Twenty years of madness
This is a sort of journal, of course, but not only about me. The is a blog attached to a larger website (www.saulsrecreation.com) which will be the ongoing account of work I am doing on a project with, and about, my brother — Archie. Let me do the introductions.
This year, 2005, represents the 20th anniversay of Archie’s career as a manic depressive. To use the standard psychiatric term, he suffers from chronic bi-polar disorder. From the age of 15 he has experienced cataclysmic breakdowns, delusions of demonic possession, unfathomable despair, uncontrollable mania. He has been arrested, sectioned, medicated, therapised and administered with electroconvulsive treatment. In one episode, he was dosed with enough sedatives to kill a man and still raged around like a stunned rhino; in another, he lost 7 stone in a week. On his 30th birthday, he re-named himself “Archie.” It was a mostly usuccessful attempt to make a break with his past.
What’s in a name?
While we were growing up together, my brother’s name was Saul. Hence the title of the website: Saul’s Recreation. It’s about a boy’s descent into psychosis, his survival into manhood, and his attempt to transform himself. But it’s also about what madness means: the way it throws people into a kind of recreational existence, a tormented playtime — either set apart from normal social functions or penned in for protection. That the mad exist outside of social functions is nearly a definition of madnes. (In this they are like the unemployed, but revolving on a more remote orbit.) And yet, my brother is one of the most skillful social operators I have known. Barriers of class, or age, or profession don’t seem to matter to him. He has a curse, but he also has a gift. He is vulnerable, but also resilient. His recreation is human company; other people are his salvation — everyone from the bars of Edinburgh pubs, to the bars of Edinburgh lawyers; from criminals to policeman; from the working class to the upper class; from uptight old men to louche old queens; from clubbers to cricketers to prostitutes to professors… in fact, pretty much anyone, however psychotic or sane. And people do not easily forget him.
With Archie’s illness (or madness, or whatever it is) comes the belief that he was born into an inherited condition, condemned by genetics and “upstream” biology. His neuro-chemical tempests have been too overwhelming for analysis or therapy to penetrate. He often speaks in religious terms; and predestination is a strong, lingering idea. He views all analysts and therapists as “moonies.” Instead, he has religious faith on the one hand and faith in his psychiatrist on the other. Professor Owens, an expert on the side-effects of psychiatric drugs, works at the Royal Edinburgh hospital. In hospital, under professor Owens’ tutelage, Archie has lived by the principle of fighting fire with fire, chemistry with chemistry, neuro-interference with electric shocks. But, the question remains. In the process, has my brother rejected the history of his mind; is there a psychological backstory which help explain, or perhaps contributed to, his disorder. Has he ignored the meaning of his life?
Psycho-babble vs bio-babble
Recreating Saul’s story is what Archie and I are doing together, to get closer to to that question, if not to provide an answer. And it’s an interesting sibling tale, as well as a narrative of mental illness. But underlying our joint project is the familiar nuture vs nature question. Do life events make us who we are? Or are we products of the predispositions handed down to us through our genetic inheritance? Frankly, in the psychiatric world, the biological arguments are winning. A combination of neuroscience and genetics, evolutionary psychology and pharmacology, have all but removed the psychoanalytic arguments from mainstream psychiatric practice in the UK. Yet the new biology may be as much of a myth as the unconscious celestial realm of Freud. This journals is not the place for complex interpretations of that dilemma — the “Psychotheories” section of the website will take a closer look at mainline disputes. This, rather, is a journal for day-to-day accounts and observations. As a thumbnail reminder, just think of the debate as being: psycho-babble vs bio-babble.
Now, my brother may be a militant anti-analyst, but I am not. I am just a sceptic. And, let’s face it, a bit troubled about all these issues. So it seems to me, if Archie represents nature, I can represent nurture. I do not feel biologically determined; I feel susceptible to every little thing that happens to me. In fact, I could do with a bit of psychoanalysis myself: to understand what it is my brother is rejecting, to know what I am talking about when I speak about the subject, and — well — perhaps for some personal reasons too.
Slowly, as my research progresses, I am becoming familiar with the new, mainstream therapies: basically, CBT (cognitive behavioural therapy) and EMDR (eye movement desensitising and reprocessing). But it’s my hunch that even although these have rejected most of the mythologies of psychoanalysis, they nevertheless owe their essential language to it. In fact, I’m not a great believer in the factions, it’s the broad church issues that matter, and the as-it-were theological schism is really between the psychological and the biological. Now, any fool will tell you it’s a war being fought on false terms (of which more on the website) but as any military historian will tell you, a war being fought over false premises is just as deadly as one being fought for good reasons. And I need to spy into both camps. To me, it seems that psychoanalysis is an essential training ground, even for the sceptic.
