Gracefully Insane: The Rise and Fall of America's Premier Mental Hospitalby Published 07 Jan 2003
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Its landscaped ground, chosen by Frederick Law Olmsted and dotted with Tudor mansions, could belong to a New England prep school. There are no fences, no guards, no locked gates. But McLean Hospital is a mental institution-one of the most famous, most elite, and once most luxurious in America. McLean "alumni" include Olmsted himself, Robert Lowell, Sylvia Plath, James Taylor and Ray Charles, as well as (more secretly) other notables from among the rich and famous. In its "golden age," McLean provided as genteel an environment for the treatment of mental illness as one could imagine. But the golden age is over, and a downsized, downscale McLean-despite its affiliation with Harvard University-is struggling to stay afloat. Gracefully Insane, by Boston Globe columnist Alex Beam, is a fascinating and emotional biography of McLean Hospital from its founding in 1817 through today. It is filled with stories about patients and doctors: the Ralph Waldo Emerson protégé whose brilliance disappeared along with his madness; Anne Sexton's poetry seminar, and many more. The story of McLean is also the story of the hopes and failures of psychology and psychotherapy; of the evolution of attitudes about mental illness, of approaches to treatment, and of the economic pressures that are making McLean-and other institutions like it-relics of a bygone age.
This is a compelling and often oddly poignant reading for fans of books like Plath's The Bell Jar and Susanna Kaysen's Girl, Interrupted (both inspired by their author's stays at McLean) and for anyone interested in the history of medicine or psychotherapy, or the social history of New England.
Gracefully Insane: The Rise and Fall of America's Premier Mental Hospital Reviews
What I liked best about this book is that Alex Beam does not simply mock the wealthy, upper-class persons who were the patients at McLean Hospital in Massachusetts. Instead, he places these patients' and doctors' lives into a social and historical context. The result is a compassionate and generally respectful look at patients' suffering and struggle to overcome mental illness. He includes sections on Anne Sexton, Robert Lowell, and James Taylor (the pop singer).
After watching a television show depicting ghost hunters in an "insane asylum" I found my curiosity increased about the history behind some of these institutions. By far, this is the book I enjoyed reading the most. The author focuses on the McLean hospital, part of the Harvard medical system and a temporary home to some of the rich and famous. A little teaser, the author of Girls Interrupted spent time at this hospital. The book focuses on the history of the hospital. Yet it is evident that the author spent additional years learning more about the patients who stayed there and he includes numerous additions from these sources. He is able to pull the story of the hospital together intertwined with stories of the patients and employees resulting in a book that I recently described as a "delightful read". A quote opening Chapter 2 states "Crazy people much more pleasant than I expected." At times I found myself cheering and other times devastated by the loss and I believe the author did a great job of depicting the plight of mental illness in a small segment of that population.
Beam's "Gracefully Insane" is rich in anecdotal history, but poor in other areas. Makes for a light, enjoyable read, but Beam rarely teases out the interesting insights that arise from his excellent access to the inner workings of America's "Premier" mental hospital.
This book will make you think about the (troubled) history of psychiatry/ treatment of mental illness, and Beam's portrait of this institution caused me to shed no tears for the fall of this fabled refuge for blue blooded loons.
Reading interviews with "graduates", its hard not to question the assumptions that underlied McLean's very reasons for existence. Few of the individuals profiled within seem like they were ever a "danger to self or others". Indeed, when a rash of suicides hit McLean a couple of decades ago, the staff were singularly unprepared to cope. Perhaps this is because the "inmates" were not as bad off as one might suppose?
Makes an interesting companion piece for Goffman's "Asylums".
The story of McLean hospital, one of the most famous mental hospitals in the US. Sometimes it seems as though anyone who's anyone spent time in McLean; throughout the 20th century it was famous for catering to the rich and famous with the utmost discretion. Among its "alumni" are poet Robert Lowell, Sylvia Plath (who based her novel The Bell Jar on her experiences there), James Taylor and his siblings, Susanna Kaysen (who wrote about her experiences in Girl, Interrupted), John Nash, and Ray Charles, just to name a few.
In many ways, the history of McLean is the history of the last century of mental health care, although McLean as whole has been a kinder, gentler place than most mental hospitals. There are still stories of brutal, though well-intentioned, treatments: insulin shock therapy, icy hydrotherapy, electroshock therapy (with much higher levels of electricy than today's electroconvulsive therapy). Only a handful of lobotomies were ever performed at McLean, however, and the main emphasis was on milieu therapy -- the theory that providing structure and a relaxed, comfortable environment would go farther to help patients than any invasive procedure.
Of course, the milieu therapy led to a lot of long-term residents at McLean. In the heydey of psychoanalysis, the intake period was 40 days -- the actual treatment usually didn't start for weeks. This kind of treatment has fallen by the wayside in recent years, as health insurance and rising healthcare costs make it impossible for patients to afford more than the usual five day stay, and in turn, McLean is now a ghost of what it once was. It's easy to feel sort of nostalgic for the "old days" of psychotherapy, particularly since insurance and an overloaded system mean that many patients are diagnosed, given drugs, and only receive a very limited amount of talk therapy, if any at all. On the other hand, there's little evidence that McLean's milieu therapy was any more effective than the current methods, particularly in the case of psychotic patients. Still, one wishes somewhat for a happy medium -- no six month hospital stays, but enough time to offer a little caring and patience. As this book makes clear, however, this luxury was only ever available to the very rich, even when it was considered the best treatment for what ails you.
A work of non-fiction cataloging the history of the famous McLean Hospital, a psychiatric facility located in the Boston suburbs, this was a pleasure to read. Especially since I grew up a couple miles from the hospital (had even volunteered there as a young adult), I felt protective of this fine institution and all that it represented. It always seemed a staple of mental health treatment which was well known in the psychiatric circles but otherwise seemed to be a "secret" to others outside of the nearby community. Turns out Beam's novel revealed that this hospital was even more well known than I had suspected, just that this reputation existed a little above my pay grade. The novel catalogues the hospital's 200 year history from its humble beginings to its heyday in the 1900's as a facility providing excellent treatment for those who could afford it. The listing of the rich and famous who sought treatment within its walls is extensive and author Beam does a great job juxtapositing the historical background of the hospital with its evolving treatment modalities, as well as information on some of its more well-known residents. The hospital, much like many psychiatric hospitals across the country, has faced challenges in how it administers care in a changed health care environment and this stepwise progression is depicted nicely by Beam. For those with any training in psychology, medicine, or psychiatry this is a very well researched piece of medical history that is engrossing and factual. Readers without some of this background should not be intimidated by the subject matter or mental health terminology since Beam is able to provide good explanations for all without alienating. Highly recommended.