The Space Between: Literature and Culture 1914-1945

Phyllis Bottome—An Intermodernist Under Treatment in the Age of Modernism: Tuberculosis and the Embrace of Alfred Adler’s Depth Psychology

Alexis Pogorelskin
University of Minnesota-Duluth

The essay that follows is devoted to the prolific British novelist Phyllis Bottome, best known for her anti-Nazi novel of 1938 The Mortal Storm. I argue that Bottome’s decade-long treatment for tuberculosis encouraged her embrace of Alfred Adler and his version of Viennese depth psychology, known as Individual Psychology. For Bottome, the psychiatrist replaced the lung specialists who had previously dominated her. The essay further argues that medical practice in treating tuberculosis by means of the patient’s near total submission, both medically and psychologically, to an all-knowing lung specialist prepared for acceptance of similar dominance by a depth psychologist. The controlling medical specialist had already found a place in Western culture in treating tuberculosis. Bottome’s documented sensitivity to the rise of fascism is connected to her experience of authoritarian medical practice. In the interwar period the novelist proved to be an astute observer of right-wing fanaticism. Her observations of persistent anti-Semitism in Vienna after World War I, she recognized, could become rampant. The other vulnerability existed within Bottome. In turning her life decisions over to medical practitioners, she experienced, consciously or unconsciously, the totalistic submission characteristic of fascist movements. The essay therefore engages with issues raised by scholars of modernism as well as by those in the newly emerging field of intermodernism. Bottome’s work belongs readily to the latter category, yet she was hardly an outsider to modernism, sharing “the modernist fascination with madness and illness” (Heynan 684). But unlike the modernists who became implicated in fascism, Bottome did not harbor illusions about what its adherents intended.

Key Words  Phyllis Bottome / Alfred Adler / Tuberculosis / Modernism / Intermodernism / Fascism / Nazism

“The smallest details of the patient’s life [must be] controlled by the supervising physician and nothing of any importance should be left to the patient’s judgment.”—TB Specialist Dr. Paul Kretzmer, 1888

“I’m right as always [. . .]”—Dr. Behrens, Supervising Physician, International Sanatorium, the Berghof, Davos, Switzerland in The Magic Mountain

“Joyce [. . .] speaks of being ‘yung and easily freudened’ in Finnegan’s Wake [. . .]”—Maud Ellmann, The Nets of Modernism

“Are you going to do what I advise or not?” —Alfred Adler to Phyllis Bottome


In the late nineteenth century and first decades of the twentieth, the treatment for tuberculosis (TB) and psychological disorders similarly demanded patients submit to medical practitioners whose unquestioned expertise permitted them to dominate patients’ lives. Treatment for diseases of the mind and lung shared something else. Ideas concerning both ailments originated in German Romanticism with, first, its notion of the restorative power of the mountains and, second, the unconscious as a source of creativity as well as individual identity. Neither of those assumptions could be proven scientifically; taken on faith, however, they underlay the practice of medicine as the twentieth century dawned.

When first diagnosed with TB in 1901—shortly after her sister died from the disease--Phyllis Bottome willingly joined those patients who sought treatment in an alpine setting. She submitted herself to experts in clinical medicine who specialized in lung ailments. Her later experiences with psychological analysis followed a similar path. While residing in Vienna after World War I, she was exposed to the city’s tradition of depth psychology. She rejected those whom the historian Mark Micale has dubbed “the sole exemplars of psychological modernism [. . .] Freud and occasionally Jung” (7). Freud’s former associate Alfred Adler appealed to her in part because of his emphasis on individual choice and conscious goal setting, but he required strict adherence to his advice. Bottome also sought assistance from Adler in her own creative efforts. In the age of “the interface between the aesthetic and [the] psychological,” Bottome hoped to expand her creative potential through analysis (Micale 3). Adler, according to statements Bottome makes in her autobiography, provided the psychological dynamic for what she termed her adult fiction, which appeared primarily in the interwar period (The Goal 128).

While concerns about the body that could be termed modernist consumed her, Bottome does not fit comfortably under the modernist rubric.1  Although she embraces matters similar to those of her modernist contemporary Thomas Mann, Bottome is distinctly intermodernist in her artistic approach. In this essay I will examine how her attitudes toward illness, medical expertise, and the emerging psychological enterprise in the 20th century translated into concerns about dictatorial experts and the critical anti-fascist perspective of her interwar fiction.

Modernist/Intermodernist: The Magic Mountain (1924) and Old Wine (1925)

Comparison with Thomas Mann, a distinctively modernist writer, sets off the intermodernist stance Bottome takes toward content and form, particularly as she embraces medical expertise. Mann filled The Magic Mountain with his disdain for doctors, in part exhibiting the “anti-psychiatric” attitudes of “the broader left-wing revolutionary movements of [. . .] post-World War I” Germany (Heynen 683). Many in Weimar Germany feared psychiatry as another form of the confinement and control they associated with the harsh policies the Kaiser’s government had employed during the recent war (Heynen 683).

In The Magic Mountain, Mann reveals his attitude toward current medical practices in the rivalry between the emerging field of psychiatry and treatment of lung diseases, itself a recent development in medicine. At the Berghof sanitarium, Dr. Behrens is the lung specialist and Dr. Krokowski the psychiatrist. They mostly work in tandem. Dr. Krokowski “[plays] the role of the perfect assistant” to Dr. Behrens, who occupies the senior position in the sanitarium (44). Such apparent harmony hides bitter competition as Krokowski chafes at his subordination to clinical medicine. Krokowski’s treatment rooms are symbolically located “two steps lower than the hallway” that led to Behrens’s medical suite (131). Mann emphasizes the point of inferiority.

