Posts Tagged 'Bethlem Hospital'

In the Spotlight: Relatives 2

Having focussed on relatives of those historically associated with Bethlem or the Maudsley Hospitals in July, this month we turn our attention to three Bethlem patients who were related to people who were otherwise well known in their time, and to a fourth person who, while related to someone famous, was never a Bethlem patient – but is widely believed to have been.

At the start of the nineteenth century, Bethlem Hospital was locked in bitter rivalry with its near neighbour St Luke’s Hospital, whose founding physician William Battie made a point of admitting patients who had been discharged uncured from Bethlem for treatment. (As far as the patients were concerned, it may have been a case of ‘a curse on both your houses’. According to one of their number, popular wisdom about the respective regimes held that ‘St Luke’s is clean with tyranny; Bedlam’s all filth with liberty’.1) Bethlem was not in the habit of returning this favour, but did so for one Mary Turner, who had been admitted aged around sixty to St Luke’s in November 1799 and discharged uncured in December 1800. Mary arrived at Bethlem shortly after Christmas in that year, and stayed until her death in April 1804. Today she is chiefly remembered as the mother of the artist J.M.W. Turner (1775-1851). Since medical records were not kept by Bethlem at the time of Mary’s residence, Turner’s biographers have been able to do no more than speculate as to the reasons for her admission to the Hospital, the nature of her progress (in fact decline) there, and any possible effects on her artist son.2

Elizabeth Catlett, a beloved niece of the slave-trader turned evangelical preacher and hymn-writer John Newton, was admitted to Bethlem Hospital on 1 August 1801, spending about a year there before being discharged recovered. At the time of her residence, Newton was elderly, infirm and rather short-sighted, yet, according to his biographer Josiah Bull, ‘it was [his] custom to walk every morning at a certain hour to the hospital [in the company of a friend], and to look up to the window of the poor patient’s ward, and for each party to make an understood sign of recognition … at the turn…Pointing to the window, he would say [to the friend next to him], ‘ Do you see a white handkerchief being waved to and fro ?’ — he could not see himself — and being satisfied the good man returned home.’3

Bethlem Hospital was relocated, reformed and changed beyond recognition in the course of the century that followed the admission of Mary Turner and Elizabeth Catlett. By 1904, the London Argus could opine that its arrangements were ‘not so much those of an asylum or a hospital as of a first-class hotel’.4 Into this institution stepped a patient on transfer from the privately-run Bethnal House in May 1901, one Bertha Lawson, then wife of the Australian poet Henry Lawson. The pair had come to London with their two young children in the hope that they could make their living by Henry’s pen. (Incidentally, it would be unfair to consider Bertha solely under the rubric of her husband’s talent. She was an aspiring author in her own right. In London, however, her responsibilities were limited to childcare.) This hope was to be disappointed. Shortly after their arrival. Bertha’s health broke down – no thanks to her husband, according to his biographers – and she was hospitalised. Within three months of her transfer to Bethlem, she had recovered and left. However, Henry had been unable to establish a writing career in London in the interim, and the family returned to Sydney in 1902. Sadly, their return marked a decline in Henry’s fortunes from which he seems never to have recovered. A suicide attempt on the part of Henry, and an application for marital separation on the part of Bertha, followed in quick succession; and it was Henry, rather than Bertha, whose later years were spent in and out of Australian mental hospitals.5

That Hannah Chaplin (1865-1928), mother of the comic actor and film director Charlie Chaplin, was at one time a Bethlem Hospital patient is an established piece of wiki-orthodoxy, but one without any foundation in fact. Since the Hospital’s admission records, complete and comprehensive for the term of Hannah’s life, are held here at the Archives & Museum, we are in a position to be quite certain about this. In the 1890s, poverty forced Hannah and her sons Sydney and Charlie into temporary periods of residence at Renfrew Road Workhouse in Lambeth, an institution which had nothing to do with Bethlem Hospital other than being within sight of its distinctive dome. She later spent time at Cane Hill Hospital and Peckham House, but she was never admitted to Bethlem. How, then, to account for the persistence of rumours to the contrary? Is there, perhaps, something about the association of acknowledged celebrity with assumed notoriety which defies correction?

