Craig Fees, 'Dr. Josephine Mary Lomax-Simpson – ‘Doc’ (11 March 1925 – 25 May 1999): Founder of Messenger House Trust therapeutic communities (1970-1987) and of Hutchinson Settlement for students (1977-1987)', THERAPEUTIC COMMUNITIES 20:3 (1999), pp. 231-236
“I had nits twice myself as a child, and I consider it a qualification for any child psychiatrist…I also couldn't read. That's a very good qualification for a child psychiatrist too.”
At irregular intervals over the past few years the telephone would ring, and I would dash downstairs leaving the children in the bath, knowing in my heart of hearts that at that time of night it could only be Josephine Lomax-Simpson and that she would be asking me, by way of invitation, when I was planning to come down to Wimbledon again. With something of the sensation of being in a roller coaster just before it drops, we would set a date. Apart from ensuring that the tape recorder and the car were in good working order, there was almost nothing else I could do to prepare. We almost never did what she said we would. If I went down to interview her we would be off like a shot to visit the only patient who had ever seriously tried to kill her. Or to be surrounded by a life-time of paintings and fed impromptu dinner in her studio flat by a Polish-born artist who had fled Paris with her husband-to-be in advance of the Germans. Or pop in unannounced for lunch on the Messenger House Trust single mother – a woman now with a lovely grown-up family - behind the invention of “Smarties”.
Having begun her professional life in conventional hospitals, and then stepped outside them as a child psychiatrist into children’s homes, Josephine Lomax-Simpson had progressively created around herself a therapeutic community without walls, realising in her own way the project begun at Dingleton under Maxwell Jones. For a brief time in the late 1970s and early 1980s, when she was a member of the ATC’s Steering Group and Convenor of its Supervisor’s Group, she tried to situate her work within the mainstream of the therapeutic community movement; but came to realise that the core of the ATC was firmly institution-based, and that the kind of exploded therapeutic community within the community which she had created in the Messenger House Trust would remain on the fringe. She concentrated her attention, in what no one I think believed could be her last years, on ensuring the survival of the family which had grown up intentionally around her; “to make quite certain that when I die the whole family does not collapse.” Talking about her death and weaving people’s lives together were an integral part of her thinking; the phone call to me was part of her calculation. She might appear to be gliding through lives like a Society dame; but inside she was fiercely, creatively acting.
She did dangerous work. In the Messenger houses spread around the community there were residents who were rootless and homeless, bound together by meetings and meals, by students and voluntary helpers, and by their babies and by their responsibility to and for one another. But they were also bound by their own internal chaos and deprivation and need; some dependent on drugs, some into crime, some in prostitution. There were no live-in therapists in the houses, and it didn’t always work; there was occasionally violence and destruction. One of the (ultimately) nine houses had to be closed down in the end to resolve its problems. Looking back, it was in some ways an unthinkable project; she knew it would probably no longer be allowed. On occasion she reflected that she was lucky to have survived unscathed by the law.
But there was also an immense social and therapeutic common sense, and the fact is that it tended to work. By drawing neighbours, policemen, clergy, social workers and others into the work of the Trust and into the meetings with residents, it tended to work. By giving residents the secondhand furniture donated by neighbours, to use in their rooms and then take with them when they moved on; and by relying on the residents themselves to hold the houses together, it tended to work. “Smarties” – Doc’s trademark alternative to prescribing anti-depressants – were invented by a single mother who had kept another resident alive following a drug overdose, the third she had handled that week. ‘Why not give them Smarties instead’. Which Doc did, and found that it worked. She never lost a patient to suicide. And she created in Smarties – a commercial sweet or candy - a quietly powerful, physical symbol of belonging, readily available; which, unlike prescription pills, a drunken or depressed young mother could safely lose on the floor without potentially killing her baby.
Several weeks ago I was phoned by a woman of 55 who had first met Josephine as a 13 year old in a children’s home for maladjusted children. What was special about her? ‘You could call her up at two o’clock in the morning and she didn’t mind’. Years would go by, and then the girl/woman would need to ring. Josephine’s memory was so exceptional, and it worked with such alacrity, that she would immediately be with the person, and would surround them with a knowledge of their own history and connections. And where that was lacking, she was happy to weave in her own, to give people a sense of belonging to herself and to her own history; akin to Melvyn Rose’s development of the sense of the history within the place, Peper Harow.
