‘The results of psychotherapy cannot fairly be judged by the patient’s condition at the termination of treatment.’
Mary Constance Luff was born in Marylebone, London in 1897[1]. She qualified MRCS, LRCP in 1925, having attended Newnham College, Cambridge, and University College Hospital, London[2]. In the summer of 1923 Mary Luff married Philip Wiles at St George Hannover Square, London[3]. Philip Wiles went on to become a consultant orthopaedic surgeon at the Middlesex Hospital[4].
Mary Luff started her career in psychiatry in 1927[5] and in 1930 joined the Tavistock Clinic[6], where she quickly made her mark and was elected to the Tavistock’s Medical Committee in 1931[7]. Then in 1933 when JR Rees became the Medical Director, he appointed Mary Luff to be one of the two Assistant Medical Directors[8]. She was responsible for the efficiency of the medical administration[9] and for organising case records in a way that could easily be abstracted[10].
In 1935 she used these records to publish, in the British Medical Journal[11], probably the best pre-World War 2 follow-up study of the effects of the treatment on neurotic disorders three years after discharge[12]. This report showed that across the board 65.6 per cent of patients were improved at the end of treatment and 55 per cent remained improved three years later[13]. Anxiety states did better, with 80 per cent improved at discharge and 64 per cent still improved after three years[14]. The most stable benefit (73 per cent) was for patients with sexual difficulties[15].
Around the same period Mary Luff also worked with Henry Dicks investigating the clinical value of intravenous barbiturates for hypno-analysis[16]. Although they found it to be of some use in diagnosis they found it to have no value for treatment[17]. Some years later similar conclusions were reached following the experiments of William Sargant, from the Maudsley, into the use of sodium amytal for cases of shell shock during World War 2[18].
At the start of World War 2, in 1939, Mary Luff joined the Emergency Medical Services as a psychiatric specialist at Stanboroughs in Watford (one of London’s four centres for receiving air-raid casualties). In the event few patients were ever received and Mary Luff was released to return to the Tavi, which had been evacuated to Westfield College, a small college that was part of the University of London, situated on Kidderpore Avenue, Hampstead[19].
Returning to the Tavi Mary Luff initially resumed part-time duties, but, as the Director JR Rees had been called up, she became the Acting Director in late 1939[20] – becoming the first woman to be in charge of the Tavistock Clinic. Then with the coming of the Blitz in 1940 she left the Tavi to take her children to the safety of the United States[21].
Other women soon followed Mary Luff as wartime heads of the Tavistock Clinic: Jane Isabel Suttie (who had been responsible for translating many of Sándor Ferenczi’s papers into English[22]) became the second woman to be in charge of the Tavi[23]. Margherita Lilley then became the third woman to be in charge of the Tavi[24], though she was never accorded the rank of Acting Medical Director[25]and finally, in 1944, Rosalind Vacher became the Acting Director[26].
Mary Luff returned to the UK and in 1941 became a Major in the Army, taking part in selection work with the Women’s Service[27], before transferring to the Royal Army Medical Corps (and the Invisible College) to become head of the psychiatric unit at Shenley Military Hospital[28].
In general, the war years were a catalyst for women to work in more roles[29]. As men were called up, women were needed to fill their positions in industry, such as the many employed as munitions workers, parachute riggers and mechanics. Many women entered the services often taking up new roles such as wireless operators and codebreakers. For example 75% of the workers at the Bletchley Park military intelligence were female[30]. Also, during the war the marriage bar was suspended, so married women were able to take up white collar occupations such as teaching or the civil service[31]. Similarly, women already in roles were able to take up more senior positions during the war, so just as Mary Luff became Acting Director at the Tavi and then a Major in the Army, so Margaret Posthuma[32] and then Kathleen Todd[33] became Acting Directors at the London Child Guidance Training Centre. Although there was a general shift in working patterns, evidence suggests that the biggest change was experienced primarily by women in the top half of the education distribution[34].
After the war Mary Luff returned to the Tavistock Clinic and was elected to the Interim Medical Committee (IMC), chaired by Wilfred Bion[35]. By October 1945 the IMC was already debating the size and nature of senior permanent staff[36] and inviting former Army colleagues from the Invisible College to join the Tavi. This committee soon became the real power inside the Tavi and started organising the Tavi around democratic rather than hierarchical principles as Bion began implementing his war-time theories of groups at the Tavi. To facilitate this new socio-political approach Mary Luff and Henry Dicks resigned their positions as Assistant Directors[37].
