Portraits of the Insane: Theodore Gericault and the Subject of Psychotherapy

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In the early 1820s, in the gloomy aftermath of the 1789 Revolution and the Napoleonic wars, the French Romantic painter Theodore Gericault (1791-1824) made five portraits of patients in an asylum or clinic. No depictions of madness before or since can compare with them for humanity, straightforwardness and immediacy. Why were they painted? For whom? Art-historical ways of accounting for them open up questions about the nature of psychoanalytic interpretation. The portraits challenge us to find responses in ourselves to the face and the embodied mysteries of the other person, and to our own internal (unsconscious, disavowed) otherness: in this sense, Gericault was a "painter-analyst". The challenge could not be more urgent, in our world of suspicion of the stranger, and of the medicalisation of madness. The book sketches the history of this last process, from the Enlightenment through to the Revolution and its public health policies, to the birth of the asylum in its interface with the penal system. But there was also a new medico-philosophical conviction that the mad were never wholly mad, and their suffering and disturbance might best be addressed through relationship and speech. For contemporaries like Stendhal and Hegel, we are all split subjects. The portraits, painted during a period of unprecedented social, cultural and economic transformation, on the threshold of modernity, register a critical moment in the history of psychotherapy and psychiatry, and of the human subject itself. They help us grasp and give proper value to some of the living roots of psychoanalysis.

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Introduction

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Some time in the early 1820s, not long before his death, the French painter Théodore Géricault made a group of portraits of anonymous inmates of an asylum or a clinic for the insane. They are powerful, startling works—but they are far from voyeuristic or prurient. They show ordinary, recognisably individual, idiosyncratic people. At the same time, these people seem distracted, estranged from us. With a directness shared by few other portraits in the history of Western art, the paintings point us straight to the most profound, human questions. Who is this other person? What does she or he want of me? How do I respond to the call that her mere presence seems to make on me? What does he stir in me? How do I see and hear her? What if there are more like him? Under what conditions might I be open to our common humanity?

When I am not too anxious or terrified myself, might be one answer. Precisely because they are merely paintings (but what paintings), Géricault's five portraits offer us safe and hospitable enough conditions for an imaginative exploration of such questions and their attendant terrors. These questions could hardly be more urgent. For in the political and emotional climate of the first decades of the twenty-first century, they speak to widely held fears: about being taken over, taken from, overrun by nameless others. The portraits, I wish to argue, offer us help. Remarkably little is known for certain about the circumstances in which they were made, except that they were painted in an asylum or clinic, in some sort of partnership with a doctor. Although plausible accounts of their genesis can be put forward, none is absolutely incontrovertible or definitive. They remind and oblige us to keep open minds.

 

Chapter One: Illustrations

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This chapter gathers together twenty of the images discussed in the book: ten paintings and a sheet of drawings by Théodore Géricault, a painting by Jacques-Louis David and another formerly attributed to him, a painting by Eugène Delacroix, a lithograph after a painting by Horace Vernet, three engraved book illustrations, by Ambroise Tardieu, including one made after a drawing by Georges François Marie Gabriel, a drawing by this same Gabriel, and a plate from a book by Charles Bell. The reader might care to linger on these for a while, in as open-minded and free-associative a way as possible, before reading on.

Illustration 1. Théodore Géricault. Monomane du vol d'enfants (Monomaniac of Child Abduction). c.1822–1823. Oil on canvas. 86.8 × 54 cm. Museum of Fine Arts, Springfield, MA.

Illustration 2. Théodore Géricault. Monomane du comandement militaire (Monomaniac of Military Command). c.1822–1823. Oil on canvas, 81 × 65 cm. Collection Oskar Reinhart “Am Römerholz”, Winterthur, Switzerland.

 

Chapter Two: The Canvases Unrolled

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In 1863 Louis Viardot, journalist, translator, and former director of the Théâtre des Italiens in Paris, was party to the discovery of some rolled-up canvases in a trunk in an attic in Baden-Baden: five bust-length, life-sized portraits in oil, three of men and two of women. They belonged to a retired doctor named Lachèze. Viardot himself had recently moved to the spa with his wife, the legendary singer Pauline Garcia, as a voluntary exile from France. An opponent of the autocratic regime of Napoleon III, Viardot was also an art critic; he recognised the paintings as the work of Théodore Géricault.

Géricault's reputation in France, then as now, was colossal. He had died at the age of thirty-three in 1824 and was, with Delacroix (who himself died in 1863), a figurehead of the Romanticism of the previous generation, and of liberal opposition and dissent. His massive The Raft of the Medusa had been bought for the Louvre shortly after his death, where it still hangs; by the mid-century its status as a national icon was firmly established. In a long letter to the eminent critic Charles Blanc, written from Baden-Baden on 6 December 1863, Viardot produced the first account of the newly discovered Géricaults; it was published in Paris the following month.

