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Differential Diagnosis and Surrealism in Leonora Carrington’s Down Below

Marie Allitt, University of York

In 1940, Leonora Carrington suffered a mental breakdown and was committed to a treatment facility in Spain, where she underwent convulsive shock treatment. In Down Below (1943), Carrington offers an account of her experience, from the retrospective point of 1943, where narrative, memory, and mental health are interwoven in significant, yet complex ways. A significant surrealist artist and writer throughout her life, Carrington was born in Lancashire, England in 1917, but spent the majority of her life living in Mexico City. From early on, Carrington rejected the authority, Catholicism, and upper-class values of her family, and this rebellion, alongside her fascination with Surrealism, dictated the subject matter of much her work. By 1937, she was fully estranged from her family, moving to Paris and living with Max Ernst. With rising tensions across Europe and hostilities within France, in 1940, Ernst was arrested as an enemy alien, and interned in a labour camp, leaving Carrington alone. She was persuaded by friends to leave France and travel to Madrid, Spain, where the events of Down Below took place.[1] The beginning of the novel explains the journey from France across Spain, the onset of her breakdown and political paranoia, before being committed into the asylum against her will. The rest of the (short) novel depicts the experience inside the asylum; convulsive treatment; cruelty and abuse; her delusions and hallucinations, all of which are framed by her retrospective narration three years later.

The narrative is self-conscious and deeply autobiographical, and yet acknowledges the very fact that some of it is not true: ‘I am afraid I am going to drift into fiction, truthful but incomplete, for lack of some details which I cannot conjure up today and which might have enlightened us.’[2] Carrington does not “fear” this drift, but follows it, at times offering very lucid impressions of events, which cannot be disentangled from the overtly surrealist aesthetic. As Erich Hertz notes, ‘the story is inextricable from the drama of Surrealism itself’[3] – thus, we must read the text as simultaneously surreal and symptomatic and representative of mental illness.

Carrington’s novel is troublesome for the reader: what are we to believe, and what should we focus on? Fact blurs with fiction, and is further obscured by hallucinations. Existing scholarship notes this unreliability, but rather than reading into the illness and treatment experience, many concentrate on the retrospective lucidity.[4] Ann Hoff urges us instead to recognise the significance of the drug treatment in terms of this perceived unreliability: ‘When set beside clinical descriptions of Cardiazol treatment and its side effects, scholarly doubts of Carrington’s accuracy must recede. In that context, her narrative is far more realistic than previously supposed.’[5]

Some of the harder parts of the novel to read, not only for their obscurity but also for their subject matter, are the scenes of convulsive shock treatment. These are horrifying, violent, and inhumane episodes, which many have disregarded as far more symbolic than authentic. On the one hand we can read these strange passages as the pinnacle of surrealist aesthetics, combining mystery with the epitome of madness.[6] Throughout the novel, Carrington offers visions of robots, and dead bodies; she sees herself as a white horse, as vast and cosmic, ‘the Moon, the Holy Ghost, a gypsy, and acrobat’ and Elizabeth I.[7] These are hallucinatory, epitomising the surreal thrill, yet, the hallucinations are not simply dreamlike or metaphorical; they also evidence her unstable mental state, and the fractured sense of self in her mental breakdown. But there is more. Crucially, we cannot overlook the influence of the psychiatric drugs: we now know that Cardiazol often induced hallucinations, and thus, the hallucinatory moments cannot be singularly considered a consequence of surrealist thinking.

As readers, we must not fall into the trap of reading the text as only one which testifies to the experience of incarceration: it is no simple retelling, and we cannot be enticed into a simple diagnosis. With this in mind, how should we read Carrington’s novel? I suggest it is most operative to read her text as multiple: as surrealist aesthetics, as recounting her incarceration, and representing the experience of mental illness and convulsive treatment. I propose a specific kind of reading of this text, through a “narratological differential diagnosis”. We know that the text is part real experience, part surrealist impression, and part representative of mental illness itself. Each of these entangled, parallel narrative planes certainly overlap. In medical contexts, the differential diagnosis is fundamental: ‘Beginning with the preliminary data, the physician assembles a list of possible hypotheses – the differential diagnosis – that could account for the signs and symptoms.’[8] We must do this for Carrington’s novel, where we cannot disregard the surrealist aesthetics, the retrospective narration, nor the experiential dimensions of mental illness. We must keep the differential in play as we encounter each of the images, events, and descriptions.

In discussing her approach to articulation, Carrington poignantly indicates a writing practice that relies upon simultaneity: ‘The task of the right eye is to peer into the telescope, while the left eye peers into the microscope.’[9] It speaks to her artistic philosophy that she endeavours to represent the inaccessible. She represents commitment to accessing precisely what is not visible to the naked eye: both the telescope and the microscope magnify that which is unattainable, conforming to surrealist desires to access the unconscious and internal, while also illuminating the incomprehensible.

This image is also significant in its gesture towards ambidexterity: doing two different things with each part of her body at once. It is reminiscent of other aspects of her life: Marina Warner notes that at Carrington’s former boarding school, ‘the nuns were disturbed by her way of writing backwards with her left hand while writing forwards with her right (later in life, she also painted with both hands at the same time).’[10] This simultaneous ambidexterity emerges in several aspects of Carrington’s life, as something both physical and symbolic, which also signposts how her work should be read. There is no single image being conveyed here: with one hand Carrington presents her experience of illness, with the other she creates a truly Surrealist work (one which Breton undoubtedly envied), and just as different parts of her body are simultaneously working on different things, so too must a reading take into account the multiplicity. We must look at the interplay of these narrative planes, and, at the sound of hooves, we must think both horses and zebras.


[1] Further biographical details can be accessed: , or

[2] Leonora Carrington, Down Below (New York: The New York Review of Books, 2017), p. 19.

[3] Erich Hertz ‘Disruptive Testimonies: The Stakes of Surrealist Experience in Breton and Carrington’, Symposium, 64.2 (2010), p. 97.

[4] Ann Hoff, ‘“I was Convulsed, Pitiably Hideous”: Convulsive Shock Treatment in Leonora Carrington’s “Down Below”’, Journal of Modern Literature, 32.3 (2009), p. 84.

[5] Ibid.

[6] André Breton, ‘First Surrealist Manifesto’ (1924), Theater of the Avant-Garde 1890-1950: A Critical Anthology, ed. Robert Knopf (New Haven & London: Yale University Press, 2015), p. 339-346.

[7] Carrington, p. 45.

[8] Kathryn Montgomery Hunter, Doctors’ Stories (New Jersey: Princeton University Press, 1991), p. 16

[9] Carrington, p. 19.

[10] Marina Warner, ‘Introduction’, Down Below (New York: The New York Review of Books, 2017), p.  xvii.

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