THE BIRTH OF NEUROSIS: Myth, Malady, and the Victorians

Though there have been books about the-unconscious-before-Freud, and about sexuality/pathology-before-Havelock Ellis, no previous popular work has assayed so wide-angle a vision of the Victorian psyche. The result sometimes falls short of razor-sharp scholarship and scintillating prose, yet it has intrinsic fascination. Everyone has heard of Charcot and Janet and Mesmer, but few probably know the details of the strange band of hysterics recruited to Salpêtre: posturing females who produced fits on command (or rather by application of pressure to specific body sites). These women, the models for hypnosis, apparently had life histories straight out of the Marquis de Sade. Yes, he comes up for mention, along with Sacher-Masoch, the works of Krafft-Ebing, and an impressive roster of medical and literary folk in Europe and America. Drinka, a psychiatrist (Boston Children's Hospital) with an Oxford M.A. in history, reminds us of those familiar Victorian terms ""the vapors,"" frayed nerves, neurasthenia, ladies of ""delicate disposition,"" and of the prototypical symptoms: paralysis, swoonings, palpitations, fetishes, perversions. He has searched behind the words and symptoms to sketch the concepts that the leading figures developed and that governed their approaches to treatment. He is particularly good in contrasting American optimism with the more gloomy European view. Thus, for such Americans as George Miller Beard and Silas Weir Mitchell, attacks of nerves were associated with intelligence and an advanced stage of evolution; much brain work led to nerve exhaustion, and American know-how could come to the rescue. (Electrical treatments were a favorite of Beard's, while Mitchell preached ""rest, relaxation and retreat from the world's cares."") Europeans tended to approach nervous ills with depressing myths evoking Zeus (the bolt from the blue that strikes the patient down) or concepts of ""Angelic Invalids,"" ""Onanism,"" ""degeneracy,"" or ""Sinful Genius"" (Wagner, the prime example). In those pre-Freudian times, of course, leading medical men looked for physical causes in brain tissue or nerves, not ""mind."" The book's later chapters contain capsule biographies of men and women who exemplified Victorian maladies or, in some instances, victories over them: George Sand and George Eliot, Proust and Verlaine and Rimbaud, the Brownings, the James family, the Rosettis, Nietzsche, Wagner. Finally, Drinka introduces Breuer and Freud, the departure from hypnosis and the French school, the advent of talking therapy with Anna O. and the Wolf-man. With such an extraordinary crew, Drinka can be forgiven for occasionally seeming off-course or too glib. Overall the book succeeds admirably in enlarging the reader's perspective and revealing links between today's eclectic approach in psychiatry and the century past.