The birth and death of Villa 21

Introduction

British anti-psychiatry was the point of intersection between psychiatry and the burgeoning counter-culture of mid-twentieth-century Britain. A short-lived movement, it began with the publication of R.D. Laing’s The Divided Self in 1960 and had, by and large, collapsed by the early 1970s. Its adherents were heavily influenced by both Marxism and French Existentialism, and their ideology was radically anti-authoritarian and anti-institutional. They advocated communal living, free love, and the use of psychedelic drugs for consciousness-raising. Their friends were revolutionaries, beat poets and hippies. The most famous institution associated with the movement is Kingsley Hall, a community in East London from 1965 to 1970. There are obvious reasons for its fame or notoriety: it was run by the Philadelphia Association, which exists to this day; it had several famous residents; it operated at the height of anti-psychiatry’s fame; and it was a hub for the counter-cultural scene in London. It is generally forgotten, however, that there was another major experimental anti-psychiatric community in the 1960s. This community, known as Villa 21, is mostly ignored in histories of the period. ¹ Where it is mentioned, it is treated as an introduction to a discussion of Kingsley Hall. This article is an attempt to escape the dominant, Kingsley Hall-based, history of anti-psychiatry by constructing something of the history of Villa 21 and thereby reasserting its historical significance.

The birth of Villa 21

In 1924 Porters Park Estate, Hertfordshire, was donated by Cecil Frank Raphael to the Middlesex County Council. Harperbury Hospital was opened on the site in 1928; in 1933 the park was divided in two and Shenley Mental Hospital was established on part of the site. Shenley Hospital was built as a system of numbered villas of various sizes, initially meant to hold 1000 patients in total, although this number increased as new villas were built and old ones were extended. The hospital centred on the administrative building, formerly Porters Park House. Each of the surrounding villas served as an independent ward or unit of the hospital. Patients were allotted to different villas depending on their gender, disposition and general symptoms. For instance, certain villas were marked ‘Quiet and Harmless’, ‘Senile and Infirm’ or, in the case of Villa 21, ‘Semi-Convalescent Males’, and later the ‘Insulin Coma Ward’. The hospital used a number of different treatments that represented both the progressive and traditional treatments of the time. To this end the grounds included a farm and workshops in which patients could be set to work, insulin coma wards and electroconvulsive therapy rooms, as well as more traditional long-stay facilities.

By the early 1960s Shenley was typical of British mental hospitals. With a population of over 2000, ² conditions were cramped, and many of the buildings had not been properly modernized since their construction. World War II had taken its toll on the hospital: many of the wards had been used to treat soldiers, causing huge overcrowding which put more pressure on the facilities and, added to this, the grounds had been damaged by air-raids. Staff shortages meant that the doctors and nurses were overworked. ³ Although there was a modest ‘modernisation programme’ at Shenley Hospital in the early 1960s which included laundry and water softening plants, electric fires in the nurses homes, modernization of kitchen facilities and the repainting of many villas (Planning & General Purposes Committee, 1962), the management committee of Shenley Hospital reported to the North West Metropolitan Region Hospital Board that:

Shenley suffers from the disadvantage of being regarded as a modern psychiatric hospital. This … has militated against its receiving adequate financial allocations, since older established hospitals have presented a greater apparent need, so that the standards of Shenley have slowly deteriorated. (Mental Health Sub-Committee, 1963)

The same Sub-Committee report estimated that in order to rectify this deterioration the hospital would need £100,000. However, their appeal failed and instead the Committee was informed that ‘it might be possible to fit in some modest schemes from the Board’s capital funds after 1966’ (Mental Health Sub-Committee, 1963).

Medically the hospital was dragging itself, however slowly and reluctantly, into the age of psychiatric reform. Psychoanalysis in post-war Britain was vastly different from that of the 1930s. As Mitchell (1979) points out, World War II had dramatically ruptured the structure of the family. This precipitated a radical shift in the focus of psychoanalysis. Rather than attempting to explain psychic structures, which had been its preoccupation in the 1920s and 1930s, post-war psychoanalysis focused on the changing face of the family. In this context, new styles of analysis arose. Anna Freud and Dorothy Burlington produced a ‘developmentally orientated form of child analysis’ (Mitchell, 1979: 229). John Bowlby’s ‘attachment theory’ came into vogue in the immediate aftermath of the war and heralded the rise of the Tavistock Clinic, which was at the cutting edge of family psychology throughout the 1950s and 1960s. Finally R.D. Laing, D.G. Cooper, A. Esterson and the ‘anti- psychiatrists’ of the 1960s further developed various theories revolving around the schizogenic family. The coincidence of these changing attitudes in post-war psychiatry and the development of phenothiazine-based anti-psychotic drugs in the 1950s had opened the way for massive institutional reforms. The introduction of open-door policies in hospitals, the attempted abolition of sex-segregation, the reduction in locked wards, the creation of patients’ social clubs, even the relaxation, in some more progressive hospitals, of the patient-staff relationship became suddenly desirable in the mental hospitals of the 1950s. In Shenley in the 1960s these ideas were being slowly introduced and often sat in uncomfortable proximity to the traditional ‘bin’ style mental facility. The increased openness of the facility faced opposition, for various reasons, from the more conservative, or perhaps institutionalized, members of the medical staff, the administration and local residents. However, many progressive steps were taken at Shenley in the late 1950s and early 1960s. The Alpha Club, a social club for patients, was started; many of the locked wards were opened; and the fence that enclosed the hospital was removed, although this was later rebuilt. A most interesting development, in the context of this article, was that Cooper was given a ward in which to test his ‘ultra-permissive’ ideas (Cooper 1967: 95); this ward was Villa 21.

