Tag: psychiatry

Author, Book review, Fiction, Harper Collins, literary fiction, Publisher, Setting, UK

‘The Shock of the Fall’ by Nathan Filer

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Shock of the fall

Fiction – Kindle edition; Harper Collins; 321 pages; 2014.

Nathan Filer’s The Shock of the Fall — which won the 2013 Costa Book of the Year, announced in January — charts one boy’s descent into madness. But this is not a sensationalised account of mental illness — it’s a highly nuanced and very readable book, worthy of the praise that has been heaped upon it.

The story is told by 19-year-old Matthew in a chatty, personable voice, often directly aimed at the reader — “I don’t know if you watch Eastenders, or even if you do, I don’t suppose you’ll remember an episode from so long ago” — which makes for quite an intimate, occasionally claustrophobic, experience.

This intimacy is further encouraged by the way in which the book is printed: different fonts are used to  show when Matt is typing his story on a typewriter or a computer, and it includes letters, both real and fake, from doctors and caseworkers, along with small illustrations, or doodles.

Tragic incident

While Matt never names his illness, we know that it has necessitated a stay in a psychiatric ward and is currently managed by weekly injections (because he’s inclined not to take his pills). We also know that it can be traced back to a tragic incident in his childhood: the death of his older brother, Simon, while the family were on holiday in Dorset, and for which Matt blames himself.

This blame seems to manifest itself in anger, which Matt struggles to contain — when he’s 10 he stabs a classmate with a compass; as a teenager his angry outbursts frighten his parents, his nanna and the nurses — so that a nasty undercurrent of violence seems to simmer below the surface at all times.

It doesn’t help that his mother appears to have problems of her own. In the immediate aftermath of Simon’s death, she fusses over Matt to such an extent that one wonders if she has Munchausen by proxy syndrome. But his grandmother, “Nanny Noo”, is a real tower of strength. She treats him kindly at all times and respects his desire for independence. When he moves out of home aged 17 to live with his school friend and takes up a low-paid job as a care worker, she offers him endless moral (and occasionally financial) support. Their relationship is beautifully told.

A story about mental illness

The novel’s greatest strength lies in its depiction of mental illness. It’s very well done, but this is probably no surprise given the author is a qualified mental health nurse and worked for the mental health service in Bristol for many years. There’s a lightness of touch so you never feel as if you’re reading a book about “issues”, and the ways in which the narrator intersects with medical staff and caseworkers feels incredibly authentic.

At times, Matt’s descent into madness reminded me very much of MJ Hyland’s Carry Me Down (though far less dark) and Patrick McCabe’s The Butcher Boy (though far less violent), with a tinge of Mark Haddon’s The Curious Incident of the Dog in the Night-Time thrown in for good measure. Given that these are three of my favourite novels, this is high praise indeed.

Admittedly,  I wasn’t sure I liked the voice to begin with, because it felt a bit “dumbed down”, but I soon got used to it.  And the ending, which is redemptive and emotional, was a little too twee for my tastes.

It also feels as if the book is aimed at a young adult audience, and I suspect it would particularly appeal to teenage readers or those adults who don’t read very much and want something easy to sink their teeth into. That’s not to damn it with faint praise: The Shock of the Fall is a highly readable book that deserves a wide audience because it deals with uncomfortable, often ignored, subjects in an intelligent, well-informed and gently perceptive way.

Author, Book review, Books in translation, crime/thriller, Europa Editions, Fiction, literary fiction, Publisher, Setting, USA

‘The Avenue of the Giants’ by Marc Dugain

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Avenue of the giants

Fiction – paperback; Europa Editions; 340 pages; 2014. Translated from the French by Howard Curtis. Review copy courtesy of the publisher.

Marc Dugain’s The Avenue of the Giants is loosely based on the life story of California “Co-ed Killer” Edmund Kemper, who was active in the 1970s.

It is one of the most astonishing books I’ve ever read, not the least because it’s so gruesome and shocking in places, but also because it has such a strong and powerful narrative voice. The first 100 pages are especially gripping as you are placed firmly in the head of Al Kenner, a depraved yet highly intelligent killer. His first person narrative is immediate and rational, yet coolly detached, making for a rather chilling reading experience.

A murderer’s memoir

When the book first opens, we meet Kenner in prison. Told in the third person, it reveals that he is desperate to get his memoir published. His only visitor is Susan, a woman in her 60s, who had a lucky escape from Kenner in the past. She is submissive to him in a way partly explained by the fact she is ever so grateful he spared her life.

