Mind’s Introlude

In an old piece for the New Statesman, Nick Cohen anticipated the latest Diagnostic and Statistical Manual of mental illness:

The first edition (DSM-I) was published in 1952. It was a pamphlet which listed a mere 60 disorders. At 134 pages, the 1968 second edition might have been mistaken for a novella. The third, in its revised version of 1987, had 567 pages and was longer than most novels. DSM-IV, the current dictionary of delusion, was published in 1994 and would be easier to handle if it had appeared in two volumes. It has 886 pages and even in paperback weighs 3lb 4oz. DSM-V will be out in 2011. No one is expecting a haiku.

Nick’s critique is a familiar one if you follow mental health – the idea of ‘diagnostic inflation’, that psychiatry has a tendency to medicalise everything and increasingly passes off all kinds of bad or common behaviour as some sort of clinical disorder. As he says, ‘Whether you are happy or sad, neat or messy, chaste or promiscuous, bumptious or withdrawn, fat or thin, drunk or sober, you have the symptoms of a mental disorder.’

Since Nick’s article the backlash against the DSM has grown to the extent that this weekend, the Observer reported that the Division of Clinical Psychology has attacked the concept of psychiatric diagnosis altogether, saying that ‘diagnoses such as schizophrenia, bipolar disorder, personality disorder, attention deficit hyperactivity disorder, conduct disorders and so on [are of] limited reliability and questionable validity’. This raised my eyebrows. I can see why concepts such as ‘disruptive mood dysregulation disorder’ could be called into question, but claiming that a diagnosis of bipolar psychosis is essentially of ‘limited reliability and questionable validity’ is a huge step.

You can see why people want to move away from the medical model. Too many service users have antidepressants thrown at them when talking therapies would be far more helpful. The DCP wants to gear treatment more towards the social factors and bad experiences that influence all of us. Dr Lucy Johnstone said that ‘there is no evidence that these experiences are best understood as illnesses with biological causes. On the contrary, there is now overwhelming evidence that people break down as a result of a complex mix of social and psychological circumstances – bereavement and loss, poverty and discrimination, trauma and abuse.’ Who could argue with that, for practically no one outside of Nietzschean fantasy can be stripped of the influence of the past. Joyce wrote that ‘When the soul of man is born in this country there are nets flung at it to hold it back from flight. You talk to me of nationality, language, religion. I shall try to fly by those nets.’ But he was dreaming. Most of us get caught in the nets at some point.

And yet I feel some scepticism about this somewhat drastic swerve in approach, for many reasons. First is that there are ingrained predispositions towards mental illness. Far sighted neurologists like Steven Pinker have spent years fighting the simple lie that we are an empty canvass and nothing else. His argument is to accept that to some extent we do have destiny coded into our skin and we have to deal with that as best we can. There is a fascinating recent piece by the neurocriminologist Adrian Raine about how brain development can affect a predisposition to criminal acts. The idea of predestination led us into some very scary places during the twentieth century. However the work of serious researchers like Raine can’t be as easily dismissed as quack phrenology.

A completely social model of mental illness also has little to say to people with normal backgrounds who nevertheless develop terrifying distress and chaotic lives. They can be all too casually derided as attention seekers. Nothing in my stable childhood explains the anxiety and depression I developed as an adult. Nor would a social model provide much insight into the lives of high born people I have known who went completely off the rails.

There is also kookiness in this view of life. Ladies and gentlemen, I give you Oliver James, celebrity psychologist and author of the bestselling Affluenza, which proved that mental illness was caused by godless Western materialism. Post crash, he’s still plugging that thesis, claiming again that ‘Thirty years of Thatcher and ‘Blatcher’ turned us into a nation of ‘affluenza’-stricken, shop-till-you-drop, ‘it could be you’, credit-fuelled consumer junkies.’ The lost souls in the crisis centres of working class neighbourhoods are not distinguished by an excess of designer shopping trips and cheap easy credit. James’s theories are regarding as liberal in a liberal age, but they are animated by an old conservative-religious impulse that a shot of austerity sharpens the soul.