Cooper (1967: 83) refers to ‘[t]he inception of the unit in Villa 21 in January 1962’, but the unit was conceived of several months earlier than this. In March 1961 ⁴ Drs Hayward and Cooper of Shenley Hospital put forward a proposal to the Clinical Research Sub-Committee of the Regional Hospital Board for research into the intra-familial environment of the schizophrenic patient (Clinical Research Sub-Committee, 1961: App. B). This proposal provides a full description of a ‘a unit of between 20 and 30 patients … [in which] [t]reatments will consist entirely in group and community therapy … [and] [d]rug therapy will be avoided.’ In order to operate such a ward, Drs Hayward and Cooper suggested that they needed ‘a special villa for between 20 and 30 patients’, two doctors, a full-time psychiatric worker, an occupational therapist, personally selected nursing staff ⁵ and, possibly, a clinical psychologist. When Cooper wrote Psychiatry and Anti-Psychiatry in 1967, he described Villa 21 as a ward with 19 beds staffed by hand-picked nurses, a full-time occupational therapist, a psychiatric social worker and three doctors. The only significant organizational difference between Villa 21 and the ward proposed to the Hospital Board in 1961 is that Villa 21 was specifically for ‘men aged between fifteen and late twenties’ (Cooper, 1967: 85), although in 1961 he had not mentioned this in the proposed admissions policy. However, he had suggested that they would take ‘patients in their first schizophrenic breakdown’ (Clinical Research Sub-Committee, 1961: App. B). A further amendment to the policy suggested in 1961, which had aimed at an exclusively schizophrenic population, was that one-third of the patients at Villa 21 had never been diagnosed as schizophrenic, but they ‘bore such labels as adolescent emotional crisis or personality disorder’ (Cooper, 1967: 85). Other minor differences were the absence of a psychologist, the presence, initially, of three doctors instead of two, and the population of the ward was slightly below the proposed 20–30.

However, the initial 1961 proposal received a mixed reaction from the Regional Hospital Board. The proposal was assessed on behalf of the Research Sub-Committee by J.D Sutherland, in conjunction with R.D. Laing, both of the Tavistock Clinic. Sutherland dismissed the possibility of Cooper receiving a ward in which to carry out the research in two sentences: ‘This work is very time-consuming and to carry out on adequate scale would require a relatively large team. Since Dr Cooper is working on this material largely by himself it is unrealistic to expect any control studies to be done at this stage.’ (Clinical Research Sub-Committee, 1961). In spite of this, Sutherland enthusiastically refers to Cooper as a ‘careful observer and an energetic worker’ and recommends that the Sub-Committee grant him ‘limited support for, e.g. up to £200 over two years’ for part-time secretarial assistance to help with the transcription of interviews. Perhaps interestingly, the Sub-Committee resolved to give him twice as much (Clinical Research Sub-Committee, 1961).

It is an indication of the progressive nature of Shenley’s administration in the early 1960s that, in spite of the absence of support from the Regional Hospital Board, Cooper was given control of a ward the following year, 1962, when insulin coma treatment was phased out and the insulin coma ward, Villa 21, became free. It was here that he would begin his four-year experiment on ‘the anti-hospital’ (Laing, 1976a: 45).

At the beginning of the experiment, the community at Villa 21 consisted of: 19 patients in their late teens and early twenties; ⁶ seven nurses in three shifts (two day shifts with one charge nurse, one staff nurse and one student nurse each, and one nurse on the night shift); a full-time occupational therapist; a psychiatric social worker; and three doctors.

Ostensibly the experiment set out to address three of Cooper’s major concerns about the hospital. The first was the treatment of adolescents, who presented with ‘acting out disturbances and also young schizophrenics’, in wards in which the majority of patients were advanced in both years and their series ‘of recurrent psychotic breakdowns’ (Cooper, 1967: 83). This, Cooper felt, led to the young patients defining themselves through the rigid structure of stereotypes on the ward. He also thought that by localizing ‘adolescent sexual and aggressive acting-out’ (p. 84) it might reduce the likelihood of ‘blind repressive measures’ in retaliation on behalf of the staff. Cooper’s second concern was that conducting any sustained research into ‘group and family-interactional research in schizophrenia and … disturbed adolescence’ (p. 84) had proved difficult on general admission wards, and so Villa 21 would provide a clear space for such research to take place. Finally the villa was to serve as a ‘prototype for a small autonomous unit which could function in a large house in the community, outside the psychiatric institutional context’ (p. 84).

