The Mice Will Play Theatre in a Psychiatric Clinic Walter Pfaff

Introduction The Natural Thing Is Playing All people share a play instinct. This urge is often hidden, covered over in the course of life. Perhaps playing is the way that a society passes on its culture. I am convinced that the play instinct makes people human, and is what has created communal human society in all its great and small forms. Social competence arises to a significant degree from the ability to play roles, consciously or not (see Pfaff 2010). Every interpersonal action is influenced by play instinct. The primacy of the play instinct provides a foundation for my work with long-term schizophrenic disorder patients. Since 2005, I have been pursuing the question of how theatrical processes can be implemented into everyday life in order to improve the ability of people in difficult situations to function. From 2008 to 2010 I carried out a research project under the title Creating Belonging by Means of Performance, commissioned by the Swiss National Fund, demonstrating that the implementation of theatrical methods improved the self-integration of migrants.1 In 2011, a professor at the Psychiatric University Clinic Zurich led me to the question of whether theatrical acting — what I refer to as playacting — could also be fruitfully implemented for work in a clinical setting. I decided that it was worthwhile to give it a try. In light of the worldwide increase in diagnosed mental illness and controversial discussions regarding psychotropic drugs (Angell 2011), for me it appeared essential to develop methods of playacting that could enable self-navigation for people in clinical settings. I assumed that the play methods that had facilitated the self-integration of migrants could also be effective for people with psychological disorders. My initial questions: Can playacting in a clinical context be a good nontherapeutic path to independent action for people who have long lived with a diagnosis of schizophrenia? Can acting ease the navigation of difficult situations for people in closed clinical situations? Can their play actions help them creatively handle the demands of their environment? Do theatrical

1. Within the safety of play rehearsals, the participants created roles related to having contact with the locals. They practiced these roles as actors with the goal of improving their ability to integrate into social groups (see Pfaff 2010).

Walter Pfaff has directed theatre in Austria, Germany, Switzerland, and India. From 1996 to 2005 he was director of the Centre de Travail de Recherches Théâtrales in Burgundy, France, and until 2010 artistic director of the MAXIM Theatre in Zurich. He has been a guest teacher at Osaka, Salzburg, and Zurich Universities. Since 2012 he has worked as a theatre-maker at psychiatric clinics in Switzerland. At present he is working on his first film, “Zi Ran.” [email protected]

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114 Walter Pfaff the magicofplay. health, whichevenpeoplewhohadbeenlabeled “sick” couldcelebrate, havingsproutedfrom forth, andthatjovialplayispossibleonthissideaswellthat. Itrestedupontheuniversalsof of judging. Itresteduponthejoyofknowinghowboundarycanbejumpedover, backand part. This moodemergedfromaninnerlaughteraboutthecomedyofworldanditsway ect, asIshiftedbackandforthbetweenthetwoareas, Inoticedasustainedcheerinessonmy home eachevening, betweentheillandseeminglyhealthy?Overcourseofproj- emerged: whereistheboundarybetweenthoseconfinedtoclinicandwhocango term schizophrenicpatients. To mysurprise, asworkstarted, afurtherquestiondramatically in broadersocietyanditsculture. tives? Iwantedtoknowwhetherthepeoplewhoparticipateinactingalsoresumeparticipation ability toactinatheatricalsettingleadnewactions, newknowledge, andnewlifeperspec- methods helppsychologicallyillpeoplerestoretheirabilitytotakeaction? Will theirlearned for yourentertainment,” butrather “stand up, we’regoingtoplaytogether!” play, notgames. InthetheatrecourseIofferinclinicwedonotsay “sit downandwe’llplay element ofembodimentandexcludes competitiveoraleatorickindsofplaying. The focus ison instinct Iamusinghere. However, Iwillkeeptheterm becauseitimmediatelyemphasizesthe ventional/ready-made culturalassociationsthattosomeextent runcontrarytothekindofplay nal abilitytoplay. Inmyviewtheatreisthebestinstrument toreachthisgoal. to returnthepatient’sactivityitsoriginalspaceandpurpose, reanimatingthepatient’sorigi- normative actionsasuniqueshapings(disorders)oftheludic drive inactionandlookforaway from thefieldofwhatisconsiderednormal. Asatheatre director, Iconceiveofthesenon- side realityweak. Doctorstrytocategorizeassymptoms anyofthepatient’sactionsthatdeviate and dreams. Schizophrenicpeopletendtobefixatedon theinteriorworld, theirsenseofout- rior grayreality, experiencedasconstraint, thatthey loseaccesstotheinteriorworldoffantasy ing, andbeingfixedinoneofthetwoworlds. Somedepressed peoplearesotrappedinanexte- play instinctisaninhibitionofthismovement. This disturbance isexpressedasfreezing, stiffen- Play istheprancingbetweenworldsofinteriorandexterior. Onedisturbanceof the the worldoffacts. The adjectives “light” and “variable” belongtoplay;itsqualityismovement. possible societally. as culturalexperiencewiththepresentaplaceofactionandfuturefieldwhatis instinct stageslifeasacreativeactandexperienceintimespace. Playingconnectsthepast vidual andothers. Ouroscillationbetweenthesetwopolesisaconstantinourlives. The play tingly calledthisa “potential space” (2005:129). hard factsbeyondone’scontrol. The childpsychiatristandpsychoanalystD.W. Winnicott fit- interior, asintheworldofdreams, hallucinations, andfantasies;norexterior, asintheworldof in humanactions, andthisiswhatIusedasspaceforplayintheclinic. This spaceisneither play. The technicalapplication of the concept reveals the precise value of theintermediaryspace mediary spaceenablesthefunctioningofelements. The pistonwouldgetstuckwithoutthis ment withanotheroragainstpossible. Itmediatesbetweenthem. Onlythefreeinter play inthecylinder. Inotherwords, playistheclearancethatmakesmovementofoneele- of playintechnologyandgavemeanimportantclue. A piston, forinstance, hasandneedssome Anthropologist Victor Turner ([1982] 1995:163–65)illuminatedtheapplicationofconcept Play Instinct The pilotprojecttookplacein2011thePsychiatricClinicKönigsfeldenwithlong- Of course, theterm “theatre” isproblematicin thismedicalcontextbecauseitprovokescon- In theclinicweusesocialandinteractiveeffectofplaytojoinimaginedworldwith Societal experienceandtheexperiencesofplayinginapotentialspaceliebetweenindi- - Theatre in a Psychiatric Clinic 115 in — for instance, the for instance, — all separate in normal all separate in normal — the leadership of the clinic; the leadership of the — the clinic; under one authority the clinic; under one — the fellow patients. Everything that is done is done to reach the Everything that is done is done to reach the fellow patients. —

coalesce (or disappear) when patients are institutionalized. The patients’ entire lives take when patients are institutionalized. coalesce (or disappear)