The history that she gave depended to some extent on the needs of the person with whom she was working. If your child had nits, she had had nits as a child. If you couldn’t read, she couldn’t read. If you had a lost person in your life, she had lost a brother, through the incompetence of doctors, as he was being born.
But there was a more general history. When the Association of Therapeutic Communities met for its October conference at the Messenger House Trust in 1980, she took the Trust’s history back to the 1880s, when her grandfather designed model homes for working-class families in Bolton, Lancashire; and to her father’s work on the designs for Port Sunlight on Merseyside, “the community preceding all other experiments in planning the environment”, between 1910-1934.
Her own personal awakening she took back to 1939. With the spectre of the imminent mass bombing of London, five children from industrial, working class Wandsworth were evacuated to Whinfold, the rural Worcestershire home of Lord Leverhulme’s close friend and Unilever Company Architect, James Lomax-Simpson. Fourteen year old Josephine was made responsible for them, and over the course of the next year discovered a world and intimations of a vocation which transformed her life. Apart from anything else she discovered in these deprived and dislocated children, who had never seen a bath, who considered it a punishment to have a bed to themselves and devised elaborate procedures to decide who would have to sleep alone, a capacity for play which she herself said she didn’t have. They let her play with them.
She went on to take her medical degree at Aberdeen in 1948, did paediatrics in Australia – where her memory and experience enabled her to diagnose a rare case of Von Girkes disease in Sydney - adult psychiatry in Oxford, and child psychiatry at the Child Guidance Training Centre under William Moody and Susanna Davidson, among others, in 1952-53. In 1954 she was appointed psychiatrist to Hartfield House Children’s Home, the London County Council’s pioneering special unit for emotionally disturbed children in Roehampton, and her vocation blossomed. She became actively involved with the founding years of the Association of Workers for Maladjusted Children (now the Association of Workers for Children with Emotional and Behavioural Difficulties), which she considered a kind of precursor to the Association of Therapeutic Communities. She became involved in the Planned Environment Therapy Discussion Group founded and run by Marjorie Franklin. And she counted Donald Winnicott among her influences and friends (indeed, years later Winnicott did a Christmas card for the Messenger House Trust, and with permission she posthumously named one of the Trust’s houses after him).
But it was the knock on the door of her flat in Chelsea one night in the early 1960s, by a girl who had been at Hartfield House and who had sought Josephine out because she had nowhere else to stay, that led specifically to the Messenger House Trust. Although this girl was the first, it was clear she would only be the first, and in 1963 Doc bought a house to accommodate the flow of homeless young people which came. She christened the house “Whinfield”, combining the name of her own childhood home, “Whinfold”, with that of Hartfield. It became a place of meals and meetings and community, and led to the foundation in 1970 – primarily for homeless young women with babies – of the Trust, named for Doc’s mother. With loans and donations the Trust grew rapidly – Messenger House opened in 1970, Thorley House in 1973, Mollie Lee House in 1974, Hayward House in 1975, Winnicott House in 1976, Selwyn House and Sansovino in 1977, Eileen Younghusband House in 1978, and Gwen Capel House in 1984 - the names embodying benefactors, family, friends, and colleagues who had inspired and supported the work of the Trust over the years. In 1977 she created the Hutchinson Settlement for students, who lived in Selwyn House in return for giving a tenth of their time to the Trust. Between the two, and up to the time they were wound up in 1987, some five hundred young people had passed through her hands.
When I first met and interviewed her in 1991, Josephine had just retired from the National Health Service, having given up her posts as Consultant Psychiatrist/Family Therapist at the East Grinstead Family Consultation Centre and as Consultant Psychiatrist at the Nelson Hospital in Merton the year before. She had surrendered the Messenger House Trust and transferred its properties to the Leonard Cheshire Foundation in 1987, four years earlier; giving up her post as Consultant Psychiatrist at the Wallington Day Hospital in Croydon in the same year. She remained an extremely busy person, with private patients and the Large Group which she had first convened in 1975; and she had found a way to remain therapeutically involved in people’s lives and to weave therapeutic relationships among members of her extended ‘family’ to bind them together, without any sense of ‘client’ obtruding into or complicating the work that almost invisibly was going on. But she was struggling with loss; and she was struggling with the problem of her death and with the life of the ‘community of concern’ which her endless weaving helped to sustain, and the community of which was inevitably focused on her.
