[Archipelago; 2024]

Tr. from the Danish by Martin Aitken

In contemporary literature, the psychiatric institution is saddled with a heavy burden. Variously depicted as a microcosm of a stultifying world, a setting for individual transformation, a site of battle against oppressive systems, and a place of revelation about the limits of human abjection, the institution encompasses stark contradictions: isolation and camaraderie, compliance and subversion, sadism and care. 

Within a narrative, even a personal one, the symbolic significance of the institution can overshadow an authentic sense of the lived experience of its residents. That is not the case in Fine Gråbøl’s moving, lyrical debut novel, What Kingdom, translated from the Danish by Martin Aitken. This first-person work of autofiction is set in the young people’s section of a Copenhagen psychiatric care facility and is devoted to recording the mundane details of everyday life within its walls. It is refreshingly without an overarching message or even a hierarchy of happenings. The book’s unnamed young female narrator uses the same relaxed, arguably even serene tone to catalog pieces of furniture or food items in her room as she does to recount events the reader might consider crises. It gives the novel a quiet, meditative rhythm that is affecting in its affectlessness.

“For the time being the second-degree burn on my left arm tells of my uncoupling from the world,” she thinks, then reveals that she’s poured boiling water on herself, not for the first time. Though she concedes that it’s “a painful, messy affair,” the reference to an “uncoupling” is emblematic of Gråbøl’s abstracted, poetic detachment. Refusing to reveal much—what kind of “episode” it was, whether it occurred in a moment of dissociation or depersonalization—the narrator exerts an eerie control over the brutal scene of her own self-harm. 

This impassive tone has an equalizing effect on all that the narrator surveys: “Most rooms are quiet, fridges hum gently, I remain alive,” she thinks. Elsewhere, she reports, “I eat a plum . . . I throw up in the kitchen’s biggest pot . . . I light a cigarette and it crackles. I put on a pair of comfy fleece trousers and a pale yellow sweater.” Later, she thinks, “We try to die in different ways, while life and the section and the system keep us here; we seldom cry; we drink beer on the patio on Fridays.” In a seemingly medicated present tense, facts like these are not so much juxtaposed as sitting comfortably beside one another. In this institutional space, Gråbøl seems to be saying, like in perhaps all others, banality and violence naturally coexist. The effect could have been discomfiting, but instead it engenders tolerance and refuses to elicit the shock we’ve been conditioned to expect or perform, encouraging us instead to suspend moral judgment. 

In spite of her flat affect, Gråbøl’s narrator reports, “I feel far from apathetic.” In a sense, the youth unit is a place of fledgling hope, unlike the other floors of the building, which house permanent residents. The facility “is a kind of exploration of having a home,” where, she thinks, “our daily routines are our best illusions of new beginnings, a new cycle.” Because the young people on her floor—the usual ensemble cast, here called Marie, Lasse, Kian, and Hector—are meant to resume a more independent form of living after they leave, manufacturing ordinariness is one of the institution’s functions. The recreation room “has been done out a bit like a café. The sound of the industrial kitchen’s dishwasher is almost constant.” And “meal day,” when residents cook for their fellow residents and the staff, “is an exercise in ordinary days, ordinary life,” she thinks, noting that it’s one of the times when the hierarchy between the two groups is diminished.

Though told in fragments, the story proceeds roughly chronologically and is relayed with deadpan humor. The reader learns that before coming to this institution, the narrator was hospitalized and subjected to electroconvulsive therapy. Now, she grapples with disastrous insomnia and shuffles around her floor during the night shift. She has recently attempted suicide, an experience that deepens her faith in the staff: “They showed me a lot of trust when they decided not to put me in the hospital after that business with the open window and the police.” It was a relief not to jump, she thinks, and to fall instead into the open arms of Thomas, the section leader of whom she’s particularly fond. “I cried like a dad, swore never to do it again,” she thinks. 

The only thing approaching conventional novelistic drama comes about halfway through the slim volume, when Thomas announces he’ll be stepping down and replaced by someone new.

The staff are depicted as humane and yet also sometimes absent, generic, or beside the point. “Who put the poinsettia on top of the drawers?” the narrator wonders as she looks around her room. “Who actually waters it and keeps it alive?” Still, she recognizes that they show kindness. She recalls the “teary alarm” of the nurse who bandaged her burns and talks about those on the night shift sympathetically: “They possess a hardness that shouldn’t be mistaken for coldness or not caring, it’s more an expression of practiced care.” (All this could seem rather exotic to the American reader. Long-term psychiatric care has largely been phased out in the US, replaced by in-app doctor’s visits and mail-order pharmaceuticals.)

