Sample text for Out of her mind : women writing on madness / edited by Rebecca Shannonhouse.

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Counter A century ago, in a genteel neighborhood of Montgomery, Alabama, a child was born who would eventually embody the freewheeling spirit of the 1920s flapper. Lavish and impulsive, Zelda Fitzgerald offered an alluring mix of privilege and melodrama to complement her young novelist husband, E Scott Fitzgerald. The couple stormed through the New York and Paris party circuits, cutting a lasting image of beauty and flamboyance. He produced great works of literature; she wrote fiction and essays, painted, and dreamed of being a dancer. Before she turned thirty, however, Zelda's life would take an abrupt turn as she experienced the first of several mental breakdowns. To those who knew her, the great American flapper had slipped behind a veil of madness.

Like Zelda Fitzgerald, generations of other gifted, unconventional, and tormented women have seen their lives eclipsed by mental illness. They have suffered from depression, schizophrenia, manic depression, and other psychological disorders. Their life ambitions have been derailed by illnesses that bring sadness, delusions, and fears leaving one, as Zelda once described herself, "heart-broken, grief-stricken, spiritually sick."

Other talented, outlandish women have been labeled "mad" simply for defying societal norms. They are the ones, in the not too distant past, who were considered lunatics for rejecting their socially imposed roles as homemakers. They are the ones who were dragged to institutions for disagreeing with their husbands about religion. They are the ones, like Ann Hopkins, the seventeenth-century politician's wife, who, according to one observer, became insane after "giving herself wholly to reading and writing."

So what is "madness"? When is it mental illness? Or when is it the circumstances of a woman's life driving her "out of her mind"? These are the fundamental questions that first inspired this anthology. In looking for answers, my instincts guided me to literature and history. Ever since I first read about Zelda Fitzgerald some twenty years ago, her life has felt unresolved to me, like a stranded traveler in the back of my mind. Was she destined to be mentally ill, or was she overshadowed by her marriage, driven mad by her unfulfilled aspirations?

My purpose in creating this anthology was twofold: to compile selections from the writings of Zelda Fitzgerald and other twentieth century women, such as Sylvia Plath, Susanna Kaysen, Kate Millett, and Lauren Slater, who have so deftly rendered their psychological turmoil in American literature; and to track down the other troubled, often misunderstood women whose forgotten writings on madness were buried, I suspected, somewhere on library shelves or confined to aging reels of microfilm.

At Princeton University, I read volumes of Zelda's manuscripts and letters, most of them composed in her brash, big-looped handwriting. While reviewing her lifetime of correspondence, I happened upon unpublished letters written during one of her many hospitalizations. Four of those letters are published here for the first time.

At other libraries, I began to unearth historical selections-many of them out of print-including an 1896 essay titled "Confessions of a Nervous Woman"; an 1887 expose describing how the famed journalist Elizabeth Cochrane, better known as Nellie Bly, feigned insanity to investigate a mental institution; and an 1873 account by Elizabeth Parsons Ware Packard, whose husband had her committed after she publicly challenged his beliefs. For historical context, I turned to the reportage of another Victorian stalwart, the social reformer Dorothea Dix, who, though she was not mad, single-handedly recounted the abuse of mentally ill women in several states.

During my searches, I came across other harrowing pieces of history. There were tales from the Middle Ages, detailing how those suffering from mental illness were considered lepers and sent away to remote countrysides or warehoused on a "Ship of Fools." Other stories spoke of public whippings and barred windows that allowed passers-by to observe mad men and women shackled by chains. To represent this period, I have included an excerpt from The Book of Margery Kempe, which tells of the violent mental collapse of a medieval mystic.

Digging through old books and journals also confirmed the uniqueness of women's experiences in the world of mental illness. The notion of "hysteria," which some people once linked to witchcraft, had overtaken the public consciousness by the nineteenth century. With that came a preoccupation with the female reproductive system-the uterus, in particular, the Greek name for which gives us the word "hysteria"-which dictated many of the medical profession's misguided attempts to cure this broad, undefinable category of mental conditions. In the medical literature of the late 1800s, one can easily find references to gynecological procedures, such as removal of the ovaries or even cauterization of the clitoris, which doctors performed on their hysterical patients. Perhaps no other piece of writing embodies this era of oppression and medical injustice better than Charlotte Perkins Gilman's classic short story "The Yellow Wallpaper," which also is included in the collection.

