R. D. LAING,1967 (QUOTED BY HOWARTH-WILLIAMS 1977, 80–81)
PERHAPS THE MOST CENTRAL CHARACTERISTIC OF AUTHENTIC LEADERSHIP IS THE RELINQUISHING OF THE IMPULSE TO DOMINATE OTHERS. . . . THE MYTHICAL PROTOTYPE OF THE INAUTHENTIC LEADER IS WILLIAM BLAKE'S URIZEN, THE MAN OF HORIZON, OF LIMITS, CONTROL, ORDER. . . . THE NAZI DEATH CAMPS WERE ONE PRODUCT OF THIS DREAM OF PERFECTION. THE MENTAL HOSPITAL, ALONG WITH MANY OTHER INSTITUTIONS IN OUR SOCIETY, IS ANOTHER.
DAVID COOPER,PSYCHIATRY AND ANTI-PSYCHIATRY (1967, 96–97)
THERE WAS A SPECIAL PSYCHIC ATMOSPHERE WITHIN THE COMMUNITIES; THERE WAS A HOPE AND A PROMISE; THERE WAS A FEELING OF THE GROWTH OF CONSCIOUSNESS, OF EVOLUTION. . . . IT WAS A SPIRITUAL REFUGE, A PLACE WHERE ONE COULD GROW AND CHANGE AND LEARN IN A WAY THAT WAS IMPOSSIBLE OUTSIDE, LIKE A MONASTERY OR A CAVE IN THE MOUNTAINS.
DAVID BURNS,THE DAVID BURNS MANUSCRIPT (2002, 20)
Kingsley Hall (fig. 5.3) could accommodate up to fourteen people; it included shared spaces, such as a dining room, a kitchen, a game room, and a library that became a meditation room; there was also a meeting room that could accommodate about a hundred people.37 The group that lived there was mixed. It included schizophrenics and psychiatrists—hence "therapeutic community"—but, according to an American resident therapist, Joe Berke, "the majority of the community, and visitors, were not medical or paramedical men and women. Many were artists, writers, actors or dancers" (Barnes and Berke 1971, 260). Kingsley Hall thus offered a kind of support community for the mentally ill; put very crudely, it was a place designed to help people through the sorts of inner voyages that Bateson had first conjured up in Perceval's Narrative, free from the interruptions of mainstream psychiatry.
Figure 5.3. Kingsley Hall, London. (Photograph by Gordon Joly, used under Creative Commons Share Alike 2.5 Generic License.)
Kingsley Hall was run as a commune—an association of adults who chose to live together, all paying rent and free to come and go as they pleased (including to work, if they had jobs). And the key point to grasp is thus that at Kingsley Hall the mentally troubled and psychotherapists (and others) came together symmetrically within a very different frame of power relations from those of the conventional mental hospital. Except for the usual mundane considerations of communal living, the therapists and the mad were on the same plane.38 The therapists were not in charge, they did not make the rules, and they did not deploy the standard psychotherapeutic techniques—they did not prescribe drugs or ECT for the other residents, for example.
It is also worth noting right away that life at Kingsley Hall asked a lot of its residents, including the psychiatrists. Conditions there, and later at Archway, were often, by conventional standards of domesticity, hellish. The behavior of schizophrenics is, almost by definition, often bizarre. It can take the form of catatonic withdrawal, which is disturbing enough, but David Burns (2002) mentions residents at Archway who would shout continually for days on end, frequent trashings of the kitchen, a tendency to disrobe and stroll off to the shops naked (with accompanying hassles with neighbors and police); the ubiquity of potential violence; and a resident who stabbed a cat to death.39 At Kingsley Hall, psychotic behavior also included urinating and smearing excrement all over the place (Barnes and Berke 1971). No picnic, and not surprisingly therapists and others in residence tended to burn out from stress in a period of weeks or months, typically moving out but continuing to visit the community. Laing, in fact, lasted longer than most, staying at Kingsley Hall for its first year, before establishing a smaller community in his own home.40 Staging a place where madness could be acted out carried a significant price; conventional psychiatry looks like an easy way out in comparison with antipsychiatry.
