Hypnosis at Bethlem

In January, our Friends Secretary went to Manchester to take part in the annual British Society for the History of Science Postgraduate Conference, as part of her PhD research. The event included a presentation on the BSHS education programme, during which several videos – the efforts of the Society’s “Strolling Players” – were screened. The most recent of these – “The Tables Turned” – evoked a few thoughts on late nineteenth century Bethlem.

The short film, part of an educational outreach event exploring scientific knowledge within a historical context, showed a nineteenth century séance, at which one character attempts to investigate the possible causes of the popular pastime of table turning. A number of recent historians of psychiatry have stressed the importance of the Victorian interest in spiritualism to the developing science of psychology in the nineteenth century, in particular attempts to define and understand the “unconscious” mind. While, today, research into psychical phenomena tends to be regarded a “pseudoscience”, it is important to recognise the impact that spiritualism had in the nineteenth century.

Certainly, physicians at Bethlem were interested in whether spiritualism might help in understanding and treating patients. Early experiments in hypnosis took place in 1883, in which superintendent George Savage tried unsuccessfully to be hypnotised himself, in order to understand what “honest hypnotism really was.” In the late 1880s and early 1890s, the Hospital received a number of visits from “Mr Smith of the Psychical Society,” otherwise known as the Society for Psychical Research, which had been set up in 1882 to investigate apparently psychical phenomena. Were these external events, connected with a spirit world, or were they being consciously or unconsciously performed by unscrupulous or gullible mediums? How could this account for the experiences of others involved in a séance? And what else could this suggest about the workings of the human mind?

At Bethlem, Mr Smith tried several experiments in hypnotising various patients, either in an attempt at cure or to alleviate particular symptoms from which the patient suffered. Most of these efforts were ultimately judged unsuccessful, nonetheless – as Bethlem superintendents frequently remarked – it was important to try every possible new treatment for insanity, and the “method … is reported to have met with considerable success abroad.”

To watch “The Tables Turned” visit: http://www.youtube.com/watch?v=OjBl3HhVP64

To find out more about the British Society for the History of Science, visit: http://www.bshs.org.uk

Nineteenth Century Society: Women, Madness and Marriage 1

This short series looks at the very different experiences of several of Victorian Bethlem’s female patients regarding marriage. The diversity of these reminds us of how problematic it can be to make general assumptions about social expectations in the nineteenth century, despite the fact that some cases do indicate elements of the stereotypes commonly indicated by many feminist histories.

What might be of particular interest in an era in which online dating has received regular attention – both positive and negative – is those references found in the Bethlem casebooks to matrimonial agencies. For single women well past the usual marrying age, such as Mary Ann Swann, who was admitted to Bethlem in July 1895 as a voluntary boarder, social expectations could be difficult to deal with. Young people were expected to suffer from insanity following “love disappointments,” yet in fifty-year-old Swann’s case, her attitudes to marriage were seen as evidence of her mental illness. Mary Ann held the delusion “that she is persecuted by her sisters in order that they may keep her money … She is also erotic & desires to marry some man who will protect her from her sisters & brothers.” While her desire to marry in order to escape her perceived persecution could be regarded as quite a rational response to something she felt was very real, Mary Ann’s persistent desire to marry was instead regarded in Bethlem as a further delusion, related to her “erotic” nature: inappropriate behaviour in someone regarded as a confirmed spinster.

What was most problematic was Swann’s use of matrimonial agencies to effect her object: the Commissioners in Lunacy clearly regarded this as a dubious means of finding a suitor. After she was discharged well, in September 1895, Commissioner Mr Frene paid a visit to the Hospital, presumably instigated by the patient’s relatives, “to enquire how it was that this patient was at large as she was doing most extraordinary things & was shortly to be married to a man whom she had got to know through the Matrimonial News.” The Bethlem medical officers promptly arranged for Swann’s re-certification: presumably suspicion of such dating agencies was widespread. Mary Ann herself regarded her re-admission as a conspiracy on the part of her relatives, claiming that there was nothing extraordinary in her conduct. Yet, as Bethlem superintendent George Savage pointed out in his published writings, in the frequent absence of visible physical signs and symptoms the presence or absence of insanity had often to be determined by behaviour, regardless of the patient’s protestations. In the event, Mary Swann was discharged well after three months as a Bethlem patient.

Visit Bethlem at Open House London on 18 September

One of many London buildings not usually accessible to the public is the Victorian Bethlem Hospital at the Imperial War Museum. Opened in 1815, when Bethlem was moved from its crumbling former premises at Moorfields, the Hospital was located on this site until 1930, when it moved to its present location in Beckenham. Although the conversion of the building to the Imperial War Museum, established in 1920 and opened on this site in 1936, as well as extensive bomb damage in the Second World War (a total of 41 incidents) means that much of the building’s original fabric has been altered, the facade is still distinctly recognisable, while the pathways and walls in Geraldine Mary Harmsworth Park, formerly the Hospital grounds and airing courts, still follow the plans of nineteenth century Bethlem.