 

Chapter Three: Géricault, a Biographical Sketch

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Simple and modest, he admired others and was rarely content with himself. He did not pose, he did not think of playing a role, and one would be tempted to believe he did not know himself. If he thought of posterity, it was to fear that he had not deserved his name to be recorded. In studying this unostentatious life, I had on more than one occasion to ask myself if I were not the plaything of an illusion, if it really was a great artist I had before my eyes…(Clément, 1868, p. 1, translated for this edition)

So wrote Charles Clément, who published the first book-length biography of Géricault in 1868. The Géricault myth is familiar, and the painter became a key contributor to the mythology of the Romantic artist: passionate, troubled genius, ahead of his times, his life, like those of his British contemporaries Keats, Shelley, or Byron, cut tragically short. His career as a painter lasted only eleven years, and we need to keep in mind that the man before us never stops being a young man, still finding his way, at times reaching his goals with supreme flair and acumen, and at times floundering, without, in either instance it would seem, a particularly developed self-awareness or secure sense of himself. We know that he brought determination, courage, and energy to virtually everything he did, and that he was also subject to crushingly severe emotional crises; that he revelled in his own physical and athletic prowess, admired Michelangelo above all other artists, and, as a mere glance at his work will confirm, loved horses. “Horses, as he himself confessed, just made him crazy…so much was his passion for the horse akin to madness,” recalled a cousin in the 1860s. “An excellent rider, his greatest pleasure was to gallop wildly through the countryside” (Athanassoglou-Kallmyer, 2010, p. 15). A startling film, Mazeppa, made in 1993 by the French horse-trainer Bartabas, is a colourful and highly visual account of him, and it centres on this passion (Bartabas & Karmitz, 1993). There is not much dialogue, but the film does contain the line: “Learn from your horses, not your mentors.” It is suggestive of the nature of Géricault's originality; while he certainly had mentors and learnt from them, what distinguished him was his willingness to give himself over to his subjects and as it were be taught by them, to the point of self-effacement, or even self-loss. He was extraordinarily open to the emotional currents around him.

 

Chapter Four: Madness in Modernity, 1656–1789

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That mad people, at any particular historical juncture, had their own personal stories can usually, as Laure Murat has pointed out, only be read between the lines of things written by other people who had power over them: edicts, legal or ecclesiastical documents, medical or philanthropic reports (Murat, 2014, pp. 15, 20). What physicians (or priests or witch-hunters) made of madness, and what those designated as suffering from it made of it, might be “two sides of a pattern that ultimately fails to cohere” (Ingram, 1998, p. 9). There are a few, surprisingly few, powerful visual images—Hogarth, Goya—but they are generic, contain multiple figures, and typically serve satirical rather than documentary agendas. We have to work to imagine what the person historically classed as insane might really have been like to meet, although there are occasional, tantalising glimpses, the eighteenth-century encounter between the philosopher Diderot and the nephew of Rameau, for example (Diderot, 1805). There is a distinguished handful of fictional and real individuals, from the Old and New Testaments and from Greek tragedy, and from the late Renaissance onwards (Don Quixote, Lear, Smart, Cowper), some of whom, like Gérard de Nerval (1855) or less fêted figures like Hannah Allen or James Tilly Matthews (Ingram, 1998; Jay, 2012), left their own accounts of their experiences.

 

Chapter Five: The Revolution, Cabanis, Pinel, the Asylum

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Citizens and public health

In August 1789, within weeks of the fall of the Bastille, the social and administrative foundations of the old regime in France were being comprehensively dismantled. The National Assembly, which now held most of the reins of power and had transferred them from the royal court at Versailles to Paris, was undoing royal, feudal, and church powers and privileges; in passing the Declaration of the Rights of Man on the 26th, it proclaimed the principle of equality: social equality, equality before the law, equal liability to taxation, and equality of opportunity. At a stroke the nobility lost its automatic monopoly of the higher offices of state. “All citizens”, decreed the Declaration, “without distinction of birth, are eligible for all offices, whether ecclesiastical, civil or military” (Hardman, 1998, p. 112).

