Current Comments@ EUGENE GARFIELD INSTITUTE FOR SCIENTIFIC lNFORMATION@ S501 MARKET ST., FUUADELPHIA, PA 191o4 Psychiatrist and Biographer Differ over Ame Sexton’s Suicide. Was It Preventable or Inevitable? Number 11 March 16.1992 ABSTRACT Anne Sexton; A Biography by Diane Middlebrook is discussed in terms of the role Martin T. Orrre played in its creation, particular y the controversial release of the ps ychiatrist’s therapy tapes with the poet. Ome’s Foreword to the biography, in which he expresses the view that Sexton’s suicide was preventable, is reprinted. Middlebmak srgues that Sexton had reached a point in her life where the act was inevitable, When I fmt learned that Diane Middle- observers like Albert Rothenberg15 do not brook was writing a biography of Anne Sex- believe that depression and poetic creativity ton,l I was fascinated by the coincidence of are necessarilyy linked. The fact that depres- several isolated events. In the first place, I sion is largely undiagnosed in the general had originally met Diane through her hus- population may give the impression that it band, chemist Carl Djerassi. Secondly, I had is more prevalent among highly creative learned to respect her competence as a hu- people. manities scholar and was aware of her infht- I must confess that before encountering ence in the creation of Djerassi’s Cantor’s Middlebrook’s biography, I had not read Dilemma,2 a novel about a scientist winning Anne Sexton’s poetry. Of course, like many the Nobel Prize. others, I had heard about her work and what Another coincidence was my acquaintance she symbolized to her many admirers. with Martin T. Ome. I ftrst met him when I Perhaps the most controversird aspect of was seeking an expert on hypnosis, the sub- Middlebrook’s biography is the role that ject of a Current Contents@ (CC’) essay3 Martin Ome played in its creation. He has and a topic discussed peripherally in other been widely criticized, perhaps unfairly, and essays.$b ~ter I met Martin at Sevemi so- rdso supported for having agreed to release cird functions. And still later, we met at an the tapes to the biographer of his therapeu- annual get-together of the Unit for Experi- tic sessions with Sexton over a three-and-a- mental Psychiatry at The institute of Penn- haif-year period. sylvania Hospital. Sexton kept chronological therapy note- Last but not least, suicide is unfortunately books that detailed each session of her treat- a subject of which I have fiisthand knowl- ment with Ome. Sexton’s estate had pro- edge. My daughter Thea committed suicide vided these to the biographer years before more than 10 years ago. Concomitantly, the the release of the tapes. However it is one subject of depression, inseparable from sui- thing to read about the therapy process and cide, has been discussed in CC in many dif- quite another to actually be able to hear the ferent contexts.7-12Clearly, there is a wide- work of therapy-both the anguish as well spread belief that it is an affliction common as the triumphs. There were no new facts among creative people.13,14However, some brought out from the tapes, but listening to 35 them allowed the biographer to live with disclosure of information provided by a pa- Sexton and Ome for 311 hours.’6 The im- tient in confidence, but Sexton was a pa- pact of actually being with Sexton was suf- tient who wrote confessional poetry about ficient to change Middlebrook’s feelings her mental illness and who requested that about her; she said that the person she came details of her therapy on tape be used to to know from the tapes required her to re- help others; thus, the unusual circumstances vise her portrayal of the poet in the final in this case may wamant public disclosure. biography. 17 In his Foreword to the biography, re- A Little About Sexton and Orne printed below, Orne explains some of his reasons for having released the tapes and Anne Sexton committed suicide in 1974 also expresses fundamental disagreement at the age of 45. She went into her garage, with Middlebrook on the question of turned on the ignition to her car, and died whether Sexton’s suicide could have been by carbon monoxide poisoning. Her life as prevented. Middlebrook argues that Sex- a poet and mother had been tumultuous. ton had reached a point in her life where Tragically, over the years she had become her desperate act was inevitable. While by addicted to drugs and alcohol. Neverthe- 1974 suicide might have been inevitable, less, she was able to maintain the disci- Ome takes the position that proper therapy pline required of an artist and teacher al- in the preceding decade would have pre- most to the end. vented her suicide. Sexton was born in 1928. She was the These matters have been widely dis- thiid of three