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The Last Asylum: A Memoir of Madness in our Times
In July 1988, Canadian-born historian Barbara Taylor was admitted to Friern Hospital, a once-notorious asylum for the insane. Her journey there began when, overwhelmed by anxiety as she completed her doctoral studies in London, England, she found relief by dosing herself with alcohol and tranquillizers. She then embarked on what would turn out to be a decades- long psychoanalysis.
The analysis dredged up acutely painful memories of an unhappy and confusing childhood back in Saskatoon. As Taylor struggled to cope with these, she would twice be re-admitted to Friern. She took refuge in day-care institutions and a psychiatric hostel, all the while continuing her therapy, which eventually put her on the road to recovery.
This searingly honest, beautifully written memoir is the narrative of the author’s madness years, set inside the wider story of our treatment of psychiatric illness: from the great age of asylums to the current era of community care, ‘Big Pharma’, and quick fixes. It is a meditation on her own experience as well as that of millions of others – both in Europe and in North America – who have suffered, are suffering, and will suffer from mental illness.
The analysis dredged up acutely painful memories of an unhappy and confusing childhood back in Saskatoon. As Taylor struggled to cope with these, she would twice be re-admitted to Friern. She took refuge in day-care institutions and a psychiatric hostel, all the while continuing her therapy, which eventually put her on the road to recovery.
This searingly honest, beautifully written memoir is the narrative of the author’s madness years, set inside the wider story of our treatment of psychiatric illness: from the great age of asylums to the current era of community care, ‘Big Pharma’, and quick fixes. It is a meditation on her own experience as well as that of millions of others – both in Europe and in North America – who have suffered, are suffering, and will suffer from mental illness.
283 pages, Kindle Edition
First published April 1, 2014
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About the author
Barbara Taylor
6 books7 followersBarbara Taylor is a British historian specialising in Enlightenment history, gender studies, and the history of subjectivity. She has taught at the University of East London since 1993, and held visiting posts at the universities of Amsterdam, Indiana, and Cambridge. She was a Distinguished Visiting Professor at the University of Notre Dame in 2009.
Her publications include Eve and the New Jerusalem: Socialism and Feminism in the 19th Century (1983), which received the Isaac Deutscher Memorial Prize; Mary Wollstonecraft and the Feminist Imagination (2003), Women, Gender and Enlightenment (co-edited with Sarah Knott, 2005), and On Kindness (co-written with Adam Phillips, 2009). Her writings have been translated into seven languages. She is the Reviews Editor of History Workshop Journal, and reviews regularly for the London Review of Books.
Her publications include Eve and the New Jerusalem: Socialism and Feminism in the 19th Century (1983), which received the Isaac Deutscher Memorial Prize; Mary Wollstonecraft and the Feminist Imagination (2003), Women, Gender and Enlightenment (co-edited with Sarah Knott, 2005), and On Kindness (co-written with Adam Phillips, 2009). Her writings have been translated into seven languages. She is the Reviews Editor of History Workshop Journal, and reviews regularly for the London Review of Books.
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July 23, 2014
The Last Asylum: A Memoir of Madness in Our Times. This title, distilled to the three keywords: "asylum, memoir, madness" is what caught my attention. Together, of course, with a photo on the cover depicting the longest corridor in a mental institution – the thing that Will Self called so beautifully ‘the North Circular of the soul’ (I promise myself this is the only nice thing I will ever say about Will Self).
Barbara Taylor is an accomplished historian who went quite mad during her early thirties. It started off innocently enough but soon enough she was doing psychotherapy five times a week, and eventually ended up in a ‘looney bin’.
Now, I wanted to feel for her but it was hard, because Taylor is no Sylvia Plath and her descriptions of her psychoanalysis and her descend into madness are not very interesting. To be perfectly honest, to this lay reader it seemed that it was the daily psychoanalysis that was making her so unstable. I am a very practical person who has gone through a short period of being very unwell mentally and I know for a fact that if I had spent my days vivisecting my childhood then, I would've been medicating heavily now.
The problem I had with Taylor’s account was that I could never understand what her madness really was, how the psychoanalysis was helping her and how she finally got better. Blame my low empathy levels but I haven’t read about a person struggling with her own mind and her demons. I have only seen a baby-emperor (as she once aptly called herself). She makes it almost impossible to feel any empathy towards her. She was young, she didn’t have to work 9-5, she drank a lot, had lots of sex with unsuitable men, had anxiety attacks and horrible dreams. That’s me and half of my friends on any given weekend. Thank God, I absolutely cannot afford twenty one years of psychoanalysis. Twenty-one! Daily.
Frankly, she doesn’t make a good case for psychoanalysis. She quotes constant shouting matches with her therapist and then even in the chapter called ‘Cure’ I couldn’t see how the cure had anything to do with those years of therapy. She presented it as if she just grew out of it. I don’t doubt that she gained a disturbingly deep knowledge of herself but I don’t see how knowing what makes you ill can make you better. Additionally, her sister who obviously grew up with the same set of parents turned out perfectly fine. So what’s the point of this torturous analysis?
She does a way better job in the second part of the book where she takes on a role of a historian and observer and treats us to a crash course of the mental health system as well as insightful observations of her fellow patients. Those parts are definitely the highlights of this book. She describes asylums (now almost all gone) as generally safe places offering a respite from life with all its obligations once those obligations became unmanageable. She also describes warmly the community feel of them, even despite the fact they were often violent places full of hostile patients. Now the asylums are gone and have been replaced by the so called ‘community care’ which emphasizes independence and self-reliance. For people weakened and often basically paralysed by a mental illness it doesn’t seem to work very well. Despite its many flaws Taylor is a defender of 'bins' and I guess, so am I.
So what’s the lesson and note to myself here? Don’t go mad, Kinga. Don’t go mad. Don’t go mad because if you go mad there will be nowhere for you to go.
Barbara Taylor is an accomplished historian who went quite mad during her early thirties. It started off innocently enough but soon enough she was doing psychotherapy five times a week, and eventually ended up in a ‘looney bin’.
