Dr. Lindemann and Dr. Howard continued to reassure Mrs. Prouty that Sylvia would “recover completely,” that she showed no “psychosis” or “schizophrenia”; they had “no fear the present neurosis will develop into a more serious mental condition.”81 Dr. de Marneffe later said, “I don’t think one would call her borderline, the diagnosis we use these days….She had no delusions. She didn’t seem to be psychotic.”82 Plath’s McLean diagnosis confirms that she entered the institution “sane.”
In November, however, Sylvia had begun withdrawing. On November 10, her “privileges” were revoked—she was no longer allowed to leave or wander McLean’s grounds as she had done previously, and her outgoing mail was censored.83 Dr. Beuscher said Sylvia spoke with her about “the possibility of suicide…[she] feels hopeless about the possibility of recovery.” “There is nothing in my head,” she told Beuscher, who nevertheless felt “some progress is being made.”84 But Sylvia complained to Prouty that November about “her idleness and long objectless hours of nothing-to-do”; she longed “for some kind of simple occupation.” Prouty wrote to Dr. Lindemann that Plath had seemed better in October, but had reverted to her earlier sadness. She told Dr. Wood that she often found Sylvia “wandering listlessly up and down the corridor and when I leave she says she will do the same, as there is nothing else for her to do.”85 Wood defended McLean’s approach, responding that Plath was “an accomplisher” who was “excessively self conscious in her depressed state; and usually tries to put her worst foot forward saying that anything she is doing or thinking is ‘nothing.’ ” He did not want to push her too hard, or make her adhere to “the pressure of a schedule.”86
On November 24, Plath was transferred to Women’s Belknap I, a ward for less disturbed patients, and put on a course of Thorazine, which had just come to McLean.87 The drug made her drowsy and listless. Dr. Beuscher explained that these were normal side-effects, but Sylvia refused to believe her and attributed these distressing symptoms to her own worsening condition. “This makes her feel hopeless,” Beuscher noted. Like her Valley Head shock treatments and her insulin course, Thorazine made Sylvia’s depression worse.88
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When Sylvia began to regress yet again, Mrs. Prouty considered practicalities. In late November, she told Aurelia that she was consulting her lawyer about “the financial situation” and that he would “probably advise a more economical place be found” should Sylvia need long-term care.89 McLean was charging $20 a day, which did not include the price of medications—an extortionate fee, Prouty felt, given the lack of structured activities for patients. She asked Dr. Terhune if Silver Hill Hospital might consider waiving or lowering their fees for Sylvia. They reached a solution in December: on Dr. Lindemann’s advice, Mrs. Prouty and Aurelia visited the Boston Psychopathic Hospital and agreed to transfer Sylvia there. “I did hesitate to expose Sylvia to ward life when she had suffered so intensely in the ward at M.G.H.,” Prouty wrote Dr. Lindemann.90 But she could not support Plath at a luxurious place like McLean indefinitely. The Boston Psychopathic Hospital had an excellent reputation at the time—better than McLean’s—but it was a brick-and-mortar urban psychiatric hospital, not a campus with a golf course. There would be no more private rooms with Persian rugs and views of the hills.
When Mrs. Prouty informed Dr. Wood of her decision, he promptly made “greater effort” to give Sylvia a routine of scheduled activities—just as Prouty had been suggesting since September.91 Dr. Beuscher, too, finally had “a long and satisfying talk” with Aurelia.92 Wood may have believed Plath was better off at McLean, or he may have become tired of losing younger patients to other hospitals. Dr. Howard promised Prouty, who had already paid the hospital $2,500, that McLean would bear all expenses for Plath after January 1. “He explained that they were doing this because they believed she was a very worthwhile person and they had become intensely interested in her case.”93 Howard also told Prouty that they were going to try shock treatment on Plath again. Prouty finally relented; Plath would stay at McLean. She told Aurelia, somewhat ruefully, that Aurelia was now in charge of her daughter’s care.
