According to McLean’s 1953 “Report of the Clinical Service,” “The patient is first studied thoroughly, and the situation considered in conference. Hereditary, cultural, sociological, somatic, and personal elements are considered. The problems and assets are evaluated.”35 Patients were not always interviewed. Perhaps because two-thirds of psychiatric patients were women, willingness to cooperate and serve others was considered a sign of progress.36
Dr. Ruth Tiffany Barnhouse Beuscher, a thirty-year-old psychiatric resident at McLean, was assigned to Plath on her admission. Dr. Beuscher had never received formal analytic training and was skeptical of the benefits of psychoanalysis, though her former colleague, Dr. de Marneffe, remembers her practicing what he called psychotherapy.37 In The Bell Jar, Dr. Beuscher becomes Dr. Nolan, who evinces a similar wariness toward Freudian talk therapy. (“I never talked about Egos and Ids with Doctor Nolan,” Esther says.)38 Dr. Beuscher herself delineated the distinction: “The work that Sylvia did with me was ‘therapy’—not ‘analysis.’ Analysis is three to five times a week on a couch, usually. This was less often, face-to-face.”39 When Alfred Stanton took over as McLean’s director in 1955, Dr. Beuscher was deeply dismissive of his psychoanalytic approach, saying, “He hired a bunch of analysts and social workers.” He was reluctant to prescribe the sedative Thorazine, which had come out in 1953–54 and which Dr. Beuscher called “God’s gift to the mental hospital.” She got patients to open up through art and music therapy—drawing had gotten Sylvia to talk, she said. “Others I would say, let’s go for a walk, whatever. I wouldn’t sit there off behind my desk asking foolish questions.”40
Sylvia was one of the first patients that Dr. Beuscher, who arrived as a resident at McLean on July 1, 1953, treated. Plath liked Dr. Beuscher immediately—here, finally, was a female doctor to whom she could relate. Dr. Beuscher thought that Plath’s depression was symptomatic of her inability to reconcile her literary ambition with marriage. She felt that Plath had been “traumatized” by her experience in New York, where her high expectations of women’s professional success had met with “a low-level, stereotypical, superficial version of that.” Beuscher concluded, “This left her with no place to go. She didn’t have any appropriate models.”41
In fact, Dr. Beuscher herself would become the model Plath so badly needed. She was young, stylish, intelligent, and ambitious. Sylvia compared her to Myrna Loy and later called her a mother figure.42 But she was more of a double. Dr. Beuscher suggested as much when she told an interviewer that they “considered themselves two of a kind: Both were child prodigies with high IQs; both were ambitious and determined; both considered themselves ‘intellectual snobs.’ ”43 Dr. Beuscher even had the kind of marriage of true minds Sylvia coveted: her husband was a fellow psychiatric resident at McLean. Beyond offering sympathy and direction, she had something to teach Sylvia about successfully integrating her own seemingly conflicting desires. In The Bell Jar, Plath portrayed her male psychiatrists as men who doled out punishment for “unfeminine” ambition. Ruth Beuscher, alternatively, stood for everything Plath wanted in her own life.
Yet, unbeknownst to Sylvia, Dr. Beuscher had paid a steep price for her own professional freedom. Her father, Donald Grey Barnhouse, was an imposing, influential Presbyterian minister who “dominated” his family.44 Barnhouse was famous in his day: his Bible Study Hour was syndicated on more than one hundred NBC stations nationally, and he founded a successful religious magazine, Eternity. Ruth infuriated him when, at Vassar, she eloped with a Princeton student she had met in her religious youth group. She later graduated from Barnard, then Columbia medical school. While in medical school, she divorced her first husband, with whom she had had two children. Dr. de Marneffe, who described her as “flamboyant,” claimed that she had put herself through medical school by singing and playing the piano in New York nightclubs.45 Such moonlighting may explain why her ex-husband received custody of their children. He made it difficult for her to visit them, and she eventually stopped trying; the decision would haunt her throughout her life. (She resumed her relationship with her daughter years later, but never reconciled with her son.) She met her second husband, William Beuscher, at medical school; that marriage, too, was beset by problems.
By the time Dr. Beuscher met Sylvia, she had severed ties with her father, lost custody of her two young children, and had begun to suspect that her husband was an alcoholic. She was also grieving her mother, who had recently died of cancer. Sylvia, presumably, would not have known any of this, yet the dramatic upheavals in Dr. Beuscher’s life suggest that she was suffering alongside her patient. This was not a cool, clinical relationship, but—as it would turn out—something more symbiotic.