The death of Villa 21

Four years later, in 1966, David Cooper gave his notice to Shenley Hospital. After his departure any physical memory of Villa 21 was obliterated with what appears to have been systematic efficiency. Initially, a new community was established under Dr Michael Conran in which the basic principles were diametrically opposed to those of Cooper’s Villa 21 (see below). The building was renamed Villa 20a in the early 1970s after Conran departed from the unit, and later Oakdene, making it the only villa that was not either sequentially numbered or named for its specific purpose – for instance one of the larger buildings near the manor house was called the Intensive Care Unit, and another smaller one was called the Operating Theatre. In time the entire building was to be gutted and its internal structure entirely reorganized.

Ultimately, Villa 21 disappeared. Its complete obliteration begs the question of why the community had to be destroyed. The descriptions of the life there hardly seem sufficiently terrible to merit this type of reaction. The general consensus is that, while Villa 21 was not a complete success, it was certainly not an unmitigated failure. The story is that, in the beginning, Cooper set about blurring the staff-patient boundaries, recategorizing patients as ‘visitors’ (Laing A, 1996: 85), then restricting the duty of the staff to managing the drug cupboard and ‘dealing with ward administrative issues involving other hospital departments’ (Cooper, 1967: 92). Finally he abolished all hospital rules other than those forbidding nudity and masturbation in public areas of the ward. Under this new regime, conditions in Villa 21 deteriorated – windows were broken, rubbish accumulated in the corridor and plates went unwashed. Eventually, while Cooper was holidaying in Eastern Europe, a group decision was taken by the inmates of the villa to reassert some controls on the ward regarding eating, cleaning and weekend leave. Cooper (1967), Clarke (2004) and Double (2006) tell the story up to this point. However, the reason for Cooper’s departure from the unit in April 1966 is never discussed.

How did the Villa 21 experiment, the stated intentions of which, although progressive for the time, could hardly be called radical, end in convulsions that forced the resignation of a well-known psychiatrist and the hospital’s apparently concerted attempt to forget that the experiment ever happened?

Reconstructing the life of Villa 21 has proved surprisingly difficult, not least because of this institutional forgetting. A number of channels, which would normally have provided a wealth of information, have been closed. There are remarkably few first-hand accounts of the villa, apart from Cooper’s own in Psychiatry and Anti-Psychiatry (1967), but even this has been of limited use because it refers only briefly to actual events in the villa. This lack of material is particularly surprising when we consider the number of people who visited the villa, including journalists, doctors, social workers, etc., at various times during its four-year existence. Furthermore, the administrative records of Shenley Hospital, which were deposited in the London Metropolitan Archive, are incomplete: after 1955 the only two records are one from 1958 and another from 1974.

There are a number of dramatic stories regarding Cooper’s departure from Shenley Hospital and the end of the Villa 21 experiment, mostly amounting to little more than unfounded, often slanderous, rumours. Many are not worth recounting here as they bear no relation to any kind of historical reality. Others are slightly more plausible, making reference to Cooper’s increasing alcohol consumption, his incompatibility with other senior members of staff or the increasing friction regarding questions of hygiene at Villa 21. In short, almost everyone has a different opinion as to why Cooper left Shenley and, unfortunately, there is no extant documentary evidence to provide us with a definitive answer. ⁷

The only two concurring accounts that I have come across seem to be those of Marc Cooper, David Cooper’s eldest son, and Joseph Berke, his fellow anti-psychiatrist, ⁸ both of whom I interviewed. ⁹ They agree that David Cooper left Villa 21 and Shenley Hospital for two very simple reasons. First, because his interests had moved on, and there were more promising political and anti-psychiatric experiments elsewhere. The second, and perhaps more important reason, was that after four years of fighting for the survival of the unit, Cooper was simply fed up. This coincides with the version of events put forward by Clancy Sigal in Zone of the Interior (1976). Finally, it also seems to tally with Cooper’s own conclusion about the Villa 21 experiment.

The result is the establishment of the limits of institutional change, and these limits are found to be very closely drawn indeed – even in a progressive mental hospital. The conclusion is that if such a unit is to develop further, the development must take place outside the confines of the larger institution … The unit must ultimately become a place to which people choose to come in order to escape, with authentic guidance, the inexorable process of invalidation that grinds on ‘outside’. It must become this rather than a place by means of which ‘the others’ deviously rid themselves of their own scarcely perceivable violence by a medically certified human sacrifice to the gods of a society that seems determined to sink and drown in the mud of its illusions …

And a step forward means ultimately a step out of the mental hospital into the community (Cooper, 1967: 104).

In the light of what Marc Cooper and Joseph Berke have said, we can see that in this passage Cooper gives two reasons for leaving: the boundaries of the institution were too restricting – i.e. he had to struggle continually against these boundaries to keep Villa 21 going; and the next step will be to apply what he has learned in the community, i.e. he wanted to move on to new projects outside the hospital.

In many ways this seems to be an entirely unsatisfactory explanation. It is a strikingly dull end to such an exciting and turbulent project, particularly as the subsequent complete erasure of the unit suggested that there had been some terrible, almost cataclysmic, event which needed to be forgotten. But perhaps this undramatic end has saved us from a vast misinterpretation of Villa 21.

