376

History of Psychiatry 23(3)

Furthermore, Carlisle places a great deal of emphasis on Packard’s femininity, but does not
clearly define how her femininity informed her feminism. Clearly, Packard’s femininity is viewed
as a factor that should not deny her any civil rights. Yet at the same time, Carlisle overlooks the fact
that Packard was not seeking to elevate women’s rights to a status equal to men’s, nor was she
afraid to play up male’s masculinity – especially if it served her cause. Highlighting this balancing
act would add complexity to the study and broaden its appeal/readership.
Yet these are minor points against a book that contributes greatly to mental health and gender
studies. The author sets out each chapter in a coherent and lucid manner. While ultimately keeping
Packard as the focus, she diverges into how the AMSAII redefined ‘moral insanity’ and how most
states changed their laws to protect the rights of people accused of being mentally ill as a result of
Packard’s actions. Overall, this engaging book shows the fluid nature of what constitutes mental
illness, and the evolving role of women in the household. Additionally, it examines how Packard
helped to foster an age of reform in American mental health.

Angela Woods, The Sublime Object of Psychiatry: Schizophrenia in Clinical and Cultural Theory, Oxford University
Press: Oxford, 2011; viii + 266 pp.: 9780199583959, £34.95 (pbk)

Reviewed by: Kieran McNally, Independent Scholar

This philosophical study of schizophrenia seeks to explore how the concept of schizophrenia
came to be ‘awash with significance’ in clinical and cultural theory. In doing so, it builds on Mark
Cheetham’s notion of the disciplinary sublime: those objects of inquiry or issues which signal ‘the
provisional limits and flash points of particular disciplines’.
In a series of readings which intersect classic psychiatric texts by psychiatric figures such as
Eugen Bleuler, Sigmund Freud and Jacques Lacan, the work attempts to establish schizophrenia
as a disciplinary sublime in clinical theory. It then moves on to explore more recent texts con-
cerning schizophrenia, postmodernism and cultural theory (referencing thinkers such as Gilles
Deleuze, Félix Guattari, Bret Easton Ellis and Jean Baudrillard). In the process, it develops new
concepts such as the paradoxical sublime, whereby, among other things, the marginal is reposi-
tioned as central.
The subject matter is broad and complex and the analysis necessarily reflects this. Yet on the
whole, the work offers an extensive, worthwhile and informative analysis of the relationship between
schizophrenia, postmodern culture and society. Furthermore, it successfully positions itself as
the leading elucidation of the tendency among cultural theorists to normalize schizophrenia and
pathologize ‘normal’ subjectivity.
For historians, however, the book is somewhat problematic. This is unfortunate because the
importance of historical scholarship is asserted by the book’s author, Angela Woods. In the intro-
duction, Woods informs us of a concern ‘to preserve the scholarly integrity of cultural and his-
torical analysis’; and in the conclusion, the reader is reminded of an intention ‘to offer a historical
analysis of schizophrenia’s representation’. Yet for all this ambition, the book’s historical
foundation is heavily dependent on secondary sources. Few non-English texts are consulted;
and, strikingly, very few texts prior to 1950 are consulted and only two referenced.
This latter void – nearly half the chronological history of the concept – inevitably produces
unsettling statements, which undermine the reader’s confidence. The opening declaration in the
introduction that the word ‘schizophrenia’ first appeared in Swiss psychiatrist Eugen Bleuler’s
Dementia Praecox or the Group of Schizophrenias [sic] is but one example (the term first appeared
Book Reviews 377

earlier in 1908, in an article in Allgemeine Zeitschrift für Psychiatric und Psychisch-Gerichtliche

Medizin). Elsewhere the author goes along with the widespread, yet erroneous, conflation of
schizophrenia with earlier diagnoses in psychiatric history – most notably dementia praecox.
Consequently, Daniel Paul Schreber’s nineteenth-century diagnosis (a fulcrum of sorts in the book)
is classified as schizophrenia and so, to take Foucault’s line, the diagnosis precedes the conditions
of its own possibility.
The net achievement of such an approach is to build a framework of the disciplinary sublime on
shaky historical foundations. The critique of the representation of schizophrenia among cultural
theorists is worked out within, and confined by, a fairly orthodox historical account of the concept
(as mostly worked out by non-historians). All this casts doubt in the reader’s mind. Therefore,
while the overall analysis remains important for anyone trying to understand the relationship
between postmodernism and schizophrenia, it nevertheless represents a missed opportunity for the
history of schizophrenia.
Just why schizophrenia is awash with significance in clinical and cultural theory remains open
for historical investigation.
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