Now, I wanted to feel for her but it was hard, because Taylor is no Sylvia Plath and her descriptions of her psychoanalysis and her descend into madness are not very interesting. To be perfectly honest, to this lay reader it seemed that it was the daily psychoanalysis that was making her so unstable. I am a very practical person who has gone through a short period of being very unwell mentally and I know for a fact that if I had spent my days vivisecting my childhood then, I would've been medicating heavily now.
The problem I had with Taylor’s account was that I could never understand what her madness really was, how the psychoanalysis was helping her and how she finally got better. Blame my low empathy levels but I haven’t read about a person struggling with her own mind and her demons. I have only seen a baby-emperor (as she once aptly called herself). She makes it almost impossible to feel any empathy towards her. She was young, she didn’t have to work 9-5, she drank a lot, had lots of sex with unsuitable men, had anxiety attacks and horrible dreams. That’s me and half of my friends on any given weekend. Thank God, I absolutely cannot afford twenty one years of psychoanalysis. Twenty-one! Daily.
Frankly, she doesn’t make a good case for psychoanalysis. She quotes constant shouting matches with her therapist and then even in the chapter called ‘Cure’ I couldn’t see how the cure had anything to do with those years of therapy. She presented it as if she just grew out of it. I don’t doubt that she gained a disturbingly deep knowledge of herself but I don’t see how knowing what makes you ill can make you better. Additionally, her sister who obviously grew up with the same set of parents turned out perfectly fine. So what’s the point of this torturous analysis?
She does a way better job in the second part of the book where she takes on a role of a historian and observer and treats us to a crash course of the mental health system as well as insightful observations of her fellow patients. Those parts are definitely the highlights of this book. She describes asylums (now almost all gone) as generally safe places offering a respite from life with all its obligations once those obligations became unmanageable. She also describes warmly the community feel of them, even despite the fact they were often violent places full of hostile patients. Now the asylums are gone and have been replaced by the so called ‘community care’ which emphasizes independence and self-reliance. For people weakened and often basically paralysed by a mental illness it doesn’t seem to work very well. Despite its many flaws Taylor is a defender of 'bins' and I guess, so am I.
So what’s the lesson and note to myself here? Don’t go mad, Kinga. Don’t go mad. Don’t go mad because if you go mad there will be nowhere for you to go.
July 1, 2017
Wow! I picked up this book thinking it was going to be another Bell Jar, but oh no. This is by far the most detailed look on Asylums and Mental Health treatment in Westernized countries I've ever read. 5 stars for just being so thorough. Some people may find this Memoir to be too dense or too educational. I just found it to be an engrossing history on a topic I'm completely interested in.
Barbara Taylor is a historian. While in college she wrote papers on the history of feminism. She wrote a book! However the anxiety of all that she was doing and teaching became too much. In 1988, Barbara was admitted into Friern Hospital, one of Britain's last asylums.
Barbara's illness was very much involved. The pain of living with herself and her feelings become so overwhelming Barbara started self-medicating with alcohol and prescription pills. In the early stages she decided to work on her inevitable demise by hiring a psychoanalyst. Barbara and V worked together for 21 years! She started her psychoanalysis at the age of 31, six years later she was in and out of Friern Hospital seeking treatment for her illness. The illness is never given a name. It could be depression/anxiety, but I'm not a doctor.
Barbara not only gives the reader an extremely well documented account of asylum politics she discusses herself through all of this. Barbara kept journals of her 21 years with her psychoanalyst. She weaves her story throughout the history telling, which makes for some amazing reading. The timeline is all over the place because it is written in a way that even though the "story" is moving forward Barbara continues to give the reader facts and with these facts come references and sources. I am so interested in the people she talked about in this book and their works. Many of the people Barbara interviewed for this book have written their own memoirs of asylum life.
Asylums have a long history. Most of us readers only know about what we see in the media, shackles, straight-jackets, neglect, abuse. Scary, dark times in large derelict buildings. When Barbara was in and out of Friern she could still see the old ways, but new concepts were being introduced. The sad thing about the Mental Health world is that the attitude toward the patients ebb and flow. Doctors see their patients as people, then a few years later the attitude shifts and patients are a nuisance that needs to be medicated and forgotten, until the outside community catches on and starts a verbal war. Then the politics change and everyone is for treating the patients again instead of ignoring them.
One of my favorite things about this book was V, the psychoanalyst. He really was in it for the long haul. The relationship between V and Barbara was like a parent. At least in Barbara's eyes. I found it fascinating.
If you are interested in Mental Health and how it was treated throughout history in Western societies (Canada, American and mostly in Great Britain) pick this book up. It has so many layers to it. I love that you get two stories in one. The story of our "protagonist" and her search for truth of self and her illness and the historical growth of the way society and the medical community thought of and treated people with mental illnesses/disorders.
Barbara Taylor is a historian. While in college she wrote papers on the history of feminism. She wrote a book! However the anxiety of all that she was doing and teaching became too much. In 1988, Barbara was admitted into Friern Hospital, one of Britain's last asylums.
Barbara's illness was very much involved. The pain of living with herself and her feelings become so overwhelming Barbara started self-medicating with alcohol and prescription pills. In the early stages she decided to work on her inevitable demise by hiring a psychoanalyst. Barbara and V worked together for 21 years! She started her psychoanalysis at the age of 31, six years later she was in and out of Friern Hospital seeking treatment for her illness. The illness is never given a name. It could be depression/anxiety, but I'm not a doctor.
Barbara not only gives the reader an extremely well documented account of asylum politics she discusses herself through all of this. Barbara kept journals of her 21 years with her psychoanalyst. She weaves her story throughout the history telling, which makes for some amazing reading. The timeline is all over the place because it is written in a way that even though the "story" is moving forward Barbara continues to give the reader facts and with these facts come references and sources. I am so interested in the people she talked about in this book and their works. Many of the people Barbara interviewed for this book have written their own memoirs of asylum life.
Asylums have a long history. Most of us readers only know about what we see in the media, shackles, straight-jackets, neglect, abuse. Scary, dark times in large derelict buildings. When Barbara was in and out of Friern she could still see the old ways, but new concepts were being introduced. The sad thing about the Mental Health world is that the attitude toward the patients ebb and flow. Doctors see their patients as people, then a few years later the attitude shifts and patients are a nuisance that needs to be medicated and forgotten, until the outside community catches on and starts a verbal war. Then the politics change and everyone is for treating the patients again instead of ignoring them.
