Akihito Suzuki.
Madness
at Home: The Psychiatrist, the Patient, and the Family in
ISBN
0–520–24580–6.
Akihito Suzuki’s Madness at Home: The Psychiatrist, the Patient, and the
Family in
responses to mental illness in late Georgian and early Victorian
society. Situating his topic
firmly within its broader cultural context, Suzuki skillfully delineates
madness outside the
parameters of the psychiatric profession to reveal the pivotal role
families played in psychiatric
treatment and care. Critically analyzing a number of arguments
both within and outside of the
history of psychiatry, he presents a multifaceted picture of
nineteenth-century English society’s
attempts to grapple with mental illness and, in the process,
positions our understanding
of madness beyond the world of the asylum.
Madness at
Home reflects an important shift in the
historiography of mental illness that
has increasingly interpreted psychiatric discourse in broad
terms to incorporate the views of
greater society. Rather than concentrate exclusively on the
theories and practices of “mad”
doctors, Suzuki explores social perceptions of mental illness
and familial or domestic care of
“lunatics”
and posits that the household was paramount to the construction, regulation,
and
management of mental illness, even as psychiatry was
professionalizing and asylums grew in
number. Employing the concept of “domestic psychiatry,” he
rejects the perception that
psychiatrists wielded great power in the nineteenth century and,
instead, argues that their
authority was tempered by the views, attitudes, and actions of lay
society. Deconstructing the
relationship between families and doctors, Suzuki demonstrates how
the “process towards
professionalization and establishment of psychiatry was not accompanied by the
establishment
of narrowly scientific aspirations or research programs but
by the consolidation of the
role of the family” ( pp. 63–64).
To unravel the
subtleties of “domestic psychiatry,” Suzuki employs cases of commission
of lunacy, a legal procedure that investigated the mental
state of accused individuals. Relying
on newspaper coverage of commissions of lunacy in the The Times of
sample contains approximately 200 cases, a dozen of which
garnered significant attention in
the press. The principal players in the commissions—alleged
lunatics, their families, witnesses
(including
doctors), lawyers, and juries—came from predominantly middle- and
upper-class backgrounds. Nevertheless, the trials were often held in
taverns or coffee houses,
attracted large crowds, and thus constituted public spectacles.
However, rather than interpret
the trials as opportunities for indulgent voyeurism, Suzuki
presents them as sites for contested
notions of mental illness, liberty, and justice, and as
indicative of society’s desire to understand
and study mental illness in the nineteenth century. Moreover,
he uses the commissions
to complicate our understanding as to why relatives sought
state intervention, arguing that the
trials did not stem primarily from intolerance of behavior or
the desire for institutional confinement,
but from concerns over the management and disposal of
property.
Although greater
attention to both regional variations (especially because one of his key
sources, The Times, is firmly rooted in the context of
juries for the lunacy commissions would have been helpful, this
is a beautifully written book
brimming with provocative insight and compelling arguments.
Perhaps the work’s greatest
attribute is the author’s rejection of one-dimensional or
simplistic interpretations and his
ability to map the diversity that characterized a range of
issues related to madness in the nineteenth
century. Ultimately, by analyzing arranged marriages, cases of
wrongful confinement,
private “keepers,” social constructions of masculinity, and the
influence of Evangelicalism on
psychiatric practices, Suzuki illuminates the complexities,
contradictions, and ambiguities
that riddled the relationships between families, state
authorities, doctors, those deemed mentally
ill, and the public, and reminds us of the important historical
role “the home” played in
determining psychiatric practices.
Reviewed by JANET MIRON, Assistant Professor of History,
ON,
BOOK
REVIEWS 435
Journal of the History of Behavioral Sciences, Volume 43 Issue 4 (Autumn (Fall) 2007)
DOI: 10.1002/jhbs