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The history of mental illness is curiously coterminous with the history of psychology, a fact which proponents of such therapy claim is a testament to its importance. Without belaboring the matter, I will say that retroactive imputations of mental illness to famous figures in history is not so much outlandish as proof that this type of approach engenders silly speculation befitting computerized minds. There are some prominent movements afoot that revile psychiatry, and the more one knows of the subject the more one is inclined to heed such warnings. Ultimately, we will have to understand that a small segment of our population – much smaller than pharmaceutical companies and their agents would care to admit – is truly ill and in need of medication and perhaps occasional inspection. The rest of us can jolly well fix our own problems, which brings us to this delightfully gloomy novel.

Our narrator is Peter Cleave, a senior psychiatrist at an asylum redolent of Victorian Gothic and situated in the British countryside. The year is 1959, a watershed for English mental institutions by virtue, we are told, of the passing of the Mental Health Act. The intergalactic weapon known as Google informs me that this piece of legislation trumped the "1890 Lunacy Act" (surely a glorious feat) and more or less provided a legal framework to detain mental patients in appropriate institutions against their will. This stipulation will become important on more than on one occasion in Asylum, but let us briefly step through the brambles of the plot. A new deputy superintendent, Max Raphael, his voluptuous wife Stella, and their plump, generally ignored ten-year-old son, Charlie, have been getting accustomed to life in this dreary if lush pocket of existence. Cleave is skeptical about this arrangement from the very beginning:   

Stella .... was the daughter of a diplomat who had been disgraced in a scandal years before. Both her parents were dead now. She was barely out of her teens when she married Max. He was a reserved, rather melancholy man, a competent administrator but weak; and he lacked imagination. It was obvious to me the first time I met them that he wasn't the type to satisfy a woman like Stella. They were living in London when he applied for the position of deputy superintendent. He came down for an interview, impressed the board and, more important, impressed the superintendent, Jack Straffen. Against my advice Jack offered him the job and a few weeks later the Raphaels arrived at the hospital. 

With this unsubtle introduction, it is clear that we will soon encounter someone who is Stella's match, and probably also Max's opposite. This task falls to Edgar Stark, a large, muscular psychopath who fancies himself to be a bit of a sculptor (what he did to his wife, a disgusting crime that landed him in lockdown, will tell you all you need to know about his artistic capacity). In any case, Stark is certainly attractive in a brawny, Lord Byron sort of way, and Stella has been "more or less celibate" for the last several years. How does a "cultured, beautiful woman," who also appears to be a fine cook and homemaker, end up so neglected that she confesses her feelings at a dinner party? It is one of the odd conceits of the novel that Max's lack of imagination is blamed; in fact, this lynchpin is so dubious as to cast enormous shadows on all that is to come. To wit, if you have a wealth of ambition and a dearth of sensuality, why would you ever marry a beautiful woman whose curves gain her the nickname from one of the characters of "Rubens"? Not only is her ability to play hostess untested and unlikely, but a buxom bombshell will raise more than eyebrows regarding Max's maturity. And when Stella willingly allows Edgar's advances to conquer her whole, the novel skids down some rather implausible slopes.

Yet this is again to the credit of McGrath, who excels when he writes about his native England, but is far less successful with his American-based works (despite that he has long been a New World resident). Stella and Edgar fornicate, spend hours thinking themselves unwatched amid the sprawling hospital gardens – or, I should say, Stella alone believes this nonsense – and enjoy probing each other's physical and emotional limits. Then one fine day, Edgar has the impudence to seduce her on her own bed then make off with some of Max's clothes. Escape from an asylum, observes the usually purblind Max, requires two things: clothes and money. How nice of Stella then, when Edgar asked a week or so before, to have "given him everything she had in her purse." Edgar, to no one's surprise except Stella's, absconds to London where the second act begins, with Stella joining her lover and the latter's henchman Nick in an urban warehouse loft she will come to fear. Here we get scenes as plebeian as the raw and unfinished surroundings, and it is also here that Stella tries to refashion Edgar – who has hitherto come off as merely an unctuous, self-serving beast, at least to us – into the lover she really craves, not unlike Edgar's desire to sculpt her head:

She knew the thread was unbroken; even in his worst fits of aggressive jealousy she felt him straining for her, she felt the passion, only it was confused and misdirected, it was as though it had been shunted off down some passage from which it emerged monstrous and unrecognizable. This was his illness. And she said that it was during the two days she spent with Nick that she attempted what she called her heart's prompting: she tried for the first time, not intellectually but emotionally, to separate the man from his illness, and yes, she could do it. Oh, it was easy, she was more than equal to the task: she imagined him clutching his head as the storm raged in his poor benighted mind, but the storm wasn't him! The storm would pass, he would recover, he would be himself again. But for his sake she must avoid him while he was mad; later she would go back to him.

As Cleave duly notes, Stella has learned little from living among psychiatrists. Her few weeks in London are Bohemian in that very banal manner so commonly incident to lesser novels – which seems precisely like what has entrapped Stella. Edgar's "benighted mind" eventually gets the better of him, as it always has, and Stella makes her fallen way back to the familial country home alongside the titular institution.

Although I have not seen all of the doggedly faithful screen adaptation, I will permit myself use of its less complimentary reviews. While the film has been loathed in particular for Stella's abrupt stupidity, the novel's original improbabilities are greatly magnified by the casting choices, especially with this late actress as Stella. Richardson is sadly ten years too old and, unfortunately, not enough of a bimbo to make this work – and herein lies our greatest trouble. Our narrative, while gripping, will evolve in guarded steps; indeed, McGrath has never written more beautifully or more accurately. The premise of its stemming from the pen of an elderly psychiatrist bestows the semblance of an ornate clinical report. What happens to Stella and Charlie and Max in the third act, which begins in some downtrodden Welsh village called Cledwyn Heath, indicates that Edgar is not the only ailing soul among the dramatis personae. Max, as usual, does not quite catch on:

The house seemed too large for them, and they drifted about it like strangers in an empty hotel. Max was unable properly to begin his punitive campaign, perhaps, she thought, because the magnitude of her guilt awed him. That she should still eat, and drink, and move from room to room, burdened as she was with sin, this struck him dumb with amazement and even a sort of admiration. He could not quite believe that she wasn't crawling about on her hands and knees, begging his forgiveness.

Stella does nothing of the kind, and Max keeps her around with the old excuse that a child needs a mother. Now, a child certainly does need a mother, but not one like Stella. Not one who has succumbed to "those large emotions that by their very nature tend to blaze freely and then die, having destroyed everything that fed them." Well, almost everything.

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