Performing Psychologies: Imagination, Creativity and Dramas of the Mind 9781474260855, 9781474260886, 9781474260879

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Performing Psychologies

Performance and Science: Interdisciplinary Dialogues explores the interactions between science and performance, providing readers with a unique guide to current practices and research in this fast-expanding field. Through shared themes and case studies, the series offers rigorous vocabularies and methods for empirical studies of performance, with each volume involving collaboration between performance scholars, practitioners and scientists. The series encompasses the modalities of performance to include drama, dance and music. SERIES EDITORS John Lutterbie, Chair of the Department of Art and of Theatre Arts at Stony Brook University, USA Nicola Shaughnessy, Professor of Performance at the University of Kent, UK IN THE SAME SERIES Affective Performance and Cognitive Science edited by Nicola Shaughnessy ISBN 978-1-4081-8398-4 Performance and the Medical Body edited by Alex Mermikides and Gianna Bouchard ISBN 978-1-4725-7078-9 Theatre and Cognitive Neuroscience edited by Clelia Falletti, Gabriele Sofia and Victor Jacono ISBN 978-1-4725-8478-6 Theatre, Performance and Cognition: Languages, Bodies and Ecologies edited by Rhonda Blair and Amy Cook ISBN 978-1-4725-9179-1 Performing the Remembered Present: The Cognition of Memory in Dance, Theatre and Music edited by Pil Hansen with Bettina Bläsing ISBN 978-1-4742-8471-4

Performing Psychologies Imagination, Creativity and Dramas of the Mind Edited by Nicola Shaughnessy and Philip Barnard

METHUEN DRAMA Bloomsbury Publishing Plc 50 Bedford Square, London, WC1B 3DP, UK 1385 Broadway, New York, NY 10018, USA BLOOMSBURY, METHUEN DRAMA and the Methuen Drama logo are trademarks of Bloomsbury Publishing Plc First published in Great Britain 2019 Copyright © Nicola Shaughnessy and Philip Barnard and contributors, 2019 Nicola Shaughnessy and Philip Barnard and contributors have asserted their right under the Copyright, Designs and Patents Act, 1988, to be identified as the authors of this work. For legal purposes the Acknowledgements on pp. xii–xiii constitute an extension of this copyright page. Series design by Louise Dugdale Cover image: Peter Hobday in Cleansed by Sarah Kane, Dorfman Theatre, National Theatre, 2016. (© Stephen Cummiskey) All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage or retrieval system, without prior permission in writing from the publishers. Bloomsbury Publishing Plc does not have any control over, or responsibility for, any third-party websites referred to or in this book. All internet addresses given in this book were correct at the time of going to press. The author and publisher regret any inconvenience caused if addresses have changed or sites have ceased to exist, but can accept no responsibility for any such changes. A catalogue record for this book is available from the British Library. A catalog record for this book is available from the Library of Congress. ISBN: HB: 978-1-4742-6085-5 ePDF: 978-1-4742-6087-9 eBook: 978-1-4742-6086-2 Series: Performance and Science: Interdisciplinary Dialogues Typeset by Integra Software Services Pvt. Ltd. To find out more about our authors and books visit www.bloomsbury.com and sign up for our newsletters.

Contents List of Figures List of Contributors Acknowledgements

vii viii xii

Part One  Contexts 1 Changing Minds and Minding the Gap: Interactions between Arts, Science and Performance  Nicola Shaughnessy and Philip Barnard

3

2 Imagining An/Other: Histories, Theories and Theatres of Mind through the Mirrors of Hamlet and Stages of Ophelia  Nicola Shaughnessy

21

3 Paying Attention to Meanings in the Psychological Sciences and the Performing Arts  Philip Barnard

41

Part Two  Interdisciplinary Perspectives 4 Evaluating Atypical Imagination and Cognition in Autism: Working in the Arts/Science Interspace  Ilona Roth

69

5 The Wind and the Rain: Facing Dementia in Lear/Cordelia and The Garden  Robert Shaughnessy

85

6 ‘Her Painful Legs Joined in the Conversation’: Dramatherapy and the Space before and beyond the Talking Cure  Emma Brodzinski

99

Part Three  Practices and Responses 7 Where Is Her Mind? Space, Feminism and Madness in Plays by Sarah Daniels and Sarah Kane  Chris Dingwall-Jones Response: Incomprehensibility and Mutual Recovery  Paul Crawford

115 129

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Contents

8 A Cry without an Echo: Consciousness, Creativity and the Healing Work of the Arts  Ellen W. Kaplan Response: Artistic Healing and the Overcoming of Rehabilitation Paradigms  Fabiola Camuti 9 Autism and Affect in Post-Realist Theatre  Marla Carlson Response: Scientific Truth, Artistic License, Fiction and Reality  Thalia R. Goldstein

133 145 149 161

Part Four  Changing Minds 10 Reflections on The Eradication of Schizophrenia in Western Lapland: A Conversation between David Woods and Jon Haynes of Ridiculusmus with Commentary by Richard Talbot

167

11 Recreating Psychiatry through Participatory Performance: Playing ON Theatre and Mental Health Acts  Nicola Shaughnessy, Jim Pope, Philip Osment and Hugh Grant-Peterkin

189

Epilogue  Nicola Shaughnessy

203

Notes Select Bibliography Index

207 235 242

List of Figures 3.1

A four-subsystem mental architecture

43

3.2

Illustrative traces of image content in a basic mammalian mental architecture

45

The Interacting Cognitive Subsystems (ICS) mental architecture with nine subsystems

48

An informal characterization of the kinds of internal loops within the ICS architecture that support thought

50

Two imagery-based instructions and dancers’ experiences sampled while creating movement material

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3.6

Mental imagery loops while thinking with the body

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3.7

(a) Exercises and principles to support creative innovation in imagery; (b) instructions to translate imagery into novel forms of movement

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AI-generated imagery used as a stimulus for making new movement material in the creation of Atomos

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A schematic attentional score for a segment of movement creation in dance

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3.3 3.4 3.5

3.8 3.9

3.10 Two illustrative attentional scores: One for fragments of depressive rumination and other for a mindfulness training exercise

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4.1

75

The Sally–Anne false belief task

List of Contributors Philip Barnard (co-editor) is a retired cognitive psychologist and Honorary Member of the Medical Research Council’s Cognition and Brain Sciences Unit, University of Cambridge, UK. His long-term research programme focused on theorizing about how memory, attention, language, body states and emotion all work together. He developed Interacting Cognitive Subsystems (ICS) as a conceptual framework for understanding normal and dysfunctional cognitive–affective relationships and their modification. ICS has been applied to depression, schizophrenia and eating disorders. He has collaborated with choreographer Wayne McGregor and arts researcher Scott deLahunta to develop productive and applicable synergies between choreographic processes and our knowledge of cognitive neuroscience (Wellcome Trust ‘Thinking with the Body’ Exhibition, 2013). He is the coauthor of Affect, Cognition and Change: Re-modelling Depressive Thought (with John D. Teasdale, 1993) and has written numerous papers for a wide range of science and humanities journals. Emma Brodzinski is Senior Lecturer in the Department of Drama, Theatre and Dance at Royal Holloway, University of London. She has particular research interests in arts and health and her publications include Theatre in Health and Care. She is also a practising dramatherapist and has worked in NHS and private settings. Fabiola Camuti is an artist-researcher and Lecturer in Theatre Studies at the University of Utrecht and the University of Amsterdam. She completed her doctoral research in a joint PhD programme between the Sapienza University of Rome and ASCA (University of Amsterdam) on the topic ‘Theatre and Meditation’. Her interdisciplinary research encompasses humanities, neuroscience and a practice-led approach to the analysis of theatrical phenomena. At Sapienza, she was part of a multidisciplinary team in a threeyear project involving prison theatre and physiology. She  organized the ‘International Conference Theatre as Enriched Environment’ series and coedited (with Roberto Ciancarelli and Aldo Roma) the volume Teatro come Ambiente Arricchito, Biblioteca Teatrale, 111–112 (2014 [2016]). Marla Carlson is Associate Professor of Theatre and Film Studies, University of Georgia, and President of the American Society for Theatre Research,

List of Contributors

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2018–21. Her publications include Performing Bodies in Pain: Medieval and Post-Modern Martyrs, Mystics, and Artists (2010) and Affect, Animals, and Autists: Feeling Around the Edges of the Human in Performance (2018). Paul Crawford is Professor of Health Humanities at the University of Nottingham, UK. He has pioneered the new field of health humanities, attracting funding from the Arts and Humanities Research Council (AHRC), the Economic and Social Research Council (ESRC), the Leverhulme Trust and the British Academy. He is the author of over 100 publications and serves on a range of editorial boards. His books range from the BMA awardwinning Evidence Based Research (2004) to the critically acclaimed novel about mental illness, Nothing Purple, Nothing Black (2002). Christopher Dingwall-Jones completed his PhD at the University of Kent in 2014 (‘Antic Dispositions?: The Representation of Madness in Modern British Theatre’). He then changed tack and is now a deacon in the Church of England. He retains an interest in performance and has recently published on puppetry, physical theatre and shared subjectivity. In his new role, he is keen to explore intersections between performance, liturgy and psychology. Talia R. Goldstein is Assistant Professor of Applied Developmental Psychology at George Mason University researching children’s role-play, pretend and acting. She is the author of numerous articles and book chapters on the effects of acting training on social skills, how we understand fiction and children’s developing understanding of pretend. Hugh Grant-Peterkin is Registrar in Adult & Older Adult Psychiatry in the East London NHS Foundation Trust. He has a strong interest in medical education, and he was a teaching fellow at Barts and the London Medical School from 2016 to 2017 and a visiting lecturer in medical education at the University of Harare in 2011. Ellen W. Kaplan is Professor of Acting/Directing at Smith College, a Fulbright Scholar, an actress, director and playwright. She performs and directs internationally; her plays, including several based on verbatim materials, have been produced in China, Israel, Romania, Costa Rica and across the United States. She has worked extensively in prisons and with underserved groups. Philip Osment is a highly experienced writer, director, dramaturg and teacher. He has written and translated plays for a wide range of organizations,

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List of Contributors

including Method and Madness, the RSC, 20 Stories High, Theatre Centre, the Unicorn Theatre, BBC Radio, the Royal Court, Red Ladder Theatre Company, National Youth Theatre, Hampstead Theatre, Theatre Royal, Stratford East. He has directed for Gay Sweatshop, Theatre Centre, Red Ladder, at the National Theatre Studio, Bristol Old Vic and Teatrul Dramatic, Constanza, Romania. In 2011, he created and directed Mad Blud (Theatre Royal Stratford East) and won the 2013 Best Play for Young People Writers’ Guild award for his play Whole produced by 20 Stories High. He is the co-director of Playing ON theatre company, co-directed Inside and wrote Hearing Things. Jim Pope created the Playing ON programme for the National Youth Theatre (NYT), providing accredited learning for those not in education, employment or training. He has provided training for several London theatres and taught on BA and MA courses at Brighton University, Central School of Speech and Drama and Rose Bruford College. He is CEO and Artistic Director of the Playing ON theatre company. Ridiculusmus are Jon Haynes and David Woods, co-founders and coartistic directors. They have co-written and devised more than twenty-five productions for the company and both have completed practice-based PhDs in Drama (University of Kent, 2006). In 2012, they began collaborating with psycho-pharmacologists and psychiatrists. This has resulted in a trilogy of plays informed by research into different approaches to mental health: The Eradication of Schizophrenia in Western Lapland (2014), Give Me Your Love (2016) and Die! Die! Die! Old People Die! (2018). Ilona Roth is Senior Lecturer in Psychology, School of Life Health and Chemical Sciences, The Open University. With background in cognitive psychology, she is author of film, multimedia and written teaching resources on autism. Her research on autistic cognition embraces a broader interdisciplinary focus on imagination and creativity. Research collaborations include the HEAT+ project for autism research and rural health worker training in Ethiopia, and the MIDAS project on early-stage dementia. She has recently completed her BA (Hons) degree in Humanities and Romance languages. Nicola Shaughnessy (co-editor) is Professor of Performance at the University of Kent. She is the principal investigator for the AHRCfunded projects ‘Imagining Autism’ (2011–14) and ‘Playing A/Part: investigating the experiences of autistic girls through drama, interactive

List of Contributors

xi

media and participatory arts’ (2018–21). Her publications include essays in Interdisciplinary Science Reviews (2013), the Wiley Handbook of Developmental Psychopathology (2017) and The Cognitive Humanities (2016). She is the author of Applying Performance: Live Art, Socially Engaged Theatre and Affective Practice (2012) and the edited collection Affective Performance and Cognitive Science: Body, Brain and Being (Methuen, 2013). Robert Shaughnessy is Professor of Theatre at Guildford School of Acting, University of Surrey. He has published extensively on historical and contemporary performance; his most recent books are Shakespeare in Performance: As You Like It (2017) and Shakespeare in the Theatre: The National Theatre, 1963–1975: Olivier and Hall (The Arden Shakespeare, 2018). Richard Talbot is Senior Lecturer in Performance in the School of Arts and Media, University of Salford. Other writings with Ridiculusmus have appeared in the journals Performance Research (2017) and Studies in Theatre and Performance (2014). His current Practice as Research investigates ‘Virtual Clowning’; see Comedy Studies 5, no. 1 (2014).

Acknowledgements This book has been a large and complex task, as befits an interdisciplinary project, engaging different communities of practice (academics from arts and science, practitioners and clinicians) with different agendas and motivations. We are extremely grateful to all the contributors for being so generous with their time and to the participants in the various research projects featured in the volume. We wish to thank Robert Shaughnessy for his editorial support, stylistic and witty dogmatism and for his patience. Georgina Watts provided invaluable assistance and wisdom in the final stages. Her perfectionism and eye for detail was greatly appreciated. Thanks to both for their tenacity and generosity in steering this through to publication. Nicola Shaughnessy wishes to thank the School of Arts at the University of Kent for research leave, financial and administrative support, particularly Gillian Lodge for her extraordinary work. She is grateful to colleagues for dialogue and debate as the work progressed, especially Shona Illingworth, Shaun May, Roanna Mitchell, Melissa Trimingham, Freya Vass-Rhee and Aylish Wood. Thanks are also due to colleagues from the Cognitive Futures in the Humanities Network, where some of the work was rehearsed, especially Rhonda Blair, Amy Cook, John Lutterbie and Ilona Roth. She is indebted to Jon Haynes and David Woods for sharing the work of Ridiculusmus throughout the development of their Wellcome Trust-funded trilogy and for the invitation to participate in the mental health and theatre panel which inspired the epilogue. Thanks also to Richard Talbot for dialogues around this work and for his insightful contributions. Special thanks are also due to Jim Pope and Philip Osment for the privilege of experiencing the Playing ON workshops and to Hugh Grant-Peterkin for his unique contribution as a Le Coq-trained psychiatrist and for discussions of empathy in medical training. Above all, she wishes to thank the participants who contributed to the Mental Health Acts programme and who are also co-authors of Chapter 11. Finally, she wishes to thank the health professionals who contributed their expertise to developing this body of work: Nigel Jacobs, Alison Gillings and Ruth Hoskins. We acknowledge permission from Michigan University Press to reprint material for Chapter 9, which revises material extracted from Marla Carlson, Affect, Animals, and Autists: Feeling Around the Edges of the Human in Performance (Ann Arbor: University of Michigan Press, 2018).

Acknowledgements

xiii

Finally, we are extremely grateful to the anonymous reviewers who provided such an important perspective as the potential audience for the volume and whose advice helped to shape it. We are very appreciative of the support from Methuen Bloomsbury and wish to make special acknowledgement to Mark Dudgeon for his determination to get the book into production and his faith in our ability to do so, and to Lara Bateman and Shamli Priya for their work behind the scenes to ensure we made it to the final act. Both authors wish to acknowledge the role of their families in supporting the production of this volume and recognize its relational impact: Caitlin, Nathaniel, Gabriel and Erina Shaughnessy have contributed to the volume variously through culinary creativity, music and sibling care. Philip Barnard thanks Geraldine Owen who has patiently provided loving and vital life support to the Barnard household while periodically wondering what the word ‘retired’ actually means.

xiv

Part One

Contexts

2

1

Changing Minds and Minding the Gap: Interactions between Arts, Science and Performance Nicola Shaughnessy and Philip Barnard

‘How do you show the inner workings of a person’s psyche to an audience sitting 25 feet away in the dark?’ For theatre director David Woods, the solution is simple: ‘Get in a cardboard box.’1 Simple the solution may appear to be, but engaging with the experience of psychosis through performance involves complexities of theory and practice that are central to the concerns addressed in this volume, particularly in terms of the embodied mind, empathy, emotion, identities in transition, as well as the fraught relationship between madness and creativity. The performance referred to here is Give Me Your Love, a staging of post-traumatic stress disorder. This is the second piece in a theatre and mental health trilogy by the UK company Ridiculusmus – whose The Eradication of Schizophrenia in Western Lapland is the focus of Chapter 10 – presented in a form appropriate to content, as a dialogue between the two performance makers David Woods and Jon Haynes with Richard Talbot as a third voice providing a critical commentary. Described as ‘the play that wants to change the way we view mental health’, the dramaturgy is informed by the Finnish ‘open dialogue’ approach to therapeutic intervention for acute mental illness. The dialogic systems theory informing this radical therapy and associated understanding of the relations between mind, body and environment are endemic to the principles and practices of cognitive and affective approaches to theatre and performance. In the contributions to this volume, the embodied, embedded, enactive, extended and ecological interact as meaning-making structures through the creative practices featured. Since the publication of Affective Performance and Cognitive Science in 2013 and the launch of the Performance and Science series, discussion of arts–science and performance–health interfaces has continued through volumes on Theatre and Cognitive Neuroscience (edited by Clelia Falletti, Gabriele Sofia and Victor Jacono), Performance and the Medical Body

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Performing Psychologies

(Alex Mermikedes and Gianna Bouchard), Theatre, Performance and Cognition (Amy Cook and Rhonda Blair) and Performing the Remembered Present: The Cognition of Memory in Dance, Theatre and Music (Pil Hansen and Bettina Bläsing).2 In these interdisciplinary dialogues, contributors discuss the various forms collaboration can take and the different roles played by the arts in engaging with science. Accessing conditions of mind through creative practices is a pervasive theme in these volumes and in the burgeoning fields of arts/health with subfields developing in relation to autism, dementia, ageing and trauma.3 Interdisciplinary collaboration between arts and science is increasingly acknowledged as a means of addressing complex problems,4 with the contested territory of ‘mind space’ a focus of investigation and funding. Indeed, in 2015 an international interdisciplinary delegation (artists, humanities scholars, neuroscientists, psychologists and social scientists), organized by the Wellcome Trust and the UK Arts and Humanities Research Council, met for three days to ‘explore the inner and outer dimensions of the  mind, to look at how the spaces we inhabit, our own bodily awareness, the presence of others, shared experience and illness affect the spaces our minds  occupy’.5 Key questions for discussion and debate  were concerned with how we understand the mind (across disciplines), the challenges of collaboration and the capacity to change thinking in conditions that cause psychic distress. One provocation suggested that ‘we can change the mind (via drugs, electric shock therapy), but know very little about the mind’. The clinical psychologist Emily Holmes, a participant in the discussion, countered this view with a provocation that ‘we know so much about the mind and so little about how to change it’. In this volume we aim to elucidate the various ways in which interactions between performance and science can complement, interact with and enrich our understanding of the embodied mind while also having the capacity to change our thinking and perception through experience and action. In so doing, we venture into areas of new knowledge creation and practice, emerging across disciplines that challenge traditional paradigms. Recognition of the value of lived experience to research is mobilizing qualitative methodologies through concepts such as ‘living labs’, discourse analysis and creative research tools in the social sciences.6 This is also in the context of debates around medical versus social models of disability, whereby the emphasis of the biomedical model on impairments, abnormality and intervention is challenged through a civil rights approach, advocating that societal structures and attitudes determine dis/ability.7 There is also increasing recognition of the importance and value of engaging service users, particularly in mental health contexts as ‘experts by experience’, contributing to the design and delivery of care models and training. Similarly, the burgeoning development of community-

Changing Minds: Arts, Science and Performance

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based participatory research models, particularly in autism and dementia research (two conditions that feature in this volume), is in response to gaps between ‘knowledge and practice’ with community advocates demanding research that has relevance to their day-to-day experience and well-being as evident in Elizabeth Pellicano’s 2014 policy report on autism, A Future Made Together, in which the prioritization of biologically based research and the lack of consultation with the autistic community mean that ‘advances in research fail to impact upon those who need them most: autistic people, their parents and carers and those who help support them’.8 Across disciplines there are related concerns about the need to engage first-person perspectives in research and to challenge divisions across and within communities of practice, powerfully articulated by Peter Fonagy in a postscript to Psychoanalytic Psychotherapy, which refers to the ‘regrettable dichotomy’ emerging from ‘laboratory versus clinical encounter oriented papers’ in discussions of depression.9 Fonagy finds ‘the interiority of the clinical account is only partially met by the exteriority of the laboratory science’, referring to the necessity for the ‘complexities which the interiority accounts present’ and the value of ‘dynamic description’ which is ‘not yet captured’ by empirical research. Fonagy’s articulation of the need to systematically and explicitly link first- and third-person data in these studies of depression reflects similar concerns in mental health research more broadly: ‘It will require a comprehensive examination and evaluation of subjective experience that is able to preserve its richness and complexity at the same time as quantifying its key characteristics.’10 Related concerns are prevalent across disciplinary cultures (and in this volume) as scholars investigate questions of value in practice-based research, relations between evidence and knowledge, ‘intrinsic and instrumental impacts, and the value of participatory research’.11 When seeking to elucidate complementary interactions between performance and science, it is vital to probe deeper into disciplinary cultures. Humans quite naturally categorize or otherwise pigeonhole all sorts of aspects of the world we inhabit. For example, we are not just artists and scientists. We are musicians, actors, painters and sculptors or we are doctors, biologists, physicists, chemists and psychologists. The particular knowledge and skill sets of the associated communities of practice, as well as their differing languages, play a big part in determining not only what we do but also what we attend to, what we understand and how we understand it. Since we live in a richly connected world we, as individuals, can belong to several communities of practice and intersect in one way or another with many others. At these intersections lie both risks and opportunities.

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For example, a scientist who works with an explicit logic of words, mathematical algorithms or chemical symbols will most likely value replicable phenomena, methodological rectitude, predictability and statistical significances but may well be challenged, or perhaps even mystified, when it comes to understanding an artist who senses feelings and significant meanings in the arc of an unpredictable improvised performance in contemporary dance, or who sees knowledge embodied and expressed in the abstract form of a unique artistic artefact. Yet the sciences and arts very obviously do intersect in a rich variety of ways that are considered valuable. Over the course of history many artworks have been inspired by a stimulus from science or nature. Likewise, many scientific studies of, for example, creativity, or of the brain structures on which it depends, have focused on arts practice and performance. The products of many of these studies are often primarily intended for use by other scientists working in similar paradigms. However, where they are intended to promote interdisciplinary dialogue a key issue then becomes whether the products of science merely constitute a noteworthy and interesting general point for discussion, a simple idea to be requisitioned, or whether they can usefully extend or enrich what artists actually already know or otherwise do well. If we are to benefit from potential opportunities at intersections between psychology and the performing arts, then, at least for some projects, we need to attend to an object of study conjointly and build bridges to support shared understandings as well as meaning-making and preferably go beyond that to do some form of real work. In approaching that work, we need to formulate and express ideas that provide a balance between rigour and richness.

Performing psychologies: Reflections on terminologies The terminology of the title Performing Psychologies is an integration and conflation of arts/science, with performing associated with activities in process as well as the translation of material from one medium to another, while psychologies are associated with the scientific study of the mind, mental processes and the characteristics and behaviours of individuals and groups. The editors are themselves representative of these different communities of practice engaged in interdisciplinary dialogue. Barnard’s work as an applied scientist is introduced by Shaughnessy in Affective Performance and Cognitive Science, as a means of ‘thinking in threes’, to bridge dualisms between the ‘two cultures’ through new paradigms of arts/science interaction.12 Shaughnessy’s earliest work on feminism and theatre was informed by psychoanalytic theory, prior to her turning to cognitive and affective neuroscience to conceptualize embodied and creative processes

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in applied and socially engaged theatre. On encountering Barnard’s work in dance contexts (particularly the ‘choreographic thinking tools’ he ­co‑developed with dance specialists) and his model of Interacting Cognitive Subsystems, or ICS (Chapter 3), the framework was used by Shaughnessy in the analysis of a drama project with autistic children, Imagining Autism.13 This interdisciplinary collaboration between drama and psychology engaged autistic children (7–12-year-olds) in a programme of drama workshops and immersive installations using improvisation, puppetry and interactive media to facilitate communication, social interaction and imagination.14 ICS offered ‘a macro-system’ for the analysis of the creative activities, the interacting sensory modalities and the thinking and feeling processes that contribute to meaning-making in participatory theatre.15 The theoretical landscape of mainstream laboratory-based cognitive psychology in the 1970s largely relied on micro-theories developed to account for ‘performance’ in tightly restricted and focused tasks designed to study specific mental skills such as short-term memory, visual attention or use of language. Outside the laboratory it was not easy to categorize intellectual or emotional faculties so cleanly. Working in applied contexts such as information design, human–computer interaction or clinical psychology was doubly challenging. First, it required a way of thinking about macrotheoretic relationships among all the different facets of cognition to which ICS was the response. Second, it required careful thought about how theories themselves might best be elaborated to make them transformable into something useful when the rigour of science needs to be traded off against the complexity and richness of so much of what we do in everyday life. The wider bridging paradigm is a response to that second challenge as a flexible design for conceptualizations of interdisciplinary theory and practice. It identifies generic representations and processes used when creating or extending knowledge of all types and applying that knowledge back into a social context. The tripartite model illustrates the processes and interactions between experiences and behaviours in the ‘real world’ of people and their representations in applied science. As such it can be adapted to explore and analyse the relations, intersections and interactions between the different states and intermodalities we negotiate as theatre and performance scholars and/or practitioners.16 Our specific articulation of ‘bridging practices’ between scientific theory and the real world not only describes the craft of clinical practice (as originally intended) but has also been used as an analytical framework for practical research processes in applied theatre, dance and film.17 The introduction to the macro architecture of ICS facilitated a new framework for dialogue between contemporary neuroscience and neuropsychologies,

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and between cognitive, perceptual and creative processes in applications of science and performance.18 Barnard has stated that as a scientist, he is ‘particularly challenged by a whole range of deep questions that arise when it comes to thinking about cognition, creativity and the arts’.19 He warns that ‘to even approach a level of sufficient adequacy and applicability our theories must inevitably address that complexity [i.e. different mental functions] in one way or another’. The development of ‘basic macro-theories of broader scope’ offers a paradigm for use as a bridge between psychology and a potentially wide range of performing arts. For example, the articulation of ‘bridging practices’ between the real world and scientific theory describes not only the craft of clinical practice but also the practice-based research that was the basis for his work with dancers, particularly Wayne McGregor and Scott deLahunta, whose collaboration with Barnard led to the development of the ‘attentional score’ (discussed in Chapter 3). This interdisciplinary model offers a framework for understanding and analysing cognitive–affective interaction and change. It recognizes qualitatively different kinds of information, distinguishing between two levels of meaning, one specific, the other more holistic, and suggests that the more holistic one is linked to affect. This has been used in relation to several of the conditions of mind that are referenced in this volume as the psychologies that are engaged with through performance, to include depression (Chapter 7), schizophrenia (Chapter 10) and eating disorders (Chapter 6), helping us to understand how the cognitive biases and thought patterns associated with mental illness might be addressed through a remodelling of negative thought. Indeed, rationales derived from ICS also indicate the potential of the arts as novel interventions for some conditions.20 This theoretical framework also explains the contrast between ‘hot’ and ‘cold’ cognition, ‘knowing with the head’ versus ‘knowing with the heart’ facilitating understanding of the central aspects of psychological change. Performance and psychology have been conjoined in various ways, with three key categories emerging in terms of practice and academic writing. The first is a representational function whereby psychological states and experiences are conveyed through literature, plays and film. The arts have been a fertile form for representations of madness and as a medium for engaging with non-normative psychologies, so much so that an interdisciplinary subfield has developed around the theme.21 While this body of work includes contributions from psychologists, testifying to the value of literature and theatre as creative expressions of mental illness within a fictional framework, recent scholarship from within theatre and performance studies positions itself differently as in Anna Harpin’s Madness, Art and Society: ‘thinking

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9

critically with rather than about non-normative psychological experience’.22 The representational function of performance is also evident in the rich tradition of ‘sci arts’. Barnard has contributed to this movement through his work on process and concept tracking (PACT), a method of mind mapping, featured in the Wellcome Collection’s ‘Thinking with the Body’ video gallery.23 A wealth of performance work funded by the Wellcome Trust in connection with its public engagement grant schemes offer further endorsement of the value of the arts as a means of accessing and interacting with medical and particularly psychological themes. Ridiculusmus discuss their Wellcomefunded trilogy exploring mental health (Chapter 10) with particular reference to The Eradication of Schizophrenia in Western Lapland and open dialogue therapy. This approach is described by its pioneers (Seikkula and Olson) as ‘a way of resisting the experience of ‘pathology’, building a ‘transformative dialogue’ within a social network’.24 Form and content coalesce through the split staging (with the audience changing sides at the interval). The audience are the makers of meaning as they ‘can hear both sides but can see only one’ in the simultaneous performance of Acts One and Three. The dramatization reflects Mikhail Bakhtin’s concepts of polyphony and dialogism, facilitating understanding of psychosis as temporal, dynamic and embedded: [A]ny sense of reality is suspended in a staging that insists on the ‘tolerance of uncertainty’, one of the principles of open dialogue theory and part of the contract between performers and audience. We are uncertain about whose reality we are witnessing, who is mad and who is sane, whether the sons are children or adults, whether the Doctor is or isn’t a patient and, at the end of the play, who is dead or alive.25

This is an example of how performance moves beyond the illustrative function to the more dynamic space in which our relationships to mental health can be renegotiated. Secondly, there is the form of work categorized as applied and socially engaged performance and theatre to which Shaughnessy has contributed.26 This has also been a rapidly developing field of scholarship and practice alongside work categorized as arts, health and well-being.27 In these contexts and with reference to mental health in particular, performance practices are used as creative and communicative tools for exploring lived experience, relationships (to others and to the social and physical world) and subjectivities. While applied theatre is often defined and evaluated in terms of effecting change, these socially engaged approaches are differentiated from psychotherapeutic creative practices (e.g. dramatherapy or music therapy). This volume includes a chapter by Emma Brodzinski, who is

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both a theatre scholar and a practising drama therapist (Chapter 6). While creative psychotherapies involve specific training and development of skills in clinical contexts, with outcomes defined in terms of intervention or treatment, applied drama, in its broadest sense, emerged from traditions of political and educational theatre (Bertolt Brecht, Paolo Freire, Augusto Boal), seeking to give voice to disenfranchised groups and to challenge oppressive structures through practice-based activities. Critiques of contemporary forms of applied theatre as forms of social work and the instrumentalization of the arts as ‘soft’ methodologies in the service of ‘hard’ science28 have led to an increased emphasis on the importance of aesthetics (in conjunction with ethics) as practitioners are concerned for their work to be evaluated for artistic skill and creative quality as well as social impact. Gareth White’s edited collection entitled Applied Theatre: Aesthetics challenges the dualisms of aesthetic and ethical theatre: [T]he engagement and the relational influences face in both directions, so that the art and artist are transformed by those they engage with, as well as being the catalyst for change themselves. And an understanding of aesthetics that serves this purpose needs to face in two directions too: it needs to show how art can be ‘real knowledge’ in its own right, and at the same time remain a tool of social and personal change.29

Hence the third formulation of performance interacting with psychologies can be defined as aes/ethics,30 forms of theatre in which aesthetic and ethical objectives coalesce. This is a focus of Chapter 11, in a discussion of the Playing ON theatre company (director Jim Pope and playwright Philip Osment) whose work engages psychiatrists, mental health service users and theatre practitioners (director, playwright and actors) in participatory performance practices that change the relations between health professionals and service users (in both locked wards and theatre settings). The company generates different forms of performance through informal devised pieces (‘sharings’ for stakeholder audiences) as well as staged plays that emerge from the workshop processes (e.g. Hearing Things). One of the distinctive features of this company’s work is its collaboration with a group of psychiatrists and service users (Re:Create Psychiatry), committed to transforming training through approaches that recognize the importance of empathy, responding to criticisms of the profession’s overreliance on diagnostic criteria and medication with ‘purported disregard for empathetic, humanistic interventions’: For psychiatrist Dr Lauren Gavaghan, Re:Create Psychiatry is ‘an effort to restore this compassionate sense of community, where our mutual dialogue becomes the basis for inspiring change within

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a system that could perhaps easily be regarded as sick’.31 This perspective is endorsed by Hugh Grant-Peterkin, a psychiatrist and participant in the Playing ON’s Mental Health Acts project (discussed in Chapter  11): ‘the whole profession stumbles forward not quite knowing how to engage with its own feelings, a fractured empathic state’.32 The decline in empathy in medical training and practice is evidenced in a series of studies, with particular reference to the mind doctors.33 Many have written that psychiatry is losing its way as a clinical and academic discipline by overemphasizing medication treatments, which often have limited effectiveness, to the exclusion of a deeper, interpersonally rich paradigm of understanding and treating mental illness.34 One of the features of this volume is to present different disciplinary voices and perspectives in dialogue across the three sections. In Part Three, focused on performance practices, we invited responses from experts in fields related to the conditions discussed. In his response to Christopher Dingwall-Jones’s chapter on feminism and mental illness (Chapter  7), Paul Crawford, a professor of medical humanities, also refers to his experience of the shortcomings in psychiatry in a statement that is in tune with the perspectives and practices articulated in Chapter 3: It has been a damnable feature of contemporary mental health care that despite a focus on patient or service user involvement and a rhetoric of personal recovery despite symptoms, little has changed in psychiatry. Patients remain patients and the power of expertise is retained by the clinicians. Clinicians are the preferred ‘sane’ and patients are the preferred ‘mad’. Psychiatry pays only lip service to expertise through experience. (p. 130)

He also refers to ‘the blurring of boundaries between mental health staff/ patients and asylum/community is prominent in what we have called elsewhere Mad Lit’. This leads us into the ‘third space’ of psychology interacting with performance through work associated with an aesthetics of neurodiversity. While there is dialogue and debate between mad studies, neurodiversity and disability studies in terms of impairment, disabled identities and the positives or negatives of the social model, there is the potential for convergence through shared understanding of ‘all humans as beings with embodied differences’. Hence it is suggested that ‘dialogue between mad studies, neurodiversity and disability studies might move us beyond the limitations of identity-based politics that create “insiders” and “outsiders”’.35

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Neurodiverse aesthetics These forms of contemporary performance facilitate responses more akin to the ‘being with’ positionality advocated across disciplines than to traditional observational relationships between patient and clinician or audience and performer. Two key points that can be taken from the performances featured in this volume are, firstly, the complexities of the human mind and, secondly, the potential of performance as a cognitive and affective medium, conveying something of the perceptual and emotive experience of psychic distress and the thinking and feeling processes of the neurodiverse imagination. Contemporary modes of ‘postdramatic’ performance36 offer visceral, nonlinear and discordant spaces for exploring dis/embodied minds and emotion in processes of change or crisis. In Hans-Thies Lehmann’s configuration, ‘dramatic theatre proclaims wholeness as the model of the real. Dramatic theatre ends when these elements are no longer the regulating principle.’37 Crucially, his account draws attention to changes in perception, so that ‘a simultaneous and multi-perspectival form of perceiving is replacing the linearsuccessive’. Characterized by heterogeneity, and emphasizing the body, space, time, visual, aural and media cultures, moving beyond text to different forms of theatre language and multimodal sensual vocabularies, these elements of performance offer a rich palette for contemporary artists engaging with theatres of mind. This was beautifully evoked by Melanie Wilson in discussion of a performance that staged the experience of dementia (Autobiographer), where she referred to her work as ‘drawing out the life of the  mind and exploring it through the felt, live spaces of performance’.38  Exploring neurodiversity through the polyvocal, multisensory languages  of theatre and performance is both aesthetically and  ethically motivated, enhancing awareness and understanding of embodied difference. While being mindful of the risks of romanticizing associations between creativity and mental illness, many of the chapters in this volume challenge the  dualisms between the typical and  atypical that divide sanity and madness, reconceptualizing the complexities of these relationships. Performing Psychologies responds to calls from the scientific community for new approaches to understanding  and engaging with the mind. Emily Holmes  calls for ‘mental-health science’ whereby clinicians and neuroscientists would work collaboratively: Neuroscience is shedding light on how to modulate emotion and memory, habit and fear learning. But psychological understanding and treatments have, as yet, profited much too little from such developments. It is time to use science to advance the psychological, not just the pharmaceutical treatment of those with mental health problems.39

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Holmes is a cognitive scientist and clinical psychologist who is curious about mental imagery. Her medical training followed an arts foundation course and she continues to be drawn to art, working with drawing, for example, to engage with bipolar disorder and trauma and evidencing the efficacy of visual imagery techniques such as ‘imagery rescripting’ to recast negative schemas. Writing about theatre, in a review of This Room, a piece by Laura Jane Dean based on Dean’s experience of obsessive compulsive disorder (OCD), Holmes addresses the readership of Nature with a ‘call to action’, citing Trevor Robbins, the neuroscientist who worked with Dean: Laura has interacted with our researchers studying OCD to bring their findings into register with her subjective experience. Having talked to her he feels ‘even more convinced that researchers should bring together psychological and neuroscientific experiences to improve treatments’.40

While Dean’s show offers affective insights into the experience of OCD, the development of the piece carries a health warning and a challenge to the neoliberalism of the recovery movement. Originally conceived as Head, Hand, Head, the first version staged a linear recovery narrative as Dean’s monologue, delivered in close proximity to the audience with minimal staging (a chair and a bed), charted her journey from diagnosis to health, facilitated through graded exposure and response prevention (ERP). This involves the individual, supported by a specially trained therapist, gradually confronting their fears through a staged process, culminating in an experiential encounter in a situation that activates their obsessive thoughts, but within a safe environment so they don’t carry out the compulsions.41 In Dean’s staging, based on her own experience, this is a climactic potentially suicidal scene in which she stands on a chair having placed a pair of stockings around her neck to confront and overcome the demonic voices in her head. The performance ends with Dean’s apparent recovery as she cites diagnostic scores in the normal range and the audience progress through an installation in which original case notes, photos and artefacts verify the authenticity of this autobiographical performance. In the subsequent version, however, retitled This Room (performed at the Cambridge Science Festival, Battersea Arts Centre, in 2016), the ending is more ambivalent as the symptoms return and the relapse leaves the audience with a more profound sense of mental illness as being in flux (rather than a fixed diagnosis), a temporal, relational and changing process (in terms of life course, relationships and environment). In this scenario, sickness and wellness are reconceptualized. Rather than being conceived as a linear narrative from illness to cure, This Room recognizes the iterative nature of conditions such

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as OCD and the  importance of diagnosis not becoming self-defining. For one reviewer,  the  conflation of the ethical and the aesthetic was a source of ambivalence: Lauren Mooney  describes  This Room as  ‘accomplished but  rather chilly, the writing never quite gelling with the more theatrical staging’ but then concludes magnanimously: Despite this it’s an intelligent and necessary piece, saying unambiguously that the journey to mental health after severe mental illness takes a lifetime. It is also hard not to be impressed by Dean’s bravery, seeing her directly address her own anxiety while doing something as inherently frightening as standing on stage, speaking to us.42

This raises questions about the reviewer’s criteria for value and quality; it is as if the personal content and the story being told demands or justifies a different mode of evaluation as the courage to overcome stage fright is not something that professional theatre reviewers would normally take into account. There’s a risk here of ‘adjustments’ being made that diminish the aesthetic quality of the work, relegating it to a different category in the context of arts and well-being. Related issues associated with artistic practice and the well-being agenda are powerfully articulated by Lynn Froggett in her preface to Olivia Sagan’s study of creativity and mental illness and its critique of positive psychology and ‘happiness science’: [T]he discourse of recovery is strongly normative at times, and can itself take on the aspect of an ideology […] the responsibility to recover and be well may be experienced by some as an empowering spur to self-efficacy, but the suffering of those who fail will be stamped with desolation and futility. If the generalization of recovery discourse develops in the absence of a range of mental health resources that offer an individuated approach, including those which allow for the full expression of disturbance and despair, the recovery movement unwittingly aligns with the neo-liberalisation of health care. It presupposes a health-care system in which there is little patience and even affordability for the expression of existential crisis and its working through […] The re-symbolisation of the relationship between mind, body and world that art making allows is beyond its scope. Under these conditions arts provision will gain the support of health professionals and policy makers to the extent that it offers a cost-effective route to self-responsibility.43

Throughout these chapters, constructions of self and conceptions of agency are questioned, practically and theoretically. One of the unifying themes

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connecting these accounts is an awareness of psychologies in relation to cognitive ecologies, defined by the cognitive scientist John Sutton and literature scholar Evelyn Tribble as ‘the multidimensional contexts in which we remember, feel, think, sense, communicate, imagine, and act, often collaboratively, on the fly, and in rich ongoing interaction with our environments’.44 This draws upon conceptions of identity and the sense of self as located in intersubjective meaning-making acts constructed in relation to the environment, physical and social relations as well as subjectivities. It shifts attention beyond the individual and biological configurations to the relational and affective. Congruent with this is a shift in research methods, as noted by Sagan: Current research in arts and mental health is moving beyond single project studies that attempt to measure therapeutic impact to multi-site studies using combined methodologies in a ‘theory of change’ model to assess the social and environmental as well as clinical dimensions of benefit. Evaluation here still needs to refine definitions of key concepts of social inclusion and empowerment, and resolve problems of reliable attribution of benefit to the effect of arts interventions.45

Performing Psychologies offers a contribution to a developing interdisciplinary community that recognizes the potential of the arts for exploring thinking and feeling states and the importance of documenting lived experience. At the time of writing, recognition of the value of creative practices to scientific research is gaining traction. In an article entitled ‘The Arts as a Venue for Developmental Science: Realising a Latent Opportunity’, three eminent psychologists (Thalia Goldstein, Matthew Lerner and Ellen Winner) refer to arts practices as facilitating the study of phenomena such as ‘attention, engagement, motivation, emotion regulation, understanding of others’ citing ‘a current wave of methodologically rigorous studies [that] shows the depth of arts learning, as well as how arts engagement can be harnessed for transfer to other skills’. The authors state that ‘developmental psychologists cannot afford to ignore such a developmentally entwined experience as the arts’.46 On a related note, Thomas Tao emphasizes the role of the arts in his call for the ‘psychological humanities’ to contribute to new understanding of subjectivity as a core topic for psychology in a paper that is a further example of a call to action for a new integrated approach to ‘conceptualizations of subjectivity and mental life’: Because of the temporality of human subjectivity, the psychological humanities do not provide a final theory of subjectivity. However,

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Performing Psychologies they provide general building blocks in emphasising that a theory of subjectivity needs to consider the uniqueness of experience while maintaining that subjectivity is embedded in history, society, culture in showing that the idea of subjectivity as a first-person standpoint is too narrow; in arguing that corporeal dimensions such as embodiment, habits, or performativities need to be accounted for; in showing that we need to address the relationship of subjectivity to awareness, consciousness, identity, or self; in distinguishing between various forms of subjectivity (epistemic, ethical, aesthetic); in arguing that subjectivity needs to be looked at in various domains of life and in analyzing how psychological functions such as thinking, feeling, willing, and acting come into play; in showing that we might need to consider not only what is happening in subjectivity, but also what is possible (including resistances against subjectification); and in suggesting that we need to consider how subjectivity is changing in a globalized and technologized world.47

While such statements are further evidence of the changing scientific contexts in which these essays are situated and important endorsements of the potential of the arts to contribute to scientific understanding (and vice versa), there remain issues about disciplinary hierarchies and tensions between the communities of practice engaged in collaboration.

Minding the gap: Interdisciplinary encounters The focus for this volume is the space beyond the binaries, the gap between disciplines increasingly referred to as the ‘third space’ or ‘third culture’,48 a heterogeneous trans-disciplinary field of collaborative aesthetic and scientific investigations in which new methods are emerging for knowledge creation. ‘Thirdness’ is described by Olivia Sagan as ‘a node around which social relations and imaginative constructs are generated’.49 This is also a fluid and dynamic space, associated with process, entanglement and the productive tensions of collaborative interspace. In the introduction to their edited collection Performance and Participation, Anna Harpin and Helen Nicholson refer to a ‘paradigm shift’ in the move beyond active/passive binaries towards a ‘messier’ recognition of participation through creative activities as intersectional and embodied practices, reconceived ‘along sensual and sentient lines’ through ‘an ecology of mutual doings and beings’.50 This volume, in a similar key, is situated in the messiness of the in-between spaces of arts and science and of cognitive and affective ecologies.

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Hence three conceptual themes can be identified that reverberate throughout the editors’ interdisciplinary dialogues and the volume as a whole. The first of these is meaning-making processes in relation to the environment, social relationships and ‘sensing subjectivities’, to use Harpin and Nicholson’s term. This framing of meanings about the self, world and others is a feature of Barnard’s theoretical frameworks. The second focuses on conceptions of neurodiversity, cognitive difference and psychopathologies as dynamic, embedded and temporal, in keeping with changing conceptions of the self and subjectivity. Rather than conceiving of mental illness as interior and isolated states needing to be unlocked by those with the keys to medical knowledge, there is recognition of recovery as a position, rather than a cure and the ‘journey’ metaphor being one that can take different directions. Thirdly, the role of the arts is discussed as an intermediary in these processes and as an embodied form, an ‘aesthetic third’, and a convergence of the cognitive and affective. Artistic input challenges the interface to science, as evident in May and Barnard’s discussions of film, in which they demonstrate that film cutting can perhaps teach us more about attention than psychology.51 The chapters that follow map a series of encounters, exploring and probing interactions between the etic and emic, the ‘we’, the ‘I’, the clinical and personal, and the in-between space that is the d/evolution of agency and identity in relation to environments, social relations and subjectivities. This is also the space where thinking and feeling states merge in a configuration conceptualized by Barnard in the attentional score. In Chapter  2, Nicola Shaughnessy offers a scene-setting overview of the relations between the history of psychiatry and theatre, through a study of changing representations of Shakespeare’s Ophelia and the social construction of madness, drawing upon feminist theory and the work of cultural historians. In Chapter 3, Philip Barnard provides an overview of Interacting Cognitive Subsystems as ‘a macro-theory of mental architecture rather than a theory of a particular facet of human performance’ and the evolution of a creative analytical framework, ‘the attentional score’, through his collaborations with dance practitioners. The chapter is itself a model of ICS, describing the origins of the ideas, their development through interdisciplinary practices and the living laboratory of the dance workshop and then the potential to extend the work back into the clinical domain, where ICS had already been applied, particularly in mental health contexts. Part Two contains three chapters in which arts practices engage with psychopathologies, written by experts in psychology, theatre and dramatherapy. Chapter 4, by Ilona Roth, is one of two chapters in the volume devoted to autism representing a psychologist’s changing view of imaginative engagement and theories of mind through her work as a film-maker. It raises

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a number of significant questions about what can be missed when rigorous scientific tests focus our attention on specific attributes of autism, such as theory of mind. Roth suggests that much of the potential richness of atypical imagination may require other forms of enquiry to reveal a more holistic picture. Her account interacts with the discussion of autistic representations in theatre by Marla Carlson (Chapter 9). In Chapter 5, Robert Shaughnessy draws upon Jen Brockmeier’s critique of the dominant medical models of dementia, ageing and memory to consider some theatrical alternatives to this approach. Rather than regarding ‘successful’ remembering of a narratively coherent past as imperative, this work focuses instead on the being-in-thepresent of dementia. Chapter  6 offers a counterpoint to the others in this section as a blending of the clinical and creative. Dramatherapist and theatre scholar Emma Brodzinski discusses her work in a secure unit for women with eating disorders. The chapter traces the ideological and procedural links between Freud’s theories on creativity and catharsis and current practices in arts therapies, emphasizing the importance of an embodied approach in a space ‘before and beyond the talking cure’. It is an example of the ‘fleshy listening’ advocated by Anna Harpin in moving ‘beyond illness’ to explore mental distress as a response to social and relational adversity and trauma. Part Three is arts-led, with a series of chapters on plays or performances in which psychopathologies are staged, followed by expert responses. In the opening of Chapter  7, Christopher Dingwall-Jones declares that ‘madness is making a comeback’, defending the terminology as an opportunity to challenge and question the models that ‘distance us from phenomena which trouble us’. His discussion explores the gendering of madness, (specifically as experienced and articulated by women) with a particular focus on the spaces, both physical and conceptual, that it inhabits. Through a reading of Sarah Daniels’s Beside Herself and Head-Rot Holiday and Sarah Kane’s 4.48 Psychosis, Dingwall-Jones examines the complex spatialities of the representation of female madness as well as the permeability of the boundaries between madness and sanity. In his response to the chapter, Paul Crawford draws upon his experience of working in the mental health sector and his research on the concept of mutual recovery. Chapter 8 takes us inside the experience of incarceration and trauma through Ellen Kaplan’s experience as a theatre practitioner and playwright, working with men and women on death row or facing life without parole (LWOP). Kaplan’s account complements Emma Brodzinsky’s discussion of dramatherapy through her attention to embodied and sensory creative processes in exploring and questioning identity and memory. In her co-creation of Someone Is Sure to Come, she makes the important point (with reference to James Thompson) that ‘revisiting traumatic memory is not an imperative, necessary to “healing”’. Her account,

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moreover, addresses the ethics of working in contexts where rehabilitation is a questionable goal for prisoners whose futures are unlikely to involve release. Her approach is predicated on positions of ‘not knowing’ and ‘being with’ rather than a ‘doing to’, emphasizing the importance of play. In Chapter 9, Marla Carlson continues the theme of neurodiversity and representations of the autistic imagination in her comparison of The Curious Incident of the Dog in the Night-Time (National Theatre, 2012) and Chekhov Lizard Brain (Pig Iron Theatre, 2007). In a discussion which interacts with Roth’s psychologist perspective in Chapter  4, and with reference to two autistic protagonists deemed to be ‘high functioning’ in the medical account, Carlson argues that a faulty scientific paradigm can still generate successful art and, moreover, contribute new knowledge. Her account is responded to by Thalia R. Goldstein, an expert in autism and developmental psychology and director of the Social Skills, Imagination and Theatre Lab (SSIL) at George Mason University. In Part Four, the chapters offer accounts of pioneering work, funded by health organizations in which performance is changing minds as aesthetic and ethical practice. Chapter  10 is a dialogue between David Woods and Jon Haynes of Ridiculusmus and theatre academic Richard Talbot, reflecting on The Eradication of Schizophrenia in Western Lapland. Their discussion of the representation of mental distress, and the potential of the open dialogue approach and its synergies with theatre as a new way of engaging with the experience of madness, articulates themes that have permeated the volume as a whole. In the final chapter, the focus is on new approaches to training through theatre and the role of empathy in psychiatry. This examines performance practices in health and community contexts with particular reference to the collaboration between clinicians, mental health service users and theatre practitioners in the work of the Playing ON theatre company and their collaborations with Re:Create Psychiatry. Through a collective ethnographic approach, it articulates the various perspectives of the authors as participants, drawing upon their combined roles and experiences as theatre academic, playwright, director, psychiatrist and service users. The chapter explores the processes of shifting understanding, the role of empathy in effecting change and the cognitive ecologies at play in the different forms of the work (stage play, devised piece, workshops and training).

Conclusion Both the science and arts-based contributions in this volume share underlying concerns with how to bring about some form of beneficial reaction, understanding or change to multimodal making of meanings.

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It is widely acknowledged in discussions of working in interdisciplinary space, among other things, that it takes time and perseverance to overcome communication difficulties or to find tractable means of either working with ideas from other disciplines or establishing shared objectives for joint endeavour. Science typically favours strategies and concepts to keep things simple, while the arts and humanities are more inclined to emphasize intricacies, uniqueness, richness and meanings that are less than explicitly expressed and therefore often open to ambiguous interpretation. The way in which a wolf attends to events (Chapter 3), the use of dolls to assess theory of mind (Chapter  4), how a song can connect minds (Chapter  5) and the connection between Freud’s ideas and embodied expression in drama therapy (Chapter 6) are undeniably strange bedfellows. Some tensions, mystifications and curiosities will undoubtedly be experienced by readers who work either in the humanities or in one or other of the sciences. We invite you to grasp these curiosities; it could just prove to be the case that novel understandings arise out of those mystifications and tensions. The work described by Barnard in Chapter 3, the development of practical augmentations to artistic practice in the dance studio52 and a broader conceptual analysis of interdisciplinary collaborations53 were all long-term products of just such a mystification. Throughout the volume there are also shared themes and dialogues as performance practices offer new ways of understanding and engaging with psychopathologies such as autism, dementia and schizophrenia. The cognitive and affective potential of multimodal and polyvocal contemporary arts vocabularies, as evident in the examples featured, as well as the productive messiness in the entanglements of different communities of theoretical thinking and practice, offers new ways of engaging with conceptions of madness through the arts/science interspace. There are parallel principles between participatory and relational aesthetics and approaches to treatment based on dialogic practices. The changing hierarchies between therapists and clients and relational understandings of family and patients as agents of change with a forum and language for their experience are analogous to the shifting relations between artist and spectator in participatory arts and in the changing hierarchies between researchers and the researched in participatory community models. The practices featured also address tensions between scientific models of explanation and arts approaches that seek to properly document and understand first- and thirdperson perspectives through creative expression.

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Imagining An/Other: Histories, Theories and Theatres of Mind through the Mirrors of Hamlet and Stages of Ophelia Nicola Shaughnessy

The front cover image, from Katie Mitchell’s 2016 National Theatre production of Sarah Kane’s Cleansed, is an entanglement of gender positionalities, realism and the post-dramatic, situated within historical and contemporary modes of theatrical reference. It gestures towards representations of Ophelia as a woman/man who lies on a verge (inside and outside), adjacent to daffodils and in proximity to death but within the self-reflexive and unreal frame of performance. The photograph features Peter Hobday as Carl, the gay lover whose persecution is central to the action, with scenes depicting the progressive removal of his tongue, hands and feet, targeting the communicative means through which he expresses his love. The image, like the play, is paradoxical in its juxtapositions and doubling: a man dressed as woman, lying in a posture that could be dead (eyes closed and inert) or alive (elegant positioning suggesting staged fainting) and in a setting that is both outside and inside (the flagstoned floor from which daffodils sprout from gravel suggests both tomb and prison). The image is appropriate to a play that is simultaneously disturbing, disruptive, beautiful and ambiguous. Within the first scene, the sadistic Tinker (supposedly a poke at the late Daily Mail theatre critic Jack Tinker, notorious for his martinet views and in this context his poisonous review of Kane’s Blasted) enacts the first atrocity, injecting a lethal dose of heroin into the eye of Graham, a young man who requests the overdose and whose love for his sister Grace (and hers for him) is at the heart of the play. It is also a production in which imagination, creativity and the drama of the mind involve a dialogue between Kane’s anti-naturalism and Mitchell’s closely observed realism in the affective staging of emotion: anger, disgust, fear, sadness, surprise, trust, joy and love; these are felt to such an extent that (in a further synergy with the cover image), stage management reports document regular audience faintings.1

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The gaps between appearance, imagination and reality are fundamental to conceptualizations of both theatre and madness. Sarah Kane’s suicide in 1999, a year after the Royal Court premiere of Cleansed, creates a ghostly state of authorship, haunting these productions through her presence and absence. While acknowledging the problematic relationship between creativity and mental illness2 and myths associated with the deaths of authors that form Kane’s maternal (and modernist) literary heritage (most notably Virginia Woolf, Sylvia Plath, Anne Sexton) this is a play (and production) in which gender trouble plays a significant role (see Chapter  7). This contributes to its metatheatrical complexity (gender as performative), its questioning and disruptions of sexual identity, the human and non-human, truth and artifice, all of which are entwined with the themes of love, loss and psychic distress. The cover image reflects the influence of Barthes’s A Lover’s Discourse on Kane’s dramaturgy: ‘I have projected myself into the other with such power that when I am without the other I cannot recover myself, regain myself: I am lost, forever.’3 The stage direction in the final scene specifies that ‘Carl wears Robin’s clothes, that is Grace’s (women’s) clothes.’ Simultaneously, ‘Grace now looks and sounds exactly like Graham. She is wearing his clothes.’4 These transitions execute the performativity of gender, moving us beyond the binaries of male and female identities, as well as raising fundamental questions concerning the self and ontology, existential issues that both look forward to contemporary philosophical debates and gesture back to rich traditions of theatre history, and to the network of influences upon Kane, including Artaud, Büchner, Bond, Beckett, Kafka and Pinter, whose work also engages with atypical mental states in ways that resonate with Kane’s work and experience. What is signified in the cover image (reflecting the production) is a meaningmaking triangulation between the material environment (exteroception), sensory body-based subjectivity (interoception) and relational ontologies (whereby the relations between entities are more significant than the entities themselves). The difference between sanity and insanity or between the typical and atypical lies in the precarious balance between these elements. Mitchell refers in the programme to the ‘exquisite slices of this university world’, which Kane identifies as the setting for the play. For characters and audience, the knowledge produced in this context is embodied and empathic, a felt understanding of this ‘fable’ and its morals (or immorals). The university is also a reference to ES3, the ward at the Maudsley Hospital, referred to in the play’s dedication where Kane sought to address her personal experience of mental illness (depression, eating disorders), offering insight into and a language for the drama of the embodied mind and psychosis.

