Laurent Schmid:
At the first workshop with the volunteers there was a good energy in the air. In Kassel at Documenta it was contagious; it went from the therapists to the visitors. So Pedro, is the Sanatorium an optimistic project?
Pedro Reyes:
believe so. It may be optimistic in the sense that the environment allows for a plethora of insights, which happen in an almost effortless way. Many small miracles happen. It is optimistic in the sense that we are always surprised by the fact that helping each other is easier than what we had thought. So after you test the experience you gain confidence. There is a general assumption that when you help someone you somehow lose energy, but often the opposite happens. There is a spark of excitement that you get from helping others.
LS:
You said that it is important to you that the therapies can be conducted by anyone and everyone, and you reference Jacob Levy Moreno’s “sociatry.” Moreno wrote in Who Shall Survive? that “… a truly therapeutic procedure should have as its objective nothing less than the whole of mankind.” You also mentioned the aim to open the Sanatorium to a wider public and to share this project, to let it develop in a broader terrain.
PR:
These days therapy is a
luxury for a lot of people, and
every day there are more people
in the world who need it but
can’t afford it. There is also a
stigma attached to it that makes
many people think that those
who go to therapy must be crazy.
Yet today, especially in cities,
there is a vast population who
could benefit from it: unattended
victims of depression, loneliness,
neurosis, family violence, suicide,
etc. That’s why I’m so interested
in alternative structures,
like Moreno’s sociatry, in which
human connection is paramount.
You won’t find it in prescription
drugs or hospitals, but it’s
crucial to generate healthier
communal life.
I am also very interested
in deprofessionalization, which
Iván Illich wrote extensively
about in the 1970s in Mexico.1
In Illich’s terms, our obsession
with growth and productivity
discourages people from satisfying
their needs and forces them
to consume the treatment and
services of specialists who do not
care for the poor. In many different
fields, like education, social work, and transportation, he
finds a vicious cycle in which new
knowledge is applied and progress
is measured and then used
to exploit society as a whole to
the benefit of the professional
elite. In opposition to that capitalist
model, he defines convivial
society as the result of social
arrangements that guarantee everyone
free and ample access to
the tools of the community,
limited only to ensure the equal
access of others. In other words,
individuals relate to society in
the way they use its tools.
In the case of Moreno,
when he developed psychodrama
and the notions of "encounter"
and group therapy, he was basically
creating a toolbox that
reveals the resourcefulness of
the group. The beauty of these
approaches is that their procedures
are equally effective regardless
of the credentials of those
who use them.
LS:
So these ideas have to do
with acknowledging that you
could not wait for solutions to
come from the top in order to
achieve greater social justice?
PR:
Yes. Paulo Freire articulated
this in his Pedagogy of the
Oppressed, and his ideas had enormous
penetration in Latin
America from the 1960s into the
70s and 80s. In his own words,
the school system “teaches the need to be taught,” when true
learning has to be driven by the
curiosity and desire of every
person.2 Likewise, in the sphere
of hygiene and mental health,
Iván Illich offers an example to
illustrate this:
I know a North American girl, a
sixteen-year-old that was jailed for
treating 130 cases of first-stage
syphilis. A technical detail pointed
out by an expert earned her pardon:
the results she obtained were statistically
better than those of public
health services. Six weeks after the
treatment she performed satisfactory
control tests on all of her patients,
without exception. This is about
knowing whether progress should
mean progressive independence
or progressive dependence.3
I like this quote because it clarifies
that the desire for these alternative
approaches is to move
towards progressive independence.
Today we cannot expect to
reach good results out of pure
spontaneity nor pure planning.
The Sanatorium is not conceived
as a substitute for existing therapies
and social services, but as
a space for encounter, since so
many of our everyday pathologies
result from this lack of connection.
LS:
Illich often mentioned the
need to rethink the very idea of
learning, rather than the methods used in its enforcement.
What could this mean if we apply
it to therapy? Could this
also mean that it is necessary for
everyone?
PR:
Illich introduces the idea
of iatrogenesis, which means
diseases that stem from previous
treatments, prescribed by physicians,
that have a negative
impact on health. These begin,
in many cases, at the moment
of birth, the main example being
excessive reliance on Cesarean
deliveries, as well as doctors
who encourage mothers to feed
their children with formula
instead of breast milk.
