A Radical Psychiatrist in His Time

Before the Second World War, when psychiatry was held in low esteem, much of the work was done in asylums which were reluctantly moving away from a custodial role. Only a limited array of treatments were available and, in the absence of anything else, charismatic individuals could assert themselves to an extent not possible elsewhere in medicine.

Psychiatrists’ lives do not lend themselves to biography. Freud (who was not a psychiatrist), yes; Kraepelin’s mind-numbingly dull personal life, no; after that the list falls away almost vertically. The Australian scene is even bleaker. John Cade, the first to use lithium, was a modest man whose life outside his work would barely take up a few paragraphs. More recent efforts are shudderingly parochial or self-obsessed.

All this time the life of Australia’s most eminent psychiatrist between the wars has been awaiting exhumation. He pioneered treatments that were to change the profession forever, while waging a ceaseless campaign to overturn conservative shibboleths and dehumanising patient practices. He paid a high price for his beliefs, yet never recanted.

Reginald Spencer Ellery (1897–1955) pioneered malariotherapy and psychoanalysis, mixed with the leading intellectuals of his day, including Max Harris, John Reed, Albert Tucker and Sidney Nolan, and supported the Communist Party and eugenics. Described as a “flamboyant, outspoken and unquestionably erudite” figure, Ellery wrote on a range of progressive topics in what was described as bohemian prose. His autobiography, The Cow Jumped over the Moon, written in typically quirky, if not idio­syncratic style shortly before he died, confirms the impression of a restless and creative mind reluctant to be constrained by convention.

After qualifying as a doctor with an undistinguished pass in March 1923, Ellery heard of a vacancy for a medical officer at the Kew Asylum in Melbourne. There was a salary and quarters were provided, but the patients were lunatics, scarcely a promising group to work with. Although he could have kept his head down and done as little work as necessary, he was taken by the plight of the wretched patients in the wards of what was known as Kew Idiot Cottages. Ellery tried to improve their lot by extracting rotting teeth, catheterising sluggish bladders, throwing out termite-ridden furniture, and improving nutrition.

Disaster followed. He ran head-on into the Attendants’ Union, who were determined to prevent anyone from disturbing their comfortable satrapy. Complaints flowed, the Lunacy Department was informed and there were leaks to politicians. Smith’s Weekly ran a campaign against him, and the newly-elected Prendergast Labor government responded by appointing a royal commission, conducted from November 5 to 19, 1925, to inquire whether Ellery was guilty of “maladministration, cruelty to the children, and conduct unbecoming to a medical officer”. This gave Ellery, if nothing else, the dubious distinction of being the first Australian psychiatrist to have a royal commission inquiring into his activities—not Dr Harry Bailey, as is widely believed.

Ellery, represented by a promising young advocate, R.G. Menzies, was exonerated by the inquiry but, for his pains, transferred to Sunbury State Mental Hospital in the country, presumably to ensure that he did not make more waves. This proved to be a futile hope, but Ellery now devoted himself to his career with impressive results.

On May 26, 1925, he started a trial of malario­therapy on six syphilitic patients who were facing a terrible death from what was known as “generalised paralysis of the insane”. The results were spectacular; three of the six patients recovered. Malariotherapy was the first successful treatment in psychiatry, paving the way for a new mood of optimism that forever changed the relationship between doctor and patient. Ellery has the distinction of being the first in Australia to try this treatment.

Tiring of the bureaucracy of the Lunacy Department, Ellery resigned in 1931. He set up a Collins Street practice as a psychiatrist and defied the department’s monopoly on mental health care by opening in the suburb of Malvern in 1933 the first Victorian private “psychopathic hospital”. He soon became Melbourne’s most prominent psychiatrist, treating the rich as well as those who could least afford help. Married to the musician Mancell Kirby, he was a prominent feature on the Melbourne social scene. They often entertained leading musicians at High Wycombe, their nineteen-room mansion in Hawthorn. He was a regular contributor to scientific meetings and journals, establishing a reputation as a leader in this developing field.

