All in the Mind 
by Alastair Campbell.
Hutchinson, 297 pp., £17.99, November 2008, 978 0 09 192578 9
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I recently received an email headed ‘Literature and Madness Network’ inviting me to the ‘1st Seminar of the Madness and Literature Network’, which is to culminate in the ‘1st International Conference in Health Humanities’ in 2010. Leave aside the use of the word ‘network’, and the mystery of ‘Health Humanities’: at least the upshot is a conference, which is something I can grasp. What got me stuck for a moment was the Literature and Madness of the subject line, and the Madness and Literature in the body of the email. I find I’m always pretty near the edge of Alice’s rabbit hole, but the apparent randomness of Literature and Madness and Madness and Literature – the ‘do cats eat bats or bats eat cats’ quality of the switch – almost had me tumbling. Which? Does it mean what it says or say what it means? Does it matter? Carroll says: ‘As she couldn’t answer either question, it didn’t matter much which way she put it.’ Well, it does matter, I think, though I’m not totally sure. One seems to be a category (unfortunately) within the discipline of literature, while the other suggests two equal but different disciplines. Still, I’m at a loss to know what question is asked by either. But then I read the seminar title, ‘Fat beyond the Call of Duty: The Nature in Power within Psychiatry’, and I quite lost my footing. There are certain verbal nonsenses that induce the feeling – check the marmalade on the shelves and practise curtseying for when you land – that Alice experienced. Just close enough to sense and yet entirely meaningless. Unless, that is, I’ve drifted into a state where the sense of the world no longer functions: if it persists we call it madness. I was saved by changing the t in ‘fat’ to an r, and replacing ‘in’ with ‘of’. ‘Far beyond the Call of Duty: The Nature of Power within Psychiatry’. Typos can be dangerous. Reality may not be as exciting, but finding it can be a great relief to a troubled mind.

I describe this passing moment partly as an example of how easy it is to lose one’s bearings about what makes sense, but also, quite gratuitously, to avoid grappling with my real task for as long as possible. Although making sense in and of the world is not irrelevant to a review of Alastair Campbell’s first novel, All in the Mind, it was my initial plan, after reading it, to extend the preliminary discussion of the niceties of sanity and madness to about 2975 words, after which I would round up to a respectable 3000 words with a final sentence: ‘Alastair Campbell’s novel is about a psychiatrist who is having a breakdown while helping his patients come to terms with their problems: it is not good.’ But it turns out once again that I have serious superego issues (I use the word to get into the swing of the novel’s discourse) and so I find that I’m obliged to engage (ditto) in more detail with the matter of my task.

Campbell’s novel is about a psychiatrist who is having a breakdown while helping his patients come to terms with their problems . . . Oh, let me evade for a moment more. Campbell’s first book was The Blair Years. That was not a novel, but an account of being spin-doctor supreme in the government of Tony Blair. As Blair’s director of communications and strategy and then adviser, Campbell was involved, among much else, in presenting the massaged facts that took us to war, and dealing with the press after the death of David Kelly. He was a gleeful fixer, bully and phrase-maker for a prime minister who had streamlined the Labour Party (as in discarded anything that smacked of socialism) until it was indistinguishable from the Tories, and oversaw a government obsessed with wealth, targets and the corporate organisation of public services. Nothing in his public life inclines me to like him.

I don’t know Campbell personally, but he has been forthcoming about his private life. In an article in the Telegraph entitled ‘I’ve Been to Hell and Back’, he explained: ‘It happened in 1986 when I was 29. I’d been a journalist at the Mirror and was poached by Eddy Shah’s Today when it was launched. It was a disaster. I’d left a professional and political base I felt totally at home with and gone somewhere I felt a bit alien. I was over-promoted; I hit the bottle, got completely manic and cracked.’ He was banged up in jail in Scotland, then admitted to a private psychiatric clinic for a week or so. Since when, less dramatically, but more chronically, he has suffered from spells of depression which he finally decided to combat using anti-depressants when necessary. His breakdown was the subject of an hour-long documentary shown on BBC2 three weeks before the publication of his novel, and although he can’t be held responsible for the moody Byronic poses he was asked to hold for far too many seconds while the camera moved in for extreme close-ups of his eyes to peek into the anguished soul that lay behind them, he described his persecutory breakdown in considerable detail. He explained that he presented the programme in the hope that it would help to dispel ignorance about mental illness, give comfort to current sufferers to know that others had gone through similar experiences, and to assure his viewers, finally, that mental illness ‘does not have to be a weakness, it’s a fact of life’ (though I would have thought that weakness is also a fact of life).

So Campbell’s private mental distress is laid out by Campbell himself for all to see just as his novel on the subject appears. I am a great believer in keeping fiction and author separate. But there’s fiction and fiction. Campbell’s fiction and the recent documentary are too close to each other not to be connected by a reader: he speaks similarly in interviews of hoping the book will have a benign effect on attitudes to mental illness, and several of his descriptions in the documentary clearly foreshadow events and some of the characters’ experiences in the book. On the one hand, we know Campbell is an expert witness on the subject of his novel, and on the other, we know that a novel is not to be judged by the life of the writer.

