by Jenny Diski
I was one of about thirty patients at the Paddington Day Clinic, an experiment in intensive group therapy, set up and funded by the local Health Authority, at Royal Oak in West London. A committee of elected patients interviewed prospective patients after one of the two psychiatrists in charge had done so and passed on to us those they thought could benefit from joining the emotional scrummage. New people were only admitted if they passed their second interview. Admission committees generally admit those most like themselves, so it was a fairly homogeneous group: young, very few people over twenty-five, disturbed, angry, dysfunctional, but often talented in a wasted, wayward sort of way, and highly articulate. Not much point in a full-time regime of group therapy from nine to five, five days a week, if people weren’t able to express themselves. We undertook not to take any drugs, including prescription tranquillisers and anti-depressants, and to participate in the various large and small groups that went on during the day. It was a place of high and constant drama. Everyone, some time or other, had their moment as the centre (or victim) of the group’s attention – anyone who didn’t volunteer to talk about themselves and their problem and have it considered by everyone else would, after a period of grace, be challenged and confronted on their silence. It could be very harsh. There were tears, arguments, walkouts, collapses and sometimes violence. Relations within the community, general and sexual, were examined with scalpels. The skin of everything was lifted back to look at the bloody mess that inevitably lay beneath. Every day brought smaller or larger crises and emotional turmoil. You really needed to be quite tough or hooked on emotional turmoil to survive it. Some of us were very troubled, others less obviously so, but if you got through the rather gruelling, unsympathetic patients’ committee interview, it was reckoned you could cope. Mostly, this was right, but during my four months there one or two people attempted suicide rather than talk (or as a result of it); others spoke out and, finding themselves overwhelmed by the effort or the response, left, sometimes for less experimental psychiatric inpatient care. There were those who watched, for as long as they could get away with it, and those who made themselves the centre of the group as much as they could get away with it. It was an education in group dynamics if you were a watcher, but there was always someone watching you and sooner rather than later you would be dragged into the collective eye of the group. If you denied the accusation of evasion or defended yourself, you were not facing up to your problems, or you were aggressive and not facing up to your problems; if you agreed with others’ assessments, you were too compliant and probably concealing the real issue. Breaking down, one way or another, was pretty much a requirement; a proof that you were ‘working’.
Clon lasted longer than any of the watchers – even me. He was never successfully enticed or goaded into the centre of a group session. He sat with his bold, knowing smile on his face and spoke neither on someone else’s problems or his own. If asked directly for a comment or how he felt, he’d shrug and open his blue eyes wide. ‘I’m cool, man.’ He had an exceptional capacity to resist being drawn in. Partly it was his compelling charm, and a mysterious ability to deflect attention as if he had a mirrored surface that enquiry slid off harmlessly and on to whomever else his eyes might turn towards. But it was also because of the confusion he created by the fiendishly cunning puzzle he set the community. I was on the committee that admitted him. His answer to the standard question ‘Why do you think you would benefit from joining this community?’ was instant and direct, spoken with a broad open-faced grin: ‘Because I’ll get a medical certificate and the sickness benefit, man.’
It was a novel response. All patients did get a medical certificate for as long as they were with the clinic to say that they were unfit for work by virtue of a psychological disorder and were entitled to about (I think) £7 a week state benefit. But everyone, including Clon, had been referred to the clinic by an outside psychiatrist as needing treatment and being potentially suitable for this particular experimental form. And nearly everyone given the opportunity at the admission interview to itemise their neuroses and psychoses had to be silenced eventually, or there would be nothing left to tell the group if we let them in. So we laughed at Clon’s casual joke. Yeah, funny, but, really, what was his problem?
‘I haven’t got one. Really. I heard about this place and it’s, like, perfect. I want to hang out here and get paid same as you guys. I’m cool, man. Happy childhood, life’s great. But it would be better if I didn’t have to get a job.’ He smiled amiably as he spoke, as if we were all in on the scam and knew exactly what he was talking about.
