Beyond the Asylum: Mental Illness in French Colonial Vietnam by Claire E. Edington (review)

As the title of her book indicates, Claire Edington wants to move "beyond the asylum" in order to understand mental illness in French colonial Vietnam. As she explains in her introduction, much of the scholarship on colonial Indochina has focused on the violence and economic oppression that marked the expansion of French imperialism in this part of the world (p.8). As a result, historians know relatively little about the social history of the region and the operations of everyday life. Edington, wishing to correct this absence, calls her book a "social history of psychiatry and mental illness in French Indochina," from the late-nineteenth century to the Second World War (p.2). Her profect, however, is more ambitious. Rather than giving us a simple history of the patients who were confined within the asylum as much of the "new social history of psychiatry" has called for, Edington turns to psychiatry for what it can tell us about life outside the walls of the asylum, about families and communities, about the local dynamics of colonial rule.¹ As she puts it, "the way 'abnormal' individuals came to circulate throughout the colony reveals the emergence of new networks of institutions and people that tied the structures of Vietnamese private and public life together with those of the French colonial state. This history of psychiatry is therefore intended as more than a history of a medical category or field of professional practice. Rather, it is the story of society's transformation as told through the experiences of those at its margins" (p.3).

In order to access this level of experience, Edington pursues two lines of inquiry that intersect throughout the book. On the one hand, she offers a study of how mental illness was institutionalized in Indochina under French rule. Here she traces how the evolution of psychiatry in the metropole affected the colonial sphere, how doctors relied on their expertise to treat patients, and how political and economic evolutions in the colony (notably a 1900 law that required all French colonies to balance their own budget and to use public debt to finance public expenditure) affected the daily administration of the asylum. On the other hand, Edington pursues a second chronology which recounts the history of the local confrontation of two medical systems within colonial Vietnam. French psychiatry, she argues, constantly "interacted with long-standing beliefs and practices surrounding mental illness," and Vietnamese families and communities "used or rejected these new institutions to their strategic advantage" (p.5).

Edington decidedly moves beyond the vision of the asylum as a totalizing institution exercising unbridled power over patients. Likewise, she pushes back against the image of power flowing unidirectionally from metropole to colony. Instead, Edington demonstrates how "more hybrid forms of accommodation and dependency" permeated between the hospital and the community (p.5). She refers to these as "colonial micropolitics," defined by "everyday exchanges between French experts, colonial authorities, and Vietnamese families that resulted not only in small erosions in the authority of colonial psychiatrists but also, and more significantly, in the emergence of a new, more diffuse kind of psychiatric power" (p.5).

In six chapters, Edington maps the complex relationships between the asylum and the community from different points of view. Conceived as "concentric circles radiating outward from the asylum" (p. 16) and organized in a roughly chronological manner, these chapters explore the historical construction of the legal category of the "insane" person in French Indochina (chapter l), the everyday challenges of patients and staff to the asylum administration (chapter 2), the work (presented as integral to the therapy) undertaken by the patients in the asylum (chapter 3), the complex web of family negotiations with the asylum (chapter 4), the treatment of mental illness in the Vietnamese popular press (chapter 5), and finally, the intersections of the psychiatric and the criminal justice system (chapter 6). Ultimately, as Edington suggests, her book offers a...