In my grandfather’s account of his sister’s life, he continually returns to the question: why did this happen? Could she have recovered had she not had a leucotomy? Reading the stories of others with schizophrenia, it seems likely my great-aunt was always vulnerable to a breakdown. Insecurities within her own life and in the world around her conspired to make her collapse seem inevitable - but did it have to be permanent?
In the months leading up to her first breakdown, I guessed that my great-aunt’s mind, horrified by the terror unleashed on the world by the Nazis and the persecution of innocents, began to see nightmares everywhere. However, psychological research suggests that her susceptibility to schizophrenia, the likelihood of her becoming ill, was increased by events in her life, including trauma suffered before she was born.
If it hadn’t been for the war and the loss of those close to her, would she have had a better chance of remission? She might have been able to live with the condition. She might not have had that leucotomy.
To introduce hope into my novel, I needed to know if there were protective factors, environmental or human, that could prevent the onset of schizophrenia, delay it, or put it into remission - without the use of drugs.
When the mental barrier between the real and the surreal starts to disintegrate, what can be done to restore it? Is it an irreversible chemical reaction or can what we perceive as sanity be returned by altering the environment a person is living in, building trusting relationships, self-confidence?
My great-aunt was first admitted to hospital in 1938. She came out and seemed to recover following her initial admission. She gradually regained her confidence, began to look for work again, see friends - she took back some measure of control. It was later, when friends began to die fighting and the world disintegrated around her, that she was re-admitted and certified.
Cycles of recovery and relapse are common with schizophrenia, but could her relapse have been temporary if the world around her had been stable? What or who helped her regain her self-esteem when she came out of hospital after her first admission? She had not had a leucotomy at this point, though the treatment she received (including deep insulin, cardiazol and ECT) was intrusive and frightening.
When the remarkable John Nash (‘A Beautiful Mind’) died there was a lot of commentary about the way he managed his own condition. Through personal choice, he stopped taking drugs and found a way to live with schizophrenia, recognising the voices he heard as dream-like, unreal and, amazingly, living with their presence. He reconciled with his wife and led a quieter, happier life.
My grandparents passed on boxes of letters to and from my great-aunt, that provide insight into her condition and clues about how it was managed. After her first admission, on the road to recovery, her doctor advised a calm environment, no sexual relations, no contact with those who had caused her stress. She went to live in the countryside, away from the rush of London. She recognised her illness and was determined to get better. She was removed from the colleagues who had criticised her, removed from the undercover work she had been pursuing, the atmosphere of fear, the mistrust, the deception that she had become caught up in. Her brother, her best friend, and her mother supported her. Then there was the man who had loved her almost since their first meeting, the man who stood by her throughout her illness and helped restore her confidence. He was clearly also a factor in her recovery - his tragic death triggered her relapse. If he hadn’t died, she might still have had cycles of relapse and recovery, but she might not have had the leucotomy that precluded all chances of living a normal life again.
It was on this man, whom I called ‘Richard’, that I decided to pin my hope at the end of ‘A Thin Sheet of Glass’ – on his stable, enduring, calm presence in her life, that I concluded my story. Strong, protective influences can prevail given the opportunity but in my great-aunt's case, I had to challenge and change history to give them a chance.
Are you writing or researching a novel with a main character who suffers from mental illness? Do you have questions about my portrayal of schizophrenia in #AThinSheetofGlass? Please do get in touch.