I contend that what the institution seems to have attempted to erase from its memory was actually the Villa 21 community itself. In many ways I have fallen into the same trap as most other writers on anti-psychiatry. I have seen Villa 21 as fundamentally a medical experiment. As a medical experiment Villa 21 was, as I said at the beginning of this article, not particularly radical. There are a few things that might have caused problems for the running of a ward; the refusal to use restraints, for example, either physically or chemically, would have made the villa difficult to maintain, even if the staff roles had not been abolished. Furthermore, the refusal to stop patients’ outbursts meant that windows and furniture were periodically smashed. All this made the ward undesirable from an administrative point of view. However, the liberalization of the mental hospital particularly through the use of therapeutic communities was, in many ways, the cause célèbre of progressive psychiatry in the early 1960s, so medically it was not altogether outlandish.

The anti-hospital – the politics of Villa 21

What is at issue here is not a medical quibble about the benefits of one treatment over another. Instead, we must understand these arguments in the context of the anti-psychiatrists’ political radicalism and their anti-institutionalism. In thinking about anti-psychiatry we must always remember that it is a fundamentally political movement. Although often couched in the language of individual consciousness, anti-psychiatry prescribed a liberatory programme that was rooted in a radical social change. This change, they argued, must be based on a basic reorganization of the interpersonal relations that bind society together. In many ways, Cooper summed up this revolutionary programme in an interview he gave in 1968 about his involvement with the Anti-University when he described what the prefix ‘anti-’ meant:

The ‘anti’ signifies a basic change in the rules of the game, whatever game one’s playing, whether it’s in the context of a hospital, a certain art form, academic situation, it’s a basic, qualitative, radical change in the rules of the game. Whereby the basic aim is to break down all false compartmentalizations, in other words, boxes that people get into. So we’re concerned to breakdown academic boxes, in terms of the total nature of the bureaucratic academic institution, false discipline compartmentalizations and this extends to many other areas … (BBC, 1968)

Villa 21, the anti-hospital, was a political battleground. Cooper was seeking to effect a basic change in the rules of the hospital. In fact he was seeking to negate what he saw as the traditional authoritarian purpose of the psychiatric hospital. The anti-hospital is the hospital turned on its head. ‘Although many inmates of mental hospitals are there because they deviate from social norms in the way they think, feel, and act, mental hospitals insist they conform to a set of rules that permit a narrower spectrum of thoughts, feelings and acts than society outside does.’ (Schatzman, 1969: 295). The function of the anti-hospital was to open up new modes of consciousness and allow the person to liberate him or herself. Cooper was attempting to disrupt the mystifying and invalidating strategies, not only of the hospital but, by doing this, also those of the family, the police, the school and the university, etc. In short Villa 21 was the first anti-psychiatric attempt at ‘a revolutionary centre for transforming consciousness’ (Cooper, 1968: 197). In the light of this rereading of the villa, we must consider anew the opposition which Cooper and other staff members felt from those outside the unit.

The conflicts within Shenley Hospital over Villa 21 were not simply clashes of personality or medical theory and certainly nothing so mundane as a dispute over the administrative cost of replacing broken windows, furniture and crockery. Such clashes may have happened but they were merely battles in a much greater war. To the institutional structures of the hospital, Villa 21 was a critique and an attack on the continued existence of the hospital itself. To the staff and inmates of the hospital, Villa 21 posed an even greater threat: it was an attempt to destructure and destroy the very basis of their livelihood and society.

A patient’s recollections of Villa 21

In the course of my research I interviewed a man, whom for privacy reasons I have called Adam. He was a resident at Villa 21 for six to eight months in 1963–4 ¹⁰ when he was in his late teens. Having been treated for some months as an out-patient by a psychiatrist from Shenley, he was admitted directly into Villa 21. Adam described life at Villa 21 in a good deal of detail to me, so I am able to present a synopsis of some of Adam’s recollections. Through these we can get a better understanding of what Villa 21 was like on a day-to-day basis and of the conflicts between Villa 21 and the hospital at large.

Arriving in the height of Villa 21’s experimental phase, Adam remembers there being no rules, or obligation to perform any particular tasks; patients ‘were allowed to do more or less what the hell … [they] wanted’. He recalled that when he first arrived at the villa the ‘place was quite a mess’ and smelled of ‘Dettol and pee’ (Adam I). He also remembered that his father was shocked. However, his shock seems to have been more focused on the psychiatric hospital in general rather than Villa 21 in particular. In fact, Adam did not remember being frightened at all when arriving at the villa, which, he remarked, one might expect, given the strange environment.

