The first case was a film editor friend in the Swinging Sixties. In the commune we were living, noone had any idea what to do. But the situation became quite physically threatening, so we resolved to take him to Paddington Hospital. We decided on a subterfuge whereby we told him we were going to meet a mutual friend arriving at the airline terminal on Cromwell Road. He, surprisingly, agreed - we were expecting resistance.

It was clear that we were not driving to Cromwell Road, but no objections. When we arrived at Paddington Hospital. He asked if he would need a suitcase. We said no. And he then transformed Paddington Hospital into a city terminal - he wanted to be taken to `check-in', he addressed the nurse as if she was an airline representative, and before they took him from reception, he said "I'll see you when I get back". Sadly he never came back until long after I had left the UK.

The second case was a young Finnish girl artist in a radical art group called Revolutions On Request. There were clear indications of ongoing self-harm, and though I was not central to the decision, my view was that someone was going to get hurt without committal, or at least the help of professionals.

The 3rd case was a young family friend who I had long ago `diagnosed' as a coming alcoholic. He is the youngest of a large internationally known rich family of artists and brilliant, competitive conversationalists. The only way he could get attention was to perform even more bizarre party tricks, mostly with guitar and a foghorn voice. He was very, very funny, but it became a behavioural problem when, unable to be funny 24/7, alcohol became the prop, and later, dope.

When his mother asked, I explained my theory, but with the burden of having been involved in two previous committals, sough to reassure her, rather than recommend the action I thought was needed. Eventually he was committed. It took several years of lithium for him to slowly re-emerge. Now he is married, has just got a son, and has progressed far enough in AA to become a sponsor. He was brave and I was wrong. Earlier professional treatment might have caused less impact.

The 4th case began last night when I heard about a close friend being committed, by his family. I went to visit him today. He was behind locked doors.

He's been in LA for 10 years in movies. He's been peripheral, but deeply involved. His ex-wife was a script reader for a major studio. We've met over the decade, each year, as he returned to Finland for summer holidays. After a supposedly amicable divorce, he came back to Finland. We've talked though various projects, although we have never done anything together.

A few months ago though, adrift from the wife, LA and movies, he began to formulate a radical response to economic shenanigans. He created a new system called `Citizen'.

Citizen is an emphatic economic order where Competition, Cooperation, Charity and Civic Virtue are all incentivized in a single system of exchange. By forcing the consideration of every transaction from the counter party's point of view, the traders quickly learn to optimize both outcomes. It can be seen as a strategy game where talent combined with wise allocation always results in beauty and prosperity.

The concept, which only exists presently as a constitution and blueprint, is very interesting, but radical. If you do read the link, please don't comment on it directly here. It is unfinished.

What our patient has been doing for the last few months is to try to live according to this incomplete structure - using himself as a guinea pig. He's organized a couple of free street festivals and other stuff, successfully, according to the rules he set himself. I didn't think this was a career move, but I had full respect for the intentions.

But his mother, who has seen him, as I have, only on those summer trips, has now committed him. I met her for the first time at the hospital this afternoon.

There are two different things going on, and I've been carefully trying to put the case of that difference all day. One, he's definitely more manic than usual - even after medication (I tried to find out what). My guess is that shortage of money and a consuming passion for his new concept, have meant sleepless nights, poor diet and general debilitation. `Manic' is not that difficult to treat because it's a rejection of routine and familiarity - and John (as I'll call him) is adrift from 3 major components of his previous life (his routines) for the last decade. The medication is relatively non-toxic, and counselling can provide the routines necessary to stablilize a lifestyle.

The problem is that his `economic theories' (and practice) are perceived by the doctors (i.e. the one-sided story from the mother) as being `crazy'. So his `mad' theories and temporary mania are being conflated. I'm not sure what to do, but I'll probably write to his doctor. I spoke briefly to one doctor, and we agreed she would call me if she needed further background.

This is a strange situation. I see it is as something like a hard Christian parent (the mother) assuming that their son, an atheist, must therefore be a Satanist. The two things only have a connection in the hard Christian's perception. As the mother sat there stiff in her mink-lined coat and ashen face, it was clear that her son was a blasphemer in a world measured by possessions.

We are all (here at ET) crazy in some way. We are looking for solutions, and some of our friends offline don't get it. But we keep on looking. I prefer to call this heretical thinking. Calling it crazy can get someone else committed.