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

GETTY
Show Hide image

Conjuring the ghost: the "shape-shifting, queer, violent, hippie genuis" of David Litvinoff

A new biography tracks down the elusive Kray confidant who became a friend of Mick Jagger and Keith Richards.

David Litvinoff is a mythic character to anyone with an interest in London during the Sixties. An intimate of the Krays, he was a tough and violent Jew from the East End. He was also a musical genius with an unrivalled knowledge of jazz, the blues and rock that made him a valued friend of Mick Jagger and Keith Richards. It was his ability to move from the East End to Chelsea, from the dives of Soho to Notting Hill, that was the critical factor in the extraordinary vision of London that Donald Cammell and Nicolas Roeg conjured into the film Performance, for which Litvinoff is credited as dialogue coach. And yet, even though all this is known and recorded, he remains a ghost, a figure who wrote nothing and who systematically destroyed all the records of his life he could lay his hands on. Even his exact role in Performance is shrouded in mystery. He is said to have dictated much of the script to Cammell. This biography claims that Jagger’s mesmerising song on the soundtrack, “Memo from Turner”, was in fact a memo from Litvinoff.

Multiple reports describe him as the most brilliant talker London had known since Coleridge, but although there are rumours of tapes they have always been just rumours. I’d have thought he was a figure who would defeat any biographer – a shape-shifting, queer, violent, hippie genius lost in a mist of hallucinogens – but Keiron Pim’s account of this extraordinary character is a magisterial work of scholarship. He tracks down all the living witnesses; he has also unearthed letters, and even some of those long-lost tapes.

The story that emerges is even harder to believe than the legend. Litvinoff came out of the Jewish East End but he was from one of its most talented families. His name was not even Litvinoff: his mother’s first husband went by that name but David was the son of her second, Solomon Levy. Long before he met the Krays or the Stones, he was a gossip columnist on the Daily Express, practically inventing the Chelsea set that shocked the prim Fifties. By that time he had met Lucian Freud, who painted him in an astonishing study, the working title of which was Portrait of a Jew. Litvinoff was furious when Freud exhibited it with the new description of The Procurer, and the bad blood between these two men, both of whom inhabited the drinking clubs of Soho and the Krays’ gambling joints, remained for the rest of their lives. In fact, it is Freud who comes over as the villain of the book, fingered by Pim as the man behind the most violent assault on Litvinoff: he was knocked unconscious at the door to his own flat, on the top floor, and awoke to find himself naked and tied to a chair suspended from the balcony, nose broken and head shaved bald.

I learned much from this book: a period working for Peter Rachman before he became involved with the Krays; sojourns in Wales and Australia when he was fleeing threats of violence. The big discovery for me, however, was Litvinoff’s encyclopaedic knowledge of the jazz and blues traditions that gave birth to rock’n’roll. He taught the Stones a lot but he taught Eric Clapton even more – they were both living at the Pheasantry building on the King’s Road, and Litvinoff seems to have had unlimited access to the most recherché back catalogues and the most recent unreleased recordings. The book traces, but does not comment on, a transformation from an amphetamine-fuelled hard man in the Fifties and early Sixties to the oddest of hallucinogen hippies by the Summer of Love in 1967.

But, for all Litvinoff’s knowledge, wit and gift for friendship, his tale is a tragedy. A man who could talk but couldn’t write; an out gay man long before it was acceptable, who seems never to have been at ease with his sexuality; a proud Jew without any tradition of Judaism to which he could affiliate. Above all, this was a man who lived to the full the extraordinary moment when London dreamed, in Harold Wilson’s Sixties, that class was a thing of the past. Back from Australia in the early Seventies, Litvinoff awoke again to find that it had indeed been a dream. His suicide in 1975 was cold and deliberate. He had outlived his time. 

Colin MacCabe edits Critical Quarterly

Jumpin’ Jack Flash: David Litvinoff and the Rock’n’Roll Underworld by Keiron Pim is publisyhed by Jonathan Cape (416pp, £16.99)

This article first appeared in the 25 August 2016 issue of the New Statesman, Cameron: the legacy of a loser