The Collected Schizophrenias.
I read this collection of essays by Esmé Weijun Wang (Penguin, 2019) in our work-based book club Many Stories Matter, organised by my work colleague Helen Coop to encourage discussion about equality and diversity. These are my own notes.
Wang has a diagnosis of schizo-affective disorder and what is presented is her account of living with that diagnosis. The book’s opening two-word sentence , “Schizophrenia terrifies”, is not encouraging. The second paragraph begins “People speak of schizophrenics as though they were dead without being dead…” and goes on to cite psychoanalyst Christopher Bollas about “schizophrenic presence” as “being with [a schizophrenic] who has seemingly crossed over from the human world to the non-human environment”. Whatever that means.
A first impression is that, notwithstanding the purple prose, Wang embraces a fairly standard medical-psychiatric view of what is going on. She talks frequently about diagnostic statements by the (several) psychiatrists she has consulted – she has herself worked administering research diagnostic interviews and seems to take them at face value as disease labels. Drug names are scattered through the text. Diagnosis apparently equals prognosis, although Wang points out the disparity between her own “high functioning” and the usually expected course of schizophrenia-like illnesses. On the other hand, there are descriptions of the abusive nature of inpatient treatment and of physical restraint. One of her psychiatrists (Dr M.) is described as suggesting her final diagnosis during an email consultation. And there is a disturbing account of a summer camp at which she and her husband, untrained and largely unsupervised, “looked after” a number of children diagnosed, along with multiple other conditions, as bipolar. All this suggests a more ambivalent relationship with the uncertain practice of psychiatry.
The complexity in this book resides in more than the ambiguity of the author’s position. There is no obvious organising principle, thematic or chronological, and even within chapters it can be difficult to follow the thread. It is surprisingly difficult to gain a detailed picture of what exactly is Wang’s personal experience of her illness and its evolution. Scattered and uncritical references are made to Rosenhan’s discredited On being Sane in Insane Places, to the laughable film A Beautiful Mind, to the opinions of astrologers, and to the Big Pharma sponsored National Alliance on Mental Illness – as if these sources jostle with the more orthodox for explanatory influence. Passing comments about family tensions and a history of repeated self-harm are not expanded upon or integrated into the narrative. Finally there is a long derailment into describing Wang’s pursuit of psychic healing and treatment for chronic Lyme disease as solutions to the failure of conventional psychiatry.
It is difficult to know what to make of all this. Is the narrative style an intentional or performative device, aimed at representing Wang’s experiences? Or a more-or-less unselfconscious demonstration of her current way of remembering it all? Andrew Scull’s review in the Times Literary Supplement was subtitled “A fragmentary memoir of mental unrest” and that seems about right. I was left unclear how much this is a collection of essays about psychosis as opposed to being about the author’s overshadowing attempt to frame her life as somebody with psychosis. Perhaps that is at it should be: the book’s main value is to illustrate one of the dilemmas inherent in living with longstanding mental disorder – the appeal of certainty that resides in psychiatric diagnosis and treatment comes with the limitations of its purview and the disbenefits of its actual practice, while the broader search for personal and cultural meaning does not always yield useful insights or practical solutions.