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

In Madness, Religion, and the State, David Lederer examines the role of "spiritual physic"—pastoral care provided by the clergy—in the treatment of mental disorders in early modern Bavaria, as well as the contribution of these religious remedies to modern psychology and psychoanalysis. Analyzing the efforts Catholic clergymen to heal those suffering from mental distress with spiritual tonics, including auricular confession, pilgrimage to sacred shrines, and exorcism, Lederer traces the burgeoning use of these remedies during the crisis years of the 1600s and their decline at the end of the century. Lederer argues that the growing skepticism regarding "spiritual physic" that developed during the late seventeenth century was not the product of intellectual shifts associated with the early Enlightenment or Scientific Revolution, but rather stemmed from the disciplinary activities of the confessional state. In the late seventeenth century, the Bavarian authorities increasingly discouraged "superstitious" practices like public exorcisms that stirred popular emotion, in an effort to apply greater social control. As Lederer points out, however, structural limitations precluded the absolutist state from constructing state-sponsored mental health facilities to replace the old penitential regime. Finally, he explores tantalizing links between "spiritual physic" and the development of modern psychological treatments. Following recent studies that downplay the role of the Scientific Revolution as a watershed in the modernization and secularization of society, Lederer uses his findings to critique teleological elements in the history of mental health care by elucidating its religious and political origins.

Perhaps the strongest feature of Madness, Religion, and the State is the remarkably diverse body of evidence that the author collected in his research into spiritual physic, an important phenomenon long neglected by scholars. Weaving together diverse sources, including the miracle books produced at pilgrimage sites (both published and unpublished), religious iconography, learned medical and demonological treatises, and official records from the Bavarian state and the Catholic church, Lederer produces a vivid image of madness and its remedy across three centuries. His approach to these sources is sophisticated, providing an articulate discussion of the challenges inherent in understanding early modern mental disorders on their own terms, without introducing anachronism. For example, Lederer considers the variety of psychic disorders described by early modern sufferers, ranging from demonic possession to melancholy, without lumping them all together under the catchall term "madness." His use of prominent scholarly theories, including those of Norbert Elias, Michel Foucault, and Gerhard Oestreich, is equally adroit. Lederer situates his findings within these theories, but approaches them from a critical stance, modifying them to fit the Bavarian experience. In the case of Michel Foucault's "Great Confinement," for instance, Lederer argues that while the ideological impulse to segregate the mentally ill developed in the late seventeenth century, the early modern state lacked the fiscal resources to build the requisite state mental hospitals until the nineteenth century.

After outlining the aims of his study, the nature of his sources, and the intellectual background of early modern spiritual physic in chapter one, Lederer turns to the role of auricular confession in post-Tridentine Bavaria and its role in treating the mentally ill. As Lederer demonstrates in chapter two, these practices, promoted by Jesuit confessors at court, offered not only spiritual consolation for troubled souls, but also important political and disciplinary benefits for the Wittelsbach dynasty. The next chapter examines another form of spiritual physic: pilgrimage to shrines associated with miraculous cures. Here the tensions between state patronage of such religious devotion and increasing official concern for order and discipline are central. In chapter four, Lederer analyzes the sorts of spiritual afflictions described in early modern sources, primarily the miracle books compiled at pilgrimage sites, using detailed case studies to reconstruct the experiences of sufferers, whose anguish often coincided with major rites of passage like marriage or childbirth. Chapter five explains the decline of spiritual explanations for such mental ailments, with the appearance of a secular insanity defense, by...