Opening with the definition of schizophrenia enshrined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Cate Reilly’s provocative and eloquent book calls the reader to cast their gaze back to the historical precedents of American psychiatry’s all-powerful diagnostic handbook. Reilly locates a profound shift in conceptions of mental health and illness taking place during the nineteenth century. Previously held to be the domain of philosophical speculation, the mind came to be quantified and empirically measured. The rise of German somatic psychiatry in the late 1800s saw mental illnesses reframed as “natural disease entities” (Emil Kraepelin) that had a firm biological basis. Showcasing the extensive reach of Kraepelin’s research, Reilly explores how central and east European literature gave voice to the personal and political implications of the shift to a calculable model of the mind. In chapters that cover both canonical modernist works (Georg Büchner’s Woyzeck) and lesser-known experiments by Vsevolod Ivanov and Ernst Toller, mass spectacles (Nikolai Evreinov), psychiatric memoirs (Daniel Paul Schreber), and case histories (the Wolf-Man), Reilly traces the representational repercussions of Kraepelin’s groundbreaking contention that mental illnesses could be classified and differentiated from each other. While the cultural impact of psychoanalysis is well established, the ramifications of a clinically based psychiatry have received far less scrutiny. Reilly explores the implications of this oversight most directly in the book’s final chapters, problematizing an uncritical acceptance of neuroscience’s claims to objectivity and value neutrality by examining the neurological drawings of Santiago Ramón y Cajal.

At the heart of Reilly’s investigation stand the contours of a “new technology of knowledge-power” arising in the nineteenth century (8). “Psychopower,” for Reilly, names the effort to delimit, standardize and manage mental health that emerged concurrently with popular sovereignty’s establishment of new rights and entitlements. Reilly shows how the shift to a modality of power that set its sights on the cultivation of human life and bodily capacity, famously described as biopower by Michel Foucault, was underwritten by a “psychopolitical power to ‘make sane’” (72). In another crucial innovation, Psychic Empire proposes that the tensions within the psychiatric diagnostic project are best illuminated through a mode of “counterdisciplinary” reading. Acknowledging the “epistemological gap” and “productive tension” between the aesthetic and the scientific realms (10), this methodology challenges interdisciplinarity’s tendency to cast the humanities in the supporting role for the “main protagonist” of scientific endeavor. If the value of interdisciplinary projects is frequently determined by instrumental goals—the inclusion of medical humanities programs in medical education as a means of cultivating more “empathetic” doctors being a vivid case in point—Reilly instead foregrounds the capacity of aesthetic objects to critically unravel the unacknowledged assumptions that sustain scientific rationality.

Psychic Empire sets it sights on distinguishing two approaches that it claims are too often conflated—the psychoanalytic and the clinical psychiatric. Kraepelin’s project of identifying general patterns beyond singular cases is masterfully contrasted with Sigmund Freud’s attentiveness to the unique stories of individual patients. Yet historical precedents of psychoanalytic explanations being used to reinforce the claims of biologically oriented psychiatry, explored in detail by Lisa Cartwright, offer a pause for thought. The book’s concentration on the two poles of Kraepelian psychiatry and psychoanalysis also raises the question of how projects of social psychiatry, such as Lev Rozenshtein’s attempt to find the sources of mental distress in the conditions of work and everyday life in the early USSR, fit into the model of psychopower. Indeed, Soviet specialists baulked at a wholesale embrace of Kraepelinism even after Soviet psychiatry’s biological turn in the 1930s, tending to lament his neglect of the “social perspective.” Finally, Psychic Empire’s discussion of psychopower might engage with other crucial attempts to understand the psychic repercussions of the new mode of governance emerging in modernity—namely Jacques Lacan’s linkage of modernity to the displacement of traditional forms of authoritarian power by the rule of “objective,” scientific knowledge (framed by Lacan as a shift from the “master’s discourse” to the “discourse of the university”). While scholars who have developed Lacan’s thesis, such as Eric Santner, are by no means overlooked here, Santner’s exploration of “the biopolitical pressures of popular sovereignty” in The Royal Remains is said to privilege “bodies and flesh” over questions of the mind. In my reading, Santner’s concept of the “flesh,” however, figures not merely a physiological entity, but rather names the enigmatic “surplus” generated by symbolic inscription. Elsewhere, it is precisely Reilly’s close attention to such obstinate points of textual ambiguity that elude scientific classification and ready diagnosis that makes Psychic Empire such a pleasure to read. Her compelling argument for the value of humanistic enquiry and appeal for a genuine, two-way dialogue between the arts and the mind sciences has never been more pertinent.