An introduction to Hilary Mantel’s introduction[2][3][and see below] to her and Anthony Stadlen’s (2014-19 ) 50th-anniversary Inner Circle Seminars on the ‘Abbotts’[4] and the other families in Laing and Esterson’s Sanity, Madness and the Family (1964, 1970)
Anthony Stadlen
Anthony Stadlen
Copyright © Anthony Stadlen 2015, 2020
[Existential Analysis 26,1 (January 2015): 21-24. Title modified.]
R. D. Laing and Aaron Esterson wrote in Sanity, Madness and the Family: Vol. 1. Families of Schizophrenics (1964: 13):
We believe that the shift of point of view that these descriptions both embody and demand has an historical significance no less radical than the shift from a demonological to a clinical viewpoint three hundred years ago.
Fifty years later, the ‘clinical viewpoint’ still reigns supreme – even among most ‘existential analysts’ and ‘phenomenologists’, although Laing and Esterson’s book was published in the series Studies in Existential Analysis and Phenomenology (edited by Laing).
But William Shakespeare saw beyond both the demonological and the clinical viewpoints more than four hundred years ago.
Inner Circle Seminar No. 202, ‘Sanity, Madness and Shakespeare’, on 27 April 2014 , marked the four hundred and fiftieth anniversary of Shakespeare’s birth and the fiftieth anniversary of Laing and Esterson’s book. We listened to Arthur Jonathan and Angela Buxton reading aloud the dialogue in which Hamlet contradicts his mother Gertrude’s assertion that he is mad. Then we heard Esterson’s 1961 recording of Mary Irwin resisting her mother’s insistent attribution that Mary is either selfish or ill. The parallels were startling.
The novelist Hilary Mantel, who had just been made a Dame in the Queen’s Birthday Honours, applied for a place at Inner Circle Seminar No. 205, ‘Maya Abbott and the Abbotts’, on her own birthday, 6 July 2014, as (she explained) a ‘treat’ for herself. This was the first of eleven seminars in which I present my research findings on the eleven families in Sanity, Madness and the Family after fifty years. I invited Hilary Mantel, instead, as a guest speaker to introduce the seminar.
Why is she interested in this book? Why has she taken it everywhere with her? In a Guardian article she explained that it gave her the courage to become a writer (Mantel, 2008):
Some of us need a little push, before we recognise we have the right to pick up a pen. In my case it came from a book by the psychiatrists R. D. Laing and Aaron Esterson...
The people in it seemed close enough to touch... Sanity, Madness and the Family is vivid, direct, gripping. It is a series of interviews with families, who each include one member who has spent time in psychiatric hospitals. Each interview is a novel or play in miniature...
So many of these family conversations seemed familiar to me: their swerves and evasions, their doubleness. All the patients profiled in the book are young women. I know their names are pseudonyms, but over the years I’ve wondered desperately what happened to them, and if there’s anyone alive who knows, and whether any of them ever cut free from the choking knotweed of miscommunication and flourished on ground of their own: Ruth, who was thought odd because she wore coloured stockings; Jean, who wanted a baby though her whole family [actually, only her husband – A. S.] told her she didn’t; and Sarah, whose breakdown, according to her family, was caused by too much thinking…
For most of my life I had been told that I didn’t know how the world worked. That afternoon I decided I did know, after all. In the course of my twenty-one years I’d noticed quite a lot. If I wanted to be a writer, I didn’t have to worry about inventing material, I’d already got it. The next stage was just to find some words.
I know this, I thought. I have always known it. Moreover, I have lived it, in a sense I have lived it. These family conversations, I have heard them. I could, I felt, have constructed another chapter and called it The Mantels.
In Giving up the Ghost (Mantel, 2003) she gives an astonishing account of her own family. Her historical novels twice won the Man Booker prize.
I wrote to her after reading her Guardian article (Mantel, 2008). I explained that I was researching the eleven families and could answer some of her questions. This was the start of our friendship.
All the others, including psychiatrists, who wrote to her about that article told her how wrong she was.
The ‘professionals’ claim Laing and Esterson said families ‘cause schizophrenia’. But Laing and Esterson wrote (1970 [1964]: vii):
No one can deny us the right to disbelieve in the fact of schizophrenia.
And Mantel, a twenty-year-old ‘laywoman’, understood (2017 [2014]):
Laing and Esterson did not set out to show that family interactions cause schizophrenia. They questioned the existence of the condition, and observed that the behaviour described as psychotic became intelligible, seen in context; to understand the context, you had to listen when the families told you about themselves.
Ordinary people, and extraordinary ordinary people (Shakespeare, Mantel), often see what psychiatrists, and even ‘existential analysts’ and ‘phenomenologists’, do not – or in bad faith will not.
Mantel writes of those who wrote to ‘correct’ her (2016 [2014]):
This long failure to engage seemed to me dishonest.
She ends (2017 [2014]):
Just read the simple words the people speak.
The simple words may be subtle and profound; they may condense, or clarify, complex contradictions and incompatible injunctions. Aaron Esterson once said to me: ‘These are the deepest secrets.’
At the seminar on the Abbotts we heard a 1959 recording of Maya Abbott telling Esterson about her experience. Some participants voiced surprise at his straightforward way of speaking with her. He was struck by her unusual awareness of her bodily experience, and said so. Because of his interest, and his willingness to make time to listen and learn as she explained in detail, we were privileged to hear her describe how she could imitate other people’s actions but only at a price. For example, she could talk with ‘hardened’ vocal cords, but to do so would be to lose touch with the ‘soft’ vocal cords that children have.
Hilary Mantel was clearly moved to hear Maya speak. But she wrote to me (Mantel, 2014a):
It was interesting how hard it was for participants to keep the reality of schizophrenia ‘in parenthesis’. The discussion kept jumping the rails. You said it would be like that.
Who is the phenomenologist here, able to keep the unproved assumption of ‘schizophrenia’ in parenthesis? The ‘existential’ and ‘phenomenological’ participants, or the ‘lay’ author?
Mantel wrote to me (2014b):
I shall always remember the moment of hearing Maya’s voice. Over the years the women who live in the book have become fabulous creatures to me. I no more expect to meet them than I expect to meet a mermaid; they speak from the depths.
Three weeks after the seminar, Maya Abbott died peacefully in her sleep. Hilary Mantel wrote to me (2014c):
I find tears in my eyes. It may be fanciful or superstitious to say this, but perhaps you have released her. Perhaps it was the act of letting her voice free into the room the other week; while her body lay, as you said, bedbound and inert, her spirit was escaping. I felt it was an important moment then and I feel it more now.
Anthony Stadlen is a Daseinsanalyst, Independent Effective Member for
Address: ‘Oakleigh’, 2A Alexandra Avenue , London N22 7XE
Email: stadlenanthony@gmail.com
Inner Circle Seminars: http://anthonystadlen.blogspot.co.uk/
References
Laing, R. D. and Esterson, A. (1964). Sanity, Madness and the Family. Vol. 1. Families of Schizophrenics. London: Tavistock.
Laing, R. D. and Esterson, A. (1970 [1964]). Sanity, Madness and the Family: Families of Schizophrenics. (Second edition.) London: Tavistock.
Mantel, H. (2003). Giving Up the Ghost: A Memoir. London: Fourth Estate.
Mantel, H. (2008). Author, author: Every writer has a ‘How I became a writer’ story. http://www.theguardian.com/books/2008/sep/06/1.
Mantel, H. (2014a). Personal communication. Email to A. Stadlen, 9 July 2014.
Mantel, H. (2014b). Personal communication. Email to A. Stadlen, 17 July 2014.
Mantel, H. (2014c). Personal communication. Email to A. Stadlen, 29 July 2014.
Mantel, H. (2015 [2014]). Existential Analysis 26,1 (January 2015): 25-35.
[1] First published in Existential Analysis 26,1 (January 2015): 21-24.
[2] Mantel (2015 [2014])
[3] Dame Hilary Mantel introduced Inner Circle Seminar...
[4] Laing and Esterson: 1. The Abbotts. 50 years on. H...
[2] Mantel (2015 [2014])
[3] Dame Hilary Mantel introduced Inner Circle Seminar...
[4] Laing and Esterson: 1. The Abbotts. 50 years on. H...
Hilary Mantel’s Introductions
to the Families in
Sanity, Madness and the Family:
Families of Schizophrenics
(1964, 1970)
by
R. D. Laing and Aaron Esterson
Hilary Mantel
introduces
11 of the 12
Inner Circle Seminars
on Sanity, Madness and the Family
in honour of its 50th anniversary
conducted between 2014 and 2019
by Anthony Stadlen
Copyright © Hilary Mantel 2020
See also: ‘The simple words the people speak’: An introduction to Hilary Mantel’s introduction to her and Anthony Stadlen’s (2014) 50th-anniversary Inner Circle Seminar on ‘Maya Abbott and the Abbotts’ in Laing and Esterson’s Sanity, Madness and the Family (1964) (January 2015)
See also: ‘The simple words the people speak’: An introduction to Hilary Mantel’s introduction to her and Anthony Stadlen’s (2014) 50th-anniversary Inner Circle Seminar on ‘Maya Abbott and the Abbotts’ in Laing and Esterson’s Sanity, Madness and the Family (1964) (January 2015)
Also printed above.
1.
Maya Abbott
Inner
Circle Seminar No. 205
6
July 2014
Laing and Esterson: 1. The Abbotts. 50 years on. H...
Dame Hilary Mantel introduced Inner Circle Seminar...
Laing and Esterson: 1. The Abbotts. 50 years on. H...
Dame Hilary Mantel introduced Inner Circle Seminar...
How
many books go by us, in the course of a life: and how many afternoons, a book
in hand? Of the questions I am asked as a writer, the one I find most difficult
is: what are your influences? What shaped you? It is often too casual a
question, and that’s why I find it difficult: the answer should fit a line or
two in a magazine interview. You should say, ‘This book, or that book, built my
books.’ But I find it difficult to separate texts and life events: a book may
mean nothing at one stage of your life, everything at another, and there is
always a question of timing: what brought me to that book, or that book to me,
at a moment when I was equipped to understand and change? I should like to take
you to an afternoon in 1973, a place, a time, a book, a moment of inner
decision, dawning knowledge. In a word, I will tell you how I came to read SMF , at a decisive time in my life: almost
twenty-one, on the cusp of graduating from university, and beginning to
speculate, with some apprehension, about my future. If I speak personally, you
will forgive me, because I am here just as a person: I am not a professional in
this sphere, and I represent no one but myself.
That spring of 1973, I was already a married woman. I had
married a fellow undergraduate, the man to whom I am married now. Why the
hurry? When families fall apart at one seam, there’s an instinct to stitch
themselves together at another; and my partner’s father had died the previous year:
not suddenly, like a death in the street from accident or heart attack, but
suddenly in the sense that a man who was well in autumn was ravaged by an
aggressive cancer, and dead in January. The dislocation and distress speeded up
our decision to marry, as if we were trying to save something from the
wreckage.
My husband’s father left a family business, into which my
husband had been expected to step; but it had to be sold, and our expectations
were derailed, and so my husband decided to train as a teacher. He went over to
Alsager in Cheshire
The histories begin with Maya Abbott[3].
Maya had been a wartime evacuee, away from her family between the ages of eight
and fourteen: surely an unusually long time, but then one knew of evacuees who
had never returned to their family of origin at all. I thought, as I often had,
how unexamined the phenomenon of the evacuees was; I had often wondered what
sort of parents they made themselves, and whether the bomb damage still so
evident in the streets of my childhood suggested inner explosions in the psyche
of parents and children torn apart. So immediately I thought, this is not the
whole story: but when do we ever get the whole story? When I read the case
histories now, what leaps out at me is the question of whether one of the
things these families are covering up is sexual abuse. New times, new
questions. But I did understand that the researchers did not set out to give a
comprehensive account, or to judge, or to impose interpretation. Yet
interpretation came naturally, spontaneously, to those well-grounded in
metaphor. Before Maya was born, Mr Abbott read about the excavations of Mayan
tombs and thought, ‘Just the name for my little girl.’ I remember the chill
those words struck into me. I thought, she is born with the dead.
Of course I do not know her real name. All the identities
are disguised. I assume, though, that the researchers chose a name that
reflected the real one.[4]
When Maya rejoined her family, it seems that they related to her not as the
fourteen year old who had returned, but as the eight year old who had gone
away. In between, she had dropped into some tomb, dungeon, oubliette. Or she
had been in some suspended state in their imagination; this kind of suspension
occurs in fairy tales, and keeps a girl frozen, pre-pubertal. Maya’s own story
about her time away was that she had been in hospital. This is how she
explained it later. She thought there had been something wrong with her.
I knew that my immediate reaction might be leading me away
from the facts before me, and leading me, perhaps, towards some other story,
that was meaningful in the context of my own family; but my attention was
prisoner to the resonances those early pages created. So I read the book in one
sitting. That is my impression. I cannot have read it in any great detail but I
ripped through it and then I got my own copy[5].
I still have it. It has travelled the world with me; there are few books I have
not left behind, replaced, jettisoned, to travel light, but I have always taken
this one with me. The immediate effect on me was profound. I had been
fascinated by The Divided Self but
that book brought me news; I found it difficult. This book inflicted the shock
of recognition, and I found it easy, and easy in the best possible way: I found
it clear, and I found it clarifying. I know
this, I thought. I have always known it. Moreover, I have lived it, in a sense
I have lived it. These family conversations, I have heard them. I could, I
felt, have constructed another chapter and called it The Mantels.
This is not the place to unfold the intricacies of my own
family, but I must put you briefly in the picture so that you will see how
easily I related to the families in the book. I was born in 1952, and I come
from a working class family of Irish origin, migrated (long before I was born)
to a Derbyshire village. I didn’t have a rural childhood; it was a mill
village. It was like living on a dying planet: resources depleted, air running
out. The mills were closing throughout my childhood, and there was a feeling
that the future was elsewhere. The same fatigue and general air of
pointlessness would soon blight pit villages. You said, why are we here? How
soon can we go somewhere else? I wanted to emigrate to Australia
I was the eldest of three children. My father’s name was
Henry. When I was six or seven, a man called Jack, my mother’s lover, came to
live in our house. My father didn’t leave; he just moved rooms. There was no
point in pretence and no effort at pretence. We were, naturally, stigmatised.
For four years we provided the village with a daily feast of gossip. None of
the three adults seemed to know how to get out of this situation. It was like
locking yourself in the village stocks and throwing away the key.
Four years on, my mother and father Henry parted company.
We went to live in another town eight miles away and we changed our name to
Jack’s. My brothers were too young to remember their former life. They thought
Jack was their father. Jack, I believe, thought the younger of the two boys was
his, but time showed he was wrong. For my part I did not know which man had
fathered the boys. My sense of chronology was shaky and so was my knowledge of
human reproduction. My mother, possibly, did not know, but she had her
preferences, and they counted far more than facts. The sins of my father, my
mother told me, were unspeakable; yet for four years of my childhood, she had
spoken to me of little else.
When we moved house, her monologue changed. Our former
life was erased. My mother and Jack were not married, but pretended to be. I
never saw Henry again: he was disappeared, like a victim of Stalin. Photographs
of him were thrown away. My mother cancelled her first marriage and purported
that I too was Jack’s child. We were in contact all the time with people who
knew about our past, but it was supposed to be a secret, and it was a secret I
was charged with keeping, and I was considered the one most likely to blow the
family’s future to bits by revealing the truth; so, it seems to me, I was
punished in advance, in anticipation of the damage I might do. The
mystification process, which the recordings in the book catch as it is
happening, was a basic mechanism in my family. We ran on lies as a cooker runs
on gas. No one was to blame, perhaps: no one person. Mystification is a process
that can survive even the death of the mystifiers. Some families never get their
story straight, generation to generation. Some extended families try to repeat
patterns through generations, even when those patterns create misery and
damage: as if, because they are recognisable, they are safer than anything new.
As a novelist I find this fascinating: as a daughter, as a sister, I find it
chilling. When I look back at my teenage years it seems to me that I was not
only unhappy but caught up in profound ambivalence, like Absalom hanging from
the tree waiting to be slaughtered.
This is a cursory glance at a situation which had many
facets, none of them pleasant. But you will be familiar with the dynamics of a
family where a parent is profoundly narcissistic, where both parents have a
self-reinforcing paranoid style; and in case you think I am handing out blame,
I should say that in the light of wider family history, the styles of both my
mother and my stepfather are understandable. For me the difficulty was that you
cannot thrive in such a family, and you cannot thrive outside it. By the time I
was nineteen I was sick. I mean to say, I was physically ill. I was alive to
the fact of something wrong in me, physiologically; I was also alive to the
fact that in the economy of my family, illness had a particular function. So I
was self-doubting, while unable to ignore my symptoms. I was aware that I was
caught up in a long game, and that I could not see the end of it; yet present
reality required relief. I could not get a diagnosis, but worse – I could not
even get tests, or a proper examination, or a proper hearing. I know that my
symptoms were confusing, that they did not offer a clear picture, a pointer. I
accept that my manner was apologetic. I asked for help but I did not insist.
Self-doubting, I undermined my own credibility. Yet a sure, swift leap
occurred, and I can’t quite excuse it; my illness was assumed to be some sort
of fiction, unless I could prove otherwise. Because the doctors I saw couldn’t
work out what was the matter with me, they made the extraordinary decision that
it was not they who were ignorant, it was I who was mad.
I say extraordinary: it is, looked at objectively. But in
those days, the early 1970s, it was happening all the time. The medicalisation
of unhappiness had begun, tranquillisers were being handed out like sweets, and
the word ‘psychosomatic’ was passing into common use: it was taken to mean,
‘imaginary’. I was one of thousands of young women labelled, diagnosed and
drugged; the stupidity of the era did seem to impact most on women. What seemed
like a medical judgement was often a value judgement, a fact to which Laing and
Esterson would draw attention. The cure for my supposed illness was a range of
drugs; my brain was working wrongly and needed to be helped to work right; the
reason for the wrongness, the lurking first cause, was over-ambition. I really
longed, a psychiatrist told me, to work in a dress shop. If I abandoned my
false pride and admitted this, I would be on the way to a cure. Every time I
opened my mouth to defend myself, I seemed to make matters worse, my verbal
facility merely an aspect of my disease. The vicious circle, the double-bind: I
knew these mechanisms, these traps. And I knew them, as traps, to be horribly
successful.
There is, Laing and Esterson pointed out, a deep and
pernicious fallacy at the heart of much of the treatment of mental distress. A
disease process is assumed, and all the words and deeds are interpreted in the
light of that assumption, which tends to validate itself. Once the diagnosis of
a ‘mental illness’ has been made, there is no clean way to see the person to
whom that diagnosis has been attached, try as you might; all subsequent events
are interpreted to reinforce a decision which has already been made, one which
is in accord with the prevailing scheme, the prevailing orthodoxy. We see it
happen all the time now: if you are in the US
Laing and Esterson asked us to interrupt the process and
suspend judgement; instead of assuming that words or deeds of the patient were
unintelligible, therefore mad, should we look at the context in which they
occur, and see if they became intelligible? Could we, by close attention to how
these families communicated, cast light on why one member was so unhappy, or
bore so much blame? The eleven families studied were chosen from two hundred
with whom the researchers worked. The assumptions on which they proceeded are
clear from each case history; these patients have been diagnosed as
schizophrenic, but this study will hold ‘in parenthesis’ the question of
whether schizophrenia has any reality, or what that reality might be. They were
aware that the study would be regarded as ‘anecdotal’ and therefore met with
derision. In the preface to the second edition, attempting to meet some of the
objection already raised, they restated their case: are the experience and
behaviour of their patients intelligible, in their context? The context here is
the family; all the patients are young women, more or less dependent, embedded
in a family network. They were at pains to say that they were not contending
that parents were responsible for producing schizophrenia in their children.
They were rather questioning the existence of the disease entity. It is this
question that the world found so difficult to hear.
The scope of the book is carefully and precisely defined.
Laing and Esterson are clear on what it is and is not. To every reader, it
became perhaps a little more than the authors meant it to be, and it may be
that I am as guilty as anyone of embellishing what is on the page, perverting
it to my own ends. But for me it acted as a key. The room it unlocked for me
was a spacious room and I still live in it. It opened up the possibility of
greater knowledge, or allowed me to formulate into knowledge what I dimly
perceived. I no longer regarded my situation as unique. For the three years of
my degree course (I studied law) I had taken in information, not knowledge. I
was like every other person of that age; the conversion into knowledge comes
later, it is a life’s work. But I needed, because my back was to the wall, a
particular kind of assistance. The book made sense of my world. You do want to
know how your particular experience attaches to the general experience, and at
twenty-one you can’t know; you are happy if you are taught by a book.
The book enlightened me but it did not act like a book of
magic spells. It made my own situation intelligible to me but it did not at
once give me the power to change it. It is easy for me to say in retrospect how
I should have lived my life, what I should have done: at eighteen, I should
have left my family and not gone back. But I had two younger brothers and I
felt that by staying around I could help them. That was the conscious part of
it; I suspect, though, that I could not extricate myself, because families like
mine are enmeshed, they are sustained by their own damaging strategies. What
the book did for me, immediately, was to stop me feeling ignorant. I had been
told I did not know how the world worked. But it seemed I had noticed a lot. I
was qualified to comment on what I knew.
About a year later two things happened. The first is that
I made a decision that come what may I would never again accept a referral to a
psychiatrist nor knowingly take a psychotropic drug. The question of whether I
was or was not physically ill was still open, but the question of whether I was
mentally ill was closed. It was a non-question. It was not up for debate. This
may sound arrogant. But I believe it was necessary for me to draw a big black
line between my past and my future. I had to save my life, I felt. I did not
have a solution to my problems, but the solutions offered by others had led me
deeper into trouble. I had taken on other people’s view of me as not just a
sufferer, but a patient. I had taken the drugs they handed to me and they had
produced in me symptoms which looked and felt like madness. Once I had
experienced akithesia, I knew what madness felt like. So it was not a question
of minimising, disguising, covering up my distress; it was a question of
redefining it.
At the same time I began to write. This was my way of redefining
me. I felt the insights I had from the book in many ways empowered me to do so;
I had more faith in my own judgment and powers of observation and indeed, you
might say that for a while they were the only things I trusted. The book helped
me to think about power relationships in the family and wider society. About
duplicity. About corrupt communications. But I didn’t, and I don’t see writing
as therapy. It was therapy, I suppose, in the way that a rope is therapy for a
drowning man. But if you set out to become a communicator, not a scribbling
solipsist, you must get your head up above your circumstances; and it is in
that gesture, that strategy of turning outwards that, in my view, some of the
healing power of art resides.
I didn’t, as you might expect, write autobiographically.
The first book I wrote was not the first I published. My career had what looked
at the time like a false start. After many years of work I met with rejection
and had to step back and reconsider and begin again. When I wrote my first
published book I chose an epigraph from Pascal:
‘Two errors: one, to take everything literally: two, to
take everything spiritually.’
That could stand as an epigraph for everything I have
written since, and it is a kind of watchword for me, a rule: when I ask myself,
‘what is this thing?’ I am guided, I am warned, that I must look beyond the
substance of any phenomenon to its inner nature, but I must not be blind to
surfaces, I must be attentive to presentation, I must look squarely at the
thing I am shown. Then when I have worked out what it is, I must ask, ‘And what
else is it?’
Now, I am a professional user of metaphor. No writer of
fiction can breathe without it. Looking though a writer’s eyes at questions of
sickness and health, it seems to me that a failure to understand metaphor lies
at the heart of much shaky diagnosis, and of much human unhappiness.
Unfortunately, a facility with metaphor is not something that is easy to teach.
It’s like trying to teach someone to see in colour, when their eye is only
equipped for black and white and shades of grey. A person’s ability to express
themselves through metaphor seems to have little to do with education or
cultural level or intelligence; neither is a person’s ability to perceive
metaphor constrained in this way. If, as in the case of these families, the
penalty for plain speaking is too great, the sufferer must seek some other way
to utter. Sometimes, for a patient, only symbolic expression of distress is
safe.
But what if it is not safe? What if meaning slides from
under language and tips us into the mire? What if the will is taken for the
deed? What if a woman says, ‘I could kill you’ and so her husband calls the
police? If fear simply freezes speech, distress will break out in physical
symptoms, in nightmares and daymares. Or when the sufferer tries to articulate
distress or ask for help, images leap unbidden to her assistance, zealous
servants, too zealous sometimes; before you know it, the metaphor is out of
your mouth, and you are ripe for misconstruction: for diagnosis: for treatment.
A doctor who is inept with metaphor will interpret as a delusion what is, for a
patient, a forceful and vivid attempt to express her reality. Once, doctors did
not know this, because it was axiomatic that one did not ‘talk to psychosis.’
Laing knew that if you can get past that prohibition, and listen, you will hear
in the language of supposed madness an art as sophisticated as the poet’s art;
and I say that not to valorise or glamorise the sick soul, but to express my
wonder at the business of being human, at the many strategies the mind and body
has available, to work for its own salvation. Doctors of all kinds, not just
psychiatrists, demand that the patient communicates on one level, a level that
is rational, logic-bound. For the patient this is sometimes impossible –
because the communications that must be made, the news that must be told, come
from a part of the self where different rules apply. When a patient is in pain
then, past a point, he screams. We do not accuse him of madness because we
cannot parse the scream. We acknowledge the honesty of the communication. We
try to alleviate his pain. We do not try to cure him by gagging him, or by
putting our fingers in our ears. But this has been, very often, the fate of
those whose pain is not easily named. The miracle of this little book is that
within it we heard voices: not just those of the named patient, but of the
confused and conflicted people about them; with the dead hand of the diagnosis
removed, they became eloquent.