Aurelia was relieved that Sylvia would stay at McLean, and thought Sylvia was making “good progress” there by early December. “Periodically I still have to battle with myself to combat the waves of terror I feel in connection with this continuing experience,” Aurelia wrote to Mrs. Prouty on December 9. “But it is the help and understanding that you have poured forth so constantly that form the bulwark to which I hold fast.”94
Neither Mrs. Prouty nor Aurelia balked at the prospect of another round of shock treatment. But Plath did. Dr. Beuscher knew Sylvia had a horror of shock treatment from her traumatic experience at Valley Head and that the thought of more rounds was contributing to her depression. In 1985, Dr. Beuscher offered a remarkable admission to the critic Linda Wagner-Martin: “You suggest that my reason for gaining Sylvia’s trust would be to prepare her for shock treatments. This is not accurate. I hoped that shock treatment would not be necessary, but Sylvia’s fear of it made her withhold much important information and many of her feelings lest I would prescribe shock treatment.”95 The psychiatrist’s logic is painfully ironic: Dr. Beuscher prescribed shock treatment because Plath would not admit the depth of her depression lest she prescribe shock treatment. Beuscher said she and Plath “did set up the honor system” regarding shock treatment, meaning full communication and honesty, though Plath suggests otherwise in The Bell Jar.96
In December, Beuscher felt that Plath continued “to be so depressed that suicide appears to be a real risk.”97 She felt Sylvia would become “chronic” without more aggressive treatment.98 “She was just as depressed as when she had walked in,” Beuscher said. “We had talked about a lot of stuff….But she had been in there for months, and Mrs. Prouty was paying the bills—this was going on and on. I discussed it with Paul [Howard], and we decided to try electroshock treatment.”99 Beuscher later revealed that she alone pushed for shock therapy over the concerns of Dr. Lindemann and Dr. Howard, who advised against it. She convinced them “that Sylvia’s overriding sense of guilt and unworthiness could only be purged by the ‘punishment’ of shock treatments.”100
Dr. Beuscher said she decided on the treatment in a desperate effort to break through to her patient. (In 1953 she had approved a lobotomy for one of her schizophrenic patients—an “unhappy” delusional woman who ate cat food—though she admitted that “none of us really liked that treatment.”)101 Dr. de Marneffe confirmed that Plath “did not really cotton on to psychotherapy….there was a consultation with Dr. Paul Howard, and that’s when she started some ECT.”102 Yet de Marneffe claimed that at least part of the reason for Plath’s shock treatment had to do with Prouty’s threat to withdraw financial support: “There was pressure there.” Patients who could afford McLean’s high fees, including his own patient Jane Anderson, “would remain a year, a year and a half in intensive therapy.”103
In The Bell Jar, Esther tells Dr. Nolan about her horrific shock treatment under Dr. Gordon, promising, “If anyone does that to me again I’ll kill myself.” (Sylvia would say the same to her Smith friend Ellie Friedman in 1954.) Dr. Nolan reassures Esther that she won’t have any more shock treatments, but then catches herself: “ ‘Or if you do,’ she amended, ‘I’ll tell you about it beforehand, and I promise it won’t be anything like what you had before.’ ”104 Esther continues to worry that Dr. Nolan will prescribe shock treatments, and begins to doubt the doctor’s professional judgment. “I didn’t see how Doctor Nolan could tell you went to sleep during shock treatment if she’d never had a shock treatment herself. How did she know the person didn’t just look as if he was asleep, while all the time, inside, he was feeling the blue volts and the noise?”105
Dr. Nolan eventually prescribes shock treatment for Esther, but she stays with her and offers comfort before and after the procedure. When Esther awakens, she feels the
