It is a wonderfully rich and brilliantly researched intellectual history spanning two centuries of women's psychiatric treatment by mostly male doctors. Appignanesi asks why, over the years, we have continued to classify women in psychiatric categories far more often than we do men. She points out how a particular period's definitions of appropriate femininity or masculinity are closely linked to definitions of madness. Not conforming to a norm risks the label of deviance or madness, and sometimes attended by confinement. Mad, Bad and Sad is, Appignanesi tells her readers, not only "the story of madness, badness and sadness and the ways in which we have understood them over the last 200 years," but also a survey of the mad, bad and sad themselves, the particular women, including Mary Lamb, Zelda Fitzgerald, Lucia Joyce, Virginia Woolf, Marilyn Monroe, Sylvia Plath and many less famous patients, who suffered "frenzies, possessions, mania, melancholy, nerves, delusions, aberrant acts, dramatic tics, passionate loves and hates, sex, visual and auditory hallucinations, fears, phobias, fantasies, disturbances of sleep, dissociations, communion with spirits and imaginary friends, addictions, self-harm, self-starvation, depression" and so on. She gives us accounts not only of famous patients, but also of famous patient-doctor collaborations, such as those between Freud and "Dora", Jung and Sabina Spielrein, R D Laing and Mary Barnes, Lacan and "Aimée".
Mad, Bad and Sad echoes and enlarges upon Elaine Showalter's book The Female Malady: Women, Madness, and English Culture, 1830-1980. However, Showalter's perspective is more exclusively feminist, arguing that psychiatry as practised on women is a history of their subjugation and control by men. But as Appignanesi makes clear, women have had no little role in creating and fulfilling the definitions of their madness. The spreading and treatment-resistant phenomena of anorexia and bulimia are owned largely by women, who account for some 90 percent of patients with eating disorders and who are counseled and treated by an industry of specialists whose attempts to raise consciousness about these diseases have helped also to spread them, in much the same way that neurasthenia so captured the Victorian imagination.
Mad, Bad and Sad echoes and enlarges upon Elaine Showalter's book The Female Malady: Women, Madness, and English Culture, 1830-1980. However, Showalter's perspective is more exclusively feminist, arguing that psychiatry as practised on women is a history of their subjugation and control by men. But as Appignanesi makes clear, women have had no little role in creating and fulfilling the definitions of their madness. The spreading and treatment-resistant phenomena of anorexia and bulimia are owned largely by women, who account for some 90 percent of patients with eating disorders and who are counseled and treated by an industry of specialists whose attempts to raise consciousness about these diseases have helped also to spread them, in much the same way that neurasthenia so captured the Victorian imagination.
She begins with the 18th-century writer Mary Lamb, the co-author, with her brother Charles, of the children's classic Tales from Shakespeare. She uses her case to illustrate a time before professionalization of mind-doctoring. When Mary took a knife to their mother, stabbing her fatally, Charles saved her from a murder charge and death on the gallows. As soon as he found his mother dead, and a blood-spattered Mary still with the knife in her hand, he put his sister into an Islington madhouse, thus making it clear to the coroner and jury who promptly arrived to ascertain the facts that his sister should be classified as a lunatic rather than a criminal. He guaranteed that either he would care for her or that she would be cared for in a private madhouse. Given a private room and affectionate treatment by her nurses, Mary quickly returned to the self all her friends knew and loved. Her brother then took over the responsibility for looking after her.
By the time Mary was institutionalized, a new form of dealing with the mad had begun to take hold - physical brutality was replaced with moral authority. As Michel Foucault had pointed out, with moral management, the manacles, chains, handcuffs, strong chairs and scold's bridles - the whole apparatus of physical coercion - gradually went, to be replaced by the moral tools of talk, observation and judgement. Madness meanwhile had become feminized and tamed, no longer wild, raving and dangerous, but pathetic. In the nineteenth-century cultural idea about women - their supposed irrationality at a time when Reason was male - shaped the time's definitions and treatment of women's insanity. "Often enough," Appignanesi notes, "extreme expressions of the culture's malaise, symptoms and disorders mirrored the time's order." She describes ways in which mind-doctors have colonized our ways of thinking about behaviour and the inner life. She sets out to chart the way in which the mind-doctoring professions – from the early moral managers and alienists through to the neurologists, psychiatrists, psychoanalysts, psychotherapists, psychopharmacologists – grew into positions of power. She was also interested in knowing how it was that in our own period, now with the help of the drug companies and the brain imagers, the mind-doctors have come to dominate and provide the principal narratives and pictures through which we understand the self.
