The morning I picked up Disorder in the Court: Morality, Myth, and the Insanity Defense, news was spreading about the Michigan State University shooting. While preparing this review, there were several more mass shootings. Such tragic events (re)shape our lives. The Aurora, Colorado shooting profoundly redrew the social boundaries of my own life, and it is no coincidence that the Aurora shooting is where Andrea Alden begins her illuminating book. Disorder in the Court uses “mass shooting” as a visible marker of mental illness and a productive opening for a study of the rhetorical shifts in the insanity defense.From the outset, Alden explores humanity's desire to reason with madness, highlighting society's perpetual search for the origin of mental illness. Her deep historical and close textual work demonstrates the constitutive nature of language in relation to fields of expertise, like law and medicine, that require a facade of stability in exchange for the public's faith. Disorder in the Court highlights three rhetorical moments in the legal and medical responses over time, mapped by shifts in the insanity defense. Alden then turns to analyze the high-profile trial of John Hinckley, Jr., and, finally, summarizes the current state of the insanity defense in the United States, ruminating on biomedical advances. Alden posits this book not as a solution to problems of madness and malice, but rather as a chance to “untangle the complexities of the rhetoric of sanism,” or as she defines it: the “irrational fear of mental illness and people who suffer from it” (4, 5). Disorder in the Court unpacks the historical realities at the intersection of law and medicine, identifying both the explicit and implicit tropes of sanism, such as shared fate, the law as (failed) deterrence, and pandemonium.Chapters 1 and 2 introduce the hegemonic rhetoric of sanism and its history. From medical advances to reforms in evidentiary standards, Disorder in the Court emphasizes that a rhetorical study of textual evidence can expose the shortcomings of ideological discourses. This detailed textual work is bolstered by the inclusion of the primary texts at the end of the volume, signaling a strong appreciation for the text itself. Identifying the danger inherent in a rhetoric of sanism, Alden reminds us that the anxiety that “I, too, may become mad” does not result in compassion; it results in segregation and the asylum mentality of the early 1800s. Or, to borrow the Platonic perspective of sanism: “Madmen are not to be free” (24).Chapter 2, “A Brief History of Western Thought on Mental Illness and Its Relevance to the Law,” is a masterclass in condensing a long timeline into digestible material without sacrificing details. Alden extensively covers the dialectic of rationality/irrationality from fourth and fifth-century perceptions of “madness,” through Greek and Roman civilizations’ emphasis on reason, and into the moral panic of the Middle Ages, before landing at the humanitarian turn of the Enlightenment era, when the body and the brain were regarded as intertwined. By weaving textual evidence from Plato and Aristotle, from St. Augustine, and from John Locke and Renee Descartes, Alden maps the evolution of thought through these discourses with authority and interest.In Chapters 3 through 5, Alden shifts to analyzing specific cases that have reshaped the insanity defense. She begins with an 1843 political assassination trial, where defendant Daniel McNaughtan asserted paranoid delusions as the cause of his violent actions. Alden describes the burgeoning field of psychiatry, where conceptions of “madness” were shifting from a moral (religious) failure to a modern medical defect. Swift and public backlash to McNaughtan's acquittal included tropes of pandemonium, fakery, and (medical) illegitimacy, ultimately resulting in a verdict of “not guilty by reason of mental disease or defect,” a phrase still recognizable to a modern audience. The eponymous McNaughtan Rules require a defendant to be unaware of the “nature or quality of the act . . . [and] not know it was wrong” (46).Chapter 4 introduces readers to the reforms in mental health care in the nineteenth century, eventually focusing on two cases, Parsons and Davis. Alden argues that as the field of psychiatry moved away from harsh methods of patient confinement (led by reformers like Dorthea Dix), legal questions shifted toward tests for impulse control. Alden first investigates the impacts of the appeal in Parsons, where Alabama Supreme Court Justice Somerville reversed a jury verdict. Sommerville's opinion argued that judicial authority should consider a defendant's ability to control their actions, elevating the discipline of psychiatry by adopting the reformist position of compassion and not assuming a defendant's moral failure. A few years after Parsons, the United States Supreme Court issued an opinion in Davis v. United States (1895) that extended the same approach, a “control test,” as the legal standard: Could the defendant resist their “irresistible impulse” at the time of the crime? Alden argues that, although scant, the media coverage of both Parsons and Davis relied on tropes of sanism. Not unlike more contemporary debates, public reaction to these cases was dismay about the law as a criminal deterrent, challenging the idea that momentary loss of self-control mitigated legal culpability.By the time Durham v. United States was decided in 1954, the publication of the first edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-I) was only a year away. In Chapter 5, we learn that the field of psychiatry had been reshaped by the influences of neurologists like Jean-Martin Charcot and Sigmund Freud, and the psychiatric field was continually revising categories of mental illness and