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Appignanesi's huge, rather rambling compendium embeds case histories in both detailed cultural-historical material (especially as it concerns the various mind doctors who treated these female patients), as well as commentary by today's theorists, such as Foucault, Hacking and Showalter. This makes for an at times readable, but often unwieldy, whole.
In themselves, the case histories are fascinating, especially those neglected by others writing about the stretch Appignanesi's explorations cover – the last two hundred odd years, that saw the emergence of clinical psychiatry as a response to madness.
Mary Lamb's story, with which the book opens, is one of these neglected ones. Author, with her younger brother Charles, of the ever-popular Tales from Shakespeare, Lamb was a member of London's literary circles at the very end of the eighteenth century and beginning of the nineteenth. She endured straightened circumstances, supporting her invalid mother and senile father, until the day she stabbed her mother to death with a kitchen knife. She was then briefly institutionalized and released in the care of her devoted brother. Despite further intense episodes of madness, for which she needed to again be temporarily secluded, Mary Lamb lived out the rest of her life, under the watchful eye of her brother, in an apparent state of psychic equanimity; indeed, she was remembered as a paragon of calm and thoughtful reasonableness.
Another case of homicidal madness recounted by Appignanesi, this one more familiar from Foucault's writing, is that of Henriette Cornier. In 1825, then a young woman working as a domestic in Paris, Henriette Cornier kidnapped and coolly beheaded the nineteenth month old child of neighbors. As Appignanesi graphically writes:
Henriette cuddled the child fondly to her. When she reached her own room with its window overlooking the rue de la Pépinière, she stretched little Fanny out on the bed. With one hand she held up the small head and with the other, sliced it off. The child didn't have time to scream. Blood spurted everywhere -- on Henriette, on the bed, and into a chamber pot placed at exactly the angle needed to catch the flow. Henriette put first head, then body, on the window ledge. (page 73)
Appignanesi recounts the sequelae of this chilling incident with careful detail - the police, the trial, the attempt to portray Henriette as more mad than bad, the diagnosis ("homicidal monomania"), and the politico-legal debate that it engendered.
Some of these stories -- the familiar sagas of Virginia Woolf, Zelda Fitzgerald, and Sylvia Plath, for example -- are by now well worn, and arguably over-exposed. This introduces one sort of challenge for Appignanesi's project. Such case histories deserve retelling only if in doing so the author is able to shine new light on them, either from additional historical evidence, or through theoretical analysis. And this, I think, Appignanesi fails to do. Undoubtedly, the generous historical-cultural contextualizing that she provides is valuable. Her account of the particular mind doctors and the way they construed their patients' conditions through the assumptions and expectations of their own times is interesting and does much to make sense of these mad women. But, especially with these overly familiar cases, it has been done before, and better, by others. In such shop-worn stories, Appignanesi adds nothing fresh enough to warrant their retelling. (The same sort of criticism applies to her showcasing of certain apparently rather arbitrarily selected clinicians. Added to the vast bodies of research about figures such as Pinel, Charcot and Freud, for example, the few pages she devotes to each are otiose.)
Arguably, in the less familiar cases such as that of Mary Lamb, Appignanesi is at her best. And her "embedding" approach -- of providing the when and where and how and why, as recognized by the culture of the times and identified with hindsight from our contemporary perspective, is in principle an admirable one. Yet here, too, the book fails. Too much minutiae; little effort to separate salient points from mere details; and a timidity around theorizing or proposing policy, leave the reader at awash in a mass of details.
Even without a crisper organization, better elucidated and emphasized themes, and a more robust set of observations and conclusions, this book would have been more navigable were there helpful chapter headings. But other than knowing that these cases and ideas are ordered chronologically, we are provided with the merest hint of the content of each section: clever and evocative they might be, but chapter headings such as "Nerves," "Sex," "Rebels," and "Abuse" constitute imperfect and quite insufficient guides.
In her defense, it may be said that what seems to be Appignanesi's main thesis -- that madness is culturally shaped and can only be understood through the historical-cultural setting within which it occurs -- is one whose demonstration must be messy and inchoate, the way culture itself is. Well, perhaps. But this is a book, not a culture.
© 2008 Jennifer Radden
Jennifer Radden, Department of Philosophy, University of Massachusetts, Boston