The psychiatrist resents his status, longing to usurp the elevated position of the clinician. The unprepossessing Krokowski conducts seances where he explores “those dark vast regions of the human soul that are called the subconscious” and “enjoin[s] patients to see in his stout person a true leader [. . .],” that is the practitioner who belonged at the top of the medical hierarchy (Magic Mountain 644; 659).

With a Slavic surname in a German setting, Krokowski’s status is already “two steps lower” than that of Behrens. Behrens’s surname asserts a German pedigree, a mark of status at the Berghof. “Krokowski” on the other hand is not simply Slavic, but Polish or possibly Kashubian, suggesting not only a stigmatized ethnicity (to Germans) but recalling the eastern territory contested for generations between Slavs and Germans.2 In that geopolitical sense, Krokowski’s name suggests a liminal space of uncertainty, rivalry, and competition just as the psychiatrist himself is in a state of conflict with Behrens, seeking to supplant the hegemony of the latter’s clinical expertise.3

The patients similarly grow annoyed at their required submission to medical expertise. The liberal romantic Ludovico Settembrini expresses contempt for one of the primary diagnostic tools of the lung specialists. He tells fellow patient Hans Castorp that the interpretation of an X-ray “lies more or less in the eyes of the beholder,” adding “our lords and masters never base a diagnosis solely on such playthings” (Magic Mountain 238). Mann’s character expresses a now-acknowledged truth about the objectivity of X-ray results. As of 1910 X-ray machines figured “among the standard equipment of sanitariums,” yet they failed to provide irrefutable diagnoses, even as TB specialists insisted that the machines guaranteed their scientific authority (van Dijck 85-88).

In The Magic Mountain, Mann describes the newly emergent world of clinical medicine as far from rigorous, filled with squabbling, competing specialists more interested in advancing their own status than in the well-being of their patients. Dr. Behrens, for example, maintains his dictatorial arrogance despite his glaring failure to diagnose accurately a case of strep in Hans Castorp (616-18, 626). Treatment and diagnosis, Mann suggests, occur in a place of hocus pocus and magic, that is on a magic mountain where deception reigns and incompetence prevails. The consequences were not confined to the world of fiction. The inadequacies and conflicts in the novel when observed in reality could be seen to provide the ingredients for conflict on a massive scale.

There, according to Mann, lay the origins of World War I. The novelist was well-positioned to see World War I as the culmination of what he described in The Magic Mountain. According to his diaries, Mann wrote the majority of the novel in an intense period between February 1919 and the end of 1921. He had abandoned the project during the war but took it up within months of the armistice (Mann, Diaries 38-123). Mann published the novel in November 1924 to great acclaim.

Almost simultaneously, Phyllis Bottome wrote her novel Old Wine, set in Vienna in the early 1920s and published in 1925. It is a very different kind of fiction from Mann’s and forms an intermodernist counterpoint to his experimental novel. She had written it in two drafts in the winters of 1923 and 1924 (The Goal 123, 127), during the period that Mann made final revisions to his magnum opus. Bottome explores many of the themes Mann develops in The Magic Mountain, but at every turn her perspective diverges from that of the German writer. In the character of Dr. Carl Jeiteles, for example, she depicts clinical medicine as competent and compassionate despite the harrowing conditions of post-war Vienna. Bottome is similarly positive in her references to psychiatry. Although she had not yet met Adler when she composed Old Wine, she was already familiar with his ideas. Her use of sibling rivalry and discord in the plot suggests Adlerian influence, and Adler even makes a slightly harried cameo appearance, “surreptitiously looking at his watch” (Old Wine 129). The psychiatrist is nonetheless the wise raissoneur in a tense situation: a meeting called to address the recent murder of Jews in Budapest. “Two social elements,” Viennese Jews and Austro-Hungarian aristocrats, have gathered “which centuries of studied isolation had kept apart,” yet Adler is able briefly to form a bridge between them (Old Wine 125).

Characteristically for intermodernist writers, Bottome’s novel is more overtly political than Mann’s. The very isolation of the so-called magic mountain insulates Mann’s characters from political engagement apart from arguments and abstractions. Bottome, on the other hand, engages directly with politics (see Bluemel and Lassner 23). She depicts the involvement of her characters in the conflict-ridden world of Vienna after the Austro-Hungarian defeat in World War I. She is acutely sensitive to the potential for violence inherent in the traditional anti-Semitism of mitteleuropa, now driven by the bitterness of post-war deprivation and sense of loss. One character tells another: “There are a few hundred Jews in Wien who will regulate our new-found freedom and starvation to fill their own pockets. They will survive” (Old Wine 9). Mann’s setting is pre-war, when anti-Semitism, while rife, had not yet moved to the center of political life in Germany. Bottome acutely observes that post-war prejudice has become dangerously prominent.

A Very Literary Disease

Both Mann and Bottome participate in a long tradition of invoking tuberculosis, or the White Death, in literature. The disease, also known as consumption, killed nearly four million between 1851 and 1910 in England and Wales alone (Bynum 110). Young people were its primary victims. According to historian Helen Bynum, “more than a third of those aged 15 to 34 and half of the 20 to 24 age group” succumbed to it (110). In France it was termed the great “killer of the belle époque” (Bynum 117).