Most of the former Hospital rooms now form the “behind the scenes” areas of the Imperial War Museum, with the public galleries located in what was originally a central garden. Some of the most distinctive Hospital locations, however, will be open for visitors on Saturday 18 September only, as part of Open House London weekend: the Dome and the Boardroom. Smirke’s Dome, added to the Hospital during improvements carried out between 1838 and 1846, was one of the most distinctive features of the nineteenth century building: the patient-edited Hospital magazine, begun in 1889, was titled Under the Dome. The Dome contained Bethlem’s chapel, pictured below. More recently, after restoration following an arson attack in 1968, the Dome housed the Imperial War Museum’s Reading Room (from May 2010, this was moved to the new Explore History Centre). The guided tour, led by archivists from the Imperial War Museum, will also take in the Boardroom - the only room in the building still used for its original purposes, having formerly served as Boardroom for Bethlem’s Governors. The room currently contains a collection of artworks by William Orpen.

Tours take place on the hour from 11am, with the last tour starting at 5pm. Staff from the Imperial War Museum and Bethlem Royal Hospital Archives and Museum will be on hand to provide information and answer questions, and information from the Bethlem Archives will be on display in the Dome. Like all Open House events, tours will be free of charge. Spaces are limited (max 15 per tour), so please book in advance to avoid disappointment. Booking will open on Saturday 11 September at the Imperial War Museum Information Desk, in the ground floor display area.

To find out more about Open House London and the Imperial War Museum visit:

http://www.londonopenhouse.org/

http://london.iwm.org.uk/server/show/nav.34

To explore nineteenth century Bethlem online, visit our interactive guide:

http://www.bethlemheritage.org.uk/explorebethlem/

Madness and Literature 2: “A Hideous Torture on Himself”

When not working at the Archives and Museum, the part-time Friends Secretary is also researching the nineteenth century casebooks. She presented at the Madness and Literature conference, examining representations of self-mutilation (a term introduced and defined by psychiatrists, including Bethlem superintendents George Savage and Theo Hyslop, in the 1880s) in nineteenth century literature and psychiatry. The title bears reference to Nathaniel Hawthorne’s The Scarlet Letter, first published in 1850. Set in puritanical seventeenth-century Massachusetts, the novel tells the story of the punishment of Hester Prynne, forced to wear an embroidered “A” on her chest (the “scarlet letter” of the title) as punishment for having borne an illegitimate child. At the close of the novel, this “A” is exhibited burnt into the chest of the Reverend Arthur Dimmesdale, publicly revealing him to be the child’s father, made physically and mentally ill through the long-guarding of his guilty secret. In Hawthorne’s work, the origins of the wound are debated, although to late nineteenth and early twentieth century psychiatrists, as well as certain of the spectators described by Hawthorne, the only “rational” explanation was that Dimmesdale’s self-punishment had been “followed out by inflicting a hideous torture on himself.”

Although Hawthorne’s representation of Dimmesdale was certainly not intended as a medical case history, the case was referenced by medical writers who had no problems with what some later authors, including Henry James, saw as a crude use of symbolism in an otherwise psychologically interesting novel. Indeed, many nineteenth century medical writers on self-mutilation expected their patients’ acts to be similarly symbolic, analysing motives and “hidden meanings” in a manner often starkly at odds with that in which other problematic behaviours were portrayed (in the Bethlem casebooks, refusal of food or persistent removal of clothes, for example, is usually simply dismissed as troublesome).

We can find many examples in the Bethlem casebooks of these attempts – by patients and practitioners – to give meaning to self-damaging actions such as face-picking, hair-plucking and self-cutting. In 1889, James Hipwood’s attendant stated that the former had cut his face because “he liked to see the blood that followed.” To his mother, meanwhile, Hipwood said that he cut himself because “he wanted to see if he could feel anything.” Yet, in Bethlem, an alternative explanation was implied. Although the doctors found it hard to get anything out of their patient at all, he did tell them “that he does not want to live & hints at something dreadful that is going to happen & at great suffering which he will have to bear.” The medical officers suggested that “he is apparently trying to prepare himself [for this] by inflicting pain on himself now.”

Photograph of Mary Stoate, admitted to Bethlem in 1895

Life in a Victorian Asylum 2: Clerks and Governesses

While certainly connected to moral treatment, improvements at Bethlem were presumably also related to the changing patient profile: throughout the nineteenth century the Hospital became increasingly middle class – by the 1860s, the majority of patients tended to come from lower middle and “educated” working class backgrounds. As Hood lamented in 1854, “The records of all Asylums show how liable are clergymen, authors, artists, governesses, professors and similar persons to be attacked by this terrible calamity. None are more subject to this visitation, none are less able in a pecuniary point of view, to struggle through the trial of such an affliction, yet none are less cared for by the many charitable institutions of our country.” This changing patient profile is indicated in the admissions: 10% of male admissions to Bethlem in 1845-55 were clerks (compared to just 0.01% of the population), while 7% of female admissions were governesses or school mistresses (again, just 0.01% of all women were governesses).

In reflection of this changing class of patient, the Hospital’s wards increasingly came to resemble the Victorian domestic ideal: as the Illustrated London News put it, “that which was once a prison-cell has now become a cheery, domestic room,” while Freeman’s Journal later described photographs of the late nineteenth century hospital as “luxurious” and of “hotel-like magnificence.” This was in line with similar changes described at St Luke’s by Charles Dickens, in his article A Curious Dance Round a Curious Tree. Nonetheless, most contemporary observers were aware that these changes might be little consolation for many patients. As the correspondent from the Illustrated London News concluded: “I thought of the luxuries and the comforts, the plants and the pet animals, the books and the periodicals, the billiard and the ball room, the skill and tenderness of the physician; but all these, to my mind, would not fill up the vast abyss of human mental misery yawning beneath the lofty dome in St George’s fields…”