The evolving nexus between psychiatry and Nigerian literature

The representation of human health situations is part of the social and redemptive vision of the writer as every good literary text captures the sociological, psychological and the rhetorical dimensions of reality. For some decades now, literature has been deployed as a sustainable tool to facilitate better medical practices, through the humanization of the health care profession. This innovative thought has birthed Literature and Medicine as an independent field of inquiry. Beyond the informal synergy between medicine and the art, the formal origin of Literature and Medicine is credited to Joanne Trautmann Banks in 1972. As the first full time Professor of Literature to head US Medical School, Trautmann Banks introduced literary approaches to the practice of medicine and this revolutionized the relationship between literature and medicine in countless ways. With the advancement of its curriculum and the establishment of relevant journals, such as Literature and Medicine in 1982, The Lancet and others, Literature and Medicine has evolved as a discipline that promotes the health care profession— it explores interface between literary and medical knowledge, through a close investigation of physical and psychopathological conditions as well as medical ethics in literary texts (McLellan, 1996, 1997; Jones, 1996, 1997; Abse, 1998; Taylor and Kassal, 1998, Omobowale, 2001, 2008; Oyebode, 2002, 2009, 2012; Evans, 2003, Owonibi, 2010 and Kekeghe, 2018). Evans (2003) notes that literature and medicine helps to stimulate a humanistic approach to physician-patient relationship.

The effort to introduce Literature and Medicine in Nigeria is traced to Professor Emmanuel Babatunde Omobowale’s thesis, “Literature and Medicine: a Study of Selected Creative Works of Nigerian Physicians” (2001) in the Department of English, University of Ibadan. Some of the Nigerian physician-writers that form the thrust of Omobowale’s study are: James Ene Henshaw, Anezi Okoro, Latunde Adeku, Wale Okediran, Tolu Ajayi, Femi Oyebode and Martin Akpaa. One remarkable achievement, in that regard, is the offering of Literature and Medicine in the Department of English of the University of Ibadan as an elective course for M. A. students of literature. This has engendered a lot of interests in students that passed through Prof Omobowale’s medical humanities classes. Dr. Sola Owonibi is a major advocate of the scholarly sustenance of the symbiotic relationship between literature and medicine in Nigeria. In Owonibi’s thesis, “Patient-Writers’ Portrayal of Disease and Psychological Trauma” (2010) submitted to the Department of English, University of Ibadan, he examines the interplay of physical illnesses on one’s psychological conditions. This study and others have inspired interests in scriptotherapy, a domain of bibliotherapy therapy, in Nigeria.

Like physical diseases, the representation of mental health situations in literature, has gained reputable limelight in Europe and North America. In the introduction to Mindreadings: Literature and Psychiatry, Professor of Psychiatry, Femi Oyebode (2009) declares that “what the arts and humanities can do for psychiatry is to reinforce the importance of the subjective”; illustrating further, he says: “Like every other skill, our moral imagination, that is, our empathy, needs to be exercised and tested and literature provides a safe way of doing this” (P. viii). In addition to the commonly divulged sociological and rhetorical dimensions of realism, literature explores psychological realities of the people to whom it is attributed. The close affinity between literature and psychiatry as a subspecialty of the medical humanities has been affirmed by a number of scholars like Louis A. Sass, Anne Hudson Jones, Faith MceLellan, Mary Evans, Allan Beveridge, George Rousseau, Paul O’Malley, Neil Vikers, Michel Foucault, Christopher A. Vassilas, R. D. Laing, Allan Ingram, Edward Rudin, Rachel Edelson, Mark Servis, Femi Oyebode, Stephen Kekeghe and others.

