Recounting the complete psychiatric history of Anne Sexton would require verbiage far beyond that of a blog post, or series for that matter.  And it would be exceedingly tedious.  Dr. Diane Middlebrook’s Anne Sexton:  A Biography does a decent job giving the play-by-play of suicide attempts, the near-suicide attempts, the hospitalizations, the medications, and the psychiatrists she came to know both inside of therapy and out. 

Perhaps it would be more helpful here to recount some of the psychological themes that developed both inside and outside these therapy session.   These shine light specifically on Sexton’s relationship with Dr. Martin Orne, which extended far beyond his role as her official shrink.


Theme One--Suggestibility

One of the things that Dr. Orne first mentions about Sexton was the diagnoses previous doctors had given her.  Basically, they were all the same:  one flavor of schizophrenia or another.  Orne too initially saw her as typically schizophrenic until he discovered something that changed his entire attitude about Sexton.  He wrote in the Foreword of Anne Sexton:

As I began to get to know Anne, I realized that she was showing ideation that one might expect in a patient with a thought disorder.  Fortunately, she happened to mention that she was spending a good deal of time with two patients who suffered from a schizophrenic disorder, and thus I became aware of her tendency to take on symptoms that were like those of the people with whom she was currently interacting.

After several weeks of working with Sexton, Dr. Orne dismissed schizophrenia diagnosis.  Instead, he regarded her as highly suggestible, and immediately secured her release from the hospital lest she fall under the influence of truly psychotic patients.  As often as he could, he treated her on an outpatient basis.       

During her life it would be difficult to say how this hyper-suggestibility manifest itself, especially in a figure so iconoclastic as Anne Sexton, a woman seemingly almost infatuated with her own individualism.  However, there were times she complained about a suffering a certain kind of loneliness, even in her work:

I have gone out, a possessed witch,
haunting the black air, braver at night;
dreaming evil, I have done my hitch
over the plain houses, light by light:
lonely thing, twelve-fingered, out of mind.
A woman like that is not a woman, quite.
I have been her kind. [From “Her Kind”]

Hyper-suggestibility would imply that Sexton had almost a desperate longing to fit in, much like the eponymous character in the movie Zelig.  In her sessions, she depicts herself as someone trying to live according to the mandatory stereotype of the 1950s normal, suburban, middle-class housewife.  But try as she might, she can’t keep up the charade very long before completely ‘losing it.“  Of course, losing it meant another trip to the hospital.  She sometimes talked about not being a “real” woman--from her inability to care for her kids to questions about her own sexual orientation, to wondering if her literary ambitions were, for a lack of a better term, ladylike.

In this we can imagine that Sexton had a desire to blend in.  I find it curious that the only place where Dr. Orne can confirm her fitting in is with schizophrenics.  On the other hand, this might also help explain her development as a poet.  She hooked up with some pretty heady and erudite people, among them Maxine Kumin, who had two Masters by the time she met Anne.  Maybe fitting in with that crowd helped to refine a raw talent. 

Then again, that’s sort of the purpose of workshops whether the attendee is highly suggestible or downright obstinate.


Theme Two: Doppelgängers

Inside many of us
is a small old man
who wants to get out.
No bigger than a two-year-old
whom you'd call lamb chop
yet this one is old and malformed.
His head is okay
but the rest of him wasn't Sanforized?
He is a monster of despair.
He is all decay.
He speaks up as tiny as an earphone
with Truman's asexual voice:
I am your dwarf.
I am the enemy within.
I am the boss of your dreams.
No. I am not the law in your mind,
the grandfather of watchfulness.
I am the law of your members,
the kindred of blackness and impulse.
See. Your hand shakes.
It is not palsy or booze.
It is your Doppelganger
trying to get out.
Beware . . . Beware . . .
--Anne Sexton, from “Rumpelstiltskin”

In therapy and out, Sexton seemed to profess a belief that every individual consisted of at least two different people.  There’s the person themselves, of course.  Then there’s an other self, an archetypal soul that might center on one body, but encompass one or several.  In the poem “Rumpelstiltskin,” for example, she references shaking hands as a symptom of a hidden self emerging. 

Sexton’s hands did in fact shake at one time.  Of course, her tremors probably had more to do with a side effect of an antipsychotic medication prescribed to her, specifically chlorpromazine.*  Nevertheless, the fact that she would see the trembling in this particular way, as if someone else were trying to get out, becomes especially interesting for two reasons.  First of all, since Dr. Orne dismissed schizophrenia as a potential diagnosis, then an antipsychotic seems a weird drug to administer.  True, the drug's also used in the treatment of migraines, opiate withdrawal, severe itching, and cholera.  It’s also been used as a sleep aid for insomnia, and that would seem to be why she received it.**  Still, there were other sleep remedies available at this time, some of them over-the counter.  Given that one of the side effects of the drug is potential memory loss, one would have to wonder why she received this drug in the first place, and whether or not her brief usage of it resulted in any long-term ill effects.

A second reason to look at that passage is that because of Dr. Orne’s 1991 disclosure of Sexton’s sessions we know that during the summer and fall of 1957, Anne manifest a second personality.  Calling herself Elizabeth Harvey (the name of Sexton’s paternal grandmother), the second personality began typing unsigned letters to Orne, explaining that Anne was unaware of her existence.  Moreover, she typed them in the dark so that if Anne did get suspicious or remembered something she still couldn’t read what was in the letters.*** The Elizabeth personality eventually receded after Dr. Orne made the decision not to acknowledge her existence anymore. 

Sexton (as Elizabeth) made an early and conscious connection between the split of her personality and the Capgras Syndrome delusions of her beloved aunt Nana.  In one typed-in-the-dark missive, she wrote:

[Anne] thought of me as a brother that died--she used to think about him all the time there wasn’t really any brother--but she liked to pretend about him--I’m not so different from her but I would tell you what she doesn’t dare think--She acts her life away….I am part of her sometimes but she is not part of me…Nana knew I was not Anne….If you give her enough time to get dissociated enough she will be willing….I know a lot.

What Sexton (as Elizabeth) is referring to here is a pretend sibling that she fantasized about at the age of five.  Unlike the other grownups, Nana indulged the fantasy.  Because of the alcoholism and aloofness of her mom and dad, Sexton found in her aunt a parental confidante, an irreplaceable figure that at times during her life she had to replace.  Consequently, just as Sexton had this eternal soul of Elizabeth inside her, she could just as easily see the spirit of Nana in others.  Thus, a lot of people began to play the role of auntie in her life, among them Kayo Dr. Orne, her father-in-law George Sexton, her mother-in-law Billie Sexton (who began to refer to herself as “Nana”), Dr. Forked Tongue, and Dr. Anne Wilder, a psychiatrist friend whom she didn’t see professionally.

_________________________
*Chlorpromazine sold under the brand name Largactil in most places, and as Thorazine in the United States.

**Dr. Diane Middlebrook mentions that Dr. Martha Brunner-Orne would occasionally pinch-hit for her son when the latter wasn’t available.  During the early 1960s, the two seem to have had some disagreement over sleep medications, so I’m not certain if he prescribed it or she did.  Whatever the case, Sexton found it difficult to write under the effects of Thorazine, and eventually discontinued its use.

***While he took the emergence of a second personality seriously, Dr. Orne never knew for sure whether or not she was joking about the typed letters in the dark.