THE FEMALE MALADY: Women, Madness, and English Culture, 1830-1980.By Elaine Showalter. Pantheon. 312 pp. $19.95.
MODERN FEMINISM has dedicated a great deal of intellectual energy to the study of women and madness. Why, a number of feminists have asked, have women been so disproportionately represented in psychiatric hospitals and consulting rooms? The answer that a number of feminists -- like Phyllis Chesler and Frenchwomen Helene Cixous and Xaviere Cauthier -- propose is that women's madness is an exquisite protest against traditional sex stereotypes. As Elaine Showalter wisely points out at the beginning of her excellent new work on the subject, these writers "come dangerously close to romanticizing and endorsing madness as a desirable form of rebellion." A serious study of "The Female Malady," which is jut what Showalter has produced, "should not romanticize madness as one of women's wrongs any more than it should accept an essentialist equation between femininity and insanity. Rather, it must investigate how, in a particular cultural context, notions of gender influence the definition and, consequently, the treatment of mental disorder."
To do this, Showalter takes us inside a series of English asylums, where we meet the adolescent psychotics and cases of post- partum depression of the 1850s, the hysterics and neurasthenics of the 1870s and the schizophrenics who became the central figures in 20th-century dramas of madness and cure. The author introduces us to the male psychiatrists who apparently considered their female patients blank pages upon which to inscribe their differing theories of redemption. And, finally, through an exhaustive exploration of their diaries and fiction, Showalter allows madwomen to speak for themselves.
Showalter begins her study in the 1850s, with the advent of "psychiatric Victorianism." Rather than continuing to commit the insane to prisonlike asylums where they were generally chained up and left to rot, Victorian humanists constructed pleasant hospitals where "moral management" replaced physical constraint. Victorian psychiatric reformers like John Connolly tried to "domesticate" madness. In so doing, Showalter argues, they were "inevitably reproducing structures of class and gender that were 'normal' by their own standards."
Victorians viewed "normal" women as extremely vulnerable to insanity. Rather than explore how sex-role stereotypes that confined women to strictly defined roles within the family might have led women to seek escape in madness, Victorians believed that their reproductive organs created what they called "reflex insanity." To prevent female insanity, Victorian psychiatrists (until the early 20th century, English psychiatrists were all male) repressed any hint of female sexuality and even tried to retard the onset of menses.
THE VICTORIANS' attempt to domesticate madness also coincided with its feminization. Ironically, as more and more women were admitted to Victorian asylums as patients, more and more women were dismissed as administrators and staff. As traditional feminine stereotypes came to dominate psychiatry, it was deemed unsuitable for sane women to dwell amongst their mad counterparts.
Not surprisingly, Victorian humanists failed to eradicate madness. By the 1870s a new psychiatric fad emerged -- psychiatric Darwinism. Psychiatric Darwinists attributed madness to heriditary rather than moral flaws. They also considered any deviance from "normal" female behavior to be a sign of madness. They had no sympathy for the "abnormal" women who joined the burgeoning feminist movement, and were horrified when their patients exhibited "unnatural" desires for independence, privacy or creative work outside the family. Depressed women who wanted to engage in useful work were thus forced to undergo rest cures that deprived them of company as well as activity. At the same time hysterics were treated with a dose of "observant neglect."
In an interesting chapter on the treatment of shell-shocked soldiers in World War I, Showalter contends that psychiatrists began to listen to women only when the psychiatrists were confronted with masses of hysterical soldiers who refused to fight. Suddenly, the mad merited at least a modicum of respect.
The Female Malady concludes with a section on 20th-century psychiatry which includes a discussion of psychiatrists' claims that shock therapy and lobotomy would finally cure schizophrenia, as well as a critique of R.D. Laing's anti-psychiatry. Although she credits Laing with insights that helped women understand the relationship between femininity, madness and the family, Showalter believes his movement quickly degenerated ino a cultlike celebration of schizophrenia.
The Female Malady is far more than a catalogue of women's sufferings. It is a sobering essay about power, deviance, and society's longstanding unwillingness to accept responsibility for the mentally ill. Reading about the various "cures" hailed and then abandoned in the 19th century is a disturbing reminder of the contemporary desire to find a "final solution" to madness. This obsession all too easily leads to the promotion of cures geared to ridding the sane of the mad rather than the mad of insanity.
Powerful as it is, The Female Malady has one major flaw. Rather than exploring the feminist theories which are "essential to the future understanding of women, madness and culture," Showalter's conclusion merely hints at their existence. Her abrupt ending is as disappointing as it is tantalizing. For Showalter is such an intelligent and articulate guide that the reader is eager to learn how she thinks madwomen ought to be treated once their voices are heard and respected.