Bordering on madness

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), defines schizophrenia as “a disorder that lasts for at least six months and includes at least one month of active-phase symptoms (i.e., two [or more] of the following: delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, negative symptoms).”[1] In fragmented, perhaps schizoid, prose passages, Bhanu Kapil’s book Schizophrene speculates that the high incidence of schizophrenia in diasporic Indian and Pakistani communities extends from the trauma experienced during Partition and the subsequent displacement, xenophobia, and racism confronted by those who fled and their descendants. She also implicates Partition in the “parallel social history” (i) of domestic violence. Through these explorations, Kapil begins to prod the question of how both mental illness and national identities are constructed.

In the introductory “Passive Notes,” Kapil explains how Schizophrene was assembled from the handwritten draft she had discarded, thrown into the garden to be buried in snow. “[B]efore the weather turned truly warm,” she writes, “I retrieved my notes, and began to write again, from the fragments, the phrases and lines still legible on the warped, decayed but curiously rigid pages”(i). Thus Schizophrene is a palimpsest, a text constructed from successive layers and erasures. In a work spanning three continents, the juxtapositions of narrative fragments and the placement of space mark border crossings, as reoccurring images of maps and grids document movements, locations, and violence, the relative positions of bodies.

In “Partition,” Kapil writes,

It is psychotic to draw a line between two places.

It is psychotic to go.

It is psychotic to look.

Psychotic to live in a different country forever.

Psychotic to lose something forever.

The compelling conviction that something has been lost is psychotic.

Even the aeroplane’s dotted line on the monitor as it descends to Heathrow is a purely weird ambient energy.

It is psychotic to submit to violence in a time of great violence and yet it is psychotic to leave that home or country, the place where you submitted again and again, forever.

Indeed, it makes the subsequent involuntary arrival a stressor for psychosis. (53)

Thus, for someone who lived through the Partition of India, psychosis is inescapable. It is a condition perpetrated and perpetuated by borders, by breakage, by violence and displacement.

One of three epigraphs to Schizophrene is from Dinesh Bhugra and Peter Jones’s Migration and Mental Illness. In this quotation, Bhugra and Jones suggest that the combined stressors of migration, racism, and poverty contribute to mental illness. Kapil characterizes schizophrenia as a “trans-generational effect” (i) of Partition. Yet neither Bhugra and Jones nor Kapil herself seems willing to consider that these factors may lead to the increased likelihood of a diagnosis of mental illness rather than the thing itself.[2] On this subject, the DSM-IV remarks:

There is some evidence that clinicians may have a tendency to overdiagnose schizophrenia in some ethnic groups. Studies conducted in the United Kingdom and the United States suggest that Schizophrenia may be diagnosed more often in individuals who are African American and Asian American [and, presumably, Britons of African or Asian descent] than in other racial groups. It is not clear, however, whether these findings represent true differences among racial groups or whether they are the result of clinician bias or cultural insensitivity.[3]

Like borders, mental illness is constructed — the invention of a powerful few that is imposed upon the many. But if Kapil is primarily interested in mental illness as a metaphoric or formal device, why choose schizophrenia? Why not multiple personality disorder? Why not, for the cartographic resonance of its name, borderline personality disorder, hovering over a demarcation?

According to the DSM-IV’s entry on schizophrenia, “Delusions (Criterion A1) are erroneous beliefs that usually involve a misinterpretation of perceptions or experiences. Their content may include a variety of themes (e.g., persecutory, referential, somatic, religious, or grandiose).”[4] In the context of Schizophrene, a perception of persecution is likely not delusional at all. During Partition women were tied to border trees and disemboweled (40). In Britain, immigrants are harassed by racist and xenophobic neighbors (49), and domestic violence is quite literally mapped onto ethnicity, as “a local government map of the London Borough of Ealing, of the ethnic origin of a borough-wide population, overlays a Social Services map, in which different kinds of abuses are recorded as having happened in particular homes” (44). Could impressions pathologized as “delusional” be accurate perceptions of insane realities or, as Kapil is suggesting, the stains left behind by them? And is a somatic delusion not also linked to some reality? In “India: Notebooks,” the speaker recalls:

In the pharmacy, I met an exhausted woman whose daughter had been hospitalized for a phobia. When a spoon touched her lips, she had the terrible sensation that it was slipping down her throat. Her condition worsened. If anything touched her sari, if one of her children brushed against her thigh, she felt a peristaltic reflex. She felt she was swallowing them too. (18)

In Schizophrene, eating is linked to violence. When the speaker’s mother glimpsed women tied to border trees during Partition, it was their stomachs that were cut out (40). The lone sentence on another page reads, “He dragged her down the stairs by her hair to the room where we were eating” (47). Is this an act of domestic violence or of political violence? Does it occur in India? Pakistan? Britain? The US? A meal is the only location given. For immigrants, food is a mark of difference. “I keep going back to what we ate, what we were fed,” Kapil writes in “Partition.” “It is my way of communicating with you, the other children in your houses,” who come to the window to jeer “with a boo and a hiss and a You fucking Paki, what do you think you’re doing? This is England, you bleeding animal” (49). When eating is such a fraught activity, is a fear of swallowing so irrational?

At times the disease and the cure seem nearly interchangeable. In “India, Fragments,” Kapil writes, “Schizophrenia is rhythmic, touching something lightly many times” (61), while in her notes at the back of the book, she explains, 

From cross-cultural psychiatry, I learned that light touch, regularly and impersonally repeated, in the exchange of devotional objects, was as healing, for non-white subjects (schizophrenics) as anti-psychotic medication. In making a book that barely said anything, I hoped to offer: this quality of touch. (71)

Thus, with its use of restraint, fragmentation, and intermittent italics, Schizophrene moves toward a kind of ritual healing — even as it enacts the very thing that must be healed. Near the end of the book, the speaker tears a page from her notebook and holds a funeral for it, alone within the communal space of a riverbank.

Mid-air, above the ghat, ochre shards began to stream, upwards

 from the bank. They reversed themselves to make an urn.

 Fire and water flowed from each cracked point.

This image knew no bounds. Red then white.

White then red.

Then black. (66)

Only in hallucinations do borders disappear. In the world of Schizophrene, the space opened by hallucination is the only place that is not restricted, multifurcated, schizoid. The question becomes not whether schizophrenia is the result of systemic mass trauma but whether the cure for that trauma can be the “illness” itself.

1. American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR (Washington, DC: American Psychiatric Association, 2000), 298.

2. Author’s note, June 2014: Since this review was originally published in June 2013, I have learned that Kapil has discussed the possibility of misdiagnosis on her blog and elsewhere. See Was Jack Kerouac A Punjabi?: Misdiagnosis, the allele and syntax: vectors from an interview with FLORE. 

3. Ibid., 307.

4. Ibid., 299.