- Paperback: 560 pages
- Publisher: W. W. Norton & Company; 1 Reprint edition (August 31, 2009)
- Language: English
- ISBN-10: 0393335437
- ISBN-13: 978-0393335439
- Product Dimensions: 5.5 x 1.2 x 8.2 inches
- Shipping Weight: 1 pounds (View shipping rates and policies)
- Average Customer Review: 4.0 out of 5 stars See all reviews (7 customer reviews)
- Amazon Best Sellers Rank: #784,857 in Books (See Top 100 in Books)
Enter your mobile number or email address below and we'll send you a link to download the free Kindle App. Then you can start reading Kindle books on your smartphone, tablet, or computer - no Kindle device required.
To get the free app, enter your mobile phone number.
Other Sellers on Amazon
+ Free Shipping
+ Free Shipping
+ Free Shipping
Mad, Bad, and Sad: A History of Women and the Mind Doctors Paperback – August 31, 2009
Frequently bought together
Customers who bought this item also bought
From Publishers Weekly
Award-winning British novelist Appignanesi (The Memory Man) has written a fascinating if somewhat diffuse study of how, over the past two centuries, women's ability to live creative lives has been controlled by culture, and how their unsuccessful attempts to rebel frequently lead to mental illness-itself a slippery, ever-evolving cultural concept. Appignanesi's sources are wide-ranging but largely literary, based upon letters, diaries, articles and fiction from feminist writers such as Betty Friedan, historians like R.D. Laing and Jacque Lacan, psychologists such as Melanie Klein, and troubled subjects like Zelda Fitzgerald and Marilyn Monroe. Beginning with the lives of mentally ill women in the 19th century, Appignanesi moves chronologically through the history of psychology-as ideas like schizophrenia replace earlier notions of hysteria-and its relationship to the creative woman, using in-depth profiles of Virginia Woolf, Alice James and others. Looking at the complex cultural, political and familial circumstances under which mental illness emerges, and their implications for the present (in which depression and eating disorders have become major problems), Appignanesi convincingly asserts that "symptoms and diagnoses... cluster to create cultural fashions in illness and cure," suggesting provocatively that "what is at issue here is not psychic disorder so much as social deterioration of a radical kind."
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved. --This text refers to the Hardcover edition.
“Ambitious . . . brilliant . . . a powerhouse of a book.” (Daphne Merkin - New York Sun)
“Sophisticated, vigorously written, full of striking subtexts . . .an entertaining and well-researched book that avoids easy answers.” (Andrew Scull - Times Literary Supplement)
“Fascinating. . . . A meticulous and exhaustive account.” (Kathryn Harrison - New York Times Book Review)
Browse award-winning titles. See more
If you are a seller for this product, would you like to suggest updates through seller support?
Top Customer Reviews
The first part of Mad, Bad, and Sad concerns the case of Mary Lamb, who stabbed and killed her mother in 1796. The description of Mary's case is exhaustive--and exhausting--filled with largely irrelevant details and faulty conclusions. The idea that Mary's "cold, uncaring mother" was partially to blame for Mary's mania is classic, and very outmoded, second generation Freudianism. Even more behind the times is Appignanesi's statement that "Throughout the nineteenth century, talented middle-class women were able to shake off the chains of their socially restricted forms of usefulness by unconsciously choosing invalidism as a preferable form of life." (p 44) The claim that an illness is a liberating lifestyle choice is not only absurd (how can becoming ill "shake off chains"?), it cannot possibly be substantiated. Indeed Appignanesi makes no attempt to do so, as she has simply lifted this idea from earlier feminist writings (which also failed to consider rib-crushing corsets, rampant industrial pollution, and the lack of antibiotics as possible causes of 'invalidism').
If Appignanesi had simply limited herself to antiquated Freudian and feminist interpretations, this book might have been somewhat salvageable, but she descends into sheer lunacy when she claims that "The ever resisted notion of infantile sexuality--which most recently has found our cultural abhorrence of its extreme writ large in the scapegoating of 'paedophiles' - has continued to be the manifold structure which analysts focus on within the analysis, precisely because it so often results in producing what is called the 'negative' transference." (p 201) Aside from the fact that this sentence is nearly unintelligible, it expresses the idea that pedophilia, or the suspicion of pedophilia, is due to the fact that as a culture we cannot accept the idea that infants are sexual. What, in heaven's name is Appignanesi thinking?
