Gracefully Insane: The Rise and Fall of America's Premier Mental Hospital

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Gracefully Insane: The Rise and Fall of America's Premier Mental Hospital

by Alex Beam (Goodreads Author)

3.72 of 5 stars 3.72 · rating details · 732 ratings · 101 reviews

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 Tayl...more

Paperback, 296 pages

Published January 7th 2003 by PublicAffairs (first published November 30th 2001)

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Surviving The Fourth Cycle by Nathan Daniels

The Yellow Wallpaper by Charlotte Perkins Gilman

Memoirs of Madness

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Sep 25, 2010 Andrea rated it 4 of 5 stars

Shelves: 2009

It took me over three months to read this book! To be honest it may have to do with the fact that I was also reading several other books at the same time. Anyhow being from Boston made this book extra special for me since this is the location for that famous McLean Mental Hospital. The rich history of the facility and the treatment of mental health was fascinating. I also found some of the famous patients like Sylvia Plath and the Taylor (James, Livingston, and Kate) family to be very interestin...more

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Jul 30, 2012 Rob Freund rated it 2 of 5 stars

Alex Beam’s, “Gracefully Insane” presents a unique look at the development and history of mental health in America, framed in the focus of one of the nation’s oldest and most prestigious asylums (later to be known as a mental health hospital). Narrowing his investigation to just one institution as it progresses through history provides an intimate, accessible review of mental health therapies, diagnoses, and the major players within the field.

Rating: 2 stars for being well written, and comprehen...more Alex Beam’s, “Gracefully Insane” presents a unique look at the development and history of mental health in America, framed in the focus of one of the nation’s oldest and most prestigious asylums (later to be known as a mental health hospital). Narrowing his investigation to just one institution as it progresses through history provides an intimate, accessible review of mental health therapies, diagnoses, and the major players within the field.

Rating: 2 stars for being well written, and comprehensive, but at times a bit dry, and overall a little sensational in its endeavor. (I'm a harsh critic.)

Beam’s novel begins with the contemporary setting of McLean hospital, located in Belmont, Massachusetts, which is near to Boston. He discusses the nature of the grounds, and describes the museum located within the hospital. In so doing, he presents an argument and rationale of why McLean is an ideal window through time for examining the history of mental health. All of the items in the hospital museum have come from the hospital itself, each tracing back to the point of their origin; the hydrotherapeutic baths, electroshock devices, medicines, letters and portraits of famous physicians. From there, Beam enters the past, beginning at the hospital’s inception in 1816.

The story of McLean hospital begins with a pragmatic, historical focus. As the premiere establishment for Boston’s wealthiest and well bred, it can be of little surprise that some of America’s best known authors, poets, musicians and business tycoons took up residence at one point or another. These include such persons as Robert Lowell, Anne Sexton, and Sylvia Plath, James Taylor, and Ray Charles. Because we are familiar with these people as artists, reading their stories in McLean as people help the reader to feel closer to the institution (if not, at times, slightly voyeuristic). The novel offers many other accounts based off of research and interviews. The life of Stanley McCormick, whose family was made one of the country’s wealthiest through the development and sale of the mechanical reaper, is one such example. The reader receives a short biography, including many startling details of his life-long illness, marriage, and family. The same is done of many other McLean residents throughout the hospital’s history.

Of interest to readers in mental health professions, will be Beam’s account of the therapeutic developments and controversies that took place at McLean. Because of its age, the hospital lived through nearly all of the trends that struck the mental health arena. Each in turn is highlighted as it emerged in the history of the institution. Perhaps most interesting is the introduction of psychoanalysis, and the lengthy portions of the book focused on patients at McLean who had once been Freud’s clients, students, and friends. The reader becomes privy to personal letters and journal entries that shed a surprisingly personal light on Freud's character.

Beam also discusses the generational changes in and factors affecting institution management. The book ends on a contemporary setting, discussing the current policies of McLean that are in accordance with the managed care systems. The note of nostalgia in Beam’s ending is unavoidable; a sense of something lost in time that policy took away. The personable nature of life at McLean has changed, because the management of it has changed. Whether this change has been for the better or worse, one cannot determine, but Beam’s writing suggests that it is likely not for the better.

