I came away characteristically over-stimulated, thoughts and questions bubbling away in my brain, (and, naturally, tumbling out my mouth), having encountered a range of fascinating people presenting and discussing a deliciously wide range of perspectives.
And I left with one big question mark. It hangs over the concept, meaning and practice of "diagnosis" in general, and of posthumous diagnosis (especially of individuals who died a couple of hundred years ago) in particular.
There was a clear consensus that, for several reasons, attempting posthumous diagnosis is an unequivocally bad idea.
- What's the point? They're dead so there's no chance of curing them
- It distracts from talking about the more important aspects of an individual's work (in this context, the individuals concerned were, predominantly, writers)
- It says more about the diagnoser and their context than it does about the person being diagnosed or whatever illnesses/conditions they may or may not have had
- In almost all cases, this can only be pointless speculation: the diagnosis can never be confirmed, rendering the practice, in Roy Porter's words (I believe), a parlour game.
Yet, the impulse to do it is, it seems, almost irresistible: if it wasn't, I think it's unlikely that
a. so many people would do it
b. so many people would be so dead against it
I am guilty of a. So, the following may read as pure self-justification, but I hope there's a bit more to it than that. To be fair to me, I am a lifelong and enthusiastic hypochondriac (in the present, not long-eighteenth century, sense), and it was, at least in part, my generally anxious fascination with matters medical that drew me to William Hayley in the first place.
Also, as someone working biographically, I'm finding the process of exploring possible diagnoses particularly useful in framing my thoughts on Hayley's first wife, Eliza.
The best description I've yet encountered of Eliza is by the poet Anna Seward. She wrote it shortly after Eliza's death in 1897:
Fire in her affections, frost in her sensations, she shrunk from the caresses of even the husband she adored. Hence, while she had a morbid degree of tenaciousness respecting his esteem and attention, she was incapable of personal jealousy; and would amuse herself with the idea of those circumstances, with which she could so perfectly well dispense, being engrossed by another. …William Hayley – despite his medical knowledge and his particular interest in mental health issues – found himself unable name or, over the long term, meliorate to her condition. He recorded that "The fluctuation of her spirits was rapid to an alarming degree", "Though she is not, and perhaps never may, fall into absolute insanity,
… With sportive fancy; with no inconsiderable portion of belles-lettres knowledge; with polite address, and an harmonious voice in speaking, and with the grace of correct and eloquent language; with rectitude of principles, unsuspecting frankness of heart, and extreme good humour; she was, strange to say ! not agreeable, at least not permanently agreeable. The unremitting attention her manner of conversing seemed to claim, her singular laugh, frequent and excessive, past all proportion to its cause, overwhelmed, wearied, and oppressed even those who were most attached to her; who felt her worth, and pitied her banishment from the man on whom she doated.
(from Letters of Anna Seward: Written Between the Years 1784 and 1807, vol 5 pp22-25)
the state of mind, to which she has long been subject, is to all who tenderly regard her, an evil much more distressing than madness itself; it is a state not easily described. At times suspicion and pride (the two frequent forerunners of absolute insanity,) appear its chief characteristics; at other times, depression and melancholy.and that, as "one of her most attentive medical friends" said
“Her whole frame is full of pins and needles; at every turn they run into her, and she imputes the blame to the first cause that occurs to her agitated fancy.”He also tells us that, "While he retained his health, and the native cheerfulness of his spirit, a lively imagination afforded him the best possible antidote for the marvellous mental infelicities of his pitiable Eliza. When he could no longer divert her volatile mind with lively sallies of fancy, she considered Eartham as a dungeon" (ibid p339). On one occasion "at a time when his health was cruelly shattered":
(Memoirs of the Life and Writings of William Hayley, Esq. Vol 1, p210, p342, p484)
She said to him, with an air of innocent naïveté that proved she spoke only from painful ennui, “You were once the most agreeable man in the world, but you really have lost all your talents,” to which he mildly replied, “I believe, my dear, you speak something near the truth, according to your own ideas of it; yet it seems rather hard to hear it from you.”I read Eliza's letters along with what Hayley and others say about her and I can't avoid speculating about her condition. Given that my medical qualifications don't even extend to an O level in biology, this is, at best, cheeky. But, for me, it's all part of trying to understand what made her tick, to get a feel for what she was like and why.
(Memoirs of Thomas Alphonso Hayley p120)
I think there are five possibilities, as follows
- Asperger's: on the basis that she "she shrunk from the caresses of even the husband she adored", and that her social and conversational behaviour didn't conform to norms/social mores.
- Attachment Disorder: on the basis of her early life experience. Her mother had gone mad following the deaths of several of her children, and Eliza was the result of an attempt to cure her by getting her pregnant. And on the basis of her innocently naïve bluntness about her husband's loss of talents, her avoidance of touch and the nature and mode of her conversation.
- She was a healthy, intelligent and educated woman who was massively stressed by a combination of the limitations society and culture imposed on women at that point in time AND her unusual personal circumstances.
- A possibility that I haven't thought of/am unaware of.
- A combination of some or all the above.
- Why I feel the need – particularly given my total lack of medical credentials – to try to work this out.
- The fact that I have focused on three potential diagnoses that, while not exactly "fashionable diseases", are, at present, floating around in public consciousness.
- What it means for a lay person to try and diagnose someone. How far is it about about labelling or pigeonholing and/or trying to help/support and/or understanding and/or making allowances for, knowing how to react to, making judgements about – or being morally judgemental of – the individual we are trying to pin a diagnosis on? What does it mean about how we see ourselves in relation to others?
- How different individuals react differently to the same diagnosis: how for me a diagnosis could feel like a relief, a liberation, the first step to managing or curing a condition, while for someone else, it could feel like stigmatising label, a failure , simply, confirm a belief that all is decaying.
- If one is researching and writing a biography and its subject's physical or psychological condition has a significant impact on their life and experiences, can one, should one avoid thinking about a diagnosis? Or, is it not the speculation, the exploration, that's problematic, but the drive – where it exists – to prove or argue one possible diagnosis over the others?
- And how has what it means to make a diagnosis – both during the lifetime of an individual, and posthumously – changed over the centuries?