Psychiatry is a medical specialty that deals with the diagnosis, analysis and treatment of mental diseases (O’Malley, 2000: p. 9). Mental diseases are illnesses that damage the human psyche, leading to poor thought-action or behaviour. Psychiatric conditions include psychoses, psychosomatic disorders, psychopathic states and the neuroses (Onyango, 1982; Mbanefo, 1991 and Olatawura, 1982; 2002). As a subspecialty of Literature and Medicine, Literature and Psychiatry has three layers which include creative works by mental patients, works by physician-writers and non-physician-writers. All of these sub-areas focus on the creation of mental health awareness through literature.

The emergence of literature and psychiatry can be traced to the development of Greek psychiatry— the disconnection of the human’s soul from his physical body was first recounted in the philosophical narratives of Heraclitus (540-475 B. C). Furthermore, Plato’s (540-475 B.C) argument on the inevitability of irrational human’s conducts in his Republic and Aristotle’s (384-322 B. C) theorizing of the cathartic method on mental health, underscore the synergy between psychiatry and the humanities (of which literature is a constituent part). However, in Anne Hudson Jones’ “Literature and Medicine: Narrative of Mental Illness” 1997 and Femi Oyebode’s “Autobiographical Narrative and Psychiatry”, they reveal that the first set of works in Literature and Psychiatry are autobiographical narratives by mental patients and psychiatrists, who recount their experiences in asylum. Such autobiographical accounts were initially religious but gradually shifted from the obviously religious to a quasi-secular and an apparently secularisation of mental conditions (Ingram, 1998).

On the emergence of literature and psychiatry as an intellectual field of inquiry, credit must be given to the Scottish psychiatrist and poet, R. D. Laing who worked on writers such as William Blake, Fyodor Dostoyevsky, Franz Kafka, Samuel Beckett and Jean-Paul Sartre to construct his existential model of madness. Other notable writers and scholars that pioneered the synergy of literature and psychiatry are Marcel Proust and Michel Foucault. Shakespearean literature and the absurdist tradition of 20th century literature witness some of the artistic imaginations of madness. In Louis A. Sass’ Madness and Modernism (1992), he argues that “schizophrenia bears a remarkable resemblance to much of the most sophisticated art, literature and thought of the twentieth century, the epoch of modernism” (1992: p. 16).

Though there have been pockets of studies that examine mental conditions in Nigerian literature, Dr Stephen Kekeghe’s thesis, “Psychiatric Conditions in Selected Nigerian Literary Texts” submitted to the Department of English, University of Ibadan, in January 2018, is a major achievement on Literature and Psychiatry as an evolving subspecialty of Literature and Medicine in Nigeria. In Oyebode’s Madness at the Theatre (2012), he devotes a chapter to examine postmodernist madness in the plays of Wole Soyinka, namely Madmen and Specialists, A Play of \Giants, King Baabu and The Road.

The exploration of madness in Nigerian literature is evident right from the works of the first generation of Nigerian writers. Soyinka’s Madmen and Specialist easily comes to mind. In Achebe’s Things Fall Apart, we can deconstruct bipolar features such as dysphoric mood, aggression, distractibility and disorganisation from Okonkwo’s conduct, in his failed attempt to sustain the African indigenous tradition, which eventually leads him to commit suicide. In Achebe’s short story, “The Madman”, he explores the predominance of psychotic manifestations among individuals in a community— Achebe seems to illustrate that mental illnesses are embedded in our social behaviours. Also, J. P. Clark’s Song of a Goat exposes us to cases of mental disintegration in a domestic setting— Orukorere manifests schizophrenic symptoms such as auditory and visual hallucinations, which might have been triggered by moments of depression, arising from her childlessness. Ebiere shows signs of depression and dysphoria, which are engendered by her husband’s impotency. We also notice the depressive state of Zifa and his possible suicide which is elicited by his impotency as well as his wife’s infidelity with his brother, Tonye; and the guilt-induced severe depression of Tonye after sleeping with Zifa’s wife which also makes him to commit suicide.

