5 Tips for Exploring Mental Health in Your Fiction
As a therapist for 25 years and as a writer for my whole conscious life, I view every therapeutic and literary journey through the lens of emotion: What we react to, how we react, and why we react that way. My therapy clients arrive at my door with their emotional origin stories embedded—often deep within their minds and bodies. Together we identify themes and stumbling blocks with the hope of identifying a path toward resolution. For writers developing fictional characters, the process isn’t all that different, though we start from scratch.
(At the Intersection of Romance and Mental Health.)
Two passengers on the same airplane encountering the same turbulence can have wildly diverging experiences. Passenger A is pleasantly lulled to sleep, as the rocking sensation recalls being soothed as an infant in the arms of an adoring mother. Meanwhile, passenger B—who survived a devastating earthquake that decimated her family’s home and killed a sibling—is profoundly retraumatized. I just made that up, but I’m already curious about Passenger B’s internal response—both to the turbulence and to Passenger A’s incomprehensible serenity.
Emotion dictates a protagonist’s unique response to difficulty. Does she conceal her feelings or wear them on her sleeve? For example, what if Passenger B is a mother traveling with her young son? The scene might then become an internal battle as the mother desperately masks her own terror to reassure the child of his safety. That’s conflict—the scaffolding of every story.
As fiction writers, we take normal, everyday conflict and crank it up to a 10 to make our stories compelling. In a mental health focused novel, it’s the absence of and quest for mental health that’s the meat of the story, the source of the conflict at its heart. Some of my favorite examples are Chemistry by Weike Wang; A Little Life by Hanya Yanagihara; Elinor Oliphant is Completely Fine by Gail Honeyman; and Jayne Allen’s Black Girls Must … series.
What drives the plot is not what happens in the story, but the interplay between external factors and the hero’s response to them. There are dos and don’ts to writing about neuroses, neurodivergence, or mental illness that will make your characters and their struggles ring true—not flat and stereotypical.
Think Through the Origin Story of Your Character’s Mental Health Issue
This can be rich in terms of your story creation. Even if you only hint at it in the narrative, as an author, you need to understand the root cause of your character’s struggle before you decide what the manifestation will be. Family quirks, trauma, relocation, immigration—all of these can impact mental health. I love childhood backstory as long as it comes in scenes rich in character development, scene, and action. The villain’s origin story can be a whole book. (Think Penguin of the DC comics.)
In my newest novel, Mirror Me, I started with a young man who had been abandoned by his Swedish birthmother and adopted into an Upper West Side Jewish family. He is biracial with an African birthfather (the birthmother did not know what country he was from). Eddie’s uncertain identity leads to a powerful clinging attachment to his mother, his brother, and later women. Being “exotically attractive” (leaning into the stereotype often imposed on mixed race people) means others impose their fantasies onto him. He feels like an imposter as a result, always anxious that he is going to lose someone’s love.
The what-if-things-had-been-different undercurrent of being an adoptee is central to the story too, in that Pär, a consciousness who came into being at the moment of Eddie’s separation from his birth mother, allows the reader to envision multiple possibilities for Eddie’s life.
Mine Your Own Past and Life and Family
This could get you in trouble with loved ones, but there’s help for that! (See Jane Wong’s LitHub article entitled, On Memoir, Permission, and the Thorny Terrain of Writing About Family ‹ Literary Hub (lithub.com).) But in this case the old write-what-you-know adage can prove fertile ground for character development.
Here’s a personal story. I’m an only child who began nursery school—my first prolonged exposure to other children—at the age of three. I routinely wet my pants because I didn’t dare ask the teacher to take me to the restroom. I thought if I left, no one would remember me when I returned. Being an only kid shaped my childhood going forward, compounded by being biracial—Black and white—and resembling no one in my family. Fitting in became enormously important and often impossible for me. I’ve channeled some of my own quest for belonging into Eddie’s story.
Understand the Role Mental Health Will Play in Your Story
Is the story about mental illness? Based on something very familiar that you know well? Is the book set in a psychiatric hospital? Think Susanna Kaysen’s memoir, Girl Interrupted. Or is the condition a side issue, a challenge that makes your protagonist’s life a little more complicated? Think Jonathan Lethem’s Motherless Brooklyn.
Be Accurate and Avoid Stereotypes
If you are not writing something autobiographical, drawing on your own personal experiences, make sure to do your research. Interview people, read articles by and about those with the psychological challenges you intend to feature. Make sure to keep it three-dimensional, even if your book is about being mentally ill.
No one is just depressed or just anxious. No character is the sum of their quirks and ticks. Make sure any character with a mental health issue is well-rounded and interesting in other ways.
Don’t Be Afraid to Lean Into the Humor
Par for the course with mental health issues are misadventures, foibles, and overcorrects that can end in comically disastrous results. As long as readers can laugh with rather than at the mix-ups, it’s all good. In fact, if everything we wrote about mental health were tragic, if everything we wrote about trauma were traumatic, the work would be pretty hard to stick with as a reader or as a writer.
Whatever story structure you employ—classic three-act, spiral, or what have you—a well-drawn main character is essential. The interplay between the self (Passenger B for example), her circumstances (air turbulence), and others in her life (the frightened son and the maddeningly calm Passenger A) creates conflict, obstacles to resolution. Your hero’s place on the mental health continuum gives her texture and relatability. Her mess-ups, embarrassments, and misunderstandings are what resonate for readers and make your work thrilling, agonizing, and yes—satisfyingly fun!
Check out Lisa Williamson Rosenberg’s Mirror Me here:
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