Manic Minds: Mania's Mad History and Its Neuro-Future (review)

The history of psychiatry, insane asylums, and mental illnesses has been a growth industry during the last half century. Historians, social scientists, psychiatrists, and social and literary critics and scholars have engaged in debates over the character of psychiatry, the institutions with which it has been associated, and the nature and meaning of the very concept 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, psychiatry and the ubiquitous asylum are surrogates for the rise of industrial capitalism and—more importantly—a means of standardizing human behavior and enforcing certain social norms. On the other side are those who maintain that the specialty and its institutions deal with disorders that admittedly have a murky pathology and present formidable barriers to effective care and treatment, but are nevertheless serious and often disabling. Debates between and among these two competing approaches have often taken place in a contentious and heated atmosphere.

In Manic Minds, Lisa M. Hermsen—whose disciplinary background is in literature—traces the many ways in which the word "mania" has been used by medical, philosophical, academic, and popular writers. At the outset, she concedes that her interest in mania was aroused by her own experiences. Diagnosed with a manic disorder, she was treated with lithium. "My mania," she notes, "is a raging fury and a dysregulated neurotransmission with an enduring (partial) connection to madness at its intersection with a potential neurofuture" (2).

Although standing somewhat apart from the contemporary debates dealing with psychiatry and its checkered past, Hermsen has clearly been influenced by Michel Foucault and other literary figures. As with most literary critics, she insists that words matter, and that it is possible to write a "rhetorical history of mania . . . that pays close attention to the layers of description that have framed mania from classical Greek medicine onward" (2). Hence she rejects a progressive history that presumes that mania emerged from its affiliation with general madness to a cyclic relationship with melancholy in manic depression and now bipolar disorder as well as a narrative of medicalization. There is, she insists, a multiplicity of mania, and its meanings have shifted dramatically over time as has its complex relationship to madness and mental illness.

The first chapter of Manic Minds follows the words used to describe the multiple connections, disconnections, and coherent picture described in the medical literature from the Greeks to the present. Successive chapters focus on nineteenth-century state asylum reports, the relationship of heredity to the making of mania, and memoirs written by those suffering from mania. The concluding chapter reflects in a sympathetic manner "on the potential in neuropsychiatry of imaging technologies and pharmaceutical treatments" (12).

Manic Minds is a somewhat peculiar book. Its language is obtuse, and it is difficult to follow a clear line of thinking. In places, its rhetorical paeans confuse rather than enlighten. Consider, for example, Hermsen's description of nineteenth-century asylum reports and depictions of reform in literary journals and the popular press.

The mania that is coordinated in the asylum reports to support a reform movement and the mania that emerges from a nineteenth-century communication culture is that of an overlapping materialized and metaphorized body. The asylum is neither reformed nor fully realized as a medical institution, and mania is never solidified as a scientific object—as a mental illness.

The maniac elopes from the asylum, both more and less a real and phenomenal monster. While the maniac possesses an undeniable and iconic reality, his body is a momentarily diverse category. Mania has scattered, multiply transfixed by its cultural salience. The criteria for inclusion in or exclusion from the category "mania" have grown both weaker and stronger.

(62)

Hermsen's obvious admiration for Foucault and his spellbinding interpretations of modernity (as well as other literary...