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The natural environment as an element in a therapeutic community treatment programme

John Gale

It may seem strange to suggest that the natural environment could play a significant part in a therapeutic community treatment programme. To put it at its simplest, the idea of a therapeutic community is that community interaction is the factor which brings about change and here community means, of course, other people. It is by belonging to a group of peers that a person becomes more self-aware and can adapt his behaviour. It is by projecting his primitive feelings, anxieties and phantasies onto the community that the community can act as a container (Haigh, 1999) and become the analyst (Hinshelwood, 1979) or the doctor (Rapoport, 1960). The therapeutic community stands, par excellence, for the idea that it is other people, a human society which forms the basis for treatment, because psychotherapy is a dialogue between people (Hobson, 1979; Lacan, 1993) and speech always implies community membership, being an insider (Wittgenstein, 1999).

A gulf exists between man and nature and we can say that in opposition to nature, human society rests on culture. Man it would seem is radically alienated from nature. For the basis of human culture is language and as Lacan emphasized, human language differs radically from the codes used by animals. All the elements which characterize human culture seem to be distinct from the natural order. The notions of civilization, tradition, value and education – all those things which belong to communities – depend on language. Language is the structural foundation of all cultural forms – thought, poetry, literature, music, architecture, sculpture, mathematics and so forth, all depend on language and form. Imposing and perfecting structure, developing self-consciously ideals and making judgments about values within a community, mark the essential difference between nature and culture. Culture is the human realm and it is impregnated with language. In this sense we can call the human world of culture a symbolic world. Nature, on the other hand is the world without language, a world without the symbolic.

Seen from a psychoanalytic perspective we can understand the basis for this fundamental alienation of man from the natural order to have its origins in the part the father plays in the development of the child during the Oedipus complex (Freud, 1988; Lacan, 1997). The key paternal function, which may not necessarily be the father himself, is to introduce the rules and boundaries which form the fundamental principles of social order and govern the network of familial relationships. Language and the law, which mark man's birth into the symbolic world, bring to man not just community and the possibility of communion with others, but also self-awareness. Man can never be just present, encountering in nature like the birds and beasts.

Rather, he is always self-consciously aware of himself in that environment and it is with this awareness that time enters man's horizon. Human self understanding always occurs within language, for it is by naming things that man draws boundaries and constructs his world (Ellwood, 1995; D'hert, 1978). Nature, as man experiences it, is paradoxically always a human world. It is a world brought to birth in language, “for every human world is a linguistic one” (D'hert, 1978, p. 149). Awareness, remembering the past and anticipating the future characterize his stance within the natural world and hold him back, at a distance from it. This separation occurs not just at the level of consciousness but at the unconscious level as well. In this sense we can say that man always sees the natural environment in a way which is distorted by his unconscious phantasies (Hinshelwood, 1993) which form a kind of discourse.

Yet, while being alienated from nature, man's existence – all that man is – is radically and fundamentally worldly. During the 1960s and 1970s as part of the anti-psychiatry movement much was made of the implications this understanding of man's being has for the aetiology of mental illness – the way it is diagnosed and treated (Foucault, 1992; Szasz, 1961; Laing, 1971). This had its impact on therapeutic communities, principally through R.D. Laing's experiment at Kingsley Hall and David Cooper's work at Shenley Hospital (Kennard, 1998). However, almost exclusively the world has been understood not as the natural environment but as the social environment, as society. In his discussion of the work of Foucault, Laing and Cooper, Keith Hoeller writes:

“... what all these critics of psychiatry have in common is the Heideggerian notion that human beings are always constituted by the concept of “being-in-the-world”, and that “madness” is a societal event which occurs between people who may in fact have conflicting values and goals” (Hoeller, 1993).

