Mad Muse: The Mental Illness Memoir in a Writer’s Life and Work, by Jeffrey Berman

Jeffrey Berman’s Mad Muse is a fascinating book to read, and one that evoked complex thoughts and emotions in this reader. Berman himself appears fleetingly and lightly in the text – there is no heavy-handed literary theory here – but what he has masterfully done is to bring together the writings of seven memoirists of mental illness, and let the complexity, contrasts and inconsistencies, in their life, work and illnesses, remain.

In his discussion of William Styron, Kate Millett, Kay Redfield Jamison, Linda Sexton, Lauren Slater, Andrew Solomon and Elyn Saks, Berman frames their explicit mental illness memoirs, and their experiences of depression, bipolar illness/manic depression and schizophrenia, alongside their wider life and writing. He allows the reader to make connections across these domains and between the authors. We see how the writers differ, for example, in their views of psychiatry, of psychotherapy, of hospitalisation, and we can develop our own views on these and other matters, and are perhaps left with the insight that here, in the experience of mental illness, no easy answers are given and no one person’s experiences are sufficient. Millett, a trenchant critic of psychiatry, exemplifies this complexity in her own foreword to the 2000 edition of The Loony-Bin Trip where, despite her arguments against psychiatry, medication and diagnosis, she talks of “the moments when the darkness returns and a small prophylactic dose of lithium seems a sensible precaution”.

In his introduction, Berman discusses the development of the mental illness memoir and the reasons given for writing them. He examines the idea that writing itself may help the author understand their illness in the context of their life, and the wish to tell others who are suffering that they are not alone. However, such memoirs may have a wider importance in advancing mental health care, and in our training of practitioners.

Despite first-person perspectives being viewed sceptically on occasion, such accounts are crucial for clinicians and researchers to understand what mental illnesses are like – we still lack biomarkers for mental health problems and so diagnostic manuals rely on self-report and measures of psychopathology. There is concern that contemporary classificatory systems, such as the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, are impeding research and the goal of finding new treatments for mental illness. In parallel with this concern, and spurred on by it, we have seen a resurgence in phenomenological approaches to mental illness, and the importance of studying subjectivity. Here, first-person narratives, despite their seeming heterogeneity, can yield important insights into structural changes in experience in psychopathology – for example, changes in temporality, embodiment and the experience of the world and others. Such changes can serve as important guides to discovering new mechanisms and treatments, and may be more valid than lists of symptoms.

Berman’s book is an inspiring anti-heroic narrative: he contrasts the “triumph” narrative with the “survival” stories of mental illness. The accounts he brings together in Mad Muse are bleaker, darker, more ambiguous than those in other areas of medicine, but these stories also show resilience, stamina and the ability to “hold on” and navigate the complexity of illness, identity and one’s professional and personal life.

Matthew Broome is chair in psychiatry and youth mental health, and director of the Institute for Mental Health, at the University of Birmingham.

Mad Muse: The Mental Illness Memoir in a Writer’s Life and Work
By Jeffrey Berman
Emerald Publishing, 384pp, £19.99
ISBN 9781789738100
Published 3 September 2019