Malevolent, Mad or Merely Human: Representations of the ‘Psy’ Professional in English, American and Irish Fiction Submitted by Jacqueline Hopson to the University of Exeter as a thesis for the degree of Doctor of Philosophy in English in SeptemBer 2020 This thesis is available for Library use on the understanding that it is copyright material and that no quotation from the thesis may Be puBlished without proper acknowledgement. I certify that all material in this thesis which is not my own work has been identified and that no material has previously been submitted and approved for the award of a degree by this or any other University. Signature……………………………… 1 Abstract This work draws attention to the widespread, damaging, cultural depictions of psychiatrists and allied (or ‘psy’) professionals. I first explore the frequent presence of these specialists in such artefacts as horror fiction, literary novels, detective fiction, movies, comics with their related films and video games, asylum-Based entertainments and cartoons. Close analysis of four representative novels will form the main Body of this thesis, each fiction Being set in a significant stage within the relevant historical treatment of the mad Between 1946 and 2008. In this way, I shall demonstrate how fear and distrust of ‘psy’ professionals pervades anglophone fiction. I shall show how the overwhelming number of negative portrayals greatly outweighs positive depictions. I suggest this can lead to a proBlematic response to the ‘psy’ professions from prospective and current patients and the general population. Broad internet searches of patients’ reactions will show that fear of seeing a psychiatrist is a common reaction. I shall consider the widespread concern, evidenced in scholarly journals, among ‘psy’ professionals aBout the negative perception of their role and work, noting that distrust and denigration of ‘psy’ practitioners is also apparent among medical colleagues and students, with a resulting proBlem of low recruitment to this specialty. I shall suggest that the roots of this suspicion lie in the pervasive cultural fear of madness, Anti- Semitism and the persistent notion that psychiatry and allied professions are pseudo-scientific, unlike other medical disciplines. Using historical examples, I shall demonstrate that the ‘psy’ professions are tainted By historical treatment failures and rogue professionals in ways that do not occur elsewhere in medicine. While ‘psy’ professionals are generally less transparent (for reasons including confidentiality) than other medical specialists, they face vociferous criticism from within their own ranks, especially on the internet. This thesis will promote an understanding of the injurious negative place ‘psy’ professionals hold in our culture. 1 Malevolent, Mad or Merely Human: Representations of the ‘Psy’ Professional in English, American and Irish Fiction Page number Abstract 1 Contents 2 Preface 5 A note on selected vocabulary 9 CHAPTER ONE: Madness and Culture SECTION 1: An introduction to the terrifying taBoo of madness and the cultural fascination with insanity and its treatment 10 SECTION 2: How contemporary culture sees the ‘psy’ professional 14 SECTION 3: Cultural representations of ‘psy’ professionals and proBlems of stigma 32 SECTION 4: The response of scholars, ‘psy’ professionals and patients to negative cultural depictions 34 SECTION 5: Gender, the ‘psy’ professional, the patient and feminist critiques 43 SECTION 6: Fear as the response of ‘psy’ patients to cultural depictions of ‘psy’ professionals and theoretical explanations from psychoanalysis, social science and social psychology 48 SECTION 7: Other significant factors affecting the ‘psy’ specialties: Anti- Semitism, attacks from within the ‘psy’ professions and patient support groups 54 CHAPTER TWO: The almost invisible oppressor: the psychiatrist within the state mental asylum in 1940s America as presented in Mary Jane Ward’s The Snake Pit (1946) a) Introduction to The Snake Pit 59 b) The historical setting of The Snake Pit: the American insane asylum and the development of American ‘psy’ professions 61 c) The impact of Mary Jane Ward’s novel The Snake Pit on US attitudes to psychiatric care 67 d) Psychiatry and the psychiatrist in Ward’s novel 70 2 e) Virginia’s perception of the psychiatrist within the asylum 73 f) Narrative strategy and the writing of The Snake Pit 82 g) The psychiatrist in Anatole Litvak’s film of The Snake Pit (1948) 90 h) The Reader’s Digest condensed version and the popular success of The Snake Pit 99 i) The Snake Pit: Conclusion 101 CHAPTER THREE: Seeking the elusive psychiatrist in an unresolved madness narrative: Penelope Mortimer’s Long Distance (1974) a) Introduction to Long Distance 103 B) Long Distance: the