Chapter Four

This Chapter is the first of four on Fraser House and commences with Neville’s adaptation of his father’s Keyline to Cultural Keyline within the context of evolving Fraser House, a psychiatric unit that opened in 1959 within North Ryde Hospital in Sydney, NSW. The Unit’s processes assuming a social basis of mental illness, and Fraser House locality, cultural locality, layout and sourcing of patients are discussed. An overview is given of the Unit’s milieu and Neville’s processes for evolving it as a therapeutic community. The Chapter concludes with a description of the Re-socializing Program entailing patient self-governance and law/rule making via patient-based committees. In the forward of Clark and Yeomans’ book about Fraser House, Maxwell Jones, the pioneer of therapeutic communities in the United Kingdom wrote, ‘Throughout the book is the constant awareness that, given such a carefully worked-out structure, evolution is an inevitable consequence’ (Clark and Yeomans 1969) (my italics). The reasons for this comment by Jones about Fraser House are discussed in the next four chapters.

A SOCIAL MODEL OF MENTAL DIS-EASE AND CHANGE TO BEING WELL

Window Of Opportunity

Neville had completed degrees in zoology, medicine and the further studies to become a psychiatrist in the mid Fifties. In 1956, three years prior to setting up Fraser House, Neville initiated the first group psychotherapy program for schizophrenics in Gladesville Hospital (Yeomans 1965, Vol. 12, p. 66-69). Neville recognized that, with considerable upheaval and questioning in the area of mental health in New South Wales, and a Royal Commission being mooted into past practices - there was a small window of opportunity for innovation in the mental health area. The New South Wales health department built the Fraser House residential unit especially for Neville. Neville was aged thirty-one when he obtained the go-ahead from the New South Wales Health Department to take in patients at Fraser House, a psychiatric Unit located in the grounds of North Ryde Hospital in Sydney, New South Wales - now called the Gladesville Macquarie Hospital. The Fraser House men’s ward was opened in September 1959 and the women’s ward in October 1960. Fraser House was a 78 bed and 8 cot short-term government hospital for voluntary severe psychiatric people; psychotics, schizophrenics, psycho-neurotics, and people with personality disorders. This Unit was established from outset as a therapeutic community, with Dr. Neville Yeomans as founding director and psychiatrist.

Photo 1 Neville and nurse at Fraser House

Assuming A Social Basis Of Mental Illness

Neville evolved Fraser House assuming a social basis of mental illness. Consistent with this, the treatment was sociologically oriented. It was based upon a social model of mental dis-ease and a social model of change to ease and wellbeing. Neville and Fraser House worked with the notion that the patients’ life difficulties were in the main, from ‘cracks’ in society, not them. Neville was familiar with twin sociological notions that people are social products and at the same time people together constitute their social reality (Berger and Luckmann 1967). Neville took as a starting framework that a person’s internal and external experience, along with interpersonal linking with family, friends and wider society all have connexity. Given this, Neville held to the view that pathological society, pathological community, and dysfunctional social networks give rise to criminality and mental dis-ease in the individual. As well, his view was that ‘mad’ and ‘bad’ behaviors emerge from dysfunctionality in family and friendship networks. Problematic behaviors may be experienced as feeling bad or feeling mad, or feeling mad and bad. For these people, life may be lived as unfathomable mess. While Neville recognized massively interconnected causal process were at work, he also recognized and emphasized this macro to micro direction of complex interwoven causal processes within the psychosocial dimension. Working with the above framework Neville set out to use the Keyline principle, ‘do the opposite’ to interrupt and reverse dysfunctional psychosocial and psychobiological processes.

Neville told me a number of times that the aim and outcome of Fraser House therapeutic processes was ‘balancing emotional expression’ towards being a ‘balanced friendly person’ who could easy live firstly, within the Fraser House community, and then in the wider community. The process doesn’t require or need ‘intellectual’ therapy. In this there is resonance between Nevilles and Assagioli’s thinking (Assagioli 1971). Neville’s view was that the intellect is the ‘servant of emotions’ and ‘servant of reproductive and survival instincts’. Many Fraser House patients returned to functionality with little by way of insight about what had happened to them. Neville said that what they were researching at the Unit was whether sharing everyday Fraser House milieu would lead to emotional corrective experience and a move to functional living in the wider society.

