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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Erdogan’s purge was too big and too organised to be a mere reaction to the failed coup

There is a specific word for the melancholy of Istanbul. The city is suffering a mighty bout of something like hüzün at the moment. 

Even at the worst of times Istanbul is a beautiful city, and the Bosphorus is a remarkable stretch of sea. Turks get very irritated if you call it a river. They are right. The Bosphorus has a life and energy that a river could never equal. Spend five minutes watching the Bosphorus and you can understand why Orhan Pamuk, Turkey’s Nobel laureate for literature, became fixated by it as he grew up, tracking the movements of the ocean-going vessels, the warships and the freighters as they steamed between Asia and Europe.

I went to an Ottoman palace on the Asian side of the Bosphorus, waiting to interview the former prime minister Ahmet Davu­toglu. He was pushed out of office two months ago by President Recep Tayyip Erdogan when he appeared to be too wedded to the clauses in the Turkish constitution which say that the prime minister is the head of government and the president is a ceremonial head of state. Erdogan was happy with that when he was prime minister. But now he’s president, he wants to change the constitution. If Erdogan can win the vote in parliament he will, in effect, be rubber-stamping the reality he has created since he became president. In the days since the attempted coup, no one has had any doubt about who is the power in the land.

 

City of melancholy

The view from the Ottoman palace was magnificent. Beneath a luscious, pine-shaded garden an oil tanker plied its way towards the Black Sea. Small ferries dodged across the sea lanes. It was not, I hasten to add, Davutoglu’s private residence. It had just been borrowed, for the backdrop. But it reminded a Turkish friend of something she had heard once from the AKP, Erdogan’s ruling party: that they would not rest until they were living in the apartments with balconies and gardens overlooking the Bosphorus that had always been the preserve of the secular elite they wanted to replace.

Pamuk also writes about hüzün, the melancholy that afflicts the citizens of Istanbul. It comes, he says, from the city’s history and its decline, the foghorns on the Bosphorus, from tumbledown walls that have been ruins since the fall of the Byzantine empire, unemployed men in tea houses, covered women waiting for buses that never come, pelting rain and dark evenings: the city’s whole fabric and all the lives within it. “My starting point,” Pamuk wrote, “was the emotion that a child might feel while looking through a steamy window.”

Istanbul is suffering a mighty bout of something like hüzün at the moment. In Pamuk’s work the citizens of Istanbul take a perverse pride in hüzün. No one in Istanbul, or elsewhere in Turkey, can draw comfort from what is happening now. Erdogan’s opponents wonder what kind of future they can have in his Turkey. I think I sensed it, too, in the triumphalist crowds of Erdogan supporters that have been gathering day after day since the coup was defeated.

 

Down with the generals

Erdogan’s opponents are not downcast because the coup failed; a big reason why it did was that it had no public support. Turks know way too much about the authoritarian ways of military rule to want it back. The melancholy is because Erdogan is using the coup to entrench himself even more deeply in power. The purge looks too far-reaching, too organised and too big to have been a quick reaction to the attempt on his power. Instead it seems to be a plan that was waiting to be used.

Turkey is a deeply unhappy country. It is hard to imagine now, but when the Arab uprisings happened in 2011 it seemed to be a model for the Middle East. It had elections and an economy that worked and grew. When I asked Davutoglu around that time whether there would be a new Ottoman sphere of influence for the 21st century, he smiled modestly, denied any such ambition and went on to explain that the 2011 uprisings were the true succession to the Ottoman empire. A century of European, and then American, domination was ending. It had been a false start in Middle Eastern history. Now it was back on track. The people of the region were deciding their futures, and perhaps Turkey would have a role, almost like a big brother.

Turkey’s position – straddling east and west, facing Europe and Asia – is the key to its history and its future. It could be, should be, a rock of stability in a desperately un­stable part of the world. But it isn’t, and that is a problem for all of us.

 

Contagion of war

The coup did not come out of a clear sky. Turkey was in deep crisis before the attempt was made. Part of the problem has come from Erdogan’s divisive policies. He has led the AKP to successive election victories since it first won in 2002. But the policies of his governments have not been inclusive. As long as his supporters are happy, the president seems unconcerned about the resentment and opposition he is generating on the other side of politics.

Perhaps that was inevitable. His mission, as a political Islamist, was to change the country, to end the power of secular elites, including the army, which had been dominant since Mustafa Kemal Atatürk created modern Turkey after the collapse of the Ottoman empire. And there is also the influence of chaos and war in the Middle East. Turkey has borders with Iraq and Syria, and is deeply involved in their wars. The borders do not stop the contagion of violence. Hundreds of people have died in the past year in bomb attacks in Turkish cities, some carried out by the jihadists of so-called Islamic State, and some sent by Kurdish separatists working under the PKK.

It is a horrible mix. Erdogan might be able to deal with it better if he had used the attempted coup to try to unite Turkey. All the parliamentary parties condemned it. But instead, he has turned the power of the state against his opponents. More rough times lie ahead.

Jeremy Bowen is the BBC’s Middle East editor. He tweets @bowenbbc

This article first appeared in the 28 July 2016 issue of the New Statesman, Summer Double Issue