Things I learnt over the holidays: New Year’s Eve, with its retrospective mood and all our social media feeds flooded with best of 2014 lists, is not the best of days to read a depressive, mental illness institutionalisation and grief book.

But sure enough, lured in by a Christmas 99p offer, I read Nathan Filer’s debut novel The Shock of the Fall, and was totally unprepared for it and how it would hit me.

It’s a brilliant book, by all means. It deservedly won the Costa Book of the Year Award last year and has been selling in bucketloads ever since.

Yet, the bleak and stifling picture it paints of institutionalisation, of the relentless pain and suffering of mental illness sufferers and their families, is hard to stomach.

At one point in the novel, the stoic father of a schizophrenic son leaves him a heartbreaking message scribbled on a wall at home:

“We’ll beat this thing mon ami. We’ll beat this thing together.”

The son’s reaction makes up 21 of the most powerful words in the book:

“… a tightness gripped at my chest. It was the thought of his sadness. It was the fear that he was wrong.”

Filer, the author, is a mental health nurse, and it shows – you can tell he knows that of which he writes.

He populates his novel with those people living around the sufferers: relatives and friends but also mental health workers, who try and fail to strike a supportive note.

Some of them dismissive, of the sort who think – hope? – that minimising the issue will make it go away, and others who make lunges at empathy yet misread the patient’s level of emotiveness.

Our sanitised interpretation of fate and life in general, seems to give us the illusion that anyone burdened with an illness or condition of any kind will have a sort of karma-induced ‘immunity shield’ against further tragedy. The Shock of the Fall quite bluntly strips us of that illusion.

Yes, a mentally ill person can have other tragedies befall him and his family. Matt, the protagonist, is schizophrenic, but is also grappling with tragic death in the family, with grief and guilt. As is all his family.

His older brother, Simon, who has Down’s Syndrome, dies in a horrific freak accident. (This is no spoiler, as Matt – and Filer – reveal it on the book blurb itself and within the first couple of pages of the book.)

The Shock of the Fall is not, however, a pile-on-the-tragedies melodrama. It is a highly sensitive, extremely well-informed and empathic journey along with Matt and his various bouts of institutionalisation in soulless mental institutions.

A highly sensitive, extremely well-informed and empathic journey

And it also deals with the worst horror of all parents: having to leave a mentally ill child alone, to make his or her way in the world.

“I want to talk about the difference between living and existing and what it was to be kept on an acute psychiatric ward for day after day after day after day after day …”

Everyone keeps comparing this book to Mark Haddon’s classic The Curious Incident of the Dog in the Night Time, but I find the comparison somewhat lazy and simplistic.

Sure, they’re both narrated from the point of view of a young sufferer, but to be honest I don’t see much similarities beyond that.

Where Curious Incident was relatively light-hearted, its protagonist coping remarkably well, and left the reader with a – somewhat unrealistic – optimism towards the fate of the child, The Shock of the Fall is anything but.

And of course, they deal with very different realities: Asperger’s Syndrome in one, schizophrenia in the other.

I’ve always thought – don’t stone me, all you fans of the book – that the deification of Curious Incident on the whole did more harm than good to the cause it is often wheeled out to promote.

It humanises sufferers on the autism spectrum, yes, fine, but it somewhat falsely reassures us that all will be well, that we needn’t worry because, hey although they’ve got issues they’re brilliant at maths and deadpan rhetoric and can cope just fine, thank you very much.

I swear, if I hear another person say “but children on the spectrum are brilliant at maths/have an amazing memory/can memorise the telephone directory like that Rain Man guy,” I’ll throw the damn directory at them.

And don’t even get me started on the Sheldon bloke from Big Bang Theory.

What someone close to a sufferer does not need to hear is how “u le Alla jbierek qisu m’għandu xejn” (don’t worry, God bless, he looks alright) or “u issa tara kemm jikber u jsir bravu” (don’t worry, he’ll grow up to become really smart), because that does not respect, but rather devalues the sufferer’s life and challenges.

Not to mention the broad brushstrokes that it paints, generalising conditions where no two pat-ients are affected in the same way. And Filer knows this very well. So what he does in his novel is show us at point-blank range the realities of their everyday life, when no one else is looking.

In both novels, the central character’s condition is at times visible, and others near to invisible, or iceberg-like showing just a fraction of its real self to the surrounding community.

Filer uses the words ‘mental illness’and ‘sufferer’ repeatedly, refusing to go for the politically correct ‘condition’ and other assorted euphemisms.

His accurate descriptions of the consequences and realities of what Matt goes through, leave no doubt as to what it feels like to him. From there forward, debates on how to define or cauterise it become merely academic and frankly irrelevant to those involved.

There is a place and time for political correctness. Facing up to the realities of mental illness is not one of them.

“I’ve told you about my first stretch in hospital, but I’ve been back in since. And I know I will again. We move in circles, this illness and me. We are electrons orbiting a nucleus.”

(All extracts above taken from The Shock of the Fall by Nathan Filer.)

Sign up to our free newsletters

Get the best updates straight to your inbox:
Please select at least one mailing list.

You can unsubscribe at any time by clicking the link in the footer of our emails. We use Mailchimp as our marketing platform. By subscribing, you acknowledge that your information will be transferred to Mailchimp for processing.