This Chapter outlines Family-Friends Therapy and Big Group Therapy process along with some of Nevilles leader roles and processes during Big Group and Small Groups. A number of other innovative change processes are specified including Small Group Therapy with membership based on a set of rotating sociological categories. Two case studies provide a feel for Fraser House in action. The Chapter concludes with a discussion of Nevilles adaptation of his fathers Keyline to Cultural Keyline
Typically, patients arrived at Fraser House with a small (2-7 people) dysfunctional family/friendship/workmate network. Neville said that the assumption and the experience of Fraser House people was that the individual patient was fundamentally a part of this dysfunctional social context. Patient pathology was inter-related, inter-connected and inter-woven with the pathology of the social (family/friendship) network in which the patient was enmeshed. The Units treatment aim was to increase the patients role-taking functionality and psychological comfort towards their returning to functional life in their local community with an extended and functional family/friendship/workmate network,
typically of around seventy people! Processes whereby most patients achieved this are discussed later in this Chapter.
According to Chilmaid in August 1999, there was not so much a treatment program, more that everyone new who had what problems. Treatment tended to be context driven and informal rather than formal and planned. Notwithstanding this frame, both the Admissions Committee and the Progress Committee did identify the big and small chunks that needed resolving and these were made known to the community-as-therapist.
In his paper, Sociotherapeutic Attitudes to Institutions, and consistent with creating cultural locality, Neville wrote that mental health professionals must aim at allowing the outside culture into the institution (Yeomans 1965 Vol. 12, p. 46, 60-61). One of the change processes at Fraser House was called Primary-Group Therapy. It was also called Family-Friends-Workmate Therapy and Household Therapy. This therapy involved attendance of a patients family, friends and workmates as outpatients at Big Group and Small Group therapy. One of Nevilles monographs reports that, relatives routinely attended groups in 1961; it also mentioned that relatives friends and workmates attended the Unit (Yeomans 1965, Vol. 4. p. 2-4).
There was a rule implemented that patients and their families and friends were required to attend twelve groups before the patients admission. This rule ensured prospective patients knew that families and friends regular attendance was a requirement Additionally, this rule had the effect of having people absorbed into the community before becoming residents or outpatient friends and relatives of residents with all the advantages flowing from this close fit.
This is discussed in the next two sections. Given that the patient and his family-friend-workmate network was the focus of change, Primary-Group Therapy was fundamental and a requirement for a patient being accepted into Fraser House.
During Big Group everyone was in therapy. Visiting Family, workmates and friends would sign on as outpatients. In an April 1999 conversation with Bruen he said that while it was not spelt out to staff that they too were in therapy, a person could not be in Big Group and not be in therapy; it was just so dense that people had to have psychosocial and emotional shifts occur. This view was confirmed by Neville, Cockett and Chilmaid. This is resonant with Maxwell Jones comment that anyone in Fraser House had to change (Clark and Yeomans 1969, Preface).
Family, friends and workmates attending small groups would be regularly split into differing groups by design, and because of the dividing of groups by sociological category. Pathological families who were patients at Fraser House were regularly split up (the cleavering of pathological unities) during day-to-day life in the Unit. For example, they would not be allowed to sit next to each other at mealtimes. They would attend differing small groups. This cleavering was to allow space for new behaviors and the taking on of new roles towards building a more functional unity. This carefully planned cleavering and strategic linking of the parts was a feature of a process Neville called mediation therapy where mediation is an adjective hinting at the process involved in re-constituting functional relating in dysfunctional family-friendship networks.
There was also the age based inter-generational cleavering, the married/single cleavering and the mad/bad cleavering (under-controlled/over-controlled and the under-active/over-active). There was the cleavering of the mad/bad between all the diagnostic categories represented. Recall that in Firths terms cleavered unity was a feature of Tikopias life. A list of the diagnostic categories represented in Fraser House at one point in time is shown in Appendix 3. The cleavered unity of Big Group was continually cleavered into differing small groups that rotated each weekday through the various sociological categories. As required, special groups were convened outside of structured group time to work through crises, or for special purposes. These were at times run by the patients without staff attending. Typically there were around twelve special groups a week.
Family units were set up early in Fraser Houses history. Fraser House was the first unit in Australia to be use family therapy, family-friends therapy and full family residential therapeutic community. Recall that there were eight family units that included cots for young children. Virginia Satir was around the same time pioneering family therapy in the United States (Satir 1964; Satir 1972; Satir 1983; Satir 1988). The Fraser House experience was that among patients networks, inter-generational dysfunction was common and that people within pathological families were often being rewarded for deviance.
Independent of genetic psychosocial pathology (inheritance), aspects of the patterns of daily interaction (heritage) were helping to constitute and sustain pathology, often among three generations. There was also evidence that in many families, the heritage of pathology went further back than the three generations. This evidence was consistent with Nevilles requirement of have a patients multiple-generation family-friendship network attend the Unit as outpatients.
All the above terms were used to refer to the whole community meeting held twice a day during weekdays. Morning Big Group was held from 9:30 AM to 10:30 AM. Evening Big Group was from 6:30 PM till 7:30 PM. These were followed by a 30-minute tea break. Then everyone reconvened separated into Small Groups.
In Nevilles paper, Collective Therapy Audience and Crowd (Yeomans 1966), Neville wrote, the skilled use of collective forces is one of the paramount functions of the socio-therapist and such skills are defined by the team as, Collective Therapy. In his paper, Sociotherapeutic Attitudes to Institutions Neville wrote, Collective therapy, both audience and crowd, utilizes social forces in the patients primary group (Yeomans 1965 Vol. 12, p. 46, 60-61). Neville engaged all involved in Fraser House in recognizing, understanding and utilizing these social forces. The Fraser House Handbook written by patients (excerpts in Appendix 05) also refers to audience and crowd behavior, especially contagion, being a central aspect of Big Group (Yeomans 1965 Vol. 4, p. 18-20, 50-54)
Twice a day during weekdays all people in Fraser House gathering in what was called Big Group. For a time it involved around 100 people (reference) and then it grew to around 180 people. It peaked at 300 on one occasion. All these people would be crammed into a rather small room - a mixture of the very mad and the very bad patients, along with their (often strange) friends, workmates and relatives as outpatients, together with all the staff on duty at the time, as well as guests. Often there were visitors to Big Group in addition to friends and relatives of patients. These included people who attended the Psychiatric Research Study Group, people Neville had invited from the media, people Neville connected with through his extensive outreach talk schedule, students and others who made requests to attend. Members of Alfred Clarks External Study team would also attend. On one occasion a TV crew from the ABC came and filmed a section of Big Group. I was not able to track down this film in the ABC archives. Some of the many organizations that had their people attend Big Group to learn group skills are mentioned later.
Some patients had jobs that they would go to during the day. They would attend evening Big Group. Once Big Group started, the ground rule was that no one left before it was finished. A toilet was available within the room behind a screen. Two staff were assigned to be recorders, one for content, one for process. Big Group process records were kept in a very large hard covered red book. This assignment was rotated to improve staffs attending and process observing skills. This record was referred to during staff discussion in the tea break following Big Group. I have been unable to trace this red book. It seems that no records exist of any aspect of Fraser House in Government records. Neville and Margaret Cockett both confirmed that there were powerful forces very determined to see all trace of Fraser House eliminated.
Photo 1 The room at Fraser House Where Big Group Was Held
The Fraser House Handbook written by patients (Yeomans 1965, Vol. 4, p. 1-54) confirms that during the staff discussion in the tea break following Big Group the two official observers for the meeting used the Red Book to give their report to staff followed by comments by all staff members present, including the Group Leader/Therapist.
The points assessed were: mood, theme, value and interaction, therapists role and techniques employed. From these post-mortems comes much of the knowledge needed.
The aim must be always to look at the community in the BIG as a whole and this certainly is no easy matter (Yeomans 1965, Vol. 4, p. 51).
Neville always led Big Group when Fraser House was first set up. After a time, others began to get a feel for how to do it. Big Group was then also taken by medical staff. Later on, some nurse leaders also lead Big Group. As mentioned, three of the people I interviewed for this research, Cockett, Bruen, and Chilmaid all ran Big Group many times. After Neville left Fraser House in 1968 some Big Groups were even run by skilled patients. This was reported by Warwick Bruen in a conversation in April 1999. According to Neville and Margaret Cockett, Margaret Mead ran Big Group very skillfully when she visited Fraser House. Mental health was one of Meads passionate interests as an early head of the World Mental Health Federation (2002).
Evening groups catered for friends and relatives who found it difficult to come during the day, and for inpatients that worked during the day. The evening Big Groups and follow-on small groups were voluntary, though well attended (query this was it voluntary for outpatients, or all). Thursday morning Big Group was administrative only.
During an interview/conversation with Neville in April 1999 he stated that any attempt to bring up an administrative matter in a therapy group was deemed to be flight and was interrupted with compassionate ruthlessness. Any attempt to bring up a therapy matter during an administrative group was deemed to be obstruction and deferred.
All therapy sessions at Fraser House were set strictly at a length of one hour. Timing of the following tea break and the one-hour small group was strictly adhered to. When the hour was up they stopped, even if it was in mid sentence. This was specified by Neville after reading articles that therapy sessions get progressively longer once over forty-five minutes. This material comes from a discussion with Neville on 30 June 1999. What tends to happen is that people tend to leave opening up to the last five minutes, and when they do open up there is some pressure there to work through something and the session is extended. Next time nothing much happens till the last five minutes of the longer period, and so the session extends even further.
To stop this session creep, Neville set sixty minutes as the non-negotiable length. This worked. Typically, people did have things that they wanted to vent during Big Group. After this set time length protocol was established, people with issues would be clamoring to have them heard at the very start of Big Group. People knew that if people procrastinated and then it started hotting up at the 55-minute mark, it would then stop a few minutes later. Everyone soon learned to do things faster. In a very short time Big Group would get underway immediately. Soon it started itself. There were always one or two people trying to start before people arrived. Solve my problem. He is harming me! Criminals would want to attack. An anxious person would want support. A criminal would say he is being blamed wrongly.
During the Thursday morning Big Group meeting, ward administrative matters were discussed and patient committee elections were held under the auspices of the Parliamentary Committee. Reports were also received from the other patient committees.
Completely superficial matters and domestic problems could be brought up during the final stages of the Thursday morning administrative Big Group meeting. All Big Group meetings except on Thursday morning were designated therapy only. Problems of ward routines were prohibited except when they involved very intense emotional relationships reflecting treatment related difficulties.
So that everyone could see everyone at Big Group, moveable wooden tiers were set up along each of the long sides of the Big Group room. The room was laid out as depicted in Diagram 06. Staff, Patients and Outpatients were all mixed together. A raised podium was set up at the far end for the two recorders who kept a transcript of the proceedings.
It is interesting to gaze for a time at the depiction below of all the people in Big Group. One may get a sense of the dynamic of the number of people in the room and the cleavage between staff, patient and visitors. The Big Group room was rather small for the numbers that crammed into it - around 8 meters by 16 meters. Typically, the attendees sat in two rows along both of the long sides. An opening was left near the doors where seats were reserved for latecomers. Attendees were all jammed in shoulder to shoulder. The peak attendance was around three hundred and the room must have been crammed as it is a relatively small room. Mostly it was around 100-180. . When the numbers exceeded 180, there would be three rows along one or both of these long sides. These attendance figures were mentioned by Phil Chilmaid in an April 1999 interview.
The Sixties were a time when women were generally quiet in mens presence and would be quiet if men were talking. In other hospital environments this reticence to talk in the presence of men tended to apply to both female staff and female patients. An observation made by Phil Chilmaid during an August 1999 discussion was that at Fraser House, females were often passionate in groups and would often catch the groups focus and hold the floor.
