Malingering: Representations of feigned disease in American history, 1800--1920

Feigning disease, or malingering, is an age-old tool that a variety of nineteenth-century Americans used to cope with the anxieties of a developing industrial capitalist society. Like legitimate disease, malingering provided an arena for projecting, rationalizing, and contesting social values. Elites represented malingerers as dependent, idle, immoral, and undeserving of citizenship. Yet, other images of the behavior as sometimes justified persisted, particularly when it upheld deeply rooted values. Individuals' attempts to cope with industrial capitalist society by malingering can be viewed collectively as a challenge to the social, economic, and political demands of that system. Representations of malingering illuminate the relationship between the individual and the state through a person's most basic frame of reference and experience, the body. Though neglected by most historians, malingering is a common phenomenon in the cultural history of Western societies. People malingered to avoid work and other social responsibilities prescribed by their race, class, and gender. Traditionally associated with the underclass, malingering was perceived to be on the rise among all social groups throughout nineteenth-century America. Moral suasion and internalized codes of behavior were taking the place of overt physical control to regulate social conduct, yet they did not deter malingering. Sentimentalism and sympathy, considered key components of a humanistic, developed society, disseminated values surrounding illness behavior through various cultural media that also sometimes portrayed deception as a useful tool in an increasingly complex and unequal environment. Slaves, soldiers, workers, middle-class women, children, and criminals all used malingering to pursue their personal goals. Their varying success demonstrates the different degrees of freedom and dependence experienced daily by nineteenth-century Americans. Malingerers challenged values such as the work ethic, truthfulness, and sympathy for the sick and disabled. Fears about malingerers reflected anxiety that many people were not committed to the American State and the industrial capitalist system. In reality, however, malingering served as a safety valve; those who could achieve some autonomy through feigning sickness had no reason to demand reform overtly. Malingering demonstrates that physical condition is a crucial and often overlooked factor in an individual's experience of state power.