Mad, Bad, and Sad: A History of Women and the Mind Doctors

by Lisa Appignanesi

  Rooms of their own: Zelda Fitzgerald (1900–1998), Lucia Joyce (1907–1982), Virginia Woolf (1882–1941)

  Switzerland had been the nineteenth-century headquarters of sanatoria catering to tuberculosis patients. In the early twentieth, with a shift in illness patterns, it became the premier European site for mental clinics that more than rivalled their Austrian kin. When the famous American writer Scott Fitzgerald was looking for a sanatorium for his wife Zelda in June 1930, Prangins near Nyon was recommended. Run by Auguste Forel’s son Dr Oskar Forel, Prangins had something of the aspect of a luxury resort. Located on the shores of Lake Geneva, amidst some hundred acres of beautifully landscaped grounds which included tennis courts and a winter garden, Prangins looked after its small number of ‘guests’ in four villas. Three others housed therapeutic staff. Forel diagnosed Zelda as schizophrenic.

  Scott and Zelda Sayre Fitzgerald had been married for ten years. They were already a legendary couple, famous in the way that celebrity would only become again after rock and roll had invented pop stars. Precariously rich through the success of Scott’s fiction–This Side of Paradise, The Beautiful and the Damned, The Great Gatsby and, most popular and lucrative of all, his many stories for the Saturday Evening Post–they spent and drank and spent some more that they didn’t have in their peripatetic progression from the deep south of Zelda’s childhood in Montgomery, Alabama, to the Midwest of Scott’s, to New York, Paris, the Riviera, North Africa and back again, always and ever in search of the good, rich, leisured high life.

  They were the very stuff of magazine copy, their life together a glittering and exuberant exhibition of what it meant to be young and daring in the Jazz Age. The twenties gaiety, the beauty and rebellious bravado they embodied–always already lost, a sweet memory before it had been fully lived–was the very stuff of Fitzgerald’s art and sometimes hers. Of his novel Tender Is the Night, which turns Zelda’s madness into fiction while steering, as so much of his writing does, perilously close to the autobiographical truth, Fitzgerald writes, ‘The novel…should show a man who is a neural idealist, a spoiled priest, giving in for various causes to the ideas of the haute bourgeoisie, and in his rise to the top of the social world losing his idealism, his talent and turning to drink and dissipation.’ The man was a psychiatrist, Dick Diver, who saves and then is destroyed by the golden heiress, the little lost mad girl, Nicole Warren.

  Somewhere along the way in the real life of excess and art, the Fitzgeralds had had a daughter, Scottie, born in October 1921, whom Zelda, in the girl’s early years, preferred not to notice. She was nine at the time of her mother’s first breakdown. There had also been an abortion, and two love affairs–Zelda’s, unlike Scott’s, perhaps unconsummated, but both experienced as a betrayal by each. In the midst of all this, Zelda increasingly felt that she had nothing of her own, nothing that defined self and gave it boundaries: her writing, brilliant in its imagistic leaps, was not as successful as Scott’s. Their child seemed to prefer him. Then, too, Zelda’s idealized father, a strict and much respected judge, disapproved of her life.

  Zelda had been a late child, a spoiled and much loved afterthought. Allowed to run wild by a mother who adored her, called ‘baby’ by the family into adulthood, she had grown in her teens into the wildly flirtatious and capricious belle of Montgomery, an expert in the performance of femininity if not of friendship. Handsome in his First World War captain’s uniform, Scott had won her from a host of rival suitors. She recognized that jealousy both sparked and intensified his love, and that she needed him to feel it. She needed his desire, his attention, needed to be conquered to acquire definition. Somehow his jealousy limited what felt like her excessive depths of dependence.

  When Scott’s attention wandered, her acts grew increasingly reckless. In Los Angeles, legend has it, she burned all her clothes in the bath tub while Scott entertained next door. On another occasion, she collected dinner guests’ jewellery and boiled it all in a great pot. When Scott knelt at the feet of Isadora Duncan at a restaurant in St Paul de Vence, Zelda plunged down a precipice of stairs.

