What I read in March...

I’ve been thinking about the nature of mental illness and the role of therapy this month. There are clearly important debates to be had about whether we over-diagnose mental illness nowadays and medicalise emotional states that are either just part of being human or a normal response to abnormal situations - such as lockdown. Escalating numbers of people self-reporting mental illness suggest we live in a culture that both nurtures and validates individual vulnerability. But while this is a broader social and political issue, we also need to think about how we treat individuals who are suffering with mental illness.

Zig-Zag Boy: Madness, Motherhood and Letting Go by Tanya Frank is a beautifully written first-hand account of a mother’s struggle to help her young adult son who has been diagnosed with schizophrenia. We follow her on a heart-aching journey as she struggles to find the right combination of medication and psychiatry that can help her son return to something resembling his old life. After years spent seeking treatment but with no success, she begins to accept that no such return is possible and a new reality needs to be accepted. This raises challenging questions about the nature of mental illness. What makes a mental illness incurable? At what point do the side-effects of medication for psychiatric conditions outweigh the benefits? And if a person either cannot be treated - or does not want to be treated - what are the limits of parental responsibility? 

In making sense of this, Frank seems to arrive at the conclusion that mental illness is a matter of degree - that reality is ‘consensual’ rather than objective - and what counts as ‘normal’ is a social construct rather than a moral absolute. I found this difficult to agree with. I worry that by pushing the onus onto society to change to accommodate mental ‘differences’, rather than treating the ill individual, we might end up abandoning people in need of help. It might seem cruel to tell people that normality is beyond their reach but telling them there is no such thing as normality to aspire towards anyway surely leaves them no further forward.

Many of these questions were raised again in Cynical Therapies, Perspectives on the Antitherapeutic Nature of Critical Social Justice, a collection of essays from practicing counsellors and psychotherapists edited by Dr Val Thomas. This excellent book explores the impact Critical Social Justice (or woke) ideas have had on therapy. The contributors argue persuasively that by seeing clients as members of an identity group rather than individuals, whose problems are a result of social injustices rather than in their own minds, those seeking help are actually harmed. Activist therapists are less interested in dealing with complex mental health problems than they are in recruiting angry victims to their political cause. My full review of this book will be published on Spiked in the coming days.

The devastating impact of this new approach to therapy is spelled out by Hannah Barnes in her superb book Time to Think: The Inside Story of the Collapse of the Tavistock’s Gender Service for Children. Barnes meticulously details the recent history of the Tavistock and, in so doing, reveals what happens when mental health professionals are captured by a rigid ideological approach. Increasing numbers of ever younger children have had a new gender identity affirmed, and been sent down a path leading to medication and surgery, with scant records kept of their medical history and few opportunities provided for them to discuss broader mental health problems, concerns about their sexuality, autism or a history of sexual abuse. Alongside this, Barnes tells of the repeated efforts of several practitioners, dating back over many years, to sound the alarm. The fact that they were ignored shows the terrible consequences of professionals becoming so blinded by a sense of political righteousness they lose all sight of the specific needs of the individuals they are supposed to help. 

For something more lighthearted, I read two fiction books, both narrated through the eyes of young boys. The first, The Giver by Lois Lowry, is set in an imagined future where people exist in a state of complete safety and total equality. Every aspect of life is both pre-determined and the same for everyone - from what people eat and what they wear to how they speak to one another. Twelve-year old Jonas is allocated his adult role and has to come to terms with new responsibilities. As he learns more, he discovers that the cost of emotional safety is the absence of true feelings - including grief and love. 

Danny is the 10 year-old hero of One Small Step by Michael Flavin. He harbours dreams of becoming an astronaut but has to confront the reality of growing up in an Irish Catholic family in Birmingham in the 1970s. As The Troubles spill out of Northern Ireland, into England, and eventually into his own home, Danny tries to make sense of the adult world. This is a period of British history many seem reluctant to revisit; the issues seem both too close for comfort and too morally complex. The use of a child narrator could have allowed Flavin to provide a sugar-coated, faux-innocent and one-sided account of this time, but he never falls into this trap. Instead, One Small Step is a well-written, sensitive and politically nuanced story that confronts challenging content head on. I recommend it.