“Gracefully Insane” presents an interesting opportunity to view the development of mental health treatment in an entertaining, personal framework. While not without its flaws, the work is a well written to evoke the humanity of those suffering from mental illness, the scandal of professional and aristocratic indiscretions, and the poignancy of mental health profession's triumphs or failure. Because it focuses on an institution that catered to the rich and powerful, and because of certain shifting foci throughout, “Gracefully Insane” should not be taken as a definitive history of psychiatry and mental health, but rather a sampler that would entice the reader to delve deeper into those subjects of the past which interest them most.
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Jul 12, 2012 Cameron rated it 4 of 5 stars

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...more

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Aug 26, 2007 Rachel rated it 5 of 5 stars Recommends it for: confessional poetry readers, esp. of Anne Sexton and Robert Lowell; psychotherapy readers

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).

4 likes · like · see review

Mar 26, 2011 Kyrie rated it 4 of 5 stars

Shelves: medicine, psychiatry

This book was also referenced by the author of Shutter Island. It's the story of McLean, a famous mental hospital in Massachussetts that has treated the rich and sometimes famous for years. Sylvia Plath was there, Robert Lowell, Kate, Livingston and James Taylor, Ray Charles, were also there. It seems more steeped in the tradition of the Quakers - who were into gentleness, and rest to cure or at least help the mentally ill. It brings back a gracious era - where we packed Mad Old Aunt Maddie off...more

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Dec 21, 2010 Rachel rated it 3 of 5 stars

While it covers fascinating material, it feels disjointed and choppy in many places. It sort of reads like a research paper that has been expanded into a book, meaning that there are often stories that seem irrelevant to the overarching history of McLean. This means, though, that the really interesting topics that get broached to fill pages, like famous patients or antiquated methods of psychoanalysis don't get covered in the depth I'd like to see, because this book isn't really about them. It s...more

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Apr 16, 2013 Tara rated it 2 of 5 stars

Interesting history of the McLean Mental Hospital in Belmont, MA. Chronicling the shift from inpatient care to the medicated, short stay, outpatient care of today. Info on treatments that would be considered barbaric now. And even a bit about Freud. Making it sound like sometimes he kept patients on more for the entertainment value rather than helping them.

It was a place where lots of people from very wealthy families lived out their adult lives. Celebrities thought of stay as a badge of honor....more

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Nov 07, 2011 Kristin rated it 3 of 5 stars

+ This book was perfect to read around Halloween! I also started it on the flight to Boston, not knowing that the mental hospital was near Boston!!
+ I was the most interested in learning about the treatments - hydrotherapy, electroshock therapy, insulin induced comas, lobotomies (yeaaaa haha)
+ Sylvia Plath went to McLean and I love learning about her (I've read 3 books about her life, and the Bell Jar). A few poets went to McLean and there were poetry classes. This poem stood out to me:
...I feel...more

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Feb 02, 2012 Marie rated it 4 of 5 stars

It's probably more of a 3.5...not the most organized book. It is all over the place and choppy (expect more a collection of short stories and it shouldn't bother so much), but it's an interesting glimpse into what used to be one of the most prestigious mental institutions for the wealthy and talented. It's the subject of many famous books/films and housed many famous individuals, Girl, Interrupted, Sylvia Plath/The Bell Jar, Ray Charles, James Taylor, many Harvard educated intellectuals...and a...more

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Feb 10, 2011 Hollowspine rated it 3 of 5 stars

Very eye-opening history of McLean Hospital, very in-depth and revealing as to the various treatments given over the years and the changes in those, in staffing and running the hospital and in the culture of McLean from past to present. It was a little dry in places, but overall enjoyable. Very good reading for those interested in psychology as well as those researching various artists 'stamped their cards' at McLean.

It was also interesting knowing that it is the hospital portrayed in the Susan...more

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Feb 01, 2012 Erin rated it 4 of 5 stars

This book was great. I sort of expected it to focus more on the various messed-up therapies common in the days when McLeans was started, but it kept that to a minimum. I found myself saddened that in the current age of "treat 'em and street 'em" therapies, a place like McLeans is having to change what made it essentially the best mental hospital in New England: a place where the mentally ill could take their own time to get better. I was also extremely entertained to learn how many famous people...more

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Aug 11, 2011 Stephanie rated it 4 of 5 stars

Shelves: psychology, true-stories, history

Fantastic read. This read like fiction and I couldn't put it down. BUT, unfortunately, there were problems with it. A lot of times, I wanted to know the year something was happening and it wasn't included. Sometimes the year was included for certain events and sometimes it wasn't. I found myself flipping back a couple pages to try to find a date, thinking I missed it. It was also a little jumpy. Some facts were repeated in later chapters and it didn't seem like they needed to be. The fame of man...more

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Jul 25, 2011 Amy rated it 3 of 5 stars

Shelves: non-fiction

I really wanted to know more about the "who" in this story. Or rather, I would have preferred to learn more in depth about a few people rather than having such a broad history. The author presents a revolving cast of patients and staff that changed before I had a chance to absorb their impact on the history he had been describing.

