‘Art in the Asylum: creativity and the evolution of psychiatry’, is curated by Dr Victoria Tischler and Dr Esra Plumer, and presented in the Djanogly Art Gallery, Lakeside Arts Centre, University Park until the 7th November. This exhibition is a richly rewarding experience on two levels. Firstly, the viewer is offered each work in its own particular chronological and spatial context. The exhibition includes a diverse range of material, including pieces from artists whose work is produced within the influence of continental psychiatry and work representing the earliest asylum art from Scottish institutions. As this exhibition unfolds in front of us, we are witnessing the evolution of over 100 years of artistic activity in British psychiatric institutions, spanning from the 1800s to the 1970s.
But the exhibition is an enriching experience on another level. Woven into the historical and comparative narrative are the voices of each individual artist. As you walk through the exhibition space, you become aware of the clamouring of these voices. Voices which, paradoxically, can only truly make their experience understood through visual means. The content of each piece is part of an intensely personal journey made by an individual struggling to maintain, or explore, their sense of identity in the face of mental illness. Much of this work is locked to this internal focus; the artist is overwhelmed by the need to relate an internalized experience. But for some of the artist-inmates the opportunity to ‘make’ art in the asylum is an opportunity to become political, to set their experience in a socio-political framework.
One work which uses this socio-political framework is ‘I spit on Life’ by William Kurelek.
In creating ‘I Spit on Life’ , the poster image for this exhibition, William Kurelek shows us, in a powerful series of illustrative vignettes, that the inmates of our asylums, the recipients of our ‘care’, can take the initiative in the dialogue between the ‘individual ’ and the ‘system’. My own research is particularly concerned with the changing relationship between the client and the expert practitioner within the social institutions of education and health. I am exploring the possibility that in our post industrial world the locus of authority is shifting from the practitioner, the system, to the client, the individual. For me, Kurelek’s work is not only important for its expression of his personal experience but in the way it makes explicit that, in the words of Shulamith Firestone: ‘the personal is political’. Kurelek describes his experiences not only for us to comprehend his personal distress but for us to regard, and to judge, the ‘political’, the ‘system’, in action.
There is a theatrical and dynamic sense about Kurelek’s work which transforms us from passive viewers into an engaged audience. Among the series of vignettes which make up this work there are two which I find are particularly powerful representations of this effect. They concern his experiences in the institutions of education and of health. In Image 2, Hospital, the patient is receiving a lecture from a psychiatrist. We see the unconcerned nurse, sitting in an almost languid pose on the coffin lid, but using her body weight to push it down on the patient while the psychiatrist, seemingly without any reaction to the horrific scene in front of him, continues to expound some theory, or perhaps offer some advice. We suspect that the psychiatrist’s theories and his advice are not relevant to the man peeping out in horror from his institutional coffin. The lid is about to close and we feel the urge to step in, lift the lid and free the man trapped underneath it. The action we would bring to this scene is based on our common humanity, a sense of outrage at what is happening. Kurelek cleverly engages our sympathies with the terrified ‘patient’, who is the only figure in this vignette showing a ‘normal’ emotional response to the event. By default, those showing no emotion, the institutionalised professionals, must be the abnormal ones.
Thus Kurelek persuades us of the efficacy of his argument; institutions desensitize individual practitioners until they no longer respond with recognizable humanity in the face of the suffering of their ‘clients’. This, of course, is the very argument that has led the political debate in the last few years over the training and behaviour of our expert practitioners in Health and Education.
The student cramming knowledge in a library (Image 4 Student Days), gives an equally damning picture of the institution of higher education. The student is alone, holding his head in his hands, and behind him stretches a vast empty corridor of books. We sense his desperation. He must learn, and learn at the pace dictated by the institution, some examination of which he is taking. He seems to find no pleasure in learning. The implication is that he is on his own, unsupported by the institutionalized professionals whose job it is to ‘teach’, to ‘lead’, to ‘guide’, him to academic success.
Again, Kurelek is directing his anger at the ‘professionals’, the ‘expert practitioners’, who fail to fulfill their contract of public service.
