Tuesday, November 25, 2008

Book Review: A Spot Of Bother by Mark Haddon

I'm in a book club. Did I tell you that before? It's great, a fantastic bunch of girls, and we've read a different interesting book every month, lots of them ones that I wouldn't have thought of reading for myself otherwise. Our book last month was A Spot Of Bother by Mark Haddon. I was looking forward to reading it, because I really enjoyed his other book The Curious Incident of the dog in the night-time. (I ran out of steam on capitalising the first letters of the words in that sentence. Did you notice? But do you still capitalise each word when it's a really long title? Is there a limit? If not, should there be? Anyway.)

So, a few things stood out to me about A Curious Incident. (Firstly, aside: if you haven't read these books, please do. Both because they're fabulous books, and also because I may unintentionally let loose a few spoilers in this blog. Check back here when you've finished reading them.) Firstly, the main character is said to have "some kind of disability", this is mostly assumed to be Aspergers Syndrome. One of my cousins is mildly Aspergers, and reading this book really helped me to understand how it might feel, or look, from inside that kind of viewpoint. During a cursory googlesearch I found a review of the book by a boy who has Aspergers, and he seemed to quite like the way the story was told and the character portrayed.

In 'A Spot of Bother' there were a whole heap of different issues raised. Each character had their own secret, their own dysfunctionality, their own private motivations, and mostly they seemed inclined to keep them to themselves, which only exacerbated all the problems until they reached an inevitable conclusion. The character I want to focus on is George. George is described like this by Mindy Laube in an SMH review:

"an unobtrusive, middle-class, middle-aged man politely unravelling. George is a thoroughly decent chap who, in his desperation to avoid making a fuss, goes quietly, somewhat willingly, mad; his growing paranoia only becoming of real concern to him when it begins to look a little undignified."

Let me give you an example of George going "quietly mad". George is sitting watching television when
"someone unscrewed a panel in the side of George's head, reached in and tore out a handful of very important wiring.
He felt violently ill. Sweat was pouring from beneath his hair and from the backs of his hands.
He was going to die.
Maybe not this month. Maybe not this year. But somehow, at some time, in a manner and at a speed very much not of his choosing.
The floor seemed to have vanished to reveal a vast, open shaft beneath the living room.
With blinding clarity he realised that everyone was frolicking in a summer meadow surrounded by a dark and impenetrable forest, waiting for that grim day on which they were dragged into the dark beyond the trees and individually butchered.
How in God's name had he not noticed this before? And how did others not notice? Why did one not find them curled on the pabvement howling? How did they saunter through their days unaware of this indigestible fact? And howm once the truth dawned, was it possible to forget?
Unaccountably he was now on all fours between the armchair and the television, rocking back and forth, attempting to comfort himself by making the sound of a cow."

George has an anxiety disorder (my diagnosis!). As I was reading the book, at first I couldn't help but wonder why he didn't just snap himself out of it? So he's thinking things that part of his brain knows isn't true - well, why don't you listen to the part that you know is telling the truth? What's the point of making up bad things that might happen and believing them? Towards the end of the book I could see that George had no more control over where his thoughts were leading him than I would have over my reflexes of pulling my hand away from something hot. George starts hurting himself, to try to take his mind off his thoughts. It doesn't work.

A friend recently told me about how things felt to her when she was badly affected with anxiety. She said that she woke up in the middle of the night with the complete knowledge that her baby was going to die in around two minutes. Of course, her baby wasn't going to die, and didn't die, but that thought in her head was as irrefutable as fact. She also knew that if she used the microwave, it would blow up, if she would pick up a knife, she would cut herself, if she got in her car, she would have an accident.

Wikipedia lists lots of different types of anxiety disorders. But what I'm most drawn to is the para at the bottom about treatment. There are many ways to treat an anxiety problem, but it must be treated. Wik says:
"The choices of treatment include psychotherapy (such as cognitive behavioral therapy); lifestyle changes; or pharmaceutical therapy (medications).

Mainstream treatment for anxiety consists of the prescription of anxiolytic agents or antidepressants or referral to a psychologist. Treatment controversy arises because some studies indicate that a combination of the medications and behavioral therapy can be more effective than either one alone; however, others studies suggest pharmacological interventions are largely just palliative, and can actually interfere with the mechanisms of successful therapy.

Meta-analysis indicates that psychotherapeutic interventions have superior long-term efficacy when compared to pharmacotherapy. The right treatment may depend very much on the individual's genetics and environmental factors. Therefore it is important to work closely with a psychologist and medication provider who is familiar with anxiety disorders and current treatments.

A number of drugs can be prescribed to treat these disorders. These include benzodiazepines (such as Xanax), antidepressants of most of the main classes (SSRI, TCAs, MAOIs), and possibly Quetiapine."

So basically there are 3 ways to treat an anxiety disorder. With drugs, with behavioural therapy, or lifestyle changes. Someone close to me once had very bad anxiety disorder, and managed to change their whole outlook by changing their lifestyle - they starting exercising regularly, looked into natural remedies for depression, and radically changed their diet, to include a much greater proportion of fresh food and vegetables. Did this cure the anxiety? Not entirely, but it did help this person immensely, bringing them much further back into the 'normal' scope of being able to cope with day-to-day living.

So why am I talking about how to treat an anxiety disorder? Spoiler alert! Because in the end of A Spot of Bother, George basically cures himself, as an obliging contribution to a neat and happy ending. With only a "It was time to stop all this nonsense" George seems able to turn off the anxiety, and the book finishes, with the unstated promise that things would be okay from now on because he now wanted them to be. It's not that easy, it just isn't. And I guess I felt a bit cheated that Mark Haddon seems to go into such depth in what an anxiety disorder feels like from the inside, really working to cast aside the typical stereotype that it's an easy thing to just talk yourself out of, only to let the team down at the end and conform to popular misconeption. George has now decided. Oh, he's decided now has he? Well, if only he'd have done that before and saved us all the bother.

All in all, it was an incredibly gripping book. I just felt let down with the unrealistic ending, so all up I'm giving 3 stars.