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How to fictionalise mental health difficulties in a sensitive manner
How can writers capture the reality of mental disturbance without perpetuating negative stereotypes such as ‘the madwoman in the attic’ in Charlotte Brontë’s Jane Eyre? How do we avoid the other extreme of presenting serious disorder as just another ‘bad hair day’?
I don’t think you’ll find the answer by swotting up on diagnoses and unpronounceable drugs. It’s much more a matter of honing your existing skills of empathy for your characters, however flawed.
Psychologists perceive mental health difficulties as arising through an interaction between pre-existing psychological and/or biological vulnerabilities and stress. We’re less concerned with classifying symptoms than with identifying what’s happened to a person both recently and in the past. What kinds of vulnerabilities do they carry from childhood and what pressures are they facing in the present to push them over the edge?
This isn’t a million miles away from how writers view our characters. Pre-existing vulnerability equates to backstory; stress is like the inciting incident which pushes the character off their normal track.
Psychologists also search for meaning in what are commonly labelled psychiatric symptoms. We don’t dismiss these as bizarre, but as the best the person can do in their particular circumstances. The mental health problem might be protecting them from something that feels worse. But there might be a better way; the clinical psychologist’s job is to focus on the individual’s unique experience to help them find it.
Again there are parallels with writing fiction. Our characters begin with flaws, blind spots and behaviours that prevent them from getting what they want. We need to delve below the surface to ensure readers are convinced by the character’s strengths and weaknesses. We need to show that, when they change, that makes sense too.
I’ll address this in more detail in an online workshop I’m running with Nottingham Writers’ Studio later this month. I want to empower participants to write about mental health difficulties and emotional stress in a non-stigmatising way. It would be great if some of the Ranchers could join me. Click here for more information.
Meanwhile, if you would like to see how I address mental ill-health in my own fiction, my novella, Stolen Summers, about a young woman admitted to a psychiatric hospital after giving birth to an ‘illegitimate’ child, is available at only $.99 for a time-limited period. Go to books2read.com/StolenSummers
Do you explore mental health issues in your fiction writing? What have been your successes and challenges?
Anne Goodwin’s drive to understand what makes people tick led to a career in clinical psychology. That same curiosity now powers her fiction.
Anne writes about the darkness that haunts her and is wary of artificial light. She makes stuff up to tell the truth about adversity, creating characters to care about and stories to make you think. She explores identity, mental health and social justice with compassion, humour and hope.
An award-winning short-story writer, she has published three novels and a short story collection with small independent press, Inspired Quill. Her debut novel,Sugar and Snails, was shortlisted for the 2016 Polari First Book Prize.
Away from her desk, Anne guides book-loving walkers through the Derbyshire landscape that inspired Charlotte Brontë’s Jane Eyre.
Subscribers to her newsletter can download a free e-book of award-winning short stories. Website annegoodwin.weebly.com
Lockdown literature: humour and mental ill-health
My 99-word story for the recent flash fiction collection, a new way to office, is about as social worker’s unease about office humour. Was it derogatory? Disrespectful of the clients? Or was it an essential part of the professionals’ toolkit, a barricade against burnout for those dealing daily with distress?
I cheated when I turned in my story. I used a character and situation from my new novel, Matilda Windsor Is Coming Home. The topic drew me because, like my character, I’m currently preoccupied with the role of humour in the book itself.
Humour and delusion
Matilda Windsor Is Coming Home is about a brother and sister, separated for fifty years, and the ardent young social worker who seeks to reunite them. What has kept them apart for decades? Will they reconnect?
My novel is set in a long-stay psychiatric hospital and a seventy-year-old patient is the star. Matty perceives the world differently to those around her: Ghyllside is a country estate, the nurses are servants, her fellow patients are houseguests and the psychiatrists are journalists researching stories about a society heiress.
I didn’t intend to write a comical novel. In fact, I cringed when Matty turned out to be funny. Mental disturbance is no laughing matter. People given a psychiatric diagnosis are too often the butt of jokes. Yet I couldn’t find any other way around it if Iwanted Matty to be both good company and authentically mentally ill.
