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The Madness of our Lives contains eleven brief accounts of experiences of mental distress or illness and recovery, as related to journalist Penny Gray. Each account comes with a brief introduction from Gray, and from that point each individual speaks for themselves, with minimal rewriting or editing. The stories are directly related first person accounts, told in the personal voice, and in a conversational style. Individuals go off on tangents (although not enough to make the content irrelevant), use colloquialisms, and at times talk directly to Gray as interviewer. The Madness of our Lives is informative, and at times entertaining, often poignant, and with the inevitable sense of grief that attends lives interrupted by trauma, illness and disrupted relationships.
The book is divided into four sections; Dealing with life stresses; Women survivors of childhood abuse; Young men in crisis; and a section of commentary from mental health workers. This range of perspectives results in a mix of stories, a range of age groups, and a range of views about mental distress and illness, and those who seek to provide care and treatment. The book is as much about the responses of others: family, parents, lovers, friends, professionals and voluntary workers as it is about the individuals affected. Gray's method of recording the stories without interpretation means that the character of each individual is fully apparent, as is their unique perspectives on their experiences. Although Gray pulls together some key points in a final chapter on "Conclusions and practical advice" the points summarized in this chapter are already clear from the individual accounts.
A sample from each section of the book will provide a sense of its scope. Jane has been a 'psychiatric patient' for more than 22 years, with the range of diagnoses that is common for those so categorized. Jane was initially treated for an eating disorder, then later for psychosis. Her life is a tumultuous pattern of hospitalizations, fluctuating weight, addiction to prescribed benzodiazepines, and failed attempts to engage in helping relationships. In amongst this are periods of relative stability, usually when Jane has found a way to maintain some balance in her life and stay away from health professionals. Another narrator, Diane, tells a story of childhood physical and sexual abuse, self-initiated attempts to rebuild a life after migrating, followed by successive breakdowns. She naively embarks on adult relationships while still traumatized from her early experiences. In her encounters with the mental health system she has counseling, drugs, ECT, and group therapy. The story ends with Diane in employment, although after a struggle with stigma and workplace harassment. Lesley is one of the entertaining characters of the book. Never one to take a step backwards, she challenges and confronts people in authority, especially if she finds them insincere. Lesley comes from a traumatic family background, in which her father was physically abusive. The behavioral manifestations of her distress attracted psychiatric labels and drugs, but very little support. Her life is spent in and out of hospitals, marked by constant conflict. It is Lesley who provides the book's insight into the relationship between repetitive self harm and suicidality. Angry with herself, and after many episodes of cutting, she is appalled by the health professionals who, when stitching her up, offer advice about "how to do it properly". With typical forthrightness, Lesley states: "It's nothing to do with killing myself. I've never had a gripe with life or living. I had a gripe with being me, which I found intolerable. I hated being me." (p. 115).
A more dryly comic character is Stephen, a self treated psychiatrist with bipolar disorder. Stephen works from a biological model in respect of his own experience, although doesn't feel the need to apply that model to others. His account is fast paced and often humorous, although there is no mistaking the problems posed by his ever present mood disorder. Like others in this book, Stephen encounters the hostility and duplicity reserved for those with stigmatized identities, in Stephen's case exemplified by covert testing of a the contents of a syringe found in his flat, and by a health clinic's insistence that he undergo an unnecessary chest X-Ray.
Each chapter in this collection tells a story, and each story shines its own light. Together they capture the uniqueness of experience. They exemplify the need for ordinary kindness in a mental health service system and society that too frequently is rejecting and abusive. Although the philosophy of 'recovery' is briefly discussed, readers who want this sort of discussion will need to look elsewhere; it is simply not the purpose of this book to cover theoretical or conceptual issues in depth. The names covered in this section provide more than enough leads to the available literature (Bentall, Boyle, Mosher, Thomas, Anthony etc). The Madness of our Lives is rich in insights and anecdotes. Health professionals will feel chastened by the practices of some of their peers, and heartened by those who have genuinely connected with the people they seek to help. The variety of experiences is such that I imagine most people with experience of mental distress or illness will find something in this book that speaks to their experience. Penny Gray has done a fine job of bringing to life these experiences in voices that are fresh and clear.
The Madness of our Lives is a worthy contribution to the literature on first person accounts of mental distress and illness. Its strength is in the range of experiences it canvasses, and in the freedom given to interviewees to tell their own stories. This is a highly readable and informative book.
© 2007 Tony O'Brien
Tony O'Brien RN, MPhil, Senior Lecturer, Mental Health Nursing, University of Auckland, firstname.lastname@example.org
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