Greg Eghigian, ed. The Routledge History of Madness and Mental Health. Routledge Histories Series. New York: Routledge, 2017. 404 pp. $225.00 (cloth), ISBN 978-1-138-78160-3.
Reviewed by Michael Rembis (University at Buffalo (SUNY))
Published on H-Disability (February, 2018)
Commissioned by Iain C. Hutchison (University of Glasgow)
With the publication of two important edited anthologies, Mad Matters: A Critical Reader in Canadian Mad Studies (2013), edited by Robert J. Menzies, Geoffrey Reaume, and Brenda A. LeFrançois, and Madness, Distress and the Politics of Disablement (2015), edited by Helen Spandler, Jill Anderson, and Bob Sapey, one could argue that the relatively new multidisciplinary field of mad studies is beginning to cohere around a central set of concerns that focus largely on challenging Western psychiatric epistemologies and modes of intervention with the voices and experiences of pathologized and psychiatrized social actors both in the past and in more contemporary times. This promising new field, which is most evident in the United Kingdom and Canada and is energized by a creative and dialectical mix of activism and scholarship, should not be confused with the history of madness, a subfield within social history of medicine that began to emerge in the 1960s and became more widespread beginning in the mid-1980s. While the history of madness takes a more critical approach than older histories of medicine and psychiatry, which were written largely by physicians or by social scientists employed in medical schools or institutes, it cannot be considered part of mad studies or disability studies. Yet historians of madness have built a wealth of research that considers what has come to be known as "mental health" or "mental illness" and its (ostensible) treatment in various times and geographic locations. While mad and disability studies scholars may be critical of this work on any number of levels, they must nevertheless engage with it in meaningful ways if they want the important work that they are doing to circulate beyond their own relatively small but growing fields.
It is with this caveat in mind that I begin a review of The Routledge History of Madness and Mental Health, edited by Greg Eghigian, Penn State University professor of history and former director of the Penn State Science, Technology, and Society Program (2007-12). Eghigian, who describes himself as a historian "of both the human sciences and modern Europe," and as someone who is "particularly interested in how societies grapple with the questions and problems associated with modernity through the vehicles of science, technology, and medicine," has brought together the work of leading scholars in twenty-one different areas of study within the history of madness.
Comprising six parts, the collection sets a new benchmark in the growing subdiscipline of the history of madness, but it is not without its limitations. The topics covered in the book range from antiquity to the late twentieth century and from western Europe to Japan, Latin America, South Asia, and Africa. Refreshingly, there is little in the book on the United States or Canada, two countries that can receive a disproportionate share of scholarly attention within edited anthologies, especially within mad and disability studies. Noticeably absent in this otherwise broad range of geographic locations and time periods is any sustained discussion of madness or mental health in eastern Europe. The closest we come to eastern Europe is in chapter 8, in which Ilya Vinitsky, professor of Russian literature at Princeton University, presents an analysis of the life and work of Konstantin Batiushkov (1787–1855), whom Vinitsky describes as "a major poet of Russia's Golden age of poetry, one of the creators ... of Russian Romanticism," and someone who was institutionalized during his lifetime, to illustrate the pervasiveness of madness in (curiously) Western literature and the fine arts, especially during the nineteenth century (p. 156). "From the [Russian] Romantic vantage point we can observe the multi-century tradition" of the imbrication of madness and the arts and literature "in its complex richness," Vinitsky concludes (p. 167). According to Eghigian and to clinical psychologist and associate professor of psychology, Richard Noll, who authored chapter 18, "Psychosis," madness has powerful cultural resonances in Western (and Western colonized) cultures precisely because, as Noll argues in his chapter, it "implies no necessary historical or geographical or epistemic center" (p. 333). In his introduction to the book, Eghigian adds that madness "has always been entangled in the transformation and interactions of changing human aspirations and moralities." It has many "histories" (p. 2). And this is evident in The Routledge History of Madness and Mental Health.