Campbell himself is concerned about being wrongly judged. In an interview with the Bookseller, he was asked what he hoped for from reviewers and replied: ‘I think anyone who reads it fairly – as opposed to it’s got Alastair Campbell’s name on it therefore I’m going to say it’s shit – will be hard-pressed to say it’s not an interesting, pretty well-crafted book. But I am not going to pretend I was put on this earth to be a great novelist.’ If, however, this is a bad novel, published at a time when it is increasingly difficult even for good first novels to be published, then the fact that ‘it’s got Alastair Campbell’s name on it’ is relevant to a reviewer. Moreover, I can’t see that an experience of madness and depression excuses a bad novel on the subject from criticism; but then again, if the writer tells the prospective reader as Campbell did in the interview that writing is ‘therapeutic’ and ‘a way of giving a creative expression to a pretty horrific time’, life and art, as it were, become inextricable. I’m aware of the awfulness of mental illness, so I find myself needing to say that I’m very sorry for Campbell’s personal suffering before I quote again from the Bookseller: ‘One executive from a chain bookseller sniffed: “I started reading it for ten minutes, and I’d like those ten minutes back.”’ And when chain booksellers sniff about the badness of a book, things are very dire indeed.

Then we come to a further quote: ‘Campbell says that he will judge the success on what his friends and family say about the book, and on how it goes down with readers, making reference to the reader-driven success of the Katie Price books. “It will only sell if it is good, regardless of what people say about it.”’ That’s Katie Price, a.k.a. Jordan, who has an interesting take on authorship: ‘I’m not going to lie, I don’t sit there with a typewriter and write it, of course I don’t. I don’t have time to do that. I say how I want the storyline to be, each chapter is done, I read through it, change it and then it goes away to be written.’ Her publisher defends her as the ‘author’ of a ghost-written book. There is no doubt that Campbell has written his own book. It begins: ‘Professor Martin Sturrock was feeling stressed enough already, even before the phone call from Simon telling him Aunt Jessica had died.’ But can he really expect reviewers to forget his former role in the New Labour government when he uses ‘sell’ and ‘good’ in that combination in relation to – well anything, but in particular writing? He will, at least as far as I’m concerned, have to settle for the praise – printed on the jacket – of Stephen Fry (‘a trademark assured elegance . . . devastating penetration of the human mind . . . A brilliant debut novel’) and Anne Robinson (‘It is an unexpected pleasure to discover that Alastair Campbell can tell a tale quite so brilliantly’).

So . . . Alastair Campbell’s novel is about a psychiatrist who is having a breakdown while helping his patients come to terms with their problems. It is set over a single weekend – Friday to Monday. This, I suppose, is part of what he means by ‘well-crafted’, though ‘crafted’ would work better for me. The problem with such a scheme is that as you get to the heading ‘Saturday’, you know that you’ve got to get through Sunday and Monday before you’re done. Professor Sturrock, who rather oddly is referred to almost throughout the book as ‘Professor Sturrock’ by the third-person narrator, sees five patients over this period: David the depressive, Arta the asylum seeker who was raped after settling in England, Ralph the alcoholic government minister, Emily the facial burns victim, and Matthew the QC whose wife thinks he’s a sex addict. This crafting, too, has the problem that you know you are going to have to get through each of them suffering, resisting and then having their epiphany before the end is in sight. There are further structural efforts. Patients unknowingly intersect on their way to or from the consulting room: the QC’s taxi causes the bus to pull up short, making Arta drop her notes. Sometimes crafting helps a book, sometimes it just doesn’t.

Sturrock seems to be a practitioner of Cognitive Behavioural Therapy – the quick fix so welcomed by the cash-strapped, budget-driven NHS. He gives homework to his patients: write lists of all the good and bad things that have happened to you. Make a list of the best and worst moments in your day. Buy a packet of raisins, examine it and its contents carefully and then write about the experience. (My word, it gives you a perspective on your own troubles.) He encourages lucid dreaming. He gives David the depressive an elastic band to put on his wrist and snap every time he finds himself thinking negatively, saying to him: ‘That’s your positive-thinking band . . . Just try to think a little bit positively.’ There are glimmerings of a deeper approach when Sturrock suggests to Ralph the alcoholic that his drinking might be caused by ‘something in you that you want to forget. It may be something in your past.’ He’s also a bit of a philosopher: ‘He believed that humility was the key to self-respect and mutual respect.’ And he’s a ‘skilful and profound observer of human nature’ who ‘always tried hard to imagine how his patients felt’. He works in a hospital, where only the most difficult cases are referred to him, but also takes on private work – Matthew the QC and Ralph the MP, for example – because ‘the income helped him fund his various research projects, his current one being a study of the psychiatric impact of resettlement on asylum seekers.’ (Things must be even worse than we thought with the NHS if medical research is funded from private-patient fees donated by doctors.) He offers his patients buzz words like key triggers, and the phrase downward curve is unvaryingly used, along with plunge, to describe the experience of beginning to feel depressed. I dare say some or all of these techniques and insights are useful to people desperate for a solution to despair, but I believe that research has shown they aren’t useful for long. Even so, time is the thing with depression, and if a person and those involved with them can be tided over with elastic bands, key triggers and generalities such as ‘Sometimes these illnesses can be every bit as bad for the family as for the sufferer,’ then I suppose that’s a good thing. The question is, is it a good novel?