The subtitle of this book is "the rise and fall ..." but the author doesn't focus much on the rise or the fall, leaving me to believe that it was clever marketing added...more

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Aug 05, 2012 Mary rated it 3 of 5 stars

This book was mentioned in the opening acknowledgments of Shutter Island so that plus the fact that I read girl, interuppted like 100x, meant this was a must read. I found it very interesting, watching the evolution of psychiatric care. specifically how these pointless and even dangerous treatments were deemed beneficial. And how disroders we are all basically familiar with, say OCD, were a mystery to even the best doctors back then. Furthermore, as someone who works with kids who have special n...more

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May 08, 2011 Anamika rated it 3 of 5 stars

The subject matter of this was significantly more riveting than the book itself. I have to admire Beam for his clearly exhaustive research, but the presentation of it was sloppy at points. Too many moments of overexplaining something that had been well-explained in a previous chapter, or the opposite: assumptions of knowledge, or moments where the author clearly seemed to think he'd introduced a source or idea and in fact hadn't at all, leaving the reader feeling lost. The book as a whole had th...more

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Nov 26, 2012 Tia rated it 2 of 5 stars · review of another edition

Shelves: mental-illness

I just couldn't get into this book. I was expecting more about what went on at the hospital. I wanted to know about how the patients were treated and what happened to them. This book was not about that. Most of the book was about the hospital building itself and its location and how it changed throughout time. There were a few small mentions of who stayed there, but not enough to hold my interest. I guess this could be of interest to those who want to know about hospital buildings, but don't loo...more

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May 09, 2013 Eddy Allen rated it 4 of 5 stars

Shelves: arts-and-historical

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Mar 30, 2013 Nicole rated it 3 of 5 stars

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 th...more

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May 28, 2012 April rated it 3 of 5 stars

Shelves: mental-health, non-fiction, history

Tedious. This book would be better described as the history of an elite mental health institution, the likes of which most of us will never see. Indeed, at the end the only remnant left of 'the old days' is a 'ward' for the super-rich.

It's also painfully apparent that the author has no understanding or serious conception what mental illness (or for that matter being in a 'standard' 21st century mental ward) is actually like.

Decent if you're looking for a historical perspective of McLean, rubbi...more

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Feb 16, 2008 Kirsten rated it 5 of 5 stars

Shelves: read-pre-12-07, from-library, mental-health, non-fiction, psych-and-neuroscience

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 Char...more 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.(less)

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May 27, 2009 AB rated it 3 of 5 stars · review of another edition

Shelves: psychology, nonfiction, author-m

This review has been hidden because it contains spoilers. To view it, click here. About as effective as anything which in 244 pages tries to summarize the history of something that's been around since 1811 can be, I think.

Thinking about the huge swaths of material he was most likely skipping over in order to cherry-pick from one or two patients' histories made me a little twitchy, and there were moments when Beam started to get a little too sensationalist for my bullshit-ometer, but it's undeniably interesting stuff and he's not a bad writer. He has both a really dry sense o...more

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Jan 11, 2008 Osho rated it 2 of 5 stars

Shelves: psychology, 2007

This rather superficial book can't decide whether it's a history of McLean Hospital outside Boston, or celebrity dish about famous people who have been McLean patients, or a critique of psychiatry. It doesn't quite manage to be any of these, so it comes off as fairly meanspirited and catty. Adding to the problem is Beam's writing, which has an airy tone and seems to assert that author and reader are complicit and in agreement about Beam's negative views, coupled with Beam's lack of knowledge abo...more This rather superficial book can't decide whether it's a history of McLean Hospital outside Boston, or celebrity dish about famous people who have been McLean patients, or a critique of psychiatry. It doesn't quite manage to be any of these, so it comes off as fairly meanspirited and catty. Adding to the problem is Beam's writing, which has an airy tone and seems to assert that author and reader are complicit and in agreement about Beam's negative views, coupled with Beam's lack of knowledge about the history and contemporary practices of psychiatry. Beam seems to relish describing treatments such as hydrotherapy and coldpacks that are not used today and would be considered bizarre in contemporary psychiatry. Because he does not place McLean's practices in the context of contemporaneous psychiatry, he implies by omission that only McLean was stupid enough to use these practices. This isn't so. Beam's knowledge of current practice also seems scant. His diagnostic impressions when he speculates are often reductive and inaccurate, and his assertions about current diagnosis and treatment are strangely incomplete.

