Crimson Peak movie review

Imagine a completely humourless instalment of A Series of Unfortunate Events in which a young Count Olaf seduces Violet’s dim-witted older cousin and takes her to live in his haunted red paint factory. Throw in some incest and a lot of graphic violence. Or you could skip seeing the movie and go straight to stabbing yourself in the eye with a fork.


1984 in 2015

During this year’s Melbourne Festival I attended the Headlong Theatre stage production of 1984, and a panel discussion (Language, perfomance and power: reflecting on 1984 in 2015) featuring Daniel Raggett, the associate director of the production, Denise Varney, Professor of Theatre Studies at the University of Melbourne, and Robert Hassan, head of the Media and Communications Program at the University of Melbourne.

The play is very cleverly staged, weaving what could have been mere utilitarian scene changes or allusions to off-stage action into an integral part of the performance. Making explicit use of the appendix of the book, the action starts with parallel stories playing out in the same space, around the same table: Winston starting to write his diary and going about his daily routine at work, and a group of academics from the book’s imagined future discussing his writings and their meaning. Shifting attention from one to the other is achieved by temporarily freezing the movement in one group while the other continues. The theme of revising history, of deleting and ‘unwriting’ is brought to life by a sequence in which the same scene is replayed over and over with fewer and fewer characters. The sense of privacy and seclusion in Winston and Julia’s secret meeting place and the co-existent invasion of that privacy and ultimate exposure is evoked by the use of a live video feed from cameras hidden in the room, projected onto a screen above the stage. The room, which we are initially led to think is off stage, is in fact concealed on stage behind layers of scenery and is later exposed, stripped and dismantled by the uniformed thugs of the regime in a brilliant scene change to the spartan Room 101. In contrast to this complete change of scene pragmatically and relentlessly unfolding in front of our eyes are the internal shifts which occur in utter darkness punctuated by intense and overwhelming bursts of light and noise which draw us in to the experience of Winston’s psychological intimidation and final capitulation. Despite the appendix of the book leaving us with the positive message that the totalitarian regime had not prevailed, my identification with Winston had me leaving the theatre feeling demoralised and beaten down. As I reflected on the relevance of the book in 2015, this was a pointed reminder that we should not overlook the suffering of the individual that occurs both because of and in spite of our attempts to socially engineer a ‘better’ world.

The panel discussion took up a number of interesting points. One thread which they explored was the power of theatre and its ability, with the actor-audience interaction (however subtle), to create a sense of immediacy and emotional connection which other media cannot achieve. The other main thread was that of the relevance of 1984 in today’s world. This is a broad topic and the discussion can easily be hijacked by a tendency to interpret its relevance in a literal and therefore limited sense rather than to examine the themes behind the depiction of a fear-driven totalitarian state (for more on this I recommend listening to the debate between Waleed Aly and Scott Stephens on the ABC Radio National program The Minefield on 20 August 2015). This tendency was illustrated by the examples chosen for discussion by the panel. There was some reference to contemporary examples of Newspeak such as the term rendition, and panelist Robert Hassan posited that in contemporary society the ‘Big Brother’ of surveillance was represented not by government but by corporations, who use reward rather than fear to ensure our acquiescence (notwithstanding that governments are attempting to access and make their own use of the data gathered by this surveillance), but on the whole the discussion was fairly superficial and barely touched on the important themes in the novel of the mutablity and hence controllability of memory and recorded history, and the use of language to exert control over ideas including the very notion that the content of thought can be controlled. A pity, because these themes are actually fundamental to any examination of the relevance of the novel in 2015.

The idea that the very concepts underlying our thoughts can be influenced by the language available to describe them is not new, and will be familiar to anyone who speaks more than one language. I’ve discussed this briefly in a My Medieval Life blog article about cultural context in historical research where I refer to Umberto Eco’s Experiences in Translation. The practicalities of applying this knowledge in order to completely suppress thoughts deemed undesirable, as described by Orwell in 1984, is limited by the continual evolution of language by means of appropriating foreign-language words, mashing together existing words to create composites  and inventing completely new slang and other words. Thousands of years’ worth of linguistic evidence says that that Newspeak simply won’t happen. Where this concept, the idea that we can influence the content of thought by altering the mental environment in which it occurs, does intersect neatly with an area of current relevance is in the corporate co-optation of mindfulness meditation to use as a tool for increasing worker productivity. One of the principles underlying the Buddhist practice of mindfulness meditation is that all thoughts – and their associated emotions – are of equal (un)importance. With practice we can learn to direct our attention and hence let these fleeting thoughts pass by without the resulting suffering. While this may be appropriate in the original context it is more problematic when the technique is intentionally used to increase the tolerance for unhealthy workplace conditions. In the words of the Indian philosopher Jiddu Krishnamurti (1895-1986) “It is no measure of health to be well adjusted to a profoundly sick society”. Similarly, the principle of reframing thoughts that underlies cognitive behavioural therapy – which by extension implies that there are ‘good thoughts’ and ‘bad thoughts’ –  slides dangerously close to the Orwellian concept of thoughtcrime. Might mental illness be described as thoughtcrime? Thomas Szaz’s views on this topic from his 1970 book Ideology and Insanity remain highly relevant today.

