Monday, 16 January 2017

Bedlam and Ballyhoo.

"The world is a great bedlam where those that are more mad look up to those who are less" - Thomas Tyron, English author, merchant, and early advocate of vegetarianism, 1689.

I was back at the Wellcome Collection. They were hosting a free, and incredibly popular, exhibition about the history of mental asylums and, particularly, that of the Bethlem Royal Hospital. Founded in 1247, during the reign of Henry III, just outside the walls of London and not far from where Liverpool Street station now stands. The name Bethlem gave way to the term 'bedlam' and all of its connotations.

The history part of the exhibition has been interspersed with modern art pieces relevant to the subject. I'm not entirely sure they work. I certainly didn't think it was a great idea to have the entire first room devoted to one. Eva Kotatkora's Asylum (2014) consisted of books, cages, collages of trapped people, grotesques, and poems. It wasn't that it was bad. It just wasn't what I had expected - and, without seeing the other rooms first, didn't have much context.

You pass by a film showing the procession of St Dymphna, the patron saint of the 'mentally distracted'. Dymphna was, according to legend, a 7th century Irish princess. Her mother died and her father Damon made a vow that he would only remarry if he found a woman as beautiful as his wife. Trouble is the only woman who fitted that bill was his daughter. So Dymphna fled to Geel in Flanders. There she built a hospice for the sick and poor of the region. When her father found out where she was he too travelled to Flanders where he cut her head off with a sword. Mental illness or strong religious beliefs? As if they're different things.

Her shrine now stands in Geel and often people with mental illness, or even epilepsy, were taken there to find a miracle cure. In another remarkable example of Christian inhumanity often those who were not cured (which would have been pretty much all of them) were just left there to fend for themselves. Obviously they'd just not prayed hard enough. Come on, meet God halfway.

Those who'd not been left in Belgium to fend for themselves didn't have it particularly easy either. A history of the three different Bethlem institutions speaks volumes about how much our attitudes to mental illnesses have changed - and how far they still have to go.

Bethlem's moved about a bit. In the 1600s, when located near London Wall, it was open to public visitors and was part of a popular tour of the capital city. See the zoo, the tower, the royal palaces, but don't forget the nutcases! In the 18c it was located in Moorfields and known, officially, as a 'madhouse'. Southwark, in the building that now houses the Imperial War Museum, was the site of Bethlem's 19c 'lunatic asylum'. Victorian asylums were, predictably, as class ridden as society itself. By the last century, in Beckenham, the preferred term had become 'mental hospital'.

Jacobean dramas and masques would incorporate stock characters representing inmates and inmates would've been the correct word in the 17c as madness was defined, in those days, by law and not medicine. The fact that the Vagrancy Acts of 1714 and 1744 made it a crime to whip mad people gives you some idea of how lowly sufferers were viewed and how badly they were treated. One 'inmate', James Norris, was chained to the wall by his neck for ten years.

About the first sign of positivity comes with the story of Huguenot tea broker James Tilly Matthews. Matthews was believed to the be the first fully documented sufferer of paranoid schizophrenia. He believed. amongst other things, that the then Home Secretary, Lord Liverpool, was involved in a conspiracy to murder him and that gangs of spies were using 'pneumatic chemistry' to read, and influence, people's minds. It's not unclear how or why he improved in Bethlem but it seems that he did and, following that, he came out with some eminently sensible ideas. He proposed that those interned there should, if possible, partake in community work and vegetable planting rather than being locked up. Or chained by the neck to the wall.

This story neatly segues into a section of the exhibition that shows some of the more notable clients of mental institutions. We can see the artist Richard Dadd at work and Van Gogh's etching of his physician Dr Paul Gachet made in the Saint-Remy asylum. There's also patient art from Sergei 'Wolfman' Pankejeff, a patient of Freud, and Adolf Wolfli who spent 35 years in a Bern psychiatric institution. Nijinsky (the ballet dancer, not the racehorse) spent time in and out of asylums. When committed to Burgholzli in Zurich in 1919 he contended, not entirely unreasonably, that as the world was at war he was no madder than everyone else.

Gradually new ideas came in. Some good. Some now discredited. Most still hotly contested. Family care, care in the community, and pharmaceutical alternatives. ECT therapy was introduced in the 1940s and was, initially, often administered without either consent or anaesthetic. The New York 'personal care' company seem to, in retrospect, have existed just for this exhibition. As well as providing drugs to mental health sufferers they commissioned Salvador Dali's Crisalida.

In 1961, around the time of the further advent of tranquilizers like Valium/Diazepam and Miltown/Meprobomate, the then minister for health, Enoch Powell, announced the phasing out of mental hospitals and many were, indeed, closed. Often sold on to be converted into luxury flats. Some things never change.

Thinkers began to approach mental health from new angles. R D Laing, the psychiatrist, saw schizophrenia not as a disease but as an understandable way of coping with unbearable situations. The philosopher Michel Foucault went even further suggesting that asylums had become a handy way for society to suppress, or silence, the voices of the mad. The neurologist Franco Basaglia proposed the dismantling of all psychiatric hospitals in his native Italy. In 1978 the Basaglia Law was passed and the state ones, at least, were all closed down.

Elsewhere people were looking to cognitive behavioural therapy, traditional Chinese medicine, herbal remedies, and, worst of all, homeopathy. A post-truth medicine if ever there was one. Music and dance didn't cure but at least alleviated the worst of symptoms in many patients. Benjamin Franklin played a glass armonica to Izabella, Countess Fleming. The Polish noblewoman was quoted as saying "The music made a strong impression on me. In that moment I was cured of my melancholia".

Bethlem's 350 beds are situated in Bromley now. The current preferred term is psychiatric hospital. That sounds much better than madhouse or lunatic asylum but who's to say how our descendants will look back on the way our society treated those with mental health issues. Certainly the way the present government are intentionally seeking to destroy the NHS doesn't bode well for the future.

This was a fascinating look at mental health history. It probably didn't need so many architectural models and the modern art, like Javier Tellez's 'psychiatric' chess pieces, were more of a distraction than anything. Rather than end on the negative state of affairs as regards our current health service I'll leave you with the heartwarming news that, following in the footsteps of Vincent Van Gogh, Bethlem now has a resident artist and patient in Mr X. That's one of his cardboard vehicular structures at the bottom of the piece. To your health.

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