More useful is the response from Simon Wessely of the Royal College of Psychiatrists, who writes that while the DSM isn’t perfect, it at least tries to map the territory and many service users find diagnosis the first step to recovery or at least management. (As Terry Pratchett said of Alzheimer’s, to kill the demon you first have to speak its name.) The truth is that saying ‘it’s all society’ is as reductive as saying ‘it’s all chemicals’ – surely the key is in understanding how external influences impact on whatever predispositions we might have. That’s our best shot at fighting the nightmares that may engulf all of us. This is where science becomes an art.

The Shock of the Now

I haven’t seen the new Gatsby film but from what I’m hearing it doesn’t exactly surpass the book. The writer Irvine Welsh tweeted yesterday: ‘Two hours in, I never wanted to see anything by F Scott Fitz again. Please: read book first or don’t let this movie put you off the book’ and also ‘Gatsby looks great, acting is good, but I sensed they wanted to make a ‘movie of this classic novel’ rather than actually felt the material.’ It’s not true that film can’t improve on literature – Kubrick’s version of The Shining has a better ending than the book – but when directors try to update a modern classic embarrassment generally follows. You get Baz Luhrmann doing Romeo and Juliet, and making it about drug dealers or something, and it just doesn’t work. The more I read about Luhrmann’s Gatsby film, the more it sounds like the Entourage version.

There is a condescending contemporary idea that people cannot ‘get’ classics if they are not made more ‘relevant’ to people’s lives. True, great writers were creatures of their own time and their works are littered with archaic signifiers and allusions that make little sense today. Nicholas Lezard points out that Dante’s Inferno is filled with the poet’s axe-grinding and Florentine political allegiances – ‘He loathed some people so much – those who had behaved treacherously to guests – that he couldn’t even wait for them to die.’ So good translations, contextualisations and commentary are essential. But what do you make of education curricula that encourages schoolkids to recreate World War Two using Mr Men characters? And we wonder why we are turning out generations of young adults who can’t write a job application that most people would understand.

Consider also the impact of set and setting on the plot. Many classical storylines are driven by customs and taboos that no longer exist. In her excellent essay on Fitzgerald, Sarah Churchwell explains that transported to a contemporary setting, no one would care where Jimmy Gatz’s money came from. He could be exposed as a Russian mafiosi and today’s London elite wouldn’t blink. As Churchwell says, ‘Today the illusion of Jay Gatsby would not have shattered like glass against Tom Buchanan’s ‘hard malice’: Gatsby’s money would have insulated him and guaranteed triumph – an outcome that Fitzgerald would have deplored more than anyone.’

There are of course contemporary dramas like The Wire and Breaking Bad that in their richness and moral complexity echo the ancient Greek tragedians and the great Russians. Don Draper is a Gatsby in his way. But David Simon, Matt Weiner and Vince Gilligan were trying to create something new whereas today’s liberal pedagogues and celebrity directors who rework classic art just end up patronising the audience and wasting everyone’s time. The scramble for timelessness is a fool’s game and good writers know this. I remember seeing Bret Easton Ellis, at a reading in Manchester, responding to a criticism that his novel American Psycho had become dated. Ellis said that (I paraphrase) ‘It was dated while it was being written.’ Like the political references of Dante, the long closed bars, restaurants and forgotten Manhattan topography of American Psycho didn’t make the novel any less fresh – in fact, it’s that very archaic nature of such references that makes the feel of the novel. You don’t achieve timelessness on purpose. You achieve it when you write a great story.

And the demand that everything be made ‘relevant’ always reminds me of the office bore who tells you, ‘There’s more to life than books, you know. Live in the real world.’ As if the world of books, stories and dreams were any less real than mortgages, barbecues and fucking pension plans?

