Abstract
The main aim of this book is to study the emergence of psychological medicine in nineteenth-century Spain. The initial thesis is unmistakable: the reflexivity of the modern self brought about the cultural establishment of psychiatry and mental illness, since this process could hardly have evolved without the background furnished by a culture of subjectivity in which the self has usually been perceived as problematic and precarious and where the sources of emotional distress have ended up being situated and processed in the domain of an interior world attached to the individual.
Despite suggestions contained in some now classic studies (Foucault, Dörner, Swain), there are only a few works analysing the process behind establishing psychological medicine from its development and the dissemination of the modern culture around the self or subjectivity. In the 1990s, the German historian Doris Kaufmann demonstrated, in her Aufklärung, bürgerliche Selbsterfahrung und die ‘Erfindung’ der Psychiatrie in Deutschland, 1770–1850 (1995), how the new perception of the individual, encouraged by the Enlightenment and Romanticism, brought a new vision of insanity; this, in turn, was decisive in creating new institutions for the insane and in consolidating a new medical discourse on mental illness.
Novella’s book aims, using similar coordinates but applied in a very different geographic (and socio-cultural) context, to analyse the process of this breakthrough in Spanish alienism during the nineteenth century. Novella focuses not only on the discourses and practices of alienism in Spain, but above all on how cultural conditions created a ‘breeding ground’ that made this new perception of insanity possible. He also argues that the progressive medicalization of the old domains of the soul created a profound crisis which demanded the intervention of medicine to regulate human passions and, therefore, to establish the liberal-bourgeois order.
As Novella contends in the first section of the book, this new perception of insanity – as an individual condition and as an object of public attention – peculiarly impregnated public opinion, which explains the interest and concern of the press and traditionalist literature about insanity and the treatment handed out to this ‘humanity in pain’. He proceeds to analyse Spanish doctors’ progressive development of medical knowledge of the psyche as a phenomenon with three factors or elements running through it: the progressive implementation of the project of naturalizing the soul; medicine’s new self-understanding as a global anthropological knowledge; and the attempt to consolidate a moral order endorsed and backed by the authority of science. Of special interest to me are Novella’s pages on the institutionalization of psychological knowledge in Spain via the educational reforms set in motion in the second third of the nineteenth century. Through an extremely spiritualistic orientation, the liberal elite articulated a whole pedagogy of subjectivity in secondary education that, in a way, would counteract the naturalization and fragmentation of psychism that a more materialistic science started to advocate. Finally, I would like to highlight the author’s analysis of contributions by Spanish doctors to psychic hygiene or, in other words, the ‘therapeutic’, ‘prophylactic’ and ‘morally regenerative’ proposals to counteract the threat posed by overwhelmed imagination, disordered passions, etc., for the integrity of the self.
La ciencia del alma goes through the epistemological, social and cultural coordinates that led to the birth and consolidation of psychological medicine in Spain from an original and novel perspective. In my opinion, the book provides a valuable input to the history of psychiatry, as previously there were no works that delved in such detail and so soundly into this historic process from the point of view of its ‘cultural preparation’. This expression refers to the decisive cultural transformations that brought on the rudimentary modernization of the country throughout the nineteenth century, especially the introduction and diffusion of the new concepts of the individual and subjectivity fuelled by the new liberal order.
Moreover, the book is impressive for the wide range of sources used, broadly transcending medical and psychiatric literature, as well as for the abundant critical apparatus that allows the author to contextualize sources thoroughly. The result is a brilliantly erudite analysis within a solid theoretical framework, explicitly displayed: that of the cultural history of subjectivity, not far from the influence of Jan Goldstein.
In summary, this study is an important monograph which will be of undoubted interest not only to historians of psychiatry, psychology or medicine, but also to historians of pedagogy and general historians, not forgetting philosophers and anyone interested in historic and epistemological reflection on psychological medicine. This book, written in a beautiful and painstaking Spanish, represents a complete case study, thus proposing a research model that could well inspire similar studies in other national areas.