The story then switches to the first person and covers Kenner’s exploits from his mid-teens onwards. We soon learn that he is not your average teenager. He is 7ft 2in tall, exceptionally intelligent (his IQ is supposedly “higher than Einstein’s”) and struggles to make friends. He has depraved fantasies about women but stresses that he would never carry them out.

My fantasies were enough for me. It never occurred to me to want to sleep with a girl for real, not only because I knew it would be difficult for me to find one who’d agree to it, but because it was a matter of control. In my fantasies I controlled everything, but what might have happened in real life? Anything might have gone wrong.

He’s constantly bored, sees himself as superior to everyone else, but has “a visceral fear of violence”. And yet one day, in 1963, he picks up a shotgun and brutally shoots dead his paternal grandmother, with whom he is living, because he is sick of her controlling his life. He then shoots his grandfather because he doesn’t want him to feel sad about the loss of his wife.

Kenner then goes on the run, but he is upset that his crime — which he hoped would make him famous — has been upstaged by Lee Harvey Oswald, who assassinates President Kennedy on the very same day. He gives himself up and then spends the next five years in a psychiatric hospital, where he develops an academic interest in psychiatry.

When he’s released on parole he does his best to fit back in to society and reinvents himself as a fine upstanding citizen: he becomes a quasi police “profiler” helping to track down student runaways, gets engaged to become married and re-establishes contact with this estranged mother.

But all is not well. He struggles to contain “bad thoughts” and drowns them in vast quantities of alcohol — he must drink two bottles of wine quickly before he begins to feel “normal”.  He also finds it increasingly difficult to behave civilly towards his mother — and eventually this leads to his downfall.

A betrayal of confidence

When the book returns to the third person and we discover, right near the end, why Kenner is now back in prison seeking to get his memoir published, it comes as a terrific blow to the reader. Indeed, I felt winded — and betrayed. As a reader I’d been taken into his confidence, but he had not always been truthful and the crimes he carries out are utterly repulsive and shocking.

Dugain’s portrait of Kenner is exceptionally good. Instead of taking the easy route and painting him as a monster, he shows us all the complexity of his personality: his desire to be loved and respected; his need to control people and events; the ways in which he adored women but was fearful of intimacy; his inability to let go of his own ego; his constant struggle between right and wrong; and the amazing talent he had to con and deceive.

The author is also very good at capturing the spirit of the times. Most of the novel is set in California during the 1960s counter-revolution (at the time when Ronald Reagan was governor), and Kenner is constantly “at war” with the hippies around him — he rails against their concepts of free love, drug use and communal living, which all seems rather dated now.

Unfortunately, the narrative is patchy in places — it loses momentum after those first 100 or so pages and never quite recovers — but because it’s such a deftly written account of a sociopathic character’s mindset it remains a compelling page-turner. However, it’s not for the faint-hearted: it covers some pretty gruesome, stomach-churning crimes (I often felt “dirty” reading it). But if you’re fascinated about what makes people carry out horrendous acts, then The Avenue of the Giants won’t disappoint — but it will take you to very, very dark places.

Author, Book review, England, Marjorie Wallace, Non-fiction, Publisher, Setting, true crime, UK, Vintage, Wales

‘The Silent Twins’ by Marjorie Wallace

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Silent-twins

Non-fiction – paperback; Vintage; 304 pages; 2008. Review copy courtesy of the publisher.

I first remember reading about identical twins June and Jennifer Gibbons when I was a teenager. They were featured in an article in Reader’s Digest magazine (my parents were subscribers), which explained that the girls did not communicate with the outside world because they had developed their own private language.

A complicated history

The Silent Twins, first published in 1986, updated in 1998 and reissued in 2008, explores June and Jennifer’s complicated history. It is written by an investigative journalist, Marjorie Wallace, who founded the mental health charity SANE on the back of her experiences writing articles on schizophrenia for The Times.

In fact, after years of incarceration — the sisters were sentenced to Broadmoor after going on a five-week crime spree when they were teenagers — both June and Jennifer were diagnosed as schizophrenic. Wallace, who befriended the girls as part of her research for this book, argues otherwise.