Humour and dementia
Until reminded in a recent interview (see above), I’d forgotten I had a model for Matty in Emma Healey’s beautiful debut, Elizabeth Is Missing. Eighty-one-year-old Maud is a decade older than Matty, and is diagnosed with dementia rather than schizophrenia, but both characters contain a similar blend of poignancy, humour and tragedy.
Dementia renders the ordinary unfamiliar. Names of people and everyday objects are forgotten; life becomes a mystery to be solved. This aspect of the condition is beautifully played out in the novel as Maud attempts to resolve the dual mysteries of the sudden absence of her good friend, Elizabeth, as well as the disappearance of her elder sister in her 1940s childhood. If you haven’t read Elizabeth Is Missing, I urge you to give it a try.
I’m reassured to imagine the ghost of Maud lodged within my laptop in the years I toiled on Matilda Windsor Is Coming Home. Of course, there were other influences, but none with the same kind of humour. But I’ve read a couple in the space between turning in my manuscript and publication. If you didn’t think mental ill-health could be both funny and serious, get hold of these and think again.
Humour and depression
As the world prepares to see out 2008 with a party, forty-year-old New York writer, Bunny, is clinically depressed. If she wasn’t, it would be a fine excuse to opt out of dinner with her husband and two other couples at a pretentious restaurant, followed by a party hosted by people she hates. But one of the paradoxes of depression is that those who are prone to it often aren’t very good at taking care of themselves, and they’re especially bad at taking care of themselves when they need it most. So despite her husband’s best efforts to dissuade her, despite not having had the energy to wash for a week, Bunny is determined to go. And where does that determination take her? Seeing in the New Year on a psychiatric ward.
It’s hard to write honestly about depression without sucking the reader into the mire; Rabbits for Food by Binnie Kirshenbaum must be the best fictional representation I’ve read.
Humour and hearing voices
Tom doesn’t expect life to be easy; it’s more important to follow true path. Single, jobless and reliant on benefits, he prioritises abstinence, spreading kindness, and devotion to his god. For twenty years he’s trod the tightrope between sanity and madness, with those who police the boundary as much a hindrance as a help. When the novel opens, Tom is under pressure from both his sister and his care coordinator to participate in a drug trial, for a substance initially developed to treat athlete’s foot. His psychiatrist refuses to prescribe the only medication Tom deems effective but, in the British mental health system, the patient’s assessment of his own well-being is often overruled.
Jasper Gibson was inspired to research and write The Octopus Man after the death of a family member who had a schizophrenia diagnosis. In my work as a clinical psychologist, I met many people like Tom. They also had a love-hate relationship with voices that would both protect and persecute. They felt a similar ambivalence about their dependence on a service system that defined their cherished beliefs as insane. They experienced the daily humiliation of underperforming, and being patronised by care staff who were younger, and/or less intelligent, than them.
But this is a novel, not a case study. It’s a beautifully written and absorbing story, narrated by an unusual character who is as lyrical communing with nature as he is conversing with his personal god. I strongly recommend it for its compassion and humour, and, most of all, and in every sense, for the voice.
Which – if any – of these novels takes your fancy? Can you recommend any that portray mental ill-health authentically and with humour?
Anne Goodwin is a clinical psychologist turned author who writes entertaining fiction about identity, mental health and social justice. She is the author of three novels and a short story collection with small independent press Inspired Quill. Anne posts about reading and writing on her blog Annecdotal.
Lockdown literature: Women in translation
Diversity is the hallmark of the Ranch, with an international group of writers bringing our unique perspectives to the weekly flash fiction prompt. But what about diversity in our reading?
There is some evidence that reading diverse benefits our brains, and, if language affects thought, there can’t be a better way of accessing a mindset different to one’s own than reading novels in translation. Unfortunately, far less fiction is translated into English than from English, with the former comprising under 3% of the translation market. Furthermore, only about a quarter of literature translated into English is written by women; thankfully August’s Women in Translation Month, can help us get our hands on those rare gems.
