mental illness
Hay Book Festival
I’m like a pig in muck this week!! Hay Book Festival is online again. Wahey! They’ve already reached upwards of 2 million people, and I feel privileged to be one of those visiting and enjoying such thought-provoking and stimulating events. I’m immensely grateful to the team that ensures it happens. They’ve had more than their fair share of technical glitches unfortunately, but I think we’re all acclimatising to those kinds of issues in this era of Zoom. Puts our own mishaps into perspective.
In this first week, I’ve already listened to vaccine hesitancy, the effects of the pandemic, motherhood, grief, the first human cyborg (who has MND), deafness, adoption, racial discrimination … I won’t bore you with a rundown on them all, but three really stood out as exceptionally memorable for me. (Please excuse the quality of the photo – screenshot during the performances, so no time for finesse!)
The title, Life and Death with Covid, sums up one brilliant session. Dr Rachel Clarke, Palliative Care Specialist/author, who’s always good value, was in the chair and sensitively and confidently steered the conversation between herself, the legendary author/poet/presenter Michael Rosen, and a specialist in critical care and anaesthetics/author, Dr Jim Down.
The two doctors spoke eloquently about the impact of the pandemic on staff, and the imperative and willingness to care – really care – for all their patients, be they serial killers or prime ministers, to the end of their lives. Their selfless dedication shone through. Michael Rosen spoke from the Covid patient’s angle. He survived 48 days in intensive care and 3 months in hospital, and compared the attention he was given to the love that drives a father to sit all night beside the bed of his sleeping son. The NHS, in his judgement, is the most ‘caring collective cooperative thing’ he could ever imagine – polar opposite of the Holocaust that killed so many of his relations. One of the most engrossing literary events ever. I simply HAD to buy all three books: Many Different Kinds of Love (Rosen), Breathtaking (Clarke), Life Support (Down). Reviews will doubtless follow on this blog! They arrived lovingly encased in red tissue paper too!
I’ve heard Ruby Wax and Alastair Campbell on the topic of their depression before – both appeared again this year with new books to talk about, but new to me was travel writer and teacher of creative writing, Horatio Clare, talking about his mental health experience.
In Heavy Light: A journey through madness, mania and healing, he has eloquently captured the reality of being sectioned/detained when he developed bipolar disorder, an action he believes saved him. And he really underlined the importance of listening to the patient and tailoring care to individual need. What an articulate and sympathetic speaker. I was riveted.
Then there was Rev Richard Coles speaking to psychotherapist Julia Samuel (the ‘Queen of Grief’ as Richard described her). He spoke eloquently of the devastation, and the powerful emotions of anger, guilt, emptiness, he has experienced following the death of his beloved husband David, who was an alcoholic as well as fellow priest. No empty platitudes or trite sayings or pious hopes from him! And what sensitivity he must bring to bereaved parishioners. Julia Samuel concluded with poignant accuracy that, though he is still grieving acutely, he is taking David with him into a planned future of ministering to prisoners where the effects of addiction are seen as their harshest. A wonderfully honest and moving conversation, laced with humour, about a subject that needs more openness and candour. I’ve heard Coles speaking before; here I think he was at his best.
To be continued …
Hold your Breath
Having written a thriller myself, I’m always now intrigued by their structure and component parts. One attribute is a capacity to make you suspend your breathing, just willing the protagonist to escape whatever horror lies in store. So Hold your Breath seems such an appropriate title for a book in this genre.
This one is by Barnaby Walter who dives into the disturbing world of mental illness – a world where things spin out of control, and people are scarily unpredictable. One key ‘character’ in this tale is the setting: a spooky forest, backdrop to shady night-time happenings.
Dark elements of child neglect and exorcism and witchcraft and disordered minds pile on the shivers. With the main action removed from the safety and scrutiny of suburban civilisation, events feel even more sinister, and the truth more elusive.
We know from early on that something dreadful happens, but so much is unknown and unknowable or half-understood because it’s synthesised through the young impressionable mind of the protagonist, Kitty Carlson. Adults are concealing the truth from her; she herself witnesses incomprehensible behaviours; we cannot be sure where fantasy ends and grown-up reality begins. As her mother’s mental health regresses we feel the approach of something dreadful, we hold our breath, fearful as to what form it will take.
