This excerpt from Chapter Two, “The Psychiatrists’ Pick,” explores the mental health profession’s treatment of “gender-different” people in Washington state during the 1930s and 1940s — following the famed actress Frances Farmer toward her possible encounter with one of America’s most notorious lobotomists, Dr. Walter Freeman

A few blocks from the corner at Washington and Second, east up a steep hill, sits Harborview Medical Center, a brown fortress-like complex that is King County’s hospital for those considered mentally ill. It seems to loom over the mud flat and, in the imagination of the city’s homosexuals, it did from the 1930s through the 1960s. Frances Farmer arrived there on March 21, 1944, but not willingly. Earlier in the morning, she had been grabbed by three hospital attendants, straitjacketed and thrown screaming into a van.

Born 30 years earlier while her parents were living on Seattle’s Capitol Hill, Farmer had grown up a tomboy in West Seattle, across the Duwamish River from the mud flat, and as a child she had enjoyed playing kick-the-can into the late evening hours. She liked hiking in the Olympic Mountains and once, in 1941 after she had moved to Hollywood, she even drove by herself from California to hike alone near Sol Duc Hot Springs, out of sight of the movie cameras and the news cameras that by then had become her life. Many of those who met her, both as a teen and as an adult, would almost invariably comment about how little she seemed to care for the traditionally feminine clothing people expected her to wear, especially since she could appear so beautifully feminine in the publicity photos that had accompanied her rise to Hollywood stardom. Given the chance, she ignored her dresses and opted for blue jeans and work shirts. One famous wire service photograph of her, taken at a time when she was running from her mother and from the psychiatrists, shows her looking especially hardened and masculine, clad in overalls and an army shirt and grasping a cigarette in her left hand. The news story about her that time quoted her as saying, “I want to be strong enough to fight for myself.”

Throughout her years at West Seattle High School, she had showed little interest in boys. No one seems to remember her dating when she attended the University of Washington, either. An autobiography ghostwritten by her closest friend, a woman, years later said, “I accepted dates only when I needed someone to take me to a special event. They soon learned not to paw, and any adolescent attempt at lovemaking resulted in a tongue-lashing that sent them scampering.” A movie magazine reported that she had once written a letter in 1935 about her experience with men in Hollywood in which she said, “I prefer my own company to that of most of the men in this town. If they want to pass me by, that’s all right with me.” She added, “If I couldn’t stand my own company, I’d be the unhappiest girl in the world, because I’m alone, morning, noon, and night.”

Farmer waited for two days at Harborview. Under Washington law, family members were allowed to file complaints that could lead to involuntary commitments for mental observation. Psychiatrists could then determine whether those detained needed treatment for any of a wide range of symptoms, with the treatments ranging from simple counseling to drug therapies to those designed to physically shock the body, either through electricity or plunges into cold water. The treatments could be done at Harborview or, if it seemed that a longer period of therapy was required, at a state mental asylum about 30 miles south of Seattle. There, the treatments could be even more extreme.

In Farmer’s case, her mother Lillian had filed the complaint. She claimed the actress had refused to work anymore in Hollywood, that she was depressed, and that she was becoming violent. On March 23, Farmer was taken to her hearing before two psychiatrists, Drs. Don Nicholson and George Price. According to a Seattle Times story, Lillian Farmer told the two that her daughter had “turned the radio up loudly, which I knew would annoy the neighbors. I asked her to turn it down and she became quite angry, grabbed my wrists and pushed me into a chair.”

“I realize,” Lillian Farmer continued, “that she needs institutional care, as I am entirely unable to control her at home.”

Nicholson and Price asked Frances Farmer a series of questions. The Times story said that they reported that her speech was “voluble and at times rambling.” They also noted that while at home with her mother, Farmer had “started drinking [and had become] agitated and delusional.” The two psychiatrists thought the delusions indicated that she was “paranoid” and concluded that she was suffering from schizophrenia.

For the cause, they looked to her previous emotional and sexual life. While in Hollywood, Farmer had eloped with an actor named William Anderson–his better-known stage name was Leif Erikson–but the marriage, while pleasing to the Hollywood publicists, had lasted only about three years. In the autobiography, Will There Really Be  a Morning, Farmer would call the marriage a mistake. “I neither loved him, nor was in love with him,” the book said. “He was simply an attractive childlike man who seemed to want to understand me . . . . I considered him totally dull. In my mind he had become the youngest pup in a crowded litter, and I could find no place for him to fit. I was miserably unhappy and deeply discontented.”

Nicholson and Price concluded that “marital difficulty is said to be a pre-disposing cause of the insanity.” The next day, a King County Superior Court judge committed Frances Farmer to the state mental asylum.

If the first method of constructing Seattle’s sexual minorities as a group of outcasts was the use of law, the second was a mental health rhetoric founded on psychiatry. As members of a young medical profession that emerged during the 19th century, psychiatrists quickly set up classifications determining which behaviors and passions could be considered normal and which were abnormal. Although the classifications might have been well intentioned, sometimes they simply reinforced non-medical moral choices, so that those who veered from the expected norms for sex or for acting in an appropriately masculine or feminine way might find themselves declared sick. The American Psychiatric Association, in its Diagnostic and Statistical Manual, would eventually define homosexuality as a sociopathic personality disturbance, but the patients also included women who wore men’s clothing or vice versa, those who masturbated too much, or those who felt guilty or angry because they engaged in any behavior that somehow did not live up to the expectations of respectability.

