Lisa M. Hermsen. Manic Minds: Mania's Mad History and Its Neuro-Future. New Brunswick: Rutgers University Press, 2011. Illustrations. xiii + 154 pp. $69.00 (cloth), ISBN 978-0-8135-5157-9; $23.95 (paper), ISBN 978-0-8135-5158-6.
Reviewed by M. Lynn Rose (Truman State University)
Published on H-Disability (August, 2014)
Commissioned by Iain C. Hutchison (University of Glasgow)
Multiplicities of Mania
Manic Minds is a single-authored book consisting of five chapters. The chapters are framed by an introduction that takes the book’s subtitle, “Mania’s Mad History and Its Neuro-Future,” and an epilogue called “A Mad, Mad World.” Lisa M. Hermsen explores terms used to describe “mania,” especially the “manic episode,” in nineteenth- and twentieth-century American, British, and European writing; discusses the present state of terminology and its implications; and contemplates present and future combinations of psychiatry and technology.
Immediately in the introduction, Hermsen situates herself as a consumer of psychiatric services, having been diagnosed with an “abnormal neurotransmitter system” (p. 1). A narrative of the depiction of “mania” follows, with examples and illustrations of the ways in which “mania” has been associated with animalism, immorality, segregation, and medical categorization. Hermsen avoids treating manic states as complete social constructions while recognizing that variable criteria of “madness” make a consistent vocabulary impossible. After summarizing the objectives for each of the five chapters, she summarizes her approach: madness is performed, mania is crafted, and mental illness is practiced. The meanings of all descriptive states shift, change, and multiply within their historical contexts.
The introduction’s explanation of emblematic multiplication explains the title of chapter 1, “Mania Multiplies with Fury,” which consists of four “enactments,” an “interruption,” and a conclusion. The chapter provides an overview of diagnostic textual descriptions of mania. The first “enactment” takes the reader from Hippocrates to the end of the nineteenth century; “Enactment Two” traces psychiatric classificatory systems, especially the first through fourth iterations of the Diagnostic and Statistical Manual of Mental Disorders (DSM) (1952, 1968, 1980, 1994). “Enactment Three” interjects the parallel method of psychoanalysis, and “Enactment Four” summarizes the present state of diagnostic criteria for mania as a spectrum with specific subtypes. (The fifth edition of the DSM was in preparation but had not been released at the time of publication of Manic Minds.) The chapter ends by reminding the reader of the central point: the meanings of mania rest on symptoms. The scale of the categorization of symptoms, though, shifted and narrowed, coming to rest on miniscule criteria such as neurotransmitters.
Chapter 2, “Mania and the Iconography of Reform,” focuses on medical categorization and classification in nineteenth- and twentieth-century Europe, then discusses the asylum. Hermsen provides excerpts of the roughly contemporary Philippe Pinel and William Tuke, and traces the myth of asylum reform up to and through Michel Foucault’s reinterpretation. Turning to the asylum in the United States, Hermsen points out that the rhetoric of reform (i.e., cure of the inmate) had become embedded into the myth of the asylum. The bureaucracy of the asylum and the convention of reporting are detailed in the sections “Confinement,” “Classification,” and “Curable and Chronic Cases.” The section “Asylum Morals and Metaphors” is an overview of the myth of asylum reform in popular culture, from Dorothea Dix and Edgar Allen Poe to dime novels, and full-circle to Foucault. The chapter concludes with Benjamin Reiss’s 2008 critique of Foucault, Theaters of Madness: Insane Asylums and Nineteenth-Century American Culture. Reiss interprets the asylum not as an agonistic arena, but as an ongoing and dynamic cultural process and processing of culture. Hermsen points out that asylum reform—the “utopian dream and a dystopian nightmare” (p. 63)—relies on the iconic figure of the maniac, which provides a nice segue to the following chapter.
“Midwestern Mania: Genetics in the Heartland,” the third chapter, summarizes eugenic principles developed and codified by the Cold Springs Harbor Laboratory and its Eugenics Record Office and, more broadly, the ideas of genetics and inheritance. It also situates the period of eugenic science as a transition from mania as an individualized collection of general traits to a specific genetic phenomenon located in the diagnosis. While there are no startling revelations in this chapter, it presents the intertwined body and mind nicely: figure 3.2, “Mania depressus,” is an unremarkable photograph of an older and younger woman standing side by side outdoors and not exhibiting anything unusual, yet is used as an example of the dangers of generational mania. The chapter concludes with questions about new genomic medicine. Here, we see Hermsen’s very thoughtful reflection on her own experiences in the world of genomic psychiatry, as she submits to “this new enactment of mania” (p. 78). The chapter ends with a question: “If diagnostic identification and drug efficacy become possible, what will mania come to be if no longer the collective symptoms of madness?” (p. 80).
Chapter 4 assesses the value of mental illness narratives. “Manic Lives: Mad Memoirs” considers recent memoirs, such as Andy Behrman’s Electroboy (2002) and Kay Jamison’s The Unquiet Mind (1995). Hermsen poses questions about whether or not the authors of such accounts have the ability to perform with authenticity (she concludes that they do). The most engaging component of this chapter is Hermsen’s memories of her own mania, about which, to this point, she has been transparent but very reticent. In “Something Is Wrong,” she ends her own brief and poignant account: “I am bipolar and have a medical diagnosis. And I am a freak; I am mad. There are no two options; I am both and I am more. I can have it both ways” (p. 97).
