This Way Madness Lies

Jay, Mike

Primary Category: Literature / Nonfiction
Secondary Category: Visual Arts / Visual Arts

Genre: History

Annotated by:
Glass, Guy
  • Date of entry: Oct-17-2017
  • Last revised: Oct-17-2017


This Way Madness Lies was published in partnership with London’s Wellcome Collection for the exhibition “Bedlam: The Asylum and Beyond,” which ran from September 2016 - January 2017 and was curated by Mike Jay and Bárbara Rodriguez Muñoz. It is a book that was meant to accompany the exhibition, yet which, by virtue of the substantial text and reproductions, can stand alone.  

The book traces the history of treatment of the mentally ill by following the colorful story of Bethlem Royal Hospital from its antecedents in the Middle Ages up to the present.  Its sway over the public imagination evidenced by its appearance in everything from Jacobean Drama to “Sweeney Todd,” Bedlam has truly attained archetypal status.  An archetype, yet also a real functioning hospital.  Sections of the book entitled “Madhouse,” Lunatic Asylum,” and “Mental Hospital” chronicle the facilities designed respectively during the 17th/18th, 19th, and 20th centuries, and explain how they reflect changing notions of madness in each era. 

The first structure was visually grand but lacked a foundation, a metaphor for what was going on inside: “a façade of care concealing a black hole of neglect” (p. 39).  It became a tourist attraction along the lines of the zoo, with nothing preventing the public from gawking at and taunting the inmates.  While its replacement gave the impression of being more functional, conditions proved equally squalid.  On the other hand, 19th-century Europe and the United States saw asylum reforms, as well as the medicalization of madness as an “illness” and the ascent of psychiatry as a branch of medicine.  Finally, in 1930, the buildings still in use in Monks Orchard, a suburb of London, were constructed.

By contrast, we learn about treatments elsewhere, most notably Geel, Belgium.  There, for centuries, as an alternative to being warehoused in psychiatric hospitals, the mentally ill have been successfully boarding with townspeople. 


This Way Madness Lies is copiously illustrated and splendidly designed.  One has the feeling one did not miss a thing by not having caught the exhibition at the Wellcome.  Worth special mention are the many beautifully reproduced examples of the “Art of the Insane.” In addition to frequently seen works by the Swiss schizophrenic Adolf Wölfli, here we have the fascinating output of many lesser-known artists.

In the text, Mike Jay, cultural historian, has taken the approach that the history of the treatment of the mentally ill is “defined by repeated pendulum swings” (p. 14). Time and time again we see how abuses are responded to by reforms, only to be supplanted by further abuses.  The overall effect is even-handed in that the psychiatric establishment feels neither demonized nor put on a pedestal.  All things considered, although This Way Madness Lies may be said to cover a vast amount of material superficially, the narrative of Bedlam provides an engrossing framework for the book.


The superb Wellcome Collection needs almost no introduction here.  It provides an oasis in central London for “the incurably curious,” including a bookshop, café, library, and a vast number of events and exhibitions that relate to Medical Humanities.   

Bethlem Museum of the Mind was opened to the public at Bethlem Royal Hospital in 2015.  It houses the “
internationally renowned collection of archives, art and historic objects, which together offer an unparalleled resource to support the history of mental healthcare and treatment.”


Thames & Hudson

Place Published

New York



Page Count


Secondary Source