Along the way, I read a great deal about the doctors who hoped to cure the so-called menace of hysteria. Yet I was struck by the icy tone of one in particular, Dr. Edward C. Mann, who in the 1880s wrote about hysteria in a medical journal: "The mental condition of a woman with hysteria is somewhat peculiar," he explained. "The patient, when the hysterical feelings come upon her, does not feel disposed to make the slightest effort to resist them, and yields to her emotions, whatever they may be. She will laugh or cry on the slightest provocation, and is very nervous and excitable. She cares nothing for her duties and seemingly takes pleasure in exaggerating all her slight discomforts and annoyances, and by her suspicious exacting and unreasonable behavior makes life generally uncomfortable to those about her."

Perhaps no one professed to know more about unraveling mental chaos, though, than the Viennese neurologist who staked claim to the patient's unexplored dreams and fertile unconscious. Building from his studies of hysteria, Sigmund Freud introduced psychoanalysis at the turn of the century as a means of understanding neuroses. After implicating the lasting psychological impact of childhood traumas, he fathered the era of "talk therapy," which many authors have mined for its rich drama.

While reading Sylvia Plath's devastating account of a doctor-patient therapeutic relationship in The Bell  Jar, Dr. Mann's coarse statements about hysteria and Dr. Freud's theories of mental suffering seem to echo behind her prose. I had imagined a kind, ugly, intuitive man looking up and saying 'Ah!' in an encouraging way, as if he could see something I couldn't, and then I would find words to tell him how I was so scared, as if I were being stuffed farther and farther into a black, airless sack with no way out," wrote Plath. "But Doctor Gordon wasn't like that at all. He was young and good-looking, and I could see right away he was conceited.... The whole time I was talking, Doctor Gordon bent his head as if he were praying, and the only noise apart from the dull, flat voice was the tap, tap, tap of Doctor Gordon's pencil at the same point on the green blotter, like a stalled walking stick."

Not long after patients were encouraged to talk about their mental distress, the medical establishment adopted more extreme measures, such as electroshock therapy (EST), insulin therapy, and the lobotomy. For women whose mental illnesses defied medical doctrine, doctors increasingly prescribed massive surges of electrical currents delivered to the brain,-Iarge doses of insulin to induce convulsions, or, for seemingly hopeless cases, a surgical operation to sever nerve pathways in the frontal lobes of the cerebrum. Mary Jane Ward's popular novel The Snake Pit and New Zealand writer Janet Frame's Faces in the Water are excerpted in this collection to portray the ominous world of EST during its early years of use.

The venue of such therapy was typically the dreaded asylum, where generations of women have gained ' or lost their sanity, depending on one's viewpoint. At the urging of doctors, family members delivered the mentally ill to these austere institutions with the intention of rejuvenating the mind and spirits of those who could not find solace in their homes. Sadly, many asylums quickly gained a stronger reputation for the horror of their locked wards and punishing regimens than for the effectiveness of their institutional care. Like Zelda Fitzgerald's letters, The Loony-Bin Trip by Kate Millett captures the monotony and crushing isolation of day-to-day existence in a mental institution.

By the time I closed in on the I latter part of the twentieth century, it was clear that mental illness had become inextricably tied to a vast array of prescription drugs. While some of these drugs are still delivered forcibly to women in institutions, others, such as Valium, Xanax, Paxil, and Prozac, to name just a few, are consumed eagerly by legions
of devotees. To address some of the resulting philosophical questions about the influence of chemicals on one's true personality, the essays "Black Swans" by Lauren Slater and "Thorazine Shuffle" by the film-maker Allie Light have been included in the collection.

Other questions-big, eternal ones about the meaning of insanity-appear as themes in many of the works excerpted here, such as the anonymously written Autobiograpby of a Schizophrenic Girl and Girl, Interrupted by Susanna Kaysen. In her memoir, Kaysen describes the onset of madness: "Experience is thick. Perceptions are thickened and dulled. Time is slow, dripping slowly through the clogged filter of thickened perception. The body temperature is low. The pulse is sluggish. The immune system is half-asleep. The organism is torpid and brackish. Even the reflexes are diminished, as if the lower leg couldn't be bothered to jerk itself out of its stupor when the knee is tapped."