bell jar has lifted. “I was open to the circulating air.” Yet Esther also feels betrayed by Dr. Nolan, who does not tell her about the shock treatment until the morning of the procedure. When Dr. Nolan later tells her that she will now have the procedure three times a week, she is terrified and asks, “For how long?” The doctor’s answer is slightly menacing: “ ‘That depends,’ Doctor Nolan said, ‘on you and me.’ ”106 Even in the best consensual relationships between doctor and patient, Plath suggests, the doctor still holds all the power. Dr. Beuscher later claimed that she had worked on preparing Plath for shock treatment “for months.”107 Yet fiction may be closer to fact: Dr. Howard had written Mrs. Prouty in mid-November, “Although electroshock therapy is…a possibility I do not believe, considering her improvement, that it would be good to think of [it] at this time.”108
Sylvia had her first shock treatment on December 10. Dr. Beuscher said that after this first treatment, she “made an apparently dramatic recovery. From that time onward, she felt certain she would be well, was cheerful, thoughtful, cooperative, was no longer suicidal or depressed.”109 But Sylvia was more fearful of this treatment than Dr. Beuscher implied. On December 17, Sylvia sent Aurelia a postcard from McLean saying that she was having her sixth shock treatment “tomorrow,” on Thursday, December 18. “I hope I won’t have any more,” she wrote.110 Dr. Beuscher admitted that after Sylvia’s sixth treatment, “she began to rebel against the shocks and refused to have any more. Was persuaded to have one more, but after that the series was discontinued….Her chief complaint was the recovery period after each treatment, during which she felt keenly her loss of identity.”111
Though Dr. Beuscher stayed with Sylvia during the procedures, as promised, Plath obviously dreaded them. She always would. Two nights before she died, in 1963, she spoke to her friend Jillian Becker about her shock treatments. “It was a horror to her,” Jillian remembered.112 Ted Hughes later wrote to a correspondent that Plath’s “mismanaged” shock therapy “goes straight to the fundamental catastrophe—as she herself understood it.” The experience, he said, had “pervaded everything she was & did.”113 The procedure gave her nightmares, which she described to Eddie Cohen in December: “I need more than anything right now what is, of course, most impossible; someone to love me, to be with me at night when I wake up in shuddering horror and fear of the cement tunnels leading down to the shock room, to comfort me with an assurance that no psychiatrist can quite manage to convey.”114 In her last letter to Dr. Beuscher, sent two days before her suicide, Plath wrote, “What appals [sic] me is the return of my madness, my paralysis, my fear & vision of the worst—cowardly withdrawal, a mental hospital, lobotomies.”115 Her nightmares and terrifying memories strongly suggest Plath developed post-traumatic stress disorder as a result of her shock treatments.
And yet, those treatments administered at McLean seemed to heal—at least in the short term. Dr. Beuscher thought Sylvia made a startlingly quick recovery, as did Sylvia herself. Five years later, Plath was still trying to understand what had made her better. “Why, after the ‘amazingly short’ three or so shock treatments did I rocket uphill?” she wrote in her journal. “Why did I feel I needed to be punished, to punish myself.”116 Dr. Beuscher herself was at a loss to account for the sudden change. “Nobody can explain why Sylvia got over her depression after one or two shock treatments. She just didn’t want to have any more shock treatments, so she reorganized herself inside so she wouldn’t have any more. I never saw it happen with anybody else.”117 (Both underestimated, looking back, the actual number of shock treatments.) Dr. Beuscher was convinced that the procedure had “a psychological significance, apart from whatever shock treatment does to people.” She speculated that Sylvia needed to “be punished for something,” and that when she was, the depression lifted.118 Dr. de Marneffe’s explanation was simpler—he said Plath “responded beautifully” to the treatment.119
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AT McLEAN, Sylvia entered into a competitive relationship with Jane Anderson, a McLean patient and Smith acquaintance. Jane was the inspiration for the character of Joan Gilling, Esther’s doppelgänger in The Bell Jar. As Plath experimented with the double, a favorite Dostoevskian motif, Jane provided a perfect example. The similarities between the two young women were uncanny. Both were high-flying Smith students from Wellesley: Jane had been president of her sophomore class and Sylvia had been elected to Phi Beta Kappa that fall. Both had attended the same Unitarian church and dated Dick Norton. Both had endured breakdowns.