Following on from my guest post in April on facing, fleeing or forgetting the virus through fiction, and June’s post on sleep, pandemics, healthcare and political satire, may I offer you some recommendations of novels by female authors translated into English (and/or American)? As physical international travel remains difficult, it’s a great way of virtually visiting other countries. If any of these novels seem promising, clicking on the link will take you to a longer review on my blog.
Convenience Store Woman by Sayaka Murata
Keiko has worked in a convenience store since it opened, eighteen years before. That’s half her life. Considered odd since early childhood – although she perceives herself as logical and accommodating – she seems to have found her niche. The beep of the tills is soothing and the rigid phrases with which she’s been trained to greet the customers removes all the messy uncertainties from social interaction. The management injunction to maintain her mind and body in a fit state to do the job ensures that she eats properly and gets enough sleep. Unfortunately, Keiko is about to be pushed out of her comfort zone.
If you relish the zany, be sure to grab a copy of this novella about the pressures to conform to societal norms of female identity, translated from the Japanese by Ginny Tapley Takemori and published by Portobello Books.
Mirror, Shoulder, Signal by Dorthe Nors
Sonja is learning to drive, but her first teacher won’t allow her to change gear and her second covers her hand on the gear stick with his. Now in her 40s, Sonja moved from rural Jutland to Copenhagen as a student, but now feels lonely, unable to reconnect with her sister and nostalgic for the dramatic landscapes of her childhood. It’s perhaps no coincidence that she finds herself better at reversing than driving forward, but can she embrace the future without backtracking on life?
With a perfect balance of poignancy and humour this, in Misha Hoekstra’s translation from Danish, is another lovely story about navigating contemporary life as a single woman, published by Pushkin Press.
The Unit by Ninni Holnqvist
Dorrit isn’t needed. With no dependents, no long-term cohabiting relationships and a patchy employment record, she’s never been needed. Relishing the freedom to please herself and having ample thinking space for her writing, she was fine with that. Until her fiftieth birthday loomed. Not because she was afraid of ageing but because at that point she’d be decreed dispensable and obliged to relocate to a community of similarly economically worthless men and women …
This dystopian novel, translated from the Swedish by Marlaine Delargy and published by Oneworld Publications, explores whether lives can be sacrificed for the greater good.
Waking Lions by Ayelet Gundar-Goshen
Eitan Green, a promising neurosurgeon, has relocated with his wife and two young sons from Tel Aviv to the culturally and geologically dusty city of Beersheba. One night, after an exhausting shift at the hospital, he knocks someone down in the desert. Seeing that the man, a migrant from Eritrea, is beyond help, Eitan drives off. He is still battling his guilt when the victim’s widow knocks at his door. There’s a price for Sirkit’s silence, to be paid not in money, but in sleepless nights running a makeshift hospital for illegal immigrants, which will risk his health, his marriage, his official job and, eventually, his life.
This engaging novel about the lengths to which we go to evade our responsibilities towards our fellow human beings is translated from the Hebrew by Sondra Silverston and published by Pushkin Press.
Her Father’s Daughter by Marie Sizun
At four and a half, the child is blissfully content in the Paris apartment she shares with her mother. The war means little to her and, while her grandmother disapproves of her freedom, her mother always takes her side. The only cloud in her blue-sky world is the lie told by the two older women when they insisted she’d imagined the baby sister presented to her mother in a Normandy hospital. Now the war is coming to an end and the father she’s never met will be returning home. The child is unable to share her mother’s excitement. All too quickly, this stranger has taken over the apartment. His standards are exacting, his rage when they are not met terrifying.
This poignant story of lost innocence, and of the casual mistreatment of children, is translated from the French by Adriana Hunter and published by Peirene Press.
