This is an odd and uneven book. The author, Liam Clarke, a reader in mental health at the University of Brighton, argues quite reasonably that exposure to great works of fiction can deepen our understanding of people with a mental illness and that a narrow ‘evidence-based’ approach, focusing on facts and figures, constricts our therapeutic ability. Clarke examines the depiction of madness in the work of an idiosyncratic selection of writers, including Shakespeare, Kafka, Hermann Hesse, Kingsley Amis and Pat Barker. Although he brings great enthusiasm to the subject, the book is marred both by the author's opinionated pronouncements and the style in which it is written. This extract is illustrative:

Badly written, this passage conveys the tone of the author, who makes repeated disparaging comments about psychiatrists throughout the book. The writing veers wildly between different styles. There are inappropriate attempts at blokeish informality – we learn that Anne in Shakespeare's Richard III is expected to ‘bugger off stage left’. There are bizarre occasions when the reader is directly addressed and asked for their thoughts. And there is the ill-digested use of academic jargonese, for example, Charlotte Perkins Gilman's The Yellow Wallpaper is said to reveal ‘the relationship of madness to sociality and especially its loci of power instituted in medical and gendered constructs’ (p. 75).

Clarke begins with a brief history of the novel, informing us that novels can be very long but also quite short. As an example of the latter, he cites Kafka's Metamorphosis, which I always thought was a short story. He then tells us it was only in the 1950s that writers started to experiment with the form of the novel and the role of the narrator. This rather ignores Laurence Sterne's Tristram Shandy, which as early as the 18th century was playing with the conventions of the genre. It also neglects James Hogg's Private Memoirs and Confessions of a Justified Sinner, a novel written in 1824 which features unreliable and double narrators. In Clarke's account of the history of psychiatry, we learn that psychoanalysis was a dominant force in British psychiatry in the 1930s, though this is not the case. We read that mental illness in women in the 19th century was often brought about and perpetuated by ‘male malevolence’ and patriarchal physicians, though recent feminist historians, such as Nancy Tomes and Joan Busfield, have challenged such simplistic readings of the past and have pointed out that the incidence of mental illness in males was roughly the same as in females. We are told that R. D. Laing ‘should have attended more [to] the Western literary canon’, although he was steeped in European literature and drew extensively on it in his writings.

Clarke seeks to demonstrate that the humanities can teach clinicians and therapists to be more reflective about their practice and the predicaments of their patients. Unfortunately, despite his obvious passion for literature, he does not emerge as a good advert for the benefits of reading. The charge of ‘smugness’ would seem to be more appropriately levelled at an author who, in the course of his book, is able to dismiss such major thinkers as Socrates, Nietzsche and Foucault.