Sarah Wardle, poet and author of ‘A Knowable World’ recently came to speak at a conference I helped organise. A Knowable World follow’s Sarah’s detainment in a Central London psychiatric hospital for over a year for manic episodes of bipolar disorder and it received positive reviews from both the British Journal of Psychiatry and the Guardian newspaper. I would also recommend it as her poems offer an eloquent glimpse of experiences that are relatively rarely documented.
Sarah has kindly allowed me to publish one of her poems to accompany this interview, which can be found in the post following this one.
Can you tell us about the circumstances which lead to you writing ‘A Knowable World’?
I had already had two collections published and in my third book wanted to chronicle time spent in hospital, much as Kate Clanchy chronicled pregnancy and childbirth in her third book, Newborn.
Were these poems written in the large part with events, or afterwards?
Apart from a few at the beginning and end, written before and after, most poems were written on the wards, for example one that begins, ‘The consultant psychiatrist is on the ward./ In his proximity all is hope with the world’. Others were responses to the daily round of fire alarms and PRN, to snow seen on Easter Sunday from a ward window, or to a fellow patient’s suicide. The opening poem describes the MRI scan that prompted a previous psychiatrist, Professor Basant Puri, to take me off medication and put me on fish oil. The closing poem describes walking up Ben Nevis and celebrates being out in the open again. Writing was a lifeline for me and I was heartened to receive in hospital acceptances from journals, such as The Times Literary Supplement, for poems written on the ward.
In his famous experiment Rosenhan reported the staff commenting on pseudo-patients’ ‘writing behaviour’. Did the staff ever comment upon your writing?
I wasn’t writing only poems. I tried to write, not fight, my way out, for example, writing for tribunals and hearings. I remember after writing a sonnet to the doctor, a nurse saying he would throw it away.
What was your aim with AKW – to inform, to record, to heal? Your poems are often very personal, and are about events about which many people might prefer to get as little attention as possible; did you ever consider not publishing any of the poems?
Yes, my aims were exactly those – to inform, to record, to heal – for others as well as myself, and to make ‘a knowable world’ of such circumstances to those who may have little experience of them and may perhaps stigmatise people who have mental health difficulties. Hopefully they will have appeal beyond their subject matter. I have to say, as a writer, I write for the intrinsic pleasure and pastime of writing and this act of concentration helped me in hospital. Because I value authenticity in writing, I did not self-censor.
I’m not generally a reader of poetry, but I was impressed by the emotional immediacy of your poems and their power to compel me to reconsider situations from an alternate viewpoint. Why do poems have this advantage over prose? ( I’m reminded of how Francis Bacon said he wanted to paint portraits: "Not an illustration of reality, but to create images which are a concentration of reality and shorthand of sensation" – perhaps poems are similar.)
Because poetry is midway between music and painting, it can deploy both sound and imagery to affect emotions and transmit truths in a more startling and defamiliarising way than prose. Iambic pentameter, the lifeblood of poetry in English, has a soothing beat and I was interested that when I had the MRI scan, I was told that parts of the brain responsible for music were highlighted, since, as it says in the opening poem, ‘I kept speaking poems I had written/ to myself, trapped inside that white coffin’.
Throughout the book there is a sense of your fighting against state systems of containment (the police, components of the mental health system etc.) which suggests a very negative experience – and it’s more than some people’s jobs are worth/to open a locked door or grant a wide berth ("Wild Card") – but yet you are strongly drawn to the psychiatrist who is in charge of your care and also write of missing the ward when you are discharged. How do you reflect now on this apparent contradiction?
Well, I have never literally fought anyone, in terms of punching, or kicking. Growing up without siblings, I never learnt to fight. I fought for my liberty by applying to tribunals and hearings and this very system is there so that you can be discharged earlier than your hospital care plan allows. There is inherent struggle to the psychiatric patient’s position, since you find yourself detained in a challenging environment for the foreseeable future with little explanation of why you must be medicated against your will.
You don’t often glimpse your doctor on the ward, though the consultant allotted to me was more present than others, but when you do, the nursing staff and patients defer to him, plus he holds your release in his hands, so he can become a larger-than-life figure. One sees policemen even more rarely, but it is a comfort when you do, because they come when you have called them for help, when you feel you are being mistreated.
I developed a crush, or transference, on the psychiatrist after I’d been A.W.O.L. and he mentioned a poem from my first book, called ‘Flight’. I must have looked amazed he’d read it because his response to my expression was to cry and I was moved by his sympathy.
The patient may be discharged, as I was, to living alone and it is true that after a whole year of the camaraderie of fellow patients, one has to adjust to silence, but I have no doubt this is preferable.
At the Art of Psychiatry conference you were able to meet psychiatrists in an out-of-work context, so you’ve seen us at ‘work and play’. What do you think of us?
First, thank you again for inviting me to take part in the conference. It was a very interesting day and the people I met were thoroughly pleasant. It was cathartic to be faced with a hall of people with sectioning powers and be treated as a working equal, not a ‘patient’.
Do you have any advice for the psychiatric profession?
As a lecturer I see a class of students, but try to get to know each one’s writing and themes and read and listen to them as individuals. In this respect students are like patients and benefit from empathy and individual care. I would recommend my consultant, Dr Ronnie Taylor, as an example of good practice in this regard. Some doctors and nurses would do well to remember we are all patients of some specialism in the end.