The majority of the afflicted acquired the disease from the unsanitary and overcrowded conditions that nineteenth century urbanization imposed. But poverty was only part of the story: the disease infected literature as surely as the urban slums of Europe. The suffering it imposed inspired a cultural outpouring that came to dominate the artistic creativity of the century. Literature provided a composite portrait of the disease, making it a ubiquitous theme in the century’s fiction. Dickens, for example, wrote of the disease in Nicholas Nickleby and David Copperfield. The Goncourt brothers’ account of Madame Gervais’s suffering as she succumbs to consumption inspired Zola “in formulating the doctrine of realism in the novel” (Dubos and Dubos 52).

The list of victims in the major fiction of the century is extensive. In Wuthering Heights, for example, “several of Emily Brontë’s characters die of consumption” (Dormandy 92). Unlike Dickens and Zola, who show the social conditions in which the disease flourished, Brontë, like Bottome, witnessed the ravages of the disease in her own family. On the other side of the Atlantic, the wildly popular Uncle Tom’s Cabin contained an arresting account of the saintly end of Miss Eva as she perishes from the disease.

It was no different in France and Germany. According to Thomas Dormandy, the Bohemians who inhabited the Parisian Left Bank as well as their counterparts in nineteenth-century French fiction and opera, were also “riddled with tuberculosis” (95).  Germany offers a whole genre of “tuberculosis poetry” in nineteenth-century romantic Lieder (Dormandy 88). Small wonder that René and Jean Dubos called the disease “the muse of literature” for the second half of the nineteenth century (66).

The disease continued to influence literary culture in the twentieth century. For example, George Orwell already suffered from advanced TB when, during the most prolific period of his career, he completed Animal Farm in 1945 and 1984 three years later.

Bottome had a similar personal and literary association with TB. She wrote Old Wine while sitting on a balcony of an inn in the Austrian alps, wrapped “in a sheepskin” against the cold. It was 1923 and she fought a return of the disease by once again taking to the mountains (The Goal 127). There, as though seeing Vienna from above, she wrote her novel of the city “drained of its life blood [. . .] without food supplies or raw materials” (The Goal 69-70). By then she was a practiced hand at alpine treatment. She had first sought relief from TB in the alps nearly 20 years earlier. Now her enforced rest encouraged her to write the novel she termed her “first really ‘grown-up’ book” (The Goal 128).

In Treatment: From Tuberculosis to Psychology

The disease runs like a red thread through the three volumes of Bottome’s autobiography. The first two volumes, Search for a Soul (1947) and The Challenge (1953), address her life up to the end of World War I, when she was in her mid-thirties. The third volume ends in 1937 with the publication of the British edition of her novel The Mortal Storm and covers the interwar period in which she wrote most of her most noteworthy fiction.

Bottome’s exposure to TB began early in life. Like Keats and Emily Brontë, she nursed a sibling—her elder sister Wilmett—who died of the disease. Bottome subsequently cared for her best friend, Lisle Brock, who succumbed to tuberculosis in early 1923. Bottome emphasized the pervasive influence of TB on her life by titling the first volume of her autobiography Search for a Soul, alluding to a famous consumption autobiography, The Story of a Soul (1898) by French Carmelite nun Thérèse Martin (see Bynum 90). The volume ends with the death of Wilmett. All three volumes of her autobiography are overlaid with Bottome’s subsequent experience of psychological analysis. She termed that first volume “an Adlerian book” because it covered her life up to age 18, or what Adler described as “the malleable years.”4 Thus, Bottome, consciously or unconsciously, bonded the infectious disease to Adler’s approach to depth psychology.

The second volume of her autobiography, The Challenge, is largely devoted to the treatment for tuberculosis that she underwent in the Swiss and Italian Alps early in the century. For five winters she joined fellow patients who had placed themselves under the care of one particular lung specialist or another. Such medical practitioners often functioned as father figures, though they could be less benevolent usurpers of their patients’ personal responsibility. Treatment for tuberculosis at this time entailed complete surrender to a specialist who not only diagnosed and prescribed but also made life choices for his patients. In Spitting Blood, Helen Bynum explains that both morality and the greater social good underlay medical authority in the treatment of the disease: “Not following the doctors’ orders was a form of moral deviance, which was to be countered by those in authority for the greater good of society” (138). Such control betokened the seriousness of the disease.

The disease Bottome suffered from early in the century was frequently terminal. Most patients succumbed within fifteen years of diagnosis and many much earlier. Fear and desperation encouraged patients to turn their lives, or what remained of them, over to those who held out hope of recovery. Bottome’s own fear and desperation are evident in her description of the specialists who treated her best friend Lisle Brock for the disease. In charge of making decisions for her very ill companion, Bottome in turn relinquished all control, as was the custom, to a series of physicians: Dr. Wenkebach, “a very great doctor,” Dr. Eiselberg, “the greatest of Viennese surgeons,” and to Professor Strasser, “a wise and competent physician” (The Goal 93 and 98). TB made Bottome a believer in the efficacy of medically trained practitioners whose titles in her lexicon included “great,” “greatest,” “wise and competent.”

