Memoir and Mental Illness: Madness in Paula Keogh's 'The Green Bell'
Tegan Edwards
By their very nature, memoirs are intrinsically personal and subjective. The Green Bell covers a lot of ground and makes complex connections between a range of disparate topics, and in doing so embraces this aspect of the genre’s format with subversive effect. This is most poignant in its rendering of the language of mental illness. Unable to ignore her own schizophrenia, Paula Keogh meditates more generally on the conceptual and linguistic parameters of psychological suffering. Fundamental questions about mental illness lie at the core of this memoir. How do we talk about mental illness? How can we represent or define it? What has caused the gulf between a sufferer’s self-articulation of it versus the prescriptive typecasting of others? Can such a harmful chasm be bridged?
Content Warning
The book that is discussed below has references to: mental illness, suicidal ideation, schizophrenia, psychosis, electroconvulsive therapy, drug use, addiction, and death. War and state-sanctioned violence are also mentioned (but not described)
Keogh is alienated from a world not built for the dark and sometimes hallucinatory meanderings of her mind, and she can only answer these questions by describing how difficult it is to speak about them. She does this through the exploration of a human, rather than clinical, madness. Striking and perceptive, this view of mental illness counters a tradition of writing which, since the nineteenth century at least, has been riddled with subhumanist tropes of insanity, hysterical behaviour, and disordered lunacy. Such stereotyping served as a mechanism of control and oppression that bolstered the social acceptance of asylums and institutionalisation instead of treatment for mental illness.✢ Sensationalised and often gendered, these depictions are deeply tied to theories of morality, respectability, and eugenicist perceptions of disability as undesirable and burdensome. Within this historical tradition, women especially were labelled mad but never given the chance to speak of their own supposed insanity.✢ Keogh’s memoir rejects this silencing and the achievement is momentous. Mad, not schizophrenic, is what describes her and her experience. This is the foundation of the book and it has profound existential consequences. Madness is a fundamental way that humans have understood themselves for time immemorial and has given those outside society’s norms a framework in which to understand themselves in their difference.
Schizophrenic, I belong to science; mad, I belong to the human race.
– paula keogh, 'the green bell'
page 68
As Keogh depicts it, madness encompasses the many iterations and manifestations of mental illness, and it’s damn compelling in its complexity and intensity. For women, for those who suffer mental illness, and for artists; for us all, if we are to be kinder and more compassionate moving forward. The singular narrative of madness is not nullified by being placed within this wider tradition, but instead—this one story, of one woman’s life—chips away at the veneer of mental health rhetoric by describing her schizophrenia in unapologetically fragmented and poetic terms. It comes closer to the truth of a group of illnesses that are still misunderstood but only grow in prevalence, a burden on so many people’s lives all the more heavy for being mysterious and obscure.
In the very first pages the toll of incommunicability is signalled. Struggling to describe an affliction that is so foreign but such an inherent part of being mentally ill, Keogh portrays the way in which perceptions of mental illness amplify a dehumanisation that is violently lonely. When self-articulation or representation is nullified, an intrinsic part of the narrative of the self and one's own humanity is denied. Unable to communicate the pervasiveness and potency of illness, forging an understanding of one’s own identity is obstructed. Parts of the person must, necessarily, be kept hidden from view. Keogh describes her own mental illness in human, rather than medical or diagnostic, terms to emphasise this: “My world is inaccessible,” she writes, “It has lost the language of the everyday” (5). “I can’t speak to others of the noise inside my head” (4). She is dispossessed of an understanding of herself in relation to the world; unable to voice it or to give it a voice, she is denied the much needed human connection that could potentially ease the severity of psychological distress. Perpetually seeking recognition—to be seen or understood by a shared experience and humanity—there is an invisible barrier that alienates those who suffer mental illness. What is happening and what is being inflicted upon them is made void, as if not real because it cannot be described. This lack of language around something so debilitating, isolating, and often deadly, severs one even more from others and the world: “There are no words to say what my life is like”, Keogh writes, “The safety net of language has holes in it, and I’ve fallen through” (18). Stripped of interaction outside of yourself, beyond yourself, and the ability to narrativise what is happening to you—or, indeed, who you are—you no longer feel connected to society or people. The internal and the external domains of oneself become war lords waging a campaign against one another and you are left in the dark, lonely purgatory of no woman’s land. A place that is so often impenetrable. This is especially so for any artist, whose driving impetus is to make something representative, something symbolic—a signification beyond the everyday, beyond themselves. By placing language at the centre of mental illness, what it means to be human, and moreover, how this changes when you are mentally ill, is given a space otherwise closed off. It realigns to focus on the words we use and how we use them when we talk about diseases of the mind. Even for the “crazy”—or perhaps more so—language and humanity are indivisible. It ties the self to the other, the individual to the social, and implicitly demands dignity and accountability to the one who is sick; the one who suffers under the burden of illness but who is no less valid or valuable as a person. For Keogh this disconnect draws her to art and to the poetic—to potentially powerful alternative modes of understanding and uses of language.