After Dr. Beuscher’s second marriage ended, she left psychiatry and became a practicing Episcopal clergywoman. She had a deep interest in astrology and tarot, which she practiced regularly; she called herself a “white witch.” In 1974, she brought a Plath biographer to a “professional astrologer” who could help her “find Sylvia.”46 By then, Dr. Beuscher’s treatment of Plath had come under scrutiny. She would eventually divulge details about Plath’s treatment to three biographers, most notably Harriet Rosenstein, who never finished her biography. Dr. Beuscher had “clandestinely read all the significant parts of her [Plath’s] McLean Hospital record” out loud into a tape for Rosenstein, and given her “the last few letters” Plath sent to her—fourteen in all, including one Plath wrote a week before her suicide.47 (Beuscher told Rosenstein she had “foolishly” burned most of their correspondence “a year or so before she [Plath] died.”48)
Dr. Beuscher’s flagrant disregard for doctor-patient privacy suggests that she may have violated other professional norms. Dr. de Marneffe said that Dr. Beuscher was “not a good psychiatrist” and was “quite unprofessional and unethical in her treatment of Plath in later years.” Indeed, her “poor treatment” of Plath was an open secret in the psychiatry community, he said. He speculated that Dr. Beuscher needed Sylvia’s friendship as much as Sylvia needed her professional guidance, a suspicion Beuscher herself seemed to confirm when she told Rosenstein that she and Sylvia “went shopping” together and had a sisterly relationship.49 “Whose need was being met?” Dr. de Marneffe wondered.50 Dr. Beuscher continued to treat Sylvia on and off after she returned to Smith, and again when Sylvia and Ted Hughes lived in Boston in 1958–59. She would come to wield enormous influence. It was Dr. Beuscher who convinced Plath to seek a divorce from Hughes in September 1962, and to whom Plath wrote in February 1963 about her desire to “pull up the psychic shroud” and die.51
* * *
PLATH WAS ADMITTED to McLean on September 14. Dr. Beuscher remembered that she “spoke very little spontaneously in initial interviews” and was “preoccupied with the idea that she had been betrayed, that there was no one she could trust.” She felt Plath’s mind was “very active” but that Plath simply did not want to “discuss her thoughts with anyone.”52 Dr. de Marneffe remembered that Plath was initially housed on the first floor of Codman House, which burned down in 2016, and was moved “up” to Women’s Belknap (now South Belknap) when she made progress. (In The Bell Jar, Caplan is based on Codman House, Belsize on Women’s Belknap.) Plath’s notes confirm de Marneffe’s memory: in a 1961 outline of The Bell Jar, she wrote, “Drive in chauffeured car with Mrs. P. [Olive Prouty] to 3rd hospital / Codman—end of hall.”53 Dr. Paul Howard, presumably in consultation with Dr. Beuscher, first suggested a course of sub-coma insulin treatment for Plath—a procedure that required insulin injections three times a day in the hope of a “reaction.”54 The treatment had come to America from Vienna, where Dr. Manfred Sakel had hailed the calming effects of insulin on patients undergoing opiate withdrawal. He experimented with higher doses of insulin on schizophrenic patients, essentially drugging them into a stupor from which they predictably emerged less hostile. The treatment made its way to America and was widely practiced, along with shock treatment, at midcentu
ry. Yet some doctors who prescribed it daily suspected it provided no real cure. Dr. Max Fink, who was the head of the insulin coma unit at Hillside Hospital in Queens from 1952 to 1958, called the treatment “unpleasant and dangerous,” with a mortality rate between 1 percent and 10 percent.55
Plath’s provisional diagnosis upon her admission to McLean was “psychoneurotic disorder, depressive reaction”; her determined diagnosis was “sane.”56 Dr. Beuscher’s own “diagnostic impression” was “delayed adolescent turmoil.”57 On September 18, Sylvia began her three-month course of ambulatory insulin sub-coma treatment, which made her gain significant weight. Her bloated appearance depressed her, and she became listless during her unstructured days. Mrs. Prouty visited her in October and wrote to Dr. Beuscher about her frustration regarding McLean’s lack of routine. “I told Dr. Wood (and I think he agreed with me) that I thought it would be beneficial to Sylvia if she had a definite schedule to follow each day—a routine which divided her day into periods. Each time I have visited her she has dwelt on the long objectless hours spent in her room.”58 Dr. Wood, however, informed Prouty that “schedules for patients was not the method now followed at McLean’s.”59 Occupational therapy was available—Sylvia practiced weaving and pottery—but she was still too depressed to “plan her own day.” Prouty also told Dr. Beuscher that Sylvia felt “isolated” and was “not mixing well with the other patients.” A heavily marked passage in Plath’s copy of William James’s Varieties of Religious Experience suggests her sense of isolation: “And when I laid down, would say, I shall be perhaps in hell before morning….I would many times look on the beasts with envy, wishing with all my heart I was in their place, that I might have no soul to lose…” Next to this passage, Plath wrote in the margin, “cf: McClane yard & fly & cricket.”60 (James himself was rumored to have been a McLean patient.)
