University of Illinois Professor Mark S.

Micale
Spring Semester, 2010 Department of History
Fridays, 5:00-8:00, P.M. msmicale@illinois.edu

History 396:
The History of Madness and Psychiatry

Subject of the Course: What is insanity? How do we define the normal and the
pathological in human mental behavior? Who in society is best suited to determine what
constitutes psychological health and sickness? And when is society justified in committing a
person against their will to a mental hospital? How do class, race, religion, and gender influence
our views of mental health? Which past and present psychiatric treatments have been beneficial
and which harmful? Ultimately, is psychiatry a helping, humanitarian profession or a
controlling, coercive one? At the beginning of the twenty-first century, the sciences of the mind
—psychiatry, psychoanalysis, clinical psychology, psychopharmacology, the cognitive
neurosciences—claim tremendous scientific authority and exert enormous influence over our
lives. Yet these are only several of the basic, urgent questions that remain unanswered or
controversial today.
This seminar seeks to explore these and many related subjects. Our approach to these
questions will be historical. Specifically, we will study the social, cultural, intellectual, and
institutional history of madness and psychiatry in America and Europe from the late eighteenth
to the present. Topics of study will include: the origins of the modern asylum, historical
theories of normality and abnormality, patient autobiography, the history of the insanity defense
in the courts, psychiatry and heredity, the emergence of the concepts of neurosis and
nervousness, the importance of race in American medical practice, “shell shock” in the First
World War, psychiatric labeling and classifying, and the advent of our own “age of prozac.”

Course Readings: The following books have been ordered for the course:

--Barker, Pat, Regeneration: A Novel (1991).

--Kramer, Peter D., Listening to Prozac (1993).
--Lombroso, Cesare, Criminal Man (1876-1896; reprint 2006).
--Metzl, Jonathan, The Protest Psychosis: How Schizophrenia Became a Black Disease
(2010).
--Rosenberg, Charles E., The Trial of the Assassin Guiteau: Psychiatry and Law in the
American Gilded Age (1968).

--In addition, there is a Course Reader of photocopied documents and articles.

Other Course Activities: Throughout the semester, we will also watch several films
pertaining to aspects of psychiatry that we will be studying. The dates and times of the movies
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are to be arranged.

Course Requirements and Grading:

1) attendance at the weekly classes (15%)

2) informed participation in class discussions (25%)

2) a five-to-six-page essay on an assigned question of your choice due on Friday,

February 19 (15%)

3) an in-class presentation of about twenty minutes on a relevant book, article, or film

drawn from the weekly supplemental reading listed below (15%)

and then either

4) a longer essay, running from 8-10 pages in length, on a topic or question of your
choice in the history of psychiatry chosen in consultation with the professor, which is due
at the end of the course (30%)

or

5) a final examination, given on Friday, May 14 (30%)

Schedule of Classes

Week One
January 22
Introduction: What is the History of Madness and Psychiatry? Why Study It?

David L. Rosenhan, “On Being Sane in Insane Places,” Science, (1973). Handout before
class.

Mark S. Micale, “The Psychiatric Body,” in Medicine in the Twentieth Century (2000),
chapter 22. Handout before class.

Part One:
The History of Psychiatry, 1780-1850
Week Two
January 29
The Enlightenment Origins of Modern Psychiatry
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Philippe Pinel, A Treatise of Insanity (1801), Chapter Two. Hand out in class.

J. Crichton-Browne, “The History and Progress of Psychological Medicine,” Journal of

Mental Science, 7 (1861), 19-31, in the Course Reader.

Week Three
February 12
The Anti-Psychiatry Movement

Erving Goffman, Asylums: Essays on the Social Situation of Mental Patients and Other
Inmates (1961), Chapter One. Hand out in class.

Thomas S. Szasz, “The Myth of Mental Illness,” The American Psychologist (1960), in
the Course Reader.

Student Report: Greg Smith, Goffman and Social Organization: Studies in a

Sociological Legacy (1999), Chapter Five.

Film #1: Girl, Interrupted (1999), directed by James Mangold, starring Winona Ryder,
Angelina Jolie, Whoopi Goldberg, and Vanessa Redgrave.

Week Four
February 19
Psychiatry and Religion

Anne Digby, Madness, Morality, and Medicine: A Study of the York Retreat, 1796-1914
(1985), Chapters One to Six and Eight. Hand out in class.

Film #2: One Flew Over the Cuckoo’s Nest (1975), directed by Milos Forman, starring
Jack Nicholson and Louise Fletcher.

Student Report: Lynn Gamwell and Nancy Tomes, Madness in America: Cultural and
Medical Perceptions of Mental Illness before 1914 (1995), Part II, 37-118.

Week Five
March 5
Early History of the Asylum: Review

Student Report: Norman Dain, “Psychiatry and Anti-Psychiatry in the United States,” in
Mark S. Micale and Roy Porter, editors, Discovering the History of Psychiatry (1994),
chapter 21.
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--First Assigned Essay Due--

Part Two:
The History of Psychiatry, 1870 to World War One

Week Six
March 12
“Neurasthenia” and the Origins of the Concept of Neurosis

George Miller Beard, A Practical Treatise on Nervous Exhaustion (Neurasthenia) (1880),

chapters. 1, 2, 5. Hand out in class.

