How to write controversially about what gets called ‘mental illness’ (or The Madwoman in My Attic)



On the way home at twilight today I approached my flat from a different direction. Instead of turning into my street and making a beeline for my address, I stepped through a gap in the fence adjoining the park on one side of the block, followed a circuitous route obscured by other buildings, slipped through the entrance, tiptoed upstairs, and eased my key into the lock like a hand into a glove. What’s more, since inching the door shut I’ve crept around barefoot, opening or closing the fridge and cupboards with infinite care, setting down or moving pots and mugs and spoons with heightened awareness. And all because I don’t want my upstairs neighbour to know I’ve come home. She suffers from random episodes that attract or even demand attention. Which is why I’m performing an experiment: Is she still mentally ill when no-one is watching or listening?

So far tonight I’ve done nothing that she’d be likely to hear. And she’s been uncharacteristically quiet. I know she’s awake only because she flushed her toilet. Yet I can’t keep on suppressing all noise. Very soon, I’m going to need to pee. It didn’t take much to muffle the sound of my kitchen tap running, but I don’t intend to pee onto a sponge.

Why am I so fixated on my neighbour’s behaviour? What sort of antics could inspire such dread? As a writer, I find that peace and quiet aid my concentration; they let me hear the voices in my head. Sometimes it’s my narrator’s voice (not the same as mine); sometimes it’s dialogue. A voice might be remembered or I might think I’ve invented it. The thing is, too much external noise overwhelms it. Right now, I can hear myself think despite the radio blasting across the street; a voice in a foreign language is actually less distracting. Not that the volume isn’t a problem; simply, it’s free of unsettling meaning. Not so, the content of my neighbour’s monologues.

By now you may be wondering whose bats in the belfry are causing more trouble. (Though my neighbour’s just flushed her toilet for the third time in under an hour, she hasn’t once slammed the bathroom door like she usually does.) Which reminds me, it’s time I made an un-PC admission: I don’t subscribe to our society’s belief in ‘mental’ illness, the notion that disordered thinking exists independent of emotions. In fact, an example of disordered thinking is surely the ‘us and them’ mentality, the idea that they are crazy and we are sane – an idea I’ve resisted for months now despite the otherness of said neighbour. By day or night, though alone at all times, she rants and bellows obscene invective. Each bout might last 10 minutes or 10 hours. Sometimes I can distinguish lines (e.g. ‘You’re a fucking liar!’) and sometimes her diatribe becomes unintelligible as she stomps through her flat banging doors and objects and turning taps on and off. Months of exposure to her unpredictable hissy fits, which seem to arise whenever she’s reminded of my partner’s and my existence, have taxed my reserves of tolerance for others with anger management problems. While she’s free to sleep or watch TV all day, and mixes booze with her meds (if she’s taking them), my neighbour, however antisocial, isn’t that much crazier than most.

The psychosis described in my novel Hum doesn’t look or sound anything like this. For instance, my protagonist manages to stay outside the mental health system. Despite having lost her way in the dangerous wasteland of victimhood, she escapes the gravitational pull of those who might keep her in it.

The idea of psychosis as an initiatory soul path, which, if followed, might lead to shocking yet liberating and healing self-knowledge, went out of fashion along with the radical psychiatrist RD Laing. A UK author who writes with rare insight on madness, Jenny Diski, explored RD Laing’s philosophy in her novel Then Again (1990), but that – like much of her other, brilliant fiction – has gone out of print. In our social climate of escalating anxiety and depression, the medical model of madness is deemed politically correct. In fact, that evocative word, madness, is no longer quite PC – a word so richly layered with implication because it predates not just the rise of psychiatry but the onset of the Cartesian body–mind (and body–soul) split. Note the context of ‘madness’ in this quote from an old King James Bible, below (Eccl. 9:3):

‘This is an evil among all things that are done under the fun, that there is one event unto all: yea, alfo the heart of the fons of men is full of evil, and madnefs is in their heart while they live, and after that they go to the dead.’

Madness located in the heart? Ha! We know better now. Consider the following from a fact sheet found in a GP’s waiting room, ‘Schizophrenia THE BRAIN DISEASE THAT AFFECTS YOUNG PEOPLE’:

‘Schizophrenia is caused by changes to both the anatomical structure and the operating functions of the brain. / How these brain changes come about is still unknown. However, it appears that genetic (inherited) factors play an important role in defining individual risk.’ [Italics mine]

Symptoms listed on the same page include ‘unusual behaviour’. I once met a teenage schizophrenic, the child of someone I knew. Sure, the teen behaved oddly (obsessive-compulsive shaving of the whole body), but the parent had once fasted for 108 days straight (let’s not even begin to get into their occult logic). ‘Unusual behaviour’ may or may not be passed on genetically (and is, of course, relative) – but it seems fair to say that this parent demonstrated it.

My novel’s protagonist (who feels invisible) slips through the social safety net and survives her initiation despite (or because of) not fitting in. Through a process of trial and error – thrashed out in the crack between mainstream and countercultures – she slowly develops internal boundaries. Yet Hum doesn’t chart a path that most mental health professionals would advise. For one thing, they’d be out of a job if forgoing treatment were generally viable.

It’s easy to treat, say, genital herpes without having contracted it personally (regardless of how a patient got it, the cause and proof are biological). But whether or not a healer has fully experienced their own grief may affect how they treat a patient who’s bereaved. Will they write a prescription, or calmly offer tissues and listen? The medical model of mental illness means that the healer, in most cases, can’t know how the sufferer feels, and such distance can only increase the stigma. Why does this model dominate contemporary Western society? Akin to the rift between astronomy and astrology, its body–mind split continues to bode ill for most earth-dwelling life forms, while caged souls like my neighbour’s suffer the fate of the canary in the mine.

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