Mad, Bad, and Sad: A History of Women and the Mind Doctors

by Lisa Appignanesi

  The cold, uncaring mother, the repulsed daughter, the childhood which shapes a predisposition to considering oneself deranged, the inner conflict–all this was part of the backdrop to Mary’s recurring adult illness. What is surprising is how easily the self-same reading of her illness could have been offered within the frame of a Freudian or post-Freudian understanding of the aetiology of mental illness, though of course Charles doesn’t mention the enacted Oedipal rage.

  There is more. Although during her lifetime and because of the murder, none of her writings could appear under her own name, Mary collaborated with Charles not only on the Tales from Shakespeare, but on the collection of children’s stories Mrs Leicester’s School: or, The history of several young ladies, related by themselves of 1808. All but three of the stories here come from Mary’s pen, though each bears a different pseudonym. It is clear from these stories that Mary was particularly adept at entering into the voice of childhood; and mother–child relations, with all of the child’s frustrations, anger and disappointed hopes, are a recurring theme.

  In the story ‘Mahomet Explained’, published under the pseudonym Margaret Green, Mary seems to be reinvoking and examining a particular sequence from her own childhood, part of which was spent in the large country-house, complete with library, which her grandmother looked after.

  The little girl in the tale is a lonely creature. Apart from a word exchanged over breakfast, neither her mother nor the lady of the house ever speak to her, so engaged are they with their ‘needlework’. This leaves the child to her own devices and to the discovery of the locked and forbidden library with its strange tome, Mahomet Explained. She immerses herself in the story of Abraham, Ishmael and Mahomet, secretly reads it over and over. ‘It must have been because I was never spoken to at all that I forgot what was right and what was wrong,’ the narrator comments. The thrall of the tale, the repetitive, forbidden reading, her abandonment and loneliness make her susceptible to transforming the imaginary into the real. She is consumed by a fear that anyone who is not a True Mahometan Believer, as she has become through her reading, will be unable to cross the ‘silken thread’ of a bridge that leads to the afterlife. The unconverted will tumble into a ‘bottomless gulf’. She longs to tell her mother and the woman of the house, but to do so is to admit her trespass.

  Trapped between the desire to save her mother by converting her and the panic of self-revelation, she falls into a fever. When need finally forces the story from a mouth no longer accustomed to speech, her mother, who is now sleeping in the child’s room, thinks she is ‘delirious’ and sends for a physician. Madness here is both real and a misunderstanding: it comes from an inexpressible wish and the tantalizing desire, which Mary Lamb makes us alert to, for revenge. Delirium is the only action the trapped child can take.

  The kindly doctor extracts the admission that the child has read herself into a ‘Mahometan’ fever. He gives her medicine and recommends rest. Once the temperature has subsided, he takes the girl away to his wife, who he says has experience in such cases. The wife is a better mother. In this early version of a cure through love and innocent talk therapy, she engages the child in conversation. She then recommends, instead of medication, a visit to Harlow Fair. Here cheerful human faces and a little spoiling work wonders on the child. After a month with these new parents who bring friends to the house for games and amusement, she is returned home completely cured.

  ‘Mahomet Explained’ is redolent with echoes of Mary’s childhood and her adult assessment of its lacks, the part played by an inattentive mother in bringing on her ‘delirious’ state. It can hardly be coincidental that the obsessive labour which keeps the two women in the story from ever engaging with the child is needlework–the very needlework which was to drive the adult Mary to the ‘delirium’ in which she killed her mother and which flung her into the ‘bottomless gulf’.

  In her essay ‘On Needlework’, published in The British Lady’s Magazine in 1815 under the name Sempronia–a character out of Addison and Steele’s The Tatler who is a shark amidst matchmakers, marrying women off with no attention to their future well-being–the fifty-year-old Mary Lamb condemns an activity which keeps middle-class women falsely busy, where in fact their intelligence would benefit from the kind of leisure which is men’s natural right. The busy-ness of needlework is also at the expense of the working-class woman who has few other means of earning her keep. The activity, which is meant to keep the devil who loves idle hands at bay, in fact keeps women chained. ‘Needlework and intellectual improvement are naturally in a state of warfare,’ Mary writes, as fervent in her analysis of women’s condition as her near-contemporary Mary Wollstonecraft, and foreshadowing Virginia Woolf’s later analysis. There were no seventeenth-century women poets, Woolf wrote, because ‘Shakespeare’s sister’ was too busy mending stockings or tending to the stew. From Mary’s point of view, her mother had even given the needlework precedence over her daughter.

