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Sylvia visited Dr. Thornton at his Commonwealth Avenue office in Boston for her first psychiatric appointment, which, according to Aurelia, took place on July 21.44 Aurelia described Thornton as young, “handsome but opinionated.”45 Sylvia disliked him immediately—his arrogance reminded her too much of Dick. In The Bell Jar, Esther hopes that her new psychiatrist will “help me, step by step, to be myself again.” But when she reveals to Dr. Gordon that she cannot eat, sleep, or read, he responds, “Where did you say you went to college?” Esther is “baffled” by the question, but answers him. “Ah!” he responds, “I remember your college well. I was up there, during the war. They had a WAC station, didn’t they?” He tells her “they were a pretty bunch of girls,” and laughs.46 Esther has not washed or changed her clothes in three weeks, and Dr. Gordon’s comment makes her feel utterly miserable. In real life, Sylvia had one more appointment with Dr. Thornton on July 27. After these visits, according to Aurelia, “she began to regress.”47 The young doctor recommended shock treatment. Dr. Francis de Marneffe, director emeritus of McLean Hospital, recalled that such a suggestion was not unusual in the early 1950s, even after only one psychiatric session. “Even then there was somewhat of a dividing line between ourselves and what we call the shock artists—people who were basically committed to shock treatment and saw that as a treatment of choice.”48 Aurelia despaired. “I felt so inadequate, so alone.”49
Would Dr. Thornton have recommended shock therapy on a brainy but depressed Yale man after just two outpatient sessions? In The Bell Jar, Esther is nearly catatonic after she comes home from New York City. She refers to herself as a zombie, and tells her family doctor that she can no longer read, write, or sleep. Yet according to Plath’s calendar, she did not begin to suffer from full-blown insomnia until after she began seeing Dr. Thornton, who seems only to have increased her anxiety. Sylvia was depressed, but she had not experienced a psychotic break with reality. Mrs. Prouty found her charming at her July 27 dinner party and, like Gordon, had no idea how badly she was suffering.
The Bell Jar exposed not only the horrors of Plath’s own early psychiatric treatment but the treatment of women psychiatric patients generally. The novel is usually read as a coming-of-age tale—a female Catcher in the Rye—but it is also an eloquent and prescient work of social protest by an emboldened voice of dissent. (Dr. Ruth Beuscher, Plath’s psychiatrist, later said the novel was a “pretty accurate” report about Plath’s time at McLean.)50 When Sylvia began seeing Dr. Thornton, 91 percent of psychiatrists belonging to the American Psychiatric Association were men, as were 85 percent of clinical psychologists.51 Psychiatry, like much of medicine, was an inherently sexist institution in the early fifties. Medical historians have suggested that male psychiatrists were trained to regard high ambition and strong will in women as pathological: the unspoken idea was that “only men can be mentally healthy.”52 In the 1950s, women’s discharge from mental hospitals often hinged on their desire to resume their feminine duties as wives and mothers. Those “who refused to function domestically, in terms of cleaning, cooking, childcare and shopping” when they returned home, as one 1961 study showed, were often recommitted.53 Indeed, a promotional article for McLean that appeared in The Boston Globe in 1964 outlined a situation where a middle-class wife might benefit from a short McLean stay: “She is irritable and impatient with her husband and children. She thinks she can’t cook any longer or take care of household duties.” The article showed a photograph of the woman’s “therapy”: cooking in the McLean kitchen. She is released when she is “better able to handle” her “home responsibilities” and to continue her “voluntary job as a typist.”54 The article depicts with brutal accuracy the pre-Friedan equation of female “sanity” with domestic proficiency. Indeed, the term “depression” was not used in most British and American women’s magazines in the 1950s. Articles referred instead to “nervous exhaustion,” “mental conflict,” or “anxiety and nervous tension.”55 These were the types of phrases Aurelia would supply to reporters from The Boston Globe when Sylvia went missing in August. It is probably no accident that The Bell Jar’s heroine Esther Greenwood shares the same name as the unjustly maligned woman in Charlotte Perkins Gilman’s feminist short story, “An Unnatural Mother.” Esther’s literary ambitions make her appear “unnatural” to her male doctors, and Plath wrote the novel in 1961 when she herself was struggling to balance motherhood and writing.