As depicted in modern Nigerian literature, the obsession with power and political megalomania are common mental conditions manifested by ambitious politicians in Nigeria. Many Nigerian playwrights explore the gradual descent of ambitious politicians into irredeemable psychotic states. Major Lejoka-Brown in Ola Rotimi’s Our Husband Has Gone Mad Again, Chief Kuti in Femi Osofisan’s The Restless Run of Locusts and Chief Oyewumi in Muyiwa Ojo’s Memoirs of a Lunatic, underscore the obsession and irrational anxiety to attain political position and privileges and the eventual loss of it which trigger anger neurosis, bipolar and schizophrenic episodes. The political aspirant, Chief Kuti manifests manic depressive symptoms such as impulsivity, recklessness, distractibility, disorganisation, depression, anxiety, delusions, hostility and violence which make him to commit murder and suicide. Chief Oyewumi exhibits schizophrenic symptoms such as perceptual disorders and thought broadcast which is elicited by his eventual loss of his position as the Chairman of Igbantuntun Local Government Area. Though Lejoka-Brown’s mental state is not so grave, he displays a level of illogicality, restlessness, disorganization, distractibility and disinhibition which can be deconstructed as bipolar features. However, unlike Kuti in Osofisan’s The Restless Run of Locusts who commits suicide as a result of his negative mood, or Chief Oyewumi, in Ojo’s Memoirs of a Lunatic, who becomes psychotic, roaming the streets for garbage, Major Lejoka-Brown connects back to reality and regains his sanity after losing political grip at the end of the play. Like the satiric tactics in the texts above, Peter Omoko’s Crude Nightmen metaphorically thematizes madness to replicate the illogical anxiety manifested by people in their cravings for material possession, which has become the bane of Nigeria’s oil-rich Niger Delta, a similar thematic thrust that is foregrounded in Stephen Kekeghe’s Pond of Leeches. Political megalomania is also parodied in Osundare’s The State Visit and Soyinka’s A Play of Giants. The characterizations above are in agreement with Plato’s declaration that the politician, owing to his aggressive ambition for power and material gains “is goaded on to madness” (Republic, p. 294). Plato’s discussion of the appetitive and the high-spirited highlights the conduct of the politician, whose excessive quest for wealth and fame destroys his saneness, thereby manifesting undue power, leading to autocracy. Plato illustrates that “an insane or deranged person expects to be able to lord it not only over men, but even over gods” (Republic, p. 295). Like in the texts above, an unhealthy anxiety to control wealth and material possession trigger the feuds between the two stepbrothers, Martin and Freddy in Emmanuel Babatunde Omobowlae’s Seasons of Rage. The literary-diagnosis of the devastating effects of ambition, on people’s psyches, is a commendable effort in promoting mental health awareness in the Nigerian socio-political landscape. In agreement with Freud’s theorizing of the artist’s neurosis, the obsession of an artist, to his art, is also represented in Nigerian literary texts. In Irobi’s The Other Side of the Mask, Jamike’s mental disintegration is engendered by his obsession and anxiety to attain fulfillment in artistic creation.

Post Traumatic Stress Disorder (PTSD), arising from war and violence, sexual harassment and socioeconomic repression, is frequently recounted by Nigerian writers. Through Erelu and Orisaye in Femi Osofisan’s Women of Owu, Helen’s father in E. E. Sule’s Sterile Sky, Ali Banana and other Chindits in Biyi Bandele’s Burma Boy, the devastating effects of war and violence on the individual’s mindscape is represented. Also, in Bayo Adebowale’s Out of His Mind, Alamu’s mental crumbling is provoked by the sweeping decline in his economic status which reaches its severity the moment he is unjustly relieved of his job as an accountant in the prestigious Bajok Company. Interestingly, Alamu regains his sanity as soon as he is reinstated in Bajok Company with full payment of his arrears. Depression arising from sexploitation, trauma and socioeconomic repression trigger the schizophrenic episodes of the nameless protagonist in Niyi Adebanjo’s play, A Monologue on a Dunghill. While sexual plunders, traumatic memories and dehumanizing encounters engender Abigail’s depression in Chris Abani’s Becoming Abigail, emotional betrayal elicit Jennifer’s and Tobrisi’s mental breakdown in Omobowale’s novel, Seasons of Rage and Ojaide’s short story, “I Used to Drive a Mercedes” respectively. We also notice extreme depression, arising from lack of sexual gratification in Ojaide’s short story, “Nobody Loves Me”, as manifested by Ngozi, who commits suicide in the story as a result of her inability to curb her dysphoric mood. The significance of these literary representations of mental health experiences is noteworthy— it cautions the public against some obvious social triggers of mental illnesses. PTSD or reactive depressions are commonly manifested by Nigerians due to the constant exposure of tragic news that perpetually denigrates the values of humanity.

