Extreme emotions in the West

Lisa Appignanesi, Visiting Professor at King’s College London and Chair of the Royal Society of Literature, gives a brief history of extreme emotions.

Lisa Appignanesi

Writer and Visiting Professor in Medical Humanities

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Lisa Appignanesi

Writer and Visiting Professor in Medical Humanities

24 Sept 2025

Key Points

The Western tradition of grappling with extreme emotions goes back to Ancient Greece – to Aristotle and to Homer’s The Iliad, in which Achilles enters a state of “melancholy” and grief at the death of his friend.
The Greeks, in their medical system, attributed extreme emotions to “humours” that manifested in the mind, body and soul.
In the Christian epoch, the understanding of emotions was connected to the seven deadly sins. The emotions that we now think of as negative, such as greed and lust, were thought of as “sins”.
Psychiatry emerged in the 19th century: French “mind doctor” Pinel was the forefather of the asylum, where people diagnosed with madness were, among other methods, “distracted” as a form of treatment.

A very long Western tradition of thinking

There’s a very long Western tradition of thinking about the emotions and trying to grapple with them, trying to understand them. It goes back as far as the written word – back to the Greeks, who thought of the emotions as something that you didn’t want to allow to get out of control and to take precedence over reason, rationality and deliberation. Aristotle tells us that. Yet, we see extreme emotions everywhere in Greek society and literature. We find it in Homer, with Achilles worrying and being in a state of melancholia, of grief. He’s mourning his dead friend and he’s also being possessed by the gods.

So, there are two alternative descriptions of what we could call extreme emotion. One is the emotion that drives you mad from without, and the other is the one that drives you mad from within. One is linked to grief and the other is linked to a kind of possession.

The Ancient Greek definition of extreme emotions

The Greeks had a medical tradition – a tradition of natural philosophy, which also influenced Aristotle – of looking at the way in which the body functioned. Hippocrates, in the fifth century BC, and then Galen by the first century AD looked at the body in terms of the humours: substances that went through the body and actually formed the temperaments. If these substances were in too great or too little quantity, they could make the person go mad in a particular way.

Phlegm was one of these humours, and the phlegmatic person – cool and composed in ordinary times – could also become lazy and slothful. Yellow bile marked the choleric type – angry, mercurial – and this type of person could also fall over into the kinds of madness that are linked to anger, which Seneca called the short madness; that which leads to violence and is responsible for wars, as well as the kinds of domestic violence that we know all too well in these times.

Melancholy was the condition linked to black bile; melancholy being what we now term depression. It was a humour which made you despondent and was linked to too much self-reflection or reflection about the world and could topple over into illness. So, for the Greeks, it was important to maintain proportionality and a kind of equilibrium between not only these humours but also between judgement and the emotions or the passions.

The emotions were important to Aristotle in building character. But if they got out of hand, they led you astray and away from what was the ideal, which was a kind of golden mean, a balance between reason and emotions.

Christianity and the “seven deadly emotions

When you come to the Christian epoch, where God, of course, takes over love, all the other emotions stay with the human – with the person – and, again, extremes of these emotions lead to what is called madness, irrational behaviour.

The emotions that we, too, now think of as negative were thought of within the seven deadly sins. Everything from lust to greed or avarice – what we would now call acquisitiveness, the fuel of capitalism – through to gluttony, this desire for excess in food and in drink, which was linked to alcoholism – was definitely something you didn’t want to engage in.

Love, which was the most Christian of properties in its charitable form, was also linked to lust, and lust toppled you over into madness as well.

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One could be taken over by it, possessed by the devil who drove you into lustful forms of behaviour – and that needed to be exorcised. So, the ways in which we dealt with these excesses were either by bleeding, to get these humours into proportion, or by exorcism, to get rid of the devil inside, who is creating this inappropriate or completely lunatic behaviour.

Descartes and deliberation

By the time you get to the 17th century and we move into what we now recognise as the beginnings of the age of science and Descartes’ great imperative, “I think therefore I am”, reason becomes the defining human property. Aberrations of the emotions lead very quickly into madness, and the emotions themselves become effectively over time characterised as something which is more appropriate to women – the other side of the human equation – than to man, who is thought of as reasonable, rational and deliberate: the thinking being.

Women very quickly become guardians of the emotions, whether the domestic emotions of love or caring for children or the aberrant emotions of too much passion. They’re easily led astray into things which confuse them, and that emotional confusion can easily result in particular forms of madness.

This madness now becomes broken down and characterised because the doctors take it over. The doctors become the mind doctors and they become specialists, by the time you get to the 19th century, in what is eventually named psychiatry. But I call it, generically, mind-doctoring, a term that covers both asylum keepers and later psychiatrists and psychoanalysts.

Welcome to the asylum

In France, the first of the great mind doctors, Phillipe Pinel, during the French Revolution frees the mad people from their chains. They’re in chains because they have been in manic states which can’t be controlled in other ways. Pinel begins to think of other ways of controlling these manic departures, these raving moments. Most of the mad are not raving all the time. They’re there because they fall into moments of delirium; Pinel recognises that and finds ploys and ways of dealing with these excesses in a more managed and understanding way. One of his favourite ways of dealing with madness is to distract people from it, they will lead more manageable lives and, eventually perhaps, be able to live outside the asylum. Esquirol, the doctor who takes over from Pinel at La Salpêtrière, also becomes the man who rolls out the growth of asylums throughout France, places where people can go and be taken care of.

Their extremes are managed by forms of distraction, or by being cared for, or by something he took from the English – who were also developing madhouses at this time – forms of discipline, forms of order and structure in life through which madness can be managed. We begin to see through history that the emotions which drive people mad – for example ambition in Napoleon's France – take on both the look of their times and are treated according to the understanding of their times, whatever the possibly common biochemical elements.

People on the whole no longer now suffer from the delusions which make them into gods or Napoleon in their moments of mania. They tend to have other kinds of delusions which are now very quickly controlled through various forms of sedation, which came in in the 19th century. Drugs have been used since doctors would give them to you. Now, we have a great many more drugs, and they’re linked to huge industries that produce them, which leads to its own kinds of problems.