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Review by James du Cann of Bryony Gordon’s ‘Mad Girl: A Happy Life With a Mixed-Up Mind’ (Headline 2016)

Published in the Summer 2016 edition of the British Psychoanalytic Council’s ‘New Associations’ magazine


Aficionados of television comedy may recall a sketch from the BBC’s A Bit of Fry and Laurie in which Stephen Fry, dressed up as a lady of a certain age, addresses the camera as if replying to an unseen pavement interviewer. Fry interrupts his own sentence with the words: ‘Oh Christ, I’ve left the iron on!’, before scuttling off screen to a soundtrack of canned laughter. Just such a preoccupation led the journalist and columnist Bryony Gordon to take her own iron to work in a handbag, preferable as this was to spending hours checking that it was switched off.

‘Mad Girl’ is Gordon’s story of her struggles with mental illness from childhood to motherhood, set against her rise up the Fleet Street career ladder. Her Obsessive Compulsive Disorder revealed itself in a remarkable way. At the age of twelve, she woke from a dream in which she had a terminal disease and thereafter became convinced she was dying of AIDS. So began a pattern of breakdowns, depression, anxiety, addiction, panic attacks and eating disorders lasting until her mid-thirties. As she calls it, an ‘endless cycle of self-loathing and despair’.

The candour of this thought provoking book is its forte – the word ‘honest’ appears four times in its first six lines – the degree of self-disclosure utterly unsparing. Meares (2001) refers to this in relation to OCD as an impediment ‘of the boundary between inner and outer worlds’. Sadness and humour walk arm in arm in the story, not always to the greatest effect as it is when the two separate that the prose is at its most powerful. One wonders whether the author felt the need to cradle this sadness in a humorous tone to make herself more palatable to her unknown readers? Stylistically, this can grate somewhat. Throwaway words like ‘nutso’ and ‘bonkers’ sit uncomfortably next to more considered phrases such as ‘linguistic parsimony’. Nevertheless, Gordon can be terribly funny. She tells us about arriving in China with Joan Rivers who started looking for its ‘Great Mall’. She casts herself as a permanent fish out of water which gives her a detached observer’s eye to events, never more insightful than when she finds the disappointments of own body easier to accept while witnessing the amount of synthetic body components on show at a Hollywood party. She can also break the reader’s heart, telling us that as a child she longed to hold her mother’s hand but feared she would infect it with a poisonous touch.

Gordon invites us to be ringside at every part of her life to the extent that we become voyeur participants, peeking through our fingers. This raises questions about the merits of self-disclosure and the appeal of apparent ‘madness’ to those looking on. The title and the cartoonish cover of the book, showing the author facing outwards with an open mouth and startled face, beckons us into her internal world through the very mouth that will address us directly throughout the book. The fact that there are no other photographs in the book to act as a juxtaposition to the portrayal of the author as ‘mad’ leaves no room for confusion. We are supposed to believe our subject is ‘mad’ and therefore interesting. After all, she tells us that she comes from a family of journalists ‘where all personal humiliation can be used for the greater good and mined for a few hundred words’ and inhabits a world in which self-destructive behaviour is rewarded with a column while her editor calls her stress related alopecia ‘a story’ and so it naturally follows that it must be written about. It is no surprise when the author tells us at the end of the book that in spite of her whole hearted dance around the confessional pole, it was a difficult experience to write the book and her OCD symptoms reappeared. Little wonder she can come across as an unwilling contestant caught up in a larger journalistic game that does not have her best interests at heart.

There are two other areas in which the book serves as a useful, if not edifying, commentary. Firstly, Gordon comes into contact with medical professionals and therapists from time to time. Almost all of these meetings prove uncomfortable reading as they show very poor practice, leaving the patient confused and humiliated. Although Gordon admits that she wishes she had stuck to a particular course of therapy, the tragedy is that she felt obliged to suffer in silence for so long and that silence was not helped by the poor care she received. Clearly, twenty years is far too long to find the appropriate care for a disorder such as OCD. Secondly, Gordon reveals that she is frequently subject to sexist comments about her appearance after her articles appear in print. Although she bats this away with typical humour, it reflects critically on the way in which female journalists are in the firing line of mostly male comment from behind the anonymous computer screen.