Outside of Big Group, all involved in Fraser House were dispersed throughout the quarter of a kilometer long complex. In squeezing the total community and visitors into Big Group Neville was creating concentrated cultural locality. Everyone was part of the shoulder-to-shoulder crowd; everyone was audience and spectator. And everyone knew they would become the center of the crowds focus and that this could happen at any time. Being the focus of Big Group was a very potent extraordinary socio-emotional experience. Neville was very adept at creating the unexpected sudden shift in group focus. That anyone could become the focus of group attention at any moment served to create and maintain tension in the group.
In Diagram 05 male/female, staff/non-staff and inpatient/outpatient cleaverages are shown by code.
Diagram 1 Layout of Big Group showing two tiered platforms.
Neville is depicted as the black triangle in the middle of the lower row.
Diagram 2 The Cleavered Unity of Big Group Was Then Cleavered Into Ten Small Groups
Big Group was a collectively constituted and shared context/reality - and this same context/reality folded back to produce healing change. The product was normalized people. Berger and Luckmann write in their book, The Social Construction of Reality about the interplay between the individual and the community/society in linked notions shown in Diagram 07 (Berger and Luckmann 1967).
Diagram 3 The Circular Concept
A key part of the Big Group reality was maintaining a healing environment that was a natural growth force. The German word stimmung is apropos. Stimmung (Pelz 1974, p.89-90) has as one of its meanings, a mood that attunes people together. Within Big Group, Neville set up processes whereby the collective stimmung that was maintained for the time together was tuned to healing (Pelz 1974, p. 89-90). However this did not necessarily mean gentle caring and kindness. Healing often entailed what Neville called, ruthless compassion. Healing was at times rugged and relentless. It was at times exhilarating and at other times it was emotionally draining. In separate April 99 discussions with Neville, Warwick Bruen and Phil Chilmaid, they all confirmed that Big Group was very tightly structured and that no one liked it - staff and clients alike. At the same time it was widely acknowledged among both patients and staff that Big Group was very important - a crucial aspect of the Fraser House change-work.
The Big Group was not unstructured like T Groups of the late sixties (Dean 1971); rather, it was very tightly structured by Neville and the others who followed Nevilles modeling. Big Group was run like a meeting (Yeomans 1965, Vol. 4, p. 18, 50-54). The patients wrote a detailed handbook on the role of the Fraser House Nurses and the Conduct of Groups in Fraser House. It is an extraordinary document, given that it was the patients who wrote it. However, when it is considered that the patients were the primary source of training of trainee psychiatrist in community psychiatry, that they specified the nurses role and group processes in the Handbook all fits and is fitting. In writing about group process the handbook states:
The first essential in taking a group is to see it as a meeting and like all meetings, there is a need for a chairman to conduct affairs and keep issues to the point. The function of the therapist is to see that the group functions as a group. Be directive. The group could function well if the chairman adopts a completely passive and wordless role (Yeomans 1965, Vol. 4, 17-20, 50-54)
The Patients papers on the Nurses Role and Big Group Process are in Appendices 4 & 5.
Any destructive non-ecological behavior was interrupted. One criticism of T Groups was that destructive non-ecological feedback was often happening with destructive consequences. Within Fraser House non-ecological behavior was regularly occurring because of the nature of the patient/outpatient population. However this behavior was continually interrupted with ruthless compassion. Examples of the use of pattern interrupt are included later (Hanlon 1987). Big Group was edge stuff, hence liminal - threshold stuff towards new constructed realities and contexts. The concept liminal is from limin meaning the threshold or doorstep. It is embedded in the word preliminary. This concept is discussed in Chapter Nine. Bruen commented in April 1999 that Big Group was exhausting for all present and that the leader had to be really on the ball and aware of everything.
The Fraser House Handbook written by patients includes to following comment on Big Group process:
When both the staff and patients are working well together in the Unit, a peak of enthusiasm is reached at times when everyone sees almost any move at all as being gainful. New enterprises are embarked upon with an eagerness that is almost inspired and success is a certainty.
Again, when as a whole the big group is swayed by frustration, - contagious aggression and excitement result; just as contagious as the feelings of fear and panic experienced due to shared threat anywhere (Yeomans 1965, Vol. 4, p. 51)
The patients writing the handbook note that theories of behavior of crowds and audiences apply to Big Group. Further discussion on tuning is contained in Chapter Six. Creating a collective mood tuned to healing that colors the collective reality as healing, is itself therapeutic. Within Fraser House, the realized (in the two-fold sense of made real and understood) reality/context, the shared meanings about what we are here for, and the collective mood, were all healing. All participants (apart from newcomers) shared memories of previous Big Groups where healing had occurred in the shared cultural locality of the Units Big Group Room. The very space in the room had become healing space. Healing memories were anchored to this space (Dilts, Grinder et al. 1980, p. 119-151; Lankton 1980, p. 56-60, 70-72, 74, 90-104, 109, 113-116, 118; Bandler, Grinder et al. 1982, p. 53, 107, 109-110, 150, 165, 175-176, 180-185, 187-188, 193, 198; Hanlon 1987). Here we are altogether again for more of this, whatever it is! It was into this shared mood/reality - this very special stimmung space - that the mad and bad were entering - not just any old space. This is resonant with Indigenous notions of Special Places and Sacred Places. It is also resonant with Aboriginal Geoff Guests storytelling place discussed in Chapter Nine (Petford Working Group 2000).
Nevilles perspective (isomorphic with Milton Eriksons (Hanlon 1987)) was that people can only do their best, and for mad and bad people, their best is typically pathological. Often a pathological part of their repertoire is the only defense they have in particular contexts. To take that part away from them would leave them defenseless. Functional and hence more adaptive parts can be added to repertoires so problematic resources can be used rarely and ecologically. For example, given a wider range of relating skills, the childs withering comment that shatters her playmates can be reserved for the adult sleaze.
Given the prevalence of pathology, Big Group as healing stimmung was still riddled with people doing their best with pathological repertoires, including dysfunctional beliefs about the world and each other, as well as problematic values, attitudes and habits and pervasive self-doubt. All of these were being constantly held up to community scrutiny and challenged. Neville had highly refined competences to ensure ecology in this dysfunctional seething. This is discussed later in this Chapter.
A lot of Big Group was like theatre with vocal people sometimes being rather passionate and rowdy. This was attested to by Neville and Bruen in April 99. Big Group meetings were sometimes extremely frightening and challenging. Despite this, as said before, the context was framed as healing and very tightly controlled.
As an aid to getting a feel for how Big Group worked and fitted in with other aspects of the Fraser House milieu I will divert from discussing Big Group to outline firstly some of Nevilles roles as leader and secondly his Big Group processes.
Nevilles process for working with destructive non-ecological behavior was as follows. He was continually scanning everyone and various factions to sense where everyone was at (Bruen in April 1999). Whenever Neville was with more than one person, he is always on the side of the constructive striving of everyone present - their ecological bits. Examples are included later. This process may be termed ecology therapy. The essence of this therapy is that Neville never took sides verbally or non-verbally (Yeomans 1965, Vol. 5, p. 66). This is isomorphic with the Keyline principle, make use of the free energy in the system. When carrying out therapy with family and friends within Big Group, Neville did not take the side of any one person. Rather, he took the side of, or supported the healthy component of a role in the relationship between the individuals concerned in that unfolding context. Neville discussed his process in a monograph entitled, The problem of Taking Sides (Yeomans 1965, Vol 5, p. 46-47).
When working within the intra-psychic structure of any one person in the family group, Neville supported certain role behaviors of the particular individual and not other role behaviors. More specifically, he supported the normal component of certain roles undertaken by the person in the particular context. Neville did not take sides between the two or more individuals, even though typically they may be attempting to make him do this.
Neville was constantly supporting the positive component in role relationships, and in any one individual in the role relationship - that persons positive role behavior component. Using this process, it was surprising easy for Neville to flow very comfortably through the most potentially disturbing of family quarrels and conflicts. Neville was supporting the normal component of their role relationships, and consequently the normal component of the intra-psychic role structures, Neville was, intra-psychically speaking, supporting the normal sub-total of roles in the individual and the group. At the same time, Neville was not supporting and condoning the abnormal role part functions of any in the group.
Looked at from the perspective of a persons total personality, Neville was personally supporting each member of the group as a person, while fundamentally not supporting nor condoning anyones abnormal behavior. Each member of the group was accepted. Everyones abnormal behavior was rejected. The tension in each individual within the family/friendship sub-group was thus supported towards the normal. For example, lets say that in a couple, the woman was the more dominant partner. During any discussion or argument between the two, any masculine (Yang) strivings in the man would be supported by Neville while female (Yin) strivings in the male were actively rejected, by implication rejected, or at least not supported. Any feminine (Yin) striving in the wife would have being supported. In another context and with the same couple, Neville may support the feminine (Yin) aspect of the male and the male (Yang) aspect in the female because in current unfolding context that emphasis would support towards the normal.
What Neville was actually doing was changing his position as a function of the particular roles that were being attempted by one of the partners in the argument. Neville was always supporting the context specific healthy role functions. A colleague David Cruise pointed out the resonance of the words of the Henry Mercer song (Mercer 2000):
In this context, Neville was a positive, Mr. In-between and according to all of my interviewees, he was so far ahead of everyone else in his strategic ruthless compassionate caring that it was best not to mess with him if you were into tearing down wellbeing.
Typically, peoples faith and trust in Neville continued in spite of his apparent siding with one or the other. They stayed in the group therapy and come back for more. Also, people tended to have no idea that Neville was using this process of supporting each person as person, supporting their ecological bits and not supporting or rejecting the non-ecological bits. While at times being compassionately ruthlessness, Neville would often use subtlety and deftness - drawing on his Aboriginal Yolgnu experience of behaviors mirroring the ebb and flow of the tide. At appropriate times Neville would gently move on something. At other times Neville would gently withdraw. At other times he could be compassionately ruthless. Neville let the context be his guide. In all this, he excelled at maintaining rapport with others. This does not mean that others necessarily agreed with, liked, accepted, or understood Neville rather, I use rapport to connote that there remained a melding energy between Neville and others even in the presence of disagreement, dislike, non-acceptance and non-understanding. Often Neville would intentionally get people so that they detested him and were furious with him and still they would continue engagement.
In Big Group, if anyone was bitching about another person present, Neville engaged and then immediately interrupted the attacker and suddenly withdrew rapport and switched full attention to the person being attacked, and ignored the attacker, and possible the ongoing attacking. This sudden withdrawal of rapport from the attacker was all the more potent because Nevilles prior report was so strong. At the same time he would continue to monitor the attacker as part of continual meta-scanning of the whole group and group process. He may provide support and comfort, and respond to any constructive striving of the victim. This behavior rewarded the victim and was punishing the attacker. Sometimes he may isolate out and focus on the constructive and ecological bit(s) of the attackers behavior and use this to interrupt the destructive aspects. Neville was very adept at this rapid pattern interrupt to non-ecological behavior. Aspects of the interrupt process may include the sudden removal of gaze, the rapid turning of eyes, head and body away from the attacker, the cessation of Nevilles attention (as perceived by the attacker), perhaps the hand up, stop now hand gesture of the traffic policeman, the non-acknowledgment of the attackers words and being-in-the-room, and the engagement of the victim as Nevilles (and the Groups) new center of attention. Typically, the victim became the new center of the group-as-audiences attention and the attacker was for the time, excluded by the Group process. This was an example of Nevilles use of social forces. This sudden withdrawal of being the center of the Groups attention, the supports to the attackers taken-for-granted whats happening- this denial of the attackers reality - typically creates an internal interrupt to their state and functioning. Often they go into momentary confusion. Often the state of the suddenly interrupted person may collapse. For example, anger may collapse through confusion to frustration to brooding till the dramatic theatre unfolding around them captures their attention and they shift to being profoundly engaged as part of the audience to others change-work.
