In Soul-Health: Therapeutic Reading in Later Medieval England, Daniel McCann contributes to several major conversations within and beyond medieval studies: the history of emotions, theories and histories of reading, and the role of affect in devotional practices. Drawing principally from texts contained in the Vernon manuscript (c. 1400), McCann's study is an invaluable addition to our understanding of medieval vernacular devotional reading practices.

Among McCann's most crucial interventions is his expansion of the ways in which we think about therapeutic emotions in medieval literature. Most scholarship on the therapeutic effects of reading in the Middle Ages has focused on secular works, and on positive emotions, such as joy, instead of the "negative" emotions of grief and contrition that are conjured by devotional literature (153). Taking as its central premise that "the health of the soul can be obtained by reading texts which evoke only the most difficult and dangerous of passions" (1), Soul-Health argues that stimulating these painful emotional states is crucial to the formation of a penitential subjectivity in Middle English vernacular devotional literature.

The guiding question of this book is "how texts can evoke and manipulate emotions to create the state termed salus animae--the health of the soul" (1). It is thus a book about reading, but also about emotion, psychology, theology, and medicine: a truly interdisciplinary examination of the curative powers of devotional reading that responds to the recent interest in medieval devotional reading practices and in medical humanities.

A substantial introduction situates McCann's study within multiple disciplinary conversations: theories of affect, medical humanities, and medieval devotional practices. One important contribution--which others have also made, but to which McCann adds--is to push against the medicalized sense of "affect" as an ahistorical given. Instead, he argues, the concept of emotions was (and is) "subject to discursive framing, and thus discursive change" (3): the "frameworks" through which emotions are viewed affect how they are understood and experienced (3). The book as a whole successfully contextualizes emotions within medieval discursive frameworks, in particular medical and theological discourses.

The introduction further provides an overview of the concept of "sowle-hele," or soul-health, tracing the history, from late antiquity through the Middle Ages, of the idea that reading can be spiritually beneficial. McCann frames this benefit--as medieval writers would have done--in terms of "medicine." The "bitter treatment" of Scriptural medicine is a "therapeutic practice that concerns itself with purging the soul, with reforming it through intense feeling" (11). By prompting difficult, unpleasant, and even dangerous emotional states, reading heals the sin-sick soul.

The first chapter, "Apprehensive Medicine," focuses on fear, or drede. McCann's decision to use the Middle English term "drede" throughout the chapter reminds his readers thatdrede is not exactly identical to what they might think of as "fear" or "dread," prompting us to suspend our preconceptions about emotional states. Divided into two parts, the first section discusses the theological meaning of drede, while the second investigates how this emotion is summoned in two texts contained the Vernon manuscript: the Speculum Vitae and the Prick of Conscience. Drede, McCann explains, "is the only medicine strong enough to remove the universal sin of pride" (31). Its therapeutic action is to root out this sin, and, in its absence, it opens the way to grace. But drede is not static; it must progress from the servile fear of God to filial fear. In this way, drede's most important action is to produce a relationship with God--and then to improve and ameliorate this relationship, as the reader moves from fear of punishment to "a more beneficial relationship with God based upon humility" (34). This movement, McCann demonstrates, is visible in the Speculum Vitae and the Prick of Conscience. Although the Speculum is dated later than the Prick of Conscience, it appears first in the Vernon manuscript, which may be intentional; the Speculum establishes the importance of reading examples that will stir the soul to drede, while the Prick of Conscience uses vivid, even "horrific" (43) imagery to produce such drede in the reader. McCann's close readings of the latter text in particular illustrate how it is intended to produce feelings that will lead to a closer relationship to God and, in turn, to more virtuous activity--the ultimate goal of this process.

Chapter 2, "Lyrical Treatment," concerns penance--specifically, how lyric poetry can "move" the reader into a penitential state (52). Fear and drede are only the starting point of soul-health; the next stage is penitential awareness, which requires both attrition, or sorrow for sins, and contrition, the deeper, more intense feeling of sorrow that actually "crushes sin out of the soul" (56). This chapter closely reads penitential lyrics to show how they evoke such sorrow and invite the reader to experience the emotions that they express. This sorrow is likened to a therapeutic purgation, expelling evil from the soul. Crucial to this reading is the "emptiness" found in references to sin in many penitential lyrics. The poems that McCann analyzes, such as Richard Maidstone's translation ofPsalm L, the lyric "Miri it is while sumer I-last," and "An Orison of Penitence to Our Lady," often omit specific sins, lamenting--in the first person--the general sinfulness of the speaker's life. This emptiness, McCann argues, "create[s] a narrative space so open that anyone can enter into it... All that is left is a universal regret at a universal state of being" (72). Inhabiting the narrative voice, the reader is drawn through the experience of intense, crushing contrition that the poem describes.

The third chapter, "Compassionate Healing," focuses on the compassion that many devotional texts strive to produce. While this is not a new topic, McCann's chapter presents a valuable addition to this body of scholarship by carefully anatomizing the various emotions that are involved in compassion, revealing something much more complex than what is sometimes implied by the oft-used phrase "affective devotion." As a medicine, he argues, compassion is best understood as a compound: "not a single emotional state, but rather a complex blend of fear, penance, pity and sorrow alongside a precise configuration of intersubjective awareness" (83). This heady brew produces humility in the reader, preparing them for the subsequent stages of healing.

