Living in One of R. D. Laing’s
Post-Kingsley Hall Households

Michael Guy Thompson
51
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Kingsley Hall was the first of Laing’s household communities that served as a place where you could live through madness until you could get it together and live independently. It was conceived as an “asylum” from forms of treatment — psychiatric or otherwise — that many were convinced were not helpful, and even contributed to their difficulties. Laing and his colleagues, including David Cooper and Aaron Esterson, leased the building from a London charity and occupied it from 1965 to 1970. The house was of historic significance, having been the residence of Mahatma Gandhi when he was negotiating India’s independence from British rule. Muriel Lester, the principal trustee of Kingsley Hall, agreed that Laing’s vision for its use was faithful to its long-established humanitarian purpose. Kingsley Hall was leased to his organization — the Philadelphia Association — for the sum of one British Pound per annum.

In 1970 the lease expired and Laing moved his by-now-famous operations to a group of buildings that were acquired by various means. Esterson and Cooper departed and a new cadre of colleagues and students who shared Laing’s unorthodox views about the “non-treatment” of schizophrenia joined him. They included Leon Redler, an American, Hugh Crawford, a fellow Scotsman and psychoanalyst, John Heaton, a physician and phenomenologist, and Francis Huxley, the nephew of Aldous Huxley and an anthropologist. Numerous post-Kingsley Hall houses gradually emerged, each adhering to the basic “hands-off” philosophy that had been initiated at Kingsley Hall. Each place, however, was different, reflecting the personalities of the people who lived there as well as the therapist or therapists who were responsible for each house.

By the time I arrived in London in 1973 to study with Laing there were four or five such places, primarily under the stewardship of Leon Redler and Hugh Crawford. I opted to join Crawford’s house at Portland Road. Though it was essentially like the others, I was drawn to Crawford’s personality and the unusual degree of involvement he effected with the people living there. While some of the houses went to extraordinary lengths to adopt a hands-off approach to the members of their household, Crawford employed a more engaged, in-your-face intimacy that I found inviting and comforting. Most of the people living there were also in therapy with him, an arrangement that was unorthodox, though had its advantages. Getting in wasn’t easy. Since there was no one officially “in charge,” not even the therapist who visited regularly, there was no one from whom to seek admittance. No one was paid to work there, not even the therapist who was responsible, but not in charge. And because I didn’t happen to be psychotic, I lacked the most compelling rationale for wanting to join. Some of the students I had met told me how they had visited Portland Road and, while sipping tea, offered to “help out.” “What’s in it for you?,” they were asked. When they replied that, being students, they wanted to learn more about psychosis and what it meant to be mad, they were summarily rejected. Having failed the test, they were never invited to return.

It occurred to me it would take some time, as with any relationship, to gain sufficient trust to be welcome. I attended Crawford’s seminars on Heidegger and Merleau-Ponty, went to the occasional Open House that welcomed strangers, and slowly made my presence felt. Eventually I was invited to participate in a “vigil,” an around-the-clock relay of two-person teams commissioned to accompany a person who had succumbed to a psychotic episode. These affairs usually lasted a couple of weeks, sometimes longer, before they abated.

In my first such experience, a man in his twenties was in the throes of a manic episode. In Laingian terms a psychotic “voyage” of self-discovery. Having managed to stay cool and not panic in such situations, I suppose I proved I could be counted on and sensitive to the extreme vulnerability of the people living there. After six months or so, I was finally invited to live at Portland Road. Crazier people fared better. Like Laing, I had struggled with depression since childhood. My mother commited suicide when I was fourteen, and I was still struggling with the guilt I felt at not being able to prevent that. But depression was not usually a rationale for living at Portland Road. In Britain, just about everyone was depressed due to the weather, so that was hardly out of the ordinary. Typically, a person who was interested would call, say he or she was going through a crisis or had simply reached the end of their tether, and they would be invited to come around to visit. On arrival, everyone who lived there – a dozen people or so – would meet with the visitor. He, in turn, would have the evening to himself in order to make his case heard. What were people at Portland Road looking for? By the same token, what criteria do psychotherapists use in evaluating a prospective patient’s suitability for undergoing therapy? At Portland Road this was especially problematic because many of the applicants were not interested in therapy and, if they were, had a hard time finding a therapist who was willing to work with them off of medication. Still, there were similarities between the two frames of reference.