One of my favorite things about this book was V, the psychoanalyst. He really was in it for the long haul. The relationship between V and Barbara was like a parent. At least in Barbara's eyes. I found it fascinating.
If you are interested in Mental Health and how it was treated throughout history in Western societies (Canada, American and mostly in Great Britain) pick this book up. It has so many layers to it. I love that you get two stories in one. The story of our "protagonist" and her search for truth of self and her illness and the historical growth of the way society and the medical community thought of and treated people with mental illnesses/disorders.
April 12, 2016
Britain’s asylum system is a thing of the past. You might expect this book to crow the author’s triumph at their closure (given she was a former patient of one), but that is not the case. In fact, she seems to think their abolition is not entirely positive. Along with her personal story, Taylor weaves in the history of mental asylums and psychoanalysis – the latter not practiced in England until after World War I. She raises pressing questions about how the mentally ill are treated today: questions of independence and choice versus recovery and risk. This is a powerful book, especially recommended for fans of Bad Blood.
(See my full review at Nudge.)
(See my full review at Nudge.)
February 13, 2014
I don't know how Taylor wrote this in the way she has. To give us such rich detail of a long analysis in such short space. But, more, to weave intricately the historical responses to madness with her own personal journey. It has touched me deeply in how it mirrors my own experiences of the 'system' and my concerns for how we treat mental distress today. Asylums were not ideal, all too often abusive, but that the ethos of open-ended care, of giving people time to just be in order that they may re-emerge, is more than a travesty.
For anyone interested in psychoanalysis, a short history of madness, the experience of someone who has a long and profound history of mental distress (or mental illness if you want to call it that - I have mixed feelings about this), the coming-through of a seemingly hopeless life, this is for you.
I'm off now to continue thinking about all that is offered up here in such a short space.
For anyone interested in psychoanalysis, a short history of madness, the experience of someone who has a long and profound history of mental distress (or mental illness if you want to call it that - I have mixed feelings about this), the coming-through of a seemingly hopeless life, this is for you.
I'm off now to continue thinking about all that is offered up here in such a short space.
June 9, 2015
Author Barbara Taylor is in a unique position to write about mental health services: as a historian, mental illness sufferer, and one of the last residents of a Victorian-era asylum in London, she not only had an inside view of “the old way” of dealing with mental illness, but she also has had twenty years to digest her own experience and bear witness to what came next; what came after institutionalised care was abolished.
In The Last Asylum, Taylor shares her Canadian childhood (as the daughter of an activist father who had fought Franco's forces in the Spanish Civil War and a mother who, while a sitting judge, suffered her husband's abuse and philandering), her adult life in England (as an academic, sexual adventurer, drug and alcohol abuser), her twenty-one years of psychoanalysis (five days a week!), her three admissions to Friern (lasting from two weeks to six months), and her years of after-care in Day Centres and other supportive services that no longer exist. Along the way, Taylor shares many anecdotes (from many sources) and sketches the historical backdrop of evolving attitudes towards those with mental illness and the type of care that those in power believed should be available to them.
Taylor's story is agonising and beautifully told, but despite sharing so much personal information, I'm left with no real picture of what her mental illness actually looked and felt like (besides wanting to stay in bed, get drunk, and yell at her therapist) and neither do I have any clue as to how her decades of psychoanalysis ended up curing her. There are many transcribed sessions like this one, which I found to be painfully circular:
As for her time in the asylum, Taylor doesn't get as detailed as, say, Girl, Interrupted, but despite some elements of danger and poor resources, she demonstrates that Friern (her “stone mother”) was a vital port in her storm – and Taylor in particular makes the case for the importance of asylum for the low income patients on her ward; those who are today cheerily sent off with a list of community services that they are self-empowered to access at their own discretion. While she mentions briefly the connection between the closing of asylums and the rise in homelessness, she provides these stats on the prison system; the new asylum:
No real surprise there. As for the miracle drugs that are supposed to allow the mentally ill to lead independent lives in the community?
So what does Taylor conclude, based on her experience and observations?
When I've thought of a mental hospital like Friern, I've always imagined straight-jackets and electric shock therapy and evil Nurse Ratcheds. Their closure – which have not really been replaced by on-site hospital wards – always seemed like a progressive move to me, but perhaps that policy change was a mistake after all. Taylor has packed so much information into this book – not least of which was her own crazy childhood, while avoiding making this a “misery memoir” – and it will continue to give me much to ponder. Solidly 3 and a half stars and I'm rounding up for the excellent writing.
In The Last Asylum, Taylor shares her Canadian childhood (as the daughter of an activist father who had fought Franco's forces in the Spanish Civil War and a mother who, while a sitting judge, suffered her husband's abuse and philandering), her adult life in England (as an academic, sexual adventurer, drug and alcohol abuser), her twenty-one years of psychoanalysis (five days a week!), her three admissions to Friern (lasting from two weeks to six months), and her years of after-care in Day Centres and other supportive services that no longer exist. Along the way, Taylor shares many anecdotes (from many sources) and sketches the historical backdrop of evolving attitudes towards those with mental illness and the type of care that those in power believed should be available to them.
Taylor's story is agonising and beautifully told, but despite sharing so much personal information, I'm left with no real picture of what her mental illness actually looked and felt like (besides wanting to stay in bed, get drunk, and yell at her therapist) and neither do I have any clue as to how her decades of psychoanalysis ended up curing her. There are many transcribed sessions like this one, which I found to be painfully circular:
I'm in the bin, you bastard! So what are we going to do now?
Psychoanalysis? That's what you come here for, isn't it? Or maybe it isn't? Maybe you just come here to punish me?
Punish you? For what??
You just said. You're in a mental hospital. And this is somehow my fault.
Yes!
Yes what?
Oh...oh...I don't know...! Fault, whose fault?...I don't know?...[Angry silence]What if I can't come here any more? What if they lock the door and won't let me out?
Has anyone tried to do that?
Well, no...But they could! And then what? Would you come to me?
No.
Never??
No, never.
So! You bastard! You drive me crazy, I end up in hospital, maybe locked up in there, and you won't come and see me?!
