It's not all like "A Beautiful Mind": you can’t make schizophrenia nice

We’re brilliant at defending the mentally ill in principle, but we can be terrible at hiding our revulsion at some of the sick people we’ve encountered in the flesh.

 

The worst thing about psychiatric hospitals isn’t the treatment, it’s the patients. Or rather I guess it depends. Personally, I’ve had good treatment and bad, brilliant treatment and terrible. The one constant has been frustration with the other patients. Whatever else is going on, both inside and outside your own head, they’re always there with you and dealing with that can be hard.  

My brother suffers from schizophrenia while I’ve suffered from depression and anorexia. I’m fighting the urge to write “therefore it’s a laugh a minute round our way” but actually, sometimes it is. Not always – for my brother, the impact of increasingly large doses of medication has been devastating – but the dark humour offers some degree of comfort. If we feel traumatised, it’s often more by treatment than illness itself. We’ve occasionally spent time in the same institutions and end up reminiscing on some of the same people. It’s rare that we’re complimentary about any of them. We remember all the bad things. In a reversal of the way prejudice often operates, we’re brilliant at defending the mentally ill in principle, terrible at hiding revulsion at some of the sick people we’ve encountered in the flesh. I have no desire to defend this – I can’t – but it is, I think, a problem with chronic mental illness.

Familiarity breeds a special kind of contempt. Perhaps more so if you have suffered yourself, you become unwilling to separate the personality of the sufferer from the manifestations of his or her illness. To do so would seem patronising, maybe even a denial of his or her personhood. It’s difficult to think “they’re someone else, but for the illness”, equally difficult to think “the illness doesn’t inconvenience or frighten or anger me, because it’s not really them”. I’m not able to do this with my brother, but then I’m not sure I want to. How much of him do I want to discount, and how much of him would then remain? At what point has so much been amputated that there’s no person left? I don’t want to start chipping away at the person but if I fail to do this, to what extent am I seeing only the illness? People are not their diagnosis but the symptoms of mental illness can colour everything.

There is a need to combat the deep-rooted and irrational fear of mental illness that many people carry with them. Schizophrenia sufferers are not likely to be violent towards others. Those of us with depression don’t fall apart at the slightest touch. Mental illness can be incredibly lonely, with the psychological isolation of the disorder compounded by a real lack of contact with others, because these others are afraid. Charities such as Mind and Rethink have fought hard to challenge perceptions, in the face of constant scaremongering and casual bigotry throughout the national press. This element of their work – only a small part of all they offer sufferers and carers – is incredibly important. All the same, there are times when I wonder whether the message that filters through to the mainstream ends up being the one people want to hear rather than a true reflection of the instability and ugliness of some types of mental illness. When I see advertising campaigns such as this one and this, emphasising the “normality” of people who are mentally ill, I don’t feel as though they have much to do with those closest to me. If anything, I worry that my brother is letting the side down by conforming too closely to the stereotypes that are being questioned. That doesn’t mean the bigots understand him, but it might mean different tactics are needed to make them see the human being.

I remember my own family’s mistrust when the National Schizophrenia Fellowship became Rethink in 2002. I can see reasons for the decision being made – it is more positive and more inclusive – but to them it felt like New Labour-esque rebranding. “They don’t want people to hear the word ‘schizophrenia’,” was my father’s view. “They’re pandering to the stigma.” This may be unfair but there are reasons for such a degree of defensiveness. Rethink sounds nicer than any phrase that contains the word “schizophrenia”. But you can’t make schizophrenia nice.

Just as sufferers of physical illness are often expected to make up for their “flawed” status by being brave little Pollyannas, mentally ill people need to exhibit compensatory features in order to earn the right not to be discriminated against. Well-meaning people tell me “well, your brother must be really good with numbers” and obviously I’m tempted to say “yes, he’s just like that bloke in A Beautiful Mind” (a film I haven’t actually seen) rather than admit he failed GCSE maths three times in a row. After all, I’d only disappoint and embarrass these people following their plucky attempt to look on the bright side. Nonetheless, once it’s clear you don’t actually measure up to the compensatory factors, this can be used against you. I remember hospital staff telling me that as far as anorexics went, I wasn’t “one of those Best Little Girl in the World types but a selfish attention-seeker”. Well, yes. I never promised to be anything other than that. The point is, even if the symptoms of your illness make you a selfish attention-seeker – and even if these symptoms are so enmeshed in who you are it’s impossible to tease out the strands – all people who are mentally ill deserve human contact and support, not just the “good” ones.

You can’t always tell by looking whether a person is mentally ill. Nevertheless there are times when you can make a pretty good guess. Sometimes the mentally ill person is the man shouting on the street corner, rather than that nice man who was off work but is back in the office having “good days and bad days”. Sometimes mental illness is so debilitating that a person never experiences paid employment. That doesn’t mean they’re not a part of our society. It doesn’t mean we’re not responsible for them and it doesn’t mean we’re allowed to stick to what for them may be impossibly high standards for social interaction. Suffering from a mental illness and/or engaging with a sufferer can be messy, embarrassing and deeply distressing. You might never reach a point at which it isn’t. That doesn’t mean understanding is impossible or that attempts at contact and inclusion are worthless. For many people, they’re worth far more than can ever be expressed. 

Russell Crowe in "A Beautiful Mind". Unfortunately, not all schizophrenics are good at maths.

Glosswitch is a feminist mother of three who works in publishing.

