Tales of Normansfield: The Langdon Down Legacy (2007)

Citation

Gore, N. (2012), "Tales of Normansfield: The Langdon Down Legacy (2007)", Tizard Learning Disability Review, Vol. 17 No. 3, pp. 151-152. https://doi.org/10.1108/tldr.2012.17.3.151.1

Tales of Normansfield: The Langdon Down Legacy provides an accessible, insightful and moving account of the creation, history and eventual closure of Normansfield Hospital. Merriman, who has a daughter with Down syndrome, blends historical references, documents and interviews with personal reflections and commentary. Interestingly, the preserved buildings from Normansfield have recently been opened as a museum and, together with this book, offer students, professionals and family carers an insight into some of the roots of social care, with the potential to inform better support and services for the future.

The book begins with the life story of Patricia Collen who entered Normansfield in 1926 at the age of 10 and lived through its various manifestations for 71 years, whereupon she was re‐connected with her wider family and supported to live in her own home with an individually tailored package of support. Changes in where and how Patricia lived and the extent to which her individuality was celebrated and supported are shown to have resulted in significant variations in her quality of life and wellbeing.

Chapter 2 – “Imbeciles, idiots and the feeble” – gives a brief historical overview of support and policy regarding people with learning disabilities, starting from the provision of workhouses as generic “dumping grounds” in the eighteenth century, through the development of the Lunacy Commission in 1845 with the corresponding creation of county asylums and the later creation of Earlswood Hospital, to specifically house “idiots and imbeciles”.

Merriman explains how, following a period of medical training and experience in pharmacy, John Langdon Down came to take charge of Earlswood. Interestingly (and perhaps thankfully), Langdon Down had no prior experience of institutional treatment and so adopted a fresh approach to develop his own “moral treatment of idiots” that focused around an educational system. His belief that “the idiot has to learn” promoted use of both positive reinforcement and less ethical/effective strategies (control and removal of privileges) but his insight that people with learning disabilities could learn and should be afforded opportunities to do so is highlighted by Merriman to represent a truly “radical experiment”.

The chapter goes on to explain that, during this period, Langdon Down and his wife also supported a number of service users within staff members' own community homes (via additional financial arrangements). Undeniably, Langdon Down's resignation from Earlswood and the establishment of Normansfield (a private institution of his own for “wealthy clients”) was underpinned at least in part by the same capitalist motivations as many of his contemporaries. The work he achieved in Normansfield and the values he brought to health and social care at this time are, however, recognised by Merriman as far more unique and praiseworthy.

The following chapters detail many of the medical advances (e.g. categorisation of the Down syndrome phenotype; the early treatment of thyroid dysfunction), therapeutic approaches (e.g. the integration of art, music, drama and physical pursuits within all aspects of people's lives) and principles (e.g. promoting dignity through work and productivity, full enjoyment of holidays/celebrations) that Langdon Down, his wife and subsequent generations of family were responsible for.

Perhaps one of the most inspiring accounts concerns John and Marry Langdon Down's genuine willingness and dedication to work with families and understand the individual needs of the people they supported. Merriman provides several examples of the incredibly frequent personal letters written between the Langdon Downs and parents that evidence this well.

The restrictions, dynamics and dangers of institutions are evident to the informed reader throughout the book. Although not highlighted by Merriman to a great degree, there is a sense of paternalism together with indicators of implicit and explicit forms of control within the early decades of Normansfield. But segregation here is at least intended to offer genuinely better lives and support to people with learning disabilities.

It is within the later chapters of the book (covering the decline of Normansfield in the twentieth century) that Merriman demonstrates most poignantly the horrific experiences and circumstances that people (including staff, families and service users) encountered when institutional forces spiralled out of control in the hands of Dr Terrence Lawyer. Merriman provides stark testimonials of this period that include a report from Sarah Seyman (Information officer for the Down's Syndrome Association) who visited Normansfield in 1983.

A woman was lying naked on the floor of the corridor blocking our path. We were not at all sure of what to do but the nurse told us to just step over her.

We asked why people were naked and were told “well, they ruin their clothes when they wear them”.

Much is to be learnt from the development and eventual closure of Normansfield but the book's greatest value lies in its use of the (nearly destroyed) photographs, letters and records that are drawn upon to recount the lives of individuals who lived and worked in the hospital. The life stories Merriman tells are fascinating from a professional and academic, but more so human point of view. At times both hopeful and sad, they tell us something of the contexts and forces that gave rise to a whole host of behaviours and experiences from the great to the truly deplorable.