Diagnosis: Female

NYT Book Section
Review by KATHRYN HARRISON
MAD, BAD AND SAD: Women and the Mind Doctors
By Lisa Appignanesi
535 pp. W. W. Norton & Company. $29.95.

Back when Zelda Fitzgerald, her skirts wet from diving into public fountains, was accelerating from madcap toward outright madness, a Wharton School economist named George Taylor made the seemingly fey observation that hemlines rose and fell with the stock market, proposing a causal connection between two presumably separate spheres of human enterprise. Fashion, as the now familiar “hemline index” suggested, is socially determined. With prosperity come optimism and tolerance for risk; women are emboldened to show off a more daring length of leg. But what of more empirical, utilitarian domains? Surely doctors hypothesize independently of whatever forces drive style. Take, for example, the diagnosis and treatment of mental illness. Most of us trust psychiatry to remain immune to fads. And it does, doesn’t it?

One of the consistently fascinating and disturbing aspects of “Mad, Bad and Sad: Women and the Mind Doctors” is Lisa Appignanesi’s assiduous tracking of the modishness of what might be mistaken for a sui generis discipline. Of course, as anyone who has visited a psychiatric hospital — or ridden the subway — can attest, crazy is what we call people who refuse to conform to accepted norms of behavior. And the definition of nonconformity must change in step with styles of conforming.

“Mad, Bad and Sad” is, Appignanesi tells her readers, not only “the story of madness, badness and sadness and the ways in which we have understood them over the last 200 years,” but also a survey of the mad, bad and sad themselves, the particular women, including Zelda Fitzgerald, Lucia Joyce, Virginia Woolf and many less famous patients, who suffered “frenzies, possessions, mania, melancholy, nerves, delusions, aberrant acts, dramatic tics, passionate loves and hates, sex, visual and auditory hallucinations, fears, phobias, fantasies, disturbances of sleep, dissociations, communion with spirits and imaginary friends, addictions, self-harm, self-starvation, depression” and so on. Phew. A list like this makes a girl grateful that Freud even bothered to ask what such desperate, deluded creatures might want. No wonder the 19th century couldn’t build enough asylums to house them.

(Continued here.)