On July 29, Aurelia’s neighbor Betty Aldrich drove Aurelia and Sylvia to Valley Head Hospital, about thirty minutes north of Wellesley in the sleepy, affluent town of Carlisle. Valley Head was a genteel hospital for the well heeled, filled with private rooms, Oriental rugs, and ornate wooden furniture. It was where President John F. Kennedy sent his wife, Jackie, for electroshock treatment after a particularly brutal fight about his infidelity. Dr. de Marneffe claimed that in the 1950s Valley Head was a place where “shock artists” practiced electroshock treatment “for profit, short term”: “Valley Head had the worst reputation among the psychiatric hospitals in the Boston area.”56 There, Sylvia was led into the place that would remain etched in her memory as a chamber of horrors: the shock unit.
In 1953, electroshock treatment was still in its infancy. Developed in 1938, it had been in use for only fifteen years and was, according to a McLean Hospital historian, “crude” therapy, “often unpleasant and frightening for patients.”57 The procedure involved placing electrodes on the temples and shooting an electric current into the brain to induce a seizure. The hope was that the force of the shock and accompanying convulsion would “reboot” the brain and cure mental disease. The founder of the treatment, a neurologist named Ugo Cerletti, had observed slaughterhouse pigs being “shocked” and anesthetized before their death and wondered if the procedure might help humans. He eventually tried it on schizophrenic patients, with promising results—partly because the memory loss that accompanied the treatment often wiped away patients’ fear of it.
Today electroshock treatment is often used successfully to alleviate the suffering of the severely depressed. But shock treatment was not well regulated or well understood in the early fifties. The doses of electricity were much higher than they are today, as was the frequency of treatments. And the instruments were crude. Plath was given no anesthetic or muscle relaxant to help prevent the convulsive muscle spasms that often resulted in bone fractures during shock treatment. This was not atypical for the time, Dr. de Marneffe noted. He remembered attending several shock treatments in the early 1950s when patients “sometimes broke their backs, quite often actually, and fractured the vertebrae.”58
Sylvia woke up alone after the procedure, which felt like an electrocution, and was returned to her mother in the waiting room. There was apparently no talk therapy between sessions, just a prescription for sleeping pills later administered by Dr. Kenneth Tillotson, who took over the treatments after Dr. Thornton went on vacation. (Tillotson was a former head psychiatrist at McLean Hospital but had retreated to private practice in 1949 after a sex scandal involving a nurse.) “Many of the horror stories the public eventually heard about ECT and lobotomy came out of institutions where such therapies were wantonly prescribed and inexpertly administered,” wrote McLean’s historian.59 According to Dr. de Marneffe—once the most preeminent psychiatrist in Boston—Plath was a casualty of such wantonness. Her 1961 notes on The Bell Jar—“Doctor Gordon Fictional, though botched shock treatment real”60—show that she based Esther’s shock treatment on her own horrific experience:
Doctor Gordon was fitting two metal plates on either side of my head. He buckled them into place with a strap that dented my forehead, and gave me a wire to bite.
I shut my eyes.
There was a brief silence, like an indrawn breath.
Then something bent down and took hold of me and shook me like the end of the world. Whee-ee-ee-ee-ee, it shrilled, through an air crackling with blue light, and with each flash a gr
eat jolt drubbed me till I thought my bones would break and the sap fly out of me like a split plant.