‘No,’ said the chair of our committee. ‘Seriously.’
‘Seriously,’ said Clon. ‘They’ve chucked me off the dole and I don’t want to work. I want to be like you cats.’
He had nothing to add. He gave a bland account of being brought up I can’t remember where, nothing interesting, no problems, just didn’t want a job and had heard about the clinic. He went to his doctor, saw a shrink, said what he had to say to be referred, and here he was. Smiling. Coming clean, wanting some of what we’d got.
‘Why should we admit you if you’ve really got nothing wrong with you?’
‘Why not? What’s it to you if I hang around here for a while?’
Bristling, the committee chairman said that everyone here was entitled to be here because they had serious and genuine problems and needed psychiatric help. He would be taking the place of someone who needed treatment. Clon kept his face locked into a smile, while he threw in his ace.
‘Yeah, well, how do you know I’m not faking it... the not being crazy?’
We sent him out of the room so we could discuss his application. It should have taken seconds to come to a decision, and for one or two people there was nothing to talk about. But there was another view. Clon’s brilliant skill at concealing his problems made him an ideal candidate for the clinic. Obviously, he had severe problems – he had been sent here by a doctor, passed on to us by our psychiatrists – and anyone who insisted that they had no mental problems, in general and in particular to the admission committee, was either really deluded or crying out for help to uncover their inner horror. He had virtually told us, with a sneer that by no means meant it wasn’t true, not to take him at his own word. Wouldn’t we be failing him if we rejected him? Colluding with his refusal to face the painful truth about himself? He was in.
For weeks great efforts went on within the large morning and evening group and the smaller groups that continued through the day to get Clon to confront his problems.
‘Clon, everyone has their difficulties. You’ve seen how people open up here. There’s no shame in admitting your fears. We’re here to help. You have to work on your stuff, like everyone else.’
‘Yeah, well, I would, but I don’t have any problems. I’m having a great time. If you’re bothered by me, that’s your problem. I’m getting what I want. This is fun and I’m being paid.’
It was true there was no evidence that Clon was other than quite content sitting in the groups, drinking tea, having lunch, hanging out until five o’clock. He wasn’t moody or given to sudden violence, weeping in corners, turning over tables, or screaming at someone he could no longer tolerate. He tolerated us perfectly, even seemed to enjoy himself, without ever actually participating with issues of his own or commenting on those of anyone else. Eventually, the admissions committee met to decide whether to expel Clon. He was summoned. All he had to do was say that he was fucked up like the rest of us.
‘Hey, I told you the truth and you admitted me. How can you expel me now? Nothing’s changed.’
He was right. The question was whether Clon was madder than all of us or a brilliant con artist. Yet he wasn’t exactly conning us. He certainly wasn’t pretending to be mad. But was he pretending not to be mad? Or – was he pretending to be mad by claiming not to be mad? He was a maestro of the double bind. Ronnie Laing would have loved him. But there were other ways, easier ways of getting social security, wit
hout having to sit through day after day of people having tantrums and obsessing about their inner demons. And even if he was just using the place, might it not teach him something in spite of himself? The big question kept returning: was he or wasn’t he authentic? I found myself wondering why it mattered so much to us. Having accepted him, shouldn’t we let him stay? And what the hell if he was playing the system? I had a kind of respect for his position, whatever it was, or really was. But then I’m the daughter of a conman. It was a long meeting. Finally, he was expelled. The danger that we were being taken for a ride (even though, or because, we couldn’t be sure what kind of ride we were being taken for) was too great for us to risk. As Clon had said over and over again in group: it was our problem. We called Clon in and told him he was out. I remember his shrug, and the who-cares, it-lasted-as-long-as-it-lasted beaming smile on his face.
‘Well, fuck you, then,’ he said, not entirely amicably, and swaggered out of the room, out of the building, never to be seen again.
