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Anti-Psychiatry:
The Ethical and Practical Alternatives to Traditional Treatment

by Dr. Joseph H. Berke

"Anti-psychiatry" essentially means a strong opposition to the theories and practices of traditional Western European psychiatry. By this I refer to the medical model of mental illness and the physical methods, usually drugs, electroshock and institutionalisation, that comprise psychiatric treatment. The term was coined in the 1960's by R.D. Laing and David Cooper.

I discovered 'anti-psychiatry' as a medical student in New York during the early 1960's. I had to spend several months on the psychiatric ward of a large city hospital. During this time I was taught to distinguish different categories of disease, from the neurotic to psychotic to psychopathic, as well as their prognoses. Since the ward was psychodynamically orientated, neurotic patients received psychotherapy. But those diagnosed as psychotic received drugs or electroshock. We were told that one third of them got better, one third got worse, and one third stayed the same, no matter what you did for them or to them. Moreover, we were assured that the rambling speech of 'schizophrenics' was a sign of their damaged thought processes and was inherently unintelligible.

Imagine my shock when I discovered that I could easily talk with many of the 'schizophrenics' and that these people often made perfect sense to me. I thought I was crazy too. Two teachers helped me sort out my confusion and upset. One was John Thompson, an unusual and original man, 'an existential psychoanalyst,' who used to sit silently with his disturbed, catatonic patients, week after week, month after month, until they were ready to converse with him. He explained that these people were not sick, rather very frightened, and that their symptoms were a self-protective shell, to keep the world from destroying them, or to keep them from magically destroying the world.

My other mentor was R .D. Laing. I came across his book, The Divided Self, by accident in a medical bookshop, and was attracted by the interesting title.⁽¹⁾ I quickly discovered that this young Scottish psychoanalyst, who was unknown in the States at the time, held views that were remarkably similar to Thompson, ".....that schizophrenic behaviour is a special strategy that a person invents to live in an unlivable situation." Moreover, Laing meticulously related 'mad' behaviour and experience to the social context in which it occurred, thereby making it intelligible, even obvious.

I liked Laing's social critique. His perspective covered the way individuals were treated in small interpersonal settings, like the family; and large settings, like schools or hospitals; and finally society at large. In addition, his analyses covered a much wider range of phenomena than traditional psychiatry, for he not only discussed interpersonal events, that is, behavioural transactions, but inter-subjective events, how people influence each other's experience. ⁽²⁾

Laing's work seemed especially relevant to America in the 1960's, a period of intense social ferment -- civil rights, the Vietnam war and flower power. The latter refers to the attempt by youngsters to replace hate with love and guns with hugs. Really, the whole culture was in turmoil.

A seminal film was Ken Kesey's, "One Flew over the Cuckoo's Nest." The action concerned a group of patients who tried to escape from a repressive, soul-destroying mental hospital, representing America of the 1950's. The plot was, of course, a phantasy, the internal world of the writer, a psyche trying to break the shackles of childhood. But the film also depicted actuality. I was personally asked to help people who were sent to mental hospital for singing in the street, or dressing unusually, or for demonstrating against atomic bombs. And the public hospitals to which they were sent often held twenty to thirty thousand souls, in highly oppressive conditions, with treatments that were often degrading and dangerous. These included excessive medication, electrical and chemical convulsions, endless incarceration, and, if none of these worked, psychosurgery, a direct physical assault on the brain. Here we can clearly see how alleged issues of 'psychopathology' mask a more basic agenda: institutional authority, social deviance and political control.

Concomitantly, a wide variety of scholars, found they could query the way society worked, indeed the very foundations of social policy, by examining the ways mental patients were diagnosed and treated. The psychoanalyst Dr. Thomas Szasz, called the whole concept of mental illness, 'a myth.' And in a dozen or more books he showed how this myth justified institutional sadism. Similarly, the sociologist Irving Goffman pointed out that social deviancy and 'mental illness' were identical. For him diagnosis equalled labelling, the transformation of 'bad' to 'mad.'