But, as I reflect on my research interviews with over forty expert practitioners in Health and Education, and while accepting that we are in what has been described as a ‘crisis of service’, I find my sympathies lie as much with these expert practitioners as with their clients. These practitioners are the ‘professional class’, described by Perkin (1989) as having an ethos of service, a respect for properly adjudged qualifications and a desire to work effectively within the pursuit and use of their knowledge. As I listen to my audio transcripts I hear expert practitioners tell me that these principles are under increasing threat from a devaluing of the centrality of their expertise to the successful delivery of our ‘Public Services’.
Expertise relies upon a basis of what Frank Webster (2006) called ‘theoretical knowledge… formalized in texts and transmitted through the educational process’. At the 2013 Kaleidoscope Conference in Cambridge, Stephen Ball, in reference to ‘theoretical knowledge’ spoke of the fundamental ‘job of academia’; to tell the truth. He described the effect of ESRC Impact guidelines, positing that research could no longer be seen to be an end in itself, and implying that researchers were no longer free to ‘search after the truth’.
In support of that argument, it is suggested that, in university education, with the introduction of the REF ‘there is a new shift from accountability over finances to control over substance and the content of what is researched’ (Olssen 2011).
What effect does this shift of control away from the expert practitioners have on their experience of daily professional life? A Cardiff University study by Smith, Collins, Matthews and McNamara (1993) into workplace stress commissioned by the Health and Safety Executive found that, apart from bureaucratic overload and a general lack of time to complete tasks… ‘there are anecdotal reports from professionals ….. that uncertainty due to the changing nature of work, may be related to the increases in perceived stress.’
After reading this, I look again at the psychiatrist in Image 2. Is he suffering from burnout? Is that passive face the expression of a man with low affect? Is he depressed? We have to ask again, although with a perceptibly altered perspective from that of Kurelek- is indeed the psychiatric patient the healthiest person in this image?
Perhaps Kurelek’s powerful depiction of the ghastly failings of organized society to recognise the vulnerability of the individual could extend its franchise to include the expert practitioners who are caught up in these devalued ‘services’?
Processes such as the collection of both qualitative and quantitative data on client responses to Health and Education through ‘student voice’ and ‘patient feedback’ demonstrate the increasing governmental emphasis on the importance of ‘client critique’ to assess practitioners. This client critique could extend out from its narrow focus on the perceived failings of individuals within the public services to encompass both an informed critique of the actual structure of these services and an understanding of the implication of constant change for the expert practitioner. Extending the remit of ‘client critique’ in this way could contribute to a powerful partnership between the practitioner and the informed client. The lobbying power of such a partnership would be a political force with which to be reckoned.
I ask you to look back at the dark images of ‘I spit on life’ for a moment and imagine Kurelek’s images reformed into a network of such successful partnerships. Not a glossy public relations exercise in imaging the promised land but a real depiction of a functioning set of services embedded in, and supported by, the society which it serves. Something which works.
To paraphrase Mrs Doyle,’Ach, come on. Sure, we know we want it.’
The question is – how to get it?
Writer: Fiona Birkbeck PhD Title: The Cry for Professional Intimacy. Changing relationships between the expert and the client in the post industrial landscape of our health and education services. Email: firstname.lastname@example.org
Ball, Stephen. (2013) Kaleidoscope Conference, Cambridge
Firestone, Shulamith. (2003) The Dialectic of Sex: The Case for the Feminist Revolution
Olssen, M. (2011) The strange death of the liberal university: research assessment and the the impact of research’, in R,King, S Marginson and R Naidoo (eds) A handbook of globalisation and higher education, Cheltenham: Edward Elgar
Perkin, Harold. (1990) The Rise of Professional Society: Britain since 1880 Routledge
Smith, A., Brice, C., Collins, A., Matthews, V., and McNamara, R. (1993) The Scale of occupational stress: A further analysis of the impact of demographic factors and type of job Centre for Occupational and Health Psychology, Cardiff University for the Health and Safety Executive
Webster, Frank. (2006) Theories of the Information Society Routledge