We’re waging a “war on
drugs” right now for the reason
that drugs are considered a
threat to public health. But if
you compare the number of
deaths each year from legal and
illegal drugs, you see that in the
United States the number of
prescription drug-related deaths
rose from 6,000 in 1990 to
27,658 in 2007.4 Each year at
least 106,000 people die from the
drugs they are prescribed and
administered,5 while illegal
drugs result in around 10% as
many deaths.6 This shows how
much we need to readjust our
priorities.
There is another concept
that is the opposite of iatrogenesis:
salutogenesis, which Dr. Gabriel
Stux lectured us about at the
Sanatorium in Kassel. The term
describes an approach focusing
on factors that support human
health and well-being,
rather than on factors that cause
disease. Aaron Antonovsky
developed this theory in rejection
of the “traditional medical-model
dichotomy separating health
and illness.” He described the
relationship as a continuous variable,
what he called the “healthease
versus dis-ease continuum.”
7 Antonovsky says that we
have to understand health not
as the absence of disease, but as
the way people maintain their
“sense of coherence,” by which
he means the belief that life
is manageable and meaningful.
It’s how we retain our ability to
keep going when facing changes
internally and externally. Here
the key is to be prepared to make
changes in your life.
LS:
How can the Sanatorium
help prepare you for these
changes?
PR:
This is an amazing question,
because that’s why play is so
important in the Sanatorium.
One of the main aims of the
Sanatorium is to be a rehearsal
space. In the Museum of Life
you can do a kind of draft for
your future developments. In the
Philosophical Casino you can
reflect on a decision that you
have to make in the same way
that people in ancient times consulted
with oracles. In Goodoo
you prepare for reconciliation
with another person. This has to
do with the idea of “surplus
reality” that Moreno talks about.
In Moreno’s psychodrama you
stage a confrontation that you
plan to have, and this helps you
foresee all the interactions that
can happen in that future conversation.
This provides the patient
with a new and more extensive
experience of reality, a “surplus”
reality.
At the Sanatorium Moreno
founded along the Hudson River
in Beacon, New York, part of it
was a psychodrama stage, which
I find remarkable. It’s like the
equivalent of an operating room
in a hospital, with the difference
that on the psychodrama stage
you can rehearse the changes
needed in your life.
I realize that it may be too
much to ask for a work of art
to have such an impact. But here
I see art, and particularly play,
as a warm-up phase that prepares
us for change. What is most
important to achieve is a mental
state where we have the confidence
to produce changes, but
it is very difficult to arrive at this
state. That’s why the warm-up
of the light-hearted spirit of play
is so critical.
LS:
So you are talking about
discoveries that are the result of
a collective process. It seems
that in all these processes the
“other” is very important, as if
these kinds of breakthroughs
were hard to reach on your own.
How important is it that the
Sanatorium’s activities are done
in groups?
PR:
Moreno defines encounter
as an exchange between two people
where each of them sees
themselves from the other person’s
perspective. This stuff
doesn’t happen every day, where
people get to really talk to each
other and forget about their roles
or whatever other ways they
define themselves. What we’re
looking for at the Sanatorium
is for people talk to each other
without the client-specialist
relationship. Actually, there is
an advantage that these encounters
happen among strangers,
which is that you may never see
this guy again. It’s not your family
or friend or coworker; these
are people you usually just make
small talk with, but here it’s the
inversion of small talk. You talk
about what’s most important and
share deeply personal experiences.
There is a famous quote
from a poem by Moreno, which
is super trippy:
A meeting of two: eye to eye,
face to face,
And when you are near
I will tear your eyes out
And place them instead of mine,
And you will tear my eyes out
And place them instead of yours,
Then I will look at you with
your eyes…
And you will look at me with mine. 8
It’s interesting that some visitors
to the Sanatorium requested to
conduct therapies in addition to
receiving treatment. On occasion
the students have become their
coaches and taught them how to
conduct the sessions. This is an
example of how the protagonist is
the process, and how important
it is to have a companion with
whom you can do a role-reversal
and warm up your spontaneity.
It’s important to have horizontal
structures where everyone can
take the lead as well as follow.
LS:
Were the students always
ready to take the lead?
PR:
I remember that when we
were doing the training in Geneva
prior to Documenta, we had a
session of questions and answers.
I knew the expectation was for
me to be the resource for all answers,
but what I did instead was
to ask the person on my left if
he had a question. Then, instead
of answering, I deferred the
question to the second person
on my left. Once that person had
come up with an answer, she
asked a question that was answered
by the person on her left, and so on until everyone in
the group had both asked and
answered a question. This is one
quick activity that takes less
than fifteen minutes and shows
the group its own resourcefulness
and independence from a
leader.
