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  • Theaters of Madness: Insane Asylums & Nineteenth-Century American Culture
  • Gerald N. Grob
Theaters of Madness: Insane Asylums & Nineteenth-Century American Culture. By Benjamin Reiss. Chicago: University of Chicago Press. 2008.

The history of psychiatry, insane asylums, and mental illnesses has been a growth industry since the 1960s. Historians, social scientists, social and literary critics, and others have engaged in debates over the character of the specialty, the institutions with which it has been associated, and the nature of mental illnesses. On the one side are those who insist that an understanding of these subjects can shed light on far larger social, economic, political, and intellectual themes. In their eyes the psychiatry and the asylum are surrogates for the rise of industrial capitalism and a means of standardizing human behavior and enforcing certain social norms. On the other side are those who maintain [End Page 156] that the specialty and its institutions deal with disorders that admittedly have an unclear pathology and present formidable barriers to effective care and treatment. Debates between and among these two competing approaches have often taken place in a contentious and heated atmosphere.

In Theaters of Madness Benjamin Reiss has written a provocative book that clearly falls into the first camp. A scholar of literature, he analyzes the writings of prominent nineteenth-century literary figures as well as patients in an effort to delineate not only the character of asylums and psychiatric thought, but the very nature of American society. That he has been influenced by such figures as Michel Foucault, Erving Goffman, and David Rothman is clear even though he does not accept their interpretations without reservations.

The treatment of the insane in the mid-nineteenth century, according to Reiss, "was a central topic in cultural conversations about democracy, freedom, and modernity" (x). In chapters that cover such diverse topics as the writings of patients, the use of blackface minstrelsy within the asylum, the constant referral to Shakespearean psychology to validate the system of moral and medical treatment, and an analysis of such literary luminaries as Emerson and Poe, he attempts to justify this claim. Culture was deployed as a tool to reinforce social norms and standardize human behavior.

That Theaters of Madness will appeal to those in cultural and literary studies is clear, if only because it presents a critique of mid-nineteenth-century American society. To those like myself who are situated in the history of medicine, however, the book has numerous shortcomings. The use of literary sources, for example, tells us little about the reality of institutional care and treatment. The assertion that individuals confined in asylums in the late nineteenth and twentieth centuries included "the maladjusted, the drunken, the visionary, the drug-addled, the brain-damaged, the promiscuous, the self-polluting, the lazy, the depressed, the raving, and the violent" (123) is at best a caricature and almost assumes that mental illnesses do not exist. To be sure, our knowledge of the etiology and pathology of mental disorders–like that of many other diseases–are fragmentary and incomplete. But this does not mean that such diagnostic categories are meaningless. The critique of asylums, moreover, ignores the fact that they provided sustenance to a dependent population for whom means of survival were tenuous. While claims of curability were overstated, there is evidence that many persons benefitted from asylum care. This is not to argue that asylums were without major shortcomings; it is merely to suggest that like most human institutions, they combined virtues and faults. Theaters of Madness in many ways reveals the chasm between historians of medicine and scholars in cultural and literary studies.

Gerald N. Grob
Rutgers University, New Brunswick
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