An interview with Lisa Appignanesi about Mad, Bad, and Sad: Women and the Mind Doctors

The July Bookslut went live today, and I’m delighted to say that it includes my long interview with Lisa Appignanesi about her recent book, Mad, Bad, and Sad: Women and the Mind Doctors. People who study Freud will know Appignanesi from the book she co-authored with John Forrester, Freud’s Women; writers of all stripes will know her as president of English PEN, and a novelist and memoirist. The interview was terrific [don’t take my word for it: Mindhacks calls it “fantastic”]–she was very generous with her time, and thoughtful with her answers. Here’s a taste:

Inasmuch as symptoms feed into diagnoses and diagnoses feed into symptoms, it almost seems as if, given the medicalization of mental health, you would expect a huge proliferation of syndromes, and this alleged explosion of mental health disorders in the population.

I think that’s right. We sometimes find what we look for, and as the mind-doctoring professions have really colonized our mental and emotional life, we have more and more things that are disordered, that are seen through those spectacles. We find more and more depression, where at one time we would have found unhappiness, or poverty, or any of a multitude of emotional and social problems. But we look to the mind doctors for their cures. At the moment, at any case, mind doctors would rather be released from being the omnipotent source of remedy because of course they can’t cope with all these things. They’d like to help in many cases, but often they just really don’t know how. So they, too, are caught in a kind of bind over this. Various studies have shown that if you go walking in a group that can alleviate depression. Well, of course! Because we’re sad, and we’re lonely, and that doesn’t have to be diagnosed as something that can be cured by pills. It can be seen in many other ways.

One of the interesting things for me about this research has been to really clarify that, because of seeing the ways these patterns emerge over time — seeing these things that haven’t been illnesses before becoming illnesses. The easy one, of course, is ADHD (Attention Deficit Hyperactivity Disorder), where more and more children are being diagnosed with an inability to pay attention. Well, it’s very hard to pay attention when the kinds of quick cuts you have on your television and films, or in computer games are such that you’re not asked to pay attention in a particular way. It is quite possible that we develop emotional and neurological ways of coping with this which to an older generation will look like a disorder! But in fact it’s a much wider social imperative than it is simply an individual’s problem.

Be sure to read the whole thing*! You can find an archive of my long-form interviews here.

*It was about 13 pages in typescript!

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2 Responses to An interview with Lisa Appignanesi about Mad, Bad, and Sad: Women and the Mind Doctors

  1. This is an interesting review and the book looks intriguing. While I agree somewhat with the relation ship between culture and disease categories, there’s nothing like getting a mood disorder yourself to recognize the limitations of social construction theory. [I have a colleague who likes to quip that it’s all well and good to say diseases are socially constructed until you get one — this guy’s wife died of cancer by the way]

    Also, regarding the stigma of mental illness — is it really fair to place the blame on the patient seeking care? Shouldn’t the goal be to change social attitudes about mental illness?

  2. Jason says:

    Thanks for this message. I don’t think anyone with a psychoanalytic orientation holds to a purely social constructionist model–the main thing is that the way one lives with, experiences, and suffers from a disease is socially conditioned.

    As far as blaming goes, I think Appignanesi’s take on this was pretty balanced: Labels can be quite comforting–“what I’m suffering from is real! others have it, too!”–but then people get put into a box. So, yes, as she says in the interview, the goal needs to be to change attitudes.

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