Bottome came of age while undergoing treatment from such practitioners and she became accustomed to deferring to medical authorities. In 1904 she met her future husband Ernan Forbes-Dennis at one of the sanitariums in St. Moritz, where he too was a patient. He proposed a year later. Their engagement ended a year after that under a combination of family pressure and medical objections. At that time, Bottome had come under the care of an English physician named Dr. Huggard. She described the strong competition among lung specialists over whose methods were the most successful in curing the disease. The recent discovery of X-rays promoted a seemingly more scientific approach as well as more accurate measure of success among competing specialists, each of whom had a band of impassioned believers under his care. Bottome described Huggard as one of those competitive specialists, but, like any good medical practitioner, he also employed psychology: “He was a determined psychologist who practiced what he knew upon his patients’ minds as well as upon their bodies” (The Challenge 231).

Bottome revealed another similarity between the treatment of neuroses and diseases of the lung in her description of Huggard. She wrote in praise of him,

Dr. Huggard, who was to be the arbiter of destinies, was a striking exception to British doctors abroad—quite a number of his un-British colleagues respected him –and he had many patients from other countries than his own. (The Challenge 231; emphasis added) 

In effect, Huggard had won the respect of his Central European colleagues—a significant achievement in the competitive world of lung specialists where German accents provided an added cachet to medical credentials. When Bottome encountered the German-speaking depth psychologists their speech patterns betokened the same trustworthy medical expertise she had come to know as a patient suffering from tuberculosis (see Eksteins 55-94).

She did not, unfortunately, enjoy the anticipated remission from the disease under Huggard’s care. When Forbes-Dennis’s health improved Bottome decided that she was “a liability rather than an enchantment, and an unsuitable partner for [his] new kingdom of health and freedom” (The Challenge 253). Confused and uncertain, she turned to her lung specialist for advice: Should she remain with Forbes-Dennis or let him go, she asked Huggard. His response was “both caustic and illuminating,” leaving her “equally startled and relieved” (The Challenge 255). Huggard encouraged her to rely on Forbes-Dennis’s commitment and affection, advice she willingly accepted.

Bottome’s continued ill-health appeared to require the intervention of another specialist whose advice proved far less benign. In 1909 Sir Thomas Barlow, the Forbes-Dennis’s family physician and lung specialist, temporarily curtailed their engagement, “proclaiming that [. . .] the engagement must end, that marriage would be madness for [them]. Had Ernan not lost a brother and” Bottome herself “a sister from TB?” (The Challenge 265). She wrote of her disgust at Barlow’s failure to consult Huggard, yet Huggard in fact was no better in that regard. Bottome observed without complaint, “Patients either obeyed Dr. Huggard or were driven from his door” (The Challenge 231).

They did not marry until 1917 when Forbes-Dennis’s distinguished military service on the Western front gave him the courage to propose again. Thus, the practice of relinquishing life decisions to others began for both in the mountains of Switzerland when Bottome and Forbes-Dennis met and fell in love. Such consultations occurred in three phases in their lives, the first of which was the delayed marriage in the early years of the century. The second and third phases occurred in Munich and Vienna when they consulted Leonard Seif, a disciple of Adler, and then Adler himself on a number of critical issues including where they should reside and how they should share two demanding professional careers.

After the war Forbes-Dennis ran the British Passport Control Office in the Austrian capital, probably as a cover for intelligence gathering. The position therefore carried more status than the role of passport officer would suggest. In 1923 the return of Bottome’s TB prompted them to leave Vienna and take up residence in Kitzbühel in the Austrian alps, where they established an international school for adolescent boys. The project had two purposes: first, to provide an educational environment for boys who had not adapted well to other schools, and second, to establish ties among boys whose fathers had only recently fought each other on the Western front, proving that the next generation could nonetheless establish a lasting European peace.

Overnight, on medical advice, the war hero and rising young diplomat jettisoned his own career to put his wife’s precarious health first. The decision in 1923 established a pattern, against which Forbes-Dennis sometimes chafed, of subordinating his career to his wife’s needs and advancement. Adlerian analysis reinforced the pattern (Hirsch 137).

At Forbes-Dennis’s invitation, Adler visited them in Kitzbühel to share his ideas on adolescent education. He was known to have success with boys in that age group, especially those who had already shown signs of maladjustment. For Bottome the visit came as a revelation. She discovered that “Adler was a great man” and that his teachings rang true (The Goal 140). But there was more to that discovery. She had once again found in the mountains a medical practitioner who assumed the same role that the lung specialists of decades earlier had played in her life. She, like her husband, became a convert to Adler’s Individual Psychology and a devotee of Adler himself.

The meeting with Adler marked a shift from dependence on tuberculosis specialists to depth psychologists and provided an excuse to leave Kitzbühel behind. Shortly afterwards, Adler went on an extended lecture tour of the United States, but by 1930—and on Adler’s recommendation—Bottome and her husband had settled in Munich to devote themselves to study and analysis with his “trusted colleague” Leonard Seif (The Goal 162). Once in Adlerian analysis Bottome’s bouts of TB abated. Her last recurrence came in 1931 in reaction to a dose of diphtheria anti-toxin which was known to trigger the disease (208). Bottome returned to health in three months and never suffered from TB again.

The immersion of Bottome and her husband in Adler’s circle replicated the isolated world of the TB sanitoriums the couple knew from their youth. Bottome and her husband embraced the advice of the practitioners of depth psychology as they had once heeded the commands of physicians who specialized in treating TB.

