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Marcus Coates attempts to understand how we relate to each other and the world around us. By collaboratively re-enacting different states of being, his artistic practice explores the lived realities of people, animals and nature in an effort to gain more understanding and empathy, often investigating relational tools beyond conventional language. His approach is often functional with a social and ecological impact in mind. Coates has collaborated with people from a wide range of disciplines including anthropologists, ornithologists, wildlife sound recordists, choreographers, politicians, psychiatrists, palliative care consultants, musicians, and primatologists.

The Directors is a compassionate approach to challenging stigma around mental health disorders that was initiated by Marcus Coates who worked closely with Dr Isabel Valli, a senior lecturer at the Institute of Psychiatry, Psychology and Neuroscience, King’s College London.

Coates explained that he wanted to create films that were relatable, mutual and authentic to the directors’ voices. The project was founded on interest in understanding more about what living with psychosis is like. He said: 

“A big motivation for me was to make something that was leading people into the idea of relatability for these experiences, to allow people to reflect on their own idea of their reality and the temporal nature of that, but also to allow people to reflect on their own stigma.”

What is Marcus Coates’ artistic practice and why did he want to work with people with lived experience of psychosis?

The research, development and filming of The Directors took place from 2017 to 2022. Coates’ research began at the South London and Maudsley NHS Foundation Trust where he was artist in residence and worked alongside psychiatrist and neuroscientist Dr Isabel Valli, observing her consultations with patients. With input from Michael Morris (previous co-Director at Artangel) and Dr Valli, the focus of his research considered the dynamics of personal understanding and empathy and the role of the wider community and public attitudes.

He learnt that it was often very difficult for people with lived experience of psychosis to convey their experiences. He started to explore different ways of trying to understand, relate to and empathise with the patients beyond just using words. The concept emerged from the artist acting as a willing conduit for the person with lived experience to project their experiences onto in order to describe their worlds. Coates describes his role as “like an actor that doesn’t act but enquires and tries; whose motivation isn’t to portray but to understand.”

In 2020, Coates and Artangel formed an advisory group which included voice hearers, psychiatrists, activists and other mental health advocates and professionals, to help them ethically navigate the project. With UK Mental Health Charity MIND, they put a call out for people to participate and those interested in taking part got in touch.

Coates collaborated with each of the Directors over a two-year period to develop trusting relationships based on care, reciprocity and understanding. This allowed them to unpack their experiences together over time. Each experience working with the individual directors was unique. He explains: 

“I couldn’t repeat the process with each person in the same way. I had to be very open to it and almost start from scratch to create a new language with each person. I think the trust we established was also a big part of it, allowing each other to experience discomfort for the sake of creating something meaningful together.”

Coates speaks of his approach as focused on servicing the narrative of each Director. Of his experience of working with director Marcus Gordon, Coates says: 

“That collaboration was really important and the emphasis was on me servicing Marcus' narrative, that’s all I felt like I was doing, and I was doing that by being interested in his human experience.’ 

Similarly, when working with director Anthony, he comments:

"His narrative was the most important thing and everything had to serve that. Anthony is more important than anything in that film. It felt quite liberating for me as a filmmaker to do that.” 

A rigorous ethical approach was essential to the process. The directors and Coates speak of how they routinely checked in with each other during planning and filming, facilitated through their established, trusting relationships over the period.

What did the filmmaking process involve and what was the artist’s approach?

One of the major motivations that encouraged the directors to get involved in the project was the opportunity to reduce stigma and raise awareness about the breadth of experiences that psychosis can involve. They wanted to address the public perceptions and misconceptions around psychosis, while addressing the individuality and particularities of their experiences, even if only in a partial way. As Marcus Gordon points out: 

“Getting a one hundred percent accurate representation of my psychosis is just never going to be possible, but this is the best I’ve ever seen done to get my psychosis across. Before, I’d probably look to get someone to agree to ten to twenty per cent, but this is right up there into the eighties, I’d imagine.” 

The directors were motivated to participate in conveying their experience in a more accessible and understandable way to family, friends and medical professionals. Lucy describes the importance of addressing vulnerability and fear that is often associated with the social alienation that experiencing psychosis can foster. She says: 

“I wanted people to understand how scary and debilitating it can be, but also that if you know someone who’s struggling, how much they might need you there. So, as scary as it is for us, how important it is for those around them to help, because it is very lonely.”

Why did the Directors want to be involved in the project?

