Contemporary Novels and Autobiographies about Psychiatric Illness

The dark recesses of the mind have long been fertile subject matter for creative people. For every light, fun, upbeat song, book or painting about life and love, there is a blacker one exploring the psyche when it is not so happy and bright. From Kafka and Dostoyevsky through Camus, Hesse, Grass, Follet to more contemporary writers like Easton Ellis, stories about the disturbed, paranoid, neurotic and psychotic have provided screeds of fascinating insights into the minds and treatment of those with psychiatric problems. And art history would be woefully dull without the phenomenal and original art produced by the disturbed psyches of Dali, Van Gogh, Schiele, Rothko, and scores of others.

Often, a haunting facet is the continuum between ‘normal’ and ‘abnormal’, ‘sane’ and ‘insane’. Many a pimply, mournful adolescent has identified with the loners and outsiders depicted in literature. Often, normality seems so trite and conventional, shallow and meaningless. And besides, who can judge sanity in a world that is often so insane and beyond logic itself? The French Foreign Legion used to sanction the murder of Algerians who absconded from the army – quis custodiet ipsos custodies?

Contemporary literature is teeming with atmospheric books about psychiatry. Here are a few I’ve enjoyed over the past couple of years.

Sebastian Barry‘s Overall Costa 2008 Award winning, Costa Best Novel 2008 winning and Booker 2008 shortlisted The Secret Scripture is written in the form of logs kept by its two main protagonists, Roseanne McNulty, a frail old lady of around 100 years who has been in mental asylums for most of her adult life, and William Grene, Roseanne’s psychiatrist, who is approaching retirement. The setting is a small town called Roscommon near Sligo in Ireland.

Roseanne is writing her history – as she remembers it – because she knows her life is nearing an end. William Grene is keeping a diary because his private life has imploded with the disintegration of his relationship with his wife Bet. He also has the task of assessing the patients of Roscommon mental hospital to see which can be released into the community when the hospital is pulled down and rebuilt at another site with far fewer beds. Because of this, he needs to ascertain the reasons for each patient’s admission – whether they are truly ‘insane’ and in need of continual care in an institution, or whether they are potentially able to be re-integrated back into the community.

Thus starts a curious friendship between the two, based more on empathy than on communication. Roseanne keeps her written account of her life secret by hiding it under the floorboards and only allows Dr Grene to coax tiny fragments of her past from her. For his part, William Grene is content to not traumatize Roseanne with intrusive questioning, but the mystery of her past starts to haunt him.

The interspersing of Roseanne’s and William Grene’s written accounts draws the reader slowly into both their lives. Roseanne’s sections are written in a more archaic tone than Dr Grene’s because of her age, and the prose in her testimony is almost poetic at times, dreamy and nostalgic. In its tragedy and wistful, fragile flashes of beauty, it is reminiscent of John Banville’s prose in The Sea. Roseanne’s writing reveals not only her own difficult life but also much of the social and political history of Ireland from the 1920s on. As with Maggie O’Farrell’s The Vanishing Act of Esme Lennox, the reader reels from the revelation of the ease with which women could and were locked up in asylums. The grim realization of how much life has changed for women is also never far away.

My only gripe with this book is a tiny one about the fact that authors do so much research into so many aspects of their work but almost always neglect the area of accuracy of medical facts. There are many references to Dr Grene having been a ‘penniless student studying psychiatry at a hospital in England’ or of him having been ‘a few months out of college’ before his arrival at Roscommon. The fact is, you don’t go to ‘college’ to study psychiatry, you go to medical school where you study some psychiatry with all the other specialties like medicine and surgery and paediatrics, and after that, you’re out of college for good and if you want to specialize in psychiatry you do so by working your way up the career ladder in hospitals while swotting at home for professional exams. I gave Barry the benefit of the doubt on this, assuming Grene was just a few months out of medical school before moving to Roscommon, but it transpires he was in his mid thirties when he arrived in Roscommon, which would mean an extraordinarily long spell at medical school. Plus there’s a reference to him being inspired to ‘read psychiatry at Durham’ – well, there was certainly no medical school at Durham in 1983 so there can’t have been one in the ’60s when Grene would have been a student.
Elsewhere there is reference to the fact that Grene’s ‘degree wasn’t exactly glittering’ which is another inaccuracy – medical degrees are either pass or fail, they’re not graded (first, two-one, etc) like other degrees. Finally, there’s a nonsensical comment from Greene about a character with throat cancer being ‘old enough for such a cancer to move very slowly’, as if age of onset had any consistent relationship with aggression of a malignancy (which depends on spread of cancer at diagnosis, number of lymph nodes affected, metastatic involvement of other organs, cell type, site, etc.)

