Mentally ill in The Netherlands – Anthropology of the Dutch

Of all the countries and peoples
I visited… ..the Dutch were the most peculiar. Not one people, but a tombola
of cultures, clubs and groups. With strange tribes
and exotic communities. Just like other anthropologists
before me… …I’m going to visit them,
dissect them… …measure them and understand them. I’m going on safari in our own country,
looking for the wild in each of us. Call me ‘the pigeonhole man’. the pigeonhole man Looking for the mentally ill. What do they call themselves?
– Residents. Neurotics.
– Neurotics, yes. Is there humour?
– I hear Amsterdam. Screw you, piss off. Are they still hidden away? And how do they cope
among normal people? Close to Bakkum in North Holland
lies a curious village… …where you can only live
because of special circumstances. A gift from civilization to a group
entitled to compensation. It was badly needed. A decent place
for the so-called insane. Today, a new neighbourhood
is the entrance… …to the former Provincial Hospital
Duin en Bosch. The fences are mostly gone. But the old buildings are still there. The Old Men’s Pavilion
is uninhabited and locked. Once this was a revolutionary,
self-sufficient village. With its own water tower,
an apothecary, a cemetery… …a shop, workshops… …a launderette, its own tramline
and its own fire brigade. The main building is still being used. Because patients still live
on the country estate. No longer identifiable by their inmate
coats, that hindered escaping. Bringing back an escaped patient
made you two guilders. Something tells me you’re not a patient.
– That’s possible. But are you?
– No. But can you tell? No.
– Me neither. But you sound very lucid, and… Have you ever met a normal person?
That’s a different question. Most provincial hospitals
were closed long ago. But this one has remained
a psychiatric village to this day. Under the new name Dijk en Duin
it’s still a refuge for people… …who are burdened by their confusion. I had a psychiatrist who said:
There’s no such thing as crazy. No such thing.
– As there’s no such thing as normal. Normal doesn’t exist either, right. Do you always know if someone
is a patient or a nurse or a guest? I can often tell, yes.
– How can you tell? I can’t tell you, I wouldn’t dare.
I can’t say what it is. But you can tell. You can tell right away that he…
– That he? I can’t tell.
– But I can. The oldest building with patients in it
is De Breehoorn. Completed just before World War II. The patients had just been housed
when they had to leave again. The Nazis saw the building
as their ideal headquarters. And soon they had plenty of room
for their own sick thoughts. The occupier loved to make his boots ring
in De Breehoorn’s long corridors. When approaching a timid community… …a stranger should join in
with the daily ritual. In De Breehoorn the daily rhythm
is ushered in at 8 am… …with the dispensing of medication. Nico.
– Good morning. Look. Here you go. Hello, Ma’am. How did I find out
I used to be Rembrandt? You are Rembrandt?
– I used to be. You had a son as well. Titus.
– Yes, he was born in September. But my daughter already died
after two weeks. And now they’re back. People reincarnate.
– You were reincarnated? And what is your name now?
– Marcel. What happened
that made you come here? Most people say it’s schizophrenia. Schizophrenia?
– So they say. I don’t believe it. What is schizophrenia?
– I don’t know. People who have multiple personalities.
– Multiple personalities? Apart from that, I don’t have an answer. Do you also hear voices in your head?
– Yes, that too. But I ignore them. Or I’d go crazy. Another fixed part of the daily ritual
takes place around noon. The staff make the rounds
to offer food and household products. The outsider can be present
and still stay in the background. Hoping that the curiosity
will eventually be mutual. Good morning, man. The groceries. What do you need?
– Plain chocolate sprinkles. Sweeteners. Here.
– Thanks. Shouldn’t you drink more? It’s hot.
– I will. We have apple juice, orange juice…
– No need. Are you sure? Okay. What do you need?
– A little cheese. Salami? This is convenient. Home delivery. Next. The groceries.
– What’ll it be? I’d like two cartons of coffee creamer.
– Two cartons. I think it’s the one on the bottom. You look very beautiful. You look pretty good too.
– Thank you. Our outfits match very well.
– A little beige, and white. Nice. There’s a good chance the stranger
first meets the amiable Samira Bulhan. Administrative worker
and confirmed vegetarian. Wonderful.
– Isn’t it? Shall I put this down? See you.
– May I thank you? See you soon. Over sixty residents
live at De Breehoorn. No one stays forever, is the rule,
except when it’s necessary. You can choose to dine together… …play together… …and of course, to smoke. I don’t want to be disturbed by fellow
residents anymore. Don’t ring the bell! Not everyone will open their door. Many people choose a stay
in relative seclusion. Others kindly show their hospitality. Like Hermien Smit, educationalist
and avid reader. Especially when she’s gloomy. Reading. Does reading comfort you?
