Personalizing Illenss and Modernity

Personalizing Illness and Modernity: S. Weir Mitchell, LiteraryWomen, and Neurasthenia, 1870-1914

Schuster, David G.

Bulletin of the History of Medicine, Volume 79, Number 4, Winter2005, pp. 695-722 (Article)

Published by The Johns Hopkins University PressDOI: 10.1353/bhm.2005.0172

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695 Bull. Hist. Med., 2005, 79: 695–722

Personalizing Illness and Modernity:S. Weir Mitchell, Literary Women,and Neurasthenia, 1870–1914

DAVID G. SCHUSTER

summary: This article examines how the affliction of neurasthenia, commonlydiagnosed in the late nineteenth and early twentieth centuries, acted as a catalystfor intellectual and lifestyle changes during a time of modernization. At thecenter of the study are three individuals: neurologist S. Weir Mitchell (1829–1914) and two of his patients, critic and historian Amelia Gere Mason (1831–1923) and writer and homemaker Sarah Butler Wister (1835–1908). Usingarchived correspondence between Mitchell and his patients, this article seeks toreveal how each woman tailored her treatment to fit her personal sensibilities;to reassess Mitchell’s notorious reputation as a misogynist (gained largely fromhis 1887 treatment of Charlotte Perkins Gilman); and to develop a morenuanced understanding of the doctor-patient relationship in neurasthenia cases.

keywords: history, medicine, culture, gender, doctor-patient relationship, S.Weir Mitchell, Amelia Gere Mason, Charlotte Perkins Gilman, Sarah ButlerWister

“I thrive on idleness but succumb straightaway to any effort whatever,”Amelia Gere Mason admitted in 1897 to her friend and physician, S. WeirMitchell.1 Frustrated by a weak body and a modern world built of skyscrapersand business rather than sentiment and imagination, the sixty-six-year-old

I would like to thank Mary O. Furner, Michael Osborne, Lisa Jacobson, Jane DeHart,Kim Pelis, Regina Morantz Sanchez, and the three anonymous reviewers for their usefulcomments, as well as the College of Physicians of Philadelphia, the University of CaliforniaHumanities Research Institute, the University of California Interdisciplinary PsychoanalyticConsortium, and the University of California, Santa Barbara, Graduate Division for theirgenerous support. This article was awarded Honorable Mention for the 2004 ShryockMedal of the American Association for the History of Medicine.

1. Amelia Gere Mason to S. Weir Mitchell, 6 December 1897, Mitchell Papers, series 4.3,box 9, College of Physicians of Philadelphia, Philadelphia, Pa. (hereafter referred to as MP-CPP). All future references to the Mason-Mitchell letters come from the same series and box.

Angelia Fell

new muse

696 david g. schuster

Mason yearned for inspiration and vigor. “How to live in this stupid worldis a problem. I tire of inanities and take refuge in the clouds only to bepulled down again by a machine that declines to serve.”2

Like thousands of other Americans at the time, Mason suffered fromneurasthenia. Michigan alienist E. H. Van Deusen published the firstaccount of the illness in April 1869, but it was New York neurologistGeorge Beard who reached a wide audience with his article a few monthslater, and whose name has since become synonymous with neurasthenia.3

The diagnosis rapidly spread through society as physicians applied it tomen and women of all ages and classes, so that by the turn of thetwentieth century it was one of the most common medical conditionsafflicting Americans.4 From the Greek for “lack of nervous strength,”neurasthenia reportedly occurred when people depleted their “nervousenergy,” a vital force thought to be produced by digestion and distrib-uted throughout the body via the nervous system. This energy allowedpeople to think rationally, to remain active, and to stay healthy.Neurasthenia’s symptoms varied and included insomnia, depression,fatigue, indigestion, muscle pain, headaches, an inability to concentrate,and general anxiety. Reflecting the lack of standardization in nineteenth-century medicine, the illness had many names, among them “nervousprostration,” “nervous fatigue,” and “nervous exhaustion.” Today, physi-cians commonly compare the diagnosis and its collection of symptoms toa range of disorders including chronic fatigue syndrome, fibromyalgia,clinical depression, bipolar disorder, post-traumatic stress disorder, andpostpartum depression.5

2. Ibid.3. E. H. Van Deusen, “Observations on a Form of Nervous Prostration, (Neurasthenia,)

Culminating in Insanity,” Amer. J. Insan., 1869, 15: 445–61; George M. Beard, “Neurasthe-nia, or Nervous Exhaustion,” Boston Med. & Surg. J., 1869, 3: 217–21. Beard’s best-knownwork on neurasthenia was American Nervousness: Its Causes and Consequences, A Supplement toNervous Exhaustion (Neurasthenia) (1881; reprint, New York: Arno Press, 1972). For a conciseaccount of Beard’s life and work, see Charles E. Rosenberg, “The Place of George M. Beardin Nineteenth-Century Psychiatry,” Bull. Hist. Med., 1962, 36: 245–59.

4. Physicians often expressed amazement at neurasthenia’s popularity, both as an illnessand as a topic of discussion among Americans. See I. N. Love, “Neurasthenia,” JAMA, 1894,22: 539–44 (excerpts reprinted in JAMA, 1994, 271: 1242); Charles L. Dana, “The PartialPassing of Neurasthenia,” Boston Med. & Surg. J., 1904, 150: 339–44; G. Alder Blumer, “TheComing of Psychasthenia,” J. Nerv. & Ment. Dis., 1906, 33: 336–53.

5. Donna B. Greenberg, “Neurasthenia in the 1980s: Chronic Mononucleosis, ChronicFatigue Syndrome, and Anxiety and Depressive Disorders,” Psychosomatics, 1990, 31: 129–37; Susan A. Abby and Paul E. Garfinkel, “Neurasthenia and Chronic Fatigue Syndrome:The Role of Culture in the Making of a Diagnosis,” Amer. J. Psychiatry, 1991, 148: 1638–46;Edward Shorter, “Chronic Fatigue in Historical Perspective,” Ciba Found. Symp., 1993, 173:

S. Weir Mitchell, Literary Women, and Neurasthenia 697

Unlike tuberculosis, which consumed the lungs, neurasthenia lackedan obvious cause and clear pathology. This prompted a number ofpeople at the time to question the validity of the diagnosis and to doubtthat neurasthenics suffered from anything more serious than a “fashion-able” desire to be sick.6 Others believed that the diagnosis was too broadand needed to be parsed in favor of more specific and rigorous diag-noses.7 Those physicians who were untroubled by neurasthenia’s ambi-guity created lists of potential health hazards, such as living busy lives,engaging in prolonged mental activity, and failing to eat, sleep, or exer-cise properly. Doctors also blamed environmental factors, includingNorth America’s climatic extremes, the constant hustle and bustle ofurban life, and the lack of fresh air and fortifying nature in the nation’sburgeoning cities.8 I do not attempt here to address the diagnosticvalidity of neurasthenia, nor to assess what neurasthenics “really” suf-fered from. Instead, I approach neurasthenics as the historian of scienceGeorges Canguilhem suggested patients be approached: by allowing thesick to define themselves.9

Neurasthenia faded as a medical diagnosis in the United States by the1930s, but it arose again as a subject for academic investigation in the 1970sas scholars across the humanities revived discussion of the condition.10

6–22; F. M. Corrigan et al., “Neurasthenic Fatigue, Chemical Sensitivity and GABAa Recep-tor Toxins,” Med. Hypoth., 1994, 43: 195–200. Joan Brumberg has suggested that early casesof anorexia nervosa were sometimes diagnosed as neurasthenia, in Fasting Girls: TheEmergence of Anorexia Nervosa as a Modern Disease (Cambridge: Harvard University Press,1988).

6. Love, “Neurasthenia” (n. 4). O. Henry’s short story on neurasthenia is also a goodillustration of people’s growing belief that the condition was nothing more than an absurdcelebration of invalidism: O. Henry, Adventures in Neurasthenia: Let Me Feel Your Pulse (NewYork: Doubleday, Page, 1910).

7. Dana, “Partial Passing of Neurasthenia” (n. 4); Blumer, “Coming of Psychasthenia”(n. 4); John E. Donely, “On Neurasthenia as a Disintegration of Personality,” J. Abnor.Psychol., 1906, 1: 55–68.

8. For a good overview of the medical literature surrounding neurasthenia and itsdemographics, see F. G. Gosling, Before Freud: Neurasthenia and the American Medical Commu-nity, 1870–1910 (Chicago: University of Illinois Press, 1987).

9. Georges Canguilhem, A Vital Rationalist: Selected Writings from Georges Canguilhem, ed.François Delaporte, trans. Arthur Goldhammer (New York: Zone Books, 2000), pp. 321–50.

10. Even though Dr. George Beard nicknamed neurasthenia the “American Disease,”Europeans and Japanese also employed the diagnosis, and Chinese physicians were stillidentifying the condition in the late twentieth century. See Arthur Kleinman, Social Originsof Distress and Disease: Depression, Neurasthenia, and Pain in Modern China (New Haven: YaleUniversity Press, 1986); Anson Rabinbach, The Human Motor: Energy, Fatigue, and the Originsof Modernity (Berkeley and Los Angeles: University of California Press, 1990); Marijke


Some in women’s history argued that neurasthenia represented amedicalized tool of social control that victimized Victorian women, whileothers saw the disease as an opportunity for women to bargain withpatriarchy, or, more recently, as an outright source of patient agency.11

Historians of medicine have used neurasthenia as a waypoint in medicine’sprofessionalization and practice, especially in psychology and psychiatry,or have linked the diagnosis to its more modern equivalents.12 Literaryscholars have investigated how neurasthenia influenced the way peoplefrom the period wrote of, spoke about, and understood themselves and

Gijswijt-Hofstra and Roy Porter, eds., Cultures of Neurasthenia from Beard to the First World War(New York: Rodopi, 2001); Laura Goering, “‘Russian Nervousness’: Neurasthenia andNational Identity in Nineteenth-Century Russia,” Med. Hist., 2003, 47: 23–46; SabineFrühstück, Colonizing Sex: Sexology and Social Control in Modern Japan (Berkeley and LosAngeles: University of California Press, 2003).

