Jack Kerouac Revisited

ORIGINAL ARTICLE
Jack Kerouac Revisited

Madness in On the Road Between Stigma and Glorification
Moritz E. Wigand, MD, Nicolas Rsch, MD, and Thomas Becker, MD
Abstract: On the Road is a classic American novel that appeared at a time of
great political, cultural, and psychiatric upheaval. Published almost 60 years
ago, it still exerts great influence. We propose that the affirmative approach
toward madness in the novel can enlighten our understanding of alternative
perceptions of mental illness. The novel is analyzed with quantifying and
narrative methods focusing on the concept of madness, which is a prominent
theme in the novel. Stigma and glorification of madness can be found
throughout the text. The positive sides and the pitfalls of an overly positive
attitude toward mental illness and minority group members are discussed, including benevolent discrimination, recovery, and positive psychiatry.
Key Words: Benevolent discrimination, fiction, Kerouac, positive psychiatry,
recovery
(J Nerv Ment Dis 2016;00: 0000)
[] because the only people that interest me are

the mad ones, the ones who are mad to live, mad
to talk, desirous of everything at the same time,
the ones that never yawn or say a commonplace
thing but burn, burn, burn like roman candles
across the night.Jack Kerouac, On the Road
The Original Scroll
he decade after World War II (WWII) saw rapid changes in the

organizational status, importance, and funding of psychiatry in
the United States with the signing of the National Mental Health
Act in 1946, the formation of the National Institute of Mental Health
in 1949, and the publication of the first edition of the Diagnostic and
Statistical Manual of Mental Disorders (DSM) in 1952 (APA, 1952;
Staub, 2011). Psychiatry became interested in the traumatic experiences of soldiers coming home from the war, in the personality
structure of the Nazi opponents, and in the interpretation of
undemocratic attitudes (Staub, 2011, p. 14). LIFE magazine began
a series with the telling title, The Age of Psychology in the U.S.,
pointing out how everyday life had become interwoven with psychological and psychiatric thinking (Havemann, 1957). In the arts, the
clear forms of Modernism gave way to the more playful and selfreflective era of Postmodernism, a transition that for the visual arts
is described as [p]erhaps the greatest, and certainly the loudest, event
in American cultural life since World War II (Gopnik, 2015). As the
world left behind WWII and moved toward the Cold War, the political climate became more restrictive. It was a time in which artists
and intellectuals were required to prove their innocence and loyalty
to the United States [, and any] minor offense could have been labeled
deviant (Vlagopoulos, 2008, p. 55).
Department of Psychiatry II, Ulm University, Gnzburg, Germany.

Send reprint requests to Moritz E. Wigand, MD, Ludwig-Heilmeyer-Str 2, D-89312
Gnzburg, Germany. E-mail: moritz.wigand@bkh-guenzburg.de.
Copyright 2016 Wolters Kluwer Health, Inc. All rights reserved.
ISSN: 0022-3018/16/00000000
DOI: 10.1097/NMD.0000000000000520
In this politically and culturally turbulent era appeared a novel