As a psychodynamic psychotherapist, it is hard to read the book without looking for ‘clues’ as to the aetiology of Gordon’s OCD. In this way, the book is a psychodynamic detective’s treasure trove but it is perhaps best left to every reader to find their own way into this material, from the endless self-deprecation to a maternal figure who looms large, invested with the power of moral arbiter, whose words to her daughter are laden with meaning far beyond their apparent simplicity. The book might also make the psychodynamic community pause and consider its thinking about OCD. Esman (2001) traces the way in which contributions from biological psychiatry and behavioural psychology have marginalised psychodynamic thinking in relation to the treatment of OCD. Gabbard (2001) too points to the increasing tendency within psychiatry to consider the biologically based aetiology of OCD. The latest research published by the Lancet in June 2016 suggests that a range of interventions is effective in the management of OCD symptoms, specifically a combination of psychotherapeutic (mostly exposure and response prevention techniques) and psychopharmalogical methodology. Where does this leave psychodynamic thinking?

Leib (2001) contends that a purely psychodynamic approach has serious limitations in this area but that it can add much to a combination of modalities, including more standard techniques such as the aforementioned exposure and response prevention. My own experience in the field supports this. Like others, I have introduced a longer session time to facilitate this approach and it has been a seamless process, not impinging at all on the depth of the psychodynamic work. If we accept that OCD symptoms are rich in unconscious meaning, an understanding of this fact can be most helpful to a patient in the implementation of behavioural therapeutic interventions. Furthermore, as OCD fluctuates, an understanding of its unconscious triggers can assist in the management of symptoms. One last point is to stress the importance of the assessment process before embarking on psychodynamic work as a part of a combined modality approach with an OCD patient. As ever, it is the assessment task to establish whether a working alliance can be established with the particular patient in the light of what might be cripplingly severe symptoms? After all, what use might a florid interpretation into unconscious processes be to a patient whose only thought is that they might be about to crash our table lamp into our skull?

Gordon’s own experience is free from exposure to psychodynamic practice so we can only speculate as to how that might have assisted her, if at all. What we can be more sure of is that her story is a valuable part of a growing canon of work including authors such as Matt Haigh and Stephen Grosz whose books on mental health are reaching a wide audience. In July 2016, ‘Mad Girl’ became a top ten selling book in the UK. We are all, patients and therapists alike, engaged in a process of battling stigma and Gordon’s courageous contribution to this is most welcome. These kind of publications assuredly make it easier for sufferers to discuss their illnesses, bringing them to our doors to seek the help they need.

James du Cann
james@southbankcounselling.co.uk


References:

https://www.youtube.com/watch?v=dUM6MxqaMDA (A Bit of Fry and Laurie)

http://dx.doi.org/10.1016/S2215-0366(16)30069-4 (The Lancet)

Esman, A.H. (2001) Obsessive-Compulsive Disorder: Current Views. Psychoanalytic Inquiry 21: 145-156

Gabbard, G.O. (2001) Psychoanalytically Informed Approaches to the Treatment of Obsessive-Compulsive Disorder. Psychoanalytic Inquiry 21: 208-221

Leib, P.T. (2001) Integrating Behaviour Modification and Pharmacotherapy with the Psychoanalytic Treatment of Obsessive-Compulsive Disorder: A Case Study. Psychoanalytic Inquiry, 21: 222-241

Meares, R. (2001) A Specific Developmental Deficit in Obsessive-Compulsive Disorder: The Example of the Wolf Man. Psychoanalytic Inquiry, 21: 289-319


Amy Winehouse: Fragments

by Jennifer Coles

published in the British Psychoanalytic Council’s magazine New Associations 18, November 2015


Asif Kapadia’s documentary (Amy, 2015) paints a portrait of the singer Amy Winehouse through a montage of material: archive footage gathered from television and radio broadcasts, home videos and interviews with people whose lives were intertwined with her own. Presenting the subject in fragments through myriad lenses, the film raises the question, who really knew this woman? What does it mean to be known?

In an interview with the Guardian, Kapadia has made clear his intention to challenge the media image of Amy and present a ‘true version of events’. He dismissed comments by acquaintances which he felt to be inauthentic, telling his interviewees, ‘I don’t think you really met Amy. The person you describe, that’s not Amy.’ The truth, of course, is elusive, filtered through subjective perception. In his selection of material, the director is showing us his own version of Amy. However, the unconventional absence of a guiding voiceover leaves the film open to interpretation. We are invited to form our own opinions from the material at hand and revise them in the light of new information.

Amy is presented as a young woman rising to fame whilst becoming increasingly lost in her addictions to drugs and alcohol. A conflict runs throughout her life between creative and destructive forces, culminating in her death aged 27. She died alone at home, by then estranged from potentially supportive friends and family. The film is more a celebration of her life than an investigation of her death, but the knowledge of her tragic ending haunts the narrative throughout and provokes curiosity about what went wrong as well as what went right.

As in psychoanalysis, what is concealed is as significant as what is revealed: the unknown can only be inferred from the known. The more visible Amy becomes in the public eye, the more material there is available for analysis. The roots of her struggles are obscured, but there are hints from which we might create our own version of the story.