Under Bion’s leadership ‘Operation Phoenix’ was put into action[38]. New staff were co-opted from the military, including Eric Trist[39] and Jock Sutherland[40], who were soon followed by John Bowlby[41] and John Rickman[42]. In November 1945 the Tavi inaugurated a new era by moving into new premises at 2 Beaumont Street and establishing the principles of Tavistock Institute of Human Relations (TIHR)[43], which would carry out new social and preventive psychiatric work[44] applying psychodynamic ideas to social techniques and industrial relations[45].
The TIHR was formally established as a separate entity in September 1947[46] and Mary Luff was one of founder members, along with Elliott Jaques, Henry Dicks, Leonard Browne, Ronald Hargreaves, John Rawlings Rees, Wilfred Bion and Tommy Wilson. With the Tavistock Clinic joining the NHS in 1948 this incorporation as a separate identity was important, as it meant that it could take on work beyond the boundaries of medicine[47], take grants from sources and form partnerships with organisations that would not have been possible for the Tavistock Clinic as part of the NHS. Thus the TIHR was founded with a grant from the Rockefeller Foundation[48] (through the agency of the already existing Tavistock Institute of Medical Psychology) and from the outset developed a close relationship with the MIT (Massachusetts Institute of Technology)[49].
As well as her role in founding the TIHR, Mary Luff was integral to getting the Tavistock Clinic ready to join the NHS. In April 1946 she went with JR Rees to meet senior commissioners within the Ministry of Health[50], which confirmed that the clinical side of the Tavistock’s work would remain much the same. A separate meeting with Sir Francis Fraser of the Ministry of Health showed that the pre-war plans to increase training and develop the Tavistock Clinic into a post-graduate teaching institution would be completely out of step with plans for the new NHS. Each medical discipline would have just one post-graduate teaching institute[51]. The Tavi was too small, it had no beds and could not hope to be designated a post-graduate institute with teaching status. The official post-graduate teaching was to be concentrated at the Maudsley under Aubrey Lewis[52].
Although this was a huge blow to the aspirations of the Tavistock Clinic, in practice it meant that its more academic functions fell to the TIHR to develop teaching and education in psychological medicine and the behavioural sciences[53].
Towards the end of 1946 Mary Luff once again stepped back from her near full-time responsibilities at the Tavistock Clinic to meet her domestic responsibilities[54].
In the immediate run up to joining the NHS the new Clinical Director, Jock Sutherland, decentralised the work of the Adult Department into self-contained clinical units. Mary Luff (on a part-time basis) and John Kelnar were put in charge of these autonomous units[55]. In 1948 she also took charge of a newly established therapeutic social club at the Tavi, based on Bion’s wartime Northfield Experiment[56].
In 1949 Henry Dicks and Mary Luff began working together on a new line of research, a pilot study into the field of marital difficulties[57]. Similar to the wartime experiments with groups, Henry Dicks and Mary Luff treated husband and wife together at the Tavistock Marital Unit in a joint interview—a four-person session involving both partners and both psychiatrists[58]. This provided Dicks and Luff with the opportunity to observe patterns of interaction that would normally be hidden[59]. Together they established the essential techniques and concepts from which the Tavistock Marital Unit grew. Mary Luff never put her name to any of the publications that resulted from this work[60]. Initially the unit operated as a research team, but this was abandoned because of lack of adequate funding and so it became a clinical unit for the treatment of disturbed marriages[61].
In the same period marriage became the subject of another organisation: the Family Discussion Bureau (now known as Tavistock Relationships). This was established in 1948[62] by the Family Welfare Association to offer marriage counselling services. It came about in response to the high incidence of family breakdown after the war, following recommendations by the government’s Harris Committee[63]. The Family Discussion Bureau was established by three more pioneering women: Alison Lyons, Lily Pincus and Enid Eicholz (later to become Enid Balint); to develop a deeper understanding of the forces underlying marital difficulties and develop therapeutic and preventative interventions[64].
In 1956 the Family Discussion Bureau joined and became part of the TIHR[65]. Both the marital unit at the Tavi and the Family Discussion Bureau held similar concepts and used similar approaches, with the psychoanalytic concept of transference used as the basis for understanding the dynamics of the marriage relationship[66]. The Tavi’s Marital Unit was perhaps more overtly psychiatric[67], but once within the TIHR (and with its support) the Family Discussion Bureau was also able to take on a role of providing teaching to probation officers and magistrates courts[68], while the marital unit focused on the internal teaching of registrars[69].
Mary Luff retired from the Tavistock Clinic in 1958[70]. She and her husband moved to Jamaica, where Mary helped to set up the island’s first family planning clinics[71].
Mary Luff died on 14 September 1993 aged 95[72].
