Chapter Six - Fraser House Milieu

 

 

 

ORIENTATING

 

This is the first of five chapters on Fraser House researching the questions, ‘What change processes, innovations and social action evolved in and from Fraser House? How do these differ from other psychiatric therapeutic communities? What were the outcomes and effects of Fraser House?

 

This chapter gives an overview of Fraser House’s milieu and Neville’s processes for evolving it as a micro-model in exploring epochal transition. Neville’s assuming a social basis of mental illness is discussed along with his emphasis on and strategic use of locality, layout, and mix of patients.  Chapter Seven discusses the Fraser House Re-socializing Program entailing patient self-governance. Chapter Eight discusses Fraser House Big Meeting of all staff, patients, outpatients and guests, as well as Neville’s group processes. Chapter Nine looks at the change processes evolved at Fraser House, and Neville’s evolving of Cultural Keyline from Keyline is analysed. Chapter Ten looks critically at Fraser House, and details ethical and other issues in replicating Fraser House. Neville’s actions in closing down Fraser House are outlined and the implications of locality and networks within Fraser House are discussed.

 

INTRODUCING FRASER HOUSE

 

Neville set out to evolve a very rich inferential social place (Pinkard 1995, p. 115) at Fraser House approximating the richness of the family’s farms. Neville planned to gather marginalized dysfunctional people to his social place where they could sort out and re-constitute their own inferences together. Neville understood the potential of dysfunctional societal processes external to self, evoking mindbody disintegration and dysfunctional networks. Neville created a social place, space and climate whereby dysfunctional people could be energized to re-constitute themselves towards wellbeing, and to let go of dysfunctional tensions and contradictions permeating through them from prior struggles in socially toxic places.

 

Neville planned to take in people fractured by living in dysfunctional social contexts and places in society, whom society’s response was in Neville’s view (Dec 1993, July 1998) to place in even more dysfunctional anti-social contexts and places - asylum back wards and prisons. In contrast to these total institutions (Goffman 1961), Neville wanted to create a social space where people and their family and friends could ‘genuinely find themselves at home in it’, and be able to constitute their own inferential functional space of their own mutual making, and to reconstitute their social networks towards functionality, and take these functional networks out and create their own functional social spaces back in wider society. How Fraser House differed from other total institutions is detailed in Appendix 3).

 

During the years 1956 to 1959 Neville began laying the groundwork to set up Fraser House. The commencing focus-of-action was to be a very innovative and iconoclastic therapeutic community based psychiatric unit. Neville set up the unit as Fraser House in 1959 within North Ryde Psychiatric Hospital in Sydney, NSW. As well as being a therapeutic community, Neville spoke (Dec 1993) of his intention in forming Fraser House:

 

That the Unit would engage in prolonged continual action research into epochal transition[1] through re-constituting both people and people-in-community as they were evolving together shared everyday realities that fostered wellbeing.

 

Neville followed through on this intention - later describing Fraser House as, ‘the most significant psycho-social research institute in this State’ (Yeomans, N. 1965a, Vol. 4, p. 24).

 

Neville was familiar with Marx’s sociological writings about the interplay between concurrently re-constituting people and society – that societies are socially constituted realities, and that these realities concurrently fold back, as it were, to constitute people as varied constitutions of these realities. Comminel (1987, p.135) quotes Marx (1844) who wrote:

 

Thus the social character is the general character of the whole movement: just as society itself produces man as man, so is society produced by him.

 

Marx writes immediately after the above quote of the interplay of activity, enjoyment and nature:

 

Activity and enjoyment, both in their content and their mode of existence, are social: social activity and social enjoyment. The human aspect of nature exists only for social man: for only then does nature exist for him as a bond with man… Thus society is the complete unity of man with nature – the true resurrection of nature – the accomplished naturalism of man and the accomplished humanism of nature.

 

Neville was extending natural thrival processes in nature to exploring human nature emerging from communal bonding: the above interplay of action and enjoyment discussed by Marx.

 

Neville included the following diagram in his 1971 paper, ‘Mental Health and Social Change’ (1971c; 1971b) in succinctly specifying his view of epochal transition process.

Diagram 1. Neville’s Diagram

In describing the form of the shift Neville wrote:

 

 The take off point for the next cultural synthesis, (point D1 in the above diagram) typically occurs in a marginal culture (1971, p. 1).

 

In my understanding in Cultural Keyline terms, Neville timed and positioned Fraser House at D1. In ‘Keyline form’, Fraser House was just below the steep fall off the main ridge (mainstream asylums in crisis) at a Keypoint in a ‘primary valley‘ on the margins of the decline of the old cultural synthesis and the first beginnings of a new cultural synthesis.

 

 

Diagram 2 Neville’s Diagram recast in Keyline terms

 

 

Neville chose to populate the Fraser House enclave from the ‘marginal culture’ of the mad and bad from the dysfunctional fringe of the old cultural synthesis in Sydney. Continuing Neville’s ‘Mental Health’ paper about the old cultural synthesis:

 

It develops a relatively anarchical value orientation system (1971b, p. 1).

 

This aptly describes Fraser House; values oriented the unit. While the values were deemed anarchy by some in the health hierarchy, this was relative to their top down control of the disempowered. Neville evolved a patient self governance based value system energising patient empowerment. Neville then writes in his ‘Mental Health’ paper about the old cultural synthesis in decline becoming dedifferentiated (uniform and undifferentiated) with little innovation:

Its social institutions dedifferentiate and power slips away from them. This power moves into lower level, newer, smaller and more radical systems within the society. Uncertainty increases and with it rumour (1971b, p. 1).

