Archive and Study Centre Publications: Series 2 Essay 2
For decades the name of Maxwell Jones was dominant in Therapeutic Communities. He had founded and operated the most famous therapeutic community, at Belmont Hospital. We had all been to see it; we had read his books; he had visited our hospitals. Though he died in 1990 his name is still linked indissolubly with the concept.
And yet Max did much more than found the first and best therapeutic community. He had conducted earlier social experiments and he tried many other social projects after leaving Britain in 1970. He preferred to call himself a “social change agent” rather than a “psychiatrist”. For nearly 50 years he worked in many settings in many parts of the world. He was brilliant, charming, infuriating, kind, and cruel. As a result different people have very different memories of him, and any attempt to describe Max is met by the cries of “That’s not My Max”! So all I can do is to talk of where and when I met and experienced Max, while acknowledging that others may recall him quite differently.
I first heard of Maxwell Jones when I was working at the Royal Edinburgh Hospital learning psychiatry with Sir David Henderson just after the War. I heard that one of his former pupils had just been awarded a Gold Medal for this M.D. thesis - the first time a psychiatrist had been so honoured. I read an abstract of the thesis. It was a powerful and dense account of the investigation of “Disordered Action of the Heart” in soldier conscripts, which had proved that the mysterious disorder was in fact psychosomatic. A masterly academic exercise.
The next I heard of Max was from a sardonic Australian post-graduate who came to Edinburgh from London in 1949. He had been working at Belmont Hospital and told tales of the extraordinary units there. In one wing William Sargeant was practising narcoanalysis and abreactive therapy with ether, whipping battle neurosis cripples into dramatic abreactive displays of emotion and terror, while at the other end there was an “Industrial Neurosis Unit” where Maxwell Jones had collected an amazing collection of “psychopaths” who would present a psychodrama every Friday where one of the psychopaths would get the others to enact his life’s tale. He said that this was called a “therapeutic community”.
When I went to work in London, at the Maudsley in 1950, I began to hear more about therapeutic communities, about social therapy, about Maxwell Jones. In due course I went for a day visit to the Belmont unit. This was an exhilarating, paradigm changing moment for me. For some years I had been pondering on the life of the old mental hospitals, with the locked doors, oppression, brutality and bizarre rituals, and wondering whether it could be different. I had read sociological studies and visited pioneering units. But Belmont was amazing. Here was a society where everyone - patients, doctors, nurses - were on first name terms and apparent equality; where open and frank discussion went on about the daily crises, examining the staff behaviour as freely and penetratingly as those of the patients. I was amazed and excited. Could this work elsewhere? Probably not, said the cynics. Belmont only worked with psychopaths who have the wits to play the game; it recruited staff who are mostly psychopaths themselves! I ran into Max a number of times in my London years, especially at meetings of “Social Psychiatrists”. I noticed that he often seemed willing to disrupt the orderly proceedings to point out what he thought was happening in the room. I found this behaviour irritating.
In 1953 I went to Cambridge and tackled the task of turning the overcrowded, demoralised, decrepit Fulbourn Hospital into a lively hopeful place, mostly by developing activities for the patients and by opening the doors of the wards. This kept me very busy for several years.
In 1957 I was offered a place on a Refresher Course for Medical Superintendents at the King Edward’s Fund Staff College in London. I was amazed and delighted to be asked. I found myself in a group of 10 men which contained some of the most innovative Superintendents of the time - men like Rudolf Freudenberg, Duncan Macmillan, Samuel Last, and Francis Pilkington. To my surprise Maxwell Jones was also one of the group! For four weeks we took part in lectures, discussions, and seminars about what could be done to improve mental hospitals in those days, just before the 1959 Mental Health Act. I was filled with ideas and with challenges. Best of all was the comradeship of the others; but for me, especially with Max. He put himself in the position of the radical, the outsider, the challenger of the ancient asylum assumptions. I found myself gleefully allying with him in teasing some of the more pompous members. It was a delightful experience.
After that I kept in touch with Max and sent some of my staff to visit Belmont. I was saddened to hear that he had left England for America in 1959. When I went lecturing to the USA in 1961 I found many people talking of his visit to hospitals and units. When I was invited to California for a post-graduate year in 1962/3 I found that Max was working in Oregon at the Salem State Hospital. I managed to make several trips, staying with him and his wife Kirsten, and getting to know him and the Salem hospital and its pioneering Superintendent Dean Brooks very well. Max was promoting change and controversy in the hospital and the small town of Salem with vigorous glee and, as ever, arousing devotion and opposition around himself.
