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Mediating Madness is mainly about the representation of mental illness in British TV and newspapers. It follows in the tradition of Otto Walh's 1997 US focused Media Madness: Public Images of Mental Illnessand the 1997 UK collection Media and Mental Distress, while moving in different theoretical directions. Both those earlier works are straightforward in their message: they argue that the media is full of inaccurate and stigmatizing portrayals of mental illness, which lead to worse treatment of the mentally ill and discrimination against them and their families.
While Cross agrees with much of what those other authors say, his approach is slightly different. His book is, by his own admission in the conclusion, hard to sum up, because there is no unifying argument or message. Some of the 6 main chapters focus more on describing certain genres of media rather than arguing for a large claim about the media. They are interrelated and cross-referencing, which does bring them together. Unfortunately, is it occasionally difficult to achieve clarity on what precisely the main claims of the chapters are.
Nevertheless, there is much here that repays careful reading. Chapter 1 is especially rich in its discussion of the notion of madness in the popular imagination. Cross discusses whether we should use the term madness, and examines the politics and ethics of the term. The major worry about it is that it is stigmatizing. Cross argues that while many media representations of mental illness are indeed problematic, it does not follow that we should just eliminate the concept of madness. He ties this to the idea that mentally ill people have distinct experience which we must pay attention to. He also argues that the concept of madness has a richness that is not captured by other less charged terms to refer to mental illness. His argument covers many relevant issues, and shows a strong understanding of the history of the literature about mental illness and culture in the last century, yet it is meandering, and hard to pin down.
This is particularly a concern in the second chapter, in which he argues against what he calls the standard view of viewing images of madness. The standard view is best represented by Otto Wahl, who argues that the stigmatization of mental illness today builds on the traditional images of madness that go back to ancient times. Cross argues that Wahl is wrong about this, because images need to be understood in their historical context. The meaning of madness changes over time; Cross uses the example of Bedlam to make this point. He goes over some of the history of that most famous place of madness, and shows how it changed over the centuries. He also goes into some of the history of photographing the mentally ill, as a way of scientifically documenting their different appearances. This is an extremely rich chapter that deserves careful study, and his basic point that the interpretation of images requires us to be historically contextual is very plausible. It would have helped to better motivate the need for the argument, however, since it is far from clear that Wahl's argument in his book rests much on any assumptions about the possibility of ahistorical interpretation of past images. Furthermore, even though he makes a general claim about needing to understand continuities of stereotyping against historical changes, he does not say much about how this affects our understanding of stigma. So we are left hanging.
The third chapter is an informative discussion of activist journalism and reportage covering mental asylums in the nineteenth and twentieth centuries. As we would expect, Cross puts this work in historical context, and he remains mostly descriptive, with comparisons of different kinds of reporting and discussion of what effects the writing might have had. His main examples are Charles Dicken's account of his visit to a madhouse on Blackwell's Island next to Manhattan in 1842, which compared very poorly to his visit to St. Luke's Asylum in London in 1852. He compares these with the account of a madhouse by 'Nellie Bly' in 1887; this was the pen name of the journalist Elizabeth Jane Cochrane. Cross describes "10 Days in a Madhouse" as voyeuristic. From the mid-twentieth century, he describes "Bedlam 1946" by Alfred Maisel and Shame of the States by Alfred Deutsch. All these forms of writing were aimed to provoke an improvement in the conditions of asylums. More recently in the UK, journalist Marjorie Wallace wrote a series of articles in 1985 and 1986 on schizophrenia, "the forgotten illness," for the Times. She later went on to form the charity SANE, which advocates for people with schizophrenia. Cross also mentions some TV documentaries that expose the inadequacies of institutional psychiatric care. This is an interesting chapter, in that most readers will learn something new, and the theme is one that deserves investigation. It is less clear how it fits with the other chapters though. We might also wonder about his selection of cases. Presumably there are not many cases of activist journalists in the nineteenth century who highlight madhouses, but as he moves into the twentieth century and he moves from newspaper to TV, the number of possible cases to choose from grows substantially. That leaves us with the question of why he chose the cases he did, and how representative the cases he chose are of more general trends. This is a major methodological issue in cultural studies. Cross does not completely ignore it, and he makes no claims to be surveying a representative sample. But still, for his approach to have any generalizability, that is a desideratum.
