The Silent Weaver (10 page)

Angus MacPhee was among the schizophrenics. His ‘simple schizophrenia' diagnosed in Stirling may have been one of the less aggressive mental and behavioural disorders. But as his family had discovered, it was serious enough.

‘Schizophrenia' would be popularly misinterpreted. It did not suggest an unusual level of dual or multiple personalities. It merely implied the same apparent loss of comprehension, expression and capability that could earlier have been called mania, or dementia praecox, or mental deficiency, or acute confusion, or nervous collapse, or even melancholia.

As the twentieth century progressed, the catch-all term of schizophrenia would encompass a number of varying conditions, such as paranoid schizophrenia, hebephrenic schizophrenia and catatonic schizophrenia. Angus MacPhee's variety of simple schizophrenia was often used, as the World Health Organisation pointed out, as a convenient label for a relatively mild form of the disease. It was a schizophrenic disorder nonetheless, and

schizophrenic disorders are characterized in general by fundamental and characteristic distortions of thinking and perception, and by inappropriate or blunted affect.

Clear consciousness and intellectual capacity are usually maintained, although certain cognitive deficits may evolve in the course of time. The disturbance involves the most basic functions that give the normal person a feeling of individuality, uniqueness, and self-direction.

The most intimate thoughts, feelings, and acts are often felt to be known to or shared by others, and explanatory delusions may develop, to the effect that natural or supernatural forces are at work to influence the afflicted individual's thoughts and actions in ways that are often bizarre.

The individual may see himself or herself as the pivot of all that happens. Hallucinations, especially auditory, are common and may comment on the individual's behaviour or thoughts. Perception is frequently disturbed in other ways: colours or sounds may seem unduly vivid or altered in quality, and irrelevant features of ordinary things may appear more important than the whole object or situation.

Perplexity is also common early on and frequently leads to a belief that everyday situations possess a special, usually sinister, meaning intended uniquely for the individual. In the characteristic schizophrenic disturbance of thinking, peripheral and irrelevant features of a total concept, which are inhibited in normal directed mental activity, are brought to the fore and utilized in place of those that are relevant and appropriate to the situation.

Thus thinking becomes vague, elliptical, and obscure, and its expression in speech sometimes incomprehensible. Breaks and interpolations in the train of thought are frequent, and thoughts may seem to be withdrawn by some outside agency.

Mood is characteristically shallow, capricious, or incongruous. Ambivalence and disturbance of volition may appear as inertia, negativism, or stupor. Catatonia may be present. The onset may be acute, with seriously disturbed behaviour, or insidious, with a gradual development of odd ideas and conduct . . .

[There are] ‘negative' symptoms such as marked apathy, paucity of speech, and blunting or incongruity of emotional responses, usually resulting in social withdrawal and lowering of social performance . . . [and also] a significant and consistent change in the overall quality of some aspects of personal behaviour, manifest as loss of interest, aimlessness, idleness, a self-absorbed attitude, and social withdrawal.

It was not realised in 1946 that Angus MacPhee's age and fractured life made him most vulnerable to the latent condition. Schizophrenia, which can lie for a lifetime as dormant as some malevolent frozen seed, usually surfaces in young men in their late teens and early twenties, and in young women a few years later. Almost no 10-year-olds or 70-year-olds suffer acute schizophrenia for the first time.

It is often triggered by insecurity and physical dislocation. Young immigrants are exceptionally prone to schizophrenia. So are people within the vulnerable age range who leave their childhood homes for more ordinary purposes. Students can develop schizophrenia during their early terms on an unfamiliar campus. And by the late twentieth century it would be recognised that an unusually high proportion of young men manifest the illness during their first year of military service.

In the years before diagnosis and treatment, schizophrenics played different but readily identifiable roles in Western society. The ‘oddities of conduct [and] inability to meet the demands of society', which along with self-absorption, idleness and aimlessness were identified by the World Health Organisation as symptomatic of simple schizophrenia, were displayed by Angus MacPhee.