  As Fitzgerald drank more and more and lost himself in work or the inability to do it, since despite his alcoholism he could only write sober, desire dwindled. Zelda began to suspect him and accuse him of homosexuality, which rankled. They had always fought. Now they fought harder. In the late twenties, Zelda turned to dance both for escape and for a sense that here was something she could control, could succeed at. Ballet–practising, rehearsing, training, occasionally performing–became the compulsion that swallowed her days. In America, report has it, she would wordlessly abandon guests at the dinner table to practise ritualistically at the huge mirror and bar she had had installed. In Paris, ballet became as addictive as Scott’s drinking, and more exhausting. It was her consuming ambition. It was also a ritual that allowed a certain sense of self-command. Zelda danced, rehearsed, danced and worried about her progress, while Scott drank and sometimes wrote.

  Then, in early 1930, came breakdown. Eczema covered her. A recurrent asthma took hold. There were fainting spells. Terrifying voices, dreams, and phantoms of hallucinative force pursued her day and night. Dazed, incoherent, she attempted suicide to evade them. Morphine helped, but didn’t stop the dreams’ vivid pursuit. Scott took her to Malmont in Switzerland. The doctor’s notes record that ‘from an organic standpoint, there is nothing to report’. In calm moments, ‘the patient understood quite well that she was at the end from a physical and nervous (psychological) standpoint and that she badly needed to take care of herself, but then an hour later she again wanted to know nothing about that and insisted on her return to Paris. Numerous discussions with her were fruitless because of all her real thoughts she expressed only a few incoherent ones.’ The call to Paris was the call of dance.

  During one of her more reasonable moments, Zelda agreed to be transferred to Prangins for psychiatric treatment. With a friend, Scott came to collect her and delivered her to Dr Forel.

  Fundamental to Zelda’s treatment was separation from Scott. Both wanted to cooperate, yet three weeks in, Zelda wrote to him begging to be allowed home; urging him, also, to ask her beloved ballet teacher, Egorowa, where she thinks Zelda, who feels her legs are ‘already flabby’, stands with her ballet. Are her ambitions realistic? Scott asks for her. He is both relieved and surprised at Egorowa’s judicious response. She tells him that Zelda started too late; but with that given, she has progressed well and could perform adequately in certain venues.

  During the summer months and into the autumn, Zelda’s treatment had little impact: lucidity alternated with descents into darkness. Her letters to Scott, regular enough, talk of panic, of things being ‘barren and sterile and hopeless’. In this wavering condition, she is also able to describe something of what being inside her madness is like. She does it with all the panache of her extravagant, but utterly accurate, pen, conveying a sense of the limitlessness, the excitement, the intensity of colour and sensuous reality the experience brings.

  In Paris, before I realized that I was sick, there was a new significance to everything: stations and streets and façades of buildings–colours were infinite, part of the air, and not restricted by the lines that encompassed them and lines were free of the masses they held. There was music that beat behind my forehead and other music that fell into my stomach from a high parabola and there was some of Schumann that was still and tender and the sadness of Chopin Mazurkas…And there was…a detachment as if I was on the other side of a black gauze–a fearless small feeling, and then the end at Easter–But even that was better than the childish, vacillating shell that I am now. I am so afraid that when you come and find there is nothing left but disorder and vacuum that you will be horror struck. I don’t seem to know anything appropriate for a person of thirty. I suppose it’s because of draining myself so thoroughly, straining so completely every fibre in that futile attempt to achieve with every factor against me.

  Other letters are more incoherent or vio
lently hostile towards Scott, or simply plaintive. In the autumn, Forel, who had found Zelda uncommunicative and evasive, hit on the idea of having her write down her feelings about her family and herself. On paper, Zelda conveyed her family: her indulgent mother who came to her in striking images; the distant father for whom she had both respect and mistrust; her sudden sense of their unhappy marriage, though neither complained. She also wrote out her ‘love affair with a French aviator’ the feeling that ballet provided an impersonal escape into a world in which she could express herself. And how one day ‘the world between me and the others stopped’. No one, it seems, picked up on her accusing Scott of homosexuality at the same time as her ambitions focused on her ballet teacher as a signal that the boundaries between them had disintegrated. Her identification with Scott had taken on psychotic proportions which may well have played into their later mutual paranoia about whose life belonged to whose writing.