I haven't 'driven you crazy'. And I'm not going to come to Friern to see you, not ever. I'm not going to give you more reasons for staying in hospital.
Huh! You don't care what happens to me!
As for her time in the asylum, Taylor doesn't get as detailed as, say, Girl, Interrupted, but despite some elements of danger and poor resources, she demonstrates that Friern (her “stone mother”) was a vital port in her storm – and Taylor in particular makes the case for the importance of asylum for the low income patients on her ward; those who are today cheerily sent off with a list of community services that they are self-empowered to access at their own discretion. While she mentions briefly the connection between the closing of asylums and the rise in homelessness, she provides these stats on the prison system; the new asylum:
In Britain it is estimated that over 70 per cent of the prison population have two or more mental disorders; similar estimates are made for the Canadian prison system. In the United States right now, the three biggest mental health providers are prisons.
No real surprise there. As for the miracle drugs that are supposed to allow the mentally ill to lead independent lives in the community?
Decades of intensive research, much of it funded by drug companies, have thus far produced no persuasive evidence for the neurobiological origin for any mental illness.
So what does Taylor conclude, based on her experience and observations?
The mental health system I entered in the 1980s was deeply flawed, but at least it recognized needs – for ongoing care, for asylum, for someone to rely upon when self-reliance is no option – that the present system pretends do not exist, offering in their stead individualistic pieties and self-help prescriptions that are a mockery of people's sufferings. The story of the Asylum Age is not a happy one. But if the death of the asylum means the demise of effective and humane mental health care, then this will be more than a bad ending to the story: it will be a tragedy.
When I've thought of a mental hospital like Friern, I've always imagined straight-jackets and electric shock therapy and evil Nurse Ratcheds. Their closure – which have not really been replaced by on-site hospital wards – always seemed like a progressive move to me, but perhaps that policy change was a mistake after all. Taylor has packed so much information into this book – not least of which was her own crazy childhood, while avoiding making this a “misery memoir” – and it will continue to give me much to ponder. Solidly 3 and a half stars and I'm rounding up for the excellent writing.
April 11, 2015
Taylor spent some time in a mental institution and a lot of time being psychoanalysed. Here she talks about her experiences as well as the treatment of the mentally ill in Britain. Some parts of this read like literary fiction and I had to keep reminding myself it was not a novel so I guess that shows how talented a writer the author is. Interesting and thought-provoking.
June 5, 2015
As a counsellor, I struggled with some of the transcripts of her sessions, and would question the 'success' of a 'treatment' that took 21 years of full time analysis, but she makes some good points about the current system.
February 21, 2014
From BBC radio 4 - Book of the Week:
Barbara Taylor's story of her own breakdown and her recovery in England's last asylum.
Barbara Taylor's story of her own breakdown and her recovery in England's last asylum.
August 3, 2015
Not always an easy read, but I am really glad I perservered with this one. It is a fascinating and important examination of mental health services, told within a framework of personal experience. There is also some very interesting history of the treatment of mental health, and of the hospital that treated the author, Friern (previously Colney Hatch). Really recommended. Blog post (video) here: http://t.co/Nzv8HieCo0
January 13, 2015
this was one of the best books that i have ever read on this subject i found it particularly evocative as i myself worked in the last asylum in Derby the book is beautifully writen and well reshearched i would recommend this book to anyone who has as interest in social history or the history of mental health
December 2, 2023
The history is interesting, the family memoir is interesting, the personal stories are interesting, but somehow the book as a whole did not grab me. Rather, I could dip into it and be it held my attention, but found myself unable to read it straight through.
The conversations in italics and especially the recounted dreams almost always threw me out of the story.
The conversations in italics and especially the recounted dreams almost always threw me out of the story.
March 7, 2018
For me this was a remarkably uneven book that begins as an endearingly forthright memoir that ultimately devolves into a sea of problematic, self-contradictory and retrograde conclusions at the current state and future of psychiatry. In the epilogue for the post-asylum age, we have Taylor drawing a pitchfork against every initiative rolled out by the mental health services in the last decade (concept of Recovery, Choice, Risk and Sectioning), all of them being dismissed as cost-cutting, "Orwellian rhetoric" and a nationwide ploy by the specialists to either have people drugged or being left out in the community to die in misery.
There is even a climactic wish for the clock be turned back and large scale institutionalisation be brought back, so the mentally ill people can somehow work through their demons in closed spaces with authorities and clinicians roaming around (though elsewhere she finds current sectioning of people with mental illnesses in wads "custodial") and like our author herself, come out of the asylum after a period of "silting" with other mentally unwell inmates, all recovered and ready. I am afraid such extrapolation from limited experience, cherrypicked evidence and mixing of issues and villains is not just specious and fanciful but undermines the context, the historical pressures, the litigious environment, the sheer vulnerability and danger of the patients in question here, the abuse they need to be protected from and the everyday work of thousands of compassionate mental health professionals that involves collaborating with patients and families, all of them working towards enabling and encouraging those with mental health disorders to function independently, to find happiness and get able enough to relate with the wider world.
Being a GP trainee currently passing through a six month placement in the specialty, I have had a decent initiation into this overwhelming ecosystem where week upon week I get to assist and emulate alone my professional specialist colleagues (consultants and nurse practitioners) who adroitly manage, through complex pattern recognition and past history & management of presenting patients, hordes of suicide attempts and crises that come via the A&E and informally to the wards. They hold meetings and clinics together to update progress of these and other subset of patients, i.e. those out in community with varied pathologies from somatisation disorders to anxiety spectrum disorders to dementias (Mrs Taylor would perhaps be surprised at all of us still taking lengthy and systematic histories in all encounters to come up with a formulation and writing possibly the most detailed assessment and discharge letters to GPs and allied agencies)-with most patients grateful to be with the circle of family, household, friends and neighbourhoods that they have chosen themselves, while others working with mental health and other local agencies to find the right place of care (Never easy in the labyrinthine bureaucracy and funding structures, but that's a whole other essay), all the while having their mental illness monitored (or in case of dementia, deteriorating with chosen family in the loop) with regular home/clinic visits from CPNs and doctors (once again,working with the minimum of resources, training and support plus snowed under paperwork and admin).
