Bethlem Blog

The Politics of Interior Decoration

bethlemheritage — Thu, 16 May 2013 09:00:56 +0000

As mentioned in a recent post to our In the Frame thread, Oliver Sacks devotes a chapter of his recent book Hallucinations to recounting the hallucinogenic experiences of himself, his patients and correspondents and those who have featured in medical literature on the subject since the 1840s. He could have included the visionary experiences to which Christopher Mayhew was subject after he took mescaline as part of a 1955 experiment for the BBC’s Panorama programme, footage of which was withheld from broadcast.

Mayhew was a British Labour MP with a sustained interest in issues of public health. (Later, in 1957, he checked himself into Warlingham Park Hospital in a bid to obtain first-hand experience of what a mental hospital was like, and also in order to interview staff and patients for the BBC.) During the experiment, which was conducted by Dr Humphrey Osmond, Mayhew pays unusually close attention to patterns he saw on a curtain hanging just out of shot, which he describes as having “the most extraordinary gradations of mauve, and ah, and ah, lights (sorry, it’s just my own poverty of vocabulary, I can’t describe it)”, and declares himself “amused” when Osmond ventures that “it look[s] to be a rather dull orange-red curtain”.

A variety of other causes of hallucinations are discussed in Oliver Sacks’ book. Among them is sensory deprivation (“the prisoner’s cinema”), which is commonly held to be the cause of the most celebrated fictional hallucinations in modern literature – those of the unnamed female protagonist in Charlotte Perkins Gilman’s short story The Yellow Wallpaper – an early example of the multiple forays writers of fiction have made into the arena of “madness” and mental health treatment over the last century and a half. Gilman’s spare prose does not actually assert, but encourages readers to infer, that the growing fascination with the wallpaper which is the central preoccupation of the book is the direct result of the application of a form of the ‘rest cure’ promulgated in the late nineteenth and early twentieth centuries by Dr Silas Weir Mitchell.

This managed regime of seclusion, bed rest and diet inter alia became a target of early feminists such as Gilman and (Virginia) Woolf, and it is easy to see why. They thought that the “rest cure” amounted to an assault upon the wills of (usually female) patients on the part of (usually male) doctors, in the context of unequal power relations between the sexes. No doubt they were right about the inequality of power between the sexes, but, as has been acknowledged within second wave feminism, it hardly seems fair to lay the blame for this entirely at the door of medical practitioners. “The nervous women of the fin de siècle were ravenous for a fuller life than their society offered them, famished for the freedom to act to make real choices,” writes Elaine Showalter. The doctors of that generation did nothing to dismantle patriarchy, true enough, but they did employ the “rest cure” to restore their patients, some of whom “had been total invalids of many years’ duration”, to “lives that were much more active and satisfying than the ones they had been leading”.¹

Of course, such was not the case for the fictional protagonist of The Yellow Wallpaper. Her visual hallucinations, of the patterns on the wallpaper forming bars behind which a woman was (or many women were) trapped, comprise an eloquent protest, not so much against Weir Mitchell, Gilman’s ostensible target, as against the historical and social constraints that framed Victorian womanhood.

1 Elaine Showalter, The Female Malady (Virago, 1985), pp. 140-144.

Life in a Victorian Asylum 3: Patient Rights

bethlemheritage — Mon, 13 May 2013 09:00:09 +0000

It’s easy to assume that, once inside in an asylum, Victorian patients had no rights whatsoever. Many were, however, well able to communicate with the outside world. Letters to the Commissioners in Lunacy or the Home Office – or, in the case of many private patients, their solicitors – were by law to be forwarded unopened. Other letters could be checked by the medical officers, but had to be shown subsequently to the Commissioners, to ensure that this had been done to protect the patient or prevent offence to others: a fine of £20 was payable if letters had been wrongly withheld. Although the decision to withhold letters does seem to have been made fairly often (given the numbers of letters addressed to outside parties pasted into patient records), there are also occasions when patients’ letters appear in the case books alongside a complaint from a relative who has returned them, urging the Hospital to be more strict in their censorship. There was, then, no hard and fast rule as to what was considered permissible.