However, it was equally
important for me to be available
as a resource when questions
came up, especially because it’s
necessary to know where the
therapies come from.
LS:
Now to reverse roles on you,
what have you learned from the
volunteers?
PR:
Well actually, if I’ve done
each therapy a dozen times, an
average volunteer may have done
it fifty times by the end of Documenta.
So you could say they
have more mileage. That is why
I felt it was so important for
this book to include testimonials
on the encounters they had.
In every case there were discoveries
that I had not foreseen.
LS:
All therapists had a shared
common background as art
students/artists. Did this change
the parameters? In what ways?
PR:
It was a very privileged situation
where people were ready
to be surprised with progressive
ideas. When one person is more
creative, his inquisitive skills become more sophisticated. So
there was a constant inquiry
about the meaning of the project.
LS:
Have the therapies ever
changed from the input of the
volunteers?
PR:
Sure, there have been suggestions
that have been incorporated.
For instance, with the Goodoo
doll, one therapist from the Sanatorium
in New York suggested
that the patient should press
each of the five points in order to
“switch on” their intentions. This
is a sort of symbolic acupressure.
In the Museum of Hypothetical
Lifetimes, Sylvain, one of the
therapists in Kassel, pointed out
a missing space for friendships
between the work axis and the
love axis. This is something I’m
still trying to fit into the blueprint.
At first, in the Compatibility
Test for Couples each couple
could only choose two fruits;
each person only picked one for
themselves. But then a therapist
suggested that each person pick a
fruit for herself and one for her
partner. When the partner does
the same, you have four fruits
total. You can make one juice per
person, which is the couple according
to A or B, or mix them
all together. There are many
possible combinations.
LS:
Your project is participatory
and also questions the hierarchic structure of common therapies.
It was interesting to see the problems
this led to. I remember that
we discussed with the students/
therapists the power relationship
they found themselves involved
in without actually wanting it.
The aesthetic you used, from lab
coats to the architecture, relies
on a well-known system and instantly
transformed visitors to
patients. I see a certain contradiction
here, and I never really understood
to what extent you
play with irony here — for me it
was intriguing and disturbing
not to be sure. At the same time
I liked to feel this resistance of
the piece.
PR:
Role play is fundamental to
free oneself from the one-dimensional
labels that society assigns
to each of us. While white coats
are used by doctors, they’re also
used in schools when you go to
the lab or in other work environments.
So the white coats actually
have more than one connotation,
and there is room to play here.
Friedrich Schiller says that someone
is only fully a person when
she plays, and she has to play in
order to fully become a person.
RS:
But you are clearly empowering
the volunteers with the
white lab coat…
PR:
In hospitals, doctors who
don’t wear a white coat usually carry a stethoscope when attending
patients, whether they need
to use it or not. The white lab
coat is in itself part of the placebo
effect. The placebo effect
doesn’t only refer to sugar pills
but to the entire aura surrounding
medical practice, which encompasses
the clinical aspect of
hospitals, medical jargon, etc.
The whole idea of bedside manner
is actually something close
to what a shaman or medicine
man would do: to use the expectation
of the patient to activate
the healing process. One of the
Sanatorium’s advisers, neurologist
and writer Alice Flaherty,
had extensively studied this. She
gives as an example that if an
overweight doctor asks a patient
to lose weight, the patient is less
motivated to comply than if
that doctor were a healthy weight.
LS:
So once a volunteer is “in
character,” thanks to the lab
coat, what specifically happens
next?
PR:
Every therapy is like a small
ritual. Rituals are procedures
that help you reconcile your desires
and change your mindset.
The problem is that you often
access rituals in a religious or
esoteric context, so you have to
subscribe to those systems of
beliefs. So what the Sanatorium
attempts is to reproduce the same
psychodynamics by conducting rituals without any ethnic specificity,
without their aura of
authenticity. It’s not only about
creating an alternative space
from the health system; it’s also
an attempt to create alternative
spaces to those provided by
magic, religion, etc. Because these
places are also industries in
which a few gurus concentrate
huge followings.
So in that sense it’s very
important that in the Sanatorium
there is not one dogma or fundamental
text and that volunteers
have the opportunity to develop
therapies, which after a phase
of trial and research can become
part of the inventory of services
the Sanatorium provides. I’m
interested in the democratization
process here. In a way what
I’m doing is a sort of reverse
engineering of medical environments,
borrowing their clinical
packaging as a neutral space
in which you can benefit from
these rituals that are often beyond
our reach.