What Appignanesi is thinking is that allegations of child abuse are a form of "mass hysteria." In the section entitled "Abuse", Appignanesi states that "Being alive as a woman at the end of the twentieth century meant to be an incest survivor." (p 416) This sort of sweeping, unfounded generalization characterizes Appignanesi's writing throughout the book, but in this context it becomes simply repugnant. Like the Freudian psychoanalysts who ignored their patients' real suffering by reducing incest to "incest fantasies", Appignanesi simply dismisses the reality of widespread sexual abuse. Indeed, she takes it one step further by implicating the child.
In her discussion of "the redoubtable" Phyllis Greenacre's claim that because children experience sexual pleasure, they are participants in their own trauma--and it is worthwhile to point out here that this idea is shared only by child molesters--Appignanesi says "Our turn-of-the-century idea of 'sexual abuse' hardly permits this possibility through the door." (p 421). It is not our "turn-of-century idea" which does not permit blaming a child for rape, but our laws. Sex with a child is, by definition, non-consensual. Whatever Freudians may believe regarding infant sexuality is utterly irrelevant. The same holds true for whatever Appignanesi believes.
In sum, this book has as much value as a high school term paper. Perhaps less. (I doubt any high school student could get away with some of the atrocious claims that Appignanesi has managed to get into print.) If you are interested in a good critique of "mind doctors", read Jeffrey Masson's "Against Therapy" or anything by Peter Breggin. Both authors know what they are talking about.
Chapter One “Mad and Bad”
Appignanesi explores the early “Georgian”, or time contemporary and influenced by the literary romantic, understanding of mental illness through the story of English brother and sister, Mary and Charles Lamb. They are notable for numerous reasons, including the co-authoring and editing of various popular and poetic literary works together, friendships with other English poets, and most notoriously, Mary’s killing of their mother. The first chapter also develops an understanding of the way in which literary and philosophical conceptions of madness were expressed through and shaped the expressions of Charles’ and Mary’s understandings of madness. Specifically, Appignanesi indicates the prominence of the thought of John Locke and Jean Jacques Rousseau, whose articulations and language were employed in the correspondences and semi-autobiographical pseudonymous writings of about madness penned by Charles and Mary.
Chapter 2 “Passions”
Appignanesi marks a change between the treatment of madness in the case of Mary Lamb to that of Henriette Cornier. In the elapsed time (and place), madness came to be understood much more on a continuum with normalcy. The continuity produces a kind of complexity that requires expertise and knowledge to understand and comprehend. The terminology changes (under the influence of new “Alienists” such as Pinel) and new distinctions are created and map madness differently.
Chapter 3 “Asylum”
The third chapter charts the rise and fall of the use of asylums to house mentally ill people. Dr. Thomas Pritchard “abolished all mechanical restraints during their tenure from 1838”, offered “moral” treatment instead, consisting in “kindness, a soothing relationship between doctor or carer and patient”. The Asylum became viewed as a “therapeutic tool” which employed “women’s moral energies” of “love, patience, and fortitude”. Mental health care was conceived of in feminine terms. Through this time there were also multiple forms of abuse perpetrated by the new "alienist" experts:
-refusal of doctors to admit mistakes in diagnoses
-closing ranks and defending one another’s mistakes against the patient
-Colluding with abusive fathers and husbands, particularly against wives and daughters.
-Entrapment within diagnosis.
Ch. 4 “Nerves”
As the title suggests, the chapter focuses upon a new way of conceiving of madness in terms of the term ‘nerves’. She explains again, as she had in previous chapters, that the older meaning of the reference to nerves was as an adjective that when applied meant something like brave, courageous, resilient. What is generally meant when it is said still “you’ve got a lot of nerve!”
