Lisa Appignanesi's "Mad, Bad and Sad"

Lisa Appignanesi is a novelist and writer who has been made a Chevalier de l’Ordre des Arts et des Lettres in recognition of her contribution to literature. She is president of English PEN.

She applied the "Page 99 Test" to her latest book, Mad, Bad, and Sad: Women and the Mind Doctors, and reported the following:

What I do in this book is to provide a long view of the rise and rise of what I call the mind doctors – the specialists who initially termed themselves alienists and then became as the mental health professions grew, neurologists, psychiatrists, psychoanalysts, psychotherapists, psychopharmacologists and so on. Alongside this I probe the various understandings and experiences of extreme emotional states and mental disorders.

Putting things side by side in a historical order doesn’t necessarily reveal the great march of progress. What it does show is that ‘every epoch has its own firm rules on how to behave when you’re crazy.’ And alongside that how ideas, a social moment, diagnoses and treatments feed into each other to produce certain fashions in illness and treatment.

Page 99 begins the section entitled ‘Nerves’ and is a pretty good sample of the way the book proceeds. We’re in the final quarter of the 19th century: commentators in Europe and America were adamant that life had taken on a clang, clamour and speed that acted as an irritant on the nerves. Sensations forced themselves on any and everyone, whether in real or fictional streets. The times themselves, it seemed were a shock to the nervous system, with their crowds and dirt and the inevitable “decadence” that followed. Trains (that new technology) chugged, smoked, crashed and produced the trauma of ‘railway spine’ as well as a spate of railway murders.

During this time, it became current to link a large strand of mental illness to nervous exhaustion or what became known as ‘neuresthenia’. The treatment was enforced and radical rest, particularly for woman whose nervous condition might show itself in everything from reading too many books or not being quite satisfied enough by their husbands. The equivalent in our own druggy age is to think in terms of chemical imbalance: depression is the name of our key mental ill – a diagnosis so pervasive that by 2010 the World Health Organization predicts it will have become the single largest public health problem after heart disease. The pharmaceutical companies are on hand to help the diagnosis along and, of course, to provide the kind of chemical quick fix we prefer.

Read more about Mad, Bad, and Sad at the publisher's webpage, and visit Lisa Appignanesi's official website.

--Marshal Zeringue