THE LETTER 61 Spring 2016, pages 77-81

Barbara Taylor is a much-acclaimed academic historian. The Last Asylum: A Memoir of Madness in Our Times is a meditation on her own experience with mental illness. Taylor was a patient at Friern— otherwise known as the Colney Hatch Lunatic Asylum— in North London during a period of transition within the field of psychiatric health care. It is from this unique perspective that she chronicles both her own emotional breakdown and the demise of the Victorian Asylum system in general.  However, the main purpose of her memoir is, as she puts it, to serve as ‘a work of gratitude’ to those friends, family, doctors and nurses who helped her along the way and, in particular, to the ‘psychoanalytical process and the analyst who practised it with [her]’.

The original conception of the Asylum structure, formulated in the 19th century provides a yardstick against which she measures the emergence and decay of an ideal system.  She traces the process whereby ‘the institutions, which had begun on a tide of conformist optimism, floundered in a flood of anti-institutional anti-welfarist sentiment’.  Asylums were originally dedicated to mitigate human suffering. Friern was exemplary in this respect. It had a reputation across Europe as ‘a prestige institution to comfort and heal the human mind’.  The centuries-long prevalence of patient maltreatment was replaced by a new kind of therapy known as ‘moral treatment’. This operated on the principle that through exhibiting benevolence and sympathy during treatment, human suffering could be reduced. Accordingly, prior methods of restraint —straitjacketing and physical punishment, for example —were banned. As a result, patients were not only freed from corporal suffering but from the enforced isolation and mental anguish that such practices entailed. Moreover, the benefit of this new therapy with its emphasis on care and com-passion proved to be more effective when administered in an environment shared with others. Taylor gives a brief snapshot of how these principles were put into practice. Patients worked, mixed and conversed with each other and with the staff in the gardens and in various other work places within the …