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Sad, Mad and Bad: Women and the Mind Doctors from 1800

by Lisa Appignanesi

In her impressive and frustrating new book, Lisa Appignanesi, author of Freud’s Women, Losing the Dead, and others, provides a tour through the minefield of women’s mental illness (real or assumed) from the 18th century’s Age of Reason through to the modern era of pharmacological cure-alls. As Appignanesi notes, one of the most telling conclusions that can be drawn from this survey is the fact that, despite the voluminous amount of research on the subject, the treatment of mental illness, particularly for women, remains as much a mystery as ever.

Appignanesi documents with painstaking detail the treatment of women’s mental illness from its religious roots through to Freudian sexual theories and on to today’s systematized, drug-driven management, using some of the most famous and infamous case studies through the ages. She also chronicles the professionalization and medicalization of the field, with the consequent “evolution” of practitioners from priest to alienist to psychiatrist. As other writers – many of them feminists – have noted, the diagnosis and treatment of female mental illness has often reflected the social and political attitudes of the day toward women.

While the detailed research and breadth of information Appignanesi presents are remarkable, the academic nature of the prose, along with the heavy use of psycho-jargon, make it unlikely that this book will reach a wide audience. The conclusions drawn, though pertinent and relevant, are not particularly original and are better argued elsewhere. If Appignanesi was attempting to provide a history that is accessible to the layperson, one that moves and shocks as well as informs, she would have done well to have used her talents as a fiction writer and novelist to create a tome that is more heartfelt and less pedantic.