The Madhouse (1812-19)
The work of Francisco de Goya shows a touch of paranoia. Worry of going insane can cause quite a strain.
Understanding Mental Illness: A Comprehensive Guide to Mental Health Disorders for Family and Friends by Carlin Barnes
My rating: 4 of 5 stars
This book is a concise overview of mental illness for individuals who don’t know much about the subject, and who may hold misunderstandings about mental illness and the mentally ill. If that’s what you’re looking for, you’re in the right place. If you’d like to know more about the variations in particular disorders or about relatively obscure conditions, you’ll probably find this book doesn’t meet your needs. The book advocates for doing away with the stigma associated with mental illness and having a better idea of the nature of mental disorders.
The book has fourteen chapters that are mostly logically organized. I say “mostly,” because chapters three, ten, thirteen, and fourteen deal in unique situations facing specific demographics (children / teens, the elderly, women, and professional athletes, respectively.) I’m not sure why these are spread out with topics that have a tighter logic interspersed in between them. I also am not sure why there is a chapter specifically dealing with professional athletes. Mind you, I understand the author’s argument about the unique mental health risks afflicting professional athletes and retired pro athletes. However, it seems like there are other careers that create unique problems (e.g. air traffic controllers) that touch more lives. Given the fact that an important part of the author’s message is about how those with mental health issues are frequently misunderstood and stigmatized, it seems like if one had to pick one career group to represent in the book, one would find one that is bigger and more relatable (e.g. military personnel, cops, social workers, therapists, or even poor / unemployed people.) If it was done to appeal to the general readership’s interest in celebrity, it’s a fail.
Chapters 1 and 2 set the stage by discussing what exactly a mental illness is, how it can be distinguished from the quirks that we all have in varying ways and degrees, and what the various causes are. Chapters 4 through 9 are the heart of the book, and present information on various mental illnesses by type (i.e. mood disorders, anxiety disorders, psychotic disorders, personality disorders, eating disorders, and substance abuse, respectively.) Chapters 11 and 12 discuss suicide and mass shootings, both are worthy inclusions.
The chapters discuss the clinical criteria for various ailments (which often seem arbitrary, but that’s part of the need for such a book – to give readers an understanding of the difficulty of diagnosing the mentally ill.) There are brief case examples included throughout to help the reader recognize the signs. That said, there isn’t a lot of room to deal in the tremendous levels of variation seen within given disorders.
There is an appendix with resources and links. Otherwise, there isn’t much ancillary matter in the book.
I would recommend this book if you are looking for a quick overview of mental illness with some presentation of typical examples. Particularly if you want a handy convenient guide without a lot of searching about. [Which is to say, I don’t think there’s a great deal that one would get from this book that one wouldn’t find doing some internet research.]
The Collected Schizophrenias: Essays by Esmé Weijun Wang
My rating: 5 of 5 stars
Schizophrenia is ill-understood, and that’s just by psychiatrists and psychologists, the rest of us tend to downright misunderstand the condition. Wang’s book collects thirteen essays on her experience of living with schizo-affective disorder. I found Wang’s prose to be clever and engaging, though she does get into the weeds of technicality a bit in some of the early chapters. The book is not only well-written, it’s also brutally forthright. We hear a lot of how the author uses her alma mater (Yale) as a combination of sword and shield to combat the ever-present assumption she will be a stark-raving – not to mention dangerous — lunatic.
The book begins with discussion of diagnosis, but it doesn’t begin with her being diagnosed as Schizo-affective, but rather as Bipolar [formerly know as, manic-depressive.] There’s a great deal of discussion of the inexactitude of psychiatric science, and the fact that — to be fair — it’s not like every case is presents the same. The set of symptoms seen may create the potential to classify the same individual in different ways; hence, psychiatric diagnosis is often a long and winding road.