In 1963 I went back to Fulbourn and was soon amazed to hear that Max had been sacked from Salem but that he was coming back to Britain as Superintendent of Dingleton Hospital, Melrose already famous as having been the first hospital in Britain to open all its ward doors in 1948.
As soon as I could I arranged to go up to Scotland to see what Max was doing at Dingleton and I managed to visit him there quite often. We also had him as a visitor to Fulbourn whenever we could. After he left Britain finally in 1970 he used to come back most summers and would often come to visit us in Cambridge, always challenging me for my “Establishment ways” and my acceptance of the hierarchy of British psychiatry. I visited him in Phoenix, Arizona, in 1975 and he helped me to decide not to go to Australia but to stay and continue to work in Cambridge.
My last major experience of Max was in 1986. We were both asked to be speakers at an International Conference of Therapeutic Communities organised by the Concept House (Drug-Free) Therapeutic Communities in Rome. We were in the same hotel and spent time together. Max was, of course, the star of the Conference, giving interviews for radical Italian newspapers and delighting and infuriating the Roman Catholic Monsignors who were managing the Conference. It was then that Max had his mystic experience in St. Peters that led to future discussions, since I was exploring transcendental experiences and meditation at that time. Once again we found much in common. A high point was an audience with Pope John Paul whom Max, as ever, charmed.
So I met Max in a number of settings over 50 years, a period in which he and I both changed. It is perhaps worth exploring these because they throw light both on how he changed and how I did.
In the 1950s I was in my thirties, grappling with a demoralised, overcrowded, static asylum. I wanted to see the life of the patients improve and thought that I could do it. I sought vigorously for models. I visited the three main Open Door Hospitals and their charismatic Superintendents - Warlingham Park, Croydon (T.P.Rees); Mapperley Hospital, Nottingham (Duncan Macmillan); and Dingleton Hospital, Melrose (George McDonald Bell). These visits showed me that Open Doors were possible and gave me some ideas how they might be achieved. I warmed to George Bell’s passionate hatred of locking people up, to T. P. Rees’ flamboyant style of leadership, and to Duncan Macmillan’s quiet, steady style. I worked hard, and by 1958 Fulbourn was an Open Door Hospital. I could see what to do at Fulbourn. But Belmont and Max seemed a different world; I admired what he was doing but could not see how it would apply at Fulbourn.
Then, in 1957, came the King Edward’s Fund course, and I got to know Max as a friend. I realised that we had a number of things in common. He was older than me, but we had had many similar experiences. We both attended Edinburgh Day Schools for boys, where we were both outsiders; he went to Daniel Stewart’s and I went to Watson’s. We were both clever students (“swots”), but Max excelled at rugger, where I was incompetent. We both trained in medicine at Edinburgh and both studied psychiatry under Sir David Henderson and learnt his psycho-biological approach to the study of a patient’s life and disorder.
I enjoyed forming a “left wing” pair with him on the Course, but was saddened to see how his dominating style of group manipulation often infuriated reasonable and friendly people. At that time Max was questioning what he was doing. Robert Rapoport and his team of social scientists were studying Belmont, and Max was hoping that they would “tell him what he had done and how he had done it”.
During my 1962/3 year in California I met many people running therapeutic communities in the Bay area around San Francisco who had been inspired by Max a few years earlier. During my visits to Salem I saw Max at work in the State Hospital, stimulating, exciting, but also infuriating the long stay staff, attendants and doctors. I stayed in his home and he constantly challenged me as to why I did not make Fulbourn into a Therapeutic Community.
During the 1960s I tried to do just that, developing therapeutic communities first in the “disturbed wards” and later in an admission ward, and encouraging the doctors and nurses who worked with me to try the method in other parts of the hospital. We began to visit other therapeutic communities seeking support and inspiration, and I made a point of visiting Dingleton where Max worked from 1963 to 1970 as often as I could. It was always stimulating to go there; he was always welcoming and challenging, bubbling with the latest idea he had picked up on his world travels. Also, I felt a welcomed and valued visitor, and I could look at what he was doing with an experienced eye.
Then, in 1970, he left Britain. My contacts over the next twenty years were fewer, but closer. I enjoyed visiting him in Phoenix, Arizona, and he came to Cambridge during most of his frequent visits to Britain. These were more difficult times. Economic recession blocked many initiatives; then came Thatcher and Reagan. Max sought openings in USA - Colorado, the Virgin Islands, Arizona - but found no place where he could settle and work fruitfully. Finally he retreated to Nova Scotia, Canada, to a more tolerant land and settled as an ailing sage. But he never became downhearted, nor did he lose his enthusiasm for new opening or new ideas. He relished figures like Karl Pribram, Gregory Bateson, Fritjof Capra, Marilyn Ferguson, and enjoyed their new perspectives. Every time I met him there was some new enthusiasm or some new insight. In Rome in 1986 we had long talks on the Spiritual Dimensions in our lives, since we had both had transcendent experiences and were trying to make sense of them, both starting from a Scots pragmatic view-point. As ever Max was prepared to go further than I was.
