Gracefully Insane
 Alex Beam
 (Associate Writer & Reviewer - Dr. Alma Bond)
 2002 Public Affairs/Perseus Book Group
  ISBN: 1891620754


A social history of The Rise and Fall of America's Premier Mental Hospital, the McLean Hospital from the time it was founded early in the 19th century to the present day.

The hospital is famous not only for its therapeutic regimen, but also for its artistic & literary landscape, dotted with four-&-five-story Tudor mansions & red brick dormitories. Designed by Frederick Law Olmstead, the designer of New York City's Central Park, the glorious landscape reminds one of the buildings & campus of a university or a well-endowed prep school. There are no fences, guards, or locked gates.

Associate Reviewer Dr. Alma Bond writes:

Gracefully Insane, the title, is taken from a line in a poem that Anne Sexton wrote about the poet Robert Lowell, “I must admire your skill. You are so gracefully insane.” It is a biography of that hospital, as well as an overview of the treatment of mental illness over the years. One of the most famous, elite, & luxurious of mental hospitals, McLean alumni include artists, scholars, writers & musicians, as well as many other notables from the rich & famous.

Olmstead believed in the curative powers of sculptural landscaping, whether for the cramped citizens of New York City, or the wealthy Bostonians recovering from mental illness. McLean presented a radical break with the usual notions of the “lunatic hospital look,” & the design created very comfortable living quarters, twenty of which were private apartments with parlors, bedchambers, & bathrooms. One observer noted that the impression it gave “was of gentlemen's country residences irregularly dispersed in a pastoral landscape” (p. 32).

The accommodations resembled a five-star hotel more than an institution, with oriental rugs, antiques, private bathrooms, tennis courts, gymnasiums, room service, & a cuisine similar to that of the finest restaurants. The hospital has also been described as the “Insane Asylum for the Rich,” & the “Mental Club Med.” Upham Memorial was nicknamed “the Harvard Club,” because at one time all four corner suites were filled with Harvard men. According to historian Sylvia Sutton, “for patients who hailed from a certain stratum of Boston society, McLean looked a lot like home” (p. 32).

Within these pages lie the entire history of the treatment of mental illness. Psychotherapies practiced for over two hundred years all had their heyday at McLean. Electroshock, insulin comas, lobotomies, psychoanalysis, moral treatment, music therapy, hydrotherapy, hypothermia, psychopharmacology, & a weird treatment called “total push,” which forced inmates to get dressed & go for walks whether they wanted to or not. As each fad in psychiatry came & went, these were the treatments of choice.

One patient of Freud's, Dr. Horace Frink, an analyst himself, became famous as the “most disastrously botched case in the annals of psychoanalysis.” Another patient, Carl Liebman, was known as “Freud's failure.” Not only was his analysis unsuccessful, but he also was a veteran of 200 shock treatments, insulin shocks, media therapy, & a lobotomy! Liebman was diagnosed as a paranoid schizophrenic, as evidenced by his fear that he was being followed. Years later, his relatives informed the hospital that they had indeed hired detectives to follow Liebman around. Despite all his “treatments,” he remained insane & a patient at McLean's for the rest of his life.

McLean is also a living museum of Boston culture, that for over a century was synonymous with the culture of America. The buildings are still rife with the names of the wealthy Bostonians whose stay, or that of their relatives, subsidized the hospital. Many famous patients were McLean alumni, such as Robert Lowell, Sylvia Plath, Anne Sexton, Livingston & Kate James, James Taylor, Ray Charles, John Forbes Nash, & almost certainly, William James, & interestingly enough, the designer of McLean, Frederick Law Olmstead himself. According to Diane Middlebrook, “McLean has always held an odd glamour as the hospital of choice for the occasionally mad artists of Boston” (p. 247).

Anne Sexton is a particularly sad case. She gave poetry seminars on Tuesday evenings in the hospital's library to patients, who seemed to improve under them, & even produced some fairly creditable poetry. Then, in “the terrible leveling of mental illness” (p. 168) Ms. Sexton herself was admitted as a patient. One of her former students met her in the North Belknap medium security hall, & said, “She looked so awful...my heart went out to her” (p. 168). Ms. Sexton later committed suicide. Apparently the return of staff as inmates was not considered at all unusual at McLean's. A similar case concerned Dr. Doris Menzer-Benaron, a prominent member of the Boston Psychoanalytic Institute, who had trained some of the McLean doctors. Unfortunately, she, too, eventually was admitted there as a patient.

The hospital reigned as a palace for wealthy madmen until the great revolution in the 1970s, when the explosion of psychopharmacology radically reduced the stay of patients from years to months, or even days. In addition, the cost of a single day's treatment & residence at McLean, increased over the years from five dollars per day to nine hundred & more, so that many of the wealthiest patients no longer could afford years of affluent care & treatment.

Other changes contributed to the transformation of the hospital, such as the establishment of an adolescent wing, complete with Arlington, an accredited high school. Many teenagers were admitted for treatment of drug addiction, & contributed to the “trashing of Upham Memorial,” one of the loveliest of the old buildings which now stands decrepit & abandoned. Yet at least some of the young people seemed to enjoyed their stay at McLean. One girl said, “I love McLean and want to stay here forever.” A day care or outpatient treatment center further changed the ambiance of the hospital, which had “always viewed itself as a high-class hotel for the mentally inflicted” (p. 132).

It is ironic that McLean researchers contributed significantly to the drug revolution, an important factor in the downfall of McLean. As early as 1953, Dr. Willes Bower published the first paper in the United States on clinical trials of Thorazine, an anti-psychotic drug which became the treatment of choice in mental hospitals across America.

McLean, along with many other mental hospitals, has run into lean times in these years of managed care. Insurance companies HMOs, & Medicaid and Medicare have cut back on reimbursement for psychotherapy, & psychopharmacology is now the treatment of choice. The population has declined to less than a third of the number of patients institutionalized in the heyday of the hospital. As a result, it has had to resort to selling off half of its original 250 acres in order to survive. MCOs & politicians now make the financial decisions that determine McLean's future. Although McLean reigned as the kingpin of mental hospitals for centuries, sadly enough, it is now just another institution for the treatment of the emotionally ill.

Gracefully Insane is a well-written & unique book, which includes fascinating & revealing gossip about many well-known people. It is recommended to anyone interested in mental health care, the history of psychiatry, or in the social history of New England.
(04/21/02)

Dr. Alma Bond
2002©Alma Bond
A RebeccasReads.Com Sr. Associate Reviewer

A RebeccasReads author featured in Authors & Books

Reviewer's Bio:
Dr. Alma Halbert Bond is the author of ten published books, including:
The Deadly Jigsaw Puzzle;
The Tree That Could Fly;
Tales Of Psychology (2004);
I Married Dr. Jekyll And Woke Up Mrs. Hyde (2000);
The Autobiography Of Maria Callas, A Novel (1998);
On Becoming A Grandparent: A Diary of Family Discovery (1994);
Who Killed Virginia Woolf? A Psychobiography (1998);
Profiles of Key West (1996).

She recently recorded her new manuscript, Old Age Is A Terminal Illness, as an audio book.

She is also the author of a just published children's picture book called The Tree That Could Fly.

Dr. Bond teaches Psychology & Writing online at WriterSchool.