as a comparison point to today’s time, where there are multiple forms of treatments for multiple types of mental illnesses. In a way, we all are fighting an inner demon behind closed doors. The secrets we hide through masks and walls that we put up demonstrate that society must be more accepting and caring towards the mentally ill, for we never know when we may be inflicted with a disease of our own and need support from others. This is how we will grow as a society and overcome the negative stigmas that are associated with mental illness.

 

 

Works Cited

Diaz, Laura. “Schizophrenia and Other Psychotic Disorders.” CCNY FIQWS 10008,             https://docs.google.com/presentation/d/1ebRRXwt19GN-             r0XRzO61jDAHoFR6SH5iW4dMH1X6gN8/edit#slide=id.p1 Accessed 8 Nov. 2018.

Gogol, Nikolai. “Diary of a Madman.” Arabesques, edited by Mary Carolyn Waldrep and            Thomas Crawford, Dover Publications Inc., 2006.

Gupta, Sanjay. “Why Is Schizophrenia So Hard to Treat?” Stroke Center – EverydayHealth.com,             Ziff Davis, LLC, 13 June 2014, www.everydayhealth.com/hs/schizophrenia-caregiver-            guide/sanjay-gupta-why-is-schizophrenia-so-hard-to-treat/.

Hickey, Phil. “Schizophrenia- Not an Illness.” Behaviorism and Mental Health, 3 Jan. 2013,              behaviorismandmentalhealth.com/2013/01/03/schizophrenia-not-an-illness/.

Jablensky, Assen. “The diagnostic concept of schizophrenia: its history, evolution, and future              prospects” Dialogues in Clinical Neuroscience vol. 12,3 (2010): 271-87.

Keefe, Richard S.e., and Michael S. Kraus. “Clues to the Cognitive and Perceptual Origins of      Social Isolation and Psychosis in Schizophrenia.” American Journal of Psychiatry, vol.   169, no. 4, 1 Apr. 2012, pp. 354–357., doi:10.1176/appi.ajp.2012.12010042.

McCarthy-Jones, Simon. “The Concept of Schizophrenia Is Coming to an End – Here’s              Why.” Theconversation.com, The Conversation, 19 Sept. 2018, theconversation.com/the-             concept-of-schizophrenia-is-coming-to-an-end-heres-why-82775

Poor, Maria C., and David R. Diaz. “New developments in the maintenance and treatment of              schizophrenia.” Annals of the American Psychotherapy Association, Winter 2009, p.              40+. Academic            OneFile, https://link.galegroup.com/apps/doc/A216961286/AONE?u=cuny_ccny&sid=A ONE&xid=ffe39aa9. Accessed 8 Nov. 2018.