This chapter primarily focuses on Passion meditations, especially in the Prickynge of Love, which is contained in the Vernon manuscript. Compassion, here, produces a new self-image: it "initiates a series of states within the soul: pity shades into awe, awe into self-knowledge, self-knowledge into a hatred of sin and a sense of shame" (94). This "deepen[ed] self-awareness" (95) ideally leads, through the torturous windings of the meditations on Christ's and Mary's sufferings in the Prickyinge, to a sense of humility--of the penitent reader's own worthlessness relative to God. Here as elsewhere in the book, McCann does not gloss over the frankly appalling details of medieval Passion meditations--such as the Prickyinge's speaker's desire to be the spear that would stick into Christ's side and stay there, or how his eyes "were filled ful of [Christ's] blod" in another meditation (99). These images are, as McCann writes, "[a]t once tender and horrific" (99), generating a complex emotional response that is simultaneously "brutal, desirous, tender and penitential" (101). This blend is at the heart of the compound medicine of compassion that is needed for the cure of the soul.

The next stage of soul-therapy that McCann analyzes is the need for a deep, painful longing for God. Chapter 4, "Longing for Health," explains that this desire is predicated upon a specific form of self-awareness that generates a kenotic self-emptying and an intersubjective relationship with the divine. Like compassion, it is a compound medicine: it builds upon the yoking of drede and love, hinges upon hope, and is predicated upon an attitude of meekness. Meekness is an inherently intersubjective attitude that incorporates both a penitential self-awareness and a sustained contemplation of God that fundamentally "alters the soul" by reforming it (118). Longing, then, includes fear, love, meekness, and penitence, which converge to contribute to the health of the soul.

How does reading produce these feelings? McCann closely reads several passages from A Talking of the Love of God, which is contained in the Vernon manuscript, to show how reading can be used to enhance the reader's emotions. The language of these passages, he argues, draws the reader both "within and outside the events it describes" (125), summoning the reader as a witness to Christ's Passion but also thwarting any response other than helplessness. Lyrical elements of these passages, such as interjections, rhyme, and rhythmic repetition, bring the reader into an emotive response of sorrow, fear, and love that contributes to the generation of desire.

The final chapter, "Dangerous Reading," considers the hazards of excessive reading. Immoderate reading can disorder the emotions, thereby destroying one's reason. Writers such as Walter Hilton and Aelred of Rievaulx caution against the indiscreet reading of even religious texts, for texts "designed to evoke passionate states within the soul" (134) are especially dangerous. Framing these dangers as "pathological" (134), McCann explores how readerly excesses can promote a corrupted sorrow and inordinate pride. The cure--or, rather, preventative treatment--for these maladies is the "virtue of discretion, and the modified penitential subjectivity it seeks to evoke" (134). Focusing on texts that are not contained within the Vernon manuscript, especially the Chastising of God's Children and the texts of the Cloud author, the final chapter brings together threads that have run through the book--such as the development of a penitential mindset, the capacity of reading to change self-perceptions and generate self-knowledge, and the importance of an intersubjective awareness--to demonstrate medieval writers' understanding of the potentially dangerous as well as curative psychological effects of reading.

A brief conclusion reviews the book's major interventions and gestures towards changes after the Vernon manuscript's production. In the early fifteenth century, McCann argues, texts of soule-hele become much more moderate and less intense in their imagery, and more focused on "evoking an elaborate penitential subjectivity" rather than "pushing the soul to its emotional limits" (154). The conclusion is thus a reminder of the warning that McCann issued in his introduction: that the meaning of "affect" depends upon its discursive context and is not an ahistorical given.

Throughout each chapter, McCann's argument is built carefully through a series of extended close readings, often working phrase by phrase through thorny and intricate passages. The book's attention to individual phrasings, to subtleties of language like embedded rhyme, alliteration, and allusion, is quite impressive. Because McCann moves through so many different texts in each chapter, it is occasionally unclear what text is being quoted--more explicit contextualization (or footnotes instead of endnotes) would have made identifying the texts easier on this reader, at least--but this is not a significant issue. More pressingly, given the centrality of the Vernon manuscript to much of this study, the book would benefit from further exploration of how these texts work within that particular manuscript--both sequentially and in interaction with each other--and why this manuscript is taken as McCann's putative focus; I say "putative" because a significant portion of the book is about texts that are not contained in the manuscript. On the other hand, by not focusing too narrowly on Vernon, Soul-Health leaves the implications of its analysis more open to broader applications.

On the whole, this book is a well-documented, very carefully analyzed exploration of how Middle English vernacular devotional writers understood the therapeutic effects of reading. It will be invaluable to scholars engaged not only in the conversations mentioned at the beginning of this review, but to any scholar interested in a deeper understanding of how human psychology was understood in later medieval England. McCann's work reveals a great deal of complexity and nuance in perceptions of selfhood and the workings of self-knowledge, and of how our imaginative engagement with written words can change us in profound and significant ways.​