Fierce and hopeful

This play, staged by the Belarus Free Theatre company, was a powerfully insightful and highly emotionally charged portrayal of Arnhild Lauveng's personal account of developing schizophrenia, her encounters with mental health professionals, and her long road to recovery. It provided a relentless insult on the senses, not dissimilar from the overwhelming experiences of those in the acute stages of psychosis, punctuated by moments of humour and tenderness which provided welcome relief to the audience (and no doubt were crucial to Arnhild's survival of often brutal internal and external attacks).

Despite the fierceness of the play, the main message was one of hope. Through the support of her family and the staff that had faith in her ability to succeed and have a future outside of the mental health system, Arnhild found the strength to finish her schooling and is now practising clinical psychologist despite 10 years of being 'lost in the forest' of psychosis. This story of recovery reflects the more optimistic perspective adopted over the past two decades by the Early Intervention movement, which strongly focuses on getting young people back into education or employment rather than writing off their lives when schizophrenia is mentioned. Arnhild's transition between 'patient' and 'clinician' identities was perfectly captured by the actors constantly interchanging between these roles during the play. This also served as an important reminder that none of us are immune to the potentially devastating effects of mental ill health and that the perspectives of patients and professionals are equally valid.

The inclusion of full nudity in one scene of the play was rather unexpected, and potentially (or indeed intentionally) uncomfortable for the audience, but it highlighted how vulnerable and powerless individuals can feel while on a psychiatric ward. Ironically, Arnhild had just been granted her request of a bath by a doctor who had listened to her plea of wanting to be treated like a 'normal' woman, but then had her dignity quickly swept aside as two members of staff (and the entire audience) watched her undress and bathe. Such close observation is undoubtedly essential when an individual is considered to be at high risk of taking their own life, but the scene provided an important insight into how degrading the experience of mental health 'care' can be for those on inpatient wards. 

The issue of using physical restraint in mental health settings was also tackled in the play – initially facetiously through a farcical staff training session followed by the brutal reality of experiencing it firsthand. The theatre company ran a campaign alongside the play to end face-down restraint; a highly dangerous practice that unfortunately still sometimes occurs on psychiatric wards in the UK. The depiction of physical restraint was suitably balanced in the play though, with Arnhild acknowledging that she wouldn't be alive without such intervention, but stressed the importance of using words first and explaining to the person what is happening before and during the process.

Indeed the whole play challenges mental health professionals to take a long hard look at the way they interact with individuals under their care and screamed (sometimes literally) for the adoption of a more compassionate approach that respects the individual's right to be treated as a human being and equal. This need not be complicated; small acts of kindness (such as a smile, taking a few moments to listen to the person's needs, and respecting their opinion) clearly made a huge difference to Arnhild's experience of psychiatric care and her ability to hold on to an ounce or two of self-worth. This sentiment was echoed during the post-show discussion I did with Jonny Benjamin, a prominent mental health campaigner who has schizoaffective disorder, who emphasised the importance of small gestures from staff in making his stays on psychiatric wards bearable. 

I found participating in these post-show discussions rewarding and very humbling. It was a fantastic way to directly and creatively engage the public in thinking about mental health and to begin to breakdown the stigma that is still associated with schizophrenia. Indeed we were privileged to have this discussion space, given that in Belarus we could all have been arrested for simply watching the play let alone discussing its subject matter!

- Reviewed by Dr Helen L. Fisher, a Senior Lecturer at the Institute of Psychiatry, Psychology & Neuroscience, King's College London