Adam remembers Villa 21 as being a community distinct from that of the rest of the hospital. He did not socialize at the Alpha Club, which was the patients’ social club, and there was a sense among Villa 21’s inmates that they were ‘a bit special’. This sense came, not only from the fact that they had more freedom than other patients, but also from the fact that some of the Hospital staff did not treat them with the seeming contempt that they showed towards conventionally treated patients. Adam recalled:

I can remember actually being in a ward when there was a black guy and he got taken off to a padded cell and the senior nurse of the acute ward came and was spouting this racist rubbish about how there was a thinner veneer of sanity on black people than there was on whites … And I can also remember people coming back from sessions in the padded cell with black eyes, they used to get … treated rather brutally. (Adam I)

The inmates of Villa 21 were on the receiving end of very little of this brutal treatment. Similarly, according to Adam there was a social worker who used to talk to conventional patients in an abusive manner, but she could not speak to him like that. Indeed, the patients held a position of power at Villa 21 that was unheard of elsewhere in the hospital. For instance, when one of the permanent nurses on the ward decided to reassert some of the conventional hospital rules:

… it was a Sunday morning, anyway, the morning shift came on and normally, as I said, we got up when we wanted to get up, if we got up at all. They decided to actually get everybody out of bed and the patients went berserk. There was a sort of mini riot and it was number one item on the group therapy session on the Monday morning, the nurse denied that he had done anything but I contradicted him and said you did, you know, and then he confessed and he never came back to the ward. (Adam I)

The significance of this example is not that the nurse was moved off the ward for attempting to get the patients out of bed – this might have been expected, given that it was in contradiction of the doctors orders. What is interesting, however, is that the word of a patient was taken so seriously that it forced a nurse to admit to his actions. Not only were patients trusted to tell the truth, but their judgement was trusted to the extent that their advice was asked for by the doctor. On one occasion an ‘inmate was found dabbling with a couple of electric wires and a basin full of water’. In this case Cooper asked the community meeting what they thought should be done, and Adam suggested that the patient should be medicated. This course of action was agreed upon by the group and enacted by the staff. Also we can see that patients were not only trusted to judge each other’s medication, but also to judge their own because ‘the odd sleeping pill or tranquillizer was available [to patients] on request’. In spite of these radical elements, Adam was at pains to remind me that at the fringes of the Villa 21 community traditional forms of treatment were still evident. For instance, although drugs were generally not used within the villa, there were occasions when people were medicated, like the man found playing with electricity and water, and others were given ‘an injection of paraldehyde’.

Adam suggests that, although the staff-patient roles had not been entirely abolished, as Cooper had hoped, the boundaries were extremely blurred. We can see this, not only in the patients’ riotous reaction to a nurse attempting to get them out of bed, but also in the two examples Adam gave of the relationships between nurses and staff. One nurse, whom he remembered with some affection, used to take the patients to the pub in the nearby village of Shenley, until he was thrown out for serving drinks from a bottle of whiskey that he had sneaked in. Another nurse, on the other hand used to take patients back to his flat in St Albans. Adam was very suspicious of this because, although he knew that several of the patients were gay, he suspected that others ‘were being taken advantage of’. These familiar relationships undoubtedly indicate a permeation of the barriers between staff and patients. This partial success in breaking down the staff-patient roles came from Cooper’s selection of nurses. Adam suspected that in many cases the nurses did not completely share Cooper’s radical views, although they did ‘accept the sort of ideology’, but were able to work successfully within Villa 21 because they were a ‘more relaxed type of nurse’, who did not need to treat patients with the same disdain that he thought many nurses did.

Another interesting aspect of life at Villa 21 emerged from my interview with Adam. As we saw earlier, the community at the villa felt that it was ‘a bit special’ and it did not associate too closely with the patients from other wards. One reason for this was the style of social life that the two groups engaged in. The patients of Villa 21 saw the more institutionalized patients as spending ‘their days passively sitting in a lounge doing bugger all’. The community at Villa 21, on the other hand, ‘used to get into intellectual debates’, and this was particularly true when Clancy Sigal visited and they ‘used have much more discussion with him in depth about life, about politics’. They also took part in escapades that might have been impossible in other, stricter, wards – for instance, the trips to the pub with the nurse. A more extreme example, however, occurred when Villa 21’s television broke down.

[O]ne incident I remember, I said the television was extremely important, and our television was up the creek, you know. So, sort of collectively, what we decided to do was to get ourselves another one and we thought we’d get one from the doctors’ quarters … so we toddled off and we created a distraction, we nicked their television set and then we distracted the night nurse that was on duty, at the time … [laughter] … And we left that old clapped out telly in the doctors’ quarters … and got ourselves another … So we were, ya, not entirely daft. Though there was a big enquiry about it, though no one got punished for it … (Adam I)

Although in many ways Villa 21 appears to have been a more tolerable place than the traditional ‘bin-style’ facilities, there were several people who chose to leave Villa 21. Perhaps most interestingly there was a man who was so agoraphobic that he ‘had great difficulty going outside the institution’. This patient ‘elected to go to a more conventional ward, he just wanted to be treated like a conventional psychiatric patient’. Others ran away. An ‘upper class public school boy who was mad as a hatter ran away one time and he was found because he was in some place trying to buy a boat’. Another patient had been ‘sectioned’ and was furious about it, but the doctors were afraid that if they did not have him under section he would run away. However, he pleaded with Cooper and eventually convinced him to take him off section, then he immediately ran away. Others ran away, only to come back again of their own volition. For example, there was an Irish patient for whom ‘clothes were very important’, but after a while his own clothes became shabby and worn out so the hospital ‘tried putting him into institutional clothing, which was absolutely awful’, so he ran away and came back with a brand new, and probably stolen, wardrobe.

