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

Home Alone 2: Lost in New York
Show Hide image

The best film soundtracks to help you pretend you live in a magical Christmas world

It’s December. You no longer have an excuse.

It’s December, which means it’s officially time to crack out the Christmas music. But while Mariah Carey and Slade have their everlasting charms, I find the best way to slip into the seasonal spirit is to use a film score to soundtrack your boring daily activities: sitting at your desk at work, doing some Christmas shopping, getting the tube. So here are the best soundtracks and scores to get you feeling festive this month.

A Charlie Brown Christmas (1965)

Although this is a children’s film, it’s the most grown-up soundtrack on the list. Think smooth jazz with a Christmas twist, the kind of tunes Ryan Gosling is playing at the fancy restaurant in La La Land, plus the occasional choir of precocious kids. Imagine yourself sat in a cocktail chair. You’re drinking an elaborate cocktail. Perhaps there is a cocktail sausage involved also. Either way, you’re dressed head-to-toe in silk and half-heartedly unwrapping Christmas presents as though you’ve already received every gift under the sun. You are so luxurious you are bored to tears of luxury – until a tiny voice comes along and reminds you of the true meaning of Christmas. This is the kind of life the A Charlie Brown Christmas soundtrack can give you. Take it with both hands.

Elf (2003)

There is a moment in Elf when Buddy pours maple syrup over his spaghetti, washing it all down with a bottle of Coca Cola. “We elves like to stick to the four main food groups,” he explains, “candy, candy canes, candy corns and syrup.” This soundtrack is the audio equivalent – sickly sweet, sugary to an almost cloying degree, as it comes peppered with cute little flutes, squeaky elf voices and sleigh bells. The album Elf: Music from the Motion Picture offers a more durable selection of classics used in the movie, including some of the greatest 1950s Christmas songs – from Louis Prima’s 1957 recording of “Pennies from Heaven”, two versions of “Sleigh Ride”, Eddy Arnold’s “Santa Claus is Coming to Town” and Eartha Kitt’s 1953 “Santa Baby”. But if a sweet orchestral score is more your thing, the Elf OST of course finishes things off with the track “Spaghetti and Syrup”. Just watch out for the sugar-rush headache.

Harry Potter (2001-2011)

There are some Christmas-specific songs hidden in each of the iconic Harry Potter scores, from “Christmas at Hogwarts” to “The Whomping Willow and The Snowball Fight” to “The Kiss” (“Mistletoe!” “Probably full of knargles”), but all the magical tinkling music from these films has a Christmassy vibe. Specifically concentrate on the first three films, when John Williams was still on board and things were still mostly wonderful and mystical for Harry, Ron and Hermione. Perfect listening for that moment just before the snow starts to fall, and you can pretend you’re as magical as the Hogwarts enchanted ceiling (or Ron, that one time).

Carol (2015)

Perhaps you’re just a little too sophisticated for the commercial terror of Christmas, but, like Cate Blanchett, you still want to feel gorgeously seasonal when buying that perfect wooden train set. Then the subtly festive leanings of the Carol soundtrack is for you. Let your eyes meet a stranger’s across the department store floor, or stare longingly out of the window as your lover buys the perfect Christmas tree from the side of the road. Just do it while listening to this score, which is pleasingly interspersed with songs of longing like “Smoke Rings” and “No Other Love”.

Holiday Inn (1942)

There’s more to this soundtrack than just “White Christmas”, from Bing Crosby singing “Let’s Start The New Year Off Right” to Fred Astaire’s “You’re Easy To Dance With” to the pair’s duet on “I’ll Capture Your Heart”. The score is perfect frosty walk music, too: nostalgic, dreamy, unapologetically merry all at once.

The Tailor of Gloucester (1993)

Okay, I’m being a little self-indulgent here, but bear with me. “The Tailor of Gloucester”, adapted from the Beatrix Potter story, was an episode of the BBC series The World of Peter Rabbit and Friends and aired in 1993. A Christmastime story set in Gloucester, the place I was born, was always going to be right up my street, and our tatty VHS came out at least once a year throughout my childhood. But the music from this is something special: songs “The Tailor of Gloucester”, “Songs From Gloucester” and “Silent Falls the Winter Snow” are melancholy and very strange, and feature the singing voices of drunk rats, smug mice and a very bitter cat. It also showcases what is in my view one of the best Christmas carols, “Sussex Carol.” If you’re the kind of person who likes traditional wreaths and period dramas, and plans to watch Victorian Baking at Christmas when it airs this December 25th, this is the soundtrack for you.

Home Alone (1990-1992)

The greatest, the original, the godfather of all Christmas film soundtracks is, of course, John William’s Home Alone score. This is for everyone who likes or even merely tolerates Christmas, no exceptions. It’s simply not Christmas until you’ve listened to “Somewhere in My Memory” 80,000 times whilst staring enviously into the perfect Christmassy homes of strangers or sung “White Christmas” to the mirror. I’m sorry, I don’t make the rules. Go listen to it now—and don't forget Home Alone 2: Lost in New York, which is as good as the first.

Anna Leszkiewicz is a pop culture writer at the New Statesman.