I wondered what terrible thing it was I had done.61
Plath was not the first woman author to regard electroshock as, in Elaine Showalter’s words, “punishment for intellectual ambition, domestic defiance and sexual autonomy”: she was drawing on other women’s asylum narratives, such as Mary Jane Ward’s popular 1946 novel, The Snake-Pit.62 Ward’s protagonist also wonders, “Was my crime so great?” as she receives shock treatment.63 Later, Sylvia told Mrs. Cantor that her psychiatrist had told her with “brutal frankness” “how screwed up she was—hence the necessity for shocks.”64
In The Bell Jar, after her first procedure, Esther tells her mother that she is “through” with Dr. Gordon. Sylvia was not so lucky. She noted in her calendar that she had another shock treatment on July 31, the day after a family outing in Seabrook, New Hampshire, with her uncle Frank and aunt Louise.65 Sylvia had four treatments under Dr. Thornton and Dr. Tillotson.66
Four months after Plath tried to end her life, she wrote lucidly to Eddie Cohen about her motivations for suicide. Her “badly-given” shock treatments had been a “traumatic experience” that shattered her sense of safety and trust in her mother.67 Sylvia told Eddie she foresaw
an eternity of hell for the rest of my life in a mental hospital, and I was going to make use of my last ounce of free choice and choose a quick clean ending. I figured that in the long run it would be more merciful and inexpensive to my family; instead of an indefinite and expensive incarceration of a favorite daughter in the cell of a State San, instead of the misery and disillusion of sixty odd years of mental vacuum, of physical squalor—I would spare them all by ending everything at the height of my so-called career…still a memory at least that would be worthwhile.68
Later, in May 1962, Plath wrote in a progress report on The Bell Jar how “Esther’s shock treatment goes wrong: there is not enough voltage and she is conscious during it, feels as if she were being electrocuted, thinks shock treatments are supposed to be like that, and says nothing. She resolves to kill herself, rather than suffer another.”69 There is nothing paranoid about Plath’s analysis of Esther’s and her own situation. She did not know that electroshock therapy could be more safely and effectively administered, or that Mrs. Prouty would be willing to pay for her treatment at a luxurious private hospital. She saw instead a lifetime of incarceration and torture at the hands of arrogant and uncaring doctors.
After Plath’s suicide attempt on August 24, Prouty wrote a scathing letter to Dr. Thornton about his botched electroshock treatment:
Unfortunately the shock treatments at Valley Head proved disastrous, as you know. Sylvia was not hospitalized during the treatments and her experience and memory of the shock treatments led to her desperate act. I realize that you left on vacation during the course of the treatments, but the fact remains that she was not properly protected against the results of the treatments, which were so poorly given that the patient remembers the details with horror. I feel very strongly that Sylvia should have been guarded against what happened, while she was undergoing the shock treatments. I think her attempt at suicide was due largely to the horror of what she remembers of the shock treatments, and the fears aroused….I would like to hear from you in regard to this….Have you no interest in a case that had such a disaster following your treatment of her?70
Prouty had hit a nerve. Three days later, a riled Dr. Thornton wrote her an angry, condescending reply. He called her “psychiatrically ignorant” and her opinions “worthless.” He claimed that Plath had responded favorably to the treatments—an outrageous professional claim given Plath’s subsequent suicide attempt. He hoped his letter would “stimulate” her to learn more about psychiatry, and asked her not to “burden” his office with “any further communication.”71 Still, Thornton agreed to cut his bill in half—the closest he would come to an apology.72 Seven years later, in her poem “The Hanging Man,” Plath would likewise suggest that her botched electroshock treatment led to her first suicide attempt:
By the roots of my hair some god got hold of me.
I sizzled in his blue volts like a desert prophet.
The nights snapped out of sight like a lizard’s eyelid:
A world of bald white days in a shadeless socket.
A vulturous boredom pinned me in this tree.
If he were I, he would do what I did.
Dr. Thornton’s and Dr. Tillotson’s treatments at best had no effect on Sylvia’s depression and at worst exacerbated it. She later told her Smith friend Ellie Friedman about how she had been “electrocuted”: “What this was from all that she told me was terror and pain….they would wheel her down, and they would electrocute her….She told me that it was like being murdered, it was the most horrific thing in the world for her. She said, ‘If this should ever happen to me again, I will kill myself.’ ”73 Sylvia despised Dr. Thornton and dreaded the procedure, but she submitted to it because she had no choice, fearing that if she resisted her shock treatments she would be institutionalized; in 1953, this was a very real possibility. (Indeed, the number of American psychiatric inpatients peaked in 1953 at a little over 500,000.) She was at the mercy of a patriarchal medical system that assumed that highly ambitious, strong-willed women were neurotic. As women, she and her mother had no power to defy the system: the doctor knew best. Indeed, Aurelia allowed Dr. Thornton to administer the shock treatments despite her own misgivings about both his inexperience and the procedure itself.