When the Doves Disappeared by Sofi Oksanen
Cousins Roland and Edgar have grown up together, although they’ve never seen eye to eye. But they find their paths crossing as they hide out in the forest of their native Estonia, on the run from the Red Army. When the Nazis drive out the Communists, Roland goes deeper into hiding, while Edgar reinvents himself with a new name, and a post in the new regime. Edgar’s wife Juudit finds the love that he has never been able to give her in the arms of Helmuth, an officer in the German army. Roland realises he can use her to help members of the resistance escape to safety …
Moving back and forth between the early 1940s and 1960s, this complex novel, translated from Finnish by Lola M Rogers and published by Atlantic Books, examines the near-impossibility of living a moral life under occupation by forces at both extremes of the political spectrum.
Hotel Silence by Auður Ava Ólafsdóttir
Lonely, and sick of life, forty-nine-year-old Jónas decides to end it all. Considering it far too messy to kill himself at home, he buys a one-way ticket to an erstwhile tourist destination, recently ravaged by civil war. But he can’t hold himself aloof from the horrors: a traumatised child; the assumption that everyone still alive has killed someone; rape as a tool of war. Then there are the opportunist entrepreneurs who perceive the chaos as potential profit, like the unpleasant man in the room a few doors down. Will Jónas rethink his decision?
Despite the painful topic, the tone is light: a quirky upbeat story of a handyman who takes his toolbox and thoughts of suicide to a troubled country, translated from the Icelandic by Brian FitzGibbon and published by Pushkin Press.
Dance by the Canal by Kerstin Hensel
Under a bridge in Leibniz, East Germany, alongside the canal that has been part of her life since childhood, Gabriela writes her autobiography on stolen scraps of paper in the pauses between her daily struggles to find warmth and food. The only child of a top vascular surgeon and a popular society hostess, Gabriela’s early years are characterised by loneliness, obsession and the confusing contradictions of the State. As the years go by, her story is defined by a series of disappearances, unexplained to her but likely to result from the individual’s unpopularity with the Communist regime, such that, in the end, she can’t be sure she hasn’t been disappeared herself.
Translated from German by Jen Calleja, and published by Peirene Press, this is another cheerful novella about a cheerless subject: a woman who identifies as a writer and poet whose homelessness challenges the Communist ideal.
The Faculty of Dreams by Sara Stridsberg
Raped by her father since the age of seven, and witnessing her mother’s chaotic dependence, it’s perhaps not surprising Valerie Solanas dreams of a world without men. Leaving home with the typewriter she got for her fifteenth birthday, she finds a soulmate in a male prostitute she befriends on a campsite, but only she has the wherewithal to get to college. Then it’s on to grad school to study psychology, which seems to consist of tinkering with the physiology of mice. It’s here, along with her lover, Cosmogirl, that the seeds of the SCUM Manifesto – a radical feminist thesis which is both satirical and deadly serious – are sown.
Translated from the Swedish by Deborah Bragan-Turner and published by Maclehose Press, this is a literary fantasy derived from the life and work of Valerie Solanas, radical feminist and would-be assassin of Andy Warhol.
The Blue Room by Hanne Ørstavik
Although now an adult, Johanne is still preparing for life to begin. Sharing a cramped Oslo apartment with her mother, she’s studying hard at the university, dreaming of, and saving for, her future as a clinical psychologist in an idyllic woodland setting. While the mother-daughter relationship is enmeshed, the pair spending their leisure time together, they have separate lives during the weekday 9-to-5. The mother also has a lover – albeit one who is unlikely to leave his wife and family – but the relationship sours when Johanne acquires a lover too.
Translated from the Norwegian by Deborah Dawkin and published by Peirene Press in 2014, this is a coming-of-age story about a young woman’s sexual awakening conflicting with her desire to please and protect her mother.
The Wind That Lays Waste by Selva Almada
It’s ten years since Reverend Pearson abandoned his wife and her suitcase by the side of the road, and he’s been travelling with his teenage daughter, Leni, across northern Argentina ever since. When their car breaks down miles out of town, he trusts that God, through the mechanic, Gringo Brauer, will put it right. While he waits, he tries a spot of evangelising with the mechanic’s assistant, Tapioca. At sixteen, the boy is the same age as Leni, and also without a mother, having been left at the isolated garage half his lifetime ago. Brauer has treated him well enough, although, given he could already read and write, saw no need to send him to school, or church.
