OSix years ago, Horatio Clare got out of bed one morning and watched the winter sunrise through a closed window. “You are,” he said aloud, “in a psychiatric hospital under Section Two of the Mental Health Act.” A few days earlier, the police had taken Clare to this psychiatric facility in Yorkshire for his own good. “I had a psychotic delusion,” he recalls, “believing I was helping the Security Service and aliens bring about world peace, and I was engaged to Kylie Minogue.”
Clare suffered from cyclothymia (a type of bipolar disorder), seasonal affective disorder, alcohol problems, self-loathing and a failed relationship due to cheating on his partner. He had also experienced a psychotic episode, prompted by sleep deprivation and high-potency marijuana. But, in the words of anti-psychiatrist RD Laing, which are surprisingly not quoted here because they capture Clare’s book philosophy so well: “Madness need not be just a breakdown. It can also be a breakthrough.”
And so it was for Clare. Being away from family and relationship obligations was, he writes, “a blessing and a relief.” The utopian Clare imagines a good future in which mental hospitals will become known as retreats, where each of us can retreat for a while from the greater madness of this world.
His book is an overwhelmingly friendly and inspiring self-help book. The tone – unfailingly hopeful, sometimes Polyannis – is captured by the tagline: “If you or a loved one is in a tough place mentally, hang in there. Things can and will get better. This book shows you how, and Horatio wrote it for you.’
And yet it could be read profitably by anyone: very few of us will leave this mortal coil without suffering from 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 angry in this crazy society, there is something Real wrong with you.
That said, Clare’s experiences may not be entirely relatable. For starters, his name is Horatio. He is a white, middle-class journalist who teaches writing at university and has presented a Radio 4 series called Does psychiatry work? and has written 15 books. One of them, the one from 2021 Heavy Light: A Journey Through Madness, Mania, and Healingincluding details of Clare’s experience of bad luck, some of which is recycled here. Very few of us would dare, much less be commissioned, to ever write about hitting rock bottom; Clare has succeeded twice, in an astute but also uncynical way.
Aware of what he is entitled to, he writes: “Privilege is the reason I can possess my own brand of madness… I am often poor in money, but in freedom and self-determination I am fundamentally rich.” The purpose of this book is to instill the self-determination he had in others who struggle like him. What gives the book strength and energy is that it was written out of outrage at the “disastrous way in which we misunderstand and abuse people suffering from mental illness.” He longs to help others find a third way – between madness and lifelong medication.
To this end, he interviews many mental health professionals, each in their own way squirming in the straitjacket of a mental health care system that does not do enough good for its users. Mike Slade, professor of mental health recovery and social inclusion at the University of Nottingham, tells Clare that the current system is riddled with “toxic assumptions”, with people often being told at the most difficult moments that “everything is hopeless and that (they ) have to give this up. (their) life ambitions and accepting (an) identity as a ‘mental health care user’ and living with the stigma and discrimination that entails”.
Clare’s book is a two-finger salute to what Slade calls that “nonsense story.” He often writes like a Martin Lewis of mental health, a consumer champion offering tips on how to game a system that only a fool would have consciously devised; one full of obscenely long waiting lists and overly stigmatizing diagnoses and which, at worst, eliminates antipsychotic medications in the long term to keep the fool on his back.
But this is not an individualist’s charter; Rather, Clare’s third way emphasizes the need to interact with other people as part of recovery. He’s really taken with something called Chime, a recovery system set up 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 for understanding and operationalizing what recovery means”. It’s not anti-psychiatry, but it’s certainly anti-doom.
What Chime boils down to was best expressed for me in the most beautiful passage of the book. On a rainy winter morning, Clare looked out of another window in Yorkshire. Bent neighbors passed by, defeated by the season. And then he saw an indomitable woman picking up trash and finding meaning and connection in the most humble yet valuable tasks. She agreed with Clare and with me too: a bit of altruistic, life-affirming sanity in a world gone mad.