The never take sides and support the ecological bits of all concerned framework of ecology therapy may generate very subtle strategies. For example, a very talented woman with major psychological difficulties was avoiding doing healing work on herself by using her considerable administrative skills within a number of the patient committees. She had so mobilized the women patients to assist her on the committees that the gender balance was in Nevilles terms, out of whack. The women patients were according to Neville, running the show. The other patients had recognized that this excessive involvement by this woman was avoidance behavior in respect of her own healing.
At Big Group, Neville thanked the women for all the obvious good work that they were doing and berated the men for not pulling their weight in committees, and before any male could respond Neville asked for the womens support in using their considerable administrative ability to get the men involved so that gender balance in committee work could be re-established. The women accepted this challenge and in a very short time gender balance was restored.
The women on the committees worked on the woman talented in committee work suggesting that she be one of those who make way for increased male involvement so she could get on with her own change work. This woman bowed to group pressure and relinquished all her roles and did get on with her own change-work. Neville here used recognition of the ecological parts of the women to have them lower their power. If he had confronted them about their excessive use of power, it is highly likely he would have met their resistance to their relinquishing power, and in forcing gender balance, he could have easily created aggrieved losers. The men, for their part welcomed the return to gender balance. This interaction is another example of doing the opposite of the obvious, namely, co-opting the talent of the women and giving the men a rev up. It is also an example of working with the free energy in the total group. It was the woman patients, not the staff, who engaged in mutual help in supporting the talented woman getting on with her change-work. The process was self-organizing. They engaged in mutual-help and self-help. It was Neville who set up this possibility.
As leader, two of the roles Neville used were enabler and orchestrator. For this, Neville was accused of being irresponsible and not doing his job of leading - loosely defined as, telling everyone what to do. Being the Director and Psychiatrist in charge of the Unit, he was expected to do just that. In his profound love of all involved, Neville was accused of being, too emotionally close. In his tight, tough, humane, meticulously specific, and precise interventions in crisis contexts he was accused of being a megalomaniac. Accusations would depend on which moment a critic happened to be observing. The seeming conflicting roles of non-interventionist/interventionist and uninvolved passive/totally involved tyrannical megalomaniac are fully consistent with use of opposites and cleavered unities. Nevilles behavior was consistent with his behavior being superbly appropriate to each passing moment and context.
There is another sense in which Neville used control and abandon in his own functioning. It is resonant with what Castanedas wrote about the Yaqui Indian, Don Juans way. Don Juan spoke of walking the path between control and abandon and how to combine both of these in peak performing - to control oneself and at the same time abandon oneself. to calculate everything strategically - thats control, then once this is done, to act, to let go; thats abandon (Castaneda 1974). Neville could seamlessly slip between control and abandon or use both simultaneously at differing levels of functioning. This letting go and abandoning is resonant with Wolffs writings in his book, Surrender and Catch (Wolff 1976). Even in surrendering/abandoning there is keen seeing of what others may not see.
Neville used and fostered practical healing wisdom in action. Neville knew of the Rataiku people of Bougainville who have the word Haharusingo for loving wisdom in action (Misang 1998). For Neville, practical wisdom was always linked to place and context and embodied, especially emotional- kinesthetically, and was linked to all forms of artistic expression (Yeomans and Spencer 1993). The person of practical wisdom deliberates about things that are variable, not about things that are invariable or impossible. Neville describes a pervasive passive feeling as the source of the passive voice form in the language he typically used.
As for Nevilles view on drug based therapy, licit Drugs were used, but as a last option. In Fraser House there was no drug-induced oblivion for containment as occurred in the back wards. The head charge nurse/sister was authorized by Neville to sedate patients, and quite prepared to do so if they were a definite danger to themselves and/or others and the timing and circumstances warranted it rather than using other more preferred interrupt strategies. Stephanie Yeomans said that in her experience there was no culture of illicit drugs use in Fraser House and this would not have been permitted by Neville.
To get a sense of Nevilles (and his fathers) phenomenology, think about de Bonos types of thinking. Imagine refining divergent thinking so that everything is linked to everything, and then tempering this with thinking filters like, look for free energy, look for emergent properties, look for the patterns that connect, look for what works close to what does not work - where there may be potential for a ripple through effect; and then going into serendipity and creative thinking, and blending this with strategic thinking of the, what if, and if this then x.y.z , and then further linking this to a devils advocate or what could go wrong type thinking, and then imagining all of this psycho-physical-verbal-emotional internal action happening in nanoseconds; where (as in Fraser House) Neville experiences something happening the moment he walks into the room. He then instantaneously responds superbly to stop a potential murder! This incident is discussed Chapter Six.
Neville had noticed that there was a differing pattern to group interaction according to size (Yeomans 1965, Vol. 5, p. 64). Groups below twenty may be intimate. Attendance of between twenty to fifty people tended to have a pattern emerging in the interaction that takes the form of the discussion leader giving little lectures or sermons or taking on a teacher role. This discussion leader role may shift between the designated group leader and other staff and patients. Once there were over 50 people shoulder-to-shoulder, those present became a crowd with a different dynamic, where crowd stimmung, synchrony and contagion were possible for collective affect. Because of the above observation, Neville kept groups under twenty or over fifty.
Neville was particularly interested in processes for crowd synchrony and contagion and how to use this for enabling caring and wellbeing. Nevilles models for his own Big Group leader behavior were Churchill, Hitler, Billy Graham and Jesus - that is, people who could create crowd synchrony and contagion; people who could inspire, manipulate, emotionally move and control a crowd. He did not use them as content models. He often mentioned to staff and clients that he used these charismatic people as process models.
Nevilles abiding metaframe was love surrounded by humane caring, psychosocial ecology, and safety. Aspects of this metaframe emerge through this research. In a 30 June 1999 conversation Neville said that one appeal of charismatic leaders is that, for many followers, the paradox of existence requires the intervention of the miraculous. Many believe that such leaders can deliver miracles. When I said, And there were miracles at Fraser House, he said with flourish, Of course it was miraculous. We were the best in the planet, and we all believed this, so we would acknowledge our failings, as we were streets ahead of everyone else. I was accused of being an impossible optimist. I sense I was more of a fatalistic optimist. I didnt know then that the system was falling apart. I was context driven - if I go to creative context then everything is creative - it worked like that. As for the miraculous - well that was a calm night.....peaceful.... remember we were filled with the very bad and the very mad - the under controlled and the over controlled.
According to Bruen and Chilmaid in April 1999 Neville had an amazing ability to perceive inside and outside of the person(s) he is attending to, as well as every person in the group (up to 300), and to do all this instantly, and be ten or more steps ahead of everybody in a very strategic way. Neville had the capacity to recall virtually verbatim everything everyone said and his or her non-verbals and actions over at least the whole of a one-hour Big Group (around 180 people) or small therapy group at Fraser House. Often he would refer a person back to what they had said 20 or 40 minutes ago and be able to repeat verbatim what they said back to them.
It seems that in sensory terms, when Neville was tuned into social interaction, he typically stayed attending to external as opposed to internal recalling or imagining seeing and hearing things. He would receive thoughts as guides to action as bolts out of the blue out of internal silence with these, and their link to unfolding action, linked to his immediate (fast) emotional and kinesthetic responses as a check on ecology and fit. He could attend to specifics and scan the context concurrently, always looking for the free energy in the social milieu. For Neville free energy was the context specific and resonant functional bits of behavior and the psychosocial resources in each person present. This theme is discussed more fully in Chapter Six.
Place was fundamental for Neville. Initially I had not realized that when he and I were talking about another place (or events in another place) to the place we were situated, Neville would mentally place himself in this other place as an aid to discussion and functioning. Similarly, Neville always checked out his and others context and metacontext (the context of the context) in social exchange, so that he could get a feel for the interconnections in everyone present (Goffman 1974). None of this detail ever bogged him down or cluttered the conversation. Neville was a man of few words for him, the less said the better.
Four major themes stirring emotions are gain, loss, threat and frustration. A discussion of neuro-psycho-biology underlying these states and the relationship between the therapeutic processes used by Neville and internal functioning is discussed in Chapter Six. Neville would expressly use incidents with a high probability of heightening emotional arousal within Big Group. Below is an example of how Neville intentionally heightened the groups emotional arousal during a Big Group meeting.
On one occasion after Fraser House had been going for around two years, and as soon as Big Group started, Neville went berserk. All present thought Neville was having a mental breakdown. At first, Neville was just screaming and yelling. Then he conveyed that he was sick of everything. This raised everyones emotions. Threat was a dominant theme. After a short time the nub of Nevilles outburst was revealed. He was going on extended leave and the Department had not arranged a replacement. This was a serious matter. Nevilles (Yeomans 1965, Vol. 5, p. 1-14) file note at the time about going berserk in Big Group said in part:
With my impending holiday today I allowed my aggressive frustration full play in the community meeting this morning. The meeting began by John asking me if I was really going on holidays. I said I was even if the bloody place fell down. I then berated the Division and the fact that Dr ----- or some other Doctor should have been here at least two weeks ago.
I took a most regressed and childish aggressive view against the department and in support of Dr Barclay (head of North Ryde Hospital) and my own efforts, pointing out that both of us were letting them down because of the departments incompetence.
Nevilles outburst had made threat and anger through loss, a dominant community focus. The Unit would be without a doctor/psychiatrist. Some replacement was coming in two or three weeks, but in the meantime, they were on their own. Even when the replacement got there, he or she would have no experience of the Fraser House way. There was the major uncertainty of what changes a new psychiatrist would make in Nevilles absence. Neville was scheduled to be away for many months. Nevilles behavior and this news heightened emotional arousal to fever pitch in everyone - a combination of anger, rejection, abandonment, confusion, anxiety, panic, frustration and fear. Neville then slammed the Department as the culprit.
Both patients and staffs emotions were, by this shift in focus, directed into anger at the Department. Then Neville refocused thinking to everyone taking responsibility for Fraser House and each other. Again, patient and staff emotions were directed into this new issue of self-help and mutual-help; another mixture of emotional energy - panic, concern, uncertainty, questions of being up to the task, to name a few. Then Neville drew everyones attention to the suicidal nature of one of the patients present in the room and laid it on the line that this persons wellbeing - his very life - was in everyones hands. This was the next shift in emotional focus. Here the focus was on gain in the face of loss and threat, and how to get gain safely. Nevilles interaction with staff and patients was all about engendering communal cooperation towards safety and gain in the face of danger and loss.
Neville arranged for eight separate peoples reports of the particular Big Group meeting where he went berserk to be placed in the archives at the Mitchell Library (Yeomans 1965, Vol. 5, p. 1-14).
Everyone of these reports similarly confirmed that Neville had intentionally mobilized and used group emotional energy towards group cohesiveness in caring for itself, and that this shifting around of emotional contagion was a crucial aspect of the Unit functioning extremely well during the ensuing months (nine) while Neville was on holidays. One staff members report of the above incident ended with, This story has no end because we still continue to function as a unit (Yeomans 1965, Vol. 12, p. 2). Another staff member wrote a file note saying, I have no vivid recollections of the first week of Dr. Yeomans absence except that the nursing staff occasionally seemed surprised that the ward was still running and that we were able to get through staff meetings without Dr. Yeomans (Yeomans 1965, Vol. 5, p. 15). Warwick Bruen in April 1999 also recalled Nevilles behavior in going berserk in Big Group and collaborated the above material.