  In September, Forel tried a new tack. He hypnotized Zelda, who succumbed like a perfect subject. In the thirteen-hour trance that followed, her terrible eczema oozed away. As she told Forel afterwards, she now realized the eczema was a warning device, signalling her deep conflicts with Scott. By November, it had returned, and Zelda was dull, unresponsive, lacking in affect. Under pressure from Scott, Forel called in Bleuler for a consultation. He wanted to be certain of his diagnosis, and discussing with the master this ‘difficult patient…who was more intuitive than intelligent’ would help. Scott reports all this in a letter to Zelda’s parents, also noting that Forel had not been able to psychoanalyse Zelda for ‘fear of disturbing and sacrificing what precious little equilibrium she possessed’.

  Bleuler, according to Scott, was selected after some weighing up of the choices. Jung had been considered but, at the $500 Scott names as his consultation fee, at a time when a new Chevrolet coupé cost $600, thought too expensive. Scott was also under the impression that Jung handled primarily cases of neurosis, and Zelda’s was more than that.

  Bleuler travelled over from Zurich and spent an afternoon with Zelda, who treated him as ‘a great imbecile’, according to Forel. In the evening Bleuler, perhaps not so much an imbecile as all that, given the weight of his experience, reported to Forel and Scott. His diagnosis didn’t differ from Forel’s, but his prognosis was interesting–given the long-term pattern of Zelda’s illness. Three out of four cases akin to Zelda’s, Bleuler said–according to Scott’s report to Zelda’s parents–were discharged as cured, ‘perhaps one of those three to resume perfect functioning in the world, and the other two to be delicate and slightly eccentric through life–and the fourth case to go right down hill into total insanity’. Bleuler also indicated that Zelda’s descent had begun some five years before and that though Scott might have retarded it, he couldn’t have prevented it. He must stop blaming himself. Apparently, Scott asked the doctors if a change in his way of treating Zelda, who preferred men ‘of a stable and strong character’, might help. He was told that ‘it was possible that a character of tempered steel would help, but that Mrs. Fitzgerald loved and married the artist in Mr. Fitzgerald’.

  There is a possibility, of course, that Scott had finessed this last comment for the benefit of Zelda’s strong and upright father. Sayre, an Alabama Supreme Court judge, was also–unlike Fitzgerald–utterly impervious to the mirror society turned on him and his ranking in the popularity stakes. The two men could hardly have been more different. Scott’s residual grievance against Judge Sayre, the effect his emotional distance and unreachability had on Zelda, may have something to do with the way in which he transformed Nicole Warren’s father in Tender Is the Night into a widowed seducer, whose sexual slips with his beautiful thirteen-year-old daughter had led to her breakdown a few years later. It is as if Scott wanted to deflect responsibility on to the paternal figure. But there is no trace of any ‘sexual abuse’ in Zelda’s actual history. In the novel, Fitzgerald introduces the matter almost blithely, thereby both giving sufficient reason for Nicole’s breakdown and subsequent love–hatred of men, and chasing her father away from any further contact with his girl. She is saved by Dick Diver, only subsequently to destroy him.

  Given that there are no grounds in Zelda’s history for attributing sexual abuse, it is interesting, in terms of the 1980s ‘discovery’ of what has often been claimed in America as the patriarchal and psychiatric burial of women’s real lived experience, that one of the country’s most famous novels from an earlier era writes it large, but as a fictional invention. Zelda herself never mentioned an actual paternal seduction. She did, however, later trace or construct an Oedipal family narrative out of her childhood in her frankly autobiographical novel, Save Me the Waltz, where she pointed a finger of blame at her father, characterized as ‘a living fortress’, a stern, unloving judge as harshly correct as his wife was supple. The fictional father may give his daughter Alabama, security, but his inaccessibility is ruinous, and his unassailable integrity comes with a code of conduct the new generation can never hope to emulate. Safe when they are within his aegis, as soon as they enter the outside world the judge’s children are crippled, unable to think for themselves, undone.