When I speak of the body and its metaphors, its ways of
articulating distress, it is no news to you; nor is it news to you that
listening is in itself a healing art. To a great many people in our society, it
is news. To many of the doctors Laing worked with, it was news of an unwelcome
sort, the kind of news you could only contrive NOT to hear by an effort of
will: but many doctors did manage to live in the equivalent of a clockwork
universe, long after its day had passed. Innovation, to them, meant new drugs.
Thinking was always within the box. What they defined as progress was in fact
redefinition and reordering of familiar premises: an intellectual shuffling of
the feet.
I do not want to stigmatise one profession; it’s common.
Historians do it; they pass the ball of received opinion from one generation to
the next. That is an intellectual vice, but it does not have immediate,
personal consequences. Weak powers of analysis, closed minds: when exhibited by
clinicians, these blight lives. Where stupidity is willed, it becomes not a
misfortune but a vice. A failure to ask difficult questions, to challenge your
own assumptions, can call in question your ethical status. Sometimes, when you
look at what has been done in the name of health, you ask, are these
interventions not profoundly diseased? Are these actions, undertaken to cure,
the actions of decent men? We assume humane intentions. Perhaps we should not.
We assume a certain ethical fastidiousness, and we know we should not. You may
remember the passage[6]
in Wisdom, Madness and Folly, where
Laing relates an experience as a medical student. His group were shown films
produced by prolonged X-rays of the human body, displaying joint movement and
the process of digestion. These films had been made by Nazi experimenters, and
the experimental subjects would all have died in great pain. When Laing
realised what he was being shown, he says, he walked out, along with another
student. The other two hundred remained, unperturbed. When he approached his
teacher he was told that the material was unique, and this contribution to
knowledge should be used; otherwise, the victims would have died in vain.
It is a viewpoint. There is something to be said for it.
The thing that appalled Laing, and I am sure we have all met similar instances,
is that his fellow students were oblivious to the difficulty. They did not see
that there was an issue. He felt, he says, ‘terror.’ It is an awful warning;
those bright enough to become doctors can be, in many ways, dull. We assume it
is a prime desire in those who wish to study medicine, that they alleviate
human misery; we assume they wish to be good people; we should not assume they
know how to be good. There is no
parity between doctor and patient. A patient can be stigmatised a neurotic or a
fraud. But a patient never calls a doctor a fraud. They may call them
unethical, uncaring, but they assume they are competent and intellectually
equipped for their task. But it seems to me that much medicine is fraudulent,
in that much accepted practice depends on assumptions, about individuals and
society, that bear radical re-examination.
I was reminded of this when a few
years ago I wrote about Laing in a column[7]
in the Guardian, explaining how I thought he had influenced me as a
writer. I concentrated chiefly on SMF ,
and readers wrote to me, to set me straight. Only one letter-writer, and that
was Anthony Stadlen, appreciated what I was trying to say. The others made the
familiar objections which, in later editions[8],
Laing and Esterson themselves engage with. They were resigned correspondents,
more in sorrow than in anger; I was a lay person, they felt, who had been
misled. Did I not know that Laing was a covert Marxist? Did I not know that he
was a drinker? They themselves, in their many years as mad-doctors, had known
many young schizophrenics emerge from families whose saintly qualities shone
out from their medical notes. The same mechanisms the book had identified, they
argued, could be found in families where no one was schizophrenic. I feel I can
endorse that last point. But it does not affect the book’s observations. I
wrote back, and reiterated what I have said above: Laing and Esterson did not
set out to show that family interactions cause schizophrenia. They questioned
the existence of the condition, and observed that the behaviour described as
psychotic became intelligible, seen in context; to understand the context, you
had to listen when the families told you about themselves.
This long failure to engage seemed to me dishonest. My letter-writers
set up a man of straw, in order to knock him down. In their case study[9]
of the family they call the Danzigs, the researchers listened to the things the
family said about the patient, Sarah, and remarked, ‘They seem to be talking
about wickedness, not sickness.’ In the same way, my letter-writers were
confusing Laing’s personal qualities, to which they objected, with his
arguments, which they had not evaluated. My correspondents appealed to me to
trust their lifetime of experience. But that was the very thing I distrusted.
It is hard even to entertain the notion that you may have founded your
professional life on a giant misperception, and it is easier to deal with what
crosses your desk, day by day, in the way it was dealt with yesterday: it is
easier to deal with a symptom than with a person, and easier to deal with a
sick person than to confront cultural malaise. It took me some years to see my
story in a cultural context, as well as an individual one. The sense of
wrongness – not of doing wrong, but being wrong – afflicted a couple of
generations of women, caught between old expectations and new demands. A
working class girl with an education might not necessarily know what to do with
it; that was part of my problem. No one knew how to be a young woman in those days. I’m not sure anyone knows
now. When you applied for a job, they would say to you, ‘When are you going to
start your family?’ as if you were going to work some trick on them, or had
ill-disguised criminal intent. If you said you had no man or children in mind,
they would say, ‘What? A lovely girl like you? You’ll soon change your mind! Or
some man will change it for you!’
I wish, looking back, I’d carried a tape recorder with me
for a decade. It is hard to get your head up above circumstances, and see the
big picture. That is the value of this book, which has endured all these years.
You can leave the big picture to form itself. Just read the simple words the
people speak.
2.
Lucie Blair
Inner
Circle Seminar No. 213
[Hilary
Mantel was not present]
3.
Claire Church
Inner
Circle Seminar No. 220
The purpose of my introduction is to say what I notice
about the Church family, drawing on the case study – and to show how the
mechanisms that Laing and Esterson note in the case studies in general operate
in this particular family. The protocols of confidentiality, though necessary,
seem to disadvantage us more than with most of the families, because the setup
seems unusual, and you would like to know a little more, to help you get a fix.
Mother is described a businesswoman and the daughter of a
businesswoman: at one point she is self-described as a dressmaker, though it’s
not clear if that’s what she does now or what she did when she began her
career: and for long periods, it seems, the family live in hotels. But we must
manage as best we can: and I note also that there are only two voices here.
As in our earlier seminar, I am keen to hear the tapes,
because I am very much aware of the limitations of a transcript, and I will
explain why. I know that to introduce an element of personal anecdote is to put
pressure on the material, and raises the danger of distorting it – but that
said, I am here as a person, rather than a theoretician, so if you will permit
me I will allow myself to digress into my own experience.
I grew up with a mother and a stepfather, both volatile
and angry people. Rows were their hobby, rows almost daily. No weekend went by
without violent explosions. When I was about 14, crouching in another room with
my homework, hoping not to be noticed, I fell into the habit of writing down
exactly what they said, as if I were taking dictation. I realised even at the
time that it was a mechanism to control and subdue my own anxiety, but it’s
probably constructive, for a future writer. My transcripts showed several
things clearly: the lack of logic in the conversation: my mother’s willingness
to pursue every point: my stepfather’s blanket contempt for women, shown in his
mimicry of what he thought was a female voice. When you read the rows back,
they were blackly funny. Funny, as long as you were at a safe distance. I
wasn’t.
Nowadays, I see all the time the partial nature of
transcripts. When I give interviews to journalists they are taped. I read my
words in cold print, and mostly I can’t deny those are the words I spoke, but
the intent and meaning, and above all the irony, seems to have fallen out of
them. When I think back to my family rows – the speakers were devoid of irony,
but what was missing from my paper record was the feeling-tone, and the effect
of the dialogue on others: the intense fear and helplessness provoked in a
witness who had no choice but to see and hear, short of leaving the house and
leaving the family. I think tone matters almost as much as the exact words. In
our earlier seminar we heard tapes, but because my hearing is poor I could make
out very little. However, the speaker’s personality came over clearly – and
Maya’s voice was a surprise and a joy. I realise my unexamined expectation was
of a downbeat depressive tone – and what we heard was quite different – so it
was a warning to me about making assumptions.
Assumptions – that’s an important word here. Why, we ask,
has the message of this book and these writers gone unheard, or been
misinterpreted? Partly it is because of the assumptions that language traps us
inside. Once the label schizophrenic is affixed, it may be easy – or not – to
challenge the validity of the diagnosis in any individual case, but it’s
difficult to get back beyond the assumption that the condition exists. We keep
getting trapped into using the term. One interesting question, I suppose, is
how far Laing himself and his associates fell into the trap – conceptually, if
not verbally – whether they were misinterpreted because they were ambiguous,
and whether they were ambiguous because their position shifted. Certainly Laing
had shifted his position from where he was when he wrote The Divided Self, which is still the most famous of his books: but
one book doesn’t define us. The blame question seems central – it’s often
stated that Laing and Esterson ‘blamed’ families for ‘causing’ schizophrenia.
That, I think, is not what they did – what they did was to challenge the
reality of the condition. There are several overlapping but distinct questions.
Do the family mechanisms cause the
patient’s suffering? Do Laing and his supporters imply they do? And a different
question: are the families to blame? Do our researchers blame them?
It’s become hard to talk about mental suffering without
equating it to mental illness. There is no doubt the women in the case
histories are suffering. The question is how we can talk about that suffering
without falsifying its nature. When I was studying criminal law I used to be in
an aggrieved spin about how my fellow students talked about ‘the criminal,’ before
the use of the term was warranted – before the person had been tried – even
before he had been accused. They would talk about ‘the criminal,’ even before
we had established that the act under discussion was criminal – before we had
established whether the person could form criminal intent, or had done so. I
understood that they were using shorthand but I wasn’t willing to give way to
it. It seemed to me that we should not be using policeman’s language and
jailers’ language before we needed to. Assumptions of guilt are dangerous
because they bleed quickly into the facts around them. You can’t easily get
your mind clear again, or back to first principles, unless you keep your
language clear.
It seems to me we have a similar difficulty here. We reach
for a label and assume it represents a reality – when it may be just jargon, and
the reality beneath it assumed, rather than imagined. We use it because it’s jargon – it’s short, and
it’s easy, and we all understand broadly – to take the case under review – what
schizophrenia is supposed to involve – a pattern of thought disorder, a history
of affective impairment. It’s easier to allow the term to slide by, than
critique it on each occasion. It seems Laing
and his associates were not always clear and consistent about their own use of
the term. That may be because they did not want to admit, or did not clearly
admit, that their thinking had evolved. At some stage, for them, the reality of
‘schizophrenia’ started to melt away, but it is easier to keep on using the old
term than to put it in inverted commas each time. Also (and here I am employing
imagination, because I do not know what these difficult conversations must have
been like) it must have been gruelling to steer through encounters with
families who would misunderstand if you hinted that the illness did not exist.
There is so much potential for misunderstanding. A diagnosis is something to
cling to. It can serve as an explanation, even if false, and it can serve as an
excuse for behaviour no one wants to examine too closely. Also, diagnosis has
practical results. It creates a place within a system – it leads to a hospital
bed, a treatment protocol – it leads to some sort of action, to outsider
involvement, the comforting arrival of experts. So for families of patients, a
label may be welcomed even if it’s erroneous. In questioning the validity of
the term ‘schizophrenia’, Laing did not deny his patients were suffering – they
were suffering and also malfunctioning, in terms of the society around them. He
did not repudiate the term ‘madness.’ Yet he has been commonly accused of that.
When I read these histories, I feel as if the ground is hot. At every step,
take care where you are placing your feet.
Still, I find reading the transcripts illuminating. They
are starkly exposing. It seems I am hearing in operation many of the mechanisms
with which my own amateur transcripts made me familiar. If I may speak about
the case histories generally – there are secrets in these families. The
consequences of telling the secret are seldom spelled out and are all the more
frightening for that: it is hinted that they are catastrophic. A special duty
of keeping the secret is placed on one person. If she were to tell it, it would
be especially indecent. The fact of her knowing
it is in itself indecent. The fact that she knows means that her innocence is
sullied and that innocence – like a daughter’s honour, in some cultures – is
something that the whole family own, and talk about long after it has vanished,
as if it were still a fact. One wonders about the sexuality of these families –
but there are other secrets too – surrounding, for example, neglect of
religious observation, or dishonesty in business – and also the big secret of
who’s who: I suppose everybody born before the 1960s knows of a family in which
a so-called ‘big sister’ was actually a mother, or an aunt was a mother: whole
family networks came together to hide what they thought of as disgrace, and the
collusion was not a one-off – because these were lies that had to be sustained
and elaborated and carried on for years. I would say the patient wants to tell
the secret and also wants to hide it. These women are profoundly ambivalent
about their families. They are dependent. And the families who have encouraged
the dependence also blame the patient for it. Mixed messages abound. Indeed
there is hardly any other kind. The circumlocutions around sex were also
elaborately confusing – and I suggest this was the case in families where no
one was ever accused of being ill, but where blame was thrown around freely. You
will see how Mrs Church worries about a fantasy Claire, and how she discusses
sex and pregnancy in loaded and mysterious phrases. These could, I think, be
absorbed by a young child – not the actual words perhaps, which aren’t
understood – but the tone – so that the consequences of committing some blunder
seem calamitous – it would be very bad to do that thing – but you don’t know
what that thing is. This produces a state of permanent dark tension within the
individual: there are areas where questions are prohibited; even if you could
ask them, it’s intimated that the person who answers would suffer terribly
because of your careless demand. Some families seem wrapped in a fairy tale –
if certain words are said, they will be frozen, or exiled, or …or what? The
vaguer the consequences, the more threatening they are.
Claire is a career patient, 5 years already in hospital
when the work begins. Her brother Michael had already had a breakdown of some
sort when he was 16. I’m not sure if Anthony can tell us more about Michael. I
notice that in some families, dissent from a son is often tolerated, but
dissent from a daughter is pathologised. I would imagine that’s less the rule
these days, but you may have a view. I’m sure the patriarchal impulse doesn’t
go away. I don’t know how far modern conditions demand it be reined in. But in
this case, 2 of the children are subject to a diagnosis of mental illness.
The parents describe the family as happy and Claire as
compliant. Mrs Church says Claire is very like her, so she understands her. How
threatening that can be, to be told you are understood – that an interpretation
of your actions is ready-prepared: the explanation comes before the action
occurs, and everything you do will be interpreted as ‘like me’ – therefore
right – or ‘not like me’ – therefore anomalous, and wrong. The children in this
family can choose – I quote – ‘whichever way they wanted to go, provided it was
the right one.’
Claire has certain specific, familiar complaints about her
mother – that she has not allowed her to emerge as her own person. In this
family there seems to be a tussle about who loves, and who doesn’t love. It’s a
fraught area in many families and relationships. Is the one who loves too much
the weak one, or the strong one? How much is the right amount of love? Guilt is
heaped on the person said to be unloving. But love can be coercive, because
conditional. Some families use the word like a weapon, some like a blindfold:
they say they can’t possibly harm each other, because they love each other.
When I look at the case histories as a whole, I see two common attributions
made about the patients. One is over-sensitivity. One is coldness of heart.
Both are wounding. Both are difficult to disprove. As you try to mend one
offence, you stumble into the other. It’s a bind, a trap. You’re always trying
to please, and always failing: and I think this is Claire’s situation.
‘Fussing’ seems to be a code word in this family for the
expression of an infant’s needs for care and closeness. Mrs Church seems unsure
whether she is a good mother, but she knows she is a sacrificial mother. The
family story that prevails says that Mrs Church has been made ill by working so
hard for her family – so the children, by implication, are to blame. The
researchers notice the contradictions in her position; she is also said to be
too ill to work for long periods – it’s not clear if it’s two different eras
we’re taking about, or two different interpretations. There was an infant death
in this family when Claire was 3. The child lost was an infant of 7 months. Mrs
Church usually blames air raids for Claire’s nervous illness, but on one
occasion she refers it to the loss of this baby. Michael, Claire’s younger
brother, has been asthmatic and chronically ill from babyhood. To help this
condition, he was taken into bed by his mother and sister. There is a family
pattern. Mrs Church also had a younger brother who required looking after. The
researchers say Michael was born when Mrs Church was profoundly depressed. I’m
not sure of the timings here: whether she was in fact mourning, whether Michael
was born into a family that was mourning the 7 month old. I wonder what the
researchers mean by depressed – whether they are echoing a medical opinion
given at the time – whether they are medicalising the mourning process – but we
don’t have enough facts, from the transcripts.
But on the topic of pathologising, Mrs Church’s
relationship with her GP is interesting. Never has the expression ‘family
doctor’ seemed more loaded. She says she has spoken to the doctor about the
fact that Claire doesn’t express herself – one wonders how she managed to
present this as an illness. She says that the doctor reassured her, but now she
knows she should have pursued Claire to find out what was wrong. If as a result
Claire became upset, ‘I should have had to put up with it. ’ So an expression
of negative emotion on Claire’s part would be a trial, an imposition on Mrs
Church. She also mentions to the doctor once or twice that Claire isn’t
interested in fashion. Again he reassures her. But you wonder, what does she
take a doctor’s role to be? It is as if the doctors were there to make minor
adjustments and tailor life to Mrs Church’s satisfaction. You wouldn’t trust Mrs
Church to know what an illness is. It seems as if she wants a confidante and a
servant, a yes-man. If I may allude again to my own family: illness is very
important there, in puzzling ways. It was never an objective fact, but a
subjective reality, defined by my mother. I too had an asthmatic younger
brother, too sick to go to school, but he wasn’t elected to his role till I
myself, at the age of 11, was ejected from the role of sick child and told I
was well. Then he too, at the age of 11, was evicted from the role, because my
mother wished to begin a career. She has always said she doesn’t like babies; a
chilling thing for a child to hear. I think it may have been true, and a source
of guilt, and one way for a woman to demonstrate her maternal credentials
beyond all doubt is to have a sick child. A sick child is also a good excuse,
if you want to do things but don’t dare; if you are afraid of failing, and want
an excuse not to go out into the world. I am not saying that in this case
Michael was ‘not really ill.’ We don’t know enough to say that – and of course,
even if his symptoms had no identifiable physical cause, they were still real,
still distressing.
Such a situation entraps the parent as much as the child.
They construct a reality they both accept, and it’s in constant negotiation.
When you read the transcripts what you see at work is the strategy or mechanism
the researchers call mystification,’ which they describe it as ‘a constant
shifting of meaning and position.’ It’s the practice of systematic
inconsistency. Of narrative disruption, and narrative corruption. It ensnares
the person in contradictions and makes them doubt their own memory and their
own power of observation. It acts to cut links between cause and effect.
Attitudes which are well-worn can suddenly be abandoned, and new and startling
positions announced. And queries are met with a torrent of self-justification.
If you belong to such a family you develop a way not so
much of listening, but of ‘listening through,’
to work out what is happening. It’s not the words but the non-spoken
communications that enlighten you and maybe arm you. Clearly the researchers
would be aware of these communications among family members, but the problem is
how to record them. In one of the other families, certain members have a way of
exchanging glances – collusive glances – which the patient is not supposed to
see, yet can’t help see. Once you have learned to read your family, you may
know what’s really going on: but you still can’t use that knowledge. You’re not
allowed to have it. You cannot speak of what you see, or know what you know.
Because it will be denied. And confusion and self-doubt sets in, and maybe
isolation within the family – and so one person is chosen as victim, as
sin-eater.
At the time of Claire’s crisis she was 23; the family
business was failing. Claire describes her mother and father as business
partners, not as parents. She may have been making a shrewd observation there –
but one that, coming from her, couldn’t be tolerated. She is understood
literally – it’s taken to be a delusion. Claire is not allowed metaphors. She
is allowed delusions, because she is a patient. She understands herself to be
at risk from imminent and dreadful violence, which literally speaking is not
true. But she makes a metaphor. She says she has the atomic bomb inside her,
which means she can destroy other people and destroy herself. It is said among
writers that ‘censorship is the mother of metaphor.’ For an artist constraint
can be fertile – but he is licensed for metaphor. Imagery is dangerous for the
women in these case histories. They would do well to state exactly what they
mean, in bald terms, except that all their lives they’ve been primed not to do
that. They are barely allowed the weapon of irony. Self-expression is allowed
within narrow limits. It’s almost trite to say that sometimes parents have
trouble seeing their children as fully human: they see them as a reflection or
sub-self or Mini-Me, or as objects. Mrs Church makes a remark about the
hospital doctors – how it’s their job to fix Claire – as if her daughter were a
machine that had broken down. And this is how Claire sees herself – a
manufactured thing, volatile, lethal to everyone around, including herself and
those who made her. A bomb doesn’t talk, it just explodes. That’s what you must
do, if your feelings are bottled. Alternatively, if you can’t speak, you will
show, your body will show: you will develop physical symptoms. If you dare not
even show, perhaps you will become catatonic. If nothing within you is
acceptable, including your thoughts, you will empty yourself out in a torrent
of images and suffer the consequences; if your real being is overlooked, if you
cannot be seen, you will consider yourself wiped away.
4.
Sarah Danzig
Inner
Circle Seminar No. 222
My notes for our meeting fall into two parts: those I made
over the last few days by the light of reason and by day, and those I made in
the darkness early this morning, Valentine’s Day, guided by feeling and
intuition. As an outsider from another discipline, I ask myself what I can
bring to the table in these seminars, and today I can bring my dream.
I dreamed that we, as a shadowy collective of strangers
and semi-strangers, visited the Danzig
household to help the family clear it up. Confidentiality was preserved in the
dream. It was too dim to see the faces of the family, or our own faces. We
found them sitting in misery in dirty and disordered rooms. They were in
mourning for the family dog, a large, brindled muscular boxer dog, a beast of
unruly energy. (As soon as I woke, I made the association with what Esterson
says in The Leaves of Spring: that
the family has lost touch with their animal selves.) Without this boisterous
animal, the family were husks, shells. The energy had drained from them.
What they did not know was that the animal was still
present, as a ghost: as lively, uncontrollable as it had been in life. It had
brought other animals to the house. Together they rampaged through the rooms,
trashing them, shitting everywhere. The Danzigs were very dimly conscious of
the presence and also the inevitability of the animals, and their necessity –
aware they should do something to accommodate them, they tried to feed them by
pouring on to the floor the contents of cans of dog food, brown slurry which
added to the mess and the stench.
The animals had no awareness of. or relation to, the
humans they shared the house with. They did not mean them either good or ill.
They simply possessed the territory.
Our task, as bringers of order, looked more impossible by
the minute. We were Hercules in the Augean stable. But less successful.
When I woke I wrote my dream down. In The Leaves of Spring Esterson describes the family in terms of an
unregulated bowel, stressing the anal quality of their interrelated phastasies.
In waking life, I had resisted this: I understood, but I felt it was an
unhelpful retreat in a Freudian direction. The dreams showed me in the most
graphic way that I should think again, and admit how powerful and authentic
Esterson’s perception was.
When I fell asleep after making my notes, I had a second
dream. I was on my way to the seminar. But I got off the bus early, in Chelsea Chelsea
So I begin feeling I have already done a day’s work, and
amused by my own inner processing. In waking life I do not feel it is our business
to clean up the case history. I feel it is a work of retrieval and for me, it
feels like a work of mourning. In the culture in which I was brought up early
in life (northern, working class, Irish origins) mourning is a strenuous
business. If you visit a family that is bereaved or where there is sickness, it
is your job to help clean and restore respectability, so nothing of the
family’s private misfortune need show. You look after the practicalities,
taking particular care to clean the doorstep, the threshold between private and
public. It can be a noisy, insensitive business, done badly; done well, a great
relief to the suffering people in the house, who have a burden lifted and are
free to concentrate on being rather than doing.
This is a sad story. Anthony will be able to bring us much
extra information about the Danzig family, and
shed light on what eventually became of Sarah. I have been re-reading
Esterson’s book, The Leaves of Spring,
published 1970. It is a complex book but I will try to summarise and refresh
our memories.. The Danzig case study forms the
first chapter. The rest of the book extends it, and offers certain theoretical
perspectives and speculations, and a critique of psychiatry as Esterson sees it
practiced, but the Danzig family is at the
heart of it: mother and father, the eldest child Sarah, her brother John. There
is another daughter, Ruth, still a schoolgirl. She does not form part of the
investigation. The only thing we learn about Ruth from The Leaves of Spring is that she gets up at 6:45 every morning, and
so is a paragon of virtue. The Danzigs are one of those families in which early
rising equals moral worth.
Esterson gives something of the social and historical
context. The families of both Mr and Mrs Danzig had immigrated to Britain at the end of the nineteenth century
from Eastern Europe . Both families left
relatives behind, and both had relatives who died in the camps.
Mrs Danzig’s mother and father were both tailors. After a
struggle, the father came to own his own business. Mr Danzig’s father was a
businessman too, with a reputation for ‘learning, piety and holiness.’ Mr
Danzig was one of four sons. He idealises his family, but further exploration
reveals they were not as harmonious as they appeared. Both families were
notionally orthodox. Mr Danzig’s parents were more strictly observant. Mrs
Danzig’s father, she says, knew how to overlook breaches of ritual – if she
went out on the Sabbath, he would wink at it. She herself observes the rules in
part at least, just to please her husband, as her mother in her day tried to
please her father. But she says that what happens in the family kitchen is her
affair – which is a ferocious sideswipe at the patriarchy, as the dietary rules
are very much the heart of the matter.
Mrs Danzig is an only child. The marriage was arranged
between the two families. Mr Danzig’s father decided it was time for him to get
married and introduced him to a suitable candidate. Mrs Danzig simply obeyed
her family. At the time of the study they have been together for twenty-five
disharmonious years. Mr Danzig says that his wife has sometimes threatened
suicide. He is aware she is unhappy, and says he is not happy either, but it
must not be discussed in front of the children. He wants them to present a front
of solidarity, to the children and to the outside world, whatever their private
differences. He senses a pathology within the family, wondering at one point if
his wife has caused Sarah’s illness. The parents quarrel a good deal, but when
Sarah remarks on this, they deny doing so. Mrs Danzig doesn’t want her husband
to bully or impose on the children. She says to him, ‘They are a different
generation.’ She tries to keep the peace and act as a referee between John and
Mr Danzig. Mr Danzig’s fear is that the children will, ‘run riot, run wild’,
but Mrs Danzig says, it’s not the Victorian era. Esterson sees a desire to
control her husband and son – he may sense that, but much of what she says, in
cold print, is reasonable by any standard. Esterson sees her as undermining her
husband’s masculine authority – which of course she is – but I can’t help
thinking he is putting her into a bind, like Sarah, where she can’t do right.