Translated from the Spanish by Chris Andrews and published by Charco Press, this is about the unexpected intimacy forced upon four lonely people – two motherless teenagers, an evangelical preacher and a cynical mechanic – when a car breaks down in the pause before a storm in rural Argentina.
Nothing but Dust by Sandrine Collette
Life’s hard for sheep and cattle farmers on the bleak Patagonian steppe, but it’s rendered yet harsher for four boys brought up on a ruined estancia without love. Especially for Rafael, born after their father’s departure, and relentlessly bullied by his big brothers from almost the moment he emerged from the womb. Raised on thrashings herself, the mother turns a blind eye to the child’s maltreatment and pins the blame on him when he staggers home, dirty, scratched and bruised. When the mother gambles one of the boys in a poker game, it seems that things can’t get any worse. But it could be that leaving the homestead is exactly what he needs. Although it might be too sentimental to expect an altogether happy ending, this is nevertheless an uplifting story of endurance and survival against the odds.
Translated from the French by Alison Anderson this is a startlingly honest account of the harshness of life on the Patagonian steppe and the impact of a mother’s inability to love on herself and her sons.
Sorry I’ve got a bit carried away here! So many great books! And all of them read before August 2019. If you’d like to know about the women in translation I’ve been reading since then (18 novels at the time of writing), come and visit my blog towards the end of next month.
I hope you’ve found something here to whet your appetite and do use the comments to add recommendations of your own. If you want advice on finding a novel on a particular theme or in a specific location, just ask. If I can’t help you, someone else probably can.
In my next slot at the Ranch:
September 22: Fictional therapists (because I reckon half the world will be having therapy and the other half delivering it after this)
This post comes from Rough Writer Anne Goodwin
ANNE GOODWIN
Anne Goodwin posts about reading and writing on her blog Annecdotal, with around ten novel reviews a month. A former clinical psychologist, she’s also the author of two novels and a short story collection with small independent press Inspired Quill. Her second novel, about a man who keeps a woman locked up down in a cellar is another potential lockdown read.
Subscribe to Anne’s newsletter for a free e-book of prize-winning short stories.
Website: annegoodwin.weebly.com
Twitter @Annecdotist.
Lockdown literature: sleep, pandemics, healthcare and political satire
As lockdown loosens, yet with many social activities still out of bounds, are you running out of things to read? Following on from my guest post in April on facing, fleeing or forgetting the virus through fiction, I have a few more recommendations for you. The topical themes I’ve chosen this time are sleep, pandemics, healthcare and political satire. If any of these novels seem promising, clicking on the link will take you to a longer review on my blog.
Disturbed sleep
If anxiety wakes us in the wee small hours, is that a good time to read about fictional insomnia and sleep disturbance? If you’re tempted, you might consider these:
Jonathan Coe’s comic novel The House of Sleep is set in a clinic and research centre for sleep disorders that was previously a student hall of residence. Although it relies on a number of coincidences to reunite the characters from the past – including Sarah who suffers from narcolepsy and Terry Hill has insomnia – it’s a cracking read.
In another supposedly funny novel – although I found Ottessa Moshfegh’s My Year of Rest and Relaxation desperately sad – an alienated young woman thinks that she can – and actually does – solve most of her problems through spending a year in a drug-induced stupor.
Caring for babies and young children is a common cause of sleeplessness that can leave parents, especially mothers, slightly unbalanced for years. In Kyra Wilder’s debut novel Little Bandaged Days the reader follows a young mother’s unravelling through a gradual process of sleeplessness, isolation and a determination to keep up appearances learnt at her mother’s knee. Besides being beautifully written, it’s a powerful argument for scepticism about an exhausted person’s gritted-teethed “I’m fine!”
A quick mention for two novels that aren’t about sleep but contain the word in the title: In the City of Love’s Sleep by Lavinia Greenlaw is described by the publishers as “a contemporary fable about what it means to fall in love in middle age”; Sleeping on Jupiter by Anuradha Roy is about the violence behind the beauty and apparent serenity of India.