– They’re just simple little books. Simple books. Like
When Happiness Takes A Detour. Does it influence your mood? It distracts me a little
from my gloomy thoughts. It distracts you. Mrs. Constance van den Heuvel-
Zonneveld also opens her door. She’s been my sister for 67 years.
– Your sister? So we’re dealing with
the two Zonneveld sisters? When she came here,
she wasn’t far from home. Her mother used to live here too,
and all her sisters. Look, this is us as…
– Hang on. This is Bep. That’s her. This is Nel, and that’s me. I see. But it’s a coincidence
you both live in the same institution? Pure coincidence?
– That’s right. So four daughters from one family
had mental problems. Did you have the same problems? Well, no. Did we?
– One of us has… Do you get voices? Voices? Or not?
– Voices? Did I vote? Voices in your head.
You mentioned telepathy. How would you describe
what’s the matter with you? Nervous. I’m a neurotic.
– A neurotic? A neurotic.
– A neurotic, yes. Sharon Meijer is very sociable.
The social heart of this community. Will you come in?
– Is this your room? I love to deal with people,
and it’s easy for me. That’s one positive side I have.
Being able to deal with people. When you walk around here… …does it feel like a village?
A community? How does it feel? It’s a village, that’s nicely put.
Yes, actually. A village with different sites.
Like Center Parcs with a different aim. Center Parcs with a different aim. This is the paint club.
Where people can paint, obviously. And here’s the garden.
– Do you work there? No. That’s not my thing. The remains of Duin en Bosch… …contain a 100-year history
of dealing with the mentally ill. The hospital village was the fruit
of Enlightenment. The age of reason. ‘Insane’ was no longer synonymous
with ‘possessed’ or ‘antisocial’. The big discovery was that
confused people were possibly sick. And maybe had a right to sympathy
for the jumble in their minds. And that they could be brought
to reason again. The madhouses, warehouses crammed
full of insane people, were emptied. In the new place, the doctor saw himself
as the wise father of many children. He provided them with clean beds,
heating and discipline. But his faith in a cure by reason
started to wane. At most, behaviour could be modified. There could be raging inside, as long
as it looked orderly from the outside. And when that failed, when behaviour
conflicted with common sense… …the problem was moved
to the padded cell. Where are we?
– This is Joanne’s store. Whose store?
– Joanne’s. Who’s Joanne?
– We set this up four years ago… …especially for the people
who live on the hospital grounds. From Duin en Bosch’s start,
work was expected to bring a cure. The time of permanent bed rest
was over. Have you got fifty cents for me?
– Fifty cents? I don’t think so.
– Check. The day had to be spent usefully. Daily activity.
– Good daily activity. Are you from Amsterdam?
– Why? I think I hear Amsterdam.
– Screw you, man, piss off. It’s like open house here.
– Yes, I think so. A place to get together.
– The nicest place on the grounds. Come on in. Here are
the ladies’ clothes, on this side. Work fosters ambition,
was the new concept. As well as a fitting sense
of self-satisfaction. Who are they?
– They work in the greenhouse. Are they patients too? Lazy people were more susceptible
to insanity. Work was said to prevent zealotry,
drinking, poverty and sick thoughts. Good afternoon.
– Hello. Excuse me? Oh, you speak a foreign language.
– Only Turkish. She only speaks Turkish? No one can understand her. I’ve warned them. In 2020,
everything will be wiped out here. Here on earth. So… The end of the world.
– Yes, it’s coming. In 2020. Can you imagine other people, hearing
you, will say: He’s lost his marbles? Let them say that, and think that. I’m just saying, in my way, that in 2020
they’ll all be screwed. From the time provincial hospitals
came up… …the mentally ill found themselves
out in nature more and more. As a physician-psychiatrist said
more than 150 years ago: Nothing affects a recovering patient
more… …than the pleasant influence of nature. It distracts the sufferer
from his thoughts… …and fills him with enjoyable
sensations. In the early years of Duin en Bosch
you weren’t supposed to talk at work. Noisiness and overstimulation
were to be avoided. Much was expected of nature,
as antidote to an unhealthy society… …with a profusion of impressions. And if nature wasn’t the miracle cure
after all… …hard labour out in the open
had other benefits in any case. Fatigue. And with it,
a good night’s sleep. And because of that,
quiet wards and corridors. In spite of the warning on her door… Can I come in? …Marja van Dusson
is willing to welcome a stranger. No.