— The fact that a theatre director would start working in a psychiatric clinic seems doubly The fact that a theatre director would start Large tables are set in cloistered courtyard. A3 unit is located around a wonderfully The the back of The difficult cases are in unit H3.2 located on the second floor of a new tract in The barrier the clinic sets up between patients and the outside environment cuts them off The barrier the clinic sets up between patients This is the method of playacting/theatrical praxis I developed in my work with migrants developed in my work praxis I method of playacting/theatrical This is the be open for the in a way that would clinic had to be built for the work in the The setting short, as a personal catastrophe about which nothing can be done. But also, as soon as patients But also, as a personal catastrophe about which nothing can be done. short, Patients orient themselves to the situation. they begin to participate in its life. enter the clinic, the image the clinic has of them. They adapt to the clinic and therefore to since early and, play can be useful for patients, obvious: the knowledge of the forms of human of human life have taken expressions extreme in the Greek tragedies, least, at culture Western in the clearest. It is in these extremes that the essence of human life appears place in the theatre. The Königsfelden Clinic Aargau, largest psychiatric clinic in Canton The Psychiatric Clinic Königsfelden is the in the municipality of Vindonissa the area of the former Roman legion camp Switzerland, clinic meets the basic psychiatric needs of the 660,000 inhabitants of the can- The Windisch. erected here with Austria had an early Gothic church of Agnes Queen In the 14th century, ton. including After serving various functions, Orders). a double monastery (Franciscan and Clarist clinic in 1866 the monastery was converted into a psychiatric as a camp for Napoleon’s soldiers, and continuously expanded in the subsequent decades. with blossoming plants in pots and a view of the meadow and its grazing quiet yard, the green, The patients in the unit are con- well-lit common rooms. A3 is equipped with spacious, cows. there are strict rules at this unit sidered relatively easy cases; nonetheless, patients have to remain seated at the evening meal until the clock strikes six. There is a large on either side of a narrow hallway. with two-person rooms the main building, a book- several old sofas, equipped with two tables and full ashtrays, foggy with smoke, room, There is a second television that is constantly on. and a loud television case with 60 books, introduced other the experienced head of nursing, Arthur, for nonsmokers. always empty, room, and with the same people 1961:41–80). official goals of the clinic (see Goffman various possibilities that once formed their lives dis- These from their previously diverse roles. afraid of the outside because they notice that certain roles have Some patients become appear. they may have even They have lost parts of the apparatus of identity; been lost to them forever. this Patients experience obtained self-image. forgotten how to present their biographically of their self-image as humiliation and degradation and eradication obstruction, restriction, during my tenure as director of the MAXIM Theatre in Zurich from 2005 to 2010 (see in Zurich from Theatre the MAXIM tenure as director of during my Pfaff 2010). to be able to pursue Every actor had expressions of the actors. very individualized diverse and the path to a state in as possible on as free and unconstrained needs and be her/his respective to the world. could help the actor find a creative connection which joy in playing Approaching the Clinic Directors, Care Givers, Care Givers, Directors, the Clinic Approaching and Patients The Essence of a Clinic lives are consolidated and cut an institution in which all aspect of patients’ A psychiatric clinic is friends pleasure, work, Accommodations, world. off from the outside life space place exclusively in one Downloaded from http://www.mitpressjournals.org/doi/pdf/10.1162/dram_a_00796 by guest on 29 September 2021 Downloaded from http://www.mitpressjournals.org/doi/pdf/10.1162/dram_a_00796 by guest on29 September 2021

116 Walter Pfaff along onesideoftheinnercourtyardthatwascoveredwithalawn. patients andlifeintheclinic. Almost allthepatientssatonbeautifuloldmonasteryterrace to knowthemineverydaysituations. The aimofmyvisitwastogainafirstimpressionthe the patientswouldbefreeandinunitatthattime, andIwouldhavethepossibilitytoget wards, Iorganizedameetingfor5:00p.m. withEvelyn, theheadofnursinginunit A3. All of Königsfelden tookplaceintheloftyroomsbelongingtomanagement. Formyvisittothe for meandmy “interesting project,” andtheywerewonoverdespiteinitialreservations. and letters, Ivisited, explained, andexploredtheterrain. The headsofnursingwereprepared ing personnellastedsixmonths. Iapproachedlifeinthecliniclikeanethnologist. Iwroteplans My processofcontactingtheclinicdirectors, doctors, therapists, and, aboveall, theseniornurs- Establishing Contact nated. The smokers, andalmostallofthemare, havetogodownintotheyard. when theywant. rules intoH3.2:everyoneisasfreepossible, everythingasopenpossible. Everyoneeats

and unimpededintothewarmsummerevening?Uponwaking, therewasthestrangelyslowed ing me well-attuned andmutuallyconsideratecommunitybornofnecessity. Ireturnedhomecheerful. not lying. Ican’tlie. ButIcanfeignthingsverywell.” The group gave theimpressionofbeinga his Jewish, Polish, and American roots. “I’m goodatacting, Imeanactingasif, feigning. No, me, andtheynailedhimtothecross!” Oneman, Jury, whomImetafterdinner, toldmeabout play herebecausenoonelistens”;thatsomeonesuffersterribly, “Jesus Christsufferedlessthan covered thatsomeonelikedtosing, someoneelseplayedtheguitar, Haydn, Bach, “but Ican’t about thefearofandcontemptforfriendlypeople, aboutthefantasyofkillingsomeone. Idis- suicide ofayoungpersonfromtheclinicweekbefore(hehadjumpedinfronttrain), carpenter, aboutthevillagenearBelgradewherethingsfellfromsky(bombs), aboutthe ward. of Königsfelden, greetedmegracefullyandreclinedmajesticallyontheonlydeckchairin and pale, hadrestlesseyes;Ernstwasveryfriendly;andMax, withhiswhitebeard, theking cloth onhishead, staredatmewithhislargedarkeyes, hisfaceexpressionless;Nori, young lar, andtoldmehewantedtogothecinemaincityoneday;Urs, who, withasmall would sitthereandneverbeabletostepoutagain;Heribert, whowaslarge, strong, andangu- me upalertly, andrevealedthatsheneverhadtakenapublicbusbecausewaspetrified who wasreadingandclearlydidn’twanttobedisturbed;Roswitha, whowasfriendlyandsized Magda, whowasyoung, beautiful, andwithdrawn;Reto, aneight-yearveteranoftheward, I shouldgetlost;Boran, wholookedsilentlyintothedistancebeforeandaftergreetingme; 3. 2. Here iswhoImet:Friedrich, I firstsetfootinthepsychiatricwardssummer2011. Previously, allofmymeetingsin The thirdunit, H2.1, isthesameasH3.2, exceptthatthesmokingroomwasrecentlyelimi- work, reflecting on it, and steering it. thedevelopmentfeelings. I did not censor myself in these reports. of theThey were for observing important each session, recording the sequence of events, the patients’ reactions, and my own experiences, thoughts, and pretation between what is unfamiliar and what is one’s own “local knowledge.” I composed a precise report after culture that seems strange. It to come to terms with whatever is foreign is necessary in a constant dance of inter- The situation of a theatre-maker in a clinic doesnot differ so much from that of an ethnologist working within a I have changed all names of patients. The nextmorning, Iawokeanddidnotdareopenmy eyes. There wassomethingoppress- We chattedforawhile. Morewassharedafterthemeal. Iheardaboutpreviousworkasa — I wasafraid. 3 HadIlefthappilybecausewasabletostrollthroughthegate freely 2 acorpulent, friendlyelderlyman;Kurt, whoyelledoutthat Theatre in a Psychiatric Clinic 117

This open and process-oriented format is similar to the one proposed by EXA (Expressive-Arts Therapy) (see Kriz Kriz (see Therapy) (Expressive-Arts EXA by proposed one the to similar is format process-oriented and open This 2013:115–23). My work in the clinic is also work on myself. It’s important that I trust in those opposite me, me, It’s important that I trust in those opposite My work in the clinic is also work on myself. But emotion is an undependable partner that swings from happiness to suffering without from happiness to partner that swings is an undependable But emotion in on Sundays, preferably times per week, units one or two I visited the three on, From then trust of my new patients/col- to me how long it would take to gain the It soon became clear It would take time. already after two weeks I noticed that I Yet unsure. for I was too, And I would need time, Throughout the duration month after my first visit. The first theatre course took place one 4. Space for Play Space for Play The ceiling The clinic provided the room that was set up as an auditorium and used as a chapel. with three tall windows toward the green outdoors and well-lit was high and moderately sized,

