Berlin Electropolis: Shock, Nerves, and German Modernity (review)

During the summer of 1896, the citizens of Berlin were invited to a great spectacle on the banks of the river Spree. In order to commemorate the twenty-fifth anniversary of the founding of the German Empire, the Trade Exhibition at Treptow Park presented Germany's capital as a modern "world city." With its impressive displays of machinery, transportation, and communications equipment, the exhibition demonstrated Germany's rise to a major technological and industrial power. Berlin, as a center of the science-based, electro-technical industry, represented the promises of technological civilization like no other German city. Yet, as Andreas Killen's Berlin Electropolis shows, the celebration of Berlin's impressive development was coupled with more somber reflections about the hidden costs of technological progress.

Among the costs of modern civilization were nervous disorders that sapped people's energies and threatened their productivity. Killen's history of neurasthenia contributes fresh perspectives on the history of mental illness during the period of classical modernity and is a valuable complement to Paul Lerner's study Hysterical Men (Cornell University Press, 2003) and Joachim Radkau's Age of Nervousness (Das Zeitalter der Nervosität, Hanser, 1998). In contrast to Radkau, who focused on the experiences of nervousness among middle- and upper-class Germans, Killen examines how neurasthenia was defined and redefined through the interactions between doctors and patients from lower-middle- or working-class backgrounds. With the expansion of the pension and accident insurance system since the 1880s, Germany's medical establishment pushed for a redefinition of medical diagnoses for nervous disorders in order to keep down health insurance and pension costs.

While neurasthenia started out as an authentic disease of industrial modernity, it became increasingly reconfigured as a pseudo-illness in the decades after 1900. As Killen shows, this process was shaped by perceptions of social class. Whereas doctors took the nervousness of wealthier patients seriously and validated their illness experiences through individualized treatments involving natural and electrical therapies, insured patients from poorer backgrounds who asked for treatments for occupation-related nervous illnesses were frequently suspected to be malingerers. This trend accelerated when World War I produced large numbers of hysterical and otherwise disabled soldiers who threatened military morale as well as the long-term productivity of the nation with their pension claims. Changing concepts of etiology shifted the responsibility for neurasthenia from external causes to patients. From interpreting such disorders as a form of "traumatic neurosis" caused by invisible somatic injuries to the nervous system, doctors shifted to an understanding of nervous illnesses as psychogenic disorders that were linked to a constitutionally inferior personality often characterized by a weak will. The latter construct exonerated the military and civilian employers and freed the pension and health insurance system from liability.

Killen examines the epistemological shifts in discourses on mental illness in three different contexts: 1) controversies about the etiology of nervous illnesses involving railroad accidents before World War I; 2) the treatment of nervous soldiers during the war; and 3) conflicts between physicians, telephone operators, and their employers about the causes of nervous illnesses among telephone operators. Female employees at telephone exchanges worked in a profession that was emblematic for industrial progress and its associated risks. Killen's discussion of the so-called telephone accident raises interesting issues concerning the relationship between technological modernization and social constructions of individual risks and social responsibilities. Operators claimed that their nervous disorder was caused by electrical shocks they received during their work. Initially, some physicians were willing to accept these claims and validated them with their diagnosis as traumatic neurosis caused by an invisible injury. With rising insurance claims and shifting epistemological assumptions concerning the causes of nervous illness, physicians refused to accept patients' claims and denied them a diagnosis that entitled them to a longer stay in a sanatorium or a pension. Instead of a physical trauma (Schock), physicians claimed that operators suffered at most from an irrational fear (Schreck) that was exacerbated by their desire to qualify for a pension. Before...