Schizophrenia is probably one of the least understood mental illnesses, as much because the diagnosis is based on observation of behaviour rather than any specific test such as blood. Also because the symptoms vary, and can show up at various points in a person’s life. In the case of Barb Hawkins, the illness remained dormant, or perhaps hidden for much of Barb’s young life. Beautiful, vibrant and intelligent, young Barb appeared to have every gift. At college she met and married professor Karim Shallal and followed him to Iraq. During that period her letters became increasingly erratic, and Karim eventually brought Barb back in the hopes that his family might obtain help for what seemed to be a rapid decline into an insular world of voices, hyper-sensitivity, and fear. Barb’s younger sister Margaret Hawkins tells the story — as much her own story as Barb’s — with an extraordinary sense of delicacy, honesty and above all, bravery. There’s an intimacy in the writing that draws the reader in.
It would have been easy for Margaret to point a finger at her overbearing and overprotective father, particularly when Barb’s voices eased off once she began taking Risperdol after her father’s death. However, the story invites us to set aside our own prejudices, not only about the mental illness that colours and shapes Barb’s life, but also about the parents who collude to keep Barb from treatment for so many years. Margaret gets under her parents’ skin, illuminating the secret depression and schizophrenia suffered by her mother, and her father’s pathological distrust of the medical profession. Margaret analyzes her parents with the kind of care that a novelist shows her characters, avoiding judgement and allowing the reader to see their point of view and the limitations that underlie their decisions. So many times the Hawkins’ lean in the right direction, almost taking the right step, and then pull back in fear. For example, while cleaning her father’s bookshelf, Margaret finds a book: Surviving Schizophrenia with a note offering help to her father:
When I retrieved the book all those years later, the letter with its invitation was still tucked between the pages, suggesting maybe there was once a wish, a weak intention to seek help, lurking underneath my father’s steely stoicism and my mother’s sad, sighing resignation, and which, though never acted upon, hinted at hope for change. But in the end the call was not made, the letter not written; things continued to continue as they had. (90)
It isn’t until the father’s death that Margaret starts to research and address her sister’s illness and to bring in resources to help her sister as she takes on the role of caregiver. At that point, there was nothing on file for Barb, who had become a full-fledged agoraphobic and wouldn’t leave the house to see a therapist or get treatment. It took a significant amount of effort to keep Barb in her own home, and organise for help – both practical and medical – to come to Barb. The medication and emotional assistance was part of how Margaret got Barb back, but what really made the difference was in opening the door to discussion and problem solving. The key message from the book is that mental illness thrives in an environment of shame and secrecy. It is only when Margaret begins talking with other people, reading, and asking for help that Barb is able to find some semblance of herself.
The quiet joy that Margaret takes in rediscovering her sister is inspirational. What we find at the end is not the old Barb, but, rather, Barb as she is and has become. How We Got Barb Back is an important book, not just for those looking for answers and understanding about a relative struggling with mental illness, but for everyone. There is universal appeal in Margaret’s understated writing, and in the story of sisterly love.