Kitty is only 10 when the tragedy happens, but she’s already traumatised beyond her years. She knows that her family has secrets; they’ve always been different. It’s why her father took them to live in the woods during the half term holiday. It’s why unmentionable things are done in the haunted rental house, and why she’s sent to wander alone amongst the trees when the Catholic Father arrives.
As a young child she just buries her experiences.
She knows …
that her mother ‘gets upset’ and ‘makes scenes’, that her paintings have become disturbing, that she says and does violent things, that she needs to be handled with care, that she needs psychiatric help.
She knows …
that her father has become more like a dictatorial school teacher than a loving parent, that he is liable to ‘flamin’ rages’, that he is involved with another woman.
She knows …
that she herself is mesmerised by small living creatures, that she resents having her innocent enquiries deflected, that she has learned early on to be self-sufficient, that she is a loner.
It’s only when she grows up that she starts to ask the most difficult questions, and delve into painful memories. The past has been buried for a reason. Eventually she’s driven to write a book, crafting something definite, something physical, out of her dreams, her nightmares, her memories. ‘It was probably the fusion of catharsis and hate that did it. Working through my issues by putting them onto the page, only to shoot them through with a strong dose of anger and resentment.’ She has a story crying out to be told.
Although Kitty insists it’s fictional, there’s enough fact in it to identify people, places and events, and the book triggers powerful reactions. Her father and his new wife are incensed by the revelations. Her stepmother takes actions that have massive consequences. And 33 years after the tragedy, Kitty is summonsed to Newcastle to a police station. She is under caution, not yet arrest. But what she has to say could change all that.
Walter captures the perspective of a young girl sufficiently authentically for me to be taken in. I believed her account of what happened … the narrative that found expression in Kitty’s book. Writing it was ‘an act of self-therapy’; it blows demons right out into open view. Kitty herself knows she couldn’t cope with the attention a true-to-life memoir would attract, but nor can she relinquish her personal take on events and injustices. As a young girl she attributed human emotions to spiders and beetles; her mind has been altered by the things she’s seen in her childhood, by the emotions she’s suppressed. Small wonder that her own behaviours and reactions fall outside the box of normality.
The ending is rather too neat for my personal taste, but I was relieved that Kitty survived the re-living of her past. I cared about the child turned woman, and that’s another key element in the success of this book.
Festival time
So far we’ve had a humorous take on Shakespeare (a World War II version of the classic play, All’s Well that Ends Well); an intriguing and delightful performance around the Tudor queens (by an American troupe!); a clever skit where Sherlock Holmes and his associate Watson, vie with each other to solve a crime in which Holmes himself is the supposed killer; an exploration of the issues of entrapment and abuse through a dark re-imagining of the infamous Grimm’s fairytale Rapunzel. Our teenage granddaughters, with their own cascades of beautiful hair, proving themselves observant, insightful critics and excellent company. Still to come: a wartime tear-jerker, a drama (paying homage to CS Lewis) exploring life and death decisions, a contemporary musical storytelling about the life of John the apostle viewed from his prison, a costumed Austentatious, and an adaptation of Pilgrim’s Progress. Good times.
But for me personally the highlight of my week was a special session at the Book Festival under the banner: Staying Well, which incidentally also explored the concept of entrapment. Male suicide has increased significantly over the last twenty years and statistics for self harm in the UK are the highest in Europe. My current novel revolves around mental health issues, so this one: Stepping Away from the Edge, was a definite must.
Two of the three speakers have themselves suffered from severe depression. Debi Gliori is a writer-illustrator of children’s books and she has created a wonderful collection of pictures which portray how she feels while depressed – feelings which can’t be captured in words, she says. Her talk was illustrated with these magical drawings. Author Matt Haig has captured the horrors of severe mental illness in words. His book, Reasons to Stay Alive, is receiving widespread acclaim. In the Garden Theatre Tent, he also relied on words and his own palpable emotion to speak about his suicidal experiences. The third speaker was psychologist Rory O’Connor who heads a team at Glasgow University specialising in suicide, and his talk gave the stark statistics and facts and latest thinking about both self harm and suicide.
