The Last Asylum: A Memoir of Madness in Our Times by Barbara Taylor; My Age of Anxiety: Fear, Hope, Dread and the Search for Peace of Mind by Scott Stossel; The Man Who Couldn’t Stop: OCD, and the True Story of a Life Lost in Thought by David Adam - review by John Clay

John Clay

Coping Strategies

The Last Asylum: A Memoir of Madness in Our Times


Hamish Hamilton 289pp £18.99 order from our bookshop

My Age of Anxiety: Fear, Hope, Dread and the Search for Peace of Mind


William Heinemann 399pp £20 order from our bookshop

The Man Who Couldn’t Stop: OCD, and the True Story of a Life Lost in Thought


Picador 324pp £16.99 order from our bookshop

Anxiety is overtaking depression as the foremost mental health issue of the moment, according to the World Health Organization. Our culture, with its ever-changing fluidity and restlessness, is rife with anxiety: just look at the mobile-phone users on streets, buses and trains. Even young children are succumbing to anxiety disorders, referral agencies increasingly report. Each of these three books deals with present-day anxiety, in one or other of its manifestations.

Barbara Taylor’s The Last Asylum: A Memoir of Madness in Our Times moves from the author’s youthful anxiety to her near-total adult disintegration. She begins with her childhood in Canada, the daughter of high-achieving parents: her father was a veteran of the International Brigades in the Spanish Civil War and her mother was a practising judge. A ‘miasma of grandiosity’ hung about the house. She leaves for England, aged 21, with ambitions to be a writer.

Her personal life becomes chaotic. She’s in and out of unsatisfactory relationships. Her father’s shadow lies over this: his charisma made it hard for boyfriends to have a chance of success, even though he was a tyrant at home, forcing his wife to submit to his dictates and treating his daughter both seductively and critically. Her mother, too, played her part in the ‘drip-drip of mockery’ Taylor was subjected to during her adolescence.

Taylor moves into a collective household. Soon her housemates become concerned by her drinking and drug-taking. She begins psychoanalysis at a classy Harley Street address, aware that the ‘woman I had worked so hard to keep afloat – with her sharp opinions, her self-assurance, her small triumphs – had been a fake, a simulacrum of personal success’. Her method is to give us short verbatim extracts from these sessions with her analyst, ‘V’. This makes for fascinating material. We witness her self-doubts, her ‘wild’ fantasies concerning her analyst – ‘why is his wedding ring missing?’ – and her relentless attacks on the process itself, trying to derail it so as to perpetuate her self-destructiveness. Her analyst stands firm (he comes out of this very well), reflecting back her manoeuvres, asking her to examine what is going on.

Her private life deteriorates further and her housemates ask her to leave. She ends up in Friern Hospital in north London, formerly Colney Hatch Lunatic Asylum, with its famous corridor one-third of a mile in length. This is the asylum of the title. The second half of the book takes us through her stay there as she negotiates the institution’s tendency to infantilise its patients – it is less trouble for the staff that way. Danger and violence lurk, sexual attacks threaten, but friendships are also formed, often precarious but meaningful to her. The asylum becomes, at times, her place of safety. ‘Cradled in Friern’s unyielding embrace, I found myself surviving emotions that out in the world had felt unendurable.’

Aided by the constancy of V, she survives. Her analysis, in fact, has lasted twenty years, but it pays off. She reaches an understanding of her hidden longing for a nurturing mother and her deep-seated envy. She leaves the asylum before it closes in 1993, and finds a partner with whom she falls in love, a woman with two sons; a new family is created.

This is an impressive book, strong on narrative, deeply felt and measured in tone. Taylor is an accomplished writer. The Last Asylum will stand the test of time as essential reading for anyone interested in the intricacies of psychoanalysis or keen to get a picture of what life in the lost age of the asylum was like.

Scott Stossel’s My Age of Anxiety: Fear, Hope, Dread and the Search for Peace of Mind is also a personalised account. As a child he suffered from acute separation anxiety, finding his mother’s absence unbearable. If she disappeared, he threw ‘epic tantrums’ and banged his head on the floor. On his first day at nursery school, he clung desperately to her leg and whimpered. Soon he developed emetophobia, the fear of vomiting. This has continued to haunt him in his adult life, particularly when faced with public speaking, which now, as editor of The Atlantic, he often has to do. One of the book’s many strengths is the way Stossel uses research to underpin his personal account. For example, he relates how the Harvard Medical School says that 85 per cent of anxiety disorders start with a childhood phobia.

Aged six, his situation worsens. His mother leaves home to attend evening law school. Racked by anxiety, he sits on the radiator by his bedroom window peering out, waiting for her return. In later conversations, his mother acknowledged that she ‘consciously withheld affection’ during his childhood, even though she still physically dressed him until he was nine and chose his clothes until he was fifteen. This mixture of overprotection and withheld affection was a ‘pernicious combination’ for him, and caused his suppressed emotions to be expressed bodily, not just through emetophobia but also, later, in uncontrollable bowel movements, as happened once, embarrassingly, at the Kennedy household at Hyannis Port.

Anxiety had run in his family. His great-grandfather, dean of students at Harvard, broke down in the 1960s and was put in McLean Hospital, ending up curled in the foetal position. Stossel’s daughter now shows signs of emetophobia too. Stossel considers whether anxiety is genetically transmitted or due to upbringing and circumstance. He doesn’t come down on one side or the other. For him it is a continuing problem. Yet he can see how he has put his own anxiety to good use by writing this book, taking advantage of the ‘proximity of wound to gift’, as Jeanette Winterson puts it.

My Age of Anxiety is a mine of information and extensive soul-searching. For contemporary readers, especially those beset with anxiety, it will prove an invaluable resource. He names his last chapter ‘Redemption and Resilience’, stressing the latter quality as the way forward. Pascal once wrote, ‘If you fear, fear not. If you don’t fear, then fear.’ Scott Stossel would agree with that.

David Adam’s problem was his obsessive fear of catching HIV. When he was at university he perceived the threat everywhere – on shared taps, towels and telephones. Most people assumed he was sexually promiscuous, which he wasn’t. His irrational thoughts become so persistent that he found he could only suppress them by compulsive behaviour. OCD sufferers, he states, can on average waste up to six hours a day on their obsessions and up to four hours on their compulsions. Obsessions are usually fears of contamination by dirt or disease, or the more familiar ‘Did I lock the door and turn the oven off?’

In The Man Who Couldn’t Stop: OCD, and the True Story of a Life Lost in Thought Adam recounts his journey with humour and detachment. At one point, trying to allay his fears, he speaks regularly to the National AIDS Helpline, changing voices and adopting a regional accent to get more of their time. His book is doubly useful as he covers all the recent research on the subject. As with Scott Stossel and Barbara Taylor, writing has proved therapeutic. His overbearing thoughts no longer hold him captive.


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