I Can Get Through It

By Sheila Hollins, Christiana Horrocks & Valerie Sinason. 80 pp. ISBN I 901242 20 X

Going into Hospital

By Sheila Hollins, Angie Avis & Samantha Cheverton, 80 pp. ISBN I 901242 19 6

Going to Out-Patients

By Sheila Hollins, Jane Bernal & Matthew Gregory. 72 pp. ISBN I 901242 18 8

All published in London by Gaskell/

St George's Hospital Medical School. 1998. £10 (pb)

The three titles reviewed here form part of a wider series entitled Books Beyond Words, the purpose of which is to assist people with learning disabilities to understand events such as going into hospital and so lessen any associated anxieties. Other titles in the series seek to address the emotional aspects of difficult and potentially traumatic life events such as bereavement, or less common events such as being under arrest and going to Court. I believe these books to be an essential purchase for any service where these issues are likely to be of concern. They are supported by helpful glossaries and details of organisations that can provide further resources. The illustrations that form the main content successfully avoid being ‘pictures belonging to childhood’ and manage to stand independently, as they surely must in such a series. I did wonder, however, what standards may have been achieved if the UK had as strong a tradition of bande dessinée production as say Belgium or France and their more developed tradition of picture-based narration for adults.

These books raise interesting issues regarding the use of narrative with this client group. While there is an implicit picture-based narrative, there is also a descriptive text, as well as suggestions on to how to use single images as a basis for the (co-) construction of more individualised, personal narratives. Originating from a therapeutic position, the books encourage narratives of resolution. In some senses, these are stories of hope and ‘wonder’ as defined by the Russian formalist Vladimir Propp as “ any narrative… that develops from an act of injury or state of lack, through certain mediating functions to an eventual wedding or other concluding function”. They have, therefore, a tendency to a reductive trajectory, although based on a strong claim of believability. How strongly the narratives can be maintained in the real world is of some importance, as is the issue of how far these tools can help address the emotional content of these experiences. I have some concern that there may be a certain encouragement given to an inappropriate didacticism at the expense of the more engaged, shared emotional meanings that are ultimately more personally costly.

There is the real issue here that the provision of helpful aids can only be one part of any endeavour to support people at times of crisis and difficulty, and what people are often seeking are not so much ‘interventions’ as relationships with meaning to frame experiences. Given this, the narratives should equally be seen as structuring and creating meaning for supporters, many of whom may have little personal experience to draw upon for these purposes.

The hospital and out-patient titles are particularly useful in addressing the issue of consent or, rather, lack of it. For specialist learning disability services this remains an issue to be vigilant about, and many services will have examples of relatives being contacted after 15 or more years of infrequent or non-contact with an individual for the purposes of ‘obtaining’ consent. Regular contact between specialist services and key other secondary care specialities about this issue is of benefit, and I would strongly encourage joint discussion and use of these books in that context.