It was fantastic to see the importance given to mental illness at this international book event – an excellent line-up of speakers from both sides of the couch; an extra long slot (90 minutes instead of the usual 60); a large audience listening sympathetically and contributing sensitively; a team of specialists available afterwards in the Imagination Lab for anyone with specific issues or questions (a steady stream of people headed in that direction in spite of the late hour).
As I stood admiring the magnificence of Edinburgh at night I couldn’t help but be glad that it was this city that had been the setting for another step towards equality between physical and mental illness.
Tragic deaths
It’s hard for healthy busy contented people to understand the mind of a youngster who will go to any lengths to be extremely thin; almost impossible to comprehend the anguish of their parents, powerless to halt the deadly progress. But that’s what I’ve been trying to do for my latest novel, so perhaps it’s not surprising that news of youngsters who die as a result of this craving hits me foursquare.
Serious eating disorders have a profound and devastating effect on both patient and family, and it’s well known that the death rate among young people with anorexia is frighteningly high. So exploitation of such vulnerable people seems particularly heinous.
This week saw the inquest into the death of 21-year-old Eloise Parry who, after years of bulimia, sent away for diet pills online to hasten the slimming process by speeding up her metabolism. They contained an industrial chemical, DNP (dinitrophenol) a dangerous toxic substance which is commonly used in explosives and dyes and pesticides. Online marketing describes it innocuously as ‘fat-burning’; experts agree it is not fit for human consumption.
So what persuades an intelligent person to acquire this unlicensed ‘medication’ in the first place, and what drives them to even exceed the recommended dose? Real desperation, distorted thinking, and perhaps too a level of naivety about the dangers of unlicensed drugs acquired online from companies with no scruples as to legality, purity, cleanliness or even authenticity.
Things certainly went catastrophically wrong for Eloise when she took 4 pills at 4am in the morning of April 12, (2 represents a fatal dose) and a further 4 when she woke up later that same morning. Shortly afterwards she drove herself to hospital, aware that she was in big trouble. She even sent a text message to one of her college lecturers at 11.31 saying she was afraid she was going to die, apologising for her stupidity. Her prediction sadly came true at 3.25 that same afternoon. Eloise is the sixth Briton to die in this horrible way – the body’s metabolism speeds up so violently that they burn up inside; nothing can be done to reverse it. What an appalling tragedy.
Eloise’s mother has appealed to others not to buy anything containing DNP. The coroner says he will write to the Government to recommend such products are not accessible. The Department of Health put out an urgent warning to the public. Interpol has issued a global warning. And yet there is clear evidence that some companies are still fraudulently importing this deadly substance under various guises heedless of the consequences.
Bad enough when the mental state of the young person drives them to starve themselves slowly. To have their susceptibility and fragility exploited so shamelessly is nothing short of evil.
Motherhood lost and found

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How did you feel, I wonder, when you heard this past week about the bodies of 800 children in a septic tank in Western Ireland, stumbled upon by a group of teenagers in 1995 and now suspected to be the tip of a much larger iceberg? The site was formerly that of a home for unwed mothers between 1925 and 1961; decades during which illegitimacy carried a serious stigma, abortion was illegal, and infant mortality rates were high.
I’m old enough to distinctly remember the effects of backstreet abortions: the terrible sepsis, the mutilation, the deaths of young women, abandoned babies … I was a practising midwife in Scotland in the 1960s and worked in areas of multiple deprivation as well as a large specialist hospital, so I saw these things firsthand. Even after the Abortion law came into effect here in 1967, Irish girls had no such provision, so they came across the sea secretly for a way out of their dilemma.
This latest news story of the 800 bodies brought back long-buried memories and emotions for me; it was a harsh era riddled with double standards and hypocrisy. But it also reminded me of a book I’ve read much more recently: A Small Part of Me.
