Posts Tagged 'first person narratives'

First Person Narratives 7

Gail Hornstein, Professor of Psychology at Mount Holyoake College and sometime visitor to the Archives & Museum, makes passing reference to our modest displays (though not to her visit) in her recent book Agnes’ Jacket: A Psychologist’s Search for the Meanings of Madness. She is also the author of To Redeem One Person is to Redeem the World, a biography of the psychiatrist Frieda Fromm-Reichmann. Fromm-Reichmann is most well-known today for being the real-life “Dr Fried” in Joanne Greenberg’s fictionalised autobiography, I Never Promised You a Rose Garden, about which we have previously blogged. A Jewish psychoanalyst, who emigrated to America in the 1930s, Frieda Fromm-Reichmann controversially – but apparently, at least in some cases, successfully – treated schizophrenia with psychotherapy (and not medication).

Dr Hornstein has recently made the latest edition of her bibliography of ‘first person narratives of madness’ available on her website. We think we have spotted at least one unchecked (and uncheckable!) reference in this bibliography. Alas, as far as we know the existence of a 1620 Petition of the Poor Distracted Folk of Bedlam is no more than a rumour. Naturally, we would be delighted to be proved wrong about this! The bibliography is nevertheless an extremely valuable resource for those interested in first person narratives of mental distress.

Moving from first to third person narratives, we are glad to say that a short e-book entitled Illustrious Company: Authors, Artists and Other Adventurers in Bethlem Hospital is now available for download onto Kindle e-readers at Amazon and Amazon UK. It has been written by our Archivist with contributions from Canadian authors Aislinn Hunter and Lesley Krueger. Regular readers of this blog may recognise some but not all of its text. The book is already cheap to download, but watch out for special promotions to make it even cheaper over the summer.

First Person Narratives 6

A late addition to an in-principle never-ending series. In Depression and How To Survive It (Arrow Books, 1994), co-authored by Spike Milligan and Anthony Clare, there is a rare insight into late twentieth century psychiatric recordkeeping practice. In it Milligan, the writer and comedian of affectionate memory, allowed Clare, a Maudsley-trained psychiatrist, to lay out his life in the form of a typical psychiatric assessment, with details of his presenting symptoms, his personal, family, educational, medical, marital and psychiatric history, and diagnosis. As it happens, Milligan was never a Maudsley patient – he was interviewed by Clare on the BBC radio series In the Psychiatrist’s Chair – and even if he was, records such as these would be protected by the law of medical confidence. His courageous decision to put these details on record, in the interests of demystifying the experience of depression, had the secondary effect of bringing Maudsley medical recordkeeping practice, the results of which are otherwise kept confidential, into the public sphere.

As useful as third-party medical professional analyses of the experience of depression may be for clinical purposes, no-one pretends that they may stand in for the often poignant narratives of those who suffer from it. Depression and How To Survive It opens with a poem (entitled Manic Depression) written by Milligan when a patient of St Luke’s Hospital in Muswell Hill in the early 1950s. This piece, along with other poetic cris de couer, featured in a recent BBC radio programme entitled Spike Milligan – The Serious Poet (available to UK listeners via iPlayer until 20 November). In the programme, a recording of Spike reading his poem The Journey (starting ‘I think I am going out of my mind / The journey shouldn’t take long’) was played, but only in extract. On the morning in February 2002 that his death was announced on BBC radio, the clip was played to its bleak conclusion, Milligan rasping the lines (‘A white-washed nurse / a tray of NHS food … / it’s my stomach they’re treating / letting my head starve to death’). Unmatchably authentic, these lines were in fact written decades before his death, their grim humour attesting simultaneously to his comic genius and his periodic mental torture.

First Person Narratives 5

In August and September we published a string of posted entitled First Person Narratives. Today we present a short coda to this sequence; although in truth a series like this could go on and on. Last weekend’s Guardian drew attention to the story of the painter Kim Noble, the woman with 100 personalities. She has written a book charting her experience of dissociative identity disorder, one of the most contested psychiatric diagnoses of the nearly 300 that appear in the fourth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders. ‘I don’t ever know if I am coming or going’, she told the Guardian journalist. ‘I could switch [identities] at a door, like at the doctor’s surgery, and think, ‘Have I just been in?’

Coming or Going Man is the poignant title Kim (or ‘Abi’) gave to one of the works of art she contributed to the Outside In exhibition at Pallant House Gallery in 2009. It has since come into our collection here at the Archives & Museum. All of Me: My Incredible Story of How I Learned to Live with the Many Personalities Sharing my Body is published today by Piatkus Books.

