This article considers the intimate, the violent and the psychopathological in Bukavu, an eastern Congolese border city known for rape and war. A phenomenological focus pries open tensions in this ruinous, neoliberal ‘boom town’, frictions related to mental health, patterns of resort, and derangement. Ethnographic portraits from co-produced fieldnotes reveal family and street dynamics and a few adaptive, public figures of madness. Bukavu knows unhinged, delirious, psychotic people and PTSD infrastructures in this ‘trauma zone’. Patterns of psychosis go with ‘vivacity’, a Foucauldian word. The non-scientific term madness points to politics and the everyday, with many mad persons roaming the streets with performances. Intimacy enables rethinking this city, where ways of telling and knowing madness speak to agitation, kinship, strangeness and ordinary matters of sleep, dress and faecal matter.