Author: Glenn Gossling
Bibliography
Mary Luff, ‘A case of obsessional neurosis closely allied to schizophrenia. In Individual psychology and sexual difficulties’, p54-66, Individual Psychology Medical Pamphlets, no. 3, C. W. Daniel, 1932,
Mary Luff, ‘Emotional conflicts between husband and wife’, p9, Parents and Teachers 1, no. 2, 1934
Mary C Luff and Marjorie Garrod, ‘The After-Results Of Psychotherapy in 500 Adult Cases’, p54-59, British Medical Journal, London Vol. 2, Issue 3888, 13 Jul 1935
Quotes
‘The results of psychotherapy cannot fairly be judged by the patient’s condition at the termination of treatment.’[73]
[1] England and Wales Birth Registration Index, 1837-2008
[2] Kevin Flintan, ‘Obituary’, p 1491, British Medical Journal, Vol. 307, Issue 6917, 4 December 1993
[3] England and Wales Marriage Registration Index, 1837-2005
[4] Kevin Flintan, ‘Obituary’, p 1491, British Medical Journal, Vol. 307, Issue 6917, 4 December 1993
[5] Kevin Flintan, ‘Obituary’, p 1491, British Medical Journal, Vol. 307, Issue 6917, 4 December 1993
[6] HV Dicks, 50 Years of the Tavistock Clinic, p333, Routledge, 1970
[7] HV Dicks, 50 Years of the Tavistock Clinic, p51, Routledge, 1970
[8] HV Dicks, 50 Years of the Tavistock Clinic, p56, Routledge, 1970
[9] HV Dicks, 50 Years of the Tavistock Clinic, p56, Routledge, 1970
[10] HV Dicks, 50 Years of the Tavistock Clinic, p63, Routledge, 1970
[11] Mary C Luff and Marjorie Garrod, ‘The After-Results Of Psychotherapy in 500 Adult Cases’, p54, British Medical Journal, London Vol. 2, Issue 3888, 13 Jul 1935
[12] HV Dicks, 50 Years of the Tavistock Clinic, p69, Routledge, 1970
[13] HV Dicks, 50 Years of the Tavistock Clinic, p70, Routledge, 1970
[14] HV Dicks, 50 Years of the Tavistock Clinic, p70, Routledge, 1970
[15] HV Dicks, 50 Years of the Tavistock Clinic, p70, Routledge, 1970
[16] HV Dicks, 50 Years of the Tavistock Clinic, p68, Routledge, 1970
[17] HV Dicks, 50 Years of the Tavistock Clinic, p68, Routledge, 1970
[18] B. Shephard, War of Nerves, p215, Jonathan Cape, 2000
[19] The Tavistock Clinic, Report for the period 1st January to 31st December 1939, p1
[20] HV Dicks, 50 Years of the Tavistock Clinic, p101, Routledge, 1970
[21] HV Dicks, 50 Years of the Tavistock Clinic, p101, Routledge, 1970
[22] S. Ferenczi, Further Contributions to the Theory and Technique of Psycho-Analysis, Hogarth, 1926
[23] The Tavistock Clinic Report for the year 1940, p5
[24] The Tavistock Clinic Report for the year 1941, p5
[25] HV Dicks, 50 Years of the Tavistock Clinic, p101, Routledge, 1970
[26] HV Dicks, 50 Years of the Tavistock Clinic, p112, Routledge, 1970
[27] HV Dicks, 50 Years of the Tavistock Clinic, p109, Routledge, 1970
[28] Kevin Flintan, ‘Obituary’, p 1491, British Medical Journal, Vol. 307, Issue 6917, 4 December 1993
[29] Sarah Dawood, ‘Women in wartime: the rise of the female public servant’, The Guardian, Sat 8 Nov 2014
[30] Sarah Dawood, ‘Women in wartime: the rise of the female public servant’, The Guardian, Sat 8 Nov 2014
[31] Sarah Dawood, ‘Women in wartime: the rise of the female public servant’, The Guardian, Sat 8 Nov 2014
[32] Medical Directory, 1941
[33] HV Dicks, 50 Years of the Tavistock Clinic, p296, Routledge, 1970
[34] C Goldin and C Olivetti, ‘Shocking Labor Supply: A Reassessment of the Role of World War II on Women’s Labor Supply’, p257-62, American Economic Review, 103(3), 2013
[35] HV Dicks, 50 Years of the Tavistock Clinic, p121, Routledge, 1970
[36] HV Dicks, 50 Years of the Tavistock Clinic, p148, Routledge, 1970
[37] HV Dicks, 50 Years of the Tavistock Clinic, p148, Routledge, 1970
