The Skeleton Cupboard by Tanya Byron

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Reviewed by Victoria Best

When my son was still a child, he used to be transfixed by The House of Tiny Tearaways, a BBC programme in which families experiencing some nightmare of parenting – children who wouldn’t eat or sleep or talk – were counselled and given new techniques and strategies to try. My son loved it while chaos reigned; he was fascinated by those out-of-control children, whereas I thought that the psychologist who whipped those families into shape was nothing short of a genius. She excelled at tough love, forcing parents to confront the fears and anxieties that perpetuated the crises and showing them solidarity whilst they went through the heart-wrenching business of standing firm against bad behaviour. That was one of the nation’s earliest introductions to Tanya Byron, and she has gone on, unsurprisingly, to be hot media property, heading up a string of parenting programmes and writing for The Times and Good Housekeeping.

Now she has written this book, The Skeleton Cupboard, a memoir of life as a clinical psychologist drawn from her days in training. In the preface, she traces her interest in the field back to a gruesome experience when she discovered, aged 15, her grandmother bludgeoned to death by a young, pregnant heroin addict. Whilst other teenagers might have sunk into a traumatic disorder, Tanya Byron decided instead to become a mental health practitioner. Returning in these pages to her training, she might suggest that the Tanya Byron of those days was somewhat more naïve and idealistic than the one we see on television, and that she was also so young that having to deal with the sexual problems of a couple who were both older than her, or the angry, confused parents of an anorexic girl, were challenges for her nascent authority. But if you’ve ever seen Tanya Byron in action, you will recognise her firm, swift, no-nonsense approach. Not keen on Freud and the psychoanalytic brethren, she seems from her earliest days to favour a direct, almost confrontational approach, one that seeks the heart of the problem and delivers it a sucker punch.

All of this makes for very entertaining reading, and she chooses a variety of case histories to cover. The opening chapter is a compelling account of one of her first clients, a man who describes himself merely as a victim of anxiety and panic attacks. Tanya Byron sets to and seems to be having a gratifying impact on the man, only to discover that she is being played. He turns out to be a well-known psychopath who has accidentally slipped through the system and into her cupboard-sized consulting room. Which she happens to have set up with an eye to style and not to the panic button being out of her reach.

Evidently, she survives the encounter and goes on to other aspects of her training – drug addicts, child abuse cases, anorexic teenagers, beautiful young men dying of AIDs, and so on. The stories are competently written in a dialogue-heavy style that makes the reading zip past. And they can be deeply moving. In particular, the story about the elderly Holocaust survivor who is sinking slowly into dementia and whose main worry is his wife, who is already lost to the disease. Byron realises that part of her training is learning to deal with the emotional fallout of such encounters, and that she must find a way not to flinch in the face of extreme distress. It is to her immense credit that she never feels she has to hold back her tears. The compassion she displays for those in crisis always seems genuine.

This is a gripping, fascinating and easy to read book, but it is not without its flaws. Byron also depicts some of her private life at the time, and the evenings she spends with her girlfriends are often rather irritating intrusions. Having read Christine Montross’s Falling Into The Fire for our last edition, a book that continually challenged the ethics of mental health care and considered the rights of its troubled souls with close attention, I could not quite escape the feeling that Byron’s brusque accounts made for a freak show – something she clearly does not intend. But properly revealing the full humanity of the sick and suffering requires a delicacy and richness of account that this book sometimes lacks.

The most intriguing – and to me disquieting – aspect is Tanya Byron’s proud claim to client confidentiality. In it she states that ‘while all I describe is drawn from real clinical practices, the characters I write about are entirely fictional, their stories inspired by many of the incredible people I had the privilege to meet during my training.’ Now this is a well-intentioned notion, but a strange one that begs the question why we should choose ever to read non-fiction. For my own part, I read it because life evades narrative in fascinating ways. It is always rougher round the edges, less open to easy resolution, to neat and tidy closure. It is also the guarantor of its own truth. We may marvel at what happens in its pages because we are assured that these things really occurred. So at its best, non-fiction challenges the very structures of storytelling – its organised triage of beginning, middle and end, its clever turning points and its meaningful conclusions. Life just isn’t like that, and particularly not when it comes to people with real, dreadful, life-destroying problems. So what are we to make of Tanya Byron’s neat and tidy accounts of case histories? Her one-line interventions that make all the difference, her swiftly drawn characters that adhere to the stereotypes of controlling anorexics and beautiful, clothes-obsessed homosexuals? If these stories are not real, if they are mere constructions, how much actual significance can we draw from them? I suggest you read the book and decide for yourself.

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Victoria is one of the Shiny editors.

Tanya Byron, The Skeleton Cupboard (Macmillan, 2014), 320 pages.

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