Review of Eghigian’s The Routledge History of Madness and Mental health, New York: Routledge, 2017

Greg Eghigian, ed. The Routledge History of Madness and Mental Health. Routledge Histories Series. New York: Routledge, 2017. 404 pp. $225.00 (cloth), ISBN 978-1-138- 78160-3.

Reviewed by Michael Rembis (University at Buffalo (SUNY)) Published on H-Disability (February, 2018)
Commissioned by Iain C. Hutchison

With the publication of two important edited an- thologies, Mad Matters: A Critical Reader in Canadian Mad Studies (2013), edited by Robert J. Menzies, Geof- frey Reaume, and Brenda A. LeFrançois, and Madness, Distress and the Politics of Disablement (2015), edited by Helen Spandler, Jill Anderson, and Bob Sapey, one could argue that the relatively new multidisciplinary field of mad studies is beginning to cohere around a central set of concerns that focus largely on challenging Western psy- chiatric epistemologies and modes of intervention with the voices and experiences of pathologized and psychia- trized social actors both in the past and in more contem- porary times. This promising new field, which is most ev- ident in the United Kingdom and Canada and is energized by a creative and dialectical mix of activism and scholar- ship, should not be confused with the history of mad- ness, a subfield within social history of medicine that be- gan to emerge in the 1960s and became more widespread beginning in the mid-1980s. While the history of mad- ness takes a more critical approach than older histories of medicine and psychiatry, which were written largely by physicians or by social scientists employed in medi- cal schools or institutes, it cannot be considered part of mad studies or disability studies. Yet historians of mad- ness have built a wealth of research that considers what has come to be known as “mental health” or “mental ill- ness” and its (ostensible) treatment in various times and geographic locations. While mad and disability studies scholars may be critical of this work on any number of levels, they must nevertheless engage with it in meaning- ful ways if they want the important work that they are doing to circulate beyond their own relatively small but growing fields.

It is with this caveat in mind that I begin a review of The Routledge History of Madness and Mental Health, edited by Greg Eghigian, Penn State University profes- sor of history and former director of the Penn State Sci- ence, Technology, and Society Program (2007-12). Eghi- gian, who describes himself as a historian “of both the human sciences and modern Europe,” and as someone who is “particularly interested in how societies grap- ple with the questions and problems associated with modernity through the vehicles of science, technology, and medicine,” has brought together the work of leading scholars in twenty-one different areas of study within the history of madness.[1]

Comprising six parts, the collection sets a new bench- mark in the growing subdiscipline of the history of mad- ness, but it is not without its limitations. The topics cov- ered in the book range from antiquity to the late twen- tieth century and from western Europe to Japan, Latin America, South Asia, and Africa. Refreshingly, there is little in the book on the United States or Canada, two countries that can receive a disproportionate share of scholarly attention within edited anthologies, especially within mad and disability studies. Noticeably absent in this otherwise broad range of geographic locations and time periods is any sustained discussion of madness or mental health in eastern Europe. The closest we come to eastern Europe is in chapter 8, in which Ilya Vinitsky, professor of Russian literature at Princeton University, presents an analysis of the life and work of Konstantin Batiushkov (1787–1855), whom Vinitsky describes as “a major poet of Russia’s Golden age of poetry, one of the creators … of Russian Romanticism,” and someone who was institutionalized during his lifetime, to illustrate the pervasiveness of madness in (curiously) Western litera- ture and the fine arts, especially during the nineteenth century (p. 156). “From the [Russian] Romantic vantage point we can observe the multi-century tradition” of the imbrication of madness and the arts and literature “in its complex richness,” Vinitsky concludes (p. 167). Ac- cording to Eghigian and to clinical psychologist and as- sociate professor of psychology, Richard Noll, who au- thored chapter 18, “Psychosis,” madness has powerful cultural resonances in Western (and Western colonized) cultures precisely because, as Noll argues in his chapter, it “implies no necessary historical or geographical or epistemic center” (p. 333). In his introduction to the book, Eghigian adds that madness “has always been en- tangled in the transformation and interactions of changing human aspirations and moralities.” It has many “histories” (p. 2). And this is evident in The Routledge History of Madness and Mental Health.