Adam suggests that both the inmates of Villa 21 and the general staff of the hospital were aware of the fact that the community was an experiment.

Interestingly, Adam seems to have been proud of the part he played as the exemplary patient to those who visited the villa. This stands in stark contrast, however, to the feelings outside the villa. Adam suggests that a large number of the staff outside the villa resented the presence of Villa 21 in the hospital. This resentment could be felt both outside and inside the villa. Adam recalls one or two visits to Villa 21 by a psychiatrist from elsewhere in the hospital who was ‘very puritanical and critical of Laing and Cooper’ (Adam II). Such negative incursions are also described by Cooper (1967), although he was more inclined to focus on the senior nursing officers. ¹¹ On another occasion Adam remembers being in the nurses club and overhearing some nurses who ‘were quite contemptuous of Villa 21’ (Adam I).

Michael Conran and dismantling the Villa 21 project

After Cooper’s departure in April 1966, Villa 21 was briefly in the hands of two Irish charge nurses, and then in May 1966 Dr S.T. Hayward, the consultant in charge, placed Dr Michael B. Conran in charge of the villa with the injunction to find out all he could about schizophrenia. Conran had already worked at Villa 21 for four years (Conran, 1999: 28). We can follow his work in a number of texts that he wrote on the subject. The largest is the unpublished thesis (Conran, 1971), written while he was at the Institute of Psychoanalysis (he was training as an analyst throughout the time he worked at Villa 21). He also published information about his time at Villa 21 in an essay (Conran, 1999), and an article (Conran, 1976).

Superficially, Conran’s work at Villa 21 was very similar to Cooper’s but in fact his analysis was diametrically opposed to it. He asserted that schizophrenia is intelligible, and that schizophrenics could be treated in a therapeutic community. In his writings he refers to many of the theorists popular among the anti-psychiatrists. ¹² Furthermore he argued that psychiatric drugs complicated the schizophrenic’s situation, and within three months of taking control of Villa 21 Conran had taken all his patients off psychiatric drugs. He did not approve of many of the arbitrary symbols of power that were current in the psychiatric hospital of the 1960s, for instance one of the first arguments between Conran and Villa 21’s charge nurse was occasioned by the charge nurse’s refusal to ask his staff to eat from patients’ crockery. ¹³

In spite of apparent similarities, Conran and Cooper started from fundamentally different positions. The core of their difference may be plainly seen by comparing their respective works appearing in 1971. Cooper published The Death of the Family (1971), a sustained attack on the structure of the family as an institution in itself and as the blueprint for most of society’s powerful institutions. In the same year Conran was awarded his MD for his thesis ‘The family as a model in an application of psychoanalysis to the care and treatment of young male schizophrenics’ (1971), in which he argues against Cooper’s position, as it was laid out in The Death of the Family.

Conran’s theory was that the institution actually needs to try to mirror the structure of the family. In fact he goes so far as to prescribe the family roles within Villa 21, describing in some detail how he as the ‘father’ of the villa ‘married’ the nursing staff, embodied by the charge nurse, who were collectively the ‘mother’ of the villa’s ‘children’ – the inmates. Throughout his thesis he continually refers to his patients in paternalistic terms, for example:

One patient asked the charge-nurse “can I see the doctor? I want to see the doctor.” When I came to the Villa, I saw this boy standing anxiously in the corridor. On my way to the office I greeted him, ‘Hello!’ as I passed … Two hours later … X, now red in the face and trembling from embarrassment, was shepherded in and sat down. I smiled at him and waited. The charge nurse grew embarrassed and said kindly ‘don’t be afraid, you can ask Dr Conran whatever you want to’. More discomfiture and embarrassment. The charge-nurse resumed his goading and I stopped him. I said to X ‘perhaps you just wanted to see me?’ X looked relieved and I said ‘well, that’s alright’. He got up and went. I pointed out to the charge-nurse that a two year old child will nag mother all day long ‘I want daddy. I want to see daddy’. When daddy arrives, mother remonstrates ‘you’ve been asking all day to see daddy, now he’s come you won’t go to him’. the point being, ‘I want to see’ does not mean he wants anything more. (Conran, 1971: 52, original emphasis)

Unlike Cooper’s attempt to use Villa 21 to destructure the family both institutionally, in the hospital, and as a mode of thought in the patients and staff of the villa, Conran was actively trying to restructure the family both personally and institutionally. As we know, the anti-psychiatrists have always been accused of blaming the families of schizophrenics for the condition; however, Conran goes much further down this road than the anti-psychiatrists ever did. Cooper and Laing asserted that ‘schizophrenia’ was the result of subtle manipulations, or contortions, of or around the ‘schizophrenic’ which distorted their ability to be in the world, and to accept the world as it has been handed down to them. Curiously, the anti-psychiatrists always maintained that the schizogenic family often looks very similar to the ‘normal’ family, or the family that produces mentally healthy progeny. For them it is only the minutiæ of everyday life, the slips of the tongue, the subtlety of body language, etc., that differentiate these families. Conran (1971: 31), on the other hand, states outright that schizophrenics are ‘derived from families in disarray’. The implication is that there is something strikingly wrong with the family of the schizophrenic. Conran’s idea was ‘to provide, consciously, a structure in Villa 21, as near as possible, affording a secure organized family life’ (p. 31), that is to say to formulate Villa 21 as a family with the cohesion and stability that he believed schizophrenics lacked in their families of origin. As such, Conran was attempting to negate Cooper’s work entirely, by reinscribing the family onto Villa 21.

