Outrageous Reason: Madness and Race in Britain and Empire 1780‐2020 by PeterBarham. Published by PCCS Books, Monmouth, UK, 2023; xv11 + 248 pp, ISBN 9781915220394.

What connections might there be between the lives of a mixed-race seamstress/governess in mid-19th century Kingston, Jamaica, and a white domestic servant in early 20th-century London? Henrietta Dawson and Alice Triggs are two of the case studies in this new book by Peter Barham, across nearly all of whom there was a deep connection: subjection to the abusive psychiatric regimes of their times. Their experiences were of course different. Dawson was taken to the Kingston Lunatic Asylum during an acute depressive episode in 1858. She recovered, and wrote about the ordeals which she had suffered and seen others undergo in the brutal asylum. Triggs was beset by depression and anxiety throughout her life, and from 1915 was a ‘revolving door’ patient in Colney Hatch and Napsbury Lunatic Asylums, receiving no real care or attention, before spending over 40 years at Napsbury until her death there in 1962. Both were from modest backgrounds, though not destitute. Dawson was the daughter of a lawyer, one of the colonial white men who gave ongoing financial support to the offspring of their liaisons with black women. Triggs' working-class parents died while she was in her teens, but her siblings appear to have been upwardly mobile, in contrast to her own fate. These and other richly detailed case studies are at the core of Barham's book, much of which builds on his previous work about connecting with and respecting the life-worlds of those now called ‘service users’, especially those labouring under diagnoses of psychosis. In this latest study, the author's interdisciplinary skill in weaving together psychology, history and sociology are deployed in his case analyses. But while focussed empirically on individual examples, he aims to show how within Britain and its empire a particular set of values has been at the centre both of the state's management of psychological distress and of the white racism characteristic of the imperial period. The clue to the content of these values is in the book's title. Barham does not explicitly unpack the phrase ‘outrageous reason’, but he does not need to. The message he draws from his case studies and develops into an overall narrative is that a moralistic model of rationality underpinned both racism and, as it emerged in the 19th century to shape the state's response to a range of problems, psychiatry. At the centre of this model was an image of ‘reason’, reflecting the outlook, behaviours and values of the dominant classes within Britain of the high imperial era. Where that ‘reason’ held sway, those unable or unwilling to inhabit that image were at best marginalised, and in danger of restrictive or punishing measures being taken against them. In this respect, mentally disturbed people and non-white people were the same, both having fallen outside the community of ‘reason’ by virtue of their ‘unreasonable’ behaviour, be it strange, disinhibited, aggressive, indolent or whatever. The former did so through individual mental weakness or anti-social nature (a feature explicitly addressed in the diagnostic term ‘moral imbecile’, applied at one stage to Alice Triggs whose unreliability was a problem for her successive employers). The latter were so through their bio-racial nature, lacking as that nature was believed to be in intelligence and industry. The former lived at risk of societal rejection, and for some, of sadistic abuse by asylum staff (extremes of which against mainly non-white inmates were recorded by Henrietta Dawson). Of the latter, many were condemned to slavery or later forms of bondage, and all to a status of intrinsic inferiority. But the basic dynamic was the same, Barham suggests, whether between psychiatric functionaries and their patients, or between imperial personnel and individuals amongst the subject peoples. If not demonstrably ‘reasonable’, any person could be deprived of respect and of voice – ‘cancelled’, though much more deeply than the term suggests today. That was the outrageous consequence of this hegemonic ‘reason’ (notably, Barham's title could have a second meaning: deviants from that model of reason could be seen – in their behaviours often described as ‘outrageous’ – to be expressing alternative forms of ‘reason’, since they certainly ‘had reason’ for their actions). This is not, however, a simple narrative of bad powerful people oppressing innocent powerless ones. Two more of Barham's case studies, again based on intensive archival research, broaden the picture. The small state of Khairpur, now in Pakistan, was under British influence during the Raj, and in the 1930s, the British authorities were concerned that the Prince of Khairpur was not a suitable person, psychologically, to succeed his father as ruler – he did not behave ‘reasonably’. It seems they did not prevent his succession, but imposed on him a regime of psychiatric investigation and restriction, which deepened his difficulties and led to probably permanent regression. The second of these cases is the extraordinary one of Robert Racey, a Canadian appointed to an administrative post in the Ugandan Protectorate in 1896. Although this man with ‘a peculiar bent of mind’ was suspected of leading a massacre of local chiefs, and of ordering the execution of criminals by spearing, it was his punching of a British soldier ‘in front of the natives’ that led to his being returned to London in 1901. However, the following year he resumed duties in Africa, until he was finally removed on health grounds, having developed a possibly psychotic fascination with a local spiritualistic cult. Barham interprets this man's trajectory as first expressing the violence of the colonial project, and then moving towards a kind of regretful empathy with the local culture – which put him beyond the line which ‘reason’ drew around acceptability. So he and the Prince illustrated how agents and accessories of imperial power were also subject (if not fully effectively) to the disciplines of the imperial reason, which sought to exclude or incarcerate ways of being not compatible with its vision. Barham