In 1972, the feminist actress, dramaturge, writer, director and singer Jane Arden spent a few months in the Welsh mining villages of Abertillery and Cwmtillery. 45 years earlier, Arden was born in Pontypool, a small market town about 10 miles away from the villages. On this return to her home county she brought with her the members of her experimental theatre company, Holocaust, which she had formed following the successful and sold-out run of her play Vagina Rex and the Gas Oven at the London Arts Lab in 1969. Holocaust’s first work was a play called A New Communion for Freaks, Prophets and Witches, and Arden was in South Wales to turn it into a film. The ensuing filmmaking process was so painfully intense for almost everyone involved that it brought an end to the Holocaust theatre company, and the majority of participants parted ways for good.
The resulting work, The Other Side of the Underneath, was the only British feature film in the 1970s directed by a woman. It is an extremely challenging film about mental illness and womanhood, offering an interrogation of the connection between social control and schizophrenia. Stylistically, it sits somewhere between the unflinching depiction of madness in Fredrick Wiseman’s 1967 film Titicut Follies and the avant-garde dreaminess of Maya Deren’s short films. Shot in an intensely experimental version of cinema verité, The Other Side of the Underneath features — among various other disorienting and agonising scenes — a group therapy session undertaken by women dressed in Victorian nightgowns, in which Arden herself plays a belligerent therapist. In an interview given in 2007, Natasha Morgan, one of the participating actors, remembered that everyone in the session was on LSD and Arden herself was drunk, having been steadily drinking her way through the entire production. There was also reportedly a brown bear in the next room, trying to claw its way through the wall. The session is a particularly brutal scene, in which the participants’ voices are distorted and echoing.
It’s an unpleasant and extreme film, which subjects the viewer to vivid depictions of psychic distress and offers a disjointed and aggressive critique of attitudes towards mental illness. The Other Side of the Underneath was made at a time when the status of mentally ill people was a topic of much discussion. The anti-psychiatry movement – an uneasy coalition of hippies, libertarians, existentialists and political radicals – was at its height. Arden was familiar with the central thinkers of the movement, particularly R.D. Laing, who happened to be her exact contemporary, both of them born in 1927. “Anti-psychiatry” is a broad, amorphous term which became shorthand for any number of positions disagreeing with mainstream psychiatric thinking. At its heart was a conflict between those who wanted better mental health services, more resources and legal protection from systemic injustice, and those who were mostly aggrieved by the social-control functions of psychiatry and wanted to abolish all psychological intervention. Arden belonged to the latter camp, fusing insights she gleaned from this movement with radical feminist thinking in order to develop her position: to be a woman in society was to be condemned to madness.
A few months after Arden’s film was screened at the London Film Festival, the first political organisation advocating for the position of the mentally ill in Britain was formed, building on the efforts of a small and short-lived Scottish organisation with similar aims which had briefly existed a few years earlier. Born out of a Marxist analysis, The Mental Patients Union argued for an informed-consent model of psychiatric care, which would see the abolition of compulsory hospitalisation and give patients the right to refuse any treatment, as well as ensuring that any new treatment offered was properly researched. They also published A Directory of the Side Effects of Psychiatric Drugs, a user’s guide to medication. It wasn’t until the 1983 Mental Health Act that some small degree of patient autonomy was introduced into British law; this was the first time that the right for an individual to refuse treatment was protected. The previous Mental Health Act, passed in 1959 by the then-Health Minister Enoch Powell, left the decision over treatment entirely in the hands of medical professionals.
A lot has changed in mental health provision in the five decades since The Other Side of the Underneath was made. The old asylums, already on their way out in the early 1970s, are now gone, replaced by an unsuccessful model of community care ravaged by austerity. Mental health services in the UK are now run according to the ideology of recovery, which casts the patient (or service user, client, customer) as a self-governing rational actor whose goal should be to avoid becoming reliant on long-term care. If they succeed in recovery they’ll return to being “independent” in “the community”, which, in practice, typically means struggling to access further care when needed.
If people are so unfortunate as to appear incapable of recovery, as is often the case of people who receive diagnoses of schizophrenia, they will find themselves at the mercy of a triple-threat strategy of coercion, containment and abandonment. The closure of asylums has left a void in terms of the numbers of beds available in acute in-patient mental health facilities. Not only are there fewer beds available, but an increasing proportion of the people in these beds have been detained under the Mental Health Act, i.e. sectioned: as high as 50% in 2020, up from less than 10% in the late 1970s. At the same time, there has been an explosion over the past few decades in the use of Community Treatment Orders, legal restrictions which demand certain behaviours from patients. These often entail the use of compulsory medication, including regular injections of strong anti-psychotic drugs. The grim truth of the current state of mental health services in the UK is that often the only way to try and find some support is to repeatedly get sectioned and hope to end with a bed.
Considered more or less lost for almost 25 years, The Other Side of the Underneath wasn’t shown in the UK between 1983 (when it appeared as part of a tribute to Arden at the National Film Theatre, commemorating her career following her death by suicide the year before) and July 2009, when it screened at the BFI in anticipation of a DVD release. This reappearance led to a new interest in the film, and it has begun to be recognised as an important document of avant-garde British cinema, a unique work reflecting a cultural moment at which radical feminism, political theatre and an interrogation of the repressive functions of psychotherapy met. Watching it 50 years later, the film offers a truly experimental aesthetic practice in nature: it’s messy, unstructured and chaotic, rejecting any sense of technical professionalism in favour of exploring an aggressively raw psychological experience.
In 2022, psychiatry is still used as a method of social control; mental health services in Britain still struggle to provide acceptable levels of care to a society which needs them more than ever. In many ways, the situation is as bad as it’s ever been, and there seems little prospect of any organised resistance against the deterioration of the sector. The Other Side of the Underneath is very much of its time, coming from a period in which the radical critique of psychiatry was possible and fruitful. Anti-psychiatric tendencies have largely petered out since the 1970s, becoming more or less a historical curiosity. The movement failed to achieve its aims, disparate as they were. But there’s still something to be gained from spending time with the creative work it inspired, as challenging and extreme as it is: a recognition that there are many ways of thinking about severe mental illness and its origins in society.