The only other mild criticisms is that the twist at the end is so unlikely as to almost be implausible, but it’s testimony to Barry’s writing that instead of flinging the book across the room as I’m wont to do with other unfeasibly neat, glib endings, I read it instead with a lump in my throat.

So, pedantic nit-picking aside, this is a gorgeously written book, almost brittle and translucent in the delicacy of some of its prose. The misery of existence in Ireland in the early to mid twentieth century means that it is not an easy or uplifting book, but it is beautifully atmospheric. ****0

Patrick McGrath‘s 2008 thriller Trauma, which was shortlisted for The Costa, revisits a theme that has long fascinated him, psychiatry.

McGrath’s fascination with mental illness stems partly from the fact that when he was growing up, his father was Medical Superintendent at Broadmoor psychiatric hospital in London. His fiction, dark and brooding, haunted with unmentionable secrets, forbidden desires and repressed memories, teams with the mentally unstable, from the disturbed Spider in 1990 and Dr Haggard in ’93, through Peter Cleave, the psychiatrist in Asylum in ’96 and the disturbed father of Martha Peake in 2000, to the frighteningly volatile unreliable narrator of Port Mungo in 2004.

The third novella in his trilogy Ghost Town, in 2005, featured a psychiatrist who showed signs of being as unstable as her patients. The pattern continues with Trauma, which centres around Charlie Weir, a New York psychiatrist approaching forty.

Charlie is haunted by demons. There are the memories of his mother, who he spent his childhood protecting, but who always unfathomably favored Charlie’s older brother, Walt, who seemed indifferent to her suffering. There’s Charlie’s estranged father Fred, who deserted his family when Charlie was eight. There’s Charlie’s ex wife Agnes who Charlie pushed away seven years before after a catastrophe for which Charlie and Agnes both blamed him. And there’s the glowering relationship Charlie has with Walt – the brothers goad and resent each other, but keep circling each other like prowling beasts about to attack.

Into this maelstrom comes the fragile and disturbed beauty Nora, with whom Charlie starts a relationship. But his personal life becomes entangled with his work when he finds that Nora’s problems are deeper than he insitially believed.

McGrath spins a gripping, compelling story that enmeshes the reader inexorably. His prose is punchy and potent and often devastating in its understated power, as in this sentence on Charlie’s mother :

‘If she was typing then she wasn’t crying, although later she was able to do both at once.’

Or this one on his ex-wife Agnes:

‘Could I read her like I used to? But no, a new layer of emotion had silted and hardened upon what once had been a virgin bed of trust.’

There are sections of stunning, acute perception, where McGrath perfectly nails experiences most people have had but never articulated, such as this account of the exhausting, restless and broken sleep that haunts the disturbed and anxious:

‘I slept in my mother’s bed that night and was badly disturbed. I grappled through the hours of darkness with intensely frustrating problems of logic, or so it felt, but had a waking memory only of repetitive circular movements of the mind that allowed no resolution or escape, like being trapped inside the mechanism of a clock. Of the specific content of these dreams I had no recall, but I woke in a state of dread.’

And McGrath’s insight into psychiatry and the reasons doctors become psychiatrists is chillingly astute, as evidenced by this aside of Charlie’s:

‘It is the mothers who propel most of us into psychiatry, usually because we have failed them.’

The only slight let-down in this wonderfully compelling, dark thriller was the way in which the novel ended fairly suddenly, with a few loose ends left dangling. Not only are questions left unanswered – why was Nora so disturbed? Why didn’t Fred shed some light on his ex-wife’s psyche, either at the end of the novel or during the previous 40 years? Why did Charlie’s mother behave as she did? – but those answers that are provided seem inadequate: the reason for a recurring nightmare Charlie has is given, but the rationale for that event is never explored. The ending thus seems rushed and unfinished.

But then, clean, tidy endings to a McGrath novel would lessen the dark, bitter thrill, the lingering taste left haunting the palate. ****0

As mentioned above, the third story in Patrick McGrath‘s 2005 trilogy Ghost Town is also centred around a psychiatrist. The trilogy consists of three novellas all set in New York, with characters of each sometimes inhabiting almost identical areas of Manhattan. Chronologically, though, they move in sequence. All three are involved to some extent or other with violence and its devastating aftereffects.

