My contention in this essay is that the role of psychiatry in Tender Is the Night is best understood as a critique of the profession as it evolved in the early twentieth century into an authoritative scientific method for treating and explaining psychic and social fragmentation. I hope to show that especially in the representation of Doctor Richard Diver a sometimes ambiguous but generally critical stance towards psychiatry's influence on Western civilization is presented by Fitzgerald, tempered by sympathy for Diver in his misguided faith in the profession's promise to control life's contingencies. Moreover, I want to argue – through cultural context, biographical evidence, and textual analysis – in favour of Malcolm Bradbury's more general view of the novel as a ‘great psycho-historical portrait of the age’, which he associates with earlier efforts by Thomas Mann in The Magic Mountain (1925) and Ford Madox Ford in The Good Soldier (1915) (356). This reading differs from the early feminist approach of Judith Fetterley and the character study by Jeffrey Berman, mainly in the degree to which social and historical forces are shown to infuse the novel and add layered meanings to Fitzgerald's delineation of medical practice and its influence.
In an anonymous review of Tender published a year after the novel, the Journal of Nervous and Mental Disease declared that ‘[for] the psychiatrist and psychoanalyst the book is of special value as a probing story of some of the major dynamic interlockings in marriage […] conditioned by a set of economic and psychobiological situations’ (Bruccoli and Bryer 390–91). The ‘special value’ for the medical practitioner in better understanding the workings of cause and effect, of stress and disorder in the marriage of Dick and Nicole Diver went beyond therapeutic exegesis and training exemplar; for the article's confident explication of the novel, its insular language, and its underlying assumptions regarding the value of psychiatry itself are revealing about the status of the profession in the United States by the mid-1930s. The very existence of such a journal and the presence of a book review about a novel within it, just 26 years after Freud's only visit to the United States, speaks for the rapid institutionalization of psychiatry within American medical practice and the widespread public acceptance of Freudian psychotherapy in particular.