7 Suspending His Intellectual Functions

EVENTS BEGAN GATHERING TO A HEAD. THE SITUATION PROMISED TO propel Madison from his deadening life at Montpelier into the revolution threatening to break the country’s chains. Then, Madison, at long last, received a clear advancement from the profession of tutor. On October 2, 1774, he received a letter signed by seven men on the statewide Committee of Safety. The committee, Madison read, placed “especial Trust and Confidence” in James Madison’s “Patriotism, Fidelity, Courage, and good Conduct,” and appointed him colonel—the same rank as his father. The advancement testified to Madison Sr.’s power and to the confidence of the leading men of Orange County advocating for the small but strangely prepossessing young man. Yet the appointment also careered Madison into a shame that would haunt him for the rest of his life.

ON JULY 28, 1775, HE EXCITEDLY WROTE BRADFORD THAT VIRGINIANS were raising an army of three to four thousand men—“The Preparations for War,” he wrote, were “every where going on in a most vigorous manner.” The issue of army supplies particularly preoccupied him—the “Scarcity of Ammunition,” he told Bradford, was “truly alarming.”¹

He hurled himself into the effort. That summer, he practiced firing a musket for the first time. Tearing open gunpowder packets and ramrodding in bullets and powder—and pulling the trigger for a shocking blast—thrilled him. He boasted to Bradford that the “discipline & hostile preparations is as great as the Zeal with which these things were undertaken.” He quickly came to view himself as a military man, becoming a bit haughty in the process. “You would be astonished,” he confidently advised his friend, “at the perfection this art is brought to.” A man, he declared, should be able to hit “the bigness of a man’s face” at a hundred yards. The militia’s men were so strong and well trained that they would demolish the officers of the enemy “before they get within 150 or 200 yards.” His own aim was good, and he boasted that he “should not often miss it on a fair trial” at that distance.

But Madison—ever his father’s son and Witherspoon’s student—was vigilant against vanity. “I am far from being among the best,” he quickly said.2

Madison began his service by joining the other men in a simple firing drill. Looking on, the younger men were ordered to practice their advances and fire their weapons. Performing before his father and the other men, Madison was suddenly struck by an overwhelming self-consciousness. As he moved from musket practice to actual company maneuvers, he anxiously felt a wrenching stomach-ache begin. Suddenly, he was unable to stand. Mortified, he then collapsed. The other men were forced to help him off the field.

The event was humiliating, and the shame stayed with Madison for his entire life. Writing about it when he was eighty years old, he masked his embarrassment, but his pain was apparent. “He was restrained from entering into the military service by the unsettled state of his health,” he recounted in third person about himself, “and the discourageing feebleness of his constitution of which he was fully admonished by his experience during the exercises and movements of a minute Company which he had joined.”³

What happened to Madison on that battlefield?

SCHOLARS HAVE HEATEDLY DEBATED EXACTLY WHAT WAS WRONG WITH Madison. Ralph Ketcham, his authoritative modern biographer, notes that Madison’s parents ordered drugs for “an Epilepsy” in October 11, 1753, when their son was in his second year.⁴ Lynne Cheney notes that these medications included two laxatives—Anderson’s Pills and pulvis basilicus. Because he was the “only member of his family for whom there is any indication of epilepsy,” Cheney concludes that the medicines were for the toddler James.⁵ However, this could just be a false negative; the medication could very well have been for another member of the family with unrecorded symptoms of epilepsy, or for a slave with epilepsy whom Madison’s parents were treating, or not for epilepsy at all (but for constipation).

Cheney takes her evidence to suggest that Madison, from a very young age, suffered from classic epilepsy, a nervous disorder that causes seizures. She suggests that Madison’s confusing symptoms can be squared with classic epilepsy because he may have experienced “complex partial seizures,” whose symptoms may include “dreamy states” and “automatic movements,” such as plucking at clothes, as well as generalized “partial seizures” resulting from electricity in one part of the brain spreading to another, which can cause a victim to lose consciousness and fall to the ground, convulsing.6

These explanations all depend on what psychiatry deems an “organic” explanation of Madison’s sickness, meaning that it was caused by a physical condition causing the symptoms. If, on the other hand, symptoms are based on psychological problems, one can have symptoms but not have a cause. There can be nothing functionally wrong with the body. The symptoms are psychosomatic (a word whose Greek roots are psyche, for” mind,” with soma, for “body”).

And this is what evidence suggests: that Madison suffered from severe anxiety-driven panic attacks that made him ill. In other words, his illness was a bodily condition driven by mental problems. In the parlance of modern psychiatry, he suffered from “psychogenic nonepileptic seizures.” He did not, in other words, suffer from classic epilepsy; he suffered from crippling anxiety.

Why did he suffer such anxiety? There, again, we have to approach the problem like detectives, for the record is so fragmentary, and Madison was himself hardly transparent or fulsome about his condition.

Here is what we know.

