World Mental Health Day: Mental Health in Fiction

Today is World Mental Health Day. Call me morbid, but I’ve always been fascinated by mental health issues both in real life and in fiction. I seem to have quite a few friends with different mental health conditions, have suffered from depression on-and-off myself and have always read research papers on the topic. For a while, I was tempted to become a psychiatrist, except I couldn’t face going for so many years to medical school.

I find the self-help books often surprisingly unhelpful, and it’s a bit hit and miss with memoirs. I appreciate the honesty and find them inspiring in small doses. But, somehow, fiction describes it best – and there certainly is no shortage of such fictional treatments (pardon the pun). From Dostoevsky’s Idiot (who really only suffers from epilepsy and a good heart) to that well-known Victorian disease, hysteria in women, in The Yellow Wallpaper, from the graphic descriptions of electro-shock therapy in The Bell Jar to the horrific wards in One Flew Over the Cuckoo’s Nest, it seems that we are endlessly fascinated by the unpredictability of the human mind.

Now that I’m out of the danger zone myself, I’ve read more books on this topic in recent months. Books that I might have avoided 18 months ago. Although never explicitly diagnosed, in Bellevue Square by Michael Redhill we probably encounter (spoiler alert!) schizophrenia or paranoia, and various other conditions in the secondary characters. Meanwhile, Zero by Gine Cornelia Pedersen describes a horrific slo-mo fall into depression and self-destruction – exact diagnosis is not always possible or useful.

The most recent book I read on this topic also has a woman struggling with mental health issues (in all three of these books, it is the woman who suffers – hmmm), namely The Pumpkin Eater by Penelope Mortimer. This was also my contribution to the #NYRBFortnight. [There is another excellent book published by NYRB which relates to this subject and which I might tackle next: The Three Christs of Ypsilanti, a non-fiction book by psychologist Milton Rokeach, who brought together three paranoid schizophrenics who each believed they were Jesus Christ.]

The unnamed narrator of the the Mortimer novel (or named only as Mrs Armitage, thus being denied of any identity of her own that does not relate to hear role as daughter, mother or wife) is a woman who can’t stop getting married and having children. We never quite find out the exact number of her brood, nor any of their names, except for the oldest daughter Dinah. We do know that she is in love or believes she is in love with Jake, her current (fourth) husband, who has become a successful and well-paid film director. But clearly there is something missing in her life, a gap that she tries to fill through babies, although she is somewhat ambivalent about them once they are there. They tear her apart with their ceaseless demands, yet she clearly would do anything for them.

She sees a therapist but finds it less than useful (he wants to talk about her previous husbands and her father, which she doesn’t believe to be relevant). Most of the book is constructed on dialogue, which prove to be hugely revealing of character.


“Do you like children, Mrs. Armitage?”
“How can I answer such a question?”
“Could it be a question that you don’t wish to answer?”
“I thought I was supposed to lie on a couch and you wouldn’t say a word. It’s like the inquisition or something. Are you trying to make me feel I’m wrong? Because I do that for myself.”
“Do you think it would be wrong not to like children?”
“I don’t know. Yes. Yes, I think so.”
“Why?”
“Because children don’t do you any harm.”

Except, of course, indirectly they do. A year before Betty Friedan’s Feminine Mystique, Mrs Armitage expresses all the boredom and frustration, being slowly stifled by domesticity and colluding (sometimes quite happily, sometimes feeling she has no choice) in her own oppression. She is given some ‘happy pills’ but still has a breakdown in the linen department at Harrods. Her husband, the insufferably self-absorbed Jake, convinces her to have an abortion and sterilisation, but she discovers almost immediately afterwards that he has been having an affair with an actress. This was one of the most angry and poignant parts of the story and I was devastated to hear that it was autobiographical. But with what admirable control Mortimer takes real life and transforms it into fiction!

Penelope Mortimer, from the National Portrait Gallery.

