Mad, Bad, and Sad: A History of Women and the Mind Doctors

by Lisa Appignanesi

  Whether or not Zelda was schizophrenic in 1960s terms or not, she certainly couldn’t follow Forel’s injunction about conflict. It couldn’t be avoided, and not only with Scott. Zelda turned out to be Bleuler’s third kind of patient, delicate and eccentric throughout her life, with periods in institutions. These served a double purpose of providing an ordered existence, while removing her from an increasingly difficult life with an alcoholic Scott.

  Another troubled young woman arrived at Prangins not long after Zelda had left. On 30 July 1933, twenty-six-year-old Lucia Joyce, a talented contemporary dancer, sometime member of Paris’s racy Surrealist set, was confined to the asylum on doctors’ advice and with her worried father, James Joyce’s, consent. She stayed just long enough to get Forel’s diagnosis of schizophrenia, reachable by ‘persuasion and suggestion’, before she was taken home again to Paris. Here her frenzied outbursts and violent acts–such as cutting the telephone wires–had her back in the asylum the following February.

  As stormy and uninhibited in temperament as her romantic namesake, Lucia di Lammermoor, Lucia didn’t fare as well as Zelda had under the constant vigilance and order Forel and his staff imposed at Prangins. Far from the attention of her father, the one man in her life who–her biographer Carol Loeb Shloss argues–had any impact on her, Lucia was amenable to neither care nor persuasion. She spent a fair part of her stay in closed, solitary quarters, less furious only when she could engage in sports. Like Zelda, physical exertion, preferably in dance, kept the inner demons or the chemical system in balance, if only partially. When her mother Nora and James Joyce came to collect her seven months or so later, she set fire to her room in some symbolically apt enactment of her need for her father. Joyce said of her that whatever ‘spark’ he possessed had been transmitted to Lucia and ‘kindled a fire in her brain’. Certainly Jung, whom Lucia next consulted, felt that ‘fire’ had much to do with her father. Jung hated Joyce’s Ulysses. He judged it with undisguised ferocity as the ‘wreckage of a violently amputated boyhood’, ‘a delirious confusion of the subjective and psychic with objective reality’, containing ‘nothing pleasing’, an analogy for ‘schizophrenia’.

  For Jung, Lucia seemed to be not much more than her father’s symptom. His first task was to separate the two psychically so that Lucia might be amenable to treatment. But despite the fact that he appointed a kindly minder, Cary Baynes, to act as something of a ‘mother’ therapist in the overseeing of Lucia, whose own mother seemed to have raised her with more resentment than love, Lucia did not improve. The bond with her father was unbreechable. Lucia remained closed to the transference Jung needed to establish for the talking cure to begin. He called her Joyce’s anima, his femme inspiratrice. By January 1935, the treatment had stopped.

  There was to be no real respite for Lucia: the bouts of unpredictable fury alternated with despairing lucidity for the rest of her days. The war separated her from her father, who died, blind and broken, in January 1941. Miraculously, Lucia survived both the war years and the Nazis in a clinic outside Paris run by a Dr Delmas. Harriet Weaver, Joyce’s benefactress, looked after her far better than her mother or brother. With Delmas’s death in 1951, Lucia was moved to St Andrew’s Hospital in Northampton, the asylum where Celia Brandon had earlier stayed. Lucia lived here until 1982, the straitjacket used to confine her eruptions of furious violence eventually replaced with phenothiazine.

  After Zelda was released from Prangins, the Fitzgeralds moved back to America. The Depression was at its height. They settled near Zelda’s family in Montgomery, both once more taking up their writing, Zelda with a new-found discipline and speed, which soon meant publication for her stories. Offered a contract in Hollywood, Scott left–both for financial reasons and because life in Montgomery, where the judge was dying, was stifling. He died in November, and Zelda coped with the funeral and her mother’s grief. But after Christmas during a holiday with Scott in Florida, the eczema appeared again. Sleepless, Zelda found a flask of Scott’s whiskey, drank it down and woke him at dawn in a tumult of irrational thoughts in which ‘someone is causing the eczema and the eye-hurting with my connivance’–as Scott wrote to Dr Forel on 1 February 1932, asking for advice. He had earned enough money to buy him time to work on his big novel and he didn’t want to have to spend it on a clinic for Zelda. But ten days later, Zelda’s state once more scared them both, and she asked to be taken to hospital. The next day, having wired Dr Adolf Meyer, the director of the Henry Phipps Psychiatric Clinic of the Johns Hopkins University Hospital in Baltimore, Zelda moved in.

