Women and madness

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Appignanesi, Lisa. Mad, Bad and Sad: A History of Women And The Mind Doctors From 1800 To The Present. London, Virago, 2008. RRP $65

Mad, Bad, SadThe 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 particular susceptibility of women both to the diseases of the mind and to the efforts of the mind doctors and their 'talking cures'.

She extrapolates from these suggestive facts a fascinating case that — without soapbox or sermon — places women very much at the centre of the historical issues surrounding mental illnes.

Her women however are not the passive victims of male oppression that theorists such as Elaine Showalter have painted, but rather, willing and socially conditioned accomplices to prevailing trends of behaviour, even going so far (as in the case of Henry James' sister Alice) as to employ invalidism as an escape from the limiting categories of healthy female life.

Philosopher Julia Kristeva, in her theory of 'abjection', posits that any substance, notion, or individual cast out by society, rather than disappearing or ceasing to be of value, instead serves reflexively to define the 'self' of the subject and to interrogate its boundaries.

Appignanesi's book represents a compelling working-out of this same notion, and her 'mad, bad and sad' women have significant implications for the 'shallow sanity' of mainstream society and its norms.

It seems both curious and inevitable that a book about madness should become so fundamentally a discussion of sane society, and of the ways in which its thinkers, doctors and politicians have all laboured to preserve its ordered workings precisely through the treatment and categorisation of the insane.

Appiganesi's scholarly work is a timely reminder of the 'other' side of those necessarily contingent categories of sanity and insanity, healthy and diseased, and is an eloquent invitation to its readers to interrogate many of the most fundamental social and ethical categories.

Alexandra CoghlanAlexandra Coghlan graduated from Oxford University in 2006 with BAs in English Literature and Music, and completed an MPhil in Criticism and Culture at Trinity College, Cambridge. She lives in Sydney, where she works as a teacher and freelance journalist prior to returning to Oxford for a DPhil in October 2008.


Topic tags: Alexandra Coghlan, Lisa Appignanesi, Mad, Bad and Sad, A History of Women ad The Mind Doctors



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Existing comments

A friend passed me the link to this book review and it's certainly one I'll be checking out. As someone who has just started an NFP around insanity and challenging traditional beliefs around insanity, mental illness, mental health (so many labels to choose from) suggest I keep pedalling and reading as the community grows.

Martina McGrath | 11 August 2009


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