Mental Health as a Concept

Creating a series of conceptual poems about mental illness

Keshia Starrett

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I first had the idea for this project a few years ago. I was on a bus in Leeds, and I was thinking about how crowded the bus was when someone was coughing, and how everyone on the bus would have germs all over them from this person’s coughing. The whole thing was uncomfortable; from the sweaty condensation to the awkward shuffling when more people got on at the next stop. The bus was like an incubator for germs and if I felt unhappy about it, it occurred to me how much of a nightmare it would be for someone with OCD. My project does not centre on Obsessive Compulsive Disorder, but as it was what sparked the idea for it, I’m going to talk a little more about it.

Now, I know a few people with Obsessive Compulsive Disorder and it’s only through knowing them (and a lot of research) that I found out it isn’t all about germs – it can be about symmetry, colour, order… Basically – any number of things. In a broad sense, I’ve gathered it’s about having rituals and how an inability to fulfil said ritual will cause severe distress to the person with OCD. Having dated someone with OCD, I’ve seen and heard a lot of stigmatisms surrounding it. A lot of people in their naivety, see it as a positive; your house must be lovely and clean etc… And it used to frustrate me that people would belittle a disorder that I had seen causing someone severe distress; a disorder that on many occasions dictated how a day would go entirely. But something else occurred to me; most of these people didn’t mean any harm – they just didn’t know any better. I thought about how many programmes on TV I’d seen that address OCD; from soaps to documentaries. Some of these programmes set out with the intention to educate and others seemed to propagate naïve ideas for their own ends. So where do I come into any of it?

At the time I had been hearing a lot about conceptual poetry at university. For those of you who don’t know what conceptual writing is, don’t worry. I’ll try to summarise although the inability to define conceptual writing has been at the centre of many debates. For the sake of explaining why I chose it as the mode for my project, I need to give a loose definition as I perceive it. Conceptual writing is writing that is dictated by the overall concept behind the writing as opposed to focusing on the end results. In other words, the process of creating the writing is as important as the end results. A well-known example of conceptual writing is Day (2003 )by Kenneth Goldsmith. Goldsmith rewrote the New York Times newspaper word for word to create this text. In this instance, the concept outweighs the writing itself. This was no small task to undertake. At times I’d dare say it was a boring and laborious thing to be doing. So why do it? From my point of view, it challenges ideas of authority in writing. It raises issues of creativity, and begs the question: How thin is the line between plagiarism and influence?

I could talk for a long time about the varieties of conceptual writing, and I’ll touch upon it in a moment. My point here, is that I spent a lot of time thinking about how monotonous it must’ve been for Goldsmith to rewrite that newspaper word for word. That’s when it occurred to me: that feeling might be similar to what people with OCD feel as they’re fulfilling their compulsions. I can’t speak for everyone with OCD – and I strongly distrust anyone who feels they could, but I know that for some people; they do not want to fulfil compulsions. The clue is in the name – they feel compelled to complete rituals; it’s not a matter of wanting. Maybe Kenneth Goldsmith didn’t feel that same compulsion to rewrite the New York Times – maybe he wanted to, but I’m sure there were times when he wondered why he started. Probably when his hands started aching from typing…

To touch upon some of the processes involved in conceptual writing is difficult but here are a few. What Goldsmith did for Day would generally be calling ‘copying’, Yedda Morrison’s Darkness, in which Morrison deletes large sections of Joseph Conrad’s Heart of Darkness (1902) in order to create a new text in which only words related to nature remain would be referred to as ‘deletion’, and Jen Bervette’s Silverettes in which the artist marries weave structures, grids and quotations from writers such as Susan Howe, would fall under the category of being ‘hybrid’. There are so many more categories and sub-categories in conceptual writing, but I hope you’re getting an idea of what it’s all about, and why I thought it would work well in creating poems about mental illnesses.

I designed the project because I felt would further my own understanding of mental illnesses I didn’t know a lot about, and that it would hopefully illuminate others on the topic too. I decided to create a series of poems about mental illnesses that were frequently stigmatised, or simply not as well known, using conceptual writing processes. The idea started with OCD when I recognised a relationship between it and process in conceptual literature, but I realised this was simply a starting point. There were and still are, so many mental illnesses that I have little understanding of. A friend of mines was diagnosed with depression many years ago. Last year, she told me she thinks she might actually have Borderline Personality Disorder (BPD) as opposed to depression. I didn’t know much about BPD if I’m honest – I had barely heard of it. But I was alarmed because when I did look into it, I had to agree with her; it seemed much more reflective of her than depression…

I’m not a doctor but on the other hand, does that actually mean I understand less about mental illness than they do? If you think that’s a bit of an overstep I’d urge to read The Book of Woe (2013) or Margaret Price’s Mad at School (2011); both of which address issues of diagnoses and the medical approach to mental health. Moreover, does a doctor know what’s happening inside someone’s head better than they understand themselves? Maybe… maybe not. My head was spinning, and my heart was going out to my friend who was grappling with a mental illness she couldn’t name, and wondering whether the medication she was taking for said illness wasn’t working for her because she had a different illness altogether. She had placed her trust in the medical profession, and now she didn’t know if she should’ve. And I didn’t know either. I still don’t.