1 Mike Jay, The Air Loom Gang (London, 2003), p. 220.

2 Cecilia Powell, ‘Turner’s Women: Family and Friends’, Turner Society News (no. 62, December 1992), pp. 10-12.

3 Jonathan Andrews et al, The History of Bethlem Hospital (London 1997), p. 543.

4 Josiah Bull, But Now I See: The Life of John Newton (Edinburgh 1998).

5 Brian Matthews, ‘Henry Lawson’, Australian Dictionary of National Biography, volume 10 (Melbourne 1986), pp. 18-22; Meg Tasker and Lucy Sussex, ‘That wild run to London’: Henry and Bertha Lawson in England’, Australian Literary Studies (October 2007).


Christmas at Bethlem

In a recent post, we highlighted a fact about admission to Bethlem Hospital in the eighteenth century which is not as well known as perhaps it should be: that admission was commonly for a period of no longer than twelve months. What was true of the Georgian and Regency Hospital in Moorfields also held good for the Victorian and Edwardian Hospital at Southwark. There were, however, always a few exceptions that proved the rule – people who stayed longer than twelve months – especially after the establishment of the Hospital’s incurable ward.

Each Christmas season, the Hospital had to tackle the question of how to sustain its patients in positive (perhaps even festive) mood. This question could be particularly acute in the case of those who faced more than one successive Christmas as inpatients. Its first strategy appears to have been to send convalescing patients home on temporary leave.

Emma Lane was admitted in May 1893 after having spent twenty years of savings in a matter of weeks on unneccesary food, baby clothes and theatre bookings. Her husband kept in close contact with the Hospital throughout her extended stay, at one stage writing ‘I am anxious to see her resume her old place, but fear she is not yet well enough’. Emma was granted temporary leave to spend time with her family a number of times, including at Christmas 1893 and 1894, but matters did not run smoothly, and on each occasion she was returned to the Hospital. Christmas 1893 seems to have been particularly stressful, the family’s report being that Emma had been ‘giving trouble’, Emma’s version of events being that she had ‘just bought a few things’. Emma was discharged uncured in January 1895; the story of her hospital stay may be read in Presumed Curable: An illustrated casebook of Victorian psychiatric patients in Bethlem Hospital by Colin Gale and Robert Howard (Wrightson Biomedical, 2003).

Of course, not everyone could be sent home for Christmas, and the Hospital’s second strategy to maintain seasonal morale seems to have been to bring Christmas to the majority of patients and staff that remained in residence throughout. The photograph below offers remarkable evidence of one attempt to do so. It shows a statue that stood in one of the Hospital’s galleries (shared ward space) dressed as St Nicholas for the Christmas season of 1907. To our contemporary gaze, the visual effect is unusual, even a little unsettling. Yet the intention must have been to lift the spirits, and we may hope that the display succeeded in doing so at the time. In any event, all the staff of the Archives & Museum wish the readers of this blog a very happy Christmas and safe and prosperous New Year.

Xmas 1907

Gender and Madness in Post-War Bethlem: A Meeting of Minds?

World War Two has been depicted as an era of innovation, professional growth and public acceptance for British psychiatry. Nevertheless, in the psychiatric treatment of women, ‘progress’ may have been transient: they have been considered more susceptible to insanity due to supposed biological propensity or exacting social expectations. Clinically, a rising tide of voluntary admissions from the 1930s coincided with the emergence of ‘psycho-neuroses’, a category in which women were over-represented. Women also outlived and outnumbered men, and gender disparities in admissions were subject to preferences of GPs and other ‘gatekeepers’. Whilst some evidence also links male admissions to transgression of stereotyped career norms, this finding is obscured by historical emphasis on female patients.

