For each of the 12 days of Christmas, here鈥檚 something to beguile, distract 鈥� and leave you with questions for the year ahead
We celebrate the achievements of physicians and researchers at the cutting edge of medicine, but the patients whose lives are central to such advances mostly pass unknown.
Advertisement
One striking exception is the 19th-century German judge, Daniel Paul Schreber, one of modern psychiatry鈥檚 most fascinating case studies. His remarkable life has inspired film and nonfiction treatments, and is now explored in , a haunting new novel by Alex Pheby.
Schreber had what we today call paranoid schizophrenia, labelled in the late 19th century as 鈥渄ementia praecox鈥�. He was institutionalised three times, and his case is inextricably linked to the early history of both psychoanalysis and modern psychiatric medicine. His sister Anna married Carl Jung, and Sigmund Freud made extensive use of Schreber鈥檚 published accounts of his delusions as he developed his analytic theories.
Yet Sonnenstein asylum, where Schreber spent his final years, was by that time moving backwards from its progressive treatment of mental illness. By the time of Schreber鈥檚 death there in 1911, this once-groundbreaking 鈥渢herapeutic asylum鈥� had regressed to a dumping ground for the incurable. Schreber鈥檚 life ended in almost medieval conditions of confinement and semi-starvation. It was his strange fate to occupy the juncture between progressive and retrograde understandings of mental illness.
Soulless automata
And what an astonishing form Schreber鈥檚 illness took. The retired judge believed himself to be a 鈥減laything of the Lower God鈥�, and that the world around him had no substantial reality. To him, people were: 鈥淧uppets, soulless automata, clicking and whirring and chirruping to each other on a flat street of false houses and dust blown by the perishing wind.鈥�
What drew Freud to Schreber鈥檚 story were his sexual obsessions, for the judge believed himself desired by God. 鈥淚n my belly is an octopus,鈥� he tells his doctors, 鈥渁nd in it are God鈥檚 children. Living children. There are things I must not think of.鈥�
鈥淭hings that must not be thought of鈥� are, of course, the very things we should give ourselves permission to think about. Pheby has been thinking about them for some time. He has written about mental illness before, in his 2009 debut Grace, whose protagonist escapes from a secure psychiatric hospital.
But in Playthings, he doesn鈥檛 merely narrate Schreber鈥檚 illness. He invites us to inhabit it 鈥� using writing that is both precise and beautiful. His disjointed prose conveys disordered thinking. Readers are fully immersed in paranoid psychosis, yet unlike Schreber, remain in full possession of their faculties.
It鈥檚 an experience that remains with you long after the last page has been turned and the door to Schreber鈥檚 asylum cell has swung open. Conjuring his delusions so acutely reminds us how far, despite neuroscience鈥檚 best efforts, we are from understanding the interior state.
Image credit: Mike Kemp/In Pictures/Corbis artist: Robert Indiana
