Colleen Donnelly
Denver, Colorado, United States

In her dictated autobiography, written in the latter part of the fourteenth century, Margery Kempe offers a first-person description of postpartum psychosis, experienced after the birth of one of her fourteen children. She attributed this period to her struggles with an unconfessed sin she took to her grave, likely adultery. Referring to herself in third person as the “creature,” she recollected how

this creature went out of her mind and awfully vexed and assailed with devils for half a year, eight weeks, and an odd number of days. At this time, she said, devils attacked her throat and entered her mouth and inflamed it with burning flames of fire as if they should swallow her up, sometimes rallying her, sometimes, threatening her, sometimes pulling her hair and yelling at her both day and night during the aforesaid time. And the devils also screamed great threats at her and told her she should forsake her Christianity, her faith, and deny her God, his mother, and all the saints in heaven, her good works and all good virtues, her father, her mother and all her friends. … She slandered her husband, her friends, and her own self; she spoke many a reproach word and curses; she knew no virtue nor goodness; she desired only wickedness, as the spirits tempted her to say and been, so she said and did. She would have killed herself many times due to her afflictions been damned to hell. And as witness to this, she bit her own hand so violently that it was seen for the rest of her life. And she tore at the skin of her body with her nails spitefully, since she had no other instruments, so that for her safety, she was bound and held by strength both day and night.¹

Psychosis symptomology reflects the zeitgeist, both in whom the sufferer blames for torturing them as well in the nature of the delusions and hallucinations. Reflecting medieval ideology, particularly Christian theology, Margery believed her psychosis to be a punishment righteously determined by God, who commanded she be continually visited and possessed by demons. Notably, Margery recorded self-harming, suicidal impulses, being tortured by hallucinations, and an inability to perform her wifely and motherly duties. While her behavior was dangerous and disturbing, family, servants, and community patiently attended to her at home, and she eventually recovered. According to her, this occurred through divine intervention and a visitation by Jesus: “Afterwards the creature’s wits stabilized and became as reasonable as she ever was before, and she praised her husband, as soon as he came to her, that she might have the keys to the pantry so that she might have her meat and drink as had done before … And she was now able to perform all the duties that fell on to her.” Her condition reflects medieval consternation; inflicting personal psychical and mental distress also disrupts interpersonal and social relationships. Moreover, it is worth noting how community surrounded and cared for her, deeming she had recovered by her capacity to reassume her domestic and civic responsibilities.

In the seventeenth century, for the public’s benefit, severely mentally ill individuals began to be removed from their homes and warehoused in jails and almshouses. As the eighteenth century drew to a close and the Industrial Revolution took hold, so did the asylum movement of state-run and private hospitals. While asylums claimed to treat individuals and not simply intern them, recovery rates were low, particularly among the less affluent. Conditions were often brutal, and treatment varied based upon one’s class, economic status, and gender.

James Tilly Matthew, a peace activist, returned to England after being imprisoned in Paris for three years during the French Revolution, where he had been charged with being a British spy. On his return, he entered the House of Commons and accused the Lord of Liverpool of treason, believing his betrayal by the British government had resulted in his incarceration in France. He was deemed insane and remanded to Bethlem Hospital, where he remained for the rest of his life. Matthews declared that his delusions were the result of Jacobian agents working an “Air Loom,” a machine fueled by the “fetid effluvia” of animals that was pumped into the air by underground bellows, creating a magnetic fluid that he inhaled as he walked the streets of London in physical pain, feeling he was suffocating and tortured with “brain-sayings” that fueled his political paranoia.² His explanation of the nature of his torture reflects the pneumatic chemistry understanding of gases circulating at the time. The demons of the Middle Ages as primary sources of this suffering were replaced by the toxic fumes of the Industrial Age. Matthews appeared to recover and even become an unacknowledged architect of the new Bethlem facility. Perhaps due to politics, despite attempted interventions by family and influential friends, two doctors declaring him sane, and the Bethlem director being exposed and dismissed for his abusive practices, Matthews remained interned, exiled from family and society until his death.

In the twentieth century, psychotic delusions were often described as fueled by apprehension about technological and scientific advancements and an expanding awareness of an unknown universe. Individuals reported having been subjected to experimentation that included being implanted with electromagnetic devices, either inserted through medical procedures or as the result of extraterrestrial abduction. The general public was educated to the details of schizophrenia and psychosis through the notable case of John Nash as captured in the film A Beautiful Mind. In interviews, the Nobel Prize-winning mathematician described being stalked by crypto-communist conspirators scheming against him and threatening both his work and the country.³ Nash was involuntarily committed a number of times during the 1960s; however, later correcting the creative license taken in depicting his life in film, he spoke about how, through his own determination to intellectually reject the delusions, quiet living, and the support of family and friends, after 1970, his symptoms waned and he gained control over his condition. The latest iteration of cultural angst-fueled psychosis is the newly defined AI psychosis, which is defined by technically influenced delusions and social isolation.⁴ Here again, psychosis is fed by cultural anxiety and seems to be exacerbated by devolving social connections.

Reported psychosis symptomology often differs in non-Western cultures. Individuals experiencing psychosis often describe the external, casual agents more positively, as ancestors or spiritual visitations sent to deliver messages or assist them.⁵ Not only is the individual experience different, but the way it is perceived and treated by society also differs. Family support and social integration, as well as spiritual and holistic treatments, are standard practice, and studies often report better outcomes than found in Western societies.⁶

History alerts us to how anxiety concerning social change and uncertainty contributes to how psychosis is experienced and understood. Historical and cultural research indicates that psychosis should be approached not only as an individual medical condition, but also as a response to broader cultural factors and social forces. In addressing contemporary cultural anxieties, encouraging and strengthening social connectedness, and recognizing how social norms and expectations influence both individual symptomology and treatment as well as the communal responses to psychosis, more culturally and socially responsive interventions can be crafted that may produce better outcomes.

References

1. Kempe, Margery. The Book of Margery Kempe. Translated by B.A. Windeatt. London: Penguin Books, 1985, 42-43.
2. Jay, Michael. The Influencing Machine: James Tilly Matthews and the Air Loom. London: Strange Attractor, 2012.
3. Wallace, Mike (host). “John Nash’s Beautiful Mind.”60 Minutes. March 17, 2002. CBS and Samels, Mark (director) “A Brilliant Madness.” American Experience. Public Broadcasting Service, April 28, 2002.
4. Hudon A and E. Stip. Delusional Experiences Emerging from AI Chatbot Interactions or “AI Psychosis.” JMIR Mental Health, Oct. 2025.
5. See for example, Vermeiden M., Janssens M., et al. Cultural differences in positive psychotic experiences assessed with the Community Assessment of Psychic Experiences-42 (CAPE-42): a comparison of student populations in the Netherlands, Nigeria and Norway. BMC Psychiatry. 2019 Aug 6;19(1):244.
6. See for example, Babalola, D., et al. Global perspectives on the traditional approaches used in the treatment of schizophrenia: A systematic review. Schizophrenia Research, 2024.