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The image is also reminiscent of Ophelia and of historical representations and stagings of gendered modes of madness, or the ‘female malady’ to use Elaine Showalter’s term. A Google Image search of Ophelia yields a series of pictures of women in various states of repose, lying or in close proximity to flowers, a similar triangulation of nature, gender and disorder with a similar sense of beauty as the familiar become strange through juxtapositions of the real and not real. The changing representations of Ophelia have been documented in Showalter’s foundational account, with several other commentaries charting the dynamic relations between social history and perceptions of madness, mind doctoring and the ‘production’ of Ophelia. As medical historians and feminist theorists have demonstrated, the relationship between gender, madness and psychiatry has a discrete history, heralded by Simone de Beauvoir’s The Second Sex and its account of historical definitions of madness being linked to conceptions of femininity. From nineteenth-century biological theories of brain disorders arising from the uterine system (George Man Burrows) and notions of madness as ‘biological and emotional in origin’5 to the twentieth century’s turn to Freudian psychoanalysis and its theatrical account of female hysteria, dramas of the mind reflect the history of psychiatry as narratives in which women represent disorder. This is a co-production between the authorities who regulate the diagnostic script (the DSM) and the cultures that produce, define and treat mental illness. However, in the context of radical changes to conceptions of gender (post-Butler), mental health and disability (Winterbourne Review, 2012 and Care Act, 2014) and the turn to a social model of disability, questions are being asked about the extent to which the psy-sciences hold the key to understanding the mind, with practices being challenged and reshaped as evident in the examples featured in this chapter and in the volume as a whole.6 Taking my cue from this and its connections to the Ophelia archetype, I focus on two examples in which we see the intimate relations between theatre and the discourse of psychology through productions that reflect changing understanding of ‘madness’ (a preferred term for mental illness),7 as well as theoretical insights informed by cognitive ecologies, the turn to affect in theatre and neuroscience and ongoing dialogues between mad studies and neurodiversity.

Contexts: Performance histories Showalter’s commentary on Ophelia for the 2016 British Library exhibition on Shakespeare refers to Ophelia as ‘the most represented of Shakespeare’s heroines in painting, literature and popular culture’.8 Developing her 1985

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essay, Showalter considers how Ophelia continues to be ‘a potent and obsessive figure in our cultural mythology’,9 whose staging mirrors contemporary ideas and questions about gender identity, psychology and sexuality. Representations have shifted from the biological and emotional ‘erotomania’ (repressed sexual desire) of Victorian culture, conveyed through costume and physicality: virginal white dresses and the purity of flowers contrasting with the bestiality of dishevelled hair, sexual gesturing and singing. During the nineteenth century, Ophelia was infantilized, as evidenced in Bridget Escolme’s account, as a child-like figure whose madness ‘is close to that of a fool’ to contain its disruptive potential, an erasure of sexuality, to ‘save’ her from ‘a sexuality that troubles ideals of female perfection’; traces of this have lingered well into the present, in ‘a tradition of calming and confining Ophelia and her representation’. This political and psychological repression and oppression, Escolme suggests, may ‘reflect the ways in which the current theatrical moment wants to take mental illness seriously in the production of four hundred year old plays with different attitudes and values’. She ends by taking up Petra Kuppers’s call for performance practice that ‘subverts representational certainties’ looking forward to new stagings for the future: ‘to see more Ophelias whom the court has failed to calm down’.10 Escolme’s reference to ‘taking mental health seriously’ may well indicate and explain the cautious ‘kid gloves’ approach to Ophelia’s representation, with concerns about gender stereotyping and the exoticizing of madness and otherness. However, as Damian Milton has observed, citing Socrates, in his writing on neurodiversity and the narratives of madness, ‘there are two types of madness, one arising from human disease, the other when heaven sets us free from established convention’.11 The continuing tensions between the negative pathologization of madness as a disease and a more positive view of madness and neurodiversity in terms of difference, plurality and relationality is evident in Anna Harpin’s Madness, Art and Society: Beyond Illness (2018), in which she aims ‘to provide ground for collaboration rather than division in the reimagining of madness and its treatment’ (my emphases) and considers how art practices are a means of ‘thinking with, rather than about, psychological distress’.12 Harpin’s critique of empathy discourses (as predicated on claims of knowing) and her conceptualization of tenderness and companionship as approaches to researching and working with ‘difficult’ feelings are in dialogue with both the critical approaches adopted here and the creative practices discussed. In both case studies (Buzz Goodbody’s 1975 Royal Shakespeare Company (RSC) Hamlet and Kelly Hunter’s adaptation Hamlet, Who’s There? for Flute Theatre in 2016), the influence of R.D. Laing and the anti-psychiatry movement is evident. This is also the starting point for Harpin’s account in her re-evaluation of Laing’s controversial legacy,

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the continued importance of the questions he raised about defining and understanding madness and its relations to the family and society as well as his call for new approaches to psychiatric care and attentive listening to divided selves. Ophelia is cited by Laing to illustrate what he calls the ‘praecox feeling’, ‘being in the presence of another human being and yet feeling that there was no one there’; he writes: This ‘praecox feeling’ should, I believe, be the audience’s response to Ophelia when she has become psychotic. Clinically she is latterly undoubtedly a schizophrenic. In her madness, there is no one there. She is not a person. There is no integral selfhood expressed through her actions or utterances. Incomprehensible statements are said by nothing. She has already died. There is now only a vacuum where she was once a person.13

Divided selves: Buzz Goodbody’s Hamlet (1975) While Buzz Goodbody was very influenced by Laing’s theories, foregrounding family relations, madness as a reflection of the environment in which it is produced and an approach which looked at characters ‘as human beings in human situations’,14 her interpretation of Ophelia moves beyond Laing through her attention to audience response and her use of theatre language to explore what she refers to as the ‘power’ in Ophelia’s madness. As Alycia Smith-Howard has noted, citing her notes on the prompt copy, Goodbody challenged Laing’s interpretation of Ophelia, by asserting that her madness is a form of liberation: In her madness she has learnt, ‘she hears/There’s tricks i’th’world’. She is also for the first time becoming demanding, she is importunate, ‘pray you mark’ She has POWER at long last. She says ‘we must be patient …’ all her life she has been patient. She becomes active in her madness. She allowed herself to be killed, [and] has a suicide’s burial.15

Howard’s use of the term ‘liberation’ and Goodbody’s reference to power are striking in relation to both Milton’s aligning of madness and neurodiversity with ‘freedom from convention’ and the call from Escolme for a representation of Ophelia and madness that ‘subverts representational certainties’. Language is key to this as the liberation and the power referred to moves beyond discursive practice. ‘She hears’, Goodbody notes, and while Laing maintains

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that ‘incomprehensible statements are said by nothing’ and that ‘there is no integral selfhood expressed through her actions or utterances’, Goodbody is herself playing a listening role, asking what Ophelia’s vocalizations and actions tell us and questioning notions of coherent selfhood through the staging of fragmented experience and a drama of mind that reflects her own lifeworld. I am reminded of Erving Goffman’s sociological study, The Presentation of Self in Everyday Life (1956); its dramaturgical analysis of social life in terms of stage acting resonates with the performances of gender and madness in Goodbody’s staging. Goffman’s work on stigma is similarly relevant with a subtitle that is particularly apt in relation to Ophelia’s representation: Notes on the Management of Spoiled Identity.16 Goodbody’s metatheatrical strategies develop those within the text and its staging of madness: the play within a play and Hamlet’s performance of an antic disposition: ‘These but the trappings and the suits of woe’ (1.2.86). Indeed, Goodbody opened her rehearsals with a five-minute version of the dumbshow. Hamlet is a theatre of identity, a rehearsal of manic subjectivity in which Goodbody plays with the performance of gender and madness, through a directorial strategy that complements both Laing’s unorthodox approach to twentieth-century psychiatry and the call from twenty-first-century scholars for a different approach to engaging with psychic distress. Harpin refers to the ‘dire need for tenderness in how we think of and respond to madness’ and the urgency of what she refers to as ‘fleshy listening: of listening that extends beyond the ears and is dispersed throughout the body in acts of radically generous relational exchange […] such a stretching forth may enable you generously to hold the different stories I am calling upon you to hear’.17 This advocation of ‘fleshy listening’ seems to me to be appropriate to the impetus behind Goodbody’s response to Mikel Lampert, the actress playing Gertrude who was ‘distressed’ by the limited opportunities her character has to speak: ‘Buzz was so thrilled that I was concerned about that. “But she’s there! She’s there!” She cried. I then asked, “why does she say so little when such enormous things are happening in her world?”’ Buzz responded, ‘That’s what we have to find out.’18 She interprets Ophelia as a character with strength, drawn from a supportive family unit, who is loved and loves (Hamlet and Polonius): ‘developing the Polonius family in this way provided a vehicle for Ophelia’s madness’. Goodbody writes that her story is ‘a tale of other people’s needs and other’s pain. She is ignored and becomes isolated and confused and then she stops fighting back’.19 Ophelia’s behaviour is interpreted by Goodbody as expressive of her response to changes in the family network, which she experiences as devaluation and rejection. This is consistent with Laing’s understanding of the environment that produces psychosis. In conceiving of Ophelia’s madness as liberation and ‘active’, Goodbody’s

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representation is consistent with contemporary feminist perspectives and the ‘reimagining’ of madness Harpin advocates. Citing Wendy Brown and Ann Cvetkovich’s work, Harpin writes: ‘I am less concerned with what madness is than what it wants and what it needs.’20 This reconceptualizing of madness as ‘protest against, or resistance to the norms, values and roles we are expected to adhere to and adopt’21 is precisely Goodbody’s approach. It can be read in the context of Judith Butler’s conceptualization of gender trouble and the current dialogues between mad studies and neurodiversity, critiquing normative constructs of identity.22 ‘The construction of coherence conceals the gender discontinuities that run rampant’, writes Butler, suggesting there is no preceding self outside of a gendered self and the ontological reality of gender only exists through our actions.23 The stylized repetition of gendered acts is exaggerated in Ophelia’s performance of femininity and madness in Goodbody’s production through an interpretation that mimics and displaces gendered convention, provoking an ambivalent critical response: she was described as ‘pert and sexy, all but disfiguring her face with lipstick’; ‘overparted … pathetic enough in the “nunnery” scene and powerful in the mad scenes which she played very roughly, a genuine violence in the sexual allusions … But … mad scenes are money for jam’; her ‘inadequate’, costume ‘might have implied her independence of courtly fashion, but the performance proved nothing conclusively’.24 Stage and Television Today was ‘undecided’, due to her being played as ‘a girl not so much very young but mentally unmature, yet the mad scenes lacked pathos’.25 For the feminist theatre historian Elizabeth Schafer, this production was the first Hamlet she ‘ever saw’: ‘Ben Kingsley was a dark, slightly balding Hamlet, full of unpoetic anger and rage. Denmark was peopled by businessmen in suits … Ophelia covered her face in lipstick and wore Polonius’ dressing gown when she mourned him.’26 This gesturing towards the performativity of femininity and an active production of madness operated in the context of gender troubles for Goodbody in relation to her family, the RSC and professional theatre. In what is probably her earliest interview, aged twenty, following her award-winning debut production at the National Student Drama Festival, Goodbody spoke with Hunter Davies, who reports that her ‘views on drugs, sex, depression, therapy, feminism-not typical of the 1960s’ were ‘ahead of her time in every way’.27 Goodbody recounts a deeply unhappy childhood in which her ‘middle-class, public-school type’ parents ‘lost money’ when she was young and ‘moved a lot’. She refers to revolts against her parents, particularly a controlling mother and her deeply unhappy time at Roedean School: ‘it’s a barbaric custom, sending kids away to boarding schools’. The anger about her education was due to its intellectual and social constraints

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as a uniformed girls school, with a traditional curriculum: ‘we stopped dead at Ibsen and T. S. Eliot’, she said, somewhat ominously, in view of the circumstances of her suicide.28 Lamenting the absence of contemporary writers such as Pinter, Beckett and modern novelists, she describes herself reading Ulysses under the bedclothes at night and ‘sneaking Woman’s Own into sixth form’. Her references to ‘silly primitive sexualness’ anticipate the critical response to Ophelia. This behaviour stemmed from a single-sex environment with a ‘keen-ons’ culture of dances and valentines. Having flirted with religion, her rebellion became political: ‘I was arguing about race, and religion and politics’, she remembers in contrast to her peer group’s focus on ‘the ban on boys’. The first suicide attempt, also an overdose of pills, was in this context and is remembered in sensory terms: ‘I’m still terribly emotional when I think of school … I can still smell it and feel it.’ At Sussex University, her depression led to another overdose and a breakdown. She had been seeing a psychotherapist, the head of the student health centre, a doctor with whom she formed a positive relationship, as someone who ‘cares’ and facilitated dialogue: ‘He tells me I’m not neurotic. Not classifiable enough to be put away, but I’m not adjusted, I can’t do without him.’ After her suicide attempt he was ‘absolutely marvellous’, allowing her to smoke in the health centre where he administered her finals papers, ‘when I got too upset, he’d take them away and brought them back again when I was better’. In his understanding of psychosis as relational, Goodbody’s doctor might be seen as something of an R.D. Laing in her own life. She recalls that ‘when the doctor told me how she [her mother] was affecting me, I didn’t believe him’. For Laing, madness was considered an understandable response to a mad world, hence located not in biology but in families and the environment. Madness became a radical politics and schizophrenia a form of epiphany in ways that are played out in Goodbody’s production through Hamlet and Ophelia. Indeed, in some respects these representations reflect Goodbody’s divided self. Ophelia’s sexual displays, particularly during the mad scenes (4.5; e.g. she ‘grabs CL’s hand and holds it against her crutch’),29 may derive from Goodbody’s earlier experiences of promiscuity and sexual power practices: ‘once I’d got power over [boys] I’d drop them. Once I became sexually dissatisfied with them and got the ascendancy, they no longer attracted me, so I just left them.’ Goodbody’s reference to Ophelia’s ‘power’ is striking in relation to the language used to describe herself: ‘depressive, obsessed with power. If I can’t dominate someone, I regress and become like a child, overdependent on someone as I was on my mother.’ She was also aware of gender expectations: ‘if you haven’t got a bloke in a competitive society like Sussex, then you’re a social failure.’ While Goodbody was anticipating postgraduate study at the time of the interview (prior to

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John Barton’s invitation for her to assist him at the RSC), her frustration with her position as a woman anticipates the feminist principles she espoused: ‘there are thousands of girls like me, interested in literature and drama, but what can we do about it if we don’t want to teach? It’s so unfair. The whole system is wrong.’ At the RSC, she encountered a culture in which her identity as a woman shaped her encounters in the rehearsal room as well as critical responses to her work. As Schafer observes, ‘Readers are informed that Goodbody’s name is apt and “she’s leggy, curvy, well-endowed in the right places”.’ Schafer goes onto cite the reference in the obituary in the Sun to ‘the shapely brunette stage director’. While actresses would ‘flirt’ or sleep with the director, Goodbody reported, ‘I have to convince them that I have a different kind of strength.’30 Her political intentions, however, were frustrated in a context that domesticated small-scale theatre and ‘chamber’ productions. The difficulties Goodbody faced, and the deep-seated sexism that disempowered her project, are evident in Mary Maher’s interview with Kingsley. In the course of this lengthy discussion, detailing his work on the role, Kingsley mentions Ophelia only once, in his account of the treatment of the nunnery scene: He says at first, ‘Thank god, because you’re a friend, a lover.’ I still think the play could have gone off in a totally different direction if she’d said ‘I’m still wearing what you gave me.’ But instead, at that moment she says, ‘Here you are,’ and hands back the jewellery. It is completely devastating; when he has arrived at his own virility the woman in his life says, ‘I don’t want this stuff anymore.’31

Kingsley’s telling counterfactual (‘if she’d said’) indicates that it is her unlooked-for response that triggers his misogynistic rage (‘that unlocked, understandably, a huge amount of venom and anger’), and it also seems to suggest that it is somehow Ophelia’s fault; that had she pandered to his needs rather than asserting her separateness, their relationship, and the play, might have been retrieved. Maher and Kingsley’s concern is, understandably, with Hamlet’s journey rather than Ophelia’s, but the ease with which her role in this scene is subordinated to its capacity to catalyse his reflects the extent to which her real madness was viewed as mere collateral damage. Kingsley, for his own part, was in no doubt that Hamlet’s own ‘lunacy’ was performative, but that this could also involve a blurring of lines: ‘He [Hamlet] wasn’t mad … But in feigning madness, he gives himself so much license that he began to erode his own limits.’32 Divided over the question of whether this Hamlet was really mad or not, reviewers emphasized how much it was acted out, frequently in the form of a physical restlessness barely contained by

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the play or the building it was enacted in: Kingsley’s madness is described thus: ‘faced with the golden opportunity to kill Claudius he hurls himself against the nearest wall’; it is ‘not so much an antic as a frantic disposition’, with ‘burning eyes, darting gestures and a Satanic vehemence (as when he slaps his mother)’; Kingsley plays ‘with a nervous intensity that leaves no doubt that Hamlet is neurotic, if not psychotic … it wears you down through more than three hours of performance’ but ‘grips you just the same. His lines are fired with the rapid fluency of a machine gun.’33 Other critics refer to Hamlet’s ‘fury and resolve’, the ‘leaps and bounds of his own existential imaginings. His thoughts fly not up, but out and beyond each physical situation he himself manufactures … in contemplating them fiercely his own terrible circumstances crowd around him to beat against’; ‘he can see it all coming, and the variety of his performance amounts to an effort to escape from this knowledge … always returning to a trance-like obsession in which the remaining characters already appear as so many standing corpses’.34 Indeed, it is as if Ophelia represents one part of Goodbody’s divided self and Hamlet the other, as one is struck by the parallels between her descriptions of herself and the critics’ references to Hamlet: ‘volatility and indecisiveness, a bit manic-depressive’, [Kingsley] ‘plays Hamlet as feigning mad, which is too dangerous a game for him to play, for playing at it drives him into madness, able to recover, but each time with diminishing coherence’.35 One reviewer notes a ‘preoccupation with family rather than political conspiracy; and [Hamlet’s] nervous sensitivity to any mention of the words “father” and “mother” suggests a latent violence ready to be unleashed’, another the ‘continually shifting from violent outbursts of quick-fire anger to wicked bitter humour, usually at someone else’s expense’.36 Whereas Ophelia turned her destructive fury inwards, Kingsley’s Hamlet unleashed it on his others: Ophelia, Polonius, Gertrude, Laertes and, finally, Claudius. ‘He feigns insanity as a youth feigns drunkenness – to disguise the fact that he is drunk’, wrote the Jewish Chronicle reviewer, who indicated that this was not just antiheroic but deeply unnerving: ‘the blackness grips him and he becomes like the men who march the city streets shouting at themselves, the kind whose eyes you avoid because it is dangerous to catch them’.37 If Ophelia and Hamlet can be seen as projections of Goodbody, the staging was similarly implicated. The Denmark courtiers were bastions of a male-dominated powerhouse, masculinized in pinstripe business suits, while the peculiarities of the inner play suggested a self-reflexive critique of sexual stereotypes, ‘figures in white paper masks lasciviously pawing each other whilst a copulatory rhythm is beaten out on a tabor’.38 One can’t help speculating whether this was Goodbody’s reference to the promiscuity and sexism at the RSC. The staging was designed to place the audience in

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the mind of the play; Goodbody wanted ‘every member of the audience to feel themselves “inside” the experience’.39 Seated in the centre, in darkness and on benches without backs, the production’s physical demands on its audience members would ensure an embodied response, being aware of themselves in a space described as cramped and claustrophobic. In the first scene, ‘torches provided the only light, and their beams, thrown across the audience, picked out the ghost at the back of the room’.40 The Telegraph found this ‘thrilling’, the torches ‘trying to locate the Ghost like searchlights in an air-raid. It communicates terror’. The association of the staging with mind space is reinforced through its anthropomorphic qualities: ‘the stage, at one end of the room, puts out arms along its sides: ledges which also serve for approaches and retreats as does the centre aisle, which divides the audience. We are in the middle of the action.’41 Richard David confessed that he was ‘reluctant, when the actors on stage were calling to the Ghost at the back of the hall’, to turn round, as he ‘felt that the mere movement would be “action” and so transpose me into the actors’ world instead of leaving me to observe it dispassionately. So small is the difference between being “in” the actors’ world (as was the audience almost throughout this performance) and being “of ” it.’42 For Thomson, however: ‘There was remarkably little sense of a performance taking place. Rather, we were silent participators in a series of events whose intense logic required that they take place here and nowhere else.’ This became a ‘likely story’ because ‘our presence and participation guaranteed its likelihood’;43 ‘actors confront each other and their audience … The closeness of the actors results in genuine physical involvement’.44 The use of ‘all reaches of the auditorium’ gives ‘the play’s sense of speed, perspective, and danger’.45 Thus the staging drew attention to the blurring of the boundaries between the lived experience of the audience and the world of the play, in ways that parallel Goodbody’s troubled relationship with the production as the drama of mind that is Hamlet is also Goodbody’s theatre of identity. It is impossible to discuss Goodbody’s Hamlet without acknowledging that the production was (and continues to be) viewed through the lens of her suicide four days after it opened. The press did not get to see the production until nearly a month after it opened at The Other Place on 7 April; four days into the run, Goodbody was found dead by her flatmate (the theatre maker Susan Todd), having taken an overdose of barbiturates. Practically every reviewer hailed the production while mourning the loss: it was, wrote Nicholas de Jongh, ‘another reminder of what we have lost by her death’ (Guardian), and Irving Wardle recorded that ‘the theatre has lost a superb talent at the very moment that is was moving from promise into fulfilment’ (The Times). By the time Hamlet transferred to the Roundhouse in London in February  1976, Goodbody’s suicide narrative had become worked into

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the reviewer, audience and performer experience. Few were as callous or as cynical as the Observer’s Robert Cushman, who began his review by declaring ‘To get good notices it helps to be dead’, and that the coincidence of her death and the Stratford premiere ‘offered great cause for suspicion’, and when Bernard Crick wrote that Goodbody ‘chose to take that journey from which, after all, the Lord Hamlet turns back’, he voiced the prevailing sense of the production’s very particular poignancy, though he offered a uniquely individual interpretation of that ‘journey’ when he declared that ‘even if mankind may go like the ending of the play – as she went – in one perhaps part-accidental or part-wilful holocaust, yet the intelligence redeems it all’.46 For Kingsley, there was an absolute convergence between Goodbody, Hamlet and Hamlet himself: ‘Everyone agreed that had Buzz Goodbody continued her career, she would have been brilliant … And that’s what they say about Hamlet – that’s what Fortinbras says about Hamlet at the end of the play.’ Goodbody, he suggested, found the suicidal resolution of her own conflicts in Hamlet’s own contemplation of it in ‘To be or not to be’: You see, this is what happened to Buzz. She got us all through ‘To be or not to be’ and said, ‘I’m not joining you on the other side.’ … that soliloquy said, ‘Well, Buzz, you go with the rest of them into adulthood or you don’t.’ That’s what the voice said to her. And she must have answered, ‘Well, I can’t do it. I just can’t do it.’47

‘She had asked herself Hamlet’s question’, Kingsley concluded, ‘and here was her answer.’48 Kingsley’s interpretation is no more nor less plausible as an attempt to make sense of an act that media onlookers found senseless than theirs, but it is likely to be closer to the truth. One key difference was that whereas the press commentary stressed the seeming randomness and irrationality (conventionally gendered female) of the act, Kingsley and others treated it as a considered decision. Colin Chambers, whose history of RSC studio performance appeared four years after Goodbody’s death, wrote that it was ‘a willed act, planned some time beforehand’, and borrowed from the terminology of Marxist dialectics by stating that ‘she could not cope with the contradictions she faced’.49 The tendency to make Goodbody into an icon, a suicide who was legible and meaningful in terms larger than herself, is also reflected in Dympna Callaghan’s invocation of Margaret Higonnet’s reading of self-killing as a means of validating her feminist legacy: suicide is ‘a symbolic gesture … doubly so for women who inscribe on their own bodies cultural reflections and projections, affirmation and negation’.50 At the time, the temptation to read Hamlet into Goodbody’s death (and vice versa) was hard to resist, as Kingsley recalled: ‘We had a lot of people in the

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audience afterwards, who stayed behind … there were people, women her age, and men a little older saying, “That was for us. Thank you very much.”’ One woman even stopped me in the street and said, ‘You did that play for me, you know.’51 In any other context, this might sound like evidence of psychosis; here it seems an entirely appropriate response. Through her Hamlet, Goodbody staged what Harpin refers to as ‘the dimensional, relational, embodied nature of madness’.52 After visiting four doctors to gather four bottles of pills, she was found with a copy of T.S. Eliot’s Four Quartets by her body and her suicide note: ‘I am a tortoise without a shell.’53 It is difficult not to think of Ophelia playing with her dead father’s dressing gown as one of the many container metaphors in Goodbody’s production. Ophelia’s madness is here acted inwards, manifested in an act of care towards a mourned, absent other (in contrast to Kingsley’s outward performance of madness through acts of aggression and outright violence, such as slapping Gertrude in the closet scene). The coat was laid out by Ophelia as she sang ‘he is dead and gone’; she ‘gathers the coat to her’ when Claudius enters and puts it on for her exit, ‘swirling’.54 The coat is core to the mad scenes, an ‘object’ of emotion, to use Sara Ahmed’s term,55 as she lays it on the floor with flowers on her return, laying fresh herbs, a further detail in the immersive sensory staging. Finally she picks up the coat and bell, kissing Laertes as she exits. The herbs, flowers and bell are all referenced in Four Quartets, while the coat as the object of attachment and all that this signifies is reminiscent of Eliot’s lines from ‘Little Gidding’: There are three conditions which often look alike Yet differ completely, flourish in the same hedgerow: Attachment to self and to things and to persons, detachment From self and from things and from persons; and, growing between them, indifference Which resembles the others as death resembles life, Being between two lives – unflowering, between The live and the dead nettle.56

Playing in a minor key: Kelly Hunter’s Hamlet, Who’s There? (2015) Four decades separate the final London performances of Goodbody’s production from the first of those of my second Hamlet, which began its life in 2015. Goodbody’s production was a three-and-a-half hour, lightly cut version of the play; Flute Theatre’s Hamlet, Who’s There? is a ninety-minute redaction

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for six actors that focuses on the tragedies of two families and the fates of seven characters: Hamlet, Claudius, Gertrude, Ophelia, Laertes and Polonius (here doubled, ambiguously, with the gravedigger). The text was adapted and directed by Kelly Hunter. She states that she ‘starts with a feeling’ and in her reworking of Hamlet, grief was the impetus.57 Specifically, the transference of grief, stimulated by her own experience after her son suffered a bereavement, ‘the kind that stops you in your tracks, grief coming in unstoppable ways capable of swallowing a person whole’. Having ‘felt the grief acutely’ Hunter became aware of its resonance and contagion while playing Mrs Alving opposite Mark Quartley’s Oswald in Ibsen’s Ghosts: ‘I harboured the idea of creating a production that would place the audience as close to Hamlet’s experience as possible while exploring transference of grief as a primary palpable experience for each of the characters in turn.’58 Grief is conceived here as a contagious ‘sticky’ feeling, to use the term from affect theory, and Sara Ahmed’s ‘outside in’ model of affect, informed by the sociology of emotion, whereby ‘to receive is to act’.59 Teresa Brennan’s account of ‘affective contagion’, which informed Ahmed’s work, draws on biochemistry and neurology as well as cultural factors in her analysis of emotion transmission. Brennan suggests that the ‘catchiness’ of grief, anxiety or anger ‘makes the Western individual especially more concerned with securing a private fortress, personal boundaries, against the unsolicited emotional intrusion of the other’.60 While Hamlet’s mind is the focus and the soliloquies were the starting point for what was initially conceived as a one-actor production, the decision to include other characters is indicative of a relational ontology that underpins this piece, so that the ‘who’s there?’ of the title refers to the people and context in which the grief is situated: ‘The wound is open. The wound is peopled.’ Hunter cites this epigram, taken from an early essay on Shakespeare by Harold Pinter, in her handbook for actors, Cracking Shakespeare.61 In her introduction to the text of Hamlet, Who’s There?, she explains the role of the other characters: ‘Each character had to be entirely connected to our play’s primary concern: the transference of Hamlet’s grief within the two families.’ Hence Ophelia, Claudius and Gertrude ‘had to be there’, while Laertes, Polonius and a Gravedigger ‘were essential too’. The concept of the wound being ‘peopled’ refers to embodied emotion within a distributed framework whereby the performance environment is conceived as ecologies of interaction, exploring what emotions do and how they circulate. The dynamics between emotion and affect are played out in ways that are in tune with affect theory, as articulated by Sianne Ngai: ‘At the end of the day, the difference between emotion and affect is still intended to solve the same basic and fundamentally descriptive problem it was coined in psychoanalytic practice to solve: that of distinguishing first-person from

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third person feeling, and, by extension, feeling that is contained by an identity from feeling that is not.’62 In this production we can see the dynamics of the ‘inside out’ model as articulated by Ahmed: Emotions are not simply something that ‘I’ or ‘we’ have. Rather, it is through emotions, or how we respond to objects and others, that surfaces or boundaries are made: the ‘I’ and the ‘we’ are shaped by and even take the shape of, contact with others.63

This is evident in a number of ways, not least in the cover of the text depicting Mark Quartley with the skull of a dog (this version’s Yorick) pressed between his nose and lips. The play, Hunter says, ‘is about a father who was missing all his life’ and in this moment, ‘Hamlet holds the dead skull of the person who was there for him.’64 The props have multiple uses as objects of emotion in the minimalist staging. The blankets in which Ophelia wraps herself to feel close to Hamlet (acting as a container in similar ways to Goodbody’s dressing gown) are transitional, shifting their connotations from security to suicide as they become the means through which she starts the process of dying, by suffocating herself, Hunter explains. In a later scene they become the gravedigger’s emotive tool as he ‘whips the stage with the blankets, creating a “storm” of photographs, flying in the air’. As the pictures settle onto the floor, they resemble tiny graves. The photographs played a crucial role in the dramaturgy. Members of the company contributed photos of personal significance, each carrying a story that had been shared. ‘At each important moment of our narrative the photos increased with resonance’, Hunter states: ‘Photographs of a father Hamlet never truly knew but who exists within him as a Ghost. Photographs that Hamlet hurls at his mother in the closet scene as he searches for pictures of father and uncle with which to shame her. Photographs that Ophelia tries to organize into some kind of order when she’s lost her mind.’65 Hamlet opens the play, sitting on the sofa, ‘sorting through the photographs’.66 He returns to the sofa and photographs after his dialogue with Polonius, ending with his decision to ‘put on an antic disposition’: ‘he looks through the box, finding a photograph’ before delivering the lines ‘Remember me, Remember me. The time is out of joint.’67 This means the photograph that is found will be different each night, creating a new context for the lines, imbuing them with new meaning in each delivery. In the closet scene, the photographs are a vehicle for Hamlet’s expression of anger: Hamlet Look here, upon this picture, and on this. He throws the box of photographs at Gertrude. The photos are all over the floor, surrounding them.68

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This action is echoed when, after the death of Polonius, Ophelia in the midst of her mad scene ‘slowly and deliberately stamps on the photographs, trying to obliterate them’.69 The photographs are themselves a representation of the interplay between subject and object, self and other. Indeed, in explaining the significance of the photos in the production, Hunter makes this explicit in her citation: ‘Poor Ophelia divided from herself and her fair judgement, without the which we are but pictures or mere beasts.’70 Moreover, the extent to which the ‘I’ and the ‘we’ can ‘take the shape of contact with others’, to use the terms from Ahmed’s account, is epitomized in Hamlet’s fusion with the Ghost: We wanted our Hamlet to be possessed by the spirit of his father at the beginning of the play and speak the entirety of the Ghost’s speech as if in the midst of a profound haunting, allowing us to place a divided self in the physical and emotional centre of the stage. The Ghost’s second visitation is arguably more torturous, ripping Hamlet to shreds and witnessed by his mother who ‘sees’ and ‘hears’ her dead husband through the body and voice of her possessed son.71

While the influence of Laing is also important to Hunter’s Hamlet, her approach is sensitive to and reflects the contemporary concerns that have contributed to the affective and cognitive turns in both feminist and theatre scholarship, addressing the relations between body, mind, environment and language, emotion and affect in the exploration of identity and psychic distress. In Hunter’s play, Ophelia’s lines (and Gertrude’s) are uncut: ‘all the words Shakespeare gave the two women are there’, Hunter declares. This interpretation, while complementing the feminist strategy of revising and rehabilitating representations of mad women, is also driven by Hunter’s declared conviction that ‘acting comes out of listening’. This takes us to Harpin’s similarly expressed concerns, cited earlier, and links to Goodbody’s Gertrude. In listening to Ophelia, there’s an understanding of what her madness tells us and what it needs. However, the emotion associated with Ophelia’s madness in Hamlet, Who’s There? is differently conceived to Goodbody’s interpretation and is far from empowering or emancipatory. Hunter doesn’t oppose the negative with a positive by replacing a stereotypical model of hysteria with a revolutionary one. Her attention to the ways in which Ophelia’s sense of self is shaped through her relations with others and the interactions between emotion, language and bodies are evident in the staging of Ophelia’s madness, influenced by the 2014 concentration-camp documentary Night Will Fall:

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One image they filmed unendingly was the piles of bodies, many with people still alive at the bottom who had stayed motionless to save their own lives while lying underneath the corpses of their loved ones. I was struck by the impossibility of staying sane while lying under such a pile which led me to invent a key moment for Ophelia. In the middle of our play, when Hamlet’s crazed energy is flying out at whoever is in his sights, Ophelia runs away and hides under a blanket behind the sofa. At the beginning of the closet scene Polonius hides behind the sofa unseen by the audience, unaware that his daughter is there. There he is killed by Hamlet, thus dying on top of his daughter who lays, too terrified to move underneath her dead father. When Hamlet finally leaves the room Ophelia crawls out from underneath her father’s corpse covered in his blood, with no wits left to hold her together. Divided from herself. Halfway through the ensuing mad scene she crawls on to the sofa and wraps herself in Hamlet’s blankets. Her brother comes into the room looking for his family and finds his father dead and his sister mad, thus continuing the transference of grief.72

What we see here is an explicit engagement with fear, attending to the specificities of emotion and how it affects action, rather than a representation equating Ophelia with emotion as a conglomerate or hysterical excess. Also striking in relation to Ahmed’s theorization is a moment where disgust is staged, as Claudius ‘retches like a bilious dog’ throughout his repentance speech.73 This was also inspired by film, in this case Joseph Oppenheimer’s 2012 documentary about the anti-communist cull in Indonesia, The Act of Killing, in which the perpetrators of genocide (wealthy ex-gangsters) repeatedly re-enact their methods of slaughter, culminating in the protagonist (Anwar Congo) retching and howling like an animal in selfdisgust, a physical response to the realization of the effect of his actions on others. As Ahmed has written, the effect of disgust is physical as the body pulls back in abjection from the object to which the disgust is attached; it is performative, ‘not only as the intensification of contact between bodies and objects, but also as a speech act’.74 Hunter’s interest in epigenetics resonates in the staging and is similarly in tune with Ahmed’s concerns to preserve histories of injury, challenging therapeutic notions that equate ‘good’ feeling with being open and ‘bad’ with being closed. Hunter recognizes the importance of embracing both the ugly and the beautiful in the chemistry of staging emotion and the means through which performance affects. An actor preparing for Hunter’s Hamlet refers to their being ‘no nesting in emotion’75 and also expresses a dislike for actors who ‘switch on’ tears. Hunter describes Hamlet as ‘being allergic to anything not authentic’, playing

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with his awareness of madness as a performative act: hence Hamlet ‘has a mad screaming tantrum to get everyone’s attention’76 prior to this version’s reworking of The Mousetrap. He becomes the director of this drama of the mind, controlling the actors in the game he initiates of ‘who killed the king?’ At this moment, the tension lies in the space between reality and pretence as Hamlet’s performance moves beyond linguistic structures: ‘needing to get everyone to come to him [Hamlet], destroys the fabric of the proceedings and deliberately comes out of the form of Shakespeare’s language. He screams and shouts, turns upside down, bangs on the drums, whoops and whistles, dances, falls on the floor, cries and laughs hysterically’.77 This is a playing with madness as the mask is unsettled, the other characters are unsure of whether the antics are feigned or genuine and their anxiety means they respond to his demands to play the killing game. The authenticity that Hunter advocates involves the balancing of technique and feeling in acting, in ways which are consistent with cognitive theoretical approaches to theatre and performance and the understanding of the physiological relations between bodily action and emotional experience so that the staging of emotion is not necessarily psycho-‘logical’.78 By performing psychologies the relations between subjectivity and the psyche as well as the I and the eye are challenged as dominant meaning-making systems. Hunter’s approach reflects her understanding of different modes of sense making and of neurodiversity through her work with autistic children.79 This physical approach is very much concerned with the musicality of language. In Hamlet, Who’s There? music is an actor, with a drum kit stage left as significant as the sofa just off centre. The sofa is an affordance that is both beneficial and injurious as a comforting space for Hamlet’s melancholy and Ophelia’s despair and as a facilitator in the multiple deaths as Hamlet leans over it to stab Polonius with Ophelia concealed underneath. Following Hamlet’s ‘what a piece of work is man’ speech Laertes ‘plays a blistering drum solo. Hamlet lies on the sofa the whole way through, listening and watching. Throughout the drum solo Laertes becomes increasingly crazed and cries out towards the end’.80 In a subsequent scene, Hamlet ‘sits at the drum kit’ to deliver his ‘To be or not to be’ soliloquy while Ophelia ‘sits on the sofa reading’ with Polonius and Claudius hiding behind it.81 This production, like so much of Hunter’s work, operates in the interspaces of language; it is experienced in the gut, communicating ‘the feeling of what happens’, to use Damasio’s phrase.82 ‘In her discussion of autistic perception, the philosopher and arts practitioner Erin Manning, cites an anecdote by the blogger Amanda Baggs: ‘I know an autistic woman who failed a test of nonverbal communication because it used actors and she kept describing their real feelings instead of their acted ones’.83 Perhaps this is the ‘real’ that lies at the heart of Hunter’s

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methods. Baggs is cited by Manning in The Minor Gesture, a book in which neurodiversity is the disruptive and creative force, ‘defined by its capacity to vary, not to hold, not to contain’. Manning asks a question that is crucial for this volume: ‘how to articulate modes of existence, to articulate fields of experience, that operate as much in the non-conscious as in the conscious realms, how to do so in a language that operates chiefly within the realm of the conscious’. In the chapters that follow and in a minor key, performance practices operate at this cusp, offering insights into and imaginative engagement with neurodiversities, variously categorized as dementia, autism, depression, schizophrenia and the associated spectrum of experiences defined as ‘atypical’ or mad. I conclude by returning to the cover image, which, in its coalescence of male and female, the natural and artificial, human and non-human, life and death, is an enactment of the minor gesture, as conceptualized by Manning, also positioned between theatrical pasts and performance futures. The work discussed, through various forms of arts practices, enacts the minor gesture. It is a means ‘to think ecologically from the middle’ in the ‘cleaving’ of experience and in so doing creates ‘a form of listening that hears the untimely noises of what cannot even be contained in the words that describe the event’.84

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Paying Attention to Meanings in the Psychological Sciences and the Performing Arts Philip Barnard

During every moment we are on the stage, during every moment of the development of the action of the play, we must be aware either of the external circumstances which surround us (the whole material setting of the  production), or of an inner chain of circumstances which we ourselves have imagined in order to illustrate our parts.1

Introduction This chapter discusses how we experience mental imagery and attend to meanings about the self, others and the world. These are themes that lie at the heart of many performing arts and are vital elements of clinical applications of basic psychological science. Performing artists, practicing clinicians and scientists are naturally drawn from distinct communities of practice who place different emphases on rigour and richness in how they address such themes. The discussion here focuses on the concept of an ‘attentional score’. This concept emerged in 2013 in a studio during the making of the work Atomos by choreographer Wayne McGregor. It was developed as one element of a suite of strategies for enhancing the mental skills of contemporary dancers when creating and performing new movement material. McGregor gives dancers instructions to work with specific properties of mental images, to translate those properties into novel movement phrases and to assess bodily feedback to modify and develop their phrases. They are attending to meanings about bodily attributes of self as well as to conceptual attributes of images and movements. They are also attending to significant others, such as McGregor providing instructions or feedback, and to the actions of other dancers who are following the same instructions.

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The strategies for enriching dance creation were developed over ten years and blended aspects of a model of the architecture of the human mind, called Interacting Cognitive Subsystems (ICS), with McGregor’s studio-based practice. Importantly, ICS had already been applied to analysing mental health conditions with implications for therapeutic interventions. Once developed, the concept of an attentional score offered a means of balancing rigour and richness that enabled several strands of reasoning about meaning and attention across both arts and clinical applications to be drawn together. The resulting intersections are elaborated in later sections. For those with a humanities background, it is important to note that models like ICS do not just offer ‘an idea’ that can be woven into discourse on a shared topic of interest. As a macro-theory, the full resources of ICS need to be introduced before we can examine how its perspective on meaning and attention can contribute to work in a performance studio or mental health clinic. The next two sections introduce ICS by adopting an evolutionary perspective. While subsequent sections concentrate on choreographic and clinical interventions, by its very macro-theoretic nature, potential applications range over numerous other territories in the humanities, performing arts and contemplative studies. It is now many generations since Stanislavski referenced inner experiencing, embodiment, mind, will and feeling in the construction of a general theatrical sense of self, and the opening epigraph relates to just one facet of his views. Across subsequent generations of practitioners in the performing arts and humanities, many communities of practice have evolved that make reference, in their own favoured terminologies, to aspects of meaning and attention. Many different terminologies are also in use in clinical communities. The evolutionary perspective offers a way of grounding and sharing what we mean by images in the mind, attention and multimodally derived systems of meaning. The differentiation of mental capacities across an evolutionary time span directly confronts the intricacies of interrelationships between attention, emotion and the active construction of mental images in the mind’s ear and mind’s eye. A fully differentiated ICS provides a unified perspective on the extraordinary range of mental imagery that can play such a central role in creative and therapeutic contexts.

The composition of minds, meanings and attentional scores A recurring theme in cognitive psychology is the concept of limited attentional capacity. Most readers will be aware of the cocktail party phenomenon,2 where we easily single out one conversation among many in a crowded social context.

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The metaphor often used is of a mental spotlight moving around entities in our visual, auditory or bodily scenery with only selected material gaining access to the central processes that underpin thinking, emotion and actions in the world. It is helpful to elaborate this basic idea by considering one detailed view of how the mind of a mammal such as a wolf is organized and how its attention might work before progressing to our own more complex minds. Figure  3.1 illustrates one way of theorizing about this. It supposes that the architecture (A) of our wolf ’s mind is divided into four basic units (Bs) referred to as subsystems. Three of these are sensory-perceptual subsystems operating on visual inputs, acoustic inputs and states of the body. The fourth subsystem integrates the products of perception to create a multimodal synthesis that can be used to control somatic, visceral and skeletal responses. Importantly, emotions or ‘core affects’3 reside within this multimodal subsystem. Notice that each of the four subsystems of mind has the same internal architecture. The constituents (Cs) are an image, a memory and processes. The image component can be understood by considering what we ourselves experience. The images in the sensory subsystems are what we

Figure 3.1  A four-subsystem mental architecture. Photo: Steve MacIntyre.

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‘see’ and ‘hear’ out there in the world or what we experience as sensations in our bodies. These images are dynamic – they have an extent in time. We experience branches swaying in the wind, the changes in pitch in the characteristic call of a cuckoo, or we experience the dynamic embodied sensation of stroking a cat. The memory component encodes and models the regularities underlying what is experienced in these images. In these three examples it would be what psychologists call perceptual learning. The  contents of these memories are modality-specific and capture the essence of what goes with what in a given modality and how the patterning of what goes with what changes over time. The process constituents create images and memories, access them and then transmit information from one subsystem to another or to control somatic, visceral or skeletal responses. Figure  3.1 captures only the configuration of process that transmit information into and out of subsystems and represents them as arrows. To keep things simple, the internal architecture of how processes create and use images and memory content is not elaborated here. The multimodal subsystem has exactly the same components. The image contains a synthesis of its three multimodal inputs. When information is transmitted from the sensory-perceptual subsystems to the multimodal subsystem, what is actually passed is not the original input but a simplification of it – more like a summary or a precis. This simplification discards the detail but retains essential features represented in an abstract form. What is synthesized and experienced in the multimodal image is thus a coalescence of abstract features that capture a sense of self (wolf) in a state of their body and the physical and social world around them at the time. That sense may be affectively neutral or affectively charged. Since mammals of this type are born with innate action predispositions, multimodal patterns simply trigger actions that are best tuned to the context – for a wolf the action repertoire might include to attack prey, greet conspecifics in the same pack, retreat, suckle, groom, just scan an environment or actively navigate through it. Action selection is guided by core affects. It is helpful to think of what is experienced as multimodal image content as a ‘sense or feeling’ – a term we ourselves use to describe our more ineffable experiences. The memory component in this case models regularities that interlink these multimodal patterns with adaptive actions. While the multimodal memory mediates classical and instrumental conditioning, these processes are typically studied in laboratories with simple stimuli and responses. In more ecologically valid contexts, it is worth emphasizing that the multimodal memory system is effectively building abstract schemata that, for social animals, support a rich repertoire of behaviours. We tend to think of animals as responding ‘simply’ on the basis of the adaptive benefits of actions. However, we can equally well

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regard them as responding on the basis of an intricate system that encodes cognitive–affective meanings about the self, the world and others, but in a rather less abstract form that we ourselves use. The ICS approach to attention4 adopts the widely held assumption that any one process can do only one thing at a time. Additionally, it proposes that information can be processed directly from moment-to-moment input to a subsystem or indirectly with a short extra time lag by accessing image content. Since images have temporal extent this enables processes to ‘see more’ and react more robustly. This was given the technical name ‘buffered processing’. When buffering is occurring, the internal reconfiguration of processes delays the onward passage of information by a small amount of time, but only for the information being buffered. The theory further holds that only one process can be working in the buffered mode at any given time. These considerations map onto qualitative differences in awareness. In the case of our hypothetical ‘wolf self ’, the construction of images creates a mental landscape of diffuse awareness of image content in all four domains of vision, audition, body states and multimodal synthesis. However, the theory holds that the wolf, like us, can only be focally aware of information in one of these four domains, and that the selective nature of buffering means that they will be focally aware of only one ‘stream’ of information within that domain. This implies two different facets of shifting what is in focal awareness. One facet involves moving attention among entities in the same domain, for example vision, as would happen when a wolf shifts attention from one potential prey animal to another in a herd. The other facet is shifting attention from one of the four domains to another. We can explore these facets by examining Figure 3.2.

Figure  3.2  Illustrative traces of image content in a basic mammalian mental architecture. The content of focal awareness is captured in an attentional score.

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Figure  3.2 adopts the form of a musical score. The top four staves capture attributes of image content from each subsystems shown in Figure 3.1. Naturally the ‘full’ contents of these images would be extensive. Here, for illustrative purposes, each stave simply traces a single stream of information that is changing over time. The particular stream that is in focal awareness is highlighted by emboldening the relevant segment, and shifts of attention are marked out by arrows directed from one stave to another. This score could describe a wolf at rest on the prow of a hill, initially attending to the multimodal flow experience when the appearance of a sound-related blip in its multimodal synthesis leads its attention to shift first to locate the sound, then to its visual image to identify the source and the reaction of its fellow pack members followed by a bodily stretch before a multimodal synthesis again becomes the attentional focus to control the behaviour of moving off to initiate a hunt with others in the pack. The bottom stave is the attentional score. This stave identifies the content of focal awareness. From a biological standpoint, a good case can be made for the home state for focal awareness being on the contents of its multimodal image. The  multimodal synthesis contains the ‘best’ overall information for controlling action selection since it is sensitive, moment to moment, to what is out there in the world and to the state of the body. If sated after a meal, a wolf would not be interested in more action unless threatened. Further, when uncertainties arise, the wolf may benefit from shifting focal attention to sensory images to refine or enhance multimodal image content. There is no need for a homunculus to decide where to move the ‘spotlight’. It was noted earlier that the buffering of information in a sensory image introduces a lag in the onward transmission of information to the multimodal image. This means that when the focus of attention is at the multimodal image all three sensory flows arrive in temporal unison. Where attention shifts to any one of the three other images, that pattern will change in a manner that reflects the particular sensory subsystem whose image content is in focal awareness. The memory component of the wolf ’s multimodal subsystem is not just modelling patterns of information out there in the world or in its body, it is also modelling patterns of attention. This means that the mechanics of shifting attention are an integral part of the multimodal synthesis and its system of meaning, not something separate. With a four subsystem architecture, these together shape its sense of self and how it models the behaviour of others and the world. A wolf ’s system of meanings will be constrained by its perceptual capabilities and, as a highly social animal, its system of meaning would also be different from less social mammals. It may not be particularly ‘deep’ but it most certainly requires a rich characterization.

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The attentional score offers a potential medium for interdisciplinary discussion of our awareness of cognitive–affective imagery. The score marks out where attention is located within the overall mental landscape and how long it dwells there. So we can think of periods where attention dwells at the same image and on the same stream of information as ‘taking a long look at something’, while shifts of attention of shorter duration are more akin to just glancing at different images or streams of information. The longer looks at some element can be thought of as elaborated processing of a theme, while the shorter glances can be thought of as perhaps just ‘noting’ the presence of information but then not processing its content to any great temporal extent. In addition, just as a musical score can be annotated in different ways, attentional scores can be annotated in a manner that best suits the particular intellectual filters that may apply when the rigours of basic laboratory science are in place, or where clinical sciences and the worlds of art practices seek to express similar ideas but with greater richness of meanings. For example, we can consider what part attention plays and how it switches from bodily experiences to visual dynamic or music in the kinds of tasks used in a dance or drama studio. In order to address these issues in later sections, we need to consider the human mental architecture with its more advanced capabilities for imagination, abstract thought and creativity.

Meanings, imagery and attention in the human mental architecture The ICS architecture has, in part, been justified through developing an evolutionary argument that advanced cognitive capabilities were supported by the addition of new subsystems.5 In an information processing equivalent of cell division, the functions of the multimodal subsystem of Figure  3.1 subdivide and a new daughter subsystem emerges. This argument held that subsystems were added first in the domain of spatial cognition, with the emergence of a fifth subsystem to handle skeletal control following the evolution of dexterous hands and bimanual manipulation. This in turn led to the emergence of a sixth subsystem to process more abstract mental representations of spatial-praxis.6 To make this concrete, the image of the spatial-praxic subsystem equates with what we experience as dynamic visual imagery in the mind’s eye rather than the images of the world ‘out there’. The theory holds that this form of advanced cognition evolved in the last common ancestor we share with great apes. The process then repeats across the hominin line but in the vocal domain. A seventh subsystem was added to control complex vocal articulation and an eighth to process more abstract

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mental representations of sounds and words – a phonological subsystem. The mental image associated with this addition is the inner ear, or what we experience when we imagine someone speaking to us or generate an image in our heads of a musical phrase. At this point in evolution, our immediate precursor species have really quite sophisticated verbal and spatial skills and out of these skills emerge a new form of meaning – and with that the ninth and final propositional subsystem that encodes conceptual meanings. The nine subsystems of the ICS mental architecture are shown in Figure 3.3. Elsewhere we have argued that ICS is sufficient, with necessary recourse to additional assumptions, to develop wide-ranging accounts of human mental abilities for laboratory tasks and practical applications in the real world.7 For the current discussion of attentional scores, two features merit further elaboration. First, the five new subsystems augment rather than replace the

Figure 3.3  The Interacting Cognitive Subsystems (ICS) mental architecture with nine subsystems. Photo: Michael Shelford.

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four subsystems of Figure 3.1. Indeed, the signature of that architecture is retained here with the four original subsystems shaded in black with the new subsystems shaded in grey. Importantly, the subsystem that was referred to as the ‘multimodal’ subsystem is now re-designated as the ‘implicational’ subsystem. This reflects the fact that it now receives additional input from the propositional subsystem. Implicational meanings now synthesize inputs from the self in an environment (visual, acoustic) and in a body state with the products of propositional thought. The implicational subsystem creates and relies on deep schematic abstractions about regularities of experience across all modalities that most usefully resonate with experiential descriptions such as wisdom, intuitions or feelings. Emotions are retained in this subsystem. It is here that the mind builds mental models of the self, other agents and the inanimate world. The new propositional subsystem captures the essence of specific ideas and the properties and relationships they exhibit. Propositional meaning carries no affective charge and is the sort of meaning that we express in sentences and use to solve intellectual problems. As with the discussion of attention and meaning in the context of a four-subsystem architecture, entwined within these propositional and implicational mental models are also the constraints, both innate and acquired, that govern shifts in attention. In sum, the nine-subsystem architecture has two qualitatively different types of meaning, and these two forms of meaning can enter into reciprocal dialogues that enable humans to develop and reorder ideas – a feature which, among other mental skills, supports creative thinking. This dialogue has been described as the central engine of human ideation.8 A useful exercise to help grasp how this approach can support analyses of our mental life is to trace through the pathways involved in different tasks. Language understanding requires a chaining of processes across subsystems and concurrent generation of content in their images (acoustic-phonologicalpropositional-implicational schemata), while language production invokes a partially overlapping inverse sequence (implicational-propositionalphonological-articulatory). A sense of meaning or a specific property can be expressed in gesture or movement, as when talking about being ‘uplifted’ is accompanied by a simple physical gesture of a hand being raised. In this case, parallel outward routing passes directly from implicational meaning to skeletal control – note the relevant arrow in Figure 3.3 passes behind the propositional system rather than through it! In other cases of the conceptual control of a more intricate and movement sequence, the outward flow might pass through the spatial-praxic subsystem. Inspection of Figure  3.3 shows that the phonological and spatial-praxic subsystems act as gateways between incoming and outgoing pathways. This means that there is the potential for the four central subsystems to interact with one another without necessarily

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controlling overt movements or vocalizations. These internal mental dialogues or processing ‘loops’ are summarized informally in Figure  3.4. These interactions are the stuff of human thinking and were the motivation for naming the model Interacting Cognitive Subsystems. With the full ICS architecture, we would need to address attention by preparing a score for a nonet with ten staves – one for the image content of each of the nine subsystems and a tenth – the attentional score – to summarize the content that lies in focal awareness. Since the central subsystems interact, the shifts among the central loops are less constrained by states of the world and body and are now more open to the constraints of mental habits. Further, we have to contend with two forms of meaning and knowing contributing to the control of attention and action. We can caricature these as knowing what to do or think ‘with the heart’ (implicational meanings) and knowing what to think or do ‘with the head’ (propositional meanings). Both of these contribute to shifts in attention. Since the wolf multimodal schemata were simply a synthesis of perceptual and bodily experiences, its meanings were formed from just two layers of processing. The wolf ’s attentional scores are necessarily ‘mindful’: its experience is embodied and directly in touch with moment-to-moment changes in the world. In marked contrast, the example of the chaining of mental processes in language comprehension illustrates that implicational meanings can encapsulate abstractions that include elements that are four layers deep. The thinking and attentional shifts that underpin abstractions about the self, the world and others include products of what has been thought or imagined rather than being directly coupled to

Figure 3.4  An informal characterization of the kinds of internal loops within the ICS architecture that support thought, be it a reflection of well-practiced mental habits or novel creative insights.

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events in a physical and social world. While being mindful in the present moment was a way of life for the wolf, it is far from the only attentional stance that humans can adopt. When we have a musical score – say for a symphony – that score expresses instructions for what should be played and how it should be played. Clearly, with a nine-subsystem architecture, seeking to mirror such a level of detail would be a task of intractable complexity. However, we can use a score-like notation to characterize the idea of where attention characteristically dwells, what it dwells on and how it typically shifts as well as simple annotations describing content. Whereas our wolf could shift attention among its perceptual systems and a single multimodal image, Figure  3.4 identified four purely mental images at which focal attention can reside and dwell for varying amounts of time. In everyday discourse, we describe some people as visualizers and others as verbalizers; we may also place individuals who are more likely to respond intuitively/empathically in one conceptual pigeonhole and those who respond conceptually and deliberatively in another. Not only can we regard such distinctions as reflecting differences in how they distribute their attention among these four loci, we can also consider how expertise in domains such as the graphical arts, music, drama or dance leads to alternative pathways for differentiation of mental models of the self, the world and others and to patterns of attention to image content.

Attentional shifts when making movement material in contemporary dance Contemporary dance is of interest because the creation of new movement material is an integral part of what the community of practice does. Dance is also created and performed in a multimodal context that encompasses acoustic, visual and body state components. During a decade-long collaboration between the dance company of Wayne McGregor9 and a group of cognitive scientists, one strand of research sought to examine how movement material was created and to explore how knowledge from the cognitive sciences might be recruited to engage more fully the imaginations of dancers while creating new material. It was this strand that gave rise to the concept of an attentional score. McGregor often asks his dancers to use imagery as a means of exploring new movement vocabularies. The dancers individually explore the movement possibilities that a given set of instructions afford. Following an initial generative phase, McGregor will select and edit material that best expresses the properties he is interested in. At the outset of this research, it was not only acknowledged that the dancers had habits

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of movement – their characteristic movement signatures – but they also probably had habits of mind when generating images, when translating those images into actions and when evaluating how good or appropriate a particular movement felt. In addition to setting these tasks, McGregor resources his dancers with ideas about how to transform their mental images as a way of exploring a richer range of movement possibilities. Figure  3.5 illustrates a dancer working with spatial-praxic mental imagery of a bell in response to the ‘imagine an object’ instruction. The dancer is describing the bell through arm movements. In exploring movement possibilities, the dancer might, for example, relocate the bell in his or her imagination to be higher up in space, resulting more in the exploration of reaching actions than those involving bended knees. Likewise rescaling the image size or viewing the bell structure from a different perspective – from above or below rather than side on – would provide a different shape to work with and the description in movement might be achieved by using their legs to describe part of the image rather than their arms. In order to investigate their mental habits, we asked the dancers to follow the two kinds of instructions shown in Figure 3.5 and periodically stopped them and asked them to report on the imagery they had been using. Some sample data are reproduced in Figure 3.5.10 Each spoke of the spider’s web

Figure 3.5  Two imagery-based instructions and dancers’ experiences sampled while creating movement material (May et al. 2011). Image of Agnès López Rio in Dyad 1909 project (choreographed by Wayne McGregor) with David Kirsh, UCSD, 2009. Photo: Adrienne Hughes.

