Dancing about psychiatry

No one knows who first said that writing about music is like dancing about architecture, but dancing about psychiatry certainly does not seem to work. Stigma can be conveyed without the use of words.

On Friday, I attended a really enjoyable party in honour of Vanessa Cameron, who leaves the Royal College of Psychiatrist at the end of the week after 33 years as Chief Executive. I was asked to speak. I was involved in writing this profile of her. Vanessa was very open when we interviewed her in August, which made it easy to write a profile that is (I think) a good read.

Having travelled, I decided to take the opportunity to spend the weekend in my hometown. I always welcome the opportunity to let my accent revert. On Saturday evening, I went to the ballet. I had been to the ballet once before, the Nutcracker in 1965. I remember being very impressed with the opera glasses, hired for the evening for sixpence. My knowledge of dance is close to zero. That is why I went.

“Tender is the Night” is one of my favourite books. It is about the moral collapse of a psychiatrist, but I am equally drawn to the elegance of Fitzgerald’s prose. The show was a contemporary adaptation of the book by the Eifman Ballet of St Petersburg. It was called “Up and Down”, which as a synopsis of the book is a bit of an over-simplification. An enjoyable evening was marred by serious discomfort over Eifman’s depiction of people with mental illness. I had to agree with Lynsey Winship who, in a negative review in the London Evening Standard said

“In Eifman’s jazz age asylum the patients have crazy eyes and stupid grins, it’s psychosis as light entertainment”

Perhaps the use of apparently crude stereotypes has something to do with cultural mistranslation between Russia and the UK. Nonetheless, vacant-eyed grins, people pulling wildly at nooses and grotesque childishness are unacceptable as ciphers for serious mental illness. I thought that one recurrent dance motif alluded to ECT, which is an anachronism as ECT was introduced long after the 1920s. It was all rather unnecessary, as the book is far more thoughtful than that.

Despite these serious misgivings, some of the actual dance was stunning. I was amazed that they were successful in conveying the concept of eroticised counter-transference through the medium of modern dance. Leaving aside stigmatising lapses, the main problem with the show was that they zipped through the story far too quickly to make sense of it. The subtleties of small ethical and moral compromises that eventually lead the main protagonist, Dr Dick Diver, to destruction were completely lost.

Some reviews of the show have been very positive. It may be my ignorance of dance that leads me to feel that dancing about psychiatry is a type of category error. It seems obvious that almost everything that makes the book so attractive was bound to be lost in translation from language to movement. According to an old Guardian review, an earlier ballet adaptation of another Fitzgerald novel, The Great Gatsby, failed for similar reasons.

It would be reasonable to ask why I went in the first place, with no understanding of dance and a vulnerability to taking offence at clumsy theatrical depictions of the subject that I know most about. My riposte would be that if I had not been offended, I would have been guilty of the same compromised values as Dick Diver. Maintaining a dialogue with people who offend our values is an essential element in making progress between psychiatrists, politicians and senior managers. Losing our values is quite another matter. Once you cannot be offended, you have lost yourself.

At the end of my speech at Vanessa’s leaving do, I said that she is a good advocate of values held by British psychiatry: a belief in the importance of human rights, of social justice, of equality, of tolerance, and of decency. I said that I was pleased that she intends to continue to work in mental health, because these values are needed in public life now more than ever. We have to defend them by doing business with people who do not necessarily respect diversity. It is a tough discipline.