What drove women mad?
In Victorian science, the womb and the mind were inexorably linked
BRIAN BETHUNE | November 15, 2007 |
In 1810, a London physician created a table of what he considered the causes of the mental illnesses in 843 patients in Bedlam, his city's notorious madhouse cum tourist attraction. William Black's list, as Lisa Appignanesi shows in Sad, Mad and Bad(McArthur), her shrewd, humane, and wide-ranging look at two centuries of mad women, is poised between two eras. The most common cause given is "grief"(almost four times more prevalent than "drink and intoxication"), but organic injury("contusions and fractures of the skull," "venereal")finds a place, as do "religion" and even "methodism." Thus it was far from a traditional reckoning, which might well, in earlier times, have summed up all under "demonic possession" and would certainly not have dismissed God-drunk religious enthusiasm as mania.
At the same time, Black's table bears no resemblance to modern psychiatry's reigning bible, the Diagnostic and Statistical Manual of Mental Disorders, if only because Black was interested in causes rather than symptoms and labelling, and wrote in plain English. But Black nonetheless pointed the way to the scientific future in his secular attitude and — not least for 19th-century female patients — in his belief that body and mind were linked in a particularly intense way in women.
No fewer than 139 of his 843 Bedlamites were incarcerated because of "childbed." Known as "puerperal madness," this well-attested disorder of the era covered not just post-partum depression, newly prominent in our own time, but other manias blamed on the belief that the milk of nursing mothers sometimes poisons their brains, just as the blood of menopausal women did. Autopsies soon dismissed those notions, but a complex relationship between women and their mind would mark psychiatry through the century.
Like her favourites among the pioneering scientists, and Oliver Sacks today, Appignanesi traces her tale through individual case histories. Some are as famous as Freud's hysteric Anna O, others as obscure as Miss Beauchamp(a landmark case in personality disorder), but all of them say something about the subtle interplay of symptom and diagnosis, culture and contemporary worries.
The nascent Romantic movement valued storms of passion, and that cultural backdrop can be seen in the case of Mary Lamb, sister to famed essayist Charles. The siblings' classic children's book Tales From Shakespeare has never been out of print since they wrote it in 1807, and Mary was highly regarded in the Lambs' social circles, which included Samuel Coleridge and William Hazlitt — despite the fact that, in the grip of some mania, she had fatally stabbed her mother in the heart in 1796. Whatever her private troubles — and it's beyond easy to give a feminist reading to the case of a talented woman forced into endless hours of needlework to support an infirm mother, a senile father and an alcoholic(if also talented)brother — Mary was fortunate in her public circumstances. Upon Charles's promise of supervision she was released to a private madhouse and soon back to her home. Four years later, after Parliament rushed through a confinement act, Mary would have been locked up by law, her chances of eventual release minimal.
Almost a century later, with Freud's Anna O(the case name for German-Jewish feminist Bertha Pappenheim), hysteria, previously thought to be a disease of feeble-minded poor women, moved to being a disorder of the high-strung leisure class. It had always been a malleable condition, a label doctors were susceptible to pasting on anything they couldn't otherwise categorize. Anna O may have been a case in point: many modern neuroscientists are convinced her problems were entirely organic, derived from brain lesions developed as she cared for her tubercular father. But hysteria was also a useful vehicle for some young, well-off fin de siÃ¨cle women, otherwise forbidden by their culture to even think about sex and work, let alone express themselves. Illness was a licence to act out, in provocative ways.
Likewise Miss Beauchamp(in reality Clara Norton Fowler), who developed three alternate personalities during treatment between 1898 and 1904. The original was a repressed and proper Bostonian; the main alter ego was much more carefree and attention-seeking. Once again, looking backwards, such a young woman in that era, in the home city of the American Woman Suffrage Association, does not seem so strange. Fowler later married her analyst's colleague: "Star patients," Appignanesi dryly writes, "one way or another often end up staying in the profession."