But man's “life-relationship to the concrete environment” as it has been called (Bubner, 1990, p.30), is not restricted to society. Man belongs to the natural world as well as having a social environment and “the aroundness of the environment” (Heidegger, 1990 p. 135), everything which we encounter in the world appears in the context of meaning, in which it possesses relevance for our action (Bubner, 1990). From Wittgenstein's perspective, meaning refers to an event or praxis by which “the world to which I belong becomes the world which belongs to me” (D'hert, 1978 p. 157). The natural world speaks to us of man, because man exists as a unitary part of that world and is formed within it. So we can get to know profound aspects of human existence by looking at the natural world. Man dwells in the natural world, is literally absorbed in it, constituted by it and can never be free from it. From this Tucker (1999) has argued that the more fully in touch with himself and at home with himself a person is, the more he will care for the natural world (Smith, 2000) – the more fascinated he will be by nature (Heidegger, 1990). Ultimately we can say that the natural world matters to man, because man is legitimately self-absorbed and man's concern for the natural environment is ambiguously a concern for himself as a being-in-the-world.

References

Bubner, R. (1990) Modern German Philosophy, (trans.) E. Matthews, Cambridge: Cambridge University Press.

D'Hert, I. (1978) Wittgenstein's Relevance for Theology, European University Papers, Series XXIII, Bern: Peter Lang.

Ellwood, J. (1995) (ed.) Introduction, Psychosis. Understanding and Treatment p. 1-6, Jessica Kingsley Publishers: London and Bristol, Pennsylvania.

Foucault, M. (1992) Madness and Civilization. A History of Insanity in the Age of Reason, (trans.) R. Howard, London: Routledge

Freud, S. (1988) The Interpretation of Dreams, (trans.) J. Strachey, The Pelican Freud Library Vol. 4, London: Penguin Books.

Haigh, R. (1999) The Quintessence of a Therapeutic Environment. Five Universal Qualities, Therapeutic Communities. Past, Present and Future p. 246-257, (ed.) P Campling and R. Haigh, London and Philadelphia: Jessica Kingsley.

Heidegger, M. (1990) Being and Time, (trans.) J. Macquarrie and E. Robinson, Oxford: Basil Blackwell.

Hinshelwood, R.D. (1979) The Community as Analyst, Therapeutic Communities: reflections and progress (ed.) R.D. Hinshelwood and N. Manning, p.103-112, Routledge and Kegan Paul: London, Boston and Henley.

Hobson, R.F. (1979) The Messianic community, Therapeutic Communities: reflections and progress (ed.) R.D. Hinshelwood and N. Manning, p.231-244, Routledge and Kegan Paul: London, Boston and Henley.

Hoeller, K. (1993) (ed.) Dream and Existence. Michael Foucault and Ludwig Binswanger New Jersey: Humanities Press.

Kennard, D. (1998) An Introduction to Therapeutic Communities (Second Edition), London and Philadelphia: Jessica Kingsley Publishers.

Lacan, J. (1993) The Psychoses. The Seminar of Jacques Lacan. Book 111 1955-1956. (ed.) J.-A. Miller, (trans.) R. Grigg, London: Routledge.

Lacan, J. (1997) Ecrits. A Selection (trans.) A. Sheridan, London: Routledge.

Laing, A. (1994) R.D. Laing: A Life, London: Harper Collins.

Laing, R.D. (1971) The Politics of the Family and Other Essays, London: Tavistock.

Paget, S. (2000) Delusions as discourse in a therapeutic community, Therapeutic Communities Vol. 21 (4), p. 253-259.

Rapoport, R.N. (1960) Community as Doctor London: Tavistock Publications.

Rawlings, B. and Yates, R. (2001) Therapeutic Communities for the Treatment of Drug Users, London and Philadelphia: Jessica Kingsley Publishers.

Smith, E. (2000) Care and the Source of Being (ed.) S. Tucker, p. 115-128, A Therapeutic Community Approach to Care in the Community. Dialogue and Dwelling, London and Philadelphia: Jessica Kingsley.

Szasz, T. (1961) The Myth of Mental Illness: Foundations of a Theory of Personal Conduct, New York: Harper and Row.

Tucker, S. (1999) Community Care: The Therapeutic Community Approach and Learning to Care, Therapeutic Communities. Past, Present and Future p. 151-161, (ed.) P. Campling and R. Haigh, London and Philadelphia: Jessica Kingsley.

Wittgenstein, L. (1999) Philosophical Investigations (trans.) G.E.M. Anscombe, Oxford UK and Cambridge USA: Blackwell.

Gale, J.(2003). The natural environment as an element in a therapeutic community treatment programme. Therapeutic Communities – The International Journal for Therapeutic and Supportive Communities. pp. 206-208

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