In January 1895, a middle-aged gentleman by the name of Edward Peter King was admitted to Bethlem. King’s case well illustrates the lines of communication open to an asylum patient in the late nineteenth century. Diagnosed with mania, he was regarded as talkative and troublesome. He was constantly writing letters to the Home Office which, rather to his doctors’ annoyance, were often responded to, making him “more fixed in his idea about his importance & the interest taken in him by the State.” Several months after his admission, King ensured that he received a second medical opinion on his case after writing two letters to the eminent George Savage (a previous Bethlem superintendent) asking him to call, which he did, noting that “at all events I consider him insane as far as CONDUCT is concerned & if at large I believe he will always be getting into scrapes.”

King certainly managed to get into a number of “scrapes” even at Bethlem, apparently irritating his fellow patients by constantly passing wind audibly (on one occasion this so aggravated a Mr Rowland that he threw a book at King, and tried to follow this up with a vase before being stopped by an attendant). On March 8 the Commissioners in Lunacy investigated King’s case, after the patient wrote to the Home Office saying he had not been allowed to visit two dying relatives: a request the Hospital claimed neither the patient nor his relatives had ever made.

With the medical officers checking his post, King made full use of his legitimate channels of communication: the Home Office, the Commissioners in Lunacy, and his solicitor. To the latter, he frequently sent bulky packages, containing letters to be passed on elsewhere (much to the despair of his doctors, who regularly lamented his ingenuity in bypassing their regulations), or advertisements to be placed in the press. In late March, for example, one of these appeared in the Morning Post, asking “parents and guardians” to provide “steady well-educated Young Gentlemen as ARTICLED PUPILS for five years” for a “high-class sixpenny illustrated paper” he wished to start up.

King’s frequent letter-writing was sometimes an embarrassment to the Hospital: in particular, when the patient received a letter from the Home Secretary asking him to give evidence in an enquiry into Holloway Sanatorium, but nothing official was sent to the Hospital. From the tone of the case book, it seems that the medical officers may have found some truth in King’s contention that “the Home Secretary looks upon us [i.e. the Hospital staff] with contempt”.

Edward King was discharged well, just four months after admission, although his life immediately following release does not seem to have been an easy one. It was later recorded that he had spent time in several prisons, and he returned to Bethlem at least once, to try and borrow £1 (which was refused). Although the level of correspondence King maintained while at Bethlem was unusual, his case is a particularly strong example of that way in which, even when certified, a late-nineteenth century patient might still interact to a considerable extent with the world beyond the asylum.

In the Frame for May 2013

bethlemheritage — Wed, 08 May 2013 09:00:56 +0000

This month, the Friend’s Secretary has chosen to highlight a painting displayed at the recent Museum of the Mind exhibition at the Bethlem Gallery: Russell Barton’s Potential Murderers? The sheer size of this picture means that it is rarely possible to display it at present, but it provides an interesting talking point. One interpretation, used in the exhibition, is that the painting questions one of the common public misconceptions surrounding mental ill-health. The “potential murderers” of the title might thus refer to the seated figures of patients along the wall, the bowed heads and subdued attitudes indicating how ludicrous the generalisation can be. As Barton himself apparently said, “In our mental hospitals today, there are thousands of harmless patients, people who have never done harm, people who never will do harm.”

Yet the figure of the nurse in the foreground is the first thing that draws the viewer’s attention, her face cold and unsmiling, perhaps ignoring those in her care. Meanwhile, the stark walls of the institution fill most of the background: perhaps it is this, and those who run it, that is suggested to have the potential for murder. Barton, who died in 2002 after a lengthy psychiatric career, was an advocate for community care and asylum closure. His key textbook – Institutional Neurosis – argued that asylum care generated a neurotic condition in patients over and above their original ill-health. Colleagues considered that Barton’s experiences at Shenley and Severalls Hospitals (following his training at the Maudsley under Aubrey Lewis) encouraged this thesis: this painting was probably painted during his time at the latter, in the 1960s. The extreme nature of the painting’s title might also reflect the doctor’s early experiences: as a medical student, in the aftermath of the second world war, he volunteered to attend the survivors at Belsen, one of the most notorious Nazi concentration camps.

