Mental Health
Resources

 email page    print page

All Topic Reviews
50 Signs of Mental IllnessA Beautiful MindA Beautiful MindA Bright Red ScreamA Casebook of Ethical Challenges in NeuropsychologyA Corner Of The UniverseA Lethal InheritanceA Mood ApartA Research Agenda for DSM-VA Slant of SunA War of NervesAbnormal Psychology in ContextADD-Friendly Ways to Organize Your LifeAddiction Recovery ToolsAdvance Directives in Mental HealthAggression and Antisocial Behavior in Children and AdolescentsAl-JununAlmost a PsychopathAlterations of ConsciousnessAm I Okay?American ManiaAmerican Psychiatric Publishing Textbook of Neuropsychiatry and Clinical NeurosciencesAn American ObsessionAngelheadAnger, Madness, and the DaimonicAnthology of a Crazy LadyApproaching NeverlandAs Nature Made HimAsylumAttention-Deficit Hyperactivity DisorderAttention-Deficit/Hyperactivity DisorderBeing Mentally Ill: A Sociological Theory Betrayal TraumaBetrayed as BoysBetter Than ProzacBetter Than WellBeyond AppearanceBeyond ReasonBinge No MoreBiological UnhappinessBipolar DisorderBipolar DisorderBipolar Disorder DemystifiedBlack-eyed SuzieBlaming the BrainBleeding to Ease the PainBluebirdBlueprints Clinical Cases in PsychiatryBody Image, Eating Disorders, and ObesityBorderline Personality DisorderBrain Circuitry and Signaling in PsychiatryBrave New BrainBreakdown of WillBrief Adolescent Therapy Homework PlannerBrief Child Therapy Homework PlannerBrief Therapy Homework PlannerCalm EnergyCassandra's DaughterCaught in the NetChild and Adolescent Treatment for Social Work PracticeChildren Changed by TraumaChronic Fatigue Syndrome (The Facts)Clinical Handbook of Psychological DisordersClinical Manual of Women's Mental HealthCognitive Theories of Mental IllnessCommonsense RebellionCommunity and In-Home Behavioral Health TreatmentComprehending SuicideConcise Guide to Child and Adolescent PsychiatryConquering Post-Traumatic Stress DisorderConscience and ConvenienceConsciousnessConsole and ClassifyContesting PsychiatryCoping With TraumaCopshockCrazy for YouCrazy in AmericaCrazy Like UsCreating HysteriaCritical PsychiatryCruel CompassionCultural Assessment in Clinical PsychiatryCulture and Mental HealthCulture and Psychiatric DiagnosisCultures of NeurastheniaDaddy's GirlsDante's CureDarwinian PsychiatryDaughter of the Queen of ShebaDaughters of MadnessDeinstitutionalization And People With Intellectual DisabilitiesDelivered from DistractionDepression In Later LifeDepression SourcebookDepression-Free for LifeDescriptions and PrescriptionsDestructive Trends in Mental HealthDevil in the DetailsDiagnosis: SchizophreniaDiagnostic and Statistical Manual of Mental Disorders DSM-IV-TRDirty Filthy Love DVDDisorders Of DesireDisrupted LivesDissociative ChildrenDivided MindsDr. Andrew Weil's Guide to Optimum HealthDr. Weisinger's Anger Work-Out BookDSM-IV SourcebookDSM-IV-TR CasebookDSM-IV-TR in ActionDSM-IV-TR Mental DisordersE-TherapyEccentricsElectroshockEmergencies in Mental Health PracticeEmergency PsychiatryEmotional and Behavioral Problems of Young ChildrenEmotions and LifeEmpowering People with Severe Mental IllnessEssential PsychopharmacologyEssentials of Cas AssessmentEssentials of Wais-III AssessmentEthics and Values in PsychotherapyEthics in Mental Health ResearchEthics in Psychiatric ResearchEthics, Culture, and PsychiatryEverything In Its PlaceFamily Experiences With Mental IllnessFatigue as a Window to the BrainFear of IntimacyFinding Iris ChangFinding Meaning in the Experience of DementiaFlorid StatesFolie a DeuxFor the Love of ItForensic Nursing and Multidisciplinary Care of the Mentally Disordered OffenderFountain HouseFrom Madness to Mental HealthFrom Trauma to TransformationGandhi's WayGender and Its Effects on PsychopathologyGender and Mental HealthGenes, Environment, and PsychopathologyGetting Your Life BackGracefully InsaneGrieving Mental IllnessHandbook of AttachmentHandbook of DepressionHandbook of Self and IdentityHealing