The third story is set in the aftermath of the terrorist attacks on the twin towers. It involves an unreliable narrator, a trick McGrath pulled off with chilling aplomb in Port Mungo. A psychiatrist tries to help a confused and damaged man cast off his ghosts and forge healthy relationships. Or does she? Whose interest is the psychiatrist serving, and what are her motives?

It makes up the last in a stunning trio of tales which gives a hint of the wealth of human emotion and destruction that has taken place in one of the world’s most famous cities. ****0

Sebastian Faulks’s epic novel from 2005, Human Traces, spans more than 600 pages in the hardback edition. Its scope is vast, and its ambition – to recap the advances and recreate the excitement of psychiatric innovations in the late 19th and early 20th Centuries, all within the boundaries of a credible work of fiction – is enormous. Yet Faulks pulls this monumental task off with astonishing skill, creating a novel that both informs and fascinates.

The story starts in 1876 in Breton, France, where an inquisitive 16 year-old, Jacques Rebiere, dissects small animals clandestinely in his bedroom, away from the prying eyes and disapproval of his strict father and disinterested stepmother. Jacques comes from a dysfunctional family – his mother died shortly after his birth, and his older brother Olivier is a schizophrenic – a condition which at that time was steeped in mistrust and fear.

Across the sea in England, Thomas Midwinter is also 16 that year. He comes from a very different family environment. His parents love him, he has a doting older sister Sonia, and his days are spent in boyish japes and reading his beloved Shakespeare.

The story follows the path of these two individuals and their families as both boys study medicine, develop an interest in the then fledgling specialty psychiatry, meet, and make plans to work together. As they follow their chosen careers, the reader is given an insight into the appalling conditions in most psychiatric hospitals in the 19th Century. Decent, altruistic, kind doctors existed but ignorance and suspicion meant that efforts to treat the insane with humanity were still in their infancy.

Faulks has obviously carried out a huge amount of research into the history of psychiatry and neurology for this amazingly accomplished novel. Theories of the experts and luminaries of the day – Charcot, Babinski, Tourette, Janet, Freud – are outlined in way that rarely seems forced. It is a very difficult task to drop these theories into a work of fiction without seeming to push unnatural sounding speeches into the fictional characters’ mouths, but Faulks manages this with aplomb: apart from a couple of lectures given by the characters – which are both highly plausible as lectures recapping current knowledge – the rest of the work is explained in natural-sounding dialogue between Thomas, Jacques, their wives and their colleagues.

But there is much more to this novel than the history of diseases of the mind. Thomas is fascinated by the work of Charles Darwin, and the gradual acceptance by intelligent people of natural selection is shown elegantly, together with some of the evidence Darwin cited. In addition, Faulks uses his knowledge of the first world war – seen so poignantly in his earlier work Birdsong – to paint a vivid and disturbing picture of political events and to bring the life of one of the characters to painful life.

The prose is as muscular and elegant as one would expect from Faulks. Characters are for the main part beautifully rich and complex, although a slight excess of minor characters may have contributed to Sonia, Jacques’ wife, and Kitty, Thomas’s wife, being somewhat interchangeable as loyal, intelligent, articulate women.

There are only a couple of areas with which I have quibbles. Having discussed the evidence for evolution so carefully and shown the mistrust with which a theory proposing the absence of a divine creator was initially received, I found it a shame that in two parts, Faulks falls back on inexplicable ‘supernatural’ phenomena. One is when Jacques visits a medium – although he later says he believed her to be a charlatan, the picture Faulks presents of the scene at the medium’s house is disappointingly full of seemingly psychic phenomena. If this happened in any other novel, the reader could simply note the US sceptic Randi, whose offer to pay a million dollars to anyone displaying unequivocal and repeatable evidence of psychic gifts remains an unclaimed prize – testimony to the rational sceptic’s view of the world. But for Faulks to include this scene when he has spent 600 pages building up the case for science as opposed to the spiritual world is jarringly annoying, it negates much of the work he has done in elevating the world of evidence-based science. The other scene which disappointed for the same reason was one in which Sonia calmly sees a ghost – again, a ridiculous proposition and almost like a cowardly sop to those offended by the overtly scientific basis of the book until that point.

