Studying the history of psychiatry can be an affecting enterprise, encompassing the past emotional states of historical actors, the present feelings of the historian, and the potential reactions of the historian’s audience. Reading a 100 year old casebook often throws up challenges to the old ideal of historical ‘objectivity’. I’ve been moved by many stories encountered during my research, such as the male asylum patient who died in 1890 having had ‘no visitors since [his] admission’ 20 years previously. Such episodes sometimes seem unhelpfully far away, however, taking place within an alien context that is difficult for the historian to grasp fully.
This is where films such as Lawrence R. Hott’s Imagining Robert come in, providing us with a much more accessible means of thinking about the history of mental health care. Complementing the 1997 book of the same name, Imagining Robert tells the story of Robert Neugeboren, chiefly through the eyes of his brother, Jay. After suffering his first breakdown at the age of 19, Robert was admitted to what would be the first of many psychiatric hospitals and a seemingly endless round of therapists and treatments.
Jay Neugeboren’s book, Imagining Robert: My Brother, Madness, and Survival, chronicled Robert’s chaotic journey through the American mental health system since his first admission in 1962. It led to several offers of help from interested readers, including New York City’s Project Renewal, a ‘highly structured living’ initiative that aims to help homeless men and women suffering from mental illness or addiction problems live a more independent life. The film documents Robert’s first few months with Project Renewal, during which his relish for his new life is plain to see as he goes about everyday activities such as buying shoes or visiting a restaurant for lunch. He is a delight to watch: with his sunglasses, baseball cap, and ever-present cigarette he’s not a million miles away from Fear and Loathing in Las Vegas’s Raoul Duke (a comparison one suspects would please Robert, who evidently loves the camera). Reciting his poetry and sketching self portraits, his frequent witticisms merge with the angry outbursts of the stereotypical ‘artist’s temperament’. “Why don’t you work for the census bureau?” he challenges a social worker whose questioning irks him.
Brother Jay takes all this in his stride, with the two sharing an obviously strong bond. Though old home movie footage sets up a picture of the contented all-American family, as the film progresses it becomes clear that family life for Robert was more complicated than it first appears. Robert and Jay’s mother is a contradictory and mysterious figure, all the more so as she is unable to tell her side of the story, suffering from Alzheimer’s and in residential care. Jay relates how her distress at Robert’s mental illness resulted in a self-conscious distancing from her son; after a 15 year interval during which she had not seen him, she introduced herself to him at a social function and enquired who he was. “I’m Robert Neugeboren, your son.” On another occasion, she had placed Robert’s belongings in a large trunk for safe keeping, in anticipation of the day when he was able to live on his own in the community: a wedding photograph, his beloved 16mm camera, a framed sketch, Robert’s diary of his hospital experience. The complexity of the family’s role in mental illness, explored by historians such as Patricia Prestwich and Akihito Suzuki (among others), is a timeless issue; the recollections of Robert’s family are a reminder that there isn’t a ‘blueprint’ for how a family deals with mental illness.
At the end of the film, screened as part of LSHTM’s ‘History, Health and Films’ series, one audience member asked what Robert’s diagnosis was. Alex Cohen of LSHTM referred back to a scene in the film in which Jay notes the constantly shifting nature of psychiatric diagnoses. Robert’s diagnoses were, said Jay, dependent on which drug therapy proved successful at the time: when lithium was deemed effective, he was bipolar; when it was Thorazine, the diagnosis changed to schizophrenia. Encapsulated in Jay’s brief assessment is an astute recognition both of the idiosyncrasy and historicity of diagnostic terms, and indeed definitions of mental health and illness more generally. In a relatively short period of time, Robert and his family underwent a whole gamut of treatments – as well as drug therapies, there was also family therapy and orthomolecular therapy (strong doses of vitamins). The latter drew sniggers from the audience: like the use of trepanation in the late 19th century, orthomolecular therapy was viewed as a faintly ridiculous and naive therapeutic route, yet its relative newness highlights how quickly theories about, and treatments for, mental illness can change.
Opinions of the psychiatric hospitals portrayed in the film are both negative and positive. Fittingly, it is Robert himself who assesses the hospitals he has passed through, describing abuse and restraint at Creedmoor State, but better experiences at Long Island’s Hillside hospital. Robert and Jay visit the crumbling Creedmoor site, Jay remembering how he hated visiting his brother there. The building is a stark symbol of 20th-century deinstitutionalisation, whilst Robert, who has experienced the psychiatric hospital, its demise, and aftermath, reclines on the grass outside.
The next films in the LSHTM’s series are This is Your Hospital (2011) and The Hurt Mind: Physical Treatment (1957) on 12 December. Further details can be found here.
– Jennifer Wallis