Film #3: The Road to Wellville (1994), directed by Alan Parker, starring Anthony
Hopkins, Matthew Broderick, John Cusack, and Dana Carvey.

Student Reports: Barbara Sicherman, “The Uses of a Diagnosis: Doctors, Patients, and
Neurasthenia,” Journal of the History of Medicine (1977), 33-54; Charles E. Rosenberg,
“The Place of George M. Beard in Nineteenth-Century Psychiatry,” Bulletin of the
History of Medicine (1962), 245-259; Marijke Gijswijt-Hofstra and Roy Porter, eds.,
Cultures of Neurasthenia: From Beard to the First World War (2001), Introduction,
Chapters One, Two, and Four.

Week Seven
March 19
Legal Psychiatry and the Early Insanity Plea in America

Charles E. Rosenberg, The Trail of the Assassin Guiteau: Psychiatry and Law in the
Gilded Age (1968).

Student Reports: Thomas Maeder, Crime and Madness: The Origin and Evolution of the
Insanity Defense (1985); Rita J. Simon and David E. Aaronson, The Insanity Defense: A
Critical Assessment of Law and Policy in the Post-Hinckley Era (1988), selections.

Week Eight
March 26
Psychiatry and Criminology: The Nineteenth-Century Theory of Degeneration

Cesare Lombroso, Criminal Man (1876-1893), selections.

Student Reports: Stephen Jay Gould, “Carrie Buck’s Daughter,” in The Flamingo’s
Smile: Reflections in Natural History (1985), Chapter 20; Foucault, Michel, "About the
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Concept of the `Dangerous Individual' in 19th-Century Legal Psychiatry," International
Journal of Law and Psychiatry, (1978), 1-18; Robert Proctor, Racial Hygiene:
Medicine Under the Nazis (1988), Chapter Five.

Film documentary #4: Selling Murder: Killing Films of the Third Reich (BBC Film,
1999).

April 2: No class

Week Nine
April 9
Shell Shock and the First World War

Pat Barker, Regeneration: A Novel (1991).

Eric J. Leed, No Man’s Land: Combat and Identity in World War I (1979), Chapter Five.
Handout in class.

Student Reports: Eric T. Dean Jr., Shook Over Hell: Post-Traumatic Stress, Vietnam,
and the American Civil War (1997); Ben Shephard, War of Nerves: Soldiers and
Psychiatrists in the Twentieth Century (2001); Mark S. Micale and Paul Lerner, eds.,
Traumatic Pasts: Medicine, Psychiatry, and Trauma in the Modern Age, 1870-1930
(2001), Introduction, chapters 9-12; Allan Young: The Harmony of Illusions: Inventing
Post-Traumatic Stress Disorder (1995).

Film #5: Behind the Lines (1994), directed by Gilles Mackinnon, starring Jonathan Price
and James Wilby.

Part Three:
Some Contemporary Issues in Psychiatry

Week Ten
April 16
Psychiatric Diagnosis Gone Wild

American Psychiatric Association, The Diagnostic and Statistical Manual of Mental

Disorders, fourth edition (DSM-IV), (2000).

Student Reports: Herb Kutchins and Stuart A Kirk, Making Us Crazy: DSM, or the
Psychiatric Bible and the Creation of Mental Disorders (1997); Allan V. Horwitz and
Jerome C. Wakefield, The Loss of Sadness: How Psychiatry Transformed Normal
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Sorrow into Depressive Disorder (2007); Christopher Lane, Shyness: How Normal
Behavior Became a Sickness (2008).

Week Eleven
April 23
Psychiatry and Race

Jonathan Metzl, The Protest Psychosis: How Schizophrenia Became a Black Disease
(2010).

Student Reports: Matthew Gambino, “’These Strangers Within Our Gates’: Race,
Psychiatry, and Mental Illness among Black Americans at St. Elizabeths Hospital in
Washington, DC, 1900-1940, History of Psychiatry (2008), 387-408; John S. Hughes,
“Labeling and Treating Black Mental Illness in Alabama, 1861-1910,” Journal of
Southern History, 58 (1992), 435-460; Thomas S. Szasz, "The Sane Slave: A Historical
Note on the Use of Medical Diagnosis as Justification,” American Journal of
Psychotherapy (1971), 228-239; Albert Deutsch, “The First U. S. Census of the Insane
(1840) and Its Use as Pro-
Slavery Propaganda,” Bulletin of the History of Medicine, 33 (1959), 454-465.

Week Twelve
April 30
The Age of Psychopharmacology

Peter D. Kramer, Listening to Prozac: A Psychiatrist Explores Anti-depressant Drugs

and the Remaking of the Self (1993), selections.

Student Reports: Andrea Tone, The Age of Anxiety: A History of America’s Turbulent
Affair with Tranquilizers (2009); Nicolas Rasmussen, On Speed: The Many Lives of
Amphetamine (2008); Robert Byck, editor, Sigmund Freud: Cocaine Papers (1974).

Week Thirteen
May 7
Conclusions and Optional Student Presentations in Class

No reading assignment

Student Report: Simon Winchester, The Madman and the Professor: A Tale of Murder,
Insanity, and the Making of the Oxford English Dictionary (1998).

Final Examination Review: TBA

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Week Fourteen
May 14

Research Papers Due

Final Examination Given