that features madness as a prominent theme, a novel that has exerted
influence on the public ever since it was first released. Jack Kerouacs
On the Road is set in the late 1940s, was written in the early 1950s,
and was first released in 1957 (Kerouac, 2008; Kupetz, 2008). Published almost 6 decades ago, its status as an American classic
(Charters, 1994, p. 7) and a cultural phenomenon (Griffey, 2008,
p. 483) is underlined by the legend that it is alongside the Bible, []
one of the most frequently stolen books (Vlagopoulos, 2008, p. 53)
and sells an average of 100,000 copies annually (Griffey, 2008,
p. 486). The ability of On the Road to inspire readers and artists
endures into the present day. In 2007, half a century after its first
publication and after considerable research, the so-called Original
Scroll, the earliest complete draft of the novel (Kupetz, 2008, p. 84)
came out, singer/songwriter Brooke Fraser alludes to the novel in her
song Jack Kerouac (from the album Flags, released 2010), and a movie
version appeared in 2012.
Most of Kerouacs works are autobiographically inspired, but
he is seen as an American novelist (Griffey, 2008, p. 481), and his
works are regarded to be works of fiction. On the Road contains numerous descriptions of mental states and behaviors that can be interpreted
as mental illness. In addition, there are numerous descriptions of minority group members such as persons with physical handicaps that are
also known to suffer from stigmatization (Sensky, 1982). The novel
shows reactions to these persons and behaviors from those belonging
to the Beat Generation as well as from characters representing the
public attitude (family members, tourists, policemen). The attitudes
range from stigmatization to glorification of madness. Taking On the
Road as a reference, we will discuss these views on mental illness in
addition to benevolent discrimination (Fehr and Sassenberg, 2009),
a concept derived from work on hostile and benevolent sexism (Glick
and Fiske, 1996). The discussion of several attitudes toward mental
illness seems of importance, because despite the fact that mental
health literacy, especially the general understanding of biological
models of mental illness, has increased, stigmatization of people
affected by mental illness has been stable over the last decades with
even a trend toward the worse. Pescosolido et al. (2010), in the United
States using vignettes in the General Social Surveys in 1996 and 2006,
found an increase in public neurobiological understanding of mental
illness, whereas public stigma did not decrease significantly and was
unrelated to or even increased by a neurobiological disease model.
Schomerus et al. (2012), in a systematic review and meta-analysis
of population surveys, found that attitudes towards persons with
mental illness have not changed for the better, and have even deteriorated towards persons with schizophrenia (p. 448).
We will also turn to the question of the usefulness of the concept
of madness presented in On the Road to more recent ideas in psychiatry such as the recovery from mental illness and the emerging concept
of positive psychiatry (Jeste et al., 2015). If recovery involves the
development of new meaning and purpose in one's life as one grows
beyond the catastrophic effects of mental illness (Anthony, 1993)
and also means that [p]eople with mental illness may have to recover from the stigma they have incorporated into their very being
(Anthony, 1993), we suggest that a balanced look also at the less
catastrophic qualities of mental illness and on the strengths
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Wigand et al.
and resources of the persons affected can help this very process
of recovery.
The fact that major protagonists of the Beat Generation and
their relatives (Allen Ginsberg, his mother, Jack Kerouac, and his
short-time girlfriend Mardou) had been in psychiatric treatment or
under psychiatric observation (Charters, 1994, pp. 37, 95, 110, and
183) underlines the relevance of their depiction of mental illness
and stigmatization, because they can be seen both as eye witnesses
and as persons with psychiatric experiences. Interestingly, one of
the novels (and its adaptation for the screen) that very much influenced the general publics view on psychiatry in the 20th century
(Zimmermann, 2012), namely, One Flew Over the Cuckoos Nest,
was also written by a protagonist of the Beat Generation, Ken
Kesey (1963). This novel appeared shortly after Erving Goffmans
(1961) Asylums, another important critical text of that period, and
both texts can be interpreted as complementary rather than comparable early 1960s manifestos against the public mental hospital
(Staub, 2011, p. 69). Differences and similarities between the postwar era and our time will have to be discussed when interpreting
Jack Kerouacs concept of madness.
Fiction can simulate social experiences by the mechanisms of
abstraction, simplification, and compression (Mar and Oatley, 2008)
and deliver different types of knowledge as propositional knowledge
(knowledge that such and such is the case), phenomenal knowledge
(knowledge of what an experience is like, or how an emotion or
mood feels), and operational knowledge (knowledge how to do
something, where the doing in question may include not only bodily
actions, but those involving use of the imagination) (according to
the thesis of Literary Cognitivism by Green, 2010; all quotes taken
from p. 4). Thus, turning toward a novel of a certain time and society
to address sociological and psychiatric questions is a valid methodological approach. Novelist Shashi Deshpande (2012), in an article
for the Indian Journal of Psychiatry, takes it one step further by
pointing out that the novelist catches the truth not by giving the
reader a mirror image of society [but by creating] a picture that goes
behind the faade, beneath the surface.
The link between literature, psychiatry, and madness is manifold and works in several directions. As German philosopher Matthias
Bormuth points out, besides its biological aspect, psychiatry has
also to be seen as a cultural science taking a hermeneutical approach
(Bormuth, 2010). In fact, psychiatrists have repeatedly suggested turning toward fiction to further our understanding of the human condition
(Beveridge, 2003; Goldberg, 2001). Psychiatry itself is embraced as an
interesting subject by novelists around the world (Cole, 2011; Duiker,
2001; Kesey, 1963; Kita, 1984, to name a few), and madness as a
concept of standing outside the conventions of society has been an
inspiration not solely for authors of the Beat Generation, as can be
seen in the following quote by F. Scott Fitzgerald on the term generation: It is distinguished by a set of ideas inherited in modified
form from the madmen and outlaws of the generation before [].
(quoted from: Charters, 1992, p. xvi).
To our best knowledge, the concept of madness in Jack
Kerouacs highly influential novel On the Road has not been analyzed previously. On the Road appeared at a time of great political,
cultural, and psychiatric upheaval that shows parallels to our time,
as will be discussed later. We propose that turning toward this classic
of American postwar literature can enlighten our understanding of
alternative perceptions of mental illness, thereby adding to biological,
psychological, and sociological models an additional, affirmative
approach toward phenomena of mental illness, which adds weight
to concepts of recovery and positive psychiatry. At the same time,
the glorification of madness seen in the novel will have to be discussed with regard to the pitfalls of such an approach to persons with
mental illness. The specific aims of this study were (i) to establish
a Diagnostic and Statistical Manual of Mental Disorders, Fifth
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Edition (DSM-5) diagnosis of Neal Cassady, one of the main characters, as depicted in the novel; (ii) to analyze other characters reactions to the madness displayed by Neal Cassady and others; (iii)
to quantify the usage of the word madness and semantically related words in the novel; (iv) to find descriptions of other characters
in the novel showing signs of mental illness or belonging to
minority groups.
METHODS
The version of On the Road that was used for this research is
the so-called Original Scroll, a publication of the first complete draft
written by Jack Kerouac in 1951 that is without the editing work that
went into the 1957 publication (Kerouac, 2008; Kupetz, 2008). For
further insight regarding the characters of the Beat Generation, especially Jack Kerouac and Neal Cassady, Ann Charters biography of
Kerouac was taken as a reference (Charters, 1994). A short summary
of the plot of On the Road and the names that were used for the 2 main
protagonists in the 1957 version are given (Appendix 1).
The text is approached with quantifying and narrative methods
(Taylor and Francis, 2013). Overall, an inductive and hermeneutical approach to the text was chosen, meaning that all passages
containing the depiction of psychiatric symptoms, the reaction to
these symptoms, and passages generally related to the concept of
madness were extracted without preemptive assumptions. In a
second step, an interpretation of the text in the light of psychiatric diagnoses, stigmatization, and glorification of persons with
mental illness and persons belonging to other minority groups
was undertaken.
Conditions depicted in the text that can be interpreted as mental
illnesses are summarized. The hypothesis that mental states that
modern psychiatry would consider manic episodes are described in
the person of Neal Cassady was tested by matching passages from
the novel to the corresponding DSM-5 criteria (APA, 2013) for
manic episodes. Descriptions of episodes of mental illness and other
conditions of characters in the novel that suggest minority group status are summarized.
Examples of stigmatization and of glorification are given, and
the importance of the concept of mental illness in the text is shown
by a count of words from the semantic field of mental illness.
RESULTS
The main character of the novel apart from the first person narrator Jack Kerouac is Neal Cassady, who initiates Jack
Kerouacs travels:
[A]nd then Neal got on the bus that said
Chicago on it and roared off into the night.
I promised myself to go the same way when
Spring really bloomed and opened up the land.
There went our wrangler. And this was really
the way that my whole road experience began
and the things that were to come are too fantastic not to tell. (p. 114)
An analysis of the text reveals that descriptions of mental state