Significantly, the anthropologist Gregory Bateson studied patterns of communication in the family. He proposed the 'double bind theory of schizophrenia,' which concludes that an individual exposed to an array of contradictory communications, may go mad. For example, a little girl is eagerly awaiting the return of her mother from work. The mother comes home and the little girl runs to her shrieking, "Mommy, Mommy." In response the mother stops, scowls and tenses. The little girl, a bit confused, sees this and stops. The mother replies, "What's the matter, don't you love mommy?" Her daughter is confused but starts towards her again. But the mother does the same. Usually the little girl can't articulate what is happening, and often withdraws. But if she could comment on the transaction, her mother might reply, "Don't be rude, I did no such thing, I only wanted a hug." Later in life, when exposed to a similar pattern of communications with a parent or close friend, Bateson noted that the girl might enter a catatonic state, or a suicidal depression.

As a medical student and young doctor I was fascinated by these issues, all of them a central focus in the work of Laing. So in 1965, I decided to go to London to work with Laing and his colleagues, David Cooper and Aaron Esterson. I wanted to learn more about strange states of mind. I thought men and women should be treated humanely and with respect regardless of their condition. Moreover, I believed one could transform their life-situation by validating their experience, rather than turning them into mental 'invalids.' ( I refer to the basic meaning of 'invalid' -- sick, incapacitated and worthless .)

At the time Laing had just established Kingsley Hall. This was meant to be a special place, a therapeutic milieu without staff or patients. It was to be a community of men and women "....obstinately trying to recover the wholeness of being human through the relationship between them."

For Laing, breakdown carried with it the possibility of breakthrough. The fundamental idea was that mental and social breakdown was as an opportunity for growth and development. Laing himself thought that psychosis, a term he used to denote a state of being, was akin to a mental and spiritual voyage. He thought that an individual could pass through a psychosis, and become stronger in himself, if he were given the necessary support and encouragement.

The healing potential of regression, as Laing knew, was a feature of many spiritual traditions. The ancient Greeks used the term 'incubation.' At the temples of Aesculapius or Demeter physically or mentally damaged people were invited to spend days in a special cave, awaiting a healing dream. When it came, their symptoms were relieved. In our day and age, I think the most common form of regression is 'a cold.' The mild fever and pains provide the good excuse to refrain from work and stay in bed. Conscience permitting, after a few days one usually returns to the world feeling refreshed.

These ideas fascinated me. Therefore, I was very pleased to be invited to join the Kingsley Hall community, and within a few weeks, to be asked by Laing to establish a close relationship with Mary Barnes. Mary was a forty five year old nurse who had a long history of mental breakdown. She had been in and out of hospital many times and had all the usual treatments; drugs, ECT, rigid institutional 'care.' But she had the idea that what she really needed was to be allowed to regress, to literally become a fetus, and then grow up again. As her wish coincided with Laing's theory, Mary was soon a prestigious, although difficult resident of the community.

Little did I know what I was getting into, or how I would be affected. The basic story has been told in the book we wrote together: Mary Barnes: Two Accounts of a Journey Through Madness⁽³⁾. It describes how I fed her with a baby bottle, cleaned her and played sharks and alligators, while always having to withstand the ravages of 'IT' as she called her dark rages. The book also relates how Mary became a very talented painter and writer. Perhaps more importantly, it demonstrates how her self perception, as well as others' perception of her, changed from mental patient to human being.

Subsequently, Mary published an account of her life after leaving Kingsley Hall entitled, Something Sacred⁽⁴⁾. She concludes with this poem:

Softly we touch,

here, and there,

as the current

of our life, flows

on its way.

How lightly we step on the

Sand.

How soon comes the

Tide.

Kingsley Hall closed in 1970. The owners refused to renew the lease on the building. But the reality was more complicated. Laing had gotten involved in other ideas and projects, and so had I. Was Kingsley Hall a success, was it a failure? Long ago a former resident remarked,

"Those who live here see 'Kingsley Hall' each in his own way ... simply (put), Kingsley Hall is a place, where some may encounter selves long forgotten or distorted."

After 1970, the therapists who had been involved with Kingsley Hall split into two groups. Laing's original organisation, The Philadelphia Association, emphasised existential therapy as part of a wide educational and support programme. A new organisation called "Arbours" was started by myself, Dr. Morton Schatzman, a friend who had come from New York to work with Laing, our wives and others. We thought of the temporary dwelling places, in Hebrew, 'Sukkot,' where the Israelites lived in the wilderness after the exodus from Egypt. The English equivalent is Arbours, places of shade and shelter. The name also sounds like 'harbour', a place of safe anchorage for ships during storms. We felt people in distress needed a similar haven or sanctuary, one with a more consistent degree of support than Kingsley Hall had provided.

