The Unpersuadables: Adventures with the Enemies of Science (23 page)

‘I am a reluctant convert to what I am about to tell you,’ he says. ‘There is incontestable evidence that there’s a wide range of bad things that can happen to kids, including sexual abuse, which increase the risk of psychosis dramatically. Contrary to what you’ll find in virtually every psychiatric textbook and regular papers published in respected journals, the evidence for a genetic determination of these disorders to specific genes is wafer-thin. If there was a gene for schizophrenia they would have found it by now. What it looks like is that there are probably a thousand genes which each produce a small increase of risk. However – and this is also contrary to what you’ll find in psychiatric textbooks – there is a massive amount of evidence of environmental factors playing a role.’

In his book
Doctoring the Mind
, Bentall quotes multiple surveys of psychotic patients who have experienced ‘very high levels of sudden trauma, including violent incidents and sexual assaults, compared to the experiences of ordinary people.’
A typical example is a 2004 paper
in the
British Journal of Psychiatry
that found the rate of childhood
abuse in adults suffering psychosis to be fifteen times greater than expected. He is currently preparing to submit a meta-analysis to ‘one of the world’s top medical journals’ which will compile ten years of large-scale studies into the environmental causes of psychosis. ‘Just to tell you what the meta-analysis will say – the odds ratio is three. That means that somebody who has been sexually abused has a three times greater chance of becoming psychotic than somebody who has had a healthy childhood.’

I ask Bentall what he thinks of Ron Coleman’s contention that there is no such thing as schizophrenia. ‘Isn’t that a bit extreme?’

‘I don’t see it as extreme,’ he says. ‘I’ve said it myself. It’s an utterly useless concept. It hasn’t helped anybody. But there’s a philosophical question to be asked about all this – how do we define mental illness? We don’t have any kind of biological reference for psychiatric disorders in the same way that we do for, say, appendicitis. Even if we did, there’d be an issue of where we draw the line between a psychiatric disorder and not. Virtually all of them lie on a continuum with normal function. It’s not you’re schizophrenic or you’re not – people are more or less schizophrenic.’

At some point in my journey, wherever the line into true mental illness actually lies, I suddenly realise that I have crossed it. I wonder when I did it, and with whom? Who amongst all the people that I have met are just ordinarily irrational? And which are the ones who are ill?

But inside the ermine robes of these lordly judgements hangs a soggy pocket of doubts. What qualifies me to act as this binary-thinking St Peter of the sane? Am I certain that I am on a different side of the line to Margot from Ramsgate? When I was in my early twenties I would sneak back to the flat I shared with my girlfriend, two minutes after leaving for work, so convinced was I that she was having an affair with the man upstairs. I had no reason to suspect this. I didn’t even know who lived up there. As I tip-toed to the door, I would tell myself, ‘You’re fucking
mad
.’ And yet there I was, leaning in, listening for footsteps. It was the same as the occasions on which I would find myself helplessly phoning premium dating numbers in the local paper, to check if any of the women ‘seeking love’ were her. It was irrational. Delusional. One version of me knew it, while another couldn’t help itself.

I do not consider myself mentally ill, and yet I have behaved in ways that I could neither control nor explain. I have had suicidal thoughts. When things become difficult, I often console myself that simply resigning from the game is ‘an option.’ In that moment I believe it to be a rational judgement – I have my models of the world and I understand it to be an essentially hostile place. If it overwhelms me, then I am overwhelmed. I have done my best and it didn’t work. A decision simply to stop fighting seems reasonable. Fair.

And yet, as I write this, it seems like anything but. It is disorientating. I
know
that when I feel suicidal, I am convinced that it is my life and my choice and that I am making it in a clear and reasonable condition of mind. But now it seems equally obvious that this is the product of damaged cognition; that to leave my wife and family in this way would be cruel. There they are again, those two people – the one that believes in UFOs and the one that doesn’t; the one that wanted to stop stealing and the one that couldn’t help it; the one that wanted to help the screaming Buddhist and the one that couldn’t; the one that knew the lover was faithful and the one that knew she wasn’t. Which person am I? Am I two people?
More?