Through the co-authorship dynamic established between the directors and Marcus Coates, as Anthony explains, they discussed with him “the many avenues of actually expressing their experiences” in a way that was truthful and accessible. The directors talk about the project as a challenging yet empowering experience. Lucy explains: 

“The experience was a bit scary at first but once I accepted that being the director was my role in it, that was very empowering, facing it head on for myself, because for a very long time I didn’t feel comfortable talking about it because a lot of people weren’t comfortable discussing it.” 

The project provided a platform for the directors to take agency over their personal experiences and centre their narratives, rather than certain stories and conceptions being projected onto them. “I did really enjoy the power dynamic to actually own my own situation and own experience,” explains Anthony. Similarly, Lucy describes, “To take that power back and say, ‘Look I want to show you’, was amazing.” 

Nonetheless, the directors describe their struggle with communicating their experiences entirely and accurately. As Marcus Gordon notes: 

“It was like there was this disconnect between what I was trying to say about my experience and what the interpretation of my experience was. The level of intensity just never seemed to translate, and I think this film is the first time I’ve ever seen it translated in a way that it shows that intensity”.

How did the Directors reflect on their experience and the outcome of the films?

Coates acknowledges that he began the project with his own prejudiced perspective on what living with psychosis can be like. He says: 

“I came to this process with the usual rucksack of stigma and that was part of my motivation to do this, to face that and understand that. It had an enormous effect on me. The biggest thing I’ve learnt is to not take my realities for granted.”

This underscores how engaging in the process prompted Coates to broaden his understanding of the spectrum of lived experiences by those experiencing psychosis and reflect on the subjectivity of reality.

He describes that when filming begun, he was already feeling vulnerable but that as the process progressed he experienced many of the emotions associated with psychosis firsthand, which significantly affected him. On his experience of being directed by Marcus Gordon, Coates comments: 

“It was the combination of dread, fear, doubt. Within all of that it wasn’t the hallucinations themselves, it was the doubt of whether I could assess everything — I was constantly trying to see whether things were real or not.” 

Coates’ description of his embodied experience during the process underlines how his approach of using radical empathy can test actual and perceived boundaries between individuals and produce new ways of relating with others. 

From the outset of the project, Coates always intended for the films to go beyond the function of solely being an artwork—to become a social and learning resource.

How did Marcus Coates reflect on his experiences and the outcomes of the project?

Film has been referred to by Marcus Coates and the directors as a medium that allows for greater empathy and understanding when addressing lived experiences of psychosis. Dr Valli describes the artistic medium as a fundamental research-based element of the project that can provide viewers with tools to empathise and be educated about the multifaceted experiences that make up psychosis: 

“I think the film has two important elements. One is that it offers a first-person account of how it feels to experience psychosis, and so it can improve the viewer’s knowledge of psychosis. It does this with an intimate film contact, so one can empathise through meeting the person through the film. I find that this is a good example of research-informed art practice, using what we know from research to make art that can actually help reduce stigma.”

The accessibility of the film medium can provide a bridge between art and other disciplines such as education and medicine. Working with film has allowed for a wider application and mobility of the directors’ narratives, which have been used as a learning resource for psychiatry training within the NHS. As Coates points out, “It is important to incorporate art, to some extent at least, in medical education, to show students that there’s also this side to a person’s real-life experience.”

Why were films used instead of another medium?

Experiences of psychosis can vary significantly and require personalised frameworks of support. There are some approaches that may help to create more inclusive, trusting environments for people to share their experiences and to challenge the associated stigma.

For someone experiencing psychosis, attempting to convey their experience can be challenging. 

“Explaining schizophrenia to someone whose never had it before is like explaining to someone who's never had a cold before — it's that hard to explain. But empathy, understanding, sympathy and kindness goes a long, long way,” explains Mark. 

Believing and taking seriously someone who is trying to describe and share their experiences can be an important factor in making the person feel safe and listened to. Lucy describes how not being believed made her experience of psychosis much harder, particularly as a younger person: “It felt like I wasn’t taken very seriously for a long time and I really struggled with that.” She affirms that belief and ongoing support can be really helpful.

Marcus Gordon explains that, for him, someone asking if he’s alright often causes him greater anxiety and raises self-doubt: “The more I’m asked that, the more I doubt myself, the more I question my reality.” What might be preferred is asking how you might be able to help that person or what they might need. He explains: 

“If you don’t know the person, you’re not going to know the right things to say. Just do your best; ask them what you can do to help. Essentially just act like you would otherwise and carry on as normal and I will eventually get through it, but that’s me — it could be different for somebody else."

As a psychological therapist, Marcus Gordon affirms that challenging the associated stigma will hopefully encourage more people to reach out for support sooner.