Mrs Danzig is one of these people who makes you want to unpick the word
‘housewife.’ She does seem to be married to the house rather than to her
husband. She idealises her own father, who she says was wise, pragmatic,
tolerant and in love with her mother. Mr Danzig denies this. They are both
clear that they were never in love with each other. Sarah asks, ‘Why don’t you
divorce?’ It seems that her parents come from an older world where marriage is
a social institution, and the happiness of individuals is incidental; but it’s
doubtful Sarah understands this. All she sees is the day to day conflict, and
the denial of that conflict. I am interested in the way some families locate
themselves in history and some try to cut free, and some are experts in
forgetting and others can’t forget – and I wonder what to be Jewish means in
this family, and if the past would ever be spoken of, and how it has been
internalised. Mrs Danzig is adamant that John mustn’t marry out. But she says
oddly, ‘There’s no harm in going to the synagogue on Saturday, that’s all
right.’ It’s not a ringing endorsement of community or tradition. It’s as if
she feels that the main feature of the faith is a set of petty rules fathers
impose to make life difficult. Mr Danzig feels she doesn’t respect him, that
she undermines his authority, and as in all families there is a system of
shifting alliances between parents and children – but finally, Sarah is the one
who is isolated.
Mrs Danzig describes Sarah as having been a good baby and
a compliant child. At the age of thirteen she becomes ‘lazy.’ At seventeen she
begins to withdraw into herself, becomes a nocturnal creature and eventually
drops out of her studies. The pattern is so familiar in adolescence – I am sure
we have all seen it, or been part of it ourselves – the young person sleeping
at different hours from the rest of the family and disrupting the routine. In
some families, what begins as a hormonally-driven need for extra sleep hardens
into a form of protest against intrusion. It then agitates parents – who
foresee dire consequences in the outside world – they nag – the young person
feels more and more impinged upon. In any family it arouses resentment, when
one member seems to have latitude and to be allowed an easy life; in a family
like the Danzigs, this behaviour is an evasion of control, deeply disturbing
and ungrateful. The young person might have dreams, and dreams cannot be
policed. Lying in bed also creates dirty linen. And as Sarah is socially inept,
and often angry, the fear is she might wash the dirty linen in public.
Invariably when the child goes on to have a career as a patient this phase is
seen, in retrospect, as the beginning of the illness. So it is with Sarah. Mrs
Danzig will blame herself for not seeing that Sarah’s laziness was, in fact,
illness. She says she should have called a doctor sooner.
At 21 Sarah’s behaviour took a more florid turn. She felt
persecuted, she expressed anger with her family. Finally a quarrel with her
mother precipitated a crisis. She ran out of the house, was gone all night and
when she returned said she had been to a hotel with a man. This led to her
first admission to hospital. It seems to be John who first suggested she needed
a doctor, and at this point mother agreed, but father didn’t.
Anthony can tell us more about John. In the transcripts he
seems self-aware. He admits that there is a double standard in the family, and
that he is on the whole freer than Sarah, though he quarrels with his father
about religious observation. But he plays a part in the effort to control Sarah
– there’s a tiny thing that blazed out at me – by his mother’s account, John
will come home from his evening out, see Sarah’s light is on, and switch it
off. I wondered why I was so outraged by this – but I myself am an older sister
– if one of my younger brothers had done that to me, I wouldn’t need a light,
I’d be incandescent. We are so sensitive to crossing the line, to any
derogation of our place in a family – but Sarah sometimes seems less a person
than a sort of service to the others – a magic mirror, as I’ll say later.
So, hospital: after two weeks she returned home,
spiritless and withdrawn. She shut herself in her room and read the Bible.
Later she would say that in hospital she had been raped. In the climate of the
time this would be taken as a fabrication, or at best as a metaphor, but now we
would be less sure.
Sarah had taken a secretarial course and spent some time
at art school. Both her parents and her brother describe her as highly
sensitive, and her brother also says she is highly intelligent. After her
hospitalisation she went to work in her father’s office. You can understand the
protective impulse that creates this set-up. But big problems begin here. The
Danzigs as a family are very keen to appear respectable and above board in
everything they do, and to stand well in the eyes of their community and the
outside word. When Sarah goes to work in the business she notices
irregularities in the accounts which she naively takes to be mistakes, and so
draws attention to them. Clearly she is meant to collude in these mildly
dubious practices. But no-one has explained this to her. Her position is
difficult because the other staff know about her hospitalisation and she is
aware they talk about it. She also has the usual problems the boss’s daughter
would have – people are wary of her, and it appears that she is the target of a
malicious trick. In time she refuses to go to work. You can see the tension
that would be generated. Sarah knowing what she does – she could ruin the
family’s reputation. Shame and fear of scandal are very potent in this family,
and they are increasingly ashamed of Sarah.
We may ask, what does Sarah do that convinces her family
that she is ill? She sleeps and wakes at odd hours, she refuses to go out, she
believes her parents quarrel. She says her parents listen to her phone calls.
She gets angry with her father when he enters her room without knocking. She
smokes on the Sabbath: John says this makes her father ‘fume internally ‘ –
wonderful choice of words – you wonder how often she is enacting for them the
unruly behaviour they fantasise about. She is shy, and she refuses to be
independent when her family tell her to be so. She stays awake thinking or
reading. John says she is thinking about herself. Her mother says she is
thinking, ‘rubbish – a lot of nonsense’. She reads the Bible a good deal, which
Mrs Danzig doesn’t think is normal. She plays a trick on her father, putting
lemonade in his tea – a trick that I am sure you will find thought-provoking.
I’m not suggesting that Mr Danzig was sexually intruding on Sarah in a physical
sense, only that she is aware of undercurrents of soured sexuality in the
household. Sarah says that she is afraid of her father. They say she is not.
She has no power to describe her own feelings. Nor is she sure if she has any
right to privacy. Mr Danzig describes his intrusive behaviour as love. It’s
fair to add that he also goes into John’s bedroom and goes though his things.
He justifies this need to know about his children’s lives as a need to protect
them. Sarah needs to be on guard against ‘men with glib tongues.’ John needs to
be wary of ‘confidence tricksters.’ Like many of the families in the study, the
Danzigs apprehend the outside world as a very dangerous place. Esterson says
they are ‘divorced from the animal in them’ and alienated from their own
instinctive life. It appears the parents’ own sex life has been unsatisfactory,
and they are very fearful of the possible results of their children’s
sexuality. They worry of course that Sarah will get pregnant. Mrs Danzig agrees
that it is all right for John to have sex, but only with non-Jewish girls. They
worry that John will make a woman pregnant, that he will catch an STD, or be
blackmailed. Despite this, Sarah is encouraged to go out – but she has to give
an account of herself. It is right to have boyfriends, but she must bring them
home for approval. Sarah has never had much social confidence. She has asked
her mother to advise her how to behave in social situations, but Mrs Danzig has
grown exasperated about the amount of reassurance she needs. She tells her,
‘People don’t bother about you. They forget you the minute you go out of the
room.’
This seems a technique calculated to deprive a shy person
of any resources. When we say reassuringly, ‘Nobody is looking at you,’ the
implication is that you are not worth looking at: indeed, you’re barely there.
But the parents are very self-conscious and afraid of public opinion, as if
they were constantly observed. Mr Danzig worries people will think less of him
because of Sarah’s illness. He hasn’t shown leadership, hasn’t controlled his
family.
Whilst objecting to the strange hours she keeps, the
family in some respects organize themselves around her, her mother cooking
meals for her whenever she appears. They say she is spoiled. They have got
themselves into a bind: they indulge her and then blame her. Sarah is subject
to mystification. They do open her letters and listen to her telephone calls,
but of course they say that they don’t. She’s the member of the family expected
to be compliant and respectful, not to call their bluff: and so she has to
perform all sorts of metal contortions to reconcile what she witnesses with
what she’s allowed to mention. The Danzigs both have stern views on the duty of
children to pay back the investment, in time and resources, that parents have
put into them. Mr Danzig talks in terms of assets: you invest in your children,
and you get interest from them. Sarah is failing to pay him back. She has run
out of control and become a sexual being, and now she’s gone mad. You can’t help
think of The Merchant of Venice: ‘Oh my ducats! Oh my daughter!’ The Christian
who reports Shylock’s cry is a hostile reporter, and he calls his pain
confused, strange, outrageous, but there’s no mistaking his desolation: the
sealed bag has gone, the jewels, you can’t distinguish between your own flesh
and your money, you work hard for both – it’s not, if I may say, only a Jewish
mistake.
Mrs Danzig equates Sarah’s state to a natural disaster. It
is something that happens to the
family, not in the family. It is a calamity,
like being flooded out.
Esterson says this family have ‘no experience of
inwardness and none of self-doubt’. They are alarmed by evidence that Sarah has
an inner life they can’t know, a private place where they can’t follow her.
They want her to take sleeping pills and tranquillisers – this would put paid
to her habit of sitting up at night and thinking. The family also, Esterson
says, lack any sense of paradox. They have no way of facing and containing
their own contradictions. When inconsistencies in their thinking and behaviour
are pointed out, the family think they are being criticised.
Most people do. I wonder if Esterson expects too much of
them. There are inconsistencies in his own behaviour. Anthony has said he has
found apparent contradictions in the Sarah Danzig tapes. When Esterson first
records Sarah he remarks, after she has left his room, that she has a
"schizophrenic illness". I learn from Anthony that in Oct 1963 on a
home visit, Laing (meeting the Danzigs for the first time) says: "I hope
you don't think we're saying there's nothing wrong with Sarah. Sarah's a
schizophrenic." He adds a saving phrase, something like ‘in the medical
understanding,’ to indicate his dissent. Esterson says shortly afterwards (or
on another occasion: Anthony can verify)"It's not helpful to think of
Sarah as having an illness." It’s quite understandable that their thinking
evolves and their terminology shifts, but you can see it must have been
confusing for the patients who were in the middle of that shift.
In talking to the Danzigs, it seems that Esterson
interrogates them quite fiercely about their religious attitudes. He seems to
want to convict them of hypocrisy, yet there is nothing odd or rare in their
social strategies. The household calls themselves orthodox. Both parents relax
the rules to different degrees. But outside the house they watch their step.
Outside, they are witnesses to their faith. Their religion is something to be
performed and demonstrated – the performance defines you, and it is important
for social cohesion to carry it through convincingly. It is hard to understand
why Sarah’s reading the Bible appears transgressive, but we become aware that
she is seen as usurping her father’s function. There is no spirituality in the
family, but Sarah seems to belong to an older world when study of the Law was
the highest duty. In fact Sarah’s role is, as Esterson says, ‘keeper of the
family conscience’. Her role is to, ‘see no evil, hear no evil, speak no evil,
and feel no evil.’ It’s as if they need to witness themselves through her eyes
– she has to be a mirror in which they can see an ideal shape of themselves,
pure, free from transgression, free from contradiction. There’s a gap between
that desire and the knotty, collusive reality – that’s the gap Sarah falls
through.
Sarah was hospitalised for a second time after an outburst
against her father. John says that in her anger she used ‘sexual words.’
Esterson points out that it was on the Day Of Atonement that they sent her back
to hospital – an unaware, unspiritual family acting as if entranced by a
tradition they don’t consciously think about. Sarah is the sacrificial animal
who is ejected, sent out – except that she is a human sacrifice.
When she is in hospital her parents say that they have
left her telephone messages daily. Esterson believes this is not true: it
seems, though we can’t be sure, the family admitted it was not true. Sarah then
believes the staff are maliciously withholding the messages. She cannot believe
ill of her parents. She believes it is the doctors who wish to detain her. She
refers any malfeasance to an outside agency, a higher power – the doctors, the
telephone company. These attempts to make sense of her world are seen as
delusions. Her compliance and passivity in hospital are seen by the family as a
trick to persuade the doctors to let her out. If she talks about her disturbing
ideas and feelings she is showing signs of illness, but if she doesn’t, she is
still sick, just cleverly pretending to be well. At this point its difficult to
see what she is to do or how she is to help herself.
When I first came across Sanity, Madness and the Family I felt that it was holding up a
torch for me, but I didn’t see the full extent of what it illuminated. The case
studies seemed to shine a light on the workings of families like mine. It is
only a couple of years ago that I read The
Leaves of Spring for the first time. I find the book illuminating,
exasperating and profoundly moving. Illuminating in the obvious sense, that it
extends the case study: also in the sense that I pick up from the longer
transcripts a certain hostility and obtuseness in the writer, and I wonder how
far this is perceived by the family. But of course, the tone is everything, and
the non-verbal communications – and maybe I am worrying unduly here – I am only
saying what I pick up from the cold print. And I say ‘exasperating,’ because
once Esterson has decided that the family functions as a collective bowel which
imagines it needs to be regulated, he labours the point. I don’t dispute the
force of his description, in the context of the family’s dread of disorder, Mr
Danzig’s accumulative and retentive character and fear of dirt and mess, Mrs
Danzig’s zealous but failing attempts to keep order – Esterson says she is
diligent but not competent, domestically – I’m entertained by his picture of
her trying to serve tea, but I think a few of us might get in a muddle with the
teaspoons and biscuits if we were going to talk to strangers about whether our
child was mad or not. My concern was that Esterson was intent on fitting the
family into a theoretical framework. Yet at the same time I have no doubt he
intuits their state of being. If I did have doubts, my dream removed them.
And I find the book moving, if I may speak personally,
because the later chapters seem to cast light on what I’ve lived and written
over forty years. He explores the concept of revolution, in the personal and
political sense, as a continuous remaking, a process: and he unfolds the
concept of reversion. For me, this was a gift of a useful term for something I
had written about, but had no single word for. ‘Regression,’ is his term for
moving back in time, but within the individual’s life-history: in reversion,
the ‘I’ is obliterated, and the experiencing individual falls outside time, and
into the realm of the transpersonal. How that might feel, I have explored in my
novel Beyond Black, which is about a
professional psychic, and I find this part of Esterson’s book has helped me tie
the topics together – revolution and reversion, charisma, cults, the collective
mind. What I also find deeply moving is an image, one that I find most haunting
of all those thrown by the case studies – and that is the picture Mrs Danzig
evokes, of Sarah in her blue nightdress, alone, sitting in the family kitchen,
indulging in the treacherous business of thinking in the watches of the night.
5.
Ruby Eden
Inner
Circle Seminar No. 226
I think in all these case histories there is no picture so
harrowing as the picture of Ruby Eden held down by her female relatives while
they try to abort her child, at the same time heaping abuse on her. I won’t be
giving too much away if I tell you at the outset that the outcome for Ruby,
after she leaves these pages, was better than one has reason to hope. I will
leave Anthony to unfold that part of the story, while I concentrate on what the
book tells us. I usually apologise at this stage for dragging my personal
history with me. No one wants to think they have nothing to offer but
autobiography. We would like to think we have some faculty of abstraction, to
get us beyond our own lives to general principles. But these cases are
accessible to anyone to think about, and if a reader brings nothing else, she
can bring her own experience of being human, living in a family, trying to
become a person in her own right. My reverence for the process of these
seminars is driven by gratitude to these 11 women and the researchers who
compiled this material, because it has helped me uncover certain mechanisms
which operated within my own family, and make sense of my own past.
Essentially, the histories confirm to me that I know what I know: I remember
how it feels to have that security confiscated.
In the one way the material here is impoverished. The
researchers mention their difficulty in getting key interviews. There is only
about half as much material as in the Danzig
case, and there is much paraphrasing, so we miss the peculiar eloquence of
transcripts. But if it’s deficient in one way, it still exemplifies and
condenses the core issues. We have a family suspicious of outsiders, easily
shamed, afraid of scandal, living in a situation comprehensively and
systematically falsified, where uncle is daddy and aunt is mother, where lies
are transparent, but it’s necessary to act as if you don’t see through them.
The very beginning of the account directs one to look at
language, as it gives us the official terms used about Ruby. When she is
admitted she is in an ‘inaccessible catatonic stupor.’ She has stopped eating,
stopped communicating, made herself like a corpse – as if the only good Ruby is
a dead Ruby. The case history speaks of ‘clinical psychiatric terms,’ and so
makes it clear that other terms are available. The assumption that governs the
clinical description is that Ruby, and others suffering in a like manner, have
passed beyond choice: they are victim of a disease that flies in, like an
air-borne infection, and alights on them. Mrs Danzig in the previous case
refers to her daughter’s supposed illness as something that ‘has happened’ – ‘
we thought these things only happened to other people’s children’ (116) she
compares it to being flooded out – to a natural disaster, or what the insurance
industry calls an act of God.
At this distance, we can see sense in what Ruby’s doing
and saying – we see it might be a tactic for self-preservation. We don’t know
from what’s on the page how Ruby came to be admitted, or what she was told
about her condition. A suspect questioned by the police is often best advised
to say nothing. Ruby’s situation is analogous to someone detained for an
unnamed crime and for an unspecified length of time. A girl so mystified, a
member of a family so confused and confusing, a girl encouraged to doubt her
own sense of reality, a girl belied and stigmatised – perhaps her best tactic
is to say nothing, do nothing, block out what she can as self-protection, move
into a fortress of silence and inaction till she can in some way work out what
are the rules here.
I’m not discounting how alarming it must be to see someone
shut themselves down in this way. I imagine it would first present as a nursing
problem, not a philosophical problem. But then, we are told, Ruby is ‘coaxed’
to eat. So her will is still alive. The carers know she can choose. In her
inaccessible state, she still has agency. In psychiatry the diagnostic terms
alienate – in a way they don’t, in a physical illness. You can say someone has
typhoid fever without casting them outside the normal, but if you say they
‘have schizophrenia’ you exoticise them – a glance at the media any day shows
you we are still governed by that thumping literalism that insists a broken leg
and a broken mind are the same kind of thing.
Ruby is a paradise for a medic with a check list of
symptoms. She has delusions of reference, hears voices that threaten and abuse
her, has grandiose delusions with a religious and sexual content. She is deemed
to have inappropriate feelings about her situation – she laughs, or seems
indifferent. Her ‘sense of reality’ is in shreds, the writers say – putting the
phrase in brackets. We are drawn to ask what exactly is reality in this case – exactly
what is going on here – not in a psychological sense, not in a spiritual sense,
but simply, what is happening in the daily lives of this family? Like other
families in the studies, they have a capacity not only for reshaping their
present but for rewriting the past, and punishing and invalidating a member who
casts doubt on their veracity and accuracy. Ruby is keen to be ‘good’ by
falling in with the family version. When she reports that she hears ‘voices’
denigrating and abusing her, it is literally true. In real life, the voices
belong to her family and their neighbours. But her family deny they are hostile
to her and deny that the neighbours gossip. These voices are therefore
disembodied – no one will own them. It is not surprising that to Ruby the
voices seem outside herself, as such critical commentary is the soundtrack to
her life. When Ruby is supposedly ‘mad,’ she knows and states accurately what
her family think of her. Her return to ‘sanity’ is marked by her acceptance of
the family version – that her family are good, loving, and want what’s best for
her. To be considered ‘sane’ and ‘well’ she has to deny what she truly knows.
Ruby lives with her real mother, and an aunt she calls
mother. At one stage she calls her uncle daddy. When Ruby’s real mother was
pregnant she was rejected by her own family, it seems, and so she moved in with
Peggy and Jim – her sister and brother in law – and this is where she still
lives. Ruby, the unwanted and inconvenient child, is the focus of the family’s
anxious attention, and of intense ambivalence. She is asked to believe her
family love her. If she doubts this, she’s in trouble. She is told the
neighbours are not talking about her, when they are. The family express to the
researchers their shame – describing Ruby as a slut and a prostitute. Her uncle
accuses her, to the researchers, of making sexual overtures to him, and admits
he has tried to throw her out of the house – though when Ruby mentions this has
occurred he denies it. (135) Her perceptions are falsified – there is nothing
she can rely on, not even where a matter of fact is at issue.
Ruby’s real father, who she calls uncle, has another
family elsewhere. Ruby has not been officially told she is illegitimate, until
she herself becomes pregnant. Her cousin believes she has known for a long
time. This is one of the family mystifications. You know, but you don’t know:
you’re not allowed to know. When she was a child, her uncle would say to her,
‘come and sit beside your dad,’ and she would go and sit on the other side of
the bus; it occurs to me she was mutely stating the true state of affairs:
that’s not my dad. (137) But – as when she is admitted to hospital – a mute
statement is all she can manage. Her mother and aunt have different ideas of
what Ruby should do, but she is the one who has the task of reconciling their
different demands. It doesn’t occur to them that she could ignore them both,
and obviously it doesn’t occur to Ruby either. To somehow please them both, to
please everybody – that’s her burden and her task.
I ask myself, as I’m sure you do, what’s happening
sexually among these people. Her uncle shows his workmates pictures of Ruby,
(137) with the intention of showing her off as sexually attractive, and then
constructs a picture in which Ruby visits injury on those who desire her,
blinding them, like a creature from a myth. It is said that Ruby would stroke
her father and slap him playfully: I find it difficult to imagine what he is
wearing when she slaps his legs until they are red. The families in the book
make us consider the shift in public attention that made sexual abuse of
children visible – after generations when it appeared not to occur, because no
one was looking. The unspeakable is constantly speaking in these histories –
but it may be no one is listening. The patients in the case histories are
trapped in a bind where their metaphors are taken as delusions, but their
literal complaints – of actions, of deeds, of possibly criminal deeds – are
taken as metaphorical. When Ruby says people are lying on top of her at night
having sexual intercourse, this may be her way of expressing her fear of the
people around her or her suspicion of their intentions, and/or it may be a
protest – she may have consented to sex but still felt coerced and ‘in the
dark’. Or it may simply be true. Such things happen within the family and
within institutions, as we now acknowledge.
Ruby repeats the ‘stroking’ with her cousin Alistair, and
I wonder what he means when he says it’s not entirely her fault. It sounds as
if Ruby is trying to placate people. There is huge resentment between family
members, who accuse each other of being ‘pampered’ and ‘spoiled.’ These words
keep jumping out. They talk about play – ‘I’m not the playful type,’ uncle says
– and whatever they mean by play, it’s something that might happen between
adults – Ruby’s mother says the uncle will ‘play sometimes with me and Peggie.’
And sometimes the stroking of Alistair turns into a ‘game,’ between Ruby and
himself.
It seems sinister, but we have no more facts to go on, not
from the page alone. Ruby’s delusions seem like condensed, encoded, symbolic
expressions of her situation. She has given birth to a rat, she says. We have
been told how she’s been subjected to the abortion attempt: any woman violently
handled in that way, if the child sticks, is bound to fear that the child will
be damaged. You ask yourself what happened when Ruby’s own mother was pregnant.
The family say history is repeating itself. You wonder if that includes an
abortion attempt. She wasn’t, in any event, a wanted child, and it may be true
that the only good Ruby is a dead Ruby.
This is not a family who have slid into misrepresentation – they have consciously made a lie that
they can all get along with, and which they believe protects them from damage
and disgrace. But given the nature of the community they live in, it’s a fair
bet that their neighbours know who is who. It’s an open secret. It’s the open
secret that interests me particularly in these case histories. I try not to
stand in my own light, by over-identifying, but I too grew up in a family where
there was a deliberate muddle over identity, and also with two people who
pretended to be married to each other but weren’t – often a necessary pretence
in those days, and something I am sure many others did. I knew who my father
was, but he wasn’t the man I called father, for the world’s purposes; my real
father had in fact been written out of the family drama. My younger brothers
assumed the man they called their father was their father; I knew he possibly
wasn’t; lies were not told directly about that issue, but they were told by
implication. I never had more than half-knowledge, but I couldn’t improve on
it, because questions were forbidden, so I had the burden of carrying a secret
of unknown dimensions: I didn’t know where its boundaries were, I didn’t know
when I was straying into the danger zone. I made the assumption that my brothers
were my half-brothers, and it took a lot of time, and the emergence of family
resemblances, for the facts to show themselves to me. The truth was like a
photograph taken at the end of the 1950s, and slowly, slowly developing itself
over decades. It seemed that if I wanted the truth, I just had to wait.
But when I was growing up I was perplexed about what I was
allowed to know and what I wasn’t, and what other people knew about my family.
I didn’t know how far the secrecy about our circumstances extended, so I was
permanently wrong-footed. It seemed that any reference to the family at all,
outside the four walls, might be wrong; so as with Ruby, even casual
conversation could lead to accusations of giving too much away. There was a
sense of impending catastrophe; it was like living in a factory that made high
explosives.
And yet, everything was permeated by a sense of falsity
and exaggeration. Suppose you grew up in a building where you were forbidden
access to certain areas. And you were told ‘We make gelignite, that’s our
family business.’ But you suspected that in the forbidden zone they really make
jelly babies. You still have to pretend the danger is there. The whole place is
plastered with KEEP OUT signs and hazard warnings. So you walk on tiptoe and
speak in whispers. Yet your elders clump about in big boots and shout. You must
ask then, are you the locus of danger:
are you a walking peril?
In those circumstances, it’s easy to understand what
process of making metaphors is at work if, for example, a person says, ‘I have
a bomb inside me,’ or ‘I am poisonous’. When Ruby goes to the hairdresser and
mentions she’s making a visit to a relative, it seems harmless, but it becomes
a grievance, it’s treated as an indiscretion that is close to a betrayal. The
neighbours know about her pregnancy, and that she has been hospitalised, and
talk about it, but her family deny she is the focus of gossip.