11. Those who understood neurasthenia as a social tool to control women include AnnDouglas Wood, “‘The Fashionable Diseases’: Women’s Complaints and Their Treatment inNineteenth-Century America,” J. Interdiscip. Hist., 1973, 4: 25–52; Barbara Ehrenreich andDeirdre English, Complaints and Disorders: The Sexual Politics of Sickness (New York: FeministPress, 1973); and Suzanne Poirier, “The Weir Mitchell Rest Cure: Doctors and Patients,”Women’s Studies, 1983, 10: 15–40. The term “bargaining with patriarchy” comes from DenizKandiyoti, “Bargaining with Patriarchy,” Gender & Soc., 1988, 2: 274–90, and is applicable toJohn S. Haller, “Neurasthenia: The Medical Profession and the ‘New Woman’ of the LateNineteenth Century,” New York State J. Med., 1971, 71: 473–82; Carroll Smith-Rosenberg,“The Hysterical Woman: Sex Roles and Role Conflict in Nineteenth-Century America,” Soc.Res., 1972, 39: 653–78; and Regina Markell Morantz, “The Lady and Her Physician,” in Clio’sConsciousness Raised, ed. Mary S. Hartman and Lois Banner (New York: Harper & Row,1974), pp. 38–53 (an expanded version of Morantz’s earlier article “The Perils of FeministHistory,” J. Interdisc. Hist., 1974, 4: 649–60). As for using neurasthenia as a source of agency,see Nancy M. Theriot, “Women’s Voices in Nineteenth-Century Medical Discourse: A Steptoward Deconstructing Science,” Signs, 1993, 19: 1–31.

12. Nathan G. Hale, Jr., Freud and the Americans: The Beginnings of Psychoanalysis in theUnited States, 1876–1917 (New York: Oxford University Press, 1971); Barbara Sicherman,“The Uses of a Diagnosis: Doctors, Patients, and Neurasthenia,” in Sickness and Health inAmerica: Readings in the History of Medicine and Public Health, ed. Judith Walzer Leavitt andRonald L. Numbers (Madison: University of Wisconsin Press, 1985), pp. 22–35; Gosling,Before Freud (n. 8); Edward Shorter, From Paralysis to Fatigue: A History of Psychosomatic Illnessin the Modern Era (New York: Free Press, 1992); Elizabeth Lunbeck, The Psychiatric Persua-sion: Knowledge, Gender, and Power in Modern America (Princeton: Princeton University Press,1994); Simon Wessely, “Neurasthenia and Fatigue Syndromes,” in A History of ClinicalPsychiatry: The Origins and History of Psychiatric Disorders, ed. German E. Berrios and RoyPorter (New York: New York University Press, 1995), pp. 509–32; Eric Caplan, Mind Games:American Culture and the Birth of Psychotherapy (Berkeley and Los Angeles: University ofCalifornia Press, 1998). For works linking neurasthenia with more recent diagnoses, see n.5 above.


their world.13 For those concerned with culture, neurasthenia repre-sented a method of coping with widespread changes in the economy,society, and gender roles.14 The latest book on neurasthenia, MarijkeGijswijt-Hofstra and Roy Porter’s edited volume Cultures of Neurastheniafrom Beard to the First World War (2001), points toward promising newdirections of neurasthenia research, including comparative studies be-tween nations that incorporate discussions of consumerism, doctor-pa-tient relationships, medical professionalization, health paradigms, andthe roles of class and gender.15 Regardless of disciplinary approach, manyof the studies done on neurasthenia over the past thirty years have beeninfluenced by provocative work on the constructed nature of illness andnormality by authors such as Thomas Szasz, David Rothman, MichelFoucault, and Susan Sontag.16 Consequently, questions of who had au-thority over the diagnosis and what was neurasthenia’s social influencehave fueled some of the most fascinating discussions on the disease.

This paper follows the tradition of Tom Lutz, Regina Morantz-Sanchez,Barbara Sicherman, Nancy Theriot, and those who have explored patient

13. Tom Lutz, American Nervousness, 1903: An Anecdotal History (Ithaca: Cornell Univer-sity Press, 1991); Diane Price Herndl, Invalid Women: Figuring Feminine Illness in AmericanFiction and Culture, 1840–1940 (Chapel Hill: University of North Carolina Press, 1993);Jennifer Shannon Tuttle, “Empire of Sickness: Literary Professionals and Medical Discoursein the Age of American Nervousness, 1869–1911” (Ph.D. diss., University of California, SanDiego, 1996); Barbara Will, “The Nervous Origins of the American Western,” Amer. Lit.,1998, 70: 293–316; Rebecca Charlotte Hyman, “Territories of the Self: Nervous Disease andthe Social Logic of Pre-Freudian Subjectivity” (Ph.D. diss., University of Virginia, 1998).

14. T. J. Jackson Lears, No Place of Grace: Antimodernism and the Transformation of AmericanCulture, 1880–1920 (Chicago: University of Chicago Press, 1981); George Frederick Drinka,The Birth of Neurosis: Myth, Malady, and the Victorians (New York: Simon & Schuster, 1984);Peter G. Filene, Him/Her/Self: Sex Roles in Modern America (Baltimore: Johns HopkinsUniversity Press, 1986); Gail Bederman, Manliness and Civilization: A Cultural History ofGender and Race in the United States, 1880–1917 (Chicago: University of Chicago Press, 1995);Kathleen Spies, “Figuring the Neurasthenic: Thomas Eakins, Nervous Illness, and Genderin Victorian America,” Nineteenth-Cent. Stud., 1998, 12: 85–109.

15. Gijswijt-Hofstra and Porter, eds., Cultures of Neurasthenia (n. 10).16. Thomas Stephen Szasz, The Myth of Mental Illness: Foundations of a Theory of Personal

Conduct (New York: Hoeber-Harper, 1961); Szasz, The Manufacture of Madness: A ComparativeStudy of the Inquisition and the Mental Health Movement (New York: Harper & Row, 1970);David J. Rothman, The Discovery of the Asylum: Social Order and Disorder in the New Republic(Boston: Little, Brown, 1971); Michel Foucault, Madness and Civilization: A History of Insanityin the Age of Reason, trans. Richard Howard (New York: Vintage Books, 1973); Foucault, TheBirth of the Clinic: An Archeology of Medical Perception, trans. A. M. Sheridan Smith (New York:Vintage Books, 1994); Susan Sontag, Illness as Metaphor, and AIDS and Its Metaphors (NewYork: Doubleday, 1990).


influence within the late nineteenth-century doctor-patient relationship.17

At the center of my discussion are Dr. Weir Mitchell (1829–1914) and twoof his neurasthenic patients: critic and intellectual historian Amelia GereMason (1831–1923), and essayist and homemaker Sarah Butler Wister(1835–1908). Using archived correspondence from the College of Physi-cians of Philadelphia and period works in medicine and literature, Iexamine how Mason and Wister developed an understanding of theircondition that accepted, rejected, and sometimes went beyond theirphysician’s advice. Although Mitchell’s relationships with Mason andWister may not be typical of all relationships between physicians andneurasthenic patients, the letter-to-letter interaction of their correspon-dences provides a dynamic picture that helps to flesh out previousstudies that have sought to identify the patient’s role using patientrecords and medical articles.18 The trusting relationships that emergebetween the women and Mitchell help to put into perspective CharlottePerkins Gilman’s notorious encounter with Mitchell and allow for a morenuanced understanding of the doctor’s treatment of his female patients.By no means exclusively a diagnosis constructed by physicians and foistedupon patients, neurasthenia allowed the afflicted to personalize themeaning of their suffering and enact what Lutz has called “significant lifechanges.”19 Mason and Wister, working in conjunction with their physi-cian, used their neurasthenia as a lens for critically assessing a moderniz-ing America; it let them hone personal beliefs, engage in new leisurelylifestyles, and question gendered labor and family roles.

17. Lutz, American Nervousness (n. 13); Tom Lutz, “Neurasthenia and Fatigue Syn-dromes,” in Berrios and Porter, eds., History of Clinical Psychiatry (n. 12), pp. 533–44;Morantz, “Lady and Her Physician” (n. 11); Regina Morantz-Sanchez, Conduct Unbecoming aWoman: Medicine on Trial in Turn-of-the-Century Brooklyn (New York: Oxford University Press,1999); Morantz-Sanchez, “Negotiating Power at the Bedside: Historical Perspectives onNineteenth-Century Patients and Their Gynecologists,” Fem. Studies, 2000, 26: 287–309;Sicherman, “Uses of a Diagnosis” (n. 12); Theriot, “Women’s Voices” (n. 11). Lears, NoPlace of Grace (n. 14), also recognizes patients’ influence on the construction of neurasthenia.