Peter Aldrich remembered his mother telling him “that Sylvia really hated to go, but she knew she had to. Sometimes Aurelia had to force her into the car. I thought: What are they doing to her?…My only glimpse of her after a treatment was one day when she was coming out of my mother’s car and she seemed uncharacteristically lifeless. It was just not like her and I thought to myself, ‘That’s not Sylvia.’ What had they done to her?”74 Sylvia seemed “subdued,” he remembered, “out of it,” almost like a “zombie.”75 Peter remembered that after treatments she would disappear inside the house for hours, which was unusual, as she normally spent so much time outside sunbathing. His mother, Betty Aldrich (Dodo Conway in The Bell Jar), “hated” driving Sylvia and Aurelia to Valley Head, but she felt sorry for the family and did what she could to help.76
Aurelia and Betty had grown friendly over the years. Both were educated women—Betty had a master’s degree in literature from Radcliffe—and Sylvia and Aurelia were regular visitors to her home.77 (Betty and her husband later visited Sylvia and Ted in England.) Aurelia was always “discreet” about her problems, but she confided to Betty about Sylvia’s depression and her own financial worries. Peter remembered that Aurelia seemed lonely and did not have many friends besides his mother, who found her “sweet, but an odd duck.” To him, Aurelia resembled a character out of the 1930s, with her stiff woolen suits and low-heeled, tightly laced Oxfords. He remembered her and Sylvia’s grandparents as reserved and quiet. Yet Aurelia was hospitable and considerate, always bringing him homemade apple strudel on his birthday. Peter spent many afternoons at the Plath home with Warren, who taught him to make model airplanes, and he sensed that Aurelia had an easier relationship with her son. Their conversations were not marked by the tense exchanges he sometimes overheard between mother and daughter. Later, he wondered if such tension was due to Aurelia’s confusion about how to handle Sylvia’s “freer” instincts—her sunbathing in the driveway (which left him “agog”) and her many boyfriends. When Sylvia went missing that August, Peter was one of the neighborhood kids who helped Warren search the woods around Elmwood Road.78
Despite her recent trauma, Sylvia continued to socialize throughout July and early August. She visited Cambridge, played tennis, attended parties, saw Marcia, danced at the nearby Totem Pole club, went to the beach with her friend Pat O’Neil, and dined at the Cantors’. In her cal
endar she recorded an appointment with Dr. Tillotson at four p.m. on August 12, and “cocktails, 6 pm.” She was trying to keep busy. But in mid-August the calendar goes blank, except for two small words on August 17: “call marty”—her nickname for Marcia.
Still, she managed to write to Myron on August 18. Her tone was upbeat and gracious as she congratulated him on his promotion to a better baseball team. But there were hints of unease: “Life here has been very placid…I had to give up the idea of summer school this year because life at home demanded attention: the doctors ordered me to take time off and rest, and so I have been helping with the house, visiting Cambridge occasionally, and taking a few trips to the beach.”79 Around August 20 or 21, Sylvia had dinner with Marcia in Boston. Sylvia spoke of her “terrible frustration of not being able to write, her powerlessness before the need that she couldn’t fulfill. She couldn’t sleep, was miserably unhappy….She had very deep circles under her eyes.” She looked, to Marcia, the way she did when she had a sinus infection. “Perhaps twice each winter she was flattened by one of these things. Flat in the sense of flat on her back and flat emotionally—just lacking in everything—‘Don’t speak to me till I’m better—leave me alone.’ ” Marcia considered conferring with Aurelia, but (perhaps remembering her Wylie) she was afraid Aurelia would “smother the hell out of Sylvia.” She called Sylvia often, but did not “appreciate the gravity of the situation.”80