We know that throughout Madison’s life, the affliction would appear, as Ralph Ketcham notes, at “times of strain and tension.”*⁷

We know that after Madison died in 1836, his brother-in-law, John C. Payne, tried no less than three times to capture the problem in a short biography. First, Payne wrote:

“But a constitutional liability to sudden attacks, of the nature of epilepsy, deterred him from—”

Payne was understandably reluctant to darken a great man’s legacy with a sickness like epilepsy, which was then thought to attack its victims, taking advantage of their weakness. So Payne altered the description to read:

“But a constitutional liability to sudden attacks, of the nature of epilepsy, deterred him from of a character and effect which suspended his powers of action.”

But that wasn’t good enough, either. Now, a “suspended” Madison appeared to be paralyzed—unable to move. Payne wanted instead to describe Madison as a combatant, as a survivor who otherwise would have bravely pursued military service, so he tried a third time:

“But a constitutional liability to sudden attacks, of the nature of epilepsy, deterred him from of a character and effect which suspended his powers of action the feebleness of his health which he had experienced in training restrained him from entering the military service.”8

That version was not perfect, but it better described Madison as having valiantly “experienced” an impartial “feebleness of health” while training, than as some frail weakling unable even to try.

We know that the ailment became a leitmotif for Madison. From his twenties to his eighties, he would complain almost constantly to family and friends alike about the problem that surfaced on the militia training field. In the fifteen-page document commonly cited as his authoritative biography, which he wrote in retirement, he recounted his sickliness no less than ten times, using terms like “very infirm health,” “very feeble health,” “unsettled state of his health,” “confinement with bilious fever,” and “detained by sickness.” The fits seemed to arrive with any activity that made him feel self-conscious or anxious, particularly when he needed to seem successful in front of others, and most particularly when his father or other men were watching. The attacks could last for hours, even days, often sending him into bed where his sole thought was to recover through quiet and stillness—though he would remain pale and tremulous.

We also know other things Madison said more quietly about his condition. In his unpublished scribblings, Madison was explicit about the experience of his condition. In a memorandum requested by a Mr. Delaplane in 1816, Madison describes the “unsettled state of his health and the discouraging feebleness of his Constitution.”9 However, there was much more to it than that. In a version of the autobiography that Madison’s presidential secretary Edward Coles recorded after interviewing Madison in 1828, Coles noted that as a young man he had an “affection of the breast and nerves.”¹⁰

We know that there was another, more drastic symptom of the disorder, which Madison went to great pains to hide. In the Princeton University archives rests a mysterious version of his autobiography, written in Madison’s own hand. This autobiography contains an extra handwritten sentence in smaller, more disorganized script than usual. After recounting his failure to “enter the army,” Madison added the following sentence:

viz. his feeble health, and a constitutional liability to sudden attacks, somewhat resembling epilepsy and suspending his intellectual functions. These continued thro his life, with prolonged intervals.¹¹

In other words, his disorder not only caused him shame, it made him think he was going crazy.

We know from this description that the attacks, in his words, were “sudden”—as if he was being seized and shaken. Yet Madison carefully emphasized a confusing fact: that the attacks only “somewhat resembled” epilepsy itself. The attacks, in other words, were not a familiar illness. There was something alien about them. Madison wrote the notes describing the “suspension of his intellectual faculties” sometime between 1816 and 1831.¹² In every other version of his autobiography, the crucial phrase disappeared, and he said instead that he was “restrained from” entering into military service because of the “unsettled state of his health” and “the discouraging feebleness of his constitution.”13 It was almost as if he felt compelled to disclose a secret that he later tried, like Pandora, to recapture.

THE FACT IS THAT HE WAS EXPERIENCING ANXIETY ATTACKS. THE MODERN Diagnostic and Statistical Manual of Mental Disorders, which mental health practitioners use, includes nine criteria for diagnosing panic attacks: heart palpitations; sweating, trembling or shaking; shortness of breath or smothering sensations; the feeling of choking; chest pain or discomfort; nausea or abdominal distress; feeling dizzy, unsteady, lightheaded, or faint; feelings of unreality or detachment; fear of losing control or going crazy; numbness or a tingling sensation; and chills or hot flashes.¹⁴

A patient who experiences four of these symptoms at once has anxiety attacks, and Madison routinely experienced many more. From his own descriptions and those of his friends, his “bilious” or “epileptic” fits included palpitations, trembling, choking, chest pain, abdominal distress, fainting, and the fear of going crazy.

Taken together, these frameworks perfectly describe what James Madison experienced, not just on the battlefield in Orange County performing military exercises, but throughout his life. “Think of anxiety like a continuum,” Dr. Joseph Cooper, an expert in psychodynamic counseling at Marymount University, told me.¹⁵ In what’s known as a psychogenic nonepileptic seizure, a patient’s anxiety takes physical form by tensing the smooth muscles that line the intestines and the stomach (leading to cramping and upset stomach) and the blood vessels (creating high blood pressure and headaches).