The starkest contrast in the painting is that between the muted colours of the hospital walls and the bright blue and green landscape beyond. One lone patient stares, perhaps wistfully, through the railings at this apparent utopia beyond. A rather romanticised view, perhaps, reflecting the hopes of those who fought to close asylums in the late twentieth century. An addition to Barton’s obituary in The Psychiatrist, from a friend and colleague, noted that “He never regretted his role in the deinstitutionalisation movement, although he recognised, like the rest of us, that the actual performance fell well short of what he would have wished to see happen.”¹

1 Miodrag Ristich, “Obituary of Dr Russell Barton” The Psychiatrist (2003) 27: 196.

Hospital Snapshots 6

bethlemheritage — Mon, 06 May 2013 09:00:18 +0000

One of the aspects that make the Hering collection fascinating is how much they resemble portraits, either painted or photographic, rather than institutional mug shots. For the most part, the clothing, pose and objects would not look out of the ordinary in a conventional portrait of the time.

Photography, as a new medium in the late 1850s, may well have been something of a novelty for the type of patient Bethlem admitted. To have a photograph taken in this early period might have been seen as a mark of distinction. Queen Victoria herself had been photographed and the photographic series ‘Living Celebrities’, published monthly by Maul and Polybank, depicted key individuals such as politicians, churchmen and writers, alongside their biographies. Bethlem’s patients might not only have enjoyed the experience of a photographic session, but have had their own ideas about how they should be shown according to the photographic conventions as they understood them.

As in painting, clothing is an important indicator of circumstance, individuality and taste. Although the hospital did not issue clothing, for patients choice may have been somewhat limited. A number are wearing dresses of the same material and style, perhaps because Bethlem bought in fabric and ‘sewing parties’ were held in which the female patients could make or alter their own clothing. Despite these constraints many of the photographs show touches of refinement and personality, perhaps giving a hint to the individual themselves.

The patient we know only as EA is dressed as a respectable, middle class woman. Her clothes are neat and well made but not showy, the material good but not expensive. Her hair is firmly tied back, though unusually not covered. There are touches of decoration such as the ruffles on the sleeves of the dress, lace collar and cuffs. A fringed shawl is draped around her. She has taken care over her appearance.

In other photographs, clothing and occupation are more closely allied. Edward Oxford, the would-be assassin of Queen Victoria, is shown here as if taking a break from his decorating. He appears to be dressed for the task in hand, wearing a painting overall on which can be seen some traces of paint. Though the shirt underneath looks fairly standard, the tie appears worn for the occasion.

Clothing was clearly, at least to some extent, within the control of the sitter and helped give personality to each image; next month’s post will consider pose and props.

From Melancholia to Prozac: Depression throughout History

bethlemheritage — Thu, 02 May 2013 10:17:55 +0000

As the new Bethlem Museum of the Mind will reflect on, Bethlem – or Bedlam – continues to loom large in the public imagination, often as a lens through which ideas about mental health care and treatment are cast. That this is the case for researchers as well as journalists is aptly illustrated in a recent book by Clark Lawlor, From Melancholia to Prozac.

Lawlor refers several times to the “enduring” image of public visiting to eighteenth-century Bethlem, which he describes as “a combination of prison and freak show”.¹ He uses this to contrast with nineteenth-century claims to offer “moral treatment” (as, indeed, asylum reformers did in the 1830s and ‘40s). Both ideas he seems to accept at face value, something that we at the Archives and Museum certainly remain wary of: championing or demonising the past can easily serve modern agendas.