and behavior of Neal Cassady in the novel display all diagnostic criteria
of manic episodes according to DSM-5 (APA, 2013). Table 1 shows
this using excerpts from the novel. While the novel mostly speaks of
manic symptoms and only provides evidence for distinct manic episodes, we know from other sources that there were, in Neal Cassadys
life, suicide attempts in what could have been depressive or mixed
episodes (Charters, 1994, p. 93).
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TABLE 1. Passages From the Text That Could Indicate Neal Cassadys Manic Episodes According to DSM-5 Criteria (APA, 2013)
A. A distinct period of abnormally and persistently elevated, expansive,
Fury spat out of his eyes when he told me of things he hated; great glows
or irritable mood, lasting at least 1 wk (or any duration if hospitalization
of joy replaced this when he suddenly got happy; every muscle twitched
is necessary).
to live and go. p. 216
Neal was all beside himself with happiness [] he was overjoyed and
exuberant. p. 239
B. During the period of mood disturbance, 3 (or more) of the following
symptoms have persisted (4 if the mood is only irritable) and have been
present to a significant degree:
inflated self-esteem or grandiosity
Neal: [] you know that Im capable of doing everything at the same
time and I have unlimited energy [] p. 236
decreased need for sleep (e.g., feels rested after only 3 h of sleep)
And still Neal drove, he had no thought of sleeping till we got to
Chicago. p. 332
We had come from Denver to Chicago, 1028 miles according to the
Rand-McNally mileage chart, in exactly 23 hours counting the two hours
we wasted in the Colorado ditch and at the Ed Uhl ranch eating, and the
hour with the police in Iowa, for a mean total of 20 averaging 51 across
the land with one driver, and 59 counting the extra 150 miles out of the
way for Sterlin. (or 1178 mis. in all). p. 335
more talkative than usual or pressure to keep talking
Neal: Now darling here we are in Ny and although I havent quite told
you everything that I was thinking about when we crossed the Missouri
and especially at the point when we passed the Booneville reformatory
which reminded me of my jail problem it is absolutely necessary now to
postpone all those leftover things concerning our personal lovethings and
at once begin thinking of specific worklife plans pp. 10910
Neal: [] yass, yass. Well Jack old man whats the story, when do we
take off for Mexico? Tomorrow afternoon? Fine, fine. Ahem! And now
Jack I have exactly sixteen minutes to make it to Al Hinkles house where
I am about to recover my old railroad watch which I can pawn on Larimer
street before closing time, meanwhile buzzing very quickly and as
thoroly as time allows to see if my old man by any chance may be in
Jiggs buffet or some of the other bars and then I have an appointment with
the barber Brierly always told me to patronize and I have not myself
changed over the years and continue with that policykaff! kaff!At
six olclock SHARP! sharp har me? I want you to be right here where Ill
come buzzing by to get you for one quick run to Bill Tomsons house, play
Gillespie and assorted bop records, an hour of relaxation prior to any kind
of further evening you and Ed and Frank and Bev may have planned for
tonight irrespective of my arrival which incidentally was exactly forty-five minutes
ago in my old 37 Ford which you see parked out there I made it together
with a long pause in Kansas City seeing my stepbrother not Jack Daly but
the younger one p. 362
flight of ideas or subjective experience that thoughts are racing
see above; also:
Ahahyou must listen to hear. We listened. But he forgot what he
wanted to say. Really listenahem look dear Jack sweet Joan
Ive come Im gone but wait Ah yes. [] But you see no
need to talk any more and further. pp. 4056
distractibility (i.e., attention too easily drawn to unimportant or irrelevant He [Neal] stumbled around in a circle and looked everywhere. What
external stimuli)
do my eyeballs see? Ahthe blue sky. Long-fellow! He swayed and
blinked. He rubbed his eyes. Together with windowshave you ever
dug windows? Now lets talk about windows. I have seen some really
crazy windows that made faces at me and some had shades drawn and so
they winked. Out of his seabag he fished out a copy of Eugene Sues
Paris and adjusting the front of his T-shirt began reading on the
streetcorner with a pedantic air. Now really Jack lets dig everything as
we go along He forgot about that in an instant and looked around
blankly. p. 287
(Continued on next page)
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Wigand et al.
TABLE 1. (Continued)
increase in goal-directed activity (either socially, at work or school,
of sexually) or psychomotor agitation
He had become absolutely mad in his movements: he seemed to be doing