Neville wanted to create a special place where people could evolve their own way of life – their own culture – together; where they could evolve themselves as they evolved their shared reality. This follows from Neville’s ‘interconnected living system’ view on embodiment outlined in Chapter Three, namely that our ideas, processes and actions with others in constituting shared realities may sustain and change the way our body functions, and simultaneously the way our body functions may sustain and change our ideas, feelings processes and actions. While all manner of things were awry with patients – cognitively, mentally, physically, emotionally, and socially – within the Fraser house milieu, all structure and process framed and actuated the ‘community’ as the central transforming process in the therapeutic community, regardless of a patient’s presenting condition and conventional diagnosis.

LAYOUT, LOCALITY, AND CULTURAL LOCALITY

Locality and Layout

Fraser House was a set of buildings over a quarter of a kilometer long. The buildings were set in a long thin wiggly line along the contour line - refer map below. From my reckoning, the building is along a Keyline, and Neville’s office was at the Keypoint. I had already noted this when in 2001 Jack Wells, who is familiar with Keyline and worked at Fraser House in the early 1970’s after Neville had left, also pointed out to me the Keyline connection in the Unit’s layout. I met Wells through a conference festival that Neville helped evolve called ConFest. This Conference Festival is discussed in Chapter Eight.

Photo 2 Jack Wells at ConFest

Photo 3 Fraser House along Keyline where the convex curve becomes concave

The buildings were linked by enclosed walkways. While Fraser House was specially built for Neville, he had no say in aspects of the design layout. The Health Department ‘system’ required complete separation of males and females in different wards. A single story administration building was in the middle. At one end of the central administration section was a meeting room (approximately eight meters by sixteen meters) where the big meetings were held.

Diagram 1 Map of section of Gladesville MacQuarrie Hospital, (formerly North Ryde Hospital) showing Fraser House, made up of Wards 8 & 9, now called the Lachlan Center

At either end of the administration block there was a double story 39 bed ward, and there was a dining room at each end. There was a separate staff office in each ward. Most rooms were 4 bed dormitories. There were a few single rooms in each ward.

In Fraser House, the State system’s intention to have a division of sexes in separated wards would have been ‘shattering’ any chance of what Neville called ‘total community’, ‘transitional community’ and ‘balanced community’. Neville viewed the original planned (by the system) use of space as ‘schizoid’ - completely divisive, split - creating ‘them and us’ and ‘no go’ areas for both patients and staff. Neville saw this separation of the sexes as isomorphic with cleavered dysfunctional community. Warwick Bruen was a psychologist at Fraser House in the early 1960’s. In a 1998 interview, Bruen described the initial separation of sexes into different wards required by the Department as, ‘an extension of the medical infection model’.

Photo 4 One Wing of the Fraser House Dorms

The female ward opened in October 1960. Neville rearranged room allocation so there were no separate wards for males and females, although bedrooms remained same sex. This required some negotiating between Neville and the male staff and Unions as there was resistance to this change. After the Unit was running for a time, eight downstairs rooms were set aside for families-in-residence. The eight cots were also in these rooms. School age child patients at Fraser House attended local schools.

Neville arranged for the dining room at one end to be used by all patients. The other dining room was turned into a TV, games and recreation room. This created the necessity for patients and staff alike to walk more than quarter of a kilometer wending through each building and along winding covered walkways between buildings to go to these popular places. The dining room, the lounge room and the long corridor between them were all public spaces conducive to meeting and talking. Fraser House was a replication of the community space of the Tikopia Villages and trails.

Locality As Connexion To Place And Connexity With Place

The following is a synthesis of my crosschecked findings from interviewees and archival records. Neville created opportunities for Fraser House residents to respect and celebrate their diversity in creating social unity and cohesion as the Fraser House Community. While Fraser House was located in the grounds of the North Ryde Hospital, Neville was creating locality in the sense of ‘connexion to place’. He structured interaction such that the close communal living and the mores they evolved together helped constitute and sustain individual and communal psychosocial wellbeing among the residents. Neville also structured interaction during Fraser House events, and outdoor picnics and excursions (Fraser House Follow-up Committee of Patients 1963). Just as in Tikopia, Neville structured social exchange such that psychosocial wellbeing processes were woven completely into every aspect of their lives together. There was constant linking within and between people of differing generations, gender, ‘clan’ (family group), ‘village’, home locality, status and occupation (that is, differing sociological categories). Neville did this by cleavering the Big Group attendees into the Small Groups, each time using different sociological categories. This is discussed in Chapter Five.

