Tag: Hollymoor Hospital

Who was Thomas Forrest Main?

Published on by Andrew MarshallLeave a comment

Introduction

Thomas Forrest Main (1911-1990) was a psychiatrist and psychoanalyst who coined the term ‘therapeutic community’. He is particularly remembered for his often cited paper, The Ailment (1957).

Refer to British Journal of Medical Psychology for The Ailment.

Life

Thomas Main was born on 25 February 1911 in Johannesburg, where his father was a mine manager who had emigrated there from England. At the start of World War I his mother returned to England with Thomas and his two sisters Isabella and Mary, while his father joined the South African Army. Main was educated at the Royal Grammar School, Newcastle-upon-Tyne before studying medicine at Durham University, graduating in 1933 and becoming a doctor in 1938. Specialising in psychiatry, he gained a Diploma in Psychological Medicine from Dublin in 1936. In 1937 he married Agnes Mary (Molly) McHaffie who also graduated in medicine at Durham University and who also became a psychoanalyst. They had three daughters and a son, Jennifer (Johns), Deborah (Hutchinson), Ursula (Kretzschmar) and Andrew.

Main worked as superintendent at Gateshead Mental Hospital. During the Second World War he joined the Royal Army Medical Corps as an adviser in psychiatry, attaining the rank of lieutenant colonel and working at the Northfield Army Hospital (aka Hollymoor Hospital) for the treatment of war neuroses. The work conducted at Northfield is considered by many psychiatrists to have been the first example of an intentional therapeutic community. The principles developed at Northfield were also developed and adapted at Civil Resettlement Units established at the end of the war to help returning prisoners of war to adapt back to civilian society and for civilians to adapt to having these men back amongst them.

The term “therapeutic community” was coined by Main in his 1946 paper, “The hospital as a therapeutic institution”, and subsequently developed by others including Maxwell Jones, R.D. Laing at the Philadelphia Association, David Cooper, and by Joshua Bierer.

After the war Main joined the Cassel Hospital, as medical director in 1946 and continued working there for the next thirty years.

Training as a psychoanalyst under Michael Balint, he was supervised by Anna Freud, Melanie Klein and Paula Heimann. In 1974 he co-founded with Michael Balint the charitable Institute of Psychosexual Medicine in London. He served as its Life President. He also served as vice-president of the Royal College of Psychiatrists, and was a co-editor of the British Journal of Medical Psychology. He died in Barnes, London on 29 May 1990, aged 79.

His papers are held in the Archive of the British Psychoanalytic Society, whose member he was for many years.

Works

  • The hospital as a therapeutic institution.
  • The Ailment and other Psycho-Analytical Essays, ed. Jennifer Johns, London: Free Association Books, 1989. ISBN 1-85343-105-2. The noted essay, The Ailment, is a report of Main’s detailed study of the feelings aroused in a team of nurses caring for a group of psychiatric patients with low potential for recovery. He found that a sedative would be used in the management of a patient “only at the moment when the nurse had reached the limit of her human resources and was no longer able to stand the patient’s problems without anxiety, impatience, guilt, anger or despair”.
  • Mothers with children on a psychiatric unit.
  • A fragment on mothering.
  • Meanings of madness: psychiatry comes of age.

Reference

Main, T.F. (1957) The Ailment. British Journal of Medical Psychology. 30(3), pp.129-145. https://bpspsychub.onlinelibrary.wiley.com/doi/10.1111/j.2044-8341.1957.tb01193.x.

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A Brief Overview of Hollymoor Hospital

Published on by Andrew Marshall1 Comment

Introduction

Hollymoor Hospital was a psychiatric hospital located at Tessall Lane, Northfield in Birmingham, England, and is famous primarily for the work on group psychotherapy that took place there in the years of the Second World War. It closed in 1994.

Refer to Group Analysis.

History

Construction and Expansion

The hospital, which was designed by William Martin and Frederick Martin using a Compact Arrow layout, was built as an annexe to Rubery Lunatic Asylum by Birmingham Corporation and opened 06 May 1905. During the First World War, Hollymoor was commandeered and became known as the 2nd Birmingham War Hospital.

The Northfield Experiments

During the Second World War, the hospital was again converted to a military hospital in 1940. In April 1942 it became a military psychiatric hospital and became known as Northfield Military Hospital. In 1942, while Northfield was serving as a military hospital, psychoanalysts Wilfred Bion and John Rickman set up the first Northfield experiment. Bion and Rickman were in charge of the training and rehabilitation wing of Northfield, and ran the unit along the principles of group dynamics. Their aim was to improve morale by creating a “good group spirit” (esprit de corps). Though he sounded like a traditional army officer Bion’s means were very unconventional. He was in charge of around one hundred men. He told them that they had to do an hour’s exercise every day and that each had to join a group: “handicrafts, Army courses, carpentry, map-reading, sand-tabling etc…. or form a fresh group if he wanted to do so”. While this may have looked like traditional occupational therapy, the real therapy was the struggle to manage the interpersonal strain of organising things together, rather than simply weaving baskets. Those unable to join a group would have to go to the rest-room, where a nursing orderly would supervise a quiet regime of “reading, writing or games such as draughts… any men who felt unfit for any activity whatever could lie down”. The focus of every day was a meeting of all the men, referred to as a parade.

“.. a parade would be held every day at 12.10 p.m. for making announcements and conducting other business of the training wing. Unknown to the patients, it was intended that this meeting, strictly limited to 30 minutes, should provide an occasion for the men to step outside their framework and look upon its working with the detachment of spectators. In short it was intended to be the first step towards the elaboration of therapeutic seminars. For the first few days little happened; but it was evident that amongst patients a great deal of discussion and thinking was taking place”

The experiment had to close after six weeks as the military authorities did not approve of it and ordered the transfer of Bion and Rickman (who were members of the Royal Army Medical Corps). The second Northfield experiment, which was based on the ideas of Bion and Rickman and used group psychotherapy, was started the following year by Siegmund Foulkes, who was more successful at gaining the support of the military authorities. One of the military psychiatrists involved in the project was Lieutenant Colonel T.F. Main, who coined the term therapeutic community, and saw the potential of the experiments in the development of future therapeutic communities.

Northfield Military Hospital was the setting for Sheila Llewellyn’s novel Walking Wounded, published in 2018.

Decline and Closure

Poet Vernon Scannell was a patient at the hospital in 1947. By 1949 Hollymoor Hospital was recognisably distinct from Rubery Hill Hospital. It held 590 patients, falling slowly to 490 by 1984, and then dropping rapidly to 139 by 1994. After the introduction of Care in the Community in the early 1980s, the hospital went into a period of decline and closed in July 1994. It was subsequently largely demolished.

This page is based on the copyrighted Wikipedia article < https://en.wikipedia.org/wiki/Hollymoor_Hospital >; it is used under the Creative Commons Attribution-ShareAlike 3.0 Unported License (CC-BY-SA). You may redistribute it, verbatim or modified, providing that you comply with the terms of the CC-BY-SA.