Memoirs of madness and recovery

Mental illness is common, complex and costly, but it is personal suffering that lies at its very heart.

<em>Mind on Fire: A Memoir of Madness and Recovery</em> is a new book about one person’s experience of depression, mania and various other forms of psychological suffering. Written by Arnold Thomas Fanning and published by Penguin Ireland, <em>Mind on Fire</em> belongs firmly to a small but highly distinguished canon of work about personal experiences of mental illness and treatment in Ireland.

There are few, if any, surviving personal accounts of mental illness in Ireland from the 1700s or 1800s. This is very regrettable. In the UK in 1838, John Thomas Perceval (1803-76), son of Spencer Pervecal (1762-1812; UK Prime Minister, 1809-12), published an exceptionally valuable account of his 17-month stay at Dr Edward Fox’s Lunatic Asylum in Brislington, near Bristol.

In the US in 1908, Clifford Whittingham Beers (1876-1943) published his account of psychiatric hospitalisation, titled <em>A Mind that Found Itself: An Autobiography</em> (Longmans, Green and Co). Beers went on, in 1909, to co-found the National Committee for Mental Hygiene. Ireland, however, had to wait until the mid-1900s for similarly personalised accounts of psychiatric institutionalisation, with the appearances of <em>It Happened in Ireland</em> by the Reverend Clarence Duffy in 1944 (Christian Press) and Hanna Greally’s memoir <em>Bird’s Nest Soup</em> in 1971 (Allen Figgis and Co).

<em>It Happened in Ireland</em> presented an account of the Reverend Duffy’s six-month admission to Monaghan Mental Hospital in the mid-1930s. Duffy wrote that, prior to admission, he had developed the belief that a Communist cell had been established near his parents’ home.

Duffy wrote that the treatment of patients in the mental hospital was brutal and rough. Some of the attendants were more compassionate than others; however, while kind in manner and seemingly aware of the injustices endured by patients, even these attendants seemed powerless to remedy matters in the overall scheme of the asylum. Duffy provided an especially interesting account of his fellow patients, stating that most were there owing to diseases of the brain or mind, poor diet, lack of self-restraint or in order to avoid prison.

Similar issues came to the fore again almost three decades later in 1971, in another valuable, thinly veiled account of the Irish psychiatric inpatient experience, this time written by Hanna Greally. In 1943 Greally was admitted to St Loman’s Hospital, Mullingar, ostensibly for a rest, based on a civil committal signed by her mother, who died six months later. Greally was to remain in St Loman’s until 1962 when a newly-appointed doctor approved her discharge.

In her book, Greally described her tearful parting from her mother following her arrival at St Loman’s and painted a picture of grey walls, bad food and a profound lack of privacy. She wrote about treatments including sedatives, liquid paraffin, ECT (which Greally received) and insulin therapy. Following her period of six months in the admission ward, Greally spent six years moving between other wards, apparently based on efforts at behavioural modification (reward, punishment, etc.); seven years working in the hospital laundry; and a final six years in Prospect House, where there was less supervision and a certain amount of autonomy.

Ultimately, a change in medical staffing was accompanied by the establishment of a new rehabilitation centre to which Greally was discharged in 1962. She went on to work in Ireland and later travelled to England. Greally also wrote poetry, short stories and three full-length manuscripts, and made a memorable appearance on <em>The</em> <em>Late, Late Show</em> on RTÉ. Greally died in Roscommon in 1987, but <em>Bird’s Nest Soup</em> remains a valuable, if harrowing, account of her experience of an Irish mental hospital in the mid-1900s.

 <em>Mind on Fire</em> is a very welcome addition to this collection of memoirs. Fanning had his first experience of depression during adolescence, following the death of his mother. Several years later, as an up-and-coming playwright, he was overcome by mania and delusions. This was followed by a period during which Fanning was often suicidal, increasingly disconnected from friends and family, sometimes in trouble with the law and even homeless in London.

Fanning’s account of these experiences is unsparingly direct, searing and honest. An early passage provides a startling vision of an elated mind rushing along at high speed, tripping over itself as it leaps from topic to topic, generating unsustainable momentum that is somehow sustained for a seemingly impossible period of time. It is gripping to read and must have been exhausting to live.

Of course, many health professionals reading the book will hear much that is familiar: The symptoms of mania, the torment of depression and the devastation that episodes of mental illness wreak in the lives of sufferers and their families. But there is also much that is new. Fanning provides very affecting personal accounts of symptoms, explores the impact of illness and treatment on relationships (especially between episodes of care) and demonstrates the extraordinary ability of people to somehow live through deeply challenging mental states and to recover.

<em>Mind on Fire </em>is well worth a read and richly merits a place alongside the testimonies of the Reverend Clarence Duffy and Hanna Greally in the history of psychiatry in Ireland.