To list the essays with descriptions wouldn’t do them justice, so, instead, I’ll present some of the highlights. There’re a couple of chapters that look at how Wang tried to cope with, or counteract, the impression of people finding out she had schizophrenia. One of these involved the aforementioned repeated references to the Ivy-league institution that ultimately kicked her out and wouldn’t let her back in once she’d been treated and stabilized. Another was attachment to the label — and the idea — of “high-functioning,” which can be a hard sell for a condition like Schizophrenia. (Though not uniquely so. I once had a conversation with friend who didn’t understand that there could be such a thing as a “mild stroke.” This person believed that if one had any stroke one would surely be unable to talk correctly or have adult cognitive functioning. Though it occurs to me that my analogy is not entirely apt because anyone with a diagnosis of Schizophrenia will at some point experience severe symptoms – e.g. hallucination, delusion, etc. – otherwise they would be unlikely to be [rightly or wrongly] so diagnosed.)
There’s a chapter that deals with the question of having children. This brings up the twin questions of whether the schizophrenic can be a good parent throughout the development of the child, as well as how likely they are to pass on the trait through genes. [Those who’ve watched “A Beautiful Mind” will remember a scene in which the bathwater is rising on the baby because Nash is having an episode.]
Wang uses a number of sensationalist cases – e.g. murders – both to counteract the notion that all Schizophrenics are dangerous by contrasting with her own [more typical] experience, but also to let the reader know such extremes do exist. It should also be pointed out that one of these cases was the murder of a Schizophrenic by a family member who was living in terror that said schizophrenic (her brother) would ultimate kill her and her daughter, given the things he said and the auditory hallucinations he was said to have had.
One of the most interesting discussions for me was Wang’s description of leaving the Scarlett Johansson film “Lucy” asking her boyfriend whether what she saw was real. Everybody has that situation of being drawn into a film in an edge-of-the-seat fashion, but is fascinating to imagine a person who can’t disentangle from that state.
Chapter ten talks about the author’s experience with Cotard’s Syndrome. Cotard’s is a condition in which the individual believes they are deceased. I’ve read of Cotard’s in popular neuroscience books, but Wang’s first-hand account provides an extra level of connection to it.
The last essay discusses Wang’s pursuit of spirituality. It should be noted that in many tribal societies, Schizophrenics have been made shamans and are seen as having special powers. Wang doesn’t talk about this in great detail though she does a little [it is the premise of the series “Undone” on Amazon Prime], but it’s interesting to consider how religion and spirituality might influence the Schizophrenic mind.
I found this book fascinating and the writing to be elegant. I would highly recommend it for anyone with interests in the mind, mental illness, or just the experiences of other people.
Crazy For Alice by Alex Dunn
My rating: 5 of 5 stars
Ben has a secret and keeping it sends him into a depressive spiral. He’d had almost everything going for him. With his high IQ, he was sailing through school on his way to a top-tier college. He was also an athlete of local renown on the swim team. The only source of consternation in his life was a deadbeat drunk of a father, and the fact that said father recently passed away. Ben was in the car accident with his father, and was the last one to see him alive. Fortunately, Ben has an older brother who’s a cop, Gavin, who looks out for him and tries to keep an overbearing mother at bay.
After an attempted suicide via wrist slashing, Ben is institutionalized. It’s during this time that he drops into a coma. While he’s not conscious of the real world, his consciousness takes up residence in a place he calls “Gray World.” Besides being monochrome, Gray World exhibits the characteristics of a dream. The laws of physics, cause & effect, and consistency of space and time are all freely violated. Ben soon meets a girl named Alice who is initially cautious about him. Over time, the two develop an increasingly close relationship. Then Ben comes out of his coma.
In the real world, Ben is obsessed with getting back to the Gray World to rescue Alice. It seems that all the residents of Gray World are individuals suffering severe depression. The problem is that Ben only has a first name and a probable city of residency. Of course, to his mother, brother, friends, and doctors, this obsession is a sign that Ben’s depression has migrated into a full-blown delusional psychosis. His mother, terrified of losing him, treats Ben as a prisoner. Gavin, while well-meaning, feels the need to prove that Alice was just a dream.
I enjoyed the story and also found it to be thought-provoking. The characters are well-developed enough to care about, and the reader can see how each of the key players is trapped in his or her behavior—behaviors that are sub-optimal. At one point, I thought that it strained credulity that Ben took so long to realize he needed to play along to get some space for his search. He kept being forthright about his intentions to find Alice, and this just made his mother more nervous and smothering–and made Gavin more insistent. But it occurred to me that Ben’s ego as a genius kept him in that state. He wasn’t used to being challenged in his understanding of the world, and reacted to it poorly. He had a need to be right that overrode his capacity to recognize what those around him wanted to hear. His mother was trapped by fear into an increasingly suffocating form of love. Gavin, the most emotionally stable of the trio, thinks he can force Ben to accept an understanding of reality through the brute force of reason—missing that being right might not be as important as being compassionate.