Freud, for example, had looked for patients who, irrespective of how neurotic they happened to be, were nevertheless prepared to be honest with him. The fundamental rule of analysis assumes a capacity for candor. Similarly, at Portland Road people were expected to be candid with the people to whom they offered their case, no matter how crazy they might be. The residents who conducted the interview were looking for a sincerity of purpose and a hint of good will beneath all the symptoms the interviewee was saddled with; seeking, no matter how crazed or crazy, to contact that part of their personality that was still sane.

To complicate matters further, every applicant had to be admitted unanimously. One negative vote and you were rejected. Yet, once in, the new member could count on the unadulterated support of everyone living there, because of the fact that everyone supported his moving in. The sense of community and fellow-feeling was extraordinary. So was the frankness with which everyone exercised their “candid” opinions about everyone else. The effect could be startling, as one was slowly stripped of the ego that was so carefully created for society’s approval. I soon realized why candor is something most of us prefer to avoid, however much we complain about its absence. Again, the similarity to the psychotherapy experience was unmistakable. But now, instead of having to contend with merely one therapist for one hour a day, at Portland Road you were confronted with an entire cadre of relationships, all of whom engendered transference reactions, all of which you had to manage and work through.

I would now like to introduce Jerome, a twenty year-old man who had been referred to Laing by a psychiatrist at a local mental hospital. Jerome was a rather slight, dark-haired and extremely shy person who, in a quiet and tentative manner, told us the following. Over the past two or three years Jerome had developed a history of withdrawing from his family — mother, father, and a younger sister — by retiring to his bedroom and locking himself in. His parents would try to cajole him to come out of his room, and when that didn’t work they became angry and threatened to punish him if he did not open his door. Jerome refused to budge. Eventually, his parents contacted the local mental hospital for help. Jerome was then forcibly taken from his room and removed to hospital via ambulance and restraints. Once there, he persisted in his behavior and refused to speak to anyone. All the while, he couldn’t say why he was behaving this way or what he hoped to gain by it. He simply believed that he must.

He was soon diagnosed as suffering from catatonic schizophrenia with depressive features. A series of electro-convulsive therapy sessions were administered and before long Jerome was returned to his ordinary, cooperative self. Six months or so later he repeated the same scenario: withdrawal, removal to hospital, ECT, recovery. Never any idea as to why Jerome persisted in this behavior was ever determined. But each time he repeated it, a lengthier course of treatment was required to bring him back “to his senses.” He and his family endured this routine on three different occasions over a period of two years.

The psychiatrist who contacted Laing confessed that his colleagues at the hospital had thrown in the towel with Jerome and vowed that if he were admitted to the hospital again he wouldn’t leave. This, now, was the fourth such episode. On this occasion, when his parents implored Jerome to come out of his room he replied that he would on one condition: that Laing would see him. Jerome had read The Divided Self and concluded that Laing was the only psychiatrist he could trust not to “treat” him for a mental illness.

When Jerome visited Portland Road, he recounted what he wanted. He wanted a room of his own, to stay in until he was ready to come out. We were asked to honor his request and, with some tripidation, we agreed to his terms. I single Jerome out, of all the other people I came to know at Portland Road, because he presented us with the most serious challenge we had ever had to face. Due to the nature of his terms, Jerome effectively deprived Portland Road of its most effective source of healing: the communion shared by the people living there. Jerome’s plan undermined the philosophy that Laing and Hugh Crawford had formulated, a sense of fellow-feeling that honored a fidelity to interpersonal experience, no matter how crazy or alarming a person’s participation in that process was. We felt that Jerome was entitled to pursue the experience he felt called upon to give way to, even if the outward behavior his experience effected was problematic. Though a person’s experience is a private affair, the behavior with which one engages others is not. Because the two are invariably related, the philosophy at Portland Road was to tolerate unconventional behavior to an amazing degree in order to facilitate the underlying struggle that person was engaged in.