(Image: Rigo Design)

We’re Going On A Bulgarian Hunt

Okay, everyone’s sick of UKIP stuff and I shouldn’t be inflicting this on you any more. But the Queen’s Speech today has got me thinking. A few days ago I speculated on the possibility of a UKIP ‘Knesset scenario’ where Farage would effectively get a rolling veto over national policy due to the real or imagined threat that his party poses to the Tory led coalition. Then: a Queen’s Speech designed for the silo nation.

The centrepiece of today was a new Immigration Bill designed to ‘ensure that this country attracts people who will contribute and deters those who will not.’ But, says the Guardian’s home affairs editor Alan Travis, ‘the Downing Street briefing on the contents of the immigration bill is very sketchy on any actual detailed measures.’ In fact, ‘There were only two specific measures mentioned by Downing Street that will be in the new immigration bill.’ There are plans to limit immigrants’ access to JSA (which was tight anyway) and residency requirements for council properties (when local connection is prioritised by most local authorities anyway, if not all). What is new here?

The thing that really made me look up was a duty on private landlords to check migration status of their tenants. It’s news to me that private landlords in this country have a duty to do anything. As Travis points out, ‘the proposal would be unworkable without a register of private landlords’ – exactly the policy, in fact, that the coalition junked within weeks of taking office. The shocking state of the cowboy private rental market was well known in 2010 and has got worse. The Tories are the landowners’ party and they didn’t want to reform private sector housing in a way which would give ripped-off tenants a voice. Now, it appears, the agenda is a big statist HMO hunt for illegal immigrants.

Travis also says that ‘a system of migrants’ residents permits or foreigners’ ID cards is needed to police such restrictions on access to public services based on the time someone has lived in Britain. That is likely to prove unpalatable for two political parties who were elected on a pledge to scrap identity cards.’ Is there anyone left in Britain who still thinks this government knows what it’s doing?

One positive aspect of the immigration debate is that for the first time we are beginning to hear the voices of immigrants. Which brings me to a marvellous piece in the HuffPo by an Indian immigrant in Britain, Balaji Ravichandran, whose article brings the fresh keen air of perspective to this tired and bitter discourse. Highlights:

I, and many others like me, are here for reasons entirely different from the economy. I am here because I wanted to be in a country where being gay is accepted, and sexual minorities are afforded equal rights as straight people. I am here because, it meant something to me when Britain protected Salman Rushdie, after he wrote The Satanic Verses, whereas India was the first country to proscribe it altogether. I am here because my talents, such as they be, were recognised first by people in this country rather than that of my birth and childhood. I am here, most importantly, due to the cultural affinities that bind me to this country and to Western Europe as a whole.

Remember that most of what you take for granted is a privilege, a luxury for the rest of the world, and even then, not everyone wants to come here and settle down permanently. Remember that the choices you make affect the lives of thousands of others like me. Most of all, ask yourself if you’d rather live in a country of cultural monotony and uniformity, or one which welcomed, among others, Handel, Henry James, Sigmund Freud, TS Eliot, Mitsuko Uchida and VS Naipaul, and have made this the most culturally exciting country in Europe.

(Image via @AdamBienkov)

How To Live Without Really Trying

Christopher Hitchens said towards the end of his autobiography that the tragedy of this life is that we have so many more desires than opportunities. Wherever we are, whatever we do, we can’t help but miss out on something. Worse than this is the possibility that life is what happens when you are waiting for life to begin. As Mariella Frostup counselled a lost young woman over the weekend: ‘You shrug off the more than 20 years that have already passed and mutter about getting to grips with things before you are 30. That will be a third of your life you’ve relegated to a practice run!’

These days I try to get as much as possible every single day. I work, write, go to cultural stuff, take long walks, go for runs, socialise and still fall into bed cursing myself for not doing enough. I’ve lived a little, sure, I’ve danced in fields and quarries, flown to Europe, drank at the Groucho. But like all of us I’ve failed to step up on more than one occasion. I had a neurosis where I kept thinking I was out of the moment even while inside the moment, and couldn’t stop looking at myself from the outside. I’ve turned down interesting propositions, slept through sunshine. I have stayed in when I should have gone out.

