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 schizo- phrenic disorder patients. Since 2005, I have been pursuing the question of how theatrical processes can be imple- mented 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 peo- ple 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 act- ing 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] TDR: The Drama Review 62:4 (T240) Winter 2018. ©2018 New York University and the Massachusetts Institute of Technology 113 Downloaded from http://www.mitpressjournals.org/doi/pdf/10.1162/dram_a_00796 by guest on 29 September 2021 methods help psychologically ill people restore their ability to take action? Will their learned ability to act in a theatrical setting lead to new actions, new knowledge, and new life perspec- tives? I wanted to know whether the people who participate in acting also resume participation in broader society and its culture. The pilot project took place in 2011 in the Psychiatric Clinic Königsfelden with long- term schizophrenic patients. To my surprise, as work started, a further question dramatically emerged: where is the boundary between those confined to the clinic and those who can go home each evening, between the ill and the seemingly healthy? Over the course of the proj- ect, as I shifted back and forth between the two areas, I noticed a sustained cheeriness on my part. This mood emerged from an inner laughter about the comedy of the world and its way of judging. It rested upon the joy of knowing how the boundary can be jumped over, back and forth, and that jovial play is possible on this side as well as that. It rested upon the universals of health, which even people who had been labeled “sick” could celebrate, having sprouted from the magic of play. Play Instinct Anthropologist Victor Turner ([1982] 1995:163–65) illuminated the application of the concept of play in technology and gave me an important clue. A piston, for instance, has and needs some play in the cylinder. In other words, play is the clearance that makes the movement of one ele- ment with another or against another possible. It mediates between them. Only the free inter- mediary space enables the functioning of the elements. The piston would get stuck without this play. The technical application of the concept reveals the precise value of the intermediary space in human actions, and this is what I used as space for play in the clinic. This space is neither interior, as in the world of dreams, hallucinations, and fantasies; nor exterior, as in the world of hard facts beyond one’s control. The child psychiatrist and psychoanalyst D.W. Winnicott fit- tingly called this a “potential space” (2005:129). Societal experience and the experiences of playing in a potential space lie between the indi- vidual and others. Our oscillation between these two poles is a constant in our lives. The play instinct stages life as a creative act and experience in time and space. Playing connects the past as cultural experience with the present as a place of action and the future as the field of what is possible societally. In the clinic we use the social and interactive effect of play to join the imagined world with the world of facts. The adjectives “light” and “variable” belong to play; its quality is movement. Play is the prancing between the worlds of the interior and exterior. One disturbance of the play instinct is an inhibition of this movement. This disturbance is expressed as freezing, stiffen- ing, and being fixed in one of the two worlds. Some depressed people are so trapped in an exte- rior gray reality, experienced as constraint, that they lose access to the interior world of fantasy and dreams. Schizophrenic people tend to be fixated on the interior world, their sense of out- side reality weak. Doctors try to categorize as symptoms any of the patient’s actions that deviate from the field of what is considered normal. As a theatre director, I conceive of these non- normative actions as unique shapings (disorders) of the ludic drive in action and look for a way to return the patient’s activity to its original space and purpose, reanimating the patient’s origi- nal ability to play. In my view theatre is the best instrument to reach this goal. Of course, the term “theatre” is problematic in this medical context because it provokes con- ventional/ready-made cultural associations that to some extent run contrary to the kind of play instinct I am using here. However, I will keep the term because it immediately emphasizes the element of embodiment and excludes competitive or aleatoric kinds of playing. The focus is on play, not games. In the theatre course I offer in the clinic we do not say “sit down and we’ll play for your entertainment,” but rather “stand up, we’re going to play together!” Walter Pfaff Walter 114 Downloaded from http://www.mitpressjournals.org/doi/pdf/10.1162/dram_a_00796 by guest on 29 September 2021 This is the method of playacting/theatrical praxis I developed in my work with migrants during my tenure as director of the MAXIM Theatre in Zurich from 2005 to 2010 (see Pfaff 2010). The setting for the work in the clinic had to be built in a way that would be open for the diverse and very individualized expressions of the actors. Every actor had to be able to pursue her/his respective needs and be as free and unconstrained as possible on the path to a state in which joy in playing could help the actor find a creative connection to the world. Approaching the Clinic Directors, Care Givers, and Patients The Essence of a Clinic A psychiatric clinic is an institution in which all aspect of patients’ lives are consolidated and cut off from the outside world. Accommodations, work, pleasure, friends — all separate in normal life — coalesce (or disappear) when patients are institutionalized. The patients’ entire lives take place exclusively in one space — the clinic; under one authority — the leadership of the clinic; and with the same people — the fellow patients. Everything that is done is done to reach the official goals of the clinic (see Goffman 1961:41–80). The barrier the clinic sets up between patients and the outside environment cuts them off from their previously diverse roles. These various possibilities that once formed their lives dis- appear. Some patients become afraid of the outside because they notice that certain roles have been lost to them forever. They have lost parts of the apparatus of identity; they may have even forgotten how to present their biographically obtained self-image. Patients experience this restriction, obstruction, and eradication of their self-image as humiliation and degradation — in short, as a personal catastrophe about which nothing can be done. But also, as soon as patients enter the clinic, they begin to participate in its life. Patients orient themselves to the situation. They adapt to the clinic and therefore to the image the clinic has of them. The fact that a theatre director would start working in a psychiatric clinic seems doubly obvious: the knowledge of the forms of human play can be useful for patients, and, since early in Western culture at least, in the Greek tragedies, extreme expressions of human life have taken place in the theatre.