18. Recent works that have relied on patient records include Theriot, “Women’s Voices”(n. 11); Hilary Marland, “‘Uterine Mischief’: W. S. Playfair and His Neurasthenic Patients,”in Gijswijt-Hofstra and Porter, eds., Cultures of Neurasthenia (n. 10), pp. 117–39; JoachimRadkau, “The Neurasthenic Experience in Imperial Germany: Expeditions into PatientRecords and Side-looks upon General History,” ibid., pp. 199–217. Lutz relied on articleswritten by physicians to get at the evolving place of the doctor-patient relationship withinneurasthenia’s multifaceted history; see Tom Lutz, “Varieties of Medical Experience:Doctors and Patients, Psyche and Soma in America,” ibid., pp. 51–79.

19. Lutz, “Neurasthenia and Fatigue Syndromes” (n. 17), p. 542.


Dr. Mitchell

Weir Mitchell was one of America’s most influential shapers of neuras-thenia during the late nineteenth century. Born a doctor’s son in 1829,he followed the family profession after earning his two-year medicaldegree in neurology from Jefferson College in Philadelphia. Typical ofhis day, he spent an internship in Europe with the added advantage ofstudying under the renowned French physiologist Claude Bernard.20 Heworked for the Union Army as a contracted doctor during the Civil Warand co-authored a seminal book on the treatment of gunshot wounds,which helped to establish him as America’s premier nerve specialist.21

After the war, Mitchell spun his reputation as a neurologist into a lucra-tive career treating the nervous disorders of America’s elite. By the timeof his death in 1914, fellow physicians hailed him as the most accom-plished neurologist of his day.22

Yet Mitchell’s career was hardly typical of the narrow specializationthat would characterize medicine in the twentieth century. He was also anovelist and poet of moderate success, a regional celebrity, a sought-afterpublic lecturer, a philanthropist, a University of Pennsylvania trustee,and the president of numerous medical organizations—all occupationsthat kept him in the public limelight and at the head of the medicalcommunity for fifty years. Written with a novelist’s flair, Mitchell’s books,articles, and lectures on neurasthenia exerted a powerful influence onpopular and professional understanding of the illness. They depicted thedisease much as Beard’s work had done, as a distinctly modern conditionthat occurred as Americans began to shed their traditional lifestyles.Families left spacious countrysides for burgeoning cities; men left theplow and field for the office and business; women left parlor and familyfor university and careers; speeding trains, rattling stock tickers, andclacking telegraphs created a fast-paced world that drained people of

20. For an account of mid-nineteenth-century American physicians studying in France,and the professional reputations they cultivated as a result, see John Harley Warner, Againstthe Spirit of System: The French Impulse in Nineteenth-Century American Medicine (Princeton:Princeton University Press, 1998).

21. S. Weir Mitchell, George R. Morehouse, and William W. Keen, Gunshot Wounds andOther Injuries of Nerves (Philadelphia: Lippincott, 1864).

22. College of Physicians of Philadelphia, S. Weir Mitchell (1829–1914): Memorial Addressesand Resolutions (Philadelphia: College of Physicians of Philadelphia, 1914); Lawrence C.McHenry, Garrison’s History of Neurology (Springfield, Ill.: Thomas, 1969), p. 327. For auseful, albeit uncritical, overview of Mitchell’s career, see Ernest Earnest, S. Weir Mitchell:Novelist and Physician (Philadelphia: University of Philadelphia Press, 1950).


their mental strength.23 For those who fell victim to these modern lifestylesand became neurasthenic, Mitchell often prescribed his hallmark “restcure,” consisting of six to eight weeks of complete bed rest, a diet offattening foods, and frequent massages to prevent muscle atrophy. Thecure was designed to replenish the body’s supply of “fat and blood”thought necessary to generate vital biological energy.24

Mitchell wove conservative patriarchal beliefs about women’s rolesinto his literature on neurasthenia. He argued that young women shouldrefrain from thinking too deeply, stay out of professional careers, and putoff college or avoid it altogether lest they risk depleting their nervousenergy. These prescriptions sprang from a belief, shared with others inthe nineteenth-century scientific community, that there were fundamen-tal, biological differences between men and women.25 In his popularhealth book Doctor and Patient (1888), Mitchell claimed that men andwomen had different intelligences, “both quantitative and in a measurequalitative,” that education could never change; women would never be“equal” to men.26 If women competed with men, his argument went, theynot only risked overexertion and sickness but they also risked spoilingtheir feminine virtue—their “true attractiveness”—thereby making them-selves less fit to be man’s “friendly lover.”27 For Mitchell, women bestserved society as supportive wives and healthy mothers, roles that werethreatened when they competed with men academically or professionally.

Yet despite his seemingly patronizing attitude toward them, Mitchellwas a complicated man who had a reputation for respecting and enjoyingthe company of intelligent women.28 Most of his patients were women

23. S. Weir Mitchell, Wear and Tear, or, Hints for the Overworked, 4th ed. (1887; reprint,New York: Arno Press, 1973). Linking illness to progress has been a common practice inWestern society for centuries; see Charles E. Rosenberg, “Pathologies of Progress: The Ideaof Civilization as Risk,” Bull. Hist. Med., 1998, 72: 714–30.

24. S. Weir Mitchell, Fat and Blood and How to Make Them (Philadelphia: Lippincott,1878). It should be noted that men were occasionally prescribed the rest cure, even thoughit has developed a reputation as a women’s cure.

25. One of the most vocal opponents to women’s full participation in academic life wasDr. Edward Clarke, a professor of medicine at Harvard, whose ironically titled book Sex inEducation, or, A Fair Chance for Girls (Boston: Osgood, 1873) was at the center of latenineteenth-century debate over women’s education. For a good overview of the scientificcommunity’s belief in sexual difference during the nineteenth century, see Cynthia EagleRussett, Sexual Science: The Victorian Construction of Womanhood (Cambridge: Harvard Univer-sity Press, 1989).

26. S. Weir Mitchell, Doctor and Patient (Philadelphia: Lippincott, 1888), p. 138.27. Ibid., pp. 139–40.28. Morantz also recognized Mitchell’s respect for “educated, intelligent, strong-minded

women” in her essay “The Lady and Her Physician” (n. 11), p. 42. In addition to Mitchell’s


who specifically sought him for treatment. Among these was Amelia GereMason, a neurasthenic who enjoyed Mitchell’s friendship and relied onhis medical assistance but believed that the doctor’s patriarchal beliefswere misguided. Neurasthenia did not discourage her from engaging inintellectual activity; rather, Mason’s struggle with the illness encouragedher to become a published critic of modern American culture and anadvocate for an expanded public role for American women.

Amelia Gere Mason

Born Amelia Ruth Gere in 1831 in Northampton, Massachusetts, as a girlMason moved west with her family to Chicago, a city that remained hermore-or-less permanent home until her death in 1923. After earning herdegree in music from Mount Holyoke College in 1851, she served asprincipal of a private school and taught classics until neurasthenia struckand her health failed, causing her to withdraw from school teaching andadministration. Mason’s neurasthenia came and went in cycles, allowingher to teach piano and write while she was healthy, but forcing her intoseclusion—often outside the city—when she was ill. Marriage does notseem to have been a high priority, for she waited until she was forty-onebefore wedding businessman Alverin Armington Mason in 1872. Theyhad no children.29

Mason took advantage of the culture that Chicago offered to a womanof comfortable means. She visited exhibits as they passed through andkept abreast of the art world by reading the cutting-edge journal The NewPath and the more mainstream Fortnightly Review. She found herself partof a community of culturally minded women that revolved around Kate

longtime relationship with Amelia Gere Mason and Sarah Butler Wister, he also carried ona lifelong friendship with Agnes Irwin, the first dean of Radcliffe College. Archival evidencesuggests that people capitalized on his respect for knowledgeable women to ask favors ofhim. The minister, reformer, and author Edward Everett Hale wrote him a personal letterasking him to treat a family friend. In the letter, Hale tried to entice Mitchell by showcasinghis friend’s intellectual qualities: “She is a singularly well educated lady, with a real passionfor natural sciences, on using the microscope—in botany—and in geology. She is a leaderamong all the amateur students and is . . . feted and esteemed by our best scientific men”(Edward E. Hale to S. Weir Mitchell, 8 May 1898, MP-CPP, series 4.3, box 8, folder 2).

29. Although her 1891 work Women of the French Salons is widely available in electronicform, there is remarkably little biographical information available on Amelia Gere Mason.Who Was Who in America (1942), p. 785, has a short biography; Mount Holyoke CollegeArchives and Special Collections, South Hadley, Mass., has a small Mason biographical file(class of 1851); and Mason infused some episodes from her own life into the biography shewrote of Emily Eames MacVaegh entitled Memories of a Friend (Chicago: Woodworth, 1918).