everything at the same time. It was all a shaking of the head, up and
down, sideways, jerky vigorous hands, quick walking, sitting, crossing of
the legs, uncrossing, getting up, rubbing of the hands, rubbing his balls,
hitching his pants, looking up and saying Am and sudden slitting of the
eyes to see everywhere; and all the time he was poking me in the ribs
and talking, talking. p. 217
So now Neal had come about four thousand miles from Frisco, via Arizona
and up to Denver, inside four days with innumerable adventures sandwiched
in and it was only the beginning. p. 219
Now we must all get out and dig the river and the people and smell the
world said Neal bustling with his sunglasses and cigarettes and leaping
out of the car like a jackinthebox. p. 242
excessive involvement in pleasurable activities that have a high
Neal: Man, thats a detective car and every precinct in town knows my
potential for painful consequences (e.g., engaging in unrestrained buying fingerprints from the year that I stole five hundred cars. You see what I do
sprees, sexual indiscretions, or foolish business investments)
with them, I just wanta ride man! I gotta go! Listen, were going to wind up
in jail if we dont get out of here this very instant. p. 322
Then suddenly he blew his top and while walking down the street one day
he saw a 49 Hudson for sale and rushed to the bank for his entire roll.
He bought the car on the spot. [] Now they were broke. Neal calmed
Carolyns fears and told her hed be back in a month. p. 213
Neal: Oh I love, love, love women! I think women are wonderful! I live
women! p. 242
C. The mood disturbance is sufficiently severe to cause marked
I think Louanne was very very wise leaving you Neal. For years now you
impairment in occupational functioning or in usual social activities or
havent any sense of responsibility for anyone. Youve done so many awful
relationships with others or to necessitate hospitalization to prevent
things I dont know what to say to you. And in fact that was the point
harm to self or others, or there are psychotic features.
and they all sat around just looking at Neal with lowered and hating eyes
and he just stood on the carpet in the middle of them and giggledhe
merely giggled. He made a little dance. p. 292
D. The symptoms are not due to the direct physiological effects of a
Drugs are taken by the characters depicted in the novel, but it is clear that
substance (e.g., a drug of abuse, a medication, or other treatment) or a
the symptoms mentioned above are not due to the intake of drugs or other
general medical condition (e.g., hyperthyroidism).
substances. Depiction of symptoms that were described together with the
intake of drugs (Allen Ginsberg: Sometimes we stay up two days [].
We had to take benny [Benzedrine]. p. 145; [] and I suddenly realized
it was only the T that we were smoking [] p. 229) were omitted in
the list above.
Indications of distinct episodes:
Neal has settled down in San Francisco, has a wife (Carolyn), a daughter, and a regular job. Then suddenly he blew his top and while walking
down the street one day he saw a 49 Hudson for sale and rushed to the bank for his entire roll. He bought the car on the spot. p. 213
But his energies ran out. One rainy afternoon the salesman came around to find out what Neal was doing. Neal was sprawled on the couch. p. 275
Apparently Neal had been quiet a few months; now the angel had arrived and he was going mad again. p. 283
Throughout the novel, signs of mental illness in Neal Cassady