I’d recommend this book for fiction readers. It’s written for the YA (young adult) market, but is intriguing for adults as well.
Challenger Deep by Neal Shusterman
My rating: 5 of 5 stars
“Challenger Deep” is the story of a smart and artistically talented young man, Caden Bosch, who is afflicted with Schizophrenia. There are essentially two story lines being told in parallel. One is the real world, and in the chapters in this line we see Caden’s descent as it takes place. From references to past events, we gain insight into how Caden was before the disease. In the early part of the book, these chapters are set at school and at home, and then later at the mental hospital at which he’s admitted as a patient.
In the other story, Caden is on a sailing ship headed to the Challenger Deep—the deepest portion of the Marianas Trench at almost 7 miles down, and—symbolically—Caden’s rock-bottom . Shipboard life is Caden’s hallucinated experience of the mental hospital. Over time the reader begins to match up characters from the real world with those from the delusion—both patients and staff members. This is a mutinous vessel, and the tension reflects the pull between Caden’s desire to be well and the appeal of the world of delusion.
Over time the author shows key events in both lines and the reader can connect them up to interpret how delusional Caden experiences the world. The story isn’t strictly told in a chronological order, though the broad sweep of it is. The bits of disjoint create no confusion while helping to convey the nature of a fractured mind. This works, in part, because the book is told over 161 short chapters, and, because the chapters are so short, a diversion doesn’t take one far and it’s easy to show the match up of events. The book artfully conveys the bizarreness of a dreamlike world of delusion while remaining clear and readable. Any confusion in the early chapters becomes rectified as the author reveals how the delusional world and the real world zip together.
This book was imaginative, enjoyable to read, as well as allowing the reader insight into the nature of mental illness. Atypical of a work of fiction, there is a resources section that provides contact information for organizations that support mental health.
I’d highly recommend this book for fiction readers.
5.) Veronika Decides to Die by Paulo Coelho
Premise: A young woman who attempted suicide is told that in the process her heart was damaged and she now has only five days to live. While it might seem that this would be all the same to a suicidal patient, it turns out to matter.
4.) Norwegian Wood by Haruki Murakami
Premise: The lead character, Toru, doesn’t suffer from mental illness, but his life is shaped by those who have. He must decide between two women. One of whom, Naoko, has been institutionalized since her boyfriend, Kizuki, committed suicide. Kizuki had been Toru’s high school best friend, and this weighs heavily in Toru’s feelings of obligation. Add into this Naoko’s roommate–a sage influence in Toru’s life, despite being institutionalized herself.
3.) Challenger Deep by Neal Shusterman
Premise: An adolescent boy, Caden Bosch, is transformed from a model student to a paranoid schizophrenic. The title refers to the deepest point on Earth, down in the Marianas Trench, and comes into play because the institutionalized Bosch believes he’s on a ship who’s Captain thinks all the treasure in the oceans got swept to the deepest point.
2.) Fight Club by Chuck Palahniuk
Premise: The unnamed narrator meets the eccentric Tyler Durden and soon Fight Club is born. It’s fueled by a feeling that men have been tamed to be turned into consumers. However, the underground fights are only the beginning, and our lead character is dismayed to discover that from the Club has sprung Project Mayhem with a nefarious terrorist plot.
1.) One Flew Over the Cuckoo’s Nest by Ken Kesey
Premise: Randle McMurphy has convinced authorities that he’s insane for the purpose of getting out of hard labor in prison and into a “cushy” insane asylum. The ward is run by the iron hand of Nurse Ratched. McMurphy on the other hand is rebellious and unruly. The clash is inevitable. McMurphy increasingly disrupts Ratched’s sedate and harmonious ward (re: heavily drugged and cowed into submission.) The story is told from the perspective of a patient named Chief Bromden who has the staff convinced that he’s deaf and mute. Like McMurphy, he’s not what he appears. The book is a scathing indictment of how mental health care was conducted in Kesey’s day.