The lives of two women - Sylvia Plath and Marylin Monroe - are classic examples of growing up in dysfunctional single parent families. Plath's authoritarian father passed away when she was only eight. In her diary as well as in her autobiographical novel Plath reveals her hatred for her mother. Marilyn Monroe's father left her mother when she was pregnant with her. Twelve days after her birth her mother had a breakdown and she had to be institutionalized. Marilyn was boarded out to a family of religious zealots who talked of little but sin and hellfire. When she was six, a friend of the family raped her.
For the women's movement Plath grew into a saint of female victimization, her madness and suicide themselves signals of what patriarchy did to talented women who dared to aspire, and dared doubly by also loving passionately. In 1953 she made her first suicide attempt by taking an overdose of sleeping pills. She describes this period in the only novel she ever wrote, Bell Jar. In 1956 she married the poet Ted Hughes. During the second year of their married life, while Hughes's poetry met with increasing success, Sylvia struggled with writing, sexual jealousy and writer's envy. Depression, a sense of her own worthlessness and impossibility of the battle with language and form, gripped. In her last weeks Plath was provided a live-in nurse by her analyst while her children's flu took its course, then hospitalization was recommended for her. However, space wasn't instantly available. Soon after, on the evening of Sunday 10 February, 1963, she carefully prepared her children's breakfast, set the trays beside their beds, opened their windows and sealed their door. Then she went downstairs to place her head deep within the gas oven. She was thirty years old; her son had had his first birthday a month before, and the daughter wasn't quite three. 'Dying/ Is an art, like everything else./I do it exceptionally well', wrote Sylvia in Lady Lazarus.
Marilyn Monroe had committed suicide just six months before Sylvia Plath. Sylvia, the scholarship girl, and Marilyn, the blue-collar ‘orphan’, may have come from backgrounds miles apart, but both were trying, with working alliance between the feminine, the sexual and the thinking parts of their identity. Like Sylvia, Marilyn was also touchy and resentfully insecure about her place in the world and her husband’s love. She was also the addict, the heavy drinker and suicidally depressive madwoman. She was a borderline personality, addictive, needy, impulsive, and prone to bouts of rage and feelings of self-abasement compounded by sexual and emotional excess, unstable in her relationships as well as in her own identity. For young women growing up in the sixties, her plight as a beautiful woman tossed on the stormy seas of her gender and sexuality and trapped by the unconscious of others also reinforced their sense of a need for radical change. That need for change encompassed the psychiatric and psychoanalytic professions, which as guides for ‘a way of living’ seemed to have failed both Marilyn and Sylvia Plath, let alone countless unsung others.
An anti-psychiatry movement was launched as a part of the more general sixties political attack on the bastions of power and science from a variety of sites. Primary amongst these were the ranks of psychiatric profession itself. Thomas Szasz’s ground-breaking The Myth of Mental Illness and Erving Goffman’s Asylums were both published in 1960. InFrance
Feminism fuelled the anti-psychiatric movement. For the women’s movement, which championed before all else, taking control of one’s own life, including its sexuality, it now grew evident that what men, doctors and the world they had created had always done was to drive women mad by limiting their possibilities – by insisting on their sexual identity and their secondary status. Psychological characteristics, attributed to them by the patriarchy, had been naturalized and internalized as truth. Now women needed to expose the forces that had created their condition.
The triumph of Mad, Bad and Sad is to mix evocative case studies with the history of psychology and psychiatry. The conclusion one draws is that all men and all women, are mad, bad and sad at times and by labelling them we are simply labelling a human condition.