This all sounds terribly depressing, but the book refuses to be self-indulgent and self-pitying. Instead, it is just the right proportion of fierce and funny, ironic and devastating. Reading it can feel a bit surreal, particularly at the beginning, when you wonder just why the heroine makes so many marriages and children. I particularly enjoyed the  pitch-perfect non sequiturs, whenever Mrs Armitage replies to anyone. She refuses to allow herself to be defined or questioned or pinned down by her victim. She refuses to be a victim, although she sometimes seems in danger of getting crushed by raw emotions. Her revenge is often sly, indirect, simply by ridiculing the men in her life. A woman’s weapons at a time when there were few other weapons available. But at other times, she explicitly calls out for women to rebel… although that letter (significantly) never gets sent. Still, this passage resonated particularly at this moment in time:

You have a vote, Mrs Evans. Now, why don’t you take advantage of it? I have a vote. Really, anyone would think that the emancipation of women had never happened. Dear Mrs Evans, let us march together to our local headquarters and protest in no uncertain terms. Let us put forward our proposals, compile our facts, present our case, demand our rights. The men – they are logical, brave, humanitarian, creative, heroic – the men are sneering at us. How the insults fly. You hear what they are saying, as we run the gauntlet between womb and tomb? ‘Stop trying to be a man! Stop being such a bloody woman! You’re too strong! you’re too weak! Get out! Come back…’ When we were young, we said the hell with it and used our breasts as shields. But the tears fall so easy when they take away love.

Peter Finch kisses Anne Bancroft on the forehead in a scene from the film ‘The Pumpkin Eater’, 1964. (Photo by Columbia Pictures/Getty Images)

If this be insanity, then perhaps all women (at that time) were insane. To me, it seems like a perfectly reasonable response to difficult external circumstances. Yet, although it encapsulates a certain time period, it also feels very modern (and also quite American, so that I often was startled when I came across references to London in the text). Perhaps I say American because it reminded me of Shirley Jackson’s home life. I think the two of them would have got along very well.

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#WITMonth: Zero by Gine Cornelia Pedersen

One of the privileges of working for a journal for world literature like Asymptote is that I get to know some of the best translators, as well as getting an early peek at some of the things they are working on. When Rosie Hedger, one of the most promising young translators from Norwegian (she has also translated that wonderfully claustrophobic novel The Bird Tribunal by Agnes Ravatn), mentioned that she was unsure about the reception her most recent translation would have, because it is bold and mad, I was eager to read it. Additionally, it is published by Nordisk Books, whose previous publication Love/War was equally unusual but intriguing. So thank you very much to Rosie for sending me a copy of the book, but you know me well enough by now to realise that this has in no way swayed me to write positive stuff about it if I didn’t like it.

Luckily, I did like it! In fact, I was so captivated by it, that I read it in a couple of breathless hours sitting in my back garden at the weekend. It is very quick to read, written in something resembling a free verse style (short line breaks), but it’s certainly not an easy read. The unnamed narrator, a young girl with mental health problems, does horrible things to others and to herself; meanwhile, horrible things are done to her too. It is the machine-gun approach to storytelling, or one long, angry howl.

There are quite a few accounts of people suffering from mental health problems in literature, some of them very well-known, such as Girl, Interrupted, The Bell Jar, One Flew Over the Cuckoo’s Nest, others far less so: Down Below by Leonora Carrington or Janet Frame’s An Angel at My Table. What they all have in common is a very unflattering perspective on daily life in a mental asylum, which is certainly present in this book too. However, all of the other books are written retrospectively, while Zero is written in first person, present tense, like a diary. It feels like speleology, like visiting the dark insides of someone’s ‘defective’ head. We witness each thought as it arises, often contradicting the previous sentence, all the jumps and starts and sudden turns. It can feel like trying to navigate a small boat in very rough seas and my advice would be to just give up navigation and allow yourself to be carried away by the monster waves.

The narrator is entirely self-absorbed. Like any child or adolescent she believes the world revolves around her. And she maintains this belief even as she grows up. Everyone else is described in relation to her. Alcohol, drugs, sex, friendships are consumed as casually as the cigarettes she half-smokes. Her self-hatred and doubt are so all-encompassing that they extend to anyone who loves her and believes in her. She pushes away her mother, her boyfriends, her girlfriend. How can they possibly love someone as screwed up and worthless as herself – that must make them either deceitful or worthless.

