Though my interviews with Ruth Barnhouse answered some questions, they raised even more. I was left with the inescapable conclusion that this talented therapist had certain blind spots about Sylvia that may have interfered with her treatment. While it is clear these two women forged a powerful relationship that helped Sylvia Plath, they also crossed some professional boundaries along the way.

I am in no way, however, suggesting that Ruth bears any responsibility for Sylvia's death. Blame is cheap and does not do justice to the longtime internal struggle and unbearable emotional pain that characterizes any suicide. One therapist told Ruth her treatment may well have kept Sylvia alive a few extra years, and there's no reason to think that isn't true. Every therapy relationship fails in some ways, even when it succeeds grandly in others. Sylvia and Ruth were no exception.

"The Bell Jar" recounts how Plath, on Aug. 24, 1953, took a large number of pills, left a note saying she had gone for a long walk, and then hid in a crawl space underneath the kitchen. After her family found her two days later, she was taken in a semicomatose state to the hospital, and when she had recovered from her physical illness, she was transferred to McLean Psychiatric Hospital. It was there, after being diagnosed by senior psychiatrists, that Sylvia was assigned to Ruth Barnhouse for treatment.

In the "The Bell Jar," Ruth was given the name Dr. Nolan, and described as looking like "a cross between Myrna Loy and my mother. She wore a white blouse and a full skirt gathered at the waist by a wide leather belt, and stylish crescent-shaped spectacles." So she reminded her of a movie star. On Ruth's part, she said she liked Sylvia immediately, that they clicked. She told me in our earlier phone interview, in 1990, that they considered themselves two of a kind: Both were child prodigies with high IQs; both were ambitious and determined; both considered themselves "intellectual snobs."

Sylvia, though, didn't know she was being treated by a novice therapist. Ruth was a psychiatric resident, with very little experience in psychotherapy, when she was assigned to treat Sylvia Plath. Ruth told me, "Sylvia was one of my first patients at McLean."

Now, while Sylvia had little money, she did have status. She had a wealthy mentor in writer Olive Prouty, who arrived at the hospital in her black Cadillac, promising to pay for Sylvia's treatment. Sylvia was no poor patient stuck on a back ward. But, as Ruth told me in 1990, McLean was, first and foremost, a teaching hospital, and it was not unusual for the high-status patients to be assigned residents. Also, Ruth was 30 years old and Sylvia only 19. Perhaps the hospital's graybeards thought a young resident might bond more easily with their young patient.

But why would Prouty and Aurelia Plath, Sylvia's mother, allow Sylvia to be treated by a trainee? When I asked Ruth this, she responded, "I don't think they knew I was that inexperienced. It was McLean and I was the doctor assigned to her. That was it."

Furthermore, while the body of Sylvia Plath literature refers to Ruth Barnhouse as her "analyst" or "psychoanalyst," she was not a psychoanalyst. She received psychoanalytically oriented training and supervision during her residency at McLean, but did not go through analytic training. She was in therapy during medical school with an analyst in training, but told me that "at least a third of the time I didn't show up. I don't think I ever really got into it." Later, when she experienced marital difficulties, she said she went through analysis, and that it was helpful. But during the two periods of time when Ruth treated Sylvia, she had not yet had her own treatment. Back then, in the heyday of psychoanalysis, personal experience with therapy would have been considered essential for managing Sylvia's primitive feelings and the emotions she would trigger in Ruth.

Was Ruth daunted at the prospect of taking responsibility for treating such a seriously ill patient? Characteristically, she said, "Not at all. It never occurred to me to think that I couldn't treat her. I knew I could." Ruth's neophyte bravado may well have been both the source of her immediate therapeutic success with Sylvia, and also the reason she underestimated the extent of her illness.

Ruth Barnhouse was a very self-confident woman, and I have no doubt that she was a precocious, strong-willed young psychiatrist. When she observed how upset Sylvia became after having visitors, Ruth did not hesitate to ban all visitations until further notice. This naturally angered both Prouty and Aurelia Plath, both of whom felt they had a right to see her regularly and monitor her treatment. They felt Ruth was turning Sylvia against them, and soon made plans to transfer her to another hospital.

They changed their minds, reluctantly, when the hospital staff convinced them that Sylvia's condition had improved under Ruth's care. But the wounded Prouty did say she would no longer pay for Sylvia's treatment after January. No doubt there was pressure, spoken or unspoken, to "cure" Sylvia by the end of the year.

Recent Stories