Heterotopias of mental health care: The role of space in experiences of distress, madness and mental health service use.

The change from an institutional to community care model of mental health services can be seen as a fundamental spatial change in the lives of service users (Payne, 1999; Symonds & Kelly, 1998; Wolch & Philo, 2000). It has been argued that little attention has been paid to the experience of the specific sites of mental health care, due to a utopic (idealised and placeless) idea of ‘community’ present in ‘community care’ (Symonds, 1998). This project hence explored the role of space in service users’ experiences, both of mental health care, and community living. Seventeen ‘spatial interviews’ with service users, utilising participatory mapping techniques (Gould & White, 1974; Herlihy & Knapp, 2003; Pain & Francis, 2003), plus seven, already published first person narratives of distress (Hornstein, 2009), were analysed using thematic analysis (Braun & Clarke, 2006). Mental health service sites are argued to have been described as heterotopias (Foucault, 1986a) of a ‘control society’ (Deleuze, 1992), dominated by observation and the administration of risk (Rose, 1998a), which can in turn be seen to make visible (Hetherington, 2011) to service users a passive and stigmatised subject position (Scheff, 1974; 1999). Such visible positioning can be seen to ‘modulate’ (Deleuze, 1992) participants’ experiences in mainstream space. The management of space has hence been argued to be a central issue in the production and management of distress and madness in the community, both in terms of a differential experience of spaces as ‘concordant’ or ‘discordant’ with distress, and with movement through space being described as a key mediator of experiences of distress. It is argued that this consideration of space has profound implications for the ‘social inclusion’ agenda (Spandler, 2007; Wallcraft, 2001).

(Un)covering ground: dance, space and mobility

Ballet and modern dance teachers often exhort students to ‘travel across the floor’ and ‘cover ground’. These instructions invoke metaphors of travel and mobility that capture an array of common assumptions about dance, space and movement. This essay examines the spatial and mobility discourses that these instructions simultaneously build upon and produce while exploring the seductiveness of technique’s promise of mastering space through the moving body. Threading auto-ethnography with critical theory and moving across different disciplinary fields and writing styles, I explore the ways in which these instructions leak outside the perimeter of the dance studio to feed into the narrative of a dancer’s extended physical, geographical and social mobility. Analysing the mobility and travel discourses of my dance training vis-à-vis poststructuralist theorizations of the subaltern power of the nomad and theories of space and place, I argue that this narrative becomes complicit in the construction of an idealized notion of artistic nomadism, which, in turn, aligns with current neoliberal logics organised around the production of mobile subjects.

Space-related confabulations after right hemisphere damage

Confabulations are usually referred to memory distortions, characterized by the production of verbal statements or actions that are inconsistent with the patient’s history and present situation. However, behavioral patterns reminiscent of memory confabulations can also occur in patients with right hemisphere damage, in relation to their personal, peripersonal or extrapersonal space. Thus, such patients may be unaware of their left hemiplegia and confabulate about it (anosognosia), deny the ownership of their left limbs (somatoparaphrenia), insult and hit them (misoplegia), or experience a “third”, supernumerary left limb. Right brain-damaged patients can also sometimes confabulate about the left, neglected part of images presented in their peripersonal space, or believe to be in another place (reduplicative paramnesia). We review here these instances of confabulation occurring after right hemisphere damage, and propose that they might reflect, at least partially, the attempts of the left hemisphere to make sense of inappropriate input received from the damaged right hemisphere.