the SplitHerbs for the MindHidden SelvesHigh RiskHope and DespairHow Clients Make Therapy WorkHow People ChangeHow to Become a SchizophrenicHow We Think About DementiaHughes' Outline of Modern PsychiatryHumanizing MadnessHysterical MenHystoriesI Hate You-Don't Leave MeI Never Promised You a Rose GardenI Thought I Could FlyI'm CrazyImagining RobertImpulse Control DisordersIn Others' EyesIn Two MindsInsanityIntegrated Behavioral Health CareIntegrative MedicineIntegrative Mental Health CareIntuitionJust CheckingKarl JaspersKissing DoorknobsKundalini Yoga Meditation for Complex Psychiatric DisordersLaw and the BrainLaw, Liberty, and PsychiatryLegal and Ethical Aspects of HealthcareLiberatory PsychiatryLife at the BottomLife at the Texas State Lunatic Asylum, 1857-1997Life Is Not a Game of PerfectLithium for MedeaLiving Outside Mental IllnessLiving with AnxietyLiving With SchizophreniaLiving with SchizophreniaLiving Without Depression and Manic DepressionLost in the MirrorLove's ExecutionerLoving Someone With Bipolar DisorderMad in AmericaMad TravelersMad, Bad and SadMadhouseMadnessMadness at HomeMadness in Buenos AiresManaged Care ContractingMandated Reporting of Suspected Child AbuseManic Depression and CreativityMary BarnesMasters of the MindMeasuring PsychopathologyMedia MadnessMedicine As MinistryMelancholy And the Care of the SoulMemory, Brain, and BeliefMental HealthMental Health At The CrossroadsMental Health Issues in Lesbian, Gay, Bisexual, and Transgender Communities Mental Health MattersMental Health Policy in BritainMental Health Policy in BritainMental Health Professionals, Minorities and the PoorMental IllnessMental Illness and Your TownMental Illness, Medicine and LawMental SlaveryMindfulness in Plain EnglishModels of MadnessMothers Who Kill Their ChildrenMozart's Brain and the Fighter PilotMultifamily Groups in the Treatment of Severe Psychiatric DisordersMuses, Madmen, and ProphetsMyths of ChildhoodNapkin NotesNeural MisfireNew Hope For People With Bipolar DisorderNight Falls FastNo Enemies WithinNolaNormalNot CrazyNovember of the SoulOf Two MindsOn Being Normal and Other DisordersOn Our Own, TogetherOn The Stigma Of Mental IllnessOrigins of Human NatureOut of Its MindOut of the ShadowsOvercoming Compulsive HoardingPathologies of BeliefPathways through PainPersonal Recovery and Mental IllnessPersonality Disorder: Temperament or Trauma?Pillar of SaltPoints of ViewPoppy ShakespearePosttraumatic Stress DisorderPsychiatric Cultures ComparedPsychiatric Diagnosis and ClassificationPsychiatric Genetics and GenomicsPsychiatric Illness in WomenPsychiatrists and Traditional HealersPsychiatryPsychiatry and ReligionPsychiatry in SocietyPsychological Dimensions of the SelfPsychology and the MediaPsychopathia SexualisPsychopathologyPsychopathyPsychotic DepressionQuitting the Nairobi TrioRaising a Moody ChildRapid Cognitive TherapyRebuilding Shattered LivesReclaiming Soul in Health CareReclaiming the SoulRecollection, Testimony, and Lying in Early ChildhoodRecovery from SchizophreniaRecovery in Mental IllnessRedressing the EmperorRelational Mental HealthRemembering TraumaRepressed SpacesResearch Advances in Genetics and GenomicsRestricted AccessRethinking the DSMReviving OpheliaRewarding Specialties for Mental Health CliniciansSaints, Scholars, and Schizophrenics: Mental Illness in Rural IrelandSchizophreniaSchizophrenia RevealedSchizophrenia: A Scientific Delusion?Self-Determination Theory in the ClinicShunnedShynessSigns of SafetySilencing the VoicesSlackjawSocial Cognition and SchizophreniaSocial Inclusion of People with Mental IllnessSoul Murder RevisitedSounds from the Bell JarSpeaking Our MindsSpontaneous HealingStop PretendingStraight Talk about Psychological Testing for KidsStranger Than FictionStreet CrazyStudy Guide to the DSM-IV-TRSurviving Manic DepressionSurviving SchizophreniaSurviving SchizophreniaTaking Charge of ADHD, Revised EditionTaking the Fear Out of ChangingTalking Back