  Mary Lamb’s account of her childhood state and the fall into delirium is interesting on several counts. It builds up an experience of the child’s madness as a misassociation of ideas. The little girl generalizes from her book, a kind of primer about Mahomet complete with missing pages, to build up a mistaken notion of the real. This is a picture of madness clearly based on the ideas of John Locke, whose probing of mental states was so to influence the rise of the first ‘theoretical’ psychiatry in France. Locke’s ideas about madness moved away from earlier religious conceptions and classical paradigms reinvigorated in the Renaissance. Madness was no longer either possession or retribution for sin. Nor was it the overthrow of reason by an excess of passion, whether beastly or holy. Nor was it hereditary or biological. Rather, madness, as the eighteenth century progressed and took on an increasingly Lockean hue, became a matter of the false association of ideas.

  In his Essay Concerning Human Understanding of 1690, Locke differentiates the mad from what he calls ‘idiots’, or ‘naturals’, the congenitally damaged, and argues that the first ‘do not appear to have lost the faculty of reasoning but having joined together some ideas very wrongly, they mistake them for truths, and they err as men do that argue right from wrong principles’. This is an optimistic view of madness: it leaves open the possibility of cure and introduces a commonality of reasoning–from false to true–between the sane and the mad and within the same person.

  Mary’s little girl in this story has, one might say, a Lockean experience of madness. But the fact that the adult Mary Lamb, the writer who developed from this child, thinks it worthwhile to remember this girlhood experience and in a sense show its genesis and ‘cure’ casts it into a different register. The idea of a formative link between childhood experience and the deformations of the adult is so familiar to us now that it seems natural, altogether self-evident. Conceptually, however, this pairing is new to the late eighteenth century and the Romantic movement. Richard Burton in the several volumes of his encyclopaedic disquisition on madness, The Anatomy of Melancholy (1652)–an early exploration of all the many factors that play into the humour of melancholy–has nothing to say of the subtle ways in which the child is father to the adult. Nor does Burton search for the roots of melancholy in childhood experience.

  Once Jean-Jacques Rousseau and the Romantics burst on the scene, everything shifts. Childhood, the importance of education, of relations between parents and children, become paramount. Given this and their personal experience, it is perhaps not surprising that childless Charles and Mary not only take on godchildren and enjoy their company above much else, but also engage in the writing of stories for children. They translate Shakespeare with an eye to education, and in Charles’s case are adamant that children need their imaginations educated as much as their minds. Deforming pasts can be formed anew in the next generation.

  MADNESS, NERVES AND SENSIBILITY

  In his essay ‘Christ’s Hospital Five and Thirty Years Ago’, Charles Lamb, in the guise of his most popular persona Elia, reminisces ab
out his schooldays and remembers how their games ‘would have made the souls of Rousseau and John Locke chuckle to have seen us’. The pairing is important. The period derived a vocabulary of sensation from Locke and mixed it with Rousseau’s language of imagination and memory: that faculty through which childhood is recovered. To experience feeling, its extremes in passion, became important; so too did the analysis of feeling. Within this new language of the emotions, madness is transformed. Extremes of passion are states people see they have in common. Outbursts of passion, from revolutionary fervour to assassination attempts on the King, are manifestations worthy of intellectual interest. They are cultivated and indeed fascinate the young, radical intelligentsia.

  Byron, in Childe Harold, had hailed ‘wild Rousseau’, the ‘self-torturing sophist’, as ‘The apostle of affliction, he who threw Enchantment over passion’ and knew ‘How to make madness beautiful’. In 1766, Rousseau, exiled from France and Switzerland, had been brought to England by David Hume. Given a house at Wootton in Staffordshire, not to mention a pension of £100 a year by George III–which Rousseau drew for only one year–he wrote the first six volumes of his confessions. It is in the first part of The Confessions that, remembering his early facility for reading, Rousseau notes how he acquired–not unlike the young heroine in ‘Mahomet Explained’–‘a too intimate acquaintance with the passions. An infinity of sensations…without possessing any precise idea of the objects to which they related.’