One other minor point – Thomas is said from the start to hear a benign voice in his head as a child and young man. This later comes in handy to back up his own theory of the evolution of the brain, one that has, in real life, been suggested by some individuals in the past. To a doctor who has an interest in psychiatry, the hearing of ‘benign’ voices by non schizophrenic individuals sounds highly implausible, and giving the rational Thomas this bizarre and inexplicable quirk only so that he can back up a little known and dubious view of the evolution of the brain seems a mistake.

Still, the overriding feel of the book is of a fascinating and compelling novel casting a searchlight into the darkest recesses of the human mind and asking some of the most profound questions about man’s existence and consciousness. ****0

Engleby, Sebastian Faulks‘s seventh novel, is less a book about psychiatry than one narrated by a man with obvious personality problems. The fact that the reader is kept guessing throughout as to the degree of disturbance in Engleby’s mind makes it a compelling, potent novel showing Faulks at his powerful best.

The story is narrated by Mike Engleby, an oddball character who has always felt an outsider. Engleby is difficult to warm to – just as one starts to feel sympathy for his loner status, he spits some vituperative comment about others, is callously cruel – the bullied turned bully – or indulges in conscience-free thievery.

Engleby’s loner mental status may be exacerbated by the drugs he casually crams, but it is obvious that he has always been an outsider. One early memory has him curiously viewing his younger sister playing with her friends; interaction is something at which he is neither naturally good nor shows any interest.

The novel starts with Engleby a student at an esteemed English university (Cambridge), which he coyly avoids naming. He talks the reader through his present circumstances and then skims through his past, which is at times so traumatic as to be almost physically painful. Yet Engleby is matter-of-fact about the horrific bullying he endured at school. Moreover he takes no moral stance on abuse – as soon as he is senior enough, he turns abuser himself, sadistically picking a younger boy who seems to glow with contentment and popularity. It is a chilling example of an emotionally deprived individual savagely resenting other people’s happiness.
A major incident mentioned on the back blurb clouds Engleby’s time at university, but he goes on to life in the outside world until the past comes back to haunt him.

Faulks writes with a taut, precise style that is completely mesmerizing. It also ideally conveys Engleby’s emotionally stunted, matter-of-fact narration – there are no flowery descriptions or inconsequential social tangents to distract from the powerful meat of the story.

Faulks skillfully weaves in all the delicious contradictions of a classic unreliable narrator – Engleby’s own point of view of events lacks all insight, even when faced directly with the real perception others have of him. There is a throwaway line that captures this beautifully where Engleby states that Jennifer, the object of his obsession, leaves a cafe with her boyfriend and forgets to say bye to Engleby:

‘She was so absorbed by what Robin was saying that she forgot to say goodbye to…me…’

This is despite him having already read Jennifer’s own view, clearly stated in her diary, which is that she manages to escape without attracting Engleby’s attention.

Many other such instances of failure of perception litter the pages like shudder-inducing gems – the fact that Jennifer invites someone else to a party while Engleby is standing next to her and fails to mention the party to him, the cringeable way in which Engleby invites himself to her lectures and tells people that she is a good friend, and so on.

Faulks carries the unreliable narrator aspect off so well that the reader is aware early on that Engleby is narcissistic and lacks insight into his own effect on others. Engleby’s inability to perceive the truth continues to cause shivers down the reader’s spine, whether it involves him musing on the near certainty of obtaining a First, his warped appraisal of his effect on others or his totally unnecessary dishonesty.

Yet, unlike some books with unreliable narrators, Faulks doesn’t cop out of responsibility for his character. The reader is treated to a full discussion of Engelby’s traits and characteristics at the end; there is no avoidance of explanation or analysis, no vague label of ‘mad’, which would fail to explain Engleby’s clarity and ability to function in the real world.

This is a potent, absorbing novel, and shows Sebastian Faulks at the peak of his considerable talents. Wonderful. *****

The Vanishing Act of Esme Lennox by Maggie O’Farrell is a haunting and harrowing indictment of the treatment of unconventional women in the past. O’Farrell’s deceptively simple style is perfect for narrating a shocking story like this which needs no stylistic embellishment. The way in which unruly young women were incarcerated for life in the past is potently brought to life by O’Farrell’s use of the present tense and her way of conjuring up family life, which effortlessly transport the reader to the past. There are many themes covered subtly here as well as the horrific one of forced institutionalization and the cruelty that went on in psychiatric hospitals. The close bonds between siblings which can switch in an eye blink to jealousy, the existence of favouritism in families, the stultifying conventionalism of the past, horror, shame and secrecy . It made me shudder and engrossed me totally. O’Farrell writes in a haunting, lilting style, bringing to life colours, textures and smells as well as emotions and events. Reading her is a very rich sensory experience despite the ostensible simplicity of her style. It’s as if you’re immersed in the places, times and people she’s describing, seeing everything first hand. An excellent book. ****0

James Lasdun‘s debut novel in 2002, The Horned Man, followed several successful collections of poems and short stories, one of the latter being adapted by Bertolucci for the cinema. The Horned Man attracted good reviews but it wasn’t until Lasdun’s Booker listed follow up Seven Lies that he became well known in literary circles.