Passages about the staff also serve to remind the reader that, as Rachel Aviv shows in Strangers to Ourselves: Unsettled Minds and the Stories That Make Us, the encounter between the patient and the psychiatric establishment is two-sided. Aviv writes of the subjects in her book, including one with whom she was hospitalized in her youth, “Their distress took a form that was created in dialogue with others, a process that altered the path of their suffering and their identities too.” In a similarly recursive cycle, alongside her fellow residents and the institution’s medical staff, Gråbøl’s narrator makes and remakes her relationship to her own diagnoses.

The institution’s residents are also in dialogue with the outside world. The narrator and other residents are free to come and go as they please, the monotony of their days often punctuated by trips to the market or karaoke nights. But those trips aren’t figured as escapes or new beginnings. In fact, What Kingdom denies the reader the kind of defining moment of entry into or exit from the institution that we’ve grown to expect from novels or memoirs about mental illness. Typically, in these stories, a young woman is dragged, literally or figuratively, to the asylum against her will by “society”—that monstrous monolith, which punishes her for not conforming to its ideals—and locked inside. Gråbøl’s institution is porous. There’s a seamlessness to the movements of its residents. In the same way moments of anguish or pain are treated not as deviations, but expected elements of the day, so too is the occasional outing or errand.

Gråbøl invites comparison to other accounts of mental illness, especially those written by women, by deliberately situating What Kingdom within this tradition. The title of the novel in Danish, Ungeenheden, translates to “Youth Unit,” but the English title comes from Girl, Interrupted, Susanna Kaysen’s 1993 memoir about the eighteen months she spent at McLean, the well-known psychiatric institute in Massachusetts. In the film version of Girl, Interrupted, it’s part of a line spoken by Vanessa Redgrave as the forbidding Dr. Wick, who’s quoting Roman dramatist and statesman Seneca, by way of T.S. Eliot: “Quis hic locus? Quae regio? Quae mundi plaga?” She then asks the questions in English: “What world is this? What kingdom?” The residents in Gråbøl’s novel watch the 1999 film, starring Winona Ryder and Angelina Jolie, and become “totally absorbed” by the characters.

In Kaysen’s memoir, one of the best known autobiographical accounts of psychiatric hospitalization by a woman, she recalls the peculiar freedom of the institution: ”In a strange way we were free. We’d reached the end of the line. We had nothing more to lose.” Gråbøl inverts this idea, representing the facility instead as a place of illusory, prison-like safety. “I felt secure; I had no power,” she thinks. Kaysen’s sense of there being nothing to lose is empowering, but there is nothing of that sort in the world Gråbøl limns: “I have no secrets and therefore no history,” her narrator muses darkly. 

Instead, like Suzanne Scanlon, who writes of getting “better at being a mental patient” at New York State Psychiatric Institute in Committed: On Meaning and Madwomen, Gråbøl’s narrator thinks, “It’s getting harder to recognize myself outside my room.” She can’t remember the first time she was admitted. Over time, she learns to make her needs legible, which requires defining herself through her sickness: “I own only the illness inside me,” she thinks, “the rest is something they take away.” In clear moments, she wonders about her learned helplessness, resenting the ways she must perform illness in order to receive care. But in spite of such thoughts and philosophical insight as well as, occasionally, deft political analysis of the medicalization of mental illness, the narrator largely submits to the logic of the institution—whether by acclimation, acquiescence, or a steady dose of medication. She is at home. 

Aviv, Kaysen, and Scanlon all wrote about their youthful experiences with psychiatric institutions from the vantage of adulthood, with both the natural and practiced detachment that that distance entails. Gråbøl’s debut is a work of fiction and therefore bound by different conventions, but it also simply feels younger. The experiences the author draws on are more recent—and that is a credit to the work. The narrator is still in formation, her identity not an established fact hewn by time. She is confused. She thinks, “I sometimes wake up and realize that what’s going to happen has no name.” Her tale is not one of redemption, nor was it written to engender empathy or promote visibility, though perhaps it has. It’s an often beautiful chronicle of ambiguity, ambivalence, disorientation, and above all, fatigue. With her steady, precise attention to everyday life on this sad, cozy ward, Gråbøl gently troubles our received ideas about healing. 

Nina Renata Aron is the author of Good Morning, Destroyer of Men’s Souls. Her work has appeared in The New York Times, The Los Angeles Times, The Los Angeles Review of Books, Poetry Foundation, The New Republic, Jewish Currents, and elsewhere. She’s on Instagram and writes a newsletter about books.


 
 
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