Care and Control

An Education in Silence – Peter Cross

Rear Window Publications
1995 ISBN: 0 9521040 3 2

© Peter Cross

In 1972, I made a very symbolic suicide attempt, which resulted in an 11-month stay at the Maudsley Psychiatric Hospital in South London. My late adolescent crisis, expensively serviced by psychoanalysis, drugs, University, eight years at public school, and the Ortonesque gay scene of London in the sixties, exploded in the grim reality of a vast psychiatric institution.

We studied de Sade, Artaud, Rimbaud, Freud; tried drugs, rebellion, listened to a friend reciting Laing’s Bird of Paradise, standing on a table in his parent’s house in Chelsea. Self-conscious rites of passage. Into the laborious progress down endless corridors, eye and brain dealing with the side-effects of medication, the sedated blandness of hospital routing overlaying the incoherent misery and pain of my fellow inmates. The doors of perception opened onto a world of depression, voices in the head, schizophrenia, delusion, anorexia, compulsion, obsession. The institution was like a many-tentacled organism with brain, stomach, points of entry and exit, open sections and hidden recesses, self-monitoring and generating, unceasing, with its own super-ego and id, each section dependent on the other, diffused but monolithic.

The people in it cared or were cared for. Those of us who lived there or were incarcerated there as inmates, were thrown together in an astonishingly random way. No bus queue, train carriage, airport or waiting room could force such a variety and disconnected group of people into such physical and emotion intimacy, in such neutral surrounding. The modern engine of uprooting, disconnecting, de-contextualising, while simultaneously monitoring, supervising, and recording is nowhere more vividly experienced than while losing one’s only capacity to survive it; the ability to reason. At the moment, one is most incoherently, “alienatingly,” and vividly oneself, the hospital throws one into intimate confederacy with others who are suffering precisely through an inability to function socially.

Looking back, what really shocked me the most was the loss of language or the power of speech. The delicate membrane that connects experience and its articulation into language was suddenly ruptured, its contingency was drained away. In the face of this rupture, doctors seemed to hold the keys to language, or to put it in another way, the language of psychiatry translated the raw dialects of our experience into a synthesis of modern discourse: cold, precise, specific, detached, and self-referential. “Health” was power—power of speech; “illness” was failure—or worse, danger, violence, and terminal decay. Places beyond the boundaries of language. To reach these places, to fill in these ruptures, the medical model, empowered by its language, proposes “medication,” the giving out and taking in of powerful drugs that effect a technologically advance kind of social straightjacket. Leaving the institution meant leaving a world where speech had an assumed hierarchy of power and rejoining the wider “outside” world, where, for the purpose of daily life, speech is assumed to have the character of dialogue. The slippages of language, that are as much a feature of speech as the linkages, were the starting points for my own experience as an artist. I quickly learnt that art practice represses “otherness” as effectively as any other type of power play. Van Gogh’s bandaged ear is just decoration for another conformist body of education, money-making, and intellectual discourse.


The conundrum posited by my experience of rupture, the loss and regaining of language and the coercive power of medication has for over 20 years provoked an infinite series of questions, which pushed me last year to approach Lyn French with the idea of building an exhibition around these issues. Our hope in this exhibition is to begin to ask questions about this contradiction between illness and treatment, and behind it, the concept of care. Can art practice begin to define social issues? Is there a language capable of healing the rupture: What are the foundations of the language of psychiatry, of therapy, or medication? Is it possible for an outsider, without being “patronised,” or “worthy” to work with those entrapped in that loss of language, that rupture? Who can question the already existing structure that houses these contradictions—the institution itself?

We want to ask these questions in two ways: to artists, by offering them the context of the institution, a functioning hospital in which to present their work; and to patients by offering them the context of their own institution as a living vessel for their experience, presented as works of art. To begin to mark Rear Window’s presence in art workshops, which gradually intensified into direct contact between hospital users and professional artists, I joined the Hackney Arts Initiative programme in the hospital. In doing so, I exposed myself, after twenty years, to the language of service users and began to speak about the role of site-specific artwork in relation to an exhibition marking the closure of their institution. I spent eight months in the programme.

Hackney Hospital, like the Health Service it is part of, is in a state of traumatic change. It is in a permanent state of crisis, under-funded and over-extended. In our association with the institution, it has undergone three changes of management structure. The Psychiatric Services, supposedly such a priority to the Government, are the last group of the cared-for to leave the decaying old hospital buildings to take up operation in the gleaming, purpose-built new units that replace them. And the change goes further. For the psychiatric patients (or “service users,” or more astonishingly, “episodes”), the nineteenth century model of the lunatic asylum has finally been replaced with “care in the community,” a programme that combined utopian idealism with the cynical needs of the Government to cut its expenditure on such an unproductive sector of the public. This concept of care is a long way from the ethic of Christian charity that first established a House of Paupers in Homerton High Street in 1729, or is it?

Collaboration has been our model for planning and implementing Care and Control. Hospital administrators, psychiatrist, therapists, artists in residence, and nurses have responded to our proposals and worked with us imaginatively and enthusiastically in the face of an already totally demanding commissioning programme. The artists we approached were people we felt were aware of the language of institutions, of the losses and power plays involved in dealing with them. Nevertheless, the boundaries they placed around their work were often questioned by the implications of the institution or the people who lived or worked there. The already problematic nature of site-specific work was made even more elusive in a site that was so steeped in human experience and still in the process of being decommissioned.

For the hospital, our project represents an opportunity to mark the end of their occupation of the Victorian Infirmary and Workhouse buildings and with it an era in health and community care. This exhibition is a form of leave-taking.

For Rear Window, collaboration with the hospital has highlighted our own status as members of another institution, the art world. Strategies of operation were created and carried out with a real risk: that the initiative, once set in place, would not create the outcome expected or planned for. It has also questioned the notion of site-specificity: Can any work of art survive in such surrounding? Who is the curator ultimately responsible to if the site triumphs over the work? Who is the artist, to address a social issue? And who are we, to juxtapose the work of professional artists with the outcome of clinically monitored workshops involving service users?

In a way, the boundaries around this collaborative process were set up in order to be blurred, erased, or broken down. What for? As an individual, to satisfy my own feelings of powerlessness as an ex-psychiatric patient. As a member of the community, to engage in a collaboration with “inside” users in order to open a dialogue with the “outside” world. As a curator, to give artists the possibility of addressing social and/or political issues. As an artist, to address the fundamentally equivocal nature of visual language. As a human being, to reappraise the notion of care.