Apart from the theoretical distinctions between Conran and Cooper, there were also significant differences in the manner in which they ran the villa. In his 1999 essay, Conran briefly mentions Cooper’s time at Villa 21: ‘Time does not permit me to dwell upon the life and work of ‘Villa 21’, which had a psychoanalytic conception, followed by an infantile period wherein it achieved a certain fame or notoriety through Cooper (Cooper 1967). I was the psychiatric registrar in analysis following Cooper.’ (Conran, 1999: 28). These differences can be seen most clearly in the relationship between Conran and the patient whom he refers to as ‘the leader’. When he arrived at Villa 21 he discovered ‘that a small coterie of rather articulate patients, led by a young married man who could not easily be described as schizophrenic, dominated the Villa’ (Conran, 1971: 27). The first thing that he notes about this relationship is that the nurses did not wear uniforms. He then noticed that the nurses in the ward were browbeaten by the patients. Then he had his first confrontation with the leader of the coterie.

The leader announced to me on my arrival – the coterie occupied the nursing office when I was there, or when a patient wished to talk – that the practice of the ward was to call everyone by their first names. Henceforth I should be called ‘Michael’. I said that I regarded that as his problem. It was not mine. Thereafter, nobody called me ‘Michael’ except this person, who thereby isolated himself from the whole ward. (Conran, 1971: 27, original italics)

The inmates of Villa 21 seem to have resented Conran’s presence in the ward. His arrival at the villa prompted a ‘contemptuous silence’ (Conran, 1971: 27) among the inmates, and then a discussion of obscure topics that Conran could not possibly follow. This resentment was not, perhaps, without reason. Conran seems to have operated a policy of divide and conquer, as can be seen in the way that he rejoiced in the isolation of ‘the leader’ from the rest of the community. He sought to befriend any group of patients that would accept him. There seems to have been a strange transference between Conran and ‘the leader’. Retrospectively, Conran is acutely aware that his anxiety adversely affects the patients at the villa. ‘My distress and anxiety during this period of two or three weeks was so intense that … I was a ready target for a great deal of patient distress, not least of which derived from their anger at the sudden collapse of the previous regime, with all its magical expectations.’ (Conran, 1971: 28). In spite of this awareness he did not seem to notice that he had made ‘the leader’ the receptacle for all his ill feeling towards the previous ‘regime’ (p. 28). Throughout his description of his early days at Villa 21, Conran seems to make no therapeutic references to ‘the leader’, and in fact all his references are adversarial and confrontational. It should be said that these confrontations do not seem to be unprovoked: ‘It was evidently known to the leader of the coterie that I subscribed to a psychoanalytic way of thinking about mental illness. On one occasion he publicly informed me, in a patronizing voice that “Freud has no place in Villa 21”.’ (Conran, 1971: 28). The first major confrontation arose over the distribution of drugs on the ward. Conran had been expected to ‘rubber-stamp’ the amount and types of drugs that the patients at the villa were receiving. ‘The leader’ sent a message to Conran while still in bed, asking Conran to renew his prescription. At this point Conran renewed the prescriptions of three other patients. He then went to see ‘the leader’:

I took a chair and sat by his bed in full view of the other patients – like plenipotentiary at the emperor’s couch. He said he had nothing to say to me. I said he could scarcely expect me to prescribe in an irresponsible way. Whatever he thought of me as a person, I was a doctor and had an obligation not to hand out drugs unless I was convinced a patient needed them, and would be helped by them. In a casual tone, annoyed to have his rest disturbed, he said he must have drugs to sleep. I said he would have to tell me about his insomnia. He refused to discuss his problems with me – ‘you wouldn’t understand’. So I did not renew his prescription. (Conran, 1971: 28)

Having won this first victory over the ruling coterie, Conran decided to follow through and, while ‘the leader’ was elsewhere in the hospital being interviewed by the BBC, Conran intervened in a group meeting. At the meeting a young man had been discussing his problems and in the course of the discussion he began to weep. None of the patients or nurses present made a move to comfort him; Conran (1971: 29) comments that ‘there were two [nurses] present, who sat as mute as some schizophrenics’. He concluded that the nurses ‘had lost their feeling of professional worth’ because, under Cooper’s regime, they no longer wore uniforms. Conran argued that it was important for the nurses to wear a uniform akin to ‘a skirt’ that patients in distress could identify as ‘a haven to which to turn’. This triggered a series of discussions about the nurses’ uniform which took place in the absence of the patients. Eventually Conran told the nurses that it would be their own decision whether or not to wear the uniform and ‘[i]t was not long before all the nurses – even one of the nursing assistants – put on their white coats’ (p. 30). During this period Conran encouraged the other members of staff to reassert their privileges. For instance they began to exclude patients from the office, which had been the place where impromptu group discussions had taken place. In this situation, in which the authoritarian structure of the hospital was rapidly reasserting itself over Villa 21, ‘the leader’ seems to have desperately sought to undermine this authority by intervening in Conran’s attempts to establish relationships with members of the community. This finally came to a head in an argument over the equality of members of the community.