The compensatory ultra high-functioning workaholic approach has its problems too, I know – it’s a sure way of having a heart attack before you hit forty. There’s no time, you might not get to do everything you were curious about, you might not even get to read everything you wanted to read. A byproduct of this is that other people’s lives are even more of a mystery to me. I’m completely baffled by people who commit to jobs they dislike and spend every evening in front of the box. I’m sure these guys know something I don’t, but come on, why turn your face against the night?

Of course this is all a bit middle class and ‘first world problems’. Through most of history most people haven’t had the luxuries of this pointless contemplation. And even in this country in 2013 there is still so much suffering and struggle and darkness. So does it matter that I haven’t yet got round to reading Gibbon on the decline of Rome?

Congratulations on reaching the end of what must be the most silly and pointless blog post on here to date.

Competition Time!

There’s been some stir about this year’s Manchester Fiction Prize run by my old university. A local young author pointed out on Facebook that the entrant fee – a cool £17 – is fairly high considering the average income of a struggling writer in Manchester. Other writers piled into the thread who are students or lone parents or doing entry level jobs in the service sector. All said they couldn’t justify spending £17 on the fee. A novelist associated with the prize responded in the thread but his posts were defensive and didn’t really justify what was happening.

I think it’s fair enough for competition organisers to charge an entrant fee given the huge admin involved in such things and the amount of submissions that will come in, many of which won’t be worth reading to the end. There’s also the probability that MMU set this up with an agenda for the national stage, maybe a few lines in the Bookseller or Guardian Review. However you cannot get past the fact that MMU has effectively priced out its own students, who are already paying substantial fees to attend the university. And don’t give me that ‘£17 is just four or five pints’ bullshit. I know students in Manchester who struggle to feed themselves.

There’s also the point that other competitions – the Bridport, the Bristol Prize, the V S Pritchett – charge around half as much as MMU, and the really prestigious contests, like the BBC National Short Story Prize and the Sunday Times EFG, do not charge at all. (For that matter, no commercial agent in the UK charges people to submit to them.) It is also the case that scam artists set up worthless contests to make money from aspiring writers (for example, if you have an online contest with a £500 purse and £10 entrant fee and you get 100 entries, that’s £500 profit) and you have to be very careful about what you enter, what goes on your CV and who gets your first rights. I’ve seen transparent stuff of this nature even distributed through the MMU alumni mailing list.

MMU is a good university with a strong creative writing programme and I have entered its contest in the past. I will probably do so again – but then, I can afford it. I appreciate that only so much can be done for free but MMU is not a workers’ co-operative. It is an established HE body that gets thousands of pounds per year per student. Its initiative could be more accessible to its own students than it is at present.

This Other England: The Inevitable UKIP Post

I haven’t written about UKIP before, even though they represent currents of thought I have been writing about for years, because, well, they’ve got no MPs, no councils and represent no real chance of forming a government. A couple of things made me look up. First was this piece by George Eaton. In it Eaton summarises opinion polls: ‘The Conservatives are four points behind on 25 per cent, UKIP are on a remarkable 23 per cent and the Lib Dems are on 14 per cent’.

Whoah. Fucking hell. 23 per cent? And, like, 117 council seats?

UKIP have been around for years of course, but they used to be primarily an anti-EU party and did badly because they only appealed to a certain kind of EU nut. Now, Farage has realised that if he realigns UKIP into an anti immigration party he can appeal to a much larger proportion of nuts from across the political spectrum. UKIP’s local manifesto focuses almost entirely on immigration – despite the fact that immigration is something which local authorities can do little or nothing about. UKIP put a poster up in my old stomping ground of Levenshulme, saying ‘Stop open door EU immigration – enough’s enough.’ I support their right to free expression, UKIP should be able to advertise where it likes, but if you know the area, it’s a real slap in the face for Levenshulme’s Asians. Friends of mine from the locality petitioned ClearChannel. They were trolled on the internet and bullied by UKIP supporters. We’re not supposed to say that criticism of immigration is racist. But the BNP vote collapsed this week. Who could be taking all their support?