If a year is to be chosen as the apogee of Ellery’s career, 1937 is as good as any. He went to Europe to visit clinics where the new treatments of insulin coma and convulsive therapy were practised, and saw for himself the looming Nazi threat. He met Anna Freud, and was thrilled when he looked up from the street at 19 Bergasse and saw the ailing Freud in the window. Then followed a trip to the Soviet Union that convinced him that he had glimpsed the future.

In his career, Ellery continued to be at the cutting edge. The time of the new treatments had arrived, and everyone was keen to try insulin coma therapy, cardiazol fits, sleep therapy and electroconvulsive therapy. Ellery was in the forefront, introducing the new treatments in his practice. He set up another clinic for this purpose; among his patients was the writer Aileen Palmer.

Ellery, with Roy Winn and Paul Dane, was a pioneer in bringing psychoanalysis to Australia. Their work resulted in the establishment of a psychoanalytic institute in Melbourne and the arrival of Clara Geroe, the first training analyst in Australia, in 1940.

He probably achieved his most active role outside psychiatry through his involvement with Melbourne intellectual, painting and writing circles. He was close to John and Sunday Reed, becoming in-house psychiatrist to the Heide Set—who needed it more than most, although it is doubtful if he could have prevented the regular squabbles, schisms and breakdowns that characterised the group. He showed Sidney Nolan drawings by psychotic patients which influenced his work, in particular a series of heads exhibited in 1943. He treated Cynthia Reed, the sister of John, who was later to marry Nolan; in gratitude, she added his name to her daughter Jinx and made several references to him in her books. He may also have treated Albert Tucker, at any rate providing him with a medical certificate in an unsuccessful attempt to keep him from being conscripted.

As an associate of Max Harris, who said that all the painters in Angry Penguins had a free copy of his book on schizophrenia, which insisted on the validity of psychotic art in “abnormally literary flavour”, he was a regular contributor to Angry Penguins and an expert witness at the obscenity trial that followed publication of the Ern Malley poems.

Even in far-off Australia it had been impossible to ignore that war was coming. As a communist, Ellery could rationalise the situation as another war between capitalist nations, but this must have taken a severe battering with the 1939 Nazi-Soviet Pact. After Hitler’s invasion of the Soviet Union in 1941, he could put his energy into agitating for the Soviet cause now that they were official allies. This however did not lessen suspicions of communism or its supporters and fellow travellers. As usual Ellery was prepared to take the high position and lash out, following a path that would inevitably antagonise the establishment. The heroes of the conflict, he said, were the Soviet people, the only ones to take on the might of the Nazi war machine, paying for it in blood but saving the world in the process.

He poured his energy into writing, producing his first book, Schizophrenia, the Cinderella of Psychiatry, in 1940. A practical guide to the condition, it stressed the individuality of the sufferers and the role of social and psychological factors in causing it. It was his most successful work, going on to a reprinting.

Consequently, he was not re-appointed to his position as Visiting Medical Officer at the Alfred Hospital in 1940, something that bitterly upset him. He was also rebuffed when he offered his services as a psychiatrist to the armed forces, so he had no choice but to continue in the Australia Soviet Friendship Programme and the Russian Red Cross.

Ellery, ever defiant, wrote about health in Soviet Union and then a pamphlet on the Soviet system—Eyes Left. On the cover is a picture of Ellery. Smartly dressed in a suit, his arms folded across his chest, hair slicked down, a cigarette protruding from his fingers, he looks both laconic and stern.

In 1945, Ellery published Psychiatric Aspects of Modern Warfare, with one of Nolan’s heads on the cover. It tried to assimilate the experience of total war using insights derived from both psychoanalysis and socialism, with mixed success. War, Ellery maintained, arose in psychoanalytic terms and the German people suffered from a collective psychosis. Consequently, in the future, they would need to be assessed by psychiatrists before they could be readmitted to the stable of nations. That this view involved not only a grandiose view of the capacity of psychiatry to solve every problem in the world, but also indicated a gratuitously incorrect understanding of society and history, did not seem to have occurred to him. Reviewing the manuscript, John Reed commented that he would get into “hot water again” with the trenchant criticisms of war, capitalism and socialism. Nevertheless, the book received some good reviews, here and overseas.

