Helen Bömelburg, Der Arzt und sein Modell. Porträtfotografien aus der deutschen Psychiatrie 1880 bis 1933, Medizin, Gesellschaft und Geschichte, Band 30, Stuttgart, Franz Steiner, 2007, pp. 238, €38.00 (paperback 978-3-515-09069-8).

Abstract

This book investigates how photographic portraits of psychiatric patients generated concepts about mental illness that were then diffused into society. Bomelburg argues that psychiatrists had a marked interest in visually portraying mental deviance. She explores how these portraits were understood and used, and what aesthetic and moral preconceptions psychiatrists brought to this imaging technology. She describes the book as “a medical, photographic, artistic, and cultural history of vision and representation” (p. 33). It draws on patient records from Hamburg, Giessen and Goppingen (chapter 3) and on pictures published in journals and textbooks (chapter 4). In chapter 5 Bomelburg considers the aesthetic and gender attributes of the portraits, before finally attempting to embed them in the traditions of other physiognomic, bourgeois and criminological forms of representation. Throughout much of the book, Bomelburg’s analysis is plagued by the albatross of psychiatrists having written virtually nothing about the photographs they used. Although Bomelburg notes this on several occasions, it does not stop her from drawing sweeping conclusions about the significance of portraits. Nor does it prevent her from extrapolating—at times recklessly—from those relatively isolated examples of practitioners who did reflect on their use of portraits (such as Hermann Oppenheim or Robert Sommer) to all psychiatrists in Germany between 1880 and 1933. Bomelburg interprets portraits as “stagings of morbid deviance” (p. 23) and as mirror-images of bourgeois values. There is certainly much truth to these claims. But they are also only part of the story, because psychiatrists also had an interest in curing their patients. Alongside the staging of deviance stood their efforts to demonstrate that many patients were cut from the same cloth as everyone else. If only to evoke empathy in the general public or to demonstrate the danger that mental illness posed to everyone, psychiatrists had no unbounded interest in staging deviance. On the contrary, the walls separating psychiatric institutions and the general populace were becoming more porous. Outpatient clinics, expanding community care, and institutional alternatives for alcoholics and “nervous” patients blurred distinctions between the institutionalized madman and “respectable” society. While at times psychiatrists had an interest in staging the otherness of patients needing their expertise, they also had an interest in staging the sameness of patients returning to productive lives. Bomelburg’s narrow perspective on portraits fails to capture these dual motives; nor does she recognize that psychiatrists may well have shied away from using portraits because they did not want to reinforce the public stereotypes that undercut their efforts to see patients reintegrated into society. In some respects, Bomelburg has tried to have her cake and eat it too. On the one hand, she sees a “fundamental contradiction” in psychiatrists publishing psychiatric portraits while simultaneously warning about the dangers of “naively reading disease from a patient’s body” (p. 106). On the other, she finds that the “proportion of patient portraits was small” (p. 109) compared to other kinds of pictures in medical journals. Indeed, it seems that publishing patient portraits was very much the exception, not the rule. Yet reading the book, one comes away with the sense that photographic portraits were enthusiastically embraced by psychiatrists as being morally salubrious and scientifically de rigueur. But in fact, portrait-photography faced resistances and critique. For example, contrary to Bomelberg’s assertions, German Lombrosians like Hans Kurella never defined a viable portrait style. If anything, Lombroso and Kurella put psychiatrists off trying to depict the complexities of madness using portraits. Furthermore, to my knowledge, no one ever claimed that portraits could supplant direct bedside observation; indeed, perhaps portraits were so little used and talked about because psychiatrists recognized them to be exceedingly poor clinical tools. By contrast, if there was a style of representation used to depict madness between 1880 and 1933, then it is far more likely to have been the microscopic photography of stained brain specimens. Compared with patient portraits, these images were immeasurably more significant in producing psychiatric knowledge, legitimating professional practice, shoring up bourgeois values and cultivating an aesthetic sense of scientific work. Because Bomelburg fails to recognize these alternatives and resistances, hers is an implausible story of portrait photography’s role and significance in psychiatric practice.