Her real problem is that she is so thin-skinned that she has no skin left at all, or as she puts it early on: ‘I absorb everything unfiltered’. At times you want to rush in and protect her, but then her self-destructive gene kicks in and you want to slap her and tell her to get a grip on herself.

I’m lucky to be alive, the doctors say

They’re idiots, every last one of them

They don’t realise that I’m actually very unlucky to be alive

There is no sugar-coating, no attempt at self-justification or excuses in this ‘punk rock’ saga. A doctor tells her that she has too much of the victim mentality, that she is feeling too sorry for herself and refusing to accept any responsibility. Part of the narrator understands and agrees with that, but then the rebellious voice starts shouting and she is unable to remonstrate with her.

Author photo, credit Pernille Marie Walwik.

You might ask yourself how much of this is autobiographical, since the narrator aspires to be an actor, and the author is best known for her acting role in a Norwegian TV series, but it doesn’t really matter. This is the rawest, most believable account of schizophrenia that I have ever come across (at least I assume it is schizophrenia, I’m not a trained doctor, but I’ve had a couple of friends with this affliction). The translation does an excellent job of capturing the fragmented, jolting nature of the work, the repetition, the almost incantatory poetry of it, the breathless present tense. I’m not surprised this won the Tarjei Vesaas First Book Award in 2013 – it is a remarkable and original piece of work.

 

Sarah Moss: Signs for Lost Children

Actually, I wanted to read the latest book by Sarah Moss The Tidal Zone, but my local library did not have it. Then I thought her non-fiction book about living in Iceland might be of interest, or her book about the clash between motherhood and an academic career Night Waking. But guess what? They didn’t have those either, so I picked up Signs for Lost Children instead, looked at the blurb and thought: pioneering women in medicine? Meiji Japan? hmmm, intriguing topics…

That’s what is so amazing about Sarah Moss: every single one of her books is very different and yet each one sounds fascinating in its own right. There are far too few writers nowadays who can surprise without disappointing you from book to book.

signsforlostchildrenSigns for Lost Children is a gendered history of discovery. Tom and Ally, the newly married couple at the start of the book, discover new worlds, both outside and within the relatively narrow confines of Victorian society. They also go on intense personal journeys, are forever changed and may not find their way back to one another. Just a few weeks after getting married, Tom sets off to a rapidly modernising Japan to build lighthouses, while Ally stays behind in Cornwall to work in a women’s asylum.

At first the scrupulously alternating chapters between his voice and her voice, Japan and England, felt somewhat belaboured, especially since there was a bit of time lag between them (the time it takes for a letter to travel between the two countries by ship, perhaps). Later on, I began to appreciate the parallel structure: it was like watching a tree grow into two separate trunks, yawning apart.

The chapters on Japan were, of course, a delight for anyone who has ever visited Japan, but had a lot to say about British Empire as well (or present-day expats in exotic locations). The observations about Western blindness to Japanese nuance and traditions are spot-on, and the firm insistence that the Japanese should adapt themselves to Western standards, for example, that their chefs should cook English meals (which they slaughter mercilessly) is very funny.

Mrs Senhouse apologises again for the dinner. It is so hard to explain to Japanese servants what is required.

Tom sets down his fork. The food indeed requires apology. ‘Perhaps a Japanese cook would be more competent in preparing Japanese food?’

She wrinkles her nose. ‘It is the slimy things one cannot abide. Rice, of course, and clear soup, but I cannot expect Mr Senhouse to do a day’s work on such pauper food.

He thinks of the jinrikisha men, and the men who carried stones up the rocks for the lighthouses, and the men on the mountain farms.

Senhouse is also giving up on what is probably tinned ham cooked in salty brown sauce with some inexplicably gluey vegetable admixture. ‘The Japanese constitution is a mystery.’