  Swiss-born Adolf Meyer had not only studied medicine and psychiatry on his home terrain, but had visited key European centres before coming to America in 1892, where he was led to believe the scope for his ambitions might be greater. This proved to be the case: in rapid succession Meyer moved from staff pathologist at a mental hospital in Kamkakee, Illinois, to Worcester, Massachusetts, one of the many American asylums to have deteriorated into vast state ‘bins’. It, too, wanted to shift into the new scientific age, with his help. From there in 1901, Meyer went to the Pathological Institute in New York City. Through these years, he shifted from a belief in pathology as the key to brain science towards a ‘bedside’ approach which involved extensive taking of histories, investigation of the patient’s environment and record keeping. Kraepelin was his model, as he was for the nascent American psychiatric profession as a whole at that time: his textbook was the most widely used teaching instrument until Bleuler’s arrived in translation in 1923.

  American hospitals had traditionally kept science and the clinic separate: Meyer was one of the doctors who helped to build up a psychiatry which brought them together, and in 1910, when he took up an appointment as Professor of Psychiatry at Johns Hopkins in Baltimore, their union was precisely his goal. In 1913 the new four-storey Phipps Clinic, with its facilities for medical, psychological and laboratory investigation, proudly opened its doors to patients and to medical students. Given Meyer’s wish to be all-embracing, it was perhaps inevitable that he would continue moving with the times towards a more psychosocial model of mental illness and potential cure. When Zelda arrived at the Phipps, it was the country’s premier psychiatric institution, a training hospital which combined medicine with Meyer’s own eclectic version of psychoanalytic practice and it also boasted that innovation, an outpatients’ clinic.

  By the 1930s Meyer had more or less put biological psychiatry behind him and was well on his way towards an understanding of schizophrenia as psychogenic. In his influential doctoral thesis on paranoid psychosis, based on the case of Aimée, the famous French psychoanalyst Jacques Lacan cites Meyer approvingly as an example of a doctor who daringly took on psychoanalytic treatment of paranoid and hallucinating patients.

  Zelda was seen by Meyer, whose Germanic authority made her rebellious and uncooperative. Her resident physician, the young Dr Mildred T. Squires, fared better, and it was to her that Zelda eventually dedicated her one finished and published novel, Save Me the Waltz. But despite the presence of the young woman doctor, Zelda’s history was almost entirely assessed from Scott’s point of view: she was seen as irritable, over-ambitious, uncooperative in her marriage. The hospital was also worried about her plays on words and her sudden leaps of thought, suspecting there might be some kind of physical disorder present.

  Another way of seeing this is that it is precisely in the sensuous or verbal leaps that Zelda makes–her surprising vantage point on experience–that her considerable literary talent resides. When Dr Squires read her work, she commented to Scott that, although it was vivid and had charm, it tended to break off and leave the reader in the lurch. Scott wisely corrected her apprehensions about the needs of modernist style–the fact that ‘the form of so many modern novels is less a progression than a series of impressions, as you know–rather like the slowly-turned pages of an album’.

  Zelda was plagued by an involuntary smile and Dr Meyer’s harping on her inability to make friends. She also fe
ared she might spend the rest of her life in sanatoria. The talking therapy had a way of escalating neuroses, perhaps even the learning of a few new ones. She wrote to Scott early on in her stay:

  Life has become practically intolerable. Everyday I develop a new neurosis until I can think of nothing to do but place myself in the Confederate Museum at Richmond. Now it’s money: we must have more money. Tomorrow it will [be] something else again: that I ran when mamma needed me to help her move, that my hips are fat and shaking with the vulgarities of middle-age, that you had to leave your novel…a horrible sickening fear that I shall never be able to free myself from the mediocrity of my conceptions. For many years, I have lived under the disastrous pressure of a conviction of power and necessity to accomplish without the slightest ray of illumination. The only message I ever thought I had was four pirouettes and a feueté [sic].

