Life Writing and Schizophrenia: Encounters at the Edge of Meaning by Mary Elene Wood (review)

This is an important book, advancing the study of first-person narratives of madness and demonstrating the substantive contributions that literary scholars can make to medical history. Wood succeeds in her goal to “write respectfully about the often startling mental phenomena that are a part of human experience” (p. x), partly by taking her own account and that of every person she writes about equally as objects of inquiry. With “stories of schizophrenia” her explicit focus, she makes clear at the outset that these include “stories written by those living with it and stories written by those who study and treat it” (p. 1). Wood understands clearly the key challenge faced by all scholars of madness narratives: “How do those living with schizophrenia write about their lives given that the diagnosis defines them as unable to tell a coherent story?” (p. 2).

Chapters are organized around a thought-provoking set of exemplars—from the heavily constrained personal accounts published by the medical journal Schizophrenia Bulletin and the “shadow narratives” hidden in doctors’ casebooks to the more familiar hospital memoirs and fiction that Wood and others have previously analyzed and finally to the unwritten story of her own mother, who struggled with schizophrenia throughout much of her adulthood. This last is a daring choice for a careful scholar like Wood, fully aware of the ethical and empirical challenges of constructing and interpreting a parent’s life story. Less intimately, another chapter addresses the metaissue of a “narrative engaged in an encounter with another narrative” (p. 121), focusing on the case study that Freud based on Schreber’s memoir and Bateson’s introduction to Perceval’s narrative. (Helpfully, each chapter is individually referenced so it can stand on its own; several would be excellent as supplementary course readings.)

Wood’s choices reflect the key insight of this book, expressed clearly in its title—that life writing and schizophrenia “encounter” one another at “the edge of meaning.” She is not afraid to defend patients’ right to have their own perspectives count, both for ethical reasons and because psychiatrists have so little basis on which to assert their claims as authoritative. But she positions herself on complex epistemological ground, critiquing Freud for “distort[ing] and appropriat[ing] the patient’s words” while praising “the seriousness with which he took them” (p. 126) and the “multivocal narrative” he created as a result (p. 127). Wood avoids the trap of taking first-person accounts as any more or less layered than those of doctors—never simply “true” or “invented” or “metaphorical” but all those things and many more. She analyzes an impressively diverse range of narratives and reads them equally closely. But in the end, she seems reluctant to challenge “schizophrenia” itself, constantly referring to it as “the disease” as if this terminology were not itself at issue.

In analyzing the brief personal accounts in Schizophrenia Bulletin, Wood does emphasize how “contributors are asked to write themselves up as case studies” (p. 80), conforming to the expectations of doctors by, for example, “shap[ing] stories to emphasize the effectiveness of medication in reducing symptoms” (p. 89). She draws attention to the revealing fact that “there is no dialogue with or acknowledgment of these writings in other sections of the journal” (p. 80), even though one such account has been included in each issue since 1979.

Perhaps the most astute chapter in this very astute book focuses on the DSM-IV casebook. Wood shows how the patient’s voice appears in “‘shadow narratives’ [that] interrupt the narrative of [the] schizophrenia diagnosis, exposing it as the story-telling that it is” (p. 226). Calling attention to the details the doctor chooses to include or omit in a case example, she reveals the “universalizing sweep of the diagnostic gesture” (p. 236) and explores diagnosis as narrative, a topic rarely considered in the burgeoning literature...