by Katy Geisreiter
Psychiatry underwent vast change during the first half of the twentieth century. As psychoanalysis increased in popularity, a movement toward deinstitutionalization began in France and the rest of the world. While psychoanalysis was increasing in popularity, there was a movement of deinstitutionalization in France and the rest of the world. In France, the first half of the twentieth century was a time of change for psychiatry. The government ran the nation’s health care, including the establishment of mental hospitals. Patients of mental hospitals in France experienced poor conditions, including overcrowding and lack of proper treatment. Attempts to reform asylum laws arose in the years preceding World War I. These laws, which had been in effect since 1838, were considered outdated and were generally criticized. In response to the reform movement, the French government created specialized facilities for specific patients. Zelda Fitzgerald’s treatment for schizophrenia in various mental hospitals is representative of treatment of psychological disorders in the early to middle twentieth century.
In April 1930, Zelda Fitzgerald was admitted to a hospital on the outskirts of Paris called Malmaison. Although she was admitted in a state of extreme anxiety, she discharged herself after a short stay and immediately resumed her previous habits of working and partying. A short while later, Zelda suffered a serious nervous breakdown. This breakdown included hallucinations that made her dazed and incoherent, so she took morphine to calm herself down. She then moved to Valmont, a clinic in Switzerland, where psychiatrist Dr. Oscar Forel treated her. Dr. Forel stated that Zelda could only be cured with psychotherapy; he later diagnosed Zelda Fitzgerald as schizophrenic. Zelda later developed eczema, which was linked to her psychological issues. To treat the eczema, Dr. Forel hypnotized Zelda. The hypnosis, which was a typical treatment at the time, allegedly helped Zelda. In 1931, Zelda transferred to a second Swiss mental hospital, Prangin. Zelda eventually returned to the United States, where she stayed in two mental hospitals before her death in 1948.
As a schizophrenic, Zelda Fitzgerald experienced hallucinations and paranoia. She described these hallucinations in a letter to her husband: “Now I see odd things: people’s arms too long or their faces as if they were stuffed and they look tiny and far away, or suddenly out of proportion” (Milford 177). Schizophrenia, a term first used by Swiss psychologist Eugene Beuler in 1911, is defined as a group of severe disorders characterized by disorganized and delusional thinking, disturbed perceptions, and inappropriate emotions and actions (Myers 669). When Zelda Fitzgerald was being treated in mental hospitals, schizophrenics received hydrotherapy and electroconvulsive therapy as treatment. These treatments did not cure schizophrenics. The first antipsychotic drug, Chlorpromazine, was not created until 1952.
At the time when Zelda Fitzgerald was having her breakdown, there were “fashionable” causes of insanity. For example, incest, as demonstrated in Tender is the Night, was often cited as the cause of mental health disorders. Disorders like schizophrenia were not seen as caused by genetics; rather, they were viewed as the result of a specific event. The attribution of mental health problems to a certain event was a characteristic of psychoanalysis, which Sigmund Freud made famous in the beginning of the 20th century. In 1931, Henri Ey, along with other French psychoanalysts formed the Société Psychanalytique de Paris.
During this time, there was a great expansion of mental hospitals around the world. Before World War I, asylums had generally become “vast warehouses for the chronically insane and demented” (Shorter). In the 1920s and 30s, however, a deinstitutionalization movement began in Europe and the United States. There was a change from long-term stay psychiatric hospitals to community mental health services. Nancy Milford describes the anti-institutional atmosphere of Prangins, the Swiss hospital Zelda Fitzgerald entered in 1931: “The atmosphere was intended to be homelike rather than institutional and the number of patients was admitted was limited to ensure close psychiatric care” (Milford 162). Prangins’s attempt to make the treatment of mental problems specialized rather than impersonal epitomizes the shift in focus from vast asylums to community health service experienced in the early twentieth century.
According to Psychiatric Cultures Compared, “the beginning of the 1920s was marked by an increasing preoccupation with hygienism and individual health protection” (Coffin 227). In response to this preoccupation, the Ministry of Social Hygiene, Assistance, and Prevention was formed; this later became the Ministry of Public Health. While the creation of the Ministry of Public Health demonstrated a movement toward proper attention for mental health treatment, the government still had not adequately revised the asylum laws. After World War II, there was more avocation for reform of mental institutions, and attempts to reform were continued through the 1940s and 50s.
Gijswijt-Hofstra, Marijke, Harry Oosterhuis, Joost Vijselaar, and Hugh Freeman, eds. Psychiatric Cultures Compared. Amsterdam: Amsterdam UP, 2005. Electronic.
“La Question De La Formation.” Société Psychanalytique de Paris. Web. 06 Nov. 2010. <http://www.spp.asso.fr/main/histoirepsy/histoire/items/8.htm>.
Milford, Nancy. Zelda: A Biography. New York: Harper & Row, Publishers, Inc., 1970. Print.
Myers, David G. Psychology. 8th ed. New York: Worth, 2007. Print.
Shorter, Edward. A History of Psychiatry: From the Era of the Asylum to the Age of Prozac. New York: John Wiley & Sons, 1997. Electronic.