A special commission of the Assembly, the Comité pour l'extinction du paupérisme, was investigating the problem of beggary and poverty, in order “to apply…to the protection and preservation of the non-propertied class the great principles of justice decreed in the declaration of the rights of man and in the constitution” (Miller, 1940–41, p. 154). But the Declaration of the Rights of Man included no provision for health. Within a few months, thousands of poor, sick, and unemployed people were petitioning the Assembly, prompting the committee's chair, the liberal aristocrat the duc de la Rochfoucauld-Liancourt, to proclaim that society owed the poor and ill assistance that was “prompt, free, assured, and complete”. The droit d'assistance assured free medical treatment for anyone unable to pay for it, and it was to be “avilé ni par le nom, ni par le caractère de l'aumône” (“debased neither with the name nor the character of almsgiving”) (Miller, 1940–41, p. 154). For the first time in Western history a nation faced an obligation to compensate for the disadvantages, including the physical illnesses and imperfections, of its citizens (Weiner, 1993, pp. 3–4, 276). Patients were being transformed from Christians relying on Christian charity, “meekly accepting pain and suffering”, into citizens, in the full meaning of the word, with duties as well as rights: to maintain, once they were recovered, hygiene in their persons and homes and, later in the decade, after the Consulate had set up a public health programme, to protect common resources such as water, be vaccinated, and report health hazards to the police. Old distinctions between the respectable and the undeserving poor disappeared in the face of Equality (Weiner, 1993, pp. 6, 8).

 

Chapter Six: A New Account of the Human: Responses to Pinel's Traité

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Precedents

In certain respects Pinel's and his students’ approach to madness was nothing new. We have seen how his initiatives in moral treatment belong among Europe-wide developments. As long ago as the early seventeenth century the surgeon Pierre Pigray had extolled kindly words as far more use than physical remedies when working with the mad; Samuel-Auguste Tissot, in his influential Traité des nerfs et de leurs maladies (1778 onwards), was critical of doctors who were ignorant of the emotional lives (le moral) of their patients (Bernard, 2015). Rousseau had been acute to his own and others’ internal discrepancies and self-deceptions.

It is impossible for a man constantly putting himself about in society and ceaselessly engaged in dissimulating to others not to dissimulate a little to himself, so that when he did get time to study himself he would find it almost impossible to recognise himself…

he wrote in “Mon Portrait” (Rousseau, 1782, p. 162). This catches both the idea that social life can alienate us from ourselves and that we can be divided against ourselves in the first place; a part of us that wants to know ourselves does, however, survive. St Paul and St Augustine themselves are evidence that Pinel was hardly the first to entertain such thoughts.

 

Chapter Seven: The Golden Age of Alienism

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Medicine as master-discipline

The medical profession was gradually shedding its former, mixed reputation and gathering prestige. Alongside other professions, civil engineering, for example, or painting, it was consolidating its claim to be a profession in its own right, with its own traditions, high standards, and contributions to make to human progress, rather than a trade with mere guild status. A portrait of 1783 by Jacques-Louis David, for example, brimming with gravity and confidence on the parts both of painter and sitter, shows the gynaecologist Alphonse Leroy as an intellectual, a philosophe, whose credentials are founded in a marriage of past and present; he leans on a volume of Hippocrates, and is lit by the latest “Quinquet” device, a lamp of unprecedented brightness patented in France in 1780 (the painting is in the Musée Fabre, Montpellier).

Philosophically grounded medicine, which was uniquely placed to explore the mysteries of body–mind relationships, held out the promise of a more comprehensive understanding still: it saw itself as a new master discipline, a future “omnibus science of man”, with vast potential in contemporary minds. Only medicine, wrote Esquirol's pupil Etienne Georget, is able to understand every human function without exception (1820a, p. 12). It was, in the words of another learned contemporary, “the supreme science of the living man” (Goldstein, 1987, pp. 49–51, 78); no profession, what is more, “requires so comprehensive a mind as medicine”, for there are “few departments of either physical or moral science with which [medicine] is not, in a greater or lesser degree, connected” (Almeida, 1991, p. 7 and note 10).

 

Chapter Eight: Géricault and the Alienists

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Medical friends

Géricault had numerous contacts with the medical profession during his work on the Raft, notably with the ship's surgeon Henri Savigny with whom he spent much time in 1818–19, learning from his and Alexandre Corréard's accounts of insanity, delirium, and hallucination on board. He made friends with doctors and students at the hôpital Beaujon where he procured corpses for his studies for the picture. He had also painted the head of a robber who had died at Bicêtre (Clément, 1868, p. 51, catalogue no. 105). He may have met Etienne Georget through these contacts, if he and Georget were not already friends since childhood (Michel, Chenique, & Laveissière, 1991, p. 286), or had not met through their mutual friend Brunet. Perhaps they met through Dr Laurent-Thomas Biett (1780–1840), who in 1819 took possession of a major oil painting, Le Haquet, dated 1818 by Clément (ibid., p. 50, catalogue no. 96; Miller, 1940–41, p. 158), showing two magnificent draught horses with a wagon, under an imposing arch. Biett was a pioneering skin specialist who worked and taught at the Hôpital Saint-Louis, where Corréard had also been cared for; it is possible that Biett attended Géricault during his illness and depression in late autumn 1819 (Eitner, 1991, pp. 56–57). Might he have consulted Biett, who gave his name to a particular syphilitic skin symptom, for a suspected venereal condition? Biett was to attend him on his deathbed.