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indexes the dancers’ experience using qualitatively different types of mental image. The black and grey polygons, respectively, show the distribution of reports for the two forms of instruction. Each polygon captures the pattern of what the dancers reported to be in their focal awareness. The  further out along a spoke, the higher the percentage of the probes gave rise to that form of image. Notice that focal awareness of emotions, intuitions and limb/muscle control is particularly infrequent when creating with the feelings resulting from familiar music. Of rather higher frequency are verbal thoughts, body sensations, propositions (ideas) and images from external space. When creating using imagery of objects such as the bell, the dancers are, unsurprisingly, more aware of spatial-praxic images, body sensations and the muscular control of their limbs. When these patterns were fed back to dancers, they were made aware that how they distributed their attention was not fixed but varied in ways that they had not reflected on previously. The two tasks implicitly invoked attentional scores with different distributional properties. This led to a recognition that just as they could transform image content to realize new forms of movement, so they could redirect their attention to different images in their own mental architecture and that too could be another resource for breaking habits of thought. It rendered explicit the idea that they could intentionally rewrite their own individual attentional scores. For example, if they were working with an image of a bell in their mind’s eye and that generated movements that felt uninteresting, they could shift attention from spatial-praxis to a particular sound of a bell and work with one or more attributes of what then came to mind. This could be a reverberating echo in the mind’s ear. The dancers might then generate a reflected movement analogous to a sound echo, allowing them to explore other properties such as magnitude and temporal lags as variants of the movement. From this point of departure, the research collaboration focused specifically on the development of what became called choreographic thinking tools to enhance the imaginations of the elite dancers in McGregor’s company. This was a collaborative design exercise in which techniques were explored for the dancers to reflect on how they were generating specific images, the principles they were making use of to transform those images and, finally, the strategies and tactics they were using to translate image content into movement. Part of this was based on studio exercises and part on basic lectures on the topics of mental architecture, meaning and attention. Tools to enable them to make notes about their experiences were developed alongside summaries of the principles. The contribution of cognitive science was the idea that during creation they were making use of three dialogues among the central subsystems of

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ICS that were shown in Figure  3.4. These mental dialogues are annotated in Figure  3.6 as three dashed ovals. These serve to highlight the fact that semantic imagery, spatial imagery and phonological imagery all intersect on and around specific ideas, in this case ideas about movement. While working with ideas and translating them into movement, the dancers’ attention may be primarily working in one of three modes – relating ideas to images in the mind’s eye or the mind’s ear, or evolving ideas in dialogue with potentially affect-laden deep schema of implicational synthesis. Each of these three dialogues are conducted entirely internally and, moment to moment, the dancer can intentionally switch his or her attention between these three loops. Of course, when actually moving concurrently translating ideas into movement, there is a fourth action-based loop in which the body state consequences of an enacted move are, in real time, fed directly back to the multimodal synthesis of the implicational subsystem where it would also be integrated with exchanges in the three depicted mental ‘loops’.

Figure 3.6  Mental imagery loops while thinking with the body.

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This enactment loop is shown as an external feedback loop in Figure  3.6. While the mental processing of ideas intersects at the level of propositional meanings, the external and bodily feedback of overt movement during enactment intersects at the level of implicational meanings. The dancers do not just think with their bodies; they are orchestrating their own use of multiple image systems as well. Such intersections of thinking both with the body and with the mind are not just an aspect of dance; they are, of course, the stuff of performing arts more widely. The idea of developing tools to exercise the dancers’ skills of imagination was initially seen as something to be done, rather like company movement class, as an intellectual rather than physical ‘warm up’ before the making of new choreography in earnest actually took place. After a week of exercises, the elite dancers became quite comfortable with talking about imagery loops, proprioceptive loops, properties and translations. Debriefing sessions following trials of the tools enabled dancers to share strategies and capitalize on collective as well as individual insights. Two follow-on projects reshaped the tools for use in educational contexts with dance students in secondary and tertiary education. Since younger students could not be expected to work with abstractions relating to imagery, attention, conceptual properties of movements or abstract principles, some imagery exercises were rephrased as questions to exercise the pertinent principles implicitly rather than explicitly. Figure 3.7a shows part of a lesson plan for exercising creative imagination within our spatial-praxic loop, alongside some clues for shifting attention. Figure  3.7b shows the instructions for creating a movement phrase very much like those discussed earlier in the context of Figure 3.5. Notice in both cases that questions and instructions implicitly recruit the principles that were explicitly discussed with elite dancers. For the teachers, the right-hand panels of Figures 3.7a and 3.7b make it clear what principles and attention shifts are invoked by the exercises. The idea of representing the development of creative content and shifts in attention during making in terms of an attentional score only arose after the initial research with choreographic thinking tools. In the making of Atomos, McGregor used a very sophisticated form of external dynamic imagery based on the rendering of a non-human body moving and evolving over time. This entity was rendered by artificial intelligence algorithms and was created to form an immediate stimulus for dancers to respond to. Aspects of its evolving behaviour were encapsulated in its name – ‘Becoming’.11 The dynamic image appeared on a life-sized monitor and was viewed with 3-D spectacles (Figure 3.8). Since there was no task to solve like those described in Figure 3.5, image generation in mind’s eye or ear would have potentially interfered with

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Figure  3.7  (a) Exercises and principles to support creative innovation in imagery; (b) instructions to translate imagery into novel forms of movement. Mind and Movement was produced by Studio Wayne McGregor. Original design by Magpie Studio.

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Figure 3.8  AI-generated imagery used as a stimulus for making new movement material in the creation of Atomos. Becoming and Company Wayne McGregor dancers. Photo: David Bickerstaff, courtesy of Wellcome Collection.

moving creatively in the moment in response to Becoming. One possibility was to concentrate on what could be achieved by exploring alternative ways in which the dancers might attend to what they were seeing and feeling. This spawned the idea of making an explicit score to guide what to attend to and how to attend to it – features that McGregor exploited by asking them to attend to the ongoing dynamics and, for example, shift from attending to how a specific part of Becoming was behaving to focus on more global senses of how Becoming as a whole was behaving. The idea of musical and choreographic scores of various kinds is one that dancers are very familiar with and they had no problems in extending it to what they were attending to and how they were attending. Once in place, it was then a simple step to retrofit the same concepts for task-based making. Figure 3.9 shows an attentional score prepared to capture features of what might happen when following instructions using imagery of a bell (Figure 3.5). It is important to grasp that this score is not intended to be descriptively accurate, or to represent exactly what would really be going on moment to moment in making, or to make scientific predictions. Rather, the score is intended as a communicative device for understanding studio-based work.

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Figure 3.9  A schematic attentional score for a segment of movement creation in dance.

It is a potential aid for recognizing mental states with particular properties and for identifying significant moments where interventions might lead to revisiting and remodelling mental skills underpinning creative endeavour. This particular score is retrofitted to link in with the ways in which our elite dancers appeared most comfortable talking about, and reporting on, their experiences during the development of the choreographic thinking tools. Hence, the focus of attention is notated as being mostly located in one of four loops. Three are derived from the interactions among the central subsystems (Figure 3.4) of propositional/spatial-praxic (visual imagery); propositional/ phonological (verbal imagery) and propositional/implicational (the dancers referred to this as the ‘deep schema loop’) and the fourth is mediated by feedback of actual skeletal, muscular and postural effects via the body state subsystem and any allied visual/acoustic correlates of those effects (Figure 3.6). Consistent with the data of Figure 3.5, this score also happens to exhibit a preponderance of working with visual imagery and bodily feedback. Notice in the second line of the score there are brief moments where attention moves to stimuli in the auditory and visual landscapes of the studio context. While our hypothetical score for the wolf was indicative of information streams, here the content of mental states can be indicated in the score while the annotations indicate key inflection points in the score associated with, for example, the use of a principle such as rotation to modify an image or the shift of attention from working in one mental imagery loop to another, in order to identify and work with a new property. In Figure 3.9, significant moments are annotated with vertical arrows and by use of upper case abbreviations. Double-headed horizontal arrows index the mental imagery loops.

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The choreographic thinking tools12 developed for dancers made use of experience sampling techniques to help them become more aware of how they were attending to what they were doing. The principles for manipulating image content and shifting attention were practiced in many exercises, and the dancers were encouraged to consider and develop their own principles to extend their scope. The reasoning behind the approach is that such practice would implicitly lead the dancers to develop new mental models to enhance their creative skills. In the case of dance, we have explored how attention, abstract properties of images, thinking by moving a body and senses of selfrelated meaning interact under circumstances where referential forms of meaning are, by and large, absent or implied. The idea of an attentional score has the potential to do useful work in another domain, that of mental health, where such meanings are prominent.

Attentional scores in mental health conditions and their treatment Over three decades ICS has been used to model the underpinnings of mental health conditions such as depression, bipolar disorder, schizophrenia, anorexia nervosa and anxiety states. While the language used here is very different from that used by other authors in this volume who tackle issues associated with these and other conditions, there are numerous shared concerns that could be explored and exploited. The ICS focus on meanings and attention in psychopathologies has been referred to as the ‘Schematic Model and Modes of Mind’ hypothesis.13 The schematic model focus relates to how meanings about the self, the world and others are represented as implicational meanings, while the modes of mind element references how attention is dynamically directed over time to images within the architecture. Importantly, this approach differs from standard medical models based on diagnostic categories. ICS analyses mental health conditions as states of mind that hold when the processing of meanings about the self, the world and others moves towards or beyond its normal range of functioning. Of course, sometimes that may be attributable to problems with the functioning of underlying neural systems, but many symptoms arise because the mind is processing meanings and feelings in atypical ways that compromise everyday living. The ICS architecture defines how processes in the mind are configured, and we can use that configuration to reason about what can go wrong and how it goes wrong. Repetition can assist in learning and maintaining habits while innovation requires forming new patterns of image content.

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The previous section has already discussed aspects of how intersecting mental loops interact in creative work and can counteract habits of mind. Information-processing loops of this sort can also enter atypical states that are relatively well understood in computational and control theory. If we apply this to the central engine of ideation – the propositional/implicational or deep schema loop – we can identify three straightforward conditions enabling patterns to move towards or beyond their normal limits.14 First, repetitive habitual thinking involving negative propositions about the self can be thought of as continually regenerating the same implicational mental model of the self as an ‘inadequate and useless person’. This is a negative feedback state in the central engine of ideation that has been associated with major depression – depressive interlock. Second, if mental models in place generate many different ideas that are invoked unchecked, then a positive feedback state may occur leading to a runaway pattern of dendritic thinking associated with creativity and, in extreme form, mania. Runaway anxiety can also be modelled as a state in which ideation in the central loops is unable effectively to modulate the feedback from somatic, visceral and other bodily states such as tremor. Third, the central engine involves reciprocal processing in which patterns of propositions are mapped into implicational meanings and patterns of implicational meanings are used to derive new propositions. These reciprocal processes occur in real time, and were one of those processes to acquire an atypical or variable temporal lag, it would lead to distorted patterns of meanings about the self, the world and others being projected into the images of the propositional and implicational subsystems. Such asynchronous processing has framed candidate explanations of the schizophrenic and autistic spectrums of disorders.15 Any complex system would be of little use if the tolerances on feedback or reciprocity were too tight. At some points in our lives, we all have repetitive thoughts about personal inadequacies or get overexcited about new ideas. Likewise, in hypnopompic and hypnogogic states linked to going to sleep or waking, or in dream states, we may all experience distorted patterns within our mental images. It will be recalled that models of the self, the world and others encoded in implicational and propositional meanings also inherently control how those meanings are attended to. So, particular experiential and attentional patterns may develop that predispose the individual to enter depressed, anxious or psychotic states. The inherent interlinking of mental model content and attention provides a key both to explanation and to the development of psychological interventions to alleviate symptom patterns. In the case of depression, for example, it has been proposed that depressed states are associated not just with the activation of negative models of the self, the world and others but also with an imbalance in

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the allocation of attention to the images associated with the two forms of meaning. The analysis, supported by evidence, suggests that focal awareness in depression is directed mostly at the two images within the propositional/ phonological loop discussed earlier. This corresponds to the experience of ruminative thinking in the mind’s own ear. Importantly, material in the landscape of the implicational image and hence the ‘bigger picture’ of the self in all its potential diversity is thus mostly out of focal awareness. Possible imbalances in bringing varied images into focal awareness are also assigned a major explanatory role in addressing other conditions. Anorexia nervosa, for example, is regarded as sharing with depression a relative paucity of focal attention to implicational image content but differs in that anorexics are seen as having far more agentful schematic models of self.16 In marked contrast, manic states are seen as involving the focus of attention dwelling excessively on the content in implicational images and a corresponding neglect of material in propositional images that could trigger feedback that supports more systematic checks on ill-advised thoughts and behaviours. When it comes to formulations of therapeutic interventions, it is useful to have a theoretically grounded account of symptoms that enables us to reason about how an intervention would act to draw the pattern of mental activity back into a normal or asymptomatic range. The issues associated with attention to meanings in dance focused on properties of images, meanings, movement and body states. Although the concept of an attentional score was created in a performance studio, that endeavour produced something that could also help us to reason about interventions in any context where self-related meanings are of broader scope and potentially open to disabling affect. While the theoretical claims had already been extensively developed, the concept of an attentional score offered considerable communicative value that would also be applicable in the clinical domain. To illustrate this potential, Figure  3.10 sketches out two hypothetical, and necessarily simplified, scores. In this case, rather than referencing loops, the focus of attention is notated at a specific image.17 Depressive rumination, shown in the upper panel, is often allied with an experiential focus on the verbal realization of negative thoughts about the self and catastrophic interpretations of events in the world. Consistent with the ICS account, attention in this score often focuses on propositional image content but rarely focuses on implicational image content. This might perhaps also resonate in other theoretical frameworks as a potential mechanism of experiential avoidance of unpleasant syntheses about the self and the negative affect that might result. Of course, no single score should be seen as definitive or representative of all forms of depression. Other

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fragments of score might bring sadness or lack of energy into focus more often than is the case in Figure 3.10. While depression and its close relative worry bring into focal awareness thoughts about specific ideas with mostly verbal form, other atypical mental states demonstrate many other forms of bias in what is experienced and attended. In post-traumatic stress disorder, flashback imagery may often intrude on day-to-day thinking, while atypical developmental trajectories, such as those characteristic of the autistic spectrum, may also be accompanied by specific patterns in which attention is distributed over time. Our own use of experience sampling in dance projects was actually inspired by the work of psychologist Russell Hurlburt, who had developed the technique to study the experience of those with mental health conditions. One such study with two other psychologists, Francesca Happé and Uta Frith, revealed that the thought patterns over time of three individuals with Asperger’s syndrome were dominated by imagery in the visuo-spatial domain.18 Given that other atypical states are associated with alterations to normal distributions of attention, the kind of attentional score shown in Figure 3.10 can be used to characterize important attributes of symptom patterns without necessarily requiring diagnostic categories to be applied. The broad outline given so far is sufficient to indicate how attentional scores can help determine what needs to be rebalanced to bring cognitions, and affective experiences linked to them, back into a less dysfunctional range.

Figure 3.10  Two illustrative attentional scores: One for fragments of depressive rumination and other for a mindfulness training exercise.

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In early developments of this approach, clinical psychologist John Teasdale entertained the idea that this particular form of theoretical analysis could be melded with features of eastern mediational practices such as mindfulness to form an intervention to bring the content of the implicational image more readily into focus.19 Subsequently, mindfulness-based cognitive therapy has been quite widely applied as a means of preventing relapse in patients who have already experienced multiple episodes of depression. The exact extent to which it is efficacious and the means by which it might be bringing about any beneficial outcomes still remain to be clarified.20 Early discussion of mechanisms within this mental architecture focused on how mindfulness might lead to new patterns based on buffering of implicational image content. However, such an account left certain challenges unresolved. In particular, mindful states are associated with being aware, moment to moment, of self in the world and body. Were the focus of awareness to reside solely at the implicational image, then this would place awareness of entities in the visual, auditory and bodily landscapes outside focal awareness. The evolutionary analysis mentioned in the discussion of a four-subsystem architecture suggested a resolution to this issue by making greater use of the idea of taking extended looks at one image, while glancing periodically at others. In discussing the attentional mechanisms at work in wolf cognition, it was argued that the most adaptive home state would be for attention to be focused on the content of the multimodal image while taking glances at visual, acoustic and body state images to refine or enhance content that was salient in the context of current behaviour. There were, of course, no central processing loops in the four-subsystem architecture. In marked contrast, in the nine-subsystem architecture, the focus of attention can move to many images and there may be different home states for intellectual tasks (extended focus on propositional meanings), for tasks engaging manual skills (focus on spatial-praxic image content) and for tasks relying on social skills (implicational image content). One way of resolving the theoretical problem is to view mindfulness not as a state of mind but as a dynamic for managing the allocation of attention. We can make theoretical sense of mindfulness by arguing that it returns the management of attention to something close to that used in wolf cognition while retaining all the advantages of the more sophisticated mental capabilities of the nine-subsystem arrangement. Put simply, if the focus of attention is not allowed to dwell at the propositional image, then we can think of the system having a home state with a focus on implicational image content, but only glancing at visual, acoustic, body state and propositional image contents.21 A stable means of managing attention in this way would prevent thinking getting stuck in ruts in either of the spatialpraxic or phonological-verbal loops.

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This state of affairs is reflected in the fragment of attentional score for a mindfulness exercise shown in the lower part of Figure 3.10. Notice that this score is dominated by attentional states dwelling for the longest periods on the content of the implicational image. The score starts with a focus on body state information and then shifts to an extended focus on broader feelings. This in turn is followed by brief glances at body state, visual, acoustic and propositional image contents. It is this look-glance dynamic that provides mindful management of attention with the characteristic concurrent blend of broadened intellectual and sensory awareness in the present moment. What follows in this score are three significant moments associated with mindfulness training – where a verbal thought intrudes it is noticed and let pass or attention is returned to the breath. A third significant moment concerns the occurrence of a spatial-praxic image which is also encouraged to pass unelaborated. As with the transformations and shifts in attention discussed for creating movement material in a dance studio, these techniques provide conditions where the mind itself can remodel how to attend to meanings about the self, the world and others. This kind of analysis is not just descriptive or a neat way of providing common communicative ground between science and art. It helps frame deeper questions about explanation. In the earlier discussion of the mechanism of buffering associated with focal awareness of the contents of a particular image, it was pointed out that buffering introduces a lag on the arrival of sensory data at multimodal image of a four-subsystem architecture. Much greater lags and disparities occur as a result of information being processed in a nine-subsystem architecture and around the three central loops schematized in Figure  3.4. One consequence of reducing shifts of attention within these loops so that information arriving at the implicational image under conditions of the mindful management of attention is that there will be less variation and shorter lags in the arrival in that image of related strands of information. Shorter lags and reduced variability improve the chances of the memory component of the implicational subsystem detecting and modelling regularities in the patterning of attention to meanings about the self, the world and others. This is a clear theoretical formulation of how mindfulness could be providing enabling conditions for beneficial cognitive–affective changes even if it does not guarantee them. In the context of the current volume, it is pleasing to note that a potentially helpful representation of a clinical intervention has drawn upon insights gained while working in a performance studio with dance artists. Note also that flow experiences in the performance of technical tasks and in the performing arts are potentially open to a dynamic allocation of attention not unlike mindfulness.

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Summary and opportunities for extension This chapter has addressed the challenge of balancing rigour and richness in bridging thinking across three communities of practice – basic science, performing arts and psychologists working in mental health practice. The  emphasis has been on the development of tools and techniques that can promote shared understandings. Although it has to be acknowledged that absorbing the ICS model itself requires considerable commitment and focused attention to meanings, the concept of an attentional score offers a platform for interdisciplinary dialogue. This in turn could yield a family of descriptive and theory-based tools that do real work in the studio, in the laboratory and in the clinic. Habits of mind play a significant role in movement creation in studio work and atypical forms of thinking about the self, the world and others. The idea of an attentional score provides a means both of exposing aspects of those habits and of reasoning about how to remodel those habits. It aligns well with what Stanislavski referred to as an ‘inner chain of circumstances we ourselves have imagined to illustrate our parts’. Mindfulness-based cognitive therapy is one of several third wave therapies. Compassion-focused therapy22 and acceptance and commitment therapy23 are two others. Each of these interventions would come with their own characteristic attentional scores emphasizing different aspects of attention to self- and other-related meanings. Rather like the symphonies of different great composers where there is a common underlying structure, third wave therapies may all be creating the same underlying enabling conditions for remodelling attention to meanings about the self, the world and others. In doing so, each form of therapy may be rewriting attentional scores to enable minds to focus on implicational image content, while only glancing at visual, acoustic, body state and propositional image contents. As noted earlier, in these respects, successful interventions may be returning the management of attention to something more like the patterns used by much simpler mammalian minds while capitalizing on the more advanced forms of meaning, imagery and mental multitasking. These particular third wave therapies also differ from a whole raft of other contemporary practices. Traditional cognitive behaviour therapy places an emphasis on challenging propositional thoughts24 while other approaches target rumination25 or imagery re-scripting.26 Figure  3.6 highlighted the idea that three imagery loops in the mind intersect one with another and also with an external feedback loop from states of the world and body. This structure can be used to pose research questions concerning alternative routes to promoting beneficial change. Mindful approaches may be emphasizing routes that

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work with a primary intersection at implicational meanings, while others may be primarily working with interactions in the mind that intersect at propositional meanings. In the studio-based interventions developed in collaboration with Wayne McGregor, it was sufficient for these interventions to be used and extended into the educational resource for workshops with students. No attempt was made to prove that they enhanced creativity27 or lead to beneficial change in other forms cognitive–affective ideation. Profound questions linked to beneficial change obviously arise with arts-based interventions such as drama, dance and music for those experiencing mental health issues. In these cases, there are many alternative interventions that have great richness and potential that is well illustrated throughout this volume. Yet there are wellknown issues associated with the extent to which there is good evidence of their efficacy. The attentional scores illustrated earlier pinpointed a number of significant moments, a term sometimes used in discussions of arts-based therapies with individual clients. The theory-based explorations of dance creation provide a concrete example of how practice-based research can refine research questions and to explore how to focus particular elements of technique on potentially fruitful outcomes with audit traces back into both arts practice and scientific theory.28 Here the concept of an attentional score has been illustratively, but separately, applied to issues concerning attention to meanings in both performing arts and mental health. A key challenge for the future would be to explore the utility of such scores for refining research questions at their intersections to bring about a rebalancing of rigour and richness.

Part Two

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4

Evaluating Atypical Imagination and Cognition in Autism: Working in the Arts/Science Interspace Ilona Roth

Hans Asperger, writing in 1944 and later translated by Uta Frith, observed that ‘Autistic children are able to produce original ideas. Indeed they can only be original, and mechanical learning is hard for them … the special abilities and disabilities of autistic people are interwoven.’1 Yet in 1991, Frith added this footnote to Asperger’s paper: ‘The appearance of rapt attention and deep absorption in their own preoccupations may be partly responsible for the belief that autistic children have a rich inner imagination. However, there is little evidence to suggest that autistic children have the same sort of fantasy life as normally developing children.’2 Asperger’s reputation as an autism pioneer has foundered following the shocking revelations of his role in Nazi euthanasia programmes.3 Quoting him here is in no way to endorse the man but rather to highlight some of the strikingly different interpretations of the autistic imagination that serve as background to this chapter. In examining research into those constraints on imagination typically considered characteristic of autism, I draw upon my experience as a psychologist specializing in the autism field, as well as my educational film work as an Open University (OU) academic. My long-standing personal interest in the arts and humanities began to infuse my work on autism in the early 2000s, when I conducted studies of poetry written by writers on the autism spectrum.4 I consolidated my arts base with an honours degree in humanities and Romance languages, completed in 2017. In a recent paper, I offer a poetic response to visual artworks by autistic artists.5 My ongoing quest for the rapprochement of science and arts forms a backdrop to this chapter, as does my engagement with the evolving culture of autism research over a number of decades.

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In what follows, I employ a first-person perspective rather than traditional scientific narrative to revisit video footage in which, over more than twenty-five years, I have sought to portray key findings about autism. Drawing upon five vignettes or ‘scenes’, I explore epistemological, interpretive and ethical issues highlighted by working in a space where scientific method is juxtaposed with the richer more individualistic interpretations that the video medium promotes. In the first three scenes, scientific tests of imaginative capacities are put under the spotlight and reconsidered in terms of questions and insights suggested by the footage. In the fourth scene, I interview a young autistic man, who offers ‘inside’ insights into his own skills and difficulties with social and individual imagination. In the fifth, I consider the life story and work of an artistically gifted autistic child.

Autism, case studies and psychological science The first descriptions of autism, by child psychiatrist Leo Kanner6 and paediatrician Hans Asperger,7 took the form of case studies, that is, detailed observations of characteristics and behaviour, together with developmental history, of individual children in their clinical care. Asperger, notably, described some of his young child patients as having clever if eccentric ideas and interests – what by today’s standards would surely count as imagination, albeit of an unusual kind. Yet both clinicians also described the narrow, restricted focus and adherence to repetitive behaviours and routines, which have been accepted as a hallmark of autism ever since. In DSM-5, the latest version of one of two internationally used diagnostic systems,8 this symptom cluster forms one of two main diagnostic criteria, along with problems in social interaction and communication. Case studies provide a wonderfully rich mine of information, but they are of their nature selective, reflecting what the author considers most significant, especially in establishing a new diagnostic profile or matching observations to an existing one. Alongside the 1960s paradigm shift to cognitive psychology, which promoted experimental studies of the human mind, it was inevitable and important that the behaviour of autistic children would be more systematically explored. Science also helped to challenge ill-founded theories and spurious claims of an autism ‘cure’. For instance, Bruno Bettelheim’s corrosive and stigmatizing theory that autism was caused by emotionally cool and detached mothering was countered, in part, by convincing scientific evidence for genetic influences

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in autism.9 Psychological and neuroscientific work has continued to play a key role in presenting a reliable and authoritative picture of autism.

Autism and imagination Theories about how autistic people think evolved in the 1980s, with the experimental work of Simon Baron-Cohen and Uta Frith, among others. Yet insights into imagination in autism remained fragmentary. Restricted and repetitive behaviours and interests (RRBIs), long recognized as diagnostic, implied that autistic individuals, with their strong dependence on structure, sameness and routine, would struggle to generate novel and original ideas and thus lack creativity. Kanner and Asperger had noted that their case study children showed little pretend play. For instance, instead of using a brick as a toy car, or a stick as a gun, they preferred to line up their toys or sort them by colour or shape. Baron-Cohen reported concordant experimental findings, although whether diminished pretend play reflects motivational or cognitive difficulties is a matter of some debate.10 Paradoxically, a small minority of children on the autism spectrum show exceptional talents in fields typically associated with creativity, including visual arts and music.11 The fact that these gifts are frequently attributed to exceptional memory and attention to detail conveniently sidesteps any challenge they otherwise pose for the diagnostic criterion of imaginationrelated difficulties. I argue for a more complex and nuanced account of creativity which better accommodates this work.12 Underlying the absence of a coherent picture of imaginative capacity in autism lies a wider lack of theoretical consensus about imagination and its relationship to creativity, which has been addressed elsewhere.13 For present purposes, I will adopt a broad definition of imagination as encompassing social imagination – the capacity to imagine what other people are thinking and feeling – considered fundamental for reciprocal social interactions, and individual creativity, the capacity to generate novel, original ideas and outputs.

The autistic imagination in film: Revisiting an archive As an OU academic, I have had opportunities to devise and present audiovisual resources for undergraduate distance teaching courses. In my earlier ventures, some doubling as BBC general service broadcasts, my aim was to demonstrate the methodology and theoretical implications of experimental

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and other scientific work on autism and imagination. This aim characterized the first three of the five scenes discussed here. My purpose now is not to question the important contribution of the scientific methodology and findings illustrated here. Yet in revisiting the footage with a more visual focus, I have observed nuances and considered issues that the experimental tasks were not designed to capture. I see cues from the children which might usefully have been pursued, and even missed opportunities to scaffold their responses to the tasks, but for the experimental design, and protocol which constrains an experimenter to adopt a consistent, neutral stance towards all participants. I have found myself questioning this studied neutrality and its epistemological and ethical consequences. In the two final scenes, interviews recorded in 2017, I adopt a different lens.

Scene one: The Sybil Elgar School, London, 1989 I am with an OU/BBC production unit, filming for an undergraduate psychology course.14 The Sybil Elgar School has a special place in autism history. It was the first school for autistic children established in the 1960s by the National Autistic Society, at that time a pioneering group of parents seeking better services and support for their children with the then little known autism diagnosis. These parents have fulsome praise for all that Sybil Elgar, the charismatic head – teacher, achieved with their children.15 Our filming starts in the school playground. The broadcast commentary highlights that the children tend to play alone and explains that they have ‘a condition known as autism’. I recall that the producer insisted on a male commentary ‘to suit the subject matter’. The rather portentous tones of my colleague, once an actor, bother me to this day. We film inside the school too, children in their classrooms, artwork on the walls and a poignant interview with two parents describing their feelings on learning that their child was autistic. Then we set up to record what is, in its way, a historic sequence of educational film. I had invited psychologist Simon Baron-Cohen, then not long out of graduate school, to reprise experiments he had published in 1985, which became landmark studies of autism, and launched his own distinguished career.16 In a school classroom, we recreate and record experimental scenarios illustrating the step-by-step sequence through which Simon tested his big idea. Our participants are two autistic children – Sara and Andrew – both aged about 11 and pupils at the school and as the experimental ‘control’, a younger neurotypical (non-autistic) child, Gabriel, aged about 4.

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Mirror recognition and self Simon first sits next to Sara, holds a mirror in front of them both and asks Sara to identify each person in the mirror. He repeats the test with Andrew. Both children respond, naming themselves and Simon correctly. Simon then comments that contrary to a theory prevalent at the time, this result shows that autistic children do have some sense of self: ‘At least at the lowest level of being able to appreciate that they are physical objects separate to other people.’17 Almost thirty years ago, this comment seemed broadly acceptable – a logical inference from the results. However, whenever revisiting the footage, I have found the observation dehumanizing. While I doubt that Baron-Cohen himself would use such language nowadays, here is an example of experimental stance setting the researcher apart from participants in a cool relationship of expert interpreting ‘subject matter’. This is not a question of unkindness: Simon cares deeply about autistic children and has devoted his life’s work to autism. But his communications with the children in this experiment follow a script, and his demeanour, though courteous, is detached – almost, one might say, a mirror for the behaviour he is studying. Yet with a different investigative stance, Simon could have asked Sara and Andrew to say more about the self they had recognized in the mirror, perhaps evoking interesting insights into the autistic sense of self and each child’s inner life. Whenever I look at this footage, I am struck by Sara’s proud, smiling demeanour. The appearance of depth and something enigmatic in her expression suggest an inner life far from Simon’s reductive account. Andrew, by contrast, is a reserved and sad-looking child, but here too there is surely a story. Perhaps these children could have talked about themselves and expressed their thoughts about the tests. According to the quote from Frith opening this chapter, little would come of such an exercise. Yet a number of autistic people, for instance Temple Grandin and Daniel Tammett, have written autobiographies documenting rich if unusual inner lives.18

Perceptual perspective-taking The mock-up laboratory is now rearranged. A toy telephone is placed on the table in front of the child, a toy frog on a table to one side and a toy elephant to the other side. Simon sits opposite the child directing his gaze to each toy in turn and asks Sara and then Andrew what he, Simon, is looking at. The children respond correctly each time, from which Simon concludes

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that, in a ‘purely perceptual sense’, these children can take the perspective of another person. Visually, they can see the world from another person’s point of view. There is no comment on the rather sophisticated visual processing required to work out where someone else is looking, to look there too and identify what they are looking at. Rather this result is framed as a comparatively unremarkable achievement compared with the challenge of the next test.

The Sally–Anne false belief task There is now a final scene change. Simon sits at the table facing Andrew and plays out a scenario with two small dolls, Sally and Anne, and some other props, describing each step as he goes (Figure 4.1). First he introduces and names the dolls and equips each doll with a small coloured ‘box’ (actually an inverted toy brick), placing a marble inside Sally’s box. He now walks Sally ‘out of the room’, saying that she is going out to play. He then walks Anne over to Sally’s box and enacts her removing Sally’s marble and walking back to her own box to hide the marble. He brings Sally back ‘into the room’. He now asks Andrew three seemingly simple questions, which form the core of the test: Belief question: Where will Sally look for her marble? (Correct response: in Sally’s box) Memory question: Where was the marble at the beginning? (Correct response: in Sally’s box) Reality question: Where is the marble really? (Correct response: in Anne’s box) Andrew follows the procedure closely with the rather impassive expression he has had throughout these recordings. He answers without hesitation, correctly pointing to Sally’s box in answer to the memory question and to Anne’s box in answer to the reality question. But his confident response to the belief question is that Sally will look in Anne’s box where the marble is now, not in her own box. Now it is Sara’s turn, and as before she approaches the task smiling, head held high and, notably, returning Simon’s gaze. But as for Andrew, her unhesitating response to the belief question is incorrect: Anne’s box, not Sally’s. The last participant is Gabriel, the four-year-old ‘control child’. As Simon explains, if much younger controls respond correctly, this rules out that the autistic children’s difficulty with the task reflects general intellectual delay. Gabriel answers all three questions correctly and grins conspiratorially at

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Figure  4.1  The Sally–Anne false belief task. The props differ somewhat from those in the filmed version but essentials remain the same. Image: The Open University.

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Simon when responding to the belief question, as if he knows that this is a game in which Anne has cheekily deceived Sally and hidden her marble. Why do the two older autistic children fail on the crucial belief question, while the younger neurotypical child passes? Simon attributes this to their inability to put themselves in another person’s shoes, mentally speaking. Unable to take the mental perspective of another, they fail to understand that another person’s belief about a situation may be different from their own – and in this case wrong. It is principally from the incorrect answers of children like Andrew and Sara in the Sally–Anne task, and performance in similar false belief tasks, that the highly influential idea of a ‘theory of mind deficit’ in autism took off, stimulating a veritable industry of further psychological studies and embellishments to the theory over subsequent decades. In  addition, the finding influenced the linguistic pragmatics approach known as relevance theory19 and the newly evolving cognitive approaches to literature. Claims about theory of mind problems in autism have nonetheless needed increasing qualification and revision.20 The validity and scope of false belief tasks as tests of theory of mind have been questioned.21 Not all children with autism fail false belief tasks and yet those who pass still have difficulty with social communication and interaction.22 There has also been an increasing move to recognize enhanced cognitive skills, for instance exceptional memory and attention to detail, in theoretical accounts. Accordingly, Baron-Cohen has reformulated his own theory as the ‘empathizing-systemizing model’.23 This claims that autistic cognition combines skill in systemizing, defined as an affinity for systematic, rule-bound domains such as mathematics and engineering, with a deficit in empathizing, broadly a reworked theory of mind construct. In one formulation or another, the notion of a theory of mind problem has prevailed with professionals in the autism field, albeit with many qualifications. There is no question that the children’s incorrect answer to the belief question in the Sally–Anne task suggests an important gap in their social imagination, which may help to explain the difficulties of both autistic children and autistic adults in social communication, as well as a marked literality in their understanding and use of language. But once again, close analysis of the video footage raises some additional questions. Firstly, the scenario is a piece of make-believe – a sort of puppet show, with Simon as the puppeteer, and Sally and Anne as the two puppets. Yet despite autistic children’s documented difficulties with pretend play, Andrew and Sara seem quite ready and able to engage with the pretence. Otherwise the question ‘Where will Sally look for her marble?’ would make no sense at all. Of course, it might be argued that it is precisely because the children’s understanding

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of pretence, necessary only to process the belief question, is compromised that they cannot answer this question correctly. But in replications of the experiment, with real people rather than dolls carrying out the actions, autistic children still answer the belief question incorrectly. In the present version of the task, the children’s ability to attribute human agency to the dolls is sidelined in the interests of the theory of mind headline story. The experimenter’s script for the task includes not only describing the actions of the make-believe characters but also giving feedback to the children. In keeping with the experimental protocol, to avoid biasing the  results or ‘giving the game away’, Simon simply says ‘good’ or ‘well done’  to each participant after each stage of the task. So Andrew and Sara receive the same  positive feedback on their incorrect response as on their  correct response. The merit of this approach is that the children are not  upset by being told that they have failed. Autistic children can be especially sensitive  to failure. Yet a kind word pointing out the correct response might have opened up a fruitful opportunity to ask the children why they thought that Sally would look ‘where the marble is now’ rather than where she had left it. Moreover, the script requirement for the children to receive inaccurate feedback poses an ethical dilemma, since it deprives the children of an opportunity to learn from their mistakes. Curiously, when giving feedback on the belief question, Simon’s tone seems just fractionally more positive and encouraging when addressing Gabriel. If this reflects a minute departure from the experimental script, this is undoubtedly unconscious – perhaps human nature and experimental rigour vying for the territory?

Scene two: Fawcett Primary School, Trumpington, Cambridge, 2001 For this second teaching video, entitled Imagination,24 that faculty has had free rein. The skulls of different hominid species are filmed in the Cambridge Museum of Archaeology and Anthropology, then juxtaposed with palaeolithic tools and cave art to illustrate human imagination evolving across the millennia. Children are filmed playing make-believe in a school playground. A gifted young pianist, Javier Negrín, is filmed at the Royal Academy of Music collaborating with neuroscientists trialling neurofeedback to enhance emotional and expressive engagement in performance. The artist Issam Kourbaj describes how images of his Syrian childhood have inspired his sculptures made with found objects, and the neuroscientist and theatre director Daniel Nettle improvises with young performance arts students,

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also considering possible links between artistic temperament and mental disorder. Now we are recreating experimental tasks testing the hypothesis that autistic cognition lacks such striking expressions of creativity. Fawcett Primary School is not a specialist autism school but has a policy inclusive of children with special needs. The experimenter is Jamie Craig, whose PhD, supervised by Baron-Cohen, focused on evaluating creative imagination in autism. His published studies are among the few in the literature on this theme.25 Our participants include an autistic pupil aged about eight and younger neurotypical pupils as controls. Jamie explains that unlike theory of mind and pretend play, which involve social imagination, the tasks we are filming test ‘individual creativity’ – what a child can imagine when not required to attribute intentions or take another person’s point of view. As will emerge, however, this social versus individual distinction is blurred. A child’s reading of the social context and implications of the task may influence the creativity that is expressed. The key task here is an adaptation of the Alternate Uses Creativity test,26 in which participants are asked to generate as many as possible uses for an object such as a brick. Their creativity or ‘divergent intelligence’ is scored in terms of the number and originality of uses they suggest. For instance, using the brick as a doorstop might score less than incorporating it into a robot sculpture. In the adapted version, the child is shown a piece of white foam, triangular, narrowing into a long thin strip. Jamie first asks the autistic child, ‘What could this shape be? What does it look like?’ The boy looks bored and uninterested, but he tugs at the foam and says ‘glass’, evidently seeing the triangle and its thin extension as the bowl and stem of a wineglass. ‘Good response’ says Jamie and prompts the child for another suggestion. When he holds the foam upright with the triangle at the bottom, the boy says ‘foot’ and enacts the foot walking across the table. After that he offers no more suggestions. Next Jamie presents the task to a neurotypical participant, a girl of about six. Her eyes light up and she smiles with pleasure. She turns the foam this way and that, modelling and describing her suggestions: extended, the foam is a snake, placed encircling her head, it is a hat, folded over it becomes a measuring rule, then a circle, a leaf and stem, a shoe and leg. Like Simon, Jamie keeps to the experimenter script, politely praising and recording each child’s responses. But, especially with the autistic child, he sounds uncomfortable, as if he would like to give more encouragement or cues. And of course his feedback phrase ‘well done’ is ambiguous. The autistic child’s responses are undoubtedly limited in number and originality compared to the neurotypical child’s, a consistent finding in Craig’s studies. But in some ways this difference is less interesting than

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the children’s strikingly contrasting approaches to the task, only apparent thanks to the recording. The little girl engages enthusiastically: each idea is enacted with flair and flows seamlessly into the next. Notwithstanding Jamie’s view that the task evokes individual creativity, social imagination infuses her responses. She has read the intention of the experimenter’s instructions as an invitation to perform and acts her part with the experimenter as her audience. Her creativity lies not just in the number and quality of her ideas but in the richness – not scored – of the enactment. By contrast, there is little social engagement and limited enactment in the autistic child’s responses. My question, again, is whether a differently framed task might have offered learning opportunities, albeit compromising the experimental aim of showing autistic children’s limitations. For instance, many autistic people have areas of special interest, sometimes unusual in topic, and pursued with high levels of commitment and motivation.27 If autistic children do not spontaneously see the alternate uses task as fun, perhaps imagination tests harnessing their special interests would evoke more enthusiastic engagement.28 Koegel and Porter both report such benefits in interventions, for instance an autistic boy was encouraged to pretend through scenarios involving his interest in trains.29 Notably, although not a fully-fledged performance, the boy in our video did enact a brief pretence, walking the imaginary foot across an imaginary floor. Thus another way to nurture such embryonic creativity might be through engagement with drama and fantasy, an effect demonstrated in the Imagining Autism project.30 Since Craig’s intention was scientific hypothesis testing, these suggestions for practical interventions might seem misdirected. Yet the footage has also effectively highlighted the theoretical question of whether Craig’s findings suggest a fundamental creativity block or just low creative motivation.

Scene three: Queensmill School, London, 2009 Queensmill is a state-funded primary and secondary ‘special school’ for autistic children, with an exceptional track record. Working with an Italian freelance film-maker, I have permission to video regular activities throughout the school, as well as to recreate experimental tasks. Video clips will be used in my new OU course ‘Understanding the Autism Spectrum’, combining online and hard copy teaching resources.31 Much as at Sybil Elgar, we film children at play, in classes and at lunchtime. New, though, are the trampolines and gym equipped for sensory–motor stimulation. For years, parents and schools had no doubt that heightened or lowered sensitivity to

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sensory stimuli affected how their children responded to the world. Yet only in 2013 was this symptom cluster included in the diagnostic criteria. We are provided with a small room to film pupils participating in brief illustrations of cognitive tests for use in teaching. Clips for the new course will include another false belief task to complement the 1990 footage of Sally–Anne, together with some verbal and non-verbal tests from the WISCIV (Weschler Intelligence Scale for Children).32 As we have no experimenter, a Queensmill teacher agrees to play this role. She is instructed on the test procedures and mostly sticks to the script, remaining neutral and avoiding giving the children hints. Yet with her encouragement and affection for the children, who are interacting with someone familiar, the atmosphere is palpably warmer. The false belief task involves a Pringles canister with a lid. The teacher shows the canister to our first participant, a boy of around eight, and asks him what is inside. He answers ‘crisps’. Then he is shown that the canister contains only an orange ‘Pentel’ pen, which drops out when the teacher opens and upturns the canister. The child picks it up and identifies it as a pen. Then the teacher encloses it in the canister again and asks the child ‘If Mary saw this, what would she think is inside?’ (Mary is a teacher whom the child knows). The child’s response ‘a Pentel’ complies with the prediction: he does not understand that unless Mary has witnessed the scenario she will have a false belief about the contents of the canister. At this point, it seems that the teacher has misheard his response ‘Pentel’ as ‘pencil’ and she continues to refer to pencils, not Pentels, in her follow-up questions to him. Procedurally, our experimental demonstration is flawed by this pencil/ Pentel confusion, but we cannot re-film it because the child now knows the denouement. Yet I am somehow comfortable with the unflustered way the boy keeps to his own ‘Pentel’ script. And when offered crisps as reward for his participation, in a disarmingly sweet gesture, he pushes them back to the  teacher saying, ‘you have them’. Despite theory of mind difficulty according to the test, he is socially both graceful and generous. From the other tests filmed at Queensmill, I will describe one further example of how rigorous procedure may constrain interpretation. This is the block design task, a non-verbal sub-test from the WISC-IV.33 The teacher sits opposite the boy participant. She makes geometrical designs using square blocks with surfaces all red, all white or diagonally split red and white and invites the child to copy the designs with more blocks. On one ‘trial’ the teacher has formed the upward-facing designs of four blocks into a red square with a superimposed white diamond. The child goes to great lengths to position his blocks correctly, turning them over so that he has the right designs facing upwards. Working carefully and deftly,

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with a frown of concentration, he produces a perfect copy of the teacher’s block design, except that the colours are transposed – red diamond on white square. The teacher asks him if the two designs are the same and he says ‘yes’ without hesitation. According to WISC scoring this would be an error, and yet it is an appropriate and even, one might say, creative variation of the test design, only apparent thanks to the video. Moreover, it suggests that the child is attending to the overall pattern, not its details, in contrast to the common claim that autistic children fixate on details. Without praising this ‘incorrect’ response, the teacher moved on to the next trial. A question to the child, not part of the protocol, might have shed interesting light on his thinking.

Images of autism through interview and art, 2018 This year I am replacing our ‘Understanding the Autism Spectrum’ course, studied over nine years by more than 7,000 students, with a new short online course.34 Developments in the autism landscape, already underway in 2009, mean that conveying autism adequately is evermore challenging. The course will describe developments in autism science and therapeutic intervention, services for autistic people and so on. But I also need to convey to students the growing demand for pluralism and inclusivity in methods for understanding autism.35 As shown in scenes one to three, the visual medium highlights nuances of behaviour and questions of interpretation which experimental tasks are not designed to address. One route to a richer analysis is more video-based observational research, and this has indeed become more common. For instance, Maestro and colleagues’ studies of parents’ early home videos of their infants highlighted subtle but important differences in the focus of attention between infants subsequently diagnosed with autism and neurotypical control infants.36 As for my teaching videos, these home recordings yielded unforeseen insights. The episodes in scenes one to three also begged the question of what the participants themselves thought. Since it is commonplace, in 2018, for people with autism to speak for themselves, it is important for autism, as portrayed in the new course, to be informed ‘from the inside’ by autistic people’s perspectives and experiences. Even less verbal children may express themselves powerfully through non-verbal means, their parents adding complementary insights derived from long-term knowledge and close bonds with their offspring.

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So in 2018, I am enriching the course with videos recorded in the previous eighteen months, together with visual arts, to convey a sense of individual lives. One such encounter is with a young autistic man and the other with an exceptionally gifted autistic child and her parents. In brief selections from this material, I now return to the themes of self, inner life and imagination.

Scene four: Walton Hall, The Open University, 2017 Alex has driven himself and his mentor from Surrey to our interview recording in Milton Keynes. There is a quiet composure about him, and he engages well with the interview,37 never appearing unwilling to answer my questions. He recounts that he has always excelled at science and maths and is putting these skills to good use, studying pharmaceutical science at university while working part-time at a book-makers. He loves calculating betting odds and his flair for mathematics and computing is clearly well used. He tells us about his family, friendships and plans for the future. There is so much that could be the story of a neurotypical boy growing up. But Alex also talks of being isolated and friendless at school, of his social difficulties and obsessions and of how he overcame quite extreme bullying. I don’t ask Alex whether he has participated in tests of theory of mind, empathy, systemizing or creativity. His own self-insights offer a rich and nuanced picture that test scores might do little to enhance. Regarding social imagination, he talks of his difficulties in imagining other people’s thoughts and feelings. Yet he recounts episodes of helping his friends which speak of empathic generosity. He also states that he dislikes fiction because he does not understand the characters’ intentions and cannot follow plots. Yet he has a strong sense of autobiography, self and identity, of which his autism is an integral part. Here, then, are expressions of a rich inner life, even if Alex’s imagination is fired by scientific formulae and mathematical equations, not by fiction and fantasy.

Scene five: Northamptonshire, August 2016 I am with a producer and a cameraman at the house of Iris Grace, aged seven, and her parents, P.J. and Arabella. Iris Grace has few words, and for part of our visit she is out of the house with her father. In my interview with Arabella, she talks at length about the early realization that Iris was developing differently.38 She would not settle at night, was so hyper-sensitive to textures that she was difficult to clothe and her language development was slow and limited. Arabella describes the difficult experience of Iris Grace’s diagnosis,

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when she was aged two, and the approach that she and P.J. developed to provide security, stimulation and learning for her. Arabella made mugs of watery paint to encourage Iris Grace to express herself and communicate, for instance by choosing colours and asking for more paint. By the age of three, Iris Grace displayed unique and special gifts, the evidence of which is all around us as we talk. She mixes her own paint colours and often drops or flicks the paint onto paper from above, with a technique almost like Jackson Pollock’s. She selects small and large brushes or rollers and sponges to achieve different effects (for examples see https://irisgracepainting.com/paintings/). The exceptional quality of Iris Grace’s artwork, which is sold all over the world, evokes so-called ‘savant talent’, defined as an exceptional talent in the context of profound disabilities.39 Savant autistic art is often described as the product of exceptional memory and meticulous attention to detail reflected in accurate representation of real scenes. This proposal, attributing autistic art to quirks of neuropsychological functioning,40 conveniently avoids reconciling evidence of creativity with a diagnostic profile that has imagination deficit as a criterion. Although some autistic artwork does involve memory and replication, many examples transcend a single reducible genre. Iris Grace’s unusual brushwork bears comparison to abstract expressionism, and her paintings have qualities of colour, light and spontaneity reminiscent of impressionism. Yet her work is no pastiche: each painting has its own strongly coherent abstract patterning, a variation on a unified and distinctive style. Iris Grace might be unable to participate in theory of mind or creativity tests. Yet it is surely plausible to see her work as the expression of a rich inner imagination.

Conclusions The earlier scenes in my archive of video teaching material induced me to articulate a certain ambivalence about classic scientific approaches to ‘understanding’ autism. I am a cognitive psychologist by training. I  appreciate the role of experimentation and other quantitative work in researching autism, and I have employed these methods in my own work. Scientific methodology plays the important role of identifying behaviours and traits, which autistic people tend to share in common, and of testing explanations against evidence. Rigorous testing is necessary, above all, in trials of new therapeutic interventions. Yet, as I have shown, experimental tasks constrain what questions are asked and what evidence is considered relevant to the answers. The phenomena of interest are defined by the task and the researcher’s stance. Further information is lost when reports of

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these studies are published. Traces of the original observations are typically confined to words, numerical data and the odd figure, and individual participant behaviour is not reflected in the mean scores and statistical analyses which constitute the data. By contrast, video preserves traces which give access to richer fields of enquiry. With some exceptions, for instance spatial ability tests on which autistic people perform especially well, experimental tasks have predominantly focused on evaluating deficits. Even Baron-Cohen’s systemizing quotient, which measures enhanced affinity for fields governed by systems and rules, seems, paradoxically, to imply limitation. At several points in scenes one to three, instances of skilful or imaginative responding fell outside what the test was measuring. More interactive engagement with the participants might have evoked insights which the experimental protocol precluded. No wonder that Elizabeth Pellicano has advocated an integrated role for autistic people in both formulating research questions and interpreting evidence.41 In my teaching approach for 2018, I feature individuals with scientific and artistic talents as one of several routes to a richer appraisal of autistic capabilities. Of course, most individuals on the autism spectrum do not have the exceptional flair portrayed here, so in my teaching I am also careful to offer widely contrasting life stories. Yet demonstrating that rich inner imagination is possible in autism opens the dialogue about how it might be nurtured. One promising approach unfolds weekly at the house of Iris Grace herself. At the ‘Little Explorer’s Club’, Iris Grace is joined by other children for activities designed to both harness and stimulate their imagination. Group leaders build learning around children’s special interests and skills and through playful exploration of the environment. The ‘method’ of understanding autism through personal stories is entirely contrary to the careful control and statistical analysis of experiments and other psychological tests. Part of the power of experimental studies lies in minimizing individual differences in order to convey a representative picture. Individual stories cannot be representative of all autistic experience, but they are authentic and informative in a different way. Notably, they emphasize the wide spectrum of variation which autism encompasses. They also empower individuals to speak and enable expressions of creativity to be recognized and celebrated.

Acknowledgements Use of all video material discussed in this chapter has been approved by the Open University Human Ethics Research Committee (HREC/2922/Roth). My grateful thanks to all who participated in the original recordings.

5

The Wind and the Rain: Facing Dementia in Lear/Cordelia and The Garden Robert Shaughnessy

We have heard a lot about the relationship between performance and memory in recent times. Following the publication of Joseph Roach’s Cities of the Dead (1996) and Marvin Carlson’s The Haunted Stage (2001), memory in all of its guises has come to be seen as a central component of theatre making and reception, whether at the most fundamental level of mnemonic practice (how do you remember those lines?) or at that of cultural commemoration and memorialization, whereby the theatre remains as one of the most privileged and distinctive repositories of (shared and contested) histories and heritages.1 What has received less attention has been remembering’s necessary corollary: forgetting; as Peter Holland has recently put it, studies of the phenomenon are ‘almost a by-product or afterthought’, even though (quoting Stephen Orgel) it is ‘an equally essential creative principle’.2 This consideration is particularly pertinent to those forms of drama and theatre that engage with ageing and the elderly, wherein loss of memory is often a (sometimes the) defining element of protagonists’ and spectators’ experience. Michael Mangan has documented how there has, over the past decade or so, been an upsurge in reminiscence theatre, a form that characteristically assembles the autobiographical memories and narratives of elderly participants, usually with the conviction that memory is something to be retrieved, recreated and preserved; envisaged as a ‘creative act in the present’, memory-based theatre ‘has been seen as something which may have a therapeutic value, or which may improve the quality of life for older people’.3 In this respect, there is broad agreement between makers and researchers in the theatrical and clinical fields: memory, especially within the contexts of dementia and Alzheimer’s disease, is something to be defended from impairment and loss, for, it is often assumed, its disappearance marks the erasure of personhood itself; neuroscientist Daniel Schachter maintains that memories ‘form the core of personal identity’, so that ‘our sense of ourselves depends crucially on the subjective experience of remembering our pasts’.4 One difficulty with

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this view, which reflects the consensus, is that by equating certain practices of retention and recall (tested via one’s reliable storage of certain kinds of information, such as the name of the current British prime minister) with the coherence and integrity of self, their biologically inevitable deterioration comes to be seen not just as a cognitive systems failure but also as a loss of identity. Confronting the dominant clinical paradigm of memory and its relation to dementia, philosopher of science Jens Brockmeier has argued that its preoccupation with personal autobiographical memories has operated at the expense of a socially embedded, embodied and relational understanding of how these work contextually, interactively and in process: central to the standard account, he writes, is ‘the idea of personal identity as bound to the temporal trajectory of one’s autobiographical past, present, and future’, a trajectory ‘viewed as a biologically anchored sense of time … as remembered time’.5 Brockmeier argues that this triangulation of time, memory and identity misconstrues memory as a natural phenomenon rather than as a cultural and social practice, ‘one of those epistemic entities that not only represent and define, but also structure, evoke, and to a certain degree constitute the  reality to which they refer’;6 chronological time, likewise, should be seen ‘as a model by which we think and organize our experiences, not as a given condition  under which we live’.7 The implication of this is a shift of attention  from ‘how we autobiographically localize ourselves “in time”’ to  ‘how we localize ourselves in meaningful contexts’; rather than privileging  ‘individual cognitive capacities’, care activities (which, importantly, include artistic work)  around dementia needs to embrace ‘social forms of life that are embedded, embodied and extended’.8 Brockmeier finds a model for this kind in the work of  American media and theatre maker and scholar Anne Davis Basting, which arose specifically out of her disappointment and frustration with ‘the failure of reminiscing techniques and memory training programmes’ and which aims ‘to decenter the traditional understanding of autobiographical memory’ that his essay critiques.9 In this chapter, I examine two UK-based theatrical projects that, in different ways and with very different means, can similarly be seen to offer alternatives to the theatre of reminiscence and that by conceiving of memory as, in Basting’s terms, a ‘relational process’  resituate ‘the act  of remembering’ precisely so as not to ‘exacerbate the shame and fear surrounding forgetting and human frailty, dependency and mortality with which forgetting is linked’.10 The first of these, Derby-based 1623 Theatre Company’s Lear/Cordelia, was staged as a pilot project in 2016 by a company whose aspiration is ‘to give voices to marginalised people in response to Shakespeare and the world today’ by working ‘with communities while being accessible, inclusive and diverse’.11 A

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double bill derived from Shakespeare’s King Lear, it was praised by both theatre artists and dementia specialists; representing the former, the composer Mark Melville hailed ‘Amazing work, brave storytelling, moving detail’, while, for the latter, Jill Henderson of the Care  Quality Commission declared: ‘Every care home manager needs to watch this pair of inspirational plays about dementia and its impact.’12 The second, The Garden, is an installation, devised and directed by Arti Prashar for Spare Tyre in 2015, designed for performance in care homes and day centres as well as theatre spaces. It is the work of a company committed to ‘empowering those often denied a voice’, among them adults with learning disabilities, women who have experienced violence and people with dementia.13 In the words of Tom Dening, professor of dementia research at the University of Nottingham, The Garden is ‘a work of genius’, wherein ‘the everyday disadvantages caused by dementia are laid aside and we inhabit  a dementia-free zone, where everyone’s response is equally authentic. The effect is beyond relaxing, it is stunning’.14 Surveying the narratives that contemporary culture creates about dementia, Basting observes that these stories of loss are frequently reminiscent of ‘Greek and Shakespearian tragedy’, in the sense that they ‘most commonly involve people who stand out, people with extraordinary hearts and minds’, in a pattern that can be seen as ‘a Shakespearian fall from great heights’.15 Basting has her eye on mainstream films such as the 2001 biopic Iris, based on John Bayley’s memoir of the final years of his wife, philosopher and novelist Iris Murdoch (a more recent example is the 2014 film Still Alice), where ‘the main character begins as a whole person, the product of a lifetime of experiences and accomplishments, and slowly unravels, sometimes taking those who care for him or her along for the downward ride’.16 If Shakespearean tragedy appears to offer a template for the narrative of Alzheimer’s, the condition has begun to be seen as a frame of reference for Shakespearean tragedy in particular, King Lear. Writing in The Lancet on the occasion of the 400th anniversary of Shakespeare’s death in April 2016, Shakespeare scholar Jonathan Bate instanced this work as an example of its author’s capacity to pre-empt the discoveries of modern medical science; in this instance, ‘a checklist of symptoms for dementia with Lewy bodies mapped onto the development of King Lear’s behaviour in the play’: Changes in thinking and reasoning, often manifested by eruptions of rage: Lear’s sudden, irrational decision to disinherit Cordelia because she will not play the game of flattery. Confusion and alertness that varies from one time of day to another or from one day to the next: Lear is sometimes lucid but at other times does not know where he is or what time of day it is. Visual hallucinations: Lear has many of these,

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Bate’s source for this diagnosis was the actor Simon Russell Beale (it was provided by his nephew, a medic training in geriatrics), who incorporated the psychological and physical symptoms of dementia into his acclaimed 2014 National Theatre performance of the role. Quite independently, for 1623’s artistic director Ben Spiller, a clinical reading was also the starting point for his company’s dementia-focused work with the play, which included a series of workshops in care homes during 2013 and 2014. This was one of three concurrent research strands: working with health professionals to develop a diagnosis of his condition, Spiller concluded that Lear has Parkinson’s disease at the start of the play (‘as he’s quick to anger when challenged and he becomes obsessive’), develops Lewy bodies dementia as it progresses and (contrary to Bate and Russell Beale) ‘displays evidence of the early onset of Alzheimer’s towards the end’.18 At the same time, 1623 created a participatory project that invited members of the public to respond creatively to Lear’s line ‘Let me not be mad’ (1.5.43),19 which resulted in ‘photographs, video, audio files, songs and creative writing’20 and a video collage made by the artist Darius Powell. The company also took the ‘King Lear Tapestry’ into care homes; working with residents, families and staff, they ‘took 10 embroidered artworks inspired by characters/settings/images/props in King Lear and used them as stimuli with participants to shape new stories. These stories (from 3 homes) partly inspired Farrah Chaudhry’s script’.21 Mindful of its potential to provoke anxiety, Spiller was careful not to place the emphasis on the act of remembering: Spiller made the work ‘about that day in the room’ and on artefacts that were ‘tactile pieces that are simple to hold and trace  with fingers’.22 As time went on, participants became increasingly interested in some of the curious gaps in the play’s own memory and in particular that of the pre-history of the relationship between Lear and Cordelia. This is unsurprising, in that the reconciliation scene, in which Lear awakens from mania to urge his daughter to ‘forget and forgive’ (4.7.83–84; not, as the familiar saying has it, the other way round), is the closest to a parent-carer relationship that the play offers. It is far from the first time that the play has prompted extra-textual creative speculation: readers and theatre artists have long wondered about the state of the Lear family before King Lear, which includes the mystery of what happened to the daughters’ mother (or, some have suggested, mothers). These range from the minor Georgian

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poet and playwright Gordon Bottomley in 1915 (King Lear’s Wife), through Elaine Feinstein and the Women’s Theatre Group in 1987 (Lear’s Daughters) and Howard Barker in 1990 (Seven Lears), who in various ways read Shakespeare’s near-silence over the occupant of (as he puts it to Regan) ‘thy mother’s tomb’ (2.2.324) as harbouring guilty secrets. For 1623, this resulted in a new play by Chaudhry, Cordelia, which formed the second part of the double bill and which considered the impact of the father’s dementia from the perspective of a daughter resisting being cast in the role of carer. Set in the present, the play is a naturalistic forty-minute twohander that deals with the events leading up to Lear moving out of the family home and into care; Lear is a retired right-wing politician, Cordelia an idealistic junior doctor who has returned from relief work in France (or so he thinks) to supervise the transition. It quickly becomes clear that Lear is at best ambivalent about it, and that they are deeply at odds: over this matter, but also politically and personally. Lear is stubborn, cantankerous and bigoted, and also deeply needy; Cordelia is driven, altruistic and deeply conflicted. Lear attempts, forlornly, to persuade her to extend her visit by another day (a distant echo, perhaps, of ‘Cordelia, Cordelia, stay a little’ [5.3.269]) by reminding her of an attachment to the scene of her upbringing that she does not and cannot share; she refuses his attempts to emotionally blackmail her into surrendering life and career to care for him. ‘When are you going to have some time for me?’ he pleads at one point. ‘When I don’t have a flight to catch’, she coolly ripostes.23 As they argue, the disputed details of a dysfunctional family romance emerge: in one key moment, Lear digs out a paper party hat which he presents to Cordelia as a kind of peace offering: LEAR Would you like this hat? You made me wear it on my 69th. Or was it earlier? Was it 2004 or 2005? It was – CORDELIA I remember it. LEAR It was a great party. For Cordelia, it was not ‘great’ at all (‘I remember you with this stupid thing on, and I wondered then if you were made of stone’), and Lear’s determination to belittle her relief work finally provokes her to declare (to his horror) that she has actually been in a war zone. This leads to the play’s lengthiest soliloquy, an account of a death in a field hospital: This boy was rushed in, his two older brothers brought him in. God knows how, they couldn’t have been older than ten themselves … They walked over to their brother’s body and they kissed him on the forehead

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Performing Psychologies again and again. Gently. I don’t suppose that they wanted to hurt him. And then their mother walked in. and she took her dead son in her arms and walked out into the street. Holding him tightly, howling. She said she needed some time. With some time she could lift him, she could wake him again. Imagine holding your dead child in your arms, just limbs and blood, convinced that they would wake up.

