Mental Health Tropes in Writing

I was interviewed on this topic for the *INDIE BOOK TALK PODCAST* a while back. The link is here (~20 minute listen):
https://tinyurl.com/zcfj8jtn

I'd be interested in hearing other authors' takes on it. Thanks!

Best,
:-{D)
_Mark

I prefer reading to listening. (My reading speed is so much higher than my listening speed! I keep seeing youtube videos titled "the top ten dramas that feature x" or "20 amazing facts about y" and I think, if that was an article instead of a video, I might have actually clicked on that.)

Would it be possible to sum up the key points here?

If you asked about this oon an indie book talk podcast, it seems likely that you wrote a book that has some connection to the subject. I have noticed that it's been a "hot subject" in asian drama-land recently, but I haven't noticed it in my reading so much. (Also, it seems weird that it is THE TOPIC now, when all sorts of mental health issues have been popping up in dramas for forever -- they weren't dealt with very realistically however, so maybe that's the difference?)

Now that I've said all that, I find myself wondering...
Why do I NOT notice mental health issues in my reading as much as my TV watching? Is it because I read different kinds of stories than I watch? Is it just less common in books? Do I just not notice it as much for some reason?

Anyone else have any insights?

>2 LShelby:
Hey, L.
I was the inteviewEE, not the one asking the questions; and it was recorded several weeks ago—so I couldn't recreate it now. I do recall it was a pretty far flung discussion, for being so short.

I can't speak to your experiences, of course. I do think mental health tropes are prevalent—and highly misused/abused—in all media.

My talk was about how to handle that as a writer. One (possible) answer to your question is that unreliable narrators are more easily forgiven (or sometimes even "rewarded") by audiences of movies/TV than in prose fiction.

Best,
_Mark

>2 LShelby: once again we agree - put captions videos and let me speed through them (work training videos are the worst for not doing this, I have other things I need to be doing rather than waiting for you do get to the point), and I don't listen to podcasts at all, they're just too slow.

I'm not sure how much an unreliable narrator should be included in mental health issues, although for example in wizard of the pigeons it does occur. I've only got 18 books tagged mental illness https://www.librarything.com/catalog/reading_fox&tag=mental+illness and another 3 mental health, the crossover with unreliable is 0 even though I should have included Pigeons. Some other of my favourites on the mental health theme include borderline and signatures

>4 reading_fox:
The topic is "mental health tropes in writing". That is, what are the various ways neuro-divergent characters are handled by authors? Including such characters in a way that isn't inaccurate or degrading can be a challenge. This is especially true if it's your protagonist and you're determined not to make the story just all about their illness.

I mentioned unreliable narration for two reasons:
i) because that is one technique that is used to bypass the problem altogether (sort of a variation on the "it was all just a dream" trope), and;
ii) it is a possible explanation of why one might see notice FEWER neuro-divergent main characters in writing than in other media, like movies. In a movie/TV show, if we find out that multiple scenes (A Beautiful Mind, Fight Club), or a season (Dallas, Undone), or an entire show (Newhart) was the product of unreliable narration, we tend to be more forgiving than if an author tries that with a novel.

In fact, mentally ill protag as unreliable narrator is mentioned in the GR reviews/comments to "Borderline" (one of the books you mention). The reviewer says something about how "Borderline" stands out because it *doesn't* have the mentally ill protag be an unreliable narrator.

As an aside, "Borderline" sounds like it was well done, although another trope that we talk about on the podcast is also mentioned in that book's reviews: the way authors tend to show these characters by demonstrating *all* of their possible symptoms, like they were ticking off checkboxes on the DSM.

Best,
_Mark

>4 reading_fox:
Oh great, more book bullets. (Hmm... My library only has Wizard of the Pigeons available as an audiobook. Arg! Why?)