Nerve also had the sense of referring to an opposition that seems like the mind vs. the body, with the latter represented by “muscular” (p. 114). The general prescription for disorders of nerves was conceived in terms of The Rest Cure. It was conceived as the “breaking up of bad habits” by cutting off the patient from the normal influences of their life, and feeding them a lot but depriving them of social relations. Also there is an emphasis of shoring up of the patient’s will-power.
Ch. 5 “Hysteria”
A notion central to the conception of mental disorders in the middle nad end of the 19th century was "hysteria". Appignanesi begins the chapter remarking that initially “[i]n France, full-blown hysteria was a condition of the poor”.
The invention of the medical diagnosis of hysteria was part of an anti-clerical movement, or more generally the French “battle for secularism”. The Church held but lost substantial influence over the prescribed social roles of women, especially as regarded their sexuality. The behavior through which hysteria was described was often transgressive of the social norms attaching to women: sexual promiscuity, intellectual activity, expressing themselves through activity not confined to the household. The author explores hysteria through the case study of “Augustine”, a patient of Charcot’s. Appignanesi recognizes Freud for theorizing the cultural contribution to hysteria, in the sense that he saw that it was a consequence of the tension created between the hypocritical expectations on women to demonstrate a chastity and moral purity that was not expected of men and unrealistic of women. The 19th century had produced problems that expressed themselves through hysteria by its denial of women’s sexuality. Freud’s medical theorization of the problem condemned the hypocritical morality of the time, which was at once a criticism of religious morality.
ch. 6 “Sleep”
The title of this chapter is deceptive, as Appignanesi uses it to refer to several different things: hypnotism, the occult, seances, and psychoanalysis. What they all have in common is an underlying interest in the importance and exploration of something as mysterious and as present to something as our sleep, and perhaps especially in our sleep: a sub- or un-conscious. Appignanesi follows the lead of William James’ and Morton Prince’s interests and investigations of the occult, before shifting to a focus upon the hypnotism.
ch. 7 “Sex”
In chapter 7, “Sex”, Appignanesi explains the meeting of traditional sexual morals for women with a new scientific understanding of sexuality. The new understanding is largely destructive of the old sexual morals.
Ch. 8 Schizophrenia
Appignanesi begins the chapter referring to Dr. Emil Kraepelin (1856-1926) and his initiation of the diagnosis of schizophrenia. The narrative then follows Dr. Eugen Bleuler (1857-1939) and the paths of doctors and patients who proceeded through the hospital of which he was in charge, the Bürgholzli in Switzerland. Bleuler was a close corresponder with Freud. Carl Gustav Jung (1875-1961) was a young resident at the Bürgholzli, and began the treatment and relationship with the patient Sabina Spielrein (1885-1942) Freud interpreted the symptoms attributed to “Schizophrenia”, specifically the hallucinations, through the concept of repression and an attempt to withdraw from the world. Similar to Depression, as presented by Freud under “Melancholia”, the hallucinations are a residue of cathexes. Instead of giving rise to paranoia through projection, the meanings are more free-floating residues of former meanings appearing. The story of Schizophrenia also follows the lives and treatments of Zelda Fitzgerald and Virginia Woolf.
Ch. 9 “Disturbances of Love”
The chapter opens with the description of the attention that psychiatric cases of madness had for Surrealist intellectuals inteh the early 20th century. Appignanesi brings together several themes. On the one hand, several case histories of well-publicized madness in France exemplify the way that erotic attraction appeared as the key to extreme cases of psychoses. This was important in part because Freud himself had thought that psychoanalysis could only likely be helpful in treating neurosis among reasonably well-adjusted persons. A psychoanalyst who has become only second to Freud in terms of intellectual influence in psychoanalytic studies, Jacques Lacan (1901-1981), rendered ingeniously complex interpretations of the symptoms of psychotic patients. These interpretations made the psychoses intelligible in the same terms as more traditional neuroses. In those interpretations, the psychoses that manifested themselves in violent attacks were explained by Lacan as disturbances of love, or erotic fixations.
ch. 10 “Mother and Child”
Appignanesi follows the history of four psychoanalytic theorists: Anna Freud, Melanie Klein, D.W. Winnicott, and John Bowlby. The four are important to the history of psychoanalysis partly because of the rupture to what semblance of unity there might have been among the various psychoanalytic schools. Despite this, the similarity of their thought, and especially their theorizing the importance of the child is remarkable. The child became an important preoccupation because children were notably affected during and in the aftermath of the second World War. There were many war orphans, and many other children who were psychologically disturbed by the bombings, especially of Great Britain.