but also fundamentally trust myself and my theatrical competence. As director, I provide the As director, theatrical competence. but also fundamentally trust myself and my able to dare to do something in the theatre course patients with the security they need to be change. that would contribute to concrete steps towards Rules Play Auditorium, Big in the from 3:00 to 5:00 p.m., Wednesday, The fixed workshop time was every and could could leave at any time, Everyone could play along, reliable rules. and had consistent, The condition of participation being absolutely voluntary lowered the threshold for the return. The format was open and process-oriented. but also created a helpful pre-selection. course, The Structure of the Theatre Course The Structure of the The effective means of temp- was temptation. The central element of my work at the clinic (c) exerting no pressure (b) playing along with the patients, tation are: (a) loving the patients, space and a special and (d) creating a special freedom as possible, allowing as much whatsoever, creating a In other words: of therapy and the clinic. atmosphere that differs from the everyday patients the that there is It dependable. and safe as experienced is which play, for space tempting me. could encounter each other and encounter reason, from satisfaction to malaise. Whether or not I felt comfortable shouldn’t play a role. shouldn’t play a not I felt comfortable Whether or satisfaction to malaise. from reason, brought chocolates and cig- I spoke with the nurses and patients, order to build up confidence. Swiss francs given to patients gold in light of the daily allowance of seven arettes (almost worth and established rela- theatre course, advertised for the costing 7.60), and a pack of the cheapest I was excluded from at first I felt a little like a leper. and came slowly, Trust tionships and trust. unless I was a doctor. They didn’t want to be approached, the society of the patients. I was in something new. even longer to convince them to participate laborators; it would take and only one was enthusiastic. conversations during the first evening, only able to have five only occurred because they Several interactions approached me herself. A female patient had bum a cigarette. could come to me to the clinic as someone who had been initiated; I offered I now stepped into entered differently. but just like slipping past, not too quiet, not too loud or pandering, exactly the right greeting, knowingly returned the greeting. and the patients someone in-the-know, in the with whom I had worked Daniella Franasek, of the course I was assisted by the actress MAXIM Theatre. rhythm of the group inside me, and the panic that I would land in a place like unit A3 where the A3 where like unit I would land in a place and the panic that the group inside me, rhythm of can’t go out anymore. but you be open, door might Downloaded from http://www.mitpressjournals.org/doi/pdf/10.1162/dram_a_00796 by guest on 29 September 2021 Downloaded from http://www.mitpressjournals.org/doi/pdf/10.1162/dram_a_00796 by guest on29 September 2021

118 Walter Pfaff dow openstoafantasythatisdeep andfulloflifeexperiencecoyness. Sheisfrom Bern, Bertha isanelderlywomanwith agentlevoiceandcalmmovements. Ifsheisdoingwell, awin- of seconds. satisfaction, andourplayingresumed. Hermoodschangefromcheerytoaggressive in amatter there, readytointervene. Sheonlybrieflyglancedoutthewindow, returnedtoherchairwith kill myselfnow!” andwalkedtowardsanopenwindow. Ididn’tbelievehercompletely, butsat repeatedly withloud, meaninterjections. Onedayshe yelled, “I can’ttakeitanymore!Ihaveto tossed aboutinaseaofpills, hercareerremainingbutadream. Shedisruptedthecourse Claire hadbeenattheconservatory;shewantedtobecomea pianist. For51yearsshe’sbeen aliens. uals, performedmostlyinhertinyroom. Shewrites longandartfulpoemsonthelifeof Maria triestore-establishcontactwiththemthehelpof elaborateandverypersonalrit- of aliens, whohadbeenleftbehindonearthwhenher kin departedintoouterspace. Signora to visitherintheclinic. Sheisconsideredanincurable case. Shebelievessheisachildoftribe on darklypaintedlips, apaleface, a Traviata whosehandonewouldliketokiss. Hersonrefuses dressed whenshewasdoingwell. Shewritespoemsin German andItalian. A Dostoyevskysmile band andherson. An entirefamilyalbumcenteredaroundher, abeautiful womanelegantly Signora Maria, whoseroomwasfullofphotosherfromlongago, withpicturesofherhus- was holdingonfast. Sheperiodicallyisunabletowalkbecauseofanoldinjury. why doIhavetosufferso, andnooneelse?” Shehadstoppedsmokingsixmonthsbeforeand “That wasgood, alcoholloosens,” shesaid. “Why doesithappentome, ofallpeople, why me, underneath that, “save myself.” Beforebeingcommitted, shedrankabottleofhardliquordaily. of ourearlyencountersinherunitshewrote “help, saveme,” onablankpieceofpaper, and Nora, ayoungwomanwithrosyfaceandsmallbrighteyesonanoversizedbody. Inone dramatis personaeoccasionallyenteredthefield: The membersofthetheatregrouprevolvedaroundasetcoreparticipants The Players emphasis oninteractingandinvigoratingsocialskills. placing trustinoneselfandtheothers. The improvisationconsistedofrole-playingwithan bodies andspace, oftimeandmovement, ofsimpleactionsandreactions, ofconcentrationand improvisation. Eachhaditsownkindofacting. The warm-upemphasizedtheperceptionof so Iconsideredamusicalsection. was informedbythenursesthatarelativelylargenumberofpatientsusedtoplayinstruments, was opentotheactors. Evenpeopleinwheelchairsorthosewhodidnotspeakwerewelcome. I central personally, whetherproblems, worries, orinsufficiencies(seeKriz2013:120–23). space-time ofactingtheindividual/patientcandistancehim-orherselffromwhatisotherwise a worldinwhichphysicalandsensualexperienceimaginationarefrontcenter. Inthe Whoever givesintoactingexperiencestheworlddifferentlythaneverydaylife. Oneenters My fundamentalmaxim: “What canbeseenonstagecannotpsychoanalyzedafterwards!” Play Actions on theotheryouareanactorinatheatre. part oftheauditoriumasourplayspace. Ononesideoftheropeyouareapatientinclinic, rope, weclearlyseparatedtheactingareafromeverydayspaceofclinicbycordoningoff semicircle. We putchocolate, chips, Coca-Cola, andsparklingwateronatable. Usingacolorful the Christiansymbolsfromwallsandmobilealtar;wearrangedchairsinanopen a pleasantwoodenfloor. Inamatterofminutes, DaniellaandIremovedtheofferingbox I dividedthetheatrecourseintotwoparts:firstwaswarm-up, andthesecond, In dialoguewiththedoctorsandheadsofnursing, itwasgenerallyagreedthateverything — but alsonew Theatre in a Psychiatric Clinic 119 that’s why I want to tell you what this is — so that you notice how many possibilities you have inside yourselves that —

With some players I was glad that I did not know their stories; I could take them as they were. some players With At the beginning of the course, we are a group with seven patients and Arthur the head group with seven patients and we are a At the beginning of the course, There are always a thousand reasons to not do ‘Why should I do it?’ might be thinking, “You Several patients were very much in their own world, the “wall around themselves,” which “wall around themselves,” the own world, Several patients were very much in their all about. This is a chance to, for once, do something very simple, slightly different from what do something very simple, for once, This is a chance to, all about. you otherwise do For exam- real possibilities that you can control very easily. Good, you don’t even know yet. to try out. something These are things you can play with, or speak. ple: the way that you walk, enough talk. Alright, and not the other way around. So that you tell your horse where to go, Let’s start!” nurse. My words of welcome had been carefully prepared: My words of welcome had been nurse. At least there is something to drink will be fun after all. But maybe I’m right and it something. intelligent You’re and cigarettes during the breaks. The Progression of the Theatre Course The Progression of the Day The First this, Despite the theatre course before it started. had determined the exact progression of We who don’t Our main concerns: patients first session. Daniella and I are very anxious before the or having no etc.), yelling, patients who dominate the session (speaking, want to participate, participants at all. Arthur repeatedly named as a symptom of schizophrenia, and which makes slipping off into and which makes slipping schizophrenia, Arthur repeatedly named as a symptom of very considered thought experiments for example, Luciano, one’s own world almost tangible. “the airplane with a good or “the crazy cliff diver,” He said and thought out loud. amusing, Perhaps we would not and gave us brief glimpses of parts of pictures that only he knew. grasp,” all of it. understand a picture even if we could see and sang a sad but beautiful song about Maidservant Verena on the Mountain of Guggis with a on the Mountain of Verena about Maidservant sad but beautiful song and sang a child’s voice. moving pure, sud- said psychopaths He and psychopaths. between psychos the difference Luciano explained are They never kill. But psychos before. seem crazier than a bloodbath but don’t denly cause “I’m a psycho.” just crazy. quietly and waves shyly and very He speaks very were from Cambodia. Thanh The parents of hesitantly. explaining that he wrote all the with his big blue incandescent eyes, Rino laughs at all times He songs of Lady Gaga. Coppola and composed the most successful films of Francis Ford Al Pacino and Dustin with and would tell you that he acted actor” “electric calls himself an Hoffmann. It is hard to guess difficult. Communication with her is occasionally Anka comes from Kosovo. because she simply cannot speak Does she not speak due to shyness or what she understands. was the most withdrawn of our play- most in the group could speak? She the language German, very secretly and she laughs, when Sometimes, single tooth in her mouth. She has only a ers. only to hide it again. a part of her soul, she shows quickly, between play and real- often could not differentiate workshop, unlike the others in the Kasper, taking the His laugh is ready and open, Again and again he asked me which ward I was from. ity. While play- somewhat sharp old farmer’s smile. jovial, slightest cause for cheer and showing his taking her role for reality. he fell in love with a character portrayed by Daniella, ing, tongue in his He has difficulties keeping his Ernst does not speak and has breathing problems. but at the moment he started dancing a waltz, He has been in the clinic for 20 years, mouth. way. His joy was demonstrated in a reserved playing reawakened memories of life outside. Downloaded from http://www.mitpressjournals.org/doi/pdf/10.1162/dram_a_00796 by guest on 29 September 2021 Downloaded from http://www.mitpressjournals.org/doi/pdf/10.1162/dram_a_00796 by guest on29 September 2021