The advice, not to say direct orders, they received whether from lung specialists or depth psychologists followed a similar pattern. Specialists in both disciplines addressed Bottome’s relationship with her husband. The couple’s prior experience with tuberculosis made them  vulnerable to such interference and they turned to specialists when a fault line in their relationship emerged: whose talent and professional development should have priority? Forbes-Dennis taught piano at a high level. With skill, and often delicacy, he arranged concerts and lecture tours for others, Adler among them. But Bottome possessed talent and creative abilities that earned her international attention as well as significant income. In the 1930s she sold three novels to Hollywood. The unresolved issues in their relationship found ready attention from the medical specialists they consulted and, it must be said, succumbed to.

In Analysis

By the time that Bottome embraced Adlerian psychology, that and similar therapies for neuroses had been gaining acceptance in European culture since the end of the nineteenth century. By the first decade of the twentieth century the phenomenon included what historian Mark Micale has termed “a kind of comprehensive psychologization of culture” (Micale viii). At the same time psychiatry itself “became more ‘literary’ and narrative” driven, enhancing its appeal to a novelist like Bottome (Micale 7).

The 1920s, the decade that Bottome first encountered Adler’s ideas and joined his circle, also saw two very different developments that together encouraged the “comprehensive psychologization” of Western culture. In 1924 the Hogarth Press began publishing Freud’s works “in authoritative English translation,” making his ideas about the talking cure available to a large Anglo-American readership (Micale 62).

The second development encompassed the adaptation of sound to cinema or rather, as Tim Armstrong has observed, the adaptation of the human “voice-sound located in the body-rather than sound per se.” The technological revolution altered the “visual language” of cinema (229).
Prior to the 1920s, silence had prevailed in both medicine and cinema. During the silent era of film, the language of the body had monopolized communication. Viktor Shklovskii, the great Russian Formalist had then characterized cinema as “conversation prior to an alphabet,” a non-verbal entertainment where montage and the body’s movement drove the narration (qtd. in Armstrong 231).

The TB specialists whom Bottome had consulted also practiced medicine as a “conversation prior to an alphabet.” The patient’s voice communicating a personal assessment of his/her condition did not count. Temperature charts, X-ray photos, the interior sounds of the body, and family history provided the basis for diagnosis. Silence itself constituted an integral part of treatment. Robert de Traz wrote the novel Silent Hours (1934), set in a TB sanitarium, as a “paean to [. . .] the daily regime of [. . .] silence,” lasting hours at a time in the alpine spas of Central Europe (232).

The sound revolution also enhanced cinema’s psychologization with the ideas of depth psychology because the coordination of voice and character on screen created more psychological integrity than the often-antic figures of silent cinema. At the same time the employment of the human voice altered the language of diagnosis and treatment in medicine as practiced by depth psychologists. Medical practice in the form of “talking therapy” now came into its own. With the coming of the “talkies,” individual ownership of the voice occurred on screen just as in psychotherapy the patient took ownership of his/her neurosis through verbal narration. Such ownership of both symptoms and treatment was particularly true of Adlerian therapy.  In the age of modernism, medicine as well as entertainment had been inflected by the sound of the human voice. It may be no coincidence that Private Worlds (1934), Bottome’s first novel adapted to the screen and written under the influence of Adler’s ideas, was set in a mental hospital. The voice in medicine as well as in cinematic entertainment converged in Bottome’s art.

Once they became members of Adler’s circle, Bottome and her husband could take comfort in the similarity of circumstances to those they had known when treated for TB, but familiarity did not always bring comfort. As in their treatment by alpine lung specialists, each was to have a very different experience and relationship with the depth psychologists whom they consulted. Bottome, for example, found Dr. Leonard Seif, the analyst whom Adler recommended they turn to while he lectured in America, more to her liking than Forbes-Dennis did and with good reason.

Temperamentally, Bottome believed, Seif and her husband were unsuited for each other. Describing the failure of their relationship, she wrote, “Ernan became increasingly unhappy in his work with Seif, and never reached the satisfactory relation he had [. . .] with Adler” (The Goal 166). The problem, she suggested, lay with Forbes-Dennis’s pride, “so sensitive and entire that it could not be touched safely by any but the lightest surgeon’s hand.” Adler, she added, “had those hands, and he loved Ernan as a friend” (The Goal 166).

The issue of pride, touched on by Bottome, arose because Seif privileged Bottome’s career over Forbes-Dennis’s. The analyst insisted that she make the trips to the United States in the early 1930s where, despite her fear and trepidation, she acquired a first-rate American publisher (Houghton Mifflin) and sold the movie rights to Private Worlds to Paramount. Seif believed that Bottome showed more promise than Forbes-Dennis -- that she was the breadwinner -- and her husband should therefore defer to what advanced her career rather than his own. Seif had also taken the feminist position, a basic tenet of the Adlerian approach. In Individual Psychology, women were treated as individuals. The period of analysis with Seif, as chronicled by Bottome’s biographer Pam Hirsch, proved difficult for Forbes-Dennis (177-178).

Seif’s advice disconcerted Forbes-Dennis in another way. In the fall of 1931 while under the analyst’s care, he received word that a beloved uncle who resided outside of Turin lay seriously ill. Seif intervened, urging him to remain in Munich to continue analysis rather than rushing off to Italy. Forbes-Dennis reluctantly agreed, belatedly traveling to Turin only to arrive too late (The Goal 174).