Chapter 5, “Neuropsychiatry, Pharmacology, and Imaging the New Mania,” rests on the premise that madness moved from being medicalized to being technologized. This chapter is the most satisfying visually: the author compares a sixteenth-century image of the cerebral cortex with a contemporary image of an MRI and two nineteenth-century depictions—one a sketch and one a photograph—of a woman with “mania.” Neuro-imaging and especially psychopharmacology, Hermsen argues convincingly, has furthered the fragmentation of mania, which brings the book full circle to its initial intention of showing how mania is subject to multiplication. The phenomenon of merging technologies with humans already exists; our neuro-future is hazy. The chapter concludes by emphasizing that the language in which we speak of neuropsychiatry shapes our reality, and calls for “alternative rhetorics that leave us with more productive narratives” (p. 116).
The short epilogue is titled “A Mad, Mad World,” which would have been a trivializing subtitle had Hermsen remained outside her scholarship rather than identifying as an insider. One of the strengths of the book, though, is her awareness that she is both a participant and an observer, and that finding the balance between those identities is delicate. Remnants of classical mania survive in ever-multiplying categories of psychiatric disorders, and another rhetorical “interruption” could effect the possibility of a positive enactment of mania.
The core of the book is strong. Its chronological bookends—ancient history and neuro-future—are insufficient braces. The introduction presents the work as a “theoretical history” and claims a historical approach (p. 6), and Hermsen claims that a history of the concept of mania from Hippocrates to the present is possible. After a few glances at classical medical history, though, an abrupt shift to the DSM is followed by a leap to Pinel and Foucault. In chapter 1, the reader is taken from Hippocrates to the Middle Ages in two paragraphs without guidance to helpful and important works, such as those of Patricia A. Clark, C. F. Goodey, and Wendy Turner. It is not unusual to ignore the premodern era, but the lack stands out to me, an ancient historian. Clark’s work has been, until recently, difficult to find.[1] The book by Goodey, A History of Intelligence and “Intellectual Disability”: The Shaping of Psychology in Early Modern Europe (2011), came out the same year as Hermsen’s, and the collection edited by Turner, Madness in Medieval Law and Custom (2010), was published only the year before. Scholars whose work is in the other chronological brace will determine whether or not the discussion of the neuro-future is slim. It seems slim, especially because it is part of the book’s title.
The material will be of interest to scholars of cultural and literary studies, of ethics, and of medicine and psychiatry. Anyone engaged in the history and philosophy of psychiatric disability will find the work of great interest. Hermsen emphasizes the importance of understanding psychiatric disability as sets of rhetorical and performative interactions. As such, and on the one hand, the book will be of interest to disability historians, as well as to activists and consumers. The absence of reference to disability studies, on the other hand, will be disconcerting: even standard nods to any of the pioneering histories and cultural studies, such as those of Lennard Davis, Paul Longmore, David Mitchell and Sharon Snyder, and Rosemarie Garland-Thomson, are absent. Psychiatric consumers who are also activists and researchers, for example, Jean Campbell, are not mentioned. Current disability studies scholarship on asylums, and the construction of intellectual ability and disability and its embodiment would have deepened the narrative; probably, though, Patrick McDonagh’s historical and literary study of nineteenth-century institutioanalization, Idiocy: A Cultural History (2008), had just been published when Hermsen was completing her manuscript. The index, too, lacks such keywords as “activism”; the ADA (Americans with Disabilities Act); and, most noticeably, “disability” or “disability studies.” For that matter, neither Judith Butler’s work is cited in the bibliography nor is “performance” an index entry, so all of this omission could simply be a matter of choices made to fit limited space.
This volume is not an easy read or a quick read, nor does it have any reason to be easy or quick. It is, in fact, quite densely packed. A reader unacquainted with the history of psychiatry might be dissuaded by the technical terms, and a reader without a background in cultural studies might not appreciate the interweaving of medicine and literature. This would not be a good choice as a main text in any but the most advanced and specific courses, although its basic premises could be incorporated into class material. It should certainly be in every standard library collection.
Manic Minds presents a thoughtful organization of an ephemeral phenomenon, and is an important work of interdisciplinary scholarship. As an analysis of the constructions of mental disability and their social ramifications, it is an important contribution to disability history, even though the author does not acknowledge the field of disability studies. Hermsen took on the formidable challenge of naming mania as a phenomenon, untangling and making sense of its often-nonsensical documentation, and placing the entanglements into the historical context of representation, all while remaining aware that she is an actor in the performance, entangled in the tendrils that she analyzes. And she succeeds.
Note
[1]. P. A. Clark, “The Balance of the Mind: The Experience and Perception of Mental Illness in Antiquity” (PhD diss., University of Washington, 1993), full text forthcoming on History of Learning Disability, www.historyoflearningdisability.com.
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Citation:
M. Lynn Rose. Review of Hermsen, Lisa M., Manic Minds: Mania's Mad History and Its Neuro-Future.
H-Disability, H-Net Reviews.
August, 2014.
URL: http://www.h-net.org/reviews/showrev.php?id=40390
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