When Mrs. Prouty’s pleas fell on deaf ears, she took it upon herself to provide Sylvia with distractions. She encouraged her to use the weaving loom, and asked her to type part of a manuscript. Gordon wrote to Sylvia that she had once made him promise that, whatever happened in his life, he would always read. He lightly suggested that she do the same. But Sylvia was in a daily stupor due to her insulin treatment. She dressed up in a “pretty blue suit” for a drive with Prouty in October, but she seemed depressed about her lack of progress. She derided her weaving attempts as “awful,” though Prouty thought her weaving “the best in the shop…really exquisitely done.” Sylvia’s typing, too, she told Aurelia, was “flawless.”61 Typing Prouty’s manuscript was the one activity that seemed to lift Sylvia’s spirits, and Sylvia asked her for more typing work.
Mrs. Prouty continued to press Dr. Beuscher for more information about Plath, but Beuscher was tight-lipped. She would say only that Sylvia was “a perfectionist—which accounts for her self-deprecation if she fails.”62 This was not news to Aurelia, who, like Prouty, was becoming increasingly suspicious of Beuscher’s methods. “I wonder if you talked with Dr. Beuscher,” Prouty asked Aurelia in late October. “I don’t seem to have very satisfactory talks with her. Do you? She is always in a hurry—even though we have an appointment, she speaks only of superficial details about Sylvia.”63 Dr. Beuscher’s refusal to share details of Sylvia’s treatment was actually progressive for the time; Plath’s male psychiatrists were much more willing to discuss her case.64 Soon Prouty was writing to Dr. William Terhune at the Silver Hill Hospital in Connecticut about the possibility of transferring Sylvia there. Their program was much more structured, and Prouty trusted Dr. Terhune.
Aurelia remained on the sidelines that fall, shocked into submission while Mrs. Prouty managed her daughter’s care. Prouty tried to include her as best she could: “You are Sylvia’s mother & you are the one to decide what is best for her. I want you to express yourself freely to me and to know exactly what is going on in my mind and to share with you all the information the doctors give me.”65 But Aurelia allowed Sylvia’s benefactor to make the relevant decisions. The two women took Sylvia for drives in late October—Prouty brought her out to a local farm stand, while Aurelia took her to visit her aunt Dot. Dr. Beuscher later suggested that Sylvia did not enjoy these outings, nor did she relish visitors, whose well-meaning but oppressive presence often made her feel worse. Mrs. Cantor came and lectured Sylvia about Christian Science principles, while Mr. Crockett played word games with her in an effort to regalvanize her mental agility. He remembered her as “disheveled, and very sad.”66 They did not understand the side effects of her insulin treatment, which embarrassed her.
For Sylvia, the last straw came on her twenty-first birthday, when Aurelia brought her a blooming bouquet of yellow roses, her favorite flowers. Sylvia threw the flowers away, just as Aurelia suspected she would. Plath eventually re-created the scene in The Bell Jar:
That afternoon my mother had brought me the roses.
“Save them for my funeral,” I’d said.
My mother’s face puckered, and she looked ready to cry.
“But Esther, don’t you remember what day it is today?”
“No.”
I thought it might be Saint Valentine’s Day.
“It’s your birthday.”
And that was when I had dumped the roses in the wastebasket.
“That was a silly thing for her to do,” I said to Doctor Nolan.
Doctor Nolan nodded. She seemed to know what I meant.
“I hate her,” I said, and waited for the blow to fall.