to PsychiatryTarnationTeen LoveTelling Is Risky BusinessTelling SecretsThe Age of InsanityThe American Psychiatric Press Textbook of PsychiatryThe American Psychiatric Publishing Textbook Of Child And Adolescent PsychiatryThe Anger WorkbookThe Anorexic SelfThe Behavioral Medicine Treatment PlannerThe Betty Ford Center Book of AnswersThe Bipolar ChildThe Bipolar Disorder Survival GuideThe Body in PsychotherapyThe Borderline Personality Disorder Survival GuideThe Broken MirrorThe Burden of SympathyThe Cambridge Medical Ethics WorkbookThe Case for Pragmatic PsychologyThe Center Cannot HoldThe Chemical Dependence Treatment Documentation SourcebookThe Chemical Dependence Treatment PlannerThe Child and Adolescent Psychotherapy Treatment PlannerThe Clinical Child Documentation SourcebookThe Clinical Documentation SourcebookThe Complete Adult Psychotherapy Treatment PlannerThe Condition of MadnessThe Construction of Power and Authority in PsychiatryThe Couples Psychotherapy Treatment PlannerThe Criminal BrainThe Cultural Context of Health, Illness, and MedicineThe Day the Voices StoppedThe Death of PsychotherapyThe Depression WorkbookThe Difficult-to-Treat Psychiatric PatientThe Early Stages of SchizophreniaThe Employee Assistance Treatment PlannerThe Employee Assistance Treatment PlannerThe Epidemiology of SchizophreniaThe Essential Family Guide to Borderline Personality DisorderThe Essentials of New York Mental Health LawThe Ethical WayThe Evolution of Mental Health LawThe Explosive ChildThe Fall Of An IconThe Fasting GirlThe Forensic Documentation SourcebookThe Forgotten MournersThe Gift of Adult ADDThe Good EaterThe Green ParrotThe Healing Power of PetsThe Heart of AddictionThe Heroic ClientThe Insanity OffenseThe Invisible PlagueThe Last Time I Wore a DressThe Limits of Autobiography The LobotomistThe Madness of Our LivesThe Mark of ShameThe Meaning of AddictionThe Meaning of MindThe Medical AdvisorThe Mind/Mood Pill BookThe Most Solitary of AfflictionsThe Mozart EffectThe Naked Lady Who Stood on Her HeadThe Older Adult Psychotherapy Treatment PlannerThe OutsiderThe Pastoral Counseling Treatment PlannerThe PDR Family Guide to Natural Medicines & Healing TherapiesThe Places That Scare YouThe Plural SelfThe Problem of EvilThe Psychology of Religion and CopingThe Quiet RoomThe Real World Guide to Psychotherapy PracticeThe Right to Refuse Mental Health TreatmentThe Rise of Mental Health NursingThe Roots of the Recovery Movement in PsychiatryThe Savage GirlThe Self-Help SourcebookThe Talking CureThe Trick Is to Keep BreathingThe Unwell BrainThe Virtuous PsychiatristThe Way of TransitionThe Wing of MadnessThe Wisdom in FeelingTheoretical Evolutions in Person-Centered/Experiential TherapyTherapy's DelusionsTheraScribe 3.0 for WindowsThis is Madness TooThoughts Without a ThinkerThrough the Looking GlassTo Have Or To Be?Toxic PsychiatryTransforming MadnessTraumaTraumatic PastsTraumatic Relationships and Serious Mental DisordersTreating Affect PhobiaTreating Chronic and Severe Mental DisordersTreating Self-InjuryTreatment and Rehabilitation of Severe Mental IllnessTreatment Plans and Interventions for Depression and Anxiety DisordersTwinsUnderstanding and Treating Violent Psychiatric PatientsUnderstanding Child MolestersUnderstanding DepressionUnderstanding ParanoiaUnderstanding the Stigma of Mental IllnessUnderstanding Treatment Without ConsentUnholy MadnessUnspeakable Truths and Happy EndingsUsers and Abusers of PsychiatryViolence and Mental DisorderVoices of MadnessVoices of RecoveryVulnerability to PsychopathologyWarning: Psychiatry Can Be Hazardous to Your Mental HealthWashing My Life AwayWhen History Is a NightmareWhen Someone You Love Is BipolarWhen the Body SpeaksWhen Walls Become DoorwaysWitchcrazeWomen and Borderline Personality DisorderWomen and Mental IllnessWomen Who Hurt ThemselvesWomen's Mental HealthWrestling with the AngelYou Must Be DreamingYour Drug May Be Your ProblemYour Miracle Brain

