In Search of Madness: A psychiatrist’s travels through the history of mental illness

by Brendan Kelly

Who is ‘mad’? Who is not? And who decides?

In this fascinating new exploration of mental illness, Professor Brendan Kelly examines ‘madness’ in history and how we have responded to it over the centuries.

We travel from the psychiatric institutions of India to Victorian scientific studies of the brain. We discover the beginnings of formal asylum care and witness the experimental ‘therapies’ of the cavernous psychiatric hospitals of the nineteenth and early twentieth centuries in Ireland, England, Belgium, Italy, Germany and the US.

Covering institutionalization, lobotomy and the Nazis’ ‘Aktion T4’, as well as Freud, psychoanalysis, cognitive behavioral therapy (CBT) and neuroscience, Professor Kelly examines the shift from ‘psychobabble’ to ‘neurobabble’ in recent times.

In Search of Madness is an all-encompassing history of one of the most basic fears to haunt the human psyche, and it concludes with a passionate manifesto for four proposals to make mental health services more effective, accessible and just.

Genres: Nonfiction, Psychology, Mental Health, History

300 pages, Paperback

First published April 1, 2022

Reviews

[Felix · Rating 3 out of 5]

I felt this book raised interesting questions, but rarely satisfyingly fleshed out the arguments he'd clearly read extensively about. I think it was perhaps overly ambitious, and might've been better off focussing in depth on fewer issues.
A lot of the chapters began as though addressed to the general reader, but drifted off into a dull clinical style of writing.

[Lisa · Rating 4 out of 5]

In Search of Madness is a well-researched, well-written text which highlighted how people of all times and all social backgrounds have suffered from mental illness: mental illness is not, as is sometimes implied in contemporary discourse, a modern affliction or middle class affectation. Brendan Kelly, who comes across as equal parts knowledgeable and kind, is also at pains to distinguish between mental health and mental illness. As he puts it, no amount of wellness initiatives or ‘broccoli, jogging, or mindfulness’ can stave off serious mental illness and the work of psychiatry is to treat mental illness, not to promote mental health.
Although intimidatingly well-qualified, Kelly also does not get mired in academic debate but focuses on how treatments and approaches throughout the ages have helped – and harmed - people suffering with mental illness. He is impatience with neuroscience, for example, for what he sees as its failure to deliver tangible improvements for people in distress. The final chapter of the book, a manifesto to improve the treatment of mental illness, is also strong enough to work as a standalone piece.
This is an ambitious text which variously travels around the world, through history, across diagnoses, and uses patient case histories to develop its themes. However, it could have benefited from a slightly more ruthless editor. I was itching to slash whole paragraphs and scrawl ‘superfluous’ in the margins. Interesting as some of these digressions were, for example that Kelly enjoys the travel writing of Erika Fatland or that psychiatrist Emil Kraepelin wrote earnest but terrible poetry, they wandered away from rather than added to the book’s overall arguments. Conversely, the case histories needed to be integrated more fully into the text to do them justice. That said, these are minor gripes about a reflective and very empathetic text.

[Elisabeth · Rating 4 out of 5]

A very travel journal like book exploring the history of mental illness research and practice in history. It is interestingly written and his passion for the topic is very evident besides the two decades of work in the field. I was not too keen on the reiteration several times of certain ideas and it got a bit repetitive at times. His manifesto is definitely appropriate, calling out for more acceptance and treatment for mental illnesses to stop the stigma and offer health equity to those with mental illnesses.

[Pete Wade · Rating 3 out of 5]

A well written enjoyable book on the journey of psychiatry over the years to it's present day. I wanted to give the book a 4 but held back. Mostly because I don't think the author paid enough attention to the inclusive mind body arguments that I find persuasive from thinkers like Gabor Maté. When dealing with biological research he seems pre occupied with the brain while the vegas nerve, the gut and the heart to name a few are glossed over. Very enjoyable as a history of mental healthcare though.

[Kristina · Rating 3 out of 5]

I will gobble up most books about the history of how mental health conditions are treated, but I found this book to not quite know what it was. The author inserted himself at times and almost felt memoir-ish, but then focused on the history of how different mental health conditions have been treated over time. I found it to be really just scratching the surface and did not learn much new. The author is from Ireland and he connected much of the treatment to how common it was in Ireland, so it may not be as generalizable to other countries.