In my family the complication was that many people did
know about our circumstances. I too was keeping an open secret. I am interested
in Ruby’s claim that she was the Virgin Mary and the wife of Cliff Richard. As
to the first, I don’t know if Ruby had any particular religious background. But
we all know that the Virgin Mary represents an impossibility – virgin AND
mother – it’s a feat no other woman can hope to achieve. But Mary is not just a
locus of anatomical impossibility. I remember how often I was told as a child,
‘The Virgin Mary sees everything you do,’ as if surveillance were her
speciality – she was an extension of human mothers in that way, and she could
read and judge your thoughts, and because you couldn’t actually be her, she was perpetually
disappointed. She simply can’t be pleased.
And Cliff Richard: there’s a life with a fundamental
misrepresentation in it, which you may be aware of: he was born in India and
seems his family have some Indian blood, but at the time his career got
underway, his management must have decided that it would harm him if this were
known, so the story was created that he was thoroughly white English and his
parents had been merely visiting India at the time of his birth. The whole
family – he has sisters – assented to this deception, at one time admitting to
a Spanish ancestor – and as far as I’m aware it’s never really been resolved, though
the family have confessed to a grandfather who committed bigamy – he pretended
to be dead, but he wasn’t dead, he was in Coventry Birmingham England
As for the Indian ancestry, you think – surely, nowadays,
no one would stage that sort of charade? But it’s not so long ago that Michael
Jackson was bleaching and remodelling himself in the glare of the world’s
cameras, and denying that he was doing what we could all plainly see. I’m not
suggesting that Ruby was aware of the duplicitous nature of her fantasy
husband, but just pointing out that open secrets exist on a massive, public
scale. The families in the case histories are hugely optimistic in expecting
their lies to be believed, in or out of the family house, but they are not mad,
or even that unusual. As you know, if you mention this book, if you mention
Laing & Esterson, you will be told that their theories are discredited. If
you ask, ‘What is the theory that is discredited?’ you will be told they
‘blamed the family’ for schizophrenia – when by the time they produced this
book they deeply doubted the term ‘schizophrenia’ makes any sense or
corresponds to any reality. It may be that sometimes they ‘blame’ the family in
the loose popular sense of the term – that’s to say, they judge them adversely.
It would be above the human standard to make no judgment at all, when you
consider the vulnerability of some of the young patients. But they do not
‘blame the family’ in the sense of saying that the family cause schizophrenia –
the introduction makes clear that they repudiate the term – or at least, they
set it aside. And we have to keep reminding ourselves that they are not pathologising the family – that is not
the shift they are making. These families, enmired in their own
misrepresentations, are part of a wider culture and society that has trouble
saying what it means and meaning what it says. I don’t know if there could be a
society that has a cleaner relationship with the truth: but to ask that takes
us into the deep waters of collective identity and the myths that hold tribes
and nations together. When delusions are nurtured on such a massive scale, it
seems harsh that people like Ruby are the ones described as mad.
An afterword: some information from Anthony’s researches.
Ruby was born in 1943 and is still alive. She has had a
long, stable and happy marriage, and after her marriage, her cousin Alistair
states, had no more need for contact with mental health services. (I don’t
remember his exact term.)
The extracts from the interviews in this case were written
down by Esterson (or possibly partly by Laing after a joint home visit to Ruby
after her discharge). They are not transcriptions from tapes. However, Anthony
stresses that L & E were accurate and skilled in capturing exact
expressions.
There is an important figure missing from the tapes –
Ruby’s maternal grandmother, with whom the whole network – Ruby and her mother,
Peggy and Jim and Alistair – were housed at one time. Ruby on tape describes
her grandmother as ‘Victorian.’ When Ruby’s mother was ‘in trouble’ her parents
repudiated her, but wartime exigencies resulted in their living under the same
roof. Ruby vividly remembers hurting her back when her grandmother dragged her
along the ground by her long plaits. She was about 8.
The young Ruby (on tape) speaks warmly of her cousin
Alistair as generous and like a brother. She describes a background of ‘nattering’
– constant criticism – from her mother and aunt. The older Ruby is still reluctant
to criticise her female relatives. Peggy seems to have been dominant, though
she is the younger sister. Young Ruby says on tape to Esterson that her uncle
was ‘boss’ in the household – not just the titular head, but the real power. Alistair
says that Ruby’s mother, though not retarded, was of limited ability and slow
to assimilate information. ‘Old Ruby’ movingly describes her mother’s hard work
in a factory, her hands always in water.
Ruby’s father, though a married man with another family, visited
her regularly and took her and her mother on holiday. He broke off contact by
letter just at the point when Ruby discovered her own pregnancy. Two reasons
were given by Ruby’s mother; one was that he had to look after his sick wife,
and the other was that he had discovered Ruby was a ‘slut’ and was disgusted by
her. Both these things could be true. We don’t know whether the latter
attribution was added on later by mother; or it may be that even before her
pregnancy was announced, her father had become aware that Ruby was sexually
active. Clearly he did not know about the pregnancy itself at the point when he
wrote the letter, or he would have given that as his evidence of her bad
character.
Ruby describes herself her young self as a ‘tomboy’ and
‘naughty.’ In her early teens there were two spells in St Ebba’s Hospital, Ewell
– this hospital had an adolescent unit for patients 12-17, but Ruby also speaks
of being with older women patients. She is not clear what led to her admissions.
(Or maybe I’m missing it?)
During the hospitalisation described in the book, Ruby was
seen by Esterson, who was in charge of admissions, and Anthony believes he
began his interviews soon after. Ruby remained in the hospital after Esterson
had left and was given drugs and ECT. She speaks of Esterson with great warmth,
and it is easy to pick up from the tapes his careful, friendly, egalitarian
manner in talking with patients. It is more like a conversation between friends
than an interview.
The episode in which Ruby lost her illegitimate child
remains murky. Alistair witnessed an abortion attempt, it seems. But young Ruby
also says that she had drunk a great quantity of gin, a method of ‘shifting’ a
child renowned in folklore, and that she fell downstairs; after this accident,
in which she hurt her back, she saw the doctor, who advised rest if she was not
to lose the child; her mother and aunt then told her to walk about, precisely
so that she would lose it. The foetus was 3-4 months and ‘would have been a
little girl,’ says Ruby. The chain of cause and effect is hard to work out and
possibly it was easier at the time not to try to pinpoint exactly what led to
the pregnancy’s ending.
Some listeners to tapes of the young Ruby were struck by
what seemed to them a synthetic quality – she sounds perhaps older than she is,
and is trying to do so – but all agree that she is cogent and articulate.
6.
June Field
Inner
Circle Seminar No. 230
I would like to begin with a general comment on the cases
– less pertinent to June Field than the cases in general, but I want to share
it while it’s in my mind. A couple of weeks ago I gave a lecture in the US
I spoke of the writer and her family: ‘You begin by
looking at your immediate surroundings, you house and your street, and you
register anomalies. Your evolving consciousness is like an instrument that can
be used to measure an earthquake and trace it – you pick up on disturbances
that will occur, but also register the effect of those that have occurred, maybe 50 years before.’
At that point it struck me that I was talking not only
about the embryonic writer, I was talking about the women in the case
histories. They also notice the anomalies and the gap between what is said and
what is done – they may not be able to interpret what they observe, but the
very fact of pointing to it can be threatening to the family. The simplest
example is in the Sarah Danzig case – she went to work for her father and found
discrepancies in the accounts, which she mentioned innocently, trying to put
things right – not realising that in a mild way her father was fiddling the
books. Sometimes the discrepancy in a family’s account of itself stems from the
fact that illegitimacy is being concealed: so, you have two fathers, or your
supposed sister is your mother. Also, there are double standards, which the
child must somehow not notice: ‘Do as I say, not as I do,’ should be the motto
of many of these families, and they often show a fear of the outside world and
unify themselves by a ‘them against us’ mentality, while concealing the
divisions within – there’s a lot of papering over the cracks, and often it’s
been going on for more than one generation.
I emphasise, as we always must, that when I speak of
June’s family, I am looking to cast some light on how she sees the world. I am
not looking for an explanation of why she is ill – the whole point is that Laing & Esterson do not
necessarily take her behaviour to be illness. We have to keep restating this,
because it is the most misunderstood, most misrepresented facet of these case
histories. Yet the authors are quite clear: they suggest that what the women do
is comprehensible, without the need of explanations that pathologise them, and
in June’s case, the point comes over very clearly: as they say in Maya Abbott’s
case, the clinical signs and symptoms become dissolved in social
intelligibility. All these patients are walking into a giant preconception –
which is that the concept of mental illness is valid and applies to them. This
preconception is set in stone, in bricks and mortar in the shape of hospitals,
and it is enshrined in medical training, in social assumptions, and in
budgeting: the chronic complaint is that not enough resources are allocated to
treat mental illness, and to question what
is being treated is still dangerously radical. And of course you can see why
the status quo obtains – it’s easier to stigmatise individuals, to privatise
the problem, rather than challenge social institutions and entrenched pieties. I
am not questioning the good will and compassion involved. How can doctors and
nurses help, unless they can find an illness to treat? They are deeply invested
in the diagnosis. To question the reality of it is to question their own
existence. I need not continue on this line – you are all familiar with it. But
I feel that it needs to be stated repeatedly, because people are so conditioned
to acceptance of the present system and its intellectual underpinnings, and so
earnest in their desire to help those who are ‘ill.’
The first thing about June: she is very young. 15. At 14
and a half her personality is said to have undergone a change. You might call
it growing up, preparing to be a woman, becoming aware of sexuality. It is
June’s mother who begins calling it illness. In the table laying out the case I
notice the use of the word ‘anamnesis’ – I think I’m correct in saying it’s the
only time they use it – as you know, in old-fashioned medical usage it means
compiling a case history by question and answer. But then in platonic thinking,
it means the recovery of the knowledge that is innate in our souls, which we
mislay when we become incarnated; and in Christian theology it means a
re-enactment that more than a commemoration, but is a living connection with
what once took place – so the eucharist is not just a commemoration of Christ’s
last supper, but a sacrament by which the believer abolishes time and space and
gets a seat at the table. In June’s case, the circumstances of her early life
were re-enacted, when for a week during her hospitalisation she was fed like a
small child by her mother, thus restoring their early relationship. Only after
this did June begin to feed herself, as if she were trying to start her life
all over again.
When June was a small child she had a hip dislocation and
was in plaster for a long time. At the age of 2 she was in hospital for 6
weeks. ‘I pushed June around for four years,’ her mother says. (In the
metaphorical sense, she seems to have continued pushing her around.) June had
to learn to walk in a leg-iron. She could not be put down on the ground, for
fear she would damage the plaster, because she was a strong heavy child, and
her mother describes how she would use a system of dog leads and tethers to
fasten her on the bed but allow her some limited freedom of movement. The
researchers remark on a certain blitheness with which Mrs Field talks about
June’s early life – she thinks of June as a very happy little girl – indeed she
may have been, as she would not remember any other kind of life, but it’s hard
not to imagine her as tearful and frustrated at times – as one supposes Mrs
Field herself must have been. Mrs Field reassures the listener, ‘I didn’t ever
leave her.’ She was happy, June was happy, the family was happy – it’s happy
all round – and Mrs Field doesn’t want this picture to change with the years.
June didn’t gain freedom from the surgical devices till
she was ten. Then she’s standing on her own two feet. But it’s all pretty
uneventful, as reported, till she is 14 and a half. The change noted by her
mother takes place over a period of 6 months. June goes away to a church camp
for a month. The researchers say her mother was the only one to go with her – I
assume they mean she escorted June, then went home. During this time June split
up with her best friend, and there were other developments in her life about
which we have no specific details. After this separation, her mother says, ‘I
did not know her.’
I was at Stratford
It occurred to me also that in the days of the case
histories the threshold of adult life was different, because 15 was the
school-leaving age: we’re not told, I don’t think, whether June was leaving
school: there was a strange period of in-between status, with the age of
majority at 21. It’s interesting to cast forward to the Mary Irwin case and see
the similarities. Mary was 20 when she was seen by the researchers, but she was
about 15 when her troubles began. Like Mrs Field, Mary’s mother described her
infant daughter as ‘happy – no trouble – just happy.’ The researchers comment
on how she treats Mary as if she were a nurse and Mary the patient. Like
June’s, her teenage transgressions are mild to the outside observer, but her
mother sees them as evidence of illness: ‘I’ve got to think she’s ill,’ she
says, ‘or I couldn’t put up with it.’ Like Mrs Irwin, Mrs Field seeks to be at
one with her daughter, and this separation, when June goes to the camp, is the
beginning of what she sees as a split between them, and a split between June
and her old self. By her mother’s account, June has gained weight. She seeks
solitude. She’s rude and truculent and contrary. She doesn’t believe in God
anymore and we gather that God or at least religious conformity is a force in
this family. At times, June’s mother says, she looks evil.
Only Mrs Field sees this – not her father, sister,
headmistress nor two GPs. The examples of her oppositional behaviours are mild
in themselves, but they are violation of this family’s code of conduct and of
her place in the family. It seems she is trying to find a place in the adult
world but she is tethered by her mother’s attributions. It wouldn’t be
surprising if June were resentful of her continuing dependence, of the
expectations placed on her. But we learn that she has hidden things from Mrs
Field for some time. Since 13 she has been having boyfriends while pretending
to be at a church club. It’s not clear in the text how sexual these
relationships are. Are the boyfriends young people the family know, and it’s
just that the relationships have become less childish than the adults imagine?
Or are they young men they don’t know – in which case there’d be some point to
the mother’s remark about how she can’t trust June with any Tom, Dick or Harry.
Without more facts it’s hard to know how far her fears about June’s friends are
reasonable or not, the kind of fears any parent would have, or whether she’s
trying to micro-manage June’s outside contacts.
You would of course like to know more about Sylvia, June’s
elder sister. Mrs Field seems more detached from her, but doesn’t lament that.
The parents say that June used to be physically affectionate, but isn’t now.
Sylvia was never affectionate – her chilliness or self-containment, or whatever
it is, is described as more ‘refined’ – so in a way she is given approval for
it. June’s neediness is both encouraged and derided, and as she recovers from
her ‘illness’ her mother’s ridicule of her is pronounced. June’s father seems
passive, but also a dramatiser – saying that June is ‘lost to him’ because she
has taken a small sum of money. Her mother speaks of June as if her basic
functions are infantine – she says June just falls asleep, without being able
to control it – and she speaks as if these basic functions fall to be overseen
by her elders: ‘I couldn’t have you going, falling asleep,’ she says.
There is some turning point we don’t know about. If I have
one wish with these case histories, it’s to know what happens in the household,
or to the patient, to precipitate their admission – I mean, the hours or the
day before. Presumably before her admission June’s stroppiness rose to new
heights. I’m not trivialising what may have happened. So much that goes on
between parents and teenagers is banal, and foreseeable, but it’s not trivial. It
seems to me that sometimes people at this age do need asylum, but there isn’t
one, so they run away or break down. When family members are entangled, their
feelings are sharp and sore, and everyone needs a bit of time out, physical
distance, a breathing space. As a society we refuse to know this. It seems to
me nothing we learn about the family stops us from idealising it. We do not
know any perfect families, but we hope they exist somewhere. Sometimes the
least healthy place for the child is the parental home – but that is the last
thing parents can admit. These families in the case histories are the kind who
huddle into themselves, and there never seems to be a saving outside influence
– a mentor, or another relative – who can throw the young person a lifeline.
June’s struggle to grow up is not successful – not for the
while, anyway, and by the time she comes to hospital, she is in crisis. She
won’t eat, won’t speak, doesn’t want to move. She’s not reporting mental
distress, she’s acting it out physically. June can’t win. The better she does
at articulating her own position, the worse she does, in her mother’s eyes, and
when she graphically shows the bind she’s in, by becoming still and mute, then
other people agree she is ill. (As always, the diagnostic terms seem to couch
the signs as an infliction from the outside, like the plague. This way of
describing takes away the agency from the patient; the hospital considers the
patient is not deciding against
movement, speech, food – she is under a compulsion.) Yet it is not at all
clear, in this case, whether June feels she cannot
move, speak, eat, or whether she chooses not to do so. If you made a new
protocol, whereby you simply observed a patient’s behaviour and said, ‘At the
moment she is behaving in this way, doing x and not doing y,’ it might take
some of the terror and strangeness out of her situation, but when a hospital
describes it also makes a judgement – a diagnosis is a judgment.
In June’s case, it seems the words ‘schizophrenia’ was not
used to the family; but whether the diagnosis was presumed, and by whom, is
another story. You can tick June off on the check list. Flattening of affect,
delusions – florid delusions about poison and the destruction of the world. As
always you wonder glumly if, when the patient shows the textbook signs, whether
the textbook isn’t playing a part – she fulfils the expectations of the
hospital which is geared up to treating the patient – why would she be here, if
she isn’t ill? The patient’s ‘break with reality’ is said to be diagnostic. But
the boundaries of her reality are set and patrolled by others. Lack of insight
is said to be diagnostic, but the people around may be far less searching in
their demands on themselves, in their interrogation of the world, than the one
designated a patient. That person’s efforts to rescue themselves are often
muddled and make them seem even less competent than they are. For June, who
won’t eat, it seems survival depends on regression. She must eat, her mother
must feed her. Mother is as necessary as she was when June was an infant. So
Mrs Field has the glory of being right. She has said that June is not capable
of independence, and now it is demonstrated – here is something very simple
that the whole world can witness.
When it comes to June’s recovery, the question is what her
mother regards as ‘better’ – as opposed to what June and others think is
better. It’s interesting, the language the case history uses here – ‘steps
forward’ and ‘steps back.’ In hospital June regressed to the stage where there
was no progress without her mother, and so afterwards her mother gets to define
what progress is. She is anxious when June is seen with a young male patient,
and she suggests to June that she forces her company on boys. You can imagine
how any such hint sabotages a young girl’s confidence. You wonder about Mrs
Field’s own growing-up, and if in some way she is trying to pre-empt
humiliation for June. In any event, any boys whom June goes around with will
have to be able to take ‘responsibility’ for her – as if Mrs Field will pass
the burden to someone worthy, but there’ll be no interim period in which June
manages herself.
Earlier I spoke of the likenesses between the writer and
the patient. Of course there are crucial differences. Up to a point, writers
live with imprecision, with formless, borderless concepts, but then they find
the exact words to pin down their experience, and in my belief that habit of
skewering starts early; you may be suffering, but like someone with a religious
mindset, you start to look for the use of it, and without knowing it you start
to take charge – you use language to boss your experience around. If their
families are desperate and dysfunctional, writers have a habit of making that
pay off, in later life. For writers, the worse things get, the better they get.
Your failures, your sins, your embarrassments – they all find a use, disguised
thickly or thinly. Not so in these lives. For these women the consequences of
not fitting in, of knowing too much and saying the wrong thing, are severe and
lasting. When we leave June she’s striving for recovery. What happened next,
Anthony can tell us.
After the seminar:
Wisdom from Anthony and some afterthoughts.
It seems that Mrs Field was in fact a nurse. (This may be
why she feels she has a special status when it comes to detecting ‘illness’ in
her daughter; others can’t see it, but she is more expert.)
The family were Methodists.
At the time of her admission June was hallucinating
soldiers in field-grey uniforms, sent by Hitler, outside the family house. We
know this from a later publication by Esterson.
Her detention was compulsory. We notice that she was
’making sense’ within days, at her first interview with Esterson.
Relatives say June married happily at 31. She died of a
pulmonary embolism aged 47, after she was injected with lithium. I am not clear
whether this was a result of a medical accident relating to the injection
itself, or whether it was an adverse reaction to what was injected. (Maybe the
relatives don’t know?)
After her discharge June had some contact with psychiatric
services – mostly as an outpatient? We assume she was diagnosed as bipolar or
that she was in a hypomanic state at some point – hence the lithium. It seems
she would sometimes ‘run away’ and turn up unexpectedly to friends – I thought
‘eccentric’ was a good word for her reported behaviour, but she doesn’t seem to
have done anything in subsequent years to cause harm to herself or anyone else,
or to show ‘illness’ in the way she did at fifteen.
6.
Ruth Gold
Inner
Circle Seminar No. 233
I’d like to start at the end, at the point where Ruth is
at home, with her parents, and embracing their view of the world. She still has
doubts over their attitudes and their construction of the recent past, but she
can only express them tentatively; she is dubious, she says. The interviewer
asks, ‘But do you feel you have to agree with what most of the people around
you believe?’
She replies, ‘Well if I don’t I usually end up in
hospital.’
Ruth shows herself clear-sighted, unillusioned, and seems
to speak for many of the subjects of the book. Like a dissident in a
totalitarian regime, she has no negotiating position; she bows to superior
strength, and accepts the practicalities of survival. Her ambitions, her
creativity, are put behind her.
Ruth is 28 at the time of the study. Her career as patient
begins at aged 20, and she has been admitted 6 times, with a fluctuating
diagnosis, hysteria or schizophrenia, but various institutions have settled on
the latter. It strikes me that nowadays, well-read people are willing to
consider hysteria as a complex social construct, and yet still talk about
‘schizophrenia’ as if the term denoted something as specific and clear as a
broken leg. Hysteria has entered into literature and art, it’s been claimed for
civilisation, if you like; disorders of mood have also become part of the
cultural landscape, because celebrities claim to be bi-polar: whereas the
popular picture of a person with schizophrenia, encouraged by the media, is of
some shambling wreck sleeping on the streets, or worse, running through them
brandishing an axe or a gun. This is why it matters so profoundly, to examine
the concept in a radical way – because all these years on from the publication
of the book, the basic concept of schizophrenia – whether it makes sense,
whether it’s valid – is still passing without a challenge. I will speculate on
what might have happened in this family, but I want to say I am wary; I try to
put limits and safeguards on my imagination; the last thing I want to do is to
embroider, and steal the case histories away and make them over into
literature. There is so much reality behind them, so much life lived to which
we have no acccess now.
It is far from clear, from the transcripts anyway, that Ruth
has a disease, but it is easy to see how her life has lurched into crisis. She
has trouble functioning in the role her family want her to play; there is a
vacancy for a good daughter, but she doesn’t fit it, which is why the
researchers evoke the image of the Procrustean bed – she is being squashed and
stretched to fit. And the spontaneous growth of an adult woman – of creativity,
of complexity – is a challenge this rigid family can’t accept. As the years
pass, it seems the particular person that is Ruth is being lost – in the clinical process, as well as in other
ways. She’s being subsumed into her diagnosis. The authors say that it is
typical that medical reports of the patient become ‘more stereotyped and
succinct’ as time goes on. I find those words some of the saddest words in all
these histories. In these cases, the term ‘schizophrenia’ has worn a groove or
furrow into reality, and each year the groove is worn deeper, and the patient
has fallen into it and is becoming lost from view. So the staff, I suppose, are
looking at their expectations of the patient, rather than the way the patient
behaves; almost everything is cast as a symptom; the patient can be said to be
better, or worse, but stands little chance of losing the attribution of
illnesss entirely; she could even be declared cured, and discharged for ever,
but she couldn’t get back to being simply a woman, without a diagnosis. At
least not in the eyes of the hospital; we have met brave examples of patients
who became un-patients, have walked back into their lives, but Ruth isn’t one
of them: though she does say, quite baldly, ‘I don’t think I’m ill at all.’
This is a small family: older brother, long ago left home:
mother, father – who won’t be interviewed without his wife, and so becomes an
echo or mimic of her – or an ‘ape,’ to use the family’s own word. It seems as
if the brother would be very important, but there is no transcription of an
interview with him – perhaps we will learn later why that is. More and more, as
our seminars go on, it’s the gaps I notice. Sometimes the extra information
that Anthony has gathered is revelatory, but he doesn’t tell me in anything in
advance; my job is to pay attention to the words on the page. But I never think
of these young women as paper and ink. One of the things that moves me about
the book is how much of them lingers; they entered an underworld when they
became patients, and there are not many survivors now – in the physical sense.
It would be inflationary to suggest we can go into the underworld and lead
someone back: but what can do in these seminars, I think, is to put out a hand
into the dark and see who grips it.
At the last seminar we speculated on what the families may
have been told was happening to their hospitalised member. Antony
‘she came home that night – oh it was about ten o’clock at
night, in a taxi, sobbing and crying, with her shoes – the heels of her shoes
broken, and from then on we went from one psychiatrist to another.’
No screenwriter could do better. You could write a whole
thesis, I suppose, on what happens when a high heel snaps – how suddenly
helpless even a sober woman becomes, even in broad daylight: but how the
associations take us far beyond footwear malfunction: it’s always night in our
imagination, and the city, and streetlights shining through the rain, and drink
is involved, and perhaps some sexual misadventure, and whenever her heel is
broken, her coat is open and her hair is messed up and her mascara is running,
and she’s probably got bruises – here’s an unravelling woman, an awful warning
– and what then arises is pity, and a measure of contempt. And those are the
reactions Ruth has seemed to elicit from her parents all along. As for her
illness, about which they talk so much – it is remarkably elusive.
We have to go back. Ruth is a compliant child. She is
everything her parents want. She is obedient, happy. There really isn’t much to
say about her. There’s no cloud on the horizon until she is 18 or so, when she
becomes depressed following the end of a love affair. But there is a shadow
hanging over her, as the parents are well aware. Mrs Gold had a younger sister,
who killed herself at 19 after a broken engagement. Ruth is named after her.
Ruth is understandably pre-occupied with the dead woman, because it seems their
lives are running in parallel. Ruth wants to know what happened and why, and
whether the first Ruth was regarded as insane, and how their circumstances line
up – perhaps I am reading something in
to the words on the page, but it seems there is a kind of sinister complacency
in the way her mother handles the topic – a dismissal of Ruth’s concerns – ‘she
didn’t even know her’ – and at the same time – I cannot prove this, I am just
intuiting it – it’s as if some form of malign teasing is going on. It is as if
the disaster in the previous generation has been handed to Ruth, parcelled up –
it remains sealed, hints are dropped about the contents, but all she can do is
feel its shape. When Mrs Gold talks about her sister’s death she says she was
young, she didn’t mean to do it, it was a manipulative gesture, she was only
trying to frighten people: the power of her death is taken away, it’s made incidental
and almost ridiculous, like Ruth’s efforts to be an artist.The question of
‘naming after’ is something I’ve tried to approach in my own fiction, but
without coming to any conclusion as to what it meant in my own family. Freud
said that he named his children for people he had been fond of, rather than
naming them according to fashion, and then, he said, ‘Their names made the
children into revenents.’ But if you open what Auden called ‘a lane to the land
of the dead,’ you must know it is a two-way street. The dead come back for a
second chance, but a meeting may be required, a cross-over point; it seems to
me that the ‘naming after’ gave Ruth a great push in the direction of death,
when she was scarcely born.