  It is also in the opening chapter of his Confessions that Rousseau analyses the way in which childhood punishment shaped his life. In the first instance, the spanking he received at the age of eight from a woman of thirty influenced ‘my propensities, my desires, my passions for the rest of my life, and that in quite a contrary sense from what might naturally have been expected’. Rousseau sought out humiliation, and was, as he explicitly confesses, roused by it because of this childhood punishment which had a disciplinary intent.

  The second punishment, a beating inflicted by his uncle, had a different if equally formative impact. Intended as chastisement for a theft of which Rousseau says he was innocent, it turned him into a champion of justice, so deeply did it engrave itself on his being:

  Even while I write this I feel my pulse quicken, and should I live a hundred thousand years, the agitation of that moment would still be fresh in my memory. The first instance of violence and oppression is so deeply engraved on my soul, that every relative idea renews my emotion: the sentiment of indignation, which in its origin had reference only to myself, has acquired such strength, and is at present so completely detached from personal motives, that my heart is as much inflamed at the sight or relation of any act of injustice.

  Childhood shapes the adult irrevocably in Rousseau’s analysis, shapes him sexually, too.

  Charles and Mary’s understanding of madness and its precipitating childhood experience falls into this new culture of Rousseauian Romanticism. We might speculate that Charles is not only tolerant towards his sister’s ‘lunacy’. He respects it and, given his own bouts of melancholia and their lifelong proximity, also identifies with it. So, judging from the tone of Coleridge and Hazlitt’s comments on Mary, not to mention her correspondence with Dorothy Wordsworth, do the others in their circle. They are compassionate. Despite the enormity of her crime, they are prepared to accept her into their society as an equal.

  It would be wrong to generalize across the whole of the period from a single example from the writing classes. However, certain things are clear. With the eighteenth century, the age of reason, a change of sensibility had made a certain nervous susceptibility a sign of class. Not the dullards, but those ‘of the liveliest and quickest natural parts, whose Faculties are the brightest and most spiritual, and whose Genius is most keen and penetrating’, are prone to nervous disorders from melancholy to hypochondria. According to Dr George Cheyne, author of The English Malady (1733), it was the most refined and sensitive amongst the rising middle classes, those with the most leisure, who succumbed to spleen, to the vagaries of imagination, to various maladies of the nerves, those newcomers on the medical scene–mysterious messengers between body and mind and somehow responsible for a host of imprecise ailments. In the moist, vaporous climate of Britain, where cities had grown ‘populous and consequently unhealthy’, where there are ‘Efforts to go beyond former Times in all the Arts of Ingenuity, Invention, Study, Learning, and all the Contemplative and Sedentary Professions’, nerves were particularly susceptible to ‘distemper’.

  Only in the eighteenth century does it become possible to ‘suffer from nerves’. The expression doesn’t appear in Shakespeare, for whom ‘nervy’ is a cognate for ‘strong’. Beginning with Cheyne, weak nerves become a marker for sensitivity and, indeed, a cultural superiority. Dr Johnson, with a tinge of disapproval and under the label of ‘medical cant’, nonetheless notes this new meaning of ‘nervous’ in his Dictionary: ‘having weak or diseased nerves’. Casual allusions occur in the Lambs’ Letters. Mary Lamb refers to her ‘weak nerves’ Charles talks of ‘a sad depression of spirits, a most unaccountable nervousness’ of his and Mary’s ‘nervous minds’.

  For Cheyne, a successful London and Bath doctor, as for Freud over a century and a half later, civilization comes at the price of certain discontents. The times give rise to a proliferation of difficult-to-diagnose illnesses–prominent amongst sensitive women–for which patients and their families want to find a physical cause, where none except perhaps the activity of the nerves, so elusive in their determinable function, may be to hand to provide a somatic substratum. Yet insist on that bodily base, Cheyne does–it is something which separates him radically from the understandings of madness that had come from seventeenth-century doctors and thinkers: nervous distempers for him have nothing to do with ‘Witchcraft, Enchantment, Sorcery and Possession’, which are the ‘Resource of Ignorance’.

