Playing ON was set up in 2010 to give voice to disenfranchised people and to create professional theatre of the highest artistic quality. The company engages with the target group, running drama workshops and creating scratch performances. The aim is to translate these authentic voices into new theatre scripts that inspire audiences through an urgent and truthful portrayal of life in contemporary Britain. It is intended that, through taking part in Playing On workshops and shared performances, participants gain skills for life and are empowered to re-engage with education, training and employment.
Our first production focused on the lives of young fathers in prison. After a successful run at the Roundhouse in the autumn of 2010 the company took the decision to turn its attention to mental health service users and professionals.
There followed five years of research and development that included work with a range of agencies and institutions including residencies in locked psychiatric wards.
The company’s process consists of creating characters and bringing these characters into relationship with each other to create improvised scenes and story, adopting and adapting techniques Jim and I had learnt in our work with the director Mike Alfreds.
The format usually involves a series of weekly or bi-weekly workshops with the participation of both staff and service users. This is followed by an intensive rehearsal process culminating in some kind of improvised performance.
In using lived experience to create fictional characters and stories, participants come to an appreciation of each other’s skill and insights as people. It enhances self-esteem, diminishes stigma, and gives a sense of achievement which might have been missing from their lives for many years.
One tricky aspect of running workshops where both staff and patients are present is that the patients are wary of being assessed, which might affect perceptions of how well or ill they are. Staff might at the same time feel threatened by a lack of boundaries. However the process can break down boundaries in a safe way. When we worked on a locked psychiatric ward at Homerton hospital we created scenes where patients played staff and staff played patients. The performance on another ward drew staff and patients together and the director of the unit commented on the value of her nurses seeing patients’ accurate and humorous depiction of themselves. She felt it encouraged them to see the person and not just their diagnosis. One patient clearly felt liberated by the experience; he was heard to say, “I’m off to drama to be mad and it doesn’t matter.” In fact after our residency at the Maudsley it was noted that participants were discharged because their recovery had been more rapid than expected. This was attributed to their attendance at the workshops.
At times over the five years the company would also develop scratch performances using a combination of professional actors and service users. These were more developed pieces looking at relationships of staff and patients and situations thrown
up by our residencies and crafted into something more resembling a play. These scratch performances were presented to audiences in theatres and hospitals.
By Spring 2016 we had given a number of such performances and an application had been made to the Arts Council for a professional production that would be written by me. When this bid was successful I was faced with the task of somehow bringing together all that research and all these performances to create a script. It was a rather daunting prospect.
One of my concerns was to avoid the pitfall of demonising the psychiatrist and falling into the rather easy trap of showing him or her as the villain of the piece. At the same time the psychiatrist’s role and the need at times to constrain people suffering from psychosis through sectioning, creates a power imbalance which underpins what is often a combative relationship. This can result in patients finding themselves caught in double binds as described in the play. If they express anger at being constrained against their will, or show lack of compliance with a drug regime because the medication has unpleasant side-effects, then this is seen to be proof that they are ill. However during the course of our research the psychiatrists we met were all too aware of these contradictions and were often trying to help the patients manage their symptoms and healing process. There is a push to develop the idea of co-production where ex patients are enlisted as advocates and peer mentors, whose lived experiences give them insights which can prove effective in aiding other patients’ recovery.
The truth is that psychiatrists themselves are on their own journeys and have a whole range of approaches. Within psychiatry there is an ongoing debate about the use of talking therapies. The medical approach focuses on the idea of chemical imbalance in the brain which might arise because of genetic susceptibility, whereas the emphasis of psychologists would tend to be on trauma going back to childhood and its impact on the patient’s wellbeing. But talking therapies are time consuming. Lack of funding and time constraints, the need to see as many patients as possible and to free up beds, mean that medication is used as a first resort because it guarantees a more speedy diminution of symptoms and therefore a more rapid discharge.
The medical model raises concerns about the whole process of diagnosis. Often patients find themselves classified differently depending on the observations and bias of the last psychiatrist they saw. These classifications themselves have been made in what could be seen as an arbitrary and subjective manner. I think Nicholas is all too aware of these contradictions, which makes it particularly difficult for him to contend with his father’s characterisation of psychiatry as being non-scientific. It seemed to me that for the psychiatrist who sees the value of a more psychological approach, like Nicholas, this can prove challenging.1 I wanted to show that he is also caught in a double bind and explore how his well-intentioned treatment of Janet exposes him to possible litigation. I found online newspaper reports of similar incidents. This double bind means that he retreats into the role of entrenched expert and is over cautious about discharging Innocent.
These are some of the issues which led me to make my central character a psychiatrist who is having a mental breakdown. It was partly informed too, by experiences on the ward where it was sometimes difficult for us to distinguish staff from patients – in one instance, a staff member who was under pressure because of lack of space for our workshop, approached Jim and delivered a panicky monologue about the problem which caused Jim to think at first that he was dealing with a patient. One psychiatrist observed to us that the patients do eventually leave the hospital; it is often the staff who become institutionalised.
The characters themselves are amalgams of people that we met during residencies and characters developed by the actors during rehearsals for the scratch performances. So, for instance, Janet is based on a character created by Jeanette Rourke who plays her in our production. Jeanette also created an improvisation from research, of strategies for dealing with hearing voices which has been used in the play. There were numerous incarnations of Innocent based on work by Michael Amaning, an associate member of the company. I have made my own additions and adjustments and re-imaginings. The scene where Innocent reads the Marvin Gaye speech arose from my observation that sometimes patients who were still quite ill, had a perspective on the character they had created; a perspective which they might lack in relationship to their own experiences. However this was a scene imagined and created in the writing process. It is interesting that audiences sometimes falsely assume that the script arises from verbatim material which I take as a compliment.
HEARING THINGS runs until 27 Jan – get your tickets here→