– Really? After some urging and in the company
of her favourite nurse. Her beacon of rest
among the stimulants and chaos. Can I come in? Where there is still room for love.
– Maarten. Marja’s friend. No, fiancé.
– Well, her fiancé, no less. Marja’s boyfriend? And this is my engagement ring. Talk to him. I want to mop first.
– You’re right. My voices are acting up.
I’m getting restless. You met here, I gather?
– Here in the grounds. And was it love at first sight?
– Yes. More or less.
– We were neighbours. Sit down everyone, I don’t like this. Do you know what Mick
wants me to say? I am worth it. I’m in control of the voices. But last week, I wasn’t.
I was a different person then. And that person is called Sabina.
– That’s her name? Now I’m Marja. But when everything
was hectic and carrying on… …I was a different person.
– And she’s called Sabina? I’m made up of different personalities,
aren’t I, Mick? Do you know who they are?
There’s Sabina… And who else? They’re pimps.
– Pimps? Why don’t you say anything? Do you see other patients often?
– The girl next door. Who is she?
– Samira. Dark-skinned. You know her. And do you see other patients?
– Patients? Residents. I’m sorry, residents. Do you think you’ll ever get out of here? When I’m stable. Right, Mick? Mick, am I right?
– Yes. You’ve made some progress. And if you keep that up,
you’ll really have a chance. In life, there are ups and downs.
– That’s right. Where?
– Spanish Waters. What is that?
– Curaçao. When?
– When I get out of here. When is that?
– Next year. When your hair is grey. Me too. When I’m grey, I’ll get out.
– You’ve been here ten years? You’ve had mental problems
for ten years? No, before this, I’ve been in The Hague,
Scheveningen… …Alkmaar, Dordrecht, Assen… …Amsterdam, Hoorn,
Purmerend, Zaandam. After Hoorn I first went to
an anthroposophical farm in Drente. They dragged me out of a meadow
after two days. Then I was brought here.
First Westlinge F. I had them all. Except Scheer and Hogesteeg,
for old people. And now I’m still here. Those who tend to be called confused
deal with him regularly. The normal person. The normal person, with his constant
urge to communicate. What do you think about
when you paint? I don’t really know exactly. The normal person wants to understand.
He notices peculiarities. You paint on the bed.
– Yes, now I do. The normal person wants clear answers
to orderly questions. Can I ask you how old you are?
– How old? It’s July the second.
Late this month I’ll be 30. Thirty. Just listen to me. Then I’ll be nine, nine four.
– You’ll be four nine? Forty-nine? The normal person shouldn’t expect… …the confused man to see himself
as confused. Mr. Zwaanswijk are you… …crazy? Crazy… I wouldn’t know. Sometimes I look in
the mirror: Is my hair okay? And it is. How do you think
other people see you? I don’t know. Sometimes I have curls. It’s hard to communicate
with a normal person. His phrasings presuppose
an obviousness… …but contain many mysterious concepts. Have you ever been in love? Well, let me see… Let me see… It has to do with marriage,
or something. Living together, other things,
I don’t know. I can’t say. I mean you personally.
Have you been in love with someone? I wouldn’t know exactly. I’m not
a musician when it comes to that. They often know more about this. Yes, they get on well with girls,
don’t they? Musicians, you mean? I can’t deal with this.
– With my questions? You can’t deal with them?
– The questions. You’re right. I am very nosey. I don’t know much about all that. I’m so isolated, you know. I feel imprisoned here. And I do want to have friends
around me. Healthy people, outside the clinic?
– Good people. You don’t know what’s wrong
with other people. Do you want to know? I am interested,
but don’t really need to know. Maybe you’re just like me.
You feel sorry for others… …while you have enough on your plate.
– I’m more caught up in myself. Especially now. Yesterday I looked
at a house in IJmuiden. Do you look forward to it?
– Very much, yes. Will it take long, do you think?
– It can take a few months. The hardest thing for me in going back
to live in society… …is that people look at mental illness
as a kind of taboo. I’m afraid people will look at me
strangely: There’s the girl who had
a mental illness. You look very well groomed.
– That’s just the thing. You’re bright, your mind is fine,
you’re always there for others. You can’t see there’s something wrong
with you, or notice when you talk. That’s why it’s so hard. You can’t tell. Sometimes I think:
I wish I had a broken leg. Then people could see
what was wrong. But other people have nothing to do
with your life. That’s easy for you to say.
