The Politics of Interior Decoration

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.

Holding Your Nerve 1

In the introduction to Medical Muses, a study of hysterical patients in the Salpêtrière Hospital in the nineteenth century, Asti Hustvedt notes that there is today “a crop of bizarre new illnesses that, like hysteria, afflict mostly young women and stubbornly resist biological explanation”. She observes that “No drug exists to cure anorexia, bulimia, self-mutilation, chronic fatigue syndrome, and multiple personality disorder, and no genetic flaw has been found to explain them”; and, somewhat more tenuously, that “today’s scientists are scrambling to find biological explanations for behaviour, and everything from human mating strategies to homosexuality, from shyness to alcoholism, has been supposedly located in biology”.¹

Broadly speaking, it is true that biological explanations came to be favoured over psychoanalytic ones within the psychiatry (though not within the psychology or the social work) of the Western world by the end of the twentieth century. More recently, however, the theoretical reductionism and mental health guild wars of the twentieth century have begun to give way to a broader appreciation of the factors that contribute to the many and various conditions that are commonly found sheltering under the umbrella term of ‘mental disorder’. Some may be biological, others behavioural, still others environmental. The profile of most ‘disorders’ is shaped by a combination of these factors, arising from discrete sets of circumstances and requiring individual attention. The examples given by Hustvedt are illuminating. The most helpful perspective from which to view alcoholism or anorexia is probably behavioural, at least as far as remedy is concerned, while the diagnosis of multiple personality disorder may be understood as an extreme example of a life story in critical need of rescripting. As far as the nineteenth-century diagnosis of ‘hysteria’ is concerned, Hustvedt does not deny that the “fatherless, unmarried, and poor” subjects of her study were really ill, but finds it impossible to say “to what degree their disease was socially determined and to what degree it was physically determined”. She began her study expecting to find “a clear-cut world of exploited women and exploiting men” within the Salpêtrière, but found instead “a hospital culture that was in many ways less oppressive than the world beyond it”. If it is true “hysteria was at least partly an illness of being a woman in an era that strictly limited female roles”,² perhaps amelioration of the plight of ‘hysterical’ patients was never likely to be more than partial, a fact for which the doctors of the time had limited responsibility and over which they had little control.

This territory will be ploughed by a new exhibition at Museum Dr Guislain in Gent, Belgium. Nervous Women opens on 13 October 2012 and runs until 26 May 2013. Bethlem is making a unique contribution to this exhibition; we intend to tell our blog readers what it is in the near future.

 ¹ Asti Hustvedt, Medical Muses (2011), p. 7.

² ibid., pp. 4-5.

Nineteenth Century Society: Women, Madness & Marriage 4

Marriage breakdown could cause massive disruption in the lives of married women in the Victorian era. Even in cases where the termination of the marriage had been desired, such as that of Kate Marian Merriman, admitted as a patient of Bethlem Hospital in July 1891, the change in position might be hard to deal with. Suddenly returned to the care of her family after separation from her husband six years ago, 36 year old Merriman “had considerable trouble with her relations over family matters,” most of which seem to relate to her desire for independence for, like Grace Sapsford a decade later, she felt that “I surely have a perfect right at my age to choose my future.”

Kate Merriman told the medical officers a lengthy story of her admission, refuting or explaining most of the issues stated as delusions in her medical certificates. “The night before admission she stayed at a hotel at Henley by herself with no luggage but a travelling bag. She was much upset by the way she was treated there, she says with great want of respect. The people there mistook a razor in her bag for a suicidal instrument, whereas she always carried it to cut her corns. She says nothing in her conduct accounted for the rude way in which she was treated. This bother caused her so much annoyance that she refused her food.”

It is unclear whether the medical officers took the word of Kate’s brother (who connected her illness with her separation from her husband six years before) or herself – for they certainly commented on the lack of clear symptoms of insanity. Moreover, the conversational tone of the letter written by Mrs Merriman to Dr Hyslop after her discharge indicates that she felt he understood her: “as you know, I have not had anything to do with my relatives for some time.” However, as Kate was legally regarded as a dependent of her parents, the medical officers were in a difficult position: they would have to send her back to her parents’ home. This, she wrote, caused her to feel “isolated” in the Hospital, and: “While forgiving as one hopes to be forgiven, one cannot forget the past six & a half years of their life. … I have lived the quietest of lives in rooms with my children before, if necessary I can do it again, & be far happier there, than I could ever be with my own family.”

Ultimately, Kate Merriman managed to achieve her aims. Discharged cured in November 1891, her certificate was signed by a doctor in Penzance – where she had long claimed she wished to move with her children, well away from the family she disliked, in part due to their overbearing views on her marriage. This doctor, Humphry Davy, in fact disagreed with the diagnoses which had led to her certification in the first place. He declared that he had seen Mrs Merriman many times in the last four years and had never witnessed any symptom of insanity: as he saw it, her ideas of persecution at the hands of her family were entirely rational.

