Tuesday, May 22, 2018

 

When characters with mental illness appear in popular fiction, it is typically because the work itself focuses on the mental illness. However, there is a small contingent of fictional projects that have characters with mental illness that do not make that illness the central plot. These books follow the typical narrative arc and literary conventions of their genre and include conflicts unrelated to mental illness; psychiatric disorder is featured but defines neither the character nor the book.  

Authors writing about mental illness, however small or large a part of the plot, can raise public awareness and understanding or can strengthen harmful misconceptions. Two recent romance novels, both of which include a character with bipolar disorder, present strikingly different viewpoints in many respects.

In Promises Under the Peach Tree by Joanne Rock, a Harlequin Super Romance published in September 2014, Mack Finley and his high school sweetheart Nina Spencer are reunited in their hometown of Heartache, Tennessee, after a separation of many years. Nina is fleeing a failed business venture in New York City; Mack has returned because his brother Scott’s marriage is on the rocks. Readers learn that Mack and Nina were driven apart by tragic events surrounding their graduation; however, their relationship faced additional challenges because of Mack’s commitment to avoid fathering children. Growing up with a mother who suffered from bipolar disorder, Mack experienced firsthand the challenges of the disease and is determined not to take the genetic risk with a child. His stance on this issue complicates a reunification with Nina for which both of them long. When Mack’s niece Ally begins exhibiting her own signs of mental disorder, however, Mack is forced to reexamine his feelings.

Mack’s mother, Mrs. Finley, is ultimately (though not initially) portrayed as a sympathetic character who is open about her disorder and its negative effects on familial relationships. She remains optimistic about the evolving effectiveness of psychotropic medications and treatment in general (“The doctors have much better medicines today than they did when I was a girl. More choices, too. And as much as I make fun of all that talk therapy, the truth is, treatment works better if you combine the meds with counseling.”) Mack begins to understand that his mother’s illness is better managed and that his reactions to her illness prevented him from seeing her strengths.  He further realizes that it is his fears and not bipolar disorder itself that are limiting his life choices and threatening his relationship. He and Nina vow to work it out in a happy ending (which is typically a requirement for classification as a romance novel).

In the book Saving Steele by Anne Jolin (2016), bipolar disorder and treatment options are presented in an entirely different light. Jackson Steele, the titular character, has a long-standing diagnosis of bipolar disorder with which friends and family have helped him cope. One day a 6 year-old boy arrives on the doorstep claiming to be Jackson’s son. Jackson warms to the challenge of becoming a father, and soon falls in love with his son’s kindergarten teacher Kennedy. Kennedy has problems of her own, including obsessive-compulsive behaviors, parental abandonment, and infertility. Despite these obstacles, love conquers all and a happy ending ensues.

Positioning Jackson’s bipolar disorder as but one piece of his character and presenting conflicts unrelated to mental illness are both commendable aspects of this book from a mental health perspective. However, the portrayal of bipolar disorder itself is sometimes limited and perpetuates negative stereotypes of sufferers as uncontrollable rage machines. Jackson’s eyes change color from green to black and he refers to the onset of a manic episode as “going black.” He even has tattoos portraying his two sides: “green” for his baseline and “black” for his manic personality. Depressive episodes are not mentioned and do not appear to be a part of his pathology. The absence of depressive symptomatology, combined with the florid descriptions of the changes in physical appearance that signal mania, make Jackson feel more like a threat than a person with a disorder.

When his son’s mother reappears to claim the boy, Jackson flies into a wild abandon of “hitting anything within arm’s reach and alternating between sobbing and screaming.” After this stressor, he suffers a six-day episode of uncontrolled mania, during which he abuses substances and sexually mistreats his girlfriend (who accepts this behavior out of what seems to be the belief that it is somehow therapeutic), but inpatient hospitalization is never mentioned as a possibility. Similarly, Jackson is reported in another section of the book to have a counselor whom he sees twice a month and a psychotropic medication regimen with which he is compliant. However, during the crisis, neither his counselor nor his prescribing provider are mentioned. The view of the characters seems to be that the episode must simply be endured, without professional intervention.

Both of these novels communicate an understanding that medication and “talk therapy” are important in managing bipolar disorder. The books portray the disorder as simply one facet of the character’s identity, a facet that does not prevent relationship connection and general fulfillment in life. Despite these similarities, however, these works ultimately present significantly disparate views of the disorder itself, suggesting a continuing need for mental health professionals and advocates to interact with this sort of material.

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