Ivor Browne, psychiatrist who reformed Ireland’s old-fashioned treatment of mental illness – obituary
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Ivor Browne, who has died aged 94, was a psychiatrist who transformed the public perception of mental illness in Ireland, overseeing the move away from crammed hospital wards and electro-convulsive therapy towards a holistic view of the human mind.
When Browne began his career in the 1960s, mental health provision in Ireland was in a parlous state. Proportionately Ireland had the highest rate of incarceration in mental hospitals in the world – higher even than that of the Soviet Union – and there were, on average, just two psychiatrists per mental hospital (one per 454 inpatients). Often, patients were committed to an institution because they caused difficulty for their families or the church. Many remained there for decades.
Browne set out to dismantle the system, declaring: “We no longer need the mental hospital as we know it.” While he agreed that some people would always need long-term residential care, he pushed for hospitals to be integrated into the community, rather than sequestered behind walls. He was against the over-prescription of mood-altering drugs and held that measures such as electro-convulsive therapy should only be tried when every other form of treatment had been ruled out.
Instead Browne argued for talking therapy, which sought to trace mental ill health back to its root. In 1985 his article, “Psychological Trauma, or Unexperienced Experience”, was published in the Irish Journal of Psychiatry. Here, Browne laid out his hypothesis that traumatic events cause the psyche to generate a “non-ordinary state of consciousness” in an act of self-protection. This cause the body to hold on to trauma, in what Browne termed the “frozen present”.
Traumatised children might re-enact the event in play; adults might suffer from upsetting dreams, flashbacks or intense distress upon meeting circumstances that reminded them of the past event. “If it has been blocked, you’re not reliving the experience,” Browne explained. “You’re living it for the first time.”
Healing could begin once the patient, with the help of a therapist, had worked through his or her traumatic experience. It was then an ordinary (if unpleasant) memory; the patient could still recall it, but it was no longer intruding into everyday life. In group workshops, Browne encouraged his patients to lie down while they relived their experiences, allowing themselves to react spontaneously to the trauma.
In the introduction to Browne’s 2008 book Music and Madness, the writer Colm Tóibín recalled screaming aloud as the “unexperienced” pain of his father’s death finally washed over him. Tóibín became a friend of Browne’s, while the novelist Sebastian Barry likened Browne to a father figure. “When Sebastian and Ali [Alison Deegan, his wife] were not doing well, we used to bring them fish and chips,” Browne recalled.
Willing to break rules in order to save lives, Browne attracted a reputation as a maverick. His sympathy with his patients and opposition to many established practices of the last century also set him at odds with some colleagues. In 1996 he spoke out on behalf of Phyllis Hamilton, who had children with the celebrity Catholic priest Fr Michael Cleary. He defended her from accusations that she was a liar and a blackmailer, and went on RTE radio to say that Cleary had always been open with him about the relationship.
For this, Browne was attacked by the Catholic Church and sanctioned by the Medical Council. He remained unapologetic, however, feeling that he had to prioritise the well-being of his patient over the reputation of the Church. He remained in contact with Phyllis Hamilton and was with her when she died in 2001.
One of five children, William Ivory Browne was born into a middle-class family in Dublin on March 18 1929. Years later he learnt that his parents, determined not to have any more children, practised a form of birth control in which his mother kept the bedroom door locked. Ivor was conceived after his father climbed in through the window.
Through his father, a former Catholic who defected to the Church of Ireland on marrying Browne’s mother, Ivor inherited a love of literature, music and history. His mother nurtured his spiritual side.
As a boy Ivor struggled with dyslexia and did poorly academically, but had a love of music and took up the trumpet. After leaving Blackrock College he went on to the Royal College of Surgeons, where he spent much of his time playing jazz. One professor informed him: “You’re only fit to be an obstetrician or a psychiatrist.”
In his third year at RCS he contracted tuberculosis, which put an end to his trumpet-playing. After graduating in 1955 he started out in neurosurgery where, as a student he assisted in lobotomies (a fact that later caused him great regret). He went on to a position at Warneford Hospital in Oxford, before returning to Ireland and St John of God Hospital in Dublin.
It was there that he began to develop scepticism about the use of psychotropic drugs as he watched schizophrenic patients being readmitted to hospital months after a supposed “cure”. “Whatever we were doing, it was clear to me we were not changing the process,” he recalled.
In 1962 he took a job at St Brendan’s Hospital in Dublin, where he was appalled at the overcrowding and the use of crude treatments like insulin coma therapy. He rose to become medical superintendent in 1966 and set about establishing group therapies in a disused church on hospital grounds. His approach involved new drugs, intensive one-to-one therapy, and moving patients back into the wider community.
At the same time he was experimenting with more radical and controversial therapies, such as the use of LSD and (later) ketamine. He had a lifelong interest in Indian spiritual practices and championed the psychological benefits of yoga and meditation. He presented a manifesto for change in his interview for the job of chief psychiatrist of the Eastern Health Board, and was appointed to the position in 1966, eventually retiring in 1994.
Ivor Browne was Professor of Psychiatry and Head of Department at University College Dublin from 1967. He was also president of the Committee of Experts on psychiatric reform in Greece and served as director of the Irish Foundation for Human Development.
Strikingly tall, with a trim white beard, Browne was a warm presence, and would often greet people with a hug. He was popular on the jazz scene and founded the record label Claddagh Records with his friend Garech Browne, the Guinness heir. Unafraid of dying, he was a believer in reincarnation and once said that he felt he might have been an Italian monk in a past life.
With his first wife, Orla, Ivor Browne had four children. The marriage ended in divorce and in 1999 he married his partner of 30 years, June “Juno” Levine. She died in 2008.
Ivor Browne, born March 18 1929, died January 24 2024
