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Defining Madness: Examining Agnes's Jacket and Alias Grace

Are you defined, like Agnes or Grace, by your illness?

I think I'm drawn to Gail Hornstein's Agnes's Jacket: A Psychologist's Search for the Meaning of Madness, published earlier this year by Rodale, for very much the same reasons that I'm drawn to Margaret Atwood's Alias Grace.

There's something about women, madness and the turning of textiles into text, that fascinates me.

A friend of the author gave me a copy of Agnes's Jacket knowing I just finished teaching a graduate class on Freud and believing that the question of the very definition of madness as addressed by the book would get me to read all 383 pages, despite the fact that it was summer.

She was right.

Hornstein's book isn't so much about the one case of Agnes Richter, a seamstress in turn-of-the-century Germany who, while institutionalized seems to, as the author explains it, "have pieced together the jacket from ripped-up hospital uniforms and then stabbed the intricate text into the cloth. Textile historians detect hundreds of insertions of the needle, far more than necessary to create the forms. Agnes's intense emotion and the tattoolike quality of the text make the jacket feel inhabited, like a suicide note or the scent lingering in someone's clothing long after death. Encountering her jacket feels more like seeing a ghost than inspecting a work of art."

But yet Agnes is woven throughout the compelling narrative. Her personal story appears like a bright thread through even the most academic chapters. In one of those rare books where an accessible, readable approach to fairly hardcore research, Hornstein tells the story about her own experiences with groups of people who are eager to engage with alternative forms of psychological treatment and who are for the most part rejecting the labels and rituals prescribed by mainstream doctors, hospitals, social workers, and caretakers.

As the author, herself a professor of pscyholy at Mount Holyoke, describes it, "Plunging into their world, I've often felt like one of those anthropologists who manage, even today, to discover a new culture in some isolated locale. Like the gay world of the 1950s, whose hundreds of meeting places, organizations, and publications remained invisible to the straight community, this ‘psychiatric survivor moment,' as it's called, is equally vibrant, diverse, and hidden. My experiences there have completely transformed my understanding of how the mind works. Agnes's Jacket is the story of what I've learned"

For example, one of the groups Hornstein focuses on-and one from which Agnes might have benefited she been living now-is the "Hearing Voices Network." Since hearing voices is what, in the most cartoonish way, has come to represent the most widely accepted evidence of madness, it's startling to hear--as a non-psychologist, as an ordinary but merely general reader-- her question that experience as a definite symptom of insanity.

The best parts of the book, however, are the ones that had me thinking about the very largest issues: the idea that once a person is diagnosed with mental illness of any kind, that all experience becomes filtered through and defined by that label.

It reminds me of a line from novelist Elizabeth Bowen's great modernist work The Last September when a young woman does not want to hear herself described by an older relative; she chooses to shut the door when she hears the sentence, "Lois is so . . ." before she can hear the final word because otherwise she would be trapped inside that word "like a fly under a tumbler."

The idea that the pathologizing of certain kinds of behavior actually shapes a life and constructs a personality, is, I believe, at the heart of Hornstein's work; it is also what many of the people she has encountered--the ones who are against mainstream treatment-- are actually rejecting.

Some recipients of mainstream psychiatric treatment are rebelling against the idea that a person is primarily and essentially defined by his or her illness; as Hornstein says, "A person can have arthritis but you are depressed. You can have diabetes, but you are bipolar." While some might dismiss this as being merely a function of language, those of us who deal with language for a living are all too aware of how language does more than represent: it actually controls, creates, and transforms.

(This reminds me of yet another line by a novelist, this one from Fay Weldon, who in an early work titled The Fat Woman's Joke has one character warn another, "One must be careful with words. Words transform probabilities into facts and by sheer force of definition, translate tendencies into habits.")

To put it simply, if you keep being told you're something early enough, often enough, by enough people in positions of authority, it's very difficult to insist that you're something else without being considered mad. "Thirty years ago, patients with serious cardiac disease resigned themselves to lives of immobility and restriction. They were told not to climb stairs, not to have sex, not to work too hard. Today's cardiologists say that if patients watch their diets and get regular exercise, they can often live normally. It's only psychiatrists who are still parroting the pessimism of a nineteenth-century theorist and telling their manic-depressive patients they'll never get better," writes Hornstein.

In Alias Grace, Atwood's central character is locked up as a criminal, institutionalized as a mad woman, regarded by some as a victim, by others as a martyr, and by everyone as extraordinary. As Agnes creates her jacket, so does Grace fabricate a quilt (each section of Atwood's novel is named after different quilt patterns) and thereby constructs an autobiographical "text" from different fabrics representing the people and places that have shaped her life. Agnes's jacket is also a document, unintelligible and yet profoundly significant, eerily compelling even though it is undecipherable. I keep going back to Atwood's novel to try to understand the mysteries of how the character is constructed and pieced together.

I have a feeling that I'll be returning to Hornstein's book for the very same reasons.