treatments. To illustrate the last major rhetorical shift in the insanity defense, Alden recounts the fate of Monty Durham—a recidivist's tale of petty crimes, institutionalizations, and temporary release into unstable housing. By the time of his appeal in 1954, the system was shifting blame for Durham, arguing about the likelihood of future criminality. Alden writes: “Nobody knew what to do with him, and nobody wanted to be responsible for him or his actions, so they just shuffled him back and forth between jail and the hospital” (68).Readers will surely recognize the deflection of blame in this modern rhetorical cycle, and while Alden details the trial and its misgivings, this reader couldn't help but return to the opening example of mass shootings and the pervasive anxieties about the inadequacy of law. And indeed, Disorder in the Court promptly brings Durham into conversation with McNaughtan, Parsons, and Davis. Alden rounds out Chapter 5 by examining the wide-ranging, written opinion from Circuit Judge Bazelon, who argued that all prior standards for legal insanity were insufficient. Bazelon's opinion historicized the medical and legal debates before moving to establish a new effects-based “product test,” meant to consider updated medical discourses concerning mental disease; this replaces the presumption of a lack of impulse control with the idea that a defendant's mental state might influence planning, decision-making, and execution of a crime (as is the case in schizophrenia or paranoid delusions). It was contrary to the previous position that legal insanity would be characterized by an inability to plan or execute actions with intent or purpose. Despite the potential importance the Durham opinion could have had, this new legal framework did not become the standard. Alden contextualizes Bazelon's opinion in relation to its reception and effects.Chapter 6 applies Alden's framework to the criminality and culpability of John Hinckley, Jr. in his trial following an assassination attempt of President Ronald Reagan. The trial arguments referred to categories laid out in the DSM-III, revisions to which had heralded the biomedical turn in psychiatry as the “triumph of science over clinical ideology” (78). Alden lays out the particulars of the Hinckley case, from his cross-country travel to contact Jodie Foster (whom he relentlessly stalked) to his attempts to conceal the actions he planned to take against government officials. Alden explains that the trial and media coverage focused on questions of rationality, mainly Hinckley's actions and his travel. Was Hinckley's meticulous behavior the cold-calculating choice of a determined killer or the obsessive, single-minded mania of a raving lunatic?The moral outrage that followed Hinckley's acquittal relies on the tropes of sanism that Alden identifies throughout the book. Because she includes explicit and implicit examples of the tropes, readers have a framework to understand how Hinckley's “not guilty by reason of insanity” verdict was received by the public. Lambasted as a miscarriage of justice, as encouraging criminal action, and as proof that experts-for-hire pervert the criminal justice system, the Hinckley trial's response illustrates sanism's pervasiveness. Following the trial, Congress passed the 1984 Insanity Defense Reform Act (IDRA), and some states adopted alternative verdicts (such as “guilty but mentally ill”) or eliminated the insanity defense altogether, though most still employ some form of the McNaughtan Rules. Alden explains that legal standards lag behind the current understanding of psychiatric medicine and further highlights that, like other legal questions, laws and punishments differ across states.She concludes the book by arguing that the pervasive rhetoric of sanism has ideological staying power; it outlasts the material shifts of case details and medical progress. Moreover, the legal standard of insanity remains the same: “Here we are, back in England in 1843,” Alden writes (97). The legal landscape is, in effect, unchanged. She concludes this masterful book with a careful proposal for how to rethink discourses: first by acknowledging they are, in fact, rhetorical; second by tapping into the nature versus nurture debate. Exploring newer, technologically-driven medical advances, Alden leaves her readers with this consideration: “anti-social behavior is the result of both biology and socialization, nature and nature” (99). Alden argues that rhetoric helps us “untangle the knots” of a one-size-fits-all approach to law and psychiatry (100). As she concludes, she reminds readers that hers is a study of competing discourses, an attempt to “shore up their boundaries” and smooth “over the narrative ruptures always threatening to break through” (95). In other words, when analyzed as rhetorical discourses, the ideological faultlines of law and medicine become clear. Rhetoric, Alden writes, “allows us to see more clearly why” there are still problems at the intersection of law and medicine in the insanity defense (102).So while we constantly fear the next mass shooting and struggle somewhere between the Platonic ideal of locking madness away and empathy towards those suffering with mental illness, it is evident that Alden has given us a reference point for understanding the intersection of legal and medical discourses in the insanity defense. Identifying the tropes that shortchange meaningful engagement with mental health opens the possibility for a both/and approach to law and psychiatry. While scientific discovery sorts out how our nurture affects our nature (and vice versa), rhetorical scholars might continue to consider where science interacts with social and cultural constructions, like the law, to promote nuanced understanding of mental illness.