But UKIP are more than a far right party. Mainstream politicians have spent weeks grappling with the phenomenon. They set up focus groups of UKIP supporters to discover what exactly is peeling off mainstream support – sessions that, by all accounts, went like a junkercrat dinner party in late 1920s Berlin. The commentator Andrew Rawnsley has an anecdote that is worth thousands of words’ analysis:

One senior party strategist says he listened in some wonderment as his focus group of Ukip voters spent an entire 90-minute session wailing and gnashing their teeth about the state of Britain. Not a good word did they have to say about the country today. At the end of the session, he thanked them for their time, and said he had one more question. Was there anything about Britain that made them feel proud? There was a silence. Then one man leant forward and said: ‘The past.’ The rest of the group nodded in agreement.

Rawnsley goes on to say that ‘A Ukip vote is not mainly, if at all, about making a choice based on an assessment of policy.’ In the run up to the local elections spin doctors planted stories about the more deranged of UKIP’s candidate base. The public did not care. Mainstream politicians point out time and again that UKIP’s manifesto makes no sense. UKIP are offering free money for everyone and to clear the deficit. Any mainstream politician would be slaughtered for such unrealistic promises. The public do not care. Professional politicos need to realise that we are not dealing here with rational demands, it cannot be said enough: we are dealing with a miserable embittered shriek of self pity and unfocused rage. It’s not fair! Why doesn’t the world revolve around me? These are the questions that the nation wants answered.

Over at Telegraph Blogs, Dan Hodges writes that UKIP’s victory smashes the myth of a progressive majority in this country. He says, ‘Since 2010 Labour has moved Left, anticipating it would be inundated by people seeking sanctuary from the evils of austerity. They’re not coming. Those angered by the Coalition are knocking on Nigel Farage’s door, not Ed Miliband’s.’ In fact, there are plenty of progressives in this country. They’re just not in politics. As I’ve argued recently, British politics is not a place for reasonable people anymore. Smart progressives who want to make a difference don’t go into politics, they go into public policy or advocacy or journalism or law or the police or the Royal Marines. Because smart people are leaving politics, the field is left clear for maniacs, illiterates, thieves, neo-Nazis and toytown power merchants. This is particularly true at local level.

And it’s not true, by the way, that UKIP represent an ‘anti-politics party’. UKIP are more pro politics than anyone. They encourage huge unrealistic expectations of what politics can deliver. Vote for me and I’ll give you everything you want or need, your darkest fear, your fondest dream.

A point James Bloodworth makes is UKIP’s age profile. James points to a survey that claims UKIP’s support as 43% over 65 and just 8% from people under 35. James even says that ‘Such are the demographics of the Ukip vote that many who have supported them in this week’s local elections will actually be dead by the time the 2015 election comes around.’ Obsession with immigration, in my experience, chimes with that – it tends to be a consuming concern for people over forty. I’m not saying young people are not critical of mass immigration, but they do not obsess over it in the way of the old. Immigration is the fixation of the 1950s-1970s generation that had the world handed to them on a plate and never sacrificed anything and bankrupted the country and now have nothing to offer except self pity. ‘The world was a great place when I was young’ – that’s their battle cry. What they mean, of course, is: ‘The world was a great place because I was young.’

A significant minority of voters who hate everything about this country except the past. It’s a depressing vision – but one that we now have to confront. I used to think UKIP would tear the political right in two and the left would take advantage. That hasn’t happened. Labour’s performance in the locals was appalling compared to where they should be, while even the Cameron brand of liberal conservatism has almost completely vanished. Because the mainstream is scrambling to regain UKIP support, we could effectively be giving UKIP a rolling veto over mainstream policy. A nightmare Knesset scenario.

Government by local referenda. Will the last person to leave Britain please turn out the lights?