120 Walter Pfaff able tolaughandplaymightalsobesurvive incandescent blueirisesthesepuppetslookintothewhitesofoureyes,theyarelaughing.Whoeveris howled. Couldhumanlifebeareduced,diminishedversionofthesepuppets’lives?Whenwiththeir and rupturedskullsbecamegleefullyknowing.Theyledmeintoazoneofbeingwhereaninsanetruth Wicki’s sculpturesofexcrescencesanddislocations,limbs joined“wrong,”offossilizedconvulsions, personas ofinnerlandscapesandprophetsfate.Allphotos©ChantalWicki. players, populatedbyunknowndevils,princesses,lovers,magicians,priests,popes,Buddhas,andfools: working onUnknownBeauties.Theseobjectstomebecameamirroroftheinnerworldsmypatients/ to investigatethesefields.AtthetimewhenIstartedworkingatKönigsfeldenclinicin2011,shewas within herworktheabyssesofpsychictransgressions.Since2010wetalkedalotaboutwhatitmeans Instead: How toillustrate“TheMiceWillPlay”?Photographsofmyworkshopswiththepatientsarenotpossible. Unknown BeautiesbyChantalWicki,aprodigiousSwissartistwhoforlongtimehasexplored High PriestessasMedusa Chantal Wicki’s UnknownBeauties — in oroutsidetheclinic. Pope Illuminated Temperance Angel Theatre in a Psychiatric Clinic 121 The Lunatic Devil Priestess

Magician Wondering Devil Gorgo Downloaded from http://www.mitpressjournals.org/doi/pdf/10.1162/dram_a_00796 by guest on 29 September 2021 Downloaded from http://www.mitpressjournals.org/doi/pdf/10.1162/dram_a_00796 by guest on29 September 2021

122 Walter Pfaff His gestureisagraphiccommentary onthedifficultiesofhisprofession. Itaketheindividual the stageandpracticesindividually. Arthur usesthechairasapillowandlies downonthefloor. patients tojoinheronstage. Daniellademonstrates, theneveryonepicksoutonechair thatison It ishelpfultohaveapro(Daniella) atmysidewhocaninitiateactionswitheaseandentice the already abletostartwiththesecond partby3:55. and chat. We arequicklybackup, evenClairewithhervarious abortedexits, sothatweare has tosmokegoesdowntwoflightsofstairstheyard. We stand intheyardsmallgroups of myclappingalsohelpsdeterminethemomentactivity. those nearthem, “Hello, howareyou?” The playersaresocial, changepartners, andtheaccent continue walkingthesecondtimeIclap. Inthesecondphase Iinvitethemtosaysomething I clap, everyoneissupposedtostandstill, lookaround, appreciatethespace, people, light, and after thisexercise. the feelingoftrulystandingonastage. Ernstisalreadyexhausted; hequietlyleavesthegroup comes fromtheothersidewithacountermovement. A momentlatereveryoneprobablyhas the backandthenwalkfromtofrontagain, ineightstepswithtwoaccents. Rino ories oftheideadancingobviouslydonotcorrespondwelltoactualsituation. waltz withme. Things arealreadymoving! The youngermenhavemoredifficulties, theirmem- clarinet, andmoveallthewaytodance. IwillneverforgethowanimatedErnstwasdancinga grate rhythm(veryslow, normal, quick), combinedwithstomping, combinedwithDaniella’s sists ofmanydifferentvariationsthatbuilduponeachother. Mygoal:tousewalking inte- repeat thedemonstration. all, wheretheactionsarenotregulatedbyrulesgoverningeverydaylifeinclinic. I the differentsides, rulesgoverningwhereyoulook, wheretheactionsareofinterest, andabove rope theeverydayspaceofclinic, ontheother, thespaceforplay. Differingrulesapplyon that Iwillhangacolorfulropeintheroom. Idemonstratetwospaces the theatrecoursewasthere.) entire clinic. Evenintheblue-velvetwalledlobbyofclinic’sdirectors, everyoneheardthat behind them. (Overtime, our “orchestra rehearsala” wouldbecometheloudesteventin everyone. Everyoneseemstoberelievedthattheirfirstindependentaction(participation)is with freevariationsdoestheexercisebecomesomewhatchaotic, butstillappearstobefunfor other onthethird. That alsoworks. The variationofsingle/doublealsoworksquitewell;only beats, whichworksverywell. Then Idividethegroup, onepartclappingonthefirstbeat, the already abletodosomethingtogether. First, everyoneclapswiththeaccentonfirstoffour utmost, aplaceofbirth. in thisnewsurroundingistoostrong, andnobodyriskstooffermorethananameatthe themselves byname. And whoeverwantsisinvitedtosaysomethingpersonal. Buttheinsecurity a timeofhischoosing). We beginwiththefirstroundofintroductions. Everyoneintroduces Luciano standsup, apologizespolitelyandleaves(hewouldcontinuetoleaveeachsessionat tinues toplay, unperturbed. The entirecoursewillbeaccompaniedbythesepseudo-departures. ing tothedoorwithherbagsfull, butthenturnsonherheelandreturnsbecauseDaniellacon- and beginstoplayfortwominutes. Clairecomplains(“Thattakesthecake”), standsup, walk- and quicklysaythatwewanttobegineverysessionwithmusic. Daniellaproducesherclarinet Now thefocusisoninteracting withrealobjects. A chair:Howmanywayscanonesit onit? The first45minutesarealreadyover. Thebreakseemstocomeattherighttime. Whoever We continuewithwalking. Nowtheaccentisonencounterbetween theplayers. When I attempttopracticewhatcouldbetheopeningnumberofamusical. The actorslineupin The nextexerciseshowstheyhaveunderstoodmyrules. “Walking” isontheagenda. Itcon- Then wecometothemostimportanteventofday:producingspaceforplay. Iannounce After theseintroductions, Istartwithasmall “clapping” exercise. Iwanttoknowifweare Next tome, Clairebeginstobabbleloudly. Inoticethatamlosingthegroup’sattention — on theonesideof Theatre in a Psychiatric Clinic 123 - in case someone still wants to say, in case someone still wants to say, —

