Book Review: Breakthrough by Dr Ahmed Hankir
Breakthrough: A Story of Hope, Resilience, and Mental Health Recovery begins with a quote from Dylan Thomas. This quote has special meaning for Dr Hankir, and it describes the core theme of the book well. Dr Hankir encourages readers to persist and prevail, rather than accept defeat in the face of life’s challenges.
The first chapter recounts Dr Hankir’s family history, beginning with his grandfather, a retailer, moving to his father, a physician, and then to himself, a psychiatrist. Intergenerational trauma and political conflict are core aspects of these opening pages, with the Israel-Lebanon War and the Irish Troubles serving as developmental backdrops.
The second chapter focuses on issues of identity and belonging. Dr Hankir reports a sense of diaspora, as well as an ambiguous self-concept that was especially pronounced when unable to speak Arabic while living in Lebanon. This chapter also provides an interesting sociopolitical context. We also learn about Dr Hankir’s ties to prominent political figures and his tendency to excel academically.
The third chapter explores Dr Hankir’s preparations to enter medical school, which involved sitting A-Levels. He recounts how his head of sixth form lacked faith in his abilities, and how she was ultimately proven wrong when he achieved full marks on his mathematics exam and, indeed, straight As across the board. Something that emerges at this point in the book is that, whether things are going well or not, Dr Hankir’s mind instinctively turns to the positive experiences in his life. When he is fatigued from working long hours in retail, soaked from the rain and having missed his bus, he recalls receiving a standing ovation for his academic achievements back in Lebanon. This capacity to seek strength in the positives appears to be closely linked to the theme of resilience mentioned in the title.
Chapter four recounts the darker parts of Dr Hankir’s journey, namely his descent into a depressive illness alongside the pressures of medical education and the abuses he experienced at the hands of his seniors and the course administrators. Dr Hankir emphasises the lack of support offered to him at the point of his struggles, and how this lack of support ulimately compounded his difficulties. The chapter ends with a reflection about how he has not fully recovered from these events, and how difficult memories from this time in his life continue to resurface even now.
Chapter five focuses on Dr Hankir’s steps toward recovery, which coincided with his finishing of medical school. This chapter also neatly outlines the different attitudes held on the issues of medication and other forms of treatment, the biopsychosocial model, antipsychiatry and critical psychiatry stances (especially on Twitter/X), and the origins and status of the chemical imbalance theory. Dr Hankir also makes the much needed distinction between the chemical imbalance hypothesis and the action of SSRIs, a distinction that is often blurred in online forums.
The sixth chapter recounts further difficulties on the issues of representation and prejudice. In particular, Dr Hankir describes a difficult, unprofessional interview that shattered his confidence despite an exemplary academic record. He reports feeling humiliated by this encounter.
Chapter seven focuses on the origins and success of Dr Hankir’s The Wounded Healer initiative, a theatric approach to challenging mental health stigma. We also learn about Dr Hankir’s meeting with senior members of the WHO, which would lead the receipt of two further awards. Dr Hankir recalls, fondly, his encounters with celebrities at one such event. Another theme that runs through the book is the importance of external validation. Dr Hankir routinely directs readers to awards, celebrity encounters, and the praises he’s received. It is clear that these events and accolades mean a great deal to him and motivate him to continue his advocacy work.
Chapter eight looks at the positive role that the Islamic faith has played in Dr Hankir’s recovery. This chapter also focuses on Islamophobia, hate crimes, and prejudice in healthcare. This is a particularly enlightening chapter for people unfamiliar with Islam.
Chapter nine focuses on social media, particular Dr Hankir’s journey with Twitter/X. He provides some very important advice about maintaining boundaries online and the need for greater oversight and accountability when it comes to online abuse.
Chapter ten recounts Dr Hankir’s experiences of workplace bullying. He explains how he was asked to evidence extenuating circumstances in an excessive and pedantic way, and how he was excluded from public recognition of his award wins. This chapter also recounts many positive experiences, however, such as succcessful talks garnering standing ovations - a core motif throughout the book.
Chapter eleven focuses on the impact of the Covid pandemic and the tragic loss of two patients in particular. Dr Hankir explores, with deep sensitivity, the impact that these deaths had on the patients’ relatives and their surrounding clinical teams. The impact of the pandemic on NHS services is well articulated here, and the extent of the effect on staff morale and mortality is also well expressed.
The final chapter is a well-rounded summary of the preceding chapters and the book’s core themes. Dr Hankir ends with a powerful message of hope and recovery, whilst conceding that not enough is done for those with severe and enduring mental illness. This is a delicately handled chapter that draws appropriate attention to where work is yet to be done while also celebrating the things that we can be grateful for now.
I read Dr Hankir’s book in only a couple of hours. It’s an excellent read. Well and sensitively written, it champions important messages about hope, resilience, and recovery. The core motif of standing ovations is an apt one, as this book is truly worthy of such acclaim. If you haven’t read Breakthrough: A Story of Hope, Resilience, and Mental Health Recovery, I encourage you to seek out a copy.