Learning from the pitfalls of large scale institutionalisation, the mental health professionals (across the board) have come to regard that hospital wards and environments are best only for the most vulnerable and/or dangerous who need admitting under Section or supervised placement to allow a parallel comprehensive assessment to manage their future from all angles with help from a battery of professionals' expertise being sought while they are monitored in a closed environment with medications that have a body of evidence when prescribed for every symptom, disorder and exacerbation.
To imply that there is something underhanded afoot in this elaborate enterprise at all times in managing these group of people and their risks is just lazy thinking that I expect from tabloid journalists and I thought Mrs Taylor's book and conclusions could have benefited from some research with just a week with a psychiatry consultant to get a first hand glimpse than be cramped by limited interaction of her own and second-hand recollections from online forums.
Psychiatry, I feel is a broken specialty, but I have not seen its legs being broken in UK by paucity of intelligence, self-awareness or evidence-based practice of its practitioners but by the brutal service cuts which leave the professionals exasperated and many key services that can offer the pastoral support (befriending support,abuse and domestic violence etc) shut down. In many ways this is probably the best time to be treated for mental health in UK what with a never-before appreciation and incorporation of psychotherapies, specialty-around conservatism for the biopsychiatric model and patient management by pills, intricate legal framework and sections to protect patients and the treatment administered (appeals, second opinions, tribunals all included). While we continue to have more patients each year seeking help for mental health, the funding for two thirds of the country's mental health has systematically dropped in the last 5 years. Under such a squeeze and the pressure to admit the sickest in a safe environment in jampacked wards, its inevitable that corners are inevitably cut when discharging and I wish Mrs Taylor had taken this opportunity to perhaps appeal the powers-to-be to go beyond empty rhetoric and give these mental health services the funds and the commissioning they need than a strange appeal for the specialty to look backward and reclaim its madhouses. But it's her perspective, her opinion and I could not bring myself to agree with it.
When it comes to her personal odyssey, which while I wholeheartedly commend for the courage it must have taken for her to reflect and articulate a long, painful phase for the benefit of us readers, she surprisingly wasn't able to communicate to me the windfall moment of her recovery convincingly. A sequence of dreams and self-realisation made her break out of some calcified way of framing her past, her self-defeating, self-destructive behaviour in the present and boom, she's out of her funk (but then such can be the vagaries of mental life and psychopathology). All the italicised back-and-forth shouting matches played in the therapist's office and beyond, I am afraid, did not make for a very convincing endorsement of psychotherapy or patient's odd psychotherapist-figure constructed by her(I'd recommend Yalom or Grosz's Examined Life) and they were more often than not, exasperating to read.
The stuff that did work for me is the promising first part where we go from Taylor's culture-seeped childhood, her ambivalent relationship with her parents, right down to her first mental crisis in the pre-asylum days. In prose that's measured, transparent and suggestive, Taylor really draws a compelling case of dysfunctionalia, subtle abuse and neuroticism seguing convincingly into the self-amplification and self-sabotage as she dips her toes in psychoanalysis, substance abuse and eating disorder. She also makes a decent stab at the history of asylums and held my attention for her experience in the asylums. It is only when I saw her take leave of nuance in the final broad sweep, it made me more conservative in appreciating the book's initial triumphs.
There is even a climactic wish for the clock be turned back and large scale institutionalisation be brought back, so the mentally ill people can somehow work through their demons in closed spaces with authorities and clinicians roaming around (though elsewhere she finds current sectioning of people with mental illnesses in wads "custodial") and like our author herself, come out of the asylum after a period of "silting" with other mentally unwell inmates, all recovered and ready. I am afraid such extrapolation from limited experience, cherrypicked evidence and mixing of issues and villains is not just specious and fanciful but undermines the context, the historical pressures, the litigious environment, the sheer vulnerability and danger of the patients in question here, the abuse they need to be protected from and the everyday work of thousands of compassionate mental health professionals that involves collaborating with patients and families, all of them working towards enabling and encouraging those with mental health disorders to function independently, to find happiness and get able enough to relate with the wider world.
Being a GP trainee currently passing through a six month placement in the specialty, I have had a decent initiation into this overwhelming ecosystem where week upon week I get to assist and emulate alone my professional specialist colleagues (consultants and nurse practitioners) who adroitly manage, through complex pattern recognition and past history & management of presenting patients, hordes of suicide attempts and crises that come via the A&E and informally to the wards. They hold meetings and clinics together to update progress of these and other subset of patients, i.e. those out in community with varied pathologies from somatisation disorders to anxiety spectrum disorders to dementias (Mrs Taylor would perhaps be surprised at all of us still taking lengthy and systematic histories in all encounters to come up with a formulation and writing possibly the most detailed assessment and discharge letters to GPs and allied agencies)-with most patients grateful to be with the circle of family, household, friends and neighbourhoods that they have chosen themselves, while others working with mental health and other local agencies to find the right place of care (Never easy in the labyrinthine bureaucracy and funding structures, but that's a whole other essay), all the while having their mental illness monitored (or in case of dementia, deteriorating with chosen family in the loop) with regular home/clinic visits from CPNs and doctors (once again,working with the minimum of resources, training and support plus snowed under paperwork and admin).
Learning from the pitfalls of large scale institutionalisation, the mental health professionals (across the board) have come to regard that hospital wards and environments are best only for the most vulnerable and/or dangerous who need admitting under Section or supervised placement to allow a parallel comprehensive assessment to manage their future from all angles with help from a battery of professionals' expertise being sought while they are monitored in a closed environment with medications that have a body of evidence when prescribed for every symptom, disorder and exacerbation.
To imply that there is something underhanded afoot in this elaborate enterprise at all times in managing these group of people and their risks is just lazy thinking that I expect from tabloid journalists and I thought Mrs Taylor's book and conclusions could have benefited from some research with just a week with a psychiatry consultant to get a first hand glimpse than be cramped by limited interaction of her own and second-hand recollections from online forums.