The conventional psychoanalytic setting, for example, places enormous constraints on a person’s behavior, including the use of a couch to facilitate candor. At Portland Road, you were obliged to live with the behavior that everyone else exhibited, so the course of a given person’s behavior was unpredictable, and sometimes violent. In other words, there was an element of risk in living in such conditions because no one knew what anyone else was capable of and what lengths some might go to in order to be “true” to what they were experiencing, authentically.

True to his word, Jerome took to his room and stayed there. He had his own room, which no one saw him come in or out of. Though it wasn’t uncommon to forgo the occasional meal, the way Jerome removed himself from the household was extreme. No one even saw him sneak downstairs for food in the middle of the night, or to use the bathroom. Our sense of worry soon turned into alarm. Jerome apparently wasn’t eating anything and it became increasingly clear that he was also incontinent. We tried talking to him. Out of frustration we said, “This wasn’t part of our agreement”; to turn us into a hospital where we would have to take care of him. “Oh yes it is!” Jerome insisted. Still, Jerome wasn’t in any ostensible pain. He didn’t seem especially depressed, or anxious, or catatonic. He was just being stubborn! He insisted on doing this his way, even if he could not or would not explain why.

We reminded Jerome that we had put ourselves out on a limb for him, keeping his parents in the dark while he was jeapardizing his health. Where was the gratitude, a gesture of good will, in return? Jerome refused to discuss his behavior or explore his underlying motives. Nor would he acknowledge his withdrawal as a symptom that was generating a crisis. He simply submitted to, and was inordinately protective of, his private experience, the details of which he refused to share. Jerome eventually agreed to eat some food in order to ward off starvation, as long as we brought it to him. The stench of his incontenance became onerous, though Jerome was apparently oblivious to it. Not surprisingly, he soon became the topic of conversation each evening around the dinner table.

“What are we going to do about him,” we wondered. Ironically, he had transformed Portland Road into a mental hospital. We were constantly concerned about his physical health, his diet, and the increasing potential for bed sores, which he eventually developed. He continued to lose weight due to the meager amount of food he was eating. We could either tell him he had to leave or we had to capitulate to the extraordinary conditions he presented us with. As news of our dilemma leaked out, Laing became increasingly nervous. Once Jerome developed bed sores he was in danger of being taken to a hospital for medical treatment. Compounding everything else, Jerome couldn’t keep down the meager amounts of food he was eating and vomited it up frequently. Whether this was self-generated or involuntary we didn’t know.

None of us possessed the expertise or inclination to serve as a hospital staff. Who was going to clean him, bathe him, and all the other things that were essential to his survival? Some of us eventually consented to be his nursemaid in order keep his condition stable. At least he was alive and more or less coping. But how much longer would we have to wait before Jerome finally came out of it and abandon his isolation?

Four more months went by. By now Jerome’s family insisted they visit and threatened legal action if we wouldn’t permit them to. We weren’t, however, about to let that happen. Crawford implored us to remain patient and let things take their course. Laing, however, was especially worried, but given our determination to see this through, he agreed to support us and keep Jerome’s family, who had by now complained to him, at bay. Meanwhile, Jerome continued to lose weight and was becoming ill. Now, six months into this, we faced a real crisis. Jerome developed bed sores, but he continued to resist talking to us or to relent in his behavior. On the contrary, he bitterly protested our efforts to bathe him and even to prevent his starvation.

We finally decided that a change of some kind was essential if we hoped to see this through to a satisfactory conclusion. We decided that Jerome needed to be in closer proximity to the people he lived with, whether or not he wanted to. The threat to his physical health and the lack of contact, in the most basic human terms, was alarming. If he couldn’t, or would not, join us, perhaps we could join him. So we decided to move him into my bedroom to share. In deference to the sacrifice of my previously private room, others agreed to bathe Jerome and feed him on a regular schedule, change his bed sheets, spend time with him, and endeavor to talk to him, even if he refused to reciprocate. We gave him therapeutic massages to relieve the loss of muscle tone and for some physical contact. We resigned ourselves to the fact that we had, whether we liked it or not, become a “hospital,” however reluctant we were to. We felt confident, however, that his condition was bound to improve.