What did life at Kingsley Hall look like? There are accounts of Laing's role as dinner-time raconteur and guru, dancing through the night and annoying the neighbors. Clancy Sigal (1976) portrays Laing as an evil genius and claims to have gone mad there just to please him. To get much further, we have to turn to Barnes and Berke's Two Accounts of a Journey through Madness (1971). Barnes was a mentally disturbed woman who found her way to Laing and moved to Kingsley Hall when it opened, determined finally to live out an inner voyage; Joe Berke was an American therapist at Kingsley Hall who took much of the responsibility for looking after Mary. The book interweaves descriptions of Mary's journey written by both, and on these accounts Berke's strategy in latching onto Barnes was a double one.
One prong was performative. "As soon as I got to Kingsley Hall, I realized the best way to learn about psychosis would be for me to help Mary 'do her things.' And so I did. . . . Getting to know Mary was simple. I imagined where she was at and then met her on that level. Our first encounter consisted of my growling at her and she growling back at me" (Barnes and Berke 1971, 221). Mary's voyage consisted in going back to her early childhood, and much of Berke's engagement with her consisted in setting up such childlike physical games (Mary was forty-two when she went to Kingsley Hall). Besides bears, they also played together at being sharks and alligators. Mary would often hit Joe, and on a couple of occasions Joe hit Mary and made her nose bleed. He fed Mary, when necessary, with milk from a baby's bottle, and bathed her, including one occasion when she had smeared herself with feces. He provided her with drawing and painting materials and Mary responded avidly, producing a series of large paintings and later becoming a successful artist. And the trial-and-error aspect of these experiments in engagement is evident in the fact that not all of them worked (Barnes and Berke 1971, 224):
It became obvious that it wasn't words that mattered so much as deeds, and even when the words and deeds coincided and were seemingly accepted by her, the ensuing state of relaxation could revert to one of agony for the barest of reasons. All I had to do was turn my head, or look inattentive, or blink an eye while feeding her, and Mary began to pinch her skin, twist her hair, contort her face, and moan and groan. Worse shrieks followed if I had to leave the room and get involved in another matter at about the time she was due for a feed. Suffice to say that if my acts and/or interpretations had been sufficient, such agonies could have been averted. So I said to myself, "Berke, you had better stop trying to tell Mary what you think she is wanting, and pay more attention to that with which she is struggling."
Berke's interactions with Barnes thus put more flesh on the earlier idea that latching onto schizophrenics as exceedingly complex systems necessarily entailed trial-and-error performative experimentation, and also the idea that such experimentation might well entail an expansion of the therapist's variety—Berke was probably not in the habit of playing bears, sharks, and alligators with other adults. Here, then, we have another instance of ontological theater: Berke's interactions with Barnes stage for us a more general image of homeostat-like systems performatively interfering with each other's dynamics without controlling them. And, from the other angle, those interactions again exemplify how one might go in practice—here, in psychiatry—if one thinks of the other on the model of the cybernetic ontology.
Having said that, I should turn to Berke's other mode of engagement with Barnes. Berke continually constructed interpretations of the nature of Barnes's problems and fed them back to her. He concluded, for example, that much of her strange behavior derived from anger. This anger was related to guilt: because of her inability to distinguish between inner and outer states, she tended to blame herself for anything that went wrong at Kingsley Hall, often including things which had nothing at all to do with her. Barnes also tended to interpret any situation on models derived from her childhood: Berke concluded that sometimes she was treating him as her mother, or her father, or her brother, and so on. Barnes at first rejected much of this but eventually came to share many, though not all, of Berke's interpretations, and this acceptance seems to have been an integral part of her recovery.
What should we make of this? The first thing to say is that there is nothing especially cybernetic about Berke's interpretive interventions into Barnes's life. They take us back inst
ead to the field of representation rather than performance; they belong to the other ontology, that of knowable systems. But we can also note that the epistemological aspects of the interaction—Berke's interpretations of Barnes's performances—were parasitic upon their performative engagement. They did not flow from a priori understandings that determined those interactions from beginning to end: "It became obvious that it wasn't words that mattered so much as deeds." I have also emphasized that this performative engagement had an experimental quality; Berke had to find out how to relate to Barnes, and his psychotherapeutic interpretations grew out of that relation as reflections upon its emerging substance. And, further, the interpretations were themselves threaded though a performative feedback loop running between Berke and Barnes, and the value of specific interpretations depended upon their contributions to Mary's behavior: "If my acts and/ or interpretations had been sufficient, such agonies could have been averted." This aspect of the Barnes-Berke interaction thus again stages for us a performative epistemology, in which articulated knowledge functions as part of performance—as arising from performance and returning to it—rather than as an externality that structures performance from without.