The gendered experience of mental health was amongst issues debated at a recent conference on the history of post-war women’s health, hosted by the University of Manchester’s Centre for the History of Science, Technology and Medicine. Emerging research based on analysis of primary source material used Bethlem Hospital as a case study for exploring similarities and differences in the experiences of male and female patients in this period. Admission register and casenote data provided a unique glimpse into prevailing theories of mental illness, and the changing character of the hospital and its patients. This was complemented by interviews with former Bethlem staff.

Key patterns were identified in the demographic composition of Bethlem’s patients, diagnostic practices and treatment delivery, with discussion of how these characteristics evolved over fifty years, against a wider backdrop of legal, social and scientific change. The findings chiefly indicate a postwar convergence, and, in some cases, reversal, of traditionally ‘gendered’ diagnoses – such as anxiety – and the ascent of ‘affective psychosis’ (e.g. manic depression) amongst women. This was countered by a widening age disparity between male and female admissions, most prominent within the over-60 age groups, where a middle-class bias remained apparent. Although the psychological effects of marriage are unresolved, the research suggested that women may also benefit, and that in this area too, the experiences of men and women had more in common than has previously been acknowledged. Finally, investigation of psychotherapy services is shedding further light on how shifts in theory and practice affected the hospital’s population and recovery rates.

Although one should not over-generalise from case study evidence, it is very striking that the Bethlem data do not conform to gender dichotomies of mental illness established in both academic discourse and the popular imagination. This, in itself, highlights the value of such research in deconstructing accepted accounts of male/female disparity in psychiatric experience and the need for continued engagement with documentary and oral histories of mental health care.

The programme for the conference, which took place last month, is
available on the University of Manchester website.

Getting into Georgian Bethlem 3

In previous posts we described the restrictions placed on admissions to Bethlem Hospital, and to its ‘incurable’ ward, in the eighteenth century, and told the first of two stories of attempts made to gain admission for a patient. The second concerns Sarah Lufkin of Little Bentley near Manningtree, Essex, who came into the Hospital on 16 February 1782, and was discharged uncured on 15 February of the following year, in strict accordance with the previously-described rules governing admission and discharge. Mrs Lufkin was considered a ‘fit Object’ for transfer to Bethlem’s ‘incurable’ ward, but had to go on the waiting list for a vacancy. It took seven years for her to be offered a place, and a letter written to the Hospital by Sarah’s son John Lufkin is preserved in the archives.

‘My Brothers, Sisters and myself have Deliberated on the matter,’ John wrote, ‘and although her who has been one of the tenderest Mothers still continue in a state of Insanity, I leve [sic] you to judge from your own feelings if it would not be a heard, very heard work for us to part from her and perhaps never to see her more.’ This was no exaggeration on John’s part. Little Bentley was at least two days’ coach journey away from London in the eighteenth century, and the fare was not cheap.

By 1790 Sarah Lufkin’s children had been seven years without Bethlem’s assistance in caring for her. ‘Ever since she left London she has been in a very Creditable Famaly [sic] where she is treated with the greatest kindness and has every Indulgence a person in her Situation can have, and where we can see her as often as we please as the Distance is only half a mile from our own Famaly.’ What would they do, then, with Bethlem’s renewed offer of help?

‘Although it is a very heavy Expence’, John Lufkin continued, ‘we hope with the Blessing of God to be able to support her till it shall please the Lord to release her from her heavy affliction, for can we do two [sic] much for a good Parent’? That John Lufkin’s filial devotion was shot through with practicality is evidenced by the next (and effectively last) line of his letter: ‘Sir, if we omit this opportunity and if at a futer [sic] time any thing unforeseen should happen so that we find the Expence more than we are able to support, could she then at a Vacancy be admitted’? No record survives of the answer given by the Hospital, but we may surmise that, if that it stuck by its rules, the answer would probably have been ‘No’.

Getting into Georgian Bethlem 2

Correspondence between two eighteenth century solicitors, currently being edited for publication by the Sussex Record Society, provides an unexpected insight into how the rules of admission to Bethlem Hospital (described in an earlier post) functioned in practice at that time. We are grateful to the editor of these letters for drawing our attention to this example, and for permission to cite it here.