By the end of the war, Ellery’s attitude to communism seems to have become more nuanced, and his writing shifted to a broader canvas, namely the impact of social and psychological conditions on individual psychology. Ellery developed the first symptoms of rheumatoid arthritis, an illness that progressed steadily over the next eighteen years, steadily restricting his activities. He found it easier to spend his time in his study at home, surrounded by his book collection and listening to Mancell’s music. Then came the final blow: an inoperable cancer of the nasal antrum. The only consolation must have been that he had a closely related condition to that of Sigmund Freud. Ellery did his best to cope with the condition in a stoic fashion, but it was a miserable existence. He died on December 27, 1955, at Prahran.

The Cow Jumped over the Moon, published after his death, covers Ellery’s career, giving an insight into the psychiatric world he entered in 1923. It is also a testimony to his disillusionment with the causes that he had so eagerly embraced over the years: Freud and psychoanalysis, Stalin and communism. Although reluctant to entirely dispense with communism, especially as an alternative to the capitalist-driven approach to mental health in the West, he seemed to embrace a broader and largely ideological humanitarianism. Psychiatry, if not all human activities, Ellery stated, needed to consider the person as a whole, certainly consistent with the psychoanalytic view, but after that he could not espouse the narrow focus on oedipal complexes.

An obituarist said:

It combines the vision of the poet, the understanding and analysis of the psychiatrist and the polished language of the litterateur. Full of imagery and beauty of expression, it gives Ellery life and spirit as no biography … can hope to do.

Reg Ellery is arguably the most eminent psychiatrist in Australia between the wars, a crucial period when the nascent discipline moved from alienists caring for lunatics in asylums to psychiatrists working in public hospitals and private practice, confidently using a new range of biological and psychological treatments, agitating for professional recognition and respectability. Starting with malariotherapy, Ellery was in the forefront of developments, embracing psychoanalysis when it was regarded by many both in and out of the profession as either charlatanry or immoral, and taking a prominent role in agitating for a psychiatric college.

Considering his entry into psychiatry as an undistinguished medical graduate who was soon subjected to a royal commission, his ascent against more established colleagues did not just mark him as a significant player in the field, but also indicated extraordinary drive, ability and initiative. Had he not died prematurely, he would have been among the first to embrace the new drugs of the psycho­pharmacological revolution that were so to change psychiatric practice.

It would be all too easy to dismiss Ellery, while praising his professional and creative achievements, if not humanitarian goals, as just another misguided middle-class “useful idiot” who aspired to a universal ideology and strained to find a creative outlet for impulses that were scarcely contained within the tedium of clinical practice. But this misses the point. Ellery’s achievements were no accident. Despite his professed casual attitude, recurrent attempts to self-destruct his career and distancing himself from the mainstream, he was highly innovative, adept at picking up the latest developments and more than just a pillar of the profession. He was no ivory-tower academic either, and from his early years at university he regularly participated in the organised activities of his profession. All of this implies enormous energy, bearing in mind he ran a successful and demanding practice and had to maintain a high income.

But, to the end of his life, Ellery refused to define himself solely by his work as a psychiatrist; rather, he saw himself as a writer, poet, journalist, polemicist, activist. To this can probably be added artist and social engineer, although he doubtless would have demurred at both terms. He had his faults and was woefully incorrect on some issues, but he was remarkably prescient in the issues that he promoted, many of which we now take for granted: a humane approach to patients, a focus on the creative and individual aspect of mental disorder, an innovative and flexible approach to treatment and, above all, a determination to fight for patient rights in the face of indifference, either bureaucratic or professional. As such he truly was a prophet of psychiatry.

Ellery was the central figure in Michael Thornhill’s movie Between Wars (1974). More recently, he featured in the exhibition Inner Worlds: Portraits & Psychology at the National Portrait Gallery, Canberra.