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Former Irish premier John Bruton on Brexit: "Britain should pay for our border checks"

The former Taoiseach says Brexit has been interpreted as "a profoundly unfriendly act"

At Kapıkule, on the Turkish border with Bulgaria, the queue of lorries awaiting clearance to enter European Union territory can extend as long as 17km. Despite Turkey’s customs union for goods with the bloc, hauliers can spend up to 30 hours clearing a series of demanding administrative hoops. This is the nightmare keeping former Irish premier John Bruton up at night. Only this time, it's the post-Brexit border between Northern Ireland and the Republic, and it's much, much worse.   

Bruton (pictured below), Taoiseach between 1994 and 1997, is an ardent pro-European and was historically so sympathetic to Britain that, while in office, he was pilloried as "John Unionist" by his rivals. But he believes, should she continue her push for a hard Brexit, that Theresa May's promise for a “seamless, frictionless border” is unattainable. 

"A good example of the sort of thing that might arise is what’s happening on the Turkish-Bulgarian border," the former leader of Ireland's centre-right Fine Gael party told me. “The situation would be more severe in Ireland, because the UK proposes to leave the customs union as well."

The outlook for Ireland looks grim – and a world away from the dynamism of the Celtic Tiger days Bruton’s coalition government helped usher in. “There will be all sorts of problems," he said. "Separate permits for truck drivers operating across two jurisdictions, people having to pay for the right to use foreign roads, and a whole range of other issues.” 

Last week, an anti-Brexit protest on the border in Killeen, County Louth, saw mock customs checks bring traffic to a near standstill. But, so far, the discussion around what the future looks like for the 260 border crossings has focused predominantly on its potential effects on Ulster’s fragile peace. Last week Bruton’s successor as Taoiseach, Bertie Ahern, warned “any sort of physical border” would be “bad for the peace process”. 

Bruton does not disagree, and is concerned by what the UK’s withdrawal from the European Convention on Human Rights might mean for the Good Friday Agreement. But he believes the preoccupation with the legacy of violence has distracted British policymakers from the potentially devastating economic impact of Brexit. “I don’t believe that any serious thought was given to the wider impact on the economy of the two islands as a whole," he said. 

The collapse in the pound has already hit Irish exporters, for whom British sales are worth £15bn. Businesses that work across the border could yet face the crippling expense of duplicating their operations after the UK leaves the customs union and single market. This, he says, will “radically disturb” Ireland’s agriculture and food-processing industries – 55 per cent of whose products are sold to the UK. A transitional deal will "anaesthetise" people to the real impact, he says, but when it comes, it will be a more seismic change than many in London are expecting. He even believes it would be “logical” for the UK to cover the Irish government’s costs as it builds new infrastructure and employs new customs officials to deal with the new reality.

Despite his past support for Britain, the government's push for a hard Brexit has clearly tested Bruton's patience. “We’re attempting to unravel more than 40 years of joint work, joint rule-making, to create the largest multinational market in the world," he said. It is not just Bruton who is frustrated. The British decision to "tear that up", he said, "is regarded, particularly by people in Ireland, as a profoundly unfriendly act towards neighbours".

Nor does he think Leave campaigners, among them the former Northern Ireland secretary Theresa Villiers, gave due attention to the issue during the campaign. “The assurances that were given were of the nature of: ‘Well, it’ll be alright on the night!’," he said. "As if the Brexit advocates were in a position to give any assurances on that point.” 

Indeed, some of the more blimpish elements of the British right believe Ireland, wedded to its low corporate tax rates and east-west trade, would sooner follow its neighbour out of the EU than endure the disruption. Recent polling shows they are likely mistaken: some 80 per cent of Irish voters say they would vote to remain in an EU referendum.

Irexit remains a fringe cause and Bruton believes, post-Brexit, Dublin will have no choice but to align itself more closely with the EU27. “The UK is walking away,” he said. “This shift has been imposed upon us by our neighbour. Ireland will have to do the best it can: any EU without Britain is a more difficult EU for Ireland.” 

May, he says, has exacerbated those difficulties. Her appointment of her ally James Brokenshire as secretary of state for Northern Ireland was interpreted as a sign she understood the role’s strategic importance. But Bruton doubts Ireland has figured much in her biggest decisions on Brexit: “I don’t think serious thought was given to this before her conference speech, which insisted on immigration controls and on no jurisdiction for the European Court of Justice. Those two decisions essentially removed the possibility for Ireland and Britain to work together as part of the EEA or customs union – and were not even necessitated by the referendum decision.”

There are several avenues for Britain if it wants to avert the “voluntary injury” it looks set to inflict to Ireland’s economy and its own. One, which Bruton concedes is unlikely, is staying in the single market. He dismisses as “fanciful” the suggestions that Northern Ireland alone could negotiate European Economic Area membership, while a poll on Irish reunification is "only marginally" more likely. 

The other is a variation on the Remoaners’ favourite - a second referendum should Britain look set to crash out on World Trade Organisation terms without a satisfactory deal. “I don’t think a second referendum is going to be accepted by anybody at this stage. It is going to take a number of years,” he said. “I would like to see the negotiation proceed and for the European Union to keep the option of UK membership on 2015 terms on the table. It would be the best available alternative to an agreed outcome.” 

As things stand, however, Bruton is unambiguous. Brexit means the Northern Irish border will change for the worse. “That’s just inherent in the decision the UK electorate was invited to take, and took – or rather, the UK government took in interpreting the referendum.”