A family forced to pass through hell

AUTOBIOGRAPHY : Henry’s Demons: Living with Schizophrenia – A Father and Son’s Story By Patrick and Henry Cockburn Simon &amp…

AUTOBIOGRAPHY: Henry's Demons: Living with Schizophrenia – A Father and Son's StoryBy Patrick and Henry Cockburn Simon & Schuster, 222pp. £16.99

CHRISTMAS 2001, and the Cockburn family were at their holiday home in Waterford. Henry, the elder of Patrick and Jan’s two sons, was, by his father’s account, his usual intelligent, charming and humorous self. Henry had just turned 20. As a boy he had been described by parents and teachers as artistic, quirky and original, if often disorganised. After the usual bumpiness of adolescence – nothing that suggested incipient psychosis – Henry seemed to have found his stride. A budding young artist, he had just finished his first term at art college in Brighton. He told his father that Christmas: “I have never been happier.”

The change came swiftly. By early February Henry had been rescued from the freezing waters of Newhaven estuary – he’d been told by voices to go there – and was in the Priory, a psychiatric hospital in Hove. It was the start of a years-long cycle of psychotic breakdowns, hospitalisations, disappearances and periods of lucidity that will look all too familiar to anyone who has witnessed a friend or family member succumbing to schizophrenia.

At the time of Henry's first hospitalisation Patrick, an award-winning foreign correspondent and author (born and raised in Cork), was in Kabul, covering the fall of the Taliban for the London Independent.He flew home to join Jan in Canterbury. (Jan teaches English literature at the University of Kent.) Unsurprisingly, neither of them knew much about schizophrenia. Unless we are psychiatric professionals or social workers, or have suffered the illness or been close to someone who has, most of us remain ignorant of what is a devastating illness, one that affects roughly 1 per cent of the world's population.

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Patrick quickly came to distinguish between the “positive” symptoms of schizophrenia – hallucinations and delusions – and the “negative” symptoms, which include apathy, diminishment in normal thoughts and speech, and an absence of emotional expression: “I felt as if a part of [Henry’s] brain was in overdrive and part in underdrive.”

When he and Jan asked the doctor what a diagnosis of schizophrenia might mean to their son, they were quoted the same one-third “rule” that my own parents heard almost 40 years ago, when my eldest brother was diagnosed schizophrenic: a third of patients recover completely, a third improve but continue to have intermittent problems and a third do not improve.

For the next five years Jan, Patrick, Henry and Alex (six years Henry’s junior) passed through their own forms of hell. Henry had a particularly strong resistance to taking his medication and a Houdini-like capacity for escape; in two years on the “secure ward” of St Martin’s hospital in Canterbury, he slipped away 17 times. Patrick and Jan lived in terror that their son would kill himself, either inadvertently (he had a habit of wandering naked in the snow and swimming in freezing waters) or purposely. Suicide is the number-one cause of premature death among people with schizophrenia – an estimated 60 per cent of males with the illness attempt suicide at least once; 10 to 13 per cent die of it – and Henry was not immune to the impulse: “If the windows of Fitzmary 2 hadn’t been sealed tight . . . I probably would have jumped out headfirst and shattered my skull.”

By 2007 Henry's condition had stabilised enough that his father proposed they write a book together. Patrick's hope was that writing about his illness might make it easier for Henry to accept that he was ill and thus to accept the treatment on offer. The result of their collaboration is Henry's Demons, an intelligent and humane work that provides a rare inside view of an illness that does not lend itself readily to autobiography.

Henry describes his own dissolution in a prose that is sadly detached and emotionless, even as it renders for the reader talking trees, nights of cowering naked in the back gardens of strangers, fanciful or terrifying hallucinations and delusions, the suicide of a friend.

“Toby had committed suicide by jumping in front of a train. This surprised everyone in the ward. One of the patients rang up Toby’s parents to say that he might not be dead. Toby’s mother said she had seen the body and he was quite dead. The last time my mother had come to see me I had been playing football with Toby in the garden, but now I stopped playing football.”

Schizophrenia is an illness for which there have been no major advances in treatment since the first antipsychotic came on the market, in 1953. Antipsychotics are generally effective in controlling hallucinations and delusions, but they do little or nothing to address negative symptoms. As the illness tends to plateau after the first few years of raging psychosis, what one may be left with is this debilitating set of largely untreatable symptoms. One of the most tragic costs of the illness is this split between experience and emotion (schizophrenia has nothing to do with a split personality). Talking trees may, while they last, be terrifying, but the disintegration of a once-vibrant personality and a lost capacity for emotional engagement often constitute permanent damage.

The lack of advance in treatment is related to the fact that the illness is still not very well understood. Causes seem to be myriad and overlapping. Diagnosis is an inexact science. It is not clear whether there is a single illness called “schizophrenia” and not, instead, many forms of the disorder, each with its own causative factors. It is believed that people who develop the illness have inherited a predisposition that likely involves the interaction of many gene variations, and that the illness arises from an interplay between genetic and environmental factors. Henry was a regular cannabis user, and though Patrick mentions the drug’s “possible devastating impact on somebody genetically predisposed to schizophrenia”, the book doesn’t dwell on this angle, presumably because of the difficulty of establishing clear cause and effect.

While we wait in hope for therapeutic progress to be made, we can, in the meantime, enhance our knowledge of the illness and our compassion for those who suffer it, and a book like this can help enormously in that process.

Henry is now in a “step-down” facility and has not run away in more than two years. The psychosis hasn’t disappeared, but he has accepted that medication helps him to combat what he calls his “polka-dot days”. At the same time he continues to question, at least intermittently, whether he is ill.

“Do I have schizophrenia? My mother and father and the dreaded psychiatrist definitely believe I am schizophrenic. They have grounds for their belief, such as my being found naked and talking to trees in woods. Yet I think I just see the world differently from other people.”


Molly McCloskey's new book, Circles Around the Sun, a memoir about her brother's schizophrenia, will be published by Penguin Ireland in June