First Person Narratives 4: ‘One Good Year’ Part 2

The remainder of Jackie Hopson’s account, One Good Year: Being an in-patient in the Charles Hood Unit, Bethlem Royal Hospital, 1974 -1975 follows (to read part one, click here):

Something new for me, after the long, inactive days in county asylums, was occupational therapy, of which there were four sessions each week, one of them being entitled, “Social Skills”.  I particularly remember the well-equipped pottery workshop (I still have a dish I made at Bethlem by my bedside, 35 years later).  There were two gruelling but productive afternoon sessions on Wednesdays and Thursdays: these were Psychodrama (role-play, improvisation, reading dramatic texts and dance), led by the inspirational Miriam Plummer, and Art Therapy.  On Fridays, there was a large meeting of all patients and staff (medical, OT and social work) together in the big room.  We who were patients were involved in decision-making.  On one evening each week, one or two patients would collaborate to cook an evening meal for all patients and those staff who could come, which often included the consultant psychiatrist.  All of this was very different from the “them and us” set-up of the county asylums, where the staff members were, on the whole, more like prison wardens, who most certainly didn’t fraternise with patients or relate to us in any way that wasn’t disciplinary.

Because we lived in a hostel, slightly apart from the main hospital, I didn’t feel like an in-patient.  We went out to the supermarket, the pub (sometimes meeting escapee alcoholics from another Bethlem ward) and to the shops in Croydon.  Friends visited us in the hostel, sometimes staying overnight (though I never discovered the official policy on guests, if indeed there was one.)  All of this normality within our hospital experience made the transition to post-discharge life outside much easier.  We were in charge of much of our own lives, within the safe and tolerant setting of the hospital.

I remember several noteworthy events, some terrifying and others positively joyful.  The freedom and lack of hierarchy could be scary.  After one of us being permanently thrown out of the unit for violent behaviour, the rest of us, alone in the big room, smashed the entire supply of dinner plates against a brick wall.  This was both liberating and very frightening: the nurses left us alone in the ward.  We felt both powerful and scarily uncontained.  Another, more positive, day saw the whole group of eight patients (no staff!) setting off to London to celebrate the 21st birthday of one of our number.  We went to a great restaurant in Greek Street and had enormous fun on the way home, encouraging everyone on the tube train to sing, “Smile, though your heart is breaking.”  (Not many passengers joined in – they clearly thought we were bonkers!)  We were high on normal life and it was wonderful.

Sometimes we behaved like unruly children.  One day in the pottery workshop, the OT potter having left briefly, we had fun throwing lumps of clay at each other and the ceiling.  The OT leader returned to shout, “It’s bloody bedlam in here!” which, of course, increased the hilarity.

I am aware that we were a very privileged group, specially selected and given a most unusual opportunity to receive a rather experimental form of treatment.  My overwhelming memory is that we were considered as human beings with futures that we might realise, rather than psychiatric dregs to be confined, drugged and, at all costs, to be kept away from the “healthy” population outside.  The Charles Hood Unit at Bethlem set me off on a path to believing it might be possible to live.  When I left (I discharged myself, having become impatient with my life being on hold), I felt I was leaving a safe home, better able to cope in the outside world.

First Person Narratives 3: ‘One Good Year’ Part 1

Following on from two recent pieces on first person narratives (here and here), we are extremely grateful to the author of Through the Wasteland, Jackie Hopson, who has written us an account of her experiences at Bethlem’s Charles Hood Unit, entitled One Good Year: Being an in-patient in the Charles Hood Unit, Bethlem Royal Hospital, 1974 -1975, to be posted in two parts. She writes:

Winning a place in the Charles Hood Unit at Bethlem Hospital in 1974 was harder than getting into university and felt to me like a greater achievement.  There were two long and demanding interviews, each time with a roomful of doctors, nurses and social workers.  After the first interview, they sent me away with what seemed an insuperable task: to finish university, get a job and survive for a few months.  I sat down on the platform at King’s Cross Station and cried.  Some months and the second interview later, I was given a place.

Bethlem was very different from the county asylums where I had earlier spent many months.  I felt safe and settled at Bethlem: in other psychiatric hospitals I had felt punished, a prisoner, alert for possibilities of escape, fearful of ever-worsening, harsh, physical treatment and drugged into stupor.  Our time-table at the Charles Hood Unit was demanding but, with a small, supportive group of patients and a very informal, non-hierarchical atmosphere (all staff and patients were known by their first names), life was pleasant and felt pretty normal.  Some eight or so patients lived in a “hostel”, a large, comfortable house called “Winchelsea”, which was, I believe, the former Hospital Governor’s residence.*  We were all roughly between 20 and 35 years old and, almost without exception, well-educated, though some members had dropped out of higher education because of illness.  Every morning, we walked across the field to the Charles Hood Unit, where most of our activities (it didn’t feel like treatment) took place in a huge, light, high, wood-ceilinged room, comfortably furnished and with an adjoining kitchen.  We had lunch provided here by the hospital; breakfast and supper we made for ourselves at the hostel from an in-patient stipend of £4 per week.  This meant we had to shop in the local area and cook, together or individually.  We did our own cleaning and laundry in the house – and had to deal with the tensions that arose among the “tenants”.  We were given no psychotropic medication whatsoever.