Let me quote from a statement in one of our first brochures as it presents some of our motivating beliefs, beliefs which we continue to hold today:

"We feel it is more helpful and humane to givepersons who have been or could become mental patientsachance not to be seen as mentally ill, called mentallyill, or treated as mentally ill. There are practical reasons for this approach. The label 'mental patient' remains a severe social stigma. It may limitwork, travel and educational opportunities. Other people-- friends, relatives or strangers -- behave differentlytowards those they perceive as 'mentally ill'. They areoften intimidating, rejecting or patronising.Furthermorethe term 'mental illness' can be confusingand unhelpful for the people to whom it is applied. The'mentally ill person' tends to take on others'unsympathetic attitudes and abdicate responsibility forhis life to outside authorities or institutions, all to hisdetriment. He or she may become type-cast and see nopossibility for himself other than to embark on a longterm career as a mental patient.

"We are aware that certain experiences andbehaviour may be unusual. However, what is regarded asodd or bothersome in some social circles may not beseenthat way in others. Many people who might otherwise be trapped within an ill identity need theopportunity and encouragement to come to terms with their problems. We intend that the Arbours should be aplace where people may encounter selves long distortedand forgotten, where they can regain and contain theirexperiences, and achieve a sense of integrity andautonomy. In other words our task is to enable them toperceive and apperceive reality and to dream thedreams which are truly their own."

The first Arbours community was in the home of Morton ( Morty) Schatzman and his wife, Vivien Millett. For several years they and their children shared their house with several people who might otherwise have been in mental hospital. About the same time, we rented a house in London and established a community which has continued until this very day. Now the Arbours has three houses, each with 7-10 residents who share comfortable accommodation in North London.

In these households residents know and sympathise with each other's emotional and social problems. Two psychotherapists co-ordinate the activities of each household and offer personal and practical support. Psychotherapists-in-training also live in and contribute to the life of the communities.

No one is cast in the role of mental patient. Residents are responsible for shopping, cooking, cleaning and managing communal affairs. And they go to great lengths to look after each other. I recall a young man who lived in our south London household. He had become very agitated, so much so that the community found it hard to cope with him. So Morty Schatzman suggested that he moved to his house. Still the man found it hard to calm down. Instead he decided to live in my old three door taxi which was parked outside the house. We obliged by arranging for his therapist to see him daily in the rear of the taxi, for a pint of milk to be delivered to the taxi each day and for him to be able to take a loaf of bread at the local bakery. The arrangement seemed to be working and the man began to calm. Regretfully the story does not have a happy ending. Although known and generally tolerated in the neighbourhood, this person was picked up by a policeman who did not know about his circumstances. When he refused to talk and appeared peculiar, he was taken to a mental hospital, forcibly detained and was not allowed to return to us. Sadly, this episode precipitated his career as a mental patient for a long time.

Other outcomes have been more fortunate. Many men and women with severe psychiatric histories have managed to return to their homes or establish themselves in separate living quarters after residing in our households for periods of a few months to a few years.

During these first years we tried to accommodate a wide variety of people who sought refuge with us. But we often found this to be a difficult task, either because of their own immediate needs which conflicted with the long process of joining a community, or because they needed a degree of consistent support which the communities could not give. After long discussions we decided to establish a staffed community where individuals, couples or families who were acutely upset could obtain immediate and intensive support, with or without residential accommodation.

Our first effort to get a house for the project was scuppered by alarmed neighbours. This was in November 1972 when we learned a direct and painful lesson about the extent of the public's fears of 'mental illness.' At the time a friendly vicar told us that we could use a disused church hall to establish a new community, to be the forerunner of our Crisis Centre. We were overjoyed. But before we could move in, the vicar insisted that the project was given the OK by a neighbourhood community association, a group which had not met for many years. We did not realise this would be a problem, and, after informing local residents, organised a meeting to explain our project. To our astonishment no less than seventy angry locals showed up for the meeting. One rage-filled tradesman was especially vociferous and seemed to articulate collective concerns. He shouted that the women and children of the neighbourhood would not be safe to walk the streets if Arbours had use of the hall. Mental patients, actually he used the word, 'deranged,' were extremely dangerous. He was convinced the violence, rape, maybe murder would be perpetrated by the members of the proposed community. At the least, immorality and chaos would be let loose onto a quiet north London neighbourhood and his family would be stricken.

