Filed under: Books
Upcoming Art of Psychiatry speaker meeting:
“James Tilly Matthews and the Influencing Machine”
With our speaker – writer, historian and curator Mike Jay
Date: Thursday February 23rd
Venue: Robin Murray B Institute of Psychiatry, Psychology and Neuroscience.
Please join us for a speaker meeting concerning the fascinating case of James Tilly Matthews. James Tilly Matthews was a former peace activist of the Napoleonic Wars. He was confined to the Bedlam asylum in 1797 for believing that his mind was under the control of the “Air Loom” – a terrifying machine whose mesmeric rays and mysterious gases were brainwashing politicians and plunging Europe into revolution, terror, and war. But caught up in high-level diplomatic intrigues in the chaos of the French revolution many of the conspiracies in which Matthews claimed to be involved were entirely real.
Matthew’s “Influencing Machine” has recently been materialized by artist Rod Dickinson, and is currently on view at the Bethlem Gallery.
About Mike Jay:
Mike Jay is a historian, curator and writer. His recent book is This Way Madness Lies, a highly illustrated history of madness and the asylum, published in the UK and USA by Thames & Hudson. It was written in conjunction with Wellcome Collection’s exhibition Bedlam: the asylum and beyond, on which he was guest curator. His previous book, The Influencing Machine, is out in paperback and on Kindle. He reviews regularly for the London Review of Books, the Wall Street Journal and the Literary Review.
Find out more:
A film about James Tilly Matthews – https://vimeo.com/113601286
Mike Jay’s article about James Tilly Matthews – http://publicdomainreview.org/2014/11/12/illustrations-of-madness-james-tilly-matthews-and-the-air-loom/
Mike Jay’s book: Influencing Machine, The : James Tilly Matthews and the Air Loom
About the Air Loom in the Bethlem – www.theairloom.org.
This is an open meeting and all are welcome (including SLaM employees, psychiatry trainees, service users, members of the public). No need to book. It’s okay to turn up late. Entrance is free!
Filed under: Books
Upcoming Art of Psychiatry speaker meeting:
“Art, Autobiography and the Avant-Garde Asylum”
Please join us for what will be a fascinating AoP meeting with our speaker Dr Sarah Chaney.
About Dr. Sarah Chaney:
Dr Chaney is a Research Associate at the UCL Centre for the History of Psychological Disciplines. Her PhD thesis focused on the concept of self-mutilation in late nineteenth-century psychiatry, and she is currently expanding this into a ‘History of Self-Harm’ (to be published 2016). She has also worked for Bethlem Museum of the Mind and runs the exhibition and events programme at the Royal College of Nursing. She tweets as @kentishscribble
This is an open meeting – all are welcome – including service users, SLaM employees, psychiatry trainees, and members of the public
Crisps and wine provided.
July 2013 book: The Examined Life by Stephen Grosz
All grades of psychiatrist were round the table on July 9th, despite the sizzling heat outside. For some, Grosz’s work was a distillation of 25 years’ therapy into an honest, simple tome: “What I’m describing here isn’t a magical process,” says Grosz of psychotherapy, “It’s something that is a part of our everyday lives – we tap, we listen”. Nicely put. And yet, for others round the table, there was something unnatural about this tapping.
“Which genre does it belong to?”, one member cried, holding aloft a stick of satay chicken. A forensic consultant sipped his orange juice and replied, “these are a series of case-studies”. This suggestion did not hold under scrutiny. The histories are mere pages long, some even lacking patients. For example, the chapter ‘Going Back’ concerns his odd gift to his father: a holiday to Eastern Europe, and thus to a childhood marred by Nazism. Even in the more patient-focused chapters, things seem rather well-wrapped for clinical realities. The first, ‘How we can be possessed by a story that cannot be told’, is about a mendacious patient who fakes his own suicide to upset Grosz. But then the ending is more Grimm than grim: he marries, settles – lives happily ever after. Some of us loved the strong presence of the therapist’s own life and humanity, loved also the subtle, jargon-free exploration of dreams. Others yearned for more warts, more confusion, and more obvious use of psychological technique. Orange juice was exchanged for glasses of viticulture from the warm South, as we approached something like a conclusion.
