European / International Joint Ph.D. in
Social Representation and Communication

If on the street you meet a ‘mad person’

The broad social debate that developed on psychiatry in the 1970s and 1980s, and which accompanied the deinstitutionalization of madness (as enacted in Italy by the Basaglia Law n°180 promulgated on 13 May 1978 with repercussions that extended well beyond Italy’s borders), coincided with a series of studies on mental illness.

In social psychology, research in this field was conducted in regard to both social cognition and social representations. However, despite thematic affinities, the different epistemic principles characterizing the two theoretical paradigms (de Rosa 1990b, 1992a, 1992b, 1994b) gave rise to bodies of research with different purposes and methodologies. Those studies inspired by the theory of social representations differed from those drawing on the various paradigms of social cognition, by paying particular attention to the symbolic order of reality and its historical and cultural roots (Moscovici 1986), and by using more articulated investigative methodologies suited to disentangling the individual and social, cognitive and emotional, symbolic and cultural – and therefore not purely processual – dimensions of information processing.
Among the researches inspired by the paradigm of social representations, that by Denise Jodelet (1989, 1992a, 1993, 1996; see also Jodelet and Harvey 1993) in France has acquired value as an exemplary study for an anthropological approach to, and field study of, a community for the mentally ill. In the 1980s, another study with strong impact in terms not only of its results but also its modelling value was financed by the Ministry of Scientific Research in Italy among projects of outstanding national interest and simultaneously supported by research units working in the North (Bologna), Centre (Rome) and the South (Naples) of Italy, respectively coordinated by Zani, de Rosa and Bellelli. The project considered the points of view of practitioners (psychiatrists, psychologists, psychiatric nurses) and trainees (university students of psychiatry and psychology or ones attending vocational school for psychiatric nurses), as well as those of the general public (Bellelli 1994; de Rosa 1994a, 1994b; Zani 1984).

During the 1990s and 2000s, mental illness has continued to be a salient theme of research (see e.g. Angermeyer and Matschinger 1999; Angermeyer et al. 2004; Castillo et al. 2008; Cross 2004; Dixit 2005; Dorvil and Benoit 1999; Flores Palacios 1997; Foster 2001, 2003, 2006, 2010; Howarth et al. 2004; Leblanc 2007; Morant 1995, 1998, 2006; Narter 2006; Petrillo 1996; Rose 1998; Wagner et al. 1999; see also, in a broader context, Nascimento-Schulze et al. 1995). Among the pioneering studies of the 1970s and 1980s, the only research programme concerned not just with adult subjects but also ones of developmental age arose from the pilot studies of de Rosa (1981a, 1981b, 1982) and Quadrio et al. (1981), based on the de Rosa’s doctoral dissertation (de Rosa 1980). The originality of the results of these studies – which evinced the existence of a developmental pattern in the image of madness and the insane – prompted further research by de Rosa during the 1980s  (de Rosa 1984, 1987a, 1987b, 1988a, 1988b, 1988c, 1994a, 1995a, 1997; de Rosa and Schurmans 1990a, 1990b), with a follow-up conducted in Italy in 2006 with the collaboration of Bocci (and extended in Brazil with the collaboration of Pedreira) also on the urgings of Moscovici, and with funding granted by the Balzan Foundation.

By extending the data gathering to over 4000 subjects among children, adolescents and adults (parents, teachers, trainee experts, and experts), these investigations demonstrated that a purely linear reading of the evolution of social representations of madness in history – whether social and collective (historical perspective) or inherent to individual development (the developmental and differential perspectives) – showed a shift from a magical–sacred vision of madness to a criminalized one. The latter became gradually decriminalized with the advent and imposition of the medicalized view (first in strictly organicist terms, then on the basis of psychosomatic explanatory hypotheses), and it was finally supplanted by a psychologized – psychodynamic, relational or socio-genetic – view of madness.
Generally, in smaller children (aged 5 and 6) the representation of madness was anchored to deviance. Consequently, when such children were asked to indicate what they considered to be the most suitable therapeutic structures, they identified them in prisons, just as they indicated prison guards as responsible for furnishing treatment (a cure, moreover, they very often deemed impossible). Subsequently, with the rise of the medicalized representation among children aged 8 to 9, the protagonists of therapeutic treatment became doctors, and the places of treatment were hospitals. Finally, during adolescence, the representation of mental illness further evolved from physical to psychological. The family and society were therefore identified as the places of treatment, while the therapists instead became psychologists and psychiatrists. An active role of the ill person was also envisaged. The language used in adolescence became more specialized in that it drew on the diagnostic categories of psychiatric nosology employed by experts (de Rosa 1984, 1987a, 1987b, 1994a, 1995a).

At the same time, deeper examination of the dynamic structure of the ‘representational field’ of madness deducible from many historical sources, and from the many levels investigated (iconic/symbolic and prescriptive/behavioural) using various approaches (verbal and non-verbal, direct and indirect, structured and projective) has enabled identification of figurative nuclei still bound up with the magical conception of the mad person (as a mythological figure or a demonic one possessed by alien forces, as a monster, an androgynous creature, as theriomorphic or dysmorphic, etc.). Such representations were flanked by the conception of madness as social deviance: the mad person as a criminal, a drug addict, a tramp, an alcoholic, a transvestite, or as a behavioural misfit; or by the ‘medicalized’ conception: the mad person as sick, physically handicapped, cerebropathic, under-developed, etc.; or the ‘psychologized’ view of madness: the mad person as depressed, prone to hallucinations, emotionally disturbed, as a scapegoat for damaged affective relations, as a social victim, etc.
In the figurative tools included in research designs, the magico-fantastic representation of madness was manifest in a polarization between positive connotative dimensions (a joker, a clown) and negative ones (a devil, a monster, a mythological figure). The representation of madness as deviance depicted the mad person as a threat to society, as a social reject incongruous in terms of behaviour, while the medicalized representation focused both on the physically ill person and the psychologically insane one (de Rosa 1985, 1987a, 1987b, 1995a, 1997, 2009; de Rosa and Schurmans 1990a, 1990b).

The interest of the results obtained by the first research wave through use of a wide array of verbal and non-verbal techniques stemmed from the co-existence in the same subjects of representations of madness that were at once evolved and archaic, despite the linearity found from both the phylogenetic and ontogenetic perspectives.
The research furnished empirical confirmation of the theoretical construct termed ‘cognitive polyphasia’ by Moscovici (Moscovici 1961, 2000; see also among others: de Rosa 1990b, 2009; Emiliani and Palmonari 2009a; Jovchelovitch 2008): the co-existence of archaic and scientific representations related to either common sense or expert knowledge divulged to the general public which make the expression of knowledge regulated by criteria of social desirability apparently contradictory.

Given the dynamic nature of social representations, around thirty years from enactment of the Basaglia Law, interest in following up on this initial research induced us to verify whether and to what extent the images of the insane and madness identified by the first research wave had changed, and whether or not those more archaic images still persisted alongside the more scientifically evolved representations, thereby confirming the hypothesis that cognitive polyphasia is a means to resist change and adhere to pre-scientific collective representations.

In this regard, there follows a review of the main results obtained by the first research wave using verbal and non-verbal techniques of data collection, with brief discussion of the continuities and the main differences recorded by the follow-up research.