ARCHWAY
When we turn to the Archway communities that succeeded Kingsley Hall, we find a similar pattern, though at Archway the interpretive aspect of therapy receded still further.41 Burns (2002, 23) mentions that during his time in Archway he had three years of formal therapy with the psychiatrist Leon Redler but says nothing about the interpretive aspect of their interactions and instead emphasizes the performative techniques that evolved there (Burns 2002, 14–15):
We obviously had to find ways of coping with . . . extreme and distressing behaviors that did not contradict our philosophy of not interfering violently with what might be valuable inner experience. We learned the hard way, perhaps the only way. At Kingsley Hall, when a resident had screamed for forty-eight hours continually and we were trying to have dinner, someone briefly sat on him with his hand over his mouth. For a moment we had calm and silence but of course it could not last. He soon started screaming and running about again. This did not work.
Compassion, understanding, acceptance, all these were important and necessary. But they were not sufficient. Eventually we found a way to contain and lovingly control the behavior of a person under stress. We needed to do this for the sake of our own peace of mind and also because of the problems that occurred when a person took their screaming or nakedness into the outside world. . . . One resident at Archway . . . behaved in such distressing ways that we had to give her total attention. She would fight, kick, scream, pick up a knife, urinate in the kitchen or walk out the door, down our street and into the street of shops completely naked. She was nevertheless beloved by many of us. She was the first person to receive twenty-four-hour attention. To control her violence and keep her from going outside naked we had to keep her in the common space and make sure someone was always with her. We found this painful at first, but over months the twenty-four-hour attention became an institution of its own, and a major way of restoring order to community life.
"Twenty-four-hour attention" was a technique sui generis at Archway. In this passage it appears to have a purely negative function, but it quickly developed a positive valence, too (15–16): "Usually a group will gather and there will be something of a party or learning atmosphere. Change will occur not only in the person in crisis but in others who are there. . . . A resident may wish to attempt some project, exploring his inner world, overcoming his loneliness, his fear or his sadness, or coming off medications, drugs and alcohol. If the support group is large and strong enough a resident may request similar twenty-four-hour attention; or he may be encouraged to accept twenty-fourhour care, for example to come off phenothiazines or other substances." Other techniques were introduced to Archway from the outside, largely, it seems, by Leon Redler, and largely of Eastern origin (Redler invited Zen masters to stay at his apartment). Burns (2002, 28) mentions hatha yoga and "sitting"—Zen meditation—and the list continues:
Other techniques include Aikido and tae-kwon-do, oriental martial arts without the aggressive factor. Zen walking, moving through hatha yoga postures and Aikido are all forms of dance. Massage became an important part of community life at different times; one of our residents set up as a practicing giver of massage. . . . Various herbalists and acupuncturists applied their techniques. We realized the importance of the body, of the body-mind continuum. To think of mental illness outside of its physical context seems absurd. Thus much of the cooking at the community was vegetarian; there I received my introduction to the virtues of rice, beans, and vegetables. We had become aware of dance, of the movement of the body; we also became aware of music. . . . Music was always important to us, whether listening to records, playing the flute or chanting the Heart Sutra. Laing is an accomplished pianist and clavichordist. He would come visit us and play the piano, or organize a group beating of drums.
Various aspects of these developments are worth noting. "Twenty-four-hour attention" clearly continues the Barnes-Berke story of experimental performative engagement, culminating here in a relatively stable set of arrangements to protect members of the community from each other and the outside world while supporting their endogenous dynamics. One has the image of a set of homeostats finally coming more or less into equilibrium through the operation of this technique.42
Burns's list that starts with yoga requires more thought. We could start by noting that here we have another instance of the connection between the cybernetic ontology and the East, though now at the level of performance rather than representation. Bateson appealed to Zen as a way of expanding the discursive field beyond the modern self in order to conceptualize the inner experience of schizophrenics; at Archway Zen techniques appeared as material practices, ways of dealing with inner experiences.
