Gracefully Insane: The Rise and Fall of America’s Premier Mental Hospital by Alex Beam.

Even so, I must admire your skill.
You are so gracefully insane.”

Poet Anne Sexton, an admirer and student of poet Robert Lowell, in a poem called Elegy in the Classroom that she wrote about Mr. Lowell’s mental illness

Gracefully Insane is a name-dropping history of McLean Mental Hospital in/near Boston, Massachusetts. A list of the alumni of McLean reads like a combination of Who’s Who in the arts and business and the Boston social register: navigator Nathaniel Bowditch, Edward and Robert Emerson, brothers of the more famous Ralph Waldo, International Harvester heir Stanley McCormick, art collector and patient for a time for Dr. Freud himself, Scofield Thayer, another of Freud’s unsuccessful analysands, Carl Liebman, poets Sylvia Plath, Robert Lowell, and Anne Sexton, musicians James Taylor, Kate Taylor, Livingston Taylor, Ray Charles, and Clay Jackson, author of the McLean memoir Girl, Interrupted Susanna Kaysen, and many other very rich, socially prominent people whose families could afford to have them live in a mental hospital/resort. For many of the patients, the records are still sealed because McLean promises, among other amenities, perpetual confidentiality. William James may have been a patient at McLean, but nobody knows for sure because the documents in the case, if there are any, are sealed and inaccessible.

In addtion to as much name-dropping as is possible under the circumstances, Gracefully Insane tells the story of how mental health care and treatment for the insane and the distrubed has changed over the past hundred years. At first (1817), McLean was a refuge for the members of Boston’s First Families who were unable to cope with, or unwilling to follow the rules of, Boston society. The eccentric and the insane were housed in luxury and with minimal treatment at Charlestown (later called McLean) Asylum. They were sometimes given cold baths or treated with purgatives or other medicines, but mostly they were admonished to behave themselves and left to their own devices as long as they stayed within the purvey of McLean’s rather small staff. Many inmates brought their own servants to minister to their physical needs.

One reason I found this book interesting is its association with one of the books by Caroline Cooney that I just read, Out of Time. In that book, set in the 1890’s, Hiram Stratton, Jr., heir to a great fortune, is imprisoned by his father who is the villain of the piece. Strat, as he is nicknamed, has had a serious disagreement with his evil father, and his father sends him to a mental institution. There Strat recieves no treatment for mental illness, but is subjected to the most horrifyingly dehumanizing treatment imaginable. Cooney implies that commitment to a mental asylum was a common way for the very rich to get rid of undesirable relatives. Although McLean was a much more humane place than the fictional hospital where Strat was imprisoned, Gracefully Insane corroborates the idea that eccentric and embarrassing relatives were sometimes sent to an asylum to be genteelly incarcerated and kept out of circulation.

Gracefully Insane is both a history of a particular hospital and a history of American psychiatric practices in general. I can’t see that we’ve really learned too much about the causes and cures of mental illness in the hundred or so years since McLean first opened its doors. Those wealthy families who can afford it still send their mentally unstable members to some sort of hospital/resort to maybe recover, and the poor and middle class still cope as best they can. Cures are as hard to come by nowadays as they were a hundred years ago.

Two interesting sidenotes:
The cover from the Amazon site (above) has a different picture and a different subtitle from the books I got at the library. In my library copy, the emphasis on the cover and in the subtitle is on the hospital itself. In the Amazon incarnation, the emphasis is on “life and death”, the people of McLean. Was this a change to sell more books?

I found this book last year sometime recommended by Marshall Zeringue at Campaign for the American Reader.