Newell Doggett, an avid botanist, skilled dancer, and vice-president of theNational Woman Suffrage Association. These women voraciously de-voured Dickens, Thackeray, George Eliot, and Hawthorne, consideredEmerson their “sage and philosopher,” religiously read the Nation, andvalued James Russell Lowell and the Atlantic group as a “national trea-sure.” By the late 1860s Mason and her friends carried on, as she laterrecalled, an “indefatigable search for everything that could throw a ray oflight on what was going on in the world of art and intellect.”30

Inspired by Matthew Arnold’s Culture and Anarchy (1869) and JohnStuart Mill’s The Subjection of Women (1869), by 1873 Doggett’s circle hadevolved into the Fortnightly, a formal club that met in the tradition of theFrench salons and dedicated itself to the intellectual and cultural devel-opment of women.31 The similarity between the Fortnightly and Frenchsalons was no coincidence: Chicago was then home to the glamorousMadame d’Héricourt, a former salon hostess in exile from France whofrequently gave lectures on literature, society, politics, and philosophy.32

The legacy of European salons, especially women’s role in them, left anindelible impression on Mason, who later spent seven years in Europeresearching the history of the French salon tradition and published thewell-received (and still widely available) work of intellectual history TheWomen of the French Salons (1891).33

For Mason, modern Chicago was a gendered city. As its men increas-ingly placed economic profits over social responsibility, women had toassume the duty of sustaining civic culture. She saw the most talentedmen engaged in a “race for money” after the Civil War, always thinking ofthe “utilitarian side of life” and unwilling to dedicate their talent to thearts.34 Indeed, business was the topic of the day in Chicago as the citygrew at an astounding rate, generating economic activity that only accel-erated with the rush to rebuild after the Great Fire of 1871. The popula-tion more than doubled during the Civil War decade, to 350,000 inhabit-ants by 1870—a number that would triple in another twenty years tomake Chicago the second-largest city in the United States.35 Mason

30. Mason, Memories of a Friend (n. 29), p. 15.31. Muriel Beadle, The Fortnightly of Chicago, the City and Its Women: 1873–1973 (Chicago:

Regnery, 1973), pp. 3–4; Mason, Memories of a Friend (n. 29), p. 53.32. Mason, Memories of a Friend (n. 29), pp. 41–42.33. Who Was Who in America (n. 29), p. 785; Amelia Gere Mason, The Women of the French

Salons (New York: Century, 1891).34. Mason, Memories of a Friend (n. 29), pp. 14–15.35. William Cronon, Nature’s Metropolis: Chicago and the Great West (New York: Norton,

1991), pp. 279, 301–2.


believed that her city desperately needed the moral, stabilizing influenceof artistic and literary culture, and with local men dedicating themselvesto business, “this work was clearly to fall upon women,” she claimed, “ifdone at all.”36

Although Mason was an active, confident, and ambitious woman,neurasthenia sporadically left her lethargic, insecure, and depressed. Aparticularly devastating bout with the illness in 1882 caused her to “letgo” the “threads of care” and convinced her that her life “had ended.”37

Despondent, she traveled to Philadelphia and sought Mitchell’s help forthe first time. Details of their initial meeting are scant, but one thing iscertain: Mason gave Mitchell credit for restoring “value” to her life.38

What ensued was a thirty-two-year relationship between patient anddoctor recorded in nearly two hundred letters.39 Because the two lived indifferent cities (Mason in Chicago, Mitchell in Philadelphia), they metonly a few times for consultation; letters filled the therapeutic void, andtoday they give us insight into the nature of Mason’s illness and themethod of Mitchell’s treatment. Over the years their roles of patient andphysician became less distinct, especially once Mason began writing herhistories and essays and Mitchell his novels and poetry. By Mitchell’sdeath in 1914, their friendship seems to have become therapeutic initself as each relied on the other for emotional support and engagingconversation.

“Intellectual enthusiasms are wearing,” Mason complained to Mitchell;“thinking too severely exhausts me.”40 She had explosions of activity inwhich she penned essays (on literature, music, and society), publishedbooks (including Women of the French Salons in 1891 and Women in theGolden Ages in 1901), presented papers at society meetings, read the latestnovels, and kept up with friends. But inevitably her motivation wouldcollapse under a demanding schedule: “I wish to do twenty things atonce, hence, I am idle.”41 With her energy exhausted, her thoughtsveered toward despondency, especially during the holiday season whenher life lacked inspiration, joy, and hope. “I stay here,” she somberlywrote during a Chicago winter, “because it is a very good place to die in.

36. Mason, Memories of a Friend (n. 29), p. 57. Maureen Flanagan has also recognized theimportance of women in Chicago’s reconstruction and the development of a civic culture:Flanagan, Seeing with Their Hearts: Chicago Women and the Vision of the Good City, 1871–1933(Princeton: Princeton University Press, 2002).

37. Mason to Mitchell, 17 February 1912, MP-CPP.38. Ibid.39. These letters are currently held in MP-CPP, series 4.3, box 9.40. Mason to Mitchell, 25 April 1907, MP-CPP.41. Mason to Mitchell, 17 March 1892, MP-CPP.


There is so little that is interesting to leave.”42 The need to nurse her sickhusband, who suffered from vertigo and crippling falls to the ground,also weighed heavily on her mind. “Everything falls on my weak shoul-ders,” she lamented; “I give out but get up and stumble on. . . . the Swordof Damocles hangs always over my head.”43 Following her husband’sdeath in 1904, Mason felt even greater loneliness and isolation. “Theflowers and souvenirs scattered about my room tell me that I am notforgotten,” she remarked to Mitchell a few days after Christmas in 1912,“but I feel on the outside of things and it is chilly.”44

To regain control over her mind and to combat neurasthenia’s demor-alizing grip, Mason threw herself into the role of critic. “One must dosomething to avoid thought when one is alone and no longer young,”Mason, in her seventies, explained; “but I don’t care for the surface oflife—and its depths I am afraid of.”45 It was to this area between the“surface” of life and its “depths” that she turned her attention in 1907. In adiversionary exercise, she wrote an “exact picture” of her life, as a strangermight see it, from childhood to the time she left college. “It is curious totrace the growth of a soul,” she said of her “psychological” work.46 Al-though she shied away from finishing this introspective self-examination,the perspective she took—third-person—is telling, for it reveals a womanwho understood the need for emotional distance. By assuming the pointof view of a third person and writing about “a soul” rather than “my soul,”Mason established a critic’s cushion of objectivity that allowed her to gazeupon her life without succumbing to neurasthenia’s morbid, depressingthoughts.47 Acting as a critic was therapeutic for her, and she often turnedher rational mind toward assessing the world around her.

Not surprisingly, Mason critically evaluated Mitchell’s medical care,which she described as “autocratic,” yet effective. A key element in hissuccess as a physician, she suggested, was an “impersonal” demeanor thatmade him the perfect person with whom women could share theirproblems and secrets. Comparing Mitchell’s office to a confessional, she

42. Mason to Mitchell, 6 December 1897, MP-CPP.43. Mason to Mitchell, 10 November 1899, MP-CPP.44. Mason to Mitchell, 28 December 1912, MP-CPP.45. Mason to Mitchell, 25 April 1907, MP-CPP.46. Ibid.47. By observing and assessing her psychological state—her “soul”—Mason seems to

have been following in the spirit of the “new psychology” movement that was gainingground in America during this time, represented by figures such as William James, JohnDewey, and G. Stanley Hall. Mason was well aware of James, for she mentioned him in ahandful of letters to Mitchell. For more on turn-of-the-century “new psychology,” see JeffreySklansky, The Soul’s Economy: Market Society and Selfhood in American Thought, 1820–1920(Chapel Hill: University of North Carolina Press, 2002), pp. 137–70.


claimed: “A woman confides to a trusted physician what she could say tono other friend.”48 For Mason, the doctor-patient relationship was asource for emotional comfort that appears to have partially supplantedwhat historian Nancy Cott described as the “bonds of womanhood” ofthe early nineteenth century.49 Mason had “faith” in the ability of physi-cians such as Mitchell—rather than other women—to provide comfort intimes of woe. “What are physicians for? To serve as a receptacle forhuman sorrows?” she asked Mitchell; “Many die, as you know, for the lackof someone to persuade them to live.”50

Although Mason trusted Mitchell’s medical opinion, she displayedremarkable candor in criticizing his patriarchal assumptions. Takingexception to his characterization of the submissive Olivia, the heroine inhis novel Roland Blake (1886), Mason suggested that his “autocraticposition” with patients had caused him to overestimate women’s “humil-ity under masculine despotism.” Women, she explained, loved strengthbut never loved being “made to yield.”51 Choice, rather than duty, shouldbe the basis for women’s decisions; to think otherwise, she insisted, was a“popular fallacy” that she believed the “coming woman” of the latenineteenth century would dispel.52 During another exchange in whichMitchell claimed that female physicians lacked “poetic femininity,” Ma-son sharply reprimanded her doctor:

Why should a woman with a capacity for certain things quite legitimate andhonorable, spend her life in poverty and distasteful toil because men think thethings she likes and can do, unpoetic, or rather why do men think thepractical embodiment of the ministering angel unpoetic? Is it less poetic toprescribe for the sick than to nurse them, or to make bread, or to sew?53

Mason’s experience participating in Doggett’s salon clearly left her confi-dent of women’s intellectual and social abilities. Despite her own prefer-ence for dispassionate physicians, she recognized a place in medicine forwomen’s sympathetic (“poetic”) character, a conviction that ReginaMorantz-Sanchez has argued was shared by those who were determinedto open the profession of medicine to women.54 Also, by linking the

48. Mason to Mitchell, 27 December 1886, MP-CPP.49. Nancy F. Cott, The Bonds of Womanhood: “Woman’s Sphere” in New England, 1780–1835

(New Haven: Yale University Press, 1977).50. Mason to Mitchell, 10 February 1911, MP-CPP.51. Mason to Mitchell, 27 December 1886, MP-CPP.52. Ibid.53. Mason to Mitchell, 7 July 1892, MP-CPP.54. Regina Markell Morantz-Sanchez, Sympathy and Science: Women Physicians in American

Medicine (New York: Oxford University Press, 1985).


professional limits women faced with the “poverty and distasteful toil” inwhich they too often found themselves, Mason recognized how womenwere challenged by a combination of factors, including economics, ostra-cism, and patriarchy. “I don’t like all of the changes in attitude ofwomen,” she wrote to Mitchell in 1912, “but I like less the old attitudetowards them, which stamped them with inferiority in spite of a pretenseof chivalry.”55