This is not an attempt to criticise doctors; they set out to help people and I’m sure they try their best. But when it comes to mental health, there is still a lot we don’t know. Maybe this is at the heart of the problem; we want to know; to have a clear idea; to name; to diagnose; to treat. It seems to me the only thing I can do, is try to further my own understanding of mental illness without trying to provide solutions, and try to share that understanding.

So I chose the following mental illnesses as my starting point: Obsessive Compulsive Disorder, Borderline Personality Disorder, and Schizophrenia. I needed to figure out if there were any conceptual processes that I could use to help me relate to these disorders, so I started reading more conceptual writing and researching mental illness. These is an irony in being concerned about the medical outlook on mental illness, and issues surrounding diagnoses, while also having to rely on this information to identify which conceptual processes might work well in relation to them. However, this is also why I am using accounts from people who have mental illnesses once I begin the writing process. I am presenting medical diagnoses, diagnoses from well-known mental health services, and finally first-hand experiences/accounts from archived material, in relation to each other. This way, the different perspectives and approaches to each illness would be side by side, and any connections or contrasts would be apparent to readers. These are the illnesses and conceptual processes I currently think will work well together. They are subject to change.

OCD or Obsessive Compulsive Disorder is characterised by the need to perform rituals in an effort to provide momentary relief from an intrusive thought. The conceptual mode of copying relates strongly because the writing produced is governed strictly by the concept or rule underlying the practice at hand. The frustration of reading the sentences produced which are not grammatically or linguistically correct, correlates with the feelings of anxiety and distress felt by OCD sufferers, as well as feelings of a lack of control over the illness.

Borderline Personality Disorder (BPD) is accompanied by feelings of isolation, fear of abandonment, a lack of sense of self, feelings of numbness and emptiness, and impulsiveness, among others, according to websites like Mind, NHS and Rethink Mental Illness. The conceptual mode of deletion will be used in order to relate to the rapid shifts in perspective and difficulties in grasping a sense of self, by illustrating how a text can be altered and the understanding of it changed according to the omission of certain words/names. The deletion also correlates the feelings of emptiness and isolation. A strong example of this kind of deletion is an exchange of emails in which certain words are blacked out, by Stacy Doris and Lisa Robertson. Attention is drawn to what cannot be seen, and how the removal of names creates a feeling of dissociation when reading the emails despite the rest of the text being visible. As readers we feel removed, frustrated and slightly out of the loop which correlates the feelings felt by individuals with BPD.

Schizophrenia often involves having delusions (unusual beliefs) and hallucinations (e.g. hearing voices/seeing things that aren’t there), and it causes sufferers to feel their thoughts are muddled, disorganised and confused, according to Mind, Rethink Mental Illness, and the Royal College of Psychiatrists. For the poem on this I will use two processes: cutting, and a strand of corpus linguistics (word frequencies). To gather the material for the poem I will establish which words/phrases recur the most in a variety of first-hand accounts from people with schizophrenia. This material will then be subjected to the process of cutting. By cutting I mean the selected sections of texts will be cut out and arranged at random in order to portray the disorganisation felt by individuals with schizophrenia. The cutting process was made all the more popular by William Burroughs. A strong example of his use of it is apparent in his novel The Soft Machine (1961) in which Burroughs cut up pre-existing manuscripts (mainly The Word Hoard which he had written in the years preceding The Soft Machine).

In using this method readers of the poem trying to make sense of the words and understand their position in the sentence will be able to relate to the illness as they feel frustrated and confused about which order the words should be in and what they mean.

There were a lot of things to consider in designing and carrying out this project: representation, appropriation, safeguarding… to name a few. Identifying material to work with was a difficult task: What literature already existed, that I could apply conceptual processes to, without crossing a line of appropriation and running into massive issues surrounding safeguarding? I did not want to end up in the next version of The Book of Woe… More importantly, I didn’t want to further any stigmas and misrepresentations of mental illnesses. I felt very anxious about this project; I still do. But on the other hand, there was something to be said for that worry. An awareness of the problems pertaining to representations of mental health, and a fear of misrepresenting it myself, will help me in constantly assessing where the line is regarding appropriation, and if I’m anywhere near it.