Placing eight separate staff members reports along with his own report of the going berserk incident and its sequalae for me and others to find in his archives is another example of Neville, the researcher strategist par excellence. I suspect that he did this expressly for the likes of me to find them all nearly 40 years on!
Phil Chilmaid mentioned one Fraser House research project that demonstrated that there was a consistent pattern that significant break-throughs tended to follow about 6-7 days after some major crisis (Cockett and Chilmaid 1965).
Recall that in the methods section in Chapter Two in writing about Dichter and Denken (Pelz 1974) I said, In the Fraser House outreachings and Laceweb networking contexts, we may contemplate the merging of firstly, Neville and his other system designers/co-reconstitutors, secondly, system designing/co-reconstituting, and thirdly, the system(s); and in so doing, perceiving these three as a connexity/holon. An example of Nevilles use of Dichter and Denken in Big Group and other contexts was his simultaneously scanning for initiators of, the initiating process involved in, and the unfolding of, gain, loss, safety, and danger and the interplay of high/low levels of each in patients, outpatients and staff - e.g., safely doing dangerous things, while maximizing gain and minimizing loss; another is spotting when relatively safe things are being done dangerously for little gain and potential for high loss. In all this Neville is using non-linear multi-sensing processing. Here I am talking about 'connexity perception'. A part of this in the visual sense is simultaneously attending to visual full field - the ever shifting background-foreground distinction, the flitting point of high acuity, the distant-close distinction and the peripheral; and including in awareness the aware self as responding perceiving (sense-making) mindbody-viewer, the viewing and the viewed. In the July 2000 Gatherings in Cairns discussed in Chapter Nine the Brazilian enabler had participants experience micro-experiences for increasing connexity perception (Laceweb-Homepage 2001). I enabled participants use these micro-experiences in workshops during the New Year ConFest in January 2001
Big group was a potent context for emotional corrective experience. To reiterate, four major themes stirring emotions are gain, loss, threat and frustration. Another simple model with similar focus used by Neville involved two continuums set along the X and Y axis, namely safety-danger and gain-loss (Clark and Yeomans 1969, p. 17). This is depicted in Diagram 08.
Diagram 4 Nevilles Model
Most of the criminality group had no sense of danger or when they were in dangerous situations. Typically, they also had no sense of contexts wherein safety and loss were issues. Normal people tend to have alarm bells ring (or something similar) when they sense danger. For example, seeing someone about to plunge a live electrical appliance into water will typically galvanize action. Stop!! Dont do that!!
Typically, people who end up in jail may have some notion of gain or payoff with no awareness in the other quadrants. If they have the thrill of danger, this is not balanced by an ecological sense of safety and potential for loss. Over-controlled, under-active people may be obsessed with safety or loss, or both of these, and have little sense of the danger involved in these obsessions. They may have little sense of how they may take action towards gain or a more balanced ecological sense of safety. Neville would have the above model as one of his aids to understanding and action.
One Fraser House process Neville called nanotherapy, where nano means a 1,000 millionth part. He likened it to precise micro detective work - focusing on the tiniest bits of verbal or non-verbal behavior. Something trivial may be mentioned or conveyed non-verbally and this may be picked up and explored in minute detail. Newcomers would typically become bored or annoyed by this preoccupation with minutia. They soon learned that the exploring of minutia invariable led to major breakthroughs for the focal client(s) and that this in turn rippled through to change others who were seemingly uninvolved. By modeling Nevilles nanotherapy, both staff and clients began using it as an integral aspect of their relating.
In the Big Group nothing was taboo. The Sixties were far more prudish than now, and yet in the Big Group anything could be discussed. On one occasion there was a detailed discussion of a patient who was obsessed with painting his scrotum blue. Neville told me of this scrotum incident in 1993. It was confirmed by Chilmaid and Bruen in April 1999. During the early part of a Big Group, Neville kept engaging this patient about his blue scrotum - on and on ad tedium. After forty minutes of the patients constructive struggling had been enabled, acknowledged and respected by Neville, it became apparent to those present that all manner of people were beginning the resolving of aspects of their own ambivalence, conflict and confusion about their own sexuality and relating with others. The blue scrotum became the catalyst for community loosening up. One by one patients and outpatients started disclosing aspects of their sexual life that they could see as somehow related to this other fellow and hence, in this place, safe to discuss.
While the rotating of patients as well as their friends and family members through various small groups tended to cleaver pathological groups in functional ways, typically people could sit where they wanted in Big Group. Cliques and factions would be continually forming and disintegrating within Fraser House. This would be particularly evident in who is sitting beside whom, and where at Big Group. Community processes would constantly contribute to disintegrating unhealthy factions - not to remove factions - rather, to enable the forming of healthy factions (from Neville, April 1999). As well, some patients would become for a time, isolates (From Chilmaid, April 1999s; also refer Clark, A. W. and Yeomans, N., 1969, page 131). Occasionally people would be separated by staff or patients if they were causing intolerable disruption.
A particular spontaneous pattern to the use of space in Big Group was recognized by Neville. This is depicted in Diagram 07.
Clients who saw themselves as Nevilles administrative faction (constructive administrative) would sit beside him on his right. Emotional supporters (constructive emotional faction) would sit beside him on his immediate left. Further on the left would be the emotional destructive faction. Further on the right would be the administrative destructive faction or utilitarian rationalist faction. On the far left would be the mad. On the far right would be the criminal/bad (from Neville, April 1999). Since Neville pointed out this use of space by factions, I to have frequently found this same use of space by the same factional groups (in relation to a key figure in the group) in my own group work. Recall that in medieval times, the Kings right-hand man - the Kings Champion - would sit on his right hand side.
This spontaneous use of space in Big Group has fractal and connexity aspects as well as hints of embodiment and mindbody effecting individual and group behavior and vice versa. The left-right cleavage and behavior characteristics as an aspect of space choice approximate the split in brain hemisphere function. The right hand side of the body is controlled by the left hemisphere where linear, rational logically processing occurs. The liver (for energy) is on the right-hand side. Many of the fight flight ergotrophic functioning (refer Chapter Six) is on the right hand side of body with left hemisphere involvement. Note the active constructive/destructive administrative and the active mad sat on the right the in-your-face active who, while often emotional are typically dissociated from emotion. The left hand side of the body - the hearts home has links to right hemisphere functioning with holistic and artistic aspects. The emotional constructive and destructive as well as the disintegrated mad were spontaneously on the left. A lot of their attention is internal and responding to emotion. Note how all of this is reflected in the spontaneous use of space in response to the power spot of the Big Group Leader Facilitator.
Diagram 5 The use of space in Big Group
The four corner positions were also trouble spots and were typically taken by troublemakers, nudgers and whisperers. Neville wrote a paper on this called, Whispers Relationships A Collusive Alliance (Yeomans 1965, Vol. 5, p. 38). Neville, in speaking of the constructive emotional and the constructive administrative support in a paper entitled A General Theory of Welfare Functions included the following Table 04 (Yeomans 1965, Vol. 2, p. 38 - 40.).
Recall that Neville engaged both forms of opinion and action leaders among patients and staff for support in sustaining the two functional imperatives, (a) serving to maintain the stability of the system and (b) maintaining the interaction of the system as a system with other systems within systems. Neville and Margaret Cockett research into different forms of leading is discussed later in this Chapter.
Affectional Integrative primacy
Weak - Strong
Figure 1 Constructive Emotional and Constructive Administrative Support
Once when the far right criminal/bad Mafia faction were really blocking progress in the group, Neville ruined their sabotage by being in Nevilles terms, the angel of God under their bums. They were all sitting on a raised section at the back of the room and Neville had someone who was skilled at the task, take over chairing the Big Group meeting and he, with the Mafias knowledge, went and crawled in underneath where they were sitting. In some magical way this totally interrupted their behavior and a number of things that had a very long history of pathology were quickly resolved. This is an example of Nevilles recognition and use of significant space and place.
Some professionals hold to the view that people with certain mental disorders should not be in group therapy. Neville challenged this. We mingled all manner of disturbed people every hour, everyday. In a conversation with Neville on 30 June 1999 he said, Sure, things happened, though nothing we couldnt handle. Some peers claimed that group therapy for schizophrenics would definitely make them worse. Neville found that he got excellent results. He found that he got even better results when there were criminals in the therapy group with schizophrenics. Schizophrenics often have difficulties living in their pathological social networks. Many of the criminals had learnt, albeit in anti-social ways, how to live amongst social pathology. They had no compunction about making withering remarks to the domineering mothers of over-controlled underactives. Neville said that it often happened that schizophrenic patients who were overwhelmed by their pathological parents and in a helpless hopeless state would see their polar opposite (under-controlled over-active) suddenly reducing their all-powerful parents to metaphorical ash! Theyre nothing! Time and again, anxious, tentative over-controlled schizophrenics would be amazed at the under-controlled criminals approach to things that they found overwhelming. Where a Schizophrenic may tremulously say, You cant do that, their criminal room mate may reply, Oh yeah! Just watch me! Often seeing a fellow patient put their parent firmly back in their place was a life changing experience for the over-controlled under-actives. Nevilles comment on this was, No one is totally under-controlled or totally over-controlled. Both the schizophrenics and the criminals moved to the center - to being more functionally normal.
One therapeutic aspect of the above exchange is the denial of the schizophrenics reality (Hanlon 1987) - namely that something was not allowed or not possible. The criminal sets up a new frame (Goffman 1974) - a world where being allowed is irrelevant, and something being necessary is just not so and instead something is possible.
When the criminal does do what he said he would do, the schizophrenic may see the consequences namely, their supposedly all-powerful parent retreats. Within Fraser Houses controlled environment, the forceful confrontation of the domineering person typically would neither bring the end of the World nor disastrous consequences.
Clark and Yeomans refer to a similar incident to the above criminal rejoinder (Clark and Yeomans 1969).
This time it is the over-controlled who is experimenting with using assertive rejoinders:
The group not only encourages and supports new behaviors, but provides patterns on which it may be modeled. Thus it can be seen in the following exchange how an under-controlled patient, Barry, aged 20, both provoked John and provided a model on which he could base aggressive behavior: Barry, Oh, why dont you shut up? To which John replied, Why dont you should up?
Most importantly it was only within the shelter of the group that John was courageous enough to use such an aggressive rejoinder. It was here that he saw under-controlled patients behaving in this way without catastrophic results and, that at the same time, knew that he would be protected against actual physical assault, of which he was usually terrified.
This is another example of a trivial exchange/action, which in context has immense transformative potential.
Neville well knew the potency of labeling, especially the potency of using terms like patient and mental asylum in constituting and reifying aspects of peoples response to themselves, each other, and their place in the world. On the issue of labeling, Neville preferred the term resident rather than patient. However, in his words, Not to use patient was just too hard within the hospital milieu at the time. All patients who arrived at Fraser House already arrived with a life history of negative labeling as psychosocial baggage that they had to live with. In Neville and the interviewees view, the combined Fraser House process easily outweighed the effect of all this negative labeling.
The Small Groups were mainly conducted by the nurses, with some groups being lead by medical officers, the social worker, and the chaplain. Margaret Mead ran a Small Group when she visited Fraser House. The chaplain ran some spiritual groups. Typically, one staff person ran the Small Group and one other staff person was a process observer, on-sider and trainee. Just like Big Group, Small Groups were run like meetings. The Fraser House Handbook written by patients specifies the nurse therapist role in Small Groups:
The role of the Small Group therapist and observer has always been the province of the nurse in Fraser House, and represents part of the rise in therapeutic status. Nurses have become therapists in their own right.
The first essential in taking a group is to see it as a meeting, and like all meetings, there is a need for a chairman to conduct affairs and keep issues to the point.
