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Features'...actually, you're too mad...'

‘…actually, you’re too mad…’

Best selling author Horatio Clare has written a book about his journey through madness, mania and eventual healing. He talked to Fergus Byrne in advance of his appearance at Bridport Literary Festival in November.

At Manchester airport, waiting to board a flight to Innsbruck, Horatio Clare begins to notice subtle gestures amongst fellow passengers. Concealed interactions slowly become part of a growing conspiracy. Suddenly, with a thump in his heart he realises he is involved, he is part of some ‘great and secret scheme’. When he and his family reach their hotel in the mountain village of Campitello De Fassa, guests include members of the British Special Forces, Italian Intelligence Services and Russian agents. Before long he believes that amongst the black pine trees and around the snow-covered mountain crags, elite soldiers are training—awaiting orders. He decides it will take time and patience for him to discover his role in this fast-developing international operation, but he knows he has to play a leading part.

Describing the early stages of a developing hypomania in his extraordinary book, Heavy Light, Horatio remembers how his room in the Italian Alps became a ‘relentless theatre’. On his balcony, he was being watched by dozens of unseen observers; television programmes and internet browsing contained messages that only he could decipher and he became consumed with the idea that the well-publicized drone sightings at Gatwick airport that same week were craft of a superior technology. In the grand scheme of things, he decided, the drone story was simply a cover-up.

The first chapters of Heavy Light bring the reader on a wild ride through the early stages of increasingly erratic delusional episodes, right through to the frightening conclusion that he has had a complete mental breakdown. In an initial assessment sometime before eventually being sectioned, Horatio explains that he has had two crises earlier in his life; one in 2008 and one in 2016. He says both involved ‘stress, heat, exhaustion and cannabis’. He has experience of dealing with mental health services and knows not to present with either special powers; thoughts of killing himself or admittance to hearing voices. ‘If you can make a persuasive or at least coherent case that you are well, it is easy to slip between the different services’ he writes. Many can hide behind a bit of eccentricity.

‘I am not really able to process or even really hear information which does not concur with my delusions’

However for Horatio the episodes become one ‘chaotic, cyclonic poem’. Back home from the Alps and too frightening and unstable to stay with his partner Rebecca and his five-year-old son, he retreats to a flat in town where he hacks a hole in the back of a cupboard with a knife believing it’s a trap door to a secret passage, and dangerously fiddles with gas and electricity supplies. He becomes a harassing nightmare turning up at Rebecca’s house at all hours wanting to see his son. Rebecca’s memories help fill in the gaps in the story for Heavy Light. He posts insane rants on Facebook; races around the valleys near his home; patrols the moors and even attempts to drive into a lake believing he is being instructed to do so by voices on the car radio. ‘I am not really able to process or even really hear information which does not concur with my delusions’ he writes. Throughout the whole episode, he remembers the police, often helpless to intervene, becoming heroes. Afterward, he discovers that a huge proportion of their time is spent dealing with people in mental distress.

After being sectioned, another nightmare begins. Horatio discovers that the only way out of the hospital is through a pill bottle. Dr. X, the name he gives to the psychiatrist handling his case, offers him a choice of three pills. By giving Horatio the choice of which medication to take, responsibility for any subsequent bad reaction is passed onto the patient. ‘Whatever the pills do to me will be the consequence of my choice, except there is no choice’ he writes. He can refuse medication but if he is not engaging with treatment he will not be allowed to leave. He sings Happy Birthday down the phone to his son before going to bed where a torch is shone on his face every hour to make sure he is OK. He likens it to torture through sleep deprivation.

Heavy Light is a gripping, illuminating, and at times horrifying description of one person’s journey through a serious mental health crisis. Horatio calls it a ‘personal journey through society, psychiatry and psychotherapy’. Through the book, he seeks a greater understanding of a widespread crisis ‘which shame and fear have tended to conceal.’

Today, back home in Wales and rebuilding his life, Horatio is now appearing at Literary Festivals such as the upcoming BridLit and promoting Heavy Light in the same way he did for many of his previous best-selling books. He has occasionally said that he is glad he had a breakdown. On the telephone from St David’s he explained why: ‘I got into a rhythm of destructive behavior, both to myself and others’ he says. ‘So I used to enjoy the destruction of the rising high and then wallow in the depression and self-hatred—which is another form of narcissism, certainly the way I did it—of the down. And I think in a way that I probably would have been able to carry that on because the person that it makes you inside becomes someone not worthy of protection.’ He says the good thing about being sectioned is that it is unambiguous. ‘Society has said, actually, you’re too mad to be continuing.’ He says that although people say depression and mental health are not like a broken leg, for him at least, it was more like a broken neck. ‘Afterwards, I had to spend the two years since being quite humble in the face of reality. You have to be because you can’t talk you’re way out of it anymore and there’s no ambiguity. So I’m glad those things have happened because of the effect those things had on my family and the conversations we have had since the book came out.’ Today, he tells me, he and Rebecca have come to a different arrangement and says ‘my son’s parents are now happy and deeply fond of each other.’

