Administrations of Lunacy: Racism and the Haunting of American Psychiatry at the Milledgeville Asylum by Mab Segrest

Abstract

Reviewed by: Administrations of Lunacy: Racism and the Haunting of American Psychiatry at the Milledgeville Asylum by Mab Segrest Dennis Doyle Administrations of Lunacy: Racism and the Haunting of American Psychiatry at the Milledgeville Asylum. By Mab Segrest. (New York and London: The New Press, 2020. Pp. xvii, 396. $28.99, ISBN 978-1-62097-297-7.) Scholar-activist Mab Segrest's latest book is not simply another entry in the growing list of publications arguing for the centrality of the South, race, and African Americans to the history of U.S. asylums and psychiatry. Segrest's ultimate aim is different. Administrations of Lunacy: Racism and the Haunting [End Page 554] of American Psychiatry at the Milledgeville Asylum is an ambitious retelling of the history of long-nineteenth-century Georgia that presents the now-defunct Milledgeville Asylum as a touchstone whose microhistory mirrors larger shifts in both the state and the South. Segrest conceives of antebellum Georgia as, first and foremost, a white settler society erected on land forcibly wrested from Indigenous peoples and transformed into a cotton kingdom through racial slavery. All of that was accomplished through violence and exploitation of the vulnerable, aided and abetted by a cheerleading state insensate to the pain it inflicted. That is when the Milledgeville Asylum entered the story in 1842. As the largest institution in Georgia's public sector, it served the state's interest. And this frontier state had a vested interest in both growing its plantation-based extractive economy and ignoring the suffering that racial slavery inflicted on the people it exploited. According to Segrest, archival records reveal that doctors served that interest by taking in the white victims of such a violent settler society while conveniently eliding the possibility that racial slavery could inflict pain and suffering on Black people. Georgia's leading alienists theorized that people of African descent were somehow racially immune to stress, helping justify the exclusion of Black people from the asylum and render invisible the plantation system's cruelty. The key to Segrest's thesis is that the asylum doctors' obliviousness to the violence and racism endemic to Georgia endured well after slavery's end. It lasted through the Civil War, with psychiatrists hesitating to attribute the cause of the soldiers' and refugees' ills to the horrors of war. Segrest then argues that in 1867, as the asylum became racially segregated, it joined the Black Codes, the Milledgeville penitentiary, a convict-lease system, and chain gangs in providing postbellum Georgian elites with a carceral state that could compel Black labor. As African Americans suffered terrorism, lynching, debt peonage, and the indignities of Jim Crow, the asylum's clinicians helped the state overlook that violence by blaming Black asylum commitments on the Black race's alleged lack of emotional fitness for emancipation. As the asylum entered the twentieth century, the superintendents' tendency to blame Black illness on racial heredity led them to ignore how the asylum's overcrowding and inadequate menus produced disease. Segrest rounds out her narrative by contending that by eventually embracing eugenics and therapeutic nihilism, the asylum superintendents located the blame for the failings of racial capitalism squarely within the biology of Georgia's citizens. Segrest ultimately argues that Georgia and the South's current reliance on mass prison incarceration to care for mentally ill African Americans is a legacy of a society that habitually confined suffering African Americans rather than reckon with how it caused that suffering in the first place. Administrations of Lunacy is engaging, but advanced graduate students might find its epistemology, methods, and style problematic. Almost every chapter makes use of an individual patient's record to create illustrative vignettes, but it is unclear how representative these cases are. More troubling, Segrest takes liberties in second-guessing the clinicians, imposing contemporary diagnoses, and speculating on disease causation. She also falls back on techniques of narrative fiction to imagine a historical actor's perspective or life [End Page 555] details when the historical record is silent. Undergraduates will be more likely to overlook these flaws, as Segrest's style is irreverent and conversational, makes no apologies for her support of prison abolitionism, and enlivens the page with gripping and...