 

Chapter Nine: History Painter

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In line with Georget's clinical thinking, the portraits reflect both le physique—passions impact on the brain and body and can invest the person—and le moral—the sitters are not deprived of mind, or of sharply differentiated individualities. As such, the portraits are products of the humanising, democratising impetus of the post-Revolutionary period, and contributions to it; they are more than just throwbacks to the 1790s. Géricault was engaged in a larger project, to paint contemporary history, but as a history without heros. He was also in the process of constructing an audience, in the sense that Bakhtin proposed (1981). For Géricault this imagined, hoped-for audience might well have been based on the template of the Vernet circle: an audience that might resonate to shared themes and messages, some more overt, some more subliminal, and that might engage in imaginary dialogue.

In The Raft of the Medusa he demonstrated how the conventions and ambitions of neoclassical history painting as understood by the school of David, with its depictions of morally elevating moments of heroism from antiquity, might be enlisted to comment on the present day—on history-in-the-making. Géricault became the painter of the apparently defeated, of the shipwrecked. In making the portraits of the washed-up inhabitants of the Salpêtrière or Bicêtre he was furthering this project. Contemporary history is inscribed in the faces and bodies of his sitters: portraits, like the Chasseur's, as bearers of historical weight. His intense concern with the physical was always also a concern with the existential and psychological, with our embodied psycho-somatic and psychosocial beings: “…in Géricault it is time and again the body that proves to be the residue of all human experience and its affective reflection. Not excluding death” (Wedekind, 2013, p. 93). Understanding and transformation could only be arrived at through the flesh. The head of the child abductor, as another modern critic put it, is

 

Chapter Ten: Surplus and the Limits of Interpretation

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Perhaps no one among his near contemporaries manifested the energy of Géricault's figures more powerfully and consistently than Honoré de Balzac—born in 1799—in his own characters. Among Balzac's earliest published writings, from the late 1820s, are fictions centring on the question of madness: Adieu (1830a), Le colonel Chabert (1832a), Louis Lambert (1832b). Despite his defence of throne and altar, “…you never find in him the least contempt for ordinary people,” wrote Eric Hazan (Hazan, 2010, p. 154). For Baudelaire, Balzac's characters were “weapons loaded with will right up to the end of the barrel”, ready to go off at any moment; in their intense vitality, they were “more firecely alive, more active and cunning in combat, more patient in misery, more gluttonous in their pleasures, more angelic in devotion than the comedy of the real world shows us”—except, Baudelaire might have added, the world inside the asylum; each, down to the humblest, has genius (1859, vol. II, p. 120, and see Calasso, 2012, p. 163). In Adieu Balzac, drawing on contemporary medical models, depicted different types of aliénation: the “idiot” Geneviève, the demented Stéphanie, driven mad by the trauma of the crossing of the Berezina during the retreat from Moscow in 1812, and the “monomaniac” former soldier Philippe, who is also a victim of his experiences in Russia. Philippe's idée fixe, in a nice ironic twist, is nothing more antisocial than a wish for the cure of Stéphanie (Balzac, 1830b). The Comédie humaine (the title Balzac gave his great series of novels on nineteenth-century life) is full of figures destroyed by the force of their own thoughts, ambitions, and passions. His thinking was also informed by contemporary ideas on the links between mind and body, as is evident in the vividness of his physiological and physiognomic descriptions and their power to evoke character.

 

Some Conclusions

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A historical and biographical summary

If Rousseau had sought to establish feelings as reason's natural allies, the sheer force of the popular movement in 1789 and 1790, and especially after 1794, brought about a new recognition of just how powerful in their own right feelings and the irrational could be. Differences now arose as to how they were to be valued. For thinkers of the Enlightenment, and for the triumphant bourgeoisie of the later 1790s, feelings must be understood, worked with, harnessed, contained, and socialised within an expanded vision of sociality, of citizenship, with its new, democratic dimensions and obligations. But there must also be the force of law to keep them within bounds. In Freudian terms, binding of the drives through repression.

Napoleon provided the means for this channelling and enforcing, with a new, all-embracing legal Code, a universal system of measurement, and a highly policed state. In this he was a true child of Enlightenment. But he was also the focal point for another way of valuing feeling and the irrational: he seemed to demonstrate that passion had its own creative/destructive motive force and logic, that it could break old moulds and constrictions in a continuation of the spirit of 1789–1795, literally smashing borders and boundaries. Fused with ideas from Germany on the power of what Schelling christened “the unconscious” (1800, esp. Part III, pp. 47–154), this ethic became Romanticism, with the help, in France, of the former Napoleonic soldier Stendhal (Stendal is a town in Prussia Beyle may have passed through with the Grande Armée, on its way to Moscow), and then Hugo.

 

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