Despite the unambiguity of time spent in a mental health institution and the trials of learning about and highlighting how episodes of mental distress are dealt with in this country, Horatio has shown enormous bravery and tenacity by putting his own life in the spotlight. I asked him how he coped with the label that inevitably comes with publicly promoting such an episode of enormous instability. ‘You have to own the label’ he says. ‘I don’t identify as someone who is bipolar and in remission, but rather as somebody who had a breakdown. Yes, I did think “am I going to be the writer where people think, yea he’s the guy who went nuts and got sectioned” and before the book came out that was a real fear. Those first interviews I did were really nervy and the photographs that lots of papers and magazines took, you can see the deep uncertainty, and yet the reaction has been astounding and incredibly heartening.’

He cited an appearance on Start the Week with Ahmed Hankir who he says identifies as bipolar in permanent remission and never took the psychotropic drugs. ‘It was really inspiring because he’s a front line psychiatrist and you suddenly realise that these models are written, and descriptive models drawn up by people who may have had many skills, but close observation and writing wasn’t one of them. So we suffer individually and yet the model treats us in category, and the results I think are disastrous. We’ve barely made any progress in a century. And yet we’ve spent billions and people have bravely, every day continued to take pills that are not without side effect and are not without harm. And they do it often for their loved ones and for authority and sometimes for their anxiety. …. all the evidence suggests that the model is shot.’

‘So we suffer individually and yet the model treats us in category, and the results I think are disastrous.’

In Heavy Light Horatio highlights less potentially destructive therapies and says he respects the good intention of psychiatrist practice. However, he says ‘In terms of the ones I met only one of them was practicing the kind of new model preaching which is de-prescription and social prescribing. And the others, certainly the two who treated me, might have well been pill dispensing machines. I mean Dr. X in the mental hospital tried, but he only had one model which was lifetime medication. Lithium destroys your liver, so it’s a proper curse I think. Yet people are told there’s no option really.’ He says that everyone is rightly very careful and respectful of those people who are taking them and those people who are prescribing them, for the best reasons. But he believes that Big Pharma ‘really does have a culpable role in the story because they’ve even withdrawn effective drugs that are no longer profitable, and a psychiatrist told me that. They don’t do third-generation research, they basically try and milk the models they have and they are incredibly successful at it.’ He bemoans the fact that the pandemic stalled the de-prescribing movement. ‘What we know is that people taking pills and coming on and off them are more likely to need re-admission and also bed nights in a hospital than those people who, for example, are fortunate enough to be treated through open dialogue. I think, without holding any group to blame, we have evolved a scandalous and inefficient system that does great harm while meaning to do great good.’

The current increase in mental health issues because of the pandemic makes Horatio’s story even more vital and crucial. Whether through fear of the consequences of illness or the insecurity brought on by lockdown, society’s battle for over a year and a half has been with a virus. However, the virus’s effect has also caused an enormous amount of mental anxiety, instability, and uncertainty. A disease that causes a very physical illness has also produced a sizable element of obsession, distrust, and fear. The inevitable question of, “what’s really going on”, leads to growing uncertainty and in extreme cases, delusion. Writing in the New York Times in November last year the philosopher Yuval Noah Harari pointed to the fact that there are those who believe “the world is secretly ruled by Freemasons, witches or Satanists; others think it’s aliens, reptilian lizard people or sundry other cliques.” He pointed out that theories such as these offer solutions; they offer a single, straightforward explanation when everything in life seems out of control. They also offer comfort in knowing that everything is being dealt with, as well as a platform to make people feel they have a piece of superior knowledge. I asked Horatio at what point do these manifestations become mental health issues, ones that would attract intervention. ‘The answer that the social services who section people would give is that, if it’s in character for you, if that’s the sort of person you are and you’re not threatening yourself or anyone else, then you’re free to believe what you want. It’s the moment that it becomes out of character and extreme and threatening that it’s, rightly I think, treated as illness and a deviation as it were, from what is safe.’ However, he says, there is ‘the question of how you define that from evolution under pressure, changes that might not have come if we’d been able to keep our own rhythm’.

Intervention on the scale that Horatio Clare experienced is chilling and the treatment he endured is nothing short of intimidating. He described the process of producing Heavy Light as two parts of a three-part structure, where the third part couldn’t be written until ‘we’d all come to terms with the sort of clarity and the discussions that writing and publishing brought’.

In this case the process has helped resolve a crisis, but the outcome was more despite treatment rather than because of it. In a world currently struggling to treat people face to face, his story leaves plenty of reason for concern about how others will cope and also about how we define what constitutes a need for intervention.

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