Theaters of Madness provides an analysis not often used in exploring the origins of asylums and the ideas about madness that provided their rationale. Benjamin Reiss is a professor of literature and brings a different set of analytical tools to our understanding of an institution which, if not enduring as a social reality, occupies a central place in the imagination of any student, practitioner or user of mental health services. Reiss also draws on a range of resources not often considered in histories of the asylum: literature, theatre, race and everyday culture. Early in the book Reiss states that he 'follows his nose' and you'll be glad he did, because Theaters of Madness: a genuinely new approach and an analysis that goes far beyond conventional history. I'm probably wrong to call Theaters of Madness a history, it is an historical analysis through the lens of culture.

There are six substantive chapters to Theaters of Madness, following an introduction on 'Sanative Culture'. The introduction revisits Foucault, shifting from the emphasis in Madness and Civilization on social control to Foucault's later lectures on cultural control. This is important, because Reiss wants us to think about the almost uncontested legitimacy in the early moral treatment era, and as becomes apparent, how its exaggerated claims contributed to its undoing. Reiss is interested in asylums in the United States, but this part of the story is something shared with England. Early enthusiasm quickly led to massive expansion, but also to a perception of the asylum as a panacea. It did not take long for the model asylums of Utica and McLeans to degenerate into something Scull has called 'warehouses of despair'.

In the following chapters Reiss explores writing and publication at Utica, asylum minstrel shows, Shakespeare, Emerson and the transcendentalists, Poe's allegorical short story and finally gender. The result is a diverse set of case studies, linked by a common theme of the contradictory place of the asylum, the cultural struggle with unreason, and the human foibles of those who for various reasons took a position on madness and the asylum. Overall there is a sense of tragedy to this story. In the epilogue Reiss remarks that, surveying the monumental remains of the asylum era, one is forced to reflect that "our society was capable of thinking broadly and creatively — if not critically enough — about its responsibility towards those whom it deemed incapable of managing their independence". There will no doubt be those who take this as an invitation to romanticize; to dream as the architects of the asylum dreamed, of a gilded past which, if only we could recreate its best features, would solve the modern problem of madness. But by the time you've read to this point of Reiss's book you know this is a conceit, albeit understandable. It is sobering to realize that there was no gilded age and that, even if there was, the present it its own time and demands its own answers. Reiss does point out that the very early asylums, while they remained small in scale, were able to live up to their founding ideal of using the environment as a therapeutic tool, but he adds that "even given the most generous reading, the [asylum] movement contained the seeds of its own undoing".

If all this is rather gloomy, Theaters of Madness is a fascinating read for its range of material, depth of analysis, and its theoretical clarity. Any of the chapters would make an absorbing journal paper; each can be read individually if you can make the time. You'll want to make the time, because the reading is richly rewarding, and full of detail that generally escapes notice. Production of The Opal, a print magazine, at Utica is interesting on many levels. The photograph of the print workshop shows the extent of endowment necessary for such an undertaking. But the content of the magazine is another story again. Inmate-authors were caught in a bind which saw them apparently demonstrating the benign influence of the asylum, but also enacting multiple subversive roles. The Opal was not a protest broadsheet as a consumer newsletter might be today; it was a decorous production with literary aspirations. In one of the many ironies of The Opal the authors were almost always anonymous, for fear that they might jeopardize their social reintegration on leaving the asylum. But did this not mean that part of the problem of madness was public perceptions, something we might today call stigma? And the anonymity of the authors both mimicked and mocked the literary pretensions of writers in popular magazines, who would not deign to publish their names lest their writing be thought of in crass commercial terms.

Chapter Two explores "saneface mimstrelsy", a metaphorical term derived from the blackface variety. There are too many layers of theater going on here to lay them all out, but this chapter catalogs the patterns of deceit that typified asylum actors. Reiss explores the nexus between blackness and madness, how that was enacted in the 19^th century asylum, and the shadow of eugenics that fell over the institutions in the latter part of the century. The chapter on Shakespeare Bardolatry in Bedlam is a gem. In this chapter Reiss provides a new perspective on the construction of asylum authority, showing how, in the absence of science, asylum superintendents turned to the Bard for the cultural authority. Shakespeare's authority was self fulfilling, but the alienists were coy about how they gained access to this hidden meaning that had apparently eluded scholars for two centuries. Reiss underscores the irony of this situation with a quote from a patient: "If we can learn more by studying the Bard than the Bible, or more by going to the theater than going to church, then priests better become actors".

In the chapter on Emerson, Reiss tackles the question of the legitimacy of the asylum through the case of a singular thinker, but one who ultimately couldn't stare down the cultural forces of rationality. Emerson's position as social critic and friend of the poet James Very forced him to make some difficult choices, that were both philosophically and ethically compromising. Reiss suggests that, in his response to the incarceration of Very, Emerson may have been influenced by experience of madness in his own family. Whatever the reasons, as Reiss so pithily puts it in the next chapter, "Emerson blinked". The consequence for Very was a sense of abandonment, poignantly expressed in his poetry: "And you in turn must bear the stripes I bear / And in his sufferings learn alike to share".

Reiss then moves his attention to France, to consider the effect of the revolution on the lives of the mad, finding that Pinel's "Freeing the insane", the subject of one of most enduring images of the moral treatment era, in fact ushered in new coercive practices to fill the void left by the rejection of the lettres de cachet. This chapter also includes an analysis of Poe's short story The System of Doctor Tarr and Professor Fether. At one level a typically gothic Poe story, Reiss shows how Poe captured both the contradictions of class and madness, and the infusion of madness with the cultural dread of blackness. This chapter brings together historical and literary analysis to explore deep seated anxieties about otherness, unmasked by a political lacuna that resulted from the revolution. The final chapter covers gender, and here Reiss turns a critical eye to the gendered nature of insanity in the 19^th century. There are contradictions here, too, as Reiss explores Elizabeth Packard's appeal to patriarchal institutions to at least do what they purport to do: protect the vulnerable. As others including Elaine Showalter have done, Reiss shows that 19^th century asylums, for all their emphasis on stereotyped gender roles, were not unproblematic bastions of male privilege,. The effect of male stereotypes is explored through Melville's story Bartleby the Scrivener whose passive, feminized "I would prefer not to" led to his incarceration and demise.

In the epilogue Reiss considers the contemporary cultural position of madness and the social position of those who we now call the "mentally ill". Historians of psychiatry and social historians will find this book of considerable interest. In a sense it might be thought of as an extension of Rothman's The Discovery of the Asylum. Rothman put the American asylum into historical perspective, showing it was a response to what was seen as a "social problem" but not the necessary and inevitable response it is sometimes considered to be. Reiss takes this further by showing how the asylum interacted with other cultural institutions of the time, and how utopian ideals, because they arise at a time of need, can lead to unjustified optimism, especially when championed by respected authorities. As Reiss states in relation to minstrel shows at Utica, the asylum arose in "a hopeful, even utopian, moment in the treatment of the insane; when it was believed that providing a sanative physical environment and a restorative cultural one would actually cure insanity an return the dispossessed to contact with society". For those whose work involves the contemporary management of madness, Theaters of Madness offers a corrective to professional hubris, and a lesson in the limits of orchestrated social change. Reiss shows that to understand madness we need much more than the conceptual tools of psychiatry and, for that matter, of its more reactionary opponents.

© 2009 Tony O'Brien

Tony O'Brien RN, MPhil, Senior Lecturer, Mental Health Nursing, University of Auckland, a.obrien@auckland.ac.nz

Keywords: intellectual history