daughters to Ralph and Mary cussed, even on the front page of The New Gray Staples Harvey, described by YorkTimes18and in numerous other publi- Middlebrook in the biography as being “like cations. If a measure of a book’s success is characters out of a Scott Fitzgerald novel, the number of reviews and news stones it children of the Roaring Twenties: good- generates, then this publication is a block- Iooking, well-to-do, party-loving, and self- buster. indulgent.’” (P. 4) 1 will not attempt to review all the argu- The family called Wellesley, Massachu- ments for and against the general subject of setts, home. At age 20, Anne married public release of information about patients. Alfred Muller Sexton II, nicknamed Kayo I observe that Middlebrook indicates in her after the character in the comic strip Moon preface “Everything I have learned about Mullins. They had two children, Linda and her [Sexton] suggests that she would not Joy. Anne had divorced Kayo shortly be- have held back from the archive of her fore she committed suicide. manuscripts and private papers the full col- After her second daughter, Joy, was born, lection of tapes.”[ (p. xxii) Sexton, suffering from severe depression, Orne had Sexton’s explicit verbal per- sought the help of a psychiatrist who had mission and request in 1964 to use the treated her briefly once before. This was tapes in any way that could help others. Martha Brunner-Ome, the mother of Mar- Middlebrook and Ome believe that if Sex- tin Ome. She would recommend her son as ton were alive today she would still have a therapist, and he treated Sexton for some enthusiastically approved publication of eight years, playing a pivotal role in her the biography. Since the biographer had life. the encouragement of Sexton’s daughter Martin Orne was 29 when he became and literary executor, as well as other fam- Anne’s psychiatrist. At that time, he was ily members and friends, the exception to an MD from Tufts University and was the inviolate rule of confidentiality may completing his PhD in psychology at be justified. Harvard, where he had earned his under- Understandably, no ethical physician graduate degree. He also was a resident in would want to be seen as encouraging the psychiatry at the Massachusetts Mental 36 I Martin Ome Diane Mia’dlebrook Health Center. Today he is professor of could pursue-prostitution. Given her diffi- psychiatry at the University of Pennsyl- culty in remembering significant emotional vania Medical School, director of the Unit interactions in therapy, a new therapeutic of Experimental Psychiatry at The Insti- technique was devised which included the tute of Pennsylvania Hospital. and adjunct taping of therapy sessions, Sexton’s writing professor of psychology at the University up of everything she remembered from the of Pennsylvania. session, and then listening to the tape the Ome has written extensively in his field next day and correcting her initird report to and served on the board of many psychiat- reflect what actually transpired during the ric journals, He is a Fulbright scholar and session. In this way, over time, her memory has received other awards, particularly for recall was strengthened. his work in hypnosis. His most-cited paper, Ome’s encouragement to write evidentiy “On the Social Psychology of the Psycho proved to be just what she needed. Within logical Experiment, With Particular Refer- four years of entering therapy, Sexton pub- ence to Demand Characteristics and Their lished her first book of Poetry?l followed Implications,”19published in 1%2 in Amen”- by a second only two years later.22 During cmr Psychologist, had been cited more than this time, she also became a Radcliffe 740 times when Ome wrote his Citation scholar. This, indeed, was an accomplish- Classic@ commentary in 1979.20Since then, ment for a patient of such low self-esteem it has been cited an additional 350 times in whose only schohdy accomplishment be- the Social Sciences Citation Index@. fore therapy was finishing high school. After diagnostic tests in 1956 reveaied While the professional ethics of releas- that Anne Sexton had considerable undevel- ing the therapy tapes turned out to be the oped creative potentird,Orne encouraged her focus of press attention, Middlebrook had as part of therapy to develop herself as a anticipated a greater reaction to the revela- poet and writer. But Sexton had very low I tion that Sexton had had a prolonged love self-esteem. At the time of entering therapy, affair with the psychiatrist who treated her she indicated only one possible talent she I after Ome moved to Philadelphia. 37 Mkhllebrook Comments ;haracter, toward whom the stance of the on the Biography’s Reception mthor is that of investigative journalist or malyst.