Of more importance though, is the idea that memory is mutable, and that by controlling information  about the past we can rewrite history and our memories will follow suit. Orwell expressed this idea in a newspaper article some five years before the publication of 1984:  “The really frightening thing about totalitarianism is not that it commits ‘atrocities’ but that it attacks the concept of objective truth; it claims to control the past as well as the future”. In a more innocent way we seek to rewrite our own histories all the time. We cut our ex-spouses out of photographs, we throw away souvenirs and we delete social media posts, as if by removing evidence we can actually alter the reality of the past. Certainly our current ‘reality’ can be influenced by the information we have available. Going back to discussion panellist Robert Hassan’s view that corporations are the contemporary ‘Big Brother’, it is not difficult to see that this concept extends beyond his specific comments on surveillance to the ways in which these same corporations control our access to information with the intention of influencing our decision making, by means such as personalised search algorithms and targeted advertising. While we may be aware of it to some extent, this influence is exerted far more subtly than government attempts to control and suppress information on matters currently in the public eye, such as offshore detention facilities and government-corporate business relationships, in an attempt to control public perception and opinion in favour of the policies of the government of the day.

All of which supports the argument that 1984 is still a highly relevant text in 2015. We may not live in the totalitarian state of his novel, but the concerns which Orwell raises are ones we should continue to examine today.

(originally published 22 October 2015)

Mental Health Week – suicide prevention and mental health care in Australia

paint your own sunshine

As my contribution to Mental Health Week, I’d like to talk about suicide and mental health care in Australia. A confronting topic, but important to discuss. As a doctor and also someone who has experienced a number of episodes of depression, it’s something I can talk about from both sides of the bed, as it were.

R U OK? Day last month drew a lot of attention to identifying people at risk of suicide. I found the campaign very frustrating for two reasons. Firstly, what they’re not saying is that you really shouldn’t be asking the question unless you’re prepared to deal with the answer. Secondly, no-one is talking about what happens next. I think many people assume that in this situation it’s a tidy little sequence: you get admitted to hospital – where you’re safe – they treat your mental illness, you get better, then you are discharged and go on your way with the medications which will keep you well. The reality is not quite so simple.

Suicide is NOT just about mental illness. People commit suicide because they feel trapped and in pain, believing that things will never get better and that there is only one way out. Everything except that pain becomes less real – people, memories, the sense of hope. And because those things are less real, leaving them behind doesn’t really seem to matter. Mental illnesses such as depression may take you some of the way to that point, but other factors are nearly always involved: personal loss, social isolation, poverty, trauma, violence, substance abuse, lack of meaningful employment – in its broadest sense – and sometimes, really not having many options in life. Sometimes mental illness is the least of the problems.

Hospitalisation can be truly helpful, but … there are a lot of buts. It’s a lot harder to get admitted to a psychiatric hospital than you might think. And if you are admitted you’re thrust into a highly stressful situation away from familiar surroundings, subject to an externally imposed schedule of mealtimes, sleep times, medication rounds and treatment sessions, alone among strangers – often quite disturbed strangers. Hospitalisation can be helpful if you can’t take care of your own basic needs. It can provide a respite from the stresses of work and family pressures, give you access to more intensive treatment and allow you to be monitored more closely. But it’s not a guarantee of safety. People do sometimes commit suicide in hospital. Equally disturbingly, a 2013 report by the Victorian Mental Illness Awareness Council (VMIAC) revealed that 45% of women in the state’s psychiatric hospitals had been sexually assaulted or harassed while in their care.

If an adequate level of outpatient care is available, there’s a lot to be said for being around healthy people, sleeping in your own bed, eating familiar food, seeing familiar faces and keeping to something like your normal schedule.

As for medications: yes, they play a role in treating underlying mental illnesses, and when they work they can produce amazing results, but they don’t work immediately, they don’t work for everybody, and they can have nasty side effects. Antidepressants in particular can sometimes make things worse, either by triggering a manic episode if you happen to have bipolar disorder, or by making you more suicidal or even violent or homicidal.

The things that really make a difference are having (or building) a life worth going back to, one where you feel you belong and are truly valued; and, whether in or out of hospital, individual support – a person or people who will really listen, who will help you find better ways of coping with your problems, who will remain calm and hopeful for you even when you are in crisis, who are able to mobilise extra help for you if necessary. And who can do all this for as long as it takes. Support for a suicidal person is not a one-time thing. Suicidal thoughts and feelings and the desire to act on them wax and wane in intensity, often over quite a long period of time. The level of support that is needed is above and beyond what can be asked of friends and family.

Our society is increasingly fostering a culture of divisiveness, fear and xenophobia and a mentality of scarcity, marginalising and isolating anyone who is different or who is judged undeserving. We are systematically destroying opportunities for people to build lives worth living by our failure to provide individuals and communities with equity of access to basic infrastructure, education, employment and an adequate welfare safety net.

And we are not funding the necessary levels of psychological treatment and support for the people who need it. Medicare and private health funds will cover part of the cost of treatment by a psychologist for a limited number of sessions per year, however not all psychologists are prepared to manage actively suicidal patients. Medicare funds a higher number of sessions per year for a psychiatrist, but those who offer psychotherapy are few and far between and the out of pocket costs can be far greater (and will be even more so with the impending cuts to the Medicare Safety Net). Even highly successful publicly funded programs, such as the Perinatal Depression Program and various youth mental health initiatives, struggle with chronic under-funding or the withdrawal of existing funding. Lifeline, the telephone crisis counselling service which is advertised in nearly every single news article about suicide, relies predominantly on volunteer staffing and private funding.

My own experience was that treatment with antidepressants only worked for some of the symptoms, some of the time, and on one occasion I became much worse while taking them. However, I’ve been very fortunate in being able to access good quality psychotherapy over an extended period of time and in having considerable educational, employment, financial and social resources in my life to fall back on. I am well aware that my situation is the exception rather than the rule.

If we’re serious about reducing suicide in Australia, we need to work on building a society worth living in, and on providing appropriately funded and accessible services that address ALL the issues relevant to suicide.

(originally published 8 October 2015. The artwork is Paint your own sunshine, one of my previous Mental Health Week poster competition entries)