For all their allure, we agreed that there is a tension in Grosz’s tales, between clarified fact and coddled artifice. This is alluded to in the fly-notes, which describes the cases as “aphoristic”, an original thought expressed in memorable form. None other than Hippocrates was the originator of the aphorism, with his famous maxim on medicine: ars longa, vita brevis (the life so short, the art so long to learn). Fairy tales are also a kind of aphorism. And thus with Grosz: his studies are so short, the point they make is so clear, so elegantly put across, that some readers perceived hints of the artificial behind the seeming reality of his tales. Does this too-neat packaging of clinical truths matter? Perhaps not. Grosz is clear about his project, quoting Isak Dinesen who said: “Any suffering can be borne if it is put into a narrative.” He has done just this – indeed, done it beautifully with each case-tale. More than artful, perhaps even bordering on Art itself, these histories drew excited comparisons from works of poetry to the musical studies of Bartok. In the final analysis, we raised our collective glasses to Grosz, only to find our glasses empty. Well, such is life – and having examined it thoroughly, we closed our books.
September 2013 book: The Myth of Mental Illness by Thomas Sasz
(This meeting is rescheduled from 24 September)
Tuesday 12 November 2013 6pm Institute of Psychiatry Seminar room 6
Speaker meeting: Maria Walsh talks about her book Art and Psychoanalysis
In Art and Psychoanalysis Maria Walsh investigates how psychoanalysis has been an invaluable resource for artists, art critics and historians throughout the twentieth century. Artists as varied as Max Ernst, Louise Bourgeois, Cindy Sherman and Marina Abramovic can be examined with the benefit of psychoanalytic thinking, and contemporary critics use psychoanalytic concepts as tools to understand how meaning operates. Walsh’s argument is that psychoanalysis, like art, is a cultural discourse about the mind in which the authority of discourse itself can be undermined, provoking ambiguity and uncertainty and destabilising identity.
This is a public meeting, all are welcome.
Filed under: Books
Date for next book club is Tuesday September 11th 2012 at 6pm, IoP, room to be confirmed.
Here are Amazon links – please use to support the book club
Filed under: Books
Influential when it was published during the 1970s, how relevant is Anthony Clare’s Psychiatry in Dissent today? We discussed this book last night at the Maudsley book group, and were joined by Prof Robin Murray, and friend and colleague of Clare.
Clare, a clever and urbane Irishman, was one of the first to take on the arguments of ‘anti-psychiatrists’ such as Thomas Szasz and R. D. Laing. Although Clare was still in psychiatric training when Dissent was published he found himself propelled into the limelight as a spokesman for the profession. This was something that Prof Murray said caused some resentment at the time, not least because Dissent is, in places, quite critical of contemporary senior psychiatrists.
After the passage of years the book is notable for both what it does and doesn’t include. The first two chapters of the book are perhaps the strongest. They explain the concept of psychiatric illness and the process of diagnosis, both of which have undergone little change. Also still relevant is Clare’s critique of the Rosenhan experiment . This is an interesting, but methodologically flawed, study. Controversy was raging about it in the mid-70s and its results are still cited uncritically today.
There’s no mention of ADHD, PTSD or bipolar spectrum – these didn’t ‘exist’ then. A similar book written today would need to address controversy of the efficacy of SSRI antidepressants. There is a chapter on psychosurgery, something of a non-topic now, and already on its way out during the 1970s. The 40s, 50s and 60s had seen lobotomy used for a wide range of presentations from schizophrenia to migraine.
The final chapter “Contemporary psychiatry” is notable in that in many respects it echoes many of the problems of psychiatry today, as if nothing has changed: poor recruitment to the specialty and under provision of services.
