Martin also greeted Olivia and Lucy with great warmth, but immediately plunged back into the flow of the conversation he had been having with his wife. He was well known for being one of the rare psychoanalysts who was prepared to take on schizophrenic patients. They were referred to him, without the usual preliminary consultation he would have had with a private patient, at the mental health clinic where he worked once a week for free. He had been sent a new patient the day before and was complaining, as he often did, about the limitations of psychiatric approaches, which treated the disordered language of schizophrenics as a symptom that needed to be suppressed rather than a communication that needed to be understood.

‘The intelligent patient I saw yesterday had bought the Oxford University Press Very Short Introduction to schizophrenia, written not by one but by two professors, because he was trying to research his illness. And this is what he got for his pains,’ said Martin, opening a little green book at a page he had marked with a torn piece of kitchen towel. Olivia smiled at Lizzie in recognition of Martin in full flood.

‘This,’ he said, ‘was an IQ test for naming as many animals as possible in three minutes:

The errors of patients with poverty of speech and action tended to be of omission. These patients often failed to respond in the time permitted. For example, on a verbal fluency test one patient could name only three animals in three minutes. He commented, ‘The only one I can think of is cheetah.’ In contrast, the errors associated with the disorganization syndrome tend to be of commission, that is patients fail to inhibit inappropriate responses. For example, another patient performing the same verbal fluency task produced the sequence, ‘emu, duck, swan, lake, Loch Ness monster, bacon …’ In this example, the word ‘lake’ is closely associated with the word ‘swan’, but should not have been given since it is not an example of an animal. The word ‘bacon’ is also inappropriate, and why the patient produced it is difficult to understand, but this inexplicable conjunction of words is typical of the incoherent speech sometimes associated with schizophrenia.