Madness: American Protestant Reponses to Mental Illness by Heather H. Vacek

Abstract

Reviewed by: Madness: American Protestant Reponses to Mental Illness by Heather H. Vacek Lawrence B. Goodheart Heather H. Vacek. Madness: American Protestant Reponses to Mental Illness. Waco, Tex.: Baylor University Press, 2015. 283pp. $39.95 (978-1-4813-0057-5). In order to understand the perspective of the author, it is important to know that she is assistant professor of Church History at Pittsburgh Theological Seminary. Vacek has written a scholarly jeremiad in which she has weighed her co-religionists’ responses to mental illness in the moral balance and found them wanting. The organization of the book highlights what she persuasively argues is a perennial gap between belief and practice in her faith community. There are five chapters that profile exceptional Protestants—Cotton Mather, Benjamin Rush, Dorothea Dix, Anton Boisen, and Karl Menninger—who acted to do good in the field of mental health over several centuries. The conclusion is the piece de resistance in which Vacek offers compelling pastoral guidance on Christian duty to the afflicted. The prose is clear, the documentation thorough, and her stance heartfelt. Boston-born Mather, a prodigy of Puritan erudition, wrote The Angel of Bethesda in 1624, the only comprehensive medical tome of the colonial era. He famously declaimed in post lapsarian metaphysics, “What is the Whole World, but an Entire Mad-house?” (p. 12). He identified sin, natural causes, and the supernatural in the inexplicable etiology of mental disease. He found no contradiction in mixing the theological with the scientific. In the face of medical resistance, he advocated inoculations during a smallpox epidemic of the early 1720s. He coped with a third wife who suffered psychic distress, and he ministered to the sick of his congregation. For future reference, note should be made of Gershom Buckeley, Mather’s contemporary in Connecticut. Unlike Mather during the Salem hysteria of 1692–93, Buckeley—a minister, physician, and attorney—played a critical role in ending executions for witchcraft during the same time in Connecticut. The Philadelphian polymath Benjamin Rush combined devout Presbyterianism with his medical humanitarianism. Widely known as the “father of psychiatry” in the United States, he was also a signer of the Declaration of Independence, a foe of slavery, and an opponent of the death penalty. Whereas the Puritan Mather linked sin with mental abnormality, the Enlightenment-era Rush saw organic causes, particularly the excessive blood flow to the brain. His practice of copious bleeding and other heroic measures, however, soon fell out of favor with subsequent physicians. Nonetheless, his religious and medical commitment made him the American counterpart in “moral” (humane) treatment of the insane to Phillipe Pinel in France and the English Quaker William Tuke. The antebellum crusader Dorothea Dix launched and expanded thirty mental asylums. With initial success in the famous Memorial to the Massachusetts Legislature (1843) on behalf of the neglected insane, she enthused that she “was now an instrument of divine grace” (p. 81). Vacek includes a brief obligatory comment on Michel Foucault and the well-worn social control thesis. The paradigm of the book relies, however, heavily on the judicious assessments of scholar Gerald N. Grob. The work of Mary Ann Jimenez, Norman Dain, David Gollaher, and Lawrence J. Friedman is also brought to bear in relevant chapters. [End Page 334] The two last figures are the little known minister Anton Boisen and the well-known psychiatrist Karl Menninger. A Presbyterian cleric, Boisen suffered five severe psychotic episodes. His personal odyssey with schizophrenia led to what Vacek terms his “call for physicians of the soul” (p. 113) that included a chaplaincy at Worcester State Hospital in Massachusetts, clinical training for seminarians, and a reflection on his own hospitalization, The Exploration of the Inner World: A Study of Mental Disorder and Religious Experience (1936). Directly influenced by the religious commitment of his mother, Karl was a member of a remarkable family of physicians who established the renowned Menninger Foundation and the Menninger Clinic in Topeka, Kansas. This most famous American psychiatrist of the twentieth century was inspired to good works in a perceived unity of religion and medicine. In his own words of 1964, “The basis of all religion is the duty to love God and offer our help...