Sunday, September 07, 2008

Review: Sad, Mad and Bad

[Lisa Appignanesi. Sad, Mad and Bad: Women and the Mind-Doctors from 1800. Toronto: McArthur & Company, 2007.]

This is the book that I wanted it to be. It may not be everything, but it is just what I was looking for.

As the subtitle indicates, Sad, Mad and Bad is a historical survey that looks at various kinds of "mind-doctors" over the past two centuries, with particular interest in the experiences of women and a focus on the United States, the United Kingdom, and France. It is skeptical and critical. It is story-based, with a focus on individuals, especially well-known doctors and patients. It uses an eclectic mix of sources. It manages significance without any pretence of completeness. Its bias, which it keeps in check but does not hide, favours talk- and care-based approaches but recognizes the good and bad that all ways of responding to what we currently call "mental illness" have entailed.

In particular, I like how in its tracing of the evolution of mind theories, and of diagnostic categories, it illustrates their socially constructed character. It doesn't necessarily exhaustively explore how they are socially constructed, but it is matter-of-fact and accessible about the fact that people's sufferings are real, but the categories to which they are assigned, the assumptions about appropriate social responses, and even the ways in which symptoms cluster and are co-created in some situations by those who see themselves as providing treatment, are a product of more than what is going on inside an individual person. It should be obvious just because of the changes in understandings of mind and mind-doctoring over time that this is the case, but I think it is often hidden by the powerful narrative of progress that dominates our society -- changes happen, we are told, because through Hard Work, things get Better and we more closely approach Truth. She could have addressed this reading more directly, I suppose, but still makes it quite obvious that it is not her take at all.

There are a number of things that this book is not. It is not terribly concerned with the ways in which mind-doctoring might or might not be related to projects of ruling over the course of the development of capitalism, and it only sporadically deals with how mind-doctoring is integrated into broader social relations. It consistently pays attention to gender, and in places offers insights that (though not necessarily phrased this way) talk about the gendered emergence of the modern subject, a project helped along by mind-doctors. However, though I don't know much about it, I have the sense that the emergence of the modern Western subject was also intimately connected to colonial encounters with the Other, and that such things were not without impact on theories of mind. However, this goes largely unmentioned, as do race and racism in the 20th century West. There is also little mention of the history of mind-doctors producing, regulating, and punishing queer sexualities.

Finally, and most directly relevant to me, there is part of a chapter devoted to anti-psychiatry. You see, the reason I'm reading this is because the upcoming chapter I will be working on for my book focuses on an individual who has been active in the anti-psychiatry movement in Canada.

Like I said, this is the book I wanted it to be. It provides an overview and some introduction to various critical perspectives, even if there are lots of things that interest me that it leaves untouched. As I do more reading for this chapter -- and at the moment I'm actually working on a different writing project that has nothing to do with the book, but I'm hoping that will be largely done by the end of this week -- this will be a useful reference and source of context.

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