 

Neville spoke (Dec 1993) of Fraser House being placed as one of the ‘lower level, newer, smaller and more radical systems within the society’ that he wrote about in his ‘Mental Health’ paper (1971c; 1971b). Also referencing the same paper,Neville ensured that ‘uncertainty and with it rumour’ abounded about how Fraser House mismatched the psychiatry of the old cultural synthesis. Another quote from Neville’s ‘Mental Health’ paper (1971c; 1971b):

 

Also an epidemic of experimental organizations develop. Many die away but those most functionally attuned to future trends survive and grow (1971b, p. 1).

 

Fraser House was just such an ‘experimental organization’. In terms of the old cultural system, these ‘experimental organisations’ are like an epidemic – spreading viral like; the Sixties and Seventies saw the emergence of all manner of interest in alternative living. Neville was constantly engaged in action research into how well Fraser House was ‘functionally attuned to future trends’ so it could ‘survive and grow.’

 

To protect Fraser House from attack, very few people knew of Neville’s epochal-transition agenda. This agenda and Neville’s adapting of Keyline and Indigenous way were never mentioned in any of Neville’s writings of the period. The only people I interviewed who knew of this agenda were Ken and Stephanie Yeomans, and his Fraser House personal assistant Margaret Cockett. Neville did have the support of people at the top of the Health Department who, I understand, also did not know of Neville’s wider agenda. It was commonly known that Fraser House would be an experimental unit and a therapeutic community. Initially only Neville knew how iconoclastic he intended it to become.

 

Window of Opportunity

 

Neville had completed degrees in zoology, medicine and 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, N. 1965a, Vol .12, p. 66 - 69). Similar to the mood change in psychiatry in England after the Second World War (discussed in Chapter Three), 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.

 

Photo 1 Neville and nurse at Fraser House in 1960 (Yeomans 1965a).

 

Fraser House was 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.

 

LAYOUT, LOCALITY, AND CULTURAL LOCALITY

 

Fraser House was a set of buildings over a quarter of a kilometre long. The buildings were set in a long wiggly pattern along the contour line – refer Diagram 8 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 spotted the Keyline connection in the Unit's layout and told me about this. I met Wells through a conference festival that Neville helped evolve called ConFest - discussed in Chapter Eleven.

 

 

Photo 2 Jack Wells at ConFest – From DTE Archives

 

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 metres by sixteen metres) where the big meetings were held.

 

 

Photo 3 A photo I took in June 1999 of Fraser House through the trees along Keyline

 

The diagram below shows Gladesville Macquarie Hospital (formerly North Ryde Hospital) showing Fraser House, made up of Wards 8 & 9, now called the Lachlan Centre.

 

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 (with administration as a ‘wall’ between them) as isomorphic with 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 health department as, ‘an extension of the medical infection model’.

 

 

Diagram 3. Map of section of Gladesville Macquarie Hospital

 

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.

 

 

Photo 4 Photo I took in June 1999 of one wing of the Fraser House Dorms

 

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 kilometre wending through each building and along 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.

 

ASSUMING A SOCIAL BASIS OF MENTAL ILLNESS

 

Neville evolved Fraser House assuming a social basis of mental illness. This has links to the important role social cohesion plays in preventing mind-body-spirit sickness in Australian Aboriginal culture (Cawte 1974; Cawte 2001).

 

Regardless of conventional diagnosis, in Fraser House it was assumed that dysfunctional patients would have a dysfunctional inter-personal family friendship network. This networked dysfunctionality was the focus of change.

 

Consistent with this, the Fraser House 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 said (July 1998) that he and all involved in Fraser House worked with the notion that the patients’ life difficulties were in the main, from ‘cracks’ in society, not them. Neville took this social basis of mental illness not out of an ignorance of diagnosis. Neville was a government advisor on psychiatric diagnosis as a member of the Committee of Classification of Psychiatric Patterns of the National Health and Medical Research Council of Australia.

 

Neville was familiar with twin sociological notions that people are social products and at the same time people together constitute their social reality (Marx 1844; Berger and Luckmann 1967). Neville said (June 1998), that he took as a starting framework that people’s internal and external experience, along with their interpersonal linking with family, friends, and wider society, are all interconnected and interdependent. Given this, Neville held to the view that pathological aspects of society and 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’ behaviours emerge from dysfunctionality in family and friendship networks. This was compounded by people feeling like they did not belong - being displaced from place (dislocated). Problematic behaviours may be experienced as feeling bad or feeling mad, or feeling mad and bad.

 

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 a Keyline principle, ‘do the opposite’ to interrupt and reverse dysfunctional psychosocial and psychobiological processes (biopsychosocial). That is, he would design social and community processes that would inevitably lead to Fraser House Residents re-constituting their lives towards living well together.

 

Neville told me (Sept, 1998) 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 their new, expanded, and functional network in the wider community. The Fraser House process didn’t require or need ‘intellectual’ therapy. Neville’s view (Dec, 1993, June-August, 1998) was that the intellect is the ‘servant of emotions’ and ‘servant of reproductive and survival instincts’. Neville said (Sept, 1998) that many Fraser House patients returned to functionality with little by way of insight about what had happened to them. Neville said (Dec, 1993) 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. 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 inevitable central transforming process in the therapeutic community, regardless of a patient’s presenting condition and conventional diagnosis.

 

LOCALITY AS CONNEXION TO PLACE

 

Resonant with Tikopia, 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.

 

Neville created Tönnies' small village community (Tönnies and Loomis 1963). Like in Tikopia, with all of the constant social exchange, any strife soon became common knowledge and following the Fraser House slogan ‘no madness and badness here’, typically, it was interrupted before it could start. Patients had little or no such spaces and places outside of Fraser House that allowed for, and fostered 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 infere