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The Journal of NAMI California, Issue 4: "WOMEN and Mental Illness", is a collection of articles written by mental health practitioners and women who suffer from mental illness. Often, authors embody both roles. The journal seems to be directed mainly to women who suffer from mental illness, and to a lesser degree, practitioners who work with this population.
Unlike more scientific journals, with a hard-core experimental and statistical basis, this journal focuses on the personal stories and experiences of women who have been involved with the mental health profession, as consumers or providers. This lack of a scientific tone does not detract in any way from the main theme of recognizing how women are marginalized and hidden behind the predominantly male-orientated diagnosis and treatment methodology of psychiatric profession. A secondary, underlying theme is how mental illness affects women in their role as mothers, from both the perspective mothers and of their children.
The articles fall under three basic themes. The most prolific is a theme of the special difficulties women face when dealing with mental illness in their social context. The emphasis here, by the both the thrust of the articles, and the experiences of the women themselves, is family dynamics. Linda C. Tolizian's article, "They Tell Me Suicide is Not the Answer" explores her experience with bipolar disorder and how it has affected her relationship with her children and extended family. Ms. Tolizian articulately expresses the emotional struggle and terror she experiences when dealing with what should be joyful events, like her son's wedding. She writes about her mourning for what she has lost through her illness, her son's respect as a strong single parent. Colleen King's article, "My Personal Journey" discusses her attempts to document and thereby understand her major depression through photography. Her photographs accompany the article, illuminating her emotional turmoil and how it affects her interactions with her husband and son.
The second basic theme is of our culture's impact on the mental health of women. Three articles dealing with eating disorders are the most obvious of this type. The three explore the issue from different angles. The first, "Eating Disorders", by Barton J. Blinder, MD, Diane Ketty, and Visant A. Sanathara, is clinical exploration of the disorder, with treatment recommendations. The second, "Living in Fear of Food", by Leah Berkowitz, is the personal story of a young woman who is recovering from a combination of bulimia and anorexia. The third, "Eating Disorders in a Disordered Culture", by Kathryn Sylva and Robin Lasser, is a description of an artistic and informative project which takes he stories of women who suffer from eating disorders and creates a visual and audio immersion in their world. The authors have also compiled reactions to the project. These, combined, have provided the material for an advertising campaign designed to challenge those components of our culture that contribute to eating disorders. This article was very moving. One of the quotes, "what angers me most is that I received so many compliments from guys when I was anorexic. I was the same size that I was when I was a fourth grader. Couldn't they see that I was sick?" (page 44) is an excellent illustration of the forces in our culture that influence the prevalence of eating disorders in young women.
Also included in this theme is a collection of articles which examine how victimization of women contributes to and interacts with mental illness. "A Trauma Recovery and Empowerment Group Model" by Maxine Harris, Ph.D. and Marlene Dunsmore, MSW, describes the author's discovery of the prevalence of physical and sexual abuse histories in the client population and their methods of treatment. Two articles, "Ashbury House" by Bonnie Fluke, MA, and "Tangled in the Criminal Justice System" by Karen Streich, Ph.D., describe how our criminal justice and mental health systems are not designed for women with children, and in fact further victimize or punish women and children by separating families.
The final theme is that of examining how women's physiology and hormonal structure command a different treatment for mental illness than that which is appropriate for men. The most overt of these articles is "Gender Matters" by Beverly Abbott, L.C.S.W., Gale Bataille, L.C.S.W., and Sandra Naylor Goodwin, Ph.D., MSW. The Authors examine the problems with current treatment as related to social physiological, and emotional issues, and then recommend improvements in treatments and services. There is also a series of articles which examine the dynamics of mental illness interacting with women's reproductive cycles across a lifespan.
One notable feature of "WOMEN and Mental Illness" s the laudable absence of language comparing women to men to explain or illustrate an issue. Women are allowed to exist and define themselves independently. This is very comforting in a journal which exists to allow women their proper place in psychology and psychiatry, which is to say, a central and respected role.
This journal is clearly not seeking to add to the scientific literature of the profession. If the intended audience of "WOMEN and Mental Illness" is the clinical population, the overt purpose seems to be to change and modify the way women are viewed and treated, socially as well as clinically. While this is an admirable goal, the current format does not seem to be strong enough to meet that goal. The abundance of personal stories certainly illustrates the problems of mentally ill women. However, the reader is left wondering, " But what can I do?"
If the intended audience of "WOMEN and Mental Illness" is women suffering from mental illness, the purpose would seem to be offering the comfort of recognition and sisterhood through the stories of other afflicted women. The authors certainly have written passionate and emotive, yet articulate descriptions of their experiences. However, there is often an almost palatable feeling of despair. "Failure to Thrive" by Brenda J. Smith, is an angry lament for a life devastated by mental illness. "The Judicial Suicide of Priscilla Ford" by James Richard Lucas is a narrative of a woman who finds no help for her problems, and is sentenced to death when she succumbs to her schizophrenic homicidal urges. The previously mentioned article, "They Tell Me Suicide is not the Answer" by Tolizian, details the author's continued struggle against the lure of suicide. It doesn't seem like she's winning. There isn't much hope to be found in these personal stories, and therefore more harm than comfort to be garnered for mentally ill women.
The true strength of this journal is its use as a resource for accurate, moving, primary-source explorations of living with mental illness as a woman. That can certainly not be discounted as being valuable to students, clinicians, and, especially, to women seeking to further understand their own lives.