The ridiculous manifestations of inter-gender skirmish are also represented in some Nigerian literary texts. Inter-textually, Rotimi’s Our Husband Has Gone Mad Again and Utoh’s Our Wives Have Gone Mad Again! create an inter-gender conversation, for marital sanity. While Rotimi interrogates the insanity of patriarchal arrogance as exhibited by the character of Lejoka-Brown, Utoh exposes the depravity of radical feminism which is manifested by Irene, Funmi, Ene, Mairo and Ifeoma, a group of radical and left-winged women, who connive against male supremacy. These two playwrights seek for gender parity by condemning the excesses or what could be regarded as the insanity in the misappropriation of gender behaviours. Through the character of Beatrice in Purple Hibiscus, Adichie explores the subject of depression with mania which is induced by patriarchal oppression. This is manifested by Beatrice by killing her husband, Papa Eugene and by displaying schizoid symptoms of extreme introvertedness. We can also deconstruct patriarchy-induced depressive neurosis in Buchi Emecheta’s The Joys of Motherhood.

The subject of mental disturbance is represented in many Nigerian poems. Melancholia and trauma are common intensifiers in poetic expression, which have yielded rewarding discussions on scriptotherapy. Tayo Olafioye’s A Stroke of Hope, which serves as a catharsis to the poet when he was subjected to different complex surgical operations and Niyi Osundare’s City without People, which artistically conveys the poet’s grief during the Hurricane Katrina of New Orleans, are reliable examples. Significantly, the import of the human’s mind, in social activities, has been explored by Nigerian poets— Remi Raji’s Webs of Remembrance and Sea of My Mind; Jumoke Verissimo’s I am Memory and The Birth of Illusion, greatly attest. In Ohaeto’s The Chants of a Minstrel, he captioned a section of the collection as “Chants of a Mad Minstrel”, to foreground the obsession of the artist to salvage a society that is peopled by mentally poor followers. Besides ridiculing the politician as displaying irrational conducts, Ohaeto also satirizes the idiocy of the common Nigerian who does nothing to assert his or her rights to self-determination. In poems like “The Tongue of a Mad Minstrel”, “The Minstrel Chants of Lunacy”, “Mad Minstrel Plays with Fire”, “The Dilemma of the Lunacy” and others, Ohaeto communicates the subject of madness to the audience. In Ben Okri’s Mental Fight, he advises the reader to utilize his or her mental disturbances in the art of creative expression. Furthermore, in The Hate Artist, the poet-psychiatrist, Niran Okewole, explores experiences that border on psychiatric practices.

It is refreshing that a good number of Nigerian writers create mental health awareness by depicting psychiatric illnesses. The writers also reveal in their texts, the various socioeconomic factors that trigger such mental conditions. In this way, people may be more conscious of their conducts so that milder mental challenges will not aggravate to psychotic states. Therefore, more robust efforts are required for the institutionalization of Literature and Psychiatry as a subspecialty of Literature and Medicine in Nigerian universities.

• Dr. Stephen Kekeghe teaches literature in the Department of English, College of Education, Warri, Delta State.