  George Cheyne (1691/3–1743) was a remarkable doctor, one in a series who were their own most illuminating patients. In his twenties, he suffered a breakdown. He pulled himself together with a blend of mysticism, based on Jakob Boehme and the quietist asceticism of such women mystics as Antoinette Bourignon and Jeanne Guyon, and a milk-based diet. Rebuilding his practice in the spa town of Bath and in London, he gathered around him a fashionable clientele including Robert Walpole’s daughter Catherine, and the novelist/printer Samuel Richardson whose Sir Charles Grandison would become a key text in the later establishment of French psychiatry. He also began to write a series of what could be called the first medical self-help books: bestsellers which had what we would now call a holistic underpinning, linking mind, body and spirit in a whole marked by commonsensical advice and moral exhortation. ‘Learned, philosophical and pious’ were the adjectives Samuel Johnson used to describe the good doctor, who called for moderation in all things. His Essay on Gout (1720) was followed by An Essay on Health and Long Life (1724), which ran to nine editions in his own lifetime and was translated into several European languages.

  Cheyne himself was enormously fat, his weight in the late 1720s reaching a record 32 stone (448 pounds, 200 kilos)–which brought in its train many of the symptoms he set out to cure: melancholy, biliousness, nausea, spleen (or a kind of aggravated, near-metaphysical lethargy), anxiety, distemper. These were the by-products of affluence and civilized life, Cheyne noted. The cure was dietary moderation, vegetarianism, exercise, emetics and forays to the spa in Bath. Prevention, however, was better than any cure.

  For Cheyne, mental distempers had their origins in the body, and primarily in the nerves. Nerves, those conveyors of sensation and motion, like the strings of a musical instrument, had to be kept well tuned. They needed to vibrate at a proper pitch when struck; if they lost their tone, grew weak and inelastic, or were obstructed through the excesses of civilized life, pain, sluggishness, gloom, resulted, perhaps even chronically–not to mention fevers, ‘cholicks’, gouts, ‘wandering and delusory images on the brain’, paroxysms, and convulsions whic
h could be accompanied by raving and incoherence. Since the quickest thinkers, those of greatest sensibility, had this weakness of the nerves, it was all the more important to prevent breakdown: a balanced life had to be led, a golden mean kept to.

  Cheyne was not a mind doctor in the sense that the specialization was to emerge in the next century, though he could be seen as an early neurologist, a medical tradition that sometimes coincided with, sometimes strayed away from, what became psychiatry. Patients, however, often presented similar symptoms to both kinds of doctors, particularly when it came to the ‘functional’ diseases, to use the later term. Vaporous mental states running the gamut from instability and unsettledness to hysterical fits and even paralysis and apoplexy were not, according to Cheyne, psychological phenomena, produced by mind and emotions. They were the product of obstructed nerves and vessels, clearly the province of bodily malfunction. Many from the mid-eighteenth through to the nineteenth century followed his cue.

  Dr William Cullen (1710–90), one of the great figures in that bastion of Enlightenment thinking, Edinburgh University, provided something of a physiology to underpin Locke’s philosophy of associationism–how ideas combine in the mind out of representations of experience. Cullen’s influential First Lines of the Practice of Physik, published between 1778 and ’84, gives great prominence to the underlying role played by the nerves in disease. He coined the term ‘neurosis’ to refer to all motor and sensory afflictions which are not linked to a ‘topical affection of the organs, but a more general affection of the nervous system’. Importantly, in terms of future psychiatric research, he also linked mania and melancholy to fluctuations in the flow of nervous impulse or ‘excitement’ to the brain, noting that since intellectual operations require orderly and exact recollection, abnormal or unequal excitement in the brain may give false perceptions, associations and judgement. He also gave an explanation for hysteria and linked it to sexual overactivity, a ‘turgescence of blood’ in the female genitalia. In 1807 Thomas Trotter (1760–1832), a Scottish doctor, published his View of the Nervous Temperament, in which he claimed that ‘nervous disorders have now taken the place of fevers, and may be justly reckoned two thirds of the whole, with which civilized society is afflicted’. Two-thirds of all ailments, suffered particularly in the city where nervousness is rife, implicates a great many sufferers.