Tom himself starts out dreading the tea ceremony and ends up appreciating it, even bringing it back with him to England. Of course, this is Meiji Japan we are talking about, the period when Japan opened up to the rest of the world after several centuries of isolation. They caught up with Western technology remarkably quickly, to the point where they started producing fake traditional goods for the Western visitors to take home as souvenirs.

Meanwhile, Ally begins to suspect that the women who are locked up in the Truro asylum are driven mad by their family life, and find more respite in the hospital itself, despite the harsh conditions there and the unsympathetic nurses.

… if all the women in here who speak of indecent things, who recount endlessly obscene acts and unnatural couplings, are speaking from unhappy experience, then their madness may be perfectly reasonable. May be the inevitable response of a healthy mind to things that should not happen. And if that is the case, then the primary problem is not so much with the minds of some women as with the acts of some men. Older men, almost invariably. Men with power.

Ally herself is susceptible to the anxieties which haunt these women. Growing up with a kindly but absent father focused too much on his own artistic career, a mother who shows more concern and sympathy for the general ills of the world than her own daughter and a sister who committed suicide, she experienced her own nervous breakdown early on. Nevertheless, she pushed herself to find her way as a female doctor in a world which is not quite ready for them yet, where even the most kindly friends and relatives do not understand her need to be working with mad people.

Author photo from Granta Books website.
Author photo from Granta Books website.

But will Tom understand her when he returns from Japan? Long-distance relationships are never easy, but in that particular time and place it must have been harder still. The author steers clear of both the saccharine and the bitter in describing the reunion. Will they each, separately or jointly, find that ‘place of healing and hope for the future as well as a distaste for the past’, which Ally is trying to create for her ‘lunatic’ women? The proto-feminist storyline blends seamlessly with the cross-cultural dimension: ultimately, it’s all about keeping an open mind, being curious and forgiving about others.

An elegant novel, with understated prose which nevertheless burns lyrically intense at times. I will certainly be reading more of Sarah Moss … if ever I can find her. (And isn’t that a beautiful cover?)

 

Depression and Breakdown: in Fiction and in Life

yatesRichard Yates: Disturbing the Peace

This is the world of Mad Men: 1960s New York and advertising, men earning enough money to support their families whilst feeling strangely alienated from them, trying to find some deeper meaning and purpose, but not quite succeeding. Except, of course, Richard Yates was the original and the writers of Mad Men have been influenced by him. This is not as moving a book as Revolutionary Road, possibly because it only presents one man’s point of view, nor is it as subtle, but it’s nevertheless a masterly description of a disturbed psyche who refuses to help himself.

Yates is one of the best authors to scrape away the thin veneer of comfortable, civilised, well-adjusted lifestyles and expose the despair and sense of emptiness lying beneath. Our main protagonist John Wilder was not wildly successful at school and university, but has made a reasonable career for himself in selling advertising space. One night, on his way back home from a business trip to Chicago, he has a nervous breakdown and gets sent to Bellevue mental hospital for a few days, where he feels like the only sane person in a sea of madness.

Richard Yates, from babelio.com
Richard Yates, from babelio.com

This experience marks him profoundly, but it estranges him further from his wife Janice (who craves nothing more than normality) and his sulky pre-teen son. His psychotherapy sessions are a joke, he goes to AA meetings without any intention of giving up his drinking and he embarks on an affair with a young girl, Pamela, believing she will help him to reinvent himself and resurrect his childhood dream of becoming a film producer. Needless to say, everyhing he touches turns to rot. There is a lengthy impressionistic scene describing John’s descent into paranoia and violence which is chilling, but perhaps even more sinister is the final resignation and incarceration. (Hopefully that’s not a spoiler alert – you just know there’s not going to be a happy ending with a book by Yates.)

