Dx: Diagnosis and Writing
An Interview with Kate Mascarenhas
This conversation started when I asked the question "Are you a writer with a diagnosis”? on social media and Kate Mascarenhas answered. I found our short conversation fascinating and realised I wanted to know more, and Kate very generously agreed to an interview.
Tell us about your diagnosis.
I was diagnosed with bipolar disorder in 2012. Although autism has repeatedly been queried in my notes, assessment isn’t a priority for now. I also have two long term physical conditions, one diagnosed in 2005 and the other in 2021, which place some constraints on my ability to work.
Why do you write?
For meaning and a sense of purpose. When writing is going well it feels fully immersive. (My motives for publishing are separate – I publish to be paid).
Can you say a bit more about that feeling of writing as immersive – where does that come from for you?
Working in solitude, with a high level of focus, when what I want to create is within my competence. The solitude and the self-sufficiency is important; I find it much easier to be productive out of contract. Often illness prevents me from writing and that frustration is awful. I grieve the work I don’t get to do, that I’d enjoy.
In our brief exchange online, I recognised the feeling of being misunderstood and the issue of overloading interlocutors in a face-to-face situation. This now makes more sense to me in light of my recent ADHD diagnosis. When writing, I can prune facts and logically rearrange things, and thus I feel it allows me to be better understood, whereas I sense you feel more ambivalent towards writing.
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Your expectation of being misunderstood, where does that come from, do you think?
Does that expectation relate to your diagnosis or traits?
It’s a learned expectation. Perception and communication are important to bipolar criteria and, in a different way, are central to autism criteria too. I think the high likelihood of misunderstanding and being misunderstood is built into both diagnoses, by definition.
Could you say a bit more about you experience with bipolar and writing? I am especially interested in perception and communication that you mention.
If you can hear and see things other people aren’t hearing and seeing, or you’re experiencing a delusion, or your emotional reactions seem disproportionate, then you’re also regularly encountering people who don’t find you intelligible. You aren’t even necessarily intelligible to yourself; maybe you’re “double bookkeeping”, behaving in a way that doesn’t match your patterns of thought and feeling. I’ve never been able to write during a bipolar episode, so to the extent being bipolar does influence my creative interests or style, it’s always during recovery. In my experience it’s relatively straightforward to interest commissioning editors in writing on depression, anxiety, trauma – but not psychosis. There isn’t stigma attached to the bipolar label per se, but any psychotic symptoms aren’t considered “relatable”. That’s a limitation on how possible it is to overcome misunderstanding through literature, quite separate from what can be done creatively to build empathy.
Sometimes I hear authors describe their writing process as a kind of madness and I’m never quite sure whether that’s an opportunity for peer connection or not. For instance, it’s very common to hear novelists describe how their characters started talking to them as if they had an independent existence. The novelist “hears” their characters’ voices and is forced off-plan. I sometimes want to ask, “wait, are you being whimsical, or do you actually hallucinate?” As a metaphor it pulls me short, because when I hear voices as an auditory hallucination, it doesn’t feel anything like the experience of inventing fictional characters. Those two things feel very different to me, although I am curious about other mad writers who feel an overlap. There is this Romantic tradition of associating madness with creativity, and older classical ideas of being visited by the muse, which I don’t identify with very much.
When you write in what way do you change your expression? Does it depend on what you are writing?
It does, and there’s a degree of this which I think is just entirely regular writing practice – when I write fiction, I draw up style sheets for each project covering vocabulary, syntax, and tone, and I treat those as part and parcel of world building. That’s quite a common approach for writers of all neurotypes, as far as I’m aware, although I wonder if it suits me well because the rules are very clear; they can be taught and learnt explicitly. I felt the same way as a copywriter, when I’d have to adopt whichever house style the client asked for.
The changes I make also depend on who else is involved in publishing my work. On that front I’ve had great experiences, and also fraught, miserable ones.
What are the differences between your “authentic” expression and that which you tend to write in? I’m interested in this – is there not something of you in that writing, even though you have re-worked to suit an audience? Why do you feel that this an uncomfortable compromise?