I can’t get it out of my head. It’s not allowed to drink alcohol
at De Breehoorn. But free as they are, the patients
can visit the bar in Bakkum. It feels like a hospital on the inside.
– Is that a good thing? Not for the clients themselves, I think. You say clients.
– I dislike the word patients. Patients is not a good word?
– No, it should be clients. Yes, I prefer the word clients. For generations, the small hotel has
welcomed residents from Dijk en Duin. Or as the family sometimes calls them:
Those from the big hotel. Hi, Yolanda.
– Hey, Hermien. How are you? Fine.
– Haven’t seen you a while. Good to see you.
– Do you come here often? Yes, certainly.
– On average about once a week? Yes, sometimes more often. But where I live, there aren’t
a lot of cheerful people. And I like to see ordinary people. Not normal people, but ordinary people
who work and enjoy a laugh. Who go out and have fun.
And we don’t have that. How long have you lived
at De Breehoorn? Two years.
– And at the hospital? For a long time.
– How long do you think? I’ve known you all my life.
– You knew her when you were a boy? I think we already met
when I was in my late teens. When I first came,
there was still a fence around it. When you walked through a hole
in the fence, you arrived at Borst. Suddenly, you were in the bar. Sharon just told me in the van
they don’t like to be called patients. They prefer client. Clients. That’s the generation gap.
Hermien wouldn’t mind… …if we called her a patient. But I have the impression young people
don’t want it to be known… …that they live in the institution. I don’t mind. I’m not ashamed of it.
– Okay, you’re an exception. But most of the people
don’t advertise it. That’s true. They won’t shout it
from the rooftops. Since the Sixties,
new buildings have been added… …conforming to another vision
on mental illness. The hospital wards were replaced
by small living units. In the days of anti-psychiatry,
the patient wasn’t sick, but society was. The staff took off their uniforms.
Experiments were banished. Authority was mistrusted. And limiting
the patients’ freedom was taboo. But that time also passed. Too much
freedom also meant a lack of structure. But the padded cell survived
all the changes. What pills and talk don’t rein in,
can be raged out of your system here. Now and then, people at De Breehoorn
are visited by a doctor… …who can judge their wellbeing.
The psychiatrist. And wellbeing often means
being able to return to society. You ended up here
18 or 24 months ago? 2.5 years. Three summers.
– Time flies. You’ve been very sick,
but you’re doing a lot better. So I think it makes sense to start
considering, slowly and calmly… …what your next step could be. You shouldn’t stay all your life.
– You should if necessary. But I don’t think it is.
That would be a waste. If we don’t work on it,
you could get stuck here. I think I can handle a new step. Even though I’ve grown very fond
of the people here. How independently can you cook here?
– I get readymade meals. That’s a difference with living at home.
– I’d have to buy readymade meals. You could, but you’d have to buy them
yourself. That’s another difference. I’d have to go the stores.
– You can start various things here. Talking to a resident,
the psychiatrist is used… …to a second or even third partner
joining in. In Samira’s case,
it’s the little boy Dafur. Dafur? Who’s he?
– He’s inside me. A second personality. He’s still young. He says he loves me,
and will take care of me. That I have to wait
for the good life to begin. But it’s not a voice that tells me
to kill myself, or do bad things. So he could stay?
– Yes. I’d miss him. You’d miss him?
– We’ve become best mates. We laugh a lot, we talk a lot. Is it possible to hear voices
and still function normally in society? What is functioning normally? You can
function in the sense that it’s not risky. It can still be a nuisance,
but it can be inspiring as well. Ten percent of the Dutch hear voices.
So it can be normal. I also talk to myself in my head.
A kind of dialogue. But not everyone hears
a literal voice out loud. That’s the difference.
– As real as my voice is to you. You hear an actual voice?
– We all have thoughts we think about. Our thoughts are dual. But if you don’t know what you’ll say,
if it’s said for you, it’s different. Then it’s a third voice,
different from your own. The residents are used to visiting
the outside world at regular intervals. Supervised or not. A visit to the thrills and whims of the city
is something to look forward to. But also something to fear. You’re restless and tense… …realizing that this restlessness
and tension can take over… …and influence your behaviour. You feel the pressure of having
to meet the expectations of the world. The residents know what
the outside world expects of them. Self-control. Being inconspicuous. Do you want to pet him?
