The Asylum (by Karen Coles)

(Amazon UK link)

As with so many of the books chosen for our local book group, I had not heard of the author, Karen Coles. Nor would I probably have picked this book up if I had seen it on a bookstall. The cover is attractive but it’s billed as a psychological thriller, set in the UK in 1906, and features an asylum. Not my kind of book at all. 

So it was with some reluctance that I picked it up a couple of days ago. I calculated that I would need to read 90 pages on each of the subsequent four days to finish in time for the group. On that first day I read over 100 pages. Today I read another 120 pages in the morning, then dipped into it again in the afternoon… and suddenly two hours had gone by and I was engrossed. I finished it in just two days. 

The main protagonist is called Maud, and the novel is told from her point of view. She’s locked in a cell in a ‘lunatic asylum’, as psychiatric hospitals were called at the start of the 20th century. She hears people wandering around, and is disturbed by various noises. There’s evidently something very traumatic in her past as she can remember almost nothing. She knows she has been in the asylum for five years, but has forgotten what led up to it, and has no idea whether she might have been perfectly sane beforehand.

Maud is kept in an almost comatose state by drugs, and is told that she has behaved violently. So she’s never let out. Her meals are brought by warders, whom she dislikes. Her life must be incredibly boring, but then she sleeps a lot. She’s haunted by nightmares and sometimes wakes screaming… only to be drugged back into oblivion. 

A new doctor, Dr Dimmond, comes to work at the asylum. He is a caring person who has some modern ideas about psychiatry, including the use of hypnosis to bring suppressed memories to the fore. The main doctor, Dr Womack, whom Maud dislikes, is against this. But Dimmond - or Diamond, as Maud calls him - has been commissioned to try hypnosis for a research project. And Maud, he believes, is an excellent candidate. 

Maud doesn’t trust Diamond at first, and refuses to tell him anything. But she gradually lowers her defences when he repeatedly shows her kindness. He convinces her that if only she can recall the traumas of her past, she might find healing, and possibly even freedom. 

So, after some initial resistance, the hypnosis starts to bring back some of Maud’s memories. They’re written in Italic form, either spoken by her when hypnotised, or in dreams, or in her mind as she starts to draw images that she can recall. There’s a man chasing her, she knows, as she feels herself slipping into the marshes, and she’s terrified of him. But there are other people too - a woman playing the piano, a man with a knife… so many mixed impressions going through her mind. She doesn’t know what’s real and what is her imagination, and, at first, neither do we. 

Gradually the past is opened up to Maud, and her story emerges. She clearly feels extensive guilt at incidents that were - probably - not her fault. Each time something new comes to light, Diamond hopes she will find peace. But each time she knows there’s something more…

It’s clear that the unpleasant Dr Womack doesn’t want her to remember anything. His methods are brutal, even for the era, and since he is the boss, he can order emetics, heavy doses of drugs, a straitjacket, confinement in the dark, and more.  He exerts his authority over Dr Diamond, wanting to have Maud restrained, back in her room, unable to do anything. 

There are a lot of traumatic descriptions, both in Maud’s memories and in the ‘treatment’ she is given by the Dr Womack. I had to skim over some of them, but that didn’t detract from the story at all. The treatment given to her is horrifying from the perspective of the 21st century. Yet, although Dr Womack is clearly a vengeful, evil character, some of his methods were in use in the eras before mental illness was understood. The author did her research well. And evidently some of the patients in the asylum did have severe mental health issues.  

The rampant sexism is horrendous, too. Dr Womack states that women could not be scientists as their brains were not made for studying. It was apparently a commonly held opinion. The book demonstrates how men are doctors, the women just assistants. The doctors have absolute authority over everyone else. And the asylum patients are all female, as far as I remember.

It’s gripping stuff.  The writing is excellent, the plotting meticulous. There aren’t any real surprises for the reader through most of the book. We know early on, from hints, many of the things that are going to be revealed, and which people are implicated in Maud’s past. Some might object to the revelations and twists being hinted at in advance, but for me that added to the ‘gothic’ nature of this book. I was on tenterhooks, not wondering what was coming, but how it would happen, and how it would all be resolved - if, indeed, anything would be resolved. 

Then the ending, when Maud is unexpectedly released from the asylum, was a surprise to me. I had not expected that she would behave as she does... and it brought several issues into question. Was she really cured...? Perhaps we'll never know. 

It’s not a book I’m likely to read again, but I thought it was very thought-provoking and quite eye-opening too. Definitely recommended if you like this genre. 

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