does not locate this severe and defensive ‘reason’ in relation to the progress of rationality in its other, different forms as a foundational feature of Western culture. To do that might require a more detailed account of the content of that particular code of reason, and of its regional and chronological variations, and crucially of how it differed from other sets of values also claiming to represent ‘reason’ but playing very different parts in history. Not the least of these would of course be the roles of rationality in the project of science, and in our post-enlightenment culture's pursuit of universal human values. For example, in the mental health field, the humanisation of carceral institutions began in the mid-19th century with an approach (called ‘moral treatment’), which sought to appeal to the ‘reason’ of inmates. This approach was admirably based on believing in a universal potential for reason, rather than claiming it exclusively for the outrageous forms of the imperial ego (unfortunately, it could not benefit from the later psychoanalytic study of the equally universal capacity for irrational negativity, which was to foil its clinical effectiveness). However, that contextualisation would be another book. In this one, the author's focus is on arguing that in the 19th and 20th centuries, psychiatric and racist discourses were largely cut from the same cloth of a moralised, rationalistic metapsychology. Both saw differences between people as stemming from essential characteristics, such that the mentally ill and the non-white could not qualify for full personhood. The strength of this cruel ‘reason’ in the historical development of modernity has deeply damaged relations between ethnicities, between the ‘sane’ and the ‘mad’, and also of course between men and women, since it was the normative male who was the truest benchmark of ‘reason’. The great merit of Barham's book is in the case studies which he has harvested and narrated, and which enable us to see a complex epochal force played out in different ways in individual lives. This raises the question of whether that force is now itself played out. Barham's view on this is clear, though contestable. Rather than seeing the psychiatric and racial exclusions of unreasonable voices as overlapping or interlocking variations of a broader need to subdue the world under the sign of reason, he sees the racial dimension as fundamental, such that ‘Whiteness’ is the core form of oppressive ‘reason’. The White state of mind is somehow – his analysis is less clear around this – the primary source of the inhumanity. Moreover, he argues, its malignancy thrives to this day: three chapters review some of the well-publicised UK cases of black men dying while in psychiatric or police custody. Barham adds his voice to the claim that racism is ‘hard-wired into the fabric of British society’. Of course, there are tragic and enraging examples of violent racism in Britain today, as well as widespread lower level frictions, but they do not necessarily support that general claim. There have been major changes in British society in recent decades that (to continue with the rather loose metaphor) have reconfigured the architecture of our socio-cultural wiring. Might the charge of oppression nonetheless still apply to psychiatry? Barham's final chapter goes on to insist that psychiatry has not purged itself of Whiteness, and outlines the ‘Afropessimist’ assertion that Black suffering is a unique form of suffering, in that it is irrevocably tied to ‘slaveness’, and thereby to a sort of nonhuman status, one necessary to ‘mark the border of Human subjectivity’. Readers familiar with this line of thinking may be able to see its direction of travel; others will probably find this section enigmatic. Here, especially if slavery is central, it would be helpful to have some analysis of psychiatric practices from colonial histories and contemporary societies other than the British – the Portuguese, say, whose involvement in slavery was extensive and long. We should also take into account recent scholarly work (e.g., Biggar, 2023; Holland, 2019) which suggests British colonialism was morally more complex and multivalent than the presently dominant view allows. A notable absence from this book is much referencing of the large body of work on the history of psychiatry, Foucauldian and other. Having previously contributed to that work, Barham opted here to start somewhere else, and he attends more to recent publications by black studies authors. That brings a freshness to his page but leaves for another time the task of situating his thesis in relation to overviews of psychiatry's development, along with empirically assessing how ‘outrageous’ is the ‘reason’ employed by mental health professionals today. Is the CBT project, for example, the heir of colonialism's defensive rationality? If so, flawed and even false as that project may be (Dalal, 2018), we might consider it to mark some progress. But direct comparisons between the 19th and 21st centuries are hard to make. From the middle of the 20th century, psychiatry – once the only game in town – has been joined by the other mental health professions, most dramatically by the huge growth of the psychotherapies and counselling. The societal response to mental health difficulties has fragmented, and expanded to the point where there are policies and initiatives about mental health in all kinds of institutions and organisations. For some time, there has no longer been a single ‘regime’; instead, we have a pluralistic therapeutic culture. Psychotherapists and counsellors are now, much more than in the recent past, interested in the societal contexts of their work, and so despite the historical distance of much of its narrative, this book should find an eager readership. It has an accessible style and much fascinating material, and will provoke thought about the hidden frames of therapeutic work today. Some readers may see contemporary practice in different terms from those suggested by Barham, but will still learn from his scholarly project to trace a common pattern in values and practices across decades and continents.

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