Yet despite the apparent capaciousness and amorphousness of madness both as analytical concept and lived experience, the trend in the historiography and in The Routledge History of Madness and Mental Health is to create a single geographical and epistemic center, as well as a more or less linear historical narrative for madness. This becomes evident in the first paragraph, and ultimately the first sentence of the book, in which Eghigian invokes the American Psychiatric Association (APA) and its Diagnostic and Statistical Manual of Mental Disorders (DSM). Eghigian asserts that "many" contended that the APA, with the publication of the fifth edition of its DSM in 2013, "was responsible for irresponsibly medicalizing normality." While on the surface, this can be read as a critique of modern psychiatry (and perhaps the introduction of alternative ways of understanding "mental illness"), its more insidious and pernicious effect is to inscribe powerful and not easily dislodged Western psychiatrized epistemologies upon madness. This is evident to the point that Eghigian refers to madness as a "mental or neurological disorder" and as a form of "disease and disability," as well as a "problem" (p. 1). At one point in the introduction, Eghigian refers to the history of madness as "the history of psychiatry" (p. 8). He adds that even though "indigenous views of mental disorders" persist, "one of the most prominent topics authors in the book take up is the global spread of [Western psychiatric] knowledge and treatment practices" (p. 11, emphasis in original). While Eghigian and the rest of the authors in the collection remain sensitive to local cultures and contexts, as well as change over time, they nevertheless rely on and default to—to varying degrees—not only the language of Western psychiatry but also its temporal and spatial frames in their analyses of the history of madness.
Although the book is decidedly Western and modern (1800–present) in its focus, it is nevertheless an impressive and at times nuanced assessment of more than three decades of scholarship produced in the history of madness. Acknowledging the diverse and growing body of scholarship that explores madness and its history in various times and locations—but primarily in the global West or North and the modern era—Eghigian characterizes The Routledge History of Madness and Mental Health as "a snapshot of the discipline—an opportunity to see how leading scholars go about their work, the kind of evidence they use, the conclusions they are reaching, and their assessments of the historiography of madness today" (p. 3). With only three chapters that cover material before the seventeenth century and only one chapter on the "early modern healthcare market" (chapter 4), the collection will be of most value to graduate students and specialists interested in the history of psychiatry, asylums, and the creation of nosological systems and technologies of "care" in the nineteenth and twentieth centuries. Interdisciplinary scholars interested in such topics as the importance of visual culture in creating and documenting madness within psychiatry (chapter 9), psychiatry and religion (chapter 7), or the connections among dementia, aging, Alzheimer's disease, and madness (chapter 16) will also find this book a valuable resource.
Historians of disability will also be interested in chapter 15, "From the Perspectives of Mad People," written by long-time mad activist, historian, and ally of disability studies and mad studies, Geoffrey Reaume. In this chapter, Reaume brings his deep knowledge of patient life and asylum history to bear on a historiographical essay that offers a thoughtfully organized and carefully argued overview of first-person accounts of madness from biblical times to the late twentieth century. Interest in the "patient perspective" has been growing since the mid-1980s, and it is evident in the number of edited collections that reprint the writing of mad-identified people and historical monographs that take seriously evidence left behind by mad subjects. While Reaume admits that much more work needs to be done from the perspectives of the most marginalized mad people among us—poor people or First Nations peoples, for example—he argues that "the broadening of historical perspectives by and about people who experienced madness has provided a fuller and more authentic understanding of meanings and experiences of mental disturbance as understood by people who lived this history beyond the views of observers.... As historiographical developments recounted here indicate, the perspectives of mad people have made, and continue to make, an immense difference in the interpretations of the history of madness. The field can only advance by making such views central to the overall historical narrative" (pp. 292–293). The centrality of such views is something that people working in mad peoples’ history, disability history, disability studies, and mad studies will no doubt continue to take up in future research and writing.
Despite the problematic conceptualization and organization of the book, The Routledge History of Madness and Mental Health remains an impressive and valuable contribution to the history of madness. It has established a new benchmark that will no doubt inspire future researchers in a number of different areas of study.
. Penn State, College of the Liberal Arts, Department of History Directory, Greg Eghigian, http://history.psu.edu/directory/gae2 (accessed January 30, 2018).
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Michael Rembis. Review of Eghigian, Greg, ed., The Routledge History of Madness and Mental Health.
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