The initial function of the therapist is to see that the group functions as a group (Yeomans 1965, Vol. 24 p. 18).
The Handbook then gives detailed specifying of group process. Sections of the Handbook on the Nurses Roles and Big Group process is Appendices 4 & 5.
Small groups were held from 11 A.M. to 12 Noon and were preceded by a staff discussion over morning tea reviewing the previous Big Group meeting. After a similar Thirty-minute staff discussion period, Small Groups were run from 8 p.m. to 9 p.m. During the staff discussion, patients and visitors had an informal morning tea together separate from the staff. All groups and the refreshment break ran strictly to time. To reiterate, this was to prevent what Neville called, session creep.
Generally, nearly all the outpatients (typically, friends, workmates and relatives of patients) attending Big Group stayed and were allocated to the various Small Groups in both the morning and evening sessions. It was expected that outpatients attend both Big and Small Groups. There were ten or more concurrent small groups typically made up of between 9 to 18 people, or more per group
Drawing 1 A Sketch of a Fraser House Small Group
Small Groups were formed of people having common bonds based on common sociological categories. Each of these categories was as important a factor in socio-therapy as they are in sociology theory and wider society. All the groups at any one time were of the same category. The social categories were: (i) age, (ii) married/single status, (iii) locality, (iv) kinship, (v) social order (manual, clerical, or semi-professional/ professional) and (vi) age and sex. Fridays Small Groups were made up according to both age and sex for both staff and patients. This was the one exception to the non-segregation policy. Often inter-generational issues, including sexual abuse issues, were the focus of these Friday groups. Both the sociological category and the composition of Small Groups varied daily. People in pathological social networks would be all together with everyone else in Big Group. However, because of the continual changing composition in Small Groups, the members of these pathological networks were regularly split up (cleavered) for the Small Group sessions. Age grading was deemed very important, as it is one of the basic divisions in society. The thinking was that age grading sets a context for the production of personality changes to prepare the client for normal outside life. Age grading also allowed space for sorting out inter-generation pathology that was very prevalent.
Because of the number of categories, any visitor coming regularly on certain days of the week would find that they would be attending groups based on differing categories. For the Small Groups based on locality, Sydney was divided into a number of regions. In most cases, groups of people came regularly on the same trains, buses and each others cars so they all got to know each other. Patients and Outpatients would attend the Small Groups allocated by locality for their region of normal domicile, and typically, by the time they were about to leave, they would have formed a larger friendship/support network of around seventy people. This meant that people who may have previously had a social network that was smaller than typical in society, ended up having one that was typically larger in terms of the number of people in the closely known and regularly interacting part of their social network. These individual patient family/friendship networks would have members with cross-links to other patients networks, and with a continual changing Unit population with overlap in stays, these nested patient-networks became very extensive. As well, all these people had all of their rich Fraser House experience in common, and a common set of advanced communication and mutual support skills. The critical role of locality and Nevilles use of locality in this increase in the size and functionality of patients social networks is entirely resonant with Indigenous links to place and the significance of place and placeform in Keyline. Recall that Neville used to say that he wanted to increase locality, meaning people connecting to place.
Large and small child-parent groups were held on Tuesday nights where attendance was based on being a parent with accompanying child. Therapeutic play relationships were the primary focus for the first half. Typically, parents were extremely reluctant to play with their children when they first started attending. The first segment involved parents and children interacting. Often these became very emotional with many parents demonstrating poor parenting and coping skills. During the second half, the parents remained in the same room, and the parents together with staff enablers would process the interaction that had happened. The children went upstairs and continued play. Terry ONeill used to facilitate this upstairs child-play segment as a volunteer psychologist when this Parent Child group first started in the Sixties. You may recall that I received my counseling skills training from Terry in the late Seventies. He told me that on his first evening alone with the children, so much emotional energy had been generated during the first segment, playing with their parents, that the nature of the frenzied play upstairs was scary. Some of the older children were kicking a soccer ball round like a deadly missile. Everyone had to be super alert not to get his or her head knocked off. Terry said that having a number of disturbed children in play therapy in these evening sessions stretched his skills to their limit.
After having the Fraser House experience for a time, Terry came to Melbourne to take up a counseling role and joined a self-help group of psychology/counseling professionals who met regularly. Terry stated that he was assimilating, making sense of, and adapting into his counseling work the Ways he learnt from Neville and Fraser House for many months after arriving in Melbourne. When I interviewed Terry in the late Nineties he said that in his subsequent counseling work he would often mentally return to his Fraser House experience as a guide to action.
When deemed appropriate to connexity, face-to-face therapy between two patients, a patient and a nurse, or a patient and a doctor was held regularly. Even in this individual therapy, the central focus was inter-patient relationships. Encouragement was continual given to bring it up in the group.
While it was recognized that during some crisis times, individual support was needed by a doctor or nurse, most face-to-face therapy was between patient and patient, with the wider community always a background.
Fraser House pioneered home visits and domiciliary care by psychiatric nurses and patients. A monograph reports that follow-up groups to homes became routine in 1962. (Yeomans 1965, Vol. 4. p. 2-4). Patients, who had substantially changed to being psychosocially functional and proficient as co-therapists and were anticipating leaving the hospital themselves in a few months, would call on ex-patients and their families and friends to assist and resolve difficulties (Yeomans 1965, Vol. 5, p. 63). Neville wrote that these patients involved in domiciliary care work were very skilled and helped to destroy the lunatic image that often some of these disturbed relatives have of the hospital and other patients in it (Yeomans 1965, Vol 5, p. 106). Participating in Domiciliary Care was not time based - so many months prior to leaving - rather psychosocial health and competency based. This use of patients who had not been released to support those who have, is resonant in some aspects with de Bonos lateral solution to ensure that a potentially polluting industry that requires clean water itself remains environmentally responsible - require it to discharge its water upstream of its own plant water intake. Fraser House, patients were helping ex-patients settle back into the community before they became ex-patients themselves.
Upon reading my juxtaposing the De Bono example with Fraser House, a colleague of mine Dr. Dihan Wijewickrama wrote, the two processes are not strictly isomorphic. In fact one is an example of a first order cybernetic system - imposing control on a system - steering it so that it establishes a normative behavior. The process is essentially a corrective process and appears to have a ceiling to the benefit. Fraser House was a second order cybernetic system - potentially self-steering. The process here is self-referencing (positive feedback) and reconstituting - current patients helping ex-patients to fit better into community reconstitutes everyone double dividends. There would probably be no absolute ceiling to the benefits - community making more and more wellbeing both inside and outside Fraser House. Wijewickrama has written on second order cybernetics (Wijewickrama 2001).
Aspects of this domiciliary care have been adopted into mental health practice with staff doing the visits. An early example modeled on Fraser House was the Domiciliary Care Program at Kenmore Mental Hospital in Goulburn (Mitchell 1964).
The little red van used for this domiciliary care, including petrol and maintenance costs, were funded and maintained by the patients through the profits generated by their Fraser House canteen. A group of patients would often go, without staff, on these domiciliary visits. The Follow-up Committee would also be continually requesting the visitors, relatives and friends for patients to be able to use their cars and petrol to conduct domiciliary visits (Yeomans 1965, Vol. 5, p. 63). After a time it was decided to keep activity records and during the first nine weeks of activity recording (1 July 1963 to 6 Sept 1963) there were 71 group activities to homes. The average was just under 8 visits per week with a range of 5 to 12 per week.
From the outset of Fraser House a Suicide Clinic was set up as an aspect of the Unit. This may have be an Australian first. Neville obtained a lot of media attention about the role of this Clinic. In 1959 the Weekender reporter Green tells of a dedicated telephone number for Fraser House being SUI, similar to 011 today (Green 1959); telephones in those days had alpha and numeric numbers. People at risk and their family and friends could attend Fraser House as outpatients and at risk people could become inpatients. After only four months in operation, Fraser House had a five-month waiting list of people wanting to get in.
Neville was constantly seeking and gaining media attention on Fraser House. Neville placed a large collection of media clippings and other Fraser House archival material in the Mitchell Library within the NSW State Library (Yeomans 1965). Within the first nine months, Fraser House had hundreds of calls on their suicide hotline as reported in the Sun Newspaper, June 23 1960 (von Sommers 1960). Other Newspaper articles had headings like Suicide Urge Clinic Saves Lives - The Neurotic and Alcohol Unit of the New Psychiatric Center at North Ryde (1960), Pulled From the Brink Suicide Clinic (1960), Dial the Club and Talk it Over Men Who Stop Suicides (von Sommers 1960), Alcoholics V Neurotics (1960), 880281 A Phone Number That Saves Lives (Kelly 1962), and Why do People Commit Suicide (1962). The Readers Digest ran a story called, Love From a Stranger in May 1960 (1960). The Pix Magazine ran a special report on 14 October 1961 called, Are You a Potential Suicide (1961).
In evolving support for suicidal people Fraser House adopted the process of having patients and staff constantly around potential suiciders as a support and crisis intervention group so that suicidal people were never left alone. Patients would be co-opted as therapeutic enablers and patients could and did take on the role of being caring support for other patients, especially those in danger of self-harm. Any person who was in a heightened emotional state, disturbed or suicidal would be immediately specialed. This meant that two patients or a patient and a staff member would continually stay with that person (and be replaced by another shift if necessary) until, on the say of a group, the specialed status was removed. Processes were set up such that a cooperating team of patients with or without staff would take on the responsibility of providing twenty-four hour support to other patients at-risk of suiciding, and in the process gain response ability. In the archives there is only reference to one suicide at the unit. Neville and three other staff people I interviewed confirmed that suicide was extremely rare in Fraser House. Patient suicide was common in other hospitals.
Recall that when Neville went berserk at the start of Big Group when he was about to take leave, Neville harnessed group consternation around him taking leave without the health department arranging a replacement, to galvanize support around a suicidal patient. This idea of setting up support processes for suicidals was subsequently used elsewhere in the wider society and became a standard practice in mental health services. However, outside of Fraser House, I understand only staff are used in the support process. Previously, the practice had been to isolate suicidals and keep them under periodic observation. However, this practice may be inadequate - it only takes a few minutes to choke to death! In Fraser House Special Groups could be called at any time whenever a crisis occurred. These groups would last as long as required to do the job.
Fraser House may well have been the primary source of Australias suicide telephone help lines. Neville had started to give a constant stream of talks to churches and other agencies as part of his linking of Fraser House into the community. Fraser House became known in Sydney as the place to call for suicide support. Requests for help with potential suiciders came from all over Sydney. Often patients alone or with nurses would go from North Ryde over to the Gap at all hours of the day and night to talk suicidals into come off the edge. This having patients seeing their Fraser House therapeutic community having wider community relevance, and seeing their own healing ways and their peers as significant to themselves and others, was yet another element of the Fraser House healing process. Photo 24 shows how far North of the city Fraser House was. Patients would have to go into the city and then on to the Gap on South Head. The Gap has very high cliffs looking out on the Pacific. This makes rescue and crisis counseling all the more precarious and potentially life threatening for the counselor(s). Even if a person decided to return to safety, they could be so distressed, the climb back may be dangerous, especially in rainy and windy weather.
Photo 2 The Gap at South Head
Photo 3 The Sheer Cliffs at the Gap
Neville began speaking at Ted Noffs Wayside Chapel at Kings Cross in Sydney and at other places. Neville mentioned to Noff that Fraser House could not carry traveling the distance between the North Ryde and the public calls Fraser House was receiving about helping potential suiciders. Neville invited the churches and other agencies to take over the suicide help line. The Wayside Chapel started a helpline. The telephone emergency service Lifeline was set up by the Methodist Central Mission in Sydney in 1963 (Bootes 1978). This evolving of telephone emergency services was confirmed by Neville and Bruen in April 1999.
