This book will change your mind about mental health, commented

In This book will change your mind about mental healthNathan Filer, a former mental health nurse with the UK’s National Health Service, explores the myths and misconceptions surrounding schizophrenia – a disease he writes affects around one in a hundred people worldwide – through the experiences personal details of four interview subjects, and their family members, in the UK and Ireland.

As someone whose own family has a long history of mental illness — including a cousin and aunt with schizophrenia — I was pleased to see that Filer chose his interview subjects carefully. There are stories of tragedy and triumph, and nuances in between.

Filer’s nuanced characters—ranging from a struggling mother of four to a successful freelance journalist—are of particular significance to the lay reader, given the overwhelmingly negative connotations associated with schizophrenia as a diagnosis.

When you say the word out loud – as Filer encourages us to do on page 5 – you experience vulnerability. You can’t help but look around, wondering if anyone heard you.

Because truth be told, despite all the anti-stigma campaigns and the extent to which Irish society has evolved to become more tolerant and inclusive, our notions of schizophrenia are still deeply influenced by the distortions and exaggerations of popular culture. – like the movie Flight over a cuckoo’s nest.

Filer, who now works as a mental health researcher in Bristol, is himself no stranger to using mental illness as a backdrop. His first book, The Shock of the Fall, was a critically acclaimed novel about a young man facing – and trying to overcome – a “strange and often misunderstood illness” which Filer does not name, but confirms in This book will change your mind about mental healthas being, essentially, schizophrenia.

But what exactly is schizophrenia?

Filer tells us that it is derived from the Greek words skhizein – which means “to divide” – and phrēn, which translates to “spirit”. Naturally, this can lead to the conclusion that a person diagnosed with schizophrenia has a split personality – at least one of which, one might assume, could potentially be unpredictable, even dangerous.

But that assumption, Filer points out, is wrong. He quotes Professor Elyn Saks, a mental health expert who was diagnosed with schizophrenia. His description is that of a “spirit [that] is not divided but broken”.

In purely medical terms, schizophrenia is characterized by a collection of symptoms – from thought disorders to delusions and hallucinations – which present themselves in different ways and at different levels of severity in each individual.

While some people with schizophrenia resort to violence, there are many others who wouldn’t dream of hurting another soul. Likewise, the severity of the disease – and the extent to which sufferers are able to resume normal functioning – depends on a host of factors that cannot be easily cataloged.

Indeed, as Filer goes on to explain, even the term “schizophrenia” has long been the subject of controversy, having emerged from an early 20th century debate between two German psychiatrists – one of whom considered it a physical illness, the other as psychological. Filer defines his own position by calling it “so-called schizophrenia” — not to dismiss it as illusory, but to “explore broader notions of health, suffering, and all the curious absurdity of being human.”

Luckily for the lay reader, this is about as academic as the book gets – and Filer soon moves on to exploring this hypothesis through the eyes of its four main characters.

First, we meet Molly.

Molly is the product of a prosperous middle-class family that suddenly implodes when her father has an affair and her mother starts drinking. Marked by what she calls The Clusterfuck, Molly begins performing at school. By the time she graduated, she gave up her goal of getting into a good college and started working as a housekeeper so she could buy nice dresses and go clubbing.

Molly eventually pulls herself together and continues her fashion studies. She moved to London and got a job as assistant fashion editor for a major newspaper. The Clusterfuck, it seems, is over.

Except that, thanks in part to her unresolved self-esteem issues, Molly has become what she calls “functional bulimia.”

In an effort to force herself to eat more, she begins to smoke cannabis – knowing it will give her the cravings in the early morning. The problem is that she quickly realizes that she is being watched. By his friends. By his family. And by MI5.

Filer goes on to describe Molly’s downward spiral – as well as her efforts to maintain gainful employment. Although she thinks she is ‘Britain’s most wanted criminal’, she holds positions as a journalist, medical receptionist and fashion speaker. She also continues with a second degree, in journalism, and manages to settle in New York.

“I find Molly’s ability to go through all of this, without anyone’s help, to be more than a little humbling,” Filer writes.

It’s an apt statement. While mental illness is often seen as a moral weakness or character flaw, the Molly we know is an intelligent, balanced person with extraordinary levels of resilience.

The same can also be said for the main Irish character in the book. Brigid, a former nurse, is the mother of four children whom she raises entirely alone. Brigid died aged 62, after many years of poor health, and her story is told in retrospect by her daughter, Kate, a Dubliner who works as a doctor.

Brigid’s mental illness first reveals itself in an obsession with a photograph of the Virgin Mary. One photograph quickly becomes many, and she is also suspicious of her husband, a fellow nurse. Eventually, she comes to believe that he is having an affair. The couple separates and the husband is never seen again.

Brigid, Filer writes, soon becomes an example of what is called the “drift hypothesis.” It is a phenomenon in which people who were previously healthy – and successful – gradually drift downward in terms of economic and social status once they are ill.

In Brigid’s case, she and her four children end up living in dank, shoddy social housing, without even enough money to turn on the heating in the winter. She is never properly diagnosed – or treated – and spends most of her time drawing maps and diagrams that she believes will solve world problems such as war and famine. Yet she somehow manages to care for her children – to feed and clothe them; and sell what little she has to pay for schoolbooks.

Several years later, while studying medicine at Trinity College, Kate flips through a textbook and recognizes her mother’s symptoms as schizophrenia. She contacts her family GP and her mother finally gets the treatment she needs.

But instead of feeling a sense of relief at finally finding out what happened, Kate feels an intense sense of guilt for having taken so long to put the pieces of the puzzle together.

It’s a common feeling – a feeling that affects many family members of people with mental illness. But, as Filer points out when he and Kate meet for coffee at a south Dublin cafe – with “lots of avocados on the menu” – Kate was a child when her mother first fell ill. There was no way she could have known the signs and symptoms of schizophrenia at that age.

Still, Kate remains tormented. And there is also another feeling. A lingering sense of social stigma as a result of her childhood experiences.

“Vulnerable people like us are always sympathized in the abstract – but not when they become real,” she says.

At the end of the book, Filer asks the reader again to say the word “schizophrenia” out loud. Is it different this time? he asks.

For me, it did. I stopped seeing schizophrenia as something scary and all-encompassing, and started seeing it as just another illness. One that affected its victims, but did not necessarily have to dominate or define entire identities.

Comments are closed.