The other players don’t want to participate yet. So we move to the exercise “walking with to the exercise So we move want to participate yet. The other players don’t I thank them for their courage and Everyone is excited. The street scene takes us to 4:45. goes to the back But then he gets up, the nerve. Thanh quietly tells me that he doesn’t have the patients leave us and Gradually chat a while. drink water, We I close the theatre session. He want to thank him for his participation. We After mealtime we go up to Ernst’s unit. grinning wildly. I am boisterously joyful, And so our theatre course began successfully. encounters.” One group of players stands on the right, the other on the left side of the stage the other on players stands on the right, One group of encounters.” one comes from the same time, at the the stage from the right and, One person crosses area. and several meetings with just After a rather quiet encounter the middle. They meet in left. - I explic on the margins of the stage. small scenes arise that continue are you,” “how and “hello” Daniella begins the improv by begging passersby itly introduce the location as a street and real street scene The passersby discuss the begging and a Longer sequences arise. for change. remains on the side of the stage until they are Whoever doesn’t want to participate develops. prepared to dare to cross over again. open at the end their ideas and say that the stage is always and each of them shares one after another goes up, my surprise, To share something. sing, do, Signora Maria recites a poem a high-pitched voice and fighting tears, With something personal. sits down on a chair and starts telling her med- Claire goes up, about the world of the aliens. this will go on endlessly and will bring down the lively From earlier visits I know ical history. her piano-playing, At the moment she touches upon I will have to interfere. mood of the group. a Beethoven sonata for four hands on an imag- I go onstage and propose that she and I play playing I immediately start playing in the way one may imagine a young pianist inary piano. and finally she starts to move her old then delighted, At first Claire is bewildered, Beethoven. of ful- I terminate the sonata with a crescendo and gnarled fingers on the imaginary keyboard. acting as a and Claire goes back to her seat, Everyone laughs and applauds, minating chords. prima donna. himself to the He throws “I’ll do it anyway!” and loudly proclaims, turns around, of the stage, The rest burst into wild applause. street dance. acrobatic and performs a short, ground, and I clean up. Daniella go back to their units on their own. Luciano Suddenly, Thanh. with Luciano and the shy but we get into a conversation isn’t there, virtuosic, He gets his guitar and begins to play Brahms, nod. We asks if he should get his guitar. later fetching a stand and music. He keeps on playing, even if far too quickly. very beautifully, Magda is dancing a wild, On the other side of the yard, He plays Spanish guitar pieces tirelessly. A3 says it’s the Evelyn the head nurse of join in. Gradually the nurses curiously youthful dance. first time Luciano has played since being admitted to the clinic some two years before. — Subsequent Developments Progress cur evaluate the outcome of the we compare our notes on the sessions, by week, Week our planning for the next session accordingly. and adjust rent session with the unit heads, ways of sitting as a starting point for actions. We clear off the stage, and everyone takes a seat in takes and everyone off the stage, clear We for actions. as a starting point ways of sitting join Others position. “their” and assumes their chair to the stage Someone takes the audience. scene in which the space Daniella develops a with Rino, Together arises. An improvisation in. in the Rino sees angels appearing and talk about the weather, They mountainside. is an alpine soon starts it a raincloud, Rino invents chilly. Daniella becomes three minutes, After clouds. on Maria sits down Signora In the next scene, directions. and both run off in different raining, her chair as a burdensome legacy Daniella drags pulled up to her chest. her chair with her knees a conversation about how sitting Out of this arises and sits down on it. from her grandmother They drift closer and farther what kind of sitting is good for you. and the soul are connected, Daniella Ever alert, her soul. suddenly states that Daniella has stolen till Signora Maria apart, The scene her soul is now empty. Signora Maria states gives her soul back. invents an action and the colored rope. The two women embrace and climb over is over. Downloaded from http://www.mitpressjournals.org/doi/pdf/10.1162/dram_a_00796 by guest on 29 September 2021 Downloaded from http://www.mitpressjournals.org/doi/pdf/10.1162/dram_a_00796 by guest on29 September 2021

124 Walter Pfaff avoid passivelygivingintoillness andmisfortune. The patientsassumedresponsibility forthe taking onthischallenge. relation toformandexecution. Thanks totheirnewlygainedself-confidence, theynowenjoyed with theseconflictingdemands. wouldn’t bebored. Although wehadexpectedagreat deal offluctuation, itwasn’teasytocope had to take place in such a manner that new players could easily find a way in, and the old hands ture oftheclinicchangedfromapublicinstitutiontoprivate corporation. The coursealways institutions. Inaddition, theparticipantsfromlong-term unitswereparedawayasthestruc- joy butoursorrow, individualpatientslefttheclinic inordertomoveintosmallerpsychiatric participate inhisownway. were fewerthanthreepatientparticipants. Hewaspleasedand seemedrelievedtobeable that Iwouldn’tcajolehimtoparticipateanymore, andthathe couldgoimmediatelyifthere ally pickingthemupfromtheirroomsandbringingback afterward. Ipromised Thanh ble tocarryoutthecoursevigorously. explained tohimhowconcrete, specific, andeffectivehisreactionshadappearedtome. theatre tome. Thanh laterclarifieshehadfeltalittleuncomfortableandhadn’tactedatall. I ing asinglewordandremainingsteelywithdrawn. Fromtheoutside, thisseemslikegreat and finallyevenwithquietwords. Hewavesheroff, saying “no” byshakinghishead, notspeak- begins asilentsceneinwhichsheconstantlyapproacheshimwithshyglances, hintedgestures, on the “barstool” nexttohimthewholetime, hishatpulleddownlowoverface. Daniella little girlwithDaniella. Finally, heleavesthestage, staggeringdrunkenly. Thanh sitsmotionless he doesn’twanttotakeherhome. Hesayshehasagirlathome. No, hedoesn’twanttohavea doesn’t letherstayathisplace. Shebuyshimlotsofwhiskey;hedrinks, butremainsfirm:no, tures. Daniellamakesitclearthatshedoesn’thaveapassportandwillbelostinthecityifRino me sitonchairs. All ofthemspeakdifferentlanguagesandcanonlycommunicatewithges- participate withouthavingtobecomeactive:Iamthebartenderandthreeguestsinfrontof to participate. Forthesecondexercise, weestablishthatareinabar, and Thanh isableto other threeimitatetheactionlikeanecho. Thanh isactive, evenifhesaiddidnotwant feet. We formacircle, andonepersongoesintothemiddlewitharhythmicbodilyaction. The stant beat. Daniellabeginswiththe “musical” exercise, duringwhichtherhythmiskeptwith persistently rejectseveryvariation. Iremindhimhowimportantitisthatsomeoneholdsacon- ipates theentiretimeandclapsoutbaserhythmwithgreatenduranceprecision, but then theirownbodies, finallythesaxophone(Daniella)andpatients’voices. Thanhpartic- complex improvisations:double, triple, syncopation. Firstthechairsareusedassoundboxes, these “orchestra rehearsals” oneofthetwokeepsa4/4rhythm, theothertriesoutincreasingly ance ofacting. We startwithclapping, withthegoalofbecomingaminusculeorchestra. For does anyway. With suchasmall groupIhavetofindabeginningthatdoesn’ttheappear had envisioned. Moreover, Thanh stateshewantstowatchinsteadofparticipate, althoughhe had beendistractedbysomethingalongtheway. We can’tcarrythroughwiththeprogramwe very generouswiththeircontributionandjustgivesuswater. status symbol, justasdesiredintheclinicMarlborocigarettes. The managementhasn’tbeen enriching element. The manyexercisesremainsimilar, butprogressissteadyaseverytimeweaddanewand Through theiracting, the patientsengagedindecision-makingandexpressedtheirwill to Step bystep, encouraging personalabilities, Islowlyputmoredemandsontheactors in A firmcircleofninetheatreplayerswasestablished. Inthe course ofthreemonths, totheir We continuedtowooourplayers, remindingthemeachtimeofthenextsession, occasion- This exampleshowedthatevenwithatinycastofcharactersandmodestcourage, itispossi- For thesecondsession, only Thanh andRinoshowup. Apparently, Ernstlefthisunitbut I bringalongsweetsanddrinkstogetthingsstartedforthesecondsession. Coca-Colaisa - Theatre in a Psychiatric Clinic 125 of play, of play, — is.” — only