Yet Seif’s influence with the couple paled before that of Adler with whom they worked from 1935 to Adler’s death in May 1937—precisely the period in which Bottome wrote The Mortal Storm. In that interval, residing in Vienna, she “saw Adler every day, sometimes to attend his lectures, often to spend the evenings with him among his friends and constantly for private talks” (The Goal 250). She subsequently revealed that “Adler was the person in her mind when she wrote” The Mortal Storm (250). Bottome dedicated the novel to him, but she went even further in the American edition. In that version, as though correcting an oversight, she made the protagonist, the wise, Jewish scientist Professor Roth, a Nobel Prize Winner, and even more significantly, an expert on the treatment of tuberculosis. In fiction at least, she had merged the roles of therapist and lung specialist.

Even before residing in Vienna near Adler, Bottome sought his advice. In 1934 she was torn between continuing as a novelist or devoting herself to public lectures in America. Her account suggests that she met with Adler on a regular basis. Bottome wrote, “The problem I had to bring to Adler in New York was a professional one. Should I or should I not take full advantage of my newly found lecturing opportunities” (The Goal 230). Adler’s response was “But why do you not do both?” advising her against “taking too many precautions” in her life (The Goal 230). Adler had “removed all sense of urgency or tension from my problem” (230), she remembered gratefully. The real relief lay in Adler’s assuming responsibility for a major decision in her life.

Adler’s advice not only relieved Bottome of responsibility, it also solidified his relationship with Bottome and her husband. In 1935, she wrote of seeking Adler’s counsel for “the next [problem] we had to solve”:

where best to found our permanent home now that the two dictators had driven us out from our flat in Munich and our villa on Italian Lake Orta [. . .] Adler made no suggestion as to our future home, beyond saying that as he himself was to pass the summer in Vienna, he very much hoped that we might be able to do the same (The Goal 236).

They joined him in Vienna without hesitation.

Adler possessed a quality that distinguished him from other depth psychologists, not to say the lung specialists she had consulted over the years. He made her feel, Bottome writes, like a participant as well as a patient, someone with her own voice: “talks with Adler differed from the treatment with Freud and Jung. There was no authoritarian approach, no hint of a couch. Adler sat opposite as a fellow worker. Whatever material he gave you, he expected you to work it out with him” (The Goal 251).

However much Adler lacked an “authoritarian approach,” the “working out” did not include the freedom to reject his advice. Bottome succumbed to Adler as she had once succumbed to Huggard rather than be “driven from his door.” She was as much a disciple of the Austrian psychologist as she had been while an awe-struck tuberculosis patient. She told her friend Lady Bonham-Carter in 1941, “I want to devote the rest of my life to disseminating [Adler’s] ideas.”5

Although Adler was an improvement over the authoritarian lung specialists, and an exception among psychologists of his day, his influence on Bottome was not always light or disarming. The psychologist insisted in the fall of 1935 that although, as Bottome wrote, both she and her husband “wanted to be together [. . .],” remaining in Vienna, a city they knew well, Adler advised them otherwise. He insisted they do the opposite of what they preferred. As a result, a kind of power struggle ensued, the resolution of which only increased Adler’s influence in their lives. The analyst advised, as Bottome explained,

that we should separate in October [. . .], Ernan remaining alone in Vienna while I went to London to fix up for us both a temporary home. Reluctantly we agreed to follow his advice [. . .] I was horrified at the very idea of facing England alone, and more than willing to remain in Vienna. (The Goal 256).

They hesitated, determined to remain together in the Austrian capital. Adler’s response to their resistance was harsh: “Are you going to do what I advise or not?” (256). To Forbes-Dennis’s dismay his wife caved before Adler’s anger at their new-found independence. Bottome on the other hand remained conflicted by her divided loyalties to Adler and Forbes-Dennis.

Once in England she at first found little resolution. “I went alone to England [. . .] no one knew me [. . .] what confronted me now was a wilderness of strangers” (The Goal 256-257). She nonetheless sold The Mortal Storm to Faber and Faber. She also began to earn notoriety as “a premature anti-Nazi” (The Goal 258), because, as she wrote, she awakened an England that had “gone Nazi in its sleep” (The Goal 259). The Mortal Storm, first in Britain and then in the United States, became a weapon against fascist sympathies. Forbes-Dennis joined her in the fight against appeasement and found new life and renewal for himself as well.

The influence of Seif and Adler had had the same effect. However difficult it may have been to accept their advice, it proved a powerful corrective, certainly in Bottome’s case, to behavior that might have defeated her talents. As painful as it was for her to separate from Forbes-Dennis, in going to the United States in 1931 and to England in 1935, the result proved vital in launching and sustaining her career as a novelist with an international reputation able to sell her fiction to Hollywood. As a result, Bottome became an effective propagandist for aid to Britain in the United States, on the lecture circuit, and on screen. The MGM adaptation of The Mortal Storm figured in the pivotal Presidential election of 1940, when President Franklin Roosevelt won a third term and confirmed the policy of aid to Britain for which Bottome had advocated so forcefully. Re-released in 1941, the film had a second life, encouraging the American public to accept the reality of war in the months before Pearl Harbor.6

Adler’s Influence on Bottome’s Mature Fiction

For Bottome at least, the “tyranny of therapy” proved eminently beneficial for her literary productivity and cultural impact. The experience of authoritarian medical regimes spurred her activism in the face of Hitler’s rise, and Adler’s ideas proved crucial to her literary success and her plot-making. She said of her short story collection, Masks and Faces, which she distributed to the cast of The Mortal Storm, that five of the nineteen stories “are Adler subjects treated in an Adler way.”7 The example of Adler himself proved crucial in crafting the protagonist of The Mortal Storm. Adlerian therapy worked for Bottome as a patient and a novelist.