Nineteenth Century Society: Women, Madness & Marriage 3

The medical records of an appreciable number of the young women admitted as patients of Bethlem in the late nineteenth century provide evidence of a close interplay of social intimacy, expectation and vulnerability. Nancy Jessie Joy was admitted twice in 1888. Aged 22, Nancy was a Still Room Maid, regarded as suffering from melancholia. She was quickly discharged cured following her first admission, but later claimed to have been simply pretending to be well. After this discharge, while still depressed, she “had the idea that if she became “ruined” a change would come over her mind.” She wandered from home and was “accosted by a gentleman.” Having “allowed him to have intercourse with her,” she “now feels she is going to hell and wants to hurry this on.” In Nancy’s case, conventional gender roles were used to attempt to avoid the stigma that might be associated with her behaviour: the “seduced woman,” Nancy’s actions are interpreted as entirely passive (she “wanders,” and does not instigate relations but simply “allows” it), while the “accosting” gentleman is the active party. Her “seduction” was seen as the reason for Nancy’s re-admission in October 1888 – popular literature in particular frequently associated female insanity and suicidal behaviour with seduction: again, however, she was quickly discharged as recovered, without further comment on her actions.

Yet the role of the Victorian psychiatrist in such cases was complicated – at once physician, moral guardian and spiritual counsellor, indicated by the letter Nancy wrote to Dr Smith three years after her discharge. Having apparently remained well, she begged Dr Smith for advice, for “I feel I cannot ask my mother.” Two things, Nancy felt, might prevent her marrying, as she described her situation to Dr Smith as follows:

“I am engaged to a young man who wishes to marry me & does not mind my having been insane. I could not frame my lips to utter, or I would rather have come & ask you. [sic] Sir, in my sane mind not an impure thought enters my mind. … Am I really ruined or not? If I am I will never marry, no man shall reproach and if you are able to say I am not ruined then one question more, was my insanity of a nature that it would not be right for me to marry?”

There is no indication of Dr Smith’s response to this letter – or whether he even replied at all. However, Nancy was still single when she was admitted to Bethlem in 1899, aged 32, her relapse caused by “mental worry,” presumably due to her “self accusation.” This time, she was discharged uncured.

Nineteenth Century Society: Women, Madness and Marriage 2

Unconventional behaviour was sometimes (but not always) regarded as evidence of insanity. Victorian Bethlem’s medical officers certainly did not appear to think badly of those female patients who chose education over marriage (perhaps unsurprising: obituaries of George Savage hailed him as a champion of medical education for women) – nor, indeed, was this necessarily the case with the patient’s families. Isabella Clemes, admitted in 1892, was a Teacher of Mathematics and graduate of Newnham College, Cambridge; her brother felt that she had shown “no special nervousness” prior to the commencement of her illness – indeed, eccentricity seemed to be predominantly on the male side of the family and, although the maternal grandmother “was carried away a little by “spiritualism” in her old age … up to that time she had been a remarkably able & executive woman.”

“Disappointment in love”, often regarded as a cause of illness in single patients, was thus not particularly associated with women, as indicated in the case of Alfred Freeman and Alice Meeks. Twenty-one year old Freeman’s sentimentality was regarded as part of his apparently troublesome nature; he is “generally annoying everyone” wrote Bethlem’s medical officers in 1894, inserting examples of his love poetry into the casebooks as evidence. Also inserted was the letter he wrote to a female patient, Alice Meeks, after meeting her at one of the regular Hospital dances.

“Dear Dr Hyslop,” Miss Meeks wrote after receiving Freeman’s proposal of marriage. “You will be greatly amused at my letter, also the one which I have enclosed. I must say you won’t be more surprised than I was this afternoon at receiving such a stupid lot of nonsense. I can assure you my ideas of love are very far from that quarter. I don’t suppose in my 22 years of happiness I could ever have thought less about that sort of thing. You remember about my speaking to you about a secret, that even my own Mother & Father know nothing at all about, at the early age of 19 years I had an offer of marriage from a Medical Student, he was very young only 23, but to all outward appearances seemed rather to like my company. He said that in 5 years time he hoped to have a good home for me, but I only laughed at it as I could not & do not understand that meaning love. I fear I am rather a loveless creature. Hoping you will not laugh at me. Yours sincerely, A.G.M. Meeks.”

Seemingly well aware that her behaviour as a “loveless creature” rather defied the expectations of society, the firm and decisive manner of Miss Meeks’ letter is rather at odds with her apparent condition in the Hospital, in which she was generally seen as silent, depressed, and later “stuporous.” Her independent tone, however, was echoed by many other young women in the 1880s and ‘90s: most of whom were working, and often did not live with their families. Those who did might express the opinions of Fanny Hider, a 30 year old governess admitted in 1888, “that if she is allowed to go home she will have her own way, & will do as she likes, she means to be independent.” Shortly thereafter, Fanny was discharged well.

A Hospital Dance in 1859