As the World Health Organisation observed, in the absence of a safety net they are also a formula for vagrancy. The same
symptoms are evident in the tramps and down-and-outs of the developed world. At its zenith in the nineteenth and early twentieth centuries, between the decline of rural communities and the introduction of the welfare state, the lifestyle of the British tramp could have been framed for a schizophrenic. Simple schizophrenics certainly helped to define the lifestyle of British tramps. Eccentric, aimless, unwashed, unemployable, simultaneously dependent and ungovernable, and harmless to all but themselves: before the welfare state and the motor car, the life of the gentleman of the road was a natural career choice for a simple schizophrenic.

Many seriously afflicted schizophrenics are and always must have been propelled by metaphysical, religious impulses. The mystics and visionaries common in medieval Europe and in much of the rest of the modern world often were and are schizophrenic. The itinerant, dishevelled, mendicant holy men who cared nothing for their personal appearance or hygiene and who spoke to villagers in voices of unimaginable things, would probably be diagnosed as schizophrenic in the twenty-first century. Modern psychiatrists might look at a latter-day Saint Joan of Arc or Saint Theresa of Avila and observe the symptoms of schizophrenia.

The saints were in good company. Another notable fact about schizophrenia was not properly recognised when Angus MacPhee entered his asylum in the late 1940s. Schizophrenics are unusually creative. ‘Almost all schizophrenics paint,' said the art therapist Joyce Laing.

Depressives just walk away from therapeutic work, don't want to know. But schizophrenics all paint, quite strange things some of them.

The subconscious seems to be stronger with them.
Medication now means that none of them need to be in hospital, but on the other hand none of them can hold down a job. Jean Dubuffet said that they were unable to do anything but produce their own work, that they were self-taught. My definition now is that they couldn't hold down a job in Tesco's for a day. I'm sticking to that. They just couldn't stack shelves for a day. They'd start stacking and then their imagination would start to fly. They'd think, ‘What if you made a tower!' And they'd be away . . .

Schizophrenics are unusually creative in many meanings of the phrase. They are unusually creative because a higher than average proportion of schizophrenics are gifted, unusually because their work is unusual, and unusually because many of them reach peaks of brilliance that mundane humanity can only describe as genius. Their very condition relieves schizophrenics of many inhibitions and allows them to view and interpret the world from a fresh and startling angle, whatever their inventive field.

In the words of Patrick Cockburn, whose 20-year-old son Henry developed the illness while at art college, ‘the genetic inheritance that produces schizophrenia . . . is related to the genetic combination endowing people with exceptionally original and creative minds'. The painter Vincent Van Gogh was almost certainly schizophrenic. The musician Syd Barrett of Pink Floyd was schizophrenic. The novelist Evelyn Waugh fictionalised his own most vivid episode of schizophrenia in
The Ordeal of Gilbert Pinfold
. The Nobel Prize-winning mathematician John Nash, who was celebrated in the film
A Beautiful Mind
, suffered from schizophrenia for most of his adult life.

So have millions of others. Schizophrenia, whether dormant
or active, is blind to nationality, class, colour or creed. At any given time roughly 1 per cent of the world's population either suffers from or is prone to the condition. There are few early warning signs. Henry Cockburn was as a child and a youth consistently ‘able, original, likeable and articulate, but . . . he could be spectacularly ill-organised, was forgetful of all rules and regulations, and did only what he wanted to do himself'. That describes a normal rather than a worryingly abnormal teenager, and the teenage years almost invariably precede male schizophrenia.

Despite the official statistics, when Angus MacPhee entered Inverness Asylum there were another 50,000 adult schizophrenics in Scotland and probably 3,000 in the north and western Highlands and Islands. Some were quietly struggling to accommodate a mild or half-awakened version of the disorder; some were diagnosed and treated; some were homeless and drunk in the country lanes and on the city streets; others were fighting lonely battles in ordinary homes against their chaotic lives.

‘In this hospital and in many others throughout the country,' said Dr Joanne Sutherland, a psychiatrist at Inverness, ‘there was a population in the long-stay wards of people who had a chronic form of schizophrenia. They came into hospital in this disturbed, distressed state which went on sometimes for months. In time the very active phase quietened down, but it took often a very long time, and once that had settled the person was sometimes really very impaired, and sometimes just a shell of what they used to be.'

