Madness, Religion and the State in Early Modern Europe: A Bavarian Beacon (review)

The relationship between religion and mental health care in the early modern period has been one of the major bones of contention in history of psychiatry. For Whiggish historians who worked in the wake of nineteenth-century positivism, religion was an obstacle to progress. Religious understanding of madness, symbolized in witch hunting and exorcism of demonic possession, represented the barbarism of the Dark Age, to be overcome by secular, medical, and humane understanding of madness. For Michel Foucault and his followers, the age of secularization signified the great confinement. In Mystical Bedlam, one of the best historical works of scholarship inspired by Foucault, Michael MacDonald claimed that religious healing practiced by seventeenth-century Anglican clergyman Richard Napier represented a more sympathetic attitude to the spiritual afflictions.¹ With the decline of the religious approach to mental health, MacDonald has maintained, mad people were subjected to confinement by secular powers and somatic treatment allegedly based on medical science. To ask questions about the role of religion in early modern times is thus to examine the origin of secular authority’s power over the fate of the insane and the ascendancy of medical–scientific ways of thinking about the disease of the mind. Both of them are fundamental questions of history of psychiatry of any time frame and any region.

David Lederer engages himself with these central questions through meticulous scholarship and in-depth analysis, setting a new standard in the history of early modern psychiatry. His geographical focus is early modern Bavaria, and he makes the best use of this choice of a middle-sized geographical unit of research: the book is more focused than Midelfort’s “Germany” and more extended than MacDonald’s archive of a Buckinghamshire clergyman. ² From the vast archives of Bavaria, Lederer has found rich and diverse materials relevant to early modern mental health inspired by religion, or “spiritual physic.” Although the term “spiritual physic” might be strongly associated with religious healing, Lederer maintains that the dichotomous understanding of the physic of the soul and physic of the body is anachronistic. The early modern physic of the soul and the physic of the body did not exclude, let alone oppose, each other as in the Cartesian dualistic scheme. The spiritual physic had considerable overlaps with the medicine of the body. Indeed, the spiritual physic was integrated into the moral cosmology, connecting the psyche of an individual with the world of Galenic humors and Aristotelian substances. The spiritual physic of Counter-Reformation Bavaria was inseparable from the physic of the body, as the Calvinist rhetoric in Tudor and Stuart England was saturated with the metaphors of the body, as has been shown by David Harley.³

The core of the book examines the rise, the fall, and the survival of the spiritual physic in the context of religious policies of the post-Tridentine Bavarian state, in several distinct settings: auricular confession enforced by the state; two shrines of St. Anastasia in Benedictbeuern and the Beata Alta in Puerten, both of which were dedicated solely to the healing of psychological ills; witchcraft and demonic possession, which are now a classic subject in the history of madness in early modern Europe; legal debate on suicide and its secular insanity defense; and last but not least, confinement to the Holy Spirit Hospice in Munich. These rich and diverse archives allow the author to depict many aspects of mental health care in early modern Europe in an enviably detailed way.

Throughout the book, the author perceptively analyzes the ambiguity of the confessionalization of the populace living in Counter-Reformation Bavaria. It was a kind of social control from above that functioned to eradicate heterodoxy from the elite and to police religious orthodoxy among the populace. The state organized ecclesiastical mechanisms for auricular confession, a highly individualistic penitential...