The Heartland

by Nathan Filer

Faber 256pp £14.99

The Week Bookshop £11.99

Nathan Filer’s first novel, the Costa Prize-winning

The Shock of the Fall, centred on a psychiatric patient, said Hannah Jane Parkinson in The Guardian. The former mental-health nurse again draws on his professional experience for his “absorbing” second book, a non-fictional exploration of schizophrenia. Often described as the “heartland” of psychiatry (hence the book’s title), schizophrenia is also among its most contested afflictions. There is precious little agreement as to what causes the condition, and how best to treat it; and some even question whether it truly exists. The term schizophrenia (meaning “split mind”) was coined in the early 20th century by the Swiss psychiatrist Eugen Bleuler, said Paul Broks in the Literary Review. He saw it as being characterised by a “splitting of cognitive and emotional functions”, leading to symptoms such as paranoia and disordered thinking. But the name has also fuelled the “enduring misconception” that schizophrenics have “split personalities”. Today, Filer writes, schizophrenia is a “battleground upon which the fiercest ideological disputes about madness and its meanings are fought”. In The Heartland, he does a “brilliant job” of picking his way through this “chaotic scene”.

Filer elucidates the debates surrounding schizophrenia as well as taking us into the world of those who suffer from it, said Cathy Rentzenbrink in The Times. Among others, he introduces us to Erica, a journalist who drinks bleach because she is convinced she has committed unforgivable crimes; to Jasper, a senior nurse who “runs a patient-led support group where he too admits that he has always heard voices”; and to Clare, who lost her son, Joe, to the condition. Mental illness is a “difficult terrain”, but Filer navigates it with wisdom and humanity.