After the difficult and traumatic birth of her first child, Laura Richmond finds herself outside a mother and baby unit in Winchester. She’s spent weeks wading through the dense fog of postpartum — but this isn’t her first time in hospital. In a blur of sleepless nights and baby grows, she’s forced to string together the paper chain of events that led her to this moment: countless psychiatric admissions and mental health assessments spanning more than a decade.
All My Worldly Joy, a memoir of an undiagnosed autistic woman, arrives from the brilliant mind of Laura Richmond. She describes scenes from her childhood: we meet a small child with a very particular dress preference, an imaginary wizard and a favourite grave in a churchyard that belongs to a fourteen-year-old girl from 1862. There’s real comfort and reassurance in Richmond’s ghostly apparitions. She captures those early, undefinable connections that are so rarely acknowledged in autistic people, as it’s generally implied that we have limited interest in other human beings. Yet those who we’ve never met are some of the most alive to us, whether it’s a musician or a TV character, a historical figure or a name on a stone in the ground. So many of us grow up feeling lonely, even in company, so perhaps we’re more inclined than most to stretch a hand back across time.
Following the loss of her beloved nan, Richmond retraces her adolescent years. After being removed from her boarding school for self-harming, she’s thrown into a young person’s unit that’s predominantly populated by eating disorder patients (if you’ve been an eating disorder patient yourself, you’ll know this is terrible news). By the end of her admission, Richmond is informed by her psychiatrist that she has an ‘emerging personality disorder’, which in his tone may as well be a design flaw. If a psychiatric label is nothing but a doomed prophecy, what use is it to anybody? This enforced diagnosis follows Richmond throughout her life. Years later, another professional tries to formally assess her for the disorder, having met Richmond only minutes earlier. We’re familiar with the phrase ‘poor historian’ when it comes to a patient, but what is the term for the health professional who will inevitably scan your past and come to the wrong conclusion?
There are vivid, all-too-familiar descriptions for anybody who has lived within the walls of a mental hospital: ‘the radio was a permanent feature, so whatever was in the charts became a soundtrack to that admission.’ Fill that gap with the smash hit of your breakdown month or year, and you’ve nailed the universal psychiatric experience.
This book could have been written in fury, and that would have been justified. Yet Richmond’s tone isn’t merely critical — it’s thoughtful, playful and searching. She credits the mother and baby unit for her survival. Hope appears in a heartening message scrawled by a nurse, an unexpected hug from a health worker, the battered copy of a memoir being slipped under a door. It’s the exceptions and tiny acts of humanity that reach us and holds us together, rather than the structure of the system itself. Richmond pays this kindness forward, and tends similarly to the reader throughout this book.
A personal tale detailing recurring crisis admissions could easily risk becoming a little monotonous. We should fall down a hole, but Richmond scoops us up, holds us gently and makes us laugh. She remains consistently funny, whether it’s humour in tragedy or in specific observations (such as describing mood stabilisers as ‘the emotional equivalent of a wobbly bicycle’). There’s an amusing reversal of a patient letter, in which Richmond describes her psychiatrist in detail, his ‘confused thinking and lack of insight’ after diagnosing her with bipolar, psychotic depression and schizoaffective disorder after just two appointments. It’s this sharp, precise wit that carries the book.
Somehow, as the title suggests, joy prevails. I’m not a parent myself, but the joy to be found in motherhood seems like joy in life itself — it arrives, much like everything else, against all expectations. Richmond’s words are a salve to any survivor of mental health services who might fear themselves to be a less than competent parent. A common anxiety is that birth will reopen the person we were before, the worst we have ever been, and it seems absurd for anyone to say, ‘no it won’t’. Instead, Richmond provides a third option: you might return there, but there’s still a way through.
But through to where? Richmond refuses to resolve her narrative as ‘safely recovered, positioned on the correct side of a neat before and after.’ Instead, the question is this: how do we evolve from a frozen figurine to gaining control of our story? It’s the ability to comprehend our experiences that pulls us from one trajectory and into another. We’re forced to become our own historians, become PhD students of our own minds, bodies and timelines. When nobody looks at us hard enough or long enough to understand, we must do the work ourselves. Despite professionals being determined to assign her any number of labels, it’s Laura herself who unearths the right one. Often, the reality is just that: we’re left to find the answers we need, because they simply aren’t coming from anywhere else. Yet autism is never offered as a tidy explanation or an oversimplification of Richmond’s struggles, and nor is it an afterthought. It weaves in as part of the intricate web of a life, and casts a light rather than explains.
All My Worldly Joy is a skilful and beautifully written memoir. It’s essential reading for mental health professionals, and offers hope for those still submerged in psychiatric systems. And to all those who have ever felt like a slumped rag doll in madness, Richmond will leave you sitting a little further upright.
All My Worldly Joy by Laura Richmond can be bought here (£18.99 hardback).
Elsa Williams is a writer and lived experience worker. You can find Elsa on Medium, Instagram and Bluesky.