Sure of you: book review in the Lancet

 Hoyle-Pretend-Friends

If home is where the heart is, it makes sense that Pretend Friends is set in a home with a verdant garden, furnished with a picket fence, where conversations take place. It’s a book born of love by author Alice Hoyle and illustrator Lauren Reis. Collaborators include Katy Gray, who has schizophrenia and has consulted on the book. Sale proceeds go to the Rethink Mental Illness campaign to help with their work in reducing stigma and raising awareness of disorders such as schizophrenia among people of all ages. The power of metaphor is used to describe the schizophrenia experienced by Big Jay, an adult, and the imaginary friends of Little Bea, a child. Little Bea wants to make her pretend friends big so Big Jay’s pretend friends—that is to say, distressing hallucinations and delusions—can’t hurt or scare him anymore.

As someone with schizophrenia, who is an auntie to two-year-old Archie, I wonder if he’s old enough to understand the story when he reaches four. Yet a children’s book using metaphor to introduce them to the different experiences people have is a worthwhile concept. It’s been observed that Eeyore in Winnie the Pooh has symptoms of depression, yet his friends still love him irrespective. That’s a very important message to drive home for children. Pretend Friends projects AA Milne’s philosophy further, and says that Big Jay needs “special medication” for his pretend friends. But in my own childhood, the very notion of this as a reality for a loved one would have been terrifying. However, there’s a section for adults at the back of the book that address any fears a child might have. It gives example questions about Big Jay with thoughtful responses that foster greater understanding and compassion. Causation and cure (or lack of it) are all covered, and the message is conveyed that, with the right help and support, Big Jay is going to be okay. It’s also stated that psychosis is no-one’s fault and not the child’s responsibility.

Conversations such as this one are very important. Once over dinner with two adults and their 15-year-old son, I brought up my schizophrenia and the 15-year-old laughed in my face. It illustrates how we must tackle misconceptions early and bring such a stigmatised illness in the open, rather than pretending that it doesn’t exist. Regarding my relationship with Archie, I’m keeping the book to give him when he’s just about tall enough to have a conversation over the beautifully illustrated brown picket fence.

Published source: Lancet Psychiatry online

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