  During his consultation, Bleuler had told Scott, it would be appropriate for him to see his wife occasionally. Fitzgerald moved to Lausanne and came for brief visits every two or three weeks. Meanwhile, there were letters on both sides trying to understand what might have gone wrong. Scott felt guilty; so did Zelda, by turns, though she veered between tenderness and vindictiveness: ‘When you saw in Paris that I was sick, sinking–when you knew that I went for days without eating, incapable of supporting contact with even the servants, you sat in the bathroom and sang “Play in your own backyard”.’

  Zelda’s letters offer a finely honed insight into her schizophrenia, though they don’t chart the violence that occasionally takes her over:

  My memories are mostly lost in sound and smell…Try to understand that people are not always reasonable when the world is as unstable and vacillating as a sick head can render it–that for months I have been living in vaporous places peopled with one-dimensional figures and tremulous buildings until I can no longer tell an optical illusion from a reality–that head and ears incessantly throb and roads disappear, until finally I lost all control and power of judgement and was semi-imbecilic when I arrived here.

  Not so long after these letters she asked to see her daughter for Christmas, but when confronted by the child–a relationship which never ceased to cause her enormous difficulty–babbled incoherently and in a rush of violence destroyed the ornaments on the Christmas tree.

  At the end of January, Scott’s father died and he travelled back to America. In his absence, Zelda improved, eating regularly with the other patients for the first time and taking up skiing. Scott had always advised the doctors that regular exertion would help her, and it now seemed to. By spring, she had stopped recriminating him. On his return, they were able to go on brief outings together and contemplate a shared future. She also went out with other patients, revelling in the new freedom. In July 1931, after two weeks spent with both Scott and Scottie at Annecy, Zelda retrospectively conjured up the perfection of their holiday, the tennis, the warm nights dancing by the lake, ‘white shoes gleaming like radium in the damp darkness. It was like good gone times when we still believed in summer hotels and the philosophies of popular songs.’

  She also wrote tenderly to Scott, offering herself and making light of her condition:

  My dearest and most precious Monsieur,

  We have here a kind of maniac who seems to have been inspired with erotic aberrations on your behalf. Apart from that she is a person of excellent character, willing to work, would accept a nominal salary while learning, fair complexion, green eyes, would like correspondence with refined young man of your description with intent to marry. Previous experience unnecessary. Very fond of family life and a wonderful pet to have in the home. Marked behind the left ear with a slight tendency to schitzophrenie [sic].r />
  Zelda’s ability to mock herself was a sign of her improvement. After a trial of her ability to contend with life outside the clinic during a long visit to friends in Austria, Forel decided that she could leave Prangins. She had spent fifteen months in the clinic. The language in which Forel couches his prognosis shows a marked conservatism about woman’s role, almost as if the whole feminist pre-war battle had to be fought again–which, of course, in most quarters, vote apart, it did. But his notions of inferiority are also the fashionable ones of Viktor Adler. Her case ‘was a reaction to her feelings of inferiority (primarily towards her husband)’. Though Forel had also told Zelda that to keep writing was good for her, he estimated her ambitions in ballet as ‘self-deceptions’ which caused ‘difficulties between the couple’. Prognosis was only favourable if conflict could be avoided.

  In 1966, writing to Nancy Milford, Zelda’s biographer, Forel ‘put aside’ his original diagnosis of schizophrenia, explaining that now, while ‘certain symptoms and behaviours or activities, are called schizoid’, this does not ‘mean that the person is schizophrenic’. Times had changed. By 1966 the wonder drug chlorpromazine had come along, eliciting differing definitions and diagnoses of schizophrenia–functioning, one might say, as a diagnostic agent in the same manner as Charcot’s hypnotism: if it worked, then hysteria (or schizophrenia) was present.