One of my clinical psychologists once observed that I have better than average declarative knowledge of how people act around each other, but my procedural knowledge is worse.
For instance, I’m very bad at flirting – but I can give an excellent verbal description of all the different microgestures made by someone flirting, stage by stage. Meanwhile, a confident flirt might struggle to explain how it was done. When I’m writing, I can describe certain kinds of relating without an implicit understanding of how to do it in real life. I actually like the challenge of working that way, and I like getting praised for a good job, when I’m lucky enough to move a reader. It’s just there is a strangeness to hearing I’ve depicted something beautifully when I’m on the outside of it. I don’t think it’s an uncomfortable compromise, exactly. I’d call it a dissonance.
I do get rewards and enjoyment from exercising that declarative approach in fiction, which complicates any clear dividing line between authentic and inauthentic expression. And all my books also contain material I have implicit understanding of – they’re a mixture – although it causes a different kind of dissonance when the parts I identify with more directly attract the most reader puzzlement.
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What is the reason, do you think, that your mode of communication, whether written or spoken is “detail orientated, information heavy” as you put it?
If I’m trying to render experience on the page, and I’m very specific describing clothing or architectural features or anything else, that’s because the same level of detail is constitutive of day-to-day perception for me. I’m good with patterns and explicit rules, so coherent arrangement per se isn’t usually a problem in my speech or writing, even at my most intensely detailed.
Writing advice along the lines of “cut whatever readers skip to get to the action” used to dismay me. I know it’s really a point about pacing, but I enjoy reading detailed description on its own terms, presumably at greater length than is usual. I do wonder whether received wisdom on when and where to cut description invokes a particular perceptual baseline that I’m out of step with. Novelists can defy expectations for literary experiment or, in my corner of upmarket commercial fiction, to give voice to a quirky narrator; but I think that points to unequal burdens of justification, where the typical is regarded as the natural – as something that gets to just be rather than requires explanation.
When I say I expect to be misunderstood, I’m not limiting that to manner of expression. Rather, I think there’s a possibility of two-way empathy problems, and different respective experiences that shape how my communication lands. I remember once – this isn’t an example from novel writing, but life writing I suppose – I was invited to a diary event, where people exhumed their teenage diaries to laugh at their adolescent melodrama. After looking through my own old diaries I declined. For instance, there were pages and pages where I described roll-on roll-off ferries, which I knew wouldn’t fit the vibe. As descriptions they were perfectly clear, and in the abstract, I can see how they might be amusing too, but people would have been puzzled at why I’d written such a thing, I think.
These are traits that might fit a diagnosis, or might be explicable in terms of personal history, or both. In the drive for content, social media amplifies over-certain claims about this or that thing being related to neurotype, so I try to hold any connections lightly, and with curiosity.
I just read your latest novel Hokey Pokey, which I very much enjoyed. I was struck by how it is a story about the protagonist, Nora, finding her true self, in fact, her voice. Without giving too much away, she is someone who is very good at fitting in by mimicking, and who fears that her true self is monstrous to others.
She seems to enact your feelings about writing – that it is a kind of mimicry, that is necessary to hide your authentic mode of communication, which would be misunderstood. Can you say a bit more about the novel and the character of Nora?
Oh, I’m glad you enjoyed it! The novel’s set in 1929. Nora is a psychoanalyst who follows a colleague’s wife to a hotel, ostensibly to collect evidence of her infidelity. A snowstorm cuts the hotel off and guests start disappearing in supernatural circumstances.
As you say, it’s revealed early on that Nora has this unusual skill as a mimic. I agree that she reflects my interest in what it means to be authentic. My qualification would be that her mimicry is more of a compulsion, or a drive, than an attempt to fit in, and there’s signs the drive is still there even at the story’s close. Mimicry’s often a private activity for her – she imitates people when she’s alone, or in the context of burgeoning intimacy, such as her romantic relationships. Her claims to be a monster are complicated, because she feels ashamed of moral injuries she had no control over. But we also see her do objectively terrible things of her own volition, and we might reasonably expect her to feel guilt there.