Yet despite the apparent capaciousness and amor- phousness of madness both as analytical concept and lived experience, the trend in the historiography and in The Routledge History of Madness and Mental Health is to create a single geographical and epistemic center, as well as a more or less linear historical narrative for mad- ness. This becomes evident in the first paragraph, and ultimately the first sentence of the book, in which Eghi- gian invokes the American Psychiatric Association (APA) and its Diagnostic and Statistical Manual of Mental Dis- orders (DSM). Eghigian asserts that “many” contended that the APA, with the publication of the fifth edition of its DSM in 2013, “was responsible for irresponsibly med- icalizing normality.” While on the surface, this can be read as a critique of modern psychiatry (and perhaps the introduction of alternative ways of understanding “men- tal illness”), its more insidious and pernicious effect is to inscribe powerful and not easily dislodged Western psy- chiatrized epistemologies upon madness. This is evident to the point that Eghigian refers to madness as a “mental or neurological disorder” and as a form of “disease and disability,” as well as a “problem” (p. 1). At one point in the introduction, Eghigian refers to the history of mad- ness as “the history of psychiatry” (p. 8). He adds that even though “indigenous views of mental disorders” per- sist, “one of the most prominent topics authors in the book take up is the global spread of [Western psychiatric] knowledge and treatment practices” (p. 11, emphasis in original). While Eghigian and the rest of the authors in the collection remain sensitive to local cultures and con- texts, as well as change over time, they nevertheless rely on and default to—to varying degrees—not only the lan- guage of Western psychiatry but also its temporal and spatial frames in their analyses of the history of madness.

Although the book is decidedly Western and mod- ern (1800–present) in its focus, it is nevertheless an im- pressive and at times nuanced assessment of more than three decades of scholarship produced in the history of madness. Acknowledging the diverse and growing body of scholarship that explores madness and its history in various times and locations—but primarily in the global West or North and the modern era—Eghigian character- izes The Routledge History of Madness and Mental Health as “a snapshot of the discipline—an opportunity to see how leading scholars go about their work, the kind of evidence they use, the conclusions they are reaching, and their assessments of the historiography of madness today” (p. 3). With only three chapters that cover material before the seventeenth century and only one chapter on the “early modern healthcare market” (chapter 4), the collection will be of most value to graduate students and specialists interested in the history of psychiatry, asylums, and the creation of nosological systems and technologies of “care” in the nineteenth and twentieth centuries. Interdisciplinary scholars interested in such topics as the importance of visual culture in creating and documenting madness within psychiatry (chapter 9), psychiatry and religion (chapter 7), or the connections among dementia, aging, Alzheimer’s disease, and madness (chapter 16) will also find this book a valuable resource.

Historians of disability will also be interested in chapter 15, “From the Perspectives of Mad People,” written by long-time mad activist, historian, and ally of disability studies and mad studies, Geoffrey Reaume. In this chapter, Reaume brings his deep knowledge of patient life and asylum history to bear on a historiographical essay that offers a thoughtfully organized and carefully argued overview of first-person accounts of madness from biblical times to the late twentieth century. Interest in the “patient perspective” has been growing since the mid- 1980s, and it is evident in the number of edited collections that reprint the writing of mad-identified people and historical monographs that take seriously evidence left be- hind by mad subjects. While Reaume admits that much more work needs to be done from the perspectives of the most marginalized mad people among us—poor people or First Nations peoples, for example—he argues that “the broadening of historical perspectives by and about people who experienced madness has provided a fuller and more authentic understanding of meanings and experiences of mental disturbance as understood by people who lived this history beyond the views of observers…. As historiographical developments recounted here indicate, the perspectives of mad people have made, and continue to make, an immense difference in the interpretations of the history of madness. The field can only advance by making such views central to the overall historical narrative” (pp. 292–293). The centrality of such views is some- thing that people working in mad peoples’ history, disability history, disability studies, and mad studies will no doubt continue to take up in future research and writing.

H-Net Reviews

Despite the problematic conceptualization and orga- nization of the book, The Routledge History of Madness and Mental Health remains an impressive and valuable contribution to the history of madness. It has established a new benchmark that will no doubt inspire future re- searchers in a number of different areas of study.


[1]. Penn State, College of the Liberal Arts, De- partment of History Directory, Greg Eghigian, http: // uary 30, 2018).

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Citation: Michael Rembis. Review of Eghigian, Greg, ed., The Routledge History of Madness and Mental Health. H- Disability, H-Net Reviews. February, 2018.