by Dylan Tighe
(Editors’ Introduction: This text has been adapted and expanded from an address delivered as part of a session entitled ‘Are the Performing Arts driving us Mad?’ which formed part of the 2013 IETM Performing Arts Conference in Dublin attended by over six hundred Performing Arts delegates from around the world. For this session Dylan Tighe invited Ivor Browne and Dublin City Council Arts Officer Ray Yeates to discuss the relationship between the Arts and mental health, particularly in relation to exploring ways in which the mental health of artists and arts workers could be enhanced and protected within the arts.)
Using as its starting point my own personal history and archive of psychiatric diagnosis and treatment, my ongoing project RECORD combines the release of an album of original songs, a theatre performance, and a series of talks and discussions. Further iterations have included a music video, lectures, essays and a radio drama for RTÉ. The project aims to move beyond the mere representation of mental distress and instead attempts to enact an alternative way of conceiving of and talking about the causes of distress and to promote a creative re-conceptualisation of issues of ‘mental health’. Certain issues arose out of the process of creating the work which I felt demanded further attention.
It is my belief, and experience, that many people working in the performing arts, and the arts in general, are particularly vulnerable to mental and emotional problems, not because of any biological or genetic predisposition as has traditionally and popularly been proposed but, instead, due to the often intolerable conditions under which we work. Long periods spent in the dark under often stressful working conditions are two of the most obvious factors but there are many others that I have identified that may play a part including: financial insecurity, interpersonal conflict, poor nutrition, excessive alcohol intake, high levels of personal risk, commercial expectation, exploitation and burn-out or exhaustion. At the same time artists can be instrumental in leading and shaping how society conceives of matters of mental wellbeing.
According to the Amnesty International Mental Health Act 2001 review, published in 2011: “a change in culture and attitudes is key to reform” (7) in mental health. However the term ‘mental health’ is somewhat misleading. Emotional and mental wellbeing are not simply matters of health or medicine but infiltrate every aspect of our lives. How we deal with mental and emotional wellbeing as a society can give us a valuable insight into our wider cultural and ideological principles. The framing of mental wellbeing as purely a health issue fails to address the root causes of distress. Instead of looking seriously at the economic, social, interpersonal and cultural reasons why and how we are driven mad, a health-focused discourse invites us to see our mental wellbeing as something which requires a solely health-focused solution. I would argue that the solutions to mental and emotional distress lie not only in the realm of health but on much deeper social, political and cultural levels and it is artists I believe who have the sharpest tools to excavate and explore these underlying factors.
While there are still many lingering popular misconceptions about ‘mental illness’, fuelled mainly by the continuing medical promotion of unproven biological and genetic hypotheses, many influential voices within psychiatry have already admitted that no evidence to back up such theories has been found. As Arthur Kleinman, Professor of psychiatry at Harvard University has recently written:
After decades of investment in biological psychiatric research, there are many intriguing and potentially significant findings, yet still not a single biological test that can be routinely used in the clinic to determine whether someone has a particular mental disorder. Brain science has advanced impressively for neurological conditions, and for our general knowledge of how the brain works, but it has not determined what causes schizophrenia, depressive disorder or anxiety diseases. This should count as an extraordinary failure.
(Kleinman, 2012: 421-422)
Many of the assumptions, and language, underpinning our traditional understanding of ‘mental illness’ are now being challenged from both within and without medicine and science. Progressive thinking is now firmly moving away from biomedical frameworks, and is re-focusing on an exploration of the defining role played by environmental, ideological, social and cultural contexts in our individual and collective mental wellbeing. After decades of research, science and medicine have reached a dead end in their search to prove their theories of biological and genetic causes for mental distress and are still hell-bent on focusing on what we don’t yet know. Musicians and artists have been focusing with laser precision for hundreds of years on what we do know, that we are driven mad by traumas of living, broken dreams, the death and excesses of love, man’s inhumanity to man, the terrors of human existence and consciousness. These philosophical and emotional conundrums of the human condition are not the terrain of medicine.
Central to this seismic shift in thinking, and its public dissemination, is the role played by experts by experience – those who have experienced mental distress and treatment first hand and who have concrete proposals and alternatives based around autonomy and creative approaches which put their knowledge, interpretation and narrative at the heart and at the forefront of any model of recovery. As these ideas gain increasing currency, I believe it is art, and particularly the performing arts, that have the unique capacity to explore these alternative narratives. There is a long history of performing artists who have articulated their struggles with distress and madness, most significantly the French poet, artist and theatre-maker Antonin Artaud and the ballet dancer Nijinsky, both of whom left incredible testaments of their mental suffering and treatment which contain enormous insights and implications for our understanding of mental distress.
A medicalised language to explain crises of the human condition has failed. Art and performance, and the contexts surrounding our work, can help us to invent new ways of expressing the reality of our experiences, beyond imposed vocabulary and terminology. In the sphere of mental health where so much research and thinking is anything but independent, art represents a valuable refuge of independence uncontaminated by corruption and the motivation of commercial gain. Through my research it seemed to me that while there were countless schemes and campaigns to reduce ‘stigma’, there was little or no public promotion and investigation of alternative conceptions of what mental distress can mean, beyond medicalised discourse. Outside of the radical mental health and survivor movements, and academia, these opinions did not seem to be making an impact on the mainstream. I set about forming alliances with survivors, activists and independent thinkers and putting some of those ideas at the heart of my project. The project sought to infiltrate various economies of discourse and inititate dialogue with different audiences simultaneously in the music scene, theatre and performance scenes, print, online media and TV, academia, and activism, in an attempt to extend the reach of the work as far as possible beyond the often narrow and elitist confines of the theatre context.
