Stigma, Estrangement and Psychosis: One Woman's Account of Hospital Life and Apartheid's Lasting Scars

Abigail was in her early twenties, living alone in Johannesburg, when she had the nervous breakdown that put her in a mental hospital. She had spent nearly a year there, first at a shelter for abandoned women and children in Hillbrow, then at the Salvation Army on Simmonds Street, in the central business district near the banking quarter. The Star newspaper and the ANC offices were a short walk away. Her account, published as a first-person essay, begins in that setting and works outward to her family and to the country they lived in.

Before the shelter, she had lived with her paternal aunt Babs in her mother's childhood home. In the evenings her aunt would fix her a hot plate of food and they would watch television, but neither her aunt nor her cousin would speak to her. She writes that her aunt talked to her other female cousins differently. Those cousins had straight hair and lighter skin; her own curls never behaved. When they laughed at her, she laughed along, knowing she was the joke. Her maternal Uncle Davy and his sons treated her the same way. More than twenty years on, she says she has not seen those cousins or spoken to them by phone, and they never wish her happy birthday.

She defines stigma, in her own terms, as estrangement from family. Her sister, who lives somewhere in Europe and will say no more than that, has deleted her from all social media. When they do speak, the question is whether she took her blood tests, not how she is coping. Abigail says her sister can afford full-time care for their father, who is recovering from radiation therapy, yet sends no money and expects Abigail to do everything: cooking, cleaning, washing and dressing him, helping him to the bathroom, cutting his nails. Her life, she says, has come to a standstill. She also says her sister, who can pass for white, hides that the family is Coloured, and has rejected their brother because he cannot pass. She notes that their brown-skinned father paid for her sister's education at the University of Cape Town.

The family history she lays out is heavy. Her maternal grandfather was a policeman and a functioning alcoholic. Her paternal grandfather served in the Second World War and earned four medals, now lost somewhere in her childhood home. She believes he came back with chronic post-traumatic stress; he developed epilepsy, and neighbours nicknamed him "Fitzy" for his seizures. She also witnessed domestic violence and alcoholism in her maternal aunt's home, where the aunt abused sleeping tablets and over-the-counter medication. Her father was manic depressive, and she describes her parents as two people living past each other, held together by their children. She also refers to her father's humiliation at the hands of the Secret Police.

Her brother had been her closest companion. He worked as a credit risk analyst at Nedbank, lost his job, and turned to drugs after falling in with a new group of friends. He went through three rehab facilities. She says she is frightened of him and walks on eggshells. She recounts that he had her certified for the second time by telephoning the police; she says she had not been hypomanic, manic or psychotic, and believes he wanted revenge. She was taken to St. George's Hospital, escorted by police, and rode in the back of a car belonging to a church sister and brother from the Gospel Hall. Her worry was who would look after her father, who used a wheelchair.

Of the hospital care, she is critical. Her mother was the only person who visited, and was waiting outside the nurse's office at each discharge. She credits perhaps the psychiatrist and a Muslim clinical psychologist, but thinks the doctors treated signs and symptoms rather than the whole person, with a pill for each and a sedative injection for misbehaviour. She says she has forgiven her mother. She traces her psychoses to maternal estrangement and severe bullying at Alpha Primary School and the high schools and colleges she attended, including Collegiate, Intec, Damelin, Hill College and St. Marks. She says teachers bullied her too. She began writing poetry at eight, and her work appeared in the children's section of The Weekend Post.

She ties this to apartheid's legacy: forced removals that put black and brown families in low-lying, flood-prone areas with poor soil, and a psychological toll that she says persists in a post-apartheid, post-Covid South Africa. Where she lives, she says, there is gunfire day and night. She asks that mental illness be understood like heart disease or diabetes, and psychosis like a chest cold that needs rest and recovery. The essay ends by calling for psychological healing and repair, and for the children of liberation-struggle parents to be understood on their own terms.