1This publication is a contribution to the academic discussions around the interaction between literature and mental illness, especially in the British sphere. It distinguishes itself from feminist works cited by Nicolas Boileau such as Shoshana Felman’s Writing and Madness or Sandra Gilbert and Susan Gubar’s The Madwoman in the Attic as it does not explain irrationality as a rebellion against the social order. It is more in line with Jean-Jacques Lecercle’s work on the linguistic creativity of delirium, or with the interdisciplinary credo of medical humanities, seeking to foreground the insights of literature for the practice of medicine. It blends together contemporary bibliographic references (Baker, Crawford et al.) and more seminal modernist sources such as Woolf’s “On Being Ill,” in keeping with the scope of Nicolas Boileau’s publications. It also opens a dialogue between this area of interest and wider debates around the understanding of madness as either socially constructed according to parameters of gender, culture and race or as better accounted for by psychiatry and psychoanalysis. Nicolas Boileau’s approach fits into the long history of such explorations, prominently addressing the worldwide influence of the DSM III as American nosography, which in the long 20th century medicalized a phenomenon that was long perceived as mystical.
2While it pays tribute to that genealogy, this volume pioneers an approach through the concept of symptoms in its analysis of a corpus of British literature of the 20th and 21st centuries. It is mostly interested in the way literature does not only represent symptoms, but produces them, “and how this represented illness defies cure and care and resists the attempt currently made to erase symptoms instead of working from and around them” (32). Thus, the book does not only contemplate satirical instances of the biomedical order and its reductive taxonomies, it also questions how literature manifests that symptoms are a subjective apprehension of the world and not merely messages to be deciphered. The understanding of the notion comes from Lacan, and symptoms are defined as a structural pattern through which one makes sense of their jouissance (Le Séminaire), an area beyond the symbolical which jeopardizes the self and which the symptom, even though unwritten, regulates. Right from the start, one needs to underline the central part played by Mrs. Dalloway which is a reference point in other works of Boileau’s corpus. Moreover, the cultural era of modernism as a moment of emergence of crucial insights into the human psyche is largely documented in this study. The books which are examined, even though diverse in their chronological context, are all inscribed in cycles, address similar themes (such as war or PTSD), are informed by the modernist intertext and, often, feature secondary characters who are mentally afflicted and who, like Septimus Smith, affect the story in considerable ways.
3The body of the text is divided into three parts, which contain seven chapters. The first section is concerned with representations of failing doctor-patient relationships and symptoms calling into question the scientific method that does not manage to reify polymorphous subjectivities blossoming on the page. The second section focuses on secondary characters with mental health problems who impact the plot in ways that reveal social formations as symptomatic. The third section bears on two contemporary texts which tackle the link between voice, silence and symptom, in a way that delineates more contemporary modalities of psychic trouble, wavering between “hyperconnection and disconnection” (204).
4In the first part, three chapters pay homage to persistent symptoms that resist cure in books that dramatize a therapeutic encounter: Boileau’s originality consists in centering his analysis on the representation of patients. Chapter 2, entitled “Symptomatic Silence: Situating the Subject in Mrs. Dalloway,” revolves around Septimus Smith, the poor soldier experiencing shell shock, and it argues that his symptoms, his mutism and outbursts, are fundamentally antisocial and subjective, as opposed to the communal medical discourse on that disease at the time, as a product of the Zeitgeist. His speech pattern remains unexplained, mysterious and singular. Chapter 3 delves into Asylum by Patrick McGrath, the grim account of a destructive passion by an author who was inspired by his father’s job as a psychiatrist. Boileau contends that critical work has often underlined the unreliability of McGrath’s narrators, flawed psychoanalysts who are blinded by their knowledge. However, he prefers to delineate the generic influence of the “clinical case study” (82) in the portrayal of Stella, bringing to the fore the Lacanian notion of “foreclosure,” that is the iteration of a lack that has not been taken into account, an absent absence, defying the authority of nosography. Finally, chapter 4 covers Pat Barker’s Regeneration Trilogy, a very popular cycle whose success is ascribed to the convenience of the First World War as a topic allowing contemporary issues to be addressed and to its resolute criticism of postmodernist fiction. The psychiatrist’s method is lambasted by Barker for its reduction to physical symptoms and its lack of attention to the invisible: the diagnosis which wavers between shell shock and hysteria, although speaking to the bisexuality of the character, cannot be reduced to a social reading. According to Boileau, the novel testifies to a form of excess that transcends the symbolical order and enhances the alienation of language.