The Messenger House Trust had not been able to survive her attempts to let go of it; and the pain of that and of that closing was still very evident. Something which added to the pain, I think, was a kind of inarticulateness which Doc felt within herself. She was not at peace with words. Unlike Barbara Dockar-Drysdale (whose obituary appeared in Therapeutic Communities 20:2) - whose social background was in many ways similar and who shared many personal and professional spaces – she did not have a poetry which conveyed in language the beauty and complexity of what she was doing, and it was easy for what she was trying to say to get lost or to be misunderstood or even discounted. Something of the real poetry in Doc’s work was in the way that people suddenly found themselves being places and doing things that they would never have expected, but which seemed in retrospect obvious; with the sense that they had grown, and that they had done someone a service; and that they belonged, however briefly, to something larger than themselves which had a sense of understated love and concern.
She was also someone who was not embarrassed by paradox or the need to do what needed to be done. Knowing the effect of introducing an outsider into a therapeutic environment, she once stopped a passing neighbour outside one of the Messenger House Trust houses, asked him if he were a gentleman, and when he replied “Yes” (what else could he say?), told him to come with her. He duly followed her into the house, where his simple entrance prevented a furious resident from pouring boiling oil over one of the Trust’s voluntary workers. She raced to another crisis one night in her night gown, knowing that speed was of the essence, and that the incongruity and the absurdity of the picture would in itself defuse the situation. She was prepared to do apparently simple-minded or absurd things, if it achieved the aim; and she was an extremely creative and resourceful person in that respect. The problem was confusing that with the person at furious work underneath.
Never having seen her at work within the Messenger House Trust I do not know what, in that situation, she was like. Having been introduced into her world as an outsider – meeting people who had been boys at Hartfield, or clients from her time at the Child Guidance Centre even earlier; having seen the children and in some cases the grandchildren of the single mothers who came into Messenger House Trust – many of whom would otherwise have been separated from their babies by conventional social services; seeing her at work like an old woman knitting futures on the couch while reminding a “client” of her state of mind nearly forty years ago when caught up in the mix of magistrates, street sex, and abandonment; feeling the amusement, annoyance and affection she provoked, and her responses to it; I came to understand something of the complexity and depth behind the phrase she used, “continuity of concern”.
Latterly she had developed this into “community of concern”, perhaps in an attempt to help her to hand over her central position and to conjure the reality. But hand over to whom, and how? Communities, to survive as communities, need focii of belonging: objects, or tasks, or rituals, or people, or history, or events through which an identity of belonging is experienced and ratified. For many years the primary focus of the community was Josephine herself, with Smarties as a kind of communal object. Could it survive without her?
In practice, and for a considerable time now, much of the day-to-day work in maintaining the community has been carried out by Audrey Beaton, who first joined the Trust in 1976. She remains an active presence. The Large Group first convened by Doc almost twenty-five years ago is still meeting; it played an important supportive role during her own final crisis, and as a permeable group into which many who knew Doc at one time or another will have passed, if it survives it also embodies a potential for continuity. In a different dimension altogether, over the past few years Josephine spent considerable time painting small characteristic pictures, incorporating some of their loved objects such as teddy bears or dolls for the many children in her community; creating the potential, over time, for their recognition of shared belonging: “Who painted that?” “Doctor Lomax-Simpson” “Who was Doctor Lomax-Simpson?”
Josephine Lomax-Simpson was a creative and resourceful person. She set herself the task of ensuring that the family she had built around her did not collapse when she died; and having been in touch with some of them since her death, I think that at least has probably been achieved. Her legacy for others is the community of concern which she left behind; a family still vigorously involved with each other.
As for herself: In hospital, deprived of speech by the brain tumor which then killed her, she apparently gave up the struggle to talk and, for a short while, surrounded by the former Child Guidance children, Messenger House Trust families and grandchildren who insisted on seeing her there, she was at peace. It was the first time, according to someone who had known and worked with Doc for many years, they had seen her that way.