On the most literal level, her experience neatly inverts mine. Her knowledge of how people behave is really procedural, for one thing. In person I’m woefully bad at being someone other than myself.
I also read Nora as someone with many neurodivergent/autistic experiences and traits: the feeling of otherness, echolalia, difficulty not telling the truth, observing and mimicking others in order to make connections with others, and even details like being exhausted by social interactions and sensitivity to fabrics. Was this deliberate?
It’s emergent. Mimicry and heightened sensitivity are old gothic monster tropes and primarily I included them on that basis – Hokey Pokey is part doppelganger story, part vampire story. As I wrote it, I was re-evaluating a long period in my life when I’d been abused. During attempts to repair my self-esteem, I’d argue with an internal voice telling me I was crap, and it was striking to me how peaceful it felt sometimes to relent: to mentally agree, “Yes, I am awful.” Nora complies with a fairly standard gothic arc – the protagonist becomes a (literal) monster – partly because I wanted to examine the horrific potential of finally feeling congruent in the worst way.
So neurodivergence wasn’t the main lens I was viewing Nora through, although there’s a lot of scope for analysing why conflicted gothic monsters might look autistic, and whether that’s a factor in me feeling drawn to the genre. My gut feeling is that another psychological framing might match Nora more closely. Shortly before Hokey Pokey was published, I read a book on echoism by the psychotherapist Donna Savery. I was surprised by how much the description matched Nora: children who suffer particular forms of emotional abuse and manipulation can grow up with no sense of their own voice, lacking a sense of self, and taking on the traits of people they’re intimate with. Echoists are changeable, whereas an autistic person typically has a stable personality and values. Autistic echolalia is an attempt at communication or self-soothing rather than a sign of changeability.
I have deliberately written an autistic-coded protagonist before, though. My second novel, The Thief on the Winged Horse, was about a young woman who makes dolls that spark particular emotions when you touch them. The heroine is socially awkward, over literal, completely baffled by hierarchy, and worries that these things will exclude her from making art that resonates with people; she also finds her role in a community where she is loved. It’s a warmer story than Hokey Pokey.
Nora does find a way to be herself and to be loved, even in her difference – is this something you think is possible for everyone?
Some people do go their whole lives unloved, clearly. For me, love means acting towards someone in full recognition of their best interests, their uniqueness, and their irreplaceability. By such a standard everyone is definitely loveable, but I’m not sure whether everyone is capable of loving. Although Nora shows this capacity by turns, and the deep attachment she forms is meaningful in its own way, she isn’t seeking love as I define it. I’ve noticed reader reaction to the last chapter of Hokey Pokey has been very split on whether Nora is breaking a destructive cycle, or repeating one, and I wonder if that also reflects differing underlying ideas of what love is.
I do particularly like Nora’s character because she is “morally” ambiguous. I am not sure working though trauma always means simply vanquishing the monster within.
Could you say something more about being drawn to the gothic, and to speculative fiction in general? Do you think, apart from the monster as a figure of divergence trope, deviating from straight realism has a resonance for you and perhaps people with various diagnoses in general?
If I have to spend a lot of time working out rules anyway – because I’m on the backfoot in reality – why not lean into it and create a different world altogether? The Psychology of Time Travel was science fiction, and Thief was a contemporary fairy tale, so I am more of a speculative fiction writer than a specifically gothic one. I’ve always liked the idea that estrangement is one of the most important literary functions, which speculative novels are well placed to achieve. Other writers with diagnoses, as people who don’t fit the norm, might also be drawn to genres with that transformative potential.
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Kate Mascarenhas was interviewed by Eva Aldea.
About Kate Mascarenhas
Kate Mascarenhas is an author based in Birmingham, England. She has a PhD in Literary Studies and Psychology, and is a chartered member of the British Psychological Society. Previously she has written for The Guardian, Observer Magazine, Big Issue North, and Mslexia. Her novels include The Psychology of Time Travel, The Thief on the Winged Horse, and most recently, a roaring twenties supernatural horror called Hokey Pokey.
You can buy Hokey Pokey here.
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