The passage typifies the play’s intricately transformative relationship with its Shakespearean source, as the image of the pietà combines with the final moments of King Lear to depict a humanitarian catastrophe in which Cordelia becomes the witness, not of a father carrying the corpse of his daughter but of a mother cradling her dead son. Elsewhere, the transpositions are more direct: Lear tells Cordelia that ‘Your lack of response, your “nothing”, your silence, your ingratitude … speaks volumes’ (‘nothing will come of nothing: speak again’ [1.1.90]); we learn that Goneril and Regan have remained loyal to Lear by choosing careers in Conservative politics and towards the end (in accordance with a familiar dementia care scenario) it is revealed that he has granted them power of attorney. Verbal echoes of King Lear are lightly braided through the dialogue: Lear defines his personal philosophy first, simply, as ‘eat or be eaten’ (‘Humanity must perforce prey on itself / Like monsters of the deep’ [4.2.50–51]) and later, more elaborately as ‘We are driven by instinct. We cover it up with lies and false morality’ (‘A dog’s obeyed in office … . Through tattered clothes small vices do appear / Robes and furred gowns hide all’ [4.6.160–161]). The bestial imagery of King Lear surfaces in Lear’s repeated references to foreign migrants as ‘animals’, and as Lear complains that ‘The longer I sit here … like people who look like ants, from way up above, you’re going higher and higher, and I’m getting smaller and smaller’, he invokes the view from Dover Cliff: ‘Methinks he seems no bigger than his head. / The fishermen that walk upon the beach / Appear like mice … ’ (4.6.16–18). Just as Cordelia seems to be playing a game of dramaturgic hide-and-seek with Shakespeare’s play, it likewise adopts a now-you-see-it, now-you-don’t approach to dementia, which is viewed less in terms of Lear’s experience of the condition than of its impact on Cordelia. In an exchange included in the draft script but cut from the performance, Lear’s madness becomes the matter of ironic counter-transference (Cordelia declares ‘You’re driving me mad!’ and he responds, ‘Don’t be mad. You have your whole life ahead of you. Don’t spoil it with madness’),24 and Lear exhibits only a few symptoms of early stages Alzheimer’s. At one point he looks for his house keys, having forgotten where he put them, and a brief exchange indicates memory malfunction:

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CORDELIA You haven’t even asked me about where I’ve been, what I’ve done, what I’ve seen. LEAR O I know all about the Gulf war and all the innocent people that you – CORDELIA The Gulf war? Dad, that was years ago. LEAR What was? CORDELIA The Gulf war. LEAR Of course it was. Although Cordelia reminds Lear that ‘You’re not well. We need to move you into your new home’, it is an isolated instance; as the play progresses, it becomes clear that the problem of memory is a shared one, and a key conflict between father and daughter is over whose version of the past will prevail. Wondering where he has stowed his RAF memorabilia, Lear recalls that ‘I haven’t looked at those for years. Maybe … I could give you one of those. You used to get me to present you with the medals, to pretend you were in the air force.’ ‘I don’t remember that. You never told me that’, Cordelia counters, and he retorts: ‘Well, there are a lot of things that you don’t know. You only like to remember what you want to remember.’ The final word is Cordelia’s as she turns his own against him: ‘Nothing will come of nothing. I’m going home.’ The action of Cordelia is chronologically prior to that of the first half of the diptych, Spiller’s 45-minute collage of scenes from Shakespeare’s play, and the sequencing is significant in a number of ways. First, it particularizes dramatis personae that, as noted above, in Shakespeare’s text have next to no personal history without seeking to ‘explain’ them; encountered first, Shakespeare and Spiller’s Lear and Cordelia are semi-archetypal figures in a way that Chaudry’s are not. Second, it complicates the teleology of the decline and fall narrative identified by Basting; Lear is last seen estranged but, relatively speaking, mentally fit rather than unwell. Third and perhaps most importantly, it enables the audience to see the rupture between Lear and Cordelia through the frame of its (theatrically earlier, chronologically later) healing. Lear consists of nine scenes, the first, fourth and last of which rework (with variations) Shakespeare’s reconciliation scene (4.7) as three of Cordelia’s visits to her father’s care home. The play begins with Lear sat in an armchair (for me, reminiscent of Hamm in Samuel Beckett’s King Lear offshoot, Endgame) and a knock at the door. What follows is the cut, lightly adapted text of the forty lines in Shakespeare’s play from the moment Lear wakes up to his exit with Cordelia and the Doctor (absent from this version), from Cordelia’s ‘How does my royal lord? How fares your majesty?’ (l. 44; ‘How do you, sir? How fare you?’ in Spiller’s text) to ‘I am old and foolish’ (4.7.84). Lear and Cordelia walk together and then, in a deft conflation of their later scene of imminent incarceration and

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the end of Lear’s storm scene, he turns to ask: ‘Are we in prison? / We two alone will sing like birds in a cage’ (‘Come, let’s away to prison; / We two alone will sing like birds i’th’cage’ [5.3.8–9]), and sings a few lines from the Fool’s song ‘The Wind and the Rain’ (3.2.73–76). Scene Four (‘Second Visit’) reduces the text to seventeen of Lear’s lines and Cordelia’s ‘Sir, do you know me?’ Whereas Spiller’s first visit scene (and Shakespeare’s text) stages Lear’s recognition of his daughter (‘For, as I am a man, I think this lady / To be my child Cordelia’ [4.7.68–69]), the second sees him struggling to identify her and groping for words:

LEAR

CORDELIA

For, as I am a man, I think this lady To be – To be – To be – Your child, Cordelia.

Between the first and fourth scenes, Lear is alone with his memories and fantasies: raging in the storm (‘Blow, winds, and crack your cheeks … ’ [3.2.1–24]), and replaying the love-test (1.1.35–268), with Cordelia, Goneril and Regan appearing as video projections. As he does so, language splinters and disintegrates under the pressure of the effort to remember: Know that I have divided In three my fortune In three – My fortune – My fortune – Divided – My fortune divided In three Three (1.1.36–7) And now, our joy, our joy, our joy, our joy, Although the last, not least; to whose young love The land of France – of France, of Calais, France – Strives to be interested … . (1.1.82–5) Half my love, my love, half, half, half, half, half, Half, half, half, half, half, half – Nothing. (1.1.86–104) Scenes Five to Seven chart the fallout from Lear’s riotous assembly of knights (1.4.192–194), here imagined as an election-night party that gets out of hand,

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his curses and the breach with the daughters. In the penultimate scene (‘Dogs’), Lear has descended into a fugue state: elaborating one of Lear’s hallucinations in the mock-trial scene (‘The little dogs and all, / Tray, Blanch, and Sweetheart, see, they bark at me’ [3.6.60–61]), he sits and dreams of remembered pets who morph in the projections into Goneril, Regan and Cordelia: LEAR

Tray, Blanche, and Sweet-heart! Unaccommodated men are no more but poor, bare animals as you are. Unaccommodated man is – Unaccommodated man, Unaccommodated. Unaccom – No accom – No accommo – No accommodation. No home. No – Nothing.

This is how Cordelia finds him when she makes her third visit in the final scene. This time, Cordelia’s ‘Sir, do you know me?’ yields only the fragments of an answer: LEAR

CORDELIA

You are a spirit, I know: when did you die? Where have I been? Where am I? Am I in France? Methinks I should know you. I should know you. I should. I– I– I– We’re in prison, but – We two alone will sing, We will sing, Sing, Sing like birds. Birds. In a – In a – In a – In a cage?

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The iterative, echolalic nature of the three visit scenes charts a process of decline, but also, importantly, one of reconciliation and acceptance; as Lear loses his words, Cordelia finds them for him – and perhaps for herself. The central mechanism here is the repetition of the song ‘The Wind and the Rain’, which Lear sings at the end of each scene and which, in the first and second instances, provides a segue to the next. The song is itself recursive, a musical memory text, having first appeared in a different, longer form at the end of Twelfth Night (first performed some five years prior to King Lear) as an epilogue sung by Robert Armin’s Feste. In King Lear it is a single verse: He that has a little tiny wit, With heigh-ho, the wind and the rain, Must make content with his fortunes fit, For the rain, it raineth every day. (3.2.73–76)

In Lear, this becomes La la la la la, la-la-la-la-la With a … hey, ho, the wind and the rain. La la la la, la-la-la-la-la With a … hey, ho, the wind and the rain. La la la la la-la-la-la-la For the rain it raineth every day.

In Twelfth Night, the verse lines chart an incomplete journey from childhood to adulthood that promises to map a temporal sequence not dissimilar to that of Jaques’s ‘Seven Ages of Man’ which, as the Arden editor notes, ‘ends with senile “second childishness”’: ‘When that I was a little tiny boy’ to ‘But when I came unto my beds’ (5.1.381–400).25 The song may or may not have been written by Shakespeare; possibly it was an adaption of a traditional air, perhaps by Armin, a man in his early forties reprising his younger-self Fool from the position of a performer who, in terms of his own culture, was already at a relatively advanced age. In King Lear, the narrative of ageing is reduced to the itinerant, dispossessed predicament of ‘He that has a little tiny wit’ making do with whatever he might (‘his fortunes fit’); reviving the memory of a once-popular hit, perhaps the fragment activated a bittersweet theatrical nostalgia. Whatever it did for the spectators on the Globe stage around 1608, this was certainly the effect for the actors and audiences involved in the making of Lear. During the workshops, Spiller recalls, ‘the song really resonated with people when we sang it with them in the care

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home’, and ‘people learned it very quickly’: ‘it is the music, the lyrics, the beat, that levels all out in that room and we have a creative experience together’. In her rehearsal blog, similarly, assistant director Kate Wood characterized the song as a musical palimpsest: ‘Imagine Victorian nursery rhyme mixed with a hint of practically any hymn you sung at school.’26 This sense that the song offered both collective access to a shared musical past and an opportunity to meet as equals is expressed in the play in the form of caregiving turntaking: in its first iteration, Lear sings solo; in the second, Lear leads and Cordelia follows; in the third, she initiates the singing and he joins her as the lights fade to black. It is an instant of tentative reconciliation and shared co-presence as father and daughter softly sing together: shared musicalmemory, and music-making, is what remains to connect them. It is well known that even persons in the advanced stages of dementia retain a strong capacity for music-making (which can include both playing and listening), though accounts differ as to why and how this is so. Representing the established cognitivist view, neurologist Oliver Sacks stated that ‘music imprints itself on the brain deeper than any other human experience’, and thus it is ‘the deepest part of one’s being, and may be preserved, almost to the last, in a dementia’.27 Taking issue with this cerebrally centric model, Pia C. Kontos proposes a model of ‘embodied selfhood’ wherein ‘the key to the seemingly inexplicable coherent and spontaneous expressions of musicality that emerge from the depths of dementia is to be found in the body’s own primordial potential and sociocultural significance that sustain selfhood at a preflective level’ and poses the question: ‘Might musical performance in the face of the progression of Alzheimer’s disease reside somewhere deeper than cognition?’28 In Lear, music (as so often in Shakespeare, a symbol of harmony and reconciliation) lingers where words, memory and thought have failed; in Spare Tyre’s The Garden, the musical and sonic journey to ‘somewhere deeper’ dispenses with spoken language (and, to a large extent, narrative) altogether. Described in company publicity as an installation, the structure of this show is recursive and iterative: over the course of fifty minutes, two young female performers (Yolande Bramble-Carter and Fauve Alice) engage in a series of simple everyday actions that chart the passage of the seasons from late summer through autumn, winter and spring to summer again: hanging washing on a line, executing gardening tasks, roasting marshmallows over a wood burner. Behind the two women, who move within an ambient soundscape of keyboard and birdsong (composed by Josh Grigg) augmented by a single live musician (Nick Cattermole) on percussion, woodwind and world stringed instruments, are projected video images of waterfalls and woodlands, golden autumn leaves, snows and squirrels, birds and spring flowers. The performance is gently interactive,

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tactile and sensory: a piece of white fur is fashioned into a kitten which is offered to audience members to stroke; stick-and-paper puppet butterflies flap their wings; the marshmallows are shared; cut sprigs of lavender are rolled and sniffed. The world of the show is one in which its audiences will feel at home, its action calmly reassuring in its everydayness, and there is no obligation to keep track, no pressure to remember. The youthfulness of the performers invites their watching elders to imagine themselves as might once have been or dreamed of being: with Yolande sporting a flowery shirt and denim dungarees and Fauve red wellingtons, yellow stockings and a jauntily angled red beret, they are ageless and timeless. Exhibiting what psychiatrist Robert Butler, in a classic formulation, characterized as the shared ‘lively capacity’ of the very old and very young to ‘live in the present’, they and the show embody ‘the direct enjoyment of elemental pleasures such as nature, children, forms, colours, warmth, love, and humour’, as the end of life allows one to ‘become more capable of mutuality with a comfortable acceptance of the life cycle, the universe, and the generations’.29 The cyclical nature of The Garden reflects this sensibility; importantly, it moves not, as one narrative of ageing would have it, from spring to winter but from summertime to summer again. Like Lear, King Lear and Twelfth Night, The Garden also prominently features a hit song, one that shares both something of lyrical sentiment of ‘The Wind and the Rain’ and its capacity to act as repository of deep cultural memory. A third of the way into the show, as summer has given way to autumn (swathed in a long overcoat, Fauve sweeps dried foliage while projected leaves drift in the wind), the pinging of a xylophone cues the sound of rushing air and falling water; umbrellas are unfurled, Nick places a circle of foil to create a puddle, in which Yolande stands. She playfully mimes flicking water towards Fauve, turns on her heel and then, accompanied by Nick’s solo flute, they break into dance – to ‘Singin’ in the Rain’. Generationally speaking, for this audience, the choice of a musical moment from one of the all-time great Hollywood musicals that also epitomizes the genre’s golden age is apt enough, but it is more than that: Gene Kelly’s song-and-dance routine in the 1952 film that bears the song’s title is a much-loved shared celluloid memory in itself, but it is just the centre of a rich network of replayed and repeated re-iterations of itself in the form of cover and tribute versions, homages, pastiches and parodies: not least among them, I would suspect, the affectionate reworking by Eric and Ernie for their 1976 Morecombe and Wise Christmas special, a routine which remains one of the duo’s most popular and best-remembered. As a piece of deliberately low-tech rough theatre, the staging of the number in The Garden participates in this musical history and also invites participation

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in it, as the sequence extends, audience members are coaxed to their feet; for the time being, the dance is all there is. In their different ways, Lear/Cordelia and The Garden answer Brockmeier’s call for an understanding of dementia that ‘shifts attention from the question of how we autobiographically localize ourselves “in time”’ to ‘how we localize ourselves in meaningful contexts by – possibly – using temporal assumptions and constructions’30 and by exploring theatrical forms that, by playing upon ideas of time, memory and forgetting, make such a shift at least imaginable. If the rain it raineth every day, we may find a time and a space to sing in it.

Acknowledgements My thanks to Ben Spiller, Farrah Chaudhry and Arti Prashar for their generous help in writing this chapter.

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6

‘Her Painful Legs Joined in the Conversation’: Dramatherapy and the Space before and beyond the Talking Cure Emma Brodzinski

Introduction In this chapter, I draw on my experience as a dramatherapist and theatre academic to consider how this therapeutic practice works as an embodied engagement with the talking cure. Dramatherapy continues to be regarded as experimental, even though its emergence can be traced back to the beginning of the last century. While it is registered on the UK’s National Health Service (NHS) pay-scale, it is not perceived as truly mainstream and, indeed, this marginality is something which many dramatherapists embrace. It seems that there is a perception of something risky and avant-garde about the practice – which I would suggest relates to its arts-based approach and, more fundamentally, to its attention to the body as a medium of expression. Here, I will be drawing on my own therapeutic work with a client within a secure mental health setting, exploring how her speaking body was engaged in conversation within the dramatic framework of our sessions. My broader aim in this discussion is to reflect upon how this dramatherapeutic practice has a direct trajectory, both ideologically and procedurally, back to early developments of mainstream psychoanalysis and the work of Freud. I want to attend to what appears to be an amnesia/ erasure around Freud’s early body practices both within and beyond dramatherapy and the critique, through the emphasis on the ‘talking cure’, that psychoanalysis avoids engaging with embodiment and ‘shies away from dealing with … how bodily sensations and experiences become symbolic tools’.1 This is in the context of current concerns about psychiatric diagnosis and the critique of the biomedical model for its emphasis on the curative role of medication in treating mental distress as disorders of the brain. The alternative approach advocated by proponents of a psychosocial model

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attends to causal factors which are relational, located in the environment and in experience.2 Dramatherapy has a potentially important role to play in these debates as a medium through which people can find meaning in their symptoms and experiences through narrative and praxis as discussed by Richard Hougham and Bryn Jones in their edited volume, Dramatherapy: Reflections and Praxis: ‘The key in understanding this rests with the view that our “being” is not a permanent, fixed and static state but one of continual revision and flux. It is being viscerally engaged with the process of our becoming in the very moment to moment messiness of our daily lives.’3 This chapter seeks to unpack and understand the central importance of the body within the initial moments of psychoanalysis, why this might have shifted within its current practice and how dramatherapy may signal what Freud might term a ‘return of the repressed’.

Listening to the body Some of my most recent clinical work has been in a secure mental health unit for adolescents. There were a range of therapeutic interventions on offer within the unit but dramatherapy was a new endeavour. As often happens in my experience of working in such contexts, I had to define the role and function of dramatherapy, as if it was a radical alternative to the more mainstream offerings of one-to-one sessions with a psychologist and cognitive-behavioural therapy (CBT) groups. What became really clear for me (working in this context) was the significance of dramatherapy’s focus on the body as a tool of exploration and expression. This approach, which acknowledges the agency of the body and looks to work with its articulations, is quite different from the other talking-based approaches which were on offer within the setting and provided a mode of communication which seemed particularly useful for those with disordered eating. The embodied self is a key philosophical perspective within dramatherapy, drawing upon phenomenological understanding of the person (and identity) as being inseparable from their being-in-the-world and beingwith-others.4 This phenomenological perspective means that mental illness is not regarded as something merely mental, biological or attributable to a brain dysfunction but is shaped by a person’s experience of their social and physical environment, intersubjective relations and sensory experiences. Dramatherapist Phil Jones refers to Merleau-Ponty and the significance of the physical body within lived experience, with consciousness understood as embodied consciousness.5 Merleau-Ponty’s perspective resists the separation of subject and object and, in doing so, opens up an exploration

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of how understanding may emerge from body memories and affective states rather than purely from intellectual appreciation. Jones sees this as useful to dramatherapy as it posits a sense of connected identity that relates to the client’s relationship with her own body, her self-image and the attitudes of others. The ongoing dialogue between phenomenology and psychopathology, as discussed by Thomas Fuchs, ‘provides a rich framework for the analysis of subjectivity and its disturbances in mental disorders’.6 The questions Fuchs suggests the phenomenologist will start with are endemic to the practices I discuss here: ‘how does the patient experience his or her world: How does he or she express, move and define space as an embodied subject?’7 As dramatherapists begin with a sense of the fundamental importance of the embodied self, the embodied practice of arts-based expressive processes is a useful vehicle for the exploration of both interpersonal and intrapersonal identity. I recognized that this would be particularly important when working with adolescents. As Erik Erikson (student of Anna Freud) noted in his stages of psychosocial development, a central concern of the adolescent phase is identity. Erikson sees this period as being taken up with what he coined an ‘identity crisis’ as an individual moves from childhood into adulthood and seeks to explore the roles they will play in the adult world. This turning point in human development seems to be the reconciliation between the person you have grown into and the person society expects you to become. For Erikson, adolescents ‘are confronted by the need to re-establish [boundaries] for themselves and to do this in the face of an often potentially hostile world’.8 It is unsurprising, given the turbulence of this phase of life, that adolescence can be marked by experiences of mental health crisis. The secure mental health unit that I was working in is a specialist provision that looks after young people aged 12–18 with severe mental health problems and eating disorders. Within the group that I was working with, there were initially two girls from the eating disorders specialist wing – of which one stayed. Jessi (name changed to ensure anonymity) was only in her mid-teens but had already been a long-term resident on the unit. Recent NHS statistics suggest that approximately 1 in 250 women and 1 in 2,000 men will experience anorexia nervosa at some point, and eating disorders typically have their onset during the developmental stages of adolescence. An eating disorder represents a complex relationship between the psychological and the physiological. Over the centuries, there have been differing understandings of the condition and, thanks to the work of feminist scholars such as Marilyn Lawrence and Susie Orbach,9 these have shifted from biologically based interpretations to more nuanced cultural readings of anorexia as socially constructed. This does, however, generate tensions between psycho-medical and feminist ideologies.10

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Hence psychoanalyst Hilde Bruch considers anorexia as a disorder of the self; a kind of hysteria where the individual is looking subconsciously to keep their body in premenstrual state. She sees ‘disturbed psychological functioning’ as being at the heart of the disorder.11 Feminist scholar Morag McSween’s critique of Bruch’s work identifies that the issues at play may be more systemic with anorexia virtually unknown outside the developed West. McSween suggests that the social situation of middle-class women in contemporary Western culture has a role to play in the aetiology of the condition. For example, in 1999, anthropologist Anne Becker published a study on the effects of TV exposure on eating habits. The research looked at the people of Fiji who, before viewing Western television programmes, reported that the ideal body was plump, round and soft. Interviews after thirty-eight months of exposure to Westernized shows suggested a sharp decrease in self-esteem and an increase in symptoms of eating disorders in teenage girls. Such research seems to support the critique of the Western media as presenting a particular type of body as desirable and heightens the potential importance of the external presentation of the body in relation to anorexia nervosa. As a feminist psychotherapist, Susie Orbach offers an elaboration around the interaction between the personal and the cultural in relation to anorexia and the way in which anorexics may seek to synthesize contradictory aspects of their social situation within the ‘anorexic body’, as McSween terms it.12 She identifies the three basic demands of femininity in contemporary Western culture: women are expected to put others before themselves; to anticipate and strive to meet the needs of others; and find their identity through relationship with another. Presented with these particular cultural expectations of how a woman should be, Orbach says: The body, offered as a woman’s ticket into society … becomes her mouthpiece. In her attempts to conform or reject contemporary ideals of femininity she uses the weapon so often used against her; she speaks with her body.13

Because those with disordered eating are speaking with their bodies, it seems important that this modality be honoured within the therapeutic programme, something that dramatherapy with its emphasis on bodily expression can effectively facilitate, as discussed in my case study of Jessi below. Moreover, although this work was seen as a novel intervention within the mental health setting, we might actually trace it back to the beginning of psychoanalysis. Indeed, the title of this chapter comes from Freud’s account of his work with his patient ‘Elisabeth von R’.

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[H]er painful legs began to ‘join in the conversation’ during our analyses … If by a question or by pressure upon her head I called up a memory, a sensation of pain would make its first appearance, and this was usually so sharp that the patient would give a start and put her hands to the spot. The pain that was thus aroused would persist so long as she was under the influence of the memory; it would reach its climax when she was in the act of telling me the essential and decisive part of what she had to communicate, and with the last word it would disappear.14

This commentary describes the centrality of the body within the early work of Freud. Freud and his collaborator Josef Breuer employed massage and touch in the treatment of their patients and perceived a direct relation between somatic symptoms and the expression of the unconscious. There was a recognition that the patient’s body was speaking – ‘joining in the conversation’ – and expressing something that their conscious minds might not. The somatic symptoms were read as signals of repression, and there was an understanding that it was the therapist’s role to attend to them and allow them full articulation in order to move towards integration. In 1896, Freud presented a paper on what became known as his ‘seduction theory’ to the Society for Psychiatry and Neurology in Vienna. The paper was based on his clinical work with pressure technique. The theory suggested that hysterical symptoms, as Freud identified them, were related to childhood sexual abuse. This caused some consternation – which was unsurprising not only because of the subject matter but also as Freud didn’t publish any strong supporting evidence – and, not long after, Freud abandoned the pressure technique to work on the ‘talking cure’, which shifted emphasis from attending to the utterances of the body to assembling narrative in relation to the metaphorical theory of the mind. It is for this version of psychoanalysis that Freud is remembered rather than his earlier experimentations. As a dramatherapist, much of my work is about listening to people’s bodies and following that articulation. However, in all our attention to bodies within the practice of dramatherapy, while Jung is often cited, Freud isn’t really acknowledged as an influence on the discipline, and I am interested to explore that. While there are many problems with Freud’s work – such as his less than rigorous methodology and his gender blindness – I am fascinated by the fact that he listened to women’s bodies in an era when that was not the cultural norm and how his work may have opened up the clinical potential of the attention to the somatic. Freud was a keen theatregoer, as evidenced in his essay ‘Psychopathic Characters on the Stage’, and his interest in the theatrical and live presentation of bodies in spaces may have influenced his clinical practice. Like the modern dramatherapist, he can be seen to be attempting

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to combine the theatrical and the therapeutic. Freud drew on theatricalized mythic narratives such as Oedipus in order to develop the theoretical basis for his work and sought to listen to the bodies of his clients to help them to develop their own ‘private theatre’ – as termed by an early psychoanalysis client – as ‘Anna O’. I suggest that contemporary dramatherapy continues the journey that Freud began as it enters into a conversation with clients’ bodies and encourages them to develop action. In looking to reclaim Freud’s innovation, I draw on the work of analyst and cultural theorist Luce Irigaray who revisits Freud’s early work to recoup the ‘gesture’, as she calls it, within the therapeutic encounter. She notes that Freud and the early analysts attended to gesture but describes how later developments in psychoanalysis sought to immobilize the body. She  discusses what she terms the ‘practicable’ of the analytic encounter where the analysand lies on a couch and the analyst sits to their head, but not facing them.15 Irigaray reflects on how this type of classical psychoanalytic encounter – client on the coach, therapist sitting out of view – privileges a certain kind of speech and how this may particularly impact on female subjects in a negative manner. Like her contemporary French feminist theorists (Hélène Cixous and Julia Kristeva) with whom her work is often compared, Irigaray emphasizes the importance of the expressive body to women, a dance in which the woman constructs ‘a vital subjective space’ for herself.16 In ‘jouissance’, she says, ‘they keep their limbs, their whole body moving, and in particular their legs’. Indeed, she notes ‘that in all the cases of paralysis in women described by Freud and Breuer it is the legs which are effected’.17 Irigaray identifies the importance of movement for a sense of female agency. What she sees in the later developments in psychoanalysis is what she terms an ‘analytic violation’. She describes how the subject is forced to lie back on the couch, open her lips and come out of herself. She posits ‘a woman is more at a loss when she is immobile than when she is moving’ and notes that the latter setting can be seen to enforce in order to serve the analyst and is imposed by ‘a practice of sexuality’.18 So Freud, she argues, disturbed by the theory of seduction, seeks to make passive the subjects in his consulting room. In order to resist that therapeutic violence, Irigaray proposes that the therapy space should allow for an active subject and the possibility to speak through the body. Irigaray argues that women have a particular relationship to ‘the flesh’, and her work suggests that this has significance within the therapeutic encounter. Dramatherapy can be seen to correspond to Irigaray’s desire for a ‘practicable’, which serves the speaking body of the client rather than to be immersed in the language of the analyst. More than that, the client is able to explore the space and the body-in-space rather than being limited to lying

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on a couch (or sitting on a chair). Not only is the client more physically free, she or he is also ideologically autonomous in that the dramatherapist very rarely uses interpretation as a therapeutic tool. What is of importance here is that the client develops confidence in his or her own psychological reflection. The notion of witnessing is central to dramatherapy: both witnessing others and witnessing oneself. Witnessing self – in the observer or director position – can allow for a different perspective of the client’s identity and experience. The therapist can also take the witness role, honouring their account. The therapist’s position is not about judgement or interpretation but simply ‘being with’ and acknowledging the client. The dramatherapist’s work in this mode can be seen to reflect Freud’s early work with his patients before he began to interpret their verbal narratives. For example, Freud’s work with his client Frau Cacilie M saw him lying on the floor ‘sometimes for hours at a time accompanying [her] through hysterical crises’.19 As Irigaray notes, Freud later turned to more analytical interactions but his initial impulses were to work intuitively with physical sensation and to dialogue with the speaking body. This methodology is seen to be at the heart of dramatherapy as well as being central to anorexia, whereby the sculpting of the body gives voice to mental distress, inextricably tied to issues of agency.

Speaking with the body: Embodied emotion A conventional psychosocial understanding of anorexia considers emotional aspects as central to the disorder. The term ‘hysterical anorexia’ is attributed to Ernest Charles Lasegue who, writing in 1873, identified anorexia arising when ‘A young girl, between 15 and 20 years of age, suffers from emotion which she avows or conceals’.20 For Lasegue, this emotional overwhelm results in disordered eating. There is something of this understanding in contemporary readings, where disordered eating can often be seen to signal a disconnect between physical experience and cognitive understanding. It is not uncommon for clients in therapy to distance themselves from difficult feelings, preferring to rationalize instead. This can be especially true for clients with eating disorders. This client group often prefer verbal to non-verbal expression with the latter experienced as more frightening as it is potentially more overwhelming. The need for more attention to the affective aspects of anorexia is discussed in works by Rebecca Park, Barnaby Dunn and Philip Barnard.21 They suggest that anorexia is sustained through an ‘oscillation’ between two states: the first type is referred to as the ‘doing’ mode, focused on restrictive eating, shape and weight, ‘with a neglect of broader emotional meaning and body states associated with starvation’. This is contrasted with

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the other extreme, when control is lost or taken away and the individual moves into ‘mindless, bodily emoting mode. Here, attention flips between aversive bodily sensations and emotional beliefs, resulting in feeling out of control, afraid and self-disgusted’.22 Hence, it is proposed that ‘cultivating a “being embodied” mode of mind, involving a shift in quality of attention to emotional and somatic experience, [is] a common route to recovery’.23 In anorexia nervosa, a division is often seen between head and body; some clients even state that they perceive themselves as consisting only of a head.24 Indeed, this can become physically manifest as the body shrinks, the head can appear out of proportion. This sense of disjuncture hinders non-verbal articulation and expression which involves the complete person – body and mind. There is a sense in which talking therapy can be very accessible to clients with eating disorders as it allows them to remain centred in their heads and engage in cognitive processing where they feel comfortable and in control. Psychoanalyst Selvini-Palazzoli suggests that the client ‘believes that her mind transcends her body and that it grants her unlimited power over her own behaviour and that of others’.25 Clients with anorexia are therefore more likely to display great emotional insight but not to be in touch with em-bodied emotion. This was certainly true of Jessi. She inhabited complex emotional worlds and demonstrated an astute awareness of the complexities of interrelationships yet, at the same time, she seemed disconnected from her body that would often convulse with involuntary twitching. The dramatherapy space was offered as a place for her to engage with both her emotional mind and her emotional body. To be out of one’s body (or dissociation, to give it its psychoanalytic title) is seen in relation to repression and the desire to distance oneself from the pain of a traumatic experience. Within dramatherapy, the body is attended to as a site for exploration which can reveal and re-member parts of the self which may have been cut off or stunted through past experiences. Clients often seek out this kind of therapy as opposed to the talking cures available as it offers them an opportunity for direct, physicalized exploration. Dramatherapist David Johnson’s client, who had previously been in talking therapy, articulates this approach clearly in saying that her hopes for dramatherapy were that she felt it might help ‘my body reveal what’s holding me back’.26 Dramatherapy, with its physically expressive exploration, which may circumvent cognitive processes, needs to be carefully introduced to clients such as Jessi who may perceive it as threatening. A two-stage process including a ‘taster’ group session, followed by a one-to-one, is a common strategy I use in this context. Jessi played a dynamic role in the taster session, where she created a vivid emotional backstory for the characters she was working with. In her one-to-one session, she expressed a real desire to join the project – overcoming her concerns about working in the group.

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The individual and the group As with many clients with anorexia, Jessi had used withdrawal from others as self-protection. Psychoanalyst Marilyn Lawrence notes how ‘Anorexia is a “no entry” sign’.27 Orbach talks about the emotional responses that might be experienced when meeting an anorexic woman. She talks about an awareness of an ‘almost physical boundary’ that seems impenetrable.28 On meeting Jessi, I was struck by her great ability to tell a story and the energy that exuded from her but also, as with Orbach’s experience, a kind of shield that kept her separate. Her talking could be experienced as a tactic to keep the listener at a distance. There was certainly a sense of distance and a desire to maintain that. One of McSween’s interviewees describes herself as ‘being surrounded by glass’.29 This was an experience common to many of the dramatherapy group members within the setting. Indeed, another group member, not diagnosed with an eating disorder, described himself as being behind a glass screen. As McSween notes, this desire to maintain a distance can often be understood in relation to early needs not being met and a sense of self which is ‘shaky’.30 I was acutely aware of the fragility of the individuals within the group and sought to provide a safe space within which productive interaction could be experienced in a non-threatening manner. Psychotherapist Nigel Jacobs notes that for a client with a vulnerable sense of self, monologues often become the norm.31 This mechanism prevents any threatening interaction and serves to maintain the integrity of the barrier between self and other. The beauty of working with dramatherapy is that the monologue can be addressed directly as a form, and they were my starting point for the creative work. The group were initially invited to develop their own narratives which could be delivered, without interruption, to the rest of the group. Over time, I would look to develop these into what I would term a ‘social monologue’, where other group members were invited to share in the monologue and so shifting subtly from the individual focus to a group experience. The group work would come in the form of concretizing the narrative that the individual had created. This seemed to demonstrate that the individual’s story has been heard as well as inviting group members to literally step into another’s story as they enacted it. Radmall, a dramatherapist specializing in work with clients with eating disorders, says: One of the features of anorexia is a concretisation of thought and feeling into the body. There is little space for an alternative perspective … I believe that beginning to be an audience to oneself and growing in

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awareness of others’ perspectives can free the client to adopt alternative, more flexible stories of the self.32

Thus, dramatherapy can offer a space to step outside the limits of the glass barrier that one has created for oneself and to begin to be in dialogue with self and others.

The body as transitional object Astrid Jacobse describes how her dramatherapy clients with eating disorders often ‘do not move much [and] talk softly’.33 This was certainly true of Jessi. She seemed to try and take up as little space as possible physically and vocally, speaking very quietly. She was always accompanied by her soft toy. Even the way she announced her companion spoke volumes. She said: ‘People think he is a duck, but he is a chick.’ She seemed to be informing the group straight away that they did not understand what they were seeing, as well as indicating the relation of her soft toy to her own identity. This connection, with what we might understand a ‘transitional object’, can be seen to indicate the exploration of boundaries which is often at play in eating disorders. For a range of reasons, there can be confusion as to the boundaries of the client’s own body and connection to the (m)other. Psychoanalyst Winnicott explains the transitional object as that which enables the child to take something of the (m)other figure while they experiment with their own separateness from her. Jessi’s soft toy was welcomed and acknowledged within the group. Sometimes he would take on a character and while we all recognized this as a puppet figure – there was no sense of delusion that he was real – I noted that this was a way in which Jessi could place part of herself within the action without placing her real body. This links with dramatherapist Ditty Doktor’s observation that many clients with eating disorders experience body boundaries which are a few inches outside the skin and create a protective shell. I took the sign of Jessi’s comfortor – which was attached to her through her hand – entering into the action as a sign of her body edging towards participation.

Safety and control Control is a very important element for any client in therapy but perhaps has a particular resonance for clients with eating disorders, who are often looking to control the detail of their lives through food and the body. Orbach describes

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how a person with an eating disorder may fear that their body’s urges may lead to it ‘going off full steam without me’.34 His or her daily concerns will often centre around being in control and demonstrating to himself or herself that he or she ‘can be more in control of her life than anyone else’.35 Entering into therapeutic process can be incredibly challenging, especially in a secure setting such as Jessi was in, where a lot of autonomy has been stripped away and her eating was controlled by others. This loss of agency can induce a real crisis and fear of disintegration as the structures and control that the anorexic has developed are taken away. For this reason, I felt it was essential in our work together that Jessi was given as much agency as possible. For Jessi her real concern about being in the group was that she should not be touched. As McSween notes, dislike or fear of touching is common in those with anorexia, and I was careful to assure Jessi that a non-consensual touch rule would be in place in the group. Agency was also supported by the group being in control of the environment and able to decide how the room was set out, being able to choose the activities each week from a given selection – to choose whether they were going to participate in the activities and to set boundaries within the activities. It was really important that the session was a safe space. As the facilitator I was at pains to assure the group members that there was no way they could do the exercises ‘wrong’. I was aware that success/failure is an important element for those with eating disorders, with failure as something that they anticipate for themselves which can lead to withdrawal. The exercises were relatively low risk, creative explorations where the story acted as a container. The ritual structure of the sessions with a consistent game which opened and closed each session offered predictability and safety. The emphasis on projection and externalization also served to reassure as projective techniques provided a useful distance.

Body/voice For a long time, Jessi would prefer to be at the edges of the action within the sessions. She would have lots of ideas and rich appreciation of complex emotional scenarios but would prefer to observe action from the sidelines and not physically engage. McSween references the ‘careful watching of one’s body’ which the anorexic often engages in and it seemed that, for Jessi, this was translated into the careful watching of other’s bodies too.36 The structures in place allowed this to be a valid choice within the sessions (including, as we have already mentioned, the use of her soft toy ‘proxy’). Over the course of the group, however, Jessi’s participation developed from observation to directing the actions and finally modelling physical activity.

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During one of the last sessions, we engaged in creating freeze-frames for a story that had been created by another member of the group. The participants were taking on different characters and holding a pose to create tableau of moments within the scene. It seemed important to work with frozen images in order to ‘contain’ the material and not to overwhelm the fragile members of the group by releasing into unpredictable action. Jessi had been actively observing the work, making suggestions as to what might be important within the scene. As always, her observations were astute and brought nuance to the relationships between characters. As she became more involved within the story, she started to suggest where characters might be in proximity to one another. She then picked up a prop to place in the hand of one of the characters and moved into the playing space. It was a shimmering moment, and I took the chance of asking her to show how it might be held by that character. It was a risk because I was asking her to make a physical gesture and be observed doing so but she did and, just for a moment, her arm extended. This was then mirrored back to her as her co-participant took up the pose. It felt like a truly significant event as she initiated a gesture towards another character and her body entered into a conversation. Positioning theory, as proposed by Luk van Langenhove and Rom Harre, posits positioning as a discursive act which ‘serves to make a person’s actions intelligible … and within which the members of the conversation have specific locations’.37 This was enacted within the dramatherapy session as Jessi was able to experience herself positioning an other and, in relation, to understand her own positioning and her ability to be in conversation and negotiate with an other. Her understanding of the situation was able to shift the perspective of others and demonstrate (both to herself and others) her ability to be in productive relationship. I would not frame this as ‘giving Jessi a voice’ but rather that her voice was acknowledged through attending to the physical form through which she was speaking. Witnessing Jessi’s body enabled an appreciation of her own fragility but also the potential for her developing awareness as the physical expression of her body articulated her complex subjectivity. This form of therapy allowed her to speak on her own terms in her own language and present herself in a way in which she felt comfortable.

Conclusion In her chapter ‘Psychoanalytic Approach to Drama Therapy’, Eleanor Irwin discusses the catalysts for theoretical change that marked a move away from psychoanalysis. She notes that innovations such as attachment theory and object relations served to move therapeutic practice into a

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more relational space. Yet she argues that core psychoanalytic concepts – such as the unconscious, resistance and transference – can still illuminate the work of the contemporary dramatherapist. What she doesn’t address, however, despite acknowledging that Freud’s work proposed both theoretical concepts and therapeutic methods is how early Freudian practice can prove instructive in the work of the dramatherapist as well as his theoretical models. Interestingly, Irwin cites Freud’s practice as ‘on the couch’ analysis.38 As I have demonstrated, Freud’s early work was often not on the couch and afforded a freedom of movement which was led by the client. I would suggest that Irwin’s methodological blind-spot emerges in the same way as the theoretical shift describes in the development from Freud’s model on drives to his later work. Perhaps for Irwin, the couch-based model of Freud’s practice is useful for its dismissal in that it stifles the relational aspect of the therapeutic encounter that was central to the emerging models. Freud’s earlier work is perhaps forgotten as it troubles the understanding of Freud as an overbearing patriarch. The image of him lying on the floor next to his client does not sit with the orthodoxy of the anti-analysis movement of which dramatherapy can be seen to be part of. A recent publication by the American Psychological Association, entitled Beyond Talk Therapy: Using Movement and Expressive Techniques in Clinical Practice, indicated a desire within contemporary clinical practice to reconnect with what came before talking therapy. There is a developing appreciation of the importance of the body and the potential of non-verbal interventions to work with clients who may not engage with talking therapies (or engage too easily in the case of those clients with eating disorders who can use verbal articulation as a defence). Dramatherapy, with its vocabulary of embodied practice, may offer useful models for that development. I often begin my consultations with a client by inviting them to identify a fictional story that is important to them. Jessi said that Wonder was her favourite story. In Wonder, R.J. Palacio tells the story of Auggie, a feisty yet loveable ten-year-old boy, who was born with distorted facial features. Palacio describes her thinking around the story as an exploration of ‘what it must be like to … have to face a world every day that doesn’t know how to face you back’.39 Jessi’s connection with this narrative was clear – especially signalled in her discussion of the reception of her soft toy that is often see as a duck (ugly duckling?) not a chick. Through the dramatherapy sessions, Jessi appeared to develop a greater sense of agency and authorship in positioning herself in relation to the world, facing it and trusting others to face her back with an enhanced understanding of her perspective and experience. Within dramatherapy, Jessi was able to rehearse how she may begin to take up her place/space within the world and be in dialogue with others.

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7

Where Is Her Mind? Space, Feminism and Madness in Plays by Sarah Daniels and Sarah Kane Chris Dingwall-Jones

Madness is making a comeback. As a PhD student in 2013, staggering under the varied and politicized terminology for describing experiences which might be described as ‘mental illness’, I chose to use ‘madness’ as an expansive term, which would encompass both the concept of ‘unreason’ and the particularized experience of individuals who may or may not have a diagnosis of ‘mental illness’. In a recent book, Anna Harpin offers a lyrical defence of ‘madness’ as a deliberately contentious, unstable term which offers a ‘radically open, relational, experience-led model’,1 which troubles the neat conceptualizations we habitually use to distance ourselves from phenomena which trouble us. This return of madness, and focus on individual and communal experiences, offers an invitation to engage with concrete, lived mad experiences. Harpin notes that despite the focus on institutional space in histories of psychiatry, less attention has been given to ‘patients’ experiences of sites’ or ‘the inter-relations between these places and their wider social and political milieus’.2 She proposes further that the cultural context of psychiatric spaces might be usefully traced through their artistic representation. This chapter responds to Harpin’s invitation by drawing attention to the particularly gendered articulation of certain cultural understandings of madness through a reading of plays by Sarah Daniels and Sarah Kane. The fruitful nature of this dialogue can be seen first in the stubborn persistence of tropes which marry women and madness, particularly with respect to the theatre. In a famous essay, Hélène Cixous argues that ‘only when [a woman] has disappeared can the curtain go up; she is relegated to repression, to the grave, the asylum, oblivion and silence’.3 More recently, Elin Diamond4 has suggested that the relationship between women and madness onstage is more permeable than Cixous’s account would allow. For

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her, while naturalist theatre represents ‘hysterical’ women in order to cement its own claim to objective rationality, the very attempt calls this rationality radically into question. If Harpin is right to identify cultural and (in particular) artistic representations as a key source of evidence in revaluating ‘how we articulate, conceive of, and treat madness’,5 then we must also pay attention to how particular works interact with their specific culture. Writing during a period shaped by the 1980s programme of deinstitutionalization known as ‘Care in the Community’, Daniels and Kane offer divergent perspectives on this complex and contested policy, during which the number of psychiatric beds were reduced, so that the ‘asylum’ ceased to be an easy metonym for madness. In her discussion of the spaces of madness, Harpin argues that too much focus on the surface ‘packaging’ of treatment ‘marks a failure to listen to the depth and breadth of experience’.6 By engaging with the complex spatial interactions staged by Daniels and Kane, this chapter aims to attend to precisely this depth and breadth, troubling the neat boundaries (spatial and conceptual) we attempt to erect around ‘madness’. Barry Edginton, describing a moment of conceptual transition which parallels the shift towards community care, characterizes William Tuke’s York Retreat (opened in 1796) as follows: In an era of transformations when the mad were no longer thought of as animal or inhuman, the Retreat provided an institutional bridge: a salubrious environment, a refuge, and a safe haven from the world.7

The metaphor of the ‘bridge’ is revealing – a controlled, two-way path connecting the world (reason) and the ‘mad’ (unreason). If Harpin is correct to note that ‘it is through the interactions of people, things, and the material space that lived experience is forged’,8 then the spaces and concepts we are considering are always more permeable than we might think. In order to bring to light these interactions, this chapter will pay close attention to the immediate social and political contexts of the plays under discussion. It will begin by exploring the relationship between space and mental illness in two plays by Sarah Daniels – Beside Herself and Head-Rot Holiday – reading them particularly within the context of 1980s feminist thought with which Daniels was engaging, as well as the sociopolitical framework of community care which informs the plays’ settings. It will suggest that while Beside Herself brings into focus the damaging consequences of the kind of binary thinking which attempts to restrict madness to its own proper ‘place’, it ultimately fails to escape this restrictive approach. By contrast, the cyclical structure of Head-Rot Holiday, as well as its genesis in interviews with patients, actively

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refuses this form of binary thought, providing a more fruitful focus on the complexities of patient experience. The discussion of Sarah Kane’s work will likewise be contextualized in relationship to the political changes which mark the distance between Daniels’s explicitly feminist approach and Kane’s more complex engagement with gender. The second section of the chapter will thus begin by outlining the contested discourse of ‘post-feminism’ with which Kane was engaging. It will then suggest, by reference to Henri Lefebvre’s spatial theory, that critical engagement with space provides a thematic ‘through line’ between her early plays (Blasted, Phaedra’s Love) and her later work (Crave, 4.48 Psychosis). The staged experience of space marks the point at which Daniels and Kane differ on the spatial, embodied experience of madness. Daniels’s feminist dramaturgy emphasizes the close association between space and mental illness, exploring the boundaries we set up between sanity and madness. This provides an important context for Kane’s more complex approach, which probes the points where all boundaries begin to dissolve. This probing finally leaves the audience with no categories by which madness can be held at arm’s length – the theatre no longer places madness ‘out of sight and out of mind’, but rather confronts the audience with its proximity. The chapter concludes with a comparison of two productions of Kane’s 4.48 Psychosis, which draws attention to the ease with which an uncritical use of cultural tropes of madness can defuse even the most critical attempt to offer this confrontation.

Sarah Daniels: Contested spaces and critical realism Daniels’s Beside Herself tells the story of St Dymphna’s ‘halfway house’ and its employees, focusing on Evelyn and her double, Eve, a figure for Evelyn’s own growing madness. Although introduced as an authority figure in contrast to the mostly silent residents of St Dymphna’s, Evelyn is forced, as the play progresses, to confront the traumatic consequences of her experience of abuse at the hands of her father. By drawing attention to the experiences of both staff and residents, Daniels examines how we recognize and interpret madness. The play opens in a non-realistic space: while the costume and blocking suggest a Renaissance painting, the set which contextualizes them consists of supermarket shelves. From here, the action quickly moves into the realistic setting of St Dymphna’s. Like Tuke’s York Retreat, St Dymphna’s provides a liminal space, a bridge between the ‘traditional’ location of  madness in the asylum and the public space which it is beginning to transgress through the process of deinstitutionalization. It is thus both the site of the residents’

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attempts to negotiate their own re-entry into public  space and the site of resistance from that public. This tension is made clear by the set used for St Dymphna’s: The room has been vandalized. The recently emulsioned walls have been daubed with paint. The only decipherable word ‘Loonies’ has pride of place between the picture rail and frame of the mirror over the fireplace. The mirror is smashed. The fragments lie scattered over the floor.9

These features visually reference the drawing room of turn-of-the-century realism, while the vandalism suggests that for ‘reasonable’ members of the community, madness must be marked by disorder. There is a tension between the apparently respectable trappings of the drawing room and the room’s function as a home for those marked as mad. This articulation between reason and unreason, when considered in relationship to Cixous’s notion of gendered conceptual binaries,10 is also a gendered articulation – bringing the basic connections between reason and unreason, gender and madness, into focus. While, to the patients, St Dymphna’s represents their chance to reintegrate, to ‘the community’ it possesses the disorderly valence of the asylum, rendered more threatening because it lacks the reassuring presence of gates and medical staff. This spatial ‘bridging’ is emphasized by the play’s structure, which oscillates between scenes in St Dymphna’s, and scenes with allegorical titles (‘The Power and the Story’, ‘Genesis’, ‘Exodus’) which take place in other locations, notably including a supermarket and the kitchen of Evelyn’s father. It is also echoed in the physical division between Evelyn and Eve, a division which constantly undermines the gestures towards realism, while emphasizing the fact that madness itself can be experienced as a spatial phenomenon. This is particularly evident in Part 2, Scene 5, where Dave (one of the residents) is found dead. Eve stands back ‘sizing up Evelyn’s performance’11 while the latter is speaking to the Ratepayers and then is the first to notice and respond to Dave’s death. While Evelyn attempts to hide Dave’s body by standing between him and the Ratepayers, Eve ‘jumps back in fear’, a response more appropriate to the situation, but finds herself questioning, in the second person, ‘are you mad? Are you mad? You are mad!’12 Continuing this spatial concern, Evelyn’s movement towards healing is represented, in Scene Eight, by walking out of the supermarket into the ‘open air’.13 In Beside Herself, the supermarket is a polyvalent location: at once a space of madness in which Evelyn’s façade of ‘normality’ finally crumbles and a space coloured by its position in the surreal opening sequence as both ‘a dream’ and Hell.14 Leaving the supermarket is seen as a

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moment of potential deliverance and cleansing, as implied by Scene Eight’s subtitle, ‘Exodus’. Biblically, the Exodus was a moment of deliverance, in which the Israelites passed through the Red Sea (an image of chaos) into the uncertainty of the wilderness. Following the resonance of the scene’s title, the supermarket can be related to the Red Sea, keeping Evelyn in slavery to her past and to the patriarchal conventions which see her as ‘absolutely barking mad’.15 It is through her ability to say to Nicola ‘there’s something I want to tell you’16 that she is able to cross it and, again paradoxically, to return to the ‘Genesis’ of her distress in order to confront it, first by sharing the truth of her abuse with Nicola and then by her cathartic confrontation with her father. However, in contrast to the instability of both St Dymphna’s and the supermarket, the spatial dynamic of the ‘Exodus’ into the ‘open air’ seems too simple. Indeed, it risks re-inscribing a patriarchal myth which, in associating women with nature, subordinates them to culture. Following Diamond’s observation that realism can ‘catch’ melodramatic elements from the representation of hysteria, Daniels’s dramaturgy here could, in the play script at least, be argued to have ‘caught’ patriarchal realism by implying an identification between women and nature. Heather Debling sees the scene in ‘the open air’ as ‘a straightforward or unproblematic testimonial process’,17 characteristic of the kind of understanding and community necessary to challenge the psychological trauma created by patriarchal structures. However, the spatial logic of the play also implies that in order to establish this female community, women must escape the built environment of supermarket, community home and asylum and return to nature – the open air. This is not the ‘entirely different stage/scene’ Cixous sees as necessary for a theatre hospitable for women,18 but rather another patriarchal myth in which women appear as the weaker half of a binary opposition. Because the play does not challenge the nature/ culture division, this subordination remains integral to the play’s resolution. While undermining the binary which identifies women with irrationality, Daniels’s dramaturgy re-inscribes women within the related binary of nature/culture. Although this may have been mitigated in production by leaving the set of the supermarket in place for both the Exodus and Genesis scenes, the identification of spatial escape with resolution is a problematic feature of much of Daniels’s work, from Mary’s suicide in Ripen Our Darkness (1981) to the utopian escape at the end of The Madness of Esme and Shaz (1994). Henri Lefebvre defines utopias as ‘spaces occupied by the symbolic and the imaginary’ and argues that ‘the most effectively appropriated spaces are those occupied by symbols’.19 This suggests something of the danger of Daniels’s

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approach: if resolution necessarily occurs ‘elsewhere’, then actually existing space is abandoned to domination, appropriation and immutability. Head-Rot Holiday gestures towards a less utopian approach to space. Set in a ‘special hospital’ for women considered to be both criminal and ‘mad’, Head-Rot also addresses the psychiatric landscape post-‘Care in the Community’ and emphasizes the fragile distinction between patients and carers. The play is made up of a series of vignettes, broadly arranged as the preparation for and aftermath of a Christmas party. Three actors double their parts, playing both nurses and patients, and we see how a history as survivors of abuse provides a context both for the behaviour of the ‘patients’ and for the abusive behaviour of nurse Barbara towards those in her care. Like Beside Herself, Head-Rot is structured around a division between broadly ‘realistic’ elements and elements which eschew realism. However, while the former ties this division to space by alternating between St Dymphna’s and allegorical spaces, the non-realistic set of the latter, consisting of a huge committal document which covers both backdrop and stage, remains constant. HeadRot claims realism not through the set but by drawing the material for its vignettes from experiences reported by actual patients in interviews – the play was commissioned by Clean Break, a theatre company for women exprisoners. While the vignettes are based on real experiences, the play’s structure draws attention to its own artificial circularity – the quip ‘hello. With the emphasis on Hell. Welcome to Head-rot Hotel’,20 from which the play takes its name, is used to welcome the new nurse Sharon at the play’s opening and is also the very last line, suggesting that for all the events of the play, nothing has really changed. Carina Bartleet relates this circular structure to hysteria by citing Julia Kristeva’s notion of women’s time as ‘cyclical’.21 She argues that the focus on embodied experience can be seen as ‘a doubly hystericized dramaturgy, which itself collapses the distance and separation between the knower and the known […] the play stages […] experiences rather than displaying the madwoman as a spectacle’.22 Although the play does not make a complete escape from the objectification of ‘the madwoman’, its critique of this objectification is possible because of the productive tension between the biographical vignettes, the play’s cyclical structure and the closed, nonrealistic space. Possibly as a result of the terms of her commission, Head-Rot Holiday is less straightforwardly redemptive than other of Daniels’s plays, because it offers no easy way out of the nexus of patriarchy, madness and power. As a result, it avoids the trap of abandoning the issues under discussion too soon, giving a narrative appearance of resolution which, by transcending rather than fully resolving the issues, leaves questions open, at odds with

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the artificial neatness of the dramatic denouement. For women in special hospitals, there is no easy way out, and the play’s dramaturgy attempts to communicate the mutually reinforcing relationship between the repressive structures of the institution and the ways in which madness shapes each individual’s embodied experience of those structures. The non-realistic set divided critical opinions, mostly on the basis of preconceived ideas about the play’s intentions. While Rick Jones of the Evening Standard saw the set as ‘the only outstanding feature’ of the play, giving the actors ‘the aspect of insignificant pawns enclosed by the terrifying greatness of the law’,23 Kate Bassett in City Limits argued that this failure of realism undermines ‘the play’s potent docudrama authenticity’.24 Bassett’s comments showcase critical assumptions about theatre’s role and about the ways in which female experience of madness should be staged. This can be related to the above account of the intersections between realism as a positivist form and hysteria as a gendered madness – the set, as well as the ‘awkward visionary insertions’ Bassett also complains of, absolutely refuses the audience’s desire to read the play as a straightforward ‘docudrama’. This refusal frustrates the culturally ingrained attempt to participate in a ‘monologue of reason about madness’,25 thereby forcing the audience to engage with the lived experiences of the characters rather than prematurely placing them in socially sanctioned narrative categories. By refusing the realist/psychoanalytic claim that madness exists only insofar as it can be ‘read’, but rather offering a mediated version of the subjective experience of those labelled ‘mad’, Jenny Tiramani’s set placed Head-Rot Holiday outside the visual epistemology on which realism is based. The audience is not offered a simple recourse to other binary constructions, but is caught in a constant conceptual dialogue between the implicit space of the mental institution, the visual space of the stage, the vocal communication of subjective experience and the body-presence of the actors. Although autistic spectrum conditions (ASC) are clearly a very different phenomenon to the madness under discussion here, Nicola Shaughnessy’s work on the imagination in autism26 can provide a fruitful approach to this apparent contradiction between naturalistic and hysterical dramaturgies. Shaughnessy draws on the work of Francesca Happé and Pedro Vital to suggest that there are different kinds of imagination and that the apparent imaginative deficits in autism only appear as deficits in relation to a narrow, neurotypical definition of imagination. For Happé and Vital, autistic spectrum conditions provide a unique world view which leaves ASC children ‘more able to think their own thoughts’, where typically developing (TD) children ‘lose aspects of their originality’.27 If we extend this line of thinking, then madness can also be understood as a ‘unique world view’, or indeed a set of

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unique world views. If this is the case, then a dramaturgy which is open to its logic, such as that employed in Head-Rot, may appear ‘impaired’ in its refusal to conform to the generic conventions it sets up. The  next section of this chapter will discuss how the shifts in space discussed above, in combination with changing conceptions of feminism, might affect the theatrical spaces in which gender and madness interact, particularly in the work of Sarah Kane. Bearing in mind this notion of madness as a ‘unique world view’ might offer one way of understanding the ways in which, as we will see, Kane’s work has been accused of being ‘impaired’.