In fact, his condition stabilized, but that was about all. I got used to the stench, the silence, the close quarters. But it didn’t help my depression, sharing a room with a ghost who haunted the space but couldn’t occupy it. I needed something to relieve the deadness that now permeated our shared space, so I invited the most floridly “schizophrenic” person in Portland Road, another young man who believed he was Mick Jagger, to move into our room with us, making it three who were sharing the room. This new person, who I will call Mick, serenaded Jerome morning and night with his guitar – which he had no idea how to play! – and probably made Jerome feel even crazier than before. But hey, at least it was a livelier, if more insane, arrangement, and with all the commotion and Jerome’s complaining I soon recovered from my depression. Whether Jerome liked it or not, our “rock star” guest was here to stay, and I admit to the guilty pleasure I felt in the comfort that Jerome was not in complete control of our lives.

Before long a year had transpired, but still no discernible change in Jerome. In the meantime, a number of crises had occurred between Jerome’s family and Laing, Laing’s growing impatience with us, our impatience with Jerome, and finally, between ourselves and Hugh Crawford for not supporting our numerous efforts to have Jerome removed from the house. We were ready, – eager! – to admit defeat and resign ourselves to an unmittigated failure. Jerome’s condition was apparently interminable. His “asylum” with us had become for him simply a way of life. It seemed obvious to us now that this was all he had really wanted from us, to live in the squalor he had generated around himself.

The time, in the immortal words of Raymond Chandler, staggered by and the urgency of Jerome’s situation gradually became a commonplace, and somehow less urgent to resolve. Life continued at Portland Road independent of Jerome’s situation. Others had their problems too, which were addressed in the communal way that was our custom. Another month slipped by, and then another, until I finally lost track of the time and stopped counting. Jerome had long ceased to be the nightly topic of converation and his presence had become a fixture, like the furniture in the house. Nobody even noticed the year and a half anniversary since Jerome had arrived at Portland Road. We had become so accustomed to his odd definition of cohabitation: the baths, the linen changes, the serenades, that we hardly noticed that evening by the fire when Jerome nonchalantly sauntered downstairs to use the bathroom. When he was finished he flushed the toilet, peeked his head into the den to say hello, and quietly returned upstairs. To put it mildly, we were in a state of shock, and pinching ourselves to make sure we weren’t dreaming.

An hour later, Jerome came back, summarily announced that he was famished, and effectively terminated the fast that had reduced him to 90 pounds of weight. This was a Jerome we had never even met: talkative, though shy, but suddently social nonetheless. We couldn’t believe our eyes and ears. How long, we immediately worried, would this last, before he returned to our room and his isolation? By the next day, Jerome had obviously taken a new turn. He was finally, if inexplicably, finished with whatever he had been doing, engaged in God-knows-what manner of bizarre silent meditation. Naturally, we wanted to know. “What on earth were you up to, Jerome, all that time by yourself?” I asked him. “What was it you were getting out of your system?”

I don’t think any of us expected an answer. We didn’t think that Jerome had one, but it turned out that he did. He told us that the reason he had isolated himself all that time, for a year and a half, was because he had had to count to a million, and then back to zero, uninterrupted, in order to finally achieve his freedom. That was all he had ever wanted to do, over the past four years, since his first compulsion to withdraw into his bedroom at home. No one had ever let him do it.

