The Philadelphia Association

The Philadelphia Association is a psychotherapy training organisation based in London. They were set up by the maverick sixties psychiatrist R. D. Laing who was subsequently barred from practising by the GMC. [1] The Philadelphia Association runs two of what they call “Therapeutic community households” in London. The editor of this web site spent 9 months in one. Billed as radical places of “asylum” for the deeply troubled they are in fact authoritarian and boring institutions run for the benefit of the self-styled and self-appointed community therapists who feed off the residents” Housing Benefit. The editor has written a summary of his experiences which is available here. He recently came across an article by author Meg Kelly. Meg stayed in one of the households for nearly two and a half years. Her article is published in the Autumn 2013 edition of Asylum Magazine. A preview is available online. To read the whole article it is necessary to purchase the relevant print issue of Asylum Magazine. If you send an email to contact — AT — they will help you do that. Though Meg Kelly stayed in the other house to the one this author stayed in her experiences sound remarkably similar. This criticism gets straight to the heart of the matter (or rather the no-heart):

My suggestion is that life at The Grove [the name of the house] might accurately be understood as subject to disciplinary structures aiming at a form of ”treatment”. The desired outcomes of this treatment would be, in order of importance: attendance at house meetings, not to behave in ways which were disturbing to others, and to replicate the accepted ”therapeutic” discourse of the house.

That last sentence really gets to the point. At the meetings at the house this writer stayed in there was an almost ritualistic format. Residents would be prompted to complain about each other. When they did, the therapists would fall on them urging them to examine their own fault. A highly moral discourse. This practice of group therapy where patients are encouraged to see their faults in the light of their failed relationships with the people around them was brilliantly depicted in the book One Flew Over The Cuckoo”s Nest by Ken Kesey. [2] The problem is: even if people do have faults that lead to them having difficulties in relationships observing them and rubbing their noses in their failures won”t make them any better. This is why this practice always leads to a sterile and moral tone. The therapists think they are doing their job (self-appointed or otherwise) because on occasion they successfully identify a fault in a patient. But this doesn”t have the claimed “therapeutic” effect. On occasion therapists in this kind of practice just make up supposed faults and impose them on the patients. (An example of this is given in this author”s testimony of life in a Philadelphia Association community household). It is one of the rules of this game that therapists are god-like and never have any faults. If they do they are certainly not up for discussion; unlike those of the patients. A second point in the Asylum magazine article which directly echoes this writer”s experiences concerns the hierarchical nature of the houses. Meg Kelly again:

Whereas an important aim of the early PA [Philadelphia Association] communities was to break down the binary structure of ”treater” (psychiatrist, psychotherapist) and ”treated” (patient, resident), by the time I arrived at the Grove in 2010, this distinction was fundamental. No room was left for doubt as to who was managing the institution, and who was subject to it. For example, anyone enquiring about moving in would be put in touch with the house therapists, who would vet them before telling us that this person would be visiting. Similarly, PA trainee-therapists wishing to do a placement at The Grove would arrange this with the house therapists, who would then inform us when the trainee would be coming.

At the house this writer stayed in similar arrangements were in place. Though, possibly, the residents had some direct communication with a visiting applicant. The house meetings at the house this writer stayed in were mostly arranged for week-day daytimes. (One evening meeting and two daytime ones). Obviously this suited the therapists well for whom it was a slot in their daily schedule. However; since attendance at the meetings was de rigour,  this made it hard for any resident to take up a full-time day job and still be in the house. The pressure thus worked to maintain the power imbalance. The therapists were financially rewarded by the same mechanism that worked to keep the patients unemployed. At the house this writer stayed at the finances depended on state Housing Benefit. The residents claimed Housing Benefit to live in the house. This covered the cost of the house (mortgage payments and maintenance) and was also used to pay the therapists an hourly fee. This unusual arrangement may explain in part why the house schedule was structured so as to discourage residents from getting a job. In reality the residents were probably worth much more to the Philadelphia Association as recipients of state Benefit than they would have been in low-paid jobs. Meg Kelly tellingly comments that at The Grove:

Like other similar arrangements (such as our complete ignorance of the houses” finances) these were presented to us as ”protective”, whilst simultaneously denying us any autonomy as a community.

Another telling comment in Meg Kelly”s article concerns surveillance. She describes how the focus at meetings was on “individual responsibility”. The general idea was that if the therapists decided that someone had not taken responsibility for something they would be upbraided in the public meeting. Meg Kelly makes a link between this practice and a structure of surveillance which extended beyond the meetings:

Though dependent on the house meetings, the most potent form of surveillance at The Grove took place outside of them. We were constantly aware that anything any of us said or did in the presence of another, even in confidence, could potentially be ”brought to a meeting”.

She goes on:

Like prisoners or psychiatric inpatients, we were simultaneously subjected to intense scrutiny in our immediate surroundings and hidden from outside view.

Meg Kelly”s article “Out of Sight” is cautionary reading for anyone considering entering a Philadelphia Association household. They are run by self-appointed amateurs who amply confirm the rule of thumb that therapists typically have less not more understanding of human relations than ordinary people. They are dreary and demeaning institutions. If you are broken when you go in you”ll stay that way. (The only exception to this is the remote possibility that through a process of being disciplined, which may take years, you become more contained, more subdued and more “normal” and thus able to function without doing anything to cause people around you to be concerned/disturbed). If you aren’t broken when you go in they will try to break you.

If Meg Kelly reads this please do get in touch as I would like to re-print your article.



see also:

2. Ken Kesey. One Flew Over The Cuckoo”s Nest. Various Editions. E.g. Penguin 2005.’

Author: justinwyllie

EFL Teacher and Photographer