Life writing and schizophrenia: encounters at the edge of meaning

Reading narratives from people with schizophrenia and their associated doctors or clinicians in the form of life writing is helpful to our appreciation of illness or the experience of hearing voices, but Wood is clear, in this book, that both kinds of account may be problematic. The patient might be an unreliable narrator due to the nature of the delusions they experience, but equally the doctor might be unreliable as the nature of the diagnostic exchange between patient and doctor might not be the neutral narrative that the doctor believes it to be. My interest in this book is as a lecturer in creative writing and as a former worker with survivors of sexual abuse, some of whom experienced understandable paranoia and a few of whom experienced hallucinations. I believe Life Writing and Schizophrenia might be useful to lecturers in a variety of disciplines.

Chapter Three might be most useful to those exploring the history of psychiatry and psychoanalysis. In 1911 Freud examined the published memoir of Daniel Paul Schreber (1902), a former judge. Schreber had heard the voice of God and believed he was being transformed into God’s female consort. Freud used this case to formulate a theory about homosexual repression and appears to see reading Schreber’s memoir as an equivalent methodology to the interview notes he undertook with private patients. Wood is good at pointing out the anomalous nature of such assumptions: how can the unmediated speech of a distressed person in a consulting room be the same as the reflections of a man who has drafted, and re-drafted, a work for publication? Gregory Bateson’s 1962 consideration of the eighteenth-century John Perceval’s madness memoir is also included in this chapter.

Chapter Two discusses first-person accounts of delusion and recovery in Schizophrenia Bulletin, a journal aimed at the medical profession. Woods suggests that the Bulletin desires stories that follow a trajectory of breakdown–hospitalisation–medication–recovery and utilise medical terminology, but not every contributor abides by this proscription and some even seem slightly subversive.

Chapter Five looks at diagnostic narratives in the Diagnostic and Statistical Manual of Mental Disorders fourth edition Casebook. These accounts differ from those of Chapter Two by being told in the third person. The Casebook writers have sometimes reduced patients’ life stories into digestible accounts that are worryingly ‘entertaining’. One such story is contained within a detective-fiction narrative frame, with its opening mystery and final denouement. A black man has adopted a FBI persona and is searching for his ‘other’ self, Harry. The detective-fiction framing glosses over this man’s reality for the sake of a literary punch-line. A further case study describes a man sedated in Guinea-Bissau after having attacked a policeman whilst naked. These actions appear ‘crazy’ until we discover that the man was seeking help from his religious leaders. He removed his clothes to swim across a bay and was apprehended by the policeman. His family wished to take him home to a local religious leader, but the powers within the city put him on a plane for hospital. Wood points out that the Diagnostic and Statistical Manual of Mental Disorders fourth edition Casebook fails to contextualise the religious movement mentioned. It was not a backward fringe group but a group that had emerged after violent colonial rule, and it expressed ‘many of the ideas of revolutionary philosophy – equal voices for women, participation of all people in decision-making, a valuing of rural peoples and their experience’ (243). Wood questions the latent racism in these accounts.

Chapters One and Four may be most useful to English, creative writing, or literary disability studies students. Chapter One examines four memoirs published between 1985 and 1998. The female writers had all been incarcerated in mental hospitals in North America. The writers are ‘looking back’ to an earlier time in their lives and I would have liked to know to which decades their hospital accounts referred. In particular, I wanted to know when Gilhooly was sectioned for displaying lesbian behaviour and when Scholinski was diagnosed with Gender Identity Disorder. In part the women are presented as social ‘rule-breakers’, but at times their other realities (and/or voices) go further. Here diagnoses are stories and can ‘be manipulated in order to gain control over treatment and negotiate the physical space in the best possible way’ (55). Asylum architecture is prominent in this chapter and patients are aware that speech has consequences. The diagnosis of schizophrenia invariably accords with the status of the ‘truly mad’ and will result in women being sent to the ‘worst wards’ (45). I was interested that Wood noticed that Kaysen’s memoir is poorly reflected in its film adaptation, Girl Interrupted.

Chapter Four considers the career of New Zealand author Janet Frame, who spent eight years in mental hospitals with a diagnosis of schizophrenia. Her published novels and memoirs explore institutional life and illness, but, when older, Frame distanced herself from the diagnosis and suggested that she had been seduced by the notion of the ‘mad’ poet presented by a former lecturer. Of course, if one writes from life and utilises similar content within novels, then one’s creative abilities might be disparaged by critics, as has been the case for female writers exploring the domestic. Therefore, Frame has an interest in revising her autobiography.

In the final chapter, Wood discusses her mother’s life story. Eunice’s ‘nonsensical’ comments on her first hospital admission appear less nonsensical considering her background. She had believed her parents to be the television stars Jack Benny and Mary Pickford. This sounds ‘crazy’ but Jack Benny was an ‘in the closet’ Jewish actor and Pickford a blonde white actor. It turns out that Eunice’s mother married her father believing him to be Russian, not Jewish; Eunice was subject to parental racism. We later see that Eunice fared better on medication, but we also see the side effects – her pacing, her inability to sit down and read. After many years of stability the theories of Laing are in the ascendancy, and local psychiatrists decided to take all schizophrenic patients off medication, suggesting full-time work and healthy lifestyles instead! Eunice was terrified. Finally, Eunice is allowed back on medication after another psychotic break and she then receives regular meetings with a psychiatrist for the rest of her life.

Many of the book’s concerns about race and gender recur. We are left with a model of schizophrenia that allows for brain chemistry to be moderated by drugs but also advocates a supportive environment where a patient is listened to for their version of events. Not all hallucinatory experience has a rationale behind it, but Life Writing and Schizophrenia suggests that professionals should be aware of how societal oppressions may flavour hallucinations that do occur – and that sometimes their content might be informative.

Cath Nichols
University of Leeds, UK
[email protected]
© 2014, Cath Nichols
http://dx.doi.org/10.1080/09687599.2013.888832