Indeed, the main problem with Lawlor’s book is a frequent lack of critical historical thinking. As part of a project to explore depression before this modern label was applied, Lawlor retrospectively diagnoses various historical conditions as equating with modern depression. Many historians of psychiatry would argue against viewing clinical depression as the same as melancholia, hypochondriasis or neurasthenia (all terms used in the past to describe conditions that had some association with low mood). This is not to say that any of these states of illness are somehow imaginary: simply that prevailing cultural and medical concerns impact on not only the ways in which they are described, but also how they are experienced.

One particular example offered by Lawlor, acedia, is a case in point. When medieval monks were suffering from this condition, the low mood and lethargy they descibed might well be described as depression today. However, this was certainly not the most important component of acedia to these monks: most prominent was the loss of spiritual and religious feeling, something which had previously dominated every activity of their daily lives in an isolated monastery. Even the most devout person in the modern world is unlikely to put such an all-encompassing emphasis on spiritual connection today, and therefore cannot experience its loss in the same way that a thirteenth-century monk would have done.

Back to Bethlem, and Lawlor reproduces an image of Cibber’s famous statues, using them to claim the physiognomic emphasis on diagnosing depression in the late seventeenth and early eighteenth centuries. Yet, on viewing the original statues, school groups at the museum frequently comment that “Melancholy Madness” doesn’t look sad to them. Might different facial expressions have meant different things to people around 1700? Might they have associated other emotional experiences than sadness with melancholy, such as the fear highlighted in the Carnival of Emotions? We certainly cannot be certain that clinical depression is the culmination of one universal story of understanding extreme misery.

1 Clark Lawlor, From Melancholia to Prozac (Oxford: Oxford University Press, 2012), p. 80

Sketch of a woman diagnosed as suffering from melancholia.

Lithograph, 1892, after a drawing made for Sir Alexander Morison (Wellcome Library, London).

held by Jane Fradgley: A Symposium on Restraint

bethlemheritage — Thu, 25 Apr 2013 09:00:58 +0000

On the evening of 31 July, the MRC SGDP Centre at the Institute of Psychiatry and the Damaging the Body seminar series will co-host a public symposium on the topic of restraint and strong clothing in mental health care. This event accompanies artist Jane Fradgley’s held exhibition, on display in the foyer from 10th July to 27th September. This series of striking photographs of garments from the Bethlem collection was funded by Guy’s and St Thomas’ Charity and, as previously noted on this blog, the artist has captured these late nineteenth and early twentieth-century garments in a very different manner from the usual methods of displaying such objects (previously explored in Curatorial Conversations IV).

The exhibition is currently on display at Plymouth Arts Centre (until 16 June). However, Jane’s photographs have already opened up debate around the topic in London. Last year, the Bethlem Gallery hosted a focus group on “strong clothing”, bringing together a variety of people within the mental health field: service users, clinical and curatorial staff, therapists and art practitioners. The garments and their history were exhibited, and a lively debate explored the various forms of coercion adopted within contemporary health care and the relation of the historical garments (and their display) to this context.

The term “strong clothing” was used by late nineteenth-century psychiatrists to refer to garments used in English asylums to restrict movement. These doctors wished to distinguish the clothing they used from the “revolting instruments of mechanical coercion” rejected by the “non-restraint” movement of the 1840s and ‘50s. While English asylum superintendents at this time claimed to have abandoned all methods of mechanical restraint, physicians of the 1880s and 1890s re-introduced restraining garments by claiming them to be something else entirely. Strait-jackets (generally known as strait-waistcoats) and handcuffs were replaced with “strong dresses” and “padded gloves”, placed on a relatively small number of patients to prevent self-inflicted injury or the destruction of clothing and other items. By the turn of the twentieth century, however, strait-jackets appear to have returned to some institutions.

Today, it is often assumed that the exhibition of restraining garments will be distressing to viewers: a stark reminder of past cruelties. Participants in the focus group, however, exposed a much more nuanced view of these items. The forthcoming symposium will invite a wider audience - including clinicians, historians, artists and service users - to explore what restraint is, and how (and if) we can ever draw a line between care, cure and control. Following short presentations from a variety of practitioners, the debate will be opened up to the audience.