Novels featuring pandemics
In my previous post on lockdown literature, the section on novels about confinement and pandemics received a general thumbs down. So why give it space again? Because, back then, I had no idea how it might feel to read about a fictional pandemic when you’re in the middle of a real one, and now I do. My verdict? If you’re feeling fairly safe – anxious, perhaps, fed up but not panicking – and the book’s well-written, you don’t need to look away.
The Strange Adventures of H by Sarah Burton is a fun story about morality with echoes of our current pandemic and of the theatricals of its 17th-century setting. Reading this, I was impressed how quickly the authorities were able to contain an outbreak of plague in London, albeit by the Draconian practice of boarding up infected homes. I was also impressed by the author’s ability to anticipate the emotional atmosphere that must have felt strange at the time of writing but is so familiar now.
Set three centuries later, The Dark Circle by Linda Grant is about nineteen-year-old twins whose lives are interrupted when they are diagnosed with tuberculosis and banished from the East End of London to an isolated sanatorium in Kent. Will the somewhat snobbish community accept the lower-class arrivals foisted on them by the burgeoning NHS? Will the twins lose their vitality to the passivity of the patient role?
Healthcare
Hopefully we won’t need to be hospitalised with covid19 and, if we are, we’re unlikely to be in a fit state to read. These novels might make us especially grateful not to need to confront the limitations of our healthcare systems directly and help channel our campaigns for more investment.
I haven’t reviewed Lionel Shriver’s novel, So Much for That, but its dissection of the injustice of the US healthcare system through the experiences of two families has stayed fresh in my mind since I read it ten years ago. Maybe one to save for when this is over, or read now to hone your arguments with potential Trump supporters before the November vote.
In planning this piece in my head, I recalled The Tidal Zone by Sarah Moss as a more reassuring read. But this story of family life disrupted when a fifteen-year-old collapses at school and suffers a cardiac arrest, is full of anger about public services in 21st-century Britain. Despite, or because of, the heavy subject matter, it’s also very funny, with beautiful writing and engaging descriptions.
If you fancy a laugh-out-loud novel about mental health, you can’t go wrong with Binnie Kirshenbaum’s Rabbits for Food. Although I wasn’t so taken with the second-half set on a New York psychiatric ward, the first half nails the experience of depression with mordant wit.
Political satire
Watching as our leaders congratulate themselves on mismanaging the crisis, with UK clown Boris Johnson appearing almost statesmanlike when set against President Trump, do we laugh or do we cry? Perhaps the most helpful thing I’ve done is to shout about my favourite read so far this year. Cleverly plotted, beautifully written (unless you object to a second-person narrative) and unashamedly political, Enter the Aardvark by Jessica Anthony is a trenchantly honest yet uplifting tale of populist politics, closet (literally in one case) homosexuality and wearing the skins of your enemy to get what you need.
I hope you’ve found something here to whet your appetite and do use the comments to add recommendations of your own. If you want advice on finding a novel on a particular theme or in a specific location, just ask. If I can’t help you, someone else probably can.
I have two more slots at the Ranch this year and plan to venture out of lockdown with posts as follows:
July 28: Reading Women in Translation (because, even if we can’t travel physically, we can connect with other cultures through a book)
September 22: Fictional therapists (because I reckon half the world will be having therapy and the other half delivering it after this)
But I’m open to suggestions, so let me know if you have other ideas.
This post comes from Rough Writer Anne Goodwin
ANNE GOODWIN
Anne Goodwin posts about reading and writing on her blog Annecdotal, with around ten novel reviews a month. A former clinical psychologist, she’s also the author of two novels and a short story collection with small independent press Inspired Quill. Her second novel, about a man who keeps a woman locked up down in a cellar is another potential lockdown read.
Subscribe to Anne’s newsletter for a free e-book of prize-winning short stories.
Website: annegoodwin.weebly.com
Twitter @Annecdotist.