The Green Bell’s vernacular is poetic and lyrical, and it supplants pathology with philosophy. It remoulds words, drawing them out from underneath the clinical umbrella of mental illness to focus on the loss and loneliness of the individual. Fragmented by the dispossession of language, mental illness engenders an existential instability that is particularly oppressive because it comes from within. Through self-criticism and doubt, mental illness would have you believe that the inadequacy is a reflection not of society but of you yourself. Your mind, your thoughts, your failure. “How are you?,” Keogh writes, “is complicated… It’s me that’s not right. Not my kidneys or my tonsils. My self” (5).
I’m just…a disease that has to be eliminated. As a person, I’m ignored… and when I try to understand what’s happening to me from within my strange and estranged reality, I’m silenced.
page 41
Diagnosis and the “recovery” process often reinforce this: “The psychiatrist says that the treatment will silence the noise in my head but, instead, it silences me” (21). A self-determined narrative, one’s own story of themselves and the ways it is presented to others, is not granted to the mad-person. Misunderstandings and preconceived ideas so insidiously permeate diagnosis and treatment that they are told what their story is. They are stripped of self-narration and they are told they don’t have the right to tell their own story or have control over their own identity. They must endlessly grasp for, but never possess, who they are and how they are defined. Their words are neutralised and can exist only outside the plane of perceived normalcy, becoming “a form of treachery…with no possibility of self-determination” (139). Beyond the reach of everyday language, the articulations of the mad are severed from the speaker and reduced to a symptom of their disease. Their words are made impotent by the diagnostic frameworks used to pathologise or invalidate them. If one claims to be mentally ill, they are maligned for exaggeration or hypochondria, but if one claims to be stable—to be un-mad—they do not know themselves or are attempting deception so they are not to be believed. According to this logic, the mad do not know themselves, they never can. And they are not allowed to speak for themselves to begin the process of discovery. Subtly but nefariously, they are implicated in their own silence—they are made to feel it is their own fault, that there is something inherently wrong with them, and that they have no claim to themselves. If “identity is, above all else, a pattern that enables you to have coherent responses to other people and the world around you” (136), as Keogh posits, then their identity does not belong to them because the right to words—to self-representation and autonomy of language—are never granted to them. Ostracised, they are forced to embrace the liminality of madness and make a language of their own in the face of silence.
Silence, especially the silencing of others, can be a tactic of wilful misunderstanding weaponised by a fear of difference. When the mad-person refuses to be silent through a language of their own, it opens unknown planes of comprehension. These modes of articulation, forms of expression, and ways of perceiving pose a threat to the comfortable constructions of the supposedly non-mad to reinforce their normalcy. It, and they, are suspicious and alien because they embody an unknown. While the known is stable, safe, rational, and objective in its comprehension, “madness,” as Keogh laments, “is anti-story, anti-chronology, anti-plot, anti-character” (55). It ruptures rhetorical stability and breaks language, making stories that are alternative and sometimes strange. But breaking does not mean broken. The force generated by this breaking can create a momentum with the potential to belie the compulsion to control the unknown. Embodying this heavy contradiction—forced to exist liminally and amorphously—the mad both suffer and triumph when they invoke language. It is a poetic manoeuvre that brings together the transcendence of artistic aestheticism and the bleak emotionality of the mind. It both defies and redefines reality.