The label seems to fit awkwardly the profound and complex problems of their twinship. […] I have met many people with schizophrenia and have read many of their letters and writings. In the million or more words written by the twins I read in preparing this book, I have not yet found any sign of the fragmentation of thought so typical of this illness. Nor do the twins appear to suffer the more florid symptoms of schizophrenia, such as hearing voices. In any of my conversations with them I did not feel the fundamental disintegration of personality; or those moments of vacancy which can make communication so difficult. The twins are certainly not normal. They do suffer from feelings of paranoia — the people are watching them or reading their minds, one of the symptoms of schizophrenia. But how much was that paranoia an extension of their own experience of reading each other’s mind and their jealous vigilance over each other?

Alas, I’m getting ahead of myself. Let me tell you a bit about the twins when they were youngsters and what made them so unusual.

Identical twin girls

They were born in 1963 to a West Indian couple, where they were brought up on an RAF base in Wales (their father was a technician in the RAF). But from the age of three the girls rejected communication with everyone around them — they would only talk to each other, and even then it was in a soft but high-pitched voice in a private language no one else could understand.

Because of this, they lacked social skills and failed at school (they weren’t sent to a special school until they were 14, by which time it was too late). The older they got, the more private — and reclusive — they became. By the time they were 16, they’d dropped out of school, were living on benefits and rarely left the bedroom they shared with a younger sister. Most of their time was spent writing purple-prosed novels, which they would send off to be published by a vanity press.

But when editorial success eluded them they decided to seek their fame and fortune in other less legal ways: they went on a five-week crime spree involving petty thieving, breaking-and-entering, and arson. They were caught and sentenced for an unlimited period to Broadmoor, the only facility prepared to accept them.

Wallace charts the girls’ lives from birth until their release from Broadmoor in 1993.

Diaries reveal their secret lives

Throughout their teenage years and beyond, the girls kept incredibly detailed diaries to which Wallace had access. These show that they were intelligent and that they cared deeply for their parents and siblings, even though they were unable to show emotion and unwilling to communicate with them.

And it reveals how they made a childhood pact to only communicate with one another, often through the subtle use of body language or eye contact. The pact became so all-consuming they were never able to break out of it.

What emerges is a powerful study of two siblings caught in a peculiar bond in which they loved and hated each other in equal measure — when they were separated, which the psychiatrists would do as part of their “treatment”, they pined for each other to the point of illness, but thrust back together they would fight violently, tear their hair and scratch each other’s faces.

Truth is stranger than fiction

The book is written in an easy-to-read narrative style and there were times when I had to remind myself it was not fiction. Truth can, at times, be stranger than fiction, and no more so than the case of The Silent Twins. It’s a compelling and tragic tale.

You can find out more about June and Jennifer Gibbons via this Wikipedia entry — but be warned, it does contain plot spoilers.

Author, Bloomsbury, Book review, Fiction, literary fiction, New York, Patrick McGrath, Publisher, Setting

‘Trauma’ by Patrick McGrath

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Trauma
Fiction – paperback; Bloomsbury; 224 pages; 2009.

I read Patrick McGrath’s Ghost Town: Tales of Manhattan Then and Now last year and enjoyed it so much I made a note to read more of his work. Trauma, his most recent novel, was the ideal follow-up, mainly because it felt remarkably familiar to the final story, Ground Zero, in the previous collection.

Trauma is about a Manhattan-based psychiatrist, Charlie Weir, who is still coming to terms with the break-up of his marriage seven years earlier. Even though he treats patients who have gone through traumatic events, he seems largely unable to confront his own demons.

The opening line makes it clear that Charlie has a guilt complex about his mother:

My mother’s first depressive illness occurred when I was seven years old, and I felt it was my fault. I felt I should have prevented it.

Having spent most of his childhood worried about her constant rages, depression and alcoholism, and forever trying to protect her from her suffering, he’s self-aware enough to realise that he chose his profession because of his mother.

It is the mothers who propel most of us into psychiatry, usually because we have failed them.

But the psychological effect of his love for her, and her indifference to him, has been further complicated, or worsened, by the absence of his father, Fred Weir, who deserted the family when Charlie was eight years old. A tense, resentful and problematic relationship with an older brother — Walt, a successful artist — who never cared much for his mother but was clearly her favourite child, means Charlie’s got a few family hang-ups.

All this, by the way, is merely a backdrop to Charlie’s real story, which begins with a tentative reunion with his ex-wife, Agnes, and their young daughter, after a seven-year silence. (The reason for their marriage breaking down and Charlie’s subsequent solitude is a plot spoiler, so I won’t elaborate further.) As the pair begin the long, drawn-out process of mending their relationship, Charlie acquires a new lover, Nora Chiara, and his life, finally, seems to be falling into place.