Sarah Kane: Singing on the boundaries Elaine Hall and Marnie Rodriguez note that ‘according to the popular media, the United States entered a postfeminist era around 1990’,28 while Justine Ashby29 identifies a similar trend emerging in Britain over the course of the 1990s, with the Spice Girls and Bridget Jones’s Diary (2000) being exemplary instances of post-feminist media. ‘Post-feminism’ is a contested term: while Susan Faludi suggests that it represents a ‘backlash’ against feminism,30 Angela McRobbie complicates this by arguing that post-feminism ‘draws on and invokes feminism as that which can be taken into account, to suggest that equality is achieved, in order to install a whole repertoire of new meanings which emphasise that it is no longer needed’.31 Rosalind Gill goes further, suggesting that post-feminism simultaneously expresses feminist and antifeminist ideas, so that ‘notions of autonomy, choice and self-improvement sit side-by-side with surveillance, discipline and the vilification of those who make the “wrong choices”’.32 For Gill, post-feminism is ‘best thought of as a sensibility’,33 so that if, with Frederic Jameson, we see postmodernism as ‘the cultural logic of late capitalism’,34 post-feminism could be seen as ‘the gender expectations of late capitalism’. This returns us to the complex interrelationship between space, gender and madness discussed above. Because these terms are integrated into the binaries which structure understanding within cultures, changing gender expectations affect the construction of madness, and changing understandings of madness affect gender expectations. Similarly, these changing understandings also affect and are affected by changing spaces. The impact of these shifts on British theatre in the late 1990s and early 2000s can be glimpsed in Aleks Sierz’s Rewriting the Nation, in which he argues that ‘British playwrights in the 2000s explored the inner space of the individual mind’.35 By examining Sarah Kane’s use of space and its development, I will show how it has been affected by changes in both gender expectation and the

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physical location of mental health treatment, as well as how it engages with and challenges these discourses. My approach to Kane’s work will draw on insights from Elaine Aston and Alicia Tycer in order to avoid some of the more well-worn furrows of Kane’s criticism. Tycer suggests that ‘for many theatre critics, Kane’s final play [4.48 Psychosis] served to collapse the distinctions between life and art’ and draws attention to the ‘danger of over-eulogizing Kane and connecting her life too closely to her work’.36 Although it is true that Kane’s biography has inevitably shaped the reception of her plays (even to repudiate this strategy is, paradoxically, to repeat it), the following discussion will build on Tycer’s proposal that interpretation of 4.48 Psychosis moves away from autobiographical readings, aiming to trace more generally the trajectory of Kane’s dramaturgical approach to space. In addition to a rejection of autobiographical readings, this analysis will also build on Elaine Aston’s ‘disinterment’ of Kane’s first play, Blasted, and her reinstatement of it ‘as a landmark play in the context of contemporary women’s playwriting, and as seminal to an experiential genealogy of women’s playwriting where feeling the loss of feminism presses upon the drama’.37 Aston argues that Blasted can be seen as a way of moving beyond the second wave ‘rape-crisis’ discourses in feminism, without diminishing the crucial centrality of rape as evidence of the violence underpinning the (patriarchal) social order. If this is the case then Kane’s later plays, in their treatment of the spatial experience of madness, can be seen similarly as both genealogically related to and crucially different from those feminist narratives of madness which, like Beside Herself, see it simply as a figure for the psychic effects of sexual violence. Blasted stages the abusive relationship between Cate and Ian and their subsequent responses to an explosion which destroys their hotel room and introduces a still more violent soldier into the action. Of Kane’s plays, it is Blasted, with its focus on the relationship between interpersonal violence and the violence of society more broadly, which indicates most strongly the genealogical link between her concerns and those of Daniels. As with HeadRot, critics focused on the use of space in Blasted. Christopher Wixson notes that ‘Kane’s characters long for a space that confers upon them the properties of home [ … but] find themselves lost in place’, and argues that ‘spatial transgressions are at the heart of some of the critical resentment of Blasted’.38 As an example of this, Michael Billington suggests that the play ‘falls apart’ because there is ‘no sense of external reality’,39 expressing frustration at Kane’s refusal to situate the action of Blasted within a concrete space or time. Henri Lefebvre can help us consider the implications of this refusal, a refusal which also applies to Head-Rot. He suggests that an excessive focus

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on textuality and visibility abstracts our awareness of time and subordinates it to ‘the modernist trio, […] of readability-visibility-intelligibility’.40 This trio creates a space which ‘presupposes and implies a logic of visualization’,41 and which hides the process by which it comes into being. Plays like Blasted and Head-Rot, by refusing this straightforward approach to space, can reveal the articulations between space and truth, if only briefly and in glimpses. Blasted can ‘work affectively on audiences so that they might feel the loss of feminism’42 precisely because it resists the naturalistic impulse of a fully realized fiction. Billington’s criticism unwittingly highlights precisely this strength – the refusal to fulfil the expectation of dramatic space allows the play to ‘communicate directly with the spectators’ nervous systems, not to inform them’.43 Thus, the play’s use of space can be seen as an instance of the ‘relational, experience-led’44 approach called for by Harpin. This critical approach to space remains a key element of Kane’s dramaturgy throughout her career. Partly as a result of Kane’s use of a pseudonym (Marie Kelvedon) to disrupt the assumptions created by the Blasted controversy, Crave (1998) and 4.48 Psychosis (2001) have often been seen to mark a break in her career – Ken Urban describes them as ‘companion pieces, both reflecting a shift in her work’,45 while Sierz sees 4 .48 as the point at which Kane ‘kissed goodbye to realistic play-making’.46 Although it is true that, with Crave, Kane abandons her detailed and often unstageable stage directions for a deliberate silence concerning set and blocking, it is just as legitimate to read this shift as the logical conclusion of this earlier approach. Stage directions such as those at the end of Phaedra’s Love (1996, an adaptation of Seneca’s Phaedra), in which ‘Man 1 pulls down Hippolytus’ trousers./Woman 2 cuts off his genitals./They are thrown onto the barbecue’,47 point directly to the inability of theatre to represent them literally and hence to the loss inherent in any staging. In Phaedra, and in the later Cleansed (1998), the articulation between text and space becomes clear precisely at the point at which it breaks down, the point at which the fiction of transparent space is replaced by clearly contingent stage action. Lefebvre, in arguing against semiological readings of space, admits ‘that space signifies is incontestable’. His main point of contention with semiology is that it reduces space to its signification and thus obscures the fact that spaces are ‘if anything, “over-inscribed”: everything therein resembles a rough draft, jumbled and self-contradictory’.48 Kane’s stage directions demand such an over-determined response – in directing Phaedra, Kane ‘made a decision that [she] would try to do the violence as realistically as possible’ in order to test the signifying potential of theatrical space: ‘if it didn’t work then we’d try something else’.49 The result of this was that, in rehearsal, cast and crew were ‘all severely traumatized’, and in performance the distinction between

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audience and performers collapsed, as the stage blood and entrails were ‘chucked over the audience’s heads’50 and ‘audience members’ turned out to be ‘plants’ from the cast, implicating the audience as part of the crowd baying for Hippolytus’s death. As David Greig writes in the introduction to Kane’s Complete Plays, ‘by demanding an interventionist and radical approach from her directors she was forcing them to go to the limits of their theatrical imagination’51 – and in reaching those limits, they are forced to disavow the simple legibility condemned by Lefebvre. By the time that Kane came to write Crave, even the boundaries imposed by the near-impossible stage directions have vanished, but this does not mean that space is abstracted, since the very fact of staging implies and produces a space. In his discussion of Kane’s work, Christopher Innes connects her focus on the visual ‘which […] required a production evolved from improvisation and devising’ with the influence of performance art, in which ‘physical action becomes the equal of verbal dialogue, or even the dominant mode of expression’.52 By shifting her practice away from providing near-impossible stage directions to providing none at all, Kane offers creative teams a way out of the over-determined space of the institution. In Beside Herself, Head-Rot and even Kane’s own Cleansed, the identity of the institution is challenged by drawing attention to the fact that those who are supposed to be the custodians of madness may also be mad. However, this approach still objectifies madness, focusing on ‘surface packaging’,53 even if in a critical manner. By contrast, Crave and 4.48 Psychosis create for themselves a liminal space at the articulation between individual experience and social constructions of sanity. This liminal space is not, at bottom, a metaphorical representation of the point at which madness enters the physical world, but rather the playing out in time and space of a concrete process: as a voice within 4 .48 says (thinks? hears?) ‘I sing without hope on the boundary.’54 4 .48, an experimental ‘text for performance’ with no stage directions, cast list or division of characters, addresses questions of madness directly, offering meditations on the nature of suicide, psychiatric medication, love and the therapist/patient relationship. The play orientates itself with one eye on the feminist asylum dramas of Sarah Daniels and Caryl Churchill and another on the hyperindividualism evident in some ‘post-feminist’ approaches. Kane herself draws attention to the crucial yet permeable boundary between mind and space, linking the experience of psychosis and her own formal experimentation: If I were psychotic I would literally not know the difference between myself, this table and Dan […]. They would all somehow be part of a continuum, and various boundaries begin to collapse. Formally I’m

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trying to collapse a few boundaries as well; to carry on with making form and content one.55

However, Kane combines the conviction that psychotic experience entails a breaking of boundaries and loss of self with the necessity of interpersonal connection. She describes madness in strikingly Cartesian terms, as ‘the split between one’s consciousness and one’s physical being’, for which the only solution ‘is to connect physically with who you are emotionally, spiritually and mentally’.56 The task of anyone directing the play, therefore, is not to resolve this apparent contradiction but to allow it to be embodied – a split between consciousness and physicality results in a dissolution of the split between self and space. The remainder of this chapter will compare the use of space in two productions of 4 .48, one directed by James Macdonald (2002) and other by the Polish company TR Warszawa. In Macdonald’s production, Jeremy Herbert’s set produces a sense of disorientation and foregrounds the interaction between space, self and identity by placing a huge mirror, slanted towards the audience, behind an anonymously minimalist set. The mirror does not simply reduce the amount of (physical) space available but also (paradoxically) increases the sense of space, doubling the actors and projecting them into a non-space beyond the bounds of the theatre itself. In addition to the commentary on ‘different states of consciousness’57 provided by this mirror, its spatial and theatrical function cannot be overlooked. For Lefebvre, ‘the mirror is an object in space which informs us about space, which speaks of space’ and which ‘introduces a truly dual spatiality [  …  arising] in connection with the (material) body/subject and the (material) mirror/object’.58 As such, it speaks to the spatial and material grounding of psychic experience. In Macdonald’s production, the mirror allows the audience to experience a dual spatiality, positioning them within the process by which physical space is articulated into psychic space and vice versa. This may be one reason why critics reported a sense of release as, on the play’s final line ‘please open the curtains’,59 the theatre’s shutters were opened, reconnecting the audience to the ‘real’ space of Sloane Square. By reorientating audience experience to the ‘non-theatrical’ outside space, the distinction between psyche and space, undermined by the dual function of the mirror, is reinstated. The mirror links back to earlier constructions of madness as a visible and legible condition, exposing them to critical evaluation – madness as a problem to be solved. In Daniels’s plays, the ‘splitting’ device in Beside Herself notwithstanding, this ‘clinical’ approach to madness is maintained. Madness is re-conceptualized as having its aetiology in the social realities of patriarchy

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rather than being an essential biological feature of femininity, but it remains within the logic of the visible. In keeping with Aston’s observations about the relationship between Kane’s work and earlier, more explicitly feminist theatre,60 both Crave and 4 .48 radically resist this logic. Instead of examining the social forces acting on an identifiable body, Kane refuses to be explicit about the body/ies to and in which the experiences presented are occurring. In both 4 .48 and the similarly fragmented Crave, it is hard to be sure how many individuals are involved or the extent to which the events depicted are playing out in physical or psychic space. The odd moments of chorus in Crave (‘C: LEAVE/A: COME BACK/ALL: STAY’, the alternating ‘yeses,’ ‘noes’, and ‘short one syllable scream[s]’)61 complicate any attempt at individuation, while Macdonald’s production of 4 .48 emphasizes that play’s even deeper ambiguity in characterization, as the mirror undermines even the notion of a single speaking body. Other companies have been less eager to embrace the radically unstable spatialities implied in 4 .48. An instance of this more conservative approach is a production by Polish company TR Warszawa, first presented in the UK at the 2008 Edinburgh International Festival. Dominic Cavendish’s description of the set in his review for the Daily Telegraph, ‘lined with washbasins at the back, bisected by a transparent wall’,62 already suggests the difference between the two productions. Rather than Macdonald’s experimental stage space, we return to the institutional trappings of the asylum. The desire to confine the stage representation to a more-or-less well-defined institution arises in part from a desire for legible spaces of madness. As we have seen above, this legibility is antithetical to Kane’s conception of psychosis as the point at which ‘boundaries begin to collapse’.63 In order to maintain the security of the asylum walls, TR Warszawa is compelled to rewrite the script, replacing Kane’s carefully paced text with a coherent, linear narrative. While this approach may be more coherent, emphasizing the individual experiences of Magdalena Cielecka’s character, it also removes the disorientation created by the text’s refusal to attribute itself to a specific voice. Rather than extending the text’s polysemic resonance, the insistence on narrative coherence repeats attempts to give a transparent meaning to the experience of madness, just as one voice in the play tries to define the ‘meaning’ of self-harm: ‘lots of people [self-harm]. It relieves the tension’. Another voice retorts ‘it does not relieve the tension [ … I do it] because it feels fucking amazing’.64 While TR Warszawa’s version of 4 .48 relieves the tension of the text’s paradoxical structure, this is at the expense of the play’s spatial complexity. The asylum setting insulates the play, insisting that madness remain in its ‘proper’ place, and in so doing removes its danger, while reinscribing the trope of the vulnerable, sexualized woman, who ‘begins pale,

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taut and angry and ends blank-eyed and half-naked’.65 Cielecka’s experience is isolated, frozen in an institutional non-time, and related only to Kane’s own suicide. Innes argues that ‘the violence of Kane’s images is intended to destabilize sanity, to free the subconscious’.66 While this is a limited reading, attributing an anti-psychiatric valence to a play which is fully aware of the consequences of the place from which it speaks, 4 .48 does have the potential to draw the audience into its own logic as the boundary between self and other is challenged. In order for this to occur, however, the text demands a space which allows this boundary to be called into question, not one which insists on its permanence. It is only when this invitation is accepted and allowed to influence every element in production that Kane’s play can serve as an example of ‘thinking not about but with madness’.67 The plays and productions discussed in this chapter have enabled us to think critically about the interaction between the historical association of femininity and madness, and the various stage spaces in which these associations are explored and challenged. The plays of Sarah Daniels, under the influence of feminist scholarship, sought to undermine the mapping of the sane/mad binary onto the male/female binary. They explored the unstable psychiatric spaces resulting from deinstitutionalization and sought to turn these spaces to tactical advantage. By contrast, the formal and spatial experiments of Sarah Kane responded to the ‘loss’ of feminism implied by the recuperative logic of post-feminist thought by turning to post-dramatic spaces and unstable bodies. In Kane’s plays, space becomes at once more central and more problematic as the madness of the characters inhabiting that space becomes more acute. By refusing to attribute a specific identity to the spaces of madness, Kane’s dramaturgy calls into question both the totalizing logic of scientific and medical gazes, and the essentialist approaches to gender and madness implicit in earlier feminist discourses. When the potential for spatial disruption is grasped, these plays confront the audience with the proximity of madness by highlighting the futility of conceptions, categories or spaces which attempt to keep it at arm’s length. In this way, they encourage audiences not to view madness as an external phenomenon to be assessed but as something always uncomfortably proximate.

Acknowledgements The author acknowledges the Arts and Humanities Research Council for its funding of ‘Creative Practice as Mutual Recovery: Connecting Communities for Mental Health and Wellbeing’ (grant number AH/K003364/1).

Response: Incomprehensibility and Mutual Recovery Paul Crawford

Reading Christopher Dingwall-Jones’s chapter, ‘Where Is Her Mind?’, provokes one’s own mental journey into the concept of space, the liminality of the imagined and the real and the social-politicalphilosophical interpretation of ‘mental illness’ or, less formally, ‘madness’. We are tethered by a close, dare I say stable, theorizing of the unstable by Dingwall-Jones who provides a nuanced account of the challenging presentation of plays by two Sarahs (to extend the double motif inherent in the piece) – Sarah Daniels and Sarah Kane. Dingwall-Jones diligently maps out and interrogates the interplay between feminist notions of social reality and the experience of mental states and spaces. He conveys both the suffering of fugue and the binary wedding of notions of sanity/ insanity or reason/unreason, marking a transition between institutional changes in the treatment of people with mental states deemed problematic, notably in the purported shift from the asylum to community care in the UK. I say ‘purported’ because it is not clear that all that can stand under the term ‘asylum’ disappeared in the by no means comprehensive reorganization of psychiatry’s buildings and clinical workforce in the UK in the 1990s. This is something I explore in my novel Nothing Purple, Nothing Black, in which the ‘mad and the sane’ end up sharing ‘the same bathwater of life’.1 Dingwall-Jones’s analysis also pushed the refresh button on some of my thinking and academic writing about mental health. First, his carefully footed commentary on the silencing of women and those deemed ‘mad’ reminded me of my work with colleagues on ‘incomprehensibility’ in the narratives of people diagnosed with schizophrenia.2 Congruent with Shaughnessy’s approach to lack in autism,3 we argued that narratives of people with this diagnosis are not incomprehensible or to be dismissed as meaningless by clinicians. Incomprehensibility is not simply a lack in the person with schizophrenia and their language, even in psychosis, but in the clinician who determines what stands as a disordered mind and what

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such a mind can or cannot articulate. This secular excommunication or delistening, of course, has bedevilled people who have ideas, behaviours or, indeed, genders, which refuse to fit the prevailing social contract. Second, the blurring of boundaries between the identities of clinicians and patients in the asylum that D ­ ingwall‑Jones’s chapter addresses features strongly in my own observations while working in the mental health sector and most recently in investigating the possibilities of ‘mutual recovery’.4 The blurring of boundaries between mental health staff/patients and asylum/community is prominent in what we have called elsewhere ‘Mad Lit’,5 for example, in Edgar Allan Poe’s short story, The System of Doctor Tarr and Professor Fether,6 in which the patients take over an asylum and lock up the staff or keepers as lunatics. Importantly, such blurring of boundaries challenges us to think about the limits of this division in status and role. This is something we can consider in terms of the possibilities for mutual recovery. It has been a damnable feature of contemporary mental health care that despite a focus on patient or service-user involvement and a rhetoric of personal recovery despite symptoms, little has changed in psychiatry. Patients remain patients and the power of expertise is retained by the clinicians. Clinicians are the preferred ‘sane’ and patients are the preferred ‘mad’. Psychiatry pays only lip service to expertise through experience. Even policy language of mental health recovery reveals that people with experience of mental decline or difference are there to confirm the decisions of the experts – a kind of soft excommunication. Yet clinicians are struggling with their mental health too and, in this sense, share ‘the same bathwater of life’ with those they are paid to care for. As such we need to consider more seriously their need for recovery alongside that of patients. To conclude, Dingwall-Jones’s chapter and the turbulent presentations of spaces and boundaries for sanity and insanity generated by the plays he inspects offer a welcome provocation to consider the artificial firebreak that is set between mental health clinicians and patients. Both populations experience mental states or elicit behaviour which they or others find problematic or unacceptable. It is my view that a closer look at how clinical staff and so-called patients can mutually recover a better life is timely. We  need community and mutuality-led conceptions of recovering mental health that de-stigmatizes and narrows the boundary between clinicians and patients. Of course, this will always be a battle as clinicians protect their expertise surplus to maintain salary levels and to avoid replacement by cheaper units of delivery, be these online or flesh and blood. Unfortunately, a neoliberal individualism dominates psychiatry, blocking mutuality, sustaining hierarchies and subjugations, encouraging as much inequality, loneliness and excommunication as possible. The plays of Sarah Daniels and

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Sarah Kane, alongside the analysis by Dingwall-Jones, are excellent rejoinders to the drive to make some people less than others and control intracranial and extracranial space or territory to support this. We can perhaps grasp a little more that the institutional asylum is less a place than a mentality and a metonym for discrimination. If we are held within an ‘asylum’ or argue against it, we perform incomprehensibility to those who welcome the contrast it provides to their particular kinds of sanity, stability and order. By sharing a mission of ‘mutual recovery’, perhaps this gap can be eroded.

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A Cry without an Echo: Consciousness, Creativity and the Healing Work of the Arts Ellen W. Kaplan

‘In here, there are only three ways to go’, wrote Robert L. Cook of Graterford State Correctional Institution in 2015, ‘Snap out, snap down, or snap up. I  snap up!’ Arts practitioners working in prisons have testified to the inherent value of creative work as enhancing self-esteem, fostering selfinsight, developing the ability to work with others and sharpening skills.1 Yet few resources are directed at long-term incarcerees (‘incarcerated’), and arts programming on death row is exceedingly rare. Self-evidently, those who can only expect ‘pine box parole’ do not need programmes that support reintegration or ‘rehabilitation’.2 But artistic expression offers dignity and purpose, ‘a profound assertion of self ’, allowing even the lifelong prisoner to ‘keep hope, and emotion, alive’.3 ‘Recent research suggest[s] that meaningmaking through creative work may lead to post-traumatic growth’,4 say the authors of ‘Bringing the Whole Universe to Order: Creativity, Healing and Posttraumatic Growth’, an essay in James C. Kaufman’s Creativity and Mental Illness, which reviews current scientific knowledge on the healing power of creative work. Creative expression is potentially an act of resistance to stigma and shame, with both individual and societal implications. As a theatre practitioner working with prisoners serving life sentences or facing execution, I have found that ‘playfulness’, as a fundamental element of creative work, has a vital, if incongruous, role in addressing the trauma associated with incarceration. In this chapter, I consider the process of co-developing a play with prisoners using playful, non-realist strategies and pose questions about how theoretical studies of trauma and recent advances further inform. How does the relationship between creative expression and trauma influence arts practices in prison?5 How can resisting realism, with its authorizing voice and insistence on normative thinking, benefit those who have experienced trauma (as have most prisoners) and open spaces previously inaccessible to feeling?6 How might such processes encourage personal agency and the

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project of reconstructing the self? Finally, how might arts practitioners develop strategies that are ethical and responsive to social and individual imperatives related to incarceration, where trauma so deeply informs identity and experience?

Making work, doing hard time Someone Is Sure to Come (SISTC) was written in collaboration with men and women on death row or serving life without parole (LWOP); several have spent decades in solitary confinement. The play was produced at Smith College, along with an art exhibit by one of the inmates, as part of a campuswide initiative focused on incarceration. Subsequently, it was presented with a professional cast at La Mama Annex in New York City, where family members and friends of one of the inmates were among the audience. A  condensed version was published in Tacenda, a journal featuring work about crime, punishment and social justice. SISTC uses poetry and story to weave composite portraits in which prisoners explore the confines of their world; they reach up and out, but cannot touch; contact is not allowed. The  narrative is framed by a fictional outsider, a girl adrift on an ice floe in the barren Arctic Sea. Isolation and fear drive her mad; she hallucinates, doesn’t remember who she is or why she’s here; she cannot sleep; time spools out, unvarying; nothing ever changes. Ultimately, her hair turns grey and she hangs herself with her own braid. Five black men and two white women from state prisons across the United States contributed to SISTC; gender and racial imbalances reflect the realities of incarceration in the United States and mirror the extreme over-representation of black males facing the death penalty. The play evolved through long-term conversations by phone, letter and email, and in three cases, through lengthy in-person interviews. Material was elicited through open-ended prompts; elucidated through frank discussions, brainstorming, free association and poetic elaboration; additionally, some work was excerpted, with permission, from previously written poetry collections and book-length memoirs. Ru-Jo submitted over 600 pages of a life-narrative, from which short anecdotes were distilled. Basemore offered a cycle of poems (‘Po Hymns’), which reflect the anguished racial history on which the carceral enterprise rests. One major challenge was to develop texts that use a wide range of poetic strategies to evoke, rather than simply describe, the material conditions of prison life. Eliciting such material was only partially successful; some of the writers struggle with basic literacy, and most are habituated to realism as a default style. Still, the process of

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exploration and experiment, and the opportunity to be heard in a public forum, is valuable to the writers and potentially to the audiences for whom it is performed. SISTC does not address life histories or past crimes; rather, it chronicles lived experience, emphasizing the here and now. The contributors to SISTC are survivors of significant trauma; all cope with the stigma associated with incarceration; they write about the emotional impact of facing execution and serving hard time. These authors inhabit a world of uniformity and ennui; their lives are delimited by institutional needs, which, for economic, political and ideological reasons, are often impervious to change. The writers expand the parameters of daily life by visceral and active writing that focuses on sensory and kinaesthetic experience, dialogic encounters and dream imagery. The play’s structure is non-linear; it incorporates movement and text with strong melodic and rhythmic undercurrents. Choreographed segments include a fable about an inter-species war between rams and boars that allegorizes racial oppression; a dance of killer whales starved of sustenance and forced to hunt in depleted waters, which speaks to conditions that contextualize violence; a choral piece about a guard who tries, and fails, to cut down a ‘hangar’ – a suicide – on the row. Personal and societal traumas are addressed indirectly, with no attempt to literally explain or describe them. Dramatization offers an opportunity for writers to examine their personal stories and the conditions in which they live; the non-realistic style broadens the scope of how these stories are rendered.

Process and production of Someone Is Sure to Come Several years ago, an education specialist at Ludlow SCI (MA) invited me to bring in ‘entertainment’ for a programme that served incarcerated mothers and their children. Infrequent and inconsistent visits, scheduled once a month, plus the fact that many mothers were functionally illiterate and couldn’t read to their children, made the visits problematic. We brought the cast of Twelfth Night to the prison in costume and in character, but rather than ‘do scenes’ for, we played with our audience: Feste juggled, Sir Toby belched, Sir Andrew Aguecheek did pratfalls and taught the kids his silly dance. One mother gave Orsino a dressing-down for being an egotistic jerk; another told Viola to stop waiting around for her man. We took pictures with an old Polaroid camera and shared them with the mothers and children, who then re-staged themselves with the actors to create new pictures. The exuberant participation informed my subsequent work, which has included conducting theatre workshops with rural and inner-city kids,

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‘special needs’ children, adjudicated teens, adult learners; teaching a college seminar in a women’s prison; and devising new works of communityfocused theatre. These experiences, along with pedagogical and political concerns about the brutal realities of incarceration, sparked my interest in how theatrical performance might translate into the rough settings of solitary confinement and death row. However, physical performance is an unattainable option for most of these prisoners.7 When theatre programming is limited or non-existent, creative writing strategies that imagine an unconfined body and emphasize sensory awareness can offer a powerful substitute.8 G., on the row at Central Prison in Raleigh, NC, speaks to the inherent benefits of acting, which had been available to him until a theatre programme on the row was suspended. He explained that performing offered a sensory, bodily and cognitive engagement with ‘many possible selves’; when acting was no longer an option, writing became an alternative way to articulate and distill personal struggles.9 The substance of my work with inmates has been an interactive, relational process of sharing life stories as co-equal artists. Significant here is my own background as a survivor of sexual assault and major illness, which spurs my (partial, incomplete) connection with those facing longterm incarceration. This personal history gives me a committed place from which to engage; it has left its mark on my work as an actor and writer and has fully informed my interactions with inmates who collaborate with me. In developing SISTC, deeply personal, highly sensitive material has been discussed; clearly, not everything offered in private is permissible (or legally advisable) to share. My role is not to probe vulnerabilities or open old wounds. Rather, in what I hope is an equitable exchange, I speak openly, barter skills, offer an arts ‘tool-box’ and try to be a relational and ethical listener.

Ethical listening, relational listening, reciprocity Acknowledging and inhabiting the space of difference is crucial to establishing trust, which is fundamental to the relational aspect of collaboration. Jill Bennett, whose work in trauma studies has opened an important conversation about art produced in zones of conflict, defines ethical listening as ‘a mode … that can support and tolerate difference, rather than either repudiating it or assimilating the experience of the other to the self ’.10 She cites artists whose ‘work proceeds from an identification forged with the primary subjects of violence … [allowing] the pain of the other

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to inhabit the self ’.11 As an ethical listener, I cannot remain impassive and unchanged by the words of those with whom I work. And as co-writer, I am not a disinterested presence. Being heard by others is a deep-seated need; connection matters. As one inmate says in SISTC: ‘I take what nourishment I can, little bits of light, I grab it, take it into my cell, when I talk to you.’12 But meaningful exchange is based on trust and must be reciprocal. Participation requires openness, a truthful reveal of one’s own limitations and vulnerability. Certainly, this is what the inmate/authors contribute: CUSH I spread my arms, spread eagle, I touch the walls of my crib. That’s how big. The span of my living quarters, 29 years. Gritty shitty concrete mold. Gotta keep from snapping out. I write, I paint. Every stroke of the brush, every stroke of the pen. That’s how I get a grip on these walls. Push ‘em out, so I can breathe. Then they close in again. Someone’s got to listen. Someone’s got to know I’m here. RU-JO Plenty men, they profit on me. Plenty profit from my degradation. CUSH I’m buried in here. You’re building your house on my bones. BASEMORE Welcome to the unholy. You are death personified now, Please be advised: This is the death posture, You’ve been selected …  For the death roster.13

Agency, meaning-making and being heard ‘I write, but who the hell is listening?’ asks Basemore, in solitary for over two decades. ‘I need to speak because no one knows I’m here … If people don’t know who you are, you don’t exist.’14 His poems vibrate with the tragedy of black history: I hear the rumbling of bones in the clouds. I hear bloody chains rattle on like memories that don’t die. The snap of lashes, whipping up the winds, bringing to me the rhythm of your hurt. Your rhythm is chased by the rhythm of death, hungry to devour everything, even our unborn

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children. Polyrhythms of the whip occur and recur and I stand against them, I am their nemesis. / Even in the ocean I hear The Beat. / Souls of the middle passage / Let me not find sleep.15

Jarvis is a practising Buddhist and a published author of powerful, incisive autobiographies. He has been on death row for twenty-eight years. This story is based on an incident he witnessed, when an inmate committed suicide on the row: Bobby Goose is hanging off the cell door. A twisted bed sheet wrapped around his neck. ‘He only have one shoe on.’ The guards try to loosen the knot, scramble to find the ‘cut down tool,’ push hard to bring Bobby back to life. They administer CPR to this man who will die – one way or another – on the Row. The guards, Jarvis discovers, see this man as a human being. ‘Somewhere in me had always thought … nobody on death row would ever be entitled to … them [the guards] doing anything.’ In that instant, the guards, ‘seen [sic] a human being, not a condemned man, awaiting execution. They reacted as human beings and did everything, everything to save the life of another human being.’

Folding the story into SISTC, we created a movement score and a chorus of voices to further dramatize the event and its impact on those involved. One of the guards told Jarvis that after Bobby Goose died, his perspective on death, and on the death penalty, changed. The guard had done all he could to save a life that was slated to end by execution, and after that, he could no longer support the deliberate taking of a life (by the state). Jarvis’s own point of view transformed as well; for the first time, he came to see the COs as human. Theatricalizing the story, writing characters, teasing out voices, pushed the writer – and perhaps the audience – towards empathy and insight. In Prisoners, Solitude and Time, Ian O’Donnell writes that for many in prison the burden of self-examination is unbearable, while for others, artistic expression catalyses insight.16 Moor Allah, in solitary at Graterford, PA, writes: ‘Prison has changed me for the worse.’ Every day he sees the scarred men on his tier: hard, cold and dead inside. ‘Acting grown doesn’t make a man. This place forces you to hate everyone around you. And what’s crazy is you really can’t share these feelings with the people your [sic] around because there [sic] feeling the same things. I’m really starting to hate men’s voices … I just shut down … Besides [writing], I’m just withering away.’17 For G., however, ‘the writing itself creates the meaning’.18 Writing about himself as a six-year-old conjures up sense memories: textures, colours, sounds, smells, which in turn evoke previously forgotten relationships and events.

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The  memories lead to an unexpected exploration of sexuality, masculinity and criminality. He  recalls how, at eleven, he started smoking and then stealing cigarettes, which conformed to his child’s image of being a ‘man’. Growing up in a household with four brothers and an abusive, alcoholic father, he could not protect himself from extreme violence nor could he challenge the prevailing (and unarticulated) conceptions of maleness which constructed the self he begins, now, to understand. O’Donnell identifies meaning-making as key to resilience: ‘He who has a why to live, can bear with almost any how.’19 Meaning, according to O’Donnell, stems from ‘ideology’, often religious or political, which gives context to suffering. O’Donnell calls this reorientation one of seven ‘Rs’ that support survival in prison. Ru-Jo meticulously describes how he structures time (which O’Donnell calls rescheduling) through rigorous spiritual retreats: I have to find a way out of this hell hole of a maze. So I came up with this retreat to keep me sane. I stay in my cell for a month, no going outside at all. I do these 5-day fastings to clear my BODY, SOUL, and MIND. No meat, no bread, no salt, no sugar. Week 1, no TV. Lots of Bible. 48 hours no sleep,  72 hours no food, that’s the first 5 days, very intense. Week 2, no breakfast. Week 3 no breakfast, work out twice a day. Week 4 no reading, no writing. Week 5 very intense, no talking. It helps me deal with the madness in this hell hole. I recharge my spiritual battery.20

Other strategies O’Donnell identifies include removal (sleeping, reading or watching TV), raptness, the absorption that accompanies creative activity, and resistance. Cush, determined to fight what he sees as the injustices of a system that put him on death row, has consciously chosen ‘acts of resistance’, for which he has spent twenty-nine years in solitary confinement. For him, resistance is an act of psychological and spiritual survival. To ‘snap out’, he says, is to go crazy; to ‘snap down’ is to crumple, give in, quit living; but to ‘snap up’ is to push yourself to another level, to channel love, rage, pain and joy into creative action. Cush chooses to ‘snap up’: his wide-ranging studies in theology, African-centred spirituality, history, anthropology and new-age physics, along with his extensive work as a prison advocate for himself and others, are testaments to his resilience. So are his fantastical writings and abstract paintings, which give oblique expression to decades in solitary. He cannot explore his experience directly; approaching the psychic wound directly is paralysing, he says. Trauma exceeds words, expression is inadequate to

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experience. But Cush’s artistic production offers the intense raptness that O’Donnell identifies, even as it speaks an unspeakable pain. ‘Writing is one way of finding freedom where there is none. When [writers in prison] are engrossed in the process of writing, they are no longer confined.’21 Raptness positions the writer to move beyond the sublimations and erasures that characterize trauma; it allows her to access material ordinarily unavailable from scarred-over, ‘dead’ places. The traumatized artist may begin to break free of a reiterated narrative which confines and, she believes, defines her.

Trauma: The paralysis of pain In Jill Bennett’s discussion of poet and Holocaust survivor Charlotte Delbo, she asserts that a literal representation of trauma is impoverished or inadequate; rather, Delbo’s poetry ‘bears the imprint of trauma’,22 moving her work ‘toward a practice that sees the artwork as generating sensation so as to produce an encounter in the present’.23 ‘The poetics of sense memory involve not so much a speaking of but a speaking out of a particular memory or experience’, to make ‘trauma present instead of simply representing it’.24 We feel meaning before we can explain it; sense imagery offers a vocabulary that supersedes discursive exposition about an unspeakable, often unknowable, past. Trauma is, in Cathy Caruth’s formulation, ‘an overwhelming experience of sudden or catastrophic events’.25 As Judith Herman asserts, it is ‘an affliction of the powerless … the victim is rendered helpless by overwhelming forces’.26 Social trauma intersects with individual trauma; racialized and class-based incarceration is understood as an attack on collective identity, hence, social trauma. Prisoners, many of whom are both victimizers and victimized (by poverty, racial oppression, structural inequality, violent communities), are scarred by trauma. Expressive arts in prison can help shift perceptions of self and community, but personal agency is key; the artist/inmate need not revisit traumatic memories to rebuild the self, but she or he must take charge of what they say and how they say it. Arts practitioners may facilitate projects and provide openended opportunities for expression, but they are tasked with delimiting or predetermining content. Theatre workers generally agree that ‘theatre is not therapy’, but we also must be wary of unexamined biases that inadvertently exploit or retrigger trauma. James Thompson makes cogent points about an essentially Western narrative about social trauma that guides arts work in conflict

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zones. He  warns that ‘dependency on theories of trauma … aligns applied theatre with some deeply problematic practices and assumptions’.27 Not every individual benefits from telling their story nor is that a necessary precondition for relief. In the narrative Thompson critiques, ‘not-telling’ is seen as a failure or the site of continued harm.28 But tellers must be in charge of what they say and how they say it; they decide how to move past suffering and how to find new ways of apprehending themselves as heroic, powerful agents of change. In SISTC, for example, Cush depicts himself as a warrior: ‘Without warriors, the battle is already lost.’29 Rather than reflexive reliance on literal ‘truth’, or narration of life events, linguistic playfulness creates space for a more expansive idea of the self.

Playfulness Creative expression inclines towards openness, unexpectedness and elasticity – in a word, playfulness. In developing material for SISTC, we used visceral imagery and elaboration of fantasy to explore what Cush refers to as the ‘alternate reality’ of prison. Moor Allah, struggling to cope with serious depression, began with an image of being buried, which he elaborated into ‘my only wish is to be buried beside a slave, to remind the world, no matter if you worked the field or lost your appeal, slavery still exist’. Extended metaphors, comic juxtapositions and fragmented narratives were among the many approaches used to expand the writers’ repertoire, though not all attempts to forsake realism were successful. E., for example, suggested a scene of a famous women who faced death in prison meeting at a dinner party, but her writing style didn’t accommodate this kind of comic, fantastical rendering. Not all strategies work with all writers, though most of the pieces included in SISTC sought to disrupt the moralizing authority of realism and to highlight a more dimensional representation of lived experience.30 Writing by inmates often focuses on making ‘good’ choices and correcting ‘bad’ behaviour, leaving little room for ambiguity.31 To counterbalance this tendency, some practitioners explore other modalities: for example, Jenny Hughes, in discussing her work with young offenders, talks about moving away from social realism and embracing ‘the metaphorical and the fantastic’ in the exploration of offenders’ lives. Hughes speaks to the need for more playful and theatrical expressions, pushing past the boundaries of social realism in examining ‘desire, fantasy and power’ as aspects of experience. She goes on to say that ‘the connections between the fantastic and the real can be reimagined,

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embodied, experienced’ as a means to ‘explore and undermine fixed patterns of thinking and constructions of self ’.32 In her discussion of playfulness and art, Anne F. O’Reilly writes: ‘Poetic language with its attention to symbol and metaphor can expand horizons, open up possible worlds.’33 The fabulist elements in SISTC, its use of disjuncture, spatial and temporal displacements, creative visualization of imagined spaces, reflect life as it seems (metaphorically) or feels (sensorily) to the writers. Poetry and playfulness help to communicate the scarred and wounded places within, which cannot be adequately represented in realistic prose.

Writing through the senses Jill Bennett calls attention to visual artists who ‘render sensation present’ in work that is ‘neither explicit in content nor didactic; they do not tell stories nor prescribe responses’.34 The senses are central to the vocabulary of the artist, who hopes to (re)create experience unmediated by any kind of ‘message’ or explicit meaning. Moreover, sensation is indispensable to the construction of the self. Vannini, Waskul and Gottshalk theorize that the senses are involved in ‘sense-making practices’, which they call ‘somatic work’. The processing of internal sensations and those received from outside the body participate in creating subjectivity.35 Vannini et  al. are interested in ‘how the body makes sense; how it perceives, how it understands, how it knows, [which is] made possible because of sensual experience’.36 Somatic awareness, specifically a detailed attention to and articulation of sensory experience, generates a sense of self.37 When the sensory environment is impoverished, detailed and specific writing may help to reanimate the senses. C.’s first response to a writing prompt is ‘Windows Suck’. With encouragement, she gets specific: ‘My window is 4 inches wide. At night I can see a sliver of moon. When the moon is out. Daytime, I see a sliver of blue.’ This leads to a new thought: ‘I’ve been looking at the same thing for 17 years. I miss the sky. I miss the bigness of the sky.’ Again, of herself, she says, ‘I’m pickled in here. I used to just change my hair color: mad black, crazy henna, fire red. Then I got to work changing myself. But nothing changes. Not for real.’ For those whose confinement means that they can (never, no longer, not again) move freely, writing can reanimate the senses and inspire – ‘in-spirit’ – the body. Writing from and through bodily memory communicates directly; it ‘registers a sense of the interior experience’,38 allowing the writer to ‘make … the experience of trauma present instead of simply representing it’.39 Cush writes vividly:

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‘Tired of black and white. A cut, a splash of color. Red. Black and white extinguished. In a pool of red.’40 Writing that employs visceral and kinaesthetic imagery can unleash and amplify the prisoner’s voice, increasing a sense of personal agency. As Robert Johnson says, Writing … tackles the prison world head on. The act of describing something objectifies it and puts it at arm’s length, giving emotional quarter to the writer. In this sense, all writing that bears witness to confinement and its effects helps the person cope by naming and, in a sense, controlling or taming the harms to which they are subjected … Writing offers a kind of mastery, then, which allows for survival.41

Who sees and what is seen Responses to SISTC were visceral and emotional, and ultimately, cognitive. In subsequent talkback sessions, questions arose about the political and racial dimensions of incarceration; there was an energetic discussion of the death penalty; and there was some disputation about the authenticity of representation when the prisoners cannot speak directly to their audience. In one talkback session following the presentation of SISTC, an audience member suggested that a cage might be built around those watching, as a way for incarceration to be felt more fully. The discussion led to considerations of staging and questions about the desired impact on the audience. Do we want people to ‘feel’ imprisonment, as a means of generating empathy? Would the experience be any less rich if the audience for SISTC was metaphorically ‘imprisoned?’ Is it our goal to immerse the audience or is a proscenium-style presentation sufficient and effective? Do we hope that the audience is moved to action, and are there specific end-goals we hope to achieve? As producer, I wrestle with these questions. My belief is that the power of the work lies in the text and its reception will differ with each audience member. SISTC is conceived as a reading with choreographed movement; for most of the play, each actor is alone and ‘imprisoned’ in a spotlight. Only the figure of the Guard moves freely, positioning himself on a metal staircase that he bangs with his ring of keys. Correlative to the idea that body-centred writing engages the author in a way parallel to performance is the postulate that the audience experiences these iterations as if they were real. The narrowly focused spotlights, the floating white platform, the Guard’s spiral staircase

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are scenic metaphors intended to evoke visceral responses in the audience. One consideration for future production is to use a minimal bird-cage like construction to partially conceal the actors at the beginning of the play, but that may be overly literal; audience empathy is not enhanced by concrete imagery, when the goal is to suggest and evoke.

Neuroscience and the actor Recent advances in neuropsychology42 and theories about synaptic plasticity (neural ‘rewiring’)43 lead me to consider implications for arts practices and their relation to healing trauma. Joseph LeDoux writes, ‘The ability of neurons [and neural pathways] to be altered by experience’44 underlies learning.45 ‘Life’s experiences leave lasting effects on us by being stored as memories in synaptic connections’,46 and ‘experience changes synapses’.47 It is a fair hypothesis that telling the tale differently, reimagining but not reiterating trauma, may be a way to rebuild the self. The coerced and confined bodies on the row could benefit from re-patterning to reconstitute identity, using the power of ‘as if ’ to take control of their own story. As actors know, hypotheticals are real to the mind. As Stephen Di Benedetto, a theatre scholar and scenic designer who explores the role of the senses in performance, asserts, ‘Our brains respond as if stimuli, real, imagined, or remembered, are occurring now.’48 The subjunctive ‘as if ’ is foundational to Stanislavski-based acting, in which the actor must ‘live truthfully in imaginary circumstances’. Stanislavski’s methodology aims, by means of a psycho-physical craft which draws its power from sensory engagement and the ‘as if ’ of the imagination, to create a state of readiness which will allow unconscious material to emerge. The interplay between conscious and unconscious forces, mediated by the imagination, allows the artist to access her inner world and bring it to the surface. As an actor, I am aware of the spaces that exist between text, the constructed framework developed in rehearsal and the free moment of expression in performance. This is the moment prior to articulation: it is the ‘I’ before I speak, the elusive images and impulses which live just below awareness. As arts practitioners and educators, we are positioned to approach traumatized populations, and engage our own creative processes, through an expansive and liberating playfulness.

Response: Artistic Healing and the Overcoming of Rehabilitation Paradigms Fabiola Camuti

Ellen Kaplan’s chapter brings new nourishment to academic writings on the topic of prison theatre. Firstly, it does so by approaching the field with care and respect as someone who is both a scholar and a practitioner and hence engages with fundamental issues concerning praxis in prison theatre (combining theoretical and practical perspectives). The author draws upon her personal experience in working in contexts of trauma and with the incarcerated; the experiences she draws upon are also, in a respectful and subtle way, the ones of those people who made the work possible in the first place: men and women on death row or serving life without parole. Reading the reflections generated by the direct involvement of the researcher with a practice-led approach reminded me of the issues I encountered in my doctoral research, which engaged with practice-based training approaches in different contexts. I conducted an interdisciplinary analysis of the relationship between meditative and performative practices, blending theoretical and historical perspectives with neuroscientific and practice-based approaches to design and direct practice-based theatrical training programmes. Parallel to that, I was part of a multidisciplinary project series on ‘prison theatre’. For this project, I have worked with artists, prison theatre workshop facilitators, theatre scholars and neuroscientists, conducting prison theatre sessions inside prison. This is where Kaplan’s work resonates with my own experiences of working in this field. The specific project series I was involved in was funded by Sapienza University of Rome, with a special multidisciplinary funding trajectory which encouraged researchers from the humanities to collaborate with other faculties and departments, particularly the ‘hard sciences’. My department (Art History and Performing Arts) joined forces with the Department of Physiology and Pharmacology on the topic ‘Theatre as Enriched Environment (EE)’.

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Until relatively recently, scientists regarded brain activity as being determined exclusively by genes and therefore substantially not able to change. Now, after decades of research, it is known that environmental factors can positively alter our brain’s physiological processes and this is what is referred to as environmental enrichment. The human brain is highly plastic and is able to modify the neuron number, network organization and function upon specific stimulation. Enhanced social interactions, sensory and motor inputs increase brain plasticity and modulate cognitive performances, thus creating an enriched environment for the brain. Starting from this concept of EE, we postulated that theatre is indeed a form of enhanced interaction, especially when this is carried out in situations of deprivation, for example inside prisons.1 Ellen Kaplan’s work and mine are different in terms of setting, institution and, last but not least, continent (I leave observations regarding differences in the criminal justice system in Europe and the United States to another moment) while busy with equal considerations at the same time. Nevertheless, I appreciated overlapping themes and synergies when it comes to strategies, concerns and approaches (and I am here referring to the involvement of cognitive-behavioural reflections). Kaplan’s chapter discusses many issues that have validity to other research within the field, particularly, the importance of ‘co-authorship’. This kind of work is based upon a process of sharing, in which the facilitators and the participants stand together as ‘co-equal artists’. I would like to focus, however, on another issue the chapter raises indirectly concerning the evaluation of prison theatre practices. Theatre projects with prisoners explicitly claim individual and social transformative potentials, including benefits in terms of social reintegration, rehabilitation and a heightened self-esteem.2 But how can such claims be measured, assessed and qualitatively evaluated? And how can all this be done without having to compromise too much on ethical and personal needs? A practice conducted with incarcerated people on ‘death row’, as in the case of this experience, might be regarded as naked practice: stripped away from the – sometimes too often patronizing – concepts of cure and rehabilitation. An experience such as this one is forced to deal with concepts beyond the moralistic idea of cure, as they rather encourage reflections on personal agency or intentional strategies, responding to individual needs. I have experienced first-hand the difficulties of analysing theatre practices and experiences in relation to their effects on the daily lives of incarcerated people. Assessing the impact of arts and artistic intervention has now largely

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become a requirement from funders and social welfare authorities.3 The underlying assumptions around impact and the demand for the evidence of it can occur at the expense of the ethics of the artistic practice itself, with the risk of losing sight of the complex processes of creativity and human interaction.4 Reading Kaplan’s chapter made me even more aware of the necessity of pointing out the inadequacy of existing evaluative models of prison theatre practices, which often disregard the ethical aspects as well as the complex human dynamics that belong to the processes of prison theatre (and its interventions). Theatre practitioners and scholars need to point out the challenges of evaluating prison theatre practices, suggesting qualitative, experiential models of evaluation in combination with evidence-led impact assessment. With the increasing turn in academic research to evidence-based practices, many prison theatre experiences have to deal with a problematic ‘blind’ benefit-oriented analysis. Kaplan’s reflection stands as a concrete example of a possible interaction between quantitative and experiential accounts by creating a dialogue between theoretical, cognitive and practicebased theatrical approaches. My wish for prison theatre practice in relation to their evaluation procedures is that of the possibility of widening the understanding of expected outcome by including not only social effects but also, and on equal terms, emotional, subjective and experiential aspects, thus combining an empirical and an interpretative register. I strongly believe in the need of bringing together cognitive neuroscience and cultural policy studies focused on effect/outcomes of arts in social development with more processoriented, practice-based artistic research centred on experience and affect, rather than effect. This suggests a way of going beyond the idea of theatrical practice as tool towards the production and objectification of measurable ‘effects’. An interaction of this kind, as shown by Kaplan’s experience, will rather consider prison theatre in an affective perspective, which includes the human capability to affect and be affected, one’s capacity to act, engage and connect, in a subjective, experiential and sensorial manner.5 A way of looking at theatre practices conducted in jail which considers both effective and affective registers will allow an innovative evaluation process aware of the needs of both current policy making and artistic practice to develop.

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Autism and Affect in Post-Realist Theatre Marla Carlson

This chapter compares two plays that make use of popularized scientific research. The more obscure of the two, Chekhov Lizardbrain (Pig Iron Theatre, 2007), plays upon the scientifically discredited but popularly persistent conception of a triune brain that preserves earlier evolutionary stages within successive layers, the titular ‘lizard’ brain referring to a cold reptilian core surrounded by an instinctually emotional mammalian layer, both of them wrapped in the rationally conscious human neocortex.1 The tremendously successful The Curious Incident of the Dog in the Night-Time (National Theatre, 2012) presents autism as an empathy deficit resulting from miswired brains, good at math and bad at social relations.2 Both of these enjoyable theatrical experiences elicit a positive affective engagement with their protagonists, who exhibit behavioural characteristics currently associated with Asperger syndrome (AS) although neither script explicitly invokes this diagnosis. Presuming that art helps to shape our understanding of ourselves and of the world, I argue that cultural products such as theatre can shore up faulty paradigms and perpetuate them beyond their scientific lifespan, as well as potentially influencing the direction of psychological research and therapeutic practices. A seemingly fortuitous paradigm match helped Mark Haddon’s 2003 young-adult novel Curious Incident replace the 1988 film Rain Man as a central reference point for popular conceptions of autism; that is, the novel began to inform and even determine what many people understand autism to be.3 Haddon apparently did next to no research on autism for fear that it would limit his creativity. According to a study guide that the National Theatre provided for school groups in connection with its adaptation of this novel, Haddon said: ‘I know very little about the subject [autism]. I did no research for Curious Incident other than photographing the interiors of This chapter revises material extracted from Marla Carlson, Affect, Animals, and Autists: Feeling Around the Edges of the Human in Performance (Ann Arbor: University of Michigan Press, 2018).

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Swindon and Paddington stations, reading Oliver Sacks essay about Temple Grandin and a handful of newspaper and magazine articles about, or by, people with Asperger’s and autism.’ He further explained: I deliberately didn’t add to this list. Imagination always trumps research. I thought that if I could make Christopher real to me then he’d be real to readers. I gave him some rules to live by and some character traits and opinions, all of which I borrowed from people I know, none of whom would be labelled as having a disability. Judging by the reaction, it seems to have worked.4

(I note that Bruno Bettelheim’s imaginary construct, the refrigerator mother, also worked remarkably well for a previous generation.) Grandin, who first achieved professional success as a designer of humane livestock-handling equipment because she notices details important to animals that neurotypical humans overlook, has become arguably the most prominent autistic spokesperson with multiple books and DVDs, speaking engagements and ‘Temple Grandin Conferences’.5 The New Yorker initially published the essay that Haddon mentions with the title ‘An Anthropologist on Mars’ in 1993, and Sacks’s included it in an eponymous 1995 collection. Psychologist Uta Frith (to whom Sacks attributes the speculation that Sherlock Holmes may have been autistic – taking no account of the fictionality of this persona) suggested that he visit Grandin, whose autobiography had been recently published.6 Sacks’s essay roughly coincides with the fourth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, which introduced Asperger syndrome as a differential subcategory within the grouping autism spectrum disorder (DSM-IV, 1994). Although DSM-5 (2013) reconfigures the category and omits this particular sub-diagnosis, Asperger syndrome, its acronym AS and the adjective or noun ‘Aspie’ so thoroughly infiltrated the popular lexicon over the previous two decades that they persist unabated.7 The diagnostic terms pervade analysis of  the novel as well the theatrical adaptation’s publicity and  programme essays.8 Haddon’s novel takes its reader through the thought processes of its first-person narrator as he solves a dog-murder mystery, passes his Maths A-Level exam, reunites with his mother and begins to reconcile with his father. Fifteen-year-old Christopher Boone displays a collection of sensory and cognitive difficulties: he cannot stand to be touched, restricting physical intimacy with his parents to touching fingertips and producing outbursts when policemen grab him on two occasions and his mother’s new partner on another. Prior to the story’s beginning, he has never by himself left the block

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on which he lives. He must learn to ask for and follow directions to screen out the overwhelming sights and sounds first of the railway station in rural Swindon and then of Paddington Station and the London tube. In contrast with Haddon’s reliance upon his own imagination, the National Theatre’s creative team conducted preparatory research at four schools for students with autism spectrum disorders, and the brief documentary filmed as an introduction to the NTLive broadcast of the Cottesloe production shows actor Luke Treadaway during some of these visits.9 They hired autistic performance artist Cian Binchy to coach Treadaway and subsequent actors in the role.10 In one programme essay, noted autism researcher Simon Baron-Cohen explains the fit between this character and his own ‘psychological theory of autism spectrum conditions’, that is, ‘impaired empathizing alongside intact or even superior systematizing’.11 He supports the mindblindess paradigm, arguing that Aspies don’t learn the unwritten rules of social behaviour because they have no ‘theory of mind’ – that is, they cannot grasp other people’s mental and emotional states.12 Baron-Cohen has gone so far as to characterize autism as an effect of the ‘extreme male brain’, which is good at systematizing and bad at the empathy that supposedly characterizes female mental life, all characteristics that he considers to be hard-wired in the brain.13 These qualities take visual form onstage: at the opening of Curious Incident and various other points of stress, a white grid projected on the bare stage establishes Christopher’s mathematical mind, suggesting that he projects a set of coordinates on the world in order to graph its occurrences and remove them from chaos, and a percussive electronic sound score evokes data processing to reinforce this symbolism even as it encourages the audience’s affective engagement. During difficult moments, Christopher calms himself by thinking about astronomy or math, particularly prime numbers. He also draws a schematic face on the grid to show the audience an example of the diagrams he matches to facial expressions so that he can read explicitly what others have learned to accomplish as a background task. He doesn’t use this sort of diagram at any point in the play, but showing and explaining this fairly well-known teaching tool reinforces the impression that the AS diagnosis fits Christopher. Small-scale domestic tragedy lurks in the novel’s background at the distance that one might imagine it existing for the protagonist: isolated and depressed due to the stress of caring for her demanding child, Judy has drifted into an affair with her neighbour and gone off with him to live in London two years before the story begins. Ed has told Christopher that she died rather than attempting to explain the situation. The first portion of Christopher’s ‘book’ gradually establishes these details as he sets out to

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discover who killed the neighbour’s dog, Wellington. Ed’s effort to disrupt the investigation ironically leads Christopher, in search of his confiscated notebook, to discover a box of Judy’s letters to him. This discovery leads, in turn, to Ed’s confession that he killed Wellington, to Christopher’s journey alone to find Judy in London and to the end of her new relationship. Even in adopting an Aspie voice to tell this story, though, the novel depends upon the ability of its presumably neurotypical reader to understand things that Christopher doesn’t and to fill out scenes beyond his matter-of-fact narration. For the theatrical adaptation, the parents’ embodied presence onstage and the use of realistic acting for central domestic scenes move the family drama to the foreground. Although the multimedia staging and narrative structure are post-realist from the start, Treadaway’s acting stays within realist bounds for the opening set-up of character and story, and the other central characters such as Ed and Judy maintain this style even as the ensemble’s work becomes more inventive. Treadaway moves back and forth between modes, playing the interactions with his parents realistically. As Ed explains how he happened to kill Wellington, for example, Treadaway sits on the floor, shirtless, twisting the fabric of his pants at the knee. His back slumps in a shallow C-curve, and we can see his breathing change as he listens, his gaze fixed in the middistance. He subtly draws himself inward. When Ed moves closer and puts up a hand to touch fingertips, Treadaway refuses to reciprocate, keeping his hand near the opposite arm. The fingers remain curled in on themselves but agitate as if they fight uncurling and returning the touch. The moment could slide easily out of its abstract stage setting and into a realistically detailed film set without adjustment. These family scenes create a familiar spectator position: we watch the interaction from outside yet feel both with and for the characters. Like the novel, the stage version uses presentational techniques from midcentury artistic experiments to intensify the impact of the narrative. For the novel, this is first-person writing, the inclusion of letters and other ‘evidence’, and intertextuality – Christopher explicitly models his investigation upon the adventures of Sherlock Holmes. For the theatrical adaptation, Treadaway’s virtuosic movement engages spectators kinaesthetically, intensifying their positive engagement with his performance. The staging shifts to evoke Christopher’s sensory experience when he is either literally alone or alone in public, overwhelmed by the sights and sounds of his journey. To create the train station in his home town, for example, the ensemble criss-cross the stage in formation, in step, and Treadaway has to navigate around and between them. The sound score includes words and phrases that would appear on the station’s signs, as though we’re hearing what Christopher sees.