But why, we asked, did it have to take so long? A year and a half! Did it have to take that much time? We had given him his way, hadn’t we? According to Jerome, yes and no. After all, we didn’t just let him be. We intruded and interfered, talked to him, played music, gave him massages and generally distracted him from the task at hand, his counting. He said that every time he got to a few thousand, even a few hundred thousand, someone broke his concentration with a song, a massage, or whatever, and he was obliged to start counting all over again, from the beginning. The worst, he said, was when we added the guitar player! “But why didn’t you just tell us,” we asked, “what you were doing?” “We would have eagerly obliged, if only we knew what you were doing.” “That wouldn’t have counted”, Jerome shot back. “It was essential that you let me have my way, but without having to explain why.”

Apparently, it was only when our collective anxiety over Jerome’s behavior subsided, after the anniversary when we finally gave up and backed off, that he was able to complete the task that he had set himself to accomplish. We had eventually, without entirely appreciating its significance, submitted to his conditions, permitting him to get on with, and submit to, his own self-imposed mission of whatever mad inspiration had compelled him to count to a million and back again, uninterrupted, without excuse or explanation.

The unorthodox nature of the “treatment” that Jerome received at Portland Road is impossible to compare with conventional treatment modalities. Nevertheless, the question is invariably asked: did it really “work?” And if so, how? Nearly forty years later, Jerome has never experienced another psychotic episode again. He soon left Portland Road, resumed his life, and proved to be an unremarkable person, really; ordinary in the extreme. Naturally, we wondered why Jerome had felt the need to withdraw in the first place. What were the dynamics, the unconscious motivation that prompted such a radical solution to his problems? These were questions that Jerome couldn’t answer. It is telling, and doubly ironic, that Jerome didn’t need those questions to be answered in order to repair what he, in his shattered condition, couldn’t himself comprehend.

This story won’t make much sense to anybody who attempts to glean from it an identifiable treatment philosophy, unless they take into account the central importance that Laing gave to the inherent problem of freedom in every therapy experience. This was a concern that had also preoccupied Freud in the development of his clinical technique, just as it did the existentialist philosophers, such as Kierkegaard, Nietzsche, Heidegger, Sartre, with whom Laing was principally identified. How does one “help” those who are in some measure of personal jeopardy without impinging on that person’s inherently private, though socially intelligible, right of freedom?

Freud’s solution to this problem was analytic neutrality, the cornerstone of his clinical technique. It followed the ancient dictum: “do no harm”; what Laing recognized as a form of benign neglect. In many ways, Jerome’s experience at Portland Road was a perfect example of benign neglect put into practice. The respect we tried to pay this young man was all that any of us felt qualified to offer. We didn’t understand what was the matter with him, nor did we pretend to. We weren’t sure what would help nor what might make matters worse, so we did as little as possible. Following the principle of neutrality, we employed benign neglect as unobtrusively as we could. Neither Laing nor Crawford directed the treatment, because there was no “treatment” to direct.

The way that we struggled with and responded to Jerome’s impasse as it unfolded will no doubt be regarded as reckless, indulgent, dangerous, even bizarre by the psychiatric staff of virtually every mental hospital in the world. His behavior — intransigent, stubborn, resistant — would no doubt be met with an even greater force of will, determination, and power than his own. Who do you suppose, given the forces at play, would ultimately “win” such a contest? Naturally, the use of medicating drugs would be brought to bear, and electric shock, as well as whatever form of incarceration is deemed necessary.

Few, if any, psychoanalysts believe it is possible to treat such an impasse with analysis. Yet, our treatment of Jerome was arguably a form of analysis, stretched perhaps beyond its limit. Because Jerome refused to talk, we were obliged to let his behavior do the “talking.” D. W. Winnicott, Harry Stack Sullivan, Frieda Fromm-Reichmann, Clara Thompson, and Otto Allen Will, Jr., are only some of the prominent psychoanalysts to helped people in this kind of crisis. Some have recounted the many hours they spent with patients who were silent, letting time run its course until something broke through the impasse they were struggling with. Who would deny that Jerome resisted treatment? But what manner of treatment can a person wholeheartedly submit to when it coerces its way in, without invitation or compassion? And let’s be frank about this, without love. It seems to me, on reflection, that it was our love for Jerome that finally had its way when we backed off from all of our efforts to “help” him, when we were able to just let him be, as he had asked us to, and allow him to join our community, but on his terms, not ours.