Ch 11 “Shrink for Life”
Appignanesi describes the famed account of literary and film stars, Sylvia Plath and Marilyn Monroe. Both of these celebrities (Plath didn’t achieve full fame until after her death) had troubled childhoods and psychiatric histories, and each found treatment with psychoanalysts during the 1950s when psychoanalysis in the United States was influential in healthcare, movies, and among artists and intellectuals. Both of these artists also ended their lives in suicide. Appignanesi provides detailed accounts of the troubles they grappled with, the psychoanalytic treatments they depended upon, and the psychoanalysts who treated them. The complex descriptions of each of their cases present a kind of apology for the psychoanalytic treatments they received, against later accusations and apparent scapegoating of psychoanalysis made in the popular media of their demises.
Ch. 12 “Rebels”
The chapter entitled “Rebels” focuses upon proponents of the anti-psychiatry movement and feminist criticisms of psychiatry and psychoanalysis. The chapter opens with case anecdotes from Andrew Scull’s Madhouse, 2005, which document incredibly tortuous “treatments”, including surgical organ removals, that were forced upon patients within the 20th century. The life and positions of R.D. Laing, well-known for heading the anti-psychiatry movement, are examined. Finally, the complex relationship between Freudian psychoanalysis and the feminist movements are presented, in which Freud at one time was seen as a symbol and main culprit in purveying, and making sound scientific, patriarchal notions, and is also, along with his followers, viewed as a theoretical ally and inspiration to theorizing the confluence of culture and upbringing to producing oppressed and oppressing psychologies.
ch. 13 “Body Madness”
Appignanesi examines anorexia and bulimia. She offers as an example the struggle with Bulimia suffered by Jane Fonda.
ch. 14 “Abuse”
Appignanesi’s chapter on abuse covers a wide range of topics including child sexual abuse, the development of the concept of trauma and post-traumatic syndrome disorder (PTSD), debates regarding “recovered memory”. The latter topic, that regarding recovered memories forms an interesting part of her discussion. She links several cultural forces to what influenced and was at stake in the debate, including the women’s movement.
ch. 15 “Drugs”
The final chapter focuses on the contemporary models of diagnosis, the DSM, and treatment, psycho-pharmaceuticals and cognitive-behavioral therapy (CBT). The origin of the current paradigms has an interesting history. Appignanesi remarks that the United States' primary mode of understanding and treating mental disorders went from being the least biologically oriented of all industrialized countries to turning radically toward biomedical understandings and treatments. The rise of “Big Pharma” or the pharmaceutical industries, which produce our psychopharmaceuticals, initiated its foray into treatment of mental disorders with the discovery and development of Meprobamate and Benzodiazepan in the 1950s and 1960s, and reached a peak that it has not descended from with that of Prozac in the 1980s. While Appignanesi expresses appreciation for what these have offered, she also critically points out several ways in which those innovations have ominous side-effects. From the creation of chemical dependency, to the treatment-driven medical model that does not strive to understand underlying mechanisms and dynamics, to the pervasion of medical diagnostic language into everyday life and self-understandings, the author urges caution and circumspection along with the general celebration of the apparent advances of the biomedical model of mental health intervention.
Other Amazon reviewers of this and the (identical) edition printed on the other side of the Atlantic ocean seem to have poorly misunderstood Appignanesi's discussions of child sexual abuse. A careful reading of her treatment of this topic does not suggest that the author denies its existence and prevalence, nor that she is interested in defending abusers. Rather, the author is interrogating the meaning of it in the clinical understandings which both work upon and are worked upon by popular understandings. The "hysteria" that she refers to in relation to child sexual abuse is that related the epidemic of diagnoses of "multiple personality disorder" and the problem of "recovered memories" which problematized the epistemology and forensic employment of therapeutic remembering. Appignanesi discusses these topics with delicacy and insight, which unfortunately has not prevented those who have read without sufficient care from misunderstanding.