But, there are complications. He begins sleeping with his ex-wife, who is now married to another man, and then Nora begins freaking him out by behaving in irrational and unexpected ways.

As the tale unfolds it doesn’t take long to see that the psychiatrist is becoming just as unstable as his patients.

What I liked most about this book was the fast and furious pace of the story-telling. Even though the narrative jumps all over the place, from past to present and back again, often within a matter of pages, it’s easy to follow, and allows the reader to build up a picture of a man quite clearly troubled by past experiences and unable to deal with the consequences of his actions. He’s morally dubious throughout, but at what point does the reader even trust his version of events? And who’s to say Agnes, Walter or any of his family members are any better?

There’s something dark and disturbing about the subject matter, but Patrick McGrath has an uncanny ability to really get to the heart of what makes people behave in the often strange and absurd ways that they do. This is the type of novel you race through then wish you’d lingered over the deliciously simple prose that little bit longer. I felt bereft when I came to the end of this book — read in one sitting, I might add — and I rather suspect it would make a great choice for a book group, as there’s clearly so much to discuss, including psychiatry, family relationships, marriage, sex and jealousy.

Author, Bloomsbury, Book review, Fiction, literary fiction, New York, Patrick McGrath, Publisher, Setting

‘Ghost Town: Tales of Manhattan Then and Now’ by Patrick McGrath

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GhostTown

Fiction – paperback; Bloomsbury Publishing; 256 pages; 2006.

I have long wanted to read something by British-born New York-based writer Patrick McGrath if only because his subject matter, often dark and Gothic, intrigues me. I bought this one on a week-long trip to Manhattan last October when I prowled the city’s book stores looking for novels set in New York. This one practically leapt off the shelf at me, so I bought it, but not without reservation: I’m not a huge fan of the short story.

I needn’t have worried. The three stories in this collection could best be described as novellas (63 pages, 112 pages and 68 pages apiece) and each was incredibly gripping in its own distinctive, haunting way. Each first-person narrative is set in Manhattan, but at different time periods, beginning with the American Revolution and ending in the days following 9/11.

The Year of the Gibbet is told through the eyes of a man dying of cholera in 1832 looking back on his childhood. “It is fifty-five years since my mama died, and I have no doubt but that I will follow her before the week is out,” he tells us on page 2. Here, on his death bed, he comes to terms with the guilt he feels for his mother’s death, for it was his suspicious behaviour as a boy that lead to her capture by the British Army. She was later hanged for being a traitor.

The second story, Julius, is also told by a narrator looking back on past events. In this case, a woman tells the tale of her grandfather, a painter, whose eye was gauged out by a student of his who lost his mind and was put in an asylum for 20 years. The student came from a very wealthy family. When he fell in love with an artist’s model — an Irish woman from the wrong side of the tracks — his father cruelly stepped in to prevent the union.

The final story, Ground Zero, revolves around a psychiatrist treating a male patient, Dan Silver, who has problems sustaining intimate relationships with women. In the aftermath of the terrorist attacks on the World Trade Centre, Dan tells his shrink that he has fallen in love with a Chinese prostitute, Kim Lee, who has problems of her own. Kim lost her lover in one of the towers but believes she still sees his ghost walking the streets.

Each story is written in stark, clear prose, but there are flashes of brilliance on almost every page, which meant the book took twice as long to read as normal, because I kept going back to re-read bits that impressed me. (One of my favourite lines was this, from page 157: “More glances flitting around the table like little birds in a conservatory, all atwitter with questions.”)

But it’s the descriptions of Manhattan that I liked best, particularly this scene describing the city as it was in 1859:

All over New York buildings were going up, others coming down, some no more than ten years old, but in this impatient town where nothing ever has a chance to decay, ten years was practically an eternity. […] For him the din and chaos of a city engaged in an unending turmoil of construction was nothing more than a spectacle provided for his amusement. It was theatre, and this being a period when increasing numbers of Europeans were arriving in Manhattan every day, the streets became more diverse, more colourful and exotic with every ship that discharged its cargo of humanity at the Battery.

There are common themes throughout the stories, namely death and ghosts and the terrible things people do to one another at times of extreme duress. The city, too, is a malevolent presence, where only the toughest inhabitants survive. Indeed, the opening line from a story set in the late 18th century — “I have been in the town, a disquieting experience, for New York has become a place not so much of death as of the terror of death” — could almost be its closing sentence describing the days after 9/11, too.

All in all, a thoroughly superb trio of elegantly spooky stories, and a great taster for McGrath’s work.