This work was first published as Earning A Token Of Self Respect in the Observer Magazine, pp.58-62, 15 October 1978. Writer: Alan Road.
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The Smoking Room
r/t: 4 min, 36 sec.
This story is about mental illness and the beginnings of 'care in the community'. In February 1978 I spent two weeks living in a psychiatric hospital, in a ward for long-term schizophrenics...
James Agee and Walker Evans. Book. 1941. Let Us Now Praise Famous Men. Sent in 1936 to produce a magazine article on the poverty of white sharecroppers in Alabama, Agee and photographer Evans stretched out the assignment and made a book instead. Agee didn't have a rule book to tell him what precisely to document. So he precisely documented everything: from the depth of dust in a drawer to his passionate feelings for one of his subjects. Here he observes a family preparing to be photographed by Evans: "...looking into your eyes and seeing thus, how each of you is a creature which has never in all time existed before and which shall never in all time exist again and which is not like any other and which has the grand stature and natural warmth of every other..."
Clayton Ward (or The Smoking Room)
In February 1978, I lived for two weeks with twenty long-stay psychiatric patients at Prestwich Hospital in north Manchester. Forgotten souls, most of them had been there for at least as long as I was old. I was twenty-six.
Brought together from all over the hospital, these patients were guinea pigs in an experiment.
Encouraged by what psychiatrists had discovered from the application of post-war psychopharmacology, and influenced by R D Laing's 'politics of experience' and the behaviour modification theories of B F Skinner, psychologists at Prestwich established Clayton Ward. Here they instigated a token economy scheme.
The objective was to enable patients to live 'out in the community'. First, though, they needed to learn how to behave in ways that would not upset or alarm people 'on the outside'. The prerequisite for a patient's inclusion in this experiment was that he (for it was mostly men who took part) should have an addiction, in this case tobacco smoking. 'Good' behaviour — engaging in 'verbal interaction', making your bed, wearing a tie, tucking your shirt in and so on — was rewarded with tokens. However tokens were needed to buy not just tobacco but also food and drink.