LS:
The notion of ritual makes
me think of Félix Guattari.
He understands ritual as a “machine”
that determines the
fluctuations of real and virtual
forces, producing subjectivity
in a process-driven concept not
limited by subject-object division
and reloading the real with
possibilities (“possibles”). This
seems to me quite near to your project. I suppose that Guattari’s
thinking, as well as the way he
got to practice his theories in the
context of the experimental La
Borde clinic, has influenced you?
PR:
Yes, indeed. La Borde is
one of the most inspiring antipsychiatric
experiments, since
it blurred the division between
patients and psychotherapists.
The interns took on duties, including
in management and
administration of the clinic. It is
a Marxist-Leninist idea that
members of a community must
engage in both manual labor
and intellectual labor.
But this idea can be traced
back to Plato’s ideal community.
Just as Guattari wanted the asylum
to embody a shelter, a place
of refuge, and a sanctuary, in
Mexico, Vasco de Quiroga also
created “hospitals” were also places
where the peasants learned
trades such as music, sculpture,
iron work, etc. But I’m interested
in Guattari because, at a time
when deconstruction was so
hyped, he was also interested in
reconstruction. Reconstruction
has a specific aim, it’s therapeutic
in itself. When it’s made
through ritual, as you said, the
subject and the object are integrated.
That’s why it works.
LS:
Often you are doing a recontextualization
of existing techniques,
which were intended for a different context than the ones
you use here.
PR:
Actually, most of the therapies
are combinations or mashups
of existing traditions. What
we are going for is spiritual
promiscuity, not exclusivity! We
are trying to borrow whatever
works, anything, from anywhere,
getting rid of tunnel vision.
The Sanatorium is “dogmatically
anti-dogmatic.”
LS:
Artists are often afraid of
being copied and thus to lose
control over their work, but you
chose to open your project, to
think it as a medium of circulation.
PR:
You mention circulation,
which is indeed appropriate.
Moreno proposes that creativity
is like a “sleeping beauty” that
has to be woken up by the catalyzer,
spontaneity. He says spontaneity
is something that operates
in the present, in the here
and now, that propels people to
find a good response to a new
situation or a new response to an
old situation. He describes the
relationship as an arch: spontaneity
awakens creativity, which
then produces “cultural conserves,”
the name he gives to
works of art and inventions
— books, music, theories, technology,
etc. In turn these
cultural conserves inspire more spontaneity when they are experienced,
like when you whistle
or hum along with a song. Doing
this, a musician may come up
with a melody that can become a
song or a score. So when this
song is played again, it trig-gers
more spontaneity and people
dance and sing and may interpret
the song, incorporating new
elements.9
In the Sanatorium, the
therapies are crystalized as cultural
conserves, but it is in their
nature to inspire the spontaneity
of those who take part either
as therapists or participants. In
that way the participant is incorporated
into the system as an
artist, which is very close to the
notion of the “spect-actor” articulated
by Augusto Boal, where
the spectator becomes an actor.
LS:
You have called the Sanatorium
a prototype and have mentioned
plans to multiply it, to
transfer it from the space of art
into a wider cultural field. How
will this be done?
PR:
I feel very fortunate to be
working in the field of contemporary
art because it’s a cultural
environment that welcomes
uncommon ideas. However, it
would be a sad prognosis to
expect these inventions to remain
under the umbrella of art
institutions. The nature of the
project itself asks to be tested in different environments, to try
itself in the wider arena of culture.
My plan for the Santorium’s
future would be to tour around
Mexico. It could travel to different
cities, but I would prefer
to avoid local museums and instead
place it in street festivals
and traditional fairs that have
combined commerce and culture
for centuries. The Sanatorium
mobile unit would be composed
of several geodesic tents and
remain in one place for two weeks
at a time. In these contexts it is
local governments that can sponsor
each installment out of the
budget they would otherwise
dedicate to music, theater, and
traveling amusement parks.
So the Sanatorium is “marketed”
not much differently from a
roadside attraction. What I find
interesting about this is the
creation of new audiences that
otherwise would not go to a
museum.
In a way, treating the
Sanatorium as entertainment is
also a tactical device, because
in certain social sectors there is a
stigma for those who go to therapy:
they may be seen as weak
or disturbed. It is the pretense of
being a Sanatorium that helps
people drop their defenses. Also,
it is important that as a space
of encounter you can visit it in
different groups: with friends,
classmates, coworkers, family, on
a date, etc.