Psychiatry, I feel is a broken specialty, but I have not seen its legs being broken in UK by paucity of intelligence, self-awareness or evidence-based practice of its practitioners but by the brutal service cuts which leave the professionals exasperated and many key services that can offer the pastoral support (befriending support,abuse and domestic violence etc) shut down. In many ways this is probably the best time to be treated for mental health in UK what with a never-before appreciation and incorporation of psychotherapies, specialty-around conservatism for the biopsychiatric model and patient management by pills, intricate legal framework and sections to protect patients and the treatment administered (appeals, second opinions, tribunals all included). While we continue to have more patients each year seeking help for mental health, the funding for two thirds of the country's mental health has systematically dropped in the last 5 years. Under such a squeeze and the pressure to admit the sickest in a safe environment in jampacked wards, its inevitable that corners are inevitably cut when discharging and I wish Mrs Taylor had taken this opportunity to perhaps appeal the powers-to-be to go beyond empty rhetoric and give these mental health services the funds and the commissioning they need than a strange appeal for the specialty to look backward and reclaim its madhouses. But it's her perspective, her opinion and I could not bring myself to agree with it.
When it comes to her personal odyssey, which while I wholeheartedly commend for the courage it must have taken for her to reflect and articulate a long, painful phase for the benefit of us readers, she surprisingly wasn't able to communicate to me the windfall moment of her recovery convincingly. A sequence of dreams and self-realisation made her break out of some calcified way of framing her past, her self-defeating, self-destructive behaviour in the present and boom, she's out of her funk (but then such can be the vagaries of mental life and psychopathology). All the italicised back-and-forth shouting matches played in the therapist's office and beyond, I am afraid, did not make for a very convincing endorsement of psychotherapy or patient's odd psychotherapist-figure constructed by her(I'd recommend Yalom or Grosz's Examined Life) and they were more often than not, exasperating to read.
The stuff that did work for me is the promising first part where we go from Taylor's culture-seeped childhood, her ambivalent relationship with her parents, right down to her first mental crisis in the pre-asylum days. In prose that's measured, transparent and suggestive, Taylor really draws a compelling case of dysfunctionalia, subtle abuse and neuroticism seguing convincingly into the self-amplification and self-sabotage as she dips her toes in psychoanalysis, substance abuse and eating disorder. She also makes a decent stab at the history of asylums and held my attention for her experience in the asylums. It is only when I saw her take leave of nuance in the final broad sweep, it made me more conservative in appreciating the book's initial triumphs.
September 23, 2015
Lots of good reviews of this book, seemed like something to read given my interest in former mental institutions and the treatment of the mentally ill.
What it did was make me wonder if it was her therapy that was making her ill. Years and years of analysis I, some of it for months, daily, would prevent ever stepping out of your head. I am astonished Barbara Taylor managed to extract herself from this disease causing cycle and get on with her life.
It is terrifying to think of the damage that can be done with bad mental health care, and that is front and centre in this telling.
I wonder. I have gone for therapy myself, the useless for me CBT, now trauma-centred therapy. I'm not convinced much of it helps, and the risk of becoming a victim of the system is very large.
Scary, scary book, and so sadly self-obsessed. Page after page of dreams and analysis of her dreams and chewing over her life and such. Had to start skimming after chapter three, though it is well-written and offers some wisdom. The horror of watching Ms. Taylor self-flagellate on the point of a pin was too horrible to watch.
What it did was make me wonder if it was her therapy that was making her ill. Years and years of analysis I, some of it for months, daily, would prevent ever stepping out of your head. I am astonished Barbara Taylor managed to extract herself from this disease causing cycle and get on with her life.
It is terrifying to think of the damage that can be done with bad mental health care, and that is front and centre in this telling.
I wonder. I have gone for therapy myself, the useless for me CBT, now trauma-centred therapy. I'm not convinced much of it helps, and the risk of becoming a victim of the system is very large.
Scary, scary book, and so sadly self-obsessed. Page after page of dreams and analysis of her dreams and chewing over her life and such. Had to start skimming after chapter three, though it is well-written and offers some wisdom. The horror of watching Ms. Taylor self-flagellate on the point of a pin was too horrible to watch.
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August 8, 2016"Going crazy is much different in the twenty-first century from how it was a hundred years ago. It is less brutal (no more lobotomies), but also less picturesque. There is a verbal aspect to this. lunatic, for instance, a nice-sounding term derived from from certain old ideas concerning the psychoactive powers of moonbeams, is no longer in clinical use to describe mentally ill persons, because this is scientifically ridiculous. However, some people are not so impressed by modern science. Taylor uses 'lunatic' often, for its poetry yet also to make a point. Her madness may have occurred 'in our times,' as her subtitle has it, but like her word choice it wasn't really of our times."
–James Camp on Barbara Taylor's The Last Asylum: A Memoir of Madness in Our Times in the April/May 2015 issue of Bookforum
To read the rest of this review, go to Bookforum:
http://bookforum.com/inprint/022_01
–James Camp on Barbara Taylor's The Last Asylum: A Memoir of Madness in Our Times in the April/May 2015 issue of Bookforum
To read the rest of this review, go to Bookforum:
http://bookforum.com/inprint/022_01
December 28, 2014
This is a wonderful book. It achieves several things -- its a history of asylums, with special reference to Friern Barnet (now turned into luxury apartments); a history of recent mental health provision now there is so little long-term residential care available; a personal account of the author's breakdowns, and the steps she took to recover; a vivid account of her therapy, which includes many sessions with a psychoanalyst, as well as stays in Friern Barnet, visits to Day Centres, and the use of other resources. It's also an account of the development of her self-knowledge and her intellectual grasp of mental health issues. This account is not dry as dust, but very honest and detailed about her own struggle. Very highly recommended -- it's Christmas and it's my choice for Non-Fiction Book of the Year!
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July 4, 2015Taylor's story of how she devolved from published historian to madness. She suffered bouts of paralyzing helplessness, panic attacks and suicidal rage which also involved alcoholism and unpredictable mood swings. She spent over twenty years in almost daily psychoanalyis with one doctor and had three stints in a mental asylum before gradually getting better in the early 1990s. What ailed her is never diagnosed, never named. It appears to be a severe case of repressed feelings. The book also includes a potted history of asylums in England (where she lived), a history of therapeutic care and an analysis of the state of mental health care today. But it is the roller coaster ride of Taylor's life that stays with you.