To the sounds of heavy applause, his speech carried the vote. The project was turned down. The streets remained 'safe,' and we all came down with bad colds.

This might have been the end of the matter. But some months later a close colleague took on a new patient in psychotherapy. She lived a few blocks from the hall and was having an affair with a local tradesman. But he had become every jealous and had taken to sitting all night in front of her house with a loaded shotgun, convinced that she was two-timing him. The woman was terrified, both for herself and her boyfriend. Fortunately no one came to any harm. But, as you may have guessed, the jealous lover and the angry local who carried the meeting were one and the same person. By a stroke of luck we were able to see clearly how private passions can go public.

The man suffered from well founded fears of himself, of his own immorality, violence and rapacious impulses, which for him, if let loose, or even acknowledged, constituted insanity. He dealt with this dilemma by projecting his fear and impulses unto others, the unknown people, the 'nutters' whom the Arbours proposed to bring into the neighbourhood. Without the coincidence of his girl friend seeing an Arbours therapist, we might never have been able to make sense of the meeting where our project was turned down, nor known for sure, why the locals were so frightened of us.

In fact, these scenarios go on all the time and make it difficult for any community based mental health projects to get off the ground. Therefore, when we establish new communities we make sure never to announce ourselves in advance. But we also make sure that our gardens, front and back, are well tended and the residents get on speaking terms with the neighbours. This policy has paid dividends on several occasions, including the time when we were forced to seek planning permission for one of our long stay communities. The council sent letters to nearby residents. Soon afterwards the household was confronted by a highly anxious next door neighbour, a mother of six, who rang on the door to tell people that some group called Arbours was threatening to set up shop and flood the area with mental patients. No one would be safe.

"Really." After inviting her in, the residents of the community gave her a cup of tea and calmly explained that they were Arbours. "Oh, you are nice. I feel so much better." Subsequently she wrote a letter to the council praising the community and saying how much she supported it. Planning permission came soon afterwards.

With all this is mind, we eventually rented a small house in North London to establish the Arbours Crisis Centre, which opened in January 1973. Two therapists, lived in the house. It was their home. They became known as the resident therapists. This arrangement has continued and worked well right through to the present.

People whom we help, come as guests, not patients. This simple shift in roles makes a tremendous difference in the relationships that unfold. 'Guests," for example, are less likely to play 'being crazy' or replay the role of 'mental patient.'

The first house had room for three guests. Subsequently, we were able to purchase a much bigger house in north London. The Crisis Centre moved there in 1980. It has room for three resident therapists and six guests, including a family suite. To the best of my knowledge it is the only facility I know that can take in an entire family, including children and, if necessary, the family pet, on short notice. ⁽⁵⁾

The Crisis Centre uses a team approach. The therapy side of the Arbours' team consists of a resident therapist (the RT), an experienced psychotherapist known as the team leader (the TL) and an Arbours trainee or other professional studying at the Centre.

But the first intervention is on the phone. Sometimes this will suffice. If not an appointment will be made with a team to meet at the Centre, or occasionally, at the caller's home.

The team may decide to do a focussed short term intervention using only a few consultations, really brief psychotherapy. But if the situation is more serious it may invite the caller or other family member to be a guest.

Inevitably, people who do come for a stay, are deeply disturbed. They may be frankly psychotic, or suicidally depressed, or as happens more frequently in the past decade, they may be anorexic and self-mutilating. Our aim is not to stop bizarre or disruptive experience or behaviour, but to contain it and make sense of it. These goals are interconnected. The guests need help because they are no longer able to keep in themselves, and to themselves, wildly distressing thoughts, feelings and wishes. We make things bearable again by tolerating the pain and discomfort in ourselves. In other words, the essential point of being a therapist has to do with being able to suffer on behalf of another without losing one's own integrity. It's not easy. In this regard we don't reply on medication to keep others' feelings at a distance. Quite the opposite. We try to be very sensitive to the emotional currents swirling around the Centre. Technically I am referring to countertransference exchanges.

