21 July 2011

Would Jonker have lived today?

Ingrid Jonker committed suicide over 46 years ago. Would modern-day psychiatry have saved her life?


My lyk lê uitgespoel in wier en gras
op al die plekke waar ons eenmaal was*

Afrikaans poet Ingrid Jonker wrote these prophetic words more than ten years before the fateful night of 19 July 1965 when she walked into the sea at Three Anchor Bay. She was 31.

Many who were close to her were not surprised by her suicide. She had threatened to end her life several times before.

Jonker, the gifted poet who brought us three anthologies, including the poem The Child (clip below), which Nelson Mandela read at his inaugural address in parliament on 24 May 1994, had a long history of mental illness.

Some say that she suffered from major depression; others say she would now have been diagnosed with bipolar disorder. Close friends speculate that her mental illness had its origins in her failed relationship with her father, who rejected her at an early age and whose love she was still trying to win in adulthood. They speculate that she tried to “repair” this rejection through romantic involvements with men – including the writers Jack Cope and Andre P. Brink. These relationships unfortunately all turned out to be stormy and unfulfilled and perhaps even confirmed the sense of rejection she experienced when her father left her.

Jonker today
If Jonker had lived in current times, would she have had a greater chance of recovery?

“Quite possibly,” says a Cape Town psychiatrist Dr Bennie Steyn, “because the treatment options and support for people with mental illness have improved a great deal over the years.”

“Early diagnosis is vital. If someone's condition is diagnosed correctly early on and if they receive prompt treatment, their chances of recovery are much higher,” he says.

In the fifties and sixties, mental illness was still taboo and highly stigmatised, and little was done to educate the public in this area. It is therefore possible that Jonker's condition went unnoticed and therefore untreated for a long time.

The modern-day diagnostic system is also a great deal more sophisticated than in Jonker's time. The Diagnostic and Statistical Manual of Mental Disorders (DSM), which clinicians refer to when making a diagnosis, had just been developed. The fourth edition is currently in use and the fifth is due out shortly.

“Today we are aware of a greater spectrum of mood disorders and treatment is more specific. Patients also benefit from a greater variety of psychiatric medication.”

Jonker was most probably treated with the old tricyclic antidepressants. These drugs are very effective in treating depression, and are still in use, but they have bothersome side-effects, and many people therefore stop taking them. One of the greatest drawbacks of tricyclics is that they are lethal when taken in huge quantities, and are therefore not the treatment of choice for someone who is at risk of committing suicide. Electro-convulsive therapy (ECT), which Jonker had, is used today – but far more selectively and usually only when other treatment methods have failed.

The conditions in psychiatric hospitals such as Valkenburg Hospital, where Jonker was admitted, have also changed. The new Mental Health Care Act emphasises the human rights and freedom of patients, and encourages community care. Patients have more rights and those who have the capacity to make decisions, have the right to refuse treatment. Unfortunately patients have to face other problems, including overcrowding and lack of resources.

"In Jonker's time, there was an active group who rebelled against psychiatry. Many writers and artists of that time romanticised mental illness and saw it as a journey towards self-discovery. They criticised psychiatric care and its tendency to pathologise. A creative person such as Jonker who struggled with convention must have found it very difficult to be in a restrictive, lock-up environment such as Valkenburg. As an anti-apartheid activist, she might also have objected to the racial segregation which was hospital policy at the time."

Jonker's legacy
Suicide is as much a reality now as it was in Jonker's time. But people are now far more aware of the underlying brain processes and chemical imbalances that contribute to mental illness, and this has made it easier for people to seek treatment and benefit from support groups.

Jonker’s legacy is rich and varied, including the charming poems she wrote for her daughter Simone, as well as darker pieces that speak of her own struggle while expressing great empathy for others’ experience. A poem like I am with those is as relevant to people living with mental illness now as it was in her time:

I am with those
who abuse sex
because the individual doesn't count
with those who get drunk
against the abyss of the brain
against the illusion that life
had once been beautiful or good or sacred
against the garden parties of falseness
against the silence beating at the temples
with those who poor and old
race against death the atom bomb of the days
with those stupefied in institutions
shocked with electric currents
through the cataracts of the senses
with those whose hearts have been removed
like the light from the robot of safety
with those coloured african deprived
with those who kill
because every death confirms anew
the lie of life
and please forget
about justice it doesn't exist
about brother hood it's deceit
about love it has no right

- Ilse Pauw, Health24, updated July 2011

*My corpse lies washed up in grass and wrack
wherever memory should call us back

Need someone to talk to?

Contact the South African Depression and Anxiety Group (SADAG) on 0800 21 22 23 or visit their website

Read more:
Riding the bipolar roller coaster
To tell or not

Visit our Depression Centre



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