The issue of family also asserts itself time and time again in these writings. In contemporary stories and histories alike, relatives existed as diminished, shattered figures beside the raging force of mania, despair, or paranoia. What are the experiences of those who cannot escape the heat of mental illness? What is the psychological toll of caring for someone who is emotionally troubled? The Woman Warrior by Maxine Hong Kingston and "Isolation" by Martha Ellen Hughes search for answers to these questions while also penetrating some of the family myths that shroud madness in so many cultures. In other excerpts, such as those from Signe Hammer's By Her Own Hand and Linda Gray Sexton's Searching for Mercy Street, the mother-daughter bond, and its attendant conflicts, is seen through the prism of suicide.

In addition to the distinct psychiatric conditions, such as schizophrenia and obsessive-compulsive disorder, that are represented in the anthology, I felt that it was important to present a few selections about depression, the mental illness that affects nearly twice as many women as men. In the collection, excerpts from The Beast by Tracy Thompson and Willow Weep for Me by Meri Nana-Ama Danquah express the numbing sorrow and emptiness of the disorder that both writers and clinicians refer to as the "common cold" of mental illness. In her memoir, Danquah wrote: "Depression offers layers, textures, noises. At times depression is as flimsy as a feather, barely penetrating the surface of my life, hovering like a slight halo of pessimism. Other times it comes on gradually like a common cold or a storm, each day presenting new signals and symptoms until finally I am drowning in it. Most times, in its most superficial and seductive sense, it is rich and enticing. A field of velvet waiting to embrace me. It is loud and dizzying, inviting the tenors and screeching sopranos of thoughts, unrelenting sadness, and the sense of impending doom."

Though many of the writers whose work is included here have been widely read, their nonfictional and fictional accounts of mental illness have not been collected in a single volume. The scholar Troy Porter has written extensively about the history of madness in a number of books, including The Greatest Benefit to Mankind and A Social History of Madness. The institutionalization of women has been documented in Dr. Jeffrey L. Geller and psychologist Maxine Harris's wonderful collection Women of the Asylum. And feminist psychologist Phyllis Chesler has eloquently indicted the oppressive clinical tradition that has prevailed for so many years in her classic, Madness and Women. Yet the general topic of madness in women has not been addressed in a literary and historical collection, only in individual novels, essays, memoirs, and articles. With this anthology, I hope to create a collective voice that will speak for the mentally ill women who have so frequently been cast aside for their "otherness."

In researching this book, I also encountered a number of delightful women whose circumstances surrounding their madness were more remarkable than their writings. I have not included their work in the collection but offer two such remarkable stories here:

In 1890, a brazen 41-year-old known as Andrew M. Sheffield, who cursed and defied the conventions of feminine propriety, was committed to an Alabama mental asylum. An addict and an alleged arsonist who had an affair with a man who supplied her with drugs, she corresponded with a succession of governors in hopes of being moved to a prison. For thirty years, she was unsuccessful in her efforts and eventually died at the hospital. Her correspondence is published in The Letters of a Victorian Madwoman, edited by John S. Hughes.

Another Victorian eccentric was an Englishwoman named Georgina Weldon, whose husband tried to have her committed after learning that she believed her dead mother had been reincarnated as a pet rabbit, a claim that these days might win her a lucrative book contract and a place on the bestseller lists. However, by locking herself in the house and disguising herself as a nun so she could safely leave the premises, Weldon escaped from an alienist who had been instructed to escort her to an asylum. Her experiences eventually played a part in the reform of insanity laws, and in 1878 she published The History of my Orphanage or the Outpourings of an Alleged Lunatic.

In 1999, well over a century after Weldon eluded the asylum, the White House sponsored its first-ever conference on mental health. At that gathering, Tipper Gore referred to mental illness as the "last great stigma of the twentieth century." Though it is debatable how far society has advanced in its treatment of those who, seemingly at random, have been besieged by madness, it is clear that there is an important body of literature that can reveal to others the largely private world of emotional suffering. The writers whose works are collected in this anthology not only represent creative, romanticized women, like Zelda Fitzgerald, Sylvia Plath, and so many others, but also, in a sense, the silent, anonymous ones who, for generations, have existed behind harsh, impersonal statistics of mental illness. It is my hope that, with this book, their stories will also be told.

Library of Congress subject headings for this publication: Mental illness Fiction, Mentally ill women Fiction, American prose literature Women authors, English prose literature Women authors, Mentally ill women Biography, Mentally ill, Writings of the, Mental illness