(From a series of experiments with re-writing the logbook)
Introduction by: Bhavani Esapathi
Astrid Feringa and Lindsay Stegenga’s work stems from addressing the implicit bias in institutional care. By studying Feringa’s own clinical logbook during a stay at a mental health facility, they unpack a variety of themes that often go unnoticed while providing clinical care. Can institutions learn to treat humans humanely? What role do patients themselves play in determining treatment, or rather, what would that model of healthcare look like?
These are some of the overarching questions that can be explored through their piece. However, the biggest question remains do institutions listen? We can only wait and see the impact this piece will have on larger healthcare systems.
We have known each-other since our 4th year of high-school. We never lead with this bit of information, when talking about a project or writing a collective bio. And yet, for the context of the project —in order to explain the duration and the extent of it— it is actually a very crucial bit.
So, we’ve known each-other for about 17 years now, and for at least 10 of those, we have been in an ongoing collaboration, centred around the topic of mental healthcare, and the affective role that institutional documentation plays in somebody’s experience and self-perception. Based on Lindsay’s own, de-stabilising experience, of being hospitalised in a mental healthcare facility, we have been exploring ways to re-write the stubborn narrative that was produced about her through the clinical logbook of her hospitalisation.
‘Mrs. was called this morning for the day-opening. Did not want to get up because supposedly she wasn’t feeling well. Asked her to get up regardless. Furthermore, Mrs. tied the net-curtains around the main curtains, in a way that left the window uncovered. Just like that, Mrs. was lying in a tank top in front of the window.
In April 2022, this collaboration resulted in CRISIS: a short documentary that uses the clinical logbook of Lindsay’s hospitalisation as script. In the film, Lindsay responds to certain logbook entries written by the staff about her, giving her account of the event. In doing so, she highlights the discrepancies between institutional documentation and lived experience, and between what is written down and what is not.
The storyline of CRISIS focusses retrospectively on Lindsay’s growing discomfort with and distrust of the facility and its staff, highlighted by a selection of concrete logbook entries. It also focusses on the impact that this experience still has on her life today, and reflects on the urgency to systematically implement knowledge-trough-experience in education and policy concerning mental healthcare.
Window faces the parking-lot, where construction-workers are working on renovations. Addressed Mrs. concerning this; that I thought it was a bit strange, the way she was laying on display like that.
The length of the film is 23 minutes, guided by the production format of a short film. For this, we recorded a total of 18 hours of audio (spread over 6 days of recording, within a timespan of roughly 7 months). These 18hrs cover one full reading of the logbook, meaning: going over each logbook entry together, reflecting on it, from there entering another topic, etc. Each logbook entry highlights a different aspect of mental health(-care), hospitalisation, lived experience, each leading to a story-line on its own. The logbook itself counts 18 pages (22 when including the referral letter of the GP, the initial intake, and Lindsay’s written application to request the logbook), and covers a period of approximately 3 months.
According to Mrs. she couldn’t sleep otherwise, in the dark. Told her that at night it’s dark anyway, whether the curtains are open or closed.
Instrumental for this conversation was the informal setting: at the living-room table, cats interrupting by sitting on top of the logbook papers, scrolling through salsa and reggaeton playlists, looking back at party pictures from ‘before therapy’. We’ve had many conversations like this since Lindsay’s first hospitalisation in 2012, 3 of which were also recorded for earlier iterations of this project.
Reading the logbook together in this setting, has initially been a tool for us to start the conversation and to understand what happened. To actually see that, yes, this is how things are (or are not) written down, and this is how they happened. And with reading and re-reading, it became a tool to reflect on the broader social and political implications of ‘things’: the assumed dichotomies between sane-insane, doctor-patient, inside-outside, normal-not normal.
She says she turns on a small light at night, and still prefers the curtains open. Told her that I think she should at least close the net-curtains, because she is right in front of the window.
So while the documentary —by formalising Lindsay’s perspective as the main narrator— re-writes the larger narrative-arch of the logbook, we propose the continuation of these conversations —and the recording, documenting, archiving, registering of them— as the overarching work.
One iteration that we’re currently working on is the unpacking of the expanding narrative prompted by single, specific logbook entries, as an experiment in the making public/sharing of the affective space that is created through the setting and duration of the conversation.
I then proceeded to close the curtains myself.
The issue of the closing and opening of curtains re-emerges multiple times throughout the logbook, and had a big impact on Lindsay’s experience of the hospitalisation, as well as her sense of self during and after hospitalisation. What seems like a childish argument, for Lindsay pinpoints the framing of a logically explainable state of distress through the lens of a stigmatised and highly gendered diagnoses, indicated by predatory, soliciting and/or promiscuous behaviour.
By meandering through the different pathways leading from this (or any) one logbook entry, we hope to re-frame distress, anxiety, psychosis as valid modes of experiencing the world that exist in a larger context and thus —rather than from a place of isolation— should also be addressed from there.
Went to check on her again one hour later, because she was still in bed. Was lying in bed, again, with all the curtains opened. I closed the net-curtains, again, which Mrs. immediately opened, again. She did show up for lunch.’