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 a freelance writer in Berlin and a former 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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In Guardians of the Galaxy Vol 2, every other line reeks of a self-help manual

This lame sequel suggests the makers have largely forgotten why the original was so refreshing.

The 2014 romp Guardians of the Galaxy boasted the budget of a blockbuster and the soul of a B-movie. What that meant in practice was that audiences had to endure the same biff-pow battle scenes and retina-blistering effects as any space adventure, but they were rewarded with eccentric characters and tomfoolery for its own sake.

Despite the Marvel Studios imprimatur, the film showed the forces of intergalactic evil being fought not by superheroes, but by a ragtag band of bickering goofballs: Peter Quill (Chris Pratt), aka Star-Lord, a self-regarding rogue in the Han Solo mould; the green-faced alien Gamora (Zoe Saldana); Drax (Dave Bautista), a literal-minded hulk; Rocket, a racoon-like warrior (voiced by Bradley Cooper); and Groot, a piece of bark that says “I am Groot” over and over in the dulcet tones of Vin Diesel. Movies this odd don’t usually become $770m smash hits but this one did – deservedly.

Those characters return in Guardians of the Galaxy Vol 2 (the “Vol 2” reflects Peter’s love of mix-tapes) but the new film suggests the makers have largely forgotten why the original was so refreshing. Gags are rehashed; several sequences (including an interminable slow-motion section involving a laser-powered arrow) are dragged way beyond their desirable lifespan. Late in the day, Rocket tells his shipmates that they have too many issues, which rather pinpoints the problem with the screenplay by the director, James Gunn. Gunn has saddled his characters with unreasonable baggage, all of it relating to family and belonging. No matter how far into space they travel, all roads lead back to the therapist’s couch.

Peter, raised by his late mother, is delighted when Ego (Kurt Russell) materialises claiming to be the father he never knew. The old man makes grand pronouncements, only to undercut them within seconds (“’Scuse me, gotta take a whizz”) but, on the plus side, he has his own planet and pulls the whole “One day, son, all this will be yours” shtick. Gamora also has family business to contend with. Her blue-skinned sister, Nebula (Karen Gillan), wants to kill her: Nebula has never quite got over Gamora being Daddy’s favourite. To be fair, though, he did force them to fight one another, replacing parts of Nebula’s body with metal whenever she lost, so it’s not like we’re talking about only one sister being allowed to watch Top of the Pops.

The more Peter gets to know Ego, the less admirable he seems as a father, and soon we are in the familiar territory of having parenting lessons administered by a Hollywood blockbuster. The reason for this became obvious decades ago: the film industry is populated by overworked executives who never get to see their children, or don’t want to, and so compensate by greenlighting movies about what it means to be a good parent. Every other line here reeks of the self-help manual. “Please give me the chance to be the father your mother wanted me to be,” Ego pleads. Even a minor character gets to pause the action to say: “I ain’t done nothing right my whole life.” It’s dispiriting to settle down for a Guardians of the Galaxy picture only to find you’re watching Field of Dreams with added asteroids.

Vol 2 gets by for an hour or so on some batty gags (Gamora misremembering the plot and star of Knight Rider is an especially juicy one) and on the energising power of Scott Chambliss’s glorious production design. The combination of the hi-tech and the trashy gives the film the appearance of a multimillion-dollar carnival taking place in a junkyard. Spectacular battles are shot through scuffed and scratched windscreens, and there are spacesuits cobbled together from tin pots and bubble-wrap. This is consistent with the kitschfests that inspired the Guardians aesthetic: 1980s science-fiction delights such as Flash Gordon, Spacehunter: Adventures in the Forbidden Zone and The Adventures of Buckaroo Banzai Across the 8th Dimension.

If only Vol 2 had mimicked their levity and brevity. Gunn ends his overlong movie with a bomb being attached to a giant brain, but this is wishful thinking on his part. He hasn’t blown our minds at all. It’s just a mild case of concussion. 

Ryan Gilbey is the New Statesman's film critic. He is also the author of It Don't Worry Me (Faber), about 1970s US cinema, and a study of Groundhog Day in the "Modern Classics" series (BFI Publishing). He was named reviewer of the year in the 2007 Press Gazette awards.

This article first appeared in the 27 April 2017 issue of the New Statesman, Cool Britannia 20 Years On

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