Photo 4 Photo of the city skyline from Fraser House as indication of distance. This photo also indicates the convex to concave Keyline
Neville commenced his postgraduate diploma in sociology shortly after Fraser House started, and completed it in 1963. He spoke of Fraser House being, in part like a Post Graduate Research Institute and of the Unit being the most advanced Social Research Institute in Australia.
Neville had pointed out to me that Franz Alexander had observed the potential for healing of the caring relationship between Freudian analysts and patients (Alexander 1961). Similarly, Elton Mayo (Trahair 1984) had found in the Hawthorne experiments amongst workers in the early part of this century, that the change component was not so much the various treatments of the research - rather that it was that the researchers were acknowledging the workers dignity and worth and showing an interest in them. Change was linked to the emotional experience of being research subjects.
Similarly to Mayos work, Fraser House patients and staff were the focus of continual research by Fraser House researchers and the outside research team headed up by Alfred Clark. Patients were being continually asked to reflect on themselves, other patients, other staff, Big Groups, small groups and on every aspect of Fraser House and aspects of wider society. Fraser House staff were totally devoted to patients healing, and patients experienced this emotionally on a daily basis. Through all of the research, patients learned about the notions of validity, reliability testing and trustworthiness, and how these are very useful notions as part of living in a modern community, especially one riddled with pathology. Patients also became involved in both qualitative and quantitative research data gathering and discussion concerning the results of research.
During 1963-1966 research by nurses in Male wards in Fraser House was supervised by Neville (Yeomans 1965, Vol. 12, p. 69). Neville gave preliminary training of nurses in research methods and also trained the social worker in research methods. At one time Neville arranged a Fraser House Research workshop with 25 associated projects (Yeomans 1965, Vol. 12, p. 86-99). One example was a consensual technique that involved patients considering the extent of patient participation and improvement. Patients were asked to nominate which patients were the most and least in various categories for questions like those in Figure 05:
Figure 2 Examples of Research Questions Asked in Fraser house
In answering, patients were not only being encouraged to notice healing micro-experiences (experience of little bits of behavior that may contribute to healing), they were receiving the strong positive emotional experience that what they thought and felt about things mattered and was of value. Having come from conflicted family environments where contradictory communication (Laing and Esterson 1964) was the norm, doing reality testing and checking the validity of their observations was valuable. Patients and outpatients would start discussing a very diverse range of topics and in the processes evolve their capacities in forming, expressing and evaluating opinions.
Another example of treating them with respect, dignity and worth was asking them to explore and give answers to questions about their value systems. One of these questions was almost a quote from Assagioli, that is, The Spirit working upon and within all creation is shaping it into order, harmony, and beauty uniting all beings
Neville carried out extensive values research based on the concepts of Florence Kluckhohn 1950 (Yeomans 1965). A list of the questions that were asked in Nevilles Values Research is in Appendix 5. This Fraser House values research was followed up by questionnaires being completed by over 2,000 people in Sydney, Melbourne and Brisbane, the three largest cities in Australia. A Survey called, The Survey of the Youth of Victoria was conducted by the Good Neighbor Council and the Commonwealth Department of Immigration Survey Section Canberra 1967. (Yeomans 1965, Vol 13) This survey collected information on social and economic themes as well as attitudes and values. It used Neville Values Questionnaire for the values component. There were 1035 informants and 1017 used in final analysis.
Substantially shifting core values amounts to shifting culture. Chapter Nine discusses the Laceweb experience regarding the effect of changing values, frames and behaviors at the level of everyday lived life, and the potential of this in the longer term for producing social change; that was and still is the potential of Fraser House/Laceweb healing energy. Neville stated that at the time, this values research was, in all probability, the most extensive research on values that had been done anywhere (Clark and Yeomans 1969, p. 20-26).
Patients knew that all manner of data was being collected about them relating to demographic and socio-economic data, length of stay, participation by their friends and relatives and the like. Research outcomes were discussed with patients. All this research had parallels to patients being asked to be on committees. It had the effect of involving them in participatory and humane democracy. Participatory and humane democracy is discussed further in Chapter Nine in relation to post-conflict situations like East Timor and Bougainville. This is resonant with Nevilles later studies in humanitarian law and having humane law and community democracy as foci in the Laceweb (refer Chapters Nine and Ten).
Within a connexity based Cultural Keyline frame it made absolute sense to ask psychiatric patients and ex-prisoners their attitudes towards overseas trade with SE Asia, or about landscape planning and urban renewal, or their thoughts and attitudes about crime and substance abuse. This is consistent with the Hawthorne effect. It engaged them as people of worth and encouraged them to see their place in their local place linked to the Region.
Neville told me that a process he used to protect Fraser House was that a number of research workers from Sydney Universities carried out research at Fraser House obtaining higher degrees. To close Fraser House would have meant closing many students research. Alfred Clark had his PhD on Fraser House under way. Margaret Cockett was doing her Masters research in Anthropology when the keeper of Units records discarded all of her material and they were burnt, therefore aborting that degree (Yeomans 1965, Vol.12, p.68). Margaret suspects this destruction was deliberate, because of a sustained and pervasive dislike of Fraser house by elements within the wider North Ryde Hospital. Margaret later obtained her masters based on different research. I have found no records of Fraser House in Health Department Records. It is as if it never existed.
Margaret Cockett, also did a lot of research making sociograms of networks within Fraser House using the concepts of power, opinion leaders, leaders and influence. This was brought to my attention by Warwick Bruen in a conversation I had with him in August 1999. The doing of this research was later confirmed by Margaret Cockett. Regrettably, this research was among the materials discarded by North Ryde Hospital perhaps an example of hostile attitudes held by some against what was happening in the Unit. Like all of the other research, the results were discussed with staff and patients, within groups and the progress committee.
Appendix 6 and Appendix 7 lists inventories developed and used at Fraser House (Yeomans 1965, Vol. 4 , p. 43) (Yeomans 1965, Vol. 11). These inventories enabled the putting together of a holistic psycho-social emotional mindbody portrait of each patient and outpatients whole life, covering presenting matters, recent past, post-school period, childhood as well as work history and recreational activity. This is consistent with the holistic socio-emotional focus of change at Fraser House.
Despite being extremely busy with every aspect of Fraser House and its links into the community, Neville was very active in research and writing up papers. He was an active presenter at conferences and other professional meetings. Appendix 8 contains three Tables (A, B, and C) listing fifty seven of the extensive body of Nevilles research papers and monographs mentioned in his collected papers in the Mitchell Library. Many are undated though come from the 1959-1965 period.
Group and crowd behavior during big groups was a constant research theme. For example, Neville used the terms Collindivism and Colindivity to described the nature of interaction at Fraser House (Yeomans 1965). The terms (col from collectivities and indivity from individuals) referred to a gathering of individuals and collectivities interacting as individuals and collectivities.
The most frequent collindivities would be those including both the extreme individualists and extreme collectivists working together on a common problem in interaction. The collectivists would tend to function as parts of a team and for its stability, while the individualists would function as single entities and for their own separate stabilities. Such a subgroup of individualists could be called an indivity', that is, a collectivity functioning under an individualistic ideology with its individual units primarily fostering the reality of their own systems; for example, an international gathering of extreme nationalists (reference). Neville fostered a climate that supported indivity and collindivity. Fraser House became a center for studying Group and crowd behavior. This is discussed later.
Fraser House research served at least two other functions. Results were fed back in to modify the structure, process and action research in the Unit. For example, the critical and destructive role of extremely dysfunctional families and friends in holding back patient improvement became clearer to staff and patients alike from both experience and research over the first three years. Greater efforts were then made to involve these networks.
The research was used to protect the Unit and ensure its survival, at least for a time. Research outcomes and the evaluation of Fraser House are discussed later. Neville set up the Psychiatric Research Study Group as an integral aspect of Fraser House Research. This is discussed in the following section.
During the early days of Fraser House and as part of Nevilles passion for inquiry and continuous action research on networking, he formed the Psychiatric Research Study Group. This was an early example of Neville enabling networking and learning about fostering self-organizing emergence. Neville set up the Psychiatric Research Study Group on the grounds of the North Ryde Hospital adjacent the Unit. The Group was a forum for the discussion and exploration of innovative healing ideas. The study group networked for, and attracted very talented people. Students of psychiatry, medicine, psychology, sociology, social work, criminology and education attended from the University of NSW and University of Sydney and other places. The Psychiatric Research Study Group became a vibrant therapeutic community in its own right with a connexity relation with Fraser House. Prison officers and parole officers with whom Neville had been working within the prison and corrective system attended the Study Group. Tony Vinson also attended the study group. He is now Emeritus Professor at the School of Social Work at the University of New South Wales. Neville spoke of Tony Vinson doing sociology studies in the early Sixties, obtaining his PhD in 1972 and becoming the Foundation Professor of Behavioral Science in Medicine at the University of Newcastle in 1976, and Chairman, of the NSW Corrective Services Commission in 1979. A 1963-65 Research Report states that, Tony Vinson and his team of Social Work 11 students from the University of NSW, with the Fraser House research Team, for a time acting in an advisory capacity regarding research design and field work methods, carried out a study to assess the effectiveness of the Lane Cove Community Aid Service and the Fraser House Community Psychiatric Programme (Yeomans 1965, Vol. 12, p. 45-90).
Students and others would present papers at the Psychiatric Research Study Group and passionate discussion would follow. Many of the attendees could not, or would not discuss their ideas within their respective university departments. In the University environment of the day, some were scared of presenting certain of their papers because of their innovative and groundbreaking content. Some had tried and could not get an audience for their ideas.
The Study Group provided a space where ideas that would in all probability have been rejected out-of-hand in other forums, were enthusiastically received and discussed. The Study Group was another cultural locality. Anything raised in the Study Group that seemed to fit the milieu in Fraser House was immediately trialed by Neville in the Fraser House. In trying something to see if it worked Neville spoke of the survival of the fitting. Margaret Mead chaired the Psychiatric Research Study Group when she visited Fraser House as head of the World Mental Health Federation (Yeomans 1965, Vol. 12, p. 68).
At one time there were 180 members on the Psychiatric Research Study Group mailing list. Neville wrote that the Study Group, Represents every field of the social and behavioral sciences and is the most significant research institute in this State. The Psychiatric Research Study Group maintained a central file of research projects underway throughout NSW and acts in an advisory and critical capacity to anyone planning a research project (Yeomans 1965, Vol. 4 , p. 24). Meetings were held monthly at first at Fraser House and then elsewhere. Margaret Cockett said that during the 1970s she was continually meeting up with all manner of very interesting people who had links to Fraser House and the Psychiatric Research Study Group.
As stated above, the canteen provided one context for using work as therapy. Another example was the patients winning a contract to build a bowling green against outside contractors. This involved the tendering, winning and carrying out of a construction/landscaping contract to build a bowling green for Fraser House. The patients controlled every aspect of the tendering and work.
Photo 5 Patients building the Fraser House bowling green in the Sixties.
Photo from Sydney Morning Herald Clipping in Mitchell Library
The above photo above was taken in August 1999. It shows the Bowling Green area behind the fence that was leveled out by patients with hand tools. The retaining wall was also built by the patients and it has stood the test of time - still vertical
This was the therapeutic use of an actual economy, not token work as used in United States Research by Paul and Lentz (Paul and Lentz 1977). The link between this US research and Fraser House is discussed in Chapter Seven.