By the time Mary was institutionalized, a new form of dealing with the mad had begun to take hold - physical brutality was replaced with moral authority. As Michel Foucault had pointed out, with moral management, the manacles, chains, handcuffs, strong chairs and scold's bridles - the whole apparatus of physical coercion - gradually went, to be replaced by the moral tools of talk, observation and judgement. Madness meanwhile had become feminized and tamed, no longer wild, raving and dangerous, but pathetic. In the nineteenth-century cultural idea about women - their supposed irrationality at a time when Reason was male - shaped the time's definitions and treatment of women's insanity. "Often enough," Appignanesi notes, "extreme expressions of the culture's malaise, symptoms and disorders mirrored the time's order." She describes ways in which mind-doctors have colonized our ways of thinking about behaviour and the inner life. She sets out to chart the way in which the mind-doctoring professions – from the early moral managers and alienists through to the neurologists, psychiatrists, psychoanalysts, psychotherapists, psychopharmacologists – grew into positions of power. She was also interested in knowing how it was that in our own period, now with the help of the drug companies and the brain imagers, the mind-doctors have come to dominate and provide the principal narratives and pictures through which we understand the self.
The lives of two women - Sylvia Plath and Marylin Monroe - are classic examples of growing up in dysfunctional single parent families. Plath's authoritarian father passed away when she was only eight. In her diary as well as in her autobiographical novel Plath reveals her hatred for her mother. Marilyn Monroe's father left her mother when she was pregnant with her. Twelve days after her birth her mother had a breakdown and she had to be institutionalized. Marilyn was boarded out to a family of religious zealots who talked of little but sin and hellfire. When she was six, a friend of the family raped her.
For the women's movement Plath grew into a saint of female victimization, her madness and suicide themselves signals of what patriarchy did to talented women who dared to aspire, and dared doubly by also loving passionately. In 1953 she made her first suicide attempt by taking an overdose of sleeping pills. She describes this period in the only novel she ever wrote, Bell Jar. In 1956 she married the poet Ted Hughes. During the second year of their married life, while Hughes's poetry met with increasing success, Sylvia struggled with writing, sexual jealousy and writer's envy. Depression, a sense of her own worthlessness and impossibility of the battle with language and form, gripped. In her last weeks Plath was provided a live-in nurse by her analyst while her children's flu took its course, then hospitalization was recommended for her. However, space wasn't instantly available. Soon after, on the evening of Sunday 10 February, 1963, she carefully prepared her children's breakfast, set the trays beside their beds, opened their windows and sealed their door. Then she went downstairs to place her head deep within the gas oven. She was thirty years old; her son had had his first birthday a month before, and the daughter wasn't quite three. 'Dying/ Is an art, like everything else./I do it exceptionally well', wrote Sylvia in Lady Lazarus.
Marilyn Monroe had committed suicide just six months before Sylvia Plath. Sylvia, the scholarship girl, and Marilyn, the blue-collar ‘orphan’, may have come from backgrounds miles apart, but both were trying, with working alliance between the feminine, the sexual and the thinking parts of their identity. Like Sylvia, Marilyn was also touchy and resentfully insecure about her place in the world and her husband’s love. She was also the addict, the heavy drinker and suicidally depressive madwoman. She was a borderline personality, addictive, needy, impulsive, and prone to bouts of rage and feelings of self-abasement compounded by sexual and emotional excess, unstable in her relationships as well as in her own identity. For young women growing up in the sixties, her plight as a beautiful woman tossed on the stormy seas of her gender and sexuality and trapped by the unconscious of others also reinforced their sense of a need for radical change. That need for change encompassed the psychiatric and psychoanalytic professions, which as guides for ‘a way of living’ seemed to have failed both Marilyn and Sylvia Plath, let alone countless unsung others.
An anti-psychiatry movement was launched as a part of the more general sixties political attack on the bastions of power and science from a variety of sites. Primary amongst these were the ranks of psychiatric profession itself. Thomas Szasz’s ground-breaking The Myth of Mental Illness and Erving Goffman’s Asylums were both published in 1960. In
Feminism fuelled the anti-psychiatric movement. For the women’s movement, which championed before all else, taking control of one’s own life, including its sexuality, it now grew evident that what men, doctors and the world they had created had always done was to drive women mad by limiting their possibilities – by insisting on their sexual identity and their secondary status. Psychological characteristics, attributed to them by the patriarchy, had been naturalized and internalized as truth. Now women needed to expose the forces that had created their condition.
The triumph of Mad, Bad and Sad is to mix evocative case studies with the history of psychology and psychiatry. The conclusion one draws is that all men and all women, are mad, bad and sad at times and by labelling them we are simply labelling a human condition.
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