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Rituals of Diagnosis argues that nineteenth-century America’s literary representations of madness and its diagnosis respond to interdisciplinary efforts at cultivating a national psychology. Uniting theological and philosophical traditions with medical speculation, mental health reformers from Benjamin Rush to Dorothea Dix linked the expansion of democracy with new vulnerabilities for madness. Theories about insanity thus hypothesized relationships between freedom and responsibility. I examine how America’s first psychological fictions contributed to this rich field of discussion. Taking up novels by Charles Brockden Brown, Robert Montgomery Bird, and Oliver Wendell Holmes that pivot around the investigation of madness, I examine how literary works from the Revolutionary Era to the Civil War dramatize interpretive processes that classify transgressive behavior. I argue that the grotesque subjects at the center of these investigations—Anglo-Americans who are likened to demons, animals, and “savage” racial others—indicate the provisionality of the period’s theories of mental illness and register anxieties about affiliation and responsibility that accompanied their development. This inquiry contributes to contemporary conversations about authority, desire, and the role of violence in the American imaginary, and argues that scientific speculation and literary experimentation collaborated in constructing this imaginary. While many have acknowledged that discourses of mental health participated in codifying social and political norms, I draw explicit attention to literary form as a site for examining the motivations that fuel these discourses by showing how their narrative trajectories put medical knowledge into conversation with sentimental ideologies. Examining how these novels conjoin problems of interpretive confusion with affective confusion, I explore how these mysteries destabilize the disembodied rationality central to the perch of objectivity that sustained white supremacist interrogations of racial and gendered others. The struggle to situate the locus of social unrest into psychological and ethnic others betrays an archive of fears and fantasies contained by diagnostic procedures. / text