June ‘book to look forward to’: The Heartland: Finding and Losing Schizophrenia’. Nathan Filer. (Faber) Kindle edition £7.19

The brief description added on the Literary Review Calendar of ‘books to look forward to’ for June 2019 said:
‘The former mental health nurse’s non-fiction follow up to his Costa book of the year-winning novel’.

Back in the early 1980’s, living in a shared house a group of us young lefty student ‘radicals’ (we thought we were, but as it turns out, we were just young) debated ‘the troubles’ as we called the situation between Britain and Ireland back then.  Some of us referred to terrorists and some freedom fighters – the debate about where each of these sat of course depended on one’s perspective.  Being earnest young things we decided to become properly informed so we wrote to each of the political parties on each side of the divide to ask for manifestoes and leaflets etc.  We had a right old laugh at how many of the envelopes that subsequently arrived had been “damaged in the post” and appeared to have been opened but I don’t think any of us could truly imagine they had been.  One day I was on the phone to a friend. It was a proper old phone, fixed to a place by a flex with a handset that tied to the phone itself by way of a curly cord.  We were having a natter about nothing very much but it was a terrible line.  Suddenly I heard the conversation I had just been having played back to me!  The call – I – was being recorded. I shouted to another housemate to come and listen and then the phone cut off, line dead.  I am not sure who was doing the recording but a house full of women must have been quite tedious to listen to.  It was the first time I experienced paranoia and was glad two other people heard the whole thing.

(image Regos-Kornyei via Upsplash)

Whoever would have imagined MI5 had recorded little old me? People might have thought I was insane for saying so.

Fast forward more than ten years. I was working in a secure mental health facility.  A patient told me that ‘star signs’ were accurate descriptions of different personalities because they were cultural descriptions of people from 12 different planets of the solar system.  An ‘Aries’ was a descendant from one planet and ‘Cancerians’ were from a completely different planet.  He was a Piscean and he desperately wanted his family to come and rescue him from Earth and take him home.  The patient had been diagnosed with schizophrenia and was said to be delusional.  Strangely he was the second person in less than a year to put forward the view that ‘star sign’ personality traits in humans were a cultural legacy of being from 12 different planets of the solar system. The person I first heard espouse this theory was the chief copywriter, editor and company director of a successful advertising and marketing company. 

I was reminded of each of these (true) stories when reading Filer’s remarkable book.

The heartland of the book’s title refers to schizophrenia – the ‘heartland’ of psychiatry.

Filer artfully draws upon compelling stories which encourage the reader to have empathy and understanding to and with those experiencing mental distress. He forces the reader to consider labels, descriptions and diagnoses – how they are arrived at and who they serve (rarely the patient it would seem). The language of mental illness and treatment is that of control and uniformity and it would be hard to disagree that for the most part, conceptually mental illness is problematic and does not serve those experiencing distress well.

That schizophrenia and indeed psychiatry are problematic and that the people who are most badly affected by the problematic nature of each are the patients labelled is not a new idea but this book certainly adds much to the discussion.

Filer uses clever language techniques (‘so-called’ schizophrenia) to cause the reader to really think about the label and how it is used. The reader can only reflect on the impact of mental ill health on those who experience it and ‘the rest of us’ – whoever that is. Filer talks about the problems in service provision and treatment strategies without coming down either way on simple for/against arguments which means the reader must engage with the text and consider – what do I think? It is a well-written book – lyrical and flowing and with a friendly conversational style. It is a thought-provoking book and one I would recommend to most people but especially anyone going into helping professions (especially doctors). I was pleased to read stories showing patients as humans with varying ideas and understandings of the world and how it is (also showing patients with insight) because usually, we hear of ‘the mad’. This is a great book.

Apparently, according to Niler, social media is replacing religion as the source of paranoid delusions. It would appear that some people think social media is manipulating us, using and gathering data on us. As if…