I don’t doubt that Campbell drew deeply on what he found when he had his breakdown, both personally and in the psychiatric community, but suffering and even observation don’t necessarily make a person think and write with more subtlety (‘as she was forced onto the sofa, she felt physically and psychologically powerless’). Subtlety may not be an essential quality in a self-help book, but it goes a long way to making a good novel. Still, All in the Mind functions well enough as one of those books for children called ‘Milly Has Two Daddies’ or ‘Dickon’s Mummy and Daddy Get Divorced’. It seems to be designed to explain mental illness and how it is treated to people who have never thought much about it before.

The stigma of mental illness is constantly referred to in the book, feared by all the patients and their families – even the QC finds it deeply shaming to be going to see a shrink. But then in his BBC documentary Campbell himself and the friends and family he interviewed expressed their bafflement at what was happening to him when he had his breakdown. Campbell’s partner, Fiona Millar, who coped with being Cherie Blair’s adviser for eight years, had no idea that Campbell was likely to sink into a depression after his ‘breakdown’, or what to do about it when he did. He got medical help only after she became paralysed down one side of her face and her GP asked her if anything unsettling was happening in her life. His journalist friends still look quizzical when he talks about mental illness and suggest that he just had a drink problem. If this book is read by millions who still know nothing about psychological distress, and are enlightened by it, so that they can either get or give help, then again that’s a good thing. Still, it remains a self-help book disguised as a novel.

Mind you, even if they are enlightened (up to a point) on the subject of psychiatry, readers won’t receive much help for any lurking gender prejudices they may have. Professor Sturrock, it turns out, has been making visits to prostitutes for years and is filled with self-loathing, which tips him into a crisis. When the crisis occurs, his wife chooses eventually to forgive him (forgiveness is very important in the essential epiphany-healing of Sturrock’s technique), but she does so ‘amid her shame at his use of prostitutes, and any failings in her that led him down that path’. Arta the asylum seeker, so distressed at having been raped in the country she fled to for safety, is told by Sturrock that ‘the basic vision she had of herself was as a devoted wife and mother. The rapist must not be allowed to take that from her.’ Sturrock’s wife, ‘though she had a second-class degree in fine art, had been a full-time wife and mother for most of their marriage.’ Not even a good second-class degree, yet with such a brilliant husband. And, most Byzantine, when he tries to imagine what it must have been like to be raped, Sturrock finds he can’t because he can only think of male rape, yet he can understand that ‘a heterosexual man was likely to be raped in a part of his body he shared with nobody. And so Sturrock believed . . . that male rape was less likely to destroy the victim’s long-term interest in a sex life with a female partner. Arta’s problem, as well as the dreams, was that she now couldn’t face sex with her husband.’ In addition, Sturrock also knew ‘that rape of a woman could change her partner’s self-image which in turn could badly affect not just his sex drive, but his self-esteem.’

There is no doubt that a lot of work has gone into writing this book. This is true of all novels, every damn one – eighty thousand words and more take a long time to write, and getting them in the correct order requires a good deal of effort. But though admirable in some Protestant sort of way, trying hard, even trying very hard, isn’t quite enough if you can’t write and lack wit. Sturrock monologues about a eulogy he is required to write: ‘When will I finish the eulogy? But you have an outline. It’s rubbish. It’s just a sketch. It has no life in it. It has no colour and texture. People’s lives come alive with stories and colour and texture.’ Well, people’s lives come, if you must, alive in a piece of writing if the writer can make the writing work. The words story, colour and texture are no more helpful to a writer than key trigger, downward curve and plunge are to someone in the grip of a depression without a way to use them effectively. If Alastair Campbell wanted to write a novel about such a thing as people’s lives coming alive, then he or his editor should have tried much harder to wrench the language away from the turgid and the thought beyond the banal. The craft of fiction is not working out a plan that looks balanced on a spreadsheet and then clothing it with words. The trick about writing a good novel is to be a good writer, though I understand that many A-level students these days are assured that there is no such thing as good writing, or even good novels, only what readers like. That’ll be the market. ‘It’ll only sell if it’s good,’ Campbell says. Or was that ‘It’s only good if it sells’? And there’s that rabbit hole again.

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Vol. 30 No. 23 · 4 December 2008

Jenny Diski believes that things must be bad if medical research is funded from private-patient fees donated by doctors (LRB, 6 November). This is a common practice. When I was the dean of a large medical faculty in England, many of the clinical staff supported part of their research this way. Some of the sums were large: millions of pounds might be accumulated and spent over the years.

David Gordon
University of Copenhagen

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