Along these lines, Edward Coles’s reference to Madison’s “breast and nerves” as the physical location of the attacks is especially meaningful. Madison’s anxiety might have begun with a flutter of tension in his hand and jaw. As it increased, his anxiety would move into his body. His heart might have raced, his breathing becoming faster. Then his stomach would become upset. As his anxiety further escalated, he might start to feel dizzy, to get “foggy” in his head. He might have gotten “jelly legs.” As the anxiety moved further into the body, he might then actually faint or even collapse.¹⁶

These symptoms would all have been made worse by repression. If someone has experienced trauma, but fears expressing it—for example, someone who feels anger or fear as a result of some trauma, but does not feel comfortable sharing those emotions—a “conversion disorder” can result.*

Even in an age far before therapy, Freud, and the invention of the ego, many of his contemporaries were writing introspective letters full of descriptions of their own emotions, whether John Adams or Alexander Hamilton or Thomas Jefferson. Among them, Madison was unusual for his remarkably adamant disinterest in his emotional or psychological well-being. As for what exactly happened on that battlefield, we can only speculate. Madison loved his father but felt controlled by him. By the descriptions of most people who met him but did not know him well, he was extremely reserved. His friends described him as deeply sensitive and easily wounded. Madison may have felt deep anger at his father (watching him attempt to perform military exercises in front of the entire company), and his anxiety could have resulted from the conflict between that anger and his inability to express it.

When people have conflicted feelings toward “attachment figures,” such as a parent, this can produce feelings of anger and rage toward the parent. In this case, Madison’s father might have been communicating that his son was not good enough, that he needed to be who his father wanted him to be. Such feelings can be “threatening to a child because they threaten to break the attachment relationship, the bond,” Dr. Cooper suggested. That creates feelings of guilt that are highly uncomfortable and can create physical and psychological symptoms.” Anxiety and then collapse could result—as they did.¹⁷

We cannot, of course, know the truth. On such questions, the historian is like an archaeologist assembling a window from shards of glass. The missing piece of the puzzle is whether childhood trauma played a role in the trail of events leading to Madison’s seizures. Some form of childhood trauma is strongly associated with nonepileptic seizures.¹⁸ Unsurprisingly, many patients are “unaware of psychic conflict that might be related to the symptom” and often “doubt that their symptoms are related to internal psychic processes.”19 Among these patients, nonepileptic seizures are strongly associated with depression, panic disorder, and chronic anxiety.²⁰ Did Madison, as a young boy, experience some trauma—whether emotional, sexual, or physical? Again, we cannot know. Perhaps he had no childhood trauma at all. But he certainly acted as if he did.

At any rate, the most remarkable aspect of Madison’s seizures was not his struggle, but his victory. Regarding Madison’s symptoms, Professor Jim Coan of the University of Virginia’s Department of Psychology, an expert in neuroscience, told me, “It’s the response to the panic attack that sets the stage for the future.” He explained, “Humiliation is a key risk factor for developing the full-on disorder. From there, fear of bodily sensations combine with a fear of further humiliation to place the sufferer in a choke hold of chronic insecurity.” People with panic disorders seek out anything they can hold onto, to explain the panic attack(s) they have experienced. They often avoid those things, which is one reason so many are agoraphobics as well. “You isolate yourself in order to avoid humiliating displays of panic,” Coan said. “Consequently, your anxiety diminishes when you’re alone, so being alone is further reinforced by a decreased frequency of panics. The cost of isolation of course is extreme loneliness—it’s own kind of emotional hell.”

For these reasons, the humiliation that Madison likely suffered about his attacks, Coan said, “offers insight both into Madison’s disorder and—and I think this is important—his courage and strength.”²¹

For the most part, Madison outmatched the rebellion of his body, just as he mastered the country’s most riotous elements. It’s no coincidence that his greatest contribution to the Constitution was his philosophy of how to govern the seemingly ungovernable.

AFTER HIS MORTIFYING COLLAPSE WITH THE MILITIA, MADISON SPENT the next year before the Virginia Convention, wielding weapons not in military exercises, but on more scholarly terrain. He believed another battle, perhaps more important than the one with muskets, would soon play out on the field of ideas, where he could make his mark, if he prepared as he had at Princeton.²² And so he plunged in.

*  Irving Brant, Madison’s most exhaustive biographer, also wrote in 1941 that the best explanation was not the “organic” disease of epilepsy, but instead the “functional” ailment of “epileptoid hysteria.” He noted the then recent scholarship of Freud had followed the findings of the French psychologist Jean-Martin Charcot in discovering that “epileptiform convulsions” could mimic epilepsy, but instead resulted from the “impress upon the mind either of a physical injury or a mental experience corresponding to it.” Brant noted the “common connection” of this sort of hysteria was “overstudy, day-dreaming, hypochondria, and a sense of physical inferiority.” Irving Brant, James Madison: The Virginia Revolutionist, 1751–1780, vol. 1 (New York: Bobbs-Merrill, 1941), 107.

*  One recent study found that psychogenic nonepileptic seizures were correlated with problems with “emotional regulation,” which means the ability to control one’s behavior while experiencing intense emotions. Amanda A. Uliaszek, Eric Prensky, and Gaston Baslet, “Emotional Regulation Profiles in Psychogenic Non-epileptic Seizures,” Epilepsy and Behavior 23 (2012), 364–69. Another recent study found the seizures stem from “conversion disorders,” which is when psychological stresses develop (or “convert”) into physical symptoms. See endnote 18.