Mad, Bad and Sad
A HISTORY OF WOMEN AND THE MIND DOCTORS
FROM 1800 TO THE PRESENT
Reviewed by Mira de Vries
Does a novelist
have something new to add to the history of
psychiatry? It is certainly an eye-opener that,
according to Appignanesi, the term "depression" was
introduced not by a psychiatrist but by the novelist
George Eliot in her last publication, Daniel Deronda.
Appignanesi does not mention why she focuses on women
in psychiatry. Perhaps it is because in some though
not all sectors of psychiatry women are
Early psychiatrists associated perceived diseases of
the mind with malfunction of the internal female
reproductive organs, hence the word "hysteria."
Depression was originally the disease of middle class
housewives condemned to spending their days with
nothing more fulfilling to do than needlepoint.
Borderline is the disease of women who were sexually
abused in childhood. There are the hormonal swings of
menstruation, pregnancy, and childbirth. Even some
psycho-drugs target women, such as Valium, famously
called "mother's little helper" by the Rolling Stones.
Later when women themselves entered the fields of
psychoanalysis and psychotherapy, research found they
were better at it than men, thus contends Appignanesi.
A large part of the book is devoted to famous
"patients" such as Mary Lamb, Anna O., Virginia Woolf,
and Kay Redfield Jamison, to name but a few.
The book is well researched as evidenced by the
references provided in an appendix. As she avoids
cluttering the main body of the text with footnotes or
end-notes, it is sometimes difficult to distinguish
her own viewpoints from her summery of other people's
The last chapter before the epilogue is a discussion
about psychiatric drugs, which, she illustrates, were
always a part of psychiatry, from the now abandoned
chloral hydrate on. Curiously, she chooses this
chapter to discuss the DSM which has stamped its
pseudo-authority on so much of psychiatry the past
With nearly 600 pages of small type one might expect
this history to be thorough, yet there is no mention
at all anywhere in the book of the T-4 program.
Imagine a book subtitled "A History of the World and
Europeans from 1800 to the Present" not containing any
mention of WWII. True, the T-4 program did not target
specifically women, but neither did Teen Screen. She
does mention degenerationist theories in connection
with Kraepelin and Maudsley but not the mass murder of
between 80,000 and 400,000 (depending on who counts
and how) perceived mad people to which those theories
Another subject about which she says little, is
deprivation of liberty. "He saw me for only a minute
or two ... and he sentences me on the strength of
Doctor Calmeil, who sentenced me on the strength of a
doctor who had never seen me at all, who took me away
as a favor to somebody else, on the strength of what
they had told him." This quote is from Hersilie Rouy
in 1854. No mention is made of coercion in our modern
Although Appignanesi recognizes psychiatry's
inefficacy and records different forms of psychiatric
abuse (medical experimentation, social control, etc.)
she doesn't condemn psychiatry outright.
All in all it is an interesting book, but devoid of
new insights, including regarding the role of women in