  Ballet was replaced at the Phipps by a strict writing routine. Zelda slept well. By March the first draft of her novel was finished and Dr Squires was pleased with her progress. Scott’s reaction, however, was vituperative. Zelda had sent him the novel only after she had mailed it to their joint publisher, a certain sign that she had foreseen his rage. She had used some of the material he had read to her from a draft of Tender Is the Night– material, needless to say, which was about her. Reaching agreement on whose life belonged to which member of the writing couple wasn’t to be easy, though eventually a very few, if telling, excisions ended up by satisfying Scott.

  Luxuriant in its imagery, redolent in sensuousness, Save Me the Waltz contains particularly lucid insights into the mind of its heroine, Alabama, a barely masked version of Zelda. The description of Alabama’s love for David/Scott looks forward, as her biographer Nancy Milford so accurately points out, to the psychiatrist R.D. Laing’s description of schizophrenia.

  When she meets David, Alabama feels she is looking into a mirror at herself. As they kiss, she feels herself getting closer and closer until he becomes distorted in her vision and she senses ‘the essence of herself pulled finer and smaller like those streams of spun glass that pull and stretch till there remains but a glimmering illusion’. Though she doesn’t break, Alabama in love is a very small, suspended, ecstatic self who can through the kiss enter David’s grey and ghostly brain, and run over ‘a mystic maze of folds and ridges’ until she loses herself in a worried frenzy wandering through the bleakness of his mind which is also the empty fragility of her own.

  In The Divided Self, the sixties bible on what he sees as the family-induced madness that is schizophrenia, R.D. Laing conjures up the schizophrenic’s tension between the desire to reveal himself and the desire to conceal himself. He feels both

  more exposed, more vulnerable to others than we do, and more isolated. Thus a schizophrenic may say that he is made of glass, of such transparency and fragility that a look directed at him splinters him to bits and penetrates straight through him. We may suppose that precisely as such he experiences himself.

  We shall suggest that it was on the basis of this exquisite vulnerability that the unreal man became so adept at self-concealment.

  Having read Save Me the Waltz, Dr Mildred Squires decided that, rather than only trying to talk to Zelda, having her write her version of what had happened to her would help in her cure. And so Zelda wrote her story for ‘the eyes of the psychiatrist [which] moved back and forth under the heavy lashes, like the shuttle of a loom weaving a story from the dark heavy thread’. The injunction was to ‘tell the story with no embellishments’.

  ‘Very well,’ began the sick one patiently, ‘but it is the story of a fathomless solitude, of a black detachment of nothing. A vacuum can only exist, I imagine, by the things which enclose it.’

  And so began what Zelda called her ‘fairy tale’ for the psychiatrists. The aim of the therapy, now, on Scott’s insistence, seemed to be to find Zelda’s permissive mother at the root of her problems: her mother had been fixated on her, let her get away with everything, catered to the assertiveness Zelda’s novel-writing gave voice to. By mid-April 1932, Scott was visiting daily, and a pattern emerged. The couple quarrelled; Scott reported the battles to the doctors; Zelda kept them to herself. His version of her problem was that she was reacting to him, competing, trying to use her ‘values’ to express herself, mistakenly imagining that self-expression had anything to do with the making of art. He adamantly didn’t agree with this. Her writing had to be stopped. Zelda wouldn’t give in to his view of things: he wasn’t her doctor. His role should be ‘to mother me and bear with a lot of unpleasantness which is not part of how I feel towards you at all but the result of my health’.

  This talking and writing out for the doctors of what were the couple’s deep-rooted problems and patterns went on for some years, even after Zelda left the clinic. The war between them about who owned the fictionalization of their lives, about Zelda’s right to write given that Scott paid the bills, including the expensive private sanatoria, became a life-struggle in which Zelda’s madness and Scott’s drinking were the weapons of choice–to be used against each other before an audience of medics. The audience never made the battle less real, since the struggle existed even without the medical gaze: but nor is it clear that the doctors’ presence ever made the battle less rather than more intense.

  Squires left to be replaced by the young and handsome Dr Thomas Rennie, who was interested in literature. Zelda far preferred him to Meyer. The doctors sometimes backed an increasingly fragile Scott and asked Zelda to curtail her ambitions. At another point, Meyer actually defended Zelda, his patient, against Scott and wanted to take him in to tend to his drink problem. By this time, in the summer of 1932, the couple were living in a grand house not far from the hospital and Zelda was being treated as an outpatient. A strict routine was set down which allowed for no more than two hours’ writing a day, followed by tennis and finally painting–all to be rigorously kept to in an atmosphere of calm reclusiveness.

