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Studies in Religion, Theology, and Disability
Madness: American Protestant Responses to Mental Illness
Madness is a sin. Those with emotional disabilities are shunned. Mental illness is not the church's problem.
All three claims are wrong.
In Madness, Heather H. Vacek traces the history of Protestant reactions to mental illness in America. She reveals how two distinct forces combined to thwart Christian care for the whole person. The professionalization of medicine worked to restrict the sphere of Christian authority to the private and spiritual realms, consigning healing and care―both physical and mental―to secular, medical specialists. Equally influential, a theological legacy that linked illness with sin deepened the social stigma surrounding people with a mental illness. The Protestant church, reluctant to engage sufferers lest it, too, be tainted by association, willingly abdicated care for people with a mental illness to secular professionals.
While inattention formed the general rule, five historical exceptions to the pattern of benign neglect exemplify Protestant efforts to claim a distinctly Christian response. A close examination of the lives and work of colonial clergyman Cotton Mather, Revolutionary era physician Benjamin Rush, nineteenth-century activist Dorothea Dix, pastor and patient Anton Boisen, and psychiatrist Karl Menninger maps both the range and the progression of attentive Protestant care. Vacek chronicles Protestant attempts to make theological sense of sickness (Mather), to craft care as Christian vocation (Rush), to advocate for the helpless (Dix), to reclaim religious authority (Boisen), and to plead for people with a mental illness (Menninger).
Vacek's historical narrative forms the basis for her theological reflection about contemporary Christian care of people with a mental illness and Christian understanding of mental illness. By demonstrating the gravity of what appeared―and failed to appear―on clerical and congregational agendas, Vacek explores how Christians should navigate the ever-shifting lines of cultural authority as they care for those who suffer.
All three claims are wrong.
In Madness, Heather H. Vacek traces the history of Protestant reactions to mental illness in America. She reveals how two distinct forces combined to thwart Christian care for the whole person. The professionalization of medicine worked to restrict the sphere of Christian authority to the private and spiritual realms, consigning healing and care―both physical and mental―to secular, medical specialists. Equally influential, a theological legacy that linked illness with sin deepened the social stigma surrounding people with a mental illness. The Protestant church, reluctant to engage sufferers lest it, too, be tainted by association, willingly abdicated care for people with a mental illness to secular professionals.
While inattention formed the general rule, five historical exceptions to the pattern of benign neglect exemplify Protestant efforts to claim a distinctly Christian response. A close examination of the lives and work of colonial clergyman Cotton Mather, Revolutionary era physician Benjamin Rush, nineteenth-century activist Dorothea Dix, pastor and patient Anton Boisen, and psychiatrist Karl Menninger maps both the range and the progression of attentive Protestant care. Vacek chronicles Protestant attempts to make theological sense of sickness (Mather), to craft care as Christian vocation (Rush), to advocate for the helpless (Dix), to reclaim religious authority (Boisen), and to plead for people with a mental illness (Menninger).
Vacek's historical narrative forms the basis for her theological reflection about contemporary Christian care of people with a mental illness and Christian understanding of mental illness. By demonstrating the gravity of what appeared―and failed to appear―on clerical and congregational agendas, Vacek explores how Christians should navigate the ever-shifting lines of cultural authority as they care for those who suffer.
283 pages, Hardcover
First published January 1, 2015
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59 people want to read
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Displaying 1 - 4 of 4 reviews
November 1, 2015
My favorite part of this book was the concluding chapter where Vacek offers her own practical theology of suffering. I love it when authors take the time to answer the "now that you've read my book, so what?" question.
September 29, 2022
Vacek’s work here is vital to the historical narrative of American Protestants and their efforts involving mental illness. She seeks to find the trajectory of the shift from the clerical/religious world wielding authority on matters of mental “maladies” to the medical apparatus - she does so well. The shift is complex and does well to prevent any “radical orthodox” valorisation of days gone by.
As history, Vacek is unmatched. However, she fails to provide a robust interpretation of these historical figures other than to illustrate how Protestants draw on their faith to alleviate suffering. A few key points of value as well as contention:
1) Vacek clearly illustrates the consistent dominance and organizational themes in American approaches. However, she does not analyze the depths of these approaches outside of “stigma.”
2) The proposal of hospitality as a solution strikes me as largely one sided and focused on the “normal” person as opposed to the mad person. More to be said concerning this, but it fails to provide room for those experiencing psychosis to contribute. Likewise, Vacek’s understanding of mental “health” and “illness” is firmly planted in the notion of inherent suffering - something I thought disability theology should have already made clear is problematic.
A key story that Vacek provides looks into the life of a pastor who experienced psychosis and valued it for its spiritual potential. Much more than the proposa concerning anti-stigma, Vacek could have drawn from this to provide a more robust account.
All in all, an excellent work of history and vital to a theology which seeks to make madness more central to systematics (a wish she herself alludes to).
As history, Vacek is unmatched. However, she fails to provide a robust interpretation of these historical figures other than to illustrate how Protestants draw on their faith to alleviate suffering. A few key points of value as well as contention:
1) Vacek clearly illustrates the consistent dominance and organizational themes in American approaches. However, she does not analyze the depths of these approaches outside of “stigma.”
2) The proposal of hospitality as a solution strikes me as largely one sided and focused on the “normal” person as opposed to the mad person. More to be said concerning this, but it fails to provide room for those experiencing psychosis to contribute. Likewise, Vacek’s understanding of mental “health” and “illness” is firmly planted in the notion of inherent suffering - something I thought disability theology should have already made clear is problematic.
A key story that Vacek provides looks into the life of a pastor who experienced psychosis and valued it for its spiritual potential. Much more than the proposa concerning anti-stigma, Vacek could have drawn from this to provide a more robust account.
All in all, an excellent work of history and vital to a theology which seeks to make madness more central to systematics (a wish she herself alludes to).
January 19, 2025
I enjoyed this, it's a nice overview and very clearly written. The summaries of mental health reforms were a tad perfunctory, but that wasn't the main focus of the book, and I doubt that people looking for that would pick this up first. When it's tracing the evolution of protestant views and treatment of madness, it really shines. Plus it exposed me to a the fascinating case of Anton Boisen. My one complaint is that Vacek doesn't really touch on the question of race in any depth, which was especially important for the psychiatry of Rush, Dix, and (at least insofar as it comes into the question of eugenics) Menninger too. Rush's abolitionism is mentioned, but without exploring how his religious beliefs informed his medical theories, while Dix's racism and her apology for slavery (and personal relationships with slavers) were left out completely.
September 13, 2016
Fascinating historical review of how Protestants have coped with this illness in the US. The author reviews five people who shaped these responses: Cotton Mather, Benjamin Rush, Dorothea Dix, Anton Boisen, and Karl Menninger. The concluding chapter was valuable in considering current attitudes, actions, and remedies for churches dealing with this segment of our society.
Displaying 1 - 4 of 4 reviews