the farmer's wife

Peter Kramer on The Farmer's Wife

How badly we want for them to prevail. The effect of David Sutherland's lucid storytelling is to instill desire in us, the audience, to make us wish we could do something for Juanita and Darrel. Grant them dry weather at planting time and rain for the growing season. Cut them a break, so that they can continue as they choose, as farmers and as a couple. So that they can survive in their element.

For me as a psychiatrist, there is comfort in seeing that psychotherapy allows the Buschkoetters to treat each other caringly while they weather the effects of dry farm life in a dry season. There is less comfort in seeing how narrowly they squeak through and how little my profession speaks to their more fundamental problems. Short of doctoring the weather, what is to be done for them? They will supply the labor -- the Buschkoetters are remarkable for their capacity to toil all hours of the day and in all moods. But while they are working and waiting for their luck to turn, they need support of other sorts, quite concrete support much of the time.

Their parents help, we hear about money and hand-me-downs. But family help is contingent. Darrel believes his father is slow to hand over control of his own farm. Her mother offers to have Juanita's teeth fixed, but only if Juanita will postpone her wedding. Juanita marries, and the orthodonture is withheld. Here is one tough mother -- though it may be tough mothers who produce tough daughters, and Juanita needs her drive and resilience more than she needs a standardized smile. Like many parents, Juanita's mother is most liberal with advice, especially advice her daughter cannot live with.

Psychotherapy helps, couple therapy and then group therapy. The Buschkoetters are lucky that good therapists are available to them, since in much of the country public mental health services have been in decline for decades. Often only the gravely mentally ill receive care. Couple therapy is especially neglected -- by the public sector and the research community alike. Four years ago in an essay about the annual meeting of the American Psychiatric Association, I commented that the scientific program contained not a single research session devoted to developments in family or couple treatments -- as if the profession, in its romance with brain biology, had forsaken tools that patients find enormously helpful. And as if those disorders brain biology seeks to understand -- depression and impulsivity and the like -- might not arise from failures of marital and family life.

Darrel and Juanita do seem to suffer in ways that ought to engage psychiatrists. Juanita's openness to small pleasures lights up the film, but she can also be tearful and tired and despondent. Some of that down-to-the-bones look that makes shots of Juanita's face reminiscent of the Dorothea Lange and Walker Evans farm administration photographs may arise from mental depression. Darrel's irritability and verbal aggression, and his constant suspicions of those in authority, suggest depression or one of its variants. Psychiatrists are barred from diagnosing those they have not interviewed, but surely Sutherland's selection of clips is meant to suggest quite serious and protracted anguish in both husband and wife.

The Buschkoetters endure stress, but to say this much, or rather this little, is to reveal the inadequacy of the word. They face repeated assaults on their security, and they face them with limited social support. They have faith in abundance, but despite the views we are given of holiday ceremonies, we have little sense of whether the Church ever comes to their aid. The occasional gracious creditor notwithstanding, the Buschkoetters seem to live in a socially fragmented rural county. Farmers sink or swim on their own.

What helps most, it seems, are federal programs, loans and food stamps and Pell grants. Without the availability of federal funds to keep the family afloat and (despite Darrel's grousing) federal advice about rationalizing the finances of the small farm, the Buschkoetters would fail in ways that would make their story too painful to watch. Juanita's classes at the community college are perhaps the most important source of hope. Along with psychotherapy and faith, we must include government programs among the antidepressants that work for Darrel and Juanita.

For me as a psychiatrist, watching "The Farmer's Wife" aroused a particular anxiety: Has my profession lost touch with a broad aspect of what matters when it comes to helping? Attention to the "social frame" is largely missing from contemporary psychiatry, though the glory of American psychiatry was once our awareness of the ambient culture at every level. Supervising the care of a gravely disturbed man in the 1940s, the preeminent psychiatrist of the mid-century, Harry Stack Sullivan, would ask the treating resident whether the patient had served on a destroyer or a destroyer escort in the navy, since the tensions on the two sorts of vessel are so different. Erik Erikson and Erich Fromm and the Menningers in their different ways demanded that psychoanalysts take cultural factors into account in assessing the proper approach to patients. Psychologists and psychiatrists were social commentators by necessity -- by virtue of their professions -- because they believed that mental health could be nurtured or undermined by social policies. During the middle decades of this century, the social surround was a proper subject for psychiatric research.

In 1981, at the start of the Reagan Administration, an edict came down from above (reportedly the ultimate source was David Stockman in the Budget Office) to purge the federal mental health portfolios of social research. I happened at the time to hold a junior position at a high level of mental health administration. I did not understand the directive -- to me our portfolios supported science, whether the cause of depression was posited to be genetics or poverty. With others, I drafted a definition of "social research" so narrow as to permit the continuation of almost any study under contemplation by the National Institute of Mental Health (NIMH) and its cohorts. But this expedient had minimal effect. For reasons of its own, the field was turning to strictly biological work -- the basis for today's novel medications and for high-tech inquiries, from brain scanning to genetics, into the underpinnings of mental disorder.

These studies could hardly be more promising. But the high-tech research neglects ordinary aspects of human suffering -- neglects the Buschkoetters. Epidemiologists tell us we are in the midst of an epidemic of depression. If they are right, the reason is as likely to be in the social sphere as the (narrowly taken) biological. It is at least plausible that one of the vectors for depression is a lack of social cohesion, a lack of reliable social support.

"The Farmer's Wife" does not indicate whether the Buschkoetters were offered or took medication in their time of trouble. Other than through complaints of aches and pains, the video makes no reference to illness, and viewers have no way of knowing whether the family saw doctors for any reason. But neither medication nor contemporary psychotherapy would be likely to get to the heart of what ails this couple. Juanita indicates as much repeatedly, when she says Darrel was a different man when he was able to make a go of farming. In Darrel, need and abilities are united; his abilities are as a self-employed farmer, and his need is to exercise those abilities.

It is possible to view "The Farmer's Wife" as a political film, a film about the ravages of capitalism and the saving grace of the tattered federal safety net. The diametric opposite of the "welfare queen," in terms of political stereotyping, the "farmer's wife" is a worthy recipient of, say, food stamps. Federal largesse, as it is often condescendingly called, allows the Buschkoetters to employ their talents, though the couple is saved finally by Darrel's father's additional acreage; as viewers, we understand that without that family resource this couple could not hold on.

"The Farmer's Wife" is also a psychological film, one that shows how much of intimate psychology is social. As I sit down to collect my thoughts about the film, images of Jonathan Mann intrude. Jonathan Mann was the internist and human rights activist who died in the crash of Swissair flight 111 in the waters off Nova Scotia. He was my intern when I was a medical student, and I have followed his career ever since. In the fight against AIDS, which he led for the World Health Organization and then from academic posts, Jon made the point that medicine cannot be merely a technological enterprise. It was his genius to frame AIDS as a problem not only of virology but also of human rights: women's rights, child rights, gay rights, rights of the poor, rights of the citizens of developing countries. It was his genius to see politics as an aspect of medicine. Surely it is an aspect of psychiatry.

For me as a psychiatrist, there is comfort in seeing that psychotherapy allows the Buschkoetters to treat each other caringly while they weather the effects of dry farm life in a dry season. There is less comfort in seeing how narrowly they squeak through and how little my profession speaks to their more fundamental problems. I want more for these good people, more protection for their marriage and their children and their individual well-being. That protection must finally be social and political, through attention to the communal needs of families in the face of an economic system that, however successful in the aggregate, is relentless in its pressures on those who stumble.


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