Rejecting out of hand the patriarchal subtext that Mitchell attemptedto write into neurasthenia, Mason nevertheless agreed in principle to thedoctor’s suspicion of modernity. Mitchell’s warning that America’s pur-suit of the “dollar devil” robbed the nation of its vital energy must havemade intuitive sense to Mason, who blamed what she saw as a tragicdecline of culture in Chicago on the post–Civil War drive for profit.56

Both Mitchell and Mason saw a capitalist society out of touch with whatwas important, be it the vital need for rest or the equally pressing needfor culture. Mason’s critique of modern America went beyond her indict-ment of capitalism to include the “radical democracy” of Jane Addams,the “colorless” realism in literature, and the “uninspiring” skyscrapers inher hometown of Chicago.57 For Mason, it was nearly impossible to spendtime on intellectual and cultural matters without seeing herself as anactivist of sorts—not a radical or progressive activist, but rather whathistorian Jackson Lears might call an “antimodernist” who believed thatmorality and social stability could be found in philosophy, literature,music, art, and a healthy respect for intelligent, talented women.58

Mason’s relationship with Mitchell reveals subtleties in the doctor’spersonality and therapeutic approach typically overlooked by scholarswho otherwise focus on the neurologist’s trademark rest cure. Mitchellreserved his rest cure for only the most severe cases, for patients inneurasthenic tailspins who were incapable of caring for themselves. Inthese situations, he believed, physicians needed to create a highly struc-tured environment in which every aspect of the patient’s life—includingeating, drinking, and movement (bed pans were provided)—was regu-lated for at least a month. The rest cure operated on two levels: First, itensured that neurasthenics ate properly so that they gained weight—“fatand blood,” in Mitchell’s words—which presumably promoted higher

55. Mason to Mitchell, 9 January 1912, MP-CPP (emphasis in the original).56. Mitchell, Wear and Tear (n. 23), pp. 8–9; Mason, Memories of a Friend (n. 29), pp. 14–

15.57. Mason to Mitchell, 2 January 1911, 1 August 1912, 14 October 1912, MP-CPP.58. Lears outlines antimodernism in No Place of Grace (n. 14).


levels of nervous energy.59 Second, the rest cure’s controlled environ-ment allowed physicians to put patients through a psychological bootcamp in order to strengthen neurasthenic minds otherwise weakened bysickness. According to Mitchell, this required “a firm and steady will” onthe part of the physician (an “autocratic position,” as Mason saw it) sothat he could “insure belief in his opinions and obedience to his de-crees.”60 The goal was to discourage patients from dwelling on morbidthoughts or wallowing in self-pity, and to encourage an active, positiveattitude (something that the contemporary Harvard neurologist JamesJackson Putnam compared to using the power of suggestion).61

To this end, Mitchell suggested that people who found themselvessinking into a neurasthenic funk should engage in intellectual and cre-ative activity. Using the example of a neurasthenic he had known foryears, he argued that her “safeguard from utter wreck” was a “clear andresolute faith,” and “a profound and unfailing interest in men and thingsand books.” This, he claimed, “gave strange vigor to her whole range ofintellectual activities.”62 The goal, according to Mitchell, was forneurasthenics to strengthen and occupy their minds so that they wouldnot succumb to sorrow, pain, and despair. Training the brain to sharpenits focus and operate rationally was, in his opinion, one of the best thingsa woman could do. So long as they stayed away from depressing topics, heencouraged women to read, sketch nature, paint, learn photography,keep a diary, and write poetry as constructive ways to control their mindsand strengthen their wills. If these activities piqued women’s curiosityand desire to learn more about the world, Mitchell believed this was “somuch the better.”63

The key element of Mitchell’s therapeutic strategy is that it was, to adegree, escapist and designed to distract people from the depressing,morbid thoughts and lassitude of neurasthenia. He did not seem to expector anticipate that his patients would use their creative and intellectual

59. Mitchell, Fat and Blood (n. 24). Interestingly, Joan Jacobs Brumberg has likenedsome cases of neurasthenia to a sort of nineteenth-century anorexia: neurasthenics weretypically thought of as skinny, malnourished, and victims of improper eating habits. SeeBrumberg, Fasting Girls (n. 5).

60. Mitchell, Fat and Blood (n. 24), p. 42.61. James Jackson Putnam, “Remarks on the Psychical Treatment of Neurasthenia,”

Boston Med. & Surg. J., 1895, 132: 505–11.62. Mitchell, Doctor and Patient (n. 26), p. 88.63. Ibid., p. 173. George Cotkin has observed that hobbies such as these, especially

photography, were thought to be feminine activities in the late nineteenth century: see Cotkin,Reluctant Modernism: American Thought and Culture, 1880–1900 (New York: Twayne, 1992).


activities to challenge the separate gender roles that he believed werenatural and healthy. Illustrative of his therapeutic strategy was Olivia, theheroine of his novel Roland Blake (and the same character Mason foundtoo submissive), who took up sketching the ocean at Cape May as a way ofescaping the neurasthenic influences of her troublesome cousin and acomplicated love affair.64 Sketching did little directly to solve Olivia’sproblems, but the activity allowed her to gather her thoughts and rejuve-nate emotionally in the face of an impending romantic crisis.

Mitchell employed this therapeutic strategy of keeping neurasthenicspreoccupied with something other than their illness in his correspon-dence with Mason. A recovering neurasthenic himself, Mitchell revealedto Mason that he relied on writing to keep from “dwelling upon [the]intolerable calamity” of his daughter’s death.65 He regularly encouragedMason to think and write critically, especially on novels and poetry, hisown work included. This she did. Sometimes she wrote to vent frustra-tions, as when she complained about Nietzsche (“Do you read that manwho is coloring all the new thoughts? I detest him!”).66 Other times sheposed philosophical questions (“Does anybody . . . ever really love morethan one person at a time?”).67 Occasionally she wrote out of despair (“Itseemed as though the world was crumbling under my feet, so I wrote youa long letter”).68 These therapeutic interactions allowed her to developher ideas, motivated her to remain active within America’s culturalcircles, and afforded her refuge from the emotional ravages of herneurasthenia.

Encouraged by her relationship with Mitchell, Mason combined hertherapeutic need for intellectual activity and writing with her dedicationto keeping culture alive in modern America. Emblematic of this is TheWomen of the French Salons, the product of seven years of Europeanarchival research and personal interviews, which was a clarion call forAmerican women to mobilize in defense of a national culture she thoughtthreatened by “false standards” and “aggressive materialism.” “It is inFrance that we find the forerunners of the intelligent, self-poised, clear-sighted, independent modern woman,” she observed in her preface.69

64. S. Weir Mitchell, Roland Blake (New York: Century, 1915). Although this strategy mayseem a superficial cure to some therapists today, one must keep in mind that facingpersonal psychological problems did not became a widely accepted form of therapy untilthe arrival of Sigmund Freud and his psychoanalytic strategies in the twentieth century. SeeGosling, Before Freud (n. 8); Shorter, From Paralysis to Fatigue (n. 12).

65. Mitchell to Mason, 12 [no month] 1900, MP-CPP.66. Mason to Mitchell, 16 September 1912, MP-CPP.67. Mason to Mitchell, 17 February 1912, MP-CPP.68. Mason to Mitchell, 30 November 1911, MP-CPP.69. Mason, Women of the French Salons (n. 33), p. v.


American women should look to the salon matrons of France, whoguided their national culture through a century of political and socialupheaval, as models for how to save an American culture threatened byencroaching modernity. With this book, Mason sought to perpetuate themodel of woman-as-intellectual that she had first encountered a quarter-century earlier with Kate Newell Doggett and Madame d’Héricourt, andto use it as the template for the ideal modern American woman—acultural counterbalance to the materialistic modern man. Women of theFrench Salons acted as a response to Mitchell’s claim that women bestserved their nation by remaining healthy and bearing children, a beliefthat categorically excluded the neurasthenic and childless Mason. Masoncelebrated the vitalizing potential for educated women of all ages—married or unmarried, with or without children, sick or healthy—tostrengthen their nation through cultural and intellectual endeavors.

Sarah Butler Wister

Sarah Butler Wister was another intellectual and accomplished neuras-thenic patient of Weir Mitchell. Born in 1835, she was of the samegeneration as Mason but she identified more closely with the traditionaldomestic sphere than did Mason. It was these things—taking care of herhusband, son, and large family estate—that she cherished, but that shenonetheless believed lay at the root of her neurasthenia. In contrast toMason’s relationship with Mitchell, which began as that of a patient andher physician and evolved into a friendly, intellectual exchange, Wisterwas Mitchell’s cousin first and his patient second. Consequently theirletters were typically intimate, dealing with family matters more oftenthan with health. Yet each looked to the other for professional aid:Mitchell relied on Wister as an informal editor of his novels and, accord-ing to his biographer, as the model for several of his heroines, whereasWister relied on Mitchell for medical advice.70

Wister was the oldest daughter in a family that was troubled from thestart. Her father, Pierce Butler, owned Georgia plantations and was oneof the largest slaveholders of the antebellum period. Her mother, thefamous English actress Fanny Kemble, was an ardent abolitionist. Kemble,who claimed that she did not know the source of her husband’s incomeuntil after they had married, wrote treatises against slavery throughoutthe late 1830s, the most famous being Journal of a Residence on a GeorgianPlantation (later published during the Civil War). Unwilling to live withher slaveholding husband and abide by his increasingly abusive ways, she

70. Earnest, S. Weir Mitchell (n. 22), pp. 73, 130.


left for London in 1845 to rekindle an acting career, only to return toAmerica three years later to defend herself unsuccessfully against divorcewhen Butler sued on grounds of abandonment. Sarah and her sisterFrances both stayed in the custody of their father. Despite Kemble’s flightto London and subsequent divorce, the young Wister grew to appreciateher mother’s abolitionism and artistic interests.71