8 November: “Today the notion that even the maniacs are getting a bit of a yawn.” “Today 8 November: They were important for observing the develop- I did not censor myself in these reports. were and behaviors role suggestions, games, Gradually I was able to note which exercises, a vase of three chairs around a table, a sofa, produce a residential unit: three chairs as We THE the exercise each of the people living in we establish that for In another session, - the patients’ reac the sequence, recording each session, a precise report after I composed at my own image in not almost the long and exploratory looking “Is it 29 September: looking at the me the openness and the strength for a deepened the mirror that gives one has to not only not dis- in order to understand difference if, [...] I wonder patients. it.” but try to become miss it, still wet from rain, the leaves on the ground as I left the clinic, just “Today, 10 October: pain but from a kind of inner not from physical sometimes I suffered, that the experience, leaving the and that today, always concealed this sickness from myself; and that I sickness, I am really sick [...].” I tend to say: clinic, that move inside my All the dead of Signora Maria: the improvisation “After 1 November: What the improvi- even past. It is not the past is never dead. right, players! Faulkner was There is no such thing as was me: sation of Maria teaches ment of the work, reflecting on it, and steering it. steering it. and reflecting on it, ment of the work, Only in this or reinvented. replaced, had to be adjusted, and which ones productive and why, what how the topics of the improvisations arose, for instance, way was I able to recognize, Only and so on. how they developed, which inhibitions they encountered, course they followed, it became clear Soon liberation for the play instinct. in this way was I able to follow the path of not just practice. produce theatre, that many of the participants wanted to really Structure The Narrative THE HOUSE: an I invent For the central narrative structure, we needed a story. Therefore, pick an apart- Every participant can eight apartments. apartment building with four stories and with her son has lived there for instance, Luana, ment and create a character who lives there. years prior. moved in with her partner just three the barmaid, Baby Blue, Fabio for 20 years. heels make Her high until early in the morning. She drives a Jaguar and never returns home Vreneli’s hus- There’s a fight. Enzensberger’s very ill man cannot sleep. such a racket that Ms. hand- The young, there with her cat since then. band died 10 years before; she has been living and loud music, he disturbs the others with his visitors, Unfortunately, some Jason is new here. car doors slamming shut. None of the participants have difficulty regarding and four glasses. a bottle of cola, flowers, Small visiting Now there are visitors expected. the sparse furnishings as their own apartment. Even if scenes pop up here and there: four women chatter about the gallant Jason over coffee. is already a part of the others’ acting and contin- his character Jason himself doesn’t play along, ues to develop. there Once again, “when I was six years old...” HOUSE is supposed to respond to the prompt and I realize that we have entered the world of theatre moving scenes, are dynamic, tions, and my own experiences, thoughts, and feelings. I quote from a few of these: I quote from and feelings. thoughts, my own experiences, and tions, All the participants remain true to their characters; all are drawn to each fiction. the stage, fondness and With is created and maintained. a place, a story, The coherence of a topic, other. The improvisations are very realis- they were well. the patients remember a time when detail, and relaying these experiences is the true goal of Finding tic and rich in dynamic experiences. acting and their fellow actors. My task was to put the chain of play actions into motion and keep into motion and keep chain of play actions My task was to put the their fellow actors. acting and - to act and could redis their own ability found or developed till the patients had them moving playing. cover joy in Downloaded from http://www.mitpressjournals.org/doi/pdf/10.1162/dram_a_00796 by guest on 29 September 2021 Downloaded from http://www.mitpressjournals.org/doi/pdf/10.1162/dram_a_00796 by guest on29 September 2021

126 Walter Pfaff walks quietlyandcalmlybacktoherseat. This isclearly theatre, yetatthesametime, asanalco her aninjection. Noraasksagain, “Do Ievenwant tobefree?” Sheendstheimprovisationand free?” Noraasks, againandagain. Shebegins toweep. Then Berthagetsherthedrugsandgives have anydope. “Do withoutthedrugs,” sheimplores, “then you’llbefree.” “But doIwanttobe therapy. ButNoraisstubborn. Sheneedsithereand now. Berthafindsasyringe, butstilldoesn’t at herwit’send;sheabsolutelyneedsashot. Berthasuggests shegoformethadonereplacement Bertha approachesandsitsnexttoher. “There aren’tanysyringeslefthere,” shereplies. Norais down attheground. “Where ishe, where ishe?” shesaysagainandagain. Impressive, moving. in theprocessofcreatingasafeactingspace. the performativespaceinwhichtheycouldexpressthemselves, approacheachother, andshare ing thebetwixtandbetweenthatistheatre. With that, DaniellaandIhelpedthepatientscreate doctors. Ionlyhadtoensurethecontinuationofopportunityexplorethroughtheiract- not directlyspeakaboutthesepersonalthingsasdirector. That wasforthetherapistsand and aftertheclinicwerereflectedinscenestheyplayed. FormeitseemedimportantthatI saw howthepersonalstories, dramas, tragedies, questions, andexperiencesoftheplayersbefore the improvexercisesbutapparentlyconfusedbyactionsofothers. MuchmoreoftenI orders forpsychotropicdrugs, butnotonewarmwordofcomfort. bonbons, oranges, bananas, bagsofsweets). The patientsperformedthedoctor’scold-hearted and aheftysprinklingofmassespills(withwhateverwashandy:peanuts, chips, chocolate medicinal arts, whichtheyweresubjectedtoatleastonceperweek, withimploringtouches standard versionsofthissuper-figure. Thepatientsexpressedtheiropinionsaboutthedoctor’s Everyone absolutelywantedtoplaytheroleofdoctor. Magiciansandpillpusherswere the of resistance. The mostpopularimprovisedscenewascalled “Visiting HourswiththeDoctor.” patients couldexposetheabsurdityofrulesamongthemselvesthroughacting Although theywerenotabletodefendthemselvesagainsttheorganizationofclinic, the tors’ habitsperfectlyintheworkshop. Itwasapopularsourceoflaughterandamusement. observed everymovementofthedoctorswhodeterminedtheirfate, andtheyimitatedthedoc- difficult asmakingpeacewithdeath. everyday challenge, notanabstractmedicaldebate. Ibelievethatlivinginthecliniccanbeas in aswelloutsidetheclinic. playfully enactedrealityisexpressedinactionsthatbuildontheabilitiesnecessaryforsurvival realization thattheactinginclinicisnotseparatefromrealityclinic. Rather, the was tofulfillanumberoffunctionsthatwouldbeusefulinreallife. Theresolutionliesinthe it wasintendedtohelppatientsbereleasedfromrealityinvariousways;ontheotherhand, it Two contraryassumptionsmadeourworkintheclinicappearveryconfusing:ononehand, Observations attempt torepeatasaccuratelypossiblethefollowingweek. the course:connectinginteriorandexteriorworlds. This isalsothefirstimprovisationIdare THE HOUSE, shehadplayedBabyBlue, thebartender. holic, Norahadlandedattheclinic’smostsevereunit, thedrying-outunit. Intheimprovisation In theacting, therewerenohierarchies; beingplayerstogethershiftedtheboundaries. Later, in acting. Howdidthistrust arise?Everyonebecamenotjustaplayerbutalsosourceof stories. the furthertheywent. They quicklybegantotrusttheircapabilities, living uptothedemandsof much. Butsoonweunderstood: themorewesubjectedthemto, thebetterthey understood, and Rarely didapatientfailtorecognizethedifferencebetweentheatreandlife, participatingin The actingspacebecamealaboratoryforthepatients. Intheirdailylives, thepatients For theresidents, dealingwiththedespairoflivinginclinicisatorturousanddifficult In thebeginning, weapproached theplayerscarefully, notwantingtosubjectthem totoo In oneimprovisationduring THE HOUSEsessions, Nora sitsonachair, sideways, staring — a subtleact - Theatre in a Psychiatric Clinic 127 - as if they are — never a fight about which televi- — but no link. Only just jumping back and forth. No pos- Only just jumping back and forth. but no link. — sick town and healthy town