are noted by other people, friends, lovers, and fellow travelers:
Neal had gotten worse since Texas, he [Bill Burroughs] confided in me. He seems to me to be
headed for his ideal fate, which is compulsive psychosis dashed with a jigger of psychopathic irresponsibility and violence. (p. 248)
[Louanne:] Im sad about everything. Oh damn, I
wish Neal wasnt so crazy now. (p. 263)
[about Neal] Are you really going all the way to
the Coast with that crazy cat? If I were you I
wouldnt try it. That cat is really crazy. (p. 267)
[Tourists about Neal] We cant let him drive any
more, hes absolutely crazy, they must have let
him out of an asylum or something. (p. 309)
[] Say, Neal gets crazier every year dont he?
He sure does. (p. 363)
In fact, some of those people, like Jack Kerouaks Southern

relatives, do stigmatize Neal (and also Jack) because of Neals
madness:
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What kind of friends does Jack have anyway?

they said to my sister. She was stumped for an answer. Southerners dont like madness the least bit,
not Neals kind. (p. 215)
In contrast, members of the Beat Generation regard madness

with a certain curiosity:
I told them that I was thinking they were very amazing maniacs and that I had spent the whole night
listening to them like a man watching the mechanisms of a watch that reached clear the top of
Berthoud pass and yet was made with the smallest
works of the most delicate watch in the world. They
smiled. [] If you keep this up youll both go
crazy but let me know what happens as you go
along. (p. 152)
Neal Cassady himself in the text does not comment on his

own mental state. In only 1 passage, comparing his childhood fantasies
to those of Jack, does he speak of his perhaps wilder schizophrenia
(p. 306), but from the context, it becomes clear that he does not
TABLE 2. Count of Words From the Semantic Field of Mental Illness

in the Novel On the RoadThe Original Scroll (Kerouac, 2008)
Words
Mad
Madder
Maddest
Madly
Madness
Madman/madmen
Madfaced
Total No. in Text
Sum (Total n = 220)
101
2
3
2
19
12
1
} 140
Crazy
Crazier
Craziest
51
2
2
} 55
Maniac(s)
Maniacal(ly)
10
11
} 21
3
1
}4
Insane
Insanity
disabilities, and a character with a probable neurological disorder (with

spastic symptoms and possibly with seizures), as can be seen in the
excerpts from the text. The adjectives used to describe those characters range from sweet and funniest to angelic and saint.
DISCUSSION
actually refer to the psychiatric diagnosis of schizophrenia but

rather uses it as a general metaphor for being a child with strange
ideas and fantasies. For Jack, it is a strong affection rather than
simple curiosity that pulls him toward Neals madness, as he
points out at the beginning of the novel: Nonetheless I loved
him for his madness [] (p. 111).
The importance of madness as a concept in the novel is shown
by a word count from that semantic field (Table 2). The words that were
included sum up to 220 in a text that covers 300 pages. Words around
the radical mad- lead the score, followed by crazy, maniac, and
insane. As already shown above, those words are often used with a
positive connotation in a way that madness is admired or regarded
with curiosity.
The concept of madness goes beyond the character of Neal
Cassady. The text was critically searched for all hints of mental illness
in other characters, also those only mentioned in passing, and for characters belonging to minority groups. The results are summarized in
Table 3. There are characters with intellectual disabilities, mood disorders, substance-related disorders, a character whose description may
suggest frontal temporal lobe degeneration, people with physical
On the Road is an American classic (Charters, 1994, p. 7) that

