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Hysterical Men: The Hidden History of Male Nervous Illness.

Hysterical Men: The Hidden History of Male Nervous Illness, by Mark S. Micale. Cambridge: Harvard University Press, 2008, xv + 366 pp.

In the words of the slogan, Hysterical Men does exactly what it says on the tin. Mark Micale, a leading historian of Western psychiatry, offers a history of male hysteria in Western culture, beginning with Classical Greek and Roman medicine, focusing on nineteenth-century Europe and the U.S., and ending at the fin de siecle with Freud's early forays into psychoanalysis. His central claim is that the "cultivated silence" of historians and physicians on the subject of male hysteria reflects the role of medicine in the gendering of culture and the construction of men as rational, sane, strong and normal. Micale has made several influential contributions to the cultural history of hysteria, most notably in Approaching Hysteria: Disease and Its Interpretations (1994). His most influential predecessor in this field is the critic and historian Elaine Showalter. In The Female Malady (1987), Showalter argued that the male-dominated English psychiatric establishment, drawing on a "pervasive cultural association of women and madness," created a context "in which women were first defined, and then confined, as mad" (pp. 4-5). It seems hardly surprising, then, that the major symptoms of hysteria in both genders were "a sensation of suffocation" and "loss of voice" (Micale, p. 5).

Micale begins by reminding his readers that the roots of hysteria are fundamentally gendered, an observation reflected in its name (from the ancient Greek hysteron, 'womb'). For Classical physicians, hysteria was the result of a barren and restless womb, a woman's body reminding her that her proper role was to be fruitful and multiply. But Micale also shows that the "uterine hypothesis" was only one of a spectrum of explanatory frameworks deployed throughout the history of the diagnosis. From the late seventeenth century hysteria was located in the nervous system, not the womb, and physicians began to acknowledge the possibility of male hysteria. In the "nervous culture" of eighteenth-century Europe, minds (especially sensitive, literate, socially mobile minds of both sexes) were seen to be predisposed to break down. Micale highlights the role of a "shared medico-literary culture" in the process of "nervous self-fashioning" through correspondence and conversation (p. 27).

But Micale's analysis comes into its own in the early nineteenth century. He identifies a "wave of amnesia regarding the nervous disorders," as European physicians took up a wider cultural project of "discovering and maintaining a regime of difference between the sexes" (p. 49). An increasingly conservative and evangelical culture sought to redefine the public sphere (particularly medical practice and the new life sciences) as an exclusively and definitively masculine space. Nervous disorders such as hysteria were no longer the mark of a cultured, semi-aristocratic sensibility, but revealed "a kind of character flaw, the lamentable result of a lack of will power, a pathetic excess of emotionality, or constitutional degeneration" (p. 60)--in short, femininity.

Perhaps the greatest challenge in writing the history of psychiatry is to find a vocabulary flexible enough to accommodate both modern and historical understandings of mental disorders. Though Micale acknowledges the difference between the narrow diagnostic category of "masculine hysteria" and the broader field of "male nervous suffering," he does not always observe this crucial distinction in practice. His wider argument--that the gendered language of nervous disorders was central to the cultural construction of gender roles--is convincing and well-supported, though hardly revolutionary. But to claim that male nervous disorders were hidden or suppressed because few men were diagnosed with hysteria is to ignore the large numbers of men diagnosed, treated or confined for a host of mental conditions throughout the nineteenth century. His analysis points towards a more complex set of conclusions, drawing on the manifold anxieties of globalised industrial modernity, in which the place of nervous disorders was structured not only by gender but by class, nationality and ethnicity.

For this reason, Hysterical Men is best read as a well-informed and distinguished, if problematic, reflection on the historical gendering of mental disorders. As Micale observes in his conclusion, it is a telling irony that, despite the Western philosophical emphasis on self-knowledge, the medical profession has spent much of its history avoiding "personal and collective self-knowledge of the male self' (p. 278).

Richard Barnett

University of Cambridge
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Author:Barnett, Richard
Publication:International Journal of Men's Health
Article Type:Book review
Date:Jun 22, 2009
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