Abstract
In writing a review of Richard McLean's Recovered, not cured: a journey through schizophrenia, my main concern is to place his personal account of experiencing schizophrenia into the context of other portrayals of mental illness. I believe this is consistent with McLean's stated aim of trying to demystify the illness so as to improve the prospects for those who have had, or will in the future, experience schizophrenia.
McLean starts by describing his late teen years in the chapter ‘Adventures’ – growing up in the outer eastern suburbs of Melbourne. The next few chapters tell of his gradual descent into mental illness. Surreal experiences abound as his psychotic way of perceiving reality comes to dominate his thoughts. He describes his difficulties at work and while travelling through Europe on holidays. The paranoid and delusional thoughts lead him into many bizarre situations. His friends’ perceptions shift from seeing him as eccentric to recognizing that he may be suffering from schizophrenia. The last chapters tell of the growing awareness within himself that he needed help, trying to find that help, and eventually finding the support that enabled him to largely overcome the debilitating aspects of his illness. The final chapter ‘Reflections’ puts this time into context with the insight gained some years after the confusion has passed.
In McLean's book I see a direct correlation between how he perceived reality while psychotic and Virginia Woolf's portrayal of the Septimus Smith character in her 1925 novel Mrs Dalloway. Both accounts struck many chords with my own period of mental illness. The point I want to make by drawing this parallel is that what is known as schizophrenia is the same experience now as it was 80 years ago. Woolf's novel contains, for me, the most accurate portrayal of schizophrenia I have come across. Written in a stream-of-consciousness style, she conveys psychotic thought through the character of Septimus Smith in the first-person singular. Such an approach allows the reader to appreciate the wonder and at times, terror, of the schizophrenic's merging with the environment, the hearing of voices and the delusional, inspirational moments. What is interesting to consider is that there were no institutional interventions that could in any way address the illness at that time. Septimus Smith finally commits suicide, as did Virginia Woolf – so we can assume she shared the sense of overwhelming despair she portrays in the novel. The point I want to make is that although what is known as ‘schizophrenia’ refers to the same patterns of behaviour as it did 80 years ago, it is conveyed differently by Richard McLean in that he uses the first-person singular, but in the past tense.
So what influences enabled McLean to have such an objective relationship to his illness? What interventions enabled his recovery?
I am aware that therapy for all forms of mental illness takes into account the biological, psychological and social contributing factors to the illness. The first is dealt with by medication. McLean comments a number of times in the final chapters on the importance of medications in reducing psychotic symptoms. I agree when he says we are lucky to be born in an age where schizophrenia can be treated effectively with medication. What is also evident in his account are traces left from the therapies that address the psychological and social spheres that complement the biological therapy. This doesn't take away from Richard's story; on the contrary, I want to validate the therapies that provide the tools for those who experience mental illness to incorporate it into an overall life experience.
With McLean's use of terms such as insight, self-image and delusion, we see the concepts most useful to the person recovering from the profoundly confusing and alienating aspects of psychosis. If we accept that such concepts are derived from psychology, we are able to see the role of mental health services in empowering the individual to move on with their life after their illness. This is the complete opposite to the institutional interventions seen in One flew over the cuckoo's nest. Here, patients are portrayed as oppressed and victimized by institutional sources. The fact that McLean uses these psychological terms without reference to their source indicates that they have long been incorporated into how he perceives himself.
Recovered, not cured has a place in the context of information and literature on schizophrenia. It will be useful for people who have first-hand experience of psychosis as patient, carer or professional in the field. Brochures such as Something is not quite right, published by the National Mental Health Strategy or Psychosis the SANE guide, published by Sane Australia, are clear and informative in the way they describe symptoms and behaviours typical of a person going through psychosis. They would be useful for someone first contacting mental health services. Recovered, not cured shows what happens to a person who has largely recovered, years after engaging with mental health services and gives a sense of perspective which is profoundly absent in a time of psychosis.
Richard McLean shows us that the journey through schizophrenia can be one of development and progress, where psychotic experiences can be incorporated into a transformed image of self, given institutional support and the all-important time to heal.