So what was Maxwell Jones to me? In 1980 I did a piece on Max and his contribution for a memorial volume. This is what I said then:
“Max affected British Mental Hospital practice in three ways by what he did at Belmont and at Dingleton, by what he wrote, and by what he was, as a lecturer, a consultant, a delightful gadfly in the side of the Establishment.
Max published seven books and many articles. He took his writing very seriously; he read widely and constantly annotated many sources; he strove for professional esteem in his writings. But probably Max’s greatest impact was personal. Other articles in this volume may convey something of his impact but it should be stated again. Meeting Max was always an exciting and stimulating experience. He bubbled with enthusiasm, even in his eighties. He was always excited about some new discovery or person or book. He welcomed visitors and new causes with delight, convinced they would have much to offer.
He was perhaps at his best in a one-day visit to an institution or hospital. He would charm most of those he met with his evident interest in them as individuals. He would ask them frank and disconcerting personal questions and listen with fascination to the replies that he surprised out of them and would charm them with extravagant compliments. He would listen intently to what was said and then start asking questions often putting a finger on (or into) the current local focus of anger and irritation. He would question what he saw going on and especially challenge the pompous about the way they did things. After a visit from Max a hospital would be reverberating for weeks with new ideas and challenges.
Of course there was the other side. He would rage against those who did not see his version of the truth. His joy in elevating the humble was matched by a savage delight in humiliating the pompous, the rigid, the traditional. Sometimes he harried senior office holders, especially older women, quite mercilessly. Often one left his unit infuriated as well as challenged but always stimulated.
In talking of his impact on British psychiatry it is important to mention the effect that his puckish charm had on powerful men, especially those senior to him. It may be that they saw in him what they once might have been themselves. Certainly attempts to destroy his work were thwarted time and again by powerful protectors who would intervene, even if apologetically, to protect Max and his work Professor Sir David Henderson at Edinburgh, the Hon. Dr. Walter Mackay at the Board of Control, Professor Sir Aubrey Lewis at the Maudsley and Professor Morris Carstairs in Edinburgh. Max’s puckish charm was often deployed with immense effect on the Great and the Good. This perhaps explains his surprising CBE in 1954.
In the Borders he was a guest, almost a court jester, in Ducal Mansions. To hear him in a 14th century banqueting hall questioning an Earl’s mistress about the anomalies of her position was an extraordinary experience. He was highly successful in this way in post-war London governmental life and in the Border society of the 1960s, though it did not work so well in Oregon in 1960-63, where his constant baiting of the all-powerful Governor’s wife was said to be the main reason for his dismissal.
What was Max to me, personally? He was simply the most important colleague I ever had; he had more influence on what I did and what we did at Fulbourn than anyone else. He was the richest influence in my professional work. More important, I cherished and loved him as a friend, especially in the later years when we had both retired and were exploring new fields to deploy our energies.
It is a measure of his openness and eternal friendliness that I never thought of him as a “senior colleague”. Even though he was thirteen years older than me, we always seemed to be comrades exploring new things together. This was partly because we shared youthful experiences - Edinburgh between the Wars, the harsh environment of Scots day schools for boys, Edinburgh medical training, learning psychiatry from David Henderson and Aubrey Lewis - but also because our professional activities were similar - he was Medical Director of Belmont when I was trying to learn how to be Medical Superintendent at Fulbourn, we wrote our books about the same time, we both experienced the California dream at its best time (the early 60s), and we both saw many good experiments go down in the sad years of Reagan and Thatcher.
He was always a stimulus and a challenge. I compared my prosaic plodding self with his mercurial temperament and his boldness in confronting people and situations. I realised that I could never challenge people as boldly, rashly and even cruelly as he sometimes did. How to take the good lessons from Max and avoid the regrettable ones? I envied him his charm, which enabled him to get away with so much; his openness to new ideas, wherever they came from; and of course I treasured his concern and affection for me in my struggles.
He died well, enjoying his last position as a sage in Nova Scotia, secure in what he had done but still seeking new ideas, new sensations, new insights. A wonderful achievement; a well rounded life.
This is a Planned Environment Therapy Trust Archive and Study Centre On-line Publication.
© David Clark 2005
Dr. David H. Clark
This is a Planned Environment Therapy Trust Archive and Study Centre On-line Publication.
© David Clark 2005