Liverpool and the Power of Suggestion: Alfred Betts Taplin and the Psycho-Therapeutic Institute

By Dr Gordon Bates, child psychiatrist and writer.

This year, the Royal College of Psychiatrists International Congress is being held in Liverpool. The city has made many important contributions to the development of mental health services in the United Kingdom. The ‘Liverpool Lunatic Asylum’ was built on Lime Street in 1789, in what is now, St Johns Gardens. Instigated by James Currie, a Quaker physician at the Liverpool infirmary, it was small, housing only 60 patients but its influential design would be replicated across the region. Psychiatric hospitals or lunatic asylums as they were called at the time, proliferated during the Victorian era. Rainhill District Lunatic Asylum, outside St Helens was founded in 1851 to accommodate 300 but grew in size to hold over a thousand patients.

Image 1: Liverpool Lunatic Asylum (Liverpool Binns Col., Vol.10, LRO: courtesy of Liverpool Record Office), Image 2: Maghull Hospital Staff: William Brown, WHR Rivers, Grafton Elliot Smith

To the north of the city, Moss Side Military Hospital in Maghull was an important site for the development of treatments for shellshock, for those soldiers allowed to return from the frontline due to psychological illness during the First World War. Between 1914 and 1919, its pioneering staff, who included William Brown and W.H.R. Rivers, treated 3,600 soldiers using novel therapies from the emerging field of psychological medicine.

The Liverpool Psycho-Therapeutic Institution (LPI)

A lesser known but no less significant development that occurred in Liverpool was the establishment of the Liverpool Psycho-Therapeutic Institution in 1912. This was the first medical centre for psychotherapy in the UK. During the Victorian era, most doctors understood mental illness to be brain-based but largely ‘static’ or fixed and untreatable. At best, hospitals and asylums offered board, lodging and compassionate care. However, developments in psychology suggested that behavioural and mental change might be possible for some conditions.

At the turn of the twentieth century in Liverpool, there was sufficient interest locally in the early psychotherapies of medical hypnotism and suggestion to form the Liverpool Psycho-Medical Society. Both treatments enhanced willpower and entailed positive health affirmations but hypnotism appeared to enhance their effects through the trance state. The society membership included local general practitioners and hospital doctors including Sidney Wilkinson, Albert Davis and Alfred Betts Taplin.

The committee of the society were responsible for securing the funding of £50 per year and location of the Liverpool Psycho-Therapeutic Institution. They launched the clinic in the local newspapers and established the LPI as a charity hospital initially in a house on Maryland Street. In the first year they were initially treating twenty patients a week which quickly rose to sixty. On average, patients required an assessment visit followed by three or four treatments lasting up to an hour. Some treatments were individual and others as a group. Patients were charged sixpence per visit unless ‘absolutely destitute’. Initially, the only treatment offered was hypnotism and suggestion.

Either Wilkinson, Betts Taplin or Davis would attend daily as the clinic’s honorary physicians and they treated insomnia, drink and drug habits and a range of psychosomatic and functional illnesses. Such was the institute’s success that they accepted educational visits from other physicians and medical students and had referrals from all over the country.  The committee, under Bett’s Taplin’s chairmanship, soon needed to provide accommodation at a local nursing home on the same street. After a year, they needed more space and moved to larger premises in two houses on Catherine Street. The clinic changed its name and location on several occasions. In 1924, Betts Taplin and Dr Muriel Barton Hall opened the New Psychotherapeutic Clinic on James Street which became known locally as the Liverpool Psychiatric Clinic.

Alfred Betts Taplin (1856-1939)

Betts Taplin has been called the ‘Father’ of Liverpool Psychiatry because he became the first local practitioner to specialise exclusively in the treatment of mental disease. Unusually for the time, he did not have a hospital position and attracted all his patients by word of mouth. He was the author of Hypnotism (1912) which ran to four editions and Hypnotic Suggestion and Psychotherapeutics (1918). He was a founder member and secretary of the Medical Society for the Study of Suggestive Therapeutics (MSSST) which became renamed the Psycho-Medical Society a few years later.

