| Book Review | Health and History, 9.2

Book Review

Essay Review

Catharine Coleborne, Reading 'Madness': Gender and Difference in the Colonial Asylum in Victoria, Australia, 1848–1888 (Perth: API Network, 2007). ISBN: 9781920845346. 219 pp.

Reading Madness is an intriguing and innovative history of the lunatic asylum in Victoria, Australia, between the establishment of the colony's first such institution, at Yarra Bend in 1848, and the report of the Zox Royal Commission into Asylums for the Insane and Inebriate, nearly forty years later. Coleborne's chief concern is with the ways that our colonial forebears sought to make sense of madness by containing it within a system of differences—that is, by putting it into a language. The 'language of the asylum,' as Coleborne analyses it, was structured by the rigorous distinctions drawn between patient populations, enforced in the segregated spaces and iron routines of the institution and disseminated in medical, legal, journalistic and bureaucratic texts. These texts, she contends, did not merely reflect, but actively constituted social relations by reconfiguring understandings of pathology and normality—both within the institution and beyond its walls.

As its title suggests, this is a work written from a vantage-point beyond history's 'linguistic turn.' By emphasising the fictive and generic dimensions of asylum documents, the way that they 'made up' the people they purported to describe, Coleborne aims to deconstruct or problematise the key sociological categories of patienthood which earlier medical and social historians often took for granted. Class, race and gender appear in Reading Madness, not as natural 'givens,' but as cultural constructions embodied in institutional writing and circulated throughout the wider culture. The representations generated by the asylum, she insists, cannot be accepted as transparent descriptions of an empirical reality, but must be interrogated as rhetorical vehicles for the 'production' or 'invention' of the proper patient, the authoritative doctor or the ideal asylum.

The earlier chapters of the book are devoted to the asylum's 'invention,' exploring the imagination and legitimation of a reformed and therapeutic space to replace the bedlam and the gaol. Inventing the asylum was not only an affair of state. Coleborne quotes from several colonial newspapers which agitated for separate institutional provision for Victoria's lunatics from the 1850s onwards just as vociferously as their contemporary equivalents decry the failures of deinstitutionalisation. Then, as now, community responses to the scandal of public madness were complex and ambivalent, as humanitarian considerations competed with an overriding fear of the Other. On the one hand, the mentally ill deserved protection and kindness—on the other, they required confinement and control.

Coleborne implies that this equivocal public discourse had specifically colonial overtones in a society seeking to harness economic dynamism and social mobility to the conservative values of gentility and public order. In the context of late nineteenth century Victoria, the asylum could be idealised as emblematic of a triumphant civilisation, emerging from the excesses and disorders of the past. As psychiatric statistics began to be gathered and intercolonial comparisons were made, Victorians came to see themselves as living in 'the maddest colony' of the Empire, where, as the Ballarat Star put it in 1858, uniquely 'violent and rapid changes in industry, wealth, social relations and civil status' had brought many to 'despair' and rendered them 'dangerous to society.' Against this background, the imagined curative institution would not only reform its inmates, but would palliate the ailments of an overheated and under-governed society. The tension between the idealised image of the asylum as a place of moral rectitude, caring medicine and peace and quiet, and a reality which appears to have been crowded, neglectful and routinely violent soon led—in Victoria as elsewhere—to a cycle of scandals and official inquiries, which Coleborne considers further 'wrote the mad' into the popular consciousness.

Gender is a key theme of Coleborne's history. Her argument throughout is distinguished by its attentiveness to ways that the discourse of alienism was also a discourse on the 'natural' differences between the sexes. The legitimation of the asylum keeper as an expert capable of pronouncing on legal and social issues, she argues, was crucially contingent upon his ability to naturalise the patriarchal order and to camouflage its abuses. Exploring evidence given in criminal trials and case studies presented in medical journals, she notes that all forms of conducting unbecoming a Victorian woman—theft, promiscuity, infanticide—could be publicly explained away as medical problems inherent within the unstable feminine constitution, stripping desperate or disturbing acts of their personal agency and social significance. Part and parcel of the spread of psychiatric expertise, therefore, was the spread of new languages for the subordination of women.

Patient casenotes are similarly interrogated by Coleborne, not only as reflective of gender norms, but as actively productive of them. As a 'genre,' she suggests, patient records were shaped by a set of narrative conventions which imagined the (implicitly female) 'ideal patient' as making an upward journey from recalcitrant derangement to a recovered decorum and obedience. However, this trope of recovery through submission was, as Coleborne sees it, often frustrated by the tenacious unpredictability of patient bodies. Women in the asylum remained 'shifting subjects,' whose unpredictable behaviour Coleborne reads as a form of mute resistance to institutional narrativisation. 'Bodily acts of defiance or resistance,' she conjectures, are 'evidence of a symbolic language among female lunatics.' Persistent silence or incoherent speech, we are likewise told, might be 'understood as a powerful form of female subversion and may be read ... as an alternative to the very language of the asylum.'

This construal of refractory behaviour as a form of 'women's language' or prediscursive resistance, is perhaps the most problematic aspect of Coleborne's 'readings' of 'madness.' While she is careful never to claim unmediated access to the will or the voice of the patient, Coleborne's equation of described indocility with active resistance cannot avoid certain fundamental questions. If 'it is in the casebooks that the identity of the asylum is invented,' then who is resisting, and how can we know them? What, if anything, is 'outside the text'?

Similar questions arise around the book's suggestion that some patients may have 'performed' their recoveries in order to get out of the asylum, without having fully internalised the institution's strictures. The implied distinction between genuine and somehow insincere cures seems rather paradoxical to this reader. In what did recovery consist, if not the capacity to adequately 'perform' accepted social roles? Surely anyone rational enough to convincingly fake sanity deserves to be called sane?

The book's final chapters, taking the reader through to the 1870s and 1880s, explore the growing social anxiety produced by an institution increasingly seen as overcrowded, poorly governed and unscientific. This anxiety was embodied by the growing number of patients seen as improper subjects for institutional correction. The Zox Commission of the mid-1880s, following the lead of medical opinion, argued that the asylum should be reformed through more effective classification, to separate out the 'heterogeneous' social classes now promiscuously rubbing shoulders in the asylum. Here again, Coleborne astutely points out, the debate over the administration of lunacy can be read as a proxy for broader cultural anxieties concerning immigration, degeneration and criminality in late colonial Australia. Both within and without the asylum, medical science was advanced as the ultimate solution to the impurities and hybridities which threatened to undermine the internal and external boundaries of social meaning.

Reading Madness is an imaginative and original contribution to the historiography of the asylum in Australia. Its strengths and weaknesses are largely those endemic to this sort of cultural history. Some readers will struggle with Coleborne's rather condensed and allusive prose, and will have doubts about the use of apparently peripheral shreds of information as exemplary of broader concerns. More, however, will be excited and inspired by the potentially very productive interpretive possibilities her work opens up. Viewed as a stand-alone work of scholarship, this updated PhD thesis does not quite live up to its broad ambitions. Recognised as a blueprint for more extensive research, it will doubtless inspire many present and future historians to turn fresh eyes upon the discursive asylum.

EDMUND McMAHON

UNIVERSITY OF NEW SOUTH WALES

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