The Velvet Underground bestowed an enduring legacy, influencing avant-garde aesthetics and punk and post-punk genres. They employed experimental soundscapes, blurring boundaries between audience and performers, as exemplified in their 1966 show for the New York Society for Clinical Psychiatry (now the New York State Psychiatric Association).

At the Society's 43rd annual banquet, at the decadent Delmonico hotel, artist Andy Warhol was asked to provide the entertainment. The Society's programme chair explained the intentions behind this invitation to the media: ‘creativity and the artist have always held a fascination for the serious student of human behaviour’. Warhol arranged an extravagant show for the psychiatrists, debuting his Exploding Plastic Inevitable collective. Within this ensemble, the Velvets (then managed by Warhol) performed alongside collaborators including actor Edie Sedgwick and singer Nico, in her first of numerous appearances with the group.

Led by singer, Lou Reed, the Underground delivered a high-decibel set against a backdrop of cinematic torture scenes. Warhol recalled, ‘the doors flew open’ and the filmmakers, Jonas Mekas and Barbara Rubin, with a ‘crew of people with cameras and bright lights came storming into the room’. They interrogated the audience with sexually provocative questions, subsequently asking ‘Why are you embarrassed? You're a psychiatrist; you're not supposed to get embarrassed!’.

Distorting the therapeutic relationship, one Velvet member, John Cale, labelled the performance ‘Lou's revenge’; during adolescence Reed had received electroconvulsive therapy, possibly for suspected homosexuality. For the psychiatrists, many of whom left during the show, Reed conceded ‘they had a sense of humour, up to a point’. The New York Times reported first-hand accounts of a ‘spontaneous eruption of the Id’ and a ‘message of super-reality’. Others were less generous, calling the event ‘ridiculous, outrageous, painful’ and noting ‘[i]t seemed like a whole prison ward had escaped’.

However, in the performance, the band did not relinquish its status as a psychiatric subject. Among the setlist was ‘Heroin’, Reed's ambiguous ode to first-hand experiences of heroin use. Comprising phenomenological perspectives, the song's first word, ‘I’, foregrounds the individual using heroin. Interestingly, as demonstrated by the lyrics, the psychiatrists appeared to be a relevant (if not the intended) addressee: ‘you can't help me, not you guys / or all your sweet girls with all your sweet talk’. Reflecting antipsychiatric sentiments in the 1960s and beyond, ‘Heroin’ conveys a rupturing of therapeutic logic, accentuating injurious drug use over health and recovery. ‘Heroin’, the song proclaims, ‘it's my wife and it's my life’ and ‘thank God that I just don't care’.

Of course, heroin use entails severe consequences. Sedgwick died of an overdose in 1971, aged 27, as did another Warhol collaborator, Jean-Michel Basquiat, in 1988. A lineage of artists affected by substance use disorders seems the inverse of the vitality inherent in the Velvet's performances. This exemplifies the shared concerns of art and psychiatry across the full spectrum of human emotions and behaviours.