Next, the items on Burns's list are technologies of the self in very much Foucault's original sense—ways of caring for, in this instance, the nonmodern, schizophrenic self. They were not understood as curing schizophrenia, but as ways of making it bearable, as "specific techniques for relieving stress or exploring one's inner world" (Burns 2002, 27). And this returns us to the question of power. As discussed so far, cybernetic psychiatry appears as a leveling of traditional hierarchies consistent with the symmetric version of the multihomeostat image, putting psychiatrists and sufferers on a level playing field. The Archway experiment went beyond that: psychiatrists became hangovers from the old days, and sufferers were treated as able, literally, to care for themselves. We find here the possibility, at least, of a full reclamation of the agency that traditional psychiatry had stripped from the schizophrenic.
Last, we could note that the Archway experiment converged on a position where communication was itself marginalized—the detour through words and other forms of interpersonal interaction receded into the background (at least on Burns's account) in relation to what one might think of as performative adaptation within a multiple self—the body and mind as two poles of an interactive "continuum." The Archway residents thus themselves arrived at a nonmodern ontology of the nondualist self: "In fact we [the Archway residents] gradually realized that much of what is called 'mental illness' is actually physical suffering, whether it be skin rashes, insomnia, vomiting, constipation, or general anxiety-tension. The schizophrenic process is endurable and can be meaningful in a context of minimal physical stress. . . . Zen and yoga have traditionally been means toward physical health and inner illumination" (Burns 2002, 28).
COUPLED BECOMINGS, INNER VOYAGES AFTERMATH
A CHANGE IN ONE PERSON CHANGES THE RELATION BETWEEN THAT PERSON AND OTHERS, AND HENCE THE OTHERS, UNLESS THEY RESIST CHANGE BY INSTITUTIONALISING THEMSELVES IN A CONGEALED PROFESSIONAL POSTURE. . . . ANY TRANSFORMATION OF ONE PERSON INVITES ACCOMMODATING TRANSFORMATIONS IN OTHERS.
R. D. LAING,"METANOIA" (1972, 16)
NO AGE IN THE HISTORY OF HUMANITY HAS PERHAPS SO LOST TOUCH WITH T
HIS NATURAL HEALING PROCESS THAT IMPLICATES SOME OF THE PEOPLE WHOM WE LABEL SCHIZOPHRENIC. NO AGE HAS SO DEVALUED IT, NO AGE HAS IMPOSED SUCH PROHIBITIONS AND DETERRENCES AGAINST IT, AS OUR OWN. INSTEAD OF THE MENTAL HOSPITAL, A SORT OF RESERVICING FACTORY FOR HUMAN BREAKDOWNS, WE NEED A PLACE WHERE PEOPLE WHO HAVE TRAVELLED FURTHER AND, CONSEQUENTLY, MAY BE MORE LOST THAN PSYCHIATRISTS AND OTHER SANE PEOPLE, CAN FIND THEIR WAY FURTHER INTO INNER SPACE AND TIME, AND BACK AGAIN. INSTEAD OF THE DEGRADATION CEREMONIAL OF PSYCHIATRIC EXAMINATION . . . WE NEED . . . AN INITIATION CEREMONIAL, THROUGH WHICH THE PERSON WILL BE GUIDED WITH FULL SOCIAL ENCOURAGEMENT AND SANCTION INTO INNER SPACE AND TIME, BY PEOPLE WHO HAVE BEEN THERE AND BACK AGAIN. PSYCHIATRICALLY, THIS WOULD APPEAR AS EX-PATIENTS HELPING FUTURE PATIENTS TO GO MAD.
R. D. LAING,THE POLITICS OF EXPERIENCE (1967, 127–28)
An asymmetry remains in my account of Kingsley Hall and Archway. I have written as if they existed solely for the benefit of the mad and with the object of returning them to a predefined normality. But to leave it at that would be to miss an important point. Laing's idea was that in modernity, the apparently sane are themselves mad, precisely in the sense of having lost any access to the realms of the nonmodern self that go unrecognized in modernity. Hence the sense in the above quotation of having dramatically lost touch with a natural healing process. And hence the idea that the Philadelphia communities might be a place of reciprocaltransformation for the mad and sane alike: "This would appear as ex-patients helping future patients to go mad." Clearly, the sort of variety expansion I talked about above was, to some degree, a transformative experience for the nurses in the rumpus room, for example, or Laing on LSD, or Berke playing biting games with a middle-aged woman—and all of these can stand as examples of what is at stake here. But to dramatize the point, I can mention the one example recorded by Burns of a transformative inner voyage undertaken by one of the "normal" residents at Archway.
The Cybernetic Brain Page 25