Related Topics
Diagnosis: SchizophreniaReview - Diagnosis: Schizophrenia
A Comprehensive Resource
by Rachel Miller and Susan Elizabeth Mason (Editors)
Columbia University Press, 2002
Review by Roy Sugarman, Ph.D.
Sep 25th 2003 (Volume 7, Issue 39)

From the start the authors acknowledge that this is really a book they have compiled, or rather edited, mostly from the writings of their patients at the Hillside facility in the USA.

For most of us who work in such surrounds, the stories are either comfortingly or tragically familiar. As they write of their first experiences or hospitalisations with this condition, those with psychosis present and past document the sudden realisation that their lives have changed for ever. Although some write with clarity, and the compilers appear to largely have left their syntax alone, most have the dullness and sad weight-bearing properties of the mentally challenged.

The challenge of the condition plays itself out in the usual ways: the initial strain of their lives, then the symptoms and strangeness, at first tolerated, then denied, then capitulated to, then the trap of hospital, the medication and the side effects, the interaction with society taking hold of their freedom, and the overall burden of psychosocial loss.

With most, it seems the losses drag them down for periods of up to five years, until they come to some stability. They get fat on olanzepine, drool on clozapine, tremble on risperidone, get stiff and impotent on typicals, and can't make up their minds on quetiapine. They get depressed, they deny, they resist, they capitulate.

They struggle in most human ways with telling or not telling partners in sex and society, business and family. They feel the guilt of any action that may have led to their being one of the chosen, and struggle with the fact they were. One writes "why me" and then "why not me" when told she has been touched forever by this condition.

For anyone far down the line as a treater, or carer, or patient, this is a nothing-new book. For those family or patients who are only just coming to realise that something is wrong and will be forever, this book is full of the new and the sad, bad and mad side to schizophrenia.

Some of it is only vaguely contentious, such as the mooted fact that schizophrenia is a "chemical imbalance" or that the drugs "regulate neurotransmitters" or other platitudes that violate the idea of brain systems in interaction, or the unidirectional antagonists, or of the Goldilocks drugs, or of the rich interactions between genotype and phenotype. The experts lurk in the background, but don't really put themselves on the line: this is a book by the people and for the people. It treads softly politically.

It still follows the party line, you have an illness, we have pills, we cannot cure it, you go to hospital, you will be sick forever: all true enough. But some stories, such as Zelda's, are told in more detail, and plague the mind. Some of these stories are made more effective by the banality of tone:

Eating and drinking caused ... trips to the public, dormlike bathroom ... torturous for me. The first time I went into one, a lady, maybe in her mid-thirties, looked at me and let out a low-volume Hi ... Her hair was up in a sloppy, curly ponytail; her face was lacking in makeup and happiness. I vocalised nothing in return, but my face said to her, "Please just ignore me. I'm only here because I couldn't hold it in anymore. My first choice would be to pee all over the floor in my room, but then I would have to associate with that man with the mop." Maybe she didn't hear all that with my expression. Probably she just quickly go the notion that I was as hopeless as she looked.

As a book, it avoids, like the plague, the news of the fomenting militancy surfacing amongst patients, some of whom turn on their medical carers with violence: patients who default on medication are understood, but misguided. DSM-IV is deity, and its subdivisions are fact: everyone goes to Level III in hospital. Rehab and recovery models are not offered up as viable alternatives to hospital, and stigma is accepted, not challenged, one merely has to lie and deny. This book is after all a breathy attempt to present this damning illness from the damaged goods consumers themselves in an attempt to humanise the patients and mitigate the stigma; the Who am I now? Chapter is uninspiring.

The concern is that this book will only be read by the converted, or the families who are informed a little now, but not yet there. The vast Joe Q Public average person in the bookstore will simply not buy it at all. Schizophrenia happens to someone else, means split personality, is not our problem. Overall the book is depressing. The drab, passive ordinariness of the patients themselves would scare the hell out of the lay reader, who would perhaps not discriminate so much, but certainly would be terrified. There is here only the offer of hospital care: there is no reflection from the patients that assertive community care is being applied to their cases as they leave acute services. Rehab appears to be hospital based, expensive, the stories collated by professionals.

