books: Independent choice: self-help

Pick of the week Out of Me by Fiona Shaw
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The Independent Culture
Grief is so very personal that to set out to define in words its shades and strands can be highly problematic. Easier, perhaps, to capture its essence in music or painting. "Words just can't express...", we begin, tentatively, as if any attempt at articulating profound loss might somehow dilute its intensity.

Yet in Out Of Me (Viking, pounds 16), her moving story of a postnatal breakdown following the birth of her second child Jesse, Fiona Shaw succeeds in engaging us totally. This is a harrowing tale, eloquently told, of Shaw's journey to self-understanding through suicidal despair. First came her realisation that "grinning and bearing it" was not an option, then her refusal of food ("making myself into some terrible parody of the baby I had given birth to just nine days earlier"). She arrives in the Mother and Baby unit of a psychiatric hospital, where she is later sectioned: a nurse finds her by the adjacent railway line and leads her indoors "like a naughty child".

What followed reads like the ultimate nightmare scenario: the relentless monitoring and lack of privacy, self-harming, 16 sessions of ECT. Shaw's account of the latter is particularly shocking: the punitive treatment, heaped on suffering, compounded her isolation and diminishing sense of self. Husband Hugh, in his diary, sees her as "shell-shocked". Afterwards, there is no polite conversation or shared stories - merely "stunned silence", with the tea and biscuits and two round red marks on the forehead to mark the patients' "complicity" in "this horrible drama".

Then there was the memory loss, a major legacy of ECT. Shaw writes passionately about life at the edge of the abyss, how it feels to be rendered powerless by "treatment" that seems to border on barbarism. Following one Christmas visit home, her recall is scant: "I know nothing of the brush and touch of my days with Hugh, Eliza and Jesse, not a single breakfast, story, bathtime, tantrum, nappy change or cuddle". All the cherished minutiae of a life have been wiped out forever.

After more ECT, twice-weekly therapy proved the catalyst which, with her writing, has been vital to recovery. Her narrative is interwoven with others' observations. But it is her voice that shines through, angry yet not bitter, hungry for answers, aware that the roots of her breakdown were planted in her early life.

In The Bird of My Loving: a personal response to loss and grief (Michael Joseph, pounds 15.99), Mary Sheepshanks writes in a more down-to-earth way about multiple losses: the death of her baby, the illness and death of her husband. She also includes conversations with others about how they rebuilt their lives.

What angered Fiona Shaw most was the lack of psychological support. That service is lovingly provided by Marie de Hennezel, a psychologist who worked with a team of doctors and nurses in a hospital for the terminally ill in Paris. Her book Intimate Death: how the dying teach us to live (Little, Brown, pounds 14.99) is an inspirational record of her experiences in the hospital's Palliative Care Unit. Dying is society's last taboo and this book, in its honesty, warmth and humanity, helps overcome it. Written with compassion and sympathy, the book eschews denial, transforming the unpalatable into something humane.

Its simple, anecdotal style illustrates how death can bring peace, dignity and meaning into lives, enriching both patient and carer - unconditional love in action. The writer encouraged patients to live each day as fully as possible, and an underlying thread is the importance of living in the now.

Time can stretch or shrink according to its context. With the dying, it is moments that matter. In other traumas, like Shaw's postnatal breakdown, time can drag or even stop altogether. In Elizabeth Kaye's Mid-Life: notes from the halfway mark (Fourth Estate, pounds l2), time seems more like an enemy, creeping up on us unawares like a thief in the night.

Kaye was 35 when she became aware of a deep sorrow "whose cause was not immediately apparent"; she alludes to her own growing obsession with time, "a diagnostic feature of my descent into mid-life crisis". She interweaves her feelings with vivid references to places, landscapes, food. Her writing is inventive and colourful, mixing the sensual and cerebral, mesmerised by "life's choreography, by the balletic precision with which lives intertwine, by the inexorable entrances and exits of friends and circumstances, lovers and family". This is a wistful, but by no means depressing book about the need to let go - of people, expectations, dreams - and the futility of looking back. The "good old days", she avers, are a mirage, never as good as when they are new.

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