The question of role and equality with me (or my inequality with him) eventually settled about his denial about being a patient at all. At this point I did something ruthless. It seemed to me that I needed now to show the villa that I was going to stay and that I was going to be effective. This meant that I would not tolerate destructive manipulations further. I told him, in his ‘court’ that I thought his attempts to rule me had gone on long enoughand[sic] that I doubted if he really had any business in the Villa at all. He challenged me to discharge him. I would not. He challenged me to send him to M.A.1 – the ward reserved for the most ‘refractory’ male patients – the mental hospital within the mental hospital – to which this chap longed to have me send him as a mark of honour, of being victimized.

I instructed the nursing officers that he was to be transferred that day into another ward for which I had care. It was an open ward for very long-stay, chronic, docile, working schizophrenics. Whatever else he might seek to call himself in Villa 21, in Villa 19 he would be a patient. He discharged himself from hospital forthwith. (Conran, 1971: 30)

There is a surprisingly aggressive, even vindictive, tone to this piece of writing, particularly in the penultimate sentence. This was the return of disciplinary psychiatry to Villa 21. Conran identified the troublemaker and sent him to the place that he most feared, where he was most invalidated. To stay in Villa 21 would allow him access to people who agreed with him and to send him to M.A.1, the refractory ward, would validate his beliefs about psychiatry’s violent and disciplinary methods. By sending him to the long-stay docile ward, Conran deprived ‘the leader’ of freedom and of explicit violence against which to struggle. Literally, Conran was attempting to put the leader in his place – by making him choose between being a patient or leaving the hospital Conran is denying the possibility of the anti-institution. For Conran this was a great victory. The remaining members of the coterie were furious with him, which he felt to be a far better state of affairs than the contempt with which they had treated him heretofore. He now began to feel needed as ‘an object for the discharge of angry hateful feeling’ (Conran, 1971: 30). Furthermore the ‘other patients began to establish contact with’ him. From this point, Conran seems content that he controlled the ward. He was then able to shape the villa according to his own ideas, the most surprising of which was that he locked the doors. This is particularly strange because by the late 1960s even very conservative mental institutions had abandoned the idea of the locked ward for most of their patients. However, Villa 21 was not a locked ward in the strict sense of the term; the doors were locked but some patients were allowed use the key to get out, which they would then pass back through the window to the people inside the villa. This issue of control seems to have been the greatest discrepancy between Cooper’s and Conran’s times at Villa 21. While Cooper sought to destructure the power of the doctor in the villa, Conran struggled to regain these powers. In fact this issue of direct control of the populace of the villa is a manifestation of a much deeper argument between the two men, an argument that makes Villa 21 under Conran the antithesis of Villa 21 under Cooper. Cooper (1968: 200–1) writes:

Schizophrenia is a half-completed, half-chosen retreat from the precariously and artificially stabilized level of highly differentiated experience that passes as sane in our culture at this time. Schizophrenia is a simple project – usually an abortive one thanks to social interference – to rediscover a pristine wholeness that really lies outside one’s history but which is pointed to by one’s history. This wholeness undercuts the differentiation of experience. It undercuts all the false divisions within and between arts and sciences, and the whole process of bringing people up – education.

Therefore, for Cooper, schizophrenia was in some ways an aborted attempt to achieve autonomy by breaking through the oppression of differentiated experience. Conran’s position, however, was diametrically opposed to this. For him schizophrenia was an attempt to abandon autonomy: ‘I also recognized that it was nonsense to impose upon, or offer to, patients who had declared their incapacity to govern themselves by coming into hospital, a system of patient government.’ (Conran, 1971: 31). It should be noted that Conran made some unsupported assumptions here. The most obvious is that ‘voluntary patients’ are, in fact, voluntary – surely this is a remarkably naive assumption for a practising psychiatrist of the time who might encounter patients coerced by friends, family, employers, etc. Strangely these comments follow a description of the resistance posed by patients who were insisting on their self-government. However, he does not posit any explanation for why a group of patients who have ‘declared their incapacity to govern themselves’ (Conran, 1971: 31) should fight so strenuously to achieve that self-government.

Conclusion

It would be easy to think of the Villa 21 community as a medical experiment, an infantile expression of an anti-psychiatry that had not yet managed to break free of institutional thinking. In so doing, one may reduce it to a footnote in the history of anti-psychiatry and abandon it completely in the grand history of the psychiatric profession. However, I contend that, in its proper political context, Villa 21 can be seen as a vitally important part of the anti-psychiatric movement. Villa 21 was more than a simple playing out of anti-psychiatry’s pseudo-medical theories, and was a manifestation of the movement’s political engagement, not only with conventional psychiatry but with society in general. Villa 21 was the very real battleground of anti-psychiatry’s revolt.