September 7, 2015
I found the author's writing compelling, but was not eager to live this story with her. It sounds like her illness was terrible for her and her loved ones. In the first section I found little reward in suffering alongside her. In the second, I appreciated her insights into the asylum system and to the different ways it impacted quality of clients' lives. In the closing third, her story becomes more personal again, and less compelling to me. In the end the book made me think a bit more charitable toward psychoanalysis, and reminded me of the ways in which our present impersonal, results-oriented approach to mental health care fails our communities.
May 31, 2015
Barbara Taylor tells many stories about her life allowing the reader to experience her journey at different ages. I was a little dissapointed that the book was more about her life rather than her experiences at the asylum, as it was advertised in a way that the book would be more about the asylum itself.
February 26, 2020
I got to page 181 of this book before I gave up. It was boring and there's a million other books i'd rather read. I found I didn't care about her story and it switched too much between a historical account and a memoir to keep my interest. Even within the same chapter, I found it jumped around in time and it didn't have a nice flow.
December 6, 2015
Our book club read this and we all agreed we had to "slog" through much of it.
March 28, 2021
I think this is a book I did read for longest period of time- still not finish it.
I need a material that will explain to me Brent mental health institution that's now a luxury housing complex of idiot celebrities because was in the middle of my own investigation regarding segregation and the care system in the UK. I need to understand how some things happened today. Finally, while reading the book discovered that - if the mental health system was so well developed before 1993- I did take this book from the shelf when - sorry for saying- idiotic celebrities are just 2 steps away to reopen concentration camps. The part about Hallawick drives me mad, as, indifference with 1995- seems they had some service provided while recovery, what's now gone, as Hallawick itself, lost accommodation in 2017, all peoples in need to exit "asylums/ hospital over drugged treatment" are placed back IN Hospital where Katie Price will help them with programs relevant to the nursery age. Pathetic. Try to ask psychotherapy these days.
Mental Helth Horror.
As peoples sad on here, the book is written by a rich drug addict that constantly does some things, I could not relate with, I could not understand Illness- except Alcoholism and drug addiction whats day today the common practice of Nursing Stuf on mental health ward in night shifts, UK wide.
Found lots of "Historic data" about Asylum and the history of Mental health practice before and after Diana death- but far from answer why the UK practice segregation in the Care system Today- when segregation was illegal in 1983 when Mental Health Act was made.
No connection to the "character" of the ill person, neither I finish reading the book after Asylum was closed-event moved in Hallawick, I know Hallawick is now closed (Contract of Harry and Megan engagement) , and practice from the beginning of this book is so common and painful. Drugs/locks/drugs/locks. Lots of Lunatics in the mental health system, no doctor on a sight, neither anyone keeps track of which drug goes to which patient
Book fit to the purpose of Informing ....reality today is so far brutal- when Asylum and segregation are happening under the open sky, properties of institutions are celebretisied by greedy idiots.
Peoples are dying behind lock doors, there is even starvation happening on wards, human rights been much more brutally neglected than in any part of this book, peoples have been torch and molested..looks to me today more than in 1988. No one care. I'm happy to be able to get insight into the History of UK mental health. I understand much better.
I need a material that will explain to me Brent mental health institution that's now a luxury housing complex of idiot celebrities because was in the middle of my own investigation regarding segregation and the care system in the UK. I need to understand how some things happened today. Finally, while reading the book discovered that - if the mental health system was so well developed before 1993- I did take this book from the shelf when - sorry for saying- idiotic celebrities are just 2 steps away to reopen concentration camps. The part about Hallawick drives me mad, as, indifference with 1995- seems they had some service provided while recovery, what's now gone, as Hallawick itself, lost accommodation in 2017, all peoples in need to exit "asylums/ hospital over drugged treatment" are placed back IN Hospital where Katie Price will help them with programs relevant to the nursery age. Pathetic. Try to ask psychotherapy these days.
Mental Helth Horror.
As peoples sad on here, the book is written by a rich drug addict that constantly does some things, I could not relate with, I could not understand Illness- except Alcoholism and drug addiction whats day today the common practice of Nursing Stuf on mental health ward in night shifts, UK wide.
Found lots of "Historic data" about Asylum and the history of Mental health practice before and after Diana death- but far from answer why the UK practice segregation in the Care system Today- when segregation was illegal in 1983 when Mental Health Act was made.
No connection to the "character" of the ill person, neither I finish reading the book after Asylum was closed-event moved in Hallawick, I know Hallawick is now closed (Contract of Harry and Megan engagement) , and practice from the beginning of this book is so common and painful. Drugs/locks/drugs/locks. Lots of Lunatics in the mental health system, no doctor on a sight, neither anyone keeps track of which drug goes to which patient
Book fit to the purpose of Informing ....reality today is so far brutal- when Asylum and segregation are happening under the open sky, properties of institutions are celebretisied by greedy idiots.
Peoples are dying behind lock doors, there is even starvation happening on wards, human rights been much more brutally neglected than in any part of this book, peoples have been torch and molested..looks to me today more than in 1988. No one care. I'm happy to be able to get insight into the History of UK mental health. I understand much better.
February 3, 2019
Barbara Taylor successfully integrates her own story of mental illness with a well researched exploration of the history of mental health care in the UK.
Many parts of this book are difficult to read, not because they are not well written, but because the content is so raw. I wonder if Taylor found writing this book cathartic. Her personal descent into madness is painful and sometimes confronting. I found the transcripts of her consultations with her psychoanalyst disturbing and could not help but wonder how helpful these sessions really were. I am not convinced that psychoanalysis is a successful treatment for mental illness.
Taylor is an historian, and she knows how to research her subject. The changing attitudes to mental illness and ‘madness’ over the past 150 years are fascinating and at times heartbreaking. My knowledge is limited by the few books and movies I have come across. Most of these portray asylums as living hells. Taylor’s experience was quite different. Friern Hospital had once been England’s largest psychiatric institution, opened in 1851 as part of an enlightened approach to psychiatric treatment ‘designed to comfort and heal the truent mind’. By the time Taylor was admitted in 1988 it was a shadow of its former self. However, she found friendship and camaraderie in the bleak halls of this place. She argues that the move away from asylums and facilities that provided care and accomodation for people with mental illnesses has not been successful. Community care was hailed as the new way forward, removing the stigmatism that past approaches were seen to create. But it is very easy for someone with a mental illness to now be totally isolated, left alone to fend for themselves as part of a program that is supposed to help build independence.