As members of this therapeutic community, we had a full, five-day timetable, which ran from 0915 to 1600, except for Fridays, when we finished at 1400.  Many patients then went away for the weekend to friends or family.   Three times each week we sat on the floor in a circle in a small room for a ninety-minute group therapy session which was tape-recorded.  Normally a registrar and a senior nurse were present with the patients, sometimes two nurses; and these staff members might interject personal material, as well as helping us along with frequently very painful issues.  In addition, there were two one-hour hostel group meetings each week to deal with domestic problems, again with staff present: the small group of patients was together pretty much round the clock, so there were difficulties sometimes.  Each of us then had a 45-minute session of individual psychotherapy every week.

*Actually the former residence of the Hospital Steward

First Person Narratives 2

Recently we drew attention to a first-person account of a lifetime of contact with mental health services. Here we take the opportunity to highlight a similar account, this time of the struggle with clinical depression maintained by Annie Altschul (1919-2001), sometime Principal Nursing Tutor at Bethlem and the Maudsley Hospitals and the UK’s first Professor of Psychiatric Nursing. Towards the end of a fêted career (summarised some years ago in the British Journal of Psychiatry), Altschul sought help for a condition into which she confessed she had no insight, despite having ‘nursed patients suffering from all types of depressive illness’, ‘written about depression, and talked to student nurses about it’ over the years.

She writes eloquently about the retrospective insight this experience gave her:

‘It is the positive experience of not being depressed which makes me believe that I had been depressed for much longer than other people are willing to acknowledge…Coming out of depression is something one must experience to understand. It is difficult to describe to others, even to remind myself at this stage what it was like to enjoy music again for the first time, realizing in retrospect that for years I had gone through the motions of enjoying music without the sensuous pleasure of the real thing. The ecstasy of the beauty of spring in the Scottish landscape is another landmark in my recovery which its is difficult to convey to others.’1

In the absence of any guarantee against the return of her depression, Altschul nevertheless lived the remainder of her life well. Her characteristic determination, iconoclastic acumen and dry wit seems to have been joined by a fresh appreciation of life. She inspired a generation of mental health nurses, and if the obituary written by one is anything to go by, she was held in genuine regard by them in return.

1 Vicky Rippiere & Ruth Williams, Wounded Healers: Mental Health Workers’ Experiences of Depression. (Wiley: Chichester, 1985), p. 167.

Altschul[1]

Annie Altschul teaching Bethlem and Maudsley student nurses at Brakespeare House, Dulwich

First Person Narratives 1

Our Archivist and Education & Outreach Officer contributed a paper to a recent conference held to ‘evaluate the clinical encounter, the relationship between doctor and patient, and the language of illness and pain’. While their paper explored the visual ‘language’ of recovery ‘spoken’ by ‘before’ and ‘after’ photographs of English psychiatric patients in the late nineteenth and early twentieth centuries, the conference theme was interpreted in a diversity of ways by various speakers.

First-person written testimony always brings fresh perspective to discussions such as these – we recently drew blog readers’ attention to a case in point – and there is no narrative more engaging than that of Mabel Z. Cunningham, whose memoir, published posthumously as Jeremiah’s Sister, is so scarce that it appears to remain available only in online excerpts, nowhere in hardcopy. (If anyone can locate a library copy, no doubt Ellen Dwyer of Indiana University-Bloomington, the academic who brought this narrative to the attention of conference-goers, would be delighted to hear of it.)

We have just had our attention drawn to an article in the British Medical Journal which we wish we had known about in time for the conference. In Through the Wasteland, Jackie Hopson and Jeremy Holmes reflect on their respective experiences of a shared clinical encounter. Here a journey from a family home described as ‘a dangerous place to be’ through county asylum admission (‘places of fear, punishment and long incarceration’ but also ‘the only refuges available to many’) and referral to Bethlem Hospital’s Charles Hood Unit (‘an excellent therapeutic community’) to an adulthood of light and shade is carefully and honestly recounted. So is a movement away from therapy that actually serves to reinforce self-hatred and the ‘division of suffering’ between doctor and patient towards a long-term relationship of support in which acknowledgement of vulnerability can become a two-way street. Jackie has kindly written a more detailed account of her stay in the Charles Hood Unit, which will be posted later this month.