This London-based group was an early hub for teaching and learning about ‘psycho-therapeutics’, an eclectic range of early psychological treatments which included suggestion and hypnotism as well as early Freudian analysis. Like many others of the group, he was also a member of the Society for Psychical Research (SPR), an elite metropolitan society which boasted Nobel prize winners, Cambridge philosophers and government ministers in its membership. They sought to explain metaphysical events like hauntings and spiritualism through science. The SPR is acknowledged as the home of early psychology in Britain.  

Hypnotism, Suggestion and Psychotherapy

Hypnotism and suggestion were effective early psychological treatments, both reducing anxiety and creating the conditions for behaviour change in about two thirds of people. However, hypnotism remained disreputable to many doctors and members of the public because of its associations with Mesmer, stage magic and its use by spirit mediums in spiritualism seances. In his book Hypnotism and Treatment by Suggestion (1918) Albert Davis starts his first chapter remarking that the average man is ‘repelled by the word hypnotism’ associating it with the stage character Svengali or a ‘mountebank who possesses a power that is dangerous and wicked.’ 

A French Hypnotic Clinic (File:Liebeault1873.jpg - Wikimedia Commons)

Title page of Hypnotism by A. Betts Taplin. Photo by Dr Bates.

To this day, hypnotism is not taught at medical school and rarely used in medical practice despite its usefulness in pain management, sleep and anxiety. The NICE guidance only recommends it for smoking cessation. However the method for assessing the effectiveness of any medical treatment is testing it against placebo. Hypnotism is understood to induce the most powerful of all placebo effects which are not inconsiderable, and rarely has side effects. It operates through expectancy and belief to produce the changes in the autonomic nervous system seen in profound relaxation. Its medical adherents bemoan its limited uptake.

Writing about hypnotism and suggestion in 1914, Wilkinson mused:

“In spite of the evidence in favour of the employment of psycho-therapeutic methods in selected cases, and even in some degree for many organic diseases, it still seems to be necessary to offer some sort of apology for its employment. It does not occur to us to justify the use of radiography, electricity, and other forms of treatment that are far newer.
Is it because psychic treatment is produced by an agency that cannot be seen, and felt, and measured? Yet its results are not infrequently characterised by extreme brilliancy.”

‘Recent Experience in Hypnotic Practice, Proceedings of the Society for Psychical Research, Vol. XXVII (1914-1915) (pp. 370-90)

The story of the LPI has been forgotten or simply neglected. In itself, this demonstrates the unacceptability of hypnotism to orthodox medical institutions and their official histories. However, its success led directly to the foundation of the Medico-Psychological Clinic or Brunswick Square Clinic in London and it can be argued that it contributed to the rise of talking therapies more generally. The medical historian Henri Ellenberger has convincingly made the case for this lineage.

Brunswick Square is best known for providing the preliminary training for the first wave of British Freudian analysts. It was founded by Jessie Murray and physician Julia Turner in 1913 and had a mixed staff of doctors and psychologists. They freely acknowledged their debt to the LPI and invited Sidney Wilkinson from Liverpool to their first meeting. A few years later, when the psychological casualties of WWI started to return to the UK, the mainstay of treatment was hypnotism and suggestion which was used at Brunswick Square and the LPI, as well as the newly founded military hospital at Maghull. But that is another story…

Visiting Liverpool

People wishing to visit the LPI will find that the initial site on Maryland Street has been demolished but the Catherine Street address is still standing having returned to residential use. The final resting place of the Liverpool Psychiatric Clinic before its closure was on Abercromby Square, now part of Liverpool University. 

Dr Bates' book ‘Between Imagination and Suggestion the Uncanny Rise of British Medical Hypnotism 1888-1914’ will eb published later this year.