Nathan Filer: How novels can help us understand mental health

Costa award winning novelist Nathan Filer on his life as a mental health nurse, the location of illness and the power of fiction.

Which is the better way to understand mental illness: a medical textbook, or a novel? Is there any reason to bother raking through three hundred pages of prose, when irregular human behaviour can be reduced to a simple clinical term, such as “bipolar”, or “autism”, or “schizophrenia”?

Nathan Filer thought long and hard about whether to include any of these words in his debut book, The Shock of the Fall, which won the Costa First Novel Award on 6 January. It tells the story of Matthew Holmes, a headstrong, quick-witted teenager haunted by the death of his brother on a family holiday when he was nine years old.

“I don’t diagnose him with schizophrenia, in that I never have a character in a position of authority say he’s got it,” Filer told me shortly after the prize announcement, “but then, he does end up on a community treatment order being given a depot injection against his will, so I guess it’s pretty strongly implied.”

In many ways Filer, a registered mental health nurse who worked for four years on a 19-bed open acute ward for people with a range of mental illnesses, is writing against the trend. The American essayist Marco Roth has charted the rise of the “neuronovel”, in which bad behaviour becomes synonymous with bad brain chemistry: think of Jed Parry in Ian McEwan’s Enduring Love, or Christopher Boone in Mark Haddon’s Curious Incident of the Dog in the Night-Time. For Roth, this represents a loss of confidence in fiction: an allegory of the fear that science has become the best and only reliable measure of the human condition.

There is an increasing sense that inwardness, subjectivity and selfhood – the basic stuff of fiction – ought to be discarded as soon as possible. “I never quite understood why you would read fiction to understand the human condition,” Richard Dawkins told the New Republic last year. As cognitive therapies give way to cheap and readily available pharmaceuticals (the number of people in the UK taking antidepressants doubled between 2000 and 2011), the reduction of mind to brain in literature may well have been foreseen.

“It’s a temptation to write the illness and then bolt the character on to it,” Filer says, “but having worked in the field for so many years, it became a little bit more natural for me to see the person and see the illness as one facet of their character.”

We have been depicting mental illness in art far longer than we have been diagnosing it. Hamlet may have been bipolar, but that is not all that he was. It is not unreasonable to assume that observation and imagination may still paint a broader picture than textbooks, or even help them along.

Filer speaks fluent NHS: he still works occasional shifts as a nurse and uses expressions such as “service user” and “pathologise” without sounding cold or patronising. In his book, Matthew becomes a kind of challenge – to look beyond the disease and see what remains.

“The only way we’re ever able to diagnose people in mental health – we don’t put patients in an MRI scanner – is through the way they interact with people,” Filer says, explaining how he used his novel to ask questions, arising out of his work, on the location of mental illness.

“If we say that his schizophrenia is located in him,” he goes on, “and look at his mother (clearly there’s some anxiety and depression there), it seems that their respective problems are located in the space between them.

“The catalyst for breakdown is always stress: it’s life events. If you want to depict mental illness accurately, then the interplay needs to be shown. Fiction can do that.”

Brain tweezers: fiction can be a tool for analysing how we think. Image: Illustration Works/Alamy.

Philip Maughan is Assistant Editor at the New Statesman.

This article first appeared in the 15 January 2014 issue of the New Statesman, 1914 to 2014

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Is Danny Baker a “bona fide genius”? Not in his new show

The clichéd decade: Cradle to Grave and Danny and the Human Zoo reviewed.

I’m not qualified to rule on whether or not Danny Baker is, as the newspapers insist, a “bona fide genius”; I gave up listening to the ever more blokeish BBC Radio 5 Live a while ago, and I’m too young to remember the supposedly fantastic pieces he delivered to the NME back in the day (I read that they were even more amazing than those of Tony Parsons, which is saying something, isn’t it?). But I can tell you this: his new autobiographical comedy series, Cradle to Grave (Thursdays, BBC2, 9pm), displays no evidence at all of his talents, brilliant or otherwise. Anecdotes that just peter out. Jokes that fail to hit home. Misplaced nostalgia. Honestly, what’s the point? If you want 1974 – and quite a lot of us seem to, if the performance of Jeremy Corbyn is anything to judge by – you’d be better off treating yourself to a box set of the eternally satisfying Whatever Happened to the Likely Lads?.

The series, co-written with Jeff Pope, is based on Baker’s memoir Going to Sea in a Sieve. It’s 1974, and Danny (Laurie Kynaston) is a randy teenager who still lives at home in good old Bermondsey with his ducking and diving docker dad, Fred, aka Spud (Peter Kay), his kindly mum, Bet (Lucy Speed), and his older sister, Sharon (Alice Sykes). A voice-over tells us, in effect, to forget all about the nasty old three-day week and to consider instead the warmth of lovely south-east London. How decent its people are, how eager to try out newfangled consumer goods such as the continental quilts Spud has pilfered and which now fill the hall of his tiny house like clouds. (Correct: he’s basically Del Boy, minus the Robin Reliant, the cocktail bar and, fatally, the workmanlike jokes.)

The denizens of Bermondsey are not, you understand, quite ready for the new world. In this part of London, bomb sites remain, merrily sprouting buddleia and pink willow herb; men are men and women are women. Spud is horrified to discover that his daughter’s new boyfriend wears – wait for it – white plimsolls, though not quite so horrified as Danny is to find a stranger’s ­penis flapping exuberantly against his cheek when he goes up west to see Hair (needless to say, our Danny was in search of naked girls, not sweaty blokes). If you find this kind of thing funny and (I can hardly bear to write the words) “heart-warming”, then you have seven weeks of bliss ahead. Who knows? Perhaps the characters will go on to debate the virtues of the various flavours of Old English Spangles. But I can’t believe that many people will be so easily pleased. Those who are old enough to remember the Seventies will know that the best of the decade’s own comedy was ten times more sophisticated than this, and those who aren’t – those who have never had anything other than a duvet on their bed, and can locate a naked female or even a flapping male member with just one tap of their mobile – will simply watch something altogether more grown-up on Netflix.

Kascion Franklin (centre) on BBC1. Photo: BBC/RED

Unfathomable BBC scheduling (is it having some kind of John Whittingdale-induced nervous breakdown?) treated us to two doses of 1974 as the summer limped to an end. The second loving spoonful came in the form of Danny and the Human Zoo (31 August, BBC1, 9pm), an almost-biopic drama in which Lenny Henry told the story of his painful start in comedy.

My TV critic colleagues have all been most respectful but, lovely as Kascion Franklin’s performance in the lead role was, I couldn’t altogether get with the show. Unlike Baker, Henry certainly wiped the Vaseline from the lens: his version of the Seventies was clear-eyed, particularly in the matter of racism. But his tendency as a writer is to tell rather than show, which becomes wearying, and the narrative he offered us – success on the New Faces talent show, followed by the self-loathing that came of joining the Black and White Minstrels – wasn’t exactly unfamiliar. An unscrupulous manager with bad hair; parents who think their son should get a “proper” job but are secretly oh-so-proud; Mud’s “Tiger Feet” and Alice Cooper’s “School’s Out” on the soundtrack: such TV clichés really should be illegal by now.

Rachel Cooke trained as a reporter on The Sunday Times. She is now a writer at The Observer. In the 2006 British Press Awards, she was named Interviewer of the Year.

This article first appeared in the 03 September 2015 issue of the New Statesman, Pope of the masses