Laing saw his role as one of helping the people who came to see him “untie” the knots they had inadvertently tied themselves in. He believed this entailed extraordinary care to not repeat the same types of subterfuge and coercion that had got them into those knots in the first place. Jerome had tied himself in a knot, and had come up with his own solution as to what he needed to do in order to untie them, including his insistence on doing this silently. That we were able to get out of his way and facilitate his task was nothing short of a miracle.

This degree of non-intrusion in the context of psychotherapy is a rarity. Those therapists who believe it is incumbent on them to run a “tight ship,” who maintain their authority over their patients at all costs, and who reduce the therapy experience to a set of techniques that can be learned aren’t likely to embrace a method of “treatment” that is as modest in its claims as it is cautious with its interventions. Jerome taught me that techniques are of no use when all a person is asking is to be accepted for who he is, unconditionally.

51 COMMENTS

  1. Very enlightening story! It’s amazing how our spirit guides us to our own healing if we trust and allow it to. I agree fervently that, most often, it is the need of the clinician to assert control and ‘authority’ which undermines healing. We are infinitely creative beings, including in how we heal, grow, and evolve.

    Thank you for this wonderfully illustrative article!

  2. Wow. Nice writing.

    It sounds to me that he was never sick, and the whole thing was an exercise in free will. Is the desire to count considered psychosis? Or the desire to count to the exclusion of ‘health’ that makes the observer think this is psychosis? Indeed, if it was psychosis, how would he have been able to count without getting confused, not distracted, confused? I think Occam’s razor suggests that he was never sick, just committed to his task.

    How many times do we force people to effectively become sick just because we do not understand them? Our interference makes for sickness where it is not, just because we believe it is there.

    • Apparently the current standard is all about what makes other people uncomfortable. In terms of ‘madness’ it appears to be defined by the people not experiencing it. Observers don’t label people mad when they risk their life in war or sport, but if they risk their life counting, observers are very uncomfortable (particularly if the observers don’t even know the reason).

      Since there are acts of free will that can seem irrational, the observer’s comfort level seems to be very questionable standard. This is why it’s critical to protect people’s freedoms when they are not committing a crime.

      I think the notion of sickness is not terribly useful. It seems better to deal with the context and the situation and to discover the meaning that exists. This is effectively what Open Dialogue does.

      • I know someone who was very anxious and at times believed he was Jesus. Recently he experienced domestic violence three times, was sexually assaulted and his flat was broken into. He ended up in psychiatric patient as a voluntary patient. The hospital drugged him up and ignored what had happened to him. Eventually he calmed down and went home. By that time the services had put him on a depot (injection of major tranquilisers) saying that if they inject the drugs it will have different effects if they give him pills (lies to encourage him to take the drugs).

        So context and situation was completely ignored, as is normal in mental health. But then that is the function of psychiatry.

  3. Great story about Jerome at Portland Road. Just imagine, what if his count had been interrupted by further hospitalization and ECT. He might never have emerged intact. I’m adding this point in favor of R.D. Laing to the scoreboard. When it comes to providing some sort of non-coercive care, go Laingians! I might not believe in everything R. D. Laing stood for, but I think the experiment at Kingsley Hall, and it’s successors, a really good thing.

  4. Steve Ticktin and his association with Cooper and Laing;
    http://en.wikipedia.org/wiki/Stephen_Ticktin

    When he lived in the UK he was very much a friend and allie to UK activists and groups, he actively supported us. That extended to personal support, on two occasions he helped to extricate me from hospital by coming in and posing as my private psychiatrist (they must have thought I was a secret millionaire!), saying all the right things and helping me to get out. He assisted many people and not once ever wrote about it or publicised it, he just quietly did it.
    When he worked in adult psychiatry here (he wasn’t liked by the RCP) he would play his guitar on the ward and in psychotherapy he once relayed a very funny story to me – a woman who saw him would wash her hair in the sink in the room at each visit, so he figured that he should dry it, so he did! Only someone like Steve would do that! Lovely man.