A very important type of work that some of the patients became very adept at was being therapists and co-therapists in group contexts. Often the most insightful therapy in everyday life within the community was by patients. Their therapy work extended to Big Group, the small groups, interrupting incidents within Fraser House, support to specialed patients (discussed previously), individual therapy, everyday life context therapy, getting the agreement of friends, workmates and relatives to attend Fraser House Groups, domiciliary care to ex-patients and outpatients, the on-call community suicide and crisis support service and therapy skills training for new staff and guests including training of psychiatrists learning the community psychiatry component of their psychiatric course. Fraser House became the main center for training in community psychiatry.
Photo 6 Photo taken in 2000 showing brick retaining wall
and bowling green behind wire-mesh fence
Neville refined a form of therapy where mediation was a descriptor (adjective) of the process. Many years later Renouf (Renouf 1992) wrote of the uneasy sixth step in mediating - that of a form of mediating that is inherently building and healing relationship. Almost invariably, conventional mediators are not equipped to engage in this type of process and do not attempt to do so. Nevilles mediation-therapy requires a fundamentally different set of healing and therapeutic processes and competencies/abilities compared to those typically used for mainstream mediation.
Neville placed me in sustained action research contexts using mediation therapy to refine my competencies. Chapter Eight discusses Nevilles pioneering contribution in the use of mediation within the Family Law process, and within law, neighborhood disputes, and the business community.
Fraser House offered primary patient care by skilled psychiatric nurses to many surrounding organizations. A Fraser House social worker was based in the Hunters Hill Council Chambers Administrative Office providing a service to the public half a day a week. Neville was continually giving talks to church groups and other organizations about Fraser House and its processes. Neville set up what was called the Sydney Therapeutic Club on verandah of Ward One at Sydney Hospital (Yeomans 1965, Vol 5, p. 104). Neville worked closely with eight social workers at Sydney Hospital. Some of the social workers were trained in group therapy and a consultative mental health programme was established. Six of the social workers attended Fraser House groups. Sociotherapy groups were held regularly at Sydney Hospital for three years (Yeomans 1965, Vol 12, p. 70). Fraser House patients and ex-patients attended these Sydney Hospital Groups. Neville announced the start of these Sydney Hospital sociotherapy group meetings during a Fraser House Big Group that was very tense, as a catalyst for change in that Big Groups mood (refer stimmung mentioned previously).
As an example of linking Fraser House to the wider community and vice versa, during 1965 assistance was given on an individual or workshop basis by members of the Fraser House Research Group to thirteen organizations listed in Appendix 9 (Yeomans 1965, Vol. 12, p. 94). Seventeen people from the Parramatta Psychiatric Center met monthly under Nevilles chairmanship on eight occasions. (Yeomans 1965, Vol. 12, p.85) Members of the Salvation Army undertook training in group leadership at Fraser House. Brief and extended training courses also included clergymen from all Christian denominations. Also involved were family welfare agency counselors, parole officers and nurses and administrators from private hospitals. Neville also advised the Salvation Army on the development of hostels (Yeomans 1965, Vol, 12, p. 72). Neville was the Honorary Consulting Psychiatrist at Langton Clinic for Alcoholics. He also guided that hospital on therapy, policy and research (Yeomans 1965, Vol. 12, p.70)
Neville also gave many talks and interviews about Fraser House that were broadcast on TV and radio. This was confirmed by Neville, Chilmaid, and Bruen. Neville was the Guest of Honor at the All Nations Club on 30 August 1963 (All Nations Club 1963). A draft of speech on social problems to the Ionian Club Sydney entitled Introduction on the Origins of the Ionians is included in Nevilles archived papers (Yeomans 1968, Vol. 1 p. 291. ). On one occasion a TV crew from the ABC came and filmed a section of Big Group. One of the intentions of these interviews was to have the public know so much about what was happening at Fraser House, that it would raise a hue and cry if there were any moves to close the Unit.
Neville was away overseas for nine months in 1963 exploring the state of the art in community based healing approaches in the United States and the United Kingdom. In Nevilles view Afro-American community child care centers and community welfare centers were state of art; they were looking after their own. Upon his return Neville wrote a report recommending that community mental health centers be attached to schools, because school counselors meet the families. Nevilles report recommendations were shelved. Neville energized the Paddington Childrens Community Center based in part on the Afro-American New Haven Community School he visiting in America (Yeomans 1965, Vol. 1, p70-80). This linking of support to schools has some resonance with what happened in the NSW town of Bourke as a result of two Aboriginal members of that Community attending a Human Relations Gathering enabled by Neville in Armidale, NSW in 1971. This is discussed in Chapter Eight.
Such was Fraser Houses growing reputation in the new field of community psychiatry that Fraser House became the place providing community mental health training in community psychiatry for students preparing to become members of the Royal Australian and New Zealand College of Psychiatry. Students were allocated to Fraser House for six-month periods. Social worker students from both the University of Sydney and the University of NSW were also trained (Yeomans 1965, Vol. 12, p.73). Dr William (Bill) McLeod, head of Royal Park Psychiatric Center in Parkville, Victoria for many years told me in 2002 that in the early Eighties he used Neville as an examiner for the Royal Australian and New Zealand College of Psychiatry.
Neville and Margaret Cockett both confirmed that they and Harry Oxley prepared a course introducing psychiatrists and also medical students to the sociology of medicine, socio-medicine and anthropology. They then began lecturing in this course through Callan House. This was the first course of this type. I have been unable to track down any records of this course.
Fraser House was the first mental institution in Australia to identify surrounding suburbs as an area of special interest. Church and other community groups in the area were approached and told about the programs and processes used at Fraser House. Neville was a frequent speaker at these groups. People from the groups were invited to attend Fraser House as guests at Big and Small Groups. Fraser House research people gathered data relating to the mental health in the surrounding area. This area came to be known as Fraser Houses catchment area (Yeomans 1965, Vol 4. p. 2-4). Neville supported the setting up by Dr Mitchell of a therapeutic community in the very large Kenmore Hospital in Goulburn. They were one of the first to follow Fraser House in using catchment areas (Mitchell 1964). The Kenmore Therapeutic Community is discussed in Chapter Seven. This notion of catchment areas has spread through mental health services. This was an innovation that contributed to the demise of Fraser House as total and voluntary therapeutic community. In 1968, the areas around Lane Cove were designated the Admissions Catchment Area for Fraser House, and from then on involuntary patients (people being committed) were admitted to Fraser House. This fundamentally distorted and collapsed the Fraser House voluntary self-help process.
The Anthropologist Margaret Mead visited Fraser House as the Co-Founder (1948) and ex-President (1956/7) of the World Federation for Mental Health (Brody; 2002). Margaret Cockett informed me that Margaret Mead was introduced to Fraser House by an anthropologist friend of Margaret Cockett in the Housing Department who had told Mead about Fraser House when she came to visit her. Margaret Cockett told me that initially Margaret Mead could not believe what she was hearing and came to Fraser House to check it out. Mead was escorted throughout the day by Margaret Cockett, the Fraser House anthropologist psychologist. In an interview I had with Margaret Cockett (Aug 1999) she recalled Margaret Mead saying that she was very taken with the concept of therapeutic community and had visited many such communities in different places. Mead also stated that Fraser House was the only therapeutic community that was totally a therapeutic community in every sense. In talking about her feel for Fraser Houses totality and completeness Cockett said that Mead spoke of Fraser House as the most Total therapeutic community she had ever been to. Mead was particularly taken with the fact that important others were required to regularly visit patients in Fraser House, and that one patient, having a horse as the only important other in her life, was allowed to have the horse tethered grazing on the lawns of the hospital just outside Fraser House. A few other patients had a cat or a dog as their important other.
Photo 7 These Are the Grounds Outside Fraser House Where the Horse Grazed
In August, 1999 interview Chilmaid said that the total nature of the therapeutic community was a major factor in limiting violence as well as suicide. Mead very ably conducted the morning Big Group as well as small groups. Margaret Cockett described Mead as being absolutely on the ball in the role of leader of both Big Group and one of the small groups. Margaret Mead also took the regular half hour staff group meeting that followed the Big Group.
Many big men from the health department joined Margaret Mead for lunch where according to Margaret Cockett, Margaret Mead held court and demonstrated that she was clearly ahead of every one of them in their respective specialist areas. Margaret Cockett suspects that it was Margaret Meads glowing report to these people in the NSW health establishment hierarchy that made things just a little easier for Fraser House for a while. At that time, the medical and psychiatric profession saw no relevance whatsoever for anthropology in their professions. Margaret Mead gave the big thumbs up to Fraser House to these Department Heads, heaping praise on every aspect of the Fraser House therapeutic community. Neville had completed a file note on this visit by Mead (Yeomans 1965, Vol. 12, p.69). The file note says Dr. Margaret Mead, world famous anthropologist who visited Australia last year attended a meeting of the Psychiatric Research Study Group and also stated that she considered Fraser House the most advanced unit she had visited anywhere in the world.
A mother was serving twelve years for the murder of two of her three very young children. Right through the mothers prison term she had repeatedly stated that she was waiting for the day she gets out of jail to kill the remaining child. This child had been looked after by foster parents for eleven years and was twelve years of age. When the mother was within a few months of release she was still threatening to kill the child. There was a lot of pressure from the prison authorities on the Parliament of the day to pass special legislation to ensure this woman was never released. Prison governors and warders alike were concerned for the safety of this remaining child. Upon learning of the fears about the mother and her pending release, Neville suggested to the authorities that the mother be allowed to request a transfer from prison to attend Fraser House on a voluntary basis and if she agreed, to grant her request. In process of setting up this possibility, the foster parents of the surviving child, along with the child in question were invited by Neville to attend Fraser House Big and Small Group meetings for a number of months while the mother was still in prison. Neville fully briefed the foster parents and child on Big and Small Group process so that they all knew what to expect. The Foster parents and the child agreed to attend. There were other children present, as was the custom - up to eight families were in residence at any one time. As well, families and friends visitors included children. The safety of children and everyone was always of paramount concern. As for high expressed emotion and children, typically, in these families children already had been living with it from birth.
This attending of Big Group was for the foster parents and the child to firstly, decide whether to be present in Big Group if and when the mother arrived, and secondly, so that they could all get a sense of how Fraser House operated on dysfunctionality, and thirdly, so that they could potentially - if the mother was released into Fraser House - have some clarity about where the mother was at. The alternative was for the child and foster parents to live, knowing the mother was possibly to be released, and then at large, somewhere out there, and knowing she was still threatening to kill the child. After regular attendance at Big and Small Groups, the foster parents and the daughter agreed to be present if and when the mother arrived at Fraser House. Given the circumstances, this says a something about Fraser House.
Also saying something about Fraser House and the spirit of the times, it was agreed by the Authorities that the mother be given an ultimatum - be escorted from prison directly to Fraser House and admit yourself voluntarily or we will pass legislation to keep you in prison indefinitely. She accepted the Fraser House alternative. The foster parents and child agreed to leave it up to Neville whether or not to introduce them to the mother, and when. That the child and Foster parents were attending Fraser House groups, wanted the mother at Fraser House, and that the three of them would be there when the mother arrived was made known to the various interested parties determining the mothers release. However, the maternal mother was given no information of the intention to have her daughter and the foster parents present on the day she arrived. When the mother was ushered into Fraser House she had little idea where she was or what sort of place Fraser House was - all she knew was that it was a psychiatric hospital where she would have a better chance of release compared to staying in prison where she was facing the possibility of an indefinite prison term. The members of the small assessment group who interviewed the mother upon her arrival were all patients who had killed or seriously injured members of their own families - it takes one to know one.
This assessment was by members of the Admitting Committee made up of patients and was a regular feature of Fraser House. They did not declare they were patients and that they had all murdered or had seriously injured their family members.