So we ask, how much life is permitted to Ruth? Her family are clearly narrow people – her
mother is certainly articulate, but resents the burden of education – she
regarded being taught music as an imposition: and father is self-righteous
about being philistine. When people talk in these terms they pose as the
undeceived, as if art were a trick they had seen through. Ruth’s older brother
is an artist of some sort – a writer, one guesses. Ruth has timid aspirations
of her own. Her family pour scorn on them. She is accused not of wanting to be a writer, but of ‘aping the
writers’ – as if she were promoting a false image of herself, deliberately
deceiving and pretending. She wanted to be a dress-designer, we are told, and
began a training course, which is belittled by mother – she can’t remember the
name of the school, it was a ‘little’ course, and a ‘short’ training – nothing
serious, and Ruth didn’t stick to it; given her family’s denigration of her
aspirations, you can see why. Her illness, we are told by her mother, hits her
in the form of an ‘attack’ and the warning of it comes when she dresses in what
the family think of as an artistic way. She wears coloured stockings. A
difference of taste in this family equals dissent, a crack in the façade of
wholesomeness and solidarity. The kind of people Ruth wants to mix with are a
threat to respectability. Sometimes, occasionally, she has brought someone home
to stay the night – not for sexual purposes, that’s not the problem, or at
least not the expressed problem – the problem is the challenge these strangers
pose to the family’s outlook. There is a dispute over the simple facts of
Ruth’s day-to-day life. Her mother says she has little social life. Ruth says
she does – it’s just that it’s not one her parents approve of. They don’t like
the places she goes or the people she meets, and when she makes choices they
don’t like, they say that’s not really Ruth – it’s her illness. She goes to a
drinking club. She doesn’t ‘really’ drink, her parents say. And they’ve never
seen her drunk, they admit. If anyone drinks, it’s the sick self; their good
girl would never do that. Sick Ruth is abusive, they say; she blames her family
for making her ill, she is resentful, and she can’t care for herself; her
mother has to tend her as if she were an infant.
As for the events before the breakdown: ‘history is
repeating itself,’ the interviewer says. Despite what the parents say about
family harmony, it seems as if the two years before the first hospitalisation
were choked with conflict. Ruth’s boyfriend, Richard, was a medical student.
Her parents say he is selfish and spoiled. Richard’s parents don’t approve;
they want him to study, not get enmeshed with a girl. Both sets of parents put
pressure on Richard to break off the relationship. Eventually it is broken off.
Ruth thinks it is her decision. Her mother even asks her to consider if it is
the right decision, think about it very carefully – with no hint that she
herself is playing a part in events. When Ruth sees Richard with another girl,
she is deeply hurt. Her parents sympathise – as you would, if your teenage
daughter was nursing a broken heart. They don’t admit to a piece of duplicity
that many reasonable people would regard as unforgivable.
After the relationship ends, Ruth falls into depression.
There is a sudden and strange weight gain, there are instances of erratic
behaviour, and then the crisis. Then at some point, it seems Ruth realises she
has been manipulated. But when she accuses her mother of interfering in her
life, her mother says this belief is a symptom of her illness.
At the end of the story the hospital returns Ruth in a
state of passivity that the family must find satisfactory, because it mimicks
the compliance of her childhood. Her parents stress their focus on her, their
self-sacrifice, and she agrees they know best. The alternative, as she says, is
hospital. Besides the Procrustean bed, the other image that springs to mind is
that of a doll – one of those 1950s/1960s dolls with staring glass eyes, very
clear and seeing nothing; it’s as if the parents had made such a doll – and
this doll can squeak, in imitation of human speech, but not convincingly, only
in set phrases – it is idealised, it is adored, but you can haul its plastic
flesh around in all directions, and its smile never falters, and no one could
mistake it for being alive.
This is a case where it is difficult not to be angry with
her parents, on Ruth’s behalf; but that is not the same as ‘blaming her family
for her illness,’ which is the popular perception of what Laing and Esterson
did: what they are questioning is whether ‘illness’ is the right term for what
is happening. On a human level I always wish we knew more of the worldy context
of the families – what they have to cope with, what formed them, what the
childhoods of the parents were like – but I am also interested in their inner
context, the myths that they seem to enact. Here, there is anxiety about what
the world will think, because the parents consider themselves as the social
norm – but there is also powerful threat directed inward – the mother must
stave off a reckoning with herself. We can only imagine her ambivalence to the
new-born child, when she named her daughter after her dead sister. She would
surely say it was an act of commemoration, of reverence. You could see it
benignly, as an attempt to give a child to the sister, to share her. But you
can also see it as a prophecy, where Ruth sleepwalks to its fulfilment.
I don’t mean that her mother willed Ruth to collapse or
suicide, but rather that she arranged for her to be dead-and-alive. Ruth is a
re-run. I’m interested in the time-slip genre in women’s fiction – a woman from
our time finds herself caught up in the life of a dead woman from long ago – her
ancestress, in fact or by adoption. The slip doesn’t just happen, like putting
your foot through a rotten floorboard – there is an intention to deal with the
past, to return to it: the main character is pursuing research of some kind, or
she is involved in solving a crime. First she develops a fascination with the
past figure, then an obsession, and finally she is ensnared. And almost always,
in the past, there is a fatal or near-fatal male figure; love compromises and
damages the heroine, and the love is lost: but what the time-slip genre posits
is a male figure whose power can outlast generations. The only creature who can
do that is the image a woman carries inside. I am interested that Ruth felt she
had lost somebody or something important, and that it was something that she
couldn’t put a name to, till she realised it was her boyfriend: what has been
taken away, by a trick, is her sustaining inner image, and what she has lost is
control of her own story, and what is left is a void.
We are looking at the members of the family to see how the
events might be socially intelligible, not to find causes for her illness,
because we are not necessarily persuaded that she is suffering from an illness.
Certainly she is suffering.
7.
Jean Head
Inner
Circle Seminar No. 236
The researchers say it is difficult to catch the flavour
of this family in action – it doesn’t come across on the page, you need to hear
and see them. They have 27 interviews, all but 3 on tape. That’s 35 hours,
beginning soon after Jean’s admission, continuing through her crisis period of
3 weeks, then afterwards for 7 months. In varying combinations, we have Jean,
her parents, her husband David, Jean’s brother, her foster-brother, even her
employer. As usual, though, the case report leaves a lot of questions, and
Anthony and the tapes may be able to answer some.
A DAUGHTER AND A WIFE
Most of the histories concern daughters still living with
their families. Jean is both a daughter and a wife. She is able to get some
distance from her parents only at the price of becoming dependent on her
husband David. But he feels she has not sufficiently separated herself from
them. He sees her as ‘a part of me, and not so much a part of them.’
The researchers say this is a key finding. I guess they
mean that no one recognises Jean as a being in her own right. David interprets
everything she says and does in the light in which he wishes to see it. If she is contrary, it’s because she’s ‘not
herself’, or tired, or ill. If she’s not herself, who is she? This familiar
expression becomes sinister when you live a life like Jean’s, where other
people are the experts on your past and present life, and on what you feel – as
if you exist by their grace.
FIRST BREAKDOWN
3 years before the hospitalisation described here, and
before she was married, Jean had a breakdown in which she developed a certain
delusion; she believed her parents and her fiancé were dead. She recovered in a
few weeks in a general hospital. And to outward appearances, all was well with
her, until 3 weeks before her admission, she developed creepy feelings about
what was going on around her – that all was not what it seemed.
SECOND BREAKDOWN
She thought her colleagues at work were talking about her
and plotting against her, planning to rob her. She was being followed by men
who might be planning to attack her. Then, we are told, the feelings
crystallised into delusion – which I take it means she hallucinated such
persons. And at the same time there were feelings of heightened meaning that
attached themselves to objects. She herself precipitated her admission by going
to the police to ask for their help. What happens in this second episode is
that Jean’s beliefs of three years back resurface. She says her husband is
dead. So are her parents.
I am interested that the word used, in inverted commas, is
that she ‘realised’ her husband was dead. So the suggestion is that she didn’t
discover it, as something that had just happened: rather that she simply
discerned the true state of affairs. Does this mean that in her mind she had
been living with a dead man for some time? It’s as if the time closes up,
between the two psychotic episodes, and in between them, in carrying on as if
her husband was alive, she had been just complying, people-pleasing, pretending
things were normal. I would really like to know what she said about these dead
people. Did she think they were corpses who were simulating life, like zombies?
Or did she think that living impersonators had replaced her dead husband and
parents?
In any event, Jean has passed from abnormal, heightened
sense perceptions into frank delusion, and a break with reality. We need not
shrink from saying she’s mad. Contrary to what people sometimes think, this
book is not denying that people may go mad. The question the authors ask is, is
there method in her madness? Are these delusions just random, psychic junk? Is
there a level at which they are intelligible, in the light of her past life and
present situation? Jean’s manner, as she recovers, is child-like, but it is
also a knowing, mocking imitation of childhood; she is sarcastic, we are told,
and mimics her parents. There seems a lot of anger here, graphically but
indirectly expressed, and a lot of frustration, and as you uncover her life
history you see why.
THE SECT AND THEIR RULES
Jean and her husband and her parents belong to a
fundamentalist Christian group. No pre-marital sex, no sexual fantasies within
marriage, no make-up, no dancing, no theatre, no cinema, no TV, certain radio
programmes permitted, though not on a Sunday: smoking frowned on, drinking I
suppose prohibited. No anger, or at least no demonstration of it. No
differences of opinion that could open the way to an argument. The researchers
say, ‘There is probably no section of the community whose members expect more
of themselves in certain respects than these people.’ As they point out, a
person who tries to live by these rules is enmeshed in contradictions which
create a permanent strain, as they try to reconcile the imperatives of the
church and the outside world. You have to adapt to the world outwardly – but
not inwardly. You are in the world, earning a living, but not of it: you are
prohibited from most common pleasures, you are a full-time Christian, so your
leisure time is absorbed by church activities, and probably – we don’t hear
about this, but it seems likely – you are under observation by other members of
your community. If Jean thinks people are watching her and talking about her
she is probably right, just as Sarah Danzig was right, when in her workplace
she tried to negotiate the difficult business of being the boss’s daughter.
HER PARENTS AND THE CHURCH: A CHILD MUST BE INDUCTED
Jean’s parents haven’t prospered materially. I suppose,
too much charity. They actually practice their Christianity, so perhaps they
tithe themselves or just give too much away – money or time or freedom. They
want something a bit different for their children and put emphasis on security
– perhaps, if we can conjecture, feeling times are changing, their group is not
as tight as it was and that the church can’t act as a safety net: and also that
the new generation wants and expects more by way of consumer power and material
goods.
We don’t know for sure. We don’t find out much about how
the family function socially. But these groups must cohere if they are to
survive. The child is born not into a world where people muddle along, but one
where they inherit the rules. The child has to be inducted. She must
internalise the values that drive the rules. All the world’s pressures will
push her the other way.
JEAN’S DOUBLE LIFE.
Like other parents in the study, Jean’s parents describe a
compliant and contented child. What they don’t know is that Jean has a double
life. At 9 she went to the cinema with a friend, and they didn’t find out. If
God saw, he didn’t tell her parents. Through her teens she wore makeup, had
boyfriends. It must have required great feats of organisation to keep her
parents ignorant – if they really didn’t know. Jean had the help of her
brother, who was slightly older. She managed to have a 4-year sexual affair,
from 14-18. The boyfriend was presumably older and seemed to her cultured and
had money and altogether moved in a different sphere, so when he wanted to
marry her she could not think how she could do it without breaking away from
her family. So she broke off with him. She became engaged to David, who was a
member of her church. In the next 4 months she slept with several men. Then her
first breakdown occurred.
Within a couple of months she was out of hospital, and
married David, who knew nothing about her affairs. She was lying to everyone
close to her, but she must be hostage to another set of people, off the page,
outside the family, who know different facts about her. Once married, Jean is
keen to suppress her own memory of the unruly phase in her life. She has to
keep a lid on it, pressed down tight. It’s like being a spy, a double agent.
HOW THEY COMMUNICATE: AN EXAMPLE
In the transcripts, the family seem to wrong-foot each
other all the time, using ordinary conversation as a sort of obstacle race that
none of them can win. I find myself thinking that they are afraid of each
other, because who is more likely than the people closest to you to notice a
thought that’s going astray, to notice some undesirable tendency creeping in?
Sometimes in these seminars I have talked about my own family, so you will
think that we offer examples of every possible malfunction. But it’s the reason
I have felt this book so important to me – it’s not just that when I came
across it first, I saw patterns that were familiar, but that it continued to
make sense: as the years passed and I confronted other circumstances, I saw how
astute the researchers were.
One of my younger brothers became involved with a
fundamentalist Christian group when he was in his late teens, and married
within it when he was 19. I had a lot of time for this ‘fellowship’, as they
called themselves, because I’d never before met religious people who followed
the logic of their beliefs and tried to live as Christians. They were practical
and generous and nurturing and they tried to care for each other. But at the
same time, to talk with them could leave you wanting to scream with
frustration. Reality had to be adjusted to be congruent with what they could
bear. When the marriage broke down within a couple of years, the fellowship
said that the young couple would certainly get together again, because there
were no divorces in their church. And when there was no reconciliation, they
reached for the language of pathology. Around the time of the marriage my
brother had been in a bad road accident. He’d smashed up an arm and a leg and
also hit his head. This, they said, had changed his personality. It wasn’t his
fault. They didn’t judge him. They were praying for his recovery.
This was an outrage to the facts. The bump on the head was
trivial compared to the rest. He had no impairment to cognition or change in
personality. But all conversations were defensive, circular, drawn up like a
waggon train, intent on keeping out all contradiction.
NOT ABOUT SICK FAMILIES.
So I feel the communication style of this family is
familiar. And I feel the need to mention here another thing Laing and Esterson
are accused of doing, that they don’t do. They are not pathologising the family
as a unit. They are not shifting
blame from patient to family. I used to be attracted to this idea of a sick
family unit, and we come across individuals in these case histories, parents,
who seem to behave in a monstrous way. Some people in these families have more
power than others, and some misuse it, and sometimes you see how power gives
individuals the capacity to cover up the bad things they do, whereas the young and
powerless member is the one who is exposed to the world as bad or mad. But now
I see that each family’s style is a logical outcome of their situation and
their beliefs, and each individual is struggling within the confines of their
own history. In this particular family, direct communication about an
individual’s thoughts, wishes or intentions would totally destroy the fragile
unity they are struggling to maintain in every interaction. Their strategies
may seem an affront to logic, but they make sense if what matters most is
self-preservation.
DAVID
David has huge expectations of Jean but denies having
them; he says that the expectations are hers, she is a perfectionist. There are
plenty examples of his conversational somersaults, around pages 170 – 171. The
most contentious area of their marriage is whether they should have children,
and when. David doesn’t want children. He doesn’t tell Jean that. He says
they’re just postponing till they are more secure. He says they need more money
and she believes him, so she holds down a full-time job, has taken in 2
lodgers, gets up at 6 and goes to bed at 10 pm except for the 3 nights weekly
when she’s engaged in church work. No wonder she is always weary. David says
that it’s when she’s tired or ill that differences of opinion arise between
them, and she asks why she can’t have a baby now. When she’s fresh and rested
and feeling well, she agrees with him – a family is better postponed. So Jean’s
dissent is a sign of illness, her compliance a sign of health.
David is deceiving her and he knows he is. He seems to try
to wrong-foot the researchers too, talking about giving the ‘kiddie a better
start in life,’ (172) and insisting that he loves children (179) but saying on
p 170, ‘I don’t want a family myself and would be quite happy never to have
one.’ Jean’s employer remarks that the young couple are already well set-up in
life, but Jean is trapped in unending efforts to create the conditions that
David thinks are right – not knowing they will never be right. When she is
recovering from her breakdown, her father insists Jean has the power to help
herself, but it’s hard to see how she can if she walks back into the same
contradictions.
I wonder, does the family have the power to change? To be
free? To be honest? How might they go about it? It may not be right to regard
them as a sick family, but they are certainly a family with a task before them.
JEAN VANISHES HER FAMILY AND THEY VANISH HER.
In the transcript on p 174, Jean sits with the family
group and vanishes them by closing her eyes – as a small child does. And they
discuss her as if she isn’t there: ‘She looks quite smart, David,’ mother says.
Then they start up a sort of comedy routine, calling and whistling. I am dearly
hoping we have this on tape because it’s hard to imagine how you can treat
someone who is evidently awake, and listening, and sometimes speaking, as if
she is comatose or anaesthetised and needs arousing. Jean makes the alarming
statement that she does not know who her parents are, and her mother ignores
this, only complaining that they have come a long way to see her and she should
pass the conversational ball about a bit. What would you like me to ask you?
Jean says. Whether you’re Faith…?
We don’t know if she means this abstractly. David is of a
literal turn of mind. He says Faith is the name of somebody at work. Her
father, confusingly, begins to talk about himself in the third person. Then the
transcript becomes surreal. Mother says, I went to London
As Jean begins to recover, her parents and David are
disappointed that she isn’t grateful to them – it’s not clear for what. As the
weeks pass she becomes closer to what they think of as normal, but she’s still
pushing and questioning, exposing the deceptions that underlie her life with
David. The less she pushes, the more they define her as ‘better.’
THE COMPLIANT CHILD
The account offered of Jean’s childhood is the one we have
become used to. It’s a picture of compliance. A battle over weaning, (183) but
everything normal. She’s highly strung (188) but not jealous, not difficult.
There is no requirement for control, because no dissent; Jean’s desires in
life, as she grew up, were naturally attuned to those of her family.
Jean’s account is different. She was a fearful child and
had nightmares and when she called out for help her father hit her. Her mother
denies this. There were no nightmares. No irrational fears, and by their
account, no punishments. No one in the family expresses anger, because they
never really feel it. They are allowed righteous indignation, but not passion.
It is a Christian duty to suppress any disharmony. Perhaps this family more
than others insists on the correctness of what they are doing when they repress
their children. It’s their policy, and the right one.
THE FOSTER CHILD
This brings us to the jaw-dropping story of the little boy
the family adopted.
This poor child, Ian, was born with club feet and was
further affected by polio, so he wore leg-irons. When they took in Ian he was a
child of almost school age but had to be carried everywhere. He was more work
than their own children. They were distressed by his need for attention and by
his disobedience. Mother complains he used to drag and scrape his shoes – she
seems convinced that he did this to spite them, and could move normally if he
wanted to, though almost in the same breath she stresses that he could not. He
was incontinent at night and was punished for that, and physically bound to
prevent him biting his nails – which would also of course stop him touching
himself to soothe himself in any way they disapproved of. They don’t believe he
missed his mother, because he didn’t ask for her.
To us it’s quite chilling that Jean’s mother refers to
disabled children or children separated from their parents as if they were a
class apart: they’re adaptable, they don’t realise their own situation. It
would be fair to say that some of this reflects the popular attitudes of the
time. It isn’t only religious people who thought children were either
apprentice devils or blank slates. In this family no particular weight is given
to early childhood experience. They must have wondered why the researchers were
asking them what games their baby played when she was in her pram. The game of
throwing an object away and bringing it back is discussed in The Divided Self as the ‘weaning game.’
And I remember that there, a mother told Laing that she wouldn’t put up with
this game – after going through it with her first child, she decided she’d had
enough, so with her second baby, she threw the objects, and the baby crawled
after them and brought them back, like a human retriever. I think this game is
about learning that objects in general, not just the breast, still exist when
you don’t see them: that things in the world go on without your having to know
them or will them. And you still exist, even if no one can see you. It’s the
last bit that seems to give trouble to some of the young women in the case
histories. They are surrounded by false witnesses, who refuse to acknowledge
their reality, and all the time insist they are someone other than the person
they know themselves to be. Jean’s wild phase may as well never have occurred,
if no one recognises that it did. She has to go to an extreme, to force a
crisis in her world. She’s tried being bad and that didn’t free her. So she
goes mad. I think she forfeits reality, recklessly throws it away, in order to
shake and jolt her world and jolt some sense into it. She shouts in the faces
of her family and still they don’t recognise what she is. Husband and mother
and father may be living in the ordinary meaning of the word, but they are dead
to sense, dead to information.
WHAT RELIGION MEANS TO THEM.
While in this family everything centres around their
religion, we don’t hear anything that hints at spirituality. They don’t come
upin Jean sitting up and reading the Bible, like Sarah and Maya. What religion
means to them is a set of rules. Everything is focused on outward show. Father
says that smoking or the cinema might not be bad in themselves, but he couldn’t
engage in them because it might set a bad example to a young person.
I take it that this is an imperative of their creed: they
must function as witnesses to God’s workings. In this theology, your only
salvation comes through Christ’s sacrifice, and your faith. It’s not good deeds
that save you – the good deeds act as advertisement that you are saved. It seems to me the
researchers’ discussion of the religious milieu is eloquent and respectful, but
I wish they had expanded a bit because I don’t entirely follow. They rightly
say, speaking of the people who live by this creed, ‘They are unjustified by
anything except faith. They are saved by nothing less than Divine Mercy and
Grace.’ (p 167. ) If these are people who believe in pre-destination, as surely
they are, then to a lay-person’s understanding their creed is a grim one, but I
am not sure what the authors mean when they say on p 167 that such families,
‘expressly define their spiritual-carnal condition as a double-bind.’ I see how
such beliefs can plunge you into despair, and I see how hard it is to observe
all the strictures on thinking and feeling, but I don’t see how they are a
double bind.
But I do see that for people of any kind of fundamentalist
orientation there must be a difficulty in interpreting the world, a refusal of
metaphor, a literalism, a tendency to make things black/white and either/or. If
there’s one way – and that’s the divine way, as shown to the true believer – it
doesn’t leave much room for subtle negotiations in human relationships. Your
understanding is a box into which everything must be fitted, not a net that is
held up to catch the nuance sof human interaction. There are only certain
feelings and thoughts that can be named and recognised. The others must be
nullified. If Jean doesn’t feel by the rules, she will be told how she feels.
There’s no difference admitted between how she ought to feel and how she does
feel. They close that gap. That kind of dissonance can’t be allowed.
STAUNCH AND ENDURING REBEL WITH THE VOICE OF A LITTLE GIRL
I am touched that Jean in hospital is described as
speaking in the voice of a little girl, because as we know, a crisis comes for
these young women when they try to claim adulthood and independence, and try to
bear witness to what they know, what they have seen, what they really think. The
writers say that Jean’s manner is that of ‘a puzzled child doing her best to
meet the demands of adults’ – and that seems to describe so many of the
patients – their common difficulty is that the demands of adults are not stable
and often contradictory. I think what distinguishes Jean is the thorough nature
of her rebellion, the duration of her pretence, the staunch refusal of her
parents to admit the facts of her life.
They knew she had boyfriends, her parents say. Usually she
brought them home to be inspected and usually they were of the right type. Some
of them were worldly. They didn’t forbid these relationships but they prayed
about them. They wanted her boyfriends to be Christian, by which of course they
mean members of a group compatible with theirs. If they know about her double
life there’s no hint of it. I think they must know, but they’d have to bury the
knowledge. You wonder how deep the deception runs. It seems to be a labyrinth
of denial.
Out of simple human curiosity, I look forward to anything
in the tapes that will help understand how in practical terms she managed to
split and double herself and how far the other Jean, the wild Jean, lived in
the house like a spectre they’re all pretending not to see. However she did it,
it must have taken some lying and bold contrivance – and, as I said earlier,
giving herself as a hostage to other people. Somehow she has to manage to keep
the two halves of her world distant, not knowing about each other, with no
possibility of contact. What the history suggests is that, unable to move
between two realities, Jean simply cancels her parents and her husband. She has
these short times of escape, called breakdowns, where she says that they are
dead. They are in fact dead to her reality, impervious, turned to stone, to
gravestones, or entombed in their own rigid construction of the world. She can
only express herself in mad-talk. Then she sits rigid in the hospital, and they
have to attend on her.
In the description of her at the beginning, Jean in
hospital appears like a puppet or doll. The researchers notice she still has
something of this quality even when her family say she has gone back to normal.
That says everything about how they see her – she is not fully human, not the
agent of her own destiny.
DARKNESS
Jean’s family deny she was afraid of the dark as a child:
well, perhaps a bit afraid, her mother says, (185) but only in the way she
herself had been afraid when she was young, and anyway that fear normal for a
girl. Jean had never been given a night-light, her mother says – so that proves
it was not an issue.
But of course this whole family is afraid
of the dark within – they can’t look at any negative emotion or uncomfortable
fact, or at their own shadow. But Jean is one who has confronted her own
darkness. When she was 18 she worked at a large house in the woods. She
imagined attackers were lurking in the trees and she would run all the way
along the road. I am riveted by this image, straight from a fairytale. It seems
to belong to a more primitive interior world, and I imagine Jean turning and
walking deeper and deeper into the wood and being lost from view, as some of
these patients were. But though I don’t know any details, I think that the
story about her afterlife is more positive: over to Anthony.
Wisdom from Anthony:
Anthony spoke to Jean’s father c2005.
Jean had an older sister who died aged one hour. Her name
actually was Jean.
No outside agencies were involved in the ‘adoption’ of the
child Ian. It was a fostering arrangement set up through personal contacts.
