Q&A with Rebecca Schiller, author of Earthed: A Memoir

Rebecca Schiller is a writer, occasional doula, and co-founder of human rights in childbirth charity Birthrights. She is the author of Why Human Rights in Childbirth Matter and Your No Guilt Pregnancy Plan, and has previously written for Hysterical Women about the minimising, infantilising and dismissive language of childbirth.

Her new book, published tomorrow (6 May) is a little different. Written during lockdown, Earthed is a moving and powerful memoir detailing her family’s move to a smallholding, her experience of having a breakdown, and her subsequent diagnosis with ADHD – interwoven with tales of and inspired by her land’s history, and the women who tended it before her. It also has one of the most stunning covers I’ve ever seen.

I spoke to Rebecca about her experiences, and what she’s learned about women, mental health and ADHD.

SG: How do you feel the care you received during your breakdown was coloured by your gender?

RS: I think it influenced a lot of things, and it wasn’t until I worked out what had been going on with me that I could see that one of the issues had been a real imperative, coming from loads of different directions, for me to be a functioning, well behaved, organised, capable person. I think that in and of itself, is gendered. Everyone is under pressure to fit in to society and be a useful, conforming part of the machine, but the way in which women are supposed to conform, and the space they have in which to flex is a lot smaller.

When I did the computerised test for ADHD, I was really shocked that I scored so highly on hyperactivity. I would never have said that I was hyperactive. But what I didn’t realise is that every single moment in my existence, when I am with other people, I’m moderating my behaviour and I’ve been doing that since I was tiny. When women are hyperactive the movements they make are very small and very socially acceptable, quite feminised – it’s a hair twiddle, a skirt rustle. So I have learned to be very good at hiding it.

There was certainly no attempt to look beyond that when I was coming in saying I wasn’t feeling great. When I spoke to the less nice psychiatric nurse, who said “I Googled your recent work and it seems as though you’re coping”, they were really taking me at face value – if you’re behaving like this, it must mean you’re fine. The only person who wasn’t like that was my GP, and I feel massively grateful to him. One of the things he said to me was, “what do you want to happen next?” It’s a brilliant marker of good care when somebody treats you as an autonomous adult, who has agency in the situation, and is the most important member of the decision-making team.

But I think gender is at work on almost every single level within and without myself. When you look at the information about ADHD in high functioning women, it’s very obvious that women and girls have not historically been diagnosed at the right rates, and they struggles to get access to treatment with quite serious consequences.

There seems to have been a bit of a revolution in recent years of women joining the dots and being diagnosed with ADHD – where do you think the impetus for that has come from?

I’m sure it’s an interaction of factors. The NICE guidance, for example, changed around this, and there has been a push from with inside medical system and the psychiatric profession to recognise that women and girls are just as likely to be affected but they present in different ways. So I think that has something to do with it.

I’m also really interested in the relationship between ADHD and creativity, and I think people with ADHD are much more likely to be entrepreneurs or freelancers because they need to govern their own lives in that way. I bet there’s a really significant proportion of freelance journalists and writers, and people with social media platforms, who not only have ADHD but are also high functioning enough to be able to communicate about it.

I actually got into a debate on Twitter recently with someone who was saying “oh, everybody’s got ADHD these days”, which I found quite upsetting and triggering. There’s a sense that ADHD is a made up thing about naughty kids, and I struggle with that internally. But of course, the more people start talking about it and writing articles about it, the more opportunity there is for other people to access that information. My book isn’t even out yet and I’ve had a number of women contact me to say, “this is me, and I’m now going to seek support and look at whether I can be diagnosed”. That’s the way that I came across it, hearing how it felt, rather than seeing it – I read an article about women like me.

It’s interesting you mention this attitude about more women being diagnosed, as if it’s a fad or a ‘trendy’ diagnosis, which is something I’ve heard said about endometriosis too 

I’m sure there’s a parallel with endometriosis, because they’re both invisible, so whose word do you have to take? A real thread through all of this is that, as a woman, even if you pluck up the courage to say, “you know what, I’m not feeling great”, you’re not believed. And even if you are believed, you’re not helped.

The gender element comes in there too. If you’re being a naughty boy in the classroom, you are impacting the other people around you and your teacher, you might be showing antisocial behaviour or risk-taking behaviour. If you’re not doing that, the only person that you’re sabotaging with your behaviour is yourself, and that doesn’t affect anyone else.

Like you’re only entitled to treatment when you become an inconvenience to somebody else?

Exactly. Maybe in future I should say I’ve really gone off sex and it’s affecting my husband or something!

Are there parallels too in your experience within the birthing world?

You could probably draw a parallel at every point. The ‘should’ is a big one: What are you ‘allowed’ to do? How ‘should’ you behave? What is the right thing to do? Which box am I supposed to fit into? There’s a lot of that in pregnancy, birth and reproductive health care in general – how are you supposed to function as a ‘good reproducer’? There’s definitely a way you’re supposed to behave, but it’s designed by a patriarchal system to mean that you’re always falling short.

I think access to care and treatment is another issue – like hospital trusts having blanket policies on caesareans, which Birthrights has campaigned hard to change. The same thing exists around ADHD treatment, where quite a few CCGs won’t fund your medication if you were privately diagnosed, so you have to go on the waiting list for two years to be re-diagnosed on the NHS.

I think also the presumption that it’s a sort of lifestyle thing, which happens a lot around birth – you know, the stereotypes about the water birth with candles and whale music. It’s deliberately very reductive, that this is about your ‘preferences’. The same thing happens around ADHD, where people say, “Oh, you can’t concentrate very well? Neither can a lot of people.”

People are shocked when I say that people with ADHD are much more likely to die from accidental causes, because we’re distracted – not to mention the increased rates of self-harm and suicide. So actually it’s about your quality of life and how long you live for, but you get a lot of reductiveness and dismissal and, as a woman, you’re generally made to feel unimportant, as if you have no expertise about yourself.

Mental health, just like with birth, is such a fundamental thing about your existence. With both there’s a trauma in not being listened to that goes beyond just, “I need this treatment and I’m not getting it”. For me it felt like I was being repeatedly rubbed out, again and again and again. I think that’s something that women and birthing people feel when they’re engaging with perinatal services as well, and it’s just not okay.

What difference has getting a diagnosis made?

It’s very much an ongoing process. It’s made a huge difference just having the information to understand why I feel this way, and being able to process it. I’m working with a great clinical psychologist who’s an expert in high functioning women with ADHD, and the medication has helped as well.

There’s been an upsetting process of looking back at my life and reconfiguring myself. I missed 35% of the clicks in the ADHD test, which makes me wonder, ‘am I missing 35% of things in my life?’ But it’s also allowed me to think about some of the positive stuff. There’s quite a lot of tension around talking about neurodiversity as a ‘superpower’, because it it can be incredibly disruptive and difficult, but a lot of the things I’m good at and like about my self have an interaction with the ADHD part.

You can find Rebecca on Twitter @schillerrrrr and Instagram @rebecca.schiller

Buy Earthed from Bookshop.org:

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