In Fraser House, everyone’s lives in the Unit’s space created public space. The Unit’s public space was community space - where people were in continual close social exchange - where friendships blossomed and were sustained by regular contact. Neville created Tönnies' ‘Gessellschaft’ (Tönnies and Loomis 1963). Like in Tikopia, with all of the constant social exchange, any strife soon became common knowledge and typically, it was interrupted before it could start. Within the wider civil society there is scant ‘public space’ as places that allow for, and foster people engaging in conversing and community building with friends, relatives and strangers. The shared community life in Fraser House ‘public space’ meant that people continually talked to and about each other, and hence, like on Tikopia, social news was continually circulating. In Fraser House this circulating of social news was encouraged by the slogan, ‘bring it up in a group’. At certain times of each day there was a mingling flow of females and males from one end of Fraser House to the other along a winding long passageway that mirrored the mountain trails between both sides of Tikopia Island. In Fraser House everyone was ‘contained’ within healing community space. Everybody was in every one else’s gaze, and audience to each other’s change work. Chilmaid made the observation in April 1999 that there was literally no place to hide in Fraser House. One swoop through the place would find someone if they were there.

Neville created a large community gathering place in Fraser House for Big Group Meetings and many smaller gathering places for Small Group meetings and re-creation, with the passages between these (and the dining room) mirroring Tikopia trails. In evolving Fraser House, Neville engaged in place-making and sub-place-making. For example, the room that Big Group was held in became a very special place.

Neville set up a process where there was always a support network to call on to resolve any issue. As necessary, a special support network would be temporarily created to surround one or more till an issue was resolved. For example, in Fraser House suicidal people would have a small 24 hour-a-day support group comprising patients and staff. The Unit’s evolving common stock of practical wisdom about what works was so readily passed on that this wisdom was widely held in the Fraser House community. Patients, Outpatients and staff who had been in Fraser House for a time knew ‘what worked’ in different contexts. These socio-healing actions were preventive. They sustained wellbeing. They were the norm. Social exchange that ‘worked’ constituted an integral part of the patients, outpatients and staff’s evolving good life together. Typically it was trivial ‘everyday stuff’ about how to live well together.

Like in Tikopia, within Fraser House Neville structured it so that people lived with those most different to themselves. The under-active over-controlled shared dorms with the over-active under-controls. As in Tikopia they lived with those most different in order to gain unity and strength together though regular contact in day-to-day life. All involved in Fraser House experienced inter-related cohesive factors of everyday operation, the use of a common understanding and experience of Fraser house routines and shared values, and the sharing of a common culture; the sharing of Community (with a capital ‘C’), - to paraphrase Firth - all that is implied by all involved in the Unit when they would speak of themselves as ‘being at Fraser House’, just as the Tikopian said ‘tatou na Tikopia,’ ‘We the Tikopia,’

Locality as ‘connexion to place’ became ‘connexity with place’ by Neville’s modeling and by osmosis as all aspects of Fraser House’s social forces naturally constituted interdependent, inter-related, interwoven, inter-connected, and interlinked experience and action. While I can write about this, to fully sense Fraser House we would have had to have been there; words are not up to the job – like attempting to convey with words the lived experience of listening to Bach’s Mass in B Minor. All the above is discussed in greater detail in this and later Chapters.

Cultural Locality

Crosschecked interview reports from all of my Fraser House interviewees and findings from a wide range of archival material (Yeomans 1965; Yeomans 1965; Yeomans 1966; Yeomans 1967) confirm that the Fraser House milieu became a community of people who were evolving their own sub-culture together. While all people do this all the time, Neville recognized that linking people together, and simultaneously linking them to a specific place, has potential. In the last Chapter I referred to this as creating ‘cultural locality’ (Kutena 2002). Neville used the word ‘culture’ as meaning ‘way of life together’. He used the word ‘locality’ having this meaning in his drafting of the Objects of the Keyline Trust mentioned in Chapter Eight. In specifying things being produced by the Keyline Trust Neville wrote:

(b) Such materials and productions to be Australian in origin and dominantly for the purposes of enhancing community cooperation and mutual support, locality, self respect, friendliness, creativity, culturally appropriate peaceful nationalism and multinational regional cooperation

Recall that ‘Cultural locality’ means ‘way of life together in this place’. ‘Cultural locality’ is derived from Indigenous sensitivities, wisdom and way. While Neville used the term ‘locality’ to mean ‘connexion to place’ I cannot recall him using the expression ‘cultural locality’, although I sense he would have had resonance with this expression. All people involved in the Unit belonged to and were together evolving the Fraser House cultural locality. The places and spaces in Fraser House became very familiar. They were intimately known. These spaces and places, as well as the staff, outpatients and staff in those spaces and places were all an integral part of it.