Keogh not only describes this duality beautifully but, for her, this struggle does not result in defeat. She begins by describing what is akin to a process of removing shards of glass from herself. There is no flinching from the palpable trauma inflicted by these wounds—the blood, infection, and disfiguration are all devastatingly evident in her portrayal of the poor psychiatric treatment and irresponsible use of ECT she experienced: “I tell them,” she says, “I’ve been raped. Mind rape. But they don’t want to know” (18). But this is not the end of her story. She reclaims, redefines, and reemerges. This is the triumph of the memoir. The stability of knowledge, the sanctity of control, and the veneration of the normal are de-pedestaled in favour of the poetic; in favour of that which circuitously communicates a truth by not pinning it down with restrictive explication. Perhaps this is the only way mental illness can be discussed—in fragments—within the parameters of the poetic, the expansive rather than the specific. Like music and poetry, madness cannot be contained, it cannot be designated or encapsulated in objective or certain terms.
The mentally ill are shatteringly human—beautiful and complex, incongruous and wonderful, intelligent and defiant. What Keogh’s memoir ultimately achieves is the proclamation she gives herself:
I must find the words I need to speak the fragments of my life together… Madness doesn’t have a true language: it has bitterness and fear and confusion. It kills living words, cuts them off at their roots. I am mute in its presence, but somehow I must learn to talk back to the madness.
page 141
This talking back to madness, the reclamation of voice that lies at the centre of the book, implodes the barriers erected by the fallacies of mental illness, as well as the fundamental misunderstandings and pervasive stereotypes that isolate and alienate people who suffered under it. It finds a footing in unstable ground and refuses to give power to the fear of the uncertain because it knows that humans, like the lives they pursue, can never be completely controlled. It is in these fragments of incommunicability that madness is reoriented—counterintuitively—to say something. Essential to this is the book’s reclamation of the label mad. If mental illness relegates one to a state of silence, madness defies this. Madness does not have to be antithetical to society, to relationships, to survival, and ultimately, hopefully, to thriving. There is a revelatory moment between Keogh and another woman, Kate, who is in the same ward of the psychiatric hospital but who appears only momentarily in the book. It is this moment in which Keogh pinpoints beginning to rethink the word mad. In a brief flash of tactlessness (however much founded in an appeal to optimism) she mentions that they are only momentarily unwell and that things will get better. But Kate quickly and definitively replies: “Unwell! I’m not unwell. I’m mad” (67). It is memorable for its force of clarity, for its unflinching candour, and for the recognition latent within it. Keogh remembers the impact of this statement distinctly, over 40 years later: “Kate isn’t afraid to say she’s mad. She’s defiant and forthright. Not ashamed, not humiliated. She doesn’t hide herself away, or pretend everything’s fine” (67).
Seeing at least a part of herself mirrored back at her, Keogh’s identity, her illness, and her concept of self become a little bit more her own and she is able to begin articulating her experience in her own terms. For all the indignities and inhumanities that have occurred, madness is the label Keogh can identify with and comes somewhere close to describing her experience within the colossal pool of mental illness. Madness, The Green Bell whispers suggestively, can be a self-attributed identifier that empowers us to reclaim the means of stolen articulation. We are mad because we say we are.
Facing madness each day, we intimately know what uncertainty, instability, and chaos are. We know the way out, not in spite of the fact that this reprieve is brief, fragmentary, and often contradictory, but because it is. This rendering of mental illness is sorely needed, now just as much as the uncertain times Keogh is writing about. In madness, the inextricability of language to all things mental illness becomes palpable and returns a humanity to the mad-person who, in actuality, had never lost it to begin with.
Footnotes
1. Wikipedia, 'Lunatic Asylum: Institutionalisation' - accessed June 2020
2. University of Warwick, 'The Female Malady? Madness and Gender' - accessed June 2020
Further Reading
Asylums and Ableism:
Stefanie Kaufman, 'No, we don't not want to bring back asylums (but we never 'really' got rid of them)' (2018). Project LETS - accessed June 2020
Kris Nelson, '3 Ways Popular Horror Movie Tropes Are Ableist' (2015). Everyday Feminism - accessed June 2020
Psychiatry and Social Control:
Maria Popova, 'Asylum: Inside the Haunting World of 19th-Century Mental Hospitals' (2011). Brain Pickings - accessed June 2020
Re:think, 'How Victorian Women Were Oppressed Through the Use of Psychiatry' (2017). The Atlantic - accessed June 2020