Appignanesi, Lisa. Mad, Bad and Sad: A History of Women And The Mind Doctors From 1800 To The Present. London, Virago, 2008. RRP $65
The façade of Bedlam — England's most notorious mental institution — was distinguished throughout the 18th century by the sculpted figures of two chained males, all-too vivid personifications of madness as a disease both bestial and primitive in its unrestrained passions.
In 1815 the statues were replaced by those of young and beautiful women. Madness, it seemed, had a new public face, and it was unequivocally female.
Lisa Appignanesi's book Mad, Bad and Sad: A History of Women and the Mind Doctors From 1800 to the Present explores the shifting historical relationship that has persisted between women and mental illness over the past two centuries, and the theorists, theories and social movements that have helped to shape it.
Women feature on Appignanesi's pages as patients, doctors, mothers, social archetypes, and as the subjects of projected male fantasies, providing both a focal point and a lens through which to view the vast web of social history and medical developments that make up this most revealing of issues.
Central to Appignanesi's theory, and to the fascination of her book, is the role of madness as a barometer of the values, concerns and morals of its day.
Philosopher Ian Hacking has lightly observed that, 'In every generation there are quite firm rules about how to behave when you are crazy.' It is no great conceptual stretch to perceive therefore that each generation has its equally firm rules governing what constitutes madness itself, and how those afflicted are to be treated.
What interests Appignanesi however is the subjective process by which these rules and conventions are established, and the often hidden assumptions that dictate such judgements.
She undertakes a systematic dismantling of the developments in 'medical' approaches and theories of insanity, and thereby reveals that processes and categories traditionally conceived as the empirical product of scientific fact, are — even today — more frequently the subjective and arbitrary divisions of social and cultural fashion.
Appignanesi reveals that neither diagnoses nor symptoms are ultimately immune to fads and phases, with each progressively shaping the other in a sort of medical chicken-and-egg scenario requiring the collusion — conscious or unconscious — of both doctor and patient.
Appignanesi produces a variety of compelling statistics and case studies spanning two centuries that indicate the