>5 Mark_Harbinger:
What I run into the most in dramaland is people who have PTSD (at least, so they say.) Curiously, this occasionally causes them to suffer allergic reactions to things. The last time I ran into this, I said out loud, "Because everyone knows that allergic reactions are an ordinary side-effect of PSTD." My daughter, amused, responded in kind, "Of course, they are, the last time I researched PSTD, it was right there in the list of symptoms." (She s such a kidder.) Anyway, whatever their symptoms are they are usually overcome by exposure to the curing benefits of true love.

I'm all for the benefits of true love, but my experience is that genuine mental disorders don't just go away like that. ::sigh:: I don't recall this being a common element in any book I read, but I'm willing to accept that I've just not been reading those particular type of books.

I don't think I've ever seen dream scenes that happened because of PSTD, though. (I started watching the Korean version of A Beautiful Mind, but I didn't get very far. I'm not a huge fan of medical dramas, I'm not entirely sure why.) Anyway, delusional events are one of the least common forms of mental health issues I can recall seeing.

About the checklist thingy. I remember reading someone ranting about authors who don't do their research (...and therefore believe that PSTD causes allergies?) and I think the checklist thingy comes about from the opposite research problem which is the authors who do the research, and then they feel like they have to put everything they learned into the book. Oi!

When I first read the rant I mentioned above, I was all, "Yes, yes, of course authors need to research..." and then I realized that I had at least one certifiable main character, and I only researched after I had already written him.

This would be because I never said to myself, "Let's write a character who has mental illness x", I instead crawled into the head of a character, and said to myself "this character has experienced x, y and z, so this is how I think he will respond to what is happening. Later I went looking and found out how he probably would be diagnosed... but I couldn't check off every symptom on the list, which as you point out is actually probably more realistic.

But, just because it seemed to mostly work once, doesn't necessarily mean it will always work, and maybe I should be worrying about one of the supporting characters in the book I hope to publish next. She rewrites her perception of reality, in the same way I have seen "healthy" people rewrite memories, only on a much grander scale. If she was the narrator... er, I would be writing a very different kind of book. One that would probably be much less interesting.

As the OP, I really appreciate the thoughtful responses so far.

Happy Thanksgiving to Everyone!

Best,
_Mark

I read an article recently about how patients from different cultures respond differently to having "voices in their head". Europeans consider the idea of having someone talking to them in their head negative, and as a result the voices say negative things, but patients from certain other cultures tend to assume that they are hearing their ancestors or whatever, and consider it a positive experience, and as a result the voices say more positive things.

I found this fascinating, and I wonder if any other mental illness change based on cultural/conceptual environment.

Indeed, that makes sense.

My book's MC has childhood-onset schizophrenia (or "COS", an extremely rare type). Those 'voice-hearing' illnesses (schizo-affective disorders) are genetic, run in my extended family, and, in fact, with regards to COS, I've actually lived with a person who had it. From my second-hand experience, I can tell you that, at times, the voices *definitely* express negative suggestions...there is a magnificent and truly on-point simulation on Youtube here:
https://www.youtube.com/watch?v=M3a1txtSDn0

This is, of course, terrifying for anyone. But for a child, it is especially so.

>9 Mark_Harbinger: "From my second-hand experience, I can tell you that, at times, the voices *definitely* express negative suggestions"

Sounds terrifying.

But if that truly doesn't happen when the patient assumes that the voice will only make positive suggestions...

I'm picturing two very different stories here. One would be a bit of a thriller -- tense and dramatic, and the other would be a bit more like Kipling's Kim, only following around a family member "touched by the gods" instead of an elderly holy man.

(Alas, we have limited control over what kinds of stories real-life lands us in.)

...

I watched a couple tv series where the protagonist had Multiple Personality Disorder. In both of them, it was postulated that the original fracture of the personalities was caused by being helpless to prevent something awful happening to someone else, rather than that they themselves were being abused.

This change in the cause of the illness appears to have been to make it more reasonable that none of the alternate personalities end up being too horrible to be accepted by the audience as a protagonist. I don't know that the premise is realistic, since MPD is extremely rare and it apparently takes some rather impressively severe emotional trauma to bring it about.

But is making a change like that "cheating"?

