Mental illness often goes misunderstood, stigmatised or overlooked. Words like ‘depression’, ‘schizophrenia’ and ‘psychosis’ carry weight but also bring a sense of foreignness for many. The lived experience of those who suffer with these illnesses commonly remains hidden behind stereotypes and misconceptions. Madness: Stories of Uncertainty and Hope, recently published in 2020, navigates these issues as it communicates a psychiatrist’s recollection of patients from psychiatric wards. Each chapter is accompanied by provocative illustrations drawn by the artist Fiona Moodie that complements the expression and mysterious character of the book. Simply put, this book’s contents are deeply memorable.
The author, Sean Baumann, worked as psychiatrist for twenty-five years at the public hospital, Valkenberg, in Cape Town – alongside having taught at the University of Cape Town’s Department of Psychiatry as a senior lecturer. As one may anticipate, the setting of Valkenberg provides insight into mental illness and health services amongst disadvantaged communities and diverse cultures in the post-apartheid era. Baumann does not shy away from history. Cape Town’s historical background of settler colonialism and apartheid are discussed extensively in relation to otherness that is entrenched in the spatiality of the city.
This piece of beautifully crafted non-fiction covers the conceptual field of mental illness, how it has come to be defined socially and scientifically, as well as covering personal ground by telling the stories of his patients with acute empathy. On a conceptual level, the book offers engagement with uncertainty as a phenomenon that pervades all disciplines, including science and the murkiness of diagnosis. In doing so, Baumann proposes an alternative to stereotypical binaries of mind against body and biology versus psychology. What Baumann ultimately addresses is the limits of knowledge and the challenge of working with ambiguity, a topic that provokes critical reflection.
The psychiatrist’s recollections of patients suffering from depression, schizophrenia, bipolar and psychosis are touching, heart-breaking and, at times, frightening. Alarming descriptions of hallucinations alongside the traumatic accounts of how illness has impacted families are addressed with nuanced understanding. As the title suggests, the book is also one of hope: it acts as proof of perseverance through adversity, illustrates the value of meaningful friendships, and consistently places emphasis on the possibility of healing.
Each page asks you to keep reading as the author converses in a welcoming tone. Non-Western cultural experiences of mental illness are discussed with sensitivity and respect as is the case with explanations of witchcraft, and instances where individuals hear ancestral voices. In addition, there is the proposal of a more inclusive, transformative perspective: namely the integration of cultural knowledge, such as that of traditional healers, and its ability to work productively alongside Western psychiatric frameworks.
On a social and societal level shame, alienation and exclusion are addressed to work against harmful stereotypes portrayed in the media that associate mental illness with violence (think about the not-so-distant DC production Joker starring Joaquin Phoenix, and not to mention several Netflix series). The social environment of Cape Town raises complex social issues such as gangsterism and drugs which are never blamed as sole causes. Rather, mental health conditions are understood with an awareness of South Africa’s structural violence of dispossession and impoverishment.
For readers looking to immerse themselves in psychiatry or simply to gain a more empathetic, holistic understanding of mental illness, this is a must-read. The book is available at most libraries as well as various online stores such as Takealot, Loot, Amazon.