Mental illness, says Richard Bentall, ‘lies on a continuum.’ It seems to me that, on any given day, we all suffer mild symptoms of many of them. I might hear my wife’s opinion of the fact I have left the washing up, just below the level of my conscious hearing; I might feel paranoid about an uncommunicative newspaper editor who has failed to acknowledge a submission; I might experience a light OCD when I triple-check that the iron is
definitely
off before I go out. Perhaps a full, debilitating mental illness occurs when one of these ordinary patterns of thinking takes over.

‘That’s exactly correct,’ Bentall says. ‘But the question still remains – when, exactly, do we decide it has taken over?’

I tell Richard that it is as if there are different versions of me, different agents with different opinions, all operating from within the same skull.

‘There are lots of theories about multiple selves and, depending on how you define them, they’re probably true,’ he replies. ‘The brain generates models of the world, and one of the things it does is generate
a model of what sort of person we are, what sort of person we’d like to be and also what sort of person we fear becoming. So there are all these different versions of us swimming around in our brain. They tend to come to the fore at different times – you do something which you realise is a bit embarrassing and your feared-self rears up. It’s not a nice feeling.’

‘Is this related to the fact that you’re one version of yourself with your father, and then another with your wife?’

‘Absolutely,’ he says. ‘But it’s important to remember that these are just models. They’re conceptual systems which get activated at different times. Our various selves can be more or less in tune with each other or not. When they’re not, that’s associated with psychiatric problems. So depressed people in particular have a huge gap between how they see themselves and how they would like to be – their ideal self. If you’re not the sort of person you’d like to be, that’s how you get depressed.’

*

This endlessly human and private struggle that we all go through – trying to merge our many selves into one happy and real whole – is a notion that is central to the work of an ideological co-conspirator of Ron Coleman and Professor Romme. From his Bradford base, Dr Rufus May manages to be many degrees more controversial than them both. Not only is he an NHS doctor who encourages voice-hearers to come off their medication, he is also a diagnosed schizophrenic – a fact that he kept secret during his training.

Rufus picks me up from the station in his home town of Hebden Bridge, Yorkshire. It is a freezing November afternoon and as he drives me to the top of a hill, along a narrow cobbled road, I tell him what Richard Bentall had said about the different versions of us.

‘We’ve all got them,’ he agrees. ‘We meet them in our dreams. We have dialogues with them. Most people can’t hear them in waking life, but they might influence us – when you get angry, sometimes it’s like you’re taken over by a demon. In someone who hears voices, it’s just a bit more real.’

We soon arrive at his house, where I am to meet Nutmeg the dog
and one of his patients. Deborah is twenty-five, pale, meek and crowded with unwelcome personalities. Under Rufus’s care, she has stopped taking anti-psychotic drugs. Rufus helps her by ‘dialogue-ing’ directly with the other consciousnesses that haunt her. He has promised that I can observe him as he works and, if things go well, I might even be allowed to interview one of Deborah’s voices.

As the kettle rises to a whistle and Nutmeg bounces excitedly around my legs, Deborah pulls the sleeves of her jumper over her hands and studies the surface of the wooden table. In the corner, pouring the tea, Rufus tells of his own fascinating journey into madness, which began on his eighteenth birthday. ‘I remember feeling like I needed to be somebody that I wasn’t,’ he says. ‘I started to get lots of strange ideas. I lost my sense of who I was.’

Rufus had a talent for art and had taken a job, near his parents’ home in Islington, North London, as a trainee draughtsman. ‘I was copying plans of industrial buildings,’ he says. ‘It was really boring, mechanistic. It was like my mind said, “Forget about this, just imagine what else I could be.” So I imagined I was an apprentice spy. When they asked me to deliver parcels, I thought,
Maybe they’re secret messages
. I started to create a reality that was much more interesting.’

What began as a game slowly took on the sharp corners of a life that was real. It was the time of the Cold War and Rufus fantasised that he was being recruited by the British Secret Service as a junior spy. He had had his heart broken, recently, by a girl called Jane. ‘I worked out that she was probably spying for the Russians.’

‘So that was why she’d left you,’ I clarify. ‘Because the Russians had made her?’

‘Yeah – and not because I was a crap boyfriend,’ he says with a laugh. ‘It protected me quite nicely.’

