There are a large
and increasing number of personal accounts of schizophrenia, either by
schizophrenics themselves or their families and friends and Angelhead is
an interesting addition to what has almost become a new genre of writing. It is honest and well written and from the
outset Greg Bottoms makes it clear that this is a work of the imagination, an
attempt to recover something of the experience that his brother Michael went
through and its repercussions on his family.

Greg tells a story
that is inevitably reconstructed through his imagination and in so doing
enables us to see the schizophrenic reality of insanity in America. His family goes through nearly a decade of
bizarre and at times dangerous behaviour from Michael and does not come out of
the situation particularly well. Greg
tells of the time when Michael’s behaviour became so difficult to handle that
he was forced to leave home by his mother and father because they thought his
problems stemmed from drug use, a decision that is clearly flawed in
retrospect. Hindsight, though, is
always 20/20 vision and what is more disturbing than the understandable exhaustion
of a families resources is the inability of the psychiatric institutions in
America to adequately deal with the problem of schizophrenia. One of the main messages that comes when
reading Greg’s account is the lack of adequate resources and information at a
basic level within American society.
Despite seeing counsellors and at times displaying clearly psychotic
behaviour in public, Michael is never taken under the care of a
psychiatrist. Greg’s family is left to
deal with a situation that is incorrectly diagnosed and morally condemned.
Michael is seen as a troublesome and difficult drug using adolescent, a
situation that becomes almost inexplicable as the story unfolds. Inexplicable, that is, were it not for the
references to having to afford doctors.

It is well
documented that America has the highest rates of schizophrenia in the world and
yet is not so well noted is the difference in primary level care and intervention
available in America as opposed to Europe.
In Britain, for example, the diagnosis of schizophrenia involves an
ongoing relationship with a psychiatrist.
Such a relationship is free at the source of delivery and although by no
means perfect this system prevents situations like Michaels from going
unnoticed and uncared for. Michael,
however, wasn’t diagnosed as a schizophrenic until nearly a decade after his
first psychotic episodes and so even if the care available to diagnosed
schizophrenics may be better in Europe, the question still remains of whether
the original diagnosis would have been handled differently. This is a moot point perhaps, but an
adolescent who sat in a maths lesson that was not his own, in tears and
claiming to having just seen Christ in the hallway would not, I believe, have
been sent home without being referred to a psychiatrist for suspected schizophrenia. Unfortunately Michael was treated as an
“immoral drug user” and it seems that stereotypes and prejudice were as much
contributory factors in his decline as his own mental health issues.

Michael was called
“Angelhead” because whilst on acid at fourteen he saw the face of god. Derived from the slang “pothead”, the title
of the book both illuminates the story Greg is telling and points towards the
difficulties in separating aberrant behaviour from mental health problems. Imagine the book being called “Nutter” or
“Loony” and the title begins to take on its full social consequence. The boy who sees the face of god is reduced
to a social construction, an acid head who hallucinated some bizarre and
unfathomable reality that is too far from our own lives to waste time on. Even when psychiatrists tell the family that
the religious delusions Michael suffers from are culturally specific, that in a
Muslim or Buddhist culture the hallucination would take a different form, this
still doesn’t prompt any real questioning of the social element of
schizophrenia.

Greg?s story is
mixed with both innocence and guilt.
For him, he says, “Michael literally vanished” after the incident
in the school. It was not until he came
back from a hellish experience in Orlando that he was sent to see a
psychiatrist and eventually diagnosed, a small step forwards since the family
was unable to afford private health care and had to rely upon its own
inadequate resources. The provision of
greater hospitalisation in America is not going to resolve this situation,
which is underpinned by economic realities rather than medical needs. The recognition of a social responsibility
towards the insane, as well as towards other members of our society that need
support, is the only possible route away from such tragedy as we find Greg
relating. This involves, in part, a
recognition that the family of the schizophrenic does indeed contribute towards
the problems faced by the schizophrenic.

The
schizoprenogenic ideas that were once popular have been thrown away because
they suggest that the family is part of the problem — nobody, it seems, wants
to blame those families. We have to ask
ourselves why this is the case. Might
it be because American society forces those self-same families to provide the
backrock of care? When the family fails
there seems to be no further line of defence and families, by their nature, are
full of failures. Although never made
explicit, one of the implications that can be drawn from Greg’s story is that
there is a reliance on family responsibility in dealing with schizophrenia in
America, despite the fact that it is society that determines the abberant
behaviour that leads to the final diagnosis of schizophrenia. Is the burden of care to fall on family or
community? This question is posed
urgently when reading a book such as this ? and the American community in which
this American family live is the greatest absence in Michael’s story.

© 2001 Matt Lee

Matt
Lee, University Of Sussex (PhD researcher, Philosophy)

Categories: Memoirs, MentalHealth

Tags: Schizophrenia