  5. Thanks Poet.

    Leon Redler didn’t impress me, I once heard him speak years ago and asked him whether he would be prepared to work within a person’s chosen frame of reference and beliefs – the answer was NO.

    Joseph Berke/Arbours – I listened to damning testimonies from a couple of people who had stayed there ie one being asked whether she had “enjoyed” her child sexual abuse.

    The Henderson and Castle “therapeutic communities” (Henderson is now closed)I wouldn’t touch with a barge pole.

    Laing and Mosher had the best early ideas on state funded alternative service provision for people in mental distress

        • I think that depends on what they are in charge of. If I open my house up to people I am in charge of certain things, but not others. No stealing my money, no slapping me round the face, no leaving the door open in the cold of winter for example.

          On the other hand I might be very happy with people coming and going when they please.

          In Daniel Mackler’s film about the Family Care Foundation in Sweden we learn about families who open their homes to people in crisis. The people in crisis are given therapy and the family has someone to talk things over with. Strong conflicts sometimes occur but usually there is enough support for both parties for these to be resolved and the person to carry on living in there and for good relationships to be forged. However the host family are still in charge of their home no matter how welcoming and tolerant they are.

          If these communities are not liked by the people who use them than I wonder if they are not welcoming enough and when conflicts occur, as they must with any group who are in close proximity, then they are not being dealt with in a supportive and useful enough manner. If this is not the case then I’d like to hear about people who have experienced them and why they think things went wrong.

          The one I know about has been criticised for not being welcoming enough. For the induction you have to sit in on sessions for a week but not join in. You have someone to talk to after the session. But a lot of people find sitting on the edge of a circle watching and listening to people who are distressed as they remember awful events from their past too distressing to take part in. This just seems like practitioners sticking to their training manual and not bothering to get to know prospective members.

  6. There were a couple of TV progs on Castle a few years ago, it was hard to not throw objects at the tv with their fixed ‘bedtime’ rules, a friend who works as an advocate cringed at the prospect of someone she was working with being transferred from a psych ward to there because apparently they had a no self-harm policy and for this woman self-harm was the only way she could cope with the severe sexually abusive trauma she had suffered.
    I read about the Henderson in the 90’s, a text by them (I’d have to rifle through boxes to see if I still have it), where it described how they treated people who self-harm. They were obliged to offer ‘good enough’ reasons to the whole community and could be thrown out because of it.
    I once visited another therapeutic community (somewhere near Ealing) by invite of a psychiatrist to see how they worked as a visitor not as a potential patient, and the morning group session consisted of analysing why someone had crossed their legs. Seriously John, there is so much intellectual wank going on in these places.
    As for the ‘mini’ TC’s we see now, the intensive groups 2-3 times a week for 2 years aimed at people diagnosed as PD, or people diagnosed with Schizophrenia/psychosis on depots who you know are viewed as hopeless cases being shoe horned into these groups on pain of being discharged from the CMHT because that’s the only longer term support on offer – and failure to ‘respond’ to medication, failure to ‘recover’ (discharged/employed) can be reclassified as PD.
    The descriptions of some of these groups sounds little more than organised dog fighting to me, whereby the therapist gets the group members to “challenge” each other and sits back and watches.
    I would not want to see TC’s as an alternative to psychiatry, it’s not just about who’s in charge it’s the whole ethos of the places, it would drive me nuts to have to spend my whole day every day doing endless groups analysing the minutiae.

    Good points @poet, yes the staff ARE in charge in TC’s/groups, just in a different way to acute psychiatry where it’s very obvious and blunt. Ditto dearth of women, any thoughts about why do you think this is?

    • oh dear, it sounds dire and not what I expected.

      I’ve gone on residential retreats and I’ve done lots of group work. It all stems from the principles of trying to sympathetically understand each other and working through ones fears of being close to people. Generally there are some firm rules about being on time and not violence, but as few rules as possible. Then it is up to the facilitators to try to help people understand each other. What you are describing sounds like either bullying or facilitators who don’t know what they are doing.