Wister’s adult life both rejected and resembled that of her mother.She married Dr. Owen Jones Wister, a Quaker, in 1859 and had one son,Owen Jr. (author of The Virginian, 1902). She and her family lived atButler Place, her father’s eighty-two-acre estate in Philadelphia, whereshe took her housekeeping and mothering duties seriously until herdeath in 1908. Wister kept up her mother’s artistic tradition by writingpoetry and essays and by entertaining literary figures such as WilliamDean Howells, Henry James, and the English poet Matthew Arnold(whose Culture and Anarchy had heavily influenced Mason).72 Befitting awoman who grew up with ideologically opposed parents, Wister tendedto strike a balance in her friendships and politics. One of her closestconfidants since childhood was Weir Mitchell, with whom she tradedfamily gossip and exchanged emotional support during difficult times.Another of her close friends was Agnes Irwin, the principal of a girl’sschool in Philadelphia, co-editor with Wister of a centennial volumeentitled Worthy Women of Our First Century (1877), and eventually the deanof Radcliffe College.73 As for journalism, Wister divided her readingbetween the progressive Nation and Herbert Welsh’s anti-imperialist Cityand State.74

Wister closely identified with her roles of wife and mother. LikeMason, she found herself having to take care of a sick husband. Owen Sr.suffered from a nervous collapse in 1869 (reportedly from overwork)and afterward demanded constant attention, often reminding his wifethat his “happiness depended on her.” This dependence grew into anobsession during the last few years of his life when, according to a familyhistory, he could not bear to be apart from his wife.75 Their son, Owen Jr.,

71. The best published source on Sarah Butler Wister’s life is Fanny Kemble Wister, ed.,That I May Tell You: Journals and Letters of the Owen Wister Family (Wayne, Pa.: HaverfordHouse, 1979).

72. Ibid., pp. 3, 7.73. Mrs. O. J. Wister and Agnes Irwin, eds., Worthy Women of Our First Century (Philadel-

phia: Lippincott, 1877). Although Irwin and Mitchell had opposing views on what consti-tuted the proper education for young women, the two knew each other and kept up afriendly correspondence during the late nineteenth and early twentieth centuries.

74. Sarah Butler Wister to S. Weir Mitchell, 18 August 1897, MP-CPP, series 4.3, box 9.All future references to the Wister-Mitchell letters come from the same series and box.

75. Wister, That I May Tell You (n. 71), pp. 11–12.


also relied heavily on his mother for assurance and support. She aggres-sively defended his decision to study music and become a writer, much tohis father’s chagrin; in return, he faithfully wrote to her while he wasaway from home and pleaded with her to write him more often duringhis frequent bouts of homesickness.76 Wister wanted to foster cosmopoli-tan sensibilities in her husband and son and was concerned that theywould be unduly influenced by the rustic Quaker ways of her in-laws.Consequently, she developed a reputation as an arrogant, exacting, anddemanding woman who kept a careful—if not jealous—eye on herfamily.77

Poor health and feelings of isolation dogged Wister most of her life asshe found herself surrounded by nervous sickness within her own family.In addition to her husband’s illness, her son experienced a nervousbreakdown in 1884, and her sister-in-law (also named Sarah) consistentlysuffered as what Wister disparagingly called a “demi-malade imaginaire.”78

Looking back on her life, Wister recalled that her most profound prob-lems began when she was only fifteen and developed a morbid desire fordeath—a desire that she told Mitchell was the “longest, strongest wish ofmy life.”79 By the 1860s she began to experience chronic insomnia thatlasted more than thirty years, ending temporarily around the time of herhusband’s death in 1896 but beginning again after her son’s marriage in1898.80 “I am profoundly convinced that . . . each soul must strugglethrough the bitter floods alone,” she confided to Mitchell; “the doubts,the despairs, play their parts in the scheme, whatever it may be.”81

Despite this stoicism, Wister relied heavily on personal relationships forpeace of mind and stability. While in Europe with her mother in thesummer of 1870, she experienced what historian Carroll Smith-Rosenbergdescribed as a “period of extreme anxiety” when faced with the marriageof her intimate childhood friend Jeannie Field Musgrove.82 The loss offriends and family aggravated her neurasthenia, causing incapacitatingneck and back pain.83 “I felt a terrible nervous jab,” Wister admitted to

76. Ibid., pp. 11, 13.77. Ibid., p. 13.78. Information on Owen Wister Jr.’s illness can be found in Will, “Nervous Origins” (n.

13). Reference to Wister’s sister-in-law comes from Fanny Kemble Wister, ed., “Sarah ButlerWister’s Civil War Diary,” Pennsylvania Mag. Hist. & Biog., 1978, 102: 271–327, on p. 278.

79. Wister to Mitchell, 16 February 1904, MP-CPP. (Note that Earnest’s biography ofMitchell incorrectly dates this letter as 6 February 1904.)

80. Wister to Mitchell, 19 June 1898, MP-CPP.81. Wister to Mitchell, 23 March 1898, MP-CPP.82. Carroll Smith-Rosenberg, “The Female World of Love and Ritual: Relations between

Women in Nineteenth-Century America,” Signs, 1975, 1: 1–29, on p. 5.83. Wister to Mitchell, 29 July 1897, MP-CPP; Wister, That I May Tell You (n. 71), p. 11.


Mitchell upon hearing of the passing of family friend and prominentPhiladelphia physician Dr. Jacob DaCosta; “I was really helpless. I[couldn’t] bear the fatigue of keeping house.”84

Even when faced with a good friend’s death, Wister could not puthousekeeping out of her mind. She both resented it as a chore andcherished it as a responsibility.85 She explained to Mitchell how it “infuri-ated” her when she had to stop reading an engrossing book to attend tohousework, a task that she complained required “immense attention.”86

Yet when she relied on a maid to help her “escape” the demands ofdomestic work, she found herself in a “mad gallop for errands [and]chores” to occupy her until late into the evening, by which time she was“too tired” to even read a book or write a letter.87 Keeping house wasnever easy for Wister, and it exacerbated her nervous disposition. Herfirst test was in 1861 when she supervised the spring cleaning of thesizeable Butler Place. Despite precautions, workers’ attempts to white-wash and clean the chimneys resulted in a fiasco that filled the housewith “an avalanche of soot.”88 Directing hired help frustrated her com-pletely. “The servants despite their lofty pretension,” she wrote in herjournal, “are just as incompetent as if they had never lived in a house intheir life, & so inattentive that they forget your orders while you arespeaking & disobey them under your eyes.”89 Reliant on servants withwhom she had a strained relationship, and painfully aware of the poten-tial pitfalls of running a large estate, Wister knew that housekeeping washer nemesis; “I have not the physical strength for it nor the moralserenity,” she observed during that first fateful seasonal cleaning.90 In1881, after twenty years of “household worry,” her health finally gave outin what she later described as a “terrible nervous breakdown” followed bytwo years of melancholia; she blamed housekeeping, yet she could notfind it in her to put it aside.91 Upon recovery she continued to supervisethe upkeep of Butler Place for another twenty years.

Given her compulsion to overwork, Wister found solace in a treatment

84. Wister to Mitchell, Saturday, 13 October (no year, but most likely 1900, whenDaCosta died), MP-CPP.

85. For a general overview of women’s dedication to housework and the physical andmental toll it exacted, see Susan Strasser, Never Done: A History of American Housework (NewYork: Pantheon Books, 1982).

86. Wister to Mitchell, no date (although probably 1896 or 1897), MP-CPP.87. Wister to Mitchell, 19 June 1903, MP-CPP.88. Wister, “Sarah Butler Wister’s Civil War Diary” (n. 78), p. 290.89. Ibid., p. 296.90. Ibid.91. Ibid.


for neurasthenia that permitted her periods of industriousness whileoffering relaxation and recuperation: taking prescribed breaks.92 Theidea of taking a break from stressful work was not new to Wister. After all,her cousin Dr. Mitchell had become a minor celebrity for advising peopleto take holidays, and her son Owen Jr. had traveled out west in 1884 toovercome his own bout of neurasthenia. (He avidly wrote about theexperience to his mother, and used it as the basis of his widely popularcowboy novel The Virginian.93) Without prescribed breaks, relaxing didnot seem to be possible for her, especially during the final years of herhusband’s life when he was particularly demanding of her time. As herdoctor, Mitchell advised her to dedicate time every day to paintingwatercolor landscapes. In trying to “prove” to herself whether she hadany skill at painting, Wister ended up spending two to three hoursoutdoors by herself every morning during the summer of 1893. Shefound it an invigorating experience, as it forced her to stay in the freshair “twice as much as usual” and gave her “tranquility of mind.” “For this,”she enthusiastically wrote to Mitchell, “I am your willing debtor.”94

The recognition that it was important to set aside time for herselfmarked a growing understanding on Wister’s part that modern womencould disregard the common expectation that their efforts should re-main focused on the family. During a discussion in 1895 of why women sorarely did “first-rate work in art or literature,” she asserted to Mitchellthat the answer lay in their overwhelming domestic responsibilities andtheir lack of personal time; it was simply impossible for women to“protect themselves from interruptions—the constant necessity of ‘sidetracking.’”95 George Sand, Wister pointed out, did her best work whenshe lived “à la Bohème without domestic ties or cares” so she could rigidlyenforce her “daily privilege of solitude while writing.”96 Wister also looked

92. Historian Daniel Rodgers has found that American workers in the nineteenthcentury also used neurasthenia as a reason to take breaks from work; the professor ofmedical anthropology Arthur Kleinman and the sinologist Joan Kleinman have found asimilar use of neurasthenia one hundred years later in late twentieth-century China. DanielRodgers, The Work Ethic in Industrial America, 1850–1920 (Chicago: University of ChicagoPress, 1978), pp. 102–14; Arthur Kleinman and Joan Kleinman, “Somatization: The Inter-connections in Chinese Society among Culture, Depressive Experiences, and the Meaningsof Pain,” in Culture and Depression: Studies in the Anthropology and Cross-Cultural Psychiatry ofAffect and Disorder, ed. Arthur Kleinman and Byron Good (Berkeley and Los Angeles:University of California Press, 1985), pp. 429–90.

