Tuesday, January 14, 2014

Stephanie Dowrick urges you to read Kate Richards' brilliant MADNESS

 Dr Stephanie Dowrick, for many years a psychotherapist as well as a highly successful writer, reviews the "astonishingly brilliant, brave, entirely lucid" Madness: A Memoir - and urges you to read it also.

Dr Kate Richards (left) with her trusted, deeply accomplished psychotherapist, Winsome Thomas
For a host of unimportant reasons, I postponed reading this book. Perhaps part of it was a sense that I "ought" to read it, co-existent with an expectation that I was unlikely to learn much that was new. How wrong I was. No one should read a book like this out of obligation. But everyone and anyone whose life is touched in any way by serious mental illness should read Madness: A Memoir because from it they will gain a depth of perspective rarely achieved anywhere in literature.

It is impossible for me to praise this memoir too highly. Over the years I have read many accounts of mental illness or emotional and mental anguish, and prior to this might have been quick to name French writer Marie Cardinal's The Words to Say It as one of the most outstanding. We published that book many years ago at The Women's Press in London and at the time and for many years afterwards it attracted a great deal of respectful attention. Kate Richards' book is even better. Her literary skills are extraordinary; so are her gifts of analysis. The irony in that is, of course, palpable because during her many years of moderate to severely acute psychotic illness - from late teens onwards - her own "analysis" of her situation was sometimes necessarily severely flawed. That is the nature of madness: that one is entirely convinced by things, situations, voices that are not "true" and that too frequently speak, or appear to mean, harm.  And, at exactly the same time, the absolute truth of this experience is so inadequately understood, respected, even listened to by the very people who have the power and opportunity to help.

The arrogant, ignorant "deafness", "blindness", insensitivity and ineptitude of much of Australian psychiatry is on inescapable display here. The picture is dismaying. One psychiatrist after another passes through Kate's life, points a stick in her direction, writes a script or three (or 33), and moves on. Intimacy, empathy, comprehension, dignity, respect, interest: all lacking. It ought to be unbelievable. Sadly, it is not. This does of course raise very serious questions about why people would choose psychiatry as a profession if their levels of flagrant disinterest in their patients are so high.

It's widely assumed (in the helping professions) that when people are psychotic they will be unable to respond to formal therapy. That's true enough, but with their heightened sensitivities (there were many times when Kate had to wear multiple layers of clothing to protect her skin from touch, never mind her feelings), severely mentally ill patients at least need and deserve the compassion and intelligent interest that is intrinsically therapeutic. Common sense and courtesy seem to be in alarmingly short supply, or are supplied mainly by psychiatric or community nurses, or other patients from time to time during Kate's fairly frequent hospital stays.  In every relationship it is the atmosphere generated between people that counts most. This is made up of words, projections and assumptions, both conscious and unconscious. For it even to begin to succeed, trust must also be present that each person matters to the other.

 Here is an encounter that Kate has with the last psychiatrist she reports on (someone she has been seeing for some time, I need to add):

Martin comes out of his office as he always does - stiffly.
"Hi Sarah," he says.
I look to see if anyone else is in the room and then stand up.
"Kate," I say, tapping my sternum.
"Oh," he says.
...The feel in the room is flat as concrete. After eight minutes he ushers me out and I pay the bill...

There are at least three reasons why Madness is so exceptional. The first is Richards' shocking, credible exposition of current psychiatric practices in 21st-century Australia; the second is her capacity to bring to life the inner reality of madness and the havoc it brings in one's immediate outer world; the third is the deeply therapeutic, life-changing and life-saving relationship she eventually has with Winsome Thomas, a Melbourne psychotherapist whose quiet wisdom, patience and tenacity eventually allows Kate to be seen, respected, understood and - to a significant degree - restored to a workable, productive, rewarding life. 
The relationship between the two women - one so tormented, the other calm and utterly trustworthy - is beautifully told. There is a gradual unfolding here, as there was in "real life", with absences and an increasing depth of presence brought vividly and courageously to the page and fully into each reader's awareness.

I will end this review as I began it: with unconditional praise for the literary merits of this book, for the genuinely exceptional artistry of the writer, and for the quiet, often-tested courage of Winsome Thomas and particularly Dr Kate Richards herself. Will this book become essential, required reading for all those working with patients like Kate who lack her voice - and particularly psychiatrists? I would wish so; how I would wish so.

Loving congratulations to all who brought this journey of healing to us.  I commend it to you.

You can buy this wonderful book post free: Madness: A Memoir. You can also buy any other book (postage free) from our linked bookstores - especially QBD. This returns a tiny, vital % to us to maintain this Book Club.
Dr Stephanie Dowrick has written more than 14 major books and is regarded as Australia's leading spiritual/psychological writer. Her own most recent book is Heaven on Earth: Timeless Prayers of Wisdom & Love.
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