John is not the most sympathetic character; at times you may find it hard to even pity him. He is obnoxious, selfish, stubborn and self-pitying. Yet he is also riddled with doubt and lack of self-esteem. He is so obsessed, for instance, about being too short, that he sees even the big moments of American history entirely through his self-centred perspective. Here’s what he has to say about the assassination of JFK:

He felt sympathy for the assassin and he felt he understood the motives. Kennedy had been too young, too rich, too handsome and too lucky; he had embodied elegance and wit and finesse. His murderer had spoken for weakness, for neurasthenic darkness, for struggle without hope and for the self-defeating passions of ignorance, and John Wilder understood those forces all too well. He almost felt he’d pulled the trigger himself…

Many readers think this is one of the weakest of Yates’ novels: it is true that it feels rather disjointed and episodic. There are some great set pieces and memorable scenes, but jerky transitions. I found it can still be ‘enjoyed’ (if that’s the right word) on its own terms, and it’s this ‘anti-American dream’ stance which makes all of Richard Yates’ work so interesting.

reasonstostayYou can’t help feeling that if John Wilder had read Matt Haig: Reasons to Stay Alive he might have found a way of managing his life better. Haig’s book is a very personal description of his own experience with an apparently sudden attack of depression in his twenties and he is careful to explain that each person’s depression is different. Yet it also contains very wise statements about perceptions (and self-perceptions) of depression, brings in other people’s views on finding reasons to keep on going on, raises many important points for a serious debate about mental health.

Anyone who has experienced depression or known someone with depression will find this a very useful and at times quite uplifting book. It is not a self-help book, nor is it a systematic autobiography of the darkest hour and coming out of it. There is quiet humour, but none of the manic energy which spoiled Furiously Happy for me. There are some very well-written scenes that convey just how it feels to try and cope with panic attacks and overwhelming depressive pain.

From matthaig.com
From matthaig.com

What was most interesting to me was that the author was very sceptical (as I am) of medication and that he found alternative ways of dealing with his depression. I found his conversations between ‘then me’ and ‘now me’ very revealing, while his descriptions of being overly sensitive and anxious spoke to me directly. The only criticism I would have is that perhaps the structure is too loose, it tends to jump around between subjects. But what brilliant subjects can be found here: Things people say to depressives that they don’t say in other life-threatening situations; Things depression says to you; Boys don’t cry and many more, each worthy of a lengthy discussion in its own right.

I’ll close with a couple of quotes out of the many quotable passages in the book, one that links back so well to the Yates novel:

Life is hard. It may be beautiful and wonderful but it is also hard. The way people seem to cope is by not thinking about it too much. But some people are not going to be able to do that.

I’m not talking about all that What Doesn’t Kill You Makes You Stronger stuff. No. That’s simply not true. What doesn’t kill you very often makes you weaker. What doesn’t kill you can leave you limping for the rest of your days. What doesn’t kill you can make you scared to leave your house, or even your bedroom, and have you trembling, or mumbling incoherently, or leaning with your head on a window pane, wishing you could return to the time before the thing that didn’t kill you.

The Ballad of Night Anxious

Image from http://homepages.tcp.co.uk/~nicholson/alice.html

What does it matter where my body happens to be?  My mind goes on working all the same.

I’ve done it again. Unwitting, unwelcome,

I’ve woken up Knight Anxious,

all creeping worries and lingering thoughts,

all lists and fears, tapeworms,

my warts magnified fivefold by the conjured dangers of the night.

 

He heralds tumbling tonefalls, a rain-soaked day ahead.

Regardless of the weather, he never cooks the pudding,

yet proud of his invention, he harrumphs on horses high,

failure denigrated, unhinged from little pleasures,

unwashed with median joys.

 

He watches, waits, then pounces, always the live menace,

but always unexpected.

After all this time

I still can’t find the trigger

nor welcome him sagely

nor sluice him off like wet reproaches.

I hesitate just one second:

each time the haircracks multiply,

he seeps through, sucking

all air from the cave of my lungs:

infallible gravity.

 

We soldier on, we soldier on, mounted or on foot,

no end in sight, no redeeming dawn,

we balance, we teeter… and some of us fall.

Dandelions & Bad Hair Days – how mental health & motherhood woke up the writer in me

Dandelions & Bad Hair Days – how mental health & motherhood woke up the writer in me.

Looking forward to reading this book – the anxiety that dare not speak its name in the competition of upbeat self-deprecation of the school run!