93. Will, “Nervous Origins” (n. 13).94. Wister to Mitchell, 3 September 1893, MP-CPP. As mentioned earlier, Mitchell often

prescribed painting to his patients: see Mitchell, Doctor and Patient (n. 26), pp. 167–68.95. Wister to Mitchell, 22 September 1895, MP-CPP.96. Ibid.


to George Eliot, who she argued had produced her most complete worksonly after her companion, the writer George Lewes, was at hand to“relieve her of every trivial task.”97 The example of Wister’s mother,Fanny Kemble, who found it impossible to play at once the roles oftraditional wife and successful actress, may have also helped her believein the incompatibility of complete dedication to the family and artisticexcellence. If women were to develop their individual talents and identi-ties, she felt, they needed to take the potentially unorthodox step ofsafeguarding personal time.98

After the death of her husband, Wister was free to spend the springand summer convalescing in a resort in rural Summerville, South Caro-lina, where she found the environment she needed to revitalize her ailingmind and body. A masseuse who traveled around town on a bicycle was onhand to ease her back pains—but most important, she had solitude. “Inever had a more peaceful Easter tide,” she recalled; she was “alone, quitealone for the hotel was empty save for one quiet family and two invisibleinvalids.”99 Away from the burdens, bustle, and memories of Butler Place,Wister could contemplate her widowhood and her son’s impending mar-riage without distraction. In time she met local people, wealthy and poor,old and young, sick and healthy, and these meetings developed into acommunity of sorts that helped alleviate some of her nervousness as sherealized that her new acquaintances had the same “family worries” shedid. “I was calming and fortifying my soul and, for the first time with anysort of success, [trying] to reconstruct my remnant of life,” she later wroteMitchell.100 She did not rely exclusively on Summerville for relaxation,and on other occasions she visited Homestead Hot Springs in Virginia,where she received regular courses of baths and treatments that merci-fully created a “general inability and disinclination for the least mentalexertion.”101 The prescribed necessity for physical, mental, and emotionalrelaxation essentially gave Wister permission to take a break from herhousehold duties and develop a greater sense of herself.102

Vacations became part of Wister’s lifestyle and complemented her

97. Ibid.98. Virginia Woolf, also a neurasthenic, famously elaborated on this same theme more

than thirty years later in A Room of One’s Own (London: Hogarth Press, 1929) and ThreeGuineas (London: Hogarth Press, 1938).

99. Wister to Mitchell, 10 August 1897, MP-CPP.100. Ibid.101. Wister to Mitchell, 28 September 1903, MP-CPP.102. Carroll Smith-Rosenberg has made similar observations about the role hysteria

played in allowing women to escape, avoid, and redefine their domestic roles. See Smith-Rosenberg, “Hysterical Woman” (n. 11).


sometimes self-destructive dedication to housekeeping. In the summerof 1902, after ten days of “laborious and lugubrious” work to get ButlerPlace ready for tenants, she took a short trip outside Philadelphia toWhitemarsh. “I have had a peaceful, pleasant halt,” she wrote to Mitchell,“and a little of this soreness of every sort has gone.”103 Given her drivenpersonality, it is hardly surprising that she contemplated combining herhoned domestic skills with her interest in vacations. While staying at thePine Forest Inn at Summerville during the spring of 1900, she brought toMitchell’s attention a business opportunity: an old hotel in Green Cove,Florida, with acres of land and a natural spring, had burned down, andWister believed it could be rebuilt and operated as a successful resort ifinvestors could be found.104 There is no evidence that her plans came tofruition, but she continued to spend a large part of each year until herdeath vacationing in places such as South Carolina’s Summerville,Maryland’s Deer Park, and Virginia’s Homestead Hot Springs.

Wister was joining a growing population of late nineteenth-centuryAmericans who made travel and vacations parts of a modern lifestyle.105

As historian Cindy Aron has demonstrated, previous generations lookedat vacations with “fear and anxiety” because such breaks were leisure, andAmericans associated leisure with slothfulness and weak character. But asthe nineteenth century came to a close and the railroad system openedthe continent to the growing numbers of citizens with disposable in-comes, Aron argues, Americans overcame their distrust of vacations bymaking their trips busy with rigorous, hectic itineraries and, in the caseof sojourns at health spas, strict regimens.106 Keeping in mind that thelabel “neurasthenia” already carried with it the connotation of workingtoo much, rather than too little, Sarah Wister’s case suggests that thediagnosis offered another way that Americans could justify taking vacationswithout appearing lazy. She did not vacation simply to avoid work; rather,she vacationed so that she could revitalize herself and continue to work.

103. Wister to Mitchell, 12 June 1902, MP-CPP.104. Wister to Mitchell, 22 April 1900, MP-CPP.105. One cannot help but think of Wister’s vacation habit as part of the modern culture

of consumption that was enticing neurasthenics through advertisements for products—and holidays—to ensure good health. See, e.g., T. J. Jackson Lears, Fables of Abundance: ACultural History of Advertising in America (New York: Basic Books, 1994), pp. 137–258;Gosling, Before Freud (n. 8), pp. 108–42; Sarah Stage, Female Complaints: Lydia Pinkham andthe Business of Women’s Medicine (New York: Norton, 1979). Germany also appears to havecultivated a culture of consumption among neurasthenics: see Heinze-Peter Schmiedebach’sexcellent essay “The Public’s View of Neurasthenia in Germany: Looking for a New Rhythmof Life,” in Gijswijt and Porter, Cultures of Neurasthenia (n. 10), pp. 219–38.

106. Cindy Aron, Working at Play: A History of Vacations in the United States (New York:Oxford University Press, 1999), p. 5.


Wister understood the connection between her dedication to homeand her personal health. Aided by Mitchell, her treatment for neurasthe-nia enabled her to take sanctioned breaks from housework in order todevelop personal interests and strengthen herself emotionally withouthaving to reject her life as a homemaker. These breaks, whether a fewhours of morning painting or a few months of vacation, not only pro-vided solace from domestic stress, they also allowed Wister to recognizethe personal sacrifices women made as wives and mothers. And perhaps,in some way, she was able to follow her mother and experience freedomas an independent woman without having to make her mother’s sacrificeof family ties in the process.

The Gilman Case

Over the past thirty-five years Mitchell has developed a notorious reputa-tion as a misogynist who sought to infantilize his female patients, duelargely to his failed treatment of the feminist writer and intellectualCharlotte Perkins Gilman.107 The story is well known: With the birth ofher daughter, Gilman experienced “dragging weariness miles below zero.Absolute incapacity. Absolute misery”—an intolerable condition thateventually led her to Mitchell.108 Thinking that he might find an accountof her illness useful, she wrote up her own case history in preparation fortheir meeting; yet rather than being pleased, Mitchell shocked her bydismissing her effort as an act of “self-conceit.” Their relationship dete-riorated from there. In her autobiography, Gilman claimed that Mitchellnever understood her condition because she was neither of the two typesof patients he was “well versed” in: neurasthenic businessmen “exhaustedfrom too much work,” and neurasthenic society women “exhausted fromtoo much play.”109 A hasty judgment on Gilman’s part, it was nonethelessrevealing of the difficulty she and Mitchell had in relating to one an-other. Decades before postpartum depression would be widely recog-nized, Mitchell fell back on the diagnosis of neurasthenia and treatedGilman with his trademark rest cure, which she took with “utmost confi-

107. For instance, see Wood, “‘Fashionable Diseases’” (n. 11); Ehrenreich and English,Complaints and Disorders (n. 11); Poirier, “The Weir Mitchell Rest Cure” (n. 11); JeffreyBerman, The Talking Cure: Literary Representations of Psychoanalysis (New York: New YorkUniversity Press, 1985); Thomas L. Erskine and Connie L. Richards, eds., introduction toCharlotte Perkins Gilman, The Yellow Wallpaper (New Brunswick, N.J.: Rutgers UniversityPress, 1993), pp. 3–23; Will, “Nervous Origins” (n. 13).

108. Charlotte Perkins Gilman, The Living of Charlotte Perkins Gilman: An Autobiography(1935; reprint, New York: Harper Colophon, 1975), p. 91.