The maternal mother had had no information at all about her sole surviving daughter for the eleven years she had been in jail. She had no knowledge of her daughters current whereabouts and that she would potentially meet her daughter in a Big Group setting. The maternal mother was left in the care of a staff member while the assessment group briefly gave their initial assessment of her state to the waiting Big Group. The mother was then taken down the short (soundproof) passageway and into this rather small room crammed to capacity. Around 180 people were in two tight circles and all eyes were on the mother. She was totally unprepared for this. She searched the room for familiar faces and found the members of the Assessment Group. She was directed to a spare chair and hardly noticed that she was sitting between two very powerfully built men. With their casual clothes, she had no way of knowing they were nurses who had been placed either side of her to prevent her reaching and harming her daughter. Beside one of the men was a female nurse. Unknown to the mother these three were on constant alert to stop her approaching her daughter. Directly opposite sat her daughter flanked by her foster parents who in turn were flanked by people also on constant preparedness to move together and forward to block the mother being able to reach the daughter.
Neville spoke up and asked members of the Assessment Group in turn to give the newcomer their backgrounds. Each spoke briefly of assaulting/killing members of their families. After the overwhelming confusion and emotional flooding from this introduction to Fraser House Big Group, Neville caught the mothers attention and said words rather quickly and matter of factly to the effect, and....by the way....over there is your daughter... mentioning her name.
Already in overload from the weird context, this sudden potent unexpected revelation put the mother into massive overload. The mother now had the opportunity to have a shot at killing her daughter in front of the group. This had been her fantasy obsession for eleven years and here was her daughter in the flesh in front of her - just a few steps away! After a very short time in the room the mother suddenly made a frenzied dash towards the girl and the male nurses, on razor alert for just such an occurrence, grabbed the mother. She immediately went into an almighty struggle with super-human emotional energy. The female nurse grabbed the mothers hair and pulled this to restrain the mother from her attempts at biting bits off the two male nurses heads and shoulders. There were others prepared on either side of the foster parents and child (in the middle) that headed towards the mother blocking her path to the foster family. When she was restrained the meeting resumed. After a time when she had calmed a little, the restraining hands left her. She made a couple of other dashes and the same process returned her to her chair. The mother, daughter and foster parents were the group focus for the balance of the hour. The mother was probed relentlessly to determine where she was at.
Nothing, absolutely nothing, altered Fraser House routines. The Big Group meeting always lasted sixty minutes - exactly. The four key people in this case, sometimes separately, sometimes in different combinations attended the regular and special small groups that occurred throughout the day. They were again the focus of these groups. The maternal mother was not left alone with the daughter. All four participated in the evening Big Group. It emerged that at the time of committing the offences until she arrived in Big Group, the mother had had a delusional belief that all her children had a disease that would blind them. This delusional belief was unraveled and dispensed with. After everything that had happened that day, at the end of the evening Big, Small and special Group meetings there was consensus among everyone present, including the daughter and her foster parents, that the mother was now safe. She had had an absolutely sustained nourishing and corrective emotional experience throughout the day. Neville had plotted and planned for Fraser House to be at its healing best. The whole community had been in large part focused on this challenge for weeks.
The maternal mother and the daughter stayed together alone in a bedroom that night!
The following day a staff member wanted to know who the wonderful new nurturer was, and where was the new murderess. It was pointed out that the nurturer and the murderess was one and the same person. Neville describes having an overwhelming love for this mother during the whole hour of Big Group, during the balance of the day and thereafter.
One prisoner who was to become the leader of the North Shore Bus Depot Gang was described as an incorrigible con man by all who knew him. He pretended to be schizophrenic and specifically requested a transfer to Fraser House from Long Bay Prison in Sydney. The correction authorities/parole people were open to this shift and on hearing of the request, Neville accepted him, recognizing that he was in no way schizophrenic. When things were not going as easy as planned by this ex-prisoner, he demanded that Neville send him back to Long Bay. Neville instantly agreed and the con man instantly withdrew his request.
There was a culture of disclosure in Fraser House - bring it up in the Big Group for the benefit of everyone. Compassion was shown and ruthless people were kindly entrapped. Criminality was undermined and subverted. This Long Bay Prisoner had formed a gang within the Unit from within the criminal element of Fraser House patients. They had realized that Fraser House was the perfect criminal hide-out. They were planning to rob a major North Shore bus depot on the day the depot had a large amount of cash. A couple of fellows started to have a change of heart and sensed that if the robbery happened it could reflect badly on the Fraser House community. It could have Fraser House closed!
They confessed to a couple of nurses who were taken to the place under the Fraser House building at the back of the Eastern end where imitation guns and masks were hidden. The matter was brought up at Big Group and the whole group was chastened. No vendetta took place by the gang against informers as there was a constraining network of factors to ensure this. Firstly, any small group contemplating payback would have the total community against them. Secondly, some gang members were on parole from prison and could be easily sent back there. They certainly did not want this. As well, there was the reformative pressure of the total community therapy process. Heightened crowd tension at Big Group was always used for therapeutic purposes. In this case, the threat to the community was a major component of the change potency of that Big Group. In addition, there were standing arrangements for police to have a quiet talk with clients if necessary. The gang members knew there would be no hesitation in doing this as it had happened a number of times. For example, on a tip-off from Fraser House, police would call around to the homes of absconders, especially those with drug habits and thieving records and tell them to get back to Fraser House or there would be trouble. Typically these absconders would turn up back at Fraser House looking rather sheepish. Neville has no recall of police ever coming into Fraser House. The police did however go under Fraser House to retrieve a person wanted by the police who was being sustained by some patients.
I had occasion to meet this ringleader of the North Shore Bus Depot Gang in the early nineties around 25 years after his release from Fraser House. With Neville, I was visiting Petford Aboriginal Training Farm, a remote Aboriginal Therapeutic Community. The former gang leader was at the same community doing some criminology research for a former criminologist with the Australian Institute of Criminology in Canberra. It was after some hours of three-way discussion that Neville invited the gang leader to chat about how he had first met Neville. Thats when he revealed his former life as bank robber. I would never have picked him! The ex-gang leader made it very clear that after his involvement with the Fraser House experience he was, to use his words, a completely different person. He talked about the Australian Institute of Criminology and how he became a personal assistant/field researcher there, a role he had for a number of years.
Photo 8 The Rear of the Building Where the Gang Hid Their Gear.
Every aspect of the design and redesign of the Yeomans action on their farms was pervasively integrated. It was, to use Nevilles phrase again, the survival of the fitting. Neville and his father knew that it was virtually impossible to control a living system. Living systems have self-organization as an inherent property. Neville and his father keenly attended to how the natural systems worked on the farm and designed their interventions to maximally fit with nature and allow natures emergent properties to do what they do so well. Neville took this model across to Fraser House. In mirroring Indigenous way Fraser House was about fostering respectful co-existence and meaningfully surviving well together. Everything he did in Fraser House was designed to fit with everything else - naturally. Everything complemented and supported other aspects. Things that did not work were fine tuned or discarded. Issues that arose in one context were resolved or passed on to other contexts. What worked as well as problematic aspects were discussed with everyone in Big Group. Issues not resolved in Big Group were passed on to Small Groups and vice versa. Issues within Committees were resolved, or passed on to Parliamentary Committee. Issues within the Parliamentary Committee were reviewed by the Pilot Committee. This is why Margaret Mead said it was the most complete therapeutic community she had ever seen and why Maxwell Jones said that participants in Fraser House had to change.
To use Keyline metaphors, in Fraser House Neville was breaking new ground with cutting edge processes turning the eroding rush of dysfunctional life, and enabling people to self organize in obtaining a right angle on things for heading in gentler and more thrival directions for fertile possibilities to emerge. In this, many of the words traditionally used in mental asylums were hardly appropriate words like, therapy, treat, treatment and heal. Each of these has surplus meaning associated with the notion that experts make unilateral decisions about doing things to another person that will fix them. In Fraser House they still used words like the above four, though understood them in terms of the Units milieu.
Perhaps new words need to be evolved that encapsulate the concepts explored in this research. For example, the word treatment was in the previous paragraph. Neville was not into a process whereby people were treated (as in we will fix you) by professional experts. Intervention by professional experts was expressly structured out of the process. Nevilles approach and that of all of the Fraser House community was generalist rather than diagnostic. Neville had no difficulty with diagnosis per se. He was a member of the Committee of Classification of Psychiatric Patterns of the National Health and Medical Research Council of Australia. Fraser House was not a place of service delivery in the conventional sense. If anything, the people involved were treated, as in given treats at times of partying and celebration. They were treated in this sense by giving them the gifts of joy, care, love, respect, compassion, and the company of tough, caring, loving, community associates who just would not let them persist in being crazy. The Staff did serve in the sense of enabling support, though this in no way a service in the normal sense. There are major differences between service delivery and self-help. Neville, Terry Widders, an Aboriginal colleague who Neville worked closely with, and myself had an occasion to write a monograph on the difference between service and self-help that was sent to an Australian Federal Government Health Department. The paper was entitled, Government and the Facilitating of Grassroots Action (Yeomans, Widders et al. 1993; Yeomans, Widders et al. 1993). This will be discussed later. Everything points to Fraser House patients and outpatients treatment resulting in major normalizing changes occurring in their manifest mad/bad symptoms and functional responding in the World (Madew, Singer et al. 1966; Yeomans 1980; Yeomans 1980). Coincidently, the co-author in the previous reference, psychologist Professor Peter Singer, moved to the psychology Department at La Trobe University where he was one of my lecturers.
Neville was familiar with the reciprocal concepts, Society is a socially constituted reality and simultaneously, Society produces people as social products discussed by Berger and Luckmann and told me that this was particularly germane to Fraser House process where people were reconstituted as they jointly co-reconstituting the Fraser House shared reality (Berger and Luckmann 1967). The shared life in the close community meant that helping and supporting each other was structured in. Treatment was based on the notion that emotional corrective experience was central to transforming to being well. The record of patient return to community and functional living, along with recidivism rates was significantly better than mainstream hospitals, and was effected at a significant lower cost (Yeomans 1980; Yeomans 1980).
Fraser House became a model for the World and a powerful influence in closing mental asylums. No asylums have since been built in Australia. Central to Nevilles Cultural Keyline Way was enabling living systems so that aspects, and especially latent emergent properties of the system, self organize into a better thriving. At Fraser House the challenge was how to set up natural structures and processes that were isomorphic (of matching form) to what Neville and his father had work so well for them naturally in their Keyline work. In the farm living system context, the key elements were warmth, air, water, soil biota, and dead organic material.
In Fraser House the key elements in the situated living system were the free energy (potential for thriving) within mad and bad people and their family/friendship networks, the interactive potential of situated psychosocial-emotion within internal spaces and places (as in Tikopia - (Firth 1957)) of the Fraser House cultural locality, and within the various localities and places/spaces patients and outpatients would be returning to, and the enabling resources and commitment of staff. Into all of this Neville wove Indigenous socio-medicine for social cohesion (Cawte 1974; Cawte 2001, (First edition - 1996)).
This Chapter has begun the exploring of Nevilles adaptation of Keyline to the psychosocial sphere. It described how Neville used his Way to enable all involved in Fraser House, as community, to devise and revise their own structures and processes. Big Group and Small Groups based on Sociological category and other innovative change processes including Big Group, Small Groups and other processes used by patients and outpatients (and staff) to transform their lives towards living well have been specified.
Chapters Six and Seven provide a synthesis relating to Nevilles evolving and use of Cultural Keyline within Fraser House in linking the psychosocial with the psychobiological.
Criticisms about Fraser House and Neville are outlined and responded to. The processes Neville used to spread Fraser House Way into the wider community and phase out Fraser House are described. The Chapter concludes with a brief discussion of ethical issues in replicating Fraser House.
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