Towards the end of his life Clare talked about updating Dissent, but a heart attack intervened. It would be nice to have a contemporary critique of psychiatric practice aimed at the layman – a modern Psychiatry in Dissent is sorely required today.
Filed under: Books
One year ago I decided to start a book group. Bang on trend for 2011 eh? However, this wasn’t any old book group, this one had decidedly high falutin’ aims. With psychiatric training focusing increasingly on competencies and MRCPsych requirements, there seems little time left for learning about concepts critical to the development and history of psychiatry and related fields e.g. psychoanalysis, psychology, philosophy, sociology, anthropology, neuroscience etc… Such disciplines can be hard to access for the uninitiated and a medical training doesn’t help much to furnish one with the necessary critical tools to appraise, say, a philosophy of mind book however relevant it might be to psychiatry. Thus Reading the Mind was born; unashamedly educational and aimed at psychiatric trainees wanting a little bit more.
Our first book was The Divided Self by R D Laing (1960) a seminal work by a key figure in the anti-psychiatry movement critiquing the biological model of schizophrenia. Here Laing reworks psychosis as an understandable response to intolerable pressures placed on the patient by society and the family. This was followed by Notes Upon a Case of Obsessional Neurosis by Sigmund Freud (Rat Man) (1909), a great introductory text to Freud’s core concepts of psychopathology, particularly neurosis, and an exemplar case history on the descriptive phenomenology of OCD. Next, we discussed Consciousness Explained by Daniel Dennett (1994), an influential and contemporary philosophical critique of the paradigm we use to think about consciousness outlining the foundation for his own theory of consciousness. Opening Skinner’s Box by Lauren Slater (2004) provided the group with a run-through of the ten most important psychological experiments of the 20th Century and in doing so provided a crash-course in the recent history of Psychology. We then read The Loss of Sadness by Allan Horowitz and Jerome Wakefield (2007) a devastating critique of the current concept of depression within psychiatric nosology; Illness as Metaphor by Susan Sontag (1978) a brilliant essay on the dangers of reducing illness to metaphor and the pervasive effect on doctor, patient and society; Winnicott by Adam Phillips (1998) a welcome introduction to his life, work and key concepts, and finally, The Mask of Sanity by Hervey Cleckley (1941,1982) a seminal study on the psychopath. Grounded in case studies, it profiles and refines the concept of the psychopath, and was used heavily by Robert Hare in developing his PCL checklist.
Our next meeting is on Tuesday 22nd May and we’ll be discussing Anthony Clare’s Psychiatry in Dissent (1980). Unfortunately, due to our funding, Reading the Mind is only open to Maudsley trainees. However if you’re interested in starting a similar book group then please get in touch.
Dr Lisa Conlan, ST6 General Adult Psychiatry, SLAM.
Filed under: Books
There’s an interesting programme just broadcast on BBC Radio 4: Writing Madness
From the BBC website:
“Vivienne Parry takes her diagnoses of literary heroines into the 20th century and the age of Freud, the Great War and the explosion of the ‘sciences of the mind’ focusing on three great works of fiction, mixing contemporary psychiatric and literary insight.
How did modern literary and psychiatric ideas meet and how did each shape the other? Do these heroines show literature of the period to be a critical – and even emancipating – force…or is fiction really medicine’s stooge? Novels on the couch include Scott Fitzgerald’s Tender is the Night and Virginia Woolf’s Mrs Dalloway….interestingly with both novels there’s a tendency to base the heroines on real people – Nicole Diver is based on the case history of Fitzgerald’s own wife Zelda, whereas Woolf’s Mrs.Dalloway comes very close in literary terms to what Freud calls ‘self-analysis’ – one difference is that Woolf sometimes believed ‘madness’ was necessary to be creative, while Scott Fitzgerald depicted it as disastrous drain on creativity (ie. his). And both novels have the dynamic and lucrative new industry of psychotherapy in their sights. Vivienne compares fiction in the age of Freud to literary ideas of mental health in the Victorian age and in Dickens specifically, using Great Expectations’ Miss Havisham as a case study.