Tickets are free, but places are limited and must be booked in advance at: heldsymposium.eventbrite.co.uk

Doors will open at 5pm, with a reception and chance to view the exhibition. The symposium will begin at 6pm, ending by 8pm. The artist will be releasing a book associated with the exhibition later in 2013, funded by the Maudsley Charity.

Location: MRC SGDP Centre, Institute of Psychiatry, King’s College London, 16 De Crespigny Park, Denmark Hill, SE5 8AF (within the Maudsley Hospital site).

Sign the Visitors’ Book, Please

bethlemheritage — Mon, 22 Apr 2013 09:00:15 +0000

Anyone who has made the trip to the Archives & Museum will know that one of the first things they are invited to do is sign our visitors’ book. This is old - pen and paper – technology, but effective enough in affording visitors the opportunity to sign up for our quarterly email newsletter (which can also be done by filling in the box near the top right of our homepage or leave comments, as well as in providing raw data from which we can extract annual visitor numbers. Perhaps in one hundred years’ time, historians of the future will use these books to find out about museum visitors of the early twenty-first century? After all, what we did on last year’s Just Visiting thread was not all that different. Its focus, though, was on visitors to Bethlem Hospital in the last half of the nineteenth century, and early part of the twentieth.

In using the Hospital’s Visitors’ Books of that period for this purpose, we encountered an intriguing fact. While many of the people who visited the Hospital signed the book, others – unaccountably – didn’t. The result is that, while the Visitors’ Books can – and have – been mined for information concerning who visited, the absence of a name is not proof conclusive that no visit was paid. Sometimes we know, or may fairly assume, from other sources that a person whose name does not appear in the books did actually make a visit: Charlotte Brontë, for instance. Yet she was not the only one.

Two German cases illustrate the point. The Frankfurt psychiatrist, children’s author and civic dignitary, Heinrich Hoffmann (1809-1894) visited Bethlem in June 1856. Thirty years earlier – in April 1827, to be precise – the Paris-based poet Heinrich Heine (1797-1856) also paid a visit. This much can be established from published sources: Hoffmann’s autobiography, and Fritz Mende’s biography of Heine (citing a letter of his), respectively. Hoffmann duly wrote in Bethlem’s Visitors’ Book; but – frustratingly, and for reasons unknown to us – Heine didn’t. Consequently, when Frankfurt’s Historisches Museum mounted an exhibition in commemoration of the bicentenary of Hoffmann’s birth, a facsimile of the page of the book on which he signed was included in it. By contrast, there was no paper trail for the compilers of the final volume of the modern, German-language edition of Heine’s works (currently in preparation) to follow.

All of this goes to show that signing the book was something that people opted into (or opted out of) back then, as indeed it is now for visitors to the Archives & Museum. No doubt there have always been some for whom the merits of anonymity trump the claims of posterity.

Gods, Devils and Dreams: New Exhibition Opens at the Bethlem Gallery Next Week

bethlemheritage — Fri, 19 Apr 2013 09:07:14 +0000

Next week, on 24th April, a new exhibition opens at the Bethlem Gallery. Peter Harry Lewis White’s Gods, Devils and Dreams will run until 17 May, featuring large-scale paintings and detailed pencil drawings. His work depicts visions and dreamscapes that take the viewer on a journey into abstracted landscapes, figures and happenings. “My exhibition reflects my experiences and my creations. There are some windows into my memory and mind, but the rest is just colour and form.”

The exhibition will be open for Museums at Night 2013, a nationwide festival of late openings and events at museums and galleries, in which Bethlem is participating on Thursday 16 May. The Museum will be open until 7.30pm, with a special talk on Spiritualists and Spook-Spotters in the nineteenth century at 6.30 providing the perfect follow-up to an exhibition visit. How did psychiatrists explore hypnosis and spiritualism in late nineteenth-century Bethlem? What were the hospital’s connections with the Society for Psychical Research? And how were ‘spooky’ goings-on thought to help us explore the relationship between mind and body?