5Part 2 addresses the representation of mental health through drama and structure, as its two chapters engage with secondary characters who operate as indicators of the symptomatic formations in the plots. Chapter 5 concentrates on The Fifth Child by Doris Lessing, an unusual novel compared to the rest of her work, as it is embedded in a creative period in which Lessing enjoyed less critical attention because of her statements about feminism and communism. Boileau identifies this moment of Lessing’s career, and this novel specifically, as a shift towards the politics of madness. While the patient in the novel is Ben, a child whose mistreatment by the medical institution is not shown, his symptoms are said to give away his mother’s subjectivity. In a reversal between sanity and madness, the conservative values of David and Harriet’s family are treated as the real symptoms, the mother’s incapacity to form identifications is uncovered in a crisis of maternity, and the gradual emptiness leads the reader to lose their bearings and empathy. Chapter 6 considers how Alan Hollinghurst’s The Line of Beauty, organized around the narrative perspective of Nick, a gay lodger in a conservative family in the Thatcher era, presents us with a secondary character, Catherine, who has manic depressive symptoms and who ends up revealing the psychotic subjectivity of all the other characters. While “her medical condition is used as comic relief” (186), Catherine is described as disclosing the spirit of generalized jouissance that was valued during the Thatcher years. Her marginalization also serves as a counterpoint to talk about AIDS as a condition and not an illness, as was recommended by Susan Sontag.
6The third part of the book is devoted to “voices and silence as explorations of contemporary modalities of psychic symptom formations” (203), through two cycles which investigate the pathologies of the present by revisiting the stream-of-consciousness technique, the Outline Trilogy by Rachel Cusk (2014-2018) and Ali Smith’s Seasonal Quartet (2016-2020). Chapter 7 analyzes Cusk’s three novels about divorce which do not address mental health directly but speak to the therapeutic function of language because they are full of chatter and the jouissance of language. Paradoxically, subtle symptoms of disillusion and loneliness are expressed in these boundless confessions as well as in Faye’s silence, the narrator serving as a controlling echo chamber for these fragments of life which abolish repression. The last chapter looks into Ali Smith’s Seasonal Quartet, as an example of “Brex-lit” (Shaw 21) in which Brexit is often evoked in psychiatric terms. According to Boileau, Smith scrutinizes the vacuity at the heart of contemporary experience through stylistic games with punctuation, puns, musical metaphors, and an extensive use of dialogue reminiscent of the talking cure. Art appears as a solution against the angst of the post-truth era and communication struggles.
7One of the great qualities of this monography, a major and comprehensive contribution to the field, is to group together works of varying popularities and from different eras, which have not usually been studied together, shedding fascinating light on the shared intertext of modernism and original references to Woolf. The prism of Lacanian symptoms provides an acute way of seizing the coherence of the corpus. This is also achieved through the choice of cycles, a common structural feature which remains a little bit underdeveloped as do the references to literary genres. The book offers a very rich survey of various texts, and the context of their critical reception: this is especially true of Doris Lessing and Rachel Cusk so that it will also be particularly useful to specialists of these authors. It provides an apt summary of more traditional Freudian readings and their limits. While being very clear about the theoretical lens of Lacanian psychoanalysis, the text regularly steps aside towards gender and sexuality studies to underline how certain bodies and behaviors have been misread as pathological. However, the book does not always underline the conflict between Lacanian psychoanalysis and feminist or queer studies. Although we would have loved to read more of this, especially in chapter 3, this is not the book’s commitment, and we can merely suggest that the same corpus could more systematically be probed through other perspectives. This question is dealt with to an extent, as the book regularly historicizes certain ailments and treatments (PTSD, shell shock, the rest cure…) but the reader might want to know more about the British specificities of the treatment of psychic trouble. On the whole, this study certainly broadens our understanding of the relationship between mental health and literature in the 20th and 21st centuries and it presents us with an array of thought-provoking close readings.