challenges of an unresolved madness narrative and the novel’s critical reception 104 c) Mortimer’s autoBiographies: Long Distance as roman à clef 108 d) The difficulties of complexity in Long Distance 110 e) The therapeutic community as setting for Long Distance 112 f) The rise of the British therapeutic community from its historical origins 112 g) The theories Behind treatment in the therapeutic community: the changed role of the ‘psy’ professional 120 h) R D Laing and Kingsley Hall: psychiatry and counterculture 122 i) Long Distance: a challenging madness narrative of the therapeutic community 126 j) Time and structure within madness narrative 129 k) Basil Gondzik as elusive psychiatrist 139 l) Long Distance: a neglected literary achievement 148 CHAPTER FOUR: Patrick McGrath’s Asylum (1966): the psychiatrist steals the patient’s story a) Introduction to Asylum 151 B) Asylum and its setting in British psychiatric history 153 c) Patrick McGrath and Gothic tradition: the uncanny invoked By psychiatry 157 3 d) The narrative process in Asylum: why choose the unreliaBle psychiatrist? 161 e) UnreliaBle narration as a rewarding textual device: Peter Cleave as misleading narrator 169 f) Conjecture as the Basis for unreliaBle narration in McGrath’s fiction 175 g) Cleave, Edgar, Stella and male sexual jealousy 181 h) Solving the narrative puzzle of Asylum 186 CHAPTER FIVE: The damaged psychiatrist: trauma and memory in the Irish asylum in Sebastian Barry’s The Secret Scripture (2008) a) Introduction to The Secret Scripture 190 B) The historical setting of The Secret Scripture: decarceration in the Western world 192 c) The decaying Irish asylum: The Secret Scripture as a novel of Ireland 197 d) Roscommon Asylum and psychiatric treatment: Dr Grene’s neglected professional responsiBilities 200 e) How the patient views the psychiatrist 206 f) Theories of trauma and memory 209 g) Barry’s exploration of trauma and memory in the accounts of psychiatrist and patient 213 h) Dr Grene’s growth towards recall, understanding and competence 219 i) The Secret Scripture: writing, secrets and truth 226 j) The Secret Scripture: conclusion 228 THESIS CONCLUSION 231 APPENDIX 1: Table of novels with ‘psy’ professionals 235 APPENDIX 2: Selected events in the history of Irish psychiatric care 236 WORKS CITED 241 4 Preface Identified as a psychiatric patient all my adult life, my experiences have shaped my academic interests as well as my day-to-day interactions. I have Been incarcerated in county asylums while detained under the Mental Health Act. I have Been suBject to courses of electroconvulsive treatment and have spent weeks and months in various locked wards and open wards, as well as punishment time in a padded cell. I have Been prescriBed and have taken a vast range of medication, some of which was helpful although most was not. In addition, I lived for almost a year in a therapeutic community (TC) at Bethlem Royal Hospital in the mid 1970s. Twenty-three years of psychotherapy from the mid 1980s onwards made my continued existence possiBle. The anger and dismay - and also gratitude for good treatment - that these experiences aroused have prompted me to transform interesting experience into academic study. It has Been informative Both to take advantage of the right to see one’s own case notes and to consider how this access may Be limited if deemed to Be damaging to the patient (Rethink Mental Illness). Requesting my own case notes from my GP surgery produced an edited, seemingly random array of 278 papers dating Back to 1973 (South Molton Medical Centre). These notes judgmentally descriBe me as “angry”, “withdrawn” and “inadequate”. Such qualities might usefully Be compared with the limited judgment of “unaBle to write” applied to a patient with a Broken wrist. Unfortunately, these qualitive judgments aBout my mental illness were used in a quantitative, actuarial way when I was refused life insurance after my husband’s death, when I was the sole, unemployed carer for our 5-year-old child (South Molton Medical Centre, letter to GP from C, M & G Insurance). Along with my life-long difficulty in getting work, this insurance refusal is an example of the damaging financial consequences of having Been treated for mental illness. In the 1970s I started to read novels which presented the lives of mentally ill characters. I was, in part, searching for accounts of similar illnesses and treatments to my own. However, it Became evident to me that psychiatric patients - who were silenced in the real world - could have powerful voices in fiction. In addition, I Began to read some of the texts of psychiatry and anti- 5 psychiatry. This Background has had a significant influence on my current research. Fiction has a great deal to offer to the exploration