Ian was the son of missionaries serving in India
Jean was a voluntary patient. During her marriage with
David she had an affair, and they separated and later divorced. There were 2
children of this marriage. She married twice more, men she met at psychiatric
outpatient clinics. She had no more children.
Jean died in 2011.
9.
Mary Irwin
Inner
Circle Seminar No. 239
The case history is an exploration of bewilderment. Mary
is a young woman of 20 who has been educated in what illness looks like, but
doesn’t know what health might look like. By the time the researchers see her
she is an experienced patient. She has spent 22 months out of the last 24 in
hospital: this is her third admission, her third institution.
The authors list the clinical terms that are used about
her, which make Mary fit her diagnosis, and her diagnosis fit Mary. She has
delusions of persecution: she says her mother is killing her mind. But she is
not the disappointing type of schizophrenic who just sits in a heap; she puts
on a show. That’s to say, she displays some of the more florid textbook
symptoms: grimacing, catatonic immobility, catatonic excitement: and flexibilitas cerea, waxy flexibility –
that is to say, she can be manipulated by another person into a position of
their choice, and will stay in it till moved again. It strikes one that both
doctor and patient are involved in a theatrical performance.
Mary’s symptom ‘speak to her condition.’ In fact, they
bellow. But as usual, the metaphorical dimension seems to be lost on the people
looking after her, who are ticking her off on a checklist. Among other symptoms
are ‘vagueness, speculative woolly thinking about the meaning of life,
inability to face life’s difficulties and aggressively overcome them.’ That
describes the characteristics of the more thoughtful portion of humanity on a
day to day basis, and almost the entire working life of a philosopher. But here
is an ordinary young girl, not educated, not experienced: what business has
she, asking what life is all about? As far as the hospital goes, she is the sum
of her symptoms and her background is irrelevant. The researchers say, ‘No
relationship was felt to exist between her various symptoms and her
environment. ’
But the authors set out, as they do in each history, to
challenge this. They ask, in the light of how Mary experiences the world, and
in the light of her relations with other people, are her beliefs and strategies
so unreasonable that they should be regarded as caused by an illness – which needs
daily electric shocks to contain it, and powerful drugs to treat it? When Mary
smashes things, which reportedly she does, she is behaving unbearably. But to
behave unbearably is not necessarily to behave unreasonably. Mary is a good
witness to herself – she may struggle to speak, but given a chance she does
speak, and she is capable of making sense of her struggles in a way her doctors
can’t.
Mary’s family consists of mother, father, sister Angela,
two years older, and a 16-year-old brother, and they are interviewed in various
combinations for 20 hours – if you look at the table at the back it says 2
hours were recorded in writing, the rest taped.
There is one unusual feature here: at some point before
she became a patient in a psychiatric hospital Mary had suspected encephalitis,
which can of course follow common childhood illnesses like measles. We don’t
know whether she did have encephalitis – without brain scans it would have been
harder to diagnose then – presumably you would do blood tests and a lumbar
puncture, and with Mary the evidence of infection vanished over time. I wish
the case history said more about this, because the disease in childhood has a
long tail of unpredictable consequences in terms of damage to the developing
brain, some of which don’t show up till later years
– fatigue, difficulties with memory and concentration, mood swings, clumsiness,
speech and language problems, general slowing-up of thought and reaction,
changes in personality. However, it doesn’t seem to be something the
psychiatric hospitals considered as an explanation or as a contributing factor
in the way Mary presents herself. Her afflictions are regarded as a bolt from
the blue.
According to her family Mary’s problems begin when she is
15. The picture they report is one of a young person uncertain of her direction
in life, on the cusp of adulthood and therefore just beginning to challenge the
powers that adults exercise over her. The first challenge her parents hear
about is a challenge to the authority of her school. She asks a teacher if it
is right to hit the pupils. It’s good to be reminded that that the power adults
exercised over the young wasn’t simply moral and economic, it was physical too.
When you think that Mary and her classmates are almost adults, it seems a preposterous way to go
on, and it’s fair enough to question it, but Mary’s father, from whom this
evidence comes, clearly thought it was impertinent.
But what the family think of as transgressions on Mary’s
part are quite normal behavior. Her mother tells us they used to like the same
clothes. Then the point comes where Mary wants to look like a young girl, and
not a middle-aged woman. This is seen by her mother as disturbing and
challenging. It stands in for a lot of things – sums up how she doesn’t
understand Mary any more. She takes it for granted that she should. Mary should
act as a mirror to her. But Mary has entered into a phase where she seems not
to agree, automatically, with everything she is told. She is cheeky, stubborn,
selfish: insubordinate. Her father complains she has annoying habits –
sniffing, picking at her scalp, waggling her foot. These habits, the family
feels, are not just Mary’s restlessness, but directed against them: her father
says she would do ‘everything to try and annoy you.’ And she can’t hold down a
job; she loses interest. After leaving school she held a job for two years,
though it wasn’t a job she wanted in the first place. Then within a year or so
she lost three jobs. The historical context here needs considering – this was a
time when it was easy enough to find low-skilled jobs, and changing jobs often
was normal in young people with no particular course of life in mind. But
clearly it is worrying for her family, if the problem is, as it seems to be,
that Mary gets sacked rather than leaving of her own free will.
Actual examples of objectionable behavior are hard to come
by. As the researchers say, ‘the most that happened was that on one occasion
Mary walked out after a row without saying where she was going and came back
after a few hours.’ But her mother’s fears concentrate on what could happen, if Mary had the direction
of her own life. Mary explains that from her point of view, her problems began
when she was eleven, when her mother’s continuous pointless talking and
complaining began to wear her out. Her mother was constantly impinging on her
attention when they were in the house together. Mary seems like a person with a
high requirement for peace and quiet, a sensitive girl who is treated with
great insensitivity. Her talents and interests are belittled, and she is
teased. Evidence of this comes not from Mary, but from her mother and father.
Yes, they say, when she was at school she had some talent for music and
painting. Mary was likable, and her teachers would get on her side, and
over-value her work; she only did well where subjective judgment was involved.
Mary is also the butt of family jokes, which she is expected to take in good
part. She brings home a boyfriend, and mother and father ridicule him. Mary is deeply
resentful – which her mother attributes to illness. One of the things she
thinks the hospital will do for Mary, it seems, is to make her robust enough to
stand up to her family’s sense of humour.
Mary feels that her mother puts her under ‘a debt of
obligation’ for what she does for her, while her mother prides herself on her
skill as a parent – the more so as she hated her own mother, was terrified of
her, and had to battle to get away from home. When her children were younger,
she says, her husband’s employer and ‘everybody I came into contact with,’ used
to say she was a wonderful mother. Her expectations of the infant Mary were
high. She talks about how she trained her to sleep through the night. She’d
reason with her, and say that her elder sister had gone quietly to sleep, so
she should, too. And this worked, she says. But she seems confused about the
difference between a baby and a child who can speak and who could, notionally
at least, be reasoned with. The researchers say that she speaks to Mary, in the
present day, as if she were a 3 year old, and it’s possible that in her
mother’s mind she has always been three, both before and after that age. She
was ‘just the kind of baby everybody wants.’
Imagine having a child like that! It is a great distiction
for a mother and would make her the object of envy. You will recognize a
familiar figure in these case histories – the model child: little angel, little
puppet. You may be reminded of June Field, whose mother treated her as a
patient, acting toward her as a nurse. Like June, Mary was a happy child, never
any trouble: golden curls, big blue eyes, clean, biddable, tractable. There is
a blissful state of union between mother and daughter. In childhood these girls
are not messy, recalcitrant, defiant – it’s when they’re mad that they babble,
that they break things, that they run out into the street. In crisis, they
start behaving like the child of their mother’s worst nightmares.
If you think what is it to be a compliant baby: a ‘good
baby’ is one whose biological needs are already subjugated, timetabled to suit
its family. The child is valued and praised for minimising the inconvenience of
her existence – not for being a new person and an individual, not for adding to
the family – but for not taking too much. One suspects a male child was
expected to be more demanding, possibly punished but also admired. The female
child must be self-denying. Without her family, the child can’t live: but
within it, she can’t thrive.
Mary is distressed and exhausted by what she feels she has
to do to become an adult – which is to keep her mother at bay, simply keep her
mother quiet so she can think. What begins as an irritation – her mother
talking on and on about the jobs she has to do – becomes experienced as a threat.
In any family it can be difficult to find an acceptable way to grow up, with a
mother who will not brook contradiction or stand for a rival. When you read
these histories you get a senses of the raging, unused potential locked up
inside the mothers. You may remember Julie in The Divided Self, the girl who called herself ‘the ghost of the
weed garden.’ She said, ‘I’ve been frightened of my mother all my life and
always will be.’ At the time we’re speaking of, with abortion forbidden, and
contraception less reliable and less easily available than now, motherhood was
not a state women could easily refuse, short of becoming celibate: nor could
any ambivalence towards marriage and motherhood be admitted. If a woman didn’t
go outside the home to work, then she had to make a conspicuous success of her
only role. If she did work outside the house, she was guilt-ridden, and had to
face a weight of social disapproval, and be blamed for social ills; and perhaps
she would feel a need to demonstrate she was just as much a force in her
children’s lives as if she had been minding them all the time. Either way, the
mothers in this study bring a certain unsparing ferocity to the task, and tend
to stress how much they have done for their families, how much they have
sacrificed. Behind the claim lies an ambivalence and resentment they can’t
admit to – not out loud. But it doesn’t take much for a child to conclude that
she was not wanted, or is a burden. The smallest signal will do. The child’s
fragile understanding amplifies everything: a casual word can be catastrophic
to her sense of safety. She feels she has seen through to a truth that is
painful and threatening: Julie said, speaking of herself in the third person,
‘everybody pretends to want her and doesn’t want her.’
The child who feels she is unwanted has a choice of
tactics, but they’re all self-defeating. If she offers her love, is that an
imposition? Might it make the mother go away? But if she doesn’t bother her
mother with a demonstration of her love, the mother will then accuse her of
being emotionally dead, ungrateful, not normal.
Mrs Irwin leaves no room for an emerging Mary. Regarding
Mary’s supposed illness, she says, ‘I feel it’s me that’s done something
wrong.’ When a parent makes that sort of statement, you know they expect it to
be negated immediately. You feel Mrs Irwin has a set of witnesses hovering over
the situation – all those people from her past who applauded her skills, now
ready to reassure her, ‘It’s not your fault, it couldn’t be.’ But whether she’s
a bad mother or a good mother, she puts herself at the centre of the drama. And
Mary has a variety of strategies to try to push her away. She holds her breath.
She employs a variety of distractions – the fidgeting her family complain of.
She goes rigid inside, she says, to keep her mother out. And a point comes when
she graphically demonstrates her strategy – she goes rigid outside too. At that
point her behavior has passed over into being a symptom.
I said to you earlier that by the time the researchers saw
Mary, she was an experienced patient. But before that there was a point where
she, like the other women in the study, was an innocent sufferer. We’ve talked
about how the diagnosis isn’t usually given to these patients or their
families. The word ‘schizophrenia’ is rarely used – instead, we suppose, the
hospital uses familiar terms like ‘nervous breakdown.’ As far as the patient
herself is concerned, she is upset and frightened, and behaving in a way she
can’t control, and having thoughts she doesn’t want to have. It’s a fair
assumption that when you are distressed in this way, your distress is your own;
that’s how you experience it, and it is reasonable to think that it is unique
to you, a product of everything you are, everything you’ve lived through, your
particular circumstances. But when our women come into treatment, they don’t
know they are walking into a set of pre-made categories for distress.
The danger is that what doesn’t fit the categories is not
observed and not recorded, and what is observed and recorded is noticed because
it builds up the picture that the hospital is already looking for. It’s a
system designed to falsify the meaning of experience. The nurses and doctors
think they are describing, but they are also judging. The girl sits and doesn’t
move; if you call her catatonic, you are giving an opinion as to the cause of
her immobility, saying that it originates in pathology. A healthy person might
be silent; a sick person is mute. When the descriptions become fixed and are
repeated, it’s easy to forget that what is being described is not a clinical
entity like a broken ankle. Once exoticising terms are employed, the patient
will ever after suffer according to a formula. The clinical vocabulary makes
that person alien, cuts them off from the general human experience. The simple
route would be to ask the patient why she’s doing what she’s doing, but in the
self-defeating practices of the trade at that time, that is the last thing you
would do – because she is the last person who could know.
Mary gropes for words – but what she is trying to describe
are feelings on the frontier of language. She has to keep her mother and
everyone and everything else at a distance, so she can collect herself, feel
out the contours of her own personality. But she knows that her strategy is not
useful in the long term. Encased in her suit of armour, she misses so much, but
if she relents, softens, if she tries to let good things in, bad things arrive
too. It’s a fraught, confusing process, with the hospital a controlling
environment that mirrors that of her home; when she says, ‘I seem to lose touch
with reality,’ you wonder if that is an attribution made about her, something
she has heard of as defining her illness. It is not something a person would
naturally say about herself.
Does Mary think she is ill? After her first spell in
hospital, she says, she came home in a great spirits. But her mother told her
she was too full of herself. Her mother says she was over-confident and ‘jumped
immediately into a job.’ Her attitude was selfish, and this showed she was ill
– even though she felt she was well. When pushed for an example of Mary’s
selfishness, or illness, mother says she can’t recall one. As Mary recovers
from the third hospitalization, she says would like to leave home, perhaps: her
mother agrees, and says they have urged her towards that course: but she
immediately says, now is not the time, you need to wait till you are better.
Mary implores her mother to tell her what health would look like, but can get
no straight story. But unless her mother can tell her precisely what sort of
thing she needs to be doing to show she is well, then, ‘If I get better again I
won’t know if I’m right or wrong or when I’m going to crack up again.’ To be
passive is to be ill: to be active in your own life is also to be ill.
And of course, from Mary’s experience, it is not she who
will decide whether she is well or ill, it is other people, and in fact if you
look at the murky episode of her sister’s wedding, the question is confusingly
indeterminate and negotiable. Mary was expected to be a bridesmaid, and was
asked by her mother, ‘Are you going to get better for the wedding?’
Her response to this was to take an overdose of aspirin.
She was in hospital when this happened so you would suppose there must have
been a proper record of events, but maybe not; certainly her mother is vague
about how many pills Mary took, and says she wasn’t told about it for a long
time. But when Mary woke up, she was fine. Not mad at all. She discharged her
bridesmaid’s duties, went back to hospital and was mad again.
In Wisdom, Madness
and Folly Laing talked about the Scottish psychiatric hospitals where he
had worked:
…in the so-called back wards, I have seen catatonic
patents who hardly make a move, or utter a word, or seem to notice or care
about anyone or anything around them year in and year out, smile, laugh, shake
hands, wish someone ‘a guid New Year’ and even dance…and then by the afternoon
or evening or next morning revert to their listless apathy. If any drug had
this effect, even for a few hours, even minutes, it would be world-famous….’
He attributed this miracle to the ‘spirit of fellowship ‘
– an alleviation of the intense loneliness of the men. It’s not clear whether
it’s the idea of a new dress and a good time (or just a change) that lifts
Mary’s spirits, or whether it was her family’s expectations that caused them to
revise their view of her, just while it was convenient.
It’s hard to make any sense of this episode. If you look
back at what Mary did when she was in hospital, her behaviour seems to encode
what’s almost a satirical view of her life. Demonstrating ‘waxy flexibility’ is
a neat comment from a girl whose family insists she is pliable, impressed by
their needs and desires. She was said to display ‘automatic obedience’ – which
I take it to mean that she acted like someone under the sway of a stage
hypnotist, getting up and sitting down at the word of command – again, a
reasonable demonstration of the way she has been expected to conform within her
family. Even when Mary was at home, a sort of bitter comedy was performed: her
sister describes an occasion when Mary took up one of her rigid positions,
stuck in it, became normal when their landlady came in, and took up the position
again when their father returned. There is no question in Angela’s mind – it
was totally under Mary’s control. Like a play she was performing.
And this, I think, is what this beleaguered child resorted
to: if you won’t let me speak of my inner state, if you keep interrupting me,
talking over me, interpreting me instead of listening to me, knowing better
than me, I will have to show you what I can’t tell you. What comes over is
Mary’s sense of being locked in unceasing struggle. Her requirements are quite
humble: to be allowed the space to work out her own needs and desires. ‘Is it
right to think?’ she asks. ‘You should think, shouldn’t you?’
Sometimes the question has been raised in these seminars:
why don’t the young women save themselves from their families. Why are they so
enmeshed? Why don’t they walk away, at the point when they can?
But it is often the case that people cling to oppressive
conditions even when it’s pointed out to them that their best interests lie
elsewhere. Children cling to bad parents, because they’re the devil they know,
and the wide world is full of devils you don’t know: and when children grow up,
they deny that bad parents are bad, and they say, ‘they loved me really, in
their way.’ People justify all sorts of monstrous abuse in their upbringing,
and say it never did them any harm, and children try to love their parents even
if to the outside observer it seems the parent should be in gaol: from the
child’s point of view, it’s better to be oppressed than ignored, because that’s
to fall into the void of nothingness – to have your existence denied, before
you’ve been able to establish it for yourself. Better eat the bread of sorrow
than be overlooked and get no bread at all.
In the case histories we are not dealing with the kind of
abuse you go to gaol for – not that we know – but with more commonplace abuse
of power and corrupt communications, which bewilder and tire and stress these
young women to the point where you might say, they don’t know their own minds.
You can say to these women, ‘There’s the door to freedom, go through it,’ and
you have to try to understand why they hover on the threshold. Freedom is so
hard, so testing, if when you sample it you are accused of ingratitude,
over-confidence, and if you have been underminded as Mary has. In this set-up,
being ‘better’ is defined as agreeing with people: whereas to the outside
observer, health would begin at the point where the patient wished for health,
wished for freedom, realized her freedom, and started to make use of it.
WISDOM FROM ANTHONY:
Mary was born in 1940 and was 50 at her death.
Her family is Scottish. She attended a secondary modern
school, whereas her sister Angela attended a grammar school.
Angela has led a stable life: two marriages, children,
modest career. After her marriage Angela was interviewed at home by Marion
Bosanquet, a social worker. The younger brother seems to have cut himself off
from the family early, joining the RAF and staying away thereafter.
Mary’s school reports don’t bear out her family’s poor
opinion of her. She was able across a range of subjects, including maths
(whereas the family view was that she only did well in subjects where personal
factors influenced the marking.)
One teacher describes her as ‘a good notetaker and a good
listener.’ Another remarks on her good manners.
Mary was serious about her painting and wanted to go to
art school.
Esterson saw Mary 1961- 1962. After she was discharged she
went home, but another incident with her family saw her back in hospital. She
then became a career patient, outlasting the institution in which she was
placed. After the closure of her long-stay hospital, she was transferred to
some type of hostel or half-way house (we assume) and never left its care.
Anthony has given us a 1976 paper by Esterson called
Families, Breakdown and Society, in which he includes an outline of Mary
Irwin’s case and a longer transcription from a tape of Mary and her mother
talking with him. This adds a good deal to the record in SMF. One gets a sense
of Mrs Irwin’s dogged persistence in holding to her own version of events,
though she can never supply any specifics; and also her latent anger with Mary,
barely held in check even in the interview. Esterson concludes that Mary was
never psychotic, but ‘was with complete justification in a state of existential
despair and mystification…’ She did not need institutional psychiatry, he says,
but rather a friend and confidante, and someone who could mediate with her
parents on her behalf, and give her confidence in dealing with
the world using her own resources.
10.
Hazel King
Inner
Circle Seminar No. 242
A few weeks back I was talking to a lady approaching her
90th birthday and she said, ‘Never sit down and take stock. You only
end up crying.’
All the same, I think we’ve come to a point where we might
take stock, if only because we’ve had a gap since we met: and just ask
ourselves what we are doing. In part we are puzzling over the fate of a
literary artefact. We know what is in this book, and we know what has happened
to it subsequently: how it has been read and misread, and how people who think
they have read it have actually failed to take its point. We ask ourselves why
it didn’t change much in the real world; it didn’t make professionals think afresh,
as it might have done, and it didn’t operate to change social policy or how we
define and treat mental distress.
We can come up with various reasons – apart, I mean, from
entrenched conservatism and limited intellects. One is that Laing’s flamboyant
reputation stopped people taking his work seriously as the years passed, and
that, unfortunately, Esterson’s contribution went down in the wreckage.
There is another and simple explanation for why present-day
readers misunderstand the book. As an author I am drawn to this explanation,
because I know that people can’t be relied on to read anything that comes
before ‘Chapter One.’ They think, ‘ooh, stories!’ and they plunge in.
Because they don’t read the prefaces and the introduction,
they conclude that the book simply portrays a set of nasty and sometimes
grotesque families who victimise one member and make them ill. That would be an
easy mistake to make. Readers also probably begin the book with
pre-conceptions, thinking that the authors deny that anyone is mad, or that
they claim families cause schizophrenia. Because of the case history form, the
authors can’t hold an argument within each chapter. They can’t stop the story,
to restate their position constantly, because they want to subjects to speak
for themselves. Accordingly, the opening pages of this book really matter.
The first preface, from 1963, is a conventional list of
acknowledgements and notes about the research. The second preface, from 1969,
is very different. It grapples with the misunderstandings the book has caused
to that date. As the authors say, most of the criticism is irrelevent, because
the book has been taken to be what it is not. ‘There have been many studies of
mental illness and the family,’ they say. ‘This book is not of them…’ Their
purpose is to examine the term ‘schizophrenia’– it is not not to say such a
condition exists – not to say it does not
exist. What they do is to take 11 patients with the diagnosis, and ask, how far
is what they say and what they do intelligible, if you look at it in the
context of their lives and upbringing.
The introduction goes into their thinking in more detail
and I imagine readers skip that too. Or they may as well, for all the change it
makes in popular thinking. You will be aware that many people believe in
schizophrenia as a fact, in the way they believe in a tree, or a white line in
the road. They don’t grasp that there was a time before the term was invented,
when the kind of behaviour the term describes would have needed another name. They
think that you can say, ‘This patient has schizophrenia’ in the same way as you
can say, ‘This patient has typhoid’ – as if you were saying, ‘we have run the
lab tests, and this is the sad fact.’ Or as if you could take a scan, and see
the disease working away within the skull. Medical practitioners know it’s not
that type of diagnosis, but something much more problematical. Yet they act ‘as
if,’ the authors say, it is a fact, and a chain of consequences follows the
fact, all based upon an assumption that may not be valid. The authors want to
put a delaying hand into the process. They want to say, let us peel away the
assumptions we are making about these patients, and witness them – not seeing
them through the prism of pathology, not checking off their words and deeds
against a list that ‘proves’ them to be ill – but holding the question open.
And this is hard. The years have gone by and the intellectual
effort of laying aside assumptions has been too much of a challenge for many professionals,
and when a patient comes into hospital, in a distressed and maybe frenzied
state, it must be consoling for nurses to think, this is what she has, this is
what we do: and we are all aware of how much the world has changed since this
book was written – the pressure under which decisions are taken, because the
hospital places have gone and the need is for quick fixes. There are many
reasons why patients and families themselves grasp at a diagnosis. The object of
the book is not to hand out blame, to doctors or nurses or parents. Being
human, of course, the writers have their views. Sometimes, even given the tight
format to which it’s written, they can’t suppress their distaste for one family
member or another, or their outrage at what is happening. And it sounds like
blaming. But we must be clear. They are not blaming the family for illness.
They are questioning the attribution of illness, and specifically the
attribution of ‘schizophrenia.’
Today I am extra wary, because in announcement of the
seminar, Anthony has said that his own research has shown that there is a
serious inaccuracy in the original report. That is for later. My brief is to remind
you of what’s on the page, accurate or not. It’s clear that the researchers
themselves felt wrong-footed by this family, because they say that in the
course of their 2 year investigation they were continually making new
discoveries. They could only make sense of Hazel’s life by considering her
extended family, and if you look at the table at the back, you can see how
complex the interviews become; there’s only 3 hours of Hazel alone.
When Hazel comes to hospital she is 16. She is the eldest
child, with two brothers of 13 and 11. She seems frightened, doesn’t speak,
move or eat. She’s frozen. Then she begins to whisper. She says she fears her
mother wants to poison her or get rid of her. And then, I quote, ‘She thought
that the girls at school were saying she was silly and stupid, and that she
wanted to murder her brothers.’
I don’t know what to make of that. Was Hazel saying that
she wanted to murder her brothers, or is it what she thinks the girls at school
are saying? Is she accusing herself, or is she being accused? In what world
does a sister murder her brothers? In the world of myth, perhaps. This family
seems to be acting out an archetypal drama – you think you have wandered into
King Lear, or a Greek tragedy.
In the case history we are only considering Mrs King’s
family. Mr King’s family are in Australia
Now we come to the second eldest daughter. She has what
the researchers call an ‘empire,’ even though her elder sister still has control
of the money. Her subjects include her husband, who is a cipher, and her second
daughter Sybil King, and also Sybil’s husband and family, which includes Hazel.
Mrs King is herself a second daughter. Her mother the empress didn’t like her
own elder sister, and doesn’t like her own eldest daughter, who is now Mrs
Blake. But there is a superglue bond between Mrs King and her mother. Second
daughter sticks to second daughter.
So where is the family money going to go? It boggles the
mind, but this is what the researchers say: the money follows a male heir. So
the race is on. Mrs King, not Mrs Blake, marries first. Second daughter beats
eldest daughter. Mrs King, not Mrs Blake, is the first to become pregnant. Again,
second daughter beats eldest daughter. But then Mrs King gives birth to Hazel,
and subsequently, Mrs Blake has a son. Victory to Mrs Blake.
So you have to pinch yourself. This is the mid 20th
century, not the mid 16th century. Hazel’s mother is locked into the
pattern of rivalry between sisters that started in the previous generation – and
when Hazel is born, she has lost.