I’m still not sure whether I imagine in sentimental retrospect or actually saw a brief look of fear cross his face before he cleared it, or if his shrug wasn’t exactly the kind of shrug I used to make as an adolescent when I was given up on yet again, and all that mattered was to show that I didn’t care one bit.
I’d been sent to the day clinic after a consultation with Aaron Esterson, who had co-authored Sanity, Madness and the Family, Volume 1 of the proposed series Families of Schizophrenics, with R. D. Laing in 1964. In 1965, The Divided Self, written by Laing alone and originally published in 1960, was published in the Pelican series of books – that lifeline of paperback knowledge and information of every discipline which adorned the period and, along with the system of free public libraries, gave those of us who had rejected or been rejected by a university education, a way to learn. It was the beginning of the anti-psychiatry movement of the Sixties. Families of Schizophrenics proposed the theory that it was families who were mad rather than simply the individuals who were scapegoated by them as the ‘sick member’. The case histories taken by Laing and Esterson were chilling and strangely familiar whether you came from a recognisably mad family or one you had been brought up to think of as ‘normal’. The Divided Self extended this to suggesting that society itself estranged the mad, and caused them to create false selves in order to survive. From this position, it was a short hop, given the ethos of the Sixties, to doubting the normality of normality itself and then to questioning the madness of madness. The qualities of sanity or madness were defined as ‘degrees of conjunction and disjunction between two persons where the one is sane by common consent’.23 Laing was brilliant and was taken up by the intelligentsia, as well as, when they differed, the desperate. Admirers gathered at his feet at parties to listen to him talk about his theories. He drank heavily and took to using LSD frequently. His book The Politics of Experience and The Bird of Paradise24 confirmed the holy-madness/consecrated-drugs connection. Enlightenment found another branch: drugs were already a fast route to opening ourselves up to the religious experience of Eastern philosophy, now they became a way for those not ‘blessed’ with madness to get an insight into this newly hallowed state. From being victims of their families, the mad* became the victims of society in general, and its medical institutions in particular (in timely line with the concurrently translated writings of Foucault). The mad – the word became a banner of resistance – were outcasts, prophets, speakers of unspeakable truths, and were pronounced heroes. Pushed by malign normality, the mad, on behalf of those of us who hadn’t the courage, took a journey to the furthest depths of the human psyche to look at what was really there, and who we really were. They trod the lonely hero’s journey (a classic quest scenario, also in vogue through the new popularity of Joseph Campbell’s Hero with a Thousand Faces25) beyond the boundaries of society to places most of us dared not go, and they returned changed but with news of the truth they had found and brought back for us if we would just pay proper attention. When schizophrenics babbled or screamed or wept about their voices and told terrified tales of being spied on by MI6 or Smersh, of being the risen Christ recrucified, or Satan cast down again, they were, Laing said, to be listened to on their own terms, creatively understood, translated like radio messages from the Resistance, not medicated and institutionalised back to numbness – the numbness of the so-called-sane, now revealed to be a contemptible state of willed ignorance. The mad were the super-sane. We couldn’t hear them because we were not sensitive enough, or we couldn’t bear to face the truth they spoke about our own ‘normality’. Just as we were later to discover ourselves to be racist and sexist, so, in the mid-Sixties, we were to understand ourselves as madist. Not only should we stop persecuting the mad, we needed to become mad in order to achieve real sanity.
