In the final pages of a book that studies madness in early modern England, Carol Thomas Neely draws from a more contemporary source, Susanna Kaysen’s immensely popular memoir Girl, Interrupted. In the passage she quotes, the central character confronts her alleged disorder and constructs an elaborate chart with well over a dozen possible diagnoses, ranging from demonic possession to social deviance to sanity in an insane world. The passage is meant to demonstrate how allegedly accurate diagnoses of mental illness in contemporary medical settings oftentimes are as baffling as the conditions they purport to treat. As Neely responds, Kaysen’s “‘Etiology’ precisely charts the range of conditions, diagnoses, and cures and the historical shifts in the representation and management of madness that my book traces in early modern England between 1576 and 1632.” This sentence, with which Neely’s book concludes, can be understood at least two ways, and it is in these two possible interpretations that the strengths as well as the limitations of her recent study become most clear.

At its most powerful, Distracted Subjects takes the notion of madness not as a stable category during the sixteenth and seventeenth centuries, but as a concept marked by heterogeneity, fluidity, and above all historical transformations. Neely conscientiously resists a tendency to flatten out, dehistoricize – or better still, to anatomize – early modern madness, a tendency that has met with objections only recently, with historians and critics such as Michael Macdonald and Winifried Schleiner, both of whom she draws upon. To that end, it is worth noting that Neely combines terminology. Her book explores not only “madness,” but a condition that went by the equally pervasive term, “distraction.” As she writes, “The term “distraction” also signals my thesis – that new divisions emerge when mental disorders change their epistemological profile and their cultural place. In this period, the cultural discourses that narrate and stage disorder themselves divide and produce reclassifications, revised diagnoses, changing gender associations, and new remedies.” While this shift toward distraction marks an important development in contemporary understanding of early modern psychologies, it does not prevent her from using the more familiar term, “madness,” throughout. Indeed, both terms appear in her title, and if at times they are difficult to tell apart, we owe this confusion to the original documents themselves, rather than to Neely’s careful analysis.

As a second, if not secondary, concern, Neely responds to several new historicist claims about the role of theatre in early modern culture. Most emphatically, she maintains, “Although some historicist criticism of literature appears to assume otherwise, literary representation and social history can diverge as well as converge… play texts and performances, with their many agendas, can produce rather than reproduce attitudes and ideology” (163). Though she does not enact a full intervention into the recent debates concerning the relative power or powerlessness of the theatre, she implicitly responds to them by arguing that the theatre decisively shaped contemporary attitudes toward madness. As she writes at the end of chapter two, in which she argues that the London stages actually contributed toward a new language to represent distraction, “The complexities of reading the discourse of madness in a range of cultural documents suggest the varied ways in which dramatic texts intersect with others to imagine new structures of human subjectivity. While plays are historical documents among others, they do not exist in quite the same register with all the rest. The theatre is not simply seamlessly embedded in the dominant ideology and it does not, in any straightforward way, simply reflect, contain, or subvert the cultural milieus in which it is embedded” (67). Indeed, at a crucial moment in her final chapter – and perhaps the most innovative section of the book – she argues that stage representations of Bedlam during the seventeenth century were a radical departure from anything that took place in the actual hospital. Here, her argument depends on two components, namely the absence of any documentary evidence to suggest that Bedlam was frequented by tourists who saw the insane as something of a permanent stage-show, and the notion that theatre was emphatically non-mimetic in its representations of madness.

 In the course of making her case for the theatre as a central locus for new languages and ideologies for madness, Neely explicitly makes a connection between the early modern discourses of madness and theatricality. In direct opposition to Foucault’s thesis that the epistemological grounding for early modern madness underwent a virtually seismic shift at a single moment midway through the seventeenth century, Neely argues that the process was slow, gradual, and of course “messy.” In focusing on play texts, Neely gives prominence to the unstable and uncertain techniques that were used to diagnose and treat madness. As the plays she writes about demonstrate, the very concept of madness depended almost entirely on the institutional apparatuses that made available the cultural authority to recognize it in the first place. And while Neely offers insights about many plays, she is at her strongest in her extensive readings of plays that dramatize the social construction of these apparatuses, among others: The Two Noble Kinsmen, Twelfth Night, The Comedy of Errors, The Merry Wives of Windsor, and The Changeling.