The divided church of psychoanalysis
Anyone looking for a psychoanalyist has to confront three initial problems. One: it’s expensive and it takes a long time. Two: it’s a small and introverted world that does not give up its secrets readily. Three: its religion may be under threat, but it is nevertheless a divided church. Do you want an old Freudian, a Jungian, a Lacanian, a Kleinian, someone from the “middle school” or some kind of a mix-and-match approach?
My first problem was that I wanted someone representative of the whole practice, since I do not believe analysts can really afford their denominational differences. Frankly, in a generation, they will all be an endangered species anyway.
My second problem was that I was asking for something unconventional. I wanted someone who I could interrogate, as well as someone who would interrogate me. I needed someone who didn’t mind talking to a sceptic, and was sure enough of themselves not to feel threatened by the inquiry. This is not easy to explain and, to begin with, I got a few hostile responses from analysts who thought I was out to exploit the process. This is nonsense, of course. To become an analyst, you need to have undergone analysis yourself. So why not an amateur researcher? It can’t be a sacred realm, can it?
Approaches to the institute of psychoanalysis in London felt uncomfortable. I needed a guide. I spoke to various analysts, and people who had spent long periods in analysis. Adam Phillips, the literary psychoanalyst, told me psychoanalysis was finished. Will Self, the writer, mocked his every experience of it. A Lacanian told me biological causes where a fiction of language. A biographer of the early British psychoanalysts told me she thought it was fine in practice, but nonesense in theory. I got names that I didn’t call, because I didn’t know what, really, I was looking for. Imagine if this was a matter of desperate need. How would you ever find the person you needed?
Eventually, it was a friend of a friend, a Jungian analyst, who was himself a doubter of his own profession, who made the contact that seemed to work. We had several fascinating discussions about how psychoanalysis was failing to push its arguments out there into a world dominated by neuro-psychology and mainline psychiatry. Then he rang up someone he knew of who he thought could help. It strikes me that this is really how psychoanalysis works: by recommendation, human contact, personal touch.
Christopher
I won’t mention his surname for now, because I don’t know how this will proceed, but Christopher, who — classically — practices in Hampstead, was on first hearing, exactly the kind of guy I was looking for. A tough, warm American, he instantly broke the code by establishing that we had a connection in a town in Massachusetts. He has worked both on the hard clinical edge in psychiatric hospitals, and in the more rarefied realm of private practice. He wasn’t remotely concerned by my amateur queries into the biological basis of mental illness. “We’re all the product of a sperm and an egg so, yes, we’re all biological: how much does that tell you?” He also said he believed that most of personality is genetically determined. But, equally, how much does that tell you? In such reductionism, he argued, there is a fundamental confusion about brain and mind. It reminded me of a question my neuro-psychologist friend Paul Broks asks: “How much can you learn about a software programme by looking at computer hardware? Nothing.” Crudely speaking, Paul thinks of the brain as hardware, the mind as software, and the self as the text on the screen. It’s not an analogy that bears too much scrutiny, but it serves a good, clear purpose. Human experience cannot be explained purely in terms of brain function, nor therefore can mental ilness be explained purely in terms of brain malfunction.
Well, I’m jumping to conclusions here, and I haven’t even started. In our first consultation, Christopher set me some basic challenges. He said my brother had been failed by his psychiatrists when he was 15, and the meaning of everything Saul then said – what seemed like ravings at the time – had been permanently lost, and would never be recovered. He said that it was with good reason that Archie could never go back and consider himself a product of circumstances or psychology. The sense of loss would be too great. And he said that he did not believe that Saul had suffered a breakdown purely out of some kind of chemical imbalance.
OK, I basically disagree with all that. But this was a good, deep conversation; the challenges were the correct ones, and I felt no need to argue, just to explore. I wish I had tape recorded the conversation. So much was said. It was interesting, troubling, informative, and occasionally profound. And we hadn’t even got started. Christopher knows genetics, he knows psychiatry, he knows pharmacology, he knows the big hospitals in Britain and America. Yes, he jumped to conclusions about my brother with troubling speed, but he was voicing my own internal debates, and far more lucidly than I could. I didn’t get round to asking what tradition of psychoanalysis he belonged to. It didn’t seem to matter. I had had my first proper consultation, and I wanted another.