Gods, Devils and Dreams opens on 24th April (3 – 6pm) and continues 25th April – 17th May

Wednesday – Friday 11am – 6pm

Gallery and Museum also open Saturday 11th May, 11am – 5pm

Reversible Owl – Peter White

Telling Admissions 2

bethlemheritage — Tue, 16 Apr 2013 09:00:15 +0000

Celebrities are said to live their lives in a goldfish bowl, such is the level of media interest in every aspect of their personal as well as professional lives. No doubt this accounts for how the mental health difficulties of Adam Ant, the British pop singing sensation of the 1980s, first became public knowledge – at least, those difficulties which led to the compulsory treatment orders that were placed upon him a decade or so ago. Ridicule may be nothing to be scared of but, by virtue of being in the public eye, he has had to bear more than most. Yet it is striking to note the courageous way in which the singer has chosen to respond to the intrusive press reports of that time. In publicity associated with his recent return to the music business, he said of his own mental health history: “It’s not something I’m ashamed of. It’s not something I’m particularly proud of. I did wrong things as a result of it. But there’s only one thing worse than making a mistake, and that’s not learning from it… and I’ve learnt from it.”¹

Further, in his published autobiography Ant gives details of an intense trauma – culminating in a suicide attempt – which was the occasion of a much earlier psychiatric hospitalisation, but also led to him discarding his given name – Stuart Goddard – in favour of the one by which he later became so well known.

“Adam Ant was born in 1976, in the grey, cold, echoing emergency ward of Friern Barnet Hospital, North London. He was smacked into consciousness by a hard-faced and overworked charge nurse, who calmly said, ‘Wake up, you little bastard’.

“I groaned.

“Satisfied that I was awake she left me alone. Somewhere out of sight down a winding, peeling corridor a woman was screaming. There was no one else in the emergency room. As I sat up, groggy and feeling lost, I saw the name Stuart Goddard written in chalk on a board next to a door marked ECG.

“But I had killed Stuart Goddard. A handful of my mother-in-law’s pills taken from the yellow cabinet in her bathroom had done the job.”²

From Ant’s account it might not be too much to infer that this crisis proved to be the fulcrum of his career. The ‘rebranding’ of his own person is permanent testament to his having weathered that storm, and emerged the stronger for it. “I really knew I wanted to be Adam”, he said later, “because Adam was the first man. Ant I chose because, if there’s a nuclear explosion, the ants will survive.”¹

¹ Matt Everitt, ‘Adam Ant on fame, depression and infamy’, BBC News website, 23 February 2011.

² Adam Ant, Stand and Deliver: The Autobiography (Pan Books, 2007), p. 1.

Ikons at St. Giles Church, Camberwell – Imma Maddox

bethlemheritage — Fri, 12 Apr 2013 09:00:37 +0000

In May 2013, Bethlem Gallery artist Imma Maddox will display her ikons in St Giles Church, Camberwell (Church Street, SE5), painted using traditional methods dating back to Roman times. ‘Icon’ simply means ‘image’, but has often been associated with religious paintings of a particular style. The distinctive panels are prepared using animal glue and whiting, and painted with egg tempera. It is this egg that gives the colours the warm, soft glow of the ikon. The colours can remain fresh and vivid for centuries, unlike oil paintings which crack and flake.

Imma has been painting ikons for about fifteen years, and her first piece was the ikon of St Michael, which hangs on the organ case at St Giles. She paints cats and people, hands and birds, using these images to offer up a prayer for creation. Imma has recently had additional training in the traditional techniques, which are are described in detail on the webpage for the Icon Workshop at the Saint Gregory of Sinai Monastery.

The ikons can be viewed at weekly services, and also at a series of concerts taking place in the church in May. Every Wednesday, the church will be open from 7pm to view the ikons, and the concert will start at 7.45.