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But the playing space does not belong to one of the two spaces divided by a wall. While one of the two spaces divided by a wall. But the playing space does not belong to I about how good at acting our patients were. Daniella and I were repeatedly enthused “play in a The enormous social competence of the patients was demonstrated particularly in by per I’m suddenly standing in front of a dizzying image: life in the clinic is determined This horizon of possibilities, which I felt for myself, was only evident in the patients while was only which I felt for myself, This horizon of possibilities, from the normal world by a wall The patients said that they are separated sibilities for expanding one’s behavior to accommodate both worlds. sibilities for expanding one’s behavior to come from the players can stay on their side of the wall and still try things out that playing, becomes permeable during the period of acting. The wall memories from beyond the wall. “we share a world when we play.” Daniella said their ways of expressing themselves in the clinic asked myself if a large part of their lives and the patients It is notable how competent couldn’t also be a sophisticated game of self-depiction. in the clinic were in organizing their social lives together and a completely never disputes about the distribution of food, sion program should be on, There were exceptions: sometimes someone yelled and careful avoidance of individuals’ crises. As a whole it like a fully automated ecstatic response. then everyone immediately yelled along, into life in the clinic with a high degree of sophisti- appeared as if each one of them had settled and quietly Many rejected every kind of therapy, holding fast to the comforts provided. cation, by König Max who had spent 44 dignified years as demonstrated lived on with full hotel service, in his deck chair. to look for circle”: a participant moves to take another person’s place and that person then has In order for the concept and remained seated. Several players didn’t understand a new place. the displaced person is led by her fellow players, the action has to continue; the game to work, This support was demonstrated in who gently grab her by the shoulders and help her relocate. The players helped each other and showed a great all the improvisations and acting exercises. They in the clinic. “stage hogs” There were no deal of interest in the roles of the other players. seldomly expressed their impatience with the others. and only accepted personal limitations, they were acting, seldom during my Sunday visits to the clinic. When the patients acted, they When the patients acted, during my Sunday visits to the clinic. seldom they were acting, concentration and composure, demonstrated equally by exuberance and which was changed, up against at most, The sating of this hunger was, what they hungered for. That’s abandonment. a part of schizophrenia? Or does Is this fear of fear. form, In its extreme something like fear. isn’t like others? It was clearly demonstrated: only the the fear come when one notices that one most courageous came to the theatre course. I always left the clinic happy and excited by the sincerity, vitality, and passion of the players and passion of the players vitality, happy and excited by the sincerity, I always left the clinic each week following a session. The pleasure lasted through scenes. and the strength of their with the schizophrenic peo- It was as if the exchange it again and again. Daniella also described important for a society to have Perhaps it is even healing effect on us. ple had a therapeutic, the something unfolded in me, When playing together, people. ill” “mentally contact with and the relative lessening of possibilities of what a person can become, expanded horizon of fears and depression. Inner Experiences Inner Experiences It is easy for them to and feelings. actions, rituals, behind this wall with all their thoughts, beyond the but they don’t understand the rules them, accept other patients and get along with as if there are two It is are different. “over there” They appear to be sure that the people wall. worlds another clinic, a head doctor participated in my theatre course with her patients. In that course, course, In that patients. course with her participated in my theatre a head doctor another clinic, in the back After acting, various characters. and the names of “you” each other they all called her formal title. to be addressed with that the doctor had clear to everyone it was clinic proper, formance, by how a patient learns to perform according to the rules of the clinic, and with our according to the rules of the clinic, by how a patient learns to perform formance, Downloaded from http://www.mitpressjournals.org/doi/pdf/10.1162/dram_a_00796 by guest on 29 September 2021 Downloaded from http://www.mitpressjournals.org/doi/pdf/10.1162/dram_a_00796 by guest on29 September 2021

128 Walter Pfaff phrenic peoplehaveincommon?Iwasn’tabletofindanyexternal, observablesymptomsexcept “quiet” existence, withoutthefrightofeverydaylifeoutside. and irreversibleinclusioninthe “Hotel oftheInsane.” Insidetheclinic, theyweresecureina societal mechanismsthathadpreviouslyledtotheirexclusion, butwhichnowdefinetheirsure Precisely andaccuratelycalculatingtheirmoves, theplayers-patientsimplementexactly and, moreseriously, mad, insane, demented, outofone’smind” (Greenberg[1964]2009:43). except insecret, aseccentricandstrange, freedomwastobecrazy, bats, nuts, loony, freedom-by-means-of-performance: “To thosewhohadneverdaredtothinkofthemselves, being outofone’smindwereappreciatedbytheaudience “inmates” asmomentsofashared by offeringotherscertainverydramaticperformances great theatre, thetheatreofeverydaycliniclife, inwhichthetalentedplayersprotectthemselves framework tointerpretevents, usingtheirownintelligence. ButsuddenlyIfindmyselfina independent tosomeextentfrommyactions. Insocialreality, everyoneadjuststoashared the beginning, Inoticedthatalltheplayershadaspecialkindofintelligencemadethem tions receiver. Itmovedfromanopeningtowardstheoutsideworld in aspecialtimeandplace. theatre coursewearejustakindoffocalpointwherestageandaudienceexplicitlydelivered cover ofthediagnosisschizophrenia. Exceptperhapsapowerfulloneliness. that thisfeelingwasonlybasedinmyfears. Inthisway, therewerenocommonalitiesunderthe expression Iwouldencounternext. Butthelongertheatrecourselasted, thecleareritbecame this room of individual behaviors, at any time, and that I never knew where I was and what human unpredictability. Formeitappearedthateverythingcouldhappeninthisgroup, inthisplace, in those thattracedbacktomedication(seeBrendler2015). Together theygavemethefeelingof clinic clinic. We saidgoodbyeinthepark wetfromsleet, standinginfrontofthegatesto o became reacquainted. The shy Thomas askedifhecould requestsomething. Hewantedaphoto Cordon Bleuwithfries. The restaurantwasfamousfor it. able tochoosefromthemenuthemselves. Nevertheless, wealmostallchosethesamething. had dressednicelyandallseemedtobehappyleavetheclinic. They weredelightedtobe theatre course. (We wereaccompaniedbytwoheadnursesandoneclinic director.) Everyone clinic andwenttogethertoarestaurant, agreatprivilegegranted tothosewhohadfollowedthe already lefttheclinicandtheatrecourse. All were happy toseeoneanother. We metinthe At theendofpilotprojectweinvitedallplayersto a meal, eventhepatientswhohad Venturing Outside:OurFarewell Dinner exposed. and wall —alone It alwaysallowsentryandperhapsitmitigatesthefearofbeingcompletelyalonebeyond petence ofthecommitted. The clanofschizophrenicsisalwayspresent, evenifitisscattered. ity foroneanother. OnlythroughthisbelongingcouldIgraduallyexplainthehigh socialcom- no onevoluntarilywantstobelongthis “clan” behindclinicwalls, thoseaffectedfeelanaffin- own world. relaxed evening, evenifit repeatedlyoccurredthatsomeonebrieflydisappearedinto his orher offer anythingspectacular. A picture, ameal together. Nomore wasneeded. We hadavery her. “If itwouldbepossible...” Forme, thisbriefmomentstoodforthewholeevening. We didn’t f Daniellaandme. Daniellaaskedhimifhewantedtobe inthepicture. Then hebeamedat After everyvisittotheclinicIwasleftwithapersistentquestion:whatdoalltheseschizo- For mycomprehensionofplay, thiswouldmeanthatplayingchangeditscounterpart/ One byone, thepatients bidfarewell. Then weaccompaniedthelastofthem to the We hadreservedaroomintheback. A livelyconversationquickly developed, andwe Belonging arisesfromboundaries, whetherself-createdordeterminedbyothers. Evenwhen — — back towardstheplayfor “other inmates,” thedoctorsandclinicpersonnel. From already locked! How beautifulthiseveninghad been! — for show. Believed-inperformancesof — that is, fromsocietalconnec- Theatre in a Psychiatric Clinic 129 - - - was my fundamental maxim that “what can be maxim that was my fundamental 5 The downside of this decision was (and is) that the clinics up decision was (and is) that the clinics up The downside of this 6

