Mad, Bad And Sad: A History of Women and the Mind Doctors from 1800 [Paperback]

I really wanted to like this. Not only was it going to delve into the case histories of Mary Lamb, sister to Keats's friend Charles Lamb, who stabbed her mother to death in 1796 and was intermittently held in London "mad-houses" but not subjected to a criminal trial, as well as of Sylvia Plath, the enormously gifted US poet who committed suicide in 1963, but it was also going to explore on a broader canvas subjects close to my heart: women, depression and how states commonly referred to as "mental illness" have been treated in the last 200+ years.

But it was a hard slog. Not only was the writing so convoluted in places that I almost gave up trying to untangle the logic; ideas and examples were not brought together into a coherent whole or a sense of coherent overview. There were very strange moments, too: In a chapter on abuse Appignanesi writes "The ever resisted notion of infantile sexuality - which most recently has found our cultural abhorrence of its existence 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. 228). Is she seriously suggesting that those suspected of being paedophiles are being unjustly abhorred because we, as a culture, cannot accept that children may be sexual beings? Later on she seems to disregard the prevalence of sexual abuse, arguing that much of it is imagined or fantasised within or without therapy. Satirising, she concludes: "Being alive as a woman at the end of the twentieth century meant to be an incest survivor" (p 416). That is a shockingly dismissive and trivialising statement and is - unsurprisingly, given its sweeping nature - unsubstantiated by critical statistical analysis.

I found it difficult to understand her research approach, too. She concentrates heavily on certain personalities which may not be representative - in fact part of the fascination of Mary Lamb's case, for example, is its extremity rather than its representativity. How can Appignanesi justify spending so long (the book is quite a tome, coming in at over 590 pages) on her story? I sometimes had the feeling whilst reading that she was anxious to create an atmosphere of social history while seemingly not feeling qualified to differentiate clearly between credible and less credible sources of data and information or navigate skilfully between specific and general terrain. As a result her writing tended to flee into (admittedly fascinating) celebrity case histories along with potted overviews of the big personalities of "mind doctoring", all loosely sewn together with some rather wild generalisations and a somewhat meandering train of thought.

I couldn't follow her discussion of anorexia, for example. First she seems to ascribe responsibility to the "fashionistas" - those bastions of consumerism - for whom anorexia is a "pet disorder" (p.429). Then she talks about anorexia being the exact opposite, an anti-capitalist stance, a refusal of fetishised eating and consumerism in modern-day society (p.430). Is Appignanesi even aware that eating disorders are first and foremost not about the food or anti-capitalism, but are instead a narcissistic disturbance expressed through one's relationship with food?

There were also a number of sloppy mistakes. Three brief examples: 1) Appignanesi writes that Plath's novel The Bell Jar appeared "months before her death" (p.363) when in fact it was first published a mere four weeks before her suicide; 2) She has two stabs at spelling the name of the editor of Plath's journals correctly, writing it once as Kalik and once as Kulik on the same page (p.563) when it is in fact Kukil; 3) She refers to a study focusing on the suicide risk of adolescents and adults in the US as authored by Professor Mark "Ofsen" instead of Olfson (p. 568). A pedant's paradise!

Finally, the style of writing was frequently woolly and muddled. Imprecision abounded. When describing how representations of women in advertising, media, fashion and film, etc., have increasingly shown women over time as becoming thinner, Appignanesi writes that "glamorous images of women have shed weight" (p.429). How can the images themselves shed weight? Is it a forced pun? Or is she trying to make a point about the role of Photoshop? Whatever the answer, why sacrifice intelligibility to it? Elsewhere when discussing anorexia, she writes of "the primary appetite of hunger". Why does she unnecssarily conflate two distinct states of being, that of appetite and that of hunger? Is it an attempt to puff up her writing? Or emulate the armchair intellectual tone popularised by such writers as Alain de Botton and Oliver James? I'm usually willing to overlook annoyances of style if I'm interested in the topic, but after one or two hundred pages of trying to pull the wool apart so that I could see through it, my enthusiasm was beginning to wane. That's the last criticism I have in a list meant not bitchily or in the spirit of schadenfreude, but rather as an expression of frustration and, occasionally, of anger. (1.5 stars)

Long and thorough but easily dipped into by chapters, this is a great survey of specific women - from famous literary figures on down - and the medical practices and theories that bound them and defined them in different ways. While it's clearly taken on a lot of the theory of Foucault and others in its reading of history, it's not a difficult book. Though rigorous, it is less interested in a final conclusion or a theory of history, than it is in the weave of detail and the weighing of comparables in actual lives, both of the mind-doctors and their subjects. Some of the life stories are both unbelieveable and inspiring. Making difficult ideas accessible and even entertaining to read about, i recommend this highly as a very usfeul and readable survey of the field.

Weak.This book jumps from idea to idea without linking them together. Critically ,for a historical text, it fails at explaining how things were , why they were such and why and how they came to change. The tone is highly uneven, at times reading like pop-psych fluff and at others as a leaden and pretentious attempt at scholarly research. It's neither a formal medical history ,saying little about the evolving "mind" professions or their methods, nor is it really a social history(as it ought to be given its title) assessing the wider impact of Psychiatry on women in particular. Come to think of it she never really justifies her choice to study only Psychology's relationship to women specifically as opposed to both(?!) genders.There is little by way of verifiable statistics and broad assumptions are made regarding the reader's level of knowledge.Disappointing.