Rufus would stay up all night, roaming the West End of London with his dog, trying to find the safe house where he and Jane would be reunited. He looked everywhere for clues that he was, indeed, being recruited as a trainee spy.

‘The more you look for evidence to back up your unusual beliefs the more you find them,’ he says. ‘I’d seen films where spies got special messages on the radio, so I’d twiddle around and try and find
them. Like this …’ He turns, switches on the radio next to his kettle and begins to randomly dial between clouds of white noise. The first voice we hear is stern, calm, in perfect Queen’s English.

‘ …
The British government has a shoot-to-kill policy
…’

‘Argh!’ I say.

I jump up from my seat.

‘See what I mean?’ He grins.

‘Was that really just on the radio?’ I ask.

‘That was just on the radio! That’s exactly the kind of thing. So you see, once you seek, you will find.’

On the other side of the table, Deborah mutters, ‘I’m a bit freaked out now.’

‘Once you start looking, these little coincidences become really …’ Rufus stops, unable momentarily to maintain his cool, and glances back at the radio. ‘Fucking hell. Luckily, I didn’t get that one.’ He turns back to face me. ‘So you can see – it’s really exciting and stressful, which means you’re staying up late at night, you’re hypervigilant, and when you don’t sleep, even more coincidences start to happen. My uncle was a Baptist minister. He used to say that God would communicate in strange ways. He’d see messages in advertising hoardings, or he’d open the Bible at random pages and see what the message for him was. I started to do that with driving manuals. I just made this rich fantasy world for myself.’

Rufus began to suffer chest pains. ‘I thought it must be a gadget that had been inserted into my chest by the oppositional forces.’ Oppositional forces meant Russia. And Russia meant Jane. When Rufus told his GP that his ex-girlfriend had placed a deadly gadget in his heart, she told him, ‘You need to see a specialist.’ He assumed that he would be referred to a specialist in spy-gadget removal. What he wasn’t expecting was a psychiatrist.

‘There’s some history of paranoia and psychosis in my family,’ he tells me. ‘My mum’s sister had a diagnosis of schizophrenia and heard voices and my grandad as well. So as soon as the doctors knew that, they were like – ’ he rubs his hands together – ‘job done. This is schizophrenia. It’s a genetic disorder and you’ll have to take this medication for the rest of your life.’

The medication made him feel empty, alien, dead. He could no longer draw a straight line. He could not achieve an erection. Against the advice of his doctors, he tried to halt the medication. The first two times, he ended up back in hospital. The third time, he succeeded. And then a friend of his committed suicide.

‘She jumped off a building,’ he says. ‘She was probably hearing voices and all they did was keep increasing the medication. I was really angry. I thought,
I’ve found my mission
. I would infiltrate the psychiatric system. Go undercover as a psychologist and expose it from within.’

Rufus describes the voices as messengers who speak on behalf of an individual’s ugliest experiences. ‘Through emotional trauma, someone might split off different parts of their experience, different emotions, different stories that they might have to bury. They can come back as voices. So what I do is help somebody understand different parts of themselves. It’s like a peace-making process. I turn the voices into allies.’

Before we begin the dialogue-ing, Rufus wants to confirm our prior agreement, that I will not only change the name of Deborah in my book, but all of her voices. ‘Is that okay with you?’ Rufus checks with Deborah.

She sits silently, for a moment, as her voices report back.

‘They’re all fine with that apart from Top Dog,’ she says. ‘Top Dog wants his name in.’

Top Dog is Deborah’s dominant voice. He is, says Rufus, ‘a cross between the Godfather and a Kray twin.’ He has threatened to kill Deborah many times. He has tried to convince her into suicide, saying, ‘If you don’t kill yourself, I will kill people you love.’ Rufus defends this behaviour, saying that Top Dog is ‘like a bodyguard. He was trying to protect her by getting her to kill herself, because he thought that the world was a cruel place and not worth bothering about.’

‘Hmmm,’ I say with a nod.

Earlier this year, Deborah nearly went through with it, before changing her mind at the last moment. The next day, a friend of hers died of cancer. Top Dog told Deborah, ‘I killed her because you didn’t kill yourself.’ Deborah believed him. When I ask now if she realises that
this cannot be true, she replies, ‘I’m still working on that one. It just seems a bit too much of a coincidence, really.’