Once oriented participants in the Unit knew where they were within Fraser House. This was in a twofold sense, firstly, where they were in Fraser House space, and secondly, something far more challenging, where they were in relation with all the others in the Fraser House community. They also knew where they were in relation to other places and spaces in Fraser House. All of this was embodied. They had feeling and knowings and associated shared understandings of the past happenings in Fraser House places and spaces. Their mindbody ‘livingness’ – as in ‘the whole of it’ (Kutena 2002) responded to the re-membering of these happenings. All involved were living the physical embodiment of the Fraser House cultural locality. By arranging for all in Fraser House to attend Big Group meetings Neville was creating concentrated cultural locality. The vibrant cultural locality of Fraser House was vastly different to the anomic, displaced, normless, alienated, unconnected, meaningless, overwhelming, aggravating lives they had been leading.

EMBODYING KEYLINE

The Tikopia people, in communally walking against and with gravity as they walked over the ridges to an fro - passing those opposite to themselves in friendly banter - were embodying their way of life - a mindbody synthesis with their people, their place, and their world. Like the Tikopians, all in walking to and thro in Fraser House were embodying their way of life - a mindbody synthesis with their fellow Fraser house people, in their place and in their world of their co-reconstituting. For Neville particularly, ideas, feelings, bodily functioning – even down to the neuro-psychobiological dendritic and cellular level, as well as psychosocial processes and actions in everyday life are all interactive and co-constituting, that is, each part plays a part in maintenance and change processes. This is discussed in Chapter Six.

Resonant with Neville’s view on embodiment, Stephen Rose, author of the Conscious Brain (Rose 1976; Rose 2002) in a radio interview broadcast on the Australian ABC Science Show on Saturday 29 June 2002 said, ‘Changes in Society can change people’s nature, which in turn can change their biology’. Neville would have said that change in any of these three aspects might ripple through to change the others. This has important implications. Our ideas, processes and actions individually and collectively may sustain and change the way our body functions. The way our body functions may sustain and change our ideas, processes and actions. Another term for ‘embodying’ is ‘incorporating’ from the Latin ‘in corpus’ meaning, ‘in the body’. This embodying has been intimated a number of times already. Neville was constantly exploring how to foster and use this interactive embodiment happening within and between connected people who are connected to place – cultural locality. Fraser House people incorporated Fraser House Way.

This extends ideas discussed by Berger and Luckmann that society is social constituted and in this process - people are constituted as products of society, psychosocially, and psychobiologically (Berger and Luckmann 1967). Recent research into tensegrity (integrity through tension) (Buckminster Fuller 1961; Pugh 1976) and intercellular communication is resonant with this. The creative and strategic use by Neville of tension to enable integrating possibilities (tensegrity) in Fraser House will be introduced in Chapters Four through Seven. Neville’s use of ‘extegrity’ (Yeomans 1999), a term he used meaning ‘extensive integrity’ in Laceweb peacehealing for reconstructing collapsed societies is discussed in Chapters Nine and Ten.

SOURCING PATIENTS

Back Wards and Prisons

It was not commonly known in 1959 and through the Sixties that Neville set up Fraser House to be a micro-model of a dysfunctional world and more specifically, a micro-model of the alienated dysfunctional fringe of a dysfunctional world. This was the major first step in exploring epochal change. This was where Neville felt it was the best possible place to start. What’s more it was Neville’s view that together, this fringe had massive inherent potential to thrive. This was isomorphic with nature’s tenacity to thrive at the margins. Neville’s aim was to work with and tap this potency just as he and his father worked with the emergent potential of their farmland. His relation to the land and to this alienated dysfunctional fringe was one of love, care, respect and awe at their potential, rather than one of disdain, domination and control. Neville was mirroring Indigenous way. To approximate this alienated fringe, Neville arranged to populate the Fraser House with a balanced group of ‘mad’ and ‘bad’ people. To reiterate for emphasis, Neville was not just setting himself a big challenge in starting with the mad and bad of Sydney, he did so because he firmly believed that these, along with dysfunctional Aboriginal and Islanders were the best people to work with in evolving a new caring epoch