The author is Nöelle Harrison who’s spent the last two decades living and working in Ireland, where part of this story is set. Briefly, the novel tells of a family hedged about by these same harsh realities and customs, at once offering protection and driving them apart. Christina’s mother, Greta, left home without warning when her daughter was just six years old. Her mother’s best friend, Angeline, took over the maternal role and eventually became her stepmother. Now in her early thirties, Christina has reached a crisis in her own marriage, and she goes on the run with her younger son, Cian, to find her lost mother and offer her forgiveness.
Her journey takes her to the west coast of Canada where she meets Luke, a native Canadian with his own sorry tale of family breakdown and guilt. They are instantly attracted to each other, and he helps Christina find the place where her mother now lives, although sadly they arrive one day too late. Angelina follows Christina and Cian from Ireland to Canada, and she reveals a very different story from the one Christina has believed all her life. (I’m deliberately omitting colourful detail so as not to spoil the story if you plan to read it.)
It’s not the easiest of reads. It flips about between both the main characters’ points of view and in time, and until I got to know the characters, I confess I found it a trifle confusing. Not surprisingly: both Greta and Christina have mental health issues; both apparently failed as mothers; both ‘lost’ their children; both had troubled childhoods. However Harrison subtly captures the constraints and customs and mores of an earlier time, the prejudice, the naivety, the punitive laws and judgements, which had a very powerful effect on women there – the same ‘decency rules’ which underpin the real life story of that macabre graveyard which is now the subject of a police investigation.

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I, for one, would not want to go back to those dark days when life was cheap and appearances were everything … although, it could be argued that today’s permissive attitude to abortion itself cheapens life. What do you think?
Art and mental illness
Friday evening and here I am in the transformed square of the beautiful old Medical School where I so often patrolled in days of yore. I’m here to watch The Fantasist by Theatre Témoin. I met the producer, director and principal actor at the symposium on Thursday – another young company who combine art and storytelling around themes questioning contemporary social issues; other artists beating a similar drum to my own. So I simply had to fit this one in. And they very generously gave me a complimentary ticket. What an honour.
Theatre Témoin brought this production to the Fringe last year to excellent reviews, so it’s saying something that they’re back again this year with the same show. Playing to full houses again too. As with Killing Roger, The Fantasist includes puppetry to excellent effect. (It’s been a revelation to me understanding the special role puppets can play in these dramas, and a pleasure to see them employed with such skill.)
I’m on the front row so don’t miss a thing. The basic story? Louise has bipolar disorder. We first meet her tossing and turning in bed, unable to sleep. Her mental anguish is captured by inanimate objects doing crazy things and, though many in the audience reacted with laughter, the build up of atmosphere touched a more raw nerve for me. It’s scary entering the world of the mentally ill, and I’ve long been aware of the fine dividing line between sanity and insanity. I’ve hovered perilously close myself at times!
For Louise, the boundaries between the real and the fanciful grow increasingly blurred, and she becomes entangled in a relationship with a seductive stranger who opens up a world of exhilaration and magic to her. When he’s around she feels alive and ‘good‘. But to the onlooker, the destructive elements of her fantasies are all too evident.
Throughout, the metaphor of speed is used most effectively. The changing rhythm of the thrumming heartbeat. The calm slow empathy of the community psychiatric nurse, Josie, (‘my jovial jailkeeper‘) is a perfect foil to Louise’s manic behaviour and speech. Julia Yevnine – who plays Louise – is herself French and her ability to gabble deliriously in both languages is impressive: a furious game of ping-pong played on an express train. When depression strikes, the pain is palpable, Louise is immobile; Josie, and Louise’s friend, Sophie, speed up.
The endless seesawing of moods, the exhausting demands, the threat to relationships, the constant dread of falling into a dark chasm, the stranglehold the illness exerts, all are captured most effectively. At once mesmerising and impressive. And authentic, because Julia is utterly convincing – helped perhaps by her own firsthand experience of the illness (her mother has it).
I have several friends who have bipolar disorder, and I know the devastation it can wreak on families, so I’m delighted to see this illness portrayed so sympathetically, and to know from review comments that audiences are moved by the messages. This is exactly what we need.