Black Religion in the Madhouse: Race and Psychiatry in Slavery’s Wake

In Black Religion in the Madhouse: Race and Psychiatry in Slavery’s Wake, Judith Weisenfeld offers a searing and deeply unsettling account of how Black religious expression was surveilled, pathologized, and often erased within psychiatric institutions in the post-Emancipation United States. Weisenfeld, a leading scholar in religious studies and Black intellectual history, brings together medical archives, hospital records, and institutional histories to expose how institutional logics—steeped in white Protestant norms—rendered Black religiosity as madness, unreason, or dangerous deviance. Drawing from asylum records, patient case files, and broader histories of medicine and religion, the book traces the afterlives of slavery through the psychiatric regulation of Black spiritual life. Throughout Black Religion in the Madhouse, Weisenfeld unearths powerful questions about silence, care, control, and resistance in sites too often overlooked by scholars of Africana religion. This text is a rare contribution that bridges Africana religious studies, critical race theory, and histories of medicine, offering new pathways for understanding captivity, surveillance, and spiritual resistance.The introduction to Black Religion in the Madhouse lays the groundwork for Weisenfeld’s central argument: that psychiatric institutions in the late nineteenth and early twentieth centuries were not merely sites of medical intervention, but deeply ideological spaces shaped by racial, religious, and cultural assumptions. In these spaces, Black spiritual practices—particularly those that diverged from normative Protestant expression—were frequently labeled as signs of delusion, insanity, or moral deficiency. As Weisenfeld notes, “there was no other group in American mental hospitals in the late nineteenth and early twentieth centuries for which the attribution of mental illness to religious causes was as prominent as for African Americans” (p. 7). Rather than interpreting Black religiosity on its own terms, medical authorities often pathologized these practices, reinscribing the logics of slavery and white supremacy through diagnostic labels and institutional confinement. “In making claims about race and African American religion,” she writes, “white psychiatrists simultaneously constructed Protestant whiteness as normal, reasonable, morally good, and capable and deserving of freedom” (p. 15). Her methodological approach involves a close reading of medical and institutional records, with attention to both what is recorded and what is omitted. She carefully considers the power dynamics that shape how Black patients’ lives and religious expressions are documented—if at all—and asks how these archival traces reflect broader systems of erasure and control. Through this framing, Weisenfeld challenges readers to reconsider whose spiritual lives are deemed legible, whose suffering is medicalized, and how institutional narratives overwrite individual humanity.Chapter Two, “Black Freedom and the Racialization of ‘Religious Excitement,’” builds on the book’s introduction by examining how psychiatric frameworks in the post-Emancipation era were steeped in racial logics that cast Black religiosity as a symptom of mental disorder. Weisenfeld documents how diagnoses like “acute mania” were frequently linked to so-called “religious excitement,” a term that became shorthand for spiritual expression deemed excessive, irrational, or dangerous when exhibited by Black patients. Physicians routinely pathologized Black religious speech, grief, and charismatic worship while upholding white Protestantism as the standard of mental and moral health. Through detailed analysis of asylum records, case files, and state hospital reports, Weisenfeld argues that these diagnostic categories were never neutral. “The racialization as Black of religious excitement as a precipitating cause of insanity,” she writes, “lent medical authority to the pathologizing of African American religious life” (p. 47). One key figure, South Carolina asylum superintendent James Babcock, went so far as to claim that the end of slavery itself was to blame for rising diagnoses of Black insanity, insisting that African Americans “could not manage freedom” (p. 48). The story of Charles K., a patient institutionalized for declaring himself a preacher and “ruler of the world,” exemplifies this process. His requests to attend chapel or work outdoors—moments of agency and spiritual grounding—are recorded not as care needs but as background noise to his diagnosis. Weisenfeld’s treatment of these files is unflinching; she neither romanticizes nor dismisses the fragments but situates them within a longer genealogy of racial surveillance. In doing so, she illustrates how psychiatry extended the logic of the plantation, transforming religious autonomy into institutional evidence of insanity.Weisenfeld’s treatment of the archive is not only methodologically rigorous but ethically urgent. Rather than treating case files as transparent windows into patient lives, she interrogates their form, asking what is legible and what is deliberately obscured by institutional authority. Her refusal to “rescue” patients like Charles K. through speculation is part of the book’s power; instead, she situates these fragmented records within a longer history of state violence, medical surveillance, and spiritual erasure. As a scholar working on religion, mental health, and the afterlives of slavery, I found this chapter emotionally difficult to read. That difficulty, however, is a testament to the precision and care with which Weisenfeld animates the stakes of her research. Black Religion in the Madhouse does not offer easy redemptive narratives, nor does it soften the institutional cruelty it documents. It instead demands that scholars of Africana religion, psychiatry, and U.S. history reckon with the entanglement of medical and theological power in shaping who is deemed fully human—and who is not.Scholars of Africana religion, Black studies, and medical humanities will find this book indispensable. Weisenfeld’s archival labor and theoretical clarity push the field toward deeper engagement with the spiritual aftershocks of institutional violence. Black Religion in the Madhouse: Race and Psychiatry in Slavery’s Wake is not just a historical study—it is a moral reckoning.