has not lost its impact almost 6 decades after its first publication. It was
released in a politically, culturally, and psychiatrically turbulent era in
the wake of WWII and at the beginning of the Cold War. Some parallels
to our time cannot be overlooked with the end of the Cold War in the
late 1980s, a spiking interest in neuroscientific research (this time
more biologically than psychologically oriented) as President Bush
announced the 1990s to be the Decade of the Brain (Bush,
1990), and the world now dealing with turbulences created by globalization, digitalization, climate change, and terrorism as we moved
into the 21st century. Psychiatry has seen many changes since
WWII. In the postwar era, psychiatry could be seen as a discipline
both embracing sociological models of disease causation and at the
same time being criticized on sociological grounds (Staub, 2011).
Today, we see a discipline that on the one hand relies on standardized
diagnostic criteria (Andreasen, 2007; APA, 2013), treatment guidelines, and biological disease models, but on the other hand embraces
more holistic concepts such as recovery (Anthony, 1993) and positive psychiatry (Jeste et al., 2015) and engages in extensive stigma
research (Corrigan, 2014).
Against this background, the authors analyzed the concept of
madness in Jack Kerouacs On the Road to elucidate an alternative
approach to phenomena of mental illness. Qualitative research on a
highly emotional novel as On the Road can shed light on aspects of
mental illness that neither biological nor statistical research can provide.
In the novel, we find the depiction of several conditions that, according
to modern diagnostic algorithms, would qualify as mental illnesses. In
particular, the description of Neal Cassadys inner state, behavior, and
activities fit the DSM-5 definition of manic episodes. It should be
noted in passing that there could have been an argument for using
the first version of the DSM as the version that was in place when
the novel appeared. As we want to make a contribution to todays
outlook on mental illness, we saw advantages in using the current,
more detailed version of the DSM. The conclusion about Neal
Cassadys diagnosis reached with DSM-I would not have been any
different (compare APA, 1952, p. 25).
TABLE 3. Passages From the Text That Mention Characters Who Are Bodily or Mentally Challenged or Have Mental Disorders
Neal sat the idiot girl with him up front and dug her, as he said All the way man! such a gone sweet little soul. Oh we talked, we talked, we talked
of fires and the desert turning to a paradise and her parrot that swore in Spanish. p. 214
Ed Stringham is a sad handsome fellow, sweet, generous and amenable; only once in a while he suddenly has fits of depression and rushes off
without saying a word to anyone. This night he was overjoyed. p. 226
Bill himself only got $50 a week from his own family, which wasnt too bad except that he spent almost that much per week on a drug habit
morphine; and his wife was also expensive, gobbling up about ten dollars worth a week of benny tubes. Their foodbill was the lowest in the
country; they never ate; the children never ate either. p. 244
[Bill Burroughs:] Say, did I ever tell you about Kells father. He was the funniest old man you ever saw in your life. He had paresis which eats
away the forepart of your brain and you get sos youre not responsible for anything that comes into your mind. [] p. 251
The kid had no money; he was about seventeen, pale, strange, with one undeveloped crippled hand and no suitcase. Aint he sweet, said Neal
turning to me with serious awe. Come on in fella, well take you out p. 264
Everything was collapsing, and to make things inconceivably more frantic there was an ecstatic spastic fellow in the bar who threw his arms around
Neal and moaned in his face and Neal went mad again with sweats and insanity []. Neal came in the bar and rocked back and forth with the
poor spastic kid []. Oh man, this guy is the greatest in the world! yelled Neal. [] (the spastic saint) [] And Alberta thin dark-haired
holy-eyed moaning foaming lost soulleaned on Neal and groaned and groaned for he was sick suddenly and for some odd intuitive reason he
became terrified of Neal and threw up his hands and drew away with terror writhing in his face. pp. 319320
The crippled kid was some kind of malformed midget with a great big beautiful face much too large in which enormous brown eyes moistly
gleamed. [] We watched as the angelic young midget aimed for a bankshot. p. 374
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Wigand et al.
A special interest of the current approach lies in the language

used by Jack Kerouac, because it is evident that choices made in the
field of language are regarded as important with respect to stigmatization, as can be seen in the struggle for a gender-fair language of recent
decades (Koeser and Sczesny, 2014; Kolba and Widmayer, 1989). At
the same time, Grant and Orr (1996), after a thorough overview of the
transitions from the term African to Negro to black and African
American with their implications for African Americans, challenge
any unqualified claim that language shapes political reality and advocate a differentiated approach. Also, in the history of psychiatric
institutions, names have been changed, often with the goal to reduce
prejudice and stigmatization (Carius et al., 2003). In analogy to the
civil rights movement with slogans as black pride, there seems to
be something of a mad pride movement (Schrader et al., 2013)
and a successful antistigma program of Coming Out Proud
(Corrigan et al., 2015) (now Honest, Open, Proud). The frequently
used words from the semantic field of madness (mad, crazy,
maniac, and insane with deflections and modifications) tend to
carry a positive connotation.
Jack Kerouacs language and the concept he formulates of Neal
Cassadys condition differ from a current-day psychiatric approach. A
comparative analysis of the wording of some of the DSM-5 criteria
for manic episodes and the novel suggests the following: As a diagnostic tool, the language of DSM-5 is mostly deficit oriented and stresses
the negative aspects of manic symptoms, while On the Road takes an
affirmative approach toward the phenomena described. The term
distractability, in psychiatric usage, is likely to carry a negative connotation, and the explanation given could be considered judgmental:
attention too easily drawn to unimportant or irrelevant external stimuli (APA, 2013). To Jack Kerouac and Neal Cassady, searching for
the ultimate experience, in the novels words searching for IT
(p. 304), no such thing that is unimportant or irrelevant exists (the
sky, windows, a random novel; compare the excerpt in Table 1 on distractibility). We propose that the state of mind called IT equals the romantic concept of an artistical schaffensmoment and also the click in
psychotherapy described in yet another novel on psychiatry, Samuel
Shems (1997) Mount Misery. While many of the investments Neal
makes can be seen as foolish, as DSM-5 puts it, especially buying cars
for which there is neither money at hand nor a reliable income, having a
car is a necessary precondition for most of their travels (Neal was
happy again. All he needed was a wheel in his hand and four on the
road; p. 308), and much of what is described would not have happened
without the means of transportation a car offers.
While the DSMs, beginning with DSM-III, have improved communication among mental health professionals around the world and
have been important tools in shaping modern psychiatry, they may have
also had a dehumanizing impact on the practice of Psychiatry, discouraging clinicians from getting to know the patient as an individual
person, as Nancy C. Andreasen (2007) points out. Thus, seeing the
interesting, positive, sometimes enigmatic side of people with mental
illness could be not the only, but an additional, approach to gain further
insight into the individuality these persons, an approach different from
the dryly empirical approach (Andreasen, 2007) used in diagnostic
manuals. This approach has been embraced by others. In her narrative
An Unquiet Mind of her own bipolar affective disorder, K. R. Jamison
(1995), both as a professional and a person suffering from that condition, gives us an account in which both sides, positive and negative,
are portrayed equally. Donald W. Goodwin (1992) in his article Alcohol
as Muse tries to explain the link between great American writers
and alcoholism by pointing out the positive aspects of alcohol, and
Kulhara et al. (2012), after summarizing the hardship of caring for
a person with schizophrenia (grief, stigma, social isolation,
shame, embarrassment or guilt, p. 44), give an account of the positive aspects of caregiving in schizophrenia and associated spectrum
disorders. Also in neurology, there seems to be an interest in the
6
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positive aspects of a disease that is usually portrayed in a negative