Taylor recovers after many years of psychoanalysis, 3 admissions to Friern Hospital and tireless support from her friends. She returns to her successful career and finds love. However, the future for mental health care is not so rosy. As Taylor says, it is imperative that the current system recognise the need ‘for ongoing care, for asylum, for someone to rely upon when self-self-reliance is no option’ if it hopes to provide effective and humane mental health care.
Many parts of this book are difficult to read, not because they are not well written, but because the content is so raw. I wonder if Taylor found writing this book cathartic. Her personal descent into madness is painful and sometimes confronting. I found the transcripts of her consultations with her psychoanalyst disturbing and could not help but wonder how helpful these sessions really were. I am not convinced that psychoanalysis is a successful treatment for mental illness.
Taylor is an historian, and she knows how to research her subject. The changing attitudes to mental illness and ‘madness’ over the past 150 years are fascinating and at times heartbreaking. My knowledge is limited by the few books and movies I have come across. Most of these portray asylums as living hells. Taylor’s experience was quite different. Friern Hospital had once been England’s largest psychiatric institution, opened in 1851 as part of an enlightened approach to psychiatric treatment ‘designed to comfort and heal the truent mind’. By the time Taylor was admitted in 1988 it was a shadow of its former self. However, she found friendship and camaraderie in the bleak halls of this place. She argues that the move away from asylums and facilities that provided care and accomodation for people with mental illnesses has not been successful. Community care was hailed as the new way forward, removing the stigmatism that past approaches were seen to create. But it is very easy for someone with a mental illness to now be totally isolated, left alone to fend for themselves as part of a program that is supposed to help build independence.
Taylor recovers after many years of psychoanalysis, 3 admissions to Friern Hospital and tireless support from her friends. She returns to her successful career and finds love. However, the future for mental health care is not so rosy. As Taylor says, it is imperative that the current system recognise the need ‘for ongoing care, for asylum, for someone to rely upon when self-self-reliance is no option’ if it hopes to provide effective and humane mental health care.
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August 11, 2024I don’t reread many books, but I’m glad I returned to this one.
I found the epilogue in particular as compelling as I did when I first read it six years ago. Having worked in trials for the past three years I found myself considering a problem I often come back to: how do we reconcile the need for personal, holistic, creative approaches to mental health care with that of the evidence based care I believe to be a fundamental ethical requirement when it comes to ‘treatment’ of any illness or condition.
Honestly, the reflections on the current (the book was published some years ago) situation feel a little bleak and leave me with a lot of questions. Whilst I don’t agree with everything Taylor says, her writing helped me consider the context in which professional attitudes, approaches and policy imperatives change and develop over time. This gives me some hope that the coming decades will offer some sensible, appropriate and caring responses to the problems faced in mental health care at present. Perhaps this is excessively optimistic, but that’s a delusion I will allow myself for the time being.
I found the epilogue in particular as compelling as I did when I first read it six years ago. Having worked in trials for the past three years I found myself considering a problem I often come back to: how do we reconcile the need for personal, holistic, creative approaches to mental health care with that of the evidence based care I believe to be a fundamental ethical requirement when it comes to ‘treatment’ of any illness or condition.
Honestly, the reflections on the current (the book was published some years ago) situation feel a little bleak and leave me with a lot of questions. Whilst I don’t agree with everything Taylor says, her writing helped me consider the context in which professional attitudes, approaches and policy imperatives change and develop over time. This gives me some hope that the coming decades will offer some sensible, appropriate and caring responses to the problems faced in mental health care at present. Perhaps this is excessively optimistic, but that’s a delusion I will allow myself for the time being.
May 24, 2019
Insightful and informative when it comes to the history of inpatient mental health care in the UK, but the biographical part is irritatingly self-indulgent. It's hard to sympathise with someone who spends 21 years in psychotherapy endlessly going over how her parents didn't love her... psychotherapy (along with food and rent) funded by said parents. At least she has the honesty to admit how difficult it is to navigate debilitating mental health issues with no family, friends or financial help. It's hard to escape the feeling (backed up by several statements in the book coming from Taylor's health care providers) that she was a lot closer to recovery than other patients in the institutions she describes.
July 17, 2020
Excellent writing, timely observations, well referenced.
"The mental health system I entered in the 1980s was deeply flawed, but at least it recognized needs – for ongoing care, for asylum, for someone to rely upon when self-reliance is no option – that the present system pretends do not exist, offering in their stead individualist pieties and self-help prescriptions that are a mockery of people’s sufferings. The story of the Asylum Age is not a happy one. But if the death of the asylum means the demise of effective and humane mental health care, then this will be more than a bad ending to the story: it will be a tragedy."
"The mental health system I entered in the 1980s was deeply flawed, but at least it recognized needs – for ongoing care, for asylum, for someone to rely upon when self-reliance is no option – that the present system pretends do not exist, offering in their stead individualist pieties and self-help prescriptions that are a mockery of people’s sufferings. The story of the Asylum Age is not a happy one. But if the death of the asylum means the demise of effective and humane mental health care, then this will be more than a bad ending to the story: it will be a tragedy."
August 23, 2017
Very mixed - the historical elements were interesting, as were the author's experiences within the mental health system (the asylum itself). Fellow service users are sketched effectively. The detail of her illness and psychotherapy are another matter - not interesting, and disturbing (not in the way you'd expect/want it to be, more in the way of 'what the hell is this analysis actually supposed to achieve?)
January 28, 2019
I understand this is a memoir, so the author can only write what she recalls..however I feel like I don’t really know what the point if publishing this book was. It was rather disturbing looking into her mind as she spiraled down into madness, but you don’t get much of a resolution, it’s just GONE now? She worked through it? There should have been more speaking on her recovery, in my opinion and less about how horrible she felt. It really doesn’t tell you much.
November 28, 2017
Another reviewer stated that it was a “fractured retelling” and I have to agree. I am not sure of what the author’s mental illness was and most of her story had more to do with psychoanalysis and a doctor who seemed to do a lot of yelling about her need for analysis on emptier pockets. I became more skeptical of psychoanalysis as a treatment plan as pages turned. Not what I hoped for.
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