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We eventually hear his mother’s voice guiding him and understand this to be happening in his mind, that he is remembering advice she has given him. The general lighting dims, a spot follows Christopher, and red lights at the corner of certain grid squares guide him, creating a path that he can focus on and follow. In London’s even busier Paddington Station, the projected signs proliferate, and they come in from different directions. When he puts his hands over his ears, the projections and the sounds both slow down. He takes them off, and everything accelerates. The actors move through the space like busy commuters, but they also handle him, a woman putting her hands over his ears and slowing everything again, people lifting him through a front walkover, four of them picking him up like a piece of luggage and carrying him through the space. Finally, an imagined dialogue with his father (in his mind, audible to us) guides Christopher through his journey onto the platform and then the subway train. Even as they convey the sensory overload that Christopher experiences and the means he finds to cope with it, these movement-based scenes provide a release from the dramatic situation into enjoyment of the performers’ physical skill, the tightly coordinated responsiveness of the entire ensemble and the cleverness of the representation. Similar to musical theatre’s production numbers, these interludes move the story forward and expand upon some aspect of a character’s experience. We hear the parents’ voices, which Christopher has internalized, helping him navigate the world ‘alone’ for the first time, and we see his success. In the last lines of the play, Christopher speaks of his accomplishments: getting a Maths A-level, going to London on his own, solving the puzzle of who killed Wellington, writing a book that’s been turned into a play. He asks his teacher three times: Does that mean I can do anything? She doesn’t respond. He might be overly optimistic, but we can share his optimism with respect to some of his goals. Although major plot points remain unresolved, the production draws one towards the hope that he will succeed in some math-related field as Grandin has done in livestock equipment design. We don’t know, in terms of plot, whether his parents will get back together, but they’re both present and actively involved in his life. Although this may be admirable as far as actual parenting goes, it restricts the scope of concern and responsibility to the nuclear family.14 Both the play’s success and what I see as its shortcomings are bound up with its investment in the family romance, and it structures this romance in particularly neoliberal terms: the parents function as technicians of their son’s self-fulfilment, which in turn means independence and even the hope of economic advancement. In order to draw its members into appropriate roles and ensure its own continuation, this family needs to be

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‘happy’ in the sense of working well and remaining intact. The happiness of an object such as the family connects to but does not fully coincide with the emotion, happiness: the pleasure that the ‘happy object’ creates overflows the object’s boundaries to invest the time and place of the happy (pleasurable) encounter; likewise, an object can become happy (lovely) if presented by someone whom the recipient loves. Sara Ahmed describes the feeling of happiness as both contagious and fragile, wont to dissipate or become anxious at the moment when it becomes conscious.15 As an affect – that is, a relational property both slippery and sticky – happiness circulates between people. The happy family requires parents to facilitate the growth of their children, so that each child reaches his or her maximum potential. This means not only shopping for the best educational setting but also assessing what that might be for each particular child. In the case of a child who falls outside behavioural norms, this management responsibility further extends to finding the right diagnosis and treatment regime – autism seems increasingly bound up with the neoliberal imperative to be an ‘entrepreneurial actor’ in every sphere of life.16 If the autistic child can’t attain an independent and fulfilling life and moreover enjoy it, the parents have failed in their duties. Osteen observes that ‘parents of autistic children constantly feel guilty and inadequate; if they don’t try every possible therapy, diet or medication, they may believe they haven’t done enough for their child’.17 Rebecca Mallett and Katherine Runswick-Cole argue that autism became commodified at the point the diagnosis emerged ‘as a discrete ontological entity’: that is, during the same period as Grandin’s autobiography, Sacks’s essay and the shifting DSM/ICD codifications. Reviewing the proliferation of informational, therapeutic and cultural commodities related to autism, they argue that the product being sold is ‘the promise of coherence’.18 Curious Incident remains fully invested in the happy family – not surprising for a production successfully targeted to family audiences. Yet the show appeals to these audiences because it so creatively and convincingly presents a version of Aspie experience that conforms to certain popular paradigms of autism, in particular the stereotypical association between AS, enhanced mathematical abilities and impaired empathy. Lest the lack of total narrative closure leave audiences anxious, the production reassures by bringing a live puppy onstage: Judy and Christopher are living in Swindon, and Christopher must spend afterschool time at Ed’s house but cannot trust or forgive him, so Ed buys him a puppy. Each of the three times that I saw the production, the audience responded to the puppy with an audible ‘aww’, the typical indicator for cuteness. As Sianne Ngai points out, cute things tend to be small and

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rounded or somewhat formless, often squishy, and we refer to them in softened voices with ‘soft’ terms. The cute seems to want us (our protection, our rescue, our nurturing) and this encourages us to want it – the cute is the perfect commodity.19 In contrast to this easily consumable production, Chekhov Lizardbrain twists AS characteristics into a zany package in order to deconstruct the realist family drama. Shifting focus from the commodity to the labour necessary for its production and circulation, Ngai proposes that ‘by turning the worker’s beset, precarious condition into a spectacle for our entertainment, zaniness flatters the spectator’s sense of comparative security, thus hailing her as a kind of phantasmagoric manager or implicit owner of the means of production’.20 The zany amuses its audience but produces a mixture of pleasure and aversion – ‘eww’ rather than ‘aww’ – because its ‘strained, desperate, and precarious’ hyperactivity seems designed to ‘activate[] the spectator’s desire for distance’.21 Chekhov Lizardbrain resembles Ngai’s theatrical examples, Ubu Roi and Dada cabaret, created just before and shortly after the modernist masterpiece that it parodies, Chekhov’s 1901 play The Three Sisters. The story seems to be that Dmitri, a socially awkward PhD botanist, has returned from Portland, Oregon, to his native Oswego, New York, and purchased the home of his childhood friends. This was an uncomfortable transaction, because these three brothers have in typical Chekhovian fashion disagreed about whether to sell the house after their mother’s death. As a result, Dmitri didn’t find out how to turn on the heat, and now he’s suffering in the upstate New York winter, going over and over the chain of events that left him in this cold predicament. The play presents Dmitri’s mental action within this situation, and the obsessive restaging of his interaction with the brothers gradually reveals both the recent events and key childhood interactions. The performance shifts back and forth between the historical present, with the brothers dressed in contemporary clothing, and the dramatized Chekhovian past, in which they wear long underwear, visibly false moustaches and top hats. Interactions between Dmitri and Chekhov Lizardbrain frame this remembered plot within the play. James Sugg plays both, with mannerisms that clearly distinguish the two personae. The piece begins in semi-darkness as Dmitri makes his way around the red velvet rope that demarcates the playing space. Finally making his way inside the rope, he briefly poses with the manikin that holds his hat and jacket before rolling it upstage and disappearing behind the curtain. He re-emerges as Chekhov Lizardbrain and sits at the table, preternaturally still except for his extending, moving, lizardlike fingers:

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WELCOME I know what you’re thinking who’s that guy no expression such a bummer what’s wrong with him? what’s wrong with his head? somebody help him give him some medication somebody help him out he’s in pain that’s where you’re wrong it’s me Chekhov Lizardbrain Ta daaaaa. I’m not so bad – I’m your host. (76) He speaks mostly in a monotone, his mouth barely moving, but some words are overly dramatic. He pauses with an open mouth, his jaw slack. The show thus begins with the ironic presentation of an emcee’s theatrical language and the performer’s utterly untheatrical delivery. Dmitri interrupts this prologue, talking fast, blinking a lot, twitching: Dmitri  Hey Chekhov Lizardbrain … Chekhov Lizardbrain Yes? Dmitri  Can I talk to you for a second … Chekhov Lizardbrain Sure, Dmitri. Dmitri  I don’t want … I don’t want anyone to hear me … . Is it time to – Chekhov  Lizardbrain  Everyone can hear you right now, Dmitri … . Ladies and Gentlemen, Dmitri. Dmitri  Oh … (to audience) Hi … um, let’s see … oh, um … ladies and gentlemen … There’s probably some things you want to know about, I want to know about some things, and the things I know about, um, The plants are very – Chekhov Lizardbrain  Whoa whoa whoa, Dmitri, we’re doing a show here. We’re on a very tight schedule. Dmitri  I know. Let’s keep going. I want you to keep going. I’m sorry. (77–78)

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About halfway through the play, Dmitri explains the ‘lizardbrain’ part of his alter-ego’s name: ‘He’s very in touch with his lower brain, you know, from the medulla oblongata, considering the theory of the three brains. That the upper brain is human brain and the middle brain is the dog brain and the lowest brain is the lizard brain. That’s why they call him Chekhov Lizardbrain’ (98). Pig Iron took inspiration from Temple Grandin’s reliance upon triune brain theory to explain the connections she draws between her autistic brain and the brains of animals.22 Paul MacLean developed this theory in the 1950s, characterizing the brain stem and cerebellum as a primitive ‘lizard’ brain responsible for automatic fight-or-flight response to the environment; the socalled limbic system as a mammalian development responsible for emotions, memories and habits; and the neocortex as a more recently evolved human brain, the locus of language, abstract thought, imagination and consciousness. The notion that the reptile brain represents a more primitive base from which first the mammal and then the human brain evolved presumes an outmoded linear model for vertebrate evolution – that is, that humans represent the pinnacle of development and that studying the brains of reptiles and nonhuman mammals can reveal much about the functioning of these primitive regions preserved within our brains. In explaining the alternative radial (cladistic) model for evolution, Glenn Northcutt points out that modern reptiles and mammals have been evolving separately for approximately the same length of time; thus, ‘modern reptiles cannot be viewed as representing a more primitive grade of tetrapodal organization than mammals’.23 He goes on to analyse homologous brain features developing from a common evolutionary predecessor as well as homoplastic features that evolved separately for two or more clades, either through parallel evolution from a recently common feature and involving similar parts of the genome or through convergent evolution from a distant common ancestor and involving different parts of the genome.24 In addition to the reptilian ‘smell’ brain, MacLean consolidated previous work on the brain’s involvement in emotion and memory to propose a discrete ‘limbic system’ that developed in mammals. The play leaves this area unremarked, suggesting a dysfunctional grey area existing in between Chekhov Lizardbrain and hyper-neocortical Dmitri. Neuroimaging research from the 1990s onwards suggests that neither emotion nor memory is relegated to a discrete limbic system; instead, evidence suggests that general brain networks participate in emotional as well as non-emotional mental activity. In spite of its structural and functional imprecision, illustrations continue to use the concept freely, as does ongoing neuroscientific research.25 Although the triune brain hasn’t stood up to scientific scrutiny, it serves well as a concrete image: Dmitri’s well-developed rational intellect is split off from his physical and emotional intelligence, and they can’t keep pace. Dmitri can’t turn on the heat.

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The memory scenes occur in diachronic order, beginning with a chance meeting of Dmitri and Nikolai and progressing through his visit to the house and the change of ownership. In these memory scenes, Dmitri arrives at the house bearing a Japanese maple as gift, and he takes possession of the house. Clarifying the dramatic structure, Chekhov Lizardbrain explains ‘Anton Pavlovich Chekhov’s “Five Rules of Theatre”’: One. Every play has four acts. That’s simple enough. Four acts. Two. Keep the tragedy offstage. I don’t want to see that onstage. It’s tragedy. Three. Who owns the house? […]  Don’t answer! It’s not a question, it’s a rule of theatre – has to be in every play. Who owns the house. Four. Every play has exactly one central symbol. Like a tree – […] Five. Keep it clean, keep it civil. That means no shouting, no taunting, and no cursing. (89)

Sascha, who lived in the house with his mother during her last years, wants to remain but cannot buy out his brothers’ shares. Each time their confrontation surfaces in Dmitri’s memory, the scene disintegrates. The three brothers variously remind him that the memory being played out doesn’t match what happened, mouth his persistent question about the heat, steal a plastic model of the brain and turn into a chorus of lizardbrain imposters dancing around the space. Along the way, they also replay a childhood game of ‘Lost and Lonely’, a cruel hide-and-seek with Dmitri as ‘it’ (94–95), left alone at the end of the game and at the end of the play. In his last interaction with Chekhov Lizardbrain, Dmitri says, ‘Of course I’m having trouble Chekhov Lizardbrain. It’s cold and the heater broke and the whole house is falling apart. It’s just fucking falling apart and I’m all alone’ (123). To the suggestion that he’s never alone, since he’s the star of this show going on in his brain, he objects that perhaps Chekhov Lizardbrain should go play Lost and Lonely: Only this time I won’t come and find you. I’ll just let you sit there in the cave for seven fucking hours, all alone and crying, and somebody else will come find you and take you back to your own home. And somebody else will come find you and take you back to your own room and then you’ll still just be sitting there all alone. And you won’t know when to stop. (124)

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This is Dmitri’s state for his final run-on and mostly incoherent address to the audience. Chekhov Lizardbrain makes no further appearance aside from one last deadpan ‘ta da’. The production’s costumes, stylized acting and focus upon ‘who owns the house’ could qualify as camping up Chekhov, but I would argue that the obsessive replaying of memory moves it into zany territory, and the loneliness leaves us someplace else. For me, this was the uneasiness of a familiar feeling, not a flattering distance but instead a bit too close for comfort, alone with consciousness, on a thin wire at the mental circus: Dmitri … don’t look down dmitri this is the number one rule of consciousness don’t look down and don’t don’t think about how thin thin thin thin the wire is this is the circus and everybody always goes home from the circus and at home some one broke in and stole everything and there’s dirty handprints where the television set used to be and the paintings on the wall and the rugs on the floor and don’t look down and see the empty house and that’s the number one rule of consciousness don’t look down or Pause. Chekhov Lizardbrain Ta da. (125–126) This production presents the family as a sad object rather than a happy one. There’s no sense in which the three brothers have something desirable: their mother is dead. Sascha, who seems to have been close to her, hasn’t fulfilled his potential, didn’t go to college, cries about his uncertain future and wants to keep the house. We don’t learn much about Nicholas and Peter except that they have successful lives elsewhere – they mention Indianapolis.26 The details matter only insofar as they establish a world that excludes Dmitri and does so actively. This is not a happy world, just a pattern of teasing partial invitations that end in rejection. Even Sascha rejects Dmitri’s offer to stay on and share the house with him. Dmitri repeatedly exercises empathetic imagination, an effort never reciprocated. The play doesn’t present his behaviour as a problem to be solved – he’s got a PhD, a career and the money to buy the house. That’s all we know about him except that he’s cold and lonely. Chekhov Lizardbrain presents the family as something that needs cruelty to survive, that can’t cohere except by placing someone else outside its velvet rope. The play presents no norms, just a zany world working overtime to perpetuate a hopeless situation, the family, an exhausted structure. The deadpan Aspie is just trying to cope. The enjoyable but rather sad Chekhov Lizardbrain presents its audience with an incoherent world that we can only view in a post-realist mode, and its cognitive paradigm of the triune brain seems like the scientific equivalent

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of long underwear, excellent material for zany theatre. If this or any other flawed theory helps an individual develop strategies for manoeuvering in the world, little harm seems likely. Yet when the self-understanding of a person such as Temple Grandin becomes widely disseminated by means of cultural products, including multiple autobiographies, lectures, seminars and a Hollywood biopic, and further inspires authors such as Haddon and theatre makers such as Pig Iron, the theory gets caught up in a looping effect: Ian Hacking argues that naming, diagnosing and coming up with treatment plans for certain human conditions, such as autism or Asperger syndrome, create an identity. As people thus diagnosed and named increasingly understand themselves in terms of that identity, and individuals organize around that identity, it also loops back to modify the condition. And cultural products participate in the looping effect, especially a popular success such as Curious Incident. By the time the National Theatre commissioned its adaptation, Haddon’s novel was in use as a classroom text for middle and high school, as well as being provided to policemen, non-specialist teachers and others who might need to deal with individuals who don’t communicate or behave ‘normally’.27 I argue that the effect can be pernicious in reinforcing the notion of brains hard-wired for empathy or systemizing on a strongly gendered basis and look forward to the ‘extreme male brain’ paradigm that structures Curious Incident going the way of the triune brain.

Response: Scientific Truth, Artistic License, Fiction and Reality Thalia R. Goldstein

Marla Carlson’s excellent chapter describing two different plays examines how theatrical works that use scientific evidence and discuss scientific theories may mislead audiences through misapplication of previous findings now discredited but presented as new. This is a critical issue for artists to examine. Where is the line between the necessity for scientific truth in the presentation of facts about the world and where is the line for artistic license? When do audiences take the science presented to them in artistic works as wholly fiction, when as a mix of discredited facts, artistic licence and truthful presentation, and when as a pedagogical or learning experience wrapped in a theatrical package? This has often been a point of discussion in the television world, with the so-called ‘CSI effect’ (i.e. people who watch a high number of crime programmes demand a higher standard of evidence for conviction of crimes than is typically realistic or available in real courtroom trials),1 although this may be due to a generally heightened expectation of technology and law.2 Artists should not be held to the same standards of evidence as scientists – that is not the purpose of art. Yet if audiences do not engage in any other examination of their understanding of the brain, or of atypical development, they risk having their only understanding be one of a non-scientific, noncurrent, generalized assumption. The notion of a ‘scientifically discredited but popularly persistent conception’ (an excellent phrase) is not just relegated to the areas of psychology disorders or brain development but exists across the scientific spectrum, in physics, chemistry, biology and earth science. This occurs doubly so when there are political forces dedicated to undermining the scientific consensus (as occurs in climate science and evolutionary biology). The author also mentions a concern that scientific research may be taken in the wrong direction as a result of an artistic work that provides out-of-date information. I feel this is unlikely. Scientists often bemoan the

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misappropriation and misrepresentation of their work, particularly when it comes to popular press about research findings or ‘lay’ understanding of basic science and the progress of discoveries in their field. An example of this is Samuel Mehr’s ‘Miscommunication of Science: Music Cognition Research in the Popular Press’.3 While a beginning student may enter into a scientific training programme with popular misconceptions about the brain or development, it is the job of scientists and academics to remain up to date on findings in the scientific literature (which is, truthfully, hard to parse and follow for non-scientists) and present these findings to the burgeoning next generation of truth seekers. An important aspect of these works, not explicit in this chapter but discussed elsewhere in the volume, is the availability of theatrical experiences to provide audiences with a chance to get to know the people behind disorders. Scientific research reports, and even written narratives, cannot provide the empathic experience of watching someone, in front of you, expressing realistic emotions, beliefs, desires and intentions. Audiences automatically attribute emotions to the characters they see on-screen or stage and may themselves experience those emotions.4 This empathic reaction is part of the reason why the concern about misappropriation of scientific knowledge exists. But in the same way empathy can be applied negatively for scientific misunderstanding, empathy can humanize the ‘other’, a person who is ill or abnormal. This is where many organizations for individuals with ASD approach works about individuals with ASD. For example, ASAN, the Autistic Self Advocacy Network, uses the phrase ‘Nothing about us without us’,5 which promotes autistic individuals to be engaged with the ways in which the broader world studies, intersects and understands various disabilities and different ways of thinking. Art and particularly theatre provide experiences and information about the world that audiences would not necessarily otherwise engage with, as I discuss elsewhere.6 In many cases, it is an audiences’ only chance to spend time with a person who is part of a specific group that the audience would otherwise never encounter. Artists must be careful to not promote outdated and unscientific ideas as truth and must do their due diligence (and to be fair, the writings of Temple Grandin, although one woman’s experience, are quite exemplary in their explanatory value for the way many autistics think). Yet they cannot be held to such a high standard that, like a first year graduate student just beginning to learn many years of science, they cannot be allowed to create something new. I agree that works of art can shore up the popular misconceptions beyond the scientific lifespan, but they are unlikely to alter or hinder the direction of psychological research or scientific thought (which is the point of scientific training). This disconnection, unfortunately, is where

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much of the gap between the sciences and the arts come from, but there are artists doing the hard work of collaborating with scientists to provide explanatory value and humanize scientific concepts. This gap also presents interesting scientific questions of where audiences get their knowledge from and whether their knowledge changes as the popular sources of information change (e.g. when an audience member’s understanding of autism changes based on which popular media source they use to form their judgement). Given the broad diagnosis and popular science articles written about autism spectrum disorders (there are also numerous TV shows featuring autistic characters), it may be that audiences are pulling information from multiple sources, including personal interactions.

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Changing Minds

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10

Reflections on The Eradication of Schizophrenia in Western Lapland: A Conversation between David Woods and Jon Haynes of Ridiculusmus with Commentary by Richard Talbot

Introduction Jon:   G  oing up to people going ‘Oohhhh! Margaret! Ooh!’ In our pyjamas. Well, that was mad acting. David: Yeah, and it was good fun. As theatre makers who did not so much ‘emerge’ but rather ‘burst out’, this frank reflection is typical of Ridiculusmus’s sense of comical mischief. Nevertheless, a series of recent productions have demonstrated a serious preoccupation with the problematics of representing mental illness on stage. Artistic directors David Woods and Jon Haynes1 have become increasingly involved in discourses around medical provision for mental ill health and the impact on individuals and families. Ridiculusmus have also worked with academics at the cutting edge of research into clinical therapies and invited them to post-show discussions and other public engagement activities. Consequently, their work has made an important contribution to the public awareness of the latest approaches available to mental illness diagnosis and treatment. In the following dialogue initiated by Phéline Thierens,2 David and Jon trace their experiments with ‘performing psychologies’, from childhood to early performances as the Ridiculusmus ensemble and finally in their most recent work, in which they claim to have rejected both ‘mad acting’ and acting ‘mad’. The most recent work comprises a trilogy of performances with the consistent objective of combining research insights with innovations in approaches to audience engagement. Like many twenty-first-century

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contemporary theatre makers, Ridiculusmus have grappled with the transition from a postmodern aesthetic and interest in contingency to a direct and politicized concern for issues relating to mental ill health as they are experienced. Although supported by funders who hope to increase awareness of the benefits of recent biomedical research, the work is not about mental healthcare development in an illustrative sense; rather, it is inclined to explore the boundaries of theatrical representation and comic play, and the process pushes at the limits of public discourse around madness. What follows is a collection of eight short sections of dialogue taken from a longer reflection on the company’s creative process, predominantly focusing on the making and touring of The Eradication of Schizophrenia in Western Lapland (2014). The sections have been selected because they highlight inclinations emerging in the company’s recent practice.

Staging psychosis Eradication is a production with four performers in which the playing area and audience is divided. It would be a mistake to assume that this set design is a straightforward instantiation of R.D. Laing’s psychiatric concept of ‘the divided self ’, as David and Jon are very clear that they are not representing split personality as a definition of madness. Rather, the divided space has multiple effects: of allowing a synchronicity of text and gesture and of allowing characters apparently to be in touch with the drama happening across the divide. Actors move between the two spaces and so can shift quickly from one time-space to another. Added to this sculptural device of a divided space, the movement of time on each side operates differently: one is moving forwards in time, the other backwards through a number of key moments. After an interval, the audience switch sides and are able to see characters and scenes that in the first half only appeared as shadows at windows or as fleeting interjections into the more continuous scene immediately in front of them. After the interval some audience members experience more clarity because what appeared distant and inaccessible is now visible and clearly audible. However, the action and delivery of lines is speeded up considerably and the play ends with all the characters dancing in both spaces, so that the separation of ‘here’ and ‘there’, inside and out, becomes almost redundant. The two spaces are a doctor’s consulting room and a family room. Richard is undergoing a talking therapy with a doctor who is having his own family crisis and who frequently takes mobile phone calls during which he attempts to defend his style of parenting. On the ‘family side’, or ‘private side’, ‘Mum’

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is with Rupert, Richard’s younger brother, and they are waiting for the father to come home. At one point the doctor leaves the clinic and appears at the family’s door, weaving these two stories and spaces together. Richard also moves between the clinic and the home, initially carrying a knife. Mum paces the domestic space, while her youngest son Rupert alternates between disengagement and caregiving, sometimes criticizing his older brother for leaving him to do this alone. Rupert expresses the burden of a young carer through fantasies about the house being haunted, picking up on his mother’s ramblings about Dracula. The physical action is contained, choreographically geometric and minimal. Much of the text on the family side sounds like a mantra reflecting household banalities such as tidying and planning meals (that never appear). Mum and Rupert rehearse the problem of how to manage Richard, who is now home from university. While he was away Mum reorganized his room, setting up a space for her yoga practice, and Richard resents it. Richard has started a relationship with a transgender person, much to adolescent Rupert’s amusement. While Richard was at university Mum had a psychotic episode and Rupert signed papers that approved her being sectioned, briefly. Richard is critical of this. Throughout these events the father is absent, at work or having an affair. As these facts emerge the family seems caught in the centrifugal forces of mashed codes apparently generated by Richard. Richard is writing a play, and he tells his therapist, ‘we’re in it now’. Lines are overheard and echoed by all the characters, becoming misplaced in conversations ‘on the other side’ where they trigger new meanings and confusion. Jon:   Th  e play we started making was originally going to be a family drama. It was a reaction against us doing lots of shows featuring two people, either two strangers meeting or two people at work. We began to crave characters that might have a deeper connection with one another, as in a family. David:  We ‘mined’ our family stories, for the big things. My dad’s breakdown, my brother being sectioned, your mother’s death  – all this kind of stuff – and they became the stories. We started by making a quite conventional drama, with mental health content and it was really very, very boring. Then, at some point, I don’t know when exactly, we decided to make two scripts run at the same time. That was the moment when it became a Ridiculusmus project again, really, rather than just us trying to do a straight, kind of normal theatre show. God knows. I mean it comes from various other influences.

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You mean for the staging?

David: Yes, but they weren’t all exactly the same as this idea. This was influenced by a French show that I’d heard about where they had the kitchen of a restaurant and the restaurant,3 and Two-Faced Bastard, a dance-theatre show by Chunky Move (Malthouse Theatre, Melbourne, 2008).4 It had an audience watching either side but no synchronized double text, and Michael Frayn’s play Noises Off (1982),5 which had synchronized pre-recorded text and action but only one audience. Jon:   Th  ere are also two other shows that were an influence: Ursus & Nadeschkin – Solo! (1999) by the Swiss cabaret duo Ursus und Nadeschkin6 and Dance Bear Dance (Arch 12a, 2003) by the collective Shunt.7 David: Yes. Jon:  

I remember you had this idea or just a wish to do something in a public space. We were thinking about a railway station platform or waiting rooms, this kind of thing. Do you remember when we were devising at Metal in Edge Hill, we had that wall we made within the space, and we weren’t thinking about simultaneous scenes then. We were just thinking about a room behind a wall, then another space in front of it where there were people. We didn’t actually have simultaneous scenes, I don’t think. It was more exploring this idea of another space.

David: What happens when a private place is in close proximity to a public place. Jon:   In fact, during the development phase of Eradication we used to call the family side ‘the private’ side and the doctor’s consulting room ‘the public’. Do you remember? David: But I got a feeling that was all towards trying to find a version of the double staging that worked for us. I loved this idea of this dual interpretation of a situation. That there was a whole other story behind a sequence of events. Jon:    Mischa Twitchin8 said ‘Why don’t you do it in a Chinese takeaway? Why does it have to be a railway station?’ He said we seemed quite fixated on this railway station.

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David: To the point where we did a residency in a railway station in Liverpool. Jon:  

Yes, Metal in Edge Hill.

David: This Edge Hill station was quite good because it felt like it was stranded. Later, Patrizia found a film where a train stops at an abandoned station and a very glamorous woman dreamt she got off.9 What was coming together with Eradication was this feeling that this could be an articulation of psychosis. We were very wary of saying, ‘Well, it’s the split personality and therefore it’s a split staging.’ Jon:   […] It was about the auditory and visual hallucinations that were possible because the text of the scene on the other side of a wall is audible while you’re watching the one in front of you and listening to it  – but you kept hearing this stuff. Though I’m not sure we ever thought of that while we were making it. I think this is retrospectively implied. David: There were so many phases in making it because it went over two or three years, this process. By the time of sitting in that Birmingham Hotel, mathematically working out how the text would segue into each other. It was definitely making that. It was definitely to achieve this thing of two sequences of dialogue that could be heard and sort of make sense at the same time sometimes. […] It became very technical in the end but, prior to that, we had all the material, really. We had all the elements to make, which was this family drama stuff. Jon:   W  e never thought, ‘Oh, this would be a great way of representing psychosis.’ I remember just thinking, ‘Oh, this would be a really nice effect if words coincide what the people are saying.’ David:  My idea was that, with psychosis, you hear something and then it starts off a train of thought, which is not related to the actual conversation you’re in. That’s something everybody has experienced, where you start thinking about something else after you’ve said something and you go, ‘Oh, familiar train of thought.’ You might be following something on your computer and you wonder where five hours have gone, and how on earth do you spend five hours in a room with two other people apparently

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Jon:   I was reading about the Hearing Voices Network10 and they just say, ‘Well, you know, in some cultures, when you hear that distant, other voice, it’s the voice of God and it’s to be celebrated,’ and then you’re not labelled a schizophrenic. You’re revered as somebody in connection with the gods. There’s no way they would give you antipsychotics to stop that voice because they want to hear that voice, so that it could be considered healthy. Whereas we consider it unhealthy. Therefore, medicate for it and then that person becomes ill because that confuses that process, which is a sort of natural response to unnatural circumstances. David: We can all start hearing voices anytime. We often do. In semiconsciousness we hear things being said, or we hear voices from other rooms. People who’ve been bereaved hear their loved ones.

Performing madness As part of the research for the project, David and Jon investigated open dialogue, a remarkably successful therapy that since 1985 has reduced the diagnosis of schizophrenia in Finland by 85 per cent.11 The principles of this therapeutic method, including ‘tolerating uncertainty’ and a ‘polyphony of voices’, form part of the ethical framework guiding the devising and dramaturgy of The Eradication of Schizophrenia in Western Lapland. David and Jon visited therapist practitioners in Keropudas Hospital, Tornio, Western Lapland, in March 2013 as part of their research and once again with other performers in June 2013. The company attended a conference, The Newest Dialogical Ideas and Practices in Collaboration with Families and Social Networks, in Hämeenlinna, Finland, convened by Peter Rober, Jaakko Seikkula and the late John Shotter. Seikkula is the primary exponent of the open dialogue method in Finland. This dialogic and complementary therapy treats psychosis as a condition that can be eradicated through collective and dialogic interpretation based on affective sensitivity. Therapeutic dialogue does not assert a singular interpretation of a person’s psychotic manifestations but understands it as a process of meaning-

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making. This method of de-stigmatizing schizophrenia circumvents easy pathology and is now being promoted in the NHS in the UK. Influenced by the experience of performing extracts of the family drama, as a case study, and appearing in role as clients for therapists attending the conference, Ridiculusmus became convinced of the benefits of dialogic methods and discourse as an alternative to ‘authoritative’ research-led theatre-making in which issues and information dominates dramaturgy. The language and tone of open dialogue, and in particular, the notion of embracing and trusting ‘unknowns’, seemed to define a new space for mutual collaboration between clinical psychologists and theatre makers and audiences. The extent to which the project would be able to communicate or disseminate key ideas in psychotherapy or satisfy the creative development of Ridiculusmus hinged on a commitment to unknown outcomes and investment in a new understanding of their own practices. In this way, open dialogue was practised between ‘expert-practitioners’, that is, artists and the therapists, and their various audiences, such as conference delegates, theatregoers and clients of mental health systems. Jon:   W  hen I’m going through stressful periods I often find myself walking down the streets, talking to myself very animatedly and imagining somebody else’s response and answering questions. ‘Do you ever do that?’ ‘No, I’m not. This is … ’ and then I think, ‘Oh, my God. I’ve gone completely mad.’ David:  Did I tell you about my game ‘Mad Man Or Mobile’? Jon:  

Where you pretend you’re mad?

David: No, I look at people who are walking around the street like you, talking to themselves, and I have to guess if they’re mad or on their mobile with an earpiece – you check the other side of their ear to see if there’s a Bluetooth or not, and if they’re not wearing one, they’re mad. Jon:  

How do you know they’re mad?

David: Well, that’s the label. It’s considered socially abnormal so therefore it’s mad. Jon:  

People do look very worried when they see you talking to yourself. Surely that should be a good thing.

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David: It’s considered to be dangerous because if you’re doing that, which is not socially acceptable, what else might you do? You’ve maybe got the knife in the pocket etc. Jon:   Y  es, people have caught me doing it. ‘Oh, shit. There’s somebody behind me.’ Then I take my phone out, but it makes no sense. Why would you be talking and then suddenly pull your phone out? David:  Because you’re on Bluetooth and it cut out. Jon:   O  r I start doing lines of text that are obviously me doing Shakespeare. David: This is what we were learning with open dialogue, that monological pursuits are not healthy if you really want to build a society, build communities together, you have to be in dialogue with each other. So the challenge with open dialogue was to engage the person [stuck] in the monologue into a dialogue, and then find out what really was the trauma behind this sane response to an insane circumstance. Jon:  

In the Wellcome Trust interview I said how much I liked the ‘tolerance of uncertainty’ principle of open dialogue12 and then Professor Peter Kinderman said ‘I really like “polyphony of voices”’. Then he talked for about twenty minutes, non-stop. ‘That’s not polyphony of voices’, I said. ‘You’ve now become completely monological.’

David:  You said that? Jon:  

I did. It was kind of funny. Sorry about the interruption.

David: No, that’s great. I think that this is good as well because this is polyphony and we’re arriving together at a kind of shared understanding of where Eradication came from.

More thoughts on performing madness and our approach to it For Adam Phillips, writing in Threepenny Review, acting madness involves impersonating someone who is literally trying to keep up appearances,

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because one fear behind losing one’s mind is the fear of becoming lost to others’ minds, of disappearing, socially.13 Perhaps this explains the attentionseeking early efforts by David and Jon at performing mad: they were being extremely theatrical in a public place and thus inadvertently calling attention to a fundamental aspect of madness – the need to be visible. ‘[T]he actor acting madness […] has to learn to appear to be mad – but to be mad in a way that holds people’s attention: that is, mad in a way that most mad people can never be’,14 and this is the dilemma for the performer. From an early catapulting and exuberant madness to an unnerving and internalized dizziness, performance of delusion can be enjoyable. Ridiculusmus do not run workshops as a ‘way into’ their work, preferring instead to use such contact with a potential audience to continue to devise and explore ideas. This has been the case since their residency at the Derry Playhouse from 1995 to 1999. During workshops with guest performers, for example, the intermingling of expansive devising and facilitation proved baffling for some. Direct experience of the impact of the Troubles in Northern Ireland on spontaneous expression contributed to Say Nothing (1999), a show performed entirely on a tiny patch of turf squished into a suitcase. During devising sessions for Eradication at Edge Hill railway station, the company created the role of a social worker who comes to support someone who is ‘going mad’ but cannot determine which member of the family it is, because they all appear to be acting strangely; as Phillips says, madness is theatrical. The way in which signs of madness are distributed among the social circle of individuals directly gripped by mental ill health is recognized in open dialogue therapy, and so a community is called on to acknowledge the affective and collective performance of madness. In the play, the literary parallel of theatricality is found in the boundary between egotistical hyperbole and popular mythology. Richard’s laughable claims around the Nobel Peace Prize committee and cryogenics are based on actual instabilities in reality – the committee procedure is secret and not revealed to the general public and cryogenics is sufficiently speculative to offer a hint of plausibility. The madness retains the slightest grip on present reality. The same could be said for a story told by Mum about the origin of the Dracula narrative. Both fantasies speak to the idea that there may be some truth in his madness. David: Could you give a statement on what you think our approach to mad acting, or what our thoughts on performing madness are? Jon:   If you go back to Yes, Yes, Yes (Edinburgh Fringe, 1999),15 well, actually, all the way back to 1997 when we were running around in the Botanical Gardens in Belfast pretending to be Geoffrey Rush.

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David:  In the film Shine (1996). Jon:   G  oing up to people going ‘Oohhhh! Oohhhh! Margaret! Ooh!’ In our pyjamas. Well, that was mad acting. David:  Yeah, and it was good fun. Jon:   Th  ere was also … I don’t know if this is mad acting, but a Derry devising session where we were running around with a couple of boxes on our heads. David: Which were stuffed full of clothing, and we were sort of burying our heads in them, and then sliding around the floor. Jon:  

Scaring the participants.

David:  They said it was ‘disempowering’. Jon:   So in those days, we were embracing almost stereotypical representations of madness, and these days our good taste doesn’t allow us to do that. There’s an Adam Phillips essay about acting madness16 where he actually talks about Geoffrey Rush playing Diary of a Madman on Broadway, saying, you know, it’s very compelling viewing, but this isn’t really madness, because if you put madness on the stage you wouldn’t want to look at it. It’s actually really horrible. David:  But yet, people would go to Bedlam for entertainment. Jon:   Th  at’s true, isn’t it? But in a play, on stage, maybe it’s … If you put a mad person there would that be absolutely horrible? Maybe people have done it. I’m not sure whether we’ve ever talked about it, but we didn’t want it to be obvious who was the mad person in the play. Which is very open dialogue. David:  Well, basically, you never act mad at any point, do you? Jon:   N  o, but the things my character says are not really rational thoughts, are they? They’re odd. That I’ve been nominated for the Nobel Prize. That Hitler is my father. Because of his frozen sperm.

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David:  They’re people telling tall stories. Jon:   A  nd if you think about the stuff the mother character says about Dracula coming from Ireland. It sounds mad but it’s actually true. David:  But taken out of context, it comes across as madness, and normalizing ‘madness’ fits with our saying, ‘It’s not that dissimilar to what you might feel on a daily basis.’

Losing oneself in the ‘flow’ and creating psychosis Collaborating as long-term creative partners, David and Jon benefit from a heightened sensitivity to one another that extends to the use of space and, as they suggest, to the atmosphere generated in the rehearsal space. An intoxicating mode of interaction in which performers have developed sufficient trust to ‘let go’ may be likened to a level of perception called ‘flow’. Flow implies a reduction of self-consciousness to the level of a useful but non-intrusive awareness that a performance is unfolding. The condition of total preoccupation and immersed investment in the here and now is a kind of suspension somewhere between energized relaxation and concentration.17 For David, flow begins with an idea about becoming immersed in character. Jon extends his awareness of flow to include the performance environment. A  productive atmosphere requires not only an internal sense by the performer of maximum individual investment in devising but an awareness of its effects. Thus identification with extracts of text from previous rehearsals are assembled along with significant gestural phrases, and these draw other performers into conjectures that lead to a shared immersed creativity. Jon and David appear to be exploring the limits of other people’s tolerance of an idea and using interaction with others to go beyond what one is able to conceptualize alone. ‘Mad’ people have been associated with a kind of privileged voice and afforded a licence to perform alterity and to bring a fresh perspective on social norms. At Keropudas Hospital, Tornio, Finland, the psychiatric team respond within hours of a call for help following a psychotic crisis. They visit their clients in their own homes to diffuse and reconfigure the family response to a psychotic event. The psychiatrists selfreflexively incorporate themselves in the dialogue around a psychosis, openly discussing their own feelings as witnesses of the atmosphere in the family group. They regard everybody within a family or community structure as having some agency within the after-affect of a psychotic event.

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David: Then we’ve come, now, to this point where we’re making Schizophrenia, improvising and trying to get lost in character, aren’t we? That’s a good improvisation, when we lose ourselves in the flow of something. Jon:  

Not necessarily character, but something …

David:  Performance tension or something. Jon:   Atmosphere. David: Can you think of moments like that in rehearsals, where you thought, ‘Yes, we’re onto something here!’ Jon:   In Eradication? No, I can’t. David:  At Felsted School went off on that rant about Hitler’s sperm. Jon:  

Oh, yeah.

David:  That was the best. Jon:  

I do remember.

David:  That was the best thing in those two weeks. Jon:   I remember Johnny Boy’s18 comment was ‘I want what you’re taking.’ David: Which is often what people say to us when our shows are going well, isn’t it? ‘I don’t know what they’re on, but I want some of it’, because it’s some kind of magical transformation. You know, you hit a flow. Thinking of that moment, what was it you were tapping? What was happening? Jon:   I have no idea. Sorry, that’s not very useful, but I don’t know. I mean, I suppose I’d been reading stuff, hadn’t I? I’d been watching a lot of videos of Will Self. I have actually no idea why I had. Maybe I just found him interesting: this very confident, highly articulate person. And then I was thinking about my childhood and how in school I had told that story, to a boy, when I was 10 or 11, that Hitler was actually my father.

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David:  Why do you think you did that, as a boy? Jon:  

To be more interesting than I was. I did that a lot.

David:  My son told his swimming teacher that I was dead. Jon:   O  n several occasions, I told somebody very seriously (and people believed me), that I was building a spaceship in my shed, and I was going to go to Jupiter. I’d discovered this chemical that you could paint on things so that they’d lose gravity. Just, taken from The First Men in the Moon by H.G. Wells. A friend of mine agreed that he’d come with me. David: There is a trait there, which is shared with people who are labelled ‘mad’. An insecurity. You wanted to defend yourself, or make yourself more interesting, divert people from your boring reality, by saying, ‘Oh, I’m this’, so they’d be attracted to you. It’s sort of a self-esteem problem, or non-problem. It’s just a condition that we feel at times. Jon:   M  aybe it wasn’t. Maybe it was more selfish. I wanted to feel more interesting myself, not for other people to be more interested in me. Or maybe it’s a bit of both. David: Why do we do anything really? It’s sort of to entertain ourselves, isn’t it? If you entertain yourself in a way that also entertains others, you become popular, and then you’re winning on two fronts, aren’t you? Jon:   O  r maybe it’s kind of playing a game and then drawing other people into the game, like the guy who wanted to go with me to Jupiter. These people, maybe they knew it was rubbish, but they wanted to go along with it. David: So, you were tapping into this childhood memory, and research, let’s say, about Will Self, because, had we already decided he was a writer? I seem to remember you going on about Margaret Drabble at Warwick Arts Centre. Jon:  

I don’t remember.

David: Then, later, I think in preparation for the Finland trip, we were discussing what our backstory would be, to see if these guys could

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Jon:  

I remember that when we went to Tornio, to the hospital.

David:  Keropudas Psychiatric hospital in Tornio. I thought in the improvisation there we were two artists on a retreat in Finland, and we got a blocked chimney, and I was really obsessed, and then later, Timo Haaraniemi said, ‘Oh, where are you staying?’ At the end of our visit, we’d done the improvisation, and he said ‘Where are you staying?’ We said, ‘Oh, we’re in this hotel here. It’s really hot and stuffy’, and he said ‘Ah, a blocked chimney!’ Jon:  

The real hotel, you mean.

David:  He was playing detective with us.

Not giving each other notes about mad acting Self-consciousness may stall an actor when they become too aware of the external expectations of an audience, or more specifically, a director. Unless they understand their function as a co-author, this may be challenging for a director. Due to production timescales, the published script of Ridiculusmus’s work is often not the script as it is heard on tour but an early version. David and Jon assert their authorship here, but in almost every other respect they take a pluralistic approach to generating and determining the script. They resist directing individual actors, concentrating instead on questions of the pace, rhythm or ‘scale’ of expression by the whole ensemble. They frequently substitute actors in parts that they have created for themselves or swap roles between themselves.19 David and Jon seem less concerned with questions about the ‘ownership’ of a piece of text by an individual contributor or performer. Indeed, what they appear to be looking for in their collaborators is an ability to relinquish a text.

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The process of writing the script involves open-ended conversations with diverse collaborators. Improvisation then revisits interactions and fragments of conversation, and this is recorded. Transcriptions of these recordings are performed then combined with other ‘bits’, reordered, performed and learned. A fictional narrative with an appearance of veracity emerges. Where narrative elements are missing, David and Jon resist the temptation to script autonomously, but return to an earlier phase in the process, proposing new situations for improvisation until a ‘whole’ script evolves. This is tested in public performance and edited assiduously throughout the early touring versions of the production. The written text retains the ornamentation littered around improvised expressions or ideas. Given these post-structuralist inclinations, it may not be surprising then that Ridiculusmus are less interested in psychological significance, subtext and gesture, that is, the currency of some directors’ negotiations with actors. Rather, they are preoccupied with the tempo and duration of scenes, the musicality of repetition and of rhythm in the whole text. Critical decisions about what works in the context of such preoccupations continue to develop even while the material is performed to the public. Jon:   Th  e other thing I was thinking is that we never really give each other notes about our acting. David: No. Jon:   W  hich is what a director does, and I’ve realized really irritates me, and I always give a worse performance when I’m given notes. Because I’ve been told to do something, because I’ve got to think ‘Oh, now I’ve got to show that’, this thing, and then therefore I can’t really get lost in it. You’ve got to get their approval by doing this thing that they want you to do. David: We’ve come to an understanding that if we want flow, we mustn’t give notes. Jon:   B  ut we never said, ‘Okay, you’re playing that too mad. You’re not playing that mad enough.’ Or at least, I don’t think we did. David: I suppose we give notes indirectly in the editing. In a way, the inclusion or exclusion of material says, ‘This is the kind of thing that will fit with my idea of what this play is’, and we come to a kind of harmonious agreement of what those bits are, that then stick together into the play.

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Doing our own family stories David: I know of one moment for me, when I felt I was in flow, recreating my dad at the window of the National Theatre Studio. Do you remember that? Jon:  

I do.

David:  I was like some sort of strange, nervous bird, ‘There’s a car coming, there’s not a car coming’, and all this kind of thing, and I couldn’t see anything out that window, but I was right back in 1983, and witnessing my dad’s first nervous breakdown, and not understanding it, the strange, cyclical talk of the chronically anxious, and finding it really therapeutic, but also that it is totally overwhelming me as a performer. I was loving it, just totally lost in it. Feeling like, even though my back was to the room, and I was looking out the window, that I was performing something of interest that could hold an audience’s attention. Because it was having such an effect on the other characters. It felt like a very strong thing, and it was memory, it was therapeutic, but it was chronic anxiety. It wasn’t psychosis. Jon:   B  ut yet, when you take anxiety to such an extreme, that it becomes delusional, then you really are in the realm of schizophrenia. David: Yeah, but these are the headline-grabbers. It’s this minimal thing. Again, we wanted to, I suppose, because of the influence of all that, say, ‘If you start worrying, that’s step one towards what is labelled “schizophrenia.”’ You can choose this or that label and step-by-step, you could end up at the point where you’re stabbing yourself and your family with a carving knife. That carving knife in the show was to say, ‘We acknowledge that carving knives are associated with madness.’ But we wanted to subvert that. Your first appearance is with the knife, isn’t it? Jon:  

Yes, like, ‘I’m cooking pasta. I can cook pasta.’

David: And then you come through to the doctor’s side, and I see you with the knife, and I take it off you.

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Deliberate distancing from the scene to understand the point we’re making Metatheatre, or metatheatricality, is a dramaturgical style that appears frequently in Ridiculsumus’s work, as it does in so much contemporary and postmodern performance. Conventionally, this is a device such as the ‘play within a play’, by which the formal structures of the play are acknowledged in the style of playing. Noises Off, a famously self-referential farce, was discussed during the devising of Eradication. Here, however, the inclination towards selfreference does not elucidate the genre or present anything so straightforward as a play within a play. Although it is structured and conducted with the formality and constraint of a chamber piece, Eradication is replete with sensory interruptions and visual disturbance that repeatedly draw attention to moments of coincidence, dissonance and synthesis. With a central character claiming to have composed reality, the play suggests that reality is a matter of contingency, creativity and imagination. The discipline required by the actors to memorize and deliver an interlocking four-way spoken text is a feature of the production. For audiences this might privilege the rehearsal required for this work to be effective. Moments of clarity seem to ‘land’ when there is singular coincidence of phrases and meaning. When the text falters or appears to disconnect, however, the audience is reminded of contingency and adaptation in live performance. The staging enables the audience to hear part of the text twice. The set places the audience in two different spaces and they become aware of the different experience of the play that each group has. The split audiences can hear each other and thus perform for one another, acutely aware of another group watching, listening, witnessing. Self-consciousness or double consciousness, then, is not only the reserve of the performer onstage. Here the audience as groups of people set apart from one another become conscious of what others are hearing, the condition of a hypersensitive person in everyday society. At times the audience see some action through net curtains and as shadows on the curtains. Plato’s metaphor for human consciousness and representation is a cave wall upon which are cast the shadows of people who are chained in front of a fire. This is an appropriate model here as the audience allocated to one side of the performance space are aware of both the present action and that which takes place in another room. The two spaces are, respectively, the family home of Rupert, Richard and their mother, and the clinical psychiatrist’s treatment room (or vice versa depending on the order that you experience these). The audience members see a world enacted in front of them, but the usual sense of engagement in that world is held at a distance. Just as in dreams, figures can appear to shift their guise without breaking the undertow of their intentions,

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so the characters in the two different scenes are also simultaneous. This duality is also experienced in some psychotic delusion. This device can disrupt the dramatic narrative performed in the spare and simple staging in front of each group. A simple family scene is distorted and the relations between characters and scenes are not always transparent. There is a very clear logic for David and Jon as writers. Not only are the dialogues from the two scenes interlaced, the scenes on each side are also moving backwards in time. When the audiences swap over in order to watch the scene on the other side, what they see is a truncated, speeded up version of what they have already overheard. And yet, because they have the memory of what previously were intrusive phrases, there may be a greater sense of clarity in repetition. Richard describes the play he is in as a reality created by himself and consequently the reality of others is subject to the whim of his creative writing. The tactic here seeks to avoid pinning down any certainty about the location of ‘madness’ and what is reality, and this is a much more complex device than an effect of ‘alienation’ discussed now. David: What about where we deliberately distance, so that people, in a Brechtian way, are able to detach themselves from the emotions of the scene, in order to understand the point that we’re making. What about that? Jon:  

Can you think of an example?

David: Where we deliberately break the fiction. The fourth wall, although it’s a bit confusing in that context, because we’ve got two sides. Jon:  

You mean like meta-theatre?

David:  That kind of thing. Jon:   Th  e bit about the name of the play we’re in. Is that what you were thinking? David: 

Yes, that.

Jon:  

Th at’s not really alienation, is it? We’re still lost in it.

David: Because we don’t do it, do we? Metatheatre, for us, only reveals another layer of fiction. We reinforce the inner layer of fiction by revealing a second layer of fiction, rather than reality. We’re trying to find a second layer that supports that inner layer of fiction.

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No fourth wall and David going mad Eradication opens with a longeur. The psychiatrist looks out to the members of the audience in anticipation of a response, as it turns out. His first line, ‘You seem very quiet today’, sets the tone for a reflexivity that will incorporate the audience. This presents the audience with uncertainty, a risky tactic at the outset of a play. When language fails he draws a diagram of psychosis locating himself in relation to the reality of his patient. He addresses the audience as if they were his patients and directly provokes questions about how they perceive one another. Partly due to its stubborn, yet ridiculous, complexity, the diagram is laughable. The comical impossibility of diagrammatic representation and of a clear clinical presentation, as David describes it, are complicated by the pace of the scene on the other side of the wall. To synchronize with the other scene as an actor David has to introduce moments of hiatus, during which the audience may feel that a response is expected from them. David actively includes the audience ‘in our fiction’ and uses a performance technique to focus his attention on people who, voluntarily or not, are momentarily distracted, looking away the moment that their attention returns to him, perhaps provoked by the feeling that they are being watched closely. It underlines a notion of co-presence and the responsibility for each audience member to make individual meaning from within the notion of audience or, as David calls it here, ‘mob’. He is referring to the volatility of an audience at the outset of a play. For actors and audiences, the progress of a play on any particular night is unknown and the first few minutes can often set the tone. There is an implicit invitation to interact in David’s glances and close ‘listening’. He is inviting participation by each individual, but audience members may not have the confidence to speak out. Laughter is a more collective manifestation of interaction but David and Jon reflect on the risks of pursuing a dialogue through laughter. In the instance they mention here, sniggering in the audience grows into a hysterical uncontrolled exchange that exceeds the purpose of encouraging alertness on the part of the audience. Rather than evaporating the fourth wall, such an exchange might establish an a priori relation between performer and audience before the fictional constructs of the doctor character and his ‘clients’ are introduced. David: There are other moments where I broke … you know, when I’m doing that very difficult opening speech, of the doctor, doing his medical presentation. Because of the nature of the material, you’re doing the scene on the other side, and I’m just standing there and trying to hold the moment. The only way to do it was to look at

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the audience. Because they were a living, unpredictable mob, if they coughed I would look at the person who was coughing, or if they were on their phone or if they were talking. The fourth wall, if anywhere, was outside the auditorium, it includes the people in the audience in our fiction. Jon:   B  ut you’d do the same thing in Give Me Your Love, with the box?20 You’d look at people if they coughed. David: Yes. Jon:   I remember you giving me that as a note, or something: some business to do. David: It’s a way of keeping their focus, as well, because it also recognizes the fact that the event is live, and that’s one exciting possibility of theatre, that anything can happen, and it’s here, and it’s now. Jon:  

What about that moment? When we were in BAC, that night when you were doing the doctor and those two people started giggling, and then you joined in. What was going on there? Were you starting to perform their psychologies with them?

David: I think I was going mad, because their laughter was making me laugh … that mad feeling of uncontrollable laughter. Jon:  

You were joining in with their hysteria. Was there a moment where you were conscious of, ‘This is probably helping them, this is probably a good thing to do’, so you let it go on?

David: No, it was uncontrollable. Jon:  

But afterwards, you said that, I think, didn’t you?

David: I couldn’t help it, because it was just so intoxicating. I don’t know anything like that, beyond laughter, really, that is so intoxicating that you just can’t stop it. During the Edinburgh Festival, Eradication received outstanding and almost universal critical approbation from theatre specialists and general audience members across mainstream and social media. Reviews revisited the densely

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woven pattern of text and at times tried to unpick its carefully threaded knots. While there were those who were frustrated by the complexity of the work, there was also a huge admiration for the staging and the style of performance. The play clearly worked on people’s perceptions of mental health. It increased curiosity and contributed, through post-show Q&A and other forms of dissemination, to the ways in which members of a family can negotiate family tension as well as social provision and care. Ridiculusmus aim to encourage dialogue and empathy in order to contribute to the quiet revolution against the stigmatization of mental ill health. Towards the end of the Edinburgh Festival run Ridiculusmus were awarded the Total Theatre Award for Significant Contribution to Theatre-Making in the UK. This may be one indication of the efficacy of the production as it attempts to improve both artistic responses and public curiosity about mental ill health diagnosis and treatment.

