Tanya Frank, a Londoner living in Los Angeles, wrote an essay in The New York Times titled “Unmoored by a Psychotic Break” about her son’s diagnosis with schizoaffective disorder in 2009. Her book about the next decade of her and her son’s life, Zig-Zag Boy: A Memoir of Madness and Motherhood (W.W. Norton), chronicles how psychiatric illness can redefine the relationships in and beyond a family. While the book centers on her experience as a mother and a wife caring for her son, she worries about sharing “such a personal story” that is not just her own. But her book is a personal story with a purpose.
Tanya Frank received her MFA in creative nonfiction at the University of California, Riverside. Her writing has appeared in the Guardian, the New York Times, the Washington Post, and elsewhere. She lives in London with her wife.
Photo by Nancy Huddleston
In the opening pages, we learn about the importance of oceans in her family’s life, and of Frank’s connection to seals. Eight years after her son’s diagnosis, she watched a researcher speak about great white sharks with a “desperation to set the record straight” that she recognized. Like the marine predators, her son did not “deserve to be feared and hated,” and she wants us to understand this as well. Her memoir delivers us to the depth of humanity behind every diagnosis to give a voice to families affected by psychosis.
In 2009, Frank’s son Zach, nicknamed Zigs, is admitted on an emergency 72-hour hold to a psychiatric ward. What follows are multiple trials of antipsychotic medications with severe side effects that limit Zach’s ability to remain enrolled in college. Frank struggles to find him supportive housing that he trusts and spends two sleepless weeks searching for him on L.A. streets when he is unhoused. After a brief respite in Northern California to be closer to her wife, Nance, Frank and Zach move to England to find more complete mental health support through the National Health Service, only to be thwarted by the COVID-19 pandemic. In the end, Frank, Nance and their sons settle in England. We learn about many of the traumatic details of these ten years in passing—broken items, fists sent through walls, doors, a car windscreen but Frank’s book primarily focuses on how her relationships with her son, her home and institutions she once trusted changed from managing her son’s mental health.
Along with the story of Zach’s psychotic break, Frank makes sure that we know her son as a person apart from when he started to suspect his friends at UCLA were in the Russian mafia, his cellphone was bugged and the helicopters circling Hollywood were monitoring him. She tells us about his easy smile and kind eyes. She tells us about how he was a chess whiz, a scholar and a surfer. She tells us these things so we know, and to remind herself as well. Her vocabulary anchors on loss: “It feels to me like a part of Zach has died and I am mourning him,” “I worry I have already lost a part of Zach.” She fights against the loss to “fix him” and “hold him close, so close that neither of us can breathe” until seals, a fascination of Frank’s since an early 2000s trip to Northern California, show her a way through.
This connection to the natural world is restorative in a compelling way. Frank learns that female elephant seals nurse their pups until they return to the breeding ground at Año Nuevo in Northern California, where they leave their offspring on the sand and return to the ocean. When the pups cry, Frank wants to go down and nurture them, but the mother seals know their pups are weaned and ready for their own journey. Later, when working as a docent at the preserve, Frank is sent to watch over an adolescent seal wounded from a shark bite and isolated on the beach. As he turns to the water, Frank accepts that “He would have to continue to face danger in the water, whether I saw him again or not, and I knew that being with him today was the best I could do. It was the best he could do, too, this wounded warrior beast.” Beyond offering a metaphor for her relationship with her son, the seals provide Frank her mission. Instead of trying to cure and reassemble, she advocates for “the simple idea of being with someone and not doing to them, of asking what has happened and not what is wrong.”
The frustration and fear of those ten years also alters Frank’s relationship with the United States, medicine and medical institutions. When Frank moved to Los Angeles in 2001 from East London to help care for her aging great aunt Betty, sunshine replaced gray skies and a house in the Hollywood Hills replaced a council flat. She saw a fresh start and promise for her two boys. Her language changes, though, after years of poor access to mental healthcare, and the trauma of Zach’s psychiatric hospitalizations start to take a toll on her son’s and family’s health. Zach asks, “‘Where would be the best place for me, Mum…a country where I won’t be hunted down and taken away?’” Frank soon agrees that “the USA is not a good place for Zach.” Returning to England further links her with the seals of the North Sea, and she sees her move as a reunion, her own biannual migration to the breeding grounds. While at the Año Nuevo preserve only 50% of pups survive their maiden voyage and the seals must dive to depths of thousands of feet to avoid predators, the seals of the North Sea dive to shallower depths in shark-less waters. Frank also seeks calmer seas.
Her trust in doctors and the diagnoses they provide erode as well. She challenges the biomedical model that labels schizophrenia a disease, considering perspectives that view psychosis as a response to trauma or as part of a spectrum of human experience. If psychosis is a natural response to “existential crisis” or “spiritual emergency,” then, she argues, medications and hospitals are the least natural means of treatment. In discussing auditory hallucinations, she takes a broader approach: “animals hear sounds at different frequencies from humans—and some humans, many more than is commonly understood, hear voices, or sounds that nobody else is able to hear.” She sees the Diagnostic and Statistical Manual of Mental Disorders (DSM) through the lens of pharmaceutical profits and bristles that a biomedical “hypothesis” or “theory” has saddled her son with a label. While Frank does not find a perfectly progressive and holistic solution, she finds support and solace in groups such as the National Alliance for the Mentally Ill and Safely Held Spaces.
Zig-Zag Boy does not end with an answer, but with acceptance. In her fear of losing Zach, Frank also fears she has lost herself. After ten years, and her connection to nature through the seals of two continents and two seas, she reclaims herself, as an individual, a wife, a mother and as a person connecting in the ways she can with the natural world. She comes to an acceptance and understanding that feels real and true, and as readers we welcome that resolution, as open-ended and complex a resolution such as hers can be: “Although I gave him a body, he has his own spirit. This is the greatest lesson I must learn.” —Margo Peyton
Margo A. Peyton is a resident of the Mass General Brigham Neurology Program. Prior to medical school at Johns Hopkins, she worked in film and television story development for DreamWorks Animation. Her essays and book reviews have appeared in JAMA and the Boston Society of Neurology, Neurosurgery, and Psychiatry.