Contributors include psychotherapist and essayist Adam Philips, leading psychiatrist Simon Wessely, cultural historian Lisa Appignanesi and Chris Thompson, psychiatrist and medical director of The Priory”
The programme is broadcast again on March 31 at 2330 and is also currently available on iPlayer.
Picture via Wikipedia
Richard Dadd (1 August 1817 – 7 January 1886) was an English painter of the Victorian era. Following a long tour of the Middle East in the early 1840s he succumbed to a schizophrenia-type illness, following which he murdered his father and fled to France where he attacked another traveller. After his return to England he spent over forty years in the Bethlem and Broadmoor, during which period most of the works for which he is best known were created.
Dadd’s painting The Fairy Feller’s Master Stroke is featured on the cover of a recent British Journal of Psychiatry. Nicholas Tromans, a Senior Lecturer at London’s Kingston University, is widely published on the subject of 19th century art and is author of Richard Dadd: the Artist and the Asylum. He came to talk to us about Dadd’s life and mental illness:
AoP: As a young man, how did Dadd go about establishing himself as a painter in London?
NT: It seems that Richard owed a great deal to his father, who had been a high-street chemist in Kent but who, when Richard was a teenager, took over a gilding business in central London which must have had many professional artists among its clients. Dadd’s own beginnings as a professional artist were really entirely conventional. He became a student at the Royal Academy (virtually next door to his father’s shop) and made studies after the sculptures at the British Museum. He appears to have been extraordinarily self-confident, and was soon sending his pictures to exhibitions in London and in places like Birmingham and Manchester. He managed to attract the patronage of both London aristocrats and the self-made men of the industrial cities – as well as the support of some influential critics. By the time he left for his tour of the East in 1842 he was one of the risng stars of the London art scene.
AoP: What do we know about how and why he killed his father?
NT: Towards the end of his tour of the Mediterranean, in the Spring of 1843, Richard began to suffer from delusions – that there were people trying to harm him, perhaps that he could see the devil in human forms. Many of those who had known him were worried by his unusual behaviour after his return to London, and his father consulted a psychiatrist at St Luke’s – Alexander Sutherland – who recommended hospitalisation. Possibly in response to this suggestion, Richard carefully planned a knife attack on his father, which succeeded in killing him. Richard was soon afterwards arrested and eventually sent to Bethlem Hospital in Lambeth. Later Dadd explained that the killing had been required of him by the Ancient Egyptian god of the dead, Osiris, and that although Richard approved of the destruction of the imposter who claimed to be his father, he was in effect only an instrument in the hands of the deity. It was a fantastic delusion, but one in keeping with Richard’s larger set of beliefs about the continuing truth and relevance of the philosophies of ancient cultures.
AoP: What do we know about how he was as a patient?
With regard to his time at Bethlem (1844-64) – not a lot. There are really only two entries in his casenotes, and the first of these dates from as late as 1854. This entry describes how violent Dadd was considered when first admitted, and how he would suddenly strike another patient without provocation (and then immediately apologise). The formal designation of ‘dangerous’ was applied to Dadd even during the last years of his time at Bethlem. I infer from the lack of detail in the notes, however, that he was by and large not an especially troublesome patient – not one who required strategies to manage. That he painted ambitious pictures for the two senior managers of Bethlem – paintings which he worked on for years – suggests some kind of relationship between patient and staff, although certainly not an uncomplicatedly collaborative one.
AoP: Why was he transferred to Broadmoor?