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Recreating Psychiatry through Participatory Performance: Playing ON Theatre and Mental Health Acts Nicola Shaughnessy, Jim Pope, Philip Osment and Hugh Grant-Peterkin

This chapter focuses on the work of the Playing ON theatre company (director Jim Pope and playwright Philip Osment) in mental health contexts. Formed in 2010, Playing ON describe themselves as a theatre company and as a social enterprise. A distinctive feature of their work is the collaboration between mental health service users, medical staff and professional actors in the creation of performance. We refer to three related pieces: the play Hearing Things, which is based on workshops in psychiatric hospitals; Shifting Perspectives, a participatory performance project in collaboration with Re:Create Psychiatry, bringing together service users and service providers;1 and a related workshop and performance programme, Mental Health Acts, supported by the NHS East London Foundation Trust (ELFT). Re:Create Psychiatry is a project associated with the charitable organization Mental Fight Club and its creative initiative, the Dragon Café (a weekly forum for people with mental health experience based in London). It emerged from a two-year programme of panel discussions, the Young Doctor Dialogues, in which conversations between psychiatrists and service users sought to elicit better understanding of relationships that can be divisive and hierarchical. Re:Create Psychiatry builds on this as a co-network of service users and mental health care professionals and is committed to influencing training through approaches that emphasize the importance of empathy in patient– physician communication, responding to its decline in psychiatric practice, as documented in recent studies.2 This intervention operates in the context of recent controversies surrounding the latest revisions to the fifth edition of the American Psychiatric Association’s Diagnostic Statistical Manual of Mental Disorders (DSM).3 Providing a definitive list of mental health conditions and symptoms, it has been criticized for its medicalization of mental health, for the influence

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of the pharmaceutical industry in its production and for expanding the identification of behaviours and moods as conditions to be medicalized as mental disorders. Proponents of the psychosocial model of mental health are more inclined to understand symptoms of mental distress as a response to a difficult life situation or context and psychosis as potentially a response to trauma.4 Hence increasing numbers of clinicians are expressing interest in relational approaches (such as open dialogue to treat schizophrenia, as detailed in Chapter 10), the need for more attention to empathy in training and the recognition of the importance of clinician–client relations in effective psychiatric treatment. Indeed, ‘An ethos of doing with, a practice of doing to?’ was the title of a Re:Create Psychiatry performative panel debate held at the Wellcome Collection in 2016.5 These terminologies, and the associated concept of ‘co-production’,6 are also prevalent in current discussions of applied theatre, disability studies and feminist philosophical discussions of relational ontology and the ethics of care.7 Drawing upon dialogues between the Playing ON company and the participants, as well as our experiences of creative engagement within the workshops as performers and/or observers (combining our multifaceted perspectives as writer, director, academic, performer, service user, clinician), we use a collaborative ethnographic approach. This model, whereby the author is a ‘participant observer’, makes the process an object of study, rather than the means to the end. As Gay McCauley has written, ‘the  shift of interest from art object to the process of production … is given a methodological basis through the interface with ethnography’.8 As discussion in this chapter is focused on the role of empathy in performance and medical contexts, we acknowledge  the interplay between empathy and objectivity in the act of  authorship, consistent with an ethnographic approach. The account is a  dialogue between participants, presenting their different perspectives on  the process and performance. It considers the significance of embodied  creative practices to the work discussed and interrogates conceptions of empathy and sympathy in medical training. This is in  relation to the broader context of changes in mental health services, debates between  medical and psychosocial models of disability and shifting concepts  of recovery. The challenging of hierarchies and identities is fundamental to the work discussed here and is contributing to changing structures for training and support in mental health  in the UK and beyond. The chapter challenges the authority of authorship through its content and the process of composition, reflecting a diversity of perspectives, both personal and professional. We begin with Nicola Shaughnessy’s response to the performance of Hearing Things as the event that initiated this discussion.9

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Hearing Things and fleshy listening It is rare in a theatre for the person sitting next to you to introduce themselves. We sit in the dark next to strangers, acknowledging their presence politely but respecting their privacy as part of this strange unspoken contract of socially appropriate behaviour. In this shared space, we have permission to laugh and cry (but not to cough) and we rarely say hello or goodbye. We applaud at the end and leave, generally in silence. So it was with some surprise that having taken my seat at the December  2017 Theatre Royal, Stratford East, performance of Hearing Things, I was greeted by a man who leaned over from an adjacent seat and introduced himself as a dramatherapist and also his companion who, he explained, was working on a project with him. When I asked about her role in this, my assumption that she was also a drama practitioner was countered by her matter-of-fact declaration: ‘I’m a service user.’ This encounter was an appropriate prelude to the extraordinary experience that followed. Although Western theatre has evolved from traditions associated with the concept of communitas, the traditional audience experience is in a context of privacy and constraint. Yet it is in the communitas, as conceptualized by Victor Turner, that changed understanding is facilitated through the group sharing of a common experience and a flattening of hierarchies.10 This is a key to the liminality associated with communitas: ‘Liminality implies that the high could not be high unless the low existed and he who is high must experience what it is like to be low.’11 This fluidity of status is what Hearing Things appeared to be about and is a key feature in the Playing ON method. It was also implicit in the dialogue between myself, the dramatherapist and the service user. Our roles in this context were non-hierarchical, providing different forms of expertise as invited audience members. However, the unsettling of my position as an audience member and performance scholar (with academic authority to interpret and evaluate the work) was also due to the other private knowledge I brought to this work, as someone who had previously been a service user and who knew what it was like to be on the other side of these hierarchies as someone disempowered, objectified by a diagnosis. Recovery was conceived as relinquishing my condition, something to be fought, overcome and then silenced, banished to the archives of my medical history. The performance that ensued played out my discomfort in a piece that challenged the dualisms of sanity and madness, clinician and patient, through the dynamics of depression and addiction, affecting clinicians and patients in equal measure.

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From the opening moments we were drawn into a shared intimate experience, a coalescence between the public and private. The opening scene, set on a beach, stages a family memory with a mother sunbathing as father and son play in the sand, the son burying the father, his physical position on top of his father being part of the fun. The laughter turns to anger when the son introduces some saboteur seagulls, as he mimes them swooping down to peck him and throwing sand in his face. In one short scene relationships are encapsulated and problematized: the power practices between the father (doubling as the doctor) and the psychiatrist (doubling as son) and the father’s anger and the son’s paradoxical desire to please and yet rebel. Throughout, the interplay between dualisms and hierarchies created productive tensions (outside and inside, past and present, unconscious and conscious, thinking and feeling states, clinical settings and the real world, patient and therapist). They collided and coalesced, creating the movement (and humour) in the piece as a series of border crossings, effecting shifts in understanding as the psychiatrist son transitions to service user and the oncologist father becomes a dementia patient. Strange encounters ensued in the spaces between these roles, such as when the alcohol-dependent psychiatrist encountered his previously sectioned patient at a supermarket checkout as she buys tea and he exits with a bottle of Rioja: Janet    Rioja – very nice. You self-medicating? Nicholas  Something like that Janet    It’s expensive, that one. The complex relationships between client and therapist and the multiple perspectives of the shifting power positions in play are critical to the dramaturgy, informed by the practical wisdom of the community participants and by their gallows humour. In a moment of acute poignancy and beauty, a service user’s suicide was staged as she walked slowly and purposefully across the stage, adjacent to the backdrop with sound and lighting evoking an approaching tube train as she stepped into the darkness and disappeared. The impact of her death on the psychiatrist who fought for her discharge (a Serious Incident in NHS parlance) contributes to his own breakdown, although the timeframe of the play and the complexities of the relationships mitigate against a simple cause-and-effect narrative. The simple set with natural flooring (functioning as outside beach and interior floor) is juxtaposed with the extreme naturalism of actors drinking red wine on stage and the authenticity of the roles performed. At the centre of the sophisticated interaction between dramatic form and content is the swapping of roles between the three-actor triangle: the performer playing the role of

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the psychiatrist’s wife (a vicar) also plays the suicidal service user as well as the mother of a schizophrenic patient. We are conscious of the shifting dramatis personae and aware of the interplay between status and gender roles. An actor combines the roles of schizophrenic son and patient with that of the oncologist father in early stage dementia, with the third actor playing the psychiatrist son as child and adult. This interplay enables the complexity of relationships and power dynamics to be explored and manipulated. There was a lot of ‘father stuff ’, an audience member later observed. To see men’s mental health problems staged, and hence exposed, contributed to the discomfort the play provokes. This is particularly evident in the reversal of roles when the father becomes subordinate and dependent, regressing into a child-like state as dementia progresses. His denial, fear and anger, and the impact of his condition on his family, are played out in short scene fragments, moments that appear and disappear, like his memory. For me, the heart of the play is a role transformation executed by the two male actors. The psychiatrist, in the aftermath of the suicide for which he is being held responsible, becomes angry and then breaks down as he struggles to explain to his schizophrenic client that he can’t release him from sectioning to visit his sister. The psychiatrist jumps into the arms of the other actor, who shifts from patient to father, cradling the son who is both grown-up and child. There’s a rawness in this moment, a making visible of the invisibility of male emotion and vulnerability. It’s another powerful instance of role transformation and of the interrogation of hierarchies, underlining the extent to which gender performance is also implicated in mental health.

Roles and relationality The performance of Hearing Things was the culmination of a process involving participatory workshops in psychiatric units, engaging clinicians and patients. The playwright, Philip Osment, also functioned as a dramaturg through his engagement with the process in collaboration with the director, Jim Pope, who similarly performed a dual role as one of the three actors in the piece. This positioning involves the performance makers being both inside and outside the work, a dynamic that is challenging to sustain and distinctive. The company’s work challenges the distinctions between applied and socially engaged theatre as it is both arts led and socially engaged. The work is positioned in a complementary relationship to Helen Nicholson’s discussion of applied theatre’s shifting status, ‘resituating its ambition’ through the acknowledgement ‘that life is constantly improvised and constantly in flux and that social change happens not only through

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challenging institutional structures of power but also through the relationality of experience’.12 Nicholson links relational art to relationcentred care in ways that complement the work discussed here, challenging the dualisms between active and passive spectatorship, the actor and the acted upon, through practices and approaches that are situated in between these positions. Hence, ‘it does not rely for its efficacy on an action that is subsequent to the theatrical encounter, but acknowledges that the encounter in itself holds potential for new forms of relationality (emphasis in original)’.13 The work of Playing ON takes various forms, through an iterative process that moves between clinical and arts settings. The performance, however, wasn’t an end point. Indeed, Shaughnessy’s experience as an audience member of the play was at an event to launch the Mental Health Acts project (2017). This experimental programme similarly engaged service users and health professionals, this time working in a theatre context (Theatre Royal, Stratford East) rather than in a hospital. Weekly meetings followed by an intensive week-long series of rehearsals led to a further event, a performance sharing. While the Mental Health Acts project structure and outcome is familiar as an applied theatre paradigm, it is also based on the research and development model adopted by many professional theatre companies. Moreover, the process is also aligned with practice research as the collaborators pursue work that is designed to generate new knowledge and understanding of mental health. The responses to both projects and these processes emphasize their capacity to effect change, with psychiatrists and service users reporting significantly enhanced understanding of each other’s perspectives. The workshops at the Maudsley Hospital that led to the production of Hearing Things were strongly endorsed as transformative by clinicians: Without a quantitative evaluation using any rating scales, what we know is that virtually all the patients who were engaged in the sixweek workshop programme were discharged at about the same time and in that respect I think that the performance clearly accelerated their discharge. I know in two definite cases where I can clearly say the performance led to me discharging them (Dr Dele Olajide, consultant psychiatrist, Maudsley Hospital).14

In a panel discussion, after the Mental Health Acts sharing, Marie Gabriel, chair of East London NHS Foundation Trust, stated that as someone who considers serious incident reports, she realized she had not fully understood the potential impact on clinicians. She also endorsed the holistic and

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insightful impact of the programme and her commitment to ensuring that ELFT carries this work forward.15 For Hugh Grant-Peterkin (a psychiatrist), the experience ‘took me right back to the core of why I wanted to be a doctor. It made me think of the saying (actually tattooed on a psychiatrist friend’s neck) “cure sometimes, heal often, comfort always”’.16 While the transformative potential of theatre through its impact on groups or individuals has been discussed and evidenced in a range of contexts, much of this work is categorized as applied theatre, involving participatory practices, rather than an experience in an auditorium. Perhaps the vogue for immersive performance is an indication of something different being sought for in theatre, although this has contributed to the critique of participatory theatre as a consumerist experience.17 Theatre as experience has become part of its attraction as a product for consumption, a paradox identified by Nicholson: ‘affect captures social imagination, and affect also sells’.18 Challenging the distinctions between activist and consumerist, Nicholson suggests that ‘agency … mutually comes about in the immediate material constitution of any experiential encounter’. This is evident in the work of Playing ON, through its challenge to the division between the aesthetic and non-aesthetic; Hearing Things is both scripted play and socially engaged performance. Similarly, while Mental Health Acts was a sharing at the end of a workshop process, it was also a performance in which both audiences and participants were engaged and moved by aesthetic experience and in which shifting power relationships were at the heart of the endeavour to create a collaborative activity and to challenge the hierarchical relations between doctor and patient. This is clearly articulated by Grant-Peterkin: Power! Last but not least power! So important in psychiatry. The fact that with a pen and paper (and another doctor and a social worker) I can detain someone in hospital for six months (they can appeal of course but still) is huge. It hangs heavy in the air, as does the ability to enforce medication. The space of theatre is one where this power dynamic could be explored a la Boal [forum theatre], we didn’t do that so much but we did something subtler and perhaps more important, we addressed power by simply not telling each other or being told who was in which box/team/side so then there could only be one.

The principle of not knowing the identities of participants is fundamental to the Playing ON approach, and although this may become evident as rehearsals progress, the uncertainty around roles contributes to the shifting dynamics between truth and fiction and the destabilizing of power structures. For

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Grant-Peterkin, not knowing who the participants were was challenging: ‘I, for one, was very keen to find out who was staff and can remember distinctly how different I felt it was when two more senior psychiatrists were in one week – if I am honest I was glad they did not come back each week; gives me a taste of how it may have felt for service users.’ While theatre can explicitly challenge these structures (as in Boal’s Forum Theatre), the Playing ON approach works on a different and deeper level. Empathy is a key to this, as indicated in Grant-Peterkin’s comments. In  particular he refers to the experience of improvising the role of the central persona (Fifi), a victim of domestic abuse who had been sectioned after being arrested on a motorway in her nightdress, escaping from her home and whose continuing treatment or discharge is being negotiated: [I]t made me not only think what it would be like to go back to an abusive husband but I felt it, I had a shard of fear run through me when the consultant asked me what it would be like to go back to him. Clearly none of it was real, not even ‘real’ acting, but for a tiny moment I felt that powerlessness – being sent from one man to another, each with power over me (as the character).

A key theme emerging from the performance workshops as well as from interviews with participants and members of Re:Create Psychiatry is a distinction between sympathy and empathy. This, Grant-Peterkin explains, is not explicit but exists within the matrix of medical thinking and training. Sympathy is considered an acceptable position for a clinician to adopt in the course of diagnosis and treatment, acknowledging but not experiencing the patient’s suffering as a witness (I see but don’t feel your pain); empathy, however, is problematic as the boundaries are more porous between firstand third-person perspectives. ‘Empathy is generally taken to involve more than just understanding’; the philosopher Matthew Ratcliffe observes, ‘one must also experience something of what another person experiences’. In his discussion of empathy and psychiatric illness, Ratcliffe identifies various disciplinary differences between medical and philosophical understandings, particularly in terms of mental simulation, proposing a formulation which is neither simulative nor based on philosophical alternatives, but conjoins subjective experience, moral perception and clinical observation.19 The implications for training are considerable and contentious, as evident in recent papers on decline in empathy in medical students.20 For GrantPeterkin, who teaches undergraduate medical students, this is a significant concern:

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[I]t is fascinating to me, to what extent is it in some way protective so that a change might challenge how we practice and understand our role as doctors – the whole profession stumbles forward not quite knowing how to engage with its own feelings, a fractured empathic state.

Offering an example from his own teaching, he asks students to consider how to approach questioning when talking to someone who is experiencing psychosis. ‘What would you ask me if I told you someone followed me off the bus?’ This question invites the student to listen non-judgementally to the experience being described. It invites a response that is referred to as ‘open’ and ‘curious’, which is precisely the position Grant-Peterkin advocates in clinical consultation.

Engagement, empathy and ethics: Playing ON practices and training Engaging with feelings through participatory arts is acknowledged as a messy business, as discussed in Chapter 1. It risks blurring the boundaries between therapy and theatre, creating performances that, in placing emphasis on the use of personal material, may be beneficial for participants but neglect to consider the role of the audience in the theatre event. Throughout the Playing ON workshops, however, an iterative, polyphonic process combines first-, second- and third-person perspectives, through the improvisational methods of participatory arts practiced in collaboration with a playwright and director. The collective approach combines devising and scriptwriting as participants work with loose scripts created by Osment, who observes the process and then works independently to shape the characters and dialogue, returning them to the group for further development. The practice of creating fiction from the truth of personal experience involves starting with individual accounts which are then depersonalized and collectively shared before one element is selected as the basis for further storying. It should be acknowledged that this way of working ran counter to the expectations of some of the service users who were drawn to the project by what they perceived as its autobiographical dimension. Angela,21 a 23-year-old participant with experience of repeated hospitalizations, thought the project should be ‘about’ the Mental Health Act. She argued that the devised performance should be a political platform for demonstrating the problems with the current system, the failures of diagnosis and the lived experiences of service users. By the end of the process her position had shifted.

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At an early stage it was decided that the central character of the piece, Fifi, would be played by all participants at different stages of the drama as an appropriate coalescence of form and content. The group decided on a focus and the characters emanated from a central memory or event which, in this instance, was Fifi walking along a motorway in a nightdress. In the final performance, the entire cast functioned like a chorus, entering the stage and sharing the reading of Fifi’s memoirs. The performance, like the  workshops, was predicated on a relational structure, exploring the  different perspectives of those affected by the central event, the witnesses on the night,  policeman, hospital staff, other service users and family members. Through  improvisation, the backstory was created, an account of the context  in which Fifi’s situation developed and the various factors contributing to her mental distress. The  approach combines phenomenological and cognitive understandings of identity, sense making and self-coherence as distributed,  involving individual, interpersonal and environmental factors. Pope refers to the  approach as the layering of an onion, as we discover and listen to the circumstances and contributory factors that have resulted in psychosis. The facts about Fifi were agreed in rehearsal: Having been born in England, Fifi was sent to live in Ghana, aged eight. She didn’t see her mother for ten years, returning to London when she was 18 to go to secretarial college, where she was bullied. Her father died when she was 16, and she lived with her uncle before meeting her husband in what was a loveless marriage of convenience, encouraged by her mother. She was subject to physical and emotional domestic abuse as her husband (motivated by his desire for her uncle’s wealth) forced her increasing isolation, eventually imprisoning her in the house, prior to her escape and the incident on the motorway. In the hospital she is encouraged by a social worker to join a group of service users and to write poetry, culminating in her reading a poem about her experience at a mental health awareness day.

There is an affinity between the theatre-making process and the enactive approach to cognitive science and psychopathologies discussed by Miriam Kyselo. Having argued that ‘we still lack an account of how 1st and 3rd person observations can fruitfully go together in an embodied account of disorders of the self ’, she outlines a ‘new proposal for an enactive approach that integrates 1st and 3rd person perspectives, while strongly emphasising the role of social interactions in the formation of self ’.22 Her discussion highlights an ‘important task for embodied cognitive science: to integrate

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the bodily and social dimension’ in approaches to psychopathology. The alternative framework proposed conjoins the lived subjective experience of the patient, the bodily self (the experience of ‘for me ness’ that make them mine) and intersubjectivity: [O]ntologically speaking, psychopathologies of the self are relational or social structures, dynamically emerging through the individual in its relations and interactions with the social world … it follows then that the trouble generateur does not reside or originate within the patient (in her brain, body or phenomenology) nor simply outside, in the patient’s social environment, but rather within both, i.e. the relational dynamics between them.23

Participatory performance is the basis for the enactive approach through the shifting perspectives from first-person subjective insights to third-person organizational explanation. Grant-Peterkin (psychologist) played Fifi (and other roles), while service users explored the perspectives of clinicians in debates about medication, care plans and sectioning. Kyselo notes that both Eugene Minkowski’s ‘ego’ and Merleau-Ponty’s notion of ‘total being’ refer to ‘an underlying third that transcends both symptoms and experiences and yet also stands in relation to them’;24 this is the intermedial space of theatre and Pope’s role as director-facilitator is to negotiate these positions. The integrity of the lived experience is respected and finds expression through an attention to detail associated with rigorous naturalism, the ‘truthful responses under imaginary circumstances’ that he advocates to the cast.25 ‘The expertise in the room is wonderful’, he says as the service users challenge him. ‘The thing is, Jim, this would never happen’, Angela interjects after an improvisation involving Fifi’s introduction to the ward by a sympathetic nurse: ‘you’re just ushered in and left to it.’ We are advised on the legalities of detention and that Fifi would initially be subject to a ‘Section 136 … it means the police have brought you in.’ The tour of the ward became a key scene of the performance, led by Angela in her ward manager persona (with shades of estate agent), with characteristic gallows humour: This is the office where the staff are always extremely busy with their care plans and mustn’t be disturbed by patients; this is the recreation room but I’ve never seen a service user in here; here’s the utility room where you can use the washing machine but bring your own soap and the hair dryer failed the PAT test and here’s the group therapy room although we’re only in there once a month so it’s mostly used for staff meetings. All the communal spaces for service users have windows so the staff can

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see what you’re doing as you’re all under constant observation. We have detained and voluntary patients and it’s important for you not to ask what section they’re on.

In another improvisation, Angela assumes the role of a doctor, sensitively responding to Fifi’s question ‘I don’t understand why I’m here’ as she explains the purpose of the hospital admission: Angela (as doctor)  We know you had an episode before and we call that a stressor, but we can’t be sure why someone becomes unwell. We can begin that process though, of understanding why something happened and that’s part of the reason for being here.

For someone whose relationship with clinicians had been so problematic and who positioned herself so emphatically as a victim of the system and subservient to medical authorities, this is an indication of Angela’s understanding of the rationale for detention. A dialogue between Hugh (Grant-Peterkin), playing a junior doctor, and Amelia (a hospital receptionist whose identity wasn’t known to him at the time), in role as a psychologist, explored current tensions between disciplines and the biomedical and biosocial models. The argument concerns Fifi’s care plan and whether to increase medication, with the psychologist wanting to pursue alternatives: Hugh (in role as junior doctor)  I’m not anti-psychology. I’ve even … this may blow your mind … had some therapy! Amelia (in role as Suzy)  So can you understand my concern? She’s only been with us for two weeks and she was very clear at the CP that she wasn’t suicidal; she’s starting to open up. We can work so much better with someone who is unmedicated, yet I see in your notes you want to increase the meditation … (laughs) I mean medication. Hugh (laughing)  That’s a telling slip. You can get on with your mindfulness and candles and your Budhha in the corner but I’m a junior doctor with a massive case load and if I make the decision to reduce the medication and then there’s an incident, it’s my head on the block not yours! I’m sick of psychologists banging their drums.

Watching this at an early stage in the process, it was impossible to distinguish between the professional actors, clinicians and service users as their use of lived experience facilitated spontaneity and authenticity. ‘I don’t know if

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you’re a real psychologist’, Hugh commented to Amelia as an aside, in the discussion after this sequence. The process of adapting the work for performance involves use of physical theatre and non-naturalistic techniques. Pope starts with the physical details of the body and environment, ‘Think of the eyes, hair, heartbeat’ and then asks performers to develop more stylized movements, changing levels, focus and location before introducing words: ‘If you’re going to speak, still have the structures of the movement.’ Hence the work shifts from individual to group formations, with an increasing emphasis on physicality and the language of the body, an old adage but it is a means to move beyond the intellectual and the confessional through gestural and movement-based vocabularies. Ironically, Grant-Peterkin contends, this focus on the body might be a potential stumbling block for the medical community: I also began to wonder if theatre, more specifically performance, was an unsettling medium for clinicians. Perhaps it feels exposing in a way that a joint photography/writing/painting/music-making project would not, it explicitly involves the body, relies on the body and is enacted through the body. This gives it its power (though can also be why it goes wrong) and liveliness but it is potentially anxiety provoking for a clinician who has cultivated a distanced view of the body, even psychiatrists who have not practised medicine or surgery for years retain some clinical distancing (disdain?) from the body.

For performance scholars, however, it is in the interactions between the body, the environment and the sensing subject that meanings are made; the combination of these elements creates an embodied, empathic and ethical understanding. This resonates with dialogues between philosophy (particularly feminist academics), psychiatry and mental health experts concerning the social production of meaning and knowledge and the principles of co-production which are fundamental to the praxis of participatory performance and to the Playing ON approach. The combination of elements and the interactions between ‘real world’ lived experience and the embodied creative processes lead to Grant-Peterkin’s conclusion: ‘this is why I think it is a perfect fit for psychiatry. We told a wholly truthful story that was not factual’.

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Epilogue Nicola Shaughnessy

In an account of the research process informing Ridiculusmus’s The Eradication of Schizophrenia in Western Lapland (see Chapter  10),1 David Woods refers to an event that epitomizes the power of theatre as a medium for engaging with psychologies through performance. Having started a piece about family drama, drawing upon some of their own experiences of domestic crisis arising from mental illness, the company (Woods and Jon Haynes) were directed to the open dialogue experiment in Finland after a meeting at the Tavistock Centre, London, with Charlotte Burck. The Tavistock study, Ways of Coping, Woods explains, ‘looked at the experiences of teenage carers of mentally ill parents, a role I had been in’. The pioneer of open dialogue Jaakko Seikkula invited Ridiculusmus to participate in a conference in Finland to gain understanding of the approach. It was suggested that they would improvise an open dialogue treatment session, based on the characters and situation they were developing in their script: ‘We thought it would be good for the development of the characters’ stories as well as gaining first-hand experience of the approach.’ However, the experience described moved beyond this as ‘what took place that morning … had a profound, transformative influence on the play and our practice in general’. ‘For me’, writes Woods, ‘it remains a life-defining moment that I still don’t fully understand’. We presented a fifteen minute extract from the play and were met with ponderous silence from the audience of more than 300 therapists! We then removed the wall and created a circle of chairs for the staged treatment meeting that would follow. I changed into Dad (not a costume change, a subtle head shift from one thought pattern to another; a touch of physical transformation in the spine or face maybe – a jigsaw of people from real life and elements of myself, glued together with imagination). […] I remember Jaakko thanking us, the family, for coming along to the meeting. Richard has some problem with books; Mum has gone.

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Jaakko asks, ‘What do you think Mum would say about the books? Shall we have a chair to represent Mum? Where should we place the chair? Next to Dad? Next to Richard? Away from Jade?’ We seem to have talked about nothing, but after a few simple exchanges, Dad/I am bursting with emotion. It swells in me like grief, but is also a relief. I am asked something, and I can’t speak, the words come out as a torrent of pain. Jaakko and Markku start to cry. We all mourn the absence of the fictional mother. And it ends.

It didn’t end there, however; the scene was repeated the next day, as an improvisation of a further meeting, in accordance with the principles of open dialogue and with Woods experiencing similar emotions: ‘Still in a state of embarrassment about what has been happening to me, I go along with the idea that I was performing all of that. Inside, as someone who has cried less than five times in my whole adult life, I find it all confusing.’ The breakthrough moment is triggered by the chair as the absent mother, a prop (as a material affordance) invoking an affective response. A discovery is made through a practical process that has similarities to open dialogue, involving curiosity, tolerating the unknown and being in the moment. It becomes part of the play – a self-referential moment that reminds the audience of their position as spectators (‘it’s the play that we’re in’). The meltdown isn’t a breakdown but a breakthrough ‘I now have a place for it in the show.’ It’s not therapy in the way that open dialogue functions whereby ‘all psychoses are responses to traumatic events’ and ‘Open Dialogue provides an opportunity to unlock the memory of these events and help defuse them.’ In theatre, however, the audience participate in the dialogic process and sense making, as Woods concludes: [W]hilst the therapist helps to facilitate a therapeutic narrative and understanding for the client, we, in our minimalist articulation of therapeutic breakthrough, attempt to allow the audience to come to the work with their own narratives, perhaps with traumas that are unresolved. By underwriting the specifics of our staged family-drama, we allow the audience space to process their own experience.

This is not applied theatre nor is it informational or a demonstration or representation of schizophrenia or the open dialogue approach. It is a form appropriate to content; an encounter between the performers and audience through the articulation of an experience that creates a ‘truth’ through a fiction, to use Hugh Grant-Peterkin’s term (Chapter 11). Meaning-making in theatre is produced through an embodied sensory process, rather than

Epilogue

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a cognitive act, combining first- and third-person perspectives, the hot and the cold cognition of Barnard’s ICS framework. Throughout this volume, we find examples of the ‘fleshy listening’ Harpin refers to: from Freud’s lying on the floor in Brodzinski’s account, calling attention to the language of the body, to Roth’s method of understanding autism through individual stories and Shaughnessy’s hearing the music in the rain of dementia. In Part Two, Dingwall-Jones considers place and gender in dramatizations of women’s madness, an account that is itself a demonstration of listening with the playwrights discussed, inviting Crawford’s response which critiques the ‘delistening’ of those deemed incomprehensible, advocating mutual recovery as an alternative model. In Marla Carlson’s discussion, there is too much easy listening in popular representations of autism as epitomized in The Curious Incident of the Dog in the Nighttime, a work which functions in a major/ minor tonality to her other case study Chekhov Lizardbrain and her listening to the different family dramas as well as questioning the scientific paradigms underpinning these stagings. In responding to Carlson’s piece, Thalia Goldstein emphasizes the importance of empathy in dialogues between arts and science. The ethical difficulties of empathic listening are evident in Ellen Kaplan’s piece on working with prisoners on death row and in Fabiola Camuti’s response, referring to issues of interdisciplinary evaluation in working in these contexts. In all these accounts, performance is valued for its capacity to enhance imaginative understanding and creative engagement with the complexities of mind space through embodied practice. These stories challenge the dominant medical models of psychopathology through relational and ecological understanding of mental health. Hence, as Thomas Fuchs has concluded: [T]he simple, bottom-up explanation of mental disorders as products of genetic or neurophysiological determinants is inadequate to the causal complexity involved. From an ecological or systemic perspective, the disorder should rather be regarded as the product of a circular causality of neurophysiological, subjective, environmental and social influences continuously interacting with each other. Phenomenology regards the person as inseparable from their being-in-the-world and being-withothers. This is in correspondence with a systemic or ecological view of the brain as an organ that is embedded in, and continuously shaped by environmental relations. The increasing convergence of phenomenology and embodied or enactive cognitive neuroscience also applies for phenomenological psychopathology and systemic accounts of mental illness. The potentialities held out by a close cooperation between these approaches are just being discovered.2

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Such potentialities are evident in the dialogues between cognitive neuroscience, phenomenology, performance studies, mad and disability studies throughout this volume. In talking about the knowability of madness, Harpin invites us ‘to consider if such alternative ways of speaking, listening and seeing advanced by Laing and others would not be obsolete … If we undertake the serious project of listening attentively to history, to Laing, to others, we might just hear the chords for a different future for psychiatric care’.3 Sometimes in harmony and at other times creating less easy listening through discordant textures, it is in the polyphonic voices throughout the body of work in this volume that, we suggest, these opening notes can be heard.

Notes Chapter 1 1 2

3

4 5 6 7

8 9 10 11 12 13

Neil Frizzel, ‘Meet the Man Putting MDMA Therapy on Stage’, Vice, 5 January 2016, https://www.vice.com/en_us/article/jman3g/mdmatherapy-play Clelia Falletti, Gabriele Sofia and Victor Jacono (eds), Theatre and Cognitive Neuroscience (London: Bloomsbury Methuen, 2016); Alex Mermikedes and Gianna Bouchard (eds), Performance and the Medical Body (London: Bloomsbury Methuen, 2016); Rhonda Blair and Amy Cook (eds), Theatre, Performance and Cognition (London: Bloomsbury Methuen, 2016); Pil Hansen and Bettina Blässing (eds), Performing the Remembered Past: The Cognition of Memory in Dance, Theatre and Music (London: Bloomsbury Methuen, 2017). See Sheila McCormick, Creative Ageing (London: Bloomsbury Methuen, 2017); Gill Windle et al., ‘Dementia and Imagination: A MixedMethods Protocol for Arts and Science Research’, BMJOpen 6 (2016), e011634; Carmel O’Sullivan, ‘Drama and Autism’, in Fred Volkmar (ed.), Encyclopedia of Autism Spectrum Disorders (New York: Springer, 2015). Veronica Strang and Tom McLeish, Evaluating Interdisciplinary Research: A Practical Guide (Durham: University of Durham, 2015). ‘Mind Space’ three-day workshop, Wellcome Trust and Arts and Humanities Research Council, 23–25 March, 2015. Helen Kara, Creative Research Methods in the Social Sciences: A Practical Guide (Bristol: Polity Press, 2015). This definition is from the Foundation for People with Learning Disability website: ‘Social and Medical Models of Disability’, https://www. mentalhealth.org.uk/learning-disabilities/a-to-z/s/social-model-disability, accessed 18 December 2016. Elizabeth Pellicano, Adam Dinsmore and Tony Charman, A Future Made Together: Shaping Autism Research in the UK (London: Institute of Education, 2013). Peter Fonagy and David Taylor, ‘Postscript to the Special Issue on Depression’, Psychoanalytic Psychotherapy 23, no. 3 (2009), 276–280. Ibid., 278. See Matthew Reason and Nick Rowe (eds), Applied Practice: Evidence and Impact in Theatre, Music and Art (London: Bloomsbury Methuen, 2017). Nicola Shaughnessy (ed.), Affective Performance and Cognitive Science, Body, Brain and Being (London: Bloomsbury Methuen, 2013). See Nicola Shaughnessy and Melissa Trimingham, ‘Autism in the Wild: Bridging the Gap between Experiment and Experience’, in Peter Garrett

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(ed.), The Cognitive Humanities: Embodied Mind in Literature and Culture (Basingstoke: Palgrave Macmillan, 2017), 191–212. 14 For an overview of results, see Julie Beadle-Brown et al., ‘Imagining Autism: Feasibility of a Drama-Based Intervention on the Social, Communicative and Imaginative behaviour of Children with Autism’, Autism: International Journal of Research and Practice, 2017 (online), https://doi.org/10.1177/1362361317710797. 15 Discussed in Shaughnessy and Trimingham, ‘Autism in the Wild’. 16 Shaughnessy, Affective Performance and Cognitive Science. 17 Melissa Trmingham and Nicola Shaughnessy, ‘Material Voices: Intermediality and Autism’, Research in Drama Education 21, no. 3 (2016), 293–308; Scott deLahunta, Gill Clarke and Philip Barnard, ‘A Conversation about Choreographic Thinking Tools’, Journal of Dance and Somatic Practices 3 (2012), 243–259; Jon May, Michael Dean and Philip Barnard, ‘Using Film Cutting Techniques in Interface Design’, Human Computer Interaction 18, no. 4 (2003), 325–372. 18 Trimingham and Shaughnessy, ‘Material Voices’. 19 Philip Barnard, ‘Bridging between Basic Theory and Clinical Practice’, Behaviour Research and Therapy 42 (2004), 977–1000, 987. 20 For Barnard’s work on depression, see John Teasdale and Philip Barnard, Affect, Cognition and Change (Hove: Lawrence Erlbaum Associates, 1993); on schizophrenia, see Philip Barnard, ‘Asynchrony, Implicational Meaning and the Experience of Self in Schizophrenia’, in Tilo Kircher and Anthony David (eds), The Self in Neuroscience and Psychiatry (Cambridge: Cambridge University Press, 2003), 121–146; for eating disorders, see Rebecca Park et al., ‘Schematic Models and Modes of Mind in Anorexia Nervosa II: Implications for Treatment and Course’, International Journal of Cognitive Therapy 5, no. 1 (2012), 86–98. The latter paper refers to dance and movement therapy, also citing his work with deLahunta to suggest ‘strategies that involve movement and sensory – or biofeedback while maintaining control may allow remodelling of the relationships between agency, affect, and body-related themes [in anorexia].’ 21 See, for example, the work of Paul Crawford (a respondent in this volume), who leads the literature and madness network www.madnessandliterature. org; see also Anna Harpin and Juliet Foster (eds), Performance, Madness, Psychiatry: Isolated Acts (Cambridge: Cambridge University Press, 2014). For medical perspectives on the field, see Derek Russe Davies, Scenes of Madness: A Psychiatrist at the Theatre (London: Routledge, 1995), and Femi Oyebode, Madness at the Theatre (London: Royal College of Psychiatrists, 2012); see also the edited collection Mindreadings: Literature and Psychiatry (London: Royal College of Psychiatrists, 2009). 22 Anna Harpin, Madness, Art and Society: Beyond Illness (London: Routledge, 2018). 23 https://wellcomecollection.org/articles/thinking-body-video-gallery.

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24 Jaakko Seikkula and Mary Olson, ‘The Open Dialogue Approach to Acute Psychosis: Its Poetics and Micropolitics’, Family Process 42, no. 3 (2003), 403–418. 25 See also the account of this production in Nicola Shaughnessy, ‘Opening Minds: The Arts and Developmental Psychopathology’, in David Williams and Luna Centifanti (eds), Wiley Handbook of Developmental Psychopathology (Oxford: Wiley-Blackwell, 2017), 61–85. 26 See Nicola Shaughnessy, Applying Performance: Live Art, Affective Theatre and Socially Engaged Practice (Basingstoke: Palgrave, 2012). 27 See, for example, Emma Brodzinsky, Theatre in Health and Care (Basingstoke: Palgrave, 2010), and the overview in the 2016 report Creative Health: The Arts for Health and Wellbeing, launched by the All Party Parliamentary Group on Arts, Health and Wellbeing. 28 See James Thompson, Performance Affects: Applied Theatre and the End of Effect (London: Palgrave Macmillan, 2009); Jenny Hughes and Helen Nicholson (eds), Critical Perspectives on Applied Theatre (Cambridge: Cambridge University Press, 2016). 29 Gareth White (ed.), Applied Theatre: Aesthetics (London: Bloomsbury, 2015), 5. 30 This terminology, conflating aesthetics and ethics, is used by Nicola Shaughnessy in ‘Do You See What I See? Arts, Science and Evidence in Autism Research’, in Matthew Reason and Nick Rowe (eds), Applied Practice: Evidence and Impact in Theatre, Music and Art (London: Bloomsbury Methuen, 2017), 80–94. 31 Re:Create Psychiatry newsletter. See https://recreatepsychiatry.com/. 32 Personal correspondence with Nicola Shaughnessy. 33 James Ross and Chris Watling, ‘Use of Empathy in Psychiatric Practice: Constructivist Grounded Theory Study’, British Journal of Psychiatry Open 3, no. 1 (2017), 26–33; Mohammadreza Hojat et al., ‘An Empirical Study of Decline in Empathy in Medical Schools’, Medical Education 38 (2004), 934–941; Melanie Neumann et al., ‘Empathy Decline and Its Reasons: A Systematic Review of Studies with Medical Students and Residents’, Academic Medicine 86, no. 8 (2011), 996–1009. 34 Ross and Watling, ‘Use of Empathy in Psychiatric Practice’, 26–33. 35 Brigit McWade, Damian Milton and Peter Beresford, ‘Mad Studies and Neurodiversity: A Dialogue’, Disability and Society 30, no. 2 (2015), 305–307, 307. 36 I refer here to Hans Thies Lehmann’s definition as summarized in Elinor Fuchs, in Hans-Thies Lehmann, Post Dramatic Theatre, trans. Karen ­Jürs‑Munby (London: Routledge, 2006): ‘He systemically considers the new theatre aesthetics in terms of their aesthetics of space, time and the body as well as their use of text.’ 37 Ibid., 22. 38 Interview with Melanie Wilson, cited in Shaughnessy, Applying Performance, xx. see Melanie Wilson, Autobiographer (London: Oberon Books, 2012).

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39 Emily Holmes, Michelle Craske and Ann Graybiel, ‘Psychological Treatments: A Call for Mental-health Science’, Nature 511 (2014), 287. 40 Emily Holmes, ‘Theatre: Performing Rituals’, Nature 519, no. 7543 (2015), 289. 41 This is discussed in more detail in Shaughnessy, ‘Opening Minds’. 42 Laura Mooney, The Stage, 27 April 2016. 43 Lynn Froggett, ‘Preface’ to Olivia Sagan, in Narratives of Art Practice and Mental Well-Being: Reparation and Connection (London: Routledge, 2014). 44 John Sutton and Evelyn Tribble, ‘Cognitive Ecology as a Framework for Shakespeare Studies’, Shakespeare Studies 39 (2011), 94–103, 94. 45 Sagan, Narratives of Art Practice and Mental Well-Being, x. 46 Thalia Goldstein, Matthew Lerner and Ellen Winner, ‘The Arts as a Venue for Developmental Science: Realizing a Latent Opportunity’, Child Development 88, no. 5 (2017), 1505–1512. 47 Thomas Teo, ‘From Psychological Science to the Psychological Humanities: Building a General Theory of Subjectivity’, Review of General Psychology 21, no. 4 (2017), 281–291. 48 See Lynn Froggett et al., Public Art and Local Civic Engagement, Final Report, Arts and Humanities Research Council, 20xx; Sagan, Narratives of Art Practice and Mental Well Being; Murray Smith, Film, Art and the Third Culture: A Naturalized Aesthetics of Film (Oxford: Oxford University Press, 2017); Brett Wilson, Barbara Hawkins and Stuart Sim (eds), Art, Science and Cultural Understanding (Illinois: Common Ground Publishing, 2014). 49 Sagan, Narratives of Art Practice and Mental Well-Being, 122. 50 Anna Harpin and Helen Nicholson (eds), Performance and Participation: Practices, Audiences, Politics (London: Palgrave Macmillan, 2016). 51 Jon May and Philip Barnard, ‘Comprehending Dynamic Scenes: Cognitive Lessons from Cinematography’, https://www.researchgate.net/ publication/318109993_Comprehending_Dynamic_Scenes_Cognitive_ Lessons_from_Cinematography, accessed 14 July 2018. 52 Wayne McGregor, Philip Barnard, Scott deLahunta, Jasmine Wilson and Ellie Douglas-Allan, Mind and Movement: Choreographic Thinking Tools (London: Wayne McGregor | Random Dance, 2013). 53 Philip Barnard and Scott deLahunta, ‘Mapping the Audit Traces of Interdisciplinary Collaboration: Bridging and Blending between Choreography and Cognitive Science’, Interdisciplinary Science Reviews 42, no. 4 (2017), 359–380.

Chapter 2 1 2

National Theatre Archive Records for Cleansed, dir. Katie Mitchell, Dorfman Theatre, 23 February–6 May 2016. RNT/SM/1/764. See Olivia Sagan, Narratives of Art Practice and Mental Well Being: Reparation and Connection (London: Routledge, 2015).

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NT programme for Cleansed; Roland Barthes, A Lover’s Discourse: Fragments, trans. Richard Howard (New York: Hill and Wang, 1978), 49. 4 Sarah Kane, Cleansed (London: Methuen, 1998), 43. 5 Elaine Showalter, ‘Representing Ophelia: Women, Madness and the Responsibilities of Feminst Criticism’, in Patricia Parker (ed.), Shakespeare and the Question of Theory (New York: Methuen, 1985), 80. 6 The tendency to refer to the psy-sciences in colonial terms is discussed by W.J. Penson, ‘Psy-sciences and the Colonial Relationship in the Mental Health Field’, Mental Health Review 19, no. 3 (2014), 176–184. 7 See Anna Harpin’s discussion of the terminology surrounding madness and mental illness in Madness, Art and Society. 8 Elaine Showalter, ‘Ophelia, Gender and Madness’, https://www.bl.uk/ shakespeare/articles/ophelia-gender-and-madness, accessed 5 June 2018. 9 Showalter, ‘Representing Ophelia’, 77. 10 Bridget Escolme, ‘Ophelia Confined: Madness and Infantilisation in Some Versions of Hamlet?’, in Anna Harpin and Juliet Foster (eds), Performance, Madness and Psychiatry; Isolated Acts (Basingstoke and London: Palgrave Macmillan, 2014), 174–183. 11 Damian Milton, ‘Embodied Sociality and the Conditioned Relativism of Dispositional Diversity’, Autonomy, the Critical Journal of Interdisciplinary Autism Studies 1, no. 3 (2014), 1–7. 12 Harpin, Madness, Art and Society, 2–5. 13 R.D. Laing, The Divided Self; An Existential Study in Sanity and Madness (Harmondsworth: Penguin, 1964), 195. 14 Buzz Goodbody Rehearsal Notes. Quoted in Alycia Smith-Howard, Studio Shakespeare: The Royal Shakespeare Company at the Other Place (Aldershot: Ashgate, 2006), 70. 15 Ibid., 73. 16 Erving Goffman, The Presentation of Self in Everyday Life (Harmondsworth: Penguin, 1990); Stigma: Notes on the Management of Spoiled Identity (Harmondsworth: Penguin, 1990). 17 Harpin, Madness, Art and Society, 10. 18 Smith-Howard, Studio Shakespeare, 10. 19 Ibid., 73. 20 Harpin, Madness, Art and Society, 11. 21 Ibid. 22 Brigit McWade, Damian Milton and Peter Beresford, ‘Mad Studies and Neurodiversity: A Dialogue’, Disability and Society 30 (2015), 305–309. 23 Judith Butler, Gender Trouble (London: Routledge, 1990), 172–173. 24 Michael Coveney, ‘Hamlet’, Financial Times, 16 May 1975; Richard David, Shakespeare in the Theatre (Cambridge: Cambridge University Press, 1978), 75; Peter Thomson, ‘Towards a Poor Shakespeare: The Royal Shakespeare Company at Stratford in 1975’, Shakespeare Survey 20 (1976), 152. 25 M.A.M., ‘Round House Downstairs “Hamlet”’, Stage and Televison Today, 12 February 1976. 3

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26 Elizabeth Schafer, Ms-Directing Shakespeare (London: The Women’s Press, 1998), 237. 27 Hunter Davies, ‘The Class of 66’, The Times, 3 June 2014. Davies interviewed Goodbody as a student at the end of 1966, for the Sunday Times ‘Atticus’ column, following the success of her debut student production at the National Student Drama Festival, an adaptation of a Dostoevsky short story, ‘Notes from the Underground’, which won an award. The interview wasn’t published until 2014 as part of a tribute to Goodbody: https://www.thetimes.co.uk/article/the-class-of-66l7vh2qjrv27, accessed 23 February 2018. 28 Reports on Goodbody’s suicide refer to an annotated copy of T.S. Eliot’s ‘Four Quartets’ beside her bed, where she was discovered after a fatal overdose. 29 Hamlet, dir. Buzz Goodbody, RSC, The Other Place, 1976, Promptbook, n.p. 30 Schafer, Ms-Directing Shakespeare, 233. 31 Mary Maher, Modern Hamlets and Their Soliloquies (Iowa: University of Iowa Press, 1992), 83. 32 Ibid., 71. 33 Robert Cushman, ‘The Other Hamlet’, Observer, 8 February 1976; John Barber, ‘“Hamlet” of Clarity, Speed & Immediacy’, Daily Telegraph, 5 February 1976; Dick Murray, ‘A New Hamlet’, Northamptonshire Chronicle & Echo, 17 May 1975. 34 Michael Coveney, ‘Hamlet’, Financial Times, 17 May 1975; Irving Wardle, ‘Hamlet’, The Times, 17 May 1975. 35 Bernard Crick, ‘The Slings and Arrows of Dramatic Fortune’, Times Higher Education Supplement, 13 February 1976. 36 Sunday Telegraph, 15 February 1976; Fred Sansom, ‘Why Didn’t Hot Blooded Hamlet Do Something?’, Camden Journal, 13 February 1976. 37 ‘To Do and Not to Do’, Jewish Chronicle, 20 February 1976. 38 Schafer, Ms-Directing Shakespeare, 237. 39 Buzz Goodbody, ‘The Other Place’, RSC Newsletter, 2 February 1975. 40 Thomson, ‘Poor Shakespeare’, 151. 41 Cushman, ‘The Other Hamlet’. 42 David, Shakespeare in the Theatre, 68. 43 Thomson, ‘Poor Shakespeare’, 151. 44 Coveney, ‘Hamlet’. 45 Nicholas de Jongh, ‘Hamlet’, Guardian, 17 May 1975. 46 Crick, ‘The Slings and Arrows’. 47 Maher, Modern Hamlets, 86, 82–83. 48 Smith-Howard, Studio Shakespeare, 81. 49 Colin Chambers, Other Spaces: New Theatre and the RSC (London: Methuen, 1980), 13–14. 50 Dympna Callaghan, ‘Buzz Goodbody: Directing for Change’, in Jean I. Marsden (ed.), The Appropriation of Shakespeare: Post-Renaissance

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Reconstructions of the Works and Myth (Hemel Hempstead: Harvester Wheatsheaf, 1991), 176. 51 Maher, Modern Hamlets, 68. 52 Harpin, Madness, Art and Society, 2. 53 Goodbody’s suicide note, quoted in Kate Maltby, ‘Revolution in the Shed: The Radical Theatre of Buzz Goodbody’, New Statesman, 14 September 2016. 54 Hamlet Promptbook, n.p. 55 Sarah Ahmed, The Cultural Politics of Emotion (Edinburgh: Edinburgh University Press, 2004), 10. 56 T.S. Eliot, ‘Little Gidding’, in The Complete Poems and Plays of T. S. Eliot (London: Faber and Faber, 1969), 195. 57 Kelly Hunter, interview with the author, April 2018. 58 Kelly Hunter, adapted from William Shakespeare, Hamlet, Who’s There? (London: Methuen, 2015), v. 59 Ahmed, Cultural Politics of Emotion, 10. 60 Teresa Brennan, The Transmission of Affect (Ithaca: Cornell University Press, 2004), 15. 61 Kelly Hunter, Cracking Shakespeare: A Hands-on Guide for Actors and Directors (London: Bloomsbury, 2015), xii. The quotation is from Harold Pinter, ‘A Note on Shakespeare’, in Various Voices: Prose, Poetry, Politics 1948–1998 (London: Faber and Faber, 1998), 5–7. See also Robert Shaughnessy, ‘As if ’, Shakespeare Bulletin 36 (2018), 37–48. 62 Sianne Ngai, Ugly Feelings (Cambridge: Harvard University Press, 2005), 27. 63 Ahmed, Cultural Politics of Emotion, 10. 64 Hunter, interview with the author. 65 Hunter, Hamlet, viii. 66 Ibid., 3. 67 Ibid., 17. 68 Ibid., 36. 69 Ibid., 42. 70 Hunter, Hamlet, viii. 71 Ibid., vi. 72 Ibid., vii. 73 Ibid., 32. 74 Ahmed, Cultural Politics of Emotion, 92. 75 Tom Chapman, interview with author, March 2018. 76 Hunter, Hamlet, 27. 77 Ibid., ix. 78 See Rhonda Blair, The Actor, Image and Action: Acting and Cognitive Neuroscience (London and New York: Routledge, 2007); Rhonda Blair and Amy Cook (eds), Theatre, Performance and Cognition: Languages, Bodies and Ecologies (London: Bloomsbury Methuen, 2016); Rick Kemp, Embodied Acting: What Neuroscience Tells Us about Performance (London

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and New York: Routledge, 2012) and John Lutterbie, Toward a General Theory of Acting: Cognitive Science and Performance (New York: Palgrave Macmillan, 2011). 79 See Kelly Hunter, Shakespeare’s Heartbeat: Drama Games for Children with Autism (London and New York: Routledge, 2015); Robert Shaughnessy, ‘“All Eyes”: Experience, Spectacle and the Inclusive Audience in Flute Theatre’s The Tempest’, in Fiona Banks (ed.), Shakespeare: Actors and Audiences (London: Arden Shakespeare, 2018), 119–138. 80 Hunter, Hamlet, 20. 81 Ibid., 22. 82 Antonio Damasio, The Feeling of What Happens: Body and Emotion in the Making of Consciousness (San Diego: Harcourt, 1999). 83 Cited in Erin Manning, The Minor Gesture (Durham: Duke University Press, 2016), 178. 84 Ibid., 24.

Chapter 3 1 2 3 4

5 6 7

8 9

Constantin Stanislavki, An Actor Prepares (London: Methuen, 2016), 55. E. Colin Cherry, ‘Some Experiments on the Recognition of Speech, with One and with Two Ears’, Journal of the Acoustical Society of America 25, no. 2 (1953), 975–979. James Russell, ‘Core Affect and the Psychological Construction of Emotion’, Psychological Review 110, no. 1 (2003), 145–172. Philip Barnard, ‘Interacting Cognitive Subsystems: A Psycholinguistic Approach to Short Term Memory’, in Andrew Ellis (ed.), Progress in the Psychology of Language, Vol. 2 (London: Lawrence Erlbaum Associates, 1985), 197–258. Philip Barnard, David Duke, Richard Byrne and Iain Davidson. ‘Differentiation in Cognitive and Emotional Meanings: An Evolutionary Analysis’, Cognition and Emotion 21, no. 6 (2007), 1155–1183. Praxis derives from the ancient Greek and Latin words meaning ‘doing’ or ‘action’. Philip Barnard, ‘Bridging between Basic Theories and the Artefacts of Human-Computer Interaction’, in John Carroll (ed.), Designing Interaction: Psychology at the Human-Computer Interface (Cambridge: Cambridge University Press, 1991), 103–127; Philip Barnard, ‘Bridging between Basic Theory and Clinical Practice’, Behaviour Research and Therapy 42, no. 9 (2004), 977–1000. Teasdale and Barnard, Affect, Cognition and Change. This dance company was first known as Random Dance. It was subsequently rebranded as Wayne McGregor | Random Dance, and since 2016 it is known as Company Wayne McGregor.

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10 Jon May, Beatriz Calvo-Merino, Scott deLahunta, Wayne McGregor, Rhodri Cusack, Adrian Owen, Michele Veldsman, Cristina Ramponi and Philip Barnard, ‘Points in Mental Space: An Interdisciplinary Study of Imagery in Movement Creation’, Dance Research 29, no. 2 (2011), 402–430. 11 https://wellcomecollection.org/exhibitions/thinking-body-mind-andmovement-work-wayne-mcgregor-random-dance/?video=5, accessed 20 November 2017. 12 McGregor et al., Mind and Movement. 13 Philip Barnard, ‘Depression and Attention to Two Kinds of Meaning: A Cognitive Perspective’, Psychoanalytic Psychotherapy 23, no. 2 (2009), 248–262. 14 Barnard, ‘Bridging between Basic Theory and Clinical Practice’, 977–1000. 15 Barnard, ‘Asynchrony, Implicational Meaning and the Experience of Self in Schizophrenia’, 121–146. 16 Rebecca Park, Barnaby Dunn and Philip Barnard, ‘Schematic Models and Modes of Mind in Anorexia Nervosa 1: A Novel Process Account with Treatment Implications’, International Journal of Cognitive Therapy 4, no. 4 (2011), 414–437. 17 This is technically more correct than the earlier dance illustration since only one process can be buffered on a specific image. 18 Russel Hurlburt, Francesca Happé and Uta Frith, ‘Sampling the Form of Inner Experience in Three Adults with Asperger Syndrome’, Psychological Medicine 24, no. 2 (1994), 385–395. 19 John Teasdale, ‘Emotional Processing, Three Modes of Mind and the Prevention of Relapse in Depression’, Behaviour Research and Therapy 37, Supplement 1 (1999), S53–S77. 20 Willem Kuyken, Rachel Hayes, Barbara Barrett, Richard Byng, Tim Dalgleish, David Kessler and Sarah Byford, ‘Effectiveness and Costeffectiveness of Mindfulness-based Cognitive Therapy Compared with Maintenance Antidepressant Treatment in the Prevention of Depressive Relapse or Recurrence (PREVENT): A Randomised Controlled Trial’, The Lancet 386, no. 9988 (2015), 63–73. 21 John Teasdale and Philip Barnard, ‘Mindfulness, Suffering and Cognition’, paper presented at the International Symposia for Contemplative Studies, 26–29 April 2012, Denver, Colorado, USA, http://events.powerstream. net/008/00189/2012_ISCS/ accessed 21 November 2017. 22 Paul Gilbert, ‘Introducing Compassion-Focused Therapy’, Advances in Psychiatric Treatment 15, no. 3 (2009), 199–208. 23 Steven Hayes, Kirk Strosahl and Kelly Wilson, Acceptance and Commitment Therapy (New York: Guildford Press, 1999). 24 Aaron Beck, ‘Cognitive Therapy: Nature and Relation to Behavior Therapy’, Behavior Therapy 1, no. 2 (1970), 184–200. 25 Edward Watkins, Jan Scott, Janet Wingrove, Katherine Rimes, Neil Bathurst, Herbert Steiner and Yanni Malliaris, ‘Rumination-Focused

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Cognitive Behaviour Therapy for Residual Depression: A Case Series’, Behaviour Research and Therapy 45, no. 9 (2007), 2144–2154. 26 Emily Holmes, Arnoud Arntz and Mervin Smucker, ‘Imagery Rescripting in Cognitive Behaviour Therapy: Images, Treatment Techniques and Outcomes’, Journal of Behavior Therapy and Experimental Psychiatry 38, no. 4 (2007), 297–305. 27 A collaborative project between Plymouth, Trinity-Laban and Coventry University has assessed the extent to which thinking tools of this sort have longer term effects on creative ideation in tertiary education. http://www. dancersmind.org.uk, accessed 21 November 2017. 28 Philip Barnard and Scott deLahunta, ‘Mapping the Audit Traces of Interdisciplinary Collaboration: Bridging and Blending between Choreography and Cognitive Science’, Interdisciplinary Science Reviews 42, no. 4 (2017), 359–380.

Chapter 4 1

Hans Asperger, ‘Die “Autistischen Psychopathen” in Kindersalter’ (1944), trans. Uta Frith, in Uta Frith (ed.), Autism and Asperger Syndrome (Cambridge: Cambridge University Press, 1991), 70. 2 Ibid., 78n. 3 H. Herwig Czech, ‘Hans Asperger, National Socialism and “Race Hygiene” in Nazi-era Vienna’, Molecular Autism 9 (2018), 29. 4 See Ilona Roth, ‘Autism and the Imaginative Mind’, in Ilona Roth (ed.), Imaginative Minds: Proceedings of the British Academy, 147 (Oxford: Oxford University Press, 2007); Roth, ‘Imagination and the Awareness of Self in Autistic Spectrum Poets’, in Mark Osteen (ed.), Autism and Representation (New York: Routledge, 2008). 5 Ilona Roth, ‘Autism, Creativity and Aesthetics’, Qualitative Research in Psychology (2018), http://dx.doi.org/10.1080/14780887.2018.1442763. 6 Leo Kanner, ‘Autistic Disturbances of Affective Contact’, Nervous Child 2 (1943), 217–250. 7 Asperger, ‘Die “Autistischen Psychopathen” in Kindersalter’. 8 American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders: DSM-5 (Washington, DC: American Psychiatric Association, 2013). 9 Bruno Bettelheim, The Empty Fortress: Infantile Autism and the Birth of Self (New York: Free Press, 1967); Susan Folstein and Michael Rutter, ‘Infantile Autism: a Genetic Study of 21 Twin Pairs’, Journal of Child Psychology and Child Psychiatry 18 (1978), 297–321. 10 Simon Baron-Cohen, ‘Autism and Symbolic Play’, British Journal of Developmental Psychology 5 (1978), 139–148; Christopher Jarrold, ‘A Review of Research into Pretend Play in Autism’, Autism 7 (2003), 379–390.

