For the speaker of "Mad Girl's Love Song," madness and lovesickness are inextricable, with each worsening, and perhaps causing, the other. Over the past several hundred years, people in the Western world have offered a variety of different explanations for mental illness, ranging from the divine to the neurological. As a result, the treatments prescribed for mental and emotional affliction have been just as varied, and have included everything from prayer to medication to institutionalization—sometimes all at once. Here, we'll briefly discuss how "madness" has been perceived from medieval Europe through the mid-twentieth century publication of "Mad Girl's Love Song."
During the medieval era, mental illness—like much physical illness—was thought to have divine roots as a punishment or sign from God. As a result, many of the proposed cures for these illnesses centered around divine intercession, in an echo of Christian biblical stories portraying Jesus's treatment of the sick. Those afflicted with mental illness might turn to a saint associated with such problems, such as St. Dymphna of Geel or St. Margaret of Antioch. However, while people in the Middle Ages might have been more likely than modern ones to take a religious lens, many also noted physiological or emotional causes for mental instability, including grief, the consumption of alcohol, or an imbalance of humors. The medical concept of "humors" itself comes from classical medicine. On the occasions when people in medieval Europe did take a physiological, medical approach to mental illness, they tended to use ideas from the ancient world, which formed the basis of much medical thinking for Europeans of the period. However, it wasn't until a few hundred years later that a medicalized approach to mental illness took precedence in the West.
The Enlightenment during the eighteenth century helped give way to some of our more familiar attitudes towards science, and led to a dominant focus on things that could be empirically observed. Thus, conversations about mental illness tended to focus on it as a physiological problem with roots in the body—especially the brain. These early days of neurological research also included forays into now-debunked pseudosciences, such as phrenology, which promised to provide information about physical and mental ailments with analysis of the brain and skull's shape. Meanwhile, Victorian specialists in the treatment of mental illness, sometimes called "Mad-Doctors," invented a variety of tools and devices intended to treat the mind by addressing the body. These included, for instance, a chair meant to confine an individual, depriving them of sensory information in order to tranquilize them. With this medicalization process came a boom in the growth of asylums, where people with severe mental illness were confined in institutions. The vogue for confinement echoed and accompanied a broader trend towards medical institutionalization, as processes like birth and death, long viewed as part of domestic life, increasingly came under the purview of hospitals and medical institutions. However, many mental asylums were inhumane and crowded. In the mid-nineteenth century, the activist Dorothea Dix advocated transforming these asylums into mental hospitals, which, she hoped, would focus more on patient well-being and less on unregulated experimentation and confinement.
Only a few decades later, Sigmund Freud, with his invention of the psychoanalytic method, proposed a new type of treatment—one that used conversation as a course of treatment. Freud's theories, some now-rejected and others fundamental to the field of psychology, tended to argue that mental illness had its roots in unresolved traumas, particularly from a patient's childhood. He located the roots of these problems not in the body or brain, but in the individual's experiences. Still, even as Freudian psychoanalysis became the dominant mode for treating most mental illness in the twentieth century, advances in pharmaceutical science produced new drugs meant to treat psychological problems such as anxiety or depression. Drugs weren't the only medical treatment that rose to the fore in this period. Other medical interventions, including electroshock therapy (also called electroconvulsive therapy) and, in some cases, lobotomies, rose to prominence before being rejected or even made illegal in the latter part of the twentieth century.
It was in the middle of the twentieth century, when the dominance of Freud's methods met the advent of then-new medical interventions, that Plath wrote Mad Girl's Love Song. While the poem's focus is purely on the symptoms of mental illness, some of Plath's other work addresses the experience of patients undergoing common treatments of the era (Plath, who herself suffered from mental illness, drew to an extent from autobiographical experience). Her novel The Bell Jar, for instance, describes the experience of undergoing electroshock therapy, while the poem "Tulips" takes place in a hospital setting.