Angus MacPhee, the man who as a fit and fresh-faced six-foot-tall youth had joined the Lovat Scouts, was confused and was very often scared stiff. Away from all the familiar
comforts of home, in the darkest periods of his illness he was almost permanently frightened. He was then frightened of everything and of nothing, of things which were not there and were always there. He could wake up frightened, he could go to bed frightened, and the relatively healthy cannot imagine his dreams. He was afflicted by chronic fear. He was no longer sure who he was.

Other, later, simple schizophrenics have used the friendly computer flickering in the corner of the room to tell a dozen moderated psychiatric internet forums how they felt. In 2009 one sufferer explained: ‘It's a rare type of schizophrenia consisting mainly of negative symptoms such as lack of emotions (blunted affect), lack of pleasure (anhedonia), lack of motivation and persistence (avolition), poverty of speech (alogia), trouble concentrating and social withdrawal. With no positive symptoms such as hallucinations and delusions.'

In the candid world of twenty-first-century online psychiatric forums, simple schizophrenics became sensitive to the assertion that they were little more than jumped-up depressives. ‘The two main differences between simple schizophrenia and apathetic depression,' said the same victim, ‘are that one cannot recover spontaneously from simple schizophrenia, and simple schizophrenics don't care much about their condition – it's called “la belle indifference” . . .

‘I seem to get this belle indifference more and more, and decreasingly often care about me not feeling anything. Really, I feel like I let everything go – my entire life and the entire world. My emptiness is then even supplanted by an almost trancelike state of carelessness, though it never lasts long . . . It feels like falling asleep.'

‘There isn't a “fine line” between depression and severe negative
symptoms of schizophrenia,' said another simple schizophrenic, ‘when I haven't been consistently or even moderately depressed for over four years.'

‘I have “simple” schizophrenia,' said another,

i.e. the type without positive symptoms . . . I've had it for over a decade . . . taken that long for someone to figure out what was wrong with me. Now the negative symptoms have progressed to the point that I can't take care of myself or really do anything.

I'm trying medication but it seems the likelihood of it helping is very low, because of no positive symptoms. I partly wish I had positive symptoms, just so I could have been diagnosed when I was around 13–14 (when my gradual loss of mental functioning seemed to start), instead of being 24 and only just now trying medication.

I'm on quetiapine at the moment, doesn't seem to make any difference whatsoever (been on it around a month I guess). Tried aripiprazole first, but that wasn't a good experience . . . akathisia mostly, but it also made me really indecisive, for some reason.

I suppose exercise would help but I can't get myself to just do it. Motivation, desire, they're irrelevant, I just can't get myself to do things, blah . . . I have a very high IQ in certain areas, but it's useless because I can't study, can't concentrate. I feel like I could do anything I want, if I could just . . . do things.

Really I just wish there was hope, maybe in the idea that the medication might be able to help me, I just need to be patient . . . but I feel like it won't. I think it's common knowledge that it won't.

The disorientation, social withdrawal and poverty of speech suffered by Angus MacPhee were considered in the late 1940s and 1950s to be symptoms rather than primary conditions.
They were therefore treated incidentally. It was believed that a long-term cure for or alleviation of his schizophrenia could be found only by addressing some root cause which, once identified and removed, would take away with it the patient's distress.

In the short term, his doctors had the familiar problem of how to ease Angus MacPhee's burden while they searched in vain for his primary condition.

From the middle of the nineteenth century to the closure of the asylum at the end of the twentieth century, physicians and psychiatrists at Inverness engaged in a search for the least harmful and most effective (the two were not often found in the same drug) ‘hypnotics' with which to calm their troubled patients. They wrestled simultaneously with the ethical question of how much their patients should be calmed. ‘It is conceived that if quietitude is gained, everything is gained,' wrote Inverness Asylum's superintendent Thomas Aitken as early as 1875, ‘yet no greater error nor graver error could be made.' Opiates in the form of laudanum or diacetylmorphine (which was legally marketed in Britain under the tradename ‘Heroin' until 1924) were often used to soothe excitable people inside and outside asylums, but their use was disapproved at Inverness by Dr Aitken.