‘In my belly is an octopus and in it are God’s children. Living children. These are things I must not speak of.’ These are the startling words of a German judge named Daniel Paul Schreber (1842–1911), an educated, cultivated and highly intelligent member of the legal establishment who went mad at the age of forty-two. Schreber’s case is remembered today because of his remarkable Memoirs of My Nervous Illness, written during a later period of lucidity and published in 1903. His book snagged the attention of Freud, who remarked that the author ought to be appointed director of a mental hospital. Freud’s view – much contested – was that Schreber’s psychosis was an expression of his repressed homosexuality and that his delusional paranoia originated in unpleasant childhood experiences. The memoir remains an important text in the history of psychoanalysis because of the clarity and candour of Schreber’s account and because of the astonishing range and complexity of his disorder. The case and the memoir form the basis for Playthings, Alex Pheby’s brilliant, compelling and profoundly disturbing novel.

Schreber’s wide-ranging insanity had its origins in a single transgressive thought: waking one morning, he wondered what it would be like to experience sexual intercourse as a woman, a speculation that marked the onset of an intense paranoid state diagnosed at the time as a form of dementia praecox. He believed, inter alia, that he was turning into a woman (hence the octopus that doubled as a womb), that his corporeal emasculation was to prepare him for procreation with God, that he was controlled by ‘divine rays’ emanating from other souls, and that the universe was a complex architecture of nerves. Another of his lunatic convictions – that his family had been replaced by impostor marionettes – is now known as the Capgras delusion, a condition that, despite its rarity, has been the subject of at least two recent novels: Richard Powers’s The Echo Maker (2006) and Rivka Galchen’s Atmospheric Disturbances (2008). An earlier, fictionalised account of Schreber’s childhood, published in 1973, from a largely anti-Freudian perspective, was Soul Murder by Morton Schatzman.

These are examples of what Marco Roth, writing in the Brooklyn-based journal n+1, has usefully termed ‘the neuronovel’ – fiction that explores the experience of what he calls ‘a cognitively anomalous or abnormal person’. He traces the neuronovel’s origins only as far back as Ian McEwan’s Enduring Love, and also cites Mark Haddon’s The Curious Incident of the Dog in the Night-Time (in which the main character is a boy on the autistic spectrum). Roth also lists McEwan’s Saturday (which deals with Huntington’s disease) and many genre novels that feature, for instance, amnesia and bipolar disorders. What these very different novels share is an interest in the workings of the brain rather than the mind, which reflects, claims Roth, a post-Freudian, post-Lacanian movement away from traditional theories of personality. The neuronovel explores the loss of self, though selfhood is no longer the prerogative of novelists. It has become the property of specialists in their own professional disciplines.

Pheby vividly portrays what it must be like to lose any sense of selfhood, evoking the terrible dilemma of a rational and respectable pillar of the establishment reduced to the status of a poor, bare animal. Schreber’s malaise is heartbreaking and the occasional bouts of eloquent lucidity, when he speaks with dignity and authority, add to the nightmare. There is no chance that he will ever be allowed home and he depends entirely on the ministrations of a sinister alcoholic nurse and the head of the asylum. Schreber has no insight into or understanding of his condition, only (when intermittently sane) of his vanished rights and family obligations.

Pheby renders his subject’s plight in formal and stately prose that has its stylistic roots in early modernist fiction and psychoanalytical case studies, while also sounding like an English equivalent of Schreber’s own rather dated and ponderous German. There are poignant summaries at the head of each chapter, the last of which offers an unconsoling coda for the book as a whole: ‘Memories of a time before. Thoughts such as those that might fill the mind of a man who has lost everything, and has withdrawn inside himself and found nothing of his own to cling to.’ Schreber is a lost soul with no fragments to shore against his ruin. If Playthings is a neuronovel then it’s arguably the best neuronovel ever written, particularly in its depiction of memory and the instability of personality. But it transcends any such category and is simply a superb novel tout court, Kafkaesque in its nightmarish fluency and a powerful exposition of Kant’s celebrated view that ‘the madman is a waking dreamer’.