 Neely supplements her readings of dramatic texts with examinations of other historical documents, including medical records from several prominent English doctors, and visual culture – Dutch paintings, in particular. In chapter three, for instance, Neely reads the language of case histories, a newly emerging genre within physiological studies. In chapter four, a study of the pervasive and highly vexing condition of “erotomania” – to make use of a diagnostic term she unfortunately does not use – she examines a series of comical portraits by Jan Steen in order to interrogate the “love-cure” and its socially constraining implications for afflicted women. Most intriguing is her section on the history of Bethlehem hospital, in her concluding (and longest) chapter. Against a longstanding critical tradition that assumed Bedlam provided something of cheap entertainment for throngs of curious passersby, Neely maintains that the documentary evidence from the period indicates that nothing of the sort took place; quite the contrary, it was viewed as a site of civic pride, offering temporary care to the poorest and most infirm of individuals, often under the most distressing economic conditions imaginable. In the end, her historical analysis of the hospital flouts virtually every description hitherto put into print, though as she points out, such descriptions owed more to fantasy and outdated ideological investments than hard evidence. These sections do not make up the central focus of her research. They often are intriguing, and if there is a single shortcoming to them, it is that they are too brief and too summarizing. All this said, however, these sections will hopefully open up avenues for future research.

Of more pressing concern, the brief discussions of early modern attitudes toward madness lead to potential inconsistencies within Neely’s own approach. For instance, she objects to the historical studies of melancholy that appeared during the early and mid-twentieth century on the grounds that they falsely construct a “unified picture of these conditions that is derived from culture or ideology and reflected in art” (8). While she offers in its place a more disjunctive portrait of madness(es), this portrait bears a remarkable similarity to the one she sketches with regard to our own contemporary attitudes toward madness. Thus, with regard to early modern medical diagnostics, she writes, “They may also let us remember that we continue to diagnose disturbances of the mind with imprecise and shifting terminology – schizophrenia, manic depression, bipolar, psychotic – and treat them with varying remedies such as insulin-coma therapy, electroshock therapy, psychoanalysis, strait-jacketing – and an array of drugs” (74). This is a problematic remark, not only for its brevity but for its explicit parallelism; at such moments, she appears to collapse one historical period onto the next, as though the disunities and multiple possibilities that she observes in the seventeenth century have somehow carried over into the twenty-first. To that end, when she claims that the etiology from Girl, Interrupted “precisely charts” the conditions of madness between 1576 and 1632, one may wonder just how literally she means it. To be sure, it is not objectionable to use early modern approaches to distraction as an instrument for clarifying problems about the discourses of madness and reason in contemporary culture. Nevertheless, it remains a question in Neely’s work, to what extent she views madness as an historically consistent concept, marked more by differences in nomenclature than knowledge.

 In the end, however, such a question is more than made up for by the readings of several Shakespearean and non-Shakespearean plays alike. Her sections on the individual plays mentioned above are consistently engaging. Her readings of other cultural documents are as original as they are thoroughgoing. Her extensive analysis of the status of women in early modern case studies and diagnostics goes a long way toward improving our understanding of the relation between madness and gender. Her book makes an essential contribution to research that several literary critics have already undertaken with regard to gender and early modern psychology. Most importantly, her epilogue quite vividly illustrates to readers the epistemological crisis that in fact does persist in contemporary attempts to define madness, as well as to demarcate it from an equally nebulous discourse of reason. To that end, Kaysen’s chart does apply to discourses of madness during the heyday of English theatre. So too, perhaps, can the current discourses of madness be characterized by a famous Shakespearean subtitle that Neely makes so much use of. Madness is what you will.