Recently, a colleague of mine became psychotic and very disorderly in a large city. He was taken by his mother by the GP, who sent him immediately to the psychiatrist. He spent an hour with him, sending him home with 400mg of quetiapine on board, increasing every day. Two hours after they got home, a community team consisting of a nurse, medical student and social worker arrived. They came once a day for a week, helping him and the family sort out the medication. After two weeks he felt better, and was less sedated. The family began to attend evening sessions at a local information group to find out about this illness. He is well, and despite some minor relapses in the year that followed, has yet to set foot in a hospital. Or write about seclusion, hierarchical wards and rule-driven systems. Not confined to a hospital despite being at risk, he never lost who he was, never used the dormlike bathroom, he went home to bid, like most sick people.

In most other cities, including my own, he would be writing his story from a hospital ward, spending months there, with people being rude to him, learning to adapt to the society of the damned.

His story is different.

So the book sets out to tell the story from the horse's mouth in a traditional psychiatric setting, and does so, in comic book style and with comic book charm. Charming line drawings of each writer head their paragraphs, and each character ekes through, rather like a caricature of someone we have known or locked up in our time, or jumped on five at a time, or stuck with needles loaded with oily parkinsonian agents.

Its hard to imagine the market for this book. Perhaps each new patient entering a ward with the threat of diagnosis, each family in tow, needs to be issued with such a book. 1% of the American market will need to see this, about 2 million people, a huge market, all needing to know what others like them have gone through.

Although subtitled a 'comprehensive resource' work, there is not much. It is more like a survivors journal, allowing only a tiny bit of the phenomenology of being nuts to come through. Many of my own patients have done a better job, are more colourful, and give their carers a much richer tableau of what the experience was like in retrospect. It seems the patients of Hillside give a more sanitised, mellowed or toned-down view. They have had to discard their rich experiences so they could leave the locked ward, seem tentative in trotting out their feelings and experiences when doom struck. In this way, their stories are drearily tragic, and fail to inspire. Contributions from the experts are given from the doorway, not upfront, sure done deliberately so as not to intrude, but lacking the richness of tapestry that Art Brut can provide, and denying the sick creativity produced by the illness. Oliver Sacks of course has done this so well in behavioural neurology, so much so that it is a pity to see such a chance in psychiatry slip through the fingers of the authors/compilers of this minor paperback.

So for those hospital wards who need to give out a cheap and comprehensive brochure on schizophrenia, for those families and patients who are embarking on a journey they did not choose, and would love to abandon, this is the work, easily read and absorbed, of those who have drifted through, and are trying to find meaning, positively, negatively, and cognitively. For this purpose, it is just fine, and takes a mild look at horror, decline, and despair, all with the spin of the patient advisor.

I don't think that students in the mental health professions would find this book that interesting, unless their training never fleshed out this arena at all, or they had no contact with such sufferers. It does inform though, banal and trite. The internet has become a powerful resource for most, but for those who do not have such luxuries, perhaps the drug companies could buy a few thousand of these and distribute them to the families who need to be comforted, but not aroused. Helpful, in the end, it is, but only for those in the USA.

What is missing is the concept of recovery: not from the illness, but from the loss of social position, of social capital. The book sets out to inform, and it does, but not in any revolutionary way. The experiences of those in this diary are left spun and sanitised, but without champion. Until affirmative action is used to address the seriously skewed playing ground, the stories of the damned are sad and tragic: those with serious mental disorders are facing society in an unequal relationships with their culture, and they are therein disadvantaged.

 

 

2003 Roy Sugarman

 

Roy Sugarman PhD, Clinical Lecturer in Psychiatry, Adelaide University, Senior Cinical Neuropsychologist, Royal Adelaide Hospital Glenside Campus Extended Care


Share

Welcome to MHN's unique book review site Metapsychology. We feature over 7900 in-depth reviews of a wide range of books and DVDs written by our reviewers from many backgrounds and perspectives. We update our front page weekly and add more than thirty new reviews each month. Our editor is Christian Perring, PhD. To contact him, use one of the forms available here.

Can't remember our URL? Access our reviews directly via 'metapsychology.net'


Metapsychology Online reviewers normally receive gratis review copies of the items they review.
Metapsychology Online receives a commission from Amazon.com for purchases through this site, which helps us send review copies to reviewers. Please support us by making your Amazon.com purchases through our Amazon links. We thank you for your support!


Join our e-mail list!: Metapsychology New Review Announcements: Sent out monthly, these announcements list our recent reviews. To subscribe, click here.

Interested in becoming a book reviewer for Metapsychology? Currently, we especially need thoughtful reviewers for books in fiction, self-help and popular psychology. To apply, write to our editor.

Metapsychology Online Reviews

Promote your Page too

Metapsychology Online Reviews
ISSN 1931-5716