      Challenging each other is fine if it done with a sense of care and understanding, a chair of any good committee has to do that from time to time, never mind a therapist in a therapeutic community. Challenging each other in hurtful ways is indulging in hurtful behaviour and something that a good facilitator will try to point out and limit.

      Examining the minutiae in my experience is something groups do when the group gets stuck, and is done until something shifts, not go on for days on end.

      Peter Breggin on one of his radio shows said that every time you see a therapist or other professional in a similar role you should leave feeling somewhat better. In my experience you might feel somewhat shaken but also in some way better. So my guess is that at successful therapeutic communities people should feel just a little bit better after everyday.

      I’m all in favour of staff being in charge if they know what they are doing and they are helpful and considerate. But their job should be about enabling people’s confidence to grow. what you describe doesn’t sound like it does that. Sometimes I use drama to help groups, including long time users of a mental health day centre, look at what they want or to debate certain issues. I’m very much in charge, but usually most people go home feeling much better about themselves and each other and people at the end of the workshop are more confident and outgoing than at the beginning. So I still think that successful therapeutic communities are possible. It such a pity that none spring to mind.

  7. Tell me about it, especially those in recovery work who have been honored or undertaken govnt work, Linehan was especially odd though to wait all this time before “coming out”, her career was secured a long time ago. Pity she fails to speak up on how women are routinely abused and traumatised by the diagnosis her treatment is for.

  8. Fascinating. I would also like to hear more from people who had actually spent time at Kingsley Hall or Portland as patients. I recall reading something several years ago by an ex-patient who said that all was going well in the Kingsley Hall free-wheeling style, until he seriously scared R.D. Laing because of his antics. I believe he got wrestled to the ground and medicated, so, even for Laing there was a limit, and the patient said that the limit was reached when he became really scary to his psychiatrist. But, he appeared to harbour no ill will towards Laing, and just chalked it up as part of the experience.

  9. for what it’s worth, I spent a while in a place that somewhat resembled Kingsley Hall or Soteria House, though it wasn’t modeled after either. It was set up by a non-credentialed therapist in Vancouver after his sister got committed to the local psych ward. The Vancouver Emotional Emergency Center was funded by Canadian anti-poverty money, so it didn’t have to be like a standard mental illness facility. People could just be as upset as they needed to be, and were protected and given emotional support, not drugs.

    It was very helpful for me. While there, I emotionally relived some of what had happened to me in my childhood, and even though I had always known intellectually what the causes of my emotional problems had been, this way I came to understand them emotionally. And getting emotional support and nurturing while reliving my childhood, which had little of that, was very healing.

    BUT there certainly were rules. If people were really disruptive and threatening, they were not encouraged to stay. It is important to keep in mind that while those who worked there were prepared for that sort of behavior, people like me in a very vulnerable phase of their lives should not be expected to be able to cope with too much scary behavior from others.

    • “people like me in a very vulnerable phase of their lives should not be expected to be able to cope with too much scary behavior from others.”

      That in a nutshell, to me, describes the contradiction of those who question involuntary commitment. We ALL have limits and when those limits are reached want “the mad” to be somewhere else.

      • I can tolerate a lot of strange behavior, but not when I am in a crisis and very vulnerable. Being a staff person in a place like VEEC is one thing, but when you yourself are almost helpless emotionally, it is terrifying to be with threatening and out of control people. Then it is a safe place for no one.

      • No, we don’t want “the mad” to be somewhere else. We want the rude, inconsiderate, and selfish to be somewhere else. Mad people can be considerate, caring, and worry about the welfare of others even in the depths of psychosis. I know – my husband was. He was definitely mad, but never let his children see it.
        A psychotic person is for sure scary to be around, but it’s the personality traits of the psychotic person that determine whether they are actually a threat to others, not their state of “sanity” (whatever that is). Unfortunately – tragically – mad people are generally portrayed as uncontrollably violent and that simply is not true.