Asylum at Saint-Rémy

As for doing painting and not to be sequestered in the establishment, I promise you that we will facilitate every means to allow [Vincent] his natural tastes and, in the house, allow him the greatest liberty compatible with his mental state.

—Dr Théophile Peyron to Theo van Gogh, Saint-Rémy, April 29, 1889

On May 8, 1889, Vincent van Gogh was voluntarily admitted to the asylum of Saint-Paul de Mausole, formerly a 12th-century Romanesque monastery, in Saint-Rémy-de-Provence, France. The town took its name from a bishop of Reims who is said to have brought about a miraculous cure there on his way to Avignon.²

Theo van Gogh, when he arranged his brother's admission, requested that Vincent be allowed to paint during his confinement (epigraph).³ An additional room was provided for a studio. The routine of the asylum did provide respite, allowing Vincent to create some of his best works; in his first weeks of confinement, he completed Irises and The Starry Night.⁴

The asylum was a 2-story building with separate men's and women's wards. It was surrounded by a large garden filled with flowers and pine trees. There was a field of grain in a walled plot on the grounds. Vincent described his second-floor quarters to Theo as “a little room with greenish-grey paper with two curtains of sea-green with a design of very pale roses, brightened by slight touches of blood-red.”^5(p277) The curtains and worn armchair seemed to him “relics of some rich and ruined deceased.” His studio on the first floor offered a view onto the asylum garden and the mountains of Alpilles, which formed a jagged line along the sky.^5(p278) And he described to Theo a fellow patient, who heard voices—reportedly hearing “words in the echoes of the corridors.”

In late May or early June, Vincent completed a gouache (an opaque watercolor and gum technique) of the interior of the asylum using somber colors: muddy-yellow ocher, dried blood red, and dull green. It illustrates the stark functionalism of the gloomy 19th-century interior, with its sharply receding corridors (Figure). The long hallway stretches to the end of the viewer's perspective, creating a sense of endless loneliness. A figure is shown in the long corridor; perhaps it is the person who heard voices fleeing the frightening sounds by darting into a room. Other gouaches are more cheerful; one shows light streaming into the vestibule of the asylum. It illuminates a framed and an unframed canvas. Another shows the interior and wall of his studio where 4 unframed works are hung; bottles and cups rest on the window shelf.

Vincent remained productive until the middle of July 1889, when, following his first supervised visit to Arles, he experienced another attack. He did not paint again in earnest until late September or early October. Renewed, he produced a pleasing image of the front of the asylum in bright yellow with a vivid red roof to the left behind elaborate pine trees that reach high above the building to the top edge of the canvas (cover). Intrigued by them, he writes of “the proud, unchanging nature of the pines and the cedar bushes against the blue” sky that resonates between them.^6(p260) Several figures walk beneath the huge pines: a woman with a red parasol, 2 men together and 2 women together, and another man, possibly Vincent himself, wearing a yellow hat. The strolling figures suggest the ambience of a country house, not an asylum. All are depicted using forceful, swirling, colorful brush strokes, reflecting his personal restoration.

There is considerable speculation about Vincent's diagnosis; his French doctors diagnosed his episodic attacks as epilepsy complicated by substance abuse (alcohol and the hallucinogenic drug absinthe, his preferred drug of abuse), poor nutrition, and chronic stress. Vincent reported a maternal family history of epilepsy. Some modern physicians concur, proposing episodic subictal and interictal dysphoric events and amnestic-confusional states linked to mesial temporal lobe epilepsy, aggravated by absinthe abuse.⁷ Others acknowledge⁸ that although Vincent is a classic example of Geschwind syndrome (often associated with temporal lobe epilepsy), in the absence of specific documentation of temporal lobe seizures, his symptoms might instead represent personality disorder and an unspecified mood disorder. Despite his symptoms, Vincent was extremely productive and reported to be fully recovered between episodes.

Nineteenth-century asylum communities like Vincent’s, the legacy of Philippe Pinel's moral treatment approach, provided benevolent support and offered rehabilitation.⁹ Although we seek today to emulate the humane moral treatment atmosphere of the early asylums in community residential settings, sadly, many are underfunded.

This article was corrected online for typographical errors on 7/30/2010.