Fraser House accepted long-term chronic mental patients and other severely mentally ill people balanced with an equal number of criminals, alcoholics, delinquents, addicts, and according to the sexual mores of the Sixties, homosexuals, prostitutes and other sexual deviants (Yeomans 1961; Yeomans 1961; Clark and Yeomans 1969). There was a spread across the various diagnostic categories. The intake aim was to have a spread of categories present in the Unit. Appendix 3 shows the various categories of patients in Fraser House as at 30 June 1962. Note that there were an equal number of males and females. This was typical

From the outset Neville negotiated with the Office of Corrections that Fraser House would have twenty male and twenty female prisoners released on license to Fraser House at any one time. People were transferred straight from jail and signed on as voluntary patients. None of the Wards at Fraser House were locked. Few absconded. If they did, they knew that Neville would send the police after them. Upon their return to Fraser House they would face the possibility of not being able to stay and therefore the aversive possibility of being transferred to another hospital, or for ex-prisoners, being transferred back to jail with further charges against them. The prisoners selected to go to Fraser House typically had considerable psychosocial dysfunction that had been in no way addressed by incarceration. They were typically in the last months of their prison term. Typically, that some of them had to be soon released back into society was a worry to people at all levels of society.

Fraser House patients were adults, teenagers and children of both sexes, mainly from middle and working-class backgrounds. Typically, around two thirds of Fraser House patients were referred from public agencies, especially state Psychiatric Services. Other institutional referrals came from courts, probation and parole services, and the narcotics and vice squads. Some admitted were referred by private individuals, doctors, patients and staff (Clark 1969, p.58-59). Some staff admitted themselves as voluntary patients.

In 1961, referrals were accepted from patients, and family and friends were admitted. In 1963 whole families were admitted. Desegregation of family units and single patients occurred in 1964. (Yeomans 1965, Vol. 4 p. 2-4).

During the development of Fraser House in 1959 the working name for the Unit was reported in the Weekender Newspaper as the ‘Neurosis and Alcohol Unit’. Neville was reported in the Sunday Telegraph Newspaper, 14 February 1960 as saying that he believed that Fraser House was the only clinic in the World where Alcoholics and Neurotics mingle 50% and 50 % (1960, February 14). The male Unit had both single and married men. Married men who were alcoholics could have their wives stay with them regardless of whether the wife was an alcoholic or not. The couple was the focus of change. This was the start of eight family suites. Whole families with two and three generations, from babes in arms to the elderly were involved in the suites. Neville pioneered family therapy and inter-generational therapy in Australia.

The focus of change at Fraser House for both the mad and the bad was ‘the patient in their family-friendship-workmate network’. In keeping with this, another condition of entry was that members of a patient’s family friend workmate network had to sign in as outpatients and attend Big and Small Groups on a regular basis. According to all of my interviewees, including a former patient and outpatient, the Fraser House outpatient sub-community was permeated with dysfunctional/problematic behavior, which was typically transformed to functionality by their involvement in Fraser House. It was regularly found that dysfunctional patients had dysfunctional family-friendship-workmate networks. The focus of change being the patients and outpatients and their respective networks made sense from the Fraser House experience.

In supporting mad and bad people to live well with each other, Neville’s view was that one of the primary healing processes that was both structured into and continually and pervasively at work within Fraser House, was the day-to-day lived-life dynamic healing interplay of social cleaving and unifying processes; the same processes that have been discussed in talking about Tikopia. Neville would set up scope for micro-experiences creating very strong forces cleaving pathological entanglements, as well as forging functional bonds within and between people - linking them back to their humanity.

Balancing Community

Resonant with Tikopia and as part of Fraser House’s Unity through Diversity, Neville arranged for Fraser House to be a ‘balanced community’. Neville endeavored to have equal numbers in each of a number of categories. Neville sought and obtained balance within the Unit population on the following characteristics:

· inpatients and outpatients