Once I came to the Centre for a meeting. No one was about, but I heard loud noises coming from the kitchen. When I walked into the room, I was assailed by the sight of 'Ingrid,' a very large woman, holding a knife to her wrist. Upon seeing me she started to scream, "Joe, I'm going to do it, yes I will, I'm going to kill myself, no-one can stop me." The RTs who were present seemed immobile. They had their hands out is if to stop her, but they were almost catatonic for fear she would cut her wrists, if they made a move. My reaction was total panic. But curiously, within a few moments, I noticed that I had started to feel sad, even tearful. So I said, "Ingrid, I can't stop you from killing yourself, but when I think of you doing so, I feel very sad, for I will miss you." Ingrid's immediate response was to put down the knife and exclaim, "Oh Joe, you know I was only joking." Then she walked away. In retrospect we realised that Ingrid was very sad about other guests who were leaving. But she couldn't tolerate feelings of sadness or depression. The self she wanted to kill was her depressed self. But once she had induced it in me, she felt free of this burden in herself, and no longer needed to use the knife.

On another occasion, the Centre was being terrorised by a guest who used to go up to people and put his hands around their throat. One day he did this to Andrea Sabbadini, a team leader. Instead of screaming or yelling at him to stop, Andrea replied. " You know, I am frightened when you do that, but I think you really want to make contact with me, but are frightened to do so." The man put down his hands and began to cry.

Incidents like this are very dramatic and not very frequent. Mostly both therapists and guests have a daily struggle to make sense of their experiences.

The Centre includes three separate but inter-related and inter-relating systems. These are the milieu, the group and the team. The milieu is the Centre in its role as an overall therapeutic environment. The examples I have just given with myself and Andrea illustrates the task of the milieu to contain and defuse very disturbing outbursts. ⁽⁶⁾

The group consists of all the residents, therapists and guests, and meets four times a week. Essentially these house meetings are an opportunity for people to express their experiences and gain feedback from others about themselves. Also the 'house culture' tends to be passed on during these meetings. Often guests who have been at the Centre for awhile teach newcomers what to expect. For example, one man who himself had been completely inarticulate about his feelings, took the lead in explaining to a new guest that the reason she had come to the Centre was, " ... to learn to know what you feel."

The third therapeutic system is the team. The team includes the guest and his or her RT, TL and student. This is quite a unique arrangement. The professional literature is full of articles about therapeutic groups which include several patients and one or two therapists. But the Arbours team consists of several therapists and one guest. This approach enables us to work intensively and relatively quickly with very chaotic individuals, and to bring about significant changes in their lives without relying on biochemical or other forms of physical restraint. Nothing is more uplifting both for the RTs and TLs than to see someone who had been dismissed as a 'hopeless case' regain his hope and vitality.

The outcome of our work is that three quarters of all guests return home after a stay at the Centre. About 15% go to an Arbours long-stay community or other hostel. And about 5% require hospitalisation.

In conjunction with the work of the Communities and Crisis Centre we saw the need for two further services, a training programme in analytical psychotherapy and social psychiatry, which now has fifty trainees, and a psychotherapy service. The latter provides training cases for our students and low cost therapy for clients who cannot afford full fees. ⁽⁷⁾

January 1995 will see the publication of the first anthology on the work of the Arbours called, Sanctuary: The Arbours Experience of Alternative Community Care. ⁽⁸⁾ The book includes historical accounts and reflections by Arbours therapists, trainees and clients, the residents and guests for whom the Arbours exists. Collectively we have tried to provide a detailed description of the individual, group and institutional dynamics that provide the foundation of the Arbours' practical and theoretical accomplishments.

But does the Arbours really succeed in helping people who are severely disturbed, chaotic and self-destructive? Does 'therapy', that is, listening to another with a 'third ear,' with an attentive mind, really work? The answer is yes. Yet, this is a also strange question. If we do no cure, we try to do no harm. We hope that people who come to us for help may find the selves they have lost, and the soul they never knew existed. Perhaps given time, given luck, they may hear the beat of their hearts and be able to elucidate the rhythm.

Probably this is the goal of most therapists who have worked under the heading of 'anti-psychiatry'. But are we still anti-psychiatrists? Well, yes and no. Laing himself disavowed the term many years ago. He didn't like the fact that it had been hijacked for political purposes. Thus, in Italy 'anti-psychiatry' became synonymous with left-wing radicalism. Yet in other places, the concept was fuzzy and confused, almost devoid of meaning.