This issue of whether the analysis of particular texts or multimedia items serve as illustrations of or evidence for more general claims is crucial in the next chapter also, on the depiction of mentally ill people as criminals. Cross takes some of the most notorious mentally ill killers in the UK and examines how the popular press portrays them, including the "Yorkshire Ripper" Peter Sutcliffe and the "Moors Murderers" Myra Hindley and Ian Brady. Cross claims, quite plausibly, that the UK psychiatric profession is engaged in shoring up its reputation in the popular media. He argues that they go about being the "preliminary mediators of madness," a phrase that is not transparent in its meaning. He examines some of the coverage in newspapers of the original crimes and the subsequent trials and prison lives of these criminals. He also covers some cases where psychiatric patients who have previously committed violent crimes have been judged to be safe by psychiatric experts, only to be released and commit more violent crimes. These events are used by tabloid newspapers to pour scorn on psychiatric expertise. Cross covers extremely interesting ground and provides some excellent material for analysis, but in the end comes to a safe conclusion that "the tabloid press provide a particular and distinctive frame on the criminally insane" (127); this is true enough, but to get here he has only examined a few cases, and the only way that we can assess the truth of the claim is by being familiar with the tabloid press he is discussing and having a sense whether the cases he discusses are representative. My sense is that they are.
The fifth chapter may be the one in most need of simplifying and clarifying. At its heart is a very interesting project of documenting the representation of people with schizophrenia. He covers Titicut Follies, Michael Apted's Up series, and some recent UK TV documentaries. It is not clear that all of these deal with schizophrenia specifically, which leaves us wondering whether it might not be better to be clearer about what group he is discussing. Nevertheless, Cross is astute in his observations about each of the pieces he discusses, and good at comparing them. However, it is really hard to get to those observations without having to get through a great deal of theoretical apparatus that ultimately does not seem to do any work in the conclusion. Cross does build on the work of Sander Gilman and he mentions other writers and theorists. The main conclusion seems to be that some televisual representations characterize people with schizophrenia as looking bizarre and some characterize them in other ways.
The final chapter is co-written with Graham Murdock, and is also about the representation of madness in UK TV shows. It provides a historical account that contextualizes the different kinds of show under analysis. The authors note that there are pressures on TV to draw with viewer in by using celebrities who have mental illness themselves, and to simplify and sensationalize the issues. They hold out some hope that the internet can provide a space for other sorts of portrayals of mental illness. However, for viewers without access to the shows under discussion, it will be very difficult to assess the descriptions that this chapter makes, or to make much use of their analysis. That is to say, this part of the book is especially restricted in interest to those with access to UK TV archives -- although we might hope that some of the programs under discussion can be found on the internet.
As a whole, there is a lot in Mediating Madness that deserves study, but it is a difficult book to make use of, especially for readers outside of the UK. It is certainly a difficult task to balance approachability with theoretical depth, but Cross too often makes his ideas unnecessarily complicated with his references to the existing literature. More than once he mentions the historian of madness Roy Porter, who had a great ability to provide analysis in ways that are clear to a general readership, and this book would have been much better if he had been able to model his approach on Porter's. In terms of its content, it fills a gap in the literature, but it is a specialized resource. It is not a book I would use in an undergraduate course, although I might discuss some of Cross's observations in lectures. We can hope that he continues this line of scholarship and does work that will make his main theses clearer and will be appreciated by a wider readership.
© 2013 Christian Perring
Christian Perring, Professor of Philosophy, Dowling College, New York