– Innocent contact. And while shopping, a cheerful mood. oh come, let us adore him In the ordinary world, everyone
can afford to act crazy now and then. So this can also be stimulated
by the supervisors. The goal remains to eventually return
to ordinary life. That’s the wish of many residents too. Can you still have fun
in spite of your fear? Certainly. I’ve got you with me. But that doesn’t lessen the oppression
for everyone. Every look you catch can hide
an infinite number of meanings. And without cause,
you often feel the negative meaning. It’s not true,
but every look seems to judge you. To want to unmask you.
We can see who you really are. That you’re different.
That you don’t belong here. The war of attrition of a day out… Can I get cigarettes here? …has a common remedy. even then we won’t go home
we won’t go home just yet Come on in. I heard something happened. Sit down.
– Can I sit down? Of course. I heard something bad had happened. I was committed
to the locked ward again. You went to the locked ward. I had a psychosis. I still haven’t fully recovered.
– You talk differently. That’s the medication.
– What stuff did they give you? What kind of drugs?
Haldol, promethazine, valium, tranxene. And now I’m getting… …flurazepam. Hang on. You’re getting a lot of pills.
– A lot of pills. Why so many different ones? To keep me quiet
and suppress the psychosis. And if you keep taking them,
they accumulate and you get very tired. That’s why I don’t look so hot. Wait a minute. First, what is a psychosis?
How does it work? I stopped taking my pills. Because I felt I could handle it,
and heard a voice in my head. God told me to stop taking the pills. I thought I could fly. I wanted to jump
out the window. I covered my windows with black paper.
They took that off. Have you quit the medication before?
– Years ago. Also as an experiment? I wound up in the isolation cell. I found
out I really can’t do without them. Can you see it in others? When things
go wrong, someone gets psychotic? Yes, and that makes me sad. I feel sad for the people, but it also
makes me feel I’m not the only one. So you thought you could fly.
– I wish I could. I wish I could. Hey, girlfriend.
– Hey, girlfriend. Is your family here?
– My mother and my sister. Where is your mother? Where is your mother? Your mother?
You have a mother, don’t you? A poem by my mother? No, she’s not here.
– She’s not? She couldn’t make it.
– She couldn’t make it. You’re Sharon’s mother, right? This is nice.
– Have been for years. When it’s very hectic in her head,
you come in and there’s stuff everywhere. Then I know it’s hectic
in her head again. And sometimes you go there
and it’s all neat and tidy. I have to do my best for that.
– Yes. And it’s very hard for her. She’d love to have a job,
but it’s too hectic for her. Can I ask you something? How do you like it here?
What do you think of this institution? Very beautiful.
– Very nice? It’s not just beautiful, but good as well.
– Good? I’m content. That my daughter could come here,
to this house, was a miracle to me. A miracle? That this exists?
– A miracle. A miracle, yes. This is my mother.
– Hello. And your father. How did you get so dark?
– I was adopted. I’m not their real child.
– It feels like it. You’re our child. Of course you are. And do you have
other children of your own? You don’t. This is our only sweetheart. And how is she doing, do you think? You keep saying, and I get that
impression too, that you can go home. Yes, I’m already busy
trying to rent an apartment. I can go to a living facility,
if I need to. I have a certificate of need. The city council will see if I can get
priority for social housing. Do you think she has a good chance
of managing that? There’s a 95-percent chance it’ll go well,
but 5 percent say it’ll be hard. She sometimes lives in a world
that doesn’t match the one around us. Even though you want to leave,
you have a place here too. No, I’m very unhappy here.
– Really? I look forward to leaving.
In a good way, of course. And yet, this gentleman is right.
You’re a queen here. She’s doing great here.
– No. I’m not from here. So this isn’t your home.
– Absolutely not. Did I hear you had a hard time
yesterday? What happened?
– I became psychotic. Again?
– And I heard voices in my head. Again? I found her again
after a few hours, so… We walked around a little,
and he said, I’ll call you a taxi. But he called the police, not a taxi. I said, one taxi, with one man?
No, with several people. Three police cars arrived,
with six policemen. And I ran away. I got scared. The day before yesterday?
– Friday. And I’m stopping now. You’re sweet.
– She’s sick too. Sharon is sick too…
– We’re not here for smelly feet. We know that. But it’ll be fine, okay? Be nice to each other.
That’s the main thing. Did you get some pills as well? The physicians of old
already knew, actually. When you came here,
you usually never left. In the end,
there wasn’t that much to cure. Just like normal people can’t be cured
of their rooted convictions… …about what’s normal. The normal person
only has to understand… …that in a fragile world, a confused
person is a bit more fragile, at most. But apart from that, very normal.