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To Bedlam and Part Way Back: Anne Sexton, Her Therapy Tapes, and the Meaning of Privacy

2008; RELX Group (Netherlands); Linguagem: Inglês

1556-5068

Tamar R. Birckhead,

Poetry Analysis and Criticism

The poet Anne Sexton committed suicide in October, 1974, at age of forty-five. Three months earlier, she had celebrated 21st birthday of her elder daughter, Linda Gray Sexton, and on that occasion appointed her as Sexton's literary executor. Anne Sexton provided detailed instructions in her will about disposition of her papers. She made no mention, however, of four audio tapes of her psychotherapy sessions that were later found. She also did not mention over 300 therapy tapes that were still in possession of her principal psychiatrist, Dr. Martin Orne. After Anne Sexton's death, Linda Gray Sexton created an inventory of her mother's papers and transferred their ownership to an archive at University of Texas. She placed four tapes and notebooks in which poet wrote down her thoughts and reflections of therapy sessions in a restricted part of archive. When Linda Gray Sexton asked Diane Wood Middlebrook in 1980 to become her mother's biographer, she agreed to give Middlebrook full access to her mother's estate, including four tapes and therapy notebooks. She also authorized Middlebrook to consult with Dr. Orne. In 1986, after Dr. Orne told Linda Gray Sexton that he still possessed remaining therapy tapes, he made them available to Middlebrook. While Dr. Orne did not explicitly request Linda Gray Sexton's permission to disclose tapes to Middlebrook, he knew that Sexton had veto power over anything in biography that she found objectionable to family. He also had received legal advice to effect that in most jurisdictions a literary executor could get a court order requiring release of medical records. In addition, Dr. Orne knew that Middlebrook had already obtained most sensitive material involving Sexton's life and psychiatric treatment from therapy notebooks and other biographical sources. Before releasing tapes, Dr. Orne discussed at length with Middlebrook issues raised in manuscript of biography, and was convinced that nothing in terms of salient biographical information would be gleaned from tapes. As a biographer, Middlebrook felt that process of listening to tapes would provide her with insight into Sexton that she could not gain through any other medium. The psychiatric and literary communities' response to publication of Middlebrook's biography in July, 1991, was immediate, impassioned, and well-publicized. Some claimed that by releasing tapes to public, Dr. Orne breached the contract of confidentiality that always exists between psychotherapist and patient and that his action betrayed profession. Others, in contrast, felt that decision to disclose is patient's - or executor's - and that issue is one of taste and public opinion. Sexton's close friends and colleagues defended act of disclosure, while her extended family condemned it. The issues involved in release of tapes are highly charged and controversial. The questions raised require examining intersection of theories of law, medical ethics, and artistic expression. A full analysis implicates not only legal doctrine of substituted consent and ethical issue of doctor-patient confidentiality, but also relevance of Sexton's status as a confessional poet and as a woman. An awareness and understanding of each of these areas is neces-sary to inform a meaningful discussion of whole. The psychiatric establishment and media framed key issue in controversy as whether Sexton herself would have wanted therapy tapes to be made accessible to her biographer and, therefore, made public. Given that it is impossible to be certain what Sexton would have wanted under these specific circumstances, question instead might be whether to release tapes at all, in absence of clear evidence of her preference. It is most productive, however, to view debate as a challenge to conventional no-tions of privacy while offering a glimpse of new (but not untroubled) ones. Contemporary consternation over disclosure of therapy tapes mirrors early criticism of Sexton's poetry. While object of censure is different - a psychiatrist's decision rather than a poet's words - motivation is similar: desire to maintain status quo. Sexton's writing and therapy were interwoven and interdependent. In both contexts she explored topics integral and specific to her identity as a woman, from parenting and bisexuality to domestic violence and incest. In her writing, Sexton often suggested a theme or expressed an emotion that she had not yet explored or acknowledged consciously. In this way, her poetry illuminated her inner life just as process of psychotherapy enabled her to become a poet. In both forums, Sexton inverted distinction between public and private and challenged gender norms. This Essay addresses issues raised by release of Anne Sexton's therapy tapes. First, it considers interre-lationships among Sexton's poetry, her psychotherapy, and her identity as a woman. Second, this Essay places tapes within legal doctrine of surrogate decision-making. Related to this inquiry is a discussion of doctor-patient confiden-tiality and psychobiography of artists. Throughout, Essay explores difficult questions about nature of privacy and autonomy and impact of gender upon these concepts. In addition, a contextualized, fact-specific analysis is emphasized, one that draws upon - rather than minimizes - paradox, tensions, and ambiguities expressed by debate itself.