Dadd was admitted to Bethlem as a Criminal Lunatic – someone too unwell to be punished for a crime, or (from the 1840s) one too unwell to stand trial at all. This meant being placed in a special wing of the hospital in very cramped, minimally furnished, high-security conditions. It was obvious to the authorities that something needed to be done with this novel legal category of prisoner/patient, and a dedicated new hospital was made possible by an Act of Parliament in the early 1860s. This was to be Broadmoor near Reading, to which Dadd was transferred along with his fellow male Criminal Lunatics, in 1864, and where he died and is buried. There were those – among them the Superintendent of Bethlem – who feared that gathering together these cases out in the countryside would produce “a bastile of lunacy”, feared and resented by the public. These critics were to be proved at least partly right, but for Dadd the change brought improvements. By any common-sense criteria of well-being, his life got better: he was able to see more, to move about more; he took an interest in cricket and chess; and the range of media in which he himself worked expanded.
AoP: How has Dadd’s legacy been regarded after his death?
Dadd’s meticulous watercolours never entirely went off the radar of the art market. Collectors were able to buy them as they left Bethlem and Broadmoor by one route or another. The V&A and the British Museum both acquired watercolours by Dadd while he was still living at Broadmoor. But after his death there were really only a series of false starts when it came to retrieving his biography and reconstructing his oeuvre. Various people had a go, but there was just too little to go on. Things changed only in the 1960s when the Fairy Feller arrived at the Tate and when Bethlem acquired a dynamic and imaginative archivist who was in a position to become Dadd’s first proper biographer. This all coincided of course with the passionate debates generated by the so-called anti-psychiatry movement, and Dadd – in the guise of heroic ‘survivor’ of the Victorian asylum – seemed suddenly of acute cultural significance. Interest in him has calmed down since. As I say in the preface to my own book on Dadd, I have not tried to resurrect him as a hero of any kind: I have tried to understand him as a wonderful artist – one of the most exciting of the Victorian age in my opinion – who happened to spend his career in unusual circumstances.
AoP: Despite his situation, Dadd’s pictures seem untouched by the content of his delusion and he never addressed asylum life in paint. Can you reflect on this?”
Well, “sane” Victorian artists rarely painted the streets on which they lived, or pictures which sought to sum up their philosophies of history. They were typically more interested in the same kinds of things on which Dadd remained fixed, that is, the topography of exotic places filtered through the memory, portraits, and illustrations to literature. Dadd had never been a Realist — on the contrary he was from the start of his career a painter of poetic imagination. And in any case, one reason for spending so much time thinking back, visually, over his time abroad in the early 1840s must surely have been a need to escape from the very limited environment in which he had to live.
AoP: And where can interested people see Dadd’s stuff?
NT: Not a lot of oil paintings in public collections (the watercolours can only be shown periodically of course because of their vulnerability to light).
The Scottish National Portrait Gallery have Dadd’s wonderful portrait of Dr. Alexander Morison:
Tate Britain Dadd collection
And just last year, the Harris Museum and Art Gallery in Preston acquired the early fairy subject Puck which had been in a Preston collection in the nineteenth century
The best place to head is however Bethlem Hospital itself where a substantial number of Dadd’s works can be seen in a context which helps make sense of them.
A small collection of Richard Dadd’s paintings is being exhibited Feb – April 2012 in the Bethlem Hospital museum – details.
This clip of a Richard Dadd painting being discovered on Antiques Roadshow is worth a watch (starts at 4:24)
Richard Dadd: Masterpieces of the asylum Independent 2011
Richard Dadd: Madness and Beauty Telegraph 2008
And so to philosophy… We dived in headfirst and found the waters, well, rather murky. Consciousness Explained is Daniel Dennett’s 1991 book on the most difficult conundrum facing philosophy and science today – the phenomenon of consciousness.
As a group, we started by thinking a bit about this. How would you study it? How would you define it? Hang on, what actually is it? The more we thought about it, the more difficult it seemed. Thankfully, despite our guest expert falling ill on the day of the event, we had a great turn out to make (ahem) light work of this weighty topic.
