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Bedlam: the asylum and beyond

Bedlam: the asylum and beyond

The last few years have seen sea change in how we talk about mental health in Britain, with a shift towards increased openness and greater media sensitivity. With one in four people known to experience a mental health problem every year, it’s a long overdue attitude change.

As a new exhibition at the Wellcome Collection shows, we had come along way even before this recent progress. Bedlam: the asylum and beyond’ takes as its focus the notorious Bethlem hospital, which opened nearly 800 years ago a stone’s throw from what is now Liverpool Street Station, and uses this as a jumping off point to discuss the historic treatment of the mentally ill.

Colour engraving of exterior of Bethlem Royal Hospital, St George’s Fields ® Bethlem Museum of the Mind

It’s a curiosity of an exhibition; after all, how can you depict a subject so very much of the mind? How can you build a display around something so complex? The resulting exhibition is challenging – this is no light afternoon perusing a museum – but has been pulled off with aplomb. Photographs, maps, letters, drawings and other memorabilia are used to shine a light on Bethlem, its patients and its legacy, and bring to life a particularly colourful section of the capital’s history.

Engraving of exterior of the hospital at Moorfields (c.1900-07) © Bethlem Museum of the Mind

It’s arranged chronologically, following the journey from medieval medicine to the hellish scenes depicted by Hogarth in his Rake’s Progress engraving – as the exhibition notes, Bedlam is now a byword for chaos, or worse – then on to the hospital’s move to Southwark and its third incarnation outside the city. Towards the end, it explores how the pharmaceutical industry transformed treatment, and considers modern developments such as mindfulness and cognitive behavioural therapy.

You see how mental illness has, over the years, been associated with poverty, depravity and criminality. Only since the 1960s has it been treated in mainstream hospitals, rather than Bedlam-esque asylums, with their associated stigma.  An 1876 painting, depicting a mentally unwell person being freed from chains following the intervention of a pioneer of listening therapy (progressive at the time), underlines how far we have come.

(left) Jane Fradgley, ‘Cocoon’ (2012) and (right) Jane Fradgley, ‘Within’ (2012) ® the artist

Along the way, you learn of abhorrent treatment over the years. Evidence in an 1814 parliamentary report tells of a Bethlem inmate, James Norris, chained to the wall from his neck for a decade. “A length of time, I should think far better calculated to drive away the reason of a sane man, than to restore a madman to his senses,” read one account. At one stage Bethlem was a tourist attraction, open to the public in the same way that the Tower of London was (to raise funds for the hospital). Apparently, it was especially rowdy on Sundays.

At the same time it is eye-opening to learn that our modern approach is not all that modern; in Geel, in Belgium – the birthplace of St Dymphna, patron saint of the mentally distracted (who knew?) – care in the community has been alive and well for centuries. There, at this place of pilgrimage, patients who could find no remedy were looked after by families and engaged in productive activity. This ‘moral therapy’ idea was adopted by the Quakers at the turn of the last century, who opened a retreat where patients and staff lived and worked together.

David Beales, ‘Industrial Therapy’ (2003), courtesy of the artist and Bethlem Gallery

At times it is heartbreaking, not least when you see inmates’ artwork. A poem in Bethlem’s in-house magazine tells of the impotence they felt. “Oh cruel fate! to be confined as mad / For years, in scenes so wretched and so sad.”

‘Bedlam’ is a culture trip that involves plenty of reading; the exhibits don’t always speak for themselves. A Van Gogh etching seems an odd inclusion until you learn it depicts the doctor who treated him after he was released from the Saint Remy asylum. Drawings by Salvador Dali portraying the move from mental chaos to a peaceful state of mind seem fairly typical of Surrealism, yet their purpose was marketing material for a pharmaceutical company. The photographs of Victorian-era inmates – some distressed, others defiant or resigned – become all the more moving when you discover that one school of thought held that being photographed could be therapeutic in and of itself.

Frontispiece to ‘The anatomy of Melancholy’, Christof Le Blon,(1628), Credit Wellcome Library, London

What it is not is a horror show, a London Dungeon’s-style interrogation of the gruesome treatment of the mentally unwell, though it does not avoid the gritty truth, with examples of straightjackets and a copy of the 17th century tract, ‘Anatomy of Melancholy’, which advised treatments such as bloodletting. It is much more interested in using Bethlem to tell a story of social progress.

As you leave, you walk past a vast model of ‘Madlove: A Designer Asylum’, a utopian place designed by ‘certified mad people’. It features tree houses, cooling towers for letting off steam, and an observatory for residents to see the stars and ‘get some perspective’. It’s whimsical and fun; and a reminder that we have not yet fully answered the question of how to treat mental illness. A fascinating exhibition that will make you think.

Photograph of dome of hospital building at St George’s Fields, (c. 1900-7) © Bethlem Museum of the Mind

Bedlam: the asylum and beyond is on at the Wellcome Collection until 15 January. Entrance is free.