It was incredibly seductive. The mad hero became a teacher, whose pronouncements were only for those who could or would understand. The crazy were shamans, gurus, speakers in tongues, cut loose from ordinary language and behaviour, and were at risk, as are all holy men and women, of persecution from being locked up and drugged into silence. They were the heirs to the witch hunts conducted by the Inquisition. Society found the mad intolerable and psychically killed them if they refused to conform. They spoke the peculiar language of truth, a kind of poetry, and acted out reality, inscrutable to those who refused to hear and see. Laing and fellow psychotherapists David Cooper and Joseph Burke opened a house in East London, called Kingsley Hall, where the shrinks and the mad lived communally and defied uninitiated visitors to tell which was which. It wasn’t that easy to tell even for those who lived there. Mary Barnes was a famous resident: a former nurse who had had a catastrophic breakdown in her mid-forties. In the basement of Kingsley Hall, she painted frantic pictures in swirling psychedelic colours, howled, ranted, was reborn, nursed dolls at her breast, shat like a baby and rubbed it into the walls. Everything was permitted. Everything expressed the message about reality she was trying to get across. It was a private healing process from which the ‘normal’ could benefit just by watching and reading about it.26 The Good Doctors were there not to control but to enable whatever needed to happen so that the mad could express themselves. If a ‘patient’ took off her clothes during a session, Laing took off his too in order to show that he was on her wavelength. Wavelength was everything, though I’m inclined to doubt now that the mad really wanted their doctors to be as mad as they were. Laing and the other anti-psychiatrists provided hash, mescaline and LSD to open the channels to the truth, in much the same spirit that a handful of other people, responding to similar spiritual and psychological teaching at the time, were trepanning themselves – boring holes in their foreheads in order to let the light into their third eye.
And let me say, for all its excesses and cock-ups and carelessnesses, even the stupidities, the anti-psychiatry movement had a point. Life for the institutionalised mad was grim. In the huge hospitals for the mad, left over from the Victorians, they were drugged into silence and calamitous palsies, received electroshock therapy and lobotomies, well into the Sixties and beyond. In spite of the worthy Quakers of the nineteenth century, care for the mad in large asylums was often brutal and punitive, suffering from a lack of good training and money. What mental institutions did for many people was institutionalise them. Going into the madhouse often trained the mad to want to remain incarcerated. It is not accidental that in Ken Kesey’s book One Flew Over the Cuckoo’s Nest,27 the great revelatory moment is when the Clon-like hero, McMurphy, discovers that all his fellow victims are voluntary patients, and not, like him, on a section. They could all leave if they wanted to.
I was certainly ready for anti-psychiatry. I had been in two psychiatric hospitals when I read The Divided Self, and was shortly to be in a third. I never suffered from brutality, but I saw its effects on staff and other patients. Geriatric patients and those we would now call sufferers of Alzheimer’s disease were lumped in with psychiatric patients: they were particularly hard to cope wit
h and got roughly handled. When I objected at one woman, in her late forties with an early form of dementia, who incessantly roamed round and round the day room, whimpering, being pushed into her chair, I was told to mind my own business: ‘You’re just a patient.’ Mostly, I was on anti-depressants and saw a psychiatrist twice a week for fifteen minutes (having seen the terrors of those who had ECT when I was fifteen, I always refused to have it), but in one hospital I was put into ‘sleep therapy’ after it was decided I was particularly depressed, and when a nurse noticed several days later that I was suffering from barbiturate poisoning as a result, and I became ‘difficult’ to deal with, wanting more of the lovely oblivion I had been given, I was detained under a section of the Mental Health Act that deprived me of any right to agree or disagree with my own treatment and the right to leave. I was detained, literally, being held down by several nurses and injected with Largactyl, which put me into another narcosis, but this time with hideous nightmares I couldn’t wake up from. Later, in the Maudsley, it was the ‘abreaction’ therapy and intravenous injections of methylamphetamine. A woman in the bed next to me, incredibly in 1968, was put on the completely discredited insulin shock therapy, another given LSD ‘treatment’. Two or three of the patients had received lobotomies, and sat passively waiting to be discharged. The strangest things were going on. And all the time, in all the hospitals, I watched people come back from their twentieth, thirtieth, God knows how many, electro-convulsive therapy session, pale, horrified and remembering nothing about themselves or where they were, but weeping with fear as the next ECT became due. Psychiatrists I’ve talked to since, some of them working later at the Maudsley, are amazed to hear about the treatment I saw and received, but the hospital was a teaching hospital and regarded itself as being on the experimental edge.