But Doctor Nolan only smiled at me as if something had pleased her very, very much, and said, “I suppose you do.”67
Aurelia later wrote to the literary critic Judith Kroll, “I knew in my bones she would in her depressed, negative state of mind find fault with that; but I knew also that if I ignored the day, she would write, ‘Mother saw fit to ignore my 21st birthday’ and make much of that. So I did what my heart prompted me to do—hoping for the miracle that she would understand that I saw this as an illness to be fought through and conquered and that I loved and treasured her.”68 Aurelia also told Kroll that the line in The Bell Jar that Esther attributes to her mother—“We’ll act as if this were a bad dream”—was actually spoken by Mrs. Cantor, who drove Aurelia to visit Sylvia every Saturday.69
Aurelia tried to stay calm and cheerful during her visits. Dr. Lindemann, who had treated Plath earlier at Massachusetts General Hospital, told her, “You must believe in my prognosis: that she will recover completely and you must go to her with a calm center and the true conviction that she will recover—if you wish to help.”70 Under no circumstances should she enter Sylvia’s room “trembling with fear.”71 Aurelia followed his advice to the letter. She tried as best she could to compose herself and suppress her anxiety; she even meditated beforehand so that she would exude strength during her visits. But her placid disposition seemed only to confirm, to Sylvia, the wide gulf between them. When Aurelia asked her daughter about the maternal resentment in her poem “The Disquieting Muses,” Sylvia responded, “Well, whenever you visited me in the hospital, you were always so calm and confident that I would soon recover, I felt you had no conception of the psychological hell I was going through.”72 Aurelia later wrote, “How far my vicarious sharing of her agony went, she never knew—I didn’t want her to know.”73 In fact, the stress of her daughter’s attempted suicide and hospitalization caused Aurelia’s ulcer to worsen. In 1955 she would have a gastrectomy in which three-quarters of her stomach was removed.
When Dr. Beuscher questioned Sylvia about the yellow roses in the wastebasket, she claimed she threw them away because she had no vase. Dr. Beuscher did not believe this explanation and began directing her psychotherapy “to getting her to realize she experiences hostility and to get her to express it some way other than directing it inward.”74 Sylvia finally confessed that she was angry with her mother, and Dr. Beuscher promptly canceled her visiting hours. The move thrilled Sylvia b
ut infuriated Aurelia and Mrs. Prouty, who began to circumvent Dr. Beuscher entirely. Prouty now went straight to Dr. Howard with a written list of questions, which he “answered most painstakingly.”75 Aurelia also began consulting with Dr. Lindemann regularly. Lindemann—who now worked at the Boston Psychopathic Hospital, a rival clinic, but was consulting on Plath’s case—was critical of Plath’s treatment at McLean. He confirmed that Sylvia was inactive, getting “very little sleep,” and “still felt utterly inferior and positive of the hopelessness of her condition.”76 Prouty wrote to Dr. Terhune for a second opinion regarding the treatment methods at McLean, particularly the use of insulin; she had tried to learn about the treatment at her local library, but found nothing.
Mrs. Prouty would spar with other McLean doctors over Plath’s treatment that November and December. She wrote from a position of power, fame, and fortune. Prouty herself had suffered a nervous breakdown and hospitalization as a young woman, and she was determined that Sylvia should get the best treatment. Previous commentators have called Prouty “a meddler,” someone “who seemed to set herself up as a mental health expert.”77 Dr. de Marneffe remembered her in 1953 as “controlling.”78 Yet it is chilling to think what might have happened to Plath had Prouty not paid her expenses at McLean and urged her doctors to give her more attention.
By late November, Mrs. Prouty suspected that Dr. Beuscher was turning Sylvia against her mother. She was deeply cynical about Freudian concepts. To Aurelia she wrote, “You said Sylvia remarked to you last time you were there, ‘Why, I don’t hate you, Mother!’ That reveals what line is being followed—a line familiar to all of us in this age of psychoanalysis.”79 Prouty continued to complain about what she assumed to be McLean’s emphasis on psychoanalysis as opposed to occupational therapy. On a handwritten note in the margin of a letter to Aurelia, she wrote, “I think her depression—attitude and ideas (by ‘ideas’ I mean her continued ‘idea’ that her mind has become ‘empty’ etc. etc.) continue about the same as when she first went to McLean. I feel they—McLean—should have built up her self confidence more [through] planned occupation—and less ‘psychotherapy’ talks about her ‘mother complex’ ‘guilt complex’ and whatnot!”80
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