As a person who has worked in four inpatient facilities (both public and private, both before and in the era of managed care), I find myself in vehement disagreement with statements such as "A certain cynicism attends any hospital's long-term treatment of wealthy patients who pay their bills in full and who subsidize the care of less fortunate souls" (210). I disagree not because I think that all hospitals are great, or believe wholeheartedly in their interventions, or think they don't consider their bottom line, but because this is not how hospital staff think about and talk about patients. This is Beam's cynicism, not the attitude of the majority of people working in psychiatric facilities.

For better books about psychiatric hospitals, read Winchester's The Professor and the Madman: A Tale of Murder, Insanity, and the Making of the Oxford English Dictionary, Hunt's excellent Mental Hospital from 1962, or any of the many complex and insightful accounts by patients and staff alike.(less)

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Jan 06, 2013 Lindsey rated it 4 of 5 stars

Shelves: 2013

Another book that I'd put off reading for a really long time. I don't necessarily do well reading non-fiction and avoid it because it takes me so long. This book was well worth the read, after keeping it around so long. Rather than focusing on names dates and boring historical stuff it's almost like a yearbook of the famous faces (patients and staff) that have passed through McLean over the years. It's a great history of one piece of the American mental health system and a very interesting read.

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Jul 02, 2012 Shirazita rated it 4 of 5 stars

This book may be the history of a venerable hospital, but it also serves as a cultural history of Boston and a history of psychiatric treatments and trends. Would like an update on all that has happened since the book was published (the hospital grounds have been developed into condos, from what i can see). Book left me w/ a very cynical perspective on both the efficacy of McLean as a hospital, and psychiatry as treatment for mental disease, especially within the confines of insurance restrictio...more

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Aug 23, 2007 Cat rated it 3 of 5 stars Recommends it for: slyvia plath fans.

Shelves: sociology, americanhistory

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.

Readi...more

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Aug 18, 2012 Deborah rated it 4 of 5 stars

""Rob, life is impossible," I confessed. "who can't understand the need for shelter? and who can't sympathize with the people who seek that shelter? And who could fail to be interested in a place that offered that shelter?" So this is a book about the men and women who needed shelter more than most of us, or who in some cases, where more honest about their need for protection than we are. And about the institution that provided that shelter, imperfectly, in our imperfect world. "

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Mar 22, 2011 Ally Stefanides rated it 4 of 5 stars

This hospital has been home to so many well known people over the decades. Many of those people I admired. This book uncovers the history of Mclean in both a historical and biographical perspective sparing no detail. Reading this made me greatful I am a psychiatric patient now rather than bygone eras as he repots on all the 'treatments' people were given. If you have ever been a patient in a place like this or just love medical and/or New England history you will love this book.

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Apr 08, 2011 Natasha rated it 3 of 5 stars

Shelves: psychology, non-fiction

A pretty interesting book. I liked learning about the treatments used, the life there, and about the patients. I had never heard of McLean before this book. I had wanted more of a straight chronological history, but the book jumped around and focused on different subjects for each chapter. I wanted to know more about the early type of treatment. McLean doesn't seem like it did people much good.

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Feb 07, 2010 Modern Hermeneut rated it 3 of 5 stars

Beam has a flare for the comic grotesque, but he also has a habit of leaving out the dates when events occur. Even as we get sucked into the compelling biographies of the hospital's eccentric inhabitants, we're left with little in the way of an overall chronology.

An interesting side note: it seems likely that William James was once a resident at McLean's.

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Mar 06, 2011 pri rated it 4 of 5 stars

Shelves: 2011

Very interesting. Local history, famous clientele, and interesting subject. Not a horrific tell all scare. But a serious look at how this one mental institution became an elite place to care for the mentally ill and how both the buildings and the care provided in them changed as our attitudes and pocketbooks changed in support of the mentally ill.

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About Alex Beam

I'm a columnist for the Boston Globe. Before that I worked as a business reporter in Los Angeles and Moscow. I've lived in Boston since 1984, and written for the newspaper since 1987. I'm working on my next book, about the Mormon prophet Joseph Smith. I wish I still resembled that handsome photo, taken about a decade ago.

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