>11 LShelby:

~~~
"But if that truly doesn't happen when the patient assumes that the voice will only make positive suggestions..."

That was your hypothesis (or one that you repeated). I don't believe it applies to schizoid disorders, or (frankly) really at all in the sense that the patient's conscious attitudes are truly determinative (they might have some effect) of what they hear. I would need to see the research on that.

~~~
"But is making a change like that "cheating"?"

Well, 'cheating' implies that there is a *rule*. And I seldom find thinking in terms of 'rules' helpful when it comes to creative writing. To me, there are different considerations to be balanced, right? Broadly, I would say they are:
-- the necessities of story-telling
-- the necessities of characterization
-- (for me, anyway) the responsibility of not portraying marginalized folks, of any type, in a disrespectful way. Or in a way that perpetuates the cultural mores that *contribute* to that marginalization.

Tropes tend to emerge when one of these considerations overpowers the others. Authors/Filmmakers misrepresent mental illnesses all the time. I think it is unfortunate.

Do I personally always succeed in the above balancing? Perhaps not. But I do try.

Best,
_Mark

>12 Mark_Harbinger: "That was your hypothesis (or one that you repeated). I don't believe it applies to schizoid disorders... I would need to see the research on that."

I was repeating it. As I said, I read it in an article somewhere. But, alas, I am always bad at remembering where I read what -- one of the reasons that I track my library books on LT. So all I can really say now is that this one was something that showed up on my iPad's news feed. I have no idea where to go looking for the original research.

But I am very willing to admit that not every article published is accurate. :)

In the case the characters with MPD I cited, I am guessing the reasons for wandering away from established fact had to do with the necessities of story-telling and characterization. But I don't think they were being disrespected or marginalized in any way.

When these kinds of shows use romantic leads with mental illnesses, I think it makes the audience more familiar with and therefore less afraid of the disorder. That is, at least in theory, a good thing.

So it seems to me that the real problem with these shows is that when the mental illness is so often shown as being overcome by the power of true love, the audience will develop unreasonable expectations as far as "fixing things" go.

If we're talking antagonist characters that's probably where we get into the marginalization that you refer to. :(

...Or maybe its the ones that show up as minor characters that are actually trickiest?
It's hard to be well rounded when you are only there for a few pages.

You said: "So it seems to me that the real problem with these shows is that when the mental illness is so often shown as being overcome by the power of true love, the audience will develop unreasonable expectations as far as "fixing things" go."

I very much agree with that. The irony, of course, is that there is *tremendous drama* to be had within everyday stories of overcoming these conditions. So, when some author or TV director sloppily makes up some version of MPD or schizophrenia (or pretends they are one and the same, which is totally wrong, too, of course), or makes up some bogus resolution/cure, supposedly in service to the story, they're wrong in both directions, on the facts AND on the craft of storytelling. Boom.

>14 Mark_Harbinger: "The irony, of course, is that there is *tremendous drama* to be had within everyday stories of overcoming these conditions."

But not necessarily the sort of drama that falls nicely into the established narrative frameworks so prevalent in film/video. As frustrated as one may get at books that do it wrong, I suspect that we are more likely to see it done right in a book than in any other kind of media.

My desire is to allow the protagonist with mental illness to show the reader how she experiences the terrifying changes within her. And also to allow her to ultimately become the hero of her own story--to garner the strengths within herself. This is only possible with the guidance of another. I want her to be seen with respect and dignity as I do the other patients in the 1948 mental hospital within the book, Driftless. The mental illness affects her family and community. I see the story as a story of a community.

I was excited to come across this discussion because it's the first of it's kind I have seen. I may be naive but I hope that my book is not representative of a trope.

Hello Ardys_,

As the one who started the thread, I wanted to welcome you and say that I completely agree with your goals.

I hope you enjoy the interview link (in my original post), as well. Feedback (from another thread, not this one) said something to the effect of 'I enjoyed it and it made folding my laundry more fun today'. lol.

Best,
_Mark

>17 Mark_Harbinger: Thank you, Mark.