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11 Francesca Happé and Uta Frith, ‘The Beautiful Otherness of the Autistic Mind’, in Francesca Happe and Uta Frith (eds), Autism and Talent Philos Trans R Soc Lond B Biol Sci. 364 (Oxford: Oxford University Press, 2010). 12 See note 4. 13 Ilona Roth, ‘Imaginative Minds: Concepts, Controversies and Themes’, in Ilona Roth (ed.), Imaginative Minds: Proceedings of the British Academy 147 (Oxford: Oxford University Press, 2007). 14 The Open University (1990), Autism, [BBC programme], DSE202 Introduction to Psychology (Milton Keynes: The Open University). 15 The Autism Puzzle, BBC, 15 January 2003, Director Saskia Baron, https:// vimeo.com/20748434, accessed 2 August 2018. 16 Simon Baron-Cohen, Alan Leslie and Uta Frith, ‘Does the Autistic Child Have a “Theory of Mind”?’ Cognition 21 (1985), 37–46. 17 See note 14. 18 Temple Grandin and Margaret M. Scariano, Emergence: Labeled Autistic (Novato, CA: Arena Press, 1986); Daniel Tammet, Born on a Blue Day: Inside the Extraordinary Mind of an Autistic Savant (New York: Free Press, 2006). 19 Dan Sperber and Deirdre Wilson, Relevance: Communication and Cognition, 2nd edn (Oxford: Blackwell, 1995). 20 Ilona Roth, with Chris Barson, Rosa Hoekstra, Greg Pasco and Terry Whatson, The Autism Spectrum in the 21st Century: Exploring Psychology, Biology and Practice (London: Jessica Kingsley, 2010). 21 Paul Bloom and Tim P. German, ‘Two Reasons to Abandon the FalseBelief Task as a Test of Theory of Mind’, Cognition 77 (2000), B25–B31; Sara M. Shaafsma, Donald W. Pfaff, Robert P. Spunt and Ralph Adolphs, ‘Deconstructing and Reconstructing Theory of Mind’, Trends in Cognitive Science 19 (2015), 65–72. 22 Claire Hughes and Sue Leekam, ‘What Are the Links between Theory of Mind and Social Relations? Review, Reflections and New Directions for Studies of Typical and Atypical Development’, Social Development 13 (2004), 590–619. 23 Simon Baron-Cohen, ‘Autism: The Empathising-Systemising (E-S) Theory’, Annals of the New York Academy of Science 1156 (2009), 68–80. 24 The Open University (2002) Imagination [VCR], DSE212 Introduction to Psychology (Milton Keynes: The Open University). 25 Jaime Craig and Simon Baron-Cohen, ‘Creativity and Imagination in Autism and Asperger Syndrome’, Journal of Autism and Developmental Disorders 29 (1999), 319–326. 26 J.P. Guildford, The Nature of Human Intelligence (New York: McGrawHill, 1967). 27 Ilona Roth, M.T. Roelfsema and Rosa Hoekstra, ‘Measuring Commitment to Special Interests in Adults on the Autism Spectrum’, paper presented at the 2015 International Meeting for Autism Research, Salt Lake City, https://

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insar.confex.com/imfar/2015/webprogram/Paper20342.html, last accessed 3 April 2018; Rachel Grove, Ilona Roth and Rosa Hoekstra, ‘The Motivation for Special Interests in Individuals with Autism and Controls: Development and Validation of the Special Interest Motivation Scale’, Autism Research 9, no. 6 (2016), 677–688. 28 Robert Koegel, Sunny Kim, Lynn Koegel and Ben Shwartzman, ‘Improving Socialization for High School Students with ASD by Using Their Preferred Interests’, Journal of Autism and Developmental Disorders 43 (2013), 2121–2134. 29 Noriko Porter, ‘Promotion of Pretend Play for Children with HighFunctioning Autism Through the Use of Circumscribed Interests’, Early Childhood Education Journal 40 (2012), 161–167. 30 Beadle-Brown et al., ‘Imagining Autism’. 31 The Open University, ‘Psychological Tests’, video clips for SK124 ‘Understanding the Autism Spectrum’ (Open University/Pahni Productions, 2009). 32 David Wechsler, Wechsler Intelligence Scale for Children® – Fourth UK Edition (WISC-IV UK, 2014). 33 Ibid. 34 http://www.open.edu/openlearn/science-maths-technology/coming-soonunderstanding-autism. 35 Elizabeth Pellicano and Marc Stears, ‘Bridging Autism, Science and Society: Moving Towards an Ethically-Informed Approach to Autism Research’, Autism Research 4 (2011), 271–282. 36 Sandra Maestro and Filippo Muratori, ‘How Young Children with Autism Treat Objects and People: Some Insights into Autism in Infancy from Research on Home Movies’, in Evelyn McGregor, Maria Núñez, Katie Cebula and Carlos Gómez (eds), Autism: An Integrated View from Neurocognitive, Clinical, and Intervention Research (Oxford: Blackwell, 2008). 37 The Open University, Alex Pritchard Martin in conversation with Ilona Roth for ‘Understanding Autism’, 2018, http://www.open.edu/openlearn/ ocw/course/%20view.php?id=4049. 38 The Open University, Arabella Carter-Johnson in conversation with Ilona Roth for ‘Understanding Autism’, 2018, http://www.open.edu/openlearn/ ocw/course/view.php?id=4049. 39 Darold A. Treffert, ‘The Savant Syndrome: An Extraordinary Condition. A Synopsis: Past, Present and Future’, Philosophical Transactions of the Royal Biological Society 364 (2009), 1351–1357. 40 Marion Quirici, ‘Geniuses without Imagination: Discourses of Autism, Ability and Achievement’, Journal of Literary & Cultural Disability Studies 9 (2015), 71–88. 41 See note 35.

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Chapter 5 Joseph Roach, Cities of the Dead (New York: Columbia University Press, 1996); Marvin Carlson, The Haunted Stage: The Theatre as Memory Machine (Ann Arbor: University of Michigan Press, 2001). 2 Peter Holland, ‘Forgetting Performance’, in James C. Bulman (ed.), The Oxford Handbook of Shakespeare and Performance (Oxford: Oxford University Press, 2017), 172, 175. The quotation is from Stephen Orgel, ‘King Lear and the Arts of Forgetting’, in Stephen Orgel (ed.), Spectacular Performances (Manchester: Manchester University Press, 2011), 101. 3 Michael Mangan, Staging Ageing: Theatre, Performance and the Narrative of Decline (Bristol: Intellect, 2013), 123. 4 Daniel Schachter, Searching for Memory: The Brain, the Mind, and the Past (New York: Basic Books, 1996), 93, 34. 5 Jens Brovkmeier, ‘Questions of Meaning: Memory, Dementia, and the Postautobiographical Perspective’, in Lars C. Hydén, Hilde Lindemann and Jens Brockmeier (eds), Beyond Loss: Dementia, Identity, Personhood (Oxford: Oxford University Press, 2014), 74. 6 Ibid., 79. 7 Ibid., 82. 8 Ibid., 82, 86. 9 Ibid., 86. 10 Anne Davis Basting, Forget Memory: Creating Better Lives for People with Dementia (Baltimore: Johns Hopkins University Press, 2009), 18, 22. 11 http://www.1623theatre.co.uk/, accessed 28 February 2018. 12 https://www.facebook.com/pg/1623theatre, accessed 28 February 2018. 13 http://www.sparetyre.org/, accessed 28 February 2018. 14 Tom Dening, email to Arti Prashar and Nicola Shaughnessy, 3 July 2017. Dening experienced the performance (as did I and the co-editor of this volume) as part of a two-day DAWN (Dementia, Arts and Wellbeing Network) symposium held at the University of Nottingham, 28–29 June 2017. 15 Basting, Forget Memory, 40–41. 16 Ibid., 54. 17 Jonathan Bate, ‘“The Infirmity of His Age’: Shakespeare’s 400th Anniversary’, The Lancet 387, 23 April 2016, 1716. 18 Nigel Powlson, ‘Ben Spiller of Derby’s 1623 Theatre Company’, Derbyshire Life and Countryside, 10 March 2014. 19 All quotations from Shakespeare are taken from Ann Thompson, David Scott Kastan and Richard Proudfoot (eds), The Arden Shakespeare: Complete Works (London: Arden Shakespeare, 2011). 20 Powlson, ‘Ben Spiller of Derby’s 1623 Theatre Company’. 21 Ben Spiller, email to the author, 5 March 2018. 22 Powlson, ‘Ben Spiller of Derby’s 1623 Theatre Company’. 1

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23 All quotations are from the text as first performed at the Attenborough Arts Centre, Leicester, on 14 October 2016, with David Henry as Lear, Gemma Paige North as Cordelia, Samantha Hopkins as Goneril, Victoria Brazier as Regan and direction by Ben Spiller. A video of the performance, which includes an interview with Spiller and a post-show Q&A with the cast, can be viewed online at http://www.1623theatre.co.uk/performance/ learcordelia. 24 Farrah Chaudhry, Cordelia, unpublished script, 2016, 10. 25 Keir Elam (ed.), Twelfth Night, The Arden Shakespeare, Third Series (London: Arden Shakespeare, 2008), 353. 26 Kate Wood, ‘Rehearsal blog’, http://www.1623theatre.co.uk/news/latestnews/456-kates-learcordelia-rehearsal-blog, accessed 2 March 2018. 27 Oliver Sacks, quoted in Robert Storr, ‘At Last Light’, in Janet Jenkins (ed.), Willem de Kooning: The Late Paintings: The 1980s (Minneapolis: Walker Art Centre and San Francisco Museum of Modern Art, 1995), 51. 28 Pia C. Kontos, ‘Musical Embodiment, Selfhood, and Dementia’, in Lars C. Hydén, Hilde Lindemann and Jens Brockmeier (eds), Beyond Loss: Dementia, Identity, Personhood (Oxford: Oxford University Press, 2014), 111. 29 Robert N. Butler, ‘The Life Review: An Interpretation of Reminiscence in the Aged’, Psychiatry 26 (1963), 65–76, cited in Mangan, Staging Ageing, 124. 30 Brockmeier, ‘Questions of Meaning’, 82.

Chapter 6 1

2

3 4

5

Ami Klin and Warren Jones, ‘Embodied Psychoanalysis? Or the Confluence of Psychodynamic Theory and Developmental Science’, in Linda Mayes, Peter Fonagy and Mary Target (eds), Developmental Science and Psychoanalysis (London: Karnac, 2007), 6. See, for example, Lucy Johnstone, A Straight Talking Introduction to Psychiatric Diagnosis (Monmouth: PCCS Books, 2014); B.J. Deacon, ‘The Biomedical Model of Mental Disorder: A Critical Analysis of Its Validity, Utility and Effects on Psychotherapy Research’, Clinical Psychology Review 33 (2015), 846–861. Bryn Jones and Richard Hougham (eds), Dramatherapy: Reflections and Praxis (London: Palgrave, 2017), 3. See Thomas Fuchs, ‘Phenomenology and Psychopathology’, in Daniel Schmicking and Shaun Gallagher (eds), Handbook of Phenomenology and Cognitive Science (London: Springer, 2010), 546–573, who also make reference to anorexia. Phil Jones, Drama as Therapy: Theory, Practice and Research (London: Routledge, 1996), 76.

Notes 6 7 8 9

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Fuchs, ‘Phenomenology and Psychopathology’, 547. Ibid., 548. Eric Erikson, Identity and the Life Cycle (London: W.W. Norton, 1994), 235. See Marilyn Lawrence, The Anorexic Experience (London: The Women’s Press, 1984); Susie Orbach, Fat Is a Feminist Issue (London: Arrow, 1978) and Hunger Strike (London: Faber, 1986). 10 See Nigel Jacobs, Informed Orienteering: A Study of Navigating Systemic Positioning Dilemmas within the Field of Anorexia, Unpublished Doctoral Dissertation, University of London, 2015, 12. 11 Morag McSween, Anorexic Bodies: A Feminist and Sociological Perspective on Anorexia Nervosa (London: Routledge, 1993), 39. 12 Ibid., 75. 13 Orbach, Hunger Strike, 48. 14 Sigmund Freud and Joseph Breuer, Studies on Hysteria, trans. James Strachey and Alix Strachey (Harmondsworth: Penguin, 1974 [1955]), 217. 15 Luce Irigaray, To Speak Is Never Neutral, trans. Gail Schwab (London: Continuum, 2002), 73. 16 Ibid., 132. 17 Ibid., 134. 18 Ibid., 136. 19 Peggy Phelan, Mourning Sex: Performing Public Memories (London: Routledge, 1997), 51. 20 McSween, Anorexic Bodies, 15. 21 See Park et al., ‘Schematic Models and Modes of Mind in Anorexia Nervosa I’, 415–437; and ‘Schematic Models and Modes of Mind in Anorexia Nervosa II’, 86–98. 22 Park et al., ‘Schematic Models I’, 415. 23 Park et al., ‘Schematic Models II’, 86. 24 Ditty Doktor (ed.), Arts Therapies and Clients with Eating Disorder (London: Jessica Kingsley, 1994), 128. 25 Mara Selvini-Palazzoli, Self-starvation: From the Intrapsychic to the Transpersonal Approach to Anorexia Nervosa, trans. P. Tauser (London: Human Context Books, 1974), 223. 26 Penny Lewis and David Read Johnson (eds), Current Approaches in Drama Therapy (New York: Charles Thomas, 2009), 101. 27 McSween, Anorexic Bodies, 68. 28 Orbach, Hunger Strike, 99. 29 McSween, Anorexic Bodies, 247. 30 Ibid., 76. 31 Jacobs, Informed Orienteering, 17. 32 Bill Radmall, ‘Dramatherapy and Eating Disorders: The Telling of Tales: Stories about Anorexia’, Dramatherapy 19 (1997), 3. 33 Astrid Jacobs, ‘The Use of Dramatherapy in the Treatment of Eating Disorders’, in Ditty Doktor (ed.), Arts Therapies and Clients with Eating Disorders (London: Jessica Kingsley, 1994), 128.

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34 Orbach, Hunger Strike, 152. 35 Ibid., 113. 36 McSween, Anorexic Bodies, 174. 37 Luk Lagenhove and Rom Harre, Positioning Theory: Moral Contexts of Intentional Action (Oxford: Blackwell, 1999), 16. 38 Eleanor Irwin, ‘Psychoanalytic Approach to Drama Therapy’, in Penny Lewis and David Read Johnson (eds), Current Approaches in Drama Therapy (New York: Charles Thomas, 2009), 34. 39 NPR Staff, ‘How One Unkind Moment Gave Way to “Wonder”’, http://www. npr.org/2013/09/12/221005752/how-one-unkind-moment-gave-way-towonder.

Chapter 7 Anna Harpin, Madness, Art, and Society: Beyond Illness (Abingdon: Routledge, 2018), 3. 2 Ibid., 45. 3 Hélène Cixous, ‘Aller à la Mer’, in Twentieth Century Theatre: A Sourcebook, trans. Barbara Kerslake (London and New York: Routledge, 1995), 133. 4 Elin Diamond, Unmaking Mimesis: Essays on Feminism and Theatre (London and New York: Routledge, 1997), 30–67. 5 Harpin, Madness, Art, and Society, 2. 6 Ibid., 50. 7 Barry Edginton, ‘Moral Architecture: The Influence of the York Retreat on Asylum Design’, Health & Place 2, no. 3 (1997), 92–93. 8 Harpin, Madness, Art, and Society, 45. 9 Sarah Daniels, Plays: 2 (London: Methuen, 1994), 111. 10 See Cixoux, ‘Sorties’, trans. Ann Liddle, in David Lodge (ed.), Modern Criticism and Theory: A Reader (London: Longman, 1988), 288. 11 Ibid., 161. 12 Ibid., 161–162. 13 Ibid., 176. 14 Ibid., 97. 15 Ibid., 138. 16 Ibid., 176. 17 Heather Debling, ‘“How Will They Ever Heal … ?” Bearing Witness to Abuse and the Importance of Female Community in Sarah Daniels’s Beside Herself, Head-Rot Holiday, and The Madness of Esme and Shaz’, Modern Drama 51, no. 2 (2008), 259. 18 Cixous, ‘Aller á la Mer’, 134. 19 Henri Lefebvre, The Production of Space (Oxford: Wiley-Blackwell, 1991), 366. 20 Daniels, Plays: 2, 193. 1

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21 Julia Kristeva, ‘Women’s Time’, trans. Alice Jardine and Harry Blake, Signs: Journal of Women in Culture and Society 7, no. 1 (1981), 13–35. 22 Carina Bartleet, ‘Sarah Daniels’s Hysteria Plays: Re-presentations of Madness in Ripen Our Darkness and Head-Rot Holiday’, Modern Drama 46, no. 2, 257. 23 Rick Jones, ‘Review of Head-Rot Holiday’, Evening Standard, 16 October 1992. 24 Kate Bassett, ‘Review of Head-Rot Holiday’, City Limits, 22 October 1992. 25 Michel Foucault, Madness and Civilisation: A History of Insanity in the Age of Reason, trans. Richard Howard (London and New York: Routledge, 2001), xi. 26 Nicola Shaughnessy, ‘Imagining Otherwise: Autism, Neuroaesthetics and Contemporary Performance’, Interdisciplinary Science Reviews 38, no. 4 (2013), 321–334. 27 Francesca Happé and Pedro Vital, ‘What Aspects of Autism Predispose to Talent?’, Philosophical Transactions of the Royal Society B 364 (2009), 1370. 28 Elaine J. Hall and Marnie S. Rodriguez, ‘The Myth of Postfeminism’, Gender & Society 17, no. 6 (2003), 878. 29 Justine Ashby, ‘Postfeminism in the British Frame’, Cinema Journal 44, no. 2 (2005), 127–133. 30 Susan Faludi, Backlash: The Undeclared War Against American Women, trans. Martha Noel Evans (Stanford: Stanford University Press, 1991). 31 McRobbie, ‘Post-feminism and Popular Culture’, Feminist Media Studies 4, no. 3 (2004), 255-264. 32 Rosalind Gill, ‘Culture and Subjectivity in Neoliberal and Postfeminist Times’, Subjectivity 25, no. 1 (2008), 442. 33 Rosalind Gill, ‘Postfeminist Media Culture: Elements of a Sensibility’, European Journal of Cultural Studies 10, no. 2 (2007), 148. 34 Frederic Jameson, ‘Postmodernism, or the Cultural Logic of Late Capitalism’, New Left Review, no. I/146 (1984), 53–92. 35 Aleks Sierz, Rewriting the Nation: British Theatre Today (London: Methuen, 2011), 195. 36 Alicia Tycer, ‘“Victim. Perpetrator. Bystander”: Melancholic Witnessing of Sarah Kane’s 4.48 Psychosis’, Theatre Journal 60, no. 1 (2008), 24. 37 Elaine Aston, ‘Feeling the Loss of Feminism: Sarah Kane’s Blasted and an Experiential Genealogy of Contemporary Women’s Playwriting’, Theatre Journal 62, no. 4 (2010), 585. 38 Christopher Wixson, ‘“In Better Places”: Space, Identity, and Alienation in Sarah Kane’s Blasted’, Comparative Drama 39, no. 1 (2005), 79. 39 Michael Billington, ‘The Good Fairies Desert the Court’s Theatre of the Absurd’, The Guardian, 20 January 1995. 40 Lefebvre, The Production of Space, 96. 41 Ibid., 98. 42 Aston, ‘Feeling the Loss of Feminism’, 577.

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43 Hans-Thies Lehmann, Postdramatic Theatre, trans. Karen Jürs-Munby (London: Routledge, 2006), 152. 44 Harpin, Madness, Art, and Society, 3. 45 Ken Urban, ‘An Ethics of Catastrophe: The Theatre of Sarah Kane’, PAJ: A Journal of Performance and Art 23, no. 3 (2001), 43. 46 Sierz, Rewriting the Nation, 196. 47 Sarah Kane, Complete Plays (London: Methuen, 2001), 101. 48 Lefebvre, The Production of Space, 142. 49 Quoted in Graham Saunders, Love Me or Kill Me: Sarah Kane and the Theatre of Extremes (Manchester and New York: Manchester University Press, 2002), 80. 50 Ibid., 81. 51 Kane, Complete Plays, xiii. 52 Christopher Innes, Modern British Drama: The Twentieth Century (Cambridge: Cambridge University Press, 2002), 536. 53 Harpin, Madness, Art, and Society, 50. 54 Kane, Complete Plays, 214. 55 In Saunders, Love Me or Kill Me, 112. 56 Ibid., 113. While, as Foucault has noted (see n. 25 above), this philosophical split is itself the source of some problematic approaches to the relationship between reason and madness, Kane’s non-naturalistic aesthetics alleviate these risks by refusing the stable characterization or unitary identity fundamental to the Cartesian cogito. 57 Ibid., 116. 58 Lefebvre, The Production of Space, 186. 59 Kane, Complete Plays, 245. 60 Aston, ‘Feeling the Loss of Feminism’. 61 Kane, Complete Plays, 159, 185–187. 62 Dominic Cavendish, ‘4.48 Psychosis at the Barbican Theatre. Review’, The Telegraph, 24 March 2010. 63 Quoted in Saunders, Love Me or Kill Me, 112. 64 Kane, Complete Plays, 217. 65 Sarah Hemming, ‘4.48 Psychosis, Barbican, London’, Financial Times, 26 March 2010. 66 Innes, Modern British Drama, 536. 67 Harpin, Madness, Art, and Society, 13.

Response 1 2

Paul Crawford, Nothing Purple, Nothing Black (Lewes: The Book Guild, 2002). Javier Saavedra, Mercedes Cubero and Paul Crawford, ‘Incomprehensibility in the Narratives of Individuals with a Diagnosis of Schizophrenia’, Qualitative Health Research 19, no. 11 (2009), 1548–1558.

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Shaughnessy, ‘Imagining Otherwise’, 321–334. Paul Crawford, Brian Brown, Charley Baker, Victoria Tischler and Brian Abrams, Health Humanities (London: Palgrave, 2015). Charley Baker, Paul Crawford, Ronald Carter, Maurice Lipsedge and Brian Brown, Madness in Post-1945 British and American Fiction (London: Palgrave, 2010). Edgar Allan Poe, ‘The System of Doctor Tarr and Professor Fether’, Graham’s Magazine xxviii, no. 5 (1845), 193–200.

Chapter 8 1

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3 4

5 6

7

See Robert Landy and David Montgomery, Theatre for Change: Education, Social Action and Therapy (London: Palgrave Macmillan, 2012); Theatre in Prison, ed. Michael Balfour (Bristol: Intellect Books, 2004); James Thompson, Prison Theatre: Perspectives and Practices (London: Jessica Kingsley Publishers, 1998). Bridget Keehan discusses the limitations of evaluating prison theatre programmes by how they contribute to prisoners’ rehabilitation in ‘Theatre, Prison & Rehabilitation: New Narratives of Purpose?’ Research in Drama Education: The Journal of Applied Theatre and Performance 20, no. 3 (2015): 391–394. Robert Johnson, ‘Art and Autonomy: Prison Writers Under Siege’, in Leonidas K. Cheliotis (ed.), The Arts of Imprisonment (London and New York: Routledge, 2012). Marie J.C. Foregeard, Anne C. Mecklenburg, Justin J. Lacasse and Eranda Jayawickreme, ‘Bringing the Whole Universe to Order: Creativity, Healing and Posttraumatic Growth’, in James C. Kaufman (ed.), Creativity and Mental Illness (Cambridge: Cambridge University Press, 2014), 323. For a discussion of how incarceration is trauma-inducing, see ‘The Trauma of the Incarceration Experience’, Civil Liberties Law Review 48, no. 1 (2013), 261–263. ‘Feeling’ refers to emotion that is consciously named to the self. Emotions, according to neuroscientists Antonio Damasio and Joseph LeDoux, is a set of physical manifestations which accompany appropriate action (I run [action] from a bear, as my heart speeds up [emotion] to pump blood so I can run faster, and split seconds afterward, I [feel] fear). Emotion is not directly accessible to consciousness, but ‘feelings’ are; however, those who have experienced significant trauma are often unaware of their own feelings. In writing about the effects of solitary confinement on post-traumatic growth, Ian O’Donnell says, ‘Trauma can catalyze growth’, but ‘the psychological burden of restricted movement, limited sensory input, and lack of social contact’ make this far less likely; Prisoners, Solitude and Time (Oxford, UK: Oxford University Press, 2014), 111.

226 8

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Eric Clarke, Tia DeNora and Jonna Vuoskoski, ‘Music, Empathy and Cultural Understanding’, Physics of Life Reviews 15, https://doi. org/10.1016/j.plrev.2015.09.001. See also Joel Kruger’s comment: ‘Empathy Beyond the Mind: Comment on “Music, empathy and cultural understanding” by E. Clarke et al.’, Physics of Life Reviews 15 (2015), https://drive.google.com/file/d/0B0qeRa-smHZ3My0wb2NmWlJvVE0/ view. Kruger, in responding to Clarke et al., says, ‘When we engage with and become dynamically coupled with music at neural, physiological, and behavioural levels, music potentially elicits, shapes, and regulates capacities and experiences that would remain otherwise inaccessible.’ This applies to poetry and non-narrative writing as well. See 4ECognition Group for discussion of ‘embodied mind’. https://4ecognitiongroup.wordpress.com/ research/. 9 Personal interview, 2 May 2018. 10 Ibid., 105. 11 Jill Bennett, Empathic Vision: Affect, Trauma and Contemporary Art (Stanford: Stanford University Press, 2005), 336–338. 12 Ibid., 23. 13 Ellen Kaplan et al., Someone Is Sure to Come (SISTC) (2018). 14 Personal communication, 21 September 2015. 15 Kaplan et al., SISTC. 16 O’Donnell, Prisoners, Solitude and Time, 222–255. 17 Bernard Cousar, Personal communication, 10 August 2017. 18 Personal interview, George T. Wilkerson, 28 May 2018. 19 The quote is from Viktor Frankl, Man’s Search for Meaning, a book often referenced by inmates. 20 Kaplan et al., SISTC. 21 Johnson, ‘Art and Autonomy’, 184. 22 Bennett, Empathic Vision, 23. 23 Ibid., 28. 24 Ibid., 38. 25 Cathy Caruth, Unclaimed Experience: Trauma, Narrative and History (Baltimore: Johns Hopkins Press, 1994), 11. 26 Judith Herman, Trauma and Recovery: The Aftermath of Violence (New York: Basic Books, 1997), 33 27 Thompson, Prison Theatre, 43. 28 Ibid., 45. 29 Personal communication, September 2016. 30 In The Feeling of What Happens, Antonio Damasio looks at the representation of feeling and how that interacts with ‘sense of self ’. He identifies ‘two key players, the organism and the object’, which interact to give rise to neurological patterns which are registered by a ‘core consciousness’ and then articulated back to the self as feelings. This

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articulation, I argue, is prone to clichéd expression in men and women whose primary definition of self is predicated on the views of those who hold power over them. Realism as a style can be self-limiting; poetry and plays by inmates often reflect pre-digested, repetitive imagery. In a media-saturated world, the articulation of self is too easily predetermined. Inmates, more than most, are susceptible to clichés that circumvent introspection and originality. 31 In 2012, I curated a selection of plays written by incarcerated authors, presented at the Kennedy Center in Washington, DC. Of the 60 plays submitted, almost all were didactic and had a strong moralizing component and echoed behavioural modification goals and strategies endorsed in prison programmes. 32 Jenny Hughes with S. Ruding, ‘Made to Measure: A Critical Interrogation of Applied Theatre as Intervention with Young Offenders in the UK’, in Tim Prentki and Sheila Preston (eds), Applied Theatre Reader (London and New York: Routledge, 2009), 217–225. 33 Anne F. O’Reilly, Sacred Play (Dublin: Caryfort Press, 2004), 117. 34 Ibid. 35 Phillip Vannini, Dennis Waskul and Simon Gottschalk, The Senses in Self, Society and Culture (New York and London: Routledge, 2013), 17–19. 36 Ibid., 24. 37 Damasio discusses how neural structures provide ‘the roots for the self ’ by constructing representations from sensory inputs; The Feeling of What Happens, 159–160. 38 Bennett, ‘Art, Affect, and the “Bad” Death: Strategies for Communicating the Sense Memory of Loss’, in Hilary Robinson (ed.), Feminism Art Theory: An Anthology (West Sussex: Wiley & Sons, 2015), 335. 39 Ibid., 339. 40 Personal communication, September 2016. 41 Johnson, ‘Art and Autonomy’, 178–179. 42 See Daniel C. Dennett, From Bacteria to Bach and Back: The Evolution of Minds (New York: W.W. Norton, 2017); Antonio Damasio, Self Comes to Mind: Constructing the Conscious Brain (New York: Pantheon, 2010). Also see William Seager, Theories of Consciousness, 2nd edn (London: Routledge, 2016), for a comprehensive survey. 43 Joseph LeDoux, The Synaptic Self (New York: Penguin, 2002), Chapter 6. 44 Ibid., 137. 45 Ibid., 134. 46 Ibid., 262. 47 Ibid., 155. 48 Stephen Di Benedetto, The Provocation of the Senses in Contemporary Theatre (New York and Oxon, UK: Routledge, 2011), 11. The book’s discussion of sensory engagement in performance connects theatrical practice with recent discoveries in neuroscience.

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Response 1 2 3 4

5

Fabiola Camuti, ‘“Ma c’arivamo a dama?”. Teatro e qualità della vita dentro e fuori dal carcere: osservazioni sul campo e prospettive di ricerca’, Biblioteca Teatrale, no. 111–112 (2014 [2016]), 145–157. Tony Ward and Shaad Maruna, Rehabilitation. Beyond the Risk Paradigm (London and New York: Routledge, 2007). Eleonora Belfiore, ‘“Impact”, “Value” and “Bad Economics”: Making Sense of the Problem of Value in the Arts and Humanities’, Arts & Humanities in Higher Education 14, no. 1 (2015), 95–110. James Thompson, ‘It Don’t Mean a Thing If It Ain’t Got That Swing: Some Questions on Participatory Theatre, Evaluation and Impact’, Research in Drama Education: The Journal of Applied Theatre and Performance 5, no. 1 (2000), 101–104. Melissa Gregg and Gregory J. Seigworth, The Affective Theory Reader (Durham and London: Duke University Press, 2010).

Chapter 9 1

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3

4

Pig Iron Theatre Company (conception and creation) and Robert Quillen Camp (text), Chekhov Lizardbrain, in Pig Iron: Three Plays (Chicago: 53rd State Press, 2012). Citations to this script will be included parenthetically within the text. I also thank Pig Iron managing director John Frisbee for providing a performance DVD. The Curious Incident of the Dog in the Night-Time by Simon Stephens, directed by Marianne Elliott, with Luke Treadaway, The National Theatre, Apollo Theatre, London, 17 and 22 May 2013. In addition to seeing two performances, I was able to watch the video recording of the initial Cottesloe production made for NTLive at the NT Archive and rely primarily upon this resource in my description. The production sold out its initial run in the Cottesloe that summer and played to 40,000 additional viewers in cinemas through a live-performance simulcast. In March 2013, the show reopened for a commercial run in London’s West End, winning Olivier awards for best new play, director, actor, actress in a supporting role, set design, lighting design and sound design. The Broadway production that opened in October 2014 won Tony awards for best play, director, actor, scenic design and lighting design. Stuart Murray, ‘Autism and the Contemporary Sentimental: Fiction and the Narrative Fascination of the Present’, Literature and Medicine 25, no. 1 (2006), 29; Ian Hacking, ‘Autism Fiction: A Mirror of an Internet Decade?’, University of Toronto Quarterly 79, no. 2 (2010), 645. Katy Rudd, ‘Diagnosing Christopher Boone’, National Theatre Background Pack, 13 March 2013, nationaltheatre.org.uk, accessed 15 May 2013.

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229

5 See Temple Grandin, PhD, 2012, http://www.templegrandin.com, accessed 9 July 2017; Grandin and Scariano, Emergence: Labeled Autistic; Temple Grandin, Thinking in Pictures: And Other Reports from My Life with Autism (New York: Doubleday, 1995). 6 Oliver Sacks, An Anthropologist on Mars: Seven Paradoxical Tales (New York: Knopf, 1995), 252. 7 ‘Autism Spectrum Disorder’, American Psychiatric Association, 2013, https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/DSM/ APA_DSM-5-Autism-Spectrum-Disorder.pdf. The tenth edition of the World Health Organization’s International Classification of Diseases includes Asperger syndrome under Pervasive Developmental Disorders; it remains uncertain whether ICD-11, due in 2018, will maintain this schema. ‘ICD-10:Version 2016’, World Health Organization, http://apps. who.int/classifications/icd10/browse/2016/en#/F80-F89, both accessed 8 July 2017. For the history of the diagnosis, see Majia Holmer Nadesan, Constructing Autism: Unraveling the ‘Truth’ and Understanding the Social (London: Routledge, 2005); Gil Eyal, Brendan Hart, Emine Onculer, Neta Oren and Natasha Rossi, The Autism Matrix: The Social Origins of the Autism Epidemic (Cambridge: Polity Press, 2010); Steven Silberman, Neurotribes: The Legacy of Autism and the Future of Neurodiversity (New York: Avery, 2015); John Donvan and Caren Zucker, In a Different Key: The Story of Autism (New York: Crown Publishers, 2016); Richard Hassall, ‘Does Everybody with an Autism Diagnosis Have the Same Underlying Condition?’, in Katherine Runswick-Cole, Rebecca Mallett and Sami Timimi (eds), Re-Thinking Autism (London: Jessica Kingsley, 2016), 49–66; Sami Timimi and Brian McCabe, ‘Autism Screening and Diagnostic Tools’, in Re-Thinking Autism (London: Jessica Kingsley, 2016), 159–181. 8 See, for example, Gyasi Burks-Abbott, ‘Mark Haddon’s Popularity and Other Curious Incidents in My Life as an Autistic’, in Mark Osteen (ed.), Autism and Representation (New York: Routledge, 2008), 291; Osteen, ‘Autism and Representation: A Comprehensive Introduction’, in Autism and Representation (New York: Routledge, 2008), 38–39; Murray, ‘Autism and the Contemporary Sentimental’, 33–34, 37–39. 9 Katy Rudd, ‘Workshop Diary: Planes, Trains, and Automobiles’, National Theatre Background Pack, 11 March 2013, nationaltheatre.org.uk, accessed 15 May 2013; ‘“The Curious Incident of the Dog in the NightTime”: Working on the Spectrum’, National Theatre Live, http://ntlive. nationaltheatre.org.uk/behind-the-scenes, accessed 25 June 2013. 10 Nick Clark, ‘We Need Autistic Actors Playing Autistic Roles on Stage, Says Curious Incident Adviser’, Independent, 13 August 1015, http://www. independent.co.uk/arts-entertainment/theatre-dance/news/we-needautistic-actors-playing-autistic-roles-on-stage-says-curious-incidentadviser-10454728.html, accessed 9 July 2017.

230

Notes

11 Simon Baron-Cohen, ‘Christopher and Asperger Syndrome’, programme note, The Curious Incident of the Dog in the Night-Time, Apollo Theatre, London, May 2013, 20–21. 12 Simon Baron-Cohen, Mindblindness: An Essay on Autism and Theory of Mind (Cambridge: MIT Press, 1995), 12. 13 Simon Baron-Cohen, The Essential Difference: The Truth about the Male and Female Brain (New York: Basic Books, 2003). As Stuart Murray points out, Baron-Cohen presents his controlled scientific research together with an extended case study. Selecting the mathematician Richard Borecherds for this purpose enhances the authoritative aura of his argument, whereas an artist such as Andy Warhol would have required significantly different conclusions. ‘Hollywood and the Fascination of Autism’, in Mark Osteen (ed.), Autism and Representation (New York: Routledge, 2008), 155. 14 For a related critique of the novel’s failure to develop the political points that it raises, see James Berger, ‘Mark Haddon’s Curious Incident in the Neurological Spectrum’, in Mark Osteen (ed.), Autism and Representation (New York: Routledge, 2008), 280. 15 Sara Ahmed, The Promise of Happiness (Durham: Duke University Press, 2010), 25–26. 16 See Wendy Brown, ‘Neoliberalism and the End of Liberal Democracy’, in Edgework: Critical Essays on Knowledge and Politics (Princeton: Princeton University Press, 2005), 42–43. 17 Osteen, ‘Conclusion: Toward an Empathetic Scholarship’, in Mark Osteen (ed.), Autism and Representation (New York: Routledge, 2008), 298. 18 Rebecca Mallett and Katherine Runswick-Cole, ‘The Commodification of Autism: What’s at Stake?’, in Katherine Runswick-Cole, Rebecca Mallett and Sami Timimi (eds), Re-Thinking Autism (London: Jessica Kingsley, 2016), 117–120. 19 Sianne Ngai, Our Aesthetic Categories: Zany, Cute, Interesting (Cambridge: Harvard University Press, 2012), 67. 20 Ibid., 11. Ngai traces the frenzied, compulsive mimesis of the aesthetic category ‘zany’ from the stock character of commedia dell’arte to the Lucille Ball of I Love Lucy and Jim Carrey of The Cable Guy (7–9). 21 Ibid., 10. 22 See Temple Grandin and Catherine Johnson, Animals in Translation: Using the Mysteries of Autism to Decode Animal Behavior (New York: Scribner, 2005). The connection to Grandin is widely cited in reviews and publicity materials; also see Telory Davies Arendell, The Autistic Stage: How Cognitive Disability Changed 20th-Century Performance (Rotterdam: Sense Publishers, 2015), 16, and her detailed analysis of Chekhov Lizardbrain, 15–23. 23 Glenn R. Northcutt, ‘Evolution of the Telencephalon in Nonmammals’, Annual Review of Neuroscience 4 (1981), 303. Also see Georg F. Streidter et al., ‘Précis of Principles of Brain Evolution’, Behavioral and Brain Sciences 29 (2006), 1–36.

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24 Ibid., 306. 25 See Edmund T. Rolls, ‘Limbic Systems for Emotion and for Memory, but No Single Limbic System’, Cortex 62 (2015), 119–157. For critique, also see Joseph LeDoux and Elizabeth A. Phelps, ‘Emotional Networks in the Brain’, in Michael Lewis, Jeannette M. Haviland-Jones and Lisa Feldman Barrett (eds), Handbook of Emotions (New York: Guildford Press, 2008), 161; in support of some portions of MacLean, see Jaak Panksepp, ‘The Affective Brain and Core Consciousness: How Does Neural Activity Generate Emotional Feelings?’, in Michael Lewis, Jeannette M. Haviland-Jones and Lisa Feldman Barrett (eds), Handbook of Emotions (New York: Guildford Press, 2008), 47–67. 26 Nicholas and Peter use the Russian names Nikolai and Pyotr when they occupy the long-underwear version of the past. Dmitri and Sascha keep the same names. 27 Hacking has discussed the looping effect repeatedly; for an early articulation, see ‘The Looping Effect of Human Kinds’, in Dan Sperber, David Premack and Ann James Premack (eds), Causal Cognition: A MultiDisciplinary Debate (Oxford: Oxford University Press, 1995), 351–383.

Response 1 2

3 4 5 6

N.J. Schweitzer and Michael J. Saks, ‘The CSI Effect: Popular Fiction about Forensic Science Affects the Public’s Expectations about Real Forensic Science’, Jurimetrics 47 (2007), 357–364. See Donald E. Shelton, Young S. Kim and Gregg Barak, ‘A Study of Juror Expectations and Demands Concerning Scientific Evidence: Does the CSI Effect Exist’, Vanderbilt Journal of Entertainment & Technology Law 9 (2006), 331. Samuel Mehr, ‘Miscommunication of Science: Music Cognition Research in the Popular Press’, Frontiers in Psychology 6 (2015), https://doi.org/10.3389/ fpsyg.2015.00988. See Amy Coplan, ‘Empathic Engagement with Narrative Fictions’, The Journal of Aesthetics and Art Criticism 62, no. 2 (2004), 141–152. Network, A.S.A., ‘Autistic Self Advocacy Network’, n.d., https:// autisticadvocacy.org/, accessed 16 January 2018. Thalia R. Goldstein, ‘Live Theatre as Exception and Test Case for Experiencing Negative Emotions in Art’, Behavioral and Brain Sciences 40, no. E363 (2017). Doi:10.1017/S0140525X17001704.

Chapter 10 1

I will use the first names of Jon Haynes and David Woods, because these are also used in the extracts of dialogue that follow. The play title The Eradication of Schizophrenia in Western Lapland is abbreviated to Eradication.

232 2

Notes

A producer-collaborator during the development of a new production that is intended for touring in 2018. 3 A 1989 production by Les Deschiens: Lappin Chausseur directed by Macha Makeïeff and Jérôme Deschamps at Théâtre national de Chaillot, Paris. 4 Melbourne-based contemporary dance company. Two-Faced Bastard premiered at the Malthouse Theatre, Melbourne, in 2008. 5 Noises Off is a 1982 play by the English playwright Michael Frayn. 6 Ursus and Nadeschkin, a Swiss cabaret duo. Ursus & Nadeschkin – Solo! was first presented in 1999. 7 A London-based performance collective founded in 1998. Dance Bear Dance ran at Arch 12a in Bethnal Green between May 2002 and August 2003. 8 A stage designer and collaborator on other Ridiculusmus’s productions. 9 Long-term collaborator and performer Patrizia Paolini suggested a film, The Pointsman (1986), which involved an encounter on a train. 10 Hearing Voices Network is a peer-focused national organization, supporting voice hearers. See https://www.hearing-voices.org/. 11 Jukka Aaltonen, Jaakko Seikkula and Klaus Lehtinen, ‘The Comprehensive Open-Dialogue Approach in Western Lapland I. The Incidence of Nonaffective Psychosis and Prodromal States’, Psychosis: Psychological, Social and Integrative Approaches 3, no. 3 (2011) 187, 179–191. 12 A dialogic approach to treating psychosis that was developed in Western Lapland in the 1980s. See Seikkula and Olson, ‘The Open Dialogue Approach to Acute Psychosis’, 403–418. 13 Adam Phillips, ‘Acting Madness: The Diary of a Madman, Macbeth, King Lear’, Threepenny Review 126 (2011), 14–17. 14 Ibid., 14. 15 Yes Yes Yes by Ridiculusmus was presented in St Bride’s ‘Continental Shifts’ season at the Edinburgh Fringe in 1999. 16 Phillips, ‘Acting Madness’, 14–17. 17 See Mihaly Csíkszentmihályi, Flow: The Psychology of Optimal Experience (New York: Harper, 2008). 18 John Burns, collaborator, based in Northern Ireland at the time. 19 David’s role as doctor, for example, has been played by Jon Haynes and by John Gorick, Rupert has been played by Jon Haynes, Richard Talbot and Rupert Jones at the Albany, London, and by Ben Grant at Arts House, Melbourne, Australia. 20 In Give Me Your Love (2016), a war veteran, Zach, suffering with PTSD seeks refuge in a large cardboard box. Throughout the performance, the lower legs and a pair of trainers are all that the audience can see of the performer’s body.

Notes

233

Chapter 11 1 2

3 4

5

6

7

Programme of workshops and performance, 19 May–18 June 2017, Albany Empire, UK; see https://Re:Createpsychiatry.com/shifting-perspectives/. See Matthew Ratcliffe, ‘Empathy and Psychiatric Illness’, in Heidi Maibom (ed.), The Routledge Handbook of the Philosophy of Empathy (London: Routledge, 2017), 190–282; see also Ross and Watling, ‘Use of Empathy in Psychiatric Practice’, 26–33. The Diagnostic and Statistical Manual of Mental Disorders, 5th edn (Washington: American Psychiatric Association, 2013). See Jaakko Seikkula, Birgitta Alakare and Jukka Aaltonen, ‘The Comprehensive Open-Dialogue Approach in Western Lapland: II. Longterm Stability of Acute Psychosis Outcomes in Advanced Community Care’, Psychosis: Psychological, Social and Integrative Approaches 3 (2017), 192–204. Two discussion events exploring issues in the contemporary mental health system as part of the Wellcome Collection exhibition, ‘Bedlam: The asylum and Beyond’, 15 September 2016–15 January 2017. The first event (29 September 2016) was a conversation entitled ‘Psychiatrists and Their Patients: An ethos of doing with, a practice of doing to?’ These ‘Shrink Radio’ conversations were curated by Re:Create Psychiatry: ‘a serviceuser-led exploratory platform based at the Dragon café which brings together people with lived experience of mental ill-health and medical professionals to stimulate dialogue and collaboration. Transcending the traditional roles of “expert” and “patient” enables those involved to better respond to challenges in the current model of mental health service’ (see https://wellcomecollection.org/events/recreating-psychiatry-0, accessed 1 September 2017). For further information, see http://mentalfightclub. com/; http://dragoncafe.co.uk/ and https://Re:Createpsychiatry.com/. See ‘Therapeutic Conflicts: Co-Producing Meaning in Mental Health’, a report on a project led by Edward Harcourt (Philosophy, Oxford), in collaboration with Bristol 3 Keys Project, funded by Wellcome Trust Institutional Strategic Support Fund (ISSF), Oxford University John Fell Fund and the Laces Trust: http://media.philosophy.ox.ac.uk/mentalhealth/ Coproduction%20Report.pdf. This arose from a series of interdisciplinary workshops between the Mental Health Foundation and Oxford University’s Faculty of Philosophy (2012–2013) ‘exploring points of intersection between mental illness, psychiatry and philosophy’. Lamis Bayar and Dr Khaldoon Ahmed from Re:Create Psychiatry contributed to the final workshop of ‘Therapeutic Conflicts’ in May 2016. See Wu Shiu-Ching, ‘On the Priority of Relational Ontology: The Complementarity of Heidegger’s Being-with and Ethics of Care’, Kemanussian the Asian Journal of Humanities 23 (2016), 71–87 and Johnstone, A Straight Talking Introduction to Psychiatric Diagnosis.

234

Notes

Gay McAuley, ‘Towards an Ethnography of Rehearsal’, New Theatre Quarterly 14 (1998), 78. 9 For further information, see http://playingon.org.uk/hearingthings-2016-2017/. 10 Victor Turner, The Ritual Process: Structure and Anti-Structure (Newark: Transaction Publishers, 1969). 11 Ibid., 12. 12 Helen Nicholson, ‘A Good Day Out: Applied Theatre, Relationality and Participation’, in Jenny Hughes and Helen Nicholson (eds), Critical Perspectives on Applied Theatre (Cambridge: Cambridge University Press, 2016), 254. 13 Ibid., 253. 14 The interview with Dele Olajide was featured in the Appendix to the Playing ON: Theatre Engagement Evaluation Report, October 2014 (unpublished). A condensed version that refers to Dr Olajide’s comments is featured on the company website: www.playinon.org. 15 Marie Gabriel, panel discussion at performance of ‘Hearing Things’ as part of ‘Mental Health Acts’ (3 December, 2017, Jerry’s Studio, Stratford East). 16 Hugh Grant-Peterkin, interview and email correspondence with Nicola Shaughnessy, January 2018. All further quotations from Grant-Peterkin are from this source. 17 See Nicholson, ‘A Good Day Out’. 18 Ibid., 249. 19 See Ratcliffe, ‘Empathy and Psychiatric Illness’, 191. 20 See Hojat et al., ‘An Empirical Study of Decline in Empathy in Medical Schools’, 934–941. 21 All the names of the participating service users have been changed to protect their identities. 22 Miriam Kyselo, ‘The Enactive Approach and Disorders of the Self – the Case of Schizophrenia’, Phenomenology and the Cognitive Sciences 4 (2016), 591–616. 23 Ibid., 611. 24 Ibid. 25 Nicola Shaughnessy, rehearsal notes, December 2017. 8

Epigraph 1

David Woods, ‘“Breakthrough Moments”: Open Dialogue in the Ridiculusmus Play The Eradication of Schizophrenia in Western Lapland’, Context 138 (2015), 36–38. 2 Fuchs, ‘Phenomenology and Psychopathology’, 568. 3 Harpin, Madness, Art and Society, 41.

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Index Ahmed, Sara 33, 34, 35, 36, 37, 154 Alice, Fauve 95–6 Allah, Moor 138, 141 American Psychiatric Association 150, 189–90 American Psychological Association 111 Armin, Robert 94 Artaud, Antoinin 22 Ashby, Justine 122 Asperger, Hans 69–70 Aston, Elaine 122, 127 Autistic Self Advocacy Network 162 Baggs, Amanda 38–9 Bakhtin, Mikhail 9 Barker, Howard 89 Barnard, Philip 6–7, 17, 105, 205 Baron-Cohen, Simon 71–7, 78, 84, 151 Barthes, Roland 22 Bartleet, Clara 120 Barton, John 29 Bassett, Katie 121 Basting, Anne Davis 86–7, 91 Bate, Jonathan 87–8 Battersea Arts Centre 13 Bayley, John 87 Beale, Simon Russell 88 Beauvoir, Simone de 23 Becker, Anne 102 Beckett, Samuel 22, 28 Endgame 91 Bennett, Jill 136–7, 140, 142 Bettelheim, Bruno 70, 150 Bickerstaff, David 57 Billington, Michael 124 Binchy, Cian 151 Blair, Rhonda 4 Bläsing, Bettina 4

Boal, Augusto 10 Bond, Edward 22 Botanical Gardens, Belfast 175 Bottomley, Gordon 89 Bouchard, Gianna 4 Bramble-Carter, Yolande 95–6 Brecht, Bertolt 10 Brennan, Teresa 34 Breuer, Josef 103–4 Bridget Jones’s Diary 122 Brockmeier, Jens 18, 86, 97 Brodzinski, Emma 9, 18, 205 Brown, Wendy 27 Bruch, Hilde 102 Büchner, Georg 22 Burck, Charlotte 203 Burrows, George Man 23 Butler, Judith 23, 27 Butler, Robert 96 Callaghan, Dympna 32 Cambridge Science Festival 13 Camuti, Fabiola 205 Care Quality Commission 87 Carlson, Marla 18, 19, 161–3, 205 Carlson, Marvin 85 Caruth, Cathy 140 Cattermole, Nick 95–6 Cavendish, Dominic 127 Chambers, Colin 32 Chaudhry, Farrah 88–91, 97 Chekhov, Anton 155–9 Chunky Move 170 Churchill, Caryl 125 Cielecka, Magdalena 127–8 Cixous, Hélène 104, 115, 119 Clean Break 120 Congo, Anwar 37 Cook, Amy 4

Index Cook, Robert L. 133 Craig, Jamie 78–9 Crawford, Paul 11, 18, 205 Crick, Bernard 32 The Curious Incident of the Dog in the Night-Time 19, 149–55, 160, 205 Cushman, Robert 32 Cvetovich, Anne 27 Dada 155 Daniels, Sarah 18, 115–22, 128–31 Beside Herself 18, 116, 117–20, 123, 125 Heat-Rot Holiday 18, 116, 120–2, 123, 125, 126 Ripen Our Darkness 119 David, Richard 31 Davies, Hunter 27 Dean, Laura Jane 13–14 Debling, Heather 119 de Jongh, Nicholas 31 deLahunta, Scott 8 Delbo, Charlotte 140 Dening, Tom 87 Derry Playhouse 175 Diamond, Elin 115–16 Diary of a Madman 175–6 Di Benedetto, Stephen 144 Dingwall-Jones, Christopher 11, 18, 129–31, 205 Doktor, Ditty 108 Drabble, Margaret 179 Dragon Café 189 Dunn, Barnaby 105 Edgington, Barry 116 Edinburgh International Festival 127, 186–7 Eliot, T. S. 28, 33 Erikson, Erik 101 Escolme, Bridget 24, 25 Falletti, Clelia 3 Faludi, Susan 122

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Flute Theatre 24, 33–9 Fonagy, Peter 5 Frayn, Michael Noises Off 170, 183 Freire, Paulo 10 Freud, Anna 101 Freud, Sigmund 20, 23, 99–100, 102–5, 111, 205 Frith, Uta 62, 69, 71, 150 Froggett, Lynn 14 Fuchs, Thomas 101, 205 Gabriel, Marie 194–5 Gavaghan, Laura 10 Gill, Rosalind 122 Globe playhouse 94 Goffman, Erving 26 Goldstein, Thalia 15, 19, 205 Goodbody, Buzz 24–33 Gottshalk, Simon 142 Grace, Arabella 82–3 Grace, Iris 82–3, 84 Grace, P. J. 82–3 Grandin, Temple 73, 150, 153, 157, 160, 162 Grant-Peterkin, Hugh 11, 195–7, 200–1, 204 Grieg, David 125 Grigg, Josh 95 Haaraniemi, Timo 180 Haddon, Mark 19, 149–51 Hall, Elaine 122 Hansen, Pil 4 Happé, Francesca 62, 121 Harpin, Anna 8, 16–17, 18, 24, 26–7, 33, 115–16, 124, 205, 206 Haynes, Jon 3, 19, 167–87, 203–4 Hearing Things 191–4 Hearing Voices Network 172 Henderson, Jill 87 Herbert, Jeremy 126 Herman, Judith 140 Higonnet, Margaret 32

244 Hitler, Adolf 176, 178 Hobday, Peter 21 Holland, Peter 85 Holmes, Emily 12–13 Hougham, Richard 100 Hughes, Adrienne 52 Hughes, Jenny 141–2 Hunter, Kelly 24, 33–9 Hurlburt, Russell 62 Ibsen, Henrik 28 Ghosts 34 Innes, Christopher 125 Irigiray, Luce 104–5 Iris 87 Irwin, Eleanor 110–11 Jacobs, Astrid 108 Jacobs, Nigel 107 Jacono, Victor 3 Jameson, Frederic 122 Jarry, Alfred Ubu Roi 155 Johnson, Robert 142 Jones, Bryn 100 Jones, Phil 100–1 Jones, Rick 121 Joyce, James Ulysses 28 Kafka, Franz 22 Kane, Sarah 18, 21–2, 115–17, 129–31 Blasted 21, 117, 123–4 Cleansed 21–2, 124, 125 Crave 117, 124, 125, 127 4.48 Psychosis 18, 117, 123–8 Phaedra’s Love 117, 124 Kanner, Leo 70 Kaplan, Ellen C. 18–19, 145–7, 205 Kaufman, James C. 133 Kelly, Gene 96 Keropudas Hospital 172, 177, 180 Kinderman, Peter 174

Index Kingsley, Ben 27, 29–30, 32–3 Kirsch, David 52 Koegel, Robert 79 Kontos, Pia C. 95 Kourbaj, Issam 77 Kristeva, Julia 104, 120 Kuppers, Petra 24 Kyselo, Miriam 198–9 Laing, R. D. 24–6, 28, 168 La Mama Annex 134 Lampert, Mikel 26 Lasegue, Ernest Charles 105 Lawrence 107 Lawrence, Marilyn 101 LeDoux, Joseph 144 Lefebvre, Henri 119–20, 123–4, 126 Lehmann, Hans-Thies 12 Lerner, Matthew 15 López Rio, Agnès 52 Macdonald, James 126–7 MacIntyre, Steve 43 MacLean, Paul 157 The Madness of Esme and Shaz 119 Maestro, Sandra 81 Maher, Mary 29 Mallett, Rebecca 154 Malthouse, Theatre 170 Mangan, Michael 85 Manning, Erin 39 Maudsley Hospital 22, 194 May, Jon 17 McCauley, Gay 190 McGregor, Wayne 8, 41–2, 51–7, 66 McRobbie, Angela 122 McSween, Morag 102, 107, 109 Mehr, Samuel 162 Melville, Mark 87 Mental Fight Club 189 Mental Health Acts 189 Merleau-Ponty, Maurice 100, 199 Mermikedes, Alex 4 Metal, Edge Hill 170

Index Milton, Damian 24 Minkowski, Eugene 199 Mitchell, Katie 21–2 Mooney, Laura 14 Morecombe, Eric 96 Murdoch, Iris 87 National Autistic Society 72 National Student Drama Festival 27 National Theatre 19, 21–2, 88, 149–60, 182 Negrin, Javier 77 Nettle, Daniel 77 Ngai 154–5 Ngai, Sianne 34–5 Nicholson, Helen 16–17 Nicholson, Helen 193–5 Night Will Fall 36–7 Northcutt, Glenn 157 O’Donnell, Ian 138–40 Olajide, Dele 194 Olson, Mary 9 Oppenheimer, Joseph The Act of Killing 37 Orbach, Susie 101–2, 107–9 O’Reilly, Anne F. 142 Orgel, Stephen 85 Osment, Philip 10, 189, 193, 197 Osteen, Mark 154 Palacio, R. J. 111 Paolini, Patrizia 171 Park, Rebecca 105 Pellicano, Elizabeth 5, 84 Phillips, Adam 174–6 Pig Iron Theatre 19, 149, 155–60 Pinter, Harold 22, 28, 34 Plath, Sylvia 22 Playing ON Theatre 10–11, 19, 189–201 Poe, Edgar Allan 130 Pope, Jim 10, 189, 193, 199 Porter, Noriko 79

245

Powell, Darius 88 Prashar, Arti 87, 95–7 Quartley, Mark 34, 35 Radmall, Bill 107–8 Rain Man 150 Ratcliffe, Matthew 196 Re:Create Psychiatry 10–11, 19, 189 Ridiculusmus 3, 9, 19, 167–87, 203–4 The Eradication of Schizophrenia in Western Lapland 3, 9, 19, 167–87, 203–4 Give Me Your Love 3, 186 Say Nothing 175 Yes, Yes, Yes 175 Roach, Joseph 85 Robbins, Trevor 13 Rober, Peter 172 Rodriguez, Marnie 122 Roth, Ilona 17–18, 69, 205 Royal Academy of Music 77 Royal Court Theatre 22 Royal Shakespeare Company 24–33 Rush, Geoffrey 175–6 Rusnswick-Cole, Katherine 154 Sacks, Oliver 95, 150, 154 Sagan, Olivia 14–15, 16 Schachter, Daniel 85 Schafer, Elizabeth 27, 29 Seikkula, Jaakko 172, 203–4, 209 Self, Will 178, 179 Selvini-Palazzoli, Mara 106 Seneca 124 Sexton, Anne 22 Shakespeare, William 17, 174 As You Like It 94 Hamlet 17, 21–39 King Lear 85–97 Twelfth Night 94, 96 Shaughnessy, Nicola 6–7, 121, 129, 190 Shaughnessy, Robert 18, 205

246 Shelford, Michael 48 Shine 176 Shotter, John 172 Showalter, Elaine 23–4 Shunt 170 Sierz, Aleks 122, 124 ‘Singin’ in the Rain’ 96 1623 Theatre 86–95, 97 Smith-Howard, Alycia 25 Socrates 24 Sofia, Gabriele 3 Spare Tyre 87, 95–7 Spice Girls 122 Spiller, Ben 88–95, 97 Stanislavski, Constantin 144 Still Alice 87 Sugg, James 155 Talbot, Richard 3, 19 Tammett, Daniel 73 Tao, Thomas 15–16 Tavistock Centre 203 Teasdale, John 63 Theatre Royal, Stratford East 191, 194 Thierens, Phéline 167 Thompson, James 18, 140–1 Thomson, Peter 31 Tinker, Jack 21 Tiramani, Jenny 121

Index Todd, Susan 31 Treadaway, Luke 151–2 TR Warszawa 126–8 Tuke, William 116 Turner, Victor 191 Twitchin, Misha 170 Tycer, Alicia 122 Urban, Ken 124 Ursus and Nadescjkin 170 Vannini, Phillip 142 Vital, Pedro 121 Wardle, Irving 31 Warwick Arts Centre 179 Waskul, Dennis 142 Wellcome Trust 189 Wells, H. G. The First Men in the Moon 179 White, Gareth 10 Wilson, Melanie 12 Winner, Ellen 15 Winnicott, D. W. 108 Wise, Ernie 96 Women’s Theatre Group 89 Wood, Kate 95 Woods, David 3, 19, 167–87, 203–4 Woolf, Virginia 22

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