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Madness: a Memoir

January 18, 2016

Madness: a Memoir by Kate Richards, 2014

Is There No Place for Me? Making Sense of Madness by Kate Richards, 2014

Madness: a Memoir by Kate RichardsReading Madness: a Memoir is both pain and joy.

Like the wedding guest stopped by the Ancient Mariner, I was held by Kate Richards’ story from the beginning: “I am going to cut off my right arm.”

That attempt leads to hospitalisation and ECT. She discharges herself, takes a massive overdose, and is found just in time.

Richards is a doctor, and between episodes of psychosis, depression and mania she works, first as a medical writer and then in cancer research. She tries to present a normal façade to the world, but has to deal with the voices of the people in her head, who continually scream at her to harm or kill herself.

She is tormented by a “desperate need to atone for being alive”, and applies hydrochloric acid to her leg. At the Emergency Department, the plastics registrar refuses to perform the essential surgical debriding because, with her history of self-harm, it’s “not cost effective for the hospital.”

She often self-medicates, and becomes addicted to benzodiazepines. “Mornings before work: No Doze, Red Bull, Coffee. Then in the evening I strangle the caffeine hit with benzos and alcohol and codeine. Lurching from a minor high in the morning to a semi-coma at night, I’m distilling and then diluting the people in my head.”

Kate Richards

Kate Richards (Photo from her website)

The turning point comes when she begins seeing Winsome, a psychologist. Gradually, she learns to trust Winsome, to feel safe with her. One of the most powerful scenes in the book is where she tells Winsome about the people in her head – the first time she has told anyone. Another critical point is reached when, with Winsome’s support, she actually owns all the knowledge she has about her illness.

There are many more steps on her way to recovery, to the point where she is participating with her GP and Psychiatrist in the management of her illness. Together, Richards and Winsome draw up a relapse signature – a list of early warning signs.

What makes this story of mental pain such a joy to read? Firstly, the quality of her prose – she writes beautiful sentences that convey insights in a few words: “Mania is initially as seductive as a snort of coke, a first orgasm, a religious epiphany. The world fizzes. And the illness progresses.”

Secondly, she is honest and open, exposing her inner life, her real self, to the reader – something that, for so long, she never showed to her friends, family or health professionals. The reader is taken into her thoughts and feelings, and so engages with her personality, laughs at her dark humour, and admires her courage. I felt I was there with her, in every moment, and had to keep reading to find out what happened next.

Central to this connection is the immediacy of her descriptions. During the course of her illness, she tries to make sense of things by writing notes in the notebooks that she always carries. “Writing tracks across the pages like trails of ants in search of food.” These notes became the basis for the book. The result is the closest a reader without mental illness can get to a sense of what it feels like.

Is There No Place for Me? by Kate RichardsRichards is also the author of Is There No Place for Me? Making Sense of Madness, a Penguin Special. She applies her impressive story-telling skills to vignettes of four people with mental illness, explaining the treatment and support they need, and showing how those needs are not met by our current system. “We don’t wait until an infection spreads through the bloodstream and becomes life-threatening septicaemia before admitting a person with cellulitis,” she writes. “Why do we wait until the situation becomes life-threatening before admitting a person with a mental illness?”

Both books are highly recommended.

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