For a discussion of the different forms and methods, see Petzold (1982). Petzold see methods, and forms different the of discussion a For in Buffa Opera theatre amateur with the Winska Katarzynaof work the is concept my to related Distantly clinic, the at work my to contrast In schizophrenics. as diagnosed outpatients are players Her Poland. Warsaw, artistic producing at performances aims presentations. public for Buffa Opera The strong interest by university clinics in other Swiss locations (Bern, Basel, Geneva, Geneva, Basel, other Swiss locations (Bern, The strong interest by university clinics in seems best suited for “playing theatre in the clinic” My research and experience indicate that it can be asserted that the theatre Based on my work in Swiss clinics between 2011 and 2014, What distinguished my approach most clearly from existing therapeutic forms like theatre approach most clearly from existing therapeutic What distinguished my 5. 6. to now cannot have health insurance cover my work. Therefore, I have situated my upcoming Therefore, insurance cover my work. to now cannot have health for schizophrenic migrants I prepared a theatre course side of research. projects more on the Psychiatry section of the Clinic for Psychiatry Transcultural within the not fluent in German Head Ulrike Kluge was the (Dr. the Charité Medical University in Berlin and Psychotherapy at Ming Yang PhD students at a presentation I gave for the nursing And following of Section). College Joel Stocker of the with Dr. I began to discuss a project in 2015, Taipei University in researching possibilities for an improvisation- of Medicine at National Cheng Kung University, Alzheimer’s care. related theatre course program for course under my direction at the Zurich Rheinau) led to the development of a masters-level department led the theatre courses at three differ Students in the theatre Arts. Academy of the patients taking me for another patient I participated incognito, ent clinics for six months. a profes- Some of the students later continued to work on (everyone else knew who I was). to patients, I distributed questionnaires After every course, sional level at their respective clinics. The results were analyzed and discussed under super and the course leaders. doctors, nurses, Applied psychology of the Zurich University of vision of a professor of the department of the results have Aside from this article, and the methods adjusted as needed. Sciences (ZAHW), not been published. The duration of like the Clinic in Königsfelden. use in outpatient or prolonged-care settings and trust has to The participants need plenty of time, the course should be at least six months. Despite the desired and digest something new. grasp, develop in order for them to open up to, is made known to “exceptional character” course’s it needs to be assured that the continuity, it is impor Furthermore, Each course has to find its balance in this contradiction. the patients. as from the therapy at the clinic; in other words, tant that the theatre course take place separate need to have preferably a man and a woman, leaders, The course a purely recreational program. This loved. desired, get the feeling of being invited, The players should theatrical competence. schedule. It is essential that the location and times follow a rigid is the work of good leadership. their every- And the course leader should also get to know the players outside of the theatre in day clinic lives by visiting them regularly. experiment, They learned to improvise, courses became a laboratory of roles for the patients. They were able to express their subjective interior worlds and confront and test out new selves. The playing space became a safe space of possibilities in which the external reality of the clinic.

What had started as a pilot project at the Königsfelden Clinic in 2011 based on my theoretical on my theoretical Clinic in 2011 based at the Königsfelden started as a pilot project What had clinic (management, evaluation by the the positive project had developed through assumptions in clinical settings theatre program into a new non-therapy and patients) staff, nursing doctors, field of arts therapy. entered the expanding and thus had or therapeutic theatre, drama therapy, therapy, Final Considerations seen onstage will not be psychoanalyzed afterwards!” As a theatre-maker, I declared my work I declared my As a theatre-maker, be psychoanalyzed afterwards!” seen onstage will not reaching out to those long-term thus entertainment for the patients, in the clinic to be purely therapy. patients who often resist Downloaded from http://www.mitpressjournals.org/doi/pdf/10.1162/dram_a_00796 by guest on 29 September 2021 Downloaded from http://www.mitpressjournals.org/doi/pdf/10.1162/dram_a_00796 by guest on29 September 2021

130 Walter Pfaff clinic. Whoever isabletolaughandplaymightalsobesurviveinoroutsidetheclinic. playing togetherbecamemoreandofanexperimentforimagineddeparturefromthe weakened groupoflong-termpsychiatricpatientsstrengthenedtheirself-respect. Gradually, threatening worldoftheclinic, aconcretelifeinthehereandnowaswellforafterwards. was notanescapefromreality;rather, theworkshopsenabledpatientstoreimagine, withinthe an imaginarycircleofpeoplewholednormallivesthathadnothingtodowiththeclinic. This riences andhardships, andcouldrequestadvicesupport. They surroundedthemselveswith speechless impotencedestroyedwiththepowerofwords. fragments ofrealityintheclinic. Frighteningsituationsweredisarmedwithsharedlaughter, patient’s owninteriorworldandtheworldsofothers. theatre andremaininplay. Inthisway, playingformedadelicatebutreliablebridgebetween and ideas, whichwereunderstoodasdysfunctionalintheoutsideworld, couldinvigoratethe reality oftheclinicwasexpanded. As players, thepatientsexperiencedhowtheirinteriorimages must besomethingwhichcantermedSenseofPossibility” [mytranslation]). The normal “If thereexistsSenseofReality, andnobodywilldoubtthatithasarighttoexist, thenthere hat, dannmussesauchetwasgeben, dasmanMöglichkeitssinnnennenkann” ([1943]2001:16; es aber Wirklichkeitssinn gibt, undniemandwirdbezweifeln, dasserseineDaseinsberechtigung them whatIwouldliketocall, inkeepingwithRobertMusil, the “sense ofpossibility”: “Wenn life experiences. The playersnotonlyexperiencedtheirownactingabilitiesbutgrewwithin they wereabletoactuallyrehearsetheirideasandexplorerolesfromthetreasurechestof Winnicott, D.W. 2005. Playing andReality. London:Routledge. Turner, Victor. (1982)1995. Vom Ritualzum desmenschlichenTheater: DerErnst Spiels. Trans. SylviaM. Pfaff, Walter.2010.und Theater.” “Migration In Petzold, Hilarion, ed. 1982. Dramatische Therapie: Neue Wege derBehandlung durch Psychodrama, Rollenspiel, Musil, Robert. (1943)2001. DerMannohneEigenschaften. Hamburg:Rororo. Kriz,Jürgen.2013.Künstlerischer Therapien “ZurWirkungsweise Greenberg, Joanne. (1964)2009. INever Promised You aRoseGarden. New York: St. Martin’s Press. Goffman, Erving. 1961. Asylums: Essays ontheSocialSituationofMentalPatients andOtherInmates.Garden Brendler, Michael. 2015. “Was heisstschonschizophren.” FrankfurterWissenschaftZeitung , Allgemeine Angell, Marcia. 2011. “The EpidemicofMentalIllness: Why?” The New York ReviewofBooks, 23June. References At play, thepatientsretainedtheirhumanityandself-esteem. The stigmatizedand In theimprovisationsplayersimaginedfriendswithwhomtheycoulddiscusstheirexpe- In thisprocessofstrengtheningtheabilitiestoplay, thepatientsbegantorecreatewispsand Schomburg-Scherff. Frankfurt: Fischer. um dieEcke. Therapeutisches Theater. Stuttgart:Hippokrates Verlag. und AusdruckstherapienKunst- , ed. Wulf RösslerandBirgitMatter, 115–24. Stuttgart:Kohlhammer. City,NY: Anchor. 30 August. Accessed 26July2018. www.faz.net/-hrb-879g6/. Accessed 1July2018. www.nybooks.com/articles/2011/06/23/epidemic-mental-illness-why/. Kult Aussersihl, ed. SilvioBaviera, 311–26. Zürich: Verlag — systemisch-integrative Aspekte.”In