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One morning six years ago, Horatio Clare got out of bed and looked at the winter sunrise through a locked window. “You are,” he said aloud, “in a mental hospital under Section Two of the Mental Health Act.” A few days earlier, police had delivered Clare to this psychiatric facility in Yorkshire for his own good. “I was fully, psychotically delusional,” he recalls, “believing I was helping the security service and aliens to bring about world peace, and engaged to Kylie Minogue.”
Clare was suffering from cyclothymia (a type of bipolar disorder), seasonal affective disorder, alcohol issues, self-loathing and a relationship failing because he’d cheated on his partner. He’d also experienced a psychotic episode prompted by sleep deprivation and powerful weed. But, in the words of anti-psychiatrist RD Laing, remarkably not cited here given that they express so well Clare’s book philosophy: “Madness need not be all breakdown. It may also be break-through.”
And so it was for Clare. Being away from family and relationship commitments was, he writes, “a boon, and relief”. Indeed, the utopian Clare imagines a good future in which mental hospitals will become known as retreats, to which each of us might retire for a bit from this world’s greater madness.
His book is an overwhelmingly kind-natured and inspiring self-help manual. The tone – unerringly hopeful, sometimes Pollyannish – is captured by the blurb: “If you or a loved one are in a tough mental place, hang in there. Things can and will get better. This book shows how, and Horatio has written it for you.”
And yet it could be read profitably by anyone: very few of us will quit this mortal coil without suffering anxiety, depression, insomnia, suicidal thoughts or eating disorders, nor – to get political for a moment – without being spiritually crushed by late capitalism. To put it another way, if you’ve never been mad in this mad society, there is something really wrong with you.
That said, Clare’s experiences may not be entirely relatable. He’s called Horatio for a start. He’s a middle-class white journalist who teaches writing at university, has presented a Radio 4 series called Is Psychiatry Working? and has written 15 books. One of them, 2021’s Heavy Light: A Journey Through Madness, Mania and Healing, included details of Clare’s experience of breakdown, some of which are recycled here. Very few of us would dare, still less get commissioned, to write about hitting rock bottom once; Clare, astutely if uncynically, has managed it twice.
He is aware of his entitlement, writing: “Privilege is the reason I am able to own my own variety of madness… I am often cash poor but in freedom and self-determination I am fundamentally rich.” The point of this book is to instil the self-determination he had into others struggling like him. What gives the book power and energy is that it is written out of outrage at the “disastrous way we misunderstand and mistreat people who suffer from mental ill health”. He yearns to help others to find a third way – between madness and lifelong medication.
To that end, he interviews many mental health professionals, each of whom in their various ways are writhing in the straitjacket of a mental health care system that does its users too little good. Mike Slade, professor of mental health recovery and social inclusion at Nottingham University, tells Clare that the current system is riven with “toxic assumptions” that often involve telling people at their most difficult moments that “everything is hopeless, and [they] should abandon [their] life ambitions and accept [an] identity as a ‘mental health service user’ and live with the stigma and discrimination that entails”.
Clare’s book is a two-fingered salute to what Slade calls that “bullshit narrative”. He often writes like a Martin Lewis of mental health, a consumer champion giving tips on how to game a system that only a fool would have consciously devised; one replete with obscenely lengthy waiting lists and over-stigmatising diagnoses and which, at worst, offloads anti-psychotic meds long term to make the mad supine.
But this is no individualist’s charter; rather Clare’s third way stresses the need to engage with other people as part of recovery. He’s very taken with something called Chime, a system of recovery established by Mike Slade and others. Chime stands for Connection, Hope, Identity, Meaning and Empowerment, and is now, Clare claims, “the most widely used system internationally to understand and operationalise what recovery means”. It’s not anti-psychiatry but it’s certainly anti-doom.
What Chime amounts to was incarnated best for me in the book’s sweetest passage. One rainy winter’s morning, Clare looked out of another Yorkshire window. Hunched neighbours passed by defeated by the season. And then he saw an indomitable woman picking up litter, finding meaning and connection in the most humble yet worthwhile of tasks. She chimed with Clare and with me too: a little altruistic life-affirming sanity in a world gone nuts.
English (US) ·