109. Ibid., p. 95.


dence.” After supervising a month of enforced bed rest, sponge baths,and massages, he declared her cured and discharged her with the infa-mous prescription to “live as domestic a life as possible. Have your childwith you all the time. . . . Lie down an hour after each meal. Have but twohours’ intellectual life a day. And never touch pen, brush or pencil aslong as you live.”110

For months, Gilman “rigidly” followed Mitchell’s orders and avoidedintellectual activity. Yet rather than getting better, she found herself“perilously near” to losing her mind and took to playing with a rag dolland hiding in the closet. “The mental agony grew so unbearable,” shelater recalled, “that I would sit blankly moving my head from side toside—to get out from under the pain.”111 Five years later in 1892, sheused this experience and its “mental torture” as the basis for her shortstory “The Yellow Wallpaper,” whose protagonist was slowly driven insaneby the rest cure’s intellectual and social isolation.112

The question still remains of why Mitchell, who encouraged womensuch as Mason and Wister to occupy themselves with intellectual andartistic pursuits, would want to ban Gilman from these activities. Themost likely answer is a common one in the annals of medicine: hemisdiagnosed the cause of her neurasthenia and consequently mistreatedher. After seeing her self-written case study and talking with her, heprobably thought that her intellectual and literary activities were toointrospective and, consequently, too near the “morbid thoughts” thatmade neurasthenia such a debilitating illness. Such a conclusion on hispart would have been only partly off the mark. In her autobiography,Gilman remembered being “exclusively occupied with unpleasant things”before seeing Mitchell. She recalled suffering from “every painful mentalsensation, shame, fear, remorse, a blind oppressive confusion, utterweakness, a steady brainache that fills the conscious mind with crowdingimages of distress.”113 When she met Mitchell, her mind appeared to bethe cause of her problem, not its solution.

110. Ibid., p. 96.111. Ibid.112. Part of the folklore surrounding “The Yellow Wallpaper” is that Gilman sent

Mitchell a copy of the story in the hopes that he would read it and make his rest cure morehumane; she claimed that her strategy worked and that Mitchell modified his therapy onher account. This story, however, is unsubstantiated, and Gilman’s influence on Mitchell isquestioned by Suzanne Poirier in “The Weir Mitchell Rest Cure” (n. 11) and by Julie BatesDock in Charlotte Perkins Gilman’s “The Yellow Wall-paper” and the History of Its Publication andReception: A Critical Edition and Documentary Casebook (University Park, Pa.: PennsylvaniaState University Press, 1998).

113. Gilman, Living (n. 108), p. 90.


The failure of Gilman’s treatment, and the relative success of Mason’sand Wister’s treatments, testifies to the importance of the doctor-patientrelationship in neurasthenia cases. Because neurasthenia did not have aclear pathology and was a complicated combination of mental, emotional,and physical components, physicians could not simply rearrange pa-tients’ minds and bodies as easily as they could reset a broken arm.According to recent studies on the treatment of chronic pain, the mosttherapeutic relationships are those based on a good rapport betweendoctor and patient in which the patient feels as though her ideas arebeing taken seriously.114 Even though Mitchell may have held differentbeliefs on the nature of men and women than did Mason or Wister,enough common interests existed (as well as generational, cultural, andclass similarities) to bridge this gap and create mutual respect betweendoctor and patient. Mason and Wister trusted Mitchell’s medical skill,took comfort in his autocratic ways, and consequently worked with thedoctor to find a therapy that best suited their personal needs. Theencounter between Gilman and Mitchell, on the other hand, was antago-nistic from the start, and his rejection of her case study did little to buildrapport or legitimate their relationship. Gilman may have “confidently”submitted herself to Mitchell’s care, but she was hardly comfortableworking with him. Whereas Mason and Wister were enough at ease tochallenge some of Mitchell’s ideas and take a role in personalizing theirtherapies, the doctor’s bedside manner alienated Gilman, who followedMitchell’s orders “rigidly” and, as a result, did not benefit from aneffective, mutually constructed therapy.115

114. In particular, see Dianna T. Kenny, “Constructions of Chronic Pain in Doctor-Patient Relationships: Bridging the Communication Chasm,” Patient Educ. & Counseling,2004, 52: 297–305. Other works that address the importance of the doctor-patient relation-ship include Gregory Bateson, Mind and Nature: A Necessary Unity (Creskill, N.J.: HamptonPress, 2002); Lynn Hoffman, Foundations of Family Therapy: A Conceptual Framework for SystemsChange (New York: Basic Books, 1981).

115. Gilman’s more successful treatment under Dr. Mary Putnam Jacobi (whom shevisited fourteen years after Mitchell) was closer to Mason’s and Wister’s experience in thatGilman felt that she could work with her physician. As she had for Mitchell, she spent timepreparing information about her illness to give Jacobi a “better understanding of the case,”which Jacobi gratefully accepted. Unlike Mitchell, Jacobi made the effort to get to knowGilman personally and design a therapy with her unique needs in mind: rather than rest,she asked her to practice working while ill; see Gilman, Living (n. 108), pp. 290–91.Morantz-Sanchez also found rapport to be the crucial difference between Gilman’s treat-ments under Mitchell and Jacobi: see Sympathy and Science (n. 54), pp. 213–14. As F. G.Gosling and Hilary Marland have pointed out, even the decision of whether or not to applythe diagnosis of neurasthenia was often dependent on the physician’s affinity with thepatient: see Gosling, Before Freud (n. 8), pp. 143–63; Marland, “‘Uterine Mischief’” (n. 18).


Conclusion

The story of Mitchell, Mason, and Wister illustrates how neurastheniawas a very personal disease that physician and patients alike could craft tofit their personal sensibilities. Mitchell, a man of conservative tempera-ment, saw the diagnosis as proof that American society was modernizingfaster than people’s minds and bodies could keep up. Urbanization,competitive capitalism, and the growing women’s movement were notjust distasteful to Mitchell: he saw them as actually harming people’shealth and threatening the continued prosperity of the nation. Hebelieved that Americans in the modern age needed to worry less, relaxmore, and fall back on traditional sex roles that he believed were naturaland healthy. Physicians, however, did not wield ultimate authority overneurasthenia, and Mason and Wister did not passively accept Mitchell’sopinions. They may have relied on their doctor out of desperation, asGilman did, but they also showed a propensity to reevaluate his opinionssurrounding their condition—a process that proved critical to theirrecovery.

By encouraging people to combat morbid thoughts through strength-ening their minds with intellectual and creative activities, Mitchell inad-vertently provided a mechanism that allowed patients to question patriar-chal beliefs that existed within medicine and society. Mason, who otherwiseagreed with Mitchell on the unhealthy effects of modern capitalism,clearly rejected the limits he placed on women’s health and social roles.Her experience with neurasthenia and the therapeutic effects of think-ing helped her envision an expanded public role for women as vitalcritics and caretakers of culture in a modern age. These occupations, shebelieved, would not only improve women’s personal health but wouldalso help sustain a nation whose men had abandoned it for personalgain. Understood in a broader context, Mason represented a move-ment—which included another patient of Mitchell’s, fellow Chicagoanand Hull House founder Jane Addams—that used neurasthenia as aspringboard for justifying the expanded social role for women on thegrounds of both personal health and national progress.116

Not all neurasthenics called for social change, of course. Wister under-stood that the home was not always domestic bliss, as Mitchell had

116. Christopher Lasch has made the connection between Addams’s neurasthenia andher need for social activity in New Radicalism in America, 1889–1963: The Intellectual as SocialType (New York: Knopf, 1965). Addams herself famously made the connection betweensocial work and the neurasthenic condition in her 1893 essay “The Subjective Necessity forSocial Settlements” that reappeared in her 1910 autobiography: Jane Addams, Twenty Yearsat Hull-House (New York: Bedford/St. Martin’s, 1999), pp. 90–96.


idealized it, but could be a source of unhealthy stress. Nevertheless, sheclosely identified with her domestic duties of housekeeping and caringfor her family and was willing to fulfill these responsibilities even thoughthey made her ill. Rather than rejecting her role as homemaker, shefollowed the therapeutic advice of Mitchell and placed limits on howmuch she worked. Modern lifestyles of leisure were followed. Traditionalduties were preserved. Setting aside time to paint and to take personalvacations helped her understand the sacrifices women such as herselfmade for their families. It also granted her time she could call her ownand made bearable her fastidious dedication to Butler Place.

Even Mason’s call for women to take a larger role in preservingnational culture was consistent with the Victorian belief in women’s roleas moral guide. Both she and Wister sought to expand women’s place insociety, not redefine it altogether. In the process, neurasthenia ultimatelyhelped Mason and Wister identify themselves within a modernizingAmerica. The diagnosis did not make them into passive targets of medi-cal opinion. Instead, it encouraged them to take control of their lives andtheir minds in the hopes of leading healthier lifestyles and avoiding thedepths of sickness. This process of figuring out what made them healthy—”how to live in this stupid world,” as Mason put it—became a definingfeature for them. It was a therapeutic ethos that did not rely on expertsfor solutions.117 Whether as moral anchors amid an increasingly superficialnational culture or as participants in new lifestyles of vacation andleisure, the diverse lives these women created for themselves were largelythe products of using their personal sensibilities to understand theirneurasthenia.

david g. schuster is a doctoral candidate in history at the University ofCalifornia at Santa Barbara, Santa Barbara, CA 93106-9410 (e-mail: [email protected]). He is finishing his dissertation entitled, “Neurasthenic Na-tion: The Medicalization of Modernity in the United States, 1869–1930.” Hewas the 2004–2005 recipient of the White Grant from the University ofCalifornia Humanities Research Institute and, before coming to Santa Bar-bara, was the humanities lecturer at Bahcesehir University in Istanbul, Turkey.

117. The therapeutic culture that Christopher Lasch identified in the second half of thetwentieth century is much different from the therapeutic ethos of neurasthenia: Lasch’sculture relied on experts to tell people how to live their lives, while the neurasthenictherapeutic ethos gave people greater license to live their lives according to personalstandards. In both cases, there was a psychological need to feel better. See ChristopherLasch, The Culture of Narcissism: American Life in an Age of Diminishing Expectations (New York:Warner Books, 1979).

Personalizing Illenss and Modernity

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