The Horned Man is easily as compelling and brilliant as Seven Lies. It opens with echos of the stark, persecutory shock of Kafka’s The Trial – the reader learns immediately that something is amiss. Laurence Miller, an English expatriate in New York, teaches Gender Studies at a college near Manhattan. He is separated from his wife Carol and desperately wants her back. He sits on the Sexual Harrassment Committee of the college at which he teaches, and this involves pointing the finger at a fellow English expatriate teacher, Bruno Jackson, who has been having an affair with a student.

But things are not right in Miller’s world. He has the distinct impression that someone else is using his office. He finds out that the previous occupant met an undesirable fate. Furthermore, an erratic, irascible Bulgarian professor left in heated circumstances. Miller’s gnawing desire to discover why the Bulgarian seems to have a grudge against him leads to a maze of dead ends and disparate clues, and his growing paranoia seems justified in the acts of violence that are perpetrated around him, incriminating him in the shadowy world of his pursuers.

Lasdun writes with a taut, finely honed discipline that combines flashes of poetic resonance with a plot that is compelling and hypnotic. As we learn snippets about Miller’s life – his head-splitting migraines, latent since childhood but reappearing with a vengeance in this time of stress; the circumstances leading up to his wife’s departure – our picture of Miller shifts and changes, slabs of jigsaw illuminating the image in unexpected ways. More mysteries leap up – why is Elaine Jordan, the lawyer at work, under the impression that she and Miller have a secret tryst? Who wrote to her impersonating Miller to give her this idea? Why does Miller respond the way he does? All these new twists and turns add to the intrigue, and Lasdun’s wonderful prose keeps the reader engrossed. He has a talent not only for mesmerizing story telling, but also an acute eye for humour – Miller’s encounter with his upstairs neighbour is wickedly, blackly hilarious, as are details of Jordan stealing into his office and trying to create there an intoxicating mist reminiscent of herself. Miller lands himself in bizarre positions which the reader can understand, having followed his thought processes and motivations, but which lead to a delicious thrill of anticipation since their appearance to other characters would appear so inexplicably weird if discovered. As Basil Fawlty and numerous Boyd heros have shown, the neurotic and their foibles are so endearing and entertaining when set in the yawning normality of the real world.
And towards the end, revelations light up the whole mystery, and the strangeness and ugliness of the situation become apparent.

This is a great book. My only whisper of a reservation is for pedantic reasons. (Spoiler alert – stop reading here if you haven’t read the book yet.) Lasdun’s intention at the end is that the reader finds out that Miller is not as he seems. The queasy knowledge is planted that Miller himself – and not the temperamental Bulgarian – is responsible for the crimes around him: violence towards his ex-wife in a club, the presumed murder of a woman in Central Park and even of Elaine Jordan, the impersonation of Jordan’s brother in a phone call to the college, possibly even her rape before her murder. This chilling realization is powerful but the pedant in me cries that it’s impossible psychologically speaking for a psychopath to have amnesia for his acts of violence. Certainly amnesia is possible after a trauma, most commonly a head injury, but not repeated amnesia interspersed with lucidity. The only other plausible explanation is that Miller writes the story at the end and is lying in an attempt to prove his innocence – which makes him a frightening, plotting, icily cold-hearted psychopath capable of plotting his actions – an insightful psychopath. This is the explanation I chose, because the one of a man who is prone to fits of psychotic violence for which he then loses all memory is unfeasible in psychiatric terms – psychotics would believe their violence was justified (due to paranoia about persecution for example), but would not forget about the acts.
So, a stunning debut. Not to be missed. *****

