You know that a blunt trauma can break your bone, and it takes time to heal; or malignant cells can grow on your liver, and take time to kill. But mental illness is cruelly inexplicable, intangible, an inch out of reach. This was the disturbing takeaway from Bedlam (Thursdays C4; 4oD), the first of four rare peeks inside the Bethlem Royal Psychiatric Hospital in London.
Episode one dealt with anxiety, which leads the NHS to write 7 million tranquilliser prescriptions a year. The worst cases, the top one per cent, end up in Bethlem’s residential unit. Patients who bravely allowed their extreme obsessive-compulsive disorder to be filmed included James, a 23-year-old whose irrational fear of soiling himself in public left him stuck in the lavatory for several hours a day making sure his bowels were empty, his degree studies on hold and forgotten; and Helen, who had lost her boyfriend to her irrational fear of hurting strangers, and had not been to work as a librarian for two years.
The intelligent, likeable, capable James and Helen were visible, but blurry and removed, as if trapped behind frosted glass. Helen seemed simultaneously to know and to not know that she couldn’t possibly have stuffed a series of innocent people into bins without realising. Yet this absurdity was stopping her walking down the street.
When this spiral of worries that make no sense but can’t be dismissed takes hold, what’s agonisingly frustrating for the patient is the same for their loved ones. Helen recalled how her boyfriend, before he departed, had tried standing in bins in supermarket car parks to prove that he could not fit in. And imagine the torment of James’ mother Penny, discovering during the years of helpless worry that his “intrusive thoughts” included incest with her and his sister, such that family photographs were a source of pain.
The explanation of intrusive thoughts was an invaluable lesson. Simon Darnley, the doctor in charge of the unit, confessed his own: the urge to mow down the children on the zebra crossing outside the school he drives past every day. This sounded shocking and ridiculous until you stopped and dug around for your own. All that had happened to James and Helen was that the intrusive thoughts had got a foot in the door.
This was what was so scary. Mental illness is so close. James quickly mentioned that the toilet had been a source of fear since he was five, “since even before my parents got divorced”. Was that the trigger, a family breakup turning a passing childhood brainstorm into crippling adult anxiety?
Bedlam offered no comforting explanations. Compared to most documentaries it was chaotic film-making, its narrative shifting abruptly. Aaron, a middle manager for an oil company who hadn’t told anyone about his OCD, looked like he would be a central figure as he described how his obsession with “magic numbers” and doing things that “feel right” could make him open and close the same drawer for minutes on end. But he, and Helen, and the germ-obsessed Leon who was disorientingly only filmed from the neck down, drifted away as James took over.
Watching James was fascinating, compelling, heartbreaking. His manic analysis of whether to visit the toilet or eat lunch ahead of a meeting an hour later – slightly questionably heightened by jump cuts and circus-y background music – was the sort of sight familiar only from movie scenes with straitjackets and padded cells. At one stage it wasn’t even clear what we were watching, as a dreamlike series of skewed images and extreme close-ups of James, presumably filmed by him at some point, flashed by to a harrowing soundtrack of his mother losing patience (“You’re stupid!”).
It felt like James’ problems were insurmountable when it emerged he had a deep fear of being or becoming a paedophile. Facing up to reading about Glitter, Fritzl and Savile (“I could be like them if I don’t ritualise”) was part of his therapy. James’ mum said the news had been switched off in their house, since Savile stories were triggers. Simon Darnley observed that in the 1980s, fear of Aids had been prevalent among those suffering acute anxiety. That was the doom that was fuelling the media at the time; now paedophilia has replaced it. This was mental illness manifesting as a fear of mental illness: a startling concept to be handed just as you were contemplating how frightening being in James’s predicament would be.
Yet suddenly, he was back with us, his treatment completed, his drama degree ready to restart. Having barely explained what caused all the problems, this sketchy, eccentric programme barely explained what had at least partly cured them. But this underlined that although the journey into darkness can be short, so can the journey back be, especially if help from people as skilled and sensitive as the Bethlem staff is available. Mental illness is more prevalent than you think, but also more treatable. There is no firm them and us. Aaron, deep in torment and thus not playing to the cameras one iota, said that he’d agreed to appear because “if this can help at least one person know that they have a problem and it can be helped, it’s a good thing, really”. It was surely many more than one.
A Very English Education (Sunday BBC2; iPlayer) mostly wasn’t about mental illness, but was about the effect on boys’ minds of attending Radley, a posh boarding school that featured in a BBC documentary in 1979. Hannah Berryman tracked down several boys who had appeared, to see what sort of men they were.
It was a fine idea, first because virtually nobody watching would remember the 1979 show, which was heavily extracted and was a rich stew of smirks, hormones, schemes, hats and murky cloisters. The question of privilege being passed on and reinforced was only directly addressed once, when one of the ex-pupils who was now a Mayfair investment banker said comprehensive schools could easily churn out young adults with bulletproof self-confidence if they simply overcame their “poverty of ambition”.
Would they want to, though? As these middle-aged men talked, they all revealed that they’d raged against the machine in some way, hurt by the high expectations, the narrow definition of success as a lucrative career, or the institution instilling a little too much self-sufficiency.
Berryman cleverly withheld the details of the men’s current social and financial situations for as long as possible. As they reflected on their youths, on how setting out a template for their lives hadn’t worked, because lives and souls refuse to be precisely shaped, you found yourself willing them to have turned out healthy and happy. Even the investment banker.