Abstract
In this book, Linda Carlisle traces the life of a social reformer who fought for the rights of women and mental hospital patients in later nineteenth-century USA. While other scholars have shown an interest in Packard, Carlisle’s book more closely examines her life in its historical context and highlights Packard’s impact in shaping American psychiatry. The book aims to ‘extend discussion of [Packard’s] religious ideas and political ideals’, to show how these pushed her to fight for reform and to ‘demonstrate her influence on the psychiatric profession’ (p. 14). Her goal as a reformer was to redefine the role of married women in the home, to secure basic rights for patients in the asylum, and to set legal safeguards in the committal process of potential patients, which, in the early nineteenth century, gave the majority of power to husbands and general medical practitioners.
Before Carlisle examines Packard as a reformer, the first half of the book follows her as she attempted to understand and reconcile her religious ideals alongside new feminist views in an ever-changing American society. By doing this, Packard, unknowingly, began exposing the folly of medically constrained gender and religious roles. For example, Carlisle shows that Packard’s husband Theophilus, a Calvinist minister, believed she was ‘insane’ because she dared to challenge his orthodox religious beliefs while seeking to redefine hers. According to the author, however, the real egregious actions Packard took against Theophilus were to dispute his authority in the home, though the author does not dwell upon this point. Packard did this, in part, by surrounding herself with questionable spiritualists in the community, thus weakening her husband’s social prestige, which ultimately led her to spend three years in the Illinois State Hospital for the Insane. It is clear from the beginning that Carlisle is sympathetic to Packard’s views, as she portrays her incarceration as a result of disputing her husband’s authority.
In the second half of the book, Carlisle explores Packard’s life as a reformer, dedicating the last eight chapters to her role as an activist as she travelled from state to state (and a few territories) advocating legislation to protect in-hospital patient civil liberties and the liberties of married women in the home. Yet, even as many of her proposals centred on women’s rights, specifically those accused of being mentally ill, Carlisle makes an effort to note that patients of both sexes enjoyed the fruits of Packard’s labour. Additionally, she carefully shows how one determined woman caused a stir within the medical profession such that the Association of Medical Superintendents of American Institutions for the Insane (AMSAII) took note and began to change their institutional practices and definitions of insanity.
While the second half of the book is important and clearly the focus of Carlisle’s study, its real essence, in my opinion, is contained in the first five chapters. Here, the author shows that mental health was not just an extension of social control, or purely a biological affliction. Very adeptly, Carlisle considers the interplay of gendered roles, social classes, religion, individualism, marital roles and personal morals, and presents a study that shows readers how all these ideals influenced nineteenth-century concepts of mental illness. Anyone who picks up this work hoping for a simple biography of one woman will be in for a surprise. The book is less a biography (even as Packard is the main character) and more an examination of changes in social and mental health policy exemplified in one woman’s struggle for women’s and patient’s rights.
However, Carlisle’s approach – part biography and part social history – has the unfortunate effect of distorting Packard’s place in history. Instead of relating her reforms in tandem with other social movements, Carlisle presents her as a one-woman advocate. In doing so, the author actively relegates those who helped Packard to the background as minor players while keeping her in the forefront. Carlisle might have considered broadening her scope in order to give the people who helped Packard, indirectly or otherwise, their due. For instance, she notes how, concurrent with Packard’s work, the Women’s Rights Movement was actively petitioning state legislators for women’s rights, yet Packard distanced herself from them, so Carlisle does the same. If she had mentioned how they might have circuitously led to some of Packard’s success, this would not only have made a more diverse study but might perhaps have been of interest to historians with a wider interest in nineteenth-century women’s movements.
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.