Bottome’s two most successful novels, Private Worlds and The Mortal Storm, owed the most to Adlerian psychology. Each was a bestseller and bought by Hollywood. Private Worlds earned its A-list star, Claudette Colbert, an academy award nomination. The novels’ respective settings, so different, hide a basic truth: both turn on the same Adlerian plot and originate with Adler himself. Before writing Private Worlds, Bottome and her husband traveled with Adler in Britain, visiting mental institutions and psychiatric clinics. She interviewed psychiatrists and other mental health practitioners, some of whom inspired the characters in the novel. Likewise, The Mortal Storm is strongly influenced by Adler and Adlerian principles, particularly those that encouraged Bottome’s own deeply held convictions as a feminist. The Mortal Storm, in fact, can be read as a credo for women’s emancipation as much as an anti-Nazi novel in support of persecuted German Jews.

The similarities between the two novels are striking. Each is driven by sibling rivalry and turns on the same course of events. In Private Worlds the protagonist Jane Everest loses her fiancé when her revered older brother orders her future husband executed for cowardice and desertion on the Western Front. The brother will not allow his displacement in the family order by a rival in the form of a fiancé. With the subsequent death of all her brothers as well as her fiancé at the front, Jane goes on to study medicine, become a psychiatrist, and marry a fellow physician who respects her as an equal.

In The Mortal Storm the protagonist Freya Roth also loses her fiancé, also ordered shot by a beloved older brother. Her fiancé dies attempting to cross the Austrian border to escape persecution in Germany, and Freya herself is subsequently forced to abandon Germany. She makes her way to the United States to take up a research fellowship in medicine. Her future marital status is left open, but she, like Jane Everest, escapes the deadly authority of a dictatorial male sibling and finds independence and professional fulfillment in medicine.

Bottome had much to draw on from Adler in writing those two novels. Adler, unlike the other two “giants of Vienna,” as she labeled Jung and Freud, advocated for women’s independent right to a profession. Adler, who had broken with Freud and his circle in 1910, believed that women were especially well-suited to medicine, a belief Bottome embodies in her two protagonists, Jane Everest and Freya Roth. Adler made a point of advancing Bottome’s career over her husband’s, as did his associate Seif. But there was something more at work. The two psychiatrists advertised the Adlerian commitment to women’s emancipation, separating themselves from their Viennese rivals. Forbes-Dennis particularly resented Seif’s advice, but he also chafed at Adler’s (The Goal 138). In the end both submitted to the advice of their analysts. Creatively, Bottome prospered. In the end, Forbes-Dennis too found a calling. He arranged Adler’s lecture tours and became a successful Adlerian analyst in his own right.

The foregoing raises further questions regarding the similarities between late nineteenth-century cures for tuberculosis and the embrace of depth psychology at a particular cultural moment a few decades later. Both the treatment of tuberculosis and the theories of Swiss and Viennese depth psychologists could trace their origins to German romanticism. At the same time each represented a form of German medical practice or more broadly the cult of German science, scholarship, and inventiveness that dominated Western thinking in the last quarter of the nineteenth century and continued up to the outbreak of the second world war (Eksteins 55-94).

In the treatment of tuberculosis, as Thomas Dormandy has pointed out, the German romantic belief in the mystical purity and healing power of the mountains spurred the attempt to cure lung diseases in alpine settings. By the same token, the early depth psychologists were themselves steeped in the Romantic tradition. Freud for one was a devoted reader of German Romantic poetry and could quote it by the hour. The German Romantics as well as those in France and Britain “had sought the roots of creation in the unconscious” (Gay 128). In Coleridge’s well-known phrase, the origin of poetry lies in “the twilight realms of consciousness”—as do the treatment of neuroses, Freud might have added.

But those who practiced seemingly scientific medicine also had more traits in common with the Romantics, as Thomas Mann suggests. Neither the psychiatrists nor the clinicians could claim the confirmation of hard science as to the efficacy of their treatments. Diseases of the lungs, like the neuroses of the mind, drew the afflicted to expert medical practitioners whose treatment allowed no deviance from what was prescribed as though dominance and obedience made up for the lack of hard scientific evidence regarding the efficacy of their medical regimen.

Bottome has provided an autobiographical account of how her treatment for tuberculosis in her youth, consciously or unconsciously, encouraged her subsequent embrace of Alfred Adler’s Individual Psychology. It might be said that Bottome and her husband had also, perhaps unconsciously, sought replacements for the lung specialists who had once ruled their lives. They found them in Adler and his “trusted colleagues.” In a broad sense treatment for TB encouraged those once afflicted with lung disease to embrace the psychological enterprise that had emerged by the first decade of the twentieth century.

In recounting her relationship with Adler and his influence on her, Bottome used the same language of submission and dependence that she had used in describing her relationship to the lung specialists she encountered when under treatment for TB. Before World War I her husband shared those attitudes, relinquishing responsibility for life decisions to one medical specialist or another. Their susceptibility to the dominance of depth psychology following extended treatment by TB specialists suggests a broader issue. Such submission encouraged the rapid embrace of psychological analysis as practiced among the Viennese group around Freud. Both clinical medicine and psychoanalysis in the early twentieth century demanded obedience to unquestioned expertise. Mann in The Magic Mountain on the other hand, depicts clinical medicine and depth psychology in competition with each other. To Mann, neither type of specialist deserved respect. For Bottome medical expertise was additive, one type of expertise confirming the worth of another.