[38] HV Dicks, 50 Years of the Tavistock Clinic, p121, Routledge, 1970
[39] HV Dicks, 50 Years of the Tavistock Clinic, p139, Routledge, 1970
[40] HV Dicks, 50 Years of the Tavistock Clinic, p139, Routledge, 1970
[41] HV Dicks, 50 Years of the Tavistock Clinic, p115, Routledge, 1970
[42] HV Dicks, 50 Years of the Tavistock Clinic, p115, Routledge, 1970
[43] The Tavistock Clinic and Tavistock Institute of Human Relations Report for the year 1946, p1
[44] HV Dicks, 50 Years of the Tavistock Clinic, p133, Routledge, 1970
[45] HV Dicks, 50 Years of the Tavistock Clinic, p137, Routledge, 1970
[46] SG Gray, ‘The Tavistock Institute of Human Relations’, p208, 50 Years of the Tavistock Clinic, Routledge, 1970
[47] SG Gray, ‘The Tavistock Institute of Human Relations’, p207, 50 Years of the Tavistock Clinic, Routledge, 1970
[48] SG Gray, ‘The Tavistock Institute of Human Relations’, p207, 50 Years of the Tavistock Clinic, Routledge, 1970
[49] SG Gray, ‘The Tavistock Institute of Human Relations’, p208, 50 Years of the Tavistock Clinic, Routledge, 1970
[50] HV Dicks, 50 Years of the Tavistock Clinic, p156, Routledge, 1970
[51] HV Dicks, 50 Years of the Tavistock Clinic, p249, Routledge, 1970
[52] HV Dicks, 50 Years of the Tavistock Clinic, p157, Routledge, 1970
[53] HV Dicks, 50 Years of the Tavistock Clinic, p235, Routledge, 1970
[54] HV Dicks, 50 Years of the Tavistock Clinic, p161, Routledge, 1970
[55] HV Dicks, 50 Years of the Tavistock Clinic, p176, Routledge, 1970
[56] HV Dicks, 50 Years of the Tavistock Clinic, p188, Routledge, 1970
[57] HV Dicks, 50 Years of the Tavistock Clinic, p192, Routledge, 1970
[58] Teri Chettiar, ‘Treating marriage as “the sick entity”: Gender, emotional life, and the psychology of marriage improvement in postwar Britain’, p270-282, History of Psychology, Vol. 18, Issue 3, Aug 2015
[59] Teri Chettiar, ‘Treating marriage as “the sick entity”: Gender, emotional life, and the psychology of marriage improvement in postwar Britain’, p270-282, History of Psychology, Vol. 18, Issue 3, Aug 2015
[60] Henry V. Dicks, Marital Tensions (Psychology Revivals): Clinical Studies Towards a Psychological Theory of Interaction, pxi, Routledge, 1967
[61] HV Dicks, 50 Years of the Tavistock Clinic, p263, Routledge, 1970
[62] Teri Chettiar, ‘Treating marriage as “the sick entity”: Gender, emotional life, and the psychology of marriage improvement in postwar Britain’, p270-282, History of Psychology, Vol. 18, Issue 3, Aug 2015
[63] HV Dicks, 50 Years of the Tavistock Clinic, p215, Routledge, 1970
[64] Tavistock Relationships, Our History, p1, 2018
[65] HV Dicks, 50 Years of the Tavistock Clinic, p216, Routledge, 1970
[66] Teri Chettiar, ‘Treating marriage as “the sick entity”: Gender, emotional life, and the psychology of marriage improvement in postwar Britain’, p270-282, History of Psychology, Vol. 18, Issue 3, Aug 2015
[67] HV Dicks, 50 Years of the Tavistock Clinic, p264, Routledge, 1970
[68] HV Dicks, 50 Years of the Tavistock Clinic, p238, Routledge, 1970
[69] HV Dicks, 50 Years of the Tavistock Clinic, p240, Routledge, 1970
[70] Henry V. Dicks, Marital Tensions (Psychology Revivals): Clinical Studies Towards a Psychological Theory of Interaction, pxi, Routledge, 1967
[71] Kevin Flintan, ‘Obituary’, p 1491, British Medical Journal, Vol. 307, Issue 6917, 4 December 1993
[72] Kevin Flintan, ‘Obituary’, p 1491, British Medical Journal, Vol. 307, Issue 6917, 4 December 1993
[73] Mary C Luff and Marjorie Garrod, ‘The After-Results Of Psychotherapy in 500 Adult Cases’, p54, British Medical Journal, London Vol. 2, Issue 3888, 13 Jul 1935