The disaster – as it seems to Mrs King and her mother – is
not just that Hazel is a girl – it’s that Mrs King was seen to try and fail to
displace the elder branch of the family – and now she feels that both she and
Hazel are disparaged and despised. There is an implication that Mrs King’s
early marriage was in itself a tactic to steal a march on her elder sister. Mr
King is a professional man, a scientist, and and the reseachers think he
doesn’t realise he was just breeding stock. Maybe this part of the family story
has not been revealed to him. It is impossible not to see the men of this
family wearing fools’ caps and bells.
What does Mrs Blake think – the daughter who succeeded in
having the boy? The reasearchers think she doesn’t really hold the feeelings of
spite and anger that Mrs King and their mother attribute to her. They suggest the
two of them project these feelings on to Mrs Blake in order to hate her all the
better.
Mrs King has found it almost impossible to be apart from
her mother. When she married, there was no honeymoon, and she stipulated a
house directly opposite her mother. They see each other every day. She won’t go
on holiday with Mr King and her children. He can either join her parents on
holiday, as she and the children do, or go alone, or stay at home. And usually
he stays at home. He feels he can’t disrupt the family system or his wife might
break down. Hazel is part of a constellation of mother, grandmother and
grandfather – but grandfather is under the control of the women. Hazel is not
encouraged to be close to her father or her brothers. In fact Mr King is not
allowed to take Hazel out. Hazel’s mother and grandmother says, ‘He cannot be
trusted,’ and what they mean, we don’t find out. At one point Mr King left the
family, but then he came back, feeling he might do something to protect the
children, ‘save them as much as possible from the situation.’ But it isn’t
clear that he manages to do anything helpful.
Hazel has never been out alone or brought friends home.
She is allowed to go to school and Sunday school. Her grandfather generally
escorts her there and back. Mr King feels her confinement to the family circle
is not normal, but he doesn’t know what he can do. Mrs King casts Hazel as
being devoted to her – as she is to her own mother. Such is this devotion that
she doesn’t need and other friends or external contacts. This is not Hazel’s
account of her own feelings, the researchers say, but in the account on the
page, Hazel speaks only a few words: and they are broken utterances, not even
full sentences, and objections rather than assertions. It is as if even here on
the page she is engulfed by the larger family drama, barely present in her own
story.
Both father and mother belittle Hazel to her face. ‘She’s
not entirely without brains,’ her
father says. They let her know that everything about her disappoints them. She
may have some latent ability, her mother thinks, but it’s not come out, and
it’s difficult to see how it can. Mrs King says that she is only reflecting the
wider family’s disappointment in Hazel – it is hard not to take a negative view
when everybody holds it. Hazel is given no encouragement to get on at school.
She is told she doesn’t have to worry about exams, or sit the 11-plus. The
family put this in a way that seems caring: they don’t want her to have the
strain. But it must mean that Hazel never picks up any confidence, or gets any
external validation, or any opinion that she could oppose to that of her
family. She has no weapons and no armour.
Mrs King says Hazel is jealous of her younger brothers and
inclined to sulk. She is spoiled in some way, it is alleged, and this is true,
if being spoiled means being over-protected to the point of being stifled.
Hazel is not seen, not heard: no wonder she comes to a place where there seems
no point in doing or saying anything. Mrs King says she understands Hazel and
knows what she wants, yet complains Hazel is closed against her efforts. Hazel
brings no gratification. The Kings missed out on the money, if this account is
true, because Hazel was not a boy – and she is not providing her mother with
any other form of reward.
When Hazel is in hospital the ward staff seem puzzled by
the family. They notice that they seem indifferent to Hazel’s distress. There’s
a mention, which is not followed up, of Hazel not eating before she came into
hospital, to the point where she is malnourished. We’d pay attention to that
now, it raises a lot of questions – maybe that is what would attract attention
to her as a girl in need of help. I’m not sure if Hazel has left school – because
she could have left at 15 – and if there’s a gap where she’s entirely with her
family. (ROSLA 1972) It sounds as if
she is still at school, because the other pupils and what they are saying are
on her mind when she comes into hospital, but then you think, didn’t anyone
notice her losing weight?
And the puzzles deepen: Mr King says that his wife wanted
another baby, and blames Hazel because that’s not happening – perhaps she means
that because Hazel is such a burden, she can’t add to the family. So Hazel was
not only to blame when she appeared in the world – for being a girl – she is
also to blame for the non-appearance of another child, a wanted child. Mr King
hints that Mrs King may have had an abortion. If so, she did this without
telling him. In fact, he doesn’t know whether she was pregnant or not. He
doesn’t expect to be told. You notice there are two generations of husbands who
are sidelined: Mrs King’s father is regarded as totally under his wife’s
control: Hazel’s father is distrusted and impotent, in the widest sense.
When the researchers describe Mrs King they present to us
a woman who has never established a separate existence from her own mother. She
hardly strays out without her family, is afraid of strange places and people, and
prone to think others are talking about her; she has an excruciating self-consciousness
that persuades her that people in the street are noticing her and ridiculing
her.
So when Hazel says that girls at school are ridiculing
her, two things occur to the reader: that it might be sober fact: but that even
if it isn’t, that is the way Hazel has been taught to construe life: and she
has very little guide to how the world works, she only knows how her family
works. In that family, people behave the way they do because of events that
occurred before Hazel was born, and in response to perceived malice and
hostility in other family members, which may not even exist at all, which may
be conjured up by their own feelings of guilt. They seem to be working out an
archaic pattern that they can only see dimly, and Hazel has no chance of seeing
it at all: she can’t distinguish the pattern from the background. So often with
these families you see how salvation would lie in some outside perspective – if
there were one person outside who the child could look to for a different
description of the world: but here there’s only school, and I imagine Hazel as
one of those children who is simply ignored if she causes no trouble. There’s
Sunday school – and in some of these families’ lives, religion does play a big
part, but we are not told what part it plays here.
We get a description of Mrs King from the researchers, for
which I must quote their own words. ‘Mrs King is grossly hysterical, giggly,
dissociated, frigid, subject to multiple anxieties…she does not know whether
she has an orgasm or a climax, she is not sure whether or not her husband has
‘proper’ intercourse with her, she is not sure whether he uses a contraceptive
or whether he ejaculates inside or outside her.’ (221)
She may be somewhat surprised to be asked. I’ve often felt
that the families must be puzzled by the direction of the researchers’
enquiries, when they ask about the patients as babies. But now I think, how dare you? These questions must have
seemed intrusive, bizarre, even mad. And I hate the language they use about Mrs
King, and the judgements they make, not seeming to grasp that she must feel as
if she’s undergoing an ordeal, and that questions like these are going to drive
us further from the truth because they would cause anyone to shut down. I’d
hate to think this went on in other cases.
The researchers talk about ‘our team’ and I would like to
know who is involved. One of them succeeds by lucky chance in seeing Hazel’s
grandfather, who they have not been able to interview, and who by this stage
has been excluded from the tight group around Hazel.
Grandfather complains that Hazel has been turned against
him, that Hazel blames him for keeping her a prisoner: which suggests that Hazel
is fully aware of her situation, but not of who is responsible for it, that she
doesn’t understand how power is distributed in her family. The interview with
grandfather is snatched and furtive and it ends when Mrs King is seen coming
home: it sounds as if she comes with giant footsteps, and the earth shakes. And
I wonder about Mrs King. I have read you the contemptuous description of her.
Her dependence on her mother suggests a weak person. And yet the family history,
as written up here, bestows on her not only ambition, and an intense desire to
beat down her elder sister, but the power to manipulate – maybe it was her
mother who said, ‘we need to get the family money, we need you to have a son,’
but it must have been Mrs King herself who got the man and fixed the marriage,
and then so handles him that he is utterly subservient and confused and null.
So I can’t get a fix on this woman. Does she have real power in the family? If
so, how does that show? If not, where does the power lie?
This snatched meeting with grandfather is described in a
way that I can only see as highly-coloured and emotional, when we compare it to
the way most of the data is written up: grandfather become upset and says that
Hazel won’t be in the same room as him, and then, I quote, ‘He didn’t wipe away
the tears that ran down the lines of his small round face – as though perhaps
he was too used to having them there to notice. At one time he must have been a
cheery, robin-like little man, with bright colouring and eyes…..’ (223)
Grandfather then goes into a soliloquy about Hazel that I
just can’t credit. I am assuming the researcher didn’t switch on a tape
recorder, and what grandfather is reported as saying seems unnatural to me, as
if he were reading it from a card. I don’t doubt the content, but I feel that
this is the edited verson, somewhat over-written when it’s written up later. I’m
not blaming the team member for letting feelings show, but it seems incongruent
with the usual style.
So I have worries about this case history. We are not told
what happened to bring Hazel into hospital – a point on which I always fixate,
as you know, because I want to know what occurs at the point where a drama
becomes a crisis. We are told that she recovers over three months, has another
less serious breakdown, and what is described as a partial recovery. When she
came into hospital initially she felt unable to express herself except through
silence, stillness, and then through figures of speech: she is deluded – in real life no one is
trying to murder her – but her fears do approach the uncomfortable truth – maybe
it is too late to get rid of her, but she is a girl who some of her family
think should never have been born, and who is only allowed to exist on the most
limited of terms.
I don’t feel optimistic about Hazel. I feel the forces
constellated about her are too big for her to understand, and I feel that
there’s a lot going on here that the reseachers didn’t get at: I think I would
feel that even if Anthony hadn’t said that there was more to know. I said at
the beginning that one of the things
we are doing here is to puzzle over the impact and influence of this book, or
lack of it. But we have another purpose: we are witnesses. We are removed now
by many years from these case histories, but we think it important to listen to
these voices afresh, and Anthony has let us do so – rescued the tapes, and
undertaken taxing research into the afterlives of the subjects. I make no secret
of how these stories affect me, of my own affinity with these souls: I feel as
if they are drowned sisters, and I’m trying to get them back to the surface for
a last look. Putting feeling aside, we are trying between us to get the story
straight: even if it’s wrong by the way, we are trying to get it right in the
end.
This seminar was unusual in that 3 members of the King
family were present. They included an adopted daughter, much younger than
Hazel, who was the fourth child Mrs King had wanted.
The family backed up Anthony, who had found pervasive
inaccuracies – serious enough to upset the researchers’ melodramatic account of
the family feud. In fact the feud seems not to have existed. Mrs King, not Mrs
Blake, gave birth to the first child, and in fact there was no gender rivalry
around the issue of who would get the family fortune. On the contrary, the
unmarried woman who held the purse strings also held strong feminist views.
They confirmed that the family were over-protective, but
because of distance from the events that led to Hazel’s hospitalisation they
were not able to shed much light on the troubling issues the case history
raises – for example, the status of the men in the family, or why Hazel’s
father was thought untrustworthy, or whether this was actually true. They
objected strongly to the portrayal of Mrs King in the report. She was not a
woman they recognised. But a lot of time has passed and memories have blurred.
When the voices of Mr and Mrs King were played on tape, their adopted daughter
hardly recognised them, with their clipped old-fashioned diction.
Hazel, who is still alive in a care home, was given a
lobotomy. This was privately performed, but we do not know who was the prime
mover. (Hazel would still have been a minor, I think.) The family (very
well-informed and intelligent people) do not distinguish the effects of Hazel’s
‘schizophrenia’ from her post-lobotomy deficits and difficulties. They see her
personality as having a continuity – whereas it might be thought the operation
on her brain severed the old Hazel from the new Hazel who was the creation of
the procedure.
It seems likely the operation must have been presented to
Mr and Mrs King as a possible cure, and now, to this day, it is seen by Hazel’s
remaining family as a cure that largely failed. It leads one to reflect on the
professionals’ habit of leaving patients and families mystified and cowed, and
grateful when they should have been indignant. People were frightened of
‘mental illness’ and to some extent still are. This fear, and the idea that the
whole field is of immense difficulty and delicacy, has kept families in the
dark for decades. I was reminded of Sarah Danzig’s brother, also a
well-informed man, who at the time Anthony recorded him still believed that the
bowel problems which led ultimately to Sarah’s early death were somehow part of
her ‘schizophrenia,’ rather than a side-effect of her medication.
Even with the help of the family it is difficult to form a
picture of Hazel before her hospitalisation. Indeed, she is more of an absence
than a presence in her own case history. Some participants felt that Laing
& Esterson had failed to make their case here; they had not succeeded in
convincing us that Hazel’s symptoms were socially intelligible. It should be
said, however, that this does not leave us a residue of reported behaviour
which can only be considered psychotic. It simply leaves us with inadequate
knowledge of the case.
Regarding the home visit in which the encounter with
Hazel’s grandfather took place: the peculiar tone was explained by one
participant who is a former psychiatric social worker. He says that at the time
PSWs were trained and encouraged to write in this highly-coloured way. I would
like to know whether it was also a PSW, or the same one, who gave such a harsh
account of Mrs King.
How did the researchers get it so wrong? Where did they
get their original misinformation – which family member originated the bizarre
story of the feud? A mystery remains.
11. Agnes Lawson
Inner Circle Seminar No. 247
Agnes Lawson, the plumber’s daughter: her very name is
like a sigh, and I’ve always thought of her as if she were the heroine of a
Victorian ballad. Of course I know now that her name can’t be Agnes, and her
father has some other trade. I understand and appreciate how careful the
authors were – or Esterson, at least— about confidentiality. There is every
reason to substitute the personal details. But one name is not just the same as
another, and social circumstances are never precisely equivalent.
This is the necessary weakness of the genre of the case
history. We have learned through these seminars that some of the histories are
fuller than others — we have learned from Anthony that some are inaccurate or
incomplete. This is a singular chapter, because of the method of reporting. The
researchers made recordings, but have chosen to paraphrase them, rather than
provide transcripts. Anthony however has tapes, and we might be able to work
out why they chose to work this way. The written interviewers which the team
mention have not survived.
Agnes is the youngest of the family, with 2 other
children, boy and girl, both married, both away from home. Her brother and his
wife are interviewed, the sister is not, and her parents, we are told, would
give interviews as a couple, but not alone. They would not allow the
researchers in their home, so they could only be interviewed when visiting
Agnes.
Her family
background. The
family history is one of poverty and ill-health, unemployment and over-crowded
housing. One has the impression that of the families in the book they are the
most materially deprived. Mrs Lawson had been in a TB hospital as a child. The
Lawsons’ first two children had life-threatening misadventures. Mrs Lawson
tried to breastfeed her first child, Shirley, because her doctor told her to,
but the baby was malnourished and only picked up when at Mr Lawson’s insistence
she was bottle-fed on baby formula. Jimmy was born lacking oxygen after a
difficult birth. The midwife almost gave up on him; he pulled though, but his
first 18 months were difficult.
So we have a family very stressed by circumstances. The
history as we have it suggests Mrs Lawson is compliant to a damaging degree.
She tells Agnes, ‘If you let people tell you what’s right, you’ll be all
right.’ It seems that in the case of her first child, she trusted the doctor’s
advice — which might have been handed out quite casually — more than she
trusted the evidence of her eyes, when her baby was dwindling before them.
Agnes was an unwanted child. She was conceived just a few
months after Jimmy’s birth and Mrs Lawson did not at once recognise that she
was pregnant. It was a difficult pregnancy, she haemorrhaged after the birth,
and for a year afterwards had no energy. But the Lawsons insist that as soon as
Agnes was born they loved her, and that she was a spoiled child; and sometimes
she agrees with this. But her father used to tell her that she was found on a
doorstep, or in the street. This was his idea of a joke, and he carried on with
it even though, by his own account, Agnes was a sensitive child.
Agnes’s medical history is complex, so I’ll summarise.
She’s 27 when the researchers meet her. She was first hospitalised at 19, and
given a diagnosis of paranoid schizophrenia. She was treated — I’ll come to
that — and discharged after 6 months. She spends 2 years as an out-patient.
Then there is a year in which she is not under supervision and when she holds
down a job, sporadically: at some point she starts to train as a hairdresser,
but it’s not clear at which point — her job history is erratic. After this
period of a year she is referred to the hospital again, seen as an out-patient,
and given drug treatment. After another year she is re-admitted. She is treated
and after 4 months discharged.
She is now 24. She remains at home for a year, but a month
after taking a job, she is re-admitted. She is given drug treatment, discharged
after 6 months. After 2 years as an out-patient, she begins to relapse, and is
admitted for the fourth time, aged 27. The diagnosis remains paranoid schizophrenia.
3 months after this fourth admission, Agnes is still somewhat deluded, from the
hospital’s perspective, and lacking insight, but a plan is made for her to go
to a College of Further Education to train as a shorthand typist. But where is
she to live? She says her parents don’t want her. And clearly she is right —
they stress how difficult it is to live with her. So Agnes is suspended
uneasily between two careers – madness on the one hand, shorthand typing on the
other – and at this point the researchers catch up with her and begin to piece
together her story.
TREATMENT: By the time the researchers see
her, Agnes has received drug treatment (which I imagine is Largactil, available
in 1953?) and also a total of 100 insulin comas.
I’d like to read you what Laing says of his own experience
of giving this treatment while he was an army psychiatrist. This is from Wisdom, Madness & Folly, his 1985
book. (p 90 in my 1986 Papermac edition: Chapter Four, The Army)
We don’t know what protocol was used when Agnes was
treated – whether it was the violent procedure Laing describes in the army
unit, or the more gentle method he saw in use in a unit in Dumfries .
But we know Agnes had one set of treatment, 50 shocks, during her first
admission. You ask yourself, since this didn’t produce long-term relief, even
by the hospital’s own criteria, what the point was giving her fifty more at a
later admission? But so it was. At the fourth admission her symptoms are
described as auditory hallucinations and thought disorder.
She believes people are talking about her unkindly and can
read her thoughts. She is woolly-minded, aggressive, impulsive, but also
childish, afraid of people, and pre-occupied with religious ideas, presumably
ones thought inappropriate for her to have. And she’s a defective economic
being: she can’t hold down a job and support herself.
It’s a big charge-sheet against Agnes, much of it cast in
the stereotyped terms we are used to ; so we have to ask, what is this thought
disorder from which she suffers – is it possible that her view of the world has
more basis in fact than the hospital recognises? And in the light of her
circumstances, do her symptoms amount to madness, or are they comprehensible?
Is there any evidence that Agnes has a progressive, treatable but incurable
disease called schizophrenia, and is there any evidence this condition exists
as an independent clinical entity? Does it exist, apart from in the minds of
the people who are treating Agnes and other patients thought to be like her?
Before her 4th admission, Agnes complains of
the hostility of her parents. She is, to quote the case history, ‘frightened
and lonely, insecure and rejected.’ There was a point before her admission
where she was not hearing voices, but she thought she might begin to: and then
she does, she hears the voice of an electrician who has been working at the house,
and who she thinks is interested in her and would like to take her out.
Incidentally I puzzled about this electrician, and why Mr Lawson says he
doesn’t know him, but I have realised that very likely they live in a house
divided into flats, or in separate houses with one landlord, and it is probably
the landlord who employed the electrician. (Anthony clarifies that the Lawsons
lived in a council house at this date and that the electrician was sent by the
local authority.)
It’s interesting how Agnes anticipates the arrival of the
hallucinations — as if she is saying, ‘help me, because I am distressed, and
getting more so.’ Given her cowed and compliant personality, it suggests that
she knows what signs are said to distinguish her illness, and is ready to
reproduce them; she knows what she’s supposed to be, and is being it as best
she can. By this stage in her life, ‘patient’ is her strongest identity,
together with ‘daughter’ – and for reasons not entirely clear, it seems that
she is going to go on being a daughter and no more – her mother thinks she will
not marry, and tells her she is unfit to look after a child, so she can’t hope
for a rise in status. And if she wanted to marry, she is not sure how she would
go about it.
Agnes doesn’t know if she is attractive to men: if she
isn’t, would it be right to make herself more attractive? Or wouldn’t that be
right? And what if they persist in finding her attractive, sexy, even if she
does nothing to encourage that? Who would be to blame? It’s not clear if Agnes
really has sexual experience with other people or whether she and her family
are worrying about a state of affairs that might occur. She has masturbated
since childhood and she feels very guilty about that. In bed at night she has
sexual fantasies. They are not hallucinations, but she thinks they could lead
to hallucinations. At times she has hallucinated lovers, like the electrician.
They are real men, men she thinks might be interested in her. When they speak
to her in her imagination, they are sometimes affectionate, sometimes
dangerous.
Talking about sex is difficult. She tends to laugh and
giggle when the topic is raised, which the hospital think is a sign of disorder.
In several of these cases, the young woman at the centre is treated as if she
were a sort of unexploded desire bomb: if she were to be ignited, it would be a
disaster, and there’s no middle ground between virginity and the kind of
promiscuity that has the whole neighbourhood talking. If Agnes is not to be a
wife and mother, what are her sexual feelings for, but to get her into trouble
of one kind or another? To Agnes, a sign of being grown-up would be to have a
boyfriend. But she wonders, is that a form of selfishness? Would it mean she
was pushing herself forward, wanting to be the centre of attention? She is
unsure: is it healthy to want a sexual relationship, because it shows she is
grown up – or is wanting it part of her illness, or likely to lead to illness?
Agnes thinks, and has been encouraged to think, that
keeping her thoughts to herself is another sign of illness. Here are more
contradictions. Her mother claim to be sensitive to atmosphere and able to
understand other people’s thoughts easily : but when Agnes makes the same
claim, then she is ‘imagining’ things. Imagination seems to be a danger area. I
don’t know if Agnes is clear on the difference between imagining and
hallucinating – or if she does know the difference, does she express it well
enough to keep her safe from being thought madder than she is? Agnes agrees it
would be wrong to keep secrets from her parents, who only want what is good for
her. But in fact, she says, she can’t keep secrets – she is too talkative and
open. Her parents take a dim view of openness of any sort. They say things like
‘they’re all rogues around here’ and ‘you want to watch yourself.’
What the family say
about Agnes is
confusing, repetitive, full of contradictions of the kind we have become
familiar with, from the other case histories. They say she should go out more,
but she is not one to go out: she does go out, but she goes to church, which is
not good for her: and she should not go to hospital socials, she shouldn’t have
ex-patients as boyfriends. The parents see the hospital environment as an
unsafe place: the staff condone sexual relationships between patients or
ex-patients. Yet the hospital is where she should be, because she is ill; the
fact that she is in hospital proves it. They would not stop her having
boyfriends, provided they were of a suitable type, but since they don’t meet
them, , they don’t know what type they are. She should pull herself together
and get a job, but then again she is not able to do a job, so she can’t be
blamed.
Father’s objections seem mainly directed at her
personality: she won’t be told, she is irritable, he doesn’t like the way she
talks about Jesus. Though she irritates him and needles him, this is because
she is ill: there was a golden age, before, when she was no trouble. Now her
illness is all-pervasive. It accounts for anything her family find puzzling or
challenging. Agnes has a tentative, wavering sense of self. Her opinions are
usually those of the last speaker. She seems afraid of her father’s bad temper
and her acts of resistance to him — her talking back — are called illness. The
parents blame the hospital for any evidence of Agnes asserting herself. They
say the hospital has not helped her — and father anyway is sharply conscious of
the stigma of being a patient. But then to her face, they tell her to stay in
hospital till she is better. When she tells them that other patients don’t like
her, they treat this as a delusion, though the nurses say it is true. On the
other hand, the hospital treats as a delusion her complaint that her workmates
looked down on her; but her mother agrees that when she was training as a
hairdresser, her fellow apprentices showed they despised her for living in a
council house. And since she was sacked from one job for being slow, it is likely
that her workmates do criticise her, just as she fears.
Agnes tends to parrot other people’s opinions of her. It
seems she is not able to make a simple statement without taking it back in the
second half of her sentence. Her supposed thought-disorder and her lack of
insight might also be described as a lack of self-confidence in her own
perceptions. She seems in doubt as to whether she is allowed an opinion.
Like many of the women in the study she is described as
having been a good and compliant child. You feel she would try to be exactly
what her parents wanted her to be, if she knew what that was. Her brother’s
opinion is that Agnes is over-protected, and says he was the same, but when he
left home and joined the army his independent life began. It strikes me that it
might have been hard for the parents to ease up on their control as he grew up,
because he had been such a frail child. But there is a mechanism for a boy to
break away, as we have seen in other families. He is asserting his autonomy, where
a girl is feared to be running out of control.
The modern reader of the case histories is sure to think
at some point, ‘Why don’t these young women just leave home?’ I think we have
to remember the historical context, in which wages were low for young women in
unskilled work: no equal pay in those days. In some areas where women tended to
be found, like retail or (as in Agnes’s case) hairdressing, there was little
input from trade unions, and though it was easy to find work and change jobs,
the opportunities open even to an educated young woman would shrink once she
had a psychiatric record. So as a practical matter, it was difficult to break
away and to become self-supporting. Socially speaking, it was isolating and
anomalous; in working class households and many middle class household it was
usual for a young woman, unless she was going away to study, to leave her
parents’ house only for her marital home. Emotionally too, the effort would be
enormous for these young women. It is possible to live in a state of covert war
with one’s family, yet still find it difficult to turn away from them; you
might say that the intensity of engagement in itself forms the bond, however unpleasant
and destructive it is.
Very little is stable and graspable in Agnes’s world, and
one of the most persistent attributions her parents make is that she has a poor
memory. This allows them to deny anything she says about the past. There is no
objective evidence that she has a poor memory, the study says, though Agnes
admits she has difficulty in concentrating and finishing things; you think back
to the drugs and treatments she’s had, and you wonder if they are implicated.
One thing particular to Agnes seems to be that she has a different standard of
housekeeping and hygiene from the rest of the family. There is no implication
that she is obsessive. But she insists on a certain standard, or tries to. I
imagine they take this very badly. They also accuse her of being the leaky
member of the family — the one who tells their business to outsiders. You’ll
remember from the other histories how often this comes up: the idea that the
family is exposed, through the words and actions of the sick, unstable person.
So if the young woman were to complain to an outsider, not only would the
content of what she says be unreliable, but the very fact of her speaking out
would be a symptom of illness.