Adler encouraged engagement with social reality in his emphasis on the individual in the family and the family in society. The heart of the matter in an Adlerian analysis does not lie with long-repressed sexuality held within an elusive unconscious. It lies with the responsible, conscious individual who sets goals and makes choices. Paradoxically, Adler at the same time assisted Bottome and her husband in moving seamlessly from the dominance of one set of experts to another, namely his own circle. Sensitive to both anti-Semitism and perhaps less consciously to her own willing submission to authority, Bottome recognized the fascist threat in the 1930s, earning her the label of “premature anti-Nazi” (The Goal 58). Such sensitivity to coercion and domination lay at the intersection of clinical medicine and Adlerian psychology in the age of modernism/intermodernism. At that intersection also lay the source of Bottome’s mature fiction.


1 See Armstrong on the importance of the body to modernism.

2 Such historical conflict between Slavs and Germans in eastern Pomerania and north-central Poland is a theme of Günter Grass’s The Danzig Trilogy.  Grass was himself of Kashubian descent.

3 See Robert Heynen (699) on the competition between the two specialties in Weimar Germany.

4 Phyllis Bottome to Ann Watkins. British Library, Manuscript Collection, Bottome Papers. Add. Mss. 10308. 2/15/1947.

5 Phyllis Bottome to Lady Bonham-Carter.  BL Add. Mss. 88921/3/3. no date.

6 There is growing literature on Bottome, and on The Mortal Storm in particular. See Hirsch; Pogorelskin; Lassner and Pogorelskin, “Exiled to Hollywood” and “An Anti-Nazi Special Relationship”; Lassner; Lassner and Hoder-Salmon, forward to Bottome, The Mortal Storm; Lassner and Hoder-Salmon, forward to Bottome, Old Wine; Suh; Dinsman.

7 Phyllis Bottome to Mr. Popham. BL Add. Mss. 88921/3/3. October 7, 1940.

Works Cited

Armstrong, Tim. Modernism, Technology, and the Body: A Cultural Study. Cambridge UP, 1998.

Bluemel, Kristin, and Phyllis Lassner. “Feminist Inter/Modernist Studies,” Feminist Modernist Studies, vol. 1, 2018, pp. 1-2, 22-35.

Bottome, Phyllis. Search for a Soul. Reynal & Hitchcock, 1948.

---. The Challenge. Harcourt, Brace, 1953.

---. The Goal. Faber & Faber, 1962.

---. Old Wine. 1925. Forward by Phyllis Lassner and Marilyn Hoder-Salmon. Northwestern UP, 1998.

---. The Mortal Storm. 1938. Forward by Phyllis Lassner and Marilyn Hoder-Salmon. Northwestern UP, 1998. 

---. Correspondence in British Library (London). Manuscript Collection. Add. Mss.

Bynum, Helen. Spitting Blood: The History of Tuberculosis. Oxford UP, 2012.

Dinsman, Melissa. “Mrs. Miniver Builds the Home Front: Architecture and Household Objects as Wartime Propaganda.” Modernism/Modernity, vol. 3, cycle 1, 2018, pp. 29-35.

Dormandy, Thomas. The White Death: A History of Tuberculosis. New York UP, 2000.

Dubos, René, and Jean Dubos. The White Plague: Tuberculosis, Man, and Society. Rutgers UP, 1996.

Eksteins, Modris. Rites of Spring: The Great War and the Birth of the Modern Age. Houghton Mifflin/Mariner Books, 1989.

Gay, Peter. Freud: A Life for Our Time. Doubleday/Anchor Books, 1989.

Heynen, Robert. “Cultures of Confinement: Health, Illness, and Madness in The Cabinet of Dr. Caligari and The Magic Mountain.” Modernism/Modernity, vol. 25, no. 4, November 2018, pp. 683-708.

Hirsch, Pam. The Constant Liberal: The Life and Work of Phyllis Bottome. Quartet, 2010.

Lassner, Phyllis. British Women Writers of World War II. St. Martin’s Press, Inc., 1998.

Lassner, Phyllis, and Alexis Pogorelskin. “Exiled to Hollywood: British Cinema, the Plight of Europe’s Jews, and the Case of The Mortal Storm.” Journal of European Popular Culture, vol. 3, no. 2, 2012, pp. 143-154.

---. “An Anti-Nazi Special Relationship: British Filmmaking, Hollywood Writing, and The Mortal Storm.” Hidden in Plain Sight: Jews and Jewishness in British Film, Television, and Popular Culture, edited by Nathan Abrams, Northwestern UP, 2016, pp. 49-68.

Mann, Thomas. Diaries, 918-1939. Translated by Richard and Clara Winston, Robin Clark, 1984.

---. The Magic Mountain. Translated by J.E. Woods, Vintage Books, 1996.

Micale, Mark S. “The Modernist Mind—A Map.” The Mind of Modernism: Medicine, Psychology, and the Cultural Arts in Europe and America, 1880-1940, edited by Mark S. Micale, Stanford UP, 2004, pp. 1-19.

Pogorelskin, Alexis. “Phyllis Bottome’s The Mortal Storm: Film and Controversy.” The Space Between: Literature and Culture, 1914-1945, vol. 6, 2010, pp. 39-58.

Suh, Judy. Fascism and anti-Fascism in Twentieth Century British Fiction. Palgrave Macmillan, 2009.

Van Dijck, José. The Transparent Body: A Cultural Analysis of Medical Imaging. U of Washington P, 2005.


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