On 12 November 1745, James Collier of Hastings wrote to John Collier ‘in relation to the unhappy affair of Mary Cousens, whom my uncle and I though a proper person’ for admission to Bethlem.

‘I shall be able I beleive [sic] to have some respite in regard to her removal, and when the committee are known, shall endeavour to get her minuted down for the ward of the incurables which depends principally upon the report of Dr Monro; and I am glad to find that our case, viz. a raving madness, is a circumstance that particularly induces the committee to send such poor people there.’

In seeking a place for Mary Cousens at Bethlem, Mr Collier was acting as a professional agent of the Hastings authorities legally and financially responsible for the care of all ‘pauper lunatics’ resident within their parish boundaries. His communications with Bethlem’s Physician, Dr Monro, seem to have been conducted via a third party. At any rate, he had been poorly advised. As noted in the previous post in this series, in the ordinary course of events patients were not admitted directly to the ‘incurable’ department, and people judged ‘incurable’ would not be admitted to the Hospital in the first place.

While he hoped for a Bethlem admission for Mary, James Collier did not put all his eggs in one basket. ‘By next post, I shall be able to acquaint you with certainty what will be done as to Guy’s hospital,’ his letter to John continues. ‘They never suffer anybody to enter there, who has once been in bedlam, and I am afraid private madhouses will be attended with great expence.’

How did matters turn out? From a second letter, written by James Collier to John nine days later, it appears that Mary lived under Bethlem’s roof while being assessed for admission, but was not in the event admitted. ‘Mary Cousens is not as yet removed out of Bethlem hospitall [sic], but it is impossible to get her continued there’, he writes. ‘Mr Alnright of Lambeth marsh will take her for one month upon trial for 8sh per week, but if her distemper is such as to require a more than ordinary attendance, he will have more.’ With an eye to parish finances, Mr Collier would have preferred Bethlem to relent, an outcome for which he continued to hope against hope. ‘I don’t despair at present of getting her minuted down in the list of persons who are to supply the vacancys in the ward of incurables.’ In the event, however, Mary Cousens’ name does not appear in any of the Hospital’s admission registers, incurable or otherwise. Where she went, we cannot say.

The Bethlem Tapestry: World Mental Health Day 2010

A new exhibition is now open at the Bethlem Gallery, the result of a project led by artist Mark McGowan, and involving patients, staff, volunteers and carers at the Bethlem Royal Hospital Psychosis Unit. The tapestry, the culmination of a six month project initiated by Consultant Psychiatrist, Dr Sukhi Shergill, has been created on ten metres of stretched silk. It is comprised of images and text made by the participants depicting experiences, thoughts and feelings in their daily lives over the period of the project and will be permanently installed on the ward for the long-term enjoyment of patients, visitors and staff.

Well-known London performance artist, Mark McGowan is a former patient of the Bethlem Royal Hospital. Mark described the tapestry project as an opportunity to give something back to the Bethlem Royal Hospital, part of the South London & Maudsley NHS Foundation Trust (SLaM). “I was very ill and came to SLaM in a really bad state. As a patient I was given access to the arts facilities and never looked back.”

Since leaving the Bethlem, Mark went on to complete an art degree and now teaches at Chelsea & Camberwell Colleges of Art, having travelled the world through his art projects. The Bethlem Tapestry has proved popular with patients and staff. Ken, a patient on the Psychosis Unit, said the project made him feel happier and more relaxed, “Anyone was welcome to join in, we had something to do, something productive using the imagination.”

The exhibition coincides with World Mental Health Day on 10 October 2010: the Gallery and Museum will both be open on Saturday 9 October in celebration. Running since 1992, World Mental Health Day aims to promote greater public awareness and understanding of mental health and mental illness.

Exhibition open: 23rd September – 15th October 2010

Wed, Thurs, Friday, 11am – 6pm
(including Saturday 9th October 11am – 6pm, celebrating World Mental Health Day 2010)

For travel information, visit the Bethlem Gallery website.

The Bethlem Tapestry_Holly's image_small2

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.