Review: The Female Malady

[Elaine Showalter. The Female Malady: Women, Madness, and English Culture, 1830-1980. New York: Pantheon Books, 1985.]

It may be a little strange to value writing that would normally be understood as unremarkable; the hectic period over which I've been reading this book may explain my appreciation for it in this instance. This book does not contain the sort of angry poetry or playful challenge that might make the writing stand out in a positive way. But neither does it plod or drag or confuse or annoy. It does what it needs to do, and it does it extremely smoothly. This is academic feminist history, so it is fairly dense and somewhat staid, but despite that and despite consuming this book in relatively small and irregular chunks -- and despite the various intensities pulling me in other directions -- I always found it easy to slip into and out of the flow of this book.

As the subtitle indicates, the focus of this book is women's experiences of "madness" and psychiatry in Britain between 1830 and 1980. This is a pretty sizeable chunk of time, and it encompasses a number of distinct eras. The earliest period, which maps roughly onto the early Victorian era, was optimistic that madness could be cured and its key figures were zealous reformers moving Britain's asylums from blatant confinement to what was called "moral management." The physical restraints and open brutality of asylums in the early 19th century gave way to a tightly regimented paternalism and intense surveillance framed in moral terms that saw itself as purely humanistic and benevolent. By the later Victorian era, this optimism had shifted to a profound pessimism that believed little or nothing could be done about madness. The well-appointed, (physically) comfortable institutions of moral management quickly became overcrowded and were once again little more than human warehouses. The dominant discourse of psychiatry in this era was steeped in Darwinism, and mental illness was seen as a sign of degeneracy.

The next phase was World War I, when the impact of male soldiers suffering from "shell shock" forced British psychiatry to rethink many of its assumptions from the pre-war years. This evolved into what Showalter describes as "psychiatry modernism," which had both a medical psychiatric strand and a psychoanalytic strand. And, finally, there was the eruption of anti-psychiatry thought and action in the 1960s and 1970s, as epitomized by the works of R.D. Laing.

The book looks at the psychiatric practice in each period, often in part through biographical examination of key practitioners in each era, and at literary representations of madness as a way to understand how it was perceived by the broader culture. Throughout all of the eras examined, with one partial exception, there was a strong link between conceptions of the female and conceptions of madness. Psychiatric practices were highly gendered, and almost uniformly the patient population was majority female and practitioners were mostly men. Even in the later periods when more women began to take up professional roles, control over standards, practices, and politics within the professions remained mostly masculinist. From what I understand, subsequent historians have demonstrated that Showalter's assessment of how these things were gendered may make it appear more monolithic and less nuanced than it actually was, but have not fundamentally challenged the idea that psychiatry and madness were organized in gendered ways. And the cultural link between femininity and madness is quite conclusive. The major exception to the centering of women in notions of madness was during the First World War, when huge numbers of English soldiers suffered from what was colloquially known as "shell shock" but which in symptoms and origins was actually just the quintessential female diagnosis of the late Victorian and pre-war years -- hysteria -- rearticulated in masculinized ways. This juxtaposition of the situations of men as soldiers and women under the sorts of rigid patriarchy of England in that era is quite powerful, and suggests explorations that I'm sure other feminist authors have developed in interesting ways.

Also of particular interest to me was her final chapter on British anti-psychiatry. It focuses quite extensively on the career of Scottish shrink and cultural icon R.D. Laing, and provides a nuanced but critical appraisal of his practices and legacy from a feminist perspective. This chapter wasn't quite as directly useful to my own work as I might have hoped, and I can't tell to what extent this is because of differences in the movements in question and to what extent it is about choices by this author in presenting the material, but the anti-psychiatry networks clustered around Laing in Britain in the '60s seem a bit different (in ways that I'm not sure I could fully explain at the moment) from those experienced by my interview participant in North America a little bit later.

Anyway, this is a pleasant read, and one that is useful to me in building my general understanding of the history of psychiatry, its relationship to oppression, and struggles against it.

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