light, as can be seen in the article Epilepsy is Dancing (Tuft et al.,
2015). All of this goes hand in hand with the ideas of the development
of a positive psychiatry that has as one of its goals an assessment
focus on positive attributes and strengths rather than on psychopathology (Jeste et al., 2015, p. 675).
Turning back to On the Road, we can see that not only Neal
Cassady but also members of most minority groups are depicted in a
positive light throughout the text, although Kerouac himself, as Griffey
points out, had a complicated relationship to women, homosexuals,
Jews and other minorities (Griffey, 2008, p. 484). Taking a closer
look,it seems that Neal Cassady had a strong inclination to romanticize
the condition of people who were a little different from the norm without getting seriously involved (Table 3). In fact, madness or mental
illness may have been considered ways of being totally different from
mainstream society, implying that mental illness was considered something of a conscious decision, perhaps in the end to further a persons
creative potential. As Jack Kerouac puts it, I said to myself Well I
might as well go be mad again [] (p. 281). Neal Cassadys madness toward the end of the novel gathers a saintly, mystic quality, being
the Saint of the Lot, the HOLY GOOF (p. 292), and the
Prophet (p. 398).
What we clearly see is an overly positive attitude toward and glorification of behaviors reflecting mental illness and also toward persons
that normally would suffer from stigmatization. On the positive side,
this approach may decrease social distance from people affected, as
can be seen throughout the text, and it can highlight the positive side
of symptoms of mental illness, which in turn (as described in the text)
may help reduce self-stigma (on the problem of self-stigma, see
Corrigan et al., 2009). On the other hand, the negative aspects of such
an overly positive attitude are 2-fold. First, negative consequences of
manic illness, such as financial ruin, destruction of families, and potentially life-threatening risk-taking behavior, may be neglected, although
they are mentioned in the novel. For financial aspects, see Table 1, for
family structures: So now he was thrice-married, twice-divorced, and
living with his second wife (p. 404), and for risk-taking behavior (on
a 1028-mile drive with 1 driver):
[] Neal balled straight across at the same speed
and in his tiredness was taking greater chances
than ever. At a narrow bridge that crossed one of
these lovely little rivers he shot precipitately into
an almost impossible situation. [] The road was
crowded and exploding to pass. In the middle of
this mess was the almost one-way narrow bridge.
Neal came down on all this at 110 miles an hour
and never hesitated. He passed the slow cars,
made a slight mistake and almost hit the left rail
of the bridge, was going head-on for the
unslowing truck, cut right sharply, almost hitting
the first slow car, and had to cut back in line with
another car pulling out from behind the truck to
look, toot the horn, push him back, and all in a
matter of two seconds flashing by and leaving
nothing worse than a cloud of dust instead of a
horrible five-way crash with cars lurching in every direction and the great truck humping its
back to die in the fatal red afternoon of Illinois
with its dreaming fields. (pp. 333334)
In fact, the romantic view of Jack Kerouac himself by his fans

probably supported his alcoholism (which eventually led to his death
at the age of 47 years), with fans coming to his door with alcoholic beverages and travel companions of his later life providing him with alcohol (Charters, 1994).
Second, just by admiring madness and calling members of