There have been and still are centres and therapists in many countries which do justice to the basic principles of humane, self-enhancing interventions. In Italy Franco Basaglia saw his life's work culminate in the passage of Law 180, which created the basis for a whole new approach to mental health. In the States Loren Mosher has pioneered non-institutionalised and non-institutionalising interventions at Soteria House in California, and more recently, at Soteria's successor, Crossing Place, in Washington D.C. A disciple of Laing, David Goldblatt, has continued his work at Burch House in New England. And the Philadelphia Association continues to sponsor communities and training in London.

But the problem of dehumanising treatments remain. One need only consider the massive use and abuse of psychotropic medications, the resurgence of ECT, the absence of adequate funding, and the relative unsophistication of mental health services in most areas, to ponder how much more can still be accomplished.

And if this were not enough, we have to deal with the pervasive bureaucracy which envelopes every therapeutic intervention. The 1993 (British) government white paper on mental health was supposedly designed to enable people to get help for mental problems. In practice, the opposite is the case. The new rules and regulations mean that clients have to pass through a further layer of administrators, who often seem to be charged with the task of obstructing support, rather than facilitating it.

Let me not be unjust. I meet and continue to work with social workers who act promptly and efficiently. Yet, we find that people in acute distress almost never are able to get grants to come to Arbours facilities, even though they are theoretically eligible for them.

And others, with longstanding difficulties, may have to wait an inordinate amount of time before help is made available. Then, even when funding is agreed, the contracts are so complicated that it is a wonder anyone could comply with them. The net effect is that the monies on offer pay for more and more administration and less and less direct clinical help.

If this weren't bad enough, the various bureaucracies involved in client care try to dictate how we should practice. We are told how cold the fridge has to be and how hot the air has to be. Other directives concern the size of the rooms, the number of therapists, the width of doors and so on. Most benignly this arises because the Arbours is so unique that the Crisis Centre and Communities get lumped with the category of old people's homes. The regulators then regulate accordingly. Administrative procedures supersede clinical judgment. There is little room for taking risks and to live, rather than to batten down the hatches and behave. The result is that we, as therapists, as human beings trying to assist other human beings, become more concerned with re-covering, than recovery, more preoccupied with playing safe, than with enabling those people who wish to do so, to descend into their darkness and emerge renewed.

In the face of all these pressures, can Arbours therapists remembers their vision and retain their integrity? Or will the Arbours become a somewhat offbeat, but basically conventional purveyor of therapy. And the same question assails all students and colleagues with a comparable outlook Can we practice what we preach, can we make our perspectives become mainstream, or will we be marginalised by the forces of medical tradition, bureaucracy, politically correctness and the pervasive influence of neurobiology?

In the 1960's Laing bequeathed a vision which had become obscured by the 80's. He fought battles and gained ground which need to be refought and regained during the 90's. So in this sense the Arbours, myself, kindred spirits, are very anti-psychiatric, indeed. The task remains to comprehend the knots that bind the heart and soul, and to bring the 'treat', or joy, back into treatment. Then people can ascend from the abyss of self-torment and rediscover the inherent satisfaction of making bonds with each other and to life itself.

References

1. R. D. Laing, The Divided Self, Penguin Books, 1990.

2. Laing explored the issue of subjectivity and inter-subjectivity in a number of books, most notably, The Divided Self, and The Politics of Experience, Penguin Books, 1990.

3. Mary Barnes and Joseph Berke: Mary Barnes: Two Accounts of a Journey Through Madness: Free Association Books, London, 1991.

4. Mary Barnes, Something Sacred: conversations, writings, paintings, Free Association Books, London, 1989.

5. Arbours Crisis Centre, 41 Weston Par k, London N8 9SY Phone: 0181- 340 8125. Fax: 0181- 342 8849

6. For further and extensive discussion of the different ways the Centre works with guests, see my papers: "The Conjoint Therapy of Severely Disturbed Individuals within a Therapeutic Milieu", International Journal of Therapeutic Communities, Vol. 11, No.4, Winter 1990, pp. 237-248; and "Psychotic Interventions at the Arbours Crisis Centre," British Journal of Psychotherapy, Vol. 10 No. 3, Spring 1994, pp. 372-382.

7. For information about Arbours facilities and activities contact: The Arbours, 6 Church Lane, London N8 7BU. Phone: 0181- 340 7646 Fax: 0181- 341 5822

8. Edited by Joseph Berke, Chandra Masoliver and Tom Ryan, Process Press, London.