Some notes on the “Useful Film in (Neuro)Psychiatry Europe, 1900-1950. Update on Current Research” conference

The main goal of the conference was to assess the research on “useful films” conducted during the first half of the 20th century by neurologists and psychiatrists in Europe for clinical, educational, and archival purposes. The “useful film” has been long neglected by film historians, remaining in the shadow of both commercial cinema and the “auteur film”. Partly escaping commercial theatrical release, useful films know over the years a large variety of formats, forms, and functions, but also a diversity of production, distribution, and reception contexts. Their pragmatic and ephemeral nature requires considering the context in which these films are elaborated, as well as the discourses that surround them and the practices that determine them.

Drawing on the work of Acland and Wasson, the notion of useful film refers to the multiple ways institutions conceive and engage with the tool of cinema. “The concept of useful cinema does not so much name a mode of production, a genre, or an exhibition venue as it identifies a disposition, an outlook, and an approach toward a medium on the part of institutions or institutional agents.” (Acland & Wasson 2011, 4). For our part, we employ this notion in order to designate an approach to cinema oriented by the needs of the actors in the field of neurology and psychiatry.

Kimberley Fleuren

One of the scopes of the conference was to compose, through a number of case studies, a panorama of the practices involved (themselves quite diversified, even though the model of a film as a tool within medical research largely prevails), while bringing forth new approaches or lines of research relevant for this type of audio-visual document. Contributions focused on films made in France (Jean Comandon), Italy (Gaetano Rummo and others), Great Britain (Wellcome collections), Germany (Ludwig Mayer), Belgium (Van Gehuchten and others), the Netherlands (Magnus-Rademaker), Spain (Antonio Subirana), and Switzerland (Walter R. Hess, Ernst Grünthal).

We have chosen to focus on the first part of the 20th century for pragmatical reasons, but also to reexamine the traditional history of neuropsychiatric film, which isolates two key moments in the development of the film practices of neurologists and psychiatrists. The first one amounts to the era of the pioneers around 1900–1910 (Marinescu, Van Gehuchten, Neri, Negro, Magnus, Sainton, Comandon, etc.). Their films are for the most part the result of personal initiatives and emerge outside institutional policies, as is the case with the amateur films made by Ernst Grünthal; other films are made through collaboration between a professional filmmaker and a doctor/institution/firm. The second key moment extends from the inter-war to the post-war years that saw the rise of the “institutional asylum film”, a term introduced by Bonah and Rotzoll (2015). Indeed, in addition to a persistent voluntarist tradition, films are from that moment on actively supported by medical institutions, pharmaceutical companies, and public policies.

Leander Diener

Yet how accurate is such an identification of two golden eras and what happens in between? Can the history of useful film in psychiatry and neurology really be divided into distinct periods and if so, according to what criteria? What forms does the notion of the camera’s alleged objectivity take during this period of fifty years? How do the films testify to this mechanical objectivity bestowed upon the medium of film? Certainly, the recourse to films pushes even further the fantasy of the “blind gaze” to which the scientists of the 19th century aspire – scientists who, as Daston and Galison observe, dream of becoming themselves machines with no will of their own. However, we must not forget that all statements about the objectivity of the cinematographic camera are essentially rhetorical. They serve in part to convince the scientific community of the legitimacy of such practices, since cinema is still associated with the world of entertainment. Therefore, discourses on the objectivity of the film medium have the function of legitimizing and stabilizing knowledge and practices.

Katrin Luchsinger on photography in psychiatric institutions

More importantly, these claims coexist with an acute awareness of the limits of such mechanical objectivity allowed by the film medium. For instance, the psychiatrist Paul Sainton highlights the challenges involved in properly filming subjects affected by movement disorders. It is not easy, he writes, to capture patients with neurological or mental illnesses because it happens that they freeze once they know they are being filmed: “Subjects who, in their hospital setting, had extensive movements, remained motionless when put in front of the camera.” This problem is of course magnified due to the high cost of the film. Neurologists and psychiatrists are fully aware of the epistemological obstacles that prevent them from getting a “good” shot – obstacles such as the whimsical behavior of the patients or the technical, material, and weather hazards. They know well it is a challenge to grasp some pathological movements such as hysteria or epilepsy, or to record eloquent enough movements, worthy of interest because of their emblematic or singular features. In their efforts to ensure the clarity of the images, they are forced to come up with solutions that seem contradictory to the “cognitive absolutism” of the “clinical gaze”. For instance, some doctors choose to dramatize and narrate their patients’ symptoms or to stage their own practice.