The family really do have it all their own way: they claim
that outsiders or casual visitors would never know anything was wrong with
Agnes. She saves up her worst behaviour for the home; though they do not know
what she is like in hospital. Mr Lawson is emphatic that she is not ‘normal. He
seems to use this word a lot. He doesn’t think she will get better, but will go
in and out for the rest of her life. He would shake her, if he thought that
would do any good. But there is no route back to ‘normal.’ She will never get a
job, coming from one of ‘those places.’
At a certain point in this account I start to hear voices
myself. In particular I hear Mr Lawson, who seems to be a very angry man, telling
the researchers that they can’t come to the family house and then, as indicated
on the third page of the study, shouting that they can come if they like, they
can come and talk to all the neighbours, he has nothing to hide. And there is a
particular image that sticks in my mind, which Agnes herself presents to the
researchers, and her brother and sister-in-law affirm: ‘Until she was fourteen
she would sit on her father’s knee and comb his hair while he told her fairy stories.’
That image seems to me to come straight out of a fairy-tale itself, and a
malign one. Agnes adds that she was attracted to hair, hence trying out her
apprenticeship. Now little girls have garish plastic ponies with long manes and
tails that they can groom. And I suppose little girls have always fixed each
other’s hair. But Dad as My Little Pony — a fourteen year old on his lap —
perhaps you will tell me what you think.
Then there is
Mrs Lawson’s best friend — conveniently, she has a best friend who talks about
sex, as Mrs Lawson cannot. She has had 8 children, and talks in an uninhibited
way, tells dirty jokes. She’s embarrassing, but also wonderful. She is quite
unlike Mrs Lawson, who was completely ignorant of sex when she was married, and
who says this ignorance did not do her any harm. I don’t seriously suggest Mrs
Lawson’s friend is an imaginary friend, but I find her hovering in the vicinity
of this family both odd and convenient: it’s as if they want to confess to
their own unholy impulses, but can’t manage it, so they embody them in this
unnamed woman.
Her father was very strict, Agnes says. He discouraged her
from going out and then he changed his tune and told her she should enjoy
herself. But she had passed beyond it. Her confidence had gone. She does mix
with people – at church. She goes 3 times on Sundays, she reads the Bible, she
prays. Jesus has become her friend. If Agnes’s faltering manner on the page is
reflected in real life, it wouldn’t be surprised if people thought her odd. And
her way of talking about religion, which her family object to as childish, may
be faintly alarming, though Mrs Lawson was once a Sunday school teacher, and
maybe it is she who first set the vocabulary and the tone. They say they have
no objection to religion – though it’s not doing Agnes any good, and they find
it hurtful that Jesus means more to her than they do.
Nothing in this account suggests that Agnes’s behaviour is
damaging anyone else. That she is unhappy, uncomfortable in her skin, that she
is inadequate in terms of the expectations of her world — one can’t easily
doubt that. In conventional diagnostic terms, the clearest evidence of
psychosis is her voice-hearing, which happens over a limited time and doesn’t
seem to persist. Naturally, hallucinations are taken as a very serious symptom.
But by their nature, they can only be reported by the person who suffers them —
a person who is on every other count is liable to be disbelieved. Agnes seems
to agree about her own unreliability. It may be that her memory really is bad,
by her mid-twenties; it may be that her anxiety is so great that she can’t live
outside an institution, and can’t easily live in it, either. It may be also
that the case report fails to capture what she is like., or that the researchers
never know the whole story. But in any event, by the time they catch up with
Agnes, how much of her is left? What they see is the product of treatment, for
better or worse.
I think we must always remember the fear these young women
must have suffered: some of it caused by hallucinations and delusions that
precede their hospitalisation, but some of it caused by the institution and its
procedures. And we should remember that it is devastating, even when you are a
young adult, to realise your family reject you and are ashamed of you, and that
the people you trust and look up to are false. Agnes needs help to know where
her boundaries are, and to work out who she can trust, other than Jesus: but
she can’t get help within a system that has pegged her as insane. She’s
invalidated at every turn and every time she goes for help, she’s damaged. He
father is of course quite right in one way: her history is against her, and
she’s accumulating more and more of it.
So we come back to the question the book directs us to
ask: which is not, what’s wrong with Agnes, or what’s wrong with her family:
but, since something in her words or actions has led to a diagnosis of
schizophrenia, what can we take the term to mean? Does it mean you hear the
voice of an electrician, when he’s not there? Does it mean you’re not very
likeable, or articulate, or grown-up? Does it mean you want your own towel, or
your own way? Because these are the traits, the requirements, that earn Agnes
her diagnosis and her treatment. As the researchers say, she has lived for many
years in a mystifying situation. The standard psychiatric interview is not set
up to illuminate the context of her symptoms, so everyone supposes she is the
victim of a meaningless pathological process, whereas really she is desperate
and confused precisely because she is trying to search out meaning. I find
myself thinking she must be have been a strong spirit to survive, however she
flickers on and off the page.
Afterword: Anthony explained that his
dealings with the Lawson family had not been easy and he had not been able to
get family photographs or other material. He did however have Agnes’s death
certificate, which described her as a ‘retired hairdresser’ and the group was
happy to hear that she had been able to hold down a job in later life, and one
that interested her.
The other pleasant surprise was to hear her voice – in
later tapes, she sounded neither cowed nor compliant, and was able to stand up
to Esterson when he failed to appreciate the way she dressed.
Not everyone agreed with me that Mr Lawson’s habit of
sitting Agnes on his knee and and telling her fairy stories was sinister. There
was a feeling that it might have been innocent. After we had listened to him on
tape there was a consensus that he took a bullying tone with Agnes. Despite
this he seemed to regard himself as her victim, as she upset his nerves, for
which he had a tender regard.
12.
Final Retrospective Seminar
Inner
Circle Seminar No. 249
Recently I read a book of essays called The Legacy of RD Laing (ed. Guy M
Thompson, Routledge, 2015). In the whole book there are four mentions of Sanity, Madness and the Family: two
simply recording the book’s existence, and the other two each giving it one
sentence. It obviously ranks low in the canon of Laing’s work. And yet for me,
it is among the most important and enlightening books I’ve ever read. It has
resonated through my life ever since I was the approximate age of the women in
the case histories. In 1973 when I discovered it, I found it shocking,
desolating, provoking: I still do: I never seem to exhaust it. In my
introduction to the new edition I described it as ‘one of the most
misunderstood and travestied work of the 20th century.’ I should
have added, one of the most ignored.
The peculiar thing is, even those who have read it appear
not to have read it. People will describe it to you as a study of eleven women
with schizophrenia. It is really a study of eleven women with a diagnosis of
schizophrenia, and there is all the difference in the world. I must quote the
author’s preface to the second edition of 1969: ‘There have been many studies
of mental illness and the family. This book is not of them…’
The authors go on to question the existence of
schizophrenia, in a way that is precise and intellectual fastidious: ‘We do not
accept schizophrenia as being a biochemical, neurophysiological, psychological
fact… nor do we assume its existence…we propose no model of it.’ A paragraph or
two earlier they emphasise: ‘We did not say, even, that we do not believe in schizophrenia.’
In the Introduction they say, ‘We recommend that this book
be read with the very minimum of presuppositions.’
That has proved difficult for readers, whether they are
general readers or professionals. For the general reader there may be some
excuse. People love stories, and they see this is a book of stories, and they
bypass the theory and plunge straight in. As a novelist I have learned not to
put vital clues in a prologue, because you can’t rely on a reader to take in
anything that happens before the heading that says ‘Chapter One.’ Academics and
professionals should know it is important to read a foreword and an
introduction. But they couldn’t see past their presuppositions. For them the
reality of schizophrenia was built into the fabric of the world. So they read
what they expected to read, not what the authors were at such pains to state.
Other readers interpreted the book, as it were, too
liberally, mixing up its ideas with other current and fashionable ideas. Some
people, while assuming the existence of schizophrenia, supposed the authors
were seeking causes in the environment, in the family, in the culture: but
that’s not primarily what they were doing. Some thought the message was that we
should be nicer to mad people — and that wasn’t it either. The book wasn’t
about relocating pathology in the family, or the wider culture. It wasn’t a
message about tolerating our fellow humans in all their diversity, or about
more humane and effective methods of treatment: it was an invitation to a
radical rethink. What the authors say is plain enough, so I imagine that many
people must have realised the implications and found they couldn’t face them;
their minds simply ambled away to pastures where they were more comfortable.
Because you could very well extend the question beyond schizophrenia and ask if
the categories into which we were currently dividing madness meant anything:
did they have any existence, except on paper, and outside the historical
context in which they were invented? By our way of talking about ‘mental
illness,’ were we not representing, without evidence, that the terms
psychiatrists had coined corresponded to a biological reality? Were we
proceeding by assuming that very thing which we needed to prove? Were we
permitting the fate of thousands of distressed people to be decided on the
basis of shoddy thinking? Were we being misled by terminology that sounded
precise, but whose meaning melted away on inspection? Were we muddling up facts
and opinions? Were we simply not listening to what patients said? Such simple
questions — so simple they were devastating.
Elsewhere in his work, Laing seems to accept the reality
of schizophrenia; he may not think as others do about it, but he thinks there
is an ‘it’ to be discussed. In The
Divided Self, first published 1960, he presents the case of Julie, who
called herself ‘the ghost of the weed garden.’ Julie would fit right into this
book: but he refers to her quite firmly as a schizophrenic throughout his
account. Laing was young when he wrote his very influential book. He was
entitled to change his mind, to advance his thinking. It’s unfortunate, though,
that even the text of Sanity, Madness and
the Family muddies the waters. Ideally — and in order to help those who
haven’t taken notice of the Introduction — the word ‘schizophrenia’ should
appear in inverted commas. It doesn’t always, and this makes it seem as if the
authors have conceded. Of course it should
be enough to make the point once: you shouldn’t have to conduct an argument
through punctuation. And in fact, the book’s challenge is rephrased and
recapitulated in each chapter. Yet the vital lines are somehow bypassed by
readers, who then go on to argue with the authors for what they have not said.
At this distance one can see the book was too big a
challenge to entrenched interests and ways of thinking. The more influence
people gain in their profession, the less they are likely to welcome any thesis
that suggests they shed their foundation myths. These authors demanded that you
stand outside your discipline, to look at it and listen to it: and that is an
effort too strenuous for many people, whatever the discipline is.
As for the lay person, despite all that is said about the
destigmatisation of mental illness, there is still a great mist of fear and a
smog of misinformation; it’s easier for people to avoid thinking about it by
handing over to the professionals and assuming they know what they’re doing. If
you have an individual in your immediate circle who is suffering mental
distress, who is battered by grief and fear, who can’t cope with daily life and
is spreading the distress to others, then naturally you grasp at the notion
that the person is ill.
This is what we see again and again in the case histories:
I have to believe she’s ill, the parents say, because for them the alternative
is worse: the alternative, as they see it, is that the distressed person is
behaving as she does by choice, and the structure of the family and the
community creaks and protests at such behaviour. What is a family to do, when
one member appears to break down? Perhaps it should consider its workings:
outsiders are bound to ask some questions. Any process of enquiry might
threaten unity, and expose the lines of power, overt and covert; it will
require the family to speak about the very aspects of life it has tried to
ignore. The prospect may be so uncomfortable that it may lead a family to
conclude, half-consciously, that it is better to sacrifice one member than
sacrifice the story they tell about themselves. At the worst, an individual
runs out of control, and either you send for the doctor, or you send for the
police. If there is illness, there is a lifting of responsibility all round:
friends and relatives can pass on the decisions; there is a path towards
alleviation — drugs, counselling, possibly hospitalisation. And for families
under stress, any challenge to the accepted diagnostic certainties seems like a
challenge to their veracity, or their ability to cope, or their ability to love
each other; it arouses great antagonism; on a human level this is
understandable.
It’s important to say that the authors do not disbelieve
in the reality of madness. In their careers they have witnessed and described
it. What they ask is whether, in the cases in the book, there is an
intelligibility behind the words and actions of the women, that has been missed
by those who have written them off as victims of a condition that doomed them —
certainly in their time and place — to become career patients. On the face of
it, a great deal has changed about the way the system runs, but there are still
plenty of career patients — they’re just not in hospital. And the thinking that
Laing and Esterson challenged still commands general assent. Even if
professionals have refined their position, and are in debate about the reality and
nature of mental illness, the media and the public still take schizophrenia to
be a proven fact, a clinical entity of the same order as Huntingdon’s Disease
or measles.
Then again — returning to the puzzle of the book’s
reception — when you look at the body of Laing’s work, this book was eclipsed
by the reputation and reach of The
Divided Self. I think that book, for all its merits, unwittingly flattered
its readers. It was dangerously interesting to a certain type of person. You
will remember the figure of David, the philosophy student, with his theatrical
cloak and cane. He wasn’t intended as a role model, but as I remember the era,
a lot of young men of no particular talent thought they would be intensely
fascinating if they defined themselves as schizoid individuals — they would be
deliciously misunderstood. Sanity,
Madness and the Family is a plainer book. It lacks the intellectual glitter
— though not the intellectual depth, for those prepared to look into it. And no
reader wished to be these women, or identified with them.
But I don’t want to be defeatist: the text remains and
does its work. And these women, now mostly dead, are still alive in its pages,
and alive in our discussions. We owe an enormous debt to Anthony’s tenacity and
dedication and his tact, in uncovering so much material, bringing us family
photographs, digging out the stories behind the stories. What he has discovered
has greatly enhanced our understanding of the context in which these young
women were invalided out of their routine lives and became patients. He has
given us faces and he has given us voices. They were frozen on the page, but
these seminars are a way of keeping faith with young women who never knew what a
service they were performing.
Myself I found the faces unsurprising. You used to find
albums of photographs in junk shops, and though you would know the people were
strangers, if you kept on looking, a conviction might well grow that you did
know them after all — the same flaws in the photography, all-purpose locations,
locations, familiar clothes. And if you look at your own family photographs,
you are not always sure who’s who, even if it should be well within your memory
span; people seem to change so deceitfully from decade to decade, and fashions
come around again, and a mother can be taken for a daughter, or vice versa.
I explained at an earlier seminar how I first came to this
book, picking it up in a library which I was using as a sort of waiting room
while my husband had a college interview. I had already read The Divided Self, but I didn’t know
about this book, and when I did read it I experienced revelations, both about
my past — my family life — and about my future. If I may digress, I should like
to mention another reason why I care so much about how mental distress is
viewed. In the late 1970s I was a teacher in a secondary school in Botswana Botswana is
approximately the size of France Botswana
But to return to our time and place and people, our book:
let me introduce a startling new participant to the debate: St Ambrose, who was
Bishop of Milan towards the end of the fourth century. This was his advice to
young women: ‘If you conquer your family,
you conquer the world.’ He was addressing himself to girls who wanted to
leave their families and pursue a spiritual path, whereas their families wanted
them to be wives and mothers — to do what their own mothers did. I find myself
thinking that the lives of women like those in the study — often untrained and
low-earning, less educated and free than their brothers, without reliable
contraception, without easy access to abortion — were surprisingly, in view of
the gap of time, like the lives of the women St Ambrose knew: they lacked
economic status, their gender downgraded them, they didn’t have the bodily
autonomy they might have hoped for, and they had to fight their families to
have their aspirations recognised. Outwardly, the world has changed hugely
since then, although the inner pressures on young women, the expectations
heaped on them, seem no less tyrannical now. Mothers and daughters are central
to the stories in the book: father is often a grey area, less easy to get a fix
on. We have seen a pattern where a mother holds herself up to a daughter as if
she is a mirror. The daughter is meant to look and see her mother’s features,
looking back. If she sees something different, if she sees herself, then her
perceptions are likely to be described as false or perverse. Every instance of
difference is added up, and deprecated, till difference becomes a symptom.
We meet these families at a point where they look back on
their own past and describe it in terms of Eden
Then the Fall comes: some kind of crisis. Because we live
in modern times, a diagnosis is available. The family are able to think their
child is sick, not evil. This is a relief. No one is to blame. The most that
can be said is that they should have taken her to the doctor earlier. And there
is no need to question the story about the child’s previous perfection. If they
recall there were events in early life that didn’t fit the pattern, if there
were small aberrations, then these are seen as the precursor to illness. Her
whole life is read backwards from the moment of diagnosis, and it is read
forward in terms the doctors set. From now on, all her behaviour is likely to
be cast as a symptom of a pathological process.
As listeners we are human, and we bring our own stories to
the eleven stories, and it has been fascinating to discover what we read and
hear in common, and what we dispute, and where we differ: to me this process
has been of great value, because my professional pre-occupation leads me always
to ask what different readers take from a text. What is the possible range of
interpretation? How do the words that are flat on the page come to life in our
minds? Some of the families are hard to like. Some of them ramble, are
inarticulate, plainly show us the contradictions and mystifications the patient
had to live with. Almost all of them appear literal-minded and unaware of the
undercurrents of what they say; we have to struggle not to put ourselves in a
position of judges. I wonder if some of the stories would be told or heard
differently nowadays, when we know more about the prevalence of sexual abuse in
families. But it’s not necessary to know more than we do, in order to keep
asking the question the book directs us to: when the young women are supposedly
schizophrenic, is their behaviour intelligible, when placed in context? Can it
be viewed as a valid response to an unnegotiable situation? Are their words and
actions just the flailings of a disintegrating mind? Or is there, behind the
disorder, an impulse towards a new order? A bid for self-possession?
Sometimes, Anthony Stadlen’s discoveries have helped us
patch the holes in the narrative. For me, a lot of questions remain. I am
pre-occupied with the crisis that delivers the young woman to the institution.
That seems to me a defining moment, because after that everything she does is
seen as possible pathology. She is no longer silent, she is mute: she is not
simply still, but rigid, catatonic: she is a collection of symptoms, to be run
up against the textbook criteria, and to fit them, or not; but mostly she will
fit, because observers will see what they’re looking for. At this point she has
left one family and joined a bigger family and will be seeking out its rules.
It’s a looking glass world now: if she says she is well, it will prove she is
ill. She will be, and I think this is very important, no longer just herself
but herself plus psychotropic drugs, or the effects of ECT or insulin comas. In
the attempt to find her, we are losing her.
No story can be kept clean. Here there is a tension
between the demands of a true and full account, and the demands of
confidentiality. To protect confidentiality the authors disguised names and
occupations and tried to find equivalent circumstances. I understand that they
did the best job they could. But we know that they could never make an exact
fit. No two circumstances are ever
complete equivalents and no name is quite like any other name. So to me, we
began with eleven women, and now have twenty-two: the women on the page, whose
traces we have pursued with magnifying glasses, and their shadow selves, who
are still elusive.
But we have been able to hear them. I would like to pay
tribute to Anthony’s painstaking dealings with the tapes; there is the
intricate work of cutting out the names, to preserve confidentiality, and also
the fact that they are so fragile and precious. For me the single most
startling moment has been the first moment of hearing Maya Abbot’s voice: its clarity
and strength and immediacy, bounding out into the room, defeating all my
expectations.
We all have some problems with the tapes, but I don’t hear
very well in any circumstances. This means I have to listen very carefully to
things that are not words: to gaps, silences, hesitations, and above all to
intonation. You may be amused at the unconscious bias I have found in myself. I
have only recently seen the films Family
Life and In Two Minds, because I
wanted to find subtitled versions. I think they are both wonderful films, but In Two Minds has an actor playing a
psychiatrist — or maybe he’s a real doctor, I don’t know — who is never on
camera, he’s voice only. Now he is set up to ask all the sensitive and
illuminating questions we would wish him to ask. But I realise that when I hear
the calm establishment tones of a middle-aged doctor, talking to a young,
distraught, less-advantaged woman, it makes me want to start the revolution
immediately. This bypasses logic, and it’s unfair, but I realise I trust Aaron
Esterson because I trust his accent. That, as well as his manner, seems to me to
go some way to even up the power relationship, which is so much set against the
patient.
So you can imagine I look forward to seeing him at work, and judging if I feel the same. For some of
these patients Esterson opened the door, and though they were regarded as
hopeless cases, they walked out of the institution, and out of the life
prepared for those with a diagnosis of schizophrenia. So I ask myself, what was
Esterson doing? He was listening. There is a special kind of listening that
makes a speaker audible to herself.
He was acting as a witness. It is as if he helps the women hold up a mirror to
themselves. Maybe they could see themselves in his eyes, and in that way become
witnesses to their own being, instead of looking at themselves through the eyes
of their parents. It isn’t enough to explain a patient to herself; in order to
loosen the grip of the past, it seems to me, the patient has to experience an
opening sense of possibility. There must have been a moment for each of the
women in the early case studies where her own story struck her: where she saw a
pattern or meaning: a turning point where she began to think differently about
her own capacities, and she decided, I won’t be a patient any more, I’ll be
something else.
I have been dwelling with these women for around 45 years.
I never knew the ends of any of the stories, till Anthony undertook to tell me,
and till your attentive presences enhanced and illuminated the narratives. They
will never be gone, as far as I am concerned, and I can only think my next
step, if I could ever paint, is to paint them. I think of Ruth Gold in her
coloured stockings: Ruby Eden’s female relatives pinning her down in the family
living room: Jean Head running through the dark wood from her employer’s house:
June Field dancing in the church hall: Sarah Danzig sitting in the family
kitchen in the small hours, in her blue nightdress, with the lights blazing. What
touches me is how far they are the children of light, for all the gloom that
encircles them: how far they commit to the truth, to seeking it out, digging it
out, even though they pay such a price for the search.
[ii] Probably Laing and Esterson, 1964
or 1970a [1964] (the hardback first or second edition). Hilary Mantel writes: ‘I can’t remember about the edition I read in the college library. I don’t
think paperbacks were bought for libraries much in those days.’
[iii] Laing and Esterson, Chapter 1.
[iv] They did.
[v] Laing and Esterson, 1970b [1964].
Hilary Mantel writes: ‘My
copy is the Pelican of 1969, the 3rd reprint: 1972.’ (The preface to the second
edition is dated 1969, but the edition itself is dated 1970.)
[vi] Laing, 1985: 69-70.
[vii] Mantel, 2008.
[viii] Laing and Esterson, 1970a [1964]:
vii-x; 1970b [1964]: 11-14. Preface to second edition.
[ix] Laing and Esterson, Chapter 4.
References
Laing,
R. D. (1960). The Divided Self: An Existential Study in Sanity and Madness. London
Laing,
R. D. (1965 [1960]). The Divided Self: An Existential Study in Sanity and
Madness. (Second edition.) Harmondsworth, Middlesex: Penguin.
Laing,
R. D. (1985). Wisdom, Madness and Folly: The Making of a Psychiatrist, 1927–1957.
London
Laing,
R. D. and Esterson, A. (1964). Sanity, Madness and the Family. Vol. 1.
Families of Schizophrenics. London
Laing,
R. D. and Esterson, A. (1970a [1964]). Sanity, Madness and the Family:
Families of Schizophrenics. (Second edition.) London
Laing,
R. D. and Esterson, A. (1970b [1964]). Sanity, Madness and the Family:
Families of Schizophrenics. (Second edition – Pelican.) Harmondsworth,
Middlesex: Penguin.
Mantel,
H. (2008).
Author, author: Every writer has a ‘How I became a writer’ story.
http://www.theguardian.com/books/2008/sep/06/1.
Stadlen, A. (2017). ‘The simple words the
people speak’: On Hilary Mantel’s introduction to a 2014 seminar on ‘Maya
Abbott and the Abbotts’ in Laing and Esterson’s ‘Sanity, Madness and the
Family’ (1964). Preceding this
paper in this Journal.
[2] Probably Laing and Esterson, 1964
or 1970a [1964] (the hardback first or second edition). Hilary Mantel writes: ‘I can’t remember about the edition I read in the college library. I don’t
think paperbacks were bought for libraries much in those days.’
[3] Laing and Esterson, Chapter 1.
[4] They did.
[5] Laing and Esterson, 1970b [1964].
Hilary Mantel writes: ‘My
copy is the Pelican of 1969, the 3rd reprint: 1972.’ (The preface to the second
edition is dated 1969, but the edition itself is dated 1970.)
[6] Laing, 1985: 69-70.
[7] Mantel, 2008.
[8] Laing and Esterson, 1970a [1964]:
vii-x; 1970b [1964]: 11-14. Preface to second edition.
[9] Laing and Esterson, Chapter 4.
References
Laing,
R. D. (1960). The Divided Self: An Existential Study in Sanity and Madness. London
Laing,
R. D. (1965 [1960]). The Divided Self: An Existential Study in Sanity and
Madness. (Second edition.) Harmondsworth, Middlesex: Penguin.
Laing,
R. D. (1985). Wisdom, Madness and Folly: The Making of a Psychiatrist, 1927–1957.
London
Laing,
R. D. and Esterson, A. (1964). Sanity, Madness and the Family. Vol. 1.
Families of Schizophrenics. London
Laing,
R. D. and Esterson, A. (1970a [1964]). Sanity, Madness and the Family:
Families of Schizophrenics. (Second edition.) London
Laing,
R. D. and Esterson, A. (1970b [1964]). Sanity, Madness and the Family:
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Middlesex: Penguin.
Mantel,
H. (2008).
Author, author: Every writer has a ‘How I became a writer’ story.
http://www.theguardian.com/books/2008/sep/06/1.
Stadlen, A. (2017). ‘The simple words the
people speak’: On Hilary Mantel’s introduction to a 2014 seminar on ‘Maya
Abbott and the Abbotts’ in Laing and Esterson’s ‘Sanity, Madness and the
Family’ (1964). ‘The simple words the people speak’: An introduction to Hilary Mantel’s introduction to her and Anthony Stadlen’s (2014) 50th-anniversary Inner Circle Seminar on ‘Maya Abbott and the Abbotts’ in Laing and Esterson’s Sanity, Madness and the Family (1964) (January 2015)
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