Consciousness Explained is divided into three parts. Dennett uses the first section to outline his project, method and goals. Here he introduces ‘heterophenomenology’, his ‘neutral’ method aimed at getting clear on what the phenomena that need to be explained actually are. The second part develops his model of consciousness, the ‘Multiple Drafts Model’, which he contrasts with the ‘Cartesian Theatre’ which it is so hard to think oneself out of. This is presented as an empirical theory, drawing on evidence from evolutionary theory as well as Artificial Intelligence, neuroscience and cognitive psychology. The third and final part focuses on the philosophical challenges that consciousness poses in the form of some entertaining thought experiments.
Dennett aims to ‘break the spell’ of our way of thinking about consciousness which makes consciousness seem unexplainable. He does this by providing an alternative way of thinking – an alternative set of metaphors. Few people would claim to be Cartesian dualists – to believe that the mind is made of a completely different kind of stuff than the body – yet we seem to fall into the trap of imagining consciousness as something that is played out in the brain for another observer in the brain: as if the light waves that impinge on our retinas are transduced into neural signals only to be transduced again for our real selves to ‘see’. This manifests as much in scientific as lay thinking about consciousness. His alternative metaphor is the ‘Multiple Draft’: the self exists rather as a scientific paper exists – circulating in multiple drafts – with no final, authoritative version.
Discussion focused on the book and its wider implications e.g. the mind/brain divide, the implications of materialism, is consciousness an epiphenomenon? (we thought not), is there a social definition of consciousness as opposed to individual? (we got stuck on that one!), whether Dennett believes in free will or not? (yes he does). Artificial intelligence and Turing’s famous Test came up, – a machine indistinguishable from a human being. Could a robot have a mind? What about philosophical zombies? Zombies are similar to us in appearances and behaviour but, supposedly, lack subjective conscious experience. Sadly, the zombie discussion didn’t go very far as the group were sceptical (probably rightly) about the contribution that fantasy zombies could make. It did, however, lead us to the one of the key difficulties: qualia. Qualia are the subjective ‘feel of things’, what it’s like to feel pain, to smell fresh coffee. Labelled elsewhere as ‘the hard problem of consciousness’, how can these be explained? Dennett attempts to show how the whole way of thinking in these terms is a ‘mess’, ‘best walked away from’.
Philosophy often uses thought experiments (such as zombies) to help with complex problems like this. So we thought we’d give that a go with Frank Jackson’s famous thought experiment Mary’s room. Mary is a sci-fi colour expert in the future kept in a black and white room for her whole life. Mary has never seen colour although is world expert on colour red (she knows everything! Refraction, chemical components, wave-length, subjective reports from others). One day she is released, she steps outside and sees a red-rose. Does she learn something new about the colour red? Intuitively, you might think yes. Not our group, hardcore materialist Maudsley Trainees that they are! A straw poll saw ‘no’ as the majority – albeit a narrow majority – view. They were quite happy to do away with qualia but still felt that Dennett hadn’t fully convinced them with his theory.
Well-written, witty, direct and peppered with useful footnotes and anecdotes, Explaining Consciousness was, nonetheless, an ambitious and challenging book and choice for our group. The grand project of the book and the value of philosophy in shaping ideas and questions for modern scientific exploration of consciousness were widely remarked on. The study of subjective conscious experience and the ideas of what the mind may be seemed so relevant to our practice that we wondered why the MRCPsych Course hadn’t touched upon it. Consciousness is an area the book group will return to.
The next meeting of Reading the Mind will be on Tuesday 20th September at 6pm in Seminar Room 2, Institute of Psychiatry. We will be reading Opening Skinner’s Box by Lauren Slater – an interesting run through ten of the 20th century’s most relevant psychological experiments. See you there!
Dr Lisa Conlan, ST6 Psychiatry Trainee and Simon Harrison, ST4 Psychiatry Trainee