  Dr Rennie assessed their case as if he were a marriage therapist with a particularly difficult famous couple to contend with. With a nod to the Freudian matter of the sexual which might lie at the base of their ‘problems’, it was effectively their behavioural patterns that were at issue. He hoped that the reception of Zelda’s novel might clear the air between them. It didn’t. When Save Me the Waltz came out that October, the reviews were decidedly mixed and it sold only 1392 copies. America was still in the Depression. Reviewers talked of the novel’s ‘ludicrous lushness’, of an inability to create character and of an ‘undisciplined mind’ though one mentioned the ‘dizzy delight’ of her language and looked forward with interest to her next novel. Zelda, who was in fact trying to write a new novel, one which dealt with her own psychiatric history, in the face of Scott’s adamant sense that the doctors mustn’t allow her on to the terrain of his long-struggled-towards opus Tender Is the Night, began to sink into absences and incoherence once more, as well as attack and undermine her daughter.

  By December Scott couldn’t cope with her: he was drinking, taking Luminal and, as Dr Meyer wrote to Forel in Switzerland, had begun seeing a doctor at the Phipps. Their folie was, to a certain measure, always à deux. His own assessment of his marriage had early been sent to Dr Rennie:

  In the last analysis, she is a stronger person than I am. I have creative fire, but I am a weak individual. She knows this and really looks upon me as a woman. All our lives, since the days of our engagement, we have spent hunting for some man Zelda considers strong enough to lean upon. I am not. However, I am now so near the breaking point myself that she realizes she has me against the wall and that she can drive me no further. She is a little afraid of me at the present time.

  Scott couldn’t stand the strain of tending Zelda unless he had the kind of authority over her which allowed him to order her to pack her bag and spend a week in an asylum. In May the couple met with Dr Rennie. A 114-page transcript documents what passed between them. It records Scott’s worries about Zelda encroaching on the ter
rain of his writing: he hadn’t published a novel for eight years, yet he was the professional. He needed her to stop writing. She wouldn’t. She wanted independence.

  When Dr Rennie finally asked her if being a creative artist would make up for a life without Scott, she refused the question. She couldn’t contemplate living without Scott, yet she couldn’t or wouldn’t give in to his terms. Nine months later, she was back in residence at the Phipps. There is a possibility that the publication of Tender Is the Night in serial form, beginning in January 1934, had tipped her over the always beckoning edge. Her incarnation as the heroine, Nicole, was too close to bear: ‘What made me mad was that he made the girl so awful and kept on reiterating how she had ruined his life and I couldn’t help identifying myself with her because she had so many of my experiences.’

  Virginia Woolf

  It is irresistible at this juncture to compare Scott and Zelda Fitzgerald to Leonard and Virginia Woolf, another literary couple who were unabashedly modern in their views, though of an older generation. Would Zelda have fared better, led a more productive life, under the assiduous and intelligent care of someone like Leonard Woolf, who tended to Virginia’s talent and was so alert to her symptoms that he packed her off to bed and a necessary decrease of stimulus as soon as there was a signal of the return of her illness? Surely the criticism that some have made of Leonard as over-controlling and policeman-like in his vigilance vanishes when Virginia is placed alongside other sufferers from conditions akin to hers.

  Though it is now broadly agreed that Virginia Woolf suffered from what Kraepelin had named around 1900 as cyclical manic depression, and Zelda from what Bleuler just a little later called schizophrenia, there is as much commonality in Woolf’s and Zelda’s experience of what they both jauntily designated as their ‘madness’, or in the way they resisted the controlling hand of the doctors, as there is difference in the kinds of characters their culture, accidents of geography and social place made them. They shared racing highs filled with vivid sensuous impressions, during which they might hallucinate and hear what were sometimes persecutory voices, followed by suicidal lows. In a diary entry of January 1924, Virginia evokes the curious visions she had in her room at Hogarth House, ‘lying in bed, mad, and seeing the sunlight quivering like gold water, on the wall. I’ve heard the voices of the dead here.’ On the occasion of her 1904 breakdown she talked of other ‘horrible voices’–birds singing Greek choruses, King Edward using foul language in the garden.