LS:
The Sanatorium — like other
projects of yours — has notions
of utopian thinking. Do you refer
directly or indirectly to utopian
communities?
PR:
In the early 1990s Harald
Szeemann came to Mexico.
I attended a week-long seminar
where he presented some of his
groundbreaking exhibitions in
detail, such as Gesamtkunstwerk,
When Attitudes Become Form, etc.
But what left the biggest impression
on me was his exhibition
about Monte Verità, which was
established in 1900 in Ascona,
Switzerland, as a cooperative
colony based on the principles
of primitive socialism. It later
became the Monte Verità Sanatorium.
The members detested
private property and practiced a
strict standard of conduct based
on vegetarianism and nudism.
They rejected marriage, dress,
party politics, and dogmas. One
remarkable aspect of Monte
Verità is how many artists spent
time there, such as Isadora
Duncan, Paul Klee, Hugo Ball,
Mary Wigman, as well as intellectuals
such as Carl Jung and
Rudolph Steiner, among many
others. So it was not only noteworthy
for its utopian ideals but
for the imagination it took to
come up with it and what it
inspired in these people.
LS:
Which other utopic projects
do you feel connected to?
PR:
Charles Fourier has been
another important inspiration
for me. His invention of the
phalanstery is one of the most fun
things to read, and “fun” is no
small adjective; for me, it is a
combination of imagination and
intelligence. Obviously, Fourier
is far out there, and it’s good to
read visions that far exceed that
which could happen in reality.
There are many parts of his
vision of the phalanstery and all
the activities that happen inside
that make a lot of sense, such
as the mix of urban and rural environments,
as well as the fact
that jobs would rotate so people
could do different jobs, which
were compensated in such a way
that everyone could make a
decent living. Also, a big part of
leisure time at the phalanstery
was spent in grandiose parties that
were carefully choreographed.
LS:
What about contemporary
references?
PR:
One to mention is the Flux
Clinic, which was originally
started in the 1960s as a kind of
happening in New York. It was
then adapted into van, a “mobile
clinic” that drove around Seattle
in the 1970s, visiting only streets
that began with the letters V, T,
R, and E. I don’t know why, there is not much information
about it. And of course there
are many important places such
as Esalen in Big Sur and Patch
Adams’s Gesundheit Institute.
In the case of Patch Adams,
I’m very interested in his sense
of humor, yet I don’t like how
it translates into a visual form.
Clowning is very canonical.
There is this attachment to red
noses and big shoes. It’s curious
that the same often happen to
alternative healing places; they
look like hobbit dungeons, which
really creep me out. I’m interested
in a wide range of esoteric
subjects but I dread all the packaging.
I can’t stand incense,
Celtic diagrams, mandalas, etc.
LS:
So it seems that in the
Sanatorium itself there is a role
reversal between reason and
magic, between science and art…
PR
I believe that one of the most
important parts of life is to pay
attention. When we get used
to things, we cease to pay attention
and things become grey.
So how do we bring color back?
What is needed is a sense of
estrangement, of wonder, of surprise.
What art can do is to make
the normal look strange, as well
as the opposite process, to make
the strange normal. Let’s look
closer at these effects. If you suddenly
look at normality with
estrangement, you may realize
how much of the status quo is
arbitrary, even ridiculous. In the
reverse operation, art may also
be useful to introduce something
strange but somehow necessary
in life and to welcome this change.
- Iván Illich. Némesis médica. Obras Reunidas, eds. Valentina Borremans, Javier Sicilia.
(Mexico City: Fondo de Cultura Económica, 2006).
- Paolo Freire, Pedagogy of the Oppressed, Trans. Myra Bergman Ramos. (New York: Continuum, 2006).
- Ivan Illich. La Convivencialidad, (Mexico City: Editorial Posada, 1978).
- Jeffery Kluger, “The New Drug Crisis: Addiction by prescription,”
Time Magazine, September 2010.
- Lazarou J, Pomeranz BH, Corey PN, “Incident of adverse drug reactions
in hospitalized patients,” JAMA 280, no. 20 (1998).
- Morbidity and Mortality Weekly Report 56 no. 5 (2007).
- Aaron Antonovsky, Health, Stress and Coping, (San Francisco: Jossey-Bass Publishers, 1979).
- J.L. Moreno, The Essential Moreno: Writings on Psychodrama, Group Method and Spontaneity,
ed, Jonathan Fox. (New York: Springer, 1987).
- Ibid.