Jocelyn Pook: inspired by mental illness

'Working on this piece I realised that the notion of hearing voices naturally lends itself to musical ideas and exploration'
Jocelyn Pook
Jocelyn Pook, whose song cycle Hearing Voices reflects the sadness of incarceration. Photograph: Garry Weaser for the Guardian

In the Prinzhorn collection at Heidelberg psychiatric university hospital is a jacket that was made, and worn, by a seamstress, Agnes Richter, who in the late 18th century was an inmate in a German mental institution. Agnes had created a beautifully tailored jacket from ripped up hospital uniforms, and covered every inch of it with embroidered writing. Although largely indecipherable, a few words and phrases have now been decoded.

I came across this remarkable artefact in Gail Hornstein's book Agnes's Jacket: A Psychologist's Search for the Meanings of Madness. Hornstein, quite unusually for someone working in this field, is interested in patients telling their own stories. Her book forms part of an increasingly large body of work that can be characterised as protest literature in that it records a sense of injustice at the treatment and the lack of understanding that these people have endured. It is also a document that tries to make sense of what happens to them when they are not getting the support from those who are supposed to be helping them.

I have used some of the phrases deciphered from Agnes's jacket in my new dramatised song cycle called Hearing Voices, for mezzo soprano, recorded voices and orchestra. But the project started much closer to home with the story of my great aunt Phyllis, who was in an institution for 25 years. There have been three generations of mental illness in my family, which has greatly affected my own life. My sister died as a result of her illness and my mother also suffered a breakdown. When Phyllis died she left her trunk of belongings to my mum, and in that trunk we discovered a series of writings that Phyllis had produced in an attempt to make sense of what was happening to her.

Agnes Richter's jacket
Agnes Richter's jacket, made from hospital uniforms and embroidered with largely indecipherable words and phrases. Photograph: Prinzhorn Collection

The writing is sometimes wonderfully poetic and often whimsical. My mother had a huge sense of outrage about what had happened to Phyllis. She was a very capable woman, and my mum suspected that she was practically running the hospital by the end. But she was eccentric and self-deprecatory, and was always slightly ridiculed in a very conventional army family. Humorous and absent-minded, she dressed untidily, always in mauve, wearing hats like tea cosies to cover her unruly hair, and when she became ill in the 1930s she probably did need help as she was becoming increasingly isolated.

Her jottings about that time make up an extraordinary document. She recorded what the voices were saying, and if you know the details of her life, a lot of it makes a weird kind of sense. After a year or two she was getting better and should have been released, but the family kept her in the asylum and her poems from this period reveal the great sadness she felt about incarceration.

Phyllis was my mother's godmother and her favourite aunt. The bond between them was made stronger by my mother's own mental health problems. Her breakdown in the 1950s was regarded by her family as a terrible embarrassment and disgrace. My mother, Mary Pook, went on not only to preserve Phyllis's writings, but to write a novel of her own, In Two Minds, under the pseudonym Mary Cecil, about her illness and the medical response to it. Mary was subjected to the now-abandoned deep insulin shock therapy. She was injected with large doses of insulin, which induce a coma and the horrific sensation of nearly dying. It was a 30-day course and she would come out of one treatment and then spend the rest of the day dreading the next. I learned from Gail Hornstein's book that the dancer Nijinsky had more than 200 of these treatments, which ultimately ruined him.

Working on this piece I realised that the notion of "hearing voices" naturally lends itself to musical ideas and exploration. I have collaborated with the director Emma Bernard to create a text from the testimonies of Agnes, of my mother and great aunt, as well as the artists Bobby Baker and Julie McNamara, who have both suffered mental heath problems and used their experiences in their work. I also work with the mezzo soprano Melanie Pappenheim exploring unusual utterances and uses for the voice. Melanie works not only with the BBC Concert Orchestra to sing Phyllis and Agnes's words, but also with recorded fragments of Bobby, Julie and my mother.

The five women represent five different generations, but they are linked by more than just their mental health histories. They all have a strong creative presence in their lives. As a society we value the unusual insights into our world provided by creative people, but having a heightened sensitivity to the world around can be very difficult to live with.

I wanted this idea to be reflected in the music and performance, in a way that feels true to our experiences and observations. So the performance is not a load of crazy grimacing and shrieking, but deals with the more private moments of pain. Phyllis's piece is the most agitated section of the song cycle, as she becomes increasingly confused and overwhelmed by the voices she hears, but as the piece has been informed by things that have come up in the testimonies, there have been some unexpected elements. One piece is about seeing the funny side, and using humour as a kind of survival mechanism that Bobby Baker excels in even in the bleakest of moments. This particular piece is driven by recordings of the women's giggles and the laughter tunes that I've also notated.

This isn't a work specifically written to change people's minds or to better inform them of mental heath issues. It is a piece of music and performance. But I realise the fact that I have taken this as a subject matter is, in a sense, political, and if it prompts a wider awareness of mental illness, then so much the better.