minority groups sweet, angelic, and saint will not stop the
problem of stigmatization. If anything, this approach may enhance
prejudice and is likely to set minority group members apart, standing
in the way of meeting each one as an individual person. There are
parallels with benevolent sexism, a concept that comprised subjectively positive feelings towards women that often go hand in hand
with sexist antipathy (Glick and Fiske, 1996, p. 491), and benevolent discrimination, which is a well-intended behavior toward people
who show some easily detectible differences (looking foreign or
being obviously disabled) with nonetheless harmful effects (Fehr
and Sassenberg, 2009).
Limitations
The authors of this article are aware that they are dealing with
a novel, implying that they have no intention of looking at the
historic figures of Neal Cassady and other protagonists of the
Beat Generation in an attempt of retrospective pathologization
(or pathobiography). The focus here is on the text of the novel
as it is the very text that has turn[ed] on an entire generation
(Charters, 1994, p. 276). Because of its enduring influence, the novel
has the potential to change the readers perspective on madness or
mental illness. Clearly, a psychiatric interpretation of Neal Cassady
as depicted in On the Road is one of many possible ways of looking
at this character, and completely different approaches have been
made by literary scholars: Sal wises up probably long after the
reader, who sees in Dean Moriarty another figuration of American
male desire prolonged too far past adolescence, another one of those
enthusiastic blockheads like Tom Sawyer, Amaso Delano, and Jay
Gatsby, who cannot grow up and force the world to pay for their mistakes (Barbarese, 2004, p. 593). The authors are aware of the influence that their own points of view as male Western (European)
psychiatrists of the early 21st century must have on their interpretation of the text.
CONCLUSIONS
A critical reading of On the Road can show us some positive aspects alongside the pitfalls in dealing with mental illness. A possible
goal might be that society could strive toward an attitude that sees the
positive aspects of mental illness alongside its deficits without glorifying mental illness or romanticizing the persons afflicted by it. We know
from qualitative research with persons in mental health care settings that
they wish to be heard with respect for their own experiences and illness
models and long to be seen in their individuality and not just in terms of
diagnosis and medication (James et al., 2014). Trivial as it may seem, a
strong focus on a person-centered psychiatry including a range of biological, philosophical, and sociocultural viewpoints (Mezzich, 2007)
and acknowledging individuals views of their illness without failing
to see the risks that come with the illness could be called for. This type
of approach would help counteract stigma in health care settings, selfstigmatization, and discrimination against people with mental health
problems, thereby enhancing recovery. We see some parallels to aspects
of positive psychiatry as proposed by Jeste et al. (2015). These could be
looking for positive psychological traits, promoting optimism, promoting social engagement, and laying a focus on spirituality and wisdom.
Jack Kerouacs On the Road is an American classic from the postwar era still exerting influence today as can be seen in the number
of copies sold annually and in adaptations by other forms of art
(film, popular music). Madness is a central theme in On the Road,
which is underlined by the usage of 220 words from the semantic
field of madness in a text that covers 300 pages (Table 2) and in
the extensive descriptions of manic symptoms that fit modern diagnostic criteria for manic episodes (Table 1).
The depiction of phenomena of mental illness in many parts of

the novel is overly positive. While such an approach can decrease
social distance, a glorification of people with mental illness bears
the risk of neglecting the negative consequences of mental illness
and may stand in the way of seeing the person afflicted by mental
illness as an individual.
However, seeing the strengths and resources of persons with
mental illness in an affirmative approach can be a counterpoint
to a more deficit-oriented disease concept and the dryly empirical approach (Andreasen, 2007) used in diagnostic manuals
and can promote recovery.
ACKNOWLEDGMENTS
The authors would like to thank Hauke F. Wiegand and Lisa
Box for critical reading of the manuscript and helpful advice.
DISCLOSURE
The authors declare no conflict of interest.
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APPENDIX 1. SUMMARY OF THE PLOT

On the Road is a novel about the search for the ultimate
experience, about friendship, traveling, and jazz. The firstperson narrator Jack Kerouac (in the 1957 version Sal Paradise)
meets Neal Cassady (Dean Moriarty) in 1947 and admires him
for his energy and madness. In the years to follow, they cross
the American continent several times (together as well as separately) from East Coast to West Coast and vice versa,
hitchhiking, meeting people, listening to music, and digging
everything. Jack joins a group of Mexican immigrants for a
while after falling in love with a young Mexican woman. Finally, looking for new adventures, Jack and Neal travel to
Mexico City together, where Jack falls ill and is left behind by
Neal. Jack finally returns to New York, where he marries and is
visited by Neal in 1950, before Neal recrosses the continent to
go back to San Francisco.

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[] because the only people that interest me are

he decade after World War II (WWII) saw rapid changes in the

Department of Psychiatry II, Ulm University, Gnzburg, Germany.

In this politically and culturally turbulent era appeared a novel

An analysis of the text reveals that descriptions of mental state