Just as the legal rhetoric against homosexuality had its most extreme weapon–prosecution for sodomy–psychiatry also developed its most extreme cure, the lobotomy, used mostly during the 1940s and 1950s. As with sodomy, it was the imagination and the rhetoric about homosexuals being “sick” that created an exile even more so than the numbers of attempted cures. The gay argument against the psychiatric approach was summarized years later in a flier handed out at the 1970 convention of the American Medical Association in Chicago. Psychiatry’s premise, the flier contended, was “that people who are hurting should solve their problems by ‘adjusting’ to the situation” rather than by changing anti-gay attitudes.

The story of Frances Farmer’s involuntary commitment to Western State in 1944 has become something of an underground urban legend in Seattle, appealing in particular to those who feel the city itself has remained seriously schizophrenic in its utopians’ dream of creating a “city beautiful” to match the natural environment by controlling citizens who do not fit the vision. Every decade since her death in 1970, Farmer’s story seems to resurface. In the 1970s came Farmer’s autobiography, an investigative book titled Shadowland by Post-Intelligencer reporter William Arnold, and a rebuttal by Farmer’s sister, Edith Farmer Elliott, Look Back in Love. In the 1980s, the films and stage productions arrived–a Hollywood biography called “Frances” that starred Jessica Lange,

a television mini-series, a documentary, and two New York plays. In the 1990s, Seattle’s famous grunge rock group, Nirvana, enshrined the actress in a song titled “Frances Farmer Will Have Her Revenge on Seattle.” In it, the band’s lead singer Kurt Cobain referred to Farmer as “our favorite patient” who had shown a “display of patience” for “disease-covered Puget Sound.”  The actress, the band warned, would “come back as fire, to burn all the liars, and leave a blanket of ash on the ground.”

Like any good Hollywood movie, the telling of her story has lent itself to multiple layers of interpretation by vastly different audiences. For gays and lesbians in Seattle, the story seemed to become emblematic of their own struggle against the city’s mental health system, particularly as it intertwined with a story about a psychiatrist named Walter Freeman who became one of the leading proponents of lobotomies and made repeated visits to the state mental asylum while Farmer was incarcerated there. In 1979, for example, the lesbian newspaper in the city, Out and About, recounted Farmer’s story with pages of details, matching it with a story about another woman who had been involuntarily committed to Western State, as if to remind gay women in the city of the threat they had faced if they were found dressing inappropriately, speaking inappropriately, or entering into inappropriate relationships. …

In 1936, just after Farmer went to Hollywood, the psychiatric profession acquired a new tool, a form of psychosurgery called the prefrontal lobotomy, introduced in the United States by two East Coast doctors, James Watt and Walter Freeman. Watt was a neurosurgeon; Freeman was a psychiatrist who until then had been using the older methods of counseling, straitjackets, and drugs.

The problem with mental patients, Freeman often said, was that their fantasies became too charged by powerful, shifting emotions. The cure was to disconnect the two since a fantasy unfueled by emotion would be harmless. In his writings, Freeman called it “smashing the fantasy life.” At first, the separation was made by drilling burr holes through the scalp and using a blunt knife to slice apart the neural connections between the brain cells that controlled emotions and those that created the imagination. The successfully lobotomized patient ended up with flattened emotions and typically lacked either creativity or the passion to pursue goals. At least any schizophrenia, paranoia, melancholy or tension were relieved. For Freeman, success was measured by whether patients could leave the asylum and hold jobs–usually as something like sales clerks or receptionists–and whether they could get married and raise families. As for the failures who had to remain at the asylums, they were at least easier to control.

Initially, the operation was extreme enough to be used only as a possible cure for the most intransigent of mental patients, such as those who were prone to violence or who had been through every other form of treatment psychiatrists had to offer. Eventually, it began to be considered as a way to cure nonviolent mental patients, including those whose symptom stemmed from problems with sexual adjustment.

In the mid-1940s, Freeman initiated a new, easier technique called a transorbital lobotomy. He included a sketch of the operation with an article he published in the American Journal of Psychiatryin April 1949. In it, a hand grasps the bridge of a patient’s nose to hold the head steady. A slender ice pick with a looped handle extends from below the patient’s chin past the tip of the nose into the bony top of the eye socket and on into the brain, almost reaching the top of the skull. No drilling was necessary.

Freeman described the procedure to a Seattle Post-Intelligencer reporter in 1949: “I lift the upper eyelid and insert a sharp instrument. The instrument is driven through the roof of the eye socket to a depth of about two inches. Then, I move the instrument so as to cut across the nerve connections between the centers for imagination in the front part of the brain and the centers for emotions in the center of the brain, thereby divorcing the imagination from the emotions as they concern self. The operation does not disturb emotion and imagination as regards other things.”

The only visual result was a temporary black eye. To hide that Freeman provided dark sunglasses. The ease of the technique made it possible, he argued, for the ordinary psychiatrist to administer lobotomies without the attending services of a neurosurgeon. His own neurosurgeon colleague, Watts, parted with him at that point, feeling that any poking in the brain required surgical training, but Freeman was not to be stopped. During the 1940s and 1950s, he became an evangelist for transorbital lobotomies, enthusiastically proclaiming in his book that “psychosurgery has come of age.” Like a schoolboy winning a science fair, he exuded, “If the trouble’s in the head, why work on the belly?” At least 20,000 transorbital lobotomies would be performed in the late 1940s and early 1950s.

Freeman found his converts particularly among the harried administrators of overcrowded insane asylums. In 1947, he arrived at one of the most pressured of those institutions–Western State Hospital at Steilacoom. By that time, the institution had created a feared reputation for itself with the Tacoma Times, for example, blasting its often overcrowded conditions as a “naked idol of barbarity” even as early as the 1920s….

Copyright (c) 2003 University of Washington Press