There are deep historical links between the arts and therapeutic disciplines. These links reached their peak in the early twentieth century with the advent of modernism when it looked like the fields of psychology, psychoanalysis and radical art practices were moving closer together, each informing the other, particularly in the case of Surrealism. These connections diminished as treatments for mental health became increasingly dominated by pharmaceutical drugs. With the cracks in this paradigm becoming ever bigger, and with an increasing return to an appreciation of narrative and representation as means of understanding distress, I believe a space is opening to re-establish a dialogue between art and theatre and the world of mental health. Hopefully my project, and the work of many other artists exploring the subject, can go some way to bolstering that conversation.
Equally there are a great number of artists who suffered brutality at the hands of the psychiatric system, Artaud again being one of the most prominent examples but also many others including the musicians Peter Green and Roky Erikson, to name just three who have had an enormous influence on my own work. Artistic expression has been fundamental to the survival of a great number of patients of psychiatric institutions in the twentieth century, perhaps exemplified most startlingly by the Prinzhorn Collection of asylum-patient art in Heidelberg, and others outside the psychiatric system. The psychologist and academic Gail Hornstein, author of the fascinating book Agnes’ Jacket, has mapped the little-known canon of first person literary accounts of madness and her bibliography now runs to thousands of titles. The corresponding hidden histories of theatre, music and dance have yet to be mapped but what is clear is this: that art and art- making have been fundamental to finding new ways of articulating mental distress and have conveyed deep messages to society about the causes of that distress at times when society has chosen to block its eyes and ears.
The subject of mental wellbeing and treatment is also central to the recovery of our broken economy and societies at large. Whereas we have seen a huge rise in a general distrust of authority and an articulation of that distrust, for years mental health ‘service users’ and survivors have been at the forefront of bringing that news to society, that authority cannot be blindly trusted and that new ways of working must be found if we are to safeguard against the negative exercise of authority over peoples lives. In many countries, not just in Ireland, this news and the dissenting voice were met with disbelief and, worse, seen as a symptom of madness. This found a chilling contemporary parallel recently in Davos, where the Irish Taoiseach Enda Kenny told the world that the Irish had indeed “gone mad” borrowing money and that this was the cause of our economic woes. Again here, the fault of dysfunctional authority is blamed on some kind of individual or collective madness.
As mental health care moves towards the so-called ‘recovery approach’ it is worth drawing some parallels between the recovery ethos in mental health and the rhetoric of recovery in economics. In both cases certain assumptions, particularly around power and expertise, act as barriers to recovery. In the case of economics, an unelected body, the ‘troika’, enjoys a legal and cultural position similar to that of psychiatrists, in that it has the power to impose measures on the individual which are clearly the result of collective failures of ideology, authority and models of living. There can be no recovery without restoring full autonomy to the individual to negotiate their own reality and the failure to recognize this is at the heart of both the current economic hypothesis and much mental health provision. No amount of rhetoric around recovery means anything without a true belief in the autonomy and capacity of the individual to imagine and enact their own recovery based on the specific features of their lives and relationships. The current economic situation is a clear example of the problems associated with imposed solutions. The ‘troika’ acts like the purveyor of blunt, forced treatment instead of looking for remedies that are suited to the particular and unique circumstances that each society, and indeed individual, finds themselves in.
To return to Artaud, it could be said that it was artists and not art alone that ultimately helped him the most. Artaud eventually secured release from the asylum at Rodez due to the help of many artists who donated works to auction in order to pay for his care away from the asylum, among these some of the greatest artists of the twentieth century including: Duchamp, Giacometti, Picasso, Joyce, Sartre, Arp, Bataille, Chagall and many others. This gesture serves as a beautiful and touching illustration of the solidarity, empathy and community which the arts is capable of and as an example to the rest of society of how we can reach out and support those in distress.
Dylan Tighe is a theatre-maker, musician and writer from Dublin. His radio drama for RTÉ – Record, challenging a scientific view of mental health, has been nominated for the Prix Europa Radio Prize 2013.
Amnesty International Mental Health Act 2001 Review (2011)
<http://www.amnesty.ie/sites/default/files/MENTAL_HEALTH_SUMMARY%20080 711.pdf>. Accessed September 2013.
Artaud, A. (1965) Artaud Anthology. San Francisco: City Lights.
Horstein, G. (2012) Agnes’s Jacket: A Psychologist’s Search for the Meanings of Madness. UK: PCCS.
Kleinman, A. (2012) ‘Rebalancing Academic Psychiatry: why it needs to happen − and Soon’. British Journal of Psychiatry. Vol. 201: 421-422.
Nijinsky, V. (2000) The Diary of Vaslav Nijinsky. London: Penguin.
RECORD project can be accessed at the following links:
Podcasts of all associated talks: <http://www.mixcloud.com/corkmidsummer/>.
Radio Drama for RTÉ: <http://www.rte.ie/drama/radio/specials-science- recordbydylantighe.html>.
Walsh, F. (ed.) (2013) Theatre and Therapy. UK: Palgrave.