What are the main results of the conference?

The approaches presented during the Conference reflect the diversity of the disciplines to which the researchers belong. At the same time, they are telling of the complexity and richness of the films studied. As the first panel, “Filming the Brain”, illustrated (with Kimberley Fleuren, Leander Diener and Raphaël Tinguely), three different approaches stand out: a. a clinical approach, according to which the film is treated as a document informing on certain medical practices and pathologies, thus functioning as an extension of regular clinical observation, intended to capture what escapes the eye; b. a history of medicine and science approach that uses the film as a means of shedding light on a particular aspect of this history; c. a film and media history approach that focuses on the aesthetics and the materiality of films, as well as the context of their application. All three approaches attest to the epistemic value of the neuropsychiatric film, though the actual nature of this knowledge differs according to perspective adopted. As Christian Bonah remarked, “we look at the same images, but we don’t see the same thing” (referring to Ludwik Fleck’s “looking vs seeing model”). Therefore, it is important to openly assume the position from which we interpret these multi-dimensional images (and sounds).

Angela Saward from the Wellcome Collection (London)

As Katrin Pilz reminded us, the question of the “usefulness” can be asked at different levels, depending on the actual users. To whom are these films useful? Firstly, to medical doctors, teachers, staff, students, etc. at the time of the production (we may speak, in this case, of the films’ original usefulness). Then, they were useful to operators, filmmakers, firms, etc. interested in collaborating with doctors. Finally, they are useful today to researchers, archivists, curators, etc. If their original message is quickly outdated (they are ephemeral material), they present an immense historical value, as Angela Saward explained through a specific case study. Katrin Pilz concluded that one must begin by asking why these films were considered useless for so many years, forgotten in attics, remote hospital rooms, bunkers, etc.

The usefulness of these films is a dynamic concept, as David Cantor has noted. Usefulness changes over time (it increases or decreases with time and context); it fluctuates based on the groups that engage with the medium of film; it depends on the applications to which film is submitted, but also on the audiences that watch it. The question of the usefulness of films must be distinguished at all stages of their existence: production-direction, distribution, reception. Depending on the stages of the film’s development, the medical knowledge, the technology used, the content, the contingencies of the filmmaking, the audience responses, etc., the usefulness changes in form and meaning. Utility is a concept under constant construction, the object of negotiation between production, distribution and reception entities.

The roundtable with David Cantor, Katrin Pilz, Angela Saward, Christian Bonah and Caroline Fournier

With regard to the original utility, the paradigm of mechanical objectivity dominates. But mechanical objectivity constitutes only one type of epistemic virtue among several others, as Daston and Galison have shown. For Andreas Killen, the Ludwig Mayer’s films on hypnosis resort to the truth-to-nature paradigm, in that these films aim above all to demonstrate the effectiveness of hypnosis through emblematic images of the hypnotic state.

Nowdays, these films also inform us about the history of recording technologies (35mm, 16mm, 8mm, super 8, 9.5 Pathé Baby, etc.), as the Subirana collection presented by Paula Arantzatzu illustrated. The Subirana films testify to a media convergence practice that is quite extraordinary for the time: the films combine different types of still and moving images, such as real shots, X-rays, EEG, histological sections, and photographs. Moreover, they provide informations on the history of medical imaging, i.e. the usefulness of audiovisual devices expanding the field of scientific knowledge. This is also the case with the Waldau collections analyzed by Raphaël Tinguely, Léa Ritter, and Lucas Iliani. The hybridity of both the collections and the films of which they are composed requires us to trace the wider network in which they are embedded. According to Caroline Fournier, head of the film department of the Cinémathèque suisse, hybridity is what characterizes the production of amateur films—a paradigm that allows to understand the particularity of these film practices.

Léa Ritter and Lucas Iliani from the Cinémathèque suisse

Another question raised by the original usefulness is the content of these images. What exactly is the camera filming? Illnesses; patients, doctors, interactions between patients and medical staff; state of research; brain, mind, body, etc.?