Where they veered, according to Jane, was in their attitude toward treatment. Jane had been at McLean for seven months when Sylvia was admitted, during which time she had embarked on a long course of psychotherapy. She was not discharged until many months after Plath left. When Sylvia was admitted, they forged a tentative friendship; Jane recalled that they “discussed issues of psychological functioning and matters relating to suicide and death.”120 Jane gave Sylvia the newspaper clippings about her disappearance, which she had preserved. (Joan does the same for Esther in The Bell Jar.) But the two began to drift apart. Jane felt that Sylvia wasn’t taking advantage of individual therapy. She tried to convince Plath that therapy “could be helpful to people in dealing with painful feelings so they wouldn’t feel pushed to the point that they had to try to take their own life.”121
According to Jane, Sylvia was dismissive of therapy’s benefits and reluctant to use her “cognitive capabilities to understand what was going on. She seemed to be taking a very passive attitude towards her whole situation.”122 Jane—who eventually sued the Plath estate over her portrayal as a lesbian in a film adaptation of The Bell Jar—felt that Sylvia had gleaned some of her “derisive” ideas about Freudian-style analysis from Dr. Beuscher. She acknowledged that after the shock treatments, Plath “was pretty well cured, as cured as she was going to be.”123 But Jane, who never had shock treatments, felt they were a quick fix that did not address the root cause of depression. Sylvia felt Jane was wasting her time with psychotherapy.
The two women judged each other accordingly, and their friendship cooled, as Dr. de Marneffe—Jane’s psychiatrist for many years—remembered.124 Jane thought that there may have been another source for their falling out, dating from a later point in their relationship: she and Sylvia parted on bad terms when Jane visited her at Cambridge in 1956 and Jane failed to show sufficient enthusiasm for her new fiancé, Ted Hughes. She felt Sylvia had still not confronted her problems deeply enough in psychotherapy, and she wanted to “rescue Sylvia from what Sylvia was doing to herself.”125 The two never spoke again. Dr. de Marneffe thought that Plath’s use of Jane Anderson in The Bell Jar was “an incredible projection onto Joan Gilling” of Sylvia’s own illness.126
In the novel, Esther becomes competitive with Joan about her recovery and feels superior when she makes more progress. “Ever since the shock treatments had ended, after a brief series of five, and I had town privileges, Joan hung about me like a large and breathless fruitfly—as if the sweetness of recovery were something she could suck up by mere nearness….she was confined to grounds again.”127 Sylvia was similarly smug about Jane in a letter to Eddie that December, telling him, “When I entered (in the ‘middle’ ward) she was in the highest-ranking ward (where I am writing from now); a display of temper, however, involving her breaking several windows, involved her ending up in the ‘lowest’ ward, and I haven’t heard from her since.”128 Sylvia dramatized Jane’s relapse in The Bell Jar; just as Esther is due to leave the hospital, she learns that Joan has hanged herself.
Psychoanalytic readings of the novel maintain that Joan’s suicide is a symbolic victory for Esther, and even for Plath herself—that by killing Joan, Plath symbolically “killed off” her depressive, life-threatening double. In real life, however, Jane pursued a rigorous course of psychotherapy at McLean, recovered her mental health, and eventually became a successful psychiatrist. Sylvia, who received little real psychotherapy at McLean a
nd was instead prescribed insulin coma therapy and shock treatment, suffered a fatal relapse in 1963.
There may have been another reason for Sylvia’s quick improvement that December. In November 1953, Gordon sent her some James Joyce poems from Chamber Music and apologized for a comment he had made in July when they were out walking together. His letter provides further context for Plath’s suicide attempt:
You may not remember it, but I have been haunted with the regret and ashamed that I could have said something so small and so stupid. We were talking about the great poets, and I said that the great writers had all been men. I went on to say that “Men creat [sic] art; women create people.” When I think back on it it seems to me such a cras [sic] and mean statement. I was motivated I guess to strike out perversely at you, because I was jealous that you had been able to create so recently and the Muse I felt had left me bereft. As I thought back on that statement I realized that women had not been given any near approximation of the opportunity for learning as man had until practically this century. Also the opportunity to devote oneself to a life of letters was not open to women, and even today there is strong pressure to keep her in the home.129
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