The last novel to get a mention here tonight is Poppy Shakespeare by Clare Allan. Shortlisted for the Orange Prize a few years ago, this novel takes a terrifying, wry and witty look at the current state of mental health care. Related in the semi-literate vernacular of N, one of the patients on the Dorothy ish day ward of the Abaddon mental hospital, it follows events when a new patient, Poppy Shakespeare, is admitted as a new day patient. Poppy insists she has not got any mental health problems, but this is nothing new in psychiatry – denial and lack of insight are well recognized traits in psychiatric patients. But it soon becomes apparent that Poppy really shouldn’t be there – and N embarks on a long course of action to help her get free. Thus a Catch 22-type chain of events is set in motion – Poppy can only prove she is not mentally ill by pretending to be mentally ill. Meanwhile, the system drags her to rock bottom and she develops – you’ve guessed it – symptoms of psychiatric illness.

Clare Allan has a sharp and perceptive insight into what goes on in psychiatric hospitals, and when related deadpan, it does sound risible. Yes, patients do sit about chain-smoking all day, yes, in an under-resourced and over-burdened system, interaction with nurses and doctors really can be as rare as Allan conveys, yes, some older anti-psychotics drugs really do induce vile side effects that reduce patients to twitching zombies, and so lack of compliance and abuse of drug regimes is common. And Allan captures spot-on the paradoxes and sheer idiocies of a political system that puts targets before patients and sells off health care to the highest bidder. Although events and constructions are clearly fictional, they are not that far-fetched – a Mad Tzar, after all, is only one step away from our current plethora of Drug and other touchy-feely but ultimately useless Tzars . Or from the ‘hello nurses’ instituted by the last Tory government: a nurse who would beam ‘hello’ at all patients presenting to A&E to ensure the checklist point ‘seen by a dotor or nurse within half an hour’ could be checked off – even though the patients would then have to wait many hours to see anyone interested in hearing about their problem. Meanwhile discharging patients before they are ready in order to save resources – something that crops up in this novel – is a well-established necessity in our cash-strapped NHS. Although the days of chaining up people with psychiatric problems are long gone, psychiatric care is far from the soothing and therapeutic panacea it should be. The only thing that bugged me was the fact that a central tenet of the plot was false: Poppy needs to prove herself sane to be released but in order to do so, she needs legal help which she can only finance if she’s not sane due to ‘mad money’, which presumably is incapacity benefit. This is clumsy and contrived as the story depends on this fact, but it assumes that unemployed people without incapacity aren’t entitled to any benefits or to legal aid. The whole plot would collapse without this false piece of fantasy propping everything else up.

Nevertheless, the novel is full of dry humour and shockingly astute observations, and Allan’s debut is a good read. My initial slight enniu at a text written entirely in slang dialect (a trick that has become commonplace since its devastatingly effective first few uses by the likes of Irvine Welsh and James Kelman) soon evaporated and I enjoyed this smart novel. ***00

Finally, a non fiction work to end. Sathnam Sanghera’s autobiography If You Don’t Know Me By Now was shortlisted for the Costa 2008 Biography/Autobiography award. It is a warm, affectionate and hilarious account of his search in his late twenties and thirties for the history of his family. It was only at this late stage of his life that he found out that both his father and his oldest sister both suffer from schizophrenia, and he only came to this knowledge because of his growing discomfort with the double life he was having to lead, working as a trendy journalist in London, where he dated white women but pretending to his Punjabi parents in Wolverhampton that he was a good Sikh boy willing to contemplate an arranged marriage when the time was right.

Sanghera’s account manages to be both tender and loving and also dryly witty. He is self deprecating about himself to a degree that means every page has its laugh-out loud moments. Here’s an example:

‘At school, the swottiness I’d long displayed also intensified…my relentless sucking up meant that over four years, I was made milk monitor, litter monitor, stock room monitor – a prized job for it meant being let off hymn practice – and tuck shop monitor.’

He is also obviously hugely fond of his family in a way that makes even the harrowing parts of the novel a joy to read. His lightness of touch means that none of the book ever feels mundane, even when dealing with family events that would otherwise mean little to other people. And his journey from being a layman who knew nothing about schizophrenia to coming to terms with its meaning, symptoms, treatment ,prognosis and implications, is refreshingly honest. He owns up to being ignorant about mental illness before his research and is even honest about the feeling of shock he initially felt when waiting in a psychiatric outpatient waiting room, when the patients around him seemed alien and weird rather than fellow humans with histories and personalities. This book is a must not only for anyone who wants to know more about this devastating illness, but for anyone who enjoys humorous, well written memoirs. *****