Among those listed elements, the question of the patients has proven to be of a central importance. Who are they, where do they come from, how do they experience medical observation and filming; who are these invisible and unknown people on the screen? It seems quite difficult to trace their history, and when we do have some elements, they only come in fragments. Different sources provide some data: film storage material, administrative records, patient records, written testimonies, drawings, interviews with relatives, etc. But as Maia Woolner showed, this lack of information about patients is also meaningful. It reveals something about the status of patients as objects of experimentation, demonstration, or medical observation – hence, Christian Bonah‘s call to avoid the anonymization of data for legal reasons, as this process contributes to the invisibilization of people who have nevertheless played an essential role in the history of medicine. He also rightly reminded that the question of patients’ consent to be filmed is not just an ethical issue but also a legal one. In any case, solutions need to be found to conceptualize this invisibilization of patients, by drawing, for instance, on the social history of medicine, the spectralities or disabilities studies, which are interested in social groups neglected by canonical history.

The uncanny dimension of patients was also raised. While it strikes as obvious to today’s researchers, it is safe to assume that this must also have been the case, at least to some extent, for the experts watching the films at that time of their production. For example, it is difficult to make sense of images of patients who have completely lost control of their bodies and minds, as David Cantor has noted. And how to deal with the aesthetic dimension of certain shots that reduce patients to elements of the “medical set”? Part of the uncanny comes from their nudity, which emerges as a representational convention since the beginning of neuro-psychiatric cinema. For some speakers, nudity meets a need for visibility of every part of the body and muscles affected by pathological movements. For others, it is a cultural convention that allows nature and culture to be contrasted, with patients embodying the primitive and doctors the civilized. In this latter perspective, it is used to contrast the healthy body (that of the doctor who stands by the patients) and the sick body of the patient, in a comparative gesture typical of medical thought.

But is the nakedness always necessary? In some cases, the nudity does not fail to add something spectacular to the representation. According to Christian Bonah, some of these films appear as “medical exploitation films,” in that they rely on sensationalist effects. For this reason, they lend themselves to all sorts of hijackings, as illustrated by the films of Doyen that circulated on fairgrounds. One solution might be to contextualize these images when shown today, following the model of platforms such as Medfilm or the Wellcome collection.

From Lorenzo Lorusso’s presentation about Gaetanno Rummo

In any case, these films need to be interpreted as a history of specific power relationships, as for instance, the history of Western colonialism, and more generally the history of the stigmatization of the insane based on processes of exclusion and inclusion (in other words, in terms of negotiation, as suggested by Katrin Luchsinger). As Christian Bonah highlighted, one must be careful not to essentialize what one sees, as films always reveal more than the doctors wish to show; indeed, while mechanical objectivity is inherent in the film medium, film is underpinned by ideological, even political, issues, as Paula Arantzatzu showed.

Katrin Luchsinger has raised a yet another essential question on the subject of patients, namely that of the emotions aroused by these images of madness. She reminded how important it is to take time to watch and process these films and photographs. She also drew attention to the aesthetic and spectacular dimensions that escape those who produce the images. These films also respond in a way to existential questions that will be at the core of the avant-gardes, as when they display new images of the body and mind, through new technologies, a theme highly relevant for artists from the beginning of the 20th century.

Psychiatrie Museum Bern

There are still many more questions that need to be answered: Who is filming? Who is behind the camera? Doctors, operators, assistants? How are we filming? Is it just to document experiments that confirm research hypotheses (as for W. R. Hess) or to create a sophisticated discourse to be presented to peers at conferences (as for Subirana)? Who is watching these films? Medical and non-medical audiences (films do not always reach their original audience and may be enjoyed for their spectacular dimension outside the medical realm)? How should the issue of sensitive data be approached ? (We have seen that there are different “schools of thought” depending on the institution).

References

Charles R. Acland & Haidee Wasson (ed.) (2011), Useful Cinema, Durham-London, Duke University Press.

Maike Rotzoll & Christian Bonah (2015), “Psychopathologie en mouvement. Histoire des films à Strasbourg et à Heidelberg”, in Ch. Bonah, A. Sumpf, Ph. Osten, G. Moser, T. Close-Koenig & J. Danet (eds.), Le Pré-Programme. Film d’enseignement / film utilitaire / film de propagande / film inédit dans les cinéma et archives de l’interrégion du Rhin Supérieur. 1900-1970. Une étude comparée franco-allemande, Heidelberg-Strasbourg, A25 Rhinfilm.


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