Amy is first presented as a teenager, at once precocious and diffident, shying away from a camera’s glare and playing up to it, in turns. We then circle back to her childhood, although the material is scarce. Photographs and voiceovers give an impression of Amy as a playful and creative child, deeply affected by her parents’ separation when she was nine years old. We might infer from the separation that her parents’ relationship was troubled in Amy’s earlier years, although the details are missing. Her infancy is a void to be wondered about.

Amy’s mother makes her only appearance at this point, not as a physical presence but as a voiceover, taken from a radio interview: ‘I didn’t know how to control her. She used to say to me, Mum, you have to take charge.’ Connections have been made in psychoanalytic theory between infantile feelings of emptiness and the later attempt to contain unbearable feelings through recourse to drugs (Weegman and Cohen, 2002). Her mother’s brief but revealing comment indicates a lack of containment in Amy’s early life, which may have influenced her addictive tendencies later on.

Her father is much more present in the film, although his avid involvement in her career highlights his lack of attention to her emotional and physical state. Having apparently shown little interest in his daughter during her childhood, he reappears when she is emerging in the public eye. Amy’s adoration of her well-intentioned but disappointing father elicits sympathy. His advice that she shouldn’t seek professional help for her alcohol dependency led to the song that elevated her to world fame. The apparently defiant lyrics of ‘Rehab’ mask the vulnerability of a young woman so devoted to her father that she colludes with his view that she is fine when she is visibly becoming ever more fragile.

Her passionate but destructive relationship with husband Blake Fielder-Civil seems to echo patterns with both parents. Like her father, Blake disappears when times are tough for Amy, but reappears to enjoy her success. The couple is shown to oscillate between phases of fusion and of separation. Bonded by their addictions, it is likely that both are seeking reparation for an early lack of maternal containment, but repeating patterns of self-destruction which compromise the capacity to sustain a loving relationship.

The tragedy, in Amy’s case, is that we can see that, as a teenager, she had the sense that her music offered a creative solution to difficult feelings. ‘I’m lucky to have my music’ she says, where ‘some people don’t have an outlet for depression.’ We see her quietly composing songs on her guitar: she seems to have integrity and focus and to take real pleasure in the creative process, rather than being driven by the desire for success. She says, somewhat flippantly, ‘If I ever became famous, I think I’d kill myself.’ Even though this comment is dubious in the light of her later success – she did not rise to fame by accident – there is still some indication of an early awareness that celebrity could exacerbate her destructive tendencies and stifle her creativity.

Paula Heimann (1963) regarded fame as ‘love from the distant many, needed when there is not enough from the few near ones.’ This kind of love from a distance is bound to be deficient, since it is based on projection rather than intimate contact and genuine understanding. As Amy’s story develops, so the audience watching her grows larger, from one-to-one home videos to vast auditoriums. As she grows in the eyes of the distant many, so she seems to shrink, both physically and psychically. Images of a gaunt, pale Amy intoxicated on crack cocaine bring to mind John Steiner’s concept of ‘psychic retreats’, states of mind experienced as ‘places of safety in which the patient can seek refuge from reality.’ (Steiner, 1993) The more renowned Amy becomes, the more estranged she appears to be from herself. At her final show in Serbia, she appears on stage like a lost little girl, refusing or unable to perform. A commentator remarks, ‘She doesn’t know where she is.’

Kapadia shows people drifting in and out of Amy’s life, just as she drifts in and out of her own mind, implying that being known in a helpful way has something to do with consistent relationships. There is a sense that people let her down, that no one helped her – but there is also a sense that she was difficult to help. At one stage she does manage to conquer her addictions and abstain from alcohol. She appears to be delighted as she wins a Grammy Award, then confides in a friend backstage, ‘It’s just so boring without drugs’. At the end of her life, it seems that potentially supportive friends had given up trying to stay in contact with her, having been repeatedly rejected.

What comes to light is that, to be known and intimately understood, we have to allow ourselves to be contacted on a deep level. The boundlessness of the unconscious means there will always be areas of us that are inaccessible to others and to ourselves, but the endeavour to stay open to the possibility of being known can make the unknown areas less frightening. In Amy’s case, substance misuse made her less and less available for the kind of relationship that might have helped her to draw strength from her creativity.

REFERENCES:
http://www.theguardian.com/film/2015/jun/27/asif-kapadia-amy-winehouse-doc
Weegmann, R. and Cohen, R. ed. (2002) The Psychodynamics of Addiction. London: Whurr Publishers
Heimann, P. (1963) Joan Riviere (1883–1962). International Journal of Psycho-Analysis, 44:231
Steiner, J. (1996) The Aim Of Psychoanalysis In Theory And In Practice. International Journal of Psycho-Analysis, 77:1076


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