Tag Archives: psychosis

A balloon bursts

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Watching The Directors: five short films by Marcus Coates, for New Scientist, 31 August 2022

In a flat on the fifth floor of Chaucer House, a post-war social housing block in London’s Pimlico, artist Marcus Coates is being variously nudged, bullied and shocked out of his sense of what is real.

Controlling the process is Lucy, a teenager in recovery from psychosis. Through Coates’s earpiece, she prompt Coates in how to behave, when to sit and when to stand, what to touch, and what to avoid, what to look at, what to think about, what to feel. Sometimes Coates asks for guidance, but more often than not Lucy’s reply is drowned out by a second voice, chilling, over-loud, warning the artist not to ask so many questions.

A cardboard cut-out figure appears at the foot of Coates’s bed — a clown girl with bleeding feet. It’s a life-size blow-up of a sketch Coates himself was instructed to draw a moment before. Through his earpiece a balloon bursts, shockingly loud, nearly knocking him to the ground.

Commissioned and produced by the arts development company Artangel, The Directors is a series of five short films, each directed by someone in recovery from psychosis. In each film, the director guides Coates as he recreates, as best he can, specific aspects and recollections of their experience. These are not rehearsed performances; Coates receives instructions in real-time through an ear-piece. (That this evokes, with some precision the auditory hallucinations of psychosis, is a coincidence lost on no one.)

So: some questions. In the course of each tricky, disorientating and sometimes very frightening film, does Marcus Coates at any point experience psychosis? And does it matter?

Attempts to imagine our way into the experiences of other beings, human or non-human, have for a long while fallen under the shadow of an essay written in 1974 by American philosopher Thomas Nagel. “What Is It Like to Be a Bat?” wasn’t about bats so much as about the continuity of consciousness. I can imagine what it would be like for me to be a bat. But, says Nagel, that’s not the same as knowing what’s it’s like for a bat to be a bat.

Nagel’s lesson in gloomy solipsism is all very well in philosophy. Applied to natural history, though — where even a vague notion of what a bat feels like might help a naturalist towards a moment of insight — it merely sticks the perfect in the way of the good.

Coates’s work consistently champions the vexed, imperfect, utterly necessary business of imagining our way into other heads, human and non-human. 2013’s Dawn Chorus revealed common ground between human and bird vocalisation. He slowed recordings of bird song down twenty-fold, had people learn these slowed-down songs, filmed them in performance, then sped these films up twenty times. The result is a charming but very startling glimpse of what humans might look and sound like brought up to “bird speed”.

Three years before in 2010 The Trip, a collaboration with St. John’s Hospice in London, Coates enacted the unfulfilled dream of an anthropologist, Alex H. Journeying to the Amazon, he followed very precise instructions so that the dying man could conduct, by a sort of remote control, his unrealised last field trip.

The Directors is a work in that spirit. Inspired by a 2017 residency at the Maudsley psychiatric hospital in London, Coates effort to embody and express the breadth and complexity of psychotic experience is in part a learning experience. The project’s extensive advisory group includes Isabel Valli, a neuroscientist at King’s College London with a particular expertise in psychosis.

In the end, though, Coates is thrown back on his own resources, having to imagine his way into a condition which, in Lucy’s experience, robbed her of any certainty in the perceived world, leaving her emotions free to spiral into mistrust, fear and horror.

Lucy’s film is being screened in the tiny bedroom where her film was shot. The other films are screened in different nearby locations, including one in the Churchill Gardens Estate’s thirty-seater cinema. This film, arguably the most claustrophobic and frightening of the lot, finds Coates drenched in ice-water and toasted by electric bar heaters in an attempt to simulate the overwhelming tactile hallucinations that psychosis can trigger.

Asked by the producers at ArtAngel whether he had found the exercise in any way exploitative the director of this film, Marcus Gordon, replied: “Well, there’s no doubt I’ve exploited the artist.”

This way lies madness

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Playing Hellblade for New Scientist, 29 August 2017

You are Senua, a Pictish outcast whose lover has been sacrificed to the gods by homicidal Norse invaders. To release his spirit, you must enter Hel, their underworld.

But is this all real?

Three years ago, Paul Fletcher, a psychiatrist at the Behavioural and Clinical Neuroscience Institute in Cambridge, UK, took a call from games company Ninja Theory. The firm wanted help creating a character who suffered from severe psychosis.

“My defences were up,” Fletcher admits, “but quickly I realised I was in serious company. We started by discussing the kinds of hallucinations people experience, and within two or three sessions we were into the neuroscience.”

Senua’s world blurs as she moves. The walls crawl as she passes. When she looks in her mirror, the wrong voice comes screaming out of her reflected mouth. “But more interesting,” recalls Ninja Theory’s co-founder Tameem Antoniades, “was the way someone in psychosis will make sense of their world by making associations: ones that outsiders might find very strange.”

Players will enjoy the way that runic images and the features of Senua’s landscape conjoin in perspectival games that further or frustrate her progress. And there are incidental delights: at one point, the embers of a distant fire pulse to the rhythm of Senua’s breathing.

Hellblade is more than a journey through a hallucinatory landscape (and hallucinatory it is, passing from flaming killing fields through sun-kissed meadows to a corridor of withered arms). It’s about a rational hero desperately trying to make sense of her world. “Most of us are pretty bad at that,” Fletcher points out.

He’s referring to a paper he co-wrote a couple of years ago, showing that people in the very early stages of psychosis are actually better at interpreting ambiguous visual information (think spotting the Dalmatian illusion, in which you see a dog image from the dots) than the rest of us. “Someone — I’ve never been able to find out who — said that perception is controlled hallucination. This is true. You bring what you know to bear on what you sense. That is how we recognise things.”

Not all people who experience hallucinations consider them a problem. Some who hear voices, for example, have joined networks dedicated to removing the social stigma attached to the phenomenon. “A lot of people suffer not because of the content of their hallucination, but because of being ostracised,” Fletcher says.

At the same time, games are becoming increasingly immersive. Hellblade’s binaural soundtrack, placing Senua’s intrusive voices in distinct locales for the player, is a case in point. Fletcher’s hope is that psychiatrists and designers can work together to create immersive environments tailored to the needs of specific individuals.

“Avatar therapy“, which uses a screen-based, computer-generated figure to represent, normalise and quell an aggressive intrusive voice, is already proving its clinical worth.

For Antoniades, meanwhile, “video games are becoming alternate digital realities”. Hellblade’s 8 hours of gameplay are a gruelling experience, made compelling by a staggering motion-capture performance by Melina Juergens, a freelance video editor who was initially just filling in for a “real” actress.

Certain players will find the game rather restrictive, and some of those limits are imposed by the psychological realism. Senua’s demons are consistent, staying more or less the same. Psychosis is not a variety show

It’s worth noting, though, that the game’s most traditional element is also its most radical: while Senua may be in the throes of psychosis, she is also a hero.